Management outcomes in pubic diastasis: our experience with 19 patients

Background  

Pubic diastasis, a result of high energy antero-posterior compression (APC) injury, has been managed based on the Young and Burguess classification system. The mode of fixation in APC II injury has, however, been a subject of controversy and some authors have proposed a need to address the issue of partial breach of the posterior pelvic ring elements in these injuries.     

RETRACTED ARTICLE: Penile Strangulation by Metallic Rings

A case of penile strangulation in a 35 year old male truck driver by profession reported here. Two metallic rings were self introduced upto the base of penis, in order to prevent spontaneous ejaculation at night. There was marked oedema of penis distal to rings, and these rings were removed with an indigenous technique, non-operatively     

Arthroscopic anatomic double bundle anterior cruciate ligament reconstruction: Our experience with follow-up of 4 years

BackgroundDouble bundle (DB) anterior cruciate ligament (ACL) reconstruction has been proposed to recreate the natural anatomy of ACL. Reconstruction of the anatomy of both the bundles of ACL has been thought to be able to restore the rotational stability of the knee joint. Nevertheless, it remains unclear whether DB reconstruction has better functional outcome than single bundle (SB) ACL reconstruction.PurposeTo evaluate the clinical outcomes, patient satisfaction and manual laxity tests of knee in patients treated with DB ACL reconstruction in Indian population.MethodsWe prospectively followed 25 patients with an isolated ACL injury operated for DB ACL reconstruction after applying the inclusion and exclusion criteria. Patients were evaluated pre-operatively and in the post-operative period at regular intervals with the minimum follow up of 4 years. Clinical stability was assessed by anterior drawer test, Lachman test and pivot shift test. Functional outcome was assessed by IKDC, Lysholm and Modified Cincinnati scores.ResultsAt the end of 4 years, functional outcome in terms of all subjective scores was satisfactory. Graded stability results of the Lachman, Anterior drawer and pivot shift tests were almost near to that in normal knee. No complication occurred post-operatively.ConclusionAnatomical DB ACL reconstruction seems to offer satisfactory results in terms of subjective scores and stability tests to patients with ACL tear. It has been found to be associated with no obvious complications and no failures. However a larger patient pool is desired for conclusive results.     

Sweet Potato Peels and Cancer Prevention

A bioassay-guided fractionation of an alcoholic extract from the peels of Ipomoea batatas Lam has been carried out. Sulforhodamine B and 2,2-diphenyl-1-picrylhydrazyl (DPPH) assays were used to evaluate the anticancer and antioxidant potential, respectively, while silica gel column chromatography (CC) was used to isolate compounds that were characterized using 1D- and 2D-NMR (Nuclear Magnetic Resonance) and mass spectrometry. The alcoholic extract was fractionated into n-hexane, ethyl acetate, n-butanol, and water. The n-hexane fraction which showed the most promising anticancer activity was further fractionated via silica gel CC into IB-F002A, IB-F002B, and IB-F002C. Of these, IB-F002C was the most active with IC₅₀ values 24.75, 47.91, 52.37, 34.17, 46.07, and 25.89 μg/ml against breast, colon-1, colon-2, ovary, lung, and head/neck cancer cell lines, respectively. The bioassay-guided isolation from IB-F002C afforded a glucocerebroside, which showed 10.51%, 12.19%, 16.14%, and 34.05% inhibition of head and neck, breast-1, colon-1, and ovarian cancer cell lines, respectively. Octadecyl coumarate, 7-hydroxycoumarin, and 6-methoxy-7-hydroxycoumarin that showed different antioxidant potentials were also identified in this study. Sweet potato peel, which is usually discarded as waste, contains constituents that can serve as dietary components to prevent the development of different types of cancer.     

