Traumatic Spinal Injury among Patients with Spinal Injuries Admitted to the Spine Unit of a Tertiary Care Centre: A Descriptive Cross-sectional Study.

Introduction: Traumatic spinal injury is a major source of morbidity and mortality throughout the world. The number of spinal injuries is growing annually but epidemiological and demographic features may be different in different regions. This study aims to find out the prevalence of traumatic spinal injury among patients with spinal injuries admitted to the spine unit of a tertiary care centre. Methods: This was a descriptive cross-sectional study was done on a total of 102 traumatic spinal injury patients admitted to the spine unit of a tertiary care centre from 1st June, 2019 to 31st May, 2021 after receiving ethical approval from the Institutional Review Committee (Reference number: 077/78-09). Demographic details, mode of injury, morphology, patterns of fractures, neurological level, and management methods in the hospital were recorded. Convenience sampling was done. Data were analysed using the Statistical Package for the Social Science version 24.0. Point estimate at 95% Confidence Interval was calculated along with frequency and percentages for binary data. Results: Among 130 spinal injury patients, the prevalence of traumatic spinal injury was found to be 102 (78.46%) (71.39-85.53 at 95% Confidence Interval). The most common mode of spinal injury was due to falls in 80 (78.43%) cases. Conclusions: The prevalence of traumatic spinal injury was higher when compared to the other studies done in similar settings. Keywords: falls; polytrauma; spinal cord injuries; trauma.

Prevalence of Nerve Injuries in Supracondylar Fracture of Humerus in a Tertiary Care Hospital.

BACKGROUND: Supracondylar fracture is a common childhood injury. These fractures are often associated with neural and vascular injuries. There is discrepancy in literature about the most common nerve injured in such fractures. This study aims to study the nerve injury patterns in supracondylar fractures of humerus in Nepalese children. METHODS: This descriptive cross sectional study was conducted in 152 children (aged 2 to 14 years) with supracondylar fractures of humerus attending in Bharatpur Hospital during the period of one year. All eligible patients were assessed clinically and radiologically. Neurological assessment was done for nerve injury. RESULTS: Out of 152 children, 18(11.8%) had nerve injuries. The mean age was 7.41±2.91 years. Boys were more injured (68.4%) than girls (31.6%). It was more common on non-dominant side (57.9%). Out of 18 nerve injuries, most commonly injured nerve was median nerve 10(55.5%) followed by radial nerve 7(38.9%). Median nerve injury was common in posterolateral displacement and radial nerve injury was common in posteromedial displacement type of fracture.   Conclusions: Displaced supracondylar fractures have relatively higher prevalence of nerve injuries. Most commonly involved nerve is median nerve followed by radial nerve. So, every displaced fracture should be routinely screened for nerve injuries.

Weave Technique for Reconstruction of Medial Collateral Ligament and Posterior Oblique Ligament: An Anatomic Approach Using Semitendinosus Tendon.

Medial collateral ligament (MCL) is the most commonly injured ligament in knee. The majority of MCL tears can be managed conservatively, and reconstruction or augmentation is required in few selected cases. Anatomic MCL and posterior oblique ligament reconstruction have good functional outcome, but it requires 2 tunnels each in the tibia and femur, which may be a limitation in cases in which multiligament reconstruction is required. Several studies report the use of semitendinosus tendon with intact tibial attachment for MCL reconstruction. Since the attachment of semitendinosus is anterior to MCL footprint, it is non-anatomic and anisometric, which may lead to increased laxity of the reconstructed ligament in due course of time. To prevent the laxity in long term, the reconstruction has to be isometric and anatomic. We, hereby, are reporting our unique technique of MCL and posterior oblique ligament reconstruction using intact semitendinosus at tibial attachment and re-routing to the MCL which makes the reconstruction anatomic and isometric. A supplemental video demonstration of the technique is attached with this article.

Manipulating plant geometry to improve microclimate, grain yield, and harvest index in grain sorghum.

Cultivar selection, planting geometry, and plant population are the key factors determining grain sorghum yields in water deficit areas. The objective of this study was to investigate whether clump geometry (three plants clustered) improves microclimate within crop canopy when plants are grown under varying water levels. In a 2-yr sorghum (Sorghum bicolor L. Moench) greenhouse study, plants were grown at two geometries (clump and conventional evenly spaced planting, ESP), two water levels (high and low, representing well-watered and water-limited condition, respectively), and three soil surface treatments (lid covered, straw-mulched, and bare). Air temperature and relative humidity (RH) within the plant canopy were measured every five minutes at different growth stages. Mean vapor pressure deficits (VPDs) within the clumps were consistently lower than those for ESPs, indicating that clumps improved the microclimate. Clumps had significantly higher harvest index (HI) compared to ESPs (0.48 vs. 0.43), which was largely due to clumps having an average of 0.4 tillers per plant compared to 1.2 tillers per plant for ESPs. Grain yield in the current study was similar between clumps and ESPs. However, our results suggest that improved microclimate was likely a reason for clumps producing significantly higher grain yields compared to ESPs in previous studies.