Prospective comparative study of extra-articular distal tibia fractures-intramedullary nailing versus medial minimally invasive percutaneous plating

Background: The distal tibia extra-articular fractures are treated with both intramedullary nailing (IMN) and medial minimally invasive percutaneous plate osteosynthesis (MIPPO). The aim of this study was to compare the results of IMN and medial MIPPO in distal tibia fractures. The complications and secondary interventions in both groups were compared.Methods: Fifty patients with distal tibia were randomly assigned to IMN (group 1) and medial MIPPO group           (group 2). The functional outcomes were evaluated using American Orthopaedic Foot and Ankle Society (AOFAS) score. Complications like infection, delayed union, non-union, malunion, hardware prominence and secondary interventions were compared.Results: The average union time was 21.12±6.93 weeks in group 1 and 23.56±6.96 weeks in group 2 (p=0.220). The mean AOFAS scoring was 90.76±7.9 in group 1 and 88.4±8.33 in group 2 (p=0.339). Five patients in group 1 and one in group 2 had malalignment. Deep infection was present in one and superficial infection was present in two cases in group 2. None of the patients in group 1 had infections. Three patients in group I developed anterior knee pain and six in group 2 had hardware prominence. Seven cases in IMN group required secondary interventions and fourteen in medial MIPPO group.Conclusions: Extra-articular distal tibia fractures are successfully treated with IMN and medial MIPPO with comparable functional outcomes. Prevalence of malunion was higher in IMN group and hardware prominence was more prevalent in MIPPO group. Implant removal are more in medial MIPPO group mostly due to implant irritation.

Predictors of Mucormycosis in COVID-19

Background and Aims: Mucormycosis, a serious angioinvasive infection caused by common filamentous fungi, that is, mucormycetes, constitutes the third most common invasive fungal infection, following aspergillosis and candidiasis. Although a rare infection, in recent times we witnessed a sudden surge of mucormycosis cases post-COVID-19 (coronavirus disease 2019). The present study was carried out to understand its relation to COVID-19, inflammatory markers, steroid use during COVID-19 treatment, clinical course and outcome of the disease. Material and methods: The present study was conducted at RNT Medical College, Udaipur over a period of 1 month. Written and informed consent from patients were taken. In this study, 15 patients admitted in COVID wards, medical wards, muormycosis ward and ICU were included if fungal hyphae were found on potassium hydroxide (KOH) mount and there was a history of COVID-19 illness; negative KOH mount patients were excluded. Results: In the present study, on admission, out of 15 patients, 7 (46.7%) were admitted with mean neutrophil-to-lymphocyte ratio (NLR) >5.5, mean C-reactive protein (CRP) 126, mean interleukin (IL)-6 82.4, mean lactate dehydrogenase (LDH) 528, mean ferritin 662, mean D-dimer 1760; 5 (33.3%) patients were admitted with mean NLR 3.5-5.5, mean CRP 68, mean IL-6 39.6, mean LDH 336, mean ferritin 448, mean D-dimer 780; and 3 (20%) patients were admitted with mean NLR <3.5, mean CRP 16, mean IL-6 12.8, mean LDH 172, mean ferritin 226, mean D-dimer 430. Out of the 7 patients who were admitted with NLR >5.5, 3 (42.8%) were admitted with orbital cellulitis and 4 (57.2%) with invasive sinusitis. Out of 5 patients admitted with NLR 3.5-5.5, 3 (60%) were admitted with orbital cellulitis and 2 (40%) with invasive sinusitis. Out of 3 patients admitted with NLR <3.5, 1 (33.3%) patient had orbital cellulitis and 2 (66.7%) had invasive sinusitis. Out of total 7 patients who were admitted with orbital cellulitis, in 71.4% patients, steroid was used during COVID-19 treatment and out of 8 patients who were admitted with invasive sinusitis, in 62.5% patients, steroid was used during COVID-19 treatment. In the present study, 68% patients were male and 32% were female. Around 78% patients were from rural area and 22% patients were from urban area. Overall, 74% cases were treated with amphotericin B. Among these, 36% cases were diagnosed with orbital cellulitis and 38% cases were diagnosed with invasive sinusitis. Around 26% cases were treated with posaconazole, and among these 9% were orbital cellulitis cases and 17% were invasive sinusitis cases. About 85.72% cases of orbital cellulitis and 75% cases of invasive sinusitis improved. Nearly 42.86% cases who were admitted with NLR >5.5 did not improve with treatment. Conclusion: As per present study, inflammatory markers of COVID-19, NLR and history of steroid use during treatment can be considered as predictors of mucormycosis occurrence and their outcom

