Bio-terrorism is not a new term for scientists. Post 9/11 the United States of America, as well as other countries which have grown well economically and countries undergoing the metamorphosis to developed nations, are under serious threat of bio-terrorism. This has led to the development of the software CARVER + Shock by Sandia National Laboratories and Food and Drug Administration (FDA), specifically for risk assessment and protection mechanism in the entire food supply chain from farm to table. This software requires training on the software front and interaction with industry people to chalk out a plan to safeguard the premises and the supply chain of the food products in the industry manufacturing. Such efforts should be well highlighted and advertised among food processing professionals, educators, students, and those government agencies concerning the food safety issues. Everyone must look at this software as this is going to be the future of food processing safety. This system works like Hazard Analysis and Critical Control Points and can be integrated for total quality management of the concerned industry. Our study has highlighted the application of this software in various food industries showing its strength and weaknesses.
Introduction: Physeal injuries of proximal tibia are uncommon and constitute only 1% of all physeal injuries. Major vessel injuries are also rare in children and occur in 0.6% trauma cases, out of which, injuries of popliteal artery comprise only 5%. The combination of these is an extremely rare injury pattern but is potentially limb threatening. Most of the cases of physeal injuries of proximal tibia along with popliteal artery compromise, reported in the literature include Salter Harris (SH) type II, III, and IV patterns (type II being most common) with pure type I being extremely rare. Case Report: We describe a rare posteriorly displaced pure SH I injury of proximal tibial physis with compromised vascularity of the limb. Immediate closed reduction and stabilization with Kirschner wires (K-wires) restored the vascularity of the limb and the patient went on to have a good functional recovery at the last follow-up of 1 year. Conclusion: Vascular injuries occurring in SH 1 proximal tibial physeal fractures are often overlooked or missed due to the relatively benign appearance of slip with no sharp fragments to injure major vessels. Close monitoring of neurovascular status and a low threshold for fixation, for example, with K-wires, are important to prevent limb threatening ischemia in these relatively simple appearing injuries. Keywords: Hyperextension injury, physeal injury, proximal tibia, Salter-Harris 1, vascular injury.
Traumatic retrolisthesis of the first lumbar vertebra is a rare injury and only one case has been documented in the literature. We report a case of traumatic retrolisthesis of the first lumbar vertebra in a 7-year old child. He was injured after being dragged by a cow and presented with Frenkel grade A paraplegia. His plain radiographs revealed complete retrolisthesis of the first lumbar vertebra over the second. The patient was treated surgically with open reduction and sublaminar wire loop rectangle fixation. The patient showed Frankle grade D (Frankle grade) neurological recovery in the postoperative period over a period of 15 months. This case is reported in view of rarity and mechanism of injury is described.
Introduction With increasing prevalence of coronavirus cases (including among health care providers), the current advice for orthopaedic surgeons is to favor non-operative management of most injuries and reduce face-to-face follow-up. We present our experience in managing the patients at Government-run non-COVID-19 trauma center in Delhi in an algorithmic form. Our standard operating protocols were mainly based on recommendations of Indian Orthopaedic Association and targeted to provide healthcare at a minimum risk to the treating team as well as other patients admitted to the hospital. Methodology We describe the inflow, in-hospital management and outflow of patients at our facility during the lockdown period and in the following unlock period (from 23 March to 8 July 2020). Those patients who had absolute indications for surgery were offered surgery, while conservative treatment was more favored in those with relative indications. We also highlight the changes incorporated in OT settings as well as in rehabilitative and follow-up period. Results Following the described protocol helped us maintain a balance between the safety of patients and our front line workers which was evident by very low COVID-19-positive rate in admitted patients (4.22%) and health care providers (16.67%) in the above-mentioned time period. Conclusions We need to be prepared to cohabitate with this deadly Novel Coronavirus and adapt our surgical practices according to the need of the hour by minimizing surgical indications and strengthening the training in conservative principles.
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