An analysis of functional outcome following conservative versus surgical management in fractures of the distal radius

Background: Distal radial fractures are one of the most common injuries seen in the orthopaedic department, which can be managed both conservatively and surgically. There are advantages and disadvantages in each method of management. The aim of this study was to compare the functional and radiological outcomes of intra-articular fractures of the distal end of the radius with conservative and surgical management.Methods: 80 cases of intra articular fractures of the distal radius managed by both conservative and surgical means were studied between January 2011 to January 2013 and were followed up for a minimum period of two years.Results: In our series of 80 patients, there 53 males and 27 females. Most of the patients were between 20-30 years of age with the mean age being 40.35 years. RTA was the most common mode of injury (45%). Frykman’s type 3 (41.7%) was the most common fracture type seen followed by type 8. All fractures united by the end of 6 months. Excellent results were seen in 47.5% of cases in the surgical group and 30% of cases in the conservative group. Conclusions: From this study, we conclude that surgical management is better than conservative in the treatment of intra articular fractures of the distal end of radius. Therefore, one treatment method of treatment cannot be generalized for all types of fractures and treatment should be individualized to a particular fracture in terms of age, fracture pattern, degree of displacement and amount of communition present.

An overview of laparoscopic versus open incisional hernia repair

Background: An incisional hernia is perceived as a morbidity following an abdominal wall operation. Risk factors that increase the chances of developing these hernias are wound infection, male sex, obesity, abdominal distension, underlying disease process and occasionally poor surgical closure. The aim of this study was to compare laparoscopic vs open incisional hernia repair with regard to postoperative pain and nausea, operative time, postoperative complications and length of hospital stay. Methods: We conducted retrospective review of consecutive patients with hernia in department of surgery, Sri Venkateshwaraa Medical College and Hospital, Redhills, Chennai, Tamil Nadu between September 2022 to February 2023 (6 months). We analyzed 140 patients that met the inclusion criteria and their clinical data. The patients were divided into two groups: open incision hernia repair (OI=70) group and laparoscopic hernia repair (LR=70) group. Results: In our study, the mean operative time of 99.64±13.1 min for the laparoscopic repair group was longer than the mean operative time of 74.64±9.14 min for open repair (p =0.264). Hospital stay was not significantly in the laparoscopic group with a mean of 2.4±0.6 days compared with 2.8±1.4 of the open repair group (p=0.0515). Conclusions: Smaller incisional hernias with a transverse diameter <10 cm can be repaired successfully by a laparoscopic approach if a suitably skilled surgeon is available, although an ugly scar may remain on the anterior abdominal wall. Major defects >10 cm was best repaired by an open operation

The role of primary cemented total hip arthroplasty in the management of fractures of the neck of femur in the elderly population

Background: Femoral neck fractures are common injuries in the elderly population and are associated with high rates of morbidity and mortality. The aim of surgical intervention in these elderly patients is to restore them to the pre-fracture status as rapidly as possible. The aim of this study was to evaluate the role of total hip arthroplasty as a primary option in the management of these fractures and to compare the results with studies of other authors as available in literature.Methods: 45 patients with femoral neck fractures treated with cemented total hip arthroplasty were studied from January 2011 to January 2013 and were followed up for a minimum period of two years.Results: There were 18 males and 27 females ranging from 60 to 75 years of age. Mean age was 64.6 years. Majority (80%) of the fractures were completely displaced, Garden type 4 fractures followed by type 3 in 20% of cases. The most common mode of injury was a simple slip and fall. Excellent results were seen in 17 patients, good results in 24 patients and fair results in 4 patients. No poor results were seen. Conclusions: Cemented total hip arthroplasty is a very useful procedure for the primary treatment of femoral neck fractures in elderly patients. This procedure markedly improves the functional status of the patients and gives good functional results

