Shahzad Javed

Fault detection in robot sensors using negative selection algorithm

This paper describes the methodology for fault detection in autonomous mobile robots. In this, artificial immune system based approach; a set of fault detectors is generated using negative selection algorithm which is responsible for detecting faulty behavior of system. The idea is based on the self-non self-discrimination observed in biological immune system. The feasibility of scheme is implemented on sensors of simulated mobile robot.

Capsular arthroplasty for neglected developmental dysplasia of hip

Introduction: Treatment of developmental dysplasia of hip (DDH) diagnosed after 10 years of age is extremely difficult because of the soft tissue and bone deformities. In this study, we evaluated short-term results of a single-stage procedure performed with surgical hip dislocation, femoral shortening and capsular arthroplasty. Patients and Methods: A retrospective review of charts of five patients with DDH, older than 10 years, who underwent capsular arthroplasty at Ghurki Trust Teaching Hospital between 2013 and 2015 was performed. Post-operative functional evaluation was performed using modified McKay’s scoring system and radiographic assessment using Severin’s scoring method at a minimum of 2-year follow-up. Results: We present results of five patients (six hips) with a mean age of 18.16 years. All patients had limping gait and International Hip dysplasia Institute classification (IHDI) class 4 hip dislocation. Harris hip score showed a significant improvement (53.13 vs 84.16; p = 0.0001). Femoral shortening of 2–2.5 cm was done. Additional shelf procedure was required in one patient. This patient persistently has post-operative hip subluxation. All patients had good to excellent outcomes according to McKay classification. Post-operative Severin classification was 1A in all patients. No case of avascular necrosis of the femoral head was noted during the follow-up. Conclusion: Capsular arthroplasty with subtrochanteric shortening is a useful procedure for neglected cases of DDH in patients older than 10 years.

Massive segmental bone loss due to pantibial osteomyelitis in children reconstructed by medial fibular transport with Ilizarov frame

Objectives Vascularized or non-vascularized fibula transport is a novel procedure for limb salvage but has been associated with high failure rates and complications. Ipsilateral medial fibular transport (IMFT) using Ilizarov apparatus is a modification of the procedure to prevent complications and increase success rate. This article presents the largest series of limb salvage for massive tibial bone loss in children due to pan-osteomyelitis by IMFT with Ilizarov apparatus. Methods A case series of 12 patients with a mean age of 12 (6–18) years is described. At the first stage of surgery, the excision of all dead bone was performed, and Ilizarov without traction apparatus was applied. In second stage, ipsilateral fibula is gradually transferred to tibial defect with the help of ilizarov olive wires. In the third stage, the freshening of docking sites of fibula to tibia was performed. The minimum follow up was of two years. Results Hypertrophy of the transported fibula accompanied by full weight bearing and satisfactory joint motion occurred in all patients. Removal of sequestrated bone resulted in control of infection in 27.17 ± 7.76 days. Fibular transport took 16.58 ± 4.14 days. The length of tibial bone loss replaced by fibula was 9.50 ± 2.23 cm. The mean days required for union after freshening of the docking site was 76.58 ± 6.20 days. Conclusions Ilizarov frame for pan tibial osteomyelitis with bone excision and medial fibular transport works well for limb salvage in children.

Efficacy of anterior column reconstruction in tuberculosis of the cervical spine with stand-alone titanium cage without anterior plating

Tuberculosis (TB) is a common disease, especially in underdeveloped countries. TB of the vertebral column constitutes nearly 50% of all lesions of osteoarticular TB. The most common site for the disease is the peridiscal region. The primary treatment option is usually anti-TB chemotherapy, but in some patients with severe pain and neural involvement, instability and a large abscess, surgery is recommended. To our knowledge there are no publications describing the use of a stand-alone titanium cage and bone graft without anterior plating in the treatment of tuberculous spondylitis (TBS). The aim of this study is to evaluate the efficacy of stand-alone titanium mesh cages in TB of the cervical spine. A retrospective study of 47 patients with cervical TBS was carried out at Ghurki Trust Teaching Hospital, Lahore, Pakistan, of whom 61.6% were aged 3–35 years and 28.4% were aged 36–70 years. Twenty-six were male and 21 were female. Preoperative spinal function was categorized as Frankel grade E in 26 patients, Frankel grade D in four patients, Frankel grade C in 10 patients, Frankel grade B in two patients and Frankel grade A in five patients. Following surgery, one patient categorized as Frankel grade A remained the same while the remaining four improved to grade C at follow-up. The rest of the patients improved to grade E at the 2-year follow-up. The mean preoperative Cobb angle was 39.06° [standard deviation (SD) 10.92°], which improved to –5.51° (SD 77°) (P < 0.05). When comparing the visual analogue scores, there was also a statistically significant difference in pain improvement. All patients underwent single-stage radical debridement, decompression and instrumentation. Anterior column reconstruction was performed in all patients using a stand-alone titanium cage. The use of titanium cages effectively corrects sagittal deformity in the TB-affected spine with no donor site morbidity.

