Comparison of outcome of Dynamic Compression Plate and intramedullary nailing in femural shaft fracture

Background and Objective: Treatment of the femural shaft fracture is imporoving. The aim of this study was to compare the outcome of Dynamic Compression Plating (DCP) and intramedullary nailing in the femural shaft fracture. Materials and Methods: This clinical trial study was done in orthopedic department of Shahid Kamyab Hospital in Mashhad – Iran during 2002-03. 40 patients with open fracture of femur divided into two groups. One group was treated by dynamic compression plate and the other group by intramedullay nailing. Follow-up time was 9-14 months. Results: Out of 40 patients, 75% were male. The time of clinical and radiological bone :::::union::::: was the same in both groups. There was 4 implant failure in the plate group (P<0.05). There was one deep infection in the intramedullary nailing group. Conclusion: This study showed that there is no difference between plate and intramedullary nailing group according time of bone :::::union:::::. But because of 4 implant failure in DCP groups, intramedullary nailing is recommended for femural shaft fracture

Synthesis of theranostic epithelial cell adhesion molecule targeted mesoporous silica nanoparticle with gold gatekeeper for hepatocellular carcinoma

Aim: In this study, we report the fabrication of epithelial cell adhesion molecule targeted 5-fluorouracil (5-FU) encapsulated PEGylated mesoporous silica nanoparticles (NPs) hybridized with gold NPs (PEG-Au@Si-5-FU) as gatekeeper for theranostic applications. Materials &amp; methods: The prepared targeted and nontargeted formulations were evaluated in vitro in terms of their cellular internalization and toxicity. The prepared theranostic hybrid system was also implemented for computed tomography of HepG2 tumor-bearing nude mice in vivo. Results: Fluorescence microscopy and MTT assay demonstrated that the developed epithelial cell adhesion molecule-PEG-Au@Si-5-FU had higher cytotoxicity than nontargeted PEG-Au@Si-5-FU in 2D and 3D HepG2 cell cultures. Moreover, the targeted hybrid system was preferentially accumulated in HepG2 tumor cells in vitro and in vivo. Conclusion: This work introduces a novel strategy for developing multimodal NPs via nanoparticulate hybrid materials. </jats:p

The effect of threshold inspiratory muscle training on the duration of weaning in intensive care unit-admitted patients: A randomized clinical trial

Background: The purpose of this study was to evaluate the effect of threshold inspiratory muscle training (IMT) on the duration of weaning in intensive care unit (ICU)-admitted patients. Materials and Methods: This randomized clinical trial enrolled 79 ICU-admitted, mechanically ventilated patients in 2020–2021 in Imam Reza Hospital, Mashhad. Patients were randomly divided into intervention (n = 40) and control (n = 39) groups. The intervention group received threshold IMT and conventional chest physiotherapy, while the control group only received conventional chest physiotherapy once a day. Before and after the end of the intervention, the strength of inspiratory muscles and the duration of weaning were measured in both the groups. Results: The duration of weaning was shorter in the intervention group (8.4 ± 1.1 days) versus the control group (11.2 ± 0.6 days) (P < 0.001). The rapid shallow breathing index decreased by 46.5% in the intervention group and by 27.3% in the control group after the intervention (both P < 0.001), and the between-group comparison showed a significantly higher reduction in the intervention group than control group (P < 0.001). The patients' compliance after the intervention compared to the 1st day increased to 16.2 ± 6.6 in the intervention group and 9.6 ± 6.8 in the control group (both P < 0.001), and the between-group comparison showed a significantly higher increase in the intervention group than control group. The maximum inspiratory pressure increased by 13.7 ± 6.1 in the intervention group and by 9.1 ± 6.0 in the control group (P < 0.001). Furthermore, the weaning success was 54% more probable in the intervention group than control group (P < 0.05). Conclusion: The results of this study showed the positive effect of IMT with threshold IMT trainer on increased strength of respiratory muscles and reduced weaning duration

The Role of Medial Buttress Plate Augmentation of Cannulated Screws in Unstable Femoral Neck Fractures: A Pilot Study

Background: About 20% of femoral neck fracture surgeries require re-operation. The use of medial buttress plate may reduce the reoperation rate. The purpose of this study is to examine the results of using the method of augmentation of the cannulated screws with medial buttress plate for treatment of unstable femoral neck fractures.&#x0D; Methods: This study included patients with femoral neck fractures of Pauwels type 2 and 3 in which closed reduction was not successful. The patients underwent open anatomical reduction and implantation of three screws, and then the medial placement of the buttress plate was performed. Patients were followed up after 2 weeks, 6 weeks, 3 months, and 6 months. Union and fracture healing and operative complications were assessed using plain radiography.&#x0D; Results: This study included 8 patients with Pauwels type 2 and 3 femoral neck fractures. All patients were men with the mean age of 38.0 ± 11.3 years. Re-hospitalization 30 days after surgery, surgical site infection, deep vein thrombosis (DVT), and deep infection were not observed in any of the patients. The angle between the neck and the femur shaft dramatically increased during the 6-month follow-up (P = 0.049). Union occurred in 6 (75%) patients after 6 months, while 2 patients were lost to follow up. Participants’ Harris Hip Score (HHS) had a significant improvement from 3 months to 6 months after surgery (P = 0.02).&#x0D; Conclusion: Augmentation of cannulated screws with medial buttress plate for unstable femoral neck fractures in patients has advantages in short-term clinical follow-up.</jats:p

Congenital Scoliosis: A Current Concepts Review

Context: Congenital scoliosis is a difficult condition for orthopedic surgeons. There are some influencing factors to choose the best treatment option for scoliosis. Objectives: Patients with congenital scoliosis may encounter different anomalies. There exist various surgical techniques with different indications. Methods: Electronic databases, such as Google Scholar, PubMed, and Scopus were searched for congenital scoliosis. Articles published from 1928 to 2020 were searched. A narrative review was conducted by focusing on treatment options. Results: Different methods are presented in the literature that consists of operative and nonoperative approaches. Nonoperative treatment methods are seldom a final choice. They are used to postpone the final surgery. There are different methods of surgeries in the literature; the best treatment strategy concerns the patients’ condition and the surgeon’s preference. Conclusions: The critical issue in the management of congenital scoliosis is to diagnose these patients’ curves before severe progression, i.e. mandatory to achieve desirable results. Usually, a course of nonoperative treatment can be started, but only to postpone the final surgery. The preferred surgical treatment depends on the type of congenital scoliosis and the age of the patient. The treatment of congenital scoliosis should be a multidisciplinary approach due to concomitant morbidity in these patients.</jats:p