Background: Cerebral Palsy (CP) is combined disorder of movement, posture, and motor function and may be associated sensory, neurological and musculoskeletal complications.  It is a permanent condition attributed to nonprogressive disturbances that occurred in the developing brain. The aim of this study is to Cerebral Palsy (CP) is combined disorder of movement, posture, and motor function and may be associated sensory, neurological and musculoskeletal complications.  It is a permanent condition attributed to nonprogressive disturbances that occurred in the developing brain.Methods: Retro prospective cross-sectional study done in super speciality tertiary care centre of East India. Total 70 Children enrolled in multidisciplinary CP clinic in Physical medicine and Rehabilitation (PMR) OPD between September 2017- March 2018.Results: 78.57%male and 21.42% female, all had hospital delivery with 78.5% had normal and 21.5% caesarean section. 70% had history of birth asphyxia and 61.5% required NICU admission. 61.4% had birth wt. less than 2 kg and 10% had birth wt. less than 1kg. One fourth cases had microcephaly and one third had history of seizures. Visual abnormalities, Hearing impairment and history of jaundice were found in about one sixth children. Spastic CP was the most common (76% cases) followed by Dyskinetic 10%, Hyponic and Ataxic (1%). In spastic CP Diplegia was most common (55%), followed by Quadriplegia 24%, Hemiplegia 19% and Monoplegia 2%. GMFCS score 5 was seen in 29% (mostly quadriplegic), followed by GMFCS level 1, 21.27% (mostly hemiplegic), others mostly diplegic in level 3(19%), level 2 and 4 (14%).Conclusions: Male CP are more reaching tertiary care centre in Bihar. Perinatal factors (asphyxia) were main etiological risk factor, and Spastic Diplegia is the most common type of CP. Disability need to be detected at the earliest to facilitate a timely and appropriate intervention like early rehabilitation, special education and psycho-social support.

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Treatment of low back ache due to prolapsed intervertebral disc is still controversial. Several conservative modalities are available with varied results. Surgical discectomy may lead to failed back syndrome due to change in vertebral column anatomy and its mechanics. To prevent it, conservative means are better and Ozone discolysis is one of the nonsurgical methods. The indications and effectiveness of this condition is not well defined. The present study was done to correlate the clinical outcome of this technique.</span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">This was a prospective study conducted on 67 patients presenting with symptoms of back pain with arid without radicular symptoms. X ray and MRI were done in all cases. Then intradiscal ozone gas was given at one level from a specialized machine under C arm guidance. For evaluation Oswestry disability index and Macnab scoring system was used. Post injection patients were evaluated at 2, 6 weeks and 6 months</span>.<strong></strong></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">Sixty seven patients with mean age of 47.7 years were followed up for 7.8 months. Low back pain was the commonest symptom and SLR was positive in 5.36%. The modified Macnab scoring with good and fair score improved from 16% to 89% and Oswestry disability index with minimal and moderate disability improved from 41% to 91% at end of 6 months. Seven patients had relapse of pain due to repeat disc prolapse. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Ozone discloses is better modality of treatment for low back pain with disc bulge and early disc prolapsed.</span></p><p class="abstract"> </p>

Background: There is lack of information regarding pattern of distribution of pediatric cancers in Bihar. Aim: The aim of this study is to identify the pattern of distribution of pediatric cancers. Objectives: To analyze demographic data, type, and pattern of pediatric cancers in Bihar by retrospective clinical audit. Materials and Methods: All individual consecutive patients between ages 0 and 18 years registered in the Department of Medical and Pediatric Oncology from January 1, 2018 till December 31, 2018, were enrolled in this study. Data pertaining to age, sex, and type of cancer were retrieved from clinical database by retrospective audit and stratified into hematolymphoid and solid pediatric cancer cohorts. Frequency distribution and descriptive statistics were used to analyze the data using SPSS version 17.0. Results: A total of 247 pediatric cancers were registered, of which 142/247 (57%) and 15/247 (43%) were pediatric hematolymphoid and solid cancers, respectively. The median age was 9 years, while male-to-female ratio was 2.26. Acute lymphoblastic leukemia (ALL), 76/247 (31%) was the most common pediatric cancer overall. Hodgkin's lymphoma, 27/142 (19%) was the second most common hematolymphoid malignancy, after ALL was 76/142 (54%). Among solid tumors, Wilms' tumor was the most common, 28/105 (27%) followed by Ewing's sarcoma, 16/105 (15%), and germ cell tumor, 15/105 (14%). Central nervous system malignancies were among the least common solid tumor cancers, 3/105 (3%). Conclusion: ALL and Hodgkin's lymphoma are the most common pediatric cancers. Among solid malignancies, Wilms tumor, Ewing's sarcoma, and Germ cell tumor are predominant.

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Background: Cerebral palsy(CP) is presently defined as a group of permanent disorders of the development of movement and posture, causing activity limitation, that are attributed to non-progressive disturbances that occurred in the developing fetal or infant brain. Low vitamin D levels in children with CP are also associated with decreased muscle strength, balance, muscle pain, paresthesias, and poor muscular coordination. Materials & Method: It is the Prospective observational cross-sectional study. The patients in the study group were of both sexes and aged 6 months to 12 years. All children apart from general tests underwent investigations for serum calcium total {By an automated analyzer}, serum phosphorus {By an automated analyzer}, serum alkaline phosphatase (SAP) levels {By an automated analyzer} and 25 OH vitamin D level {By CLIA (chemi luminescence immunoassay) method}. Results: Total 141 Children who satisfied inclusion and exclusion. Male children were 96 (68%) whereas female were 45(32%).The distribution by the CP type was Quadriplegia 44.0%, Diplegia 34.8%, Hemiplegia 7.1%, Monoplegia 1.4%, Hypotonic 2.1%, Dyskinetic 0.7%, Mixed 0.7%, Evolving CP 9.2%. Ambulatory CP children were 60 (42.5%) and non ambulatory were 81 (57.5%).

Background: Low back pain (LBP) and sciatica is a common clinical condition worldwide.The initial treatment of Low back pain is conservative. Epidural steroid injection (ESI) is being slowly established as a reliable mode of conservative management in many orthopaedic centres of the world. This is a preliminary report of ongoing study of the use of epidural steroid injection the management of low back pain cases coming to the orthopaedic department of Government Medical College Jammu. Methods: 150 Patients reporting with low back pain and sciatica not responding to other modes of conservative treatment were prospectively followed over a two year period. The caudal epidural steroid injections were performed, as many as three injections two week apart .The patients were assessed before and after the procedure clinically and the Level of pain, improvement in physical signs and ability to do activities of daily living were noted. Results:150 patients were observed for the duration of 2 years. Average duration of symptoms was for six months. After first epidural steroid injection 80% [120] of patients reported relief within first two weeks. Forty Four (44) patients required two injections and 12 patients required three injections. Twelve (12) patients reported no relief after first injection. The duration between two injections was two to three weeks. Average duration of pain relief was 17days. At the end of three months, good results were seen in 49%, fair in 32% and bad results in 18%. Overall 69% of patients were able to do activities of daily living. Most common complaint of patients after injection was pain at the injection site. No major complications were encountered. Conclusion: Epidural Steroid Injection is a simple, cost effective and minimally invasivemode of treatment of Low Back Pain and sciatica. It provides pain free period to enable the patient for physiotherapy which helps in early recovery.

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