bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison outcome in management of femoral neck fracture using multiple cancellous screws with and without fibular graft
Authors: Teguh Wisesa I. Komang Indra , Suryanto Dusak I. Wayan
Published: August 2020

Multiple cancellous cannulated screw is preferred method in fresh cases of fracture neck of femur in young patients. Fibular strut graft is sometimes used along with multiple cancellous cannulated screws to enhance union and early restoration of function. We conducted a retrospective study to patients aged between 20-50 years old with femoral neck fracture treated with multiple cancellous screws either with or without fibular graft between the period of January 2016 to January 2018. We obtained total of six patients (five males and one female) with femoral neck fracture treated with multiple cancellous screws either with or without fibular graft. All fractures were garden type II-IV fresh femoral neck fractures. The functional outcome based on Harris hip score was excellent for all patients. The mean time of full weight bearing was 16±8 weeks in both multiple cancellous screws without fibular group and multiple cancellous screws with fibular group. The mean time of union was also 16±8 weeks in both groups. There is no complication such as non-union, avascular necrosis of femoral head and/or broken fibular graft in both the groups occurrences. Fixation with cancellous screws and fibular strut grafts for femoral neck fractures is cost effective and technically less demanding and associated with good outcomes. There is no added advantage of non-vascularized fibular grafting with multiple hip screw fixation in fresh femoral neck fractures in young adults over multiple hip screw fixation alone.
Transcatheter closure of ventricular septal defect from retrograde transarterial approach: immediate and long-term outcome
Authors: Fatema Nurun Nahar
Published: August 2020

Background: Ventricular septal defect (VSD) is a commonly encountered congenital heart defect. The aim of this study was to analyze five years’ experience with patients who had undergone transcatheter closure of VSD using retrograde transarterial approach.Methods: It was a retrospective study conducted from December 2014 to December 2019. Cases planned for VSD closure in retrograde approach were included. A total of 147 cases fulfilled the criteria after left ventricular angiography and procedure was performed without forming arteriovenous loop. Follow up was planned at 1, 3, 6, 12 months and yearly thereafter.Results: The mean age of the patients was 5.94±4.67 years and mean weight was 17.93±8.26 kg. Perimembranous VSD was present in 70.06% cases and the size of the VSD was 5.5±1.8 mm. Amplatzer duct occluder II was the commonest device used (55.24%). Mean device size was 6.2±1.8 (5-8 mm). Complete occlusion was achieved immediately in 94.56% cases, and after one month in 99.36% cases. Four (2.78%) cases were postponed for malpositioning and encroachment of aortic valve. One patient (2.22%) had tiny residual VSD up to 3 years follow up. Bacterial endocarditis was noticed in one patient (0.80%) at one year follow up. No evidence of complete heart block was encountered in follow up period of six to 60 months.Conclusions: This study recommends that retrograde transarterial approach for closure of moderate to small VSD is safe, effective, and minimally invasive, can be performed in short time with less radiation hazard and less trauma to conducting tissues.
Visual perception skill profile pattern in children with learning disorder
Authors: Patel Ankita , Gajre Mona , Bhandarkar Prashant , Parlikar Vyankatesh
Published: August 2020

Background: Visual perception skill related problems are important in poor academic performance in learning disability (LD) children. Visual perception skill often not tested in LD children. The objective of the study is to explore visual perception skill pattern among children with learning disorder.Methods: Retrospective observational study was conducted at LD clinic of tertiary hospital. Children diagnosed with learning disorder were includes. Visual perception data were collected using predefined standard questionnaire of third edition total visual perception score (TVPS-3). Trained medical professional collected the details.Results: Total 103 children diagnosed with LD were evaluated for TVPS-3. Majority of the children had all three learning disorders-dyslexia, dysgraphia and dyscalculia. 58.42% children had co-morbid attention deficit hyperactivity disorder. From the 7 subtests of the TVPS visual discrimination, visual memory, form constancy and visual figure - ground affected more in boys and also in lower age children.Conclusions: Assessment of visual perception skill in children with learning disorder is crucial. Visual perception rehabilitation with other management of LD can benefit the overall functionality of these children.
Survival analysis of people living with human immunodeficiency virus: a study in a teaching hospital
Authors: Devi S. Bhagyabati , Singh T. Jeetenkumar , Singh Kshetrimayum Birendra , Singh N. Biplab , Ningshen Robinson , Singh Thiyam Brojendro
Published: August 2020

Background: Antiretroviral therapy (ART) have changed the outlook of people living with HIV (PLHIV) by transforming the dreaded infection to a chronically manageable disease. However, there is scant of reports which analyses quantitatively the survival benefit of PLHIV under ART. Objectives of this study were to determine the survival time of adult PLHIV who are on ARV. To analyse the factors determining survival outcome of PLHIV on ARV.Methods: This was an observational study in centre of excellence (COE) ART Centre, RIMS, Imphal from April 2004 to December 2009. Details from the data entered in documents of the ART programme were followed up every 3 months for 60 months from the date of initiation of ARV. All PLHIV above 18 years of age and undergoing antiretroviral therapy were included.Results: Survival rate following initiation of ARV was found to be significantly high among PLHIV. Higher CD4 count at the time of ARV initiation had better prognosis. Mortality was high among IDUs and they had high incidence of co-infections with HCV and HBV. The currently available ARV drugs under NACO programme have better suppression of HIV, are less toxic, low pill burden. The combined regimen used in the earlier days were not much inferior to the current ARV drugs if initiated timely with proper prophylaxis of OIs, good adherence, good nutrition and timely management of toxicities and IRIS.Conclusions: Timely treatment with ARV drugs provided under the national programme with good adherence and regular follow-up improves the survival of PLHIV.
Serum vitamin B12 and homocysteine levels in type 2 diabetes patients on metformin
Authors: Lala Kunal , Lala Divya , Duggad Saurabh
Published: August 2020

