bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence of allergic rhinitis in school going children in Kashmir
Authors: Sheikh Shahnaz , Bajaj Anushree , Dar Farooq Ahmad , Ahmad Rauf , Dar Showkat Ahmad
Published: August 2018

Background: Allergic rhinitis is a common chronic paediatric disorder affecting about 40% of children affected. Allergic rhinitis results in day time fatigue, impairment of cognition and memory which significantly affect the learning process and impact on the school performance of children. The aim of the study was to determine the prevalence of allergic rhinitis in school going children in Kashmir.

Methods: Cross sectional questionnaire based observational study. Study group included the school going children chosen randomly from various schools of urban and rural areas of Kashmir valley aged 6-18 years.  

Results: Out of the 402 children prevalence of allergic rhinitis was 28.85%. Prevalance in urban and rural area school going children was 55.2% and 44.8% respectively. The most common symptom was nasal obstruction 79.31%. The most common allergen was dust mite 77.58% and the most common comorbidity was asthma.

Conclusions: The prevalence of allergic rhinitis shows a significant rise in last few years, more common in rural areas, and existing as co-morbidity in a significant proportion of children demanding a comprehensive strategic approach to deal with them.

 
Study of effect of 1% sodium hyaluronate application on tympanic membrane perforation
Authors: Sahni Dimple , Singh Bikramjit , Uppal K. S. , Bhagat Sanjeev , Sharma Dinesh , Dogra Girish
Published: August 2018

Background: Topical applications of hyaluronic acid have been found to have beneficial effects on closure of tympanic membrane perforations. The aim of the study was to evaluate the role of 1% sodium hyaluronate in the repair of small or medium sized dry central tympanic membrane perforation and improvement in hearing following closure of tympanic membrane perforation.

Methods: 50 patients with dry central perforation of inflammatory or traumatic origin were taken up. Maximum of 4 applications of 1% sodium hyaluronate were given at weekly intervals. Final mapping for closure of tympanic membrane perforation and hearing assessment was done after 3 months.  

Results: 26 perforations closed completely while 18 perforations showed significant reduction in size. Thus 44 or 88% perforations showed positive response to 1% sodium hyaluronate application. Hearing Improvement was observed on pure tone audiometry with the average hearing gain in patients after complete closure of tympanic membrane perforation was 12.40 dB with p value of 0.001.

Conclusions: Study showed the beneficial effects of 1% sodium hyaluronate application in closure of small and medium size perforations of tympanic membrane perforation and improvement in hearing.

 
Latent vestibular dysfunction and its effect on quality of life in elderly individuals, the need of active screening and intervention
Authors: Swami Himanshu , B. M. Aravind
Published: August 2018

Background: Dizziness is a commonly reported complaint among elderly.. Among the elderly in particular, factors such as Ageing, presbycusis, diabetes, chronic kidney disease, osteopenia, and osteoporosis increase the risk. Dizziness handicap inventory is used to assess the quality of life among the individuals with vestibular dysfunction. This is also used to assess the impact of interventions for vestibular dysfunction. This study aims to estimate the prevalence of latent vestibular dysfunction among the Indian population, and the impact of interventions among the same.

Methods: A prospective observational study was conducted at a tertiary care hospital. As per sample size estimates, 200 participants aged >60 years without previous diagnosis of vestibular dysfunction were screened using appropriate tests. The quality of life of the affected individuals were assessed using Dizziness Handicap Inventory Score (DHIS) before and after intervention.  

Results: The prevalence of latent vestibular dysfunction was found to be 23.5%. Most of them reported having moderate handicap due to the condition. Following intervention, those with moderate handicap either became normal (47.8%) or had residual mild handicap (52.2%). The mean DHIS score significantly decreased from 40.91 points during pre-intervention to 16.12 points post-intervention.

Conclusions: Around one-fourth of the Indian elderly is found to have latent vestibular dysfunction. It has a major impact on the individual’s quality of life. Yet, screening and intervention is found to make a considerable improvement among the affected individuals.
A prospective study of sinonasal and nasopharyngeal pathology in chronic otitis media
Authors: K. B. Sajitha , Thomas Binu , A. T. Ihsan
Published: August 2018

Background: Chronic otitis media (COM) implies a permanent abnormality in the tympanic membrane characterized by irreversible changes in the mucosa of middle ear and mastoid cavity. Diseases of the nose and para nasal sinuses have been implicated in the development of the disease. Hence the present study aims at identifying the risk factors involved and the importance of its management in treating the disease. The objective was to study the correlation between COM and Sino nasal and nasopharyngeal pathology.

Methods: A total of 100 patients with chronic otitis media were included in the study. A Detailed history and clinical examination was done using a pre-prepared questionnaire.  Diagnostic nasal endoscopy was done in all cases to assess the nasal cavity and nasopharynx along with bacteriological study of ear and corresponding side of nasopharynx.  

Results: Symptomatic, clinical and diagnostic profile proved the evidence of sinonasal pathology in 82% of patients with COM. The comparative study of the microbiological flora of both ear and corresponding side of nasopharynx showed 77 % of ear swabs and 91% of nasopharyngeal swabs to be sterile. The results were statistically significant with a p value of 0.003.

Conclusions: This study emphasises on a thorough evaluation of nose and paranasal sinuses in all cases of COM for comprehensive management of the disease. Its detection and management is equally important as the ear surgery per se.
Pattern of hearing loss in tubotympanic type of chronic suppurative otitis media
Authors: Rao Vinay V. , M. J. Shilpa , Bhat Mahesh
Published: August 2018

Background: The aim of the study was to assess the degree of hearing loss with the pattern of tympanic membrane perforation in tubotympanic type of chronic suppurative otitis media (CSOM TTD).

Methods: This is a descriptive study conducted at Father Muller Medical College, Department of Otorhinolaryngology from Oct 2016 till Feb 2017.110 cases aged between 20-50 years with CSOM TTD were included in the study. Detailed clinical examination and history was carried out followed by hearing evaluation by pure tone audiometry. All the data collected was statistically analyzed.  

Results: 110 patients with 137 perforated tympanic membrane, aged between 20 to 50 years, were included in the study. Large central perforation involving all the four quadrants was the most common otologic findings. Significant correlation observed between size of perforation and degree of hearing loss (p value- 0.018) and no significant relation is observed between site of perforation and degree of hearing loss (p=0.107).

