Management of Length Unstable Femur Fractures in Children by Flexible Intramedullary Nails: A Systematic Review.

PURPOSE OF THE STUDY: Surgical options for paediatric femoral fractures include fl exible intramedullary nailing (FIN), plating, and external fi xators. Length unstable fractures are usually spiral, long oblique, or comminuted and are often associated with > 2 cm of shortening. The purpose of this study was to see whether FIN is effective for managing unstable femur fractures in children. MATERIAL AND METHODS: An electronic literature search was performed up to 25 February 2022 in Cochrane Library, PubMed, and Embase databases using a combination of MeSH search terms and keywords related to the population (e.g., "child" AND "diaphyses" AND "femur"), and intervention (e.g., "nail" OR "ESIN"). The data extracted included the study details, Demographic data, surgical details, postoperative immobilization, complications, and outcome. RESULTS: Eight studies with a total sample size of 369 patients were reviewed. The mean operative time, blood loss, and length of stay in the hospital were 67.62±12.32 minutes, 33.82±16.82 ml, and 4.9±1.27 days, respectively. The results were excellent in 61.92% of the patients, satisfactory in 32.61%, and poor in 5.43%. 4.54% of patients had major complications requiring reoperation and 32.46% of patients had minor complications. the most common complication was nail prominence seen in 26.30% of patients. Locked Ender's nail was associated with the least reoperation, malunion, and LLD rate compared to other types of FIN. CONCLUSIONS: FIN along with a single walking spica cast is a good choice in all forms of paediatric femoral fracture patterns allowing proper alignment and rotation. Locked Ender's nail is safe and effective for managing unstable paediatric femur fracture. KEY WORDS: pediatric femur fracture, length unstable, fl exible intramedullary nailing, submuscular plating, Flynn criterion.

A Meta-Analysis on Comparison of Open vs Closed Reduction of Gartland Type 3 Supracondylar Humerus Fractures in Children.

PURPOSE OF THE STUDY Although there are numerous studies on outcomes and comparison of open and closed reduction but there is no clarity on relationship between outcomes and complications with type of surgical intervention done for Type 3 Gartland supracondylar humerus fracture. The aim of this study is to compare the outcomes and complications of closed vs open reduction in Type 3 Gartland supracondylar humerus fractures. MATERIAL AND METHODS Electronic literature searches of Embase, MEDLINE and the Cochrane Library was conducted in February 2022 using the terms "supracondylar", "humerus", "fracture", "Gartland type 3" and synonymous. The data extracted included the study details, demographic data, procedure performed, final functional and cosmetic outcome according to Flynn criteria and complications of included studies. RESULTS Pooled data analysis revealed no significant difference in mean satisfactory outcome rate according to Flynn cosmetic criteria in open group (97%, 95% CI 95.5%-98.5%), as compared to closed group (97.5%, 95% CI 96.3%-98.7%), although a statistically significant difference in mean satisfactory rate according to Flynn functional criteria in open group (93.4%, 95% CI 90.8%- 96.1%) as compared to closed group (98.5%, 95% CI 97.5%-99.4%) was noted. On separate comparison of the two-arm studies, closed reduction favoured better functional outcomes (RR 0.92, 95% CI 0.86-0.99). CONCLUSIONS Closed reduction and percutaneous fixation have better functional outcome than open reduction with K-wire fixation. But there was no significant difference in cosmetic outcomes, overall complication rate and nerve injury with either open or closed reduction. The threshold of converting a closed reduction to an open reduction in supracondylar humerus fractures of children should be high. Key words: supracondylar humerus, open reduction, percutaneous pinning, Flynn criteria.

Distribution and concentration pathway of particulate pollution during pandemic-induced lockdown in metropolitan cities in India.

