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  Citation statistics : Table of Contents
   2013| October-December  | Volume 16 | Issue 4  
    Online since January 21, 2014

 
 
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ORIGINAL ARTICLES
Prevalence of hypertension and its risk factors among bank employees of Sullia Taluk, Karnataka
Imaad Mohammed Ismail, Annarao G Kulkarni, Suchith V Kamble, Sagar A Borker, R Rekha, M Amruth
October-December 2013, 16(4):139-143
DOI:10.4103/1118-8561.125553  
Background: Hypertension is a leading cause of mortality in the world and is ranked third as a cause of disability-adjusted life years. Epidemiological studies have shown that sedentary life-style and stress are important risk factors for hypertension. The job of bank employees is both sedentary and stressful. Studies on hypertension among bank employees are sparse in India; hence, this study was undertaken to estimate the prevalence of hypertension and identify its risk factors in bank employees of Sullia. Materials and Methods: It was a cross-sectional study conducted among employees of 13 banks located in Sullia. Data was collected using a pre-tested, semi-structured questionnaire. Blood pressure was measured following Joint National Committee-7 criteria. Analysis of data was performed using the Statistical Package for the Social Sciences version 17. P < 0.05 was considered to be significant. Results: A total of 117 bank employees including 18 managers/assistant managers, 33 officers and 66 clerks participated in the study. The prevalence of hypertension was 39.3%. Increasing age, family history of hypertension, body mass index ≥ 25 kg/m 2 and abnormal waist-hip ratio were significantly more frequent among the hypertensive than normotensive population. Conclusion: The bank employees had a high prevalence of hypertension and they must be considered an occupational risk group. We recommend periodic screening for early detection of hypertension in them.
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Presentation and outcome of snake bite among children in Sokoto, North-Western Nigeria
Usman M Sani, Nma M Jiya, Paul K Ibitoye, Mohamad M Ahmad
October-December 2013, 16(4):148-153
DOI:10.4103/1118-8561.125557  
Background: Snake bite with envenomation is a medical emergency. Children are at risk of severe manifestations due to small body mass. Unlike adult population, there is limited data on snake bite among children in Sokoto, North-Western Nigeria. We described the presentation and outcome of snake bite in children presenting to the Emergency Pediatric Unit of Usmanu Danfodiyo University Teaching Hospital, Sokoto. Materials and Methods: Case records of all children managed for snake bites from 1 st January 2003 to 31 st December 2012 were retrospectively reviewed. Demographic and other relevant information were retrieved and data analyzed using Microsoft Excel. Results: Out of 23,570 Pediatric admissions, 36 children had snake bites giving prevalence of 0.0015 (1.5/1000). Male: Female ratio was 1.6:1, with a mean (standard deviation) age of 9.6 ± 2.8 years (range = 1-14 years). Snakebites involved the lower limbs in 52.8%; and at home in 69.4%, and during the night in 58.3% of patients. The highest prevalence of bite was between April and July. Features of envenomation included local swelling (100%), prolonged clotting time (61.1%) and spontaneous hemorrhage (epistaxis and hematemesis) in 11.1%. One patient (2.8%) had seizure which may be incidental, though common causes such as hypoglycemia, malaria and meningitis were excluded by laboratory investigations. Polyvalent anti-snake venom was administered in 29 (80.6%) children, with adverse reaction observed in 13.8% (4/29) of the patients. Thirteen patients (36.1%) signed against medical advice while the remaining 23 (63.9%) were discharged home. Conclusion: Snake envenomation is associated with low morbidity and mortality in our study. Measures aimed at eliminating snake habitats around residential areas should be encouraged.
