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July-December 2014 Volume 4 | Issue 2
Page Nos. -
Online since Wednesday, January 21, 2015
Accessed 171,145 times.
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EDITORIAL |
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Are our intramuscular injections nerve-friendly? What are we missing? Simple techniques to prevent, recognize and manage nerve injection injuries  |
p. 25 |
James M Barry, Viraat Harsh, Shashikant Patil DOI:10.4103/2230-7095.149755 |
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REVIEW |
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Idiopathic intracranial hypertension: diagnosis and management |
p. 29 |
Prem S Subramanian DOI:10.4103/2230-7095.149760 Idiopathic intracranial hypertension (IIH), also known as pseudotumor cerebri, may occur at any age but is primarily a disease of obese women between the ages of 15 and 40. Diagnosis is made based on modified Dandy criteria, which include normal neuroimaging studies, elevated intracranial pressure (ICP) on lumbar puncture, signs and symptoms of elevated ICP, and a non-focal neurologic examination aside from sixth nerve paresis. Presenting symptoms include headache, pulsatile tinnitus, transient visual obscurations, diplopia, and visual field constriction. Diagnosis may be delayed because headache from other causes such as migraine is much more common, and patients may be treated for this condition without improvement before the actual diagnosis is recognized. Ophthalmologic signs may include papilledema and esotropia (from the sixth nerve palsy) as well as visual field and even visual acuity loss; the latter two signs are very ominous, as they indicate severe and potentially permanent visual damage. Medical and surgical options vary depending on the severity of the disease and are used to control headache as well as to prevent vision loss. Because most IIH is associated with obesity, weight loss is an essential element of any treatment regimen, as retrospective as well as prospective studies have shown disease resolution with as little as 6% weight reduction. Secondary causes of high ICP are being recognized in a greater number of IIH patients, and the term "idiopathic" likely applies to fewer patients than in the past. The underlying pathogenesis of the disorder remains elusive. |
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RESEARCH |
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Association of ABO blood groups with risk factors of intracranial cerebral aneurysm formation |
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Shyamal C Bir, Piyush Kalakoti, Sudheer Ambekar, Papireddy Bollam, Anil Nanda DOI:10.4103/2230-7095.149764 Introduction: The association between ABO blood groups and intracranial aneurysms is not well-understood. Many co-morbid factors are associated with intracranial aneurysms. The prevalence of different blood groups and associations with the risk factors in patients with intracranial aneurysms are reviewed. Methodology: A retrospective analysis was conducted on patients presenting with intracranial aneurysms and undergoing active neurosurgical intervention at the Louisiana State University Health Sciences Center between 1 st January 1993 and 31 st December 2012. A total of 1248 patients were identified for the analysis. Data pertaining to demographics and clinical characteristics of these patients were extracted from the electronic patient records by two authors independently. A univariate and multivariate analysis was performed to investigate the association of ABO blood groups with risk factors in patients with intracranial aneurysms. Results: The most common ABO blood group in our study population was O (543 cases, 43.5%), followed by group A (525 cases, 42%). Blood group A (46% vs. 35.5% patients; P = 0.01) and blood group B (18% vs. 7% patients; P = 0.000) were significantly associated with the development of intracranial aneurysms in Caucasians and African Americans, respectively. We found smoking (P = 0.01) and hypercholesterolemia (P = 0.006) to be an independent risk factor for the development of intracranial aneurysms in blood group O and blood group A, respectively . Conclusion: Racial disparity in the distribution of blood groups and risk factor association with blood groups in the development of intracranial aneurysm needs to be considered. The findings from our study may be useful in identifying patients at increased risk of developing intracranial aneurysms. |
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SHORT COMMUNICATION |
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Questionnaire-based community periodontal susceptibility screening index |
p. 41 |
