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Fulltext A Comparative Study between Indigenous Low Cost Negative Pressure Wound Therapy with Added Local Oxygen versus Conventional Negative Pressure Wound Therapy

Singh A, Panda K, Mishra J, Dash A

Malays Orthop J, 2020 Nov;14(3):129-136.
PMID: 33403073 DOI: 10.5704/MOJ.2011.020

Introduction: The incidence of compound fractures and severe soft tissue loss has increased manifolds due to high speed traffics. Negative Pressure Wound Therapy (NPWT) is a treatment modality for managing soft tissue aspect of such injuries. It reduces the need of flap coverage. However, many patients from developing countries cannot afford a conventional NPWT. We developed an indigenous low cost NPWT for our patients and supplemented it with Topical Pressurised Oxygen Therapy (TPOT). We conducted this study to compare its treatment outcome with the use of conventional NPWT.
Materials and Methods: The study was conducted from 2018 to 2020 at a tertiary care teaching hospital. A total of 86 patients were treated with NPWT and their results were assessed for various parameters like reduction in wound size, discharge, infection, etc. We included patients with acute traumatic wounds as well as chronic infected wounds, and placed them in three treatment groups to receive either conventional NPWT, Indigenous NPWT and lastly NPWT with supplement TPOT.
Results: We observed a significant reduction of wound size, discharge and infection control in all three groups. The efficacy of indigenous NPWT is at par with conventional NPWT. Only six patients who had several comorbidities required flap coverage while in another four patients we could not achieve desired result due to technical limitations.
Conclusion: Indigenous NPWT with added TPOT is a very potent and cost effective method to control infection and rapid management of severe trauma seen in orthopaedic practice. It also decreases the dependency on plastic surgeons for management of such wounds.
A Rare Case of Giant Cell Tumour of Bilateral Achilles Tendon Sheath - Reconstruction with Dual Tendon Transfer: A Case Report

Samal P, Mohapatra NC, Mishra J, Mylarappa A, Das P

Malays Orthop J, 2020 Mar;14(1):84-87.
PMID: 32296488 DOI: 10.5704/MOJ.2003.014

Giant cell tumour of tendon sheath is a benign soft tissue lesion most commonly found in the flexor aspect of hand and wrist. However, it is uncommon in foot and ankle and rare in bilateral achilles tendon. We report a case of 17-year-old female who presented with progressive enlargement of bilateral achilles tendon for six months. MRI findings showed that most of the tumour had intermediate to low signal intensity. Histopathology confirmed the diagnosis of giant cell tumour of tendon sheath. To help the patient regain the strength of the achilles tendon and walking abilities, a large area of tendon tumour was excised, followed by reconstruction with transfer of the peroneus brevis (PB) and posterior tibial (PT) tendon autograft. At two years follow-up, functional result was satisfactory.
Reconstruction of Metacarpals of Two Rays with Double Barrel Osteocutaneous Fibular Flap in a Hand Injury with Composite Tissue Loss: A Case Report

Mishra JK, Sahu SA, Sindhuja A, Kar BK, Saha A

Malays Orthop J, 2024 Nov;18(3):71-74.
PMID: 39691566 DOI: 10.5704/MOJ.2411.010

Free fibula flap has been a workhorse for head, neck, and extremity long bone defects. We discuss the reconstruction challenge in an unusual hand injury case involving the loss of multiple metacarpals and soft tissue with surprising preservation of finger vascularity. The reconstructive goals were addressed with a microvascular osteocutaneous fibula flap transfer with multiple osteotomies to create spitting images of metacarpals and soft tissue defects restored with the skin paddle. The outcome, in terms of functional gain, was sufficient for managing day-to-day activities. We share our experience in reconstructing this unique presentation of a complex hand injury.
Fulltext Risk communication and community engagement during COVID-19

Khan S, Mishra J, Ahmed N, Onyige CD, Lin KE, Siew R, et al.

Int J Disaster Risk Reduct, 2022 May;74:102903.
PMID: 35313476 DOI: 10.1016/j.ijdrr.2022.102903

In today's information age, both excess and lack of information can cause a disaster. COVID-19 pandemic not only highlighted the significance of risk communication but also pointed out several unintended and distressing consequences due to information gaps and miscommunications. Despite facing a common threat, the local communities suffered differential impacts during the pandemic. This paper classifies the nature of risk communications experienced across different countries into three categories, namely: inadequate, ideal, and infodemic risk communication that influenced the local perceptions and responses. It further argues that inadequately planned risk communications tend to create new risks and compromise the efforts towards managing a disaster. As global risks are responded locally, there is a need for more inclusive and engaging risk communication that involves communities as responsible stakeholders who understand, plan, and respond to risks to increase their propensity for resilience during disasters and crisis situations.