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Personality detection has become an important area of research due to its potential applications in various fields such as marketing, psychology, and human resource management. In this paper, we present a personality detector that utilizes the Big Five personality traits model to analyze and predict the personality traits of individuals. The Big Five personality traits model is widely used in personality psychology, and it consists of five dimensions: openness, conscientiousness, extraversion, agreeableness, and neuroticism. Our system utilizes a machine learning algorithm that analyzes various features such as text, social media posts, and speech to predict an individual's personality traits. The front-end of the system is developed using Python and Django, making it easy to use and accessible to anyone with an internet connection. We evaluated our system using a dataset of 1000 individuals and achieved an accuracy of 85% in predicting their personality traits

Background: The present study was done to evaluate the functional outcome and complications after open reduction and internal fixation of acetabulum fractures. Material and methods: The present study was done in 44 patients of fracture acetabulum managed by open reduction internal fixation in the Department of Orthopaedic surgery, Indira Gandhi Medical College, Shimla. Results: There were 16 prospective (36.4%) and 28 retrospective (63.6%) cases. The mean age was 45.07 years with maximum number of 39 (88%) patients in the age group of 21- 60 years. Majority (77.3%) of the patients was males and 22.8 % were females. Modified Merle d’Aubigne and postel (MDA) score was excellent in 77%patients, good in 13%, fair in 10%. Matta’s radiological score at final follow up was excellent in 54.55%, good in 36.36%, fair in 4.55% and poor in 4.54% patients. The average Modified Harris Hip score was 94 at final follow up in 44 patients. Patients with anterior column fracture had HHS of 96 at final follow up; posterior wall fracture patients had average HHS of 92 at final follow up. Two patients had complications. One patient had femoral head fracture along with fracture of posterior wall developed AVN and also had subsequently Secondary OA with post-operative subluxation of femoral head. Thus three complications were seen in this patient. Another patient with fracture dislocation with fracture of posterior wall developed AVN and subsequently secondary OA 5 year after surgery. No patient developed sciatic nerve injury post operatively. None of patients developed postoperative sciatic nerve palsy. No patient died during treatment or follow up. Conclusion: Open reduction and internal fixation as a gold standard for acetabulum fractures which is indicated with excellent to good results in majority of the patients as assessed by Modified Merle d’Aubigne score, Modified Harris hip score and Matta Radiological score with minimal complications at final follow up.

Background: The present study was done to evaluate the sociodemographic and clinical parameters after open reduction and internal fixation of acetabulum fractures. Material and methods: The present study was done in 44 patients of fracture acetabulum managed by open reduction internal fixation in the Department of Orthopaedic surgery, Indira Gandhi Medical College, Shimla. Results: There were 16 prospective (36.4%) and 28 retrospective (63.6%) cases. The mean age was 45.07 years with maximum number of 39 (88%) patients in the age group of 21- 60 years. Majority (77.3%) of the patients was males and 22.8 % were females. Forty three (97.7%) patients belonged to rural area and remaining 1(2.3%) patient belonged to urban area. Road traffic accident was the mode of injury in 63.6% patients followed by fall from height in 36.4%. Eighteen (41%) patients had posterior wall fracture followed by posterior wall with posterior column fracture was seen in 12 (27%). Average time interval between injury and surgery was 15 days (range 3-55 days). Thirty six percent of the patients were operated between 8-14 days and 34 % of patients between 0-7days. Thirty (68%) patients were operated by Kocher-Langenbeck approach in lateral position followed by 7 (15%) patients with ilioinguinal approach in supine position. Autogenous Bone graft was used in 31.7% of patients. Mean duration of hospital stay was 24 days (range 7-35 days). Conclusion: Study concluded that most of the patients were in the age group of 21- 60 years, males, belonged to rural area, injured due to Road traffic accidents, had posterior wall, operated within 15 days and were operated by Kocher-Langenbeck approach in lateral position.

