Objective: Our study was designed to evaluate the effect of dynamisation in delayed union tibia shaft fractures. Methodology: This prospective study was conducted at the Orthopedic Department, Shaheed Mohtarma Benazir Bhutto Medical College, from March 2020 to March 2021. During this timeframe total of 20 patients who underwent dynamisation for reamed intramedullary nailing were recruited. After two successive visits, those patients whose fracture failed to show progressive signs of callus formation underwent dynamisation. We removed the single static screw from the longer fracture segment to perform the dynamisation procedure. We inserted a poller screw slightly medial to the nail from anterior to posterior to provide additional stability to the proximal fragment. Statistical analysis was performed by using SPSS 23.0. For evaluating the success of dynamisation Chi-square test was used. Results: The mean age of recruited patients was reported as 35.92 years ranging from 16 years to 63 years old. Out of these twenty cases, 17 were male (85%). The mean time duration of nailing was reported as 35.4 hours. Total fourteen patients were immediately treated with nailing within 20 hours of injury, while the rest six underwent delayed nailing. Total four cases of tibial fracture were turned out as failure because the patient failed to achieve union after dynamisation and underwent augmentation plating with bone grafting for the complete union. Conclusion: Delayed dynamisation is a convenient and cost-effective technique to achieve union in femoral shaft fractures. Overall, our study reported an 80% success rate but failed to achieve early dynamisation in comminuted fractures.

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Background: Rheumatoid arthritis is an ailment that has an effect on the lungs in cases of pleural inflammation; it affects the lower as well as upper lung airways. Other effects of the disease can be seen in interstitial lung problems (parenchyma) and pulmonary vasculature. Aim: Evaluating the occurrence of pulmonary manifestations in RA patients was the objective of this study. Methods: An observatory method that was cross-section in nature was employed in this study which was held in the Rheumatology and Medicine department, Jinnah Medical and Dental College Karachi Pakistan for the one-year duration from June 2020 to June 2021. Eighty subjects were included in this study, and all of them underwent a general examination, their medical history was taken into account. Several lab tests were performed on the patients, ESR, BUN, CRP, HRCT, ALT, radiological investigations, and chest X-rays were included. Results: In this study42 percent of patients presented with pulmonary manifestations. About 45.70 percent of the patients presented with abnormalities in the spirometry test, 42.85 percent showed HRCT abnormalities. The HRCT scores vary with age, TJC (Tender Joint Count), ESR, and SJC.FEV, 1 HRCT, and FCV showed a negative correlation among each other. However other variables did not show any statistically significant correlation. Conclusion: RA showed the prevalence of pulmonary affection, and this can be observed in pulmonary and radiological functions. There was an associationof age, pulmonary functions, and ESR.

Introduction: The purpose of this research was to present our hospital results in union of fracture Tibia managed with close intramedullary interlocking nail. Methods: This research was carried out at Liaquat University of Medical and Health Science Jamshoro Pakistan from June 2020 to June 2021. A total of 250 patients with a closed tibial shaft fracture were recruited from the emergency room and outpatient clinics for this study. Our study's clinical outcomes were categorized as union, nonunion, delayed union, or malunion based on the criteria. All of the patients were given anesthesia, either general or spinal. All of the patients were tracked for a period of nine months. Results: In 90–150 days, about 88 percent (220/250) of patients had union, with a mean of 110.68. Union occurred in 11.2 percent (28/250) of patients in 95–109 days, with a mean of 103.38. There were 7.2 percent (18/250) delayed unions and 4.8 percent (12/250) non unions treated with dynamization and bone transplant. The outcomes were outstanding in 88 percent (220/250) of the patients and good in 7.2 percent (18/250). Our patients all had full range of motion in their knees and ankles at the time of their examination. Conclusion: We found that this approach is beneficial due to early mobilization (early weightbearing), reduced complexity, good outcomes, and low cost.