OBJECTIVEFractures of the femur are the most incapacitating fractures. For children aged 6-14 years, there is no clear consensus as to the preferred treatment. The conventional treatment of traction and casting is no longer recommended. We report our experience in titanium elastic nailing for treatment of paediatric femoral diaphyseal fractures.

METHODSThirty patients in the age group of 6-16 years with displaced diaphyseal femoral fractures were stabilized with titanium elastic nails. Patients were followed up clinically and radiologically for a minimum period of 1 year. The final results were evaluated using Flynn's criteria. Technical difficulties and complications associated with the procedure were also analysed.

RESULTSOverall results were excellent in 20 cases and satisfactory in 10 cases. No patient had poor result. The average hospital stay was 9 days. All the fractures healed with an average time to union of 6.86 weeks. The most common complication encountered was soft tissue irritation at the nail entry site seen in 6 cases. Clinically, lengthening was noticed in 4 cases, while no patient had shortening. Malalignment was seen in only 6 cases. Perioperative difficulties encountered were failure of closed reduction seen in 6 cases and corkscrewing of nails in one case.

CONCLUSIONTitanium elastic nails are a relatively easy to use, minimally invasive, physeal-protective implant system with high rate of good and excellent outcomes in children aged 6-16 years. Technical pitfalls can be eliminated by adhering to the basic principles.

Adolescent ; Bone Nails ; Child ; Elasticity ; Female ; Femoral Fractures ; surgery ; Fracture Healing ; Humans ; Length of Stay ; Male ; Prospective Studies ; Titanium

AIMTo evaluate the possible antifertility activity of Sarcostemma acidum (Roxb) Voigt. stem extract in male rats.

METHODMale rats were given 70% methanol extract of S. acidum stem orally at dose levels of 50 and 100 mg/kg/day for 60 days. Fertility was evaluated with mating test. Sperm motility and sperm density in cauda epididymides were also assessed. Biochemical and histological analyses were performed on blood samples and on the reproductive organs.

RESULTSS. acidum stem extract resulted in an arrest of spermatogenesis without any systemic side effect. Sperm motility as well as sperm density was reduced significantly. Treatment caused a 80% reduction in fertility at the 50 mg dose and complete suppression of fertility at the 100 mg dose. There was no significant change in RBC and WBC count, hemoglobin, haematocrit, sugar and urea in the whole blood and cholesterol, protein and phospholipid in the serum. The protein and glycogen content of the testes, fructose in the seminal vesicle and protein in epididymides were significantly decreased. Cholesterol in the testes was elevated. Treatment at both of the doses caused a marked reduction in the number of primary spermatocytes (preleptotene and pachytene), secondary spermatocytes and spermatids. The number of mature Leydig cells was decreased, and degenerating Leydig cells was increased proportionately.

CONCLUSIONS. acidum stem extract arrests spermatogenesis in male rats without noticable side effects.

Animals ; Blood Cell Count ; Body Weight ; drug effects ; Cholesterol ; metabolism ; Contraceptive Agents, Male ; pharmacology ; Glycogen ; metabolism ; Leydig Cells ; drug effects ; metabolism ; Male ; Phospholipids ; blood ; Plant Extracts ; pharmacology ; Plants, Medicinal ; Rats ; Rats, Sprague-Dawley ; Spermatids ; drug effects ; Spermatocytes ; drug effects ; Spermatogenesis ; drug effects

AIMTo evaluate the effect of an ethanolic extract of Semecarpus anacardium fruits on spermatogenesis in albino rats.

METHODSMale albino rats were fed with a 50 % ethanolic extract of Semecarpus anacardium fruit at 100 mg.kg(-1).day(-1), 200 mg.kg(-1).day(-1) and 300 mg.kg(-1).day(-1) for 60 days. Fertility test was performed after 60 days of treatment. Sperm motility and density were observed in the cauda epididymis. Biochemical and histological analyses of the blood and reproductive organs were done. Recovery of fertility was followed to evaluate the reversibility of drug action.

