A prospective study of management of tibial plateau fractures by locking compression plate in adults

Background: Tibial plateau fractures are one of the most complex and disabling fractures of the knee. The tibial plateau is important in transmitting load through the knee. These fractures need a meticulous management protocol in order to minimize patient's disability in range of movement, stability and reducing the risk of documented complications. The aim of the present study is to study the outcome of tibial plateau fractures managed with a locked compression plate.Methods: This study was conducted at a tertiary-care medical college and hospital, Aurangabad specializing in post-graduate training, where all patients who underwent surgical treatment between September 2018 and October 2020 were included. Patients were assessed using the knee society score (KSS). These evaluations were done at 1, 3, 6, 9 and 12 months.Results: In our study we included 55 patients out of which we found union in 98% of patients with 83% of patients showing good flexion at knee joint (>110 degrees). 85% patients achieved union within 6 months. An excellent KSS grade was seen in 38.2% patients with another 43.6% showing good outcome. 4 patients showed infection and 1 showed non-union. A single case of malunion was seen in our study.Conclusions: Locked compression plates in tibial plateau fractures has revolutionized the way these fractures are managed. Anatomic reduction is of utmost importance. Early physiotherapy which plays key role in preventing knee stiffness, use of bone grafts and good fixation are important for successful outcome

Short term results of total knee arthroplasty in tertiary rural tier three government medical college and hospital

Background: The objective of the study was to assess the clinical and functional outcome of total knee arthroplasty (TKA) using posterior cruciate stabilizing (PS) design in tertiary rural government hospital with limited infrastructure using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score and to offer a low cost option and assess post-operative pain relief in rural poor of the society and to compare the WOMAC score pre and post-operatively.Methods: The study was conducted on patients who have undergone primary total knee arthroplasty in Department of Orthopaedics, Government Medical College and Hospital, Aurangabad from December 2018 to December 2019. The patients were assessed using the WOMAC score and X-rays. These evaluations were performed at 3, 6 and 12 months follow up visits.Results: At 1 year follow up of 30 knees, the average pre-op WOMAC score of 79.5 improved to an average post-op score of 42.3. And knee flexion increased from 96.3 degree to 108.5 degrees both of which with a p value <0.0001 are statistically significant. One patient each had wound dehiscence and superficial infection. Patient satisfaction after the procedure was good-both in unilateral and staged bilateral TKA.Conclusions: TKA reduces knee pain significantly and improves the functional ability of the patient. And to be able to do so in a tertiary government rural setup with no laminar airflow and with such great efficacy and minimal complications bodes well for the number of people living in rural areas suffering from knee pain

A prospective study to evaluate functional results of PHILOS locking plate system in management of proximal humerus fractures in adults

Background: Various management options are available for management of proximal humerus fractures where PHILOS plating is one of them. But data available in literature on its use and efficacy in management of all types of proximal humerus fractures is still dicey. So, we through our study attempted to grow our knowledge regarding its functional results, complication rates, etc. for use in coming future.Methods: 30 patients with proximal humerus fractures classified on the basis of Neer’s classification were included in study who were operated from 2018 to 2020 at our institute. These patients were operated by PHILOS locking plate system with either delto-pectoral or trans-deltoid approach and they are followed up at regular intervals to assess them clinicoradiologicallly and functionally by Neer’s criteria.Results: In our study we found maximum incidence of these fracture between age group of 40-80 years (66.66%) with male to female ratio of 2:1 with 19 patients having left sided and 11 patients having right sided proximal humerus fracture. Complications were found in 11 patients (36.67%). Functional evaluation was carried out using Neer’s criteria at final follow up which came to excellent results in 3, satisfactory in 18, unsatisfactory in 7 and failure in 2 patients. Average time of fracture union was 12.62 weeks.Conclusions: PHILOS locking plate system serves good purpose in management of fractures of proximal humerus but requires trained faculty to do this operation who has detailed knowledge about shoulder anatomy and mechanism of injury to reduce complications associated with this type of modality

