Annals of African Medicine最新文献

{"title":"Critical Role of Antidotes in Managing Toxicological Emergencies: Historical Evolution, Categorization, and the Importance of Antidote Banking - A Review of Literature.","authors":"Venkatesh Janarthanan, Ninad Nagrale, M Senthil Kumaran, Arijit Dey, O Gambhir Singh","doi":"10.4103/aam.aam_149_24","DOIUrl":"10.4103/aam.aam_149_24","url":null,"abstract":"<p><p>Poisoning represents a significant and growing public health concern, as evidenced by the data from the National Crime Records Bureau indicating that poisoning accounted for 25.1% of the 164,033 reported suicides in 2021, with an additional 0.4% related to the ingestion of sleeping pills. This highlights the urgent need for effective antidotes in the management of toxicological emergencies. Antidotes, defined as therapeutic agents that counteract the effects of poisons, drugs, or toxins, play a critical role in toxicology. Their mechanisms of action include altering toxicokinetics, halting absorption, neutralizing toxins, or inhibiting harmful metabolic conversions. This review delves into the historical development of antidotes, their categorization, recommended dosages, indications, contraindications, and potential side effects. It also explores the concept of antidote banking, a strategic approach to ensure the availability of antidotes during emergencies. Understanding these aspects is vital for healthcare professionals in managing acute, unintentional, or self-poisoning cases effectively, especially among young adults. The historical evolution from Mithridatism, the first known antidote, to modern, evidence-based antidotes demonstrates significant advancements in medical science. Antidotes are categorized based on their mechanisms, including toxic effect bypass, inert complex formation, accelerated detoxification, reduced toxic conversion, receptor site blockade, and receptor site competition. In addition, they are classified by their site of action: serological, pharmacological, mechanical, physical, and chemical. Antidote banking, endorsed by the World Health Organization, emphasizes the need for a reliable supply of critical, emergency, and urgent antidotes to manage poisoning incidents efficiently. This comprehensive review provides valuable insights into antidote development and application, contributing to enhanced public health responses to toxicological emergencies.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":"515-521"},"PeriodicalIF":0.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12380155/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144186307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and Radiological Evaluation of Severity of Acute Ischemic Stroke with Special Reference to Neuroinflammatory Biomarkers.","authors":"K C Shashidhara, Ashika Reddy Padamati, M Manthappa, M C Prasad","doi":"10.4103/aam.aam_78_24","DOIUrl":"10.4103/aam.aam_78_24","url":null,"abstract":"<p><strong>Background: </strong>Given the complexity of stroke, diverse mechanisms are known to be involved in its pathophysiology among which inflammation is one of the major culprits. Poor clinical outcomes are seen in those stroke patients with significant systemic inflammation. Therapeutic options to fight stroke are still limited and the only approved drug is tissue-plasminogen activator and/or mechanical thrombectomy. As inflammation highly influences susceptibility of stroke patients to overcome the disease, there is an increasing need to develop new diagnostic, prognostic, and therapeutic strategies for poststroke inflammation.</p><p><strong>Subjects and methods: </strong>This study was conducted over a period of 18 months. Seventy-five patients who were diagnosed with acute ischemic stroke based on patient's clinical history, neurological signs, and radioimaging were included. Patients underwent computed tomography scan/magnetic resonance imaging scan within 24 h of admission to exclude stroke mimics and primary intracerebral hemorrhage. National Institutes of Health Stroke Scale (NIHSS) was used to assess the severity of stroke clinically. Inflammatory biomarkers such as plasma MMP-9, high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), and S100B were measured using the ELISA kits.</p><p><strong>Results: </strong>We observed that plasma concentration of MMP-9, IL-6, and S100B showed statistical significant association with severity of stroke as assessed by NIHSS, with Chi-square test values of χ 2 = 24.69 for IL-6 ( P = 0.00), χ 2 = 11.91 for S100B ( P = 0.008), and χ 2 = 19.5 for MMP-9 ( P = 0.00). The mean values of MMP-9, IL-6, S100B levels, and hs-CRP levels were significantly elevated in severe, moderately to severe stroke groups as related with mild stroke group as evaluated by NIHSS.