SINGLE STAGE KNEE ARTHROPLASTY REVISION SURGERY, OUR EXPERIENCE WITH ELEVEN CASES AND REVIEW OF THE LITERATURE
Knee replacement is a widely performed and very successful procedure for the management of knee arthritis. Nevertheless, it is postulated that a total of 2-5% of primary and revision total knee arthroplasties (TKAs) is infected every year [1,2]. Despite the low incidence, the absolute numbers of prosthetic joint infections (PJIs) are growing, owing to an increased number of replacement surgeries, and are associated with significant morbidity and socioeconomic burden [3,4]. Although several definitions of PJI exist, Musculoskeletal Infection’s Society (MSIS) definition is based on strict criteria and is one of the most used . Patients with certain risk factors have an increased risk to develop PJI [6,7]. Risk factors include presence of systemic or local active infection in an arthritic knee; previous operative procedures in the same knee, diabetes mellitus, malnutrition, smoking, alcohol consumption, co-morbidities, and immunosuppression; end-stage renal disease on hemodialysis, liver disease, intravenous drug abuse, and low safety operative room environment. PJIs are classified according to the depth of infection, to superficial and deep infections. Superficial infections are limited to the incision and superficial tissues, while deep infections, that involve deep layers, may occur up to one year postoperatively, and influence surgical management strategy. Timing of infection is also an important factor in guiding treatment. PJIs are classified to acute postoperative, within a month of the index procedure, acute haematogenous, presenting with acute symptoms in a previously well – functioning joint, and late chronic, where infection develops later than one month postoperatively . Management of PJI’s is mainly surgical, reserving conservative treatment for patients unable to undergo surgery . Surgical options include debridement and retention of the prosthetic implants (DAIR), two – stage exchange revision, single – stage exchange revision, permanent resection arthroplasty, and finally amputation as the last measure . DAIR is a viable option in early…
EFFICACY OF CHOLECYSTECTOMY IN PATIENTS WITH POSITIVE HIDA SCANS WITH TYPICAL OR ATYPICAL BILIARY PAIN: A RETROSPECTIVE STUDY
Introduction: Our investigation aimed to discover the benefits of performing cholecystectomy in patients who had a positive or negative HIDA scan result, presented with either typical or atypical biliary pain. Methods: We performed a retrospective analysis of medical records of patients who had a HIDA scan at Peninsula Health between 2012 and 2017, those who had a HIDA scan and cholecystectomy for biliary pain were selected for this study, and prospective analysis of patient reported outcome post cholecystectomy included. Results: In the past five years, 190 patients had had a HIDA scan to investigate biliary pain without a structural cause. Of those 190, 65 had a positive HIDA result and 20 of these patients went on to have a cholecystectomy. Of the latter, 17 who reported typical biliary pain had their pain resolved post-surgery but 2 out of 3 patients with atypical biliary pain had ongoing pain despite surgery (1 did not respond). Of the 125 patients with a negative HIDA scan, 14 proceeded with a cholecystectomy. Twelve patients had pre-operative typical biliary pain and 5 of these continued to have pain post-operatively. Finally, 1 of the 2 patients with atypical pain continued to have ongoing pain post-surgery. Conclusion: In summary, in patients without a structural cause for biliary pain HIDA scans and patient’s symptoms greatly aid in the decision-making process whether to proceed with a cholecystectomy, as a negative scan should prompt further clinical investigation before proceeding with surgery.
We report the case of a 69 year old female who presented with mild cognitive impairment and difficulty mobilising in the setting of profound hypothyroidism secondary to Hashimoto’s thyroiditis with associated elevated creatine kinase (CK), hyponatraemia, anaemia, renal impairment, hypercholesterolaemia and hypertryglyceridaemia. On initial investigations the patient had a thyroid stimulating hormone (TSH) of 49 mU/L, free T4
Women With Regenerative Potential As Against Women With Destructive Potential (The Case Study Of Amma Darko’s “Faceless”)
The research looked at the woman with regenerative potentials and how reliable mentors they are to the benefit of society using Ama Darko’s Faceless. The purpose of the study was to use Ama Darko’s Faceless to showcase the position of the woman with regenerative potential irrespective education because though Education empowers women to have regenerative potentials other women who are uneducated also exhibit such traits in our societies. A qualitative approach was employed to look at views related to the African woman with regenerative potential and also adopted the traditional library research approach through the use of books, articles, journals and publications in as much as they contribute to the worth of the study. It was in-formed by the stiwanist theory. The main findings of the study indicate that the woes of irresponsible mothers who do not responsibly take care of the results of their pleasure with men are being disapproved. This disapproval is as a result of the pitiful portrayal of women with destructive potential as against positive up lifting portrayal of women with regenerative potential and making them reliable mentors of society. This change has come about as a result of women’s quest to assert themselves through education and contribute towards freeing their families from cultural and societal dogmas in which women were treated to subjugation and marginalization. A remarkable observation was the intentionality of ascribing to female characters more respectable roles in novels by various writers as the years go by. A conclusion drawn from the study is that education is still a major weapon of enhancing assertiveness in women but it is not the ultimate.
