Pub Date : 2019-10-31DOI: 10.17511/ijoso.2019.i04.01
Rajiv Kaul, Chander Mohan Singh, Kamparsh Thakur
Slipped Capital Femoral Epiphysis (SCFE) is a relatively common disease of adolescents with drastic consequences in adult life if managed inappropriately. A number of surgical techniques are described to reposition the proximal femoral epiphysis and are frequently associated with a high rate of femoral head osteonecrosis. The modified Dunn’s procedure has been shown to be safe and effective in treating unstable SCFE. The incidence of development of osteonecrosis is dramatically reduced by carefully preserving the posterior periosteal sleeve, thereby maintaining the vascularity to the head. We have performed this procedure in a 21-year-old male with bilateral, sequential, unstable SCFEs and achieved a satisfactory functional outcome at the end of one year.
{"title":"Treatment of unstable slipped capital femoral epiphysis with a modified Dunn’s procedure-a case report","authors":"Rajiv Kaul, Chander Mohan Singh, Kamparsh Thakur","doi":"10.17511/ijoso.2019.i04.01","DOIUrl":"https://doi.org/10.17511/ijoso.2019.i04.01","url":null,"abstract":"Slipped Capital Femoral Epiphysis (SCFE) is a relatively common disease of adolescents with drastic consequences in adult life if managed inappropriately. A number of surgical techniques are described to reposition the proximal femoral epiphysis and are frequently associated with a high rate of femoral head osteonecrosis. The modified Dunn’s procedure has been shown to be safe and effective in treating unstable SCFE. The incidence of development of osteonecrosis is dramatically reduced by carefully preserving the posterior periosteal sleeve, thereby maintaining the vascularity to the head. We have performed this procedure in a 21-year-old male with bilateral, sequential, unstable SCFEs and achieved a satisfactory functional outcome at the end of one year.","PeriodicalId":267909,"journal":{"name":"Surgical Update: International Journal of Surgery and Orthopedics","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131240638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-10-31DOI: 10.17511/ijoso.2019.i04.03
M. Reddy, Padmanabh Inamdar, Gogineni Mahesh
Background and Objectives: Local wound care is one of the mainstays in the management protocol for diabetic foot ulcers. Sucralfate and honey are inexpensive and easily available agents for local dressing. They are highly efficacious in achieving faster and better healing. Our study compares the effect of topical sucralfate with honey dressings in the management of diabetic foot ulcers. Methods: We conducted a prospective study on 50 patients of Diabetic foot ulcer admitted indoor and were evaluated clinically. Patients were divided into Group A (n=25) and Group B (n=25). Group A patients treated with topical application of Sucralfate and Group B patients were treated with topical honey. Wounds in both groups were inspected at the end of 7 days, 14 days and 21 days. Results in the two groups were compared and interpreted. Results: In our study, mean ulcer size was reduced in both the groups on day 7, day 14, and day21 (p>0.5). The percentage of reduction in mean ulcer size in Group A was 59.53% compared to 55.05% in Group B at the end of 21 days (p value > 0.05). Completely epithelized ulcers were 10 (40%) in Group A and 9 (36%) in Group B respectively. Complete epithelization of ulcer or ulcer bed ready for split skin grafting (primary end point of study) was 21.04 days in Group A and 23.20 days in Group B (P value < 0.05). Conclusion: Even though topical sucralfate and honey were both found to be effective in enhancing the wound healing process in diabetic foot ulcers, topical sucralfate was found to be better when compared to honey for local application.
