Stab Injury with Tailoring Scissor Causing Inferior Gluteal Artery Pseudo Aneurysm: a Rare Case Report

Background: Gluteal artery pseudo aneurysm (GAP) is a rare entity, as gluteal arteries are well protected under muscles and fat of gluteal region. Gluteal artery aneurysms constitute less than 1% of all aneurysms and most of them are pseudo aneurysms.  The common etiologies of GAP  areblunt or penetrating trauma to gluteal region, infection, fractures of the pelvis or iatrogenic injury during surgical procedures on the pelvis or hips to intramuscular injection. The usual presentation is a pulsatile gluteal mass often confused with a gluteal abscess presenting 1-2 months after injury. However, at times it can cause symptoms due to compression of pelvic structures.Case Report: Our patient was a young boy who had injury to his right gluteal region with a tailoring scissor during a scuffle. He presented to casualty in shock with packing of wound done outside. After resuscitation his Computed tomographic angiography (CT angiography) revealed a psuedoanuerysm of inferior gluteal artery. He was immediately taken up for surgery a transperitoneal ligation of internal iliac artery of the involved side was done along with exploration of the gluteal wound.Conclusion: These patients of Gluteal artery aneurysms can be managed with both open and endovascular techniques. Our patient was unique in the respect that no GAP has been reported after stab injury with a tailoring scissor and ours is first case report in English literature .We want that the surgeons should keep in mind the possibility of GAP while dealing with even trivial injuries of gluteal region

A randomized controlled trial on the effectiveness of strength training on clinical and muscle cellular outcomes in patients with prostate cancer during androgen deprivation therapy: rationale and design

Background Studies indicate that strength training has beneficial effects on clinical health outcomes in prostate cancer patients during androgen deprivation therapy. However, randomized controlled trials are needed to scientifically determine the effectiveness of strength training on the muscle cell level. Furthermore, close examination of the feasibility of a high-load strength training program is warranted. The Physical Exercise and Prostate Cancer (PEPC) trial is designed to determine the effectiveness of strength training on clinical and muscle cellular outcomes in non-metastatic prostate cancer patients after high-dose radiotherapy and during ongoing androgen deprivation therapy. Methods/design Patients receiving androgen deprivation therapy for 9-36 months combined with external high-dose radiotherapy for locally advanced prostate cancer are randomized to an exercise intervention group that receives a 16 week high-load strength training program or a control group that is encouraged to maintain their habitual activity level. In both arms, androgen deprivation therapy is continued until the end of the intervention period. Clinical outcomes are body composition (lean body mass, bone mineral density and fat mass) measured by Dual-energy X-ray Absorptiometry, serological outcomes, physical functioning (muscle strength and cardio-respiratory fitness) assessed with physical tests and psycho-social functioning (mental health, fatigue and health-related quality of life) assessed by questionnaires. Muscle cellular outcomes are a) muscle fiber size b) regulators of muscle fiber size (number of myonuclei per muscle fiber, number of satellite cells per muscle fiber, number of satellite cells and myonuclei positive for androgen receptors and proteins involved in muscle protein degradation and muscle hypertrophy) and c) regulators of muscle fiber function such as proteins involved in cellular stress and mitochondrial function. Muscle cellular outcomes are measured on muscle cross sections and muscle homogenate from muscle biopsies obtained from muscle vastus lateralis. Discussion The findings from the PEPC trial will provide new knowledge on the effects of high-load strength training on clinical and muscle cellular outcomes in prostate cancer patients during androgen deprivation therapy. Trial registration ClinicalTrials.gov: NCT0065822