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Ipsilateral fracture dislocations of the hip and knee joints with contralateral open fracture of the leg： a rare case and its management principles

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Chinese Journal of Traumatology 2011年第3期14卷 183-187页

作者： ramesh kumar sen Sujit kumar Tripathy Vibhu Krishnan Tarun Goyal Vanyambadi Jagadeesh Department of Orthopedics Postgraduate Institute of Medical Education and Research Chandigarh 160012 India

This paper discussed the injury mechanism and management of a patient who had concomitant ipsilateral hip and knee dislocations and contralateral open leg fracture. A 32-year-old man presented with ipsilateral fracturedislocations of the left hip （Pipkin＇s type IV） and knee （Moore II）joints and contralateral open fracture of the leg bones after a car accident. After emergency resuscitative measures, the hip joint was reduced and Pipkin＇s fracture was fixed using Ganz approach with lag screws; knee joint was reduced closely and tibial plateau fracture was stabilized with lateral buttress plate and a transarticular spanning fixator. The open fracture on the other leg was debrided and fixed with an external fixator. There was no insta-bility in both joints after fixation when he was examined under anesthesia. The fractures united after 3 months and the patient had no residual instability of hip and knee. There was no clinical or radiological evidence of osteonecrosis in the hip joint after 6 months. At one-year follow-up, he had satisfactory functional outcome with almost normal range of motion at both joints. Ipsilateral hip and knee dislocations are rare injuries and more caution is needed for early diagnosis. A timely appropriate intervention can provide good functional outcome to the patient in this situation.

关键词： Hip dislocation Knee dislocation Fractures bone

Evaluation of Rainfall Tendency for the Twentieth Century over Indira Sagar Region in Central India

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American Journal of Climate Change 2024年第1期13卷 47-68页

作者： Rituraj Shukla Deepak Khare ramesh P. Rudra Priti Tiwari Himanshu Sharma Prasad Daggupati Pradeep Goel School of Engineering University of Guelph Guelph Canada Department of Water Resources Development and Management Indian Institute of Technology Roorkee India Indira Gandhi Agricultural University Raipur India Department of Civil Engineering Institute of Infrastructure Technology Research and Management (IITRAM) Ahmedabad India

The study investigates long-term changes in annual and seasonal rainfall patterns in the Indira Sagar Region of Madhya Pradesh, India, from 1901 to 2010. Agriculture sustainability, food supply, natural resource development, and hydropower system reliability in the region rely heavily on monsoon rainfall. Monthly rainfall data from three stations (East Nimar, Barwani, and West Nimar) were analyzed. Initially, the pre-whitening method was applied to eliminate serial correlation effects from the rainfall data series. Subsequently, statistical trends in annual and seasonal rainfall were assessed using both parametric (student-t test) and non-parametric tests [Mann-Kendall, sen’s slope estimator, and Cumulative Sum (CUSUM)]. The magnitude of the rainfall trend was determined using Theil-sen’s slope estimator. Spatial analysis of the Mann-Kendall test on an annual basis revealed a statistically insignificant decreasing trend for Barwani and East Nimar and an increasing trend for West Nimar. On a seasonal basis, the monsoon season contributes a significant percentage (88.33%) to the total annual rainfall. The CUSUM test results indicated a shift change detection in annual rainfall data for Barwani in 1997, while shifts were observed in West and East Nimar stations in 1929. These findings offer valuable insights into regional rainfall behavior, aiding in the planning and management of water resources and ecological systems.

