An evaluation of effectiveness of Ilizarov external fixation in treating infected non-union tibial fractures: a prospective observational study

Background: Infected non-union tibial fractures pose significant challenges in orthopedic care. Ilizarov external fixation has emerged as a promising treatment option for such complex fractures. The purpose of this research is to evaluate the efficacy and safety of Ilizarov fixation in non-union, infected tibial fractures. Methods: A prospective observational study was conducted on 30 patients at Indira Gandhi Institute of Medical Sciences. Inclusion criteria involved patients aged 20-65 with clinical and radiological signs of infection and non-union of the tibia. Data on patient demographics, injury details, treatment history, and outcomes were collected. Ilizarov fixation was performed, and patients were followed up. Results: The study cohort, primarily males (80%), with mean age of 35.75 years, displayed a high incidence of type III compound injuries (63.33%). Monofocal and bifocal osteosynthesis effectively reduced limb shortening, with an overall average residual shortening of 1.8 cm. Bony outcomes were favorable, with 16 cases achieving excellence. Functional outcomes were also promising. Complications included stiffness, infections, and deformities. Conclusions: Ilizarov external fixation demonstrates potential in managing infected non-union tibial fractures, offering favorable bony and functional outcomes. However, post-operative complications require vigilant management. Further research is needed to validate and optimize this approach.

An epidemiological trend in surgical management of pelvis and acetabulum fractures at Indira Gandhi Institute of Medical Sciences level-1 trauma centre in Patna: a retrospective study

Background: Pelvic and acetabular fractures, principally resulting from high-energy trauma like motor vehicle accidents, are challenging orthopedic injuries that can lead to significant morbidity and functional impairment. Understanding their epidemiology, treatment, and outcomes is crucial for improving patient care. Methods: This retrospective cohort study involving 34 patients who underwent surgery for pelvic and acetabular fractures from April 2021 to September 2023. Data on patient demographics, injury mechanisms, fracture types, surgical approaches, and post-operative outcomes were collected and analyzed. Results: The study group comprised predominantly males (67%) with mean age of 35 years. Road traffic accidents were the leading cause of injuries (95%). The most common fracture types were the posterior wall of the acetabulum (10%) and type II anteroposterior compression fractures (10%). Related injuries included long bone fractures (62.5%) and posterior hip dislocation (33.33%). Surgical treatment primarily involved open reduction and internal fixation with various approaches. Postoperative complications included sciatic nerve palsy (4.17%), venous thromboembolism (20.83%), and wound infections (12.5%), but both post-operative mortality and heterotopic ossification were absent. Conclusions: The study highlights the prevalence of pelvic and acetabular fractures due to road traffic accidents and the complexity of their surgical management. The associated injuries and postoperative complications underscore the need for specialized orthopedic care.

Extent of Adoption of Agro Advisories Disseminated Through Annapurna Krishi Prasar Seva (AKPS) at Krishi Vigyan Kendra, Palem in Telangana State, India

Agriculture is the most sector in developing countries like India, the majority of them depending on it, to upliftment of their economic status. Most farmers have adopted traditional agricultural practices for farming in the last several years. In this context, the extension system depends on the ICT platform, and it plays a greater role in uplifting the livelihoods of rural people by effectively providing need-based and location-specific information. ICT’s today serving many purposes in agriculture, business, and social development activities, etc., especially in agriculture from crop production technologies to marketing, facilitating forward & backward linkages to the farm produce. In this study impact of agro advisories disseminated through AKPS inferred that 42.50 per cent of the respondents were grouped under the medium category of adoption followed by high (40.00%), low (10.83%) and very low (06.67%) respective categories. Most of the respondents irrespective of the crop had a high level of knowledge about modern technologies. It was also found that the knowledge level of the farmers changed with what they had been growing seasonal crops.

Identification of High-yielding and Late Leaf Spot Disease-tolerant Families in Groundnut (Arachis hypogaea L.)

