Surgical Site Infection Following Fixation of Acetabular Fractures / 대한고관절학회지

PURPOSE: Acetabular fractures are mainly caused by high energy trauma. Surgical fixation of these fractures requires extensive surgical exposure which increases the length of operation and blood loss as well. This may increase the risk of surgical site infection. Our aim is to evaluate the prevalence of surgical site infections and the risk factors associated with it so as to minimize its chances. MATERIALS AND METHODS: A total of 261 patients who underwent acetabular fracture surgery were retrospectively reviewed. Patients were divided into 2 groups, with or without surgical site infection. Factors examined include patients' gender, age, body mass index (BMI), time between injury and surgery, operative time, estimated blood loss, number of packed red blood cell transfused, length of total intensive care unit (ICU) stay, fracture type, surgical approach, smoking status, patients' comorbids and associated injuries. RESULTS: Fourteen patients (5.4%) developed surgical site infection. Out of 14 infections, 4 were superficial and 10 were deep. The factors that were found to be associated with surgical site infection following acetabular fracture fixation were prolonged operation time, increased BMI, prolonged ICU stay, larger amount of packed red blood cell transfused and associated genitourinary and abdominal trauma. CONCLUSION: In our study, we conclude that measures should be undertaken to attenuate the chances of surgical site infection in this major surgery by considering the risk factors significantly associated with it.

Fucntional and Radiological Outcome of Surgical Management of Acetabular Fractures in Tertiary Care Hospital / 대한고관절학회지

PURPOSE: Acetabular fractures are mainly caused by trauma and the incidence is rising in developing countries. Initially these fractures were managed conservatively, due to lack of specialized and dedicated acetabulum surgery centres. Our aim is to study the radiological and functional outcomes of surgical management of acetabular fractures in tertiary care hospital. MATERIALS AND METHODS: Total 50 patients were enrolled. The patients with acetabular fractures were enrolled between the years 2012 to 2014. Patients were evaluated clinically with Harris hip score (HHS) and radiologically with Matta outcome grading. The factors examined include age, gender, fracture pattern, time between injury and surgery, initial displacement and quality of reduction on the final outcome. RESULTS: There were 34 males and 16 females. Mean age was 44.20±11.65 years while mean duration of stay was 9.28±2.36 days. Duration of follow-up was 24 months. Most common mechanism of injury was motor vehicle accident (n=37, 74.0%). Open reduction and internal fixation of fractures were performed using reconstruction plates. Mean HHS at 24 months was 82.36±8.55. The clinical outcome was acceptable (excellent or good) in 35 (70.0%) cases and not acceptable (fair or poor) in 15 (30.0%) cases. The radiological outcome was anatomical in 39 (78.0%) cases, congruent in 5 (10.0%) cases, incongruent in 6 (12.0%) cases. CONCLUSION: Study results indicated that mechanism of injury, time between injury and surgery, initial degree of displacement and quality of reduction had significant effect on functional as well as radiological outcome.

Frequency of subclinical hypothyroidism in patients with proliferative diabetic retinopathy

To determine the frequency of subclinical hypothyroidism in patients with proliferative diabetic retinopathy. Cross Sectional Study. This study was conducted in Dow University Hospital, Dow University of Health Sciences, Karachi from 1[st] January 2012 to 31[st] December 2012. One hundred and nineteen patients attending the medicalOPD Dow University of Health Sciences were included in study. 119 patients were enrolled in study .47.1% were male and 52.9% were female patients mean age was 55.75 +/- 7.85 years, Mean HbA1[c] value was 8.02 +/- 1.46%, Subclinical hypothyroidism was identified in 26.9% the patients. Subclinical hypothyroidism is associated with the development of proliferative diabetic retinopathy in the patients suffering from type 2 diabetics

Trend of Poisoning in Muzaffarabad [AJK]

Objective: The objective of this study is to determine the trend of poisoning in Muzaffarabad AJK. Study Design: Retrospective study. Place and Duration of Study: This study was conducted at combined Military Hospital [CMH] Muzaffarabad [AJK] during the period of 1'' January 2009 to 31" December 2010. Material and Methods: One hundred and forty cases of poisoning was brought in hospital. Information regarding Age, Gender, demography, manner, time of occurrence, and patient outcome was confirmed fiom hospital records and collected data was analyzed. Results: There were 98 female and 42 mate victims involved in this study and maximum cases belong to second and third decade of life [23.57% and 48.57% respectively. Most common manner of poisoning was suicidal 1 attempts. Most incidences of poisoning occur in month of June and an organophosphorous compounds was leading cause of poisoning followed by Benzodiazepines. Conclusion: Organophosphorous compounds are the major chemical agents which pose a health threat particularly to young people

Risk factors for multi-drug resistant tuberculosis in patients at tertiary care Hospital, Peshawar

To determine the frequency of common risk factors for multi-drug resistant tuberculosis in patients presented at a tertiary care hospital, Peshawar. Cross-sectional, observational study. Pulmonology Department, Khyber Teaching Hospital, Peshawar, from December 2006 to October 2007. Patients with positive AFB culture and sensitivity results and found resistant to both rifampicin and isoniazid with or with resistance to other first line anti-tuberculosis drugs, were recruited from both Pulmonology Ward and Outpatient Department [OPD]. Informed verbal consent was taken and a questionnaire administered to all participants of the study. Information regarding demographics, education status, occupation, monthly household income, AFB C/S, details of past history of tuberculosis and family history of TB or Multi-Drug Resistant [MDR-TB] was recorded. Data was analyzed on SPSS version 11. A total of 30 patients of MDR-TB were interviewed. Male [n=17] and female [n=13] ratio was 1.3:1. Mean age was 34.2 +/- 15.3 years. Ninety-two percent female and 52.9% male were uneducated. In 56.7%, monthly income was less than 5000 rupees and in 40% between 5000-10,000 rupees. All patients had previous history of Antituberculous Treatment [ATT], in which 20% had undertaken ATT course once, 53.3% twice and 26.7% thrice in the past. In the study group, 13 [43.3%] patients had not completed their first ATT course and 11 of them were receiving ATT from a general practitioner [GP] at that time. Seven [23.3%] patients had family history of TB but no one had documented MDR-TB in the family. Resistance to RH was present in all patients; moreover, 56.7% had resistance to RHEZ+S. The most common factors in the study group were previous history of tuberculosis, repeated courses of ATT, prescribed by different clinicians and unsupervised treatment by a GP during the initial course of ATT