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Neglected isolated fracture of the trochlea humeri

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Chinese Journal of Traumatology 2010年第4期13卷 247-249页

作者： ajay pal singh ish kumar dhammi anil kumar jain Saurabh jain Department of Orthopaedics Guru Teg Bahadur Hospital University College of Medical Sciences University of Delhi Delhi 110095 India

A 15 years old girl was found to have isolated trochlea fracture 10 weeks after an injury caused by a fall on her left elbow. Movement of the elbow was severely restricted. Radiographs showed a half moon-shaped and anterosuperiorly displaced osteochondral fragment. Medial approach capsulotomy of the elbow and excision of the intraarticular adhesions were done to expose the isolated trochlea fracture. Headless screws were used for fixation, combined with bone grafting. The follow-up showed union and excellent functional recovery of the elbow. Isolated trochlea fracture in adults is rare and usually associated with capitellar fractures and/or elbow dislocations. A neglected trochlea fracture is rarely reported in the English language literature to the best of our knowledge. Recognition of isolated trochlea fracture is vital to apprehend the pathomechanics of the injury and to devise a suitable treatment approach.

关键词： Fractures, bone Humerus Elbow

Hopf bifurcation in a delayed prey-predator model with prey refuge involving fear effect

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International Journal of Biomathematics 2024年第5期17卷 1-32页

作者： Ankit Parwaliya Anuraj singh ajay kumar Department of Applied Sciences ABV-Indian Institute of Information Technology and ManagementGwalior 474015India

This work investigates a prey-predator model featuring a Holling-type II functional response,in which the fear effect of predation on the prey species,as well as prey refuge,are ***,the model assumes that the growth rate of the prey population decreases as a result of the fear of ***,the detection of the predator by the prey species is subject to a delay known as the fear response delay,which is incorporated into the *** paper establishes the preliminary conditions for the solution of the delayed model,including positivity,boundedness and *** paper discusses the existence and stability of equilibrium points in the *** particular,the paper considers the discrete delay as a bifurcation parameter,demonstrating that the system undergoes Hopf bifurcation at a critical value of the delay *** direction and stability of periodic solutions are determined using central manifold and normal form ***,the global stability of the model is established at axial and positive equilibrium *** extensive numerical simulation is presented to validate the analytical findings,including the continuation of the equilibrium branch for positive equilibrium points.

关键词： Hopf bifurcation fear effect prey refuge periodic solutions time delay branch off

Comprehensive analysis of uncertainty quantification for the 58Ni（n,p）58Co reaction cross section

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Chinese Physics C 2024年第9期48卷 174-179页

作者： Mahesh Choudhary Aman Sharma Namrata singh Mahima Upadhyay Punit Dubey A.Gandhi Akash Hingu G Mishra Sukanya De L.S.Danu ajay kumar R.G.Thomas Saurav Sood Sajin Prasad S.Mukherjee I.N.Ruskov Yu.N.Kopatch A.kumar Department of Physics Banaras Hindu University Horia Hulubei National Institute of Physics and Nuclear Engineering-IFIN-HH Department of Physics The Maharaja Sayajirao University of Baroda Nuclear Physics Division Bhabha Atomic Research Centre Health Physics Division Bhabha Atomic Research Centre Department of Electrical Power Engineering Brno University of Technology Institute for Nuclear Research and Nuclear Energy Bulgarian Academy of Sciences Joint Institute for Nuclear Research (JINR)

In this study,we measured the58Ni（n,p）58Co reaction cross section with neutron energies of 1.06,1.86,and 2.85 *** cross section was measured using neutron activation techniques and γ-ray spectroscopy,and it was compared with cross section data available in the ***,we calculated the covariance matrix of the measured cross section for the aforementioned nuclear *** uncertainties of the theoretical calculation for58Ni（n,p）58Co reaction cross section were calculated via Monte Carlo *** this study,we used uncertainties in the optical model and level density parameters to calculate uncertainties in the theoretical cross *** theoretical calculations were performed by using *** this study,we aim to analyze the effect of uncertainties of the nuclear model input as well as different experimental variables used to obtain the values of reaction cross section.

