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A randomized controlled trial comparing the efficacy of intralesional 5-fluorouracil versus triamcinolone acetonide in the treatment of keloids
Avinash Prabhu, H Sreekar, Rajesh Powar, VM Uppin
January-April 2012, 39(1):19-25
Background: Effective keloid management is still a distant dream in spite of many recent modalities being tried for the same. Although many treatment protocols have shown efficacy of varying degrees, there are few systematic randomized trials comparing them. Objective: To compare the efficacy of intralesional 5-Fluorouracil versus Triamcinolone acetonide in the treatment of Keloids. Materials and Methods: This randomized controlled trial was conducted on 30 patients with keloids, randomly divided into two groups of 15 each, treated with intralesional 5-fluorouracil (Group A) or triamcinolone acetonide (Group B). The groups were compared for reduction in the size of keloid, pain relief, and the incidence of adverse effects. Statistical analysis was done using the unpaired student t- test and test of proportion. Results: The reduction in the size of the keloid was found to be significantly better in Group B (71.23%) than in Group A (57.48%) with a P value of 0.04. The difference in the reduction of pain, as assessed by the visual analog scale, between Groups A (18%) and B (24%), was found to be insignificant (P value - 0.47). Although the incidence of complications in Group A was three times higher than those in Group B, the difference was not statistically significant (P value - 0.13). Conclusion: Reduction in the size of the keloid, which was the main aim of this study was significantly better in those treated with triamcinolone acetonide than those treated with 5-fluorouracil. The other parameters like reduction of pain and the incidence of adverse effects were comparable in both the groups.
  10,352 465 2
Mitomycin C in ophthalmology
Rekha Mudhol, ND Zingade, RS Mudhol
January-April 2012, 39(1):4-6
Introduction to the use of Mitomycin C in ophthalmology was a significant development in the 1960s. Its use and application in ophthalmology has been increasing in recent years, because of its modulatory effects on wound healing. Current applications of this drug in ophthalmology include pterygium surgery, glaucoma surgery, corneal refractive surgery, cicatricial eye disease, conjunctival neoplasia, dacryocystorhinostomy surgeries, squint surgeries, and allergic eye disease. Although it has been used successfully in these conditions, it has also been associated with significant complications. This article reviews the current trends and uses of mitomycin C in the eye and its reported complications.
  9,637 637 -
Parameatal cyst of glans penis
Siddalingeshwar I Neeli, Praveen Patne, Suresh Kadli, Siddayya Hiremath
January-April 2012, 39(1):45-46
The parameatal cyst is a very benign condition seen in boys. We report a case of a parameatal urethral cyst in a 12-year-old boy. The cyst was recognized during early childhood, but the boy presented to our clinic at the age of 12 years, when the mass had grown enough to cause spraying of urine and poor cosmesis. A complete surgical excision was performed. Histologically, the cyst wall was lined by a tall columnar epithelium. Good cosmetic results, with no recurrence, were obtained.
  8,689 347 -
Giant 'giant cell tumor' of pelvis
Nadeem Ali, Abedullah Bhat, Khalid Muzzafar, Suhail Ahmad Bhat
May-August 2012, 39(2):98-99
Giant cell tumor (osteoclastoma) of pelvis is rare entity. Most of these have average size of 9.5cm. We here present a massive osteoclastoma involving pubis and periacetabular region to such an extent that surgical excision could not be done. Our surgical intervention was aimed to correct the associated deformity and improve function by debulking the part of tumor responsible for mechanical symptoms and deformity.
  7,923 358 -
Anencephaly: A pathological study of 41 cases
C Panduranga, Ranjit Kangle, Vijayalaxmi V Suranagi, Ganga S Pilli, Prakash V Patil
May-August 2012, 39(2):81-84
Background : Anencephaly is a lethal neural tube defect which is due to the defective closure of rostral pore of neural tube. In more than 50% of cases it is associated with other systemic anomalies. Hence this study was undertaken to assess pathological parameters associated with anencephaly in particular attention to associated systemic anomalies. Materials and Methods: It is a study on 41 anencephaly fetuses conducted in the Department of Pathology. The period of study is from January 2001 to December 2011. Results: Out of 41 cases, 30 (73%) cases showed presence of systemic anomalies, 48.5% of the cases were observed in primigravida. Most common associated anomaly was spina bifida followed by gastrointestinal anomalies. Conclusion: Pathological examination of the abortus is essential to document the associated anomalies.