Clinical profile and outcome of diabetic foot ulcers

Background: Diabetes mellitus is a common metabolic endocrine disorder, once prevalent in developed countries has become the leading ‘global epidemic’. WHO estimated that in the year 2000. Roughly 3% of the total world population had Diabetes. In India around 61million of general population affected in 2011 which may rise to 101 million by 2030. The aim of the study was to study the clinical profile and outcome of diabetic foot ulcers. The clinical profile of 120 patients with diabetic foot ulcer was studied.   Methods: Patients with diabetic foot ulcer of both genders with age above 30 years willing to participate were included in the study. All patients were subjected to routine diabetic work up with Doppler study and X-ray foot to rule out bone involvement. Results: The majority of patients with diabetic foot ulcers were of age group 51 to 60 years, male predominant, 84 patients out of 120 isolated included for study, 24 (28.6%) isolates had Klebsiella, 46(54.8%) isolates Pseudomonas, 14 (16.7%) isolates has E.coli. Conclusions: Our study gives important information that diabetic foot ulcer is more common among middle-aged people with male predominance which gives the importance of screening diabetic patients for neuropathy and peripheral vascular disease

An evaluation of functional outcome following minimally invasive plate osteosynthesis in fractures of the distal tibia

Background: Management of fractures of the distal tibia remains a challenging proposition due to the fact that the major part of the bone is in a subcutaneous location and the blood supply is quite precarious. Conventional forms of osteosynthesis are associated with high rates of infection and nonunion. Due to extensive soft tissue stripping, the vascularity is compromised and often results in poor wound healing and tends to compromise fracture healing as well. Closed reduction with minimally invasive plate osteosynthesis (MIPO) addresses these issues and has emerged as a viable treatment option with minimal complications. The aim of this study was to assess the functional outcome MIPO using locking compression plates (LCP).Methods: 32 patients with distal tibial fractures treated by MIPO technique with LCP fixation were studied from January 2012 to January 2014 and were followed up for a period of 2 years.Results: All the fractures in our series united well at the end of 6 months with mean time to radiological evidence of callus formation at 10 weeks and the mean time to fracture union was 20 weeks. There were 2 cases with varus angulation in our series and no cases with implant failure. There were 3 patients with superficial skin infections and no cases of deep infection.Conclusions: We conclude that MIPO with LCP is an effective treatment option for distal tibial fractures avoiding all the complications associated with other forms of internal fixation. We strongly recommend its usage in these types of complex injuries

An Investigation into the Effects of Pre-training Data Distributions for Pathology Report Classification

Pre-trained transformer models have demonstrated success across many natural language processing (NLP) tasks. In applying these models to the clinical domain, a prevailing assumption is that pre-training language models from scratch on large-scale biomedical data results in substantial improvements. We test this assumption with 4 pathology classification tasks on a corpus of 2907 prostate cancer pathology reports. We evaluate 5 transformer pre-trained models that are the same size but differ in pre-training corpora. Specifically, we analyze 3 categories of models: 1)General-domain: BERT and Turing Natural Language Representation (TNLR) models, which use general corpora for pre-training, 2)Mixed-domain: BioBERT which is obtained from BERT by including PubMed abstracts in pre-training and Clinical BioBERT which additionally includes MIMIC-III clinical notes and 3)Domain-specific: PubMedBERT which is pre-trained from scratch on PubMed abstracts. We find the mixed-domain and domain-specific models exhibit faster feature disambiguation during fine-tuning. However, the domain-specific model, PubMedBERT, can overfit to minority classes when presented with class imbalance, a common scenario in pathology report data. At the same time, the mixed-domain models are more resistant to overfitting. Our findings indicate that the use of general natural language and domain-specific corpora in pre-training serve complementary purposes for pathology report classification. The first enables resistance to overfitting when fine-tuning on an imbalanced dataset while the second allows for more accurate modelling of the fine-tuning domain. An expert evaluation is also conducted to reveal common outlier modes of each model. Our results could inform better fine-tuning practices in the clinical domain, to possibly leverage the benefits of mixed-domain models for imbalanced downstream datasets

The effect of sodium valproate on the biochemical parameters of reproductive function in male albino Wistar rats

