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Rare cause of pediatric obesity: Bardet - Biedl Syndrome
Mitul B Kalathia, Yogesh N Parikh, Parin N Parmar, Shyamal S Verma
March-April 2014, 7(2):198-200
Bardet - Biedl syndrome (BBS) is a rare autosomal recessive disorder, characterized by central obesity, retinal pigmentation, polydactyly, mental retardation, hypogonadism, and renal dysfunction. Other features may include deafness, diabetes mellitus, genitourinary abnormalities, short stature, hormonal abnormalities, developmental defects, and speech problems. We report a case of BBS who presented with night blindness, marked central obesity, polydactyly, syndactyly, hypogonadism, micropenis, and behavioral problems, along with a brief review of the literature.
  68,756 233 -
Comparative evaluation of prescriptions of MBBS and BAMS doctors using WHO prescribing indicators
Sangeeta Dabhade, Prabodhan Gaikwad, Sanjay Dabhade, BT Rane, Smita Tiwari, BB Ghongane, PT Pandit
October-December 2013, 6(4):411-415
Background: Irrational prescribing is a global problem. The present study was undertaken to identify the problem of irrational medicine use by Bachelor of Medicine and Bachelor of Surgery (MBBS) and Bachelor of Ayurvedic Medicine and Surgery (BAMS) doctors in outpatient setting, by using WHO prescribing indicators. Materials and Methods: This study was carried out in Vishrantwadi, Pune, India. 250 prescriptions were collected from MBBS doctors and 250 prescriptions were collected from BAMS doctors and their prescription pattern was analyzed using WHO prescribing indicators. Results: Average number of medicines per prescription was 2.4 for MBBS and 3.04 for BAMS doctors. Percentage of prescriptions with antibiotics and with injections was significantly more in BAMS doctors. Antibiotics, gastrointestinal system related medicines, vitamins and iron preparations were prescribed more by BAMS doctors. Percentage of irrational fixed dose combinations prescribed by BAMS doctors was more (57.2%) as compared to MBBS doctors (28.6%). Conclusions: In the present study, although the prescribing patterns of both MBBS as well as BAMS doctors are not satisfactory; the BAMS doctors seem to prescribe more irrationally as compared to MBBS doctors.
  32,089 761 -
Maternal hydration and L-arginine supplementation improves liquor volume in patients with decreased liquor and prolongs pregnancy
Shripad Hebbar, Lavanya Rai, Prashant Adiga
July-August 2014, 7(4):429-434
Background: Oligohydramnios (reduced amniotic fluid) may be responsible for the problems of malpresentations, umbilical cord compression, meconium staining of amniotic fluid in the liquor, and difficult or failed external cephalic version. Simple intervention maternal hydration has been reported as a way of increasing amniotic fluid volume in order to reduce some of these problems. Objective: To assess the influence of maternal hydration and l-arginine supplementation in improving liquor volume in patients with decreased liquor. Study Design: Prospective nonrandomized interventional study. Materials and Methods: 50 patients remote from term, with decreased liquor [amniotic fluid index (AFI) < 8] were enrolled in the study. Before the proposed intervention, the antenatal risk factors were studied. Patients with hypertensive disorders of pregnancy were administered l-arginine (one sachet 3 g, two times daily) and others received both arginine and intravenous hydration (500 ml of fructodex which contains 5% dextrose and 5% fructose, and lactated Ringer's solution daily). The treatment was continued till the liquor improved significantly. However, patients were considered for delivery if the liquor remained less than 5. Mean increase in liquor, intervention delivery interval, and neonatal outcome were studied. Results: The mean gestational age at the time of recruitment was 33.4 ΁ 1.9 weeks. The mean AFI at the time of enrolment was 6.9 (SD 0.8). These patients were delivered at 36.3 ΁ 1.3 weeks, and thus, pregnancy could be prolonged by 2.9 weeks. The mean AFI at the end of therapeutic intervention was 9.3 (SD 1.7), and thus, an AFI increase of 2.4 could be obtained. There was no significant neonatal morbidity in these patients. Significant improvement in liquor volume was obtained in these patients after intervention with either or both l-arginine and fructodex infusion (P < 0.0001). The pregnancy could be prolonged from 33.4 weeks to 36.3 weeks. Conclusion: Treatment with l-arginine and fructodex resulted in significant improvement in liquor and prolongation of duration of pregnancy by around 3 weeks, which enabled us to administer steroids for lung maturation (in indicated cases). Thus, treatment with l-arginine and fructodex seems to be promising in improving fetal outcome in pregnancies complicated by decreased liquor.
