Biochemical probing of phloem sap defensive traits in Brassica juncea-B. fruticulosa introgression lines following Lipaphis erysimi infestation.

The lack of resistance to Lipaphis erysimi in cultivated Brassicas makes caused this pest highly devastating resulting in significant loss of rapeseed-mustard productivity in India. B. fruticulosa, a wild crucifer is known as an excellent source of resistance to L. erysimi. Therefore, we planned to assess defense associated biochemical alterations and molecular components of B. juncea-B. fruticulosa ILs to mustard aphid. Phenotypic assessment of ILs on the basis of aphid population per plant (APP) categorized genotypes into resistant (7.15-18.50 APP), moderately susceptible (42.29-53.33 APP) and susceptible (70.00-77.07 APP) genotypes. Mustard aphid infested minimally B. fruticulosa (0.80 APP) among tested genotypes. The maximum increase in catalase (CAT) activity was determined in B. fruticulosa and resistant ILs after 48 h (2.03 and 1.76-fold, respectively) and one week (2.98 and 1.79-fold, respectively) of mustard aphid infestation. The strong induction of CAT2 transcripts (19.25-fold) and CAT activity (5.88-fold) along with low aphid count in resistant IL, Ad4-64 (13.85 APP) suggested the pivotal role of CAT in resistance to mustard aphid. Guaiacol peroxidase (GPX) was significantly decreased following pest infestation at both infestation stages. The ascorbate content was highest in resistant IL, ADV-6RD (2.14-fold) after one week of aphid infestation. H2O2 content rapidly increased in B. juncea-B. fruticulosa derived lines after 48 h of aphid infestation. The negative and significant association between APP and CAT (- 0.56** and - 0.48*, respectively), glutathione (- 0.43* and - 0.40*, respectively), H2O2 (- 0.57** and - 0.43*, respectively) at both 48 h and one week infestation stages signified their role in deterring mustard aphid infestation. The positive and significant association between total sugars (0.33* at 7 DPI), reducing sugars (0.33* at 7 DPI), sucrose (0.36** at 48 h) and APP indicated that higher the sugars content, higher will be mustard aphid infestation in B. juncea derived ILs. The information being generated and key candidates (CAT2, ascorbate and H2O2) being identified may help in effective deployment of B. fruticulosa resistance in mustard breeding.

Evaluating the Outcome of Two Different Regimes in Adhesive Capsulitis: A Prospective Clinical Study.

OBJECTIVE: Adhesive capsulitis or frozen shoulder is a painful condition affecting up to 5% of the general population. We conducted this study with the aim of evaluating the results of physiotherapy plus intra-articular methylprednisolone injection versus physiotherapy alone in idiopathic frozen shoulder. METHODS: This prospective clinical study was conducted in a tertiary care center between August 2016 and August 2018. Patients who were diagnosed with idiopathic frozen shoulder were included in the study, and each patient was randomly allocated to one of two groups: physiotherapy alone (group A) and physiotherapy plus intra-articular steroid injection (group B). RESULTS: A total of 52 cases diagnosed with idiopathic frozen shoulder were included and treated with the two modalities. There was a significant improvement in group B compared to group A at 6 weeks and 3 months in the range of flexion, abduction, and external rotation. The Shoulder Pain and Disability Index showed improvement in both pain and disability score in group B -compared to group A, and improvement was significant at 6 weeks and 3 months. CONCLUSION: The results demonstrate the advantages of physiotherapy plus intra-articular steroid injection in idiopathic frozen shoulder. The predictability of results with physiotherapy plus intra-articular steroid injection in selected patients is excellent, and it is a better modality of treatment compared to physiotherapy alone.

Do we really need to repair the pronator quadratus after distal radius plating?

PURPOSE: Fractures of distal radius are one of the common orthopaedic injuries. Placing the plate on volar surface requires release of underlying pronator quadratus (PQ) muscle. No consensus is present in the literature about the repair or not of the PQ. The purpose of this study was to evaluate the influence of PQ repair on functional outcome and complications. METHODS: Retrospectively 83 patients of distal radius fractures managed with volar plating between 2014 and 2016 were evaluated. Demographic data, operative notes and physical therapy records were retrieved. Patients were divided into group A where PQ repair was done and group B where no repair was done. Functional data such as range of motion (ROM), grip strength, visual analogue scale (VAS) score and disabilities of arm, shoulder and hand (DASH) score at 4 weeks, 3 months, 6 months and finial follow-up were retrieved. RESULTS: Totally 63 patients (n = 29 in group A and n = 34 in group B) with the mean age of 51.64 years were examined. Patients were followed up for a mean of 35.2 months (range 27.2-47.1 months) in group A and 38.6 months (range 28.6-51.0 months) in group B. Though functional outcome of the affected limb was not significantly different between two groups after 3 months, PQ repair did affect the recovery at an early stage. Repair group had significantly better ROM (p = 0.0383) and VAS score at 4 weeks (p = 0.017) while grip strength (p = 0.014) was significantly better at 3 months. CONCLUSIONS: Repair of PQ may provide pain relief and increased ROM in early postoperative period and hence every attempt should be made to achieve the repair.

Reducing shoulder dislocation without anaesthesia or assistant: Validation of a new reduction manoeuvre.

PURPOSE: Shoulder dislocation comprises 60% of all major joint dislocations worldwide and a number of reduction techniques are described in the literature with varying degrees of success. The description of a large number of techniques speaks for itself that no method is effective all the times and one should be acquainted with more than one technique. An ideal method of reduction should be simple, easily reproducible, relatively painless that can be performed unassisted without sedation or anaesthesia with minimal or no further complications. We report our results of using a novel method of anterior shoulder reduction described recently in the literature that claims to fulfil most of the characteristics of an ideal method if not all. METHODS: This prospective study was conducted in a tertiary care centre. All the cases of primary anterior shoulder dislocation presenting within three days of injury without any associated fracture or spine trauma with or without greater tuberosity fracture were included. The reduction was done using a novel method by orthopaedic residents in all cases. The need for a second reduction attempt or anaesthesia was considered a treatment failure. Time taken for reduction, pain felt during reduction and complications if any were noted. RESULTS: There were 47 (77.04%) males and 14 (22.95%) females with a mean age of (37.04 ± 12.63) years. The new technique was effective in locating a shoulder dislocation on the first attempt in 58 of the 61 dislocated shoulders (95.08%). The remaining three shoulders were reduced on second attempt by the same technique. Sedative, pre-medication or anaesthesia was not used in any case. The average time taken for the shoulder reduction was (130.5 ± 25.8) seconds and confidence interval (95%) 124-137 s. Iatrogenic complications were not seen in any of the patients. CONCLUSION: This relatively painless technique of shoulder reduction is easy to acquire and practice in emergency department. The advantages of this manoeuvre and its associated safety may justly lead surgeons to select it as their primary method for reduction of anterior shoulder dislocations.