Rare case of autonomic instability of the lower limb presenting as painless Complex Regional Pain Syndrome type I following hip surgery: two case reports

<p>Abstract</p> <p>Introduction</p> <p>According to the International Association for the Study of Pain criteria of 1994, pain is a diagnostic requirement for Complex Regional Pain Syndrome type I. However, other authors have suggested that patients can rarely present with the sensory and vascular symptoms of Complex Regional Pain Syndrome without pain. This entity has not been reported following hip surgery in the English medical literature.</p> <p>Case presentation</p> <p>We present two cases of Complex Regional Pain Syndrome-like symptoms following hip surgery and with the total absence of pain. The first case was a 29-year-old Caucasian woman who had a reattachment of the greater trochanter following non-union of an intertrochanteric osteotomy of the hip. Five weeks later, the patient presented with features of Complex Regional Pain Syndrome but with the absence of pain. The second patient was a 20-year-old Caucasian woman who had undergone an open debridement and repair of a torn acetabular labrum. Ten days later, the patient presented with features suggestive of Complex Regional Pain Syndrome which was again painless. Both patients were non-weight bearing at presentation and the symptoms resolved following recommencement of weight bearing.</p> <p>Conclusions</p> <p>The authors believe these symptoms are manifestations of vascular changes to the lower limb as a result of non-weight bearing status. Painless Complex Regional Pain Syndrome-like symptoms may occur in patients who are kept non-weight bearing following hip surgery. However, vascular insufficiency and deep venous thrombosis must be excluded before this diagnosis is made. If the clinical situation permits, early weight bearing may relieve symptoms. Orthopaedic and vascular surgeons should be aware of this entity when a postoperative patient presents to them with the above clinical picture. This is also relevant to general practitioners who are likely to see the patients in the postoperative period.</p

The phosphorous necrosis of the jaws and what can we learn from the past: a comparison of "phossy" and "bisphossy" jaw

INTRODUCTION: The osteopathology of the jaws associated with bone resorption inhibitors is a current topic that engages a variety of clinical specialists. This has increased after the approval of denosumab for treatment of osteoporosis and skeletal-related events in patients with solid malignancy. Early after the first publications, there is a possible connection between phosphorous necrosis of the jaws, a dreadful industrial disease mentioned, and bisphosphonate-induced pathology. The nineteenth century was the prime time for phosphorus necrosis of match factory workers. RESULTS: This occurrence provides an interesting insight into the medical and surgical profession in the nineteenth century. There are striking parallels and repetition of current and old ideas in the approach to this "new disease." There are similar examples in case descriptions when compared with today's patients of bisphosphonate-related osteonecrosis of the jaws (BRONJ). DISCUSSION: Phosphorus necrosis was first described in Austria. Soon after this, surgeons in German-speaking countries including well-known clinicians Wegner (1872) and von Schulthess-Rechberg (1879) pioneered the analysis, preventative measures, and treatment of this disease. The tendency at this time was to approach BRONJ as a "special kind of osteomyelitis" in pretreated and metabolically different bone. Not only the treatment strategy to wait until sequestrum formation with subsequent removal and preventative measures but also the idea of focusing on the periosteum as the triggering anatomical structure may have been adopted from specialists in the nineteenth century. Therefore, phosphorous necrosis of the jaw is an excellent example of "learning from the past.

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Not AvailableNatural plant ecology support the livelihoods of a vast number of people through subsistence use of products, such as food, fodder, and medicinal plants; cash income obtained from sale of products; and more indirect ecological benefits such as the contributions of forests and trees to agricultural productivity and environment. The links between tree cover, access to food and improved dietary diversity are also becoming increasingly evident. While the benefits from forests are numerous, the tangible benefits like timber, bamboo, fuel wood, fodder, Non-Wood Forest Products (NWFPs), etc., are quantifiable. Intangible benefits like maintenance of ecological balance, conservation of soil and moisture, regulating the water flow, carbon sequestration, etc., are not quantified but are of great significance.Pest management and pruning activities are very critical for lac cultivation. Collection activities for other NWFPs are required proper isolation norms. The lac resin deteriorates in quality during storage. Therefore, lac and lac based products need proper handling and storage practices for retaining their properties and qualities. The deterioration in physical and chemical properties of lac takes place as a result of various chemical changes during storage. As it ages, lac slowly loses its solubility in alcohol, becomes less fluid and possesses poorer life under heat as a result of slow polymerization reactions. The extent of such deterioration depends upon various factors such as method of storage, storage environment (temperature and humidity), type of lac etc. Thus when stored in improper conditions for a long time, the resin becomes useless for all practical purposes which has became a major concern of lac industries.ICAr & CCSNIAM Jaipu

Effect of Sr-doping on sinterability, morphology, structure, photocatalytic activity and AC conductivity of ZnO ceramics

The change in morphology, structure, catalytic activity and ac electrical conductivity of the Sr-doped ZnO (Zn1-xSrxO, x = 0, 0.01, 0.02 and 0.03) ceramic powders was investigated after sintering. The sintering of the Sr-doped samples results in faster growth in particle-size and the shape becomes spherical by dissolution of the sharp edges in order to reduce the strain produced by Sr-doping and to reduce the surface energy. The growth in particle-size reduces the photocatalytic activity. Sr-doping reduces the band gap of ZnO by a small value (similar to 0.1 eV). The ac conductivity values decrease with increase in Sr-concentration, but increase with temperature and frequency. This behavior is due to the conduction by small polarons created by Sr-doping. Our results may facilitate a way for the easy fabrication of monolithic ZnO based devices with improved dielectric and semiconducting properties of ZnO ceramics by doping a small amount of Sr