Background Scarring represents a significant biomedical burden in clinical medicine. Mechanomodulation has been linked to scarring through inflammation, but until now a systematic approach to attenuate mechanical force and reduce scarring has not been possible. Methods The authors conducted a 12-month, prospective, open-label, randomized, multicenter clinical trial to evaluate abdominoplasty scar appearance following postoperative treatment with the embrace Advanced Scar Therapy device to reduce mechanical forces on healing surgical incisions. Incisions from 65 healthy adult subjects were randomized to receive embrace treatment on one half of an abdominoplasty incision and control treatment (surgeon's optimal care methods) on the other half. The primary endpoint for this study was the difference between assessments of scar appearance for the treated and control sides using the visual analogue scale scar score. Results Final 12-month study photographs were obtained from 36 subjects who completed at least 5 weeks of dressing application. The mean visual analogue scale score for embrace-treated scars (2.90) was significantly improved compared with control-treated scars (3.29) at 12 months (difference, 0.39; 95 percent confidence interval, 0.14 to 0.66; p = 0.027). Both subjects and investigators found that embrace-treated scars demonstrated significant improvements in overall appearance at 12 months using the Patient and Observer Scar Assessment Scale evaluation (p = 0.02 and p < 0.001, respectively). No serious adverse events were reported. Conclusions These results demonstrate that the embrace device significantly reduces scarring following abdominoplasty surgery. To the authors’ knowledge, this represents the first level I evidence for postoperative scar reduction.

Background:Three to nine per cent of teenagers meet the criteria for depression at any one time, and at the end of adolescence, as many as 20% of teenagers report a lifetime prevalence of depression. Usual care by primary care physicians fails to recognize 30-50% of depressed patients.Materials and Methods:Cross-sectional one-time observational study using simple screening instruments for detecting early symptoms of depression in adolescents. Two psychological instruments were used: GHQ-12 and BDI. Also socio-demographic data (e.g. academic performance, marital harmony of parents, bullying in school, etc) was collected in a separate semi-structured performa. Statistical analysis was done with Fisher’s Exact Test using SPSS17.Results:15.2% of school-going adolescents were found to be having evidence of distress (GHQ-12 score e14); 18.4% were depressed (BDI score e12); 5.6% students were detected to have positive scores on both the instruments. Certain factors like parental fights, beating at home and inability to cope up with studies were found to be significantly (P < 0.05) associated with higher GHQ-12 scores, indicating evidence of distress. Economic difficulty, physical punishment at school, teasing at school and parental fights were significantly (P < 0.05) associated with higher BDI scores, indicating depression.Conclusion:The study highlights the common but ignored problem of depression in adolescence. We recommend that teachers and parents be made aware of this problem with the help of school counselors so that the depressed adolescent can be identified and helped rather than suffer silently.

Abstract:Type I diabetes mellitus (Tl OM) is an autoimm une disease th at involve s the progr essive destruction of the insulin-producing [3 ce lls in the islets oflangerhan s. It is a complex process that result s from the loss of toleranc e to insulin and other [3-cell-specific antigens. Var ious genetic and environmental factors ha ve been studied so far, but preci se causation has ye t to be establi shed. Numerous studies in rodents and hum an subj ects have been performed in order to elucidate the role of B and T cell s, wh ich determine the risk ofdevelopment and progression ofdiabetes. These studie s have demonstrated that while T 10M is funda mentally a T-c ell-medi ated autoimmune response, the dev elopment of this disease results from complex interactions between the adapti ve and innate immune system s, with numerous cell typ es thou ght to contribute to pathogenesis. Like any compl ex diseas e, the va riation in severity and inciden ce of T 10M can be att ribut ed to a combination of genetic and env ironmental factors.

Background: Pelvic fractures represent one of the most challenging clinical problems in which an urgent multidisciplinary approach is required. The early management in a suspected pelvic fracture starts with the good radiological evaluation. The standard radiographic view includes the anteroposterior, inlet and outlet views. The inlet and outlet views are taken with 45 tilt from anteroposterior plane. However, recent studies have shown that there is significant individual variation within the population and these values should be redefined. Material and Methods: This is a retrospective study carried out in a tertiary care teaching institute. Total 110 patients (including 42 female and 68 male patients) of age older than 18 years, who had a routine pelvic Computed Tomography (CT) scan performed for any indications unrelated to pelvic pathologies were included. Statistical analysis: Mean and standard deviation were calculated. For each angle measured, the effect of age was determined and a comparison was made between male and female patients, p value <0.05 is considered significant. Results: The mean angle of caudal tilt for the ideal screening inlet view was 33 +/À8 (16.3-31.3) and the mean angle of cephalic tilt for the ideal screening outlet view was 56 +/À9 (51.6-81.8). Conclusion: This study re-evaluated the optimal inlet and outlet angles in Indians and demonstrated that the mean angles needed to create an ideal pelvic inlet and outlet views are 33 and 56 respectively.

