Objectives: To determine the management of open diaphyseal fracture of tibia with plaster of Paris (pop) cast vs external fixator in orthopedic ward PUMHSW Hospital Nawabshah. Study Design: Cross-Sectional Comparative study. Setting: Orthopedic Department, Peoples University of Medical And Health Science Shaheed Benazirabad. Period: 18 months from January 2017 to June 2018. Material & Methods: The data was analyzed in SPSS Version 22.0. Results: Out of 50 patients with tibial diaphyseal fractures, there were 34 males compared to females 16 (2.1:1) (68% vs 32%) with an average age of 41 years. Patients with external fixator applied yielded decreased rates of infection; shorter duration of hospital stay and early union compared to patients with plaster of Paris (pop) cast application. However, the difference reached statistical significant value. Conclusion: Open Tibial diaphyseal fractures should be managed with external fixation that yields better results. A plaster cast is the initial treatment of modality in patients with open tibial diaphyseal fractures.

Background: Hepatitis C infection is growing threat and major burden on public health, worldwide prevalence of hepatitis C is 3% (170 million infected people). Approximately 10 million people are infected in Pakistan and prevalence is expected to be higher in remote areas. The aim of this study is to assess knowledge, attitude and practice of adolescents towards hepatitis C in Quetta Pakistan. Methods: A cross sectional descriptive study carried out from February 2013 till April 2013. Sample size of this study was 456 and method of sampling was four stage cluster sampling. Samples were randomly selected from 12 schools in urban and semi-urban parts of district Quetta. Equal number of participants were selected (228 Male and 228 Female) from urban and semi-urban settings. Close ended questionnaire was designed, checked and used to access knowledge, attitude and practice of the participants towards hepatitis C infection Results: Response rate of this survey was 100 % and mean number of "Yes" answers to knowledge, attitude and practice questions were 51%, 46% and 42% respectively. The respondent's in urban setting has two times (1.92 odds) higher knowledge, positive attitude and practice than semi-urban participants. Furthermore the respondent's in higher educational level has two times (1.7 odds) better knowledge, positive attitude and practice than lower educational level participants. Furthermore this study indicates to reveal some evidence of stigmatization being exhibited by participants in both setting. Higher level of school education (group III) and older age (group III) respondents in both setting has positive attitudes toward hepatitis C than lower level of education (group I) and younger age (group I). In addition it is observed that adolescents by growing age and entering higher education group are getting more knowledge and positive attitude and practice about hepatitis C disease and it's a positive trend. Conclusions: This study observed that knowledge, positive attitudes and practices towards hepatitis C among adolescents was partial in both setting. There are some important gaps need to be strengthened especially in semiurban setting and female group of participants. The results of study indicate that there is lack of understanding about infection control and prevention of hepatitis C among study participants. Thus there is need of critical level of public awareness in district Quetta, especially among adolescents, to decrease burden of hepatitis C infection. Extensive health education campaigns about hepatitis C are beneficial for adolescents, particularly to residents of semi-urban and rural areas.

Objectives: To compare the external fixator and unreamed interlocking nail in treating Gustilo type II, type IIIA, and type IIIB tibial diaphyseal fractures regarding complications. Study Design: Cross-Sectional and Comparative Study. Setting: Department of Orthopaedic Surgery and Traumatology (DOST) Liaquat University of Medical and Health Sciences Jamshoro/Hyderabad. Period: Two years February 2016 to January 2018. Material & Methods: 40 cases of open tibia fractures in Patients of Gustilo type II, type IIIA, and type IIIB tibial diaphyseal fractures were included. The data were analyzed using the statistical program SPSS version 16.0. Results: A total of 23 cases were treated by external fixator and 22 cases were treated by unreamed solid interlocking nail. A total of 14 cases, that is, 31% showed delayed union. Type II injury 3/15 = 20%; Type IIIA injury 6/22 = 27.3%; Type IIIB injury it is -5/8 = 12.5%. For cases treated with unreamed nail, it was 22.7%; external fixator was 39.1% among 45 cases, 05 cases showed nonunion. For cases treated with unreamed nail, it was 13.6%; external fixation was 8.7%. The overall rate of eep infection is 11.1%. The rate in interlocking nail was 13.6%, and external fixation was 8.7%. Reoperation in the form of dynamization and bone graft application after 20 weeks in unreamed nail was 36.4%, whereas in external fixation the rate was high, almost 48%. The average time of union with unreamed interlocking was about 25.4 weeks, wherein external fixation it was 28.6 weeks. Conclusion: External fixators are a good and reliable method of stabilization of Gustilo type II, type IIIA, and type IIIB tibial diaphyseal fractures, unreamed interlocking intramedullary nail yields better results in treating Gustilo type II and type IIIA tibial shaft fractures.