Objective: To assess the sero-positivity rate of HIV infection among clinically suspected subjects of reproductive age group (15-49 years), biological and behavioral characteristics of the subjects gender specific variation of sero-positivity rate, and the differentials of the sero-positivity rate for the history of blood transfusion or blood products or other organs, history of needle exposure and symptoms of morbidity. Methods: Study is based on the retrospective data of the calendar year 2005 obtained from Voluntary Counseling and Testing Centre (VCTC) (now renamed as ICTC), Department of Microbiology, I.M.S., B.H.U., Varanasi. These cases were either referred by the consultants of different OPD'S of Sir Sunderlal Hospital or came voluntarily for knowing their HIV status. About 2-3 mL of blood samples were collected in a plain vial and tested for HIV status by strategy II/III as per WHO/NACO guidelines. Results: Overall sero-positivity of HIV was 15.3% (18.1% in males and 12.2% in females) which increased 6-7 folds in the age group 35-49 years as compared to 15-24 years in both the sexes. Sero-positivity rate in male migrants was 43.1%, while in female migrants it was 18.7%. The history of multiple sexual contacts was about 3 times higher in males as compared to females; predominantly it was very high in male migrants (67.7%) as compared to male non-migrants (15.8%). History of multiple sexual contacts was not uncommon in females and it was 25.0% in female migrants and 9.7% in non-migrant females. The sero-positivity rate with the history of multiple sexual contacts was 45.4% in males and 60.3% in females, while without history of multiple sexual contacts these were only 2.8% and 5.3% respectively. Sero-positive cases had on an average 3.6±1.7 various morbidity symptoms as compared to 0.7±1.1 in sero-negatives. It is to be noted that sero-positivity rate was more in those females who seemed apparently healthy compared to those presenting with some of the symptoms; vice versa, in males presenting with some symptoms HIV infection was 7 times higher than those without symptoms. Conclusions: The findings indicate a high sero-positivity among both the genders. Multiple heterosexual contacts, especially, in migrants are the main root of transmission of HIV. These are causing spread of HIV to their spouses. The multiple sexual contacts in the society, especially, among non migrant females of this region are indicating the distortion of traditions and cultures which are a serious concern and may lead to HIV infection on the rise. Awareness program to the susceptible group is the need to reduce further spread of HIV.

The field of probiotics is an evolving field. Probiotics were first introduced to the world as a functional ingredient in dairy products, breakfast cereals and snacks. Unknown to many, probiotics offer health benefits that go beyond the scope of supporting digestive health. Research continues to emerge, supporting the use of different probiotic strains in a variety of conditions. The research now suggests that these“healthy”bacteria have beneficial effects on gastrointestinal dysfunctions, including diarrhea, as well as the immune system and conditions such as allergy, in children, adults, and in the oral cavity. Research on the horizon will develop a better understanding of the concepts of how colonizing microbes and probiotics can influence human health.

OBJECTIVEFractures of the capitellum and trochlea constitute less than 1% of all elbow fractures and a shear fracture involving the capitellum and extending medially into most of the trochlea is rarely reported. Type IV capitellum fracture is still controversial in regard to its radiographic appearance, surgical approach and osteosynthesis. We report 10 cases of type IV capitellum fracture with a view to elucidating its clinical features and treatment outcome.

METHODSWe treated 10 patients of type IV capitellum fracture with a mean age of 32 years. A uniform surgical approach and postoperative rehabilitation were followed.

RESULTSNine patients presented to us after a mean of 4 days of injury and one patient was nonunion after 6 months of injury who had been treated conservatively by a bone setter. Double arc sign was absent in 6 cases. Intraoperatively 6 capitellotrochlear fragments were devoid of soft tissue attachments. By Mayo Elbow Performance Score evaluation, 7 patients got excellent, 2 good and 1 fair results. One patient with associated elbow dislocation developed heterotopic ossification. There was no case of avascular necrosis, osteoarthrosis or fixation failures.

CONCLUSIONSType IV capitellum fractures are rare and belong to complex articular injuries. A good functional outcome can only be achieved with open reduction and stable internal fixation followed by early mobilization. Preoperative radiographic assessment and computed tomography help surgeons in choosing the right surgical approach and implants. Good surgical technique and stable internal fixation are the keys to early mobilization and good functional outcome.

