ABSTRACT
Two staged bilateral total hip replacement (THR) is commonly performed for bilateral hip end stage arthritis and is preferred as THR is a complex planned surgery and performing both sides simultaneously may be fraught with risks and complications. However, many studies now indicate that in carefully selected patients , single stage or simultaneous bilateral THR can be performed with successful and cost effective results. We report a case of one-stage bilateral THR performed in a 22 year old with bilateral severe arthritis due to ankylosing spondylitis. Patient was severely disabled due to pain and was only ambulating on wheelchair. After a successful single stage bilateral THR, patient recovered fully and after 6 weeks was walking independently without any pain, with full function of both hips and performing his occupation normally. The surgical costs to the patient and hospital were both economical. We conclude that single stage bilateral THR is a better surgical option for young and fit patients with bilateral hip arthritis.
ABSTRACT
Dry eye syndrome is currently seen with increasing frequency throughout the world including India. An evaluation of tear physiology in the form of tear secretion and tear film stability is the most important aspect of dry eye diagnosis. The aim of this study is to investigate the age and gender related changes in the result of these tear function tests (Schirmers Test and Tear Break up time) in normal Indian population. This crosssectional observational study included 120 normal subjects (60 Male and 60 females) with no ocular symptoms or ocular surface disorders. Schirmer and tear film break-up time tests were assessed in both eyes of each subject. The study subjects were divided into 4 groups according to their ages (< 20y, 20-40y, 41-60y and > 60y) each group was composed of 60 eyes of 30 subjects (15 male and 15 female subjects). The One way ANOVA test and the Statagraphic software was used for statistical analysis. We detected a statistically significant decline in both the tear function tests with increasing age. Tear function tests did not show statistically significant difference according to sex. This study suggests that the age of subjects should be taken into consideration in the evaluation of tear function test results. It is also revealed that Indian population values are different from Caucasian and Chinese values. We propose age specific cut off values of tear function tests in Indian population to aid in the diagnosis of dry eye in Indian conditions.
ABSTRACT
A simple, sensitive and high throughput ultra performance liquid chromatography tandem mass spectrometry method has been developed for the determination of mycophenolic acid in human plasma. The method involved simple protein precipitation of MPA along with its deuterated analog as an internal standard (IS) from 50 mL of human plasma. The chromatographic analysis was done on Acquity UPLC C18 (100mm*2.1mm,1.7mm) column under isocratic conditions using acetonitrile and 10 mM ammonium formate, pH 3.00 (75:25, v/v) as the mobile phase. A triple quadrupole mass spectrometer operating in the positive ionization mode was used for quantitation. In-source conversion of mycophenolic glucuronide metabolite to the parent drug was selectively controlled by suitable optimization of cone voltage, cone gas flow and desolvation temperature. The method was validated over a wide concentration range of 15–15000 ng/mL. The mean extraction recovery for the analyte and IS was 495%. Matrix effect expressed as matrix factors ranged from 0.97 to 1.02. The method was successfully applied to support a bioequivalence study of 500 mg mycophenolate mofetil tablet in 72 healthy subjects.