bluuebunny/crossref_metadata_2025 huggingface dataset:
A cross sectional study on assessment of nutritional status and factors affecting anemia in children in tertiary care teaching hospital
Authors: Posam Uma M. , Chereddy Thanmai C. , Pirati Revanth S. , Rao N. V. Rama , Bandrapalli Elizabeth , Yangalasetty Sravani , Nadendla Ramarao
Published: December 2021

Background: Earlier many studies were conducted to assess the prevalence of anemia in adults, pregnant women, and children under 5 years of age. Despite all the reasons, there is an immense need to assess the nutrition status and prevalence of anemia in a pediatric population. Therefore, the purpose of the present study was to assess the nutritional status and prevalence of anemia in the pediatric population of age group 1-12 years.Methods: The present study was a cross-sectional study with a sample size of 100 with age group 1-12 year, was conducted in Government general hospital, Guntur. The study was carried for a period of 6 months (October to March). Data were collected by using the NACS assessment guide tool for nutritional status and tallquist hemoglobin scale was used to measure hemoglobin.Results: Age group of 1-6 years had 26% severe stunting whereas in the age group lo 7-12 years, 5% of the people had severe stunting. Age group of 1-6 yr and 7-12 years had 16% of severe wasting and 13% of severe wasting respectively. The prevalence of anemia in children had a significant impact with maternal education (p<0.05), socioeconomic status of the family (p<0.05), birth order of the child (p<0.05) and doesn’t have any significant impact with father education (p>0.05), past medical history (p>0.05).Conclusions: From our study, we conclude that moderate anemia was more noticeable than mild and severe anemia in people of rural areas in and around Guntur. Severe stunting and moderate wasting was observed more in the age group of 1-6 years of children in both sexes.
Noncompaction of left ventricle - a rare cardiomyopathy
Authors: Thakkar Parth K. , Bhatt Mahesh , Chawla Sheela Bharani , Desai Hitesh
Published: December 2021

Non-compaction of left ventricular (NCLV) is a rare cardiomyopathy of unknown origin characterized by prominent ventricular trabeculations and deep intertrabecular sinusoids, in communication with the left ventricular cavity. The NCLV results due to failure of compaction during foetal development. In this study, five children were diagnosed with NCLV out of 135 cases of cardiomyopathy and the youngest case was diagnosed at 27th day of life. Congestive cardiac failure presenting as tachycardia and tachypnea were common clinical manifestations. Early detection of NCLV helps patients to get timely treatment. NCLV should be considered as one of the differential diagnosis amongst cases of cardiomyopathy.
Massive hemorrhage after percutaneous liver biopsy in a pediatric patient with graft-versus-host disease; a successful angiographic embolization
Authors: Okumuş Mustafa , Alkara Utku , Malbora Barış , Sarbay Hakan , Kamit Fulya
Published: December 2021

Most cases of bleeding that develop after percutaneous liver biopsies can be managed with follow-up and supportive treatment. In life-threatening situations, however, open surgery or minimally invasive methods are required. This case report describes the clinical course of an 11-year-old patient with a diagnosis of Wiskott-Aldrich syndrome who experienced a major hemorrhage following a percutaneous liver biopsy. Clinical findings, imaging, interventions, and results were evaluated. Allogeneic hematopoietic stem cell transplantation was performed without any problem. The patient's bilirubin level started to increase on the 20th day after transplantation. Profuse watery diarrhea started on the 24th day. Graft-versus-host disease of the gastrointestinal tract and liver was considered as his diarrhea continued to the 29th day. An ultrasound-guided Tru-cut® liver biopsy (Merit medical, South Jordan, UT, USA) was performed with an 18-gauge needle on the 52nd day after transplantation. In the fourth hour after the procedure, the general condition of the patient started to deteriorate. Active bleeding was detected in the patient with computed tomography, and he was hypotensive and tachycardic. The patient was urgently transferred to the angiography unit and a successful angiographic embolization was performed. Angiographic embolization is an intervention with high success rates in cases of bleeding where the patient is hemodynamically stable. However, it can also be successfully applied in selected patients who are hemodynamically unstable.
Early infantile form of Krabbe disease: a case report
Authors: Reddy K. Venkataramana , Soren Chapay , Geethika M. , Dharani N. , Reddy K. Sruthi
Published: December 2021

A 7-month-old female child, born to 2nd degree consanguineous marriage brought with complaints of gross developmental delay. Her examination revealed spasticity in all 4 limbs with brisk deep tendon reflexes with intact primitive reflexes and exaggerated startle reflex. Her MRI brain showed demyelination signs in bilateral thalami, dentate hila, and thickened optic chaisma. Age of presentation, clinico-radiological findings were suggestive of early infantile form of Krabbe disease.
Brain tumor masquerading as dengue in a three-year-old boy
Authors: Kikani Bhumi D. , Singh Poonam , Sengupta Dorothy , Sinha Aashita A.
Published: December 2021

