Correlation with VEGF Level for Clinical Improvement in Buerger's Disease Patients after Illizarov Surgery

Buerger's disease also called thromboangiitis obliterans (TAO), is widely recognized as a specific disease characterized by onset of distal extremity ischemic symptoms at early age in absence of an underlying proximal embolic source, trauma, autoimmune disease, diabetes, or hyperlipidemia.1The disease is far more prevalent in the middle, near, and far east regions than in North America.2 It occurs predominantly in men, but recent evidence indicates that the incidence rate in women is increasing.3Treatment of Buerger's disease is primarily medical.Surgical treatment in non responders to medical management including lumbar sympathectomy has been tried without promising result. Various orthopaedic procedures have been tested in various studies for the treatment of peripheral vascular diseases with variable successes.We have used Ilizarov surgery to distract and then compress to produce stimulus for angiogenesis.Vascular Endothelial Factor (VEGF) is an angiogenic factor which stimulates endothelial cell growth, angiogenesis and capillary permeability.4 In this study we have measured the clinical improvement parameters and VEGF level after ilizarov procedure in peripheral arterial vascular disease.

Calcified left atrial myxoma with osseous metaplasia.

An intracardiac myxoma is the most common tumour of the heart with an estimated incidence of 0.5 per million population per year. Extensive calcification is rare in these tumours.1 We describe a rare case of a large left atrial myxoma, visible on the chest radiograph, with extensive calcification and osseous metaplasia.

Development & standardization of a scale to measure socio-economic status in urban & rural communities in India.

BACKGROUND & OBJECTIVES: The commonly used available scales for measurement of socio-economic status (SES) with some cross regional applicability are old and have lost their relevance. There is a need for the development of a valid and reliable instrument for measurement of SES in rural and urban communities in India. The present study was undertaken to develop a cross regionally applicable scale for the purpose of enlisting true measures of socio-economic items applicable in multilingual, multicultural, multireligious, setting of the country. METHODS: For developing the scale, seven indicators (house, materials possession, education, occupation, monthly income, land, social participation and understanding), presumably determining the socioeconomic status were selected. These indicators were named as profiles. Thus, initially the scale had seven profiles and every profile contained five alternatives. This instrument was prepared on a 10-point scale. Weightage system of scoring (varying from 2 to 10) was followed from first to sixth profile while the additive pattern of scoring was followed in seventh profile. The final version of the scale was arrived at through three trial administrations on rural and urban families. The basis of selection of the families for the first two trials was stratified random. The validity and reliability of the scale was established through a defined visual analogue scale (VAS) and test-retest methods. RESULTS: Both the initial version as well as the final version of the scale for the measurement of SES of incumbents had seven profiles. The difference between the two versions was in terms of contents and range of items in different categories of SES. The final version was arrived at through field trials and suggestions of the experts. The reliability of the scale was high with a correlation coefficient of 0.998. INTERPRETATION & CONCLUSION: The new scale appears to be a valid and reliable instrument for the assessment of socio-economic status of the families/individuals from urban as well as rural areas in India.