Correlation between Clinical and Arthroscopic Findings in Meniscal Tear of Knee.

The meniscus is the most commonly injured structure in the knee joint. Carefully performed clinical examination can give better diagnosis of meniscal tear. The aim of this study was to find out the correlation between clinical and arthroscopic findings in meniscal tear of knee. This cross sectional observational study was conducted in the Department of Orthopaedic Surgery, BSMMU, Dhaka from July 2012 to June 2014. Thirty patients of meniscal tear were selected as per inclusion and exclusion criteria. After proper evaluation and clinical examination of these patient arthroscopic examinations was done under spinal anesthesia. A total number of 30 patients were recruited in this study. Twenty seven (90%) patients were male and only 3(10%) were female. Mean±SD of age was 26.00±5.55 and range was 17-34 years. Out of 30 patients 19(63.3%) had right knee affected and the rest 11(36.7%) had left knee affected. It was found from clinical diagnosis that most of the patients had MM injury (73.4%) and LM injury was in 26.6% patients. From arthroscopic diagnosis we found most of the patients had multiple types of injury (40.0%) followed by 26.7% patents had isolated MM injury, 16.6% patients had isolated LM injury, 10.0% patients had other injuries like ACL, PCL or MCL and rest 6.7% patients had no injury at all. Sensitivity, specificity, PPV, NPV and accuracy of clinical diagnosis in diagnosis of MM injury were 94.4%, 58.3%, 77.3%, 87.5% and 80.0% respectively. Sensitivity, specificity, PPV, NPV and accuracy of clinical diagnosis in diagnosis of LM injury were 85.7%, 91.3%, 75.0%, 95.5% and 90.0% respectively. Clinical evaluation may diagnose meniscal tear accurately.

Pulmonary metastases of a papillary adeno-carcinoma of ovary in a pregnant lady.

A 28 years young lady admitted to National Institute of Diseases of Chest and Hospital (NIDCH), Dhaka with the complaints of respiratory distress and cough for 2 months. She was in her last trimester of first pregnancy when she becomes dyspneic on exertion and at night. Gradually it increases in time and she become unable to walk when she consulted with specialists in Barisal. She was examined clinically and radiographically and found some opacity on both lung fields. She was on several antibiotics, but got no improvement. In the meantime, an emergency caesarean section was done to have a healthy baby and patient came to NIDCH for this unexplained breathlessness and cough. She was severely dyspneic, tachypnoic, cyanosed. There were bilateral coarse crepitations, bilateral opacities predominantly on both lower and middle zones of both lungs obscuring costo-phrenic angles on chest X-rays. CT scan of chest shows bilateral reticulo-nodular shadows with a homogenous opacity on right lower lung which enhances after contrast scanning. A CT guided FNAC was done from that opacity which revealed a papillary adeno-carcinoma with psammoma bodies on cytopathological study. Thereafter, to explore the primary site, thyroid gland, abdominal organs was assessed adequately and only positive finding was raised CA-125 (706 IU/ml) which was consistent with ovarian cancer. In this way, a primary ovarian carcinoma in a pregnant young lady with normal sized ovary that metastasizes to lung causing bilateral pleural effusion and lymphangitis carcinomatosa was explored. This was an unusual presentation of ovarian papillary adeno-carcinoma with cough and breathlessness at the last trimester of pregnancy in absence of any abdominal mass.

Determination of the enantiomeric purity of the phytoalexins spirobrassinins by 1H NMR using chiral solvation.

A simple and inexpensive method for enantiomeric discrimination of the phytoalexins spirobrassinin (1), 1-methoxyspirobrassinin (2) and synthetic analog 1-methylspirobrassinin (6) using the chiral solvating agent 2,2,2-trifluoro-1-(9-anthryl)ethanol in C(6)D(6) is described. Using this method the enantiomeric composition of each sample can be determined accurately by (1)H NMR and the compounds can be recovered readily by chromatography.