Introduction: Isolated Hoffa fracture is an infrequent injury and little research has been done on this subject. The purpose of this study was to evaluate the functional outcome and complications of surgically managed Hoffa fractures with cannulated cancellous screw. Materials and Methods: Between 2011 and 2014, eight isolated Hoffa fractures in seven adult patients with mean age 39.8±11.9 years (range 25-60 years) were managed with cannulated cancellous screw of 6.5mm diameter applied in anterior to posterior direction using swashbuckler and medial parapatellar approach for lateral and medial Hoffa fractures respectively. All patients were evaluated using knee evaluation score after two years or longer. Mean follow up was 28±3.8 months (range 24-36 months). Results: All fractures in the eight patients healed clinicoradiologically by the 16th week with excellent result in 87.5% cases and good in 12.5% cases. By the end of union, the range of motion (ROM) of the knee was 0° to 110° except in two patients. One patient had ROM 10°-100° and other had 15°-90°. Mean knee evaluation score was 87.5±10.4. There was no incidence of non-union, infection or avascular changes in the patients or loss of reduction till final follow up. Conclusion: Open reduction and fixation with two 6.5 mm cannulated cancellous screws with early mobilization yielded good functional outcome in isolated Hoffa fractures.

Background & Objective: Parkinson’s disease (PD) is a chronic neurological disease, many a times presenting with non-motor symptoms. Pain is one of the most important non-motor symptom and there is no consensus regarding its exact mechanism and characterisation. This study was planned to evaluate the characteristics of pain and possible factors influencing it, in a cohort of patients with established Parkinson’s disease. Methods: 104 patients consenting to participate were included in the study. Data regarding age of onset, duration of disease, treatment, Hoehn-Yahr scale, phenotype of PD, UPDRS scores, pain type and distribution of pain were noted. Single and multiple logistical regression models with pain (1/0) as the outcome variable were used to check the association of pain with the above mentioned variables. Results: 54.8% of patients with PD experience pain. Presence of sensory symptoms was significantly associated with the pain group (42.1%) than the no pain group (21%). Pain was more pronounced on the side with predominant motor symptoms (72%) and in 68.4 % patients pain responded to dopaminergic treatment. Musculoskeletal pain (82.5%) was the commonest type and lower limbs were the commonest site of pain (43.2%). Conclusion: Pain in Parkinson’s disease has multiple dimensions and characteristics. Pain itself may be the reason for early diagnosis. Proper classification of pain will help in improved management of these patients.

seconds ; defects ; Visual Fields ; Prolactinoma ; Bromocriptine

The alkaloid securinine was assessed against spore germination of some plant pathogenic and saprophytic fungi (Alternaria alternata, Alternaria brassicae, Alternaria brassicicola, Curvularia lunata, Curvularia maculans, Curvularia pallenscens, Colletotrichum musae, Colletotrichum sp., Erysiphe pisi, Helminthosporium echinoclova, Helminthosporium spiciferum, Heterosporium sp.). Spore germinations of all the tested fungi were inhibited. Alternaria brassicicola, C. lunata, C. pallenscens and H. spiciferum were highly sensitive as complete inhibition of spore germination was observed at very low concentrations (200 ppm).
Alternaria ; Azepines ; Brassica ; Colletotrichum ; Fungi ; Germination ; Helminthosporium ; Heterocyclic Compounds, Bridged-Ring ; Lactones ; Musa ; Phyllanthus ; Piperidines ; Plants ; Spores

Spinal tuberculosis is not common in the paediatric age group. Initial clinical features are often vague and non specific until the disease progresses to later stages. We highlight the diagnostic difficulties and management challenges of a complicated extradural tuberculoma with neurological deficits in a very young girl.
Tuberculosis, Spinal

