bluuebunny/crossref_metadata_2025 huggingface dataset:
General Object and Special Object Principles of the Legal Regulation of Industrial Property in Cross-Border Relations
Authors: Shakhnazarov B. A.
Published: October 2020

International agreements, as well as the national legislation of various States, in addition to the territorial principle of protection of industrial property, the principle of national treatment, the principle of convention or exhibition priority, do not specifically identify other principles of protection of industrial property that would uniform national legislation in the field of protection of industrial property in most aspects of protection, and that would also take into account the specifics of a particular object of protection. The paper distinguishes and formulates general object principles of protection of industrial property, not expressly enshrined in international agreements, as well as special object principles of protection of individual objects of industrial property. It is noted that the operation of general principles applied universally for protection of all objects of industrial property and historically established universal principles of national regime, territoriality, principles of convention and exhibition priority are supplemented by such general object principles as the principle of exclusive protection of industrial property, the principle of production and technical development. These principles can be considered general in view of their extension to other objects not expressly specified in the Paris Convention. At the same time, with regard to separate objects (groups of objects) of industrial property, one can determine special object principles of protection on the ground of their specificity.

The author applies formal legal and comparative legal methods of the study, on the basis of which special international principles of protection were formulated: the principle of exclusive protection, the principle of focus on production and technical development. The paper describes special principles of protection for individual objects: the declarative and evidentiary principle of protection of registered industrial property, the principle of protection of marks “such as they are”, the principle of protection of new creative results in relation to patentable objects, the principle of absolute nature of the rights certified by the patent.
The Origins of Limitation Period in the Old Russian Criminal Law
Authors: Nikulina V. A.
Published: October 2020

The prototype of the modern institution of limitation periods for criminal prosecution appears in old Russian law. The crime under it is of a private legal nature (offense), and the main punishment is revenge on the offender. The nascent state power requires limiting revenge, which is destructive in nature, although it continues to act as a natural reaction to deviant behavior. One of these restrictions is the establishment of a certain period during which it was allowed to take revenge with impunity. In different legal systems, this period is designated differently. In old Russian law, which was influenced by Byzantine legal practice, there was a demand for the legality of revenge only in case of immediate implementation, which brings it closer to the institution of necessary defense. This also shows the beginnings of the modern institution of limitation periods, since revenge at that time satisfied the goals of punishment. The analysis of the norms of Russkaya Pravda [Russian Justice] in comparison with the norms of ancient German law is a confirmation of this. In addition, the establishment of limitation periods in old Russian law in some cases had procedural prerequisites, which are also characteristic of the modern institution of limitation periods. Nevertheless, long-standing oblivion did not receive its further development in old Russian law. The most popular institution was monetary compensation, which not only effectively replaced revenge, but also provided an economic platform for the emerging state apparatus. In such circumstances, it was economically unprofitable to limit the payment of ransom as the main type of punishment for that period of time, and first of all directly to the state in the person of the princely power. Thus, in its historical development, the institution of limitation periods for criminal prosecution at the stage of old Russian law acquires its identity and significance only when comparing and disclosing those tasks that were solved by the state in this particular period of time by applying punishment.
Issues of Regulation and Application of the Criminal Law Norm providing for Responsibility for Occupying the Highest Position in the Criminal Hierarchy (Article 210.1 of the Criminal Code of the Russian Federation)
Authors: Pantyukhina I. V. , Larina L. Yu.
Published: October 2020

The paper is devoted to a detailed analysis of article 210.1 "Occupation of the highest position in the criminal hierarchy", which was introduced in the Criminal Code of the Russian Federation by Federal law No. 46-FZ of 01.04.2019. The authors considered the construction of this norm from the point of view of the elements of the crime and the coordination of these features with the provisions of the General part of the Criminal Code of the Russian Federation. As a result of a systematic study of the norms of the Russian criminal law, comparison with foreign experience (Georgia), and analysis of law enforcement practice, the discrepancy between the new criminal law norm and the provisions of certain institutions of criminal law was revealed. In particular, the content of article 210.1 contradicts certain principles of the criminal law (articles 6, 7 of the Criminal Code), the basis of criminal liability (article 8 of the Criminal Code), the norms of the Institute of preparation for a crime (part 1 of article 30 of the Criminal Code), as well as the goals of criminal punishment (part 2 of article 43 of the Criminal Code). To eliminate the identified shortcomings, the authors propose to include in the disposition of article 210.1 of the Criminal Code of the Russian Federation an act in the form of using the highest position in the criminal hierarchy. The proposed changes (including an act in the form of "use of the position») make it possible to prosecute persons both permanently and temporarily performing the functions of such persons, to leave outside the scope of its application persons who fully walked away from crime and not in any way affect criminal damage. They will allow you to bring the rule into compliance with the traditional understanding of the offense and those provisions of the General part of the Criminal Code, in which the regulated norms in the current edition are not made consistent.
The effectiveness of electrophoresis with caripain in the treatment of discogenic radiculopathy in the cervical spine. Clinical case.
Authors: Al-Zamil M.Kh. , Kulikova N. G. , Vasil`eva E. S. , Zhuk Yu. M.
Published: October 2020

