Background: Myocardial Infarction is one of the most common causes of mortality and morbidity among the elderly patients. Also, it is known for wide range of clinical presentations other than chest pain. This article enlightens the clinical features, risk factors, complications, prognosis and outcome of Acute myocardial infarction in elderly patients. The objective of this study was to assess the risk factors, various symptoms, complications, prognosis and outcome of elderly patients with Acute myocardial Infarction (AMI). Methods: This is a prospective study done over a period of two years in a tertiary care hospital in South India. 80 elderly patients who were diagnosed as AMI were included in the study. Results: Among the eighty patients the majority of the patients belonged to the age group 60-69 years. Twenty percent of the patients presented without chest pain. The atypical presentations included dyspnoea, giddiness, vomiting, sweating and epigastric pain. Mortality rate was 20%. Conclusions: This study showed that even though chest pain was the most common presentation in elderly AMI patients, they were also found to have atypical presentations like shortness of breath, giddiness, vomiting, sweating and epigastric pain. This signifies the need of examining physicians to meticulously identify acute myocardial infarction in elderly though they may not present typically.Keywords: Acute myocardial infarction, Chest pain, Coronary heart disease, Elderly DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20174669 Sandhya S et al. Int J Res Med Sci. 2017 Nov;5(11):4765-4769 International Journal of Research in Medical Sciences | November 2017 | Vol 5 | Issue 11 Page 4766 diagnosis of acute myocardial infarction. Eighty patients satisfying the inclusion criteria were included in the study. Duration of study was from February 2015 to November 2016. Inclusion criteria• Age-60 years or above (ICMR guidelines).• Typical ECG pattern a. ST segment elevation of ≥0.1 mV in at least 2 consecutive limb leads or ≥0.2mV in at least 2 consecutive chest leads for ST elevation MI b. 1 mm or more ST segment depression c. Definite T wave inversions and pathological evolution of q waves (>0.04s) d. New onset LBBB • Elevated cardiac enzyme levels (CKMB or Troponin T). Exclusion criteria• Patients with stable or unstable angina.Patients presenting to our casualty with symptoms of acute myocardial infarction -chest pain, giddiness, shortness of breath, epigastric pain-were evaluated with 12 lead resting ECG and cardiac enzymes (CK MB and Trop T). Those who had ECG findings of AMI and elevation of enzymes were shifted to coronary care unit and treated/thrombolysed according to the AMI protocol.History, examination and investigation findings of these patients were recorded in the Proforma. The complications these patients developed in the hospital were recorded. The investigations done included random and fasting blood sugar, fasting lipid profile, Blood Urea, serum creatinine, electrolytes, Chest X ray and 2DEchocardiogram. RES...

To treat midshaft clavicle fractures using open reduction with internal fixation and titanium elastic nailing system. The purpose of this review article is to narrate various difficulty encountered in patients with midshaft clavicle fracture. Method: An extensive search of all materials related to the topic was done for 25 years in Google Scholar and many more search engines. Overall, 20 articles focusing on the different aspects of mid shaft clavicle were identified and analyzed. Conclusion:As majority of article shows that, treatment of patients with midshaft clavicle fractures with TENS patients had an excellent success, compared with plating. Thus, we concluded that TENS is therefore superior to plating for the treatment of clavicular fractures.

Distal tibia fractures are one of commonest lower extremity fracture. The treatment is quite challenging, since it has poor vascularity and limited soft tissue coverings. There are various treatment modalities for the management of distal tibia fractures. Minimally Invasive techniques using locking compression plate has emerged as a popular treatment option because of its respect towards the biology of distal tibia, maintenance of fracture haematoma and providing a biomechanically stable fixation. It also has an advantage of early mobilization and minimal complications with a relatively higher rates on union. In this review article, we will evaluate the effectiveness of minimally invasive techniques for fractures involving distal Tibia.

<p class="abstract"><strong>Background:</strong> This observational study was conducted in order to study the functional efficacy of locking compression plate in distal femur fractures as they are one of the most common type of fractures with bimodal age distribution affecting younger age group as a consequence of high energy trauma especially road traffic accidents and elderly population due to osteoporosis.</p><p class="abstract"><strong>Methods:</strong> 40 Patients who are skeletally matured with acute distal femur fractures were radiologically assessed type of fractures, amount of comminution, articular congruence and quality of bone. pretested proforma which include age, sex, occupation, mode of injury, type of fracture, time interval between injury and surgery, associated comorbid conditions and other associated injuries.<strong></strong></p><p class="abstract"><strong>Results:</strong> Off the 40 patients under study 21 showed excellent outcome according to neers rating system and only 5 had fair results, 3 patients had superficial wound infection and 5 developed knee stiffness.</p><p class="abstract"><strong>Conclusions:</strong> Locking compression plate produces better results and appears to be good method of management in distal femur fractures.</p>

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