A comparative study on effect of platelet rich plasma Vs conventional dressing in healing rate of chronic diabetic ulcers

Introduction and Aim: This study has been undertaken to evaluate efficacy of platelet rich plasma (PRP) dressing that is recently introduced with conventional dressing. We have tried to compare PRP dressing with conventional normal dressing in healing the wound. Materials and Methods: We conducted this study in 120 patients of chronic non healing diabetic foot ulcers who were treated over the period of three years. Number of cases (60 each) were studied for efficacy of applying autologous platelet rich plasma versus normal dressing for chronic non healing diabetic foot ulcers. At every week follow up, the ulcer was examined for granulation tissue, area and volume which was calculated using Vernier calipers and marked on a graph paper and photographs were taken. Wound healing was compared between PRP and normal dressing. Results: The incidence of male susceptibility was more (70%) than females (30%) in diabetic foot. Average rate of healing per week was found to be significantly better among the PRP group than normal dressing group. The ulcer showed significant reduction in size among the PRP group in comparison to the normal dressing group with a significant P value (0.001). Conclusion: In this study application of platelet rich plasma into chronic non-healing diabetic foot ulcers in comparison with conventional dressing has shown a significant reduction in the size of the ulcer, hospital stay and cost for the patient.

The Value of Reflux Monitoring: The Old and the New for the Diagnosis and Assessment of GERD

Reflux monitoring has advanced from inpatient continuous pH recordings on scrolling graph paper introduced 50 years ago to modern catheter-based 24-hour and wireless multiple-day ambulatory recordings, and the capability of detecting reflux episodes irrespective of pH using impedance technology. Testing is performed off antisecretory therapy when there is no prior documentation of reflux disease, and pH-impedance monitoring can be performed on therapy in symptomatic patients with proven reflux. Prolonged wireless pH monitoring evaluates day-to-day variation in reflux exposure. New impedance-based metrics evaluating baseline impedance and post-reflux swallow induced peristaltic wave have potential to augment the diagnostic value of reflux monitoring.

A Comparative Analysis of Force Deflection Property of Nickel-Titanium Wires of Four Manufacturers using Five Point Bending Test: An In-vitro Study

Introduction: Over the last century, material science has made rapid progress. In orthodontics, not only the materials improved, but also the philosophies have changed. Orthodontic wires, which generate biomechanical forces through brackets for tooth movement, are central to the practice of this profession. Aim: To measure the force deflection properties of Nickel-Titanium (NiTi) wires of four manufacturers, used during orthodontic treatment. Materials and Methods: In this in-vitro study, 480 NiTi wires from four different manufacturers [American Orthodontics (AO), 3M-Unitek (3M), Rabbit Force Orthodontics (RO) and Modern Orthodontics (MO)], of various cross-sections was obtained. Samples of each wire were obtained by cutting the straightest distal portion of an arch wire, thus an approximate length of 5.5 cms was recovered. These wires were subjected to a five point bending test. Five lower anterior stainless steel brackets of tooth number 31, 32, 41, 42 (MBT 0.022” Libral traders Centrino brackets) were fixed with the face of the bracket facing upwards on the acrylic block. Each NiTi wire was placed in the slots of orthodontic brackets and secured with stainless steel ligature wires. These wires were subjected to artificial saliva (Wet Mouth) for 30 days at 37°C. This temperature was regulated by using an incubator. The main assessment criterion was the force deflection property of the wire material. Force deflection was measured using a graph paper where initially the wire was placed and plotted on the graph paper. After the deflection of the wire, it was again placed on the same graph paper such that wire ends coincided and the force deflection at the highest point was measured in millimetres using a digital Vernier Caliper (Mitutoyu). The Design of Experiments (DOE) model was used for analysis and a three-way Analysis of Variance (ANOVA) with wire shape as covariate was used for analysing the variability. Results: A 0.014” NiTi wire showed more mean deflection when compared to 0.016” NiTi wire. When a comparison between 0.016”×0.022” and 0.017”×0.025” NiTi wires was done, mean deflection was almost the same. When round and rectangular wires were compared it showed more mean deflection in round wires. When AO was compared with other three manufacturers. A significant difference (p-value <0.0001) was seen in the mean deflection values of MO and RO. When 3M was compared with the other three manufacturers a significant difference (p-value <0.0001) was seen in the mean deflection values of MO and RO. Three-way ANOVA test with wire shape as co-variate showed a significant amount of difference (p<0.0001) for AO, 3M wires with their counterparts. Conclusion: Round NiTi wires showed more force deflection as compared to rectangular NiTi wires. AO and 3M wires were superior as compared to RO and MO wires. Superelastic wires showed more deflection as compared to conventional and heat- activated NiTi. This can be attributed to the property of the wire. Stiffer the wire, less deflection was seen. Cost of the wire also played a role. Cheaper wires were not able to match the quality and standards of their counterparts.

