ABSTRACT
The commonest procedure for adult diaphyseal femoral fractures is intramedullary nailing. A thorough preoperative examination of facture pattern and its morphology are necessary. Previous studies are non-homogenous and with conflicting results. So the study was planned to find out, any relation between femur and forearm plus little finger length and its association with height/ arm span and upper segment/lower segment ratios in an individual, with its statistical validity. The study was carried on 75 male and 75 female students of more than 18 years of age, studying at AIIMS Rishikesh after taking their informed consent and ethical approval. The forearm plus hand length and the length offemur were measured as per protocol, by simple measuring tape. The mean forearm plus hand length and the length of femur were 42.85 (SD, ±1.87) and 45.88 (SD, ±2.95) cm, respectively with the mean difference between these 2 measurements of -3.03 (95% CI, -3.83 to -2.22) cm, in male and 39.56(SD, ±1.68), 40.96 (SD, ± 2.75) cm and -1.400 (95% CI, -1.917 to -0.883) cm in female volunteers. The Pearson correlation co efficient and p value 0.575, 0.0001 and 0.585, 0.0001 in male and female respectively. There was no significant variation with height, upper segment and lower segment ratios. So we conclude that there is extremely significant correlation between the forearm plus hand length and the length of femur of the individuals. The forearm plus hand length represents the maximum length of the nail to be used in femur. The length of the femur nail can be definitely predicted by the forearm plus hand length in both sexes but it has to be different in both, for the same femoral fracture and there is no significant variation in the femur length with height, upper segment and lower segment variation in the same individ
ABSTRACT
Tuberous sclerosis is a rare inherited neurocutaneous syndrome, which has multisystem involvement. We present a geriatric female patient with chronic abdominal pain who was diagnosed with giant renal angiomyolipoma (AML) and multiple sclerotic skeletal lesions. Radiological imaging played an important role in identifying these two features and diagnosing tuberous sclerosis in our case.
ABSTRACT
Background: Mental health is an important aspect in defining the “health status” of a person. Mental health of young adults plays an important role in shaping one’s life, social relationships, career and ultimately a country’s economy. Aims & Objective: (1) To assess the prevalence of probable mental illness among college students in a select university in Bangalore rural district; (2) To find the risk factors associated with probable mental illness. Material and Methods: This study was a cross sectional study undertaken at a private university (having colleges dealing with various academic streams under it) in Bangalore rural district. 404 students under the university were taken for the study considering the sample size required was 300. The General Health Questionnaire-28 (GHQ-28) was used to screen each participant for mental illness. Data was analyzed using measures of central tendency, frequencies & Chi square test. Results: A total of 404 students participated in the study. Males were 265 (65.6%) and females were 139 (34.4%). The mean age of the participants was 20.37 years with SD 1.7 years. Age of the participants ranged between 18- 26 years. A total of 152 (38%) participants were screened positive for mental illness. Probable mental illness was significantly higher among: (a) females; (b) those who reported abuse by parents; (c) those who reported gender bias at home; (d) whose parents were separated/ divorced/ one parent had died; (e) those who were day scholars. Whereas no significant association was found between probable mental illness and (a) age; (b) academic streams; (c) parental marital disharmony; (d) absence of siblings; (e) father being alcoholic. About 50 (12%) participants reported to have had definite suicidal thoughts. Conclusion: The prevalence of probable mental illness is 38% in this study which is high. We recommend screening programmes for mental illness among college students which can go long way in preventing severe forms of mental illness and dire consequences like suicide among young adults
ABSTRACT
