Open reduction internal fixation versus percutaneous iliosacral screw fixation for unstable posterior pelvic ring disruptions.

BACKGROUND: Surgical stabilization of posterior pelvic ring fractures can be achieved by either open or closed methods. They all provide a comparable biomechanical stability. The aim of the present study is to compare the clinical results of both techniques for treating posterior pelvic ring injuries. MATERIAL AND METHODS: Seventy patients operated for unstable posterior pelvic ring disruptions were retrospectively reviewed. We compared 35 patients treated by open reduction internal fixation (ORIF group) versus 35 patients stabilized by using closed reduction and percutaneous iliosacral screw fixation (CRIF group) under fluoroscopic guidance. RESULTS: According to pelvic outcome scoring system of Pohlemann et al., 28 patients out of the ORIF group obtained good or excellent results (20 excellent and 8 good), five fair and two poor. In the CRIF group, 30 patients obtained good or excellent results (25 excellent and 5 good), four fair and one poor (P=0.64). The average intraoperative blood loss in the ORIF group was 500cc with average blood transfusion of 2units (1000cc) compared to blood loss 150cc in the CRIF group, with average blood transfusion of 1unit (500cc) (P=0.002). No intraoperative complications were reported in the ORIF group while operative guide wires were broken in two cases in the CRIF group (P=0.16). There were no neurological complications observed in the ORIF group, but one radiculopathy (L5 root palsy) occurred in the CRIF group (P=0.317). In the ORIF group, three patients had superficial wound infection and one patient had deep infection while in the CRIF group, we noted only one case of deep infection (P=0.083). CONCLUSION: No difference was noticed between ORIF and CRIF. The technical decision is variable according to time of surgery, fracture types, patient general condition, skin condition, presence of ipsilateral fractures of the acetabulum and feasibility of the closed reduction. More studies are needed to identify prognostic factors related to quality of the reduction. We need for creation of decisional algorithm for ORIF versus CRIF. LEVEL OF EVIDENCE: Level 4.

Clofazimin in the treatment of scleroma.

Scleroma is a chronic progressive granulomatous disease predominantly affecting the mucous membrane of the upper respiratory tract, endemic in temperate and tropical zone countries including Egypt. Many patients in early stages respond to medical treatment while others do not. In these patients an antileprotic agent Clofazimin (Lamprene) was tried in 76 patients and the therapeutic results are very promising, especially for the early stages of the disease.

A study on fungal radioresistance and sensitivity.

Lower doses of gamma and X-rays (5 and 1 Krad, respectively) stimulated the spore germination and growth of 7 tested fungi. Higher doses (500 and 100 Krad, respectively) revealed that Epicoccum nigrum was the most radioresistant, while Alternaria humicola, Stemphylium verruculosum, Rhizopus nigricans, and Cladosporium herbarum were of moderate resistance. Aspergillus niger and Penicillium oxalicum were the most radiosensitive. Protein and polysaccharide synthesis were inhibited in the mycelium developed from irradiated spores; the inhibition was a function of dose. Study of the different factors (morphological, biological, and biochemical) indicates that variability in fungal resistance to ionizing radiation is, most probably, an inherent character, connected with mycelial water content and the natural production of a chemical substance(s) that acts as a radioprotector(s).

Possible role of solar radiation on the viability of some air fungi in Egypt.

The high occurrence of Alternaria humicola and the moderate occurrence of Stemphylium verruculosum, Rhizopus nigricans, and Epicoccum nigrum in the air of Egypt could be correlated to their apparent resistance to solar radiation. Cladosporium herbarum, Aspergillus niger, and Penicillium oxalicum, although highly occurring, were light-sensitive. The miniumum solar radiation in November, coupled with the highest total fungal catch, dominated by Cladosporium herbarum, reveals the importance of solar radiation as a factor with direct effect on the air fungal population.

Insecticides and soil microorganisms. III. Fate of 14C-labelled Dipterex as affected by two nodule-forming rhizobium spp. and roots of their respective leguminous host plants.

Chromatographic analysis led to the identification of monomethyl- and dimethyl-phosphates as metabolites resulting from the enzymatic degradation of 14C-labelled Dipterex in the buffer solutions and root tissues of broad bean and clover plants, as well as in the culture media of rhizobium leguminosarum and Rhizobium trifolii. The formation of 14CO2 from rhizobial cultures containing radioactive Dipterex suggests that some of the liberated methanol groups (during breakdown of Dipterex) are oxidatively degraded by the two Rhizobium spp.