Int roduction: Treatment of calcaneal fracture is still controversial and indication for surgery is not well established. We are reporting the mid term outcome of calcanel fractures treated conservatively. Material and Methods: Patients admitted with calcaneal fractures from 1st November 2002 till 31st December 2004 and were treated conservatively were included in this study. The fractures were grouped according to Essex-Lopresti classification and their outcomes were assessed with the Maryland foot score. We also looked at time to weight bearing and returning to occupational activity. Results: Forty-four patients were included for evaluation. Patients with extraarticular calcaneal fractures had significantly higher rating scores compared to those with intraarticular fractures (98.2 and 88.8 respectively, with a p value = 0.0001). Generally, both group of patients had a good clinical outcome. 18 of the 44 patients (41%) started partial weight bearing before or at 6 weeks and 31 patients (72%) were able to start full weight bearing by 12 weeks. 31 patients (72%) were back to work 12 weeks after the injury. Conclusion: Conservative management for calcaneal fractures is an acceptable mode of treatment with satisfactory functional outcome.

Objective: To present a detailed pharmacognostic study of the Lens culinaris Medikus (Fabaceae) seeds, a food grain used as Dhal in India. Methods: The macroscopy, microscopy, fluorescence analysis of powdered drug, physicochemical analysis, preliminary testing and other WHO recommended methods for standardization were investigated. Results: Seeds are greyish brown in colour. Treatment of powdered drug with various chemical reagents showed the presence of proteins, cellulose, lignins and fixed oils. Microscopy of seeds revealed the presence of starch grains in seed. The colour of seed coat changed from brown to greenish grey in day light and brown to black at 254nm when treated with acetic acid. Total ash value of the seeds was found to be 1.86% w/w whereas foreign organic matter was found to be nil. Qualitative phytochemical analysis revealed the presence of tannins and flavonoids in acetone extract. Conclusions: The present study on pharmacognostic profile of Lens culinaris Medikus seeds provides an important tool in identification and authentication of this plant to researchers in future.

Introduction: Risk factors for life-threatening asthma resulting in intubation and ventilation are well documented in the international literature. Patients and health systems differ and it is not known whether such risk factors apply to the Fijian population. This study documents the prevalence of risk factors and describes the outcomes of patients who were intubated for severe asthma in Suva, Fiji. Methods: Retrospective descriptive study of patients intubated for asthma at the Colonial War Memorial Hospital between December 2012 and January 2014 Results: There were 53 patients with 64 intensive care admission episodes. There were equal numbers of males and females. Regarding the risk factors identified from other studies, 75% of our study population reported increased beta agonist use and 32% reported increased inhaled steroid use. 68% had previous hospital admissions for asthma and 23% had been previously intubated. Twenty-one percent of the patients died during admission. Most deaths were due to hypoxic brain injury following cardio-respiratory arrest on presentation to hospital. At one year follow up, 15% of the discharged patients had died and 4 % had suffered another severe asthma attack resulting in intubation. Conclusion Internationally-reported risk factors were present in similar proportions in our study population. This suggests similar strategies should be employed to reduce morbidity and mortality from asthma in Fiji. These include: improving asthma education among patients and clinicians, increasing utilization of preventer medications, use of a spacer devices and asthma action plans.

Interlocking intramedullary nailing is suitable for comminuted femoral isthmus fractures, but for noncomminuted fractures its benefit over unlocked nailing is debatable. This study was undertaken to compare outcomes of interlocking nailing versus unlocked intramedullary nailing in such fractures. Ninety-three cases of noncomminuted femoral isthmus fractures (Winquist I and II) treated with interlocking nailing and unlocked nailing from 1 June 2004 to 1 June 2005 were reviewed; radiological and clinical union rates, bony alignment, complication and knee function were investigated. There was no statistical significant difference with regard to union rate, implant failure, infection and fracture alignment in both study groups. Open fixation with unlocked femoral nailing is technically less demanding and requires less operating time; additionally, there is no exposure to radiation and cost of the implant is cheaper. We therefore conclude that unlocked nailing is still useful for the management of non-comminuted isthmus fractures of the femur.

The goal of treatment in distal radius fracture is to restore the anatomy of the distal radius, however the criteria currently used to evaluate the quality of reduction are based on Western based published figures. This goal of this study was to investigate whether there are variations in the morphology of the distal radius among the multiracial population of Malaysia. Consecutive normal wrist radiographs of patients who presented to the accident and emergency unit in three major hospitals in Malaysia were measured. . The palmar tilt of the distal radius averaged 12.6o ± 3.55o, and the radial inclination averaged 25.1o ± 3.42o. The ulnar variance averaged – 0.1 ± 1.31mm, 38.4% of the patients had neutral ulnar variance, 28.8% have negative ulnar variance and 32.9% have positive ulnar variance. Our results indicate that distal radius morphometric parameters in the Malaysian population are comparable to Western figures.