To characterize the pollutant dispersal across major metropolitan cities in India, daily particulate matter (PM10 and PM2.5) data for the study areas were collected from the National Air Quality Monitoring stations database provided by the Central Pollution Control Board (CPCB) of India. The data were analysed for three temporal ranges, i.e. before the pandemic-induced lockdown, during the lockdown, and after the upliftment of lockdown restrictions. For the purpose, the time scale ranged from 1st April to 31st May for the years 2019 (pre), 2020, and 2021 (post). Statistical distributions (lognormal, Weibull, and Gamma), aerosol optical thickness, and back trajectories were assessed for all three time periods. Most cities followed the lognormal distribution for PM2.5 during the lockdown period except Mumbai and Hyderabad. For PM10, all the regions followed the lognormal distribution. Delhi and Kolkata observed a maximum decline in particulate pollution of 41% and 52% for PM2.5 and 49% and 53% for PM10, respectively. Air mass back trajectory suggests local transmission of air mass during the lockdown period, and an undeniable decline in aerosol optical thickness was observed from the MODIS sensor. It can be concluded that statistical distribution analysis coupled with pollution models can be a counterpart in studying the dispersal and developing pollution abatement policies for specific sites. Moreover, incorporating remote sensing in pollution study can enhance the knowledge about the origin and movement of air parcels and can be helpful in taking decisions beforehand.

A novel CaO nanocomposite cross linked graphene oxide for Cr(VI) removal and sensing from wastewater.

A novel green nanocomposite has been prepared by immobilizing CaO nanoparticles (CaO NPs) on the surface of graphene oxide. Biogenic CaO-NPs were synthesized from Lala clamshells. Morphological and structural characterizations of the nanocomposite were studied extensively. The adsorption capacity (qmax) of the nanocomposite for removing Cr(VI) was 38.04 mg g-1. In addition to this, the adsorption data were adequately simulated with Langmuir, Freundlich, Temkin, and pseudo-second-order models, suggesting that the adsorption process was the combination of external mass transfer and chemisorption. Electrostatic interaction was the dominant mechanism for Cr(VI) removal. In addition, the synthesized nanocomposites also serve as an excellent sensor for Cr(VI) sensing, with a limit of detection (LOD) of 0.02 µM utilizing electrochemical methods. Therefore, this green nanocomposite can simultaneously serve as an adsorbent and sensor for Cr(VI)removal from aqueous solutions.

Sequestration of heavy metal ions from multi-metal simulated wastewater systems using processed agricultural biomass.

Industrial effluents generally contain several metals, so during adsorptive treatment, they may influence the removal of each other. It is essential to explore the effect of co-cations on metal removal in multi-metal solutions. The present study examined the possibility of processed rice husk and saw dust to remove Cr6+, Ni2+, Cu2+, Cd2+ and Zn2+, from the single, binary and multi-component aqueous solutions. A substantial lesser removal of metal ions was observed in the presence of co-ions. This study revealed antagonistic effect on the removal of a particular metal ion, from the industrial effluent, even at optimum process parameters if other metal ions are present in the effluent. Although, a higher concentration of one metal ion than others in effluents increased its removal due to a greater number of ions as compared to other for the biosorption, yet presence of other ions influences the uptake of individual ions. In case of industrial effluents, maximum adsorption was obtained at pH 2.0 for Cr6+, 5.0 for Ni2+ and Cd2+ and 6.0 for Zn2+ and Cu2+. The study confirms the beneficial use of the studied biosorbents in water remediation.

A comprehensive physico-chemical quality and heavy metal health risk assessment study for phreatic water sources in Narora Atomic Power Station region, Narora, India.

An investigation of water quality and heavy metal distribution in the groundwater samples collected from the vicinity of Narora Atomic Power Station (NAPS), Narora, India, was conducted for the metals including Cu, Zn, Ni, Co, Cd, Pb, and Fe. A total of 16 water quality parameters were measured for all the groundwater samples, and TDS, TH, Mg2+, Ca2+, F-, and turbidity were found to be on the higher side in comparison to the prescribed limits of Indian standards. Geometrical mean concentrations for these heavy metals were found to be 0.049, 0.213, 0.23, 0.135, 0.017, 0.061, and BDL for Cu, Fe, Zn, Pb, Cd, Co, and Ni, respectively. Pb and Cd were more than the permissible limits (0.01 mg/L for Pb and 0.003 for Cd) prescribed for safe drinking water while Cu and Fe were exceeding the permissible limits of 0.05 mg/L and 0.3 mg/L in 32% and 36% samples, respectively. Health risk assessment was done by calculating total hazard quotient (THQ), and the values for all the metals were below the threshold value of 1.0 beyond which they may pose a significant risk.