  6,993 293 -
Low grade mucoepidermoid carcinoma of the tongue: An unusual presentation
L Ambika
May-August 2012, 39(2):85-88
Mucoepidermoid carcinoma is the most common malignant salivary gland tumor of epithelial origin. It is an unusual type of tumor and varies in its aggressiveness from a low grade to a high grade rapidly growing tumor. Low-grade mucoepidermoid carcinoma at times misleads the clinician because of its atypical location and innocent appearance. Immunohistochemical studies prove indispensable in identifying such a tumor as routine histopathology may be inconclusive.
  6,268 255 -
A study of the formation and branching pattern of brachial plexus and its variations in adult human cadavers of north Karnataka
Sheetal V Pattanshetti, PS Jevoor, VS Shirol, Daksha Dixit, Shilpa Bhimalli
May-August 2012, 39(2):70-77
Introduction and Objectives: The brachial plexus is highly variable, in its formation and branching pattern thus, knowledge of its anatomical patterns, may be insufficient for the surgeon operating on or around these nerves or for the regional anesthesiologist working in this area. Therefore, the present study was an attempt to study further about variations of brachial plexus encountered during routine dissection classes. Materials and Methods: The present descriptive study was carried out by dissection of 60 upper limbs of 30 cadavers, in the age group of 18 to 85 years, obtained during a study period of 2 years from the Department of Anatomy. The plexus was studied in its entire course commencing from the formation in cervical region, course through root of the neck and axilla, up to the main terminal branches of the upper extremity. During the dissection, variations of brachial plexus pertaining to its formation from the roots, trunks, divisions and cords and the branching pattern were observed and data was collected. Results: Out of the 60 cadaveric upper limbs studied for the anatomical variations of the brachial plexus, 2 limbs (3.33%) were pre-fixed plexuses. Fusion of adjacent trunks was detected in 2 limbs (3.33%). Variations in branches of lateral cord were detected in 8 limbs (13.33%). Among Posterior cord variations 2-thoracodorsal nerves were detected in 2 limbs (3.33%). All the other branches from brachial plexus had been found to have no anatomical variations. Conclusion: In the present study, an attempt has been made to know the possible variations of the brachial plexus. Though the variations mentioned may not alter the normal functioning of the limb of the individual, but knowledge of the variations is of prime importance to be kept in mind, during anaesthetic and surgical procedures.
  5,763 291 -
Knowledge and practices on maternal health care among mothers: A Cross sectional study from rural areas of mid-western development region Nepal
Kapil Gyawali, Damaru P Paneru, Bina Jnawali, Kalpana Jnawali
January-April 2013, 40(1):9-13
Background: Safe motherhood is a priority program in Nepal, aiming to restrain maternal deaths. Meanwhile, knowledge, practices, accessibility, and service quality are considered keys to improve service utilization. This study was conducted to identify knowledge and practices of maternal health care among mothers having < 1-year-old child in the Mid-western Development Region, Nepal. Materials and Methods: A community-based cross-sectional study was conducted during January-April 2011 in rural, Mid-western Development Region, Nepal. Three Village Development Committees (VDC) from Bardiya (plain) and two VDCs from each of the Salyan and Pyuthan (hill) and Jumla (mountain) districts were selected randomly. Hence, there were 81 clusters (1VDC = 9 clusters) and 7-8 participants were selected randomly from each cluster. Data were collected by interview using structured questionnaire and Focus Group Discussion Guideline (18 FGDs), analyzed by SPSS (16.0). CD recorded qualitative data were transcribed and narrated. Percent mean and standard deviation were calculated. Results: Three quarters of the participants had correct knowledge regarding minimum numbers of antenatal visits to be done by a pregnant woman (WHO guideline). Nearly two-fifth participants knew schedule of antenatal care (ANC) visits. Almost 60% had done ≥ 4 ANC visits during last pregnancy. Majority visited Sub Health Post/Health Post/Primary Health Care Centre for ANC Checkup. About 90% had taken Iron and folic acid tablets. About 57% were home deliveries (last childbirth), 40% deliveries were assisted by relatives/husband, and only 32% did postnatal health checkup. Conclusions: There were gaps in the knowledge and practices for health care during pregnancy, childbirth and in the postpartum period. A high rate of home deliveries with the low postnatal service utilization was prevalent. Intensive awareness progam and behavioral change interventions, regular pregnancy monitoring may promote the health service utilization.
