Aim: To observe the workload of fractures of the femur (shaft and distal femur) and their fixations along with complications in terms of infection and mortality at our hospital during COVID 19 pandemic. Study design: Prospective study. Place and duration of study: Dept of Orthopaedic, Ghurki Trust Teaching Hospital, Lahore from 01-03-2020 to 31-07-2020 Methodology: One hundred and thirty-one diagnosed patients with femur fracture (shaft and distal) during pandemic period of COVID were enrolled. Demographic data included (age, sex, implant type, surgical site infection (SSI) and mortality).Since study was done during COVID-19 pandemic, positivity of COVID symptoms was noted as yes/ no on data collection proforma. Results: There were 105 (80.15%) males while 26 (19.84%) were females with mean age was 39.20±13.02 years. Majority of the surgical interventions were done based on Intramedullary nailing 74.05%, the second prevalent surgeries were done on AO external fixation 8.4%. Infection rate was observed in 7(5.32%) patients. No mortality was seen in any of the cases. Four infected cases were observed after intramedullary nailing procedure, two from AO external fixation and one after locking plate. Conclusion: There is no significant higher complication rate due to COVID-19 pandemic to patients whom femur fracture fixation was done. None of admitted patient suffered COVID-19 symptoms during hospitalization. It was only pointless fear about orthopaedic intervention during this interval. Key words: COVID-19, Femur, Infection

Diabetes is a chronic disease and non-compliance attitude of patients poses a great challenge to the success of therapy. Multiple factors influence compliance among diabetics and other chronic diseases and non-compliance results in avoidable consequences and complications. In order to determine the magnitudeand factors of non-compliance to physicians’ advice in diabetics attending outpatients, a cross-sectional analytical study was conducted in outpatient diabetic clinics of Shaikh Zayed and Services Hospitals in Lahore. Results presented in this study are based on 177 patients investigated for 3 months (April 2014-June2014). Subjects were conveniently enrolled after taking written informed consent using a self-constructed and structured questionnaire. Out of 177 participants, 55.36% were females and 51.41% participants were in the range of 52-75 years of age. Among 79 males, majority (45.6%) were employees, whereas 91.8% werehousewives among females’ participants,. Out of 177 diabetic patients, 42 patients (23.7%) were non-compliant and 135 patients (62.5%) were found to be compliant. The normal glucose level was observed in 120/177 (67.8%) of participants. Interestingly, 97.2% subjects revealed agood attitude as the main trait of apractitioner whereas 2.8% claimed good practice and competency. Conversely, 94.4% blamed bad attitude as a trait of bad doctor whereas 4.6% reported that the bad practice and incompetency is responsible for the negative trait. Taken together, compliance to physician’s advice is better among diabetics attending tertiarycare hospitals in current study. The study encourages our health care system to provide more awareness and obtain a deeper understanding of factors causing non-compliance. A positive relationship between patient and practitioners would positively impact on the clinical outcome of the ailments and their therapies.

Aim: To appraise cases that presented with posterior dislocation of the hip secondary to trauma in paediatric age group and to analyse difficulties along with challenges that arise in the diagnosis (both radiological and clinical), treatment plan, complications and the outcome of such injury in children. Methods: Three children with traumatic posterior hip dislocation and a mean age of 3.3±0.47 years who were followed-up at 6 months were assessed. Results: The primary early treatment was closed reduction, executed within six hours of injury. The three subjects were treated with reduction under anaesthesia. The adjuvant treatment was immobilization via hip spica. Follow up was uneventful. Conclusion: Dislocation of the hip joint due to trauma should be attended to as early as possible with emphasis on achieving anatomical reduction preferably via reduction and close follow up. Keywords: Hip joint, posterior dislocation, trauma