Effectiveness of oral sucrose on level of pain during DPT immunization among infants at selected hospital Salem

Pain is an unpleasant experience to all Individuals. Infants are more sensitive to pain than older children and Adults because of their still developing brain. The pediatric pain experience involves the interaction of physiologic, psychological, behavioral and situvational factors. Non-pharmalogical interventions in the management of pain have been found to the highly effective for some children and for some procedures. A study was conducted to evaluate the effectiveness of oral sucrose on level of pain during DPT immunization among infants through Quantitative of evaluative approach quasi experimental post test only control group design was used. Thirty infants who met the inclusion criteria were selected my using non-probability convenient sampling technique from selected hospital in Salem. The mean level of pain for control group it was 11.6 + 1.17. The difference in mean Percentage was 24 indicating decreased level of pain in the experimental group. The calculated ‘t’ value13.33 which was greater than the table Value at 0.01 level indicating that the difference in mean was these difference

Analysis of functional outcome of anterolateral plating in tibial pilon fractures

INTRODUCTION: Tibial pilon fractures account for 1% to 10% of all lower extremity injuries. The difficulty in managing these injuries is primarily due to the precarious vasculature around the ankle. Subcutaneous location of tibia adds to the difficulty. It encompasses a spectrum of skeletal injury ranging from low energy injury due to simple falls to high energy explosive injury due to road traffic accidents and fall from height. Fibula is fractured in 85% of the tibial pilon injuries. Fixation of fibula fracture is crucial to the reduction of pilon fracture. Complication rates were higher in the high energy explosive fracture pattern. Medial plating using LCP on the subcutaneous medial border of distal tibia resulted in a significant rate of wound dehiscence and deep infection. Plating on the lateral surface of tibial plafond is a new entity and the anterolateral approach is gaining popularity for the fixation of tibial pilon fractures. MATERIALS AND METHODS: This retrospective and prospective study analyzes the functional outcome of Anterolateral distal tibia LCP for treatment of distal tibia fracture. The period of study was from June 2013 to December 2013 with a total duration of 7 months. In our study 30 cases with a minimum follow up of 4 months and maximum of 12 months with an average of 9 months was carried out. Fibula fixation is performed initially to restore length and achieve indirect reduction of tibia fracture using posterolateral approach. Anterolateral approach to ankle was used to fix tibia. Anterolateral locking compression plates are placed through the interval between the anterior and lateral compartments of leg. All cases were assessed postoperatively using the Kaikkonen clinical ankle score and Teeny wiss radiological score. RESULTS: 27 fractures united with a mean duration of 12 to 24 weeks. In our study we were able to achieve anatomic reduction in 32% (7 cases) of the patients. Good reduction was achieved in 50% (11 cases) of the patients. Fair reduction was achieved in 18% (4 cases). There was no case of poor fracture reduction in our study according to Teeny Wiss Score. In our study we had excellent functional outcome in about 30% of cases, good functional outcome in 50% of cases fair and poor outcome 10% of cases each based on Kaikkonen Clinical Ankle Score. In our study the complication we met were 6 cases (20%) of wound dehiscence and superficial infection which healed by secondary intention, 2 cases (7%) of flap necrosis, 3 cases(10%) of nonunion, extensor tendon exposed in 1 case (3%), implant failure in one of the three non union cases. In our study we had no deep infection (0%). CONCLUSION: Distal tibia fractures with high grade of soft tissue injury are to be internally fixed after a delay of 21 days for the edema to settle down and the wrinkle sign appears. The posterolateral incision to fibula provides a larger skin bridge between this incision and the tibial incision. A 7 cm skin bridge between two incisions is recommended to avoid wound complication. Restoration of the articular surface and reestablishing its relationship to the tibial shaft is the primary goal of treatment. Good functional result depends on reasonable anatomic reduction of the articular surface and meticulous soft tissue handling. From our study, 3.5mm Anterolateral Distal tibia Locking Compression Plating for tibial pilon fractures were found to be safe and effective. For AO type A fractures, can be fixed either using MIPPO or ORIF technique. For AO type C fractures Open reduction of the articular fragment is mandatory and then stabilize with locking compression plate for added up stability