  5,313 718 -
Apple peel jejunal atresia: Successful management of a rare case
Santosh B Kurbet, HS Patil, SM Dhaded, MR Bhandankar, RS Mane
January-April 2012, 39(1):29-31
Apple peel jejunal atresia is a rare congenital anomaly. This condition presents at birth as an intestinal obstruction, is diagnosed by X-rays and confirmed by laparatomy. Resection of the dilated proximal intestine and primary anastomosis is the treatment, but has a poor prognosis. We report here a rare form of atresia with apple peel deformity and its successful management.
  5,566 419 -
Fetal polycystic kidney disease: Pathological overview
Sunita B Patil, Madhura D Paricharak, Deepak G Paricharak, SS More
May-August 2013, 40(2):106-108
Polycystic kidney disease is a rare developmental anomaly inherited as autosomal dominant or autosomal recessive. It is characterized by cystic dilatation of the collecting ducts frequently associated with hepatic involvement and progression to renal failure. It is included in the differential diagnosis of cystic diseases of the kidney. We report a case of polycystic kidney disease, in 22 weeks fetus incidentally detected on routine antenatal ultrasonography and confirmed by fetal autopsy. This report elucidates the importance of early diagnosis and intervention in cystic kidney diseases.
  5,244 257 -
Diabetes and tuberculosis: A reemerging epidemic
Vinay Mahishale
May-August 2013, 40(2):59-60
  4,959 225 -
Nutritional status of adolescent girls residing in rural area: A community-based cross-sectional study
Sulakshana S Baliga, Vijaya A Naik, Maheshwar D Mallapur
January-April 2014, 41(1):22-25
Background: Adolescence is a period of transition between childhood and adulthood. Nutritional requirements during this period increase tremendously compared to preceding years of growth. The nutritional status of adolescent girls, the future mothers, contributes significantly to the nutritional status of the community. The present study was aimed to assess the current nutritional status of the adolescent girls. Materials and Methods: This one-year community-based, cross-sectional study was undertaken at a village Peeranwadi of District Belgaum, Karnataka among 400 adolescent girls of 10 to 19 years. Information on socio-demographic variables was collected by an interview using pre-designed and pre-tested questionnaire. A 24-hour recall method was used to assess nutrient intake. The nutrient intake was calculated using tables of nutritive value of Indian foods. For the comparison of anthropometric data, National Center for Health Statistics and National Health and Nutrition Examination Survey standards were used. Results: The mean age among the study population was 12.9 ± 2.06 years. Majorities (73.5%) of them were Hindus, 98.5% were literate, and 90% were currently studying. Adolescent girls between 10 and 14 years were more stunted (63.82%) as compared to 15 to 19 years (40.84%) (P = 0.0003) and thin (60.79% vs. 39.43%; P = 0.0009). Overall, the mean calorie intake was observed to be 1272.20 ± 133.28 kcal/day, protein intake was 40.99 ± 3.32 gm, and iron intake was 14.42 ± 2.58 mg. Conclusion: Overall, majority of girls were having dietary intake less than 50% of RDA, and almost three fourth of girls were anemic.