关键词： Precipitation Parametric Non-Parametric Tests Trend Analysis Serial Correlations

QualiW of life following total hip arthroplasW in patients with acetabular fractures, previously managed by open reduction and internal fixation

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Chinese Journal of Traumatology 2016年第4期19卷 206-208页

作者： Prasoon kumar ramesh kumar sen Vishal kumar Ankit Dadra Department of Orthopaedics Post Graduate Institute of Medical Education and Research. Chandigarh. 160012. India Department of Orthopaedics Fortis Hospital Mohali. Punjab. India

Purpose： Total hip replacement （THR） is one of the most successful and cost-effective surgical procedures and remains the treatment of choice for long-term pain relief and restoration of function for patients with diseased or damaged hips. Acetabular fractures managed either conservatively or operatively by fixation tend to present later with secondary joint changes that require THR. In this study we evaluated the functional outcome and quality of life achieved by such patients. Methods： Our study was carried out as a retrospective trial by recruiting patients who underwent THR from June 2006 to May 2012. A total of 32 patients were included with a mean age of 46.08 years ranging from （25-65） years. We evaluated the quality of life in the patients using scoring techniques of Short Musculoskeletal Functional Assessment （SMFA） and the 12-1tem Short Form Health Survey （SF-12）. Functional outcome was assessed using Harris Hip Score （HHS）. Results： The mean HHS of the patients was 84.3 with a range from 56 to 100. The SMFA averaged 13.3. The SF-12 score averaged 49.1. The correlation of the HHS with SF-12 was positive （p - 0.001 ） while with SMFA there was a negative correlation （p - 0.001 ）. Conclusion： From this study it is inferred that the functional outcome of THR and quality of life in pa- tients who had acetabular fractures and were initially managed by open reduction and internal fixation is good.

关键词： Arthroplasty, replacement, hip Acetabulum Fractures, bone Fracture fixation, internal

Perioperative mortality and morbidity of hip fractures among COVID-19 infected and non-infected patients: A systematic review and meta-analysis

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Chinese Journal of Traumatology 2023年第3期26卷 162-173页

作者： Sujit kumar Tripathy Paulson Varghese Sibasish Panigrahi Bijnya Birajita Panda Anand Srinivasan ramesh kumar sen Department of Orthopedics All India Institute of Medical SciencesBhubaneswar751019India Department of Ophthalmology Srirama Chandra Bhanja Medical College and HospitalCuttack753007India Department of Pharmacology All India Institute of Medical SciencesBhubaneswar751019India Department of Orthopaedics Max HospitalMohali160055India

Purpose:Hip fractures among elderly patients are surgical *** COVID-19 pandemic time,many such patients could not be operated at early time because of the limitation of the medical resources,the risk of infection and redirection of medical attention to a severe infective health ***:A search of electronic databases(PubMed,Medline,CINAHL,EMBASE and the Cochrane Central Register of Controlled Trials)with the keywords"COVID","COVID-19","SARS-COV-2","Corona","pandemic","hip fracture","trochanteric fracture"and"neck femur fracture"revealed 64 studies evaluating treatment of hip fracture in elderly patients during COVID-19 pandemic *** 30-day mortality rate,inpatient mortality rate,critical care/special care need,readmission rate and complications rate in both groups were *** were analyzed using Review Manager(RevMan)***:After screening,7 studies were identified that described the mortality and morbidity in hip fractures in both COVID-19 infected(COVID-19+)and non-infected(COVID-19-)*** were significantly increased risks of 30-day mortality(32.23%COVID-19+deathvs.8.85%COVID-19-death)and inpatient mortality(29.33%vs.2.62%)among COVID-19+patients with odds ratio(OR)of 4.84(95%CI:3.13-7.47,p<0.001)and 15.12(95%CI:6.12-37.37,p<0.001),*** COVID-19+patients needed more critical care admission(OR=5.08,95%CI:1.49-17.30,p<0.009)and they remain admitted for a longer time in hospital(mean difference=3.6,95% CI:1.74-5.45,p<0.001);but there was no difference in readmission rate between these 2 *** risks of overall complications(OR=17.22),development of pneumonia(OR=22.25),and acute respiratory distress syndrome/acute respiratory failure(OR=32.96)were significantly high among COVID-19+patients compared to ***:There are increased risks of the 30-day mortality,inpatient mortality and critical care admission among hip fracture patients who are COVID-19+.The chances of developing pn