Background: Metformin is reported to induce vitamin B12 deficiency, however India data is limited. The present study was conducted to assess the vitamin B12 and homocysteine levels among type 2 diabetes mellitus patients taking metformin.Methods: The present observational study included 60 patients with diabetes mellitus, 30 patients on metformin therapy (at least 6 months) and 30 patients not on metformin use. Laboratory investigations were sent for vitamin B12, homocysteine and HbA1c.Results: Mean vitamin B12 level was 159.67±95.73 and 510.73±206.18 pmol/l in the metformin and non-metformin group respectively (p value <0.001). Serum homocysteine levels were found to significantly higher in the metformin group as compared to non-metformin group (17.39±4.97 vs 14.43±2.43 µmol/l, p value <0.01). Folate levels were similar in the two study groups (22.71±3.67 vs 27.54±2.83 mmol/L). Haemoglobin A1c levels were significantly higher in the metformin group as compared to non-metformin group (7.85±0.97 vs 7.25±0.80 respectively). Triglycerides, high density lipoprotein and total cholesterol levels were found to be similar between the two study groups. However, low density lipoproteins were significantly higher in the metformin group as compared to the non-metformin group (3.7±0.92 vs 3.4±0.86 mmol/l).Conclusions: Our results show metformin use in type 2 diabetes mellitus patients was associated with significantly lower vitamin B12 levels and significantly high homocysteine levels.
A comparative study of temporalis fascia grafting techniques in cortical mastoidectomy with type 1 tympanoplasty patients in tertiary care hospital
Authors: M. Gowrishankar , K. Athiyaman , V. Suresh , R. Gayathiri , S. Natarajan
Published: August 2020

Background: Chronic otitis media is a highly prevalent middle ear disease in the developing countries which causes various pathological changes in the tympanic membrane and middle ear. Treatment of chronic otitis media involve medical and surgical methods. There are many surgical techniques followed regarding the grafts used, temporalis fascia remains the most commonly used. There are some studies debating the usefulness of dry grafts and wet grafts. Our study is aimed at comparing the both and evaluating the outcome.

Methods: A prospective comparative study conducted in the department of Otorhinolaryngology and Head and Neck surgery, Government Stanley Medical College, Chennai, with 64 patients for the period of 1 year from July 2017 to June 2018.

Results: Graft uptake of temporalis fascia in dry group is 93.8% and wet group has graft uptake of 87.5%, failure rate is low in dry group when compared with wet group. And also, this study showed higher graft uptake in small and medium sized perforation (95%) than the larger perforation (87.5%) and also there is no relationship between the duration of inactive stage and the graft uptake has been observed in our study.

Conclusion: Temporalis fascia is a reliable graft material for reconstruction of tympanic membrane perforations. In our study dry graft has shown more success rate than the wet graft. Hearing improvement was the same in dry and wet group in which the grafts have been up taken well.
Effect of pre-incisional infiltration of 0.5% ropivacaine versus placebo in post-operative pain relief among patients undergoing tonsillectomy under general anaesthesia: a comparative study
Authors: Meshram Sushil Namdeorao , Walthare Ankesha Ghanshyam , Sonone Jayant Krishna , Kumar Alok
Published: August 2020

Background:  Pain is the most common complaint in the immediate post-tonsillectomy period. Inadequate post-tonsillectomy pain management has many drawbacks. Ropivacaine is a new long acting local anaesthetic, structurally closely related to bupivacaine.

Methods: It was a prospective double blinded randomized control trial on a total of 50 patients who were posted for tonsillectomy. Randomization of each patient was done into two groups one of which had received 4 ml of 0.5% ropivacaine hydrochloride solution and other 4 ml normal saline. Data entry and analysis was done with (SPSS IBM) version 21.0. Both univariate and bivariate analysis done. Proportions were calculated for qualitative variables and mean with standard deviation was done for quantitative variables. Required tests of significance such as Chi square test and independent test were applied. Significance of p value is taken as p<0.05. Postoperative pain, first post op oral intake, duration of post-operative hospital stay, and postoperative haemorrhage was assessed. The intensity of postoperative pain was assessed on behavioural observational pain Scale and Wong baker faces pain rating scale.

Results: Pre-incisional infiltration of 0.5% Ropivacaine was an effective method to reduce post-operative pain in patients undergoing tonsillectomy under GA. Effect of  Ropivacaine was statistically significant (p<0.05).

