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Case Report
Aditya Choudhary, Manoj K Goyal, Manish Modi, Kanchan K Mukherjee, Chirag K Ahuja, Vivek Lal

Froin Syndrome

[Year:2018] [Month:January-March] [Volumn:52 ] [Number:1] [Pages:51] [Pages No:34-35][No of Hits : 858]


ABSTRACT

Introduction: Yellow-colored cerebrospinal fluid (CSF) suggestive of xanthochromia can be due to elevated CSF protein and can be one of the causes of papilledema.

Observation: We observed a 55-year-old lady with papilledema with yellow-colored CSF which was hypercoagulable along with elevated CSF protein and no cells. Her systemic and nervous system examination was unremarkable except for the eye findings. Her contrast-enhanced brain magnetic resonance imaging (MRI) showed multiple meningiomas, and on imaging of the spine, she had multiple contrast-enchancing intradural, extramedullary lesions. Her eye findings were attributed to Froin syndrome found in patients with spinal tumors.

Conclusion: Our case stresses the need to keep the possibility of Froin syndrome in mind while evaluating patients with papilledema and it may be pertinent to perform a spinal imaging, especially when no apparent cause for papilledema is found.

Keywords: Froin, Papilledema, Spinal tumors, Xanthochromia.

How to cite this article: Choudhary A, Goyal MK, Modi M, Mukherjee KK, Ahuja CK, Lal V. Froin Syndrome. J Postgrad Med Edu Res 2018;52(1):34-35.

Source of support: Nil

Conflict of interest: None


 
ORIGINAL ARTICLE
Madhuresh Kumar, Santosh Kumar, Tulika Chandra, Vineet Sharma

Clinical Outcome of Intra-articular Injection of Platelet-rich Plasma in Early-stage Knee Osteoarthritis in North Indian Patients

[Year:2018] [Month:April-June] [Volumn:52 ] [Number:2] [Pages:51] [Pages No:56-61][No of Hits : 769]


ABSTRACT

Introduction: With increasing frequency, platelet-rich plasma (PRP) preparations have been used to treat cartilage lesions to regenerate tissue homeostasis and retard the progression of knee osteoarthritis (OA).

Purpose: To determine the effectiveness of intra-articular PRP injections in early-stage OA patients and to evaluate the clinical outcome.

Materials and methods: This prospective study was conducted in the Department of Orthopaedic Surgery, King George’s Medical University, Lucknow, Uttar Pradesh, India. The study was conducted on patients with early-stage OA knee enrolled on outpatient department basis during the year 2014 to 2015. The effective sample size was 40 patients with bilateral OA knee in which intra-articular injection was given. And the clinical outcomes and effectiveness were measured in terms of visual analog scale and Western Ontario and McMaster Universities Osteoarthritis Index scores at the end of 6, 12, and 24 weeks. A p-value <0.05 was considered statistically significant.

Results: There was significant improvement in all scores at the end of 6, 12, and 24 weeks.

Conclusions: The PRP treatment showed positive effects in patients with knee OA.

Clinical relevance: There are only a few studies of PRP treatment for cartilage on OA knees. Different PRP products might be more or less appropriate to treat different types of tissues and pathologies. The clinical efficacy of PRP remains under debate, and a standardized protocol has not yet been established.

Keywords: Intra-articular injection, Osteoarthritic knee, Plateletrich plasma.

How to cite this article: Kumar M, Kumar S, Chandra T, Sharma V. Clinical Outcome of Intra-articular Injection of Platelet-rich Plasma in Early-stage Knee Osteoarthritis in North Indian Patients. J Postgrad Med Edu Res 2018;52(2):56-61.

Source of support: Nil

Conflict of interest: None


 
RESEARCH ARTICLE
Adarsh Kohli, Aditi Sharma, Susanta K Padhy

Profile of Deficits on Assessment Battery in Children with Specific Learning Disorders

[Year:2018] [Month:July-September] [Volumn:52 ] [Number:3] [Pages:60] [Pages No:120-127][No of Hits : 753]


