Our experience of management of sub trochanteric fractures of femur by proximal femoral nail.

Background: Sub trochanteric fractures of the femur remain some of the most challenging fractures. Most of the fractures result from trivial fall in the elderly; while in the younger age group, it's mainly due to road traffic accidents. Operative management is the preferred treatment. This study is intended to assess the outcome of the intramedullary fixation of sub trochanteric fractures with Proximal Femoral Nail (PFN). Methods: This study is a prospective, uncontrolled study of 40 cases of sub trochanteric fracture of femur admitted to a tertiary level hospital between August 2011 and November 2013; and treated with proximal femoral nails. Adults with recent sub trochanteric fracture of femur were included in this study; while patients less than eighteen years of age, pathologic fractures, periprosthetic fractures, and old neglected fractures were excluded from the study. Results: In our study of 40 cases, there were 28 male and 12 female patients with mean age of 51.43 years (range 22-87 years). Based on Seinsheimer’s classification, type IIIA fractures accounted for majority (32.5%) of the cases. majority of patients, i.e. 35% (n=14) showed union at 20 weeks after surgery. Cases were followed up and assessed according to the Harris hip scoring system (Modified). The outcome was good to excellent in 82.9% cases. Conclusions: From our study we conclude that PFN is a reliable minimally invasive implant for sub trochanteric fractures, with good to excellent functional outcome in the majority of cases.

Awareness and attitude regarding human papilloma virus and its vaccine among medical students in a medical school in India.

Background: Human papilloma virus is the major cause of cervical cancer in women and HPV vaccine is the most effective option. Prevention of cancer with vaccine is a new concept. Medical students should be aware of cervical cancer, HPV and its vaccine. This calls for assessment of the knowledge of HPV infection and the acceptability of HPV vaccine among medical students. The aim of this study was to assess awareness of HPV infection and HPV vaccine and to assess attitude toward these vaccines among final year medical students in Sri Venkateswara Medical College, Tirupati. Methods: It is a cross-sectional study. A total of 127 (59 males and 68 females) final year M.B.B.S. students participated. Data regarding HPV and its vaccine were collected using questionnaire based survey. The questionnaire sought student responses pertaining to the knowledge of cervical cancer, HPV and its vaccine. The data were analyzed using Microsoft Access and Excel software. Results: Most of the participants know well about the etiology and prevention of cervical cancer but information regarding the dosage, schedule, site and route of administration was lacking in majority of them. Conclusion: The medical students know the association between Human Papilloma Virus and cervical cancer, but the awareness about HPV vaccine was low among study population. Medical schools should modify their curricula to include teaching methods aimed at improving awareness regarding HPV and its vaccine.