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Background Due to the increasing emergence of multi-resistant bacteria the search for alternative antimicrobial substances is of high interest. Promising agents are antimicrobial peptides which are host defense molecules of the innate immune system in a wide range of different species. Objectives The aim of this study was to assess the activity of nisin, melittin, lactoferrin, parasin-1 and LL-37 against 35 oral bacteria and Candida albicans employing the gold standard method for anaerobic susceptibility testing. Methods The activity of the peptides was determined by an agar dilution method under anaerobic and aerobic conditions. The test media contained final peptide concentrations between 0.125 µg/ml and 8 µg/ml (melittin, lactoferrin, parasin-1, LL-37) and between 0.125 µg/ml and 128 µg/ml (nisin). Results Nisin completely inhibited the growth of Megasphaera sp., Bifidobacterium longum, Parvimonas micra, Actinomyces israelii, Actinomyces naeslundii, Actinomyces odontolyticus, Prevotella intermedia, Streptococcus anginosus, Streptococcus constellatus and Staphylococcus aureus. Melittin and lactoferrin reduced the growth of Megasphaera sp., P. micra, B. longum (melittin) and Selenomonas flueggei (lactoferrin). Parasin-1 and LL-37 showed no activity. Conclusion AMPs, especially nisin and to a smaller degree lactoferrin, might be promising alternatives to antibiotics because of their antimicrobial activity, high resistance to environmental conditions and partially low costs.Dislocation of polyethylene insert is a common complication of mobile bearing uniconylar knee arthroplasty (UKA). Dislocation, when occurs is common in anterior, lateral or medial direction. The authors report a case of posterior dislocation in which patient remained asymptomatic and the dislocation was detected in a routine follow-up radiograph done at 18 months after surgery. UKA was subsequently converted into total knee arthroplasty and patient had a stable knee at two years follow-up with no signs of loosening or instability. Posterior meniscal bearing dislocation may remain asymptomatic and continued examination with high index of suspicion is needed to disclose such complications in the absence of symptoms.

Diaphyseal tibial fractures distal to a well-fixed tibial component although rare present a significant challenge and optimal treatment remains controversial. Belumosudil Displaced periprosthetic tibial shaft fractures are ideally treated with open reduction internal fixation with plate osteosynthesis. However, this treatment method is associated with weight-bearing restrictions, which can be difficult for elderly patients with multiple comorbidities and balance impairment. We present our experience of internal fixation with an intramedullary nail that uses an inferior entry point, standard intramedullary tibial nail, and conventional instrumentation.

Between 2017 and 2018, three patients with acute tibial shaft fractures distal to a TKA (Felix Type 3A) were treated with an intramedullary nail. Preoperative planning involved assessing proximal tibia to ensure adequate room for implant and instrumentation. The average patient age was 66.3years (range 59-72years) and all patients were males. All the patients sustained fractures of distal tibial and fibula diaphysis, after a road traffic accident. There were no complications intraoperatively, and all procedures were completed uneventfully. One patient underwent additional fixation of the fibula.

All patients achieved a radiological fracture union after an average of 20.6weeks. There were no fixation failures, or nonunions postoperatively. There were no new symptoms relative to the TKA that could be attributed to the tibial nailing procedure.

We recommend that this technique can be used primarily for this fracture pattern distal to a TKA, provided there is adequate space to accommodate the nail and instrumentation proximally anterior to the tibial tray.

The ultimate success of a total hip replacement lies in patients forgetting about their artificial joints during routine activities. "Forgotten Joint Score (FJS)" is emerging as an important tool in assessing outcomes of total hip arthroplasty. There has been no version of this score available in commonly spoken vernaculars in India. This study aims to formulate and validate the Hindi version of FJS in Indian population.

A total of 136 patients with a minimum follow-up of 6months and a maximum follow-up of 18months after total hip arthroplasty were asked to fill the translated and adapted version of FJS questionnaire, at two points of time 2weeks apart. The Hindi version of FJS (I-FJS) was tested for reliability and responsiveness, floor and ceiling effect and validity against modified Harris Hip Score (mHHS). Construct validity was expressed as the Pearson correlation coefficient. Internal consistency was expressed as Cronbach's alpha and test-retest reliability as the intra-class correlation coefficient (ICC).

I-FJS showed excellent internal consistency with Cronbach's alpha of 0.88. Intra-class correlation coefficient (ICC) was 0.94. I-FJS showed good correlation with m-HHS (

 = 0.8,

 = 0.001). The standard error of measurement was 3.6 and the smallest detectable change was 9.97. There was no floor or ceiling effect observed with I-FJS. Data from this study were insufficient to establish adequate responsiveness of I-FJS.

I-FJS is a valid, reliable and reproducible score for hip function in post-THA patients. It is devoid of any floor or ceiling effect. Hindi version of FJS could be an effective tool for studying hip function in the Indian population.

I-FJS is a valid, reliable and reproducible score for hip function in post-THA patients. It is devoid of any floor or ceiling effect. Hindi version of FJS could be an effective tool for studying hip function in the Indian population.

It remains controversial whether isolated acetabular component revision or both component revision surgeries should be performed in patients with stable femoral component. The present study aimed to evaluate the survival of patients with unrevised stable uncemented femoral stem who underwent isolated acetabular component revision.

A retrospective analysis was conducted in patients who underwent isolated acetabular component revision and had stable uncemented femoral component during revision hip arthroplasty between February 1998 and December 2009. Demographic data of the patients included age, previous surgery, complications, duration between primary and revision surgery, and duration between revision and latest follow-up. Functional results were analyzed using Harris Hip Score (HHS).

Fifteen hips of thirteen patients were included in the study with a mean age of 62.08 ± 12.9years. Average time from THA to the isolated acetabular revision was 9.2 ± 3.48years. Average follow-up time from revision to the latest follow-up was 12.

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