This study aims to analyze the effect of intravenous administration of tranexamic acid (TA) on reducing the risk of revision for acute and delayed periprosthetic joint infection (PJI) after primary total knee replacement (TKR). This prospective observational cohort study included 1,529 TKRs (396 males, 1,133 females; mean age 67.8 years; range, 44 to 85.1 years) performed between January 2003 and October 2017. We analyzed the revision rate for acute and delayed PJI in a group of 787 TKRs with preoperatively intravenously administered TA (TA group) in comparison with a group of 742 TKRs without administration of TA (non-TA group). Multiple logistic regression analysis was used to evaluate significant predictors of TKR revision for acute and delayed PJI. Revision surgery due to PJI was recorded in one patient in the TA group and eight patients in the non-TA group. Cumulative revision rate of TKR was significantly lower in the TA group (0.13% vs. 1.08%, hazard ratio 0.113; 95% confidence interval [CI] 0.0147-0.937; p=0.043). Multivariate logistic regression analysis confirmed two predictors of revision: being aged over 75 years at the time of primary surgery (odds ratio [OR] 8.464; 95% CI: 2.016-35.54; p=0.004) and male gender (OR: 7.9; 95% CI: 1.879-33.26; p=0.005). The use of TA was shown as the significant protective factor (OR: 0.109; 95% CI: 0.0128-0.929; p=0.043). We have found a lower cumulative revision rate of TKR for acute and delayed PJI when TA was used. We think that the preoperative intravenous use of TA may be an effective, safe and inexpensive method for the prevention of PJI.

Background. Hilgenreiner brace (Hb) was developed to improve hip reduction rate and reduce the incidence of femoral head avascular necrosis (AVN). In children under the age of 18 months with unstable hip joints or a dislocated hip joint, the treatment method involves nonsurgical treatment in most cases. Objectives. To evaluate the effectiveness and safety of traction, closed reduction, and hip fixation in Hb in patients with severe forms of hip developmental dysplasia (DDH) in follow-up. Materials and Methods. Prospective, clinical, cohort observation and retrospective matched-pair analysis. Analysis of medical records was conducted to evaluate the effectiveness of using Hb for treatment of dislocated hip joints in <18-month-old children. The investigated cases were of the dislocated hip joint since DDH was confirmed through clinical and imaging diagnosis and treated by the application of the close reduction method together with Hb, in a nonhuman position (hip joint in 90 degrees of flexion and 80 degrees of abduction). Analysis was carried out using the modified Berkeleys Mckay criteria and hip joint centralization, and evaluation was done using X-ray images according to the basic modified Severin classification system. Results. The use of Hb applied after overhead traction to (mean 22.8 days, confidence level (95)) 68 hip joints showed a significant improvement (92) in the treated hips. In summary, only one brace replacement was performed due to swelling of the thigh and fixation pressure, three cases suffered from hip joint redislocation after removing the Hb (5), and one patient had bilateral avascular necrosis (2.8). Conclusions. The use of Hb reduced avascular necrosis of the femur head, maintained higher hygiene conditions, and lowered both the risk of cast breakage and skin complications over the use of hip spica as compared to Hb. Hb is more cost-effective, and radiolucency is an additional advantage for this technique. Closed reduction and application of Hb after oral administration of a bolus dose of chlorpromazine chloride or phenobarbital resulted in complication avoidance of total anaesthesia.

Introduction. A teratoma is a tumor developed of several different types of tissue, like hair, muscle, teeth or bone. Aim. Mature benign cystic teratomas are very rare in the salivary glands and just few cases were reported. Description of the case. A 13 years old female was presented to our dental clinic of Princes Basma Hospital in Irbid in north of Jordan, with a painless, insidious progressive swelling in left parotid region without any significant family and personal history. Parents were cancer phobic and nervous from the condition of their daughter, they were very confused. There was no pain or any history of trauma. It was present just inferior to left ear cartilage. The mass was of size 3x3cm, non-tender, fixed, soft to firm in consistency, having smooth surface. Conclusion. Teratoma in parotid region is an extremely rare entity. Lack of any pathognomonic feature, it is hard to diagnose preoperatively. Lumpectomy is advisable to remove the mass because the risk of damaging facial nerve in young patients and recurrence is rare. A definitive diagnosis is achieved after the histopathological study. Teratoma should be kept in account while evaluating a case of a soft tissue mass of parotid gland as a differential diagnosis.