Paediatric gliomas represent the most common brain tumour in children. Early diagnosis and treatment greatly improve survival. Paediatric gliomas depend on pathways and genes responsible for mitotic activity and cell proliferation as well as angiogenesis (mitogen-activated protein kinases, vascular endothelial growth factor, epidermal growth factor pathways). Symptoms seen as persistent headaches, behavior changes, early morning nausea, emesis, diplopia, and papilledema. Patients may also present with more specific localizing symptoms such as focal motor deficits, hemiplegia, pyramidal tract findings, dysmetria, and chorea; depending upon the tumor’s location can facilitate diagnosis, but they are not always present and therefore diagnosis is occasionally delayed. Here we report a case of a boy hailing from lower socioeconomic status with history of abdominal pain, irritability, fever and cough initially mimicking clinical features and symptoms of dengue encephalitis but subsequent deterioration of patient though on medication and review with MRI suggestive of a glioma.
How safe is soy in infancy? Case report of thelarche in an infant
Authors: Tripathi Parijat R. , Reddy Rahul
Published: December 2021

Soy protein based formulas are commonly used in infant nutrition for various indications like lactose intolerance and cow’s milk protein allergy. There are concerns regarding phytoestrogen related and other side effects of these formulas. We are describing a case of possible soy formula induced thelarche in a 7 months infant. There was normalization of estradiol levels with some clinical improvement after stopping soy formula over a follow-up of 12 months duration. We suggest further studies to evaluate hormone levels in infants on soy formulas and to consider it only for appropriate clinical indication and age group.
Reactive infectious mucocutaneous eruptions associated with SARS-CoV-2 infection
Authors: John Shaji Thomas , K. Gayathri , P. Rizwana , Martin Abhay M.
Published: December 2021

Several dermatological manifestations are described in COVID-19. A 3-year-old boy presented with fever, painful oral ulcers with COVID-19 infection. A diagnosis of reactive infectious mucocutaneous eruptions (RIME) was made. He was worked up for the usual causes of RIME but were all negative. His severe acute respiratory syndrome corona virus-2 immunoglobulin M (SARS-CoV-2 IgM) was positive and he was managed with Intravenous hydrocortisone with which he improved dramatically. RIME might be the first/only manifestation of COVID-19 and it should be kept in mind.
Rhinogenic contact point headache in pediatric age group: a review
Authors: Swain Santosh Kumar , Baliarsingh Prasenjit
Published: December 2021

Headache is a common clinical entity of pediatric patients in routine clinical practice. Anatomical variation in the nasal cavity may result in headaches due to contact of the opposing mucosal surfaces, called rhinogenic contact point headache (RCPH). RCPH has recently begun to be of interest among clinicians and is accepted as a cause of headache by international headache society classification. The pressure of the two opposing mucosal surfaces in the nasal cavity without any evidence of inflammation can be an etiology for headache or facial pain. Anatomical variations in the nasal cavity like deviated nasal septum (DNS), spur, concha bullosa, hypertrophied inferior turbinate, medialized middle turbinate, and septal bullosa are important causes for contact point headache. RCPH is often misdiagnosed by clinicians during the assessment of headaches in pediatric patients and is sometimes considered a headache of unknown etiology. Endoscopic examination of the nasal cavity and computed tomography (CT) scans are important tools for the diagnosis of anatomical variations in the nasal cavity causing RCPH. Endoscopic resection of the contact point in the nasal cavity is the treatment of choice. There is not much literature for RCPH in pediatric patients, indicating that these clinical entities are neglected. This review article discusses the details of the epidemiology, etiopathology, clinical manifestations, diagnosis, treatment of the RCPH in pediatric patients.
Effects of extraosseous talotarsal stabilization on the biomechanics of flexible flatfoot subtalar joints in children: a finite element study
Authors: Cheng Xiangyu , Deng Zhiqin , Song Weidong , Liu Jianquan , Li Wencui
Published: December 2021

Background: Objective of the study was to generate an experimental foundation for the clinical application of extraosseous talotarsal stabilization (EOTTS) in treatment of flexible flatfeet in children by investigating the biomechanical characteristics of flexible flatfoot and the effects of EOTTS on hindfoot biomechanics.

Methods: Three-dimensional finite element models of the foot and ankle complex were generated from computer tomography images of a volunteer’s left foot in three states: normal, flexible flatfoot, and post-EOTTS. After validation by X-ray, simulated loads were applied to the three models in a neutral position with both feet standing.

Results: In the flexible flatfoot model, the contact stress on the subtalar joint increased and contact areas decreased, resulting in abnormal stress distribution compared to the normal model. However, following treatment of the foot with EOTTS, these parameters returned to close to normal. Subtalar joint instability leads to a flexible flat foot. Based on this study, it is proposed that EOTTS can restore the normal function of the subtalar joint in and is an effective treatment for flexible flatfoot in children. We and many clinical data studies provide evidence for sinus tarsi implants in pediatric patients. It is showed that the formation of flexible flatfoot is induced by subtalar joint instability.

