KS Singh Raminder, Vaibhav C Chewoolkar, Chetan Chaudhari
“Sixteen and a half” syndrome is a recently coined terminology for a novel pontine neuro-ophthalmological condition. It is characterised by “one and a half” syndrome with an additional ipsilateral seventh and eighth cranial nerve palsy (1½+7+8=16½). We hereby present a case with “sixteen and a half” syndrome, characterised by facial asymmetry, conjugate gaze palsy and unilateral deafness with vertigo. As demonstrated by magnetic resonance imaging, the responsible pontine lesion was a brainstem tuberculoma involving the ipsilateral abducens nucleus and the adjacent medial longitudinal fasciculus (MLF), along with facial and vestibulocochlear nerve. The location of the tuberculoma and the clinical presentation is unusual. Keywords : Syndrome; Ipsilateral; Vertigo; Tuberculoma; Fasciculus Internet Journal of Medical Update 2012 July;7(2):51-53
{"title":"“Sixteen and a half”: a rare neurological syndrome","authors":"KS Singh Raminder, Vaibhav C Chewoolkar, Chetan Chaudhari","doi":"10.4314/IJMU.V7I2","DOIUrl":"https://doi.org/10.4314/IJMU.V7I2","url":null,"abstract":"“Sixteen and a half” syndrome is a recently coined terminology for a novel pontine neuro-ophthalmological condition. It is characterised by “one and a half” syndrome with an additional ipsilateral seventh and eighth cranial nerve palsy (1½+7+8=16½). We hereby present a case with “sixteen and a half” syndrome, characterised by facial asymmetry, conjugate gaze palsy and unilateral deafness with vertigo. As demonstrated by magnetic resonance imaging, the responsible pontine lesion was a brainstem tuberculoma involving the ipsilateral abducens nucleus and the adjacent medial longitudinal fasciculus (MLF), along with facial and vestibulocochlear nerve. The location of the tuberculoma and the clinical presentation is unusual. Keywords : Syndrome; Ipsilateral; Vertigo; Tuberculoma; Fasciculus Internet Journal of Medical Update 2012 July;7(2):51-53","PeriodicalId":14472,"journal":{"name":"Internet Journal of Medical Update - EJOURNAL","volume":"76 1","pages":"52-54"},"PeriodicalIF":0.0,"publicationDate":"2012-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86060754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ABSTRACT: H1N1 influenza is an emerging threat that is life threatening to pregnant women in the third trimester. Pregnant women are a high-risk group for morbidity and mortality from influenza (H1N1). During the current pandemic of H1N1 influenza, few cases of H1N1 have been reported in pregnancy. We report a case of H1N1 influenza in a 23-year old female with 28 weeks of gestation, who developed acute respiratory distress syndrome, required mechanical ventilation and eventually recovered. KEYWORDS : H1N1; Acute Respiratory Distress Syndrome; Pregnancy; Influenza Internet Journal of Medical Update 2012 January;7(1):73-76
{"title":"Life threatening severe Influenza A Virus (H1N1) infection in Pregnancy","authors":"H. Patil, V. Patil, Vaibhav Agrawal","doi":"10.4314/ijmu.v7i1","DOIUrl":"https://doi.org/10.4314/ijmu.v7i1","url":null,"abstract":"ABSTRACT: H1N1 influenza is an emerging threat that is life threatening to pregnant women in the third trimester. Pregnant women are a high-risk group for morbidity and mortality from influenza (H1N1). During the current pandemic of H1N1 influenza, few cases of H1N1 have been reported in pregnancy. We report a case of H1N1 influenza in a 23-year old female with 28 weeks of gestation, who developed acute respiratory distress syndrome, required mechanical ventilation and eventually recovered. KEYWORDS : H1N1; Acute Respiratory Distress Syndrome; Pregnancy; Influenza Internet Journal of Medical Update 2012 January;7(1):73-76","PeriodicalId":14472,"journal":{"name":"Internet Journal of Medical Update - EJOURNAL","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88803496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The present study was conducted with the objective to determine antimicrobial susceptibility of Gram positive CSF isolates in septic meningitis in a tertiary care hospital. CSF (3-5 ml) was collected from 638 admitted children clinically suspected of septic meningitis. Bacterial isolates were identified and microbial sensitivity was assessed by the Kirby-Bauer’s disk diffusion method. Of the samples tested 102 (15.99%) were culture positive of which 45 (44.12%) culture positives were found in children aged 1-12 years. M: F ratio was 1.62:1. Maximum incidence (51 cases) was in summer-rainy season and in institutional delivery (58 cases). Primary immunization did not protect against septic meningitis. The isolates in 66 (64.71%) cases