Prospective Outcome Analysis of Various Methods of Management of Compound Supracondylar Fractures of Femur

INTRODUCTION: Fractures of the distal femur are severe injuries that result in varying degrees of permanent disability. As the number of highways become more and high speed driving increases, the potential for devastating injuries like open fractures of the femur with polytrauma also increase substantially. These injuries present with varied combination of bony and soft tissue loss. Bony injury could range from a simple supracondylar fracture pattern to a severely comminuted injury with intraarticular extension and bone loss. There is further understandable reluctance on the part of most Orthopaedic surgeons to primarily use bone graft for open injuries with bone loss.With changing expectations and rise in high velocity injuries, fracture fixation and rehabilitation in open distal femur fracture injuries however is still a challenge. AIM: The aim of the study is to analyze prospectively the results of outcomes of various methods of management of Compound Supracondylar fractures of femur. OBJECTIVES: To evaluate the result of open Supracondylar fractures of femur in terms of, union, infection, range of motion of knee, complications and need for bone grafting. This study also tries to bring insight into the unpublished area of literature to highlight the importance of need for further research in open supracondylar fractures of femur. MATERIALS AND METHODS: This is a prospective study of 20 patients with open supracondylar and distal femoral fractures treated with rigid internal fixation using locking compression plate,dynamic condylar screw fixation and knee spanning external fixator and minimal internal fixation with cancellous screws and k wires at Institute of Orthopaedics and Traumatology,Madras Medical College & Government General Hospital, Chennai from May 2008 to September 2010. The patients were selected based on the inclusion and exclusion criteria as given below: Inclusion Criteria - All patients above 18 years with open supracondylar femur fractures extending upto 15 cm from the articular surface. 1. Compound grade I,II,IIIA,IIIB (Gustilo anderson’s classification) of supracondylar fracture of femur. 2. Type A1, A2, A3, B1, B2, B3, and C1,C2,C3 (Muller’s Classification), 3. reporting within 12 hours after Injury. Exclusion Criteria - 1. Associated Multiple Comorbid Conditions, 2. Associated Tibial Plateau Fractures, 3. Associated Vascular Injuries, 4. Pathological Fracture. RESULTS: 20 cases (four groups) results were studied. Group 1treated with initial wound debridement and followed by either internal fixation with dynamic condylar screw fixation or locking compression plating with an average period of gap between the initial debridement, skeletal traction and definitive fixation was about 3 weeks. Group 2 of patients were treated with initial wound debridement and external fixator with minimal internal fixation for maintaining the articular surface as well as to prevent the flexion of the distal fragment. Group 3 was treated with minimal internal fixation alone. Group 4 was treated with external fixation alone. CONCLUSION: Though we are able to achieve satisfactory union in compound supracondylar fractures of femur, the functional outcome still remains to be poor in severe (Grade IIIB) cases. External fixation can only be used as a temporary modality and not as a definitive fixation and we found better results when external fixation was converted early to definitive stable internal fixation. Amount of soft tissue injury correlates with poor results. Grade of compound wound influences more than the fracture pattern in the final outcome. Delay in stable fixation and non compliance to the early Rehabilitation physical therapy also influences the final functional outcome

Study on Early Release and Skin Grafting of Upper Eyelid Burns for Prevention of Ectropion

