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Background The present study aimed to report the outcomes of acute and subacute arthroscopic bony Bankart repairs in collision athletes. Methods We reviewed 22 consecutive rugby players with traumatic anterior glenohumeral instability who underwent arthroscopic bony Bankart repair within 4 months of injury over a 2-year period. All lesions were less than 25% of the glenoid bony area. Results A significant improvement was noted at three months and was maintained at 28 months postoperatively. The mean Constant score improved from 61.5 to 84.1, the mean Oxford shoulder score decreased from 26.3 to 13.6 and the mean Oxford instability score decreased from 42.9 to 13.5. The mean satisfaction score was 8.3 out of 10 at final follow-up. All patients returned to their pre-injury sporting level. Twenty patients (91%) remained stable and asymptomatic, although two (9%) had recurrent instability after further traumatic sports injuries. One required a modified Latarjet procedure, whereas the other patient sustained a soft tissue Bankart lesion and had a revision arthroscopic repair. Conclusions Acute and sub-acute bony Bankart lesions in collision athletes can be addressed through arthroscopic repair with a satisfactory outcome and return to pre-injury level of sport [ABSTRACT FROM AUTHOR]

The concepts of neighbourly irregular neutrosophic graphs, neighbourly totally irregular neutrosophic graphs, highly irregular neutrosophic graphs and highly totally irregular neutrosophic graphs are introduced. A criteria for neighbourly irregular and highly irregular neutrosophic graphs to be equivalent, is discussed. [ABSTRACT FROM AUTHOR]

The main purpose of this paper is to discuss the notion of neutrosophic graphs, weak isomorphisms, co-weak isomorphisms and isomorphisms between two neutrosophic graphs. It is proved that the isomorphism between the two neutrosophic graphs is an equivalence relation. Some other properties of morphisms are also discussed in this paper. [ABSTRACT FROM AUTHOR]

Objectives: The study aimed to find out the status of postgraduate training and continuing medical education (CME) of family physicians of Pakistan. Methodology: It was a 10 months postal survey between November 2009 and September 2010. Postal questionnaires were sent to randomly selected 1200 family physicians. The data was analyzed using SPSS v-17. Results: The response rate of survey was 24%. The number of family physicians receiving any kind of post graduate training was 104 (36%) while 184 (64%) had no postgraduate training at all. Medicine was the most common subject in postgraduate training (N=19, 18% of 104). The number of family physicians holding any degree was 87 (30%). Mean weekly time spent on self education was 6.5 hours with a range of 1 to 10 hours. Conclusions: Most of family physicians are practicing without training and mostly update their knowledge from books and use of online CME is low. [ABSTRACT FROM AUTHOR]

We thank Dr Fung for his interest in our article that was recently published in I JBMR i .[1] As Fung correctly states, the fracture and bisphosphonates (FAB) study showed that alendronic acid did not have a clinically important effect on fracture healing or patient-reported outcomes in patients who were bisphosphonate naïve for the previous 2 years. Fung subsequently suggests that it would be prudent to delay bisphosphonate treatment until after healing has occurred, citing two studies that examined fracture healing in people who were taking bisphosphonates as opposed to those who were not.[[4]] In one of these studies,[4] the differences in time to union in bisphosphonate-treated and control groups (6 days) was not considered to be clinically significant. Effect of preoperative bisphosphonate treatment on fracture healing after internal fixation treatment of intertrochanteric femoral fractures. [Extracted from the article]

Objective: To find the effectiveness of Continuing Medical Education (CME) program as a tool for professional development by comparing the passing rates of those doctors who participated in CME course with those who did not take the CME program. Methodology: Doctors who appeared in Membership of Royal College of General Practitioners (MRCGP) exam in 2007 and 2008 from Lahore Examination Center were included in the study. Their data was compiled from copies of their registration forms and results announced by Royal College of General Practitioners, UK. Results: A total of 145 Family Physicians appeared in MRCGP Exam in 2007 and 2008. One hundred fourteen (78%) were members of CME and 31 (22%) were not. Twenty eight were successful in final part 2 of MRCGP Exam, out of which 27 (96% of 28) were CME members and one (6%) were non members. Conclusion: Continuing Medical Education programs can also be used to prepare practicing Family Physicians for postgraduate exam. [ABSTRACT FROM AUTHOR]

An edge magic total (EMT) labeling on a graph Γ = (V (Γ), E(Γ)) with |V (Γ)| = p and |E(Γ)| = q is a bijective function: V (Γ) [ E(Γ) ! {1, 2, ..., p + q} with the property that for each edge uv E(??), ψ(u) + ψ(uv) + ψ(v) = c, where c is a constant. An edge magic total (EMT) labeling is called super edge magic total (SEMT) labeling if the smallest numbers are given to the vertices. In this paper, we study the existence of SEMT labeling of disjoint union of stars and subdivided stars. [ABSTRACT FROM AUTHOR]

