Potential role of tocopherol in protecting crop plants against abiotic stresses.

The changing global climate have given rise to abiotic stresses that adversely affect the metabolic activities of plants, limit their growth, and agricultural output posing a serious threat to food production. The abiotic stresses commonly lead to production of reactive oxygen species (ROS) that results in cellular oxidation. Over the course of evolution, plants have devised efficient enzymatic and non-enzymatic anti-oxidative strategies to counteract harmful effects of ROS. Among the emerging non-enzymatic anti-oxidative technologies, the chloroplast lipophilic antioxidant vitamin A (Tocopherol) shows great promise. Working in coordination with the other cellular antioxidant machinery, it scavenges ROS, prevents lipid peroxidation, regulates stable cellular redox conditions, simulates signal cascades, improves membrane stability, confers photoprotection and enhances resistance against abiotic stresses. The amount of tocopherol production varies based on the severity of stress and its proposed mechanism of action involves arresting lipid peroxidation while quenching singlet oxygen species and lipid peroxyl radicals. Additionally, studies have demonstrated its coordination with other cellular antioxidants and phytohormones. Despite its significance, the precise mechanism of tocopherol action and signaling coordination are not yet fully understood. To bridge this knowledge gap, the present review aims to explore and understand the biosynthesis and antioxidant functions of Vitamin E, along with its signal transduction and stress regulation capacities and responses. Furthermore, the review delves into the light harvesting and photoprotection capabilities of tocopherol. By providing insights into these domains, this review offers new opportunities and avenues for using tocopherol in the management of abiotic stresses in agriculture.

Carpal Tunnel Decompression Under Wide Awake Local Anaesthesia No Tourniquet Technique (WALANT): A Cost Effective and Outcome Analysis.

Introduction Wide-awake local anaesthesia with no tourniquet (WALANT) technique is cost-effective, resource-friendly, and safe. This can be used as an alternative to hand surgery procedures in outpatient units. It can be performed in clinics or operating rooms. Methods We retrospectively evaluated the outcomes of WALANT for carpal tunnel decompression (CTD) over two years. Measured results include wound infections, relief of symptoms, paraesthesia, haematoma, Visual Analogue Scale (VAS), hospital anxiety and depression scale score (HADS) and cost-effectiveness. Results Eighteen patients underwent CTD under the WALANT technique over two years. VAS score was recorded at 3.1 ± 1.2 during the procedure and 1.67 ± 0.933 at two weeks follow-up. Persistent paraesthesia was found in only one patient at follow-up. Minimal bleeding was recorded during the procedure. No wound infections, revision surgery or post-operative haematoma formation were found. Hospital Anxiety and Depression Scale (HADS) was reported as 4.77 ± 2.1 after surgery. WALANT was also cost-effective, with an overall amount of £20. Conclusion Performing carpal tunnel decompression under WALANT in one stop upper limb clinic is a safe and cost-effective technique with no significant patient-related complications.

Synthesis, characterization, and applications of iron oxide nanoparticles.

Objective: The green synthesis method for nanoparticles is getting more attention globally, due to its lesser cost, non-hazardous, and eco-friendly nature. The novelty of the present work is to investigate the anti-bacterial and degradation activity of the green synthesized Iron Oxide NPs. Methods: In this study, the Iron Oxide NPs were synthesized through a green synthesis route from leaves of Ficus Palmata. UV-Vis confirmed Iron Oxide NP's peaks between (230-290 nm), while Fourier transforms infrared spectroscopy analysis showed that several groups were involved in reduction and stabilization. Results: Results indicated that the highest photo thermal activity was shown in light and it was almost 4 folds greater than the control. Similarly, Iron Oxide NPs showed excellent antimicrobial potential against bacterial species "Salmonella typhi" "Xanthomonas Oryzae" and "Lactobacillus" at low concentrations (150 µg/mL). Hemolytic assay results showed that the toxicity was lesser than 5% at both dark and light conditions. Moreover, we also evaluated the photo-catalytic potential of Iron Oxide NPs against methylene orange. Results indicated that almost complete degradation was noted after 90 min in the presence of continuous light. All tests were performed in triplicates. All the data was subjected to P-test (P < 0.5) using Excel and graph pad (V.5.0). Conclusion: Iron Oxide NPs holds a promising future and could be used in treating diseases, and microbial pathogenesis and also could be used as a vector in drug delivery. Moreover, they can also eradicate persistent dyes and could be used as an alternative to remediate pollutants from the environment.

