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Introduction: In North India, orthopedic trauma, which refers to injuries affecting the bones, joints, and soft tissues, occurs frequently in pediatric patients. The aim of this study is to investigate the epidemiology, etiology, mechanisms of injury, and outcomes of orthopedic trauma in pediatric patients who are admitted to a tertiary care trauma center located in North India. Materials and Methods: This prospective study was carried out over 1 year between January 2019 and December 2019, which included 479 pediatric orthopedic trauma patients between the age group of 0 and 18 years. The collected data were systematically classified and analyzed with respect to the mode of trauma, type of injury, and outcome across various age groups and genders. Results: Age of children ranged from 0 to 18 years, of which 298 (62.2%) were male and 181 (37.8%) were female. Most fractures occurred at aged 9–12 years (38.4%) and the trend decreased with age. Fall injuries were the most common mode of trauma (49.9%, n = 239) followed by road traffic accident (29.4%, n = 141). Among operated patients, most injuries were closed (47.2%, n = 138) followed by compound injuries (32.2%, n = 94) and crush injuries (20.6%, n = 60). Sixty-three percentage of patients recovered well with independent functional status, while 30% recovered with supported functional status/residual deformity. Conclusion: Orthopedic trauma in pediatric population is growing up and prehospital care is lagging which is more required than adult counterpart. An effective and aggressive management of accident prevention programme is required, which should also include changes in lifestyle and environment, overcoming obstacles such as ignorance, inadequate resources, and illiteracy.

Aims and Objectives: This study aimed to evaluate the functional results and clinicoradiological outcomes of extra-articular closed proximal third tibia fractures managed by suprapatellar nailing in semi-extended position with a minimum follow-up of 12 months. Materials and Methods: In our prospective study, 15 cases of extra-articular closed proximal third tibia fractures admitted between January 2019 to December 2020, treated with intramedullary nailing through suprapatellar approach, were included. The patients were followed up regularly at 2 weeks, 6 weeks, 3 months, 6 months, 12 months, and every 6 months thereafter. The clinical outcome was analyzed using the Lower Extremity Functional Scale (LEFS) at 12 months’ follow-up visit. The radiological outcomes were analyzed by evaluating the radiographs for fracture union and alignment. Results: Fifteen patients having proximal third tibia fracture fulfilling the inclusion and exclusion criteria were included in the study. Patients had an average age of 34 years (24–55 years). The average follow-up period was 14 months (12–18 months) after the index procedure. The average time for radiological union was 6 months (range: 4–12 months). Two patients had procurvatum malalignment of >10°. We did not have significant rotational or varus/valgus malalignment or limb length discrepancy of >1 cm in our study. The average LEFS score at the 12 months’ follow-up was 88% (median: 90%; range: 80%–98%). Conclusion: We recommend the use of intramedullary suprapatellar nailing for fixation of proximal third tibial fractures. Suprapatellar nailing has inherent advantages of patient positioning for perfect nail entry and placement. When performed following the established surgical principles and techniques and proper patient and implant selection, it provides excellent clinicoradiological outcome with less complications as compared to other fixation methods for such fractures. There is also absence of anterior knee pain which is very common in the standard infrapatellar approach due to which its use could be extended for nailing of all types of tibia fractures.