Background: Ventilator-associated pneumonia (VAP), the most apparent infection in ICUs; life threatening, symbolizes an additional healthcare burden. Clinical traits and etiological agents vary. Early diagnosis is captious & apt tactic of quantitative culture is advocated. Regular surveillance is imperative to define strategies. The objective was to conceptualize VAP; put forth our experience of its occurrence, causative bacteria, clinical silhouette and associated variables; and to pattern antimicrobial resistance in ICUs; contributing this data to devise more pertinent approach. Methods: A prospective survey, executed at a tertiary care set up (multidisciplinary ICUs) analysed clinical and microbiological aspects of 120 patients (>48 hours-mechanical ventilation) in congruence with a clinical criteria of pneumonia by standard microbiological means. Cases were keenly observed to assess mortality. Results: Occurrence of VAP was 42.5% with dominance of males (65%) and age group of 41-60 years (Mean ± SD: 42.26 ± 19.53). Late onset type (60.8%) predominated. Principal symptom/sign was fever (82.5%)/crepitation (67.5%). Cases of OP poisoning (21.7%), associated diabetes mellitus (31.7%) were pre-eminent. Gram negative Bacteria (GNB) formed the major etiology (78.6%), cardinal being Acinetobacter baumannii (32.1%) and Pseudomonas aeruginosa (25%). Multi-drug resistant (MDR)-Acinetobacter baumannii, MDR-Pseudomonas aeruginosa, imipenem resistant Klebsiella pneumoniae and Methicillin resistant Staphylococcus aureus (MRSA) were noticed in 66.7%, 35%, 25% and 42.8% of respective isolates. Mortality record was 21.6%. Conclusions: Reliable mode of isolation (quantitative culture), less invasive sampling (ETA) and antibiotic recycling will augment VAP management. Regular intuition into contemporary trends of antimicrobial profile of etiological agents is crucial to avert undesirable consequences.
ABSTRACT
Oral cancer, more specifically oral squamous cell carcinoma (OSCC) consider as common cancer that 300,000 people diagnosed per year worldwide. The only effective treatment for OSCC is surgical intervention. Over the past two decades, overall disease condition has not improved although advancement of treatment has considerably increased. The phosphodiesterase (PDEs) are responsible for the hydrolysis of the second messengers with a fundamental role in the transduction of the intracellular signals. In numerous pathological conditions such as cellular differentiation, apoptosis, and tumor invasivity the different PDF activity has been observed that shown role in pathophysiological mechanism. The role of PDEs as an intervention factor for activation of angiogenesis by influencing a tumor growth has been shown. The objective of this study was to estimate and compare salivary PDEs levels in healthy controls and biopsy-proven oral cancer patients before definitive therapy. Study was done in patients age between 25-65 years biopsy proven oral cancer patients and control group. After obtaining prior consent from biopsy-proven oral cancer patients (n=26) (before onset of any definitive treatment) and age- and sex-matched healthy controls (n=29), salivary sample was collected for estimation of the activity of phosphodiesterases (PDEs).
ABSTRACT
Background: Oral squamous cell carcinoma is the most common neoplasm and comprises of approximately 80% of the cancers occurring in the oral cavity. The role of the host response to this neoplasm has been recognized, and for many years the regional lymph node in tumor-bearing hosts has been considered as an anatomic barrier to the systematic dissemination of tumor cells. Morphological evaluation of the regional nodes has aided in understanding the immune response. Aim: The current study was carried out to observe the morphological changes occurring in the regional lymph nodes and to evaluate whether these features could be helpful in assessing the immunological status of the patient, and thereby, the prognosis of the patient. Materials and Methods: The study was based on lymph nodes from 63 patients with oral squamous cell carcinoma, who underwent radical neck dissection or modified neck dissection. In the lymph node, four morphological patterns were observed that included lymphocyte predominance, germinal center predominance, mixed pattern (sinus Histiocytosis), and an unstimulated pattern. The cases were then divided into four groups according to the predominant immunoreactivity pattern based on the World Health Organization (WHO) standardized system for reporting human lymph node morphology. Results: Revealed that risk of metastases to cervical lymph nodes in patients with lymphocyte predominance was less (28.6%) when compared to the high risk of metastases with germinal center predominance (68%), and these results were statistically significant (P < 0.05). Patients with a mixed pattern showed less risk of metastases (45.4%), while those with an unstimulated pattern had increased risk of metastases (66.6%), but the results were not statistically significant. It was also found that in the positive nodes, germinal center hyperplasia (50.2%) was the predominant pattern. Conclusion: The present study revealed that patients with lymphocyte predominance had less risk of metastases and patients with germinal center predominance had a high risk of metastases to the lymph node.