Results of sagittaly unstable intertrochanteric fractures managed by dual reduction technique

Background: We evaluated the functional and radiological outcome of sagittally unstable intertrochanteric fractures reduced by dual technique consisting of a crutch placed posteriorly over distal fragment and pushing the flexed proximal fragment by ramrod anteriorly over a period of 12 months.Methods: A fracture was defined as sagittally unstable intertrochanteric fracture when posterior sagging of distal fragment and flexion of proximal fragment worsens after routine maneuvers for closed reduction. Out of the 80 intertrochanteric fractures treated from February 2018 to April 2019, 16 hips had sagittal instability and after reduction were treated with proximal femoral nail (Stryker Trauson) in some patients and DePuy Synthes proximal femoral nail PFNA in remaining patients. These 16 patients were followed up for a period of 1 year and functional and radiological outcome was noted.Results: Out of the 16 patients, 10 were males and 6 were females. The mean age was 68.2 years. According to the A.O classification out of the 16 patients, 7, 5 and 4 patients were classified as A1.3, A2.1, and A2.2 or more. The mean time from injury till surgery was 4.6 days. The mean surgical time was 45.8 minutes. The mean time for radiological union was 22.4 weeks. The mean pre injury activity level was 4.2 while the mean final activity level was 3.8 (1-5) according to modified Koval activity index.Conclusions: Anatomical reduction followed by rigid internal fixation is the key to success in intertrochanteric fractures.

Oligohydramnios maternal & fetal outcome in pregnant females

Oligohydramnios is considered to be one of the most common complication diagnosed more frequently these days due to frequent usage of ultrasonography. Due to oligohydramnios , risk of intrapartum complications, perinatalmorbidity and mortality increases. The aims of this study are to study the maternal and fetal effects ofoligohydramnios, to evaluate the causesof oligohydramnios and to evaluate the perinatal morbidity andmortality

Study of Factors associated with anaemia in pregnant females belonging to rural Haryana

Anemia is the most common nutritional deficiency disorder found in about 56% of all women living in developing countries as per World Health Organization. It is the second most common cause in India and is responsible for 20% of total maternal deaths. Aims and Objectives: To study the factors associated with anemia in pregnant females and To study the prevalence of anaemia in rural pregnant women. Material and Methods:538 participants were interviewed by using a pre- structured and pretested questionnaire including prime gravida, second gravida and> second gravida over a period of 1year from November 2015 to November 2016 in a tertiary care centre in district Sonipat, Haryana. Anaemia was classified as per the World Health Organization (WHO) grading criteria which is taken as 11g/dl anaemia in pregnancy which is further classified in to mild anaemia (haemoglobin 10-10.9 g/dl), moderate anaemia (haemoglobin7.0-9.9 g/dl) and severe anemia (haemoglobin <7 g/dL as per WHO. Purposive sampling technique was used to select the sample. Inclusion criteria: The study subjects of age< 20 years to 30 and > 30 years were included. the prevalence of anaemia was observed in all the three trimesters. Exclusion criteria: Females with history of recent blood transfusion, chronic renal disease and ante partum haemorrhage were excluded. The diagnosis of anemia was undertaken by peripheral blood smear examination and standard haemoglobin estimation by Sahli’s method. Results: Among 538 subjects, the prevalence of anemia was found to be 58.48% classified in mild, moderate & severe categories. Mother‘s age, parity, education, socio-economic status, and dietary habits were found to be highly significant factors associated with maternal anemia. Other factors like family structure, size and attainment of menarche were found to be of least significance so far anemia is concerned Conclusion: High prevalence of anemia (59.3) calls for strict implementation of National Nutrition Anemia prophylaxis programme

Unilateral nevus of ota: A case report of oculodermal melanocytosis!

