Masquelet technique for management of posttraumatic bone defect in a patient of chronic osteomyelitis of long bone

Masquelet technique, which is the use of a temporary cement spacer followed by staged bone grafting, is a treatment strategy for reconstruction of large, infected, bone defects. This paper describes a patient treated with this technique to successfully manage postinfective or posttraumatic osseous long bone defect. Sequestrectomy was done and the injured limb was stabilized and aligned with application of external fixator at the time of initial antibiotic cement spacer placement. After 6 weeks of proper antibiotic coverage, all antibiotics were stopped for next 2 weeks. Clinical evaluation and investigations were done to rule out any residual infection. Osseous consolidation was successfully achieved with staged bone grafting and internal stabilization of long bone defect

Treatment of stable and unstable intertrochanteric fractures using proximal femoral nail and their functional assessment using modified Harris hip score

Background: Intertrochanteric fracture is common injury and is found in both elderly and the young. Proximal femoral nail (PFN) has been in widespread use for the same in the recent past. There are advocates both for and against this implant. The aim was to study the results of PFN in the treatment of intertrochanteric fractures and their functional evaluation using the modified Harris hip score.Methods: A prospective study done on 104 patients operated for intertrochanteric fractures with PFN. Patients were followed up at 6 weekly intervals and evaluated at each visit using the modified Harris hip score (HHS).Results: The study consisted of 104 patients aged from 36 to 96 years with average age of 67.8 years. Most patients belonged to 60-80 years category. Malunion was observed in three patients (2.8%) and non union was not seen in any patient. Excellent to good results were seen in 73% patients 18% patients had a fair outcome, 7.7% had poor and 2% patients had very poor outcome.Conclusions: PFN is a good implant for intertrochanteric fracture treatment that demands a sound technique and a good reduction prior to insertion. The assessment of results using HHS has been too similar to those obtained using Kyle’s criteria in the previous studies, proving its role in the same.

Comparison of eyecare utilization at two service delivery levels during the COVID-19 pandemic as a measure of their impact: A multicentric retrospective analysis across four North Indian high-volume eyecare organizations.

Purpose: The purpose of this study was to assess the performance of the tertiary centers (TCS) and vision centers (VCs) of the four organizations participating in this research, once the lockdown was lifted, and to compare it with the performance during the same period of the previous year. Methods: This was a cross-sectional study assessing eyecare utilization in the first 2 months after resumption of services post the lockdown in 2020 and comparing that across the same time period in 2019. Anonymized data containing basic demographic details, proportions of patient visits and their reasons, as well as referral information was collected. The drop percentage method was used, and P values were calculated using paired t-tests. Results: Four TCs and 60 VCs were included. Overall, outpatient attendance dipped 51.2% at TCs and 27.5% at VCs, across the 2 years. At both levels of care delivery, the percentage drop in females was more than that in males; however, the overall drop at VCs was less than that at TCs, for both sexes. Eyecare utilization in pediatric populations dropped significantly more than in adult populations, across the overall sample. There was no significant change in referrals for refractive error as a proportion of total outpatients, although there was a significant decline in the same for cataract and specialty treatment. Conclusion: VCs are valuable and successful model for eyecare delivery especially in the continued aftermath of the COVID-19 pandemic

Dynamics of Hot QCD Matter -- Current Status and Developments

The discovery and characterization of hot and dense QCD matter, known as Quark Gluon Plasma (QGP), remains the most international collaborative effort and synergy between theorists and experimentalists in modern nuclear physics to date. The experimentalists around the world not only collect an unprecedented amount of data in heavy-ion collisions, at Relativistic Heavy Ion Collider (RHIC), at Brookhaven National Laboratory (BNL) in New York, USA, and the Large Hadron Collider (LHC), at CERN in Geneva, Switzerland but also analyze these data to unravel the mystery of this new phase of matter that filled a few microseconds old universe, just after the Big Bang. In the meantime, advancements in theoretical works and computing capability extend our wisdom about the hot-dense QCD matter and its dynamics through mathematical equations. The exchange of ideas between experimentalists and theoreticians is crucial for the progress of our knowledge. The motivation of this first conference named "HOT QCD Matter 2022" is to bring the community together to have a discourse on this topic. In this article, there are 36 sections discussing various topics in the field of relativistic heavy-ion collisions and related phenomena that cover a snapshot of the current experimental observations and theoretical progress. This article begins with the theoretical overview of relativistic spin-hydrodynamics in the presence of the external magnetic field, followed by the Lattice QCD results on heavy quarks in QGP, and finally, it ends with an overview of experiment results.Comment: Compilation of the contributions (148 pages) as presented in the `Hot QCD Matter 2022 conference', held from May 12 to 14, 2022, jointly organized by IIT Goa & Goa University, Goa, Indi

