Evaluation of percutaneous pinning in fracture proximal one-third humerus and fracture dislocation

Background: Proximal humerus fracture treatment is still an issue with lot of controversies and various treatment modalities had yielded mixed results. Our aim is to study percutaneous K-wires fixation as a modality of treatment, does not need extensive soft tissue dissection, so small fracture fragments & retains periosteal muscle & ligament attachments which held the fracture fragments together. Complications of open reduction are avoided.Methods: Fractures were classified according to Neer’s Classification system and were treated with closed reduction and K-wire Fixation. They were 16 males and 09 females, with a mean age of 40.5 years. Mean follow-up was of 20.5 months (range 9-24 months). Post-operative mean VAS score and Constant Score of patients was 2.1 (±0.73) and 78.1 (±9.61) at an average follow up of 6 months. Mean duration for union was 6.5 (±1.18) weeks. Patients were followed up at 4, 8, 12 weeks and 3, 6, 9 & 12 months interval.Results: Radiological and functional outcome assessed according to Constant-Murley Shoulder assessment. Complications treated accordingly. Percutaneous K-wire fixation is safe, limited invasive technique and following basic principles of anatomical reduction has excellent results & functional outcome.Conclusions: We concluded that the soft-tissue bridging of the fracture fragments was crucial for the reduction to benefit from the ligamentotaxis effect. This technique worked well for valgus-impacted or three-part fractures. The rate of osteonecrosis was low, and rehabilitation was easier. Overall, the results from these series are quite encouraging

Sputum Smear Microscopy at Two Months into Continuation-Phase: Should It Be Done in All Patients with Sputum Smear-Positive Tuberculosis?

BACKGROUND: The Revised National Tuberculosis Control Program (RNTCP) of India recommends follow-up sputum smear examination at two months into the continuation phase of treatment. The main intent of this (mid-CP) follow-up is to detect patients not responding to treatment around two-three months earlier than at the end of the treatment. However, the utility of mid-CP follow-up under programmatic conditions has been questioned. We undertook a multi-district study to determine if mid-CP follow-up is able to detect cases of treatment failures early among all types of patients with sputum smear-positive TB. METHODOLOGY: We reviewed existing records of patients with sputum smear-positive TB registered under the RNTCP in 43 districts across three states of India during a three month period in 2009. We estimated proportions of patients that could be detected as a case of treatment failure early, and assessed the impact of various policy options on laboratory workload and number needed to test to detect one case of treatment failure early. RESULTS: Of 10055 cases, mid-CP follow-up was done in 6944 (69%) cases. Mid-CP follow-up could benefit 117/8015 (1.5%) new and 206/2040 (10%) previously-treated sputum smear-positive cases by detecting their treatment failure early. Under the current policy, 31 patients had to be tested to detect one case of treatment failure early. All cases of treatment failure would still be detected early if mid-CP follow-up were discontinued for new sputum smear-positive cases who become sputum smear-negative after the intensive-phase of treatment. This would reduce the related laboratory workload by 69% and only 10 patients would need to be tested to detect one case of treatment failure early. CONCLUSION: Discontinuation of mid-CP follow-up among new sputum smear-positive cases who become sputum smear-negative after completing the intensive-phase of treatment will reduce the laboratory workload without impacting overall early detection of cases of treatment failure

A Review of Different Secret Image Watermarking Technique

In this paper, we discussed several different techniques use on digital image watermarking.The enlargement of internet and availability of the network incomputer now adays provide facility of multimedia data during passing information over the transmission medium. In this regularly developing society of the internet if using the traditional digital image watermarking technology doesnrsquot have the capability to provide security from intentionally or may unintentionally attacks. So multimedia data received conveniently without suffering the losses of information. The repercussion of these application create moderation and distribution of the illegal information easily for the uncertified parties. The technique of digital watermarking come into existence to vanquish these authentications issue. So watermarking is one of the solution come to salvage for protection from the unlawful operation like forgery, duplicity, modifying data content, copyright-violation. The digital based content can be protected by using watermarking. So digital watermarking is basically an embedding or hiding data technique. This data may in form of image, audio, text or video. In this paper we point two categories of digital image watermarking via spatial domain and frequency domain. We mainly focused to describe variety of techniques applied on digital image. The comprehensive set of experimental results through variety of the watermarking techniques on digital image, which is showing that their proposed method has superiority and provide improved performance of the watermarking algorithms in comparison with the previously proposed methods. These approaches having the ability to withstand against variety of image processing attacks such as salt and pepper noise, JPEG compression, Gaussian noise, some filtering attacks as median filtering, Conv filtering (Gaussian filtering and sharpening), some geometric structure distortion attacks as bending cropping, resizing and rotating. These schemes output performed to measure imperceptibility and its Robustness with Signal to Noise Ratio (PSNR) and Normalized Cross Correlation (NCC) values