ABSTRACT
Background: The aim of this analysis was to study various clinical presentation, epidemiological prevalence, various diagnostic tools applied and basic management of low back pain in special reference with sacroiliitis. Methods: We reviewed 360 patients with low back pain. Patients were evaluated and diagnosed by proper history, clinical, radiological and haematological examination. Conservative treatment trial was given to all. Results were evaluated by JOA score in the form of recovery rate at one month and at three month. Results: Mean age group affected is 40.59 years and most common cause is musculoskeletal strain. Males are more commonly affected. Among total patients of low back pain 16.38 % were suffering from sacroiliitis. On conservative treatment after 3 months, 41.67 % had GOOD recovery rate and 12.5 % had excellent recovery rate.Conclusion: Prevalence of low back pain is maximum in 4th decade of life. Males are affected more commonly (55 %). Most patients had sedentary life style. Onset of low back pain is mostly gradual (96.39 %) and most common cause is musculoskeletal strain (36.67 %). Sacroiliitis consisting 16.37 % of the total patients with low back pain. Among the special tests, FABER's test is most commonly positive in all patients, but STORK's test is most commonly positive in patient with sacroiliitis. After 3 months of conservative trial 41.67 % patients had GOOD recovery rate, and 12.5 % had excellent recovery rate.
ABSTRACT
Background: Osteoarthritis is more common in females. It is because osteoarthritis in post-menopausal women is associated with higher body weight, higher subcutaneous fat, calcium deficiency and weaker muscles linked to hormonal changes. The purpose of this study was to evaluate the role of high tibial osteotomy fixed with angle stable plate in treatment of osteoarthritis of knee. Methods: In our study 10 cases were operated by modified coventry technique , 10 cases were operated by open wedge osteotomy with non locking plates and bone graft and 104 cases were operated by medial open wedge osteotomy and iliac graft secured by locking plate. In these cases full weight bearing was allowed at 8 week, 6 week and 3rd post operative day respectively. Radiographical analysis include post operatively change in tibio-femoral angle. Mean follow up of these cases was 2 year. Results: In our study thee knee pain and function score were significantly improved (p value <0.001). The average pain score preoperatively was 1 8± 7(the maximum pain score for pain is 50) and post-operatively was 44±5. According to the grading used for functional assessment in knee scores there was definite improvement in the function of cases 122 (98.38%) at 2 yrs. The preoperatively mean functional knee score in of 110 cases (88.7%) cases was 28.86 (the maximum functional knee score is 100) and postoperatively was 70.45. There is correction in tibiofemoral angle (mean preoperative and postoperative tibiofemoral angle was 5.2±1.5 degrees varus and 5.8±1.3 degrees valgus respectively). Conclusion: There was definite improvement in the pain and function of the knee after the correction of the deformity (P value <0.001). The results of high tibial osteotomy in 88.23 percentage knees were rated as excellent. 104 out of these 124 cases were fix by locking plates. 2 cases had poor results due to excessive over correction and associated comorbidities. There is a definite correlation between the postoperative valgus obtained and relief in the pain.
ABSTRACT
Diabetic retinopathy (DR) is a serious complication of diabetes, which is fast reaching epidemic proportions worldwide. While tight glycemic control remains the standard of care for preventing the progression of DR, better insights into DR etiology require understanding its genetic basis, which in turn may assist in the design of novel treatments. During the last decade, genomic medicine is increasingly being applied to common multifactorial diseases such as diabetes and age‑related macular degeneration. The contribution of genetics to the initiation and progression of DR has been recognized for some time, but the involvement of specific genes and genetic variants remains elusive. Several investigations are currently underway for identifying DR susceptibility loci through linkage studies, candidate gene approaches, and genome‑wide association studies. Advent of next generation sequencing and high throughput genomic technologies, development of novel bioinformatics tools and collaborations among research teams should facilitate such investigations. Here, we review the current state of genetic studies in DR and discuss reported findings in the context of biochemical, cell biological and therapeutic advances. We propose the development of a consortium in India for genetic studies with large cohorts of patients and controls from limited geographical areas to stratify the impact of the environment. Uniform guidelines should be established for clinical phenotyping and data collection. These studies would permit identification of genetic loci for DR susceptibility in the Indian population and should be valuable for better diagnosis and prognosis, and for clinical management of this blinding disease.