Use of Trochanteric Flip Osteotomy Improves the Outcome of Pipkin I and II Femoral Head Fractures

Introduction: Annual incidence of femoral head fracture is constantly increasing due to increase in cases of road traffic accidents (RTA). Four to 17% of femoral head fractures are due to posterior dislocations of hip. Outcome of femoral head facture associated with posterior dislocation of hip, the pipkin I and II fracture, is unsatisfactory due to lack of universally accepted protocol for its management and treatment. Objective: To evaluate the patient outcome using relatively newer approach, the Trochanteric Flip (digastrics) Osteotomy (TFO), for the precise anatomical reduction of femoral head fractures associated with posterior dislocation of hip. Methods: Between 2013 and 2017, 21 patients with sustained isolated femoral head fracture were admitted at our hospital. We used TFO approach for the management and treatment of femoral head fractures. The patients were followed up for 42 months at different intervals. Clinical outcome were evaluated using Merle d’Aubigne Postel and Thompson-Epstein scale. Results: Retrospective analysis showed excellent, good, fair and poor results in five (23.8%) patients, 13 (61.9%) patients, two (9.5%) patients and one (4.7%) patient, respectively. Clinical outcomes included sciatic nerve injury (4.7%), moderate arthritis (95.3%), benign non-debilitating heterotrophic ossification (19%), avascular necrosis of femoral head (4.7%) and neuropraxia (4.7%). Conclusions: Use of trochanteric flip osteotomy gives the favorable outcome for the treatment of this type of fracture. Most importantly, the vascularity of femoral head remains intact which makes TFO a very useful technique for pipkin I and II fracture treatment

Functional Outcome of Intra-articular Fractures of Distal Radius: ORIF with Locking Plate vs CRPP

Background: Distal radius fractures are common, costly, and increasing in incidence. Closed reduction and percutaneous K wires fixation and ORIF with locking plate fixation are two of the mostly used surgical treatments for dorsally displaced distal radius fractures. However, there is uncertainty which of these treatments is superior. Methods: This is a prospective study on 40 patients. Twenty patients had closed reduction and percutaneous pinning (CRPP) with K wires (Group A) and 20 patients had open reduction and internal fixation (ORIF) with locking plate and screws (Group B). Evaluation were done in the means of DASH scores and ROM of operated wrist on 1.5 months, three months and six months follow up period. Results: Though the overall functional outcome is comparatively better with Group B, the significant difference for most variables like DASH Scores, extension, supination and ulnar deviation were found at early part of treatment only. The flexion and radial deviation bear no significant outcomes at all intervals of evaluations. Superficial wound infection was more common in patients treated with K-wires but otherwise no difference in complication rates was noted. Conclusion: Locking plate fixation provided lower DASH scores and reduced total postoperative complications compared to CRPP group over six months follow-up period. However, these differences were significant in early part of treatment. Further research is required to better delineate the confirmation

Noninvasive genetic population survey of snow leopards (Panthera uncia) in Kangchenjunga conservation area, Shey Phoksundo National Park and surrounding buffer zones of Nepal

<p>Abstract</p> <p>Background</p> <p>The endangered snow leopard is found throughout major mountain ranges of Central Asia, including the remote Himalayas. However, because of their elusive behavior, sparse distribution, and poor access to their habitat, there is a lack of reliable information on their population status and demography, particularly in Nepal. Therefore, we utilized noninvasive genetic techniques to conduct a preliminary snow leopard survey in two protected areas of Nepal.</p> <p>Results</p> <p>A total of 71 putative snow leopard scats were collected and analyzed from two different areas; Shey Phoksundo National Park (SPNP) in the west and Kangchanjunga Conservation Area (KCA) in the east. Nineteen (27%) scats were genetically identified as snow leopards, and 10 (53%) of these were successfully genotyped at 6 microsatellite loci. Two samples showed identical genotype profiles indicating a total of 9 individual snow leopards. Four individual snow leopards were identified in SPNP (1 male and 3 females) and five (2 males and 3 females) in KCA.</p> <p>Conclusions</p> <p>We were able to confirm the occurrence of snow leopards in both study areas and determine the minimum number present. This information can be used to design more in-depth population surveys that will enable estimation of snow leopard population abundance at these sites.</p

Clinical Profile of Injuries due to Paragliding Accident Attended in a Tertiary Hospital of Western Region of Nepal