关键词： Hip fracture Femur neck fracture Mortality COVID-19 Pandemic

Simultaneous bilateral anterior shoulder dislocation： report of two cases and review of the literature

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Chinese Journal of Traumatology 2011年第5期14卷 312-315页

作者： Sujit kumar Tripathy ramesh kumar sen Sameer Aggarwal Sarvdeep Singh Dhatt Naveen Tahasildar Department of Orthopedics Postgraduate Institute of Medical Education and Research Sector 12 Chandigarh 160 012 India

Bilateral shoulder dislocations are rare and almost always occur in the posterior direction. Simultaneous bilateral anterior shoulder dislocation is even rarer and only a few cases are stated in the literature. The most interesting part of a bilateral shoulder dislocation is about its injury mechanism as a synchronous and simultaneous force is needed to result in it. In cases of epilepsy or electrocution, the mechanism is different and the forceful contractions of the selective group of muscles result in the dislocation. This article reports two cases of bilateral simultaneous anterior shoulder joint dislocation that occurred after a road side accident and after an episode of convulsion in an epileptic patient. The dislocations were diagnosed early and reduced immediately with a proper postreduction rehabilitation. During their follow-up, both patients had satisfactory functional outcome. This article emphasizes on the importance of shoulder examination in road side accident victims and epileptic patients. All orthopedic surgeons and emergency physicians should be aware of such unusual possibilities to have an early diagnosis and *** early reduction and appropriate rehabilitation can provide satisfactory functional outcome. This article also briefly discusses the injury mechanisms, diagnoses and treatments of bilateral shoulder dislocation as reported in the literature.

关键词： Shoulder dislocation Epilepsy Accidents, traffic

Long term surgical treatment outcome of talar body fracture

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Chinese Journal of Traumatology 2011年第5期14卷 282-287页

作者： ramesh kumar sen Sujit kumar Tripathy Shakthivel RR Manoharan Vibhu Krishnan Tajir Tamuk Vanyambadi Jagadeesh Department of Orthopaedics Postgraduate Institute of Medical Education and Research Sector-12 Chandigarh 160012 India

Objective： Talar body fractures are rare and have poor treatment outcome. The purpose of this study is to report the long term surgical treatment outcome of closed talar dome ***： Eight closed talar body fractures, treated by open reduction and internal fixation with small fragment cancellous screws and/or Herbert screws in our level Ⅰ trauma centre were retrospectively analyzed. Preoperative and postoperative radiographs of the foot （antero-posterior, lateral and oblique views） and ankle （antero-posterior, lateral and mortise views） were obtained. The patients were followed up both radiologically and functionally （foot function index, FFI） after 3 weeks, 6 weeks, 3 months, 6 months and then ***： There were five crush fractures and three shear fractures （two sagittal shear and one coronal shear）,with average follow-up of 5 years. No early complications were noticed in these patients. Late complications included osteoarthrosis of subtalar/ankle joints in six patients and osteonecrosis oftalar body in four patients. On functional assessment, mean FFI after 5 years was 104.63 points and worse outcome was noticed in crush injury and coronal shear fractures. Sagittal shear fractures had a good functional and radiological ***： Late complications subsequent to surgically treated talar body fractures are inevitable, even though exact reduction and rigid fixation are achieved, thus patients are supposed to be counseled about the adverse outcome. Although crush and coronal shear fractures have poor outcome, sagittal injuries have good prognosis on long term evaluation.

关键词： Fractures, bone Talus Fracture fixation,internal

Acetabulum fractures in elderly patients:A review

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Chinese Journal of Traumatology 2022年第6期25卷 331-335页

作者： Ashwani Soni Ravi Gupta ramesh sen Department of Orthopaedics Goverrnment Medical College and HospitalSector-32Chandigarh160030India Department of Orthopaedics Max Super Speciality HospitalSahibzada Ajt Singh NagarMohali160062India

Fractures of the acetabulum in elderly patients were often caused by low energy *** involving anterior column are more common and often associated with impaction and *** further complicates the *** fracture fixation has low morbidity but it is a technically demanding *** reduction and fracture fixation is done with or without simultaneous total hip *** total hip replacement is considered in posttraumatic arthritis *** with minimal displaced fractures,associated both-column fractures with secondary congruence of joint and patients who are medically unfit for surgery can be managed *** be the method of management,these elderly patients should be mobilised as early as possible.

