Intra-articular dislocation of patella with femoral impaction-A case report and review of literature.

INTRODUCTION AND CASE PRESENTATION: Acute traumatic patella dislocations are common injuries seen in emergency departments. We present a rare injury which involves an acute, irreducible intra-articular dislocation of the patella. In this particular case, we describe a horizontal type intra-articular dislocation of the patella in a 66-year-old lady, which was complicated by impaction into the distal femur. She underwent two failed closed reduction attempts, but subsequently reduced spontaneously on the orthopaedic floor as she was waiting for an open reduction in the operating room. DISCUSSION: The management of acute patellar dislocations can be divided into closed and open reduction methods. In cases where a closed reduction is unsuccessful, an open reduction under general anesthesia may be pertinent to treat this acute condition. CONCLUSION: We report a case of an intra-articular patella dislocation which has shown that spontaneous reduction is possible for cases following unsuccessful initial closed reduction, yet it still remains unadvisable to delay open reduction. We highlight, through this case, the importance of maintaining a high index of suspicion for these uncommon injuries.

Low carbohydrate ketogenic diet prevents the induction of diabetes using streptozotocin in rats.

Diabetes continues to be an overwhelmingly prevalent endocrine disorder that leads to several micro- and macrocomplications. It has been widely accepted that changes in dietary habits could induce or prevent the onset of diabetes. It is shown that low carbohydrate ketogenic diet (LCKD) is effective in the amelioration of many of the deleterious consequences of diabetes. However, its role in preventing the onset of diabetes is not understood. Therefore, this study is focused on the effect of LCKD in preventing the induction of diabetes using streptozotocin (STZ) in rats by biochemical and histological methods. Forty-two Wistar rats weighing 150-250 g were used in this study. The animals were divided into three groups: normal diet (ND), low carbohydrate ketogenic diet (LCKD), and high carbohydrate diet (HCD). Specific diets ad libitum were given to each group of animals for a period of 8 weeks. Each group was further subdivided into normal control, sham control and diabetic groups. Animals in the diabetic group were given a single intraperitoneal injection of STZ (55 mg/kg). All the animals were sacrificed 4 weeks after the injection of STZ. Daily measurements of food and water intake as well as weekly measurement of body weight were taken during the whole 12 weeks of the experiment. After injecting with STZ, the blood glucose level of all the groups increased significantly except for the group fed on LCKD (p value<0.01). Also, food intake, water intake and urine output were significantly increased in all groups except for the LCKD group (p value<0.01). There was also a significant decrease in the weight gain of the animals that were fed on a LCKD as compared to other groups (p value<0.05). Although, substantial decrease in the number of ß cells was noticed in diabetic rats, there were no change in the number of ß cells in the LCKD treated diabetic animals as compared to LCKD control group. The results presented in this study, therefore, suggests that LCKD prevents the development of diabetes using streptozotocin in rats.

Effect of dietary hempseed intake on cardiac ischemia-reperfusion injury.

Polyunsaturated fatty acids (PUFAs) have significant, cardioprotective effects against ischemia. Hempseed contains a high proportion of the PUFAs linoleic acid (LA) and alpha-linolenic acid (ALA), which may have opposing effects on postischemic heart performance. There are no reported data concerning the cardiovascular effects of dietary hempseed intake. A group of 40 male Sprague-Dawley rats were distributed evenly into four groups that were fed for 12 wk a normal rat chow supplemented with hempseed (5% and 10%), palm oil (1%), or a 10% partially delipidated hempseed that served as a control. Plasma ALA and gamma-linolenic acid levels were significantly elevated in the rats that were fed a 5% or 10% hempseed-supplemented diet, but in heart tissue only ALA levels were significantly elevated in the rats fed these diets compared with control. After the dietary interventions were completed, postischemic heart performance was evaluated by measuring developed tension, resting tension, the rates of tension development and relaxation, and the number of extrasystoles. Hearts from rats fed a hempseed-supplemented diet exhibited significantly better postischemic recovery of maximal contractile function and enhanced rates of tension development and relaxation during reperfusion than hearts from the other groups. These hearts, however, were not protected from the occurrence of extrasystoles, nor were the increases in resting tension altered during ischemia or reperfusion as a function of any dietary intervention. Our data demonstrate that dietary hempseed can provide significant cardioprotective effects during postischemic reperfusion. This appears to be due to its highly enriched PUFA content.

Fatty acid composition and arachidonic acid intake of selected Saudi foods.

Twenty-eight Saudi Arabian common foods were analyzed for their fatty acid contents by gas-liquid chromatography using capillary column. The predominant fatty acids were oleic, palmitic, linoleic and stearic acids. The polyunsaturated to saturated fats ratio (P:S) as well as the n-3:n-6 ratio were generally not compatible with recommended values. Assessment of C20:4 (n-6) content in those foods showed a noticeable variation ranging from 9 mg/100 gm in beef sirloin to 256 mg/100 g in kannad fish. Eicosapentaenoic acid (C20:5) n-3 content was highest in kannad (925 mg/100 g). Applying C20:4 (n-6) values determined in this work to Saudi Balanced Sheet, the mean C20:4 (n-6) intake for a Saudian was estimated as approximately 115 mg/day.