were Gram positive of which 36 (54.55%) were Streptococcus spp., 24 (36.36%) Staphylococcus aureus and 6 (9.09%) cases coagulase negative Staphylococcus (CONS). Both Streptococci and coagulase negative Staphylococci were highly sensitive (100%) to Linezolid, Vancomycin and Piperacillin-Tazobactam. However, Staphylococcus aureus were 100% sensitive to Linezolid and Vancomycin but were only 87.5% sensitive to Piperacillin-Tazobactam combination. The Streptococcus species showed a high degree of resistance to Tetracyclin 91.67%, Co-trimoxazole 88.89% and Penicillin 63.89%. Staphylococcus aureus showed resistance to the tune of 83.33% each to Tetracycline and Co-trimoxazxole and 79.17% with Penicillin. In case of coagulase negative Staphylococcus, Co-trimoxazole showed resistance in 83.33%, Penicillin in 66.67% and Tetracycline in 50% cases. In septic meningitis Gram positive isolates predominate. Therapy should be based on trends of bacterial sensitivity.
{"title":"Antimicrobial sensitivity pattern of gram positive CSF isolates in children with septic meningitis in a Tertiary Care Hospital","authors":"Y. Chugh, A. Kapoor, A. Bhargava","doi":"10.4314/IJMU.V6I2.68191","DOIUrl":"https://doi.org/10.4314/IJMU.V6I2.68191","url":null,"abstract":"The present study was conducted with the objective to determine antimicrobial susceptibility of Gram positive CSF isolates in septic meningitis in a tertiary care hospital. CSF (3-5 ml) was collected from 638 admitted children clinically suspected of septic meningitis. Bacterial isolates were identified and microbial sensitivity was assessed by the Kirby-Bauer’s disk diffusion method. Of the samples tested 102 (15.99%) were culture positive of which 45 (44.12%) culture positives were found in children aged 1-12 years. M: F ratio was 1.62:1. Maximum incidence (51 cases) was in summer-rainy season and in institutional delivery (58 cases). Primary immunization did not protect against septic meningitis. The isolates in 66 (64.71%) cases were Gram positive of which 36 (54.55%) were Streptococcus spp., 24 (36.36%) Staphylococcus aureus and 6 (9.09%) cases coagulase negative Staphylococcus (CONS). Both Streptococci and coagulase negative Staphylococci were highly sensitive (100%) to Linezolid, Vancomycin and Piperacillin-Tazobactam. However, Staphylococcus aureus were 100% sensitive to Linezolid and Vancomycin but were only 87.5% sensitive to Piperacillin-Tazobactam combination. The Streptococcus species showed a high degree of resistance to Tetracyclin 91.67%, Co-trimoxazole 88.89% and Penicillin 63.89%. Staphylococcus aureus showed resistance to the tune of 83.33% each to Tetracycline and Co-trimoxazxole and 79.17% with Penicillin. In case of coagulase negative Staphylococcus, Co-trimoxazole showed resistance in 83.33%, Penicillin in 66.67% and Tetracycline in 50% cases. In septic meningitis Gram positive isolates predominate. Therapy should be based on trends of bacterial sensitivity.","PeriodicalId":14472,"journal":{"name":"Internet Journal of Medical Update - EJOURNAL","volume":"382 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2011-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80715464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The present study was undertaken to establish the efficacy of low dose propofol-ketamine infusion in maintaining hemodynamic stability when used for sedation as compared to propofol alone during spinal anesthesia. Sixty adult patients of either sex, belonging to ASA physical status I and II undergoing urological procedures were studied in a randomized manner. After administering spinal anesthesia with 0.5% bupivacaine, patients were assigned to two groups of 30 patients each. Group I (propofol-ketamine combination) received intial loading dose of propofol and ketamine followed by a continuous infusion of low dose propofol and ketamine whereas group II (propofol alone) received a bolus dose of propofol followed by a continuous infusion of propofol only. Hemodynamic parameters like heart rate, systolic blood pressure, diastolic blood pressure and sedation scores rated on a five point scale were recorded at baseline and at the predetermined intervals of 5, 10, 15, 20, 25, 30, 45, 60, 75 and 90 minutes after spinal anesthesia. It was found that heart rate, systolic and diastolic blood pressure was significantly higher in group I patients at various intervals as compared to group II patients, however sedation scores revealed no significant difference at different time intervals between the two groups. In conclusion propofol-ketamine combination was found to confer hemodynamic stability during spinal anesthesia as compared to propofol alone.
