INNOVATIONS IN ORTHOPEDIC SURGERY: MINIMALLY INVASIVE TECHNIQUES FOR JOINT REPLACEMENT AND REPAIR

The scientists compared the outcomes of a minimally invasive operation approach (MIO) to a conventional poster lateral (PL) method in overall hip replacement (OHR) in terms of itchiness, damage to muscles, and bleeding. The factors that researchers examined were the levels of Haemoglobin (Hg), a marker for oxygen depletion, the quantity of Interleukin-6 (IL6), a marker for inflammation, the heart-type fatty acid binding protein (HTFABP), and the health of the muscles. The study's findings showed that IL6 content increased beyond pre-operative levels as a result of the two surgeries. At 6 hours after surgery, the mean IL6 concentration in the PL group was 79.6 pg/ml while in the MIO group it was 76.4 pg/ml. The highest values after 24 hours of therapy were 100 pg/ml in the PL group and 92.3 pg/ml in the MIO category. In each category, IL6 levels had dropped up to this point. The post-operative mean HTFABP concentration in the MIO organization was greater (12.5 mg/l) than in the PL organization (18.3 mg/l) in terms of muscle damage. One day after surgery, however, it reached an apex and began to decline in both groups. The amounts of Hg lost throughout the procedure decreased for both sets. 12.5 g/dl of mercury was present. The MIO grouping had PL 72 hours following a procedure, while the PL grouping had 10.3 g/dl. Between the two surgical methods, there were no obvious differences in bleeding, muscle damage, or edema. These results led the researchers to draw the conclusion that there were little differences between the MIO anterior method and the traditional PL technique in terms of muscle damage, blood loss, or irritability. The lack of a learning curve in the study may account for the lack of alterations seen, they hypothesized, rendering the use of the term "MIO" in describing the approach as less traumatizing dubious. The study's methodology, sample sizes, and all other relevant material were left out, making it impossible to evaluate the study's validity and generalizability in its entirety.

MANAGING ARTHRITIS PAIN: MEDICATIONS AND LIFESTYLE CHANGES

This study aims to characterize and contrast the triennial rates at which doctors prescribe PT, determine patient, doctor, and practicing characteristics related to every therapy suggestion, and assess pain relievers, lifestyle counseling, and PT as effective treatments for knee osteoarthritis (OA). We analyzed the National Ambulatory Medical Care Survey. Nonsteroidal anti-inflammatory drugs (NSAID), narcotics prescriptions, physical therapy referrals, and primary care physician visits for knee OA have been determined and evaluated. The average yearly rate after three years of therapy was determined. Using multivariable logistic modeling with adjustments for complicated sample design, we analyzed the relationships among patient, physician, and practice characteristics and treatments. Over time the patients were prescribed physical therapy to improve their lifestyle whereas the percentage of patients who were prescribed NSAIDs or drugs. Physical therapy, lifestyle therapy, and drugs were prescribed at similar rates across time for basic care doctor visits. There was an association between nonclinical characteristics and treatment suggestions, such as provider type, practice setting, and geographic proximity. Physical therapy (PT) and lifestyle counseling (LC) seem underused in patients with knee OA, but prescriptions for pain medication rose over the studied period. The treatment decisions varied due to variables outside of medicine. Increased usage of physical therapy and lifestyle changes, as well as decreased treatment variance for knee OA, are important areas for further study.

Association between Psychological Status and Functional Outcome in Surgically Managed Fractures around Hip in Geriatric Patients - A Prospective Study

Introduction:

Fractures around the hip in the geriatric population not only lead to functional but also psychological impairment. Psychiatric disturbances can be associated with poor participation in rehabilitation, increased risk of falling again, and higher rates of mortality. The present study was undertaken to assess the association between the psychological status and functional outcome of surgically managed elderly Indian patients who had sustained fractures around the hip.

Material and Methods:

The present study was a hospital based prospective, single centre study. One hundred and two geriatric patients who had sustained hip fracture and had been managed surgically, having no cognitive dysfunction, living independently, having unhindered walking capability before the fracture, were included in the study. They were called for follow-up at 3rd, 6th, and 12th month after the hip surgery. Psychological assessment was done by the Hospital Anxiety and Depression Scale (HADS) and functional outcome by using the Harris hip score (HHS).

