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Background:Brachial plexus injuries represent devastating injuries with a poor prognosis. Neurolysis, nerve repair, nerve grafts, nerve transfer, functioning free-muscle transfer and pedicle muscle transfer are the main surgical procedures for treating these injuries. Among these, nerve transfer or neurotization is mainly indicated in root avulsion injury.Materials and Methods:We analysed the results of various neurotization techniques in 20 patients (age group 20-41 years, mean 25.7 years) in terms of denervation time, recovery time and functional results. The inclusion criteria for the study included irreparable injuries to the upper roots of brachial plexus (C5, C6 and C7 roots in various combinations), surgery within 10 months of injury and a minimum follow-up period of 18 months. The average denervation period was 4.2 months. Shoulder functions were restored by transfer of spinal accessory nerve to suprascapular nerve (19 patients), and phrenic nerve to suprascapular nerve (1 patient). In 11 patients, axillary nerve was also neurotized using different donors - radial nerve branch to the long head triceps (7 patients), intercostal nerves (2 patients), and phrenic nerve with nerve graft (2 patients). Elbow flexion was restored by transfer of ulnar nerve motor fascicle to the motor branch of biceps (4 patients), both ulnar and median nerve motor fascicles to the biceps and brachialis motor nerves (10 patients), spinal accessory nerve to musculocutaneous nerve with an intervening sural nerve graft (1 patient), intercostal nerves (3rd, 4th and 5th) to musculocutaneous nerve (4 patients) and phrenic nerve to musculocutaneous nerve with an intervening graft (1 patient).Results:Motor and sensory recovery was assessed according to Medical Research Council (MRC) Scoring system. In shoulder abduction, five patients scored M4 and three patients M3+. Fair results were obtained in remaining 12 patients. The achieved abduction averaged 95 degrees (range, 50 - 170 degrees). Eight patients scored M4 power in elbow flexion and assessed as excellent results. Good results (M3+) were obtained in seven patients. Five patients had fair results (M2+ to M3).

An experimental investigation was carried out to generate the complete stress-strain curves of steel fibre reinforced high strength concrete under axial compression. The experimental program consisted of testing 100 x 200 mm concrete cylinders. The experimental variables of the study were concrete strength levels (58.03 MPa and 76.80 MPa), volume fractions (0.5% to 2.0%) and aspect ratios (20 and 40) of flat crimped steel fibres. The effect of the mixed aspect ratio of fibres on the stress-strain behavior of steel fibre high strength concrete was also studied by blending short and long fibres. The effects of these variables on the stress-strain curves are presented and discussed. The results indicate that high strength concrete can be made to behave in a ductile manner by the addition of suitable fibres. It is concluded that short fibres are more effective in controlling early cracking, thereby enhancing the strength of the composite, whereas long fibres are more effective in providing post peak toughness. Concrete strength seemed to have an adverse effect on the deformability of fibre reinforced high strength concrete. Based on the test data obtained, a simple model is proposed to generate the complete stress-strain relationship for steel fibre reinforced high strength concrete. The proposed model has been found to give a good representation of the actual stress-strain response.

Background:Extra-articular fractures of lower end radius are conventionally immobilized in palmar flexion and ulnar deviation. In view of poor functional results, the conventional method of immobilization is giving way to dorsiflexed-immobilized method. The aim of our study is to evaluate and compare the radiological and functional outcome in extra-articular fractures of lower end radius treated conservatively with respect to its position of immobilization.Materials and Methods:Sixty-four patients, all above 20 years of age with closed extra-articular fractures of lower end radius who were treated conservatively by close reduction and below elbow cast application constitute the clinical material. Irrespective of fracture geometry the patients were randomly allocated to dorsal or palmar flexed immobilized position of wrist. Patients were followed up for a minimum six-month period. The radial tilt, palmar tilt and ulnar variance are measured at prereduction, postreduction and at 6 month followup. The results were scored by Demerit Scoring System of Saito.Results:All fractures united. Individual movement of dorsiflexion, palmar flexion, supination, pronation and radial-ulnar deviation were all significantly better in the dorsiflexed-immobilized group as compared with the palmar flexed immobilized group. Grip strength recovery with subjective assessment was better in the dorsiflexed group (77%) as compared to the palmar flexed group (23%). Radiological parameters were markedly better in the dorsiflexed group. Ninety-one per cent of patients in the dorsiflexed group had excellent to good results as compared to 66% in the palmar flexed group.Conclusion:Functional results of extra-articular fractures of lower end radius are superior if the fractures after reduction are immobilized in dorsiflexion of wrist rather than in conventional palmar flexion position.

