Correlation of Foot Bimalleolar Angle and Ultrasonography in Assessing the Severity of Club Foot in Neonates Treated by the Ponseti Method

Introduction: Correlation of Pirani score and foot bimalleolar (FBM) angle has been used in few studies but correlation of FBM angle with ultrasonography has never been evaluated so they are being correlated in assessing the severity of clubfoot in neonates treated by Ponseti method. Material and Methods: Thirty-two feet with congenital talipes equinovarus (CTEV) deformity in neonates were prospectively treated by the Ponseti method. FBM angle and ultrasound parameters were measured three times i.e. at the time of initial presentation, at four weeks of treatment and at completion of treatment. The feet were divided according to the Pirani score in groups: one (0-2.0), two (2.5-4) and three (4.5-6). Correlation between FBM angle and ultrasound parameters were evaluated using Pearson correlation/regression. Results: Correlation between FBM angle and ultrasound parameters were statistically significant (p-value < 0.05). Conclusion: Ultrasound has the potential to accurately depict the pathoanatomy in clubfoot. FBM angle and ultrasound are objective methods to assess the severity of clubfoot. FBM angle and ultrasonography correlated in severity of deformity and correction achieved along the course of treatment.

Long-term operation of electro-biocatalytic reactor for carbon dioxide transformation into organic molecules

Electro-biocatalytic reactor was operated using selectively enriched mixed culture biofilm for about 320 days with CO₂/bicarbonate as C-source. Biocathode consumed higher current (-16.2 ± 0.3 A/m²) for bicarbonate transformation yielding high product synthesis (0.74 g/l/day) compared to CO₂ (-9.5 ± 2.8 A/m²; 0.41 g/l/day). Product slate includes butanol and butyric acid when CO₂ gets transformed but propionic acid replaced both when bicarbonate gets transformed. Based on electroanalysis, the electron transfer might be H₂ mediated along with direct transfer under bicarbonate turnover conditions, while it was restricted to direct under CO₂. Efficiency and stability of biofilm was tested by removing the planktonic cells, and also confirmed in terms of Coulombic (85-97%) and carbon conversion efficiencies (42-48%) along with production rate (1.2-1.7 kg/m² electrode) using bicarbonate as substrate. Selective enrichment of microbes and their growth as biofilm along with soluble CO₂ have helped in efficient transformation of CO₂ up to C4 organic molecules.

Thoracic Endometriosis Presenting with Bilateral Hydropneumothorax

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Heavy metal pollution due to coal washery effluent and its decontamination using a macrofungus, Pleurotus ostreatus

Release of the effluent generated during washing of coal became a major problem for coal industries due to presence of many toxic metals and other pollutants. These effluents are the main source of pollution in rivers and other water bodies. Therefore in this study, we tried to analyse the toxicity of coal washery effluent (CWE) collected from one of the washery plant situated in Dhanbad, India. CWE was found to be very toxic containing large amount of suspended particles and many heavy metals above than their permissible limits. Mycoremediation of CWE was also performed to decontaminate heavy metals from the CWE using a macrofungi Pleurotus ostreatus. Efficiency of Pleurotus for remediation of heavy metals was found to be highest in the 50% diluted effluent (57.2% Mn, 82.6% Zn, 98.0% Ni, 99.9% Cu, 99.3% Co, 99.1% Cr, 89.2% Fe and 35.6% Pb) followed by 25% diluted effluent (33.0% Mn, 55.1% Zn, 97.8% Ni, 99.7% Cu, 97% Co, 84.4% Cr, 87.1% Fe and 73.4% Pb) and raw effluent (23.3% Mn, 73.1% Zn, 78.7% Ni, 87.5% Cu, 59.3% Co, 64.6% Cr, 34.6% Fe and 11.3% Pb) respectively. Increased activity of antioxidant enzymes, lipid peroxidation, concentration of metallothionein proteins and changes in peaks of FTIR spectra were also observed in fungal mycelia grown on the CWE containing media due to accumulation of different metals. Overall this study suggests that Pleurotus can be used as promising option for removal of heavy metals from the effluent released from washery plants and dilution of effluent could increase the efficiency of remediation.

