RESUMO
Membrane fusion is considered the first step in the entry of enveloped viruses into the host cell. Several targeted strategies have been implemented to block viral entry by limiting the fusion protein to form a six-helix bundle, which is a prerequisite for fusion. Nonetheless, the development of broad-spectrum fusion inhibitors is essential to combat emerging and re-emerging viral infections. TG-23, a coronin 1, a tryptophan-aspartate-rich phagosomal protein-derived peptide, demonstrated inhibition of fusion between small unilamellar vesicles (SUVs) by modulating the membrane's physical properties. However, its inhibitory efficacy reduces with an increasing concentration of membrane cholesterol. The present work aims to develop a fusion inhibitor whose efficacy would be unaltered in the presence of membrane cholesterol. A stretch of the tryptophan-aspartic acid-containing peptide with a similar secondary structure and hydrophobicity profile of TG-23 from coronin 1 was synthesized, and its ability to inhibit SUV-SUV fusion with varying concentrations of membrane cholesterol was evaluated. Our results demonstrate that the GG-21 peptide inhibits fusion irrespective of the cholesterol content of the membrane. We have further evaluated the peptide-induced change in the membrane organization and dynamics utilizing arrays of steady-state and time-resolved fluorescence measurements and correlated these results with their effect on fusion. Interestingly, GG-21 displays inhibitory efficacy in a wide variety of lipid compositions despite having a secondary structure and physical properties similar to those of TG-23. Overall, our results advocate that the secondary structure and physical properties of the peptide may not be sufficient to predict its inhibitory efficacy.
Assuntos
Fusão de Membrana , Proteínas dos Microfilamentos , Peptídeos , Colesterol/química , Fusão de Membrana/efeitos dos fármacos , Proteínas dos Microfilamentos/metabolismo , Proteínas dos Microfilamentos/química , Peptídeos/química , Peptídeos/farmacologia , Lipossomas Unilamelares/química , Lipossomas Unilamelares/metabolismoRESUMO
Stabilizing biomolecules under ambient conditions can be extremely beneficial for various biological applications. In this context, the utilization of ionic liquids (ILs) in enhancing the stability and preservation of nucleic acids in aqueous solutions is found to be promising. While the role of the cationic moiety of ILs in the said event has been thoroughly explored, the importance of the anionic moiety in ILs, if any, is rather poorly understood. Herein, we examine the function of anions of ILs in nucleic acid stabilization by examining the stability and structure of calf thymus-DNA (ct-DNA) in the presence of various ILs composed of a common 1-ethyl-3-methylimidazolium cations (Emim+) and different anions, which includes Cl-, Br-, NO3-, Ac-,HSO4-and BF4- by employing various spectroscopic techniques as well as Molecular Dynamics (MD) simulation studies. Analysis of our data suggests that the chemical nature of anions including polarity, basicity, and hydrophilicity become an important factor in the overall DNA-IL interaction event. At lower concentrations, the interplay of intermolecular interaction between the IL anions with their respective cations and the solvent molecules becomes a very crucial factor in inducing their stabilizing effect on ct-DNA. However, at higher concentrations of ILs, the ct-DNA stabilization is additionally governed by specific-ion effect. MD simulation studies have also provided valuable insights into molecular-level understanding of the DNA-IL interaction event. Overall, the present study clearly demonstrated that along with the cationic moiety of ILs, the anions of ILs can play a significant role in deciding the stability of duplex DNA in aqueous solution. The findings of this study are expected to enhance our knowledge on understanding of IL-DNA interactions in a better manner and will be helpful in designing optimized IL systems for nucleic acid based applications.
