No abstract

Arthroscopic fixation using the TightRope device for acute AC joint dislocation achieves satisfactory outcome.

BackgroundHaemarthrosis and pain adversely affects the functional outcome of ACL reconstruction, especially in case of DB ACL reconstruction due to more extensive procedure. The purpose of the study was to evaluate the effect of haemarthrosis on the rehabilitation of DB ACL reconstruction versus SB ACL reconstruction.Methods100 patients were divided into two groups, of SB ACL and DB ACL reconstruction consisting of 50 patients each. An intra-articular drain was put in every patient. The pain was evaluated till week 8 using VAS (Visual Analog Scale). The Functional outcomes were evaluated using the Isokinetic Dynamometer at 3 and 6 months in both the groups. Muscle bulk and Range of motion were also noted in each group.ResultsThe results showed that there was statistically significant difference between the drain amount (n = 60.3 ml in SB ACL group vs. n = 94.2 ml in the DB ACL group) and haemarthrosis (n = 0.7 in SB ACL vs n = 1.5 in DB ACL) at week 1 post-operatively. Also the pain outcome improved on SB ACL after day 3 (VAS, n = 1.8) as compared to the DB ACL group (VAS, n = 3.7). The isokinetic muscle strength was found to be statistically significantly (p value < 0.05) better in the SB ACL group in the quadriceps muscle (both concentric and eccentric) at the end of the 3rd month. In the SB ACL group the Quadriceps Concentric strength deficit was 22.32% as compared to 34.12% in the DB ACL group. Both the groups had comparable flexor muscle strength at end of 3rd month. Both the groups had comparable muscle strength after 6 months of post-operative rehabilitation in both quadriceps and Hamstring muscle group.ConclusionWe noted that rehabilitation of DB ACL reconstruction group lags behind that of SB ACL reconstruction during the first 3 months due to post-operative haemarthrosis & its effects, but show comparable results after 6 months. The muscle strength measured isokinetically and the muscle bulk were found to be greater in the SB ACL group initially after 3 months but was found to be similar after 6 months.

This procedure provides consistent and reproducible results in carefully selected patients and allows them an early return to sporting activities with minimal residual morbidity.

Mini-open Latarjet with graft fixation with Arthrex mini-plate provides satisfactory outcome in patients who require reoperation due to dramatic bone loss and failed soft tissue reconstruction. The modified incision improves exposure enabling plate fixation and the secure fixation accelerates rehabilitation.

This paper analyzes agricultural development in terms of policy and implementation in Nepal. More than two-thirds populations in Nepal reside in the rural area and most of them depend on agriculture. Subsistence form of agriculture is common in Nepal. Rural Area and agriculture are interrelated; like two parts of the same coin. The contribution of agriculture to national Gross Domestic Product is remarkable; however, it is declining over the decades. In fact, the agricultural sector cannot attract young people; the trend of migration from rural to urban is significantly increasing. The poverty is exceedingly marked in rural Nepal. The Government of Nepal emphasizes agriculture development in for poverty alleviation. Order to alleviate poverty, rural development, and national economic growth through the policy level. However, available data and qualitative analysis reveal that the outcome from the agricultural sector is not satisfactory due to several factors. In such situation, more than half of the population has been facing food insufficiency. Because of weak policy and implementation, the agriculture sector s been suffering poor outcome. In that way, the government of Nepal along with concerned authorities should effectively implement agriculture policies in order to reduce poverty and rural development. The agriculture-rural accommodating policies and successful performance are crucial for poverty alleviation and rural development.

Background:Multiligamentous injuries of knee remain a gray area as far as guidelines for management are concerned due to absence of large-scale, prospective controlled trials. This article reviews the recent evidence-based literature and trends in treatment of multiligamentous injuries and establishes the needful protocol, keeping in view the current concepts.Materials and Methods:Two reviewers individually assessed the available data indexed on PubMed and Medline and compiled data on incidence, surgical versus nonsurgical treatment, timing of surgery, and repair versus reconstruction of multiligamentous injury.Results:Evolving trends do not clearly describe treatment, but most studies have shown increasing inclination toward an early, staged/single surgical procedure for multiligamentous injuries involving cruciate and collateral ligaments. Medial complex injuries have shown better results with conservative treatment with surgical reconstruction of concomitant injuries.Conclusion:Multiligamentous injury still remains a gray area due to unavailability of a formal guideline to treatment in the absence of large-scale, blinded prospective controlled trials. Any in multiligamentous injuries any intervention needs to be individualized by the presence of any life- or limb-threatening complication. The risks and guarded prognosis with both surgical and non-surgical modalities of treatment should be explained to patient and relations.

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