Lady Curzon Hospital Research Articles

Depressive symptoms in type II diabetics of a tertiary care hospital in southern India

Background: International diabetes federation has highlighted that “the diabetic epidemic is here and threatens to overwhelm health systems if unchecked’’. The global prevalence of diabetes among adults has risen from 4.7% in 1980 to 8.5% in 2014. India unfortunately tops the list of countries with the largest number of people living with diabetes. Diabetes and depression are independent risk factors for one another and both are associated with increased risk of cognitive decline. Prevalence of depression is doubled in Diabetes mellitus, and also appears to vary by type of Diabetes mellitus, race/ethnicity, and duration of diabetes and associated debilitating complications and co-morbidities. Various studies using different methodology have revealed varying prevalence of depression. Data on this association of Diabetes and depression is limited in Indian context.Methods: This is a cross sectional study conducted on type 2 Diabetics attending outpatient department of Victoria and Bowring and Lady Curzon Hospital. Data regarding duration and treatment of diabetes, HbA1c levels and associated comorbidities were collected along with basic particulars of the patient. Becks depression questionnaire were used for analyzing the depressive symptoms.Results: A total of 302 diabetic patients were included in the study, out of which Males were 156 and Females were 146. Severe depressive symptoms were found in 18.21% of diabetics, and moderate depressive symptoms were found in 39.74% of study population. It is also found that the significant predictors of these depressive symptoms are increasing age, longer duration of diabetes, treatment intensity.Conclusions: In conclusion depressive symptoms are more common in diabetic subjects compared to non-diabetic population. Especially this increases with duration of diabetes and uncontrolled sugars. Hence there is a need to screen all diabetes subjects for depression.

Mesh repair versus mayo repair for paraumbilical hernia: a comparative study

Background: Para umbilical hernia is a multifactorial and complex process they are most commonly found along the midline linea Alba. This study aims to assess the efficacy of mesh repair in comparison to Mayo Repair and to analyze the morbidity associated with the management.Methods: The study was conducted in Victoria Hospital and Bowring and Lady Curzon Hospital attached to Bangalore Medical College & Research Institute, with clinical features suggestive of Paraumbilical Hernia (Minimum 30 cases each) from October 2010 to September 2012. Pediatric age group and those patients requiring emergency surgery have been excluded. 30 patients underwent Mayo’s repair and 30 patients underwent Mesh repair. Follow up period ranged from 2 months to 24 months.Results: paraumbilical hernia was found more commonly between 4rd and 6th decade of life with female: male 2.3:1. Most common presenting symptom was swelling with cough impulse (36.5%) and reducibility present. Commonest predisposing factors were multiparty and obesity. Percentage of early postoperative complications in Mayo’s repair was 13.6% and in Mesh repairs 6.6%. No statistical difference was noted. Percentage of recurrence following Mayo’s repair was 10% and following mesh repair was 0%. Postoperative complications like seroma, infections were similar in both procedures (Mayo’s repair and Mesh repair).Conclusions: Prosthetic mesh repair is a technique with good post-operative outcome, low recurrent rate and excellent patient satisfaction. It could become the gold standard in adult umbilical and paraumbilical hernia repair, in the future.

Bacteriological profile and outcome of Ventilator associated pneumonia in Intensive care unit of a tertiary care centre

Background: Ventilator associated pneumonia (VAP) complicates the course of 8-28% of patients receiving mechanical ventilation. Appropriate antimicrobial treatment significantly improves the outcome. Hence rapid identification of infected patients and accurate selection of antimicrobials are important clinical goals.Aims and Objectives: The present study was conducted with an aim to know the outcome of VAP and to identify pathogens, compare the bacteriological profile, duration of mechanical ventilation and length of hospitalization.Materials and Methods: Sixty patients who developed VAP during our study period of 2 years were included after meeting inclusion and exclusion criteria. Study was conducted in Victoria hospital and Bowring & Lady Curzon hospitals attached to Bangalore Medical College and Research institute.Results: Majority of patients were in the age group of 21-40 years. The occurrence of late VAP was 70 %. Klebsiella was the most common organism isolated in our study. Mortality was 13.3%. Average duration of intubation was 13.1±6.6days. Duration of hospital stay was 16.2±7.1 days.Conclusion: Our study concluded that occurrence of late VAP was more common than early VAP. Targeted strategies aimed at preventing VAP should be implemented to improve patient outcome and length of hospitalisation. Above all utmost importance must be given to prevent VAP. Asian Journal of Medical Sciences Vol.8(5) 2017 75-79

