Background The diagnosis of Alzheimer's disease (AD) remains at times difficult to make using available neuropsychological measures. Neuro-imaging is a relatively new form of detecting the changes associated with dementia. The present study investigated the role of magnetic resonance imaging (MRI) in diagnosing AD in adults with Down's syndrome (DS). Methods Subjects with DS and Alzheimer-type dementia were matched to non-demented controls with DS. Magnetic resonance imaging findings (i.e. volumetric and two-dimensional scans) were compared between the two groups in order to show a relationship between the changes of AD and structural MRI abnormalities. Results Specific structural abnormalities which are seen in non-intellectually disabled subjects with dementia are also found in individuals with both DS and AD. However, such findings cannot be used to diagnose clinical AD with good accuracy in adults with DS. A number of practical issues of patient compliance and over-sedation are demonstrated by the findings.

Objectives: To determine the outcome and various complications in the management of comminuted intra articular fractures of distal radius in adults treated with closed reduction associated with Percutaneous Pinning. Study Design: Observational study. Setting: Department of Orthopaedic PUMHS, Nawabshah. Period: January 2017 to December 2018. Material and Methods: 45 consecutive cases of closed comminuted intra articular fractures of distal radius matching the inclusion criteria, all patients were adult aged between 23 – 38 years having Gartland and Werly type II and III fractures of 6 to 7 days duration. After initial resuscitation, thorough clinical examination done and all base line laboratory investigations and x-rays were obtained. The demographic and clinical data was recorded on a proforma. The patients were informed about the study and surgery and a written consent was taken and all of the patients were gone for closed reduction with percutaneous K – wiring. Functional outcome like union, healing and any complication were assessed. Patients were also checked for the range of movements. After 6 weeks, the K – wires and cast were removed and the procedure of physiotherapy started. After six weeks all the patients were advised for follow up at an interval of 3 months and 6 months. The data collected was statistically analysed and the results were tabulated. Results: 45 cases of closed intra articular fractures of distal radius were assessed, out of these 20 cases have Gartland type II and 25 cases have Gartland type III fractures. The age of patient was ranged between 23 – 38 years (mean 34+ 4.63), majority (55.6%) of patients were male. The left side of fractures were present in 66.3% of cases. All the patients checked for complications and that were seen in only 07 cases consisting of pin tract infection, reduced grip strength and finger stiffness. At the end of study period the range of movements in different directed were checked and evaluation was done according to modified Demerit scoring system. Conclusion: Closed reduction of distal radius with percutaneous pinning in comminuted intra articular fractures gives promising excellent results, it is a simple and minimal procedure providing anatomic reduction, fixation of fracture and maintenance of reduction with an suitable technique of immobilization.

Objectives: To determine the pattern and frequency of various bone tumors at a tertiary care centre in rural area. Study Design: Retrospective study. Setting: Orthopaedic Peoples University of Medical and Health Sciences (PUMHS), Nawabshah. Period: June to December 2018. Material and Methods:  The 5 years record from July 2015 to June 2018, of all the patients who were admitted and operated for any bone tumor was retrieved. A total of 68 cases were included in the study having complete file record, regardless of their age and sex, the histopathological report of their bone biopsy was mandatory for inclusion in the study. The patients of incomplete file record, without histopathological report and the cases of other bone non-neoplastic conditions were not included in the study. All the collected data was recorded on a proforma, analysed statistically and results were tabulated. Results: In present study 68 cases of bone tumors were evaluated. The patients were aged between 7.5 to 73 years with a mean of 26.4 + 12.7 years. Among these 68 cases 41 (60.3%) were male. The malignant tumors were diagnosed in 25 (36.8%) cases among these 14 (20.6%) cases in male patients and 11 (16.2%) cases in female. The overall benign tumors were observed in 43 (63.2%) cases, and among these 27 (39.7%) cases were male and 16 (23.5%) cases were female. Osteosarcoma was the most common malignant tumor diagnosed in 14/25 (56%) cases followed by chondrosarcoa in 4/25 (16%) cases. In benign tumors the osteochondroma was the commonest tumor detected in 11/43 (25.6%) cases followed by benign giant cell tumor which was diagnosed in 9/43 (21%) cases. Most of the malignant tumors (24%) were diagnosed in 11 - 20 years age group, and most of benign tumors were detected in 21-30 and 31- 40 age groups each comprising of 23.3% cases. Three cases of metastatic tumors were also diagnosed and all were present in older 61 – 70 years age group. Conclusion: The bone tumors are more common in males, occurred predominantly in the second decade of life. osteochondroma and osteosarcoma was the most common benign and malignant bone tumors. Metastatic lesions were observed in older age group.