A trilogy of the oculomotor system: Part I: Ocular movements, finalities, and measurements

ABSTRACT The paper starts discussing the teleological concept that eye motions - rotations and translations - serve to vision (which supports the notion that torsions are not voluntarily driven, since they do not contribute to expand the visual exploration of space). It proposes that the primary position of the eye (not "of gaze") , the standard condition to measure them, must be defined as the coincidence of the orbital (fixed) and the ocular (movable) system of coordinates. However this becomes only a theoretic concept, since practical operations to obtain it are almost unfeasible. Besides, even a "simple" horizontal or vertical ocular rotation, though always occurring around a (presumably) fixed point (the center of ocular rotation) may be defined by different trajectories and magnitudes, depending on the two systems of measurement of eye positions and motions. Hence, in a graphical (plane) representation of such spherical coordinates, the so-called "tangent screen", an ocular "tertiary" position - a combination of a horizontal and a vertical rotations - may be described by four different points. Or, conversely, a specific eye position may be defined by four sets of angular coordinates. The mathematical representation of variation of three special coordinates in a specific rotation is best made by a matrix disposition, so that, multiplication (not commutative) of three matrices (one for each specific plane) generates six different systems (permutations) of measurements. So, though , actually, there are multiple trajectories possible between two points in space, the order in which rotations are considered influences the final result. With different systems of coordinates for each rotation and different possible orders by which they may be considered, one reaches 48 alternative systems for their measurements. Unfortunately, up to now, there I is no an established convention to express ocular rotations. So, usually, people consider that a vertical prism superimposed to a frontally placed horizontal prism, or vice-versa, correspond to equivalent processes. The paper finishes discussing inconveniences of the clinically used unity to measure eye rotations (the prism-diopter) and proposes other unities as alternative solutions.

Assessment Of Prevalence Of Malocclusion Using Angle憇 Classification Of Malocclusion (1899) Among 8 To 14 Year Old School Children In Chhatrapati Sambhajinagar � A Cross朣ectional Study.

Background:Malocclusion, or the misalignment of teeth and dental arches, is a common issue that can impact both function and aesthetics. This study aimed to assess the prevalence of malocclusion among 8 to 14-year-old schoolchildren in Chhatrapati Sambhajinagar. A descriptive cross-sectional study was conducted, involving 480 students who met the inclusion criteria. Various occlusal characteristics, including Angle's classes of malocclusion (class I, II, and III), overjet, overbite, midline diastema, and tooth rotation, were recorded. The study found that 58.75% of participants were male and 41.25% were female. Class I malocclusion was the most common, observed in 81.46% of children, while class II and class III malocclusions were seen in 16.67% and 1.67%, respectively. Among class II cases, 12.92% were division 1 and 3.75% division 2. A normal overjet (<3 mm) was found in 87.1% of children, while 12.9% had an increased overjet (>3 mm). A normal overbite was present in 47.9%, with 52.1% having an increased overbite. Midline diastema, occurring only in the upper arch, was found in 2.7% of children, and 12.7% had tooth rotation, with the maxillary right lateral incisors being the most affected. The study highlights the high prevalence of malocclusion in this age group, stressing the importance of early detection and treatment to prevent future dental and facial irregularities.

Comparison Of Insertion Characteristics Of Proseal Laryngeal Mask Airway Using Rotation Techniques Versus Standard Introducer Technique In Adults Undergoing Laparoscopic Cholecystectomy

Background: Airway management is the most essential skill in Anesthesiology and the inability to secure the airway is one of the most common reasons for anesthesia-related morbidity and mortality. [2,4] This study aimed to evaluate and compare the insertion characteristics ofAim: Proseal laryngeal mask airway (LMA) using the standard introducer technique, 90-degree rotation technique, and 180-degree rotation technique in adult patients undergoing Laparoscopic Cholecystectomy. After institutional ethical approval and informed writtenMaterial And Method: consent of patients participating a prospective, interventional, randomized, comparative study was carried out on 90 Patients in the age group 20-60 years, of either gender, ASA I/II, scheduled for laparoscopic cholecystectomy under general anesthesia with controlled ventilation using the ProSeal LMA were included in the study. The patients were randomized into three groups: Group I - Standard Introducer technique (n=30); Group II - 90-degree rotation technique (n=30); Group III - 180-degree rotation technique (n=30). The incidence of failure of Proseal LMA, bloodResult: staning of Proseal LMA and Sore throat were signi?cantly more in standard introducer technique as compared to rotation technique. Conclusion: The study concluded that the 90-degree rotation technique and 180-degree rotation were both superior to the introducer technique in adult patients in terms of insertion time, ease of insertion score, manipulation requirement, blood staining of PLMA and post-op dysphagia/sore throat .

