Long-standing unreduced anterior dislocation of the knee - a case report

A case of long standing unreduced anterior dislocation of the knee for 2 months has been reported which was treated first with open reduction and external fixation at 70° flexion of knee followed by gradual extension of knee. Once full extension was achieved, the cylindrical cast was applied for 3 months. The final range of movement of knee at one year follow up was 5-70º along with painless weight bearing. To conclude, this conservative treatment could be one of the valuable option for the patients who can not undergo major surgery because of genreral health problem, or unable to afford for the surgery especially in developing countries, or not willing for arthrodesis.KEY WORDS: Knee joint; Dislocation; Conservative treatmen

Anaesthetic considerations in patients with transverse myelitis

Transverse myelitis is an acute or subacute inflammatory disorder involving the spinal cord. Clinical signs are due to the involvement of the ascending and descending tracts in the transverse plane of the spinal cord. The most common cause is autoimmune. These patients may present with various clinical findings with which it is important for the anaesthesiologist to be familiar in order to manage such cases during the intraoperative and postoperative period. This report discusses issues relating to management of such cases

Molecular cloning of HSP17 gene (sHSP) and their differential expression under exogenous putrescine and heat shock in wheat (Triticum aestivum)

Polyamines (PAs) are low molecular weight ubiquitous nitrogenous compounds found in all the living  organisms, which have been implicated in the expression of various stress-proteins against the abiotic  stresses. Small heat shock proteins (sHSPs) are of particular importance in the thermotolerance and have  been reported to act as molecular chaperones preventing denaturation or aggregation of the target proteins. Here, we report cloning of a small HSP of ~573 bp from C-306 cultivar of wheat (Triticum aestivum L), having open reading frame of 162 amino acids. In silico analysis showed the presence of an alpha crystalline domain (ACD), the signature domain for small HSPs. Consensus localization prediction (ConLoc) provides 98%  consensus prediction of HSP17 in the nucleus. Quantitative real time polymerase chain reaction (qRT-PCR) analysis of HSP17 gene showed maximum (34 fold) transcript in C-306 and minimum (1.5 fold) in HD2329  cultivars of wheat in response to differential treatment of putrescine (1.5 to 2.5 mM + heat shock of 42°C for 2 h). Putrescine seems to enhance the transcript levels against the heat shock much more pronounced in  thermotolerant than in the susceptible cultivars.Key words: Triticum aestivum, heat stress, small heat shock protein, putrescine, HSP17, polyamine, domain, cloning

Phylogenomic analyses and distribution of terpene synthases among Streptomyces

This is the final version. Available on open access from Beilstein-Institut via the DOI in this recordTerpene synthases are widely distributed among microorganisms and have been mainly studied in members of the genus Streptomyces. However, little is known about the distribution and evolution of the genes for terpene synthases. Here, we performed whole-genome based phylogenetic analysis of Streptomyces species, and compared the distribution of terpene synthase genes among them. Overall, our study revealed that ten major types of terpene synthases are present within the genus Streptomyces, namely those for geosmin, 2-methylisoborneol, epi-isozizaene, 7-epi-α-eudesmol, epi-cubenol, caryolan-1-ol, cyclooctat-9-en-7-ol, isoafricanol, pentalenene and α-amorphene. The Streptomyces species divide in three phylogenetic groups based on their whole genomes for which the distribution of the ten terpene synthases was analysed. Geosmin synthases were the most widely distributed and were found to be evolutionary positively selected. Other terpene synthases were found to be specific for one of the three clades or a subclade within the genus Streptomyces. A phylogenetic analysis of the most widely distributed classes of Streptomyces terpene synthases in comparison to the phylogenomic analysis of this genus is discussed.NW

Objective Ultrasonic Characterization of Welding Defects Using Physically Based Pattern Recognition Techniques

Computer-based methods for analysing ultrasonic data to distinguish between different defect types have been based on a variety of techniques such as adaptive learning [1], artificial intelligence [2] and statistical pattern recognition [3]. The uncertain classification reliability of these techniques when applied to a range of realistic defect types has, however, often been a significant practical limitation to their use

The ORthopaedic Trauma Hospital Outcomes - Patient Operative Delays (ORTHOPOD) study

Aims: This is a multicentre, prospective assessment of a proportion of the overall orthopaedic trauma caseload of the UK. It investigates theatre capacity, cancellations, and time to surgery in a group of hospitals that is representative of the wider population. It identifies barriers to effective practice and will inform system improvements. Methods: Data capture was by collaborative approach. Patients undergoing procedures from 22 August 2022 and operated on before 31 October 2022 were included. Arm one captured weekly caseload and theatre capacity. Arm two concerned patient and injury demographics, and time to surgery for specific injury groups. Results: Data was available from 90 hospitals across 86 data access groups (70 in England, two in Wales, ten in Scotland, and four in Northern Ireland). After exclusions, 709 weeks' of data on theatre capacity and 23,138 operations were analyzed. The average number of cases per operating session was 1.73. Only 5.8% of all theatre sessions were dedicated day surgery sessions, despite 29% of general trauma patients being eligible for such pathways. In addition, 12.3% of patients experienced at least one cancellation. Delays to surgery were longest in Northern Ireland and shortest in England and Scotland. There was marked variance across all fracture types. Open fractures and fragility hip fractures, influenced by guidelines and performance renumeration, had short waits, and varied least. In all, nine hospitals had 40 or more patients waiting for surgery every week, while seven had less than five. Conclusion: There is great variability in operative demand and list provision seen in this study of 90 UK hospitals. There is marked variation in nearly all injuries apart from those associated with performance monitoring. There is no evidence of local network level coordination of care for orthopaedic trauma patients. Day case operating and pathways of care are underused and are an important area for service improvement

