Giant cell tumor distal end radius: resection and reconstruction using proximal fibular graft

Giant cell tumour forms 4% of all primary tumors. GCT distal radius is very rare. Current study presents a case of a 27 year female who was managed by wide excision and reconstruction with ipsilateral fibula. At one year follow up, patient had excellent range of motion at wrist joint and hand

Study on outcome of gastrocnemius recession surgery in diabetic equinus contracture

BACKGROUND: Diabetic equinus secondary to gastrocnemius contracture is a known predominant risk factor in diabetic foot ulceration characterized by reduction of ankle dorsiflexion. Recession surgery involves release of the gastrocnemius muscle at its aponeurosis and is one of the treatments of choice in improvement of diabetic equinus contracture. OBJECTIVE: To measure degree of improvement of ankle dorsiflexion and length gained at gastrocnemius aponeurosis following gastrocnemius recession surgery in diabetic equinus contracture. To assess correlation between the lengths gained at gastrocnemius aponeurosis with degrees of improvement in ankle dorsiflexion following surgery. METHODOLOGY: Total of 76 patients was recruited in the Orthopaedic clinics and wards at Penang General Hospital. Presence of gastrocnemius equinus was established with a positive Silfverskiold test. Gastrocnemius recession surgery using the Modified Strayer Technique was done following failed conservative therapy. Pre and post-operative ankle dorsiflexion was measured. Length gained at gastrocnemius aponeurosis was measured at 6 weeks post-operative using Ultrasound done in maximal ankle dorsiflexion. Results were analyzed using SPSS version 20.0 RESULTS: The severity of equinus contracture did not correlate to chronicity of diabetes mellitus. There was improvement of ankle dorsiflexion seen at 6 weeks post-operatively. It ranged from 6 to 16 degrees and was coupled with statistical significant length gained at gastrocnemius aponeurosis that ranged from a mean of 0.8cm to 3.8cm. Mean improvement ofankle dorsiflexion was 11.05 degrees. Mean improvement of length gain at gastrocnemius aponeurosis was 1.54cm. CONCLUSION: Gastrocnemius recession surgery appropriately addresses diabetic equinus secondary to gastrocnemius contractures by improving ankle dorsiflexion and is evidenced by a significant increase in length at the aponeurosis

Water scarcity in the Maltese islands: geopolitics and management issues

The Maltese Islands have a history of water resource problems. A high proportion of the Maltese population has suffered over the past few years from water scarcity caused mainly by: (a) a shortage in water production and escalating water demands; (b) rising salinity levels in groundwater and tap water; (c) an undersized and deteriorating distribution system; and (d) increasing levels of groundwater pollution. There is a spatial variation in the intensity of these problems. They are greatest in the south of Malta and it has been suggested that this is due to geopolitical, as well as social, economic and physical, factors. This inequity in water supply has, for many years, been blamed on the politicisation of water. The causes of the water problems are presented and the problems, themselves, are analysed. The link between the water problems and the politicisation of water and conflicts over water resources, is established and discussed. Finally, solutions, through water management and future planned developments, are presented. Social and geopolitical information was gathered mainly through qualitative interviews with water consumers, water suppliers, decision makers, academics and members of non-Governmental organisations, in Malta. Quantitative data on hydrology and the entire water management system was collected and analysed. An extensive literary search to support the physical, social, economic and geopolitical aspects of the research and to obtain legal information, was also undertaken. In conclusion, although the water problems have been enhanced by unsustainable management, they are a part of a wider geopolitical problem, especially the inequitable water supply. In particular, settlements with an affiliation to the political party in Government are better supplied than settlements that support the Opposition. In addition, water conflicts, at all scales, arise due to water scarcity and a lack or absence of water sharing regulations and, of course, human nature

Economic analysis of application of phosphorus, single and dual inoculation of Rhizobium and plant growth promoting rhizobacteria in lentil (Lens culinaris Medikus)

