A surge in neglected shoulder dislocations and delayed surgical management due to the coronavirus disease 2019 lockdown in India.

Four patients with shoulder problems that were traumatic in etiology presented to us with delays in seeking care ranging from 6 to 12 weeks due to the coronavirus disease 2019 (COVID-19) lockdown. The care of three cases (a 3-month-old neglected anterior shoulder dislocation with a greater tuberosity fracture in a 30-year old man, a 3-month-old neglected anterior shoulder dislocation in a 17-year old boy, and a 2-month-old neglected greater tuberosity fracture in a 31-year old man) was delayed due to the lockdown and the ensuing travel restrictions, while that of one case (a 6-week-old fracture-dislocation of the proximal humerus in a 55-year-old woman) was delayed because the patient was undergoing treatment for COVID-19 at the time of injury. This report intends to present the exceptional circumstances around these cases.

Varus Knee Deformity Classification Based on Degree and Extra- or Intra-Articular Location of Coronal Deformity and Osteoarthritis Grade.

Background: Medial coronal plane malalignment, also known as varus alignment, is commonly reported in osteoarthritic knees. Although the degree of deformity provides some insight regarding the severity of the disease, it does not always reflect the potential complexity of the surgical treatment.

Methods: This prospective observational study was conducted by analyzing the radiographs of 100 consecutive knees in patients undergoing total knee arthroplasty.

Effect of 12 mg vs 6 mg of Dexamethasone on the Number of Days Alive Without Life Support in Adults With COVID-19 and Severe Hypoxemia: The COVID STEROID 2 Randomized Trial.

Importance: A daily dose with 6 mg of dexamethasone is recommended for up to 10 days in patients with severe and critical COVID-19, but a higher dose may benefit those with more severe disease.

Objective: To assess the effects of 12 mg/d vs 6 mg/d of dexamethasone in patients with COVID-19 and severe hypoxemia.

Design, Setting, And Participants: A multicenter, randomized clinical trial was conducted between August 2020 and May 2021 at 26 hospitals in Europe and India and included 1000 adults with confirmed COVID-19 requiring at least 10 L/min of oxygen or mechanical ventilation.

Early multicenter experience of Melody valve implantation in India.

Background: Transcatheter valves provide a safe and effective alternative to surgery for treating dysfunctional right ventricular outflow tracts (RVOTs). We present our early multicenter experience of percutaneous pulmonary valve implantation (PPVI) using Melody valve (Medtronic Inc., Minneapolis, MN).

How does anterior glenoid bone loss affect shoulder stability? A cadaveric analysis of glenoid concavity and bony shoulder stability ratio.

Background: Concavity compression is an important glenohumeral stabilizing factor, and recent studies have suggested that peripheral glenoid bone loss creates the most relevant change in stability. This study analyzed changes in the bony shoulder stability ratio (BSSR) with sequential anterior glenoid bone loss (0%-40% width) and with reconstructive bone graft procedures. The aim was to quantify the critical bone defect size that would significantly alter the BSSR and determine restoration of the BSSR with the Latarjet procedure.

Intestinal Ultrasound to Evaluate Treatment Response During Pregnancy in Patients With Inflammatory Bowel Disease.

Introduction: Active disease in inflammatory bowel disease patients during pregnancy is associated with poor maternal and fetal outcomes. Objective evaluation of disease activity is a core strategy in IBD, and during pregnancy noninvasive modalities are preferred. We aimed to evaluate feasibility and accuracy of intestinal ultrasound (IUS) to objectify disease activity throughout pregnancy.

Comparative Study of Pinless Navigation System versus Conventional Instrumentation in Total Knee Arthroplasty.

Backgroud: Optimal placement of the components and achieving a neutral mechanical axis are the main goals of total knee arthroplasty (TKA). Different computerised navigation systems are presently used for these purposes. This aim of this study was to compare the pinless navigation (PNA) TKA performed using iAssist with the conventional instrumented (CIN) TKA in terms of functional and radiological outcomes.

Effects of Supervised Exercise-Based Telerehabilitation on Walk Test Performance and Quality of Life in Patients in India With Chronic Disease: Combatting Covid-19.

Background: The world is currently undergoing a pandemic, caused by the SARS-CoV-2 virus (COVID-19). According to the World Health Organization, patients with chronic illnesses appear to be at the highest risk for COVID-19 associated sequelae. Inability to participate in outpatient-based rehabilitation programs and being home-bound can increase the risk for and potential worsening of chronic health conditions.

Validation of an on-screen application-based measurement of shoulder range of motion over telehealth medium.

Background: Shoulder range-of-motion (ROM) assessment is vital for the follow-up evaluation of operated patients and for the outcome-based research studies. The aim of this study was to investigate the accuracy and reliability of a remote on-screen application (app)-based method of shoulder ROM measurement through a telehealth medium.

Materials And Methods: A consultant shoulder surgeon, a board-certified orthopedic resident, and a graduate medical doctor served as the examiners.

Simultaneous Recognition of Atrophic Gastritis and Intestinal Metaplasia on White Light Endoscopic Images Based on Convolutional Neural Networks: A Multicenter Study.

Introduction: Patients with atrophic gastritis (AG) or gastric intestinal metaplasia (GIM) have elevated risk of gastric adenocarcinoma. Endoscopic screening and surveillance have been implemented in high incidence countries. The study aimed to evaluate the accuracy of a deep convolutional neural network (CNN) for simultaneous recognition of AG and GIM.

Clinical Presentations, Management and Outcomes of Rhino-Orbital-Cerebral Mucormycosis (ROCM) Following COVID-19: A Multi-Centric Study.