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Fifty-three patients with osteomyelitis were grouped according to the duration of the disease at presentation, the bone and the part involved, the aetiology, activity, severity and stage of disease. Sera from these patients was estimated for IgA, IgM and IgG levels and in 23 matched controls. The results were compared with the normal range, and correlative studies were carried out between serum immunoglobulin levels and the different clinical parameters. Serum levels of the 3 immunoglobulins were found, in general, to fail to rise above the normal in the presence of infection. Furthermore, the levels did not show significant variation with the clinical parameters. These findings suggest that there is an intrinsically subdued immune response to osteomyelitis in most of the patients, partly confirming the suspicion of an immunodeficient state.

Purpose A mobile‐bearing (MB) posterior‐stabilized total knee arthroplasty (TKA) system with ball and socket post‐cam mechanism has been developed with the aims of better prosthesis fit and enhanced stability. However, the data are limited to compare its clinical outcomes with an already established fixed‐bearing (FB) implant design. Methods This is a prospective randomized study comparing 260 patients in the MB group and 133 patients in FB group with a minimum 2 years of follow‐up. Intraoperative variables, post‐operative functional outcomes and incidence of adverse events were compared. Results MB group showed better prosthesis fit as the incidence of over‐hang of femoral component at junction (medial: 1% vs. 5% and lateral: 2% vs 4%, p < 0.001) and trochlea (medial: 2% vs 30%, p = 0.042 and lateral: 13% vs 21%, p = 0.015) was less than FB group. MB group also showed better gap balancing as the incidence of medio‐lateral gap difference more than 2 mm was less in flexion (2.3% vs. 16%, p < 0.001) and extension (3.1% vs. 9.8%, p = 0.005). Post‐operative functional outcomes and incidence of adverse events showed no difference between the two groups at 2 years. Conclusions New MB design offers similar functional outcomes and stability along with better intraoperative prosthesis fit and gap balancing compared to an established fixed‐bearing design. Hence, this new MB design could be an alternative prosthesis of choice for posterior‐stabilized TKA. Level of evidence I.

Aim The modern trend in the management of fractures is fast changing in favor of rigid fixation and early mobilization with minimal period of plaster immobilization. We present a prospective cohort study of fixation of distal tibial fractures with distal tibial locking plate and its evaluation in terms of maintenance of accurate anatomical reduction, stable fixation, with early restoration of functions. Materials and methods A total of 25 patients with median age 38.04 years, age range 19 to 70, with distal tibial fracture were treated by using distal tibial locking plate. The outcome was evaluated using American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score. Results The majority of fractures in this study were extraarticular (64%), while 20% were partial articular fractures and 16% were complete articular fractures. Out of 25 patients, 6 patients had superficial infection and 1 patient had deep infection. Out of 25 cases, 5 cases had union by 16 weeks, 11 cases by 20 weeks, 7 cases had union by 30 weeks, and 2 cases had nonunion. According to AOFAS score at 6 months, 4 cases had score of 31 to 70 and 21 cases had score of 71 to 100. Conclusion The results of our study corroborate with the contemporary literature relevant to distal tibial fracture fixation performed with various locking plates. Therefore, locking compression plate is a good device to stabilize the fracture of the distal tibial. Clinical significance Locking plates are a good device to stabilize the fractures of the distal tibial, especially when used in conjunction with meticulous intraoperative handling of soft tissue and active participation of patients in rehabilitation program. Studying this alternative method expands the present knowledge for the management of distal tibial fractures. How to cite this article Ahmed M, Jindal S, Bansal V, Kapila R, Garg RS. Evaluation of Outcome of Management of Distal Tibial Fractures using Distal Tibial Locking Plate. J Foot Ankle Surg (Asia-Pacific) 2017;4(1):5-9.