Production of He-4 and (4) in Pb-Pb collisions at root(NN)-N-S=2.76 TeV at the LHC

Results on the production of He-4 and (4) nuclei in Pb-Pb collisions at root(NN)-N-S = 2.76 TeV in the rapidity range vertical bar y vertical bar <1, using the ALICE detector, are presented in this paper. The rapidity densities corresponding to 0-10% central events are found to be dN/dy4(He) = (0.8 +/- 0.4 (stat) +/- 0.3 (syst)) x 10(-6) and dN/dy4 = (1.1 +/- 0.4 (stat) +/- 0.2 (syst)) x 10(-6), respectively. This is in agreement with the statistical thermal model expectation assuming the same chemical freeze-out temperature (T-chem = 156 MeV) as for light hadrons. The measured ratio of (4)/He-4 is 1.4 +/- 0.8 (stat) +/- 0.5 (syst). (C) 2018 Published by Elsevier B.V.Peer reviewe

Comparisons of metabolite profile from paired serum and ethylenediaminetetraacetic acid–plasma samples using dry chemistry technology: An emergency department perspective

BACKGROUND: No data is available evaluating the difference in serum versus plasma sample assay of commonly tested parameters in the emergency department, where the sample processing time can be significantly reduced if plasma is used for analysis instead of conventionally used serum. Hence, this study aimed to evaluate the differences in serum versus plasma sample estimation of commonly evaluated biochemical parameters using dry chemistry technology. MATERIALS AND METHODS: Paired blood samples were collected from a single venipuncture of 405 patients admitted to the emergency department. Dry chemistry autoanalyzer (Vitros-350, Ortho Clinical Diagnostics) was used to process all the samples. RESULTS: Data from 401 patients were analyzed. Percentage differences between serum versus plasma samples for all analytes ranged from 0.0% to 57.44% and were <±4% for a majority of parameters, except uric acid (−6.25%), albumin (+11.90%), chloride (–5.05%), phosphorus (−6.06%), creatine phosphokinase (CPK) total (−57.44%), amylase (−37.53%), lipase (−42.74%), lactate dehydrogenase (LDH) (−8.53%), and C-reactive protein (−7.44%). For albumin, CPK total, amylase, and lipase, the difference between serum and plasma samples was more than the accepted upper range recommended by College of American Pathologists. CONCLUSION: Glucose, urea, creatinine, bilirubin, total protein, serum glutamate-pyruvate transaminase, total cholesterol, high-density lipoprotein cholesterol, triglycerides, sodium, and CPK-mb can be reliably assayed from either serum or plasma samples in emergency/routine practice. CPK total, amylase, and lipase should always be assayed from serum and not plasma due to significant variations. Uric acid, chloride, phosphorous, and LDH only in emergency situations should be assayed from plasma. For routine assays, serum should be preferred

A study to evaluate host factors for musculoskeletal injuries secondary to trauma among elderly people of Northwestern India

Introduction: As the population ages, the problems related to falls and fractures are expected to grow. This poses a great challenge to the health-care systems. Meeting these challenges requires a clear understanding of the prevalence and nature of falls. It also means identifying factors responsible for injury causation. The current study was conducted with the aim to evaluate host factors responsible for musculoskeletal injuries (MSIs) in the elderly. Materials and Methods: A hospital-based, questionnaire-based, descriptive study was conducted on all elderly (60 years) patients attending a tertiary care teaching hospital with MSIs secondary to trauma between 2013 and 2014. Results: A total of 200 elderly with MSIs secondary to trauma attending the tertiary care center between 2013 and 2014 were evaluated for the purpose of this study. Exactly half of them (50%) were more than 70 years of age. Intoxication and presence of visual and hearing impairment were observed as significantly associated with occurrence of MSIs. Discussion: Trauma is a common cause of MSI among the elderly. Therefore, identification and evaluation of host factors are important as this can help in planning prevention of injuries in elderly. Conclusion: MSIs due to trauma are a focus of public health practice as they pose a serious health threat, occur frequently, and are in most situations preventable

