Management of humeral fracture nonunion in severe osteoporosis by a combination of locking plating and intramedullary fibular grafting / 中华创伤杂志(英文版)

Nonunion of the humerus in a severely osteoporotic bone is a likely event especially if the fracture is transverse. The management of such a combination is a challenge. Most of the conventional fixation methods are unlikely to succeed as the bone failure precedes implant failure in osteoporosis. The challenge is further compounded in severe osteoporosis when the cortical thickness is affected more severely. We used a combination of an intramedullary fibula with a locking plate in 5 cases. The results show that it may be a good combination in such situations as the bone strength is augmented and the plate pullout is less likely.

Perceptions of medical students about educational environment at services institute of medical sciences, Lahore

Objective: the objective of this study was to assess the perceptions of undergraduate medical students of Services Institute of Medical Sciences [SIMS], using DRE EM questionnaire

Material and Methods: all students from the final year MBBS class of the medical college [n=150] were included in the study. The non-parametric chi-square test and Mann Whitney U Test were used to determine the significance of differences [proportion of frequencies] for individual items

Results: the total no of final year students of medical college were 150 with 135 respondents with 43% males and 57% females. DREEM score SIMS medical college in metropolitan city was 118.6 indicating a positive perception

Conclusion: DREEM is a valid instrument for the measurement of students' perceptions worldwide. The students of SIMS have positive perception about educational environment of the institute

Ossicular changes in chronic suppurative otitis media, atticoantral disease

Chronic suppurative otitis media is chronic inflammation of the middle ear characterized by ear discharge and hearing impairment. This hearing impairment is usually due to ossicular involvement and tympanic membrane perforation. The purpose of this study is to document the pattern of ossicular damage in chronic suppurative otitis media atticoantral type Sixty patients with chronic suppurative otitis media atticoantral type were selected and admitted in ENT-I Department. Ears were examined under microscope. Mastoid exploration was done in all cases. Per-operative ossicular chain status was noted. The sequence of damage to ossicles was documented and compared with other studies. Our conclusion was that in 57[95%] patients the ossicular chain was found damaged. Whole of the ossicular chain was involved in majority of the cases 25[42%]. Incus was the most vulnerable bone and was found necrosed in 20% isolated cases and in 46% along with other ossicles