In vivo evaluation of a vibration analysis technique for the per-operative monitoring of the fixation of hip prostheses

Background  

The per-operative assessment of primary stem stability may help to improve the performance of total hip replacement. Vibration analysis methods have been successfully used to assess dental implant stability, to monitor fracture healing and to measure bone mechanical properties. The objective of the present study was to evaluate in vivo a vibration analysis-based endpoint criterion for the insertion of the stem by successive surgeon-controlled hammer blows.     

A survey on clinical presentation and nutritional status of infants with suspected cow' milk allergy

Background  

Cow's milk is the most common food allergen in infants and the diagnosis of cow's milk allergy is difficult, even with the use of several diagnostic tests. Therefore, elimination diets and challenge tests are essential for the diagnosis and treatment of this disorder. The aim of this study is to report the clinical presentation and nutritional status of children evaluated by pediatric gastroenterologists for the assessment of symptoms suggestive of cow's milk allergy.     

Efficacy of fixed low-dose isotretinoin (20 mg, alternate days) with topical clindamycin gel in moderately severe acne vulgaris

Background  In view of the potentially serious side-effects of standard isotretinoin (0.5–1.0 mg/kg per day) therapy for acne, we studied the safety and efficacy of low-fixed dose isotretinoin plus topical 1%clindamycin gel in the treatment of moderate grade of acne.
Methods  In this prospective, non-comparative study, 320 adult patients, with moderately severe acne were enrolled and treated with fixed-dose isotretinoin at 20 mg every alternate day (approximately 0.15 mg/kg/day to 0.28 mg/kg/day) for 6 months along with topical clindamycin gel. All female patients were assessed for polycystic ovarian disease. Patients were followed up for 6 months.
Results  A total of 305 patients completed the study. Overall, patients received a mean of 38.4 mg/kg cumulative dose of isotretinoin, and very good results were observed in 208 (68.20%), while good response was seen in 59 (19.34%) of patients. Failure of the treatment occurred in 38 (12.46%), while relapses occurred in 50 (16.39%) of patients. Relapses were commoner in females, and 37 of 43 (86.04%) patients had polycystic ovarian disease. Though mild chelitis (91%) and xerosis (43%) were common, laboratory abnormalities in the form of elevated hepatic enzymes (5%) and elevated serum lipids (6%) were rare.
Conclusion  Six months of treatment with fixed-dose, alternate-day isotretinoin (20 mg) plus topical 1%clindamycin gel was found to be effective in the treatment of moderate acne in adult patients, with a low incidence of side-effects.

Conflicts of interest

None declared     

Gallstone Obstructive Ileus 3 Years Post-cholecystectomy to a Patient with an Old Ileoileal Anastomosis

The present case is one of gallstone obstructive ileus due to gallstones 3 yr after laparoscopic cholecystectomy. It is interesting because of the sex of the patient, the fact that ileus occurred 3 yr after cholecystectomy and that the localization of the obstruction was an old side-to-side ileoileal anastomosis due to a diverticulectomy following intussusception of Meckels'' diverticulum at the age of 3.     

Male pattern androgenetic alopecia in an Indian context: a perspective study

BACKGROUND: Androgenetic alopecia (AGA) has received scant attention, despite it being a common entity that may result in significant psychosocial morbidity. There are some patients who do not fit into any of the proposed types. Moreover, there have been no published studies of pattern and prevalence of AGA in males in an Indian context. Hence, the present study was an attempt to classify AGA in males with the aim of producing a simple, effective and easily reproducible classification. METHODS: In total, 150 male patients were clinically diagnosed as AGA. After obtaining informed consent from all patients, a detailed history/examination was carried out, including a hair pull test, a trichogram investigation and a biopsy. Classification of AGA was subsequently attempted across Norwood guidelines. RESULTS: A gradual shift in the type of AGA from the earlier types (II and III) to more severe types (VI) with increasing age was significant. Twenty-seven patients did not fit into specific patterns according to Hamilton and Norwood classifications. In addition, type 'a' variant was recorded in 20% of patients, clearly indicating limitations of the existing classifications. CONCLUSIONS: It was possible to classify 80% of the AGA, with II (28%) and III (15%) being the most common types of AGA. Twenty-seven patients (18%) could not be classified as a significant finding. There was considerable overlap in types IV, V and VI in the Norwood classification with the 'a' variants further confusing the picture.     

Distribution of alpha3, alpha5 and alpha(v) integrin subunits in mature and immature human oocytes

The distribution of three integrin subunits, alpha3, alpha5 and alpha(v), in immature and mature human oocytes has been examined using immunofluorescence and confocal microscopy. The results demonstrate that both alpha5 and alpha(v) are present at the germinal vesicle stage, while alpha3 was only detected in oocytes after germinal vesicle breakdown, in metaphase I and II stage oocytes. The cortical concentration of integrin subunits alpha3 and alpha5 is consistent with their localization in the oolemma. In contrast, the homogeneous distribution of alpha(v) throughout the oocyte suggests the existence of cytoplasmic reservoirs of this protein in the oocyte.