Study of clinico-pathological factors, indications and response to chemotherapy in breast cancer patients in a tertiary care hospital in south India

Background: Breast cancer is considered a systemic disease, surgical interventions on most of the patients can reduce the loco regional burden and chemotherapy can reduce systemic burden by reducing chances of metastasis and recurrence and prolong life expectancy. The objective of this study was to assess the clinic-pathological factors of patient presenting with breast cancer and to study the indications and response to chemotherapy for breast cancer.Methods: A prospective study of fifty patients was carried out at Victoria hospital and Bowring and Lady Curzon Hospital between October 2010 to October 2012 who underwent surgery, chemotherapy, radiotherapy and hormonal therapy.Results: Most patients presented with palpable axillary lymph nodes (64%) and belonged to stage II disease (50%). Invasive ductal carcinoma was seen in 90% of cases while medullary in 04%, colloid in 2% and Infiltrating lobular was seen in 04% of patients. Totally 64% cases were ER or PR+, and 36% were ER/PR- among the study participants. 70% of the patients operated had positive nodes. All 50 cases received chemotherapy. Chemotherapy was indicated in node positive patients and in patients whose tumour was measuring more than 1 cm. After follow-up of 50 patients for about a period of two years, 3 patients died, 4 patients had metastasis and in the remaining 47 surviving patients none of them had recurrence at the end of second year.Conclusions: Most cases and belonged to Stage II disease with Invasive ductal carcinoma being most common histological subtype seen in 90% of cases. FNAC is good diagnostic procedure cost effective and reliable as all cases post-operative HPE confirmed malignancy. Patients should be treated by chemotherapy in indicated cases, as carcinoma breast is a systemic disease and chemotherapy can reduce systemic burden by reducing chances of metastasis and recurrence and prolong life expectancy.

The orientation of acetabular component in total hip replacement using transverse acetabular ligament as a guide

Introduction: Acetabular component placement is a crucial determinant in outcomes following total hip arthroplasty. Malalignment predisposes to impingement, increased rate of dislocation, wear of the bearing, osteolysis, and revision after THA. The study aimed to determine how reliably the transverse acetabular ligament could be identified during primary THA and its validity as a guide for acetabular component placement within the safe zone in THA. Materials and Methods: In this prospective study, 52 patients undergoing total hip replacement during the period from August 2014 to January 2017 in Bowring and Lady Curzon Hospital and Victoria Hospital, Bangalore were included; in whom the acetabular component positioning was done using transverse acetabular ligament as a guide. 22 cases were done via modified lateral approach, while 30 cases were done via posterolateral approach. Acetabular reaming was done by placing the reamer parallel to TAL, starting with a reamer the diameter of the native femoral head. Following serial reaming, the final component is placed such that TAL should embrace it. The anteversion and inclination/abduction of the acetabular component was measured post-operatively by anteroposterior radiographs. Results: TAL was identified in all cases, irrespective of the surgical approach used. The mean planar anteversion was 19.84° (± 3.8°), and the radiological inclination was 43.65° (± 3.2°). Anteversion was within the safe zone in 96.15% (n=50) of the cases, while inclination was within the safe zone in 84.6% (n=44) of the cases. Conclusion: Transverse acetabular ligament can be reliably used as a guide in achieving patient-specific anteversion of the acetabular component within safe zone. A simple, reproducible technique, devoid of complex instrumentation. However, as inclination is influenced by factors in addition to TAL, TAL alone cannot be used for determining inclination of acetabular component positioning.

Clinical study on the various therapeutic approaches towards the management of hepatic abscess in adults.

