Evaluation of functional outcome of intertrochanteric femur fractures treated with proximal femoral locking compression plate

Background: The objective was to find out the clinical and functional outcome of intertrochanteric femur fractures treated with proximal femoral locking compression plate (PFLCP).Methods: The study was conducted on patients who underwent fixation of intertrochanteric femur fractures with PFLCP in department of orthopedics, GMCH, Aurangabad from January 2020 to January 2021. The patients were assessed clinically and functionally using Harris hip score and radiological evaluation at three, six and nine months.Results: At one year follow up, two patients had varus collapse, one had superficial infection and one had screw cut out. The mean Harris hip score at one month was 69.46 (52-76), at three months was 78.6 (58-88) and at nine months was 87.6 (64-96). The average operative time was 86.23 minutes (60-128 minutes), the average blood loss was 207.5 ml (170-250 ml) and the average time required for union was 15.16 weeks (10-24 weeks).Conclusions: Intertrochanteric fractures treated with PFLCP provided a strong angular stable construct and showed satisfactory outcomes

Functional results of minimally invasive cheap fixation technique for all types of intertrochanteric femoral fractures using enders nail and cannulated cancellous screws

Background: The objective was to study functional results of fixation of intertrochanteric fractures of femur using enders nail and cannulated cancellous screws.Methods: This was a prospective observational study. The study was conducted on 30 patients of intertrochanteric femoral fractures who underwent fixation by enders nailing and cannulated cancellous screws in Department of Orthopaedics, GMCH, Aurangabad from January 2018 to January 2021. Patients were assessed functionally using Harris hip score, visual analogue score, and radiological assessment at 3, 6, and 12 months.Results: All patients showed radiological union within 3 months. Functional assessment was done with Visual analogue scale (VAS) in which mean VAS score was 0.9 (range 0-3), mean Harris hip score which was 86 (range 81-90). One patient developed superficial infection at incision site which was treated by giving appropriate antibiotics and one patient complained of prominent nail on medial side of knee which was treated by implant removal after union of fracture.Conclusions: Fixation of intertrochanteric femur fractures using enders nailing and cannulated cancellous screws achieves good stability with minimal complications and improved patients’ outcome in terms of less intraoperative blood loss, less chances of infection, less operative time with minimal patient morbidity and good functional outcome

Workplace Accidents among Nepali Male Workers in the Middle East and Malaysia: A Qualitative Study

There are many Nepali men working in the Middle East and Malaysia and media reports and anecdotal evidence suggest a high risk of workplace-related accidents and injuries for male Nepali workers. Therefore, this study aims to explore the personal experiences of male Nepali migrants of unintentional injuries at their place of work. In-depth, face-to-face interviews (n = 20) were conducted with male Nepali migrant workers. Study participants were approached at Kathmandu International Airport, hotels and lodges around the airport. Interviews were transcribed and analysed using thematic analysis. Almost half of study participants experienced work-related accident abroad. The participants suggested that the reasons behind this are not only health and safety at work but also poor communication, taking risks by workers themselves, and perceived work pressure. Some participants experienced serious incidents causing life-long disability, extreme and harrowing accounts of injury but received no support from their employer or host countries. Nepali migrant workers would appear to be at a high risk of workplace unintentional injuries owing to a number of interrelated factors poor health and safety at work, pressure of work, risk taking practices, language barriers, and their general work environment. Both the Government of Nepal and host countries need to be better policing existing policies, introduce better legislation where necessary, ensure universal health (insurance) coverage for labour migrants, and improve preventive measures to minimize the number and severity of accidents and injuries among migrant workers