Background and Objectives: The COVID-19 pandemic has had a significant global impact, necessitating a comprehensive understanding of its spatiotemporal patterns. The objective of this study is to explore the spatial and temporal patterns of COVID-19 infections among five age groups (<1, 1–4, 5–9, 10–14, and 15–19 years) in 72 districts of Slovakia on a quarterly basis from March 2020 to July 2022. Material and Methods: During the study period, a total of 393,429 confirmed PCR cases of COVID-19 or positive antigen tests were recorded across all studied age groups. The analysis examined the spatiotemporal spread of COVID infections per quarter, from September 2021 to May 2022. Additionally, data on hospitalizations, intensive care unit (ICU) admissions, pulmonary ventilation (PV), and death cases were analyzed. Results: The highest number of COVID-19 infections occurred between September 2021 and May 2022, particularly in the 10–14-year-old group (68,695 cases), followed by the 15–19-year-old group (62,232 cases), while the lowest incidence was observed in the <1-year-old group (1235 cases). Out of the total confirmed PCR cases, 18,886 individuals required hospitalization, 456 needed ICU admission, 402 received pulmonary ventilation, and only 16 died. The analysis of total daily confirmed PCR cases for all regions showed two major peaks on 12 December 2021 (6114 cases) and 1 February 2022 (3889 cases). Spatial mapping revealed that during December 2021 to February 2022, the highest number of infections in all age groups were concentrated mainly in Bratislava. Moreover, temporal trends of infections within each age group, considering monthly and yearly variations, exhibited distinct spatial patterns, indicating localized outbreaks in specific regions. Conclusions: The spatial and temporal patterns of COVID-19 infections among different age groups in Slovakia showed a higher number of infections in the 10–14-year-old age group, mainly occurring in urban districts. The temporal pattern of the spread of the virus to neighboring urban and rural districts reflected the movement of infected individuals. Hospitalizations, ICU and PV admissions, and deaths were relatively low. The study highlights the need for more proactive measures to contain outbreaks promptly and ensure the resilience of healthcare systems against future pandemics.

Purpose: Is to determinate the incidence of paediatric head trauma age 0-17 years in our region in central Europe and the number of radiographic images done for paediatric patients to make a data base for further researches, to be effective in investigating, controlling, and preventing head trauma in our population and to study the real need of radiographic images: Methods: This is a retrospective study from the records of children with head trauma seen at the trauma clinics during the year 2018 Results: There were 3261 attendees recorded in paediatric age groups 0-17 years in 2018. 1168 paediatric patients presented with trauma to the head. 831 (36%) with simple injuries of the head, 295 (23.3%) with wounds in head area, 17 (1.5%) children had fractures, 23 (2%) had concussion and 2 (0.2%) patients had intracranial haematoma. 1097 (93.9%) children with head trauma were imaged by X ray (1032 patients) and CT scan (65 patients) in accordance with local guidelines for head trauma management. The percentage of patients in need of radiation is only 3.42%.Conclusion: Most head trauma in children was minor and not associated with brain injury. The radiation is over used in diagnosis of paediatric head trauma

Objective: To analyse the epidemiology of patients suffering calcaneal fractures. Methods: This is a retrospective study of patients with calcaneal fractures hospitalized in the teaching departmen t of Orthopaedics and Traumatology and in central between 2014 and 2018. Results: The work presented retrospective study to evaluate the Incidence of calcaneal fractures in NSP UNLP hospital. We retrospectively studied 15787 patients with bony fractures i n our hospital and trauma clinic in emergency department from 1.1.2014 to 31.12.2018, from our records, 156 patients had calcaneal fracture (1%). Conclusion: The research revealed a rare incidence of calcaneus fracture, affecting men 4 times more than wom en due to nature of work and daily activities. Calcaneal fracture is common cause of disability. The results of this study are expected to contribute to providing an information base that helps planners and decision makers in developing appropriate strateg ies to deal with safety at work site.