Dear Friends,

S i n c e o u r

last meeting,Ashwini

has additional two

K idney D ia l ys i s

M a c h i n e s G A I L

r e p r e s e n t a t i v e

Dr Shankar visited the hospital to assess how

well we were making use of the Rs 2 million,

Pulmonary Function Test (P F T) machine they

had donated to us, and if we needed any more

help to expand our activities. Needless to say

he was happy with us in the activities we were

leading . I am suggesting that your patients of

chronic respiratory disorders can very well avail

of this facility.

This issue contains many interesting

articles for you to enjoy and some of them may

certainly help you in your day to day practice.

Good Luck !

Dr. Vasant Kale, senior

founder director, ex. Vice

Chairman, ex. Secretary of

board of directors of our th

hospital died on 4 August

2009. His sad demise was a

great blow to all of us. He was

an intrinsic part of Ashwini's

h i s t o r y a n d c o n t r i b u t e d

immensely to its growth and development over the last

three decades. He was the doyen of dermatologists

group in Solapur and was known for his excellent

clinical sense. He was a keen bridge player and very

active in the I.M.A. He was a bon vivant and had a

large circle of friends. His sad death has caused a great

void in the life of Ashwini. He leaved behind his dear

wife Kavita and three sons (one of whom, Girish, is also

a dermatologist) and their families. Ashwini Parivar

shares with late Dr. Vasant Kale's family its grief and

deep sense of loss.

May his soul rest in Peace.

OBITUARY

Dr. Vasant M. Kale

(1939 - 2009)

Ashwini Rugnalaya Times, August 2009 Volume - VIII

Case StudyVascularised Free Fibula Transfer for Lower 1/3 Femur for Traumatic Bone Loss- Dr. Rahul Amble & Dr. Milind Joshi

Editorial

EssayDescartes, Darwin And Poor I ! – Dr. U. R. Warerkar

Doctor, Patient and the Law

Acute Kidney Injury : New Concepts – Dr. Kiran Joshi

Diverticulosis of Appendix – Dr. Pradip KasabeCase Study

Sports Injuries – Dr. Shashikant Ganjale

World of AshwiniMiscellany a) G.P.'s Corner – Know your Antibiotics b) Laughter the Best Medicine c) Quotes that can be counted on

New Surgical Technique

Bakhach's Nail Lenghthening Procedure – Dr. Chetan Dhandore

1 2-3

2 4

3 5-6

4 7-9

5 10

6 11-13

7 14-17

8 18-19

D.O.A – 16/05/09D.O.D.- 17/06/09

On examination :-

On Local Examination – Right lower limb :-

The operative details are as follows - (Fig.1)

A 40 years old male patient was brought by relatives in conscious states with an alleged history of road traffic accident, associated with trauma to the right lower limb on 12/05/09 at 4.30 pm. History of open wound at right lower limb which was sutured in a hospital at Latur and then was sent to Ashwini Hospital, Solapur, for further management on 16/05/09 There was no history of head injury. Patient was not a known diabetic or hypertensive.

A conscious adult male, moderately built and nourished, well oriented with time, place and person.Vital signs – Pulse -80/ mins , BP- 110/70 mmHg, Spo2- 100%, Pallor present, no cyanosis, no icterus.

rd rd Bony abnormalities over lower 1/3 femur and upper 1/3 of tibia. Sutured CLWS 3cm over right knee and 2cm over just below knee. Patient had tenderness and swelling locally. Peripheral pulsations were palpable with no neurodeficiancy.

On a d m i s s i o n , p a t i e n t ' s haemoglobin was 4.4 gm%, for which 10 points of fresh blood were transfused. On 13/06/09 patient's HB% was 12.1gm% after transfusion and he was taken up for surgery after detailed pre- anesthetic examination .

X-ray of right lower extremity :- rd

Communited fracture of distal 1/3 femur, with 8cm true bone loss, with fracture Patella & Segmental fracture ? T/F ( ipsilateral )

Under Spinal and Epidural anesthesia the right lower thigh incision was made on lateral aspect. A second incision, measuring 10 cm, was made on anteromedial aspect to prepare the femoral artery and vein for anastomosis as recipient vessels. After performing advanteciactomy and ligating the minor branches over 2 cms. segment as a recipient site, the rigid immobilization of fractured right femur, both segments, was done by keeping 8cms gap to avoid anatomical shortening by fixing a plate and screw. This was a special locking plate, designed for distal femur, which gave rigid hold on Shaft and femoral condyles.

VASCULARISED FREE FIBULA TRANSFER FOR

LOWER 1/3 FEMUR FOR TRAUMATIC BONE LOSS

Dr. Rahul Amble M.S., M.Ch., (Plastic Surgery)

Dr. Milind M. Joshi M.S., (Ortho)

Ashwini Rugnalaya Times, August 2009 Volume - VIII

Consultant Plastic Surgeon Consultant Orthopedic Surgeon

CASE STUDY

Fig. 1

Ashwini Rugnalaya Times, Augest 2009 Volume - VIII

COSMETICALLYUNACCEPTABLEAPPEARANCE

Skin rectangle drawn at a distance of 5 -6mm from eponychium

2 Periungualincisions made

BAKHACH'S NAIL LENGTHENING PROCEDURE

M.D.(Pathology), DIT, Diploma in R.I.A.Consultant Pathologist

Recent Additions to Ashwini Parivar

Dr. Kedar Shashikant KahateM.D.(Pathology),

Consultant Pathologist

Dr. Abhay Arvind RaikhelkarM.S.(General Surgery),

Consultant Surgical Oncologist

Dr. Fahim M. Goliwale

Miss Nameeta PatvaBHsc (F&N).PGD (Dietitics)

Mrs. Shraddha PadsalgirkarB.Hsc (F&N)

Dieticians

website: http:\\www.ashwinihospital.co.inemail : ashwinihosp@yahoo.com

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