Assuntos
Líquidos Iônicos , Ácidos Nucleicos , Líquidos Iônicos/química , Ânions/química , Água/química , Cátions/química , DNARESUMO
Although deep eutectic solvents (DESs) are regarded as useful substitutes for both ionic liquids and common organic solvents for storage and applications of biomolecules, it is still unclear whether all DESs or only specific types of DESs will be suitable for the said purpose. In view of this, the current study aims to report on the structure and conformational dynamics of BSA in the presence of two DESs, namely ethaline (choline chloride:ethylene glycol) and BMEG (benzyltrimethyl ammonium chloride:ethylene glycol), having the same hydrogen bond donor but with a distinct hydrogen bond acceptor, so that how small changes in one constituent of a DES alter the protein-DES interaction at the molecular level can be understood. The protein-DES interaction is investigated by exploiting both ensemble-averaged measurements like steady-state and time-resolved fluorescence spectroscopy, circular dichroism (CD) spectroscopy, and single-molecule sensitive techniques based on fluorescence correlation spectroscopy (FCS). Interestingly, the results obtained from these studies have demonstrated that while a very small quantity of BMEG completely unfolds the native structure of the protein, it remains in a partially unfolded state even at very high ethaline content. More interestingly, it has been found that at very high concentrations of BMEG, the unfolded protein undergoes enhanced protein-protein interaction resulting in the aggregation of BSA. All of the results obtained from these investigations have essentially suggested that both protein-DES interaction and interspecies interaction among the constituent of DESs play a crucial role in governing the overall stability and conformational dynamics of the protein in DESs.
Assuntos
Colina , Soroalbumina Bovina , Colina/química , Espectrometria de Fluorescência , Solventes Eutéticos Profundos , Solventes/química , Etilenoglicol/químicaRESUMO
The present study has been undertaken with an aim to design and develop safer and more efficient all solid-state electrolytes, so that the issues associated with the use of conventional room temperature ionic liquid-based electrolytes can be tackled. To fulfil this objective, a series of geminal di-cationic Organic Ionic Crystals (OICs), based on C3-, C6-, C8- and C9-alkylbridged bis-(methylpyrrolidinium)bromide are synthesized, and the structural features, thermal properties and phase behaviours of these as synthesized OICs have been investigated. Additionally, a number of electro-analytical techniques have been employed to assess their suitability as an efficient electrolyte composite (OIC:I2:TBAI) for all solid-state dye sensitised solar cells (DSSCs). The structural analysis has revealed that along with excellent thermal stability and well-defined surface morphology, all thsese OICs exhibit a well-ordered three-dimensional network of cations and anions that can serve as a conducting channel for the diffusion of iodide ions. Electrochemical investigations have shown that OICs with an intermediate length of alkyl bridge (C6- and C8-alkyl bridged) show better electrolytic performance than those that are based on OICs with a relatively shorter (C3-) or longer (C9-) alkyl-bridge chain. A careful analysis of the above data has essentially demonstrated that the length of the alkyl bridge chain plays a significant role in determining the structural organisation, morphology and eventually the ionic conductivity of OICs. Overall, the comprehensive knowledge on OICs that has been extracted from the current study is expected to be helpful to explore further new types of OIC-based all solid-state electrolytes with improved electrolytic performance for targeted applications.
RESUMO
The present study has been undertaken with an objective to find out a suitable medium for the long-term stability and storage of the ct-DNA structure in aqueous solution. For this purpose, the potential of a pyrrolidinium-based dicationic ionic liquid (DIL) in stabilizing ct-DNA structure has been investigated by following the DNA-DIL interaction. Additionally, in order to understand the fundamental aspects regarding the DNA-DIL interaction in a comprehensive manner, studies are also done by employing structurally similar monocationic ionic liquids (MILs). The investigations have been carried out both at ensemble-average and single molecular level by using various spectroscopic techniques. The molecular docking study has also been performed to throw more light into the experimental observations. The combined steady-state and time-resolved fluorescence, fluorescence correlation spectroscopy, and circular dichroism measurements have demonstrated that DILs can effectively be used as better storage media for ct-DNA as compared to MILs. Investigations have also shown that the extra electrostatic interaction between the cationic head group of DIL and the phosphate backbone of DNA is primarily responsible for providing better stabilization to ct-DNA, retaining its native structure in aqueous medium. The outcomes of the present study are also expected to provide valuable insights in designing new polycationic IL systems that can be used in nucleic acid-based applications.
