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Comparison between Distal Femoral Nail and Distal Femoral Locking Plate in the Treatment of Type A Supracondylar Fracture of Femur
No full textBackground: The severity and intricacy of distal femur fractures make management difficult. The knee is a weight-bearing joint that controls mobility and stability. Early surgery is needed to permit weight-bearing and prevent complications. Despite advances in surgery and implants, distal femur fracture implant choice remains debated. Objectives: To compare the outcome of distal femoral nail (DFN) and distal femoral locking plate (DFLP) in the treatment of type A supracondylar fracture of the femur.
Methods: The Orthopaedic Surgery Department of Sylhet MAG Osmani Medical College Hospital conducted a prospective comparative observational study from September 2021 to February 2024. 32 fresh type A supracondylar femur fracture patients were separated into DFN and DFLP groups. Patients with polytrauma or comorbidities were excluded. We obtained data through interviews, clinical exams, radiography, and Neer\u27s rating. Following ethical norms, SPSS 25.0 was used for analysis.
Results: The DFN group had a mean age of 33±11.37 years and the DFLP group 33.12±11.01 years, with a male majority. Average operating time was 90±7.52 minutes for DFN and 83.75±13.60 minutes for DFLP (p > 0.05). Top cause: road traffic accidents (94.3%). Bone union occurred in 75% of DFLP patients and 68.8% of DFN patients, with a substantially shorter mean union time (18.12±1.71 weeks vs. 21±1.82 weeks, p < 0.05). Anterior knee discomfort was substantially higher in DFN patients (56.2%, p < 0.05). In the DFLP group, the mean Neer\u27s score was much higher (86.56±15.05 vs. 77±10.78). Functional outcomes were excellent in 50% of DFLP and 31.3% of DFN patients, with no significant difference in bad results.
Conclusion: Both distal femoral nail and distal femoral locking plate are equally effective and adequate treatment options for type A supracondylar fracture of femur
Comprehensive Homeopathic Management of Recurrent ENT Allergic Manifestations in Childhood
No full textRecurrent nasal polyps with chronic allergic rhinitis are common in pediatric patients and can significantly affect quality of life. This case study reports an 11-year-old boy with recurrent nasal polyps and persistent allergic rhinitis, previously operated twice with recurrence. The patient presented with sneezing, nasal obstruction, watery discharge, disturbed sleep, and examination-related anxiety. Under individualized homeopathic management at Dr. Batra’s, there was marked improvement in allergic symptoms, reduction of nasal obstruction, stabilization of polyps, and overall enhancement of well-being over a twelve-month follow-up. The case highlights the effectiveness of a holistic, constitutional approach in managing recurrent ENT conditions, emphasizing regular monitoring and support of both physical and mental health
Sculpting Soft Tissue with Diode Laser: A Prerequisite for Implant Success- A Case Report
Full text linkIntroduction: Inadequate vestibular depth and insufficient attached gingiva can hinder plaque control and compromise long-term implant success. This case demonstrates the use of diode laser-assisted vestibuloplasty to optimize soft tissue conditions prior to implant placement.
Case Presentation: A 44-year-old male presented with missing mandibular anterior teeth and reported difficulty maintaining oral hygiene. Clinical examination revealed mucosal scarring and shallow vestibule due to previous faulty suturing, along with inadequate attached gingiva. Diode laser- assisted vestibuloplasty was planned to enhance soft tissue dimensions.
Management & Outcome: A horizontal laser incision at the mucogingival junction was performed without suturing. Healing was uneventful, and vestibular depth increased from 2 mm to 5 mm within 14 days. Following complete soft tissue healing, three dental implants were placed, and final prosthetic rehabilitation was completed after three months, restoring optimal function and aesthetics.
Conclusion: Diode laser-assisted vestibuloplasty is an effective, minimally invasive technique to improve soft tissue architecture, enabling successful implant placement and long-term peri-implant health
Iron Deficiency Anemia as a Risk Factor for Simple Febrile Seizures in Children Between 6 Months and 5 Years: A Case-Control Study
Full text linkBackground: Iron deficiency anemia and febrile seizures are common pediatric conditions, yet their relationship remains incompletely understood. This study investigated the association between iron deficiency anemia and simple febrile seizures in children aged 6 months to 5 years.
Methods: A case-control study was conducted with 90 children (45 cases with simple febrile seizures and 45 age and sex-matched controls with fever without seizures). Complete blood count, serum iron, total iron-binding capacity, and serum ferritin levels were measured in all participants. Iron deficiency anemia was defined according to WHO criteria, and statistical analysis included multivariate logistic regression to adjust for potential confounders.