CuO Nanoparticle-Mediated Seed Priming Improves Physio-Biochemical and Enzymatic Activities of Brassica juncea.

The use of nanoparticles (NPs) in agricultural fields has risen to a level where people are considering NPs as an alternative to commercial fertilizers. The input of copper oxide NPs (CuO NPs) as seed primers was investigated in this study, and the growth indices of Brassica juncea such as phenotypic parameters, photosynthetic attributes, and biochemical parameters were measured during maximum vegetative growth stage, i.e., at 45 days after sowing. Surface sterilized seeds were soaked in varying concentrations (0, 2, 4, 8 and 16 mg/L) of CuO NPs for 15, 30, and/or 45 min. After those priming periods, the seeds were planted in pots and allowed to grow naturally. Among the different tested concentrations of CuO NPs, 4 mg/L of CuO NPs for 30 min seed priming proved to be best, and considerably increased the, shoot length (30%), root length (27%), net photosynthetic rate (30%), internal CO2 concentration (28%), and proline content (41%). Besides, the performance of the antioxidant enzymes, viz, superoxide dismutase, catalase, peroxidase, and biochemical parameters such as nitrate reductase and carbonic anhydrase were also increased by several folds after the application of CuO NPs in B. juncea. The present study suggests that CuO NPs can be effectively used to increase the performance of B. juncea and may also be suitable for testing on other crop species.

Comparison Between Mini-Sternotomy and Full Sternotomy for Aortic Valve Replacement: A 10-Year Retrospective Study.

Introduction Aortic valve replacement (AVR) is a mainstay treatment for moderate to severe aortic valve stenosis. This retrospective study aimed to compare the clinical outcomes of mini-sternotomy and conventional sternotomy. Methodology This 10-year retrospective study compared the clinical outcomes of mini-sternotomy and full sternotomy. Patient-related outcomes include sternal wound dehiscence, operative time, length of hospital stay, and Intensive Care Unit (ICU) stay, whereas intraoperative parameters such as cardiopulmonary bypass (CPB) time and Aortic Cross Clamp time (ACCt) were compared between the two treatment groups. Results A total of 371 patients underwent AVR. Among them, 238 patients had AVR with full sternotomy and 133 patients had a mini-sternotomy. Full sternotomy patients had significantly lower bleeding than those in the mini-AVR group (p-0.002). The operation time was also found to be significantly higher in the mini-AVR group. The duration of hospital stays, ICU stay, and deep sternal wound dehiscence were recorded to be statistically insignificant between the two treatment groups. Atrial fibrillation, sternal wound dehiscence, stroke and perioperative myocardial infarctions, were equally observed between the two groups. Conclusion Mini-sternotomy is a safe option for AVR. The same number of complications were observed between the two groups; however, there was a reduction in the duration of hospital stay and ICU stay amongst the mini-sternotomy group.

Retrospective Review of Arthroplasty Radiographs: How to Define an Adequate Radiograph.