Assuntos
Líquidos Iônicos , Líquidos Iônicos/química , Simulação de Acoplamento Molecular , DNA/química , Dicroísmo Circular , Água/químicaRESUMO
With the aim of understanding the differences in the behavior of deep eutectic solvents (DESs) and room temperature ionic liquids (RTILs) in terms of their structure, dynamics, and intra- and intermolecular interactions, three different ILs and one DES having similar functionalities (hydroxyl) have been investigated by using both ensembled average and single-molecule spectroscopic techniques. Specifically, for this purpose, a choline chloride based DES (ethaline) and three hydroxyl functionalized ILs (1-(2-hydroxyethyl)-3-imidazolium bis(trifluoromethanesulfonyl)imide ([OHEMIM][NTF2]), N-(2-hydroxyl ethyl)-N-methylpyrrolidinium bis(trifluoromethanesulfonyl)imide ([OHEMPy][NTf2]), and N-(2-hydroxyethyl)-N,N-dimethylpropan-1-aminium bis(trifluoromethanesulfonyl)imide ([OHC3CH][NTf2])) are employed and investigated by EPR, time-resolved fluorescence, NMR and FCS studies. Estimation of polarity through EPR spectroscopy has revealed that the hydroxyl ILs employed in these studies are hyper-polar (close to water) in nature, whereas the polarity of the DES is found to be close to those of aliphatic polyhydroxy-alcohols. Interestingly, both time-resolved fluorescence anisotropy and FCS studies on these systems have suggested that the hydroxyl ILs are more dynamically heterogeneous than the DES. More interestingly, PFG-NMR measurements have indicated that the fluid structure of ethaline is relatively more associated as compared to those of the ILs despite the fact that all the cations have the same hydroxyl functionalities. All these investigations have essentially demonstrated that, despite having similar functionalities, both the DES and hydroxyl ILs employed in the present study exhibit microscopic behaviours that are significantly different from each other, indicating the interplay of various intermolecular interactions within the constituent species in governing the behaviours of these solvent systems.
RESUMO
In recent times, ionic liquid-based (ILs) electrolytic system has emerged as suitable alternative to the conventional organic solvent-based electrolytic system. However, since, anion of ILs is known to form aggregates in the presence of lithium-ions (Li+), and this can influence the transport properties of Li+ ion in a significant manner, it is, therefore, important to understand how lithium-ions influence the structure and dynamics of ILs. With this objective, in the present study, intermolecular interaction, structural organization, and dynamics of monocationic ILs (MILs) and dicationic IL (DIL) have been studied in the absence and presence of lithium salt. Specifically, for this purpose, two MILs, 1-methyl-3-propylimidazolium bis(trifluoromethylsulfonyl)imide ([C3C1im][NTf2]), 1-hexyl-3-propylimidazolium bis(trifluoromethylsulfonyl)imide ([C6C1im][NTf2]), and a DIL, 1,6-bis(3-methylimidazolium-1-yl)hexane bis(trifluoromethylsulfonyl)amide ([C6(mim)2][NTf2]2) have been chosen in such a way that either the alkyl chain of MILs becomes equal or half of the spacer chain length of DIL. To understand the effect of the addition of lithium-ion on the structural organization of MILs and DIL, steady-state absorption and fluorescence spectroscopies, time-resolved fluorescence anisotropy and nuclear magnetic resonance (NMR) techniques have been used. Structural organization in the apolar and polar domains of ILs has been probed by following the rotational diffusion of suitably chosen solute in the concerned media through time-resolved fluorescence anisotropy (TRFA) measurements. TRFA studies have revealed that with the addition of Li+ ion, coordination between the Li+ ions and anions of MILs and DILs takes place in the ionic region leading to a change in the structural organization of the apolar regions of the respective medium. In fact, upon adding lithium-ions, a reduction in the packing of alkyl chains has also been observed for the MILs. However, not much change in the structural organization of the apolar region of the DIL has been observed when Li+ ion is added to it. In the presence of Li+ ions, a similar trend in the change of structural organization of polar regions for both MILs and DIL has been observed. Further, measurements of the self-diffusion coefficient through NMR have also supported the observation that Li+ ion also perturbs the nanostructural organization of the MIL in a significant manner than that it does for the DIL. The behavior of DIL in the presence of Li+ ion, as revealed by the present study, has been rationalized by considering the folded arrangement of DIL in the fluid-structure. Essentially, all of these investigations have suggested that the addition of lithium-ion significantly alters the microscopic behavior of MILs in comparison to that of DIL. The outcome of this study is expected to be helpful in realizing the potentials of these media as electrolytes in battery applications.