{"title":"Circulatory responses to propofol-ketamine combination compared to propofol alone for sedation during spinal anesthesia","authors":"S. Nengroo, A. Lone, I. Naqash","doi":"10.4314/IJMU.V6I2.68188","DOIUrl":"https://doi.org/10.4314/IJMU.V6I2.68188","url":null,"abstract":"The present study was undertaken to establish the efficacy of low dose propofol-ketamine infusion in maintaining hemodynamic stability when used for sedation as compared to propofol alone during spinal anesthesia. Sixty adult patients of either sex, belonging to ASA physical status I and II undergoing urological procedures were studied in a randomized manner. After administering spinal anesthesia with 0.5% bupivacaine, patients were assigned to two groups of 30 patients each. Group I (propofol-ketamine combination) received intial loading dose of propofol and ketamine followed by a continuous infusion of low dose propofol and ketamine whereas group II (propofol alone) received a bolus dose of propofol followed by a continuous infusion of propofol only. Hemodynamic parameters like heart rate, systolic blood pressure, diastolic blood pressure and sedation scores rated on a five point scale were recorded at baseline and at the predetermined intervals of 5, 10, 15, 20, 25, 30, 45, 60, 75 and 90 minutes after spinal anesthesia. It was found that heart rate, systolic and diastolic blood pressure was significantly higher in group I patients at various intervals as compared to group II patients, however sedation scores revealed no significant difference at different time intervals between the two groups. In conclusion propofol-ketamine combination was found to confer hemodynamic stability during spinal anesthesia as compared to propofol alone.","PeriodicalId":14472,"journal":{"name":"Internet Journal of Medical Update - EJOURNAL","volume":"61 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2011-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78545346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Behcet’s disease (BD) is a systemic vasculitis of unknown origin. It is well established that Behcet’s disease predisposes strongly to venous and arterial thrombosis and recurrent superficial and deep thrombophlebitis of the lower extremities. There are different considerations about the pathogenesis of the vascular complications and the tendency for thrombosis in BD. We came across a patient of Behcet’s disease in whom extensive thrombophlebitis and erythema nodosum, which was precipitated by a needle prick, responded to corticosteroids. This case highlights the importance of suspicion of this disease in patients presenting with extensive thrombophlebitis.
{"title":"Extensive Thrombophlebitis in a patient with Behçet's disease","authors":"V. Chewoolkar, RK Singh, S. Bamborde","doi":"10.4314/IJMU.V6I2.68196","DOIUrl":"https://doi.org/10.4314/IJMU.V6I2.68196","url":null,"abstract":"Behcet’s disease (BD) is a systemic vasculitis of unknown origin. It is well established that Behcet’s disease predisposes strongly to venous and arterial thrombosis and recurrent superficial and deep thrombophlebitis of the lower extremities. There are different considerations about the pathogenesis of the vascular complications and the tendency for thrombosis in BD. We came across a patient of Behcet’s disease in whom extensive thrombophlebitis and erythema nodosum, which was precipitated by a needle prick, responded to corticosteroids. This case highlights the importance of suspicion of this disease in patients presenting with extensive thrombophlebitis.","PeriodicalId":14472,"journal":{"name":"Internet Journal of Medical Update - EJOURNAL","volume":"36 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2011-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89780198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rheumatoid arthritis is a chronic systemic inflammatory disease of undetermined etiology involving the synovial membranes and articular structures of multiple joints and is also associated with carditis, pleuritis, hepatitis, peripheral neuropathy and vasculitis. The present study was undertaken to investigate arterial stiffness using carotid-radial and femoral-dorsalis pedis pulse wave velocity measurements and electrophysiological tests for peripheral nervous system involvement. 25 patients (aged between 20-60 years) with rheumatoid arthritis according to the criteria of the American College of Rheumatology and 25 control subjects of the same age and sex were recruited. In the motor conduction studies, out of 25 patients of Rheumatoid arthritis, 6 had clinical evidence of peripheral neuropathy. 11 patients showed pure sensory neuropathy (44%), 10 showed mixed sensory motor neuropathy (40%) while 4 showed normal motor and sensory conduction velocity. Two patients (8%) showed features of entrapment neuropathy of median nerve i.e. feature of Carpal tunnel syndrome. In the pulse wave velocity evaluation statistically significant increase in pulse wave velocity between femoral-dorsalis pedis and carotid-radial artery segments was observed in Rheumatoid arthritis patients as compared to the control group. Measurement of carotid-radial and femoral-dorsalis pedis PWV may provide a simple and non-invasive technique for identifying patients at increased risk of vascular disease in Rheumatoid arthritis.
