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BACKGROUND: The anterior cruciate ligament (ACL) is a common knee ligament injury. Partial ACL tears are common, and at least 10-27% of isolated ACL tears are diagnosed as partial tears. Patients with partial tears have high risk of progression of tears to complete tears, which may require surgical reconstruction. The risk factors associated with the progression to a complete tear are poorly understood. METHODS: The present case-control study assessed the incidence and risk factors for the progression of conservatively treated partial ACL tears to complete tears in 351 patients younger than 45 years. The diagnosis of partial ACL tears was based on clinical evaluation, side-to-side difference on Rolimeter, and magnetic resonance imaging. These patients were managed conservatively and followed up for a mean of 17.5 months or until the progression of the tear into a complete tear, requiring surgery. The patients in whom the tear progressed to complete tear (group P) were compared with those in whom the tear remained stable for a minimum of 18-month follow-up period (group S). RESULTS: Of the 351 partial ACL tear patients, 166 (47.3%) patients progressed to a complete tear at a mean duration of 17.5 months, whereas the tear in 185 (52.7%) patients remained stable and did not progress to a complete tear. Group P had mean international knee documentation committee (IKDC) scores and Tegner scores of 95.7 ± 3.7 and 7.6 ± 1.6, respectively, before the injury, and scores decreased to 52.4 ± 4.1 and 5.7 ± 2.2, respectively, at the 24-month follow-up. CONCLUSION: Partial ACL tear progressed to a complete tear in 47.3% of evaluated patients. The associated risk factors were age less than 35 years, rigorous physical activities, high ACL-Return to Sport after Injury score during early rehabilitation days, early return to activity, and pivoting contact sports.
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Lesiones del Ligamento Cruzado Anterior , Traumatismos de la Rodilla , Humanos , Adulto , Lesiones del Ligamento Cruzado Anterior/epidemiología , Lesiones del Ligamento Cruzado Anterior/cirugía , Estudios Retrospectivos , Ligamento Cruzado Anterior , Articulación de la Rodilla/cirugía , Traumatismos de la Rodilla/complicaciones , RoturaRESUMEN
PURPOSE: The study attempted to compare the effects of immediate and delayed arthroscopic Bankart repair on the shoulder dislocation recurrence. METHODS: In total, 465 soldiers with first-time anterior shoulder dislocation were included in the study. Of the total, 285 soldiers underwent a quick arthroscopic Bankart repair procedure, whether 180 soldiers underwent a delayed repair procedure. The initial dislocation was traumatic in both groups and operated using the standard arthroscopic suture anchor repair technique. Patient's age, repair time since the first dislocation, number of dislocations before surgery, number of suture anchors used during the repair, duration of surgical procedure, duration from surgery to return to work, and recurrence of dislocation after surgery were recorded. Rowe score, Constant score, and American Shoulder and Elbow Surgeons score were used for clinical assessment. RESULTS: The operating time and recurrence rate were higher in the group subjected to delayed repair procedure than in the group subjected to immediate repair procedure. Repair timing was found to be crucial for a successful outcome. CONCLUSIONS: The findings suggest that Bankart repair must be performed immediately to minimize recurrence and other degenerative changes, which may require an additional surgical procedure for satisfactory repair. More studies are required to reach a definitive conclusion. LEVELS OF EVIDENCE: Level III.
