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Background: The second wave of the COVID-19 pandemic in India was associated with an increased incidence of rhino-orbital-cerebral mucormycosis. The objective of this paper was to prospectively explore the epidemiology, management, and results of 18 months follow-up of patients presenting with COVID associated mucormycosis at a tertiary referral centre in India. Methods: Patients presenting with symptoms suggestive of COVID-associated mucormycosis over two months were included in the study. Patients were staged based on the extent of the disease. Surgery was the primary modality of treatment except in those with intracranial spread, altered sensorium, and poor prognosis. A combination of liposomal amphotericin B and posaconazole was used as adjunct medical treatment. Patients were followed up and outcomes at one year of treatment were recorded. Results: Out of a total of 26 patients who were diagnosed with COVID associated mucormycosis, 21 patients underwent bimodality treatment (medical and surgical). The extent of surgery was based on the stage of the disease. Six eyes received retrobulbar injections of Amphotericin B to salvage vision. The overall mortality was 38.46% and 23.8% in those where the intent of treatment was curative. At the end of one year, 16 of 21 operated patients survived with mild to severe sequelae. Conclusions: Mucormycosis is a deadly fungal infection with high mortality. Early diagnosis and prompt, aggressive treatment is paramount in preventing mortality. A multidisciplinary approach is useful for effective management. Continuous follow up is paramount to identifying and treating complications.

Seismic event induces undesirable motion in buildings, energy dissipation systems in civil engineering are indeed needed. There is a mix of structures with passive energy dissipation supplied by Fluid Viscous Dampers systems (FVD). This technology is increasingly being utilized to improve seismic protection for both existing and new structures. The findings of the FVD systems are investigated in order to compare the structural response with and without this device of energy dissipation compared for low and high rise structures, the damper installed at different storey and varying the coefficient of damping (Cd) has been focused in this paper which provides an insight when the variation of Cd and its locations,. The findings of the FVD's impressive ability to increase the structure's dissipative capabilities without increasing its stiffness. In the case of high rise FVD performance has been evaluated through the top storey displacements which will allow for a conclusion. Keywords: Coefficient of Damping, Fluid Viscous Damper, High Rise Buildings, Seismic Response, Tall Structure

Hyperloop transportation system is the advancement of railway system. It can eliminate most of the problems which occurs when we use road as a medium of transport. It uses a capsule kind of a thing which carries upto 28 passengers. The main area of research done is on the materials used to make the capsule of the hyperloop. We have compared many materials and have come out with the best material as far as our knowledge is concerned . The capsule must be made of materials which possess very good properties and which are resistant to impact forces. We have come across 3 such materials and have included another interesting material which can be made in the near future. While selecting the material we have to do a pre feasibility study which covers aspects such as budget longetivity availability etc. The four materials which we came across are steel , concrete, carbon fibre and vibranium.

Introduction:The most challenging hurdle faced by national health systems worldwide in the last century is the ongoing COVID 19 pandemic. Initial cases of atypical pneumonia of unknown origin started in Wuhan, Hubei province, China which started the outbreak of COVID 19 in December 2019. This infection later on spread to rest of the world. Case series:Here we present a series of 3 patients who came to our casualty with polytrauma after a suspected suicidal fall from height. The patients were managed by adequate surgical interventions. Postoperative physiotherapy started with gradual mobilization. We did a psychiatric reference and proper counseling of all 3 patients patients both pre and postoperatively. Conclusion:We conclude that this COVID-19 pandemic has taken a great toll both physically and mentally on people in the form of increased mortality and morbidity as shown daily in media, increased unemployment and strict self isolation has further put a strain on peoples mind leading to psychiatric disorders and suicidal behaviour. This has increased cases of polytrauma due to suspected suicidal falls. We have adequately treated such patients who came to our institute operatively and with psychiatric support.

Individuals come across extreme Uncertainty situations, feeling rounded–up 360 degrees, as if trapped inside Chakra Vyuha (wheel form strategy). For uncertainty is often related to future, the concept of Future Time perspective (FTP) is relied upon for attaining positive states. But FTP is a critical factor which works both positively and negatively depending on other factors intervening. For politicians and businessmen such states of being trapped in Chakra Vyuha, can mean end of their political life or business life. In the current paper, the author describes the introspection of a Subject while he attempted to alter his Future Time perspective. This introspective report further gave clue for Merged Time Perspective or Seamless Time Horizon instead of FTP and also that Regulatory Focus and Resistance To Change need to be combined, coalesced and treated on a single continuum. Current author also has proposed a therapy outline to help businessmen and politicians to come out of devastating situations in which they feel rounded – up by opponents 360 degrees.

