Gaurav K.,Amrita Institute of Medical science |
Vilas J.,Bharati Vidyapeeth Medical College
International Journal of Lower Extremity Wounds | Year: 2010
Fixed flexion deformity (FFD) of the knee causes significant patient disability and is challenging to orthopedic surgeons because of its complexity. A prospective study was conducted using Ilizarovg's principles of distraction neohistogenesis and differential distraction and Ilizarovg's ring fixator for the correction of this deformity in cases with soft-tissue contracture. This was done without any concurrent bony procedures. A prospective, uncontrolled study of 26 patients (39 knees) was conducted over a 4-year period with prior approval from the local institutional review board. Patients with FFD of the knee without bony ankylosis were treated with knee-spanning 4-ring Ilizarovg's frame and gradual differential distraction. All patients showed complete correction of deformity without any significant complications. The results of this uncontrolled study permit the observation that soft-tissue distraction across a joint using Ilizarovg's principle results in soft-tissue lengthening and correction of joint deformity caused by contractures. This technique needs further detailed examination. © 2010 The Author(s).
Varkey P.,Rochester College |
Murad M.H.,Rochester College |
Grall K.J.H.,University of Arizona |
Saoji V.,Bharati Vidyapeeth Medical College
Journal of Evaluation in Clinical Practice | Year: 2010
Objective Numerous studies performed over the last 30 years suggest that doctors have poor knowledge of the costs of medical care. In most graduate medical education programmes, trainees do not receive formal training in cost-effective medical practice. Methods Comprehensive literature search of electronic bibliographic databases for articles that describe health economics, cost-containment and cost-effectiveness curricula in graduate medical education. Critical appraisal of the literature and qualitative description is presented. Heterogeneity of curricula precluded quantitative summary of data. Results We identified 40 articles that met the inclusion criteria for this review. Internal medicine residents were the targeted learners in 27 studies (68%); Family Medicine and Surgery residents were each targeted in five studies (13%); Rehabilitation, Paediatrics and Emergency Medicine residents were each targeted in one study. In general, the methodological quality of the included studies was poor to moderate and mostly targeted knowledge of health economics or cost-containment as opposed to targeting cost-effectiveness. In terms of describing the standard curricular components, studies sufficiently described the different educational strategies (e.g. didactics, interactive, experiential, self-directed) and the component of learner assessment, but lacked the description of other elements such as needs assessment and curriculum evaluation. Conclusion Cost-effectiveness curricula in graduate medical education are lacking and clearly needed. © 2010 Blackwell Publishing Ltd.
Gandhi S.,Deenanath Mangeshkar Hospital and Research Center |
Remacle M.,University Hospital of Leuven |
Mishra P.,Bharati Vidyapeeth Medical College |
Desai V.,Deenanath Mangeshkar Hospital and Research Center
European Archives of Oto-Rhino-Laryngology | Year: 2014
Spasmodic dysphonia (SD) remains one of the most difficult of laryngeal pathologies to treat. With limited role for speech therapy, various surgical modalities have been tried with various success rates. The objective of the study is to report the results of vocal outcome after thyroarytenoid myoneurectomy in patients of adductor spasmodic dysphonia (ASD). 15 patients of ASD were selected. GRBAS, and voice handicap index (VHI) were used for perceptual evaluation of voice. Thyroarytenoid myoneurectomy was performed by vaporizing the muscular layer of the vocal fold with CO2 laser, at an intensity of 6 W with 1.2 mm diameter in scanner mode. Voice analysis was repeated at 12, 24 and 48 months follow-up. Preoperative GRBAS scores and VHI score of all the patients were poor. At 12 months 12/15 (80 %) patients having strain score of 0. There was marked improvement in VHI scores at 6 months. 10/15 (67 %) patients have been followed up for 24 months. 5/10 (50 %) patients have strain (S) value of 0. VHI scoring of 5/10 (50 %) patients was <30. Two of the four patients completed 48 months follow-up had a strain (S) value of 0, one patient has strain value of 1 and one patient had strain value of 2. 2/4 patients had VHI score of <30; one patient had that of 40. Trans-oral CO2 laser thyroarytenoid myoneurectomy shows significant long-term improvement in voice quality in terms of reduced speech brakes, effort and strain in voice. © 2014, Springer-Verlag Berlin Heidelberg.
Kulkarni A.P.,Tal Medical |
Doke P.P.,Bharati Vidyapeeth Medical College
Indian Journal of Public Health Research and Development | Year: 2015
Introduction: At international level human development report is published every year. At national level state wise human development report is published regularly. Such reports below state level are scarcely available. One of the reasons may unavailability of statistics pertaining to life expectancy at birth. Objective: To explore the possibility of using infant mortality rate and/or crude death rate as proxy indicator to life expectancy at birth. Material and Method: Desk analysis of available data for the years 2005-08 was carried out. State wise data required for calculation of human development index was obtained from websites and the indices for the states were computed. Then proxy indicators were used in place of life expectancy at birth and modified human development indices for states were calculated. We used total five indicators derived from infant mortality rate and crude death rate. Correlations of these modified human development indices and conventional human development indices were studied. Correlation by using SPSS and significance of correlation by using t test was computed. Results: All five indicators have strong and significant correlation with conventional index. Highest correlation was found when 50% weightage is given to infant mortality rate and crude death rate. Conclusions: Even crude death rate can be considered as good proxy for life expectancy at birth. The modified human development index can be considered for smaller units like districts. © 2015, Indian Journal of Public Health Research & Development..All rights reserved.
Karandikar M.,Bharati Vidyapeeth Medical College
The Indian journal of chest diseases & allied sciences | Year: 2011
Thymoma is a very rare tumour arising from thymus in the anterior mediastinum. A case of a spindle cell thymoma with Myasthenia gravis in a 34-year-old female who presented with difficulty in breathing and swallowing with shortness of breath is reported.