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Lesiones de Bankart , Inestabilidad de la Articulación , Personal Militar , Luxación del Hombro , Articulación del Hombro , Humanos , Lesiones de Bankart/cirugía , Luxación del Hombro/cirugía , Articulación del Hombro/cirugía , Inestabilidad de la Articulación/etiología , Inestabilidad de la Articulación/prevención & control , Inestabilidad de la Articulación/cirugía , Rango del Movimiento Articular , Estudios Retrospectivos , Recurrencia , Artroscopía/efectos adversos , Artroscopía/métodos , Resultado del TratamientoRESUMEN
Background Severe acute respiratory syndrome corona virus-2 (SARS-CoV-2) variants, which have emerged due to several mutations in spike protein, have a potential to escape immune protection provided by the first-generation vaccines, thereby resulting in breakthrough infections. Objective To identify the socio-demographic factors, clinical features, and outcomes in both vaccinated and unvaccinated hospitalized patients infected with SARS-CoV-2. Method Socio-demographic details, clinical features, and the outcomes among fully vaccinated (double for Covishield/AstraZeneca and BBIBP-CorV and single for Janssen), partially vaccinated, and unvaccinated hospitalized patients with coronavirus disease of 2019 (COVID-19) were collected and analyzed using SPSS version 17. Result Among the hospitalized COVID-19 patients (n=299), 175 (58.5%) patients received a single-dose, 82 (27.4%) double-dose, and 124 (41.5%) did not receive any dose of the COVID-19 vaccines. The risk of SARS-CoV-2 infection when compared between vaccinated and unvaccinated patients was found to be associated among professional degree holders (23.4% versus 9.7%) (p<0.05), professional workers (43.4% vs. 25.0%) (p<0.05), hospitalization to general ward (76.6% vs. 72.6%) (p<0.05), and presence of multiple symptoms (> or equel 3) (86.8% vs. 75.0%) (p>0.05) and comorbidities (> or equal 2) (15.5% vs. 13.7%) (p>0.05). Despite such approximate incidences, the risk of in-hospital mortality among the vaccinated patients was reduced (0.6% vs. 3.2%) (p>0.05), when compared to the unvaccinated patients. The risk of in-hospital mortality was associated with the older age and the presence of multiple comorbidities including bronchial asthma, diabetes, and hypertension. Conclusion Full or partial vaccination against the SARS-CoV-2 variants of concerns might be effective in preventing in-hospital mortality among COVID-19 patients.
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Vacunas contra la COVID-19 , COVID-19 , Humanos , SARS-CoV-2 , ChAdOx1 nCoV-19RESUMEN
A hard X-ray engineering applications beamline (BL-02) was commissioned recently and started operation in March 2019 at the Indian synchrotron source, Indus-2. This bending-magnet-based beamline is capable of operating in various beam modes, viz. white, pink and monochromatic beam. The beamline utilizes the X-ray diffraction technique in energy-dispersive and angle-dispersive modes to carry out experiments mainly focused on engineering problems, viz. stress measurement, texture measurement and determination of elastic constants in a variety of bulk as well as thin-film samples. An open-cradle six-circle diffractometer with â¼12â kg load capacity allows accommodation of a wide variety of engineering samples and qualifies the beamline as a unique facility at Indus-2. The high-resolution mode of this beamline is suitably designed so as to carry out line profile analysis for characterization of micro- and nano-structures. In the present article the beamline is described starting from the beamline design, layout, optics involved, various operational modes and experimental stations. Experiments executed to validate the beamline design parameters and to demonstrate the capabilities of the beamline are also described. The future facilities to be incorporated to enhance the capabilities of the beamline are also discussed.
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W/B4C multilayers (MLs) consisting of ten layer pairs with varying boron carbide layer thicknesses have been investigated. The ML structures were characterized using grazing-incidence hard X-ray reflectivity (GIXR), resonant soft X-ray reflectivity (RSXR), hard X-ray photoelectron spectroscopy (HAXPES) and X-ray absorption near-edge spectroscopy (XANES). Depth-resolved spectroscopic information on the boron carbide layer in W/B4C MLs was extracted with sub-nanometre resolution using reflectivity performed in the vicinity of the B K-edge. Interestingly, these results show that the composition of boron carbide films is strongly dependent on layer thicknesses. HAXPES measurements suggest that most of the boron is in the chemical state of B4C in the multilayer structures. XANES measurements suggest an increase in boron content and C-B-C bonding with increase in boron carbide layer thickness.
