Management of intertrochanteric fracture in a bilateral below knee amputee

Intertrochanteric fracture in a patient with bilateral below knee amputation is rare and the management is challenging. The major difficulty is in applying optimal amount of traction for reduction of the fracture due to absence of foot. We present the case of an elderly female with bilateral below knee amputation presenting with a minimally displaced right intertrochanteric fracture. The patient was managed using reverse boot technique for applying traction, obtaining reduction and fixed with right proximal femoral nail. The patient was able to return to her pre-injury mobility status on the third postoperative day. We highlight a method of traction application using this simple modification of the fracture table so that adequate amount of traction can be applied safely

Ambiversive nature of Indian population in disease management: what is the need of the hour?

Allopathic and ayurvedic medicines have been used since ages, and both have their advantages and disadvantages. Not a single allopathic drug manufactured until date is free from side effects. Then why is allopathic medicine still preferred? Mainly because everyone of us need quick relief and/or fast action. In the case of HIV, cancer, stroke, myocardial infarction, medical emergency and/or casualty cases ayurvedic medicines are either unavailable or can’t be used

Heterogeneity of monosomy 3 in fine needle aspiration biopsy of choroidal melanoma.

PurposeTo report on the heterogeneity of monosomy 3 in a fine needle aspiration biopsy obtained transsclerally from choroidal melanoma for prognosis.MethodsAll clinical records for patients who had been diagnosed with choroidal melanoma and underwent iodine-125 plaque brachytherapy with intraoperative transscleral fine needle aspiration biopsy from January 2005 to August 20, 2011, and who had a positive result for monosomy 3 according to fluorescence in situ hybridization as reported by clinical cytogenetics testing were collected. Patient age and sex, total number of cells evaluated and number of cells positive for monosomy 3, tumor size, and metastatic outcome were recorded for each patient.ResultsA positive result for monosomy 3 was reported in 93 patients who underwent transscleral fine needle aspiration biopsy. Two patients were lost to follow-up immediately post-operatively, and the remaining 91 patients were included in this study. The mean number of cells evaluated in the biopsy was 273 (range 28 to 520). The mean percentage of cells positive for monosomy 3 was 62.9% (range 4.7%-100%). The mean tumor height was 5.91 mm (range 1.99 to 10.85 mm). Larger tumors were associated with a higher percentage of cells positive for monosomy 3. During the average follow-up interval of 28.9 months (range 3-76 months), choroidal melanoma metastasis developed in 18 (20%) patients. Patients whose tumors had 1%-33% of cells positive for monosomy 3 had a significantly lower risk of metastasis-related death compared to patients whose tumors harbored a higher percentage of monosomy 3 (p = 0.04).ConclusionsCytogenetic heterogeneity of fluorescent in situ hybridization for monosomy 3 exists in a biopsy sample. Larger tumors were more likely to have a higher percentage of monosomy 3 positive cells in the sample. Furthermore, patients whose tumors had more than 33% of cells positive for monosomy 3 had a poorer prognosis than patients whose tumors had lower percentages of monosomy 3

A Survey on Security Aspects of Server Virtualization in Cloud Computing

Significant exploitation and utilization of cloud computing in industry is come with and in the identical time vulnerable by unease regarding protection of data hold by cloud computing providers. One of the penalties of moving data processing and storage off business site is that organizations have fewer controls over their infrastructure. seeing that, cloud service (CS) providers must hope that the CS provider is capable to protect their data and infrastructure from both exterior and domestic attacks. Presently however, such hope can only rely on organizational procedures stated by the CS provider and cannot be remotely verified and validated by an external party. The central distinction between cloud computing and conventional enterprise internal Information Technology services is that the proprietor and the consumer of cloud Information Technology infrastructures are separated in cloud. This transform requires a safety responsibility severance in cloud computing. Cloud service providers (CSP) should safe the services they propose and cannot surpass the customers’ authorities. Virtualization is a buildup utterance in the Information Technology world. With the assure to reduce the ever mounting infrastructure inside data centers connected to other important apprehensions such as ease of use and scalability, virtualization technology has been in advance recognition not only with IT experts yet also among administrators and executives as well. The progressively more growing rate of the approval of this technology has exposed these systems to new protection concerns which in recent history have been unnoticed or merely overlooked. This paper presents an in depth state of art gaze at  present most old server virtualization explanations, as well as a writing study on different security matters found inside this virtualization technology. These problems can be practical to all the existing virtualization technologies accessible with no spotlight on a specific answer. Nevertheless, we do susceptibility investigation of two of the mainstream recognized virtualization answers: VMware ESX and Xen. to conclude, we illustrate some clarifications on how to progress the security of online banking and electronic commerce, using virtualization

Diagnostic confusion resulting from CD56 expression by cutaneous myeloid sarcoma

Myeloid sarcomas are tumor masses composed of aggregates of malignant myeloid precursors in extramedullary sites including the skin. We report a case of myeloid sarcoma in a patient who presented with an ear lobe mass and facial nerve paralysis. Expression of CD56 by the malignant cells led to an initial misdiagnosis as Merkel cell tumor. Comprehensive pathological evaluation confirmed the diagnosis of myeloid sarcoma with aberrant expression of CD56 and carrying the translocation t(8;21) (q22;q22). Aberrant antigen expression by cutaneous myeloid sarcomas can cause diagnostic confusion with other cutaneous neoplasms. This is especially relevant when myeloid sarcoma is the sole manifestation of acute myeloid leukemia

An unusual initial presentation of mantle cell lymphoma arising from the lymphoid stroma of warthin tumor.

BackgroundWarthin tumors presenting concomitantly with a lymphoma is vanishingly rare with only 15 reported cases in English literature. Herein, we report an unusual initial presentation of a mantle cell lymphoma involving the lymphoid stroma of a Warthin tumor.Case presentationA seventy-seven year old otherwise healthy gentleman with a 50-pack year smoking history presents with a slowly enlarging left cheek mass. CT scan of the neck demonstrated a left parotid gland tumor measuring 3.4 cm in greatest dimension. He underwent a left superficial parotidectomy, with subsequent histopathologic examination revealing a Warthin tumor with extensive expansion of the lymphoid stroma. Flow cytometric, immunohistochemical, and cytogenetic studies of the stromal component of the tumor confirmed the presence of a mantle cell lymphoma. Clinical staging demonstrated stage IVa disease, and was considered to be at low to intermediate risk due to the slow growth of the parotid lesion. The patient is undergoing close follow up with repeat PET-CT scans at six months.ConclusionTo the best of our knowledge, this is the first well documented collision tumor between mantle cell lymphoma and a Warthin tumor. This case also brings to light the significance of thorough evaluation of the lymphoid component of Warthin tumor

Emulated reactance and resistance by a SSSC incorporating energy storage device

Static Synchronous series compensator without energy storage device can exchange only reactive power with the network and can operate in limited operating range in two quadrants only. When energy storage device is connected at the DC bus of SSSC (SSSC – ES), it can also exchange real power with the network. Operating range of SSSC will be much broader and it covers all the four quadrants. However, emulated reactance and resistance by SSSC – ES is likely to affect the performance of a distance protection system. This paper presents a detailed model of an SMIB system with SSSC – ES. Injected voltage by SSSC – ES in all the four quadrants of operation is presented. Impact of operation of SSSC _ ES in different quadrants and various control strategies for SSSC – ES on impedance emulated by SSSC – ES during steady state condition and transient system disturbance is discussed.