Objectives: Shoulder instability is a commonly seen injury in orthopedics practice. The current survey aimed to assess strategies in the management of shoulder instability among orthopedic surgeons in India. Materials and Methods: A survey was created by a group of surgeons who are regularly managing shoulder instability and it was distributed among the various orthopedic surgeons from India. The questionnaire included brief details of surgeons and their experience, clinical assessment, management strategies, and the rehabilitation protocol. We also assess any difference in management strategies of Orthopaedic surgeon (OS group) as compared to fellowship trained sports surgeons/shoulder surgeons (FS group). Results: Ninety-seven orthopedic surgeons participated in the survey. Sixty-four percent were in the age group between 35 and 50 years. Forty-six percent of them were managing these injuries for more than 12 years. 37.5% of surgeons were from government academic institutes. Eighty percent of respondents treat first-time dislocation conservatively. The decision regarding the type of surgery is based on the percentage of bone loss, the number of dislocations, age of the patients as per the majority of respondents. Arthroscopic Bankart’s repair is the most commonly used procedure for anterior shoulder instability. The common criteria for return to sports include a glenohumeral range of motion, rotator strength, functional performance test, type of sports, and ability of the athlete to perform. Conclusion: Bankart’s repair is the most common procedure performed in patients with shoulder instability with minimal bone loss. Computer tomography scan is one of the preferred investigation modalities along with X-ray and magnetic resonance imaging in the first-time dislocation as per FS group. Remplissage in addition to Bankart’s repair is performed by a significantly higher number of participants from FS group as compared to OS group. Levelofevidence: Level V, expert opinion.
{"title":"Trends in management of shoulder instability: Indian perspectives","authors":"Munish Sood, Vikas Kulshrestha, Santhosh Kumar, Pardeep Kumar, Shalendra Singh, Vidhu Bhatnagar","doi":"10.4103/jmms.jmms_155_22","DOIUrl":"https://doi.org/10.4103/jmms.jmms_155_22","url":null,"abstract":"Objectives: Shoulder instability is a commonly seen injury in orthopedics practice. The current survey aimed to assess strategies in the management of shoulder instability among orthopedic surgeons in India. Materials and Methods: A survey was created by a group of surgeons who are regularly managing shoulder instability and it was distributed among the various orthopedic surgeons from India. The questionnaire included brief details of surgeons and their experience, clinical assessment, management strategies, and the rehabilitation protocol. We also assess any difference in management strategies of Orthopaedic surgeon (OS group) as compared to fellowship trained sports surgeons/shoulder surgeons (FS group). Results: Ninety-seven orthopedic surgeons participated in the survey. Sixty-four percent were in the age group between 35 and 50 years. Forty-six percent of them were managing these injuries for more than 12 years. 37.5% of surgeons were from government academic institutes. Eighty percent of respondents treat first-time dislocation conservatively. The decision regarding the type of surgery is based on the percentage of bone loss, the number of dislocations, age of the patients as per the majority of respondents. Arthroscopic Bankart’s repair is the most commonly used procedure for anterior shoulder instability. The common criteria for return to sports include a glenohumeral range of motion, rotator strength, functional performance test, type of sports, and ability of the athlete to perform. Conclusion: Bankart’s repair is the most common procedure performed in patients with shoulder instability with minimal bone loss. Computer tomography scan is one of the preferred investigation modalities along with X-ray and magnetic resonance imaging in the first-time dislocation as per FS group. Remplissage in addition to Bankart’s repair is performed by a significantly higher number of participants from FS group as compared to OS group. Levelofevidence: Level V, expert opinion.","PeriodicalId":41773,"journal":{"name":"Journal of Marine Medical Society","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136201820","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}
Introduction: Cerebral palsy (CP) is a group of disorders involving movement, posture, and motor function with the uniqueness of being an outcome of a static insult and ever-changing clinical course. Early identification and rehabilitation of associated morbidities are the keys to comprehensive management. Materials and Methods: This was a prospective observational study conducted in a tertiary care teaching hospital in western India, from January 2016 to June 2017, to determine the prevalence of ocular and hearing morbidity in children with CP. All children presenting with developmental delay and diagnosed as a case of CP were serially recruited in the study. Data were collected by using a predesigned pro forma. Results: The study included 80 children with CP. Male-to-female sex ratio of 2.08:1 was observed. The prevalence of visual morbidity was 67.5%, with the most common morbidity being squint followed by refractive error and nystagmus. Auditory morbidity was present in 22.5% of cases with the predominant type being sensorineural hearing loss. Conclusions: This study emphasizes the importance of prompt identification of auditory and visual morbidities in these children, as early intervention is the key to management and is vital for optimal speech, vision, developmental, and neurocognitive outcomes in these cases.