Errores en la interpretación de la radiografía de tórax en el lactante: ¿qué tenemos que saber de la técnica? / Errors in the Interpretation of chest X-rays in Infants: what do we need to know about the technique?

La radiografía de tórax sigue siendo fundamental para la evaluación de patologías torácicas en lactantes. Antes de iniciar su interpretación, muchos autores sugieren revisar la técnica radiológica, ya que a esta edad se presentan varias particularidades técnicas que deben tenerse en cuenta para evitar errores interpretativos y no confundir hallazgos técnicos con patologías. Entre estas particularidades técnicas se deben evaluar: el centraje transversal o rotación, el centraje longitudinal o posición lordótica, el grado de inspiración, la posición de la vía aérea superior, la penetración o exposición de la radiografía, tipos de proyecciones y el movimiento. El objetivo de esta revisión es comentar y ejemplificar las peculiaridades técnicas que presenta la radiografía de tórax en lactantes y que pueden llevar a interpretaciones erróneas.

The chest X-ray remains essential for evaluating thoracic pathology in infants. Before beginning its interpretation, many authors recommend assessing the radiographic technique, as several technical peculiarities must be considered at this age to avoid interpretive errors and prevent mistaking technical artifacts for pathology. The technical aspects to be evaluated include transverse centering or rotation, longitudinal centering or lordotic position, degree of inspiration, upper airway positioning, radiograph penetration or exposure, projection types, and movement. The objective of this review is to discuss and illustrate the technical peculiarities of infant chest X-rays that can lead to erroneous interpretations.

Retracción anterosuperior mediante el uso de microimplantes en un paciente clase II esqueletal con protrusión dentoalveolar / Anterosuperior retraction with microimplants in a skeletal class II patient with dentoalveolar protrusion

La clase II esqueletal puede deberse a una mandíbula retruida, un maxilar protruido o una combinación de ambas, dando como resultado un perfil convexo en el paciente. Actualmente existen diferentes alternativas de tratamiento siendo una de ellas la extracción de primeros premolares para mejorar el perfil. El uso de microimplantes es una mecánica de anclaje absoluto que permite la retracción y cierre de espacios de los dientes. Se presenta un caso clínico de una paciente femenina de 19 años, clase II esqueletal por postero-rotación mandibular con biotipo dolicofacial, perfil convexo, sonrisa gingival, clase I molar y canina, overbite de 2 mm y overjet de 2 mm, apiñamiento moderado con incisivos superiores e inferiores protruidos y proinclinados. Como objetivo del tratamiento se planteó mantener la clase I molar y canina, mejorar el perfil facial y liberar el apiñamiento. Mediante el anclaje absoluto con los microimplantes interradiculares, se logró retraer el segmento antero-superior, conservando la clase I molar, clase I canina y reduciendo la proyección labial mejorando el perfil facial. Concluyendo que el uso de microimplantes resulta ser una mecánica de anclaje esqueletal cómoda, práctica y estable para lograr los objetivos del tratamiento sin la necesidad de la cooperación del paciente.

Class II can be due to a retrognathous mandible, a prognathous maxilla, or a combination of both, resulting in a convex profile in the patient. Currently there are different treatment alternatives, one of which is the extraction of first premolars to improve the profile. The use of microimplants is an absolute anchorage mechanics that allows the retraction and closing spaces of the teeth. A clinical case of a 19-year-old female patient, skeletal class II due to mandibular postero-rotation with dolichofacial biotype, convex profile, gummy smile, molar and canine class I, 2 mm overbite and 2 mm overjet, moderate crowding with upper and lower incisors protruding and proclining, as treatment objectives we must maintain molar and canine class I, improve facial profile and releive the crowding. Through absolute anchorage with interradicular microimplants, it was possible to retract the upper anterior segment, preserving molar class I, canine class I and reducing labial projection, improving facial profile. Concluding that the use of microim-plants turns out to be a comfortable, practical and stable skeletal anchorage mechanism to achieve the treatment objectives without the need for the patient's cooperation.

