A study of surgical management of idiopathic congenital talipes equinovarus by posteromedial soft tissue release

Background: Idiopathic congenital talipes equinovarus is a complex deformity that is difficult to correct. The treatment of club foot is controversial and continues to be one of the biggest challenges in paediatric orthopaedics. Most orthopaedicians agree that the initial treatment should be non-surgical but if it fails, advise surgical treatment in the form soft tissue release for better results. The study was done with the aim to study a short term follow up of 14 patients treated to assess the efficacy of the treatment modality.Methods: 14 patients underwent the posteromedial soft tissue release (PMSTR) at Department of Orthopaedics, S. V. S. Medical College during the period from October 2013 to September 2015. Patients were followed up regularly up to one and half year. Severity of foot deformities were graded according to Denis-Brown classification.Results: Out of 14 cases there were 10 males (71.4%) and 4 females (28.6%) for the sex ratio of 2.5:1 male to female. The youngest child was 6 months old and oldest child was 3 years old. In bilateral cases both feet were operated at an interval of 7 to 10 days. Good results were seen in 15 feet (71%), fair: in 04 feet (19%) and poor: in 02 feet (10%).Conclusions: The PMSTR method is a safe and cost-effective treatment for congenital idiopathic clubfoot and radically decreases the need for extensive corrective surgery. Non-compliance with orthotics after surgery and surgery at late age are causes for failure of technique

A case report of synchronous primary malignancy: Papillary thyroid carcinoma and non-Hodgkin’s lymphoma

Multiple primary malignancies involving papillary thyroid carcinoma and non-Hodgkin’s lymphoma (NHL) is an extremely unusual event. Here, we report the case of a 70-year-old man presented with high-grade fevers and abdominal discomfort and were found to have pancytopenia. He had generalized lymphadenopathy, hepatosplenomegaly, goiter, and tracheal shift. Biopsy of the left cervical lymph node was positive for papillary carcinoma of the thyroid. He underwent excision biopsy of axillary lymph node which was suggestive of high-grade NHL. The patient was started on chemotherapy (R-CHOP) and his fevers resolved promptly. He then underwent total thyroidectomy and the histopathology of the thyroid gland post-operative showed papillary carcinoma. The second primary malignancy is a second malignant neoplasm occurring in a patient with known cancer. This case highlights the unusual synchronous occurrence of the papillary carcinoma of thyroid and NHL and the diagnostic challenges involved in such cases

Synthesis, Characterization, Theoretical Treatment and Antitubercular activity Evaluation of (E)-N’- (2,5-dimethoxylbenzylidene)nicotinohydrazide and some of its Transition Metal Complexes against Mycobacterium tuberculosis, H37Rv

(E)-N’-(2,5-dimethoxylbenzylidene)nicotinohydrazide) (HL) was synthesized by condensing nicotinic acid hydrazide and 2,5-dimethoxylbenzaldehyde with ONO coordination pattern. The structure of the hydrazone was elucidated by using CHN analyzer, ESI mass spectrometry, IR, 1H NMR, 13C NMR and 2D NMR (COSY and HSQC). The hydrazone was used to synthesized five metal complexes [Mo(V), VO(II), Mn(II) Ni(II) and Cu(II)] which were characterized by several physicochemical methods, namely elemental analysis, electronic spectra, infrared, EPR, molar conductivity and magnetic susceptibility measurements. An octahedral geometry was suggested for Mo(V), Ni(II) and Cu(II) complexes while tetrahedral was proposed for Mn(II) complex. VO(II) complex conformed with tetrahedral pyramidal. Structural geometries of these compounds were also suggested in gas phase by using Hyper Chem-8 program for the molecular mechanics and semi-empirical calculations. The energy (E) and eV for homo and lumo state for the prepared compounds were calculated by using PM3 method. In vitro antimycobacterial activity study of the compounds was evaluated against Mycobacterium tuberculosis, H37Rv, by using micro-diluted method. Some of the metal complexes displayed higher activity than the ligand (HL) and isoniazid (INH).Also some of the complexes showed moderate activity when compared to isoniazid. Generally, the results obtained revealed that the compounds exhibited promising antitubercular activity. However, the metal complexes were found to be more toxic than isoniazid drug

SYNTHESIS OF (E)-N'-(5-bromo-SYNTHESIS OF (E)-N'-(5-bromo-2-hydroxybenzylidene)nicotinohydrazide) AND ITS Pt(II), Zn(II), Mn(II), Ni(II) AND Mo(V) COMPLEXES AS POTENTIAL ANTI-TUBERCULAR AGENT AGENT

