Knowledge, attitude, and practice of childhood myopia among Indian optometrists: A questionnaire-based study

Purpose: To investigate the knowledge of myopia and its natural history including complications and clinical approaches for management adopted by optometrists across India. Methods: An online survey was distributed to Indian optometrists. A pre?validated questionnaire was adopted from previous literature. Respondents provided information about their demographics (gender, age, practice location, and modality), myopia knowledge, self?reported practice behaviors relating to childhood myopia, the information and evidence base used to guide their practice, and perceived extent of adult caregiver engagement in making management decisions for myopic children. Results: A total of 302 responses were collected from different regions of the country. Most respondents demonstrated knowledge of the association between high myopia and retinal breaks, retinal detachment and primary open?angle glaucoma. Optometrists used a range of techniques to diagnose childhood myopia, with a preference for non?cycloplegic refractive measures. The most common approaches to management were single?vision distance despite most optometrists identifying orthokeratology and low?dose (0.01%) topical atropine as two potentially more effective therapeutic interventions for controlling childhood myopia progression. Almost 90% of respondents considered increasing the time spent outdoors to be beneficial for reducing the rate of myopia progression. The main sources of information used to guide clinical practice were continuing education conferences, seminars, research articles, and workshops. Conclusion: Indian optometrists appear to be aware of emerging evidence and practices, but are not routinely adopting measures. Clinical guidelines, regulatory approval, and sufficient consultation time may be of value for assisting practitioners in making clinical decisions based on the current available research evidence

Growth Faltering Among Discharged Babies from Inpatient Newborn Care Facilities: Learnings from Two Districts of Himachal Pradesh

Objective: To determine the burden of early growth faltering and understand the care practices for small and sick babies discharged from newborn units in the district. Study design: Observational and follow-up study. Participants: 512 babies discharged from two Special Newborn Care Units (SNCUs) and four Newborn Stabilization Units (NBSUs) in two districts of Himachal Pradesh. Methods: Anthropometric assessments, interview of mothers and Accredited Social Health Activists (ASHAs) conducted between August, 2018 and March, 2019. Change in weight-forage z-score (?WAZ) of <-0.67SD between birth and assessment was used to define growth faltering. Outcomes: Proportion of growth faltering (or catch-down growth) in small and sick babies discharged from SNCUs and NBSUs, and infant care practices. Results: Growth faltering was observed in a significant proportion of both term (30%) and preterm (52.6%) babies between 1 to 4 months of age. Among babies with growth faltering (n=180), 73.9% received a home visit by ASHA, and only 36.7% received a follow-up visit at a facility. There were 71.3% mothers counselled at discharge (mostly informed about breast feeding). Most (96.7%) mothers did not perceive inadequate weight gain in their babies post-discharge. During home visits, ASHAs weighed 61.6% of the infants with growth faltering. Amongst infants who had growth faltering, only 49.6% of mothers had been provided information about their infant’s growth and 57.1% mothers had received breastfeeding counselling. Conclusion: Small and sick newborn infants (both term and preterm babies) discharged from special care newborn units are at increased risk of early growth faltering. Follow-up care provided to these infants is inadequate. There is a need to strengthen both facility-based and home-based follow up of small and sick newborn infants discharged from newborn care facilities.

Study Design: Observational Studies

Observational study designs are those where the investigator/researcher just observes and does not carry out any intervention(s)/actions to alter the outcome. The three most common types of observational studies are cross-sectional, case control and cohort (or longitudinal). In cross-sectional studies, both the exposure/risk factor(s) and the outcome(s) are determined at a single time point. They can provide information on prevalence of a condition and snapshot of probable associations that can be used to generate hypothesis. Case-control studies are where subjects are selected based on presence/absence of outcome and the risk factors are determined during the study after enrolment of study subjects. The association between exposure and outcome is reported as odds ratio. These studies; however, have high risk of bias, which must be taken care of during study design. Cohort studies are prospective in nature, where subjects are selected based on presence/absence of exposure, and the outcome(s) is determined at the end of study. These studies can provide incidence of disease/outcome and the association between exposure and outcome is reported as relative risk. They are useful to ascertain causality. High dropouts of study participants and confounding can be problems encountered in these studies. Keywords: Case-control, Cohort, Cross-sectional, Odds ratio, Relative risk, Survey

