Fractures of the distal femur have been reported to account for between 4% and 7% of all femoral fractures. If fractures of the hip are excluded, 31% of femoral fractures involve the distal femur. With the modern trends of high-energy lifestyles combined with increased longevity, this incidence is probably increasing. The patients included in this study were those with communited Supracondylar fractures of the femur with intra articular involvement and disruption of the joint surface. No pathological fractures or fractures in the children were included in the study. All the patients were treated in the Department of Orthopedics, Nizam's Institute of Medical Sciences, Hyderabad during the period between January 2008 and October 2012. Men and younger age group are more commonly involved by Road traffic accident. To give appropriate and optimum treatment for Supracondylar fractures with communition and intra articular extension is a challenge to every orthopedic surgeon and it needs careful preoperative planning, per operative skills and postoperative attention to obtain best results.

Background: Cultural practices of hair care are getting less attention for preventing hair loss. Objectives: To study and compare the factors associated with hair loss among the Andhra and Malayalam girls and to find out whether the cultural practices can prevent the hair loss. Methods: A cross-sectional descriptive and comparative study was carried out among 140 Andhra and 100 Malayalam girls. They were interviewed by doctors for the various socioeconomic and cultural factors causing hair loss and the preventive measures adopted by them using a predesigned questionnaire. Chi square test and proportions were used to analyze the data. Results: Overall prevalence of hair loss among 240 girls was 83.3%. Hair fall was more seen with Andhra girls (92.85%) than with the Malayalam girls (70%). More seen in middle class girls (78.5% of Andhra girls) and in 46% of Andhra girls with underweight and 50% of Andhra girls taking poor protein diet. Hair loss among the Andhra girls was found significantly high due to infrequent head bath (once a week or fortnight) and applying shampoos and soap nut usage. Hair loss was prevented in Malayalam girls by their cultural habits of daily head bath with prior massage with oil containing the powder of Hibiscus leaves, egg white application, avoiding too much sunshine and leaving hair loose for drying. Conclusion: Good cultural practices can prevent health problems. Cultural practices can assist in preventing hair fall in girls. Elimination of nutritional imbalances and other causative factors with due importance given to the cultural practices of hair care will help the girls to face this distressing health problem to a major extent.

Background: Most of the non steroidal anti-inflammatory drugs are not equally effective in all inflammatory conditions especially in chronic conditions like rheumatoid arthritis, osteoarthritis and ankylosing spondylitis. Hence there is a need for newer and safer non steroidal anti-inflammatory drugs directed against cell adhesion molecules are being studied. Objective: Evaluation of Newly Synthesized Benzofuran [3-2, d] Pyrimidine Derivatives for Anti Inflammatory Activity Methods: In the present study some of the newer synthetic compounds like fused benzofuran derivatives, were screened primarily for their anti-inflammatory activity. The results obtained with the newer synthetic compounds were compared with that of standard drug Diclofenac sodium. Results: Leukotrienes thus contribute towards leukocyte emigration. Since the compounds under study were shown to suppress emigration they might be acting by decreasing leukotrienes also. Depending upon these findings the mechanism by which C₃ and C₁ were acting as anti-inflammatory agents might be summarized as by inhibiting PG release, by inhibiting production of leukotrienes and by suppressing emigration of leucocytes. Conclusion: The efficacy of C₃ as anti-inflammatory agent seems to be almost similar to that of diclofenac sodium.