Conclusions: Because of the EOTTS provides the best biomechanical solution to subtalar joint instability, the EOTTS became an effective form for subtalar joint instability treatment.
Comparative study of plating versus conservative treatment in mid shaft fractures of clavicle
Authors: Juneja Johney , Damor Ankit , Mehra A. K. , Talesra Anurag , Jatav Dharmendra Kumar , Sharma Anamendra
Published: December 2021

Background: Clavicle fractures represent up to 4% and 1% of all fractures, respectively. Historically, both fracture types have been treated conservatively with acceptable outcomes. The surgical correction of these fractures is currently being investigated as a viable alternative to conservative management.

Methods: A systematic search of PubMed was performed to identify articles comparing open reduction and internal fixation (ORIF) with conservative treatment for clavicular fractures. Specific outcomes of interest were shoulder function, pain, strength, range of motion, and risk of non-union. 

Results: ORIF of midshaft clavicular fractures results in increased shoulder function within 6 weeks following treatment and a decreased risk of non-union. After 1 year, there was no longer a difference in shoulder function between groups. There was no difference in pain between treatment groups. Both ORIF and conservative treatment of extraarticular scapular fractures yield comparable results in shoulder function, range of motion, and strength following treatment.

Conclusions: This study, early primary plate fixation of comminuted mid shaft clavicular fractures results in improved patient-oriented outcomes, improved surgeon-oriented outcomes, earlier return to function and decreased rates of non-union and malunion. 
Epidemiology of fractures in indoor patients at a tertiary care centre in India: a study of 3000 cases
Authors: Desai Mohan M. , Kuruwa Deven R. , Elango Easwar , Wade Roshan
Published: December 2021

Background: Implementing appropriate fracture control measures and treatment protocols is crucial to maximizing health and development gains. This requires an in depth understanding of age-specific, sex-specific and cause-specific injury patterns at the national and subnational levels. No such study on fracture epidemiology has been undertaken in the Indian population.

Methods: Study was conducted in a tertiary care centre (KEM hospital, Mumbai) which is one of the highest volume trauma centres in the country. Data of 3000 patients was obtained from the medical records department for the year 2016-2019. Patients were segregated with respect to their genders and into three age groups. Etiology of fracture was noted, and fractures classified according to the anatomical area. Whether the patient received conservative or operative management was also recorded.

Results: 43.83% of the fractures occurred in 18-50 years age group. 41.33% in the above 50 group and only 14.73% in the below 18 age group. Overall male to female ratio was 1.4: 1. Vehicular accident was the most common mode of injury (47.07%) followed by fall from height (21.03%). Proximal femur fractures were the most common accounting for 19.57% of all fractures followed by forearm (10.53%), tibia diaphysis (8.10%). Talus was the least common. 81.07% cases were managed operatively and 18.93% conserved.

Conclusions: Our study highlights that Indian epidemiology is unique from our Western counterparts. Population affected is much younger, old age males are affected more than females. Lower limb fractures are more prevalent and road traffic accidents are responsible for almost half the fractures.
Functional outcome of hybrid external fixator in proximal tibial fractures Schatzker type V and VI with Gustillo grade-II
Authors: Juneja Johney , Asiger Mohzin , Kumar Dinesh , Jain Mahendra P. , Garg Gaurav , Joshi Vinay
Published: December 2021

Background: Management of high energy tibial plateau fractures along with extensive soft tissue damage is still challenging to many orthopaedic surgeons. This study evaluates the purpose of hybrid external fixator intreating high energy tibial plateau fractures with minimal invasion and accurate reduction.Methods: Twenty patients with high energy Schatzker type V and VI tibial plateau fractures with severe soft tissue injury were enrolled into the study in RNT medical college, Udaipur.Results: The results- bony union, range of movements and associated complications were assessed. All fractures united in an average time period of 20 weeks. Ten patients developed knee stiffness, five patients developed delayed union andthreenon-union.15 patients required split skin graft. Final outcome showed excellent score in 53 patients.Conclusions: Hybrid external fixation is a safe option for managing complex high energy tibial plateau fractures by simultaneously providing adequate fracture stabilization and necessary protection to soft tissue healing to achieve bony union.
Anterior inferior plating versus superior plating for middle 1/3rd clavicle fracture: a prospective comparative study
Authors: Rudrappa Girish H. , B. V. Deepak , Pradhaban Gowthama
Published: December 2021

Background: Fractures of the clavicle are common injuries that may result from direct blow or transmitted forces. Deformities are shortening and depression of lateral fragments. Various techniques are performed out of which superior and anteroinferior plating are widely used with each having its own merits and drawbacks. Our study compares the outcome between above mentioned techniques.

Methods: We conducted a prospective comparative study of 60 patients who has met inclusion criteria and out of which 30 patients were treated with anteroinferior technique and 30 patients were treated with superior plating technique. Outcome measure were assessed through constant and murley score.

Results: The demographic analysis of our study showed that the incidence of fracture is predominant among males (63.3%) with RTA being the most common mode of injury. AO/OTA classification which was used in our study revealed A1 as the most frequently involved group. Each group had 2 patients with infection post operatively which was managed with appropriate antibiotics. Increased incidence of delayed union was found in anterioinferior group (13.3%) with decreased hardware prominence in comparison with superior plating.