Introduction Adequacy of postoperative hip and knee radiographs has a direct impact on its interpretation. We undertook a quality improvement project by creating local standards to meet the arthroplasty team expectations for a satisfactory radiograph. The purposes of the study are 1. Assessment of the adequacy of radiographs according to defined criteria, and 2. Correlation of system and patient factors with inadequate radiographs. Methods Stage I: We conducted a single centre, retrospective audit to check the adequacy of a postoperative radiography following a total hip or knee replacement. A total of 100 radiographs were assessed against the nine criteria laid out with the consensus of orthopaedic surgeons and radiologists. Stage II: We created a quality improvement proforma for use in the radiology department. We re-assessed 100 radiographs during the second cycle against the nine criteria to check the adequacy of hip and knee arthroplasty radiographs, Results Stage I: Of 100 radiographs, 51 were from the knee and 49 from the hip arthroplasty group. Sixty-nine radiographs were adequate considering overall criteria, and 31 radiographs were inadequate. The inadequacy in radiographs was related to the visibility of prosthesis, cement or relevant anatomy. Stage II: We created a quality improvement performa for use in radiology department, highlighting the nine initial criteria. One hundred radiographs of hip and knee arthroplasty were re-assessed. Overall, 84 radiographs fulfilled the criteria of being adequate. Conclusion Adequacy of knee and hip arthroplasty radiographs is essential in picking up pathologies that can be missed otherwise. We present simple criteria to improve the adequacy of x-ray and prevent repetition of radiographs.

Comparison of Lateral and Crossed K-wires for Paediatric Supracondylar Fractures: A Retrospective Cohort Study.

Background Supracondylar elbow fractures occur most frequently in children aged five to seven years and have equal incidence in both genders. They are classified as flexion or extension type injuries with extension type being more common. We aimed to ascertain radiological stability with lateral and crossed wires in this study. We also identified any complications after operative management of these injuries. Methods As part of this retrospective cohort study, we identified all patients who presented with this injury from January 1, 2020, until February 28, 2022. Basic demographic data and type of operation were noted. Baumann angle (BA) and lateral capitellohumeral angle (LCHA) were measured intra-operatively and x-rays were done at the final clinic appointment. The mean of these angles in lateral and crossed wire groups was compared using paired sample t-test. Unpaired t-test was used to compare the means of both groups with normal values for these angles based on previous studies (BA=71.5±6.2 degrees, LCHA= 50.8±6 degrees). Results Fifty patients were admitted during this period. Thirty-three patients had lateral wires and 17 had crossed wires for fixation. No significant change was noted in the mean BA and mean LCHA in both groups on x-rays done intra-operatively and final clinic follow-up (no loss of reduction). No significant difference was noted between BA and LCHA noted for both groups at the final clinic follow-up with previous studies outlining normal values for these angles. No cases of iatrogenic neurovascular injury were identified. Four patients (8%) were referred to physiotherapy due to stiffness. Conclusion Both lateral and crossed wire configurations led to achievement of good radiological stability with BA and LCHA within normal limits. No loss of reduction was noted with both techniques and no risk of iatrogenic nerve injuries was noted in experienced hands.

Documentation of neurovascular assessment in fracture patients in a tertiary care hospital: A retrospective review.

Introduction: Neurovascular problems are common in acute fracture. In the emergency room, a thorough clinical evaluation is required, when examined by an orthopedic specialist or emergency doctors. Materials and methods: we registered our project with the audit department. In the first cycle, we looked at notes from 77 patients from November-December 2020, emphasis to neurovascular documentation from both ED and orthopedic Clerking notes. We submitted our findings at our audit meeting and implemented modifications. Two months later, we re-audited, this time with 82 patients as the sample size. Results: 77 patient notes were reviewed in the first cycle, 51% male and 49% female. In ED clerking notes, 22% patients had no neurovascular documentation, compared to 3.8% of patients in orthopedic clerking. 39% ED notes had acronyms written for the neurovascular status, such as NVI, to 20.7% of orthopedic notes. 82 notes were reviewed in the second cycle,44% male and 56% female.7% of ED clerking notes lacked any neurovascular comments, compared to 0% of orthopedic admission sheets. 10% of the ED sheets contained NVI abbreviation, while 4% of ortho notes had the same. There were specific notes on neurovascular state on 68 of the ED admission sheets evaluated, and 74 of the orthopedic notes did the same. Conclusion: In fracture patients, documentation of neurovascular condition was lacking. The documentation of the details of the neurovascular assessment was poor. Increased recording of neurovascular assessment and improved emergency department evaluation of patients presenting with upper and lower limb injuries were aided by the introduction of teachings.