Características demográficas y condiciones de trabajo de los internos de medicina, servicio social de salud rural obligatorio, 2022 / Demographic characteristics and working conditions of medical interns in mandatory rural health service, 2022

INTRODUCCIÓN: en 6to año de la Carrera de Medicina se realiza la rotación rural por 3 meses. El objetivo del presente estudio fue determinar las características demográficas de los estudiantes y de las condiciones de trabajo durante su rotación rural. MATERIAL Y MÉTODOS: estudio cuantitativo, observacional, descriptivo de corte transversal. Se utilizó un cuestionario electrónico de 42 preguntas de selección múltiple y preguntas abiertas. RESULTADOS: de 253 estudiantes, 63,64% son mujeres y 36,36% varones. El 93,68% son solteros. El 92,49 % no tiene hijos. El 97,23 % es de la Universidad Mayor de San Andrés y el 2,77% de otras universidades. El promedio de edad fue de 26 años. El 39,13 % rotó en un centro ambulatorio. El 33 % estuvo previo al internado, 6 años en la carrera. Entre las condiciones de habitabilidad 7 de cada 10 no cuentan con apoyo para alimentación, 3 de cada 10 no cuentan con acceso a agua potable, 2 de cada 10 no cuenta con alcantarillado y 5 de cada 10 no tiene acceso a internet. De cada 10 estudiantes, 4 perciben algún tipo de maltrato, siendo los más frecuentes el verbal y psicológico. Percibieron acoso sexual 5 de cada 100 estudiantes. CONCLUSIONES: el 30 % de los estudiantes no tiene acceso a agua potable y/o alcantarillado, el 70 % no tiene apoyo en la alimentación, el 50 % no tiene acceso a internet. El 40 % percibió algún tipo de violencia y el 5% percibió acoso sexual

INTRODUCTION: the students of sixth year of Medical Career, must carry out a rural rotation for 3 months. The objective of this study was to determine the demographic characteristics and working conditions during their rural rotation. MATERIALS AND METHODS: the study method was quantitative, observational, descriptive and cross-sectional. We used an digital questionnaire with 42 multiple-choice and open-ended questions. RESULTS: information was obtained from 253 students, with 63.64% being female and 36.36% male. 93.68% of the participants were single. Additionally, 92.49% did not have children. Most students (97.23%) were from the Universidad Mayor de San Andrés, while the rest (2.77%) were from other universities. The average age was 26 years. During the rotation, 39.13% worked in an outpatient center. Furthermore, 33% had prior experience before their internship, having spent 6 years in the program. Regarding living conditions, 7 out of 10 lacked supports for food, 3 out of 10 lacked access to clean water, 2 out of 10 had no sewage system, and 5 out of 10 lacked internet access. Among the students, 4 out of 10 perceived some form of mistreatment, with verbal and psychological abuse being the most common. Additionally, 5 out of 100 students reported experiencing sexual harassment. CONCLUSIONS: 30% of the students lacked access to clean water and/or sewage systems, 70% lacked support for food, and 50% had no internet access. Moreover, 40% perceived some form of violence, and 5% reported experiencing sexual harassment

Evaluation of Functional Outcome of Arthroscopic Capsular Release in Adhesive Capsulitis (Frozen Shoulder)- A Research Study from North India

Introduction: Frozen shoulder is a disabling and painful condition that is commonly managed in the primary care setting. Frozen shoulder has a protracted natural history that usually ends in resolution. It is a condition characterised by functional restriction of both active and passive shoulder motion for which radiographs of the glenohumeral joint are essentially unremarkable except for the possible presence of osteopenia or calcific tendonitis. Aims and Objectives: To evaluate the functional outcome of arthroscopic release of capsule in adhesive capsulitis (frozen shoulder). Materials and Methods: A prospective study conducted on patients diagnosed as having frozen shoulder. A total of 25 patients were taken who underwent Arthroscopic capsular release. Results: The mean forward elevation improved from 100.52 to 156.60 at final follow up. Mean abduction improved from 97.12 to 156.36 at final follow up. Mean external rotation 32.76 to 38.96 at final follow up. Mean internal rotation 18.88 to 37.0 at final follow up. The mean UCLA score improved from 13.16 to 32.16 at final follow. Excellent results were seen in 12 patients (48%), Good in 8 patients (32%), Fair in 4 patients (16%) and Poor in 1 patient (4%). Conclusion: Arthroscopic release of capsule in frozen shoulder (adhesive capsulitis) is a safe and effective procedure with very few complications. It gives further advantage of evaluating any glenohumeral joint and subacromial pathology & rapid rehabilitation is possible in comparison to open procedures.