Cannulated screw fixation is a widely accepted surgical method for management of fractures of the neck of femur especially in patients with poor premorbid conditions, minimally displaced fractures and those from a younger age group. A five year retrospective study was carried out in 53 consecutive patients between 2006 to 2010 to determine the pattern of injuries, management, outcomes and the associated predictive factors.All the patients underwent cannulated screw fixation, with 37 (69.8%) having had surgery within 24 hours and the remaining 16 (30.2%) 24 hours after the initial injury. All patients were followed up to union of fractures and complications thereafter if any. Good outcome was observed in 43 (81.1%) patients leaving only 10 (18.9%) patients with a poor outcome, of whom nine developed avascular necrosis (90%) and one non-union (10%). We found no significant relationship between the incidence of avascular necrosis and age of patient, fracture displacement, numbers of cannulated screws used, fracture reduction acceptability and anatomical location of the fracture. The time interval from injury to surgery and the presence of posterior comminution did seem to influence the rate of avascular necrosis but due to the small number of patients, was not statistically significant.We conclude that cannulated screw fixation is a viable option of treatment for fractures of the neck of femur.
Femoral Neck Fractures

Neurofibromatosis type 1 (NF1) is an autosomal dominant disorder characterised by various phenotypic features like hyperpigmented spots, neurofibromas, Lisch nodules, skeletal abnormalities and tendency to develop neoplasms. Only few cases of Non-Familial Spinal Neurofibromatosis-1 (Non-FSNF1) have been described in literature with tumors involving the spinal roots at every level being even rarer. We reported an interesting case of bilateral symmetrical cervical neurofibroma with multiple spinal neurofibromas appearing as mirror image on CT, associated with non familial NF-1 as a rare presentation in a 25-year-old adult male.

Background: Teachers play an important role in reducing adolescent health problems. However, the involvement of teachers in adolescent health is not well understood. This current study was conducted to address this. Methods: A cross-sectional study was conducted among teachers of randomly selected arts, commerce and science colleges in Sangli, (Maharashtra) India. The data was collected by cluster random sampling. The study period was from November 2014 to April 2015. The study tool was self-administered questionnaire. Due ethical considerations, consents were taken. Analysis was done using Microsoft Excel 2003 and IBM SPSS version 22. Results: Out of 319 study participants; 246 (77.1%) participants had good awareness regarding adolescent health problems, 254 (79.6%) participants had good attitude towards reproductive health. Forty-three (13.5%), 22 (6.9%) and 15 (4.7%) participants had good practices regarding behavioural problems, psychological problems and substance abuse respectively. Practices about behavioural problems and substance abuse were associated with adolescent health training. In bi-variate analysis, age was a significant predictor for all the three practices. Conclusion: Most teachers had good attitude and awareness; but poor knowledge and practices regarding adolescent issues. All teachers should undergo training regarding adolescent health; with periodic refresher courses or lectures. Anonymous feedback from students should be sought to keep vigilance over efforts of the teachers.

Bacillus Calmette-Guérin (BCG) is a live attenuated strain of Mycobacterium bovis that has been used as effective treatment for early-stage transitional carcinoma of the urinary bladder. We present a case of a 68 year old man who had an abdominal aortic aneurysm following BCG therapy for bladder cancer. Contrast enhanced computerized tomogram (CECT) of abdomen and pelvis revealed bilateral hypodense lesions suggestive of psoas abscesses. In addition, a saccular abdominal aortic aneurysm measuring 4x3.6 cm involving infrarenal aorta with surrounding hematoma was seen. At surgery, he was found to have a psoas abscess and hemorrhage. He underwent ligation of the aorta and an axillary-bifemoral bypass. He was given one year of anti-tubercular therapy to which he responded clinically.

Many active secretions produced by animals have been employed in the development of new drugs to treat diseases such as hypertension and cancer. Snake venom toxins contributed significantly to the treatment of many medical conditions. There are many published studies describing and elucidating the anti-cancer potential of snake venom. Cancer therapy is one of the main areas for the use of protein peptides and enzymes originating from animals of different species. Some of these proteins or peptides and enzymes from snake venom when isolated and evaluated may bind specifically to cancer cell membranes, affecting the migration and proliferation of these cells. Some of substances found in the snake venom present a great potential as anti-tumor agent. In this review, we presented the main results of recent years of research involving the active compounds of snake venom that have anticancer activity.