INTRODUCTION: Burns trauma is as old as the discovery of fire in the history of mankind. Eye lid burns are more common among the eye traumas. They induce different effects on the ocular structures, depending on the type of burns. The eyelid plays a vital role in protecting vision, which is the most important sensation. No doubt the eyelid is compared to a mother protecting a child amidst all circumstances- day in and day out. Eyelids are delicate, complicated in their anatomy and physiology. Eye lids are more prone to be damaged in the effort to save the eyeball. No day passes without winking of the eye. The eyelids do their function involuntarily without our knowledge, yet they can co-operate with us in-voluntary closure also. In ocular burns in an effort to save the eyeball the lids take the toll. Ocular burns injury can be in the form of acid burns, thermal burns or hot liquid. This is a study of injury of the eyelid due to burns and the effect of early intervention to restore the normal anatomy in retaining the function of eye. AIM OF THE STUDY: 1. To evaluate the efficacy of the collagen application immediately on admission, & early release and skin grafting for the prevention of ectropion in upper eyelid burns. 2. Release incision and apply collagen on admission in III degree flame burns and acid burns and early STSG within 6 days for upper eyelid. OBJECTIVE: 1. To find out the simple procedure to prevent (or) minimize problem in acute phase of upper eyelid burn. 2. To find out the optimum reconstructive procedure. 3. To find out post operative complication and factor to prevent. MATERIALS AND METHODS: In our study we have included 20 patients with deep partial thickness and full thickness upper eyelid burns cases examined & admitted at Burns, plastic & Reconstructive surgery department Kilpauk medical college and hospital Chennai- 10, between September 2006 to March 2009. A detailed history was taken with reference to the presenting complaint of the patient, the cause and duration and any previous treatment taken for it. All patients underwent through clinical examination. Both eyes are examined, properly documented and photographs are taken. Inclusion Criteria: 1. Patients with deep partial thickness and full thickness upper eyelid burns. 2. Eye lid burns with less then 50 % of the total body surface area burns, 3. Upper eye lid burns with out major corneal complications are included. 4. Upper eyelid burns due to flame burns and acid burns. Exclusion Criteria: 1. Upper Eye lid burn with more then 50% of the total body surface area burns. 2. Upper Eye lid burn with Epidermal and superficial partial thickness burns. 3. Upper Eye lid burn Patient with associated systemic disease like Diabetes, Hypertension, and severe systemic illness. 4. Upper Eye lid burn with age less then 13 and age more then 60 are excluded. 5. Upper Eye lid burn with previous ocular surgery. 6. Upper Eye lid burn with severe respiratory burns. Eyelid burns early release and collagen sheet applied on admission and on 6th post burn day split thickness skin graft was applied. The split thickness skin grafts used for early grafting. OBSERVATION: Total number of burn patient treated: 4819. 20 cases of upper eyelid burns were selected for release and grafting. 17 cases were flame burns and 2 cases were acid burns one case of scalds injury. All cases that were taken up for study were free from co morbid conditions like diabetes mellitus, IHD, renal, liver pathology. All cases taken up for study were present with the complaints of inability to open the eyelid because of edema. Symptoms of corneal irritation conjunctival congestion were noted in 18 cases. There was no limbal ischemia even in acid burns. Anterior chamber, pupil, fundus were normal in all the cases. There was no punctual obstruction or cicatrisation. All cases were evaluated by ophthalmologist. In all our cases because of oedema of eyelid initial evaluation of vision was not possible. All cases were under systemic antibiotic cover, anti inflammatory and analgesics. All cases had topical antibiotic eye drops All the procedures were done under IV anesthesia. Donor site of skin graft was upper arm in 10 cases and thigh in 10 cases. 100% skin graft take in 17 patients. Donor site healing was completed in 10days no donor site morbidity was observed. CONCLUSION: 1. Release incision and collagen application on the day of amission for deep partial thickness full thickness and chemical upper eyelid burn and early split thickness skin graft within 6-10 days prevent the post burn cicatricial ectropion. 2. It is a simple procedure to prevent the post burn cicatricial ectropion. 3. This procedure definitely prevent the period of wound inflamation and further complications. 4. This procedure optimize the eyelid function. A deep partial thickness and full thickness burn of the eyelids will lead to development of contraction and cicatricial ectropion and subsequent exposure keratitis, followed by blindness. For this reason deep partial and full thickness eyelid burns should be grafted as early as possible. The role of surgery in the treatment of those complex injury continue to evolve to incorporate refined concepts of tissue preservation, wound bed preparation and early attention to functional and aesthetic parameter. Social reintegration, psycho social support, and new pain control strategies have dramatically improved the quality of life for our patients during and after the acute course of care. In eyelid burn early release and grafting improved the ocular function

Inquiry of inclined magnetic field effects on Walter –B nanofluid flow with heat generation / absorption

