Background: As the body's protective skin barrier is breached in open fractures, and the potential of contamination is high, these can lead to significant morbidity. Vacuum-assisted closure (VAC) is the application of the negative pressure in open wounds, and it significantly improves wound healing both at the macro and micro levels. Material and Method: A total of 30 patients (23 males and 7 females with a mean age of 27 years) with large open fractures of long bones who received VAC therapy during the early period of treatment were studied. VAC dressing over wound was done following percutaneous pinning or external fixation. In addition, rates of infection, fracture union, duration of application of VAC, and the association of duration of VAC with the development of complications were evaluated. Results: The mean time between the trauma and the first debridement was 8.20 hours (range, 2–23). The mean duration of VAC application was ten days (range, 3–16). Delayed wound closure was performed in nine patients. In the remaining 21 patients, the mean decrease in the wound dimensions between pre and post-VAC application was found to be 43.06% (range, 20–60%). Conclusion: VAC application increases the patient's comfort by reducing the need for dressing changes, improves blood circulation, accelerates the formation of granulation tissue, reduces the rate of infection from the hospital environment, decreases edema, alleviates the need for secondary interventions, and also decreases wound dimensions. Keywords: wound, open fractures, vacuum-assisted closure, wound healing.

Introduction: Adhesive capsulitis is a painful impairment characterized by the restriction of movement of shoulder due to the adhesions across the glenohumeral joint, injection of platelet-rich plasma is effective treatment to reduce the pain and restore the movement of shoulder. Aim: To assess the effectiveness single PRP injection in management of adhesive capsulitis. Material and Methods: This study enrolled 12 patients experiencing the shoulder pain for at least 3 months and attending our medical college hospital. Patients with adhesive capsulitis were given a single injection of PRP (4 ml) and followed up for 12 weeks, VAS scores and Disability Index scores were recorded and compared with the baseline scores. Result:  In present study majority of patients were females with mean duration of symptoms was 3 months. Post PRP treatment all the patients have shown significant improvement on pains VAS score, movement VAS score on 2nd, 6th, and 12th weeks follow up. Conclusion:  Present studies conclude that the AC is more prevalent among females which can be treated effectively with PRP technique. PRP as is a simple, safe and cost-effective management of AC without any adverse effects. Keywords: Adhesive Capsulitis, Platelet-Rich Plasma, Corticosteroid, Intra-articular

Background: Avascular necrosis (AVN) or osteonecrosis is the death of bone tissues due to decreased blood flow of femoral head, it is a major orthopaedic disease with many risk factors including the chronic alcohol and tobacco consumption.  Aims and objectives: To study the relationship of alcohol and tobacco with AVN of femoral head in adult population. Materials and Methods: This study included 72 patients of AVN of femoral head (ONFH) who attending our hospital between Sept 2018 to Sept 2020. History of alcoholism and tobacco consumption, detailed information of the amount and duration of smoking and alcohol intake was recorded. Results: Majority of the AVN patients were working age groups males (72%) and 28% were females. Out of 72 patient 55% had history of alcohol consumption and 60% were smokers which indicates a positive correlation of cellular toxicity with AVN of femoral head. Conclusion: Present study conclude that the alcohol ingestion and tobacco smoking are the major cause of cellular toxicity and AVN of femoral heads. Keywords: alcohol drinking, femur head necrosis, smoking

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