Background: Care for HIV infected individuals has dramatically improved by the use of Highly Active Anti Retroviral Therapy (HAART). Nevertheless, virological failure occurs and is often associated with development of drug resistance. Adherence is a major factor determining virological suppression. Significant improvement in nutritional status is seen after initiation of ART. Objectives: To study the adherence and effectiveness of antiretroviral therapy in terms of clinical and immunological parameters in HIV infected children. Methods: A prospective clinical study conducted from April 2007 to April 2008, of all the newly diagnosed HIV positive children aged 2-15 years, started on ART, after approval from the ethical committee. Results: Adherence was > 95% in 35 cases (89.7%), 80-95% was seen in one case (2.6%) and < 80% in 2 cases (5.1%).The mean weight before ART was 15.54±5.63 kg and after ART was 18.88±5.63 kg, p value < 0.001, which is statistically significant. The mean height before ART was 102.38±18.49 cm which increased to 109.22±17.65 cm, p value < 0.001, which is statistically significant. The mean CD4 count levels increased from 515.23±79.62 to 1199.65±100.31 after ART, with p value < 0.001 which was statistically significant. The mean CD4% increased from 12.56±8.06 to 24.45±5.66, p value < 0.001 which was statistically significant. Conclusion: Adherence to HAART was good, HAART improved the average weight and height gain, and increase in CD4 counts of HIV infected children, thus significantly improving the immunological status and WHO staging.

Background: Primary Angle Closure Disease is a common cause of Blindness. Objectives: Our study was to evaluate the Intraocular Pressure and Optic Disc in the Primary Angle Closure Disease. Materials and Methods: This was a tertiary hospital study in the Glaucoma clinic, Sarojini Devi Eye Hospital and Regional Institute of Ophthalmology (RIO), Osmania Medical College, Hyderabad over a period from August 2012 to August 2014. The study group was 50 Patients clinically diagnosed as a primary angle closure disease. Detailed history of the patient with the data of age, gender and clinical status were noted. Comprehensive ocular examination was done which includes Visual Acuity by Snellen’s Chart, Anterior Segment examination by Slit Lamp, Intraocular pressure measurement by Goldman’s applanation Tonometer, Angle of the anterior chamber (Gonioscopy) by 4 Mirror Goniolens (Sussmann and Posner) and Posterior segment examination by Slit lamp - biomicroscopy with + 90 D Lens and Indirect Ophthalmoscopy by + 20 D lens. Results: Age group distribution was 10(20.0%) in 40-50yrs, 27 (54.0%) in 51-60yrs, 12 (24.0%) in 61-70yrs and 1(2.0%) > 70yrs. 14 (28.0%) were males and 36 (72.0%) were females. It was acute in 13 (26.0%) with the presenting symptoms of pain, Redness and Colored Haloes and chronic with the presenting symptom of Defective Vision in 37 (74.0%). Angle of Anterior chamber was closed in 43 (86.0%) and Hazy View in 7 (14.0%). The Intra ocular pressure in mm Hg was <20 in 1 (2.0%), >20-25 in 7 (14.0%), >25 – 30 in 27 (54.0%), >30 – 35 in 6(12.0%), >35 -40 in 5 (10.0%), >40 – 50 in 2 (4.0%) and >50 -60 in 2 (4.0%). Cup/ Disc ratio was <0.7-1 in 8 (16.0%), 0.7 – 1 in 12 (24.0 %), 0.8 – 1 in 11 (22.0 %), 0.9 – 1 in 4 (8.0%), total cupping in 8 (16.0%) and hazy view in 7 (14.0%). Polar notching was in 3(11.6%) and Disc Hemorrhage was in 3 (4.4%). Conclusions: Primary angle closure disease presented as a silent and chronic condition with Intraocular pressure of 25 - 30 mmHg and Optic cup: disc ratio of 0.7 – 1 to 0.8 -1 with a need for comprehensive ophthalmic examination in the early detection of the disease in the risk group to prevent angle closure disease related blindness in the community

Background: The cubitus varus is the most common long term complication of the supra-condylar fractures of the humerus in children .Though the deformity is considered to be more of cosmetic in nature, recent studies have also described an associated morbidity .In the past the incidence of the cubitus varus following the supra condylar fractures ranged from 9% to 58%.However with the use of the modern methods of management of the fractures, the incidence has decreased. Several methods of correction of the cubitus varus have been in vogue. They differ mostly in their approach and the methods of fixation. Objective: To evaluate the modified French osteotomy technique. Methods: 14 patients in the age group of 7 and 23 were operated for correction of cubitus varus deformity, at a primary orthopedic care hospital in rural Telangana and followed up for mean period 2.4 years. We used a slight modification of the modified French technique and found it to be of advantage in our series. Results: Our results were graded as per the functional grading used by Bellimore.79% of our patients showed excellent results. Our results compare favorably with the results from the other series. Conclusion: The modified French osteotomy is simple safest and most stable osteotomy which can be performed by orthopedic surgeons with the basic knowledge of the patho-anatomy and biomechanics of the deformity, with favorable and comparable results.

