Anterior Cruciate Ligament Reconstruction with Semitendinosus Tendon Autograft among Paramilitary Patients Undergoing Arthroscopic Surgery in a Tertiary Care Centre.

Introduction: In orthopaedic practice, injuries to the anterior cruciate ligaments occur almost on an epidemic scale, yet it continues to be of interest in orthopaedic surgery whether semitendinosus or gracilis hamstring autografts can be used for better anterior cruciate ligament reconstruction. This study aimed to determine the prevalence of anterior cruciate ligament reconstruction using semitendinosus tendon autografts among paramilitary patients undergoing arthroscopic surgery in a tertiary care centre. Methods: This descriptive cross-sectional study was conducted among paramilitary individuals who had knee injuries and were admitted between 6 february 2020 and 26 January 2022 for arthroscopic surgery after obtaining ethical approval from the Institutional Review Committee. Demographic details and the mode of injury were obtained from the patients. The treating orthopaedic surgeons evaluated the pre- and post-analysis Lysholm Knee Score and Lysholm Knee Scale based on the patient's response. A convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval. Results: Among 166 patients, anterior cruciate ligament reconstruction using a semitendinosus tendon autograft was done in 58 (34.94%) (27.69-42.19, 95% Confidence Interval). Most of the patients in the pre-analysis had mild/periodic limp issues 52 (89.66%), followed by instability during athletics or other severe exertion 43 (74.14%). Conclusions: The prevalence of anterior cruciate ligament injuries in our study is higher than other studies done in similar settings. Keywords: anterior cruciate ligament; grafts; semitendinosus tendon.

Displaced Midshaft Clavicular Fractures among Patients with Clavicular Fracture Admitted to the Orthopaedic Department of a Tertiary Care Centre: A Descriptive Cross-sectional Study.

Introduction: Midshaft clavicular fractures are common among young adults. Open reduction and internal fixation of displaced midshaft clavicular fractures with plate and screws have been shown to decrease nonunion, symptomatic malunion, and residual shoulder disability compared with non-operative treatment allowing early pain-free movement and early return to work. The aim of this study was to find out the prevalence of displaced midshaft clavicular fractures among patients with clavicular fractures admitted to the orthopaedics department of a tertiary care centre. Methods: A descriptive cross-sectional study was conducted in the Department of Orthopedics of a tertiary care centre from 31 January 2016 to 31 December 2019 after receiving ethical approval from the Institutional Review Committee (Reference number: 659/2021 P). Data were collected using hospital-based records from patients of the age group 18 to 50 years. Convenience sampling method was used. Point estimate and 95% confidence interval were calculated. Results: Among 120 patients, the prevalence of displaced midshaft clavicular fractures was 40 (33.33%) (24.90-41.76, 95% Confidence Interval). Among them 39 (90%) were males and 4 (10%) were females and the mean age of 31.45 years. The average Constant-Murley score were 95.68±5.59. Conclusions: The prevalence of displaced midshaft clavicular fractures among patients with clavicular fractures admitted to the Department of Orthopedics was lower than the other studies done in similar settings. Keywords: clavicle; fracture; open fracture reduction; orthopedics.

Factors affecting nutritional knowledge, attitude, practices and dietary intake among national players in Kathmandu, Nepal: a cross-sectional study.

INTRODUCTION: Good nutrition knowledge and nutrient intake have been regarded as significant determinants in enhancing athletes' performance and overall health status. This study aimed to assess knowledge, attitude, and practices of nutrition and dietary intake among athletes. METHODS: A cross-sectional study was conducted from January to April 2022 among national athletes from two sports clubs in Kathmandu Metropolitan City, Nepal. A semi-structured questionnaire was used to collect the data. Anthropometric measurements and dietary intake were recorded. Bivariate and multivariate binary logistic regression was used to estimate the crude odds ratios (cOR), and adjusted odds ratios (aOR) with 95% confidence intervals (CIs). RESULTS: A total of 270 players were included in this study (mean age, 25 years; 49.6% male, 50.4% female). Almost half of the athletes had good nutrition knowledge [54.1% (146/270)], attitude [56.7% (153/270)], and practices [50% (135/270)] scores. The mean energy, carbohydrate, protein, and fat intake were 35.0 kcal/kg/day, 5.6, 0.9, and 0.9 g/kg/day, respectively. Likewise, mean calcium and iron intake were 370, and 12.5 mg, respectively. In the multivariate model, families with monthly household income less than 50,000 Nepalese rupees ($400) (adjusted Odds Ratio/aOR = 2.58; 95% CI: 1.12 to 5.96), and those who did not receive diet plan (aOR = 3.14; 95% CI: 1.25 to 7.84) were more likely to have poor nutrition knowledge. Players who did not check food labelling (aOR = 1.44; 95% CI: 0.78 to 2.63) were more likely to have negative attitude towards nutrition. Players who did not ever attend nutrition class (aOR = 3.54; 95% CI: 1.46 to 8.54) and those who did not consume different food during off and on the season of sports (aOR = 2.36; 95% CI: 1.39 to 4.01) were more likely to have poor nutrition practice. CONCLUSIONS: Half of the athletes' nutritional knowledge, attitudes, and practices score were satisfactory. Nutrient intake among athletes was suboptimal. Nutrition intervention programs are critical to improve nutritional knowledge, attitude and practice related to dietary intake among national athletes in Nepal.

Stress Fractures among Paramilitary Trainee Visiting a Paramilitary Hospital of Nepal: A Descriptive Cross-sectional Study.

