BackgroundThe occurrence of both tuberculosis (TB) and concomitant hepatitis B virus (HBV) is likely to be associated with poor patient outcomes and poor treatment response. ObjectiveTo assess whether tuberculosis patients with concomitant hepatitis B virus infection were prone to poorer outcomes and treatment response. MethodologyA case-control study was undertaken at the Tuberculosis Centre,

OBJECTIVES To find the functional outcome of the open Latarjet method for recurrent anterior shoulder dislocation. METHODOLOGY The current retrospective study was conducted at the Orthopedic and Trauma Department of the Khyber Teaching Hospital in Peshawar from September 2020 to August 2021. A total of 31 patients were included in the study, of which 29 were males and 2 were females. A detailed medical history was obtained through physical examination, and all necessary laboratory tests were requested. AP and axillary views of plain X-ray radiographs were taken. We used a CT scan on all the patients to calculate the humeral and glenoid bone loss. We had all patients undergo an MRI to rule out soft tissue pathology. Six months after surgery, the outcome was graded using the Constant Murley Score on a good, good, fair, and poor scale. RESULTS In this study open Latarjet procedure was done in 31 patients with 29 males (93.4%) and two females (6.45%). The right-sided shoulder was involved in 24 (77.14 %) patients, while the left shoulder was involved in 7 patients (22.58%). A bipolar lesion in the shoulder with bone loss was seen on the glenoid side at 17.5% (range 10-25%), and the humeral side was 22.5%. Follow-up was done for six months in which 22 patients had a very good outcome (70.96%), six patients had a good outcome(19.35%), two patients had a fair outcome(6.45%), and one patient had a poor outcome(3.22%). There were no major complications seen like graft fractures, graft  malposition, neurovascular compromise, and hardware breakage CONCLUSION Recurrent anterior shoulder instability can be effectively treated with open Latarjet with excellent functional outcomes and a very low complication rate and recurrence.

Objective: To compare the role of early versus delayed fixation of intracapsular fracture of the femoral neck in young population in terms of Avascular Necrosis (AVN) of Femoral Head.                                 Material and Methods: This quasi-experimental study was conducted in Peshawar from January 2020 till June 2021 at the Department of Orthopedic Khyber Teaching Hospital and all patients with age 18 to 60 years who had the neck of femur fracture (Garden type 1 and 2 undisplaced and Garden type 3 and 4 displaced fracture) were included who presented within one week of fracture. Group 1 consisted of the early fixation group (fixated within 24 hours) while late group 2 consisted of the late fixation group (those who fixated after 24 hours). The development of AVN was assessed on follow-up X-ray at 6 weeks, 3 months, and 6 months. Data were analyzed using SPSS. Mean and standard deviation was used for quantitative data. Frequency and percentages were used for qualitative data. A p-value of ? 0.05 was taken as significant. Shapiro Wilk’s test was done to find the normality of the data. Results: The mean age of the 64 included patients was 52 ± 5 years. The male to female ratio was 1:1.5. The ratio of displaced to undisplaced fracture was 2:1. A total of 34 patients belonged to group 2 while 30 to group 1. In group 2, 9 patients with displaced fracture and 2 with undisplaced fracture experienced osteonecrosis of the femoral head. While in group 1, 8 patients with displaced fracture and 1 with undisplaced fracture experienced osteonecrosis of the femoral head. No significant effect of time delay on the chances of developing osteonecrosis of the femoral head was noted in group 2 even after a delay of 24 hours with a p-value of 0.201. Conclusion:  We conclude that there is no significant difference in the outcome of femoral neck fracture whether it was fixed early or late.