COVID-19 lockdown: a rare opportunity to establish baseline pollution level of air pollutants in a megacity, India.

This paper analyses air quality data from megacity Delhi, India, during different periods related to the COVID-19, including pre-lockdown, lockdown and unlocked (post-lockdown) (2018-2020) to determine what baseline levels of air pollutants might be and the level of impact that could be anticipated under the COVID-19 lockdown emission scenario. The results show that air quality improved significantly during the lockdown phases, with the most significant changes occurring in the transportation and industrially dominated areas. A pronounced decline in PM2.5 and PM10 up to 63% and 58%, respectively, was observed during the lockdown compared to the pre-lockdown period in 2020. When compared to 2018 and 2019, they were lower by up to 51% and 61%, respectively, dropping by 56% during unlock. Some pollutants (NOx and CO) dropped significantly during lockdown, while SO2 and O3 declined only slightly. Moreover, when compared between the different phases of lockdown, the maximum decline for most of the pollutants and air quality index occurred during the lockdown phase 1; thus, this period was used to report the COVID-19 baseline threshold values (CBT; threshold value is the upper limit of baseline variation). Of the various statistical methods used median + 2 median absolute deviation (mMAD) was most suitable, indicating CBT values of 143 and 75 ug/m3 for PM10 and PM2.5, respectively. This results although preliminary, but it gives a positive indication that temporary lockdown can be considered as a boon to mitigate the damage we have done to the environment. Also, this baseline levels can be helpful as a first line of information to set future target limits or to develop effiective management policies for achieving better air quality in urban centres like Delhi. Supplementary Information: The online version contains supplementary material available at 10.1007/s13762-021-03142-3.

Management of banana crop waste biomass using vermicomposting technology.

This study reports the vermicomposting of banana crop waste biomass by Eisenia fetida. Cow dung has been used as bulking agent in this study. The experiment was conducted in six vermireactors containing different ratios of banana leaf waste biomass (BL) and cow dung (CD) for 105 days. Earthworm activity significantly reduced pH, TOC, C:N and C:P ratio of the wastes. Whereas macronutrients and micronutrients content increased after vermicomposting. TOC content of wastes reduced by 40-64% and C:N ratio of the vermicomposts was in the range of 8.9-24.3. The benefit ratio for heavy metals (Cu, Fe, Zn, Cd, Pb, Mn and Cr) was in the range of 0.23-3.44. The results indicated that the growth and fecundity of the earthworms was best in the vermireactors having 20-40% BL. Finally, it was concluded that vermicomposting can be included in the overall scheme of banana crop waste management.

Cardiological society of India document on safety measure during echo evaluation of cardiovascular disease in the time of COVID-19.

An echocardiographic investigation is one of the key modalities of diagnosis in cardiology. There has been a rising presence of cardiological comorbidities in patients positive for COVID-19. Hence, it is becoming extremely essential to look into the correct safety precautions, healthcare professionals must take while conducting an echo investigation. The decision matrix formulated for conducting an echocardiographic evaluation is based on presence or absence of cardiological comorbidity vis-à-vis positive, suspected or negative for COVID-19. The safety measures have been constructed keeping in mind the current safety precautions by WHO, CDC and MoHFW, India.

Pb2+ and Cd2+ recovery from water using residual tea waste and SiO2@TW nanocomposites.