</p><p><strong>Conclusion: </strong>Neuroinflammatory markers such as MMP-9, IL-6, S100B, and hs-CRP are the promising tool as inflammatory biomarkers with other indicators of acute ischemic injury to diagnose acute ischemic stroke and facilitate a better clinical assessment of patients during the acute phase of the disease. More importantly, this study showed that these biomarkers have strong independent prediction values for stroke outcome. We propose that some of those biomarkers might turn out to be targets to be therapeutically altered overcoming the urgent need for the identification of potent drugs to modulate stroke-associated inflammation.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":"567-572"},"PeriodicalIF":0.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12380142/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143762846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pathogenesis and Current Treatment Strategies in Rheumatoid Arthritis: A Systematic Review Article.","authors":"Debajani Deka","doi":"10.4103/aam.aam_11_24","DOIUrl":"10.4103/aam.aam_11_24","url":null,"abstract":"<p><p>Rheumatoid arthritis (RA) is a chronic, symmetrical, and inflammatory autoimmune disease that initially affects small joints, progressing to larger joints, and eventually the skin, eyes, heart, kidneys, and lungs. It has been recorded that RA affects 0.5%-1% of the adult population of developed regions. It initially affects small joints, progressing to larger joints, and eventually the skin, eyes, heart, kidneys, and lungs. Often, the bone and cartilage of joints are destroyed, and tendons and ligaments weaken. All this damage to the joints causes deformities and bone erosion, usually very painful for a patient. RA by producing inflammatory cytokines and proteinases, such as matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases that perpetuate joint destruction by abnormal proliferation of synovium. Under the influence of synovial cells, cytokines such as - Interleukin (IL)-1 and IL-17 chondrocytes are destroyed by apoptosis. Again the extracellular matrix secretes a proteinase called MMPs that damages the type 2 collagen fibers of the cartilage matrix causing biomechanical changes to the joint movements. This way with destruction of articular cartilage of the joint surface by hyperplastic synovium leads to a reduction of joint space. The difference between the hyaline cartilage of the articular surface and other hyaline cartilage is that articular hyaline cartilage never undergoes regeneration. With limited membrane permeability and poor gastrointestinal stability, monoclonal antibodies (mABs) do not have good oral bioavailability (<1%). For this reason, they are usually not administered orally, and parenteral administration is mostly by intravenous, subcutaneous (SC), and intramuscular (IM) injections. When mABs are injected IM or SC, the absorption process from the site of injection is through the interstitial space and into the lymphatic system, with subsequent draining into the systemic circulation. Although IM and SC routes of administration offer lower bioavailability because of proteolytic degradation in the interstitial fluid or the lymphatic system, the SC route is the most widely used due to convenience and the possibility of patient self-administration. For these last two routes of administration, the peak plasma concentration after a single dose is achieved 3-7 days after administration, due to the slow absorption into the systemic circulation. Other potential routes of administration include intravitreal, intraperitoneal, and pulmonary. CRD NUMBER-42024601637.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":"532-539"},"PeriodicalIF":0.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12380159/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143967553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of Micro RNA Expression as Biomarker in Breast Cancer.","authors":"Gitika Nanda Singh, Nijarth Shahi, Parijat Suryavanshi, Krishna Kant Singh, Neetu Nigam","doi":"10.4103/aam.aam_78_23","DOIUrl":"10.4103/aam.aam_78_23","url":null,"abstract":"<p><strong>Background: </strong>The most common cancer in women is breast cancer (BC). MicroRNA-21 was one of the first oncomiRs to be found at elevated levels in a number of malignancies, including gliomas, BC, and colorectal cancer (miR-21). MiRNA is associated with processes such as apoptosis, invasion, metastasis, and proliferation, which are known features of cancer. This study aimed to investigate the molecular basis and clinical significance of miR-21 in BC, as microRNAs play a critical role in this disease.