ABSTRACT

Learning disabilities affects the acquisition, organization, retention, understanding, or use of verbal or nonverbal information. They usually result from impairments in memory, attention, phonological processing, language processing, visuospatial processing, and so forth leading to inabilities in oral language like speaking and understanding the grammatical constructions, reading like phonetic knowledge and word recognition, written language like spellings and alphabet recognition, and also arithmetic like computation.
The aim of the current study is to show the profile in learning disabled children.
Brigance Basic Skills List and the National Institute of Mental Health and Neurosciences (NIMHANS) index of specific learning disabilities are used for the purpose. The Brigance Basic Skills List is designed to assess visuomotor skills, visual discrimination, acquisition of gross motor and fine motor skills, and acquisition of alphabets and numbers. The NIMHANS index in addition to the above also assesses the reading, writing, spellings, and arithmetic skills of the subjects and other functions like attention, memory, and perceptual motor functions of the subjects. The sample was drawn from the Child and Adolescent Psychiatric clinic of outpatient of Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India. It comprised of 20 subjects within the age range of 10 to 18 years with learning disabilities in one or more areas along with difficulties. They were all belonging to middle- to upper-middle socioeconomic status and were studying in private school setup.
The results show the profile of the subjects on attention in terms of distractibility and impulsiveness, the memory profile, perceptual motor functions, basic academic skills in terms of visual and auditory discrimination, concept and sequencing of letters and numbers, and the type of errors in terms of their reading, writing, spellings, and arithmetic skills.

Keywords: Attention, Disability, Learning, Memory.

How to cite this article: Kohli A, Sharma A, Padhy SK. Profile of Deficits on Assessment Battery in Children with Specific Learning Disorders. J Postgrad Med Edu Res 2018;52(3):120-127.

Source of support: Nil

Conflict of interest: None


 
BIOSKETCH
Ajit Avasthi, Subho Chakrabarti

Prof. NN Wig... The Living Legend of Indian Psychiatry

[Year:2018] [Month:July-September] [Volumn:52 ] [Number:3] [Pages:60] [Pages No:164-165][No of Hits : 624]


ABSTRACT

Professor NN Wig is, in the true sense of the word, a living legend of Indian psychiatry. The Department of Psychiatry at the Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, owes its existence to him and his vision continues to guide the staff and students. He single-handedly brought the department into being in 1963 and he continues to be intimately associated with the department and the PGIMER as one of its emeritus professors.


 
CASE REPORT
Sanjay Yadav, Saurabh Singh, Rohit Amar, Ramvilas Nag

Traumatic Lateral Listhesis of Lumbar Spine in a Young Female

[Year:2018] [Month:April-June] [Volumn:52 ] [Number:2] [Pages:51] [Pages No:88-89][No of Hits : 586]


ABSTRACT

Traumatic lateral translation is an extremely rare presentation. The diagnosis may be easily missed. An 18-year-old female presented with fall from height and backache and weakness in bilateral lower limbs. On examination, there was tenderness in lumbar spine, step-like deformity; neurological examination revealed no sensory loss and grade III power in both lower limbs without bowel and bladder involvement. Radiographic examination showed anterolateral listhesis of L5 over S1. Magnetic resonance imaging showed spinal canal stenosis and mild compression of traversing caudal roots. Patient was treated with open reduction and stabilization with posterior instrumentation, decompression, and posterolateral fusion. Complete neurological recovery was observed over 1-year follow-up period.

Keywords: Lateral, Listhesis, Lumbar, Spine, Traumatic.

How to cite this article: Yadav S, Singh S, Amar R, Nag R. Traumatic Lateral Listhesis of Lumbar Spine in a Young Female. J Postgrad Med Edu Res 2018;52(2):88-89.

Source of support: Nil

Conflict of interest: None


 
PROCEEDINGS OF CONGRESS IBOSCON 2018
Sandeep Patel, Tungish Bansal, Mandeep S Dhillon, Devendra K Chouhan, Himanshu Kanwat, Alka Bhatia

Multiple PRP Injection vs Single PRP Injection in Early OA Knee: An Experimental Study in a Guinea Pig Early Knee OA Model

[Year:2018] [Month:April-June] [Volumn:52 ] [Number:2] [Pages:51] [Pages No:90-103][No of Hits : 560]


ABSTRACT

Platelet-rich plasma (PRP) has emerged as the forerunner among disease-modifying treatment options of early osteoarthritis (OA) of knee.1 However, there is currently no consensus on the number and frequency of PRP injections, and their dosing schedules are widely debated. A few clinical studies2,3 have shown that multiple injections of PRP are better than single injection; however, the biological basis of this effect is not yet clear.


 
Review Article
David Rajan, Mandeep S Dhillon, Udai Cheema, Devendra K Chouhan

Evolution and Current Status of Arthroscopic Surgery in India

[Year:2018] [Month:January-March] [Volumn:52 ] [Number:1] [Pages:51] [Pages No:22-25][No of Hits : 530]


ABSTRACT

Arthroscopic surgeries are worldwide accepted modality to surgically treat the intraarticular injuries and ailment. The introduction and evolution of the same in our country was little late; however, an exponential improvement was observed in last one decade. Specialized workshops, conferences, and courses are the main sources for the learning and upgradation of surgical skills in this field.

