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Surgical management of femoral shaft fractures with intramedullary nails has become the standard of care, with multiple options for entry point described, including piriformis entry, trochanter entry and retrograde femoral nails. Our present review describes the surgical anatomy of the proximal and distal femur and its relation to different entry points for intramedullary femoral nails. In addition, we reviewed relative indications for each technique, difficulties associated and possible complications.
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Humans , Femoral Fractures/surgery , Bone Nails , Femur/surgery , Fracture Fixation, Intramedullary/methods , Lower ExtremityABSTRACT
Background:Novel coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Thorough knowledge about its spread and symptoms, perceptions towards disease and practices to prevent its occurrence are essential. The goal of this study is to assess the knowledge, perceptions and practices of the Bangladeshi residents towards the COVID-19.Methods:A cross-sectional, web-based, pre-tested questionnaire was designed emphasized on the demographic profile, knowledge and perceptions about cause, transmission, prevention and cure of COVID-19. The questionnaires were distributed to 8 districts of Bangladesh only. The survey consists of close ended questions and took approximately 15 minutes to complete during the period of 20th March to 20th April 2020.Results:A total of 320 completed the study questionnaire, including (67.5%) men and (32.5%) women, and most of them are age range 31-50 years (80.00%). 87.19% people knew cause of COVID-19 is viral and 48.75% knew it spreads through coughs. 77.81% people correctly knew about symptoms of COVID-19. 70.00% mentioned all the correct preventive methods as wearing face mask, vaccination, avoid mass gatherings and maintaining hand hygiene. In reality, only 40.00% people exclusively practicing hand hygiene. Conclusions:In general, Bangladeshi population participating in our survey had good knowledge about COVID-19, and a positive attitude towards using protective measures, which is important to limit the spread of the disease.
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Background:The emergence of antimicrobial resistance possessesa great threat for the existence of mankind. Antibiotics like penicillin and amoxiclav are at the brink of losing their efficacy entirely in exposure to resistant bacteria. Thus, the present study was aimed to find out the antibacterial efficacy of black seed honey as an alternative natural source which can act independently and boost the efficacy of standard drugs alongside. Methods:Penicillin, amoxiclav and black seed honey were first individually trailedagainst four gram-positive bacteria -Bacillus subtilis, Staphylococcus aureus, Staphylococcus epidermidis andMicrococcus luteus.Afterwards, penicillin and amoxiclav were used in combination with honey and compared the synergistic effects with their individual efficacy. Zones of inhibition from well diffusion method, percentage inhibition, minimum inhibitory and bactericidal concentrations by microdilution method were determined in the present study.Results:Black seed honey alone demonstrated great inhibitory potential against S. aureus (9.7 mm), S. epidermidis (9.9 mm) and M. luteus(9.3 mm) in well diffusion method. Moreover, its combination with amoxiclav showed synergistic effect against all bacteria except S. epidermidis. However, its conjugation with penicillin was not able to produce any synergism as exhibited by zones of inhibition. The lowest concentration (1.56%) of honey applied individually or in combination in microdilution method foundhighly effective which established an inverse dose dependent relationship with efficacy.Conclusions:From the data it can be concluded that the black seed honey is a highly potent natural agent which can be utilized in antimicrobial therapy. However, further investigation is recommended to identify the responsible compound for such activity.
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@#AIM: To find out the prevalence of inherited color vision deficiency(CVD)among Palestinian male-school children aged 14-18 and compare it with other eastern and western countries. <p>METHODS: Six hundred and thirty-four male subjects(<i>n</i>=634)aged 14-18 from Palestinian Governorate of Nablus were randomly selected and screened using Ishihara pseudoisochromatic plates. Subjects who failed Ishihara screening were tested further with computer software of Farnsworth-Munsell 100 Hue test.<p>RESULTS: Out of the 634 male participants, 597 were included in the study and 8.0% of them(48 males)demonstrated red-green CVD. 5.4%, 2.3% and 0.3% of the 48 males exhibited deutan, protan and total color vision deficiency(monochromacy), respectively.<p>CONCLUSION: The results show that the prevalence of red-green CVD among the male school children from Palestinian Governorate of Nablus is not significantly different from that of male populations in nearby and Western countries.
