Outcomes of Direct Infrapectineal Buttress Plate for Quadrilateral Surface Fractures of Acetabulum Using an Anterior Intrapelvic Approach / 대한고관절학회지

Purpose@#Reduction and stable fixation of the quadrilateral plate are challenging primarily due to its location in the true pelvis, limited bone stock, juxta-articular nature, and its comminution. The current study aimed to investigate the quality of reduction and functional outcomes after open reduction and internal fixation (ORIF) with infrapectineal buttress plating of the quadrilateral surface via an anterior intrapelvic approach. @*Materials and Methods@#We conducted a retrospective review of twenty-one patients with acetabular fractures involving quadrilateral plate operated at Ghurki Trust Teaching Hospital between January 2017 and December 2018. Radiological assessment of the quality of reduction was conducted using criteria described by Matta. Functional outcomes were evaluated using a modified Postel Merle d’Aubigné score. @*Results@#The current study included 15 males and 6 females with a mean age of 40.67±12.17 years (range, 22-62 years). The most common fracture pattern was anterior column and posterior hemi-transverse in eight patients followed by true bicolumn and T-type fractures in seven and four patients respectively. Both transverse fractures were transtectal. The quality of reduction according to Matta criteria was anatomical in 14 patients, imperfect in five and poor in two. Functional outcomes were excellent in 47.6% cases, good in 42.9%, and fair in 9.5% cases. Both patients with fair outcomes had non-anatomical reduction, and one required total hip arthroplasty at a later time. @*Conclusion@#Quadrilateral plate reconstruction with an infrapectineal buttress plate applied though an anterior intrapelvic approach provides high rates of anatomical reduction and yields good functional outcomes.

Component Alignment in Simultaneous Bilateral versus Unilateral Total Knee Arthroplasty

PURPOSE: The purpose of this study was to investigate differences in component alignment between first and second knees in simultaneous bilateral total knee arthroplasty (SBTKA) and unilateral TKA (UTKA). MATERIALS AND METHODS: 274 SBTKAs and 198 UTKAs were included in study. Patients were divided into three groups as SBTKA on the right knee (group A), SBTKA on the left knee (group B) and UTKA (group C). Femoral and tibial component alignment was checked in both coronal plane (alpha [α] and beta [β] angles) and sagittal plane (gamma [γ] and delta [δ] angles) radiographs. RESULTS: There were no statistically significant differences among groups in the preoperative anatomical varus angle and Kellgren–Lawrence gonarthrosis classification grade (p=0.139 and p=0.329, respectively). In the coronal plane, the alignment of femoral component (α angle) and tibial component (β angle) was similar in all three groups (α angle, 95.01 vs. 95.14 vs. 94.9, p=0.945; β angle, 90.03 vs. 89.67 vs. 89.98, p=0.483). The sagittal plane alignment of femoral component (γ angle) and tibial component (δ angle) did not show significant differences (γ angle, 7.04 vs. 6.98 vs. 7.00, p=0.132; δ angle, 86.56 vs. 87.41 vs. 86.73, p=0.610). CONCLUSIONS: The angular alignment of components was similar between SBTKA and UTKA.

Intraperitoneal and local infiltration of bupivacaine for pain relief after laparoscopic cholecystectomy

Objective: To compare the effectiveness of intraperitoneal and local infiltration of bupivacaine on pain relief in postoperative period after laparoscopic cholecystectomy. Study Design: Randomized controlled trial. Place and Duration of Study: Combined Military Hospital Multan, from Jan to Dec 2014

Material and Methods: In this study, 72 adult patients of either gender with age between 20 to 60 years having symptomatic gallstones scheduled for elective laparoscopic cholecystectomy were divided into two groups. Patients in group A received intraperitoneal and local infiltration of bupivacaine at the end of surgery. Group B was administered placebo. Postoperatively, intensity of pain was recorded by using 10 points' Visual Analogue Score at 3, 9, 12, 24 hours. A p-value

Results: In group A, there were 27 male and 9 female patients while in group B, there were 22 male and 14 female patients. Mean age was 37.75 +/- 12.49 years and 41.92 +/- 12.73 years in groups A and B respectively. The mean postoperative pain score was 8.18 +/- 1, 6.36 +/- 0.98, 4.98 +/- 1.11 and 3.89 +/- 1.11 in group A and 8.72 +/- 1.05, 6.91 +/- 0.96, 5.92 +/- 0.96 and 4.47 +/- 1.05 in group B at 3, 9, 12 and 24 hours post operatively. The difference in mean pain scores was significant; 0.0286, 0.0188, 0.0001 and 0.0258 at 3, 9, 12 and 24 hours respectively