Background: Present study was done to evaluate the Final outcome and complications among patients of proximal tibial fractures treated with open reduction internal fixation with locking compression plate. Material and Methods: The study was conducted during 1st August 2019 to 31st October 2020 in the Department of Orthopaedic Surgery, Indira Gandhi Medical College Shimla that included 21 prospective and 4 retrospective cases who fulfilled the inclusion criteria with closed tibial plateau fracture. Final outcomes were obtained after combining functional and radiological outcomes. Results: All the patients were above 18 years of age; 60% of patients were between 31 to 60 years with mean age of 42.5±14.4 years. There were 21 males and 4 females. The ratio between male to female patients was 5.3:1. Fifty six percent patients had excellent, 36% had good and 2% had fair functional outcome. Excellent radiological results were seen in 76%, good in 20% and fair in 4% patient. No patient had poor functional and radiological results. At the end of the study, we found that 92% of our patients had acceptable results which included excellent in 56% and good in 36%. While no patient had poor outcome, 8% patients reported a fair but non-acceptable final outcome. Final outcomes was dependent on age, activity level of the patients, type of fracture, associated injuries, other co-morbidities and compliance to physiotherapy presence or absence of complications, other co-morbidities and postoperative rehabilitation. Twenty percent patients had complications. Superficial infection (8%) and knee stiffness (8%) were the most common complications. Conclusion: Majority of patients of proximal tibial fractures treated with open reduction internal fixation with locking compression plate had excellent clinical and radiological results and had acceptable results. Superficial infection and knee stiffness were the most common complications.

Background: Present study was done to evaluate the Postoperative Clinical and Radiological assessment among patients of proximal tibial fractures treated with open reduction internal fixation with locking compression plate. Material and Methods: The study was conducted during 1st August 2019 to 31st October 2020 in the Department of Orthopaedic Surgery, Indira Gandhi Medical College Shimla that included 21 prospective and 4 retrospective cases who fulfilled the inclusion criteria with closed tibial plateau fracture. Results: All the patients were above 18 years of age; 60% of patients were between 31 to 60 years with mean age of 42.5±14.4 years. There were 21 males and 4 females. The ratio between male to female patients was 5.3:1. Post-operatively eighty percent patients had no articular step and 20% had residual step less than 5 mm. Condylar width was normal in 84% patients while 16% patients had residual widening of less than 5mm. Osteoarthritis occurred or progressed by one or two grades in 16% patients. Eighty four percent of the patients had no or mild pain and 16% of the patients had moderate pain on activity involving the knee joint. Average knee flexion achieved at final follow up was 128.40±9.20 and average extension was 8.60±1.20. All patients exhibited excellent to good stability. Rasmussen’s criteria showed excellent functional result in 56% patient, good in 36% patient and 8% patient had fair result. Mean Rasmussen functional score was 27.32.Excellent radiological results were observed in 76% patients, 20% patients had good and 4% had fair results. Mean Rasmussen radiological score was 8.24. Conclusion: Post-operatively, there was decrease in articular depression, restoration of condylar widening to normal, osteoarthritis was not present or not progressed, restoration of full Range of motion both in flexion as well in extension and had excellent Clinical and Radiological results according to Rasmussen score in majority of treated patients.

In the milieu of coronavirus disease 2019 (COVID-19), there are increasing reports of paediatric hyperinflammatory conditions (PHICs), including multisystem inflammatory syndrome in children (MIS-C), paediatric multisystem inflammatory syndrome temporally associated with SARS-CoV-2 (PIMS-TS) and Kawasaki disease (KD). Few analyses of PHIC prevalence in paediatric and adolescent hospitalized COVID-19 patients exist. The purpose of this study was to perform a meta-analysis to determine a pooled prevalence estimate of PHICs in paediatric and adolescent hospitalized patients admitted for treatment due to COVID-19. Individual studies were retrieved from PubMed/Medline, EMBASE and Cochrane databases. Relevant prevalence, baseline, treatment and outcome data were extracted using a standardized datasheet. The systematic review and meta-analysis were conducted as per the PRISMA and MOOSE guidelines. Overall, 14 studies with 2202 patients admitted for treatment due to COVID-19, among whom 780 were diagnosed with PHICs, were included. The crude estimate of prevalence was 35.42%, and the pooled estimate of prevalence was 29% (random pooled ES = 0.29; 95% CIs = 0.18-0.42; p 0.0001; z = 7.45). A sizeable proportion of paediatric and adolescent hospitalized patients admitted for treatment due to COVID-19 are diagnosed with a PHIC warranting a high index of clinical suspicion for PHICs. Further studies are required to validate these findings.

