Wide Awake Local Anaesthesia No Tourniquet Surgery of the Foot and Ankle: A Review of Indications, Technique, Patient Satisfaction, and Complications.

Wide-awake surgery of the hand was surrounded by a lot of apprehension, mainly over concerns around using epinephrine near digits and its potential to cause digital ischemia and necrosis. With multiple reports underlining its safety and effectiveness, it is now being widely adopted in hand and wrist surgery. The British Society for Surgery of the Hand has already published guidelines on operating outside of main theatres, with an emphasis on wide awake local anaesthesia no tourniquet (WALANT).

Functional Outcomes of Pilon Fractures Treated by External Fixation, Delayed Plating, and Open Reduction and Internal Fixation (ORIF): A Prospective Cohort Study.

Objective: This study aimed to evaluate the functional outcomes of three surgical management strategies for pilon fractures, including primary external fixation with delayed plating, external fixation with minimal internal fixation, and single-stage open reduction and internal fixation (ORIF) with plating.

Methods: This prospective cohort study included 34 patients with complex intra-articular fractures of the distal tibia (AO-OTA type 43-C) treated between June 2018 and December 2019. Patients were managed surgically based on the local skin condition and swelling, employing either primary-stage external fixation with delayed plating (Group A), external fixation with minimal internal fixation (Group B), or single-stage ORIF with plating (Group C).

Functional Outcomes and Complications After Open Reduction and Internal Fixation of Mid-shaft Clavicle Fractures: A Retrospective Study.

Introduction: Clavicle fractures are routinely encountered in orthopedic clinical practice and have often been the subject of debate when it comes to optimal treatment. Clavicle fracture surgery has come a long way with excellent pre-contoured superior locking plates available for fixation. This study aimed to evaluate a cohort of patients operated for displaced mid-shaft clavicle fractures by open reduction and internal fixation using superior clavicle locking plates.

Preoperative Prediction of the Scaphoid Screw Length for the Fixation of Fractures Using MRI Measurements of Finger Phalanges.

Introduction: Scaphoid fractures are one of the most common carpal bone fractures, with most fractures involving the waist. When surgery is indicated, internal fixation with screws is the standard method for the fixation of these fractures. Accurate length and trajectory of the screw are two crucial parameters essential for optimal internal fixation.

A case of mesalamine potentiating hypoprothrombinemic effect of vitamin K antagonist (VKA) therapy resulting in life-threatening bleeding.

A 76-year-old male patient, who underwent a post-aortic valve replacement with a mechanical valve in 2006, was on oral anticoagulant therapy with warfarin, maintaining a stable therapeutic level of anticoagulation until 2022. He had a new diagnosis of ulcerative colitis in 2022, following which he was started on mesalamine. He had been having a supratherapeutic level of anticoagulation, as evidenced by an international normalized ratio (INR) of 12 to 14 on multiple occasions since 2022, leading to gastrointestinal bleeding, necessitating multiple packed red cell transfusions.

Utility of Intranasal Tapentadol in Redefining Postoperative Pain Management in Total Knee Arthroplasty: A Prospective Observational Study.

Introduction Effective strategies to minimize postoperative pain following total knee arthroplasty (TKA) are essential to improve functional outcomes. This study aimed to evaluate the effectiveness and safety of tapentadol nasal spray as a form of patient-controlled analgesia (PCA) for postoperative pain management after TKA. The intranasal route was chosen for the study as intranasal tapentadol has been shown to have superior pain reduction as compared to intravenous tapentadol.

Primary lung tumour stereotactic body radiotherapy followed by concurrent mediastinal chemoradiotherapy and adjuvant immunotherapy for locally advanced non-small-cell lung cancer: a multicentre, single-arm, phase 2 trial.

Background: Patients with locally advanced non-small-cell lung cancer (NSCLC) who undergo concurrent chemotherapy and radiotherapy often experience synergistic toxicity, and local regional control rates remain poor. We assessed the activity and safety outcomes of primary tumour stereotactic body radiotherapy (SBRT) followed by conventional chemoradiotherapy to the lymph nodes and consolidation immunotherapy in patients with unresectable locally advanced NSCLC.

