Bridge Plating Versus Hybrid External Fixation in the Management of Proximal Tibia Metaphyseal Fractures

BACKGROUND

Due to the surge in high-speed road traffic accidents during the past few years, extra-articular proximal tibia fractures have also risen in number. For the treatment of such fractures, various options are available like conservative treatment with casting, surgical treatment with plate osteosynthesis, or a hybrid external fixator. Exposure of the bone surface and extensive soft tissue dissection is needed in bridge plating, posing a risk of bleeding, infection, and soft-tissue healing issues, and the blood supply of the fractured area is also hampered as the periosteum is also destroyed. To avoid these complications, a hybrid external fixator can be used but it has its own risks of malunion, non-union, and pin-tract infections; another drawback is patient compliance. In this study, we compare the clinical and functional outcomes of two treatment modalities, i.e., bridge plating and hybrid external fixator, in the treatment of proximal tibia metaphyseal fractures.

MATERIALS AND METHODS

This prospective randomized study was conducted from February 2021 to June 2022 on 46 adult patients diagnosed with proximal tibia metaphyseal fracture and willing to participate. An odd number of patients were treated with a bridge plate and even with a hybrid external fixator.

RESULTS

A total of 46 patients were included in the study, sustaining proximal tibia metaphyseal fracture, out of which 23 patients underwent hybrid external fixation with an outcome of 69.43 ± 8.11 according to the Knee Society Score (KSS) and 23 for bridge plating which showed better results as their score at final follow-up was 75.00 ± 8.22.

CONCLUSION

According to our study, we found that bridge plating is a better treatment modality than the hybrid external fixator as the former showed better postoperative knee range of motion and functional outcome and led to a smaller number of complications. But the clinical outcome would also be influenced by the type of fracture, degree of comminution, type of injury, i.e., open or closed, and quality of bone.

Clinical and Functional Outcomes of Anatomical Plating in Distal Humerus Fractures in Adults

Background Overall, 2% of all adult fractures are attributed to fractures of the distal humerus, including both supracondylar and intercondylar fractures. According to recent studies, stable fixation with anatomical reduction of intra-articular fragments and early mobilization is required for best outcomes. This study included patients with distal end humerus fractures treated by open reduction and internal fixation (ORIF) with anatomical locking plates and evaluated their clinical outcomes. Methodology This prospective study was conducted at a medical college teaching hospital in southern Rajasthan, India. In total, 20 adult patients with distal end humerus fractures who presented to the orthopedic outpatient department or casualty were admitted. Patients were treated by ORIF with anatomical locking plates, followed up, and evaluated for clinical and functional outcomes. Results Using the Mayo Elbow Performance Score, out of 20 cases, excellent results were noted in five patients, good results in seven patients, fair results in six patients, and poor results in two patients. Conclusions Locking plates are reliable and effective management options for distal humerus fractures. As locking plates are strong and rigid, the period of immobilization can be decreased. Early mobilization helps in preventing joint stiffness and fixed deformity of the joint.

Photosensitized Radical-Anion-Driven Metal-Free Selective Reduction of Aldehydes Using Graphene Oxide as an Electron Relay Mediator under Visible Light

Despite the modern boost, developing a new photocatalytic system for the reduction of aldehydes is still challenging due to their high negative reduction potential. Herein, we have used a metal-free photoinduced electron-transfer system based on a cheap and readily available organic dye eosin Y (EY), graphene oxide (GO), and ammonium oxalate (AO) for photocatalytic reduction of structurally diverse aldehydes under sustainable conditions. The protocol shows remarkable selectivity for the photocatalytic reduction of aldehydes over ketones. The decisive interaction of GO and AO with the various states of EY (ground, singlet, triplet, and radical anions), which are responsible for the commencement of the reaction, was examined by various theoretical, optical, electrochemical, and photo-electrochemical studies. The synergetic system of GO, EY, and AO is appropriate for enhancing the separation efficiency of visible-light-induced charge carriers. GO nanosheets act as an electron reservoir to accept and transport photogenerated electrons from the photocatalytic system to the reactant. The reduction of the GO during the process ruled out the back transfer of photoexcited charges. Control experiments explained that the reaction involves two stages: electron transfer and protonation. This process eliminates the necessity of precious-metal-based photocatalysts or detrimental sacrificial agents and overcomes the redox potential limitations for the photoreduction of aldehydes.

