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New Delhi, India

Kumar N.,Base Hospital Delhi Cantt | Prasad M.,Base Hospital Delhi Cantt
Journal of Foot and Ankle Surgery | Year: 2014

The Tillaux fracture of the ankle is an external rotation ankle injury resulting in an avulsion fracture of the anterolateral tibial plafond. This injury is known to occur in adolescents, although it has rarely been reported in adults. We report a case of a Tillaux fracture in an adult. A brief description of the history, mechanism of injury, required imaging, and treatment and other management options are provided in the present report. Anatomic reduction, rigid fixation, and early mobilization are emphasized to obtain a satisfactory functional outcome, shown by the long-term follow-up findings. © 2014 American College of Foot and Ankle Surgeons. Source


Dixit S.,Base Hospital Delhi Cantt | Namdeo M.,Base Hospital Delhi Cantt | Azad S.,Base Hospital Delhi Cantt
Journal of Clinical and Diagnostic Research | Year: 2015

Divalproex sodium is commonly used drug to treat variety of psychiatric and neurological disorders. Hyperammonemia is infrequent adverse affect of treatment with divalproex sodium. It needs high degree of clinical suspicion or else can lead to delirium of non hepatic origin in some group of patients and to medication errors or even death. We hereby report a case of mania who developed hyperammonemia with normal sodium valproate levels and liver function tests where delirium lead to diagnostic and medication errors. Withdrawal of divalproex sodium led to clinical recovery but delirium prolonged his hospital stay. This case report cautions the clinicians about hyperammonemia as the uncommon side effects and emphasizes the need of doing blood ammonia testing in patients treated with divalproex sodium where recovery is halted or clinical condition worsens despite normal liver function test and EEG. © 2015, Journal of Clinical and Diagnostic Research. All Rights Reserved. Source


Dixit S.,Base Hospital Delhi Cantt | Khan S.A.,Base Hospital Delhi Cantt | Azad S.,Base Hospital Delhi Cantt
Journal of Clinical and Diagnostic Research | Year: 2015

Serotonin specific reuptake inhibitors (SSRI) are widely used antidepressants for variety of clinical conditions and have found popularity. They are sometimes associated with extrapyramidal side effects including Parkinsonism. We report a case of generalized anxiety disorder on treatment with SSRI (fluoxetine / sertraline) who developed irreversible Parkinsonism. SSRI are known to cause reversible or irreversible motor disturbances through pathophysiological changes in basal ganglion motor system by altering the dopamine receptors postsynaptically. Clinician should keep risk benefit ratio in mind and change of antidepressant of different class may be considered. Case is reported to alert physicians to possibility of motor system damage while treating with SSRI. © 2015, Journal of Clinical and Diagnostic Research. All rights reserved. Source


Dixit S.,Base Hospital Delhi Cantt | Chauhan V.S.,Base Hospital Delhi Cantt | Azad S.,Base Hospital Delhi Cantt
Journal of Clinical and Diagnostic Research | Year: 2015

Introduction: Social factors play vital role in unfolding of alcohol use disorders in any given population. Several factors beyond the confines of treatment settings influence treatment outcome in alcohol dependence syndrome. Social support has positive effect in treatment outcome of alcohol dependence syndrome. This has not been much studied in India in past. Therefore we decided to study the perception of social support in cases of alcohol dependence syndrome admitted in a busy hospital in armed forces. Aim: The aim was to study the perception of social support across relapsed and abstinent group and see if it reached any statistical proportion and also to see if any socio-demographic variables also affected perception of social support. Materials and Methods: Fifty five consecutive male patients of alcohol dependent syndrome without a co-morbid neurological/psychiatric diagnosis were assessed for their perception of social support after taking informed consent. They were explained the procedure and their alcoholic milestones were recorded in specially designed pro-forma. Subjects were then divided in abstinent and relapsed group. Subsequently they were assessed for their perception of social support by administering Social provision scale and Social support questionnaire. Statistical Analysis: Data were tabulated and statistically analysed by using chi square test, Mann Whitney U-Test and Rank ANOVA test where applicable p-value <.05 was taken as significant. Results: Results indicated that perception of social support across abstinent (n=18) and relapsed (n= 37) group reached significant statistical proportion as measured by social provision scale and social support questionnaire. Duration of use, dependence and family history of alcoholism did not influence perception of social support across patient population. There was inverse relationship between patients with alcohol related problem and their perception of social support. Professional and qualified soldiers perceived higher social support than soldiers and lesser qualified individuals. Conclusion: Abstinent group perceived better social support than relapsed group and soldiers in upper socio-occupational status and less alcohol related problems perceived more social support than soldiers with lower socioeconomic status and more alcohol related problems. Psychosocial therapy must be incorporated in management of Alcohol dependence syndrome. © 2015, Journal of Clinical and Diagnostic Research. All rights reserved. Source

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