Role of PFN in ipsilateral fracture neck and shaft femur: a single solution to double fracture

Background: Ipsilateral, concomitant femoral neck and shaft fracture is a rare fracture pattern that presents a diagnostic and treatment challenge. A variety of management modalities have been tried to treat this complex fracture pattern ranging from conservative approach to recently introduced proximal femoral nails (PFN).Methods: We analysed the retrospective data of 25 consecutive patients who had sustained a high energy trauma who had concomitant ipsilateral fractures of the femoral shaft associated with proximal femur fractures treated with PFN between January 2010 and January 2017.Results: Average follow up period was 1.2 years. All ipsilateral neck and shaft fractures were united with proximal femur nail (PFN). Neck fracture union averaged 4.3 months (range, 3–6 months). Shaft fracture union averaged 5.4 months (range, 4–7 months). Eighteen patients (70%) had a good functional result, five patients (21%) had fair result and in two patients the result (9%) was poor.Conclusions: We observed although technically demanding, the reconstruction nail is an acceptable, cost effective and minimal invasive alternative for the management of concomitant ipsilateral fractures of the femoral neck and shaft, with a good functional outcome and fewer complications

Giant-cell tumour of proximal radius in a 50-year-old female with wrist drop: a rare case report

Abstract Giant-cell tumour is a locally aggressive tumour of long bones of epiphyseal region commonly occurring in adults aged 20–40 years. Most common location is distal femur, proximal tibia, and distal radius. Different treatment options being used are curettage with bone graft or bone cement, resection with arthrodesis, reconstruction, radiation, and chemotherapy. We are reporting a case of giant-cell tumour of right proximal radius in a 50-year-old female with posterior interosseous nerve palsy. It is very rare, and only four cases have been reported in the literature. It was treated by wide margin resection with fibular grafting, titanium elastic nail system along with cancellous bone graft reconstruction

Correlation of acromial morphology in association with rotator cuff tear : a retrospective study

Purpose: There have been many studies that have attempted to correlate radiographic acromial characteristics with rotator cuff tears, but the results have not been conclusive. Rotator cuff tears (RCT) are the common aetiology of shoulder pain. We assessed the association of rotator cuff tears with commonly used radiographic parameters of acromial morphology and their different radiographic characteristics. Material and methods: From a retrospective study of 98 patients, we characterised acromial type and measured acromial thickness (AT), critical shoulder angle (CSA), lateral acromial angle (LAA), acromiohumeral distance (AHD), and acromion index (AI) on a 1.5T MRI, from 68 patients with partial or full-thickness supraspinatus tendon tears and 30 controls without tears. Results: Out the 68 patients with rotator cuff tear, supraspinatus was the most commonly affected tendon, with 86% (59) cases showing abnormalities. The average age of the patients was 45.11 ± 21.45 years with male dominance (80%). Partial tears of rotator cuff were more common than complete tears. Forty-eight cases showed partial tears in supraspinatus as compared to 11 cases of complete tears. The acromial type did not show any correlation with any particular cuff lesion. The AT and AI of controls were significantly smaller than cuff-tear patients. The LAA of cuff-tear patients was significantly different from that of control patients. The impingement patients demonstrated a significantly greater acromial thickness, larger CSA, decreased AHD, and decreased LAA than their control counterparts. Conclusions: A higher prevalence of rotator cuff tears and impingement associated with low lateral acromial angle, larger CSA and decreased AHD was observed. AT and AI have a direct correlation with rotator cuff tear

Carbon accounting management in complex manufacturing supply chains: a structured framework approach

Improving the management of carbon emissions in the drive to Net-Zero can involve both complex measurements and the development of cleaner technologies, which is a demanding challenge for both the private and public sectors. Specifically, within complex and often sensitive supply chains such as aerospace manufacturing, accounting for carbon management requires quantification of the extended enterprise’s direct and indirect emissions as a system. Currently however, there is a lack of standardised methods for carbon accounting suitable for use in the measurement and auditing of carbon performance both in the production process as well as in the supply chain. This research presents a structured framework-based approach, that could facilitate accurate, consistent and simplified management of carbon scoping, measurement and reporting, across complex extended supply chains. The proposed five step approach sets a thematic orientation for future customisation of carbon accounting tools at every step of the framework

The concept of carbon accounting in manufacturing systems and supply chains

Carbon accounting is primarily a process for measuring, reporting, and allocating greenhouse gas emissions from human activities, thus enabling informed decision-making to mitigate climate change and foster responsible resource management. There is a noticeable upsurge in the academia regarding carbon accounting, which engenders complexity due to the heterogeneity of practices that fall under the purview of carbon accounting. Such plurality has given rise to a situation where diverse interpretations of carbon accounting coexist, often bereft of uniformity in definition and application. Consequently, organisations need a standardised, comprehensive, and sequentially delineated carbon accounting framework amenable to seamless integration into end-to-end manufacturing systems. This research commences with the progressive evolution of the conceptual definition of carbon accounting. Then, it delves into the current state of carbon accounting in manufacturing systems and supply chains, revealing gaps and implementation issues warranting future scholarly exploration