Adult ; Elbow Joint ; injuries ; Fracture Fixation, Internal ; Fractures, Bone ; Humans ; Joint Dislocations ; Treatment Outcome

OBJECTIVETo assess the sero-positivity rate of HIV infection among clinically suspected subjects of reproductive age group (15-49 years), biological and behavioral characteristics of the subjects gender specific variation of sero-positivity rate, and the differentials of the sero-positivity rate for the history of blood transfusion or blood products or other organs, history of needle exposure and symptoms of morbidity.

METHODSStudy is based on the retrospective data of the calendar year 2005 obtained from Voluntary Counseling and Testing Centre (VCTC) (now renamed as ICTC), Department of Microbiology, I.M.S., B.H.U., Varanasi. These cases were either referred by the consultants of different OPD'S of Sir Sunderlal Hospital or came voluntarily for knowing their HIV status. About 2-3 mL of blood samples were collected in a plain vial and tested for HIV status by strategy II/III as per WHO/NACO guidelines.

RESULTSOverall sero-positivity of HIV was 15.3% (18.1% in males and 12.2% in females) which increased 6-7 folds in the age group 35-49 years as compared to 15-24 years in both the sexes. Sero-positivity rate in male migrants was 43.1%, while in female migrants it was 18.7%. The history of multiple sexual contacts was about 3 times higher in males as compared to females; predominantly it was very high in male migrants (67.7%) as compared to male non-migrants (15.8%). History of multiple sexual contacts was not uncommon in females and it was 25.0% in female migrants and 9.7% in non-migrant females. The sero-positivity rate with the history of multiple sexual contacts was 45.4% in males and 60.3% in females, while without history of multiple sexual contacts these were only 2.8% and 5.3% respectively. Sero-positive cases had on an average 3.6±1.7 various morbidity symptoms as compared to 0.7±1.1 in sero-negatives. It is to be noted that sero-positivity rate was more in those females who seemed apparently healthy compared to those presenting with some of the symptoms; vice versa, in males presenting with some symptoms HIV infection was 7 times higher than those without symptoms.

CONCLUSIONSThe findings indicate a high sero-positivity among both the genders. Multiple heterosexual contacts, especially, in migrants are the main root of transmission of HIV. These are causing spread of HIV to their spouses. The multiple sexual contacts in the society, especially, among non migrant females of this region are indicating the distortion of traditions and cultures which are a serious concern and may lead to HIV infection on the rise. Awareness program to the susceptible group is the need to reduce further spread of HIV.

Adolescent ; Adult ; Blood Transfusion ; Female ; HIV Infections ; epidemiology ; Hospitals ; Humans ; India ; epidemiology ; Male ; Middle Aged ; Morbidity ; Prevalence ; Sexual Partners ; Transients and Migrants ; Young Adult

Objective: To evaluate correlation of Alberta Stroke Program Early CT Score (ASPECTS) and early and delay outcome measures among acute anterior ischemic stroke patients who presented within 48 hours of stroke onset. Methods: In a prospective cohort study, we recruited consecutive patients with acute middle cerebral artery (MCA) ischemic stroke who presented within 48 hours of stroke onset. All the patients were evaluated at admission (Glasgow Coma Scale - GCS and National Institute of Health Stroke Scale - NIHSS) at discharge (GCS, NIHSS, Barthel Index - BI and modifi ed Rankin Scale - mRS) and at 3 months (BI and mRS). CT ASPECTS was calculated by two observers independently. We divided patients in to two groups with ‘Better’ and ‘Worse’ ASPECTS with score of 8-10 and 0-7 respectively and compared the primary and secondary stroke outcome measures. Results: Among 100 patients with acute MCA infarction (median age 55 yrs, 62 males), median ASPECTS scores had inter-rater reliability of 0.82. The mortality, GCS and NIHSS at discharge, and mRS and BI at 3 months are signifi cantly better among patients with ‘Better’ compared to ‘Worse’ APSECTS. The hospital stay was shorter in patients with Better ASPCTS. Conclusion: In the setting of acute ischemic stroke, ASPECTS has good correlation with severity of stroke, and is strong predictor of early and delayed outcome in acute ischemic stroke.