Background: Diagnostic laparoscopic evaluation for infertility is indicated for women who failed to achieve a successful pregnancy after twelve months or more of regular unprotected intercourse. Since approximately 85% of couples may be expected to achieve pregnancy within that time interval without medical assistance, evaluation may be indicated for as many as 15% of couples. Objective: To find out different causes of female infertility with diagnostic laparoscopy and their comparative frequency in primary and secondary infertility. Methods: All 72 infertile women who underwent diagnostic laparoscopy for primary and secondary infertility during this study period were included in the study, conducted at Department of Obstetrics & Gynecology, Gandhi Medical College/Hospital, Secunderabad from January 2015 to December 2015. Results: 72 infertile women underwent laparoscopy during the study period. Among this 56 (77.77%) of patients had primary infertility, while 16 (22.22%) had secondary infertility. Among this, 15 (20.82%) patients who underwent laparoscopy have no visual abnormality. Common findings were tubal blocks in 12 (16.66%) and PCO 13 (18.05%) in these patients. Polycystic ovaries were not found in cases of secondary infertility. Endometriosis was found in 4 (5.55%) patients.PID was found in 3 (5.35%) patients peritubal and periovarian adhesion were found in 7 (9.73%). Fibroids were found in 12 (16.66%) cases and ovarian cysts were found in 5 (6.94%) cases and uterine anomalies were found in 2 (2.77%) cases. Conclusion: Most common cases responsible for infertility were tubal occlusions and polycystic ovaries. Next common finding on Laparoscopy was fibroid and other cases which were found were ovarian cysts, endometriosis, and peritubal and periovarian adhesions. And in 20.82% of cases no visual abnormality was detected.

Background: Non-alcoholic fatty liver disease (NAFLD) is emerging as an important cause of liver disease. Over the past decades, it has become increasingly clear that nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) are now the number one cause of liver disease all over the world. Objectives: To study co-morbidities associated with Non Alcoholic Fatty Liver Disease. Methods: 108 Persons with Non Alcoholic Fatty Liver Disease diagnosed by USG irrespective of age admitted in hospital from September. 2014 to August 2015 were enrolled in this study after applying inclusion and exclusion criterion. The comparison of qualitative data was done using chi-square test using SPSS 16 Version. Results: 89.13% of female patients had raised SGOT levels when compared to males (58.06%) and this difference was found to be statistically significant. The proportion of elevated levels of SGPT was more among female (89.13%) study subjects when compared to male subjects (59.68%) and this difference was statistically significant. The proportion of female study subjects with metabolic syndrome (82.61%) was more when compared with male study subjects (75.81%) and this difference was not found to be statistically significant. Conclusion: As noticed by this study, NAFLD were predominantly asymptomatic. Screening to be done in high risk patients so that progression to cirrhosis and Hepatocellular carcinoma can be prevented.

Background: Transfusion of blood and blood products although considered as a life saving treatment modality, but may lead to certain infectious and non-infectious complications in the recipients. Objectives: The purpose of this analysis was to monitor the seroprevalence of anti-HCV antibody in the blood donor population in a hospital based blood bank in Hyderabad. Methods: Relevant information of all the blood donors who donated whole blood at the department of Transfusion Medicine, of tertiary care hospital in Hyderabad from the January 1, 2011 to December 31, 2013 was retrieved from the departmental records. The number of donors who were found reactive for anti-HCV antibodies was calculated. Results: Of the total 21,451 blood donors, 20801 were males and 650 were females. The percentage of whole blood donors found seroreactive for anti-HCV antibodies was 0.28 percent. The seroprevalence of anti-HCV in male blood donors was 0.28 per cent and the seroprevalence in female blood donors was 0 percent. Maximum seroprevalence of anti-HCV was observed in the age group of 18 to 30 yr (0.41%) and the minimum in the age group of 51 to 60 yr (0.26%). Conclusion: HCV seroprevalence in our study was 0.28 per cent and a decreasing trend with age was observed. Since, no vaccine is presently available for immunization against HCV infection, transfusion transmitted HCV infection remains a potential threat to the safety of the blood supply.

