Evaluation of Results of Different Treatment Modalities in Management of Diaphyseal Fractures of Humerus.

Introduction: This paper presents evaluation of 103 patients of diaphyseal fractures of humerus treated by different modalities with a mean follow-up of two years. Material and methods: This is a prospective and retrospective study conducted at Dr Rajendra Prasad Govt. Medical College and Hospital, Kangra (Tanda), HP, India during the year 2005-2006. It aimed at finding out comparison of the results obtained by different modes of treatment in fractures of humeral diaphysis. We studied a total of 103 patients out of which a prospective study involved 72 patients and a retrospective study (2003-2004) involved 31 patients (whose records were available). All the cases were examined clinically and radiologically and were managed with an appropriate method of treatment. The closed fractures were classified by Muller’s classification while Gustillo Anderson was used for open fractures. The nonoperative methods included cooptation or U-shaped brachial splint or U-slab, hanging arm cast, Velpeau dressing, Shoulder spica cast and functional brace. The patients with failure of closed reduction, with complex fracture geometry or open fractures were treated by operative methods. The patients were followed up weekly for the first three weeks and than at six weekly intervals to a maximum of two years (range 16-26 months) or till the union was achieved. From the prospective study, three patients were lost to follow-up and hence excluded from the study. Functional outcome was assessed by Modified Stewart and Hundley (1955) criteria. Results: Out of 100 patients there were (44 A fractures [A1-13, A2-9, A3-22], 36 B fracture [B1-26, B2-9, B3-1] and 20 C fractures [C1-15, C2-4, C3-1]). Out of these 14 fractures were associated with open injury (2 Grade I , 4 Grade II, 4 Grade IIIa, 3 Grade IIIb, 1 Grade IIIc). Forty-six cases treated conservatively united at 24 weeks (15.65 weeks) and 54 patients, which were treated by different modalities united at 36 weeks (Ex-fixator), 22 weeks (Nail), 20.3 weeks (Plate and screws). Good results were obtained in 100% by Velpeau dressing in children, 85% by U-slab, 50% by plate and screws and 33.3% with nailing. There were postoperative complications like infection (6%), radial nerve palsy (2%) and nondelayed union (5-6%). Conclusion: Conservative management is method of choice in management of closed diaphyseal fractures of humerus as it gives early union, better limb function and is devoid of any of the routine postoperative complications. Patients with failed conservative treatment, open fractures and fractures with complex geometry are better managed operatively. ORIF with plate and screws has proven to be better than nailing procedures in present series in terms of giving better functional outcome. Patients treated with external fixator had mostly fair and poor outcome as injuries dealt by them were open type III injuries.

Malaria in seasonal migrant population in Southern Gujarat, India

Malaria in migrant workers is always a major problem to control due to their temporary stay in shelters, and other operational constraints. Hence, a study was undertaken in brick kilns in Bharuch district, Gujarat state, India to study the problem of malaria in the work force. Mass blood surveys were carried out in 15 brick kilns. Blood slides were collected from both febrile and afebrile cases. Positive cases were treated as per the national drug policy and were followed up. Mosquito collections were carried out by pyrethrum spray collection in early morning hours. Human blood index and sporozoite rates were determined as per standard procedures. All age groups were found affected with malaria at brick kilns. Prevalence of malaria was significantly higher in 50% in migrant population. In stable population in villages, overall decline in malaria cases was observed in 2008-2010. The sporozoite rate of 4.2% in Anopheles culicifacies indicates active malaria transmission at brick kilns. The investigation demonstrated that suitable microclimatic conditions for malaria transmission exist in these areas during hottest period. The district health department should consider these factors in planning malaria surveillance and control. As current magnitude and diversity of population movements in rural as well as in urban areas are unprecedented, this issue is worthy of attention.

Enzymatic characteristics of quercetinases from some indigenous Aspergillus flavus strains.

Five indigenous Aspergillus flavus strains MTCC-2206, 1884, 1883, 1783 and 2456 were screened for the secretion of quercetinase. Fungal strains MTCC-2206, 1884, 1883, and 1783 were found to secrete the quercetinase in the range of 0.24-0.36 enzyme unit/mL of the culture medium, while MTCC-2456 secreted only 0.04 enzyme unit/mL. The enzymatic characteristics of quercetinase were determined. The Km values using quercetin as the substrate were 12.5 microM, 14.0 microM, 12.5 microM and 13.0 microM for the quercetinase produced by MTCC-2206, 1884, 1883 and 1783, respectively. The pH optima for the above enzymes were 6.5, 6.5, 6.0 and 6.0 and temperature optima were 45, 40, 45 and 50 degrees C, respectively. The partial purification from only one strain MTCC-2206 was achieved (nearly 3-fold purification).

Purification of a peroxidase from Solanum melongena fruit juice.

Solanum melongena fruit juice contains peroxidase activity of the order of 0.125 IU/mL. A method for the 11-fold purification of the enzyme was developed. The Km values of the peroxidase for the substrates guaiacol and hydrogen peroxide were 6.5 mM and 0.33 mM, respectively. The pH and temperature optima were 5.5 and 84 degrees C, respectively using guaiacol as the substrate. Sodium azide and phenyl hydrazine inhibited the enzyme competitively.

Field evaluation of biolarvicides in Surat city, India.