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OBJECTIVE: Hip fractures in the elderly are usually associated with a high rate of morbidity and mortality and affect quality of life. On review of published data, the current guidelines in the literature indicate that early surgery should be performed within 24 h of injury because it is associated with better functional outcomes and lower rates of perioperative complications and mortality. The aim of this study was to evaluate whether any correlation exists between early surgical intervention and functional outcomes. METHODS: In a retrospective study, we analyzed the records between January 2010 and December 2016 and 550 elderly patients between the age group of 65-95 were included. RESULTS: The results of early surgery were promising, 451 (82%) patients did not have any complication, 42 (7.6%) has developed bed sore, 23 (4%) developed a hospital-acquired infection, 13 (2.3%) developed wound infection, 08 (1.4%) developed DVT, 04 (0.7%) developed implant failure, and 09 (01%) died of some or other complications. CONCLUSION: Still, there is conflicting evidence in the published data that early surgery would improve mortality and function. However, early surgery definitively improves outcome and reduces morbidity, bed sores, infection, and the length of hospital stay could be improved by reducing the waiting time of hip surgery following fracture. We concluded that it is beneficial to the elderly patients to receive surgical treatment as early as possible.
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Artroplastia de Reemplazo de Cadera , Fijación Interna de Fracturas , Fracturas de Cadera/fisiopatología , Fracturas de Cadera/cirugía , Tiempo de Tratamiento , Anciano , Anciano de 80 o más Años , Artroplastia de Reemplazo de Cadera/efectos adversos , Infección Hospitalaria/etiología , Femenino , Fijación Interna de Fracturas/efectos adversos , Prótesis de Cadera/efectos adversos , Humanos , Masculino , Dolor Postoperatorio/etiología , Úlcera por Presión/etiología , Falla de Prótesis/efectos adversos , Estudios Retrospectivos , Infección de la Herida Quirúrgica/etiología , Factores de Tiempo , Trombosis de la Vena/etiologíaRESUMEN
Here we have demonstrated a novel single step technique of synthesis of highly fluorescent carbon nanoparticles (CNPs) from broth constituent and in vivo bioimaging of Caenorhabditis elegans (C. elegans) with the synthesized CNPs has been presented. The synthesized CNPs has been characterized by the UV-visible (UV-Vis) absorption spectroscopy, transmission electron microscopy (TEM) and Raman studies. The sp (2) cluster size of the synthesized samples has been determined from the measured Raman spectra by fitting it with the theoretical skew Lorentzian (Breit-Wigner- Fano (BWF)) line shape. The synthesised materials are showing excitation wavelength dependent tunable photoluminescence (PL) emission characteristics with a high quantum yield (QY) of 3 % at a very low concentration of CNPs. A remarkable increase in the intensity of PL emission from 16 % to 39 % in C. elegans has also been observed when the feeding concentration of CNPs to C. elegans is increased from 0.025 % to 0.1 % (w/v). The non-toxicity and water solubility of the synthesized material makes it ideal candidate for bioimaging.
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Caenorhabditis elegans/metabolismo , Carbono/química , Colorantes Fluorescentes/química , Imagen Molecular/métodos , Nanopartículas/química , Animales , Caenorhabditis elegans/química , Microscopía Electrónica de TransmisiónRESUMEN
BACKGROUND & OBJECTIVES: Epidemiological information on tuberculosis (TB) has always been vital for planning control strategies. It has now gained further importance for monitoring the impact of interventions to control the disease. The present study was done to estimate the prevalence of bacillary tuberculosis in the district of Faridabad in Haryana State of India among persons aged older than 15 years. METHODS: In this cross-sectional study, residents of Faridabad district were assessed for the prevalence of tuberculosis. Twelve rural and 24 urban clusters with estimated populations of 41,106 and 64,827 individuals were selected for the study. Two sputum samples were collected from individuals found eligible for inclusion. The samples were also cultured by modified Petroff's method and were examined for growth of Mycobacterium tuberculosis once a week for eight weeks. A person found positive by smear and/or culture was identified as sputum-positive pulmonary TB positive. RESULTS: A total of 105,202 subjects were enumerated in various clusters of the Faridabad district. There were 50,057 (47.58%) females and 55,145 (52.42%) males. Of these 98,599 (93.7%) were examined by the study group (47,976 females; 50,623 males). The overall prevalence of sputum smear or culture positive pulmonary tuberculosis in our study was found to be 101.4 per 100,000 population. INTERPRETATION & CONCLUSIONS: The present results showed that the prevalence of sputum positive pulmonary tuberculosis was higher in Faridabad district than the notification rates recorded by the World Health Organization for the contemporary period, a disparity that could be explained by a difference in case detection strategy employed for the study.
