Prediction of internet addiction among high school students in a rural Southern Karnataka, India-A cross-sectional study.

BACKGROUND: According to the World Health Organization, there is an explosion in the use of electronic devices, the internet, and gaming platforms. In many countries, it is a significant public health concern, prompting calls to identify adequate public policy. We aimed to investigate the prevalence of internet addiction (IA) among high school students and to assess the relationship between the internet addiction level of high school students and their demographic features with internet use. MATERIALS AND METHODS: A cross-sectional study was conducted among 424 high school children studying in eighth standard-tenth standard. Among 121 public and private high schools listed by the BEO (Block Education Officer) Office in Kolar Taluk four high schools were selected by lottery method from July 2021 to August 2021. The Internet Addiction Test (IAT) by Young was used to assess the intensity of internet usage. RESULTS: The mean IAT score of study participants was 29.6. The mean age of the study population was 14.4 ± 0.84 years. The odds of internet addiction among female students were 4.5 times higher than among male students. The majority (91.5%) of the students had used the internet for educational purpose and the other common reasons for internet usage is social media (43%), entertainment (43%), and gaming purpose (21%). CONCLUSION: The prevalence of IA among high school students is 14.6% with the moderate-risk population was 12.5% and the high-risk population was 2.1%. Students using the internet for both academic and non-academic purposes were more internet addicted. The real challenge is to have control over the usage of social sites-the amount of time being spent and the type of activities adolescents are doing online.

Advanced deep learning techniques for early disease prediction in cauliflower plants.

Agriculture plays a pivotal role in the economies of developing countries by providing livelihoods, sustenance, and employment opportunities in rural areas. However, crop diseases pose a significant threat to both farmers' incomes and food security. Furthermore, these diseases also show adverse effects on human health by causing various illnesses. Till date, only a limited number of studies have been conducted to identify and classify diseased cauliflower plants but they also face certain challenges such as insufficient disease surveillance mechanisms, the lack of comprehensive datasets that are properly labelled as well as are of high quality, and the considerable computational resources that are necessary for conducting thorough analysis. In view of the aforementioned challenges, the primary objective of this manuscript is to tackle these significant concerns and enhance understanding regarding the significance of cauliflower disease identification and detection in rural agriculture through the use of advanced deep transfer learning techniques. The work is conducted on the four classes of cauliflower diseases i.e. Bacterial spot rot, Black rot, Downy Mildew, and No disease which are taken from VegNet dataset. Ten deep transfer learning models such as EfficientNetB0, Xception, EfficientNetB1, MobileNetV2, EfficientNetB2, DenseNet201, EfficientNetB3, InceptionResNetV2, EfficientNetB4, and ResNet152V2, are trained and examined on the basis of root mean square error, recall, precision, F1-score, accuracy, and loss. Remarkably, EfficientNetB1 achieved the highest validation accuracy (99.90%), lowest loss (0.16), and root mean square error (0.40) during experimentation. It has been observed that our research highlights the critical role of advanced CNN models in automating cauliflower disease detection and classification and such models can lead to robust applications for cauliflower disease management in agriculture, ultimately benefiting both farmers and consumers.

Four-headed biceps and triceps brachii muscles, with neurovascular variation.

Anatomical variations of the biceps brachii and triceps brachii have been described by various authors, but the occurrence of four-headed biceps brachii and triceps brachii in an ipsilateral arm is rare and has not been reported before in the literature. During routine cadaveric dissection in the department of anatomy, Kasturba Medical College, Mangalore, India, various unusual variants were noted in the left arm of a cadaver of a 67-year-old man. The variants include a four-headed biceps, a four-headed triceps, communication between the musculocutaneous and median nerves, and a high origin of deep brachial artery from the axillary artery. The occurrence of these anomalies and the clinical and morphological significance are discussed.

An additional radial wrist extensor and its clinical significance.

