Mid-term outcome of arthroscopic TightRope fixation of displaced lateral end clavicular fractures: Average follow-up of 6.1 years

PURPOSE

Various surgical modalities are available to treat Neer types 2 and 5 unstable fractures of lateral end clavicle but none of them are standardized. Arthroscopic fixation of the displaced lateral end clavicle fractures provides good short-term results but mid- to long-term outcomes are not available. The purpose of this study was to show the mid- to long-term radiological and functional outcomes of these fractures treated arthroscopically by a TightRope device, and to show the complications associated with this procedure.

METHODS

A retrospective study was conducted over 2 years from January 2014 to December 2015 with a minimum 5-year follow-up. Active patients aged 18-50 years with acute (less than 3 weeks) displaced fracture of lateral end of the clavicle, with a minimum 5-year follow-up were included in the study. Patients with associated fractures of the proximal humerus, glenoid, scapula and acromioclavicular joint injuries were excluded from the study along with open fractures and neurovascular injuries. The outcomes were assessed by objective (complications and radiographic examination) and subjective criteria (quick disabilities of the arm, shoulder and hand score, the Constant-Murley score and the visual pain analogue scale). The data were analyzed by SPSS version 21.0.

RESULTS

Totally, 42 patients were operated during the study period and 37 were available with a minimum 5-year follow-up. Thirty were male and 7 were female with a mean age of 29.5 years and a mean follow-up of 6.1 years. The mean quick disabilities of the arm, shoulder and hand score was 68.2 ± 4.6 preoperatively and 1.27 ± 2.32 at final follow-up (p < 0.001); the mean visual pain analogue scale score was 6.85 ± 2.2 preoperatively and 0.86 ± 1.60 at final follow-up (p < 0.001). The average Constant-Murley score was 93.38 ± 3.25 at the end of the follow-up. There were 2 fixation failures, with established non-union and 3 patients developed radiographic acromioclavicular joint arthritis.

CONCLUSIONS

Arthroscopic TightRope fixation of displaced lateral end clavicular fractures provides good radiological and functional outcomes at mid- to long-term follow-up. With the low complication rates and high patient satisfaction, this technique can be considered as a primary option in the surgical treatment of these fractures.

Histopathology of orodental biopsies

Background: Tissue diagnosis is an essential step to come to a confirmed diagnosis in oral lesions where clinical examination alone can often be difficult and inaccurate. The aim of this study was to assess the use of histopathological services by the dental department and to correlate the clinicopathological diagnosis.Materials and Methods: This is an histopathological database analysis of dental biopsies in 23 years from 1989 to 2012 in Patan Hospital. The variables studied were age, sex, clinical and histopathological diagnosis. SPSS version 16 was used as an analytical tool.Results: Out of 396 dental biopsies 203 (51.3%) were females and 193 (48.7%) were males with  mean age 34.34 years and standard deviation of 17.9 years. The neoplastic and non neoplastic conditions were 44% and 56% respectively.Conclusion: Most diagnoses were benign in nature and had an inflammatory etiology.

Cysticercosis of the tongue

Cysticercosis is a condition in which a human being acts as the intermediate host of Taenia solium, a pork tape worm. The oral mucosa is an uncommonly involved site. A rurally living 35 year old vegetarian female presented with a swelling over the right side of her tongue of seven months duration. Histopathology of excisional biopsy revealed it to be cysticercosis. Diagnosis of cysticercosis was clinically unsuspected. The patient was referred to the general medical clinic for further treatment.

Modeling the Metrics of Individual, Organizational and Technological Knowledge Sharing Barriers

In today's knowledge-based business, knowledge is the only source of competitive advantage for engineering industries. Knowledge sharing plays an important role in the success of knowledge management (KM). Knowledge sharing barriers (KSBs) become obstacles for KM to achieve the goals of the industries. In this paper, three categories of KSBs have been identified such as individual, organizational and technological. The main purpose of this research is to measure the effectiveness of individual, organizational and technological KSBs by the application of an analytical network process (ANP) framework which helps to the managers for taking decision to enhance the successful knowledge sharing in the engineering industries. An ANP framework has been developed with the help of identified determinants, dimensions and enablers to evaluate alternatives such as individual, organizational and technological KSBs. Results indicate that the organizational KSBs have the maximum effect on knowledge sharing followed by technological and individual KSBs.

Modeling the Metrics of Individual, Organisational and Technological Knowledge Sharing Barriers: An Analytical Network Process Approach

In today's knowledge-based business, knowledge is the only source of competitive advantage for engineering industries. Knowledge sharing plays an important role in the success of knowledge management (KM). Knowledge sharing barriers (KSBs) become obstacles for KM to achieve the goals of the industries. In this paper, three categories of KSBs have been identified such as individual, organisational and technological. The main purpose of this research is to measure the effectiveness of individual, organisational and technological KSBs which helps the managers for taking decision to enhance the successful knowledge sharing strategy in the engineering industries. In this paper, an analytical network process (ANP) framework has been developed with the help of identified determinants, dimensions and enablers to evaluate the effectiveness of alternatives such as individual, organisational and technological KSBs. As per evaluation, the organisational KSBs have the maximum effect on knowledge sharing followed by technological and individual KSBs.

