Background: Traumatic amputations are very prevalent in today's world. Successful rehabilitation of an amputee largely depends on how well he/she adapt to prosthesis. However, because of poor scar characteristics, these patients often complain of pain while using prosthesis. Autologous fat graft is being vastly used all over the world to improve the scar of various etiologies. However, it has been associated with unpredictable resorption rate. Objectives: We report the results of the study which was done to assess the consequences of fat grafting over scars and to see its effects on pain management in amputated stump and compare the autologous fat graft with stromal vascular filtrate (SVF)-enriched fat graft for scar remodeling and pain modulation on amputation stumps. Materials and Methods: A prospective randomized trial was conducted from July 2014 to December 2015. A group of ten patients, who were unable to wear prosthesis due to painful amputation stump, incorporated in the study and randomly distributed in two groups. Group A of five patients (case group) was treated with autologous fat graft enriched with SVF while Group B (control group) of remaining five patients was treated with fat graft alone. The results were assessed at baseline, at 1 month, and at 6 months postoperatively using patient and observer scar assessment scale (POSAS) score. Magnetic resonance imaging (MRI) was done to compare fat content preoperatively and 6 months postoperatively. Results: All ten patients reported improvement in scar characteristics, most notably in pain in both scales of POSAS score. The improvement was comparable in both groups. However, the fat content in case group was significantly more in comparison to control group when assessed 6 months postoperatively using MRI scan. Conclusion: Autologous fat grafting is a viable and minimally invasive solution for painful amputation stump. Enrichment of fat graft with SVF can enhance its viability over long term. This study was done as a pilot project. Hence, further long term studies with large sample size are needed to ascertain the benefits observed in this study.

INTRODUCTION This is an Am bidirectional observational study. Study population is the patients who have undergone craniotomy for any indication in the department of neurosurgery of CH (EC) from September 2016 to Aug 2019. A list of patients who have undergone NCCT/CECT head during their follow up period, due to any clinical indication, drawn. All such patients interviewed and clinically examined for pain at the craniotomy site. AIMS AND OBJECTIVES The incidence of non-union was Correlation between non-union and predisposing factors via primary pathology, fixation technique, age, sex, comorbidities such as DM, TB and radiotherapy. Correlation with postoperative headache MATERIALS AND METHODS Study area Command Hospital Eastern Command. Study population- Patients who have undergone craniotomy for any indication in the department of neurosurgery of CH (EC) from September 2016 to Aug 2019. Sample size is the number of patients who have undergone CT Scan evaluation based on clinical indications in the post operative period. Am bidirectional observational study RESULT AND ANALYSIS We showed that in ICSOL was significantly in higher non union and bad union patients; Head Injury was significantly higher in good union patients. It was found that carcinoma patients were higher in non union and bad union which was statistically significant. Radiation patients were higher in good union which was statistically significant. Present study found that Post-Op Headache was significantly higher in non union and bad union and mean Rate of union was higher in good union. Association of Fixation Technique with Non Union, Good Union and Bad Union was statistically significant. CONCLUSION We can conclude that patients are more likely to have their craniotomy fuse if they did not undergo radiation treatment or have sutures secure the free flap. Craniotomy fusion rates after free flap increases steadily over time, as expected. We were not able to demonstrate that clinical factors such as age, sex, BMI, diagnosis, fixation material, and radiation have an impact on fusion rate when time to fusion was considered.

Antlanto-axial dislocation with blocked and ankylosed C2-4 vertebrae causing severe canal stenosis with compression of cervico-medullary junction has been reported. The knowledge of such anomaly may be importance for radiologists, anaesthesiologists, orthopaedicians and neurosurgeons because cranio-cervical junction anomaly may result in sudden unexpected death. It can also result in dysphagia, dysarthria due to compression of cranial nerves and quadriparesis due to compression of spinal cord. We here report a rare case of cranio-vertebral junction anomaly with blocked and ankylosed C2,3,4vertebrae with evidence of atlanto-axial dislocation causing compression of cervico-medullary junction and leading to cervical myelopathy.International Journal of Human and Health Sciences Vol. 03 No. 01 January’19. Page : 40-42

Background: Different methods are in use for fixation of metacarpal fractures. Krischener wire and titanium miniplates are most commonly used methods. Both these methods require special & sophisticated instruments. In this study, we have used a dental wire in circumosseous fashion to fix the metacarpal fractures.Methods: In the study, we included all the fracture of metacarpals with operative indication. K-wire, minilplate system and circumosseous dental wire methods were used randomly.Results: The results were compared in term of immediate post-operative complications & functional recovery in form of ability of fist formation at 06 weeks. All the three methods were found comparable, in fact in this study the results of fractures treated with circumosseous wiring were appreciable and significantly better.Conclusions: Circumossoeus use of dental wire can be an alternate method of metacarpal fracture fixation.

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