Background and objectives: Hepatic abscess is a very common and significant health condition in developing countries including India. Alcohol consumption is one of the most important predisposing factors in causation of hepatic abscess followed by uncontrolled diabetes and immunosuppression. The aim of this study was to device a definitive protocol in the management of patients with liver abscess and to evaluate the different treatment option of liver abscess, amoebic or pyogenic in order to have some guidelines in our setting Material and methods: A hospital based prospective study was conducted between August 2014 to September 2016 in Bangalore medical and research institute (Victoria hospital and Bowring & Lady Curzon Hospital), Bangalore. The following study was done in a set of 50 patients diagnosed with liver abscess admitted in our hospital. After confirming the diagnosis, patients were exposed to different treatment modalities which consisted of medical management alone, USG guided Aspiration, Pigtail catheterization and exploratory laparotomy. Results: In our study majority of the patients (84%) were of amoebic liver abscess (ALA) and only 16% were of pyogenic liver abscess (PLA). Out of 50 patients 8 patients responded to drug therapy alone, 40 patients underwent ultrasound-guided aspiration and pigtail catheter placement and 2 patients were treated with CT guided aspiration. Open surgical method was excluded in our study. Conclusion: Image guided drainage is the best modality of treatment for liver abscess size >4cm in both pyogenic and amoebic liver abscess however in small size abscess medical management is equally good. Abscess cavity resolves better and has a lower recurrence rate in case of percutaneous catheter drainage than percutaneous needle aspiration.. Mortality was not observed in our series. Prompt diagnosis, aggressive medical treatment along with minimal intervention can keep the morbidity and mortality associated with this condition to a bare minimum.

Lower limb amputations: Our experience single centre study

Background and objectives: Major limb amputation is reported to be a major but preventable public health problem that is associated with profound economic, social and psychological effects on the patient and family especially in developing countries where the prosthetic services are poor. Amputation has implications on both mobility and functionality. The purpose of this study was to outline the patterns, indications and short term complications of major limb amputations and to compare our experience with that of other published data. Material and methods: This was a cross-sectional descriptive study involving all patients who underwent major lower limb amputations at Bowring and Lady Curzon Hospital between March 2008 and February 2016. All patients who underwent major limb amputation were, after informed consent for the study, enrolled into the study Amputation was performed by the attending surgeon who also prescribed the postoperative care of the patient. Patients were followed up till discharge or death. Results: A total of 162 patients were entered into the study. Their ages ranged between 2180 years. The most common indication for major limb amputation was diabetic foot complications in 87.6% followed by chronic non healing ulcer and peripheral vascular disease. Above knee amputation was the most common procedure performed in 88.8%. Conclusion: Complications of diabetic foot ulcers and chronic non healing ulcer were the most common indications for major limb amputation in our environment. The majority of these amputations are preventable by provision of health education, early presentation and appropriate management of the common indications.

Clinical profile and outcome of dengue fever in a paediatric tertiary care centre

Background: A study of different presentation and outcome of dengue fever in tertiary care centre.Methods: the observational cross sectional study was carried out from June to October 2016 in Bowring and Lady Curzon hospital attached to Bangalore Medical College and Research Institute. Included patients from 1 to 18 years of age who presented with febrile illness. WHO classification and definitions were used to classify disease as dengue fever (DF), dengue haemorrhagic fever (DHF) and dengue shock syndrome (DSS). Clinically, haematological and biochemical findings were recorded till discharge.Results: during study period,142 patients presented with typical features of dengue fever, male being 86 (60%) and female being 56 (40%). Among 142 cases 64 cases were probable dengue, 50 cases were dengue with warning signs and 28 cases were had severe dengue. Fever (100%) was the most common clinical presentation followed by vomiting (70%), body ache (43%), abdominal pain (23%), headache (12%) and rashes (5%). Laboratory findings included thrombocytopenia, leucopenia and elevated liver enzymes. 126 (88%) cases were discharged in clinical stable conditions, (8%) were died during course of treatment and 8 cases left against medical advice.Conclusions: fever with vomiting and thrombocytopenia were most common presentation of dengue fever, appropriate clinical diagnosis and management is relatively simple, inexpensive and very effective in saving lives as long as long correct and timely interventions instituted.