The hard-magnetic soft materials (HMSMs) belong to the magnetoactive category of smart polymers that undergo large actuation strain under an externally applied magnetic field and can sustain a high residual magnetic flux density. Because of these remarkable characteristics, HMSMs are promising candidates for the remotely controlled actuators. The magnetic actuation behavior of the hard-magnetic soft actuators (HMSAs) is considerably affected by the viscoelastic material behavior of HMSMs. In this article, we aim at developing an analytical dynamic model of a typical planar model of HMSAs concerning the viscoelasticity of HMSMs. A Zener rheological model in conjunction with an incompressible neo-Hookean model of hyperelasticity and Rayleigh dissipation function is employed for defining the constitutive behavior of the viscoelastic HMSA. The governing equations of dynamic motion are deduced by implementing the nonconservative form of the Euler–Lagrange equation. The established dynamic model is utilized for providing preliminary insights pertaining to the effect of the viscoelasticity on the nonlinear oscillations of the actuator. The phase–plane portraits, Poincaré maps, and the time–history response are plotted to investigate the stability, resonant behavior, and periodicity of the actuator. The results and inferences reported here should provide the initial step toward the design and the development of modern actuators for diverse futuristic applications in the medical and engineering fields.

BACKGROUND: Tension band wiring supposedly is the most commonly used technique for displaced patella fractures, but is not effective in comminuted fractures and osteoporotic bones. It often leads to loosening of wires, dislocation of fracture, hardware problem and failure of osteosynthesis, resulting in knee stiffness and post-traumatic osteoarthritis. The aim of the study is to evaluate clinical outcome in patients with acute patella fractures (

There is an ongoing need for accurate prognostic biomarkers in the milieu of acute ischemic stroke (AIS) receiving reperfusion therapy. Neutrophil-lymphocyte ratio (NLR) has been implicated in emergency medicine and acute stroke setting as an important biomarker in the prognosis of patients. However, there are ongoing questions around its accuracy and translation into clinical practice given suboptimal sensitivity and specificity results, as well as varying thresholds and lack of clarity around which NLR time points are most clinically indicative. This article provides a comprehensive overview of the role of NLR in AIS patients receiving reperfusion therapy and perspectives on areas of future research. NLR may be an important biomarker in risk stratifying patients in AIS to identify and select those who are more likely to benefit from reperfusion therapy. Appropriate clinical decision-making tools and models are required to harness the predictive value of NLR, which could be useful in identifying and monitoring high-risk patients to guide early treatment and achieve improved outcomes. Our understanding of the role of NLR in the immunopathogenesis of AIS is also suboptimal, which hinders the ability to translate this into clinical practice.

