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Ropmay A.D.,North Eastern Indira gandhi Regional Institute of health and Medical science NEIgRIhMS
Indian Journal of Forensic Medicine and Toxicology | Year: 2010

The Casualty Department is the gateway to a medicolegal environment for both victims and perpetrators of violence. It is essential for certain personnel in the department to have the basic skills to gather evidence in a proper manner consistent with recommended standards of forensic science, and without overriding existing hospital policy. Local and state guidelines for collection and preservation of physical evidence must be kept in mind by those involved in this activity. Legal problems in this regard can be avoided if the Casualty Department is following established hospital policies and procedures based on the recommendations of a qualified Forensic Scientist or Expert.

Agarwal S.,North Eastern Indira gandhi Regional Institute of health and Medical science NEIgRIhMS
Journal of Clinical and Diagnostic Research | Year: 2014

Introduction: Children may present to an orthopaedic surgeon with congenital bone diseases, nutritional disorders like rickets, infective or traumatic due to fall etc of bones and joints.Aims: To know the percentage, common orthopaedic problems and demographic profile of paediatric orthopaedic problem in patients attending the orthopaedic OPD of NEIGRIHMS.Materials and Methods: The prospective study was conducted for the duration of 1 year from May’2012-May’2013 in the Dept of Orthopaedics in North Eastern Indira Gandhi Regional Institute of Health & Medical Sciences (NEIGRIHMS), Shillong.Results: In our study majority of the patients were in the age group of 11-15 y (37.4%), followed by the group of 0-5 y (25.6%). Majority of the paediatric orthopaedic patients came from the group of Rs.10, 000/- to 30,000/- monthly income families (56.2%). The study showed that in majority (51.6%) of the cases trauma was the major cause for bringing the child to the medical center. Male children were most commonly affected, with playing as the most common mode of injury especially outdoor (60.3%) and fractures especially of upper limb were the most common form of presentation.Conclusion: Our study here has given the bird’s eye view of various pediatric orthopedic disorders as may be found in a tertiary health care setting. This may help in formulating training modules for the medical students in the subspecialty of pediatric orthopedics. However, more community based cross-sectional studies may be required to be undertaken to determine the prevalence & incidence of the various disorders found in our patients. © 2014, Journal of Clinical and Diagnostic Research. All rights reserved.

Agarwal S.,North Eastern Indira gandhi Regional Institute of health and Medical science NEIgRIhMS
Journal of Orthopaedics | Year: 2013

Introduction: Supracondylar femoral osteotomy is the time tested method, used for correcting the angular (varus & valgus) deformities at the knee. Traditionally, Coventry type of femoral osteotomy is performed. Here, a medial or lateral based wedge of bone is removed or an open wedge osteotomy is made & subsequently the space is filled with the bone graft to achieve the desired correction. This osteotomy is subsequently stabilized with Kirschner wires or plate & screws. Later the limb is externally supported in brace or plaster cast till osteotomy unites. Here we present a case series of 10 cases, where we have analyzed the efficacy of Aglietti procedure for achieving normal limb alignment with good patient satisfaction and subsequent knee function as a method of femoral supracondylar osteotomy for correcting the valgus deformity at the knee. Short series results are also encouraging with regard to the operating time, per-operative blood loss, postoperative stability of osteotomy, early starting of postoperative rehabilitation due to good stability at osteotomy & subsequent functional outcome in relation to final range of motion (ROM) - flexion after 6 months of surgery. Case series presentation: Ten valgus adolescent knees were operated in 7 patients by the Aglietti procedure for correcting the angular deformity at the knee. The results were analyzed taking into consideration the desired correction to achieve normal limb alignment, operating time, blood loss during surgery estimated by the number of surgical mops used, stability of the osteotomy in the postoperative period & ultimate range of motion (ROM) obtained at the end of 6 months after the surgery. Results: The age of the patients taken up in the study were in the range of 12-16 years. Females predominated (n=5) against 2 males. The time taken for the procedure ranged from 40 to 50min. The size of the surgical mops used was 15×20cm. 1-2 surgical mops used per patient. The range of flexion achieved at the end of 6 months after surgery was from 125 to 135°. Conclusion: In our case series we found Aglietti procedure as an effective and easy method to correct the valgus deformity in post-rachitic adolescent knees with good patient satisfaction and no complications.However, more number of cases or a randomized control study with comparison between various techniques including Coventry method and a long term follow may be needed to make a final conclusion of establishing the superiority of this procedure over other methods. © 2013 Professor P K Surendran Memorial Education Foundation.

