Notes

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e magnetic resonance imaging. Arthroscopic excision has been reported as a safe and effective procedure for treatment.
A rapidly progressive destructive lesion characterizes pubic osteolysis (PO) in the pubic bone due to an inadequate fracture healing response. It may be seen in pelvic insufficiency fractures (IF) secondary to radiation therapy (RT) of pelvic malignancies, occurring even in the absence of significant trauma. Such a radiological picture may distract the clinician towards a malignant etiology and may affect the management.

A 79- year- old female, known case of carcinoma of the urinary bladder, underwent contrast-enhanced computed tomography (CT) (CECT) of the abdomen and pelvis as a routine follow- up and was found to have an osteolytic lesion in the right pubic bone, suggesting a malignant pathology. CT- guided biopsy did not reveal any malignant or infective etiology. The patient showed recovery with conservative management.

Osteolytic lesions of the pubic bone can often occur following radiation for pelvic malignancies. It occurs due to impaired fracture reparative response by a bone afflicted by radiation therapy RT. It can be managed effectively with conservative analgesics, bisphosphonates, calcium, and Vitamin D supplementation. The radiographic picture can imitate malignant or infective lesions and provoke invasive testing for confirmation. The clinicians need to be conscious of this clinical entity to initiate proper treatment and avoid unnecessary investigations.
Osteolytic lesions of the pubic bone can often occur following radiation for pelvic malignancies. It occurs due to impaired fracture reparative response by a bone afflicted by radiation therapy RT. It can be managed effectively with conservative analgesics, bisphosphonates, calcium, and Vitamin D supplementation. The radiographic picture can imitate malignant or infective lesions and provoke invasive testing for confirmation. The clinicians need to be conscious of this clinical entity to initiate proper treatment and avoid unnecessary investigations.
Hypophosphatemic osteomalacia can be overlooked or confused with other musculoskeletal disorders due to the variety of associated clinical, laboratory, and radiographic findings. If osteomalacia is diagnosed early and the fractures are not displaced, they often heal with nutritional supplements, but, if they progress to displaced fractures, they may require surgical intervention.

We present a case of secondary osteomalacia due to autoimmune polyendocrine syndrome Type 2 due to this condition, the patient developed bilateral tibial proximal fractures and her varus deformity had progressed. No clear indication of the timing for surgery for adults with osteomalacia has been reported. However, medical treatment improves the symptoms of osteomalacia and it is reported that in children, appropriate level of the serum phosphate (P) should be attained and maintained for the successful bone healing after osteotomy. Therefore, we prioritized pharmacological treatment and prescribed surgery after confirming that the value of serum phosphate P had been improved to recommended levels (2.5-3.5 mg/dl). We performed high tibial osteotomy for the right side and gradual correction by an external fixation for the left tibia, because of more severe deformation, and converted to an internal fixation to shorten the treatment period. During conversion, we performed the operation with a locking plate by the minimal invasive plate osteosynthesis method (MIPO).

We conclude that the use of different deformity correction methods, depending on the degree of deformity, and the pharmacological treatment of osteomalacia may lead to favorable results.
We conclude that the use of different deformity correction methods, depending on the degree of deformity, and the pharmacological treatment of osteomalacia may lead to favorable results.
The thrust plate prosthesis (TPP) is a type of cementless hip replacement. Aimed to preserve femoral diaphyseal bone, it was favored by some orthopedic surgeons in younger patients as they could potentially undergo multiple revision arthroplasties during their lifetime. Of particular note, the preserved diaphyseal bone allows for the implantation of a subsequent primary total hip arthroplasty (THA).

We reported on a 64-year-old male patient who underwent thrust plate prosthesis (TPP) implantation 21 years ago (1999) for the treatment of primary osteoarthritis (OA) of the right hip joint. At 21-year follow-up, he had not developed any post-operative complications, and he reported a SF12 score of 32 and Oxford hip score of 47/48.

TPP proved to be successful clinically and radiologically, especially in the young patient. It loads directly to the cortex of the proximal femoral metaphysis as in a native hip joint. It is a bone preserving prosthesis which allows for good bone stock in the case of revision surgery that was a victim of commercial considerations.
TPP proved to be successful clinically and radiologically, especially in the young patient. It loads directly to the cortex of the proximal femoral metaphysis as in a native hip joint. It is a bone preserving prosthesis which allows for good bone stock in the case of revision surgery that was a victim of commercial considerations.
Aneurysmal bone cysts (ABC's) are expansile, tumour-like vascular lesion. They are more commonly seen in the metaphyseal region of long bones. They are benign lesion although malignant transformation has been reported. Usually presents in the first three decades of life. Common presentation is pain, swelling, or fracture. Proximal femur with ABC's is a rare entity and with physeal extension is even sparse.

A 13- year-. old female presented in the orthopaedic emergency with complaints of pain in the right hip region following a trivial fall. Following trauma, the patient was unable to stand or walk. On examination, there was tenderness in Scarpa's triangle, straight leg raise test was not possible and limb was in external rotation. Plain radiography revealed an inter-trochanteric fracture with cystic lesion in the proximal femur extending till until epiphysis. MRI of the proximal femur showed an air fluid level with septations and soft- tissue oedema suggestive of aneurysmal bone cyst ABC's.The patient was managed by intra-lesional curettage with fibular strut grafting along with cancellous bone graft and fixation by Uni-planar external fixator.

