ESTABLISHING FREEZE DRYING PROCESS FOR CORTICAL AND CANCELLOUS BONE ALLOGRAFT CUBES

@#Freeze drying is a dehydration method to dry bone under freezing environment, enabling removal of water with no or minimial effects on bone strength and durability. Larger size bones obviously require longer freeze drying time to reduce water content to the required level for long term storage at room temperature. For small size bone cubes or chips, it is a normal practice to pool cortical and cancellous bones for freeze drying. The study was aimed at determining if different type of bones of the same size influence the drying time. Human bone cubes of 10 mm x 10 mm x 10 mm were prepared from cortical bone of tibiae and cancellous bone from femoral heads. The bone cubes were freeze dried to reduce water content to less than 6%. Moisture content was monitored using gravimetric method.Weight and density of cortical bone were significantly higher than cancellous bone despite of having similar small size (p<0.05). Cortical bones (density 2.05 ± 0.35 g/cm3) with initial water content of 10.93% required 5 hours to freeze dry, while cancellous bone cubes (density 0.72 ± 0.44 g/cm3) with initial water content of 78.95% required only 1.87 hours. This study confirmed that the structure hence density of human bone cubes determine the freeze drying time. Therefore in the standard operating procedure for freeze drying of bone allograft cubes, high density cortical bone cubes and low density cancellous bone cubes must be freeze dried separately despite being of similar small size

Epidemiologia do trauma em atendimentos do SAMU Novo Hamburgo/RS no primeiro trimestre de 2015 / Trauma epidemiology in the SAMU of Novo Hamburgo during the first three month of 2015

O trauma é considerado um problema de importância epidemiológica no cenário brasileiro e mundial, constitui-se num dos principais desafios à saúde pública e aos gestores. Trata-se de um estudo epidemiológico, documental, composto por 444 boletins de atendimento de trauma realizados pelo Samu no município de Novo Hamburgo/RS no primeiro trimestre de 2015, com o objetivo de determinar os motivos de ocorrência e sua correlação com as variáveis clínico-epidemiológicas. Os dados apontam que o principal motivo de trauma se deu em função de colisão, seguido por queda e atropelamento, além disso foram caracterizadas as variáveis relacionadas ao tipo de suporte de vida, desfecho, horário, dias e locais. Os resultados mostram a importância de estabelecer maiores estudos sobre o trauma nesse município e ações estratégias a partir de indicadores que subsidiem a gestão e contribuam para a melhoria da assistência à saúde.

Trauma, an issue of epidemiological relevance within Brazilian and world scenario, is a main challenge to public health and health management. Current epidemiological and documental study comprises 444 trauma attendance sheets performed by the SAMU in Novo Hamburgo, Brazil, during the first three months of 2015, to determine motives of occurrence and their co-relationships with clinical and epidemiological variables. Data showed that Collision, followed by Fall and Run-Over, were the main motive of the trauma. Variables related to life support, outcome, time, days and sites were characterized. Results show the importance for the establishment of further studies on trauma in the municipality and the strategic activities from indicators that foreground management and contribute towards the improvement of health care.

Knowledge on Bone Banking among Participants in an Orthopaedic Conference: A Preliminary Survey

Despite increasing use of bone graft in Malaysia, there was still lack of data to quantify knowledge level on bone banking among orthopaedic community who are involved in transplantation related work. Therefore, a survey on awareness in tissue banking specifically bone banking, usage and choice of bone grafts was conducted. From 80 respondents, 82.5% were aware about tissue banking however only 12.5% knew of the existence of tissue banks in Malaysia. Femoral head was the bone allograft most often used as a substitute to autograft. Only 34.8% respondents preferred irradiated bone grafts whilst 46.9% preferred nonirradiated, indicating the need to educate the importance of radiation for sterilising tissues. Exhibition was the most preferred medium for awareness programme to disseminate information about bone banking in the orthopaedic community. The professional awareness is necessary to increase the knowledge on the use of bone graft, hence to increase bone transplantation for musculoskeletal surgeries in the country.