Results:

Our study did not show association between psychological status and functional outcome except in one sub-group. Significant correlation was observed between the psychological status and functional outcome in most of the patients in the extra-capsular group. We have identified improvement in the depression, anxiety and functional scores during the follow-up.

Conclusion:

We conclude that psychiatric disturbances in a geriatric patient after undergoing a surgery for hip fracture may lead to poor recovery. We recommend that all such geriatric patients should undergo a psychological assessment and proper therapy should be instituted to achieve good functional recovery.

Changes in phytates and HCl extractability of calcium, phosphorus, and iron of soaked, dehulled, cooked, and sprouted pigeon pea cultivar (UPAS-120)

UPAS-120, a high yielding and early maturing variety of pigeon peas released by the Department of Plant Breeding, CCS Haryana Agricultural University, Hisar contained a significant amount of phytic acid, i.e. 886 mg/100 g. When it was subjected to various domestic processing and cooking methods viz. soaking (6, 12, 18 h), dehulling, ordinary as well as pressure cooking and germination (24, 36 and 48 h), a drastic decrease in level of phytic acid with a remarkable increase in the HCl-extractability of mono, divalent, and trivalent ions, like calcium, phosphorus, and iron occurred. Germination (48 h) was found to be the best method for decreasing the phytic acid content, i.e. 35 to 39 percent less than the control and significantly (p < 0.05) increasing the non-phytate phosphorus and HCl-extractable phosphorus. Pressure cooking of soaked-dehulled pigeon pea also rendered equally good results. The calcium, phosphorus, and iron contents of pigeon pea seeds were 197.3, 473.1, and 9.91 mg/100 g, respectively; some losses varying from 3 to 9 percent were noticed when the legume was subjected to soaking, cooking, and germination but the maximum losses, i.e. 23 percent, occurred when the seeds were dehulled. However, HCl-extractability of Ca, P, and Fe improved to a significant extent when the pigeon pea seeds were soaked, soaked-dehulled, cooked and sprouted which may have been due to decrease in the phytate content followed by processing and cooking. The significant negative correlations between the phytic acid and HCl-extractability of minerals of processed pigeon pea strengthens these findings.

Processing of newly released ricebean and fababean cultivars: changes in total and available calcium, iron and phosphorus

The seeds of newly released high-yielding cultivars of ricebean (RB-32) and fababean (VH-82-1) contained good amounts of calcium, phosphorus and iron. Due to soaking and sprouting, significant losses occurred in the total mineral content due to leaching. However, availability of these minerals improved considerably. Sprouting was found to be the best inexpensive processing method, followed by dehulling and soaking for enhancing the mineral availability.

Saponin content and trypsin inhibitor activity in processed and cooked pigeon pea cultivars

Four high-yielding varieties of pigeon pea namely UPAS-120, Manak, JCPL-151. ICPL-87 had considerable amounts of antinutrients i.e. saponins and trypsin inhibitors. Saponin content of these unprocessed cultivars ranged from 2164 to 3494 mg/100 g. There were significant varietal variations in trypsin inhibitor activity (1007-1082 TIU/g) of these pigeon pea cultivars. Some simple, inexpensive and easy-to-use domestic processing and cooking methods, namely, soaking (6, 12, 18 h), soaking (12 h)-dehulling, ordinary cooking, pressure cooking and germination (24, 36, 48 h) were found to be quite effective in lowering the level of saponins and trypsin inhibitors in all the pigeon pea cultivars. Pressure cooking of soaked and dehulled seeds lowered the content of saponins to a maximum extent (28 to 38%) followed by ordinary cooking of soaked and dehulled seeds (28 to 35%), soaked dehulled raw seeds (22 to 27%) and 48 h germinated seeds (15 to 19%). Loss of TIA was marginal due to soaking but ordinary as well as pressure cooking of unsoaked and soaked-dehulled pigeon pea seeds reduced the TIA drastically. Pressure cooking of pigeon pea seeds completely destroyed the TIA while it was reduced to the extent of 86-88% against the control in 48 h pigeon pea sprouts.