  14,029 460 -
Smegma pearl
Gaurav Sali, Iqbal Ali, Gurjit Singh, Sarang Rathod
January-February 2014, 7(1):98-99
  10,754 189 -
Comparison of modified Petroff's and N-acetyl-L-cysteine-sodium hydroxide methods for sputum decontamination in tertiary care hospital in India
Mukesh Sharma, Rabindra Nath Misra, Nageswari Rajesh Gandham, Savita Vivek Jadhav, Kalpana Angadi, Vivian Wilson
July-December 2012, 5(2):97-100
Background : Tuberculosis is the second leading cause of death worldwide, killing nearly two million people each year. Sputum decontamination with N-acetyl-L-cysteine-sodium hydroxide (NALC-NaOH) is expected to improve detection of Mycobacterium tuberculosis (M. tb) by culture better than that with modified Petroff's; which is widely used in laboratories. In this study, sputum samples collected from suspected cases of pulmonary tuberculosis (TB) were cultured directly on Lowenstein-Jensen (LJ) medium and after decontamination by both the methods and the results of smear and culture positivity were evaluated to assess whether the NALC-NaOH treatment method improves smear and culture. Materials and Methods : For each decontamination method, 30 samples were obtained from suspected cases of Pulmonary TB, from Pad. Dr. D.Y. Patil Medical College and Hospital. Two sputum samples from each patient were collected on day 1 and 2. These samples then underwent decontamination process by performing the 4% NaOH, NALC-2% NaOH treatment methods and direct inoculation. After each process a smear was made and culture was done on LJ medium. Results: The modified Petroff's and NALC-NaOH treatment methods did not significantly affect the AFB smear positivity of the sputum samples (66% and 72.3%, respectively). (However, the culture positivity for M. tb on LJ medium was significantly different by the three processes. With NALC-NaOH and modified Petroff's it was 63% and 46%, respectively, while with direct culture it was 23%. Conclusion: NALC-NaOH treatment is better than modified Petroff's treatment for the detection of M. tb by culture. However, AFB microscopy does not seem to be significantly different by either process.
  7,647 750 2
Psychogenic dyspnea
Tushar R Sahasrabudhe
January-March 2013, 6(1):14-18
Dyspnea is a very common presenting complaint of a patient. Though commonly due to an organic disease, dyspnea can be a manifestation of underlying anxiety disorder. Three typical patterns of psychogenic dyspnea, viz. panic attack, psychogenic hyperventilation, and compulsive sighing, have been reviewed in this article. The article also comments on the diagnostic features and treatment of these patterns. The overlap with organic causes of dyspnea such as bronchial asthma and Chronic Obstructive Pulmonary Disease (COPD) has also been discussed. For literature review, a Medline and Pubmed search was conducted using appropriate keywords. Articles were also identified from the authors' own knowledge of the literature as well as reference lists in articles retrieved.
  7,284 461 -
Profile of liver function test in patients with dengue infection in South India
Kunal Gandhi, Meenakshi Shetty
October-December 2013, 6(4):370-372
Background: Atypical manifestations of dengue infection with liver involvement have frequently been reported, ranging from mild elevations of aminotransferase levels to fulminant hepatitis. Materials and Methods: An analysis of 27 serologically confirmed cases of dengue infection at our tertiary care hospital was made. Patients with normal aminotransferase levels were categorized into Grade A, those with at least one of the enzymes raised to less than 3 times the reference range as Grade B, those with at least one of the enzymes elevated more than 3 times but less than 10 times as Grade C and those with elevations more than 10 times as Grade D. Results: 89% of the cases had alterations in the aminotransferase levels, with 37% categorized into Grade B, 30% into Grade C, and 22% as Grade D or acute hepatitis (P < 0.001). Aspartate aminotransferase (AST) levels were higher compared to the levels of alanine aminotransferase (ALT) (mean: 390.7 U/l and 296.9 U/l, respectively). Conclusion: Liver damage with alteration of aminotransferases is a common complication of dengue infection and valuable marker for monitoring these patients.
