Alkaptonuria is a rare inherited metabolic disorder, caused by the deficiency of homogentisate 1,2 dioxygenase enzyme. The three major features of alkaptonuria are the presence of homogentisic acid in urine, ochronosis (bluish-black pigmentation in connective tissue) and arthritis of the spine and large joints. We present a 48 years old female presented with pain, restriction of movements of right shoulder. Arthroscopy was suggestive of ochronotic arthropathy. The definitive diagnosis of ochronosis was subsequently confirmed by laboratory and pathologic evaluation.

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Disruption of anterior cruciate ligament (ACL) is a common ligamentous injury of the knee. The best choice of graft for reconstruction remains undecided. This prospective, randomized clinical trial aimed to compare clinical results of bone-patellar tendon-bone (BPTB) grafts and four-strand semitendinosusgracilis (QHT) grafts for ACL reconstruction over a 1-year follow-up interval in Indian population. Methods: 42 consecutive patients with ACL injury were recruited, by pick and draw method and allotted into two groups with 21 patients in each group. Group A patients underwent arthroscopic ACL reconstruction using BPTB graft while QHT autograft was used for patients in Group B. All the patients underwent standard ipsilateral arthroscopic ACL reconstruction procedure using a single incision, antero-medial (AM) portal technique for BPTB or the QHT autograft by a same surgeon. Patients were followed up regularly for a minimum period of 1 year. Results: After one year, the Cincinnati score was 91 AE 4.117 in BPTB group and 89.29 AE 5.371 in QHT group (P = 0.282). There was no significant difference between the two groups in the mean scores with respect to pain, overall activity level and running in the Cincinnati score. None of the patients complained of the knee giving way. Similarly, at 1 year, the Lysholm score was 92.84 AE 2.630 and 90.55 AE 2.395 in the two groups respectively (P = 0.842). There were no episodes of locking or instability and there was no significant difference in the mean Lysholm scores regarding pain and squatting. Conclusion: There was no significant functional difference between the two grafts in terms of Lysholm and the Cincinnati score, anterior knee laxity and altered sensation over proximal leg. The patients with QHT groups performed better than BPTB functionally at 6 month so early return to sport is possible even with QHT autograft.

This study is a comparison between revised Manchester Point A and International Commission on Radiation Units and measurements (ICRU) 89 reporterecommended Point A absorbed-dose reporting in intracavitary brachytherapy for patients with cervical carcinoma. METHODS AND MATERIALS:The retrospective dosimetric study is based on the data of 32 patients with cervical carcinoma treated with high-dose-rate brachytherapy. Patients received 21 Gy in three fractions (7.0 Gy X three fractions) to Point A (A flange , revised Manchester definition). All the patients were replanned with a new Point A (A icru89 ) defined on CT images as per the American Brachytherapy Society/ICRU-89. The data collected were compared with the data obtained from Point A (A flange ). RESULTS: When using the A flange plan normalization method, the mean dose of 0.1 cc, 1 cc, and 2 cc bladder volumes was 820.79