Clinical study and management of pseudocyst of pancreas

Background: Pancreatic pseudocysts can occur as a complication of acute or chronic pancreatitis. Understanding of pseudocysts has changed with times due to advancement in radiology and introduction of new treatment modalities. This study was done to access clinical features etiology and various managements for pseudocyst in a tertiary care hospital.Methods: It is a prospective study of 40 adult patients admitted in Victoria and Bowring and Lady Curzon Hospital, attached to Bangalore Medical College and Research Institute, Karnataka, India from January 2015 to December 2016.Results: Pseudocysts are more common in males. The commonest etiology associated was alcohol. Ultrasound was the basic radiological investigation done in all patients followed by CECT abdomen. Complications associated with pseudocyst were Gastric outlet obstruction and ascites. Internal drainage was done in most of the patients. Post drainage complications included infection which was managed by antibiotics and endoscopic drainage in case of recollection. Pain was most important post-operative complication. Endoscopic drainage is being preferred as it is less invasive, has a high long term success rate, has shorter duration of hospital stay and more patient comfort.Conclusions: Pseudocyst of pancreas is most commonly seen in males probably because of alcoholism. Clinical presentation can be varied, with pain abdomen being the most common complaint followed by, nausea vomiting. Initial management consists of supportive care and if the symptoms persist and complications develop surgical drainage was the most common management modality. Newer modalities of treatments like endoscopic intervention have an added advantage of lesser pain, shorter duration of hospital stay and recurrence.

Breast cancer, Clinical presentations, Risk factors, Staging

Background: Breast cancer is most common cause of cancer related mortality and second most common cause of cancer in females in India. Hence study aims to evaluate the clinical profile and risk factors of the breast cancer.Methods: This is cross sectional study done at Victoria hospital and Bowring and Lady Curzon Hospital between January 2012 to October 2012 among 50 females patients more than 18 years of age, presented with breast cancer irrespective of tumour stage, size and location and for whom preliminary diagnosis of carcinoma breast was confirmed on fine needle aspiration cytology. Preformed, pretested semi-structured questionnaire was used to collect the data regarding the risk factors and clinical presentations of the patients.Results: Maximum participants 18 (36%) were in the age group of 41-50 years, 32 (64%) patients belonged to lower class with mean age at menarche of 13.3 years. About 26 (52%) patients were in premenopausal state. In present study, 48 (96%) of the total patients were multiparous and 47 (94%) women practiced breast feeding for more than 4 months. None of the patients in this study had a family history of breast cancer. Most breast cancer patients presented with history of lump followed by pain 14 (28%) and nipple retraction 9(18%). Most of the patients 29(58%) had upper outer quadrant involvement followed by upper inner quadrant in 7 (14%).In about 26 (52%)patients, tumour size was more than 5 cm and 32 (64 %) patients had axillary lymph nodes.Conclusions: Breast cancer was predominantly a disease of middle aged, lump in breast is commonest mode of presentation with upper outer quadrant involvement and 26 (52%) patients were in stage II of TNM classification.

Liver abscess presentation and management: a retrospective study

Background: Liver abscess is defined as collection of purulent material in liver parenchyma which can be due to bacterial, parasitic, fungal, or mixed infection. It is a common condition across the globe. The aim was to study the clinical profile, microbiological aetiology, and investigation profile and treatment outcomes in patients with liver abscess.Methods: A retrospective study was conducted from January 2010 to December 2014 on 200 consecutive liver abscess patients at Bowring and Lady Curzon hospital, BMC and RI, Bangalore, Karnataka, India. Medical records were analysed for clinical features, examination findings, laboratory investigations, radiological tests, microbiological analysis and treatment modalities. Descriptive statistics were used.Results: The mean age of patients was 42.25 years. Majority were male alcoholics. The abscesses were commonly in right lobe (80%) and solitary (72%). Abscesses were predominantly amoebic in 72%. Percutaneous needle aspiration was done in 34%, pigtail drainage in 48% and surgical intervention for rupture in 4% patients. Mortality was 2.5% with all death reported in surgical group.Conclusions: Amoebic liver abscess is more common than pyogenic liver abscess. Commonly occurs in young alcoholic males. Most common presenting feature is pain abdomen followed by fever. Most common sign include tender hepatomegaly. Ultrasound abdomen is useful not only in diagnosis and intervention but also in the follow up of the condition and to assess resolution.