Conclusions: We recommend the use of 0.5% ropivacaine pre-incisional infiltration in patients undergoing tonsillectomy.
Inflammatory characterization of different non-allergic rhinitis in patients attending tertiary care hospital
Authors: Sharma Ashish , Pyadala Nagababu
Published: August 2020

Background: Non-allergic rhinitis is a chronic inflammation of nasal cavity, which can be classified based on the level of eosinophil. Thus, the present study aimed to characterize the various types of non-allergic rhinitis.

Methods: This study conducted during the period of 1 year from April 2019 to February 2020 in the ENT department of MNR Medical College and Hospital, Sangareddy. A total of 60 participants were enrolled in this study.  

Results: In case of non-allergic rhinitis, the nasal IL-17 level was 27.31±5.1, IL-4 level was 44.24±21.31, as well as serum IL-4 and IL-17 level was 50.1 and 31.06 respectively. The control group IL-4 and IL-17 level were respectively less (p<0.05). But the IL-10 level (3.7) and proportion of tregs in peripheral blood (5.2) were lower than the control group (p<0.05). There was no significant difference found between the non-allergic rhinitis group and allergic rhinitis group or the non-allergic rhinitis without eosinophilia group and the control group (p>0.05).

Conclusions: Hence, the non-allergic rhinitis was classified on the basis of eosinophil level, allergic rhinitis and NARES had similar kind of inflammatory response, but two different types of non-allergic rhinitis had different inflammatory characteristics. Therefore, it is recommended to classify the rhinitis on the basis of eosinophil level.
Disability prevention with early screening and intervention among children with congenital clubfoot in India
Authors: Aggarwal Alisha , Aggarwal Anisha
Published: August 2020

Background: Congenital clubfoot has an incidence of 1-9/1000 live births. Untreated clubfoot leads to physical, social, psychological, and financial burden on the family and society. Early intervention can prevent disability in the future. The aim of this study is to assess the effectiveness of an early intervention and conservative management to treat congenital clubfoot and prevent disability.

Methods: We conducted a retrospective analysis at an urban multispecialty hospital in North India among children with a diagnosis of congenital clubfoot managed with Ponseti technique (manipulation, casting, tenotomy and bracing). Descriptive statistics and chi-square test were used to measure association between variables.

Results: We had a total of 125 feet (41 bilateral, 43 unilateral). 78.5% (n=66) children were below 12 months of age with a mean age at diagnosis of 7.8 months. 70.2% (n=59) children were corrected with less than 5 casts to achieve complete correction. Tenotomy was required in 69% of children (n=58) and was statistically significant. A 100% success rate was achieved in our study.

Conclusions: Early intervention is essential to correct idiopathic/ congenital clubfoot, prevent disability and improve quality life in adulthood. National programs with a focus on prevention, surveillance, advocacy, and research are vital for universal health coverage.
Radiological and functional outcome of displaced mid-shaft clavicular fracture managed with open reduction and internal fixation with precountered anatomical clavicular locking plate: a prospective study
Authors: Panthi Sagar , Shrestha Rishiswor , Shakya Rajan
Published: August 2020

Background: Displaced mid-shaft clavicular fractures are treated by conservative methods which shows higher rate of malunion and non-union with suboptimal outcomes. Fracture fixation by pre-countered anatomical clavicular locking plate avoids these complications. This study aims to assess the radiological and functional outcome after open reduction and internal fixation by pre-countered anatomical clavicular locking plate.

Methods: Fifty patients of mid-shaft clavicular fractures with age group of 18 to 60 years were treated with open reduction and internal fixation with precountered anatomical clavicular locking plate from, in the span of November 2018 to May 2020. All the patients were followed up for six months for the study. Final functional outcome was assessed in six months.

Results: All the fractures united at the average time of 16.32±2.37 weeks. Mean Constant and Murley score was 96.0±5.20. The outcome was graded as excellent in 45 (90%), good in 4 (8%) and fair in 1 (2%) patients.

Conclusions: Hence displaced mid-shaft clavicular fractures can be treated with by precountered anatomical clavicular locking plate.
Impact of age, gender and body mass index on the efficacy of tranexamic acid in total knee arthroplasty
Authors: Viegas Rui , Kumar Abhishek , Carvalho Maria M. , Vide João , Fontes Ana P. , Sousa João P.
Published: August 2020

Background: Tranexamic acid (TXA) is effective and safe in decreasing blood loss and transfusion rate in total knee arthroplasty (TKA). Few studies focused on the role of patients’ characteristics on the efficacy of TXA in TKA. The purpose of this study was to conduct a retrospective analysis to investigate if age, gender and BMI influence the efficacy of TXA in reducing perioperative blood loss in TKA.

Methods: We did an observational study including 366 consecutive patients undergoing TKA in Hospital Particular do Algarve between January 2011 and April 2019 which were divided in two groups: intraoperative administration of intravenous TXA (TXA Group) and no administration of TXA (Control Group). The perioperative blood loss between groups and their relation with age, gender and BMI was compared.

Results: Of the 366 patients, 225 (61%) received TXA. In both groups, age did not correlate to the blood loss. Women in the TXA group had less perioperative blood loss than in the control group. No such difference was found for men. The normal weight group showed no difference in perioperative blood loss with or without TXA administration. However, there was a statistically significant difference in the overweight and obese groups. The mean perioperative blood loss was higher in the control group (854±342 ml) than in the TXA group (720±335 ml).

