Management of acetabulum fracture with contralateral neck of femur in an obese patient: a rare case report

Acetabular fractures are complex fractures that pose a challenge for orthopaedic trauma surgeons due to their extension into the hip joint. The simultaneous occurrence of contralateral neck of femur fracture in an obese patient makes postoperative wound healing and rehabilitation even challenging. Here, we report a case of management of acetabulum fracture with contralateral neck of femur fracture in an obese patient. We are reporting a case of a 50-year-old obese female from Chennai who presented to the Department of Orthopaedics, SRIHER, Chennai, with complaints of bilateral hip pain and inability to weight bear on bilateral lower limb, following a high-velocity road traffic accident. She was diagnosed to have left acetabulum fracture with right hip displaced neck of femur fracture. We managed her with right hip bipolar hemiarthroplasty and left acetabulum open reduction and internal fixation. 6 month follow up showed excellent radiological and functional outcome. This case report highlights how obesity alters the surgical and medical management in obese patients with contralateral acetabulum and neck of femur fracture and the importance of a multidisciplinary approach in such polytrauma patients

Intra-operative peri-articular cocktail injection in inflammatory arthritis patients undergoing total knee arthroplasty

Pain following TKA is often severe in most patients. The purpose of this case series was to assess the efficiency of intra-operative peri-articular cocktail injection in management of pain following total knee arthroplasty. This case series involves 16 patients with inflammatory arthritis of knee undergoing total knee arthroplasty (TKA). All patients had received peri-articular cocktail of drugs before the implantation of prosthesis with cement. In our study, there was significant improvement of Knee Clinical Score and Knee Functional Score following TKA. The mean KSS score was 37.5 (range: 31-44) improved to 92.5 (range, 86-99) and the functional score improved from 25.5 (range, 18-33) to 76 (range, 72- 80) at 6 months and 93 (range: 90-96) at 12 months. Intraoperative peri-articular injection with 20 ml of 0.5% ropivacaine, 1 ml of ketorolac, 1ml of clonidine and 0.5ml noradrenaline diluted in 20 ml of saline is effective in reducing immediate post-operative pain and thereby improving the overall functional outcome

A study of intra articular calcaneal fractures treated with minimally invasive cannulated screw fixation

Background: The management of displaced intra-articular calcaneal fractures (DIACFs) remains challenging and controversial. A prospective study to assess the functional outcome of patients with displaced intra-articular calcaneal fractures treated with percutaneous reduction, cannulated screw fixation.Methods: Ultimately, 14 patients with a DIACFs, underwent. percutaneous reduction, cannulated screw fixation. Functional outcomes were evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) hind foot scores. Radiological results were assessed using plain radiographs and computed tomography (CT) scans, and postoperative wound-related complications were also recorded.Results: A total of 46 adult patients were assessed in our study. Twenty patients did not meet the inclusion criteria and were excluded. Twelve patients were excluded due to severe medical ailments (2 patients) and non-adherence to the treatment plan (10 patients). Therefore, 14 patients with an average age of 42.5 years old (range, 20 to 72 years) including 10 men and 4 women participated in the study. All patients were followed-up for 12 months averagely (range, 11 to 18 months). Complete articular reduction is achieved in 8 patients, 6 patients had articular depression of posterior facet, 3 patients had heel widening and lateral impingement. There was no wound complications in any of the patients, 2 patients developed sub talar arthritis at 2 years of follow up. Conclusions: Surgical treatment of intra articular calcaneal fractures remains challenging task. Minimally invasive reductions remain good option to minimize wound complications. Cannulated cancellous screw fixation is good option for intra articular calcaneal fracture

H I 21-cm Cosmology and the Bispectrum: Closure Diagnostics in Massively Redundant Interferometric Arrays

New massively redundant low frequency arrays allow for a novel investigation of closure relations in interferometry. We employ commissioning data from the Hydrogen Epoch of Reionization Array to investigate closure quantities in this densely packed grid array of 14m antennas operating at 100 MHz to 200 MHz. We investigate techniques that utilize closure phase spectra for redundant triads to estimate departures from redundancy for redundant baseline visibilities. We find a median absolute deviation from redundancy in closure phase across the observed frequency range of about 4.5deg. This value translates into a non-redundancy per visibility phase of about 2.6deg, using prototype electronics. The median absolute deviations from redundancy decrease with longer baselines. We show that closure phase spectra can be used to identify ill-behaved antennas in the array, independent of calibration. We investigate the temporal behavior of closure spectra. The Allan variance increases after a one minute stride time, due to passage of the sky through the primary beam of the transit telescope. However, the closure spectra repeat to well within the noise per measurement at corresponding local sidereal times (LST) from day to day. In future papers in this series we will develop the technique of using closure phase spectra in the search for the HI 21cm signal from cosmic reionization

