Management of open olecranon fractures using clamp-cum-compressor device

Background:

Open fractures of olecranon are not a rare occurrence in patients with road traffic accidents particularly motor bike riders who don''t use elbow guards. Definitive treatment has to be delayed in many till the wound heals. The present study was conducted to evaluate the results of open fractures of olecranon using clamp-cum-compressor device.

Materials and Methods:

Seventeen patients between the ages of 20 and 45 years of open olecranon fractures reported 5-20 days after injury were treated using an indigenous clamp-cum-compressor. All fractures were Mayo type II-A, i.e., displaced, stable and noncomminuted. Four patients had Gustilo-Anderson grade I and 13 had Gustilo-Anderson grade II open fractures. The patients with transverse or short oblique fractures were included in the study. The apparatus was applied under regional anesthesia after thorough washing and debridement of wounds with few loose sutures applied wherever needed. The wounds healed within 2-4 weeks and fractures united within 8-10 weeks. The elbow was mobilized with apparatus still in place. The results were evaluated by MayoElbow performance score.

Results:

We achieved excellent results in twelve patients, good in four and poor in one patient, who reported late, hooks of the apparatus were cut through the proximal fragment, leading to union of fracture in elongation and restricted elbow movements.

Conclusion:

The apparatus was found to be quite useful in transverse and short oblique fractures with contamination or infection, where internal fixation has to be delayed or avoided.     

Genetic variation in small proline rich protein 2B as a predictor for asthma among children with eczema

BackgroundSmall proline rich protein 2B (SPRR2B) is a skin and lung epithelial protein associated with allergic inflammation in mice that has not been evaluated in human atopic diseases.ObjectiveTo determine whether single-nucleotide polymorphisms (SNPs) in SPRR2B are associated with childhood eczema and with the phenotype of childhood eczema combined with asthma.MethodsGenotyping for SPRR2B and filaggrin (FLG) was performed in 2 independent populations: the Cincinnati Childhood Allergy &; Air Pollution Study (CCAAPS; N = 762; birth-age, 4 years) and the Greater Cincinnati Pediatric Clinical Repository (GCPCR; N = 1152; ages 5–10 years). Eczema and eczema plus asthma were clinical outcomes based on parental report and clinician's diagnosis. Genetic analyses were restricted to whites and adjusted for sex in both cohorts and adjusted for environmental covariates in CCAAPS.ResultsVariants in SPRR2B were not significantly associated with eczema in either cohort after Bonferroni adjustment. Children from both cohorts with the CC genotype of the SPRR2B rs6693927 SNP were at 4 times the risk for eczema plus asthma (adjusted odds ratio, 4.1; 95% confidence interval, 1.5–10.9; P = .005 in CCAAPS; and adjusted odds ratio, 4.0; 95% confidence interval, 1.8–9.1; P < .001 in the GCPCR), however. SNPs in SPRR2B were not in strong linkage disequilibrium with the R501X and del2282 FLG mutations, and these findings were independent of FLG.ConclusionsAn SNP in SPRR2B was predictive of asthma among white children with eczema from 2 independent populations. SPRR2B polymorphisms may serve as important predictive markers for the combined eczema plus asthma phenotype.     

A study of the effect of nasal modes of ventilation on the incidence of gastro-oesophageal reflux in preterm neonates

Background

Nasal modes of respiratory support cause variable amounts of gastric dilatation which may increase gastro-oesophageal reflux (GER) in preterms. To compare the incidence of GER in nasally ventilated, preterm babies with controls (babies not on ventilation). Type of study: A prospective, observational comparative study.

Method

Twenty-three preterm babies of gestational age 28–36 weeks and weight ranging between 1,000 g and < 2,500 g on either nasal continuous positive airway pressure (nCPAP) or nasal intermittent positive pressure venti-lation (nIPPV) were assessed for GER. They were compared with controls not on ventilation some of who were test babies when off ventilation (subgroup A) and some were unrelated babies not on ventilator but matched for gestational age and weight with test babies (subgroup B). All babies were subjected to continuous, oesophageal pH monitoring with dual sensor (upper and lower oesophageal) catheters. Reflux index (RI) was calculated as the percentage of study time the lower oesophageal pH was < 4. Primary outcome was the RI in the test and controls groups. Secondary outcome was the temporal relation of the reflux with symptoms if any. Numerical data were shown as mean with standard deviation and statistical comparisons were done using the χ²-test, Fischer test, and t-test wherever applicable.

Results

The RI was higher in ventilated babies as compared to the control group, particularly in the subgroup A, where test babies formed their own controls. Grade IV reflux (7 cases) was seen only in the ventilated babies. There was no difference in the incidence of GER in babies on nCPAP as compared with nIPPV. Grade IV reflux could not be reliably predicted by RI alone. No definite temporal relation between episodes of reflux and symptoms could be determined in this study.

Conclusion

There is an increase in GER in preterms on nasal modes of ventilation. A combination of upper (pharyngeal) and lower oesophageal sensors are preferred to a single lower oesophageal sensor when assessing GER by oesophageal pHmetry in neonates.     