Assessment of Utility of Immunohistochemical Marker Prostein for Evaluation of Primary and Metastatic Prostatic Carcinomas

Background: To assess utility of immunohistochemical marker prostein for evaluation of primary and metastatic prostatic carcinomas.Methods:Fifty- six samples of clinically suspected carcinoma prostate was included. Immunohistochemistry (IHC) was performed for assessment of Prostein (P501S). The intensity of positivity was scored from 0 to 3 as follows: score 0 = non-stained; score 1 = weak; score 2 = moderate; and score 3 = strong. The percentage of positively stained cells for each staining intensity was estimated in the respective lesions.Results:Age group 18-28 years comprised of 6 patients, 28-38 years had 12, 38- 48 years had 16 and >48 years had 22 cases. Type of cases were normal prostatic epithelium in 11, benign prostate hyperplasia in 23, HGPIN in 10, primary prostatic adenocarcinoma in 7 and metastatic prostatic adenocarcinoma in 5 cases. Prostein expression was seen in 100% in normal prostatic epithelium with intensity score of 1.8-2.1, benign prostate hyperplasia having 2-2.7, HGPIN with 2-2.3, primary prostatic adenocarcinoma having 1-1.6 and metastatic prostatic adenocarcinoma with 0.8-1.4 intensity score. Conclusion:Prostein is a new prostate specific marker which showed 100% sensitivity and specificity to identify normal and prostatic lesions.

Assessment of Role of Platelet Aggregation in Metastatic Breast Cancer Patients

Background: To assess role of platelet aggregation in metastatic breast cancer patients.Methods:40 cases (Group I) of metastatic breast cancer patients and equal number of healthy control (Group II) subjects were included. Platelet aggregation studies in vitro using ADP and Thrombin were performed using an optical aggregometer. Detection of platelet aggregation was done by Chrono log series 490 dual and four channel optical aggregometer systems.Results:There were 4 subjects in group I and 12 in group II having ADP <60, 26 subjects in group I and 28 in group II with ADP 61-72 and 10 subjects in group I with ADP >72. Low thrombin <58 was seen in 8 in group II, normal thrombin between 61-72 was seen among 11 in group I and 32 in group II and high thrombin >82 among 29 in group I respectively. Amongst patients with normal platelet count, 14 patients had platelet aggregation with ADP in the normal range and 4 patients had platelet aggregation with ADP in the lower range. In patients with high platelet count, 12 showed aggregation in the normal range, and 10 patients showed aggregation in the higher range which was statistically significant (P< 0.05) (Table III, Graph II).Conclusion: Platelet aggregation has an important part to play in the tumor metastasis of breast cancer patients.

A rare case of recurrent hypoglycaemia

Very often clinicians are confronted with unconscious patients; the cause being hypoglycaemia. In addition to correction of hypoglycaemia promptly, a search for the cause of hypoglycaemia must be attempted at the earliest with a stepwise approach. Here, the authors present a rare case of recurrent hypoglycaemia where a stepwise approach ultimately led to a diagnosis, but there were various reports which were misleading. The diagnosis was insulinoma which was apparent from the history and presenting features. But, the initial investigations, even though having high sensitivity, were normal, thus leading to a more invasive approach. The patient was ultimately cured by enucleation.

Study of the correlation of epicardial adipose tissue with left ventricular mass and left ventricular mass index in patients with essential hypertension