  7 11,861 784
Timing of prophylactic antibiotic administration in an orthopedic hospital in a developing country
Adesina Ajibade, Oluwatoba Taiwo Akinniyi
October-December 2013, 16(4):144-147
DOI:10.4103/1118-8561.125555  
Background: Appropriate timing of administration is crucial to the effectiveness of prophylactic antibiotics in preventing surgical site infection. Poor adherence to perioperative antibiotic prophylaxis recommendations has been documented from developed countries, but there is a paucity of data on this subject from Nigeria. The aim of this study was to assess the timeliness of administration of the first dose of prophylactic antibiotics in orthopedic surgery. Materials and Methods: In this observational study in an orthopedic practice, administration of antibiotics in operations done over a 6-month period was investigated. The main outcome measure was timing of antibiotic administration in relation to skin incision and tourniquet application. Optimum timing was defined as prophylactic antibiotic administration 15-60 min before skin incision or tourniquet application. Univariate analysis was performed using CDC-Epi Info TM Version 3.5.1 (August 2008). Results: There were 102 procedures out of which 95 (93.1%) were performed without a tourniquet. Of these 95 procedures, antibiotics were given before skin incision in 53 (55.8%) procedures and administration was optimum only in 16 (16.8%) procedures. The median induction-incision interval was 19 min (range: 3-45 min). Conclusion: Timing of perioperative antibiotic administration was inadequate. Routine administration at induction of anesthesia may promote optimum timing and can be considered as in any practice where no written perioperative antibiotic protocol exists.
  2 5,307 1,469
CASE REPORTS
Additional heads of dorsal interosseous muscle in Caucasian cadavers and their clinical significance
Vaishaly Kishore Bharambe, Sapna Prashant Shevde, Vatsalaswamy Puranam, Nilesh Subhash Kanaskar
October-December 2013, 16(4):174-177
DOI:10.4103/1118-8561.125580  
Dorsal interossei are group of four intrinsic muscles of the hand that are of immense importance in its day-to-day functions. The finding of any variation related to these muscles is of significance from point of view of hand surgeons. In the present article, we report additional heads of dorsal interosseous muscle (DIM) in four upper limbs of a male cadavers. The muscles took origin from the dorsal surface of the adjacent metacarpal bones as well as from the distal row of carpal bones, had a belly separate from the two pennae of the DIM, distally joining the tendon of corresponding DIM. We discuss the anatomical details and clinical implications of this variation.
  1 4,864 256
Gorham's vanishing bone disease of ribs mimicking metastasis: A case report and review of the literature
Nadeem Ali, Adnan Rashid Matoo, Abedullah Bhat, Khalid Muzzafar
October-December 2013, 16(4):160-164
DOI:10.4103/1118-8561.125563  
Gorham's disease is a very rare self-limiting osteolytic disorder of the bone of unknown etiology, and can affect any bone of the body. Clinical presentation varies with the location and extent of the lesion. Lesions of the thoracic cage, spine and craniofacial bones are associated with high morbidity. Mortality multitude of treatment options is available, but none is satisfactory. We present a case of Gorham's disease of the ribs that was initially suspected to be metastasis, but subsequent search for the primary lesion was negative. It was the histopathology of the lesion that leads to the diagnosis of Gorham's disease. The lesion did not progress, neither did it resolve either due to the natural arrest or due to effect of the bisphosphonate therapy.
  - 8,189 350
Acute amiodarone pulmonary toxicity in a patient with acute anterior wall myocardial infarction and ventricular tachycardia
Vijayakumar Subban, Latchumanadhas Kalidoss, Anitha Lakshmanan, Mullasari S Ajit
October-December 2013, 16(4):165-167
DOI:10.4103/1118-8561.125567  
Acute amiodarone pulmonary toxicity is a rare cause of acute respiratory distress in intensive care units. A 52-year-old man developed acute respiratory distress following intravenous amiodarone administration for refractory ventricular tachycardia. His chest X-ray and high resolution computed tomography-scans showed bilateral infiltrates with peripheral sparing. Patient improved following withdrawal of amiodarone and steroid therapy.
  - 3,914 303
Xanthogranulomatous cholecystitis: Report of a case with coexistent adenocarcinoma
Sujata Jetley, Safia Rana, Usha Agrawal, Zeeba S Jairajpuri
October-December 2013, 16(4):168-170
DOI:10.4103/1118-8561.125569  
Xanthogranulomatous cholecystitis (XGC) is an uncommon benign focal or diffuse destructive inflammatory disease of the gallbladder. Pre-operative and intra-operative diagnosis is difficult and it often mimics a gallbladder carcinoma (GBC). This diagnostic dilemma caused by equivocal imaging studies and intra-operative findings can at times be aggravated by a histological picture which mimics a neoplasm. Apart from occasionally presenting as an infiltrating mass lesion with adjacent organ invasion like a malignant neoplasm, XGC can also infrequently be associated with GBC. Lack of awareness that both XGC and carcinoma can co-exist as well as interpreter's inexperience may lead to a missed diagnosis. We present a case of to illustrate this coexistence and conclude that XGC and carcinoma of the gall bladder may co-exist and present a diagnostic dilemma. We recommend increased awareness of this knowledge among radiologists, surgeons and pathologists to raise its awareness.