The cold condensation reaction of nicotinic acid hydrazide and 5-bromo-2-hydoxylbenzaldehyde to form a tridentate Schiff base hydrazone ligand {H2L3 ) was studied. The prepared ligand was characterized using CHN analyzer, ESI mass spectrometry, IR, 1H NMR, 13C NMR and 2D NMR such as COSY and HSQC. Thereafter, five novel metal complexes [Pt(Il), Zn(ll), Mn{ll), Ni(JJ) and Mo(V)] of the hydrazone ligand were synthesized and characterized based on conductivity measurements, CHN analysis, AAS, magnetic measurement, UV/ Vis, IR, ESR and TGAIDTA study. The proposed structures of the metal complexes were further supported with the use of powder X-ray analysis. Antitubercular activity study of the compounds was evaluated against Mycobac/erium Juberculosis H37Rv by using microdiluted method. The study revealed that H2L3 exhibited promising anti-tubercular activity with MlC value of 0.82 j.igfmL. Also, metal complexes {(Pt(H2L3)Cl]- 0.88 IJg/mL, [Mn{H2L3)(CH3C00)2]- 0.78 JJ.g/mL, [Zn(H2e)(CH3C00)2H20]- 0.62 J.Lg/mL and [Ni{H2L3)(CI)2]H20- 1.19 J.Lg/mL) exhibited significant inhibition as compared to the standard drug (isoniazid- 0.91 j.ig/mL). Complex 2 and 3 with coordinated acetates showed two folds inhibition than standard isoniazid drug. However, complex 5 with coordinated chlorine atom displayed lower inhibition when compared to isoniazid

Efficacy of the 1-year (13-cycle) segesterone acetate and ethinylestradiol contraceptive vaginal system : results of two multicentre, open-label, single-arm, phase 3 trials

A ring-shaped, contraceptive vaginal system designed to last 1 year (13 cycles) delivers an average of 0.15 mg segesterone acetate and 0.013 mg ethinylestradiol per day. We evaluated the efficacy of this contraceptive vaginal system and return to menses or pregnancy after use. In two identically designed, multicentre, open-label, single-arm, phase 3 trials (one at 15 US academic and community sites and one at 12 US and international academic and community sites), participants followed a 21-days-in, 7-days-out segesterone acetate and ethinylestradiol contraceptive vaginal system schedule for up to 13 cycles. Participants were healthy, sexually active, non-pregnant, non-sterilised women aged 18-40 years. Women were cautioned that any removals during the 21 days of cyclic use should not exceed 2 h, and used daily paper diaries to record vaginal system use. Consistent with regulatory requirements for contraceptives, we calculated the Pearl Index for women aged 35 years and younger, excluding adjunctive contraception cycles, as the primary efficacy outcome measure. We also did intention-to-treat Kaplan-Meier life table analyses and followed up women who did not use hormonal contraceptives or desired pregnancy after study completion for 6 months for return to menses or pregnancy. The trials are registered with ClinicalTrials.gov, numbers NCT00455156 and NCT00263341. Between Dec 19, 2006, and Oct 9, 2009, at the 15 US sites, and between Nov 1, 2006, and July 2, 2009, at the 12 US and international sites we enrolled 2278 women. Our overall efficacy analysis included 2265 participants (1130 in the US study and 1135 in the international study) and 1303 (57.5%) participants completed up to 13 cycles. The Pearl Index for the primary efficacy group was 2.98 (95% CI 2.13-4.06) per 100 woman-years, and was well within the range indicative of efficacy for a contraceptive under a woman's control. The Kaplan-Meier analysis revealed the contraceptive vaginal system was 97.5% effective, which provided further evidence of efficacy. Pregnancy occurrence was similar across cycles. All 290 follow-up participants reported return to menses or became pregnant (24 [63%] of 38 women who desired pregnancy) within 6 months. Interpretation The segesterone acetate and ethinylestradiol contraceptive vaginal system is an effective contraceptive for 13 consecutive cycles of use. This new product adds to the contraceptive method mix and the 1-year duration of use means that women do not need to return to the clinic or pharmacy for refills every few months78e1054e1064We thank The Eunice Kennedy Shriver National Institute of Child Health and Human Development of the National Institutes of Health (NICHD), the US Agency for International Development (USAID), and WHO for funding the phase 3 studies. We also acknowledge all participating study investigators (appendix p 1) and coordinators at the 27 clinical sites for conduct of the two phase 3 clinical trials and the over 2200 women participants from eight countries. We further acknowledge the medical writing assistance of Kathleen Ohleth (Precise Publications; Bedminster. NJ, USA) supported by TherapeuticsMD (Boca Raton, FL, USA). The NICHD (contract no HHSN27500403372) funded and conducted the US study and USAID (grant no GPO-A-00-04-00019-00) funded the international study, which was conducted by the Population Council. WHO Department of Reproductive Health and Research funded two international study sites. Medical writing support for manuscript submission and resubmission was supported by TherapeuticsMD. The authors acknowledge the major contribution of Daniel R Mishell Jr (deceased), from the Department of Obstetrics and Gynecology, University of Southern California, Keck School of Medicine (Los Angeles, CA, USA) who invented the concept of the vaginal system to deliver contraceptive steroids, did many of the clinical studies for the segesterone acetate and ethinylestradiol contraceptive vaginal system, and was a principle investigator for the 300 B phase 3 study analysed in this Article while a member of the International Committee for Contraceptive Research (ICCR) of the Population Council. The authors also gratefully acknowledge the contribution of Horacio B Croxatto, from the University of Chile (Santiago, Chile), who established the clinical centre in Chile, participated in all pivotal clinical studies for this ring, and provided guidance for the full development of this new contraceptive while a member of the ICC