{"title":"A prospective cohort study of auditory and visual comorbidities in children with cerebral palsy","authors":"M. Mishra, K. Adhikari, Nikita Panigrahi","doi":"10.4103/jmms.jmms_58_22","DOIUrl":"https://doi.org/10.4103/jmms.jmms_58_22","url":null,"abstract":"Introduction: Cerebral palsy (CP) is a group of disorders involving movement, posture, and motor function with the uniqueness of being an outcome of a static insult and ever-changing clinical course. Early identification and rehabilitation of associated morbidities are the keys to comprehensive management. Materials and Methods: This was a prospective observational study conducted in a tertiary care teaching hospital in western India, from January 2016 to June 2017, to determine the prevalence of ocular and hearing morbidity in children with CP. All children presenting with developmental delay and diagnosed as a case of CP were serially recruited in the study. Data were collected by using a predesigned pro forma. Results: The study included 80 children with CP. Male-to-female sex ratio of 2.08:1 was observed. The prevalence of visual morbidity was 67.5%, with the most common morbidity being squint followed by refractive error and nystagmus. Auditory morbidity was present in 22.5% of cases with the predominant type being sensorineural hearing loss. Conclusions: This study emphasizes the importance of prompt identification of auditory and visual morbidities in these children, as early intervention is the key to management and is vital for optimal speech, vision, developmental, and neurocognitive outcomes in these cases.","PeriodicalId":41773,"journal":{"name":"Journal of Marine Medical Society","volume":"25 1","pages":"43 - 47"},"PeriodicalIF":0.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42342474","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}
Introduction: Involvement of the liver is frequently reported among patients with dengue infection, and liver enzymes are commonly deranged in dengue infection. Raised levels of alanine aminotransferase (ALT) in dengue infection were linked to worse outcomes. The present study was an attempt to study the liver function test abnormalities in dengue fever (DF) and its correlation with the severity of the disease. Methods: The present study was undertaken as a hospital-based retrospective study of DF patients in the age group of 15–60 years. Five hundred and thirty patients who met the eligibility criteria and were admitted to the study hospital during the duration of data collection period (July 2018 to July 2021), comprised the study sample. Differences in means were tested using ANOVA or Kruskal–Wallis test. The difference in proportions was tested using the Chi-square test. Results: Majority of the patients were males (73.4%) with a mean of 30.3 ± 9.7 years. A significant association was observed between clinical features of jaundice, hepatomegaly, splenomegaly, ascites, effusion, bleeding, organ failure, and severe forms of DF. There was a significant positive correlation between aspartate aminotransferase, ALT, and serum bilirubin values among patients with severe forms of DF. Conclusion: Significant proportions of patients with DF without warning signs and severe DF had deranged liver function parameters. A statistically significant association was observed between liver function parameters and the severity of dengue disease.
{"title":"Liver function test abnormalities: Do they correlate with severity in dengue infection? An Indian perspective","authors":"S. Ravilla, K. Padmaprakash, N. Arun, R. Kanth","doi":"10.4103/jmms.jmms_88_22","DOIUrl":"https://doi.org/10.4103/jmms.jmms_88_22","url":null,"abstract":"Introduction: Involvement of the liver is frequently reported among patients with dengue infection, and liver enzymes are commonly deranged in dengue infection. Raised levels of alanine aminotransferase (ALT) in dengue infection were linked to worse outcomes. The present study was an attempt to study the liver function test abnormalities in dengue fever (DF) and its correlation with the severity of the disease. Methods: The present study was undertaken as a hospital-based retrospective study of DF patients in the age group of 15–60 years. Five hundred and thirty patients who met the eligibility criteria and were admitted to the study hospital during the duration of data collection period (July 2018 to July 2021), comprised the study sample. Differences in means were tested using ANOVA or Kruskal–Wallis test. The difference in proportions was tested using the Chi-square test. Results: Majority of the patients were males (73.4%) with a mean of 30.3 ± 9.7 years. A significant association was observed between clinical features of jaundice, hepatomegaly, splenomegaly, ascites, effusion, bleeding, organ failure, and severe forms of DF. There was a significant positive correlation between aspartate aminotransferase, ALT, and serum bilirubin values among patients with severe forms of DF. Conclusion: Significant proportions of patients with DF without warning signs and severe DF had deranged liver function parameters. A statistically significant association was observed between liver function parameters and the severity of dengue disease.","PeriodicalId":41773,"journal":{"name":"Journal of Marine Medical Society","volume":"25 1","pages":"48 - 52"},"PeriodicalIF":0.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46783548","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}
Pub Date : 2023-01-01DOI: 10.4103/jmms.jmms_167_22