Outer membrane proteins of Pasteurella (P.) multocida have been known to be protective immunogens. Pasteurella lipoprotein E (PlpE) has been reported to be an important cross reactive outer membrane protein in P. multocida. The gene encoding the PlpE of P. multocida serotypes A: 3, B: 2 and D: 1 was amplified from the genomic DNA. The amplified products were cloned and the nucleotide sequence was determined. Sequence analysis of the recombinant clones revealed a single open reading frame of 1,011 bp, 1,008 bp and 1,017 bp encoding a protein with a calculated molecular mass of 37.829 kDa, 37.389 kDa and 37.965 kDa for serotypes A: 3, B: 2 and D: 1 respectively. The comparison of the plpE sequence in different capsular types revealed a high degree (>90%) of homology. Furthermore, the plpE gene of Haemorhhagic septicaemia causing serotype (B: 2) was expressed in E. coli and recombinant PlpE was strongly immunostained by antiserum against whole cell antigen, indicating that the protein is expressed in vivo.
Animals ; Bacterial Outer Membrane Proteins/*genetics/immunology/metabolism ; Base Sequence ; Blotting, Western ; Cattle ; Cattle Diseases/*microbiology ; Cloning, Molecular ; Electrophoresis, Polyacrylamide Gel ; Escherichia coli ; *Genetic Variation ; Hemorrhagic Septicemia/microbiology/*veterinary ; India ; Lipoproteins/*genetics/immunology/metabolism ; Molecular Sequence Data ; Open Reading Frames/genetics ; Pasteurella multocida/*genetics/immunology ; Sequence Analysis, DNA ; Sequence Homology ; Serotyping ; Species Specificity

Bilateral hip dislocation rarely occurs. In this paper, a case of bilateral hip dislocation associated with bilateral sciatic nerve palsy resulted from a road traffic accident is reported. Both hips were emergently reduced under general anaesthesia. Acetabular reconstruction was done bilaterally due to the unstable hips. The patient subsequently developed heterotopic ossification and avascular necrosis on the left hip and underwent total hip arthroplasty. The sciatic nerve on the right side achieved complete recovery but that on the left side only partly recovered and was augmented by tendon transfer. Such injuries are serious and one should be aware of the complications because they can resurface and so patients should be followed up for a long time. To the best of our knowledge, this kind of injury has not been reported in the English language literature.
Accidents, Traffic ; Hip Dislocation ; complications ; Hip Fractures ; complications ; Humans ; Male ; Middle Aged ; Osteonecrosis ; etiology ; Sciatic Nerve ; injuries ; Sciatic Neuropathy ; etiology

We report a rare case of periprosthetic posttraumatic fracture of subtrochanteric region of femur after a megaprosthesis of the knee, done for resistant nonunion of distal femur with secondary osteoarthrosis in a 51 years old man. Treatment with a locking femoral plate was able to achieve primary union with a good result.
Bone Plates ; Femoral Fractures ; etiology ; Humans ; Knee Prosthesis ; Male ; Middle Aged ; Osteoarthritis ; surgery ; Postoperative Complications

A 45 year old woman was diagnosed as having anteromedial radial head dislocation and distal radius fracture five months after her injury on right forearm. The radial head dislocation led to ulnar nerve compression. She had severe restriction of her elbow movements. She was treated with arthrolysis, decompression of the ulnar nerve and radial head resection. The reverse Essex Lopresti injury and radial head dislocation compressing the ulnar nerve has not been reported in English language literature to the best of our knowledge. A mechanism is proposed for the injury. In acute presentations, restoration of both the radioulnar joints should be done and neglected nature of such injury leads to suboptimal outcomes.
Female ; Humans ; Joint Dislocations ; complications ; Middle Aged ; Radius ; injuries ; Radius Fractures ; complications ; Ulna ; injuries ; Ulnar Nerve Compression Syndromes ; etiology

Transanal evisceration of the small bowel is a rare surgical emergency. Rectal perforation in such cases is usually due to an underlying rectal prolapse. We report a case of a middle aged (45 years) male with spontaneous rectal perforation and transanal evisceration of the small bowel. Approximately 150 cm of small bowel had eviscerated transanally and the patient required emergent abdominal exploration, reposition of the small bowel, and repair of the rectal perforation. Small bowel evisceration through the anal verge is an emergent condition and the aim was to prevent life threatening complications related to sepsis.