Conclusions: There were no significant differences in functional outcome between both the groups except the fact that superior plating had higher chances of plate prominence. So either of the surgical technique can be employed depending upon the feasibility of surgeon.
Multilevel percutaneous vertebroplasty: safety, efficacy and long-term outcomes
Authors: Dalai Sibasankar , Datla Aravind V.
Published: December 2021

Background: The pain in vertebral compression fractures is severe, leading to reduced mobility and quality of life. Percutaneous vertebroplasty is a minimally invasive procedure for treating various spinal pathologies. This study evaluated the usefulness and safety of multilevel PVP (two to three vertebrae) in managing VCF.

Methods: This retrospective study evaluated 59 vertebral levels in 28 patients with VCF who had been operated on for multilevel PVP (two to three levels). There were 22 females and six males, and their ages ranged from 36 to 79 years, with a mean age of 68.95 years. We had injected two levels in 25 patients and three levels in 3 patients. The visual analogue scale was used for pain intensity measurement, and plain X-ray films, computed tomography scan and magnetic resonance imaging was used for radiological assessment. The mean follow-up period was 13.8 months (range, 11-19).

Results: Significant pain improvement was recorded in 26 patients (92.85%). More remarkable improvement in pain was noticed in the immediate postoperative period than in the subsequent follow-ups. Asymptomatic bone cement leakage anteriorly and into the disk spaces in two patients. Isolated anterior leakage has occurred in one patient. There was no encounter of pulmonary embolism.

Conclusions: Multilevel PVP for the treatment of VCF is a safe and effective procedure that can significantly reduce pain and improve patient condition without any significant morbidity. It is considered a cost-effective procedure allowing a rapid restoration of patient mobility.

 
Demographic, clinico-pathological features and management pattern of primary bone tumors in a tertiary care hospital of South India
Authors: Shanmugam Subbiah , Susikar Sujay , T. Bharanidharan , Jebasingh Arun Victor
Published: December 2021

Background: Primary bone tumors are very rare tumors. The true incidence of bone tumors is not well established and is under reported due to rarity and lack of accurate registries. Hence it is essential to study about the demographic, clinico-pathological features and the pattern of surgical management of bone tumors. The aim of this study is to analyze the demographic and clinico-pathological features of primary bone tumors that were managed by surgery.

Methods: A retrospective analysis of all patients with primary bone tumor who were treated by surgery from 2012 to 2019 was done. The age, sex distribution, histopathology, location of the tumor and surgical procedure done were analyzed.

Results: Among 103 patients analyzed, 66 (64%) were men and 37 (36%) were women. Primary bone tumors most commonly presented in 11 to 20 years of age with 35 (33.9%) patients occurring in this age group. Osteosarcoma was the most common primary bone tumor and it occurred in 49 (47.6%) patients, out of which 34 (69.3%) patients were below 20 years of age. Giant cell tumor was the most common benign bone tumor and it occurred in 22 patients, out of which nine (40.9%) patients were of age 21 to 30 years. Distal femur was the most common site with 39 (37.9%) patients. The limb preservation rate for malignant appendicular bone tumors was 69.0%.

Conclusions: The diagnosis of bone tumor depends not only on histopathological features but also needs correlation with age, clinical features, tumor location and radiological features for confirmation of diagnosis.
Single center, observational study to analyze correlation between vitamin D-3 deficiency and age in patients with orthopedic disorders
Authors: Rathod Girish , Raut Nitin , Borole Pushkar , Shetty Chandan , Gawali Vijaykumar
Published: December 2021

Background: Vitamin D deficiency has been strongly associated with various health outcomes, including all-cause mortality. Chronic vitamin D deficiency in adults and in old age results in osteomalacia, osteoporosis, muscle weakness, and increased risk of fall and long bone fractures. 

Methods: We examined records of 1029 such patients and to analyze association of vitamin d-3 levels and categories of age groups (1-20, 21-30, 31-40, 41-50, 51-60, 61-70, 71-80, 81-90 years). We categorized mild, moderate and severe cases age wise.

Results: During the study period records for 1029 patients were evaluated, of which 347 (33.72%) male and 682 (66.27) were female the mean age with standard deviation for male was 38.25±15.64 years and for female was 41.43±15.23 years. Vitamin D deficiency (<20 ng/ml) was present in 623 patients (61%), 189 patients (18%) had vitamin D level 20-30 ng/ml and 217 patients (21%) had sufficient levels of vitamin D.

Conclusions: Our study concludes that although there is high prevalence of vitamin D-3 deficiency across all age groups among orthopedic patients, age group 31-40 years, was found to be more affected.

 
A comparative study between anterior and posterior approach for bipolar hemiarthroplasty in intracapsular fracture neck of femur
Authors: Juneja Johney , Asiger Mohzin , Sharma Ishan , Joshi Vinay , Sen Ramesh
Published: December 2021

Background: The present study was undertaken to to compare the efficacy of treatment of intracapsular neck of femur fracture operated by anterior and posterior approaches.

Methods: A total 100 patients of either sex, aged >65 years with intracapsular neck femur fracture were operated with hemiarthroplasty. The patients were divided into two equal groups and patients were operated alternatively one with anterior approach and the second with posterior approach. Functional outcomes were compared using Harris hip score and range of movements assessed clinically. Hip function and final outcome measures were noted and compared between two groups.

