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Since the outbreak of coronavirus 2019 (COVID-19) disease in China, late December 2019, it took a substantial detriment and challenges for more than 200 countries worldwide. Recently with the upcoming insights about etiology of the virus, there is increasing evidence that many patients with COVID-19 are asymptomatic or they have only mild symptoms, but they act as carrier and are able to transmit the virus to others. There are technical difficulties in screening for these asymptomatic infections, which makes it even more challenging for any nation to control this epidemic. This article reviews entry & replication of the virus, pathogenesis, asymptomatic infections, dissemination, prevention, control & treatment in asymptomatic infections with COVID-19, expecting it would be helpful for early prevention and containment of this severe public health threat worldwide.

Background: Low back pain has plagued humans for thousands of years and it is extremely common with lifetime prevalence of 60-90% and annual incidence of 5% so we studied the problem of acute lumbosciatic syndrome which is defined as pain located near the loins in the lower back region and along the sciatic nerve, its remedies with objective to find out the possible causes of acute lumbosciatic syndrome. Aim of the study was to study characteristics of low back pain patients and outline the best possible treatment for them. Methods: The study comprises of 110 patient of adolescent to elderly age presenting with acute low back pain with radiation of pain to buttock and thigh. The prospective randomized study was completed in two years at the department of orthopedics at a tertiary care center. Results: Acute low backache was found to be more common in upper middle class and Lower class. Medium and heavy manual workers were found to be more predisposed to acute low backache and among specific occupation porters carrying heavy weights were most commonly involved. Prolapsed intervertebral disc was found be commonest cause of acute lumbosciatic syndrome. By conservative treatment in a year there was 76% of patients showed improvement in back pain, 73% showed improvement in paresthesias, 79% showed improvement in numbness and 69% showed improvement in neurological claudication. Education in proper posture and body mechanics is helpful in returning the patient to the usual level of activity after the acute exacerbation has been relieved. Conclusions: Every patient of low back pain should be thoroughly examined on all parameters before reaching to final diagnosis and treatment of low back pain by conservative treatment should be aimed on the prevention rather than treatment by multiple drugs.

Background: Osteoarthritis is an inevitable consequence of aging and second only to cardiovascular diseases in producing severe chronic disability. Osteoarthritis is characterized by degenerative changes in articular cartilage of diarthrodial joints and subsequent new bone formation at the articular margin. It is the result of excessive aging that primarily produces an alteration in the ratio of total glycosaminoglycans to that of fiber content in the matrix. The aim was to evaluate the results of proximal tibial osteotomy in medial compartment osteoarthritis (OA) of knee in terms of relief of pain, range of movement, correction of deformity and functional outcome Methods: This prospective observational study was conducted on 24 patients in the age range 54 to 70 years at the department of orthopedics, Era’s Lucknow Medical College from July 2014 to May 2016. The femorotibial angle was assessed radiologically. A written informed consent was obtained. A closed wedge osteotomy was done followed by rehabilitation programme. Results: It was concluded that proximal tibial osteotomy is a satisfactory alternative to joint replacement surgery in osteoarthritis limited to medial compartment of the knee in developing countries like India. Conclusions: The study concluded that proximal tibial osteotomy is a satisfactory alternative to joint replacement surgery when the disease is restricted to medial compartment of the knee.

Background: Inter-hospital transfer is a common in trauma victims due to paucity of super-specialty care, lack of specialty beds, and lack of funding. The government of Uttar Pradesh introduced Emergency Medical Response system (EMRS). There is a need to audit and evaluate the transfer process since the introduction of the service. The objectives of this study were to identify critical gaps in the transfer of trauma patients and secondary over triage to the trauma centre of KGMU.Methods: This prospective observational study was conducted on trauma victims referred to the trauma centre. Patients were evaluated for clinical status, Injury Severity Score, protective patient devices present, type of intravenous fluid infusion, mode of transport, and level of referring hospital. Transfer records, transport vehicles and accompanying personal were evaluated.Results: Of the 342 patients enrolled in the study, 91 had a GCS score

Background: Femoral neck fracture in elderly continues to pose a treatment dilemma. Associated co-morbidities and high mortality (1-year mortality of 25–30% and only 25% survivorship at 10 years) often skews the surgical decision. The underlying treatment goal is minimum revision and maximum functional outcome. Lack of clear guidelines is reflected by the continued debates regarding their management namely osteosynthesis vs arthroplasty; hemiarthroplasty vs total hip arthroplasty, unipolar vs bipolar and cemented vs uncemented. A review of joint registries, uniformly suggest that cemented fixation in elderly patient results in early mobilization, less residual pain and the lowest risk of revision. We analyzed clinical outcome of cemented monoblock hemi-arthroplasty (modified design) in femoral neck fracture in elderly.Methods: Total 94 cemented hemiarthroplasty, performed since January 2009, with a minimum follow up of 3 years are included in the study. Mean modified Haris Hip score at 2 years, 3 years and in the last follow up was 88 (72-91), 84 (70-89) and 81 (65-86) respectively. Acetabular erosion was noted in three patients (3.19%) (one was symptomatic) and aseptic loosening in another two patients (2.12%). Major complications such as deep wound infection, dislocation or peri-prosthetic fracture were not noted in any patient.Results: Result of the present study is consistent to marginally superior when compared to cemented Thompson monoblock and the cemented bipolar prostheses. We attribute this to routine use of cement in the elderly osteoporotic bone along with design modification of the monoblock stem. Long term result of THA is marginally (not statistically significant) better compared to hemiarthroplasty. However, it is associated with prolonged surgery, more blood loss and higher dislocation rate. The rates of dislocation following THA, bipolar and unipolar arthroplasty were 11%, 3%, and 2% respectively.Conclusions: Cemented monoblock hemiarthroplasty is effective and viable option in displaced femoral neck fracture in elderly in terms of excellent functional outcome, low reoperation without adversely affecting morbidity and mortality. Being cost effective procedure this may be considered as first line surgical option especially in socio-economically disadvantaged section of the society.

Tuberculosis of the musculoskeletal system is generally confined to bones and joints. The surrounding soft tissue is secondarily infected. Tuberculous bursitis, tenosynovitis and primary pyomyositis are rarer manifestations of the disease. Of these, primary tuberculouspyomyositis is probably the rarest entity. We report a case of tubercular myositis of infraspinatus in an 8 year-old female who presented with pain, low grade fever, weight loss, anorexia, progressively increasing pain in the scapular region and restriction of movements. There was no history of trauma, diabetes, immunosuppression, corticosteroid usage, or renal failure. History of contact was present. Tenderness was present along the medial border of scapula and movements of upper extremity requiring movement of the scapula were painful and grossly restricted. MRI of the scapulothoracic region and shoulder revealed small amount of fluid along medial border of scapula with T2 hyperintensity of infraspinatus. Histopathology showed caseous necrosis, inflammatory cells and granulomatous cells suggestive of tuberculosis. Polymerase Chain Reaction for Mycobacterium tuberculosis was found to be positive. Patient was started on four-drug antitubercular treatment and regular dressings. The patient’s general condition improved and at 4 weeks post starting ATT, there was no pain and the patient was able to perform complete range of movement. This is probably the first reported case of tubercular myositis of infraspinatus in an immunocompetent patient without any identifiable focus elsewhere in the body. Rarity of the condition, presence of characteristic findings on MRI and histopathology make the case illustrative for young Orthopaedics surgeons.