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Objectives: Assessment of upstream levels of lipid peroxidation and DNA damage regulating the development of rheumatoid arthritis. Data Source: All the samples were collected from Jinnah Hospital Lahore. Study Design: Comparative cross sectional study. Period: Two years from 18-09-2014 to 24-10-2016. Setting: The Institute of Molecular Biology and Biotechnology (IMBB) in The University of Lahore-Pakistan. Material and Methods: Blood, saliva and synovial fluid of fifty (n=50) individuals diagnosed with Rheumatoid Arthritis and fifty (n=50) age-sex matched controls were added in current study. Levels of MDA were determined spectrophotometrically while the concentrations of isoprostanes, 8-OHdG and 4-HNE were measured by the help of commercially available Elisa Kit. Results: Levels of lipid peroxidation products including MDA (μmol/ml), isoprostanes (pg/ml), 4-HNE (μmol/ml) and DNA damage in the form of 8-OHdG (pg/ml) were significantly high (p<0.015, p<0.022, p<0.004 and p<0.036) in patients as relative to normal individuals. Levels of MDA in serum (1.95±0.094 vs. 0.95±0.019), saliva (0.012±0.0034 vs. 0.056±0.0056) and synovial fluid (3.26±0.65 vs. 0.019±0.0016) were differed significantly in each groups. Level of isoprostanes in serum (12.26±5.26 vs. 1.26±0.015), saliva (2.16±0.019 vs. 0.816±0.017) and synovial fluid (34.26±4.26 vs. 0.136±0.019) were recorded higher in RA patients as compared to control. Concentrations of 8-OHdG in serum (0.945±0.014 vs. 0.019±0.0035) saliva (0.0024±0.0003/ 0.0029±0.00017) and synovial fluid (1.33±0.451 vs. 0.055±0.0016) were recorded high in RA patients. Significantly higher concentration of 4-HNE in serum (4.265±1.25 vs. 1.99±0.016), saliva (1.26±0.15 vs. 0.191±0.0091) and synovial fluid (6.35±1.16 vs. 0.094±0.00165) were recorded in patients with RA. Conclusion: Present study concluded the role of oxidative biomarkers and their differential expression in the onset of autoimmunity in patients with RA. Increased stress is involved in the DNA damage and increased lipid peroxidation in the synovial fluid. Therefore, antioxidant therapy may have some prognostic role in the patients with RA by decreasing the intensity of oxidative stress and DNA damage. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the management of tibial diaphyseal fractures treated by POP cast versus intramedullary nailing in terms of time of union. Design of study: Randomized controlled trials. Setting: Department of Orthopaedic, Allied / DHQ Hospital, Faisalabad. Duration of Study: Six months (01-08-2013 to 31-01-2014). Materials and Methods: 80 patients fulfilling the inclusion and exclusion criteria were included in the study. After laboratory and radiological assessment, the patients in Group 1 were treated by long leg cast. The patients in Group 2 were treated with intramedullary interlocking nail. The patients were followed on OPD basis. Results: 80 patients divided into 2 groups. Each group had 40 patients. Mean age of patients was 30.99 ±8.092 years. There were total of 65% males and 35% females in this study. According to geometry of fractures simple transverse fractures were 47.5%, spiral fractures were 17.5%, oblique fractures were 25% and segmental fractures were 10%. There were 71.25% closed fracture and 28.75% type l open fractures. Mean time of union was 23.86 ± 5.48 weeks in group 1 while in group 2, mean time of union was 18.35 ± 4.12 weeks. P-value was 0.001 which is statistically significant. Conclusion: It is concluded that reamed intramedullary interlocking nailing is a good mode of internal fixation comparing with conservative management of close reduction and POP cast in both close and type I open fractures in terms of union. [ABSTRACT FROM AUTHOR]

Objective: To compare efficacy of methyl prednisolone acetate injection with and without thumb spica cast for the treatment of de-Quervain tenosynovitis. Study Design: Randomized Controlled Trial. Setting: Orthopedic Unit, Allied Hospital, Faisalabad. Period: April 2016 to September 2016. Material & Methods: In each group 41 patients were included with non-probability consecutive sampling. Results: Eighty two patients were enrolled in the study. Out of 82 patients in the study, 3 (3.7%) were males and 79 (96.3%) were females. There were 10 (12.20%) pateints with age >40 years, and 36 (43.90%) patient in each of age group 21-30 and 31-40 years. The proportions of cured persons between two groups i.e., treated with corticosteroid injection and those treated with combination of injection and thumb Spica splint were found same with p-value 0.19 for Z=1.31. The efficacy was independent of treatment methods with Χ2=1.10 (p-value = 0.30). The same independence pattern was also observed in different age groups. Age range was between 18 and 70 years. Statistical analysis was performed using chi-square test. Six weeks following treatment, 29 (35.37%) patients from group A and 34 (41.46%) patients from group B showed relief of pain, swelling and tenderness and a negative Finkelstein test (p-value 0.295). post stratification of gender showed no significant association (p-value 0.388 and 0.328 in groups A and B respectively). Conclusion: It has been concluded that use of corticosteroid injection alone is sufficient to treat de-Quervain syndrome as compared to the use of thumb Spica splint with corticosteroid injection. It is therefore recommended that in patients suffering from de-Quervain syndrome, corticosteroid injection may be the choice of treatment. [ABSTRACT FROM AUTHOR]

Developmental dysplasia of the hip (DDH) is one of the most common musculoskeletal problems in newborns. It occurs in 1in 1000 live births affecting girls more than boys and more associated with breech presentation and positive family history. Objectives: To evaluate the effectiveness of arthrography in assessing the closed reduction of DDH. Study Design: Observational. Setting: This study was conducted at Allied Hospital, Faisalabad, Pakistan, Period: From December 2013 to January 2016 and comprised patients of either gender. Material & Methods: DDH was diagnosed with help of clinical examination and radiological investigations. Arthrography was performed and images were taken in different positions of the hip which were evaluated and findings noted. Results: Out of 50 hips, 34 had normal looking head of femur while 16 patients had head of femur which was either smaller than normal or of abnormal shape. Shape of acetabulum was found normal in 41 hips. Normal labrum was present in 44, inverted in 4 and everted in 2 patients. Ligamentum teres was found hypertrophic in 6 patients. Normal head coverage was present in 40 while in 10 hips head of femur was lateralized = 4 mm. No external obstruction to reduction was encountered. In 44 cases reduction was concentric and eccentric reduction was noted in 6 patients. Conclusion: Arthrography is of special help in assessing the reduction of hip in DDH as it provides information about shape of head of femur, shape of acetabulum, labrum, ligamentum teres, containment of the hip, coverage of head and external obstacles to reduction. [ABSTRACT FROM AUTHOR]