Neuroticism amongst elderly staying in Joint Families and Nuclear Families

Background: The greatest health asset for geriatric population is spending time and doing things with other people of all ages which can help keep them mentally, physically and emotionally fit. Keeping this point in mind present study was undertaken in Kolhapur and Sangli city. The aim of this study was to find out the levels of neuroticism in elderly people who are living in joint and nuclear families. Methodology: Health Questionnaire which emphasizes more on Psychosomatic, physical and body complaint was used to measure the neuroticism among elderly people. Data was analyzed by using independent sample t-test. Results: Result shows that elderly people living in joint families have good health and low neuroticism rate, on the other hand elderly people living in nuclear families have more psychological as well as physical distress that means they have higher chances of getting neuroticism. Conclusions: Neuroticism may be higher in elderly that live in nuclear families compared to joint families

Reconstruction- A Puzzle!!!

AIM:The reconstructive surgeon has to restore defect with best aesthetic and function. In recent times the high success rate of free flap has made the large defect reconstruction a possibility. The aim is to assess and evaluate the clinical outcomes in patients undergoing free flap and local flap reconstruction.METHODS:This was a retrospective study of 53 patients undergoing reconstructions with free flaps (31) and local flap (22) from June 2015 to June 2017. Types of free flap performed were Anterolateral Thigh, Radial Forearm and Fibula. Types of Local/pedicle flap performed were Pectoralis Major Myocutaneous flap, Deltopectoral flap, Nasolabial flap, forehead and scalp flap. Patient data was collected and analyzed for flap survival, complication, operative time, functional and oncological outcomes. RESULTS:The patients included 35 males and 17 females, with a mean age of 42 years. The most common tumor location was the Buccal mucosa. The majority of the diagnosed tumors were Squamous cell carcinoma. Overall flap success rate for free flap was 88% and for local flap/pedicle flap was 100%. Venous thrombosis was the most common cause for re-exploration in free flaps. The most common complication was oro-cutaneous fistula in both local/pedicle and free flaps. The average operating time for free flap was 7hr 30mins (simultaneously harvesting the graft) and for local flap was 5hr 50mins. The most important advantages with free flap are replacement of bone tissue and reconstruction of large defects. Middle third mandibular resection has no better substitute than free fibula graft. CONCLUSION:Free flap is a reliable, feasible and easy method in reconstruction of large defect with good aesthetic and functional outcome. Local flap is effective in smaller defects but cannot replace bony tissue.

Sudden death due to arrhythmogenic right ventricular dysplasia: A medico-legal case report.

Arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) is characterized by progressive fibrofatty replacement of the myocardium that predisposes to ventricular tachycardia and sudden death in young individuals and athletes. The prevalence of ARVD/C is estimated as 1:1000 to 1:1250 in the general population. Although it is a relatively uncommon cause of sudden cardiac death, it accounts for up to one fifth of sudden cardiac death in people less than 35 years of age. Clinical presentation of ARVD/C usually consists of arrhythmias of right ventricular origin that include premature ventricular beats, sustained ventricular tachycardia and ventricular fibrillation that can lead to sudden death. The authors present a case of a 26 year old young male, carpenter by occupation, previously healthy, with sudden death. The internal and external postmortem findings were normal except for mild right ventricular hypertrophy. But histo-pathological examination of heart tissues revealed replacement of myocardial tissue with mature fibrofatty tissue. The following medico-legal autopsy case is being reported for its rarity and the importance of histopathology to find out the cause of death.

Pattern of fatal blunt head injury: A two year retrospective / prospective medico legal autopsy study.

The current study was conducted from 1 November 2002 to 31 October 2004 at Topiwala National Medical College & BYL Nair Charitable Hospital, Mumbai. A total of 189 victims of fatal blunt head injury were recorded and a complete medicolegal autopsy was conducted on each of these victims during this period. The postmortem study revealed that males were the most common victims with the highest number being in the age group of the third and fourth decades. Accidents were responsible for most of them, followed by homicidal deaths, with suicides recorded as the least. Of the accidents, railway accidents were responsible for the maximum number. The study revealed that the highest number of fatalities occurred during the peak hours of the day. The fissured fracture was the most common type of fracture observed. Among the specialized fractures of the base of the skull, type-1 hinge fracture was the most common. A combination of subdural and subarachnoid haemorrhages was the most common observation. Blunt cranio-cerebral injury was the primary cause of death in more than half of the victims