Introduction A subtrochanteric proximal femur fracture occurs in the 5 cm of bone immediately distal to the lesser trochanter. UK national guidelines advise that adults with subtrochanteric fractures should be treated with an intramedullary nail (IMN). This study aims to compare peri-operative outcome measures of patients with subtrochanteric fractures treated with either an IMN or a dynamic hip screw (DHS) construct. Materials and Methods We retrospectively reviewed subtrochanteric fractures presenting at our institution over 4.5 years (October 2014–May 2019), classifying them into two treatment groups; IMN and DHS. These groups were compared on outcome measures including surgical time, blood loss, radiation dose area product (DAP), length of stay, re-operation rate and mortality. Results During the time period studied, 86 patients presented with a subtrochanteric fracture of the femur; with 74 patients (86%) receiving an IMN and 12 (14%) receiving a DHS. The comparative outcome measures reaching statistical significance were blood loss and radiation DAP. The DHS group showed a significantly lower mean blood loss of 776 ml compared to 1029 ml in the IMN group. Also, the DHS group showed a significantly lower mean DAP of 150.30 mGy cm2 compared to 288.86 mGy cm2 in the IMN group. Conclusion Although UK national guidelines recommend treating all subtrochanteric fractures with an IMN; the outcome measures assessed in our study did not show use of an IMN to be superior to a DHS. The DHS group showed a lower estimated blood loss and a reduced DAP. This, along with the reduced financial cost associated with a DHS, may support the use of DHS over IMN for certain subtrochanteric fractures of the femur. There may not be a single favourable implant for the treatment of subtrochanteric fractures as a whole; instead different subtypes of fracture may be amenable to a number of fixation devices. Choice of implant should be determined locally and based on existing and future clinical and health economic research.

Study Design: Prospective nonrandomized study. Objective: Objective of the study was to ascertain etiological correlation between Modic changes (MC) and bacterial infection through 16s DNA sequencing in patients with chronic low backache. Summary of Background Data: Modic changes are common on magnetic resonance imaging (MRI) of patients with low back pain and are strongly associated with low back pain. Various factors are associated with the etiology; of these, degeneration and mechanical factors are most common. Some studies have also found etiological relation between MC and infection. Material and Method: The study involved 20 patients of either sex (age range, 20–65 years) who were investigated for blood count, erythrocyte sedimentation rate, and quantitative C-reactive protein. The intervertebral disc removed during discectomy from each patient was sent for polymerase chain reaction (PCR) study. We have targeted the conserved gene of the bacteria (ie, 16s ribosomal DNA) and used a universal eubacteria nested-amplification protocol that may detect picograms of bacterial DNA. Result: Among the 20 cases of patients who had low back pain and MC in MRI, 13.5% showed raised leucocytosis, 28.6% showed raised erythrocyte sedimentation rate, 72.7% showed raised quantitative C-reactive protein, and 90% of the disc sample showed presence of bacteria in PCR study. Conclusion: MC may have an infective etiology. Level of Evidence: 4.

Introduction: Management of distal femoral fractures is a therapeutic challenge to the orthopaedic and due to its extensive soft tissue injuries, bone loss, comminution, articular extension, instability and usually treated surgically. There is no single implant that can be used for all distal femoral fractures. The introduction of DF-LCP is a welcome change that has brought a drastic change in management of these fractures. Aim: To evaluate the functional outcome of Distal femoral fractures treated with DF-LCP Materials and Methods: This prospective study was carried out at orthopaedics department of a tertiary care teaching hospital of Southern Rajasthan from June 2013 to December 2015. A total 34 patients of AO Type A and Type C distal femur fractures were included in the study. The method used for fixation was closed or open reduction and internal fixation with DF-LCP. All the patients were followed up for a period of one year and functional outcome was assessed according to Neer’s score system. Results: On evaluation according to Neer’s criteria mean score were 87 with a range of 62-97. Out of 34 patients 21(62%) had excellent, 11(32%) satisfactory and 2(6%) unsatisfactory result. Conclusion: We conclude that DF-LCP is a safe and reliable implant for distal femoral fractures AO Type A and Type C. However careful understanding of basic principles and identification of appropriate fracture pattern for use of DF-LCP are essential to avoid complications and to produce excellent result.