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@#Blastocystis sp. is a common enteric protozoan parasite found in humans and various type of animal worldwide. Recently, genotypic distribution of Blastocystis sp. was revealed in insects, rodents, avian and mammals, which exposed its potential of transmiting the infections to human. However, very little information on current level of Blastocystis sp. infection were reported in cattle from Malaysia. Herein, a total of 120 stool samples of cattles were collected. While the potential risk of infection such as age, gender, body score, diarrheic condition of the cattle were noted, the management of the farms was also recorded. All stool sample were cultured, but 80 samples were selected for PCR sequencing analysis. The cultivation and microscopic examination revealed only 25% of the cattle (30/120) were infected with Blastocystis sp.. But, 43.8% of the cattle (35/80) were found positive upon PCR sequencing. The study also found that age, body score condition, diarrheic condition and certain farm were associated with the infection (p<0.05). Six subtypes (STs) that were discovered during the study were ST10 (21.3%;17/35), ST5 (8.8%;7/35), ST3 (7.5%;6/35), ST1 (2.5%;2/35), ST4 (2.5%;2/35) and ST14 (1.3%;1/35). Thus, moderate infections of Blastocystis sp. and variants in the genotypic distributions of the cattle suggest its potential for zoonotic transmission. Therefore, this findings could be helpful for further understanding the parasite, which assist studies of its pathogenicity.
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Background:Mustard honey, a monofloral honey derived from mustard flower is considered a great source of nutritional and medicinal values. The honey is traditionally used as ethnomedicinein different parts of the world to cure many health problems. The present study aimed to evaluate its sedative-anxiolytic potential by integrating three conventional methods in a sequential order. Methods:Open field, hole cross and elevated plus maze experiments were performed in a row with a single oral administration of honey to the Swiss Albino mice. Behavioral parameters like square crossing, rearing, grooming, hole crossing and entry/duration in open arm were observed for each animal in different time intervals.Results:The findings were compared to that of a standard drug, diazepam (1mg/kg). Mustard honey at higher doses showed sedative activity (4g/kg and6g/kg) whereas with low doses (2g/kg) exhibited anxiolytic potential. The physicochemical properties of honey were also screened in this study.Conclusions:The integrated method proved to be an effective approach for assessment of neuropharmacologicalpotential for crude or standard medicine. However, further analysis was recommended to investigate active compound which may lead to a new drug development
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Objective: Diet-inducedhyperlipidemia and obesity are the major risk factors for type II diabetes mellitus, hypertension, musculoskeletal and cardiovascular disorders (CVD). The objective of the present study is to furnish scientific proof for the lipid-lowering effect of β-glucan, a lead compound present in barley with a defined mechanism of action. Methods: Obesity was induced in male albino Wistar rats by feeding ahigh-fat diet (HFD) for 14 w and were randomly divided into four groups of equal number (n=6). Group 1 and 2 served as control fed with normal diet (5% fat). Group 3 and 4 were fed HFD (23%fat) for 14 w. In addition, group 2 and 4 rats were administered orally with 200 mg/kg body weight of barley β glucan (BRBG) from the third week. After 14 w, the rats were sacrificed, and serum/plasma levels of total cholesterol (TC), phospholipids, triglycerides (TG), high-density lipoprotein (HDL), low-density lipoprotein (LDL) and adiponectin were determined. Results: Biochemical changes were observed in weight gain, body mass index (BMI),adiposity index (ADI), total fat pad mass (TFP), blood lipids, LDL, lipid peroxides (LPO) and antioxidant enzyme activity of HFD fed rats when compared with BRBG co-administered rats. In addition, serum adiponectin levels and 3-hydroxy-3methyl-glutaryl-coenzyme Areductase(HMG CoA reductase)activity were elevated in rats administered BRBG along with HFD. Histological examination in HFD induced rats revealed a profound change in cell size with increased hypertrophy in visceral adipose tissue. Conclusions: The results indicate that barley consumption could reverse most of these biochemical and histological changes in HFD fed rats owing to its hypolipidemic and antioxidant effect.