Objective: To assess the effects of sodium valproate on intratesticular testosterone and lactic dehydrogenase level in rats. Methods: Male Wistar rats (12 weeks old) were treated with sodium valproate and sacrificed at the end of the 2 nd , 4 th , 5 th , 7 th , 10 th and 15 th week, after the last exposure to sodium valproate. The testes were removed, weighed and processed for biochemical analysis. Results: The intratesticular testosterone level was significantly (P< 0.001) reduced in 200 mg/kg and 400 mg/kg treated rats. The intratesticular lactate dehydrogenase (LDH) level was significantly (P< 0.001) increased by valproate in a time dependent manner. Conclusion: Valproate causes reversible change in intratesticular testosterone and LDH level

Climate-Resilient Adaptation Strategies in Potato Production and Major Factors Influencing It in Karnataka, India

The World is already experiencing climate change and it has profound effects on both agriculture and horticulture. Hence present study attempts to identify climate resilient adaptation strategies in potato production and major factors influencing it in Karnataka, India. For the study Kolar and Hassan districts were selected based on their climate vulnerability status and potato crop was selected for the analysis. Primary data for the study were collected from 160 sample respondents through well structure, pre-tested interview schedule during 2021-22. To achieve the proposed objectives, descriptive statistics such as percentage and binary logistic regression was employed. The study identified six major climate-resilient adaptation strategies adopted by the respondents in potato cultivation such as early sowing, more than the recommended dose of pesticide application, preventive plant protection measures (in advance), improving water captures, drying of seed tubers before sowing and adapting heat/drought resistant varieties. Among six strategies, majority (92.50 % of Kolar and 72.50 % of Hassan) of the respondents adopted improving water captures as a major adaptation strategy.&nbsp; Binary regression revealed that education (0.5893), family size (0.7592), farming experience (1.0938), access to weather alerts (2.0914), and awareness of climate change (1.3409) had positive and significant impact on adaptation behavior of the sample respondents (pooled)

The role of primary cemented total hip arthroplasty in the management of fractures of the neck of femur in the elderly population

Background: Femoral neck fractures are common injuries in the elderly population and are associated with high rates of morbidity and mortality. The aim of surgical intervention in these elderly patients is to restore them to the pre-fracture status as rapidly as possible. The aim of this study was to evaluate the role of total hip arthroplasty as a primary option in the management of these fractures and to compare the results with studies of other authors as available in literature.Methods: 45 patients with femoral neck fractures treated with cemented total hip arthroplasty were studied from January 2011 to January 2013 and were followed up for a minimum period of two years.Results: There were 18 males and 27 females ranging from 60 to 75 years of age. Mean age was 64.6 years. Majority (80%) of the fractures were completely displaced, Garden type 4 fractures followed by type 3 in 20% of cases. The most common mode of injury was a simple slip and fall. Excellent results were seen in 17 patients, good results in 24 patients and fair results in 4 patients. No poor results were seen. Conclusions: Cemented total hip arthroplasty is a very useful procedure for the primary treatment of femoral neck fractures in elderly patients. This procedure markedly improves the functional status of the patients and gives good functional results

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Not AvailableDortus primarius Distant (Miridae: Deraeocorinae) was observed to feed on thrips and other soft bodied insects in the field. Biology, morphology and feeding potential of this species were studied for the first time in the laboratory (at 26 ± 2˚C and 65 ± 2% RH) on UV irradiated Corcyra cephalonica (Stainton) eggs. A total of five instars were observed, with nymphal duration of 17.2 days. Mean fecundity was 127.6 eggs per female. Female longevity was higher than male. One nymph could consume a total of 363 C. cephalonica eggs in its life span. Adult male and female fed on a total of 713 and 1014.75 eggs, respectively. Cost of producing 100 D. primarius nymphs and adult nymphs neonate/first instar was INR 10.34/- and INR 200/-, respectively. In this paper all immature stages, eggs and adults are described with live images. Results showed that this species could be reared on UV irradiated C. cephalonica eggs and bean pieces successfully. Further studies are needed to evaluate this species against insect pests in field.Not Availabl