Mild Pre-eclampsia Criteria SBP ≥ 140 to < 160, DBP ≥ 90 to < 110 (two readings, 4 hours apart) Significant proteinuria (≥ 300mg in 24 hrs) No evidence of organ dysfunction Management Admission Quantification of Proteinuria (24 hrs urinary total protein) Monitoring of Maternal Condition BP - 4 times a day CBC, S. creatinine, S. electrolytes, ALT, S. bilirubin - twice a week Examination of the retina Monitoring of the Fetal Condition Kick count - daily USG to determine fetal growth - every 3 weeks Control of BP BP < 150/100 - no antihypertensive BP ≥ 150/100 - oral labetalol 100 mg BD/TDS Deliver if At term Signs of fetal growth restriction Worsening fetal or maternal condition Labor or rupture of membranes Severe Pre-eclampsia Criteria SBP ≥ 160, DBP ≥ 110 (two separate readings, 4 hours apart) Significant proteinuria (≥ 300 mg in 24 hours) or any evidence of organ dysfunction, e.g., low platelet count, elevated liver enzymes, pulmonary edema, creatinine ≥ 1.1 mg/dl, headache, blurring of vision. Management Admission If ≥ 34 weeks or < 34 weeks with complications Deliver after stabilization of maternal condition. ...

Treatment Undisplaced Simple slab/splint & sling for 1-2 days (for swelling to subside) Followed by Colles’ cast for 4-6 weeks Displaced Reduction under anesthesia (hematoma block, Bier’s block, sometimes G/A) Followed by Colles’ cast for 4-6 weeks If Reduction is Not Acceptable ORIF by k-wire, plate & screw or even external fixator Colles’ Cast It is a below elbow cast with palmar flexion and ulnar deviation with the following 4 criteria: ...

Treatment Non-operative Most clavicle fractures unite rapidly despite displacement. Mainstay of treatment is simple sling for 1-3 weeks or until pain subsides. Operative ORIF by plate & screw or intramedullary nail Indications of Surgery Open fracture Widely displaced fracture Displaced distal 3rd fracture Floating shoulder Cosmetic deformity Seizure disorder When earlier return to work is needed

Treatment Young Adult Closed Reduction and Internal Fixation with cannulated hip screws Elderly (>60y) Replacement hemiarthroplasty with femoral prosthesis

Treatment Antibiotics Debridement & tetanus prophylaxis Stabilization Soft-tissue cover Rehabilitation Antibiotics 1st/2nd generation cephalosporin or co-amoxiclav Started immediately Continued up to soft-tissue cover or a maximum of 72 hours, whichever is sooner Debridement All dead and foreign material is removed Washed with large quantities of normal saline Stabilization Locked intramedullary nailing (if definitive wound cover is possible at the time of debridement) Temporary stabilization with external fixator and later replaced with intramedullary nail (if definitive wound cover is not possible immediately)