Background: Epicardial Adipose Tissue (EAT) is recognized to be a cardiovascular risk factor. In addition to providing fuel to heart, it plays a pivotal role in the pathogenesis of atherosclerosis though the secretion of adipokines. This study aims to find the correlation of EAT with Left Ventricular Mass (LVM) and Left Ventricular Mass Index (LVMI) in patients with essential hypertension. Increasing LVM and LVMI are predictors of poor cardiovascular outcome. So, if we find a positive correlation, we can say that measurement of epicardial fat in essential hypertension may help us identify high risk hypertensive patients.Methods: This study was carried out in SMS Hospital, Jaipur, after approval from the Ethics Committee. 100 consecutive eligible patients were included in the study after application of inclusion and exclusion criteria and taking proper informed consent. After history, examination and routine laboratory investigations, all patients underwent transthoracic 2D and Doppler echocardiography. EAT thickness, LVM and LVMI were measured and correlated using Spearman correlation coefficient.Results: The mean LVM was 139±42.12 g and mean LVMI was 35.76±11.28 g/m2.7. The spearman correlation coefficient (r) was calculated to be 0.691 between EAT and LVM and 0.677 between EAT and LVMI, indicating strong positive correlation between EAT and both LVM and LVMI. This implies that as; EAT increases, LVM and LVMI increases significantly.Conclusions: Thus, authors have found that EAT is positively correlated with LVM and LVMI. So, we can say that increase in EAT may lead to adverse cardiovascular outcome in patients with essential hypertension.

Overview of Early Cases of Coronavirus Disease 2019 (COVID-19) at a Tertiary Care Centre in North India

INTRODUCTION@#As the coronavirus disease 2019 (COVID-19) pandemic continues to spread on an unprecedented scale from around the world, we described our experience in treating early COVID-19 cases in India.@*MATERIALS AND METHODS@#An observational study of COVID-19 patients admitted to a tertiary care centre in North India between 2 March-4 April 2020 was performed. The clinical, epidemiological, laboratory, treatment and outcome data of patients were evaluated.@*RESULTS@#A total of 75 patients were treated and 56 (74.66%) were men. The clinical spectrum of COVID-19 ranged from asymptomatic to acute respiratory distress syndrome (ARDS). Fever (85.36%) was the most common symptom followed by cough (56.09%) and dyspnoea (19.51%). Findings from hemogram analysis showed that 32%, 21.33% and 18.67% of patients had lymphopaenia, eosinopenia and thrombocytopaenia, respectively. Inflammatory markers such as C-reactive protein, D-dimer, ferritin, fibrin degradation product and interleukin-6 were significantly elevated ( <0.05) in patients who required oxygen therapy than those who did not require it, suggesting the potential role such markers could play in predicting prognosis in patients. Mean hospital stay was 9.2 days and 72 (96%) patients made a complete recovery, but 3 (4%) patients demised after progressing to ARDS.@*CONCLUSION@#The clinical and epidemiological spectrum of COVID-19 has jeopardised the health system in India. Without a proven therapy to combat this pandemic and with no sight of vaccines in the near future, a preventive strategy should be adopted to contain the spread of this infectious disease.

Fetal growth in low-risk Indian population at a tertiary centre and its comparison with INTERGROWTH-21 standards: a prospective cohort study

Background: The objective of this study was to compare the fetal growth pattern in low risk Indian population with the INTERGROWTH-21 standards.Methods: Low risk women were enrolled at 10 to 20 weeks of gestation and followed up until delivery. An experienced operator performed abdominal ultrasound every 5±1 week and measured biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC) and femur length (FL) of the fetus. Newborn anthropometric measurements were taken within 12 hours of childbirth.Results: A total of 126 healthy women, enrolled at mean gestation of 16.8±1.6 weeks, completed the follow up until delivery. None of the participants developed any major obstetric or medical morbidity. The study subjects showed lower mean z scores for BPD (-0.7±1.3), HC (-0.4±1.3) and AC (-0.4±1.3) but a higher mean z-score for FL (0.3±1.7) as compared to INTERGROWTH-21 standards. From 1st through 5th visit, the z scores for BPD and HC improved whereas declined for AC and FL.Conclusions: The fetal growth in non-affluent healthy Indian women had a lower fetal growth compared to INTERGROWTH-21 standards.

