Complex mathematical SIR model for spreading of COVID-19 virus with Mittag-Leffler kernel.

This paper investigates a new model on coronavirus-19 disease (COVID-19), that is complex fractional SIR epidemic model with a nonstandard nonlinear incidence rate and a recovery, where derivative operator with Mittag-Leffler kernel in the Caputo sense (ABC). The model has two equilibrium points when the basic reproduction number R 0 > 1 ; a disease-free equilibrium E 0 and a disease endemic equilibrium E 1 . The disease-free equilibrium stage is locally and globally asymptotically stable when the basic reproduction number R 0 < 1 , we show that the endemic equilibrium state is locally asymptotically stable if R 0 > 1 . We also prove the existence and uniqueness of the solution for the Atangana-Baleanu SIR model by using a fixed-point method. Since the Atangana-Baleanu fractional derivative gives better precise results to the derivative with exponential kernel because of having fractional order, hence, it is a generalized form of the derivative with exponential kernel. The numerical simulations are explored for various values of the fractional order. Finally, the effect of the ABC fractional-order derivative on suspected and infected individuals carefully is examined and compared with the real data.

Metronidazole resistance in Trichomonas vaginalis determined by molecular and conventional methods.

Trichomonas vaginalis (T. vaginalis) is a protozoan parasite that infects the urogenital tract of both women and men worldwide. Trichomoniasis can cause serious symptoms if untreated. Metronidazole is the drug of choice for the treatment of trichomoniasis. In recent years metronidazole-resistant T. vaginalis has often been mentioned in clinical isolates. The aim of this study was to determine the conventional and molecular methods to determine metronidazole-resistant T. vaginalis, which is seen commonly and to discuss the possible reasons for this. Samples taken from patients diagnosed with T. vaginalis from the gynaecology and obstetrics clinic between April 2015 and June 2016 were evaluated for metronidazoleresistance using molecular and conventional methods. A total of 170 patients were examined and T. vaginalis was determined in 6 (3.5%) patients. Metronidazole resistance was determined in 2 (33.3%) of the 6 clinical isolates as a result of the molecular and conventional tests applied. Metronidazole resistance was determined using nitroreductase genes ntr4Tv and ntr6Tv. These findings suggest that metronidazole-resistance T. vaginalis strains can be determined in laboratory samples of cases with trichomoniasis. This may be an important underlying factor in the unsuccessful management of recurrent cases seen in routine gynecological practice.

Thiamine status in patients undergoing lower extremity amputation due to diabetic foot lesion.

The aim of this study was to determine the thiamine status in patients undergoing major lower limb amputation due to diabetic foot lesion. Ten patients with diabetic foot lesion, ten diabetic patients without foot lesion, and ten non-diabetic patients were included in the study. Thiamine status was determined as thiamine pyrophosphate (TPP) effect. The mean TPP effect values of diabetes mellitus foot lesion (DM foot) , DM control, and non-diabetic control groups were 16.160 ± 3.276, 13.610 ± 1.767, and 6.912 ± 2.005 respectively. There was a statistically significant difference between the DM foot and non-diabetic control groups. Although the mean TPP value of the DM foot group was slightly higher than the DM control group, it was not significant. Since transketolase enzyme is thought to be one of the key points in development of diabetic complications, to lessen the diabetic complication by maximizing the transketolase function, we recommend regular supply of thiamine to the diabetic population.

Arthroscopic treatment of anterolateral soft tissue impingement of the ankle: evaluation of factors affecting outcome.

PURPOSE: To evaluate the results for patients treated arthroscopically for anterolateral soft tissue impingement syndrome, to determine the factors affecting the outcome, and to report on a synovial shelf. TYPE OF STUDY: Retrospective clinical review. METHODS: Forty-one patients underwent operative arthroscopy for anterolateral impingement of the ankle between 1990 and 2001; the mean follow-up was 83.7 months (range, 21 to 152 months). There were 25 men and 16 women with an average age of 33.2 years (range, 15 to 63 years). All patients reported a history of inversion injury to the ankle. The most frequent preoperative complaints were tenderness localized to the anterolateral aspect of the ankle, swelling, crepitation, and pain at weight-bearing. All patients had failed to respond to at least 3 months of conservative treatment. The results were assessed according to Meislin's criteria and the American Orthopaedics Foot and Ankle Society (AOFAS) scoring table. For statistical analysis, the Mann-Whitney U test was used where appropriate and the significance was set at P < .005. RESULTS: According to Meislin's criteria, there were excellent results in 21 patients, good in 16, fair in 2, and poor in 2. The mean AOFAS score was 89.6 points (range, 60-100) at follow-up. Four different soft tissue pathologies causing impingement were described. It has been statistically shown that cartilage damage located at the anterolateral region of the ankle and not advanced to the subchondral bone, and repeated inversion injuries had negative effects on clinical results at long-term follow-up. CONCLUSIONS: The arthroscopic diagnosis and treatment of anterolateral soft tissue impingement is a safe and effective method. Any combination of associated intra-articular pathologies, such as a chondral lesion or a new inversion injury of the ankle, after the arthroscopic procedure resulted in a poor outcome. LEVEL OF EVIDENCE: Level IV, Therapeutic Study.

Irreducible posterolateral knee dislocation resulting from a low-energy trauma.

A small amount of knee dislocations is included in the irreducible knee dislocations group. In such instance, medial femoral condyle is buttonholed through the gap formed by medial retinacular and capsular structures and this prevents reduction. In this study, we present two cases in which there were irreducible posterolateral knee dislocations resulting from a low-energy trauma. In both cases, dimple sign produced by the invagination of the medial retinacular structures and capsule and ecchymosis medially were noted. Soft tissue invaginated between the trochlea and intercondylar notch was extracted by open reduction.

Tibial tubercle position and patellar height as indicators of malalignment in women with anterior knee pain.

In this study, we evaluated 70 limbs in 42 women with anterior knee pain. We investigated tibial tubercle position and patellar height indices as indicators of malalignment. Tibial tubercle rotation angles were determined by computed tomography, and patellar height indicators, Insall-Salvati, modified Insall-Salvati, Caton, and Blackburne indices were calculated on lateral knee roentgenograms. The results were compared to values obtained from 80 limbs in 40 healthy female volunteers. Tibial tubercle rotation angle was 68.1 degrees (+/-3.6) in the study group and 70.3 degrees (+/-3.8) in the control group. The difference was statistically significant (P< 0. 01). Patellar height indicators were not statistically different between the two groups. These results suggested that patellar height is not a malalignment indicator in female patients with anterior knee pain. These patients should be investigated by computed tomography to determine tibial tubercle position.