This study investigates the economic returns of lentil (Lens culinaris Medikus) by the use of phosphorus and biofertilizers [Rhizobium and plant growth promoting rhizobacteria (PGPR)] in Indian Punjab. The field experiments were conducted during Rabi 2013-14 and 2014-15 with combinations of four levels of phosphorus (0, 20, 30 and 40 kg P2O5 ha-1) and two/four biofertilizer treatments [uninoculated control and Rhizobium (LLR 12) + PGPR (RB 2)] in 2013-14, and uninoculated control, Rhizobium, PGPR and Rhizobium + PGPR in 2014-15) by replicating thrice. The use of 40 kg P2O5 ha-1 provided the highest gross returns whereas net returns and B:C were highest at 30 kg P2O5 ha-1. The combination of Rhizobium + PGPR + 40 kg P2O5 ha-1 provided the highest gross returns (Rs. 45902) whereas Rhizobium + PGPR+ 20 kg P2O5 ha-1 provided the highest net returns (Rs 20620). Furthermore, the integrated use of Rhizobium + PGPR + 20 kg P2O5 ha-1 provided higher net returns (Rs 20620) and B:C (1.88) as compared to sole application of 40 kg P2O5 ha-1 (Rs 18792 and 1.72). Thus, there was a net saving of 20 kg P2O5 ha-1 with the use of Rhizobium + PGPR inoculation without sacrificing the economics returns

Synergistic effect of metformin and fenugreek on the lipid profile of type-II diabetic patients

Background: Fenugreek is a traditional herb which has great relevance in the world since time immemorial due to its multifarious uses. Besides being a rich source of nutrition, it also finds place in the cure of certain pathological conditions. One of its highly beneficial effects is have been observed on the lipid profile of the hyperlipidemic patient. This study was thus undertaken to see the hypolipidemic effect of fenugreek seeds in patients of Type 2 Diabetes Mellitus (DM) as add-on therapy with metformin.Methods: An open-labelled comparative study of 12 weeks duration was conducted on patients (randomly divided in 2 groups of 30 each) of Type 2 DM. Group 1 was given metformin 500 mg twice a day while group 2 was given 500 mg of metformin along with fenugreek seed powder capsule, 1gm thrice a day. Evaluation for fasting lipid profile estimation was done at the beginning and at the end of the study. Student’s t-test (paired and unpaired) was applied for statistical analysis.Results: After 12 weeks of treatment, there was significant improvement in the lipid profile of both the groups. However, group 2, that received fenugreek along with metformin showed statistically greater improvement as compared to group 1 which received only metformin.Conclusions: This study shows the beneficial effects of fenugreek seeds on lipid profile in patients of Type 2 DM and can be used as an add-on therapy with metformin in controlling the lipid profile of Type 2 DM

Učinak hromosti na folikularnu dinamiku u postpartalnom razdoblju u anestričnih križanih krava

Lameness affects the reproductive performance of cows. It is not clear whether follicular dynamics is involved. Ovarian ultrasonography was performed once daily in eight non - lame (N) and 11 lame (L) cows for a period of 30 days each. Recurrent follicular waves could be detected every 8.3 ± 0.4 and 7.6 ± 0.5 days, respectively, in the N and L cows. There were no appreciable differences in the day of selection (Day 2.3 ± 0.2 versus Day 2.8 ± 0.2), maximum diameters (8.9 ± 0.6 mm versus 9.2 ± 0.5 mm) and certain characteristics pertaining to growth, static and regression of the dominant follicles (DFs) in the N versus the L cows. The L cows, however, had a tendency to have a higher number (P3≤5 mm). In conclusion, lameness did not affect the DFs that developed but failed to ovulate, but more the number of small follicles, both identifi ed and unidentifi ed, hints at some perturbance in the follicular characteristics of lame cows that needs to be addressed in the light of the mechanisms governing follicular dynamics.Hromost utječe na reprodukcijsku sposobnost krava, ali nije sa sigurnošću ustanovljeno utječe li i na folikularnu dinamiku. Jajnici osam normalnih i 11 hromih krava ultrazvučno su bili pregledavani jednom dnevno u razdoblju od 30 dana. Povratni folikularni valovi mogli su se ustanoviti svakih 8,3 ± 0,4 u normalnih i 7,6 ± 0,5 dana u hromih krava. Nisu bile ustanovljene znatne razlike u selekciji (dan 2,3 ± 0,2 u normalnih, 2,8 ± 0,2 u hromih), najvećem promjeru (8,9 ± 0,6 mm u normalnih, 9,2 ± 0,5 mm u hromih) određenim značajkama rasta, postojanosti i regresije dominantnih folikula u normalnih u odnosu na hrome krave. Međutim hrome krave pokazivale su tendenciju većeg broja (P3≤5 mm). Zaključuje se da hromost nije utjecala na dominantne folikule koji su se razvili, a nisu ovulirali, ali veći broj malih folikula, identifi ciranih i neidentifi ciranih, upućuje na neke smetnje folikularnih značajki u hromih krava koje se moraju uzeti u obzir u svjetlu mehanizma što upravlja folikularnom dinamikom