Lymphoma presenting as severe left ventricular systolic dysfunction: a case report

Lymphoma involving the heart is rare. This is a case report on non- Hodgkin lymphoma where the patient presented for the first time with heart failure and severe left ventricular systolic dysfunction due to lymphoma infiltrating the heart muscle and had simultaneous bilateral involvement of kidneys. This type of presentation has never been described in world literature and is the first reported case

Combined severe valvular aortic and valvular pulmonary stenosis and its management- A case report and literature review

Isolated congenital valvular stenosis of either aortic or pulmonary valve is commonly seen yet the presence of both these lesions in the same patient is rare. This combination presents unusual diagnostic as well as management problems. Apart from a few case reports, there is little in the literature on the combined stenosis of both semilunar valves. We present here a case report of a three and half year old boy diagnosed as a combined congenital severe valvular aortic stenosis with valvular pulmonary stenosis. The patient underwent successful balloon dilatation of both these valves in the same sitting

cross sectional study on the acceptance of pre-hospital continuous positive airway pressure ventilation among ambulance paramedic in an urban emergency medical service system in a developing country

To assess the acceptance among the developing country urban paramedics towards pre-hospital continuous positive airway pressure [CPAP] ventilation. A cross-sectional prospective study was conducted among the ambulance paramedics working at the pre-hospital care unit of the Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia from March 2012 to August 2012 on ambulance paramedics. Questionnaires were used to assess their experience, knowledge, and perception, while their competencies were assessed using an Objective Structured Clinical Examination by 2 independent-calibrated raters on the use of the Boussignac CPAP system. Twenty-six ambulance paramedics qualified for this study with an average work experience of 5.59 +/- 3.53 years. A total of 76.9% had no formal training for CPAP during their study years. Knowledge of CPAP apparatus-arrangement sequence scored as 88.5% correct, while 96.2% scored `Good` to `Very-good` in the ability to diagnose conditions that warrant its use. A total of 76.9% were confident to monitor patients on CPAP, and 61.5% in applying the device. However, only 53.8% were confident to start the CPAP, and 38.5% to troubleshoot if any problem arose. For perceptions, 96.2% felt it was easy to learn CPAP, while 88.5% felt that paramedics could use it without supervision, and 80.8% felt that it should not be confined to the Emergency Department setting. A total of 96.1% were competent in CPAP application. Developing country urban ambulance paramedics possessed adequate knowledge, positive attitudes, and demonstrated good CPAP application skills. However, lack of confidence towards decision to initiate and troubleshoot of potential complications were the main obstacles hindering its use

Isolation, characterisation and antibacterial activity studies of coumarins from Rhododendron lepidotum Wall. ex G. Don, Ericaceae / Estudos de isolamento, caracterização e atividade antibacteriana de cumarinas de Rhododendron lepidotum Wall. ex G. Don, Ericaceae

Six coumarins daphnin (1), daphnetin (2), daphnetin glucoside (3), rhodonetin (4), rhodonin (5) and umbelliferone (6) were isolated from the methanolic extract of Rhododendron lepidotum Wall. ex G. Don, Ericaceae (aerial part). The compounds and their acetyl derivatives were screened for antibacterial activity against Staphylococcus aureus ATCC-29213, methicillin resistant Staphylococcus aureus ATCC-15187, Escherichia coli ATCC-8739, Pseudomonas aeruginosa ATCC-9027 by microdilution method as compared to the reference ciprofloxacin. Compound 2 displayed the best antibacterial activity with MIC 125 μg/mL against S. aureus ATCC-29213 and MRSA ATCC-15187 followed by 4 which exhibited the MIC value of 250 μg/mL against all the four tested strains. All molecules showed better antibacterial activity than their acyl derivatives.

Seis cumarinas dafinina (1), dafinetina (2), dafinetina glicosídeo (3), rodonetina (4), rodonina (5) e umbeliferona (6) foram isoladas do extrato metanólico das partes aéreas de Rhododendron lepidotum Wall. ex G. Don, Ericaceae. Os compostos e seus derivados acetilados foram testados para verificar sua atividade antibacteriana contra Staphylococcus aureus ATCC-29213, Escherichia coli resistente à meticilina, Staphylococcus aureus ATCC-15187, ATCC-8739, Pseudomonas aeruginosa ATCC-9027, pelo método de microdiluição, usando ciprofloxacina como referência. A substância 2 apresentou a melhor atividade antibacteriana com o MIC 125 μg/mL contra S. aureus ATCC-29213 e MRSA ATCC-15187 seguido pela substância 4, que apresentou o valor de CIM de 250 μg/mL contra as quatro cepas testadas. Todas as moléculas apresentaram melhor atividade antibacteriana do que seus derivados acetilados.

Von Recklinghausen's neurofibromatosis associated with membranous glomerulonephritis

A 70-year old woman, known case of von Recklinghausen's neurofibromatosis presented with nephrotic syndrome and mild azotemia. Renal biopsy revealed membranous nephropathy. After ruling out secondary causes of membranous nephropathy, a possible coexistence of von Recklinghausen's neurofibromatosis and membranous nephropathy were thought of. This association has rarely been reported