背景与目的:局部伤口护理是糖尿病足溃疡治疗方案的主要内容之一。蔗糖酸盐和蜂蜜是便宜且容易获得的局部敷料。它们在实现更快和更好的愈合方面非常有效。我们的研究比较了局部硫糖钠与蜂蜜敷料在糖尿病足溃疡治疗中的作用。方法:对50例室内住院的糖尿病足溃疡患者进行前瞻性研究，并进行临床评价。患者分为A组(n=25)和B组(n=25)。A组患者局部应用硫酸氢钠，B组患者局部应用蜂蜜。两组分别于第7天、第14天和第21天结束时检查伤口。对两组结果进行比较和解释。结果:在我们的研究中，两组患者在第7天、第14天和第21天的平均溃疡大小均减小(p>0.5)。21 d时，A组溃疡平均缩小率为59.53%，B组为55.05% (p值> 0.05)。完全上皮溃疡A组10例(40%)，B组9例(36%)。A组溃疡或溃疡床上皮完全形成，可用于裂皮移植(主要研究终点)为21.04 d, B组为23.20 d (P值< 0.05)。结论:尽管局部应用硫糖钠和蜂蜜都能有效促进糖尿病足溃疡的伤口愈合过程，但与局部应用蜂蜜相比，局部应用硫糖钠效果更好。
{"title":"A comparative study of topical sucralfate versus honey dressing in the management of diabetic foot ulcer","authors":"M. Reddy, Padmanabh Inamdar, Gogineni Mahesh","doi":"10.17511/ijoso.2019.i04.03","DOIUrl":"https://doi.org/10.17511/ijoso.2019.i04.03","url":null,"abstract":"Background and Objectives: Local wound care is one of the mainstays in the management protocol for diabetic foot ulcers. Sucralfate and honey are inexpensive and easily available agents for local dressing. They are highly efficacious in achieving faster and better healing. Our study compares the effect of topical sucralfate with honey dressings in the management of diabetic foot ulcers. Methods: We conducted a prospective study on 50 patients of Diabetic foot ulcer admitted indoor and were evaluated clinically. Patients were divided into Group A (n=25) and Group B (n=25). Group A patients treated with topical application of Sucralfate and Group B patients were treated with topical honey. Wounds in both groups were inspected at the end of 7 days, 14 days and 21 days. Results in the two groups were compared and interpreted. Results: In our study, mean ulcer size was reduced in both the groups on day 7, day 14, and day21 (p>0.5). The percentage of reduction in mean ulcer size in Group A was 59.53% compared to 55.05% in Group B at the end of 21 days (p value > 0.05). Completely epithelized ulcers were 10 (40%) in Group A and 9 (36%) in Group B respectively. Complete epithelization of ulcer or ulcer bed ready for split skin grafting (primary end point of study) was 21.04 days in Group A and 23.20 days in Group B (P value < 0.05). Conclusion: Even though topical sucralfate and honey were both found to be effective in enhancing the wound healing process in diabetic foot ulcers, topical sucralfate was found to be better when compared to honey for local application.","PeriodicalId":267909,"journal":{"name":"Surgical Update: International Journal of Surgery and Orthopedics","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116250827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-10-31DOI: 10.17511/ijoso.2019.i04.04
A. Reddy, R. C. Reddy
Background: The dynamic hip screw is considered as the standard treatment for Intertrochanteric fracture. The procedure per se requires long term hospitalization and other complications. Researchers have proposed intramedullary nailing as an alternate procedure. The present study aims to compare the radiological and functional outcome following treatment of unstable intertrochanteric fractures with intramedullary nailing and dynamic hip screw and to compare Health-related quality of life between the two treatment methods. Methods: A prospective observational study was conducted during March 2014 to July 2016. Patients presenting with unstable Intertrochanteric fractures were recruited prospectively. The study was conducted in the department of orthopedics, Rajiv Gandhi Institute of medical sciences, Kadapa, which is a tertiary care teaching hospital. The participants were divided into two groups. Group, I constitute 25 patients who underwent DHS and Group II had 23 patients who underwent IHN. The mean age of Group DHS participants were 71.4 5.86 years, and group IMN participants were 69.7 6.13 years. The mean intraoperative bleeding of subjects in DHS group was325.24 67.32 (in ml) and it was 325.24 67.32 (in ml) in IMN group. Results: The mean time taken for the radiological union of subjects in DHS group was22.3 1.73 weeks, and it was 20.6 2.13 weeks in IMN group. Conclusions: The treatment of unstable Intertrochanteric fracture can be done in geriatric patients through surgical intervention without much morbidity and mortality. The postoperative quality of life returns to near normal at
