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Role of percutaneous cerclage wire in the management of subtrochanteric fractures treated with intramedullary nails

Chinese Journal of Traumatology 2018年第1期21卷 42-49页

作者： Vivek Trikha Saubhik Das prabhat agrawal Arkesh M Sunil Kumar Dhaka Department of Orthopaedics JPN Apex Trauma Centre All India Institute of Medical Sciences (AIIMS) New Delhi India

Purpose： Cerclage wire application has emerged as a potential therapeutic adjunct to intramedullary nailing for subtrochanteric fractures. But its popularity is plagued by the concern of possible negative effect on fracture zone biology. This study was intended to analyze the clinico-radiological outcome and complications associated with cerclage wire application. Methods： Retrospective analysis was performed on all the subtrochanteric fractures operated with intramedullary nailing between January 2012 and January 2016. After exclusion, 48 patients were available with an average follow-up of 20.8 months. Long oblique, spiral, spiral wedge or comminuted fracture configurations with butterfly fragments were particularly considered for cerclage wire appli- cation, which was employed by percutaneous cerclage passer in 21 patients. Assessment was done in terms of operation time, blood loss, quality of reduction, neck-shaft angle, follow-up redisplacement, union time, complications, and final functional evaluation by Merle d＇Aubigne＇-Postel score. Results： Average operation time and blood loss were significantly higher in cerclage group （p 〈 0.05）. However, cerclage use substantially improved quality of reduction in terms of maximum cortical displacement （p = 0.003） and fracture angulation （p - 0.045）; anatomical reduction was achieved in 95.23% of cases as compared to 74.07% without cerclage. Union time was shorter, although not statis- tically different （p - 0.208）, in cerclage group. Four patients in non-cerclage group developed non-union, 2 of them had nail breakage. No infection or any other implant related complications were reported with cerclage use. Conclusion： Minimally-invasive cerclage wire application has proved to be beneficial for anatomical reconstruction in difficult subtrochanteric fractures, whenever applicable, without any harmful effect on fracture biology.

关键词： Cerclage wire Fracture Intramedullary nailing Percutaneous Subtrochanteric Outcome

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Leukemoid reaction in a patient with COVID-19 infection: A case report

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Journal of Acute Disease 2022年第3期11卷 120-122页

作者： prabhat agrawal Ashish Gautam Anjana Pandey Harendra Kumar Nikhil Pursnani Departments of Medicine S.N.Medical CollegeAgraIndia Departments of PathologyS.N.Medical CollegeAgraIndia

Rationale:COVID-19 usually presents with flu-like symptoms and signs,but some rare presentations like leukemoid symptoms cannot be ***’s concerns:A 37-year-old female presented to the outpatient department with flu-like ***:The RT-PCR test for SARS-CoV-2 infection was positive,while complete blood cell and peripheral blood smear showed leukemoid ***:Paracetamol and fexofenadine for flu-like symptoms and leukemoid ***:On the 10th day,the patient was asymptomatic and RT-PCR was *** the patient was discharged and leukemoid presentation subsided after clearance of viral ***:COVID-19 has a myriad of presentations,and unusual symptoms/signs especially in this pandemic could be induced by COVID-19 infection.

关键词： COVID-19 Leukemoid reaction Atypical presentation Abnormal total leucocyte count Leukocytosis

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Cardiovascular sequelae in post-COVID-19 patients with moderate to severe CT severity score: A follow-up study

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Journal of Acute Disease 2023年第5期12卷 198-203页

作者： Niharika Agarwal Anamika Goyal Nikhil Pursnani Garima Kanaujia Akanksha Semwal prabhat agrawal Abhishek Raj Department of Medicine S.N.Medical CollegeAgraUttar PradeshIndia Department of Paediatrics S.N.Medical CollegeAgraUttar PradeshIndia

Objective:To study cardiovascular sequelae of post-COVID-19 patients with moderate to severe computed tomography(CT)severity ***:A prospective,non-randomized,observational study was conducted on 100 post-COVID-19 patients with moderate to severe CT severity scores from January 2021 to December ***-nine were male[mean age(54.1±12.2)years]and 41 were female[mean age(46.9±15.1)years].Patients with previous cardiovascular disease,previous chronic lung disease,and pre-existing primary or secondary pulmonary hypertension were *** were examined,and serial electrocardiogram and 2D echocardiography were performed to detect any cardiovascular ***:Post-COVID-19 patients had persistent symptoms,the most common being fatigue(59%).Most of these symptoms were relieved on follow-up.A rise in systolic,diastolic blood pressure,and pulse rate was *** electrocardiographic evaluation revealed ST-T segment changes,sinus tachycardia,ventricular hypertrophy,and arrhythmias among a considerable number of *** echocardiography,left ventricular diastolic dysfunction was most common(43%).Pulmonary hypertension,as evidenced by elevated pulmonary artery systolic pressure,was seen in 15%of ***:The present findings reveal an increased incidence of cardiovascular complications after recovery from COVID-19 infection in those without pre-existing cardiovascular or chronic lung disease.

关键词： Cardiovascular outcomes Arrhythmia Heart failure Post acute-sequale Long COVID-19

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