</p><p><strong>Materials and methods: </strong>MiR 21 was then analyzed by the quantitative polymerase chain reaction (qPCR) using the Taq-Man probe. The thermal profile included 5 min of denaturation at 95°C, then 40 cycles of denaturation at 95°C for 20 s, annealing at 52°C for 20 s, and extension at 72°C for 30 s. Two separate runs of real-time polymerase chain reaction and reverse transcription (RT) were then performed. Relative quantification of the gene expression levels (fold change) based on computed tomography values was used to examine the data from RT-qPCR for miR-21 and Glyceraldehyde-3-phosphate dehydrogenase (Livak and Schmittgen).</p><p><strong>Results: </strong>The mean fold change in serum miR-21 levels was significantly higher in cases (8.17 ± 2.49) than in controls (1.02 ± 0.23). The mean fold change in serum miR-21 levels in Stages III, IV and lymph nodes were significantly higher than in Stages I and II. The mean fold change in serum miR-21 gene expression was significant with the changes in different Ki67 levels.</p><p><strong>Conclusions: </strong>Our results demonstrate the importance of miR-21 plasma level as a diagnostic and prognostic biomarker for BC.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":"24 3","pages":"549-554"},"PeriodicalIF":0.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12380165/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144697443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"To Investigate the Laboratory Sample Criteria of Ammonia Measurement in Saudi Arabia.","authors":"Mohammed Abdullah Jeraiby","doi":"10.4103/aam.aam_80_24","DOIUrl":"10.4103/aam.aam_80_24","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to investigate the laboratory sample acceptance criteria, ammonia analysis, and the reporting of ammonia results and raise awareness of the new guidelines.</p><p><strong>Methods: </strong>It is a descriptive cross-sectional study. The study was conducted in the clinical laboratories of the hospital, KSA. Furthermore, the study used electronic questionnaires. A questionnaire was distributed to clinical biochemistry laboratories in Saudi Arabia. The results were collected and compared to updated best practice guidelines on hyperammonemia issued by the Metabolic Biochemistry Network (MetBio.net).</p><p><strong>Results: </strong>This study examined laboratory practices in ammonia analysis. EDTA tubes are widely used (78.0%) for blood/plasma ammonia measurement. Most laboratories prioritize sample delivery on ice (100%) and fast-track samples for ammonia analysis (95.1%). Awareness of ammonia analysis criteria includes automated methods for hemolysis assessment (61.0%) and rejection of grossly hemolyzed samples (92.7%). The enzymatic method is predominant (97.6%). Concerns about icterus and lipemia impact (80.5% and 85.4%, respectively) are noted. Reporting practices vary, with 65.9% setting specific thresholds for critical limits.</p><p><strong>Conclusion: </strong>This study offers insights into current ammonia analysis practices, identifying areas for improvement. Aligning with literature, it emphasizes the need for ongoing education and guideline updates for consistent and accurate severe hyperammonemia diagnosis and management.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":"573-578"},"PeriodicalIF":0.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12380135/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144186329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"To Study the Correlation of Methylenetetrahydrofolate Reductase C677T and MTR (A2756G) Gene Polymorphism in Endometriosis in Women of Reproductive Age Group.","authors":"Suman Singh, Sujata Deo, Vandana Solanki, Nitu Nigam","doi":"10.4103/aam.aam_119_24","DOIUrl":"10.4103/aam.aam_119_24","url":null,"abstract":"<p><strong>Background: </strong>One of the typical benign gynecologic conditions in women of childbearing age is endometriosis, which can almost always lead to pelvic pain, infertility, and menstrual irregularities. The biochemical features of endometriosis focus on the folic acid and one-carbon cycle. Endometriosis cannot be diagnosed by a blood test. An important enzyme in the folate cycle is methylenetetrahydrofolate reductase (MTHFR). There are a number of variants in the MTHFR gene, but the C677T polymorphism has received the most attention and is associated with a number of diseases and problems.</p><p><strong>Purpose: </strong>To investigate the association between MTHFR (C677T) and MTR (A2756G) gene polymorphisms and the pathogenesis of endometriosis.