背景:动力髋螺钉被认为是治疗转子间骨折的标准方法。手术本身需要长期住院治疗和其他并发症。研究人员建议髓内钉作为一种替代方法。本研究旨在比较髓内钉和动力髋螺钉治疗不稳定转子间骨折后的放射学和功能结果，并比较两种治疗方法的健康相关生活质量。方法:于2014年3月至2016年7月进行前瞻性观察研究。前瞻性地招募以不稳定转子间骨折为表现的患者。这项研究是在卡达帕拉吉夫·甘地医学研究所骨科进行的，这是一家三级保健教学医院。参与者被分成两组。组I有25例DHS患者，组II有23例IHN患者。DHS组参与者平均年龄为71.45.86岁，IMN组参与者平均年龄为69.76.13岁。DHS组患者术中平均出血量为325.2467.32 (in ml)， IMN组患者术中平均出血量为325.2467.32 (in ml)。结果:DHS组患者放射愈合平均时间为22.31.73周，IMN组平均时间为20.62.13周。结论:老年不稳定股骨粗隆间骨折可通过手术治疗，发病率和死亡率均不高。术后生活质量恢复到接近正常
{"title":"Comparison of functional outcome and quality of life following treatment of unstable intertrochanteric fractures with intramedullary nailing and dynamic hip screw","authors":"A. Reddy, R. C. Reddy","doi":"10.17511/ijoso.2019.i04.04","DOIUrl":"https://doi.org/10.17511/ijoso.2019.i04.04","url":null,"abstract":"Background: The dynamic hip screw is considered as the standard treatment for Intertrochanteric fracture. The procedure per se requires long term hospitalization and other complications. Researchers have proposed intramedullary nailing as an alternate procedure. The present study aims to compare the radiological and functional outcome following treatment of unstable intertrochanteric fractures with intramedullary nailing and dynamic hip screw and to compare Health-related quality of life between the two treatment methods. Methods: A prospective observational study was conducted during March 2014 to July 2016. Patients presenting with unstable Intertrochanteric fractures were recruited prospectively. The study was conducted in the department of orthopedics, Rajiv Gandhi Institute of medical sciences, Kadapa, which is a tertiary care teaching hospital. The participants were divided into two groups. Group, I constitute 25 patients who underwent DHS and Group II had 23 patients who underwent IHN. The mean age of Group DHS participants were 71.4 5.86 years, and group IMN participants were 69.7 6.13 years. The mean intraoperative bleeding of subjects in DHS group was325.24 67.32 (in ml) and it was 325.24 67.32 (in ml) in IMN group. Results: The mean time taken for the radiological union of subjects in DHS group was22.3 1.73 weeks, and it was 20.6 2.13 weeks in IMN group. Conclusions: The treatment of unstable Intertrochanteric fracture can be done in geriatric patients through surgical intervention without much morbidity and mortality. The postoperative quality of life returns to near normal at","PeriodicalId":267909,"journal":{"name":"Surgical Update: International Journal of Surgery and Orthopedics","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127954937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-10-31DOI: 10.17511/ijoso.2019.i04.08
Dr. Vijaiaboobbathi Sathiah, Dr. Karpagavel Chandrabose
Background: One of the most common endocrine disorder is the thyroid diseases. The prevalence and pattern of these conditions depends on sex, age, ethnic and geographic patterns. The incidence of thyroid nodules increases with the age hence benign and malignant thyroid disease is common in the elderly population. Aim: To compare the complication rate of various thyroid surgeries for benign and malignant diseases in a tertiary care teaching hospital. Methods: This study was a prospective observational study, Velammal medical college hospital at Tamil Nadu from December 2018-June 2019. The patients who underwent thyroid surgery for various thyroid disorders were enrolled in the study. Results: Out of117 cases, 107 were women and 10 were men. Multinodular goiter (MNG)was the most common (38.46%) condition, followed by solitary nodule (29.06%) and toxic MNG (18.8%). Among women, 40.19% were identified with multinodular goiter followed by solitary nodule (28.97%). Subtotal thyroidectomy was performed for 88.89% of MNGs, while 91.18% of the solitary nodule were managed by hemithyroidectomy Majority of the patients with toxic MNG underwent subtotal thyroidectomy with 99.91%. While 84.61% of the patients with thyroid cancer were treated by total thyroidectomy. The overall incidence of complications was 27.35%. The incidence rate of complications was high in patients with malignant disease, as compared to benign disease (69.23% in Malignant Vs 36.36% in toxic MNG and 24.44% in MNG). Conclusion: Through the present study, it was concluded that the complications associated with the different thyroid surgeries and various precautions that can be taken to reduce the complications.