Study of facial reconstruction in basal cell carcinoma

Head and neck reconstruction presents unique challenges as the defects of this region are often difficult to conceal and the demands on the surgeon’s reconstructive skills are greater than they are elsewhere in the body where cosmesis may be less vital and function less specialized. Reconstruction depends on the size as well as the location of the defect. Smaller defects created after excision can be covered by local flaps, however larger defects require a combination of flaps such as rotation, transposition, and cheek advancement. Defects located over and beyond the hairline can be covered by skin grafting as well. We have taken 10 such cases of basal cell carcinoma and explained the various surgical procedures performed on the patients. In 4 of the patients, defect was covered via grafting and in the remaining 6 patients, a combination of forehead flap and cheek advancement flap was done. All the cases have shown excellent functional as well as cosmetic result.

Evaluation of Scapular Dynamics in Sports Trainees

Background: The scapula provides stability and mobility for efficient upper-limb movement. Optimal scapular kinematics are essential for efficient force generation and injury prevention. Sports trainees, particularly those involved in sports requiring repetitive or high-intensity shoulder movements, are susceptible to injuries and performance limitations if associated with aberrant scapular mechanics. Understanding the intricacies of scapular dynamics is essential for designing tailored training interventions that enhance athletic performance.Rationale and objectives: Previous research has emphasized the need for sports-specific training protocols. The measurement of scapular rotation has gained significant attention. Evaluating asymmetries in scapular dynamics across various sports trainee populations is a step forward for the need for tailored interventions and injury prevention strategies in preventing injury and planning better exercise programs. The study uses a PALM meter for the measurement of scapular rotation.Methodology: 40 Subjects 19 to 24 years old from the sports authority of Andhra Pradesh, India, were studied after obtaining written informed consent. Scapular rotation measured in a neutral and with hands on the hip position. Root of the scapula (RSS), inferior angle of the scapula (IAS), and spinous processes (Sp) of C7 to T8 are taken as the anatomical landmarks. Measurements of scapular position taken in two arm positions: shoulder neutral, hands on hip. A right-angle triangle created by dropping a perpendicular line from the scapula’s root to intersect the horizontal line between the scapula’s inferior angle and the thoracic spine’s closest spinous process (IAS-Sp). The hypotenuse represents the distance IAS to RSS, while the side opposite the angle ? is the distance IAS-Sp minus RSS-Sp. A positive result indicates upward scapular rotation, while a negative result indicates downward scapular rotation.Results and Conclusion: This cross-sectional study revealed variations in scapular rotation and the distances from spinous processes in the scapular position in neutral and hands-on Hip positions from right to left and male to female. Further studies are required to understand scapular rotation variations concerning various sports involving overhead activity, heavy weight lifting, endurance sports and anatomical variations, muscle activation patterns, or task demands.

Finite element analysis of effects of sagittal cervical manipulation on intervertebral disc and facet joints / 中国组织工程研究

BACKGROUND:Among the pathogenic factors of cervical spondylosis,herniation of the intervertebral disc,dislocation of the facet joint and the stenosis of the intervertebral foramen are important factors leading to symptoms in patients.Moreover,inappropriate manipulation may aggravate the possibility of cervical disc rupture,leading to exacerbation of symptoms in patients. OBJECTIVE:To compare the effect between sagittal cervical manipulation and traditional cervical rotation manipulation on the area of the intervertebral disc,facet joint and intervertebral foramen at the operative segment by the finite element analysis. METHODS:The neck CT data of a male volunteer with a normal neck were selected and imported into Mimics 17.0 three-dimensional reconstruction software.Geo-magic Studio 12.0,Solidworks 2017 and Ansys Workbench 17.0 software were used for the construction of the finite element model of cervical vertebrae(C3-6)including intervertebral disc and articular cartilage.The lower end plate of the C5 vertebral body was fixed.A uniformly distributed vertical downward 50 N load was applied on the upper surface of the upper vertebral body(C3).The stress,deformation and deformation direction of the C4-5 intervertebral disc,joint capsule stress,the displacement of facet joints and the area of bilateral intervertebral foramen were compared between sagittal cervical manipulation and traditional rotation reduction. RESULTS AND CONCLUSION:(1)When using the rotation technique,the maximum normal equivalent stress(von Mises stress)of the C4-5 disc was 8.06 MPa;the total deformation was 1.05 mm,and the fiber ring expanded to the left and outside.When using the sagittal tip lifting technique,the maximum normal equivalent stress(von Mises stress)of the C4-5 disc was 2.60 MPa;the total deformation was 0.90 mm,and the fiber ring expanded to the left and back.Compared with the rotation technique,the pressure of the cervical manipulation technique on the disc was less(about 32.3%of the rotation technique),and the deformation degree of the disc was also light(about 85.7%of the rotation technique).(2)When the rotation technique was used,the maximum stresses of the left and right articular capsule ligaments were 0.37 MPa and 1.69 MPa,respectively.The overall displacement of the facet joint was 2.21 mm.The area of the right intervertebral foramen decreased by about 3.8%and the area of the left intervertebral foramen increased by about 0.9%.When the sagittal end lifting manipulation was performed,the maximum stresses of the left and right articular capsule ligaments were 0.27 MPa and 1.70 MPa,respectively;the overall displacement of the facet joint was 1.63 mm;the area of the right intervertebral foramen increased by about 2.6%,and the area of the left intervertebral foramen decreased by about 0.9%.Compared with rotation manipulation,sagittal end lifting manipulation had fewer changes in the displacement of facet joint,joint capsule stress and intervertebral foramen area,so it was safer to operate.(3)In conclusion,compared with cervical rotation manipulation,sagittal end lifting manipulation has fewer changes in facet joint displacement,intervertebral disc stress/deformation degree,joint capsule stress,and foraminal area.In clinical practice,more appropriate manipulation should be selected based on biomechanical results after an accurate assessment of patients'conditions.

