The aims of this study were to compare radiological and functional outcomes of Ilizarov ligamentotaxis and locked volar plating in comminuted intra-articular distal radius fractures (AO type C2/C3) using a non-randomised superiority trial.
A total of 72 patients with AO C2/C3 distal radius fractures were allotted into Ilizarov ligamentotaxis (n = 30) and locked volar plating (n = 42) groups based on patient preference. Primary outcome was the ability to achieve and stably maintain acceptable radiological parameters (post-operative, 6weeks, 3months, 12months), and secondary outcome was functional scoring (at 12months).
All patients completed the study. All fractures united uneventfully. Plating was superior to Ilizarov in restoring ulnar variance (100% versus 80%, p value 0.004), but Ilizarov was superior to plating in restoring volar tilt (as opposed to neutral tilt, 83.3% versus 47.8%, p value 0.002). Both groups were comparable in restoring radial height, radial inclination and intra-articular reductimost care while performing Ilizarov ligamentotaxis. Ilizarov comes with the disadvantages of reduced patient preference, pin site infections, need for removal of external fixator and slightly slower return to activity.
CTRI/2018/08/015549 LEVEL OF EVIDENCE Level III, Non-randomised prospective trial.
CTRI/2018/08/015549 LEVEL OF EVIDENCE Level III, Non-randomised prospective trial.The topical use of rosmarinic acid (RA) in skin inflammatory pathologies is restricted due to its poor water solubility, poor permeability, and chemical instability. In this study, RA-loaded transethosomes-in-Carbopol® formulations have been developed to evaluate its anti-inflammatory activity on imiquimod-induced psoriasis-like skin inflammation in mice. In vitro release profiles demonstrated sustained behavior due to the retentive action of gel and the entrapment of RA into the vesicles. However, the low viscosity of the combined formulation increased the drug release rate. Animal evaluation of anti-inflammatory activity demonstrated that transethosomes-in-gel containing dexamethasone (Dex-TE-Gel), as positive control, showed effect in all the pro-inflammatory parameters evaluated, evidencing that these drug-loaded nanocarriers have been effectively reached the site of action. In addition, transethosomes-in-gel containing RA (RA-TE-Gel) formulations produced a great reduction in the punch edema (P less then 0.001) and in TNF-α and IL-6 (P less then 0.05). However, non-significant differences were obtained for IL-1β, IL17, and MPO. Despite the protecting effect of Carbopol® and transethosomes on oxidation index and antioxidant activity of RA over the 7 days of treatment, however, a degradation process of this antioxidant to caffeic acid may be the cause of these in vivo results. We have also checked that the pH existing into the intercellular space of damaged cells (pH 6.8) may be affecting. Therefore, our results suggest that RA-TE-Gel could act as an effective RA formulation for skin delivery; further studies will help to understand the loss of activity at the cellular level.
This review aims to summarize innovations in urologic surgical training in the past 5 years.
Many assessment tools have been developed to objectively evaluate surgical skills and provide structured feedback to urologic trainees. A variety of simulation modalities (i.e., virtual/augmented reality, dry-lab, animal, and cadaver) have been utilized to facilitate the acquisition of surgical skills outside the high-stakes operating room environment. Three-dimensional printing has been used to create high-fidelity, immersive dry-lab models at a reasonable cost. Non-technical skills such as teamwork and decision-making have gained more attention. Structured surgical video review has been shown to improve surgical skills not only for trainees but also for qualified surgeons. Research and development in urologic surgical training has been active in the past 5 years. Despite these advances, there is still an unfulfilled need for a standardized surgical training program covering both technical and non-technical skills.
Many assessment tools have been developed to objectively evaluate surgical skills and provide structured feedback to urologic trainees. A variety of simulation modalities (i.e., virtual/augmented reality, dry-lab, animal, and cadaver) have been utilized to facilitate the acquisition of surgical skills outside the high-stakes operating room environment. Three-dimensional printing has been used to create high-fidelity, immersive dry-lab models at a reasonable cost. Non-technical skills such as teamwork and decision-making have gained more attention. Structured surgical video review has been shown to improve surgical skills not only for trainees but also for qualified surgeons. Research and development in urologic surgical training has been active in the past 5 years. Dyes chemical Despite these advances, there is still an unfulfilled need for a standardized surgical training program covering both technical and non-technical skills.Globally, climate change is an alarming threat to the livestock industry. Such changes in the climate can also adversely affect the returns of livestock farmers in Pakistan. Improvement in the production process could decrease the risk of losses. This study analyzes the efficacy of silage to abate the losses in livestock profitability resulting from the climate change. The study employed cross-sectional survey data of 492 livestock farmers collected from six districts of Punjab Province, Pakistan. The data are analyzed with endogenous switching regression, considering the possibility of selection bias and endogeneity in adopting silage as a climate change adaptation measure. The study findings show a significant difference in material well-being between silage users and conventional feed users. Furthermore, training programs such as silage training and livestock development programs could be meaningful provisions to abate climate change and improve food security. It is suggested that training and development programs should be incorporated in policy plans to improve the well-being of farmers in terms of their farm revenues.Dyes chemical
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