Radiographic and functional outcome of operated closed intra-articular fractures of calcaneum: a retrospective analysis

Background: The present study aims to analyse the results of surgical outcome of the operated calcaneal fractures using either plates or cannulated cancellous screws. Recently there has been considerable shift of treatment of calcaneal fractures from conservative to operative owing to better understanding of fracture pattern. However, reduction of long-term functional outcome of such patients is always questionable and remains unanswered. Methods: A 25 fractures were operated with locking plates or cannulated screws after proper assessment. Functional assessment was done using AOFAS scoring system. Radiological outcome was assessed using restoration of Bohler and Gissane angle. Results: The results were extrapolated as excellent in 20 patients, good in 3 patient's and poor result in 2 patients. Statistical analysis revealed better outcomes in percutaneous cannulated screw fixation as compared to open plate fixation.  6 patients had to undergo implant exit of which 5 were cannulated screw backout, prominence irritating the soft tissue and 1 plate removal had to be done because of infection. None of the patients had subtalar arthritis, heel pad problems, peroneal tendinitis or implant failure. Conclusions: Surgical management in the treatment of choice for intra articular calcaneal fractures after thorough evaluation. The choice of implant depends upon the communition of fracture, soft tissue compromise, joint surface incongruity and surgical expertise. Radiological maintenance of Bohler and Gissane angle intraoperatively and at follow up is a good indicator for predicting functional outcomes score.  

Challenges of Zero-Shot Recognition with Vision-Language Models: Granularity and Correctness

This paper investigates the challenges of applying vision-language models (VLMs) to zero-shot visual recognition tasks in an open-world setting, with a focus on contrastive vision-language models such as CLIP. We first examine the performance of VLMs on concepts of different granularity levels. We propose a way to fairly evaluate the performance discrepancy under two experimental setups and find that VLMs are better at recognizing fine-grained concepts. Furthermore, we find that the similarity scores from VLMs do not strictly reflect the correctness of the textual inputs given visual input. We propose an evaluation protocol to test our hypothesis that the scores can be biased towards more informative descriptions, and the nature of the similarity score between embedding makes it challenging for VLMs to recognize the correctness between similar but wrong descriptions. Our study highlights the challenges of using VLMs in open-world settings and suggests directions for future research to improve their zero-shot capabilities

Medical management of pheochromocytoma: Role of the endocrinologist

Pheochromocytoma is a rare tumor arising from chromaffin cells in adrenal medulla or other paraganglia in the body, which may be associated with many genetic syndromes and mutation. The role of endocrinologist is in biochemical diagnosis of suspected cases; its anatomic and functional localization with the help of imaging like CT, MRI, and nuclear scanning; preoperative control of hypertension; and postoperative follow-up of cases that have undergone surgical resection. Familial and genetic screening of cases and their family is important to detect occult cases. Endocrinologist will also play a role in cases with malignant pheochromocytoma in assessment of metastasis, control, chemoradiotherapy, and follow-up

Risk factor of type 2 diabetes mellitus among adolescents from rural area of India

Context: Health system is likely to encounter more adolescents with Type 2 diabetes mellitus (T2DM) as a consequence of obesity and sedentary lifestyle. Intervention at various stages of the life cycle is needed as cumulative effect of risk factors accumulated from fetal life to adult increases risk of noncommunicable disease. Aims: The aim of this study was to find out awareness regarding T2DM and distribution of risk factor for T2DM in adolescents from the rural areas of Wardha district, India. Methodology: A cross-sectional study conducted in the rural area of India involves 412 adolescent boys and girls selected by systematic random sampling technique. Data collected by a face-to-face interview and waist-hip ratio (WHR), body mass index, random capillary blood glucose (RCBG) were estimated. Results: 65.1% were aware of T2DM. Girls, older adolescents, higher education were associated with awareness (P 0.90 and 113 (71.1%) girls had WHR> 0.85, 103 (25%) adolescents had RCBG ≥110 mg/dl, and 77 (18.7%) participants reported family history of DM. Conclusions: Considering the risk factors of T2DM among adolescents from the rural area, there is a need for prevention programs for creating awareness related to T2DM, early identification of risk factor for T2DM, and targeted interventions. The study may serve as a formative research for developing and testing interventions aimed at primary prevention of T2DM among adolescents from rural India