Outcome of bone marrow instillation at fracture site in intracapsular fracture of femoral neck treated by head preserving surgery

PURPOSE

The aim of present study is to evaluate the outcome of bone marrow instillation at the fracture site in fracture of intracapsular neck femur treated by head preserving surgery.

METHODS

This study included 32 patients of age group 18-50 years with closed fracture of intracapsular neck femur. Patients were randomized into two groups as per the plan generated via www.randomization.com. The two groups were Group A (control), in which the fracture of intracapsular neck femur was treated by closed reduction and cannulated cancellous screw fixation, and Group B (intervention), in which additional percutaneous autologous bone marrow aspirate instillation at fracture site was done along with cannulated cancellous screw fixation. Postoperatively the union at fracture site and avascular necrosis of the femoral head were assessed on serial plain radiographs at final follow-up. Functional outcome was evaluated by Harris hip score.

RESULTS

The average follow-up was 19.6 months. Twelve patients in each group had union and 4 patients had signs of nonunion. One patient from each group had avascular necrosis of the femoral head. The average Harris hip score at final follow-up in Group A was 80.50 and in Group B was 75.73, which was found to be not significant.

CONCLUSION

There is no significant role of adding on bone marrow aspirate instillation at the fracture site in cases of fresh fracture of intracapsular neck femur treated by head preserving surgery in terms of accelerating the bone healing and reducing the incidence of femoral head necrosis.

Analysis of silver binding nucleolar organizer regions in exfoliative cytology smears of potentially malignant and malignant oral lesions

Nucleolar organizer regions are nucleolar components that contain proteins that are stained selectively by silver methods; they can be identified as black dots throughout the nucleolus and are known as silver binding nucleolar organizer regions (AgNOR). The number of AgNOR is related to the cell cycle and the proliferative activity of the cells. We investigated AgNOR using exfoliative cytology smears of potentially malignant oral lesions. Eighty individuals were divided into four equal groups: healthy controls, oral leukoplakia, oral submucous fibrosis and oral squamous cell carcinoma. The mean number of AgNOR in each study group gradually increased from control to oral leukoplakia to oral submucous fibrosis to oral squamous cell carcinoma. The proliferative index was increased in the oral premalignant and malignant patients compared to normal subjects. The mean AgNOR size gradually increased from control to oral leukoplakia to oral submucous fibrosis to oral squamous cell carcinoma. Spherical shaped AgNOR were most common in controls, whereas large, clustered and kidney shapes were most common in oral squamous cell carcinoma. Multiparameter analysis of AgNOR in oral exfoliative smears is a simple, sensitive and cost-effective method for differentiating premalignant from malignant lesions and can be used in conjunction with routine cytomorphological evaluation.

Prevalence of high-risk human papilloma virus types and cervical smear abnormalities in female sex workers in Chandigarh, India

PURPOSE

Cervical cancer is the most common cancer among women in developing nations. Nearly 90% of the cases have been linked to the presence of high-risk human papillomavirus (hrHPV) types 16 and 18. The risk of cervical cancer may be high in female sex workers (FSWs) due to multiple sexual partners. This study aimed to determine the prevalence of cytological abnormalities and hrHPV types 16 and 18 in FSWs in Chandigarh, North India using the liquid-based cytology (LBC) approach.

MATERIALS AND METHODS

The cervical brush samples were collected from 120 FSW and 98 age-matched healthy controls (HCs). These were subjected to pap smear using conventional method, LBC and the detection of hrHPV types 16 and 18 was carried out using polymerase chain reaction.

RESULTS

The LBC samples showed better cytological details and also reduced the number of unsatisfactory smears from 11% in Pap to 1.5% in the LBC. A significantly higher number of inflammatory smears were reported in FSWs (51.7% vs. 34.7%, P = 0.01). The hrHPV types 16/18 were detected in 33/120 (27.5%) FSW versus 23/98 (23.5%) HCs. The risk of acquiring hrHPV was higher in FSWs, who had age at first sex ≤25 years, higher income and the habit of smoking.

