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Objectives@#The purpose of this study was to estimate the minimal clinically important difference (MCID) of mouth opening (MO) and patient satisfaction in surgically treated oral submucous fibrosis (OSMF) patients. @*Materials and Methods@#The status of MO was collected preoperatively (T0), postoperatively at 3 months (T1), and at a minimum of 6 months postoperatively (T2). MCID was determined through the anchor-based approach with the change difference method, mean change method, and receiver operator characteristic curve (ROC) method. @*Results@#In this study, 35 patients enrolled and completed postoperative follow-up (T2) averaging a duration of 18.1 months. At T1, using the change difference method, MO was 14.89 mm and the ROC curve exhibited a 11.5 gain in MO (sensitivity 81.8% and specificity 100%, area under the curve [AUC] of 0.902) and was classified as MCID as reported by patients. At T2, MCID of MO was 9.75 mm using the change difference method and 11.75 mm by the mean change method. The ROC curve revealed that the MCID of MO at T2 was 10.5 mm with 73.9% sensitivity and 83.3% specificity (AUC of 0.873). The kappa value was 0.91, confirming reliability of the data. @*Conclusion@#This study demonstrated MCID values that indicate the clinical relevance of surgical treatment of OSMF if the minimum possible gain in MO is approximately 10 mm.
ABSTRACT
The prevalence of hypertension in children and adolescents seems to be increasing. The present study aimed to investigate the best anthropometric determinants of high blood pressure in school children. Methods: The present study was conducted in the department of Community Medicine. It comprised of 1160 school children age ranged 12-16 years of both genders. In all children, height (cm), weight (kg), systolic and diastolic blood pressure, Body mass index (kg/m2), Waist circumference (cm) Triceps skinfold (mm) was recorded. Results: Maximum boys were in age 12 years and 16 years and girls in age 14 years, followed by 70 boys in 12 years, 80 in 15 years and 60 in 14 years. 48 girls in 15 years, 42 in 13 years, 38 in 12 years and 17 in 16 years. Boys had 22% and girls had 20% of prevalence of hypertension. The mean height in males was 155.2 cm and in girls was 146.2 cm, weight was 37.4 kg in boys and 32.1 kg in girls, SBP was 132.4 mm Hg in boys and 124.6 mm Hg in girls. DBP was 86.2 mm Hg in boys and 74.6 mm Hg in girls. Conclusion: There is a positive correlation of weight of subjects and systolic and diastolic blood pressure in subjects. Early screening for high blood pressure in school students and introducing effective lifestyle modifications at an early age to prevent the epidemic of non-communicable diseases in future is the need of hour.
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Human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) is a major and one of the most serious public health challenges in today’s world. The present study was conducted to assess knowledge and attitude regarding HIV in rural population. Methods: The present cross sectional study was conducted by involving 960 rural population of both genders. Study participant should be more than 15 years of age and resident of the same village was used as inclusion criteria. General information such as name, age, gender etc. was recorded. A questionnaire was prepared which were related to knowledge and attitude of rural population regarding HIV. Respondents were instructed to respond in yes or no. Results: Out of 960 subjects 620 were aware of HIV/AIDS, 680 were aware of VCCT, 650 were aware of VCCT centre, 830 had heard of condom and 760 were aware of ARV. The difference was significant (P< 0.05). Conclusion: Authors found that respondents had sufficient knowledge and attitude regarding HIV infection.
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Stress is an important reference point in health studies and it is related to both an individual's general health status and different illnesses, including mental disorders, cancer, cardiovascular disease, drug abuse, chronic diseases, etc. Hence; under the light of above mentioned data, the present study was planned to assess various determinants of stress factors among general population. Methods: A total of 200 subjects were included in the present study. A selfframed questionnaire was given to all the subjects for obtaining complete demographic and clinical details of all the subjects. Second part of the questionnaire included assessment of information in relation stress related personal life parameters. The Nordic Questionnaire for Psychological and Social Factors at Work (QPS Nordic) in order to assess perceived stress was given to all subjects and asked to respond. All the answers were graded into three categories as follows: Category A: None or minimal stress, Category B: Stress to some extent, and Category C: Very much stress. All the results were recorded in Microsoft excel sheet and were analyzed by SPSS software. Results: Among subjects less than 30 years of age, 25 subjects had category B stress, while 20 subjects had category C stress. Significant results were obtained while assessing the distribution of stress among males and females. Also significant results were obtained while assessing the distribution of stress among employed people. Conclusion: Stress is particularly common in employed subjects, especially males.
