A prospective randomized comparative study between trochanteric versus piriformis entry portal for intramedullary interlock nailing in the treatment of femoral shaft fracture

Background: In case of close nailing for femoral shaft fractures, the nail is inserted into the medullary cavity through the proximal femur without disturbing the periosteal blood supply of at the fracture site. The piriformis fossa and greater trochanter has been commonly described as starting points for antegrade femoral nailing. The purpose of this study was to compare results of two entry ports being used for intramedullary nailing for femoral shaft fractures.Methods: This study was conducted during a period of one year. The patients admitted with femoral diaphyseal fractures for antegrade nailing were divided in two groups alternatively for piriformis fossa entry point and greater trochanter entry point. Total number of patient in each group was 25 (n = 25). Functional outcome were analyzed at final follow up using Hari’s hip score.Results: There was no significant difference clinical and functional output in both group but intraoperative time and fluoroscopic time was significant (P <0.001).Conclusions: Femoral nailing through the greater trochanter entry portal with specifically designed nails should be considered a rational alternative to femoral nailing compared to Piriformis fossa entry portal with the benefit of reduced requirement for fluoroscopy and decreased operative time in obese patients. Statistically no significant difference (>0.005) in clinical and Functional outcome based on Hari’s hip score

Analysis and establish a correlation between serum ceruloplasmin, serum apelin level and thyroid profile in patients with hypothyroidism and healthy controls

Background: Hypothyroidism is an endocrine disorder resulting from deficiency of thyroid hormone. It is often the primary process in which the thyroid gland produces insufficient amounts of thyroid hormone. It can also be secondary, i.e., lack of thyroid hormone secretion due to the failure of either adequate thyrotropin (TSH) secretion from the pituitary gland or thyrotropin-releasing hormone (TRH) from the hypothalamus (secondary or tertiary hypothyroidism). The patient's appearance may vary from asymptomatic to, rarely, coma with multisystem organ failure (myxoedema coma). Methods: The present observational descriptive, cross sectional study has been conducted on 120 newly diagnosed Subclinical Hypothyroidism patients of 20-50 years age group of both sex attending the OPD of department of medicine, RVRS medical college and associated group of hospitals, Bhilwara from May 2021 to May 2022. Diagnosis of thyroid disorder has been made according to the criteria recommended by the European thyroid association guidelines-2013. The result has been compared with age and gender matched 120 euthyroid subjects acting as controls. Detailed history of participants including age, history of any medications, addictions has been taken. Written consent from all the subjects has been obtained for the study.Results: The mean serum FT3 level was found to be slightly decreased in Subclinical hypothyroid subjects (group I) as compared to healthy controls (group II) but the difference was statistically significant (p<0.0001). The mean serum FT4 level was found to be slightly decreased in Subclinical hypothyroid subjects (group I) as compared to healthy controls (group II) but the difference was statistically significant (p<0.0001). A highly significant increase (p<0.0001) in mean serum TSH level has been observed in subclinical hypothyroid subjects (group-I) when compared to controls (group- II). In subclinical hypothyroid subjects, mean serum ceruloplasmin levels were found to be significantly lower in comparison to healthy subjects (p<0.0001).Conclusions: The overall findings of the present study thus confirm that serum Apelin level is significantly higher in subclinical hypothyroid subjects and serum ceruloplasmin level is significantly lower in the subclinical hypothyroid subjects. However, further experimental and observational studies are needed to illustrate the role of serum ceruloplasmin and serum apelin in subclinical hypothyroidism

Synthesis and characterization of some heteroleptic copper(II) complexes based on meso-substituted dipyrrins

The syntheses and characterizations of meso-substituted dipyrrins, 5-(4-imidazol-1-yl-phenyl)-dipyrromethene (4-impdpm), 5-(4-nitro-imidazol-1-yl-phenyl)-dipyrromethene, (4-nimpdpm), 5-(4-benzimidazol-1-yl-phenyl)-dipyrromethene (4-bimp-dpm) and heteroleptic complexes [Cu3(4-impdpm)2(hfacac)4] 1, [Cu(4-nimpdpm)(acac)] 2, [Cu(4-nimpdpm)(hfacac)] 3, [{Cu(4-bimpdpm)(acac)}n] 4 and [{Cu(4-bimpdpm)-(hfacac)}n] 5, imparting acetylacetonato (acac) and hexafluoroacetylacetonato (hfacac) groups as co-ligand have been described. The dipyrrins and complexes 1-5 have been characterized by elemental analyses and spectral (IR ESI-MS, NMR, electronic absorption and emission) studies. Crystal structures of 1, 3 and 4 have been authenticated by X-ray single crystal analyses. The reaction between 4-impdpm and Cu(hfacac)2 gave a trimetallic complex, under analogous conditions 4-nimpdpm and 4-bimpdpm reacted with Cu(acac)2 and Cu(hfacac)2·2H2O to afford mononuclear (2, 3) and 1D polymeric (4, 5) complexes

Physicochemical Characterisation of Commercially Available Prussian Blue Insoluble Samples and Its Comparison with Radiogardase Cs

