Radiological and functional outcome post fixation in unstable proximal femur fracture: comparison between proximal femoral nail antirotation (PFNA) and proximal femoral locking compression plate (PFLCP)

INTRODUCTION: Incidence of unstable proximal femoral fracture is increasing in trend and the treatment is challenging. Operative treatment offers various selection of implant including plate and intramedullary nail. The purpose of this study is to compare radiological and functional outcome between both implants: PFNA and PFLCP. METHODS: This is a single centre observational cohort study involving all patients with unstable proximal femur fracture, admitted from January 2012 till December 2017. Plain pelvic and hip radiographs at immediate, 6 month and 1 year post-operative. Neck shaft angle (NSA) and its difference on contralateral side measured. Radiological outcome evaluated prevalence of varus malalignment and quality of fracture reduction. Functional outcome is measured by using Lower Extremity Functional Scale (LEFS). RESULTS: Sample population is 91 patients. Radiological and functional outcome didn’t differ significantly (p>0.05) but PFLCP group had shown significant shorter union time (table 1,2). DISCUSSIONS: Association of radiological and functional outcome between both implants was statistically insignificant (p>0.05), which concurrent with the study by Singh AK, 2017, Li GX, 2012. CONCLUSION: Both implants were effective in treating unstable proximal femur fractures. REFERENCES: 1. Singh AK et al.Treatment of Unstable Trochanteric Femur Fracture:PFNA versus PFLCP. Am. Journal. 2017

Maternal thyroid function in women undergoing controlled ovarian hyperstimulation during IVF and its relation to reproductive outcome.

A prospective observational study undertaken in 2013 at Medically Assisted Conception unit of UKM Medical Centre. The study was carried out among women scheduled for COH in preparation in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI). A total of 88 were included for final analysis. Serum thyroid levels were measured at 4 points; before stimulation (T1), day 10 –13 of cycle (T2), during oocyte retrieval (T3) and at one week following embryo transfer (T4). Results were analyzed according to reproductive outcome

Design of Lipid-Based Nanocarriers via Cation Modulation of Ethanol-Interdigitated Lipid Membranes

Short-chain alcohols (i.e., ethanol) can induce membrane interdigitation in saturated-chain phosphatidylcholines (PCs). In this process, alcohol molecules intercalate between phosphate heads, increasing lateral separation and favoring hydrophobic interactions between opposing acyl chains, which interpenetrate forming an interdigitated phase. Unraveling mechanisms underlying the interactions between ethanol and model lipid membranes has implications for cell biology, biochemistry, and for the formulation of lipid-based nanocarriers. However, investigations of ethanol–lipid membrane systems have been carried out in deionized water, which limits their applicability. Here, using a combination of small- and wide-angle X-ray scattering, small-angle neutron scattering, and all-atom molecular dynamics simulations, we analyzed the effect of varying CaCl2 and NaCl concentrations on ethanol-induced interdigitation. We observed that while ethanol addition leads to the interdigitation of bulk phase 1,2-dipalmitoyl-sn-glycero-3-phosphocholine (DPPC) bilayers in the presence of CaCl2 and NaCl regardless of the salt concentration, the ethanol-induced interdigitation of vesicular DPPC depends on the choice of cation and its concentration. These findings unravel a key role for cations in the ethanol-induced interdigitation of lipid membranes in either bulk phase or vesicular form

Fixation of metatarsal fracture with bone plate in a dromedary heifer

Abstract An oblique fracture of the distal third of the right metatarsus in a three-year-old dromedary heifer weighing about 300 kilograms was immobilized with a 4.5 mm broad-webbed 12-hole dynamic compression bone plate and two interfragmental compression screws. The animal showed slight lameness after 16 weeks of surgery that disappeared after removal of the plate. The result was quite encouraging and the fracture healed in 16 weeks without major complications. It is concluded that the fracture of this bone can be successfully handled with bone plating at least in young, light weight animals

Fate of liposomes in presence of phospholipase C and D: from atomic to supramolecular lipid arrangement

