Comparative study of modified Stoppa approach and ilioinguinal approach for pelviacetabular fractures

Background: The present study was done to study advantages and disadvantages of modified Stoppa approach (MSA) and ilioinguinal approach (IIA) for surgery of pelviacetabular fractures involving anterior column, anterior wall, quadrilateral plate with protrusion and complex fractures, pelvic ring fractures with pubic diastasis or sacroiliac joint disruptions which needs to be stabilized anteriorly.Methods: Study was conducted in Department of Orthopaedics, Government Medical College and Hospital, Aurangabad on patients with pelviacetabular fractures during June 2018 to March 2020. In our study of 25 patients, they were divided into group A containing 13 patients operated using MSA and group B containing 12 patients operated using IIA. Follow up period was 12-18 months (mean=15) and 12-16 months (mean=14) for group A and B, respectively. Patients assessed using modified Merle d’Aubigné score and Matta’s score.Results: Mean modified Merle d’Aubigné score was 16 and 14 for group A and B, respectively (p value=0.89). Mean blood loss and operative time were less in MSA. Superficial infection was found in one patient each of group A and B whereas one patient developed deep infection in group B. One patient each of both group had hip pain suggestive of early arthrosis. In group B, two patients developed meralgia paresthetica. One patient developed external iliac artery thrombosis and inguinal hernia in group B. one patient from group A developed incisional hernia.Conclusions: MSA was better and simpler than IIA with due adequate training and practice to achieve direct access for pelviacetabular fracture reduction and also it requires less operative time, less blood loss and better postoperative outcome.

Tumour induced osteomalacia: a diagnostic challenge and its implications in orthopaedic surgery

Tumor-induced osteomalacia (TIO) is a paraneoplastic phenomenon which encompasses a wide array of clinical features ranging from musculoskeletal pain to pathological fractures. An excess of fibroblast growth factor 23 (FGF23) is produced which is a parahormone with its target receptors in proximal convoluted tubules of glomeruli. This results in decreased blood phosphate levels and decreased hydroxylation of 25-OH vitamin-D, ultimately leading to osteomalacia. Compliance with medical treatment is unsatisfactory and tedious owing to repeated dosing schedules and overwhelming side effects. Surgical excision of the lesion is the only suitable treatment

Association of thyroid dysfunction and anemia in pregnancy: A cross sectional study

Background: Thyroid dysfunction in pregnancy is clinically important as insufficient thyroxine is associated with an increased risk of premature birth, low birth weight and miscarriage. This prospective, cross sectional study, single-center study was carried out to identify the thyroid dysfunction in pregnancy in Indian antenatal mothers.                                                                                                            Methods: This prospective, cross sectional study, single-center study was conducted in the Department of Obstetrics and Gynecology, Indian Institute of Medical Science & Research, Warudi, Badnapur, Jalna, India. The study period was of 20 months from January-2018 to August-2019. One hundred and sixty six antenatal mothers with age population in range of 18-35 years were included in the study.  All the study subjects were randomly selected & rendered to serological testing’s like T3, T4, TSH. All The study protocol was performed in accordance with the principle of the declaration of Helsinki and after approval by the Institutional ethical scientific committee. The data was entered and tabulated in MS-Excel 2007, and statistical analysis was performed by using Statistical Package for the Social Sciences (SPSS 22.0). Data had been summarized as mean for numerical variables and count and percentages for categorical variables