{"title":"Pulse Wave Velocity and Electroneurophysiological Evaluation in patients of Rheumatoid Arthritis","authors":"G. Sharma, S. Sood, R. Handa, H. K. Singh","doi":"10.4314/IJMU.V6I2.68187","DOIUrl":"https://doi.org/10.4314/IJMU.V6I2.68187","url":null,"abstract":"Rheumatoid arthritis is a chronic systemic inflammatory disease of undetermined etiology involving the synovial membranes and articular structures of multiple joints and is also associated with carditis, pleuritis, hepatitis, peripheral neuropathy and vasculitis. The present study was undertaken to investigate arterial stiffness using carotid-radial and femoral-dorsalis pedis pulse wave velocity measurements and electrophysiological tests for peripheral nervous system involvement. 25 patients (aged between 20-60 years) with rheumatoid arthritis according to the criteria of the American College of Rheumatology and 25 control subjects of the same age and sex were recruited. In the motor conduction studies, out of 25 patients of Rheumatoid arthritis, 6 had clinical evidence of peripheral neuropathy. 11 patients showed pure sensory neuropathy (44%), 10 showed mixed sensory motor neuropathy (40%) while 4 showed normal motor and sensory conduction velocity. Two patients (8%) showed features of entrapment neuropathy of median nerve i.e. feature of Carpal tunnel syndrome. In the pulse wave velocity evaluation statistically significant increase in pulse wave velocity between femoral-dorsalis pedis and carotid-radial artery segments was observed in Rheumatoid arthritis patients as compared to the control group. Measurement of carotid-radial and femoral-dorsalis pedis PWV may provide a simple and non-invasive technique for identifying patients at increased risk of vascular disease in Rheumatoid arthritis.","PeriodicalId":14472,"journal":{"name":"Internet Journal of Medical Update - EJOURNAL","volume":"58 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2011-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77144332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Although phobia is more commonly observed during adolescence as compared to adulthood, its specific type of murophobia is uncommon. Especially in a country like Ethiopia, where awareness, orientation to mental health and its psychological treatment is undergoing its infancy on account of several reasons, the neurotic disorders are rarely reported to mental health clinicians. The present study is a case report of a 16-year old adolescent female with murophobia. The case was not registered in any general medical clinic and was sent to our department for further psychological assessment and intervention. The client was comprehensively examined through clinical interview, behavioural analysis and treated by cognitive-behaviour technique of psychological intervention and without the inclusion of psychiatric treatment. Details of the psychological assessment and intervention have been presented in this case report.
{"title":"Psychological Intervention of Murophobia","authors":"A. Yihun, P. Anand, F. Abebe","doi":"10.4314/ijmu.v6i2.68197","DOIUrl":"https://doi.org/10.4314/ijmu.v6i2.68197","url":null,"abstract":"Although phobia is more commonly observed during adolescence as compared to adulthood, its specific type of murophobia is uncommon. Especially in a country like Ethiopia, where awareness, orientation to mental health and its psychological treatment is undergoing its infancy on account of several reasons, the neurotic disorders are rarely reported to mental health clinicians. The present study is a case report of a 16-year old adolescent female with murophobia. The case was not registered in any general medical clinic and was sent to our department for further psychological assessment and intervention. The client was comprehensively examined through clinical interview, behavioural analysis and treated by cognitive-behaviour technique of psychological intervention and without the inclusion of psychiatric treatment. Details of the psychological assessment and intervention have been presented in this case report.","PeriodicalId":14472,"journal":{"name":"Internet Journal of Medical Update - EJOURNAL","volume":"21 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2011-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72644605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Macrodystrophia lipomatosa is a rare congenital nonhereditary mesenchymal hamartomatous malformation resulting in localized gigantism of parts of extremities that manifests clinically as macrodactyly or megalodactyly. Radiological and Pathological hallmark is the disproportionate fibroadipose tissue proliferation in subcutaneous tissue, nerve sheaths, and periosteum that leads to soft tissue and bony enlargement. As imaging is the key to early diagnosis, findings on various modalities like plain radiographs, CT scan and MRI are highlighted here.