Objective: To assess the level of professional satisfaction amongst family physicians of Pakistan and to identify the factors associated with professional dissatisfaction., Methods: The study was part of a larger national survey for "Status of PostgraduateTraining and Continuing Medical Education of Family Physicians in Pakistan" which was a cross-sectional, postal survey of family physicians conducted over 10 months between November 2009 and September 2010. The main outcome variables were professional satisfaction, as well as reasons for professional satisfaction and dissatisfaction. SPSS 17 was used for data analysis. Multivariable logistic regression was used to determine factors associated with professional dissatisfaction., Results: Of the total 1200 survey forms distributed, 288 (24%) were received back. The mean age of the participants was 37 +/- 9 years with a range between 26 and 72 years. Of the total, 226 (78.5%) were males. Overall, 213 (74%) family physicians were satisfied with their profession. The factors significantly associated with professional dissatisfaction included the participants opinion that they were not respected by the public (OR: 11.6, C.I: 1.9-71.5); as well as regretting being a doctor (OR:62.9, C.I: 8.4-469.8)., Conclusions: Most of the family physicians had professional satisfaction, but a minority had regrets about being a doctor and were dissatisfied over how their profession affected their family life. Further research may be needed to study work-life balance amongst family physicians of Pakistan.

Background: In 2005 northern parts of Pakistan were hit by an earthquake of magnitude 7.6 on rector scale. Fatima Memorial Hospital established a Primary Health care centre in village of Jared in Kaghan valley. The objective of the study was to find the pattern of different diseases presetting to health centre., Methods: All cases between August 2006 and December 2008 were included from the daily outpatient record of the centre. Data was analyses using SPSS-17. Frequency of different diseases and groups of diseases in different age groups, sexes and time of the year were the main outcome variables., Results: Total number of patients was 22,122 with a mean age of 26 +/- 16 years. The number of female patients was 12,634 (57.1%) and males were 9,488 (42.9%). The single most common condition in the study period was viral upper respiratory tract infection (5,042, 23%), followed by Scabies (3,757, 17%), Acid Peptic Disease (3,157, 14.3%), Urinary Tract infection (1,197, 5.4%) and Hypertension (n = 933, 4.2%). There was a high number of young patients with urinary tract infection and hypertension., Conclusion: Communicable diseases like viral respiratory tract infection and scabies were the most common infections. Acid peptic disease was the most common non-communicable medical problem. Except eye conditions, all diseases were more common in summer and rainy season.

Objective: To determine the perceptions of the community about prevalence of different diseases in Gulshan-e-Sikandarabad, an urban squatter settlement in Karachi and compare them with the data about disease pattern available at Primary Health Care Center in the same community., Methods: A stratified random sample of ten percent of houses of the community was selected and both male and female heads of household were interviewed. Open ended questionnaire was used to record perceptions of responders. A total of 336 persons were interviewed out of which 196 (58%) were females and 140 (42%) were males., Results: Age, education, nationality and ethnicity (Sikandarabad has inhabitants from Afghanistan as well. In our study 12 were Afghan nationals. Among Pakistani responders majority were Pathans, some were Punjabi, Saraiki etc.) had no statistically significant difference in responses. Gender had the most significant difference in responses. The perceived nine top most common diseases were similar to the top nine common diseases according to data of the health center of Ziauddin University located in Gulshan-e-Sikandarabad., Conclusion: The perceptions of community members about most of the common diseases prevalent in their community was similar to the disease pattern maintained at Primary Health Care center in the same locality. Anaemia and helminth infestation although common according to the health center record were not perceived as common by the community members.

Chemonucleolysis is an established modality in the treatment of lumbar disc prolapse and has been widely used for over 39 years since its introduction by Lyman Smith in 1963. We report the medium to long-term functional outcome of patients who had chemonucleolysis for single level disc prolapse. One hundred and twelve patients were reviewed retrospectively with a mean follow-up of 9.5 years. The Oswestry Disability Index questionnaire was used to estimate the functional outcome of chemonucleolysis. An excellent or good response occurred in 79 patients (70.5%) while 12 patients (10.7%) showed moderate response with minimal disability. Treatment failed in 21 patients (18.5%) who showed poor response and 12 of these 21 patients went for surgery within a mean period of 6 months. One patient had surgery at a different level than chemonucleolysis. There was only one incident of procedure termination because of epidural contrast leak. There was no case of anaphylaxis or discitis. We concluded on the basis of our results that in carefully selected patients, chemonucleolysis is a safe and effective treatment modality for lumbar disc herniation with good medium to long-term functional outcome.