</p><p><strong>Materials and methods: </strong>A total of 51 endometriosis cases and 51 healthy volunteers were genotyped for MTHFR (C677T) and MTR (A2756G) gene polymorphisms. Genotypes were determined by the polymerase chain reaction restriction fragment length polymorphism. The frequency of genotypes was analyzed by the Chi-square test and odds ratio for relative risk.</p><p><strong>Results: </strong>The frequencies of CC, CT, and TT genotypes of MTHFR C677T were 17.65%, 54.90%, and 27.45% in cases and 64.71%, 15.69%, and 19.61% in controls, respectively. In addition, the frequencies of the C and T alleles were 46.92% and 53.08% in cases and 72.55% and 27.45% in controls, respectively. The T-allele and the CT and TT genotypes of the MTHFR C677T gene polymorphism were significantly associated with cases. No significant association with cases was observed for the MTR A2756G gene polymorphism.</p><p><strong>Conclusion: </strong>We conclude that the MTHFR C677T polymorphism was significantly associated with endometriosis, but the MTR A2756G polymorphism was not associated with endometriosis patients.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":"579-585"},"PeriodicalIF":0.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12380132/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144191396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Patient with Marburg's Variant of Multiple Sclerosis Responded Well to Cyclophosphamide.","authors":"Foziah Jabbar Alshamrani, Rawan Salim Alyami","doi":"10.4103/aam.aam_30_24","DOIUrl":"10.4103/aam.aam_30_24","url":null,"abstract":"<p><p>Marburg's disease is a fatal variant of multiple sclerosis (MS), distinguished by its fulminant, rapidly progressive monophasic course that often leads to patients' mortality within weeks of onset. Owing to its rarity, there are no established treatment guidelines. We present a 34 year-old male who was diagnosed with MS, and magnetic resonance imaging revealed numerous supra- and infratentorial white matter plaques. Steroid pulse therapy, intravenous immunoglobulin, and plasma exchange were ineffective. After excluding other differential diagnoses, Marburg's variant MS was considered, and intravenous cyclophosphamide with methylprednisolone was administered. The patient showed significant and fast clinical improvement adding to the evidence that cyclophosphamide is an effective therapeutic modality for treating this MS variant.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":"686-690"},"PeriodicalIF":0.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12380151/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144186274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recent Scenario of Diagnostic and Prognostic Biomarkers of Sepsis in Clinical Practice and the Role of Multi-marker Approach: An Update.","authors":"Arun Sinha, Shrimanjunath Sankanagoudar, Ankur Sharma, Nikhil Kothari, Neeraj Gupta, Praveen Sharma","doi":"10.4103/aam.aam_50_24","DOIUrl":"10.4103/aam.aam_50_24","url":null,"abstract":"<p><p>Despite extensive work done in the field of sepsis biomarkers; still, there is no consensus on which parameter could be considered as an ideal biomarker for sepsis diagnosis. This review aims to look into the existing biomarkers of clinical utility which are currently being used for sepsis diagnostics along with their advantages and disadvantages. We also provide an insight into the usefulness of a multi-marker approach to diagnosing sepsis and what could be the future direction. A literature review was conducted and four search engines such as PubMed, Scopus, Google Scholar, and Research Gate were used for data mining. Three clinically relevant markers for sepsis diagnosis such as procalcitonin (PCT), prespsin, and pentraxin-3 reviewed critically. Articles were also reviewed for the assessment of a multi-marker approach. Overall more than 100 research papers were found to be eligible for this review. Currently, most of the studies are using a chemiluminescent immunoassay-based PCT as a diagnostic method for sepsis. This method has been standardized all over the world, along with traditional markers such as C-reactive protein (CRP) and highly sensitive-CRP. But now, studies are also being conducted on presepsin and pentraxin-3 which are more sensitive and specific for early diagnosis of sepsis. Despite there being literature on presepsin and pentraxin-3, but due to a lack of standardization for assay methods and the costs involved, both parameters are still a long way in finding space in the routine clinical practice. More efforts should be made to combine several markers and develop an algorithm which can overcome the shortcomings of these markers.