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Mycobacterium tuberculosis/aislamiento & purificación , Esputo/microbiología , Tuberculosis Pulmonar/epidemiología , Tuberculosis Pulmonar/microbiología , Adolescente , Adulto , Anciano , Femenino , Humanos , India , Masculino , Persona de Mediana Edad , Mycobacterium tuberculosis/patogenicidad , Tuberculosis Pulmonar/patología , Organización Mundial de la Salud , Adulto JovenRESUMEN
CONTEXT: Migrant workers constitute an important risk group for Human Immunodeficiency Virus/Acquired Immuno-Deficiency Syndrome transmission in India. Alcohol consumption before sexual intercourse has been postulated to influence condom use practices. This study aimed to assess this association with regard to non-spousal sexual encounters among male migrant workers in northern India. MATERIALS AND METHODS: A cross-sectional facility-based survey was conducted in 2011. Male migrant workers aged ≥18 years, who were born outside Haryana, who had moved to the current location after 15 years of age,had worked in the current factory for at least 1 year, who were willing to participate and were able to give written, informed consent were included in the study. A consecutive sampling was performed. Descriptive, bivariate and multiple logistic regression analyses were carried out. RESULTS: A total of 162 participants reported having experienced non-spousal sexual encounters in the last 1 year. The proportion of men who reported not having used a condom at their last non-spousal sexual encounter was 59.3%, and 78.4% of the men reported having consumed alcohol in the last 1 year. About 48.1% of men reported having consumed alcohol before their last non-spousal sexual encounter. Men who consumed alcohol were three times more likely to not use a condom at their last non-spousal sexual encounter (OR = 3.1, 95% CI: 1.5-6.4). This association persisted even after adjusting for relevant confounders. CONCLUSION: Alcohol consumption had a negative influence on condom use during non-spousal sexual encounter among male migrant workers. An integrated approach to promote condom use and reduce alcohol consumption among migrant men needs to be undertaken through targeted intervention strategies.
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Condones/estadística & datos numéricos , Conducta Sexual/estadística & datos numéricos , Migrantes/estadística & datos numéricos , Adulto , Consumo de Bebidas Alcohólicas/epidemiología , Estudios Transversales , Conocimientos, Actitudes y Práctica en Salud , Humanos , India , Entrevistas como Asunto , Modelos Logísticos , Masculino , Persona de Mediana Edad , Conducta Sexual/etnología , Población UrbanaRESUMEN
BACKGROUND: The goal of medical education is to ensure that the medical graduate has acquired broad public health competencies needed to solve the health problems of the community. We present the current teaching of community medicine to medical students of the All India Institute of Medical Sciences (AIIMS), New Delhi during their 5-week posting at the rural centre at Ballabgarh, Haryana. METHODS: The teaching activities consist of field visits to different levels of health facilities and meeting with health workers, epidemiological exercises, a community-based exercise, posting in inpatient and outpatient departments of a secondary hospital, and domiciliary visits to families of patients. These are spread over 80 sessions of about 200 hours. There is very little didactic teaching and the assessment is broad-based. The evaluation of the posting was based on comparison of blinded pre- and post-posting assessments as well as anonymous feedback of the posting by the students. RESULTS: There was a significant increase in the mean scores of all components of the posting-epidemiology (5.1 to 8.4), health systems (6.8 to 9.3) and clinical (8.0 to 10.8). The posting did not result in a better understanding of a public health approach as compared to a clinical approach. The feedback provided by students was generally positive for all activities with 94% of them rating it as good or very good. CONCLUSION: The teaching of community medicine can be made more practical and interesting without compromising on learning. However, despite such a programme, getting medical students to develop a public health approach is a daunting task.