The knowledge of anatomical variations in the antebrachial and dorsal regions of the arm and hand are useful in hand surgery. The extensor carpi radialis intermedius and extensor carpi radialis accessorius are two classic variants described for the radial wrist extensors, in the antebrachial region. We report an additional extensor carpi radialis muscle taking origin from the common extensor origin, between the extensor carpi radialis longus and extensor digitorum communis. The tendon of the variant muscle divides below the abductor pollicis longus and becomes attached to the base of the second and third metacarpal bone. Due to its considerable size and independent origin from the lateral epicondyle, we suggest the present variation should be named extensor carpi radialis tertius. The clinical significance of the present variation is discussed.

Unusual origin of dorsal nerve of penis and abnormal formation of pudendal nerve--clinical significance.

The nerve roots of the sacral plexus are fascinating and critical in the functions of defecation, micturition, parturition, and even participate in the mechanism of male sexual functions of erection and ejaculation. During our routine cadaveric dissection of the right gluteal region of a 45-year-old male cadaver, we came across an unusual origin of the dorsal nerve of the penis (DNP) and abnormal formation of the pudendal nerve. The clinical aspects of the particular variations are discussed.

Detection of talocalcaneal coalitions by magnification bone scintigraphy.

Fibrocartilaginous talocalcaneal coalitions are very difficult to identify on plain radiography in symptomatic children and adolescents before gross ossification occurs. Computed tomography (CT) has been successful in identifying osseous and some fibro-osseous coalitions. In this series, magnification imaging of the tarsus on bone scintigraphy in the medial-lateral projection correctly identified talocalcaneal coalitions, seven of the nine bars were fibrous or fibro-osseous. Three of the fibrous lesions were equivocal or normal on conventional radiography and CT. Physiologic accumulations of activity in the growing hind foot are also presented from a control pediatric population. Magnification scintigraphy of the hind foot is offered as an adjunct to plain radiography and CT in the diagnosis of elusive nonosseous subtalar bars.

Calcaneonavicular coalition treated by resection and interposition of the extensor digitorum brevis muscle.

Seventy-five feet in forty-eight patients that had calcaneonavicular coalition were evaluated at two to twenty-three years after resection of the coalition and interposition of the extensor digitorum brevis muscle. The result was excellent or good in fifty-eight feet (77 per cent). Three feet that were rated initially as having a fair result improved over time, and at the last follow-up the result in those feet was rated as good. Only five feet (7 per cent) had a poor result. The best results were in patients who had a cartilaginous coalition and who were less than sixteen years old at the time of operation.

Amputation or limb-lengthening for partial or total absence of the fibula.

Thirty-two patients who had ablation of the foot by the Syme or Boyd technique for partial or total absence of the fibula, with subsequent fitting of a prosthesis, were compared with eleven patients who had lengthening of the lower limb by the Wagner method, to assess the long-term results of each procedure. The final results were evaluated on the basis of pain, limp, limb-length discrepancy, level of physical activity, and satisfaction of the patient. Of the thirty-two patients who had an amputation, twenty-eight (88 per cent) had a satisfactory result, compared with only six (55 per cent) of the eleven patients who had limb-lengthening. The amount of inequality between the lower limbs was classified as follows: Group I--the foot of the shorter extremity was at the distal third of the contralateral, normal limb, and the percentage of shortening was 15 per cent or less; Group II--the foot of the shorter extremity was at the level of the middle third of the contralateral, normal limb, and the percentage of shortening was between 16 and 25 per cent; and Group III--the foot of the shorter extremity was at the level of the proximal third of the contralateral, normal limb, and the percentage of shortening was greater than 26 per cent. Lengthening was best suited for patients in Group I who had stable hips, knees, and ankles and a plantigrade foot. Patients in Groups II and III were best served by ablation of the foot and fitting of a prosthesis.

Congenital dislocation of the hip in boys.