  6,732 515 1
Dexmedetomidine: Expanding role in anesthesia
Jyotsna S Paranjpe
January-March 2013, 6(1):5-13
The potential uses of dexmedetomidine (DEX), a highly selective α2 - adrenoceptor agonist are very diverse. DEX appears to mimic many of the actions of mythical 'ideal' sedative/analgesic agent. Although not orally active, DEX shows good bioavailability when administered via various other routes like intranasal, buccal, IM than intra-venous. DEX has similar pharmacokinetics in all age groups. Its side effects are predictable and easily treatable, hence it has found place as a part of fast-tracking anesthesia regimens in children. DEX is the sedative of choice for peri-operative use in high risk patients, since it is cardioprotective, neuroprotective and renoprotective. Premedication with DEX obtunds the autonomic pressor responses due to laryngoscopy and endotracheal intubation when used as an adjuvant to general anesthesia. DEX in high doses offers another approach to managing morbidly obese patients and patients with a compromised airway; without causing any cardio-respiratory depression. It is near ideal hypotensive agent used for controlled hypotension. Its value as a primary sedative and analgesic is becoming more accepted and evident in critically ill patients; in adult and paediatric intensive care units. Besides use in locoregional anesthesia, it is also used as an opioid substitute, for treatment of substance withdrawal, as an anti-shivering agent, for treatment of delirium and as an end of life medication. Availability of an antidote (Atipamezole) with similar elimination half life is taking the drug into new frontiers. However, use of DEX is contraindicated in patients with hepatic failure, hypovolemic shock, advanced heart block or ventricular dysfunction.
  6,432 741 3
Supraorbital neuralgia
Vasudha Jadhav, Divakar Patil, Manohar Mane
March-April 2014, 7(2):208-210
Supraorbital neuralgia is one of the rare types of neuralgias where there is persistent pain in the supraorbital region and forehead with occasional sudden shocklike paresthesia in the distribution of the supraorbital nerve. The primary treatment is identification and removal of anything causing compression over the supraorbital nerve. A brief trial of simple analgesics alone or in combination with gabapentin should be considered for patients who do not respond to the above-mentioned treatments. Supraorbital nerve block using local anesthetics and steroids is the next step.
  6,964 186 -
Postoperative complications of mesh hernioplasty for incisional hernia repair and factors affecting the occurrence of complications
Karan Vir Singh Rana, Gurjit Singh, Niteen A Deshpande, Viju K Bharathan, Srihari Sridharan
January-March 2013, 6(1):25-31
Context: Incisional hernia is one of the common postoperative complications of abdominal surgery. Mesh hernioplasty represents the standard of care for incisional hernia repair. Aims: We report our experience with the use of mesh for hernia repair, with respect to the postoperative complications and factors affecting the occurrence of complications. Settings and Design: Fifty four cases of incisional hernia presenting to the institute between April 2008 and September 2010 were included in the study. Materials and Methods: The predisposing risk factors were identified. Mesh hernioplasty was done by the onlay technique and the patients followed up for at least 6 months. Statistical Analysis Used: An association of complications with various risk factors was explored with chi-square test and odds ratio with 95% confidence interval. Results: Twenty four patients developed at least one complication, the most common being seroma (12 cases) and surgical site infection (9 cases). The factors that showed a significant relationship with the occurrence of complications were diabetes mellitus, obesity, smoking, hypoproteinemia, advanced age, size of fascial defects, and number of defects. The recurrence rate was 3.7% (mean follow up: 13.05 months). Conclusions: Mesh hernioplasty gives acceptable results for incisional hernia repair. A sound understanding of the factors affecting the occurrence of complications and recurrence is required to improve the results of the procedure.
