A Study on post-operative radiographic factors and patient reported outcome following Total Hip Arthroplasty(THA).

INTRODUCTION: Total Hip Replacement is recommended for elderly patients with displaced Fracture neck of femur.Although Total Hip Replacement (THR) is a very successful surgical intervention, some patients experience persistent pain or dissatisfaction with outcome of surgery. Implant positioning is a major factor in the post - operative outcome of Total Hip Arthroplasty. Lewinnek et al proposed safe zone of cup anteversion as 15°±10° (AV) and cup alignment as 40°±10°.Combined anteversion of 25 to 50 degrees is the safe zone.Our aim is to determine whether post-operative radiographic variables are predictive of patient-reported pain, function and satisfaction after primary THR. AIM: The aim of the study is to analyse the clinical and radiological outcome following uncemented THA in neck of femur fractures. METHODS: In our study we analysed 40 cases of THA,with 30 cases of fresh displaced fracture neck of femur and 10 cases of Non union neck of femur in the age group of 50 to 76 years.This study is a prospective study conducted between September 2012 to September 2014 with a follow up of minimum 6 months to 2 years. All patients were taken X-rays and CT scan to measure Cup version,Cup Offset,Limb length discrepancy,femoral stem alignment ,Stem version and Combined Anteversion.The post-operative radiographic variables were statistically analysed with Modified Harris Hip score to find any significant difference in functional outcome. RESULTS: In our study it was found that offset restoration,leg length restoration,femoral stem alignment and acetabular inclination are not significant significant predictors of functional outcome following THR.It was found that there exists both statistically and clinically significant difference in functional outcome based on Modified Harris hip score with changes in CT-anteversion and combined anteversion values. Of 40 cases analysed 10 patients excellent ,18 good,6 fair and 6 poor outcome.CT-scan of 6 patients with poor outcome shows retroversion of cup and 3 patients showed an impinging lesion over iliopsoas. CONCLUSION: Implant position especially Cup version and Combined anteversion of cup and stem is a critical factor in both short-term and long-term outcome of patients with Total hip Arthroplasty.Retroversion of cup is a major cause of impingement and thus pain after THR.CT scan is the best method to find version of cup and stem and thus combined anteversion

A study on comparative study of autologous ossicular graft versus titanium prosthesis (TORP & PORP) in ossiculoplasty for ossicular pathology.

To analyze and compare the outcomes of ossiculoplasty in terms of hearing results and intra and post operative course, using autograft incus and titanium middle ear prosthesis in patients with ossicular chain erosion. Patients between 12 and 60 years of age with a history of chronic ear discharge with moderate conductive deafness (>40 dB HL) were included in the study. The patients after assessment of ossicular erosion were subjected to ossiculoplasty with autologous incus or titanium prosthesis randomly. The patients were followed up after 3 months to analyze the functional and anatomical results. Out of 21 patients with ossicular chain defect were included in the study, of whom 10 patients underwent ossiculoplasty with autograft incus and 11 with titanium prosthesis. Postoperative hearing evaluation by pure tone audiogram was done after 3months, which showed successful hearing Complications and extrusion rate were nil. In patients with incus average Post operative pure tone average was 43.5 dB and Net gain in hearing was 10.6 decibels. In patients with titanium prosthesis, average Post operative pure tone average was 41.4 dB and Net gain in hearing was 15.9 decibels. Incus and titanium has equal postoperative hearing. In terms of hearing gain Titanium prosthesis gave a better haring gain than Ossicular transposition. Complications in the short period studied are nil in both groups

Pulsatile flow of Jeffrey hybrid nanofluid in a vertical channel with entropy generation

This study examines the hydrodynamic pulsatile flow of Jeffrey hybrid (Au+Al2O3/Blood) nanofluid in a vertical channel with entropy production. The literature shows that the investigations are only related to the pulsating flow of nanofluid. Any study related to the pulsating flow of Jeffrey hybrid nanofluid in a vertical channel with Joule heating, thermal radiation, and heat source/sink did not report so far. The novelty of the present work is the investigation of entropy generation on pulsatile flow of Jeffrey hybrid nanofluid with Joule heating, thermal radiation and heat source/sink effects in a vertical channel. The transformation of the governing partial differential equations into a system of ordinary differential equations are made by applying the perturbation method and then numerically solved by fourth-order Runge-Kutta method aided by bvp4c shooting technique built-in MATLAB software. This work is useful for chemical engineering, blood cancer treatment, nanodrug delivery, pharmaceutical process, and biomedical aspects.The effects of various emerging parameters and variables on velocity, temperature, entropy generation, and the Bejan number are displayed through graphs. The consequences of physical parameters on heat transfer rate are prearranged in a table. This analysis demonstrates that the temperature of hybrid nanofluid increases with an increment in radiation parameter, and Eckert number. The entropy generation is an increasing function of Eckert number and radiation parameter whereas it decelerates with a rise in Hartmann number. The heat transfer rate has a higher impact in the case of (Au+Al2O3/Blood) hybrid nanofluid as compare to mono nanofluid

