Prolapsed intervertebral disc with sciatica: the role of common peroneal nerve block

A total of 210 patients of Lumbar disc prolapse with sciatica were given common peroneal block by infiltrating 2% xylocaine around the common peroneal nerve 3 cm below the head of fibula on the affected side. After receiving the block the pain decreased on from grade 2.99 +/- 0.46 to 0.91 +/- 0.99, and straight leg raising increased from 32.1 +/- 12.55 to 59.66 +/- 12.11 degrees. The method, as an outpatient procedure, has been found to be simple and useful in the patients of sciatica with prolapsed lumbar intervertebral disc potentially appropriate for a low-resource setting.     

An unusual case of sciatic neuropraxia due to melorheostosis

Melorrheostosis is a rare osteosclerotic bone dysplasia of obscure etiology. The typical radiographic features are flowing candle wax, sub-periosteal bone and streaky endosteal bone formation in diaphyseal and epiphyseal area with sclerotomal pattern mainly involving appendicular skeleton. It is rarely associated with nerve palsies. The authors report a case of melorrheostotic mass causing sciatic neuropraxia and to the best of their knowledge it is the first case reported in the English language literature.     

Sub-acute toxicity evaluation of an aqueous extract of Labisia pumila, a Malaysian herb

Labisia pumila (Myrsinaceae), is a popular herb among the women in Malaysia known locally as “Kacip Fatimah”. Recently many nutraceutical products containing the powdered or extracted parts of the plant have become available for women’s health care. However no evaluation of the effect of the repeated dosing of any herbal product of this plant had been undertaken prior to a 28-day sub-acute study presented in this report. The results showed that a dose of 50 mg/kg of an aqueous extract of L. pumila corresponded to no-adverse-effect-level (NOAEL), whereas higher doses were associated with some toxicity concerns.     

Technical aspects of the use of dynamic condylar screw in biological fixation of comminuted subtrochanteric fractures

Background  Indirect reduction and biological internal fixation using dynamic condylar screw (DCS) yield acceptable results in comminuted subtrochanteric fractures. An analysis of the technical difficulties of the procedure with the tricks to prevent these is presented. Materials and methods  Forty-eight consecutive patients with the mean age of 44.5 years with comminuted subtrochanteric fractures were treated with a DCS and biological reduction methods. Results  All fractures united without bone grafting at average union time of 16.16 weeks. Average Harris hip score was 87.97 points. We observed technical difficulties in six patients like inaccurate placement of guide pin in two; difficulty in sliding the plate due to obesity in one; difficulty in gliding barrel plate over condylar screw in one; and technical failure in two patients. Malunion (coxa vara) leading to limp occurred in one patient. A mean limb length discrepancy of 1.46 cm was detected in 5 patients at last follow up. We improvised the technique to overcome these difficulties. Conclusions  Accurate placement of the guide pin is the key to avoid technical difficulties during the procedure. Surgeon should not proceed further until completely satisfied with the position of the guide pin. Few tricks in the technique make use of dynamic condylar screw in biological fixation of comminuted subtrochanteric fractures easier.     

Withanolide D induces apoptosis in leukemia by targeting the activation of neutral sphingomyelinase-ceramide cascade mediated by synergistic activation of c-Jun N-terminal kinase and p38 mitogen-activated protein kinase

Background  

Ceramide is an important second messenger that has diverse cellular and biological effect. It is a specific and potent inducer of apoptosis and suppressor of cell growth. In leukemia, chemoresistance generally developed due to deregulated ceramide metabolism. In combinatorial treatment strategies of leukemia, few components have the capability to increases ceramide production. Manipulation in ceramide production by physiological and pharmacological modulators therefore will give additive effect in leukemia chemotherapy.     

Foreign body in vagina-an uncommon cause of vaginitis in children

An intravaginal foreign body of long duration can pose diagnostic dilemma in children. We present a case of eight and a half years old girl who was suffering from blood stained vaginal discharge for 3 years for which she was treated by few gynaecologists. A vaginal examination performed under general anaesthesia revealed a foreign body (lead pencil). In cases of pediatric vaginitis one should always look for foreign body in vagina.