Conclusion: Intraperitoneal and local infiltration of 0.25% bupivacaine significantly reduces the intensity of postoperative pain and analgesic requirement in the early postsurgical hours following laparoscopic cholecystectomy

One-stage Hip Reconstruction for Developmental Hip Dysplasia in Children over 8 Years of Age / 대한고관절학회지

PURPOSE: This study was performed to assess the clinical and radiological outcomes following one-stage hip reconstruction, consisting of open reduction femoral shortening and pelvic osteotomy, for neglected developmental dislocation of the hip (DDH). MATERIALS AND METHODS: This is a retrospective analysis of 77 hips in 65 patients (46 females and 19 males; 12 had bilateral dislocations), operated at a Ghurki Trust Teaching Hospital in Pakistan between 2013 and 2015. The average age at surgery was 11.02±3.43 years. According to the Tönnis classification, there were 10, 14, 22, and 31 patients in grades 1, 2, 3, and 4, respectively. The pelvic procedure utilized in this study was triple osteotomy (47 hips) followed by double and Salter osteotomy (18 and 12 hips, respectively). Postoperative evaluations were conducted using the modified MacKay's scoring system (functional outcomes) and Severin's scoring method (radiological assessment). RESULTS: Postoperatively, there were 38 (49.4%), 19 (24.7%), 14 (18.2%), and 6 (7.8%) hips in Severin grade I, II, III and IV, respectively. According to the modified McKay criteria, there were 22 hips (28.6%) in excellent condition, 44 (57.1%) in good condition, 9 (11.7%) in fair condition and 2 (2.6%) in poor condition. Both patients with poor outcomes had an unstable, painful hip with evidence of avascular necrosis of the femoral head. CONCLUSION: Based on the results presented here, we recommend the single stage procedure of open reduction, femoral shortening and pelvic osteotomy for treatment of DDH in older children with good to excellent functional and radiological outcomes.

prospective study of extracorporeal shock wave lithotripsy [ESWL] induced hypertension in Lahore division, Pakistan

Our aim was to evaluate the hypothesis in a randomized clinical trial, whether extra- corporeal lithotripsy [ESWL] causes any blood pressure change, in subjects with different genders having normal blood pressure and kidney lithiasis. A descriptive cross sectional study. This study was carried out at the Department of lithotripsy, Khan Kidney Hospital and King Edward Medical University, Lahore from February 2012 to January 2013. Adult patients [

Complications of total hip replacement

To determine the factors causing complications in unilateral total hip replacement. Analytical study. The Aga Khan University Hospital, Karachi, between 2000 and 2010. During the study period, 199 patients underwent elective unilateral total hip replacement at the Aga Khan University Hospital. Patients were divided into two groups on the basis of postoperative complications within 30 days of surgery. Significant factors at 5% significance level on univariate analysis were further analyzed by multivariate logistic regression. Postoperative complications occurred in 39 patients [19.6%]; dislocation being most common in 13 patients [6.5%], followed by wound infection in four [2%], all of these patients required intervention. Other minor complications which were managed conservatively included wound infection [2.5%], urinary tract infection [2.5%], dislocation [1%], pleural effusion and pneumonia [2%], deep venous thrombosis [0.5%] and myocardial infarction [0.5%]. On univariate analysis, patients with ASA III and IV, peri-operative blood transfusion, pre-operative hip deformity and post-operative bisphosphonate use were significantly associated with complications. On multi-variate analysis, adjusted odd's ratio for perioperative transfusion [3; 95% CI: 1.17-7.7] and hip deformity [3.2, 95% CI: 1.4-3.4] was found statistically significant. Pre-operative hip deformity and perioperative blood transfusion significantly influence the rates of complication after unilateral THR

