Factors Associated with Revision Surgery after Internal Fixation of Hip Fractures

Background: Femoral neck fractures are associated with high rates of revision surgery after management with internal fixation. Using data from the Fixation using Alternative Implants for the Treatment of Hip fractures (FAITH) trial evaluating methods of internal fixation in patients with femoral neck fractures, we investigated associations between baseline and surgical factors and the need for revision surgery to promote healing, relieve pain, treat infection or improve function over 24 months postsurgery. Additionally, we investigated factors associated with (1) hardware removal and (2) implant exchange from cancellous screws (CS) or sliding hip screw (SHS) to total hip arthroplasty, hemiarthroplasty, or another internal fixation device. Methods: We identified 15 potential factors a priori that may be associated with revision surgery, 7 with hardware removal, and 14 with implant exchange. We used multivariable Cox proportional hazards analyses in our investigation. Results: Factors associated with increased risk of revision surgery included: female sex, [hazard ratio (HR) 1.79, 95% confidence interval (CI) 1.25-2.50; P = 0.001], higher body mass index (fo

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Not AvailableIndia is blessed with rich diversity of fishery resources. However, over the years increasing human influence has led to the decline in fish diversity. Potential water areas are considered as a potential tool for conservation of fish diversity as they provide protection for fishes. It is important to know how these benefits are perceived by the local people who are dependent on these fishery resources. Ensuring local support for protected water areas is increasingly viewed as an important element of biodiversity conservation. Therefore, it is necessary to understand the perspective of the local people living around these protected water areas as this perspective would be of immense help to the planners, administrators and managers of the fishery resources. In this paper, findings of a case study of people’s perception about conservation of fishery resources outside the protected water bodies conducted in Lakhimpur Khiri district. of UP are discussed. It was found that thefishermen were aware of not only the decline of fishery resources, but also its causes and a few of the remedies. However, they were too occupied with earning a bare minimum livelihood amidst the declining fish catches, to undertake any resource enhancement or conservation measure. However, they were willing to cooperate in such endeavors .Not Availabl

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Not AvailableIn India and other developing countries, the role of institutional support and social connectedness among fishing communities is played by and large by conventional fishermen groups, fishermen cooperative societies, federations, etc. These organizations by their very nature and reason for existence are aimed at increasing the maximum output from the fishery resources and thereby, increasing the livelihood, income and wellbeing of their members. In India, fishing cooperative societies have been studied by very few researchers and most of these studies have focused on performance of fishing cooperatives on production, marketing and financial aspects. Fishing cooperative societies as a social organization have not adequately been studied in India. This paper reports findings from a study undertaken to assess the internal functioning of the fishing cooperative societies established and promoted under different scenarios. The study covered 58 fishing cooperative societies in three states viz. Himachal Pradesh, Madhya Pradesh and Uttar Pradesh.Not Availabl

An X-linked cobalamin disorder caused by mutations in transcriptional coregulator HCFC1

Derivatives of vitamin B12 (cobalamin) are essential cofactors for enzymes required in intermediary metabolism. Defects in cobalamin metabolism lead to disorders characterized by the accumulation of methylmalonic acid and/or homocysteine in blood and urine. The most common inborn error of cobalamin metabolism, combined methylmalonic acidemia and hyperhomocysteinemia, cblC type, is caused by mutations in MMACHC. However, several individuals with presumed cblC based on cellular and biochemical analysis do not have mutations in MMACHC. We used exome sequencing to identify the genetic basis of an X-linked form of combined methylmalonic acidemia and hyperhomocysteinemia, designated cblX. A missense mutation in a global transcriptional coregulator, HCFC1, was identified in the index case. Additional male subjects were ascertained through two international diagnostic laboratories, and 13/17 had one of five distinct missense mutations affecting three highly conserved amino acids within the HCFC1 kelch domain. A common phenotype of severe neurological symptoms including intractable epilepsy and profound neurocognitive impairment, along with variable biochemical manifestations, was observed in all affected subjects compared to individuals with early-onset cblC. The severe reduction in MMACHC mRNA and protein within subject fibroblast lines suggested a role for HCFC1 in transcriptional regulation of MMACHC, which was further supported by the identification of consensus HCFC1 binding sites in MMACHC. Furthermore, siRNA-mediated knockdown of HCFC1 expression resulted in the coordinate downregulation of MMACHC mRNA. This X-linked disorder demonstrates a distinct disease mechanism by which transcriptional dysregulation leads to an inborn error of metabolism with a complex clinical phenotype

Fracture fixation in the operative management of hip fractures (FAITH): an international, multicentre, randomised controlled trial

Background Reoperation rates are high after surgery for hip fractures. We investigated the effect of a sliding hip screw versus cancellous screws on the risk of reoperation and other key outcomes. Methods For this international, multicentre, allocation concealed randomised controlled trial, we enrolled patients aged 50 years or older with a low-energy hip fracture requiring fracture fixation from 81 clinical centres in eight countries. Patients were assigned by minimisation with a centralised computer system to receive a single large-diameter screw with a side-plate (sliding hip screw) or the present standard of care, multiple small-diameter cancellous screws. Surgeons and patients were not blinded but the data analyst, while doing the analyses, remained blinded to treatment groups. The primary outcome was hip reoperation within 24 months after initial surgery to promote fracture healing, relieve pain, treat infection, or improve function. Analyses followed the intention-to-treat principle. This study was registered with ClinicalTrials.gov, number NCT00761813. Findings Between Mar