ABSTRACT
Introduction: Pancoast-Tobias tumor (PTT), is a rare presentation of lung cancer that affects less than 5% of patients. Vertebral hemangioma is a benign tumor that develops in the endothelial lining of blood vessels. It is rarely symptomatic in adults, with only 0.9 to 1.2% of all vertebral hemangiomas being symptomatic. Materials and Methods: A 69 years old patient presented with right-sided chest pain, cough but no dyspnea associated with a weight loss of 10 kg over the past 06months. The patient reported inflammatory back pain that had been evolving for 2 years and had worsened in recent months. Chest X-ray-CT scan and MRI revealed a tumor mass in the apical segment of the right upper lobe extending into the right posterior mediastinal space at the costo-vertebral groove, measuring 38*33 mm with D2 and D3 vertebral body nodule in T1 isosignal, T2 hypersignal enhancing after gadolinium injection, consistent with an aggressive vertebral angioma (AVA). A multidisciplinary approach was organized, and the indication was to perform preoperative embolization, followed by hemivertebrectomy of D12 associated with costolobectomy. The patient refused to continue the treatment and passed away after 05 months. Discussion: Most vertebral angiomas are discovered incidentally and should not be treated. Pain is generally the most common symptom of discovery. MRI remains the most effective in exploring vertebral angiomas. PTT can extend to the cervicothoracic outlet, the diagnosis of these tumors calls for chest X-ray. Thoraco-abdomino-pelvic CT scan is part of the extension assessment and MRI allows for precise analysis. The management of the exclusive association of PTT and AVA remains a a challenge. Conclusion: The combination of PTT and a set of AVA is extremely rare and doesn’t appear to be described in the literature. The central problem remains the management, which is a challenge for the responsible surgical team.

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Background: Congenital clubfoot is one of the common congenital disorders. Surgery plays an important role in the treatment of patients with this deformity. Comparative studies after surgical treatment might be beneficial. Hypothesis: Surgical treatment of congenital idiopathic club foot by McKay procedure gives better results than Turco procedure. Objectives: To compare the outcome of surgical treatment of congenital idiopathic club foot between McKay procedure and Turco procedure. Methods: This is a prospective interventional study carried out at Orthopaedic Department of Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka, during the period of January 2007 to December 2008. 25 patients with 36 feet were selected in which Group-I consisted of 13 patients with 19 feet treated with surgery by Mckay's procedure and Group- II consisted of 12 patients with 17 feet treated with surgery by Turco's procedure. All the ethical considerations were fulfilled. A questionnaire was designed and prepared by the researcher himself. Diagnosis was confirmed by detailed medical history, clinical examinations and relevant investigations. Then through Turco or cincinnati incision surgery was done in two groups. Statistical analysis were done by SPSS (Statistical Package for the Social Science). Results: There were satisfactory results (Excellent + Good) in 17 feet (89.47%) and unsatisfactory results (fair + poor) were in 2 feet (10.53%) in Mckay's procedure. Where as satisfactory results (Excellent + Good) were in 9 feet (52.94%) and unsatisfactory results (fair + poor) were in 8 feet (47.06%) in Turco's procedure. Conclusion: Operative treatment of congenital clubfoot deformity is always an accepted method of treatment. The final outcome of the results shows that in Mckay's procedure satisfactory results was found in 89.47% which is more than Turco's procedure 52.94%.

ABSTRACT
Low back pain (LBP) is a pervasive health issue, affecting millions globally and leading to significant disability and healthcare costs. A crucial but often underappreciated aspect of LBP is its relationship to the sacrum, a large, triangular bone at the base of the spine, forming the posterior part of the pelvic girdle. The sacrum's role in load distribution and movement makes it a key player in both the onset and perpetuation of LBP. This review aims to consolidate current knowledge on sacral-related low back pain, discussing its etiology, clinical presentation, diagnostic strategies, and management options. By synthesizing recent research and clinical insights, the review seeks to provide a comprehensive resource for healthcare professionals and researchers. The review highlights the multifactorial nature of sacral-related LBP, encompassing biomechanical, inflammatory, and degenerative causes. Diagnostic advancements, particularly in imaging techniques, have enhanced the ability to identify sacral involvement in LBP. Treatment approaches range from conservative management to advanced surgical interventions, with emerging therapies showing promise in improving patient outcomes.