A Stochastic Model for Mean Time to Seroconversion of HIV Transmission with Change of Threshold Under Correlated Intercontact Times

This paper focuses on the study of a stochastic model for predicting seroconvesion time of HIV transmission with change of threshold under correlated intercontact times. The antigenic diversity threshold is an important aspect of consideration in the studies relating to HIV infection.  Successive sexual contacts are the mode of transmission of HIV would result in acquiring more of HIV which contribute to the antigenic diversity of the antigen. As and when the cumulative antigenic diversity contributed due to successive contacts crosses the antigenic diversity threshold, seroconversion takes place. In developing this model the result of Gurland (1955) has been used. The mean time to seroconversion and its variance are derived and the numerical illustrations are provided

1, 2-, 1, 3- and 1, 4-Cyclohexanedicarboxylates of Cd and Mn with chain and layered structures

A systematic study has been carried out on the three isomeric cyclohexanedicarboxylates (CHDCs) formed by cadmium and manganese with the three isomeric dicarboxylic acids, in the presence or absence of amines. The CHDCs have been prepared under hydrothermal conditions and their structures established by X-ray crystallography. We have been able to isolate two-dimensional layered structures of 1,2-, 1,3- and 1,4-cyclohexanedicarboxylates and chain structures of 1,3- and 1,4-cyclohexanedicarboxylates. The infinite metal-oxygen-metal linkages are observed only in the case of the 1,2-dicarboxylate. In all the three isomeric cyclohexanedicarboxylates, the e,e conformation is most favored, although the 1,4-CHDCs often contain rings in both the e,e and the a,e conformations

4-(4-Bromo­phen­yl)-6-(1H-indol-3-yl)-2,2′-bipyridine-5-carbonitrile

In the title compound, C25H15BrN4, the two pyridine rings lie in a common plane [r.m.s. deviation = 0.023 (2) Å], whereas the bromo­phenyl and indole rings are twisted away from this plane by 52.82 (12) and 28.02 (10)°, respectively. The crystal structure is stabilized by inter­molecular N—H⋯N inter­actions

4-(2,4-Dichlorophenyl)-2-(1H-indol-3-yl)-6-methoxypyridine-3,5-dicarbonitrile

In the title compound, C22H12Cl2N4O, the indole ring system and the benzene ring form dihedral angles of 21.18 (7)° and 68.43 (8)°, respectively, with the pyridine ring. The meth­oxy group is coplanar with the pyridine ring. In the crystal structure N—H⋯N inter­molecular hydrogen bonds link the mol­ecules into C(10) chains running along [011]. Intramolec­ular C—H⋯N hydrogen bonds are also observed

PCR in the differential diagnosis of Tuberculosis: A comparative study

This study is to assess prospectively the performance of PCR in the diagnosis of Tuberculosis. The repetitive sequence IS6110 is used as a target for PCR. A total of five samples were analyzed all of which were found to be PCR positive. The results were compared with AFB staining, culture on Lowenstein Jensen (LJ) medium and Enzyme Linked Immunosorbant Assay (ELISA). PCR was found to be sensitive and specific and provides a definitive diagnosis of TB. Hence it is an effective tool for TB diagnosis

4-(2,4-Dichlorophenyl)-2-(1H-indol-3-yl)-6-(2-pyridyl)-1,4-dihydropyridine-4-carbonitrile

The title compound, C25H16Cl2N4, has intra­molecular N—H⋯N and C—H⋯Cl hydrogen bonds. In the crystal structure, mol­ecules are linked through N—H⋯N hydrogen bonds, forming a centrosymmetric R 2 2(16) dimer