A comparative single dose study of oral acetaminophen 650 mg to its standard 500 mg dose in adult pyrexia patients in a tertiary care hospital

Background: Acetaminophen commonly called as paracetamol is the most used ‘over-the-counter’ analgesic for headache, musculoskeletal pain, dysmenorrhoea etc. It is the best drug to be used as antipyretic for fever due to any cause and safest to be prescribed in all age groups. Antipyretic dose of acetaminophen is 325 to 650 mg; 3 to 4 times a day and is available in the strength of 650 mg and 500 mg tablets. This study was conducted to analyse the antipyretic efficacy and safety profile of two different doses of acetaminophen in patients with low grade fever.Methods: 300 hospitalised patients aged more than 18 years, in department of General Medicine, having low grade fever (38º to 39º C) were randomly allocated into two groups of 150 each, group A received 500 mg and group B received 650 mg of single oral dose of acetaminophen tablets. Oral temperature was measured before dosing, 30 minutes after dosing, one hour, two hourlies thereafter for 6 hours after the dose. Safety was assessed by monitoring for adverse effects during the study and 24 hours after administration of the assigned drug.Results: There was a statistically significant decrease in temperature in group B patients from baseline 39.06±0.87º C to 37.02±0.89º C at the end of 6th hour as compared with 39.18±0.80º C to 38.03±0.77º C in Group A patients (p=0.031).Conclusions: Our study concluded that acetaminophen in a dose of 650 mg is highly efficacious antipyretic drug compared to acetaminophen 500 mg with no adverse effects

Effect of nano urea on greenhouse gas emissions in transplanted rice (Oryza sativa L.) ecosystems

The application of conventional nitrogen fertilizer (urea) to improve rice crop yield has a significant influence on soil methane (CH4) and nitrous oxide (N2O) emissions. An experiment was conducted at Tamil Nadu Agricultural University, Coimbatore, wetlands farm, during the summer of 2023. A Randomized Block Design (RBD) was used with 8 treatments and 3 replications to evaluate the impact of different nitrogen application strategies on greenhouse gas emissions, specifically methane and nitrous oxide in transplanted rice, including the varying nitrogen levels. The study aimed to improve rice growth and yield through foliar application of nano urea, focusing on the rice variety CO55 with a recommended dose of NPK (150:50:50 NPK kg/ha). The results indicated that applying 75 kg nitrogen/ha (50 % of the recommended dose) as basal through conventional urea, along with 3 nano urea foliar sprays at 20, 40 and 60 days after transplanting (T5), resulted in significantly lower methane and nitrous oxide emissions compared with 100 % of the recommended nitrogen dose i.e. 150 kg nitrogen/ha applied through conventional urea, with 25 % used at basal, active tillering, panicle initiation and heading stage (T1) and 150 kg nitrogen/ha i.e. 100 % recommended dose of nitrogen applied through conventional urea, with 50 % as basal and 2 top dressings of 25 % of the recommended dose of nitrogen (RDN) each at active tillering and panicle initiation (T2)

Synthesis, gene silencing, and molecular modeling studies of 4 '-C-aminomethyl-2 '-O-methyl modified small interfering RNAs.

The linear syntheses of 4′-C-aminomethyl-2′-O-methyl uridine and cytidine nucleoside phosphoramidites were achieved using glucose as the starting material. The modified RNA building blocks were incorporated into small interfering RNAs (siRNAs) by employing solid phase RNA synthesis. Thermal melting studies showed that the modified siRNA duplexes exhibited slightly lower Tm (1 °C/modification) compared to the unmodified duplex. Molecular dynamics simulations revealed that the 4′-C-aminomethyl-2′-O-methyl modified nucleotides adopt South-type conformation in a siRNA duplex, thereby altering the stacking and hydrogen-bonding interactions. These modified siRNAs were also evaluated for their gene silencing efficiency in HeLa cells using a luciferase-based reporter assay. The results indicate that the modifications are well tolerated in various positions of the passenger strand and at the 3′ end of the guide strand but are less tolerated in the seed region of the guide strand. The modified siRNAs exhibited prolonged stability in human serum compared to unmodified siRNA. This work has implications for the use of 4′-C-aminomethyl-2′-O-methyl modified nucleotides to overcome some of the challenges associated with the therapeutic utilities of siRNAs