Fe-POM/attapulgite composite materials: Efficient catalysts for plastic pyrolysis.

This article describes the catalytic cracking of low-density polyethylene over attapulgite clay and iron substituted tungstophosphate/attapulgite clay (Fe-POM/attapulgite) composite materials to evaluate their suitability and performance for recycling of plastic waste into liquid fuel. The prepared catalysts enhanced the yield of liquid fuel (hydrocarbons) produced in cracking process. A maximum yield of 82% liquid oil fraction with a negligible amount of coke was obtained for 50% Fe-POM/attapulgite composite. Whereas, only 68% liquid oil fractions with a large amount of solid black residue was produced in case of non-catalytic pyrolysis. Moreover, Fe-POM/attapulgite clay composites showed higher selectivity towards lower hydrocarbons (C5-C12) with aliphatic hydrocarbons as major fractions. These synthesised composite catalysts significantly lowered the pyrolysis temperature from 375°C to 310°C. Hence, recovery of valuable fuel oil from polyethylene using these synthesised catalysts suggested their applicability for energy production from plastic waste at industrial level as well as for effective environment pollution control.

Octylamine as environment friendlier colorimetric detection probe for hazardous 2,4,6-Trinitrophenol from wastewater samples.

The precise detection of hazardous 2,4,6-Trinitrophenol (TNP) is essential for the environment and human health. TNP is used as a precursor in whistling fireworks in ammunition, mining, agriculture and is a hazardous environmental pollutant generated from leather, chemical, and dye industries. Exploring rapid and low-cost approaches for the detection and quantification of TNP has attracted many scientists nowadays. The proposed chemosensor utilizes the concept of dispersive liquid-liquid micro-extraction coupled with a UV-visible spectrophotometer for its sensing at the ultra-trace level. Significant changes based on intramolecular interactions followed by a distinct color change to orange-red from yellow in the presence of TNP is an attractive feature for the present study. The successive addition of TNP shows ultra-trace sensitivity (3.9831 µA µM-1 cm-1) at detection limit (LOD) of 0.0015 ± 0.03 µM (S/N = 3), a linear range of 0 µM-70 µM, and a response time of <5 min. Different types of real samples such as creatinine testing kit reagent, fireflies crackers, serum, and water samples were used and recovery of TNP was calculated by spiking the known concentration of the standard analyte. The obtained recovery was 93.6-103.6% with RSD range of 1.6-4.53% (n = 3) in different samples. The analytical performance of the colorimetric Chemoprobe in terms of its recovery, linearity range, and limit of detection offers an excellent platform for monitoring hazardous TNP. The results show that the proposed colorimetric chemosensor is easy to use, low-cost, environmentally friendly and offers an easily observable visual color change. Based on these features, the chemosensor can be used for large-scale applications for the detection of TNP in water and other samples.

Clinical Features, Biochemical Profile, and Response to Standard Treatment in Lean, Normal-Weight, and Overweight/Obese Indian Type 2 Diabetes Patients.