Finite element analysis of thumb thrust in lumbar fixed-point rotation manipulation / 中国组织工程研究

BACKGROUND:Lumbar fixed-point rotation operation needs collaborative operation of the doctor's hands,and outputs rotation and thumb thrust.Lumbar disc herniation can be treated through disc displacement and adjusting stress distribution.However,the mechanical effects of thumb thrust and the biomechanical effects of loading direction on manipulative effects remain unclear. OBJECTIVE:To compare the biomechanical difference of lumbar fixed-point rotation manipulation for treating lumbar disc herniation under different thrust directions. METHODS:The L3-5 normal three-dimensional finite element model was constructed and validity was verified.According to the intervertebral disc degeneration Pfirrmann grade,intervertebral disc degeneration was simulated by modifying the L4/5 intervertebral space height,the volume of the nucleus pulposus,as well as the material parameters of the annulus fibrosus,nucleus pulposus,and ligament.Finally,the pathological model of L4/5 moderate disc degeneration with left para-central herniation was constructed,and then the pathological models were used as research objects.Simulation technique:spinning to the right;taking the condition on changing the direction of the thumb thrust to establish three modes of operation(M1:thumb push to the left;M2:thumb push to the right;M3:no thrust push).The protrusion displacement and the disc stress,and the stress and strain of the facet joint cartilage were compared in the three operating modes. RESULTS AND CONCLUSION:(1)Maximum displacement value of L4/5 disc herniation:displacement was 2.672 3 mm for M1,1.156 1 mm for M2,1.826 4 mm for M3,M1＞M3＞M2.(2)The maximum Von Mises stress of L4/5 discs was 1.846 7 MPa for M1,0.419 0 MPa for M2,and 1.257 9 MPa for M3,M1＞M3＞M2.(3)L4/5 bilateral small cartilage produced different degrees of contact stress changes:It was 0.485 5 MPa for M1,0.026 7 MPa for M2,and 0.441 4 MPa for M3,M1＞M3＞M2.Right cartilage contact force was 0.000 5 MPa for M1,0.025 9 MPa for M2,and 0.001 3 MPa for M3,M2＞M3＞M1;the left greater than the right,M1 had the highest value;cartilage strain was consistent with contact stress changes.(4)Different operation modes will have some biomechanical influences on the diseased intervertebral disc and accessory structure.The M1 operation mode can maximize the displacement of protrusion,disc stress and left joint cartilage contact,which can better promote disc displacement,balance stress distribution and reduce facet joint disorder,so the operation is better.

Establishment of a nutritional risk prediction model for femoral intertrochanteric fractures treated with intramedullary nails / 中国组织工程研究