In this article, we demonstrate a clinical case with high efficacy of Karipain electrophoresis in the treatment of a patient with discogenic radiculopathy in the cervical spine. The positive result was a complete regression of motor deficiency, restoration of sensory function and a decrease in the size of a hernia of the intervertebral disc at the level of C5C6 by 40%.
The tendencies in institutionalization of palliative care of adult population in the present-day Russia
Authors: Krom I. L , Erugina M. V , Shmerkevitch A. B
Published: October 2020

The analysis of actual interpretations of palliative care from perspective of multi-professional and multi-disciplinary approach is presented. The main trajectories of chronic diseases determining modern strategies of palliative care are considered. The main tasks and directions of palliative care are indicated. According the authors, the normative legal support of provision of palliative medical care of population permits planning and developing of the mentioned type of care in Russia. To provide availability of palliative medical care scientific methodical substantiation is required and as well development of unified classification of conditions requiring indication and organization of palliative care. The standards of provision of palliative care are to be adjusted to the mentioned classification. The article mentions that the legal documents adopted in Russia determine palliative care as palliative medical care. The medicalization of palliative care in Russia is considered from perspective of dysfunctional practices of social institution of health care.
The barriers of health preservation of rural population with occupational diseases
Authors: Yurova I. Yu , Tchernishkova E. V
Published: October 2020

The results of study of external and internal factors interfering with health saving of rural population with occupational diseases are presented. The barriers of implementation of available health saving strategies to rural residents are determined of the basis of national and foreign data and original study carried out using questionnaire survey as well. The sampling included 297 patients with occupational diseases and treated in hospital of the Saratov research institute of rural hygiene clinic. The gender distribution of sampling consisted of 196 males and 101 females. The age range consisted 35-62 years. The relationship of factors effecting health saving of rural population with occupational diseases is examined. It is determined that the most significant barriers of health saving of rural residents with occupational pathology include remoteness of medical centers with professional medical personnel and reliable diagnostic base, low living standards of rural population, absence of financial opportunity to use paid medical care, alteration of social status and attitude of staff and relatives in case of diagnosis.
L. M. Tsvibak. - To treat the delay of the placenta during miscarriages. (Prot. Imperial. Caucasian. Med. Society., 1895, February 16)
Authors: Kakushkin N.
Published: October 2020

Three cases are described: 1) Multiparous, 28 years old. A miscarriage at 4 months of pregnancy, with inflammation of the lung, after a shaking edema. After labor, I was separated the next day. A small piece of it could not be separated by fingers or a spoon; he stood out when the uterus was washed on the 5th day. When endometritis occurs, death is on day 20.
O. A. Ryznikov. - Four years of detention in the uterus of the skeleton of a fetus that died on the 7th month of pregnancy. (Yuzhno-Russian medical newspaper, 1895, No. 12)
Authors: Kakushkin N.
Published: October 2020

Peasant woman 35 years old, gave birth twice. Four years ago, being pregnant, she suffered some kind of fever, after some time after which she began to discharge pus from her genitals, and then the bones, which continues throughout these four years. The patient is emaciated, feverish at times. The fundus of the finger is 4-5 above the pubis; the uterus is in the bend back, mobile; with pressure on it, a crunch is felt in it. The appendages and peri-ocular spaces are healthy.
S. Voino. - Report on the surgical activity of S. V. Topuria's medical school in the city of Kutais from May 1, 1890 to May 1, 1894. SPb. 1895 year
Authors: Kakushkin N.
Published: October 2020

This hospital also provides assistance to gynecological patients. During the reporting period, 717 operations were performed in her outpatient clinic, including 17 gynecological operations (discisio coli uteri 2, excisio condylomatum 11, removal of cervical polyp 3 and removal of cervical cancer 1).
V.A.Petrov. - A case of hydrosalpingitis simulating an extrauterine pregnancy. (from the Proceedings of the Physico-Medical Society in Saratov, for 1894)
Authors: Kakushkin N.
Published: October 2020

Patient 37 years old. 3 months ago I was healthy from the side of the genitals; appeared to the author with a tumor, equally elastic, oval in shape, mild, 2 fingers not reaching the navel; to the right of the tumor is an unenlarged uterus. The swelling of the breast, producing colostrum, the color of the areola and the mucous membrane of the entrance to the vagina, corresponded to the usual signs of pregnancy.
V.A.Petrov. - A case of complete rupture of the uterus during childbirth with the outcome in recovery. (from the Proceedings of the Physico-Medical Society in Saratov, for 1893-1894)
Authors: Kakushkin N.
Published: October 2020

The author points out the absence in some cases of rupture of the uterus of such seizures, which are usually considered cardinal. In his case, in the second-bearing, 37 years old, (the first birth was 10 years ago), urgent labor proceeded with mild pains, the forward movement of the presenting part (head) went quite quickly and easily; the ring of contraction was not expressed.
Kleinwächter. - Uterusmyom und Gestation. (Zeitschr f. Geb. and Gyn., Bd. XXXII, Hft. 2). Uterine fibroids and fertility
Authors: Khazan S. Y.
Published: October 2020