Background: An increased incidence of drug resistance is seen even after active implementation of directly observed treatment short course (DOTS). Early diagnosis of such cases can be improved by performing DST (drug sensitivity test) in all relapse cases. Objective: To know the drug sensitivity pattern and emergence of drug resistance among the category I relapse cases of pulmonary tuberculosis by culture of sputum & drug sensitivity. Material and methods: In this prospective analysis, we have studied the pattern of drug resistance met with in Mycobaclerium tuberculosis isolates obtained from 102 relapse cases who have completed category-I treatment under DOTS. Results: A very high prevalence of MDR-TB (35.29%) is seen among the category I relapse cases. An increased drug resistance among relapse cases correlated well with extensive disease with cavitation radiologically and heavy sputum bacillary load in their pre treatment status. Conclusions: We conclude that all relapse cases should be evaluated for sputum culture and drug sensitivity at the earliest to know about the sensitivity pattern before putting them on category 2. DOTS therapy needs to consider some individualization of treatment based on case specific circumstances, not routinely but atleast for those patients with very extensive disease with cavitation and heavy bacillary load in the sputum.

Rabies is one of the deadliest diseases known to man; it remains a neglected zoonotic disease throughout the developing countries. Rabies is an acute condition, 100% fatal and it is transmitted to humans through animal bites especially dog bites. Pre-exposure rabies prophylaxis is administered for several reasons. First, although pre-exposure vaccination does not eliminate the need for additional medical evaluation after a rabies exposure, it simplifies management by eliminating the need for RIG and decreasing the number of doses of vaccine needed. It can be controlled by taking post exposure prophylaxis following animal bites. The objective of study was to estimate the burden of rabies in Telangana state and to know the epidemiological trends of rabies. Retrospective analysis of human rabies cases admitted in Sir Ronald Ross Institute of Tropical and Communicable Diseases, Hyderabad during a period of five years from January 2010 to December 2014. Average number of rabies cases admitted in our hospital is 22.4 cases per year. . Adult men of age group 41-60 years were most commonly affected and elderly people of age group >60 years were affected least. Hydrophobia was the predominant feature of human rabies. Mostly people living in rural areas who have not taken the vaccine after the dog bite were affected. It was concluded that as the disease is incurable it is important to focus on health education to increase the awareness in the community about pre-exposure prophylaxis for high risk groups and post-exposure prophylaxis after dog bite.

Surgical excision of tumors of distal tibia situated specially in poster lateral aspect may be difficult to visualize in its entirety by antero-lateral approach. If posterior approach is chosen, the difficulty in positioning of the patient and important structures behind may cause hesitation in surgeons mind. The trans-fibular approach in selected cases may be indicated for full visualization of the tumor boundary in its entirety. We report one case of osteoclastoma of distal tibia in which osteotomy and subsequent replacement of distal fibula and fixation with a semitubular plate, allowed complete excision of tumor and satisfactory outcome. This procedure provides an alternative technique to the anterior approach.

A 23 year old female patient presented to Ophthalmology OPD with complaints of left sided headache since one month, it was sudden in onset and was associated with redness, watering, photophobia and blurring of vision. There were about 8-10 episodes, each lasted for 1-2 days with asymptomatic period between the attacks. Left eye showed fine keratic precipitates with grade 2 flare and cells in anterior chamber. Pupils were mid-dilated and sluggishly reacting. IOP in left eye was 38 mmHg. Patient was started on topical steroids, oral Acetazolamide and topical anti glaucoma medication. Patient was followed after 3 days, showed decrease in inflammation and IOP of 22.00mm Hg in left eye, Gonioscopy revealed open angles and Humphreys visual field test showed no obvious visual field defects. Dilated fundus examination showed normal optic discs. Patients were followed regularly for IOP and any obvious optic disc and visual field defects.