Conclusions: The larger the perforation, the greater the decibel loss in sound perception. The location of perforation does not have significant effect on magnitude of hearing loss.
A study of deep neck spaces infection in present era at tertiary care teaching hospital
Authors: Khavdu Paresh J. , Fefar Alpesh D. , Mistry Sejal N. , Chavada Payal S.
Published: August 2018

Background: Deep neck spaces infection is a common challenging condition for otolaryngologist in day to day practice even after availability of higher antibiotics. It may leads to considerable morbidity and complications. The aim of the study was to find out prevalence, predisposing factors and changing trend of deep neck spaces infection in this broad spectrum antibiotics era.

Methods: This prospective study was carried out at P.D.U. Medical College and Hospital, Rajkot. 120 Patients were studied who came with deep neck space infection.  

Results: In this study majority of patient were in the age group of 41-60 year. Odontogenic and oropharyngeal infectionare the most common etiologies. Staphylococcus aureus, Streptococcus, E. colli, Klebsiella and anaerobes were the microorganisms commonly isolated in pus culture and sensitivity test.

Conclusions: In spite of availability of broad spectrum antibiotics in present day deep neck spaces infection is the most commonly noticeable condition in developing countries and may lead to considerable morbidity and complications. Inadequate nutritional status, poor oral hygiene and lack of awareness in dental health are common predisposing factors for deep neck spaces infection.
Middle ear cholesteatoma: a study of correlation between HRCT temporal bone and intraoperative surgical findings
Authors: Chavada Payal S. , Khavdu Paresh J. , Fefar Alpesh D. , Mehta Manish R.
Published: August 2018

Background: Cholesteatoma is a long-standing infection of the middle ear cleft having erosive properties. Chronic ear discharge and decreased hearing are most common clinical presentation. Multi-directional tomography of high quality can provide a detailed understanding of the interpretation of anatomical structures visualized by HRCT. Knowledge of the anatomical variations and changes induced by pathology in the temporal bone are the guiding marbles for surgery.

Methods: This is a Prospective study consisted of 100 cases of chronic suppurative otitis media of unsafe type requiring ear surgery admitted in the E.N.T. department of P.D.U. Civil Hospital Rajkot in 2 years from December 2015 to December 2017. A total no. of 100 patients of both gender between 5 to 80 years has been included in the study.  

Results: In this study, 58% patients were females while males were 42%. Left ear (46%) was involved more as compared to right ear (40%). Most of the patients belonged to 11-20 (25%) years of age group. mean age is 24.5 years. Most common symptoms were ear discharge (98%) and decreased hearing (83%).

Conclusions: HRCT guides the surgeon on the possible surgical hazards before the surgery and helps in earlier management and operative complications. The use of CT in the case of chronic suppurative otitis media does provide valuable information. HRCT scanning is a unique method of detection of early cholesteatoma as well as detection of cho­lesteatoma in hidden areas. In addition, HRCT scanning serves as a road map to assist the surgeon during cholesteatoma surgery.
Role of high resolution computed tomography of temporal bone in preoperative evaluation of chronic suppurative otitis media
Authors: Prakash M. D. , Tarannum Afshan
Published: August 2018

Background: Chronic suppurative otitis media (CSOM) is a common condition seen in patients attending ENT department. The diagnosis of cholesteatoma is usually made on otologic examination. The necessity for HRCT imaging in an uncomplicated case is controversial. The objective was to evaluate preoperative HRCT temporal bone and to determine its’ usefulness in patients with Chronic suppurative otitis media (CSOM) undergoing surgery.

Methods: This study was a prospective study involving 30 cases of CSOM with cholestaetoma. All the patients underwent pre-operative HRCT screening followed by surgical exploration of middle ear cleft. Pre-operative CT scan and intra-operative findings recorded and compared.  

Results: Out of total 30 patients of CSOM, 16 (53%) were males and (90%) presented with chief complaints of otorrhoea. HRCT scan was found to be very sensitive (100%) in detecting cholesteatoma in middle ear cleft but differentiation between granulations or cholesteatoma wasn’t possible. HRCT satisfactorily delineated ossicular erosion except stapes suprastructure erosion which had 81.8% sensitivity and specificity 88.88%. For bony boundaries of middle ear, HRCT showed very high sensitivity and specificity for detecting scutum erosion, tegmen erosion, mastoid cortex erosion, jugular bulb dehiscence and bony external auditory canal erosion. It was moderately sensitive for LSCC Erosion (75%), Facial canal erosion (80%) and Sinus plate erosion (85.7%).

Conclusions: These results indicate that preoperative CT temporal bone scan of patients with CSOM serves as an important guide in surgical approach for otolaryngologists, although there are limitations in evaluation of the CT results.
A study of cisplatin chemotherapy and hearing loss
Authors: Sivasankari L. , Subramanian Lalitha
Published: August 2018

Background: Various medications have been associated with ototoxicity. Platinum containing chemotherapeutic agents are associated with cochleotoxicity, characterized by high frequency hearing loss. Cisplatin and related agents are absorbed by the cochlear hair cells, resulting in ototoxicity through the production of reactive oxygen species.

Methods: About 67 patients, irrespective of the type of cancer, fit to undergo chemotherapy were considered for study after meticulous examination. Audiograms were taken prior to chemotherapy, at the end of each cycle of chemotherapy, and follow-up audiograms at 3 months and 6 months after completion of chemotherapy.  

Results: Among 37% of the patients with normal hearing, 10% of the patients developed sensorineural hearing loss after treatment. Among 63% of the patients with prior mild sensorineural hearing loss, 11.8% developed worsening of hearing after completion of treatment.

Conclusions: Audiologic monitoring is important in patients undergoing cisplatin chemotherapy and post- chemotherapy auditory monitoring is essential to rehabilitate the patients with Sensorineural hearing loss.
Impact of type of graft material on outcome of tympanoplasty: a comparison between temporalis fascia and cartilage with perichondrium
Authors: Tadke Kanchan , Ghorpade Randhir , Lahane Vaibhav , Mundada P. S.
Published: August 2018

Background: Various graft materials have been used to repair tympanic membrane perforations. Temporalis fascia and cartilage with or without perichondrium are the most commonly used materials. The objective of the study was to compare the anatomical and functional success in type I tympanoplasty by using cartilage- perichondrium graft with that of temporalis fascia in a homogenous group of population.