{"title":"Macrodystrophia Lipomatosa: A rare presentation","authors":"Sushil. G. Kachewar, S. Sankaye, D. Kulkarni","doi":"10.4314/IJMU.V6I2.68198","DOIUrl":"https://doi.org/10.4314/IJMU.V6I2.68198","url":null,"abstract":"Macrodystrophia lipomatosa is a rare congenital nonhereditary mesenchymal hamartomatous malformation resulting in localized gigantism of parts of extremities that manifests clinically as macrodactyly or megalodactyly. Radiological and Pathological hallmark is the disproportionate fibroadipose tissue proliferation in subcutaneous tissue, nerve sheaths, and periosteum that leads to soft tissue and bony enlargement. As imaging is the key to early diagnosis, findings on various modalities like plain radiographs, CT scan and MRI are highlighted here.","PeriodicalId":14472,"journal":{"name":"Internet Journal of Medical Update - EJOURNAL","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2011-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73266878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nutritional inadequacy leads to health problems, especially during the period of increased demand. Adolescents are a potential group in view of rapid growth and maturation which demands extra nutrients. With the multitude of social customs and beliefs cited against adolescents especially adolescent girls it is no wonder that they form the vulnerable group of under nutrition. With poor socio economic status, hostile living conditions and food influenced by vagaries of nature, adolescents living at hills form the distinct group to be studied. This cross-sectional prevalence study included 45 adolescent girls of age group 12-19 years residing in hills of Garhwal. The outcome measures for nutritional status were stunting, thinness and proportion of underweight/under nutrition. In this study 34.61% of adolescents’ girls were found to be stunted. The stunting was more (33.33%) in 16 to 19 years of age group. The overall prevalence of thinness was 43.47%. However percentage of thinness was higher (56.25%) in the lower age group (12-15 years). Under nutrition was prevalent in similar proportions in both the age groups with > 50% of the rural adolescent girls having less than 3rd percentile of weight for age by NCHS standards. The prevalence of stunting, thinness and underweight was high among adolescent girls living at high altitudes. In this regard special attention should be paid to the girls of hills and specific strategies should be formulated for meeting their nutritional demands.
{"title":"Nutritional Status in Rural Adolescent Girls Residing at Hills of Garhwal in India (2009)","authors":"Yogesh Saxena, V. Saxena","doi":"10.4314/IJMU.V6I2.68185","DOIUrl":"https://doi.org/10.4314/IJMU.V6I2.68185","url":null,"abstract":"Nutritional inadequacy leads to health problems, especially during the period of increased demand. Adolescents are a potential group in view of rapid growth and maturation which demands extra nutrients. With the multitude of social customs and beliefs cited against adolescents especially adolescent girls it is no wonder that they form the vulnerable group of under nutrition. With poor socio economic status, hostile living conditions and food influenced by vagaries of nature, adolescents living at hills form the distinct group to be studied. This cross-sectional prevalence study included 45 adolescent girls of age group 12-19 years residing in hills of Garhwal. The outcome measures for nutritional status were stunting, thinness and proportion of underweight/under nutrition. In this study 34.61% of adolescents’ girls were found to be stunted. The stunting was more (33.33%) in 16 to 19 years of age group. The overall prevalence of thinness was 43.47%. However percentage of thinness was higher (56.25%) in the lower age group (12-15 years). Under nutrition was prevalent in similar proportions in both the age groups with > 50% of the rural adolescent girls having less than 3rd percentile of weight for age by NCHS standards. The prevalence of stunting, thinness and underweight was high among adolescent girls living at high altitudes. In this regard special attention should be paid to the girls of hills and specific strategies should be formulated for meeting their nutritional demands.","PeriodicalId":14472,"journal":{"name":"Internet Journal of Medical Update - EJOURNAL","volume":"17 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2011-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91495021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Vk Vadgama, R. Gharia, K. Mehta, R. Sanjiv, C. Tripathi