BACKGROUND: Much evidence is available on the relationship between type 2 diabetes mellitus (T2D) and obesity, but less on T2D in lean individuals. AIM: This study was conducted in 12,069 T2D patients from northern India to find out which clinical and biochemical features are related to lean, normal weight, and overweight/obese T2D patients. METHODS: The study was conducted at two endocrine clinics in northern India as a retrospective cross-sectional study. The records of all patients who attended these clinics from January 2018 to December 2019 were screened. After screening 13,400 patients, 12,069 were labelled as type 2 diabetes mellitus according to the criteria of the American Diabetes Association, 2020, and were included in the study. The patients were subdivided into the three groups by their body mass index (BMI): lean (BMI < 18), normal weight (BMI = 18-22.9), overweight/obese (BMI ≥ 23). The study evaluated how the three subgroups responded to standard diabetes management, including antidiabetic medication and lifestyle interventions. RESULTS: Of a total of 12,069 patients 327 (2.7%) were lean, 1,841 (15.2%) of normal weight, and 9,906 (82.1%) overweight/obese. Lean patients were younger, but had more severe episodes of hyperglycemia. All three subgroups experienced significant improvements in glycemic control during follow-up; HbA1c values were significantly lowered in the overweight/obese group during follow-up compared with baseline. CONCLUSIONS: While overweight/obese patients could benefit from the improvements in glycemic control achieved by lowering HbA1c, lean and normal-weight patients had more severe and difficult-to-control hyperglycemia.

Modulation of Cellular Redox Status and Antioxidant Defense System after Synergistic Application of Zinc Oxide Nanoparticles and Salicylic Acid in Rice (Oryza sativa) Plant under Arsenic Stress.

The objective of this research was to determine the effect of zinc oxide nanoparticles (ZnONPs) and/or salicylic acid (SA) under arsenic (As) stress on rice (Oryza sativa). ZnONPs are analyzed for various techniques viz., X-ray diffraction (XRD), Fourier-transform infrared spectroscopy (FTIR), transmission electron microscopy (TEM), and scanning electron microscopy (SEM). All of these tests established that ZnONPs are pure with no internal defects, and can be potentially used in plant applications. Hence, we further investigated for better understanding of the underlying mechanisms and the extent of ZnONPs and SA induced oxidative stress damages. More restricted plant growth, gas exchange indices, significant reduction in the SPAD index and maximum quantum yield (Fv/Fm) and brutal decline in protein content were noticed in As-applied plants. In contrast, foliar fertigation of ZnONPs and/or SA to As-stressed rice plants lessens the oxidative stress, as exposed by subordinate levels of reactive oxygen species (ROS) synthesis. Improved enzymatic activities of catalase (CAT), peroxidase (POX), and superoxide dismutase (SOD), proline and total soluble protein contents under ZnONPs and SA treatment plays an excellent role in the regulation of various transcriptional pathways participated in oxidative stress tolerance. Higher content of nitrogen (N; 13%), phosphorus (P; 10%), potassium (K; 13%), zinc (Zn; 68%), manganese (Mn; 14%), and iron (Fe; 19) in ZnONPs and SA treated plants under As-stress, thus hampered growth and photosynthetic efficiency of rice plants. Our findings suggest that toxicity of As was conquering by the application of ZnONPs and SA in rice plants.

Frequency of osteoarthritis and functional outcome of operated tibial plateau fractures: A minimum of 5 years follow up.