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Prácticas Clínicas , Medicina Comunitaria/educación , Educación de Pregrado en Medicina , Servicios de Salud Rural , Humanos , India , Facultades de MedicinaRESUMEN
In the cardiovascular diseased (CVD) conditions, it is essential to choose a suitable rheological model for capturing the correct physics behind the hemodynamic in the multiply afflicted diseased arterial network. This study investigates the effect of blood rheology on hemodynamics in a blood vessel with abdominal aortic aneurysm (AAA) and right internal iliac stenosis (RIIAS). A model with AAA and RIIAS is reconstructed from a human subject's computed tomography (CT) data. Localized mesh generation and pulsatile inflow condition are considered. Non-Newtonian models such as the Power-law, Carreau, Cross, and Herschel Berkley models are used in simulations. The outcome from a validated computational model is compared with the Newtonian model to identify the suitable model for dealing with pathological complications under consideration. The capabilities and significance of various rheological models are also examined via Wall Pressure (WP), Wall Shear Stress (WSS), velocity, Global non-Newtonian importance factor (IG), Vorticity Streamlines, and Swirling Strength. It is noted that during the entire cardiac cycle, the IG factor of the cross model is found to be relatively more significant. Power Law depicts larger IG factor during peak systole and early diastole. Also, the cross model depicts larger WSS, WPS, swirling strength distribution and vorticity during the peak systolic and diastolic phases It is noted that IG â¼0.02 is an appropriate non-Newtonian blood activity cut-off value in the descending abdominal artery having AAA and RIIAS. The critical important WSS values are in the range of 0-9 Pa which is stated in WSS contour plot.
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Aneurisma de la Aorta Abdominal , Hemodinámica , Humanos , Arterias , Aneurisma de la Aorta Abdominal/diagnóstico por imagen , Aorta , Reología , Estrés Mecánico , Modelos Cardiovasculares , Velocidad del Flujo SanguíneoRESUMEN
A multilayer structure consisting of alternate layers of W and B4C has been deposited using a magnetron sputtering system. The structure of the as-deposited and vacuum-annealed W/B4C multilayer sample has been characterized using grazing incidence x-ray reflectivity, grazing incidence diffraction, and the normal incidence reflectivity has been measured using synchrotron radiation. A two-layer model consisting of tungsten and boron carbide is presented. The multilayer structure was found to be stable after 800°C annealing. Grazing incidence x-ray diffraction measurements suggested that W is polycrystalline with small grain size. No signature of tungsten carbide or tungsten boride formation could be observed during the annealing treatments. A near normal incidence soft x-ray reflectivity (SXRR) of ~8.3% was obtained at 6.8 nm wavelength. A little drop (~1%) in SXRR after 800°C annealing suggested that there were no compositional changes within the layers during the annealing treatments.
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The study of patient-specific human arterial flow dynamics is well known to face challenges like a) apt geometric modelling, b) bifurcation zone meshing, and c) capturing the hemodynamic prone to variations with multiple disease complications. Due to aneurysms and stenosis in the same arterial network, the blood flow dynamics get affected, which needs to be explored. This study develops a new protocol for accurate geometric modelling, bifurcation zone meshing and numerically investigates the arterial network with abdominal aortic aneurysms (AAA) and right internal iliac stenosis (RIIAS). A realistic arterial model is reconstructed from the computed tomography (CT) data of a human subject. To understand the combined effect of the aneurysm and aortoiliac occlusive diseases in a patient, an arterial network with AAA, RIIAS, multiple branches tapering, and curvature has been considered. Clinically significant pulsatile blood flow simulations have been carried out to trace the alteration in the flow dynamics with multiple pathological complications under consideration. The transient blood flow dynamics are investigated via wall shear stress, wall pressure, velocity contour, streamlines, vorticity, and swirling strength. During the systolic deceleration phase, the rhythmic nested rapid secondary oscillatory WSS, adverse pressure gradients, high WSS, and high WP bands are noticed. Also, the above studies will help researchers, clinicians, and doctors understand the influence of morphological changes on hemodynamics in cardiovascular studies.