Introduction: Paragliding is an adventurous aerial sport which is performed regularly in and around Pokhara. The Western Region of Nepal (Especially Pokhara, Parbat, Baglung and Syanjya) is famous not only for its natural beauty but for adventurous sports like paragliding, ultraflight and bungee jumping etc. The growing popularity of paragliding sport has led to a steady increase in the number of associated injuries. Objectives: The main objective of this retrospective review is to find out characteristic of injuries in different of paragliding accidents. Methods: This is a retrospective review of paragliding injury cases who attended emmergency department of Gandaki Medical College, Pokhara, Nepal from June 2009 to May 2016. Demographic profile (Age, sex, address), type of flight, timing of accident, severity and pattern of injures were collected and analyzed using the frequency table. Results: Among 60 people who faced accidents and brought to hospital, four of them with severe multiple trauma were declared dead in the emergency department at the time of arrival. Fifty six patients were injured with varieties of injury. Among 56 survived patients, 14 (25%) were minor injuries and discharged from the Emergency Department after treatment for soft tissue trauma like abrasion or sprain. Twelve patients with polytrauma (Including four chest injury, two abdominal injury with multiple bone fractures) and rest of the patients were admitted and treated/reffered/discharged. Conclusion: Lower limb especially foot and ankle injury were the commonest type of injury followed by spine fracture in paragliding accidents

Ethnobotany in the Nepal Himalaya

<p>Abstract</p> <p>Background</p> <p>Indigenous knowledge has become recognized worldwide not only because of its intrinsic value but also because it has a potential instrumental value to science and conservation. In Nepal, the indigenous knowledge of useful and medicinal plants has roots in the remote past.</p> <p>Methods</p> <p>The present study reviews the indigenous knowledge and use of plant resources of the Nepal Himalayas along the altitudinal and longitudinal gradient. A total of 264 studies focusing on ethnobotany, ethnomedicine and diversity of medicinal and aromatic plants, carried out between 1979 and 2006 were consulted for the present analysis. In order to cross check and verify the data, seven districts of west Nepal were visited in four field campaigns.</p> <p>Results</p> <p>In contrast to an average of 21–28% ethnobotanically/ethnomedicinally important plants reported for Nepal, the present study found that up to about 55% of the flora of the study region had medicinal value. This indicates a vast amount of undocumented knowledge about important plant species that needs to be explored and documented. The richness of medicinal plants decreased with increasing altitude but the percentage of plants used as medicine steadily increased with increasing altitude. This was due to preferences given to herbal remedies in high altitude areas and a combination of having no alternative choices, poverty and trust in the effectiveness of folklore herbal remedies.</p> <p>Conclusion</p> <p>Indigenous knowledge systems are culturally valued and scientifically important. Strengthening the wise use and conservation of indigenous knowledge of useful plants may benefit and improve the living standard of poor people.</p

Multi-level evidence of an allelic hierarchy of USH2A variants in hearing, auditory processing and speech/language outcomes.

Language development builds upon a complex network of interacting subservient systems. It therefore follows that variations in, and subclinical disruptions of, these systems may have secondary effects on emergent language. In this paper, we consider the relationship between genetic variants, hearing, auditory processing and language development. We employ whole genome sequencing in a discovery family to target association and gene x environment interaction analyses in two large population cohorts; the Avon Longitudinal Study of Parents and Children (ALSPAC) and UK10K. These investigations indicate that USH2A variants are associated with altered low-frequency sound perception which, in turn, increases the risk of developmental language disorder. We further show that Ush2a heterozygote mice have low-level hearing impairments, persistent higher-order acoustic processing deficits and altered vocalizations. These findings provide new insights into the complexity of genetic mechanisms serving language development and disorders and the relationships between developmental auditory and neural systems

Indigenous use and bio-efficacy of medicinal plants in the Rasuwa District, Central Nepal