A retrospective (2004-2013) and prospective (2014-2015) study of new born with special reference to anorectal malformations over a period of 10 years at a tertiary care centre

Background:A surgical audit of neonates with anorectal malformation in advanced tertiary neonatal care unit.Methods: A retrospective (2004-2013) and prospective (2014-2015) audit of medical records of newborn with GIT disorders admitted in a tertiary care center of central India. The trends analyzed for the duration based on gender, region and birth weight and data base was generated depicting the burden of disease in the region. The data base for the prospective study was also compared with a tertiary center from Nigeria.Results:Total 3309 admission included 73.56% (2438) patients of GIT diseases. Congenital anomalies were the most common cause in each category, major part being anorectal malformation (727) and trachea-esophageal fistula (730). Out of 727 admissions, 651 neonates were operated & total 1194 deaths recorded during this audit year 2004 to July 2015. Majority of new born admitted with were low birth weight male from rural skirts of this region. 509 have associated anomalies and 218 isolated ARM.  Conclusions:There is significant increase in admissions in last decade with triple fold increase in GIT disorder and twice rate in anorectal malformation substantially increasing onwards. The quality of management has to continue further to achieve parity with international standards, as there is lack of antenatal screening and details of any antenatal checkup are scarce, for congenital anomalies at primary level. Early recognition, risk stratification of the baby and timely referral to higher pediatric surgery units is the way forward

Strukturella modifieringar av polyesterfibrer inducerade av termiska och kemiska behandlingar för att erhålla högpresterande fibrer