Methods: 64 patients with chronic otitis media - mucosal type were included in the study. This prospective, randomized controlled trial was conducted at a tertiary care centre between December 2012 to October 2014. Patients were grouped randomly between temporalis fascia (34/64) and cartilage group (30/64). In the fascia group, the graft was placed by underlay technique. In the cartilage group, tragal cartilage was thinned by cartilage thinner keeping the perichondrium attached on one side. The graft was placed by underlay or over-underlay technique. Postoperative results i.e. graft take up (anatomical success) and hearing improvement (functional success) were evaluated at 6 months.  

Results: Graft take up rate was 94.11% for fascia group and 96.66% for cartilage group. The mean pure tone air bone gaps pre and postoperatively in the fascia group were 26.4±6.55 dB and 11.47±6.5 dB respectively, whereas for cartilage-perichondrium group, the values were 28.3±5.86 dB and 13.2±6.48 dB respectively. There was no statistically significant difference in the graft take up rate and postoperative hearing improvement between the two groups (p≥0.05).

Conclusions: Cartilage with perichondrium can be considered as an alternative to more traditional grafting material for tympanic membrane reconstruction.
Clinical study of fungal sinusitis
Authors: Waghray Jyotika
Published: August 2018

Background: Fungal sinusitis is a distinct clinical entity characterized by inflammation of the sinus mucosa caused by fungal infection like aspergillus (fumigatus, niger, flavus), mucormycosis, candida (albicans), scedosporium, pencillium. Mostly immunocompromised patients, farmers, garbage cleaners, and patients on prolonged nasal sprays are affected. There are different types of fungal sinusitis: fungal mycetoma, allergic fungal, chronic indolent and fulminant sinusitis having symptoms like chronic headache and facial swelling with visual impairment. Patients have thick purulent nasal discharge, nasal obstruction, epistaxis, cheek swelling and may be polyposis. Resident bacterial flora probably inhibits colonization by fungi through a number of mechanisms. Thus antimicrobial therapy predisposes to both the overgrowth of normal fungal flora, e.g., Candida species, and growth of opportunists like Aspergillus1. Allergic fungal rhinosinusitis is the most common entity. Aspergillosis is the most common fungal infection. Of these aspergillus fumigatus is the most common fungal pathogen. Maxillary sinuses are commonly involved.

Methods: This is a prospective study carried out at department of otorhinolaryngology at Kunal Institute of Medical Specialities Pvt Ltd. Evaluation by proper history taking and clinical examination after which the patient is selected for nasal swab, culture and sensitivity. Plain x-ray nose and paranasal sinuses. CT scans nose and paranasal sinuses. Diagnostic nasal endoscopy.  

Results: Allergic fungal sinusitis was the most common entity found with aspergillosis being the most common organism.

Conclusions: Allergic fungal sinusitis was most commonly found in the age group of 20 to 29 years with maxillary sinus most commonly affected. 
Endoscopic transoral resection of an elongated styloid process: a case report
Authors: H. Shilpa , Mathew Amrita Suzanne , Hemraj Sandhya , Sridhar Aishwarya
Published: August 2018

Eagle’s syndrome is an aggregate of craniocervicofacial symptoms due to an elongated styloid process/calcified stylohyoid ligament. Adequate history, clinical and radiological examination, and sound knowledge of mimicking pathology can help in its diagnosis. Computerised tomography (CT) with 3D reconstruction is the most accurate investigation currently available. Treatment can be either surgical or non-surgical. Surgical excision of the abnormally elongated styloid process is preferred. Extraoral and intraoral approaches are available, each with their inherent advantages/disadvantages. Endoscope-assisted transoral resection resolves the disadvantages associated with the latter, representing a favourable advancement. We report a case who presented with craniocervicofacial pain, diagnosed clinically and on 3D-CT with Eagle’s Syndrome, and treated successfully by endoscope-assisted transoral resection.
A rare cause for aphonia - Ortners syndrome
Authors: Ramasamy Punithakumar , Kale Suresh Babu , Ramalingam Senthilkumar , Veerappa Murugesan
Published: August 2018

Rheumatic mitral stenosis is prevalent in the developing world and presents with a wide array of manifestations. Aphonia and hoarseness of voice secondary to recurrent laryngeal nerve paralysis (Ortner’s syndrome) is an uncommon manifestation of mitral stenosis. We present a case severe mitral stenosis with moderate to severe tricuspid valve regurgitation and severe pulmonary artery hypertension that was masquerading as aphonia and hoarseness of voice for eight months. Mitral valve replacement and tricuspid annuloplasty was done and the quality of voice improved post-surgery. 
Limb length discrepancy after total hip arthroplasty: a systematic review
Authors: Pathak Pradeep Kumar , Gupta Rakesh Kumar , Meena Hari Singh , Fiske Rajendra
Published: August 2018

Correcting limb length inequality without compromising hip stability is one of the major intraoperative challenges in Total hip arthroplasty (THA) as it is a major cause of patient dissatisfaction and litigation against surgeon. Surgeons performing THA should aim to minimize Limb Length Discrepancy (LLD), and therefore should adopt a reliable method of doing so. Thus a reproducible technique which effectively reduces postoperative LLD without increasing operative time and is easy to apply is a need of time. Although various preoperative and intraoperative techniques are described in literature, none is universally applicable and is without limitations. We are presenting a review of 50 articles on limb length discrepancy after total hip arthroplasty, its implications and several techniques to avoid it. We suggest that every effort should be made to minimise postoperative Limb Length Discrepancy by combined use of preoperative and intraoperative techniques.
Cruciate retaining versus posterior-stabilized total knee arthroplasty: a short-term comparative study
Authors: Suthar Raghav K. , Parekh Dimple R. , Mistry Shaival B.
Published: August 2018

Background: Total knee arthroplasty has got excellent results. Among the techniques (posterior-stabilized vs posterior cruciate retaining total knee arthroplasty) it is unclear whether one design has superior outcome over another. The purpose of the present study was to directly compare clinical and radiological outcomes of these two designs.

Methods: A prospective study involving 36 patients who received a cruciate-retaining implant were compared to 30 patients who received posterior-stabilized prosthesis. At 3 months follow-up time clinical and radiological evaluation done and results were analyzed.

