How to Avoid Graft-Tunnel Length Mismatch in Modified Transtibial Technique for Anterior Cruciate Ligament Reconstruction Using Bone-Patellar Tendon-Bone Graft

BACKGROUND: We conducted this study to determine the optimal length of patellar and tibial bone blocks for the modified transtibial (TT) technique in anterior cruciate ligament (ACL) reconstruction using the bone-patellar tendon-bone (BPTB) graft. METHODS: The current single-center, retrospective study was conducted in a total of 64 patients with an ACL tear who underwent surgery at our medical institution between March 2015 and February 2016. After harvesting the BPTB graft, we measured its length and that of the patellar tendon, patellar bone block, and tibial bone block using the arthroscopic ruler and double-checked measurements using a length gauge. Outcome measures included the length of tibial and femoral tunnels, inter-tunnel distance, length of the BPTB graft, patellar tendon, patellar bone block, and tibial bone block and graft-tunnel length mismatch. The total length of tunnels was defined as the sum of the length of the tibial tunnel, inter-tunnel distance and length of the femoral tunnel. Furthermore, the optimal length of the bone block was calculated as (the total length of tunnels − the length of the patellar tendon) / 2. We analyzed correlations of outcome measures with the height and body mass index of the patients. RESULTS: There were 44 males (68.7%) and 20 females (31.3%) with a mean age of 31.8 years (range, 17 to 65 years). ACL reconstruction was performed on the left knee in 34 patients (53%) and on the right knee in 30 patients (47%). The optimal length of bone block was 21.7 mm (range, 19.5 to 23.5 mm). When the length of femoral tunnel was assumed as 25 mm and 30 mm, the optimal length of bone block was calculated as 19.6 mm (range, 17 to 21.5 mm) and 22.1 mm (range, 19.5 to 24 mm), respectively. On linear regression analysis, patients' height had a significant correlation with the length of tibial tunnel (p = 0.003), inter-tunnel distance (p = 0.014), and length of patellar tendon (p < 0.001). CONCLUSIONS: Our results indicate that it would be mandatory to determine the optimal length of tibial tunnel in the modified TT technique for ACL reconstruction using the BPTB graft. Further large-scale, multi-center studies are warranted to establish our results.

Screening of maize genotypes against stem borer chilo partellus l. in kharif season.

Maize (Zea mays L.) being the highest yielding cereal crop in the world is of significant importance for countries like India, where rapidly increasing population already out stripped the available food supplies. Maize crop possesses great genetic diversity. Maize Plant is attacked by 140 species of insects causing varying degree of damage causing an annual loss of over 1 billion in the Semi Arid Tropics (ICRISAT, 1992). Out of these, only 10 species cause serious damage from sowing till storage, of which the stemborer Chilo partellus (Swinhoe) is the major one (Hiremath et al., 1988). The larvae of C.partellus after hatching feed on soft surface of the leaves and then enter the stem through whorl of feeding on the pith of the stem. The growth of the plants becomes shunted and resulting in dead hearts when attacked by C.partellus at their initial stages. The larvae transferred from other plants enter the stem through lower nodes by making the holes. Stem borers pupate inside the stem. They make holes before pupation for the emergence of adults. Since host plant resistance is the back bone of Insect Pest Management; hence the present investigation was initiated. Present studies were designed to identify maize genotype resistance against stem borer in order to minimize pesticide use, improve natural balance, and enhance the activity of bio control agents, and to increase crop production. The investigations were carried out on the screening of Maize genotypes against Maize stem borer Chilo partellus in kharif season were conducted on the agricultural farm of the institute of Agricultural Sciences, Banaras Hindu University, Varanasi during kharif season of 2010-2011 to screen the relative resistance /susceptibility of 19 genotypes of maize to the insect pest, maize stem borer (Chilo partellus). In order to screen the relative susceptibility of different maize genotypes to maize stem borer the following genotypes were screened under field conditions. The symbols T1 to T19 have been used to represent the following cultivars of maize. HUZM 217, HUZM 185, HUZM 227, HUZM 186, AH 411, NMH 9858, HUM 152, CM 119, QPM 466, QPM 467, QPM 169, QPM 193, QPM 163, HUZQPM 240, HUZQPM 241, HUZQPM 242, HUZQPM 243, HUZQPM 246, HUZQPM 247. The maize varieties were grown in plots having 19 rows, plot size 13x2.5 m². The plant spacing between rows and plants were maintained 70 cm and 20 cm, respectively. The crop was grown as per the normal agronomic practices during the kharif season of 2010-2011. The effect of natural infestation was studied. The crop was sown on 22nd July 2010 and harvested on 10th November 2010. Entire screening was based on leaf damage, dead heart formation, no. of exit holes. No. of larvae and pupae population and mean tunnel length. Dead heart formations were higher in more susceptible genotypes than least susceptible genotypes. There were no sign of dead heart was found in cultivar HUZQPM 242, HUZQPM 246, QPM 193, CM 119, AH 411, HUM 152, NMH 9858, HUZM 185, HUZM 217. Maximum occurrences of dead heart were in cultivar HUZM 227, QPM 169. Leaf damage was measured on visual rating scale. In context of leaf injury rating mean was 2.6 to 6.6. Maximum leaf damage was reported on cultivar QPM 169.Average plant height was mean of length from root to flag leaf. Mean tunnel length was divided into three categories-Least susceptible (0-5cm), moderately susceptible (5-10cm), highly susceptible (>10 cm) and respected genotypes also have been identified.