Confirming on the basis of 184 cases of uterine fibroids the position expressed by Hofmeier (see this journal for 1895, p. 284) that neither complete infertility nor reduced fertility should be considered as a consequence of uterine fibroids affecting the uterus,, Кl., after observing of the case of fatal atonic postpartum hemorrhage, due to the presence of myomas in the uterus, however, cannot agree with the named author, as if the complications that occur with myomas during the act of childbirth only in rare cases cause serious danger.
Ludwig Pincus. - On the therapeutic use of hot (100 ° C) water vapor in gynecology. - (Centr. F. Gvnaec., No. 11, 1895)
Authors: Stroganov A.
Published: October 2020

Prompted by the declaration of prof. Snegirev on the high dignity of steam as a hemostatic agent, the author applied it in 9 cases of gynecological diseases with a completely satisfactory success.
Dr. E. T. Thring. - Case of Combined abdominal and vaginal Hysterectomie for large Fibroid Tumor of Uterus together with Cystic Ovaries. (Australasian Medical Gasette, 1894, 15 / XI, pp. 379-383). Excision of the uterus due to large fibroids and removal of cystic-degenerated ovaries simultaneously by means of abdominal dissection and through the vagina
Authors: Ginzburg M.
Published: October 2020

A 46-year-old woman who gave birth 22 years ago, more than 15 years old, after suffering peritonitis, suffered from severe pain in the abdomen, profuse regulation, pain and very frequent migraine. In 1888, Thring found in her a slight increase in the uterus (the probe passed by 7.5 centimeters) and ovaries; In 1893 - the enlarged uterus stood upside down 2 inches above the navel, both ovaries were grown in Douglas' space and each reached the size of an orange.
Prof. Cosey A. Wood (Chicago). - Puerperal Panophthalmitis due to septic Embolism. - (American Journ. Of Obstetrics, 1894, V, p. 635) - Postpartum panophthalmitis due to septic embolism
Authors: Ginzburg M.
Published: October 2020

Little is known about the origin of panophthalmitis in puerperas; even scientists like Playfair and Garrigues set out in their textbooks that a disease, starting from the conjunctiva, penetrates deeply, piercing the vitreous cornea and cornea.
Differential diagnosis of multiple neuritis. Polyesthesia and macroesthesia
Authors: Shcherbak A. E. , Ivanov I. I.
Published: October 2020

The involvement of the spinal cord in infectious polyneuritis can be primary or secondary.With regard to primary participation, here again two clinical forms must be distinguished:1) Toxins have only a short-term and weak effect on the spinal cord, which is expressed, usually at the beginning of the disease, by transient disorders of the functions of the bladder and rectum, at which, however, the usual clinical picture and the course of polyneuritis do not represent significant changes; prediction does not get worse (compare the cases of Oppenheima, Kanonnikov, Charcot, Rhode, etc.)2) In the second category of cases, the toxins act more vigorously on the blood vessels and the most nervous elements of the spinal cord, causing persistent organic damage to it, and how new, unusual for polyneuritis, features are introduced into the clinical picture, so the course of the disease changes; prediction gets worse.
About the connections of the cerebellum with the rest of the central nervous system
Authors: Telyatnik Ph. I.
Published: October 2020

As you know, the cerebellum has three pairs of legs, through which all the fibers pass, originating in it and heading to one or another part of the central nervous system, as well as fibers starting in other areas and ending in the cerebellum. Thus, knowing the composition of each cerebellar peduncle separately, we will very much have an idea of ​​the connections that exist between the cerebellum and the rest of the central nervous system. If, in addition, we could not only dismember each cerebellar pedicle into its component parts, but also trace the path of each individual bundle along its entire length to its beginning and end, then the question of cerebellar connections could be considered exhausted.
Dr. Alessandro Tedeschi: Anatomisch - experimenteller Beitrag zum Studium der Regeneration des Gewebes des Centralnervensystems. Beiträge zur pathologischen Anatomie et caet. XXI Bd. Erstes Heft. 1897. S. S. 43—72
Authors: Smirnov A. E.
Published: October 2020

The question of the regeneration of the nervous tissue in general and the elements of the central nervous system in particular was the subject of numerous and conscientious studies; but to this day this question is open, it is the arena of various, even directly opposite views. The author, on the basis of his numerous, which required a significant investment of time and labor, experiments and observations, decides the question in a positive sense regarding the participation of nervous elements in the regeneration of the central nervous system in mammals. The author, in a large, but complete essay, introduces the issue to the literature, sets out in detail the technique of performing experiments, points to the technique that he used in microscopic studies, gives several protocols of pathological and anatomical dissections of experimental animals and, finally, details of microscopic studies of the brain with an illustration of words with the corresponding drawings, gives conclusions from their observations, the presentation of which I will limit myself to this abstract.
К. Schaffer: Zur feineren Struktur der Hirnrinde und über funktionelle Bedeutung der Nervenzellenfortsätze. Arch. f. Mikrosk. Anatomie. XLVIIL 4 Heft. 1897. S. S. 550—572
Authors: Smirnov A. E.
Published: October 2020

