The COVID-19 pandemic has affected severely the economic structure and health care system, among others, of India and the rest of the world. The magnitude of its aftermath is exceptionally devastating in India, with the first case reported in January 2020, and the number has risen to ~31.3 million as of July 23, 2021. India imposed a complete lockdown on March 25, which severely impacted migrant population, industrial sector, tourism industry, and overall economic growth. Herein, the impacts of lockdown and unlock phases on ambient atmospheric air quality variables have been assessed across 16 major cities of India covering the north-to-south stretch of the country. In general, all assessed air pollutants showed a substantial decrease in AQI values during the lockdown compared with the reference period (2017–2019) for almost all the reported cities across India. On an average, about 30–50% reduction in AQI has been observed for PM2.5, PM10, and CO, and maximum reduction of 40–60% of NO2 has been observed herein, while the data was average for northern, western, and southern India. SO2 and O3 showed an increase over a few cities as well as a decrease over the other cities. Maximum reduction (49%) in PM2.5 was observed over north India during the lockdown period. Furthermore, the changes in pollution levels showed a significant reduction in the first three phases of lockdown and a steady increase during subsequent phase of lockdown and unlock period. Our results show the substantial effect of lockdown on reduction in atmospheric loading of key anthropogenic pollutants due to less-to-no impact from industrial activities and vehicular emissions, and relatively clean transport of air masses from the upwind region. These results indicate that by adopting cleaner fuel technology and avoiding poor combustion activities across the urban agglomerations in India could bring down ambient levels of air pollution at least by 30%.
Introduction Lisfranc injuries form a distinct group of rare but severe injury. Literature suggests a low incidence, but failure to diagnose these injuries early and its subsequent delay in management will affect the patient’s mobility and quality of life significantly. The preferred mode of management is said to be surgical. Conversely, the method of intervention for patients not suitable for surgery is less clear. Aim This study aims to evaluate the effect of delayed diagnosis and the treatment provided on the overall functional outcome for the patients with missed Lisfranc injury. Methodology The study was conducted at a specialist centre in the North-West of UK between January 2011 and November 2016. All patients with acute Lisfranc injuries were included in this study. Patient data was collected through electronic notes and analysed to ascertain missed diagnosis. It was also used to evaluate functional and radiological outcome. Results In our series, 58.8% of Lisfranc injuries were missed on their initial presentation. We report better results for the surgical group when compared with the non-operated group, in spite of the delay in diagnosis. Conclusion We believe that definitive treatment in the form of surgical fixation and anatomical reduction has more influence on the functional outcome than the timing of the surgical fixation in case of subtle Lisfranc injuries.
It is of interest to assess the level of knowledge on dental treatment during the COVID-19 pandemic at Patna, Bihar, India. The study population consisted of Indian subjects with a minimum qualification of high school. An online questionnaire was sent to a sample of 650 subjects consisting of both male and female in March 2020. The questionnaire comprised of a series of questions about subjects’demographic characteristics; their awareness of the COVID-19 and their perception towards dental treatment. This study included a total of 650 members aged 20-70 years (mean 36.9 years with a standard deviation of 10.5 years) participants. A total of 446 subjects responded to questionnaire. A total of 29.1% subjects had completed their masters, 52.2% had knowledge of corona virus from news, and 30.5% had read about COVID-19 from official websites. A total of 71.3% participants showed reluctance in undertaking dental treatment during pandemic. The majority of participants (60.5%) believed that dental setups could be a potential source of infection of COVID-19 and thus avoided visiting dentists. Most of them (69.7%) adhered to medicines instead of dental treatment. Most of them (96.6%) agreed not to hide any symptoms of COVID-19 from the dentist. 54.7% agreed to undergo a screening test for the virus. 93.7% participants refrained from cosmetic and aesthetic procedures during pandemic and 54.7% believed that at these unprecedented times would affect the cost of dental procedures. Subjects were aware of COVID-19 symptoms, mode of transmission of the virus, screening test and in-home precautions/measures to be taken. However, subjects had limited comprehension of the extra precautionary measures that protect them during dental procedures. It should be noted that most of them refrained from visiting dentists and avoided aesthetic procedures.
BOAST (British Orthopaedic Association Standards for Trauma & Orthopaedics) guidelines recommended that during the coronavirus pandemic most upper limb fractures should be treated conservatively, and removable casts should be used, where possible. As a result, our district general hospital started using a new soft combination (soft-combi) casting technique for conservative management of distal radius fractures (DRFs) in an attempt to reduce follow-up attendances. To assess if radiological outcomes of soft-combi casts are better or worse than previously used rigid casts for DRFs. Twenty DRFs treated with soft-combi casts were compared with 20 DRFs treated with the old rigid cast types. Radiological parameters were measured pre-manipulation, post-manipulation, at 2-week follow-up, and at final follow-up. Statistical analysis was performed to assess for significant differences seen at follow-up between the groups. The mean loss of volar angulation seen at 2-week follow-up was 4.9° for the rigid casts vs. 1.5° for the soft-combi casts ( p = 0.158; 95% CI , − 8.17 to 1.38). The mean loss of radial height after 2 weeks was 0.2 mm vs 0.5 mm ( p = 0.675; 95% CI , − 1.09 to 1.66), and the mean loss of radial inclination was 2.0° vs 1.0° ( p = 0.349; 95% CI , − 2.96 to 1.07), respectively. The soft-combi casts appeared to be equally effective at maintaining the reduction of DRFs compared to their rigid counterparts, as no statistically significant difference was seen in our study. We can be reassured that continued use of these removable casts in the current climate is unlikely to have a detrimental effect on outcomes for DRFs.
