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Khursheed O.,Government Medical College Srinagar Hospital for bone and joint surgery Barzulla | Wani M.M.,Government Medical College Srinagar Hospital for bone and joint surgery Barzulla | Rashid S.,Government Medical College Srinagar Hospital for bone and joint surgery Barzulla | Lone A.H.,Government Medical College Srinagar Hospital for bone and joint surgery Barzulla | And 6 more authors.
Musculoskeletal Surgery

Purpose: Fractures involving the femur in older adults are reasonably common. The aim of this study was to evaluate the results of MIPO technique using locking plates in geriatric patients for distal extra-articular femur fractures. Methods: About 25 consecutive patients with distal extra-articular femur fractures aged 60 years and above were treated using locking plates and minimally invasive technique. Patients were studied prospectively over a period of 3 years. Parameters studied included patient demographics, fracture type, time taken for the surgery, time to union and any complications. Results: Mean age of patients was 66.5 years. Nineteen (76 %) patients were females. Most of fractures in our study were type 33A2 fractures (64 %). Average time to full weight bearing was 14.32 weeks, and fractures united at an average of 16.88 weeks. There were two (8 %) patients with superficial infection, two (8 %) with implant tenderness. One (4 %) patient developed knee stiffness. Five (20 %) patients had extension lag of average 5°. One (4 %) patient sustained a peri-implant fracture at 2 months. None of the patients developed non-union or delayed union. According to criteria laid by Schatzker’s and Lambert, excellent results were achieved in 22 (88 %) patients. Conclusions: Outcome of minimally invasive fixation of distal extra-articular femur fractures with locking plates in patients of age 60 years and above seems to be good with high union rate despite high prevalence of osteoporosis and comminution. © 2014, Istituto Ortopedico Rizzoli. Source

Mir T.A.,SKIMS Medical College Srinagar | Ashraf M.,SKIMS Medical College Srinagar | Ahmed K.,GB Pant Hospital | Chowdhary J.,GB Pant Hospital | And 2 more authors.
Lung India

Objectives: This observational study was done to describe the clinical profile, and delays in diagnosing cystic fibrosis (CF) disease in Kashmir, India. Materials and Methods: A total of 6758 patients between the ages of 0 and 19 years were registered over a period of 1 year. Out of these, 150 patients suspected of having CF, on clinical grounds, were subjected to pilocarpine iontophoresis, and later on genetic evaluation. Apart from these specific tests, these patients were subjected to laboratory tests like blood counts, blood sugar, KFT, LFT, pancreatic function test, serum electrolytes, and chloride, urine, throat swab, blood culture, ABG analysis, chest and paranasal X-rays. In addition, sonographic evaluation of abdominal organs was carried out to know the status of internal organs. A polymerase chain reaction (PCR)-based test was used for the identification of CF mutation. Results: CF was diagnosed in three (0.8%) patients. Median age of presentation of CF was 78 months. Family history suggestive of CF was present in one (33.3%) and consanguinity in three (100%) patients. Common clinical manifestations at the time of presentation included recurrent pneumonia in three (100%), failure to thrive in three (100%), recurrent diarrhea in one (33.3%) patients. General physical examination showed pallor in three (100%), malnutrition in three (100%), and clubbing in two (66.7%) patients. Examination of respiratory tract revealed hyperinflation in two (66.7%), rhinitis in two (66.7%), and creptations in two (66.7%) patients. Sonography of abdominal organs revealed pancreatic cysts in one (33.3%), hyperechoeic and increased liver span in two (66.7%), and small gallbladder in one (33.3%). Staphylococcus aureus was cultured from sputum in one (33.3%), pseudomonas aeruginosa in one (33.3%) patients. Delta F508 mutation was present in one (33.3%) patient. Conclusion: CF may be more common in Kashmir and other parts of Asia, than indicated by our study; diagnosis is often considerably delayed when the disease is identified solely on clinical grounds. It would be advisable to raise the index of suspicion about CF. Source

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