Meteorite impact craters as hotspots for mineral resources and energy fuels: A global review

The ever-increasing recovery rate of natural resources from terrestrial impact craters over the last few decades across the globe offers new avenues for further exploration of mineral and hydrocarbon resources in such settings. As of today, 60 of the 208 terrestrial craters have been identified to host diverse resources such as hydrocarbons, metals and construction materials. The potential of craters as plausible resource contributors to the energy sector is therefore, worthy of consideration, as 42 (70%) of the 60 craters host energy resources such as oil, gas, coal, uranium, mercury, critical and major minerals as well as hydropower resources. Among others, 19 craters are of well-developed hydrocarbon reserves. Mineral deposits associated with craters are also classified similar to other mineral resources such as progenetic, syngenetic and epigenetic sources. Of these, the progenetic and syngenetic mineralization are confined to the early and late excavation stage of impact crater evolution, respectively, whereas epigenetic deposits are formed during and after the modification stage of crater formation. Thus, progenetic and syngenetic mineral deposits (like Fe, Ni, Pb, Zn and Cu) associated with craters are formed as a direct result of the impact event, whereas epigenetic deposits (e.g. hydrocarbon) are hosted by the impact structure and result from post-impact processes. In the progenetic and syngenetic deposits, the shock-wave induced fracturing and melting aid the formation of deposits, whereas in the epigenetic deposits, the highly fractured lithostratigraphic units of higher porosity and permeability, like the central elevated area (CEA) or the rim, act as traps. In this review, we provide a holistic view of the mineral and energy resources associated with impact craters, and use some of the remote sensing techniques to identify the mineral deposits as supplemented by a schematic model of the types of deposits formed during cratering process

A Knowledge Distillation Framework For Enhancing Ear-EEG Based Sleep Staging With Scalp-EEG Data

Sleep plays a crucial role in the well-being of human lives. Traditional sleep studies using Polysomnography are associated with discomfort and often lower sleep quality caused by the acquisition setup. Previous works have focused on developing less obtrusive methods to conduct high-quality sleep studies, and ear-EEG is among popular alternatives. However, the performance of sleep staging based on ear-EEG is still inferior to scalp-EEG based sleep staging. In order to address the performance gap between scalp-EEG and ear-EEG based sleep staging, we propose a cross-modal knowledge distillation strategy, which is a domain adaptation approach. Our experiments and analysis validate the effectiveness of the proposed approach with existing architectures, where it enhances the accuracy of the ear-EEG based sleep staging by 3.46% and Cohen's kappa coefficient by a margin of 0.038.Comment: Code available at : https://github.com/Mithunjha/EarEEG_KnowledgeDistillatio

Towards Interpretable Sleep Stage Classification Using Cross-Modal Transformers

Accurate sleep stage classification is significant for sleep health assessment. In recent years, several machine-learning based sleep staging algorithms have been developed, and in particular, deep-learning based algorithms have achieved performance on par with human annotation. Despite the improved performance, a limitation of most deep-learning based algorithms is their black-box behavior, which has limited their use in clinical settings. Here, we propose a cross-modal transformer, which is a transformer-based method for sleep stage classification. The proposed cross-modal transformer consists of a novel cross-modal transformer encoder architecture along with a multi-scale one-dimensional convolutional neural network for automatic representation learning. Our method outperforms the state-of-the-art methods and eliminates the black-box behavior of deep-learning models by utilizing the interpretability aspect of the attention modules. Furthermore, our method provides considerable reductions in the number of parameters and training time compared to the state-of-the-art methods. Our code is available at https://github.com/Jathurshan0330/Cross-Modal-Transformer.Comment: 11 pages, 7 figures, 6 table