The prevalence rate of pterygium in Papua New Guinea (PNG) is as high as 15%. Recurrence rates up to 50% are encountered after primary excision. In a country such as PNG where resources in terms of funds and manpower are limited, a simple procedure had to be identified to reduce this alarmingly high rate of pterygium recurrence. This article compares the results of a randomized masked study involving the single intraoperative application of 0.02% mitomycin C solution in 65 eyes undergoing surgery for recurrent pterygium using the bare sclera technique with a similar group of 65 patients in which the drug was not used. The results indicate that a single intraoperative application of mitomycin C solution was enough to reduce the recurrence rate of pterygium to 3% in the treated group as compared to 48% in the untreated group at the end of a 12-month follow-up. In the study it was also seen that, in PNG, pterygia were more common in females and that recurrences tended to occur early and were obvious in the first few weeks following surgery.
Antibiotics, Antineoplastic - therapeutic use ; Combined Modality Therapy ; Follow-Up Studies ; Humans ; Intraoperative Care ; Mitomycin - therapeutic use ; Papua New Guinea ; Prevalence

Objective Endosulfan is an extremely toxic organochlorine pesticide to aquatic organisms which might be hampering fish health through impairment of metabolism sometimes leading to death.So an experimental protocol was designed to look at endosulfan effects on a number of selected biochemical endpoints as well as to develop a mechanistic understanding of biochemical effects of endosulfan in freshwater fish. Methods The adult freshwater catfish Clarias batrachus were collected and acclimatized to laboratory condition for two weeks prior to experimentation. The toxicity bioassay test of commercial grade endosulfan (35% EC) was conducted for 21 days to determine its initial lethal concentration. The fish were exposed to sublethal concentration of endosulfan (0.06 mg/L) for 21 days. Pesticide - withdrawal experiments were also performed to study recovery. Protein synthesis inhibitors were injected to know the possible mechanism of recovery. The specimens of C. batrachus were sacrificed and brain, liver and caudal white skeletal muscle were removed. Tissues were homogenized and fractions were obtained by differential centrifugation. The activities of citrate synthase (CS), glucose 6-phosphate dehydrogenase (G6-PDH) and lactate dehydrogease (LDH) were assayed spectrophotometrically. Similarly, DNA, RNA and protein content were measured as per standard procedure. Results The exposure of sublethal concentration of endosulfan decreased the activity of citrate synthase (CS) and glucose 6-phosphate dehydrogenase (G6-PDH) in the brain, liver and skeletal muscle of the freshwater catfish, C. batrachus. The brain lactate dehydrogenase (LDH) activity was also reduced in response to endosulfan toxicity. The maximum reduction in activities of these enzyme was 34%-43%. Withdrawal of endosulfan restored the enzyme activity to control level in all the three tissues. The recovery in enzyme activity appears to be due to dissociation of endosulfan or its metabolite(s) from the enzyme molecules and/or fresh synthesis of enzymes. The treatment of actinomycin D or cycloheximide partially inhibited the withdrawal-dependent increase in enzyme activity. This substantiates de novo synthesis of enzyme during recovery period. Since the reduction in enzyme acfvity was more pronounced in response to actinomycin D, endosulfan might be inhibiting the transcription process. But endosulfan did not produce any significant effect on DNA content and RNA/DNA. However, the RNA and protein contents of brain, liver and skeletal muscle decreased significantiy in tissues. The maximum decrease in RNA and protein was approximately 30%-37%. Withdrawal of endosulfan from the medium for 21 days restored the RNA, and protein contents nearly to their control levels. The treatment of actinomycin D or cycloheximide partially inhibited the withdrawal-dependent increase in these macromolecular contents. This effect was more pronounced in case of actinomycin D which again supports the possibility of endosulfan-induced inhibition at transcription level. Conclusion The present study suggests endosulfan-induced impairment of metabolism in fish, which appeared to be due to inhibition of transcription at some unknown points.

BACKGROUND: The objective of this study was to assess the attractive facial features of the Indian population. We tried to evaluate subjective ratings of facial attractiveness and identify which facial aesthetic subunits were important for facial attractiveness. METHODS: A cross-sectional study was conducted of 150 samples (referred to as candidates). Frontal photographs were analyzed. An orthodontist, a prosthodontist, an oral surgeon, a dentist, an artist, a photographer and two laymen (estimators) subjectively evaluated candidates' faces using visual analog scale (VAS) scores. As an objective method for facial analysis, we used balanced angular proportional analysis (BAPA). Using SAS 10.1 (SAS Institute Inc.), the Turkey's studentized range test and Pearson correlation analysis were performed to detect between-group differences in VAS scores (Experiment 1), to identify correlations between VAS scores and BAPA scores (Experiment 2), and to analyze the characteristic features of facial attractiveness and gender differences (Experiment 3); the significance level was set at P=0.05. RESULTS: Experiment 1 revealed some differences in VAS scores according to professional characteristics. In Experiment 2, BAPA scores were found to behave similarly to subjective ratings of facial beauty, but showed a relatively weak correlation coefficient with the VAS scores. Experiment 3 found that the decisive factors for facial attractiveness were different for men and women. Composite images of attractive Indian male and female faces were constructed. CONCLUSIONS: Our photogrammetric study, statistical analysis, and average composite faces of an Indian population provide valuable information about subjective perceptions of facial beauty and attractive facial structures in the Indian population.
Beauty ; Cross-Sectional Studies ; Dentists ; Female ; Humans ; India ; Male ; Photogrammetry ; Statistics as Topic ; Visual Analog Scale

