Orthopedic surgeons should be alert to this morbid condition and this disease should be suspected in cystic lesions affecting any organ of the body in pathological fractures with non-union, especially in endemic areas of the world. Early diagnosis helps in eradication and salvage of the bone; misdiagnosis and delayed diagnosis are always fraught with the danger of amputation, recurrence, and sepsis.

Objectives:The association of hypothyroidism with impairment of hearing is known to occur. It may be of any kind i. e., conductive, sensorineural or mixed. The aim of this study is to assess auditory pathway by brainstem auditory evoked potential (BAEP) in newly diagnosed patients of clinical hypothyroidism and healthy sex- and age-matched controls.Materials and Methods:The study included 25 healthy age- and sex-matched controls (Group I) and 25 patients of newly diagnosed clinical hypothyroidism (Group II). The recording was taken by using RMS EMG EP MK2 equipment.Statistical Analysis Used:Unpaired Student's t test.Results:There was a significant increase in wave IV (5.16 ± 0.85 ms) and wave V (6.17 ± 0.89 ms) latencies of right ear BAEP of Group II in comparison to wave IV (4.66 ± 0.39 ms) and wave V (5.49 ± 0.26 ms) of Group I. Wave V of left ear BAEP of Group II was also prolonged (6 ± 0.61 ms) in comparison to Group I (5.47 ± 0.35 ms). There was a significant difference in inter-peak latencies IPL I -V (4.44 ± 0.66 ms) and IPL III -V (2.2 ± 0.5 ms) of right ear BAEP of Group II in comparison to IPL I -V (3.94 ± 0.31 ms) and IPL III -V (1.84 ± 0.34 ms) of Group I. A significant prolongation was also found of IPL I -V (4.36 ± 0.59 ms) and IPL III -V (2.2 ± 0.42 ms) of left ear BAEP of Group II in comparison to IPL I -V (3.89 ± 0.3 ms) and IPL III -V (1.85 ± 0.3 ms) of Group I.Conclusion:Prolongation of wave IV and V along with inter-peak latencies in BAEP of both ears suggests that central auditory pathway is affected significantly in clinical hypothyroid patients.

Background:Hypothyroidism is known to be associated with impairment of hearing. The hearing impairment may be conductive, sensorineural, or mixed.Aims:The aim is to assess the auditory pathway by brainstem auditory evoked potentials (BAEPs) in newly diagnosed patients of subclinical hypothyroidism and healthy sex- and age-matched controls.Materials and Methods:The study included 25 healthy sex- and age-matched controls (Group I) and 25 patients of newly diagnosed subclinical hypothyroidism (Group II). The recording was taken by using RMS EMG EP MK2 equipment. The unpaired Student's t-test was used and a P value <0.05 was considered significant.Results:Wave V of right ear BAEP in group II was prolonged (6 ± 0.62 ms) compared to group I (5.49 ± 0.26 ms), and wave V of left ear BAEP in group II was prolonged (5.84 ± 0.57 ms) compared to group I (5.47 ± 0.35 ms). There was no significant coefficient of correlation between wave V and inter-peak latency (IPL) I-V compared to thyroid-stimulating hormone (TSH) levels of both the ears.Conclusion:The prolongation of wave V in BAEPs of both ears suggests that the central auditory pathway is affected significantly in subclinical hypothyroid patients.

No abstract

Introduction: Shoulder pain is leading cause of disability and pain among musculoskeletal pain patients. Ultrasound is coming in a bigger way for diagnosis and management of subacromial pain due to its low cost, easy availability and accuracy in detecting soft tissues pathologies and for planning further treatment. Aim: To assess the role of diagnostic Ultrasound (US) in subacromial shoulder pathologies evaluation in shoulder pain patients. Materials and Methods: This was a retrospective observational study conducted on 98 patients who presented with subacromial shoulder pain. Diagnostic ultrasound examination was done and patients were categorised based upon underlying pathology and analysed in terms of frequency. Results: Most common ultrasound findings in subacromial shoulder pain patients were subacromial bursopathy 46 (46.93%) followed by Rotator cuff pathology including tear 38 (38.77%), mixed pathology 9 (9.18%) and Acromioclavicular (AC) joint pathology 5 (5.10%). Isolated biceps pathology was not seen in our study rather biceps pathology along with other tendon and joint involvement was observed. Conclusion: The findings in the present study imply that diagnostic ultrasound of shoulder pain patients helps to stratify them into different categories for better understanding of underlying pathology and targeted treatment approach. Ultrasound shall be used as an outpatient primary diagnostic modality for evaluation of subacromial shoulder pain patients.

Background: Failed proximal femoral fractures like operated transcervical neck fractures, intertrochanteric fractures and subtrochanteric fractures poses a great challenge to surgeon with limited options. Revision of failed internal fixation with hip arthroplasty, also known as Salvage THA (Total Hip Arthroplasty) is a promising surgical option in elderly patients providing early mobility and preventing age related complications.Methods: 45 patients with failed proximal hip fractures were treated over a period of 2 year with THA with modular cemented prosthesis by southern approach.Results: Fourty five patients were followed up for atleast 16 months with no radiological evidence of loosening and heterotrophic ossification and analyzed for pain, difficulty in walking, muscle power, range of motion of joint and functional status. The overall results were expressed in terms of Salvati-Wilson hip grading system.Conclusions: Revision of failed internal fixation with hip arthroplasty, also known as Salvage THA (Total Hip Arthroplasty) is a promising surgical option in elderly patients providing early mobility and preventing age related complications.

Background: Calcaneal fractures which constitutes 2% of total fractures are frequent and very debilitating if not treated properly. Calcaneal fractures generally affect younger population leading to significant man-days loss(around 2-5 years3) and in-turn leading significant economic burden on the society. The goal of treatment for calcaneal fractures is elimination of pain and restoration of normal foot shape, biomechanics, and walking ability. Wound related complications are common with open surgeries. After open reduction internal fixation with perimeter plates for displaced calcaneal fractures, wound edge necrosis is commonly observed with the extended lateral approach. Because of such high incidence of wound complications in open reduction of calcaneum fractures, minimally invasive approach takes priority over open reduction of these fractures.Methods: The study aimed to evaluate the results of minimally invasive approach for calcaneal fractures. To reduce the operative complications, 30 patients were treated with minimally invasive methods in both extra articular and intra-articular calcaneal fractures and the results were evaluated. All patients were evaluated clinically , functionally and radiologically 3D- CT reconstruction images.Results: All cases were followed up for 2 years at specified intervals. The outcome measures were evaluated by AOFAS scores10 with excellent result in 13 cases and good to fair results in the rest. Operated patients had no wound infection, no skin necrosis, 5 patients had mild subtalar arthrosis and 3 patients complained slight difficulty in wearing shoes. None of them have any gait abnormalities.Conclusions: Our study suggests that the minimally invasive methods will reduce the operative complication rates. The minimally invasive surgical intervention in an expert hand can yield better results with less complication rates.

No abstract