Introduction: Infection is the most prominent cause of delayed or non-union in tibial fractures because of the bone's sensitive subcutaneous location. Ilizarov external fixator application is regarded as the best approach for treating them because of several benefits. Analysis of the role of Ilizarov fixation in infected tibial non-union was the goal of this investigation and evaluating clinical & functional outcomes of infected tibial non-union. Materials and Methods: A Multicenter based non-randomized quasi-experimental prospective study was performed in Rajshahi Medical College Hospital, Rajshahi, Bangladesh. From 1st January 2015 to 31st December 2020. The study comprised a total of 61 (n=61) Tibial non-union patients treated with the Ilizarov fixator who also had an infection. ASAMI score criteria were used to evaluate the outcome. Results: The most common organism for infection was identified to be at Staphylococcus Aureus. The final follow-up showed that all but one patient had achieved union; one patient had to amputate due to infection and non-union. ASAMI score rating methodology for bone and function results rated the majority of patients as outstanding. Pin tract infections were the most prevalent problem discovered in this research. Conclusion: The Ilizarov external fixator is safe and successful for treating infected non-union of the tibia since it can offer a stable mechanical environment, bone transfer, rectify deformities, eradicate the infection, and allow patients to bear weight. Therefore, we still suggest it despite its disadvantages.
Background: Mechanical bowel preparation (MBP) for elective available colorectal surgical procedure has been practiced as a clinical routine for many decades. However, earlier randomized medical trials (RCTs) and meta-analyses endorse that MBP ought to be deserted earlier than colorectal surgical treatment due to the fact of the futility in decreasing postoperative problems and motility. The new published outcomes from three RCTs evaluating MBP with no MBP in colorectal surgical treatment in 2010 make the updating of systemic overview and meta-analysis necessary. Objectives: The aim of this study is to assess the safety of colorectal surgery without mechanical bowel preparation. Methods: This is an observational study. The study used to be carried out in the admitted patient’s Department of Surgery Rajshahi Medical College Hospital, Rajshahi, Bangladesh. In Bangladesh for the duration of the period from June 2014 to May 2015. Results: This study shows that the according to age of 80 patients aged 20-above 51 years where, 4(10%) were 20-30 years, 10(25%) were 31-41 years, 10(25%) were 41-50 years, 16(40%) were 51 and above years in Group A, and 6(15%) were 20-30 years, 6(15%) were 31-40 years, 13(32.5%) were 41-50 years and 15(37.5%) were 51 and above years in Group B. And 28(70%) were males and 12(30%) were females in group A. And 27(67.5%) were males and 13(32.5%) were females in group B. Conclusions: Mechanical bowel preparation before elective colon and rectal surgery cannot prevent complications like anastomotic leakage, wound infection, intra-abdominal sepsis, abdominal abscess and extra abdominal complications.
Background: In children, femoral shaft fractures are usually treated by initial performance and durability for 3 to 4 weeks, followed by an additional period of immobilization in a hip spica cast until union occurs. However, such treatment would involve prolonged hospital stays, thereby increasing the cost and occupancy of hospital beds. Early hip spica cast application of femoral shaft fractures in children is a valuable alternative to the traditional treatment method. It allows for a short hospital stay, thereby avoiding all the problems associated with prolonged hospitalization. Methods: This prospective study was conducted on 20 patients. Multicentered based non-randomized evaluations were performed in Modernized District Hospital, Joypurhat, and Rajshahi Medical College Hospital, Rajshahi, Bangladesh, from January 2020 to April 2022. With femur shaft fractures over two years. All the children of both sexes from 2 to 12 years of age with fractures shaft of the femur presented within day one of injury. Follow-up was done in OPD for up to 6 months. The functional result was assessed according to Flynn’s scoring criteria. Results: The mean age of the patient was 5.65 years, ranging from 2 to 12 years. The male-female ratio was 3:1. The mean duration of hospital stay was 4.1 days. Radiological union in all cases was achieved in a mean time of 7.65 weeks. Full weight-bearing was possible in a mean time of 10.07 weeks. The result was excellent in sixteen patients (80%), successful in two (10%), and poor in two patients (10%). Conclusions: Early spica cast is a simple, effective, and definite treatment method with minimal complications and acceptable results in the pediatric age group.
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