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Traditional Persian medicine (TPM) proposes a different viewpoint to the chronic diseases. Diagnosis and implemented treatment are based on individual differences among patients. Constipation or Ea'teghal-e-batn is a condition in which the patient develops difficult or painful defecation. Based on TPM concepts, the fifirst digestion step starts from halq (oral cavity), and ends via defecation from the maq'ad (anus). Avicenna believed that four faculties, ha'zemeh (digestive), ja'zebeh (absorptive), ma'sekeh (retentive) and da'fe'eh (propulsive), are involved in the process of digestion and absorption of the ingested food and expelling the waste materials. The bowel movement and appearance of the stool is a measure for evaluating the gastrointestinal healthy function. Defecation should be with no pain and fecal material should have no burning and acuity. Low food intake or foods with dry temperament, dryness of gastrointestinal tract, diaphoresis and heavy exercise as well as intestine sensory loss were discussed as main causes of constipation. Management of constipation in TPM includes dietary schemes, oil massages and subsequently simple herbal medicines. According to TPM theories, the fifirst step in treating a disease is the elimination of disease causes (asbabe- maraz) and also providing the causes of health (asbab-e-sehhat). Health care providers should know the proper condition which the herbal medicines should be administered in and be able to guide the patients about the benefifits and hazards of herbal remedies, commonly used in their living origin.
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Objective: To evaluate the therapeutic properties of nAG protein during the recovery following acute spinal cord injuries in the rat
Study Design: An experimental study
Place and Duration of Study: King Saud University, Riyadh, Saudi Arabia, from September 2014 to September 2015
Methodology: Eight rats were studied [4 control rats and 4 experimental rats; and hence 50% were controls and 50% were experimental]
All rats were subjected to an acute spinal cord injury using the aneurysmal clip injury model. Immediately after the injury, a single intra-dural injection of either normal saline [in the control group] or the nAG protein [in the experimental group] was done. Assessment [if both groups was done over a 6-week period with regard to weight maintenance, motor recovery scores, MRI and histopathology of the injury site
Results: Weight maintenance was seen in the experimental and not in the control rats. Starting at 3 weeks after injury, the motor recovery was significantly [p<0.05] better in the experimental group
MRI assessment at 6 weeks showed better maintenance of cord continuity and less fluid accumulation at the injury site in the nAG-treated group. Just proximal to the injury site, there was less gliosis in the experimental group compared to the control group. At the crush injury site, there was less tissue architecture distortion, less vacuole formation, and less granulation tissue formation in the experimental group
Conclusion: The local injection nAG protein enhances neuro-restoration, reduces gliosis, and reduces vacuole/ granulation tissue formation following acute spinal cord crush injury in the rat aneurysmal clip animal model
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Animals, Laboratory , Female , Adult , Amino-Acid N-Acetyltransferase/therapeutic use , Rats, Sprague-Dawley , Surgical Instruments , Gliosis/drug therapy , Models, AnimalABSTRACT
Objective: To determine tendon stump changes following unrepaired Achilles tendon lacerations in an animal model
Study Design: An experimental study
Place and Duration of Study: King Saud University, Riyadh, Saudi Arabia, from October 2013 to January 2014
Methodology: A rabbit model was developed and studied tendon retraction and histological changes in the proximal and distal stumps following transection of the Achilles tendon
Results: Over a period of 12 weeks, retraction of the distal tendon stump was minimal [2 - 3 mm]. In contrast, retraction of the proximal tendon stump peaked to reach 6 mm at 4 weeks post-injury and plateaued to reach 7 - 8 mm at the 12-week interval
Conclusion: Following complete transection of the Achilles tendon, tendon retraction correlated with the density of myofibroblast expression within the tendon stump. Further research is needed to investigate the pathophysiology of these findings