Background: The role of oxygen free radicals in the initiation, promotion and progression of carcinogenesis and the protective role of anti-oxidant defenses have been the subject of much speculation in the recent past with confl icting reports in the literature. Objectives: The aim of this study was to measure the concentration/levels of serum total proteins, albumin and advanced oxidation protein products as markers of oxidative stress in sera of patients with an oral pre-cancerous lesion and frank oral cancer. Materials and methods: The study consisted of sera analysis of 30 new patients of histologically proven well-differentiated, oral squamous cell carcinoma and 10 patients, clinically diagnosed with a potentially malignant epithelial lesion, speckled leukoplakia, aged between 40 to 60 years, in addition to 25 healthy controls. One way analyses of variance were used to test the difference between groups. The normality of data was checked before the statistical analysis was performed. Results: The study revealed variations in sera levels of albumin and advanced oxidation protein products to be statistically signifi cant (p < 0.001). Conclusion: The results obtained emphasize the need for more studies with larger sample sizes to be conducted before a conclusive role could be drawn in favour of sera levels of total protein, albumin and advanced oxidation protein products as markers of diagnostic signifi cance and of the transition from the various oral pre-cancerous lesions and conditions into frank oral cancers.

Premature neonates of very low birth weight (VLBW) whose treatment required the use of naso-gastric tube feeding were investigated. 10 infants suspected of having GERD (gastroesophageal reflux) received oral lansoprazole therapy by tube administration. 9 other infants formed a control group. In the treated group a fasting pH was determined before treatment and again after 7 days treatment. The control group was similarly assessed at an interval of 7 days. Despite acid reduction, the post-treatment pH mean of 1.31 would continue to pose a threat to the esophageal mucosa. The physiology of neonatal acid secretion is discussed to explain these findings.

Background & Objectives: Low serum folate level is often reported as an adverse drug sequela of long term phenytoin usage seen with prolonged duration of phenytoin therapy. There is no previous study to prospectively track the serum folate level with usage of phenytoin, which is the objective of this study. Methods: Twenty-fi ve patients between the ages of 18-50 years diagnosed to have epilepsy and planning to start phenytoin were recruited in this study. Assessment of serum folic acid was done by chemiluminiscent method prior to the start of phenytoin and after 6 months of treatment. The serum folate level of 10 age and sex matched healthy control was also taken. Results: The average serum folate level was 7.48 + 2.04 ng/mL prior to the start of phenytoin therapy, which fell to 3.9 + 1.95 ng/mL after 6-month of phenytoin therapy (p-value <0.001). The average serum folate level for the age and sex matched 10 control samples was 14.46 + 2.81 ng/mL. Conclusion: A signifi cant fall of serum folic acid levels is seen in epilepsy patients after 6 months treatment with phenytoin.

Objective To study the effects of paraphenylenediamine (PPD) and linear alkylbenzene sulphonate (LAS) alone and in combination on the skin. Methods Forty-eight guinea pigs were divided equally into 4 groups and exposed to PPD (4 mg/kg), LAS (12 mg/kg) and PPD (4 mg/kg) plus LAS (12 mg/kg) for 30 days. The biochemical parameters such as acid phosphatase, gtutathione-s-transferase, glutathione peroxidase, glutathione, lipid peroxidation and histamine contents in exposed skin were estimated. The histopathological examination of the exposed skin was also carried out. Results The skin enzymes, lipid peroxidation, and histamine increased while glutathione decreased in skin. The simultaneously exposed group showed additive toxic effects. The histopathological examination showed severe hyperkeratosis, thickening of collagen fibres and vacuolisation of epidermal cells in PPD plus LAS exposed skin. Conclusion The findings of the present study suggest that simultaneous exposure to PPD and LAS has additive toxic effects.

Cerebral Palsy is a common and devastating neurological disorder, with no medical treatment apart from physiotherapy regimes to alleviate the functional disability. Regenerative medicine using stem cells has gained momentum in recent years as a possible strategy to repair the injured brain. Present study was undertaken in a open label series to evaluate the safety, feasibility and observe for any benefi cial effects of intra-arterial infusion of autologous bone marrow derived mononuclear cells in patients with cerebral palsy with moderate disability. Functional improvement was assessed using the motor power and spasticity scales, dystonia and abnormal movements scale and the activities of daily living scales by modifi ed Barthel Index and modifi ed Rankin Scores. Serial structural imaging with MRI and functional imaging with FDG-PET scans were done. Of the 30 patients injected with an average of 10-30 million cells into each carotid artery, improvements were observed in all clinical scales, and predominantly in the disability scores. No adverse events were noted on a 12 months follow up.