  6,744 367 -
Vasculotoxic snake bite presenting with sepsis, acute renal failure, disseminated intravascular coagulation, and acute respiratory distress syndrome
Vikram Bhausaheb Vikhe, Ankur Gupta, Prakash Shende, Jinendra Jain
April-June 2013, 6(2):197-199
Vasculotoxic snake bites are well known to cause local complications like necrosis and cellulitis and systemic complications such as coagulopathy, acute renal failure (ARF), and hemolysis. We report a case of young female patient who was bitten by a viper. She developed cellulitis, sepsis, ARF, and Disseminated Intravascular Coagulation. She was treated for the above complications and all her renal and hematological parameters returned to normal on seventh day. After this, on the same day, patient developed Acute Respiratory Distress Syndrome probably due to the direct toxic effect of venom on pulmonary vascular endothelium which has been reported as a late complication of snake venom. With close monitoring and proper management of complications, the patient recovered and walked out of the hospital on the twenty first day without any complications.
  6,329 346 -
Surgical staple suture removal: A simple and innovative technique
Manjit Singh, Sukhminder J. S. Bajwa, Sukhwinder K Bajwa
July-December 2012, 5(2):168-169
  6,380 195 -
A study on awareness regarding swine flu (influenza A H1N1) pandemic in an urban community of Karnataka
K Shilpa, BA Praveen Kumar, S Yogesh Kumar, Amit R Ugargol, Vijaya A Naik, MD Mallapur
November-December 2014, 7(6):732-737
Background: Globally, India was one among the most affected countries for cases and deaths of swine flu (influenza A H1N1) during 2009 influenza pandemic with lot of public hype and panic. Aims: This study was designed to assess the awareness, attitude, myths and practices regarding Swine flu among urban population of Belgaum district, Karnataka. Subjects and Methods: This study was conducted in an urban community of Belgaum, Karnataka during 2009. A total of 250 households were interviewed using a pretested questionnaire by systematic random sampling. One person from each household preferably head of the family was asked regarding knowledge, attitude and practice during swine flu pandemic. Results: Among the study population, 73.6% had previously heard of swine flu. More than half of the participants said mass media communication was found to be the major source of information. Around 82.6% of the participants said fever was the most common symptom and using facemask was accepted as the important mode of prevention by 81.5% participants. Only 19.0% were willing to leave their locality temporarily if any cases were seen around. Majority of the participants selected government hospital for treatment facilities if they get any symptoms of swine flu. Hand washing, as a mode of prevention was known to 92.4% of the respondents. Around 33.4% of the populations were ready to share knowledge to others if they were given health education regarding swine flu. Conclusions: Knowledge regarding swine flu pandemic was low among study participants. Most of the participants had health seeking behavior. Majority of the respondents were practicing hand washing. Strategies to create more awareness about pandemic through effective mass media are vital for containing the pandemic.
  6,040 491 1
Elimination disorders: Enuresis
Vishal Patel, Rujuta Golwalkar, Sumit Beniwal, Bhushan Chaudhari, Archana Javdekar, Daniel Saldanha, Labanya Bhattacharya
January-June 2012, 5(1):14-17
Enuresis is a common childhood condition which is usually treatable. Enuresis at any age can lead to embarrassment. This coupled with teasing by peers resulting in social withdrawal, avoidance of overnight stay at relatives, and friends can have a long term effect in relationships than the enuresis itself. Organic and psychological causes should be considered, especially with the late onset or exacerbation of existing enuresis. Principles of management should be focused to address any precipitating and maintaining factors and also provide appropriate advice and explanation.
