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Research paper thumbnail of Comparative study of Vitamin D and Parathyroid Hormone Status among Fragility Hip Fracture Cases and Elderly Control Subjects in Rajasthan, India

Introduction: Vitamin D deficiency and secondary hyperparathyroidism play central role in pathoge... more Introduction: Vitamin D deficiency and secondary hyperparathyroidism play central role in pathogenesis of fragility hip fractures among geriatric population. Osteoporosis, osteomalacia, deranged renal profile and poor muscle function lead to brittle bones and frequent falls which together are important in causation of hip fractures. Aim of the study was to characterize and quantify Vitamin D and Parathyroid hormone levels among the elderly patients with fragility hip fractures and apparently healthy controls among patients of Rajasthan state, India. Material and Methods: 64 elderly (age>60 years) subjects suffering from non-traumatic hip fractures and 64 healthy control subjects included in study and their venous blood samples were analyzed for vitamin D, PTH, alkaline phosphatase and serum calcium levels. Results: A high prevalence of vitamin D deficiency (90.65%) was found in case group compared to 68.75% among controls. Mean serum 25(OH)D was 12.47±4.52 ng/ml in hip fracture g...

Research paper thumbnail of Primary ilizarov external fixation in open grade III type C distal femur fractures: Our experience

Journal of Clinical Orthopaedics and Trauma, 2019

Research paper thumbnail of Short Term Outcome of Varus Derotation Osteotomy in Late Presenting Perthes Disease

Indian journal of orthopaedics

Untreated Perthes disease can lead to osteoarthritis by the fourth decade. The treatment is conse... more Untreated Perthes disease can lead to osteoarthritis by the fourth decade. The treatment is conservative for children <6 years, operative within the age group of 6-9 years. Late onset Perthes, older than 9 years or more, are notorious with the aggressive course with poor outcome. However, literature do not come to a consensus between conservative and operative management. This study evaluates the clinical and radiological outcome of varus derotation osteotomy (VDRO) in Perthes disease presenting late with age 8 years or more. 15 children (13 males and 2 females) with the mean age of 9.4 years belonging to modified Elizabethtown classification Stage IB, IIA, IIB treated with open wedge VDRO between 2008 and 2014 were included in this study. Seven patients (46.67%) were of >10 years of age at presentation. All patients had limitation of abduction and internal rotation. Eight patients (53.33%) had pain at the hip and 12 patients (80%) had limp. Mean time between diagnosis and cor...

Research paper thumbnail of Bladder incarceration following anterior pelvic infix of a traumatic pubic symphysis diastasis treated with immediate open reduction and internal fixation

Journal of Clinical Orthopaedics and Trauma, 2017

Stabilization after a pelvic fracture can be accomplished using multiple techniques. The anterior... more Stabilization after a pelvic fracture can be accomplished using multiple techniques. The anterior external fixator has been traditionally used in variety of unstable pelvis either singly or in combination of posterior screws. These devices are cumbersome and restrict side turning and sitting particularly in obese patients. An alternative, anterior subcutaneous pelvic internal fixation technique (ASPIF) was developed which is well tolerated by patients for mobility and comfort and biomechanically more stable construct Complications of this construct included irritation of the lateral femoral cutaneous nerve, femoral nerve palsy &heterotypic ossification with reduced rates of infections and aseptic loosening as compared to external fixator. Bladder incarceration following treatment has never been reported and we encountered such a problem during management which we want to highlight.

Research paper thumbnail of Identifying Galactic PeVatrons with neutrinos

Astroparticle Physics, 2009

We perform a realistic evaluation of the potential of IceCube, a kilometer-scale neutrino detecto... more We perform a realistic evaluation of the potential of IceCube, a kilometer-scale neutrino detector under construction at the South Pole, to detect neutrinos in the direction of the potential accelerators of the Galactic cosmic rays. We take fully account of the fact that the measurement of the energy of the secondary muons can be used to further discriminate between the signal and the background of atmospheric neutrinos. We conclude that IceCube could identify the sources in the Milagro sky map as the sources of the Galactic cosmic rays at the 3σ level in one year and at the 5σ level in three years. We discuss the dependence of these expectations on ambiguities, mostly associated with our incomplete knowledge of the astrophysics of the sources.

Research paper thumbnail of Biological Reconstruction of Knee Joint by Pedicled Patellar Transplant in a Recurrent Giant-cell Tumor of Lateral Femoral Condyle: A Case Report

Introduction: Giant-cell tumors (GCTs) are benign tumors of musculoskeletal system, commonly occu... more Introduction: Giant-cell tumors (GCTs) are benign tumors of musculoskeletal system, commonly occur around knee. High-grade GCTs have a high tendency to recur after intralesional curettage. Reconstruction of joint after excision of such aggressive juxta-articular GCT has been challenging task. We describe a case of recurrence in GCT of lateral femoral condyle managed with tumor excision and pedicled patellar transplant to reconstruct the joint. Case Report: A 25-year-old male patient reported to us after 22 months after he had undergone curettage and bone grafting for GCT of lateral femoral condyle of his right knee with recurrence of primary tumor. After tumor resection, we restored the lost articular surface with musculovascular pedicled patella and managed dead space with corticocancellous bone graft and fibular strut. 2-year follow-up exhibited good functional outcome without any sign of recurrence. Conclusion: Biological reconstruction with patellar transplant can be a good opti...