Del A: Polyetylentereftalat fibrer I detta arbete presenteras olika metoder för att framställa monofilament av polyetylentereftalat (PET) (diameter: 30-50 µm) med en radiell gradient. Nyutvecklad Raman-spektroskopiteknik har använts för att kartlägga dessa inducerade radiella gradienter i t.ex. kristallinitet. På liknande sätt har FTIR-ATR teknik modifierats och anpassats för att studera ytegenskaperna hos dessa filament. Industriella filamentprover och egna smältspunna PET-filament har framgångsrikt modifierats med användning av olika termiska och kemiska behandlingar för att erhålla fibrer med förbättrade mekaniska egenskaper och minskad fibrillering. De strukturella förändringar som uppträdde i filamenten på mikroskopisk nivå karakteriserades med bl a infraröd analys, termisk analys, Raman-mikroskopi och röntgenteknik (SAXS och WAXD). Tester av fibrilleringsegenskaper utfördes av industriella partners med egenutvecklad teknik följt av testning av masterbatch-fibrer på en vävningssimulator. Resultaten i laboratorieskala avslöjade fibrernas strukturella anisotropi och radiella gradienter, vilka visade en minskad fibrillering med en viss inverkan på de mekaniska egenskaperna.  Del B: Poly(3-hydroxybutyrat) fibrer Detta arbete presenterar studier av poly(3-hydroxybutyrat) (P3HB) fibrer med reversibla strukturförändringar. Tidigare studier har visat att kristallisationen hos P3HB fibrer i huvudsakligen sker i ortorombisk α-kristallform. Stress-anlöpning resulterar dock i en förändring i beteendet hos P3HB-materialet. Strukturen hos P3HB fibrer består av amorfa och kristallina regioner samt en mesofas. Mesofasen antas vara belägen mellan α-kristallerna och uppträder som starkt orienterade bindningskedjor, s k “tie-chains”. Denna studie syftar till att observera effekten av stress-anlöpning på mesofasen och dess beroende av anlöpningsförhållandena. Förändringarna i mesofasen observeras med en anpassad och polariserad Attenuated Total Reflection Fourier Transform Infrared Spectroscopy (ATR-FTIR) samt med Differential Scanning Calorimetry (DSC). Resultaten från ATR-FTIR visar att mesofasen är närvarande i spunna och högt stress-anlöpta fibrer, medan den är frånvarande i fibrer som är lågt stress-anlöpta. Mesofasen kan emellertid återupptas i lågt stress-anlöpta fibrer genom dragning. In situ ATR-FTIR användes för att studera förändringarna i materialbeteendet under en dragningsprocess för att observera periodiciteten i förekomsten av mesofasen. Det visade sig att förekomsten av mesofasen är en starkt reversibel process som observeras som en funktion av topparnas intensitet i ATR-FTIR.Part A: Poly(ethylene terephthalate) fibres In this work, various methods to produce Poly(ethylene terephthalate) (PET) monofilaments (diameter: 30-50µm) with a radial gradient are presented along with a newly developed Raman spectroscopy technique to map these induced radial gradients in e.g. crystallinity. On similar lines, FTIR-ATR technique has been modified and adapted to study the surface properties of these fine filaments. Industrial filament samples and in-house melt-spun PET filaments have been successfully modified using various thermal and chemical treatments to obtain fibres with improved mechanical properties and reduced fibrillation. The structural changes occurring in the filaments on the microscopic level were characterized using infrared analysis, thermal analysis, Raman microscopy and X-ray techniques (SAXS and WAXD) among others. The fibrillation properties were tested by the industrial partners using a technique developed in-house followed by testing of masterbatch fibres on a weaving simulator. Lab-scale results revealed the structural anisotropy and radial gradient maps of the fibres which also demonstrated reduced fibrillation with some impact on mechanical properties also being observed. Part B: Poly(3-hydroxybutyrate) fibres This work presents studies on poly(3-hydroxybutyrate) (P3HB) fibres with reversible structural changes. Previously reported literature shows that crystallization of P3HB fibres takes place majorly in the orthorhombic α-crystal form. However, the stress-annealing results in a change of the material behaviour of P3HB. P3HB fibres compose of amorphous regions, crystalline regions and mesophase in their structure. The mesophase is supposed to be located in between the α-crystals of the material as highly oriented tie-chains. This study targets to observe the effect of stress-annealing of the mesophase present in the P3HB fibres and its dependence on the annealing conditions. The changes in the mesophase content are observed with the help of a highly adapted polarized Attenuated Total Reflection Fourier Transform Infrared spectroscopy (ATR-FTIR) and Differential Scanning Calorimetry (DSC). The presented results from polarized ATR-FTIR show that the mesophase is present in as-spun and high stress annealed fibres while it is absent in fibres annealed with low stress. However, the mesophase can be re-obtained in low stress annealed fibres through tensile drawing. In-situ ATR-FTIR was utilized to study the changes in the material behaviour during a tensile drawing process to observe the cyclicity in the occurrence of the mesophase. It was found that the existence of mesophase is a highly reversible process observed as a function of the peak intensities of the polarized ATR-FTIR spectroscopy

Strukturella modifieringar av polyesterfibrer inducerade av termiska och kemiska behandlingar för att erhålla högpresterande fibrer

