Functional and radiological outcome of osteosynthesis using proximal femoral nail antirotation II system in intertrochanteric femoral fractures

Background: Intertrochanteric fractures are relatively common injuries in adults and a common source of morbidity and mortality among the elderly. Incidence of fractures is increasing because the general life expectancy of the population has increased significantly during the past few decades. Stable fixation and early mobilization is needed in these fractures to reduce the morbidity and mortality. Extra-medullary implants are biomechanically inferior in these cases. The proximal femoral nail antirotation-II (PFNA-II) is an intra-medullary nail system designed for such fractures. The purpose of this study was to assess the results and complications of PFNA-II in intertrochanteric femur fractures.Methods: After seeking approval from institutional Ethical committee, this study was conducted on 30 patients attending our emergency department with intertrochanteric femur fractures at SKIMS Medical College Hospital Bemina, Srinagar from February 2018 to June 2019. The patients were treated with proximal femoral nail antirotation-II. Follow up was done at 2, 6, 12 and 24 weeks.  The functional outcome was assessed at 6 months follow up using the Harris Hip Score.Results: Based on the Harris hip score, 18 (60%) patients had excellent results, 10 (33%) had good results and 2 (7%) had Fair results. None of the patients had poor result. Average time to union was 12.27 weeks.Conclusions: This study found the PFNA-II to be a versatile, easy to use and dependable implant for stable as well as unstable intertrochanteric fractures. PFNA II is distinct advance over the previous methods of treatment, though it has an initial learning curve

Management of commode injuries of Achilles tendon: a newly established tertiary care hospital-based study

Background: The Achilles tendon is the largest and strongest tendon in the body, formed by the union of gastrocnemius and soleus. Despite its strength, the Achilles tendon is vulnerable to injury, due to its subcutaneous position and the high tensions placed on it. Common mode of Achilles tendon injury nowadays in India is slipping of the foot in Indian type of commode and is often fraught with complications due to the potential contamination of wound at the time of injury. The purpose of this study was to assess the clinical outcome and complications of open Achilles tendon injury with an Indian type commode.Methods: 30 patients who presented with open Achilles tendon injury between the ages of 10 to 55 years were included. All the patients were treated with emergency debridement, thorough washing and primary repair within 24 hours using Krackow technique.Results: Out of the 30 patients meeting the inclusion criteria, there was 1 case of superficial infection which resolved with antibiotics and serial dressings. Foreign body sensation was present in 3 patients at final follow-up. Hypertrophic scar formation was seen in one patient. There were no cases of re-rupture in our study. Mean ROM at ankle in saggital plane at final follow-up was 66.13 degrees.Conclusions: Commode injury is the most common cause of open Achilles tendon injury in Indian population. The complications can be minimized by early primary repair and should only be undertaken after thorough washing and debridement under proper antibiotic cover to contain the infection

Transcription factors-golden keys to modulate the plant metabolism to develop salinity tolerance

Abiotic stressors such as drought, low temperature, heavy metals, waterlogging, nutrient imbalance, and salinity are major factors that affect the growth and development of crop plants, which, in turn, results in severe loss in production and yield of economically important crops. Current literature backs up the effect of high salinity on almost all crop plants. Thus, it can be concluded that salinity stress is amongst the most dominant abiotic stress factors in current farming systems, which counteract achieving the goal of “zero hunger.” Consequently, there is a dire need to improve crop plants to develop salinity tolerance for higher yield and production, even in salinity agricultural habitats. The last few decades have established a mechanistic understanding and have identified the molecular determinants favoring salinity tolerance in crop plants. Stress-responsive transcriptional control is the best strategy crop plants adapt to alleviate abiotic stressors, especially salinity stress. In crop plants, transcription factors (TFs) central to the regulation of salinity tolerance include bZIP, WRKY, NAC, AP2/ERFBP, bZIP, and MYB. Studying these TFs and their molecular mechanisms can facilitate their molecular modification at the genetic level to modify crop plants for stress tolerance. Collectively, these reports suggest that TFs enhance tolerance to salinity stress directly or indirectly through diverse signaling pathways. This review summarizes the recent developments in deciphering the mechanistic regulation of TFs in controlling the cellular process and gene expression under salinity stress. Finally, we highlight the way forward in applying genome editing technologies to modulate TFs as hallmark genes in circumventing salinity stress in crop plants