Results: Iron deficiency anemia was significantly more prevalent in the case group (71.1%) compared to controls (31.1%). Children with febrile seizures had lower mean hemoglobin (9.8 ± 1.4 g/dL vs. 11.2 ± 1.2 g/dL, p<0.001) and serum ferritin levels (median 8.6 ng/mL vs. 18.4 ng/mL, p<0.001). Multivariate analysis revealed iron deficiency anemia as an independent risk factor for febrile seizures (adjusted OR: 3.28, 95% CI: 1.75-6.12, p<0.001). A significant negative correlation was observed between serum ferritin levels and peak temperature during febrile episodes (r = -0.42, p<0.001).
Conclusion: This study demonstrates a strong association between iron deficiency anemia and simple febrile seizures in young children. The findings suggest that screening for iron deficiency may be warranted in children presenting with febrile seizures, and iron supplementation could potentially play a role in preventing such episodes
To study the relationship between the presence and location of intracardiac echogenic foci (ICEF) and their potential association with congenital heart defects (CHDs)
Full text linkBackground: Intracardiac echogenic foci (IEF) are common findings during second-trimester fetal ultrasound examinations, yet their relationship with congenital heart defects (CHDs) remains incompletely understood. This study investigated the association between the anatomical location of IEF and the presence of CHDs to enhance current risk assessment strategies. Methods: In this prospective observational study, we examined 100 pregnant women between 18-24 weeks of gestation who presented with fetal IEF during routine anatomical scanning. Detailed fetal echocardiography was performed in all cases, documenting the precise location of echogenic foci within the cardiac chambers. All cases underwent postnatal cardiac evaluation to confirm prenatal findings. The relationship between IEF location and CHDs was analyzed using multivariate logistic regression. Results: Among the study population, IEF were predominantly located in the left ventricle (48%), followed by the right ventricle (28%), both ventricles (16%), and other cardiac chambers (8%). Congenital heart defects were identified in 15 cases (15%), with a significantly higher prevalence in fetuses with bilateral IEF (adjusted OR: 3.8; 95% CI: 1.6-9.2; p = 0.002) and right ventricular IEF (adjusted OR: 2.4; 95% CI: 1.1-5.3; p = 0.038). Ventricular septal defects were the most common anomaly (40% of CHD cases), followed by atrial septal defects (20%). Conclusion: The anatomical location of IEF demonstrates significant association with the risk of congenital heart defects, with bilateral and right ventricular IEF carrying higher risks compared to isolated left ventricular IEF. These findings suggest the need for location-specific risk stratification in prenatal counseling and follow-up protocols
Pediatric Pyogenic Meningitis: A Comprehensive Analysis of Clinical Course and Outcomes
Full text linkBackground: Pediatric pyogenic meningitis remains a significant global health challenge despite modern therapeutic advances. This prospective observational study aimed to analyze the clinical course, microbiological profile, treatment outcomes, and prognostic factors in children with pyogenic meningitis.
Methods: We conducted a comprehensive analysis of 157 children aged 1 month to 12 years diagnosed with pyogenic meningitis at Department of Pediatrics, DBVP RMC, PIMS(DU), Loni. The study evaluated clinical presentations, laboratory findings, microbiological profiles, treatment responses, and outcomes through a structured follow-up period of 6 months.
Results: The median age of presentation was 2.8 years, with male predominance (58.6%). Causative organisms were identified in 71.3% of cases, with Streptococcus pneumoniae (42.9%) being the most prevalent pathogen, followed by Neisseria meningitidis (27.7%) and Haemophilus influenzae (16.1%). Significant antibiotic resistance was observed, with 22.9% of S. pneumoniae isolates showing penicillin resistance. The overall mortality rate was 10.8%, while 26.8% of survivors developed neurological sequelae. At 6-month follow-up, hearing impairment emerged as the most common long-term complication (17.2%). Multivariate analysis identified age <1 year (OR 2.8, 95% CI 1.4-5.6), admission Glasgow Coma Scale <12 (OR 3.5, 95% CI 1.8-6.9), and delayed presentation (OR 2.4, 95% CI 1.2-4.8) as significant predictors of adverse outcomes.
Conclusions: Our findings highlight the persistent burden of pediatric pyogenic meningitis and identify critical prognostic factors that can guide clinical management. The emergence of antibiotic resistance and high rates of neurological sequelae emphasize the need for enhanced surveillance, updated treatment protocols, and structured follow-up programs. Early recognition and prompt intervention remain crucial for improving outcomes in this serious infection
Distribution and Severity of Dengue Serotypes in Pediatric Cases: Analysis of Clinical Outcomes in Children 1-12 Years in Endemic Regions
Full text linkBackground: Dengue fever remains a significant public health concern in pediatric populations across endemic regions. Understanding serotype-specific disease patterns and their correlation with clinical outcomes is crucial for improving patient care and reducing mortality.
Objective: To analyze the distribution of dengue serotypes and their relationship with disease severity in pediatric cases aged 1-12 years, examining clinical manifestations, laboratory parameters, and outcomes across different serotypes.