Sustainable synthesis of biomass-derived carbon quantum dots and their catalytic application for the assessment of α,β-unsaturated compounds

Herein, we demonstrate a simple, reproducible, and environment-friendly strategy for the synthesis of carbon quantum dots (CQDs) utilizing the mango (Mangifera indica) kernel as a renewable green carbon source. Various analytical tools characterized the as-prepared CQDs. These fluorescent CQDs showed significant water solubility with a uniform size of about 6 nm. The as-synthesized CQDs show significantly enhanced catalytic activity for the production of α,β-unsaturated compounds from the derivatives of aromatic alkynes and aldehydes under microwave irradiation in aqueous media. A potential mechanistic pathway and role of carboxylic functionalities were also revealed via various control experiments. The protocol shows outstanding selectivity towards the assessment of α,β-unsaturated compounds over other possible products. A comparative evaluation suggested the as-synthesized CQDs show higher catalytic activity under microwave radiation as compared to the conventional ways. These recyclable CQDs represent a sustainable alternative to metals in synthetic organic chemistry. A cleaner reaction profile, low catalyst loading, economic viability and recyclability of the catalyst, atom economy, and comprehensive substrate applicability are additional benefits of the current protocol according to green chemistry.

Site-specific role of bifunctional graphitic carbon nitride catalyst for the sustainable synthesis of 3,3-spirocyclic oxindoles in aqueous media

Functionalized graphitic carbon nitride (Sg-C₃N₄) has been manufactured and used as a reusable catalyst for the one-pot production of various spiro-pyrano chromenes and spiro indole-3,1′-naphthalene tetracyclic systems in aqueous media. An ultrasound-assisted method has been used for the functionalization of g-C₃N₄. The catalytic functionalities and the structural integrity of the catalyst were characterized via different analytical tools. The catalytic site-specific role of Sg-C₃N₄ was confirmed via various control experiments in one-pot reaction sequences. We recognized that Sg-C₃N₄ acts as a bifunctional acid–base catalyst for the first reaction sequence whereas it is an acidic catalyst for the second reaction sequence during the one-pot production of various spiro-pyrano chromenes. In addition, the bifunctional acid–base catalytic role of Sg-C₃N₄ has been confirmed for the first reaction sequence whereas it has a basic catalytic role for the second reaction sequence during the one-pot production of spiro indole-3,1′-naphthalene tetracyclic systems. Diverse C–C, C–O, and C–N bonds, six-membered cycles, stereogenic centers, and spiro frameworks were formed in a single reaction, enhancing the biocidal profile and possibly resulting in the discovery of new medicinal properties. The mild reaction environment, simple workup, easy separation, low cost, heterogeneity, and recyclability of Sg-C₃N₄ are some rewards of this approach.

Functionalized graphitic carbon nitride (Sg-C₃N₄) has been manufactured and used as a reusable catalyst for the one-pot production of various spiro-pyrano chromenes and spiro indole-3,1′-naphthalene tetracyclic systems in aqueous media.

The graphite-catalyzed ipso-functionalization of arylboronic acids in an aqueous medium: metal-free access to phenols, anilines, nitroarenes, and haloarenes

An efficient, metal-free, and sustainable strategy has been described for the ipso-functionalization of phenylboronic acids using air as an oxidant in an aqueous medium. A range of carbon materials has been tested as carbocatalysts. To our surprise, graphite was found to be the best catalyst in terms of the turnover frequency. A broad range of valuable substituted aromatic compounds, i.e., phenols, anilines, nitroarenes, and haloarenes, has been prepared via the functionalization of the C-B bond into C-N, C-O, and many other C-X bonds. The vital role of the aromatic π-conjugation system of graphite in this protocol has been established and was observed via numerous analytic techniques. The heterogeneous nature of graphite facilitates the high recyclability of the carbocatalyst. This effective and easy system provides a multipurpose approach for the production of valuable substituted aromatic compounds without using any metals, ligands, bases, or harsh oxidants.

