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How to Teach Professionalism in a Clinical Context?

2022-02-09T05:04:28Z

Title: How to Teach Professionalism in a Clinical Context? Authors: Badshah, Aliena; Mahboob, Usman; Yousaf, Adnan

To Evaluate Results of Operative Management of Tibial Plateau Fractures

2020-01-20T10:29:19Z

Title: To Evaluate Results of Operative Management of Tibial Plateau Fractures Authors: Haq, Shaikh Naeem-ul; Adil, Syed Salman; Askari, Raza Abstract: OBJECTIVE: To evaluate the result of open reduction and internal fixation in tibial plateau fractures in accordance with Rasmussen’s criteria of knee pain, range of motion and stability. METHODS: Ninety two patients of tibial plateau fractures of either sex between 20-60 years of age participated in this study. We used open reduction and internal fixation in patients depending on Schatzker’s tibial plateau fractures classification. This study was conducted during June 2014 to June 2015 at Dow University Hospital (DUH), Civil Hospital Karachi (CHK), Baqai Medical University Hospital (BMUH), Jinnah Post Graduate Medical Center (JPMC). Patients were followed for 6 months and outcome was compared with objective Rasmussen’s criteria. RESULTS: The results were established upon the type of fractures. Majority of the satisfactory results were in type-I, II, III and IV; however type-V and VI showed grave and poorer results. Overall range of motion of knee joint was more promising in type I, II, III and IV as compared to Type-V and VI. The results also depended upon the type of fracture. CONCLUSION: Fractures of tibial plateau are affliction of a major weight bearing joint. In case the fracture is displaced with joint instability, treatment by open reduction and internal fixation with appropriate fixation devices is the treatment of choice. However, early knee range of motion exercises, quadriceps rehabilitation and delayed weight bearing are mandatory for a good final outcome.

Dual Plating Osteosynthesis Technique used for Fixation of Inter - Condylar Distal Humerus Fractures via Transolecranon Approach

2020-01-20T10:24:55Z

Title: Dual Plating Osteosynthesis Technique used for Fixation of Inter - Condylar Distal Humerus Fractures via Transolecranon Approach Authors: Kumar, Jagdesh; Katto, Muhammad Soughat; Ahmed, Malik Wasim; Jamil, Muhammad; Rajput, Irfan Muhammad; Siddiqui, Adeel Ahmed; Khani, Ghulam Mustafa Kiam; Pirwani, Mehtab Ahmed Abstract: INTRODUCTION: The dual plate osteosynthesis technique for fixation of inter-condylar distal humerus fracture is now considered an accepted treatment modality. It provides a rigid fixation of fracture fragments to enable early post-operative mobilization for good outcome. OBJECTIVE: The purpose of study is to assess the morbidity and clinico-radiological outcome of the dual plating osteosynthesis technique used for fixation of inter-condylar distal humerus fractures (DHF) via trans-olecranon approach METHODOLOGY: This perspective cross sectional study was carried at Department of Orthopaedic Surgery, Dow Medical College / Civil Hospital Karachi from June 2014 to March 2016. A total of 21adult patients with comminuted inter-condylar fracture of the distal humerus operated with dual plating osteosynthesis technique via trans-olecranon approach were evaluated clinically and radiologically for functional outcome based on Jupiter criteria including alignment and fracture union after a mean follow-up of 8 months. Post surgical complications were noted. Fractures were classified according to Muller et al (AO). Patients with polytrauma, pathological fracture, open fracture and a fracture more than 2 week old were excluded from the study. RESULTS: Out of the 21 patients, 38% were female and 62% were male. 52.3% had left elbow while 47.6% had right elbow involvement. The mean age was 31 years (range 20 - 50 years). Mean time between injury and internal fixation was 4.8 days. The mean follow-up period was 8 months. As per AO classification, 10 cases were C1, 7 cases C2 while 4 cases were in C3. The most common cause of fracture was road traffic accident in 13 cases. All fractures achieved anatomical restoration of articular surface and were united in average 14.6 weeks. The clinical results were evaluated for functional outcome based on Jupiter criteria. According to that criterion, satisfactory results were obtained in all patients. We had no instance of postoperative deep infection and neurological complications, only Backing of olecranon K-wires were noted in 5 patients (23.8%). CONCLUSIONS: We conclude that dual plate osteosynthesis technique is an effective procedure for fixation of inter-condylar distal humerus fracture, achieves rigid fixation and hence, early mobilization. Additionally use of olecranon osteotomy offers best fracture exposure of distal humerus. Complications were minimal and healing satisfactory.

Frequency of Betel nut Addiction in Pregnant Anaemic Women and its impact on fetal outcome

2020-01-20T10:15:36Z

Title: Frequency of Betel nut Addiction in Pregnant Anaemic Women and its impact on fetal outcome Authors: Khursheed, Farkhunda; Madhudas, Chandra Abstract: OBJECTIVE: To determine the frequency of betel nut addiction in pregnant anaemic women and to find out its association with adverse pregnancy outcome. METHODOLOGY: This observational study was conducted in the department of Obstetrics & Gynaecology unit 2 at Liaquat University of Medical & Health Sciences Jamshoro from January to June 2015. All the pregnant women admitted in ward or labour room for delivery with Hb% < 11gm/dl during the study period were included. Those having history of antepartum haemorrhage, preeclampsia, eclampsia, chorioamnionitis or any medical disorder except anaemia were excluded. The frequency of betel nut consumption was calculated. The frequency of addiction in different age groups, parity and population (rural/urban) was determined. The association of addiction with severity of anaemia and adverse fetal outcome (perinatal deaths, low birth weight infants, preterm deliveries) was also determined. RESULTS: A total of 1700 women were included. Out of these, 1120 women (65.88%) were found having history of betel nut consumption. The frequency of addiction was highest in the age group of 25-35 (69.83%), para 2-5 (68.17%) and in women belonged from rural area (77.49%). History of addiction was found in 66.15% (n = 260) cases of fetal death, 71% (n = 169) cases of low birth weight infants and 68.59% (n = 121) cases of preterm deliveries. CONCLUSION: It is concluded that betel nut consumption among pregnant women is very high in our community. It is also determined that these products are positively associated with adverse pregnancy outcome.