Hypolipidemic activity of a hydroalcoholic extract of Cyperus scariosus Linn. root in guinea pigs fed with a high cholesterol diet

Lipid-lowering and antioxidant activities of a hydroalcoholic extract of Cyperus scariosus Linn. root（HCS） were evaluated in guinea pigs fed with a high cholesterol diet. Serum lipid profile（total cholesterol, triglycerides, LDL-C, VLDL-C, and HDL-C）, atherogenic indices and serum enzymes（ALT, AST, ALP, LDH, and CK-MB） were performed in each group at 0 days and at the end of 60 days. Histological study of liver and kidney was done in groups 1, 2, 5, 6 and 7. The total phenolic and flavonoid content in HCS and its antioxidant activity were evaluated by the DPPH assay. Both doses of HCS decreased serum lipid profile and atherogenic indices（P 〈 0.05）. HCS has lipid lowering, immunosuppressive and antioxidant properties, and mays have value in atherosclerosis prevention. The higher dose of HCS also reduced serum AST, ALP, and LDH levels and rosuvastatin increased AST and ALP levels（P 〈 0.05）. Histology of the liver showed decreased lipid accumulation and improvement in hepatocytes in HCStreated animals. The antioxidant activity of HCS may be responsible for its lipid lowering and cytoprotective action. HCS had significant lipid lowering and antioxidant activity, which; may be due to the phenolic compounds. HCS may be a safe and cost effective alternative to current statin therapy for patients with dyslipidaemia.     

Fibrosis in Hepatitis C Patients Predicts Complications After Elective Total Joint Arthroplasty

Effects of Hepatitis C on total hip (THA) and total knee arthroplasty (TKA) outcomes are poorly understood. Seventy-two hepatitis C patients underwent 77 primary THA or TKA and were retrospectively identified, stratified by fibrosis and thrombocytopenia and compared to matched controls. Overall, Hepatitis C and control patients had similar outcomes. After TKA, fibrotic hepatitis C patients demonstrated a greater average hemoglobin drop than non-fibrotic hepatitis C patients (4.9 versus 3.8, P = 0.023), greater deep infection rate (21% versus 0%, P = 0.047), and rate of cellulitis (21% versus 0%, P = 0.047). Thrombocytopenia showed a trend toward greater infections. Prior to fibrosis, Hepatitis C patients appear to be at no increased risk of complication after joint arthroplasty. Evaluation of fibrosis may predict poor outcome in Hepatitis C patients.     

Rupture of the primigravid uterus: a review of the literature

Uterine rupture is a catastrophic obstetric complication, associated with high rates of perinatal morbidity and mortality. The most common risk factor is previous uterine surgery, and most cases of uterine rupture occur in women with a previous cesarean delivery. Traditionally, the primigravid uterus has been considered almost immune to spontaneous rupture. In fact, although spontaneous rupture of the primigravid uterus is indeed a very rare event, a number of such cases have been reported recently. Prompt recognition of uterine rupture and expeditious recourse to laparotomy are critical in influencing perinatal and maternal morbidity. Not all uterine ruptures present with the typical clinical picture of abdominal pain, hypovolemia, vaginal bleeding, and fetal compromise. Therefore, it is important to maintain a high index of suspicion for uterine rupture in women presenting with some, or all, of these features, regardless of parity. Here we provide a systematic review of cases of spontaneous uterine rupture in primigravid women reported in the literature to date. Clinical presentation, differential diagnosis, common etiological factors, complication rates, and appropriate management of this rare obstetric event are discussed. TARGET AUDIENCE: Obstetricians & Gynecologists, Family Physicians. LEARNING OBJECTIVES: After completion of this article, the reader should be able to recall that uterine rupture in a primigravida is a rare event, without typical signs and symptoms, and explain that the morbidity and mortality of the mother and child is directly related to a high index of suspicion and prompt treatment by the clinician.     

Bilateral luteomas of pregnancy in a patient with diabetes

A patient with diabetes and luteomas of the ovaries demonstrated a significant and progressive rise in the serum levels of androstenedione and testosterone during pregnancy. The levels of these hormones were also elevated in cord blood and ovarian fluid. The increased insulin requirement to maintain euglycemia was observed at an earlier date in this pregnancy than in her previous pregnancy.     

多次抗生素骨水泥旷置治疗膝关节置换术后严重感染的临床疗效分析

目的：观察多次使用自制抗生素骨水泥间隔治疗膝关节置换术后严重感染的临床疗效,探索一种经济实用的彻底治愈膝关节置换术后严重感染的旷置翻修术。方法2007年1月到2013年1月我院收治膝关节置换术后严重感染患者7例,均采用一期手术彻底清创,取出假体并多次（2~3次）置入自制可以活动的关节型抗生素骨水泥临时间隔物,术后即可早期活动并可以完全负重。术后选用敏感抗生素静脉滴注2~4周,感染治愈后再置入翻修假体。截至末次随访时,7例患者均获得随访,记录并对比患者术前及术后HSS评分、局部感染症状、抽取关节液细菌培养及术中留取病理组织切片结果,对患者术后定期X线片进行评价。结果7例患者均经过2~3次抗生素骨水泥间隔旷置后,给予行膝关节翻修术,随访时间平均38个月（8~74个月）,未见明显患膝关节感染症状,翻修后膝关节活动范围在伸直0°-屈曲108°之间。结论自制关节型抗生素骨水泥临时间隔物在严重膝关节感染旷置术中操作方便,多次采用可以成功、彻底的治疗膝关节置换术后深部严重感染,在旷置期能够保留关节活动度,可减少术后疼痛,改善关节功能。为二期再置换假体提供方便是一种经济实用的彻底治愈严重膝关节置换术后感染的好方法。