Management of Length Unstable Femur Fractures in Children by Flexible Intramedullary Nails: A Systematic Review.

PURPOSE OF THE STUDY: Surgical options for paediatric femoral fractures include fl exible intramedullary nailing (FIN), plating, and external fi xators. Length unstable fractures are usually spiral, long oblique, or comminuted and are often associated with > 2 cm of shortening. The purpose of this study was to see whether FIN is effective for managing unstable femur fractures in children. MATERIAL AND METHODS: An electronic literature search was performed up to 25 February 2022 in Cochrane Library, PubMed, and Embase databases using a combination of MeSH search terms and keywords related to the population (e.g., "child" AND "diaphyses" AND "femur"), and intervention (e.g., "nail" OR "ESIN"). The data extracted included the study details, Demographic data, surgical details, postoperative immobilization, complications, and outcome. RESULTS: Eight studies with a total sample size of 369 patients were reviewed. The mean operative time, blood loss, and length of stay in the hospital were 67.62±12.32 minutes, 33.82±16.82 ml, and 4.9±1.27 days, respectively. The results were excellent in 61.92% of the patients, satisfactory in 32.61%, and poor in 5.43%. 4.54% of patients had major complications requiring reoperation and 32.46% of patients had minor complications. the most common complication was nail prominence seen in 26.30% of patients. Locked Ender's nail was associated with the least reoperation, malunion, and LLD rate compared to other types of FIN. CONCLUSIONS: FIN along with a single walking spica cast is a good choice in all forms of paediatric femoral fracture patterns allowing proper alignment and rotation. Locked Ender's nail is safe and effective for managing unstable paediatric femur fracture. KEY WORDS: pediatric femur fracture, length unstable, fl exible intramedullary nailing, submuscular plating, Flynn criterion.

A Meta-Analysis on Comparison of Open vs Closed Reduction of Gartland Type 3 Supracondylar Humerus Fractures in Children.

PURPOSE OF THE STUDY Although there are numerous studies on outcomes and comparison of open and closed reduction but there is no clarity on relationship between outcomes and complications with type of surgical intervention done for Type 3 Gartland supracondylar humerus fracture. The aim of this study is to compare the outcomes and complications of closed vs open reduction in Type 3 Gartland supracondylar humerus fractures. MATERIAL AND METHODS Electronic literature searches of Embase, MEDLINE and the Cochrane Library was conducted in February 2022 using the terms "supracondylar", "humerus", "fracture", "Gartland type 3" and synonymous. The data extracted included the study details, demographic data, procedure performed, final functional and cosmetic outcome according to Flynn criteria and complications of included studies. RESULTS Pooled data analysis revealed no significant difference in mean satisfactory outcome rate according to Flynn cosmetic criteria in open group (97%, 95% CI 95.5%-98.5%), as compared to closed group (97.5%, 95% CI 96.3%-98.7%), although a statistically significant difference in mean satisfactory rate according to Flynn functional criteria in open group (93.4%, 95% CI 90.8%- 96.1%) as compared to closed group (98.5%, 95% CI 97.5%-99.4%) was noted. On separate comparison of the two-arm studies, closed reduction favoured better functional outcomes (RR 0.92, 95% CI 0.86-0.99). CONCLUSIONS Closed reduction and percutaneous fixation have better functional outcome than open reduction with K-wire fixation. But there was no significant difference in cosmetic outcomes, overall complication rate and nerve injury with either open or closed reduction. The threshold of converting a closed reduction to an open reduction in supracondylar humerus fractures of children should be high. Key words: supracondylar humerus, open reduction, percutaneous pinning, Flynn criteria.

Distribution and concentration pathway of particulate pollution during pandemic-induced lockdown in metropolitan cities in India.