Keywords: Arthroscopy, Evolution, Surgery.

How to cite this article: Rajan D, Dhillon MS, Cheema U, Chouhan DK. Evolution and Current Status of Arthroscopic Surgery in India. J Postgrad Med Edu Res 2018;52(1):22-25.

Source of support: Nil

Conflict of interest: None


 
Review Article
Smit Singla, Akhilesh Verma, Snehil Goyal, Itika Singla, Anjali Shetty

Conventional and Advanced Diagnostic Tools in Oral Cancer with Emphasis on Role of Dentist and Early Detection

[Year:2017] [Month:July-September] [Volumn:51 ] [Number:3] [Pages:40] [Pages No:128-133][No of Hits : 5044]


ABSTRACT

The prevalence of oral cancer is increasing worldwide day by day. Those who suffer from oral cancer have low survival rate compared with other cancer, mainly due to delay in the diagnosis, metastases, and presence of secondary tumors. For the dental profession, it is really challenging to diagnose oral precancer or oral cancer, particularly in its early stage of the disease. Early screening and advanced diagnostic tools play an important role in the early diagnosis and treatment planning of patients suffering from oral cancer. The diagnosis method usually includes histopathology and visualization adjuncts, such as toluidine blue, vizilite, etc. This study reviews the development of new upcoming tools for early detection, emphasis on the importance of role of dentist, and early detection of oral cancer.

Keywords: Early detection, Oral cancer, Screening.

How to cite this article: Singla S, Verma A, Goyal S, Singla I, Shetty A. Conventional and Advanced Diagnostic Tools in Oral Cancer with Emphasis on Role of Dentist and Early Detection. J Postgrad Med Edu Res 2017;51(3):128-133.

Source of support: Nil

Conflict of interest: None


 
Original Article
Tvisha Ketan Parikh, S Arumugam

Are Indian Habits of Cross-legged Sitting and Squatting associated with Anterior Knee Pain?

[Year:2017] [Month:January-March] [Volumn:51 ] [Number:1] [Pages:51] [Pages No:1-6][No of Hits : 2168]


ABSTRACT

Aim: To evaluate the association between anterior knee pain (AKP) and traditional Indian habits of cross-legged sitting and squatting which involve deep knee flexion.

Materials and methods: A case control study was carried out in 225 patients and 225 age and sex matched controls at a tertiary care university hospital in South India over 3 years. Males and females between 18 and 55 years were evaluated using a clinical proforma of history and musculoskeletal examination. The details of deep knee flexion habits with quantification of duration were noted and participants were categorized into those who sat and did not sit cross legged, and squatters and nonsquatters. Odds ratios and chi-square tests were calculated for both these categorical variables. A subgroup analysis and stratified analysis were also performed.

Results: The Odds ratios for cross-legged sitting and squatting were not significant at 0.88 and 0.92 respectively. Sixty-nine point three percentage of the AKP cases and 72% of the controls sat cross legged (p = 0.534) and 67.6% of the AKP cases and 69.3% of controls habitually squatted (p = 0.685). Stratified analysis revealed a protective effect of cross legged sitting in AKP cases with quadriceps muscle tightness.

Conclusion: This study did not find an association between AKP and Indian habits of deep knee flexion. More than 65% of all the participants regularly engaged in these habits. Laboratory biomechanical analysis of these positions is suggested in future to understand their effect on knee joint.

Clinical significance: These positions are integral to daily habits of many Indians. The advice to AKP patients to avoid them due to their probable AKP association is not supported by the current study. Clinicians can consider the impact on the patient’s quality of life before advising against these positions.

Keywords: Anterior knee pain, Cross-legged sitting, Indian habits, Squatting,

How to cite this article: Parikh TK, Arumugam S. Are Indian Habits of Cross-legged Sitting and Squatting associated with Anterior Knee Pain? J Postgrad Med Edu Res 2017;51(1):1-6.

Source of support: Nil

Conflict of interest: None


 
Case Report
Nagarajan Doraisamy, Malarvizhi Chandrasekhar, Jim Jebakumar, Sukhdev DB Singh

Tuberculous Compound Palmar Ganglion

[Year:2017] [Month:January-March] [Volumn:51 ] [Number:1] [Pages:51] [Pages No:28-29][No of Hits : 1374]


ABSTRACT

Introduction: Compound palmar ganglion of tuberculous etiology is an infrequent condition, which has an obvious clinical picture, but still overlooked and should be diagnosed earlier before the involvement of underlying bones and nerves.