This work reports the fabrication of SiO2@TW nanocomposites and their application for Pb2+ and Cd2+ ions sequestration from simulated water. Residual tea waste has also been used for metal ions sequestration to compare the potential of SiO2@TW nanocomposites. The SEM, TEM, BET, FTIR and EDX techniques were employed for the characterization of SiO2@TW nanocomposites and residual tea waste. Particle sizes of SiO2@TW nanocomposites was in the range of 6.8-12 nm. The experiments were carried out in batch mode to explore the effect of various operating parameters on the sequestration of Pb2+ and Cd2+ ions from water. The experimental data was subjected to various thermodynamic, kinetic and isothermic models. According to Langmuir model, the maximum adsorption efficiency of the SiO2@TW nanocomposites was 153 mg/g for Pb2+ and 222 mg/g for Cd2+ but maximum adsorption efficiency of residual tea waste for Pb2+ was 125 mg/g and for Cd2+ was 142.9 mg/g. This study suggested that due to the presence of active sites SiO2@TW nanocomposites has greater potential for metal sequestration than residual tea waste.

Alkali-cation-incorporated and functionalized iron oxide nanoparticles for methyl blue removal/decomposition.

Enhancing the rate of decomposition or removal of organic dye by designing novel nanostructures is a subject of intensive research aimed at improving waste-water treatment in the textile and pharmaceutical industries. Despite radical progress in this challenging area using iron-based nanostructures, enhancing stability and dye adsorption performance is highly desirable. In the present manuscript alkali cations are incorporated into iron oxide nanoparticles (IONPs) to tailor their structural and magnetic properties and to magnify methyl blue (MB) removal/decomposition capability. The process automatically functionalizes the IONPs without any additional steps. The plausible mechanisms proposed for IONPs incubated in alkali chloride and hydroxide solutions are based on structural investigation and correlated with the removal/adsorption capabilities. The MB adsorption kinetics of the incubated IONPs is elucidated by the pseudo second-order reaction model. Not only are the functional groups of -OH and -Cl attached to the surface of the NPs, the present investigation also reveals that the presence of alkali cations significantly influences the MB adsorption kinetics and correlates with the cation content and atomic polarizability.

Green fabrication of ZnO nanoparticles using Eucalyptus spp. leaves extract and their application in wastewater remediation.

The present study explored removal of carcinogenic cationic and anionic dyes from aqueous medium using green fabricated zinc oxide nanoparticles (ZnO-NPs). The ZnO-NPs were synthesized employing biogenic green reduction and precipitation approach. The characterization of ZnO NPs was done using various techniques such as FESEM, XRD, BET, TGA, HRTEM, EDX, and FTIR. All experiments were conducted in batch mode. Maximum removal was achieved at pH 6.0 and pH 8.0 for Congo Red (CR) and Malachite Green (MG) dyes respectively. Dye adsorption process showed better fit with Langmuir and Temkin isotherm models for CR dye and MG dye respectively. Maximum adsorption capacity of ZnO NPs was 48.3 mg/g for CR dye and 169.5 mg/g for MG dye. The dye adsorption followed pseudo-second order model and values of thermodynamic parameters confirmed that the adsorption process was spontaneous and favourable. Reusability efficiency of the nanoparticle was explored using ethanol and water and based on results it was inferred that ZnO-NPs can be reused for dye removal. Effect of salinity on the removal of CR and MG dyes was also explored and found that presence of salinity in aqueous medium have adverse impact on the dye removal efficiency of ZnO-NPs.

Applications of Fe3O4@AC nanoparticles for dye removal from simulated wastewater.

