The nutritional status of tuberculosis patients (TBP) and controls (CT) was compared among adult (> 20 years) Bengalees in Shyamnagar, Barrackpore, Naihati and Jagaddal of North 24 Parganas District, West Bengal, India. The subjects included 310 men (154 TBP and 156 CT) and 246 women (128 TBP and 118 CT). The mean ages of TBP men was 36.4 years (CT = 34.5) and that of TBP women was 26.4 years (CT = 25.6). Variables compared included weight, height, fat mass, fat mass index, mid-upper arm fat area, and skinfolds. Results revealed that TBP had significantly lower means for all variables (except for height in men) compared to CT in both sexes. In men, the highest percent differences between the two groups were observed for fat mass (FM: 60.1%), fat mass index (FMI: 59.2%) and suprailiac skinfold (SUPSF: 58.8%). In women, the highest percent differences between the two groups were observed for SUPSF (59.7), mid-upper arm fat area (MUAFA: 58.1), triceps skinfold (TSF: 51.4), biceps skinfold (BSF: 51.2), FM (51.2) and FMI (49.0). Regression analyses confirmed that tuberculosis status had significant impact (p < 0.0001) on all anthropometric and body composition characteristics compared (except for height in men) in both sexes. Among men, tuberculosis status explained the highest percent variation in percent body fat (PBF: 57.2%), FMI (56.0%) and FM (55.6%). In women, tuberculosis status explained the highest amount of variation in PBF (67.9), TSF (63.5%), BSF (62.8), FMI (61.0) and FM(60.7). Results of contingency chi-square tests revealed that there were significant differences in the frequency of undernutrition between TBP and CT in men (χ2 = 73.13361) and women (χ2 = 59.0000). The frequencies of undernutrition were significantly more common among TBP, in both men (56.5%) as well as women (51.6%). This study provided evidence that there was significant differential amount of loss in fat and muscle measures in tuberculosis patients.
tributyl phosphate ; Male population group ; Tuberculosis ; X-Ray Computed Tomography ; Fatty acid glycerol esters

PURPOSESubtrochanteric fractures of the femur are being managed successfully with various intramedullary and extramedulary implants with reasonable success. However, these implants require precise placement under image intensifier guidance, which exposes the surgeon to substantial amount of radiation. It also restricts the management of these fractures at peripheral centers where facility of image intensifiers is not available. Keeping this in mind we designed this study to identify if contralateral reversed distal femoral locking plate can be used successfully without the use of image intensifier.

METHODSTwenty-four consecutive patients (18 men and 6 women) with a mean age of 28 years (range 19-47 years) suffering subtrochanteric fractures of the femur underwent open reduction and internal fixation with reversed contralateral distal femoral locking plate. The outcome was assessed at the mean follow-up period of 3.2 years (range 2-4.6 years) using the Harris hip score.

RESULTSTwenty-one fractures united with the primary procedure, with a mean time of consolidation being 11 weeks (range, 9-16 weeks). One patient developed superficial suture line infection, which resolved with oral antibiotics. Another patient had a fall 3 weeks after surgery and broke the plate. Repeat surgery with reversed distal femoral locking compression plate was performed along with bone grafting and the fracture united. Two cases had nonunion, which went in for union after bone grafting. The mean Harris hip score at the time of final follow-up was 90.63 (range 82-97).

CONCLUSIONThe reversed contralateral distal femoral plate is a biomechanically sound implant, which when used for fixation of the subtrochanteric fractures with minimal soft tissue stripping shows results comparable to those achieved by using other extramedullary implants as well as intramedullary devices. The added advantage of this implant is its usability in the absence of an image intensifier.

Adult ; Bone Plates ; Female ; Fracture Fixation, Internal ; methods ; Hip Fractures ; surgery ; Humans ; Male ; Middle Aged

Radial nerve palsy is the most common neurological involvement in humeral shaft fractures. But combined radial and median nerve injury in a closed diaphyseal fracture of the humerus is rare. Combined injury to both radial and median nerve can cause significant disability. A detailed clinical examination is therefore necessary following humeral shaft fractures. We report a patient with closed diaphyseal humeral fracture (AO 12A-2.3) together with radial and median nerve palsy, its management and review of the literature. As the patient had two nerves involved, surgical exploration was planned. Fracture was reduced and fixed with a 4.5 mm narrow dynamic compression plate. There was no external injury to both radial and median nerves on surgical exploration. Neurological recovery started at 3 weeks' follow-up. Complete recovery was seen at 12 weeks. Careful clinical examination is of the utmost importance in early diagnosis of combined nerve injuries, which allows better management and rehabilitation of the patient.
Bone Plates ; Humans ; Humeral Fractures ; surgery ; Humerus ; Median Nerve ; Radial Neuropathy