Osteoarthritis is a chronic painful condition affecting larger joints; most commonly knee joint. Pharmacological control of pain is the mainstay of management of osteoarthritis. Many patientsfail to achieve satisfactory reduction in pain with one of the most commonly prescribed drugs, diclofenac sodium, even after maximum daily allowed doses. Lornoxicam is a newer molecule in the Indian market promising better pain relief in context of low back pain and post knee replacement surgery pain as compared to standard therapies. As per profile of lornoxicam, if it is better than diclofenac sodium then it will be helpful in managing the patients of osteoarthritis more effectively. Till date no comparative clinical trial has been done to compare these two drugs for the management of osteoarthritis knee. So, to evaluate the same we carried out this study to compare safety, efficacy and cost effectiveness of lornoxicam and diclofenac sodium in relieving pain in patients of osteoarthritis knee. This study is a randomized, open labeled, controlled clinical trial having 40 newly diagnosed patients with osteoarthritis knee. After random allocation into two groups i.e. group D and group L (each having 20 patients); group D received diclofenac sodium 50 mg 12 hourly and group L received lornoxicam 4 mg 8 hourly for a period of 3 months. All patients were assessed with visual analogue scale and 100 meter walking test before starting of therapy, at 15 days and at 1, 2 and 3 months of therapy. Adverse drug reactions and cost of therapy was monitored during the study period. Mean decrease in visual analogue scale and time of 100 meter walking test was statistically significant in lornoxicam group as compared to diclofenac sodium. Gastric irritation was reported in one patient from group L and two patients from group D. Lornoxicam significantly relieves pain of osteoarthritis knee than diclofenac sodium without adversely affecting the tolerability to the patients.
{"title":"A Randomized, Controlled Clinical Trial Comparing Efficacy, Safety and Cost Effectiveness of Lornoxicam with Diclofenac Sodium in Patients of Osteoarthritis Knee","authors":"Vk Vadgama, R. Gharia, K. Mehta, R. Sanjiv, C. Tripathi","doi":"10.4314/IJMU.V6I2.68190","DOIUrl":"https://doi.org/10.4314/IJMU.V6I2.68190","url":null,"abstract":"Osteoarthritis is a chronic painful condition affecting larger joints; most commonly knee joint. Pharmacological control of pain is the mainstay of management of osteoarthritis. Many patientsfail to achieve satisfactory reduction in pain with one of the most commonly prescribed drugs, diclofenac sodium, even after maximum daily allowed doses. Lornoxicam is a newer molecule in the Indian market promising better pain relief in context of low back pain and post knee replacement surgery pain as compared to standard therapies. As per profile of lornoxicam, if it is better than diclofenac sodium then it will be helpful in managing the patients of osteoarthritis more effectively. Till date no comparative clinical trial has been done to compare these two drugs for the management of osteoarthritis knee. So, to evaluate the same we carried out this study to compare safety, efficacy and cost effectiveness of lornoxicam and diclofenac sodium in relieving pain in patients of osteoarthritis knee. This study is a randomized, open labeled, controlled clinical trial having 40 newly diagnosed patients with osteoarthritis knee. After random allocation into two groups i.e. group D and group L (each having 20 patients); group D received diclofenac sodium 50 mg 12 hourly and group L received lornoxicam 4 mg 8 hourly for a period of 3 months. All patients were assessed with visual analogue scale and 100 meter walking test before starting of therapy, at 15 days and at 1, 2 and 3 months of therapy. Adverse drug reactions and cost of therapy was monitored during the study period. Mean decrease in visual analogue scale and time of 100 meter walking test was statistically significant in lornoxicam group as compared to diclofenac sodium. Gastric irritation was reported in one patient from group L and two patients from group D. Lornoxicam significantly relieves pain of osteoarthritis knee than diclofenac sodium without adversely affecting the tolerability to the patients.","PeriodicalId":14472,"journal":{"name":"Internet Journal of Medical Update - EJOURNAL","volume":"46 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2011-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73062616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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