<p>Abstract</p> <p>Background</p> <p>By revealing historical and present plant use, ethnobotany contributes to drug discovery and socioeconomic development. Nepal is a natural storehouse of medicinal plants. Although several ethnobotanical studies were conducted in the country, many areas remain unexplored. Furthermore, few studies have compared indigenous plant use with reported phytochemical and pharmacological properties.</p> <p>Methods</p> <p>Ethnopharmacological data was collected in the Rasuwa district of Central Nepal by conducting interviews and focus group discussions with local people. The informant consensus factor (F_IC) was calculated in order to estimate use variability of medicinal plants. Bio-efficacy was assessed by comparing indigenous plant use with phytochemical and pharmacological properties determined from a review of the available literature. Criteria were used to identify high priority medicinal plant species.</p> <p>Results</p> <p>A total of 60 medicinal formulations from 56 plant species were documented. Medicinal plants were used to treat various diseases and disorders, with the highest number of species being used for gastro-intestinal problems, followed by fever and headache. Herbs were the primary source of medicinal plants (57% of the species), followed by trees (23%). The average F_IC value for all ailment categories was 0.82, indicating a high level of informant agreement compared to similar studies conducted elsewhere. High F_ICvalues were obtained for ophthalmological problems, tooth ache, kidney problems, and menstrual disorders, indicating that the species traditionally used to treat these ailments are worth searching for bioactive compounds: <it>Astilbe rivularis</it>, <it>Berberis asiatica</it>, <it>Hippophae salicifolia, Juniperus recurva</it>, and <it>Swertia multicaulis</it>. A 90% correspondence was found between local plant use and reported plant chemical composition and pharmacological properties for the 30 species for which information was available. Sixteen medicinal plants were ranked as priority species, 13 of which having also been prioritized in a country-wide governmental classification.</p> <p>Conclusions</p> <p>The <it>Tamang </it>people possess rich ethnopharmacological knowledge. This study allowed to identify many high value and high priority medicinal plant species, indicating high potential for economic development through sustainable collection and trade.</p

Allocating HIV Prevention Funds in the United States: Recommendations from an Optimization Model

The Centers for Disease Control and Prevention (CDC) had an annual budget of approximately $327 million to fund health departments and community-based organizations for core HIV testing and prevention programs domestically between 2001 and 2006. Annual HIV incidence has been relatively stable since the year 2000 [1] and was estimated at 48,600 cases in 2006 and 48,100 in 2009 [2]. Using estimates on HIV incidence, prevalence, prevention program costs and benefits, and current spending, we created an HIV resource allocation model that can generate a mathematically optimal allocation of the Division of HIV/AIDS Prevention’s extramural budget for HIV testing, and counseling and education programs. The model’s data inputs and methods were reviewed by subject matter experts internal and external to the CDC via an extensive validation process. The model projects the HIV epidemic for the United States under different allocation strategies under a fixed budget. Our objective is to support national HIV prevention planning efforts and inform the decision-making process for HIV resource allocation. Model results can be summarized into three main recommendations. First, more funds should be allocated to testing and these should further target men who have sex with men and injecting drug users. Second, counseling and education interventions ought to provide a greater focus on HIV positive persons who are aware of their status. And lastly, interventions should target those at high risk for transmitting or acquiring HIV, rather than lower-risk members of the general population. The main conclusions of the HIV resource allocation model have played a role in the introduction of new programs and provide valuable guidance to target resources and improve the impact of HIV prevention efforts in the United States

Remote sensing of night lights: a review and an outlook for the future

This is the author accepted manuscript. The final version is available from Elsevier via the DOI in this recordRemote sensing of night light emissions in the visible band offers a unique opportunity to directly observe human activity from space. This has allowed a host of applications including mapping urban areas, estimating population and GDP, monitoring disasters and conflicts. More recently, remotely sensed night lights data have found use in understanding the environmental impacts of light emissions (light pollution), including their impacts on human health. In this review, we outline the historical development of night-time optical sensors up to the current state of the art sensors, highlight various applications of night light data, discuss the special challenges associated with remote sensing of night lights with a focus on the limitations of current sensors, and provide an outlook for the future of remote sensing of night lights. While the paper mainly focuses on space borne remote sensing, ground based sensing of night-time brightness for studies on astronomical and ecological light pollution, as well as for calibration and validation of space borne data, are also discussed. Although the development of night light sensors lags behind day-time sensors, we demonstrate that the field is in a stage of rapid development. The worldwide transition to LED lights poses a particular challenge for remote sensing of night lights, and strongly highlights the need for a new generation of space borne night lights instruments. This work shows that future sensors are needed to monitor temporal changes during the night (for example from a geostationary platform or constellation of satellites), and to better understand the angular patterns of light emission (roughly analogous to the BRDF in daylight sensing). Perhaps most importantly, we make the case that higher spatial resolution and multispectral sensors covering the range from blue to NIR are needed to more effectively identify lighting technologies, map urban functions, and monitor energy use.European Union Horizon 2020Helmholtz AssociationNatural Environment Research Council (NERC)Chinese Academy of ScienceLeibniz AssociationIGB Leibniz Institut