Conclusions: TXA administration is efficient in controlling TKA associated hemorrhage in overweight and obese individuals and in women but it doesn’t have that effect in normal weight patients or in men.
Outcome analysis of surgical management of type 2, 3a and 3b open fractures of distal 2/3rd tibial diaphysis using external fixators
Authors: Thomas Dibin K. , S. Nishara M.
Published: August 2020

Background: There is confusion regarding ideal fixation method for intermediate grades of open fractures of tibia. In distal 2/3rd of tibia the blood supply is precarious and so it further increases the confusion. Purpose of this study is to evaluate effectiveness of external ﬁxator as deﬁnitive treatment in these fractures.

Methods: 55 patients with type2, 3A or 3B open fractures of distal 2/3rd tibia were studied. External fixator applied at the time of debridement is removed and cast applied once wound is healed. Follow up at 1, 3, 6 and 9 months recorded. Union assessed using rust scoring system. Functional outcome assessed using Modified Functional Evaluation System by Karlstrom- Olerud after patients are mobilized.

Results: Union rate was 74.5%.Functional outcome was satisfactory in 34%, moderate function in 32% and good function in 24.4%. In 7.3% the function was poor. Only one case gave excellent function.

Among diabetic patients 71.4% developed wound infection and all developed pin tract infection showing strong association between diabetes and infection.

Conclusion: Though external fixation followed by serial casting technique gave fare outcomes, there is scope for better results and so the option of other methods of treatment should not be excluded. There is a significant association between diabetes and infection and so special care and covigilance is advised in diabetic patients.
A prospective study of distal 1/3rd tibia fracture treated using locking compression plate by minimally invasive percutaneous plate osteosynthesis technique
Authors: Vikranth P. S. , Varenya N. Vamshi
Published: August 2020

Background: Distal tibia fractures are common and represent 6-8% of all lower limb fractures treated by an orthopaedic surgeon. Anatomical reduction with good fracture stability and minimal soft tissue dissection give good functional results. Locking compression plate combined with minimally invasive percutaneous plate osteosynthesis (MIPPO) technique has yielded good results. In this prospective study, authors studied 30 patients treated with LCP using MIPPO technique to know the functional outcome.

Methods: A total 30 patients were studied in this technique, which include both male and females of different age groups treated with LCP using MIPPO technique. All the patients were followed up for 12 months between March 2018 to March 2019 in orthopaedic department. The functional and radiological outcomes were assessed.

Results: A total 30 patients both male and females were studied with age groups between 18 to 65 years. Average follow-up was 12 months using Olerud and Molander scoring system authors had excellent results in 16 patients (54%), good in 9 patients (30%), fair in 4 patients (12%) and poor outcome in 1 patient (4%).

Conclusions: Surgery with locking compression plate along active physiotherapy proved to be better for distal tibia fractures.
Assessing the prevalence of various modes of injury and type of malleolar fractures based on Lauge-Hansen classification presenting at a tertiary care center
Authors: Jagiasi Jairam D , Upadhyaya Mohit R. , Rai Pranjal
Published: August 2020

Background: Ankle fractures represent approximately 9% of all fractures and are a common occurrence with an incidence of 138-169 per 100,000 per year. The mechanism of injury differs in terms of mode of injury in various age groups. The Lague-Hansen classification is a pathologic-anatomic classification and emphasizes different stages of ligamentous injury, in addition to the fracture pattern, and provides options for fracture treatment.

Methods: A retrospective observational study, where the prevalence of various types of ankle fractures were classified according to the Lauge-Hansen Classification, in the period of 2018 onwards till date. The mode of injury and age group of the patient was also noted.

Results: A total of 84 patients were analyzed, supination-external rotation (48.7%) were the most frequently observed fractures in our study population, with no significant correlation between mode of injury and fracture pattern noted. There was a statistically significant association (p<0.05) between the velocity of injury and the age groups suffering ankle trauma.

Conclusion: The Lauge-Hansen Classification continues to be an important tool in assessing the biomechanics of ankle fractures and the management options available, especially in a country like India where more expensive imaging modalities may not be available or affordable at times. Our study also highlights that high velocity fractures continue to be a major cause of morbidity in the younger age group, especially in developing countries such as India. Stringent traffic rules and public awareness need to be put into practice to reduce the toll of this problem.
Efficacy of local anaesthetic cocktail infiltration in a total knee replacement: a prospective, randomized study
Authors: Kulkarni Ameya U. , Kulkarni Umesh M.
Published: August 2020

Background: The aim of this study is to assess the efficacy of local anaesthetic cocktail infiltration in pain management during a total knee arthroplasty.

Methods: In this study we had 25 patients each in study and control group. The study group was infiltrated with the local anesthetic cocktail just before final implantation. Pain was documented by a visual analogue scale in a double blinded manner. Statistical significance was calculated using an unpaired “t” test.

Results: In study group, pain levels were significantly lower as compared to control group for the first 48 hours after surgery with a ‘p’ value of 0.0224 (<0.05). The need of intravenous tramadol for breakthrough pain on the second day was significantly lower in study group as compared to control group with a ‘p’ value of 0.033(<0.05).