{"title":"Profile and complication rate of thyroid surgeries performed in a tertiary care teaching hospital, a prospective observational study","authors":"Dr. Vijaiaboobbathi Sathiah, Dr. Karpagavel Chandrabose","doi":"10.17511/ijoso.2019.i04.08","DOIUrl":"https://doi.org/10.17511/ijoso.2019.i04.08","url":null,"abstract":"Background: One of the most common endocrine disorder is the thyroid diseases. The prevalence and pattern of these conditions depends on sex, age, ethnic and geographic patterns. The incidence of thyroid nodules increases with the age hence benign and malignant thyroid disease is common in the elderly population. Aim: To compare the complication rate of various thyroid surgeries for benign and malignant diseases in a tertiary care teaching hospital. Methods: This study was a prospective observational study, Velammal medical college hospital at Tamil Nadu from December 2018-June 2019. The patients who underwent thyroid surgery for various thyroid disorders were enrolled in the study. Results: Out of117 cases, 107 were women and 10 were men. Multinodular goiter (MNG)was the most common (38.46%) condition, followed by solitary nodule (29.06%) and toxic MNG (18.8%). Among women, 40.19% were identified with multinodular goiter followed by solitary nodule (28.97%). Subtotal thyroidectomy was performed for 88.89% of MNGs, while 91.18% of the solitary nodule were managed by hemithyroidectomy Majority of the patients with toxic MNG underwent subtotal thyroidectomy with 99.91%. While 84.61% of the patients with thyroid cancer were treated by total thyroidectomy. The overall incidence of complications was 27.35%. The incidence rate of complications was high in patients with malignant disease, as compared to benign disease (69.23% in Malignant Vs 36.36% in toxic MNG and 24.44% in MNG). Conclusion: Through the present study, it was concluded that the complications associated with the different thyroid surgeries and various precautions that can be taken to reduce the complications.","PeriodicalId":267909,"journal":{"name":"Surgical Update: International Journal of Surgery and Orthopedics","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132834485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-10-31DOI: 10.17511/ijoso.2019.i04.06
S. Prabhu, Consultant Paediatric Surgeon, G. Abraham, L. Nair
Background: Recurrent abdominal pain is one of the most common presenting complaints among school going children, with a prevalence of 10-12%. Most of the children with recurrent abdominal pain are not evaluated further, either due to the mild abdominal pain or transient nature of the symptoms. Recurrent abdominal pain requires complete evaluation to look for organic causes. However, in many cases, where no specific organic cause can be identified, a psychosomatic component has been shown to play a role. The aim of the study is to evaluate children with recurrent abdominal pain in the age group 2-12 years for a cause at a tertiary rural hospital, in an attempt to better understand this syndrome. Methods: Retrospectively collected data from 210 consecutive patients aged between 2-12 years from January 2015 to January 2017, who presented to Department of Surgery and Emergency department in MOSC Medical College with recurrent abdominal pain were studied. Data collection included demographic details, symptomatology and clinical details, and response to treatment. Each patient was thoroughly evaluated to identify an organic cause for the pain. All the patients were evaluated by the paediatrician for any underlying medical cause. Results: During the two-year period, 210 patients were evaluated and investigated, and an organic cause was detected in 44 patients, while 166 patients were diagnosed to have RAP. The 44 patients with an organic cause were treated for the primary condition and were asymptomatic on follow up. Investigations revealed that 20 patients suffered from acute appendicitis, 20 patients were diagnosed with habitual constipation Patients without an organic cause were reassured, counselled and treated symptomatically. All the patients were on follow up for the entire period of the study. Of the 166 patients diagnosed with RAP, 110 patients responded to symptomatic measures, while 21 patients were referred to child psychiatry and are on long term follow up. Conclusion: Recurrent abdominal pain is a significant cause of functional impairment in the life of a child. Thorough evaluation of the patient to rule out organic causes is vital. Majority of the children diagnosed with recurrent abdominal pain respond to counselling. Acknowledging the existence of the symptoms instead of dismissing it, and empathising with the child is often all that is required in the management of these patients
{"title":"Recurrent abdominal pain in school children in a rural tertiary hospital","authors":"S. Prabhu, Consultant Paediatric Surgeon, G. Abraham, L. Nair","doi":"10.17511/ijoso.2019.i04.06","DOIUrl":"https://doi.org/10.17511/ijoso.2019.i04.06","url":null,"abstract":"Background: Recurrent abdominal pain is one of the most common presenting complaints among school going children, with a prevalence of 10-12%. Most of the children with recurrent abdominal pain are not evaluated further, either due to the mild abdominal pain or transient nature of the symptoms. Recurrent abdominal pain requires complete evaluation to look for organic causes. However, in many cases, where no specific organic cause can be identified, a psychosomatic component has been shown to play a role. The aim of the study is to evaluate children with recurrent abdominal pain in the age group 2-12 years for a cause at a tertiary rural hospital, in an attempt to better understand this syndrome. Methods: Retrospectively collected data from 210 consecutive patients aged between 2-12 years from January 2015 to January 2017, who presented to Department of Surgery and Emergency department in MOSC Medical College with recurrent abdominal pain were studied. Data collection