BACKGROUND:Patients with femoral intertrochanteric fracture may have nutritional risks during proximal femoral nail anti-rotation surgery,and a clinical predictive model is established based on nutritional assessment tools. OBJECTIVE:To establish the nomogram of the nutritional risk prediction model for patients with intertrochanteric fracture after proximal femoral nail anti-rotation fixation and evaluate the accuracy of the model. METHODS:From December 2018 to July 2022,patients with femoral intertrochanteric fractures who underwent proximal femoral nail anti-rotation fixation in First Department of Orthopedics,Second Affiliated Hospital of Baotou Medical College were selected as the study subjects.The nutritional risk status of patients was assessed using nutritional risk screening 2002.Logistic regression was used to build the model.The receiver operating characteristic curve,Calibration plot calibration curve,and Hosmer-Lemeshow goodness-of-fit test were used to evaluate the discrimination,calibration and clinical applicability of the prediction model.The model was visualized using Nomogram diagrams. RESULTS AND CONCLUSION:(1)Seventy-six patients were included according to the inclusion criteria.The incidence of nutritional risk was 80%after being assessed using nutritional risk screening 2002.(2)The results of Logistic regression analysis demonstrated that age≥77 years old,body mass index<22.80 kg/m2,upper arm circumference<25.01 cm,hemoglobin<98.51 g/L,albumin<31.61 g/L,and prealbumin<138.56 g/L were all independent risk factors for nutritional risk(P<0.05).(3)The area under the receiver operating characteristic curve was 0.919(95%CI:0.843-0.994).(4)The results of the Hosmer-Lemeshow goodness-of-fit test displayed that nutritional risk prediction value was high.(5)It is concluded that the nutritional risk assessment model constructed in this study has a good degree of discrimination and calibration,and has a certain predictive ability,which can be used as a reference tool for nutritional risk assessment of patients after proximal femoral nail anti-rotation fixation.

Application of electronic rotation registration manual for residency training based on hospital information system docking: Practice and exploration / 中华医学教育探索杂志

The contents recorded in the rotation registration manual is not only the quantitative indicators for evaluating the quality of residency training, but also the important basis for training assessment and issuance of training certificates. In order to solve the problems of data authenticity, information delay, and repeated entry in the rotation registration manual for residency training, Shanghai East Hospital, Tongji University, launched a project to dock the electronic rotation registration manual with the hospital information system. Through the establishment of the project team, the development of working mechanisms, and the implementation of the project, data analysis was used for process reformation and system optimization, so as to continuously improve management efficiency and medical safety while solving problems and form a set of implementation system with reference significance in practice.

Efficacies of proximal femoral nail anti-rotation internal fixation in different body positions on elderly unstable femoral intertrochanteric fractures / 局解手术学杂志

Objective To investigate the efficacies of proximal femoral nail anti-rotation(PFNA)internal fixation in traction bed supine position and non-traction bed lateral position in the treatment of elderly unstable femoral intertrochanteric fractures.Methods The clinical data of patients with unstable femoral intertrochanteric fractures treated with PFNA internal fixation in our hospital were retrospec-tively analyzed,41 patients received treatment in traction bed supine position were included in the supine position group,and 55 patients treated received treatment in non-traction bed lateral position were included in the lateral position group.The perioperative related indicators,surgical reduction,hip Harris score,and incidence of complications in the two groups were analyzed.Results The operation time and incision length of patients in the lateral position group were shorter than those in the supine position group,and the intraoperative blood loss and fluoroscopy times were less than those in the supine position group,with statistically significant differences(P<0.05).There was no significant difference in the anesthesia mode,blood transfusion or hospital stay of patients between the two groups(P>0.05).There was no significant difference in the incidence of postoperative complications of patients between the two groups(P>0.05).There was no significant difference in neck-shaft angle,tip-apex distance or hip Harris score of patients between the two groups(P>0.05).Conclusion PFNA internal fixation in traction bed supine position and non-traction bed lateral position have the same effect in the treatment of elderly unstable femoral intertrochanteric fractures,while the non-traction bed lateral position for treatment has more advantages in shortening operation time,decreasing intraoperative blood loss,and reducing radiation exposure.

The experimental study of X-ray diagnosis of closed reduction rotational displacement of femoral neck fractures / 中华骨科杂志

