ABSTRACT
The Objective of this study is to assess the anatomical correction, cosmetic and functional outcome of the Ponseti method in idiopathic congenital Talipes Equino Varus [CTEV]. Experimental and case series study. The study was carried out in the Department of Orthopaedic Surgery and Traumatology [DOST] Liaquat University of Medical and Health Sciences Jamshoro for a period of two years from 21-01-2009 to 20-01-2011. This study was contains 50 cases of congenital talipes equino varus "CTEV". In this study all the case were selected with age of one year from the birth with congenital "talipes Equino Varus". All the cases with Acquired "Talipes Equino Varus", atypical foot, "talipes Equino Varus' with Arthrogryposis Multiplex Congenital, "talipes Equino Varus previously treated by method other than ponseti technique were excluded from the study. Total 50 cases of congenital Telipase Equine, Varus [CTEV] having 77 feet were analyzed in this study with [male female ratio 1:7]. Out of 50 cases, 27 [54.0%, n = 50] had bilateral [54 feet] deformities and 23 [46.0%, n = 50] cases were unilateral deformities. Severity was assessed according to Pirani Scoring system. 48 [62.0%] had severe foot deformity while 29[37.60%, n = 77] patients had moderate foot deformity. Out of 77 feet, rocker bottom foot deformity developed in 03[18%] feet, increased stiffness of ligaments and joints occurred in 1[1.2%, n 77] foot while vascular complications like skin ulceration and necrosis was observed in 1[1.2%, n =77] feet. At the end of 2 to 3 years follow-up period, in 72 [94.0%, n = 77] patients congenital clubfoot deformities were corrected successfully by using Ponseti method while 05 [6.0%, n = 77] patients were not fully corrected due to other complications. The Ponseti method is a fast, safe and effective treatment for congenital idiopathic clubfoot and radically decreases the need for extensive corrective surgery
ABSTRACT
To determine the validity of Alvarado score in diagnosing acute appendicitis keeping histopathology of appendix as gold standard. Cross sectional [Validation] study. Department of Surgery Combined Military Hospital Rawalpindi from April 2009 to October 2009. 90 patients with clinical suspicion/diagnosis of acute appendicitis were included in study. All were divided into two groups on the basis of Alvarado score. Group I with score 7-10, who underwent open appendicectomy. Group ll [a] with 5-6, who were observed in hospital. Group ll [b] with< 4 were discharged. In all operated cases appendix was sent for histopathology. Alvarado score was compared with histopathology [gold standard] Male to female ratio was 3.5 :1. Mean age was 25.34. Alvarado score had overall 88.13% sensitivity, 70.96% specificity, 85.24% PPV. 75.86% NPV and 16.90% negative appendicectomy rate. Whereas in male patients it had 90.74% sensitivity, 75% specificity, 92.45% PPV, 70.58%NPV and 6.89% negative appendicectomy rate. In female it had 60% sensitivity, 66.66% specificity, 37.5% PPV, 83.33%NPV and 38.46% negative appendicectomy rate. Alvarado score is very accurate for acute appendicitis in male patients. Patients with score 4 can safely be discharged home. USG should be performed routinely in female patients to improve the diagnostic accuracy of Alvarado score