Echinococcosis is a multisystem disease and has propensity to involve any organ, an unusual anatomical site, and can mimic any disease process. Primary peritoneal echinococcosis is known to occur secondary to hepatic involvement but occasional cases of primary peritoneal hydatid disease including pelvic involvement have also been reported. We report here 1 such case of primary pelvic hydatidosis mimicking a malignant multicystic ovarian tumor where there was no evidence of involvement of the liver or spleen. Our patient, a 27-year-old female, was detected to have a large right cystic adnexal mass on per vaginal examination which was confirmed by ultrasonography. Her biochemical parameters were normal and CA-125 levels, though mildly raised, were below the cut off point. She underwent surgery and on exploratory laparotomy, another cystic mass was found attached to the mesentery of the small gut. The resected cysts were processed histopathologically. On cut sections both large cysts revealed numerous daughter cysts. Microscopic examination of fluid from the cysts revealed free scolices with hooklets and the cyst wall had a typical laminated membrane with inner germinal layer containing degenerated protoplasmic mass. The diagnosis of pelvic hydatid disease was confirmed and patient was managed accordingly. Hydatid disease must be considered while making the differential diagnosis of pelvic cystic masses, especially in endemic areas.
Adult ; Animals ; Echinococcosis/diagnosis/*parasitology ; Echinococcus granulosus/*isolation & purification ; Female ; Humans ; Ovarian Cysts/diagnosis/*parasitology ; Ovarian Neoplasms/diagnosis/*parasitology ; Pelvic Infection/diagnosis/*parasitology

Intracapsular fracture of femoral neck is treated by anatomical reduction (preferably closed) and cannulated cancellous lag screw fixation. Malunion of these fractures have been described in the coronal plane (coxa valga or coxa vara). We reported a case of young adult patient with displaced intracapsular fracture of femoral neck that had malunited in sagittal plane with callus formation with excellent functional outcome. The radiographs revealed intracapsular fracture of femoral neck right side (Garden type 4 and Pauwel type 3). The patient was operated and closed reduction and internal fixation with three cannulated cancellous screws was performed. The postoperative radiograph revealed a loss of reduction in the lateral view. Due to this technical error, the patient was counselled for revision fixation for which he refused. At 9 months we observed union of the fracture in the displaced position by callus formation. Harris hip score at 2 years was 96 that indicate excellent functional outcome and the radiographs did not reveal any evidence of avascular necrosis of femoral head. We advised revision surgery to our patient as he had increased chances of implant failure and nonunion. However he refused the revision surgery and was continued with the suboptimal reduction. However, the fracture united and that too with callus formation, which is not a described phenomenon in neck of femur fracture.
Adult ; Bone Screws ; Femoral Neck Fractures ; diagnostic imaging ; physiopathology ; surgery ; Fracture Fixation, Internal ; Humans ; Male

Background: YouTube has become a popular source of healthcare information in orthopedic surgery. Although quality-based studies of YouTube content have been performed for information concerning many orthopedic pathologies, the quality and accuracy of information on the rotator cuff have yet to be evaluated. The purpose of the current study was to evaluate the reliability and educational content of YouTube videos concerning the rotator cuff. Methods: YouTube was queried for the term “rotator cuff.” The first 50 videos from this search were evaluated. Video reliability was assessed using the Journal of the American Medical Association (JAMA) benchmark criteria (range, 0–5). Educational content was assessed using the global quality score (GQS; range, 0–4) and the rotator cuff-specific score (RCSS; range, 0–22). Results: The mean number of views was 317,500.7±538,585.3. The mean JAMA, GQS, and RCSS scores were 2.7±2.0, 3.7±1.0, and 5.6±3.6, respectively. Non-surgical intervention content was independently associated with a lower GQS (β=–2.19, p=0.019). Disease-specific video content (β=4.01, p=0.045) was the only independent predictor of RCSS. Conclusions The overall quality and educational content of YouTube videos concerned with the rotator cuff were low. Physicians should caution patients in using such videos as resources for decision-making and should counsel them appropriately.

