Background: The new curriculum is competency-based and revised. The student must be imparted and should have learned these competencies. New teaching–learning methods such as “Case-based learning (CBL)” and “Flipped classroom (FCR)” can help medical students to be competent Indian medical graduates. Aims and Objectives: This study was aimed to evaluate the effectiveness of “CBL” over “FCR” for teaching clinical and applied aspects of physiology. Materials and Methods: Faculty and residents of the department of physiology and first-year MBBS students were introduced and oriented to the study and concept of CBL and FCR. Students were divided into two groups; one was taught clinical and applied aspects of cardiovascular physiology by CBL and another group by FCR. Pre- and post-test with a validated questionnaire were conducted for both groups. Feedback from the students was collected on 5-point Likert’s scale and the marks obtained by them were analyzed statistically by paired t -test. Results: Both CBL and FCR improved the post-test marks significantly when compared to pre-test marks ( P < 0.0001). CBL and FCR methods showed no significant difference, but the mean post-test marks were higher in FCR. As per the students’ feedback, 62% of students strongly agreed that CBL is useful for clinical and applied aspects of physiology. Conclusion: CBL and FCR both are equally important and complementary to each other. CBL was found to be slightly more effective for later days of clinical practices, whereas FCR slightly more effective for better performance in university examinations.

Introduction: Intracapsular fractures of the proximal femur form a major share of fractures in the 77 elderly. Hip replacement arthroplasty (partial or total) is emerging as a most viable treatment option, and in that, hemiarthroplasty with the Austin Moore Prosthesis is among the most commonly employed. In our study, we have made an attempt to assess the functional status at long term follow up after hemiarthroplasty with the AMP, used in the treatment of fracture neck of femur in the elderly population, and to substantiate the use of the prosthesis in modern day orthopaedic practice. Materials and : A retrospective study was carried out in patients above the age of 60 years, who had been diagnosed with non-pathological fracture neck of femur, treated operatively with hemiarthroplasty using the Austin Moore prosthesis in a tertiary care centre. A minimum follow up period of two years was considered. All the patients were evaluated clinically, and wherever possible, radiologically. Functional outcome was assessed based on the Harris Hip scoring system, and the results were analysed. Radiologically, an attempt was made to assess, among others, the amount of protrusio acetabuli at follow up, and femoral offset changes following hemiarthroplasty with the AMP. Results: In our study, we observed a positive functional outcome (excellent or good) in 9(45%) patients, with fair result in 6(30%) and poor in 5(25%). However, when pain alone was taken as criteria for assessment, upto 14(75%) patients had none to slight pain at follow up, and only 1(5%) patient had marked pain. Walking distance was significantly reduced in 6(30%) patients, who were either confined indoors or bedridden, but in only 1(5%) of them, the cause for the decreased ambulatory status was implant or procedure related (pain). Among the complications, 1 patient had a post-operative periprosthetic fracture that healed subsequently, 2 patients had marked osteolysis around the stem of the prosthesis, and only 1 patient had a radiological evidence of protrusio acetabuli. Discussion: Hemiarthroplasty with Austin Moore Prosthesis for fracture neck of femur remains a fairly good treatment option in elderly patients.

BACKGROUND Distal radius fractures accounts for 16% of skeletal and 74% of forearm fractures. Prevalence is more among females, with progressive increase in age complications arises as osteopenia and osteoporosis become more prevalent. The most common trauma mechanism is falling over the outstretched hand. The characteristics of such fractures (trace location, possible joint involvement, comminution and degree of soft tissue injury) are directly related to the force of the trauma, wrist angle at the moment of the trauma and bone health. There is no uniform consensus on the definite choice of treatment. A randomised prospective and retrospective study was undertaken to compare closed reduction and k wire fixation and open reduction and internal fixation with volar LCP and evaluated in terms of functional outcome, the rate of nonunion, malunion and local complications in patients with distal end radius fractures. MATERIALS AND METHODS Patients with distal end radius fractures (AO type A2 A3 B1 C2 C3) in age group of 12 to 78 years were recruited and randomly allocated into two groups, consisting 30 patients each. Group 1 patients were treated surgically by open reduction and internal fixation with volar LCP with whereas patients of group 2 were managed with closed reduction and k wire fixation. Follow-up was done at 06 weeks, 03 months and 06 months 9 months, 15 months, 20 months, their radiographic assessment was done and other complications were evaluated. Finally, functional outcomes were assessed at final follow up visit using "Demerit point rating system" of Gartland & Werley. RESULTS In group 1, results were excellent in 63.3% (19) cases, good in 23.3% (7) cases, fair in 13.3% (4) cases whereas in group 2 results were excellent in 46.7% (14) cases, good in 23.3% (7) cases, fair in 23.3% (7), poor in 6.7% (2) cases as per Gartland & Werley score. In group 1, 2 patients developed superficial infections which was resolved with antibiotic and dressing whereas in group 2, patients developed pin tract infection leading to removal of k wire.in group 1 2 patients suffered from grade 1, 2 arthritis whereas in group 2 2 patients suffered from grade 2, 3 arthritis. Finally modified Gartland & Werley demerit score for group 1 was 3.67, whereas for group 2 was 6.5. CONCLUSION Open reduction and internal fixation with volar LCP gave superior results as compared to closed reduction and k wire fixation in management of distal end radius fractures in terms of union and function.

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