Methods: In this multicentre, single-arm, phase 2 trial, patients aged 18 years and older were enrolled at eight regional cancer centres in North Carolina and South Carolina, USA.

Extension of impurity profiling on eltrombopag olamine to in-silico predictions: An effort to exploit correlated forced degradation products and known drug-related substances in drug discovery.

The recent pandemic has highlighted the impact of diseases on global health and the economy. The rapid discovery of new hit molecules remains a tough challenge. Pharmaceutical impurity profiling can be linked to drug discovery through the identification of new hits from compounds identified during the analytical profiling.

Pre-operative stereotactic radiosurgery and peri-operative dexamethasone for resectable brain metastases: a two-arm pilot study evaluating clinical outcomes and immunological correlates.

Enhancing the efficacy of immunotherapy in brain metastases (BrM) requires an improved understanding of the immune composition of BrM and how this is affected by radiation and dexamethasone. Our two-arm pilot study (NCT04895592) allocated 26 patients with BrM to either low (Arm A) or high (Arm B) dose peri-operative dexamethasone followed by pre-operative stereotactic radiosurgery (pSRS) and resection (n= 13 per arm). The primary endpoint, a safety analysis at 4 months, was met.

The objective measurement of hypoaesthesia after Total Knee Arthroplasty and its correlation with skin incision length: a prospective study.

Purpose: This study aims to measure the peri-incisional numbness developing after Total Knee Arthroplasty (TKA) performed using the midline skin incision. It studies the natural course of the numbness and determines its correlation with the skin incision length (SIL).

Materials & Methods: 66 knees undergoing primary TKA with a standard midline incision were evaluated.

Mismatch between pollen and pistil size causes asymmetric mechanical reproductive isolation across Phlox species.

Characterizing the mechanisms of reproductive isolation between lineages is key to determining how new species are formed and maintained. In flowering plants, interactions between the reproductive organs of the flower-the pollen and the pistil-serve as the last barrier to reproduction before fertilization. As such, these pollen-pistil interactions are both complex and important for determining a suitable mate.

Development of an UPLC-MS/MS approach to detect and quantify N-nitroso mirabegron in mirabegron.

In the mirabegron (MIR) synthesis, the N-nitroso mirabegron (NNM) is obtained during synthetic process of MIR; water is being used in reaction under acidic condition. Nitrite source is from water, and secondary amine source is from MIR as it has secondary amine; NNM is generated as an impurity during the synthesis of MIR. The presence of NNM in MIR could potentially affect its effectiveness.

Influence of phospholipid head and tail molecular structures on cell membrane mechanical response under tension.

Biological cell membranes are primarily comprised of a diverse lipid bilayer with multiple phospholipid (lipid) types, each of which is comprised of a hydrophilic headgroup and two hydrophobic hydrocarbon tails. The lipid type determines the molecular structure of head and tail groups, which can affect membrane mechanics at nanoscale and subsequently cell viability under mechanical loading. Hence, using molecular dynamics simulations, the current study investigated seven membrane phospholipids and the effect of their structural differences on physical deformation, mechanoporation damage, and mechanical failure of the membranes under tension.

Planned Dental Extractions After Radiation Therapy.

Importance: Nonrestorable teeth are recommended to be extracted prior to radiation therapy (RT). Occasionally, preradiation extractions introduce unacceptable delays in treatment initiation. Planned dental extractions immediately postradiation presents an alternative strategy, though outcomes are uncertain.

Unplanned Emergency Department or Inpatient Acute Care Within 1 Week After Administration of Peptide Receptor Radionuclide Therapy: Frequency of Occurrence and Standard Operating Procedures for Radioprotection in These Situations.

