Uterovaginal Prolapse with Giant Vesical Calculus: A Rare Case Report.

Massive or giant vesical calculus is a rare entity in urological practice. Females are less affected than males. Vesical calculi are usually due to long-standing uterovaginal prolapse and bladder outlet obstruction coupled with chronic infection. These patients present with recurrent urinary tract infection (UTI), hematuria or with retention of urine. We report a case of 50-yearold female, who presented with history of mass per vagina and recurrent UTI. Her renal function tests were normal and urine examination showed infection. Plain X-ray showed a large radio-opaque calculus in pelvic region. Ultrasound pelvis reported a large freely mobile vesical calculus 9 x 11 cm with bilateral hydroureteronephrosis, which was more pronounced on left side than right. After controlling UTI, she underwent an open suprapubic cystolithotomy and total abdominal hysterectomy and bilateral salpingo-oophorectomy. Postoperative stay was uneventful and she was discharged on 10th postoperative day. Patient is still on follow-up with good urinary function and no recurrent UTI.

T-condylar fracture delayed for 10 days in a 5-year-old boy: a case report and review of the literature / 中华创伤杂志(英文版)

T-condylar fracture is rare in paediatric age group, especially in skeletally immature children less than 9 years old, with very few cases reported in available literature. We present such a case in a 5 year old child that was initially managed as a supracondylar fracture at another centre before referral to us, 10 days after the injury. The child was diagnosed as having a displaced T-condylar fracture on plain radiograph. Open reduction and internal fixation with K-wires was performed. At 2 years follow-up, the child had good range of motion at elbow with 5°of cubitus varus. With this background we discuss the pertinent principles of management of T-condylar fractures in skele-tally immature children.

Traumatic L5 over S1 spondyloptosis without neurological involvement managed nonoperatively: a case report / 中华创伤杂志(英文版)

High-grade spondylolisthesis is very rare. We came across a case of high-grade spondylolisthesis at the L5-S1 level in a 32-year-old manual labourer who was hit by a heavy object on his flexed back. The patient presented to us with persistent deformity in the back. He complained of back pain on prolonged standing and after moderate work. Because of that he was unable to return to his work. On clinical examination there was a large step in the lower lumbar region. Detailed neurological evaluation of the lower limbs did not reveal any sensory or motor deficit, neither did bowel or bladder involvement. Radiographic examination showed L5 over S1 traumatic spondyloptosis. CT scan revealed that neural canal was in normal width. MRI confirmed spondyloptosis of L5 over S1 without any compromise of the spinal canal and with normal-looking cauda. Concerning the delayed presentation and no neurological deficit, the patient was managed conservatively after thorough counsel. At 6 months, the patient returned to his work and at the latest follow-up (15 months) he was free from back pain. Conservative means of treatment can lead to satisfactory outcome, especially when the patient has delayed presentation.

In-vitro effect of nimbolide, an isoprenoid of neem leaf, on antioxidant system of rat cauda epididymal spermatozoa: A dose dependent study.

The present in vitro study aims to address the possible evaluation of nimbolide, a major component of neem leaves, on the antioxidant system of rat spermatozoa to promote oxidative stress in a dose-dependent manner. To assess the effect of the nimbolide on activities of superoxide dismutase (SOD), catalase, Glutathione reductase (GR), Glutathione peroxidase (GPx), α-Glucosidase, production of Hydrogen peroxide (H2O2) and level of lipid peroxidation (LPO) in rat spermatozoa, increasing quantities 0.5 mM, 1 mM, 1.5 mM and 2.0 mM per ml of the nimbolide was added to the cultured medium prior to the addition of cauda epididymal spermatozoa. The spermatozoa were observed at 6th h post-culture and the expressions of enzyme activities and production of H2O2, level of LPO were recorded. The activities of antioxidant enzymes decreased significantly while the levels of H2O2 generation and LPO increased significantly in nimbolide treated spermatozoa in a dose dependent manner when expressed in terms of milligram protein and milligram DNA. The activity of α- glucosidase, a negative control against antioxidant enzymes, did not show any significant change at any of the doses. The results suggest that graded doses of nimbolide elicit depletion of antioxidant defense system in sperm, indicating nimbolide-induced oxidative stress in the epididymal sperm of rats.

Axillary artery thrombosis with anteroinferior shoulder dislocation: a rare case report and review of literature / 中华创伤杂志(英文版)

A very rare and serious complication of shoulder dislocation is a lesion to the axillary artery in the elderly population, whose vascular structures have become less flexible. Axillary artery injury secondary to anteroinferior shoulder dislocation is much rarer, especially in the young people. Proper recognition and treatment of this entity offers a full recovery to the patient. Present report highlights the possibility of axillary artery injury with anteroinferior shoulder dislocation. A few case reports and small case series of this injury have been reviewed. And recommendations for management have been brought up to date, in line with current thinking.