The article deals with Walter-B nanoliquid flow towards a extending surface with inclined magnetic field effects. Thermal relaxation analysis is made by non fourier heat flux model. Radiation, heat generation / absorption impacts are included. The non linear Partial governing systems are rebuild into nonlinear ordinary systems with the assist of proper similarity transformations. The graphical results are portrayed for velocity, concentration and temperature profile. The physical entitles of heat and mass transfer rates are graphically reported. The comparission with previous results notified the excellent agreement

Switching pulse generation for DC-DC boost converter using Xilinx-ISE with FPGA processor

This paper explains steps to generate switching pulse using Xilinx-ISE with FPGA processor for DC-DC boost converter. The switching pulse generated using Very high speed integrated circuit Hardware Description Language (VHDL) with Xilinx-ISE. VHDL is a programming language, which is used to model and design any complex circuits in a dynamic environment. This paper gives the course of action for generation of switching pulses for dc-dc boost converter using Xilinx-ISE and matlab simulink. The switching pulse generated using Xilinx-ISE with FPGA-Spartan 6 processor compared with switching pulse generated using matlab

The THREAT-ARREST Cyber-Security Training Platform

Cyber security is always a main concern for critical infrastructures and nation-wide safety and sustainability. Thus, advanced cyber ranges and security training is becoming imperative for the involved organizations. This paper presets a cyber security training platform, called THREAT-ARREST. The various platform modules can analyze an organization’s system, identify the most critical threats, and tailor a training program to its personnel needs. Then, different training programmes are created based on the trainee types (i.e. administrator, simple operator, etc.), providing several teaching procedures and accomplishing diverse learning goals. One of the main novelties of THREAT-ARREST is the modelling of these programmes along with the runtime monitoring, management, and evaluation operations. The platform is generic. Nevertheless, its applicability in a smart energy case study is detailed

Strain Pattern Analysis of Mylonites From Sitampundi-Kanjamalai Shear Zone, Thiruchengode, South India

This study aims to investigate the petrography and strain pattern of mylonites from parts of N-S trending Sitampundi-Kanjamalai Shear Zone (SKSZ) around Thiruchengode. The petrographic study indicates the presence of recrystallized quartz, K-feldspar, plagioclase, biotite and some hornblende. The kinematic analysis of Mylonites was done with the help of shear sense indicators such as recrystallized type quartz (quartz ribbon) around the cluster of feldspar, S-C fabric shows dextral shear sense and some sinisterly shear sense in some parts of SASZ which can be considered as a product of partitioning of both strain and vorticity between domains. These all indicates the simple shear extension along E-W direction and the mylonitic foliation shows the pure shear compression along N-S direction. Further the study of bulk strain analysis by Flinn plot method using L and T section of mylonite shows k<1 which lies in the field of flattening zone of finite strain. The kinematic vorticity number is calculated by Rxz/β method which gives the value of 0.36 indicating the general shear. The rigid grain graph shows that the pure shear component is more ­­­­dominant than the simple shear component. The analysis leads to the conclusion that the mylonite has experienced a high temperature shearing of above 700°cat deep crustal level

Nano-cement composite with graphene oxide produced from epigenetic graphite deposit

This study presents the development of a nano-cement composite with graphene oxide (GO) carbon-based nanomaterials synthesized from a high-purity epigenetic graphite deposit. Diamond drill sampled graphite mineralization was upgraded through beneficiation and purification to recover a high-purity graphite product (99.9% graphitic carbon “Cg”). An alternate and improved chemical oxidation process based on the Modified Hummers method was adopted for the synthesis of GO from high-purity graphite. Microstructural analysis were performed to characterise GO. The GO consists of single bondOH, single bondC=O, single bondCOOH, and C-O-C functional groups with a layer thickness of 1.2 nm, 2 to 3 layers of graphene, an interlayer distance of 0.90 nm and a Raman (ID/IG) ratio of 0.79. The effect of 0.02, 0.04, and 0.06 wt% GO of cement on the composite workability, hydration, microstructure, mechanical and transport properties was determined. Increasing the concentration of GO in the composite decreased the workability due to the hydrophilic nature of the 2D planar surface. The rate of hydration accelerated and the cumulative hydration heat increased with the increasing proportions of GO in the composite. GO dosages about 0.02 and 0.04 wt% of cement in the composites resulted the maximum enhancement of compressive and flexural strength by 83 and 26%, respectively, compared to the control mix (0 wt% GO). The microstructural investigation shows that GO enhanced the hydration of calcium hydroxide (CH) and calcium silicate hydrate (C-S-H) during the nucleation and growth stages, filled pores, bridged micro-cracks and created interlocking between the cement hydration products. Collectively, these effects ultimately improved the mechanical properties of the composites. Also, in this process, the 0.02 and 0.04 wt% GO cement composite increased the electrical resistivity by 11.5%, and decreased the sorptivity by 29%, respectively, both of which improved the overall performance of the composite

