Aim: To determine the frequency of vitamin D deficiency in patients of epilepsy on valproate sodium. Study design: Case control study Place and duration of study: Department of Neurology, Chandka Medical College Hospital, Larkana and Khairpur Medical College, Khairpur Mir’s from 1st July 2021 to 31st December 2021. Methodology: One hundred adults were enrolled which were further divided into two groups. Those patients suffering from clinically determined epilepsy (n=50) and treated for epilepsy were placed in group A and were treated with sodium valproate while healthy adults within same age group were placed in group B (n=50). Clinical assessments were made through neurological assessment for epilepsy. A blood of 2cc was withdrawn from group A and B participants and tested for 25(OH) vitamin D levels by and serum sodium valproate (in only group A) using enzyme linked immunosorbent assay. Results: The mean of group A patients was 24.2±3.5 years while of group B was 28.3±1.5 years. The dosage of sodium valproate in mg/d was given as a mean value of 869± 350.9. The mean serum levels of sodium valproate as assessed was found as 79.8 mmol/L. Body Mass Index value showed that obesity was significantly highly common in group a than Group B.A comparison of vitamin D levels between group A and Group B showed that the severe deficiency as well as deficiency of vitamin D was significantly prevalent (56%) in epileptic group such as group A while insufficiency was also higher in the similar group A. Conclusion: There was a high frequency of vitamin D deficiency in patients with epileptic condition and getting treated with sodium valproate. Key words: Frequency, Vitamin d deficiency, epilepsy, Valproate sodium

Objective: To evaluate the outcome of patients in term of range of motion after total knee arthroplasty with all poly implants. Study Design: Retrospective study Place and Duration of Study: Department of Orthopaedics, Sahara Medical College, Narowal from 1st April 2021 to 31st March 2022. Methodology: Sixty various patients who came for total knee arthroplasty were selected on the basis of their conditions. Patients were divided into two inserts groups for understanding the better outcome results in terms of range of motion (ROM). Thirty patients having fixed bearing and other 30 patients having mobile bearing inserts will all poly implants. A standardized medial-parapatellar approach was taken for surgical procedure and resection of primary tibia was done. Pain function and evaluation was performed through knee society scoring (KSS) as well as VAS score and goniometer was used for analyzing range of motion which was defined as degree of flexion of knee subtracting from number of extension-defect. Results: There was no significant difference in either the gender or ages of both implants selected patients However the mobile bearing group patients has a better BMI value than the fixed bearing implant patients. In term of range of motion mobile bearing group patients had a higher ROM value than the fixed bearing operated patients in case of overall change in range of motion analysis. The Western Ontario and McMaster Universities Osteoarthritis (WOMAC) Index, score showed a significant change with an increased value observed in mobile bearing implant patients. Conclusion: Visual analogue pain score show significant difference in mobile and fixed bearing group. In terms of range of motion, mobile implants show better outcome in contrast to fixed bearing group. Keywords: Knee implants, Mobile, Fixed bearing, Outcomes, Osteolysis

Objective: To assess the outcome of dynamic hip screw fixation in intertrochanteric femur fractures. Study Design: Prospective cohort study. Place and Duration of Study: Department of Orthopaedics, Pak Red Crescent Medical & Dental College, Dina Nath from 1st October 2020 to 31st March 2022. Methodology: Fifty Patients suffering from intertrochanteric femur fractures were enrolled. The operational time as well as incision length, measurement of blood loss during surgery was recorded. The chance of re operating on a patient and post-operative infection was also observed and documented. A complete follow up for assessing the outcomes of dynamic hip screws were continued until 18 months. Results: The mean age of the patients was 58.05±7.58 year. There were 64% males in this study while only 36% females. The ASA grade presented 32% cases within grade II while grade I and IV had equal number of cases in it. The Harris hip score presented outcome scores at 1 then 2 followed by 12 then 15 and 18 months as mean 75.37, 85.40, 88.25, 88.76 and 87.53 respectively. Conclusion: Dynamic hip screw fixation is reliable surgical procedure for treating intertrochanteric femur fractures with decreased complication rate and improved Harris hip scoring. Keywords: Proximal femoral nail technique, Distal hip, Hip fracture

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