Understanding the origins of lipid membrane bilayer rearrangement in response to external stimuli is an essential component of cell biology and the bottom-up design of liposomes for biomedical applications. The enzymes phospholipase C and D (PLC and PLD) both cleave the phosphorus–oxygen bonds of phosphate esters in phosphatidylcholine (PC) lipids. The atomic position of this hydrolysis reaction has huge implications for the stability of PC-containing self-assembled structures, such as the cell wall and lipid-based vesicle drug delivery vectors. While PLC converts PC to diacylglycerol (DAG), the interaction of PC with PLD produces phosphatidic acid (PA). Here we present a combination of small-angle scattering data and all-atom molecular dynamics simulations, providing insights into the effects of atomic-scale reorganization on the supramolecular assembly of PC membrane bilayers upon enzyme-mediated incorporation of DAG or PA. We observed that PC liposomes completely disintegrate in the presence of PLC, as conversion of PC to DAG progresses. At lower concentrations, DAG molecules within fluid PC bilayers form hydrogen bonds with backbone carbonyl oxygens in neighboring PC molecules and burrow into the hydrophobic region. This leads initially to membrane thinning followed by a swelling of the lamellar phase with increased DAG. At higher DAG concentrations, localized membrane tension causes a change in lipid phase from lamellar to the hexagonal and micellar cubic phases. Molecular dynamics simulations show that this destabilization is also caused in part by the decreased ability of DAG-containing PC membranes to coordinate sodium ions. Conversely, PLD-treated PC liposomes remain stable up to extremely high conversions to PA. Here, the negatively charged PA headgroup attracts significant amounts of sodium ions from the bulk solution to the membrane surface, leading to a swelling of the coordinated water layer. These findings are a vital step toward a fundamental understanding of the degradation behavior of PC lipid membranes in the presence of these clinically relevant enzymes, and toward the rational design of diagnostic and drug delivery technologies for phospholipase-dysregulation-based diseases

Age-Related Patterns in Clinical Presentations and Gluten-Related Issues Among Children and Adolescents With Celiac Disease

OBJECTIVES: Celiac disease (CD) is common and often cited as an “iceberg” phenomenon (i.e., an assumed large number of undiagnosed cases). Recently, atypical or asymptomatic manifestations are becoming more commonly described in older children and adolescents. Moreover, CD diagnosis in children can be complicated by several factors, including its diverse clinical presentations, delay in recognizing CD signs and symptoms, and premature dietary gluten avoidance before the formal diagnosis of CD. To date, few studies have directly examined age-related differences in clinical characteristics and gluten-related issues among children with CD. The aim of this study was to determine age-related patterns in clinical characteristics and gluten-related issues among children with confirmed CD. METHODS: We performed a structured medical record review of biopsy-proven CD patients, aged 0–19 years, between 2000 and 2010 at a large Boston teaching hospital. Data collection included demographics, medical history, gluten-related issues, and diagnostic investigations (CD-specific serology, upper gastrointestinal endoscopy, and small intestinal biopsy). The first positive duodenal biopsy with Marsh III classification defined age of diagnosis. Patients were divided into three age groups for comparisons of the aforementioned characteristics: infant-preschool group (0–5 years), school-aged group (6–11 years), and adolescence group (12–19 years). RESULTS: Among 411 children with biopsy-proven CD, the mean age was 9.5 (s.d. 5.1) years. Most were female (63%) and white (96%). All children had positive CD-specific serology. Most children presented with either abdominal complaints or bowel movement changes. Overall, boys were more common among infant-preschool group compared with the other age groups. More distinct clinical manifestations (vomiting, bowel movement changes, and weight issues) were apparent in the youngest group, whereas school-aged children had more subjective abdominal complaints at the initial presentation. Conversely, the adolescents were most likely to present without any gastrointestinal (GI) symptoms, but not when this was combined with absence of weight issues. Age of diagnosis was not associated with atypical extraintestinal CD presentations. Regarding the gluten-related issues, 10% of school-aged children avoided dietary gluten before the formal CD diagnosis, and 27% of the adolescents reported dietary gluten transgression within the first 12 months of diagnosis, significantly higher than the other age groups. Age differences in histopathology were also found. Whereas the infant-preschool group had a higher proportion of total villous atrophy, the older children were more likely to have gross duodenal abnormalities and chronic duodenitis suggestive of CD at the time of diagnosis. CONCLUSIONS: Children and adolescents with CD have age-related patterns in both the clinical presentations and gluten-related issues. More pronounced clinical and histological features were determined in younger children, whereas older children more commonly presented with solely subjective abdominal complaints or even without any GI symptoms. However, silent and atypical extraintestinal CD presentations were comparable between age groups. In addition to the aforementioned presentations, the higher rates of dietary gluten avoidance and transgression in older children make CD diagnosis and management particularly challenging. These age-related patterns may further increase awareness, facilitate early diagnosis, and improve patient care of pediatric CD