A prospective comparative study of high resolution ultrasound and MRI in the diagnosis of rotator cuff tears in a tertiary hospital of North India

BACKGROUND: To evaluate the accuracy of high resolution ultrasound (USG) and MRI in the diagnosis of rotator cuff tears (RCT) and to determine if high resolution USG compares favorably in sensitivity and specificity to MRI in the diagnosis of rotator cuff injury. MATERIAL AND METHODS: In this prospective comparative study, 40 patients with clinically suspected rotator cuff tears underwent both ultrasound and MRI of the shoulder. Out of these 40 patients, 31 patients who had positive findings for rotator cuff tears on ultrasound and/or MRI were finally included in the study while the remaining 9 patients with negative or unrelated findings were excluded. The USG and MRI were interpreted by two radiologists experienced in musculoskeletal radiology and blinded to findings of each other. Comparison was done using MRI as a standard reference. RESULTS: The agreement between USG and MRI for diagnosis of RCTs was statistically excellent; USG showed a sensitivity of 86.7% and a specificity of 100% for full-thickness tears, and a sensitivity of 89.7% and a specificity of 98.8% for partial-thickness tears; observed accuracy for full thickness tears was 98.4% and 95.9% for partial thickness tears. The Kappa coefficient of association was 0.91 for full thickness tears and 0.90 for partial thickness tears. CONCLUSIONS: Considering the comparable diagnostic accuracy of USG and MRI, the former modality can be used as a first-line investigation for diagnosis of RCT. MRI should be used secondarily as a problem-solving tool either following an equivocal shoulder USG or for delineation of anatomy in cases where surgical correction is needed

Determining the association between socio-demographic profile and difficulties encountered during fixation of trochanteric fractures with proximal femoral nailing operated in the department of orthopedics at Dr RPGMC Kangra at Tanda

Background: Trochanteric fractures are one of the commonest fractures seen in elderly people. We conducted a study association between socio-demographic profile and difficulties encountered during fixation of trochanteric fractures with proximal femoral nailing (PFN) operated in the department of orthopedics at Dr RPGMC Kangra at Tanda.Methods: This study was conducted on patients presenting to the department of orthopedics at Dr RPGMC Tanda with trochanteric fractures and fulfilling the criteria and studied for a period of one year starting from the date of study. The patients were clinically evaluated at the time of admission. Demographic data of the patients such as age, sex, pre-operative mobility status, pre-existing co-morbidities, type of fracture/fracture classification, degree of osteoporosis (measured by Singh’s index) were noted.Results: Comparison of age of the patients in which difficulties encountered was comparable to the patients in which no difficulties encountered (p=0.562) 57% (n=33/58) of the patients in which no difficulties encountered were males. Sex-based distribution was not found to be statistically significant (p=0.480). 93% (n=54/58) of the patients in which no difficulties encountered belonged to rural areas. Residence-based distribution was not found to be statistically significant (p=0.506).Conclusions: In this study, we observed that technical difficulty in PFN can arise in any patient irrespective of their age, sex and socioeconomic status

Road geometry as a factor for musculoskeletal injuries due to road traffic accidents in Sub-Himalayan State of Himachal Pradesh

Background: Road traffic accidents (RTAs) kill 1.25 million people each year and injure between 20 and 50 million more people with many incurring a disability as a result of their injury. The road environment (design and geometry) can affect driver speed choice, thereby increasing chances of accidents.Materials and Methods: Patients attending tertiary care center for musculoskeletal injuries after an RTA were enrolled in the study. The data were collected using a standard questionnaire. The details on the geometry of the road (type of road; highway or other, metaled or nonmetaled, straight, and curved) were obtaine through inspection wherever possible. Results: Majority of the RTAs occurred on state highways (n = 154/313, 49.7%) followed by national highways (NH) (n = 94/313, 30%). Link roads account for comparatively less number (n = 65/313, 20.7%) of cases. Majority of the accidents occurred on metaled road (n = 268, 85.6%); however, the association of different vehicles involved in RTA with the condition of road was not found to be significant statistically (P > 0.5). Further, the majority of the RTA occurred on straight roads (n = 204, 65.1%). Conclusion: Road geometry is an important factor in RTAs as drivers generally tend to choose their speed based on their perception of the appropriate speed for the road geometry