  4,121 641 2
Prevalence of extended-spectrum beta-lactamases, AmpC beta-lactamase, and metallo-beta-lactamase producing Pseudomonas aeruginosa and Acinetobacter baumannii in an intensive care unit in a tertiary care hospital
Varun Goel, Sumati A Hogade, SG Karadesai
January-April 2013, 40(1):28-31
Background: Resistance to broad-spectrum beta-lactams, mediated by extended-spectrum beta-lactamases (ESBL), AmpC beta-lactamase, and metallo-beta-lactamase (MBL) enzymes, is an increasing problem worldwide. Aim of the study: This study was undertaken to detect ESBL, AmpC beta-lactamase and metallo-beta-lactamase producing Pseudomonas aeruginosa and Acinetobacter species from the endotracheal aspirates. Materials and Methods: A prospective study was performed over a period of 15 month in a tertiary care hospital. A total of 26 clinical isolates of P.aeruginosa and 40 of Acinetobacter species were tested for the presence of ESBL, AmpC beta-lactamase, and metallo-beta-lactamase enzyme. Detection of ESBL was done by the combined disk diffusion method as per Clinical and Laboratory Standards Institute (CLSI) guidelines, and MBL was detected by imipenem-Ethylenediaminetetraacetic acid (EDTA) combined disk method. Isolates showing reduced susceptibility to cefoxitin (30 μg) disk were considered 'screen positive' for AmpC beta-lactamases and selected for detection of plasmid-mediated AmpC by the AmpC disk test. Results : 42.30% isolates of P.aeruginosa were positive for ESBL while 53.85% were MBL producers. Among 39 isolates of Acinetobacter baumannii, 43.59% were AmpC producers while 48.72% were MBL-producing strains. Conclusion: The study emphasizes the high prevalence of multidrug-resistant P.aeruginosa and A.baumannii producing beta-lactamase enzymes of diverse mechanisms. Thus, proper antibiotic policy and measures to restrict the indiscriminative use of cephalosporins and carbapenems should be taken to minimize the emergence of this multiple beta-lactamase-producing pathogens.
  3,504 792 -
Challenging aspects of and solutions to diagnosis, prevention, and management of hypoglycemia in critically ill geriatric patients
Vishal Sehgal, Sukhminder Jit Singh Bajwa, Upinder Khaira, Rinku Sehgal, Anurag Bajaj
September-December 2013, 40(3):128-134
There is a worldwide pandemic of diabetes. Also there is a gradual and steady increase in the elderly population. Often clinicians are faced with managing dysglycemia in the elderly with underlying sepsis and multiple comorbidities. This predisposes the elderly to potentially increased chances of hypoglycemia in inpatient settings. This article reviews the altered renal physiology and its effects in the management of dysglycemia in the elderly population. It also emphasizes the role of renal insufficiency and sepsis as the main etiological factors for hypoglycemia in both diabetics and nondiabetics in the inpatient settings.
  3,914 277 -
Laparoscopic incisional hernia repair: Polyester versus Polytetraflouroethylene mesh
Adil Bangash, Mohammad Khan Wazir
September-December 2012, 39(3):118-123
Aims and Objectives: To compare the frequency of complications of laparoscopic repair of incisional hernia between polyester and Polytetraflouroethylene meshes. Materials and Methods: This study was conducted as part of an Interventional multicentre trial at the Rehman Medical Institute Peshawar, Peshawar Institute of Medical Sciences and Pakistan Institute of Medical Science Islamabad from the 1 st of October, 2008 till 30 th September, 2011. The frequency of complications was calculated as the measure of comparing two commercially available meshes for the laparoscopic repair of incisional hernia using the Intrperitoneal placement of mesh (IPOM) technique. These patients were admitted via the out-patient department and their demographic data was collected on a proforma. The size of the defect was evaluated clinically or radiologically and if >10cm were excluded from the study. Forty five patients were alternately placed in either group and group I comprised patients with a ventral hernia that was repaired with composite polyester mesh (Parietex R ) whereas the other group was also repaired laparoscopically but repaired with a Polytetraflouroethylene (Dual R ) mesh. All data was collected on the individual proforma of each patient and was loaded on the SPSS R version 13.0. Results: The BMI (body mass index) in both groups was similar ( P = 1.41). The mean hospital stay was higher in the Polytetraflouroethylene (PTFE) mesh group but the values were not significant ( P = 1.12). No peri-operative death was observed in either group. Five patients (11.11%) from group I were re-admitted with varying complaints and were diagnosed as having sub-acute intestinal obstruction ( P = 0.04). A higher but insignificant recurrence rate was observed in the polyester group over a one year period of follow up. Four patients (8.8%) that were diagnosed with recurrences in group I. Instead the PTFE group had a lower recurrence ( P = 0.91). Conclusion: The frequency of recurrence was similar in both groups. A higher frequency of intestinal obstruction was observed in the polyester group.
