ORIGINAL RESEARCH ARTICLE | Sept. 25, 2021
Stroke; A Major Cause of Cardiovascular Mortality- A Review
Ezennaka RC, Dodiyi-Manuel ST
Page no 283-294
Background: The term stroke or cerebro-vascular accident refers to a syndrome of rapidly developing clinical signs of focal (or global) disturbance of cerebral function, with symptoms lasting 24 hours or longer or resulting in death with no apparent cause other than of vascular origin. Stroke can be classified into two broad types: Ischemic and Hemorrhagic. There are multiple risk factors for stroke but systemic hypertension (HBP) is the most common yet modifiable risk factor for stroke . Cardioembolic stroke is a heterogenous entity and a variety of cardiac conditions can predispose to cerebral embolism. Methodology: Literature search was done using google search, hinari research, PubMed and books from the author’s collection. Results: The GBD study for the years 2002-2030 has estimated that there were 16 million first-ever strokes and 5.7 million deaths in 2005. The prevalence of stroke in subjects with HBP has been reported by various authors worldwide to range from 19.5% in Canada to 29% in USA and 30% in England. Cardiac diseases have been shown to increase risk of stroke. Atrial fibrillation is the most powerful and treatable cardiac precursor of stroke. The cardiovascular risk factors from the current National Cholesterol Education Project Adult Treatment Panel III (NCEP ATP III) include the non- modifiable, modifiable and emerging risk factors.
ORIGINAL RESEARCH ARTICLE | Sept. 30, 2021
Unreamed Tibia Intra Medullary Interlocking Nails to Prevent Complications & Fat Embolisms as A Damage Control Orthopaedics in Human Even in COVID 19 Era- Legacy of Method for These Common Musculoskeletal Injuries
Dr. Vivek Amritbhai Patel, Dr Vishal Ashokraj Pushkarna, Dr. Vraj Jagdish Patel, Dr. Smit Divyesh Bhai Dave
Page no 295-302
Introduction: Tibial fracture is one of the commonest bony injuries associated with increasing number of road traffic accidents in developing countries. The long bone contains long medullary canal & have a subcutaneous position. Reaming of medullary canal may increase the chances of fat embolisms syndrome & increase the inflammatory response. Controversy prevails between reaming & unreaming of the medullary canal as considered the fracture union, ease & short surgical time & systemic complications. Objective: The objective of the study is to evaluate the results of short surgical time & unreamed vancomycin dipped tibia interlocking nail surgery in hanging leg position for tibia fractures. Material & Methods: In this study total (n= 49) cases of tibia fracture who underwent unreamed tibia nailing were evaluated retrospectively. Among (n=49) cases (n= 35) 71% were males & (n=14) 29% were females. According to Ellis classification (n=20) patients had mild, (n=25) patients had moderate & (n=4) patients had severe variant. Results: In the study total number of cases with tibia fracture included where commonest mode of injury was vehicular accident (n=40) (82%) and fall from height (n=9) (18%). Patients who were operated late had associated injuries that prevent early operation. Rust score was used for radiological union score. Mean value of rust score for this study was 8.8 with Inter observer agreement among all three reviewers was substantial, with ICC=0.78(95% CIs 0.65-0.90). Follow-up duration varied from 1 to 6 months with one patient had infection at surgical side and went for debridement and intravenous antibiotics for recovery. Conclusion: Unreamed interlocking tibial nailing can be safely used for type-I and type-II open injuries even with delayed presentation. Compared to reamed nail there is ease of technique application and the decreased operative time in unreamed interlocking nailing.