There are not many injuries that rival the injured hand in complexity. A better understanding of biologic, behavioral, and socioeconomic risk factors potentially associated with hand injuries can help identify those individuals most at risk and define potential preventative measures to help reduce the incidence. We present a prospective study of 436 consecutive patients of hand and forearm injury treated over a period of 2 years. A serial recording of the demographic profile of the patient along with the type & cause of injury sustained, hand dominance, duration of hospital stay, time lag between injury and admission, type surgery preformed with intra-operative findings and the cost analysis was done. An expected male dominance in economically viable individuals of 21 to 30 years formed 50 % of the patients of which 22.9 % were labourers and students each. The malady was altercation (27.5 %) followed by industrial & road accidents. Post prandial period was most notorious with multiple neuro (27.05 %) vasculo (39.34 %) tendinous (60.66 %) injury common with even simple lacerations. Dominant hand injury was commonest. It is challenging to assess and treat an injured hand. This study defines the demography and the etiology behind the various cases of hand and forearm injury with the detailed trauma profile. The limitation of the study was absence of functional outcome. The necessity of hand trauma registry is a pre-requisite to quantify the burden of hand injuries and formulate a prevention strategy.

Liver biopsy is considered the gold standard method for diagnosing and staging liver disease, particularly in the post-liver transplant setting. Given the invasive nature of biopsy, alternate means for accurately assessing liver fibrosis and steatosis are preferred especially as the number of patients with fatty liver disease is increasing.Transient elastography has been validated as a useful tool for evaluation of liver fibrosis, as has controlled attenuation parameter index as a tool for assessing steatosis. It is a non-invasive, rapid, and highly reproducible approach to demonstrate the presence of fibrosis among non-transplant patients with chronic liver disease of various etiologies. However, it has not yet found wide acceptance in liver transplant recipients. There are few published studies evaluating the merits and applicability of transient elastography to assess allografts after liver transplantation. We review the published data on the use of transient elastography with concurrent controlled attenuation parameter in liver transplant recipients and recommend its greater use to follow allograft function over time.

Background: There are various techniques available for airway management in patients with maxillofacial trauma. Patients with panfacial injuries may need surgical airway access like submental intubation or tracheostomy, which have their associated problems. We have been managing these types of cases by a novel technique, i.e, intraoperative change of nasotracheal to orotracheal intubation.

Introduction:Because of its functional and cosmetic importance, facial injuries, especially bony fractures are clinically very significant. Missed and maltreated fractures might result in malocclusion and disfigurement of the face, thus making accurate diagnosis of the fracture very essential. In earlier times, conventional radiography along with clinical examination played a major role in diagnosis of maxillofacial fractures. However, it was noted that the overlapping nature of bones and the inability to visualise soft tissue swelling and fracture displacement, especially in face, makes radiography less reliable and useful. Computed tomography (CT), also called as X-ray computed radiography, has helped in solving this problem. This clinical study is to compare three-dimensional (3D) CT reconstruction with conventional radiography in evaluating the maxillofacial fractures preoperatively and effecting the surgical management, accordingly.Materials and Methods:Fifty patients, with suspected maxillofacial fractures on clinical examination, were subjected to conventional radiography and CT face with 3D reconstruction. The number and site of fractures in zygoma, maxilla, mandible and nose, detected by both the methods, were enumerated and compared. The final bearing of these additional fractures, on the management protocol, was analysed.Results:CT proved superior to conventional radiography in diagnosing additional number of fractures in zygoma, maxilla, mandible (subcondylar) and nasal bone. Coronal and axial images were found to be significantly more diagnostic in fracture sites such as zygomaticomaxillary complex, orbital floor, arch, lateral maxillary wall and anterior maxillary wall.Conclusion:3D images gave an inside out picture of the actual sites of fractures. It acted as mind's eye for pre-operative planning and intra-operative execution of surgery. Better surgical treatment could be given to 33% of the cases because of better diagnostic ability of CT.

In patients with TM and chronic HCV infection, pegylated interferon alfa 2b and ribavirin combination therapy achieves a higher SVR rate than pegylated interferon alone, and is well tolerated except for an increase in blood transfusion requirement.