The author's research refers to the anterior cerebral cortex of a newborn dog. The author studies in detail the so-called tiny pyramidal cells, lying between the pluripolar cells of the molecular layer and the small (true) pyramidal cells. Already R. y Cajal drew attention to polygonal or core-shaped cells, the cells that lie behind the layer of the outermost cells (pluripolare Nervenzellen von R. y Cajal), but did not separate them into a special group, believing that these cells were gradually changing vid, go into the small pyramids, to which he numbered them. Schaffer separates these cells into a special group, calling it the layer of surface polymorphic cells. These cells have a dark variety of shapes (fusiform, oval, roundish, pear-shaped, polygonal) and lie in approximately four (4) rows. Dendrites go then, mainly, in two opposite directions (for fusiform cells), then they move radially in all directions (for round and polygonal cells). The number of dendrites is sometimes strikingly abundant. Dendrites going to the surface of the brain reach it, while dendrites of the opposite direction sometimes go down to the ammonium formations of the cerebral cortex. Special attention should be paid to the axial cylinder of the disassembled cells; on the basis of the features of this appendix, the author distinguishes 3 types of disassembled cells.
Chronicle of scientific gatherings of doctors of the St. Petersburg clinic for mental and nervous diseases. Protocol of appointment 19/3 96
Authors: Bekhterev V. M.
Published: October 2020

Chairman prof. Bekhterev, with: Erlitsky, Rosenbakh. Dobrotvorskiy, Borispolskiy, Trapeznikov, Zhukovskiy. Gize, Ostankov, Osipov, Remers, Telyatnik.Borispolskiy. Sciatic pain treatment by Scottish souls. The speaker, on the basis of his observations in the treatment of 32 cases of chronic sciatic pain by Scottish souls, came to the conclusion that the latter represent an excellent means that enhances the exchange in the diseased nerve, being the best anti-neuralgic means in general with neuralgia. Out of 32 cases, he had 23 complete cures. 7 pain relief and only 2 without any result.
The volume of the anatomical connections of the frontal lobes
Authors: Zhukovsky M. N.
Published: October 2020

The question of the connection between the frontal lobes and the various parts of the brain still remains far from solved completely, despite a whole series of studies in this direction. In view of this, at the suggestion of the highly respected teacher V.M.Bekhterev, I undertook this work with the aim of clarifying this issue in detail. My study consisted in the destruction of the frontal lobes in animals with the subsequent processing of their brains according to the Marchi method, and in addition, in a detailed study of physiological phenomena in the operated animals. But regarding the second part of my work, I intend to speak in another section, limiting myself at the present to the anatomical part. Before proceeding to the presentation of the results obtained by me, I will try to briefly outline the literature of the question of interest to me. The literature on the connections of the frontal lobe with various areas of the brain is directly adjacent to the literature on the connections of the cerebral cortex in general and seems to be very extensive, which is why I will confine myself to a more detailed sketch of a part of it, concerning more or less controversial issues, mentioning only briefly about the research on which there is a contradiction.
On the pathological and anatomical changes in the cervical nodes of the sympathetic nerve with their inflammation
Authors: Yablonsky Evgeniy
Published: October 2020

The issue of inflammatory changes in the ganglion cells of the sympathetic nerve can not be considered resolved until now, despite the existence of several works on this matter.True, research of this kind refers to the time when we did not yet possess the modern improved methods of research, and relate mainly to the regeneration of the sympathetic nerve, and therefore it is not surprising if the results of the work sometimes turned out to be completely opposite.
Friederike Oberdieck. Beitrag zur Kenntniss des Alkoholimus und seiner rationellen Behandlung. —(Arch. f. Psych. Bd. 27. Heft. 2. pg. 579 — 632)
Authors: Idelson G.
Published: October 2020

This work presents a statistical analysis of the history of the illness of alcoholics from the Burghlzli insane asylum during the period from 1879 to 1894 (367 mus. And 31 women). The known facts about the consequences of alcoholism are confirmed again in this work.
Chronicle of the society of neuropathologists and psychiatrists at the imperial Kazan University. Protocol of appointment on May 14
Authors: Mislavskiy N. A.
Published: October 2020

Chaired by Comrade Chairman N.A.Mislavskiy, with secretary B.I. Vorotynskiy; honorary members KA Arnshtein and IM Dogel were present; action. members: D. V. Polumordvinov, P. S. Skuridin. G. A. Klyachkin, V. V. Nikolaev; guests: Dr. Poroshin, Dr. Charushin. Dr. Mayevsky, prof. Savchenko and a few people of the public.
Assessment of diagnostic efficiency of real-time strain elastography by using the median nerve stiffness at females with carpal tunnel syndrome
Authors: KARATAY Emrah , TURKOGLU Ozlem , MANSIZ-KAPLAN Başak
Published: October 2020

elastography in relation to carpal tunnel syndrome (CTS) and to show the relationship between electromyography (EMG) and sonographic cross-sectional area measurements.

Materials and Methods: The patients with paresthesia of the median nerve distrubition lasting at least for 3 months were included. A total of 23 female patients’s of CTS and 25 healthy female volunteers’ wrist in which one median nerve existed included that of 36 CTS and 46 healthy wrists. The patients had clinical signs and their EMG test confirmed the diagnosis. The patients median nerve along its course on the wrist was applied strain elastography at three points of the radioulnar joint, scaphoidpsiform junction and hamate bone.