Pathological Fractures fractures of proximal femur management is are a challenge for an orthopaedic surgeon due to its location and biomechanical factors. Treatment of proximal femur ABC's should be case dependent. In our opinion, aneursymal bone cyst of the proximal femur with physeal extension can be managed by external fixation along with extensive curettage and bone graft.
Pathological Fractures fractures of proximal femur management is are a challenge for an orthopaedic surgeon due to its location and biomechanical factors. Treatment of proximal femur ABC's should be case dependent. In our opinion, aneursymal bone cyst of the proximal femur with physeal extension can be managed by external fixation along with extensive curettage and bone graft.
Homocystinuria has a wide range of clinical presentations ranging from near normal intelligence and appearance with just lens dislocation and minimal skeletal deformities to severe mental retardation with gross skeletal deformities. In this background, we describe one such case with skeletal deformity managed comprehensively.

A 17-year-old boy presented with complaints of deformity of the left lower limb since childhood more evident for the past 5 years along with a history of blurring of vision. On examination the pubis-heal length > crown-pubis length along with genu valgum of left lower-limb with 16 cm intermalleolar distance. He also had a superolateral subluxation of the lens in both eyes. Valgus angle was 16° on the left leg compared to 6° on the right. The diagnosis of homocystinuria was confirmed by biochemical investigations. The left side genu valgum was addressed with medial closing wedge osteotomy and fixed with distal femur locking compression plating. Lens subluxation was treated with poss can be avoided when identified early and associated osteoporosis which is managed effectively. A holistic approach is needed in the management of such patients with inter-departmental coordination to bring quality to the life of patients with homocystinuria.Bacterial small RNAs (sRNAs) play a vital role in pathogenesis by enabling rapid, efficient networks of gene attenuation during infection. In recent decades, there has been a surge in the number of proposed and biochemically-confirmed sRNAs in both Gram-positive and Gram-negative pathogens. However, limited homology, network complexity, and condition specificity of sRNA has stunted complete characterization of the activity and regulation of these RNA regulators. To streamline the discovery of the expression of sRNAs, and their post-transcriptional activities, we propose an integrative in vivo data-mining approach that couples DNA protein occupancy, RNA-seq, and RNA accessibility data with motif identification and target prediction algorithms. We benchmark the approach against a subset of well-characterized E. coli sRNAs for which a degree of in vivo transcriptional regulation and post-transcriptional activity has been previously reported, finding support for known regulation in a large proportion of this sRNAnt environmental conditions will enable us to deduce complex rapid-regulation schemes that support infection.Malaria is still today one of the most concerning diseases, with 219 million infections in 2019, most of them in Sub-Saharan Africa and Latin America, causing approx. 409,000 deaths per year. Despite the tremendous advances in malaria treatment and prevention, there is still no vaccine for this disease yet available and the increasing parasite resistance to already existing drugs is becoming an alarming issue globally. In this context, several potential targets for the development of new drug candidates have been proposed and, among those, the de novo biosynthesis pathway for the B6 vitamin was identified to be a promising candidate. The reason behind its significance is the absence of the pathway in humans and its essential presence in the metabolism of major pathogenic organisms. The pathway consists of two enzymes i.e. Pdx1 (PLP synthase domain) and Pdx2 (glutaminase domain), the last constituting a transient and dynamic complex with Pdx1 as the prime player and harboring the catalytic center. In this review, we discuss the structural biology of Pdx1 and Pdx2, together with and the understanding of the PLP biosynthesis provided by the crystallographic data. We also highlight the existing evidence of the effect of PLP synthesis inhibition on parasite proliferation. The existing data provide a flourishing environment for the structure-based design and optimization of new substrate analogs that could serve as inhibitors or even suicide inhibitors.In this study, multidrug-resistant (MDR) Escherichia coli isolates from retail food and humans assigned into similar Multilocus Sequence Types (MLST) were analyzed using whole genome sequencing (WGS). In silico analysis of assembled sequences revealed the existence of multiple resistance genes among the examined E. coli isolates. Of the six CTX-M-producing isolates from retail food, bla CTX-M-14 was the prevalent variant identified (83.3%, 5/6). selleck chemicals Two plasmid-mediated fosfomycin resistance genes, fosA3, and fosA4, were detected from retail food isolates (one each from chicken and beef), where fosA4 was identified in the chicken isolate 82CH that also carried the colistin resistance gene mcr-1. The bla CTX-M-14 and fosA genes in retail food isolates were located adjacent to insertion sequences ISEcp1 and IS26, respectively. Sequence analysis of the reconstructed mcr-1 plasmid (p82CH) showed 96-97% identity to mcr-1-carrying IncI2 plasmids previously identified in human and food E. coli isolates from Egypt. Hierarchical clustering of core genome MLST (HierCC) revealed clustering of chicken isolate 82CH, co-harboring mcr-1 and fosA4 genes, with a chicken E.
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