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   Table of Contents - Current issue
May-August 2019
Volume 2 | Issue 2
Page Nos. -

Online since Monday, October 21, 2019

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Editorial p. 17
Ritesh Runu
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Article writing in medicine p. 18
Ritesh Runu
Scientific publications started in 1665 by the Royal Society of London. The use of scientific literature increased for practice of medicine as well as by law agencies. With the advent and spread of the Internet, the publications of journals and articles have increased. Several guidelines are made by various organizations to maintain a standard writing format for research publications. Even then the research misconduct has increased. Plagiarism, duplicate publications, salami publications, gift authorships, and authorship conflicts are few of the major misconducts. To reduce it among writers and editors, the knowledge of the rules and regulations of article writing and journal publication needs regular update.
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Vitamin D in rheumatoid arthritis and association of disease activity with various laboratory parameters p. 21
Ravi Kumar, Kishore Kunal, Neeraj Kumar
Background: The aim was to validate the association between Vitamin D level and rheumatoid arthritis (RA); evaluate association of stages of disease activity with various parameters such as serum Vitamin D level, RA factor level, anti-cyclic citrullinated peptide (CCP), erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels; and evaluate correlation of Vitamin D with various parameters and Disease Activity Score (DAS)-28 score with various parameters. Materials and Methods: This was a prospective comparative study. The sample size was of 100 patients with 50 each in case and control groups. Investigations such as ESR, CRP (quant), anti-CCP, and RA factor were undertaken for case group. Serum 25-hydroxyvitamin D concentration was analyzed for both case and control groups. Disease activity was measured in patients of RA using DAS-28. Mean of Vitamin D level in case and control groups were measured. Association of different stage of disease activity among cases was calculated with various laboratory parameters. Correlation coefficient of Vitamin D with various laboratory parameters and DAS-28 score with various laboratory parameters calculated. Results: The mean Vitamin D level in case group was 18.726 ng/ml, while in control group, it was 42.851 ng/ml. Association of various stages of disease activity was statistically highly significant for CRP and anti-CCP levels. Vitamin D was negatively correlated with serum ESR, while DAS-28 score was positively correlated with serum ESR, CRP, RA factor, and anti-CCP values. Conclusions: Vitamin D deficiency is more common in RA patients. CRP and anti-CCP markers are associated with disease activity. Moderate-to-strong positive linear correlation present between DAS 28 score & CRP and DAS 28 score & anti CCP values respectively.
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Role of platelet-rich plasma versus corticosteroid injection in the treatment of plantar fasciitis: A comparative study p. 26
Deepankar Verma, Saurabh Kumar, Ish Kumar Dhammi, Rajnand Kumar, Rajat Kapoor, Anurag Mittal
Introduction: Platelet-rich plasma (PRP) is promoted nowadays as an ideal autologous biological blood-derived product. It enhances wound healing, bone healing, tendon healing and is currently being widely used. Aims and Objectives: A prospective cohort study was conducted to assess the efficacy of autologous PRP injection and to compare it with corticosteroid injection in the treatment of plantar fasciitis (PF). Materials and Methods: Fifty patients were included in the study and divided into two groups. Group I (25 patients) received PRP injection and Group II (25 patients) were given steroid injection. Patients were clinically assessed at different intervals. Functional outcome was evaluated on the basis of the visual analog scale (VAS) and foot and ankle ability measure (FAAM) scores. Plantar fascia thickness was assessed pre- and post-injection by ultrasound. Results: PRP and corticosteroid injection groups at the initial visit had VAS score of 8.86 and 8.60, respectively, which was reduced to 1.52 and 3.10 at the end of 6 months. The PRP and corticosteroid injection groups at the initial visit had FAAM score of 29.2 and 30.8, respectively, which increased to 84.2 and 68.3 at the end of 6 months. After injection, the PRP group had a significant reduction (34.80%) in the thickness of plantar fascia as compared to corticosteroid group (29.54%). Conclusion: Treatment of PF with PRP extract reduces pain and significantly increases function, exceeding the effect of steroid on long-term follow-up.
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Comparative study of operative versus nonoperative management of intra-articular calcaneum fractures p. 31
Ravi Kumar, Chandan Kumar, Neeraj Kumar
Purpose: The treatment of intra-articular fractures of the calcaneum remains controversial. There is no consensus in the current literature regarding the optimal treatment of intra-articular fractures of the calcaneum. In the current study, we intend to compare the outcome of operative and conservative management for intra-articular calcaneum fractures based on the objective criteria, i.e., restoration of Bohler's angle, subtalar range of motion, and subjective criteria such as pain, return to work, return to physical activity, and change in shoe wear. Materials and Methods: This retrospective cum prospective study was conducted in a government hospital at Patna, Bihar, during the period extending from April 2016 to March 2019. Twenty-four patients with 25 intra-articular calcaneum fractures were included in the study. The outcome of conservative and operative management was compared using the Creighton-Nebraska Health Foundation Assessment Score (C-N scoring system). Pretreatment and posttreatment (at follow-up) Bohler's angle were also compared. Results: Restoration of the Bohler's angle was better with operative management as compared to conservative management. In our study, the results of type I fractures managed conservatively had a better outcome than those of displaced fractures and the difference was statistically significant. Furthermore, type II and type III fractures had a better outcome with operative management, but the difference was not statistically significant. In type IV fractures, operative management was significantly better than conservative management. A significant correlation was seen between the posttreatment Bohler's angle and C-N scores. Conclusions: Conservative management has better functional outcome for undisplaced fractures. For displaced and comminuted fractures, anatomical reduction and restoration of Bohler's angle is very important. Bohler's angle has a prognostic importance and correlates well with the functional outcome.
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Nerve Stimulator-guided radial nerve block at elbow: New approach for the treatment of tennis elbow p. 37
Said Saghieh, Mohammad Nasreddine, Rachid Haidar, Ahmad Salah Naja, Tammam Hanna, Georges Haber, Zoher Naja
Lateral epicondylitis, or “tennis elbow,” is a symptomatic chronic degeneration of the wrist extensor tendons that involves their attachment to the lateral epicondyle of the humerus. Analgesic, percutaneous, and arthroscopic surgery techniques have been used with no significant difference in the outcome. We report four cases of patients suffering from lateral epicondylitis who received nerve stimulator-guided radial nerve block for pain management. The patients had substantial and extended reduction of pain.
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One-week-old irreducible hallucal interphalangeal joint dorsomedial dislocation due to an incarcerated sesamoid: A case report and its review of literature p. 40
Anurag Mittal, Deepankar Verma, Arunim Swarup, Rajnand Kumar, Rajat Kapoor, Sourabh Rai
Among the dislocations around the great toe, hallucal interphalangeal (IP) dislocation is a rare entity, with the most common being metatarsophalangeal dislocation due to its greater lever arm. We present the case of a young manual labourer with a missed hallucal IP joint dislocation with an incarcerated sesamoid, initially managed by an osteopath. After a failed attempt of closed reduction in the emergency department, we performed open reduction and reposition of sesamoid using dorsal incision and stabilized the joint with a K wire which was removed after 4 weeks. The patient was gradually mobilized and returned to his work of manual labor after 3 months without any residual pain or deformity.
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