A synergetic framework for green and lean manufacturing practices in SMEs: Saudi Arabia perspective

Manufacturers are urged to improve their sustainability performance, in terms of keeping the balance among economic, environmental, and social performances. Nevertheless, top managers and company leaders tend to complain that it is not possible to implement greener solutions without large investments. In this context, the well-known lean manufacturing approach, mainly focused on waste reduction, has come to be viewed with a renewed interest towards improving not only economic but also environmental and social aspects. Unfortunately, while there is no doubt that lean manufacturing increases productivity, efficiency, quality, and customers’ satisfaction by reducing wastes, there is a lack of research about the benefits of lean practices in relation to green manufacturing. The aim of the present work is to investigate the level of integration of green and lean manufacturing approaches, focussing specifically on the context of Saudi Arabia. As a result, a novel theoretical framework capable of combining the lean and green approaches within a synergetic environment, enhancing the former and mitigating the latter, is proposed. A survey was put together for assessing a number of hypotheses and validating the proposed framework. Qualitative analysis based on a survey conducted in different SME manufacturing companies in Saudi Arabia is presented. The statistical analysis of the collected data shows a clear trend that in Saudi Arabia, companies are starting to have a positive view about the integration of lean and green approaches implementation. The results highlighted higher maturity among the respondents with regard to the lean implementation, focussing on operational improvements. The improvements that can be attained with regard to environmental performance are coming next, and the framework proposed can help increase awareness among Saudi manufacturing SMEs

Methodology to identify and quantify sources of process scrap on shop floor

Poor quality costs are the total financial losses caused by the products or services not being perfect. Process scrap is a major contributing factor to these losses. Identification of different sources of scrap and the resulting costs is paramount for Continuous Improvement. Furthermore, quantification of this scrap and how the data can be visualised will facilitate decision making by upper management. For this, a methodology that acts as a guide will prove to be of great use in the analysis of scrap generation in any manufacturing plant. In the case study presented, a comprehensive list of the possible sources was made. However, only those which were responsible for a major part of the cost and of great concern were shortlisted. Once identified, several measurement systems were proposed to accurately quantify the resultant scrap. This was then followed by data visualisation using a dashboard that gave a weekly update on the levels of scrap generate

StudentCoin Price Prediction and Relation to Blockchain Education

The newly introduced cryptocurrency called StudentCoin which is identified by the acronym STC is a blockchain-based project. It is the first platform in the world for easy tokenization. It allows the users to learn about cryptocurrencies, blockchain technology and their use cases. Users can create their own tokens, coins and also trade them on the same terminal. This paper uses easy-to-understand modeling and simulation techniques to make price predictions for blockchain education-oriented cryptocurrencies like StudentCoin. We have used the Monte Carlo simulation technique to determine if the price of StudentCoin is expected to increase within a month, and that combining education with blockchain and cryptocurrency platforms is beneficial. The study also aims to find out if college students are aware of cryptocurrencies and see if it's possible to combine education and cryptocurrency. The paper contributes to promoting awareness among university students about responsible investment practices in the cryptocurrency market

Role of computed tomography (CT) in localisation and characterisation of suprahyoid neck masses

BACKGROUND: Suprahyoid neck lesions are difficult to assess only by means of clinical inspection and therefore imaging techniques are required to precisely evaluate suprahyoid neck spaces. The aim of this study was to evaluate the distinctive role of computed tomography in the assessment of anatomical source and pathological type of masses involving the suprahyoid neck spaces. MATERIAL AND METHODS: Sixty patients presenting with suprahyoid neck masses underwent computed tomography of the neck. The CT findings were correlated with histopathological findings and a final diagnosis was made. RESULTS: Overall, male preponderance was seen except in the case of parotid space lesions where female predominance was seen. The most common aetiology was squamous cell carcinoma and the majority of cases (30%) were seen in patients aged 41–50 years. The majority of lesions were found in the pharyngeal mucosal space (n=16) with squamous cell carcinoma being the most common pathology. In the parotid space, pleomorphic adenoma and in the prestyloid parapharyngeal space, squamous cell carcinoma were the most common lesions, respectively. In the retropharyngeal space, an equal incidence of malignant and inflammatory aetiologies was seen. Abscesses were the most common lesions in the prevertebral space. The pleomorphic adenoma was the most common benign tumour and was also the second most common tumour in the suprahyoid neck spaces. CT had an excellent correlation with histopathological findings with sensitivity of 96.4%, specificity of 100%, positive predictive value of 100% and a negative predictive value of 91.67%. CONCLUSIONS: Computed tomography definitely has a major role to play in the evaluation of suprahyoid neck masses as it has an excellent correlation with post-operative histopathological diagnosis