Treatment of tibial diaphyseal fractures with closed flexible intramedullary ender nails: 39 fractures followed for a period of two to seven years

Abstract OBJECTIVE: To assess the efficacy of flexible intramedullary Ender nails for the treatment of tibial diaphyseal. MATERIALS AND METHODS: This is a retrospective review of patients treated with the Ender Nail for both open and closed tibial shaft fractures. Between January 1989 and December 1994, 43 fractures were treated with these nails. The configuration of each fracture was determined using the Orthopedic Trauma Association classification and the extent of soft tissue damage was assessed using the Gustilo and Anderson\u27s classification. Four patients were excluded from the study due to inadequate follow-up. There were 27 closed and 12 open fractures. RESULTS: The average time to union in 34 out of 39 fractures was 17 weeks. Delayed union and malunion occurred in two patients each and superficial wound infection in 1 patient. Nonunion occurred in 5 fractures that were all located in the distal 1/3 of the tibial diaphysis. We attribute this high rate of non-union to a poor rotational control on the distal fragment by these nails. CONCLUSIONS: The Ender nails provide effective fixation for the OTA stable class of tibial fractures, where they produce good axial and rotational stability by virtue of their three-point fixation. Rotational and angular stability should be improved by a supplementary cast immobilization for fractures with unstable configuration and those located in the distal third of the diaphysis

ZnxCd1-x (O) Thin Film Nanorods for PV Applications

ZnxCd1-x (O) nanorods (NRs) thin films were deposited on ITO glass substrate by using a single step controlled electrodeposition process. Thin films of crystalline nature with zinc and cadmium concentration changing from 10% - 90% were electrodeposited onto ITO conductive glass substrates. XRD analysis confirms a hexagonal wurtzite structure having grain size 37 nm. The FESEM images of ZnxCd1-x (O) shows that hexagonal nanorods were first time synthesized via electrodeposition technique at temperature of 90 oC and the size of each regular plane of hexagonal nanorods is about 63nm. The Cd content of ZnxCd1-xO nanorods was as high as (about) 16.7 at% which as calculated by EDX. Remarkably, the ultra-violet (UV) near-band-edge (NBE) emission was red-shifted from 3.21 eV to 3.04 eV due to the direct modulation of band gap caused by Cd substitution, revealed by UV visible spectroscopy. Temperature is deemed as a key parameter for the formation of different morphologies of ZnxCd1-x (O) nanostructures. Finally, ZnxCd1-xO hexagonal nanorods thin film is used as one electrode in photovoltaic cells to produce energy by absorbing the energy from the sun, this single junction cells have been put forward as a potential low-cost alternative to the widely used solar cells. However, the cost effectiveness is due to the ZnxCd1-xO nanorods electrode. Copyright © IJNST, all rights reserved

Asymptomatic urinary tract infection: Cause of postoperative wound infection

bstract OBJECTIVE: To determine the rate of urinary tract infection in patients given incomplete treatment before undergoing hip fracture surgery. METHODS: The descriptive case series was conducted at Aga Khan University Hospital, Karachi, From October 25, 2012 to April 24, 2013. 84 postmenopausal women having hip fracture along with asymptomatic urinary tract infection. The infection was treated incompletely and postoperatively wound infection rate was determined. The SPSS version 17 was used to analyze the data. RESULTS: The overall mean age of the 84 patients in the study was 63.57+10.34 years. Overall, 14(16.7%) patients had wound infection after orthopaedic implant surgery for hip fracture. CONCLUSIONS: There was a high occurrence of wound infection after hip implant surgery in patients having preoperative asymptomaticurinary tract infection who were treated incompletely

Acetabular morphometry for determining hip dysplasia in the Singaporean population

Abstract PURPOSE: To assess and evaluate the usefulness of 7 morphological measurements of the acetabulum in establishing the prevalence of acetabular dysplasia in the Singaporean population. METHODS: Standardised plain anteroposterior radiographs of 522 hip joints of 261 asymptomatic patients (mean age, 60 years; range, 16-99 years) were evaluated. The 7 morphological measurements were centre-edge angle, acetabular angle, depth-to-width ratio, roof obliquity, extrusion index, lateral subluxation, and peak-to-edge distance. RESULTS: 19 (7.3%) patients were acetabular dysplastic (centre-edge angle of \u3c20 \u3edegrees). The mean centre-edge angle was 31.2 degrees (range, 5-52 degrees), acetabular angle 39.46 degrees (range, 10-58 degrees), depth-to-width ratio 0.32, roof obliquity 7.86 degrees, extrusion index 0.18, lateral subluxation 9.9 mm, and the peak-to-edge distance 15.65 mm. CONCLUSION: Centre-edge angle was the most useful measurement and correlated significantly with acetabular angle, extrusion index, peak-to-edge distance, and roof obliquity. These preliminary results show a relatively higher rate (7.3%) of acetabular dysplasia in the Singaporean population, compared with other similar but larger Asian studies performed in Hong Kong (1.1%) and Korea (1.8%)