关键词： 58Ni(n, p)58Co reaction covariance analysis uncertainty quantification of cross section γ-ray spectroscopy

Monteggia fracture dislocation equivalents analysis of eighteen cases treated by open reduction and internal fixation

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Chinese Journal of Traumatology 2011年第4期14卷 221-226页

作者： ajay pal singh ish kumar dhammi anil kumar jain Rajeev Raman Prashant Modi Punjab Civil Medical Services-I Mukerian Punjab India Department of Orthopaedics UCMS & GTB HospitalDelhi 110095 India

Objective： Monteggia fracture disloca- tion equivalent, though already described by Bado, is still an unclassified entity. We aimed to retrospectively analyze 18 cases of Monteggia variants and discuss the injury mechanisms, management, and outcome along with a re- view of the literature. Methods： A retrospective record of Monteggia frac- ture dislocation （2003-2008） was reviewed from medical record department of our institute. Classic Monteggia frac- ture dislocation, children below 12 years or adults over 50 years, as well as open grade iI ＆ Ill cases were excluded from this study. Monteggia variant inclusion criteria in- cluded fracture of the proximal ulna together with a fracture of the radial head or neck and skeletal maturity. Totally 26 patients were identified with Monteggia variants and 18 were available for follow-up, including 11 males and 7 fe- males with the mean age of 35 years. The ulna fracture was treated by compression plating along with tension band wiring. Radial head/neck was reconstructed in 12 patients while excised in 6 patients. Results： Follow-up ranged from 1-4 years, mean 2.6 years. Patients were assessed clinicoradiologically. MayoElbow Performance Score outcomes. At final follow-up, was employed to assess the the results were excellent in 10 patients, good in 4, fair in 2 and poor in 2. Mean range of motion of the elbow was 20°, 116°, 50° and 55° for extension, flexion, pronation and supination, respectively. Two patients had complications in the form of heterotopic ossification and stiffness of the elbow. One nonunion ulna, primarily treated by tension band wiring, was managed by refixation with locking reconstruction plate and bone grafting. Bone grafting was only required in this patient for nonunion. Another patient had implants removed on his request. The results in our series closely correlated with extent of intraarticular damage, coronoid fracture and comminuted fractures. Conclusions： Monteggia fracture dislocation equiva-

关键词： Monteggia's fracture Radius fracture Ulna

Nonunion of coronal shear fracture of femoral condyle

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Chinese Journal of Traumatology 2011年第3期14卷 143-146页

作者： ajay pal singh ish kumar dhammi Raju Vaishya anil kumar jain Arun pal singh Prashant Modi Punjab Civil Medical Services Mukerian Punjab India Department of Orthopedics UCMS & GTB Hospital Delhi India Department of Orthopedics and Traumatology Indraprastha Apollo Hospital Delhi India S.P.N. Hospital Mukerian Punjab India

Isolated coronal fractures of femoral condyle are rare in adults and nonunion of Hoffa fracture is reported only a few times in the literature. We analyzed six cases of nonunion of Hoffa fractures over a period of three years. Three patients were treated conservatively and three patients had fixation failures. Delay of presentation was 2 months to one year. Treatment protocol consisted of open reduction, excision of pseudoarthrosis, bone grafting and internal fixation along with knee arthrolysis. Union wasachieved in all patients at mean 16 weeks. The treatment of nonunion of Hoffa fractures requires careful preoperative planning and meticulous surgical technique. The literature regarding the controversies in fracture management and surgical technique are reviewed.

关键词： Femoral fracture Fracture ftxation internal Retrospective studies

Paradigm shift in transfusion practices during early COVID-19 pandemic:A single center retrospective study

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World Journal of Virology 2024年第2期13卷 78-86页

作者： Sumukh Arun kumar Sushmita Prabhu Ankushi Sanghvi Maya Gogtay Mithil Gowda Suresh Harshit Khosla Yuvaraj singh ajay kumar Mishra Susan George Department of Internal Medicine Saint Vincent HospitalWorcesterMA 01608United States Department of Hematology and Oncology University of Nebraska Medical CenterOmahaNE 68198United States Hospice and palliative Care UTHSC and McGovern School of MedicineTexasTX 77030United States Department of Gastroenterology and Hepatology UMass Chan Medical SchoolWorcesterMA 01655United States Division of Cardiology Saint Vincent HospitalWorcesterMA 01608United States