Results: At 3 months follow-up time mean knee society scores improved from 49.9/46.9 (objective/subjective score) points to 80.9/82.5 points in the cruciate-retaining group and from 48.2/43 (objective/subjective score) points to 80.4/80.2 points in the posterior-stabilized group. The ranges of motion was 117.2° (range, 90° to 130°) and 125.3° (range, 100° to 140°) in the cruciate-retaining and posterior-stabilized group respectively, at 3 month follow-up. One patient had post-operatively periprosthetic fracture reported after 2 weeks (treated conservatively), one had superficial infection (treated with dressing) and one patient with superfical infection required debridement.

Conclusions: This study did not conclusively demonstrate the superiority of one knee design over the other, suggesting that the choice of implant should be based on surgeon preference, patients knee dimensions, pre-op knee deformity and existing pathology of the posterior cruciate ligament.
Clinical analysis using proximal femoral locking plate in the management of complex, comminuted pertrochanteric femoral fractures in adults: a prospective study
Authors: Muqtadeer Abdul Aziz Ansari , Jaju Rahul Gopikishan , Lokhande Milind
Published: August 2018

Background: Pertrochanteric fractures consume major part of orthopaedic injuries with high morbidity and cost factors. They affect almost all age groups. The treatment options vary a lot depending on the type of fracture and age. Despite marked improvement in implant design, surgical technique and patient care; pertrochanteric fractures continue to consume a substantial proportion of our health care resources.

Methods: This prospective study consists of 20 adult patients of pertrochanteric fractures of femur, who were treated with internal fixation using PFLP. All patients were followed up at an interval of 4 to 6 weeks till fracture union and then once in 3 months till 1 year.

Results: Anatomical results are noted as good or poor depending upon shortening, varus deformity, hip movements and knee movements and functional result as excellent, good, fair and poor depending upon the hip pain, ambulatory status, ability to squat, and sit cross leg. In the study 2 patients had shortening of l cm. None of the patients had any varus deformity. Overall excellent to good results were achieved in 85% cases.

Conclusions: The potential advantages of the proximal femoral locking plate over intramedullary devices are better biomechanical design, ability to bear more stress due to, strong biomechanical stability shows that this technique holds considerable promise in complex, comminuted fractures in revision cases and in osteoporosis.
Assessment of functional outcome of surgical management of proximal humerus fracture treated with PHILOS plate
Authors: Jagiasi Jairam D. , Patel Mihir R. , Daliya Sagar G. , Bochare Amol , Vora Manan
Published: August 2018

Background: Proximal humeral fractures were treated conservatively in the past and often had compromised functional results. With the advancement of surgical techniques, these fractures, especially displaced, are now more often managed operatively; to meet the needs of the patient, provide early rehabilitation and better functional outcome. The aim of this study was to assess the functional outcome of operative management of proximal humeral fractures with Philos plate fixation.

Methods: In this prospective study, 30 patients aged 19-75 years (mean age 47.1 years) with fractures of the proximal humerus, including two-, three-, and four-part fractures, were treated by open reduction internal fixation with Philos plating. Patients’ functional outcomes were evaluated based on subjective (35 points) and objective (65 points) parameters, as per the constant scoring system.

Results: Functional outcome based on the constant scoring system of the patient at 6 month follow-up were compared. Excellent results were seen in 12 patients (40%), 2 had very good results (6.66%), 9 patients were having good (30%) and 6 had fair (20%) functional outcome. One patient had poor functional results (3.33%). Avascular necrosis (AVN) of the humeral head was observed in one patients.

Conclusions: Philos plate fixation for proximal humeral fractures provides good stable fixation with good functional outcome and is a feasible option.

 
A comparative study between plating versus titanium elastic nail system in mid-shaft clavicle fracture management
Authors: Sahu Anil K. , Lenka Bhabani S. , Mishra Abani K. , Panda Chandan K. , Kar Monali
Published: August 2018

Background: Clavicle fracture is one of most common bony injuries. Despite of high frequency, choice of proper treatment is still a challenge. So a comparative randomized study was planned to compare Plating verses TENS for clavicle fractures management.

Methods: Study was conducted in Department of Orthopedics, M.K.C.G Medical College, Berhampur from November 2015 to October 2017.Patients aged from 20-55 years with closed displaced were included in study. Patients were randomized in two groups- One group (25 pateints) treated with TENS and second group (25) with plate. Outcome assessed by pain VAS score, Constant & Murley score, DASH score, cosmetic result, radiological fracture healing time.

Results: Mean fracture union time in TENS group was 11.4±2.12 weeks and in plate group 13.4±3.46 weeks (difference was significant p=0.016). Mean pain VAS score in TENS group was 2.56±0.91 and in plating group 3.12±0.8 (p=0.023). Tens group were cosmetically more satisfied (mean score 4.48±0.7) than plate group (mean score 3.8±1.0, p=0.009). Mean DASH and Constant Shoulder Score in TENS group were 1.87±3.4, 9.36±7.04 and plate group 4.8±9.0 and 15.08±9.4 respectively. Both were significant (p=0.039, p=0.000).

Conclusions: Our study found that patients treated with TENS showed excellent outcome in 84% cases while 60% in plating group for displaces mid-shaft clavicle fracture. Patients in TENS group better in terms of Constant & Murley score and DASH score than treated with plate.
A prospective study to review the functional outcome between patellofemoral resurfacing versus non resurfacing in total knee replacement
Authors: Balemane Sharat , Attar Arshad , Dsouza Aaron Ruben
Published: August 2018

Background: A prospective study to review the functional outcome between patellofemoral resurfacing versus non resurfacing in posterior stabilized TKR.

Methods: We studied a total of 63 patients with tricompartmental osteoarthritis of knee. These patients underwent total knee arthroplasty between April 2013 to September 2013 at Preethi hospital, Madurai. It was prospective study which was followed up for period of 1 year. There were two groups which were made randomly into patellofemoral resurfacing group (group A n=30) and the non resurfacing group (group B n=33). In the patellofemoral resurfacing group, patella was resurfaced with the help of cemented poly component and in the non-resurfacing group, the osteophytes of the patella was removed, it was reshaped to match the trochlea of the femoral prosthesis and circumpatellar denervation was done. Knee society score (KSS), anterior knee pain, knee society function score and patient satisfaction was compared between both the groups.

Results: There was significant difference in anterior knee pain scale and incidence of anterior knee pain was less as compared in the resurfacing group. However 1 year of follow up of both groups concluded that there was no significant differences for functional outcomes. Patient satisfaction scale was significant in patellofemoral resurfacing group.