Del A: Polyetylentereftalat fibrer I detta arbete presenteras olika metoder för att framställa monofilament av polyetylentereftalat (PET) (diameter: 30-50 µm) med en radiell gradient. Nyutvecklad Raman-spektroskopiteknik har använts för att kartlägga dessa inducerade radiella gradienter i t.ex. kristallinitet. På liknande sätt har FTIR-ATR teknik modifierats och anpassats för att studera ytegenskaperna hos dessa filament. Industriella filamentprover och egna smältspunna PET-filament har framgångsrikt modifierats med användning av olika termiska och kemiska behandlingar för att erhålla fibrer med förbättrade mekaniska egenskaper och minskad fibrillering. De strukturella förändringar som uppträdde i filamenten på mikroskopisk nivå karakteriserades med bl a infraröd analys, termisk analys, Raman-mikroskopi och röntgenteknik (SAXS och WAXD). Tester av fibrilleringsegenskaper utfördes av industriella partners med egenutvecklad teknik följt av testning av masterbatch-fibrer på en vävningssimulator. Resultaten i laboratorieskala avslöjade fibrernas strukturella anisotropi och radiella gradienter, vilka visade en minskad fibrillering med en viss inverkan på de mekaniska egenskaperna.  Del B: Poly(3-hydroxybutyrat) fibrer Detta arbete presenterar studier av poly(3-hydroxybutyrat) (P3HB) fibrer med reversibla strukturförändringar. Tidigare studier har visat att kristallisationen hos P3HB fibrer i huvudsakligen sker i ortorombisk α-kristallform. Stress-anlöpning resulterar dock i en förändring i beteendet hos P3HB-materialet. Strukturen hos P3HB fibrer består av amorfa och kristallina regioner samt en mesofas. Mesofasen antas vara belägen mellan α-kristallerna och uppträder som starkt orienterade bindningskedjor, s k “tie-chains”. Denna studie syftar till att observera effekten av stress-anlöpning på mesofasen och dess beroende av anlöpningsförhållandena. Förändringarna i mesofasen observeras med en anpassad och polariserad Attenuated Total Reflection Fourier Transform Infrared Spectroscopy (ATR-FTIR) samt med Differential Scanning Calorimetry (DSC). Resultaten från ATR-FTIR visar att mesofasen är närvarande i spunna och högt stress-anlöpta fibrer, medan den är frånvarande i fibrer som är lågt stress-anlöpta. Mesofasen kan emellertid återupptas i lågt stress-anlöpta fibrer genom dragning. In situ ATR-FTIR användes för att studera förändringarna i materialbeteendet under en dragningsprocess för att observera periodiciteten i förekomsten av mesofasen. Det visade sig att förekomsten av mesofasen är en starkt reversibel process som observeras som en funktion av topparnas intensitet i ATR-FTIR.Part A: Poly(ethylene terephthalate) fibres In this work, various methods to produce Poly(ethylene terephthalate) (PET) monofilaments (diameter: 30-50µm) with a radial gradient are presented along with a newly developed Raman spectroscopy technique to map these induced radial gradients in e.g. crystallinity. On similar lines, FTIR-ATR technique has been modified and adapted to study the surface properties of these fine filaments. Industrial filament samples and in-house melt-spun PET filaments have been successfully modified using various thermal and chemical treatments to obtain fibres with improved mechanical properties and reduced fibrillation. The structural changes occurring in the filaments on the microscopic level were characterized using infrared analysis, thermal analysis, Raman microscopy and X-ray techniques (SAXS and WAXD) among others. The fibrillation properties were tested by the industrial partners using a technique developed in-house followed by testing of masterbatch fibres on a weaving simulator. Lab-scale results revealed the structural anisotropy and radial gradient maps of the fibres which also demonstrated reduced fibrillation with some impact on mechanical properties also being observed. Part B: Poly(3-hydroxybutyrate) fibres This work presents studies on poly(3-hydroxybutyrate) (P3HB) fibres with reversible structural changes. Previously reported literature shows that crystallization of P3HB fibres takes place majorly in the orthorhombic α-crystal form. However, the stress-annealing results in a change of the material behaviour of P3HB. P3HB fibres compose of amorphous regions, crystalline regions and mesophase in their structure. The mesophase is supposed to be located in between the α-crystals of the material as highly oriented tie-chains. This study targets to observe the effect of stress-annealing of the mesophase present in the P3HB fibres and its dependence on the annealing conditions. The changes in the mesophase content are observed with the help of a highly adapted polarized Attenuated Total Reflection Fourier Transform Infrared spectroscopy (ATR-FTIR) and Differential Scanning Calorimetry (DSC). The presented results from polarized ATR-FTIR show that the mesophase is present in as-spun and high stress annealed fibres while it is absent in fibres annealed with low stress. However, the mesophase can be re-obtained in low stress annealed fibres through tensile drawing. In-situ ATR-FTIR was utilized to study the changes in the material behaviour during a tensile drawing process to observe the cyclicity in the occurrence of the mesophase. It was found that the existence of mesophase is a highly reversible process observed as a function of the peak intensities of the polarized ATR-FTIR spectroscopy

