RANDOMIZED COMPARATIVE STUDY OF DEFINITIVE EXTERNAL FIXATION VERSUS ORIF IN PILON FRACTURES: AN EARLY CLINICAL OUTCOME REPORT.

Repairing Pilon fractures remains challenging. ORIF allows direct anatomical reduction, but at the expense of soft tissues dissection which are associated with recovery. On the other hand, External Fixation allows indirect reduction and causes less soft tissue damage. However, a few studies conclude that External Fixation is associated with high rates of malunion.The objectives were to evaluate and compare: primary outcome measure: ankle hindfoot function (AOFAS at 9 months) and secondary outcome measures: quality of reduction, bone union, arthritic changes, other potential complications and ultimately the optimum management for pilon fractures.A prospective randomized comparative clinical study. 40 Patients were included in the study with comminuted closed Pilon fracture. Patients were randomized by closed envelope technique into two groups: Group (1) Included 20 patients managed by external fixation with limited internal fixation. Group (2) Included 20 patients managed by open reduction and internal fixation. Skeletally immature, type 43A AO/OTA, Open fractures, compartment syndrome, Pathological fractures were excluded.There was no significant difference between External fixation and ORIF as methods of fixation for Pilon fracture in the functional activity of the patient after 9 months as evidenced by AOFAS score (P=0.547) and the development of complications (P=0.227). However, there was statistically significant difference (P<0.001) regarding the time to weight bearing between both groups, and statistically significant difference (P=0.042) regarding time to union.The best surgical modality to treat Pilon fractures is still debatable. While external fixation is used by many to avoid major complications, it has been associated with high rates of malunion, and osteoarthritis.

Use of acetic and citric acids to inhibit Escherichia coli O157:H7, Salmonella Typhimurium and Staphylococcus aureus in tabbouleh salad.

The objective of the current study was to evaluate the antimicrobial action of different concentrations of acetic (0.3% and 0.4%) or citric (1% and 1.4%) acids and their combinations (1% citric acid plus 0.4% acetic acid and 1.4% citric acid plus 0.3% acetic acid) against Salmonella Typhimurium, Escherichia coli O157:H7 and Staphylococcus aureus in tabbouleh salad stored at 21, 10 and 4 °C. Acetic acid was more inhibitory toward S. Typhimurium and E. coli O157:H7 than citric acid at 21 °C; S. Typhimurium and E. coli O157:H7 cells were not detected in tabbouleh treated with 0.4% acetic acid after 5 and 7 days, respectively. The combined effect of acetic and citric acid was synergistic against S. Typhimurium, and E. coli O157:H7, but not against S. aureus. The combinations of acetic and citric acids reduced S. Typhimurium, and E. coli O157:H7 to below the detection levels after 2 and 3 days at 21 °C, respectively. However, these treatments significantly reduced S. aureus numbers compared to the control at tested temperatures by the end of storage. Acetic and citric acids have the potential to be used in tabbouleh salad to reduce the risk from S. Typhimurium, E. coli O157:H7 and S. aureus.

Results of instrumented posterolateral fusion in failed back surgery.

The success rate following revision surgery for failed back surgery is inherently low. However, a general consensus for a satisfactory surgical intervention after failed disc surgery has not yet been reached. We present a cohort study of 25 adult cases treated by instrumented posterolateral fusion with or without nerve root exploration/decompression for recurrence or persistence of symptoms after previous disc surgery. The average age at surgery was 47 years (range 39-56 years). Complications were seen in four patients in the form of intraoperative dural tears. A satisfactory clinical outcome was seen in 80% of the patients, and the overall fusion rate was 93%.

First report of an outbreak of ovine septicaemic listeriosis in Saudi Arabia.

Although a case of human listeriosis has recently been reported in Saudi Arabia, the disease has not been reported in animals to date. The authors describe an outbreak of septicaemic listeriosis in sheep, which occurred during winter. Adult animals and pregnant ewes were principally affected, with a morbidity rate of 7.1% and a mortality rate of 2.4%; no abortions were recorded during the outbreak. Clinical signs included inappetence, weakness, fever, respiratory distress, keratoconjunctivitis and compulsive circling. Listeria monocytogenes was isolated in pure culture from affected sheep. Pathological findings indicated septicaemic listeriosis with encephalitis. Hygienic measures and antibiotics were successful in treating the rest of the flock. Aspects of the outbreak and public health implications are discussed.

Recovery of the jaw-opening reflex after lesions of the lingual nerve in the rat.

In three groups of rats, lesions were produced in the right lingual nerves near the base of the tongue; the three types of injury inflicted (cryogenic, crush, and stretch) are reputed to spare the epineurium but produce different degrees of intraneural damage. In regular assessments of recovery, an electrical stimulus (sufficient to elicit the jaw-opening reflex) was applied to either side of the tongue in turn; the amplitude of the reflex was measured as the isometric force of jaw opening. The size of the reflex response to stimulation of the injured side was followed up to 4 months post-lesion, with the response elicited from the control side used as the reference level. The reflex was absent when the experimental side was stimulated immediately after creation of a lesion; the first sign of reflex recovery was found at about 15 days post-operative. Subsequently, in 84% of the animals, the reflex activity elicited from the experimental side increased until it exceeded that elicited from the reference side; this relative hyperreflexia started 1-4 months post-lesion and had a highly variable duration. There was no difference in the incidence, latency, or duration of the hyperreflexia following any of the three types of lesion. The hyperreflexia found in this study is not readily explained by existing hypotheses of the mechanisms underlying post-lesion hyperesthesia or central neuronal hyperexcitability.

Studies on the infundibular cysts of the uterine tube in camel (Camelus dromedarius).

Two hundred eighteen genital tracts of slaughtered female camels were collected and examined. Infundibular cysts were observed in 35 tracts (16%); these were either unilateral (22 cases) or bilateral (13 cases) all containing fluids of different consistencies. The morphological and histological structures of the cysts were recorded. The bacteriological investigation and physicochemical analysis of cyst contents were carried out. Aeromonas hydrophila was isolated from 68.5% of cases. Rectal palpation and ultrasound technique were compared for the diagnosis of the cysts antemortem.