CONCLUSION

The high prevalence of hrHPV among FSWs and HCs suggests the need for the implementation of effective National Screening Programme for early detection of hrHPV types to decrease the burden of cervical cancer, especially in high-risk population.

Perturbations and 3R in carbon management

Perturbations in various carbon pools like biological, geological, oceanic, and missing carbon sink affect its global data, which are generally neglected or ignored in routine calculations. These natural and anthropogenic events need to be considered before projecting a sustainable carbon management plan. These plans have both general and experimental aspects. General plans should focus on (a) minimizing emission; (b) maximizing environmentally sound reuse, reduce, and recycling; (c) effective treatment; and (d) converting carbon into valuable products with atom economy. Experimental carbon management plans involving various biological and chemical techniques with limitation in terms of research level and economic feasibility. Chemical options have benefits of higher productivity and wider product range, but it suffers from its higher-energy requirements and environmental unfriendliness. In contrast to this, biological options are more selective and less energy intensive, but their productivity is very low. Hence, there is a requirement of hybrid process where the benefits of both the options, i.e., biological and chemical, can be reaped. In view of above, the proposed review targets to highlight the various perturbations in the global carbon cycle and their effects; study the currently practiced options of carbon management, specifically in light of 3R principle; and propose various new hybrid methods by compatible combinations of chemical and biological processes to develop better and safer carbon management. These methods are hypothetical so they may require further research and validations but may provide a comprehensive base for developing such management methods.

Quantitative evaluation of apical extrusion of intracanal bacteria using rotary ProTaper, K3XF, twisted and hand K-file system: An ex vivo study

AIMS

The aim of this study was to evaluate the number of intracanal bacteria extruded apically during root canal preparation using rotary ProTaper, K3XF, twisted, and hand K-file system.

SUBJECTS AND METHODS

Seventy extracted single-rooted human mandibular premolar teeth were used. Access cavities were prepared and the teeth were mounted in glass vials. Root canals were then contaminated with a pure culture of Enterococcus faecalis (ATCC 29212) and incubated at 37°C for 24 h. The contaminated roots were divided into four experimental groups of 15 teeth each and one control group of 10 teeth. Group 1: ProTaper; Group 2: K3XF; Group 3: Twisted file; Group 4: Hand K-file; Group 5: Control group. Bacteria extruded from the apical foramen during instrumentation were collected into vials. The microbiological samples were incubated in culture media for 24 h. Colonies of bacteria were counted and the results were given as number of colony-forming units (CFU)/ml.

STATISTICAL ANALYSIS USED

The obtained data were analyzed using the Kruskal-Wallis one-way analysis of variance and Mann-Whitney U-tests.

RESULTS

There was a significant difference between the rotary and hand instrumentation system related to the apically extruded intracanal bacteria.

CONCLUSIONS

Both the rotary and hand instrumentation systems extruded intracanal bacteria through the apical foramen. K3XF file system showed least bacterial extrusion amongst all instrumentation groups.

Malunion in displaced intracapsular fracture of femoral neck: A rare case

Intracapsular fracture of femoral neck is treated by anatomical reduction (preferably closed) and cannulated cancellous lag screw fixation. Malunion of these fractures have been described in the coronal plane (coxa valga or coxa vara). We reported a case of young adult patient with displaced intracapsular fracture of femoral neck that had malunited in sagittal plane with callus formation with excellent functional outcome. The radiographs revealed intracapsular fracture of femoral neck right side (Garden type 4 and Pauwel type 3). The patient was operated and closed reduction and internal fixation with three cannulated cancellous screws was performed. The postoperative radiograph revealed a loss of reduction in the lateral view. Due to this technical error, the patient was counselled for revision fixation for which he refused. At 9 months we observed union of the fracture in the displaced position by callus formation. Harris hip score at 2 years was 96 that indicate excellent functional outcome and the radiographs did not reveal any evidence of avascular necrosis of femoral head. We advised revision surgery to our patient as he had increased chances of implant failure and nonunion. However he refused the revision surgery and was continued with the suboptimal reduction. However, the fracture united and that too with callus formation, which is not a described phenomenon in neck of femur fracture.