included demographic details, symptomatology and clinical details, and response to treatment. Each patient was thoroughly evaluated to identify an organic cause for the pain. All the patients were evaluated by the paediatrician for any underlying medical cause. Results: During the two-year period, 210 patients were evaluated and investigated, and an organic cause was detected in 44 patients, while 166 patients were diagnosed to have RAP. The 44 patients with an organic cause were treated for the primary condition and were asymptomatic on follow up. Investigations revealed that 20 patients suffered from acute appendicitis, 20 patients were diagnosed with habitual constipation Patients without an organic cause were reassured, counselled and treated symptomatically. All the patients were on follow up for the entire period of the study. Of the 166 patients diagnosed with RAP, 110 patients responded to symptomatic measures, while 21 patients were referred to child psychiatry and are on long term follow up. Conclusion: Recurrent abdominal pain is a significant cause of functional impairment in the life of a child. Thorough evaluation of the patient to rule out organic causes is vital. Majority of the children diagnosed with recurrent abdominal pain respond to counselling. Acknowledging the existence of the symptoms instead of dismissing it, and empathising with the child is often all that is required in the management of these patients","PeriodicalId":267909,"journal":{"name":"Surgical Update: International Journal of Surgery and Orthopedics","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121140617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-08-31DOI: 10.17511/ijoso.2019.i03.02
Rajul Gupta, Vaibhav Maheshwari, S. Gour, Narendra Kumar, Avtar Singh
Introduction- Treatment of extra-articular distal humerus fractures is often difficult using conventional plates. Plates having enough screws (three to four) in the distal fragment either impinge on the olecranon fossa, or gain purchase by placing screws in the lateral or medial column of the distal humerus avoiding the olecranon fossa. Objectives- This study was to ascertain the effectiveness of modified distal tibial locking plate for use in distal third shaft humerus fracture. Methods- By using a modified distal tibial locking plate, a six to eight locking head screws can be easily placed in the in the limited length of distal fragment proximal to the olecranon fossa. Fourteen cases treated in such manner were followed up for a minimum of 24 months. Results- Union was achieved in all cases with no loss of reduction or implant failure. No patient complained of hardware complication, functional limitation or infection. Conclusion- Modified distal locking plate can be safely used in the limited space above olecrenon fossa in distal thirds humerus shaft fractures
{"title":"Technical tip: fixation of extra-articular fractures of distal humerus with modified distal tibial locking plate","authors":"Rajul Gupta, Vaibhav Maheshwari, S. Gour, Narendra Kumar, Avtar Singh","doi":"10.17511/ijoso.2019.i03.02","DOIUrl":"https://doi.org/10.17511/ijoso.2019.i03.02","url":null,"abstract":"Introduction- Treatment of extra-articular distal humerus fractures is often difficult using conventional plates. Plates having enough screws (three to four) in the distal fragment either impinge on the olecranon fossa, or gain purchase by placing screws in the lateral or medial column of the distal humerus avoiding the olecranon fossa. Objectives- This study was to ascertain the effectiveness of modified distal tibial locking plate for use in distal third shaft humerus fracture. Methods- By using a modified distal tibial locking plate, a six to eight locking head screws can be easily placed in the in the limited length of distal fragment proximal to the olecranon fossa. Fourteen cases treated in such manner were followed up for a minimum of 24 months. Results- Union was achieved in all cases with no loss of reduction or implant failure. No patient complained of hardware complication, functional limitation or infection. Conclusion- Modified distal locking plate can be safely used in the limited space above olecrenon fossa in distal thirds humerus shaft fractures","PeriodicalId":267909,"journal":{"name":"Surgical Update: International Journal of Surgery and Orthopedics","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122591930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-08-31DOI: 10.17511/ijoso.2019.i03.06
Va Bhagat, S. Brahmachari
Objectives: To study the spectra of bacterial growth in ulcers in patients and to compare the range and efficacy of Povidoneiodine, Nitrofurazone and silver sulphadiazine with Metronidazole with sucralfate as topical agents. Methods: 100 patients with different types of ulcers with either foul smell or showing response to systemic or local treatment were selected and divided into two groups. Study Group or Group A: 1% Metronidazole gel with sucralfate. Control group or Group B: for burns and scalds silver sulphadiazine, for trophic ulcers nitofurazone (Furacin ) in remaining types of ulcer/wounds Povidone iodine (Betadine) ointment was used. Periodic debridement of ulcer/wound was done in both the groups as per requirement. Other general and specific treatment of the patient with regard of his illness was same in both the groups. Systemic antibiotics were given, bacteriological and clinical assessment was daily done. Results: 93% of cases in Group A and 42% in Group B showed grade III healing within 35 days. Healing was over all faster in Group C and 95% reached grade III within 35 days. One patient in Group B died after 24 days with no signs of healing and remaining 18 patients were converted to Group C after 45 days of treatment. In Group C one patient absconded with grade II healing. Conclusion: It was observed that results with topical Metronidazole with sucralfatewere definitely superior as compared to Povidone iodine, Nitrofurazone or Silver sulfadiazine.