Results: The EMG findings, strain elastogragraphy ratios and the CSA of the median nerve were found to be correlated significantly. The median nerve strain ratio in elastography was significantly increased in the CTS patients compared to the control group.

Conclusion: Sonoelastography promises to be a useful method for the diagnosis of CTS.
On naturality of some construction of connections
Authors: Kurek Jan , Mikulski Włodzimierz
Published: October 2020

Let \(F\) be a bundle functor on the category of all fibred manifolds and fibred maps. Let \(\Gamma\) be a general connection in a fibred manifold \(\mathrm{pr}:Y\to M\) and \(\nabla\) be a classical linear connection on \(M\). We prove that the  well-known general connection \(\mathcal{F}(\Gamma,\nabla)\) in \(FY\to M\) is canonical with respect to fibred maps and with respect to natural transformations of bundle functors.
Migraine headache prevalence in Taif city, Saudi Arabia
Authors: Hassan Khaled M. , Addas Omar K. , Alharthy Fatma T. , Banan Ahmed A. , Alhazmi Asalah A. , Dabi Montaha M. , Al-Ansari Ghada A. , Albouq Abdulrahman F. , Alhowety Afrah S. , Alhamad Abdulrahman I. , Aleissa Abdulaziz I. , Alshebly Ahmad T. , Alyafi Rayan A. , Alotaibi Faihan N. , Alsobhi Ahmed S. , Al-Qahtani Talal M.
Published: October 2020

Background: Migraine is a public health concern and is the third most common cause of disability for individuals below the age of 50. Despite the multiplicity of studies on the epidemiology and nature of diseases around the world, except from Saudi Arabia. Present study was conducted to see the prevalence of migraine in Taif city, Saudi Arabia.Methods: This was a cross sectional analysis of 354 individuals in Taif area. Data were collected via a self directed questionnaire, including demographic variables, clinical variables and therapeutic variables. Data was moved to the device and analyzed using SPSS software.Results: As a result, of the 354 recruited participants, 54% were female and 46% were male. Migraine existed in 89.9% of the urban population. About 24% of migrants were unemployed, and 16% were non workers. Headache found in 71.6% of males and 86.9% of females (p=0.002). Gender has been substantially associated with migraine prevalence (odds ratio 0.28). Approximately 47% posted a pain score of 4-6. In 32.4% of females and 26.6% of males, medical advice was sought. Nausea occurred in more than one-third of patients before and after a headache. Just 31.4% of participants were conscious of migraine causes.Conclusions: The past of the family was found in 64% of the participants. In Taif city, migraine is prevalent. It is more prevalent among women and urban areas.
Outcome of complex tibial pilon fractures definitively treated with external fixator
Authors: Lemsanni Meryem , Najeb Youssef , Chafik Rachid , Madhar Mohamed , Elhaoury Hanane
Published: October 2020

Background: Complex tibial pilon fractures are typically sustained with high-energy mechanisms and they are often associated with severe soft tissue compromise that can frequently results in severe complications. The purpose of this prospective case series was to evaluate the radiological and clinical outcomes after the use of external fixation combined with minimally invasive osteosynthesis, as primary and definitive treatment of complex tibial pilon fractures.

Methods: A prospective study was undertaken during the period from March 2012 to June 2016. A total number of 109 patients with complex tibial pilon fractures were managed in our institution and included in the study. All the patients were treated with external fixation and minimally invasive osteosynthesis. The mean follow-up period was 47 months (31-60 months). Clinico-radiological progression of fracture union as well as the functional outcome were studied.

Results: Eighty fractures resulted from traffic accidents and type 43-C3 fracture according to AO/OTA classification was the most common. Seventy-eight were open fractures and 94 patients had associated distal fibular fractures. All patients were treated with monolateral external fixators for definitive management. The average time to union was 14 weeks (range 9-19). Eleven patients (10%) suffered superficial pin tract infection. One patient developed septic arthritis and evidence of radiological osteoarthritis was present in ten cases (9%) at final follow-up. The American orthopaedic foot and ankle society (AOFAS) score was 84.4±8.1, translating to good clinical results.

Conclusions: This review concludes that external fixation, combined with minimally invasive osteosynthesis, consistently produces good functional results without serious complications.
Retrospective analysis of minimal invasive plating versus intramedullary nailing for treatment of extra-articular distal tibia fracture
Authors: Soni Yogesh , Kakadiya Ghanshyam , Shakya Akash , Gandbhir Viraj
Published: October 2020

Background: The volume of cases of distal tibia fractures at trauma care centre are quite high in Indian scenario. These type of fracture often creates a dilemma for the orthopaedic surgeons over the choice of the implant for the management. The aim of our study was to compare intramedullary interlocking nail (IMILN) and minimally invasive percutaneous plate osteosynthesis (MIPPO) on the basis of various parameters.

Methods: We collected data of 40 patients with extra-articular distal tibial fractures (within 2 muller square from tibial plafond). Patients were divided into two groups: IMILN and MIPPO. We compared the 2 groups for demographic variables, union time, complication rate and functional score.

