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Introduction: Floating knee, referred to as ipsilateralfractures of the femur and tibia, is usually associated withseveral complications and mortality. This study was designedto present our experience with treatment of this injury.Demographic parameters like age, sex, mechanism of injury,associated injuries, method and results of treatment, andcomplications of floating knee are discussedMaterial and Methods: This Prospective study wasperformed between January 2014-July 2016. All patientswith floating knee injuries who were admitted to the PMCHfulfilling the inclusion and exclusion criteria were included.The information about the 20 cases of floating knee injurieswere gathered, particularly the demographic parameters, modeof injury, bones involved, condition of skin, other associatedinjuries and their neurovascular status. The patients werefollowed for a minimum of one year duration and functionaloutcome was assessed.Result: Most of the patients were between 21-30years of age(45%). The floating knee injuries were more common in males(85%). FraserType I fracture was observed in 70% of cases.Roadtraffic accidents(RTA) was the most common cause ofsuch injuries. 18 out of 20(90%) cases were having associatedinjuries while only 10%were cases of isolated floating knee.The most common early and late complications were infectionand knee stiffness respectively. The final outcome as perKarlstrom criteria was excellent and good in 11 out of 14 casesof Fraser type I fracture and in 3 out of 6 cases of Fraser type IIfracture, and this was statistically significant (P=0.05).Conclusion: This study revealed that the complication rateassociated with floating knee injuries remain high and theprognosis mostly depends on type of injury and associatedinjuries. This study also advocates early aggressive approachfor management of these injuries.
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Background: Rabies is an acute fatal disease of central nervous system, caused by Lyssavirus Type 1. Rabies in dogs is the source of 99% of human infection. Awareness about rabies and health seeking behavior are crucial determinants of rabies control. Present study was done to assess awareness regarding animal bite and health seeking behavior among affected population.Methods: A hospital based cross sectional study was conducted in central emergency department of Rajendra Institute of Medical Sciences, Ranchi, Jharkhand for a period of four months. A semi-structured questionnaire was used for data collection. Sample size was 114 using consecutive sampling method. The participants were interviewed after taking informed consent. Data collected were entered in MS Excel and analyzed using SPSS version 20.Results: A total of 114 subjects participated in the study of which 83 (72.8%) were male and 31 (27.2%) female. Most commonly affected age group found was 21-30 years (35.1%). Majority 101 (88.6%) of them resided in urban areas, and only 79 (69.3%) acquired secondary education and above. Most of the animal bite was caused by dogs 102 (89.5%), unprovoked 79 (69.3%) in nature and most common site involved lower limb 70 (61.4%). Majority 68 (59.6%) of the dog bite wound were of category II. Only 55 (48.2%) of animal bite victims washed their wound with soap and water. Majority 58 (50.9%) of the study participants had no knowledge about consequences of dog bite. Median reporting time to tertiary institute was found to be four hours.Conclusions: There was average level of awareness about rabies among animal bite victims attending RIMS, Ranchi
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Background: Accredited Social Health Activist (ASHA) acts as a „bridge‟ between the rural people and health service outlets and would play a central role, in achieving national health and population policy goals. In Jharkhand ASHA is known as “Sahiyya”. The present study was aimed to assess Sahiyyas in relation to antenatal services delivered by her in the field practice area Ormanjhi of Rajendra Institute of Medical Sciences (RIMS), Ranchi. Methods: This was a community based cross sectional study. All Sahiyyas (26), women having children under 3 years of age (196), pregnant women (140), Anganwadi workers (AWWs) (16) and Auxiliary Nurse Midwives (ANMs) (6) from the study area were recruited for the study. Assessment of antenatal services delivered by Sahiyyas was done based on interview with Sahiyyas which was then crosschecked through the responses of beneficiaries, AWWs and ANM. Results: All Sahiyyas in the study area were aware about her job responsibilities like help during registration and mobilization during pregnancy but when cross checked, 70.2% and 60.9% beneficiaries received help during registration and mobilization. Out of 336 beneficiaries, only 23.2% and 19.9% responded that were counselled by Sahiyyas on nutrition and adequate rest during pregnancy during their home visits. Conclusions: Sahiyyas were well aware of her responsibilities related to antenatal services like counselling mothers on diet, rest and other health advices through home visits but these jobs were not being done passionately by her as other incentive oriented jobs.
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Background: Objectives of current study were to determine the magnitude of left ventricular systolic dysfunction in patients with acute myocardial infarction in the rural sub-population of Uttar Pradesh in India and to evaluate the impact of cardiovascular risk factors on the risk of impairment of left ventricular systolic function. Methods: One hundred and fifty seven consecutive patients with first acute myocardial infarction were enrolled into the study. Most patients were male (73.2%) and the mean age of presentation was 52.7 years. Two dimensional echocardiography was utilized to assess conventional parameters such as Left Ventricular End-Diastolic Diameter (LVEDD), Left Ventricular End-Systolic Diameter (LVESD), LV End-Diastolic Volume (LVEDV), LV End-Systolic Volume (LVESV) and Left Ventricular Ejection Fraction (LVEF). The LV volumes (end-systolic and end-diastolic) and LVEF were calculated from the conventional apical two-and four-chamber images using the biplane Simpson’s technique. LV systolic function was considered depressed when LVEF was less than 45%. The chi-square test was used in the statistical analysis to compare proportions and a logistic regression model was used to assess the independent effect of the each variable. Results: The study projects a high proportion (42.7% of the patient population) of left ventricular systolic dysfunction in patients with Acute Myocardial Infarction (AMI). No association was found between gender or age and LV systolic dysfunction. The proportion of patients with diabetes mellitus was higher in the sub-group of patients with impaired LV systolic function (45.2% vs. 30.2%, P = 0.01); the proportion of patients with history of current or past smoking was also higher in the sub-group of patients with impaired LV systolic function (48.9% vs. 34.2%, P = 0.03). On the other hand, hypertension and dyslipidemia were not associated with impaired LVEF. After adjustment of other variables, diabetes and smoking were associated with a significantly higher risk of LV systolic dysfunction (diabetes: OR = 3.73; 95% CI = 1.25-11.16; smoking: OR = 3.8; 95% CI = 1.37-11.05). Conclusion: Since the proportion of patients with LV systolic dysfunction in patients with AMI remains relatively high, LV systolic function variables such as LVEF and LVESV should be echocardiographically evaluated in all patients with AMI. Since the post-infarction LV systolic function remains the single most important determinant of survival, treatment of AMI patients should be aimed at limitation of infarct size and prevention of ventricular dilation. Moreover, cardiovascular risk factors such as diabetes mellitus and smoking have a significant impact on the likelihood of impairment of LV systolic function in patients with AMI and hence could influence long-term prognosis.
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Helicobacter pylori, a common cause of peptic ulcer, may also lead to gastric mucosa associated lymphoid tissue lymphoma and gastric adenocarcinoma. A study was done for 17 months from 1st January 2004 to 31st May 2005. Rapid Urease Test (RUT) and microscopy were performed on endoscopic gastric biopsy material obtained from 302 patients suspected to have peptic ulcer. Thirty three (10.93%) specimens were positive by RUT and 25 of those were positive by microscopy. RUT, having high sensitivity (90- 95%) and cent per cent specificity, and also being simple cheap, rapid and convenient to perform, can be done in all the microbiology laboratories. Rapid diagnosis of H.Pylori by RUT helps the patients in effective treatment.