{"title":"Spectra of bacterial growth in ulcers","authors":"Va Bhagat, S. Brahmachari","doi":"10.17511/ijoso.2019.i03.06","DOIUrl":"https://doi.org/10.17511/ijoso.2019.i03.06","url":null,"abstract":"Objectives: To study the spectra of bacterial growth in ulcers in patients and to compare the range and efficacy of Povidoneiodine, Nitrofurazone and silver sulphadiazine with Metronidazole with sucralfate as topical agents. Methods: 100 patients with different types of ulcers with either foul smell or showing response to systemic or local treatment were selected and divided into two groups. Study Group or Group A: 1% Metronidazole gel with sucralfate. Control group or Group B: for burns and scalds silver sulphadiazine, for trophic ulcers nitofurazone (Furacin ) in remaining types of ulcer/wounds Povidone iodine (Betadine) ointment was used. Periodic debridement of ulcer/wound was done in both the groups as per requirement. Other general and specific treatment of the patient with regard of his illness was same in both the groups. Systemic antibiotics were given, bacteriological and clinical assessment was daily done. Results: 93% of cases in Group A and 42% in Group B showed grade III healing within 35 days. Healing was over all faster in Group C and 95% reached grade III within 35 days. One patient in Group B died after 24 days with no signs of healing and remaining 18 patients were converted to Group C after 45 days of treatment. In Group C one patient absconded with grade II healing. Conclusion: It was observed that results with topical Metronidazole with sucralfatewere definitely superior as compared to Povidone iodine, Nitrofurazone or Silver sulfadiazine.","PeriodicalId":267909,"journal":{"name":"Surgical Update: International Journal of Surgery and Orthopedics","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127682876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-08-31DOI: 10.17511/ijoso.2019.i03.01
Rajul Gupta, Vaibhav Maheshwari, S. Gour, Deepak Nadkarni, K. Verma
Introduction- The present study report results of a series of type 3A and 3B open fractures treated with debridement and fracture fixation and immediate bone grafting. Methods- Twenty one patients were treated from January 2017 to January 2018. All fractures were treated with a modular external fixator. Nine fractures were type 3A and 12 were type 3B. All fractures received debridement, external fixation, bone grafting and flap or skin graft coverage. All fractures were analyzed for time to fracture union, incidence of pin tract infection, incidence of wound infection, flap complications, and delayed or non union. Results- After a mean follow up period of 14 months (range 12 to 16 months), it was concluded that the time to fracture union was 22 weeks, and all fixators were removed only after radiological evidence of fracture union. 1 (5%) patients developed deep wound infection, one experienced delayed union. Conclusion- Along with early wound coverage and external fixation, primary bone grafting can be employed in grade 3 open fractures of tibia with good results and without any increased risk of wound complications ………………………………………………………………………………………………………………………...............
