Background: Backache is quite a common problem in adults.one of the common reasons for this is compression on nerve roots due to disc bulge. The pain may start from back and radiate to legs. Objective: The study aimed to evaluate the efficacy of corticosteroids when injected by transforaminal route. Study design: This descriptive study was conducted at Orthopedic Unit 2 Mayo Hospital Lahore. The duration of the study was six months from January 2018 to June 2018. Material and Methods: The study was conducted on the 127 patients attended the orthopedic department of our institute hospital. The ethical and review board committee of the hospital approved the study. Every participant was informed about the study and they willingly signed the written consent. According to the inclusion criteria the patients of age above than 18 diagnosed with the lumber pain. The 127 patients of both genders that were included in the study were given transforaminal epidural injections (TEI). The results were studied after 4 weeks. The pain reduction was scored using Oswesrty Disability Index (ODI). The age range of the patients included in the study was from 20 to 80 years. SPSS 5 was used for statistics analysis of the data collected. Results: The calculated mean ODI of patients at the start was 73.90+ and after four weeks it was reduced to 27.62-+8.66. The mean ODI score at baseline of the patients was 73.90±7.64 with lowest and highest value of 46 & 94 respectively. The average ODI score at 4th week of the patients was 27.62±8.66 with lowest and highest values of 10 & 60. The study results showed that the average reduction of ODI from baseline to 4th week of the patients was 46.29± 10.98 with lowest and highest reduction of 20 & 68. Conclusion: This study concluded that a significant reduction in mean pain score was noted with transforaminal Injections in patients with lumbar radical pain. It can be recommended to be used in patients with lumbar radical pain. The pain reduction was statistical significant after TEI. Keywords: Transforaminal epidural injection, Oswesrty score, lumbar radicular pain.

Objective: In the present study, the researchers want to establish the outcome of spine fixation for unstable fractures at the dorsolumbar junction, including fractured vertebrae, while using pedicular screw fixation techniques. Study Design: Prospective study Place and Duration: The study was conducted at Orthopaedics Department, Hayatabad Medical Complex, Peshawar and Neurosurgery Department, Frontier Medical and Dental College, Abbottabad for the duration of six months from May 2021 to October 2021. Methods: There were hundred and nineteen patients of both genders had unstable fracture at dorslumbar junction. Patients were aged between 20-55 years. Transpedicular screws were used to secure the fractured vertebra. Both radiographic and clinical assessments of back pain and impairment were conducted using the Visual Analogue Scale (VAS) and the Oswestry Disability Index (ODI) to evaluate patients (ODI). Before surgery, shortly after surgery, and eight months afterwards, all of these data were assessed. SPSS 23.0 version was used to analyze complete data. Results: Mean age of the patients was 33.5±5.42 years. 85 (71.4%) cases were males and 34 (28.6%) patients were females. Falling from the height was the most common reason found in 60 (50.4%) cases followed by road traffic accident 45 (37.8%) cases and 14 (11.8%) were others. L1 fractures were majority found in 67 (56.3%) cases followed by L2 in 40 (33.6%) cases. Post-operatively, we found significantly improvement in Cobb angle, anterior vertebral height, posterior vertebral height and sagittal index with p value <0.05. Oswestry disability index (ODI) was improved to 41.13±19.42% from 70.6±16.43%. Mean pain score (VAS) was reduced to 1.01±5.23. Post-operatively only 7 (5.9%) patients had complications. Conclusion: Our patients who had transpedicular screw fixation, which included fixing the broken vertebrae, had outstanding radiological and clinical outcomes. Treatment of the fractured vertebra in transpedicular screw fixation of dorsolumbar spine fractures is, thus, highly recommended. Keywords: Dorsolumbar Junction, Transpedicular screw fixation, Outcomes, VAS

Background: Patients suffering from severe hip arthritis and osteonecrosis are increasingly turning to total hip arthroplasty (THA) as a treatment option, according to recent research. If deep vein thrombosis (DVT) is not treated properly, it can result in a life-threatening pulmonary embolism as well as other potentially life-threatening consequences (PE). Aim: To compare the efficacy of aspirin with rivaroxaban in postoperative dvt prophylaxis after hip arthroplasty in patients at tertiary care hospital, Karachi Methodology: The College of Physicians and Surgeons of Pakistan approved this study prior to its completion. The Department of Orthopedics at JPMC, Karachi, chose those who had complete hip arthroplasty for the study. The school's ethical committee approved the study before it could begin. Before participating in the trial, all patients signed an informed consent form granting them permission to do so. Results: Patients from JPMC Karachi's Department of Orthopedics were included in the study. They were aged 49 to 75. Travel time to the hospital was an average of 58.878.19 years. They were aged 49 to 75. For every month, hour, and day spent in hospital, there are 14.416.14. Eighty people used aspirin, 32(40%) were 40-60 and 48(60%) were 61-75. In the rivaroxaban group, 40 patients (50%) were 40-60, and (61-75). The aspirin group had 80 patients, 38 male (47%) and 42 female (42%) (52.5%). One hundred and twenty-five patients (68.8%) were on rivaroxaban (31.2%). Conclusions: People who have a spontaneous venous thromboembolism should not be given long-term thromboprophylaxis after taking oral anticoagulants until more research is done. It is very important to figure out what DVY risk factors are in order to come up with preventative measures that are both safe and affordable. People can live longer if they get an early diagnosis and get treatment quickly, so they can live longer. High-quality, large-scale studies must be done before a conclusion can be drawn. Keywords: DVY risk, thromboembolism, thromboprophylaxis, arthroplasty