Protrusion acetabuli is the medial protrusion of the acetabulum in to the pelvic cavity, also known as arthrokatadysis, more common in females and classified etiologically as primary (idiopathic) and secondary forms. This is a 66-year-old female patient that presented for a plain radiograph of the pelvis and hip joints from a peripheral healthcare center on account of pain and inability to stand and move her waist and hips bilaterally, reduced movement of the legs and pain in the knees for more than three-year duration of onset. The plain radiograph of the pelvis and both hip joints demonstrate reduced density of the demonstrated bones, medial protrusion of the medial wall of the acetabulum in to the pelvic cavity bilaterally (distance between the imaginary Kohler’s line and medial acetabular wall is about 22mm bilaterally; Degree: III), obliteration of the hip joints bilaterally, thickening and sclerosis of the acetabular walls and other articular margins, subarticular cysts on the femur, acetabulum and pelvic bones. The patient had no coexisting condition like rheumatoid arthritis, Marfan’s syndrome and psoriatic arthritis. A diagnosis of bilateral idiopathic protrusio acetabuli was made. The patient was advised on bilateral total hip arthroplasty to improve the symptoms. We report a case of bilateral idiopathic protrusion acetabuli in an elderly female patient in order to describe the features of this condition radiographically.

Today nearly almost every part of the world has been impacted by the corona virus COVID-19 pandemic. COVID-19 has been unrelenting in its impact as thousands and thousands of people have died from its infections and resulting complications. Some countries have experienced severe effects of the virus than others. However, in both situations the virus has been vicious and many of those who have recovered and survived its infections have testified of how deadly this virus is. In the wake of this pandemic nations around the world have taken measures to curb its impact and spread in communities and societies. Preventative measures taken have disrupted in most cases schools and the workforce with many people being forced to work remotely from their homes and with schools going virtual. However, progress in fighting this virus is in the offing as promising vaccines are on the horizon. This paper discusses a preliminary intervention research project whose goal is to mitigate the impact of COVID-19 in Nairobi, Kenya. Results of this study may have promise of being replicated in other parts of Africa affected by this pandemic.

Introduction: Allergic rhinitis (AR) in children is a common chronic pathology with a strong impact on patient quality of life. The main physiopathology affects the nasal cavity as a multi-factorial disease involving nasal mucosa damage, nasal inflammation with high concentrations of histamine, pro-inflammatory cytokines such as histamine, TNF-a, IL-4, IL-5, IL-6, IL-10, IL-13, and IgE antibodies on the nasal mucosa. Systemic entry of these proteins through damaged nasal mucosa maintains continued inflammatory and allergen cascades. Therefore, an ideal treatment should be multitarget in order to stop allergen exposure, inflammation, and nasal mucosa barrier degradation, but such treatments are nearly impossible to conceive. We envisaged an osmotic and protective nasal barrier film, not only capable of protecting the nasal mucosa from allergen exposure but also of trapping and neutralizing selected cytokines and cleaning the nasal surface continuously without using any harmful substance for children. Materials and Methods: We associated highly osmotic glycerol solution with specific plant polymers to conceive an osmotic but stable film. As plant polymers (tannins) can bind with selective proteins, a range of glycerol binding non-cytotoxic polymers were screened using the sandwich ELISA method to select those having binding affinity for allergen induced nasal proinflammatory cytokines. After verifying cytotoxicity and irritant potential, a 15-day observational clinical study was performed with approval from the ethics committee on 30 children aged between 4-13, suffering from allergic rhinitis. The test product (TP) was supplied in 15-ml nasal sprays and applied 2-3 times per day for a period of 15 days. Saline solution served as control (CP). The scores of nasal and ocular symptoms, effect on quality of life, eosinophil count in nasal smears, and need for antihistamine treatment was evaluated at the start, at 30 minutes and on days 2, 3 and 15 of treatment. Results: A few specific polymers were able to bind with selected cytokines and histamine at adequate filmogen concentrations. The osmotic film was stable, non-irritant and was able to clean the nasal mucosa continuously for 4-6h after each application. Clinical observations of Total Nasal Symptom Score (TNSS) grouping the scores of nasal congestion, runny nose, sneezing, and itching, revealed a strong decrease right after the 1st treatment in both groups but the reduction was much stronger and faster with the TP. The mean TNSS score reduction was 44.74% in CP vs 83.53% in the TP group after 7 days of treatment (p<0.001). Total Ocular Symptom Score (TOSS) was decreased by 21.13% and 51.41% in CP v/s 35.12 and 99.59% in TP group on days 2 and 7, respectively. Nasal smear eosinophil count was equally strongly reduced in the TP v/s CP group. No treatment-related side effects were recorded in any of the groups. Conclusion: Protecting the nasal mucosa against allergens, neutralizing inflammatory cytokines, and keeping the nasal surface clean with an osmotic polymeric film, constitute a major breakthrough for the treatment of allergic rhinitis in children. This simple but scientific and logical approach should avoid exposing children to chemicals and to their long-term side effects.

Sulfasalazine is a combination of an aspirin like anti-inflammatory component and a sulfa antibiotic like component. It is an Anti-inflammatory agent used to relive the pain of the Bowel diseases, Rheumatoid arthritis, Psoriatic arthritis, Crohn’s disease and Ulcerative colitis. Sulfasalazine acts to deplete the damage to the joints, rather than just relieve the pain, it belongs to the group of medicines called disease modifying anti-rheumatic drugs (DMARDs). Methodology: The objective of the present study is to prepare, optimize the nanoparticles containing sulfasalazine and bovine serum albumin (BSA) by using desolvation method, and to study the effect of process variables like stirring speed on product yield, drug content. Glutaraldehyde is used as crosslinking agent and sulfasalazine is used as model drug. Results: The prepared nanoparticles showed maximum drug content, for continuous method-97.27% and for intermittent method-95.08%. The prepared nanoparticles showed good product yield of 96.26% (intermittent method) and 98.4% (continuous method). Invitro release of sulfasalazine loaded nanoparticles showed good sustained release and maximum drug release of 38.05% for continuous method and 40.73% for intermittent method within 6 hours interval.