Incidence Of Tibial Diaphyseal Fractures Among Patients Presenting With Motorcycle Accidents.

Background: To determine the frequency of tibial diaphyseal fractures among patients presenting with motorcycle accidents. It was a cross-Sectional Study, conducted at Department of Orthopaedic Surgery, Jinnah Postgraduate Medical Centre (JPMC), Karachi between May to December, 2020. Methods: All patients irrespective of gender, between ages 18-60 years who suffered from a motorcycle injury with a single bone involvement were eligible for the study. All patients who refused to take part in the study, had head injury, or had multiple fractures were excluded from the study. The data included patient's age, sex, associated bones involved and types of injury. The fractures were classified according to whether it was open or closed. Results: A total of 174 patients were included in the study with a mean±SD age of 43.7±12.4. Tibial diaphyseal fracture was found to be in 111 (63.8%) patients as shown. Duration of fracture, gender, side of fracture, type of fracture was done with respect to Tibial diaphyseal fracture among patients. Insignificant difference was noted in age group (p=0.346), duration of fracture (p=0.087), gender (p=0.672), and type of fracture (p=0.063) whereas significant difference was found in side of fracture (p=0.0001). Conclusion: We highlighted the importance of tibial diaphyseal fractures in middle aged men who use motorcycles as a means of transport in Karachi, Sindh which is a frequent finding among these patients. Efforts should be made at both the community and government levels to increase awareness regarding traffic rules and consequences of reckless driving.

Protective Effect of Grape (Vitis vinifera) Seed Powder and Zinc-Glycine Complex on Growth Traits and Gut Health of Broilers Following Eimeria tenella Challenge.

The current study was conducted to evaluate the impact of grape (Vitis vinifera) seed powder and zinc-glycine complex on growth parameters and cecal health of broiler following Eimeria tenella challenge. A total of 250 day-old male broilers (Hubbard) were distributed into five treatments as follows: I-negative control (basal diet); II-positive control (E. tenella challenge); III-group infected + Amprolium; IV-group coccidial infection + organic zinc (OZ) at 50 ppm + grape seed powder (GSP) at 2.5 g/kg; V-coccidial infection + organic zinc (OZ) at 50 ppm + grape seed powder (GSP) at 5.0 g/kg. From findings, a lower (p < 0.05) feed intake was noted for positive control compared to the other treatment groups. Conversely, higher (p < 0.05) body weight, dressing percentage, and feed conversion ratio were observed in infected + Amprolium, GSP2.5 + OZ50, and GSP5 + OZ50 treatments in comparison to the positive control. Moreover, the positive control showed severe cecal lesions of thickness and hemorrhages with mild congestion. The lesion scores decreased (p < 0.05) in GSP and OZ treated groups compared to the positive control. Significant (p < 0.05) lower oocyst per gram of feces was found in infected + Amprolium, GSP2.5 + OZ50, and GSP5 + OZ50 in comparison to positive control. Supplementing diet with GSP and OZ at both levels showed restoration of intense sloughing of villi. From the present findings, it can be concluded that OZ and grape seed powder positively ameliorated the growth performance, lesion score, and oocysts shedding in broilers infected with E. tenella.

Treatment of Osteoarthritis of the Knee with Bracing: A Scoping Review.

Knee osteoarthritis is a leading cause of disability around the world. Knee bracing provides a conservative management option for symptom relief. A variety of different bracing types, manufacturers and products are currently available on the market. The goal of this study is to examine the current state of the literature regarding the treatment of knee osteoarthritis with unloader bracing, specifically examining the representation of specific brace types, manufacturers and models within the literature. A scoping review technique was used because of its ability to evaluate research activity within an area of study and identify gaps within the literature. A thorough search of the MEDLINE database was conducted for articles where a knee brace model was identified, and we identified characteristics of the studies to evaluate important information about the body of literature related to knee bracing for the treatment of osteoarthritis. Fifty eligible studies were identified. The majority of studies have been published in the United States, and a large increase in the number of publications in this field was seen between 2010-2014. The most prominent study type was prospective comparative studies (44%), however there is a lack of randomized controlled trials (6%) within the literature. The most prominent hinge type within the literature is the dual hinge push brace, followed by the single hinge pull. While a large increase in the number of studies evaluating the treatment of knee osteoarthritis with bracing has occurred in the past 5 years, there is a lack of high quality studies evaluating the efficacy of the technique, as well as a lack of studies comparing bracing types and models.

"The role and ability of orthopaedic postgraduate resident's clubfoot treatment with ponseti's methodology." A comparative study of resident's versus consultant's directed treatment.

OBJECTIVE: To evaluate the outcome of Ponseti treatment carried out by the Postgraduate Orthopaedic Trainees compared with the treatment given by their Mentors. METHODS: The prospective comparative case series study was conducted at Jinnah Postgraduate Medical Centre, Karachi, and comprised idiopathic Congenital Clubfoot Deformity patients treated from September 2012 to December 2013. Also included were a few cases treated between September 2006 and September 2012, who had complete record, serial photograph and updated follow-up. The patients were divided into two groups. Those treated by residents formed Group A and those by consultants were in Group B. The follow-up duration ranged from 06 months to 05 years. Outcome measures included the number of casts required to achieve correction with Pirani score 0.5, the rate of Per-Cutaneous Achilles Tenotomy (PCAT), the rate of early relapse and treatment and failure to maintain correction. SPSS 13 was used for statistical analysis. RESULTS: Of the 172 patients in the study, 111(64.5%) patients with 185 feet were treated by the residents, while 61(35.5%) patients with 96 feet were treated by consultant. The overall mean age was 25.8±32.88 weeks (range: 1-156 weeks). The difference in age between the two groups was significant (p=0.01). A total of 166(96.51%) patients were on maintenance phase in Foot Abduction Bracing and 6(3.48%) completed the treatment successfully without residual deformity. The median number of cast per patient given by Group A was 6 and 5 in Group B. The number of 8+ casts given in Group A were 46 (24.86%) and 17 (17.7%) in Group B. Tenotomies performed in Group A were 106 (57.27%) and 70 (73%) in Group B, and overall PCAT performed were 183 (65.12%). The overall success rate was nearly similar between the two groups, with the difference of<1%. CONCLUSIONS: The best practice to achieve excellent to good results from the beginners in Ponseti technique is to provide mentorship training for the skill of Ponseti manipulation, application of cast and continued treatment.