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Aneurisma de la Aorta Abdominal , Hemodinámica , Humanos , Constricción Patológica/diagnóstico por imagen , Hemodinámica/fisiología , Arterias , Aneurisma de la Aorta Abdominal/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Modelos Cardiovasculares , Estrés Mecánico , Velocidad del Flujo Sanguíneo , Flujo PulsátilRESUMEN
BACKGROUND: Patient-Reported Outcome Measures (PROM's) are increasingly used to assess surgical outcomes in low-risk surgeries such as minimally invasive primary ventral and incisional hernia repair. The purpose of this meta-analysis was to systematically summarize the available evidence for the effect of laparoscopic versus robotic primary ventral and incisional hernia repair on PROM's. METHODS: A systematic review and meta-analysis were performed in accordance with PRISMA guidelines. Randomised control trials, retrospective and prospective studies were included. Medline, Embase, SCOPUS, Web of Science, and Cochrane CENTRAL, and two trial registers were searched. Pooled effect sizes and 95% confidence intervals were calculated using the Mantel-Haenszel method. The overall quality of evidence was assessed using GRADE. RESULTS: Of the 2728 titles screened, eight studies involving 41,205 participants were included. Return to activities of daily living, return to work day and recurrence rate were statistically better in the robotic group. Length of stay, readmission, postoperative pain, quality of life, body image, and patient satisfaction were similar in both groups. The GRADE rating of the quality of evidence was moderate for postoperative pain and low to very low for the quality of life, length of stay, recurrence and readmission. CONCLUSION: The available data of PROM's of laparoscopic and robotic primary ventral and incisional hernia repair is scarce and highly heterogeneous, thus making it difficult to assess the superiority of the laparoscopic technique over the robotic technique. Further studies with uniform reporting of PROM's in laparoscopic and robotic primary ventral and incisional hernia repair are needed.
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Hernia Ventral , Hernia Incisional , Laparoscopía , Procedimientos Quirúrgicos Robotizados , Humanos , Hernia Incisional/cirugía , Actividades Cotidianas , Calidad de Vida , Estudios Retrospectivos , Estudios Prospectivos , Herniorrafia/métodos , Hernia Ventral/cirugía , Dolor Postoperatorio/cirugía , Laparoscopía/métodos , Mallas Quirúrgicas , Medición de Resultados Informados por el PacienteRESUMEN
Considering the excellent tunability of electrical and dielectric properties in binary metal oxide based multi-layered nanolaminate structures, a thermal atomic layer deposition system is carefully optimized for the synthesis of device grade Al2O3/TiO2 nanolaminates with well-defined artificial periodicity and distinct interfaces, and the role of process temperature in the structural, interfacial, dielectric and electrical properties is systematically investigated. A marginal increase in interfacial interdiffusion in these nanolaminates, at elevated temperatures, is validated using X-ray reflectivity and secondary ion mass spectrometry studies. With an increase in deposition temperature from 150 to 300 °C, the impedance spectroscopy measurements of these nanolaminates exhibited a monotonic increment in dielectric constant from â¼95 to 186, and a decrement in dielectric loss from â¼0.48 to 0.21, while the current-voltage measurements revealed a subsequent reduction in leakage current density from â¼2.24 × 10-5 to 3.45 × 10-7 A cm-2 at 1 V applied bias and an improvement in nanobattery polarization voltage from 100 mV to 700 mV, respectively. This improvement in dielectric and electrical properties at elevated processing temperature is attributed to the reduction in impurity content along with the significant enhancement in sublayer densities and the conductivity contrast driven Maxwell-Wagner interfacial polarisation. Additionally, the devices fabricated at 300 °C exhibited a higher capacitance density of â¼22.87 fF µm-2, a low equivalent oxide thickness of â¼1.51 nm, and a low leakage current density of â¼10-7 A cm-2 (at 1 V bias), making this nanolaminate a promising material for high-density energy storage applications. These findings highlight the ALD process temperature assisted growth chemistry of Al2O3/TiO2 nanolaminates for superior dielectric performance and multifaceted applications.