When a seismic event causes unwanted motion in buildings, energy dissipation techniques in civil engineering are required. There are a variety of structures with passive energy dissipation provided by Passive Constant friction damper systems (CFRD). This technique is being used more and more to increase seismic protection for both existing and new constructions. The CFRD system results are explored in order to compare the structural response with and without this device of energy dissipation compared for low and high rise mass varied buildings, the damper put at different storey and altering the slip force has been focused in this study which gives an insight into the variation of slip load and its locations. The CFRD's potential to boost the structure's dissipative capacities without increasing stiffness was discovered. In the case of high-rise buildings, CFRD performance has been examined using top-storey displacements, allowing for a conclusion.

Stress is handled by variety of ways. Dual Task walking is also one such measure but the concept requires more clarity. Operational Definition of Dual Task Walking, Multiple Task Walking are proposed. Humming walking, Cognitive Walking and Cognitively Controlled walking techniques are clarified operationally. A variant of Multiple Task Walking systematized by current author is also outlined along with a case report of an engineering employee. Keywords: Dual Task Walking, Multiple Task Walking, Humming Walking, Cognitive Walking, Cognitively Controlled-Walking.

Introduction: Hoffa is a coronal fracture of the femoral condyle. It is an uncommon injury easily missed on X-rays, which later presents as a non-union. Computed tomography (CT) scan knee helps in diagnosing undisplaced fractures and planning the management. Case Report: A 24-year-old male patient presented to us with complaints of pain, decreased range of knee movements, difficulty in walking and clicking sound at the left knee for 9 years. The patient had a history of trauma 9 years back. X-ray of the left knee showed the non-union of left lateral Hoffa fracture, which was managed with open reduction and internal fixation with CC screws using the lateral para patellar approach. At present 1.5 years follow-up, the patient is comfortable with no pain and having a complete knee range of motion. Conclusion: Although Hoffa fracture is rare, clinical suspicion, along with radiological investigations, is essential to diagnose Hoffa fracture. A missed diagnosis can lead to malunion or non-union, which predisposes to knee arthritis. Timely and proper management of Hoffa non-union with open reduction, stable internal fixation and early knee mobilization help in getting a better outcome. Keywords: Lateral Hoffa fracture, non-union, internal fixation, functional outcome.

Introduction: Giant cell tumor [GCT] is a relatively common, locally aggressive but most often a benign neoplasm that is associated with a large biological spectrum. The GCT accounts for 4-10% of all bone tumors and approximately 20% of all benign bone tumors. Case Report: We have a 35 year old male patient, who presented with right knee pain after a trivial trauma (history slip and fall while walking) and X ray revealed pathological fracture of the medial condyle of femur along with a lytic lesion. On further investigation with other modalities such as CT scan and MRI was suggestive of giant cell tumor in the distal femur confirmed with a biopsy, and the patient was referred to a higher centre for the management of the same with the pathological fracture of the medial condyle of the femur. Conclusion: The diagnosis of giant cell tumor, as seen, is made based on several factors taken into account including history, clinical examination, imaging techniques and finally the confirmatory biopsy of the lesion. This also helps in grading and staging of the tumor which helps in determining the prognosis and deciding the further treatment modalities.

As these day we are coming across many cases of Covid-19 But still nothing is working much to reduce the number of these So we need something to be done for them so as for the betterment of the country as well as secured living of these people Therefore, taking a step forward in helping these people, we have come up with an idea of developing into an application called "Smart Sahayata (Covid-19)" which can be used by every citizen of India to provide a healthy living for the exiled All they need to do is to open up the application and click any of the 4 tabs that is to report Homeless/Find Shelter/Donation(money or food packets)/violation of social distancing Which gives the Location information of a person who is in need of accommodation or food So that govt can take necessary steps

Highlights • Brown tumor is an uncommon pathognomic sign of hyperparathyroidism. • Brown tumour more frequently asscociated with secondary than primary hyperparathyroidism (In our case it was associated with primary hyperparathyroidism). • Distal humerus a rare site of brown tumour (Brown tumours associated with primary hyperparathyroidism usually affect the maxilla, pelvis and ribs other than long bones)., Introduction A brown tumour is benign bony lesion caused by localized, rapid osteoclastic turnover, resulting from hyperparathyroidism. In this report, we present a case of 25-year-old woman with multiple swelling and bone pain. Plain radiographs of the affected bones revealed multiple erosive bone tumours, which were diagnosed as brown tumours associated with primary hyperparathyroidism. Case report A 25 year old female presented with swelling in left elbow since 1 month along with multiple swelling in body. Patient had pain in left elbow after trivial fall. X-ray showed lytic lesion of left elbow with pathological fracture. Biopsy was suggestive of brown tumour of distal humerus. Discussion We managed this case with reconstruction of defect with fibula grafting and plating. Conclusion Pathological fracture in young adult should always be properly investigated. A high index of suspicion is necessary to diagnose unusual presentation of Primary Hyperparathyroidism.