Clinical and Radiological Study of Serum Fluoride in Relation to Knee Osteoarthritis

Introduction

Fluorosis has been associated with an increased risk of degenerative changes in the knee. Multiple studies have found an association between arthritis and elevated fluoride levels. We aim to delineate if elevated fluoride level has any direct correlation with the degree of radiological grading and clinical symptoms in knee arthritis.

Materials and Methods

A cross-sectional study of 80 knee arthritis patients was conducted from February 2017 to April 2018. Serum fluoride levels were measured and patient's pain scores, WOMAC scores and radiological grading were correlated with the elevated fluoride levels.

Results

In our study, 30 out of 80 patients had increased serum fluoride level. Statistically significant differences were noted in VAS score, WOMAC score and Kellgren and Lawrence radiological grades between patients with normal serum fluoride level and those with elevated fluoride level.

Conclusion

There is an increased risk of knee arthritis in patients with elevated blood fluoride levels and patients with increased fluoride levels are associated with more severe symptoms and radiographic disease.

Microwave-assisted nanocatalysis: A CuO NPs/rGO composite as an efficient and recyclable catalyst for the Petasis-borono-Mannich reaction

A CuO NP decorated reduced graphene oxide (CuO NPs/rGO) composite was synthesized and characterized using various analytical techniques viz. XRD, TEM, SEM, UV-Vis, FT-IR, EDX, XPS and CV. The activity of the catalyst was probed for the Petasis-Borono-Mannich (PBM) reaction of boronic acids, salicylaldehydes, and amines under microwave irradiation (MW). The CuO NPs/rGO composite works as a catalyst as well as a susceptor and augments the overall ability of the reaction mixture to absorb MW. The synergistic effect of MW and CuO NPs/rGO resulted in an excellent outcome of the reaction as indicated by the high TOF value (3.64 × 10^-3 mol g^-1 min^-1). The catalytic activity of the CuO NPs/rGO composite was about 12-fold higher under MW compared to the conventional method. The catalyst was recovered by simple filtration and recycled 8 times without significant loss in activity. This atom-economical protocol includes a much milder procedure, and a catalyst benign in nature, does not involve any tedious work-up for purification, and avoids hazardous reagents/byproducts and the target molecules were obtained in good to excellent yields.

Amidic C–N bond cleavage of isatin: chemoselective synthesis of pyrrolo[2,3,4-kl]acridin-1-ones using Ag NPs decorated rGO composite as an efficient and recoverable catalyst under microwave irradiation

A facile route for the chemo-selective synthesis of pyrrolo[2,3,4-kl]acridin-1-ones via ring-opening or amidic C–N bond cleavage of isatin under microwave irradiation using Ag NPs/rGO composite as an effective and robust catalyst has been described.

A kinetic analysis on non-isothermal glass-crystal transformation in Ge(1-x)Sn(x)Se(2.5) (0 ≤ x ≤ 0.5) glasses

Differential scanning calorimetry (DSC) has been employed at five different heating rates to investigate the glass-crystal transformation in Ge(1-x)Sn(x)Se(2.5) (0≤x≤0.5) glasses under non-isothermal conditions. From the dependence of glass transition temperature on the heating rate 'α' , the activation energy of glass transition, E(t), has been calculated on the basis of the Kissinger model. Results indicate that T(g) and E(t) attain their minimum values at 0.3 at. wt% of Sn. The crystallization process has been investigated using Kissinger, Matusita, Augis and Bennett, and Gao and Wang models. Various kinetic parameters such as activation energy of crystallization, E(c), Avrami exponent (n), dimensionality of growth (m), frequency factor (K(o)) and crystallization rate factor (K) have been calculated for a better understanding of the growth mechanism. The obtained kinetic parameters indicate that stability of glassy samples decreases upto 0.3 at. wt% of Sn and increases on further addition of Sn.

Rheumatic mitral valve surgery in the fifth decade: our experience

AIM

Rheumatic mitral patients reach their fifth decade of life more often now than in the past. The purpose of this study is to provide insight into improving morbidity and mortality in these patients.

METHODS

This retrospective study included 105 patients aged 50 years or more. Seventy-five underwent mechanical valve replacement and 30 received a bioprosthetic valve. Data were collected from medical records and outpatient department (OPD) registers. Follow-up included transthoracic 2D echocardiography, supported by clinical parameters, and X-ray findings.

