ABSTRACT
Background: Osteonecrosis of the femoral head is one of the common causes of painful hip in more than 50yrs of age. At this age is associated with high functional demand. Osteonecrosis may have a devastating effect on the quality of life. The natural course of this disease is one of relentless progression with eventual collapse of the femoral head followed by secondary osteoarthritic changes in the hip. The management depends upon many factors including severity and location of necrotic lesion, patient factors and probability of collapse. Total hip replacement (THR) is needed in cases of collapse of femoral head, severe pain, osteoarthritis or destruction of hip joint. Moreover the factors like functional outcome after surgery implant longevity and need for revision surgeries must be considered while doing cemented total hip arthroplasty. In this context we conducted this prospective observational study to find out the clinical and functional outcomes of cemented THR in patients with of osteonecrosis of femoral head. Methods: The treatment period were january 2017 to june 2018 and sample size 20.we did our cemented total hip replacement through posterior approach (moore ) of hip and follow up was done at 4 ,6, 8 weeks and thereafter every 3 months. pre and post operative radiological and functional outcome has been compared. Results: In this study 18 patients (90%) had excellent results while 1 (5%) had good functional outcome and 1(5%) had poor outcome after cemented total hip replacement in osteonecrosis of femoral head. Conclusion: The mean HHS and number of patients with good to excellent result in our study..
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Background: Ten (10) cases of old fracture neck femur were treated by internal fixation and posterior muscle pedicle bone grafting of quadratus femoris and quadrate tubercle bone block. Methods: The treatment periodwere from January 2017 - June 2018 (approx18 months) at Burdwan Medical College Hospital. We did this procedure by open reduction and internal fixation by cannulated hip screws and muscle pedicle bone grafting. Follow up period was 1 to 1.5 years (average 14 months). Results: Evaluation parameter were union, non union collapse of neck, osteonecrosis of femoral head, pain, range of movement and functional activities and over all satisfaction of patient. The results of fracture healing rate was good (7), fair (2) and poor (1). The technique is simple, rewarding and easy access of fixation and muscle pedicle bone grafting. Conclusion: Bone graft was placed by making a gutter at fracture site and maintained by a screw or prolin suture.
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Background: This prospective study was done to evaluate the effectiveness of implants i.e., anatomical precontoured plate in treatment of displaced midshaft clavicular fractures. Methods: Thirty patients between 18 and 60 years of age wereincluded in this study. They were treated by fixation with anatomically precontoured plate and functional outcome was assessed.Clinical and radiological assessments were performed at regular intervals. Outcomes and complications of over 1.5 year of follow-up time were compared. Results: Range of motion was well maintained in all the patients. Constant score was excellent in 26 patients(87%) good in 2 patients(6.5%) and fair in 2 patients(6.5%).No patients had a poor result on constant scoring. The mean time to union was 5.8 months. Conclusion: In this prospective cohort study, primary open reduction and internal plate fixation of acute displaced midshaft clavicular fractures resulted in improved outcomes and a decreased rate of nonunion and symptomatic malunion.
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Background: ISpondylolisthesis is defined as anterior or posterior slipping of one segment of the spine on the next lower segment. The mainstay of surgical treatment for adult patients with low-grade acquired spondylolytic spondylolisthesis is fusion, with or without decompression. Objectives: To study the safety, efficacy and functional outcome of surgical management of lumbo-sacral spondylolisthesis with pedicle screw fixation, and free bone grafting, and its associated complications. Methods: 10 adult patients with lumbosacral spondylolisthesis treated by instrumented posterior spinal fusion with free iliac chips bone graft and their followup with functional and radiological parameters. Results: Following operation 5 patients(50%) having excellent results & 2 patients(20%) have good results. Conclusion:Instrumented posterior fusion with free graft is a good option for symptomatic lumbosacral spondylolisthesis and also has added advantages of correction of olisthesis, three column stabilization and early mobilization.
ABSTRACT
Background: Osteoarthritis is now considered to be primarily a disease of cartilage in which intrinsic biomechanical and mechanical alterations lead to its breakdown. Increasing failure of conservative treatment lead surgeons to explore the operative arena. High Tibial Osteotomy (HTO) is a satisfactory surgical method in knees with unicompartmental osteoarthritis and angular deformity. Objectives: To manage medial uni-compartment osteoarthritis of knee with medial open wedge or lateral closing wedge osteotomy and to compare between the two. Methods: HTO of 20 adult patients with medial compartment osteoarthritis or medial bicompartment osteoarthritis with genu varum deformity and their followup with functional and radiological parameters. Results: Following operation 12 patients having excellent results & 8 patients (40%) having good results. 19(95%) patients were satisfied. Conclusion: There is no significant statistical difference between the patients undergoing medial open wedge and lateral close wedge high tibial osteotomy except for medial joint space. Medial Open Wedge is technically easy with fewer risks, hence preferred over lateral close wedge.
ABSTRACT
Although sepsis is a major cause of morbidity and mortality among newborns in resource-poor countries, little data are available from rural areas on culture-proven sepsis. The aim of the present study was to provide information in this regard. The study reports results on the incidence and aetiology of neonatal sepsis cases admitted to a facility in a rural area in eastern India. Blood culture was done for all babies, with suspected clinical sepsis, who were admitted to the sick newborn care unit at Suri where the study was conducted during March 2009–August 2010. A standard form was used for collecting clinical and demographic data. In total, 216 neonatal blood culture samples were processed, of which 100 (46.3%) grew potential pathogens. Gram-negative infection was predominant (58/100 cases) mainly caused by enteric Gram-negative bacteria. Klebsiella pneumoniae was the most common Gram-negative isolate. The emergence of fungal infection was observed, with 40% of the infection caused by yeast. Gram-negative organisms exhibited 100% resistance to ampicillin, cefotaxime, and gentamicin. Amikacin and co-trimoxazole showed 95% (n=57) resistance, and ciprofloxacin showed 83.3% (n=50) resistance among the Gram-negative bacteria. Carbapenem showed emerging resistance (n=4; 6.6%). Results of analysis of risk factors showed an extremely significant association between gestation and sepsis and gender and sepsis. Gastrointestinal symptoms were highly specific for fungal infections. One-third of babies (n=29), who developed culture-positive sepsis, died. Blood culture is an investigation which is frequently unavailable in rural India. As a result, empirical antibiotic therapy is commonly used. The present study attempted to provide data for evidence-based antibiotic therapy given to sick newborns in such rural units. The results suggest that there is a high rate of antibiotic resistance in rural India. Urgent steps need to be taken to combat this resistance.
ABSTRACT
A pilot study was undertaken to develop a feasible neonatal screening strategy for hemoglobinopathies. Isoelectric focusing using dried blood spots samples as a primary screening technique was standardized for the first time in India. The screened positives were confirmed by high performance liquid chromatography followed by parental screening, confirmation, and education.