An Analysis of Functional Outcome of Autologous Blood Injection for Refractory Lateral Epicondylitis

BACKGROUND: Lateral epicondylitis is the commonest chronic disabling painful condition of the elbow. Elbow pain and tenderness with resisted wrist extension are common manifestations in lateral epicondylitis. Recent studies have suggested Autologous Blood injection {ABI} to be a safe and effective therapy for tennis elbow. OBJECTIVES OF STUDY: To evaluate the short term and long term results of autologous blood injection for the treatment of refractory lateral epicondylitis. To provide pain-free elbow. STUDY DESIGN: Prospective study. MATERIALS AND METHODS: 120 Patients over a period of 2 years from August 2016 to July 2018 with refractory lateral epicondylitis attending Department of Orthopaedics & Traumatology OPD at Govt Rajaji hospital, Madurai will be taken up for study after obtaining consent. All the patients selected for study will be examined according to protocol, associated injuries should be noted and clinical and lab investigations carried out in order to get fitness for procedure. Consent of the patient will be taken for procedure. Patients were taken 3 ml of autologous blood drawn from contra lateral upper limb mixed with 1 ml of 0.5 % bupivacine. Patient in supine with elbow is flexed to 90 degree with palm facing down. Under aspetic precautions needle is introduced proximal to lateral epicondyle along the supracondylar ridge into the tendon at the maximum point of tenderness. Pain (VAS) and NIRSCL Score& Hand grip will be assessed on follow-up. Patient’s clinical improvement will be assessed using NIRSCL SCORE & manual Hand grip clinically during every follow-up. Patient will be followed till good functional outcome is achieved clinically. RESULTS: To our knowledge this study, perhaps the large group of 120 patients having refractory lateral epicondylitis participating with follow-up of 1 year. The evaluation of the patients was carried out by the degree of the pain and the amount of disability in the pre injection phase, and at subsequent outpatient visits at 1st week, 1,3, 6, and 12 months (the final follow up). The degree of pain was assessed by employing the Visual Analogue scale (VAS), the degree of disability was evaluated by Nirschl staging & functionally by Hand grip. Pre-injection average pain (VAS) score was 8.7 (range, 6-10), the average Nirschl stage was 6.4 (range, 5-7) & the Hand grip was 28.8 (range 20-50%). After autologous blood injections the average pain score decreased from 8.7 to 0.19, the average Nirschl stage decreased from 6.4 to 0.1 & Hand grip from 28.8 to 97.3 % at 1 year follow-up. Most number of patients dramatically improved with single injection. Only 3 patients (2.5 %) required another second episode of injection, those 3 patients also having some amount of improvement in VAS score, Nirschl score & Hand grip from pre-injection & first time ABI, second injection for achieving maximum improvement in functional & pain score. The significant maximal benefit was reached at an average of 5 weeks (range, 1 wk. to 10 wk.) after injection

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

Extension of Raw Cow Milk Shelf Life by Microplasma Discharge

Cow's milk, the universal nutrient, is being stored and supplied, which seeks proper preservation. The prevalent milk preservation procedure of refrigeration, is effective only for two days, and after which, it starts to contaminate due to the growth of various milk-laden bacteria. This bacterial overload has to be inactivated properly to increase its shelf life, and is been achieved effectively using microplasma, a single-step, cost-effective and chemical-free process. Raw milk was treated for 5, 10, and 13 seconds in microplasma discharge. After 13 seconds of microplasma treatment, E. Coli, Pseudomonas, and S. Aureus bacteria got reduced at a respective rate of 89.93, 84.55, and 94.19% for in raw milk. The reactive species formed during microplasma discharge disrupts the structural integrity of bacterial cells and inactivates it, thereby enhancing the milk shelf life. Treated samples remained in good condition for 8 days. Thus, microplasma discharge increases the shelf life of milk by quickly inactivating the bacterial load

Isolation and screening of proteolytic bacteria from freshwater fish Cyprinus carpio

The present study was undertaken to isolate and characterize the protease producing potent bacteria from gastro intestinal tract of the freshwater fish Cyprinus carpio. The protease producer was characterized as Bacillus sp. morphologically and biochemically. The optimization studies for growth and proteases production of the isolate Bacillus sp. was carried out. The optimum temperature for the isolated Bacillus sp. was 350C but the optimum temperature for the protease production was 450C, the optimum pH was 7.0 in which the isolate produced 18 mMol/ml and showed a remarkable number of Colony Forming Unit. Hence, it was focused to study the intestinal Bacillus sp. in freshwater fish and its protease enzyme.&nbsp

Thermal insulation properties of jute, polypropylene and recycled polyester nonwoven fabrics for automotive textiles

186-190Three different nonwoven fabrics, namely jute, polypropylene and recycled polyester, have been produced using needle-punching method. The nonwoven fabric samples are then characterised by thermal conductivity, thermal resistance, air permeability, areal density and thickness. Objective and subjective evaluation are carried out for the fabric samples. The fibres are blended in various proportions and further converted into cross laid needle punched nonwoven fabrics. The thermal resistance of carded needle punched nonwoven fabrics are determined by using lee’s disc apparatus. Experimental results show that 100 % recycled polyester nonwoven fabrics thermal resistance behaviour is higher than the jute and polypropylene needle punched nonwoven fabrics. This nonwoven fabric can be used in the automotive field as a headlining material for the purpose of thermal insulation

Thermal insulation properties of jute, polypropylene and recycled polyester nonwoven fabrics for automotive textiles

Three different nonwoven fabrics, namely jute, polypropylene and recycled polyester, have been produced using needle-punching method. The nonwoven fabric samples are then characterised by thermal conductivity, thermal resistance, air permeability, areal density and thickness. Objective and subjective evaluation are carried out for the fabric samples. The fibres are blended in various proportions and further converted into cross laid needle punched nonwoven fabrics. The thermal resistance of carded needle punched nonwoven fabrics are determined by using lee’s disc apparatus. Experimental results show that 100 % recycled polyester nonwoven fabrics thermal resistance behaviour is higher than the jute and polypropylene needle punched nonwoven fabrics. This nonwoven fabric can be used in the automotive field as a headlining material for the purpose of thermal insulation

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