Conclusions: Study showed that apart from significant improvement in anterior knee pain scale there was no significant difference for both groups after 1 year follow up in clinical outcome, except for patient satisfaction scale. For patellofemoral pain and severe patellofemoral arthritis it is recommended to perform patellar resurfacing, otherwise patellar resurfacing do not have any added advantage.
Surgical technique of total hip arthroplasty: an experience from a tertiary level hospital in India
Authors: Gupta Lokesh , Lal Mukund , Aggarwal Vineet , Rathor Lakshya Prateek
Published: August 2018

Background: Total hip arthroplasty (THA) is performed for patients with hip pain, which may arise due to a variety of conditions.

Methods: An observational study of 20 hip joints presenting to the Department of Orthopedic Surgery, Indira Gandhi Medical College Shimla from December 2008 till December 2010 for THR was done. Laboratory and imaging investigations were performed as per the standard operating protocol of our center. Modified Harris Hip scoring was done for all included patients pre-operatively. A posterolateral approach with posterior dislocation of hip was used in all the patients. Pre-operative and intra-operative details were noted using a pretested semi-structured questionnaire. Data were analysed descriptively and tabulated to draw conclusions.

Results: Both sides were operated with equal frequency, while one patient had a bilateral THA. Most common indication of surgery was osteoarthritis secondary to avascular necrosis head of femur (n=16). Pre-operative modified Harris hip score was poor in all 20 hip joints. Duration of surgery ranged from 110 minutes to 190 minutes, mean duration being 139 minutes. Average blood loss during the surgical procedures was about 532 ml with average drainage of about 230 ml. On an average medullary canal flare index of 3.97 was for all the patients. Morphological cortical index averaged at 3.11 and Dorr index at 3.54.

Conclusions: Most systems for THA are modular which provide flexibility in dealing with intraoperative anatomical variations. Different types of femoral and acetabular implants are available for use which reflect the different philosophies regarding the techniques involved in THA. Further studies are required to support our findings.
Association of aLDFA with functional outcome of distal femur fracture treated with locking plate
Authors: Singh Ajeet , Kumar Rakesh , Ranjan Rajni , Mahajan Avijit , Ahmad Nadeem
Published: August 2018

Background: Distal femoral fracture is one of the common presentations in orthopaedic emergency. Stable fixation and early mobilization is necessary to avoid knee stiffness with maximum functional outcome. We have done a retrospective analysis of Type 33A (supracondylar) and type 33C (supraintercondylar) fracture with distal femoral locking plate. Close observation done by aLDFA for varus collapse and functional outcome.

Methods: 61 patients of Type 33A (supracondylar) and Type 33C (supraintercondylar) treated from January 2011 to august 2016 selected for the study. Functional and radiological outcome of fracture assed by mize criteria and aLDFA respectively. Most of the cases of Type 33C shows some amount of varus collapse specially type 33C3.

Results: 6 out of 8 patients treated with type 33C3 treated with isolated distal femoral locking plate showed varus collapse more than 10 associated with implant failure and non union.

Conclusions: Type 33C3 subset required a special consideration like dual plating or cortical strut graft on first go. aLDFA is strong predictor of for functional and radiological outcome.
Effectiveness of supportive educational intervention on knowledge, self-care behavior, disease activity and health status among arthritis patients
Authors: Gurjar Nema Ram , Thresiamma Thomas K. , Tiwari Mukesh
Published: August 2018

Background: Arthritis is the group of conditions affecting the joints and typically causes swelling, pain and stiffness. Osteoarthritis & rheumatoid arthritis are the most common type of arthritis. Patient education should lead not only to changes in knowledge, but also to changes in behavior and in health status. Objective of the study was to assess effectiveness of supportive educational intervention on knowledge, self-care behaviour, disease activity and health status among arthritis patients.

Methods: Pre-experimental, one group pre-test post-test research design (O1 × O2) was used. Total 20 patients of osteoarthritis and rheumatoid arthritis were selected for the study by purposive sampling technique.

Results: There was very high statistical significant difference in the mean pre-test and post test score of knowledge, self-care behavior, disease activity and health status among arthritis patients at p value was 0.001 level of significance. The study found significant fair correlation between knowledge gain score and self-care behaviour gain score, self-care behaviour gain score and reduction of disease activity and self-care behaviour gain score and health status at p value was 0.01 level of significance.

Conclusions: Study concludes that supportive educational intervention is effective to enhance knowledge, self-care behaviour & health status among arthritis patients.
Outcomes of total knee arthroplasty in arthritis using functional knee score
Authors: Goregaonkar Arvind B. , Shukla Hitesh A. , Singh Amit , Bindumadhavan Santosh , S. Rajesh
Published: August 2018

Background: Knee being a major weight bearing joint, arthritis of the knee is a common problem. Over time various conservative measures have been used to alleviate the arthritic pain, but complete pain relief has rarely been achieved. Total Knee Arthroplasty has an established place in the treatment of knee arthritis and is an effective surgical modality that provides immediate pain relief and enhances quality of life. Though most patients were satisfied by the immediate outcome of the surgery, further detailed interrogation revealed concern and inability to perform activities they previously used to do, thus arising the need for an objective method to measure the true outcome.

Methods: There are very few established objective scoring methods to evaluate the outcome following a Total Knee Arthroplasty. In our study, we have used the ‘Functional Knee Score’ for the 30 patients with arthritis who underwent TKA using the midvastus approach under tourniquet cover.

Results: The majority of the patients were from the age group of 61-70 years which accounts for 36.7% of patients in our study. The mean functional new knee society score preoperatively was 39.90 standard deviation of 3.055 which improved to 80.77 with standard deviation of 6.263 postoperatively, p<0.001.

Conclusions: Using knee society functional score, 10 patients had excellent results, 16 had a good result, 4 patients a had fair result.
A prospective study of 50 cases of patella fractures treated with different modalities
Authors: V. Chawda Rajesh , Tank Parag M. , Patel Vijay J. , Shah Yash S.
Published: August 2018

Background: Fractures of patella account for 1% of all skeletal injuries. There is no universal accepted treatment for patellar fractures. After a fracture of the patella, the best results are obtained by accurate reduction and stable internal fixation. Partial or total patellectomy is generally indicated when the patella is so severely comminuted that an accurate reduction and reconstruction of the retropatellar joint surface cannot be achieved.

