A comparative study of variable angle volar plate and bridging external fixator with K-wire augmentation in comminuted distal radius fractures.

PURPOSE: Comminuted intraarticular distal radial fractures are difficult to treat conservatively and require operative treatment. This study compared the functional outcomes between variable angle volar plating and external fixator with K-wire augmentation in open reduction and internal fixation. METHODS: A total of 62 adult patients with comminuted intraarticular distal radius fracture were randomized into 2 groups: volar plate group and external fixator group. These patients aged between 18 and 60 years had unilateral fractures, and agreed to be included in the study. Patients with a history of fracture, bilateral fracture, associated other injuries, delayed injury for more than 2 weeks, open fracture, pre-existing arthrosis or disability, psychiatric illness and pathological fracture were excluded. Patients were followed up at 6 weeks, 3 months, 6 months and 1 year. The assessment of pain, functional activity, range of motion and grip strength was done at each stage of follow-up. The pain and functional activities were assessed by patient rated wrist evaluation (PRWE) score and disabilities of the arm, shoulder and hand (DASH) score. RESULTS: Patients in volar plate group had superior PRWE score and DASH score at each stage of follow-up. At 1 year follow-up, the mean PRWE score were 7.48 for volar plate group and 7.35 for external fixator group; while the mean DASH score was 4.65 for volar plate group and 5.61 for external fixator group. They had better flexion and extension range of movement. They also had better pronation and supination range of motion at initial follow-up, however the difference get attenuated by 1 year. Volar plate group had significantly better grip strength than external fixator group. Complication rates were higher in external fixation group. CONCLUSION: Fixation with variable angle volar plate results in early wrist mobilization, better range of movement, less pain and disability and early return of function.

Monkeypox Virus (MPXV) Infection: A Review.

Monkeypox is a viral disease; its outbreak was recently declared a global emergency by the World Health Organization. For the first time, a monkeypox virus (MPXV)-infected patient was found in India. Various researchers back-to-back tried to find the solution to this health emergency just after COVID-19. In this review, we discuss the current outbreak status of India, its transmission, virulence factors, symptoms, treatment, and the preventive guidelines generated by the Indian Health Ministry. We found that monkeypox virus (MPXV) disease is different from smallpox, and the age group between 30-40 years old is more prone to MPXV disease. We also found that, besides homosexuals, gays, bisexuals, and non-vegetarians, it also affects normal straight men and women who have no history of travel. Close contact should be avoided from rats, monkeys and sick people who are affected by monkeypox. To date, there are no monkeypox drugs, but Tecovirimat is more effective than other drugs that are used for other viral diseases like smallpox. Therefore, we need to develop an effective antiviral agent against the virulence factor of MXPV.

Comparative antidandruff efficacy of plant extracts prepared from conventional and supercritical fluid extraction method and chemical profiling using GCMS.

BACKGROUND: To combat dandruff associated pathogens, supercritical fluid extraction (SFE) can be used as an alternative eco-friendly technique to obtain antimicrobial plant extracts over conventional methods. OBJECTIVES: The purpose of the study was to compare the yield and antimicrobial potential of extracts obtained by different extraction methods. METHODS: Extraction was carried out by cold percolation method using ethyl acetate (EA) and SFE using CO2. Antimicrobial activity was studied against dandruff causing microbes; Malassezia furfur, Propionibacterium acne, and Staphylococcus epidermidis by agar well diffusion and micro broth dilution method. Statistical evaluation was done by principal component analysis (PCA). RESULTS: The yield was found higher in the ethyl acetate extracts. PCA indicated that among the sixteen extracts, SFE extract of Azadirachta indica leaves was the most influential with the highest F1 score and maximum antimicrobial activity. Cinnamomum zeylanicum SFE extract demonstrated the lowest MIC against P. acne and M. furfur. GC-MS analysis of A. indica extract inferred that ganoderic acid, 13,14-epoxyoleanan-3-ol acetate, henicosanal, 2-heptadecycloxirane were the major phytoconstituents whereas cinnamaldehyde, α- muurolene and caffeic acid were primarily found in cinnamon. CONCLUSION: Bioactive compounds identified in the extracts of A. indica and C. zeylanicum can be used in natural antidandruff products.

Target Based Virtual Screening of New Leads Inhibitor against Bacterial Cell Division Protein FtsZ for the Discovery of Antibacterial Agents.

BACKGROUND: Staphylococus epidermidis coagulase negative and gram positive streptococci have emerged as major nosocomial pathogens associated with the infection of implanted medical devices and dandruff on human scalp. S. epidermidis filamenting temperature-sensitive mutant Z (FtsZ) gene encoded FtsZ protein that assembles at future bacterial cell division site that forms Z-ring structure. FtsZ is a tubulin homolog protein with low sequence similarity; this makes it possible to inhibit bacterial FtsZ protein without affecting the eukaryote cell division. OBJECTIVE: In the present study, phytochemicals of Cinnamomum zeylanicum, Punica granatum and Glycyrrhiza glabra were virtually screened for their antibacterial activity against Staphylococcus epidermidis cell division protein, FtsZ. METHODS: Molecular docking method was used to investigate new lead inhibitor against bacterial cell division protein FtsZ. SwissADME and ProTox tool were used to evaluate the toxicity of the lead molecule. RESULTS: Molecular docking based screening confirmed that among 122 phytochemicals, ß- sitosterol and glabrol showed the highest inhibitory activity against FtsZ. SwissADME tool showed ß-sitosterol and glabrol as the ideal antibacterial agents. CONCLUSION: Structure based drug design strategy has been broadly used to optimize antimicrobial activity of small molecule/ligand against large protein receptor of disease, causing pathogens which gives a major breakthrough in pharmaceuticals industries. The molecular docking and SwissADME tool showed that ß-sitosterol and glabrol may be developed to be potential topical and sublingual antibacterial agents, respectively.

Tophaceous gout in thoracic spine mimicking meningioma: A case report and literature review.

BACKGROUND: Gout is a common metabolic disorder of purine metabolism, causing arthritis in the distal joints of the appendicular skeleton. Spine involvement is rare, and very few cases of spinal gout have been reported. The authors present a rare case of axial gout with tophaceous deposits in the thoracic spinal canal resulting in cord compression and mimicking a meningioma. CASE DESCRIPTION: A 33-year-old male presented with chronic mid back pain and a progressive paraparesis. The presumed diagnosis was meningioma based on MR imaging with/without contrast that showed a posterolateral, right-sided, and T10-T11 intradural extramedullary lesion. Notable, was hyperuricemia found on hematological studies. The patient underwent a decompressive laminectomy (T9-T11) for excision of the lesion, intraoperatively, an intraspinal, chalky, white mass firmly adherent to and compressing the dural sac was removed. The histopathology confirmed the diagnosis of a gouty tophus. Postoperatively, the patient's pain resolved, and he regained the ability to walk. CONCLUSION: A gouty tophus should be included among the differential diagnostic considerations when patients with known hyperuricemia present with back pain, and paraparesis attributed to an MR documented compressive spinal lesion.