Objective:To explore the optimal index of rotational displacement of femoral neck fractures by modeling the axial rotational displacement of femoral neck fractures after reduction and based on X-ray projections.Methods:Six dry human femur specimens, comprising 2 males and 4 females, were utilized in the study. Design and manufacture a proximal femur ortholateral and oblique X-ray casting jigs and mounts. The femoral neck fracture was modeled on the femoral specimen, with Pauwells 30°, 50°, and 70° models (2 each) made according to Pauwells typing. The fractures were manually repositioned with residual anterior 20°, 40° and 60° axial rotational displacements. Each fracture model was projected at different angles (pedicled 40°, pedicled 20°, vertical 0°, cephalad 20°, and cephalad 40°), and the trabecular angle and Garden's alignment index of the model were measured to observe the imaging characteristics of the fracture line on the medial oblique and lateral oblique radiographs.Results:In the presence of a 20° and 40° anterior rotational displacement following reduction of a femoral neck fracture, the trabecular angle in the rotationally displaced group was not significantly different from that of the anatomically repositioned group in various projection positions. However, when a residual rotational displacement of 60° was present, the trabeculae appeared blurred at most projection angles in the Pauwells 30° and 50° models, failing to measure trabecular angles. In the Pauwells 70° fracture model, the trabecular angle in the rotational displacement group was significantly different from that in the anatomical reduction group. In anteroposterior radiographs, when the anterior rotation displacement was 60° in the Pauwells 70° group, Garden's contralateral index showed an unsatisfactory restoration (150°, 142°), whereas all rotationally displaced models in the Pauwells 30° and Pauwells 50° groups had a Garden's contralateral index of >155°, which achieved an acceptable restoration. In lateral radiographs, all rotational displacement models with Garden's alignment index>180° failed to achieve acceptable repositioning, and the larger the Pauwells angle the greater the Garden's alignment index at the same rotational displacement. In the internal oblique position with a bias towards the foot side, the image showed partial overlap between the femoral head and the shaft, making it difficult to assess the quality of the reduction. Conversely, when projected cephalad, the femoral neck appeared longer, particularly at a projection angle of 40° cephalad, allowing for clear observation of the fracture line and the anatomy of the proximal femur. The trabeculae were not well visualized in the external oblique position.Conclusion:There are limitations in applying the trabecular angle to assess the axial rotational displacement of the femoral head after reduction of femoral neck fractures. The Pauwells 70° with residual rotational anterior displacement of 60° was the only way to detect axial rotational displacement of the femoral head on anteroposterior radiographs Garden's alignment index. For the determination of axial rotational displacement of the femoral head, the Garden's alignment index on lateral radiographs provides higher reliability.

Role of Allelopathy in Plant Disease Management

Allelopathy is a natural and eco-friendly process causes agricultural plants to generate phytotoxins called "allelochemicals" that hinder or promote growth. The chemical substances generated through allelopathy can be potential tool to control agricultural important pests. Allelopathy can replace agrochemicals for crop disease and pest management. Agrochemical used in agriculture pollute the environment, lowers food quality, and increases disease-resistant biotypes. An agronomist can collaborate with a molecular scientist or plant breeder to selectively boost disease suppression by understanding allelopathy's physiological foundation. Allelochemicals are natural pesticides that fight disease, weeds, and insects, according to experts. Disease management strategies have been redesigned recently. Frequently, structural modifications or the synthesis of chemical analogs increase their bioactivity. Even though the progress in this regard is sluggish, some encouraging results are emerging, and many more are anticipated in the near future. This review attempts to discuss these characteristics of allelopathy for the rational management of diseases.

A Descriptive Study of Workplace Risk Assessment in the Automobile Sector of Uttarakhand, India

Aims: The auto sector in India contributes 7.1% of the country's GDP and is predicted to earn USD 810.3 billion by 2026. However, India has a greater death rate and poorer job safety than the United States, where industrial accidents happen 20 times more frequently. Musculoskeletal disorders are a significant cause of disability and accidents at work. The goal of the study was to evaluate the existing working conditions in the automobile industry, where mechanics play a crucial role in precision.Study Design: The present study was carried out in Uttarakhand at Udham Singh Nagar district, block Rudrapur; Nainital district, block Haldwani; and Almora district, block Dwarahat. Purposive and random sampling techniques were used to select the study area and samples. The total 75 respondents and 14 garages were selected.Methodology: A checklist was developed to get information about the health status of garage workers, awareness of occupational hazards, use of personal protective equipment, risk assessment, and workplace analysis.Results: The study reveals that Udham Singh Nagar garages provide cent per cent PPE to their workers, while Nainital and Almora districts lack proper facilities. Nearly half of workers lack worksite cleaning facilities, slip-resistant floors, spray booths, dip tanks, and clean toilets. Additionally, a quarter of garages require adjustments to work height, foot platforms, item holders, work-rotation systems, hanging toolboxes, and hazardous chemical container labeling.Conclusion: 7.1% of India's GDP is contributed by the auto industry, which is projected to generate $810.3 billion by 2026. In contrast to the US, the nation has a greater fatality rate and a worse level of workplace safety, and industrial accidents happen there 20 times more frequently. According to a survey conducted in Uttarakhand, whereas Nainital and Almora districts lack adequate amenities, Udham Singh Nagar garages offer cent per cent PPE to employees. There aren't enough clean restrooms, or there aren't enough slip-resistant floors for the majority of employees.