Methods: The prospective study of 50 cases of patellar fractures was carried out at the department of orthopaedics for the period from May 2015 to December 2017. The maximum period of follow up was 18 months with a minimum period of follow up of 5 months (average 11.68 months). Operative treatment was done in patella fractures for more than 2 mm of articular displacement or 3 mm of fragment separation. Surgical options includes internal fixation with tension band wiring with k wire and partial patellectomy with extensor mechanism repair.

Results: We have studied 50 patients where 7 cases were treated conservatively. In the present series 22 patients were treated with internal fixation out of which 13 patients had excellent results. 6 patients had good results. 21 patients were treated with partial patellectomy where 6 patients had excellent results, 11 patients had good and 4 patients had fair results.

Conclusions: Patella should be preserved and Osteosynthesis whenever possible has better chance for excellent results. A good surgical technique, optimal operation room environment and judicious use of antibiotics will reduce the possibility of infection.
Efficacy of intralesional corticosteroid versus autologous platelet rich plasma injection in the management of chronic plantar fasciitis
Authors: Kumar Divya Anil , Koramutla Harsha Kumar
Published: August 2018

Background: Plantar fasciitis is a common pathological condition affecting the hind foot, and a common cause of heel pain. The present study was taken up to assess the efficacy of intralesional corticosteroid compared to autologous platelet rich plasma injection in the management of chronic plantar fasciitis.

Methods: Patients were randomized into two groups (Group A and Group B) of 30 each. Group-A received Corticosteroid injection while Group-B received PRP injection. Patients were assessed functionally using American Orthopaedic Foot and ankle score (AOFAS), Visual analogue scale (VAS) scores before treatment and on follow-up visit at 6 weeks, 3rd month, and 6th month. Ultrasound of heel for plantar fascia thickness was measured before treatment and follow up visit at 6th month.

Results: A significant decrease in VAS score was observed in the corticosteroid group compared to PRP group at 6 weeks while the VAS score continued to decrease in the PRP group at 3 months and 6 months with an increase in the corticosteroid group at 3 months and 6 months. A significant increase in AOFAS was observed in the Corticosteroid group compared to PRP group at 6 weeks which increased in the PRP group at 3 months and 6 months. However it decreased in the corticosteroid group at 3 months and 6 months. Ultrasonographic evaluation showed improvement in fascial thickness in both the groups, but was better in the PRP group.

Conclusions: To conclude our study shows that corticosteroid is more effective for short term relief and PRP is more effective for long term relief.
Study of effects of negative pressure wound therapy in contaminated wounds
Authors: Kundu Atin , Phuljhele Satyendra , Wale Nitin , Gurudatta Harjot Singh , Agrawal Vimal
Published: August 2018

Background: Negative pressure wound therapy is an advanced wound therapy technique that helps in healing the wounds and accelerates granulation tissue as well as wound closure.

Methods: Prospective randomized interventional study was done in Dept. of Orthopedics, Dr. BRAM Hospital, Pt. JNM Medical college, Raipur during period from January 2016 to December 2016 involving 25 patients with open fractures up to Gustilo Anderson grade IIIB. All were subjected to this wound technique and response was observed as granulation, size of wound and closure duration.

Results: There was up to 10 to 20 mm reduction in wound size with each dressing in half the patients and up to 10 mm in other half of the patients. There was significant reduction in the bacterial growth in all patients and closure was attained in all the subjects after a few therapies.

Conclusions: Negative pressure wound therapy is a promising technique to reduce the size of the wound in large wound associated with compound fractures and hasten the healing of wound and its closure.
Use of WhatsApp to monitor proper brace application and compliance in a case of clubfoot: a feasibility report
Authors: Dharmshaktu Ganesh Singh
Published: August 2018

Internet provides immense potential to learn, indulge and implement several aspects of knowledge related activities for professionals and general enthusiasts alike. Emergence of social medial platforms, in the current scenario, has exponentially increased the reach of the data and thus its potential impact. WhatsApp is one of the leading media platforms to share views and news to a connected group and is widely used for its simple interface and ease of application. Its varied usage has benefitted biomedical and healthcare settings as well. We hereby describe feasibility of its use in home monitoring of brace application in a case of clubfoot by collaborating with parents. This turns out to be an exciting tool for this purpose in selected cases.
Plagiarism, culture, the Middle East and Westernization: a mixed methods study
Authors: Nash Julie
Published: August 2018

Academic integrity is of great importance to insure a consistent determination of what constitutes plagiarism across regions of the world. Academic integrity research spans a global scale and regardless of where the researcher is from, they are building on a pool of research findings that have no physical boundaries. Basic agreed upon research standards and fundamentals must be established to ensure the validity and reliability of the body of academic research. Problematic to the situation are differences in cultural definitions of what constitutes plagiarism. Therefore, this study aimed to build the body of knowledge on the current condition of plagiarism levels as well as perform a sample comparison of some patterns in Eastern and Western culture. A document analysis was conducted for two universities, one in the USA and one in Saudi Arabia. In addition, a survey was conducted in an academic context in Saudi Arabia to investigate students’ and faculty’s understanding of what constitutes plagiarism. It was predicted that Saudi Arabia is shifting towards a Westernized definition of plagiarism; results partially supported this hypothesis.

