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  Citation statistics : Table of Contents
   2012| January-April  | Volume 39 | Issue 1  
    Online since May 21, 2012

 
 
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ORIGINAL ARTICLES
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
DOI:10.4103/0974-5009.96466  
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.
  8 15,727 952
CASE REPORTS
Parameatal cyst of glans penis
Siddalingeshwar I Neeli, Praveen Patne, Suresh Kadli, Siddayya Hiremath
January-April 2012, 39(1):45-46
DOI:10.4103/0974-5009.96476  
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.
  3 14,987 680
REVIEW ARTICLES
Mitomycin C in ophthalmology
Rekha Mudhol, ND Zingade, RS Mudhol
January-April 2012, 39(1):4-6
DOI:10.4103/0974-5009.96457  
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.
  3 16,950 1,203
Nanotechnology - The future armour of forensics: A short review
Vinay R Hallikeri, Manjula Bai, AG Vijay Kumar
January-April 2012, 39(1):10-11
DOI:10.4103/0974-5009.96460  
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.
  1 6,165 857
CASE REPORTS
Osteochondromatosis: A rare clinical condition
Kiran Patil, Mahantesh Y Patil, Aditya Khemka
January-April 2012, 39(1):40-41
DOI:10.4103/0974-5009.96475  
A case report of multiple hereditary exostosis / osteochondromatosis is presented. Exostosis is a benign cartilaginous lesion. Solitary lesions are called osteochondroma, while the presence of multiple lesions, an autosomal dominantly inherited genetic defect, is called osteochondromatosis. In extremely rare instances they may devolve into a chondrosarcoma, the chances of which are much higher in the presence of multiple lesions. We report a rare case of an eight-year-old girl who presented with multiple swellings arising from the metaphysial regions of the femur, tibia, fibula, and the radius. She was treated conservatively by us, and is currently being monitored regularly for any malignant change.
  - 4,911 389
Rubinstein Taybi syndrome: Broad thumbs - Hallux syndrome
Mahesh Kamate, NS Mahantshetti, Anshul Mehra
January-April 2012, 39(1):42-44
DOI:10.4103/0974-5009.96474  
The Rubinstein Taybi syndrome is a rare genetic disorder that is characterized by varying degrees of intellectual disabilities, distinct facial features, broad thumbs and first toe, and delay in cognitive and motor skill development. This is often detected in newborns because of the physical features that are apparent at birth. Correct diagnosis helps in the appropriate genetic counseling of parents. Here we report a case wherein the characteristic physical features led to the diagnosis of the Rubinstein Taybi Syndrome.
  - 4,130 418
Cellulitis and deep venous thrombosis: A rare association
SM Jali, Santosh B Kurbet, Preeti Amarkhed, AS Gogate
January-April 2012, 39(1):26-28
DOI:10.4103/0974-5009.96468  
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.
  - 12,630 707
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
DOI:10.4103/0974-5009.96470  
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.
  - 12,521 817
Meningitis due to Hemophilus influenza
Manjula Vagarali, MB Kamat, SC Metgud, SG Karadesai
January-April 2012, 39(1):32-33
DOI:10.4103/0974-5009.96471  
Despite the availability of potent newer antibiotics, the mortality rate due to acute bacterial meningitis remains significantly high in India and other developing countries; ranging from 16 - 32%. A 10-year-old female child presented to us with fever, vomiting, and convulsion. Signs of meningial irritation were present. Hemophilus influenzae was identified in the laboratory. The child showed improvement with ceftriaxone and amikacin, and thus, the patient recovered satisfactorily.
  - 3,048 300
Bilateral absence of musculocutaneous nerve
Mathada V Ravishankar, Pruful S Jevoor, Lohit Shaha
January-April 2012, 39(1):34-36
DOI:10.4103/0974-5009.96472  
Brachial plexus is an important group of spinal nerve plexus that supplies the muscles of the upper limb via the ventral rami of the Cervical 5 - Thoracic 1 fibers of the spinal nerves. It is not uncommon to notice the variations during cadaveric dissections in many regions of the body, at different levels, such as, roots, trunks, division, cords, communications, and branches as reported in the literature. Although the nerve supply of the body musculature takes place in the fetal life itself, its course, branching pattern, innervations, and communication can show variable patterns as the fetal development progresses. One such anomaly was noticed during our routine cadaveric dissection in the Department of Anatomy, Jawaharlal Nehru Medical College, Belgaum, showing bilateral absence of the musculocutaneous nerve, which obviously drew the attention of the students of medicine, physiotherapy, and learning clinicians as well.
  - 3,659 393
Multiple intracranial cavernous angiomas: A rare case series
Pradeepgoud H Patil, AC Shetti, Ashwin S Patil, Vinaykumar C Udasi, Kiran S Desai, Tejas B Gosalia
January-April 2012, 39(1):37-39
DOI:10.4103/0974-5009.96473  
Cavernous angiomas are cerebral cavernous malformations and they are relatively rare lesions. Two forms of cavernous angiomas have been described: a sporadic form, in which patients usually have a single lesion, and a familial form, the hallmarks of which are multiple lesions and autosomal dominant transmission. The familial form appears to be very uncommon and has mainly been described in the Hispanic population. We report two cases of multiple intracranial cavernous angiomas which is an autosomal dominant pattern of inheritance. It is very rare to find this in non Hispanic population.
  - 4,387 398
EDITORIAL
Counseling notes: A missing title in the medical records
Ashok Godhi
January-April 2012, 39(1):1-3
DOI:10.4103/0974-5009.96456  
  - 3,250 426
ORIGINAL ARTICLES
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
DOI:10.4103/0974-5009.96462  
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.
  - 6,085 563
Hypertensive disorders affecting the morphometry of placenta
Sharmishtha Ghodke, Sandhya Dharwadkar
January-April 2012, 39(1):17-18
DOI:10.4103/0974-5009.96464  
The placenta reflects the changes due to maternal hypertension, as it is a mirror of the maternal and fetal status. The study of a hundred placentae was conducted, to find out the morbid changes in the placentae of hypertensive mothers, in comparison to those of mothers with normal pregnancies. In gross appearance the placentae of mothers with PIH (Pregnancy-Induced Hypertension) were smaller and irregular. Surface area and volume showed reduction in the placentae of PIH mothers. Thus, the severity of hypertension adversely affects both fetal and placental outcome.
  - 3,947 500
REVIEW ARTICLES
Inducible clindamycin resistance in Staphylococci: Should clinicians and microbiologists be concerned?
Madhumati Kamat, MA Vagarali, SG Karadesai
January-April 2012, 39(1):7-9
DOI:10.4103/0974-5009.96459  
The increasing incidence of a variety of infections due to Staphylococcus aureus and the expanding role of community-associated methicillin-resistant S. aureus has led to an emphasis on the need for safe and effective agents to treat both systemic and localized Staphylococcal infections. Several newer antimicrobial agents are available for treatment of systemic Staphylococcal infections, but their use may be limited by the relatively high cost of these agents or the need forparenteral administration. Clindamycin has been used successfully to treat soft-tissue and musculoskeletal infections due to MRSA, in adults and children. However, concern over the possibility of the emergence of clindamycin resistance during therapy has discouraged some clinicians from prescribing that agent. Simple laboratory testing (e.g., the erythromycin-clindamycin 'D-zone' test) can separate strains that have the genetic potential (i.e., the presence of erm genes) to become resistant during therapy, from strains that are fully susceptible to clindamycin.
  - 3,798 106
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