An insight into Transfemoral Prostheses: Materials, modelling, simulation, fabrication, testing, clinical evaluation and performance perspectives.

INTRODUCTION: A transfemoral prosthesis restores any limb amputated above the knee. Designing and developing a transfemoral prosthesis that is consistent with human performance is a tough task. While prosthetic components are widely available in the market, ongoing research is being conducted to develop parts that would restore the lost capability, taking into account numerous social, economic, and technological considerations. AREAS COVERED: The present paper provides a comprehensive review about the mechanical aspects and performance of transfemoral prosthesis in recent years based on the research findings on materials, manufacturing methods, and evaluations for suitability of the prostheses. The fundamental terminologies as well as technical advancements are covered in order to impart a better knowledge in the area of Lower Limb prostheses. This review also provides a concise description on the role of computers, advanced software packages, sensors, and other hardware components for the design, fabrication, and testing of transfemoral prosthetic devices in the current environment. EXPERT OPINION: The current state of lower limb prostheses and future research opportunities are summarized to address upcoming challenges. Based on survey of various research works, adapting modern technology may aid in the development of functional and cost-efficient prosthetic components with superior safety, comfort, and quality.

Near-miss Thoracic Spine Solitary Plasmacytoma with Neurological Deficit during Pregnancy: A Case Report.

Solitary plasmacytoma (SPC) account for only 5% of plasma cell neoplasms, and the literature hardly reports spinal SPC with a neurological deficit. Furthermore, spinal surgical intervention during pregnancy is rarely encountered and often requires multidisciplinary collaboration and management. The objective of this case report is to highlight this near-miss diagnosis and spinal surgical intervention during pregnancy. A 31-year-old woman with 24 weeks gestation presented with sudden paralysis and incontinence, with an underlying history of chronic backpain over a two-month period. Initially, she was treated for musculoskeletal back pain by obstetric colleagues during an antenatal visit, and no radiograph was performed. A non-contrasted spinal MRI was eventually requested when she started to show bilateral lower limb weakness, numbness and incontinence. The MRI highlighted thoracic vertebrae T11 vertebra plana with kyphotic deformity and a paraspinal soft tissue mass compressing the spinal cord causing spinal cord oedema. Our initial working diagnosis was spinal tuberculosis (TB), considering TB is highly endemic in Malaysia. However, TB workup was negative, and we proceeded with spinal surgery and transpedicular biopsy. Neurology improved significantly after surgery. Eventually, serum protein electrophoresis reported plasma dyscrasia, and HPE confirmed plasmacytoma. The patient was referred to a haematologist for steroidal and chemotherapy treatment.

Evaluation of third molar maturity index (I3M) in assessing the legal age of subjects in an Indian Goan population.

India affords special laws and exemptions to minors under the criminal, marriage, labour and administrative laws. Many perpetrators claim to be a minor in the hope of a lenient trial and verdict. The authorities often rely upon forensic experts to provide evidence-based reports. The third molar can be relied upon in the assessment of legal age as it continues developing into the early twenties. The method established by Cameriere et al in 2008 provides an objective method for the accurate evaluation of legal age. Our study was designed to analyze and validate the efficacy of Third Molar Maturity index (I3M) in an Indian Goan population and compare it to published literature. 542 panoramic radiographs of subjects aged between 14 and 24 years were evaluated. The chronologic age increased as I3M reduced. There was no evidence of sexual dimorphism in third molar development across various I3M classes (p>0.05). Receiver Operator Characteristic Curve was plotted for males and females which showed an Area Under Curve of 0.95 (95% CI, 0.92-0.97) and 0.93 (95% CI, 0.90-0.96) respectively. 2x2 contingency tables were used to test the performance of various I3M cut-off values ranging from I3M=0.02 to 0.14. I3M = 0.08 showed the most promising results for the assessment of legal age. Our study achieved a high degree of accurate classification of 0.90 and 0.88 for males and females respectively. Results demonstrate a sensitivity of 0.899 and 0.854 and specificity of 0.90 and 0.93 for males and females respectively. The positive likelihood ratios were 9.88 and 12.44 while negative likelihood ratio was 0.11 and 0.15 for males and females respectively. A favourable Bayes Post Test Probability of 0.95 was noted for both males and females. These results allow us to strongly recommend the use of I3M for the assessment of legal age in an Indian Goan population.

Near-miss Thoracic Spine Solitary Plasmacytoma with Neurological Deficit during Pregnancy: A Case Report

@#Solitary plasmacytoma (SPC) account for only 5% of plasma cell neoplasms, and the literature hardly reports spinal SPC with a neurological deficit. Furthermore, spinal surgical intervention during pregnancy is rarely encountered and often requires multidisciplinary collaboration and management. The objective of this case report is to highlight this near-miss diagnosis and spinal surgical intervention during pregnancy. A 31-year-old woman with 24 weeks gestation presented with sudden paralysis and incontinence, with an underlying history of chronic backpain over a twomonth period. Initially, she was treated for musculoskeletal back pain by obstetric colleagues during an antenatal visit, and no radiograph was performed. A non-contrasted spinal MRI was eventually requested when she started to show bilateral lower limb weakness, numbness and incontinence. The MRI highlighted thoracic vertebrae T11 vertebra plana with kyphotic deformity and a paraspinal soft tissue mass compressing the spinal cord causing spinal cord oedema. Our initial working diagnosis was spinal tuberculosis (TB), considering TB is highly endemic in Malaysia. However, TB workup was negative, and we proceeded with spinal surgery and transpedicular biopsy. Neurology improved significantly after surgery. Eventually, serum protein electrophoresis reported plasma dyscrasia, and HPE confirmed plasmacytoma. The patient was referred to a haematologist for steroidal and chemotherapy treatment.