Isolated ligamentum flavum ossification in primary hypoparathyroidism

Basckground: The ligamenta flava can undergo ossification and calcification resulting in myelopathy. Only seven cases of ligamentumflavum ossification in association with hypoparathyroidism have been reported, most of which had concurrent osseous changes in other spinal ligaments. Here, we report a patient with hypoparathyroidism who presented ith ligamentum flavum ossification causing both cervical and thoracic myelopathy. Case description: A 43-year-old male presented with backache, urinary retention, and lower limb weakness for the last few days. Magnetic resonance imaging scan showed ossification of the ligamentum flavum in the cervical and thoracic regions, with severe spinal stenosis. Following spinal decompressive surgery, the patient made a complete recovery. Primary hypoparathyroidism was found to be the underlying cause for ligamentum flavum ossification. Conclusion: Ossification of ligamentum flavum secondary to hypoparathyroidism should be considered as a possible cause of myelopathy in all patients presenting with symptoms of spinal cord compression

Treatment of tibial diaphyseal fractures with closed flexible intramedullary ender nails: 39 fractures followed for a period of two to seven years

Abstract OBJECTIVE: To assess the efficacy of flexible intramedullary Ender nails for the treatment of tibial diaphyseal. MATERIALS AND METHODS: This is a retrospective review of patients treated with the Ender Nail for both open and closed tibial shaft fractures. Between January 1989 and December 1994, 43 fractures were treated with these nails. The configuration of each fracture was determined using the Orthopedic Trauma Association classification and the extent of soft tissue damage was assessed using the Gustilo and Anderson\u27s classification. Four patients were excluded from the study due to inadequate follow-up. There were 27 closed and 12 open fractures. RESULTS: The average time to union in 34 out of 39 fractures was 17 weeks. Delayed union and malunion occurred in two patients each and superficial wound infection in 1 patient. Nonunion occurred in 5 fractures that were all located in the distal 1/3 of the tibial diaphysis. We attribute this high rate of non-union to a poor rotational control on the distal fragment by these nails. CONCLUSIONS: The Ender nails provide effective fixation for the OTA stable class of tibial fractures, where they produce good axial and rotational stability by virtue of their three-point fixation. Rotational and angular stability should be improved by a supplementary cast immobilization for fractures with unstable configuration and those located in the distal third of the diaphysis

Bullet-induced synovitis as a cause of secondary osteoarthritis of the hip joint: a case report and review of literature

Abstract BACKGROUND: With increasing prevalence of gunshot injuries we are seeing more patients with retained bullet fragments lodged in their bodies. Embedded lead bullets are usually considered inert after their kinetic energy has dissipated hence these are not removed routinely. However, exposure of any foreign body to synovial fluid may lead to rapid degradation and hence result in systemic absorption, causing local and systemic symptoms. We present the case of a thirty year old man who came to our out patient department with a history of progressive, severe hip pain ten years after a gun shot injury to his right hip. CONCLUSION: The common belief that intraarticular bullets should not be removed has no benefit and may result in unwanted long term complications

Non-Local Deformation of a Supersymmetric Field Theory

In this paper, we will analyse a supersymmetric field theory deformed by generalized uncertainty principle and Lifshitz scaling. It will be observed that this deformed supersymmetric field theory contains non-local fractional derivative terms. In order to construct such deformed N=1 supersymmetric theory, a harmonic extension of functions will be used. However, the supersymmetry will be only preserved for a free theory and will be broken by the inclusion of interaction terms.Comment: 12 pages, pulished versio

Social environment and depression among pregnant women in urban areas of Pakistan: importance of social relations.

Aspects of the social environment, including social conditions (socio-economic status, household situations, chronic illnesses) and social relations (attitude and behaviors of relations) are major determinants of depression among women. This study evaluates the relative power of social relations and social conditions in predicting depression among pregnant women in Pakistan. In the qualitative phase of the study, social environmental determinants were identified through literature search, and experts\u27 opinions from psychologists, psychiatrists, gynecologists, sociologists and researchers. Along with this, 79 in-depth interviews were conducted with pregnant women drawn from six hospitals (public and private) and two communities in Karachi, Pakistan. Identified determinants of depression were grouped into themes of social conditions and social relations and pregnancy-related concerns. In the study\u27s quantitative phase, the relative power of the identified themes and categories, based on their scores for predicting depression (determined by the Center for Epidemiological Studies-Depression Scale (CES-D scale)), was determined through multivariate linear regression. Social environmental determinants of pregnant women were described under the themes and categories of (1) social relations: involving husband, in-laws and children; (2) social conditions: involving the economy, illness, life events, household work, environmental circumstances and social problems; and (3) pregnancy-related concerns i.e. symptoms of pregnancy, changes during pregnancy, dependency and concern for unborn baby. Multivariate analysis found that among these themes, social relations and pregnancy-related concerns were significantly associated with total CES-D scores. Among the categories besides increasing age and less education, husband, in-laws, household work and pregnancy symptoms were significantly associated with total CES-D scores. The study highlights the importance of social relations compared to social conditions for determining depression in pregnant women

Architectural Design and Prototyping of Co-PPGIS: A Groupware-Based Online Synchronous Collaborative PPGIS to Support Municipality Development and Planning Management Workflows

Co-PPGIS has a wide variety of applications like municipal planning, emergency response, public health and security, etc. The main focus of this chapter is on the development and design of a Web Collaborative PPGIS (Co-PPGIS) infrastructure. As part of municipality’s planning and management services, Co-PPGIS is developed for real-time map sharing application system. Co-PPGIS is an effective and essential online meeting system for supporting group collaborations on geographic information such as maps and imageries, and capturing and sharing of local/domain knowledge in real time. Co-PPGIS permits amalgamation of geospatial data and collaborator’s input in the form of geo-referenced notations. It incorporates coherent components as map sharing, real-time chat, video conferencing, geo-referenced textual and graphical notations. The study aims to focus on public participation and geo-collaboration facilitated with information sharing, interactive geo-conferencing, real-time map, and data sharing with tools to draw features or add annotation to the map while discussions, uploading documents, and live communication. Co-PPGIS provides an efficient and reliable platform that will significantly reduce the time to acquire, process, and analyze data. The significance of this study is to contribute to existing public participation practices, to municipal planning, to decision-making, or to geographic information science

Utility of participatory rural appraisal for health needs assessment and planning.

BACKGROUND: While poverty and lack of life opportunities are root causes of a high burden of disease and infant and maternal mortality, inadequate health care contributes heavily. Often those who are left without care are those who need it most. Existing health services are managed without taking into account acceptance and need perspectives. This further reduces the effectiveness of and equity in health care. In order to guide the planning of reproductive health services by a national NGO, health needs were assessed in a district in Sindh using a combination of participatory rural appraisal (PRA) and qualitative and quantitative research methods. PRA is considered as a better framework to assess, analyse and develop programs with communities. OBJECTIVE: The objective of PRA was to initiate community involvement and to understand the needs of health care from a community perspective. METHODOLOGY: PRA was conducted with groups of men and women from three rural areas in a district of Sindh, Pakistan using a life cycle framework. The community members identified various stages of their life with the associated health issues. RESULTS: This research was empowering to community members as it facilitated community involvement. The respondents took charge of the process of identification of health needs at PRA sessions. PRA helped identify health problems considered prevalent and important by the community. More importantly, it helped potential service providers and the community to initiate community involvement in planning. CONCLUSION: PRA is not only an effective tool for assessment and analysis of health issues but also a vehicle to promote community involvement. Additionally, participatory methods contribute to understand the context of quantitative data generated for planning purposes