{"title":"Treatment of grade 3a and 3b compound tibial fractures with external fixation and primary immediate bone grafting","authors":"Rajul Gupta, Vaibhav Maheshwari, S. Gour, Deepak Nadkarni, K. Verma","doi":"10.17511/ijoso.2019.i03.01","DOIUrl":"https://doi.org/10.17511/ijoso.2019.i03.01","url":null,"abstract":"Introduction- The present study report results of a series of type 3A and 3B open fractures treated with debridement and fracture fixation and immediate bone grafting. Methods- Twenty one patients were treated from January 2017 to January 2018. All fractures were treated with a modular external fixator. Nine fractures were type 3A and 12 were type 3B. All fractures received debridement, external fixation, bone grafting and flap or skin graft coverage. All fractures were analyzed for time to fracture union, incidence of pin tract infection, incidence of wound infection, flap complications, and delayed or non union. Results- After a mean follow up period of 14 months (range 12 to 16 months), it was concluded that the time to fracture union was 22 weeks, and all fixators were removed only after radiological evidence of fracture union. 1 (5%) patients developed deep wound infection, one experienced delayed union. Conclusion- Along with early wound coverage and external fixation, primary bone grafting can be employed in grade 3 open fractures of tibia with good results and without any increased risk of wound complications ………………………………………………………………………………………………………………………...............","PeriodicalId":267909,"journal":{"name":"Surgical Update: International Journal of Surgery and Orthopedics","volume":"105 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131563537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-08-31DOI: 10.17511/ijoso.2019.i03.09
N. Kaura, A. Ray, Amit Kumar, India. Nicobar Islands
Objective: To determine the efficacy and safety of novel infliximab biosimilar, Infimab TM (IFB) in rheumatoid arthritis (RA) patients. Materials and Methods: Eight patients with active RA who failed to demonstrate clinical improvement with methotrexate were enrolled. Post consent, patients were administered infliximab biosimilar 3mg/kg body weight as intra venous infusion at weeks 0, 2, 6 then every 8 weeks on demand. Patients were assessed for Health assessment questionnaire (HAQ, India Score), disease activity score 28 (DAS 28), Western Ontario and McMaster Universities Osteoarthritis Index score (WOMAC), erythrocyte sedimentation rate (ESR) and Visual Analogue Scale (VAS) score at baseline and at each visit. They were also observed for any adverse effects or tuberculosis infection. Wilcoxon sign rank test was used to assess the change between baseline to each follow-up visit. Results: On any average 3 infusions were administered to patients. At visit 3 there was significant improvement in HAQ score (p=0.046), WOMAC score (p=0.018), Tender joints count (p=0.027), swollen joints count (p=0.027) and also in general health (p=0.043). Though the VAS scores and ESR values decreased at visit 3, they were not significant. At the end of visit 5, there was considerable decrease in the tested parameters, except in tender joint count. None of the patients reported any adverse effects, indicating that infliximab biosimilar was well-tolerated in tested patients. Conclusion: In this preliminary trial conducted in eight RA patients, treatment with IFB improved clinical outcomes and was well-tolerated in RA patients who failed initial treatment with methotrexate
目的:探讨新型英夫利昔单抗生物仿制药英夫昔单抗TM (IFB)治疗类风湿性关节炎(RA)的疗效和安全性。材料和方法:纳入8例使用甲氨蝶呤未能显示临床改善的活动性RA患者。同意后，患者在第0、2、6周静脉滴注英夫利昔单抗生物仿制药3mg/kg体重，然后根据需要每8周注射一次。在基线和每次就诊时对患者进行健康评估问卷(HAQ, India Score)、疾病活动评分28 (DAS 28)、西安大略省和麦克马斯特大学骨关节炎指数评分(WOMAC)、红细胞沉降率(ESR)和视觉模拟量表(VAS)评分。同时观察他们是否有任何不良反应或结核感染。采用Wilcoxon符号秩检验评估基线至每次随访之间的变化。结果:患者平均每次输注3次。在第3次就诊时，HAQ评分(p=0.046)、WOMAC评分(p=0.018)、压痛关节计数(p=0.027)、肿胀关节计数(p=0.027)和总体健康状况(p=0.043)均有显著改善。虽然VAS评分和ESR值在就诊3时有所下降，但差异不显著。在访问5结束时，除了投标接头数量外，测试参数都有相当大的减少。没有患者报告任何不良反应，表明英夫利昔单抗生物类似药在测试患者中耐受性良好。结论:在这项对8名RA患者进行的初步试验中，IFB治疗改善了临床结果，并且在甲氨蝶呤初始治疗失败的RA患者中耐受性良好
{"title":"A real life experience with novel biosimilar InfimabTM in biologic naive patients with active rheumatoid arthritis","authors":"N. Kaura, A. Ray, Amit Kumar, India. Nicobar Islands","doi":"10.17511/ijoso.2019.i03.09","DOIUrl":"https://doi.org/10.17511/ijoso.2019.i03.09","url":null,"abstract":"Objective: To determine the efficacy and safety of novel infliximab biosimilar, Infimab TM (IFB) in rheumatoid arthritis (RA) patients. Materials and Methods: Eight patients with active RA who failed to demonstrate clinical improvement with methotrexate were enrolled. Post consent, patients were administered infliximab biosimilar 3mg/kg body weight as intra venous infusion at weeks 0, 2, 6 then every 8 weeks on demand. Patients were assessed for Health assessment questionnaire (HAQ, India Score), disease activity score 28 (DAS 28), Western Ontario and McMaster Universities Osteoarthritis Index score (WOMAC), erythrocyte sedimentation rate (ESR) and Visual Analogue Scale (VAS) score at baseline and at each visit. They were also observed for any adverse effects or tuberculosis infection. Wilcoxon sign rank test was