Management of Subtrochanteric Fracture Femur- by ProximalFemoralNailing

Background: Numerous variations of intramedullary nailing have been evolved over the years for stable fixation and early mobilisation of subtrochanteric fracture, out of which one is proximal femoral nail. Aims and objectives –We conducted this study with an objective to evaluate the results of internal fixation of subtrochanteric fractures of the femur with proximal femoral nail – AO type Design.Methods:This was a prospective study carried out at our tertiary care institute on 30 patients who had suffered subtrochanteric fracture and were subsequently treated with a proximal femoral nail (PFN). Proximal femoral nail was inserted through the tip of greater trochanter. All patients were followed up for a period of one year; at an interval of 3 months and during each follow-up visit for the functional outcome by modified Harris Hip Score, was assessed in the form of walking, squatting, sitting and rising from chair.Results:Modified Harris hip score was used for the evaluation of results in our study which showed excellent result in 21 patients (70%), good results in 3 cases(10%), fair results in 3 patient (10%) and poor results in 3 cases(10%). The mean Harris hip score in our study was 90.6.Conclusion:PFN is an intramedullary load sharing implant. Reduction and management of subtrochanteric fractures is challenging in traumatology. Proximal femoral nailing spanning whole femur with proximal and distal locking appears to be a satisfactory implant in management of fractures of subtrochanteric femur.

308-nm excimer laser in the treatment of a localized recalcitrant form of perioral dermatitis: Case report

In the last two decades, 308-nm excimer laser has been increasingly recognized as a therapeutic alternative for several dermatological conditions, being currently FDA approved for the treatment of localized vitiligo and moderately severe localized psoriasis unresponsive to topical treatments. We describe the case of a 17-year-old with a recalcitrant form of dermatitis occupying the entire perioral region, previously unresponsive to several treatments, who was treated with 308-nm excimer laser with an excellent result. 308-nm monochromatic excimer laser has several advantages over other types of phototherapy, including lower UV dose exposure, shorter courses of therapy and a better sparing of adjacent tissue. Although infrequently used, 308-nm excimer laser certainly has a vast potential in Dermatology, particularly regarding recalcitrant and localized inflammatory conditions, such as the one we present.

Design and Development of Low-Level Automation for the Picking and Placing of the Object Using Pneumatic Suction

Pneumatics suction is being used in the food factory for picking and placing the ingredients of food. A clean environment inside the food factory is very much needed the maintain the quality of packaging food. The present work focuses on the low level of automation so that investment cost for processing the raw ingredient goes down. Two double-acting pneumatic cylinders, one pneumatic suction gripper, three pneumatic direction control valves, one screw compressor, one DC motor, two relays, a Push button, and a 24-volt power supply have been used the implement the system. A combination of pneumatic actuation and electrical actuation is used for controlling the motion of the system. A simple control ON/OFF system was used for the actuation. Pneumatic component drive with the help of compressed air via a direction control valve and motor direction control using the relay. By pressing the push button whole, the setup can be controlled in a very easier way and it is very user-friendly for the operator. Several testings have been done on the setup and an excellent result were obtained during execution.

Integration of Phase Change Material in the Design of Solar Concentrator-Based Water Heating System

Indonesia has been blessed with excellent solar heat distribution, which can be used as renewable energy to heat water. Various technologies have been developed to utilize these inexhaustible thermodynamic resources, in the form of photons arrays, converted into concentrated heat for daily use, i.e., solar water heater. This renewable-based water heating system can provide significant energy efficiency, benefit the environment, and reduce energy use costs. This experimental study attempts to harvest the energy from the sun using a cylindrical through collector (CTC) type solar concentrator. The CTC was made of the solar reflective film (SRF) affixed to concentrator collector surfaces which was then mounted on an adjustable angle frame of the concentrator collector support. The heat generated from the concentrator was stored in water, and phase change material is embedded in the system to retain the heat longer. The research was carried out in Langsa City, Aceh, Indonesia. The results showed that water heaters using CTC systems could produce 16 L of hot water retained at 40–60 oC for four hours. With the addition of beeswax, the water temperature of the same capacity can be maintained at 40–60 °C for around 5 h. This technology demonstrated an excellent result that produces as much as 60 L of water per day, increasing solar thermal energy efficiency. This technology presented a great potential for replication or even for further development on an industrial scale.

The Influence of Baseline Clinical Status and Surgical Strategy on Early Good to Excellent Result in Spinal Lumbar Arthrodesis: A Machine Learning Approach

The study aims to create a preoperative model from baseline demographic and health-related quality of life scores (HRQOL) to predict a good to excellent early clinical outcome using a machine learning (ML) approach. A single spine surgery center retrospective review of prospectively collected data from January 2016 to December 2020 from the institutional registry (SpineREG) was performed. The inclusion criteria were age ≥ 18 years, both sexes, lumbar arthrodesis procedure, a complete follow up assessment (Oswestry Disability Index—ODI, SF-36 and COMI back) and the capability to read and understand the Italian language. A delta of improvement of the ODI higher than 12.7/100 was considered a “good early outcome”. A combined target model of ODI (Δ ≥ 12.7/100), SF-36 PCS (Δ ≥ 6/100) and COMI back (Δ ≥ 2.2/10) was considered an “excellent early outcome”. The performance of the ML models was evaluated in terms of sensitivity, i.e., True Positive Rate (TPR), specificity, i.e., True Negative Rate (TNR), accuracy and area under the receiver operating characteristic curve (AUC ROC). A total of 1243 patients were included in this study. The model for predicting ODI at 6 months’ follow up showed a good balance between sensitivity (74.3%) and specificity (79.4%), while providing a good accuracy (75.8%) with ROC AUC = 0.842. The combined target model showed a sensitivity of 74.2% and specificity of 71.8%, with an accuracy of 72.8%, and an ROC AUC = 0.808. The results of our study suggest that a machine learning approach showed high performance in predicting early good to excellent clinical results.