Electro-biocatalytic treatment of petroleum refinery wastewater using microbial fuel cell (MFC) in continuous mode operation

Refinery wastewater (RW) treatment in microbial fuel cell (MFC) was studied in batch mode operation followed by continuous mode operation with 8h and 16h hydraulic retention time (HRT). The MFC performance was evaluated in terms of power density, organics removal, specific contaminants (oil & grease, phenol and sulfide) removal and energy conversion efficiency with respect to operation mode. Higher power density of 225±1.4mW/m² was observed during continuous mode operation with 16h HRT along with a substrate degradation of 84.4±0.8% including the 95±0.6 of oil content. The columbic efficiency during this operation was about 2±0.8% and the projected power yield was 340±20kWh/kg COD_R/day. Batch mode operation also showed good substrate degradation (81±1.8%) but took longer HRT which resulted in significantly low substrate degradation rate (0.036±0.002kgCOD_R/m³-day) over continuous mode operation (1.05±0.01kgCOD_R/m³-day). Overall, current study depicted the possibility of utilizing RW as substrate in MFC for power generation along with its treatment.

Bio-electro catalytic treatment of petroleum produced water: Influence of cathode potential upliftment

Treatment of petroleum produced water (PPW) was studied using bioelectrochemical system (BES) under uplifted cathode potential. The treatment efficiency in terms of COD and hydrocarbon removal was observed at 91.25% and 76.60% respectively, along with the reduction in TDS during BES operation under 400mV of cathode potential. There was also a reduction in concentration of sulfates, however, it was not significant at, since oxidative conditions are being maintained at anode. Improved oxidation of PPW at anode also resulted in good power output (-20.47mA) and also depicted improved fuel cell behaviour. The electrochemical analysis in terms of cyclic/linear sweep voltammetry also showed well correlation with the observed treatment efficiencies. The microbial dynamics of the BES after loading real field wastewater showed the dominance of species that are reported to be effective for petroleum crude oil degradation.

Prevalence of parasitic infection in captive wild animals in Bir Moti Bagh mini zoo (Deer Park), Patiala, Punjab

Aim:

The study was conducted to know the prevalence of gastrointestinal parasites of captive wild animals at Bir Moti Bagh Mini Zoo (Deer Park), Patiala, Punjab.

Materials and Methods:

A total of 31 fecal samples from eight species of captive animals including Civet cat (Viverra zibetha), Porcupine (Hystrix indica), Nilgai (Boselaphus tragocamelus), Spotted deer (Axis axis), Black buck (Antelope cervicapra), Sambar deer (Cervus unicolor), Hog deer (Axis porcinus), and Barking deer (Muntiacus muntjak) were screened using classical parasitological techniques including sedimentation and floatation technique.

Results:

Out of 31 fecal samples examined, 20 were positive for parasitic ova/oocysts of different species indicating an overall prevalence of 68.0%. The six different types of parasites observed in the study included strongyle (67%), Strongyloides spp. (14%), coccidia (38%), Trichuris spp. (19%), ascarid (10%), and Capillaria spp. (10%). Strongyles were the most common parasites observed (67%) followed by coccidia (38%). Mixed helminth and protozoan infection were observed in 48% of animals. No cestode or trematodes were detected during the study.

Conclusion:

The high prevalence of gastrointestinal parasites without overt clinical signs of disease or mortality as observed in this study is suggestive of subclinical infection. The findings will help in formulating the appropriate deworming protocol for parasitic control in these captive animals.