Conclusions: This study shows that the local high volume anaesthetic infiltration is effective in reducing immediate postoperative pain and the need of IV opioids for the first 48 hours after surgery.
Importance of calculating various casting indices in predicting radiological outcomes of paediatric forearm fractures
Authors: Kharbamon Pyntngen , Sheth Binoti A. , Pawar Pankaj , Parekh Siddhart , Jaiswal Rishabh , Kanade Umesh
Published: August 2020

Background: The present study is aimed at determining the importance of various casting indices in predicting the outcome of paediatric forearm fractures treated with closed reduction and plaster application in our department.

Methods: Thirty children, aged 5 to 15 years, with closed forearm fractures not requiring surgical fixation were included to assess their casting indices and radiological outcomes using X-rays. After satisfactory casting, patients were followed up weekly till 6 weeks with anteroposterior (AP) and lateral X-ray.

Results: Acceptable reduction was achieved in 26 cases, while re-manipulation was done in 4 cases. Cast Index ranged from 0.80±0.09 at first week to 0.78±0.09 at 6 weeks, Padding Index was 0.30±0.04 at first week and increased to 0.31±0.03 at 6 weeks, Canterbury Index was 1.07±0.24 at first week and 1.07±0.78 at 6 weeks, Gap Index 0.15±0.02 remained the same throughout, and Three Point Index changed from 0.81±0.08 at first week to 0.77±0.18 six weeks. Radial bow of children showed no significant change at various time points of assessment. Rotational mal-alignment was observed in 5 patients, one had a 0.5 cm radial overlap, while none had an ulnar overlap. Radial angulation was observed in five and six children on AP and lateral X-ray respectively. Ulnar angulation was seen in two and one child on AP and lateral X-ray respectively.

Conclusions: Continued use of these casting indices to assess paediatric forearm cast adequacy is supported by this study.
Functional outcome of patients undergoing open rotator cuff repair
Authors: Savio Albin , S. Nishara M.
Published: August 2020

Background: Rotator cuff tears are a common source of shoulder pain. The incidence of rotator cuff damage increases with age and is most frequently due to degeneration of the tendon rather than injury from sports or trauma. Rotator cuff tear can be treated arthroscopically, arthroscopically assisted (mini-open) or by an open procedure. Because of the technical demands of arthroscopic repair many surgeons consider open repair for the treatment of rotator cuff tears. This study was done to evaluate the functional outcome of shoulder after open rotator cuff repair.

Methods: 26 patients with partial and complete rotator cuff tears underwent open rotator cuff repair and acromioplasty. Cases were followed up at 3 months and 6 months intervals and shoulder function was assessed using Constant-Murley scoring system and compared with the preoperative scores and analyzed using SPSS software.

Results: Mean preoperative constant score was 33.95±7.545 while the mean constant score at 6 months post-surgery was 79.83±8.51 which was highly significant according to paired t test. The difference between preoperative, 3 months and 6 months constant scores of complete and partial tear patients was found to be statistically significant.

Conclusions: There was highly significant increase in Constant-Murley score after 6 months in patients treated by open rotator cuff repair. Open repair still stands as an effective treatment for rotator cuff tears and doing acromioplasty during the procedure adds to better outcome after surgery.
Difficult diagnosis of a neurogenic thoracic outlet syndrome and review of the current literature
Authors: Rosa Joao Maia , Sousa Arnaldo , Fonte Helder , Pereira Eva , Sapage Rita , Trigueiros Miguel
Published: August 2020

Thoracic outlet syndrome (TOS) is an uncommon disorder, without a clear clinical presentation or a fully accepted definition. The patients usually present a set of symptoms arising from compression of the brachial plexus or subclavian vessels during their passage through the thorax, between the base of the cervical region and the axilla. The authors present a case of a 20 years old woman with sporadic paresthesia in the territory of C7-T1 nerve root. At the physical examination she had a positive Wright's test. The imaging studies revealed the presence of a right cervical rib. A partial rib resection was performed with exploration of the braquial plexus and at the current follow up; 24 months after the surgery, the patient is asymptomatic. Our objective is to present a case of TOS and to highlight the clinical-management and treatment challenges of this pathology.
Intrapelvic migration of the hip screw of a proximal femoral nail: report of two cases and review of the literature
Authors: Abdalla Mazen A. , Oikonomou Leon T. , Giannikas Konstantinos A.
Published: August 2020

Two cases of medial migration of the hip screw in cases of cephalon-medullary nailing for the treatment of extra-articular proximal femoral fractures are reported. The first case was revised to hemiarthroplasty, that was subsequently complicated with infection and death of the patient, while the second was revised to a similar devise with favorable outcome. A review of the literature is performed in order to identify the contributing factors that result in the medial migration of the hip screw. Emphasis is given in further reporting of similar cases in order to abolish this potentially lethal complication.   
Surgical excision of a solitary osteochondroma arising from the lesser trochanter in an adult: a case report
Authors: Keny Swapnil , Dahapute Aditya , Shah Swapneel , Marathe Nandan
Published: August 2020