Fifty-five boys with seventy-eight congenitally dislocated hips were treated between 1965 and 1990. The patients were divided into three groups according to the initial treatment. Group I included thirty hips (twenty-two boys) that had been treated initially with a Pavlik harness. Two hips (7 per cent) had a successful outcome, and twenty-eight (93 per cent) needed additional methods of treatment. Group II included forty-two hips (twenty-nine boys) that had been treated initially with closed reduction and immobilization in a hip-spica cast. After the closed reduction, twenty-nine hips (69 per cent) were considered stable, although fifteen (52 per cent) of them needed a secondary procedure because of residual subluxation or persistent acetabular dysplasia. Thirteen hips (31 per cent) were considered unstable after the closed reduction and subsequently had an open reduction. Group III included six hips (four boys) that had been treated initially with open reduction. Two of these hips redislocated after the open reduction, and they were reduced with an additional open reduction. A pelvic osteotomy was later performed to treat persistent acetabular dysplasia in these two hips. Two hips that had been treated with an open reduction and concomitant pelvic and femoral procedures did not need additional treatment. This study demonstrates that boys who have congenital dislocation of the hip do not always respond well to treatment and constitute a high-risk group.

Vertebral body shape as a predictor of spinal deformity in osteogenesis imperfecta.

We analyzed forty-four patients who had osteogenesis imperfecta, in order to determine the prevalence of spinal deformities. At the time of the most recent follow-up scoliosis was present in thirty patients (68 per cent) and kyphosis, in eighteen (41 per cent). According to the classification system of Falvo et al., scoliosis progressed rapidly with growth in twelve of fifteen patients who had the congenita type of osteogenesis imperfecta and in four of thirteen who had the tarda-I type. Curves that progressed before puberty did not always continue to progress after cessation of growth. Lateral roentgenograms made at the initial examination revealed four types of vertebral body deformities: biconcave, flattened, wedged, and unclassifiable vertebrae:Biconcave vertebrae were seen characteristically in patients who had the congenita type of osteogenesis imperfecta. The presence of six biconcave vertebrae or more before puberty indicated that severe scoliosis (more than 50 degrees) was likely to develop. Biconcave vertebrae did not appear to affect the severity of kyphosis. The other types of vertebral deformities were not useful for predicting progression of spinal deformity.

Fibrous dysplasia of the proximal part of the femur. Long-term results of curettage and bone-grafting and mechanical realignment.

We reviewed the long-term outcomes of treatment of fibrous dysplasia of the proximal part of the femur in twenty-two patients (twenty-seven femora). There were fifteen male patients and seven female patients. Patients who had monostotic disease had no involvement of the calcar femorale, fewer microfractures, less deformity, and stronger bone that could support internal fixation. Patients who had polyostotic disease had frequent involvement of the calcar femorale; more microfractures; severe deformity, including shepherd's crook deformity; and, in many instances, bone that could not support internal fixation. Twenty-two of the twenty-seven femora had a microfracture at the time of the initial presentation. At least one osteotomy was performed in four femora that had monostotic disease and in nine femora that had polyostotic disease. Curettage and cancellous or cortical bone-grafting did not appear to have any advantage compared with osteotomy alone in the treatment of symptomatic lesions, as all grafts resorbed with persistence of the lesion. At the time of the latest follow-up evaluation, no lesion had been eradicated or had decreased in size. A satisfactory clinical result was achieved in twenty patients (twenty-four femora): nine who had monostotic disease and eleven who had polyostotic disease. Two patients who had polyostotic disease and an endocrinopathy (one of whom had bilateral involvement) had an unsatisfactory result. All three femora in these two patients had a neck-shaft angle of less than 90 degrees at the time of the most recent follow-up evaluation. Varus deformity of the proximal part of the femur is best treated with valgus osteotomy and internal fixation early in the course of the disease. If the calcar of the femoral neck is involved or if the quality of the bone is such that internal fixation is not possible, a medial displacement valgus osteotomy can provide a more mechanically favorable position for healing of the microfracture.

Chiari pelvic osteotomy in children and young adults.

We conducted a follow-up study of twenty-four patients who had been treated with a Chiari osteotomy at the Alfred I. duPont Institute between 1966 and 1981. The length of follow-up ranged from three to twenty years, and the age at operation ranged from ten to twenty-three years. The indication for the operation was either painful dysplasia or gross instability of the hip. Twelve patients had had congenital dislocation of the hip; six, poliomyelitis; three, cerebral palsy; and three had had another disorder. A good or excellent result was obtained in twenty-one of the twenty-four patients. Preoperative pain and antalgic gait were consistently improved. In twenty-one patients, the osteotomy had to be displaced more than 50 per cent to provide adequate coverage of the femoral head, and bone-grafting was necessary at the site of the osteotomy to prevent problems with healing.