Hulke first described nevus of Ota in 1860, but a detailed description was made first by Ota in 1939 wherein the typical pattern of the bluish black pigmentation along with the cutaneous distribution of the trigeminal nerve were described. This condition is most prevalent in Japanese population but comparatively rare among Indians. Nevus of Ota is a nonhereditary pigmentation disorder, more commonly seen in females. The authors present, yet another case of unilateral nevus of Ota in a young Indian girl

Case report: laparoscopic management of a giant ovarian cyst

Ovarian cysts are of common occurrence in women but sometimes they acquire huge sizes and need to be differentiated meticulously from malignancy. Correct diagnosis can usually be made by clinical examination and use of diagnostic modalities like ultrasonography, CECT abdomen and biochemical markers. Management varies from case to case and includes both conservative and surgical modalities

A rare case of occult abdominal tuberculosis with Poncet′s disease mimicking Adult onset Still′s disease

A 50-year-old female presented with fever, symmetrical arthralgias, rash, painful oral ulcerations and alopecia since 8 weeks. Examination showed mild hepatospleenomegaly. Investigations revealed leucocytosis, neutrophilia, elevated sedimentation rate and raised ferritin levels (3850 ng/ml). Computerized tomography (CT) abdomen showed hepatospleenomegaly, mild ascitis and mild bilateral pleural-effusion. After ruling out occult infections, tuberculosis, malignancies and autoimmune diseases by appropriate investigations, and due to raised ferritin levels, adult onset stills disease (AOSD) was diagnosed. Patient responded to oral steroids initially, but after 7 days developed severe abdominal pain. Repeat CT showed multiple enlarged, necrotic and matted retroperitoneal lymph nodes with caseating granuloma on histopathology suggesting tuberculosis. Patient was given four-drug anti-tubercular treatment and she improved. Thus our patient of occult abdominal tuberculosis with reactive arthritis (Poncet′s disease) presented with hyperferritinemia mimicking AOSD. We postulate that extreme hyperferritinemia can be seen in tuberculosis and tuberculosis must be conclusively ruled out before diagnosing AOSD in tropics

Disseminated neurocysticercosis presenting as isolated acute monocular painless vision loss

Neurocysticercosis, the most common parasitic infection of the nervous system, is known to affect the brain, eyes, muscular tissues and subcutaneous tissues. However, it is very rare for patients with ocular cysts to have concomitant cerebral cysts. Also, the dominant clinical manifestation of patients with cerebral cysts is either seizures or headache. We report a patient who presented with acute monocular painless vision loss due to intraocular submacular cysticercosis, who on investigation had multiple cerebral parenchymal cysticercal cysts, but never had any seizures. Although such a vision loss after initiation of antiparasitic treatment has been mentioned previously, acute monocular vision loss as the presenting feature of ocular cysticercosis is rare. We present a brief review of literature along with this case report

Multiple hypertrophic relapsing remitting cranial neuropathies as an initial presentation of primary CNS lymphoma without any brain or spinal cord lesion

Cranial nerve thickening as an initial isolated presentation of CNS lymphoma is rare. Once an extremely rare neoplasm, primary lymphoma of the central nervous system (CNS) now ranks  only next to meningiomas and low-grade astrocytomas in prevalence. Multiple cranial nerve thickening can be a feature of primary CNS lymphoma. Here we report a case of a 45-year-old immunocompetent female who presented with relapsing remitting multiple cranial nerve thickening as an initial feature of primary CNS lymphoma without any other brain or spinal cord lesions

Peptide-Conjugated Nano Delivery Systems for Therapy and Diagnosis of Cancer

Peptides are strings of approximately 2–50 amino acids, which have gained huge attention for theranostic applications in cancer research due to their various advantages including better biosafety, customizability, convenient process of synthesis, targeting ability via recognizing biological receptors on cancer cells, and better ability to penetrate cell membranes. The conjugation of peptides to the various nano delivery systems (NDS) has been found to provide an added benefit toward targeted delivery for cancer therapy. Moreover, the simultaneous delivery of peptide-conjugated NDS and nano probes has shown potential for the diagnosis of the malignant progression of cancer. In this review, various barriers hindering the targeting capacity of NDS are addressed, and various approaches for conjugating peptides and NDS have been discussed. Moreover, major peptide-based functionalized NDS targeting cancer-specific receptors have been considered, including the conjugation of peptides with extracellular vesicles, which are biological nanovesicles with promising ability for therapy and the diagnosis of cancer