This study deals with the removal of cationic dyes from the simulated wastewater using Fe3O4 nanoparticles loaded activated carbon. Fe3O4@AC nanoparticles were synthesised using co-precipitation methods. The Fe3O4@AC nanoparticles (nps) were characterised using different techniques and data revealed that the synthesised nanoparticles were 6-16 nm in diameter. pHpzc of Fe3O4@AC nanoparticles was 7.8. BET surface area of Fe3O4@AC nps was found to be 129.6 m2/g by single point method and 1061.9 m2/g by multipoint method. Adsorption experiments were performed to optimize the effect of process conditions such as pH of solution, nanoparticles dose, temperature, concentration of dye and contact time on contaminant removal. The maximum uptake capacity of Fe3O4@AC was found to be 138 and 166.6 mg/g for methylene blue and brilliant green dyes, respectively. In order to assess dye adsorption behaviour, adsorption isotherm models viz., Langmuir, Freundlich and Temkin were applied to the data. Langmuir isotherm best fitted [R2 = 0.993 (MB) and R2 = 0.920 (BG)] to the experimental data of both the dyes. Further, Pseudo-second order rate equation fitted better to the experimental data. Reuse potential of the nanoparticles was also investigated for the removal of both the dyes and it is inferred from the data that the synthesised nanoadsorbent has promising reuse potential, therefore can be used for several cycles.

Role of broad-spectrum sunscreen alone in the improvement of melasma area severity index (MASI) and Melasma Quality of Life Index in melasma.

BACKGROUND: Sunscreens have long been an indispensable part in treating melasma as ancillary agents. None of previous studies have evaluated the role of sunscreens alone in the improvement of melasma. AIMS: Our objective was to study the role of broad-spectrum sunscreen with sun protection factor 19 and PA+++ as the sole agent for improvement of melasma. METHODS: A total of 100 patients with melasma were included in the study. Following proper method of application of 3 mL sunscreen, thrice daily, Melasma Area Severity Score (MASI) and Hindi language version of the MELASQOL scale (Hi-MELAQOL) was done at baseline and 12 weeks. RESULTS: The mean MASI in the study group at the beginning and at the end of the study was 12.38 ± 14.7 and 9.15 ± 4.7, respectively, whereas the mean value of Hi-MELASQOL at the beginning and at the end of the study was 47.2 ± 14 and 38.1 ± 14.2, respectively. The differences of both were statistically significant. Spearman's correlation between MASI and Hi-MELASQOL before and after the study was positive but insignificant. CONCLUSION: There was both an objective and subjective improvement in melasma after 12 weeks of sunscreen use in terms of both MASI, showing an objective improvement of melasma after using sunscreens alone and also in Hi-MELASQOL showing that use of sunscreens significantly improved quality of life of melasma patients. In our study, we have attempted to re-instate the importance of sunscreens to patients and dermatologists who are inclining more toward various skin lightening agents for treatment of melasma, which have many side effects.

Wear Behavior of Graded Glass/Zirconia Crowns and Their Antagonists.

Monolithic zirconia crowns have become very popular; their surface finish is considered a key factor for restoration longevity. While polishing has shown excellent results in vivo, the surface glass infiltration of zirconia may offer superior damage resistance and aesthetic advantages by using tooth-colored glasses. Thus, the purpose of this study is to evaluate the efficacy of polishing and glass infiltration on the wear behavior of monolithic zirconia crowns. The wear behavior of intact natural molar teeth was investigated as a reference. Zirconia crowns were divided into 3 groups: PolZ-sintered then polished; PolGZ-polished in the presintered state and then glass infiltrated and sintered; NoPolGZ-as machined, glass infiltrated and sintered. Crowns were adhesively bonded to a dentin-like abutment. Zirconia crowns and molar teeth ( n = 15) were subjected to contact-slide-liftoff cyclic loading (200 N, 1.25 million cycles) with a steatite sphere ( r = 3 mm) as an antagonist in water. Surface and subsurface damages were investigated with optical and scanning electron microscopies. Wear depth and volume loss were determined with micro-computed tomography. PolGZ and NoPolGZ crowns exhibited shallow wear scars, where material loss remained within the glass/zirconia layer with no visible cracks. Meanwhile, PolZ crowns presented no visible wear damage. Volume loss (mm3) in the steatite antagonist was as follows (mean ± SD): PolZ = 0.022 ± 0.007, PolGZ = 0.011 ± 0.004, and NoPolGZ = 0.014 ± 0.006. Molar teeth yielded no measurable wear on the antagonist, while the wear scar on the teeth was greater than that on zirconia crowns, ranging from 0.07 to 0.35 mm3. The combination of polishing and glass infiltration on the occlusal surface of monolithic zirconia crowns yielded reduced wear on both crown and antagonist.