RESUMO
With an aim to understand the difference in the behaviour of imidazolium and pyrrolidinium-based dicationic ionic liquids (DILs) in terms of the intermolecular interactions, microscopic-structure and dynamics, two DILs, the imidazolium-based 1,9-bis(3-methylimidazolium-1-yl)nonane bis(trifluoromethanesulfonyl)imide and the pyrrolidinium-based 1,9-bis(1-methylpyrrolidinium-1-yl)nonane bis(trifluoromethanesulfonyl)imide, have been synthesized and subsequently investigated by exploiting combined steady sate and time resolved fluorescence, electron paramagnetic resonance (EPR) and nuclear magnetic resonance (NMR) spectroscopic techniques. Data obtained for DILs have also been compared with their corresponding mono-cationic counterpart (MILs) to evaluate and understand the distinctive characteristics of the DILs in contrast with the corresponding MILs. Steady state emission and EPR data have revealed that the pyrrolidinium-based DIL is slightly less polar than the imidazolium-based DIL. Temperature-dependent fluorescence anisotropy decay of two probes, perylene and MPTS (8-methoxypyrene-1,3,6-trisulfonate), has been measured in DILs as well as in MILs. Solute-solvent coupling constants obtained from the experimentally measured rotational correlation times with the aid of Stokes-Einstein-Debye hydrodynamic theory have indicated appreciable differences in the dynamics of both the solutes on going from MILs to DILs. More interestingly, the outcome of the NMR study has suggested that the alkyl spacer chain in the imidazolium-based DIL exists in the folded form, but the pyrrolidinium-based DIL remains in the straight chain conformation. Inherently, the outcomes of all of these studies have depicted that the microscopic structural organisations in imidazolium and pyrrolidinium-based DILs are different from each other as well as from their respective mono-cationic counterparts.
RESUMO
The mixing of ILs provides an opportunity for fine tuning the physiochemical properties of ILs for various applications. However, a suitable mixture having desired properties can only be designed when the physiochemical properties of the mixtures of ILs along with their spectroscopic properties are well understood. With an aim to achieve this objective, three different mixtures with a common anion, namely, [C2C1im][C4C1im][NTf2], [C3C1pyr][C4C1pyr][NTf2], and [C3C1im][C3C1pyr][NTf2], have been investigated in the current study. Investigations have been carried out at the macroscopic level by observing the thermophysical properties, such as molar volume and thermal expansion coefficient, and at the microscopic level with time-resolved fluorescence measurements and the pulse field gradient nuclear magnetic resonance (NMR) technique. The results obtained from the thermophysical study have indicated that excess molar volume for imidazolium-based IL-IL mixtures may be linked to the free volume created by the alkyl chain of the imidazolium cation whereas for the mixture of pyrrolidinium ILs, lowering of density can give rise to free volume. Analysis of time-resolved fluorescence anisotropy data has provided clear evidence in favor of the presence of free volume in the binary mixture of ILs. NMR studies have also supported the fluorescence anisotropy data. The outcome of the present investigation reveals that the mixtures show appreciable deviation from ideal behavior and the deviation from the ideal behavior is caused due to the generation of free volume in the resultant mixture, describing these IL mixtures as quasi-ideal rather than ideal or non-ideal.
