HIGH-VELOCITY FRACTURE: CASE OF DISPLACED INTERTROCHANTERIC FRACTURE OFFEMUR WITH SPIRAL FRACTURE OF SHAFT OF RIGHT FEMUR

BACKGROUND Intertrochanteric fracture is a common orthopedic condition characterized by extracapsular fractures of the proximal femur that occur between the greater and lesser trochanter with predominance in elderly population, especially those with osteoporosis, wherein even a low energy mechanism is enough to cause the fracture. There is an observed female predominance with ratio between 2:1 and 8:1. [1,2] Commonly observed symptoms include shortened and externally rotated limb, pain and bony tenderness around the hip joint, inability to bear weight on the affected limb to name a few. Management depends upon age of patient, nature of the fracture, number of comminuted fragments and blood loss. Treatment for intertrochanteric fractures includes conservative management using Thomas splint application and immobilization after reduction of fracture. In case the fracture is displaced then there is a need for surgical reduction and internal fixation using dynamic hip screw, proximal femoral nail or gamma nails. CASE DESCRIPTION A 27-year-old male patient presented to the emergency department of JSS hospital with alleged history of road traffic accident with inability to bear weight on the right lower limb, bony tenderness and crepitus over right hip joint and over right thigh which was confirmed to be intertrochanteric fracture and spiral fracture of shaft of femur on radiographic imaging. CONCLUSION This case report presents the mechanism of injury which is high energy mechanism leading to intertrochanteric fracture in young individual and its management

Comparison of Conventional PAP smear and Manual Liquid Based Cytology with P16 marker in screening for cervical cancer in Indian tertiary healthcare setups in Mysuru

In India, there are 20.2 per 100000 new cases of Cervical Cancer diagnosed and 11.1 per 100000 deaths annually accounting for more than one fifths of global cervical cancer deaths. [1] Thus, due to an absence of a national immunization program to cover human papillomavirus (HPV) vaccination and lack of accessible cervical cancer screening, the disease is characterized by late detection, lack of access to affordable and quality health care, and high mortality rates. [2] Papanicolaou Smear Test was a novel invention by Dr George Papanicolaou in the year 1927 which gained maximum popularity in 1950 as a screening test for Cervical Cancer. Liquid based cytological technique has been recently developed and has gained popularity because in preliminary studies the use of such techniques was associated with a reduction in incidence of inadequate cervical smears. [3, 4] Manual Liquid Based Cytology (MLBC) is a technique that enables cells to be suspended in a monolayer and thus improves detection of precursor lesions and improvement of specimen adequacy. MLBC has been reported to improve the effectiveness of cervical cancer screening in a population by increasing the detection of histologically confirmed neoplastic and preneoplastic disease while simultaneously decreasing over diagnosis of benign processes. [1] Liquid-based cytology (LBC), although claimed to provide clearer background and better preservation of nuclear and cytoplasmic details, have yet to be proven to have better sensitivity and specificity for identification of high-grade cervical intraepithelial lesions compared to the conventional smears.[5] P16 expression, which can be detected immunohistochemically, is directly related to the presence of HPV [8]. Thus, this protein can be used as a biomarker that can add significant diagnostic precision in the assessment of CIN lesions [7, 9]. Add about ancillary technique like use of immunomarker p16 on mlbc. The aim of this study is establishing that MLBC with p16 immunomarker is very effective in screening for cervical cancer as it overcomes the major setbacks like inadequate sampling, drying artefacts and obscuring blood which are seen in conventional PAP smear technique

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