Osteochondroma patellae – A case report.

Patellar tumors are rare and are usually benign as opposed to malignant tumours. The most frequent benign lesions of patella are giant cell tumor (common in adults), chondroblastoma and osteoid osteoma. A solitary exostosis is the most common benign bone tumor which occurs around the growth plate of long bones. The treatment of choice is extra periosteal resection of exostosis and ensuring complete removal of cartilaginous cap. Indications of surgery are when the exostosis is interfering or disturbing the growth of extremity, malignant transformation, presence of bone erosion, neurovascular compression, interference with joint motion, bursitis, fracture through the stalk and cosmesis. We report a rare case in an adult patient with an extra-articular skeletal osteochondroma of the patella located antero - superiorly which presented as an enlarged bursa and a bony swelling over knee joint.

Evaluation of role of topical 0.2% Glyceryl trinitrate ointment and topical 2% Diltiazem ointment in healing of anal fissure.

Backround: The patho-physiology of anal fissure is thought to be related to trauma to the anoderm from any cause. A tear in the anoderm causes acute pain, which results in spasm of the internal anal sphincter and decreased blood supply to the anoderm. Aim: To comparative evaluation of topical 0.2% Glyceryl trinitrate ointment and topical 2% Diltiazem ointment in anal fissure and to evaluate the role of topical 0.2% Glyceryl trinitrate ointment and topical 2% Diltiazem ointment in healing of anal fissure as compared to prevalent conservative treatment i.e. topical anaesthetics Material and methods: The study was conducted on the patients of anal fissure reported in outpatient department of General Surgery at Guru Gobind Singh Medical College and Hospital, Faridkot including 60 patients which randomized in 3 groups, group A, group B and group C. the data was statistically analyzed using the SPSS version 16. Results: Improvement in constipation after 8 weeks of treatment were 85%, 85% and 80% in Group A, B and C respectively and p value was non-significant (0.887). Improvement in bleeding after 8 weeks of treatment were 90%, 90% and 85% in Group A, B and C respectively and p value was non- significant (0.851). Healing was 78.57%, 92.31% and 46.15% in Group A, B and C respectively Conclusion: Topical 2% Diltiazem and 0.2% Glyceryl trinitrate ointment are equally effective in healing of chronic anal fissure. However, early pain improvement and fewer side effect profile of Topical 2% Diltiazem ointment; this study suggests it as first line treatment of chronic anal fissure.