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Objective: To recommend prerequisites for the histo-pathological evaluation of reduction mammoplasty [RM] specimens based on an audit in a tertiary care hospital
Methods: All reduction mammoplasty specimens received at department of pathology, in a tertiary care hospital over a 3 years period were re-evaluated retrospectively. Medical records were checked for age, family history of breast cancer, indication for surgery and radiological evaluation. Pathology reports were reviewed for number of blocks sampled and diagnosis. A prerequisites protocol was developed based upon deficiencies and impediments noted
Results: We received a total of 26 cases of reduction mammoplasty. Only 2 [7.69%] specimens were from males. The age of the patients ranged from 26 to 50 years. Indication for surgery was provided in all [100%] of cases, with macromastia being most prevalent indication. Family history of breast carcinoma and radiological evidence was absent or not provided in all cases. The number of blocks prepared were in range of <4 in 17 [73.91%], 5-8 blocks in 5 [19.23%] and 8-12 blocks in 4 cases [15.38%]. The main histopathological finding was fibrocystic change, [n = 12, 46.15%]. Specimen radiography was not conducted in any case
Conclusion: There is a need to stratify RM cases as high, moderate and low risk of breast cancer based on family history of breast carcinoma, clinical and radiological evaluation. The high risk cases should be oriented, with margins inked and extensive sampling done. Specimen radiography should be carried out in younger patients in which mammography is not recommended
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Humans , Female , Adult , Middle Aged , Tertiary Care Centers , Breast Neoplasms , Fibrocystic Breast Disease , Retrospective StudiesABSTRACT
Introduction: acute scrotum is one of the common surgical emergencies in pediatric age group. Although the differential diagnoses are many, most of the conditions are not urgent; of paramount importance is the prompt diagnosis and surgical treatment of torsion of the test is to avoid permanent ischemic damage. In this study we present our experience at University of Jordan Hospital in management of acute scrotum in children
Methods: a retrospective review of the pediatric patients who were admitted to the pediatric surgical unit at Jordan University Hospital with acute scrotum from March 2008 to March 2013. The characteristics of symptoms, clinical and imaging findings prior to operation, operative findings and type of management were recorded
Results: a total of 59 patients with acute scrotum were admitted and constituted the basis of this study. Operative exploration was performed in all of the 59 cases: Four patients [7%] had testicular torsion, 28patients [48%] had torsion of testicular appendix, 13 patients [22%], had epididymo-orchitis, three patients had idiopathic scrotal edema; three patients [5%] had scrotal hematomas due to trauma; two patients[3%] had incarcerated inguinal hernias; two patients[3%] had hydroceles and four patients [7%] had normal findings
Conclusions: testicular torsion is a common surgical emergency in children which should be treated promptly with early scrotal exploration; since no diagnostic test in the pre-operative work up could differentiate between the different causes and excludes torsion testis which is the major concern. A prospective study to evaluate the diagnostic accuracy of Doppler ultrasonography is suggested based on the results of the predictive values seen in our study
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Diverticular disease of the colon is a common condition in western and developed countries. Distal colon is the mainly stricken part, being the sigmoid colon affected in up to 70% of the patients. The occurrence of rectal diverticula is very rare, with only sporadic reports in the literature since 1911. Symptomatic rectal diverticula are encountered even less frequently. Most patients are diagnosed incidentally, inflammatory processes may have developed at the time of the diagnosis .Treatments of these complicated events range from conservative treatments to major surgical interventions. Here we present a patient who was diagnosed with rectal diverticulum causing constipation and difficult defecation