Application of EDTA modified Fe3O4/sawdust carbon nanocomposites to ameliorate methylene blue and brilliant green dye laden water.

This work explored the potential of magnetic sawdust carbon nanocomposites for cationic dyes removal from aqueous medium. EDTA modified magnetic sawdust carbon nanocomposites (EDTA@Fe3O4/SC ncs) were prepared by biogenic green reduction and precipitation approach. The surface properties, structure and composition of nanocomposites were characterized by HRTEM, FESEM, XRD, EDX, BET, FTIR etc. The Fe3O4 nanoparticles were 10-20 nm in diameters and having 14 m2/g surface area. Removal of Methylene blue (MB) and Brilliant green (BG) dyes from aqueous medium was studied in batch mode experiments. The maximum removal was achieved at neutral pH 7.0 with in 30 min. Adsorption capacity of EDTA@Fe3O4/SC for MB and BG dyes was 227.3 mg/g and 285.7 mg/g, respectively. Dye adsorption behaviour is well explained by Freundlich model. The rate of cationic dye adsorption is explained by pseudo-second order model. The value of thermodynamic parameters confirmed that adsorption process was spontaneous and favourable. Desorption and reusable efficiency of nanocomposites was also evaluated.

Biotransformation of bakery industry sludge into valuable product using vermicomposting.

The aim of present work was to evaluate periodic changes in bakery industry sludge during vermicomposting. Six different blends of cow dung (CD) and bakery industry sludge (BIS) containing 10 to 50% of BIS were assessed in this study. Changes in physico-chemical parameters were evaluated at 21 days interval up to 105 days. Earthworms significantly increased NPK content and EC, while decreased pH, TOC and C: N ratio of BIS. After vermicomposting, TKN, TAP and TK contents increased 2.0-3.5, 1.2-1.9 and 1.2-1.4 times, respectively as compared to initial blends. A significant reduction (65.4-83.5%) in C: N ratio was observed in all blends. The concentrations of metals were found to be higher in the vermicomposts as compared initial blends. It was inferred that bakery industry sludge spiked with cow dung can be biotransformed into valuable manure employing earthworms.

A neutral wind instrument for nano-satellite platforms.

Here we describe the first neutral wind sensor developed specifically for use on resource limited nano-satellite platforms. The instrument is a next generation redesign of the ram wind sensor flown on the Communications/Navigation Outage Forecasting System satellite for measurements of neutral velocity, temperature, and composition. Results of subsystem tests in vacuum conditions show low-power operation, promising design, and good resolution of measured parameters over the operational pressure and energy ranges expected in the low Earth orbit environment.

Green synthesis of Fe3O4 nanoparticles loaded sawdust carbon for cadmium (II) removal from water: Regeneration and mechanism.

This study focused on the synthesis and characterization of novel magnetic iron oxide nanoparticles loaded sawdust carbon (Fe3O4/SC) and EDTA modified Fe3O4/SC (EDTA@Fe3O4/SC) nanocomposites (ncs) by low cost biogenic green synthesis approach and their application for Cd (II) removal from aqueous medium in batch mode. In isotherm studies, Langmuir and Freundlich models are best fitted to Cd (II) removal data. Langmuir maximum adsorption capacity of EDTA@Fe3O4/SC ncs was found to be 63.3, 22.4 and 25 mg/g that is greater than maximum adsorption capacity of Fe3O4/SC ncs that is 51, 18.9 and 15 mg/g at the adsorbent doses of 0.4, 1.2 and 2.0 g/L, respectively. Cd (II) adsorption rate is well explained by Pseudo-second order model. Cd (II) adsorption process is spontaneous and endothermic in nature expressed by Enthalpy, Entropy and Free Energy change. The results of regeneration studies showed that EDTA modified Fe3O4/SC ncs is promising, low cost and eco-friendly for heavy metal adsorption.