The occurrence of osteochondroma around the proximal femur is rarely reported as most cases are asymptomatic. We report a rare case of symptomatic solitary osteochondroma arising from the lesser trochanter in a skeletally mature patient causing significant impairment of hip function managed by surgical excision. A 32-year-old male labourer presented with pain and swelling over right hip region for nine months. Radiographic examination (X-ray, MRI, CT) revealed the pathognomonic continuity of the cortex and medulla of the lesion with the parent bone. Cartilage cap cover (measuring 15 mm) on MRI helped to clinch the diagnosis. CT guided biopsy was also suggestive of osteochondroma. The tumour was excised en bloc by posterior approach without the need for hip dislocation. The base of the lesser trochanter was osteotomised and the entire mass with the cartilage cap was removed. A two year follow up has shown no evidence of local recurrence. Surgical excision of a symptomatic osteochondroma is a successful form of treatment with low mortality. Adequate pre-operative radiographic examination is helpful to know the location and local spread of the tumour. Measurement of cartilage cap thickness on MRI is an essential tool to diagnose malignant changes. A safe and adequate resection should be carried out in an effective manner with attention to femoral head vascularity and prevention of local recurrences. Patients with solitary osteochondroma around the proximal femur should be kept under observation to help early detection of malignant changes.
Tuberculosis of sternoclavicular joint: a rare case report
Authors: Lal Atil Kumar , Kushwaha Sudhir Shyam , Bharti Ajay , Pandey Mahima
Published: August 2020

Osteoarticular tuberculosis comprises 10-15% of the all cases of extrapulmonary tuberculosis. Tubercular involvement of the sternoclavicular joint is very rare. We hereby present a rare case report of the 38 year old female with sternoclavicular joint tuberculosis with cold abscess. The diagnosis was confirmed by FNAC and on ZN staining AFB was isolated. Patient was managed successfully by the anti-tubercular therapy at the end of the treatment. So, a degree of suspicion of the tuberculosis at these rare sites along with investigation followed by anti-tubercular therapy leads to successful treatment of the disease.
Diagnostic dermoscopic features and the correlation between dermoscopic and histopathologic features in lichen planus
Authors: Jose Sherin , Kurien George
Published: August 2020

Background: Lichen planus (LP) is an autoimmune dermatosis characterized by pruritic violaceous flat-topped polygonal papules predominantly over the extremities but can also affect trunk, mucosa, scalp, palms, soles and nails. Dermoscopy is a novel non-invasive imaging modality and the presence of salient dermoscopic features will help to obviate the need for skin biopsies in many doubtful cases.

Methods: This was a descriptive study of 108 cases of classical lichen planus cases conducted at a tertiary care hospital in South India over a period of one year. Dermoscopic examination of the LP lesions were carried out using DermLite DL3N and histopathological samples were analyzed in 35 cases.

Results: The dermoscopic features were blue globules in 100%, Wickham’s striae in 92.6% and comedo like openings in 49.1%. Vascular patterns were noted only in 13%. On correlating Wickham’s striae in dermoscopy with wedge shaped hyper granulosis on histopathology using the chi-square test we found agreement (kappa value 0.242). We also found that dermoscopy was 93.75% sensitive and 33.33% specific regarding Wickham’s striae in relation to wedge shaped hyper granulosis. In 85% of cases blue globules were present dermoscopically and dermal melanophages were found histopathologically.

Conclusions: Wickham’s striae can be considered as a diagnostic dermoscopic finding in lichen planus whereas findings like bluish pigmentation and vascular structures depended on the skin colour of the patient. We also found agreement between dermoscopic and histopathologic features namely Wickham’s striae with wedge shaped hyper granulosis and blue globules with dermal melanophages.
Clinico-investigation on epidemiological study in 119 Indian cases of melasma
Authors: Pangti Rashi , Mendiratta Vibhu , Chander Ram , Malik Meenu
Published: August 2020

Background: Melasma, a multifactorial disease, constitutes the most common facial melanosis in Indian population.

Methods: 119 cases of melasma aged 18 years or above were enrolled. Detailed history, examination and laboratory investigations were done.

Results: 20 (16.8%) were males and 99 (83.2%) females. Mean age was 35.25 years. Disease duration was more than 1 year in 102 (85.7%), 6 months to 1 year in 10 (8.4%) and less than 6 months in 7 (5.9%). 22 (18.49%) had occupation-related increased duration of sun-exposure 19 (86.3%) or heat-exposure 3 (13.6%). 79 (66.4%) had skin type IV, 26 (21.8%) type III, 14 (11.8%) type V. Centrofacial was commonest distribution pattern in 87 (73.1%), malar in 30 (25.2%), mandibular in 2 (1.7%). Mean duration of daily sun-exposure was 53.36 minutes (male-124.75, female-38.94). Mean Melasma Area and Severity Index (MASI) score was 11.602. There was significant association between MASI and skin type (p<0.001). Other etiological factors were: Oral Contraceptive Pills (OCPs) use in 17 (17.17%), melasma during pregnancy in 39 (39.4%), family history of melasma in 24 (20.2%), hair dye use in 66 (55.5%), cosmetics use in 19 (16%), mustard oil use in 31 (26.1%), mustard oil along with other oil(s)’ use in 39 (32.8%). Laboratory investigations revealed anemia in 60 (50.42%), dyslipidemia in 73 (61.34%), abnormal thyroid function test in 26 (21.85%), serum vitamin B12 deficiency in 35 (29.4%) and vitamin D deficiency in 94 (79%).

