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Introduction: The subtrochanteric fractures are one of thecommon fractures that every trauma surgeon come acrosson daily basis. The most of these fractures are treated eitherintramedullary device or a side plate. Among side plates, thechoice between the implants like DCS and DHS is variedamong the different surgeons. We made an analysis of resultsof Dynamic Condylar Screw with the aim to find out the useof that implant in selective fracture types.Material and Methods: A prospective study during 2014 to2015 was done in our institute. The study period is 1 year. Thepatients who opted for surgical treatment only were chosen.They were undergoing surgery under spinal anaesthesia, usingfracture table under image intensifier. The position of fracturereduction was checked in anterior posterior and lateral imageintensifier views. The post-operative assessment was doneat 3weeks, 6 weeks and 3months intervals with regard toradiological union and clinical outcomes. Data was analysedand expressed in terms of percentages.Result: the female to male ratio was 1:1.55. The average ageamong males is 58years and of females is 54 years. The rightside and left side were involved equally (n=28). Most of thepatients were injured by fall at home 39.2% (n=11), due toRTA 32.1% (n=9) and 28.5% (n=8) subjects were injureddue to self-inflicted road accidents. Limb shortening is mostcommon complication, which is there for 17.85% (n=5) ofpatientsConclusion: Dynamic Condylar Screw (DCS) provide goodfixation for subtrochanteric fractures with better results interms of stability and fracture union. Procedure has a fewercomplication rates if cases were selected carefully.
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Introduction: Supracondylar fractures of Humerus are one of the most common fractures in pediatric age group. The aim ofthe study was to evaluate the functional results in the management of supracondylar fracture of humerus in children by variousmethods.Materials and Methods: This study was conducted at the Orthopaedics department of Mahatma Gandhi MemorialHospital, Warangal. This was a 2 years prospective, longitudinal, hospital based, observational study and its outcomes.Participants were a total of 30 children aged 0 to 14 years (21 males, 9 females) diagnosed with supracondylar fractureof humerus.Results: Patients were assessed by Flynn’s criteria. Results were excellent in 70%, good in 20%, fair in 6.66%, and poor in 3.33%.Conclusion: Closed reduction and external immobilization are reserved for Gartland’s type 1 and select type 2 fractures. Inunstable type 2 and type 3, closed or open reduction and K-wire fixation give better results.
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Background: Tuberculosis (TB) continues to be one of the most devastating and widespread infections in the world. Of the 9 million annual tuberculosis cases, about 1 million (11%) occur in children (under 15 years of age). Childhood tuberculosis is a neglected aspect of the tuberculosis epidemic. The objective of the study was to screen the children who are household contacts of TB, HIV and TB -HIV patients and identify the children with the type of tuberculosis (Latent and symptomatic) and treat accordingly there by reducing the transmission of disease, as these children may become open cases in the future.Methods: All the registered cases of active TB, TB-HIV and HIV were traced out from district unit of RNTCP, PHC, CHC in and around Nellimarla town (10 kms radius). These patients were interviewed for medical history, treatment history, duration of treatment and degree and duration of house hold contacts (primarily children between 1 to 14 years.Results: Out of 160 registered patients 91 patients were diagnosed as having symptomatic TB infection and 69 were diagnosed having latent TB infection, with most of the affected children being in the age group of 1 to 5 years). Majority of the symptomatic patients (46.15%) were household contacts of TB- HIV patients and majority of children (40.57%) with latent TB Infection are direct household contacts of open cases of TB alone. Of the symptomatic TB infection 74.72% had pulmonary TB and 25.28% had extra pulmonary TB.Conclusions: Tubercular lymphadenopathy is the most common manifestation of extra pulmonary TB followed by tubercular meningitis and among the tubercular lymphadenopathy the cervical lymphnodes are most commonly involved.