Gentamycin induced nephrotoxicity in albino mice

Twelve, male albino mice, aged 6-8 weeks, were injected intraperitoneally, aqueous solution of gentamicin [80 mg / kg / day] for fifteen days and the effects observed on the kidney structure and function. Group A served as control while Group B was given gentamicin. At the end of the experiment, blood was drawn from each animal by cardiac puncture for renal function tests and kidneys were fixed for histological studies. In group B, values of serum urea [66.40 +/- 0.54 mg/dl] and serum creatinine [1.41 +/- 0.08 mg/dl] were significantly increased [p < 0.001] when compared with control group A [34.73 +/- 0.84 and 0.53 +/- 0.04 mg/dl respectively]. Both body weight [p < 0.001] and kidney weight [p < 0.05] decreased significantly in gentamicin treated groups. In histological preparations from group B, the proximal convoluted tubules in cortex were dilated and their epithelial cells showed hydropic changes with cytoplasmic vacuolations in some areas. Loss of brush border, patchy necrosis, presence of cellular debris and accumulation of inflammatory exudates within lumina of proximal convoluted tubules were also observed. The renal medulla from group B, showed an increase in intra-luminal tubular protein casts. Chi-square test showed statistically significant [p < 0.00] association between tubular necrosis and tubular casts. It is concluded that gentamycin is nephrotoxic in albino mice

Isolation and characterization of xanthine oxidase inhibitory constituents of Pyrenacantha staudtii / 药学学报

Six compounds have been isolated from the leaves of Pyrenacantha staudtii,two of which are new compounds.The new compounds have been characterized as kaempherol 3-O-β-rhamnopyranosyl (1→6)β-D-glucopyranoside (1) and 4-β-glucopyranosyl-(2-furyl)-5-methy-1,2-glucopyranoside phenylmethanone (2).The known compounds are 3-pyridinecarboxylic acid (3),β-sitosterol (4),sitosterol 3-O-β-glucopyranoside (5) and taraxerol (6).Their structures were determined by spectroscopic and chemical evidences.The two new compounds together with 3-pyridinecarboxylic acid showed significant in vitro xanthine oxidase inhibitory activity.To the best of our knowledge,this is the first report of these compounds from this plant.

Isolation and characterization of xanthine oxidase inhibitory constituents of Pyrenacantha staudtii / 药学学报

Six compounds have been isolated from the leaves of Pyrenacantha staudtii, two of which are new compounds. The new compounds have been characterized as kaempherol 3-O-beta-rhamnopyranosyl (1-->6)-beta-D-glucopyranoside (1) and 4-beta-glucopyranosyl-(2-furyl)-5-methy-1,2-glucopyranoside phenylmethanone (2). The known compounds are 3-pyridinecarboxylic acid (3), beta-sitosterol (4), sitosterol 3-O-beta-glucopyranoside (5) and taraxerol (6). Their structures were determined by spectroscopic and chemical evidences. The two new compounds together with 3-pyridinecarboxylic acid showed significant in vitro xanthine oxidase inhibitory activity. To the best of our knowledge, this is the first report of these compounds from this plant.

Panax ginseng, its effects on development of hair follicles - an experimental study

Abstract: The use of herbal in developed and developing countries is rapidly increasing; oil presumption that they are better and safer than conventional medicines. It is now being reported that herbal medicines have far revenging effects on body systems especially in the developmental processes. The current study was conducted to evaluate the effect of Panax ginseng on developing hair of albino mice

Materials and methods: Thirty mice, 6-8 weeks old were housed together for mating and pregnancy was confirmed by vaginal plug. The fetuses were dissected oil 19[th] day and the animals were delivered, microscopic slides of the hair follicles of the fetuses were prepared and examined under light microscope

Results and conclusion: The pregnant dams were treated with Panax ginseng and the litter obtained showed an increase in the number of hair follicles. Histological sections showed signs of hemorrhages and tissue degeneration. Although, embryo-toxicity in animal experimental model may not reflect the situations in humans, further investigation and monitoring of the adverse effects of the Panax ginseng during pregnancy is warranted in humans

Racial polymorphism in talar articular facets of calcaneum

Abstract: Calcaneum is a cancellous, subcutaneous, weight bearing bone that is considered a useful indicator for sex determination, stature estimation, and determination of osteoporosis; however, the role of Calcaneum in racial evaluation is often overlooked

Materials and Methods: In the current study a total of 350 dry calcanei were analyzed; all the bones came from adult Pakistani subjects of both sexes., and on comparison with Indian, Egyptian and Spanish patterns a definite predominance of type 1 talar articular facets was seen in Pakistani population

Conclusion: It is therefore proposed that the pattern of talar articular facets of Calcaneum is a useful indicator for racial differentiation