Effect of Rosemary (Rosmarinus officinalis L.) Leaves Extract on Quality Attributes of Chicken Powder Incorporated Fried Chicken Snacks

The present study was conducted to develop chicken meat powder (CMP) incorporated ready-to-eat shelf stable fried chicken snacks and evaluate the effect of rosemary leaves extract (RE) incorporation on physico-chemical, microbiological and sensory properties in developed product during ambient storage up to 60 days. Two different groups were made; control (without RE) and second group with RE treated (3% level). In physico-chemical properties, results showed that RE incorporation had highly significant (p<0.01) effect on thiobarbituric acid reactive substances (TBARs), free fatty acid (FFA) and tyrosine value. Similarly in microbiological parameter RE treated product had significantly (p<0.05) lower total plate count (TPC), Staphylococcus count (SC) and significantly (p<0.01) lower yeast and mold count than control. RE incorporation had highly significant effect (p<0.01) on sensory score (texture, flavour and overall acceptability except appearance) of the product during storage period. Therefore, it is concluded that RE incorporation into fried chicken snacks improved physico-chemical (TBARs, free fatty acid content and Tyrosine value), microbiological (Total plate count, Staphylococcus count and yeast and mold count) and sensory parameter (flavor, texture and overall acceptability) of the chicken snacks during 60 days storag

Vagino-cutaneous fistula: unreported, under-reported or unheralded?

Fistulas are communicating tracts between two surfaces, linking structures and planes that should, under normal circumstances, not be in dialogue. They may be congenital or acquired and are most commonly associated with the gastrointestinal and ano-rectal territories, where they link two different organ systems internally, or track outwards, creating a communicating channel between the internal viscera and the skin surface. Vaginal fistulas on occasion result from perineal tears due to traumatic delivery, or less commonly, infection or non-healing of the episiotomy wound, and are of the rectovaginal or vesicovaginal variety. Very rarely, the channel from the vagina tracks to an opening in the skin. This is the report of a patient who developed the rare vagino-cutaneous fistula following a normal vaginal delivery with episiotomy, and review of the limited literature available about the peculiar entity, so rare that no previous reports of vagino-cutaneous fistulas developing after vaginal delivery with episiotomy could be found.

Irritable bowel syndrome, endometriosis and polycystic ovary syndrome: is there a link?

Chronic pelvic pain is a common yet difficult problem to manage, plaguing the gynecologist as well as the gastroenterologist and general surgeon. Highlighted by increased visceral hypersensitivity, endometriosis and irritable bowel syndrome (IBS) are the most common causes or chronic unrelenting pelvic pain. Recently, the similarities between the two conditions has begged the question as to whether there is any common denominator between the two conditions and their likely co-existence and mismanagement. Further, the association of polycystic ovary syndrome (PCOS) in this cohort remains definitively uncharacterized. This report details a young female patient with the triad of POCS, IBS and endometriosis presenting with chronic pelvic pain.

Anthropology of Inguinal Hernia

Introduction: Inguinal hernias are among the most commonsurgical problems worldwide. Hernias, defined as theprotrusion of a whole or part of an organ through the containingwall, along with difficult childbirth and problematic bowelevacuation are thought to be the price we pay for adopting thebipedal gait from previously crawling on all fours. The aim ofthis study was to analyse the anthropological characteristics ofpatients with inguinal hernias, so as to determine the influenceof behavior, evolutionary development and flawed physiologyof their pathogenesis, and thereby identify potential domainsfor risk reduction.Material and Methods: This was a non-interventional,retrospective study. 100 consecutive patients electivelyoperated for inguinal hernias were included and theirclinical profiles studied. The details of their demography andpresentation were tabulated and analyzed.Results: Inguinal hernia had an overwhelmingly malepreponderance, with 99% of patients being male. The meanage of patients at presentation was 56.5±13.27 years. In 93% ofpatients the condition was unilateral, where as it was bilateralin 7%. Right sided hernia was more common with 49% ofcases, left side was involved in 44%. 49% were found to bedirect hernias, 36% were indirect and 8% were pantaloonshernias, with the remainder being bilateral hernias. Rightsided direct hernias were the most commonly encountered,accounting for 28% of the cases, followed by left indirecthernias which were seen in 24%.Conclusions: The epidemiological profile of inguinal herniasin the study population translate to statistically significantfindings with respect to demographic features and risk factorsfor inguinal hernias, well elucidating the anthropology ofthe condition. This study showed statistically significantassociation between inguinal hernia and high BMI, olderage and positive family history, rather than the conventionalsuggestion that increased intra-abdominal pressure is the majorrisk factor. Thus, the role of anthropology and physiographyin the development of inguinal hernias cannot be overlooked.

