Management of Fractures of the Distal Third of Tibia by Distal Tibial Locking Plate by MIPO Technique.

Distal tibial fractures are difficult to manage as the bone is subcutaneous with depleted muscular cover; the consequent decreased vascularity leads to complications. Minimal invasive plate osteosynthesis (MIPO) is a very good option for managing this type of fractures. This study was carried out to evaluate the outcome of patients treated with distal tibial locking plate by MIPO technique. Twenty patients with distal tibia fractures treated with distal tibial anatomical locking plate were prospectively studied from July 2013 to December 2016. The result was excellent in 18(90%) of patients i.e. 18 patients had an AOFAS score of 90 or greater out of a possible 100 points. The mean score was 94.28; the mean time for radiological union was 20.1 weeks with a range of 16 to 30 weeks. We encountered superficial infection in 02 (10%) of our patients which were managed with dressings and appropriate antibiotics. Two patients had union with valgus angulation of less than 5°. No malunion was detected. One patient had ankle stiffness requiring extensive physiotherapy to regain range of movement. Plate removal was done in 4 cases. MIPO technique is a good fixation method for fractures distal third of tibia, preserving blood supply & fracture hematoma.

Survival rates of anterior composites in managing tooth wear: systematic review.

The use of composite restorations for patients with tooth wear is considered as a more conservative treatment option. The aim of this study was to systematically review the literature investigating the survival rates of anterior composite restorations when used in managing tooth wear in patients. PubMed and MEDLINE (Ovid) databases were screened for studies from 1995 to 2015. Cross-referencing was used to further identify articles. Article selection and data extraction were performed in duplication. Languages were restricted to English. A quality appraisal of included studies was carried out using the Strength of Recommendation Taxonomy system. Six hundred and sixty-six articles were initially identified from which eight articles were full-text reviewed. Six articles involving five studies were selected for inclusion. Three studies were prospective and two retrospective. Included studies involved placement of 772 direct and indirect anterior composite restorations in 100 patients with follow-up periods between 5 months and 10 years. The survival rates of anterior composites were >90% and 50% at 2.5 and 5 years, respectively. Posterior occlusion was re-established in 91% of patients within 18 months. Meta-analysis could not be performed due to the heterogeneity of included studies. The systematic review's overall strength of recommendation was graded B. There is evidence to support the use of anterior composite restorations at an increased vertical dimension of occlusion in the short/medium-term management of tooth wear. Long-term reporting of outcomes remains limited. Further research is needed with standardised study design, detailed reporting of outcomes and long-term review.

A prospective survey of secondary care tooth wear referrals: demographics, reasons for concern and referral outcomes.

AIM: To provide a descriptive investigation of general dental practitioners' (GDPs) referrals to Glasgow Dental Hospital and School for management of tooth wear. MATERIALS AND METHODS: One hundred and twenty-four patient-referrals were reviewed over a 12 month period. A questionnaire was also completed by patients and three reviewing consultants to identify patient demographics, patient perception, consultant's diagnosis and referral outcome. RESULTS: Overall survey return-rate was 67% of 124 included referrals. Males represented 72% of referrals compared to 28% for females (p = 0.001). A significant percentage of patients inhabited the most-deprived areas (59%, p = 0.002). Sixty-one percent of patients were aware of their tooth wear within the past five years. Aesthetics was the primary concern for 54% of patients (p = 0.001). Attrition was the main aetiology of tooth wear in 51% of referrals (p = 0.001). Ninety-two percent of patients (n = 76/83) did not require specialist treatment and were consequently returned to their GDP, referred for hypnotherapy or reviewed later. CONCLUSION: There was a significant association between social deprivation and tooth wear in GDP referrals to a secondary care dental facility. Males aware of their tooth wear for the preceding five years, presenting with appearance as their main complaint and displaying evidence of attrition were more likely to be referred by GDPs for specialist management or advice.

Observations on renal replacement services in Russia, Belarus and Lithuania.

This report describes the current financial, technical and medical status of nephrology, dialysis and renal transplant services in these countries with the hope of helping our colleagues there to upgrade their standards of care. The general impression is that physicians as well as administrators in these countries are eager to improve conditions of patient care despite a disastrous economical climate. Our view is that we can help by providing literature, textbooks, journals, travel funds, by offering visiting fellowships to individual physicians, and by forming partnerships between nephrology centres.

Toxicity of cotoran (fluometuron) in Desert sheep.

Twelve of fifteen 6-9-mo-old clinically healthy Desert sheep were given single or repeated daily doses of 25 to 4000 mg cotoran/kg by drench. Cotoran poisoning was characterized by grinding of the teeth, ruminal tympany, mydriasis, dyspnea, staggering, paresis of the hind and forelimbs, and recumbency. Lesions were widespread congestion and hemorrhage, hepatic fatty change, catarrhal enteritis and degeneration of the epithelial cells of the renal proximal convoluted tubules. These were accompanied by significant increases in the activities of GOT, LDH and GGT and decreases in serum total protein and calcium.

Experimental metolachlor toxicosis in Nubian goats in the Sudan.

Six out of 15 Nubian goats kids were given single oral doses of metolachlor (Dual 720 EC) at 2,000 or 500 mg/kg liveweight and died within 1 h of the dosing. Other 6 goats were given daily oral doses at 200 or 25 mg/kg and died or were slaughtered between days 8 and 25. In goats receiving single doses, the signs of poisoning were convulsive episodes, incoordination of movement, tremors, severe muscular spasms, stiffness, profuse salivation, respiratory distress, abnormal posture and recumbency. In goats receiving metolachlor at daily doses, the signs were similar, but developed slowly. Increases in the activities of serum AST and GGT and in the concentration of urea, and decreases in total protein concentration were correlated with clinical changes and lesions.

Susceptibility of Nubian goats to mercury poisoning in the Sudan.

Twelve Nubian goats were given single or repeated oral dosages of mercuric chloride at 10, 20 and 40 mg/kg and died or were killed in extremis at various times after dosing (18 hours-18 days). The main signs of poisoning were anorexia, frothing at the mouth, respiratory distress, epistaxis, bloat, diarrhoea, abnormal posture and recumbency. An increase in the activity of GOT and in the concentrations of urea and inorganic phosphate and a decrease in total protein and calcium concentrations in the serum were detected. The main lesions were dilatation and necrosis of the proximal convoluted tubules, shrinkage and disappearance of the glomerular tufts, varying amounts of acidophilic homogenous material in the lumens of the affected tubules of the kidney, enteritis, hepatocellular degeneration and/or necrosis and pulmonary congestion, haemorrhage, oedema and emphysema. The changes in the red blood cells indicated anaemia.

Experimental selenium poisoning in Nubian goats.

The toxicity of sodium selenite was studied in 28 Nubian goats, 20 of which died or were killed in extremis 2 h to 21 d after dosing. Single or repeated daily oral doses of 160, 80, 40, 20 and 5 mg sodium selenite/kg were toxic to goats while daily doses of selenite ranging from 0.25 to 1 mg/kg/d for 225 d were not toxic to this species of animals. The main signs of poisoning were uneasiness, inappetence, dyspnea, salivation, diarhea, paresis of the hind limbs, arching of the back, and recumbency. The main lesions were hemorrhages in the rumen, reticulum, osmasum and abomasum, hemorrhagic or catarrhal abomasitis and enteritis, fatty change and necrosis of the centrilobular hepatocytes and of the cells of the renal convoluted tubules, splenic hemosiderosis, pulmonary congestion, haemorrhage, edema and emphysema, accumulation of lymphocytes in the vital organs, and straw-colored fluid in the serous cavities.