Evaluation of Arthroscopic Anterior Cruciate Ligament Reconstruction using Hamstring Graft.

To evaluate the results of quadrupled hamstring tendon autograft Anterior Cruciate Ligament (ACL) reconstruction fixed with bioabsorbable interference screw fixation. Methods: Twenty-five patients underwent arthroscopic anterior cruciate ligament reconstructions using autogenous hamstring graft (semitendinosis and gracilis). All patients underwent through standard surgical procedure and rehabilitation protocol. Patients were assessed using International Knee Documentation Committee (IKDC) and Lysholm knee scoring scale at a minimum duration of six-month. Results: In all patients at 6 months post surgery. The mean Lysolm knee score was 91.2 (range, 63 to 99) and the mean IKDC score was 90.7 (range, 60 to 98). Conclusion: The short-term results were quite promising on evaluation with IKDC and Lysholm scale.

Efficacy, tolerability and cost effectiveness of zotepine versus olanzapine in patients of acute schizophrenia.

Background: Schizophrenia is a functional psychosis with severe personality changes and thought disorders without cerebral damage. No reports are available in literature regarding efficacy and tolerability of atypical antipsychotic drug zotepine over olanzapine a preferred drug worldwide for the treatment of schizophrenia. Therefore, present study is undertaken to evaluate efficacy, tolerability and cost effectiveness of zotepine over olanzapine in patients suffering from schizophrenia. Methods: A prospective, randomized, single blind, parallel, 6 weeks clinical study was conducted on a total of 112 patients, of schizophrenia attending psychiatry outpatient department at G. R. Medical College, Gwalior, India randomized into two groups (56 in each). Patients received either olanzapine (10-20mg) or zotepine (75-150mg) per day for a period of 6 week. Efficacy was measured by Positive and Negative Syndrome Scale (PANSS) and Clinical Global Impression (CGI) scale whereas tolerability was measured by dropout rate and frequency of adverse effects. Cost effectiveness was calculated in terms of cost incurred for improvement at the end of treatment period. Results: Both the drugs showed significant (P<0.05) improvement in PANSS total score as compared to their respective baseline scores however, there was no significant difference between the two groups (P>.0.05). Olanzapine showed significantly better (P<0.05) positive subscale and CGI scale score improvement as well as response rate when compared to zotepine. Incidences of adverse effects like weight gain, somnolence and hyperglycemia were 42, 32 and12 % respectively with olanzapine and 39, 30 and 9% respectively with zotepine with no significant difference (P>0.05) between the two groups. Incidence of akathisia and drop out (16% and 23%) with zotepine were significant (P<0.05) as compared to olanzapine (2% and 11%) respectively. Conclusions: Though the efficacy of both the drugs is comparable, olanzapine appears to have better tolerability and cost effectiveness than zotepine in patients of schizophrenia.

Results with non-operative treatment in dorsolumbar fractures with no neurological deficit: A functional assessment.

Background: The purpose of this prospective study was to assess the functional outcome of conservative treatment with early ambulation of dorso-lumbar spine fractures with no neurological deficit. Aims & Objective: The purpose of this prospective study was to identify the risk factors for dorso-lumbar spine injuries, and to assess the efficacy of non-operative treatment with early ambulation, and functional outcome of the patients. Material and Methods: From October 2008 to June 2010, 48 consecutive patients with single- level thoracolumbar spinal injury, with no neurological deficit were managed non-operatively. A custom-made thoracolumbosacral orthosis was worn by all patients for six months, and early ambulation was recommended. Patients were evaluated as per TLICS score, and if score was <=4 with no neurological deficit then, they were treated with conservative treatment and included in the study. The Denis Pain and Work Scale were used to assess the clinical outcome. The average follow-up period was 6.5 months (range, 4 to 11 months). Statistical analysis done by observational descriptive statistics using SPSS 19.0. Results: Radiological parameters, such as Cobb’s angle, showed loss of fracture reduction, which was not statistically significant. However, the functional outcome was satisfactory in 40 out of 48 patients, with no complications recorded on completion of treatment. Conclusion: Conservative treatment with early mobilization using TLS orthosis had good results in patients with TLICS score <4. We support the concept that TLICS is a reliable and easy-to-use classification for the conservative treatment and prognosis of thoracolumbar spinal fractures.

Emergency surgery in a hyperparathyroid patient: is spinal anesthesia safe?

Hyperparathyroidism can have a profound influence on human physiological mechanism and may affect the management of anesthesia. We present a case of successful management of a 65 years old female patient with parathyoid adenoma who underwent emergency intramedullary nailing in right femur for pathological fracture under low dose unilateral spinal anesthesia. An uneventful course of anesthesia in the presented case was related to the thorough systemic evaluation and careful anesthetic strategy