THE EAR IS A LABYRINTH: JULIO ESTRADA SEARCHING FOR THE MINOTAUR

This article explores Julio Estrada's musical thinking in his early and recent works. Estrada's early works precede the development of his graphication method in the 1980s, and his recent works follow the completion of his opera Murmullos del Páramo in 2006. It is his music of these three decades between 1980 and 2006 that is most widely scrutinised – a music centred on the extensive conception and manifestation of sound as a continuum and aided in the creational process by coloured drawings on graph paper – but this article focuses on lesser-known pieces from the 1970s like Melódica and Solo para uno, as well as recent works such as his opera-in-progress, a major project conceived as a book to be read and imagined, rather than performed. It is hoped that close examination of these pieces will significantly broaden the understanding of Estrada's creative drive and lifelong research, revealing how these works entangle with his better-known developments of the sound continuum and graphication method and share common concerns with work from across his career.

Comparison of tumor surface marking by experienced neurosurgeon versus neuronavigation guidance

Introduction: Accurate flap marking has always been a challenge for neurosurgeons during tumor surgery. The use of neuronavigation has somewhat overcome this problem by allowing the navigation of intraoperative 3D neuroanatomy of the lesion. In this study, we aim to evaluate the percentage discrepancy of tumor surface marking by experienced neurosurgeon versus neuronavigation guidance. Methods: This is a prospective analytical study. Initial surface marking of the tumor was done by experienced neurosurgeon on the basis of sagittal, coronal and axial Magnetic Resonance Imaging films; and later was re-marked using neuronavigation. Photographs of surface markings were taken then comparison was done by plotting marking on the standard graph paper and percentage discrepancies were calculated for every case. Results: Percentage discrepancy ranged from 15 % to 81 % and the mean discrepancy score was 44%. Conclusion: Even in experienced neurosurgeon's hand, flap marking is not always accurate and neuronavigation definitely seems to be an effective tool.

Cervical spinal canal body ratio in normal individuals and Stenosis with Cervical Myelopathy: A simple but novel study using a graph paper over a plain X-ray lateral view of the cervical spine

Cervical spine spondylosis is so prevalent in almost all because it is a degenerative disease. Cervical spine spondylosis is a condition caused by the narrowing of the space required for the spinal cord and the nerve roots that pass through the spine to the rest of the body. Suspected cases or warranted cases are advised to avoid trauma or stress to prevent a dreadful complication that is myelopathy. This research is to study and assess the Cervical Spine Canal Body Ratio in healthy individuals and also in patients with myelopathy. The cervical spinal canal and body with disc space ratio are measured using lateral view plain X-ray of the cervical spine, placed over a graph paper. This test was done both in healthy individuals from the age group of twenty-five to thirty-five of female and male. Out of these, twelve patients were with cervical myelopathy. Cervical Spinal canal stenosis may be either congenital or acquired. The content of the canal that is the Spinal cord is more likely to get compromised when the canal is shallow even a minimal trauma or degenerative arthrosis can precipitate myelopathy. In healthy individuals it is unit and when <0.85 it indicates stenosis. This simple, less expensive study can be done even in a peripheral set up. The healthy Canal Body ratio is 0.97 to 1.02. In myelopathy it is about 0.8. Corresponding sagittal diameter is 18 to 21 mm in normal and 9 to 11 mm in cervical stenosis.

The effects of cleaning solutions on bacteria concentration on hospital wheelchairs

To what extent does the concentration of bacteria located on hospital wheelchairs vary based on the cleaning solution used between patient transport? The purpose of this study was to investigate the cause of HAIs [Hospital Acquired Infections] in hospital environments and determine the best cleaning method of wheelchairs in hospitals. The method was to swab the seats and handles of wheelchairs before and after cleaning them while wearing gloves in comparison to no gloves with varying strengths of cleaning solutions, plating the swab, and allowing the bacteria to be incubated and grow in an incubator. Then, every day for 10 days, plates were measured on a piece of graph paper to record growth. A one-way ANOVA was calculated for the effectiveness of the various cleaners and a p-value of 0.6597 was achieved and a t-test was performed to compare the values of gloves versus no gloves and a p-value of 0.2216 was calculated. The p-values were not significant at 0.05. Overall, wearing gloves while cleaning showed to have a slight positive impact on the overall cleanliness but was not statistically significant, and the highest strength wipes inhibited bacterial growth most often. Hospital protocol for the cleansing of wheelchairs between patient use should be updated to the use of gloves and high strength wipes to stop the spread of bacterial infections to patients.

How to Publish an Egyptian Temple?

This chapter aims to draw colleagues’ attention to certain important points about the principles of publishing temples. Mentioned as critical to epigraphic work are, among other things, sequential numbering, separate sheets with key plans, exploded-views of rooms, notes on the condition of the wall, collation, and working in groups. The benefits of “old-fashioned” methods, using lead pencil on graph paper, are extolled. Drawing, even without a sure hand, is above all observing and concentrating—the essence of the epigrapher’s profession. Benefits of working in this way accrue not just in the work, which requires time, concentration, and calm, but also for the worker who experiences that intellectually fertile interval. Technologies, such as reflectance transformation imaging (RTI) and orthophotography, which offer truly dazzling results, are discussed not as “new,” but are contextualized within the history of epigraphic innovation. Regardless of which method a team adopts, the purpose of all epigraphic publication should not be forgotten: to provide an easy-to-understand substitute for the monument. It is, as it were, a way of assuring the monument’s permanence.