Accuracy of clinical diagnosis in meniscal tears

Introduction: Meniscal injuries of the knee are common indications for arthroscopic knee surgery. Most of the meniscal tears can be diagnosed by clinical evaluation alone. This study aims to test the accuracy of the commonly performed tests for meniscal tears in our set up. Method: This was a prospective observational study of 32 symptomatic knees that underwent clinical evaluation followed by arthroscopy. The sensitivity, specificity and diagnostic accuracy of three clinical tests (McMurray’s test, Apley’s compression test and Joint line tenderness) were calculated against arthroscopic findings. Result: Among clinical tests, maximum sensitivity (94.44%) was with Joint Line Tenderness for Medial Meniscus Tear (MMT) and minimum (54.54%) with Apley’s Compression Test for Lateral meniscus Tear (LMT). Specificity was maximum (90.48%) with Joint Line Tenderness for LMT and minimum (64.28%) with Apley’s Compression Test for MMT. Diagnostic accuracy was maximum (90.6%) with McMurray’s test for LMT and minimum (75%) with Apley’s Compression Test for MMT and LMT. Conclusion: All three clinical tests (McMurray’s, Apley’s compression and Joint line tenderness) were found reliable for diagnosing meniscus tears. Joint Line Tenderness had the best diagnostic accuracy followed by McMurray’s test

Logarithmic Corrections to Twisted Indices from the Quantum Entropy Function

We compute logarithmic corrections to the twisted index $B^g_6$ in four-dimensional $\mathcal{N}=4$ and $\mathcal{N}=8$ string theories using the framework of the Quantum Entropy Function. We find that these vanish, matching perfectly with the large--charge expansion of the corresponding microscopic expressions.Comment: v2 : 22 pages, presentation significantly improved, published in JHE

Labial adhesion or fusion-an unusual cause of urinary incontinence in an elderly woman

Labial adhesion/fusion is an uncommon cause of urinary and vulval complaints in adult females, with unknown incidence. We present a case report of an elderly woman who presented with voiding difficulty, recurrent urinary tract infection (UTI) and urinary incontinence. She was treated by surgical division of the adhesions and had complete resolution of her symptoms

A clinico-radiological and pathological profile of lung cancer patients presented to All India Institute of Medical Sciences (Patna)

Background: Lung cancer is one of the most common cancers and cause of cancer-related deaths worldwide. The clinicopathologicalprofile of lung cancer has shown marked regional and geographical variation. Majority of the patients have locallyadvanced or disseminated disease at presentation and are not candidates for surgery. Objective: The aim of this study was toevaluate the clinico-radiological and pathological profile of lung cancer patients and difference in histopathology betweensmoker and non-smoker. We also assessed yield of the various diagnostic procedures used for confirmation of lung cancer.Materials and Methods: A total of 30 patients diagnosed between May 1, 2016, and December 31, 2016. The completedemographic profile, smoking status, clinical, radiological, and diagnostic details were recorded in the study. Data were enteredand analyzed using SPSS software. Results: A total of 30 patients (19 male and 11 female) included in our study with mean age of55.26 years. Cough (80%) and dyspnea (80%) were the most common symptom and mass (86%), pleural effusion (53.3%) was themost common radiological presentation of patients. Clubbing and hemoptysis both was found only in 8 out of 30 (26%) patients.Adenocarcinoma (46.6%) was the most common histopathological type followed by squamous cell carcinoma (16.6%) and smallcell carcinoma (13.3%). The majority of patients (60%) presented in Stage 4. Computed tomography guided biopsy had better yieldin compare to ultrasonography guided (80% vs. 70.8%). Bronchoscopic procedure had lowest yield (38.8%). Conclusion: Theclinicopathological profile of lung cancer has changed in last few years, especially in the increase in adenocarcinoma incidence,and now it is the most common cause in both smokers and non-smoker

Generalized Neuron Based Secure Media Access Control Protocol for Wireless Sensor Networks

Security plays a pivotal role in most applications of wireless sensor networks. It is common to find inadequately secure networks confined only to controlled environments. The issue of security in wireless sensor networks is a hot research topic for over a decade. This paper presents a compact generalized neuron (GN) based medium access protocol that renders a CSMA/CD network secure against denial-of-service attacks launched by adversaries. The GN enhances the security by constantly monitoring multiple parameters that reflect the possibility that an attack is launched by an adversary. Particle swarm optimization, a popular bio-inspired evolutionary-like optimization algorithm is used for training the GN. The wireless sensor network is simulated using Vanderbilt Prowler, a probabilistic wireless network simulator. Simulation results show that the choice of threshold suspicion parameter impacts on the tradeoff between network effectiveness and lifetime

Environmentally sound system for E-waste: Biotechnological perspectives

The rapid e-waste volume is generating globally. At the same time, different recycling technologies, mainly the mechanical and chemical methods well studied, while the biological method is the most promising approach. Therefore, this article provides a comprehensive information about extracting valuable metals from e-waste. In addition, this article outlines the process and key opportunity for extraction of metals, identifies some of the most critical challenges for e-waste environmentally sound management practices, and opinions on possible solutions for exiting challenges, and emphasis on importance of advanced recycling technologies that can be utilized, in order to minimize the environmental impact causes due to improper recycling of e-waste

Outcome of surgical management of ruptured Achilles tendon

Introductions: The incidence of Achilles tendon rupture has been increasing worldwide. The optimal management of this problem is controversial but the surgical intervention is being applied widely. Methods: We retrospectively analyzed patients who had Achilles tendon (AT) rupture treated surgically at Patan Academy of Health Sciences from January 2010 to December 2015. Functional outcome assessment of ankle was done by using American Orthopedic foot and Ankle Society Score (AOFAS). Results: Total 71 patients (male 45, female 26) had surgery for AT, 38 right and 33 left side. The mean age of the patient was 36.14 years (range 18-67 years). The mean AOFAS score was 83.32 (range 75-93) after first year follow up and 90.36 (range 80-99) after second year, difference was statistically significant (p<0.05). Conclusions: The study showed high AOFAS score for surgical management of ruptured Achilles tendon.   Key words: Achilles tendon rupture, American Orthopedic foot and Ankle Society Score (AOFAS

Orthopaedic services during COVID-19 lockdown at Patan Hospital, Nepal

Introduction: The COVID-19 pandemic has paralyzed the world, including elective health care services. To prevent the spread of infection, most countries have gone into lockdown and adjustments have been made to provide urgent medical care, including Orthopaedic services. In accordance with the guidelines from worst affected countries and neighboring India, Patan Hospital followed instructions from Ministry of Health and Population to provide only urgent and semi-urgent Orthopaedic services. This study aims to audit the patient profile during lockdown so as to have a clearer picture, which will enable us to be prepared for similar epidemic in the future. Method: All patients admitted to the Orthopaedic ward of Patan hospital from 24 March to 27 April 2020, during the lockdown, were included. Clinical profile, including cause of admission, management, hospital stay were descriptively analyzed. Ethical approval was obtained. Result: Out of 44 admissions, there were male 27 and female 17. Trauma cases were 38, and 18 were in age group 20-26 years. Admission due to infections were four. Conservative management were done in seven while 33 were treated surgically, out of which 30 accounted for trauma. Average 6.14 days hospital stay, range 1-22 days. Conclusion: Trauma comprised of major bulk of patients seeking urgent Orthopaedic care. Hospital needs to be prepared with necessary measures to ensure safety of health care workers and yet provide urgent Orthopaedic services. Keyword: COVID-19, lockdown, orthopaedic