Purpose: To report clinical presentations and factors affecting outcomes in rhino-orbital-cerebral mucormycosis following COVID-19.

Methods: Retrospective multi-centric interventional case series of 58 eyes with rhino-orbital-cerebral mucormycosis. Demography, clinical parameters and management outcomes were noted.

Undiagnosed Hepatic Tuberculosis Presenting With Intraabdominal Rupture and Hemoperitoneum, Requiring Urgent Hepatic Resection.

Tuberculosis (TB) affecting the liver is unusual, and isolated liver TB presenting as a liver abscess more so, even in countries where the disease is endemic. As clinical symptoms and imaging are not typical, a high index of suspicion is necessary for diagnosis. We present here a lady who was admitted with fever and chills.

Impacts of the COVID-19 Pandemic on Cardiac Rehabilitation Delivery around the World.

Background: We investigated impacts of COVID-19 on cardiac rehabilitation (CR) delivery around the globe, including virtual delivery, as well as effects on providers and patients.

Methods: In this cross-sectional study, a piloted survey was administered to CR programs globally via REDCap from April to June 2020. The 50 members of the International Council of Cardiovascular Prevention and Rehabilitation (ICCPR) and personal contacts facilitated program identification.

Understanding the COVID 19 Conundrum and Decluttering the scientific literature on COVID 19.

As COVID 19 continues to over burden the healthcare system globally, the scientists are relentlessly pursuing research and publishing copious data on relevant managements strategies for the infection. This short communication has attempted to simplify the available information on the subject in a manner that is easy to understand and implement in clinical setting. COVID 19 is not a single disease but a spectrum and should be classified based on clinical, radiological and laboratory parameters.

Gene expression of klotho & antioxidative enzymes in peripheral blood mononuclear cells of essential hypertension patients in Indian population.

Background & Objectives: Oxidative stress is known to have a causal role in hypertension. Klotho has emerged as a novel anti-aging molecule to inhibit oxidative stress at cellular level. This study aimed at evaluating the gene expression of klotho and antioxidative enzymes, manganese superoxide dismutase (Mn-SOD) and catalase, in peripheral blood mononuclear cells of essential hypertensive patients as compared to normotensive healthy controls.

Tuberculosis of the spine in children - does drug resistance affect surgical outcomes?

Background Context: The emergence of drug resistance has complicated the management of spinal tuberculosis (TB). While it is well known that the medical management of drug-resistant spinal TB is more difficult, the surgical outcomes of the same have not been studied sufficiently, particularly in children.

Purpose: To analyze the surgical outcomes in a cohort of children treated for spinal TB, and to thus assess whether drug resistant (DR) disease is associated with poorer surgical outcomes.

Retro-Odontoid Pseudotumor Without Radiographic Instability with Congenital C1 Assimilation and C2-C3 Fusion: A Case Report.

Case: The authors present a case of retro-odontoid pseudotumor (ROP) with congenital C1 assimilation and C2-C3 block vertebra without radiological instability who presented with cervical myelopathy with spastic quadriparesis. The patient was managed with occipitocervical fusion and C1 laminectomy. She had rapid neurological recovery in 3 months postoperatively and at 2 years had complete resolution of the retro-odontoid mass.

Comparative genomic signatures in young and old Chinese patients with colorectal cancer.

Background: Occurrence at a young age is known to be associated with unique clinical features in colorectal cancer (CRC). However, the genomic differences between young and old patients with CRC are not well elucidated and, to the best of our knowledge, have never been investigated in a Chinese population.

Methods: Tumor tissue samples from 29 young (age ≤50 years) and 46 old (age >50 years) patients with CRC were collected.

Delayed Treatment of a Traumatic Lumbosacral Dislocation With Associated Injuries: A Case Report.

Case: A 41-year-old woman sustained a degloving injury over her lumbosacral and perineal region with fractures of her right tibia and fibula. After diversion colostomy and osteosynthesis for the fractures at a primary center, a missed grade 2 lumbosacral dislocation was diagnosed at a tertiary center and the degloving injury was treated with debridement and skin grafting. After 5 months, the dislocation had progressed to grade 4 and she underwent delayed posterior lumbosacral reduction, interbody fusion, and L4-S1 fixation, with superior gluteal artery perforator flap and subsequent colostomy closure, with good outcomes (Oswestry Disability Index 10%) at the 3-year follow-up.

Virtual crossmatch-prodigal saviour of cardiac transplants in India.

Positive anti-human leukocyte antigen (HLA) antibodies are considered a contraindication for cardiac transplantation in India, due to its negative impact on cardiac allograft survival and increased chances of rejection post-transplant. Single antigen bead (SAB) assay helps to further characterize these antibodies. Our case portrays India's first reported successful cardiac transplant utilizing a virtual crossmatch (VXM)-based approach in a patient with positive anti-HLA antibody screen and SAB assay.

Usual and Unusual Musculoskeletal Sequalae of COVID 19!

Today the orthopedic world with respect to COVID remains focused on resumption of elective surgery and impact of the pandemic on scientific activities. However, it is equally important that we keep our eyes on the phenomenon that is quietly unraveling in front of the eyes. The phenomenon of post-COVID musculoskeletal sequelae may become a major orthopedic public health problem in coming months and needs to be investigated in depth.

Can We Innovatively Modify the Surgical Helmets to Protect Against the Droplets and Aerosols of COVID-19?

We tested the filtration efficiency of Stryker T5 surgical helmets with and without the addition of a filter medium. Two particle counters were used to count the particles of sizes .5 μm, 1 μm, and 5 μm, both inside and outside the Stryker T5 helmet, concurrently.