RESULTS

Mean age was 58.52+/-2.4 years. Follow-up period ranged from one to eleven years (mean 6.8+/-0.9 years). Immediate perioperative mortality included five patients (4.76%) and long term mortality included three patients (3%). 35 patients previously underwent closed and open commissurotomy and balloon valvotomy. Multivariate analysis showed age, repeat surgery, atrial fibrillation, tricuspid valve disease, and preoperative functional status to be incremental risk factors. Freedom from repeat operation at 3 and 6 years was 90% and 85% in group I (<60 years), respectively. Actuarial survival at 4 and 6 years of follow up was 94.24% and 88.52%, respectively.

CONCLUSION

With improving life expectancy and early interventions, the number of < or = 50-year old rheumatic valvular disease patients is increasing. The present study showed a marked improvement for this subset of patients, although age still remains the main risk factor along with atrial fibrillation, repeat surgery, stroke and tricuspid valve disease.

Expression of snowdrop lectin (GNA) in transgenic rice plants confers resistance to rice brown planthopper

Snowdrop lectin (Galanthus nivalis agglutinin; GNA) has been shown previously to be toxic towards rice brown planthopper (Nilaparvata lugens; BPH) when administered in artificial diet. BPH feeds by phloem abstraction, and causes 'hopper burn', as well as being an important virus vector. To evaluate the potential of the gna gene to confer resistance towards BPH, transgenic rice (Oryza sativa L.) plants were produced, containing the gna gene in constructs where its expression was driven by a phloem-specific promoter (from the rice sucrose synthase RSs1 gene) and by a constitutive promoter (from the maize ubiquitin ubi1 gene). PCR and Southern analyses on DNA from these plants confirmed their transgenic status, and that the transgenes were transmitted to progeny after self-fertilization. Western blot analyses revealed expression of GNA at levels of up to 2.0% of total protein in some of the transgenic plants. GNA expression driven by the RSs1 promoter was tissue-specific, as shown by immunohistochemical localization of the protein in the non-lignified vascular tissue of transgenic plants. Insect bioassays and feeding studies showed that GNA expressed in the transgenic rice plants decreased survival and overall fecundity (production of offspring) of the insects, retarded insect development, and had a deterrent effect on BPH feeding. gna is the first transgene to exhibit insecticidal activity towards sap-sucking insects in an important cereal crop plant.

Use of bar as a selectable marker gene and for the production of herbicide-resistant rice plants from protoplasts

We have used the bar gene in combination with the herbicide Basta to select transformed rice (Oryza sativa L. cv. Radon) protoplasts for the production of herbicide-resistant rice plants. Protoplasts, obtained from regenerable suspension cultures established from immature embryo callus, were transformed using PEG-mediated DNA uptake. Transformed calli could be selected 2-4 weeks after placing the protoplast-derived calli on medium containing the selective agent, phosphinothricin (PPT), the active component of Basta. Calli resistant to PPT were capable of regenerating plants. Phosphinothricin acetyltransferase (PAT) assays confirmed the expression of the bar gene in plants obtained from PPT-resistant calli. The only exceptions were two plants obtained from the same callus that had multiple copies of the bar gene integrated into their genomes. The transgenic status of the plants was verified by Southern blot analysis. In our system, where the transformation was done via the protoplast method, there were very few escapes. The efficiency of co-transformation with a reporter gene gusA, was 30%. The T0 plants of Radon were self-fertile. Both the bar and gusA genes were transmitted to progeny as confirmed by Southern analysis. Both genes were expressed in T1 and T2 progenies. Enzyme analyses on T1 progeny plants also showed a gene dose response reflecting their homozygous and heterozygous status. The leaves of T0 plants and that of the progeny having the bar gene were resistant to application of Basta. Thus, the bar gene has proven to be a useful selectable and screenable marker for the transformation of rice plants and for the production of herbicide-resistant plants.