关键词： Acetabulum Elderly Fracture Osteoporosis Hip Arthroplasty

Predictors of early outcome in unstable pelvic fractures

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Chinese Journal of Traumatology 2013年第2期16卷 94-98页

作者： ramesh K. sen Nirmal Raj Gopinathan Tajir Tamuk Rajesh kumar Vibhu Krishnan Radheshyam Sament Department of Orthopaedics and Traumatology Postgraduate Institute of Medical Education and Research Chandigarh India

Objective： To define the preoperative and intraoperative variables which may affect the immediate postoperative outcome in surgically managed patients with unstable pelvic fractures. Methods： This study was performed prospectively from January 2009 to June 2011 on 36 consecutive patients admitted to the trauma ward of Postgraduate Institute of Medical Education and Research, Chandigarh, with unstable pelvic injuries. Results： In the present study of 36 patients, 29 were managed surgically. Surgical duration was 2 hours in pa- tients operated on within 1 week and 3.4 hours in those operated on after 1 week. The blood loss was 550 ml when surgery was done after a week, but when done within a week it was 350 ml. The average blood loss through Pfanenstial approach was 360 ml, through posterior approach was 408 ml and through combined approach was 660 ml which was significantly high. Conclusion： Anterior approach to the pelvis would cause significantly more amount of blood loss than poste- rior approach and extemal fixation. Surgical approaches do not have any influence on the surgical duration or the infec- tion rate. The blood loss significantly increases when the surgical time is more than 1 h. The infection rate is not influ- enced by the duration of surgery. Presence or absence of associated injuries to the head, chest or abdomen is the main determinants of patient＇s survival and it greatly influ- ences the duration of hospital stay.

关键词： Pelvis Fractures, bone Treatmentoutcome Pubic symphysis

Logistic Regression Trust–A Trust Model for Internet-of-Things Using Regression Analysis

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Computer Systems Science & Engineering 2023年第2期44卷 1125-1142页

作者： Feslin Anish Mon Solomon Godfrey Winster Sathianesan R.ramesh Department of CSE Saveetha Engineering CollegeChennaiIndia Department of CSE SRM Institute of Science and TechnologyChennaiIndia Department of ECE Saveetha Engineering CollegeChennaiIndia

Internet of Things(IoT)is a popular social network in which devices are virtually connected for communicating and sharing *** is applied greatly in business enterprises and government sectors for delivering the services to their customers,clients and ***,the interaction is success-ful only based on the trust that each device has on *** trust is very much essential for a social *** Internet of Things have access over sen-sitive information,it urges to many threats that lead data management to *** issue is addressed by trust management that help to take decision about trust-worthiness of requestor and provider before communication and *** trust-based systems are existing for different domain using Dynamic weight meth-od,Fuzzy classiﬁcation,Bayes inference and very few Regression analysis for *** proposed algorithm is based on Logistic Regression,which provide strong statistical background to trust *** make our stand strong on regression support to trust,we have compared the performance with equivalent sound Bayes analysis using Beta *** performance is studied in simu-lated IoT setup with Quality of Service(QoS)and Social parameters for the *** proposed model performs better in terms of various *** IoT connects heterogeneous devices such as tags and sensor devices for sharing of information and avail different application *** most salient features of IoT system is to design it with scalability,extendibility,compatibility and resiliency against *** existing worksﬁnds a way to integrate direct and indirect trust to con-verge quickly and estimate the bias due to attacks in addition to the above features.

关键词： LRTrust logistic regression trust management internet of things