S. Shaw, M. Mahesh, A. Singhal
{"title":"Antimicrobial resistance an alarming global concern: Antimicrobial stewardship is the key","authors":"S. Shaw, M. Mahesh, A. Singhal","doi":"10.4103/jmms.jmms_167_22","DOIUrl":"https://doi.org/10.4103/jmms.jmms_167_22","url":null,"abstract":"","PeriodicalId":41773,"journal":{"name":"Journal of Marine Medical Society","volume":"25 1","pages":"4 - 6"},"PeriodicalIF":0.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46484415","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}
S. Manjunath, R. Hiremath, Raj Kumar, A. Khera, Kasi Viswanath
Introduction: HIV/AIDS is a challenging disease affecting multiple facets of life. From being a communicable disease alone, it is now posing mental health problems and adjustment disorders as the longevity of HIV/AIDS patients is increasing. In the present study, the quality of life (QOL) among HIV patients was studied, in physical, psychological, environmental, and social domains using the World Health Organization Quality-of-Life Scale (WHOQOL-BREF). Methodology: A cross-sectional, observational study was conducted to assess QOL among 140 randomly selected HIV/AIDS patients attending an antiretroviral therapy (ART) center. The WHO QOL BREF questionnaire was used as a tool for collecting data. Results: The overall QOL among people living with HIV/AIDS (PLWHA) was 14.29 (±1.9), with the highest mean score in social domain with a mean of 15.42 (±2.73) and the lowest in physical domain with a mean of 14.01 (±2.73). A statistically significant association was found between age, gender, place of residence, disclosure status, and overall QOL. PLWHA with high CD4 count and patients on ART had better QOL. Conclusion: Overall QOL in PLWHAs is comparable with other countries, indicating the success of National AIDS Control Programme. Few aspects, if incorporated, can increase further improve QOL among HIV patients.
{"title":"Revisiting “Do People Living with HIV/AIDS Have Better Quality of Life” – Findings from a cross-sectional study","authors":"S. Manjunath, R. Hiremath, Raj Kumar, A. Khera, Kasi Viswanath","doi":"10.4103/jmms.jmms_77_22","DOIUrl":"https://doi.org/10.4103/jmms.jmms_77_22","url":null,"abstract":"Introduction: HIV/AIDS is a challenging disease affecting multiple facets of life. From being a communicable disease alone, it is now posing mental health problems and adjustment disorders as the longevity of HIV/AIDS patients is increasing. In the present study, the quality of life (QOL) among HIV patients was studied, in physical, psychological, environmental, and social domains using the World Health Organization Quality-of-Life Scale (WHOQOL-BREF). Methodology: A cross-sectional, observational study was conducted to assess QOL among 140 randomly selected HIV/AIDS patients attending an antiretroviral therapy (ART) center. The WHO QOL BREF questionnaire was used as a tool for collecting data. Results: The overall QOL among people living with HIV/AIDS (PLWHA) was 14.29 (±1.9), with the highest mean score in social domain with a mean of 15.42 (±2.73) and the lowest in physical domain with a mean of 14.01 (±2.73). A statistically significant association was found between age, gender, place of residence, disclosure status, and overall QOL. PLWHA with high CD4 count and patients on ART had better QOL. Conclusion: Overall QOL in PLWHAs is comparable with other countries, indicating the success of National AIDS Control Programme. Few aspects, if incorporated, can increase further improve QOL among HIV patients.","PeriodicalId":41773,"journal":{"name":"Journal of Marine Medical Society","volume":"25 1","pages":"53 - 57"},"PeriodicalIF":0.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47361038","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}
Pub Date : 2023-01-01DOI: 10.4103/jmms.jmms_132_22
S. Kulkarni, Manish Sondhi
{"title":"Burnout of a peripheral government surgeon: Need to extinguish?","authors":"S. Kulkarni, Manish Sondhi","doi":"10.4103/jmms.jmms_132_22","DOIUrl":"https://doi.org/10.4103/jmms.jmms_132_22","url":null,"abstract":"","PeriodicalId":41773,"journal":{"name":"Journal of Marine Medical Society","volume":"25 1","pages":"7 - 9"},"PeriodicalIF":0.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47413418","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}
D. Gulati, S. Hashmi, Monika Aggrawal, R. Pandey, Inam Danish Khan
Introduction: Thyroid swellings are one of the most commonly encountered lesions with most of the thyroid swellings being benign. The cancerous lesions of the thyroid also present as nodules or masses and pose a diagnostic challenge. The thyroid cytology reporting system has been inconsistent with the use of various terminologies. The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) was introduced in 2007 to bring about uniformity in reporting of thyroid lesions. Aim: This study aimed to compare conventional reporting with TBSRTC. Materials and Methods: A retrospective study was done in which 6 years of data were retrieved. Cytology slides were reviewed and categorized as per the TBSRTC and compared with other studies. Results: There were numerous categories in the conventional thyroid fine-needle aspiration cytology reporting system which has been reduced to six categories in TBSRTC. TBSRTC has also streamlined the reporting removing the confusion among cytologists and clinicians. Conclusion: TBSRTC is consistent and reproducible and should be used as a standard method of reporting.