Advancement and development in computational chemistry for Colorectal Cancer diagnosis and treatment

: Colorectal cancer is the third most common form of cancer in the world and is a significant cause of death from cancer. To get a cure for colorectal cancer, early diagnosis and screening are necessary, as well as a clear understanding of the molecular basis of the disease. Molecular characterization of mutations associated with cancer provides useful information on the prognosis and reaction to therapy. This review discusses the clinical, molecular, and pathogenic features of the early onset of colorectal cancer, its screening tests, and diagnosis. The recent advances and rapid growth of computational tools in colorectal cancer used for diagnosis as well as screening are outlined in this review, including artificial intelligence, computer aided diagnosis, molecular docking, machine learning, and deep learning. In recent developments, the application of artificial intelligence has proved its excellency and shown a promising result, pointing out the severe need for a multidisciplinary approach to achieve an excellent result.

Congenital muscular torticollis: an Orl’s perspective

<p>Congenital muscular torticollis usually results from the shortening or excessive contraction of sternocleidomastoid muscle. Delay in diagnosis and appropriate early therapeutic evaluation can lead to permanent disability. We would like to report two rare cases with congenital muscular torticollis who underwent surgery followed by aggressive physiotherapy. We would like to emphasise the need of an early diagnosis and intervention which leads to best outcome. This can prevent progressive physical deformity. Surgeons should offer the patient with option of release and repair of sternocleidomastoid muscle as it gives excellent result in view of mobility and appearance for child.</p>

Investigate the Crashworthiness of high-velocity bird impact on three different designed model wings by using Coupled Eulerian-Lagrangian approach

Bird strike is a significant threat to the parts of the flying aircrafts. The wing is a central part, which provides stability to the aircraft. Mostly at wing, bird attack the leading edge. Worldwide aviation regulation FRA, EASA, required 4Ib bird strike on the wing of aircraft, and after this bird strike, aircraft is able to be safely landed. This study aims to investigate the resistance of the wing against the bird strike and damage analysis of the high-velocity bird collision on the model wing, inner structure, spar, and ribs. By using the Coupled Eulerian-Lagrangian (CEL) approach in ABAQUS/Explicit. Our contribution 1) bird strike on a wing with assembled inner structure by aluminium and outer skin composed of unidirectional fiber-reinforced composite material. 2) bird strike on-wing which is similar with the first test in which the difference is of spar designed layers of horizontal plates like a comb. 3) bird strike on-wing which is similar with second model wing difference in this wing put an aluminium leading edge on the skin leading-edge, final to analyze the damage of bird impact on the wing, the velocity of bird strike is 200m/s and analyze the behavior of the bird at this velocity. Resistance behavior of composite skin After penetration in the wing, analyze the impact on the spar and stress on the inner structure. Analysis of the kinetic and internal energy graph and Comparison all of these results and check the performance, which gives an excellent result at this velocity. based on these results suggest which inner part is sensitive.

Peculiarities of teaching a foreign language to lawyers students

The language of law is a technical language, different from other technical languages such as mathematics or physics, as it is bound to the national legal system and has its own highly specialised terminology. In a language of special communication, the text is expressed in a special language or sub-language that is subject to specific syntactic, semantic and pragmatic rules. Purpose of the study: To examine the specific features of teaching a foreign language to lawyers students. A systematic review can be explained as a research method and process for identifying and critically evaluating relevant studies and for collecting and analysing data from those studies. An excellent result of teaching legal English involves providing students with the ability to formulate speech with specific terminology and to develop their thinking about the law. Here's why teachers encourage discussion and role-playing to improve students' oral expression. An excellent method of developing listening skills in the absence of native speakers is video. We use this method with our class and it has proved very effective in attaining communication purposes. Teachers design all kinds of exercises for students and apply them while watching or post-viewing videos.

Does Juvenile Idiopathic Arthritis Affect the Course of Legg–Calvé–Perthes Disease? A Case-Control Study with a Mean Follow-Up of 8 Years

Background: This study aimed to determine the clinical and radiological course in children who had Legg–Calvé–Perthes disease (LCPD) associated with juvenile idiopathic arthritis (JIA). Methods: In a retrospective chart review between 2007 and 2019, eight consecutive JIA patients diagnosed with concomitant LCPD were identified and compared with a case-control group of 10 children with LCPD only. Results: LCPD was diagnosed at a mean age of 8.1 years (3.0–14.7) in children with JIA as compared to 6.1 years (2.9–10.0) in controls. According to the modified Harris Hip Score (mHHS), four children with JIA and all controls had an excellent result. Regarding the fragmentation severity and the duration of each stage, we found no differences using the lateral pillar and modified Elizabethtown classification. Five hips were classified as Stulberg I/II, two hips as Stulberg III, and one hip as Stulberg V with no evidence of hip dysplasia or severe overcoverage in either group. Conclusions: The radiological outcome of LCPD did not differ between both groups, while the clinical outcome was slightly better in controls. Physicians should be aware that children with LCPD may have JIA too. In suspicious cases, further investigations are recommended, and patients should be referred to pediatric rheumatologists.