Proximal Femur Locking Compression Plate In Subtrochanteric Fractures : A Prospective Analysis

Introduction:Sub-trochanteric femoral fractures are injuries that mostly affect the elderly population.Ithasa bimodal distribution. In young and healthy individuals, the injury results from high energy trauma, where as in the elder age group, most of the fractures are in osteoporotic bone resulting from a trivial fall. The aim of the surgery is to achieve initial stability and early mobilization of the patients and to avoid complications. The aim of our study is to analyze the outcomes of proximal femoral locking compression plate (PF-LCP) in these fractures.Materials and Methods:We prospectively analyzed30sub-trochantericfemoral fractures treated with PF-LCP from January 2015 to December 2018. There were 20 females (66.6%) and 10 males (33.4%) with an average age of 61.2 years (range, 36 to 75 years). The sub-trochanteric fractures are classified by Seinshemier's classification. The functional outcome was evaluated by Harris Hip Score and the Parker Palmer Mobility Score at 12 months follow-up.Results:Among 30 patients, 27 patients (90%) obtained fracture union without further intervention; 3 patients required additional bone grafting at the end of 3 months. There were no cases of hip screw cutting the femoral head. There was no post-operative mortality in our study. The average Harris Hip Score was 87 (80-93). The assessment by Parker and Palmar Mobility Score was 7.8(range 5-9).Conclusions:The PF-LCPis a good stable alternative in the treatment of sub-trochanteric femoral fractures. It providesgood to excellent bone healing with limited complications.

Hallerborden Spatz disease.

Hallervorden Spatz disease is a rare disorder characterized by progressive extrapyramidal dysfunction. We report a case of a 18 year old boy who presented with cervical dystonia, pigmentary retinal degeneration and MRI brain showing the "eye-of-the-tiger" appearance. Renamed recently as "Neurodegeneration with brain iron accumulation", we present this case for its rarity and interesting features.

Detection of virulence attributes of Burkholderia pseudomallei.

BACKGROUND & OBJECTIVES: Melioidosis caused by Burkholderia pseudomallei is an emerging disease in India. This study examined the toxin activity of bacteria-free culture filtrate in three different cell lines (cytotoxic assay) and its effect on Caenorhabditis elegans (nematode toxicity assay). Endotoxic activity of the viable bacteria was also studied in C. elegans (co-culture killing assay). METHODS: For toxin studies, serial doubling dilutions of unheated, heated crude and ultra filtrate of bacteria-free culture supernatants of B. pseudomallei were tested in 96-well microtitre plate containing confluent mono layers of McCoy, Hep-2 and HeLa cell lines. For the effects on C. elegans, the worms were exposed to heated and unheated bacteria-free culture supernatants in 24-well microtitre plate for 24h and then transferred to OP50 Escherichia coli lawn culture. The endotoxic activity of the live bacterium was studied by feeding the worms in the lawn culture of B. pseudomallei. RESULTS: All the clinical isolates (n=38) produced cytotoxic changes in all the cell lines. No difference was observed in the cytotoxicity of unheated, heated and ultra-filtered culture supernatant. The septicaemic isolates were observed to produce cytotoxic changes in high dilutions (1:160) of culture filtrate. None of the unheated and heated crude filtrate had deleterious effect on C. elegans, while all the live bacteria were found to be lethal to the nematode. INTERPRETATION & CONCLUSION: The culture supernatants, though produced cytopathic effect in various tissue cultures, failed to have any deleterious effect on the worms. However, live bacteria were lethal to the worms B. pseudomallei. Use of C. elegans model to detect virulence attributes of B. pseudomallei is recommended as an alternative to tissue culture methods as this can be carried out in laboratories where a tissue culture set up is not available.

An analysis of initial results of percutaneous transluminal coronary angioplasty for totally occluded coronary arteries.

A retrospective analysis of 680 Percutaneous Transluminal Coronary Angioplasties (PTCA) performed from April 1986 to October 1990 revealed that 81 patients had PTCA performed on 86 totally occluded coronary arteries (1.06 lesions/patient). Four of the 86 were acute occlusions. Angiographic success in the group as a whole was achieved in 57 (66%). Multivariate analysis identified only the target vessel as a statistically significant factor predictive of angiographic success from among a host of clinical and angiographic morphologic variables. Left anterior descending artery lesions were identified with the highest success. In addition the duration of occlusion was significantly lower for the successfully versus the unsuccessfully dilated chronic occlusions.