Introduction: Fracture of the shaft of the femur is among the most commonfractures encountered in orthopedics practice.1 Objectives: The aim of the study was alsocompare the outcome of solid versus canmulated inter locking nails as a method of internalfixation in closed fractures of the shaft of femur in adults. Design: Quasi Experiment design.Setting: Orthopedic Department Allied Hospital P.M.C Faisalabad. Results: We had total of60 cases, 30 in groups of solid I/M nailing and 30 in group B of Cannulated in I/M nailing wehave reported the follow up study up to 9 months. (1) There were 27 (90%) males and 3 (10%)females in group A. (2) If in group B 26 (86.666%) were males 4 (13.333%). (3) The mean agewas 37.4 + 1.61 years. Union: Group A, In 26 (86.666%) patients the fracture uniting within 3months. 3 (10%) patients went into phase of delayed union which ultimately united. 1 (3333%)patient into non-union for which bone grafts has to be done after nine months. Group B: In 26(86.666%) patients the fracture united within 3 months. Patient in group B went into nonuniondue to deep infection, second due to nail breakage an in third no apparent causes was found.Total no of cases of non-union in group B were 3. Infection: In group A one patient in groupB 2 patient had superficial infection which were treated with appropriate antibiotics. In groupB one patient had deep infection and went into non-union due to infection. Implant Failure:In group B one case with nail breakage.. 2 Cases with distal Inter Locking screws breakage& 1 case with proximal interlocking screw breakage were noted. Conclusion: (1) There isno statistical difference in union and infection in both groups (P-Value > 0.05). (2) There issignificant difference in implant failure in both groups no patients in group A went with implantfailure but four patients in group B developed implant failure (P-value < 0..05) so Solid interlocking nail is stronger than cannulated interlocking nail.
Objectives: To find out the diagnostic accuracy of ascitic fluid LactateDehydrogenase in diagnosis of Spontaneous bacterial peritonitis using ascitic fluid absoluteneutrophil count equal to or greater than 250 cells/mm3 as a Gold Standard. Study Design:Cross sectional (validation) study. Setting: This study was conducted in department ofMedicine, Madina Teaching Hospital Faisalabad. Duration of Study: 6 months starting afterapproval of synopsis (From:01-06-2016 to 30-11-16). Methodology: 10 ml of ascitic fluidwas withdrawn from these patients, and sent for cytology and biochemistry. Ascitic fluid cellcount, total protein, albumin and LDH wascalculated along with serum albumin and serumLDH. Serum LDH and ascitic fluid LDH was calculated by using Cobas C311 Roche Analyzer,serum/ascitic albumin gradient (SAAG) was calculated by subtracting ascitic albumin fromserum albumin to prove portal hypertension as a cause of ascites. AsciticLDH/serum LDH ratiowas calculated by dividing ascitic LDH by serum LDH.Absolute neutrophil count was derivedfrom total WBC count. Results: In our study, mean age was calculated as 45.37+11.13 years,53.75% (n=43) were male and 46.25% (n=37) were females. Frequency SBP on gold standardwas recorded in 52.5% (n=42). Diagnostic accuracy of ascitic fluid lactate dehydrogenasein diagnosis of spontaneous bacterial peritonitis using ascitic fluid absolute neutrophil countequal to or greater than 250 cells/mm3 as a gold standard was recorded as 82.22%, 85.71%,88.09%, 78.95%, 83.75% for sensitivity, specificity, positive predictive value, negative predictivevalue and accuracy rate, positive likelihood ratio was calculated as 5.75 and 0.21 for negativelikelihood ratio was calculated as 5.75. Conclusion: The diagnostic accuracy of ascitic fluidLactate Dehydrogenase is higher in diagnosis of Spontaneous bacterial peritonitis using asciticfluid absolute neutrophil count equal to or greater than 250 cells/mm3 as a Gold Standard.
To find out the diagnostic accuracy of ascitic fluid Lactate Dehydrogenase in diagnosis of Spontaneous bacterial peritonitis using ascitic fluid absolute neutrophil count equal to or greater than 250 cells/mm 3 as a Gold Standard. Study Design: Cross sectional (validation) study. Setting: This study was conducted in department of Medicine, Madina Teaching Hospital Faisalabad. Duration of Study: 6 months starting after approval of synopsis (From:01-06-2016 to 30-11-16). Methodology: 10 ml of ascitic fluid was withdrawn from these patients, and sent for cytology and biochemistry. Ascitic fluid cell count, total protein, albumin and LDH wascalculated along with serum albumin and serum LDH. Serum LDH and ascitic fluid LDH was calculated by using Cobas C311 Roche Analyzer, serum/ascitic albumin gradient (SAAG) was calculated by subtracting ascitic albumin from serum albumin to prove portal hypertension as a cause of ascites. AsciticLDH/serum LDH ratio was calculated by dividing ascitic LDH by serum LDH.Absolute neutrophil count was derived from total WBC count. Results: In our study, mean age was calculated as 45.37+11.13 years, 53.75% (n=43) were male and 46.25% (n=37) were females. Frequency SBP on gold standard was recorded in 52.5% (n=42). Diagnostic accuracy of ascitic fluid lactate dehydrogenase in diagnosis of spontaneous bacterial peritonitis using ascitic fluid absolute neutrophil count equal to or greater than 250 cells/mm 3 as a gold standard was recorded as 82.22%, 85.71%, 88.09%, 78.95%, 83.75% for sensitivity, specificity, positive predictive value, negative predictive value and accuracy rate, positive likelihood ratio was calculated as 5.75 and 0.21 for negative likelihood ratio was calculated as 5.75. Conclusion: The diagnostic accuracy of ascitic fluid Lactate Dehydrogenase is higher in diagnosis of Spontaneous bacterial peritonitis using ascitic fluid absolute neutrophil count equal to or greater than 250 cells/mm 3 as a Gold Standard.
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