Introduction: Thromboangiitis obliterans (TAO), also known as Buerger's disease, is a disease of unknown etiology affecting small- and medium-sized blood vessels, mainly seen in heavy smokers. The characteristic features of this disease are distal ischemia, with patients having claudication, rest pain, and toe ulcers. The proper management of TAO is still a challenging problem. Various medical and surgical treatments have been tried with a variable success. Since it is a disease characterized by chronic ischemia, achieving neoangiogenesis could have a beneficial effect. Ilizarov has shown that corticotomy and distraction of bony fragments can increase the blood supply to the entire limb. TAO can be managed using this principle of distraction osteogenesis to induce neoangiogenesis. We conducted this study to evaluate the clinical outcomes of longitudinal tibial corticotomy and horizontal distraction with Ilizarov's fixator in Buerger's disease of the lower limb. Materials and Methods: Ten patients with clinically and radiologically proven Buerger's disease admitted to our hospital between 2019 and 2021 who had failed the conservative pharmacological modalities of treatment were included. A lateral tibial corticotomy and distraction was performed by the use of olive wires and two-ring frame with horizontal distraction mechanism. Lateral distraction was started after 10 days at the rate of 0.25 mm 6 h for 25 days to achieve a distraction of 2.5 cm. The frame was removed after consolidation of regenerate. Results: Of the 10 cases, eight patients became pain free, while one had a partial relief of pain and one patient worsened on treatment and underwent below-knee amputation. Three patients had at least one episode of pin site infection which improved with oral antibiotics and dressings. One patient had delayed consolidation of regenerate. The claudication distance improved at each follow-up for all but one patient. Conclusion: Neoangiogenesis by corticotomy and distraction offers a relatively simple and cost-effective surgical option to salvage ischemic limbs from amputations and provide pain relief, ischemic ulcer healing, and improved claudication distance, thus improving the quality of life.

We measured COVID-19-related stigma and discrimination and its drivers using a concurrent mixed-methods design in Punjab. The simple random sampling was used to select blocks, subcenters, and urban primary healthcenters from each of the four selected districts. The systematic random sampling was used to select households. A sample of 423 adults was interviewed using a structured questionnaire and 10 in-depth interviews were conducted using an interview guide. Binary logistic regression was performed to find the predictors. Stigma prevalence was mild 18%, moderate 45%, and severe 37%. Logistic regression indicated that stigma was lower in the rural compared to the urban population (P < 0.01). Hospitalized patients faced discrimination more often compared to those who were treated/quarantined at home. People feared police (71%), testing (69%), and contracting the infection (65%). Fear of screening, disclosure of status, and transmission of the virus were the drivers of stigma and discrimination. Co-occurrence of labeling, stereotyping, and cognitive separation was observed.

Purpose: The aim of this study was to report a comparison between the zinc oxide eugenol dressing and plasma rich in growth factor (PRGF) with gelatin sponge in the treatment of dry socket. Materials and Methods: This study comprised of 45 patients of dry socket in the span of one year. The patients were randomly divided into three groups on the basis of treatments: Group A (PRGF with gelatin sponge), group B (zinc oxide eugenol group), and group C (irrigation with sterile saline only). The clinical progress was noted at 1 st , 2 nd , 3 rd , 7 th , and 15 th day after the treatment. Results: Patient′s healing was better in group A than in group B but symptomatic pain relief was faster in group B. Group C fared worst in both aspects. Conclusion: We conclude that PRGF with gelatin sponge might be a treatment of choice in the management of dry socket.

Objective : To use the periosteum as a barrier in treatment of buccal Grade II furcation defects of lower molars. Materials and Methods : This technique was performed on 12 patients with bilateral buccal Grade II furcation defects of lower molars. On a random basis, one furcation defect of each pair was selected for the control group and other for the experimental group. Debridement was done in the defect area in both groups. In the control group, after debridement, mucoperiosteal flap was sutured back. In the experimental group, after reflection of the mucoperiosteal flap, a portion of the periosteum along with a layer of connective tissue (periosteal membrane) was incised and mobilized in the defect area for defect coverage as a barrier, and then the periosteal membrane and mucoperiosteal flap were fixed with suture, respectively. Horizontal dimension of the furcation defect was the primary outcome measure. Gingival index, probing attachment level (PAL), and vertical dimension of furcation defect were the secondary outcome measures. Clinical parameters were registered at baseline and at 6 months. Results : Every clinical parameter was improved by surgery. Significant gain in PAL as well as horizontal and vertical dimensions of the furcation defects was found. Conclusion: This periosteum displacement technique is effective for the treatment of buccal Grade II furcation defects of lower molars.