Multiple alcohol septal ablations in a young patient with hypertrophic cardiomyopathy

A 16 year old female with hypertrophic cardiomyopathy was treated with alcohol ablation for NYHA class III symptoms on medical therapy. Three months later, patient underwent a second alcohol ablation procedure for continued symptoms. Follow-up, for 4 years now, continues to show resolution of symptoms. (Cardiol J 2007; 14: 301-304

Comparison of functional outcomes between cemented and uncemented bipolar hemiarthroplasty for intracapsular neck femur fractures

Background: The neck of femoral fracture is common and leading fracture in orthopaedic practice. The older age group and female are more to prone to develop this fracture.Methods: A prospective, clinical observational, analytical comparative study was undertaken in the department of Orthopaedics of Geetanjali Medical College and Hospital in Udaipur, Rajasthan from January 2018 to June 2019. 52 adult patients with neck of femur fracture, 26 patients in each group. Results: In our study, the mean age was 77.72 years. Female preponderance was seen in our study. In our study mean duration of surgery in uncemented group was 65.78 minutes and mean duration of surgery in cemented group was 79.89 minutes. The mean total HHS in our patient was 86.63 with standard deviation of 6.18. Mean HHS for cemented group was 86 and for uncemented group was 87.23. We found 20 excellent result and 27 good results (35.71% and 51.92% respectively). We also found 5 fair result (12.37%). There were 2 complications, both in cemented group, one had post-operative dislocation and other had a cement reaction.Conclusions: Both cemented and uncemented hemiarthroplasty are equally good options in the treatment of femoral neck fractures in the elderly. However, it is to be noted that the duration of surgery & complications, were both less in the uncemented group as compared to cemented hemiarthroplasty group in our study.

Outcome of pedicle screw fixation with transpedicular bone grafting in fracture of thoracolumbar vertebrae

Background: Posterior short segment instrumentation for thoracolumbar fracture is known for high implant failure rate because of the lack of anterior support. Anterior body augmentation by transpedicular bone grafting has been developed as an alternative to overcome this failure. In this study, we have evaluated the outcome of the cases of the unstable thoracolumbar spine injuries managed surgically with pedicle screws and transpedicular bone grafting.Methods: 20 patients were included in this study and were followed up for up to 6 months postoperatively. We assessed the outcome of each patient with Frankel scale and visual analog score (VAS) post-operatively clinically and radio logically by measuring Cobb’s angle and anterior vertebral body height post-operatively on follow-up at 6 weeks, 12 weeks, and 24 weeks.Results: We found that males had higher incidence with most common mode of injury was fall from height. D12 was single most involved vertebrae. The average Cobb’s angle during preoperative stage was 12 degrees and 22.05 degrees at 6th week and this was maintained till 24th week. The mean difference of anterior vertebral body height between pre-operative and 24th post-operative week was 7.15 mm. The mean VAS pre-operatively was 9.8 which changed to 0.75 at 24 weeks follow up. These were statistically highly significant.Conclusions: Our study established that Pedicle screw fixation with transpedicular bone grafting has a satisfactory result and can restore vertebral height, increase the stability of the injured vertebrae and leads to a significant improvement in the patient’s quality of life

A comparative study of functional outcome between platelet rich plasma injection versus steroid infiltration in plantar fasciitis

Background: Plantar fasciitis (PF) is considered as degenerative tendinopathies. Repeated micro trauma is the major etiology of these diseases. Autologous platelet rich plasma (PRP) injections are becoming more popular in the treatment of enthesopathies like PF. The growth factors in PRP cause tissue healing. We compared the result of injecting intra-lesional autologous PRP injections versus steroid infiltration in chronic PF.Methods: A prospective, interventional and analytic comparative study was done and 81 patients (120 heels) were included in this study and were followed up for 6 months. We assessed the outcome of each patient using visual analog score (VAS) and foot and ankle disability index (FADI) on follow-up at 1, 3, and 6 months. Results: In our study, female preponderance was seen. Left side was more common as compared to right side. Unilateral PF is more common than bilateral. The difference with in the individual group at baseline and at 1,3 and 6 months was statistically highly significant in terms of VAS and FADI (p=0.0001) But the difference in the between the two groups was insignificant for VAS and FADI at 1, 3 and 6 months.Conclusions: In our study, as there is no significant difference in VAS and FADI score between corticosteroid injection group and PRP injection group at 1, 3 and 6 months follow up. So, it’s reasonable to conclude that both are equally effective in PF. But as PRP injection comes out to be more time consuming and more costly, corticosteroid seems to be more efficient, cost and time wise. Hence, the latter should be a better choice.     