  5,942 406 4
Incidental tracheo-bronchial calcification
Amit Agrawal, Saginela Satish Kumar, K Raghu, Surya P Singh
July-December 2012, 5(2):166-167
  5,457 294 -
A comparison between mass closure and layered closure of midline abdominal incisions
Gurjit Singh, Rajat Ahluwalia
January-June 2012, 5(1):23-26
Background: Traditionally, a laparotomy wound is closed in layers co-opting the various layers anatomically. A new method of closure, namely single layer closure technique (mass closure technique) has come into vogue. Aims: This study aims to evaluate the benefits or otherwise between single layer closure and layered closure after comparing it with studies available in literature. Settings and Design: This study was performed in a teaching institute in patients undergoing laparotomy, either planned or emergency. Materials and Methods: A total of 80 cases were selected at random and the study was carried out over a period of 2 years. The cases were equally divided into two groups of 40. In both groups, vertical midline incision was used. In the first group, abdomen was closed using the single layer closure technique. Continuous suturing with burial of the knots was done in 20 patients and interrupted mass closure was done in another 20 patients. In the other group, the abdomen was closed in layers. The patients were followed up for minimum 6 months. Patients who did not turn up for follow up were asked to notify the development of any wound complication through postal correspondence. Results: The time required for closure was considerably less when continuous suture technique was used. One patient in the mass closure group and four in the layered group developed post-operative wound infections. One patient in the layered closure group developed a stitch sinus. There were two cases of burst abdomen with the layered closure technique. Two patients in the layered closure group developed incisional hernias 6 months post-operatively. Conclusions: Single layer closure technique offers certain definite advantage over the layered closure technique with respect to the time required for closure of the incision, incidence of wound dehiscence and the incidence of incisional hernia. However, the true incidence of wound dehiscence (burst abdomen) and incisional hernia cannot be drawn since the study was of short duration and the number of cases was small without a long follow up.
  5,188 505 -
Anesthetic management of a case of congenital diaphragmatic hernia; delayed diagnosis
Smita Joshi, Arun George
July-September 2013, 6(3):281-283
Congenital diaphragmatic hernia results from the anomalous closure of pericardioperitoneal canal. There are various challenges faced by anesthesiologists during management of such cases which include intraoperative complications including hypoxia and hypercarbia, which leads to pulmonary hypertension and right to left shunt. Mortality remains high because of associated pulmonary hypoplasia and pulmonary hypertension. Here, we describe anesthetic management of a 2-month-old female child with difficulty in breathing since birth following feeding, due to congenital diaphragmatic hernia.
  5,119 571 -
Outcome of a standardized technique of preputial preservation surgery for phimosis: A single institutional experience
Kamalesh Pal
May-June 2014, 7(3):290-293
Introduction: Pathological phimosis or preputial stenosis is a distressing problem in children leading to recurrent balanoposthitis, ballooning of prepuce, and rarely back pressure changes in the urinary tract. Circumcision has been the standard of care for such situations, although recently, various alternatives to circumcision have been reported in the literature. Most of these techniques are often complex and are met with poor acceptance. Moreover, besides personal preferences (in Hindus), advantages of preputial preservation is increasingly being realized recently. Materials and Methods: A prospective study was carried out in which a simple standardized technique of preputioplasty (dorsal slit) was used in 40 pediatric preputial stenosis cases. The outcome of this procedure including cosmesis and parental satisfaction was evaluated. Results: The average duration of this procedure was from 10 to 25 min with no intraoperative complications. The cosmetic outcome was good in 62.5%, satisfactory in 30%, and poor in 7.5% of cases. All of the boys had retractable prepuce with no functional problems. There was 100% parental satisfaction. None of the patients required a redo procedure or circumcision. Conclusion: A dorsal slit of adequate length i.e.; 1/3 rd the length from the corona to the tip leads to a satisfactory cosmetic outcome in more than 92% of cases. Preputioplasty is a safe and simple alternative to more radical procedure of circumcision.
  5,397 173 -
Nasal dermoid cyst with intracranial extension and an atretic dermal sinus tract
Vikram Singh, Sanjeev Sehrawat, Amit Kharat, Rajesh Kuber
January-June 2012, 5(1):47-50
Nasofrontal masses belong to the group of congenital midface anomalies (CMFA) in paediatric age group. Nasofrontal dermoids with patent dermal sinus tract is a rare anomaly resulting from the failure of normal embryogenic process. Most patients present in infancy or early childhood. CT and MRI together are usually required for definitive diagnosis. CT imaging provides vital information about the osseous involvement while MRI is crucial for evaluation of the intracranial extent and detailed tissue characterization. Knowledge of embryonic development is important in understanding the pathologies of nasofrontal masses in paediatric age group.