Influence of cropping sequences on soil suppressive/conduciveness against Sclerotium rolfsii in different agro-climatic zones of West Bengal, India

Aim: To study the influence of different cropping sequences (CSs) on soil suppressive or conduciveness towards Sclerotium rolfsii in different agro-climatic zones (ACZs) of West Bengal, India. Methodology: Farmer’s field surveys were conducted to explore the suppressive activity of various crop rhizosphere during each winter, October to January (2016-2019). The survey was done in 14 districts of five ACZs in West Bengal (India), and the total surveyed sample size was 511. The S. rolfsii disease incidence (DI%) data of Rabi crop in surveyed areas and sclerotial population, soil suppressive index, FDA hydrolysis, dehydrogenase activity and culturable microbial assay were performed. Results: In this data set (n=511), the foremost soils belonged to no suppressive category (74.47%), followed by slight suppressive category (20.74%). Negligible number of soils belonged to moderate (0.39%) and strong suppressive (0.39%) category. The population of Pseudomonads was higher in both strong and moderate suppressive soil rather than slight and no suppressive soils. Culturable population of soil Pseudomonads, Bacillus and Actinomycetes varied in five different ACZs. Interpretation: Paddy-brassica vegetables, paddy-maize and paddy-cucurbits vegetable-based CSs exhibited relatively high soil uppressiveness whereas paddy-legumes, jute-paddy-legume vegetables and pulses based CSs showed high soil conduciveness towards S. rolfsii. Soil microbial influences on crop rhizosphere along with “crop rotation effect” was the key reason for the disease suppressive activity.

Influence of head rotation on ease of mask ventilation: a randomized crossover study

Background: Mask ventilation is an essential part of airway management. Head rotation increases the cross-sectional area of upper airway and improves upper airway patency. Methods: A prospective crossover study in 40 patients aged 18-69, ASA physical status I, II, III and who needed general anesthesia with tracheal intubation were selected, divided into two groups of 20 each, group I and Group II. When apnea was achieved after standard general anaesthesia, mask ventilation was performed using pressure-controlled ventilation, peak inspiratory pressure 15 cm of water, 10 breaths per minute, I:E ratio 1:2. Face mask held by two hands. Group I patients received mask ventilation with the head in a neutral position for one minute, after which the head was turned to the right for one minute and the head is returned to the neutral position for one minute. In group II patients, mask ventilation was performed from right lateral position to neutral position to right lateral position. In each position, airway pressure, compliance and expiratory tidal volume were measured. Results: There was no statistically significant difference between groups with respect to demographic data. The mean expiratory tidal volume was high in head rotation than neutral position (469.545±120.09 ml vs. 397.815±86.03 ml) p value <0.05. A statistically significant (p value=0.045) seen with respect to compliance which was slightly higher in head rotation (35.83) than neutral position (29.31). Conclusions: Head rotation to the lateral position increases the expiratory tidal volume and compliance significantly as compared to head in neutral position and improves mask ventilation after induction of anaesthesia.

Exstrophy epispadias complex with adenocarcinoma in adults: a case series and repair technique

The exstrophy-epispadias-complex (EEC) is a rare congenital malformation with a spectrum of abdominal-pelvic fusion abnormalities, with an incidence of 1/46,000 LB. Recurrence is 1 in100 & the male-to-female ratio is 2.3:1. Patients rarely may present in adulthood due to a lack of knowledge or financial constraints; it increases the risk of bladder carcinoma mostly adenocarcinoma or squamous carcinoma, due to chronic inflammation, infection, and metaplasia. It has a significant physical, functional, social, sexual, and psychological burden. Three patients have been operated on in our institute. A 37-year-old male, A 19-year-old male, and A 23- year-old female patient. The operation planned was a radical cystectomy with an ileal conduit and an expanded local lymphadenectomy in all three patients. The pelvis and abdominal wall defects were repaired differently post-radical cystectomy in all 3 patients using different techniques. The first patient went through primary tension closure, in the second patient bilateral rectus muscle was used as a flap and reinforced with mesh, and in the third patient, we used a rotation skin flap. All three patients were followed for 1 year. The first patient developed wound dehiscence followed by fecal fistula during follow-up and succumb due to sepsis, the second patient recovered well with a muscle flap in the postoperative period, unfortunately, developed recurrence locally and succumb due to multiple metastases, and the third patient develops flap necrosis at the tip postoperative on day 5, however, recover well after dressing, no recurrence seen on 1 year of regular follow up. As a result, the bilateral rectus flap with mesh recovers better than the rotation skin flap, which is better than primary tension closure.