Increased pump acceptance bandwidth in spontaneous parametric downconversion process using Bragg reflection waveguides

In this paper we show that by suitably tailoring the dispersion characteristics of a Bragg reflection waveguide (BRW) mode, it is possible to achieve efficient photon pair generation over a large pump bandwidth while maintaining narrow signal bandwidth. The structure proposed consists of a high index core BRW with a periodically poled GaN core and periodically stratified cladding made up of alternate layers of $Al_{0.02}Ga_{0.98}N$ and $Al_{0.45}Ga_{0.55}N$. Such photon-pair generators should find applications in realizing compact and stable sources for quantum information processing.Comment: 6 pages, 5 figure

Design and fabrication of an intrinsically gain flattened Erbium doped fiber amplifier

We report design and subsequent fabrication of an intrinsically gain flattened Erbium doped fiber amplifier (EDFA) based on a highly asymmetrical and concentric dual-core fiber, inner core of which was only partially doped. Phase-resonant optical coupling between the two cores was so tailored through optimization of its refractive index profile parameters that the longer wavelengths within the C-band experience relatively higher amplification compared to the shorter wavelengths thereby reducing the difference in the well-known tilt in the gains between the shorter and longer wavelength regions. The fabricated EDFA exhibited a median gain ?28 dB (gain excursion below $\pm$2.2 dB within the C-band) when 16 simultaneous standard signal channels were launched by keeping the I/P level for each at ?20 dBm/ channel. Such EDFAs should be attractive for deployment in metro networks, where economics is a premium, because it would cut down the cost on gain flattening filter head

Cadmium silicate nanopowders for radiation dosimetry application: Luminescence and dielectric studies

AbstractPure cadmium silicate (CdSiO3) nanophosphor was prepared by a low temperature solution combustion technique. In this technique, meso-structured silica was used as silica source. The prepared compounds were well characterized by powder X-ray diffraction (PXRD), scanning electron microscopy, high resolution transmission electron microscopy, Fourier transform infrared and UV–vis spectroscopic techniques. The PXRD peaks of as-formed sample are broad and amorphous in nature. The compound calcined at 800°C shows pure monoclinic phase, which is the lowest temperature reported so far to obtain in this phase. The average crystallite size for phase pure compound was found to be ∼31nm. The optical energy band gap of ∼5.6eV was observed for the compound. Raman spectrum of the sample showed the all possible states of vibrational motions of the prepared samples. The UV irradiated samples with different dose and time with constant heating rate exhibit the thermoluminescence (TL) with a well resolved glow peak at ∼160°C. The variation of TL intensity with dosage time results that the material was found to be quite useful in radiation dosimetry. The frequency dependent dielectric constant of the prepared sample exhibits high value at low frequency and vice versa

Generation of polarization entangled photons using type-II doubly periodically poled lithium niobate waveguides

In this paper, we address the issue of the generation of non-degenerate cross-polarization-entangled photon pairs using type-II periodically poled lithium niobate. We show that, by an appropriate engineering of the quasi-phase-matching grating, it is possible to simultaneously satisfy the conditions for two spontaneous parametric down-conversion processes, namely ordinary pump photon down-conversion to either extraordinary signal and ordinary idler paired photons, or to ordinary signal and extraordinary idler paired photons. In contrast to single type-II phase-matching, these two processes, when enabled together, can lead to the direct production of cross-polarization-entangled state for non degenerate signal and idler wavelengths. Such a scheme should be of great interest in applications requiring polarization-entangled non degenerate paired photons with, for instance, one of the entangled photons at an appropriate wavelength being used for local operation or for quantum storage in an atomic ensemble, and the other one at the typical wavelength of 1550 nm for propagation through an optical fiber.Comment: 9 pages, 5 figures, 2 table

Myeloid-Derived Suppressor Cells and Pancreatic Cancer: Implications in Novel Therapeutic Approaches

Pancreatic ductal adenocarcinoma (PDAC) remains a devastating human malignancy with poor prognosis and low survival rates. Several cellular mechanisms have been linked with pancreatic carcinogenesis and also implicated in inducing tumor resistance to known therapeutic regimens. Of various factors, immune evasion mechanisms play critical roles in tumor progression and impeding the efficacy of cancer therapies including PDAC. Among immunosuppressive cell types, myeloid-derived suppressor cells (MDSCs) have been extensively studied and demonstrated to not only support PDAC development but also hamper the anti-tumor immune responses elicited by therapeutic agents. Notably, recent efforts have been directed in devising novel approaches to target MDSCs to limit their effects. Multiple strategies including immune-based approaches have been explored either alone or in combination with therapeutic agents to target MDSCs in preclinical and clinical settings of PDAC. The current review highlights the roles and mechanisms of MDSCs as well as the implications of this immunomodulatory cell type as a potential target to improve the efficacy of therapeutic regimens for PDAC