Hoffa's fracture is an uncommon fracture of the femoral condyle with coronal orientation of the fracture line. The mechanism of injury in pediatric Hoffa's fracture is road traffic accident, sports injury, and trivial injury. Clinical examination and proper imaging is important for diagnosis of pediatric Hoffa's fracture because of high chances of missing these injuries which can lead to nonunion and malunion at the fracture site. Open reduction and anatomical reduction of intraarticular fragment is the gold standard treatment of these fractures. We present a rare case of Hoffa's fracture in a 16-year-old girl with asso ciated ipsilateral fibular fracture.
Adolescent ; Female ; Femoral Fractures ; diagnostic imaging ; therapy ; Fibula ; injuries ; Humans ; Knee Joint ; diagnostic imaging

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.

Xanthogranuloma is a non-neoplastic presentation of chronic inflammation commonly seen in gallbladder, kidney and rarely seen in genital organs. Only one case has been reported in cervix. Here, we report a case of 60-year-old postmenopausal lady who presented with history of fever and purulent discharge per-vaginum. On speculum examination, cervix had an ulcer extending from 3 to 5 o'clock position. Uterus was bulky. On probing the ulcer, a 1-cm deep sinus was identified. Ultrasound showed enlarged uterus and fluid collection suggestive of pyometra. Pyometra was drained and cervical biopsy was taken from the ulcerated lesion; histopathology revealed granulomatous inflammation with predominantly xanthous cells suggestive of tuberculosis. High index of clinical suspicion needs to be maintained in abnormal cervix. It is a perplexing and rare entity for a clinician and also a diagnosis of exclusion; only histopathology can help for diagnosis. It mimics like malignancy and chronic infections.
Biopsy ; Cervix Uteri ; Diagnosis ; Female ; Fever ; Gallbladder ; Genitalia ; Humans ; Inflammation ; Kidney ; Middle Aged ; Pyometra* ; Surgical Instruments ; Tuberculosis ; Ulcer ; Ultrasonography ; Uterus

Xanthogranuloma is a non-neoplastic presentation of chronic inflammation commonly seen in gallbladder, kidney and rarely seen in genital organs. Only one case has been reported in cervix. Here, we report a case of 60-year-old postmenopausal lady who presented with history of fever and purulent discharge per-vaginum. On speculum examination, cervix had an ulcer extending from 3 to 5 o'clock position. Uterus was bulky. On probing the ulcer, a 1-cm deep sinus was identified. Ultrasound showed enlarged uterus and fluid collection suggestive of pyometra. Pyometra was drained and cervical biopsy was taken from the ulcerated lesion; histopathology revealed granulomatous inflammation with predominantly xanthous cells suggestive of tuberculosis. High index of clinical suspicion needs to be maintained in abnormal cervix. It is a perplexing and rare entity for a clinician and also a diagnosis of exclusion; only histopathology can help for diagnosis. It mimics like malignancy and chronic infections.
Biopsy ; Cervix Uteri ; Diagnosis ; Female ; Fever ; Gallbladder ; Genitalia ; Humans ; Inflammation ; Kidney ; Middle Aged ; Pyometra* ; Surgical Instruments ; Tuberculosis ; Ulcer ; Ultrasonography ; Uterus

Effect of sodium nitroprusside (SNP), a nitric oxide (NO) donor, on in vitro survival, growth, steroidogenesis, and apoptosis of buffalo preantral follicles (PFs) was investigated. PFs (200~250 microm) were isolated by micro-dissection and cultured in 0 (control), 10(-3), 10(-5), 10(-7), and 10(-9) M SNP. To examine the reversible effect of SNP, PFs were cultured with 10(-5) M SNP + 1 mM Nomega-nitro-L-arginine methyl ester (L-NAME) or 1.0 microg hemoglobin (Hb). The results showed that greater concentrations of SNP (10(-3), 10(-5), 10(-7) M) inhibited (p < 0.05) FSH-induced survival, growth, antrum formation, estradiol production, and oocyte apoptosis in a dose-dependent manner. However, a lower dose of SNP (10(-9) M) significantly stimulated (p < 0.05) the survival, growth, antrum formation, follicular oocyte maturation, and stimulated progesterone secretion compared to the control. A combination of SNP + L-NAME promoted the inhibitor effect of SNP while a SNP + Hb combination reversed this effect. Nitrate and nitrite concentrations in the culture medium increased (p < 0.05) in a dose-dependent manner according to SNP concentration in the culture medium. At higher concentrations, SNP had a cytotoxic effect leading to follicular oocyte apoptosis whereas lower concentrations have stimulatory effects. In conclusion, NO exerts a dual effect on its development of buffalo PFs depending on the concentration in the culture medium.
Animals ; *Apoptosis ; Buffaloes/*physiology ; Estradiol/biosynthesis ; Female ; Follicle Stimulating Hormone/metabolism ; NG-Nitroarginine Methyl Ester/pharmacology ; Nitrates/pharmacology ; Nitric Oxide/*metabolism ; Nitric Oxide Donors/pharmacology ; Nitrites/pharmacology ; Nitroprusside/pharmacology ; Oocytes/cytology/drug effects/growth & development/metabolism ; Ovarian Follicle/*cytology/drug effects/growth & development/*metabolism ; Progesterone/biosynthesis

No abstract available.
Coronary Sinus* ; Heart Defects, Congenital* ; Heart Septal Defects, Atrial

Simultaneous fracture/dislocation of the thumb carpometacarpal (CMC) joint and dislocation of the metacarpophalangeal (MCP) joint is considered as a rare injury pattern. We report an unusual case of dorsal dislocation of MCP joint of the thumb associated with extraarticular fracture of the base of the first metacarpal in a 28-year-old man. The dislocation of MCP joint had been missed during initial presentation at a peripheral centre. The patient made an uneventful recovery following open reduction and fixation with 1.25 mm Kirschner wire of the MCP joint along with repair of the ulnar collateral ligament. This injury pattern has not been previously reported to the best of our knowledge in the English-language based medical literature.
Accidental Falls ; Adult ; Bone Wires ; Diagnostic Imaging ; Fractures, Bone ; diagnosis ; surgery ; Humans ; Joint Dislocations ; diagnosis ; surgery ; Male ; Metacarpophalangeal Joint ; injuries ; surgery ; Orthopedic Procedures ; methods ; Thumb ; injuries ; surgery