Clinicopathological study of Ileal perforation: study in tertiary center

Background: The objective of this study was to evaluate the clinicopathological characteristics in Ileal perforations because of confusion and controversy over the diagnosis and optimal surgical treatment of terminal Ileal perforation -a cause of obscure peritonitis. Perforation of terminal ileum is a cause for obscure peritonitis with severe toxic state, there may be obscured clinical features with resultant delays in diagnosis and adequate surgical intervention.Methods: A prospective study was conducted in Victoria Hospital and Bowring and Lady Curzon Hospital attached to Bangalore Medical College and Research Institute over a period of 5 years from June 2011 to May 2015. A total of 136 patients presented in this period with hollow viscus perforation and out of these 64 patients had Ileal perforation alone on exploratory laparotomy. Ileal perforations account for about 20 percent of all cases of hollow viscus perforation. Emergency exploratory laparotomy was done and perforation was identified, edge biopsy was taken in all cases and the perforation was closed in two layers and resection anastomosis was done in stricture with perforation. Histopathological report was reviewed following surgery.Results: A total of 64 patients with Ileal perforation were included in the study of which 52 were males and 12 were females accounting for 81.25 percent and 18.75 percent respectively. The causes for perforation were enteric fever (82.81%), nonspecific inflammation (9.38%), and tuberculosis (7.81%). Simple closure of the perforation (74.58%) and the remaining primary resection and anastomosis were the mainstay of the surgical management.Conclusions: The common pathology of Ileal perforation is Typhoid or Enteric fever, Non-specific ulcer, Tuberculosis and others. Intestinal complications of typhoid fever are quite common in developing countries. Nonspecific inflammation of the terminal ileum was other predominant cause operative findings were similar to that of typhoid fever but no laboratory evidence of the disease was found. Intestinal tuberculosis can mimic many conditions.

“HEPATITIS B AND C PREVALENCE AND PREVENTION AWARENESS AMONG HEALTH CARE PERSONNEL IN TERTIARY CARE MEDICAL COLLEGE HOSPITALS IN BANGALORE CITY”

20Dec 2016 “HEPATITIS B AND C PREVALENCE AND PREVENTION AWARENESS AMONG HEALTH CARE PERSONNEL IN TERTIARY CARE MEDICAL COLLEGE HOSPITALS IN BANGALORE CITY” V. Channaraya , Chaitanya H. Balakrishnan , Ravi K and Chandrasekhara P. M.D., D.N.B., F.I.C.C., F.I.C.P., Professor and Head, Department of General Medicine, K.I.M.S. Hospital and Research Centre, V.V. Puram, Bangalore- 560004. M.B.B.S., (M.D.), Post Graduate, Department Of General Medicine, K.I.M.S. Hospital And Research Centre, V.V. Puram, Bangalore- 560004. M.D., Professor And Head, Department Of General Medicine, Bowring And Lady Curzon Hospital, Lady Curzon Road, Shivajinagar, Bangalore-560001. M.D., Professor, Department Of General Medicine,M.V. J. Medical College Hospital, Hoskote, Bangalore-560214.

Role of Total Knee Arthroplasty in Different Joint Diseases- A Retrospective Study

Aims: 1. To study the indication of TKA in our setup. 2. To evaluate the results clinically by assessing the functional improvement of the patients with reference to pain, walking ability and range of motion. 3. To study the implications associated with this procedure Materials and Methods: We are reporting the retrospective study and the early results of 28 knees of Total condylar knee arthroplasty using either with or without posterior stabilizing designs. 28 knees in 25 patients who visited the department of orthopaedics at Bowring and Lady Curzon hospitals. Bangalore Medical college. Bangalore, during the year 2001 – 2003. Have been selected with appropriate indications. The patients with severe knee arthritis and intractable pain were screened consecutively to select the patients. The patients with serious medical illness, infected arthritis, haemophilic arthropathy, charcoat arthropathy, and extreme complex deformed knees and follow up less than 6 months were excluded. Of the selected patients, 10 were RA, 14, were OA, and 1 had septic arthritis sequelae. Results: There were 19 (76%) females and 6(24%) males. Right knee predominates (14-56%) than left (8-32%) and bilateral (3- 12%). The unilateral replacement did pose a problem in clinical evaluation and may have an effect on long term results. As two cases could not be followed up after 6months, evaluation was done for 26 knees in 23 patients. Pre-operatively all of our patients had moderate to severe pain and 38.5% had rest pain. Post-operatively only 19% had mild pain. Pre-operatively there were no excellent knees .11.6% of the knees scored good, 26.9 % scored fair and 61.5% scored poor. Post-operatively 65% of the knees scored excellent, 16% good and 19% scored fair Conclusions: Our study of total condylar prosthesis series demonstrates that total condylar prosthesis is reliable, provide pain relief, average 90-95 motion and aood function.