To characterize the pollutant dispersal across major metropolitan cities in India, daily particulate matter (PM10 and PM2.5) data for the study areas were collected from the National Air Quality Monitoring stations database provided by the Central Pollution Control Board (CPCB) of India. The data were analysed for three temporal ranges, i.e. before the pandemic-induced lockdown, during the lockdown, and after the upliftment of lockdown restrictions. For the purpose, the time scale ranged from 1st April to 31st May for the years 2019 (pre), 2020, and 2021 (post). Statistical distributions (lognormal, Weibull, and Gamma), aerosol optical thickness, and back trajectories were assessed for all three time periods. Most cities followed the lognormal distribution for PM2.5 during the lockdown period except Mumbai and Hyderabad. For PM10, all the regions followed the lognormal distribution. Delhi and Kolkata observed a maximum decline in particulate pollution of 41% and 52% for PM2.5 and 49% and 53% for PM10, respectively. Air mass back trajectory suggests local transmission of air mass during the lockdown period, and an undeniable decline in aerosol optical thickness was observed from the MODIS sensor. It can be concluded that statistical distribution analysis coupled with pollution models can be a counterpart in studying the dispersal and developing pollution abatement policies for specific sites. Moreover, incorporating remote sensing in pollution study can enhance the knowledge about the origin and movement of air parcels and can be helpful in taking decisions beforehand.

A comprehensive physico-chemical quality and heavy metal health risk assessment study for phreatic water sources in Narora Atomic Power Station region, Narora, India.

An investigation of water quality and heavy metal distribution in the groundwater samples collected from the vicinity of Narora Atomic Power Station (NAPS), Narora, India, was conducted for the metals including Cu, Zn, Ni, Co, Cd, Pb, and Fe. A total of 16 water quality parameters were measured for all the groundwater samples, and TDS, TH, Mg2+, Ca2+, F-, and turbidity were found to be on the higher side in comparison to the prescribed limits of Indian standards. Geometrical mean concentrations for these heavy metals were found to be 0.049, 0.213, 0.23, 0.135, 0.017, 0.061, and BDL for Cu, Fe, Zn, Pb, Cd, Co, and Ni, respectively. Pb and Cd were more than the permissible limits (0.01 mg/L for Pb and 0.003 for Cd) prescribed for safe drinking water while Cu and Fe were exceeding the permissible limits of 0.05 mg/L and 0.3 mg/L in 32% and 36% samples, respectively. Health risk assessment was done by calculating total hazard quotient (THQ), and the values for all the metals were below the threshold value of 1.0 beyond which they may pose a significant risk.

COVID-19 lockdown: a rare opportunity to establish baseline pollution level of air pollutants in a megacity, India.

This paper analyses air quality data from megacity Delhi, India, during different periods related to the COVID-19, including pre-lockdown, lockdown and unlocked (post-lockdown) (2018-2020) to determine what baseline levels of air pollutants might be and the level of impact that could be anticipated under the COVID-19 lockdown emission scenario. The results show that air quality improved significantly during the lockdown phases, with the most significant changes occurring in the transportation and industrially dominated areas. A pronounced decline in PM2.5 and PM10 up to 63% and 58%, respectively, was observed during the lockdown compared to the pre-lockdown period in 2020. When compared to 2018 and 2019, they were lower by up to 51% and 61%, respectively, dropping by 56% during unlock. Some pollutants (NOx and CO) dropped significantly during lockdown, while SO2 and O3 declined only slightly. Moreover, when compared between the different phases of lockdown, the maximum decline for most of the pollutants and air quality index occurred during the lockdown phase 1; thus, this period was used to report the COVID-19 baseline threshold values (CBT; threshold value is the upper limit of baseline variation). Of the various statistical methods used median + 2 median absolute deviation (mMAD) was most suitable, indicating CBT values of 143 and 75 ug/m3 for PM10 and PM2.5, respectively. This results although preliminary, but it gives a positive indication that temporary lockdown can be considered as a boon to mitigate the damage we have done to the environment. Also, this baseline levels can be helpful as a first line of information to set future target limits or to develop effiective management policies for achieving better air quality in urban centres like Delhi. Supplementary Information: The online version contains supplementary material available at 10.1007/s13762-021-03142-3.

Alkali-cation-incorporated and functionalized iron oxide nanoparticles for methyl blue removal/decomposition.

