SKIMS Medical College and Hospital

Srinagar, India

SKIMS Medical College and Hospital

Srinagar, India
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Hussain S.,SKIMS Medical College and Hospital | Ahmad M.,Hospital for Bone and Joint Surgery | Muzaffar T.,MBBS
Chinese Journal of Traumatology - English Edition | Year: 2014

Objective To assess the therapeutic results of open reduction and internal fixation with crossed K-wires via lateral approach for displaced supracondylar fractures of the humerus in children. Methods We prospectively followed 52 children who presented with Gartland type 3 displaced supracondylar fractures of the humerus and were managed by open reduction and internal fixation with crossed K-wires via lateral approach.There were 37 male and 15 female patients; average age was 7.39 years. The most common mechanism of trauma was fall while playing (n= 23), followed by fall from height (n= 20), road traffic accidents (n= 5) and fall from standing height (n= 2). In 2 cases, mode of injury was not available. The mean follow-up was 12 months and patients were assessed according to Flynn's criteria. Results Lateral approach provided an excellent view of the lateral column between two nervous planes and enabled an anatomical reduction in all cases. Immobilizing the elbow at 90 degrees or more of flexion was not needed after cross K-wire fixation. Majority of patients regained full range of motion within 6 weeks of pin removal. Two patients had postoperative ulnar nerve injuries that resolved after pin removal. The common late complication of cubitus varus was not seen in any patient. Delayed presentation to the emergency department, repeated manipulations by bone setters and massage with edible oil were responsible for stiffness in 5 patients. Superficial pin tract infection was noted in 5 patients that resolved with dressings and antibiotics. No deep infection occurred. A detailed clinical examination and radiographic analysis was done at final follow-up. They included measurement of carrying angle and range of movements of both operated and normal sides, and radiographs of both upper limbs for comparison. According to Flynn's criteria, 90.4% patients showed satisfactory results. Conclusion Lateral approach for open reduction and internal fixation of the widely-displaced supracondylar fracture of the humerus is safe and straightforward, ensuring anatomical reduction and excellent function. The approach is easy and familiar to most orthopedic surgeons in our setup. © 2014 Daping hospital and the Research Institute of Surgery of the Third Military Medical University.


Hussain S.,SKIMS Medical College and Hospital | Ahmad M.,SKIMS Medical College and Hospital | Muzaffar T.,SKIMS Medical College and Hospital
Chinese journal of traumatology = Zhonghua chuang shang za zhi / Chinese Medical Association | Year: 2014

OBJECTIVE: To assess the therapeutic results of open reduction and internal fixation with crossed K-wires via lateral approach for displaced supracondylar fractures of the humerus in children.METHODS: We prospectively followed 52 children who presented with Gartland type 3 displaced supracondylar fractures of the humerus and were managed by open reduction and internal fixation with crossed K-wires via lateral approach.There were 37 male and 15 female patients; average age was 7.39 years. The most common mechanism of trauma was fall while playing (n=23), followed by fall from height (n=20), road traffic accidents (n=5) and fall from standing height (n=2). In 2 cases, mode of injury was not available. The mean follow-up was 12 months and patients were assessed according to Flynn's criteria.RESULTS: Lateral approach provided an excellent view of the lateral column between two nervous planes and enabled an anatomical reduction in all cases. Immobilizing the elbow at 90 degrees or more of flexion was not needed after cross K-wire fixation. Majority of patients regained full range of motion within 6 weeks of pin removal. Two patients had postoperative ulnar nerve injuries that resolved after pin removal. The common late complication of cubitus varus was not seen in any patient. Delayed presentation to the emergency department, repeated manipulations by bone setters and massage with edible oil were responsible for stiffness in 5 patients. Superficial pin tract infection was noted in 5 patients that resolved with dressings and antibiotics. No deep infection occurred. A detailed clinical examination and radiographic analysis was done at final follow-up. They included measurement of carrying angle and range of movements of both operated and normal sides, and radiographs of both upper limbs for comparison. According to Flynn's criteria, 90.4% patients showed satisfactory results.CONCLUSION: Lateral approach for open reduction and internal fixation of the widely-displaced supracondylar fracture of the humerus is safe and straightforward, ensuring anatomical reduction and excellent function. The approach is easy and familiar to most orthopedic surgeons in our setup.


