Large diameter femoral head uncemented total hip replacement to treat fractured neck of femur.

The aim of this study was to investigate the use of large diameter head THR to treat fractured neck of femur, and to demonstrate if this conferred greater stability. Forty-six independent, mentally alert patients with displaced intracapsular fractures underwent THR. Mean age was 72.1 years. Outcome measures were dislocation, reoperation/revision rate, Oxford hip score (OHS), EuroQol (EQ-5D) and residential status. At mean follow-up (13.5 months) there were no dislocations. Reoperation, revision and infection rate were all 0%. Two patients died (4.3%). Mean pre-injury and postoperative OHS were 12.1 and 17.6, respectively. Mean pre-injury and postoperative EQ-5D index scores were 0.97 and 0.83, respectively. Mean postoperative walking distance was 2.5miles. There were no changes in residential status. This is the first published series using 36-mm diameter metal-on-metal THR for the treatment of fractured neck of femur. We have demonstrated that it affords patients excellent stability with no recorded dislocations.

Long distance truck-drivers: 1. Prevalence of sexually transmitted diseases (STDs).

A cross section study was conducted among long distance truck drivers to determine the prevalence of sexually transmitted diseases (STDs) and antibodies to human immunodeficiency virus (HIV). A total of 8 drivers and their assistants en route from port of Mombasa to countries in East and Central Africa were enrolled into the study. Blood was taken for HIV and syphilis serology. Discharges from urethra and genital ulcer disease (GUD) were cultured. Seroprevalence for HIV was 18% and 4.6% for syphilis. Fifty percent of Neisseria Gonorrhea cultured were penicillinase producers. Most of the men with urethral discharge and all the GUD were culture negative, probably due to prior treatment. Lack of circumcision, past history of GUD and urethritis were significantly associated with HIV seroconversion.

PIP: This article reports the findings of a study of HIV and STDs prevalence among long-distance truck drivers from East and Central Africa. Similar to prostitutes, truck drivers and a highly mobile population, characterized by having multiple sex partners. The researchers established a tent clinic at the Athi River Weighbridge Police Station near Nairobi, Kenya, where convoys of trucks stop for 3-5 days. 331 men from several East and Central African countries participated in the study. The participants completed a standard questionnaire about their medical history, knowledge, attitudes, and sex practices, and underwent a physical examination and blood test. Their ages ranged from 18-61 years, with a mean age of 31 years. 18% of the participants tested positive for HIV. Additionally, 4.6% tested positive for syphilis, and 4.5% and 4.3% suffered from urethral discharge ranked as the highest risk factor, followed by lack of circumcision. The study found no difference in the HIV prevalence rate between married and single men. The prevalence rate was far higher among Central Africans (31.75%) than among East Africans (16.65%), possibly explained by the hypothesis that says that HIV was first introduced in Central Africa, from where it spread to East Africa. Older drivers where more likely to be infected with HIV than younger drivers, with the age group of 40-49 having the highest prevalence rate. Researchers suspect that this is due to the fact that older drivers have been exposed longer and have more money with which to purchase sex. The report concludes that truck drivers constitute a high risk group, and should be targeted accordingly, with education and condom use campaigns.

Adaptation of a method of measuring zone diameters of bacterial growth inhibition by antibiotics to suit developing countries.

A study that devised a modified method of reporting antibiotic sensitivity results was undertaken. Enterobacteriaceae and Gram positive cocci were tested for drug sensitivity by a disc diffusion method. Zones of bacterial growth inhibition were measured, dividing the isolates into four groups: the highly sensitive, the moderately sensitive, the slightly sensitive and the resistant ones. The slightly sensitive isolates were taken as indicators of antibiotic resistance acquisition. By that system, when more than 50% of the isolates fell into the slightly and resistant groups, that meant that the antibiotic concerned would be discontinued for some time until the bacteria reverted to being moderately sensitive. The study also provided a method of making antibiotic discs from local blotting papers, and a sample of a form on which antibiotic sensitivity results could be recorded was presented. The method is considered to be easy and very appropriate for developing countries in detecting gradual and abrupt acquisition of antibiotic resistance by bacteria.