Accessory Ulna: A Rare Case in an Asian Female

ANN SAUDI MED 2017 JULY-AUGUST WWW.ANNSAUDIMED.NET 336 In January 2017, a 22-year-old unmarried female presented with pain and swelling over the left forearm along the medial border of the forearm from the previous 8 days. She first experienced the swelling and deformity about 5 years before, but it was ignored because it was asymptomatic and did not interfere with the joint range of motion. The problem was only cosmetic. She could remember no severe trauma to the elbow joint, but minor injuries occurred in the routine work of a housewife. The pain was along the medial border of the forearm more on the mid half between wrist and elbow joints. She was afebrile and vital signs were stable. On examination there were two lumps, one lump at the mid of the forearm about 8×8 cm with visible deformity and another lump near the elbow joint which was 3×3 cm. There was mild tenderness along the medial border of the elbow up to mid forearm, range of motion at the elbow was normal, no palpable axillary lymph node and distal neurovascular were intact. Systemic examinations were normal. Routine tests like complete blood count, C-reactive protein and erythrocyte sedimentation rate were normal. Radiographs including anteroposterior and lateral views of the both elbow joints with forearms up to the wrists were done for comparison. X rays showed an accessory ulna articulating with the elbow joint without interfering with normal articulating joints at the elbow, extending up to the mid half of the forearm without articulating at the wrist joint. A diagnosis of accessory ulna was made. She was admitted and after a preoperative workup, surgical excision of the ulna was done. The patient was discharged on antibiotics and non-steroidal anti-inflammatory drugs. The patient was regularly followed for 2 months. Her pain was relieved and on examination there was no tenderness on palpation and the elbow had a normal range of motion. The preoperative image, preoperative and postoperative xrays and intraoperative image are shown (Figures 1-4). Accessory ulna: a rare case in an Asian female

Comparison of Three Doses of Epidural Steroid Injection with Single Dose of Epidural Steroid Injection for Lumbar Radicular pain in Spinal Stenosis Patients

Introduction Low Back pain and lumbar radicular pain due to Lumbar spine stenosis is one of the most common complaint in the Spine outpatient department or hospital admissions. Epidural steroid injection have well established role in the treatment of lumbar radicular pain, but the exact dose of Epidural Steroid injection has yet to be decided. The aim of this study is “To Compare three doses of epidural steroid injection with single dose of epidural steroid injection for Lumbar Radicular pain in spinal stenosis patients.” Materials and Methods 95 patients with lumbar radicular pain due to spinal stenosis were randomly allocated into 2 groups. In group A 42 patients were given 120 mg of Depo-medrol (40 mg per day for 3 days) and in group B, 43 patients were given 40 mg of Depo-medrol as a single dose. Both group A and Group B were matched in terms of age and gender. On visual analogue score pain was assessed after 2 weeks, 3 months and 6 months. Results In group A (3 doses of depomedrol) VAS improvement at 2 weeks, 3 months and 6 months were more than group B(single dose of depomedrol) which was statistically significant (p < 0.05). There were no major complications like epidural hematoma or abscess formation in both groups. The overall minor complications like flushing, transient hyperglycemia and headache due to CSF hypotension were more in Group A than Group B but statistics shows no significant difference. All the complications resolved without any morbidity and no patient required further hospitalization. Conclusion In the case of lumbar radicular pain, Epidural Steriod Injection with 3 doses of Depo-medrol is more effective than a single dose of epidural steroid without significant increase risk of complications.