  3,828 358 -
Cellulitis and deep venous thrombosis: A rare association
SM Jali, Santosh B Kurbet, Preeti Amarkhed, AS Gogate
January-April 2012, 39(1):26-28
A nine-year-old male child presented to us with a history and clinical examination suggestive of bilateral lower limb cellulitis. Investigations revealed leucocytosis, decreased Protein S levels, and growth of methicillin-resistant Staphylococcus aureas in the blood and pus cultures. A Doppler study revealed bilateral lower limb deep vein thrombosis (DVT). The child underwent fasciotomies under the cover of antibiotics and the DVT was treated with heparin followed by oral anticoagulation. In cases of cellulitis, DVT should be ruled out, as the clinical features of cellulitis may mask those of DVT, leading to missed diagnosis and serious complications.
  3,845 306 -
Treatment of infected non union tibia: A novel technique - lengthening using limb reconstruction system over intramedullary nail
Mahantesh Y Patil, Sumit Mehra
January-April 2013, 40(1):14-19
Background: To assess combination of an intramedullary interlocking (IMIL) nail with limb reconstruction system (LRS) in cases of infected nonunion tibia and to show influence of nail in predicting good outcome. Materials and Methods: From 2009 to 2011, records of 20 patients (17 men and three women) aged 18 to 65 years (mean, 38.4 years) with infected nonunion of the tibia treated with the LRS over IMIL Nail technique were prospectively reviewed. According to Jain et al., patients were classified into five cases of A1, five cases of type A2, seven cases of type B1, and three cases of type B2. All cases underwent LRS and IMIL. Mean amount of target lengthening was 54.65 mm. The mean follow-up was 14 months. Results: Mean amount of tibia lengthening was 51.70 mm. Leg length equalization was achieved in 19 cases (±5). According to modified scoring by Paley et al., 12 patients had excellent results, three patients had good, four patients had fair outcome, and one patient had poor outcome. Mean distraction index was 0.97. Mean maturation index was 2.43. Mean consolidation index was 3.47. Mean healing index was 1.40. One case had proximal locking screw failure. One case developed pre mature consolidation as distraction was started at delayed period due to non-compliance. Two cases developed decreased dorsi flexion of ankle. Two cases required flap surgeries for cover of bone. One case had pin breakage, which had to be exchanged. One case developed re-infection. Conclusion: The advantages of this technique include complete eradication of infective foci, reduced risk of deformity during lengthening, decrease risk of fractures post external fixator removal and reduction of time required for external fixator use thus decreasing healing index: Number of days of external fixation required per centimetre of lengthening.
  3,379 366 -
Gratification behavior in a young child: Course and management
Aditya Anand Pandurangi, Swapna Aditya Pandurangi, Sameer Belvi Mangalwedhe, Mahesh Mahadevaiah
January-April 2016, 43(1):48-50
Masturbation (gratification behavior) is rarely seen in young children. It occurs in children between the age of 3 months and 3 years with a second peak incidence at about the adolescent age. A 26-month-old child presented to us with gratification behavior. On evaluation, she did not have any physical illness mimicking gratification behavior. The parents were counseled, and 6 sessions of behavior therapy were carried out. Gratification behavior in young children is not pathological. Waxing and waning of the symptoms may be present.