A large osteosarcoma of distal humerus in a 13-year-old child - Case report

Background: Massive skeletal tumours are rare and usually have a poor prognosis. Delayed presentation alters management and reduces survival, and is challenging to manage. Case report: A 13-year-old girl presented to our OPD with a 35cm X 35cm swelling over her left arm, which had been increasing in size for the past one year and an inability to use her left hand for the last three months. The patient had been bedridden for the past eight months and had stopped schooling. The distal vascularity of the limb was intact. However, there was a left radial nerve palsy. Radiographs revealed a sclerotic swelling with peripheral calcifications, which had destroyed the shaft of the humerus. The biopsy concluded the swelling to be a chondroblastic osteosarcoma. Neoadjuvant chemotherapy was given, and a forequarter amputation was performed. The patient was discharged on the fifth postoperative day and received adjuvant chemotherapy. Currently patient has resumed her daily activities and schooling, with no signs of recurrence. Conclusion: The gigantic size of such a tumour constitutes a rare presentation and calls for analysis and audit of the loopholes in our healthcare setup that might have led to this. Proper patient education and counselling regarding the disease and management options are essential. The size of the tumour isn't indicative of the presence or absence of metastasis, and a radical surgery such as an amputation may also drastically improve the quality of life of such patients

Bus priority lane in Bengaluru: A study on its effectiveness and driver stress

This paper studies the effectiveness of the bus priority lane (BPL) for public transport buses in the city of Bengaluru in India. We use the travel times on the BPL corridor as a measure of the effectiveness of the BPL. We find that there is a significant improvement in the travel times after the introduction of the BPL; for the worst 10% of the travel times, we find an improvement between 4% and 28%. Our methodology involves extracting trips on the BPL and computing the travel times for these trips from a time series of GPS information. Our methodology is scalable and can be used to compute the travel times between any two given points in other similar studies. We supplement our results with a novel test (called the D-test) for comparing the levels of stressful driving in the following scenarios: (a) morning peak hours (IST 07:00 h to 11:00 h) versus evening peak hours (IST 17:00 h to 21:00 h), and (b) northward trips versus southward trips on the BPL. We are able to infer that the drivers are generally more stressed during the morning peak hours and during the southward trips on the BPL. Partitioning the BPL into segments, we show that a majority of the segments exhibit similar effectiveness and driver stress trends as the full BPL stretch. We anticipate that corrective measures for the betterment of travel times and driver stress levels (e.g., introducing additional buses subject to vehicle re-balancing constraints, carefully planning the bus schedules to regulate bus traffic throughout the day, etc.) in some segments can lead to further improvements in travel times and reduction in driver stress levels

The Prevalence of clotting factor inhibitors in patients with hemophilia

Background: Hemophilia A and B are X-linked diseases that predominantly affect male patients. Patients can develop coagulation factor inhibitors, which exponentially increases the treatment cost. Objective: This study aimed to determine the prevalence of factor VIII inhibitors. Materials and methods: This was an observational descriptive study. Clotting factor inhibitor screening was performed by activated partial thromboplastin time mixing studies using normal pooled plasma. Bethesda assay for quantitation of factor VIII inhibitors was performed on samples which were positive with screening tests.Results: Study was performed in total of 62 patients with Hemophillia. Out of 62 patients, Hemophilia A and Hemophilia B was observed in 92% cases and 7% cases respectively and 1 case was with Hemophillia and von willebrand disease(1%). Out of 62 patients, 39(63%) had severe hemophilia A, 18(29%) had moderate hemophilia A, and 5(8%) had mild hemophilia A. Mixing based inhibitor screening was positive in total 14 number of patients. Bethesda assay confirmed 10(16%) cases with presence of inhibitor. 4(40%) out of 10 patients were low responders (<5 BU), with mean BU of 2.88, and 6(60%) patients were high responders (>5 BU), with mean BU of 39.2. Diagnostics of mixing based inhibitor screening showed sensitivity and specificity of 75% & 60% at difference of ≥5 seconds and 60% & 100% for difference of ≥10 seconds.Conclusion: Mixing tests are an important first step in the investigation of inhibitors in cases with hemophilia as the follow up investigations are more costly and time consuming than the basic screening tests