Case report: We present the case of a 56-year-old male presenting with progressive swelling of the palm and forearm. He was diagnosed to have chronic flexor tenosynovitis without involvement of the underlying bones and was treated by complete excision and antitubercular therapy (ATT).

Conclusion: Tuberculous palmar ganglion is a condition that can be managed by excision and chemotherapy. However, it presents as a challenge to rural surgeons where the patients present late. Hence, early identification and treatment are the main goals of this article.

Keywords: Antitubercular therapy, Chronic flexor tenosynovitis, Compound palmar ganglion, Melon-seed bodies.

How to cite this article: Doraisamy N, Chandrasekhar M, Jebakumar J, Singh SDB. Tuberculous Compound Palmar Ganglion. J Postgrad Med Edu Res 2017;51(1):28-29.

Source of support: Nil

Conflict of interest: None


 
Original Article
Dhaval Ranjitbhai Lekhadia, Rohan Rai, Niveditha Hegde, Gautham Hegde, Abhinay Sorake, Anil Kumar

Assessment of Vertical Skeletal Patterns using a New Cephalometric Parameter: The Dhaval Rohan Angle

[Year:2017] [Month:January-March] [Volumn:51 ] [Number:1] [Pages:51] [Pages No:7-11][No of Hits : 1101]


ABSTRACT

Introduction: The aim of this study was to establish a new cephalometric parameter, named the Dhaval–Rohan angle (DR), to assess the vertical skeletal patterns on a lateral cephalogram with accuracy and reproducibility.

Materials and methods: One hundred and twenty pretreatment lateral cephalograms of the patients visiting the department of orthodontics and dentofacial orthopedics for treatment were obtained and divided into three groups. i.e., horizontal growth pattern, average growth pattern, and vertical growth pattern cases based on the routinely used cephalometric parameters; FMA, SN-GoGn, Y-axis angle and Jarabak ratio. This angle uses three skeletal landmarks, the point C (center of the condyle), point M (midpoint of premaxilla), and point G (center of the largest circle that is tangent to the internal inferior, anterior, and posterior surfaces of the mandibular symphysis).

Results: The one-way analysis of variance (ANOVA) test showed that the three groups studied were not the same for DR angle and the post hoc Tukey test found the groups to be significantly different. According to the Student’s t-test, there was no statistically significant difference in mean values of DR angle between males and females.

Conclusion: Cephalometric evaluation of young adults shows that the DR angle below 28.5° indicates a horizontal growth pattern, between 28.5 and 32.5° indicate an average growth pattern and above 32.5° indicate a vertical growth pattern.

Keywords: Growth pattern, Point C, Point G, Point M.

How to cite this article: Lekhadia DR, Rai R, Hegde N, Hegde G, Sorake A, Kumar A. Assessment of Vertical Skeletal Patterns using a New Cephalometric Parameter: The Dhaval–Rohan Angle. J Postgrad Med Edu Res 2017;51(1):7-11.

Source of support: Nil

Conflict of interest: None


 
Review Article
Vinay Jasani

Congenital Scoliosis

[Year:2017] [Month:April-June] [Volumn:51 ] [Number:2] [Pages:61] [Pages No:95-102][No of Hits : 935]


ABSTRACT

Congenital scoliosis is a scoliosis that occurs as a result of bony abnormalities that arise between 4 to 16 weeks of gestation. There are genetic and environmental factors involved in etiology. The majority of congenital vertebral anomalies are in the thoracic spine (64%).
The patients often have associated skeletal anomalies and can also be part of a syndrome. Skeletal, cardiac, genitourinary intraspinal abnormalities are most commonly found in association with congenital scoliosis.
The natural history seems to be related to the morphology of the bony the site in the spine, and the patient’s age. Congenital scoliosis usually progresses and often requires intervention. The aim of intervention is to achieve a flexible and balanced spine with normal truncal height and space available for lung ratio. Early intervention for scoliosis seems to be instrumental in trying to achieve these goals.

Keywords: Congenital, Hemivertebra, Scoliosis, Segmentation.

How to cite this article: Jasani V. Congenital Scoliosis. J Postgrad Med Edu Res 2017;51(2):95-102.