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The present study was conducted to assess risk factors of chronic diseases in geriatrics. Methods: The present study was conducted on 86 patients aged >60 years of age of both genders. Patients were of diabetes, hypertension, arthritis, angina, chronic lung disease and stroke. In all subjects risk factors for chronic diseases were assessed. Results: Out of 86 patients, males were 52 and females were 34. Diabetes was present in 26, hypertension in 22, arthritis in 15, angina in 8, chronic lung disease in 11 and stroke in 4. The difference was significant (P< 0.05). The most common risk factor in diabetes patients was low socioeconomic status and primary education, in hypertension was primary education and low socioeconomic status, in arthritis was low SES, in angina was tobacco, in chronic lung disease was tobacco and in stroke was tobacco and alcohol. Conclusion: Common risk factors were low socioeconomic status, alcohol, tobacco and primary education.
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Prostaglandin E2(cerviprime gel), an inducing agent is instilled intracervically or placed high in the posterior fornix of the vagina and may need to be re-in- stilled after 6 h if required. Another alternative is misoprostol (15-deoxy-16- hydroxy-16-methyl prostoglandin E1) which is used in various dosages. Methods: This was a prospective observational study of nulliparous women undergoing labor induction for one year, 100 womens, in a tertiary care center. Participants were then randomly assigned to pre-induction cervical ripening with a dinoprostone vaginal insert (0.5mg) (group I), and with misoprostol (50 microg) intravaginally(group II). Result: From our study observation, maximum patients delivered normal vaginal delivery. Of the vaginal deliveries six (18%) of PGE2 group and five patients(10%) of PGE1 having meconium stained liquor after ARM or spontaneous rupture of membrane, fetal heart was reassuring i.e, no fetal distress was there. The caesarean section rate in both groups nine (18%) and (10%) was statistically insignificant. Mean change in bishop score was also not significant in both groups. Need for oxytocine after 8hrs of induction between both group was significant, 84% in dinoprostone group and 56% in misoprostol group. Gastrointestinal side effects, uterine tacchysystole, uterine hyperstimulation was more common in misoprostol group than dinoprostone group, that is statistically significant. Induction to delivery time was shorter in misoprostol group that is statistically significant. No adverse neonatal outcomes that can directly be related with both drugs. Both agents are equally efficacious in causing cervical repining and almost equal changes in mean bishops. Conclusion: Misoprostol is an excellent labour-inducing agent and can be used liberally for labour induction, unlike PGE2 gel, is comparatively cheaper and is stable at room temperature; thus, it could be an ideal inducing agent in poor resource settings. Local application of misoprostol tablet in posterior vagina is easier method than dinoprostone insertion. Intravaginal insertion of misoprostol tablet is superior to dinoprostone gel in inducing labour and shorter interval between induction and delivery.
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Background: The use of glucocorticoids in various forms of administration is complicated by their systemic side effects. Although intravenous pulse therapy is considered to have lesser systemic side effects, there are few studies in literature comparing the effects of intravenous pulse glucocorticoids versus oral daily glucocorticoids on bone mineral density. Aim: To compare the effects of intravenous pulse glucocorticoids and oral daily glucocorticoids on bone mineral density with the aim of finding any site-specific osteopenic side effect. Methods: The study was conducted by the department of dermatology of Postgraduate Institute of Medical Education and Research, Chandigarh, India. The study comprised of two groups of patients. Group A consisted of 28 patients with pemphigus vulgaris who received intravenous pulses of dexamethasone at 4 weekly intervals. Group B consisted of 21 patients with airborne contact dermatitis who received oral daily prednisolone therapy. All the patients had a dual X-ray absorptiometry scan at baseline, and at 3 and 6 months of follow-up. The results were analyzed as changes in bone mineral density. Results: There was loss of bone mineral density at lumbar spine and the head of radius in both the groups. At the lumbar spine, Group B showed more reduction in bone mineral density at 3 months whereas in Group A it was more at the head of radius. In patients on oral steroids, the lumbar spine was significantly more affected than the head of radius at both 3 and 6 months of follow-up. However, in patients on intravenous pulse steroids, both the sites were equally affected at 3 and 6 months. Limitations: In our study, we used different glucocorticoids in the two groups: prednisolone in the oral daily group and dexamethasone in the intravenous pulse steroids group. A similar reduction in bone mineral density in both the groups may have been due to a longer half-life or more bone-directed side effects of dexamethasone as compared to prednisolone. Conclusion: Dermatologists need to be aware of the detrimental effects of high-dose intravenous pulsed glucocorticoids on bone mineral density and assessment of this parameter should be done before the initiation of therapy and also at regular intervals thereafter. During follow up, either the lumbar spine or the head of radius can be used to assess the osteopenic effect of intravenous pulse steroids, whereas the lumbar spine is a better site for this evaluation in patients on oral steroids.
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Sign of Leser-Trelat [SLT] is defined by sudden eruption of numerous seborrheic keratosis or rapid increase in the number of pre-existing seborrheic keratosis. It has been reported as a paraneoplastic manifestation in literature but its position as a paraneoplastic manifestation has both strong opponents and proponents. We hereby, report a case of a 49-year-old male who presented to us with SLT-like lesions in association with benign swellings of neck and scrotum