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Open partial nephrectomy (PN) is the standard technique for organ-sparing resection of renal tumors. PN traditionally was done (if technically possible) in patients with renal cell carcinoma in a solitary kidney, if bilateral tumors are present, in chronic renal insufficiency or for patients with hereditary renal cell carcinoma. Today, indications for PN have considerably widened to include most renal masses that can be safely and completely removed independent of their size.

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Introduction: Diabetic foot ulcer is a major source of morbidity and a leading cause of hospitalization. It is estimated that approximately 20% of hospital admissions among patients with diabetes mellitus are due to diabetic foot ulcer. It can lead to infection, gangrene, amputation, and even death if appropriate care is not provided. Overall, the lower limb amputation in diabetic patients is 15 times higher than in non-diabetics. In the majority of cases, the cause for the foot ulcer is the altered architecture of the foot due to neuropathy resulting in abnormal pressure points on the soles. Purpose: The aim of this study is to develop low cost, lightweight foot pressure scanner and check its reliability and validity which can help to prevent foot ulceration. Design/Methodology/Approach: In the present study, a low cost, lightweight foot pressure scanner is developed, and dynamic plantar pressures in a group of 110 Indian patients with diabetes with or without neuropathy and foot ulcers are measured. Practical Implications: If these pressure points can be detected, ulcers can be prevented by providing offloading footwear. Originality/Value: Differences are found in dynamic foot pressures in different study groups, namely, diabetic patients, patients with diabetic peripheral neuropathy, patients with foot ulcers, and nondiabetics. The differences are significant (P < 0.01), which showed the validity of the tool. Reliability and consistency of the tool was checked by test–retest method. Paper Type: Original Research work. Conclusion: Based on the results of the present study, it is concluded that the scanner is successfully developed and it can measure foot pressures. It is a novel device to proactively monitor foot health in diabetics in an effort to prevent and reduce diabetic foot complications.

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Introduction: Mental disorders constitute a higher burden on low- and middle-income countries like Bangladesh. Mental disease is poorly recorded, and data are not easily available in countries like Bangladesh. Hence, the aim of the present study was to observe the pattern of mental diseases found in a tertiary care center during 1-year survey. Methods: One-year patient data were explored from January 2015 to December 2015 and were extracted manually manually from the register book. All diagnosis were collected, and data were analyzed using Microsoft Excel. Results: Among the 1474 patients, most were in the age group of 11–20 years (388 [26.3%]) and 21–30 years (437 [29.6%]), next age group was 31–40 years (243 [16.5%]). One-hundred and twenty (8.1%) and 33 (2.2%) patients were found in two extremes of age <10 years and >61 years, respectively. Males were 736 (49.9%) and females were 738 (50.1%). Male:female ratio was 1:1. Schizophrenia (360, 24.4%) was the most common psychiatric disease found which was next to major depressive disorder (187, 12.7%). Bipolar mania was found in 175 (11.9%) cases, and bipolar depression was found in 19 (1.3%) cases. Some other diseases such as generalized anxiety disorder was found in 57 (3.9%), obsessive-compulsive disorder in 35 (2.4%), phobic anxiety in 12 (0.8%), and panic disorder in 76 (5.2%) cases. Conclusion: In Bangladesh, burdens of mental disorders are high but largely unrecognized and underresearched area. To improve the mental health services in Bangladesh, further well-designed epidemiological and clinical research is required.

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Context: Idiopathic nephrotic syndrome (NS) is the most common glomerular nephropathy in pediatrics, with great variation in patient characteristics in different regions of the world. Difficult childhood NS poses a great diagnostic and management challenge for the treating nephrologists. The histopathological features of NS have been extensively studied by various authors from different regions of the world with a wide variation in the histopathological distribution. We aimed to describe the spectrum of histopathological diagnosis in childhood NS from North Karnataka, India, where there is a high incidence of consanguinity. Aims: The aim of this study is to study the spectrum of histopathology in children who underwent a renal biopsy in our tertiary care pediatric nephrology center. Settings and Design: Retrospective observational study at a tertiary care pediatric nephrology center over 1 year from January 2013 to June 2015. Subjects and Methods: The medical records of all children diagnosed as NS were retrospectively reviewed for demographic data, clinical course, and histopathological diagnosis. Statistical Analysis Used: Descriptive statistics. Results: Twenty-five children underwent biopsy in the study period. Seventeen (68%) were male as compared to 8 (32%) females. Thirteen (52%) of biopsied patients showed minimal change NS, 6 (24%) had focal segmental glomerulosclerosis, and 3 (14%) patients showed IgA nephropathy while 1 patient had mesangioproliferative glomerulonephritis, IgM nephropathy, and Finnish type NS each. Conclusions: Minimal change nephritic syndrome is the major biopsy finding in our part of the country even in steroid-resistant NS. This finding needs to be confirmed with studies with bigger sample size.