{"title":"Evaluation of thyroid lesions by the bethesda system for reporting thyroid cytopathology","authors":"D. Gulati, S. Hashmi, Monika Aggrawal, R. Pandey, Inam Danish Khan","doi":"10.4103/jmms.jmms_83_22","DOIUrl":"https://doi.org/10.4103/jmms.jmms_83_22","url":null,"abstract":"Introduction: Thyroid swellings are one of the most commonly encountered lesions with most of the thyroid swellings being benign. The cancerous lesions of the thyroid also present as nodules or masses and pose a diagnostic challenge. The thyroid cytology reporting system has been inconsistent with the use of various terminologies. The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) was introduced in 2007 to bring about uniformity in reporting of thyroid lesions. Aim: This study aimed to compare conventional reporting with TBSRTC. Materials and Methods: A retrospective study was done in which 6 years of data were retrieved. Cytology slides were reviewed and categorized as per the TBSRTC and compared with other studies. Results: There were numerous categories in the conventional thyroid fine-needle aspiration cytology reporting system which has been reduced to six categories in TBSRTC. TBSRTC has also streamlined the reporting removing the confusion among cytologists and clinicians. Conclusion: TBSRTC is consistent and reproducible and should be used as a standard method of reporting.","PeriodicalId":41773,"journal":{"name":"Journal of Marine Medical Society","volume":"25 1","pages":"73 - 77"},"PeriodicalIF":0.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45539290","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}
Introduction: Beta-thalassemia plagues India and thalassemia screening of pregnant women is crucial. Hemoglobin (Hb) high-performance liquid chromatography (HPLC) (Hb-HPLC) is the gold standard, however in distant places it is rarely an option. While data on the use of red blood cell (RBC) indices to screen pregnant women for thalassemia trait is still developing, a sensitive and specific RBC index is needed to test for beta thalassemia. In service situations, these affordable indices may be useful without HPLC. Objective: We aimed to determine the role of red blood corpuscle indices as a screening tool to differentiate between iron deficiency anemia (IDA) and hemoglobinopathies in pregnant women and to find out the most sensitive and the most specific index. Methods: With ethical approval, 500 patients were evaluated from February 2020 to August 2021. Complete blood Counts and peripheral blood smears were performed. Participants with microcytic hypochromic anemia were included. On these patients, the RBC indices (i) Shine and Lal, (ii) Mentzer’s index, (iii) red cell distribution width index, and (iv) Srivastava were calculated. Ferritin, iron, and total iron-binding capacity levels were also tested. Hb-HPLC was utilized as the gold standard. The Mann– Whitney U-test was used to compare continuous variables between groups. Sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy were calculated for various metrics. A P < 0.05 was statistically significant. Results: Hb-HPLC showed 29 (5.8%) heterozygous beta thalassemia and 471 (94.2%) IDA. Based on the updated cutoff value (4.727), Srivastava Index was the best screening tool. Conclusion: RBC indices can distinguish IDA from beta thalassemia in pregnant women and are valuable screening tools in service settings.
