Outcomes of Management of Severe Clubfoot among Children by Ilizarov External Fixator

@#Introduction: Clubfoot remains the most common birth defect involving the musculoskeletal system. There are various surgical and non-surgical treatment options available for the management of clubfoot. Using the minimally invasive Ilizarov external fixator method has been reported to have good success rates and fewer complications. Materials and methods: This study aimed at analysing the morphological and functional outcomes of treating severe clubfoot by Ilizarov external fixator among children from July 2017 to March 2020. Thirty-two children who had either failed Ponseti / surgery or neglected with 44 clubfeet of Dieglio type III and type IV were included in the study. A short-leg walking cast was applied for an additional six weeks after removing of Ilizarov frame and additionally followed by an orthosis for another six weeks. Outcomes were measured by the functional rating system by Laaveg and Ponseti and interpretation done at 1 month and 12 months after the ankle-foot arthrosis. Results: About 86.4% of the patients had good or excellent outcome scores. Pre and post-Demeglio scores and functional rating scores were statistically significant (p<0.001) by using Paired t-test. Complications included superficial pin site infections in 13 feet (29.54%), 5 feet (11.36%) had claw toes, 3 feet (6.81%) had linear skin necrosis and 2 feet (4.54%) had calcaneal fractures which were manageable with minor interventions. Conclusion: The study findings highlighted that the Ilizarov external fixator method can correct complex foot deformities of severe clubfoot with minimum morbidity. Further larger and long-term studies are needed to investigate the effects of the stiff hindfoot and possible degenerative changes on the function and symptoms of these patients as adults.

Comparative evaluation of post-operative pain after pulpectomy with K-files, Kedo-S files and MTwo files in deciduous molars -a randomized clinical trial / Avaliação comparativa da dor pós-operatória após pulpectomia com limas k, Kedo-S e MTwo em molares decíduos - um ensaio clínico randomizado

Objective: Despite the tortuous course of primary root canal system, a paradigm shift occurred from conventional hand files to rotary system, which lead to faster, cost-effective, uniform and predictable fillings. One of the many advantages being, reduction in post-operative pain with the use of rotary system. Many rotary file systems were introduced, with the recent one, the Kedo-S. So the present study aimed to compare and evaluate the post ­ operative pain after pulpectomy using K-files, MTwo files and Kedo-S files in deciduous molars. Material and Methods: 75 teeth were randomly divided into three groups (group A ­ K-files, group B - Kedo-S files and group C - MTwo files) for pulpectomy of primary molars. Post ­ operative pain was assessed every 6,12,24,48 and 72 hours using facial pain scale. Results: 44% of volunteers in K-file group had moderate pain followed by Kedo-S group (8%) and then MTwo files (4%). Conclusion: The least post-operative pain was found in Mtwo group followed by Kedo-S group and K-file group. (AU)

Objetivo: Apesar do curso tortuoso do sistema de canais radiculares de dentes molares decíduos, uma mudança de paradigma ocorreu das limas manuais convencionais para o sistema rotatporio, o que leva a obturações mais rápidas, econômicas, uniformes e previsíveis. Uma das muitas vantagens é a redução da dor pós-operatória com o uso do sistema rotatório. Muitos sistemas de limas rotátórias foram introduzidas, como o recente Kedo-S. Assim, o presente estudo objetivou comparar e avaliar a dor pós-operatória após pulpectomia utilizando limas K, MTwo e Kedo - S em molares decíduos. Material e Métodos: Setenta e cinco dentes foram divididos aleatoriamente em três grupos (grupo A - limas K, grupo B - limas Kedo-S e grupo C - limas MTwo) para pulpectomia de molares decíduos. A dor pós - operatória foi avaliada a cada 6,12,24,48 e 72 horas, utilizando a escala de dor facial. Resultados: 44% dos voluntários do grupo K apresentaram dor moderada, seguidos pelo grupo Kedo-S, com 8%, e MTwo, com 4%. Conclusão: A menor dor pósoperatória foi encontrada no grupo Mtwo, seguido pelo grupo Kedo-S e pelo grupo K-file. (AU)

A rapid and low-cost microscopic observation drug susceptibility assay for detecting TB and MDR-TB among individuals infected by HIV in South India.

Background: The converging epidemics of HIV and tuberculosis (TB) pose one of the greatest public health challenges of our time. Rapid diagnosis of TB is essential in view of its infectious nature, high burden of cases, and emergence of drug resistance. Objective: The purpose of this present study was to evaluate the feasibility of implementing the microscopic observation drug susceptibility (MODS) assay, a novel assay for the diagnosis of TB and multi-drug-resistant tuberculosis (MDR-TB) directly from sputum specimens, in the Indian setting. Materials and Methods: This study involved a cross-sectional, blinded assessment of the MODS assay on 1036 suspected cases of pulmonary TB in HIV-positive and HIV-negative patients against the radiometric method, BD-BACTEC TB 460 system. Results: Overall, the sensitivity, specificity, positive predictive value, and negative predictive value of the MODS assay in detecting MTB among TB suspected patients were 89.1%, 99.1%, 94.2%, 95.8%, respectively. In addition, in the diagnosis of drug-resistant TB, the MODS assay was 84.2% sensitive for those specimens reporting MDR, 87% sensitivity for those specimens reporting INH mono-resistance, and 100% sensitive for specimens reporting RIF mono-resistance. The median time to detection of TB in the MODS assay versus BACTEC was 9 versus 21 days (P < 0.001). Conclusion: Costing 5 to 10 times lesser than the automated culture methods, the MODS assay has the potential clinical utility as a simple and rapid method. It could be effectively used as an alternative method for diagnosing TB and detection of MDR-TB in a timely and affordable way in resource-limited settings.

Effect of Probiotics against Marine Pathogenic Bacteria on Artemia franciscana.

Presently an effort has been made to determine the effectiveness of probiotics against marine pathogenic bacterial load ingested by Artemia franciscana nauplii. In this experiment Artemia franciscana nauplii was allowed to ingest pathogenic bacterial strains, viz. Escherichia coli, Salmonella typhi, Salmonella paratyphi, Vibrio cholerae and Shigella sp. Probiotic organism (Bioremid) was used against the pathogenic strains on Artemia franciscana nauplii. On completion of the experiment it was observed that the use of Probiotic organism (Bioremid) reduced the pathogenic bacterial load, especially that of Shigella sp. on Artemia franciscana.