Conclusions: Higher skin phototypes should be cautious about general measures and associated risk factors (hair dye/oils, cosmetics). Increased daily sun-exposure, OCPs use, pregnancy, thyroid disorders are risk factors. Housewives and indoor occupations should be advised physical sunscreens for protection against infra-red radiation. Anemia, dyslipidemia, thyroid dysfunction, vitamin D and B12 levels can be assessed although their exact role in perpetuating/precipitating melasma needs further studies
Disseminated talaromycosis: an AIDS defining fungal infection
Authors: Devi Bijayanti , S. Sana , Meka Bharath , Raj Bhuvanesh
Published: August 2020

Talaromycosis is a systemic mycosis caused by Talaromyces marneffi. It mostly occurs as an opportunistic infection in patients with human immunodeficiency virus (HIV). In India, its endemic in Manipur. We report 3 cases of disseminated talaromycosis with skin eruptions in HIV sero-positive patients from Manipur.
Clouston’s syndrome: a rare case report
Authors: Karjigi Siddalingappa , Reddy G. Aishwarya , Herakal Kallappa C. , Reddy Vedasree
Published: August 2020

Ectodermal dysplasias are a heterogeneous group of disorders with primary defect in hair, teeth, nail and sweat glands with an estimated frequency of about seven per 10,000 births. Numerous types have been described and several classifications exist. Clouston’s syndrome (hidrotic ectodermal dysplasia) is a rare genodermatoses, characterized by a triad of nail dystrophy, alopecia and palmoplantar hyperkeratosis. Clouston’s syndrome is transmitted as an autosomal dominant trait and caused by mutations in the GJB6 gene (13q12), encoding the gap junction protein connexin 30 (CX30). At present, there is no treatment for the disease and management is purely supportive. The improved prognosis over time is likely due to greater recognition of the condition. In this report, a 23-year-old male patient with nail abnormalities and thickening of palmoplantar skin is reported. Anodontia of permanent dentition was present along with androgenic alopecia.
DIFERENÇAS DE GÊNERO NA DIABETES: UM PONTO DE PARTIDA PARA OTIMIZAR A QUALIDADE DE VIDA
Authors: Coelho Fernanda Monteiro , Masanet Erika
Published: August 2020

Objetivo: analisar as diferenças de gênero na qualidade de vida e indicadores antropométricos entre pessoas com diabetes tipo 2 (DM2) e sem DM2. Método: Estudo quantitativo de caráter transversal realizado no Centro Hiperdia de Viçosa-Minas Gerais, com 117 indivíduos diagnosticados com DM2 e 81 controles (CTL), com idade igual ou superior a 40 anos. Utilizou-se análise univariada para as variáveis sociodemográficas e  teste t de Student para comparação das médias na qualidade de vida e nos indicadores antropométricos. Resultados:  na presença da diabetes a qualidade de vida das mulheres piora em maior medida comparada à dos homens, sobre tudo do ponto de vista mental. Mulheres apresentam valores mais elevados para as variáveis antropométricas comparadas aos homens, sendo que este pode ser um fator que interfere na qualidade de vida das mulheres DM2. Conclusão: é necessário adotar estratégias orientadas pelo gênero na assistência e controle de pessoas DM2.
PRAZER E SOFRIMENTO DE TRABALHADORES READAPTADOS APÓS ACIDENTE DO TRABALHO
Authors: Izaias Érika Maria , Pissinati Paloma De Souza Cavalcante , Galdino Maria José Quina , Barreto Maynara Fernanda Carvalho , Marcon Sonia Silva , Haddad Maria Do Carmo Fernandez Lourenço
Published: August 2020

Objetivo:desvelar os sentimentos de prazer e sofrimento de trabalhadores readaptados após acidente do trabalho. Métodos:pesquisa qualitativa realizada com seis trabalhadores readaptados de uma universidade pública. Os dados foram coletados por entrevistas semiestruturadas, submetidos à análise de conteúdo e discutidos à luz da Psicodinâmica do Trabalho Dejouriana a partir das pré-categorias: sentimentos de prazer e de sofrimento dos trabalhadores readaptados após acidente do trabalho. Resultados: o prazer esteve relacionado ao apoio recebido por colegas de trabalho, ao reconhecimento das novas atividades desenvolvidas e de sua capacidade laboral. Já o sofrimento decorreu da desvalorização do trabalhador pela instituição, sobrecarga de trabalho, inadequação de funções e não aceitação das limitações por membros da equipe. Conclusões:conhecer relatos decorrentes dos processos de readaptação funcional devido aos acidentes do trabalho permite planejar ações de vigilância que promovam saúde e prazer no ambiente laboral.
CONHECIMENTO DOS ACADÊMICOS DE ENFERMAGEM ACERCA DA HEPATITE C
Authors: Maia Annanda Luyza Carias , Marques Cristiane Da Câmara , Silva Bárbara Coeli Oliveira da , Barreto Vanessa Pinheiro , Gomes Walida Andreza de Oliveira , Feijão Alexsandra Rodrigues
Published: August 2020