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In the present study we report a new multilayer combination comprised of refracting layers of niobium carbide and spacer layers of silicon as a more stable and high reflecting combination for the 10 - 20 nm wavelength region. The reflectivity of the new combination is comparable to Mo/Si conventional mirrors. Annealing experiments carried out with NbC/Si multilayer at 600°C temperature showed a ~2.5% drop in the soft x-ray reflectivity along with a marginal contraction in the multilayer period length. The multilayer structure is found stable after the heat treatment. Crystallization of the niobium carbide and silicon layers is responsible for the compaction in the period length as revealed by the grazing incidence x-ray diffraction measurements. No signature of silicide formation or any other chemical species could be detected. The multilayer structures were grown by ion beam sputtering technique using a compound target of niobium carbide. Soft x-ray reflectivity measurements performed at the Indus-1 and BESSY-II synchrotron radiation sources are found in good agreement with the simulations.
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INTRODUCTION: Despite a widespread public health system, the private healthcare sector is the major provider of health care in rural India. This study describes the profile and medical practices of private rural health providers (PRHPs) in rural Haryana, India. METHODS: A cross-sectional study was conducted among PRHPs practicing in the villages of Comprehensive Rural Health Services Project (CRHSP) at Ballabgarh block located in the Faridabad district of Haryana State. The CRHSP is an Intensive Field Practice Area (IFPA) of the Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi. RESULTS: Eighty PRHPs participated in this study (response rate 93%). The majority (96%) did not possess a qualification in any formal system of medicine. Half of the PRHPs had a separate space (private area) for the examination of patients. Almost all had stethoscopes, thermometers and blood pressure apparatus. The PRHPs were involved in a wide range of practices, such as dispensing medicines (98.7%), providing injections (98.7%) and intravenous fluids (98.7%), and conducting minor surgery (78.5%). Dumping biomedical waste was a common practice among these practitioners. Some PRHPs (8.7%) were involved in national health programs. CONCLUSIONS: Unqualified PRHPs provide substantial outpatient healthcare services in rural Ballabgarh, India. Their biomedical waste disposal practices are inadequate. There is a need for training in waste disposal practices and monitoring of safe injection techniques among PRHPs. Consideration should be given to utilising PRHPs in important public health programs such as disease surveillance.
