"All in One or (W)hole in One Repair" for Adult Total Brachial Plexus Palsy.

Background Total brachial plexus palsy (TBPP) accounts for nearly 50% of all brachial plexus injuries. Since achieving a good functional hand was almost impossible, the aim was settled to get a good shoulder and elbow function. It was Gu, who popularized the concept of utilizing contralateral C7 (CC7) with vascularized ulnar nerve graft (VUNG) to get some hand function. We have modified it to suit our patients by conducting it as a single-stage procedure, thereby trying to get a functional upper limb. Methods From 2009 to 2014, we had 20 TBPP patients. We feel nerve reconstruction is always better than any other salvage procedure, including free muscle transfer. We modified Gu's concept and present our concept of total nerve reconstruction as "ALL IN ONE OR (W)HOLE IN ONE REPAIR." Results All patients able to move their reconstructed limbs independently or with the help of contralateral limbs. Three patients developed hook grip and one patient was able to incorporate limbs to do bimanual jobs. One important observation is that all the reconstructed limbs regain the bulk, and to a certain extent, the attitude and appearance looks normal, as patients no longer hide it or hang it in a sling. Conclusion Adult brachial plexus injury itself is a devastating injury affecting young males. By doing this procedure, the affected limb is not dissociated from the rest of the body and rehabilitation can be aimed to get a supportive limb.

Vermicomposting of paper mill solid waste using epigeic earthworm Eudrilus eugeniae.

A 90 day study was conducted to evaluate the efficiency of an exotic earthworm species (Eudrilus eugeniae) for decomposition of different types of organic substrates (mixed liquor suspended solids, cow dung and leaf litter) into valuable vermicompost. Mixed liquor suspended solids (MLSS) and leaf litter (LL) were mixed with cow dung (CD) in eight different ratios with three replicates for each treatment. All vermibeds expressed a significant decrease in pH, organic carbon, C:N ratio and an increase in total nitrogen, phosphorus and potash. Overall, earthworms could maximize decomposition and mineralization efficiency in bedding with lower proportions of MLSS. Maximum value for earth worm zoo mass and higher concentration of nutrient content was observed in CD + MLSS + LL in 1:1:2 ratios. Earthworm mortality tended to increase with increasing proportion of MLSS and maximum mortality in E. eugeniae was recorded for MLSS treatment alone. Results indicate that vermicomposting might be useful for managing the energy and nutrient of MLSS on a low-input basis. Products of this process can be used for sustainable land restoration practices.