WALANT vs standard anaesthesia in the management of flexor tendon injuries: A systematic review and meta-analysis.

Wide awake local anaesthesia no tourniquet (WALANT) surgery has gained increasing popularity in recent years for hand surgery fast-tracked by the COVID pandemic. It involves infiltration of lidocaine with adrenaline to the operative region ensuring a good visual field owing to the vasoconstrictive effects of epinephrine. It has numerous advantages over traditional anaesthetic (TA) for flexor tendon repairs including testing of tendon strength on table as well as immediate revision of the repair if needed.

Transcriptome-wide investigation and functional characterization reveal a terpene synthase involved in γ-terpinene biosynthesis in Monarda citriodora.

Monarda citriodora Cerv. ex Lag. is a rich source of industrially important compounds like γ-terpinene, carvacrol, thymol and thymoquinone.

Microsurgical limb reconstruction in the non-concordant patient.

Substance misuse is common in patients undergoing limb reconstruction secondary to open fractures and fracture related infection. This group risk breaching the social contract with their treating team through reduced engagement with perioperative care. Potential problems include limited social support, intravenous access, analgesia and withdrawal.

Neurovascular injury from supracondylar fractures in children: a 10-year experience of 762 cases.

We evaluated the management of supracondylar paediatric fractures at our institution over a 10-year period in this retrospective cohort study. In total, 762 children with a supracondylar fracture were treated. The mean age of injury was 5.

Mass balance of Nehnar glacier from 2000 to 2020, using temperature indexed-IAAR approach.

Glacier mass balance is inextricably linked to annual meteorological conditions and is a key indicator for assessing the ice reserves of a glacier. As a result, a number of studies have estimated glacier mass balance using different methods. Here, we have used the improved accumulation area-ratio (IAAR) method to study the mass balance of the Nehnar glacier from 2000 to 2020.

WAFER trial: a study protocol for a feasibility randomised controlled trial comparing wide-awake local anaesthesia no tourniquet (WALANT) to general and regional anaesthesia with tourniquet for flexor tendon repair.

Introduction: Flexor tendons are traditionally repaired under either general anaesthesia (GA) or regional anaesthesia (RA), allowing for the use of an arm tourniquet to minimise blood loss and establish a bloodless surgical field. However, the use of tourniquets exposes the patient to certain risks, including skin, muscle and nerve injuries. A recent advancement in anaesthesia delivery involves the use of a wide-awake approach where no sedation nor tourniquets are used (wide-awake local anaesthesia no tourniquet (WALANT)).

Synchronous circular frame stabilisation and microsurgical soft tissue reconstruction for open lower limb fractures-A cost analysis and description of the surgical technique.

Introduction: Current surgical paradigms for ortho-plastic management of IIIB open tibial fractures make compromises. Often, definitive circular frame stabilisation is delayed until the soft tissue envelope is secure to allow access for further soft tissue reconstruction if required. This delay has potential clinical and cost implications.

Surgical Exposure of the Distal Fibula to Protect the Peroneus Brevis Muscle Vascular Pedicle.

Unlabelled: Ankle fractures are a common presentation to orthopaedic surgeons, with the lateral malleolus involved in 86% of cases. A soft tissue injury can be a concomitant feature of these injuries as a result of the primary injury or following secondary wound breakdown. The peroneus brevis muscle flap provides a reliable and robust option to cover the distal third of the lower limb.

Distally Based Sartorius Flap for Soft Tissue Coverage of the Distal Femur.

This case report outlines the use of the distal pedicle of the sartorius muscle in the coverage of a large bony and soft tissue defects of the distal femur in a trauma setting. McArdle C, Louette S, Wilks D, Distally Based Sartorius Flap for Soft Tissue Coverage of the Distal Femur. Strategies Trauma Limb Reconstr 2021;16(2):120-122.

Wrist fusion using an induced membrane technique for forearm salvage in a patient with an infected open injury with segmental bone loss: A case report.