  3,548 136 -
Assessment of the level of stress and coping strategies among patients with coronary artery disease
Madisetty Bhagyalakshmi, Banda Venkata Ramana, Hema Suresh, Jaya Mohan Raj
September-December 2012, 39(3):136-140
Background: Stress evolves out of life events and experiences, stimulates one's thinking process and helps to maintain a basal level of autonomic arousal. Stress and certain behaviors like aggressiveness striving for achievement contribute to the pathogenesis of Coronary Artery Disease (CAD). Presence of psychosocial stressors is associated with increased risk of acute myocardial infarction. Coping processes are usually involved to reduce stress levels. Objectives: The study was conducted to assess the stress level and coping strategies among the CAD patients. Materials and Methods: Non experimental research design was chosen. The patients with CAD admitted for the first time were taken as the samples. A total of 100 patients were selected by non-probability sampling methods. The standardized tool used for the study consisted of stress and coping scale. The questionnaire consisted of 20 questions to assess stress and 20 questions to assess coping. The maximum score indicated increased stress and adequate coping and the minimum score indicated less stress and inadequate coping. Results: In this study 43% of the patients were having moderate stress and 91% of patients showed moderate coping. None had increased stress and only 5% of the patients had adequate coping strategy. Conclusions : This study demonstrated an approach to develop more coping strategies to reduce stress among the CAD patients. Nurses working in the Cardiology Department should engage themselves to address the psychosocial needs of those patients and take measures to plan coping strategies.
  3,158 351 -
Nanotechnology - The future armour of forensics: A short review
Vinay R Hallikeri, Manjula Bai, AG Vijay Kumar
January-April 2012, 39(1):10-11
Nanotechnology is the study of the control of matter of an atomic and molecular scale. At present the most widespread forensic application of micro fluidic systems is post-polymerase chain reaction (PCR) quantization. These systems are currently being used in several forensic laboratories to perform post-PCR quantification of mitochondrial DNA. Another innovation relates to assisting in solving gun crime. Using a nanoscale developer and an X-ray source, it is possible to image the etched fingerprints even if the casing has been wiped or washed. This technology is going to revolutionize the fields of virtopsy, crime scene investigation, identification, forensic ballistics, and toxicology.
  2,902 541 -
A prospective study to assess the surgical outcome in three- and four-part proximal humerus fracture with PHILOS plate
Mahantesh Y Patil, AB Patil, Sharat Balemane
January-April 2012, 39(1):12-16
Background: Optimal surgical management of three- and four-part proximal humeral fractures in osteoporotic patients is controversial, with many advocating prosthetic replacement of the humeral head. Proximal humerus interlocking osteosyntheses that maintain angular stability under load have been proposed as an alternative to hemiarthroplasty for the treatment of three- and four-part proximal humeral fractures. Materials and Methods: The records showed 50 patients, with a mean age of 57.5 years. The Neer three-part proximal humeral fractures were 18 in number, and the four-part proximal humeral fractures were 32. All the patients were treated surgically between January 2008 and December 2010. All patients had a radiographic and clinical follow-up performed at one, three, and six months and at one year. The clinical outcomes were measured with the use of the Constant-Murley system. This study was based on level 1 of the evidence. Results: The mean Constant score (and standard deviation) at the time of the final follow-up was better in the locked-plate group. The mean Constant score was 80 (range, 40 - 100). Complications with this fixation included osteonecrosis in one patient, malunion in one patient, Axillary nerve palsy in one patient, and impingement syndrome in one patient. Conclusions: The most important factor for a favorable outcome in three- and four-part fractures in the proximal end humerus gives an accurate anatomical reduction, which is achieved by locking plate osteosynthesis, with multiplanar screws. It is a safe and effective method, with minimal tissue damage, higher primary stability, and load transfer through the implant, which are important to avoid complications. The PHILOS Plate produces promising functional outcomes.
  3,026 310 -
Cytomorphology of nipple discharge and fine needle aspiration of duct papilloma
HB Bannur, VV Suranagi, R Davanagere, B Hungund, PV Patil
May-August 2012, 39(2):96-97
The primary role of fine needle aspiration (FNA) of the breast is the distinction between benign and malignant lesions; but in many cases, additional information may be obtained. The major breast lesions that yield papillary fragments on FNA are papillary carcinoma, papilloma, fibroadenoma, and invasive ductal carcinoma that have a papillary component. We present cytomorphological features of nipple discharge and FNA of breast lump in a 32-year female.
