Simultaneous Bilateral Tibial Tuberosity Avulsions—Over 6-Year Follow-up

Abstract Simultaneous bilateral avulsions of the tibial tuberosity are rare injuries. The authors found only five reported cases in the orthopedic literature. We add a further case of bilateral avulsions of the tibial tuberosity with the longest reported follow-up.     

Acute gluteal abscess following intramuscular chloroquine injection: a clinical and experimental study

This prospective study contains clinical and experimental parts. In the clinical study, 125 patients given intramuscular chloroquine for malaria were followed for 2 months in order to detect local injection site complications. Adequate local antiseptic conditions were ensured before giving the injection. Twenty-three patients (18.4%) had minimal local reaction in the form of redness, induration and/or a lump. No pyogenic abscess was noted in contrast to a previous report. In the second part of the study, an experimental animal (Green monkey) was given either chloroquine phosphate, Ampiclox or normal saline intramuscularly. The injection site was later biopsied and histologically examined. Intramuscular chloroquine was found to cause severe inflammatory reactions and muscle necrosis, whereas other injections had very minimal local effects. It is concluded that intramuscular chloroquine causes muscle necrosis which may lead to acute pyogenic abscess if minimal contamination takes place.     

Quantification by ELISA of Aldrin/Dieldrin in river Nile water and tap water samples collected in Egypt

An indirect competitive ELISA was developed for the quantitative analysis of aldrin/dieldrin. This has been used to monitor the levels of these pesticides in water samples collected in Egypt. The detection range of the aldrin/dieldrin assay in water was 5–10 ppm without enhancement. River Nile water samples and tap water samples (n = 25) were collected from 25 stations in 16 different governorates in Egypt. Pesticides were detected in 10 of the 25 Nile water samples (40%) at levels from 10 to 110 ppb. In tap water samples, pesticides were not detected at levels greater than the lower limit of the assay. The technique described provides a rapid, economical, highly sensitive and specific method of analysis that is relatively simple to perform and interpret. It will be extremely useful in monitoring levels of pesticides in water used for human consumption.     

A single nocturnal dose of famotidine for the treatment of duodenal ulcer: evaluation of efficacy and safety

The efficacy and safety of a single nocturnal dose of famotidine (40 mg) was evaluated in 30 consecutive patients of duodenal ulcer (DU). Three patients were lost for follow-up and therefore were excluded. The mean age of remaining 27 patients was 34.3 (+/- 9.9) years and male to female ratio was 8:1. The mean size of the DU was 1.21 (+/- 0.79) cm. After a 4-week therapy all patients showed significant improvement and repeat endoscopy in 24 out of 27 patients (89%, 95% confidence interval; 78% to 100%) showed healed ulcer. Clinical assessment of pain relief at 4-week showed significant drop in the mean score of baseline daytime (from 1.85 to 0.13) and baseline nocturnal pain (from 1.70 to 0.10) (p less than 0.0001 and less than 0.0001, respectively). Also shown was the significant decrease in the mean gastrointestinal symptoms score from 5.89 at baseline to only 0.89 at 4-week (p less than 0.0001). Despite that all those who failed to show ulcer healing at 4-week were smokers, logistic regression analysis could not identify smoking or any other risk factors as adverse predictors of ulcer healing. None of the patients experienced significant side effects or adverse reactions. We conclude, that a single nocturnal dose of famotidine is a practical, highly effective and safe approach for the management of DU.     

Effect of nutrition on the health of the elderly.

Nutrition may play a role in the progressive decline of several body functions with aging. Progressive decline in energy, lean body mass, and protein intake are also associated with aging. Many elderly (greater than 55 years old) drink less than the recommended amounts of water and consume less than the Recommended Dietary Allowances of calcium, iron, zinc, copper, thiamin, riboflavin, folate, and vitamins B-12 and D. Nutrition needs of the elderly to maintain activities of daily living are expected to increase in future years. Because diminished physical activity and old age disabilities cause the elderly to modify eating habits acquired at a younger age, dietary and other life-style changes should be implemented early in life so that optimal tissue function will be maintained. More research and development is needed in the areas of nutrient requirements for the elderly, effect of nutrition on chronic diseases, improved methods for assessing nutritional status and screening the elderly for nutritional risk, nutrient-nutrient and nutrient-drug interactions, and educational strategies to provide better nutrition and eliminate health fraud. Dietary interventions show promise, but must be monitored for effectiveness.     

Retinal arteriovenous communication in retinitis pigmentosa with Refsum's disease-like findings

In this report we describe, herewith, a patient with primary pigmentary dystrophy of the retina (retinitis pigmentosa) associated with unilateral retinal arteriovenous communication and exudative retinal detachment. The patient had complete resolution of the retinal detachment following laser photocoagulation treatment. Such association has not been previously reported.     

The screening and treatment of undiagnosed depression in patients with chronic obstructive pulmonary disease (COPD) in a general practice.

AIMS AND OBJECTIVES: To screen for, and to treat, depression in COPD patients in a general practice surgery, and to test the feasibility of the screening method. METHODS: We sent The Beck Depression Inventory (BDI) Short-Form Questionnaire to all patients on the COPD register (n=69) by post, excluding those already diagnosed with depression (n=3). We sent appointments to all responders with moderate to severe depression and offered them treatment including antidepressants and pulmonary rehabilitation if the diagnosis was confirmed. RESULTS: Of the 66 patients to whom we sent questionnaires, 43 were returned completed and 13 of these had significant depression (30%). 10 of these patients were contactable and attended for review. The diagnosis of depression was confirmed in all 10 cases. Treatment options were discussed; five chose antidepressant medication, three chose pulmonary rehabilitation and two declined treatment. CONCLUSION: We identified and treated a significant number of depressed COPD patients in a general practice setting using this screening method. This method could have wider applications for screening, although further trials are needed.