Assessment of the Magnitude of Goiter in the Age Group of 6-12 Years in district Bandipura of Kashmir Division

Introduction: Iodine deficiency disorders (IDD) has beenrecognized as a public health problem in India Enlargementof thyroid gland is the common manifestation of the IDDand goiter prevalence survey is used as diagnostic tool foridentifying areas of IDD. Failure to undertake early detectionand intervention measure results in secondary disablingconditions. Aim: In the present study we have estimated theprevalence of goiter in the age group of 6-12 years in districtBandipura of Jammu and Kashmir state, India and haveassessed type of salt consumed by the population.Material and Methods: This was a Cross-sectional studyconducted in Bandipura district of J and K state and the studywas conducted between July 2018 to October 2018. Samplingmethod was Gender stratified cluster sampling technique andthe sample size was based on a goiter prevalence of 30% and95% confidence interval. 30 clusters were selected and eachcluster included 90 children. Data was entered in Microsoftexcel and then analyzed using appropriate statistical software.Data was interpreted using percentages, means and SD.Results: The prevalence of grade 1 and grade 2 goitre inmales was 35.6% and 15.1% respectively whereas it was30.8% and 15.1% in females and the prevalence was morein males to the extent of 52.08% and in girls it was 49.23%.Goitre was found to be highest (51.7%) in subjects 12 yearsof age and lowest (40.6%) in subjects aged 7 years of age.There was a significantly higher goitre prevalence in childrenwho consumed crystalline/non-iodised salt than in childrenconsuming iodised salt. The TGR was 61.4% and 46.9% inchildren consuming non-iodised and iodised salt respectivelyConclusion: We conclude our study with the finding thatpopulation of Bandipura district in the north Kashmir isseverely iodine deficient. We recommended a major thrustin the implementation of NIDDCP in the said district withregular and continuous monitoring of iodine status.

Voriconazole-induced severe periostitis deformans

Periostitis deformans is an uncommon condition of the skeletal system, mainly manifested as bone pain with or without bony swellings. Voriconazole-induced periostitis is widely reported in the literature, mainly in the organ transplant patients on immunosuppressant therapy. The patient in this case report, was not on any immunosuppressant therapy, but developed widespread periostitis deformans secondary to voriconazole, who was being treated for the base of skull aspergillus osteomyelitis. This report demonstrates the severity of voriconazole adverse effects and the wider impact on patient. Radiological features of periostitis deformans are still a cause of concern and the diagnosis of this condition is not easy due to its radiological features like bone tumours. This case report is an attempt to promote more awareness about this rare condition among both the orthopaedic surgeons and the radiologists, which will help in streamlining investigation and prompt diagnosis

External fixator in the treatment of open fractures of tibia

To evaluate the outcome of external fixator used as a definitive mean of fixation in open fracture of tibia. This cross sectional study conducted at Orthopaedics Unit District Headquarter Hospital Timergara from December 2005 to September 2008 included 40 patients with grade II, grade IIIA and IIIB open fractures of tibia. Patients with grade I, grade IIIC open fractures and the patients who needed amputation for their injuries were excluded from the study. Patients with insufficient follow up were also excluded. In all these patients an aggressive approach of early initiation of treatment, radical debridement and irrigation was adopted. All the fractures were stabilized with AO external fixator, and early soft tissue coverage was provided in these patients. On removal of the external fixator Sarmiento functional brace was used till the time of union in all these patients. The mean age of the sample was 28.80 +/- 9.87. The most common mechanism of injury in these 40 patients was road traffic accidents. Pin tract infection the commonest complication, noted in 10[25%] patients, deep wound infection in 4[10%] patients, delayed union in 4[10%] patients, and mal union, non union in none of them. Dynamisation of the fixator was done in 12[30%] patients and prophylactic bone grafting was performed in 4[10%] patients. The average time of fracture consolidation was 18 weeks. External fixator can be effectively used as definitive mean of fixation in open fractures of tibia with extensive soft tissue damage

Electrolytes imbalance: a rare side effect of piperacillin / tazobactam therapy

Electrolytes imbalance has been reported with the use of several antimicrobials. We report a case of severe hypokalemia secondary to piperacillin/tazobactam in a patient with normal renal function and normal serum potassium level who had presented with a fractured neck of femur. The electrolytes abnormality was corrected once piperacillin/tazobactam was stopped. To our knowledge, this is the first case to describe an early severe hypokalemia induced by piperacillin/ tazobactam therapy in an otherwise healthy individual

Displaced supracondylar fractures of humerus in children treated with open reduction and cross k-wire fixation

To describe the outcome of open reduction and cross K-wire fixation through a triceps non disturbing posterior approach used in the treatment of type III supracondylar fractures of humerus in children. This descriptive study was conducted at Orthopaedics Unit District Headquarter Hospital Timergara Dir Lower from December 2005 to September 2008. Fifty children with type III supracondylar fractures, who presented within one week of injury, and in whom satisfactory reduction was not possible by closed means, were evaluated clinically and with radiographs before surgery and at follow up. All these patients underwent open reduction and crossed K-wire fixation through a triceps non disturbing posterior approach. Anatomical reduction of the fracture was achieved and fixation was carried out by two cross K-wires. The patients were regularly followed up and at one the results were measured according to the criteria of Flynn. The mean age was 10+6 years. In 3[6%] patients the fracture was flexion and in 47[94%] the fracture was of extension variety. Traditional bone setters were the initial treatment provider for 54% of the patients. The average delay in presentation was 31 hours. Four patients have ipsilateral fractures of the distal radial epiphysis. Postoperatively 9[18%] patients developed pin track infection, and only 2[4%] had transient neuroprexia of the ulnar nerve. Open reduction and cross K-wire fixation through a posterior triceps non disturbing approach can be satisfactorily used in the treatment of type III supracondylar fractures that could not be reduced satisfactorily by closed methods

Outcome of ocular trauma with retained intraocular foreign bodies

Ocular trauma associated with intraocular foreign bodies [IOFB] presents a challenging task to the treating physician. Outcome of eye injuries with retained foreign material is unpredictable and methods of their management are still controversial. 49 cases of intraocular foreign bodies were retrospectively studied to determine the nature of injuries and final visual results. IOFB were not seen in females and in children. Mostly the expatriate workers engaged in different industrial activities were found to be at high risk. A large number of IOFB [91.8%] were magnetic in nature and majority of them [69.38%] were located in the posterior segment of the eye. Overall outcome of patients was comparable to other studies but visual recovery was not as good as reported from developed regions of the world. Health education of vulnerable workers, upgrading of facilities and strategies of management are suggested

Pseudophakia retinal detachment

Study the outcome of pseudophakic retinal detachment surgery. Setting: Retina service, Ophthalmology department, Salmaniya Medical Centre, Bahrain. Subjects and Design: Review of medical records of all patients who presented to our unit between July 1987 and June 1995. A total of 14 cases of pseudophakic retinal detachments were analysed. Simple technique of episcleral buckling was found to be adequate to repair the detachment in 85.7% of cases. Single procedure was successful in 78.6% of patients. 64.3% of the cases regained 6/18 or better vision after surgery. Conclusions: Overall outcome of this small series of patients was comparable to the reports in the literature. Patients should be made aware of the risk of postoperative retinal detachment and its warning signals. The number of patients of this disease is likely to increase in the future and upgrading of existing facilities is suggested