Background The extraction of a femoral stem during the revision hip arthroplasty can be a daunting task and can lead to catastrophic complications for the patient. A sound technique employed intraoperatively helps in speedy recovery of the patient and reduces the risk of future surgical interventions. In this study, we present a medium-term outcome of our novel Lancaster Cortical Window technique which can be used for removal of cemented or uncemented femoral stems. Methodology The study was conducted at a specialist centre in the North-West of the UK from January 2014 to May 2019. This is a retrospective case series where patients were treated surgically using Lancaster Cortical Window technique for removal of femoral implant during a revision hip arthroplasty. Patient’s electronic notes and the radiographs were used to evaluate the functional and radiological outcome. Results In this study, 18 patients were managed surgically using Novel Lancaster Window technique. The mean age of the all the patients was 81.5 years and the male to female ratio was 10:8. Fifteen patients underwent revision surgery for aseptic loosening of the femoral and acetabular component. Rest of the three patients had revision surgery for a broken femoral stem, intraoperative femoral canal perforation while implanting a total hip replacement femoral stem and infection. Twelve femurs were replanted with uncemented long femoral stems and six with long cemented stems. The cortical window osteotomy united in all the patients in 4.2 months (mean). The mean follow up of these patients is 20.9 months, and none of them had any implant subsidence or loosening at the time of their last follow up. Conclusion We believe Lancaster cortical window technique can be safely used for removal of cemented stems during revision hip arthroplasty without the need for expensive equipment’s.
Background: BOAST (British Orthopaedic Association Standards for Trauma & Orthopaedics) guidelines recommended that during the coronavirus pandemic most upper limb fractures should be treated conservatively, and removable casts should be used, where possible. As a result, our district general hospital started using a new soft combination (soft-combi) casting technique for conservative management of distal radius fractures (DRFs) in an attempt to reduce follow-up attendances.Aims: To assess if radiological outcomes of soft-combi casts are better or worse than previously used rigid casts for DRFs.Methods: 20 DRFs treated with soft-combi casts were compared with 20 DRFs treated with the old rigid cast types. Radiological parameters were measured pre-manipulation, post-manipulation, at 2-week follow-up, and at final follow-up. Statistical analysis was performed to assess for significant differences seen at follow-up between the groups.Results: The mean loss of volar angulation seen at 2-week follow-up was 4.9 degrees for the rigid casts vs. 1.5 degrees for the soft-combi casts (p=0.158). The mean loss of radial height after 2 weeks was 0.2 mm vs 0.5 mm (p=0.675), and the mean loss of radial inclination was 2.0 degrees vs 1.0 degrees (p=0.349), respectively.Conclusion: The soft-combi casts appeared to be equally effective at maintaining the reduction of DRFs compared to their rigid counterparts, as no statistically significant difference was seen in our study. We can be reassured that continued use of these removable casts in the current climate is unlikely to have a detrimental effect on outcomes for DRFs.
It is of interest to assess the level of knowledge on dental treatment during the COVID-19 pandemic at Patna, Bihar, India. The study population consisted of Indian subjects with a minimum qualification of high school. An online questionnaire was sent to a sample of 650 subjects consisting of both male and female in March 2020. The questionnaire comprised of a series of questions about subjects’demographic characteristics; their awareness of the COVID-19 and their perception towards dental treatment. This study included a total of 650 members aged 20-70 years (mean 36.9 years with a standard deviation of 10.5 years) participants. A total of 446 subjects responded to questionnaire. A total of 29.1% subjects had completed their masters, 52.2% had knowledge of corona virus from news, and 30.5% had read about COVID-19 from official websites. A total of 71.3% participants showed reluctance in undertaking dental treatment during pandemic. The majority of participants (60.5%) believed that dental setups could be a potential source of infection of COVID-19 and thus avoided visiting dentists. Most of them (69.7%) adhered to medicines instead of dental treatment. Most of them (96.6%) agreed not to hide any symptoms of COVID-19 from the dentist. 54.7% agreed to undergo a screening test for the virus. 93.7% participants refrained from cosmetic and aesthetic procedures during pandemic and 54.7% believed that at these unprecedented times would affect the cost of dental procedures. Subjects were aware of COVID-19 symptoms, mode of transmission of the virus, screening test and in-home precautions/measures to be taken. However, subjects had limited comprehension of the extra precautionary measures that protect them during dental procedures. It should be noted that most of them refrained from visiting dentists and avoided aesthetic procedures.
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