This case report describes the management of a 27-year-old male who, after a quadbike accident, presented with an open, infected, segmental both bone forearm injury with significant bone and soft tissue loss including the radio-carpal joint. Limb salvage was accomplished in the form of a single bone forearm fusion utilising Masquelet's two-stage induced membrane technique to reconstruct the segmental bone defect. The patient proceeded to uneventful bony union by 6 months and returned to driving and riding a quadbike.

An overview of mallet finger injuries.

Mallet finger describes a fingertip deformity where the distal interphalangeal joint (DIPJ) of the affected digit is held in flexion, unable to extend the distal phalanx actively. The deformity is typically a consequence of traumatic disruption to the terminal extensor tendon at its insertion at the proximal portion of the distal phalanx or slightly proximally at the level of the DIPJ. Patients typically present with a history describing the event of injury with a typical mallet deformity.

Forensic analysis of anti-forensic file-wiping tools on Windows.

This paper presents forensic analysis of anti-forensic file-wiping tools on the Windows platform. The goal is to identify and extract the evidence of the tools used to wipe files and the files wiped by them on the Windows operating system. To achieve this goal, we analyzed the changes made by these tools to metadata structures of Windows file systems during file wiping.

Elective Cesarean Section in Obstetric COVID-19 Patients under Spinal Anesthesia: A Prospective Study.

Background: Managing obstetric emergencies in COVID-19 pandemic is a real challenge as these patients need timely intervention to save the life of the mother and the baby. Hence, to avoid life-threatening challenges, all pregnant patients were electively admitted and tested for COVID-19 near term to anticipate the difficulties and prevent complications.

Aim: Our aim was to assess the impact of COVID-19 infection on maternal morbidity and mortality as well as the effect on the neonate under spinal anesthesia.

A Sesquiterpene Synthase from the Endophytic Fungus Catalyzes Formation of Viridiflorol.

Interactions between plant-associated fungi and their hosts are characterized by a continuous crosstalk of chemical molecules. Specialized metabolites are often produced during these associations and play important roles in the symbiosis between the plant and the fungus, as well as in the establishment of additional interactions between the symbionts and other organisms present in the niche. , a root endophytic fungus from the phylum Basidiomycota, is able to colonize a wide range of plant species, conferring many benefits to its hosts.

Forensic analysis of Twitch video streaming activities on Android.

Video streaming abuses range from copyright infringement and piracy to child sexual abuse and murder. This paper performs proactive forensics of Twitch video streaming activities on Android devices. We designed our experiments using a methodology based on black-box testing principles and conducted them on Android devices using a forensic framework.

Can computer forensic tools be trusted in digital investigations?

This paper investigates whether computer forensic tools (CFTs) can extract complete and credible digital evidence from digital crime scenes in the presence of file system anti-forensic (AF) attacks. The study uses a well-established six stage forensic tool testing methodology based on black-box testing principles to carry out experiments that evaluate four leading CFTs for their potential to combat eleven different file system AF attacks. Results suggest that only a few AF attacks are identified by all the evaluated CFTs, while as most of the attacks considered by the study go unnoticed.

Plastic physicians: The surgical salamanders of the COVID-19 pandemic.

At the time of writing, coronavirus disease-2019 (COVID-19) has affected 6.42 million people globally and over 380,000 deaths, with the United Kingdom now having the highest death rate in Europe. The plastic surgery department at Leeds Teaching Hospitals put necessary steps in place to maintain an excellent urgent elective and acute service whilst also managing COVID-positive medical patients in the ward.

Generation of a chromosome-scale genome assembly of the insect-repellent terpenoid-producing Lamiaceae species, Callicarpa americana.

Background: Plants exhibit wide chemical diversity due to the production of specialized metabolites that function as pollinator attractants, defensive compounds, and signaling molecules. Lamiaceae (mints) are known for their chemodiversity and have been cultivated for use as culinary herbs, as well as sources of insect repellents, health-promoting compounds, and fragrance.

Findings: We report the chromosome-scale genome assembly of Callicarpa americana L.