ﺗﻌ ﺗﺑ ر اﻟﻧز ا ھﺔ ا ﻷﻛﺎ دﯾ ﻣﯾﺔ ذا ت أ ھﻣﯾ ﺔ ﻛﺑﯾ رة ﻟ ﺿ ﻣﺎ ن ﺗ ﺣدﯾد ﺛﺎﺑ ت ﻟ ﻣﺎ ﯾ ﺷﻛ ل ا ﻻﻧﺗ ﺣﺎ ل ﻋﺑ ر ﻣﻧﺎ طق اﻟ ﻌﺎﻟ م. ﺗ ﻣﺗد أﺑ ﺣﺎ ث اﻟﻧ زا ھﺔ ا ﻷﻛﺎ دﯾ ﻣﯾ ﺔ ﻋﻠ ﻰ ﻧ طﺎ ق ﻋﺎﻟ ﻣ ﻲ وﺑ ﻐ ض اﻟﻧ ظر ﻋن اﻟ ﻣﻛﺎ ن اﻟذ ي ﯾﻧﺗ ﻣ ﻲ إﻟﯾﮫ اﻟﺑﺎ ﺣ ث، ﻓﮭ ﻲ ﺗ ﻌﺗ ﻣد ﻋﻠ ﻰ ﻣ ﺟﻣوﻋﺔ ﻣ ن ﻧﺗﺎﺋ ﺞ ا ﻷﺑ ﺣﺎ ث اﻟﺗ ﻲ ﻻ ﺗ وﺟد ﻟ ﮭﺎ ﺣد ود ﻣﺎدﯾﺔ. ﯾ ﺟ ب و ﺿﻊ اﻟﻣﻌﺎﯾﯾر ا ﻷﺳﺎ ﺳﯾﺔ اﻟﻣﺗﻔ ق ﻋﻠﯾﮭﺎ وا ﻷﺳﺎ ﺳﯾﺎ ت ﻟ ﺿﻣﺎ ن ﺻﺣﺔ وﻣوﺛوﻗﯾﺔ ھﯾﺋﺔ اﻟﺑ ﺣث ا ﻷﻛﺎدﯾﻣﻲ. ا ﻹﺷﻛﺎﻟﯾﺔ ﻓ ﻲ اﻟﻣو ﻗ ف ھ ﻲ ا ﺧ ﺗ ﻼ ﻓﺎ ت ﻓ ﻲ اﻟ ﺗ ﻌر ﯾﻔﺎ ت اﻟ ﺛﻘ ﺎﻓﯾ ﺔ ﻟ ﻣﺎ ﯾ ﺷ ﻛ ل ا ﻻ ﻧﺗ ﺣ ﺎ ل . وﻟ ذﻟ ك ، ھدﻓ ت ھذه اﻟ د را ﺳﺔ إﻟ ﻰ ﺑﻧﺎ ء ﺟﺳد اﻟ ﻣﻌرﻓﺔ ﺣول اﻟ ﺣﺎﻟ ﺔ اﻟ را ھﻧ ﺔ ﻟﻣﺳﺗ وﯾﺎ ت ا ﻻﻧﺗ ﺣﺎ ل وﻛذﻟ ك إ ﺟرا ء ﻣﻘﺎ رﻧ ﺔ ﻧ ﻣوذ ﺟﯾ ﺔ ﻟﺑﻌ ض ا ﻷﻧﻣﺎ ط ﻓ ﻲ اﻟﺛﻘﺎﻓﺔ اﻟ ﺷرﻗﯾ ﺔ واﻟ ﻐرﺑ ﯾ ﺔ. ﺗم إ ﺟرا ء ﺗ ﺣﻠﯾ ل ﻟﻠ وﺛﺎﺋ ق ﻟ ﺟﺎ ﻣﻌﺗﯾ ن، وا ﺣدة ﻓ ﻲ اﻟ وﻻﯾﺎ ت اﻟ ﻣﺗ ﺣدة ا ﻷﻣرﯾ ﻛﯾ ﺔ ووا ﺣدة ﻓ ﻲ اﻟ ﻣﻣﻠ ﻛﺔ اﻟ ﻌرﺑ ﯾ ﺔ اﻟ ﺳﻌودﯾ ﺔ. ﺑﺎ ﻹ ﺿ ﺎﻓﺔ إﻟ ﻰ ذﻟ ك، أ ﺟرﯾ ت د را ﺳﺔ ا ﺳﺗﻘ ﺻ ﺎﺋﯾ ﺔ ﻓ ﻲ ﺳﯾﺎ ق أﻛ ﺎ دﯾﻣﻲ ﻓ ﻲ اﻟ ﻣﻣﻠﻛﺔ اﻟ ﻌرﺑﯾ ﺔ اﻟ ﺳﻌودﯾ ﺔ ﻟﻠﺗ ﺣﻘﯾ ق ﻓ ﻲ ﻓﮭم اﻟ طﻼب وھﯾﺋ ﺔ اﻟﺗد رﯾ س ﻟ ﻣﺎ ﯾ ﺷﻛ ل ا ﻻﻧﺗ ﺣﺎ ل. ﻛﺎ ن ﻣ ن اﻟ ﻣﺗ وﻗ ﻊ أ ن ﺗﺗﺟ ﮫ اﻟﻣﻣﻠ ﻛﺔ اﻟﻌر ﺑﯾ ﺔ اﻟﺳ ﻌو دﯾ ﺔ ﻧﺣو ﺗﻌرﯾ ف اﻟ ﻐرﺑﯾﯾ ن ﻟ ﻼﻧﺗﺣ ﺎ ل وﻗ د د ﻋﻣ ت اﻟ ﻧﺗ ﺎﺋﺞ ھذه اﻟﻔ ر ﺿ ﯾﺔ ﺟز ﺋﯾﺎ.
Write to improve: exploring the impact of an automated feedback tool on Bahraini learners of English
Authors: Wali Fatema , Huijser Henk
Published: August 2018

The development of written accuracy among learners of English as a Second Language (ESL) has always been a primary concern for ESL teachers and researchers in Applied Linguistics and Second Language Acquisition (SLA). While a vast body of research has examined written corrective feedback on students’ written products, few studies have focused on the development of written accuracy among Arabic speaking learners of English using automated feedback tools. This case study first examined the level of written accuracy of Bahraini learners of English in their second year at a higher education institute, highlighting the frequency of errors influenced by their first language (Arabic). The course following this first stage included a significant component of automated feedback on students’ writing; and this study explored the impact that the use of these feedback tools had on learners’ writing in English, tracking development over the course of an academic semester. A corpus of students’ initial writings and subsequent revisions was analysed to identify whether there was an improvement in the accuracy of students’ texts; and students’ perceptions were elicited.