Introduction: Compartment syndrome is a common and severe medical condition that can lead to ischemia and ultimately tissue loss. The treatment of choice is emergent fasciotomy to lower the compartment pressure. However, closing fasciotomy wound often presents a problem because of edema and skin retraction. As a result, numerous techniques have been devised to optimize wound closure. AIM: To perform fasciotomy wound closure by shoe lace technique which is a type of dermal apposition technique for gradual primary closure of fasciotomy wound. Materials and Methods: The study included 19 patients who presented with compartment syndrome involving either upper or lower extremities due to various causes. Decompression fasciotomy was performed in all the cases to relieve compartment pressure. Shoe lace technique was performed for closure of wound. Patients demographics, location of fasciotomy, time duration between injury and fasciotomy, number of tightening session, time to primary closure, length of hospital stay, need for skin grafts and any complication if occurred during procedure were recorded. Results: Out of 19 patients 15 were males and 4 were females. Average age was 34.8 years. Lower extremity was involved in 14 cases. Fracture was the cause of compartment syndrome in 16 cases. Closure was obtained at an average of 3.5 tightening session. All the fasciotomy wounds were closed within an average of 8.3 days. Average duration of hospital stay was 12.3 days. No major complication was encountered in the study one case reported to have infection at wound site. Conclusion: Shoe lace technique is a simple and economical method for fasciotomy wound closure. It takes less time to closure, does not need a second procedure for closure thus reduces need of nursing care, hospital stay resulting in lower morbidity, healthcare cost and better aesthetic result.

Objective: To evaluate the clinical and functional outcomes of joint preservation surgery in high-grade giant cell tumors (GCT) around the knee joint.Methods: A retrospective review of 25 patients of high-grade GCT (Campanacci grade 2 and 3) involving proximal tibia or distal femur managed by extended curettage, bone grafting, and stabilization with knee spanning external fixator between 2016 and 2018 was done. The radiographic outcomes, functional outcomes (Musculoskeletal Tumor Society [MSTS] score for lower limb), and complications including donor site morbidity were evaluated.Results: The mean age of the patient population was 24.04 years with an average follow-up period of 30.24 months. Fourteen patients had involvement of distal femur, and 11 involved proximal tibia. There were 16 cases of grade 2 lesions and 9 cases of grade 3 lesions. Twenty-four out of the 25 patients had radiological consolidation of graft, while one patient had graft subsidence. Twenty-two out of 25 patients had full extension and knee flexion more than 100 degrees. The mean MSTS score was 25.2. Three patients had an MSTS score under 20. All three patients had an extension lag with a restricted range of motion.Conclusion: Joint preservation surgery, when done in line with the basic principles of tumor surgery, gives good radiographic and functional outcomes even in grade 2 and 3 giant cell tumors of bone around the knee and should be attempted before replacement surgeries.

Introduction Pancreatic ductal adenocarcinoma (PDAC) often presents late with only 20% of patients being candidates for resection while majority already have advanced metastases with median overall survival of 3–6 months. Currently, the role of oligometastasectomy and local therapy options in PDAC is unknown in patients who have favorable response to systemic chemotherapy. The aim of this study is to analyze the survival outcome of oligometastasectomy and local IRE therapy in select patients who are treated with systemic chemotherapy for PDAC metastases. Methods We utilized a prospective database from 2010 to 2016 to identify patients with local surgical therapy after induction systemic chemotherapy for oligometastatic PDAC (Stage 4). The initial local therapy treatment of distant metastatic lesions was followed by adjuvant chemotherapy. Subsequently, resection of the primary PDAC in conjunction with irreversible electroporation (IRE) was performed after favorable response by RECIST criteria. Results Seven patients were identified with metastatic PDAC treated with oligometastasectomy and/or local therapy. There was single metastatic lesion in 43% (3/7) of which 57% (4/7) were localized in the liver. The treatment of the primary pancreatic cancer was performed utilizing IRE in situ in 6/7 (86%) of patients in our study with resection or radiation of oligometastasis. The median survival in our study group was 16 months with 28% (2/7) patients who remain NED (range 16–41 months). Conclusion Combination of systemic chemotherapy and oligometastasectomy with adjunctive local IRE therapy is a feasible treatment strategy in highly select patients with oligometastatic PDAC that demonstrate favorable tumor biology with objective response to systemic therapy.

