Abstract: Primary nonunion of intertrochanteric fractures is rare due to the excellent blood supply and good cancellous bone in the intertrochanteric region of the femur. A diagnosis of primary intertrochanteric nonunion is made when at least 15 weeks after the fracture there is radiological evidence of a fracture line, with either no callus (atrophic) or with callus that does not bridge the fracture site (hypertrophic). There is only one published series that exclusively describes seven primary nonunions of intertrochanteric fractures. We present a case of a 2 year old neglected primary non union of intertrochanteric fracture in a 43 year old male which was managed by heavy skeletal traction followed by an inverted L osteotomy of the distal fragment with DHS (Dynamic Hip Screw) fixation using the distal peg to fit into a trough made into the proximal fragment. No bone grafting was done and the fracture united at 21 weeks.

Abstract: Background: In some patients with refractory lumbar spinal stenosis (LSS) surgical decompression is necessary. However, a fear of iatrogenic instability has always been associated with extensive decompression. In this study, we aim to evaluate the surgical outcomes of laminotomy versus laminectomy in the geriatric patients with multilevel LSS. Methods: We retrospectively evaluated 79 (29 male and 50 female) geriatric patients with multilevel degenerative but stable LSS from August 2008 to September 2011. The mean age and follow-up period was 74 ± 12.1 (ranged; 65 to 83 years old) and 34 ± 6.5 (ranged; 25 to 51 months), respectively. We placed our patients into two groups; A: laminotomy (44 cases) and B: laminectomy (35 patients). Preoperatively and at the last follow-up visit, the patients were assessed by visual analogue scale (VAS) and Oswestry disability index (ODI). Satisfaction rate was also recorded. Then, an intra- and postoperative comparison between these two techniques was carried out, statistically. Results: No significant differences existed between the two groups in terms of sex distribution, age and duration of follow-up. Intergroup comparison showed that patient satisfaction rate and the mean improvement in VAS and ODI was comparable. Mean blood loss and operating time were both greater in laminotomy group but only the latter was statistically significant. Conclusions: In geriatric patients more than 65 years old with multilevel but stable degenerative LSS, due to its more simplicity and less operative time, we still prefer and recommend laminectomy versus laminotomy.

Abstract: Background: Preeclampsia is the most common pregnancy problems which are characterized by hypertension and proteinuria. This status can be further complicated by eclamptic seizures. Preeclampsia is among the leading causes of mortality in mothers, fetuses and newborns around the world. The exact mechanism causing preeclampsia has much been controversial and has not yet fully known. The current study sought to identify the diagnostic value of changes in the serum levels of placental growth factor in predicting the occurrence of preeclampsia. Materials and Methods: Serum samples were taken from 700 mothers who were between 8 to 12 weeks of pregnancy. Placental growth factor levels were compared and examined in 35 healthy pregnant women and 35 pregnant women with preeclampsia who were randomly selected. Results: Serum concentration of placental growth factor had a significant difference between healthy pregnant women and pregnant women with preeclampsia (P<0.05). Based on the results of the present study, placental growth factor has 57% sensitivity, 77% specificity, 71% positive predictive power and 64% negative predictive power in predicting the occurrence of preeclampsia. Conclusion: Serum levels of placental growth factor in the first trimester of pregnancy can be used to predict the occurrence of preeclampsia.

Abstract: We present a curious case of spontaneous reformation of patella/patellar tendon ossification after partial patellectomy. This is a very rare pathology that has been reported as a complication after sleeve fractures of the tibial tuberosity, total patellectomy during total knee arthroplasty, intramedullary nailing of tibial fractures, anterior cruciate ligament reconstruction with patellar tendon autograft and knee injury without fracture. Patellar tendon ossification after partial patellectomy has been reported just once in literature. We present the second one of this nature. The patellar tendon ossification resembled a reformation of the patella and could easily be mistaken for an inadequate removal of the patellar remnant.

Abstract: Introduction: Meckel’s diverticulum is one of the common congenital anomaly of the small intestine, occurs in approximately 2% population, with equal incidence in both sexes; caused by an incomplete obliteration of omphalomesenteric duct. It is a true diverticulum, containing all the three layers; Complications are known in 4% cases in adults. Case presentation: In this present case report, we are reporting a two and half year-old male child with an eight days old gangrenous, perforated Meckel's diverticulum with abscess and acute intestinal obstruction mimicking an appendicular lump. Conclusion: Even it is rare finding, but we should be vigilant for this entity while dealing with it in emergency and patient should not be kept on nonsurgical management assuming it to be an appendicular lump.