  5,202 326 -
Psychological impact of adult alcoholism on spouses and children
Darpan Kaur, Shaunak Ajinkya
March-April 2014, 7(2):124-127
Chronic alcoholism can have an adverse psychological impact on the family involved in caregiving and coping with the alcoholic. This article attempts to review and discuss relevant literature pertaining to the overall psychological impact of adult alcoholism on spouses and children. A literature search on various search engines like Pubmed, Psychinfo, OmniMedicalSearch, and WebMD was done using search words such as "psychological impact", "alcoholism", "family" "spouse", "parents," and "children". The articles perceived to be relevant have been reviewed and discussed. The literature search revealed significant problems in coping among family members. It was found that there exists a huge burden on the immediate family members of the chronic alcoholic. Recent studies have found high levels of psychological stress and depressive symptoms in spouses of alcoholics. Alcohol use has also been significantly linked to aggressive behaviors and intimate partner violence. Parentification and emotional caretaking were found in the children of chronic alcoholics. This can have a major impact on the psychological development of these children. Recent studies have shown that the offsprings of alcoholics are at a high risk for Conduct Disorders, Attention Deficit Hyperactivity Disorder, Major Depressive Disorder, and Substance Dependence. Marital and Family therapy may have a role in therapeutic as well as preventive care approaches in alcoholism.
  4,834 594 -
A study on knowledge and practices of antenatal care among pregnant women attending antenatal clinic at a Tertiary Care Hospital of Pune, Maharashtra
Barun Bhai Patel, Pranaya Gurmeet, Datttreya Ramkrishna Sinalkar, Kapil H Pandya, Ajoy Mahen, Neha Singh
May-June 2016, 9(3):354-362
Background: The maternal health status of Indian women was noted to be lower as compared to other developed countries. Promotion of maternal and child health has been one of the most important components of the Family Welfare Programme of the Government of India. For sustainable growth and development of country, there is a need to improve MCH Care in the country. Safe motherhood by providing good antenatal care (ANC) is very important to reduce maternal mortality ratio and infant mortality rate and to achieve millennium development goals. Objectives: This study aimed to determine the level of knowledge, attitude, and practice on ANC among pregnant women attending the antenatal clinic at a Tertiary Care Hospital in Pune and their association with various sociodemographic factors. Materials and Methods: A cross-sectional study was carried out among 384 pregnant women in their 3 rd trimester attending the antenatal clinic in a Tertiary Care Hospital of Pune, Maharashtra during October 2011 to September 2012. Pretested questionnaire was used for collecting data by interview after obtaining informed consent. Statistical analysis was performed using SPSS version 20 and Epi Info Software. Results: Study reveals that about 58% women had adequate knowledge regarding ANC. It was found that almost all the variables such as age, education, occupation, parity, type of family, and socioeconomic status (SES) had a significant association with awareness about ANC. 100% women were having a positive attitude toward ANC. Around 70%, women were practicing adequately, and variables such as education and SES had a significant association with practices about ANC. Conclusion: These findings can be used to plan a Health Intervention Program aiming to improve the maternal health practices and eventually improve the health status of the women.
  4,371 433 -
Deep lobe parotid gland pleomorphic adenoma involving the parapharyngeal space
Yadavalli Guruprasad, Dinesh Singh Chauhan
January-June 2012, 5(1):62-65
Pleomorphic adenomas are slow growing, well-demarcated benign neoplasms that constitute more than 80% of benign parotid tumours. Deep lobe parotid pleomorphic adenomas are rare tumors that present a diagnostic and therapeutic challenge. Approximately 10-12% of pleomorphic adenomas of the parotid are thought to arise from the deep lobe of parotid. Due to anatomical relations and restrictive boundaries of the deep lobe, parapharyngeal extensions may remain asymptomatic until reaching a very large size. These tumors have a variety of distinct clinical presentations, most commonly arising from the portion of the gland deep to the facial nerve lateral to the mandible. We present a case of deep lobe parotid gland pleomorphic adenoma involving the parapharyngeal space in a 38 year old female.