Risk Factors for Endothelial Cell Loss after Phacoemulsification: Comparison in Different Anterior Chamber Depth Groups

PURPOSE: To assess the risk factors for endothelial cell loss after phacoemulsification with implantation of intraocular lens according to anterior chamber depth (ACD). METHODS: This prospective study included 94 eyes of 94 patients undergoing phacoemulsification cataract surgery. To assess the risk factors for corneal endothelial cell loss, we examined seven variables at 1 day, 1 week, 6 weeks, and 12 weeks postoperatively in each ACD-stratified group. RESULTS: Multiple linear regression analysis showed that the only variable influencing the percentage decrease in corneal endothelial cell density throughout the postoperative follow-up period in the long ACD group (ACD III) was nucleosclerosis. The variables influencing the percentage decrease in corneal endothelial cell density in the short ACD group (ACD I) at one day and one week postoperatively were corneal incisional tunnel length and nucleosclerosis. CONCLUSIONS: Risk factors for endothelial cell loss after phaoemulsification were different according to ACD. Long corneal tunnel length can be one of the risk factors for endothelial cell loss in short ACD eyes.

Perioperative Modulating Factors on Astigmatism in Sutured Cataract Surgery

PURPOSE: To evaluate the factors that affect postoperative astigmatism and post-suture removal astigmatism, and to evaluate the risk factors associated with astigmatism axis shift. METHODS: We performed a retrospective chart review of 130 eyes that had undergone uneventful phacoemulsification cataract surgery. Preoperative astigmatism was divided into four groups (Groups I, II, III, and IV) according to the differences between the axis of preoperative astigmatism (flattest axis) and the incision axis (105 degrees). We analyzed the magnitude and axis of the induced astigmatism after the operation and after suture removal in each group. We also analyzed the factors which affected the postoperative astigmatism and post-suture removal astigmatism in each sub-group of Groups I, II, III, and IV, excluding postoperative or post-suture removal axis shift (specifically, Group I(WAS), II(WAS), III(WAS), and IV(WAS)). We identified the variables associated with the prevalence of postoperative astigmatism axis shift and those associated with the prevalence of post-suture removal axis shift. RESULTS: An increase in the magnitude of postoperative astigmatism was associated with an increase in the preoperative magnitude of astigmatism in Groups I(WAS), II(WAS), and III(WAS) (p<0.05), and with an increase in the corneal tunnel length in Group I(WAS). A decrease in the magnitude of postoperative astigmatism was associated with an increase in the corneal tunnel length in Groups III(WAS) and IV(WAS) (p<0.05). An increase in the magnitude of post-suture removal astigmatism was associated with an increase in the magnitude of postoperative astigmatism in Groups I(WAS) and IV(WAS) (p<0.05), and with late suture removal in Group IV(WAS) (p<0.05). A decrease in the magnitude of post-suture removal astigmatism was associated with late suture removal in Groups I(WAS) and II(WAS). A logistic regression analysis showed that the prevalence of post-suture removal astigmatism axis shift was associated with increased corneal tunnel length, decreased magnitude of postoperative astigmatism, and early suture removal. CONCLUSIONS: In order to reduce postoperative and post-suture removal astigmatism, we recommend a short corneal tunnel length and late suture removal in patients with Group I(WAS) characteristics, late suture removal in Group II(WAS)-like patients, long corneal tunnel length in Group III(WAS)-like patients, and long corneal tunnel length and early suture removal in patients with characteristics of Group IV(WAS).