Understanding risks and complications in the management of ankle fractures

Ankle fracture (AF) is a common injury with potentially significant morbidity associated with it. The most common age groups affected are young active patients, sustaining high energy trauma and elderly patients with comorbidities. Both these groups pose unique challenges for appropriate management of these injuries. Young patients are at risk of developing posttraumatic osteoarthritis, with a significant impact on quality of life due to pain and impaired function. Elderly patients, especially with poorly controlled diabetes and osteoporosis are at increased risk of wound complications, infection and failure of fixation. In the most severe cases, this can lead to amputation and mortality. Therefore, individualized approach to the management of AF is vital. This article highlights commonly encountered complications and discusses the measures needed to minimize them when dealing with these injuries.     

How Important is the Tunnel Position in Outcomes Post-ACL Reconstruction: A 3D CT-Based Study

BackgroundDrilling the femoral and tibial tunnels at their anatomical locations are critical for good outcomes and involve seeing the footprints well. We intended to compare two techniques of drilling the tunnels and the patient-reported outcomes and knee stability of patients undergoing single bundle ACL reconstruction using 3D CT to evaluate if the tunnels were anatomical or not.Materials and MethodsSixty single bundle ACL reconstructions were analyzed, 30 each with Technique A and B. Pre-operative and after a minimum 27 month follow-up Lysholm, IKDC, Tegner score, hop test, and Lachman test were noted. 3D CT was done to classify femoral tunnels positions as being well placed, slightly or grossly misplaced and tibial tunnels as optimal or suboptimal and compared.ResultsSixty ACL reconstructions had full follow-up with a mean follow-up of 34 months. There was no significant difference between tunnel positions between the two techniques. Well-placed femoral tunnel had better Lysholm score (62.2 ± 16.2 v/s 48.5 ± 17.2, p 0.002) and IKDC score (62.5 ± 14.3 v/s 52.7 ± 15.1, p 0.012).). Those who had their surgeries within 3 months of their injury had better hop test (4.4 ± 0.9 v/s 3.9 ± 1, p 0.034) and IKDC scores (62.5 ± 15.8 v/s 33.2 ± 13.8, p 0.026) as compared to those that had surgery done after 3 monthsConclusionTibial tunnel positions were optimal in most cases and did not differ between the two techniques. Well-placed femoral tunnels and surgeries done within 3 months of the injury produced best results.     

Marcus Gunn Jaw Winking Phenomenon with Cortical Malformation

Indian Journal of Pediatrics -     

Dissipation of Imidacloprid on White Psyllium (<Emphasis Type="Italic">Plantago ovata</Emphasis>) Under Semi Arid Conditions

A supervised field trial was conducted at Anand, Gujarat during 2015 to study the rate of degradation of imidacloprid in psyllium spikes following foliar application of imidacloprid formulation, Confidor 17.8 SL (soluble liquid) @ 25 (standard dose) and 50 (double dose) g a.i. ha^?1. The Imidacloprid residues in psyllium spikes, herbage and soil samples were estimated on high performance liquid chromatograph. The method gave very good overall mean recoveries in the range of 80.37–102.58 %. The limit of detection and the limit of quantification were found to be 0.01 and 0.03 μg g^?1, respectively. The initial deposits of 0.46 and 1.21 μg g^?1 in psyllium spikes reached below determination level (BDL) of 0.03 μg g^?1 on the 10th and 14th day at standard and double dose, respectively. The half life of imidacloprid in psyllium spikes ranged from 2.9 to 3.1 days. The residues in the soil and herbage samples collected at harvest were BDL (0.03 μg g^?1) at either dose of application.     

Pregnancy-induced obsessive compulsive disorder: a case report

Pregnancy is a well-recognised risk factor in precipitating obsessive-compulsive disorder. We present and discuss a case with the onset of obsessive-compulsive disorder in the fourth month of gestation, which fully recovered two weeks after delivery. The phenomenology of the observed disorder was similar to earlier reports of obsessive-compulsive disorder in pregnancy, i.e. the obsessions and compulsions were predominantly related to the concern of contaminating the foetus resulting in washing compulsions. Despite the initial success with anti-obsessional drugs, the patient stopped the medication in the last month of gestation. Nevertheless, she fully recovered two weeks after the delivery without any psychiatric intervention. There were no obsessive-compulsive symptoms at one-year follow up. The possible mechanisms involved in the aetiology of this case, and future research directions in understanding the role of pregnancy in OCD are discussed.     

Difference in sulphur accumulation in eleven tropical tree species growing in polluted environs

The present study was aimed to find out the differences in sulphur accumulation in eleven tropical tree species exposed to air pollution containing higher levels of sulphur dioxide. Sulphur content in the leaves and branches were studied at three different polluted sites. The results were compared with a control--25 km away from the industrial belt. The results revealed a positive correlation between the atmospheric sulphur dioxide concentration and foliar sulphur content. In few tree species higher accumulation of sulphur within the branches were recorded. The paper discusses about the trees which could be planted as sulphur accumulators.