Objective: To determine the predictors of in-hospital mortality in critically ill older patients. Participants and Methods: A prospective cohort study including 305 critically ill older adults (age ≥60 years) who were admitted to High Dependency Units (HDUs) in a tertiary care university hospital from March 22, 2019 to January 4, 2020. Demographic, clinical and laboratory data of participants were collected thought a review of medical records and clinical observation at HDUs till either death or discharge alive. Statistical analysis included univariate analysis of selected potential predictors such as various comorbidities, C- reactive protein / Albumin ratio (CAR), Neutrophil-lymphocyte ratio (NLR), Red cell distribution width (RDW), Po2/Fio2 ratio (PFR), Simplified acute physiology score II (SAPS II), Charlson comorbidity index (CCI) and multidrug-resistant Gram-negative bacterial (MDR-GNB) infection to ascertain their association with mortality, followed by multivariable logistic regression to derive the final prediction model. The discriminative ability of the model was evaluated by using the receiver operating characteristic (ROC) curve. RESULTS: Overall mortality was 53.1%. Multivariate regression analysis revealed independent predictors of mortality including dementia in clinical history with an odds ratio (OR) of 4.86 (95% CI: 1.28-18.34), total protein with an OR of .53 (95% CI: .30-.95) and the use of mechanical ventilation (MV) and/or intravenous cardiovascular support with an OR of 148.34 (95% CI: 34.28-641.77), formulating a novel prognostic model with an area under the ROC curve of .93 (95% CI: .89-.96, P.000). CONCLUSION: History of dementia, total protein and the use of MV and/or intravenous cardiovascular support are predictors of mortality in critically ill geriatric patients. It provides a novel prognostic model which needs validation in other multicenter prospective studies.
Office clutter might significantly impact productivity, yet no study examined workers differences across upper and lower employee status. The present study surveyed 202 U.S. on-site workers on work-related variables, including office clutter. Job classifications were aggregated, creating two groups: upper- and lower-level employees. A significant difference in office clutter impacted worker-levels: upper-level workers compared to lower-level workers had higher office clutter scores. Exploratory factor analysis created a two-factor solution (explaining 62.6% of the common variance): satisfaction/pleasure from one’s work and risk for work-related burnout/tension. There was a significant difference in office clutter perception: upper-level workers were significantly more likely to report clutter and being at risk for burnout/tension than lower-level workers. Office clutter significantly negatively predicted satisfaction with one’s job and positively related with risk for work-related burnout. Frequently reported office clutter items (in order of frequency) were paper, trash (e.g., used coffee cups), and office supplies.
This narrative review on massage therapy effects involved a literature search for research that was published in the years 2016-2020. The review includes studies on massage therapy effects on preterm pain and growth, newborn hyperbilirubinemia and infant colic. The pediatric literature includes studies on behavior problems including ADHD and aggression and physical conditions including diarrhea, asthma, immune function and pain. The adult studies include massage therapy effects on psychological problems including stress and anxiety and physical conditions including fatigue, sleep disturbances, post-burn scarring, gastrointestinal problems and dementia. The musculoskeletal studies are focused on range of motion, balance, muscle activity, grip strength and performance recovery. The massage for pain literature is the most extensive including pain associated with labor, cesarean delivery, shoulder, neck, low back and upper back pain, arthritis, fibromyalgia, multiple sclerosis, cancer, neuropathy, post-surgery, hospice and aging. The physiological/biochemical measures that have been used include systolic and diastolic blood pressure, heart rate, vagal activity, facial blood flow, EEG, cortisol and oxytocin. This section is followed by a discussion on potential underlying mechanisms and methodological limitations. The research continues to have methodological limitations including that the studies cannot be double blinded, they are typically not multivariate studies and they are often biased by their reliance on self-report. Nonetheless, the randomized controlled trials included here as well as systematic reviews and meta-analyses have concluded that massage therapy is typically effective when it is compared to treatment as usual control groups, More research is needed on massage therapy versus active control groups (e.g. exercise and physical therapy) in randomized, controlled trials.