BACKGROUND & OBJECTIVES: Two bacterial larvicide (bio-larvicide) formulations--Bacticide and VectoBac containing viable endospores and delta endotoxin of Bacillus thuringiensis var israelensis H-14 were evaluated in 2001 for their mosquito larvicidal efficacy under the operational conditions of urban malaria control programme in Surat city, India. METHODS: Larvicides were applied at the recommended dose in selected breeding habitats of Anopheles (An. stephensi), Aedes (Ae. aegypti) and Culex (Cx. quinquefasciatus) and reductions in the densities of III and IV instars were compared with that of untreated matched controls. RESULTS : At the construction sites in cemented tanks/chambers VectoBac produced reduction in the density of III and IV instar larvae of An. stephensi (98-100%) and Ae. aegypti (100%) in the first week of application whereas Bacticide produced 71-100% reduction in An. stephensi and 100% in Ae. aegypti. Re-application of VectoBac on Day 10 caused better control up to Day 20 when compared with Bacticide. In stagnant water pools, VectoBac produced 27.6-85.3% reduction in the larvae of An. subpictus and 18.5-83.8% in those of Cx. quinquefasciatus whereas Bacticide produced 23.3-30.3% and 39-97.2% reduction in An. subpictus and Cx. quinquefasciatus larval densities in the first week post application, respectively. Bacticide application gave better impact on Cx. quinquefasciatus larvae in the second week after re-application as compared to VectoBac. In storm water drains, VectoBac caused respectively 6.2-100% and 6.4-97.6% reduction in An. subpictus and Cx. quinquefasciatus larvae in the first week of application whereas Bacticide produced 100% and 13.3-98.8% reduction in An. subpictus and Cx. quinquefasciatus larval densities, respectively. INTERPRETATION & CONCLUSION: Both the formulations were equally effective on An. subpictus and Cx. quinquefasciatus larvae after a second application. The results showed that application of these biolarvicides would be required at 7-10 day intervals. The health workers engaged in the application of biolarvicides reported a better ease of handling and application of the liquid formulation (VectoBac) than the wettable powder formulation (Bacticide).

Secretion of ligninperoxidase by Penicillium citrinum, Fusarium oxysporum and Aspergillus terreus.

Secretion of ligninperoxidase [E.C.1.11.1.7] by Penicillium citrinum, Fusarium oxysporum and Aspergillus terreus in liquid culture growth medium has been demonstrated. Enzymatic characteristics like Km, pH and temperature optima using veratryl alcohol as the organic substrate of ligninperoxidases from above sources have been determined. Km values using veratryl alcohol as substrate for enzymes from P. citrinum, F. oxysporum and A. terreus were 69, 64 and 60 microM respectively. Km values using H2O2 as the variable substrate were 64, 72 and 80 microM.The pH optima were 4.0, 2.3 and 2.0 respectively. The values of temperature optima were 30 degrees, 25 degrees and 22 degrees C for the enzymes from P. citrinum, F. oxysporum and A. terreus respectively.

Musa paradisiaca stem juice as a source of peroxidase and ligninperoxidase.

Musa paradisiaca stem juice has been shown to contain peroxidase activity of the order of 0.1 enzyme unit/ml. The Km values of this peroxidase for the substrates guaiacol and hydrogen peroxide are 2.4 and 0.28 mM respectively. The pH and temperature optima are 4.5 and 62.5 degrees C respectively. Like other peroxidases, it follows double displacement type mechanism. At low pH, Musa paradisiaca stem juice exhibits ligninperoxidase type activity. The pH optimum for ligninperoxidase type activity is 2.0 and the temperature optimum is 24 degrees C. The Km values for veratryl alcohol and n-propanol are 66 and 78 microM respectively.

Malaria outbreak in a tribal area of Gujarat state, India.

Malaria incidence in Gujarat state had been on a general decline since 1989. However in some tribal villages in forested areas of Valsad district, southern Gujarat, there was an outbreak of malaria in September 1995. Five children died in Ashlona village. During investigation conducted in October 1995 in affected villages, the malaria parasite rate was 26% (217/833) with >91% infections due to P. falciparum. A high proportion of P. falciparum infections had ring stages suggesting active transmission. Against a minimum norm of 10% annual blood examination rate, there was a major breakdown of active surveillance for malaria. In the absence of health agencies in or near affected villages, the malaria parasite load continued to build up leading to an outbreak towards the end of monsoon season. Indoor residual spraying with deltamethrin caused significant reduction in densities of malaria vector An. culicifacies. Measures to prevent malaria outbreaks in inaccessible areas have been discussed.

Influence of nutritional and haemoglobin status on malaria infection in children.

Anaemia and malnutrition have been suggested to confer some degree of protection against malaria infection. Therefore, the influence of nutritional status as assessed anthropometrically and that of haemoglobin level on the incidence of malaria and the degree of parasitaemia was studied in 330 children in the age range of 1-9 years in Bisra block near Rourkela in Orissa state. Moderate to severe malnutrition as assessed from percentage of ideal weight was found in 48.8% (161/330) of children but only 8.8% (29/330) of children had some degree of malnutrition when assessed as weight for height indicating presence of chronic malnutrition. Similarly, 197 children (59.7%) had various grades of anaemia as estimated by haemoglobin level prevalence of malaria on initial examination was 27.6% (91/330), while incidence of clinical malaria in children during the year of study was 250/1000. There was no statistical difference in the Prevalence/incidence of malaria or severity of P. falciparum parasitaemia at different haemoglobin or nutritional levels (p > 0.05). No child died or developed severe complications requiring hospitalization. Therefore, anaemia or malnutrition do not appear to provide any protection against malaria or degree of parasitaemia in the children around Rourkela.