Results: There was no statistical difference of union time, complication rate, functional outcome and other demographic variables among the groups. Only 2 patients developed non-union and two patients had infection. Overall 38 patients obtained excellent or good result (95%) and two patient had fair outcome (5%).

Conclusions: The overall analysis suggested that both MIPPO and IMILN treatment option are comparable with consideration of all the parameters. Detailed results indicate a superiority of MIPPO over IMILN in terms of better anatomical reductions of the fracture with less incidence of malalignment while IMILN is better in terms of having lower rates of infections.

 
Functional outcome of proximal femoral nailing for unstable intertrochanteric fracture in elderly
Authors: Jose Ankit , Nazareth Edward , D. A. Vivian Roshan , C. R. Mohan Kumar
Published: October 2020

Background: This study is intended to analyse the functional outcome of proximal femoral nailing (PFN) for unstable intertrochanteric fractures in elderly.

Methods: The data was collected from the 35 patients with unstable intertrochanteric femur fracture who were subjected to PFN from 2015 to 2018. All patients were followed up at 3 months and 6 months after the operation to check the functional outcome based on harris hip score (HHS) and complication if any.

Result: In 35 patients, 1 patient was lost to follow-up and 34 patients were followed-up at 3 months and 6 months. All patient’s union was achieved at 3 and 6 months follow up. The cause of fractures was trivial fall in all 35 patients. No incidence of non-union and delayed union was reported. Functional outcome was rated as per HHS, we got excellent results in 20 cases, good in 10, fair in 03 and poor in one patient at end of 6 months.

Conclusions: PFN provides stable fixation and early post-operative mobilization with fracture union especially complex proximal femoral fractures which includes unstable, communited, reverse oblique fractures and fractures in osteoporotic bones. PFN has shown excellent results in our study.
A comparative study between variable and fixed angle volar locking plates in management of unstable intra-articular distal radius fractures
Authors: Regar Chhagan Lal , Parmeshwar Siddharath Sharanappa , Meena Ramesh Chandra , Sharma Shyoji Lal , Jain Jitesh Kumar
Published: October 2020

Background: The current study is conducted to assess and compare the radiological and functional outcomes between variable and fixed angle volar plating in unstable intra-articular distal radius fractures.

Methods: A prospective study was conducted from May 2018 to May 2020. A total of 156 patients were randomised into two groups A and B of 78 patients each. The plates were T or oblique fixed angle volar plate in group A and variable angle volar plate in group B. Patients were followed up for minimum 12 months. The functional outcome was measured by patient rated hand wrist evaluation score (PRHWE) and radiological outcome by radial height, volar tilt and radial inclination. The secondary objective was to correlate complications.

Results: In our study average PRHWE score was better in group B (p<0.05). Radial height, volar tilt, radial inclination was much closer to anatomical wrist radiology was seen in group B. The most common complication was finger and wrist stiffness in group A.

Conclusions: Patients treated with variable angle volar plate showed better results in functional and radiological outcomes at 12 months follow-up but limitations include short duration of follow up.
Knowledge, attitude and practice of preventing spread of COVID-19 amongst orthopaedic surgeons and residents in a tertiary care hospital in Navi-Mumbai
Authors: Samant Prakash D. , Sane Rohit M.
Published: October 2020

Background: With on-going coronavirus pandemic, there is high incidence of COVID-19 occupational risk exposure among health care professionals. The aim of this study was to assess the knowledge, attitude and practice (KAP) amongst orthopaedic surgeons and residents regarding prevention of spread of COVID-19 at a tertiary care hospital.

Methods: A cross-sectional, observational, web-based questionnaire study was conducted at orthopaedic department of a tertiary care hospital in Navi Mumbai. The study included orthopaedic surgeons and residents of either sex. A predesigned KAP questionnaire was used to assess the knowledge, attitude and practice regarding prevention of spread of COVID-19. The web-based questionnaire was circulated to eligible participants and the responses obtained were analysed.

Results: Overall, the knowledge regarding hand hygiene, mask etiquette and COVID-19 diagnoses was high. Majority participants knew the proper technique of personal protective equipment (PPE), but few 25% and 35% lacked correct technique for donning and doffing of PPE respectively. Majority participants knew the indications and pre/post-operative protocols for orthopaedic surgeries in COVID-19. Around 40% only knew the type of pressure system used in the COVID-19 operation theatre (OT). Majority felt that mask, hand hygiene and PPE were essential kit for prevention. In practice, majority participants were taking drug prophylaxis and were adequately practicing mask/hand hygiene.

Conclusions: Overall, KAP regarding prevention of spread of COVID-19 among orthopaedicians were adequate. Further formal preventive education on COVID-19 and structured hands-on experience workshops are necessary to advance the proper techniques of PPE handling.
Functional outcome of arthroscopic Bankart repair in post-traumatic recurrent shoulder dislocation in a private tertiary care teaching hospital in eastern India
Authors: Das Ayon , Bhowmick Subhrojyoti , Das Nikhilesh , Samanta Swarnendu , De Somanth , Das Sayan
Published: October 2020

Background: Recurrent anterior shoulder dislocations are quite common in young patients with Bankart lesions. The open Bankart repair was the gold standard for years, however arthroscopic Bankart repair has gained popularity. The aim of the study was to evaluate the functional results of arthroscopic Bankart repair in patients with post-traumatic recurrent anterior glenohumeral instability.