Results: The mean age of patients was 63.1±5.3 years in group A and 65.8±5.4 years in group B with female to male ratio was 1.7:1 for group A and 1.8:1 for group B. Operating time for group A and for group B was 65 and 78 minutes respectively. Mean intraoperative blood loss was 120 ml in group A and 150 ml in group B. The most common complication in both the groups were infection and rate in group A was 9.70% and in group B was 13.50%. Posterior approach carried an increased risk of prosthetic dislocation as compared to anterior approach. There was no intraoperative mortality seen in follow up period.

Conclusions: Anterior approach for hip hemiarthroplasty in elderly population with intracapsular femoral neck fractures provided significant benefit in early postoperative period when compared to the posterior approach in terms of duration of surgery, intraoperative blood loss, time of recovery, hip dislocation rate.
Surgical management of giant cell tumor in adolescent by excision or curettage followed by fibular strut graft
Authors: Bhaskar Reddy K. Vijaya , Chary N. Brahma , Mogili Chenna K.
Published: December 2021

Giant cell tumour (GCT) in adolescent is a rare tumour. It commonly occurs in skeletally mature patients aged between 20-40 years. In adults it is seen in epiphyseal region. In patients with intact physis, it arises from the metaphysis. Giant cells are more common in females. It is more common in the ends of long bones of distal end of femur, proximal tibia, and distal radius. 14 cases of surgical management of GCT by excision or curettage in adolescent followed by fibular strut graft. 1 year follow up of all cases of GCT in adolescent treated with excision or curettage followed by fibular strut graft was done. Out of 14 patients, 12 patients did not develop any recurrence of GCT. 2 patient developed recurrence after 6 months. All the patients were able to attain good range of movements 2 months after surgery. GCT in adolescent surgically treated with excision or curettage followed by fibular graft had excellent results in terms of recovery of daily activities, wound healing. Chances of recurrence more in patients treated with curettage and bone grafting.

 
Computed tomographic evaluation of bone tunnel enlargement following single bundle anterior cruciate ligament reconstruction with hamstring autograft
Authors: Chandrashekar Sunil , N. Manjunath A. , S. Shivakumar M.
Published: December 2021

The purpose of this study is to evaluate tibial and femoral tunnel diameter following single bundle anterior cruciate ligament (ACL) reconstruction and correlation between tunnel enlargement and clinical outcome. Twelve patients who underwent primary arthroscopic single bundle ACL reconstruction with hamstring graft were included in prospective case series. Preoperative clinical evaluation was performed using international knee documentation committee (IKDC) subjective score and grade, Tegner knee score and Lysholm knee score. Computed tomography (CT) evaluation of the femoral and tibial tunnels were done on post-operative day (POD) 1 and at a mean follow up of 9 months (range 7-12 months) and were compared with functional scores. Our study shows significant tibial and femoral tunnel enlargement on CT scan at 9 months (range 7-12 months) postoperatively. All the clinical evaluation scales showed improvement postoperatively. The mean average femoral tunnel diameter increased significantly (p<0.001) from 8.17±0.57 to 9.08±0.660 (10%) and tibial tunnel diameter increased significantly (p<0.001) from 8.08±0.669 to 9.07±0.601 (11%) postoperatively at a mean follow up of 9 months (range 7-12 months). No statistically significant difference between tunnel enlargement and clinical values were found. In our current prospective CT based study, we conclude use of extracortical fixation of femoral tunnel with stronger fixation of the tibial tunnel, tunnel orientation and anatomic fixation close to the joint line along with less aggressive rehabilitation protocol with use of extension knee brace may result in minimization of tunnel widening with quadrupled hamstring autograft.
Complications in surgical management of calcaneal fractures with anatomical plates
Authors: Quadri Asfia , Vasif M. Zeeshan
Published: December 2021

Calcaneal fractures, irrespective of their types, are treated non-operatively, one of the reasons being fear of complications. But conservatively managed fractures can result in equally problematic complications. Incidence of subtalar arthritis in such cases is reported to be 16.9% compared 3.3% in cases treated surgically. With surgical treatment aimed at achieving anatomical joint reduction, regaining calcaneal height, its length and width, successful attempts at curtailing the long-term complications can be made. This was a prospective study of 20 cases of calcaneal fractures, admitted to MNR Medical College and Hospital, Sangareddy from August 2020 to September 2021 were treated with ORIF with non-locking anatomical calcaneal plates using Fernandez’s approach, without use of bone graft. Essex Lopresti and Sander’s classification were used. Intra-operative assessment of reduction and articular surface reconstruction was done under fluoroscopic guidance. Regular follow up was done for assessment of fracture union and complications, assessment of late collapse. Among the 20 cases, 73% were men and 27% women. On typing the fractures based on Essex-Lopresti classification, intra-articular tongue type constituted 13% and 87% were of joint depression. Near normal anatomical reduction was obtained in all cases except in one where it was difficult due to comminution noted during surgery. 2 cases developed superficial skin necrosis at the surgical site, 1 case of deep infection and abscess formation and 3 cases of subtalar arthritis. This study showed that the incidence of long-term complications can probably be minimized by restoring the altered anatomy through surgical means; hence we advocate surgical management and accurate anatomical reduction in cases of displaced and comminuted calcaneal fractures with proper surgical principles.
Radial club hand managed with ulnar osteotomy and centralization of hand: a case report and review
Authors: Kamboj Pradeep , Mukherjee Mayukh , Wadhwani Jitendre , Sharma Rahul , Jain Mayank , Arora Kunal , Garg Aksha Mohan , Tanwar Abhay , Agarwal Gaurav
Published: December 2021

