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  1. Vasanthakumari Sivasankara Pillai A, Sabarathinam C, Keesari T, Chandrasekar T, Rajendiran T, Senapathi V, et al.
    Environ Sci Pollut Res Int, 2020 Jun;27(16):20037-20054.
    PMID: 32236808 DOI: 10.1007/s11356-020-08258-6
    Hydrogeochemical understanding of groundwater is essential for the effective management of groundwater. This study has been carried out to have concrete data for the seasonal variations in hydrogeochemistry of groundwater in central Tamilnadu forming a complex geological terrain with a varied lithology. A total of 244 groundwater samples were collected during four different seasons, viz, southwest monsoon (SWM), summer (SUM), postmonsoon (POM), and northeast monsoon (NEM) from bore wells. The physical parameters such as pH, temperature, TDS, ORP, humidity, and electrical conductivity (EC) were measured insitu, whereas major ions were analyzed in the lab adopting standard procedures. Overall, higher EC and NO3 values were observed and exceeded the WHO permissible limit irrespective of seasons, except for NO3 in SWM. Na and HCO3 are the dominant cation and anion in the groundwater irrespective of seasons. The highest average values of Na (65.06 mg L-1) and HCO3 (350.75 mg L-1) were noted during SWM. Statistical analysis was carried out to elucidate the hydrogeochemistry of the region. Initially, to understand the ionic relationship, correlation matrix was used followed by factor analysis for determination of major geochemical control and later factor scores were derived to understand the regional representations. An attempt has also been made to identify the samples influenced by multiple geochemical processes and to understand their spatial variation in the study period. Correlation of geochemical parameters reveals a excellent positive correlation between Ca and NO3 in SUM, SWM, and NEM due to the dominant of anthropogenic sources and minor influence of weathering process. Strongly loaded factor scores are found to be mostly in the following order POM > NEM > SWM > SUM. Principal component analysis of different seasons indicates the interplay of natural weathering and anthropogenic factors. Overall, the predominant geochemical processes in this region, irrespective of seasons are weathering and, ion exchange and anthropogenic activities.
  2. Pillai AR, Kumar GJ, Kumar P, Nizar SA, Pendyala SK, Baig FAH
    J Pharm Bioallied Sci, 2023 Jul;15(Suppl 1):S110-S113.
    PMID: 37654296 DOI: 10.4103/jpbs.jpbs_430_22
    The goal of this study is to find a cure for the masticatory muscle disease known as hemimasticatory spasm (HMS). This retrospective investigation intends to find a more efficient therapeutic approach for HMS patients by examining the clinical effectiveness of masseteric nerve avulsion performed on HMS using a temporomandibular arthroscope. A clinical study was piloted where the subjects were treated for masseter nerve avulsion by TMJ arthroscopy. The follow-up was done till 2 years, and the subjects were evaluated for the various characteristics like difficulties, masticatory abilities, and various sounds at the joint for the various functions of the joint. The diagnosis was done using the electrophysiological electromyogram (EMG) at the designated time intervals. There was a complete remission in all the subjects. The masseter nerve avulsion was effective since the scores lowered. Within 3 years of the operation, electrophysiological EMG depicted no discharge potential with a high frequency, and the total efficiency when paired with the clinical effectiveness was deemed acceptable. The maximal masseter power between the treated and nontreated sides was comparable. The mastication, on comparing, was also as effective as the normal side; however, lower mastication was noted in the first year. The avulsed nerve tissues lacked any apparent demyelination. Masseteric nerve avulsion with temporomandibular arthroscope assistance provided acceptable and stable total effectiveness for the intervention of the hemimasticatory spasm. While the strength of the muscle of the afflicted side was only marginally reduced, its masticatory effectiveness was optimally preserved.
  3. Theyvan Balakrishnan T, Bilal A, Fitzpatrick N, Dahiya R, Soelar SA, Khalid K, et al.
    Cureus, 2023 Nov;15(11):e48586.
    PMID: 38024046 DOI: 10.7759/cureus.48586
    INTRODUCTION: Over the past decade, there has been a growing interest in the identification and treatment of posterior malleolus fragments, driven by a better understanding of their significance. The Mason & Molloy (M&M) classification system has emerged as a valuable tool for systematically categorizing these fractures and assisting clinicians in formulating treatment. We aim to assess the interobserver reliability of the M&M classification for posterior malleolus fracture by using 20 raters.

    METHODOLOGY: The study was conducted at a major foot and ankle referral center in Wythenshawe, Manchester, UK. Thirty-eight Computed Tomography (CT) scans were evaluated by 20 independent raters: 15 general orthopedic and trauma surgeons plus five foot and ankle surgeons. Each rater classified the posterior malleolus fracture according to M&M classification into type 1, 2A, 2B, 3, or not classifiable. Statistical analysis was done with the R software package and SPSS (v26; IBM Corp., Armonk, NY). Fleiss kappa (κ) coefficient with a 95% confidence interval (CI) was applied.

    RESULTS: The interobserver agreement was moderate with a global κ value of 0.531 (95% CI: 0.518, 0.544). There were good agreements for identifying type 3 M&M (κ=0.785) and those that are not applicable for M&M classification (κ=0.785). There was a strong correlation between all raters in using M&M classification (Tb=0.53-0.59) except for Rater 12.

    CONCLUSION: M&M classification remains a valuable tool to guide the management of patients with these subsets of ankle fractures.

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