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A bipartite patella results from the failure of the ossification centres to unite, resulting in a fibrocartilaginous union between the bipartite fragment and patella body. Fibrocartilaginous interface is present between the accessory and main patella. A bipartite patella is usually an incidental finding and can be hard to distinguish from a patella fracture. Here, we present a case of bipartite patella in 16 year old male and its further management.

Background: Despite advances in surgical techniques and various implants, the treatment of intra-articular distal femoral fractures poses a challenge to the clinicians worldwide. In this study we aimed to evaluate the clinical outcomes of lateral locking plate combined with medial assisted plate for treating intraarticular comminuted distal femoral fractures. Materials and Methods: We conducted a retrospective study which consisted of 10 cases of distal femur fracture with intraarticular extension and treated with open reduction and internal fixation with dual column plating using single incision anterior midline approach. Results: The mean age was 40.75±12.39 with a range of 20-70 years. There were 7 males and 3 females. Mean time for union was 16.15±1.35 weeks. 1 patient had decreased ROM due to stiffness at the knee joint. 1 patient had superficial infection. No deep infection was noted. 1 case of non-union was noted in this study. Range of motion at knee at final follow up was 124.25±17.34 degrees. The mean NEER score was 82.15±9.19 with a range of 54-91. Conclusion: Single-incision dual plating approach for distal femoral fractures is effective and provides stable construct without loss of reduction and allows early rehabilitation and good functional outcomes.

The authors present a rare case report of a 30 year old male presented with a history of road traffic accident with complain of severe pain and swelling in right ankle and foot. On examination, tenderness and swelling was reported on right foot. Neurovascular examination of right foot was normal. Closed reduction manipulation under sedation was not successful in the emergency room. Open reduction under spinal anaesthesia was performed 12 hours after injury in the operating room. A 4cm longitudinal incision over the talonavicular joint was used for reduction. The talonavicular joint was stabilized with two Kirschner wires placed from the navicular bone to the talus. The Kirschner wires were removed at six weeks immediately after the K-wire removal, the joint was stressed under fluoroscan and deemed stable. Two weeks after the K-wire removal, the joint remained stable and the cast were removed 6 weeks after surgery. The patient was allowed to bear weight, with a gradual increase of load. At 6-month follow-up, his foot was painless and stable. He returned to work in the third month after trauma.

Shareholders’ Agreements are essentially agreements executed between the shareholders of a company, which define their rights and obligations. While it is the articles of association which are regarded as the constitution of the company in terms of the Companies Act 2006, and which generally contain the provisions which bind the company and its members, an increasing upsurge has been witnessed in the execution and usage of shareholders’ agreements over time. This noticeable rise has resulted due to two main reasons. Firstly, the limitations and ambiguities which are continually prevailing in the operation of the articles of association have led shareholders to make use of shareholders’ agreements to establish the construct of their rights and obligations. Secondly, the nature of such agreements makes them a favourable option for a diverse range of investors owing to them allowing shareholders to agree on additional rights and obligations and, moreover, due to their confidential private nature. This article expounds upon the striking reasons owing to which shareholders’ agreements have emerged as a common phenomenon and correspondingly, addresses and critically analyses the existent limitations and uncertainties which encompass such agreements. Agreement; Shareholders, investors, company law, articles of association, enforcement of rights

Introduction- Aside from other multisystemic symptoms, musculoskeletal symptoms are quite common in patients with COVID-19. Post covid there has been a rapid rise in diffuse complaints of myalgia and joint pain. This study was designed to calculate the prevalence of musculoskeletal symptoms in post-COVID 19 cases. Material & Methods- This was a cross-sectional single-centre study carried out at Pt. B. D. Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana. Patients aged more than 18 years who were diagnosed with COVID 19 without any previous history of musculoskeletal manifestations and a minimum of 21 days of negative RT-PCR report were included in the study. Results- 249 patients with a history of Covid 19 participated in the study and presented with musculoskeletal manifestations. Lower back pain (37.3%) was the most common symptom in patients with post-covid musculoskeletal symptoms, followed by, shortness of breath (34.1%), arthralgia (33.7%), myalgia (31.4%), upper back pain (26.5%) and only a few patients with post-covid reactive arthritis (1.2%). Fatigue was reported by almost all the study subjects. Conclusion- Generalised fatigue, diffuse muscle and joint pain are quite frequently seen in post COVID patients which amounts to a huge patient load presenting to Orthopaedic clinics. Keywords- Covid19, Myalgia, Musculoskeletal, Arthralgia

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An interesting case of large ossifying fibroma of the mandible in a child with a sickle-cell trait is reported.

The purpose of this study was to investigate complement activation and associated inflammatory mechanisms in normal, aged human retina.Evidence of complement activation and associated mechanisms was assessed in normal human retina (n = 52) using a panel of antibodies directed against membrane attack complex (C5b-9), microglia (CD11b), amyloid precursor protein (APP), scavenger receptor (CD36), and a phytolectin (RCA-I). Fifty-two eyes, categorized into two age groups, were used. Nineteen "younger" eyes (56 years) and 33 "older" eyes (69 years) with no history of ocular disease were processed between 4 and 22 hours, with a median delay of 14 hours postmortem.Age-dependent expression was evident in C5b-9, APP, CD11b, and RCA-I, but not CD36, immunoreactivity. Immunoreactivity for C5b-9 was robust in Bruch membrane (BM) and the intercapillary pillars of Bruch. Immunoreactivity for APP was robust in the basal cytoplasm of the retinal pigment epithelium. Immunoreactivity for CD11b was robust on the surface of the retinal pigment epithelial cell, in the choriocapillaris, and in BM. Lectin binding of RCA-I was strong throughout the neuroretina.Robust immunostaining for APP in older donor eyes suggested that amyloid beta peptides may be one of the triggers of complement activation during the normal aging process. Microglial markers CD11b and RCA-I also increase with age, suggesting a concomitant inflammatory response to C5b-9 deposits in the retinal pigment epithelium, BM, and CC. Immunoreactivity for CD36 was strong in both age groups; the lack of age dependence in this candidate receptor for amyloid beta suggested that complement activation may arise from interactions of amyloid beta with other candidate receptors in normal human retina.