Study of Short-Term Outcome of Surgically Managed Displaced Pediatric Radial Neck Fractures: A Case Series.

INTRODUCTION: Pediatric radial neck fractures are relatively rare elbow injuries commonly seen in children between eight to 12 years of age. Judet type III and Judet type IV radial neck fractures require surgical intervention for optimal functional outcomes. The present study evaluates the functional results of Judet type III and IV radial neck fractures operated at a single center. MATERIALS AND METHODS: This is a retrospective study conducted by using medical records of nine patients who had displaced radial neck fractures (Judet type III and type IV) treated at our institute which is a tertiary trauma care center between January 2012 and December 2021. Patients were assessed for functional outcome by Mayo elbow performance score (MEPS), the Tibone and Stoltz functional criteria, and for complications with the average follow-up of four years (range: six months to seven years).  Results: The mean age of the patients was 9.14 ± 2.2 years (range: four to 11 years). Seven (77.8%) patients were males and two (22.2%) patients were females. The right side was the most commonly injured side (right at 67%, left at 33%). Five (55%) cases were of Judet type III and four (45%) cases were of Judet type IV. Three cases treated with closed reduction and intramedullary nailing by the Metaizeau technique had excellent functional results. Among two patients treated with percutaneous pin leverage and intramedullary nailing by the Metaizeau technique, one patient had an excellent outcome, and the other had a good outcome. Among four cases treated with open reduction and K-wire fixation, two patients had good outcomes, one patient had a fair outcome, and one patient had a poor outcome. CONCLUSION: The majority of moderately to severely displaced pediatric radial neck fractures which need intervention can be managed by the closed reduction technique of Metaizeau with or without pin leverage with excellent to good functional outcomes at short-term follow-up. Some cases need open reduction which also has good to fair outcomes. Initial trauma and associated injuries seem to play a role in the outcome rather than the treatment method per se. However, a larger sample size and longer follow-up are needed for comparisons and for arriving at better and definitive conclusions.

Enhanced Mefenamic Acid Release from Poloxamer-Silicon Dioxide Gel Filled in Hard Gelatin Capsules - An Application of Liquid Semisolid Matrix Technology for Insoluble Drug.

INTRODUCTION: Liquid Semisolid Matrix (LSSM) technology involves the filling of drugmixed gel in hard gelatin capsules for different applications. METHODS: In continuation of our previous work on LSSM technology, 10% (w/w) of practically insoluble model drug, mefenamic acid was incorporated in gels of different poloxamers with 8% (w/w) SiO2. RESULTS: Gels exhibited plasticity or pseudoplasticity along thixotropy at 2 and 24 h enabling their easy filling into hard gelatin capsules without content seepage. Mefenamic acid gels prepared with L64 and L92 maintained their apparent viscosities for the study period of one month. Around 100% mefenamic acid was released within 90 min from L64- and in 150 min from L92-SiO2 gels, both with first-order kinetics. In 12 month long-term stability studies, only mefenamic acid-L64- SiO gel at 30°C/65% RH indicated dispersion stability with similar rheology and release pattern to that at 2, 24 and 30 days. No chemical drug-polymer interactions were found in FTIR. CONCLUSION: The release of practically insoluble mefenamic acid could be enhanced from gel formulated with L64 and SiO2.

The Trauma of Sexual Harassment and its Mental Health Consequences Among Nurses.

OBJECTIVE: To determine the prevalence of sexual harassment in nurses and to observe its correlation with negative mental health (depression, anxiety and stress). Further to examine the role of sexual harassment as a predictor of negative mental health in nurses and to explore the differences in the experience of sexual harassment, depression, anxiety and stress between junior and senior nurses. STUDY DESIGN: Cross-sectional descriptive study. PLACE AND DURATION OF STUDY: Public Sector Hospitals in Lahore, from December 2011 to March 2012. METHODOLOGY: Asample of 200 nurses with age range 23 to 46 years was obtained. Assessment tools used in the study were Sexual Harassment Experience Questionnaire (SHEQ) by Kamal, and Depression, Anxiety and Stress Scale (DASS) by Lovibond and Lovibond. RESULTS: Mean age of the nurses was 29.80 ±7.10 years. Among these 63% were married and 37% unmarried. The mean working experience of nurses was 13.7 ±3. 52 years and their mean monthly income was 27820 ±13687.32 rupees. Their working hours ranged from 8 to 16 hours (M = 8.32, SD = 2.12). The mean prevalence of sexual harassment was 71.66 ±19.01. A significant positive correlation of sexual harassment with depression, anxiety, stress and combined effect of them (DASS) was found. Multiple regression analysis showed sexual harassment as significant predictor of depression (ß= 0.47, p < .001), anxiety (ß= 0.43, p < .001) and stress (ß= 0.45, p < .001) in nurses. CONCLUSION: Sexual harassment was found to be a predictor of negative mental health in the form of depression, anxiety and stress in nurses of public hospitals.