Evaluation of antibiotic sensitivity pattern in cases of enteric fever in north west Rajasthan

A total of 50 cases of blood culture proved enteric fever were studied for clinical response to the treatment and compared with in vivo antibiotic sensitivity pattern. Out of 50 Salmonella strains isolated, 37 were S typhi and 13 S paratyphi A. All S typhi isolates were sensitive in vitro to gentamicin and ceftriaxone while sensitivity to ciprofloxacin was 73%, ampicillin 29.7%, chloromphenicol 27%, tetracycline 27% and co-trimoxazole 13.5%. Multidrug resistance (Ampicillin, Chloramphenicol, Cotrimoxazale and Tetracycline) was observed in 62% isolates. All Sparatyphi A isolates were sensitive to all the antibiotics. Clinical response to the antibiotic therapy was as follows: Group I--Ampicillin + Gentamicin: 15 cases, clinical response (CR), 9.1% (S typhi) and 75% (S paratyphi A), mean day of defervescence 5.33 days. Group II--Ciprofloxacin: 29 cases, clinical response 47.6% (S typhi) and 75% (S paratyphi A), mean day of defervescence--5.22 days. Group--III Ceftriaxone: 30 cases, clinical response 100% in all, mean day of defervescence--4.93 days. Thus we observed highly significant discrepancy in antibiotic sensitivity pattern of the isolates and clinical response. Most importantly we observed significantly delayed clinical response to the ceftriaxone. This may be indicative of evolving resistance to ceftriaxone.

SOME INTERESTING OBSERVATIONS IN PSYCHIATRIC DISORDERS

Abstract

PUERPERAL PSYCHOSIS

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Epilepsy-Behavior Change

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Synthesis and antimicrobial activity of 1-aryl-2-amino-3-(4-arylthiazol-2-yl)/(benzothiazol-2-yl)guanidines

The synthesis of fifteen new 1-aryl-2-amino-3-(4-arylthiazol-2-yl)/(benzothiazol-2-yl)gua nidines is described. They were screened for their antimicrobial susceptibility by the standard disc diffusion method of the World Health Organization (WHO) and the activities compared with that of standard strain of Escherichia coli NCTC 10418. The sensitive aminoguanidines were further subjected to the minimum inhibitory concentration (MIC) test.

A comparison of an A1 adenosine receptor agonist (CVT-510) with diltiazem for slowing of AV nodal conduction in guinea-pig

1. The purpose of this study was to compare the pharmacological properties (i.e. the AV nodal depressant, vasodilator, and inotropic effects) of two AV nodal blocking agents belonging to different drug classes; a novel A1 adenosine receptor (A1 receptor) agonist, N-(3(R)-tetrahydrofuranyl)-6-aminopurine riboside (CVT-510), and the prototypical calcium channel blocker diltiazem. 2. In the atrial-paced isolated heart, CVT-510 was approximately 5 fold more potent to prolong the stimulus-to-His bundle (S-H interval), a measure of slowing AV nodal conduction (EC50 = 41 nM) than to increase coronary conductance (EC50 = 200 nM). At concentrations of CVT-510 (40 nM) and diltiazem (1 microM) that caused equal prolongation of S-H interval (approximately 10 ms), diltiazem, but not CVT-510, significantly reduced left ventricular developed pressure (LVP) and markedly increased coronary conductance. CVT-510 shortened atrial (EC50 = 73 nM) but not the ventricular monophasic action potentials (MAP). 3. In atrial-paced anaesthetized guinea-pigs, intravenous infusions of CVT-510 and diltiazem caused nearly equal prolongations of P-R interval. However, diltiazem, but not CVT-510, significantly reduced mean arterial blood pressure. 4. Both CVT-510 and diltiazem prolonged S-H interval, i.e., slowed AV nodal conduction. However, the A1 receptor-selective agonist CVT-510 did so without causing the negative inotropic, vasodilator, and hypotensive effects associated with diltiazem. Because CVT-510 did not affect the ventricular action potential, it is unlikely that this agonist will have a proarrythmic action in ventricular myocardium.

Naked foot marks - a preliminary study of identification factors

Footprints of 725 apparently healthy subjects (395 males and 330 females) between the ages of 18 and 30 years were obtained. A number of measurements were taken on each footprint and converted into suitable indices to overcome the problems of registration, recording and observation. Minimum and maximum probability values for each index and combined probabilities were calculated. From the data, it was found that the maximum combined frequency of an individual in the population was of the order of 10(-4) and the minimum combined consideration crease marks and other characteristic features. Thus the present study indicates that combined probabilities could provide reasonably reliable circumstantial evidence to link the criminal with the crime. Humps and creases, which often confer individuality on a print, form additional features of the study.

Cannabis and its users in Nepal

Cannabis is easily available in Nepal, large numbers of persons using it regularly. I have studied its effects on 226 persons who had been using it for a long time and in considerable amount. As a control group I used an equal number of men of matching age and education. Compared with the controls, the cannabis users had a poor work record, poor social and family relationships, a lack of interest in sex and a general loss of initiative and efficiency. However, there was no difference in crime rate between the groups.

Some Neurotic Symptoms

SymptomsOccupationAge distributionSelection of casesGeneral ConderationPathological investigationStudy, information and impressionTreatmentDiscussion

Hyperventilation Syndromes As Seen Is Kathmandu

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Epilepsy In Children

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