Rice is a world-famous cereal food divided into pigmented and non-pigmented rice. Pigmented rice is popular as healthier food than non-pigmented rice due to its potency as an antioxidant. Nevertheless, the potential of pigmented rice has not been widely studied. Indonesian selected pigmented rice protein’s antioxidant potential and the non-protein compound were in-vitro studied. The antioxidant potencies were evaluated by extracting fresh seeds of nine pigmented rice (Aek Sibundong, Beureum Taleus, Gogo Niti-2, Lamongan-1, Merah SP, Merah Wangi, Mota, Ketan Hitam-2, and Super Manggis) and non-pigmented rice (IR-64) as control. Various free radical scavenging methods to determine the antioxidant activity (ABTS•+, DPPH•, OH• and O2-) were conducted. Meanwhile, the genetic classification was performed by a simple sequence repeat (SSR) marker to determine the relationship between varieties. The results showed that protein of Ketan Hitam-2 had the highest ABTS•+ radical scavenging (98.06%), followed by Beureum Taleus (42.54%). Ketan Hitam-2 protein also showed the highest OH• and O2- activities (43.49% and 6.02%, respectively). The highest DPPH• potency of the non-protein compounds also shown by Ketan Hitam-2 (32.23%) with the activity of OH• and O2- (20.63% and 14.56%, respectively). These results showed that Ketan Hitam-2 has the highest potency as an antioxidant, which could be recommended as a nutraceuticals compound.
THE INTRAVARIETAL RELATIONSHIP AMONG DIFFERENT ACCESSIONS OF DOLICHOS BIFLORUS WAS CHECKED BASED ON PROTEIN PROFILING USING SDS-PAGE
In this study, the phylogenetic relationship within the selected Eleven Indian (Dolichos biflorus (horse gram) varieties was analyzed for total soluble seed protein. Twenty-five bands were documented through SDS PAGE based on 100 seed weight of each variety and were studied for genetic diversity. Jaccard’s similarity matrix was acquired and used in UPGMA cluster analysis based on the polymorphism generated by the presence (1) or absence (0) of protein bands. Thus, the dendrogram showed four major groups that corre-spond to an earlier study on polymorphisms of 11 accessions of Indian Dolichos. Signifi-cant correspondence between the clustering pattern and the pedigree was observed; thus, a high genetic diversity could be kept within the Dolichos varieties. A similarity matrix among the targeted genotypes and phylogenetic analysis is considered a unique feature in the present work. Therefore, the current investigation was carried out to analyse Protein diversity of unexplored Dolichos genotypes at the molecular level, construct a dendro-gram based on similarity band matrix and generate efficiency in genetic divergence analy-sis among Dolichos. This study underlines the importance of using genetic diversity based in the Dolichos breeding program.
Population Structure And Diversity Among Improved Cowpea Varieties From Senegal Based On Microsatellite Markers
Cowpea (Vigna unguiculata) is used in West Africa for both human consumption and animal feeding. Despite its importance, the production of the crop is hampered by biotic and abiotic constraints. To overcome these constraints, the Senegalese Institute of Agricultural Research (ISRA) has set up a breeding program since 1960 leading to the release of productive varieties. Information of the genetic diversity for these varieties could improve the effectiveness of further breeding programs. The objectives of this study was to assess the genetic diversity and the population structure of 11 cowpea improved varieties from ISRA collection. Twelve (12) polymorphic microsatellite markers were used and the analysis of genotypic data showed a total of 39 alleles ranging from 2 (SSR6288, SSR6311 and SSR6827) to 6 (SSR6807) per locus. Polymorphism rate ranged from 8.33% (Mougne and Kelle) to 58.33% (Mouride) with an average of 31.06%. Intra varietal genetic diversity was very weak (0.012 to 0.091). The genetic similarity revealed that Melakh and Pakau varieties were genetically the closest while Bambey 21 and Sam were the most distant. These results are confirmed by the dendrogram, which also showed that Thieye, Leona, Kelle, Sam, Mougne and Yacine varieties have a higher genetic stability than Lisard, Melakh, Pakau, Mouride and Bambey 21. Eighty-seven percent (87%) of the total variability was attributed to inter varietal variability while 17% was due to intra varietal variation. These results provide a better knowledge of genetic resources of cowpea varieties released and held by ISRA and constitute important input for further cowpea breeding programs.