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Introduction: Temporomandibular disorders (TMD) related headaches is very common in the global population these days.77% of patients with TMD often complains of headache and orofacial pain. The Cartilage surrounding the joint is also affected and also the surrounding structures, clinically showing pain, stiffness, tenderness, trigger points due to bruxism, over loading due to one sided chewing, genetic factors that leads to flattening of the concavity, osteophytes and erosion of the joint margins. Aim and Objective: The aim of the study is to see the effectiveness of dry needling technique on orofacial muscles and suboccipital muscles in TMD related headache. Method: 30 patients with TMD related headache who visited the physiotherapy department and dental OPD were included in the study with patient consent. Patients were divided randomly into two groups; Group A received dry needling technique with occlusal splint at night, and Group B received medication with occlusal splint. Pain was evaluated by Visual Analogue Scale (VAS), active myofascial trigger point (AMTrP) was assessed by palpating tenderness and Functional Disability evaluation was done by Headache Index (HI). Pre-and post-intervention in both groups. Independent t-tests were used to compare the pre-and post-intervention results in both groups. Results: Experimental group who were treated with dry needling exhibited significant improvement as compared to the control group. Conclusion: Dry needling is an effective technique for reducing headache in TMD without any adverse reaction. we commend it to be a good technique for such patients.

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This study evaluated the effects of ulnar styloid fractures on functional recovery and complication rates in 200 patients with distal radius fractures treated with volar locking plates. Participants were categorized into groups with (USF) and without (NUSF) ulnar styloid fractures, assessing outcomes like grip strength, range of motion, DASH scores, PRWE scores, and complication rates over 12 months. Results indicated that ulnar styloid fractures marginally reduced grip strength and increased DASH and PRWE scores and complication rates, suggesting a minor but significant impact on recovery. No difference in range of motion was observed. These findings advocate for a selective approach to ulnar styloid fracture fixation, emphasizing personalized patient management. Further research is recommended to refine treatment guidelines and explore long-term outcomes, highlighting the importance of considering ulnar styloid fractures in clinical decisions to optimize patient recovery.

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Background: The endeavor of this study was done to compare the effectiveness of transcutaneous electrical nerve stimulation (TENS) in subjects with chronic non-specific low back pain (LBP) as compared to intermittent lumbar traction (ILT) with simultaneous application of extensor endurance exercise with both the interventions. Methods: Quasi-experimental approach was chosen for conducting the study with pre-intervention and post-intervention evaluation of the outcomes. Convenient sampling and random allocation to groups were used to select and assign the sample that comprised of 10 subjects each in the two experimental groups and 10 subjects in control group out of total sample size of 30. Standardized tools such as VAS for evaluating the pain, modified Oswestry LBP disability questionnaire for evaluating disability were utilized. Extensor endurance exercise with warm-up and cool down were administered to both the experimental groups in common and TENS and ILT were administered to subjects of first and second experimental group respectively. Control group subjects were only treated with hot packs. Results: The data were analyzed with help of Microsoft excel. Paired t-test was done for Intragroup analysis and un-paired t-test, ANOVA for intergroup analysis. The findings suggested that there was significant difference within group-A and group-B for pain and disability and for group-C; the significant difference was found only for pain. Conclusion: From this study we concluded that, with common intervention of extensor endurance exercise for both experimental groups; significant reductions were seen in disability of subjects with chronic non-specific low back pain after four weeks of intervention with intermittent lumbar traction than that of TENS but the reduction of pain was more significant in subjects intervened with TENS than that with intermittent lumbar traction.

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Background: Ghee and honey has been advocated and used as dressing for infected wounds by Sushruta (600BC). The gratifying results observed with the dressing have prompted this study which aims to establish its efficacy in chronic infected wounds over one year period A standardised ghee and honey dressing was used to treat: chronic post- operative wounds and infected per op wounds, Honey and ghee dressing markedly reduces the foul odour and discharge, significantly improving the quality of life. The study will tell us comparative result of honey and ghee dressing as compared to expensive vacuum dressing and the regular dressing materials. Innumerable Randomised Control Trials (RCTs) reported on honey dressing for infected wounds, there is substantial evidence that ghee and honey dressing has at least comparable results to other modes of treatment. The easy availability and low cost of this treatment makes it significant in developing countries. Specially in rural population, Required permission has been from the HOD of orthopaedics. Material and Methods: Total 20 patients with compound fracture and chronic infected wound, were studied during the period of March 2023 to June 2023 at BVP RMC Loni, Maharashtra. Honey and ghee were taken from a fresh sealed box in 50:50 portion according to size of wound and mixed well then it was applied on the wound directly and covered with gauge and, the dressing was changed is cleaned with sterile normal saline as compared to normal dressing materials ie betadin, povidon iodine ointment, spirit. All Patients data was collected and compiled in Microsoft excel and were statistically analysed using appropriate statistical test using SPSS software. Results: Majority patient were males. Mean duration of wound healing among honey and ghee dressing was 15.3 and of regular dressing was 8.9 days. Conclusion: Honey is one alternative solution that can be used for non-pharmacological therapy. Honey can be used as a topical dressing .........