The present study aims to evaluate the long-term trends of PM10 at two monitoring stations (an urban and a background station) in Shimla city, in India during the period 2011-2017. The highest daily mean concentrations were determined to be 176μg/m³ and 152μg/m³ respectively at the urban and the background monitoring locations. Similarly, the annual mean concentrations at the monitoring locations were determined to be 59μg/m³ and 45μg/m³ respectively for urban and background concentrations. Exceedance factors determined showed that at the urban monitoring location the ranges varied between ‘moderate to high’ while at the background monitoring station it remained at ‘moderate’ levels. Seasonal analysis study carried out revealed that higher concentrations were observed during summer in comparison to winter with the least concentrations occurring during the monsoon season. A regression analysis was carried out to test the interdependency of the PM10 with other pollutants and a positive correlation was observed between PM10 and NO₂ and SO₂. Similarly, correlation of PM10 with meteorological parameters such as wind speed and temperature were found to be positive while for parameters like precipitation and relative humidity it was negative. The paper also presents a critical discussion on the outcomes of the trend analysis study. This includes design and location of additional monitoring sites to adequately represent the actual ambient air quality conditions in Himachal Pradesh.

Bcl-2 (B-cell CLL/lymphoma 2), a mitochondrial membrane oncoprotein functioning as an inhibitor of apoptosis, is commonly overexpressed in a variety of hematological malignancies promoting apoptotic resistance and leading to poor patient survival. Inhibition of Bcl-2 may result in sustained regression of leukemia/lymphoma. Recently, the promoters of several cancer-related oncogenes, including Bcl-2, were found to contain sequences within nuclease hypersensitivity regions capable of forming quadruplex (four-stranded) DNA. The Bcl-2 quadruplex-forming sequence (Bcl-2 q, 23 bp) is located upstream of the P1 promoter of the Bcl-2 gene and is implicated in the regulation of Bcl-2 transcription, however, the biological role of this sequence remains unclear. We hypothesize that treatment of leukemia cells with the single-stranded, quadruplex-forming sequence (Bcl-2 q) induces cell death by inhibiting gene expression. To determine the biological role of the Bcl-2 q on leukemic cell proliferation, U937 and HL60 were treated with Bcl-2 q or the corresponding mutant sequence (MutBcl-2), which lacks runs of two or more guanines. Changes in cell proliferation were compared to levels of Bcl-2 protein expression. Quadruplex formation was confirmed by circular dichroism spectroscopy. Our results demonstrate that Bcl-2 q formed a stable parallel quadruplex structure, while the MutBcl-2 sequence did not form a quadruplex. Treatment of leukemia cells with Bcl-2 q caused a significant dose and time-dependent decrease in cell proliferation after 3 and 6 days as determined by MTT assay. No change in the growth of nontransformed stromal cells occurred in response to Bcl-2 q indicating the effect is specific for malignant cells. Two additional leukemia cell lines, Raji and K562 cells demonstrated dramatic growth inhibition while three solid tumor cell lines, DU145 (prostate), A549 (lung), and SK-BR-3 (breast) showed very little growth inhibition at concentrations up to10µM. Interestingly, the degree of growth inhibition induced by Bcl-2 q correlated with baseline Bcl-2 gene expression. Confocal and flow cytometry analysis of cells treated with FITC-labeled Bcl-2 q or MutBcl-2 showed prominent uptake and nuclear localization of Bcl-2 q not MutBcl-2 after 72 h. Inhibition of cell proliferation corresponded with decreased Bcl-2 protein expression. No significant change in the cell cycle was noted after 72 h, however, induction of cell death corresponded with a decrease in mitochondrial transmembrane potential. These results demonstrate striking growth inhibition in response to the Bcl-2 quadruplex-forming sequence related to inhibition of Bcl-2 expression. This oligonucleotide shows considerable therapeutic potential. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 1024.