dynamic condylar screw: post-operative complications when used in distal femoral fracture among adults

Objective: To determine the post operative complications when distal femoral fractures in adults is fixed using dynamic condylar screw

Study design: Observational study

Place and duration of study: Study conducted in Orthopedics department, Dow OJHA Hospital and Civil Hospital Karachi, from July 2014 to December 2015

Methodology: Although patients' with simple and closed supracondylar fractures of the femur were treated by dynamic condylar screw system, however for this study inclusion criteria was patients having closed supracondylar fracture of the femur of either gender aged between 20 to 65 years and presented earlier. Follow up of all these patients was done. Data was analyzed by using SPSS statistical package version 20

Results: Out of 46 patients, 41[89.13%] patients were males and 5[10.86%] were females. Mean age of the patient in this study was 31.1+/-3.5 years. 33[71.73%] patients sustained injury following Road Traffic Accident [RTA], 7[15.21%] presented with history of assault and 6 [13.04%] patients sustained injury following fall. The post operative complications observed in this study was infection in 4[8.69%], shortening in 3[6.52%], deformities in 3[6.52%] cases, nonunion in 1[2.17%] case and implant failure in 2[4.34%] cases

Conclusion: Dynamic condylar screw may confidently be used in the management of supracondylar fractures. The procedure is technically manageable with minimum post operative complications

Throtoxic crisis and acute hepatitis: first and co-existent presentation of thyroid disease and hepatitis E viral infection

Thyroid crisis, also known as thyroid storm and thyrotoxic cns1s, is a life threateningcondition and usually results after sustained and poorly controlled thyrotoxicosis. It may bean- initial presentation in undiagnosed children or neonates.it carries a high mortality rate .We present a unique case of a young male with no previous diagnosed medical illness, who underwent an elective orthopedic operation but developed thyroid storm during operation along with acute hepatic injury with positive serology for HEV. He was treated in intensive care unit on treatment principles of both diseases along with mechanical ventilation and rest of the supportive management. The fortunate patient survived and his hepatic injury was recovered. The diagnosis of Grave's disease was confirmed after his recovery

Evaluation of diarrhea management of health professionals trained at the diarrhea training unit of Rawalpindi general hospital

To promote the use of oral rehydration therapy [ORT], a training programme was launched by The Pakistan National Programme for Control of Diarrhoeal Disease [CDD] by establishing the Diarrhoea Training Units [DTUs]. Physicians trained at DTU were designated to establish functioning oral rehydration therapy [ORT] corners at their health centres and train health workers in delivery of facilities on standard diarrhoea case management. The study was designed to evaluate the functioning of ORT corners three years after their establishment. The study revealed that ORT corners have failed to achieve the main objectives of DTU programme. Twenty-four out of 49 ORT corners were non-functional after three years of their establishment, mainly due to frequent transfers of trained staff. In 22 ORT corners evaluated, performance of health professionals was far from satisfactory, 19 out of 22 doctors were found to have inadequate performance in diarrhoea management and only 3 out of 7 LHVs performed adequately. LHVs could not consistently deliver health education messages to mothers. There seems to be a lack of interest and willingness to participate actively, as more than 50% of both doctors and LHVs did not consider ORT work as their job. We conclude that the ultimate objectives of improved and appropriate diarrhoea case management through ORT corners have not been achieved

Perception of mothers about pneumonia

57 randomly selected mothers were assessed for their perception about pneumonia by showing them children with severe pneumonia. The abnormal signs shown were recognised by all of them. Nearly 50% of them related these signs with 'pneumonia'. The results indicate that flaring alae nasi is the sign which mothers find most easy to spot