Diagnosis of COVID-19 in symptomatic patients: An updated review.

A group of pneumonia patients was detected in Hubei Province, in China in December 2019. The etiology of the disease was unknown. Later, the researchers diagnosed the novel Coronavirus as the causal agent of this respiratory disease. On February 12th 2020, the World Health Organization (WHO) officially named this disease Coronavirus disease 2019 (COVID-19). Consequently, the disease spread globally and became a pandemic. As there is no specific treatment for the symptomatic patients and several vaccines are approved by WHO, the efficacy and effectiveness of these vaccines are not fully understood yet and the availability of these vaccines are very limited. In addition, new variants and mutants of SARS-CoV-2 are thought to be able to evade the immune system of the host. So, diagnosis and isolation of infected individuals is advised. Currently, real-time reverse transcription-polymerase chain reaction (RT-PCR) is considered the gold standard method to detect novel Coronavirus, however, there are few limitations associated with RT-PCR such as false-negative results. This demanded another diagnostic tool to detect and isolate COVID-19 early and accurately. Chest computed tomography (CT) became another option to diagnose COVID-19 patients accurately (about 98% sensitivity). However, it did not apply to the asymptomatic carriers and sometimes the results were misinterpreted as from other groups of Coronavirus infection. The combination of RT-PCR and chest CT might be the best option in detecting novel Coronavirus infection early and accurately thereby allowing adaptation of measures for the prevention and control of the COVID-19.

En diciembre de 2019 se detectó un grupo de pacientes con neumonía en la provincia de Hubei, China, desconociéndose la etiología de la enfermedad. Posteriormente, los investigadores señalaron al nuevo coronavirus como agente causal de esta enfermedad respiratoria. El 12 de febrero de 2020, la Organización Mundial de la Salud (OMS) la designó oficialmente como enfermedad por coronavirus de 2019 (COVID-19). A continuación, dicha enfermedad se propagó a nivel global, y se convirtió en una pandemia. No existe tratamiento específico para los pacientes sintomáticos, y la OMS ha aprobado diversas vacunas. Sin embargo, la eficacia y la efectividad de las mismas no se comprende plenamente aún, siendo muy limitada su disponibilidad. Además, se piensa que las diferentes variantes y mutaciones del SARS-CoV-2 son capaces de evadir el sistema inmune del huésped. Por tanto, se recomienda el diagnóstico y aislamiento de las personas infectadas. Actualmente se considera la reacción en cadena de la polimerasa con transcriptasa inversa (RT-PCR) a tiempo real el método de referencia para detectar el nuevo coronavirus. Sin embargo, existen algunas limitaciones asociadas a RT-PCR tales como los resultados falso-negativos. En consecuencia, ello ha demandado otra herramienta diagnóstica para detectar y aislar la COVID-19 de manera temprana y precisa. La tomografía computarizada (TC) de tórax se ha convertido en otra opción para diagnosticar de manera precisa a los pacientes con COVID-19 (cerca del 98% de sensibilidad). Sin embargo no se aplica a los portadores asintomáticos, y a veces se han malinterpretado los resultados como en el caso de otros grupos de infección por coronavirus. La combinación de RT-PCR y TC de tórax podría ser la mejor opción para detectar la nueva infección por coronavirus de manera temprana y precisa, permitiendo, por tanto, la adaptación de las medidas para la prevención y el control de la COVID-19.

Management of Fractures of the Distal Third of Tibia by Distal Tibial Locking Plate by MIPO Technique.

Distal tibial fractures are difficult to manage as the bone is subcutaneous with depleted muscular cover; the consequent decreased vascularity leads to complications. Minimal invasive plate osteosynthesis (MIPO) is a very good option for managing this type of fractures. This study was carried out to evaluate the outcome of patients treated with distal tibial locking plate by MIPO technique. Twenty patients with distal tibia fractures treated with distal tibial anatomical locking plate were prospectively studied from July 2013 to December 2016. The result was excellent in 18(90%) of patients i.e. 18 patients had an AOFAS score of 90 or greater out of a possible 100 points. The mean score was 94.28; the mean time for radiological union was 20.1 weeks with a range of 16 to 30 weeks. We encountered superficial infection in 02 (10%) of our patients which were managed with dressings and appropriate antibiotics. Two patients had union with valgus angulation of less than 5°. No malunion was detected. One patient had ankle stiffness requiring extensive physiotherapy to regain range of movement. Plate removal was done in 4 cases. MIPO technique is a good fixation method for fractures distal third of tibia, preserving blood supply & fracture hematoma.

Differences of Curing Effects between a Human and Veterinary Bone Cement.

The goal of the study is to understand how the curing characteristics of a human bone cement (HBC) and veterinary bone cement (VBC) influence the mechanical behavior of each cement and cement bonding with an implant. This study hypothesizes that the curing temperature and time influence the mechanical properties of the cement adjacent to the implant, which resulted in the variability in bonding strength between the implant and cement. To test this hypothesis, this study measured the exothermic temperature, flexural strength, hardness, and morphology of a HBC and VBC at different curing times. In addition, this study measured shear strength at the interfaces of implant/HBC and implant/VBC samples during static and stepwise cyclic tests at different curing times. This study used Stryker Simplex P and BioMedtrix 3 poly methyl methacrylate (PMMA) as an HBC and VBC, respectively. This study cured HBC and VBC cement for 30 and 60 min and then conducted flexural, hardness, and interface fracture tests to evaluate the curing effect on mechanical behavior of each of the cements. This study found that the curing time significantly increases the values of flexure and hardness properties of each cement and shear strength of implant/HBC and implant/VBC (p < 0.05). This study observed a difference of curing time and temperature between HBC and VBC. This study also observed a significant difference of surface porosity at the interface of implant/HBC and implant/VBC interfaces. The variability of mechanical properties between HBC and VBC due to the differences of curing conditions may influence the bonding of cement with the implant.