Introduction Unilateral isolated ulna fracture secondary to trauma are common but the bilateral nightstick fractures are quite rare in the clinical scenario. These are managed conservatively or surgically depending upon the degree of displacement, location of the fracture, fracture pattern and associated injury to other bones. Proper management of these fractures helps in getting a better outcome. The purpose of the study was to present a case of bilateral traumatic isolated ulna fracture and its management. Case report A 33-year-old male presented to the emergency department with complaints of pain and swelling over the dorsum of both forearms with a history of assault with a bamboo stick. The mechanism of the injury was, the patient placed his both the forearms in front of the face as a defense during the assault and sustained injury to both forearms. On examination, the patient had bilateral forearm swelling with tenderness. Bony crepitus was present over both the ulna on palpation. X-ray of both forearms (radius and ulna) revealed the fracture of both right and left ulna without any associated fractures/injuries. The patient was managed surgically with open reduction and internal fixation using a 3.5 mm locking compression plate. At present, 1-year follow-up, the patient is having complete wrist, elbow ROM and supination, pronation without any pain. Conclusion Bilateral traumatic Nightstick fractures of the ulna are rare and this is the first reported case of traumatic bilateral isolated ulna fracture according to author's best knowledge and literature review. Open reduction and stable internal fixation using the principles of fracture fixation along with early mobilization helps in getting better functional outcome and prevents further complications and secondary procedures. This case is unique as it helps in identifying the mode of trauma in medico legal cases like assault in cases of bilateral ulna fracture. The mode and the mechanism of injury are different in this case.

Introduction: Neck of femur fractures is the most common fractures in elderly people as they present with osteoporosis. There is a higher chance of proximal femur fracture in a schizophrenic patient as there is a loss of bone mineral density due to a drug-induced increase in the level of prolactin and immobility. Patients with Parkinson’s disease were at higher risk for the development of hip fractures due to gait disturbances and instability. Case Report: A 63-year-old male patient presented with complaints of the right arm pain, swelling, deformity of the right arm, and difficulty in extending the wrist for 3 days. The patient had a history of falls and trauma to the left arm at home. X-ray right arm showed distal one-third spiral humerus fracture for which intramedullary nailing was done. X-ray of the pelvis with both hips showed right neck of femur fracture with associated greater trochanter (GT) fracture. We managed with total hip replacement using a dual mobility cup and tension band wiring for GT fracture. Postoperatively, the patient has a good range of motion at the hip. The functional outcome is good as per Harris’s hip score. Conclusion: Neck femur fractures in elderly patients with associated comorbidities such as schizophrenia and parkinsonism are best managed with total hip replacement using a dual mobility cup. It avoids the risk of dislocation in high-risk patients and prevents secondary procedures. Careful clinical and radiological examination of the pelvis is very essential even in asymptomatic patients with a history of trauma to prevent delayed diagnosis of these types of fractures in patients with schizophrenia and parkinsonism. Keywords: Neck of femur fracture, Parkinsonism, schizophrenia, dual mobility cup, total hip replacement.

Introduction: The humerus fractures can present as isolated or associated with other injuries and these fractures can be associated with both primary and secondary iatrogenic or traumatic neurovascular injuries. The timely management of these injuries helps in preventing catastrophic consequences. Case Presentation: Two cases of humerus fractures were presented with brachial artery thrombosis. First case is 56-year-old female with distal humerus fracture and second is 32-year-old female with humerus shaft fracture. Both the patients had feeble pulse at the time of presentation. Urgent CT angiography of the upper limb was performed and vascular surgeon intervention was taken. First case showed complete non opacification of distal brachial artery due to thrombosis, which was managed with bicolumnar plating with embolectomy. The second case of humerus shaft fracture showed non contrast opacification at the fracture, which was managed with intramedullary nailing with removal of the bony fragment impinging on the artery and embolectomy. Postoperatively, both the patients are having good functional and radiological outcome without any complications. Conclusion: Proper early clinical evaluation for vascular deficits helps to prevent the delayed diagnosis and radiological investigations helps to identify the cause and location of the vascular insults. Early surgical intervention in association with vascular surgeons helps in getting better outcome and prevents complications related to vascular injuries. Keywords: Distal humeral fracture, brachial artery thrombosis, humerus shaft fracture, embolectomy.