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Atención Integral de Salud/métodos , Conocimientos, Actitudes y Práctica en Salud , Práctica Privada , Ubicación de la Práctica Profesional , Servicios de Salud Rural , Adulto , Competencia Clínica , Atención Integral de Salud/estadística & datos numéricos , Estudios Transversales , Femenino , Personal de Salud/estadística & datos numéricos , Humanos , India , Entrevistas como Asunto , Masculino , Persona de Mediana Edad , Administración de la Práctica Médica/estadística & datos numéricos , Recursos Humanos , Carga de Trabajo/psicología , Carga de Trabajo/estadística & datos numéricosRESUMEN
Introduction: Extremities arteriovenous malformations are uncommon vascular lesions that usually go unnoticed until a fracture occurs or imaged for other medical problems. The lesion is invariably quiescent, infiltrative in nature, and leads to the destruction of soft tissue and bone. Worldwide 20-30 % incidence of arteriovenous malformations has been noted in bones. This arteriovenous malformation greatly affects bone growth as compared to the normal side and leads to pathological fracture. However, few reports on the management of such pathologic fractures associated with AVM have been published in the literature.The main problem is to decide the types of implants and whether open or closed reduction. Here, we present a case series of pathologic femoral shaft fracture associated with multiple hemangiomas in the thigh that was treated successfully by minimally invasive distal femoral locking plate fixation and teriparatide. Case Presentation: We are describing our one index case. A 39-year-old woman, otherwise healthy, sustained a fall and developed a left femoral shaft fracture. At the time of admission, she had swelling and venous varicosities and non-itchy, blanchable violet patches over the left thigh. Plain radiography of the left thigh revealed Hypoplastic femoral shaft with a markedly obliterated medullary canal with distal 1/3 rd fracture with calcification of soft tissue. We planned open reduction and distal locking femoral plating because medullary canal was very small to accommodate intramedullary nail following embolization of the feeding artery. While performing open reduction, a considerable amount of bleeding (1300 ml) after incision of subcutaneous tissue occurred. After successful fracture fixation, union was achieved with administration of teriparatide 12 months postoperatively. At present patient is able to walk using elbow support. Conclusion: We present the five cases of pathologic fracture associated with large AVMs that achieved fracture union using minimally invasive distal femoral locking plate fixation and teriparatide.
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The current pandemic caused by a novel coronavirus (SARS-CoV-2) has underlined the importance of emerging diseases of zoonotic importance. Along with human beings, several species of wild and pet animals have been demonstrated to be infected by SARS-CoV-2, both naturally and experimentally. In addition, with constant emergence of new variants, the species susceptibility might further change which warrants intensified screening efforts. India is a vast and second most populated country, with a habitat of a very diverse range of animal species. In this study we place on record of SARS-CoV-2 infections in three captive Asiatic lions. Detailed genomic characterization revealed involvement of Delta mutant (Pango lineage B.1.617.2) of SARS-CoV-2 at two different locations. Interestingly, no other feline species enclosed in the zoo/park were found infected. The epidemiological and molecular analysis will contribute to the understanding of the emerging mutants of SARS-CoV-2 in wild and domestic animals.
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COVID-19 , Enfermedades de los Gatos , Leones , Animales , COVID-19/epidemiología , COVID-19/veterinaria , Gatos , Humanos , Pandemias/veterinaria , SARS-CoV-2/genéticaRESUMEN
Coronavirus Disease (COVID-19) spread worldwide has created a global pandemic. To reduce the transmission of the virus, the Indian government had imposed a countrywide lockdown on 24 Mar 2020 by suspending all public transport and industries temporarily resulting in loss of jobs in multiple sectors and looming threats to the nation economy. Lockdown on the opposite hand has removed pollutants from the air and thus improved air quality in many cities across the globe. The near-total shutdown of all economic activities except related to essential commodities like medicine and food was only allowed which resulted in the lowering of carbon emission and improvement in global warming and air pollution. This review article indented to bring important features of how the COVID-19 pandemic affects human civilization and the global environment. However, its epidemiology, symptom, possible prevention, and management will briefly describe. Authors have collected data from, PubMed, Embase, Scopus, WHO, and CDC (USA). Severe Acute Respiratory Syndrome is a result of COVID- 19 infection. This virus is transmitted through close contact by respiratory droplets from one person to another. The majority of symptoms of COVID-19 are very much similar to any viral upper respiratory tract infection ( Common Coryza). Any person with the slightest suspicion or has respiratory symptoms related to COVID-19 infection should wear a facemask, keep safe social distancing, observe cough/sneeze etiquettes. The COVID-19 pandemic has taught us a lesson to introspect the way humans are destroying the environment for their benefit. Whatever be the origin or cause, the occurrence of COVID-19 has made a foreground for us to improve the symbiotic relationship between humans, wildlife, and nature.