The cellular repair of the brain in Parkinson's disease--past, present and future

Damage to the central nervous system was once considered irreparable. However, there is now growing optimism that neural transplant therapies may one day enable complete circuit reconstruction and thus functional benefit for patients with neurodegenerative conditions such as Parkinson's disease (PD), and perhaps even those with more widespread damage such as stroke patients. Indeed, since the late 1980s hundreds of patients with Parkinson's disease have received allografts of dopamine-rich embryonic human neural tissue. The grafted tissue has been shown to survive and ameliorate many of the symptoms of the disease, both in the clinical setting and in animal models of the disease. However, practical problems associated with tissue procurement and storage, and ethical concerns over using aborted human fetal tissue have fuelled a search for alternative sources of suitable material for grafting. In particular, stem cells and xenogeneic embryonic dopamine-rich neural tissue are being explored, both of which bring their own practical and ethical dilemmas. Here we review the progress made in neural transplantation, both in the laboratory and in the clinic with particular attention to the development of stem cell and xenogeneic tissue based therapy.     

The profile of behavioral and psychological symptoms in vascular cognitive impairment with and without dementia

Objective:

The objective of this study was to compare the occurrence and severity of behavioral and psychological symptoms of dementia (BPSD) between vascular dementia (VaD) and vascular cognitive impairment-no dementia (VCI-ND).

Materials and Methods:

Consecutive patients presenting with cognitive impairment at least 3 months after an ischemic stroke and with a Hachinski Ischemic Score ≥4 were included. VaD was diagnosed as per National Institute of Neurological Disorders and Stroke – Association Internationale pour la Recherche et l’Enseignement en Neurosciences criteria for probable VaD and VCI-ND on the lines of the Canadian study of health and aging. The severity of cognitive impairment and the behavioral/psychological symptoms were studied by means of the clinical dementia rating scale and the neuropsychiatric inventory (NPI) respectively.

Results:

All patients with VaD and 89% of those with VCI-ND had at least one BPSD. The mean no. of symptoms per patient and the total NPI scores were higher in VaD than in VCI-ND. Apathy and night-time behavior disturbances were significantly more common and severe in VaD.

Conclusions:

BPSD are very common both in VCI-ND and in VaD. The profile of BPSD is similar in both groups, albeit more severe in VaD. The net burden of BPSD is higher in VaD as compared to VCI-ND.Key Words: Behavioral and psychological symptoms, neuropsychiatric inventory, vascular cognitive impairment, vascular cognitive impairment-no dementia, vascular dementia     

Acute lymphoblastic leukemia with hyperleukocytosis, sinus pauses, and hypoxemic respiratory failure in an infant

A 5-month-old female infant presented with new-onset acute lymphoblastic leukemia and hyperleukocytosis with white blood cell count of 352 × 10(9) cells/L. She developed sinus pauses and hypoxemic respiratory failure. A manual single volume exchange blood transfusion was done with complete resolution of sinus pauses and hypoxemia.     

Wells' syndrome: a clinical and histopathologic review of seven cases

Wells' syndrome, or eosinophilic cellulitis, is characterized clinically by an acute dermatitis resembling cellulitis, which evolves into violaceous plaques that resolve spontaneously without scarring. The histopathologic features are dynamic, starting with dermal edema and infiltration of eosinophils, the development of "flame figures," and finishing with the appearance of phagocytic histiocytes. We present the clinical and histopathologic features of seven cases of eosinophilic cellulitis.     

Prognostic significance of calcium-sensing receptor in breast cancer

The calcium-sensing receptor (CaSR) is a G-protein coupled receptor that is involved in tumor suppression of cancers. However, its role in breast cancer remains largely unknown. The aim of the study was to investigate the expression of CaSR in breast cancers and to evaluate its prognostic significance. We found that the protein levels of CaSR were significantly reduced in cancer lesion compared with its paired non-tumor tissues. By analyzing the expression of CaSR in a 148 cases of breast cancer tissue microarray (TMA) by immunohistochemistry, we found that patients with lower expression of CaSR were significantly associated with poor overall survival, cause-specific survival, and distant metastasis-free survival. The Cox multivariate analysis showed that CaSR was an independent prognostic significance for both overall survival and cause-specific survival of breast cancer patients. Our data confirmed the tumor suppressor role of CaSR and suggested that CaSR is an independent prognostic indicator of breast cancer.