INTRODUCTION: Young paramilitary recruits, who undergo strenuous exercise during basic training, are often presented with stress fractures, which could be due to an inadequate vitamin D (25-hydroxyvitamin D) intake. This study aimed to find the prevalence of stress fracture among young paramilitary trainees visiting the orthopedic outpatient department of a paramilitary hospital. METHODS: This was a descriptive cross-sectional study done among paramilitary trainees in a paramilitary Hospital of Nepal between April 2019 to April 2021. The study was approved by the Ethical Review Board (Reference number: 1003) of the Nepal Health Research Council. Convenience sampling was used. Anthropometric variables, serum 25-hydroxyvitamin D level, and bone mineral density of spine and hip were determined. Data analysis was performed using the Statistical Package for the Social Sciences software version 17.0. Point estimate at 95% Confidence Interval was calculated along with frequency, proportion for binary data and mean, standard deviation for continuous data. RESULTS: Among 417 young paramilitary trainees, 24 (5.76%) (3.52-7.99 at 95% Confidence Interval) were found to have a stress fracture. The stress fracture patients had a serum 25-hydroxyvitamin D level of 21.47ng/mL±6.98. Similarly, the bone mineral density value of the spine and hip among the patients was -1.34g/cm2±1.37 and 0.36g/cm2±1.24, respectively. CONCLUSIONS: The prevalence of stress fracture among young paramilitary trainee was high compared to previous studies. Additionally, average Vitamin D and the bone mineral density value of the spine and the total hip among stressed fractured patients were also low.

Formulation and evaluation of mucoadhesive buccal tablets of aceclofenac.

This project was aimed to formulate and characterize mucoadhesive buccal tablets of aceclofenac, utilizing different proportions of three polymers carbopol 934, hydroxypropyl methylcellulose, and sodium carboxymethylcellulose. Twelve batches of buccoadhesive aceclofenac were prepared by the direct compression method. The compressed tablets were then evaluated for physicochemical parameters such as hardness, thickness, weight variation, drug content, friability, swelling index, surface pH, and ex vivo mucoadhesion. In vitro dissolution test was conducted for 12 h according to Indian Pharmacopeia 2018, using the rotating paddle method in phosphate buffer of pH 7.4. Physiochemical parameters like weight variation (231.25-268.75 mg), hardness (8.32-11.56 kg), friability (0.04-0.2%), diameter (9.00 mm), thickness (3.8-4.05 mm), and drug content ((97.67-102.25%) were within the acceptable limit as per Indian Pharmacopeia 2018. The swelling index was reported to be in the range of 112.93-450.19%, at 8 h. The surface pHs of all the batches were in between 6.72 to 6.96. The mucoadhesive strengths (40.5-50 g) varied with the change in polymer concentrations especially of carbopol 934. The dissolution profile of all the batches varied greatly, with a maximum release of 109.41% (in batch 12 at 6 h) to a minimum release of 44.82% (in batch 3 at 12 h). Among them, only batch 1 ensured sustained and effective drug release (88.34% at 12 h) with appropriate swelling index (112.93%) and mucoadhesive strength (40 g). Fourier Transform Infrared Spectroscopy analysis showed no evidence of drug excipients interaction. Hence, the results concluded that buccal mucoadhesive aceclofenac tablets can be formulated. Furthermore, the property of the tablet not only depends on the concentration but also the behavior of the polymers used.

Solid-phase synthesis and photoactivity of Ru-polypyridyl visible light chromophores bonded through carbon to semiconductor surfaces.

1,10-Phenanthroline (phen) was grafted to either indium tin oxide (ITO), fluorine-doped tin oxide (FTO), or titanium dioxide (TiO2) semiconductors (SC's) by electrochemical reduction of 5-diazo-phen. The phen ligand is bonded to the semiconductor at C5, and it can be handled in air. The semiconductor-phen (SC-phen) complexes displace both CH3CN ligands from either cis-[Ru(Mebipy)2(CH3CN)2]2+ (Mebipy = 4,4'-methyl-2,2'-bipyridine), cis-[Ru(tBubipy)2(CH3CN)2]2+ (tBubipy = 4,4'-tert-butyl-2,2'-bipyridine), or cis-[Ru(pheno)(bipy)(CH3CN)2]2+ (bipy = 2,2'-bipyridine; pheno = 1,10-phenanthroline-5,6-dione) dissolved in DCM/THF (4 h, 70 °C) to form the corresponding surface-bound SC-[(phen)Ru(bipyridyl)2]2+ chromophores. The identities of the SC-[(phen)Ru(Mebipy)2]2+, SC-[(phen)Ru(tBubipy)2]2+, and SC-[(phen)Ru(pheno)(bipy)]2+ (SC = ITO, FTO or TiO2) chromophores were confirmed by X-ray photoelectron spectroscopy (XPS); inductively coupled plasma mass spectrometry (ICP-MS); UV-vis and reflectance infrared spectroscopies; and cyclic voltammetry (CV). The data were compared to analogous Ru-polypyridyl control compounds dissolved in solution. A facile ketone-amine condensation solid-phase synthesis reaction between SC-[(phen)Ru(pheno)(bipy)]2+ and [Ru(1,10-phenthroline-5,6-diamine)(bipy)2]2+ in ethanol (80 °C, 1 h) formed the dinuclear, bound chromophore SC-[(phen)(bipy)Ru(tpphz)Ru(bipy)2]4+ (tpphz = tetrapyrido[3,2-a:2',3'-c:3'',2''-h:2''',3'''-j]phenazine). Photoelectrochemical oxidation of hydroquinone and triethylamine under acidic, neutral, or basic conditions showed that the SC-chromophore photoanodes are active, and that TiO2-[(phen)Ru(Mebipy)2]2+ is the most active and stable under basic- and neutral conditions. The dinuclear chromophore SC-[(phen)(bipy)Ru(tpphz)Ru(bipy)2]4+ was most active and stable under potentiostatic conditions in acid.