Donna Ropmay A.,North Eastern Indira gandhi Regional Institute of health and Medical science NEIgRIhMS
Indian Journal of Forensic Medicine and Toxicology | Year: 2011

Hospitals can be as hazardous as some industrial settings with associated occupational health and safety risks. In recent years, they have come under increasing scrutiny, especially since the impact of microorganisms such as Hepatitis B and HIV on workers. Research, laboratory and autopsy procedures, in particular, pose a threat of acquiring infections of various types. It has therefore become mandatory for all hospital employees to observe precautions to safeguard against possible biological hazards at the workplace. This article would, hopefully, address the challenges and responsibilities in these areas.

Parida D.K.,North Eastern Indira gandhi Regional Institute of health and Medical science NEIgRIhMS | Rath G.K.,All India Institute of Medical Sciences
Reports of Practical Oncology and Radiotherapy | Year: 2014

Background: Mycosis Fungoides (MF) is an indolent lymphoproliferative disorder affecting dermis caused by abnormal proliferation of CD4+ T-cells. Radiation therapy is the most effective modality of treatment for MF which offers cure in limited stage disease and desirable palliation in advance stage disease. Treating entire skin having many curved surfaces and folds with radiation is the real challenge for the radiation oncologist. Many techniques, dose schedules and modifications in total skin electron irradiation (TSEI) have been tried since 1950s. TSEI treatment is a very time consuming, inconvenient and physically challenging to both patient as well as oncologist. Aim: At our center TSEI was performed since 1983 with conventional linear accelerator where the treatment time was prolonged beyond two hours, which was very difficult or the patient, oncologist, technical officer and eating away the machine time hampering the treatment of other patients. From 1998 we shifted to high dose rate (HDR) mode, in order to bring down the treatment time of a single patient every day from two and half hour to 15. min. The reduction of treatment time increases patient compliance and at the same time saved machine time. Materials and methods: Between 1998 and 2003, eleven pathological diagnosed MF patients were treated using HDR TSEI. All the patients were male between 40 and 70 years of age, who had the history of having the disease for 7-22 months. Four patients had T2 and seven patients had T3 stage disease with more than 90% skin surface involvement. TSEI was performed with 4. MeV electrons with a daily fraction size of 120. cGy to a total dose of 36. Gy. At the end of 36. Gy, boost dose of 10. Gy was delivered to self shielding regions like sole, scalp and perineum. Considering the treatment related toxicities and consequent treatment interruptions, in the first seven patients, the last four patients were treated using similar HDR TSEI technique with modified treatment schedule, where the treatment was given on an alternate day basis following 2nd week of initiation of treatment. Results: The patients were followed over a period of 144 months with a median of 72 months. Nine patients are alive without any evidence of disease, one patient relapsed and one died due to progression of disease. The most common radiation related morbidities are erythema, skin blisters, various degree of desquamations, swelling of joints (specially small joints) etc. which are controlled by treatment interruptions and conservative measures. By modifying the treatment schedule, the incidence of toxicity as well as treatment interruptions were brought down. Conclusions: We can conclude that HDR-TSEI is an excellent and safe therapeutic modality for the patients with MF both curative as well as palliative without any added toxicity profile, provided patient positioning is done properly. © 2013 Greater Poland Cancer Centre.

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