Templating of preoperative X-rays is routinely performed before a total knee replacement. We performed this retrospective study on preoperative templating in primary total knee replacement to assess its accuracy and reproducibility. Preoperative radiographs of 47 patients were templated twice by two observers separately after a gap of 3 months. The size of actual implant used was compared to the size predicted by templating. Data were analysed to assess inter and intra-observer variation. Templating was accurate for both tibial and femoral components in only 53.2% of observations. This study also revealed that templating is a highly-subjective and observer-dependent technique. Inter-observer and intra-observer mismatch was present in 46.8% and 43.6% of readings respectively. We conclude from this study that preoperative templating is neither accurate nor reproducible.

Background: Generalized peritonitis as a result of gastrointestinal perforation is a common surgical emergency in India. The present study was conducted to understand the spectrum of perforation peritonitis in terms of etiology, clinical presentation, site of perforation, surgical treatment, postoperative complications, and mortality encountered at Shyam Shah Medical College and Sanjay Gandhi Memorial Hospital Rewa (M.P.) India.Methods: The study was a prospective observational study conducted from July 2018 to June 2019 in the Department of General Surgery, S. S. Medical College and Sanjay Gandhi Memorial Hospital Rewa (M.P.). A total of 280 patients with perforation peritonitis were included in the study and underwent exploratory laparotomy.Results: Out of 280 patients, there were 234 males (83.57%) and 46 females (16.43%). Most common affected age group was 21 to 30 years (19.64%). Doudenal perforation was the most common type (35%), which were mainly due to Acid peptic disease (48.92%) followed by Jejunal and Ileal perforations (34.95%). In our study, a variety of operative procedures were performed depending on the patients general condition, peritoneal contamination, site of perforation, gut viability, and surgeon’s decision. Wound infection was the most common complication (29.64%). Mortality rate was 7.5% (21 patients).Conclusions: Perforation is diagnosed on clinical grounds immediately as patient reaches emergency department, time lost due to delayed hospitalization affects the outcome of standard surgical procedure. Selection of appropriate surgical procedure and postoperative care is helpful in early and uneventful recovery.

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Neurological development of children is predisposed by their know-hows. Early involvements and the environments in which they occur can alter gene expression and affect long-term neural development. Presently, open screen time, often involving multiple devices, is the single main experience and environment of children. Various screen activities are reported to induce structural and functional brain malleability in adults. However, childhood is a time of significantly greater changes in brain anatomical structure and connectivity. Pragmatic evidence suggest that extensive exposure to videogame playing during childhood may lead to neuroadaptation and structural changes in neural regions connected with addiction. Digital natives exhibit a higher frequency of screen-related 'addictive' behavior that reflects impaired neurological reward processing and impulse-control mechanisms. This review article explains the basis of current pediatric neurological concerns surrounding SDS and put forward preventive strategies for child neurology and allied professions.

Background: Distal fractures of the femur especially comminuted, intra-articular distal femoral fractures AO classification 33-C remain challenging fractures for orthopaedic surgeons. Due to soft tissue damage, comminution, articular involvement and extensor mechanism injury functional outcome is poor in fracture distal femur. Materials and Methods:We have done prospective study of 20 patients of intraarticular distal femur fracture AO classification 33-C treated operatively with locking compressive plate at S.S.G. hospital and medical college, Baroda during January 2014 to March 2016.We have studied functional outcome using neer's score, radiological outcome and complication associated with fracture fixation using LCP. Result: Out of 20 patients 14 were males and 6 were females. The youngest patient was 18yrs old and the oldest 70 yrs.4 patients had C1,10 pt had C2 and 6 pt had C3 type of fracture according to AO classification,12 patients were operated with extensile lateral approach.8 patients were operated using Swashbuckler approach. In 3 patients primary bone grafting was done for severely comminuted type C3 fracture. Secondary bone grafting was done in 1 delayed union case at 4 month. Pt shows sign of union at 9 month.1 Pt develop non-union treated with secondary bone grafting at 9 month with signs of union at 12 month.1 pt develop infection on 4 th post-operative day resolved with surgical debridement and antibiotic. The average duration of weight bearing was12 weeks. Average time for fracture healing was 20 weeks. Average range of motion of knee was 110 degrees. Among 20 patients there were 9 excellent result, 5 good results, 3 had fair results and 3 had poor results. Discussion: The LCP acts on the internal fixator principle as screws once locked to the plate do not pull the fracture towards the implant, and hence there is no displacement of the fracture once reduced. Distal femur locking plate provides angular stability and provides multiple options to secure fracture fragments, both metaphyseal and articular. In our study we get better functional outcome using locking compression plate for intraarticular distal femoral fracture. Along with anatomical reduction and rigid fixation, early mobilization and aggressive physiotherapy are key for better functional outcome. Conclusion: In present study better functional outcome achieved using locking compression plate for intraarticular distal femoral fracture along with aggressive physiotherapy.