The foliar fungal disease late leaf spot (LLS) caused by Cercospora personata is a major and widely distributed disease. Cause substantial yield loss and in combination with the diseases increased up to 70 per cent in India. Therefore, to reduce the effect of disease and yield penalty effective chemical control mainly depends on multiple fungicide applications which are costly for resource-poor farmers and also raise environmental and health concerns. Therefore, to reduce the cost of production the development of resistant cultivars is an eco-friendly concept, with this research gap study was conducted to identify groundnut families with high yield and resistance to late leaf spot disease. From 60 F7 families of three crosses (GKVK-16 × KCG-2, GKVK-13 × KCG-2 and GKVK-6 × KCG-2 along with checks KCG-6, KCG-2 and TMV-2) which were evaluated in augmented design during Kharif 2017 in disease plot and control plot, disease screening was done using a modified 9-point scale. Disease scoring was done at 60, 90 and 120 days after sowing (pod filling stage). The disease scores were mainly based on the extent of leaf area damage. Results depicted that among the 60 families, 19 families showed consistence performance both at normal and disease plots. However, three families showed differences in the pod yield both at normal and disease plots. The families that exhibited resistance to LLS disease showed per cent yield reduction that ranged from 0-35%, and moderately resistant families exhibited a yield reduction from 35-50%, however, 50-90% yield reduction was observed in the families which showed moderate susceptibility, further more than 100% yield reduction was noticed in the families which are susceptible to LLS disease in three crosses of groundnut. High values of GCV and high PCV, high heritability coupled with high GAM were observed for PDI at 60th, PDI at 90th and PDI at 120th days after sowing in all three crosses. Among 14 superior families six, among 13 superior families eight, and from three superior families one family showed resistance to LLS disease from the cross GKVK-16×KCG-2, GKVK-13×KCG-2 and GKVK-6×KCG-2 respectively. Therefore, these identified families will be forwarded for muti-location disease and further yield stabilization.

Management of three fused primary teeth.

Fusion is a dental anomaly in which two dental germs have developed separately and then become united. It is often confused with germination, unless until carefully evaluated clinically and radiographically. This paper describes a case of a six year old boy who presented with pain and swelling in right lower back tooth region. Intra oral examination revealed three fused primary teeth, which were confirmed radiographically. Radiographs also revealed missing permanent tooth buds associated with them. Since all the fused teeth were pulpally involved they were managed by pulpectomy. The incidence, prevalence, complications and treatment modalities are also discussed in this case report.

Vermian metastasis causing truncal ataxia and hydrocephalus as initial presentation of carcinoma stomach.

The common presentation of carcinoma stomach includes haematemesis, malaena and gastric outlet obstruction. Symptoms due to metastases to the liver and lung as part of the disease progression are usually preceded by the detection of a primary in the stomach. Carcinoma stomach, where the primary is silent, and which presents with truncal ataxia and features of hydrocephalus due to isolated metastatic deposit in the cerebellar vermis is exceptionally rare. The prognosis of such patients is poor and the treatment is palliative.

Neurodevelopmental, functional and growth status of term low birth weight infants at eighteen months.

This study was done to evaluate the neurodevelopmental, functional and growth status of term infants weighing 2000 g or less at 18 months, and to analyze major medical and social factors associated with an adverse neurodevelopmental and/or functional outcome. All infants were assessed for growth, audio-visual, neurological impairment, and motor and mental development using Indian modification of Bayley Scales of infant development. A detailed history was also taken. Term infants with birth weight of >2500 g without any antenatal or neonatal complications served as controls. Fifty low birth weight (LBW) term infants and 30 controls were evaluated. The mean mental development Quotient for LBW infants [91.51(16.97)] was significantly lower than that of Controls [102.02(8.4)]; the mean motor development Quotient however was comparable. The LBW infants were significantly lagging in terms of weight, length and head circumference at assessment. Neonatal complications were associated with an abnormal motor outcome while lower Socio-economic status and maternal education were related to adverse mental status. We concluded that Term LBW infants are at a significant disadvantage in terms of growth and mental scores at 18 months.

Radiological and clinical outcome following stereotactic biopsy and radiotherapy for low-grade insular astrocytomas.

Thirty patients with low-grade (WHO Grade II) astrocytomas involving the insula, who had undergone stereotactic biopsy followed by radiotherapy, were followed up to evaluate the outcome with regard to control of seizures, memory and language function, Karnofsky Performance scale and regression in tumor volume. Patients were followed up for a mean of 27.8 months, during which time they showed improvement in all the factors that were studied. A statistically significant change was, however, seen only in the reduction in tumor size, probably due to the small sample size and the short duration of follow-up. Stereotactic biopsy followed by radiation therapy provides a good short-term outcome in patients with low-grade insular astrocytomas.

Interhemispheric subdural hematoma: an uncommon sequel of trauma.

Interhemispheric subdural hematomas are relatively uncommon and usually seen in patients with bleeding disorders. They may present with signs of the falx syndrome or seizures. The management options range from craniotomy and evacuation to conservative management. We report such a case in a patient with normal bleeding parameters, which was managed with a twist drill craniostomy and drainage of the hematoma.

Autosomal recessive limb girdle myasthenia in two sisters.

Limb girdle myasthenic syndromes are rare genetic disorders described under the broad heterogeneous group known as congenital myasthenic syndromes and present with mixed features of myasthenia and myopathy. The familial limb girdle myasthenia has been described as one with selective weakness of pectoral and pelvic girdles, showing a positive response to edrophonium chloride. A report of two sisters affected by this disorder is presented.