Comparison Of Accelerated Vs Standard Ponseti Technique Among Children's Having Congenital Talipes Equinovarus.

Background: The resurgence and long duration of treatment of the Ponseti method in recent years has been punctuated by less than favourable long-term outcomes for surgically treated feet. Objectives of the study were to compare the two treatment techniques accelerated vs standard Ponseti technique among children's having Congenital Talipes Equinovarus. Methods: This was two years randomized control trial study carried out among total 104 idiopathic congenital talipes equinovarus patients in Orthopaedics and Spine Unit, Hayatabad Medical Complex, Peshawar. A convenient sampling technique was used in this study. Informed written consent was taken from each respondent. Patients in group A was subjected to accelerated ponseti technique and patients in group B was subjected to standard ponseti technique. At one month after treatment, all the patients were re assessed on the basis of pirani score. Data was collected and analyzed using SPSS version 21. Results: This study included a total 104 clinically diagnosed Congenital Talipes Equinovarus patients with mean age 5.5±2.1 months and 52 in each treatment group. Out of total 104 patients 68 (65.4%) were male and 36 (34.6%) were female. They're found significant difference in the mean ponseti scores of these two-group p=0.042 provided comparatively low mean pirani score in accelerated ponseti group. All female child in accelerated ponsati group was responded to the treatment with 100% effectiveness rate. The difference of effectiveness of treatment was significant p=0.015 for children age range 4-8 months divided in two treatment group with good effectiveness 80.8% in accelerated ponseti group. Conclusion: Accelerated ponseti technique is more effective than standard ponseti technique for Congenital Talipes Equinovarus.

Outcome Of Dynamic Compression Plate With Dorsal Radial Sliding Graft Technique For Wrist Arthrodesis In Brachial Plexus Injury Patients.

BACKGROUND: The incidence of brachial plexus injuries have shown to increase over the years. It is 1- 2% worldwide according to the WHO. In global brachial plexus injuries and lower root injures when the wrist and hand functions are lost, wrist arthrodesis is a viable option. In other cases, when there are some residual hand functions, wrist arthrodesis stabilizes the wrist as well as provides donor muscles tendons to enhance finger functions. Apart from these, wrist arthrodesis increase grip strength and power, and also wrist in extension assume a better shape cosmetically. PURPOSE: Outcome of dynamic compression plate with dorsal radial sliding graft for wrist arthrodesis in terms of time to union and complications in brachial plexus injury patients. METHODS: This is a retrospective chart review of patients treated in National Orthopaedic Hospital Bahawalpur, from January 2011 to Sep 2017. All the patients with brachial plexopathies of both genders from age 14 to 60 were included in the study. Data was analysed using MS Excel 2010. RESULTS: A total of 34 patients were included in the study. Road traffic accidents was the major cause of the injury having 30 (88%) patients whereas birth palsy and gunshots had 2 patients each (6%). Twenty-three patients had no associated fracture while remaining 11 patients had a fracture. There was union in all patients (100 %) and mean time to union was 6.5 weeks (range 6-8) radiologically. Mean follow up was 20.2 months (range 1.5-72).

Chondroectodermal Syndrome.

Chondroectodermal syndrome or Ellis Van Creveld (EVC) is a rare autosomal recessive congenital disorder. It was first described by Richard W.B.Ellis and Simon Van Creveld in 1940. Parental consanguinity is present in about 30% of the cases. A large number of cases were reported in Amish population of Lancaster County, Pennsylvania USA and also in Aboriginal community of Australia in 1964. The incidence in Amish population is 1/5000 live births and in general population 7/1,000,000. There are only 150 cases reported worldwide. The principal feature of this syndrome is a tetrad of disproportionate dwarfism, ectodermal dysplasia, bilateral postaxial polydactyly and congenital heart defects.

Azadirachata indicum (Neem): an effective biosorbent for the removal of lead (II) from aqueous solutions.

Laboratory batch experiments with Azadirachata indicum indicated that this population had an excellent ability to bind lead (II) from its aqueous solution. The experiments carried out examined pH, biomass quantity, time of contact, and temperature dependency. Under optimum conditions, the removal of lead (II) was found to be around 95%. Column experiments were performed to examine the binding of lead (II) to silica-immobilized biomass under flow conditions. During this, a slight decrease in the pH of the effluents was also observed, implying an ion-exchange mechanism for metal binding.