{"title":"Comparison of red blood corpuscle indices versus hemoglobin high-performance liquid chromatography as a screen for hemoglobinopathies in pregnant women","authors":"JasvinderKaur Bhatia, Arnab Sengupta, Jasdeep Singh, Manisha Agarwal, Brajesh Singh, RavjotSingh Bhatia","doi":"10.4103/jmms.jmms_21_23","DOIUrl":"https://doi.org/10.4103/jmms.jmms_21_23","url":null,"abstract":"Introduction: Beta-thalassemia plagues India and thalassemia screening of pregnant women is crucial. Hemoglobin (Hb) high-performance liquid chromatography (HPLC) (Hb-HPLC) is the gold standard, however in distant places it is rarely an option. While data on the use of red blood cell (RBC) indices to screen pregnant women for thalassemia trait is still developing, a sensitive and specific RBC index is needed to test for beta thalassemia. In service situations, these affordable indices may be useful without HPLC. Objective: We aimed to determine the role of red blood corpuscle indices as a screening tool to differentiate between iron deficiency anemia (IDA) and hemoglobinopathies in pregnant women and to find out the most sensitive and the most specific index. Methods: With ethical approval, 500 patients were evaluated from February 2020 to August 2021. Complete blood Counts and peripheral blood smears were performed. Participants with microcytic hypochromic anemia were included. On these patients, the RBC indices (i) Shine and Lal, (ii) Mentzer’s index, (iii) red cell distribution width index, and (iv) Srivastava were calculated. Ferritin, iron, and total iron-binding capacity levels were also tested. Hb-HPLC was utilized as the gold standard. The Mann– Whitney U-test was used to compare continuous variables between groups. Sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy were calculated for various metrics. A P < 0.05 was statistically significant. Results: Hb-HPLC showed 29 (5.8%) heterozygous beta thalassemia and 471 (94.2%) IDA. Based on the updated cutoff value (4.727), Srivastava Index was the best screening tool. Conclusion: RBC indices can distinguish IDA from beta thalassemia in pregnant women and are valuable screening tools in service settings.","PeriodicalId":41773,"journal":{"name":"Journal of Marine Medical Society","volume":"138 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136202327","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}
Pub Date : 2023-01-01DOI: 10.4103/jmms.jmms_195_22
MarshalRenuka Kunte, Kunal Chatterjee, D Basannar
Introduction: Pelvic stress fractures have been reported commonly among women military trainees from worldwide. They have been reported as the most common stress fracture in women in Indian military training academies. With the recent increase in avenues for women to join the armed forces and other paramilitary forces, there is a need for medical personnel to be familiar with the epidemiology of pelvis stress fractures unique to women. This article presents a clinical and epidemiological profile of these fractures and suggests approaches for their prevention. Methods: Fifty-one cases of pelvic stress fractures were observed among a cohort of 608 women trainees in the military training establishments of the Indian, Army, Navy, and Air force. Data on clinical presentation, diagnosis, and management were collected for those women trainees who developed radiologically confirmed pelvic stress fractures. Information was also taken to identify the possible risk factors. Measures which can be implemented during training have been suggested to reduce the risk of these fractures during training. Results: All women trainees with stress fracture pelvis presented with groin pain and difficulty in running and drill usually in the 6–9th week of training. X-rays showed involvement of the inferior pubic ramus. All of them made good recovery with conservative management. A large number of training-related factors and certain individual-related anatomical and physiological factors seem to have a role specifically leading to these fractures. Approaches to minimize the risk of pelvic stress fractures have been recommended for making the changes in training and managing individual factors. Conclusion: Specific measures for the prevention of pelvic stress fractures are required to be instituted, addressing the risk factors for Indian women undergoing military training along with general measures.
{"title":"Profile of pelvic stress fractures in Indian women during military training and approaches for prevention","authors":"MarshalRenuka Kunte, Kunal Chatterjee, D Basannar","doi":"10.4103/jmms.jmms_195_22","DOIUrl":"https://doi.org/10.4103/jmms.jmms_195_22","url":null,"abstract":"Introduction: Pelvic stress fractures have been reported commonly among women military trainees from worldwide. They have been reported as the most common stress fracture in women in Indian military training academies. With the recent increase in avenues for women to join the armed forces and other paramilitary forces, there is a need for medical personnel to be familiar with the epidemiology of pelvis stress fractures unique to women. This article presents a clinical and epidemiological profile of these fractures and suggests approaches for their prevention. Methods: Fifty-one cases of pelvic stress fractures were observed among a cohort of 608 women trainees in the military training establishments of the Indian, Army, Navy, and Air force. Data on clinical presentation, diagnosis, and management were collected for those women trainees who developed radiologically confirmed pelvic stress fractures. Information was also taken to identify the possible risk factors. Measures which can be implemented during training have been suggested to reduce the risk of these fractures during training. Results: All women trainees with stress fracture pelvis presented with groin pain and difficulty in running and drill usually in the 6–9th week of training. X-rays showed involvement of the inferior pubic ramus. All of them made good recovery with conservative management. A large number of training-related factors and certain individual-related anatomical and physiological factors seem to have a role specifically leading to these fractures. Approaches to minimize the risk of pelvic stress fractures have been recommended for making the changes in training and managing individual factors. Conclusion: Specific measures for the prevention of pelvic stress fractures are required to be instituted, addressing the risk factors for Indian women undergoing military training along with general measures.","PeriodicalId":41773,"journal":{"name":"Journal of Marine Medical Society","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136202529","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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