  - 4,068 332
Acute flaccid quadriparesis and distal symmetrical polyneuropathy complicating tuberculosis of the urinary tract
Onyeadumarakwe R Obiako, Demie Ogoina, Johnson A Kehinde, Henry Iheonye, Thomas K Nkoro, Ahmed U Hamidu
October-December 2013, 16(4):171-173
DOI:10.4103/1118-8561.125575  
Acute flaccid quadriparesis and distal symmetrical polyneuropathy (DSP) are neurological conditions associated with sudden compression of the cervical spinal cord and damage to peripheral nerves, respectively. Although quadriparesis can result from compressive myelopathy by tuberculosis (TB) of the cervical spine, it has not been reported in patients with TB of the urinary tract, either alone or in combination with DSP. We therefore report the case of a 28-year-old man who developed sudden weakness of the four limbs after 2 months of low grade fever, night sweats, malaise, and weight loss; followed by 2 weeks of low back pain, tingling sensations, and numbness of both hands and feet; all without evidence of compressive myelopathy. A diagnosis of TB of the urinary tract was made following positive Mantoux test and isolation of acid fast bacilli from one of six urine samples, and patient underwent 12 months course of antituberculous therapy with resolution of symptoms and signs of both TB infection and neurological diseass. This report has shown that anti TB therapy is effective in both TB of the urinary tract and the associated neurological complications. This report demonstrates a rare neurological complication of urinary tract Tb and the efficacy of anti TB therapy in both conditions
  - 5,771 274
LETTERS TO THE EDITOR
Bifrontal acute subdural hematoma
Pankaj Kapoor
October-December 2013, 16(4):178-178
DOI:10.4103/1118-8561.125584  
  - 2,900 222
Bifrontal acute subdural hematoma
Suryapratap Singh
October-December 2013, 16(4):179-179
DOI:10.4103/1118-8561.125585  
  - 2,860 246
ORIGINAL ARTICLES
Helical computerized tomography of the abdomen: Indications and spectrum of findings in a tertiary health center
Garba H Yunusa, Sadisu M Ma'aji, Sule A Saidu, Amina M. B Shamaki, Muhammad Danfulani
October-December 2013, 16(4):154-159
DOI:10.4103/1118-8561.125559  
Background: Helical computerized tomography (CT) has shown improved sensitivity and clinical utility as a diagnostic tool in the evaluation of patients presenting to the hospital with various abdominal conditions. This study assessed the various indications for this diagnostic tool and the CT findings in a tertiary health center. Materials and Methods: The study was conducted in the Department of Radiology of the Usmanu Danfodiyo University Teaching Hospital, Sokoto. Abdominal helical CT scans of patients referred to the department from the various clinical departments as well as the neighboring tertiary health centers were reviewed retrospectively. All the patients were scanned on Neusoft/Phillips C-3000 helical CT in the department following standard protocols for abdominal CT examinations. The patient demographics, clinical indications for the CT examination, CT findings, and provisional diagnoses were evaluated. Data was analyzed using SPSS version 17.0. Results: Thirty-five patients aged 1 to 78 years (mean ± SD; 46.6 ± 18.4) and made of 18 males and 17 females were studied. The most frequent indication for abdominal CT was in the 46-60 age group representing 34.3%, while the least number of indications were in the 1-15 and above 75-year age groups each constituting 8.6% and 5.7%, respectively. Suspected abdominal mass was the commonest indication constituting 28.6%, while further evaluation of known renal mass constituted 20% of the cases. Pancreatic, appendiceal, and bladder masses were among the commonest findings with prevalence of 20.3%, 8.7%, and 8.6%, respectively. Conclusions: Abdominal mass was the commonest indication for helical CT of the abdomen in this study, while pancreatic mass represented the commonest finding among the patients studied.
  - 4,973 330
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