  3,066 225 -
Glaucoma awareness and knowledge in a tertiary care hospital in a tier-2 city in South India
Mridula Prabhu, Shankargouda H Patil, Pravin Chandra R Kangokar
January-April 2013, 40(1):3-8
Background: Awareness of glaucoma is low in spite of being the second leading cause of preventable blindness in the world. Aim: To study the awareness and knowledge levels of glaucoma in a tertiary eye care hospital in a tier-2 city. Materials and Methods: This is a hospital-based crosssectional study. A total of 704 patients attending ophthalmology outpatient department of Sri Dharmasthala Manjunatheshwara College of Medical Sciences and Hospital (SDM) Dharwad, aged 40 years and above were administered a questionnaire after a written informed consent to assess their awareness and knowledge levels of glaucoma. Subjects "having heard of glaucoma" even before they were recruited for the study were defined as "aware", and subjects having some understanding of the eye disease were defined as "knowledgeable". Results: Out of 704 subjects recruited for the study, only 34 (4.8%) subjects were aware of glaucoma and 22 (3.1%) had some knowledge of glaucoma. Determinants of glaucoma awareness were higher levels of education, diabetes, or glaucoma and family history of glaucoma. Conclusion: Awareness and knowledge of glaucoma was very low among the subjects. The findings of the study stress the need for health awareness for effective prevention of blindness due to glaucoma.
  2,882 401 2
Rare case of giant broad ligament fibroid with myxoid degeneration
RR Godbole, KS Lakshmi, Kabbur Vasant
September-December 2012, 39(3):144-146
Giant fibroids are known to arise from the uterus, although very rarely from extra-uterine sites. Among extra-uterine fibroids, broad ligament fibroids generally achieve enormous size and generally present with pressure symptom like bladder and bowel dysfunction. Myxoid degeneration is a rare complication of benign fibroid, where presence of cystic changes mimics the metastatic malignant ovarian tumor. We report a case of true broad ligament fibroid measured about 13 kg. This case is reported for its rarity and the diagnostic difficulties in differentiating malignant ovarian tumor and benign fibroid with myxoid degeneration.
  3,079 196 1
Composite polypropylene mesh versus lightweight polypropylene mesh: The TAPP repair for laparoscopic inguinal hernia repair
Adil Bangash, Nadim Khan, Muzaffaruddin Sadiq
May-August 2012, 39(2):64-69
Aims and Objectives: To determine the frequency of complications and pain scores post-operatively following TAPP (Transabdominal Pre-peritoneal)repair for inguinal hernia, comparing lightweight polypropylene versus the composite polypropylene mesh. Materials and Methods: This study was conducted at Lady Reading Hospital, Peshawar, from December 1, 2007, to November 30, 2011. Group A included all those patients with inguinal hernia that were operated using the TAPP method and extraperitoneal placement of the lightweight polypropylene mesh, whereas group B comprised of those patients that were placed a composite polypropylene mesh (VYPRO II R ). A pro forma was prepared to record all the relevant data such as the NYHUS classification of the type of hernia, the post-operative pain scale score, and the complications that included seroma formation, testicular pain and atrophy, preoperative injuries, surgical emphysema, adhesion obstruction, mesh infection, wound infection, and perioperative mortality. The planned sequence of follow-up after discharge of the patient was at 1 week, 1month, 3 months, 6 months, and one year. Data were analyzed using SPSS R for Windows version 13.0. Results: A total of 192 patients were operated, equally divided between both groups. The VYPRO II R group had a higher number of direct hernias and the operative time was also much less but this was not statistically significant (P=0.91). The mean hospital stay was slightly higher in the polypropylene group but that was also not significant (P=0.89). The frequency of seroma formation was higher in the polypropylene group (6.25%) and majority of these patients from both groups had larger scrotal hernias (P=0.34). The most significant finding in this study was the frequency of chronic pain with a visual analogue score of >3(1-10) after the six-month period was significantly higher in the polypropylene group (P=0.02). The recurrence rate was comparable in both groups with 3 patients in group B(P=0.62). Conclusions: No difference in the frequency of recurrence was observed over a one-year follow-up period but significant pain scores were observed in the polypropylene group. Studies with longer follow-up to rule the rate of recurrence in composite meshes will determine its benefit over the lightweight polypropylene meshes.
  2,911 296 -