Intradural Extramedullary Spinal Metastasis from an Ovarian Carcinoma

Intradural extramedullary metastases from tumours are a rare occurrence, accounting for less than 2 percent of all spinal metastases. We report a patient who presented with progressive paraparesis one and a half years after being operated for an poorly differentiated serous cystadenocarcinoma. Tumour mass decompression was carried out and the intradural tumour metastasis was removed. Histopathology revealed an identical appearance to the original ovarian tumour. This is the first reported case of an intradural extramedullary metastasis from a poorly differentiated serous cystadenocarcinoma of the ovary

Intradural Extramedullary Spinal Metastasis from an Ovarian Carcinoma

Intradural extramedullary metastases from tumours are a rare occurrence, accounting for less than 2 percent of all spinal metastases. We report a patient who presented with progressive paraparesis one and a half years after being operated for an poorly differentiated serous cystadenocarcinoma. Tumour mass decompression was carried out and the intradural tumour metastasis was removed. Histopathology revealed an identical appearance to the original ovarian tumour. This is the first reported case of an intradural extramedullary metastasis from a poorly differentiated serous cystadenocarcinoma of the ovary

Magnetic activated cell sorting (MACS): Utility in assisted reproduction

491-497Assisted reproductive techniques (ART) have now been extensively incorporated in the management of infertile couples. But even after rapid methodological and technological advances the success rates of these procedures have been below expectations. This has led to development of many sperm preparation protocols to obtain an ideal semen sample for artificial reproduction. Sperm apoptosis has been heavily linked to failures in reproductive techniques. One of the earliest changes shown by apoptotic spermatozoa is externalization of phosphatidyl serine. Magnetic activated cell sorting (MACS) is a novel sperm preparation technique that separates apoptotic and non-apoptotic spermatozoa based on the expression of phosphatidylserine. This has led to the incorporation of MACS as a sperm preparation technique. The review highlights the principle and mechanism of this novel technique and enumerates its advantages as a sperm preparation technique. Its utility in ART as an efficient tool for sperm recovery and its application in cryopreservation of semen samples is also explained

Effect of Row Spacing and Nitrogen Sources on Growth, Yield and Economics of Babycorn (Zea mays L.)

The greater challenges of the 21st century is affordably meeting nutritious food demand for a world population which were expected to surpass 9.6 billion people at middle of the century and at the same time sustaining a quality and quantity of a natural resources and biodiversity. Coming to the reality a need of urgent attention for technological innovations in a sector of food production ultimately leading for “greater protein and energy production per unit of resource input”. Therefore, a field experimented was conducted at Chamelti Agriculture Farm, MS Swaminathan School of Agriculture, Shoolini University of Biotechnology and Management Sciences, Solan during kharif season of 2022 to study the effect of row spacing and nitrogen sources on growth, yield and economics of babycorn. The results reveals that significantly higher growth and yield attributing characters were observed with wider spacing of (R3) 60 cm and (N4) nano urea. However, higher yield and economic returns were significantly higher with row spacing of (R2) 45 cm along with (N4) nano urea. On the basis of B: C ratio, row spacing of (R2) 45 cm along with (N4) nano urea was found to be remunerative for baby corn under Mid hills of Himachal Pradesh