Aims and MethodWe conducted a 3-cycle audit of disposal of clinically sensitive information in a mental health unit, in order to identify and reduce potential breaches in patients' confidentiality. Material from waste bins in administrative areas of a mental health unit was examined every evening during each period of the audit.ResultsThe first search, conducted over a 3-week period, yielded 11 documents containing highly-sensitive information about patients. After feedback to staff and improvement of shredding facilities, no sensitive information was found during the follow-up 3-week survey, 3 months later. However, a third survey 2 years later found 24 highly-sensitive items after one week, despite shredding facilities being maintained.Clinical ImplicationsChanges in behaviour identified in this audit appear to be due to education rather than improved facilities. All staff involved in patient care need to maintain awareness of the need for safe disposal of confidential material.

Objective: The purpose of this study is to examine the epidemiological features of fractures that are received in bike accidents. Study design: Retrospective study Place and duration of study: Department of Orthopedic, Mardan Medical Complex, Mardan for the period of one year from January 2021 to January 2022. Methods: There were 210 patients of bike accidents were analysed through severity scoring system. Various bike types, fractures sustained, rate of mortality, helmet usage was analyzed. Detailed demographics of enrolled cases included age, sex, BMI and localities were recorded after taking informed written consent. Outcomes were assessed in terms of fractures sustained during accidents. We used SPSS-21.0 to analyze our data. Results: There were 54.8% males and 45.2% females. The mean age of the patients was 31.8±6.17 years. We found that 192 (91.4%) patients wear no helmet. The presentation of the injuries showed that majority of the cases 100 (47.6%) had lower limb injuries. The majority of patients with multiple injuries also suffered from upper limb, facial, spinal and chest trauma. Overall mortality rate was 22 (10.5%). Conclusion: We concluded in this study that wearing helmets can reduce the severe life threatening injuries caused by bike accidents. Keywords: bike accidents, fractures. Mortality, multiple injuries

Background: The 1 in every 1000 infants are affected by the idiopathic club-foot. It is most commonly observed among the people living in the low middle income countries. Objective: The study was carried out to evaluate the surgical treatment algorithm in case of neglected clubfoot among patients admitted at tertiary care unit. Study design: It is a cohort based retrospective study conducted for the duration of six months from January 2022 to June 2022. Material and Methods: The study was conducted on the 40 patients presented with clubfoot at the tertiary health unit, Khyber Teaching Hospital, Peshawar, were included. The patients mean age was 11 years. The range of patient’s age was from 3 to 25 years. 13 patients went through bilateral intervention. And among these 40 patients there were 15 had received unilateral intervention for each foot. The basic features of the patients were recorded. There were 3 groups made containing operated clubfeet patients, first group included 15 patients, second and third group included 12 patients each. Results: There were 29 patients that received only one follow-up visit. The patients visited their doctors for the first year after surgery but then the visiting attendance became irregular afterwards. The altered ICFSG data was compared for only those patients that completed at least three follow-up visits. The variation between the score of participants between group 1 and 2 was not significant statitically. Conclusion: In case of neglected club-foot condition, PMR has shown excellent to fair results in patients especially children. Therefore, it can be proposed that PMR can be used to lessen the burden of neglected club-foot in the LMICs as it also has no side effects. There is a strong link between age and the surgical outcomes so the treatment must be done as soon as possible. Keywords: Club-foot, PMR, ICFSG data, surgical outcomes.

Objectives: To determine the causative organism of long bone chronic osteomylitis through culture of the sequestrum. Studydesign: Descriptive case series. Setting and duration: Orthopaedic Surgery Unit, Mardan Medical Complex Teaching hospital, Bacha KhanMedical College, Mardan, KPK, Pakistan from September 2011 to April 2012. Methodology: Twenty five patients with radiologically provenchronic osteomyelitis of long bones who had been free of antibiotic therapy for at least 48 hours, excluding those with diabetic foot, decubitusulcers, and infected implant. At least one specimen of sequestrum was taken from each individual and subjected to complete microbiologicanalysis. Results: Staphylococcus aureus was the most frequently found organism (n=11, 44%), followed by Enterobacteriaceae (n=5, 20%),coagulase-negative staphylococci (n=3,12%) Escherichia coli (n=2, 8%) P aeruginosa (n=1, 4%), Streptococcus species (n=1, 4%) and nogrowth (n=2, 8%).More than one microorganism was isolated in two (8%) patients. Conclusions: Staphylococcus aureus was the mostcommon organism isolated. Sequestrum culture provides accurate identification of causative bacteria.

Objective: To evaluate the efficacy of dynamic compression plating against interlocking nail technique for the treatment of humeral shaft fractures. Study Design: Randomized controlled trial Place & Duration: Department of Orthopedic, Mardan Medical Complex, Mardan for the period of two years from April 2020 to October 2021. Methods: Fifty six patients (18-65 years old) of both sexes were included in the study because they had a humeral shaft fracture. The patients were randomly split into two groups. Both the dynamic compression plating group (n = 28) and the interlocking nail group (n = 28) received treatment. Radiographic examination both before and after surgery were performed. At the 12-day post-operative, complications following the operation were observed. The NEERs criteria were used to analyse the results of the functional assessments. Follow-up was taken at 6 months postoperatively. Results: Mean age of patients was 41.46±10.74 years. 42 (75%) patients were males while 25% were females. Road traffic accident was the most common cause found in 37 (66.07%) patients. Mean union time in DCP and INL group was 11.62±3.05 and 13.54±4.73 weeks. Shoulder stiffness was the commonest complication in both groups. At final follow up, in DCP group 24 (85.71%), 2 (7.14%) and 2 (7.14%) patients had excellent, good and fair outcomes, while in group B (INL) 19 (67.86%), 5 (17.86%) and 4 (14.29%) patients had excellent, good and fair outcomes. No significant difference was found in both groups regarding functional outcomes. Patients satisfaction was high in DCP group as compared to INL. Conclusion: Dynamic compression plating shows better outcomes in term of union time, complications and functional outcomes as compared to interlocking nail Technique. Keywords: Dynamic Compression Plating, Interlocking Nailing, Fracture Shaft of Humerus