An experience with soft transforaminal lumbar interbody fusion in postoperative discitis not responding to conservative treatment.

OBJECTIVE: To determine the effect of soft Transforaminal Interbody Lumbar Interbody Fusion (sTLIF) in postoperative discitis not responding to conservative treatment. METHODS: This cross-sectional study was conducted in Department of Spine Surgery, CMH Rawalpindi from August 2016 to July 2019. Patients who underwent discectomy were observed and those presenting with postoperative discitis were included in the study. Pain was noted on visual analogue scale before and after the intervention and differences in two readings were noted. Data was collected on predesigned proforma. Statistical analysis was done on SPSS 20.0. RESULTS: Mean age of these patients was 45±12.34 years. The mean pain score on VAS before treatment was 8.33±0.65 and after treatment was 2±0.95. There was statistically significant reduction in pre-treatment and post-treatment pain on VAS (p=0.000). CONCLUSIONS: Postoperative discitis is present among a small number of patients after spine surgery and pain is significantly reduced after the treatment of discitis with TLIF.

Understanding brassinosteroid-regulated mechanisms to improve stress tolerance in plants: a critical review.

Brassinosteroids (BRs) are steroidal plant hormones involved in regulation of physiological and molecular processes to ameliorate various biotic and abiotic stresses. Exogenous application of BRs to improve stress tolerance in plants has recently become a high research priority. Several studies have revealed the involvement of these steroidal hormones in upregulation of stress-related defense genes and their cross talk with other metabolic pathways. This is likely to stimulate research on many unanswered questions regarding their role in enhancing the ability of plants to tolerate adverse environmental conditions. Thus, this review appraises new insights on mechanisms mediating BR-regulated changes in plants, focused mainly on their involvement in regulation of physiological and molecular mechanisms under stress conditions. Herein, examples of BR-stimulated modulation of antioxidant defense system and upregulation of transcription factors in plants exposed to various biotic (bacterial, viral, and fungal attack) and abiotic stresses (drought, salinity, heat, low temperature, and heavy metal stress) are discussed. Based on these insights, future research in the current direction can be helpful to increase our understanding of BR-mediated complex and interrelated processes under stress conditions.

Seed priming with KNO3 mediates biochemical processes to inhibit lead toxicity in maize (Zea mays L.).

BACKGROUND: Accumulation of lead (Pb) in agricultural soils has become a major factor for reduced crop yields and poses serious threats to humans consuming agricultural products. The present study investigated the effects of KNO3 seed priming (0 and 0.5% KNO3 ) on growth of maize (Zea mays L.) seedlings exposed to Pb toxicity (0, 1300 and 2550 mg kg-1 Pb). RESULTS: Pb exposure markedly reduced the growth of maize seedlings and resulted in higher Pb accumulation in roots than shoots. Pretreatment of seeds with KNO3 significantly improved the germination percentage and increased physiological indices. A stimulating effect of KNO3 seed priming was also observed on pigments (chlorophyll a, b, total chlorophyll and carotenoid contents) of Pb-stressed plants. Low translocation of Pb from roots to shoots caused an increased accumulation of total free amino acids and higher activities of catalase, peroxidase, superoxide dismutase and ascorbate peroxidase in roots as compared to shoot, which were further enhanced by exogenous KNO3 supply to prevent Pb toxicity. CONCLUSION: Maize accumulates more Pb in roots than shoot at early growth stages. Priming of seeds with KNO3 prevents Pb toxicity, which may be exploited to improve seedling establishment in crop species grown under Pb contaminated soils. © 2017 Society of Chemical Industry.

Orf with unusual features.

We describe a case of Orf in an immunocompetent man with no history of direct contact with farm animals. The patient presented with numerous large lesions on hands and feet including a lesion in the subungual area. Later on multiple lesions with more bizarre morphology developed on the trunk. The diagnosis was suspected on clinical appearance of the lesion and confirmed later by histopathology. We consider contact with contaminated soil as the possible source of infection as virus can survive in pastures. Awareness of unusual clinical patterns of known entities is important to avoid unnecessary interventions.

Primary hypothyroidism presenting as pseudoacromegaly.

Pseudoacromegaly is a condition characterized by cutaneous manifestations of growth hormone excess but with normal growth hormone levels. This is described in patients with severe insulin resistance, pachydermoperiostitis, burnt out acromegaly and with intake of drugs like Minoxidil. Severe thyroid hormone deficiency rarely present with similar picture and the issue is further complicated in presence of pituitary hyperplasia. We report an unusual presentation of primary hypothyroidism with pseudoacromegaly and thyrotroph hyperplasia mimicking a pituitary macroadenoma. The thyrotroph hyperplasia resolved completely with levothyroxine therapy.