Efficacy of alendronate, a bisphosphonate, in the treatment of AVN of the hip. A prospective open-label study.

OBJECTIVE: To study the efficacy of alendronate, in the treatment of avascular necrosis (AVN) of the hip. METHODS: Sixty patients with AVN of the hip (100 hips with AVN) were studied. The follow-up period ranged from 3 months to 5 yr. The most common cause of AVN was steroids. Parameters studied were walking time, standing time, pain and disability on a visual analogue scale (VAS), range of motion of the hip, X-ray and MRI of the hip. All patients were treated with alendronate 10 mg/day (or 70 mg/week) along with 500-1000 mg of daily calcium and vitamin D supplements, and were advised to avoid weight-bearing. NSAIDs and analgesics were permitted as needed and were recorded. RESULTS: Forty-one patients (71 AVN hips) with AVN have been followed up for a minimum of 1 yr, 24 patients (42 AVN hips) for 2 yr and 21 patients (37 AVN hips) for more than 2 yr (average 37 month). Fourteen patients have been followed up for less than 1 yr (3-9 months). Significant reduction in pain and disability scores (P < 0.001) and significant increase in standing and walking time (P < 0.001) were observed. All hip movements improved at 1 yr (P value 0.000-0.009) with an insignificant decline after that (P > 0.001). Radiologically, the hips either stabilized in the same grade or progressed by one grade. MRI showed a decrease in marrow oedema in most cases at the 1-yr follow-up. Six patients (10 hips) required surgery and there were two (three hips) dropouts. The drug was well tolerated and there was a reduction in NSAID requirement. CONCLUSION: Alendronate reduces pain, improves function and retards AVN progression. Early surgical intervention can be avoided in most patients.

Biologic therapy.

Biologic therapy has evolved as a fourth treatment option for patients with melanoma and other malignancies. Interrelated advances in molecular diagnostics and gene therapy techniques will further accelerate therapeutic advances in this new arena. A variety of biologic therapeutic options available to the patient with high risk melanoma are reviewed.

Bioactivity of ethanol extract of Karanja (Pongamia glabra vent) seed coat against mosquitoes.

Laboratory evaluation revealed that the treatment of larvae of Aedes aegypti and Culex quinquefasciatus with ethanol extract of karanja seed coat (ALKSC) significantly increased the larval mortality and developmental period proportianately with increase in the extract concentrations. Aedes proved more sensitive to the effect of extract in terms of mortality than Culex. At a high concentration (8 ppm), 100% Aedes larvae died in the first instar within two days whereas, 16 pmm was required for achieving the same level of mortality in Culex. Culex was also found more sensitive than Aedes regarding IGR effect. In emerging Culex pupae several abnormalities were observed while Aedes pupae did not exhibit any abnormalities. However larvae which pupated successfully resulted in adults with several structural abnormalities in both the species.

Retinal projections in the ground squirrel (Citellus tridecemlineatus).

The retinal projections of the thirteen-lined ground squirrel were determined by tracing anterograde transport of intravitreally injected horseradish peroxidase (HRP) or wheat-germ conjugated horseradish peroxidase (WGA-HRP). Label was seen in the suprachiasmatic nucleus and adjacent anterior hypothalamic area, the accessory optic system (the medial, dorsal, and lateral terminal nuclei), the dorsal and ventral lateral geniculate nuclei, the intergeniculate leaflet, the pretectal nuclei (the anterior, posterior, and olivary pretectal nuclei and the nucleus of optic tract), and the superior colliculus. Most of these structures were labeled bilaterally, with dense contralateral label and sparse ipsilateral label, a pattern typical for animals with laterally placed eyes. However, the suprachiasmatic nucleus and the nucleus of the optic tract received input only from the contralateral eye. In contrast to previous degeneration studies, the sensitive HRP tracers (in conjunction with cytochrome-oxidase reactivity) revealed an elaborate organization within the lateral geniculate nucleus (dorsal LGN, ventral LGN, and intergeniculate leaflet) that is consistent with existing organizational schemes for other mammalian species.