Background:
We hypothesized that leucocyte esterase strip test can aid in diagnosing septic arthritis in native synovial fluid because leucocyte esterase concentrations would be elevated at the ...infection site because of secretion by recruited neutrophils.
Method:
The cohort included 27 patients (suspected septic arthritis and normal subjects). A standard chemical test strip (graded as negative, trace, +, ++ or +++) was used to detect the presence of leucocyte esterase. Fluid leucocyte count, Gram staining, culture, erythrocyte sedimentation rate and C-reactive protein were also assessed.
Results:
The leucocyte esterase test with a threshold of ++/+++ had a sensitivity of 79.2% (95% CI confidence interval, 65.9% to 89.2%), specificity of 80.8% (95% CI, 73.3% to 87.1%), positive predictive value (PPV) of 61.8% (95% CI, 49.2% to 73.3%) and negative predictive value (NPV) of 90.1% (95% CI, 84.3% to 95.4%).
Conclusion:
The leucocyte esterase strip test yielded a high specificity, PPV, NPV, high sensitivity and high diagnostic accuracy. Leucocyte esterase is an accurate, quick and bedside test for septic arthritis and can be used effectively for diagnosing periprosthetic joint infections along with other battery of tests according to the Musculoskeletal Infection Society criteria.
Pipkin type 3 fracture-dislocation constitutes a rare subgroup of fractures involving the femoral neck and head fracture. The management is difficult and controversial, including osteosynthesis using ...Herbert or cancellous screws and hip replacement surgery. In this case report, a 26-year-old male suffered a road traffic accident leading to a hip fracture. Radiographs and computed tomography scan of the hip depicted three large fragments of the femur head, dislocated posteriorly along with the neck of femur fracture. Considering the needs of the patient, fracture morphology, and unpredictable results of the osteosynthesis, the patient was treated primarily with uncemented total hip replacement. The complexity of the fracture leads to more chances of malreduction and avascular necrosis of the femur head. The patient had an uneventful intra and postoperative period. At the 3-year follow-up, the patient was walking unaided, pain-free, and performing all the activities of daily living satisfactorily.
To compare the efficacy of two periarticular cocktail regimens for analgesia in postoperative patients of total knee replacement.
This is a Randomized Control study done over the duration of 1.5 ...years. Twenty-five knees of either gender were selected with inclusion criteria (All osteoarthritis patients planned for TKA) and exclusion criteria (Inflammatory arthritis, patients allergic to local anaesthetic e.g. Ropivacaine, bupivacaine, known cardiac disorder patient having AV block, arrhythmia) & divided into 2 groups.
Group A was given a cocktail of Ropivacaine, adrenaline, clonidine & cefuroxime.
Group B was given a cocktail of bupivacaine, fentanyl, methylprednisolone & cefuroxime. The preoperative pain of the patient was assessed using VAS score. Combined spinal and epidural anaesthesia was given using 0.5% 2 ml of bupivacaine heavy in all patients. After taking bone cuts & before the placement of the implant, cocktail of the drug was infiltrated using sterile technique into 9 specific sites. The amount of drug infiltrated was calculated according to the weight of the patient.
The patients were assessed on: Pain relief postoperatively at specific duration using VAS score. The amount & frequency of epidural top-ups required. Knee ROM, Quadriceps strength, Extensor lag & Knee society score were assessed.
Out of the total 25 knees included in the study, 12 belonged to Group A and 13 belonged to Group B. It was observed that 4 (33%) out of 12 Group A patient needed injection tramadol for 2–3 days and fentanyl patch 25mcg. In Group B, one (8%) out of 13 patients required injection tramadol and fentanyl dermal patch for 2–3 days. The difference in additionally required analgesic between patients of the two groups is statistically significant.
The VAS score of Group B was statistically lower than Group A patients till first 24 h postoperatively.
The extension lag was lower in group B compared to group A at 24 h after the surgery and up to 5 days. Overall after 6 weeks of follow-up, the extensor lag between the groups was not statistically significant.
Average KSS in group A was 79.58 and in the group, B was 83.99 and the difference in KSS between patients of the two groups was statistically significant.
Both the cocktail regimens are effective in pain control postoperatively. The relief in pain with regimen B containing bupivacaine, fentanyl, methylprednisolone and cefuroxime was more striking in the first 24 h. By the end of two days, both regimens were found to be equally effective.
Wastewater from textile industries is a potential source of organic dyes in natural water bodies. Environmental concerns of chemical methods for removal of dyes from wastewater are no more a viable ...solution, and there is growing concern to develop alternative approaches such as green chemistry and phytoremediation. This study reports the removal of organic dyes from wastewater using
Eichhornia crassipes
(Mart.) Solms (water hyacinth), as an easily available and fast-growing plant species. Growth of water hyacinth among individual cationic (rose bengal (RB), methylene blue (MB), crystal violet (CV), auramine O (AO), rhodamine B (RhB) and anionic (xylenol orange (XO), phenol red (PR), cresol red (CR), methyl orange (MO)) dye solutions and degradation of dyes were monitored. Results indicated that water hyacinth has good absorption and degradation potential for both types of dyes (cationic or anionic) and effectively removes dyes from solution. Water hyacinth can be used as a suitable and effective phytoremediate for removal of organic dyes from the wastewater.
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