Background: Treatment of humeral shaft fractures has been a subject of debate for many decades. Even though a large majority of humeral shaft fractures can be treated by non operative methods, few conditions like open fractures, polytrauma, ipsilateral humeral shaft and forearm fractures require surgical intervention. The goal of treatment of humeral shaft fractures is to establish union with an acceptable humeral alignment and to restore the patient to pre-injury level of function. The objective was to assess the incidence of radial nerve palsy, non-union and mean time required for in anteromedial plate osteosynthesis with anterolateral approach and also to measure the functional outcome of this procedure. Method: A prospective study was conducted in the Department of Orthopaedics, PESIMSR, Kuppam, Andhra Pradesh, from August 2012 to August 2015 with a total of 54 patients who were operated with anteromedial plate osteosynthesis were included in the study. RodriguezMerchan criteria was used to grade the functional outcome. Results: Of the 54 patients, 28 (58.85%) were in the age group of 30-40 years. The most common fracture pattern identified was A3 type (48.14%).The mean (+ SD) duration of surgery for anteromedial humeral plating was 53 ± 5.00 minutes. The time taken for the fracture to unite was less than 16 weeks in the majority or 50 patients (92.59%). Four (7.40%) patients had delayed union. There was no incidence of iatrogenic radial nerve palsy. Rodriguez – Merchan criteria showed that 37(68.51%) of the patients had good and 12 (22.22%) had excellent functional outcome. Key Words: Humeral shaft fractures; Plate osteosynthesis; Antero-lateral approach
Fractures, Bone

Unused and discarded latex collection containers (LCCs) are the major breeding habitats of Aedes albopictus in the rubber plantations of Kerala, India. Platynectes sp. (Family: Dytiscidae) was observed to invade these habitats during the monsoon season and voraciously devour the larval instars of this major vector species of arbo-viral diseases. Field observations showed a reduction of 70.91% (p = 0.0017) and 100% in Aedes larval density, on the first and four days post release of eight beetles per LCC respectively. In laboratory, a beetle was found to devour 17.75 + 5.0 late larval instars of Ae. albopictus per day. Our findings indicate Platynectes sp. could be a potential bio-control agent against Ae. albopictus, the vector of chikungunya/dengue fevers, in rubber plantations.

Objective: Social Networking Sites (SNS) are gaining popularity across different cultures and age groups with its increasing role in the day-to-day life of its users. Objective of the present investigation is to study the SNS use and its relationship with online and real-life social capital, self-esteem and interpersonal relationships in normal and clinical population. Methods: The sample consisted of 93 participants of the age range 17-37 years, 63 participants from the general population and 30 from the clinical population with a diagnosis of any depressive or anxiety spectrum disorder. The tools used for this study are Basic Data Sheet, the Facebook Intensity Scale, Internet addiction Test, Internet Social Capital Scale. Results: The Rosenberg Self-Esteem Scale and Sentence Completion Test Results show that Facebook use has a positive correlation with online bonding and bridging capital. A significantly higher percentage of participants from the clinical group met the criteria for problem use of the Internet. Compared to average users, problem users of the Internet are found to have higher mean scores for online bridging capital and conflicts in inter-personal relationships and lower mean scores for real life bonding capital and self-esteem. Conclusions: It necessitates an exploration of Facebook's use patterns in routine evaluation and management of clinical conditions and implies the need for further research to develop explanatory models and management strategies for problematic use of the Internet.

Epulis fissuratum is a benign tumor like inflammatory hyperplastic growth which occurs on the mucosa along the borders of an ill fitting full or partial removable denture. If ulcerated, it can mimic oral squamous cell carcinoma. The treatment includes surgical removal of excess fibrous tissue and remodelling or reconstructing the denture suitably, ensuring better adaptability to the ridges. This case report describes a 55 year old male patient with characteristic clinical features of denture induced inflammatory hyperplasia.

A joint time–frequency localized three-band biorthogonal wavelet filter bank to compress Electrocardiogram signals is proposed in this work. Further, the use of adaptive thresholding and modified run-length encoding resulted in maximum data volume reduction while guaranteeing reconstructing quality. Using signal-to-noise ratio, compression ratio (C(R)), maximum absolute error (E(MA)), quality score (Q(s)), root mean square error, compression time (C(T)) and percentage root mean square difference the validity of the proposed approach is studied. The experimental results deduced that the performance of the proposed approach is better when compared to the two-band wavelet filter bank. The proposed compression method enables loss-less data transmission of medical signals to remote locations for therapeutic usage.
Electrocardiography ; Joints ; Methods ; Signal-To-Noise Ratio

Background: Unsafe injection practice can transmit various blood borne infections. The aim of this study was to assess the knowledge and practice of injection safety among injection providers, to obtain information about disposal of injectable devices, and to compare the knowledge and practices of urban and rural injection providers. Methods: The study was conducted with injection providers working at primary health care facilities within Kaski district, Nepal. Ninety-six health care workers from 69 primary health care facilities were studied and 132 injection events observed. A semi-structured checklist was used for observing injection practice and a questionnaire for the survey. Respondents were interviewed to complete the questionnaire and obtain possible explanations for certain observed behaviors. Results: All injection providers knew of at least one pathogen transmitted through use/re-use of unsterile syringes. Proportion of injection providers naming hepatitis/jaundice as one of the diseases transmitted by unsafe injection practice was significantly higher in urban (75.6%) than in rural (39.2%) area. However, compared to urban respondents (13.3%), a significantly higher proportion of rural respondents (37.3%) named Hepatitis B specifically as one of the diseases transmitted. Median (inter-quartile range) number of therapeutic injection and injectable vaccine administered per day by the injection providers were 2 (1) and 1 (1), respectively. Two handed recapping by injection providers was significantly higher in urban area (33.3%) than in rural areas (21.6%). Most providers were not aware of the post exposure prophylaxis guideline. Conclusion: The knowledge of the injection providers about safe injection practice was acceptable. The use of safe injection practice by providers in urban and rural health care facilities was almost similar. The deficiencies noted in the practice must be addressed.
Health Personnel ; Injections

