PRIMARY PREVENTION OF VERRUCA PLANTARIS THROUGH TOPICAL HERBAL AND VITAMIN DERIVATIVE

Objective: Verrucae plantaris (VP) results from environmental exposure to human papillomavirus causing plantar warts of the foot, resistantto treatment, and high recurrence rates. Current treatment paradigms focus on the treatment of lesions as opposed to primary prophylaxis. Wehypothesize that a topical combination of herbal supplement with anti-viral properties and a vitamin derivative* can be used prophylactically todecrease the primary incidence.Methods: We initiated a double-blinded clinical study with participants (n=282) randomization into control (lotion emollient only) (n=120),treatment (herbal and vitamin derivative) (n=110) and no treatment (NT) (n=52). Participants underwent examination of the feet at baseline (0months) to exclude VP lesions and were randomized to receive a bottle containing topical lotion with emollient only, control (C), lotion with an herbaland vitamin derivative, treatment (T), or NT, where participants did not apply anything to their feet. C and T participants applied lotion topically to thefeet once daily and were examined at 3, 6, 9, and 12 months to document the incidence of VP.Results: No incidence of VP occurred in the T group (0/110=0% incidence), two lesions in the C group (2/120=1.7% incidence), and five lesions inthe NT group (5/52=9.6% incidence).Conclusion: Treatments for VP rely on treating lesions after they occur, have high degrees of variability in success, risk of continued transmissionduring treatment, and have high rates of recurrence. Although the study number is relatively low, early indications show decreasing incidence ofVP from 9.6% in participants with NT to 1.7% in participants who used lotion only, suggesting increased health of the plantar epidermis, and 0%incidence in those participants applying topical herbal and vitamin derivative*. Additional study with increased numbers of participants is warranted

DHS for subtrochanteric fracture in a pediatric osteopetrotic fracture: a case report and literature analysis

Osteopetrosis is a rare hereditary condition which may have autosomal recessive or autosomal dominant inheritance. Patients tend to present most commonly with fractures but involvement of cranial nerves and hematopoetic system is not uncommon. In fact, patients with infantile and intermediate type tend to present more often with problems other than orthopaedic problems.  While diagnosis can be made on the basis of radiographs, management needs to be customized for every patient. Non operative and operative management both have their advantages and disadvantages. We are here reporting a case of subtrochanteric fracture in an eight-year-old child which was managed successfully with a dynamic hip screw (DHS) after closed reduction was unsuccessful. Surgery could be performed successfully by taking precautions during reduction, drilling and screw placement. At the latest follow up, which was after one and half years of surgery the fracture had united well and the child faced no limitations of activities. Thus, a DHS can be considered as effective mean of management of pediatric subtrochanteric fractures in osteopetrosis