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":"522-531"},"PeriodicalIF":0.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12380167/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143770919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of Peripheral Perfusion Index as a Noninvasive Screening Tool in Predicting Adverse Neonatal Outcome.","authors":"Rizwana Abdul Nasser, Shiji Joseph, Anila Arangassery Poulose, Ramaraj Subbiah","doi":"10.4103/aam.aam_101_24","DOIUrl":"10.4103/aam.aam_101_24","url":null,"abstract":"<p><strong>Introduction: </strong>Timely identification of suboptimal organ perfusion is crucial to detect adverse outcomes early and to prevent its long-term motor and cognitive effects. Peripheral perfusion index (PI) is a noninvasive screening tool which can identify babies at risk for hemodynamic compromise.</p><p><strong>Aim: </strong>We aimed to study the validity of peripheral PI as an early predictor of adverse neonatal outcome in comparison with other commonly used noninvasive screening modalities such as heart rate (HR), respiratory rate, temperature, capillary refill time (CRT), and blood pressure.</p><p><strong>Materials and methods: </strong>This prospective observational study was carried out between January 2021 and May 2022. All infants born beyond 32 weeks of pregnancy who are admitted to the neonatal intensive care unit and needed hemodynamic were included in the study. Peripheral PI was monitored along with other noninvasive parameters at specific intervals and compared with those parameters for the degree of variation in each at specified time intervals and with the changing hemodynamic status of these babies including adverse outcomes.</p><p><strong>Results: </strong>A cohort of 93 neonates was enrolled in the study. Our study found lower PI values among newborns with adverse outcomes. This study also revealed negative correlations between HR and PI, suggesting that low PI could indicate early neonatal compromise and circulatory inadequacy. We also established positive correlations between PI and CRT, systolic blood pressure, mean arterial blood pressure, and pulse pressure.</p><p><strong>Conclusion: </strong>PI can serve as a noninvasive screening tool which can identify babies at risk for hemodynamic compromise, especially in resource-poor settings.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":"598-603"},"PeriodicalIF":0.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12380136/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143727053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Randomized Trial Comparing the Outcome of Proximal Femoral Nailing and Proximal Femoral Nailing Antirotation 2 for Unstable Intertrochanteric Femur Fracture.","authors":"Vinay Prabhat, Thanchuingam Jingua, Govind Kumar Gupta, Rohit Topno, Sabyasachi Kundu, Abhishek Guria","doi":"10.4103/aam.aam_144_24","DOIUrl":"10.4103/aam.aam_144_24","url":null,"abstract":"<p><strong>Background: </strong>Proximal Femoral Nailing (PFN) and Proximal Femoral Nailing Anti-rotation (PFNA 2) are both intra-medullary implants having 6 degrees of proximal valgus angulation. The helical blade compact the cancellous bone in femoral head when it is driven inside.</p><p><strong>Aims and objectives: </strong>The aim of our study is to compare radiological and functional outcome and superiority over other in management of unstable intertrochanteric fracture by PFN and PFNA 2.</p><p><strong>Materials and methods: </strong>The study was conducted from October 2021 to September 2022 which included 76 patients of unstable intertrochanteric fractures of femur.</p><p><strong>Results: </strong>In PFN group, Harris hip score was Excellent in 23 cases (60.52%), Good in 12 cases (31.57%), Fair in 2 cases (5.26%) and poor in1 case (2.63%). In PFNA 2 group, Harris hip score was excellent in 24cases (63.15%), Good in13 cases (34.21 %), Fair in 1 case (2.63%) and Poor in none of the cases.</p><p><strong>Conclusion: </strong>PFNA 2 significantly reduces the operative time and blood loss compared to PFN. However Both PFN and PFNA 2 implants offers no statistically significant advantages over each other in terms of fracture unions, functional and radiological outcomes, post-operative complications and recovery outcomes.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":"621-627"},"PeriodicalIF":0.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12380163/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144186301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}