Factors that transformed maize productivity in Ethiopia

Published online: 26 July 2015Maize became increasingly important in the food security of Ethiopia following the major drought and famine that occurred in 1984. More than 9 million smallholder house- holds, more than for any other crop in the country, grow maize in Ethiopia at present. Ethiopia has doubled its maize produc- tivity and production in less than two decades. The yield, currently estimated at >3 metric tons/ha, is the second highest in Sub-Saharan Africa, after South Africa; yield gains for Ethiopia grew at an annual rate of 68 kg/ha between 1990 and 2013, only second to South Africa and greater than Mexico, China, or India. The maize area covered by improved varieties in Ethiopia grew from 14 % in 2004 to 40 % in 2013, and the application rate of mineral fertilizers from 16 to 34 kg/ ha during the same period. Ethiopia ’ s extension worker to farmer ratio is 1:476, compared to 1:1000 for Kenya, 1:1603 for Malawi and 1:2500 for Tanzania. Increased use of im- proved maize varieties and mineral fertilizers, coupled with increased extension services and the absence of devastating droughts are the key factors promoting the accelerated growth in maize productivity in Ethiopia. Ethiopia took a homegrown solutions approach to the research and development of its maize and other commodities. The lesson from Ethiopia ’ s experience with maize is that sustained investment in agricul- tural research and development and policy support by the national government are crucial for continued growth of agricultur

Moderately overweight and obese patients in general practice: a population based survey

BACKGROUND: Obesity is a main threat to public health in the Western world and is associated with diseases such as diabetes mellitus and coronary heart diseases. Up to now a minority of research studied the relation between obesity and the use of primary health care. In the Netherlands the general practitioner (GP) is the main primary health care provider. The objective of this article is to evaluate GP consultation and prescription of drugs in moderate and severely overweight (obese) persons in the Netherlands. METHODS: Data were used from a representative survey of morbidity in Dutch general practice in 2001. Our study sample consisted of 8,944 adult respondents (18+ years) who participated in an extensive health interview. Interview data were linked to morbidity and prescription registration data from 95 general practices where respondents were listed. Body mass index (BMI) was calculated using self-reported height and weight. Analyses were controlled for clustering within practices as well as for socio-demographic and life style characteristics. RESULTS: Obesity (BMI ≥ 30 kg/m2) was observed in 8.9% of men and 12.4% of women; for moderate overweight (BMI 25-<30 kg/m2) these percentages were 42.2% and 30.4% respectively. Obese men and women were more likely to consult their GP than persons without overweight. This especially holds for diseases of the endocrine system, the cardiovascular system, the musculoskeletal system, the gastro-intestinal system, and skin problems. Related to this, obese men and women were more likely to receive drugs for the cardiovascular system, the musculoskeletal system, alimentary tract and metabolism (including, for example, antidiabetics), and dermatologicals, but also antibiotics and drugs for the respiratory system. For moderately overweight men and women (BMI 25-<30 kg/m2) smaller but significant differences were found for diseases of the endocrine system, the cardiovascular system, and the musculoskeletal system. CONCLUSION: Obesity increases the workload of Dutch general practitioners and the use of prescribed medication. The current increase in the prevalence of obesity will further increase the use of health care and related costs. Since a large majority of Dutch persons visit their GP over the course of one year, GPs' potential role in effective prevention strategies cannot be denied

Search for new phenomena in final states with an energetic jet and large missing transverse momentum in pp collisions at √ s = 8 TeV with the ATLAS detector

Results of a search for new phenomena in final states with an energetic jet and large missing transverse momentum are reported. The search uses 20.3 fb−1 of √ s = 8 TeV data collected in 2012 with the ATLAS detector at the LHC. Events are required to have at least one jet with pT > 120 GeV and no leptons. Nine signal regions are considered with increasing missing transverse momentum requirements between Emiss T > 150 GeV and Emiss T > 700 GeV. Good agreement is observed between the number of events in data and Standard Model expectations. The results are translated into exclusion limits on models with either large extra spatial dimensions, pair production of weakly interacting dark matter candidates, or production of very light gravitinos in a gauge-mediated supersymmetric model. In addition, limits on the production of an invisibly decaying Higgs-like boson leading to similar topologies in the final state are presente