Our results point to the non-homogeneous nature of this group of leprosy patients with 1 to 5 skin lesions, with varied bacteriological and histopathological features. The significance of MB type findings on histopathology in patients grouped as PB leprosy should be resolved so that these patients may be given the drug therapy and the duration of therapy they warrant.

Aim: To evaluate the role of facet tropism as an etiological factor in lumbar intervertebral disc prolapse. Setting: Medical college teaching hospital from South India Design: Case series analysis Methods: The study included MRI scans of 120 patients which were studied by Heithoff's technique. The facet angles of each segment were measured by Cyron and Hutton's method. The association of asymmetry of lumbar facets and low back pain was studied. Results: In 80 patients with MRI showing disc prolapse, there was more asymmetry of lumbar facets compared to 40 patients with low back pain but MRI showing no disc prolapse. Although facet tropism was observed in subjects with MRI showing no disc prolapse, it was encountered far more frequently in patients with disc prolapse. It was seen that lateral disc prolapse occurred more frequently in patients with facet tropism and the prolapse tended to occur more frequently on the side where facet angle was lower. The results showed no significant association between facet tropism and lumbar disc prolapse. Conclusion: Facet tropism may be one of the causes of back pain because altered mechanism of the spinal motion segment. The association of facet tropism and lateral disc herniation needs to be investigated further before attributing a causal relationship.

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Background: Arthroscopic ACL reconstruction surgery is commonly performed as an outpatient procedure and is often associated with postoperative pain. Objectives: We aimed to find out the effects of intra-articular ropivacaine-morphine on postoperative pain in patients undergoing elective arthroscopic ACL reconstruction surgery. Materials and Methods: A total of 46 patients undergoing elective arthroscopic ACL reconstruction under spinal anaesthesia were enrolled. The participants were allocated to two groups to receive the following intra-articular medications after completion of the surgery and before deflation of the tourniquet: Group I, 20 mL of saline, Group II, 0.25% Ropivacaine and 5 mg morphine 20 mL in volume. Visual analogue scale (VAS) values were recorded at 1, 3, 6, 12 and 24 hours postoperatively, duration of analgesia, total analgesic consumption, and number of rescue analgesia at 24 hours were evaluated. Results: VAS was significantly higher in group I in comparison to other groups. Duration of analgesia was significantly longer in Group II than in Group I. Number of rescue analgesia and total analgesic consumption at postoperative hour 24 was significantly fewer in group II. Conclusions: Intraarticular ropivacaine-morphine combination provides effective pain relief, longer analgesic duration, and less analgesic requirement when compared with intra-articular ropivacaineclonidine combination and saline after arthroscopic ACL reconstruction surgery.

Background: Chronic Low back pain has become a very common entity in Indian population and a prolapsed inter-vertebral disc [PIVD] is one of the most leading causes. The aim of the study is to treat chronic low back ache due to a Lumbar PIVD with a Caudal Epidural steroid injection. Methodology: This is a prospective study conducted at Department of Orthopaedics, MVJ Medical College and research hospital from July 2018 to July 2019. Patients in the age group of 30-60 years with low back ache with or without radicular pain in lower limbs, not responding to oral medications and physiotherapy were included in the study. Caudal epidural block consisting of 80mg of Methyl Prednisolone, 1.5ml of bupivacaine 0.5%, 6.5ml of Distilled water is taken in a 10ml Syringe and given with 22G Spinal needle through sacral hiatus. Patients were evaluated prior to steroid infiltration and follow up at three weeks, three months and six months using the Numeric Pain Rating Scale (NPRS) and Disability using Oswestry Disability Index (ODI). Results: The total the 60 patients in our study, 2 patients were lost in follow up. Of the remaining 58 patients who were followed for a period of 6 months, 45 patients [78%] had significant relief of pain and improvement in their ODI functional outcome. Conclusion:Caudal epidural steroid injection is an effective modality of management in patients with chronic low back ache due to a Lumbar PIVD.