A cytoplasmic gradient of Ca2+ is correlated with the growth of lily pollen tubes

We have measured the distribution of cytoplasmic calcium in lily pollen tubes by microinjecting them with indo-1 and performing fluorescence ratio image analysis on them. All of the 16 tubes that were growing at the time of the calcium measurements showed a gradient of [Ca2+]i in the tip region, with Ca2+ being 1.25 to 3.32 times higher at the distal end in 15 cases and more than 5 times higher in one case. The extent of the gradient ranged from 22 to 65 microns. Most of the 15 nongrowing tubes either had no gradient or had lower Ca2+ in the tip region. While we have confirmed a previous report that lily pollen tubes can be loaded with the membrane-permeable acetoxymethyl ester forms of calcium indicators, the dyes loaded in this way are visibly partitioned into organelles and this method of loading is, therefore, not useful for the measurement of [Ca2+]i. Iontophoresis of the dye free acids into tubes produces a more uniform and diffuse fluorescence which does not appear to partition into organelles. Indo-1 remains in the pollen tubes longer than fura-2. The correlation between growth and the [Ca2+]i gradient in the apical portion of the pollen tube is discussed in relation to previous reports that have suggested that such a gradient should exist during polarized growth.

A Two-Dimensional Vibrating Probe Study of Currents around Lateral Roots of Raphanus sativus Developing in Culture

A computer-assisted, two-dimensional vibrating probe was used to study the ionic currents around developing lateral roots of Raphanus sativus in vitro. This system allowed us to superimpose current vectors on the video image of the roots. In a young lateral root, current entered the cap, meristematic, and elongation zones and exited the primary root surface close to the base of the lateral root. As the lateral root grew, current began to exit from its basal (cell maturation zone) end. The densities of currents entering the apical portion of the faster-growing lateral roots in a medium lacking indole 3-acetic acid were about twice as large as those entering the apical region of the slower-growing lateral roots in indole 3-acetic acid-supplemented medium.

The responses of pollen to applied electrical fields

The growing pollen tubes of tomato and tobacco were exposed to electrical fields and the effect on the direction of growth was measured. They responded by turning toward the positive electrode (anode) and gave a detectable response in fields as small as 0.1 mV/tube diameter. The sites of germination of tobacco pollen grains were also affected by applied fields; the pollen tubes tended to emerge from the anodal side. This effect was detectable at a field of 0.4 mV/grain diameter.

A refined technique to apply electrical currents to callus cultures

A simple, inexpensive technique is described which can be used to pass small electrical currents of a few microamperes through callus cultures under sterile conditions without contaminating the tissue or the medium with electrode products. Application of 1 or 2 microamperes currents of either polarity stimulated growth as well as shoot regeneration in tobacco (Nicotiana tabacum var. virginica) callus cultures, indicating that these effects are due to the electrical fields set up by the exogenous currents, rather than by electrode products.

Ionic basis of currents in somatic embryos of Daucus carota

A vibrating probe was used to measure extracellular electrical currents around developing somatic embryos in two lines (RCC27, RCC48) of cultured cells of Daucus carota L. at the heart and torpedo stages. At pH 5.5, an inward current of 1.2±0.1 μA·cm(-2) (n=23) was detected at the cotyledon, and an outward current of 1.0±0.1 μA·cm(-2) (n=22) was found at the radicle in torpedostage embryos from the RCC27 line. At a pH of 5.75 the currents increased by 0.2-0.3 μA·cm(-2) (n=60-62). In a few cases an additional small inward current was detected at the tip of the radicle in toepedo-stage embryos from RCC27 line. Such an inward current at the radicle seemed to appear earlier, some time after the heart stage, in embryos from the RCC48 line.Both extracellular pH measurements (using microelectrodes filled with ion-sensitive resin) and ion-substitution studies were carried out in order to ascertain the ionic composition of the currents in torpedo-stage embryos from the RCC27 line. Regions adjacent to the cotyledon and radicle, at the points of current entry and exit, were found to be more acidic by 0.02±0.01 (n=14) and 0.07±0.01 (n=12) pH units, respectively, than the bulk medium. Removal of K(+) from the medium reversibly reduced the currents to about 25% of their original value at both cotyledon and radicle. Deletion of Cl(-) decreased the currents slightly. Removal of Ca(2+) resulted in a rapid doubling of currents. Addition of either N,N'-dicyclohexylcarbodiimide or tetraethyl ammonium chloride substantially reduced overall currents, and their removal resulted in partial recovery of the currents. It is suggested that the inward current at the cotyledon is comprised largely of K(+) influx and the outward current at the radicle is mainly the result of active H(+) efflux.