Methods: Patients who underwent arthroscopic Bankart repair for post-traumatic recurrent anterior shoulder dislocation were included in the study. This was a prospective study conducted at a tertiary care Hospital in Kolkata, India between August 2017 to May 2019. All patients were followed up at an interval of 2 weeks, 6 weeks, 12 weeks, 6 months, 9 months and 1 year. Rowe score was used to assess the functional outcomes of the patients.

Results: 34 (91.9%) patients reported good to excellent results, whereas only 2 (5.4%) patients had fair outcome and 1 (2.7%) patient demonstrated poor surgical result. The total rowe score improved from 46.62 pre-operatively to 94.20 post-operatively after 1 year (p<0.01). By the end of 1-year follow-up, 35 (94.6%) patients had full range of motion in all the planes. Majority of (89.2%) patients did not have any complications. Only 1 patient out of 37 had a recurrence (2.7%).

Conclusion: Arthroscopic Bankart repair is an effective, cosmetic and safe surgical procedure with good clinical outcomes and excellent post-operative shoulder range of motion. This surgical intervention also has low recurrence rate and minimum surgical complications.
Oxford partial knee replacement by microplasty instrumentation: Indian evidence
Authors: Sancheti Mukesh
Published: October 2020

Background: There is increasing evidence in support of unicondylar knee replacement (UKR) as a superior surgical modality in a select group of patients of osteoarthritis knee. Oxford knee is one type of UKR with fully congruent, mobile bearing designed to minimize wear. This prospective study describes 5-year results of partial medial compartment knee replacement in 92 Indian cases by microplasty instrumentation.

Methods: All 92 cases were operated by a single surgeon. Mean follow up was 5 years. In all cases oxford mobile bearing medial unicondylar knee prosthesis was implanted using minimally invasive surgical technique and the cases followed up.

Results: Mean oxford score at the end of 5 year was 43. Patient satisfaction index at the end of 5 year was 98%. Mean maximum flexion was 125 degrees. Incidence of revision was 1.9. No deep or superficial infections were encountered. Average hospital stay was 3 days.

Conclusions: There are variations in Indian patients as per size of implants, stay and similarities regarding less blood loss, improved oxford knee score, good range of motion, less morbidity, higher postoperative patient satisfaction and early getting back to work. Oxford partial knee replacement by microplasty instrumentation done in carefully selected patients with proper surgical technique gives excellent functional outcome and superior patient satisfaction.
Ten years follow up of a chronic tubercular osteomyelitis of the proximal tibia in infancy
Authors: Sinha Akansha , Iyengar Raju , P. Chandrasekhar
Published: October 2020

Primary tuberculous osteomyelitis accounts for less than 10% of extra pulmonary tuberculosis in childhood.In about 50% of the patients, the vertebrae are the sites of skeletal involvement. Solitary bone TB is rare in infancy and has non specific findings and can be misdiagnosed easily. A 12 month old infant, presented with fever, pain, swelling in left knee, difficulty in moving left lower limb and inability to bear weight for 15 days at Nizam's institute of medical sciences, Hyderabad, in 2010. She was managed conservatively with injectable antibiotics, initially. After 15 days fever and swelling recurred. A biopsy was performed which showed plenty of polymorphs. A month later with second recurrence she was operated by means of debridement and curettage. Subsequent biopsy and culture revealed active Mycobacterial tuberculous infection. Anti-tubercular treatment titrated to her body weight was administered for 12 months and patient was followed up. The patient’s general condition improved with betterment in laboratory parameters, resolution of the lesion, without any sequelae. Upon a close follow up of 10 years (2010-2020), no residual deformity was noted and excellent clinical outcome achieved. Skeletal TB without spinal involvement in children is rare and it does not have any pathognomonic radiographic or clinical characteristics. Physis can heal gradually and full range of motion of the adjacent joints can be maintained. Tuberculosis should be an essential differential diagnosis while addressing cases with similar presentation in endemic regions like India. As clinical and radiological findings may be indistinguishable from malignant disease, tuberculous osteitis should be excluded in infants presenting with undiagnosed bone lesions despite been vaccinated with Bacille Calmette Guerin at birth.
Arthroscopic management of neglected complex knee injury
Authors: Amaravathi Rajkumar S. , Pilar Anoop , Manohar Sandesh G. , Muniswamy Madan Mohan , Rehman Fazal R. , Mathai Naveen J.
Published: October 2020