Methods: This prospective observational study enrolled 100 children (ages 1-12 years) with laboratory-confirmed dengue infection. Serotype identification was performed using RT-PCR, and patients were classified according to WHO 2009 guidelines. Clinical features, laboratory parameters, and outcomes were systematically documented and analyzed in relation to viral serotypes.
Results: DENV-2 emerged as the predominant serotype (38%), followed by DENV-1 (30%), DENV-3 (22%), and DENV-4 (10%). The 6–9-year age group represented 45% of cases, with a slight male predominance (54%). DENV-2 infections showed the highest rate of severe dengue (21%) and demonstrated more severe clinical manifestations, including significant thrombocytopenia (mean nadir: 35,000 ± 15,000/μL) and elevated hematocrit levels (mean peak: 45 ± 5%). The overall mortality rate was 2%, exclusively associated with DENV-2 infections.
Conclusion: The study reveals significant associations between dengue serotypes and disease severity in children, with DENV-2 consistently associated with more severe clinical manifestations and poorer outcomes. These findings emphasize the importance of early serotype identification in clinical settings and suggest the need for serotype-specific management approaches in pediatric dengue cases
Comparison of Outcome Between Anti-Tubercular Therapy Alone and Selective Neck Dissection Followed by Anti-Tubercular Therapy in Retreatment Cases of Tubercular Cervical Lymphadenopathy
Full text linkBackground: Tubercular cervical lymphadenopathy (TCL) is a common form of extrapulmonary tuberculosis (EPTB), frequently presenting with painless cervical lymph node swelling. Treatment primarily involves anti-tubercular therapy (ATT), but in cases of relapse or treatment failure, the addition of surgical intervention may enhance outcomes. This study aims to compare the outcomes of ATT alone versus a combination of selective neck dissection (SND) followed by ATT in retreatment cases of tubercular cervical lymphadenopathy.
Methods: A single-blind, randomized controlled trial was conducted at Dhaka Medical College Hospital from January 2022 to July 2023. A total of 48 patients with retreatment cases of TCL were randomly assigned to either Group A (SND + ATT) or Group B (ATT alone). Data were collected on demographic characteristics, clinical presentation, lymph node involvement, diagnostic methods, and treatment outcomes. Patients were followed up every two months for six months to assess treatment efficacy.
Results: The study found no significant differences in demographic characteristics between the groups. In terms of treatment outcomes, Group A showed a significantly higher cure rate (95.83%) compared to Group B (75.0%) (p = 0.043). Recurrence of disease was significantly lower in Group A (4.16%) than in Group B (25.0%) (p = 0.042). Complication rates were similar between the groups (Group A: 4.16%, Group B: 12.5%), with no significant difference (p = 0.300).
Conclusion: The addition of Selective Neck Dissection to Anti-Tubercular Therapy in retreatment cases of tubercular cervical lymphadenopathy significantly improves cure rates and reduces recurrence without increasing complications. These findings suggest that surgical intervention may be beneficial for patients with TCL who fail or relapse with medical therapy alone
Homeopathic Management of Pediatric Vitiligo: A Case Study with 11-Year Follow-Up Without Remission
No full textVitiligo is a chronic dermatological disorder characterized by depigmentation of the skin due to loss of melanocytes. Homeopathy offers a holistic approach by addressing the constitutional, mental, and physical aspects of the patient, using individualized remedies tailored to the totality of symptoms. This case study highlights a pediatric patient presenting with depigmented patches around the eyes, Progress was gradual and monitored over several months, with reduction in patch size, active repigmentation, and improvement in associated complaints. By the end of the treatment period, complete recovery was achieved, with no new lesions, normalized skin texture, and improved confidence. The patient responded positively to the holistic homeopathic management under Dr. Batra’s care.
This paper demonstrates the effectiveness of individualized homeopathic treatment in vitiligo, emphasizing the importance of constitutional, mental, and miasmatic assessment in achieving sustained recovery
Management of Acute Hair Loss Following Varicella Infection: A Case Study
No full textHair fall, or alopecia, is a common condition affecting millions worldwide, with androgenic alopecia and post-infectious hair loss being frequent causes in young adults. Homeopathic management focuses on individualized treatment considering the patient’s constitution, mental and physical generals, and specific symptomatology, aiming not only to control hair fall but also to improve scalp health and overall vitality. This case study presents a 20-year-old male with hair fall and thinning in the crown region, which developed following an episode of chickenpox. The patient also experienced intermittent dandruff and itching. Over a twelve-month follow-up, holistic homeopathic management led to a gradual reduction in hair fall, improved hair density, and stabilization of scalp condition. The patient reported high satisfaction with the treatment outcome, highlighting the importance of personalized care, lifestyle modification, and close follow-up