Adult-onset bilateral optic neuritis: a rare presentation

A rare case of adult-onset bilateral optic neuritis without associated autoimmune or infectious disorders has been reported in this study. A 19-year-old male described sudden bilateral diminution of vision (sequential) with headache with no other remarkable history. Ophthalmological findings revealed asymmetrically reduced visual acuity on the initial visit. Fundus examination showed nerve fibre layer oedema (more in right eye). Radiological examination was suggestive of bilateral, asymmetrical optic neuritis. Visual evoked potential tests suggested asymmetrical and sequential P100 delay. No auto-immune/infectious aetiology was found. The condition was diagnosed as an atypical presentation of optic neuritis with sequential bilateral involvement. Patient was treated with intravenous methyl prednisolone followed by tapering oral doses owing to the bilaterality of the involvement. A careful follow-up is being performed. The condition involving bilateral inflammation of the optic nerves can have hazardous outcome and hence prompt, careful and comprehensive diagnostic and treatment approach is necessitated.

Early Aggressive Enteral Feeding in Neonates Weighing 750-1250 Grams: A Randomized Controlled Trial

Background: In preterm neonates, enteral feeding is advancedslowly, considering the risk of necrotizing enterocolitis. Prolongedintravenous alimentation in these neonates, however, mayincrease the risk of sepsis-related morbidity and mortality,particularly in low resource settings.Objectives: Objective of this was study to evaluate impact ofaggressive enteral feeding on mortality and morbidities amongpreterm neonates.Design: Randomized controlled trial.Participants: Neonates with birthweight 750-1250 g.Interventions: 131preterm neonates with birth weight 750-1250g, admitted to neonatal intensive care unit between April 2012 andJune 2014, were randomized to aggressive feeding orconservative feeding regimen.Outcomes: The primary outcome of the study was all-causemortality during hospital stay. The secondary outcomes includedproportion of sepsis (blood culture proven), necrotizingenterocolitis, feed intolerance, survival without major morbidity atdischarge, time to reach full enteral feed (180 mL/kg/d), durationof hospitalization, and average daily weight gain (g/kg).Results: All-cause mortality was 33.3% in aggressive regimenand 43.1% in conservative regimen, [RR (95%) CI 0.77 (0.49,1.20)]. Neonates with aggressive feeding regimen reached fullenteral feed earlier; median (IQR) 7 (6, 8) days compared toconservative regimen, 10 (9, 14) days; P <0.001. There was nodifference in culture positive sepsis rate, survival without majormorbidities, feed intolerance, necrotizing enterocolitis, duration ofhospitalization and average daily weight gain.Conclusions: In neonates with birth weight 750-1250 g, earlyaggressive feeding regimen is feasible but not associated withsignificant reduction in all-cause mortality, culture positive sepsisor survival without major morbidities during hospital stay.Neonates with aggressive regimen have fewer days on IV fluidsand reach full feed earlier

Results of minimally invasive bipolar tenotomy of congenital muscular torticollis / Resultados de tenotomia bipolar minimamente invasiva de tortícolis muscular congénita

BACKGROUND: Congenital muscular torticollis is the postural deformity of the head and of the neck. The purpose of the present study is to evaluate the results of bipolar sternocleidomastoid (SCM) muscle tenotomy in children. METHODS: The present prospective study was conducted at the Department of Orthopedic Surgery from December 2010 to December 2014. A total of 34 children with congenital muscular torticollis and a mean age of 4.8 years (range: 1­14 years) were recruited from the Outpatient Department. They were treated with bipolar SCM muscle release under general anesthesia. The functional and cosmetic results were rated on a scoring system modified from Lim et al (2014). All of the children were followed-up for 2 years. RESULTS: At the final follow-up, the neck range of movement and head tilt improved and their appearance were cosmetically improved despite the long-standing nature of the deformity. The results were excellent in 30 patients (88.23%) and good in 4 patients (11.76%). No postoperative complications were found in any of the 34 patients. CONCLUSION: Bipolar tenotomy of the SCM muscle is a good method for correcting difficult cases of congenital muscular torticollis. It is a safe, effective and complicationfree method for these patients.

