Objective: To compare outcomes of interlock intramedullary nails with Dynamic compression plates for the treatment of humerus shaft fractures in terms of hospital stay time and shoulder Impingement. Subjects and Methods: In this comparative study, a total number of 74 patients having age 20-60 years who presented with closed and open Gustilo type I or II in middle third of humerus were included. Study was conducted in Islam hospital Sialkot and and Rajib Tayyip Erdogan Hospital, Muzaffargarh from June-2019 to June-2020. Group A (n=37) patients underwent dynamic compression plating (DCP) for treatment of fractures and group B (n=37) underwent interlocking intramedullary nailing (ILN) for humerus shaft fractures. We noted post-operative hospital stay, shoulder impingement and bone union rate in all patients. Results: The mean of patients included in this study was 42.45 (SD 9.89) years. There were 57 (77.03%) males and 17 (22.97%) females. The mean duration of fracture at the time of surgery was 39.98±7.23 days. Mean hospital stay was 4.72±1.23 days in in group A and 4.89±1.40 days in group B (p-value 0.60). There were 4 (10.8%) patients in group B in whom shoulder impingement occurred but there was no patient in group A with shoulder impingement (p-value 0.04). Complete union occurred in 35 (94.6%) patients in DCP group and in 34 (91.8%) patients in ILN group (p-value 0.64). Conclusion: Both DCP and ILN are associated with high bone union rates. The complications rate of ILN is higher in comparison to DCP group. Keywords: Humerus shaft fractures, dynamic compression plates, interlocking intramedullary nailing.

Objectives: To compare the complications and outcomes of lateral entry pin fixation with medial and lateral pin fixation for Gartland type III supracondylar fractures of humerus. Methodology: This prospective comparative study involving 190 patients of Gartland type III close supracondylar fractures were included. from March-2019 to Dec-2020. In all patients, initially the elbow was mobilized using the splint placed above the elbow joint at 30 to 45 degrees’ flexion. After closed reduction, lateral pinning was applied in group I and in group II lateral and medial cross pinning was applied using the standard protocol. Patients were followed for iatrogenic ulnar nerve injury, radiologic and function outcomes in-terms of loss of reduction, elbow range of motion, loss in carrying angle and functional outcomes. Results: The two groups were comparable for loss of elbow range of motion, loss of carrying angle and loss of Bauman's angle. On clinical examination, immediate post-operative ulnar nerve injury was diagnosed in 4 (4.2%) cases in group II and in no patient in group I (p-value 0.12). Satisfactory functional outcomes were achieved in 85 (89.5%) patients in group I and in 88 (92.6%) patients in group II (p-value 0.44). Conclusion: Lateral pinning provided stable fixation clinically and radiologically as compared to lateral and medial cross pinning. Keywords: Supracondylar fracture of Humerus, Iatrogenic ulnar nerve injury, Lateral pin entry, lateral and medial cross pin entry.

Objective: The proteoglycan decorin, which plays an important part in the aetiology of osteoarthritis as well as a role in the binding of collagen, was the focus of this study's background information and objectives (OA). This investigation was carried out with the objectives of determining the levels of decorin in the blood and synovial fluid of patients who suffered from knee OA and determining whether or not these levels had a correlation with OA and the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) score. Place of Study: Islam medical college Sialkot Duration: December 2021 to May 2022 Methods: In this prospective study, a total of 60 persons were enrolled in the study and control groups: 30 people with knee osteoarthritis and 30 people with other knee sjoint problems. For the purpose of determining how well the knee functions, the WOMAC score was utilised.Both the levels of decorin in the blood and the levels of decorin in the synovial fluid were analysed by means of an enzyme-linked immunosorbent assay (ELISA). We used a technique known as binary logistic regression, which contained both a single and a multi-categorical predictor, in order to evaluate the potential risk factors for OA. This allowed us to determine which characteristics would increase the likelihood of developing OA. Results: It was discovered that the levels of serum decorin in the group that was diagnosed with OA were statistically and considerably higher than the levels found in the group that acted as the control (P 0.001). There was not a significant difference in the amounts of decorin found in synovial fluid between those who had OA and the control group. WOMAC score (OR)=1.073, 95% confidence interval (CI): 1.032-1.116, P<0 .001 This association between OA and high serum decorin levels was shown to be statistically significant (OR=1.114, 95%CI: 1.030–1.205, P=0.007). OA was demonstrated to be strongly linked with high serum decorin levels. There was shown to be a positive association between the levels of serum decorin and the WOMAC score in patients who had OA. Conclusions: An increase in serum decorin levels may be indicative of changes in the structure of the extracellular matrix.The fact that there is a positive connection between the serum decorin level and the WOMAC score lends credence to the previous assertion that this conclusion is correct. It was found that having a higher WOMAC score and having higher serum decorin levels are both risk factors associated with osteoarthritis (OA). On the other hand, there was no link found between osteoarthritis and the amount of decorin found in the joint fluid.

Objective: To compare the clinical outcome of flexible intramedullary nailing (FIN) with external fixator in pediatric open tibial fractures. Subjects and Methods: In this randomized comparative study, 80 children having age 5 year to 14 years who presented with open tibial fractures were included. The study was conducted from June-2020 to June-2021 in Islam Hospital Sialkot and Allama Iqbal Memorial Hospital Sialkot. Patients were divided into two equal groups. Group A: underwent external fixation and group B: underwent flexible intramedullary nailing for the surgical management of tibial fractures. Frequency of infections surrounding pins, painful bursitis and re fracture rate within 3 months after surgery was recorded. Results: The mean age of children was 8.42±3.82 years in external fixator group versus 8.40±4.0 years in FIN group (p-value 0.97). Infection-surrounding pins occurred in 9 (22.5%) children were belonging to external fixator group and 01 (2.5%) children was belonging to FIN group (p-value 0.007). Refracture occurred in 6 (15.0%) patients in external fixator group and in no (0.0%) children in FIN group (p-value 0.01). Painful bursitis occurred 2 (5.0%) patient was in external fixator group and in 13 (32.5%) in FIN group (p-value 0.002). Conclusion: Clinical outcome is better in patients treated with FIN as compared to the external fixator for the treatment of pediatric open tibial shaft fractures. Keywords: Flexible intramedullary nails, External fixator, Tibial fractures.

Induced Draft Cooling Towers (IDCT) are an important industrial structures, which removes the heat absorbed in the circulating cooling water systems of thermal power plants. The cooling tower in general comprises of RCC members’ viz. Column, Beam, Slab, Wall, Louvers, Fanstack Shell etc. The process of operation is itself an important factor which affects the durability of members of IDCTs, due to which the RCC members of IDCT are subjected to varying exposure condition, some members are continuous under water, some are partially submerged, some have alternate drying & wetting and some are completely dry. Due to different exposure conditions of RCC members of these structures generally shows very contrasting states of distress i.e. varying from apparently un-distressed to highly distressed state. Apart from process of operation of IDCTs, the other important factors that affect the durability of these RCC structures are presence of Chloride in water being cooled & Chloride in concrete present during the construction and carbonation due to aging of concrete. The RCC structures were assessed by various Non-Destructive evaluation techniques and deterioration mechanisms were established. The present paper highlights the findings of condition assessment studies of selected IDCTs located in different climatic regions of India.