BACKGROUND The advent of coronavirus disease 2019(COVID-19)unveiled the worst national blood crisis that the United States had witnessed in over a *** the pandemic influencing the different stages of the acquisition of blood products outside the hospital setting,we aimed to explore the possible barriers contributing to the shortage of blood products within the medical *** COVID era and pre-COVID *** We conducted a retrospective cross-sectional study on hospitalized patients distinguishing the pattern of blood transfusion during the COVID and pre-COVID era in a community *** was tabulated to include the number of red blood cell(RBC)transfusions and if transfusions met restrictive blood transfusion criteria as per institutional ***-square was applied to test the statistical association between qualitative *** t test and Mann Whitney U test were applied respectively to test the mean difference of quantitative *** A total of 208 patients were included in the study,of which 108 were during COVID era and 100 were during pre-COVID *** leading reason for admission in both the COVID era and pre-COVID era transfused patients was shortness of breath(53.7%and 36%P=0.001),followed by gastrointestinal bleeding(25.9%and 21%P=0.001).There was a higher percentage of RBC transfusions in the intensive care unit in the COVID-era group than in the pre-COVID era group(38.9%vs 22%,P=0.008).The restrictive transfusion criteria were met in 62%vs 79%in the COVID and pre-COVID eras,respectively(P=0.008).CONCLUSION The COVID-era group received RBC transfusions with less stringent adherence to restrictive blood transfusion practices in comparison to pre-COVID era group.

关键词： Blood transfusion Restrictive transfusion COVID-19 Pre-COVID-19 Blood shortage Pandemic

Outcome of surgical treatment of type Ⅳ capitellum frac- tures in adults

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Chinese Journal of Traumatology 2012年第4期15卷 201-205页

作者： ajay pal singh ish kumar dhammi Vipul Garg Arun pal singh Punjab Civil Medical Services-I Mukerian PunjabIn-dia Department of Orthopaedics UCMS&GTB HospitalDelhiIndia Swami Pramanand Hospital MukerianPunjabIndia

Objective： Fractures of the capitellum and trochlea constitute less than 1% of all elbow fractures and a shear fracture involving the capitellum and extending medially into most of the trochlea is rarely reported. Type Ⅳ capitellum fracture is still controversial in regard to its ra- diographic appearance, surgical approach and osteosynthesis. We report 10 cases of type Ⅳ capitellum fracture with a view to elucidating its clinical features and treatment outcome. Methods： We treated 10 patients of type Ⅳ capitellum fracture with a mean age of 32 years. A uniform surgical approach and postoperative rehabilitation were followed. Results： Nine patients presented to us after a mean of 4 days of injury and one patient was nonunion after 6 months of injury who had been treated conservatively by a bone setter. Double arc sign was absent in 6 cases. Intraopera- tively 6 capitellotrochlear fragments were devoid of soft tissue attachments. By Mayo Elbow Performance Score evaluation, 7 patients got excellent, 2 good and 1 fair results. One patient with associated elbow dislocation developed heterotopic ossification. There was no case of avascular necrosis, osteoarthrosis or fixation failures. Conclusions： Type Ⅳ capitellum fractures are rare and belong to complex articular injuries. A good functional out- come can only be achieved with open reduction and stable internal fixation followed by early mobilization. Preopera- tive radiographic assessment and computed tomography help surgeons in choosing the right surgical approach and implants. Good surgical technique and stable internal fixa- tion are the keys to early mobilization and good functional outcome.

关键词： Fractures, bone Elbow joint Fracture location, internal Bone wires

Systematic review with expert consensus on use of extracorporeal hemoadsorption in septic shock:An Indian perspective

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World Journal of Critical Care Medicine 2024年第1期13卷 65-75页

作者： Yatin Mehta Abdul Samad Ansari Amit kumar Mandal Dipanjan Chatterjee Gauri Shankar Sharma Prachee Sathe Purvesh V Umraniya Rajib Paul Sachin Gupta Vinod singh Yogendra pal singh Institute of Critical Care and Anesthesiology Medanta The MedicityGurgaon 122001HaryanaIndia Department of Critical Care Nanavati Max Super Specialty HospitalMumbai 400065India Department of Pulmonology Sleep and Critical CareFortis HospitalMohaliPunjabMohali 160062PunjabIndia Department of Cardio-Puimonary Critical Care Medica Superspecialty HospitalKolkata 700099India Department of Critical Care Medicine Fortis HospitalNew Delhi 110070India Department of Critical Care Medicine D.Y.Patil Medical CollegeSant Tukaram NagarPimpri ColonyPimpri-ChinchwadPune 411018India Department of Critical Care Medicine Bhailal Amin General HospitalVadodara 390003GujaratIndia Department of Internal Medicine Apollo HospitalsJubilee HillsHyderabad 500033India Department of Anaesthesiology Narayana Superspeciality HospitalGurugram 122002India Department of Critical Care Medicine Institute of Critical Care MedicineHospital Name-Sir Ganga Ram HospitalNew Delhi 110001India Department of Critical Care Medicine Max Super Speciality HospitalDelhi 110092India