Nutritional status of rural pre-school children of Haryana state

The present investigation was conducted on 90 rural pre-school children (1-3 years) in summer and winter from arid (Bhiwani), semi-arid (Hisar) and wet (Kurukshetra) zones of Haryana State, India. Mean daily food intake of cereals, pulses, green leaf vegetables, other vegetables, roots and tubers, milk products, fats and oils, sugar and jaggery and fruits was found lower than their respective recommended dietary intake (RDI) in summer season whereas in winter season mean daily food intake of milk and milk products provided 6, 7, and 32 per cent more than RDI in the diets of pre-schoolers of Hisar, Bhiwani and Kurukshetra zones, respectively, Similar trend was also found in nutrient intakes. Mean height and weight of few children were found lower in Hisar and Bhiwani and higher in Kurukshetra compared to their reference values. On the basis of weight for age and height for age criteria as well as clinical examinations, majority of children were found normal in Kurukshetra.

Optimum domestic processing and cooking methods for reducing the polyphenolic (antinutrient) content of pigeon peas

Four high yielding and early maturing cultivars of pigeon pea (Cajanus cajan) namely UPAS-120, ICPL-87, ICPL-151 and, especially, Manak, contained significant amounts of polyphenols (1075 to 1328 mg/100g), which may limit their utilization. The effectiveness of soaking (6, 12 and 18 h, 30 degrees C), soaking and dehulling, ordinary cooking, pressure cooking and germination (24, 36, 48 h, 30 degrees C) in reducing the levels of polyphenols was investigated. A decrease in the polyphenolic contents varying from 4 to 26 percent in different pigeon pea cultivar was achieved. Pressure cooking of soaked-dehulled seeds was found to be the most effective method, followed by sprouting for 48 h, ordinary cooking of soaked-dehulled seeds, and pressure cooking of soaked whole seeds followed by sprouting for 36 h.

Effect of various domestic processing and cooking methods on phytic acid and HCl-extractability of calcium, phosphorus and iron of pigeon pea

Manak, the high yielding cultivator of pigeon pea (Cajanus cajan) released by (International Crop Research Institute for Semi-Arid Tropics) ICRISAT, India was subjected to various domestic processing and cooking methods viz., soaking (6, 12 and 18 h, 30 degrees C), soaking and dehulling, ordinary cooking, pressure cooking and germination (24, 36 and 48 h, 30 degrees C). The unprocessed seeds of this variety contained considerable amounts of phytic acid i.e. 917 mg per 100 g. This antinutrient was reduced significantly (P < 0.05) to varying extents (4-37%) in the processed samples. Except soaking and dehulling, the remaining processing and cooking methods did not lower the contents of total calcium, phosphorus and iron. That HCl-extractability of these dietary essential minerals, an index of their bioavailability, enhanced significantly when the pigeon pea seeds were processed and cooked, may be due to reduction in phytate content, which is known to chelate the minerals. A significant and negative correlation between the phytic acid and HCl-extractability of minerals further strengthens our findings.

Protein digestability of vegetables and field peas (Pisum sativum). Varietal differences and effect of domestic processing and cooking methods

Protein digestibility was found to be 60.4 to 66.5 percent in raw unprocessed seeds of different pea cultivars. Protein digestibility (in vitro) was improved by the common methods of domestic processing and cooking including soaking, dehulling, ordinary cooking, pressure cooking and sprouting of legume grains. Pressure cooking had more pronounced effect on protein digestibility followed by ordinary cooking, sprouting, soaking for 18 h and (12 h) and dehulling. Pressure cooking of soaked and dehulled seeds was noticed to give most improved protein digestibility.

Effect of domestic processing and cooking methods on phytic acid and polyphenol contents of pea cultivars (Pisum sativum)

All the pea varieties differed significantly (p < 0.05) in their phytic acid content. The field pea cultivars had significantly (p < 0.05) higher levels of phytic acid and polyphenols than those of vegetable pea varieties. All the domestic processing and cooking methods could reduce the contents of phytic acid and polyphenols but germination for 48 hours seemed to have a marked lowering effect on the levels of these antinutrients in peas.