Evaluation of albumin, fibrinogen levels with orthopedics traumatic patients' outcome after massive transfusion in tertiary care hospital at Peshawar

Objective: Objective of study was assessment of fibrinogen and albumin levels association with orthopedics traumatic patients' outcome who received massive transfusion

Study Design: Observational / cross sectional study

Place and Duration of Study: This study was carried out at orthopedic department of a tertiary care Hospital, Peshawar from March 2014 to July 2015

Materials and Methods: In all patients, the initial resuscitation was performed as soon as admitted to the emergency room. Blood samples were obtained at admission and after 24 h. Part of the serum was frozen and stored at -70°C for determination of fibrinogen and albumin by an immunoturbidometric assay. Electrolytes, hemoglobin, and hematocrit levels were measured on admission. For early restoration, normal saline or ringer was used, clinical events were recorded thereafter until death or hospital discharge

Result: We were studied forty six traumatic patients with severe limb injuries and result showed that 20 patient [41.3%] and 27 [58.7%] were alive

There was significant difference outcome observed in fibrinogen level after 24 h and in case of albumin levels, there was no significant difference observed

Conclusions: When orthopedics traumatic patients received massive transfusion, fibrinogen level play significant role in determination of these patients, while serum albumin is not important factor

Outcome of operative and non operative treatment of glenoid fossa fractures in a tertiary care hospital in Peshawar

This study was aimed at reviewing operative and nonoperative treatment of Glenoid fossa fractures in our hospital and view to identifying measures necessary to improve outcome. Retrospective study. This study was conducted at Orthopedic Department of Lady Reading Hospital, Peshawar from March 2012 to July 2014. 21 patients of glenoid fossa fractures were included in this series with 14 males and 7 females. Patients with displacement of >5 mm who were fit to undergo surgery within 3 weeks of injury were operated using a posterior Judet's approach. Overall 8 patients with displaced fractures were operated [Group A] while 9 patients with displaced fractures [Group B] and 4 patients with undisplaced fractures [Group C] were managed nonoperatively. The incidence of associated injuries was 57.14%. The mean length of hospital stay was 15.3, 32.5, and 3.9 days in groups A, B, and C, respectively. In group A, average constant score was 86.98. The least constant score was observed for group B [57.97] while group C had an average constant score of 85.9. Brachial plexus injury and fracture-dislocations had poorer outcome. Operative treatment for displaced glenoid fractures is a viable option at centers equipped to handle critically ill patients and subset of patients with fracture-dislocation as opposed to fracture alone should always be treated operatively due to persistent loss of function

Risk factors for renal dysfunction after total hip joint replacement in one territory care hospital in Peshawar

Objective: The objective of our study was to identify the possible risk factors for renal dysfunction after total hip joint replacement surgery

Study Design:Observational cohort study

Place and Duration of Study: This study was conducted in Orthopedic Department of Lady Reading Hospital, Peshawar from March 2013 to February 2014

Materials and Methods: A study was conducted among 212 consecutive primary hip joint replacements performed. According to the RIFLE criteria, increased postoperative serum creatinine was considered indicative ofpostoperative renalinjury

Results: Eighty-one patients [14.1 %] had significant moderate or severe postoperative renal dysfunction in which4 patients [1.9 %] acquired severe and permanent renalimpairment

Conclusion: We identified advanced age, hypertension, general anesthesia, high ASA scores, low intra-operative systolic BP, and prophylactic dicloxacillin as significant risk factors. Smoking, diabetes mellitus, high BMI, gender, and duration of surgery were not identified as significant risk factors

Outcome of Internal Fixation of Fractures in a Tertiary Care Hospital in Peshawar

Objective: This study was aimed at reviewing internal fixation in our hospital and attendant complications with a view to identifying measures necessary to improve outcome. Study Design: Retrospective study Place and Duration of Study: This study was conducted at orthopedic department of Lady Reading Hospital, Peshawar from March 20 12to February 20 14. Materials and Methods: The operation register was used to identify patients who had undergone internal fixation in the main theatre of the hospital over a Three-year period were collected and their case notes were subsequently retrieved from the medical records unit of the hospital. Data pertinent to study interests were extracted using a questionnaire Results: One hundred and fifteen patients had intemal fixation during the study period but case notes of only 100 patients could be retrieved. Most patients were males with male to female ratio of 2.3:l. The mean age of patients was 32.87 and 15.2 years and the mean duration of surgery was 20.56 hours. Plate and screws constituted the most commonly used implants. Interval between surgery and fracture union was increased by long operation time [> 2. lhrs] and occurrence of post operative complications. Conclusion: Improvement in operating facilities and choice of implants would reduce operation time and post operative complications thereby impacting positively on fracture union time