Preoperative cardiac evaluation in proximal femur fractures and its effects on the surgical outcome

OBJECTIVE: The aim of the current study was to evaluate the impact of cardiac risk stratification and preoperative cardiac evaluation on final outcomes in patients with acute proximal femur fractures. METHODS: This retrospective review included one hundred and three patients who underwent a preoperative cardiac evaluation prior to proximal femur fracture operation between 2004 and 2007 at a tertiary care hospital. Patients were divided into two groups. Group A included 76 patients who were tested with ECG only and Group B included 27 patients with additional clearance. All of these files were reviewed according to a set pro forma. Statistical analysis was done using the SPSS 17 software. The Student\u27s t-test and Mann-Whitney U test were applied to compare two means. RESULTS: Fifty-three patients had intertrochanteric fractures and 50 had femoral neck fractures. Only 7 patients had a metabolic equivalent task of less than 4. Group B patients had significant delay in time from triage to surgery (p CONCLUSION: Preoperative cardiac evaluation is associated with delay in surgery and subsequent ambulation. Delay in surgery is not associated with increased perioperative mortality at our institute. However, the set of guidelines proposed by ACC/AHA should be followed, as the selection of patients for additional investigation was not justifiable in most cases

Association of Physical Activity with Co-morbid Conditions in Geriatric Population

To find out association of physical activity with co-morbid conditions in geriatric population, a cross-sectional study was conducted in different cties of Pakistan in 2015. A total of 114 participants were inducted by non-probability convenience sampling technique. Data was collected after informed verbal consent by a validated questionnaire that is Rapid Assessment of Physical Activity (RAPA). Participants were categorized into two groups i.e. physically active and physically inactive. Data was entered and analyzed in SPSS version 20. There were 66 (57.9%) males and 48 (42.1%) females with mean age of 57.04±7.348 years. Among hypertensive individuals (n=43, 37.7%) there were 39 (90.7%) physically inactive, among individuals having angina (n=17, 14.9%) there were 15 (88.2%) physically inactive. Out of 37 (32.5%) diabetics, 35 (94.6%) were physically inactive. Among individuals suffering from arthritis (n=40, 35.1%), there were 38 (95%) physically inactive. A significant association was found between physical activity and diabetes and arthritis with p-value of 0.048 and 0.029 respectively. Physical activity is significantly associated with diabetes and arthritis in geriatric population. Adequate physical activity should be performed to reduce the risk of co-morbid conditions and improve the quality of life in geriatric population

Bullet-induced synovitis as a cause of secondary osteoarthritis of the hip joint: a case report and review of literature

Abstract BACKGROUND: With increasing prevalence of gunshot injuries we are seeing more patients with retained bullet fragments lodged in their bodies. Embedded lead bullets are usually considered inert after their kinetic energy has dissipated hence these are not removed routinely. However, exposure of any foreign body to synovial fluid may lead to rapid degradation and hence result in systemic absorption, causing local and systemic symptoms. We present the case of a thirty year old man who came to our out patient department with a history of progressive, severe hip pain ten years after a gun shot injury to his right hip. CONCLUSION: The common belief that intraarticular bullets should not be removed has no benefit and may result in unwanted long term complications

A review of novel dental caries preventive material: Casein phosphopeptide–amorphous calcium phosphate (CPP–ACP) complex

AbstractA paradigm shift is emerging in dentistry and dental treatments are now aimed at maximum conservation of tooth structure. It is nowadays considered an ethical duty of a dentist to provide their patients with minimally invasive treatment. Remineralization therapy is preferred in cases, where there is a chance of gaining success by preventive methods. Many novel caries preventive materials are now available in the market which contain components that have the ability to initiate remineralization. One such component which is caries preventive and is present in many dental materials is Casein phosphopeptide–amorphous calcium phosphate (CPP–ACP)

Evaluation of allelopathic potential of some selected medicinal species

Laboratory trials were made to evaluate the allelopathic potential of selected medicinal species. The aqueous extracts bioassay on two test plants (wheat and pea) was carried out through filter paper method. Toxicity and non toxicity was assessed by recording their effects on germination and percentage growth of radicle and plumule of test plants. The trials were replicated three times in Randomized Complete Split Block Design. The data was analyzed by using software SPSS v II. The results suggested that Sonchus asper and Melilotus officinalis stimulate the growth of wheat (Triticum aestivum) up to 150% of plumule and 40% of radicle. These species had significantly enhanced effect on the percentage growth of test plant. The inhibitory effect was more on the wheat, by aqueous extractions of Sisymbrium irio, Cannabis sativus and Oxalis corniculata. The growth of wheat was more enhanced in the aqueous extractions of Gallium aperine and Ageratum conizoides, almost 150% of radicle. But the most inhibitory and retarded effect was observed in case of S. irio, O. corniculata, Rumex dentatus and Parthenium hysterophorus.Key words: Allelopathy, medicinal species, filter paper