Background: Pregnancy induced hypertension (PIH) adversely affects the development of placenta and growth of fetus. The objectives of this study were to compare the placental diameter, placental thickness and number of cotyledons in mild PIH and severe PIH women versus normotensive women of District D.I.Khan, Pakistan.Material Methods: This comparative cross-sectional study was conducted in Department of Anatomy, Gomal Medical College, D.I.Khan, Pakistan from January to October 2014. Three samples were selected; each of size 50, group 1 normotensive/ control, group 2 with mild PIH and group 3 with severe PIH. Three research variables; placental diameter (cm), thickness (mm) and number of cotyledons were measured on ratio scale for three groups. Descriptive analysis included mean± SD with 95% confidence intervals for each group separately. With three groups on ratio data, one way-ANOVA test was applied to see significance of difference between three groups. Post hoc Dunnett’s t test was applied at alpha 0.05 to see difference of mild PIH group 2 to normotensive/ control group 1 and of severe PIH group 3 to normotensive/ control group 1separately.Results: Mean placental diameter was 18.28±2.15, 16.57±1.94 and 16.18±1.75 cm and mean placental thickness was 19.33 ±3.70, 19.18±2.78 and 17.60±3.52 mm in group 1, 2 and 3 respectively. Mean number of cotyledons was 14.42±2.25, 14.08±2.30 and 13.16±2.15 in group 1, 2, and 3 respectively. Placental diameter was statistically significantly lower in group 2 (p=.00001) and 3 (p=.00001) than group 1. Placental thickness in group 2 (p=.957) was similar to group 1, while in group 3 (p=.019) it was lower than group 1. Number of cotyledons in group 2 (p=.666) was similar to group 1, while in group 3 (p=.011) it was lower than group 1.Conclusion: In mild pregnancy induced hypertension (PIH), placental diameter was lower than normotensives, while placental thickness and number of cotyledons were similar to normotensives. In severe PIH, placental diameter, placental thickness and number of cotyledons were all lower than normotensives. It is concluded that in mild PIH, the development of placenta is mildly affected, while in severe PIH, the development of placenta is severely affected.

Introduction: Patella fracture account for 1 Percent of all skeletal fracture, Patella fractures are problematic because the loss of the extensor mechanism of the knee, loss of articular congruity and stiffness of the knee joint. The surgical goals are anatomic reconstruction of the articular surface and stable fixation to allow early motion. Modified tension band wiring MTBW (MTBW) is the procedure of choice for patellar fracture these days because of the dramatic decrease in post-operative complications with this procedure.The complications noted in the early post-operative period are infection,loss of reduction, prominence of hardware, and knee stiffness. Objective: To determine the frequency of early post-operative complications following modified tension band wiring MTBW for closed patellar fractures. Methods: This study was conducted in the department of orthopedic surgery, Lady Reading Hospital, Peshawar from June 2010-september 2011. Through a descriptive cross sectional study, a total of hundred patients of closed patellar fractures were selected in a consecutive manner from the OPD and ER department. All patients were subjected to modified tension band wiring MTBW under G/A by an expert orthopedic surgeon and data was also collected at 1st week, 1st month, 3 months and 6 months regarding early post-operative complications like loss of reduction, infection, prominence of hardware and stiffness. Results: Total patients were hundred. There were 60 (60 Percent) males and 40 (40 Percent) were females. Mean age of the patients was 43.82 years + 14.3SD years (range 20-85 years). 74 (74 Percent) were presented with history of road traffic accident. Overall complication rate by the end of 6 months was a total of 25 Percent with of 21 Percent patients with infection, 11 Percent had developed stiffness, 6 Percent with hardware prominence and only 4 Percent with loss of reduction. Conclusion: The frequency of early post-operative complication following modified tension band wiring MTBW for closed patellar fractures was higher than previously reported and further research work should be carried out to identify the factors responsible for it. Keywords: Developed Stiffness, Closed Fracture Patella, Modified Tension Band Wiring MTBW, Early Post-Operative Complications, Hardware Prominence,

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Introduction: Anterior Knee Pain (AKP) is one of the most common causes of persistent problems after knee replacement. Total Knee Arthroplasty (TKA) is a surgical procedure in which artificial joint or prosthesis replace the damage knee. A significant proportion of the patients experience AKP after surgery. Objective: To find out the frequency of Anterior Knee Pain after Total Knee Arthroplasty. Study Setting: Department of Orthopedics, KTH Khyber Teaching Hospital, Peshawar. Study Design: A Cross sectional study. Study Duration: June -2020 to February -2021. Subjects and Methods: After recording complete history, physical examination and routine baseline investigations were done. Patients were put on OT list and surgeries were performed in all patients by expert orthopedic surgeon designated for performing total knee arthroplasty. Post-operatively, patients were kept under observations for 5 days in ward and were discharged if indicated. Patients were followed at regular intervals and finally at the end of 3rd month to measure the intensity of pain on VAS. Results: Out of 205 patients, 69.3% were males and 30.7% were females. Means ± SD calculated for age was 48.62±7.98 years, for BMI was 24.63±3.07 and for Pain on VAS was 1.31±1.39. Most patients (51.7%) were recorded in 51-60 years age group. Rheumatoid Arthritis (RA) in 18% while Osteoarthritis (OA) was found in 82% patients. 21.5% patients were diabetic while 31.7% patients were hypertensive. AKP at 3rd month was found in 8.8% patients. Conclusion: It is evident that anterior knee pain (AKP) after the total knee arthroplasty (TKA), or total knee replacement (TKR) is prevalent and clinically relevant. There is an absolute need for further investigations to find out ways to decrease or eliminate the AKP after TKA in order to improve the quality of life after this surgery. Keywords: Anterior Knee Pain, Total Knee Replacement, Total Knee Arthroplasty.

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