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Ibn Sina is one of the most well know scholars in middle ages. This Persian physician wrote different books in medical filed which his great encyclopedia remained as one the most successful medical encyclopedia during the history. Ibn Sina discussed diseases of oral cavity and dentistry in the 3rd book of The Canon of medicine. He discussed different conditions such as different types of trauma to the motor nerves, taste sensation, different limitations of tongue movements, Ranula, halitosis, tooth sensation, different types of tooth pain, Bruxism, attrition, loss of enamel, gingival bleeding, recession and hyperplasia. For management of these diseases he introduced more than 80 herbal remedies. Most of this plant species are from essential oil reach families. Generally, Ibn Sina has a deep view in case of dental diseases and his ideas and methods for treatment of this category of disease could be studied for finding new treatment in dental ailments
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Objectives: To synthesize dihydro-pyrimidine-5-carbonitrile derivatives [5-23], as an extension of the previous series, and to evaluate their anticonvulsant potential
Methods: The designed compounds were synthesized and characterized using infrared [IR], nuclear magnetic resonance [NMR] and mass spectroscopy and were evaluated for anticonvulsant activity using the maximal electroshock seizure [MES] and subcutaneous pentylenetetrazole [scPTZ] methods. Compounds with appreciable activity were investigated for their neurotoxicity using the rotarod test
Results: Compounds 17 and 23 were found to be most active at a dose of 30 mg kg[-1] at 0.5 h and 4 h in both models and did not exhibit motor impairment activity, even at higher doses
Conclusion: The newer designed compounds were found to be better than previously reported compounds. This study also shows that increased lipophilicity is directly related to the anticonvulsant activity
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Animals, Laboratory , Pyrimidines , Epilepsy , Infrared Rays , Magnetic Resonance SpectroscopyABSTRACT
Thymus daenensis Celak. is an herb endemic to Iran belonging to the Lamiaceae family. Growing in many parts of Iran, the plant is extensively used in folk medicine. This review was performed to compile phytochemical and pharmacological data of T. daenensis. Databases such as PubMed, Scopus, Web of Science, ScienceDirect, Scientific Information Database, Embase, IranMedex and Google Scholar were searched for the terms "Thymus daenensis" and "Avishan-e-denaii" up to 1st January 2014. Following reported ethnopharmacological uses, various T. daenensis preparations have been investigated for antimicrobial, antioxidant, insecticidal and immunomodulatory effects in recent studies. Moreover, numerous studies have been published on the composition of the herb's essential oil, focusing either on environmental parameters or preparation methods. Due to its high concentration of thymol, the plant's essential oil possesses high antimicrobial activities on human pathogenic strains. However, comprehensive studies on the toxicity and teratogenicity as well as clinical efficacy of Thymus daenensis are missing.
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Humans , Anti-Infective Agents , Chemistry , Pharmacology , Antioxidants , Chemistry , Pharmacology , Ethnopharmacology , Phytotherapy , Plant Preparations , Chemistry , Pharmacology , Plant Structures , Plants, Medicinal , Thymol , Chemistry , Pharmacology , Thymus Plant , Chemistry , Treatment OutcomeABSTRACT
Solitary fibrous tumors [SFT] of the upper limb are extremely rare, and we report this tumor in the arm of a 30-year-old male. He is presented with a 22 cm painless mass. Complete surgical excision was performed. The histological diagnosis of SFT was based on the presence of ectatic blood vessels and positive staining for CD34 and vimentin. He remains disease-free at the 3-year follow-up interval. The report aims to increase the awareness of the criteria for the histological diagnosis of SFT, as well as the principles of their surgical excision and follow-up
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Humans , Male , Upper Extremity/pathology , Antigens, CD34 , VimentinABSTRACT
