Consistency and percentage agreement of preoperative surface marking of subcutaneous foreign body by colour comet tail artefact with its intra-operative positional findings – A prospective study

Background: Exact surface localization of foreign body is vital prior to its surgical removal. Preoperative localization errors lead to excessive soft tissue exploration, prolonged surgery, increased morbidity and post-surgical complications. Sarkar KN, Mandal SK, Kabiraj P, Mallik R, Gupta DK, Sarkar M. Consistency and percentage agreement of preoperative surface marking of subcutaneous foreign body by colour comet tail artefact with its intra-operative positional findings - A prospective study. IAIM, 2016; 3(6): 32-41. Page 33 Aim: Determination of percentage agreement of preoperative surface marking of subcutaneous foreign body by colour comet tail artefact with its intra-operative positional findings. Materials and methods: Prospective observational study was conducted on 100 patients over duration of eight months from September 2015 to April 2016 at our institution. Preoperative surface marking of foreign body was done using Ultrasound machine PHILIPS HD7 (2.0.1) with 7 MHz linear transducer, Excel mark premium black stamp ink 2oz, Acco smooth steel wire paper clip, Trade mark 45 cm wooden measuring scale and Apsara glass marking pencil. Percentage agreement of preoperative surface marking of subcutaneous foreign body by colour comet tail artefact with its intraoperative positional findings was studied in 100 patients prospectively. All analysis was done by using IBM SSPS statistics 24 and MS Excel. Results: The color tail artifact technique showed percentage agreement of 93.5% for accurate surface marking of vertical line within ≤ 5 mm of actual location and percentage agreement of 92.5% for surface marking of horizontal line within ≤ 5 mm of actual location. Conclusions: Blind surgical procedures of foreign body removal have been replaced by real time ultrasound guided removal under strict sterile conditions in most of the affluent nations. However in developing nations and semi urban places where there is limited and underrated sterilization and disinfection technique, real time ultrasound procedures for foreign body removal remains a challenging option. This study shall suffice to the needs of developing nations and semi urban places with precise preoperative surface localization, advantages of minimal surgical exploration, minimal local tissue injury, reduced patient’s morbidity and no real time ultrasound associated nosocomial infection. The study shall also be helpful with special emphasis to those underserved villages where surgeons still rely on blind foreign body removal procedures, causing massive tissue exploration, increased hospital stay, increased cost of treatment, failure of removal and increased patients morbidity.

Effect of friction from differing vertical bracket placement on the force and moment of NiTi wires / 대한치과교정학회지

OBJECTIVE: The purpose of this study was to evaluate the effect of force and moment produced by Nickel-titanium wires of different sizes at activation and deactivation according to differing vertical bracket displacement. METHODS: Superelastic NiTi wires of 3 different sizes (0.014", 0.016", and 0.016" x 0.022") were tied with elastomeric or 0.009-inch stainless steel ligations in a twin-bracket, 0.018-inch slot. A testing machine recorded the effects of simulated activation of 5 distances from 1 to 5 mm and deactivation of 5 distances from 4 to 0 mm, in increments of 1 mm. RESULTS: Frictional force increased the wire stiffness during loading. Ligation of 0.014-inch NiTi wire with O-ring resulted in a significant increase in the stiffness. On application of orthodontic force for 5 mm of vertical displacement of teeth, the effective displacement in the case of the 0.014", 0.016", and 0.016" x 0.022" NiTi wires was 2 mm, 3 mm, and 4 mm, respectively. CONCLUSIONS: Our results showed that movement of teeth with large vertical displacement was ineffective because of excessive friction. This finding might contribute to the understanding of the force system required for effective teeth movement and thereby facilitate the application of the appropriate light wire for leveling and alignment.

The experimental study of safe vertical displacement for minimal infusion rate change of syringe pumps / 中国实用护理杂志

Objective To find the safe vertical displacement for minimal infusion rate change of syringe pumps as the theoretical guidance for moving pumps. Methods The infusion volume within 1 minute after none and vertically moving 15, 25, 35, 50 cm of the pumps (microinfusion pump WZ-50C、WZ-50C2、BRAUN perfusor compact) at 10 ml/min were weighted and compared by the electronic balance. Results Significant differences of the infusion rate were detected. The difference of average infusion volume within 1 minute after vertically moving 15, 25, 35, 50 cm and non-movement were 0.004 (minimal),0.017, 0.033, 0.046ml. The lowest infusion curve of 15cm displacement stretches slightly above the horizontal plane until the inflexion in the section graph, leading to steeper in accordance with the increasing vertical displacement of the pumps,which implied the following drastic increase in infusion rate. Conclusions The minimal infusion change is obtained at 15cm, thus becomes the safe displacement height and the inflexion point of further soaring changes.

Shoulder Subluxation in Hemiplegia: Comparison of Therapeutic Effects of Four Different Types of Slings

The purpose of this study is to compare the effectiveness of the Rolyan, hemisling, remodified Bobath, and the newly designed triangular Bobath slings. Sixteen patients with a shoulder subluxation were evaluated by the simple shoulder AP X-rays with and without slings. The hemisling was applied with the elbow flexed at 90 and 120 degrees. The radiologic evaluation for the detection of shoulder subluxation was done by measuring the vertical and horizontal displacement on a plain AP view. The mean value of vertical displacement without a sling application was 5.21 cm which was reduced to 4.30 cm by a triangular Bobath sling application and 4.32 cm by a hemisling application at 120degrees elbow flexion. These two slings significantly corrected the vertical displacement, but other were not. In nine of sixteen patients, the triangular Bobath sling was the best sling for the vertical correction. All slings except a hemisling increased the horizontal displacement even though it was not statistically significant. The triangular Bobath sling improved the discomfort of the axilla better than the remodified Bobath sling. The results support that the triangular Bobath sling was the best among 4 slings for the correction of shoulder subluxation, although a reduction in lateral displacement and an improvement in applicability need to be explored further.