OBJECTIVE: Tibial plateau is an important weight bearing surface and its fractures are the result of axial compressive forces. Post-traumatic osteoarthritis (PTOA) occurs despite anatomical joint reconstruction. In this study we determined the incidence of PTOA after primary management of tibial plateau fractures and determined the risk factors of PTOA of patients whose results were published at 24 months and now we present a five year follow up of the same patients. METHODS: In this study, we presented the prospective data of 109 patients who were managed for tibial plateau fractures, from August 2009 to June 2018 a Jinnah postgraduate medical centre. Data of patients regarding clinical and radiological, functional outcome (according to the American Knee Society criteria), post-procedural visual analogue scale (VAS) pain score was included. Incidence of development of PTOA was noted in each patient using the Ahlbäck classification. RESULTS: Out of 109 patients with tibial plateau fractures, 81 (74.3%) were male and 28 (25.7%) were female. Mean time lag from injury to surgery was 10.14±9.07 days. Overall incidence of osteoarthritis was 50 (45.9%). Advanced age >50 years (odds ratio 9.1 (3.7-22.1), p-value <0.0001), female gender (odds ratio; 3.40 (1.36-8.46), p-value 0.007), VAS score >4 ((odds ratio; 73.28 (15.7-341.5), p-value <0.001)), Articular depression (odds ratio; 35.25 (11.49-108.1), p-value <0.001) and degree of mal-alignment (odds ratio; 25.72 (9.30-71.12), p-value <0.001) were found to be the risk factors of PTOA. While excellent functional outcomes were protective for PTOA (odds ratio; 4.8, p-value <0.001). Thirty out of fifty patients (60%) suffering from secondary arthritis of the knee required knee replacement (TKR). Twenty-one patients (70%) were males that underwent TKR. CONCLUSIONS: There is a high proportion of osteoarthritis following tibial plateau fixation. The risk factors that related to the development of secondary arthritis our cohorts were increased age, male gender, a decrease in AKSS and a higher VAS group. Knee arthroplasty is the only option for our cohorts with severe posttraumatic arthritis.

Comparison of Medial Parapatellar and Transpatellar Tendon Approach in Intramedullary Interlocking Nailing for Tibial Fracture: A Retrospective Analysis.

Introduction Tibial fractures are one of the most common traumatic fractures, particularly in automobile accidents. Percutaneous reduction with conventional reduction forceps and un reamed intramedullary nailing, transpatellar, and medial parapatellar tendon approaches are all used, but tibial intramedullary nails are still primarily inserted through a transpatellar tendon splitting or medial parapatellar tendon approach. Objective The aim and objectives of this study are to assess the mean pain score after nailing for a tibial fracture using a medial parapatellar versus a transpatellar tendon method retrospectively in order to enhance operational planning. Materials and methods This is a retrospective study that took place in a UK level 1 trauma center. Data from 60 patients were included between February 2019 and February 2020. An equal number of patients were selected for both approaches to maintain accuracy. The advanced trauma life support (ATLS) protocol was used to handle all of the patients in both groups in order to rule out any other injuries or fractures, after which they were scheduled for surgery after stabilization. They were subsequently evaluated during a three-month follow-up in an outdoor clinic, where they were given a pain score using the visual analogue score (VAS) while moving their knee joints. The mean pain score was differentiated by age, gender, body mass index (BMI), injury side, and injury type. Results Patients were divided into groups based on their ages. Patients in the transpatellar tendon group were 32.83±5.13 years old, whereas those in the medial parapatellar tendon group were 31.4 ±5.42 years old. The gender distribution of the patients revealed that the majority of the patients in both groups were male. In both groups, the left side was the most usually affected. The difference between the two groups' mean pain scores at three months was substantially lower in the medial parapatellar approach (p=0.005). Conclusion For patients having intramedullary nailing for tibial fractures, the medial parapatellar route is associated with a lower mean pain score than the transpatellar route. As a result, we may use this method in these individuals regularly.

Management of Acute Appendicitis During the COVID-19 Pandemic is Significantly Different: A Retrospective Single UK Hospital Study.

INTRODUCTION: The COVID-19 pandemic has led to a change in the delivery of acute and emergency surgical services. With emphasis on reducing unnecessary operative intervention and performing more CT scans, there has been a shift in managing acute appendicitis conservatively. We evaluate the impact of this shift on the management of acute appendicitis. METHODS: A single UK centre retrospective study evaluating patients with suspected acute appendicitis pre-COVID-19 rota (18 March 2020) and post-COVID rota implementation. Data including demographics, inflammatory markers, imaging, mode of management and operative findings were collected. Logistic regression with SPSS was used to determine which factors were associated with conservative management and treated with antibiotics. RESULTS: A total of 161 patients were analysed, 82 pre-COVID19 and 79 post-COVID19. Of the pre-COVID-19 patients, 67.07% underwent appendicectomy while the rest were conservatively managed; 24.3% of these patients underwent a CT scan only. Post-COVID-19, 22.78% of patients underwent appendicectomy with a higher percentage of diagnostic CT scans performed, 43/79 (54.4%, p <0.001). The proportion of histologically normal appendicectomies was significantly reduced in the post-COVID-19 era (12.78% vs 0.00%; p-value 0.001). Logistic regression analysis showed a normal WCC to be associated with greater likelihood of conservative management. No conservatively managed patients returned to theatre in the 30-day follow-up period. CONCLUSION: Due to the restrictions imposed by the post-COVID-19 rota, a greater proportion of patients were managed conservatively with comparable patient outcomes. The approach also led to fewer negative appendicectomies owing to greater reliance on imaging.