Objetivo: avaliar o conhecimento de acadêmicos de enfermagem acerca da hepatite C. Método: estudo transversal desenvolvido em uma universidade pública do nordeste brasileiro. Participaram da pesquisa 129 graduandos matriculados entre o 5º e 9º períodos. A obtenção dos dados ocorreu por questionário auto-aplicado entre setembro e novembro de 2015. Resultados: a maioria dos participantes apresentou nível de conhecimento moderado (69,7%), seguido de baixo nível (21,7%). Verificou-se a associação de alto nível de conhecimento com semestre avançado do curso (p 0,05), o que não foi observado nas demais variáveis como outra formação ou participação em projetos relacionados ao tema. Conclusão: o conhecimento acerca da hepatite C é reduzido entre estudantes de enfermagem, portanto sugerem-se estratégias de ensino que viabilizem maior aproximação com temática tão relevante na formação do enfermeiro.
Being Indigenous in an Unlikely Place: Self-Determination in the Yakut Autonomous Soviet Socialist Republic (1920-1991)
Authors: Sidorova Evgeniia , Rice Roberta
Published: August 2020

How and why is Indigeneity expressed differently in different contexts? This article examines the articulation and expression of Indigenous Rights in one of the most challenging contexts—that of Siberia in the Soviet Union era. Based on primary, archival research carried out in the Republic of Sakha, Russia, the review finds that re-claiming and re-defining Indigeneity can serve as the first step in crafting an effective challenge to the domination and control exercised by states over Indigenous populations. The study of Indigeneity in unlikely places has important ramifications for Indigenous Peoples worldwide who are struggling against colonial-minded governments that have not only deprived Indigenous Peoples of their lands and resources, but also suppressed their right to self-identification through imposed administrative definitions of Indigeneity.
Assessment of significant for breeding morphological traits in the double haploid population of Brassica rapa L. in controlled conditions of a regulated agroecosystem
Authors: Egorova K. V. , Sinyavina N. G. , Kochetov A. A. , Chesnokov Yu. V.
Published: August 2020

Relevance. The genus Brassica includes the most important vegetable, oilseed, spice and forage crops. Many representatives of cabbage are widely used as model objects for studying economically valuable traits. Limited publications devoted to the study of genetic aspects of the implementation of morphological quantitative features of B. rapaand the lack of data on the influence of environmental parameters on their implementation make it a very urgent task to study these features in the RAES.

Material and methods.The purpose of this work is to study the influence of environmental light factors on the manifestation of economically valuable features in the mapping populations of B. rapain the RAES. The peculiarity of our research is the study of lines of mapping populations of B. rapa in strictly controlled conditions of the RAES. The studied populations were grown under optimal conditions with a 12-hour photoperiod. 21 DH 30 lines and 31 DH 38 lines were used. Several types of economically valuable traits were studied: the timing of transition to flowering, the growth rate of the plant, the habit and morphological characteristics of the leaf and leaf rosette.

Results. A high degree of variation in the expression of the studied traits between lines within the population was revealed, which is consistent with previously published data [1, 2]. Highly productive genotypes, which can be used in further genetic selection work, including for obtaining genotypes, lines, and varieties adapted for growing in light culture, have been selected. The obtained data can also be used for further study of the influence of physical environmental factors on the manifestation of selectively significant quantitative traits in cabbage plants.
Search for cytoplasmic male sterility plants and its maintainer plants of carrots in Rogneda variety
Authors: Kornev A. V. , Khovrin A. N. , Leunov V. I. , Derevschukov S. N. , Sycheva L. V.
Published: August 2020

Relevance. Hybrid seed production of carrots is carried out on a three-line basis, which suggests the presence of a male sterile maternal line and a fertile paternal line. For the reproduction of a male sterile line, a maintainer line is needed. The process of creating an isogenic pair of a manly sterile line – a maintainer line is of great complexity. As a maintainer line, it is necessary to use only a plant – a homozygote Cyt N msms for the core genes providing sterility, but with a normal cytoplasm. The purpose of the work is the creation of maintainer line for the sterility of carrots from the population of the Rogneda variety.

Methods. Research were carried out: in 2016, at the experimental base of the Voronezh Vegetable Experimental Station (Voronezh Region); in 2017 - 2019, at the breeding center of All-Russian Research Institute of Vegetable Growing – branch of Federal State Budgetary Scientific Institution Federal Scientific Vegetable Center (Moscow Region). The material for the work was seed plants and roots of the Rogneda variety and hybrid, inbred, backcross progenies obtained from this population. Breeding methods: hybridization, inbreeding. Crosses used: simple direct and complex return (backcrosses), inbreeding.

Results.Research revealed the possibility of searching for a maintainer line in the Rogneda variety. The P43f inbred progeny is potential line B, which maintains the CMS trait of the petaloid type at 100%. Of the 67 hybrid progenies, only P43st x P43f was left, in which all plants with male sterility. 65 hybrid progenies contained both sterile and fertile plants. Associated 65 inbred progenies had sterile and fertile plants, i.e. it makes no sense to try to obtain a maintainer line is needed. The process of creating an isogenic pair of a manly sterile line – a maintainer line from such fertile plants. Hybrid progeny of P4st x P4f had 100% fertile plants. The inbred progeny of P4f was represented only by fertile plants.