Reconstruction of Secondary Type Congenital Hallux Varus with Modification of the Farmer Technique for Cover of Skin Defect: Report of Three Cases

@#The reconstruction of hallux varus deformity involves the release of contracted medial structure and realignment of the phalange, leaving a significant skin defect which requires cover. Farmer described proximal based rotational skin flap from the first web space to cover the defect. This technique may compromise the circulation to the flap and risk to the lateral digital vessels. We modified his technique to address these issues. We report a successful reconstruction using the Farmer’s technique on one patient and a modified technique on three patients. We used the excess skin from the extra digit to cover the medial defect. We found this modified technique of skin cover safe without risk of injuring the neurovascular bundle. There was no recurrence of deformity at last foolow-up. All patients were able to wear normal shoes.

Treating Asthma in Pregnancy - An Update.

Asthma is one of the most common chronic medical conditions affecting the lungs during pregnancy. At any given time, up to 8% pregnant women have asthma. During pregnancy, asthma not only affects the woman, but it can also cut back on the oxygen to fetus. But this does not mean that having asthma will make pregnancy more difficult or dangerous to fetus. Pregnant women who have asthma that is properly controlled generally have normal pregnancies with little or no increased risk to pregnant women or their developing babies. Currently available national guidelines for the treatment of asthma during pregnancy emphasize the objective measurement of control, patient education, motivation, caution and medication adherence. The article reviews the available literature highlighting the appropriate selection of medications in the treatment of asthma during pregnancy, and to identify those factors which may influence the asthma care provider's ability to successfully manage this condition, and also illustrate that maintaining asthma control with long term medications in pregnancy is safer than the risk of uncontrolled asthma or untreated exacerbations for both the mother and the fetus. Women's drug treatment during pregnancy should be regularly assessed in the light of asthma control criteria.

Antimicrobial activity of lawsonia inermis linn

Leaf extracts of Lawsonia inermis Linn. [Lythraceae] were screened for their antimicrobial activity against 11 human pathogenic bacteria [Bacillus subtilis, B. cereus, B. megaterium, Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, Salmonella typhi, Sal. paratyphi, Shigella dysenteriae, Sh. sonnei, and Vibrio cholerae] and 6 fungal phytopathogens [Alternaria alternata, Botryodiplodia theobromae, Colletotrichum corchori, Curvularia lunata, Fusarium equiseti and Macrophomina phaseolina]. During preliminary screening, the chloroform soluble fraction of L. inermis was found active against all the bacterial test organisms. The antifungal activities of extracts were found non-potential. VLC analysis of chloroform fraction showed 10 groups [A to J] depending on TLC behavior [Rf. value]. Fraction C showed highest antibacterial activity [20-41 mm] against all the pathogens tested at a concentration of 1000 microg/disc. GC/MS analysis of fraction C characterizes 14 components representing 89.14% of the total fraction. The major components were Diisooctylphthalate, 3-Octadecane [E], Heptadecane, 2, 6-Dimethyl etc

Biliary tract surgery; surgical complications

Surgical complication after biliary tract injury are serious complications of Hepatobiliary surgery. The incidence of iatrogenic bile duct injuries has increased significantly since the number of cholecystectomy operations have increased, laparoscopic cholecystectomy became the "gold standard", mini-cholecystectomy established for the treatment of cholelithiasis. Intraoperative hemorrhage can be life-threatening or may lead the death. The common uses of laparoscopic cholecystectomy and mini-cholecystectomy have made the young surgeons less familiar with open cholecystectomy procedure and the approaches to manage the biliary tract injuries. Uncommonly the patient had to undergo hepatic transplantation secondary to biliary tract surgery with several vessel injuries or biliary cirrhosis. Postoperative bile leakage can be managed by effective drainage as soon as possible. These complications uncommon with the expert surgeons, but common with comparatively inexperienced surgeons. There is no substitute of experience and caution in biliary surgery for optimization technique

Efficacy of citicoline in ischemic stroke as a supportive therapy

To study the efficacy of Citicoline in ischemic stroke as a supportive therapy. An open randomized trial to study the efficacy and tolerance of Citicoline. Setting: District Headquarters Hospital, Dera Ghazi Khan, Pakistan. Forty patients [22 males and 18 females] between the ages of 35$ 5 years, selected over a period of eight months suffering from acute ischemic stroke within twenty four hours. Thirtysix out of 40 patients [Hemiplegia 16, Hemiparesis 20] completed the study. Diabetes, hypertension and heart failure were the concomitant diseases seen in some patients. In the Hemiplegia group, 5 patients [31.25%] showed complete recovery, 8 patients [50%] partial recovery while There was no response in 3 patients [18.75°10]. In the Hemiparesis group, the results showed complete recovery in 16 patients [80%], partial recovery in 4 patients [20%] with no failure. Tolerance in both groups was good and did not necessitate cessation of therapy. When both groups are combined and taken as acute ischemic stroke, results show 58.3% complete recovery 33.3% partial recovery and 8.3% as nonresponders. Citicoline limits the size of infarct leading towards early recovery of motor and cognitive functions. As such, it can be used effectively in the management of ischemic stroke as supportive therapy

Anticoagulation with pregnancy in prosthetic valves: a review paper

Pregnancy in women with valvular heart diseases, having prosthetic cardiac valves and on anticoagulants pose a special problem. These women should, be aware of the extra risks of pregnancy to them and of the limited opportunity-to give birth to healthy children

Effects of metiamide and proglumide on gastric acid secretion in rats

The effects of metiamide and proglumide on hydrochloric acid secretions have been studied. Metiamide and proglumide antagonized the effects of the histamine on the gastric hydrochloric acid secretion

Effect of adrenaline and nor adrenaline on insolated ratureter preparations

The effect of adrenaline and non-adrenaline on the spontaneously contracting and quiescent isolated proximal and central pieces of ureters obtained from female [virgin] albino rats of the Sprague Dawley strain were studied. Adrenaline and nor-adrenaline produced a stimulant effect on the rate and amplitude of the proximal pieces of spontaneously contracting preparations. Both these drugs induced persistaltic activity in similar quiescent preparations. Adrenaline also produced a stimulant effect on the spontaneously contracting preparations of the central portions of the ureters. In view of these findings it is suggested that as far as the responses to adrenaline and nor-adrenaline are concerned, the proximal and the central portions of the isolated rat ureter preparations behave as if they possess a preponderance of alpha [excitatory] adrenergic receptors