Ankle syndesmotic injury: Tightrope vs screw fixation, A clinical academic survey.

OBJECTIVE: The goal of the study is to find out the treatment of choice for ankle fractures involving syndesmotic injury based on level of experience of orthopaedic surgeons. METHODS: A survey was undertaken to analyse the management used for ankle fractures with syndesmotic injuries AO 44c in a 35-year-old patient. Surgeons attending an orthopaedic course were invited to take part in a survey sorted into groups: junior surgeons middle grades, and experienced. Pictures of an x ray were shown to the participants and treatment options were asked. RESULTS: 100 surgeons from 20 nations took part in the event. Juniors made up 39%, registrars made up 38%, and experienced doctors were 29%. Screws, were reported by 93% for syndesmosis fixation. 66% of surgeons who used screws for syndesmosis fixation favoured a single screw over two screws.3-4 cortices were virtually evenly divided in choice, with 54% preferring three and 46% preferring four cortices. Only 22% of the time did they utilise a washer with their screws. With 52% of patients, the most typical time for permitting them to weight bear was 4-6 weeks after surgery. At 1-2 months postoperatively, 34% preferred to remove the screw, and at 2-3 months postoperatively, 29% preferred to remove the screw. CONCLUSION: Data show that the majority of junior level doctors handle their patients according to AO principles. The majority prefer one 3.5 mm screw positioned between 2 and 4 cm above the ankle joint, with three cortices being somewhat preferred. Despite the lack of data to support one procedure, the majority of people remove their screws within 1-3 months.

A Study to See the Effect of Social Media Usage Among Healthcare Providers.

Purpose This study aimed to assess how healthcare professionals (HCPs) use social media to determine how it influences the quality of patient care. Materials and methods This is a cross-sectional study conducted over eight months, between August 2020 and March 2021 using a questionnaire and checked amongst investigators. Results One hundred fifty-eight participants had electronic devices and 145 (91.9%) used social media at work. 26.6% of these HCPs said they spent less than an hour on social media forums, 31% said they spent one to two hours, 28.5% said two to three hours, and 13.9% said they spent more than four hours. As compared to nurses (46%), consultants and pharmacists use social media at a much lower rate (1% for each group). Compared to junior doctors, a higher percentage of nurses (40%) said they were aware of a social media policy at their hospital (8%). A quarter of healthcare employees (20%) were unaware of their workplace policy, potentially exposing sensitive medical details to the public. More research is needed to assess the particular effects of these results on patient care quality and can help in providing literature informing applications encrypted and secure patient data. Conclusion According to our results, a large percentage of healthcare quality professionals used social media networks. A significant proportion of doctors and nurses use it to visit online medical forums for improving education. A large portion of surveyed sample was unaware of hospital policy on social media usage. Further education is required to improve the right use of social media in the hospital setting.

Comparison of Open and Closed Nailing for Femoral Shaft Fractures: A Retrospective Analysis.