RESUMO
BACKGROUND: Multiligamentous injuries of knee are a complex problem in orthopaedics. Combined ACL-PCL injuries are uncommon, usually associated with knee dislocations. Extremity vascular status is essential because of possible arterio-venous compromise. These complex injuries require a systematic evaluation and treatment. Single setting simultaneous arthroscopic ACL and PCL reconstruction or a staged approach can be adopted to treat these cases. OBJECTIVES: To evaluate functional outcome of simultaneous arthroscopic ACL and PCL reconstruction with hamstring tendon autograft in multiligamentous knee injuries. PATIENTS AND METHODS: This prospective study was performed on 20 patients with combined ACL-PCL injuries who underwent simultaneous arthroscopic ACL-PCL reconstruction with hamstring tendon. Evaluation of functional outcome was by IKDC and Lysholm-Tegner scores. RESULTS: In 20 patients, mean age 34 years, return to full-time work and to full sports was 8 weeks and 6.2 months respectively. All patients had full range of motion except 2 patients with < 5 degrees flexion loss; 90% had negative Lachmann test; 95% had negative pivot shift and 10% patients had mild posterior drawer at 90 degrees (1+) at final follow up. Mean IKDC score was 90 (range 81 - 94); mean Tegner activity score was 7 and mean Lysholm knee score was 89. 85% returned to preinjury activity level and a 90% satisfaction rate. CONCLUSIONS: Simultaneous arthroscopic ACL and PCL reconstructions using hamstring tendon for combined ACL and PCL injuries is a clinically effective, safe, time saving and cost-effective procedure with better patient compliance and reproducible for a timely return of motion, strength, and function with favorable outcome.
RESUMO
Bilateral anterior cruciate ligament (ACL) injuries are rare with incidence between 2 and 4%, and presently no definitive guidelines for proper management exist. Ideal treatment protocol remains controversial between a single-stage and two-stage bilateral ACL reconstruction. The purpose of this study is to evaluate the outcome of single-stage bilateral ACL reconstruction with hamstring tendon autografts in bilateral ACL injuries. A prospective study was undertaken including a total of 14 consecutive patients with bilateral ACL deficient knee who underwent single-stage bilateral ACL reconstruction with hamstring tendon autograft with a mean follow-up duration of 28 months (24-38 months). Functional outcomes were evaluated by range of movements, International Knee Documentation Committee (IKDC), Lysholm and Tegner activity score, and stability tests. The mean age was 30 years (range 18-42 years). Average duration of rehabilitation was 8 weeks. Time to return to full-time work and full sports was 5.6 weeks and 6.2 months, respectively. Clinical examination demonstrated full range of motion; a total of 12 patients (86%) had a negative Lachman test and 13 patients (93%) had a negative pivot shift at the final follow-ups. The mean IKDC evaluation score was 89 points, the mean Tegner activity score was 7 points, and the mean Lysholm knee score was 91 points. A total of 12 patients (86%) returned to their preinjury level of activity and an overall greater than 90% satisfaction rate was achieved. Single-stage bilateral ACL reconstruction using hamstring autografts is clinically safe, effective, and cost-effective with better patient compliance and with comparable functional outcome as opposed to two-stage ACL reconstructions.
