<p class="abstract"><strong>Background:</strong> Pubic symphysis diastasis is a postpartum complication with an incidence of 1:385 to 1:500 births. Typically conservative treatment is performed, operative treatment is also successful alternative method. This study was conducted to assess whether surgery (ORIF) provide early pain relief and improve mobility and quality of life than conservative management does in same patients<span lang="EN-IN">.</span></p><p class="abstract"><strong>Methods:</strong> This study is a randomized controlled trial conducted at MKCG Medical College, Berhampur from December 2014 to April 2017. Total eligible 16 postpartum pubic diastasis patients coming to MKCG hospital were randomly assigned to two groups in 1:1 ratio. Group A received surgical and group B conservative management. All were followed up at 3 weeks, 6 weeks, 3 months and upto 6 months in which EQ-5D-3L score and Visual analogue scale were measured for assessing pain and general health outcome in participants. All data were analyzed with SPSS.<strong></strong></p><p class="abstract"><strong>Results:</strong> The mean EQ-5D descriptive index was almost similar in both groups at the time of admission, but declined more rapidly in group A as compared to that in group B. 75% of group A has this index 5 (lowest score) at 6 months whereas none of the group B patients attained it. lower EQ-5D index indicates patients had good mobility and early ambulation, less discomfort, able to do usual activity. There was a significant difference in mean EQ-5D descriptive index and pain VAS score between two groups<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> This study showed surgical management is more effective than conservative management in postpartum pubic symphysis patients by rapidly improving general health, ameliorating pain and bringing ambulation<span lang="EN-IN">.</span></p>

BACKGROUNDThe aim of this study is to evaluate the association between serum lipid profiles and primary frozen shoulder. MATERIALS AND METHODSThis was a case-controlled study. The case group comprised 200 patients diagnosed with frozen shoulder from June 2011 to June 2016. This study was approved by MKCG Medical College, Berhampur Ethical Committee. The diagnosis was done on basis of 50% restriction of all motion of shoulder joint and x-rays of the shoulder in true anteroposterior, outlet and axillary lateral views. RESULTSThe mean values in the patients with frozen shoulder were 6.7 months (95% CI, less than one to sixty months) for the duration of symptoms, 5.9 days (95% CI, 0 to seventy seven days) for the interval between the initial examination and blood sampling and 7.5 days (95% CI, 0 to 118 days) for the interval between the initial examination and ultrasound or MRI. Among the 300 studied patients with primary frozen shoulder, 127 had a shoulder in the freezing stage, 168 had a shoulder in the frozen stage and five had a shoulder in the thawing stage. CONCLUSIONWe conclude that elevated bad lipid levels have a significant association with primary frozen shoulder.

<p class="abstract"><strong>Background:</strong> Many drugs have been used for postoperative pain management which is a common and distressing symptom after knee arthroscopy. But no single ideal intra-articular drug has been found. This study was done to assess the efficacy of intra-articular dexmedetomidine and clonidine for postoperative pain relief in patients undergoing arthroscopic knee surgeries<span lang="EN-IN">.</span></p><p class="abstract"><strong>Methods:</strong> Fifty  patients of American Society of Anaesthesiologists of  grade I/II, aged 20-70 years posted for arthroscopic knee surgery were randomly divided into groups I (clonidine group) and group II (dexmedetomidine group). 25 patients in group I received  1 µg/ kg of clonidine diluted to 20 ml in normal saline and group II patients received 1 µg/kg of dexmedetomidine diluted to 20 ml in normal saline via intra-articular route at the end of the surgery. Visual analogue score (VAS), time to give the first dose of analgesia and total dose of analgesic required in first 24 hours was evaluated in each group.<strong></strong></p><p class="abstract"><strong>Results:</strong> VAS score was lower and time to first analgesic requirement was greater in Group II in comparison to Group I which was statistically significant. Total dose of analgesic used in Group II patients was significantly less compared to patients in Group I which was statistically significant<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> Intra-articular dexmedetomidine is more effective in providing prolonged postoperative analgesia after arthroscopic knee procedures and reduces the total dose of analgesic required postoperatively compared to clonidine<span lang="EN-IN">.</span></p><p class="abstract"> </p>

Background: Osteochondroma is most common benign bone tumour. But flat bones are rarely involved. Objective of study is to present 10 cases of osteochondroma in girdle bone that is rarely reported in medical literature and addressing specific concerns with these entities. Methods: This is a case series which described 10 cases having osteochondroma in pubic bone (2 cases) and scapula (8 cases). Patients coming to the Orthopaedics Department of MKCG Medical College, Berhampur between December 2015 to December 2017 were included in case series and those were severely ill and did not give consent were excluded. Results: Age of patients ranged from 15 to 46 years. Patients with pubic bone osteochondroma presented with swelling and dull aching, non radiating pain. Patients with scapular bone osteochondroma presented with swelling on dorsal surface of scapular body, out of which 3 had towards lateral border and 5 towards medial border.5 patients were complaining of mild pain. For pubic bone osteochondroma, under spinal anesthesia and supine position a curvilinear suprapubic incision (Like pfannenstiel approach) was given and bony mass was excised at base of outgrowth from parent bone. Similarly for osteochondroma in scapula, longitudinal incision was given over the involved area and mass was excised at base of outgrowth from parent bone. Both intra operative and post operative periods were uneventful. In all cases, patients were doing normal activity without any complain at 3 weeks and 6 weeks of follow up period. The histopathological findings of the excised mass corresponded to the findings of osteochondroma. Conclusion: This case series described rare cases of osteochondroma in scapula and pubic bone. Surgical excision of the masses was done which showed good result for the osteochondroma.

<p class="abstract"><strong>Background:</strong> Monteggia fracture presenting after 4 weeks of injury termed as neglected monteggia fracture.There are many options for management of this fracture. The present study was planned with objective to assess clinical outcome of patients who were treated with a specific technique of ulnar osteotomy without annular ligament repair.</p><p class="abstract"><strong>Methods:</strong> This prospective study was conducted in Department of Orthopaedics MKCG Medical College and Hospital, Berhampur from July 2015 to April 2018 where 15 patients of neglected monteggia fracture were operated with specific technique of ulnar osteotomy without annular ligament repair. Participants were followed up and at end point they were evaluated for pain, stability, and disturbance of daily and sporting activities. Function was assessed using elbow performance score. Data collected were analyzed in SPSS (version 16.0).<strong></strong></p><p class="abstract"><strong>Results:</strong> Mean age of study participants was 7.3 year and male constituted majority (60%). There were 11 children with Bado type I, 3 with type II and one with type III injury. The mean time from initial injury was 8.8 months. All had limited range of movements of forearm and elbow. All patients had regular follow up for 9 months to 24. In 53.3% flexion arc was improved. The mean flexion arc was increased by 20 degree and pronation-supination arc was reduced by 20 degree.</p><p><strong>Conclusions:</strong> The present study revealed that osteotomy in neglected monteggia fracture brings stability of elbow joint and this surgical management of neglected monteggia fracture without annular ligament reconstruction had good outcome. Annular ligament reconstruction is not always necessary.</p>