Search

Supplemental material, sj-docx-1-pib-10.1177_09544054231168682 for Optimization of cost and performance of the material used in the mechanism unit of Air Circuit Breaker (ACB) based on various analysis approach by Mukesh Kumar Nag and Parmanand Kumar in Proceedings of the Institution of Mechanical Engineers, Part B: Journal of Engineering Manufacture

Supplemental material, sj-docx-1-pib-10.1177_09544054231168682 for Optimization of cost and performance of the material used in the mechanism unit of Air Circuit Breaker (ACB) based on various analysis approach by Mukesh Kumar Nag and Parmanand Kumar in Proceedings of the Institution of Mechanical Engineers, Part B: Journal of Engineering Manufacture

Purpose To describe a novel modification of tuck-in Tenon's patch graft (TPG) using temporary horizontal mattress sutures and fibrin glue to hitch the graft in the management of corneal perforations. Design Ambispective interventional case series. Methods Modified technique of autologous TPG was used to seal corneal perforations measuring 3–5 mm, using horizontal mattress sutures to hitch the graft in a lamellar pocket, followed by application of fibrin glue. The horizontal mattress sutures were removed after the reformation of the anterior chamber. The primary outcome measure was a well formed anterior chamber in the post-operative period and the secondary outcome was epithelization time. Results The surgery was performed in 22 eyes. The mean age was 43.86 ± 16.02 (26–66) years, with 14 males and eight females. The etiologies of corneal perforation included dry eye (n = 10), neurotrophic keratitis (n = 6), trauma (n = 2), chemical injury (n = 2) and exposure (n = 2). The mean size of the perforation with the thinned-out area was 4.3 mm (range 3–5 mm). The mean duration of epithelialization was 14.31 ± 2.63 days (7–21 days). No intraoperative complications were observed. All eyes had a well-formed anterior chamber in the immediate postoperative period. Postoperatively, two eyes had graft pseudoectasia due to a thick graft and supra tenon haemorrhage each; one eye each had graft thinning with the formation of pseudopterygium and graft melting. Conclusion Tenon's patch graft, along with the use of temporary horizontal mattress sutures and fibrin glue, is an effective modification of the technique for managing corneal perforations measuring 3–5 mm.

The optimal treatment of the calcaneal fracture is a controversial topic. Many patients get a very good result with open reduction and internal fixation using extensile lateral approach. But there are many patients who do not qualify this category. This is the reason why many of them are either denied any surgical intervention or are put at a significant risk of developing major complications because of the open surgical intervention. The height, width, length and shape of the hind foot can be restored using Minimally invasive reduction and fixation (MIRF) and also the orientation of the posterior facet of calcaneus (Bohler’s angle) can be restored. In this paper we present a series of 23 patients treated with minimally invasive reduction and fixation using Steinmann as a treatment method for the patients not suitable for open reduction and internal fixation. The use of Steinmann pin in the MIRF technique proved out to be very effective. As per our experience the time of the surgery is short and it can be easily performed even in the presence of extensive soft tissue swelling in the period immediate after the injury. The risk of infection is low also the morphology of the calcaneus was improved and properly maintained in the term of Bohler’s angle. This technique is very suitable for the patients with medical co-morbidities such as smokers, diabetics and is also very effective for the patients who are not suitable foe extensile approach and internal fixation.

Acute lymphoblastic leukaemia (ALL) is the most common childhood cancer, with 70%–80% of cases curable with modern chemotherapy. However, 20% of the cases suffer from disease relapse with bone marrow being the most common site. Isolated ocular involvement as the first sign of relapse is extremely rare, occurring in less than 2.2% of cases. The presentation of optic nerve involvement in leukaemia represents a visual emergency and a sign of isolated central nervous system relapse even in the absence of abnormal cerebrospinal fluid cytology. This case highlights the importance of routine ophthalmic screening in ALL even during maintenance phase and prompt initiation of treatment in cases with isolated optic nerve involvement.