Avascular necrosis of the femur head (AVNFH) is a debilitating disease caused due to the use of alcohol, steroids, following trauma or unclear (idiopathic) etiology, affecting mostly the middle aged population. Clinically AVNFH is associated with impaired blood supply to the femoral head resulting in bone necrosis and collapse. Although Homocysteine (HC) has been implicated in AVNFH, levels of homocysteine and its associated pathway metabolites have not been characterized. We demonstrate elevated levels of homocysteine and concomitantly reduced levels of vitamins B6 and B12, in plasma of AVNFH patients. AVNFH patients also had elevated blood levels of sodium and creatinine, and reduced levels of random glucose and haemoglobin. Biophysical and ultrastructural analysis of AVNFH bone revealed increased remodelling and reduced bone mineral density portrayed by increased carbonate to phosphate ratio and decreased Phosphate to amide ratio together with disrupted trabeculae, loss of osteocytes, presence of calcified marrow, and elevated expression of osteocalcin in the osteoblasts localized in necrotic regions. Taken together, our studies for the first time characterize the metabolomic, pathophysiological and morphometric changes associated with AVNFH providing insights for development of new markers and therapeutic strategies for this debilitating disorder.

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The goal was to evaluate the efficacy of 2.4 mm column-specific plating for intra-articular distal radius fractures. In total, 105 patients with AO type C distal radius fractures were operated on using the locking distal radius system, Synthes. Follow-up assessments including clinical (wrist and forearm range of motion, grip strength), radiological (articular step, radial length and inclination, volar tilt, and ulnar variance), and functional scores (Disabilities of the Arm, Shoulder, and Hand; Patient Rated Wrist Evaluation) were made at regular intervals until 1 year. Union was obtained in all patients. Articular surface was anatomically reconstructed in 74 patients (70.5%). Clinical and functional evaluation showed significant continuous improvements over the first year. C1 fractures had a better chance of anatomical reduction compared with C2 and C3 fractures. Fracture type, quality of reduction, and presence of degenerative changes did not show a significant effect on functional outcome scores. Column-specific fixation of the distal radius can achieve satisfactory results in complex intra-articular fractures.

Locked plating through lateral trans-deltoid incision may offer a better alternative to the deltopectoral approach in these complex fractures where locked plating is contemplated. It respects the fracture biology, allows ease in placement of the locking plate and angle stable screws and offers a stable construct with less surgical morbidity.

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This article presents the first report on systematic synthesis and evaluation of activated carbons from the cap and stalk of two diverse mushroom species namely, Ganoderma lucidum (GL) and Calocybe indica (CI) belonging to different classes white rot and brown rot respectively. A novel microwave induced H3PO4 activation followed by carbonization and KOH activation enabled the formation of activated carbon with hierarchical structures. The activated carbons from cap and the stalk of the mushrooms are different in terms of specific surface area, pore volume, and their electrochemical behavior. Specific surface area and pore volume from GL‐cap is as high as 2432.4 m2/g and 0.54 CC/g, respectively. After optimization, the activated carbons have high graphitic content, good thermal stability and show specific capacitance as high as 271.94 F/g, energy and power densities of 13.59 Wh/kg and 127.31 W/kg, respectively. All the carbons show good capacitance retention up to 10 000 cycles. The surface area and specific capacitance in the mushroom stalks are lower than the ones made from the caps and the highest surface area and specific capacitance are 1576.2 m2/g and 137.2 F/g respectively for GL‐stalk.

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