Morpho-Agronomic Diversity in Pole-Type Common Bean (Phaseolus vulgaris L.) Landraces from Lushai Hills of North-East India

The present study was based on morphological and agronomical characterization of 23 pole-type common bean (Phaseolus vulgaris L.) landraces collected from Lushai hills of North-East India. Extensive variation in plant and seed traits was found in 16 morphological and agronomical characters. Cluster analysis based on Euclidean distance grouped the genotypes into five main branches, reflecting their growth type and reproductive traits. Significant positive or negative correlation was observed among important traits. Principal component analysis was used for assessing patterns of variation by accounting for all the 10 quantitative and six qualitative variables together. Ordination among accessions showed that the first five principal components had Eigen values greater than one, and cumulatively accounted for 72% of the variation. Characterization based on quantitative and qualitative traits enabled separation of accessions into various groups representing landraces with distinct characters

Regulation of murine cytochrome c oxidase Vb gene expression during myogenesis: YY-1 and heterogeneous nuclear ribonucleoprotein D-like protein (JKTBP1) reciprocally regulate transcription activity by physical interaction with the BERF-1/ZBP-89 factor.

A transcription suppressor element (sequence -481 to -320) containing a G-rich motif (designated GTG) and a newly identified CAT-rich motif (designated CATR) was previously shown to modulate expression of the mouse cytochrome c oxidase Vb gene during myogenesis. Here, we show that the GTG element is critical for transcription activation in both undifferentiated and differentiated myocytes. Mutations of the CATR motif abolished transcription repression in myoblasts while limiting transcription activation in differentiated myotubes, suggesting contrasting functional attributes of this DNA motif at different stages of myogenesis. Results show that the activity of the transcription suppressor motif is modulated by an orchestrated interplay between ubiquitous transcription factors: ZBP-89, YY-1, and a member of the heterogeneous nuclear ribonucleoprotein D-like protein (also known as JKTBP1) family. In undifferentiated muscle cells, GTG motif-bound ZBP-89 physically and functionally interacted with CATR motif-bound YY-1 to mediate transcription repression. In differentiated myotubes, heterogeneous nuclear ribonucleoprotein D-like protein/JKTBP1 bound to the CATR motif exclusive of YY-1 and interacted with ZBP-89 in attenuating repressor activity, leading to transcription activation. Our results show a novel mechanism of protein factor switching in transcription regulation of the cytochrome c oxidase Vb gene during myogenesis

Marker-Assisted Breeding as Next-Generation Strategy for Genetic Improvement of Productivity and Quality: Can It Be Realized in Cotton?

The dawdling development in genetic improvement of cotton with conventional breeding program is chiefly due to lack of complete knowledge on and precise manipulation of fiber productivity and quality. Naturally available cotton continues to be a resource for the upcoming breeding program, and contemporary technologies to exploit the available natural variation are outlined in this paper for further improvement of fiber. Particularly emphasis is given to application, obstacles, and perspectives of marker-assisted breeding since it appears to be more promising in manipulating novel genes that are available in the cotton germplasm. Deployment of system quantitative genetics in marker-assisted breeding program would be essential to realize its role in cotton. At the same time, role of genetic engineering and in vitro mutagenesis cannot be ruled out in genetic improvement of cotton