Human Immunodeficiency Virus-Associated Chronic Lung Disease in Children and Adolescents in Zimbabwe: Chest Radiographic and High-Resolution Computed Tomographic Findings.

Background: Chronic respiratory symptoms are common among children living with human immunodeficiency virus (HIV). We investigated the radiological features of chronic lung disease in children aged 6-16 years receiving antiretroviral therapy for ≥6 months in Harare, Zimbabwe. Methods: Consecutive participants from a HIV clinic underwent clinical assessment and chest radiography. Participants with an abnormal chest radiograph (assessed by a clinician) and/or those meeting a clinical case definition for chronic lung disease underwent high-resolution computed tomography (HRCT). Radiological studies were scored independently and blindly by 2 thoracic radiologists. Relationships between radiological abnormalities and lung function were examined. Results: Among 193 participants (46% female; median age, 11.2 years; interquartile range, 9.0-12.8 years), the median CD4 cell count was 720/µL (473-947/µL), and 79% had a human immunodeficiency virus (HIV) load of <400 copies/mL. The most common chest radiographic finding was ring/tramline opacities (55 of 193 participants; 29%). HRCT scans were evaluated in 84 participants (69%); decreased attenuation (present in 43%) was the dominant abnormality seen. The extent of decreased attenuation was strongly correlated with both the severity and extent of bronchiectasis (rs = 0.68 and P < .001 for both). The extent of decreased attenuation was also negatively correlated with forced expiratory volume in first second of expiration (rs = -0.52), forced vital capacity (rs = -0.42), and forced expiratory flow, midexpiratory phase (rs = -0.42) (P < .001 for all). Conclusions: The HRCT findings strongly suggest that obliterative bronchiolitis may be the major cause of chronic lung disease in our cohort. Further studies to understand the pathogenesis and natural history are urgently needed

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An Experimental Study of the Effect of Periosteal Stripping on Limb Length in Rabbits

Introduction: Various methods have been tried in the past for lengthening the shorter limb, e.g., introduction of foreign material or drilling of the metaphysis, obliteration of nutrient foramen, use of short-wave diathermy, lumber sympathectomy, creation of an artificial arteriovenous fistula, and epiphyseal distraction. This study was undertaken to find a simple technique for limb lengthening by a minor surgical procedure, particularly where limb discrepancy is short. Materials and Methods: The experiments were carried out on the right hind leg of 40 rabbits of three months of age in batches of five, each of which was a control. All were anesthetized using Nembutal intra-peritoneally at 40 and ndash;60 mg/kg of body weight and were then allocated to one of the five experimental groups: A] Control rabbits and ndash; anesthesia given but no operation done; B] Vertical periosteal division; C] Vertical periosteal division with periosteal stripping; D] Circular periosteal division; E] Circular periosteal division with periosteal stripping. Before proceeding to operate on the rabbits, the measurements of right and left tibiae of each rabbit were recorded by a vernier caliper from the highest point of tibial tuberosity to the tip of the medial malleolus. After a total duration of 8 weeks from the date of operation, the animals were sacrificed and the tibial lengths were compared from the upper margin of the medial condyle (as this was now the most prominent point) to the tip of the medial malleolus again for comparison. Results: The maximum increase was obtained in the group with circular division along with periosteal stripping, while in the group with vertical division, the minimum increase was obtained. Conclusion: Circumferential periosteal division with stripping is an ideal procedure for minor length discrepancies or for those with limb inequality undergoing other procedures. It is simple and safe and would not require more than a short period in the hospital. [Arch Clin Exp Surg 2014; 3(2.000): 94-101