Research paper thumbnail of Comparative study of Vitamin D and Parathyroid Hormone Status among Fragility Hip Fracture Cases and Elderly Control Subjects in Rajasthan, India

Introduction: Vitamin D deficiency and secondary hyperparathyroidism play central role in pathoge... more Introduction: Vitamin D deficiency and secondary hyperparathyroidism play central role in pathogenesis of fragility hip fractures among geriatric population. Osteoporosis, osteomalacia, deranged renal profile and poor muscle function lead to brittle bones and frequent falls which together are important in causation of hip fractures. Aim of the study was to characterize and quantify Vitamin D and Parathyroid hormone levels among the elderly patients with fragility hip fractures and apparently healthy controls among patients of Rajasthan state, India. Material and Methods: 64 elderly (age>60 years) subjects suffering from non-traumatic hip fractures and 64 healthy control subjects included in study and their venous blood samples were analyzed for vitamin D, PTH, alkaline phosphatase and serum calcium levels. Results: A high prevalence of vitamin D deficiency (90.65%) was found in case group compared to 68.75% among controls. Mean serum 25(OH)D was 12.47±4.52 ng/ml in hip fracture g...

Research paper thumbnail of Primary ilizarov external fixation in open grade III type C distal femur fractures: Our experience

Journal of Clinical Orthopaedics and Trauma, 2019

Research paper thumbnail of Short Term Outcome of Varus Derotation Osteotomy in Late Presenting Perthes Disease

Indian journal of orthopaedics

Untreated Perthes disease can lead to osteoarthritis by the fourth decade. The treatment is conse... more Untreated Perthes disease can lead to osteoarthritis by the fourth decade. The treatment is conservative for children <6 years, operative within the age group of 6-9 years. Late onset Perthes, older than 9 years or more, are notorious with the aggressive course with poor outcome. However, literature do not come to a consensus between conservative and operative management. This study evaluates the clinical and radiological outcome of varus derotation osteotomy (VDRO) in Perthes disease presenting late with age 8 years or more. 15 children (13 males and 2 females) with the mean age of 9.4 years belonging to modified Elizabethtown classification Stage IB, IIA, IIB treated with open wedge VDRO between 2008 and 2014 were included in this study. Seven patients (46.67%) were of >10 years of age at presentation. All patients had limitation of abduction and internal rotation. Eight patients (53.33%) had pain at the hip and 12 patients (80%) had limp. Mean time between diagnosis and cor...

Research paper thumbnail of Bladder incarceration following anterior pelvic infix of a traumatic pubic symphysis diastasis treated with immediate open reduction and internal fixation

Journal of Clinical Orthopaedics and Trauma, 2017

Stabilization after a pelvic fracture can be accomplished using multiple techniques. The anterior... more Stabilization after a pelvic fracture can be accomplished using multiple techniques. The anterior external fixator has been traditionally used in variety of unstable pelvis either singly or in combination of posterior screws. These devices are cumbersome and restrict side turning and sitting particularly in obese patients. An alternative, anterior subcutaneous pelvic internal fixation technique (ASPIF) was developed which is well tolerated by patients for mobility and comfort and biomechanically more stable construct Complications of this construct included irritation of the lateral femoral cutaneous nerve, femoral nerve palsy &heterotypic ossification with reduced rates of infections and aseptic loosening as compared to external fixator. Bladder incarceration following treatment has never been reported and we encountered such a problem during management which we want to highlight.

Research paper thumbnail of Identifying Galactic PeVatrons with neutrinos

Astroparticle Physics, 2009

We perform a realistic evaluation of the potential of IceCube, a kilometer-scale neutrino detecto... more We perform a realistic evaluation of the potential of IceCube, a kilometer-scale neutrino detector under construction at the South Pole, to detect neutrinos in the direction of the potential accelerators of the Galactic cosmic rays. We take fully account of the fact that the measurement of the energy of the secondary muons can be used to further discriminate between the signal and the background of atmospheric neutrinos. We conclude that IceCube could identify the sources in the Milagro sky map as the sources of the Galactic cosmic rays at the 3σ level in one year and at the 5σ level in three years. We discuss the dependence of these expectations on ambiguities, mostly associated with our incomplete knowledge of the astrophysics of the sources.

Research paper thumbnail of Biological Reconstruction of Knee Joint by Pedicled Patellar Transplant in a Recurrent Giant-cell Tumor of Lateral Femoral Condyle: A Case Report

Introduction: Giant-cell tumors (GCTs) are benign tumors of musculoskeletal system, commonly occu... more Introduction: Giant-cell tumors (GCTs) are benign tumors of musculoskeletal system, commonly occur around knee. High-grade GCTs have a high tendency to recur after intralesional curettage. Reconstruction of joint after excision of such aggressive juxta-articular GCT has been challenging task. We describe a case of recurrence in GCT of lateral femoral condyle managed with tumor excision and pedicled patellar transplant to reconstruct the joint. Case Report: A 25-year-old male patient reported to us after 22 months after he had undergone curettage and bone grafting for GCT of lateral femoral condyle of his right knee with recurrence of primary tumor. After tumor resection, we restored the lost articular surface with musculovascular pedicled patella and managed dead space with corticocancellous bone graft and fibular strut. 2-year follow-up exhibited good functional outcome without any sign of recurrence. Conclusion: Biological reconstruction with patellar transplant can be a good opti...