Entropy Generation on Pulsatile Hydromagnetic Flow of Jeffrey Nanofluid in a Porous Channel with Brownian Motion, Thermophoresis, and Heat Source/Sink Using Cattaneo-Christov Heat Flux

In this work, the entropy generation on MHD pulsatile flow of Jeffrey nanofluid in a porous channel with Cattaneo-Christov theory is investigated. Buongiorno nanofluid model is utilized to see the impact of thermophoresis and Brownian motion. The consequences of thermal radiation, heat source/sink, viscous dissipation, and Ohmic heating are considered. The governing equations are transformed to a system of ordinary differential equations by applying the perturbation procedure then numerically tackled with fourth-order Runge-Kutta scheme aided by shooting technique. The influences of different emerging parameters and variables on velocity, temperature, nanoparticles concentration, entropy generation, and Bejan number are presented graphically. The influence of emerging parameters on heat and mass transfer rates are prearranged in table. The temperature of nanofluid increases with an enhancement in Eckert number, thermophoretic, and Brownian movements, whereas it decelerates for the rising values of cross flow Reynolds number. The concentration of nanoparticles diminishes with an increment in the Lewis number, chemical reaction parameter, and Brownian motion parameter whereas it improves with a rise in thermophoresis parameter. The entropy generation is an increasing function of Eckert number and radiation parameter. Further, the Bejan number is enhanced for increasing the values of Hartmann number

Antibiotic sensitivity profile and resistance of microorganisms isolated from south Indian population, a hospital based study at Velappanchavady, Chennai, India

Background: Increasing rates of antibiotic drug resistance has been noted in recent times and this adversely affects the prognosis and outcomes of patients. There is a greater need for local resistance prevalence data in order to guide empirical prescription and to identify areas in which medical need for newer antimicrobial agents is greater.Methods: A prospective hospital based observational study was carried out to determine antibiotic sensitivity profile and resistance pattern of microorganisms. Samples were collected from urinary tract infections, while cultures from blood stream infections, sputum samples and Serology. Antibiotic susceptibility was determined by the standard disc diffusion method. Data interpretation was based on CLSI, 2017 guidelines for antimicrobial susceptibility testing.Results: The predominant isolates from the samples were, Staphylococcus aureus (16.7%) 67, K. pneumoniae (11.5%) 46, E. coli (29.4%) 118, P. aeruginosa (6%) 24. Escherichia coli, the most common causative organism showed high resistance to commonly used drugs such as Ampicillin (60.1%) 71, Amoxicillin (53.4%) 63, Amoxicillin-clavulanic acid (44.1%) 52 and Nalidixic acid (53.4%) 63. E. coli was found to be most sensitive to Amikacin (51.7%) 61, Piperacillin (69.5%) 82, Norfloxacin (61.9%) 73, Meropenem (76.3%) 90 and Imipenem (68.6%) 81. Klebsiella was most sensitive to 30 (65.2%) ofloxacin, 31 (67.4%) ciprofloxacin followed by 24 (52.2%) ceftriaxone and least sensitive to 7 (15.2%) Amoxicillin and 12 (26.1%) Ampicillin.Conclusions: Among commonly used antibiotics resistance to Penicillins (Ampicillin, Amoxicillin) was highest. Resistance to Fluoroquinolones (Ciprofloxacin) was seen in majority of the patients. Among broad spectrum antibiotics Imipenem, Meropenem resistance was seen in lesser proportion of the patients

Cubic like CoMn2O4 nanostructures as advanced high-performance pseudocapacitive electrode

In this work, a synthesis of cubic-like CoMn2O4 uniform nanostructures with KOH-NaOH involved in the hydrothermal method has been reported. The crystal structure phase purity, functional groups, and morphology of the CoMn2O4 have been investigated by X‑ray diffraction (XRD), field emission scanning electron microscopy (FE-SEM), high-reso­lution transmission electron microscopy (HR-TEM) analyses. The electrochemical beha­viour of CoMn2O4 electroactive material has been examined for supercapacitors. The elec­trode displays excellent capacitive behaviour with superior electrochemical properties. The cubic-like morphology structure with enough free space is beneficial for improving electrochemical performance. The CoMn2O4 electrode exhibits a faradaic capacitance with the highest specific capacitance value of 762.4 F g-1 at a scan rate of 5 mV s-1. The coulombic efficiency of the CoMn2O4 electrode was found to be 91.2 % after 2000 charging-discharging cycles. The nanostructures of CoMn2O4 make a prominent contr­ib0­ution to the excellent electrochemical performance of the prepared electrode

