Pattern of serum vitamin D in OPD patients

To find out the prevalence of Vitamin-D deficiency in conditions other than osteomalcia and rickets in our part of the world. Prospective and observational study from Feb. 2005 to Dec. 2006. Multi-centric including Civil Hospital and Abbasi Shaheed Hospital, Karachi. Only those patients were included who had any structural or biochemical changes in the body. Serum Vitamin-D level of all patients was sent for estimation from a single reputable laboratory, apart from serum calcium, phosphorus, alkaline phosphatase and routine blood investigations. All data was collected and processed on SPSS Version 10. Of the total 79 patients, 58[73%] were females and 21[27%] males. Minimum age was one year and maximum 90 years, with a mean age of 41.91 and standard deviation of 19.1. Majority of the patients were seen in the 4th, 5th and 6th decades of life, and most of them were house wives. The serum Vitamin-D level was found low in 73[92%] patients and the most severe form of deficiency was seen in patients with tuberculosis. Vitamin-D deficiency was seen in 92% of our patients, belonging to all age groups and suffering from different diseases

Intelocking versus kuntscher nails in the management of femoral shaft fractures

To compare the outcome of Femoral shaft fractures managed with Interlocking and Kuntscher intramedullary nails, in terms of healing time, full weight bearing and post-operative complications. Prospective, quasi-experimental study from March 1999 to May 2002. Orthopaedics Unit I, Civil Hospital, Karachi. A total of 200 cases of Femoral shall fractures. Half [100] the cases of Femoral shaft fractures were treated with Kuntscher intramedullary nails and the other half [100] with Interlocking nails, the cases being assigned randomly. The detailed data of the patients was recorded, computed and analyzed using Chi-square test and Students t-test. The main parameters compared included fracture healing time, full weight bearing time and post-operative complications. There was no significant difference between the two groups in terms of demographic data, fracture type and associated co-morbidities. The average operating time was 110 +/- 25 minutes for the Interlocking nail and 80 +/- 15.8 mins for the K-nail. All patients of K-nail group needed blood transfusion, while only 17 patients of interlocking group needed blood transfusion. The fill weight bearing time was significantly shorter [p < 0.005] in cases of Interlocking nail. Out of 200 fractures 182 [91%] healed with in six months while 18 [9%] did not. The latter included 6 [3%] cases treated with Interlocking nails and 12 [6%] with Kuntscher nails, p < 0.005. Interlocking intramedullary nailing is better than Kuntscher nailing in every respect

Evaluation of limb salvage surgery in osteosarcoma

19 cases of osteosarcoma of stage 1113 were treated at Orthopaedic department, Lyari General Hospital and Civil Hospital, Karachi. The Neo adjuvant and adjuvant therapy were done by the different techniques i.e. custom made prosthesis, free fibular graft, fibular centraliziation, segment transportation, or tumor excision and Rotation plasty. There were 17 males and 2 females. Ranged from 10 years to 25 years, mean age was 18 years. The follow up period was from 13 months to 75 months and the mean period was 27 months. One case was lost to follow up. In the end of study there were 11 cases [61.11%] disease free survival, 3 [16.67%] survival with disease and 4[22.2%] died due to tumor. The disease free cases had mean 42.5 months of survival. It was concluded that males were 8 times more affected than the females. It was further observed that the treatment of choice for osteosarcoma is limb salvage. It was further observed that the limb salvage surgery along with pre operative chemotherapy, radiotherapy and postoperative chemotherapy has revolutionized the treatment out come of osteosarcoma. This treatment is more effective in terms of functional, cosmetic and emotional outcome