Antibody response to Toxoplasma gondii in saliva samples from human immunodeficiency virus-infected patients

Toxoplasma gondii is an important opportunistic infection among human immunodeficiency virus (HIV)-infected patients as it causes fatal encephalitis. In the present study, antibody response to T. gondii is assessed in saliva samples from 100 HIV-seropositive patients and 25 HIV-negative healthy controls by indirect enzyme-linked immunosorbent assay (ELISA). Sensitivity and specificity for detection of IgG and IgM in saliva is calculated using a positive antibody response in serum samples (from an earlier study) as the gold standard. IgG and IgM antibodies were found in 20% and 25% patients, respectively. One control subject showed the presence of IgM antibody. Sensitivity for IgG and IgM antibodies was 64% and 81.25%, respectively, while specificity was 94.67% and 85.71%, respectively. This study indicates that saliva samples can be used as an alternative to serum samples to detect anti-toxoplasma antibodies, particularly IgM, for the diagnosis of toxoplasma encephalitis in HIV/acquired immune deficiency syndrome patients.

Socio-demographic, Epidemiological and Environmental Determinants of Acute Gastroenteritis in Western India

INTRODUCTION

An outbreak of acute gastroenteritis had occurred in Rajpara village of Bhavnagar district. The objective of this study was to find out the socio-demographic, epidemiological and environmental determinants of this outbreak.

METHODS

A case-control study was conducted in Rajpara village among 238 cases of acute gastroenteritis and an equal number of controls in January 2015. Multiple logistic regression was used for identifying the variables independently predicting acute gastroenteritis.

RESULTS

Upper socio-economic status, occupation requiring travel outside village, source of drinking water from well of 'new' Rajpara village, change in taste of water, use of chlorine tablets, travel outside village in last week, another family member affected with acute gastroenteritis, using common utensil for hand washing, hand washing before eating, ate food from outside in last week, having sanitary latrine at house, waste disposal in a common dump (instead of at house), waste accumulation around house and flies inside house were significantly associated with occurrence of acute gastroenteritis. On multiple logistic regression, change in taste of water (P<0.001), waste disposal in a common dump (P=0.012), another family member been affected (P<0.001), waste accumulation around house (P<0.001), higher socio-economic status (P=0.002) and eating outside food (P=0.011) made a significant contribution to prediction.

CONCLUSIONS

Socio-demographic factors (higher socio-economic status), epidemiological correlates (change in taste of water, another family member been affected with acute gastroenteritis and eating outside food) and environmental determinants (waste disposal in a common dump and waste accumulation around house) significantly determines the occurrence of cases of acute gastroenteritis.

Subaperture stitching for measurement of freeform wavefront

A method based on subaperture stitching for measurement of a freeform wavefront is proposed and applied to wavefronts calculated from the slope data acquired using a scanning Shack Hartmann sensor (SHS). The entire wavefront is divided into a number of subapertures with overlapping zones. Each subaperture is measured using the SHS, which is scanned over the entire wavefront. The slope values and thus the phase values of separately measured subapertures cannot be connected directly due to various misalignment errors during the scanning process. The errors lying in the vertical plane, i.e., piston, tilt, and power, are minimized by fitting them in the overlapping zone. The radial and rotational misalignment errors are minimized during registration in the global frame by using active numerical alignment before the stitching process. A mathematical model for a stitching algorithm is developed. Simulation studies are presented based on the mathematical model. The proposed mathematical model is experimentally verified on freeform surfaces of a cubic phase profile.

Controversies in Orthopaedic Trauma- Management of Fractures of Shaft of Femur in Children Between 6 and 12 Years of Age

The management of femoral shaft fractures in children is largely directed by the age and built of the child. There is wide consensus on the non operative treatment of children less than six years of age. Operative treatment is recommended for children more than 12 years of age, only the surgical options vary. The age group of 6-12 years remains a controversial area with multiple studies advocating different lines of treatment.We studied the literature on treatment of femoral shaft fractures in 6 to 12 year age group over the past 25 years through PubMed search and found 79 studies dealing with management of paediatric shaft femur fractures in this age group. Studies dealing with other age groups, animal studies and languages other than English were excluded. The treatment modalities included early or immediate hip spica, traction alone, external fixator, plating (open/minimally invasive), intramedullary nailing- rigid/flexible and intramedullary Kirschner wire. The short listed articles were studied for rate and time of union, complications such as non-union and malunion, leg length discrepancy, infection, implant impingement, refracture and cost analysis.Operative treatment is usually the preferred treatment option in this age group, as it decreases hospitalization time, decreases morbidity and allows early return of child to school. Flexible intramedullary nailing is recommended for length stable fractures. Submuscular bridge plating (minimally invasive) is reserved for comminuted fractures. External fixator is reserved for open fractures and initial stabilization of femoral shaft fractures in polytrauma pediatric patients. Intramedullary K wire is a viable option in resource contrained centres where specialized implants and instrumentation is not available.Kathmandu University Medical Journal Vol.12(1) 2014: 77-84