Hooch Tragedy-an Autopsy Study at Bowring and Lady Curzon Hospital, Bangalore

A complete medicolegal autopsy was conducted on 51 victims of consumption of illicit liquor were brought to Department of Forensic Medicine and Toxicology, Bowring and Lady Curzon Hospital, Bangalore Medical College and Research Institute, Bangalore. The highest peak of incidence was found in the in the age group of 31 to 40 years (35.29%). 41(80.39%) were male and 10 (19.61%) were female. The period of survival after consumption of illicit alcohol shows that most of the fatalities occurred within 13–24 hours (43.14%) of consumption. The average blood methyl alcohol and ethyl alcohol levels were 21.46 mg% and 14.53% respectively.

Evaluation of alignment in total knee arthroplasty: a prospective study.

Successful results of knee arthroplasty demand precise surgical technique, sound implant design, kinematics, appropriate materials and patient compliance with rehabilitation. The precision with which the implants are placed directly affects patient outcome as implant position and alignment influence the stability, durability and patellar tracking. Evaluating the alignment in total knee arthroplasty and functional outcome with respect to the alignment is the need of the hour. AIM AND OBJECTIVE OF THE STUDY: (1) To evaluate the accuracy of the overall limb alignment and component alignment in jig-assisted TKR. (2) To evaluate the functional outcome with respect to the alignment parameters. This is a prospective study of 120 knees in 80 patients that underwent total knee replacement at Victoria and Bowring and Lady Curzon hospitals. Patients were selected according to the inclusion and exclusion criteria and evaluated using knee society score at regular follow-up. Preoperative and postoperative standing 'long-leg radiographs' and postoperative CT scans were taken from all the patients. In our study, we had 54 female patients and 26 male patients. Indications were OA in 72 and RA in 48 knees. The average follow-up period was 36 months. Preoperatively, all the patients had moderate to severe pain. Mechanical and tibiofemoral axes were outside the acceptable range. Postoperatively, with respect to mechanical axis, the inliers had significantly better knee score (p = 0.026) compared to the outliers. But the functional score did not show any significant difference between these two groups (p = 0.2093). Inliers in tibiofemoral axis alignment parameter had extremely significant better knee score (p = 0.0001) and also functional score (p = 0.0082) compared to outliers group. Sagittal and rotational femoral component angles in all 120 cases were coming within the 'inliers group'. Similarly, the sagittal, the coronal and the rotational component angles of tibia were also coming under inliers group in all 120 replaced knees. Aligning the mechanical axis, tibiofemoral angle within (0° ± 3°) and placement of prostheses within (0° ± 3°) to the normal alignment in all the three planes significantly produce excellent result with respect to functional outcome.

A Clinical Study of Primary Amenorrhea

ABSTRACT Introduction Menstruation is the physical herald to physiologic capacity of conception. Attainment of menarche in a girl brings in a lot of confidence and feminism in a girl. Though the incidence of primary amenorrhea is less than 1%, it accounts for significant amount of psychological trauma. In the present day scenario, there are a lot of investigative and treatment modalities which can at least restore her menstrual functions, if not reproductive, and prevent complications. Aims The objective of this study is to note the various causes of primary amenorrhea and the complete clinical picture and the management done in a tertiary care center like Vanivilas Hospital and Bowring Hospital, Bengaluru. Materials and methods This is a prospective study done in 40 patients of primary amenorrhea presenting to Vanivilas Hospital and Bowring and Lady Curzon Hospital, Bengaluru during a 2 years period. They were investigated and managed. The patients were followed up for their response to treatment. Results Out of the 40 patients studied, Mayer-Rokitansky- Küster-Hauser (MRKH) syndrome (32.5%) and hypergonadotropic hypogonadism (32.5%) were most common. Cryptomenorrhea (17.5%), automatic identification system (AIS) (7.5%) and miscellaneous (4%) were found. Conclusion Evidence of primary amenorrhea is less than 1%. A detailed investigation may lead to treatment in many cases. How to cite this article Anitha GS, Tejeswini KK, Shivamurthy G. A Clinical Study of Primary Amenorrhea. J South Asian Feder Obst Gynae 2015;7(3):158-166.

