Rotary ultrasonic bone drilling: improved pullout strength and reduced damage

Bone drilling is one of the most common operations used to repair fractured parts of bones. During a bone drilling process, microcracks are generated on the inner surface of the drilled holes that can detrimentally affect osteosynthesis and healing. This study focuses on the investigation of microcracks and pullout strength of cortical-bone screws in drilled holes. It compares conventional surgical bone drilling (CSBD) with rotary ultrasonic bone drilling (RUBD), a novel approach employing ultrasonic vibration with a diamond-coated hollow tool. Both techniques were used to drill holes in porcine bones in an in-vitro study.Scanning electron microscopy was used to observe microcracks and surface morphology. The results obtained showed a significant decrease in the number and dimensions of microcracks generated on the inner surface of drilled holes with the RUBD process in comparison to CSBD. It was also observed that a higher rotational speed and a lower feed rate resulted in lower damage, i.e. fewer microcracks. Biomechanical axial pullout strength of a cortical bone screw inserted into a hole drilled with RUBD was found to be much higher (55–385%) than that for CSBD

Characteristics, Treatment Outcomes and Role of Hydroxychloroquine among 522 COVID-19 hospitalized patients in Jaipur City: An Epidemio-Clinical Study.

The present study was undertaken to investigate epidemiological distribution, clinical manifestation, co morbid status, treatment strategy and case fatality index of emerging COVID-19 infection at SMS Medical College Hospital, Jaipur, Rajasthan. It also evaluated efficacy of hydroxychloroquine (HCQ) in treatment of patients and risk of serious adverse outcomes in patients with COVID-19 in relation to their co morbid status.  The varied spectra of COVID-19 mostly affects young adult age group (third to fifth decades of life). Interestingly, early age group was also affected in significant proportion when compared with similar data from other countries. It was observed that male population seemed to be was more prone to getting infected. Majority of COVID-19 positive patients (nearly three-fourth) were asymptomatic (mostly in young age range) at the time of diagnosis, which poses a major challenge for health care workers. Fever, cough, sore throat and shortness of breath were major symptoms that could be detected in such COVID-19 patients. Symptomatic clinical manifestations were more common in old age population. Infectivity was higher in patients that had underlying co morbid disease, especially in patients with multiple co morbid conditions. Symptomatic presentation of COVID-19 was observed to be higher in patients with co morbid disease. Average recovery time from COVID-19 was 8 days with effective treatment. Mortality in COVID-19 was higher in old age population, male gender, symptomatic and co morbid patients as compared to other similarly matched group. Most of mortality was noted within first few days of admission, suggestive of early mortality due to the primary disease process. Treatment with HCQ had early recovery without effectively influencing the overall mortality. </p

The prognostic impact of human papillomavirus status following treatment failure in oropharyngeal cancer

<div><p>Introduction</p><p>Despite the human papillomavirus conferring a better prognosis in the primary treatment setting, the prognostic impact of viral status after treatment failure in oropharyngeal squamous cell carcinoma patients is poorly understood.</p><p>Methods</p><p>We retrospectively identified 33 oropharyngeal squamous cell carcinoma (OPC) patients with local and/or distant disease recurrence post-treatment, and looked at metastatic patterns, time to failure and survival patterns by HPV status.</p><p>Results</p><p>Median overall survival following local failure was not significantly different by HPV status (17 months for HPV+ vs. 14 months for HPV-, p = 0.23). However, following distant failures, HPV+ patients lived significantly longer than HPV- patients (median 42 months vs. 11 months, p = 0.004). HPV- patients were more likely to have locoregional failures as compared to HPV+ patients (p = 0.005), but the difference in distant failure between both groups was not significant (p = 0.09). HPV+ patients were more likely to develop metastases to sites other than the lung and bones.</p><p>Conclusion</p><p>HPV positivity predicts a favorable prognosis with the potential for long-term survival following distant, not locoregional, failures. These results have important implications for the aggressiveness of treatment and type of surveillance imaging performed.</p></div

The prognostic impact of human papillomavirus status following treatment failure in oropharyngeal cancer - Fig 1

<p>(A) Photograph of distant metastasis to right fifth toe. (B) Pet scan of metastasis to right fifth toe.</p

Treatment after failure by failure type and HPV status.

<p>Treatment after failure by failure type and HPV status.</p

Treatment Regimens for Adjuvant Chemoradiotherapy Cohort.

<p>Treatment Regimens for Adjuvant Chemoradiotherapy Cohort.</p

Patient Characteristics.

<p>Patient Characteristics.</p

Type of failure by stage and HPV status.

<p>Type of failure by stage and HPV status.</p

Patient characteristics and demographics.

<p>Patient characteristics and demographics.</p

Distant metastases sites by HPV status.

<p>Distant metastases sites by HPV status.</p