The physicochemical properties of insoluble Prussian blue (PB) play an important role in its thallium binding ability. Therefore, the present study aimed to characterise various physicochemical parameters of PB available commercially and compare them with the USFDA-approved Radiogardase ® -Cs. In addition, PB was synthesised by indirect and direct methods. PB samples and Radiogardase®-Cs were analysed for various parameters like particle size, moisture content, and thermogravimetric analysis (TGA) and correlated with its Maximum Binding Capacity (MBC) for thallium. Radiogardase ® -Cs showed the highest MBC of 238 mg/g for thallium with D 90 of 785 μm and moisture content of 23.24 %. The MBC of other PB samples was found to be significantly lower than Radiogardase ® -Cs which was found to be directly proportional to the moisture content. However, other parameters like particle size, and iron content vary significantly but no correlation was observed with MBC for thallium. This finding suggests that moisture content and MBC are extremely important parameters for optimising the PB to achieve desirable pharmacological efficacy for removing thallium in vivo

Prevalence of vitamin D deficiency and effect of vitamin D supplementation on feto-maternal outcome in tertiary care centre

Background: Vitamin D deficiency is widely prevalent throughout the world. Pregnant women, neonates and infants form most vulnerable groups for vitamin D deficiency. Hypovitaminosis D in pregnancy has been reported to cause various fetomaternal effect, i.e. increased risk of preeclampsia (PE), gestational diabetes mellitus (GDM), caesarean section, hypocalcemia, subclinical myopathy, neonatal tetany, hyperbilirubinemia congenital rickets and infantile rickets, etc. Only few Indian studies are available in this regard. The objectives are to find prevalence of vitamin D deficiency in pregnant women and to evaluate the effect of supplementation with cholecalciferol in improving vitamin D levels in pregnant women and evaluate its correlation with feto-maternal outcome.Methods: A prospective observational was conducted on 120 Pregnant women on their first visit to hospital irrespective of gestational age were offered the test and on the basis of inclusion and exclusion criteria are included in study and vitamin D level was done to know the prevalence of vitamin D deficiency. Apart from routine obstetrical investigation, serum vitamin D (total) level was estimated. All results were recorded and analyzed statically.Results: Out of 120 patients 101 (84.1%) were found to be vitamin D deficient. Mean age of vitamin D deficient group was 28.31±3.86 and sufficient group was 26.37±2.83.81 (67.5%) were vegetarian and 39 (32.5%) were nonvegetarian.75 (92.59%) vegetarian and 26 (66.66%) non-vegetarian found to be vitamin D deficient. (p<0.05). Vitamin D supplementation has been observed to reduce risk of preeclampsia. (p<0.05) and vitamin D sufficiency associated with reduced risk of low birth weight babies.Conclusions: Vitamin D supplementation reduces risk of maternal comorbidities and helps improve neonatal outcomes

Cell Biology in Rheumatoid Arthritis

Rheumatoid arthritis (RA) is a systemic autoimmune disease, which affects about 0.33 to 2.65% of the population. In RA Synovium contain various type of immune cell. In which only one cell population cannot cause rheumatoid arthritis that requires more than one cell population. In normal condition, they act as a switch (active or inactive the cell signaling). It controls cell growth, proliferation or metastasizes. In an autoimmune disorder such as rheumatoid arthritis, the immune system mistakenly attacks and destroys the body's cells and tissues. Mostly cells are present in limited numbers in normal human synovium, but in rheumatoid arthritis and other inflammatory joint diseases, this population can expand to constitute 5-20% or more of all synovial cells. Recent investigations in a murine model have demonstrated that cells can have a critical role in the generation of inflammation within the joint. Keyword: Cell Biology in rheumatic arthritis; Dendrite cell; T-cell; Mast cell; Fibroblastic cell; Macrophages cell

Feto-maternal outcomes following caesarean section: a prospective comparative study at tertiary care centre in North-Western Rajasthan

Background: Caesarean section (CS) is employed when vaginal delivery is not feasible or hazardous to the mother and/or her baby. The procedure, however, is not without risk. We determined the fetomaternal outcomes of CS conducted at P.B.M Tertiary hospital situated in the North-Western region of Rajasthan.Methods: This is a Hospital based prospective comparative study of all CSs performed for various indications at the Dept. of Gynaecology and Obst., S.P. Medical College and P.B.M Hospital, Bikaner, India, from August 01, 2016, to July 31, 2017. All patients who had CS at any time within the 24 h period were noted and followed up until discharge. The sociodemographic data, types of CS, indications, and feto-maternal outcomes were documented in a proforma. Statistical analysis was carried out using the SPSS version 24.Results: There were 16386 deliveries out of which 4456 (27.1%) were by LSCS. The age range of the group A was 21-25 years while in group B it was 26-30 years. The mean age group A was 22.4, and group B it was 27.9 years. Total 6572 primigravida patients delivered and 32.1% had LSCS. Total 9814 multigravida patients delivered and 12.6% had primary LSCS. In group A, 119(79.3%) LSCS were elective as compared to group B where only 19(12.7%) were elective and this difference was found statistically highly significant (p<0.001). Indication of LSCS is different in both the groups. Fetal distress was most common indication in group A (53.3%) while in group B most common indication was APH (35.9%). Perinatal mortality/morbidity was significantly higher in group B (7.3%) as compared to group A (2.7%).Conclusions: The CS rate in this study was 27.1%. Although primary caesarean section in multipara constitutes only a small percentage of total deliveries and caesarean, they are associated with high maternal and perinatal morbidity. The reason for these complications is many. Beside obstetrical causes, factors like lack of antenatal care, low socioeconomic status, anaemia, malnutrition and illiteracy also play a major role obstructed labor and previous CS among Maternal and perinatal complications were more frequent with emergency CS and in the referred cases