Assuntos
Lesões do Ligamento Cruzado Anterior/cirurgia , Reconstrução do Ligamento Cruzado Anterior/métodos , Instabilidade Articular/cirurgia , Tendões/transplante , Adolescente , Adulto , Feminino , Seguimentos , Humanos , Masculino , Estudos Prospectivos , Amplitude de Movimento Articular , Transplante Autólogo , Resultado do Tratamento , Adulto JovemRESUMO
OBJECTIVE: Knee arthroscopy is a commonly performed orthopedic procedure. Post-operatively, adequate pain relief reduces the surgical stress response and patient's morbidity and facilitates rehabilitation. The analgesic effect of dexmedetomidine (2 µg/kg body weight) as an adjunct to ropivacaine in knee arthroscopic knee procedures was studied to determine whether this would achieve longer post-operative analgesia and whether the study dosage of dexmedetomidine was safe and free of adverse effects. PATIENTS AND METHODS: In a multicenter prospective double blind trial of sixty patients undergoing knee arthroscopic procedures, patients were randomly assigned to three groups: Group R, receiving intra-articular ropivacaine (20 mL); Group D1 (18 mL ropivacaine, dexmedetomidine 1 µg/kg body weight); and Group D2 (18 mL ropivacaine, dexmedetomidine 2 µg/kg). RESULTS: Group D2 had significantly lower pain scores for the first 12 postoperative hours than Group D1 and Group R. Time to first analgesic requirement was longest in Group D2 (757.30 ± 207.68 min), followed by Group D1 (433.2 ± 54.3 min) and Group R (311.80 ± 61.56 min); these differences were significant (P < 0.05). Total analgesic requirement was significantly lower in Group D2 (82.50 ± 48.05 mg; P < 0.05). Intensity of pain was significantly less in Group D2 in the third (P < 0.01) and sixth hours (P < 0.05). CONCLUSION: Intra-articular dexmedetomidine (2 µg/kg) has superior analgesic efficacy, delayed the first postoperative requirement for analgesia and decreasing the need for postoperative analgesics with no major adverse effects.
Assuntos
Amidas/administração & dosagem , Analgésicos não Narcóticos/administração & dosagem , Anestésicos Locais/administração & dosagem , Artroscopia/métodos , Dexmedetomidina/administração & dosagem , Articulação do Joelho/cirurgia , Adulto , Artroscopia/efeitos adversos , Pressão Sanguínea/efeitos dos fármacos , Relação Dose-Resposta a Droga , Método Duplo-Cego , Esquema de Medicação , Combinação de Medicamentos , Feminino , Frequência Cardíaca/efeitos dos fármacos , Humanos , Injeções Intra-Articulares , Masculino , Pessoa de Meia-Idade , Medição da Dor/métodos , Dor Pós-Operatória/prevenção & controle , Cuidados Pós-Operatórios , Estudos Prospectivos , Ropivacaina , Adulto JovemRESUMO
We report a case of neglected multiligamentous injury that developed a complete thrombotic popliteal artery block following arthroscopic surgery. A 56-year-old man, a farmer, presented with an 8-month history of instability of the right knee. Examination revealed ipsilateral anterior (ACL)/posterior cruciate ligament (PCL) injuries. MRI and diagnostic arthroscopy confirmed complete ACL/PCL tear. Single-stage arthroscopic ACL/PCL reconstruction was performed. Postsurgery, the operated limb appeared swollen, firm and cold, without sensation or toe movement. Angiogram revealed complete thrombotic block of left popliteal artery. Fogarty's catheterism was performed and distal vascularity re-established. At 28 months, the patient was back at work with good functional outcome. We failed to examine the patient preoperatively in spite of his advanced age, history of beedi smoking and tobacco use, and presence of feeble vascular pulsations with thickened skin over leg and foot. Thus, in multiligamentous injuries, patient selection and thorough detailed clinical examination are the keys to successful arthroscopic procedures.