Cost-effectiveness of adjuvant paclitaxel and trastuzumab for early-stage node-negative, HER2-positive breast cancer

Adjuvant paclitaxel and trastuzumab has been shown to be an effective regimen with low risk of cancer recurrence and treatment-related toxicities in early-stage node-negative, HER2-positive breast cancer. We investigated the cost-effectiveness of this regimen

Wielokrotna ablacja alkoholowa przegrody międzykomorowej u młodej pacjentki z kardiomiopatią przerostową

U 16-letniej pacjentki z kardiomiopatią przerostową, dotychczas leczonej za pomocą farmakoterapii (nasilenie objawów wstępnie oceniono jako III stopień wg skali NYHA), przeprowadzono zabieg ablacji alkoholowej przegrody międzykomorowej mięśnia sercowego. Trzy miesiące później z powodu utrzymujących się dolegliwości klinicznych chorą poddano drugiej z kolei ablacji alkoholowej przegrody międzykomorowej mięśnia sercowego. W 4-letniej obserwacji odnotowano ustąpienie objawów klinicznych. (Folia Cardiologica Excerpta 2007; 2: 448–451

Evaluation of efficacy and safety of intraarticular injections of leucocyte poor platelet rich plasma in osteoarthritis knee patients

Background: The present study evaluates the safety and efficacy of intraarticular injections of leucocyte poor platelet rich plasma (LP-PRP) in osteoarthritis (OA) knee patients. Patients with early osteoarthritis (K-L grading 1 and 2)-clinically and radiologically and those who gave consent to participate in the study were injected with 2.4 ml per knee of LP-PRP over unilateral or bilateral knees at 0, 1, 2 and 6 months of LP-PRP injections. Methods: 100 patients with osteoarthritis knee pain were injected with LP-PRP at 0.1.2 months on OPD basis. LP-PRP was prepared in a centrifugation machine at 2000 RPM for 4 minutes and 2000 RPM for 10 minutes for two consecutive times and then injected into knee with a medial suprapatellar approach using 20/21 G needle. This was repeated at 1 and 2 months of follow-up. Assessment of efficacy in terms of pain relief was done on the basis of visual analog score (VAS) and clinical outcomes on the basis of knee injury and osteoarthritis outcome scores (KOOS) at 0, 1, 2, 6 months following injection of LP-PRP. Results: The mean VAS at pre-injection was 7.22±0.965 which reduced to 3.06±1.223 at post-injection follow-up at 6 months. The mean KOOS at pre injection was 33.4±7.51 which increased to 78.86±8.80 at post-injection follow-up at 6 months. Conclusions: LP-PRP has emerged as an intriguing therapy option for knee OA, and our study has shown that it is effective after 6 months

Antimicrobial Resistance and Virulence of <em>Escherichia coli</em> in the Purview of Public Health Monitoring

Antimicrobial resistance (AMR) has emerged as a major threat to human, animal, and environment health in the developed as well as the developing nations. The usage of antibiotics outside of the prescribed parameters in both the healthcare and livestock sectors is directly tied to this resistance event. Additionally, several Escherichia coli strains harbor the AMR genes, which can be transferred to humans leading to public health problems. Depending on the type of antibiotics used, E. coli has evolved to prowess several resistance mechanisms. Resistance genes that are horizontally transmissible also encode this resistance mechanism. Different resistance genes for each class of antibiotics are encoded by resistant E. coli. In conclusion, the current chapter ushers light on the molecular evolution of resistance and the regulatory genes contributing to the development of MDR in E. coli. Moreover, we have also discussed about the inappropriate practices of prescribing the antibiotics leading to intensifying the MDR in bacteria envisaging the implementation of rigorous guidelines for proper use of antibiotics in human beings

Glycogen-rich Clear Cell Carcinoma of the Breast: A Comprehensive Review.

Glycogen-rich clear cell carcinoma (GRCC) is a very rare form of primary breast cancer (<0.1% of all breast cancers). It is characterized by the presence of neoplastic cells with a glycogen-abundant clear cytoplasm (the Periodic Acid Schiff-positive, diastase-sensitive). The expression of steroid receptors (estrogen and progesterone receptors) has been variably reported (35% to 100% of the cases), whereas most studies reported low human epidermal growth factor receptor 2 positivity in GRCC. High androgen receptor positivity without androgen receptor splice variant-7 was reported in one recent study. Although sparse, the preliminary theranostic data on GRCC indicate the potential of targeted treatments in selected cases (antiandrogen, PIK3CA, and immune checkpoint inhibitors). Because of its rarity, the prognosis for GRCC patients remains controversial. Herein, we comprehensively appraise the epidemiological, morphologic, molecular, and clinical characteristics of this rare mammary malignancy