ﻟط ﺎﻟ ﻣﺎ ﻛﺎ ن ﺗ طوﯾ ر اﻟدﻗﺔ ﻓ ﻲ ﻣﮭﺎ رة اﻟ ﻛﺗﺎﺑﺔ ﺑﯾ ن ﻣﺗ ﻌﻠ ﻣ ﻲ اﻟﻠ ﻐﺔ ا ﻹﻧ ﺟﻠﯾ زﯾﺔ ﻛﻠ ﻐﺔ ﺛﺎﻧﯾﺔ اﻟ ﺷـ ﻐ ل اﻟ ﺷـﺎ ﻏل ﻟ ﻣﻌﻠ ﻣ ﻲ اﻟﻠ ﻐﺔ ا ﻹﻧﺟ ﻠﯾ زﯾﺔ واﻟﺑﺎﺣ ﺛﯾ ن ﻓ ﻲ اﻟﻠ ﻐو ﯾﺎ ت اﻟ ﺗ ط ﺑﯾﻘﯾ ﺔ و ا ﻛﺗ ﺳ ـﺎ ب اﻟﻠ ﻐﺔ اﻟ ﺛﺎﻧﯾ ﺔ. ﻓ ﻲ ﺣ ﯾ ن أ ن ﻣ ﺟ ﻣو ﻋ ﺔ ﻛﺑﯾ ر ة ﻣ ن ا ﻷ ﺑ ﺣ ﺎ ث ﻗد د ر ﺳ ـ ت ﻣ ﻼ ﺣ ظ ﺎ ت ﺗ ﺻ ـ ﺣ ﯾ ﺣ ﯾ ﺔ ﺧ ط ﯾ ﺔ ﻋ ﻠ ﻰ ﻛﺗﺎﺑﺎ ت اﻟط ﻼ ب ، ﻓﻘ د رﻛز ت د را ﺳ ــﺎ ت ﻗﻠﯾﻠ ﺔ ﻋ ﻠ ﻰ ﺗ ط وﯾ ر اﻟ دﻗﺔ ﻓ ﻲ ﻣﮭﺎ رة اﻟ ﻛﺗﺎﺑ ﺔ ﺑﯾ ن ﻣﺗ ﻌﻠ ﻣ ﻲ اﻟﻠ ﻐﺔ ا ﻹ ﻧ ﺟ ﻠﯾ زﯾ ﺔ اﻟﻧﺎ ط ﻘﯾ ن ﺑﺎﻟ ﻌرﺑﯾ ﺔ ﺑﺎ ﺳ ــﺗ ﺧ دا م أدو ا ت اﻟ ﺗ ﻐذﯾ ﺔ ا ﻻ ﺳ ـــﺗ ر ﺟ ﺎ ﻋ ﯾ ﺔ ﻋ ﺑ ر ا ﻹ ﻧﺗ ر ﻧ ت . ﺗ ﺗ ﻧ ﺎ و ل د ر ا ﺳ ـ ـ ﺔ ا ﻟ ﺣ ﺎ ﻟ ﺔ ھ ذ ه أ و ﻻً ﻣ ﺳ ـ ـ ﺗ و ى ا ﻟ د ﻗ ﺔ ا ﻟ ﻣ ﻛ ﺗ و ﺑ ﺔ ﻟ ﻠ ﻣ ﺗ ﻌ ﻠ ﻣ ﯾ ن ا ﻟ ﺑ ﺣ ر ﯾ ﻧ ﯾ ﯾ ن ﻟ ﻠ ﻐ ﺔ ا ﻹ ﻧ ﺟ ﻠ ﯾ ز ﯾ ﺔ ﻓ ﻲ ﺳـ ﻧﺗ ﮭم اﻟﺛﺎﻧﯾ ﺔ ﻓ ﻲ ﻣؤﺳـ ﺳـ ﺔ ﻟﻠﺗ ﻌﻠﯾم اﻟﻌﺎﻟ ﻲ ، ﻣﻊ اﻟﺗ رﻛﯾ ز ﻋﻠ ﻰ ﺗﻛرا ر أ ﺧطﺎ ء اﻟﺗدا ﺧل ﺑﯾ ن اﻟﻠ ﻐﺔ ا ﻻوﻟ ﻰ واﻟﺛﺎﻧﯾﺔ. ﺛم ﺗ ﺳـﺗﻛ ﺷـ ف اﻟد را ﺳـ ﺔ ﺗﺄﺛﯾ ر أ دو ا ت اﻟ ﻣ ﻼﺣظﺎ ت ﻋﺑ ر ا ﻹﻧﺗ رﻧ ت ﻋﻠ ﻰ ﻛﺗﺎﺑﺔ اﻟ ﻣﺗ ﻌﻠ ﻣﯾ ن ﺑﺎﻟﻠ ﻐﺔ ا ﻹﻧ ﺟﻠﯾ زﯾﺔ ﻛﻠ ﻐﺔ ﺛﺎ ﻧﯾ ﺔ، وﺗ ﺗﺑ ﻊ اﻟﺗ طور ﺧﻼل اﻟﻔ ﺻ ـــ ل اﻟ د را ﺳـــ ﻲ. ﯾﺗ ﺿ ـــ ﻣ ن ا ﻟ ﺗ د ﺧ ل ا ﻟ ﻣ ط ﺑ ق ﻟ ﺗ ﺣ ﺳـ ﯾ ن ﺗ ﻧ ﻣ ﯾ ﺔ ﻣ ﮭ ﺎ ر ا ت ا ﻟ ﻣ ﺗ ﻌ ﻠ ﻣ ﯾ ن ﻣ ﻛ و ﻧًﺎ ﻣ ﮭ ﻣً ﺎ ﻟ ﻠ ﺗ ﻌ ﻠ ﯾ ق ﻋ ﺑ ر ا ﻹ ﻧ ﺗ ر ﻧ ت . ﻗ ﺎ ﻣ ت ا ﻟ د ر ا ﺳـ ﺔ ﺑ ﺗ ﺣ ﻠ ﯾ ل ﻣ ﺟ ﻣ و ﻋ ﺔ ﻣ ن ا ﻟ ﻛ ﺗ ﺎ ﺑ ﺎ ت ا ﻷ و ﻟ ﯾ ﺔ وا ﻟ ﻣرا ﺟﻌﺎ ت اﻟ ﻼﺣ ﻘﺔ ﻟﻠط ﻼ ب ، ﺑﺎﻹ ﺿ ﺎﻓﺔ إﻟ ﻰ ﻣر ا ﺟ ﻌﺎ ت اﻟ ﻧ ظ ر ا ء، ﻟﺗﺣ دﯾد ﻣﺎ إ ذا ﻛﺎ ن ھﻧﺎ ك ﺗ ﺣ ﺳ ن ﻓ ﻲ دﻗﺔ اﻟﻧ ﺻ و ص اﻟﻣﻛﺗ و ﺑ ﺔ ﻟﻠط ﻼ ب .