Study of Pattern of Traumatic Brain Injury in a Series of 50 Cases of Head Injuries

Traumatic brain injuries are posing high burden of mortality and morbidity in the world with particular threat to developing nation like India, which is heading towards ultra-modernization at rapid pace. The major load of such injuries lies on road Road Traffic accidents, industrial Accidents, Domestic accidents, fall from height and physical assaults. METHODology The present study was carried out in the Mortuary, of Bowring and Lady Curzon Hospital, Bangalore attached to the Department of Forensic Medicine, Bangalore Medical College, Bangalore, over a period of two year from January 2003 to January 2005. A total of 57 cases of deaths due to TBI have been studied. The study was a cross-sectional study. RESULTS RTA is leading cause of traumatic brain injuries among all with 71.93% followed by fall 22.81%. All the causes showed male predominance with males involved being 92.68% and most vulnerable age group was those in 3rd, 4th and 5th decade of life. Language: en

English

BACKGROUND: Duodenal ulcer is a very common disease in the southern part of India and complication like perforation is still common and surgical intervention is considered the treatment of choice.(1) METHODS: A prospective study consisting of 70 patients of duodenal perforation presenting as acute abdomen to the casualty department of Victoria hospital and Bowring & Lady Curzon Hospital, Bangalore, between October 2009 to Aug 2011. RESULTS: In our study, presentation of duodenal perforation is common in males (91.4%) between 3rd to 6th decades. The incidence of the duodenal perforation is more in those consume spicy food, living in rural areas (59%) and with ‘0’ positive blood group (51%). Most of our patients presented after 48 hours and major post-operative complications observed in these patients (50%). CONCLUSION: Live omental patch closure with technical modifications is still the better operation in perforated duodenal ulcer and definitive procedure are reserved when suitable conditions are present.(2) Mortality rate in perforated duodenal ulcer is less when compared to other acute abdominal conditions and is directly related to duration of clinical symptoms, age, severity of dehydration, and peritoneal cavity contamination.

English

BACKGROUND: Forearm represent a critical anatomic unit of the upper limb, permitting the effector organ of the upper limb, the hand, to perform multi axial daily activities of living conservative reduction of fracture BBFA results in a poor functional outcome, non-union, mal-union rotational deformity. Hence perfect reduction is essential in maintaining the rotation (supination and pronation). This is achieved by ORIF using LC-DCP. The term LC-DCP stands for a new approach to plate fixation, reduced trauma to bone, preservation of blood supply, avoidance of stress raisers produced at implant removal and improved healing. This study is undertaken to assess the results of diaphyseal fractures of BBFA using LCDCP to study the advantages and its complications. MATERIALS AND METHODS: Patients who are admitted tin Victoria and Bowring & Lady Curzon Hospitals (Bangalore Medical College) taken for study after obtaining their consent. This is prospective study from January 2004 to February 2006. RESULTS: This study consists of 20 cases of fracture BBFA. All cases were openly reduced and internally fixed with 3.5 mm LCDCP. Age distribution ranged from 18-65 years with fracture being most common in 2 nd and 3 rd decade (Average 34.6). Sex distribution out of 20 patients, 17 patients (85%) was male and 3 (15%) female. Side affected 13 (65%) left side and 7 patients (35%) right side. Mode of injury RTA 10 (50%), 8 (40%) with fall 2 (10%) assault. 18 (90%) patient s had sound union in less than 6 months, 2 (10%) patients had delayed union. Results were evaluated by Andersons scoring system. Using this scoring system we had 17 (85%) patients with excellent results. 2 (10%) patients with satisfactory results and 1 (5%) with unsatisfactory result (radioulnar synostosis). Superficial infection 2 (10%) posterior interosseous nerve injury 1 (5%) Radioulnar synostosis 1(5%). CONCLUSION: LC-DCP facilitates biological, rigid fixation and early bone union with excellent radiological and functional outcome in majority of the patients. Until newer implants are devised and extensively assessed as the versatile LC-DCP these should be used as the implant of choice for all closed displaced diaphyseal fractures of both bones.