RESULTSS. anacardium fruit extract administration resulted in spermatogenic arrest in albino rats. The sperm motility and density was reduced significantly. The RBC and WBC counts, haemoglobin, haematocrit, blood sugar and urea were found to be within the normal range in the whole blood. The protein, cholesterol and glycogen in the testes and the fructose in the seminal vesicle were significantly decreased after the treatment. The fruit extract feeding caused marked reduction in the number of primary spermatocytes, secondary spermatocytes and spermatids. The number of mature Leydig cells was also decreased and degenerating cells increased proportionately.

CONCLUSIONS. anacardium fruit extract causes spermatogenic arrest in albino rats.

Animals ; Cell Count ; Dose-Response Relationship, Drug ; Leydig Cells ; cytology ; Male ; Plant Extracts ; administration & dosage ; pharmacology ; Rats ; Semecarpus ; chemistry ; Sperm Count ; Sperm Motility ; drug effects ; Spermatogenesis ; drug effects ; Testis ; cytology ; drug effects ; metabolism

OBJECTIVES: The present study examined relationships between socioeconomic status (SES) and obesity and body mass index (BMI) as well as the effects of health-related behavioral and psychological factors on the relationships. METHODS: A cross-sectional population-based study was conducted on Korean adults aged 20 to 79 years using data from the 2001, 2005, and 2007 to 2009 Korea National Health and Nutrition Examination Survey. Multivariate logistic and linear regression models were used to estimate odds ratios of obesity and mean differences in BMI, respectively, across SES levels after controlling for health-related behavioral and psychological factors. RESULTS: We observed significant gender-specific relationships of SES with obesity and BMI after adjusting for all covariates. In men, income, but not education, showed a slightly positive association with BMI (p<0.05 in 2001 and 2005). In women, education, but not income, was inversely associated with both obesity and BMI (p<0.0001 in all datasets). These relationships were attenuated with adjusting for health-related behavioral factors, not for psychological factors. CONCLUSIONS: Results confirmed gender-specific disparities in the associations of SES with obesity and BMI among adult Korean population. Focusing on intervention for health-related behaviors may be effective to reduce social inequalities in obesity.
Adult ; Aged ; Body Mass Index ; Cross-Sectional Studies ; Demography ; Female ; Health Behavior ; Humans ; Income ; Linear Models ; Male ; Marital Status ; Middle Aged ; *Nutrition Surveys ; Obesity/*epidemiology/psychology ; Odds Ratio ; Republic of Korea ; Sex Factors ; *Social Class

BACKGROUND: As lung ultrasound (LUS) can be used to identify regional lung ventilation and collapse, we hypothesize that LUS can be better than auscultation in assessing lung isolation and determining double lumen tube (DLT) position. METHODS: A randomized controlled study was conducted in tertiary care cancer institute from November 2014 to December 2015, including 100 adult patients undergoing elective thoracic surgeries. Patients with tracheostomy, difficult airway and pleural-based pathologies were excluded. After anesthesia induction and DLT insertion, patients were randomized into group A (auscultation) and group B (LUS). Regional ventilation was assessed by experienced anesthesiologists using the respective method for each group. Final confirmation of DLT position with a bronchoscope was performed by a blinded anesthesiologist. Contingency tables were plotted to determine sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy for each method. RESULTS: Data from 91 patients were analyzed (group A = 47, group B = 44). Compared with auscultation, LUS had significantly higher sensitivity (94.1% vs. 73.3%, P = 0.010), PPV (57.1% vs. 35.5%, P = 0.044), NPV (93.8% vs. 75.0%, P = 0.018), accuracy (70.5% vs. 48.9%, P = 0.036) and required longer median time (161.5 vs. 114 s, P < 0.001) for assessment of DLT position. Differences in specificity (55.6% vs. 37.5%, P = 0.101) and area under curve (0.748; 95% CI: 0.604–0.893 vs. 0.554, 95% CI: 0.379–0.730; P = 0.109) were not significant. CONCLUSIONS: Compared to auscultation, LUS is a superior method for assessing lung isolation and determining DLT position.
Adult ; Anesthesia ; Area Under Curve ; Auscultation ; Bronchoscopes ; Double-Blind Method ; Humans ; Lung ; Methods ; One-Lung Ventilation ; Pathology ; Prospective Studies ; Sensitivity and Specificity ; Tertiary Healthcare ; Tracheostomy ; Ultrasonography ; Ventilation

