Objectives: This study was conducted to determine risk factors of osteoporosis in women after menopause. Study Design: Cross Sectional study. Setting: Sir Ganga Ram Hospital located in Lahore, a city of Pakistan. Period: 1st January 2018 to 31st July 2018 comprising on seven months duration. Material & Methods: An inclusion and exclusion criteria was formed. Patients diagnosed cases of osteoporosis presenting in out-patient door of the study institution during study period and falling in inclusion criteria were selected for the study. Those not falling in criteria were excluded from the study. A questionnaire was formed containing all necessary questions such as age of patient, risk factors of osteoporosis and age of menopause. All data was documented properly. A well informed written consent was taken from all patients for including them in the study. Consent was taken from the ethical committee of the study institution for conducting study. Privacy of data of patients was maintained. Data was analyzed using statistical software and Microsoft office version 2017. Results were calculated in the form of frequencies and percentages and presented via tables and graphs. P-value less than 0.05 were considered significant. Results: Total 115 post-menopausal females with osteoporosis were studied. Their age range was 35-63 years with mean age 46.7 years. Age of menopause among study females was found to be less than 40 years in 4.3% cases, between 41-45 years in 20.9% cases, between 46-50 years in 9.6% and between 51-55 years in 25.2%. Common risk factors of osteoporosis reported in study females include low calcium diet in 60.8% cases, family history of osteoporosis positive at least in one close relative, overweight in 57.4% and history of steroid intake for prolong period was found a cause of osteoporosis in 21.7% cases, excessive intake of soft drinks (more than 400ml daily) in 34.8% and excessive coffee intake (more than 2 cups daily) reported in 33%. Other risk factors include thyroid disease, ongoing hormonal replacement therapy, and prolonged immobilization. Conclusion: Osteoporosis is a common problem among females particularly in post menopausal period. Most common risk factors of this disease are improper diet and lack of physical activity. By spreading awareness of this disease in community, encouraging proper intake of calcium containing diet and daily exercise can reduce incidence of this disease.

Objective: To study the early outcomes and complications of fixation of pediatric shaft of femur fractures using flexible intramedullary nail. Study Design: Prospective observational study. Place and Duration of Study: Orthopedic Department, Bahawal Victoria Hospital Bahawalpur, from Jan to Jun 2021. Methodology: Children between the ages of 5-11 years with shaft of femur fractures were included in the study. Fixation of fracture was done using elastic intramedullary nail. Final outcomes of fixation were observed using Flynn and Schwend Scoring System. Six-month follow-up was done in all cases. Data was analyzed using SPSS-20. Results: Total 70 cases having shaft of femur fracture were included in the study. Age range of cases was 5-11 years with mean age of 7.75 ± 1.66 years and mean weight of 24.44 ± 4.77 kilograms. Mean diameter of femur medullary canal was 7.48 ± 0.63 millimeters and mean diameter of flexible nail was 3.03 ± 0.26 millimeters. Mean post-operative period of radiological union of fracture was 8.57 ± 1.05 weeks. Per-operatively, fracture site was approached in 4 (5.7%) cases. Migration of nail was not seen in any case. Final outcomes according to Flynn and Shwend Score were excellent in 62 (88.5%), satisfactory in 7 (10%) and poor in 1 (1.4%) case. Conclusion: Fixation of shaft of femur fracture using flexible intramedullary nailing technique is safe and reliable with good outcomes among children between 5-11 years of age.

ISRA (India) = 3.117 ISI (Dubai, UAE) = 0.829 GIF (Australia) = 0.564 JIF = 1.500 SIS (USA) = 0.912 РИНЦ (Russia) = 0.156 ESJI (KZ) = 5.015 SJIF (Morocco) = 5.667 ICV (Poland) = 6.630 PIF (India) = 1.940 IBI (India) = 4.260 OAJI (USA) =

Objective: To determine outcomes of intra-articular corticosteroids injection versus physiotherapy for the treatment of adhesive capsulitis using mean pain score on the visual analogue scale. Study Design: Comparative prospective study. Place and Duration of Study: Orthopedic outpatient department, Bahawal Victoria Hospital Bahawalpur from Jan to Jun 2021. Methodology: A total of 120 cases having adhesive capsulitis (frozen shoulder) were included in the study according to inclusion criteria. Non-probability consecutive sampling technique was used for the selection of cases. Patients were divided into two groups, group-A and group B, each containing 60 cases. Patients in group-A were given intra-articular steroid injection (2ml triamcinolone 40mg ± 2ml of bupivacaine). Patients in group B received ten sessions of physiotherapy by a welltrained physiotherapist under the supervision of an orthopaedic surgeon on alternate days. After six weeks, outcomes were measured in terms of pain score using a visual analogue pain scale. Results: Significant improvement was seen among patients in group-A with mean pain score from 7.32 ± 0.89 measured initially to 5.44 ± 1.37 measured after six weeks (p<0.001). No significant improvement was found among patients in group B with a mean pain score of 7.58 ± 0.94 measured initially to 7.12 ± 0.88 measured after six weeks (p>0.05). Conclusion: Significant improvement in pain relief can be achieved using intra-articular steroid injection administered in the shoulder as compared to supervised sessions of physiotherapy among patients with adhesive capsulitis.