Enhancing the rate of decomposition or removal of organic dye by designing novel nanostructures is a subject of intensive research aimed at improving waste-water treatment in the textile and pharmaceutical industries. Despite radical progress in this challenging area using iron-based nanostructures, enhancing stability and dye adsorption performance is highly desirable. In the present manuscript alkali cations are incorporated into iron oxide nanoparticles (IONPs) to tailor their structural and magnetic properties and to magnify methyl blue (MB) removal/decomposition capability. The process automatically functionalizes the IONPs without any additional steps. The plausible mechanisms proposed for IONPs incubated in alkali chloride and hydroxide solutions are based on structural investigation and correlated with the removal/adsorption capabilities. The MB adsorption kinetics of the incubated IONPs is elucidated by the pseudo second-order reaction model. Not only are the functional groups of -OH and -Cl attached to the surface of the NPs, the present investigation also reveals that the presence of alkali cations significantly influences the MB adsorption kinetics and correlates with the cation content and atomic polarizability.

Application of EDTA modified Fe3O4/sawdust carbon nanocomposites to ameliorate methylene blue and brilliant green dye laden water.

This work explored the potential of magnetic sawdust carbon nanocomposites for cationic dyes removal from aqueous medium. EDTA modified magnetic sawdust carbon nanocomposites (EDTA@Fe3O4/SC ncs) were prepared by biogenic green reduction and precipitation approach. The surface properties, structure and composition of nanocomposites were characterized by HRTEM, FESEM, XRD, EDX, BET, FTIR etc. The Fe3O4 nanoparticles were 10-20 nm in diameters and having 14 m2/g surface area. Removal of Methylene blue (MB) and Brilliant green (BG) dyes from aqueous medium was studied in batch mode experiments. The maximum removal was achieved at neutral pH 7.0 with in 30 min. Adsorption capacity of EDTA@Fe3O4/SC for MB and BG dyes was 227.3 mg/g and 285.7 mg/g, respectively. Dye adsorption behaviour is well explained by Freundlich model. The rate of cationic dye adsorption is explained by pseudo-second order model. The value of thermodynamic parameters confirmed that adsorption process was spontaneous and favourable. Desorption and reusable efficiency of nanocomposites was also evaluated.

Measuring genetic knowledge: a brief survey instrument for adolescents and adults.

Basic knowledge of genetics is essential for understanding genetic testing and counseling. The lack of a written, English language, validated, published measure has limited our ability to evaluate genetic knowledge of patients and families. Here, we begin the psychometric analysis of a true/false genetic knowledge measure. The 18-item measure was completed by parents of children with congenital heart defects (CHD) (n = 465) and adolescents and young adults with CHD (age: 15-25, n = 196) with a mean total correct score of 12.6 [standard deviation (SD) = 3.5, range: 0-18]. Utilizing exploratory factor analysis, we determined that one to three correlated factors, or abilities, were captured by our measure. Through confirmatory factor analysis, we determined that the two factor model was the best fit. Although it was necessary to remove two items, the remaining items exhibited adequate psychometric properties in a multidimensional item response theory analysis. Scores for each factor were computed, and a sum-score conversion table was derived. We conclude that this genetic knowledge measure discriminates best at low knowledge levels and is therefore well suited to determine a minimum adequate amount of genetic knowledge. However, further reliability testing and validation in diverse research and clinical settings is needed.

Heavy metal content in various types of candies and their daily dietary intake by children.

Children are vulnerable to heavy metal contamination through consumption of candies and chocolates. Considering this representative samples (69) of candies and chocolates based on cocoa, milk and sugar were analyzed for selected heavy metals by means of flame atomic absorption spectrometry. The average concentration of Zn, Pb, Ni, and Cd was found to be 2.52 ± 2.49, 2.0 ± 1.20, 0.84 ± 1.35, and 0.17 ± 0.22 µg/g respectively. Results indicate that cocoa-based candies have higher metal content than milk- or sugar-based candies. The daily dietary intake of metals for children eating candies and chocolates was also calculated, and results indicated highest intake of Pb and Zn followed by Ni, Cd, and Cu. Comparison of the current study results with other studies around the globe shows that the heavy metal content in candies and chocolates is lower in India than reported elsewhere. However, to reduce the further dietary exposure of heavy metals through candies and chocolates, their content should be monitored regularly and particularly for Pb as children are highly susceptible to its toxicity.

Unusual Presentation of Necrotic Erythema Nodosum Leprosum on Scalp: A Case Report.