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Premature thelarche is frequently considered to be a normal variant of growth and development as it shows spontaneous remission in majority of cases. However, progression to precocious puberty is seen in up to 13% of cases. We present a case of 11-month-old female child with a history of progressive breast enlargement. Investigations revealed normal bone age and hormonal evaluation. This case emphasizes the importance of simple baseline investigations to differentiate precocious puberty and premature thelarche, thus ameliorating the parental anxiety.

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Background: Type 2 diabetes mellitus has been reported by studies as an extrahepatic manifestation of chronic hepatitis C (CHC). Aim: The present study aimed at determining the impact of CHC disease on insulin resistance (IR) and its correlation with tumor necrosis factor-α (TNF-α) in this infection. Materials and Methods: The present case–control study adopted purposive sampling technique in selecting 36 CHC and 36 anthropometrically matched apparently healthy individuals, who fulfilled the inclusion criteria. CHC was defined as persistent infection without remission for a period up to 1 year. Results: A statistically significant (P < 0.02) elevated TNF-α, fasting serum insulin (FSI), fasting plasma glucose, and homeostasis model of insulin resistance (HOMA-IR) were observed in CHC compared with the controls. The liver function profile of CHC group showed that plasma total protein and albumin were significantly low when compared to controls, whereas significant high aspartate and alanine aminotransferase levels were observed in the CHC group compared to controls. There was a statistically significant (P < 0.001) positive correlation between TNF-α and HOMA-IR (r = 0.751) and TNF-α and FSI (r = 0.694) in CHC patients. Conclusion: CHC disease could induce increased IR, partly mediated by TNF-α. We recommend metabolic profiling of chronic viral hepatitis C patients during disease management.

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Primary peritoneal serous adenocarcinoma (PPSA) is a rare primary peritoneal tumor in women. Ovarian, tubal, and peritoneal serous carcinomas have similar pathologic findings. CA125 is the common biomarker used for diagnosis, monitoring treatment response, and tumor progression. To differentiate PPSA from metastasis of primary ovarian serous adenocarcinoma, histopathological criteria were laid down by gynecologic oncology group (GOG) for the diagnosis of PPSA. We present a case of primary peritoneal serous adenocarcinoma clinically mimicking ovarian serous adenocarcinoma with omental metastasis.

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Introduction: Snoring is a common health condition which is unexplored in the context of Bangladesh. Hence, the objective of the present study is to find out the frequency of snoring among the healthy Bangladeshi people attending tertiary care center in Chittagong using a questionnaire. Methods: It was a single center, cross-sectional study conducted in the Department of Internal Medicine of a tertiary care hospital of Bangladesh among 119 apparently healthy adults who were the attendants of patients. A “Snore Survey” questionnaire adopted from an Indian study which was based on Berlin questionnaire was used. Results: With a 88.1% valid response rate, present study included 63 (52.94%) male and 56 (47.06%) female. Among all, 47.9% of (57) individuals were <30 years of age. Majority (82.4%) were recruited from urban locality. Frequency of snoring was 28 (23.5%) of total individuals. Nearly 33.3% of males and 12.5% of females were snorers. The frequency of snoring ranged from daily (25.0%) to monthly (28.6%) episodes. Some had very loud (25.0%) sound during sleep, and others had variable loudness. Male snorers were significantly taller, weighed more and had broader neck circumference than female (P < 0.05). Conclusion: Snoring is not an uncommon medical condition among healthy young people in Bangladesh. Considering the population of Bangladesh, the sample size is very small and a large scale study would certainly help create awareness among the patients as well as healthcare professionals about this neglected but very significant health problem.