INTRODUCCIÓN: La tortícolis muscular congénita es la deformidad postural de la cabeza y del cuello. El propósito de este estudio es evaluar los resultados de la tenotomía del músculo esternocleidomastoideo bipolar en niños. MÉTODOS: Este estudio prospectivo, se realizó en el departamento de Cirugía Ortopédica a partir de diciembre de 2010 a diciembre de 2014. Treinta y cuatro niños con tortícolis muscular congénita con una edad media de 4,8 años (rango: 1 a 14 años) fueron reclutados del ambulatorio. Fueron tratados con liberación de músculo esternocleidomustoide bipolar bajo anestesia general. Los resultados funcionales y cosméticos se evaluaron en un sistema de puntuación modificado de Lim y col (2014). Todos los niños recibieron acompañamiento durante dos años. RESULTADOS: En el acompañamiento final, el rango del cuello del movimiento, la inclinación y su apariencia fueron cosméticamente mejorados a pesar de la permanente naturaleza de la deformidad. Los resultados fueron excelentes en treinta pacientes (88,23%) y bueno en cuatro pacientes (11,76%).. No se encontraron complicaciones en el post-operatorio de esos 34 pacientes. CONCLUSIÓN: La tenotomía bipolar de los esternocleidomastoideos es un buen método para corregir los casos de tortícolis muscular congénita.. Para los pacientes, es un método seguro, efectivo y sin complicaciones.

Percutaneous autogenous bone marrow injection for delayed union or non-union of long bone fractures after internal fixation / Injeção percutânea de medula óssea autóloga para tratamento de retardo de consolidação ou pseudoartrose de fraturas de ossos longos após fixação interna

ABSTRACT Objectives: The aim of this study was to assess the results of percutaneous injection of autologous bone marrow in the treatment of fractures presenting with delayed union or non-union after internal fixation. Methods: This prospective study was carried out at the Orthopeedics Department from June 2005 to June 2010. A total of 93 patients with delayed union and non-union (56 delayed unions and 37 non-unions) of the long bone were recruited from the Emergency and Outpatient Departments and treated with percutaneous autologous bone marrow injections. The clinical results of this study were rated on the basis of the criteria of union. All patients were followed for 24 months. Results: All the fractures (delayed union and non-union) were united within 12 weeks. Most of the patients had discomfort at the donor site for few days; none had problems of persistent pain. The results were excellent in 68.81% (64/93) of cases, good in 19.35% (18/93) of cases, and poor in 11.82% (11/93) of cases. Conclusion: Percutaneous autologous bone marrow injection is an effective and safe method for the treatment of diaphyseal non-union and delayed union. Thus, it is concluded that with an adequate amount of autologous bone marrow injection, successful union in delayed union and non-union of fractures of long bones can be achieved.

RESUMO Objetivo: Avaliar os resultados da injeção percutânea de medula óssea autóloga no tratamento de fraturas com retardo de consolidação ou pseudoartrose após fixação interna. Métodos: Estudo prospectivo feito no Departamento de Ortopedia de junho de 2005 a junho de 2010. Foram recrutados 93 pacientes com retardo de consolidação e pseudoartrose (56 retardos de consolidação e 37 pseudoartroses) de osso longo dos Departamentos de Emergência e Ambulatórios e tratados com injeções de medula óssea autóloga percutânea. Os resultados clínicos deste estudo foram avaliados com base em critérios de consolidação. Todos os pacientes foram seguidos durante 24 meses. Resultados: Todas as fraturas (retardo de consolidação e pseudoartrose) apresentaram consolidação dentro de 12 semanas. A maioria dos pacientes apresentava desconforto na região doadora por alguns dias; nenhum caso de dor persistente foi observado. Os resultados foram excelentes em 68,81% (64/93), bons em 19,35% (18/93) e ruins em 11,82% (11/93) dos casos. Conclusão: A injeção de medula óssea autóloga percutânea é um método efetivo e seguro para o tratamento da pseudoartrose e do retardo de consolidação diafisários. Assim, conclui-se que uma quantidade adequada de injeção autóloga de medula óssea pode levar a uma consolidação bem sucedida em casos de retardo de consolidação e pseudoartrose de fraturas de ossos longos.