Lepra reactions are acute episodes occurring during the disease process of leprosy and are of 2 types: type 1 or reversal reaction and type 2 reaction or erythema odosumleprosum (ENL). In the episodes of lepra reaction several parts are affected including face and extremities like oral cavity. In the present case report we reported a rare case of lepromatous leprosy with necrotic ENL involving scalp apart from the usual sites. A 58 year old married male presented to us with complaints of spontaneous onset, recurrent eruption of multiple reddish raised painful lesions. Biopsy from the infiltrated skin over the back showed atrophic epidermis, free Grenz zone, diffuse and periadnexal macrophage granulomas with predominant mononuclear infiltrate, appandageal atrophy, fibrosis around the neural structures and leukocytoclastic vasculitis. Fites stain showed strong positivity for M. leprae. His routine blood investigations showed anemia (Hb = 7.8 gm%), neutrophil leukocytosis (TLC = 17,600, DLC = P66L28M4E2) and raised ESR (80 mm in the first hour). These bullous and necrotic lesions in leprosy may be a manifestation of severe type II reactions in patients with very high bacillary load.

Quantification of minerals and trace elements in raw caprine milk using flame atomic absorption spectrophotometry and flame photometry.

This study reports minerals and trace elements quantification in raw caprine milk of Beetal breed, reared in Northern India and their feed, fodder & water using flame atomic absorption spectrophotometry and flame photometry. The mineral and trace elements' concentration in the milk was in the order: K > Ca > Na > Fe > Zn > Cu. The results showed that minerals concentration in caprine milk was lesser than reference values. But trace elements concentration (Fe and Zn) was higher than reference values. Multivariate statistical techniques, viz., Pearsons' correlation, Cluster analysis (CA) and Principal component analysis (PCA) were applied to analyze the interdependences within studied variables in caprine milk. Significantly positive correlations were observed between Fe - Zn, Zn - K, Ca - Na and Ca - pH. The results of correlation matrix were further supported by Cluster analysis and Principal component analysis as primary cluster pairs were found for Ca - pH, Ca - Na and Fe - Zn in the raw milk. No correlation was found between mineral & trace elements content of the milk and feed.

Role of serotonin in seasonal affective disorder.

This review was prepared with an aim to show role of serotonin in seasonal affective disorder. Seasonal affective disorder, which is also called as winter depression or winter blues, is mood disorder in which persons with normal mental health throughout most of the year will show depressive symptoms in the winter or, less commonly, in the summer. Serotonin is an important endogenous neurotransmitter which also acts as neuromodulator. The least invasive, natural, and researched treatment of seasonal affective disorder is natural or otherwise is light therapy. Negative air ionization, which acts by liberating charged particles on the sleep environment, has also become effective in treatment of seasonal affective disorder.  

Lepromatous leprosy with an uncommon presentation: a case report.

28 yr old male presented with asymptomatic nodules and few well to ill defined papules on ears, asymmetrical nerve enlargement and evanescent tender nodules on the extremities without any infiltration of the skin and madarosis. Slit skin smear done from normal skin was BI 6+. Skin biopsy showed features of lepromatous leprosy.

New magnetic fluid developed with natural organic compounds biocompatible.

This work was developed with an aqueous suspension of maghemite nanoparticles and colloidal emulsions with nanoparticles of magnetite. The nanoparticles were synthesized by co-precipitation method. The first was the magnetic emulsion nanoparticles of maghemite dispersed in the aqueous extract obtained from the leaf embauba (Cecropia Obtusifolia), whose tree is native to Central and South America. Thereby achieving the magnetic fluid extract embauba stabilized with ionic buffer solution pH 7.4. A second emulsion was prepared with colloidal magnetite nanoparticles with surfaces previously coated with oleic acid as a means of dispersing and using the oil extracted from in nature seed Andiroba (Carapa Guianensis), tree of the Brazilian Amazon. These new magnetic fluids the nanoparticles were characterized by Photoacoustic spectroscopy (PAS) to determine the coating layer of molecules on the surfaces of nanoparticles. In aqueous ionic magnetic fluid Cecropia Obtusifolia (MFCO) chlorogenic acid contributes to the electron density in the presence of four groups alcohols, a ketone group and a carboxylic group. In magnetic fluid-based oil andiroba MFAD PAS spectra show that oleic acid molecules are tightly linked on the surface of the nanoparticles.

Sequestration of heavy metal ions from multi-metal simulated wastewater systems using processed agricultural biomass.