Pulp chamber is considered as a very important and integral part of the tooth. Pulp chamber undergoes different types of morphological and pathological alterations. Calcified canals are one amongst other pathological alterations. Calcified root canals have been a challenge to the diagnostician and the dental physician before diagnosis and after diagnosis respectively. It is considered that the impact of an irritant to the tooth, like trauma, caries, infection and age changes can precipitate calcification. Calcification makes a dentist to negotiate with his treatment planning and at times it can be a surprise element.

<p>OBJECTIVETo study the modulation effect of pro- and anti-inflammatory cytokines following long term use of water soluble ethanol extracts from different organs of Nyctanthes arbortristis (NAT) in mouse model of arthritis.p><p>METHODSArthritis was induced in mice by two injections of Freund's complete adjuvant on days 0 and 12 in the sub-planter surface of the right hind paw.p><p>RESULTSInjection of adjuvant resulted in a maximum primary edema of the footpad with erythema, and edema and distortion of joints of the right hind paw after 24-48 hours. Second injection of FCA led to the formation of secondary swellings persisting more than four weeks that spread onto the other hind limb but to a lesser extent. Histological analysis of the ankle on day 47 showed marked evidence of cartilage destruction in association with pannus formation and moderate bone resorption. Proinflammatory cytokine levels in the inflamed joint homogenate were elevated on days 2, 14, and 47. Oral administration of leaf and fruit extracts in arthritic mice reduced joint homogenate levels of tumor necrosis factor-alpha, interleukin-1beta, and interleukin-6 on days 2, 14, and 47 in comparison to untreated arthritic mice. Interleukin-10 level was elevated in the inflamed joint on days 2, 14, and 47 in comparisons to untreated arthritic mice.p><p>CONCLUSIONEvidence of lesser inflammation of the footpad and joint and associated histological observation support the therapeutic benefit of leaf and fruit extracts from Nyctanthes arbortristis. This study helps in understanding the mechanism of anti-inflammatory action of Nyctanthes arbortristis in the light of pro- and anti-inflammatory cytokine balance.p>
Animals ; Arthritis, Experimental ; drug therapy ; immunology ; pathology ; Cytokines ; metabolism ; Disease Models, Animal ; Female ; Mice ; Mice, Inbred BALB C ; Oleaceae ; chemistry ; Phytotherapy ; Plant Extracts ; isolation & purification ; therapeutic use

Background: With ever-increasing demand for total knee arthroplasty (TKA), most healthcare systems around the world are concerned about its socioeconomic burden. Most centers have universally adopted well-defined clinical care pathways to minimize adverse outcomes, maximize volume, and limit costs. However, there are no prospective comparative trials reporting benefits of these risk mitigation (RM) strategies. Methods: This is a prospective cohort study comparing post-TKA 90-day complications between patients undergoing RM before surgery and those following a standard protocol (SP). In the RM group, we used a 20-point checklist to screen for modifiable risk factors and evaluate the need for optimizing non-modifiable comorbidities. Only when optimization goals were achieved, patients were offered TKA. Results: TKA was performed in 811 patients in the SP group and in 829 in the RM group, 40% of which were simultaneous bilateral TKA. In both groups, hypertension was the most prevalent comorbidity (48%), followed by diabetes (20%). A total of 43 (5.3%) procedure-related complications were seen over the 90-day postoperative period in the SP group, which was significantly greater than 26 (3.1%) seen in the RM group (p = 0.039). The commonest complication was pulmonary thromboembolic, 6 in each group. Blood transfusion rate was higher in the SP group (6%) than in the RM group (< 1%). Conclusions Screening and RM can reduce 90-day complications in patients undergoing TKA.

Background: One of the symptoms annoying patients after total knee replacement (TKR) is numbness around the operative scar. Some studies have shown that altering the incision in terms of placement or length may decrease the incidence of numbness. It still remains unknown whether numbness affects patient-reported outcomes. Methods: We conducted a randomized study to compare a short-length incision (n = 50) and a lateral exit incision (n = 50) with a standard midline TKR incision (n = 50) in terms of the incidence of numbness and its progress over 1 year of follow-up. Our secondary objective was to look at the involved zone, area of numbness, and secondary symptoms. We also looked at patient-reported outcome in terms of satisfaction in all groups using a visual analog scale and Forgotten Joint Score. Results: At 3 months postoperatively, the incidence of numbness was least in the lateral exit group: 46.2% as compared to midline (62%) and short (58.3%), but the difference was not significant (p = 0.07). At 6 months, the short incision group had a significantly lower incidence (8%) of residual numbness as compared to 30% in the other two groups (p = 0.003). At 1 year, most patients recovered sensation loss and had similar function. Conclusions Placement or length of an incision did not significantly affect the incidence of numbness; however, the short incision led to early recovery of numbness. At 1 year of follow-up, most patients did not complain of loss of sensation and had similar functional outcome.