Assuntos
Ligamento Cruzado Anterior/cirurgia , Traumatismos do Joelho/cirurgia , Procedimentos de Cirurgia Plástica/efeitos adversos , Artéria Poplítea/patologia , Ligamento Cruzado Posterior/cirurgia , Fumar/efeitos adversos , Trombose/etiologia , Lesões do Ligamento Cruzado Anterior , Artroscopia/efeitos adversos , Humanos , Instabilidade Articular/etiologia , Instabilidade Articular/cirurgia , Joelho/cirurgia , Articulação do Joelho/cirurgia , Masculino , Pessoa de Meia-Idade , Ligamento Cruzado Posterior/lesões , Complicações Pós-Operatórias/etiologia , Procedimentos de Cirurgia Plástica/métodosRESUMO
A hip fracture dislocation with contralateral femur fracture is a rare combination. We report a case of neglected posterior dislocation of hip with Pipkins-II femoral head and medial condylar fractures associated with a contralateral femoral shaft fracture. Right hip joint was approached via the Kocher-Langenbeck, following reduction, femoral head fragments were fixed with two 4-mm cannulated cancellous screws with open reduction internal fixation plating of ipsilateral femoral condylar fracture and closed reduction internal fixation nailing of left femur in the same sitting. Immediate postoperative X-rays were satisfactory. Postoperative period was uneventful. Over 7-year follow-up, patient is successfully performing his duties with X-rays bearing no signs of avascular necrosis (AVN) or hip arthritis. Thus, complex femoral fractures require a multidisciplinary approach for successful treatment. Early congruous reduction, anatomical fixation and early rehabilitation help in reducing the incidence of AVN and postoperative arthritis. Successful diagnosis of Pipkin's fracture dislocations requires use of CT, MRI and ultrasound in adjunct to X-rays.
RESUMO
PURPOSE: Paediatric femur neck fractures are exceedingly rare owing to dense bone surrounded by a strong periosteum; they account for 1 % of paediatric fractures and are usually associated with high energy trauma. METHODS: This was a prospective multicenter therapeutic study on pediatric femoral neck fractures from June 2004 to September 2013 at three centres in Odisha, India. Children with femoral neck fractures (Delbet type 2 and 3) who were operated and completed a minimum one-year follow-up were included. We divided the neck of femur (100 %) into four zones (25 % each), with zone I being highly unstable and zone IV being most stable. Implants for fixation, as suggested by pre-operative zone distribution, were used. RESULTS: Twenty-eight children were studied with mean two- to seven-year follow-up. In 23 children cancellous screws were used. In zone I Smooth Moore's pins that crossed the epiphysis were the implant of choice. Causes were avascular necrosis (14.2 %), nonunion (7.14 %) and one case of implant failure, while coxa vara was encountered in two instances. Functional results (Ratliff's criteria) were good in 82.1 %, fair in 7.1 % and poor in 10.7 % of patients; the mean IOWA hip scores were 96, 94 and 98, respectively. CONCLUSION: Early surgical intervention hastens recovery, rehabilitation and return to school and decreases the risk of developing avascular necrosis. We suggest Smooth Pins fixation in zones I and II (nearer to zone I) and cancellous screw fixation in zones II, III and IV. Decompression of hip joint by capsulotomy releases the tamponade effect and should be performed in all cases of paediatric femoral neck fractures.
Assuntos
Fraturas do Colo Femoral/cirurgia , Fixação Interna de Fraturas/métodos , Adolescente , Criança , Pré-Escolar , Descompressão Cirúrgica , Feminino , Fraturas do Colo Femoral/diagnóstico por imagem , Necrose da Cabeça do Fêmur/classificação , Necrose da Cabeça do Fêmur/prevenção & controle , Humanos , Índia , Liberação da Cápsula Articular , Masculino , Estudos Prospectivos , Radiografia , Resultado do TratamentoRESUMO
The pollution levels in New Delhi from industrial, residential, and transportation sources are continuously growing. As one of the major pollutants, ground-level ozone is responsible for various adverse effects on both humans and foliage. The present study aims to predict daily ground-level ozone concentration maxima over a site situated in New Delhi through neural networks (NN) and multiple-regression (MR) analysis. Although these methodologies are case and site specific, they are being developed and used widely. Therefore, to test these methodologies for New Delhi where no such study is available for ground-level ozone, six models have been developed based on NNs and MR using the same input data set. The changes in the performance capability of the two methods are sensitive to the selection of input parameters. The results are encouraging, and remarkable improvements in the performance of the models have been observed.