Comparative evaluation of gustatory function between postmenopausal women and age‐matched men

Oral Diseases (2010) 16 , 469–475 Objective: The aim of the study was to compare the gustatory function between postmenopausal women and age‐matched men. Subjects and methods: During a period of 4 months, 30 postmenopausal women and 30 age‐matched men were prospectively evaluated for gustatory function. Each subject was given a symptoms questionnaire for self‐assessment of taste function. Then, whole mouth taste test was performed in which the quality identification and intensity ratings of taste solutions were measured. Results: Regarding correct quality identification, the results were statistically non‐significant (P > 0.05). As far as the intensity judgments are concerned, significant difference exists between postmenopausal women and age‐matched men. Intensity of taste perception for sucrose was significantly lower in postmenopausal women than intensity of taste perception for other tastes (P < 0.05). One of the noticeable findings is that 15 (50%) postmenopausal women reported a change in dietary habits; all expressed liking for sweeter food. Conclusion: Postmenopausal women appeared to have a reduced perception of sucrose, which can alter eating habits, such as intake of more sweet foods, whereas no significant difference is observed in taste perception of NaCl, citric acid and quinine hydrochloride between postmenopausal women and age‐matched men. Fifteen (50%) postmenopausal women stated fondness for sweet taste.     

Random Amplification of Polymorphic DNA Based Typing of Pseudomonas Aeruginosa

Pseudomonas aeruginosa was isolated from various sources during the course of an epidemic outbreak of bacterial endophthalmitis following an eye camp at Sangli, Maharashtra. 15 distinct isolates were obtained from clinical samples. Typing of the 15 isolates was performed by random amplified polymorphic DNA (RAPD) analysis, pyocin typing and antibiogram. RAPD typing was rapid, labour friendly and could be done within six hours. RAPD analysis produced reproducible electrophoretic band patterns on the basis of which three distinct amplification patterns could be visualised. The conventional typing methods were labour intensive and took about 48 hours. However, the results of RAPD typing, pyocin typing and antibiogram did not correlate with each other. This study suggests that RAPD typing could be an additional rapid typing method for studying the epidemiology of infectious disease outbreaks due to P aeruginosa.Key Words: Antibiogram, Pseudomonas aeruginosa, Pyocin     

HEALTH AND PERFORMANCE OF MILITARY PERSONNEL IN COLD CLIMATIC ENVIRONMENT OF THE WESTERN HIMALAYAS

Indian Armed Forces are constrained to deploy a large number of troops in the western Himalayas in the interest of national security and territorial integrity. The region represents extremely rugged, arid and cold climatic conditions. The altitude ranges from 8000 to 23000 feet with winter temperatures ranging from -35°C to - 55°C in some regions. Low environmental humidity, hypo-baric hypoxia and high solar ultra-violet radiation with its attendant problems further compound the hardships faced by the troops in these climatic conditions. The role of the Armed Forces medical personnel is extremely challenging, as they have to ensure maintenance of health and physical fitness of the troops to ensure optimal performance during peace and during operations. These considerations include nutrition, physical fitness programmes suitable for the terrain and climatic conditions, protection against cold and hypoxia induced health problems, clothing and shelter taking into consideration the ergonomic factors, human waste disposal and prompt medical attention and evacuation in case of illness. An overview of the effects of cold hypoxic environment on health and performance of Indian troops, measures employed by the Armed Forces to maintain health of troops including psychological factors and the incidence of various cold induced health problems during peace time compared to operational period over the last 10 years is presented in this paper.KEY WORDS: Cold climatic environment, Health and performance, Military personnel     

Mexican Norms For The Stanford Hypnotic Susceptibility Scale,Form C

Normative data for the Mexican adaptation of the Stanford Hypnotic Susceptibility Scale, Form C (SHSS:C) are presented. Twenty-seven raters administered the scale to 513 Mexican volunteers. Score distribution, item analysis, and reliability of the SHSS:C are presented and compared to other international norming studies. The findings show that the Mexican adaptation of the SHSS:C has psychometric properties essentially comparable to those of the Dutch, German, Italian, and United States reference samples. However, the elevated sample mean suggests Mexicans may have an elevated ability to engage in hypnotic behavior, thus they would likely be especially good candidates for hypnotherapeutic interventions that would better the health options currently available.     

Large-scale sequencing to identify disease causing variants in X-linked mental retardation

A systematic, large-scale resequencing screen of X-chromosome coding exons in mental retardation
Tarpey et al. (2009)
Nature Genetics 41: 535–543     

High prevalence of vitamin D insufficiency and its association with BMI-for-age among primary school children in Kuala Lumpur,Malaysia

Background  

Deficiencies of micronutrients can affect the growth and development of children. There is increasing evidence of vitamin D deficiency world-wide resulting in nutritional rickets in children and osteoporosis in adulthood. Data on the micronutrient status of children in Malaysia is limited. The aim of this study was to determine the anthropometric and micronutrient status of primary school children in the capital city of Kuala Lumpur.