Bianchi Type-II String Cosmological Models in Normal Gauge for Lyra's Manifold with Constant Deceleration Parameter

The present study deals with a spatially homogeneous and anisotropic Bianchi-II cosmological models representing massive strings in normal gauge for Lyra's manifold by applying the variation law for generalized Hubble's parameter that yields a constant value of deceleration parameter. The variation law for Hubble's parameter generates two types of solutions for the average scale factor, one is of power-law type and other is of the exponential form. Using these two forms, Einstein's modified field equations are solved separately that correspond to expanding singular and non-singular models of the universe respectively. The energy-momentum tensor for such string as formulated by Letelier (1983) is used to construct massive string cosmological models for which we assume that the expansion ($\theta$) in the model is proportional to the component $\sigma^{1}_{~1}$ of the shear tensor $\sigma^{j}_{i}$. This condition leads to $A = (BC)^{m}$, where A, B and C are the metric coefficients and m is proportionality constant. Our models are in accelerating phase which is consistent to the recent observations. It has been found that the displacement vector $\beta$ behaves like cosmological term $\Lambda$ in the normal gauge treatment and the solutions are consistent with recent observations of SNe Ia. It has been found that massive strings dominate in the decelerating universe whereas strings dominate in the accelerating universe. Some physical and geometric behaviour of these models are also discussed.Comment: 24 pages, 10 figure

Excess mortality from chronic physical disease in psychiatric patients - The forgotten problem

The article discusses various reports published within the issue, including one by David Lawrence and Joanne Pais on the mortality rate of mentally ill, another by Chris J. Busche and Richard Hodgson on cancer complexities, and on the incidence of chronic disorders among Canadians

Association between depression and diabetes in the South-Eastern zone of the state of Uttar Pradesh-India: A cross-sectional study

Background: Depression is among the most common mental health problems among people with chronic complications like type 2 diabetes mellitus is brought on by flaws in insulin secretion and activity; however, genetic factors also play a role in both insulin resistance and beta-cell failure, but environmental factors also play a role in aggravating both problems. The presence of depression in patients with type 2 diabetes may interfere with treatment and efficacy. This study aimed to determine the prevalence of depression in this metabolic variant clinical condition, type 2 diabetes mellitus, in major tertiary care hospitals in the South-Eastern Uttar Pradesh cities of Allahabad and Varanasi. Subjects and methods: For this study, 206 subjects with type 2 diabetes mellitus from rural and urban areas were recruited. Demographic, clinical, and diabetes-related data were collected using a semi-structured questionnaire. Depression was assessed using the Patient Health Questionnaire 9 (PHQ9), a standardized questionnaire developed in the United States and validated in the Indian population. Results: The prevalence of depression in diabetics in the community was 43.2%. The most common type of depression was mild (29.3%, 26), and the least common was severe depression (3, 3.37%). Several factors were associated with depression in the female gender: living in a rural area, unemployment, and being single. The complications of diabetes and other chronic conditions, such as hypertension and obesity, are also associated with depression. Conclusion: Depression was found to be particularly high in the study population. Because depression can significantly impede patient adherence to treatment, there is an urgent need for early diagnosis and treatment. This requires integrating mental health care for diabetes patients

Robustness Verification of Support Vector Machines

We study the problem of formally verifying the robustness to adversarial examples of support vector machines (SVMs), a major machine learning model for classification and regression tasks. Following a recent stream of works on formal robustness verification of (deep) neural networks, our approach relies on a sound abstract version of a given SVM classifier to be used for checking its robustness. This methodology is parametric on a given numerical abstraction of real values and, analogously to the case of neural networks, needs neither abstract least upper bounds nor widening operators on this abstraction. The standard interval domain provides a simple instantiation of our abstraction technique, which is enhanced with the domain of reduced affine forms, which is an efficient abstraction of the zonotope abstract domain. This robustness verification technique has been fully implemented and experimentally evaluated on SVMs based on linear and nonlinear (polynomial and radial basis function) kernels, which have been trained on the popular MNIST dataset of images and on the recent and more challenging Fashion-MNIST dataset. The experimental results of our prototype SVM robustness verifier appear to be encouraging: this automated verification is fast, scalable and shows significantly high percentages of provable robustness on the test set of MNIST, in particular compared to the analogous provable robustness of neural networks