  4,387 312 -
A rapid appraisal of traffic policemen about auditory effects of traffic noise pollution from Ambala city
Abhishek Singh, Ashish Bansal, Shewtank Goel, Pawan Kumar Goel, Pankaj Chhikara, Nand Kishore Singh
January-February 2015, 8(1):12-15
Context: Traffic policemen are at an increased risk of suffering from hazards of noise pollution because they are engaged in controlling traffic noise, particularly at heavy traffic junctions. The effect is more in this subgroup because they are continuously exposed to it. Aim: The present study was aimed at assessing the knowledge, attitude and practices of traffic policemen regarding auditory effects of traffic noise pollution in Ambala city. Settings and Design: Cross-sectional workplace survey. Materials and Methods: The present descriptive study was carried out in different traffic zones of Ambala city during April-June 2013. The study population consisted of 100 traffic policemen working in different traffic intersections of Ambala city. Statistical Analysis Used: Structured interview schedule was used to collect the data. SPSS version 17.0 was used for analysis. Interpretation of data was performed using percentages and proportions. Results: Majority (75%) of the study subjects were exposed to traffic noise pollution for more than 5 years. Of the total subjects, 5% of respondents reported below-average hearing on self-assessment of hearing ability. Seventeen percent of the study population accepted that while hearing over phone they do miss some conversation. Most (98%) of the traffic police did not use any personal protective equipment (PPEs) like earplugs/earmuffs, and the non-availability of these PPEs (90%) is the common reason for the hearing loss. Conclusions: The study concludes that traffic policemen are not much aware regarding impending auditory effects of traffic noise pollution. Duty rotation, duty scheduling and other forms of preventive modalities for exposure limitation are suggested.
  4,248 224 1
Cemented hemi-arthroplasty in proximal femoral fractures in elderly with severe osteoporosis: A case series
Rahul M Salunkhe, Shrirang Limaye, Samar K Biswas, Rahul P Mehta
January-June 2012, 5(1):36-42
Context: Inter-trochanteric fractures in osteoporotic bones which are grossly comminuted are highly unstable and difficult to treat. Conservative treatment with traction and prolonged immobilization lands up with many complications and often fatality. Rate of failure with internal fixation with dynamic hip screw has been found to be high, especially in osteoporotic bones. Revision osteo-synthesis is technically demanding and leads to complications. Aim: To assess the efficacy of cemented hemiarthroplasty in the management of proximal femoral fractures in elderly patients with severe osteoporosis. Settings and Design: A Case series of 50 cases. Materials and Methods: We divided these fractures into three groups and accordingly the prosthesis was used. Group 1- intact calcar and lesser trochanter non-communited-AMP type of bipolar prosthesis, Group 2- fracture of calcar - Thompson's type of bipolar prosthesis with calcar reconstruction, Group 3- group 2 + instability of postero-medial wall-modular type bipolar prosthesis with lesser trochanter and calcar reconstruction. Greater trochanter, calcar, and lesser trochanter were reconstructed with encirclage, tension band wiring, fashioned bone graft, or bone cement collar accordingly. Results: In our study of 50 cases with mean age 79.57 years, 20 cases were type 1, 19 type 2, and 11 type 3 fractures. The average Harris hip score was 79. Excellent to fair results were obtained at follow-up in 46 (92%) and in 4 (8%) results were poor. The mean Harris hip score was 83 (good) in Group- I, 79 (Fair) in Group- II, and 72 (Fair) in Group- III patients. Average hospital stay was 12.5 days. There were four cases of superficial operative site infection which were treated with short course of oral antibiotics. Four cases died of medical complications, earliest being 3 months, and latest being 18 months. No case of loosening of the prosthesis, break in the cement or sinking of prosthesis was seen.
  3,923 415 -
Uniform hyperdense vessels in non-contrast CT of brain: An unusual finding in plain CT scan diagnostic of polycythemia
Manash Bora, Prabha Kurian, Basavaiya Prabhu Venkatesh, Uppin Shivanna
May-June 2014, 7(3):362-365
Polycythemia is a blood disorder in which the proportion of blood occupied by red blood cells increases. It is reflected in raised hematocrit and hemoglobin values. Elevated hematocrit results in characteristic findings of increased attenuation of cerebral vessels and venous sinuses on unenhanced computed tomography. However, these imaging findings can closely mimic those of cerebral venous thrombosis, leading to diagnostic ambiguity. We present a case of polycythemia with typical features of hyperdense cerebral vasculature on non-enhanced computed tomography.
  4,079 216 -