BACKGROUND: As lung ultrasound (LUS) can be used to identify regional lung ventilation and collapse, we hypothesize that LUS can be better than auscultation in assessing lung isolation and determining double lumen tube (DLT) position. METHODS: A randomized controlled study was conducted in tertiary care cancer institute from November 2014 to December 2015, including 100 adult patients undergoing elective thoracic surgeries. Patients with tracheostomy, difficult airway and pleural-based pathologies were excluded. After anesthesia induction and DLT insertion, patients were randomized into group A (auscultation) and group B (LUS). Regional ventilation was assessed by experienced anesthesiologists using the respective method for each group. Final confirmation of DLT position with a bronchoscope was performed by a blinded anesthesiologist. Contingency tables were plotted to determine sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy for each method. RESULTS: Data from 91 patients were analyzed (group A = 47, group B = 44). Compared with auscultation, LUS had significantly higher sensitivity (94.1% vs. 73.3%, P = 0.010), PPV (57.1% vs. 35.5%, P = 0.044), NPV (93.8% vs. 75.0%, P = 0.018), accuracy (70.5% vs. 48.9%, P = 0.036) and required longer median time (161.5 vs. 114 s, P < 0.001) for assessment of DLT position. Differences in specificity (55.6% vs. 37.5%, P = 0.101) and area under curve (0.748; 95% CI: 0.604–0.893 vs. 0.554, 95% CI: 0.379–0.730; P = 0.109) were not significant. CONCLUSIONS Compared to auscultation, LUS is a superior method for assessing lung isolation and determining DLT position.

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.

Background: Graft malposition is a risk factor for failure of anterior cruciate ligament reconstruction. A 70° arthroscope improves visualisation of the medial wall of the lateral femoral condyle without switching portals. We investigated whether the use of this arthroscope affected the accuracy and precision of femoral tunnel placement. Methods: Fifty consecutive adult patients were recruited. Following one withdrawal and two exclusions, 47 patients (30 in group 1 (70° arthroscope), 17 in group 2 (30° arthroscope)) underwent three-dimensional computed tomography imaging using a grid-based system to measure tunnel position. Results: No difference was found in the accuracy or precision of tunnels (mean position: group 1 = 33.3 ± 6.0% deep–shallow, 27.2 ± 5.2% high–low; group 2 = 31.7 ± 6.9% deep–shallow, 29.0 ± 6.2% high–low; not significant). A post-hoc power analysis suggests a study of 106 patients would be required. Conclusions This pilot study suggests that tunnel position is not affected by the arthroscope used. An appropriately powered study could investigate this finding alongside other potential benefits of using a 70° arthroscope for this procedure.Trial registration: ClinicalTrials.gov, NCT02816606. Registered on 28 June 2016.

The WHO reports that billions of people and animals in tropical and subtropical regions are affected by helminthiasis as neglected tropical disease. It is predominant in underdeveloped areas; nevertheless, the increase in the number of travelers and migrants has made this infection more common. The current mass drug treatment produces severe side effects and many strains of helminths are resistant to them. None of the chemotherapeutic drugs meets the ideal requirements of anthelmintics, such as broad spectrum of activity, single dose cure, free from side effect and cost-effectiveness. Today, many researchers are screening the traditional herbal system in search of the anthelmintic herbal constituents which overcome all the problems of synthetic drugs. Several researchers proclaim anthelmintic activity of herbal medicines by using different experimental models. The present review demonstrates natural product drug discovery, outlining potential of herbal constituents from natural sources as natural leads against helminthiasis.