Growth Patterns in Small for Gestational Age Babies and Correlation with Insulin-like Growth Factor-1 Levels

Objective: Correlation of catch-up growth and Insulin-like Growth Factor -1 levels (IGF-I) inSGA babies. Methods: 50 Full-term Small for Gestational Age children aged 12-18 monthswere analyzed for Catch-up growth (gain in weight and/or length, Standard Deviation Score/SDS >0.67). IGF-1 was measured after post-glucose load using ELISA method andcorrelated with catch-up growth. Results: Mean (SD) birthweight and length were 2.1 (0.3)Kg and 44.4 (3.1) cm, respectively. At enrollment, mean (SD) age, weight and length were15.0 (2.1) months, 7.7 (1.3) Kg, and 72.9 (5.6) cm, respectively. Catch-up growth was notedin 60% children. IGF-1 levels were significantly higher in children showing catch-up growth(56.6 (63.2) ng/mL) compared to those not having catch up growth (8.7 (8.3) ng/mL). IGF-1was positively correlated with both weight and length catch-up. Conclusion: Majority ofSmall for Gestational Age showed catch-up growth by 18 months, which had good correlationwith IGF-1 levels

Outcome of surgical treatment for displaced acetabular fractures: a prospective study / Resultado do tratamento cirúrgico de fraturas acetabulares desviadas: estudo prospectivo

ABSTRACT Objective: The aim of this study was to evaluate the functional outcome of surgically treated acetabular fractures. Methods: A prospective longitudinal study was undertaken in this hospital during the period from December 2010 to December 2014. A total number of 46 patients with the diagnosis of acetabular fracture were included in the study. The main cause of the acetabular injury was a road traffic accident. All the patients were treated surgically with plates and screws. Outcome was assessed radiologically and functionally, employing the Harris Hip Score. The mean follow-up period of the patients in the postoperative period was 30 months (24-36 months). Results: The results were excellent in 60.86%, good in 21.73%, fair in 8.69%, and poor in 8.69%. Post-operative complications of acetabular fracture such as heterotopic ossification were found in 2.17%, osteoarthritis in 6.52%, skin infections in 4.34%, nerve lesions in 2.17%, and vascular necrosis in 4.34% of patients. More than 80% of patients were satisfied with the results of acetabular surgeries. Conclusion: These results show that internal fixation of acetabular fractures leads to a good outcome in the majority of patients.

RESUMO Objetivo: Avaliar o resultado funcional das fraturas acetabulares tratadas cirurgicamente. Métodos: Um estudo longitudinal prospectivo foi feito neste hospital entre dezembro de 2010 e dezembro de 2014. Foram incluídos 46 pacientes com diagnóstico de fratura acetabular. A principal causa da lesão acetabular foi acidente de trânsito. Todos os pacientes foram tratados cirurgicamente com placas e parafusos. O resultado foi avaliado radiologicamente e funcionalmente pela escala de avaliação do quadril (Harris Hip Score). O período médio de seguimento dos pacientes no pós-operatório foi de 30 meses (24-36). Resultados: Os resultados foram excelentes em 60,86%, bons em 21,73%, razoáveis em 8,69% e ruins em 8,69% dos casos. Complicações pós-operatórias da fratura acetabular, tais como ossificação heterotópica, foram encontradas em 2,17% dos casos; osteoartrite, em 6,52%; infecções da pele, em 4,34%; lesões nervosas, em 2,17% e necrose vascular, em 4,34% dos pacientes. Mais de 80% dos pacientes estavam satisfeitos com os resultados da cirurgia. Conclusão: Os presentes resultados indicam que a fixação interna das fraturas acetabulares conduz a um bom resultado na maioria dos pacientes.

Unusual Presentation Of Mesenteric Cyst In A 3-Year-Old Child - A Case Report

Mesenteric lymphatic cysts are rare congenital benign malformations of the lymphatic system. Rarely, the wall of the lymphatic cyst can undergo calcification mimicking other conditions. In the literature, about six cases of calcified lymphatic cyst have been reported. Here, we present the case of a 3-year-old child who presented with vague abdominal pain and diagnosed to have an intra-abdominal calcified cyst. On exploration, the cyst was arising from the mesentery and the child required excision of the cyst with the involved intestine. The biopsy was suggestive of a mesenteric lymphatic cyst.