Radial club hand also called radial longitudinal deficiency or radial dyspasia is a preaxial longitudinal failure of formation. As the defect is preaxial it is often associated with thumb hypoplasia or anomaly of the radial aspect of the carpus. It is diagnosed clinically and on X-rays. It is frequently syndromic so it is a must to look for associated congenital anomalies by doing a through clinical examination. The frequency of this anomaly is between 1:50000 to 1:100000 live births. The incidence of all radial ray-deficient limbs, including hypoplastic thumbs alone, is approximately 1:30000. The radial deficiency is bilateral in 50% of the cases and the male:female is 3:2. It includes a wide spectrum of disorders that encompass an absent thumb or thumb hypoplasia, a thin first metacarpal and an absent radius. We report here a 1.5 years old child with isolated type IV radial club hand without any restricted range of motion in elbow managed with osteotomy of ulna and centralization of hand.
Restoration of neglected fracture dislocation hip in elderly: a case report
Authors: Raj Praveen , Mukherjee Kaustav , Dhanrajan Gokul Raj , Bhaskar Sundararaja , Purushothaman Pradeep Jayaram
Published: December 2021

Neglected traumatic fracture dislocation of the hip is a challenging problem due to soft tissue contractures, adhesions, fibro fatty tissue filling acetabulum, avascular necrosis, arthritis and myositis ossificans. These types of injury often get missed at initial evaluation in the presence of distracting injuries and in poly trauma patients. Femoral head fractures account for only 7-16% of all hip fracture dislocations, with combined femoral head and acetabular fractures in elderly being even lower. Literature favours primary hip replacement as compared to hip salvage in age above 60 years and in patients with neglected hip fracture dislocations of more than 3 months duration due to high chances of afore mentioned complications. Here, we report a case of 69 years old male with neglected hip fracture dislocation associated with posterior acetabular wall and femoral head fracture for the challenges in management with a total hip replacement.
Intra and extraarticular localized pigmented villonodular synovitis
Authors: Juneja Johney , Choubsia Raghavendra , Sen Ramesh , Mehra A. K. , Aggarwal Basant , Sharma Krishan Kumar
Published: December 2021

A 28 year old woman had a history of knee trauma and presented with unilateral knee acute swelling and pain symptoms with sudden onset, which was there from last 2 years. She had been treated for seronegative rheumatoid patient for 1 year. Recent expansion of the LPVNS (localized pigmented villonodular synovitis) caused the development of a tender palpable soft tissue mass in the anterolateral aspect of the knee and acute reduced mobility. Preoperative magnetic resonance imaging of the knee revealed the presence of only the soft tissue mass and mild degenerative changes. Open synovectomy was performed successfully to excise the mass. Intraoperatively, macroscopic features of the bright brown inflamed synovium suggested LPVNS, which was confirmed histopathologically. Postoperatively, the symptoms of limited mobility and pain were appreciably relieved. Recurrence was not observed during the clinical follow up at 1, 6 or 18 months after surgery. Here, we reported the unique case of localized pigmented villonodular synovitis of the knee in a misdiagnosed patient with intra and extraarticular lesion, which might be attributed to the history of knee trauma and the focal defect of the lateral patellar retinaculum. Open synovectomy effectively relieved the symptoms of limited mobility and pain and no recurrence was observed prior to 18 months postoperatively. To reduce misdiagnosis, MRI examinations are recommended for all patients suspected of having PVNS, including those who have a history of hyperuricemia.
Oncogenic osteomalacia secondary to hemangiopericytoma: a case report
Authors: Matin Aamir , Tuse Sushant Sopan
Published: December 2021

We are going to present a case of hypo-phosphatemic rickets secondary to phosphaturic mesenchymal tumour who came with complaints of proximal muscle weakness which limited his effort tolerance and activities of daily life like standing from squatting position and rib pain. His FGF-23 levels were very high above normal levels and PET CT revealed a well-defined enhancing lesion abutting femoral neurovascular bundle. After consultation with endocrinologist, we have d done complete excision of the mass. Post-surgery all symptoms were relieved, proximal muscle strength improved gradually and serum levels of phosphorus, ALP and FGF-23 came back to normal.
The East, the West, and the World History
Authors: Ryabinin Alexei
Published: December 2021