A PROSPECTIVE STUDY OF THE PATTERN OF USE OF ANTIMICROBIAL AGENTS IN SURGICAL PROPHYLAXIS IN A TERTIARY CARE CENTRE

Objective: To evaluate the most common class of antimicrobial agents used in surgical prophylaxis. To evaluate the timing, dosage, route and duration of use of antimicrobial agents in surgical prophylaxis.Methods: The study subjects were 214 patients who underwent general surgical procedures at Vinayaka Missions Kirupananda Variyar Medical College from July 2013 to June 2014. The use of antimicrobial agents was noted from the first dose of antibiotic given before the induction of anaesthesia. After surgery was completed the duration of antibiotic in the post-operative ward was noted. Results: Majority of the patients were males of age group 50-60 y and the most common surgical procedure was hernioplasty. Combination therapy with two antimicrobial agents was more preferred regimen 126 (58.9%). Among the antimicrobial agent's cefotaxime 114 (24.8%) was the most commonly prescribed drug and it was followed by metronidazole 121 (21.9%). ceftriaxone 60 (13.1%) was the third most commonly prescribed antimicrobial agent. The mean duration of prescription of antimicrobial agents in the present study was 4.78 d and the mean cost of drug treatment was 787.54 rupees. The cost-effective regimen was that of aminoglycosides and imidazole.Conclusion: The choice of antimicrobial agent was based on the local prevalence pattern of microorganisms. The intravenous administration of antibiotic prophylaxis immediately before or after the induction of anaesthesia is the most reliable method for ensuring effective serum concentration at the time of surgery. The antimicrobial agent chosen must cover all the most likely contaminating organisms

Structural and optical characterization of ZnS nanoparticles co-doped with Ni 2+ and Cu

Abstract : Zn 0.97 -x Cu x Ni 0.03 S (x = 0.00, 0.01, 0.02, 0.03, 0.04 and 0.05) nanoparticles were synthesized by the chemical precipitation method. Poly vinyl pyrrolidone (PVP) was used to passivate the surface of the particles. The effect of Cu co-dopant on the structural, morphological and optical properties is discussed on the basis of EDS, FESEM, FTIR, UVVis and Pl results. EDX spectra confirmed the presence of Ni and Cu were incorporated at the Zn sites in the cubic structure without disturbing the original ZnS cubic structure. The particle size estimated from XRD was in the range of ~3.5 nm to 5 nm. FTIR spectra studies indicated that PVP simply co-exists on the surface of the nanoparticles and acts as the capping agent preventing agglomeration of the nanoparticles. Optical absorption studies showed a blue -shift of the fundamental absorption edge with respect to that of bulk ZnS. Enhanced photoluminescence was observed with increasing Cu concentration upto 3 wt% and beyond this photoluminescence quenching was observed

Clumped isotope thermometry in earthworm carbonates

Earthworm-secreted calcium carbonate can store carbon derived from the soil-atmosphere interface on geological timescales [1]. The mechanism of calcification [2,3,4] is well understood based on multiple years of research conducted both under controlled and natural conditions. We analysed carbonate granules produced by the earthworm Lumbricus terrestris cultured in variable pH and temperature for δ18O to establish thermometry [2]. The governing equation proposed for the thermometry differed from the inorganic calcite precipitation relationship, capturing the signature of kinetic processes during carbonate growth. We have now analysed the granules for clumped isotope thermometry. This provides an opportunity to understand the role of kinetic processes in governing the relationship of clumped isotope in the carbonate system. The clumped isotopic composition of these carbonates yields the following relationship with varying temperature: The linear regression relationship obtained in this study has a similar slope as seen in case of inorganic calcite [5] and otolith carbonate [6]. However, the intercept of the governing equation varied significantly denoting carbonate growth rate. The study presented here provides the first experimental results of clumped isotope composition on carbonates precipitated under monitored disequilibrium conditions and thus, enables quantification of growth rate dependency on clumping. The intercept of the linear regression relationship differs from the line proposed for inorganic calcite precipitation and thus introduces a new parameter to quantify the kinetic process. In this study replicate experiments were performed on carbonate granules generated at controlled temperature and with a knowledge of water isotopic compositio

MODELLING HETEROGENEOUS TRAFFIC SYSTEMS: CONCEPTS AND METHODOLOGY

Abstract Models in general, enable understanding of concepts and systems with ease. They are highly useful in design, prediction, and evaluation of alternatives quickly, economically, and harmlessly. Different types of models are developed such as, physical, symbolic and mental models, depending upon the nature of the system. Experiments with models often lead to generation of new hypothesis and formalization of knowledge about systems. Road traffic flow being stochastic, they are too complex to be represented by a reasonable mathematical model. Hence, simulation technique is often used to model road traffic phenomena. Computer simulation models can play an important role in the analysis and assessment of the traffic-flow characteristics under heterogeneous traffic conditions such as the ones prevailing on Indian roads. An appropriate simulation framework to model heterogeneous traffic flow has been proposed here after description on certain conceptual aspects of modelling. The proposed methodology, when applied to field conditions, was found to be valid