ABSTRACT
This study aims to comprehend the experience of hearing screening in children with suspected hearing loss at a tertiary care centre of eastern Uttar Pradesh, India using distortion product otoacoustic emission (DPOAE) as a screening modality. This study was conducted at a tertiary care centre of eastern Uttar Pradesh during the period of July, 2021to June, 2022 consisting of 96 children who were referred with suspected hearing loss. They underwent distortion product otoacoustic emissions (DPOAE) testing. Out of 96 children who underwent DPOAE testing, 25 (26.04%) passed the test, 55(57.29%) had "refer" result in bilateral ears whereas 16 (16.67%) had "refer" result in either ear. OAE is a simple, cost-effective and convenient tool for hearing screening in spite of some limitations. Universal new-born hearing screening can be implemented using OAE.
ABSTRACT
Background: Various operative procedures have been described for the treatment of traumatic paraplegia caused by unstable thoracolumbar fractures. We prospectively evaluated interbody fusion (IBF) with SS-PSF in these cases with regard to clinico-radiological outcome with the objectives: (1) Does IBF and short segment pedicle screw fixation (SS-PSF) prevent progression of kyphotic angle after surgery? (2) Can this procedure be safely performed in the setting of acute trauma?. Methods: Sixteen patients suffering from traumatic paraplegia caused by acute unstable thoracolumbar fractures were enrolled prospectively and underwent IBF with SS-PSF. They were evaluated for magnitude of shortening in spine, progression of kyphotic angle, and neurological improvement by American spinal injury association scale (ASIA). Results: Out of total sixteen, 14 patients were ASIA grade A and 2 were grade C, at the time of presentation. Thirteen out of these 14 remained grade A and one improved to B. Both the patients who had grade C involvement at the time of presentation improved to grade D at one-year follow-up. The mean blood loss was 750 ml (range; 650 ml-1150 ml). Mean kyphotic angle decreased from 20.6° (range; 13° to 37°) preoperatively to 6.2° (range; 3° to 10°) at postoperative day 2 (p = 0.002). Its mean value after 6 months was 6.5° (range; 3° to 11°). The procedure resulted in mean spinal column shortening of 18 mm (range; 16 mm-22 mm) in the spinal column. All the patients achieved bony union by a mean duration of 3.9 months (range; 3 months-6 months). Conclusions: IBF with SS-PSF has the shortest possible instrumented construct for thoracolumbar junction fusion done by posterior approach. The interbody fusion for unstable thoracolumbar junction fractures prevents the progression of kyphotic angle post-operatively. Level of evidence: Level 4.
ABSTRACT
Cortisol is a major stress biomarker involved in the regulation of metabolic and immune responses. Readily accessible assays with sufficient quantitative and temporal resolution can assist in prevention, early diagnosis, and management of chronic diseases. Whereas conventional assays are costly in terms of time, labor, and capital, an electrochemical approach offers the possibility of miniaturization and detection at the point-of-care. Here, we investigate the biosensor application of molecularly imprinted polypyrrole (PPy) doped with hexacyanoferrate (HCF) and coupled to reduced graphene oxide functionalized with ß-cyclodextrin (ß-CD). ß-CD provides an inclusion site for lipophilic cortisol and was electrochemically grafted simultaneous with reduction of GO. Next, PPy was electrochemically deposited in presence of cortisol template with HCF dopant ions serving as intrinsic redox probe. Thus, the sensor response was evaluated via changes of redox peak current in cyclic voltammetry and demonstrated a broad logarithmic detection range (5 pg/mL to 5000 ng/mL, R 2 = 0.995), with a sensitivity of 8.809 µA log-1 (ng/mL) cm-2 and LOD of 19.3 pM. The sensor was shown to be specific toward cortisol in reference to salivary cortisol concentration in saliva over structural analogues. The sensor was exhibited to determine cortisol in artificial saliva at normal and elevated levels. The good performance and facile electrochemical fabrication of this antibody- and external label-free interface are promising for the development of affordable point-of-care biosensors.
ABSTRACT
BACKGROUND: We investigated whether magnetic resonance imaging (MRI) scans can accurately diagnose arthritis of the acromioclavicular joint (ACJ) because it has recently been suggested that bone marrow oedema on MRI scans is a predictive sign of symptomatic ACJ arthritis. METHODS: The MRI scans of 43 patients (50 shoulders) who underwent ACJ excision for clinically symptomatic ACJ arthritis were compared to a control group of 43 age- and sex-matched patients (48 shoulders) who underwent an MRI scan for investigation of shoulder pain but did not have clinical symptoms or signs of ACJ arthritis. The scans were evaluated by an experienced musculoskeletal radiologist, who was blinded to the examination findings. RESULTS: Bone marrow oedema was present in only 15 (30%) shoulders in the ACJ excision group, although this was higher than the six shoulders in the asymptomatic group (p = 0.03). Forty-one (82%) shoulders in the symptomatic group had grade III/IV ACJ arthritis compared to 31 (65%) in the asymptomatic group (p = 0.05). However, 44 out of 48 (92%) shoulders in the asymptomatic group had signs of osteoarthritis on MRI scans. CONCLUSIONS: In contrast to recent reports, the present study shows that MRI is not helpful in making the diagnosis of ACJ arthritis. A focused history and clinical examination should remain the mainstay for surgical decision making. LEVEL OF EVIDENCE: Level 3.
ABSTRACT
Isolated fractures of the carpal hamate are rare. We describe a case of 28-year-old male patient who sustained a rare pattern of wrist injury: combined intraarticular fracture of the body and the hook of hamate in the non-dominant left hand. The patient was treated with percutaneous pinning of the fracture of hamate body.