The author raises in the article an important question of human civilization development: what contribution the East has made to the centuries-long evolution of society. The author emphasizes that, despite the low attention to the countries of the East in the World History books, it was the “Eastern” way that laid down by the great despotisms: Ancient Mesopotamia, Ancient Egypt, Ancient India, Ancient China, and was the main way of human development. Indeed the “Western path” did not appear immediately in Europe itself: both Minoan and Mycenaean Greece developed along the Eastern path, and only in Homeric Greece did the features of “Western” development begin to emerge, more clearly manifested in archaic Greece. The author concludes that such a “Western” emerged as a result of historical coincidence. The author turns to the similarities between the Eastern and Western paths of development, reinforcing them with examples from the history of Ancient Mesopotamia, Ancient Egypt, and Ancient China. The author pays special attention to the ancient Chinese model of statehood as a special kind of transformation of the supreme power. Many scholars record the presence in Ancient China in the 8th–7th centuries B.C. of the socio-political and political-administrative system typologically like the one that existed in Western Europe in the 11th–13th centuries. Ryabinin asks the question: “Why did this socio-political and politico-administrative system in Ancient China cease to exist?”. By the 8th–7th centuries, the Chinese state practice during the time of confrontation with the barbarians developed a new model of the political system and mobilization economy which did not allow the Chinese society to rebuild and avoid the format of a despotic regime. According to the author, the concept of “feudalism” in terms of relations within the ruling stratum does not belong exclusively to Western Europe. “Feudalism” as a system of vassal-loyal relations, for example, can also be observed in certain areas of India. Accordingly, the uniqueness of the European way of developing political systems lies not in democracy but something else. The paper emphasizes that this peculiarity is the priority of the wealthy people associated primarily with the market. It was those people who determined the main direction of the development of ancient society both in Classical Greece and in Republican Rome.
The Philosophy of the Civil-Military Relations in the Middle East
Authors: Ahmedov Vladimir M.
Published: December 2021

The Army has played a significant role in the contemporary history of the Middle Eastern states. This fact was determined not only by the frequency of wars and military crises but mainly by the role of the military in domestic politics. In the past few decades, the army and security apparatus presented a focal point of Arabian countries’ politics. The military was the center of the power and decision-making mechanism in Middle Eastern countries. In the 1980–1990-s Arab rulers managed to curb the appetites of their military for power and military coups. Further developments of “Arab spring” proved this tendency wasn’t irreversible. The author studies universal Russian and Western methodological and theoretical approaches and criteria for examining civil-military relations. Based on the given results the author attempted to work out an original model for studying the civil-military relations in the Middle Eastern countries regards specific of its developments and in view of the special characteristics of the Arabic society. The main attention is paid to historical preconditions for the formatting of the armed forces in Arab countries. The author also examines the interaction between politics and military, military and society and tries to show the main reasons behind the army’s seizure of power in many Arab countries from the social, political, and economic backgrounds of military rule. The criteria of the civil control under the military and different approaches for preventing army’s intervention in politics are in the focus of this article. The author stresses the role of the national and religious factors in the system of civil-military relations. The role of the ruler and ruling élites in determining the behavioral patterns of the military are the subject of the author’s investigation as well.
The Two-Faced Janus of Radicalization. Heretical Thoughts. Based on the Work of Dr. Arne Seifert
Authors: Starodubrovskaya Irina V.
Published: December 2021

The paper continues discussion with the ideas expressed in Dr. Arne Seifert’s work “Civil Opposition to Religious Radicalism in Central Asia” (2020) which has started in the previous issue of the journal. The author doubts that expansion of Islamic fundamentalistic views means the inspiration to go back to the norms of the Middle Ages. Instead, this process is treated as a conflicting unity of archaization and modernization similar in its essence with the Protestant Reformation in Europe. The author’s proposals how to confront radicalization are based on the concepts described in the article. The main ideas are to involve Muslims in civil society activities preventing both their isolation and their involvement in violent practices, to intensify their contacts with secular civil society groups and movements, to expand their opportunities to accept modernity on their own terms. The author illustrates the productivity of such approaches using examples from the civil society activities in the North Caucasus including those projects where the author herself was involved.
Neermahal — the Jem of Tripura
Authors: Stolyarov Alexander A.
Published: December 2021

The publication tells a story about a visit to the summer palace of the last rulers of the Tripura princely state, which is now a remarkable place of interest at the Tripura state in northeastern India. The palace is located on the island in the middle of the Rudrasagar Lake and can only be reached by boat. The current state of the palace is described as an object of cultural and historical heritage, and of a lake, classified as a nature conservation object of international importance. The opinions of experts on the measures to preserve the ecological balance in this part of the state of Tripura are given.
Himalayan Institute of Academic Research ‘Urusvati’: History and Modernity
Authors: Lebedenko Anatoly A.
Published: December 2021