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Background: Falls are a major cause a cause of unintentional injury. Reports in past suggest that majority of falls happen from fall from one level to another followed by fall from trees. In the year 2004, 17.2 million Daly's have been reported to be loss of due to falls. The study was planned with the aim to assess the pattern of fractures due to fall. Materials and Methods: The study was conducted as a hospital-based descriptive study conducted for 1 year between June 2014 and May 2015 using a record-based registration system at a tertiary care center in a rural area of Northwest India. The study population comprised all consecutive cases of musculoskeletal injuries due to fall reporting to the tertiary care center during the study except for those who denied consent to be included in the study. Results: It is seen that fracture distal end radius was the most common, followed by fracture both bone forearm and supracondylar fracture of elbow in the upper limb. Further, it is seen that intertrochanteric fracture and fracture both bone leg are the most common fractures in the right lower limb. Conclusions: Most often the cause of fall is multifactorial, even though it is know that falls are non-inevitable, therefore preventive strategies have much importance to avoid the fall related injuries.

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Introduction: Ureteropelvic junction obstruction (UPJO) is usually intrinsic; however, 15%–52% may be associated with crossing renal/lower pole vessels. Investigators have demonstrated that the presence of crossing vessels decreased the success rate of antegrade endopyelotomy. We prospectively reviewed our series of laparoscopic pyeloplasty in children and analyzed as to whether crossing vessels affected the morbidity and outcome. Methods: Children <18 years of age undergoing laparoscopic pyeloplasty for UPJO were prospectively included in the study. Pyeloplasty was performed anterior to the vessels, and the anastomosis was placed adequately distal to the crossing vessel. Children were followed up in the postoperative period for urinary tract infection, and a DTPA renogram was performed after 3 months in all. Results: Twenty (15.74%) children had crossing renal/lower pole vessels associated with UPJO. The mean age of these children was 11.0 ± years. The mean operating time was 96.15 ± 12.54 min as compared to 76.35 ± 8.16 min in children with UPJO alone. The mean blood loss was 31.50 ± 6.03 cc as compared to 29.56 ± 4.50 cc in children with UPJO alone. The mean postoperative hospital stay 51.50 h and 100% of the children showed improvement of renal function as well as drainage on the postoperative diuretic renogram done after 12 weeks of surgery. Conclusions: Crossing renal/lower polar is associated with UPJO in about 15% of children undergoing laparoscopic pyeloplasty. The presence of crossing vessels significantly prolonged operating time; however, the blood loss, postoperative hospital stay, and short-term outcomes were similar to children with UPJO alone.

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Background: Corpus callosum (CC) has an important role in establishing hemispheric lateralization of function. Significance of this structure which is the primary white matter commissure of the brain lies in the fact that damage to the CC during development has been found to be associated with poor neurological outcome and neuropsychological performance. Magnetic resonance imaging (MRI) can precisely detect, localize, and evaluate damage to CC in hypoxic-ischemic encephalopathy (HIE) patients and assist in reaching to at an accurate anatomical diagnosis, thus heeling in further management of the patient. Objectives: The objective of this study is to analyze the effect of HIE on CC morphometry by assessing various diameters of CC. Materials and Methods: Fifty-four patients with history of hypoxic-ischemic injury referred to the Department of Radiodiagnosis were included in the study. All the patients were made to undergo MRI of the brain using Siemens Symphony Magnetom 1.5 Tesla scanner after taking informed consent for the same. The findings of MRI brain were assessed and analyzed. Data analysis was done using percentages of different diagnosis and outcomes made by MRI brain were computed and compiled. Results: In the present study, male predominance is seen, 77.78% patients were male and 22.22% were female. In the present study, maximum numbers of patients were <1 year of age (37.04%). In the present study, we see that the isthmus was the most commonly affected portion of CC. Children who did not cry at birth, born with low birth weight, low Apgar score were positively correlated with severity of damage to CC. Conclusion: From the present study, it was noted that MRI is very efficient tool in evaluating morphometry of CC in HIE. Its noninvasiveness and no exposure to ionizing radiation is an added advantage. However, experience and understanding of the principles are essential for accurate diagnosis.

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Cryonics is a technology that is often looked upon with suspicion and as a science fiction. It is a life support technology that aims to revive a deanimated legally dead body on availability of suitable scientifically advanced technologies in the coming future. Thorough reasoning and analysis reveal that in fact cryonics is somewhat an extension of the current medical science and technology. The present article analyzes cryonics and attempts to discuss ethical aspects connected with it.

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