Insertion of intrauterine contraceptive device [IUCD] at caesarean section after the delivery of placenta: an experience with 60 cases

To access the safety of Intrauterine Contraceptive Device [IUCD] insertion at Caesarean section after placental delivery. Observational analytical study of cohort type. Department of Obstetrics and Gynecology, Bolan Medical Complex Hospital, Quetta, from September 2009 to August 2010. This prospective study was conducted in the department of Obstetrics and Gynecology Quetta from September 2009 to August 2010. Sixty patients who had IUCD inserted at cesarean section were studied and followed for six months. The age ranges from 20-45years. Detailed history of each patient was recorded and thorough physical examination was performed. Patients with findings of any medical disorder were excluded. All analysis and computation including data base were done by SPSS 10. During the study period, a total of sixty women who had IUCD inserted at cesarean section were observed. All the cases were within age group ranging from 20-45 years of age. Out of them 53.3% were between 20 - 30 years, 28% between 31 -40 years, 18.3% belongs to 41-45 years of age. The events that were analyzed during the puerperium were pain, bleeding, infection and expulsion. Considering the postoperative complications, pain was the main complication during the puerperium and it occured in 54% of patients. Endometritis were occurring in 25% of cases and heavy lochia in 21% of cases. The expulsion rate was 8.3%. Women undergoing Cesarean section, who are suitable for using this method, should be given the option of IUCD insertion at the same time

Wide resection and arthrodesis of knee using fibular graft in aggressive giant cell tumor of distal femur

This prospective study was conducted to evaluate the outcome of resection and massive allograft arthodesis in the management of aggressive giant cell tumor of distal femur. 10 Patients with mean age 37.8 years [30-46] with Giant cell tumor, Enneking stage-Ill of distal femur were treated by wide resection and reconstruction allograft arthodesis using free fibular graft and fixed with suitable hardware from July 1999 to 2008. There were 6 female patients and 4 male. Follow up period ranged from 30 to 65 months with an average of 45.3 months. At the final follow up, functional score ranged from 18-27 out of a total of 30. Average was 80.4%, range 66-90%. At the end of follow up all the patients were alive and disease free. All the patients achieved union. The mean union time was 16.4, ranged 14-20 weeks. Two patients had fall and fractured the graft. We had to do revision and additional cancellous grafting. Later on healed full union was achieved. One patient developed superficial wound infection which was treated with systemic antibiotics. In selected patients of giant cell tumor of distal femur, resection arthodesis of knee using fibular graft is an effective reconstructive method. It offers biological reconstruction alternative to amputation in selected patients where mobile joint reconstruction can not be carried out

Wide subtalar release in congenital talipes Equino Varus deformity of foot

There is controversy regarding preferred operative procedure for correction of Congenital Talipes Equino Varus [CTEV]. Objective of this study was to determine the efficacy of wide subtalar release as described by Mackay in 1983 in children having CTEV. Twenty patients up to the ages of 3 with grade-Il, Ill congenital club foot were treated with this procedure; those having deformity secondary to diseases like CP, arthrogryposis multiplex congenital were excluded. Patients were followed for a minimum of one year after operation. Results were graded as per Frank and Hem criteria. Clinical and radiological evaluations were done and compared with other soft tissue procedures. 72.41% patients had satisfactory, 17.24% moderate and 10.34% poor results. Club foot surgery is instituted when well planned cast correction fails. Children up to the age of 3 years can be successfully treated with this method under skilled hands