The article covers issues related to the history of the establishment of the Urusvati Institute by the Roerichs in India in 1928, its multifaceted activities, directions of scientific research, cooperation with famous scientists, scientific centers, museums, and libraries from different countries of the world. The management of the Institute aimed to introduce into the scientific sphere the results of extensive research discovered and collected by the Roerich family in 1924–1928 on the route of the Central Asian expedition, and on this foundation to comprehensively continue the research begun. The initiative to open a special scientific institution in India by the Russians cannot be considered an accident. Russian Orientalists and Travelers in the 19th–20th centuries actively explored the little-explored expanses of Asia. The circle of their interests lay in the area of that ancient and direct path that connected the peoples of Southeast Asia with Russia through Siberia and the Tibetan plateau in the direction of India. The study of the possibilities of direct communication between Russia and India through Tibet in the past, present, and future brought the Roerichs closer to Indian culture and drew their attention to the problems associated with Russian-Indian cultural and scientific cooperation. Therefore, the organization of an independent research center on Indian territory having such goals as its object was of paramount importance for the Roerichs. Despite the remote geographical location of Urusvati from Russia, the Himalayan Institute contains all the features inherent in Russian centers of science and culture. This largely determined its international specificity and provided a unique example of the synthesis of two countries’ cultures: Russian and Indian ones. The author touches upon the problem of this City of Knowledge revival in the 21st century.
Screening of Auditory Processing Disorders in School- Aged Children in Tehran, Iran Using the Auditory Processing Domain Questionnaire
Authors: Jarollahi Farnoush , Pourbakht Akram , Jalaie Shohreh , Oruie Mahbobeh
Published: December 2021

Background and Aim: Early detection of auditory processing disorders (APD) is essential for preventing learning and educational problems in school-aged children. It is crucial to take into account the comorbidity with APD, as well. The goal of APD screening is to obtain the basic information about those with auditory disorders to be referred for further evaluation. This study aimed to identify the elementary school students at risk of APD in Tehran, Iran.
Methods: Participants were the parents of 536 children selected from 11 elementary schools in four districts of Tehran city. The schools in each district were selected by a random clustering method. The auditory system of students was first evaluated. The parents were then asked to complete the Persian version of the auditory processing domain questionnaire (APDQ).
Results: The prevalence of APD was 3.3% in girls and 8.3% in boys and the difference between them was statistically significant (p=0.021). The overall prevalence of APD was 4.6% based on the cut-off points of four APDQ domains, with a male-to-female ratio of 2.6.
Conclusion: It is necessary to screen APD in school-aged children to minimize learning and educational problems in them. Moreover, there is a need for developing screening methods to provide timely detection and appropriate intervention for those at risk of APD.
Assessment of Distortion Product Otoacoustic Emissions Input-Output Function in Individuals with and without Musical Abilities
Authors: Sannamani Kavitha Gurunathgowda , Chakraborty Madhumanti , Devi Neelamegarajan , Prabhu Prashanth
Published: December 2021

Background and Aim: Musical  training  has shown to bring about superior  performance  in several auditory and non-auditory tasks compared to those without musical exposure. Distortion product otoacoustic emissions (DPOAE) input-output function can be an indicator of the non-linear functioning of the cochlea. The objective of this study was to evaluate and compare the differences in the slope of DPOAE input-output function in individuals with and without musical abilities.
Methods: Twenty normal-hearing individuals were considered in the age range of 18–25 years. They were divided based on the scores obtained on the questionnaire of musical abilities, as individuals with and without musical abilities. DPOAE input-output function was done   for each of the two groups. The slope of the DPOAE input-output function was compared at different frequencies between the groups.
Results: The results of the Mann Whitney test revealed that the slope was significantly steeper at 2000, 3000, 4000 and 6000 Hz in individuals with musical abilities. There was no significant difference in slope at 1000 and 1500 Hz.
Conclusion: The increased steepness of the slope indicates a relatively better functioning     of the cochlea in individuals with musical abilities. The enhanced perception of music may induce changes in the cochlea resulting in a better appreciation of music.
Development of a Training Software to Improve Speech- in-Noise Perception in the Elderly with Noise-Induced Hearing Loss
Authors: Rasouli Fard Parisa , Jarollahi Farnoush , Sameni Seyyed Jalal , Kamali Mohammad
Published: December 2021

Background and Aim: The incidence of noise-induced hearing loss (NIHL) is increasing rapidly worldwide. It has been shown that the long-term exposure to noise leads to permanent hearing loss. There is currently no treatment for NIHL and it is mainly managed by preventive measures. This study aimed to develop a training software to improve speech-in-noise (SIN) perception in the elderly suffering from mild-to-moderate NIHL due to temporal fine structure (TFS) damage.
Methods: This is a non-randomized clinical trial conducted on 8 older men aged 60-75 years (Mean age = 68 ± 4.5 years) with mild-to-moderate NIHL at high frequencies (43.75±6.0 dBHL) with at least for five years of work in noisy environment. They received rehabilitation using a researcher-developed training software targeted TFS for five weeks. To assess the efficiency of the training software, the signal-to-noise ratio for 50% correct scores (SNR-50%) was calculated using the word-in-noise test before and after the trial.
Results: The SNR-50% improved significantly in all participants from 13±2.63 dB to 6.10±2.85 dB (p<0.001). In the multiple linear regression model, the rehabilitation by the training software predicted 68% of improvement in SNR-50% (coefficient of determination=0.676).
Conclusion: Rehabilitation by the training software developed based on TFS can improve SIN. perception in the elderly with NIHL.