Distal third tibial fractures are prone to non-union following tibial nail insertion. The purpose of this study was to assess the union of distal third tibial fractures in patients who have undergone intra-medullary (IM) tibial nailing with one versus two distal locking screws. Sixty-five patients who had intramedullary tibial nail fixation were retrospectively analysed. Our results showed that 80% of non-unions in distal third fractures had only one distal locking screw compared to 20% who had two distal locking screws. This is statistically significant (p<0.01). We therefore conclude that two distal locking screws are essential for distal third fractures.

A sensitive, rapid, simple, and accurate high performance thin layer chromatographic method has been developed to standardize the bark of Grewia tiliaefolia Vahl. (Family: Tiliaceae) using betulin as an analytical marker. Chloroform extracts of bark from five different sources were used for HPTLC on silica gel with toluene-ethyl acetate, 90 + 10 v/v, as mobile phase. Under these conditions, the Rf of betulin was 0.22. The calibration plot was linear in the range of 1000 ng to 1800 ng of betulin and the correlation coefficient, 0.999, was indicative of good linear dependence of peak area on concentration. The mean assay of betulin was 2.596 +/- 0.594 mg g(-1) of bark. The method permits reliable quantification of betulin and good resolution and separation of betulin from other constituents of Grewia tiliaefolia. Recovery values from 96.09 to 98.87% showed that the reliability and reproducibility of the method were excellent. The proposed HPTLC method for quantitative monitoring of betulin in Grewia tiliaefolia can be used for routine quality testing.

Diabetes mellitus is a worldwide prevalent chronic disease with a significant disease burden. The associated dyslipidemia adds to the lethality of type 2 diabetes mellitus and requires newer and better treatment strategies. Peroxisome proliferator activated receptor (PPAR) α and γ agonists are approved hypolipidemic and anti-diabetic agents respectively and combining them together provides a dual benefit in type 2 diabetes mellitus associated with dyslipidemia. This novel class of dual PPAR agonists are termed as "Glitazars" and in 2013, Saroglitazar, a member of this class of drugs; was approved by the Indian regulatory authority Drug Controller General of India (DCGI) for the treatment of diabetic dyslipidemia. It is the first glitazar to gain regulatory approval anywhere in the world and is also the first New Chemical Entity (NCE) to be discovered in India. This review provides an overview of this novel drug including its mechanism of action and prospective uses.

Abstract Background: With the increased survival rates following the treatment of childhood cancer, it becomes equally important that the need for evidence based surveillance of long term effects of cancer therapy is addressed. This includes the risk of development of metabolic syndrome features like obesity, altered lipid and sugar profile, which was attempted in the present study. Materials and Methods: In this cross sectional case study, 50 survivors of childhood cancer aged between 5 – 18 years were recruited. Positive history of obesity, diabetes mellitus, dyslipidemia, and stroke in family were recorded and their anthropometry was noted with calculation of their Body Mass Index (BMI). Fasting lipid profile, blood sugar, and serum insulin levels were tested; the Homeostatic model assessment of Insulin Resistance (HOMA IR) value and the Fasting Glucose to Insulin Ratio(FGIR) were derived as markers of insulin sensitivity.  The data were analyzed using SPSS (version 17.0). Results: In these fifty children, the risk factors studied for dyslipidemia and insulin resistance due to chemotherapy were: age at diagnosis, sex, radiation exposure, steroid, and L-asparaginase use during the treatment for cancer. Among the fifty survivors, 7 were found obese, 32 normal, and 11 underweight as per the age specific BMI charts. Their metabolic parameters showed that 12 had raised cholesterol levels, 8 had raised triglyceride levels, and 4 had lowered HDL-C levels. Nine survivors also had raised HOMA-IR levels. However, these metabolic derangements were not found to be statistically significant (p value>0.05) and no correlation was found between the risk factors and obesity, dyslipidemia, or insulin resistance. Conclusion: As against the prior evidence, there was no risk of developing obesity, dyslipidemia, and insulin resistance in survivors of childhood cancers.  Keywords: Dyslipidemias, Insulin Resistance, Obesity, Survivors of childhood cancer

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