Industrial effluents generally contain several metals, so during adsorptive treatment, they may influence the removal of each other. It is essential to explore the effect of co-cations on metal removal in multi-metal solutions. The present study examined the possibility of processed rice husk and saw dust to remove Cr6+, Ni2+, Cu2+, Cd2+ and Zn2+, from the single, binary and multi-component aqueous solutions. A substantial lesser removal of metal ions was observed in the presence of co-ions. This study revealed antagonistic effect on the removal of a particular metal ion, from the industrial effluent, even at optimum process parameters if other metal ions are present in the effluent. Although, a higher concentration of one metal ion than others in effluents increased its removal due to a greater number of ions as compared to other for the biosorption, yet presence of other ions influences the uptake of individual ions. In case of industrial effluents, maximum adsorption was obtained at pH 2.0 for Cr6+, 5.0 for Ni2+ and Cd2+ and 6.0 for Zn2+ and Cu2+. The study confirms the beneficial use of the studied biosorbents in water remediation.

A novel CaO nanocomposite cross linked graphene oxide for Cr(VI) removal and sensing from wastewater.

A novel green nanocomposite has been prepared by immobilizing CaO nanoparticles (CaO NPs) on the surface of graphene oxide. Biogenic CaO-NPs were synthesized from Lala clamshells. Morphological and structural characterizations of the nanocomposite were studied extensively. The adsorption capacity (qmax) of the nanocomposite for removing Cr(VI) was 38.04 mg g-1. In addition to this, the adsorption data were adequately simulated with Langmuir, Freundlich, Temkin, and pseudo-second-order models, suggesting that the adsorption process was the combination of external mass transfer and chemisorption. Electrostatic interaction was the dominant mechanism for Cr(VI) removal. In addition, the synthesized nanocomposites also serve as an excellent sensor for Cr(VI) sensing, with a limit of detection (LOD) of 0.02 µM utilizing electrochemical methods. Therefore, this green nanocomposite can simultaneously serve as an adsorbent and sensor for Cr(VI)removal from aqueous solutions.

Hypertension management in diabetic patients.

Hypertension and diabetes are becoming increasingly common. Clinical trials have demonstrated the importance of tight blood pressure control among patients with diabetes. However, little is known regarding the management of hypertension in patients with coexisting diabetes. Most patients with both disorders have a markedly worsened risk for premature micro vascular and macro vascular complications. The appropriate management of the hypertension seen in almost 70% of patients with type 2 diabetes mellitus remains controversial. However, over the past few years, many randomized, controlled trials have provided guidance for more effective therapy. These trials have established the need for a lower goal blood pressure (< 130/80 mm Hg) than has previously been recommended. To achieve therapy goals, multiple antihypertensive drugs are usually needed.

Optimization of cow dung spiked pre-consumer processing vegetable waste for vermicomposting using Eisenia fetida.

This paper reports the optimization of cow dung (CD) spiked pre-consumer processing vegetable waste (PPVW) for vermicomposting using Eisenia fetida in a laboratory scale study. Vermicomposting process decreased carbon and organic matter concentration and increased N, P and K content in the vermicompost. The C:N ratio was decreased by 45-69% in different vermireactors indicating stabilization of the waste. The heavy metal content was within permissible limits of their application in agricultural soils. It has been concluded from the results that addition of PPVW up to 40% with CD can produce a good quality vermicompost. Whereas, growth and fecundity of E. fetida was best when reared in 20% PPVW+80% CD feed mixture. However, higher percentages of PPVW in different vermireactors significantly affected the growth and fecundity of worms.

A novel method of plasmid isolation using laundry detergent.

Since the discovery of plasmid, various methods have been developed to isolate plasmid DNA. All the methods have one common and important target of isolating plasmid DNA of high quality and quantity in less time. These methods are not completely safe because of use of toxic chemicals compounds. The developed protocol for plasmid extraction is based on the alkaline lysis method of plasmid preparation (extraction atpH 8.0) with slight modifications. Cell lysis reagent sodium dodecyl sulfate is replaced by lipase enzyme present in laundry detergent. A good plasmid preparation can be made, which is well suited for subsequent molecular biology applications. By taking safety measures on count, contaminants like, RNA and protein can be completely avoided with maximized plasmid yield. The resultant plasmid quality and quantity can be well comparable to other prevalent methods.