Source of support: Nil

Conflict of interest: None


 
Review Article
Mushtaq A Shaikh

Intraoperative Neurophysiological Monitoring in Spine Surgery

[Year:2017] [Month:April-June] [Volumn:51 ] [Number:2] [Pages:61] [Pages No:89-94][No of Hits : 917]


ABSTRACT

Intraoperative neurophysiological monitoring (IONM) encompasses a variety of neurological testing modalities used during surgery to monitor, identify, and potentially prevent iatrogenic complications to the nervous system and the blood supply to it or adjacent tissue. It has been used to monitor integrity of the neural pathway during spinal, neurological, cranial, and vascular procedures. Specific tests are designed to the clinical need of the surgery. Modalities may include: Somatosensory evoked potentials, motor evoked potentials, spontaneous or triggered electromyography, brainstem auditory evoked potentials, visual evoked potentials, electroencephalogram, and electrocorticography. During spinal surgery, a wide variety of procedures are utilized in which the spinal cord, nerve roots, and key blood vessels are frequently placed at risk from iatrogenic injury. Multimodal IONM relies on the strengths of different types of neurophysiological modalities to maximize the diagnostic efficacy in regard to sensitivity and specificity in the detection of impending neural injury. Thorough knowledge of the benefits and limitations of each modality helps in optimizing the diagnostic value of IONM during spinal procedures. As spinal surgeries continue to evolve, the value of neuromonitoring will also continue to become more prominent.

Keywords: Electroencephalography, Electromyography, Motor evoked potentials, Sensory evoked potentials.

How to cite this article: Shaikh MA. Intraoperative Neurophysiological Monitoring in Spine Surgery. J Postgrad Med Edu Res 2017;51(2):89-94.

Source of support: Nil

Conflict of interest: None


 
Review Article
Amrut U Borade, Filippo Familiari, Kyubo Choi, Jacob Joseph, Edward G McFarland

Comparison of Reverse Total Shoulder Arthroplasty vs Hemiarthroplasty for Acute Fractures of the Proximal Humerus: Systematic Review

[Year:2017] [Month:October-December] [Volumn:51 ] [Number:4] [Pages:51] [Pages No:182-187][No of Hits : 841]


ABSTRACT

The optimal treatment of proximal humerus fractures is debated; however, reverse total shoulder arthroplasty (RTSA) has become increasingly popular as the primary treatment. We systematically reviewed the PubMed, EMBASE, and Scopus databases to identify English-language clinical studies (evidence levels I through IV) comparing the results of RTSA with those of hemiarthroplasty (HA) for the treatment of acute proximal humerus fractures. We evaluated the following outcomes: Range of motion, patient-reported outcome measures (including pain relief), and complications. We identified eight published studies comparing RTSA with HA for treatment of acute proximal humerus fractures. The RTSA group (180 patients) showed significantly better postoperative pain relief, active anterior elevation, Constant-Murley scores, and American Shoulder and Elbow Surgeons (ASES) scores compared with the HA group (439 patients; all p < 0.05). There were no significant differences between the two groups for overall complications (RTSA, 11.8% vs HA, 20.8%), infections (2% for both groups), dislocations (RTSA, 0% vs HA, 2.5%), or nerve injury (RTSA, 1% vs HA, 2.8%). Scapular notching occurred in 15.8% of RTSA cases (grade I, 53%; grade II, 32%; grade III, 16%; and grade IV, 0%). In the treatment of acute proximal humerus fractures, RTSA provided better pain relief, postoperative anterior elevation, and outcome scores after surgery compared with HA and had similar complication rates.

Keywords: Complications, Outcomes, Pain, Reverse total shoulder, Shoulder hemiarthroplasty, Surgery, Systematic review.

How to cite this article: Borade AU, Familiari F, Choi K, Joseph J, McFarland EG. Comparison of Reverse Total Shoulder Arthroplasty vs Hemiarthroplasty for Acute Fractures of the Proximal Humerus: Systematic Review. J Postgrad Med Edu Res 2017;51(4):182-187.

Source of support: Nil

Conflict of interest: None


 
Invited Article
Jayesh Trivedi

Adolescent Idiopathic Scoliosis

[Year:2017] [Month:April-June] [Volumn:51 ] [Number:2] [Pages:61] [Pages No:58-67][No of Hits : 809]


ABSTRACT

Traditionally idiopathic scoliosis is divided into three categories according to the age of onset: Infantile (0-3 years), juvenile (4-9 years), and adolescent (10 years to skeletal maturity).

How to cite this article: Trivedi J. Adolescent Idiopathic Scoliosis. J Postgrad Med Edu Res 2017;51(2):58-67.

Source of support: Nil

Conflict of interest: None