used to assess the change between baseline to each follow-up visit. Results: On any average 3 infusions were administered to patients. At visit 3 there was significant improvement in HAQ score (p=0.046), WOMAC score (p=0.018), Tender joints count (p=0.027), swollen joints count (p=0.027) and also in general health (p=0.043). Though the VAS scores and ESR values decreased at visit 3, they were not significant. At the end of visit 5, there was considerable decrease in the tested parameters, except in tender joint count. None of the patients reported any adverse effects, indicating that infliximab biosimilar was well-tolerated in tested patients. Conclusion: In this preliminary trial conducted in eight RA patients, treatment with IFB improved clinical outcomes and was well-tolerated in RA patients who failed initial treatment with methotrexate","PeriodicalId":267909,"journal":{"name":"Surgical Update: International Journal of Surgery and Orthopedics","volume":"128 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131003389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-08-31DOI: 10.17511/ijoso.2019.i03.03
S. Mitra, Saswata Ghosh
Introduction: Cubitus Varus is one of the most common deformity around the elbow. Malunited supracondylar fracture of humerus is the most common cause of the deformity in children. This study was conducted to compare the degree of correction and type of complication between modified French and dome supracondylar osteotomy. Materials and Methods: The present study is a prospective study of 61 children with Cubitus Varus treated surgically between January 2017 to May 2018. In our series of 61 cases, 31 were treated with modified French osteotomy and 30 with dome osteotomy. The patients were followed up periodically. Results: At final follow-up by Flynn’s criteria for functional outcome 19 had excellent outcome, 9 had good result, 3 had fair result and none had poor result in modified French group. In dome osteotomy group 15 had excellent result, 10 had good result, 5 had fair result. There was 1 case of infection, 1 case of delayed union, 1 case of implant failure and no nerve injury. In modified French group. There were 2 cases of infection, 1 case of delayed union, 2 cases of implant failure, and 1 case of nerve injury in dome osteotomy group. Conclusion: The present study found that the degree of correction was same, but rate of complication was less in modified French treated group than in dome osteotomy group. Though lateral prominence was corrected in dome osteotomy it was associated with more complication, inadequate correction, nerve palsy, loss of motion and circulatory compromise. KeywordsCubitus Varus, Dome osteotomy, Modified French osteotomy ...................................................................................................................................................
{"title":"Comparative study on the degree of correction and type of complication between modified French and dome supracondylar osteotomy in a tertiary care centre of West Bengal","authors":"S. Mitra, Saswata Ghosh","doi":"10.17511/ijoso.2019.i03.03","DOIUrl":"https://doi.org/10.17511/ijoso.2019.i03.03","url":null,"abstract":"Introduction: Cubitus Varus is one of the most common deformity around the elbow. Malunited supracondylar fracture of humerus is the most common cause of the deformity in children. This study was conducted to compare the degree of correction and type of complication between modified French and dome supracondylar osteotomy. Materials and Methods: The present study is a prospective study of 61 children with Cubitus Varus treated surgically between January 2017 to May 2018. In our series of 61 cases, 31 were treated with modified French osteotomy and 30 with dome osteotomy. The patients were followed up periodically. Results: At final follow-up by Flynn’s criteria for functional outcome 19 had excellent outcome, 9 had good result, 3 had fair result and none had poor result in modified French group. In dome osteotomy group 15 had excellent result, 10 had good result, 5 had fair result. There was 1 case of infection, 1 case of delayed union, 1 case of implant failure and no nerve injury. In modified French group. There were 2 cases of infection, 1 case of delayed union, 2 cases of implant failure, and 1 case of nerve injury in dome osteotomy group. Conclusion: The present study found that the degree of correction was same, but rate of complication was less in modified French treated group than in dome osteotomy group. Though lateral prominence was corrected in dome osteotomy it was associated with more complication, inadequate correction, nerve palsy, loss of motion and circulatory compromise. KeywordsCubitus Varus, Dome osteotomy, Modified French osteotomy ...................................................................................................................................................","PeriodicalId":267909,"journal":{"name":"Surgical Update: International Journal of Surgery and Orthopedics","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128890334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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