Pankaj Bansal, Pritma Singh, Afshan Bey, ND Gupta DOI:10.4103/2230-7095.149769 Periodontal diseases are major causes of tooth loss and contribute to significant morbidity and healthcare costs. Therefore, identifying areas that deliver substantial returns with community-based preventive programs are a dire necessity. Planning and implementing preventive measures in periodontal oral care require identification of not only a population with current disease burden, but also of future susceptibility to disease. All major periodontal indices that have been used in community periodontal surveys are designed to identify either severity, prevalence, or treatment needs of periodontal diseases. No known index exists based on scientifically proven risk factors of periodontal disease to identify population susceptible to the disease, and to determine the need for preventive planning and interventions. In this article, a simple questionnaire-based index has been proposed to identify both individual and community susceptibility to periodontal disease. |
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CASE REPORTS |
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Giant fibroadenoma of the breast mimicking phyllodes tumor in an adult female: emphasizing the role of cytology in the diagnosis |
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Bhushan Shah, Bhavini Bhushan Shah, Kanika Sharma, Suman Sahu, Puneet Singh DOI:10.4103/2230-7095.149772 Giant fibroadenoma is an uncommon variant of fibroadenoma with an overall incidence of <4%. It is common in adolescent age group and is seldom seen in elderly. Often surgeons might encounter a diagnostic dilemma between phyllodes tumor (PT) of the breast and a giant fibroadenoma. We herein report a similar case of a middle-aged woman with an unusually large fibroadenoma of the breast mimicking a PT and emphasize the role of fine-needle aspiration cytology in differentiation of these two different breast entity. |
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Solitary diaphyseal exostosis of femur: case report of an uncommon presentation |
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Sunil Kukreja, Kanika Sharma DOI:10.4103/2230-7095.149774 Osteochondroma is the most common benign bone tumor and often diagnosed as an incidental finding. Most are asymptomatic, however significant pain, and pressure symptoms warrant excision. Most common location of solitary exostosis is metaphysics around the knee. We are reporting a case of a 14-year-old boy who presented with a swelling over the anterior aspect just below the mid-thigh level on the right side. Characteristic radiological features of exostosis were documented on plain radiograph and magnetic resonance imaging. Growth was excised, and diagnosis of solitary exostosis arising from diaphyseal region was confirmed on histopathology examination. This case report documents the uncommon diaphyseal location of solitary exostosis in an adolescent. Symptomatic lesions warrant excision. |
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CLINICAL IMAGES |
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Recurrent Kimura disease of the parotid gland |
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Shailesh Patel, Sanjay Sen, Dhritiman Maitra, Aditya Baksi DOI:10.4103/2230-7095.149776 Kimura disease is a rare chronic inflammatory disorder affecting young males of eastern countries. There are about 200 cases reported in the English literature , with <60 cases involving the parotid gland. It is characterized by abnormal proliferation of lymphoid follicles with eosinophil-rich infiltrate and peripheral eosinophilia. The disease presents as painless cervical lymphadenopathy or subcutaneous masses in the head and neck region. Although recurrence is common, radical surgery is not recommended, as the disease is essentially benign. |
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Traumatic posterior hip dislocation in a child |
p. 52 |
Arvind Kishore, Kanika Sharma, Piyush Kalakoti, Puneet Jaiswal, Sanjeev Gambhir DOI:10.4103/2230-7095.149779 Traumatic hip dislocation in children is an uncommon injury and constitutes an orthopedic emergency. We herein present a traumatic posterior dislocation of the hip in a 4-year-old child and emphasize on the role of early correction of the injury, preferably within 6 h since its occurrence to prevent long-term complications such as osteonecrosis, coxa magna, and osteoarthritis. |
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ELECTIVE REPORT |
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International clinical elective rotation: value added education |
p. 54 |
Viraat Harsh DOI:10.4103/2230-7095.149781 |
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LETTER TO EDITOR |
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Introducing 'A-Z' algorithm for extubation |
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Sunil Munakomi, Karuna Tamrakar DOI:10.4103/2230-7095.149784 |
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