RESUMEN
Introduction: Neglected clubfoot deformities are very rigid & stiff that need surgical correction. Unlike countries like china, Uganda, and Malawi, no dedicated National program has been implemented for clubfoot management in India. The burden of disability from untreated or partly treated clubfoot is relatively high. With the existing issues, it has been observed that untreated clubfoot is a public health problem in most low and middle-income countries. Objective: To conduct an observational analysis of the community approach to the correction of neglected clubfoot by corrective rehabilitation surgery camps. Methods: The study included the retrospective data of all the neglected clubfoot children who had undergone clubfoot corrective surgery in 13 different remote districts of Odisha, held every year between February 2014 to October 2022 except during covid 19 pandemic period (2020 and 2021). A total of 993 clubfeet of 731 children were corrected through community approach-based corrective camp surgery. Follow-up was done for all the operated children with post-op plaster and orthosis till they returned back to the community. Results: About 46.78% of study participants were within the age group of 5 years. Male presentation [454 males (62.10%)] was reportedly found 1.6 times higher than the female [277 females (37.89%)]. Most of them belonged to minor communities, socially and economically backward classes from various rural districts of eastern India. The Association of different socially backward categories of clubfoot children with the district they belonged to, was found significant statistically (p value < 0.001). When gender distribution was compared among the district where surgical camps were conducted, the association was statistically not significant (p value = 0.676). Conclusion: Neglected clubfoot in rural areas can be managed by camp approach. The establishment of a robust standard operating procedure for the conduction of community-based surgical camps may be required to reduce the morbidity level in children with neglected clubfoot.
RESUMEN
Background The concept of focused rehabilitative care and a dedicated rehabilitation setup is fairly less known among the people of developing countries. The main objective of the study is to assess the effect of late-onset stroke rehabilitation on its overall prognosis and to see whether and how the late initiation of rehabilitation would pose a significant effect on functional recovery and adverse medical outcomes Methods A single-center, prospective observational study was conducted in a tertiary rehabilitation center for a duration of one and a half years. The subjects admitted to the Department of Physical Medicine and Rehabilitation were divided into three groups with respect to the onset to admission interval (OAI). Patients who got admitted within 30 days (OAI≤ 30 days) were considered the early rehabilitation group. OAI between 31 and 150 days was the late rehabilitation group and OAI of 151 days or more was the very late rehabilitation group. Barthel Index (BI), Modified Rankin Score (MRS), and 6-minute walk test (6MWT) were used as functional outcome measures at admission and discharge from indoors. Results Maximum complications were observed in the late rehabilitation group, i.e. 2.75±2.74, with an overall mean of 2.02±2.04 (p=0.003). Functional recovery assessed using BI shows a significant difference between the early (35.79±8.86) and late (40.62±10.5) rehabilitation groups (p= 0.0005). 6MWT at discharge showed significant improvement in the early rehabilitation group (p=0.005). Conclusion Early onset of rehabilitation showed better functional recovery and fewer adverse medical outcomes in stroke patients. A longer length of hospital stay (LOHS), with a mean duration of 88 ±2 days was needed for patients with higher OAIs.
RESUMEN
PURPOSE: Evaluation of single and double limb support postural balance in patients with Anterior cruciate ligament (ACL)injury and comparison of the postural strategy adopted after ACL injury/deficiency(ACLD) with that of an age-matched healthy individual. METHODS: The study group that included 33 subjects confirming inclusion criteria had undergone postural balance assessment using the HUMAC Balance system. The parameters of the center of pressure excursion were recorded on a force plate and compared with age, BMI matched 66 healthy volunteers of control group. The center of pressure excursions was monitored using dependable variables such as sway path length(cm), the average velocity of sway(cm/sec), and the mean COP stability score(%). The mobility component was recorded as the percentage (%) of time spent on each target. RESULT: A decrease in postural balance in the injury group was evidenced by a statistically significant decrease of stability score(p = 0.015), increase in path length(p = 0.002) and decrease on time on target mean score (p= <0.001),. Although, the stability score path length and average sway velocity scores in the sound limb of the ACLD group showed impaired balance, the differences were not statistically significant (p = 0.180, p = 0.561, and p = 0.639 respectively) when compared with the dominant limb of the control group. CONCLUSION: HUMAC balance system is an effective and simplified measure for quantifying postural balance. Although overall postural stability in ACL injury is impaired, static postural balance is maintained by the compensatory of strategy of sound limb. However, the quantitative parameters of postural stability for the sound limb, despite of a lower mean value, did not show statistically significant differences from the dominant limb of the controlled group.
RESUMEN
INTRODUCTION: Pre-axial foot polydactyly has been termed as mirror foot, otherwise known as diplopodia. Association of a hypoplastic trapezoid shaped tibia makes the condition extremely uncommon. Whatever limited literature is available, most of it is focused on the preliminary reconstruction of deformity which again may not be feasible in late presentation. CASE REPORT: We present a 17-year-old girl having mirror foot with dysplastic trapezoid shaped tibia. She had mild equinovarus deformity of the right foot with three pre-axial extra digits that represent a mirror foot. There was also a gross shortening of the right leg with 20° fixed flexion deformity of the knee, but she could walk around with limited disability. Her chief complaint was difficulty in outdoor ambulation and poor cosmesis of the foot. Limb reconstruction may not have a predictable outcome with so much of shortening and she was also reluctant for amputation. A course of therapy was given with a treatment objective of improvement of knee flexion deformity and quadriceps control. She was fitted with an extension prosthesis which accommodates the deformed foot and also corrected the limb length discrepancy. CONCLUSION: Mirror foot with dysplastic tibia reported at an adolescent age may not be benefitted from surgical reconstruction. Functional rehabilitation is better than an anatomic correction in case of late presentation.
RESUMEN
MicroRNA (miRNA)-guided mRNA repression, mediated by the miRNA-induced silencing complex (miRISC), is an important component of post-transcriptional gene silencing. However, how miRISC identifies the target mRNA in vivo is not well understood. Here, we show that the nucleoporin Nup358 plays an important role in this process. Nup358 localizes to the nuclear pore complex and to the cytoplasmic annulate lamellae (AL), and these structures dynamically associate with two mRNP granules: processing bodies (P bodies) and stress granules (SGs). Nup358 depletion disrupts P bodies and concomitantly impairs the miRNA pathway. Furthermore, Nup358 interacts with AGO and GW182 proteins and promotes the association of target mRNA with miRISC A well-characterized SUMO-interacting motif (SIM) in Nup358 is sufficient for Nup358 to directly bind to AGO proteins. Moreover, AGO and PIWI proteins interact with SIMs derived from other SUMO-binding proteins. Our study indicates that Nup358-AGO interaction is important for miRNA-mediated gene silencing and identifies SIM as a new interacting motif for the AGO family of proteins. The findings also support a model wherein the coupling of miRISC with the target mRNA could occur at AL, specialized domains within the ER, and at the nuclear envelope.