BACKGROUND Septic shock is a severe form of sepsis characterised by deterioration in circulatory and cellular-metabolic *** standard therapy,the outcomes are *** adjuvant therapy,such as CytoSorb®extracorporeal haemoadsorption device,has been investigated and shown promising ***,there is a lack of some guidance to make clinical decisions on the use of CytoSorb®haemoadsorption as an adjuvant therapy in septic shock in Indian ***,this expert consensus was *** To formulate/establish specific consensus statements on the use of CytoSorb®haemoadsorption treatment based on the best available evidence and contextualised to the Indian *** We performed a comprehensive literature on CytoSorb®haemoadsorption in sepsis,septic shock in PubMed selecting papers published between January 2011 and March 20232021 in English *** statements for a consensus document were developed based on the summarised literature analysis and identification of knowledge *** a modified Delphi approach combining evidence appraisal and expert opinion,the following topics related to CytoSorb®in septic shock were addressed:need for adjuvant therapy,initiation timeline,need for Interleukin-6 levels,duration of therapy,change of adsorbers,safety,prerequisite condition,efficacy endpoints and management *** expert members from critical care,emergency medicine,and the intensive care participated and voted on nine statements and one open-ended *** Eleven expert members from critical care,emergency medicine,and the intensive care participated and voted on nine statements and one open-ended *** 11 experts in the consensus group(100%)participated in the first,second and third round of *** three iterative voting rounds and adapting two statements,consensus was achieved on nine statements out of nine *** consensus expert panel also recognised the necessity to form an associatio

关键词： Consensus CytoSorb Cytokine Hemoadsorption Refractory Sepsis Septic shock

Nanostructured porous polyaniline(PANI)coated carbon cloth(CC)as electrodes for flexible supercapacitor device

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Journal of Materials Science & Technology 2021年第29期88卷 168-182页

作者： Dinesh J.Ahirrao ajay kumar pal Vikalp singh Neetu Jha Department of Physics Institute of Chemical TechnologyMatunga(E)Mumbai400019India Department of Physics Ramniranjan Jhunjhunwala CollegeGhatkopar(W)Mumbai 400086India

Nanostructured porous polyaniline(PANI)has been synthesized and coated simultaneously on a highly flexible and conductive carbon cloth(CC)substrate using a simple in-situ chemical oxidative polymerization *** coated CC(PANI-CC)based flexible electrodes were further used for the fabrication of flexible supercapacitor *** the comparison purpose,pure PANI has also been synthesized and tested for its electrochemical *** energy storage capacity of PANI and PANI–CC composite was investigated using electrochemical techniques like CV,GCD,and EIS in a potential range from 0 to 0.8 V in 1 M H_(2)SO_(4)***-CC flexible electrodes exhibited the highest specific capacitance of 691 F/g;whereas,pure PANI could only achieve 575 F/g of specific capacitance at 1 A/*** also exhibited outstanding cyclic stability by recollecting 94%of its initial capacitance after 2000 GCD *** actual implementation,a flexible supercapacitor device has been fabricated using stainless steel sheets and PANI-CC flexile *** energy storage performance of the PANI-CC flexible supercapacitor device was tested at several bending angles,which resulted in 72%of capacitance retention at a maximum bending angle of 140°compared to the capacitance obtained at an angle 0°(flat state).PANI-CC exhibited improved electrochemical performance than pure PANI due to the synergistic effect between PANI and ***,CC helped in enhancing the conductivity and stability;whereas,PANI boosted the capacitance owing to its excellent porosity and fast pseudocapacitive charge storage response.

关键词： Polyaniline Carbon cloth Flexible supercapacitor Flexible electrode Composite