Peptide receptor radionuclide therapy (PRRT) is a rapidly developing treatment modality. These treatments are indicated for patients who are either heavily pretreated and/or may have neurohormonal active disease, increasing the risk of acute adverse effects and the need for unplanned acute care. The goals of this report were to characterize the frequency of unplanned acute care utilization after PRRT infusion and detail a comprehensive standard operating procedure (SOP) for radioprotection during unplanned post-PRRT acute care.

Population specific dental age estimation model for South Indian children based on normalized open apices method: A cross sectional study.

Age estimation plays significant role in forensic science especially when there is unavailability of the information concerned to the deceased. Use of population specific models of age estimation results in questionable evidence legally when tried on Indian children. The present study was designed to assess the accuracy of Cameriere's Italian and Balwant Rai Indian model on South Indian children and to derive and validate a novel model for south Indian children by considering a sample from a larger geographical area with a greater sample size of 2500.

Sonological predictors of complications of percutaneous renal biopsy-a prospective observational study.

Unlabelled: Percutaneous renal biopsy, although essential for renal disease diagnosis, is associated with a number of post-biopsy complications ranging from gross haematuria to AV fistula to death. In this study, we carried out an active haematoma surveillance and attempted to correlate renal sonological parameters-kidney length, renal parenchymal changes, renal cortical and parenchymal thickness for their potential use in prediction of post-renal biopsy complications.

Methods: This was a prospective study done from April 2022 to April 2023 on all adult patients undergoing native or transplant kidney biopsy.

Diagnostic Potential of Serum Interleukin-6 in Predicting Bacteremia in Adult Patients with Sepsis: A Prospective Observational Study.

Background: This study aimed to assess the potential of serum interleukin-6 (IL-6) as a diagnostic marker in predicting bacteremia and to determine its association with severity and outcome among sepsis patients.

Materials And Methods: A prospective observational study was conducted, comprising a cohort of 118 patients admitted to the ICU with suspected sepsis from January 2019 to April 2020.

Results: Among the 108 patients analyzed, 60 (55.

Weekly Versus Bolus Cisplatin Concurrent With Definitive Radiation Therapy for Squamous Carcinoma of the Head and Neck: A Systematic Review and Network Meta-Analysis.

Purpose: The schedule of cisplatin concurrent with definitive radiation for squamous carcinoma of the head and neck remains controversial. Most institutions deliver either a high-dose "bolus" schedule once every 3 weeks or a low-dose weekly schedule. We compared these 2 schedules via a simplified network meta-analysis with a common comparator.

Racial and Ethnic Concordance Between the Patient and Anesthesia Team and Patients' Satisfaction With Pain Management During Cesarean Delivery.

Background: Racial and ethnic concordance between patients and health care providers increases patient satisfaction but has not been examined in obstetric anesthesia care. This study evaluated the association between racial and ethnic concordance and satisfaction with management of pain during cesarean delivery (PDCD).

Methods: This was a secondary analysis on a cohort of patients undergoing cesarean deliveries under neuraxial anesthesia that examined PDCD.

Mismatch between pollen and pistil size causes asymmetric mechanical reproductive isolation across species.

In flowering plants, pollen-pistil interactions can serve as an important barrier to reproduction between species. As the last barrier to reproduction before fertilization, interactions between these reproductive organs are both complex and important for determining a suitable mate. Here, we test whether differences in style length generate a post-mating prezygotic mechanical barrier between five species of perennial wildflowers with geographically overlapping distributions.

Feasibility Randomized Controlled Trial of Face-to-Face Counseling and Mobile Phone Messages Compared to Usual Care for Smokeless Tobacco Cessation in Indian Primary Care: Project CERTAIN.

Introduction: Smokeless tobacco (SLT) use in low- and middle-income countries has adverse health consequences. We hypothesize that it is feasible to test an intervention of mobile phone messages and face-to-face counseling sessions for SLT cessation in India.

Aims And Methods: We conducted an exploratory, individual parallel two group, randomized controlled trial (RCT), with baseline and end-point (3 months from randomization) assessments in urban primary health centers in Odisha, India.