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Background: Shivering is commonly encountered both after regional and general anaesthesia (GA) with a little higher incidence in patients receiving GA. The aim of study was to compare the effectiveness of dexmedetomidine and tramadol in decreasing postoperative shivering in patients undergoing laparoscopic surgery.Methods: Total 120 patients were included in this study. In order to get a 5% level of significance and 80% power number of patients required in each group was 40, with a total of 120 patients. Randomization of groups was done based on closed envelope method. Patients were allocated into three groups group I, II and III of 40 patients each. Patients in group I and group II were administered 0.75 μg/kg of dexmedetomidine and 1.5 mg /kg of tramadol in 100 ml NS respectively half a before extubation, while patients in group III did not receive any pharmacological intervention.Results: All three groups were comparable regarding distribution of age, gender, ASA grade and temperature at beginning and end of surgery and were non-significant.Conclusions: Dexmedetomidine seems to possess anti-shivering properties and was found to reduce the occurrence of shivering in patients undergoing general anaesthesia with minimal side effects although its anti-shivering effect was not superior to tramadol.
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Aim: To compare epidural 0.25% bupivacaine with 0.25% ropivacaine for post operative pain relief in cases of abdominal surgeries. Methods: 60 patients belonging to ASA physical status I & II of both sexes (each group 30 patients n=30) were randomly selected for the study. The sensory and motor block, analgesia, hemodynamic status, complications and need for rescue analgesia were compared in both the groups. Group B patients received 0.25% Bupivacaine as continuous epidural. Group R patients received 0.25% Ropivacaine as continuous epidural. Results: The sensory block was almost similar in both groups. No significant association is observed between the ASA class, age and sex of the groups (P>0.05). The difference in mean VAS between Bupivacaine and Ropivacaine was found to be statistically significant at 24 hours (P<0.05). Motor block was significantly more (17%) in group B than group R (3%) (P< 0.05). Haemodynamic changes did not differ in patients of either group (P >0.05). The rescue analgesia requirement were minimal in group R compared to group B. Complications were less in group R. Conclusion: Our study compared clinical efficacy of 0.25% Ropivacaine and 0.25%Bupivacaine in respect to analgesia, motor blockade, hemodynamic stability, requirement of rescue analgesia and complications. Sensory block and hemodynamic stability was comparable in the two groups. Ropivacaine group had significantly less motor block than Bupivacaine group.
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Introduction: The kidneys are the most common genitourinary organs injured from external trauma, whereas ureteric trauma is rare, accounting for less than 1% all urological trauma. ureteric injury from blunt trauma is extremely rare. Advances in radiographic staging, improvements in hemodynamic monitoring, validated renal and ureteric injury scoring systems, and essential details about the mechanisms of injury allow successful conservative management strategies for renal preservation. The main purpose of this study was to suggest that conservative management will suffice in high grade renal injury also, if the patient is hemodynamically stable, and it will increase the chance renal conservation, avoiding unnecessary nephrectomies. Aims and objectives: The main aim of this study was to evaluate and stage blunt upper urinary tract injury and also assess management outcomes in such patients. Materials and methods: All the patients with blunt upper urinary tract injury diagnosed radiologically from February 2017 to January 2019 were admitted and the injuries were graded by using American association for the surgery of trauma grading. Stable patients had conservative management and operative management for unstable patients. All the patients followed up for a min of 3-18 months with a median of 6 months. Results: In our study, out of total 43 cases, 3 (6.9%) cases required emergency intervention in view of hemodynamic instability. In these 3 cases 2 underwent total nephrectomy (both are grade V injuries) and one case required renorrhaphy (grade IV injury). In remaining 40 cases kept on conservative Ravi Jahagirdar, Ravi Chander, K. Kishore, K. Gopikanth, Rajesh Singh, Vinay Jahagirdar. Our experience with traumatic injuries of the upper urinary tract. IAIM, 2019; 6(11): 99-110. Page 100 management 2 cases required delayed intervention. One case required nephrectomy and the other one required partial nephrectomy. Conclusion: In Renal trauma of all the grades conservative management is a good option in hemodynamically stable patients whereas unstable patients need laparotomy. Conservative management enables us to save as much renal function as possible which should be our aim.
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The E.N.T. surgeon must not underestimate the importance of the knowledge of the orbit in management of nasal and paranasal pathology. A sound knowledge of its anatomy and of the pathology of the conditions which may themselves have intruded into it is of paramount importance to allay any anxiety that the surgeon may face while operating the vicinity of the orbit or entering it deliberately. A brief review of the anatomy of the orbit is discussed and representative cases from among the multiple conditions that we at the al Nahdha Hospital have seen, are presented