directly over the sac and dural remnants present in the wall of the sac were dissected free of the overlying skin to create a watertight seal. The high free-floating occipital bones were rotated down and behind the torcula before proceeding with the skin closure.The immediate post-operative weight of the neonate was 2.2 kg implying an occipital encephalocele of 2.6 kg. Postoperative period was uneventful and the neonate was discharged on the tenth post-operative day.

SUMMARYAn 8-noded linear hexahedron element for large strain hyperelastic analysis is presented in this paper. The element is based on a constant deformation gradient interpolation and is formulated using a mixed variational principle of the Hu-Washizu type. Volumetric and isochoric components of the deformation are treated independently to ensure the correct evaluation of the element volume. A simple procedure to control the propagation of spurious hourglass deformation modes is also discussed. This is based on the addition of artificial hourglass forces which vanish under constant deformation gradient conditions, thereby ensuring that the element passes a non-linear version of the patch test. Applications in the field of neo-Hookean materials and superplastic forming processes are also considered.

An experimental study was carried out to investigate the behavior of high strength concrete short columns confined by circular spirals and square ties under monotonically increasing concentric compression. The test variables included volumetric ratio, spacing and yield strength of transverse reinforcement, longitudinal reinforcement ratio, lateral steel configuration, shape of cross section and concrete compressive strength. The effects of these variables on the uniaxial behavior of high strength concrete columns are presented and discussed The results indicate that more confinement is required in columns of high strength concrete than in columns of low strength concrete to achieve the desired post-peak deformability. The behavior of high strength concrete columns is characterized by the sudden spalling of concrete cover, leading to a loss of axial capacity. A comparative study of existing confinement models of high strength concrete columns was also conducted to assess their capabilities of predicting the actual test behavior. To this end, the stress-strain curves of the specimens tested in the present study were compared with the ones predicted by the various models. It is shown that Legeron & Paultre (2003) model estimates the actual experimental curves more closely as compared to the other models employed in the study.

a b s t r a c tFire, in the aftermath of an earthquake has evolved as a severely destructive force since the last century [1]. Codes and regulations exist in countries situated in seismically active regions of the world in order to ensure safety of buildings and their occupants in the event of an earthquake; it is however rare to find regulations that also require the consideration of fire following an earthquake, thereby leaving this possibility to be dealt with entirely by emergency responders on an ad-hoc basis with little preparedness. Fire following earthquake (FFE) events in the past, although rare, have sometimes been as destructive as the original earthquake. The aim of this study was to carry out a set of full-scale loading tests on an earthquake damaged, reinforced concrete frame subsequently exposed to fire. The sequential loading was devised in the form of a three phase testing procedure -simulated earthquake loading facilitated by cyclic quasi-static lateral loads; followed by a compartment fire; and finally by subjecting the earthquake and fire damaged frame to a monotonic pushover loading to assess its residual capacity. The reinforced concrete frame was well instrumented with numerous sensors, consisting of thermocouples, strain gauges, linear variable differential transducers (LVDTs) and pressure sensors. A large database of results consisting of temperature profiles, displacements and strains has been generated and salient observations have been made during each stage of loading. This paper describes the experimental investigation and serves as a vehicle for dissemination of the key findings and all the important test data to the engineering community which could be used for validating numerical simulations for further advancing the knowledge and understanding in this relatively poorly researched area.