Osseous and non-osseous coalition of the middle facet of the talocalcaneal joint.

Sixteen patients (eighteen feet) who had a coalition of the middle facet of the talocalcaneal joint had operative resection of the coalition because nonoperative treatment, such as casts, failed to relieve the symptoms. The patients were symptomatic for an average of one and a half years (range, four months to two years) before they were seen by us. The average age at the time of the operation was fourteen years (range, seven to nineteen years). Three feet had resection with no material interposed, six had resection with interposition of fat, and nine had resection with interposition of half of the tendon of the flexor hallucis longus muscle. The average length of follow-up was four years (range, two to eight years). The result was excellent for eight feet, good for eight feet, and fair for one foot; for one foot, the result was poor because the coalition recurred. Three types of coalition were identified on preoperative computed-tomography scans that correlated with the operative findings. Type I was an osseous bridging of the middle facet joint (five feet). Type II (cartilaginous coalition) was marked narrowing of the middle facet joint with cortical irregularity (three feet). In Type III (fibrous coalition), there was only slight narrowing of the middle facet joint (ten feet). The type of coalition did not influence the result. Fibrous coalitions were the most difficult to detect; bone scintigraphy was used to confirm the diagnosis when other tests were equivocal. We believe that symptomatic coalition of the middle facet of the talocalcaneal joint should be treated with resection when non-operative methods fail to relieve symptoms.

Surgical treatment of dysplastic spondylolisthesis. Results after in situ fusion.

STUDY DESIGN: Fourteen patients who had symptomatic dysplastic spondylolisthesis with an intact pars interarticularis underwent posterolateral spinal fusion. Patients initially had low back pain, tight hamstrings, and limited forward bending. In addition, four patients had signs of progressive cauda equina or nerve root impingement. In 10 patients (71%), preoperative degree of slippage was more than 50% (mean, 72%). METHODS: Ten patients underwent in situ posterolateral spinal fusion, and four patients with progressive neurologic symptoms had posterior decompression followed by in situ posterolateral spinal fusion. RESULTS: All patients had solid fusion at last follow-up. A pseudoarthrosis developed in one patient, which healed after a second operation. Roentgenographic progression of the slip after fusion was rare. CONCLUSIONS: This study demonstrated that for dysplastic spondylolisthesis in children and adolescents, in situ posterolateral spine fusion yields satisfactory results. In addition, in the presence of progressive cauda equina or nerve root impingement, posterior decompression may be necessary.

The Stryker knee arthrometer in clinical practice.

The Stryker knee arthrometer was assessed in the environment of a nonspecialized National Health Service clinic by junior doctors in training. Forty percent of proven anterior cruciate deficient knees had a measured anterior excursion of 2 mm or less compared with the normal side under the same circumstances. Twenty percent of normal knees tested showed more than this variation between knees when different observers were compared and also when the same observers were compared at three week intervals. There is thus a question about the use of this machine in a general orthopaedic clinic with different observers.

Lesions of the patellar ligament.

We report 18 cases of pain and tenderness in the mid-part of the patellar ligament in athletes. The condition may be disabling, but it responds to surgery. Ultrasound and CT scans were positive in all 17 confirmed cases, but ultrasound gave a better distinction between the cysts, granulation tissue, metaplasia, mucoid degeneration and congenital defects found at operation.

Oesophageal manometry in noncardiac chest pain.

Chest pain of oesophageal origin is an important differential diagnosis in patients with cardiac chest pain. A preliminary survey of 40 patients with noncardiac chest pain (NCCP) revealed oesophageal motility disorder in 47.5%; achalasia cardia being the most frequent disease (47.3%). 15.8% of these patients with motility disorder had features of progressive systemic sclerosis and another 15.8% had non specific oesophageal motility disorder (variants). Compared to barium swallow, oesophageal manometry was found to be superior in the diagnosis of oesophageal motility disorder.