Electrochemical removal of sulfate from petroleum produced water

Petroleum produced water (PPW) is a waste-stream that entails huge cost on the petroleum industry. Along with other suspended and dissolved solids, it contains sulfate, which is a major hurdle for its alternative use intended toward enhanced oil recovery. This study proposes a two-step process for sulfate removal from PPW. A synthetic PPW was designed for the study using response surface methodology. During the first step, sulfate present in PPW was reduced to sulfide by anaerobic fermentation with 80% efficiency. In the second step, more than 70% of the accumulated sulfide was electrochemically oxidized. This integrated approach successfully removed sulfate from the synthetic wastewater indicating its applicability in the treatment of PPW and its subsequent applications in other oil field operations.

Importance of algae as a potential source of biofuel

Algae have a great potential source of biofuels and also have unique importance to reduce gaseous emissions, greenhouse gases, climatic changes, global warming receding of glaciers, rising sea levels and loss of biodiversity. The microalgae, like Scenedesmus obliquus, Neochloris oleabundans, Nannochloropsis sp., Chlorella emersonii, and Dunaliella tertiolecta have high oil content. Among the known algae, Scenedesmus obliquus is one of the most potential sources for biodiesel as it has adequate fatty acid (linolenic acid) and other polyunsaturated fatty acids. Bio&mdash;ethanol is already in the market of United States of America and Europe as an additive in gasoline. Bio&mdash;hydrogen is the cleanest biofuel and extensive efforts are going on to bring it to market at economical price. This review highlights recent development and progress in the field of algae as a potential source of biofuel.

Production of ligninolytic enzymes by white rot fungi on lignocellulosic wastes using novel pretreatments

Production of extracellular ligninolytic enzymes (laccase and polyphenol oxidase) secreted by three species of white rot fungi (Pleurotus florida, P. flabellatus and P. sajor&mdash;caju) under in vivo condition was studied on two lignocellulosic substrates i.e., paddy straw and wheat straw. These lignocellulosic substrates were treated with neem (Azadirachta indica) oil and ashoka (Saraca indica) leaves extract. Between the two lignocellulosic substrates, paddy straw pretreated with neem oil supported maximum activity of laccase and polyphenol oxidase (PPO). The activities of both the enzymes were low on the 5th day of cultivation which increased on the 10th day and reached at peak on the 15th day. Thereafter, there was continuous decrease in the enzymatic activity. Among the three species, P. flabellatus (P3) showed maximum ligninolytic enzymatic activity followed by P. florida (P2)and P. sajor&mdash;caju (P1).

Biodegradation of wheat straw by Pleurotus ostreatus

Wheat straw pretreated with chemicals as well as hot water was subjected to degradation by edible mushroom Pleurotus ostreatus. Lignin, cellulose and hemicelluloses component of both chemically as well as hot water treated wheat straw was degraded by the fungus and in turn the edible and nutritious fruiting body of the mushroom was produced. Biodegradation of wheat straw in terms of loss of lignin, cellulose and hemicellulose showed positive correlation with cellulases, xylanase, laccase and polyphenol oxidase (PPO) activity of the fungus. During vegetative growth of the fungus, lignin degradation was faster and during fructification, lignin degradation was slower than cellulose and hemicellulose. The carbon content of the wheat straw decreased while, nitrogen content increased during degradation of the waste. Hot water treated wheat straw supported better production of enzymatic activity and degraded more efficiently than chemically sterilized substrate. The cumulative yield and biological efficiency (BE) of the mushroom was maximum on the hot water treated substrate. Degradation of the hot water treated wheat straw was better and faster than chemically treated substrate.