Meyers and mckeevers type IV comminuted pattern of avulsion fracture of the anterior tibial eminence is not an uncommon injury, however its association with root avulsions of lateral and medial meniscus is very rare combination of injury and the management of the neglected case of this complex knee injury is challenging. A 43-year-old gentleman who came with a history of pain, recurrent instability, locking of his right knee for 2 weeks with restricted activity of daily living. He also had a road traffic accident 5 years ago. He was evaluated clinically, radiologically by X Rays and MRI Scan which revealed complete tear of anterior cruciate ligament (ACL) with loose fragments, root tear anterior horn lateral meniscus and posterior horn tear with posterior root avulsion of the medial meniscus. He was managed with arthroscopic removal of large loose body with other loose bony fragments, ACL Reconstruction with hamstring autograft, anterior root repair of lateral meniscus with pull out sutures, with all inside repair of posterior horn tear of medial meniscus using fast-fix 360 device (Smith and Nephew, Andover, MA). At 4 years follow-up the patient was analysed clinically, and the functional outcome was measured with international knee documentation committee (IKDC) and knee injury and osteoarthritis outcome score (KOOS) Scoring system which showed good outcome. Patient has returned to his pre-injury activity level with no limitation of his activity of daily living. There is no set protocol of managing these kinds of neglected complex knee injury. Sometimes you need to think out of the box. A thorough knowledge of anatomy and pathomechanics of knee combined with appropriate technique of repair to save the meniscus and reconstruction of ACL and rehabilitation can yield good result.
An unusual presentation of morel- lavallee lesion in the arm: a case report
Authors: Balasubramanian Yogesh Kumar , Balasubramanian Raghavendran
Published: October 2020

Morel-lavallee lesions (MLL) are post traumatic closed internal de-gloving injury with abrupt separation of skin and subcutaneous tissue from the underlying fascia. The shearing force damages the blood vessels and lymphatics, resulting in collection of the serosanguinous fluid and necrotized fat. Early diagnosis and management minimize complications like infections or extensive skin necrosis. MLLs commonly described in pelvic and lower extremity trauma, and there are limited reports in other locations. A 28-year-old male presented with pain and swelling over the left elbow for 6 days with multiple deep bruises over the skin extending from mid arm to proximal forearm.  Ultrasound of the arm revealed a large encapsulated collection consistent with MLL. An open debridement with excision of all necrotic skin and necrotic tissue was performed followed by skin grafting. Intra-operative cultures were negative and pathology was consistent with MLL. Morel-lavallee lesions should always be considered as early diagnosis of previous trauma regardless the location. The key to recognize this injury depends on suspicious mechanism involving significant shear forces. Aggressive surgical debridement remains the key to prevent significant morbidity and mortality.
Open complex distal femur intraarticular fracture with Hoffa extension, extensor mechanism tear and post-recovery secondary traumatic peri implant fracture: report on an uncommon chronology
Authors: Tomar Lavindra , Govil Gaurav , Dhawan Pawan
Published: October 2020

Complex distal femur fractures with Hoffa’s extension are uncommon. An associated open fracture with extensor mechanism disruption are rarely reported. A secondary post-traumatic post-recovery peri-implant fracture is a rare presentation. 28-year-old pilon rider male sustained open complex fracture of left metaphyseal distal femur with Hoffa extension and tear in extensor mechanism. He was treated within a golden hour period of wound management. Primary stabilization by distal femoral locking plate and cannulated cancellous screw was done along with primary bone grafting and repair of extensor mechanism. At sixteen weeks, clinic-radiological progression allowed him his pre-injury activities. At seven months, a second trauma resulted in a non-prosthetic peri-implant femoral fracture, another unusual occurrence. Re-osteosynthesis with grafting was done. At twenty months of the primary injury, there was good functional outcome with a painless range of knee flexion to 130° without any extensor lag. Open complex distal femur injury with an associated secondary hit peri-implant fracture presented with significant challenges in management of soft-tissue and reconstruction of bony defect. The early presentation within a golden hour period allowed an early injury assessment to implement primary biological fixation as a treatment modification. Aim was to achieve favorable functional outcome which allowed early return to pre-injury status.
Diagnosis and management of skeletal fluorosis in current scenario: a case report
Authors: Jain Jalaz , Dudeja Shankey , Nandal Gaurav , Sihag Ravi , Kumar Vibhuti , Jain Deepika
Published: October 2020

Skeletal fluorosis is a rare form of toxic metabolic disease of bone characterised by increased incorporation of fluoride in bone. Skeletal fluorosis generally occurs in endemic regions where there is increased ingestion of fluorine in water and or food over a long period of time. Fluorosis is a spectrum of disease ranging from dental, non-skeletal fluorosis to skeletal fluorosis. The disease is characterised by typical clinical and radiological features that raise the suspicion towards diagnosis of the disease. Radiographic features are characterized by generalised osteosclerosis and later ossification of ligaments, tendons and interosseous membranes. Skeletal fluorosis can be easily confused with other rheumatologic disorders. People exposed to large amounts of fluoride show dental changes much earlier than the skeletal effects. Management of fluorosis generally focuses on symptomatic treatment.
Non-vascularized large free fibular bone graft in post- traumatic and infectious ulnar bone defect: a case report
Authors: Nahar Kuldeep , Nahar Nikita
Published: October 2020

This reported case is about the successful union of an adult male, having open post traumatic infected nonunion of ulna with a bone loss of ulna around 11 cm. Difficult environment around gap nonunion makes the management more difficult for bone graft to stay there. Repeated debridement and skin courage played the key role in controlling the infection. A calculated risk of putting a non-vascular 12 cm autologous fibular graft fixed with plate and screws and supported with medullary nail was taken and a successful union achieved within 4.5 months. So nonvascular free can be a choice for critical bone defects nonunion in fore bones post traumatic one also.