ABSTRACT
Quality of life (QoL) is a subjective measure which includes physical, psychological and social health and its relationship with the environment. Leprosy results in progressive damage to peripheral nerves in untreated or inadequately treated patients leading to nerve impairment and visible disabilities which may affect the quality of life. A descriptive cross-sectional study was conducted in a tertiary care centre among patients with leprosy over a period of six months, and quality of life status was evaluated using the WHOQoL Bref questionnaire based on four domains, namely physical, psychological, social and environmental. A total of 50 patients (males: females - 36:14) in the age group of 19-69 years were evaluated. Most patients (64%) belonged to the borderline tuberculoid spectrum. Patients with a disability accounted for 16% (8 out of 50) of the total cases. The psychological domain was the most commonly affected domain among patients. Females had lower scores than males in all domains. Elderly patients, patients with lepromatous leprosy and those with facial involvement had lower scores. Domain outcomes in lepra reactions were lower than in other types of leprosy. The study observed that leprosy in the ageing population, women and patients with severe forms of leprosy, associated with disabilities, have poorer quality of life.
ABSTRACT
@#Introduction: The acromioclavicular joint (ACJ) is a major link connecting the upper limb to the torso. The acromioclavicular and coracoclavicular (CC) ligaments help in stabilising the joint. We feel it is prudent to address both these ligament injuries, to achieve optimum result. This study was undertaken to analyse the results of a simple frugal surgical technique we used to deal with this injury considering stabilisation for both these ligaments. Materials and methods: In this retrospective study, skeletally mature patients with Type III, IV or V ACJ dislocations who underwent open reduction and stabilisation of the joint with temporary K-wires, repair of the capsule and augmentation of CC ligaments with suture anchors were included. Clinico-radiological and functional outcome was evaluated. Functional assessment of the upper limb was analysed using the Disabilities of Arm, Shoulder, and Hand Score (DASH), Constant shoulder score (CSS) and Oxford shoulder score (OSS). Results: Clinical and radiological evaluation of the 32 patients who had completed two years from the index surgery, was done. Out of the 37 patients included initially, five were lost in follow-up. Majority of the subjects included were males and type V was the most common injury. Mean pre-operative CC distance on the affected side was 13.92±4.94mm. In the immediate post-operative radiograph, it was 7.63±2.08mm and in the final follow- up was 9.36±2.75mm. Measurements were taken by two independent investigators and inter, and intra-observer reliability were analysed by Interclass correlation coefficient. Excellent functional outcome was noted despite the 1.81±1.50mm average loss of correction. At final followup, mean DASH score was 4.67±4.18, Oxford shoulder score was 44.06±2.44 and Constant shoulder score was 86.37±5.81. The severity of the injury had no significant effect on the functional outcome post our method of stabilisation and rehabilitation. Conclusion: Bifocal fixation restores the multidirectional stability of the disrupted ACJ. Adequate radiological reduction, good functional outcome and simplicity of execution make this technique an undemanding one for use in regular practice.
ABSTRACT
Introduction: Obesity is a chronic disease, which is knownto affect all the age groups and is prevalent in both developedand developing countries. Environmental factors like affluentlife style, high energy diet, sedentary life style, discardingold family traditions with regards to eating, exercise, outdooractivity, the couch potato culture and others have led to obesity. Furthermore, obesity is also a key risk factor in the naturalhistory of other non-communicable diseases (NCDs).Material and methods: A Community based case controlStudy was conducted in an urban community in Goa, India.106 cases group matched to 106 controls constituted thestudy sample. Cases included Obese or overweight individualwithin the age group of 30-60 years. Cases were selectedduring household survey while controls were taken in theneighbourhood of the cases. A structured questionnaire wasused to get information on general demographics, personalhabits which included diet, smoking, drinking of alcohol.Physical activity was assessed using the WHO Global PhysicalActivity Questionnaire (GPAQ).Examination and laboratory investigations were conducted.The study was approved by the Institutional Ethics Committee.Informed written consent was obtained from all the studyparticipants. The data was analysed using SPSS softwarepackage version 22.0. Odds ratio, chi square test, t test andmultiple logistic regressions were used to analyse the data.Results: Low Physical activity, less sleep duration, mixed dietas opposed to vegetarian diet, non-vegetarian serving 2 to 4times a week, calorie intake in excess of recommended intake,low fruit consumption were found to be the significant riskfactors both in univariate and multiple logistic regression.Conclusion: Considering the rising prevalence of obesityand the consequent complications, there is an urgent needto address these risk factors through health education, riskreduction interventions and other innovative strategies.