Introduction Open and closed nailing are the two reduction methods used for the fixation of femoral shaft fractures. The study aims to assess the clinical and functional outcomes of open and closed nailing for closed femoral shaft fractures. Methodology A total of 398 patients who underwent intramedullary nailing fixation of nonpathological femoral shaft fracture between January 2016 to December 2019 were reviewed retrospectively. Two hundred seventy-four underwent closed nailing, and 124 were considered for open nailing. Results The primary outcome reviewed was the union rate of fracture. Other outcomes analyzed were complications, intraoperative blood loss, time to union, and the duration of the procedure. Patients in the open group had a union of fracture in 15.71 weeks, closed nailing group had a union in 15.53 weeks (p-value 0.495). Patients with open nailing had a mean Radiological union scale in tibial (RUST) fracture score of 11.435, whereas the closed nailing group had a mean of 11.664 (p-value 0.187). Operative time was higher in the open group when compared to the closed nailing group (p-value 0.000). However, intraoperative blood loss was more in open nailing in comparison to closed nailing. Furthermore, 15 patients with closed nailing had non-union, whereas 11 had non-union after open nailing (p-0.204). Superficial infection and deep infection requiring debridement were equally observed among the two treatment groups. Conclusion Fixation of femoral shaft fractures with open nailing has similar outcomes in union rates, time to union, and rates of significant complication similar to those of close nailing.

Total knee replacement: A comparison of the subvastus and medial parapatellar approaches.

OBJECTIVE: The goal of this study is to compare the subvastus method to the usual medial parapatellar technique for total knee replacement in patients with osteoarthritis who present to a tertiary care centre, based on quadriceps function recovery in days after surgery. MATERIALS AND METHODS: We retrospectively reviewed case notes of 76 patients with osteoarthritis who had total knee replacements in a tertiary care hospital over the course of a year from August 2019 to August 2020. We divided them into two groups: group A received TKR via the subvastus approach, and group B received TKR via the medial parapatellar approach. Preoperative quadriceps strength, BMI, and baseline demographics were all recorded from their initial pre-operative workup case notes. Starting on the first postoperative day, patients recorded first unassisted straight leg raise (SLR) was kept as the main determinant for muscle function. The data were evaluated to determine the quadriceps muscle function post TKR. RESULTS: When compared to the medial parapatellar approach, the quadriceps muscle function returns sooner with the subvastus technique. Patients in their sixties showed the highest improvement. Preoperative quadriceps strength has a major impact on muscle recovery after surgery. CONCLUSION: The subvastus method to total knee replacement is linked to a faster recovery of quadriceps muscle strength, resulting in a shorter hospital stay and postoperative therapy.

Study of Association of Metabolic Syndrome and Risk Factors of Nephrolithiasis.

BACKGROUND AND AIM: The increasing incidence of nephrolithiasis in recent decades is coinciding with rising epidemic of obesity, metabolic syndrome, and type 2 diabetes. This temporal concordance suggests that a link might exist between these metabolic abnormalities and urinary stone disease. Therefore, the present study was aimed to investigate the association between presence of risk factors of nephrolithiasis and metabolic syndrome. METHODS: In a hospital-based, case control study, hundred patients of metabolic syndrome diagnosed according to IDF criteria and hundred age and matched controls were studied for presence of risk factors of nephrolithiasis. RESULTS: Patients with metabolic syndrome had significantly higher uricosuri a,hypercalciuria,oxaluria and hypocitraturia. The prevalence of risk factors of nephrolithiasis was also higher in patients with metabolic syndrome. The most prevalent was low urinary pH in 40% patients with mean pH of 5.8±1.6. Amongst other factors, 33% had hyperuricemia, 29% had hypercalciuria, 15% had oxaluria 13% had hypocitraturia and 10% had hyperuricosuria. Significant correlation was observed between risk factors of nephrolithiasis and components of metabolic syndrome. CONCLUSION: The present study provides an evidence of association between risk factors of nephrolithiasis and metabolic syndrome and suggests that nephrolithiasis may be a systemic disorder representing the interaction of multiple metabolic derangements. Determining common modifiable risk factors for the development of kidney stones might uncover new preventive strategies.