Iron-deficiency anaemia (IDA) is a common health problem in rural women and young children of Bangladesh. The university students usually take food from residential halls, and the food value of their diets is not always balanced. This cross-sectional study was conducted to estimate the prevalence of irondeficiency anaemia among the university students of Noakhali region, Bangladesh. Haemoglobin level of 300 randomly-selected students was measured calorimetrically, using Sahli’s haemoglobinometer during October to December 2011. Statistical analysis was done by using SPSS software for Windows (version 16) (SPSS Inc., Chicago, IL, USA). In the study, 55.3% students were found anaemic, of whom 36.7% were male, and 63.3% were female. Students aged 20-22 years were more anaemic (43.4%) than other age-groups. Majority (51.3%) of male students showed their haemoglobin level in the range of 13-15 g/dL, followed by 26.0% and 21.3% with 10-12 g/dL and 16-18 g/dL respectively. Although 50.5% anaemic and 51.1% non-anaemic female students showed normal BMI—lower percentage than anaemic (60.7%) and nonanaemic (71.9%) male students, the underweight students were found more anaemic than the overweight and obese subjects. Regular breakfast-taking habit showed significant (p=0.035, 95% CI 0.5-1.0) influence on IDA compared to non-regular breakfast takers. Consumption of meat, fish, poultry, eggs, or peanut butter regularly; junk food; multivitamins; and iron/iron-rich food showed insignificant (p=0.097, 95% CI 0.5-1.1; p=0.053, 95% CI 1.1-2.3; p=0.148, 95% CI 0.6-1.2; and p=0.487, 95% CI 0.7-1.4 respectively) role in provoking IDA. In the case of non-anaemic subjects, all of the above parameters were significant, except the junk food consumption (p=0.342, 95% CI 0.5-1.2). Our study revealed that majority of university students, especially female, were anaemic that might be aggravated by food habit and lack of awareness. The results suggest that anaemia can be prevented by providing proper knowledge on the healthful diet, improved lifestyle, and harmful effect of anaemia to the students.
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Aim: The aim of the present investigation was to perform the precolumn derivatization of Amantadine Hydrochloride (AMT) with phenylisothiocyanate and to develop a RP-HPLCPDA method for the quantification of Amantadine Hydrochloride-phenylisothiocyanate (AMT-PITC) complex in bulk and dosage forms which is rapid, sensitive and economical. Study Design: Method development and Validation study. Methodology: A Phenomenex C18 RP column of 250 x 4.6mm dimensions and 5μm particle size with mobile phase containing water and acetonitrile (40:60% v/v) was used at isocratic mode binary pump and eluent was monitored at 273nm. Results & Discussion: The retention time of AMT-PITC complex was 6.3 min. The developed method showed a good linearity in the concentration range of 10-50μg/mL with a correlation coefficient >0.998. The recoveries ranged between 95-105% with a Relative Standard Deviation of (RSD) < 2%. Conclusion: The developed method was validated as per ICH guidelines and successfully used for quantification of AMT by derivatization with PITC. The method was found to be rapid, specific and accurate.
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Objectives: To evaluate the efficiency of volume targeted versus pressure-limited ventilation for preterm infants with respiratory distress
Methods: 60 newborn infants with gestational age 28-34 weeks in the NICU at Alexandria University Children's Hospital randomly divided in to 2 groups ventilated with either volume targeted ventilation [VTV] or pressure limited time cycled ventilation [PLV] as primary mode or secondary to failure of NCPAP using SLE 4000 or 5000 ventilators
Results: The demographic and clinical characteristics, values of tidal volume [VT], peak inspiratory pressure [PIP], mean airway pressure [MAP], fraction of inspired oxygen [Fio2], alveolar arterial oxygen gradient [A-aDo2], carbon dioxide tension, and pH were similar for all participating infants initially. During the follow-up, the PIP, MAP and FIO2 levels were significantly decreasing in the VTV group during the first 48 hrs. Moreover, The VTV group showed significantly lower incidence of hypocarbia and non-permissible hypercarbia. The VTV group showed significantly shorter duration of ventilation. There was no statistical significant difference between both groups as regards IVH, air leaks BPD, PDA or nosocomial infection
Conclusion: The use of VTV achieves adequate gas exchange using lower MAP and with less variability in tidal volume reducing the risk of hypocarbia and non-permissible hypercarbia. The use of VTV also shortens the duration of ventilation in premature infants with respiratory distress