Present study was undertaken to study the effect of cypermethrin on oxidative stress after chronic dermal application. The insecticide was applied dermally at 50 mg/kg body weight in different groups of Wistar rats of either sex weighing 150~200 g. Significant (p < 0.05) increase in catalase activity was observed after 30 days of exposure. However, the superoxide dismutase activity declined significantly after 60 days of exposure. The activity of glutathione peroxidase and blood glutathione levels declined significantly (p < 0.05) after 30 days of cypermethrin dermal application. However, the activity of glutathione S-transferase increased significantly (p < 0.05) in all groups after 60 days of dermal exposure. Significant increase in lipid peroxidation was observed from 30 days onwards and reached a peak after 120 days of application.
Administration, Cutaneous ; Animals ; Female ; Glutathione/blood ; Insecticides/*toxicity ; Lipid Peroxidation/*drug effects ; Male ; Oxidative Stress/*drug effects ; Oxidoreductases/metabolism ; Pyrethrins/*toxicity ; Rats ; Rats, Wistar

Background: Common questions about shoulder arthroplasty (SA) searched online by patients and the quality of this content are unknown. The purpose of this study is to uncover questions SA patients search online and determine types and quality of webpages encountered. Methods: The “People also ask” section of Google Search was queried to return 900 questions and associated webpages for general, anatomic, and reverse SA. Questions and webpages were categorized using the Rothwell classification of questions and assessed for quality using the Journal of the American Medical Association (JAMA) benchmark criteria. Results: According to Rothwell classification, the composition of questions was fact (54.0%), value (24.7%), and policy (21.3%). The most common webpage categories were medical practice (24.6%), academic (23.2%), and medical information sites (14.4%). Journal articles represented 8.9% of results. The average JAMA score for all webpages was 1.69. Journals had the highest average JAMA score (3.91), while medical practice sites had the lowest (0.89). The most common question was, “How long does it take to recover from shoulder replacement?” Conclusions The most common questions SA patients ask online involve specific postoperative activities and the timeline of recovery. Most information is from low-quality, non-peer-reviewed websites, highlighting the need for improvement in online resources. By understanding the questions patients are asking online, surgeons can tailor preoperative education to common patient concerns and improve postoperative outcomes.

Background: This study analyzed questions entered online by rotator cuff patients and determined types and quality of websites providing information at the top of queries. Methods: Three strings related to rotator cuff repair were explored in Google Search. The result pages were manually collected under the “People also ask” function for frequent questions and associated webpages. Questions were categorized using Rothwell’s classification with further topical subcategorization. Webpages were evaluated by Journal of American Medical Association (JAMA) benchmark criteria for source quality. Results: One hundred twenty “People also ask” questions were collected with their associated webpages. Based on the Rothwell classification of questions, queries were thematically organized into fact (41.7%), value (31.7%), and policy (26.7%) categories. The most common webpage categories were academic (28.3%) and medical practice (27.5%). The most common question subcategories were timeline of recovery (21.7%), indications/management (21.7%), and pain (18.3%). The average JAMA score for all 120 webpages was 1.50. Journal articles had the highest average JAMA score (3.77), while commercial websites had the lowest JAMA score (0.91). The most common suggested question for rotator cuff repair/surgery was, “Is rotator cuff surgery worth having?,” while the most common suggested question for rotator cuff repair pain was, “What happens if a rotator cuff is not repaired?” Conclusions The most common questions asked on Google pertaining to rotator cuff repair evaluate management options and relate to the timeline of recovery and pain management. Most information is provided by medical practice, academic, and medical information websites, which have highly variable reliability. By understanding the questions that rotator cuff repair patients are asking online, surgeons can tailor preoperative education to common patient concerns and improve postoperative outcomes.Level of evidence: IV.

Introduction: Correlation of Pirani score and foot bimalleolar (FBM) angle has been used in few studies but correlation of FBM angle with ultrasonography has never been evaluated so they are being correlated in assessing the severity of clubfoot in neonates treated by Ponseti method. Material and Methods: Thirty-two feet with congenital talipes equinovarus (CTEV) deformity in neonates were prospectively treated by the Ponseti method. FBM angle and ultrasound parameters were measured three times i.e. at the time of initial presentation, at four weeks of treatment and at completion of treatment. The feet were divided according to the Pirani score in groups: one (0-2.0), two (2.5-4) and three (4.5-6). Correlation between FBM angle and ultrasound parameters were evaluated using Pearson correlation/regression. Results: Correlation between FBM angle and ultrasound parameters were statistically significant (p-value < 0.05). Conclusion: Ultrasound has the potential to accurately depict the pathoanatomy in clubfoot. FBM angle and ultrasound are objective methods to assess the severity of clubfoot. FBM angle and ultrasonography correlated in severity of deformity and correction achieved along the course of treatment.