Khuroo M.S.,Sher I Kashmir Institute of Medical science | Khuroo M.S.,Digestive Diseases Center | Rather A.A.,SKIMS Medical College and Hospital | Khuroo N.S.,Digestive Diseases Center | Khuroo M.S.,Government Medical College
World Journal of Gastroenterology | Year: 2016

Portal biliopathy refers to cholangiographic abnormalities which occur in patients with portal cavernoma. These changes occur as a result of pressure on bile ducts from bridging tortuous paracholedochal, epicholedochal and cholecystic veins. Bile duct ischemia may occur due prolonged venous pressure effect or result from insufficient blood supply. In addition, encasement of ducts may occur due fibrotic cavernoma. Majority of patients are asymptomatic. Portal biliopathy is a progressive disease and patients who have long standing disease and more severe bile duct abnormalities present with recurrent episodes of biliary pain, cholangitis and cholestasis. Serum chemistry, ultrasound with color Doppler imaging, magnetic resonance imaging with magnetic resonance cholangiopancreatography and magnetic resonance portovenography are modalities of choice for evaluation of portal biliopathy. Endoscopic retrograde cholangiography being an invasive procedure is indicated for endotherapy only. Management of portal biliopathy is done in a stepwise manner. First, endotherapy is done for dilation of biliary strictures, placement of biliary stents to facilitate drainage and removal of bile duct calculi. Next portal venous pressure is reduced by formation of surgical porto-systemic shunt or transjugular intrahepatic portosystemic shunt. This causes significant resolution of biliary changes. Patients who persist with biliary symptoms and bile duct changes may benefit from surgical biliary drainage procedures (hepaticojejunostomy or choledechoduodenostomy). © The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.


Khuroo M.S.,Sher I Kashmir Institute of Medical science | Khuroo M.S.,Digestive Diseases Center | Rather A.A.,SKIMS Medical College and Hospital | Khuroo N.S.,Digestive Diseases Center | Khuroo M.S.,Government Medical College
World Journal of Gastroenterology | Year: 2016

Hepatobiliary and pancreatic ascariasis (HPA) was described as a clinical entity from Kashmir, India in 1985. HPA is caused by invasion and migration of nematode, Ascaris lumbricoides , in to the biliary tract and pancreatic duct. Patients present with biliary colic, cholangitis, cholecystitis, hepatic abscesses and acute pancreatitis. Ascarides traverse the ducts repeatedly, get trapped and die, leading to formation of hepatolithiasis. HPA is ubiquitous in endemic regions and in Kashmir, one such region, HPA is the etiological factor for 36.7%, 23%, 14.5% and 12.5% of all biliary diseases, acute pancreatitis, liver abscesses and biliary lithiasis respectively. Ultrasonography is an excellent diagnostic tool in visualizing worms in gut lumen and ductal system. The rational treatment for HPA is to give appropriate treatment for clinical syndromes along with effective anthelmintic therapy. Endotherapy in HPA is indicated if patients continue to have symptoms on medical therapy or when worms do not move out of ductal lumen by 3 wk or die within the ducts. The worms can be removed from the ductal system in most of the patients and such patients get regression of symptoms of hepatobiliary and pancreatic disease. © The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.


Mohammad S.,SKIMS Medical College and Hospital | Irfana B.K.,SKIMS Medical College and Hospital | Mudassar B.,SKIMS Medical College and Hospital | Wasseem B.K.,SKIMS Medical College and Hospital
JK Practitioner | Year: 2014

The immature tooth with apical periodontitis presents numerous challenges both an endodontic and restorative that inhibit our ability to provide a predictable long-term treatment outcome. Several procedures utilizing different materials have been recommended to induce the root end barrier formation. Conventional treatment with calcium hydroxide for such cases is associated with certain difficulties, such as the very long treatment time required, the possibility of tooth fracture, & incomplete calcification of the bridge. Use of Mineral Trioxide Aggregate (MTA) apical plug appears to be a promising alternative due to its high biocompatibility, superior sealing ability & reduced treatment time. Here we present a case report where teeth with open apices and periapical lesions have been successfully treated with MTA apical plugs. During treatment procedure, 1% sodium hypochlorite was used for irrigation and calcium hydroxide paste was placed in the canals for 1 week before the apical portion of the canals (5mm) was filled with MTA plug.


Wani A.,SKIMS Medical College and Hospital | Rehman A.,SKIMS Medical College and Hospital | Lateef S.,SKIMS Medical College and Hospital | Malik R.,SKIMS Medical College and Hospital | And 3 more authors.
Indian Journal of Otology | Year: 2016

Objectives: The purpose of this study was to determine the various etiologies of traumatic tympanic membrane (TM) perforations; their clinical presentation, observation and establish masterly inactivity as the main modality of management. Materials and Methods: A prospective study was performed on 350 cases of traumatic TM perforation in the Department of ENT, SKIMS Medical College, Srinagar from January 2010 to December 2014. Results: A total of 350 patients with the traumatic TM. Perforation was enrolled for this study. The group consisted of 231 male and 119 female patients. It affects all age groups with the highest incidence among middle age group. The right ear was involved in 94 (26.85%) patients, the left ear in 249 (71.14%) patients and bilateral ear involvement was seen in 7 (2%) patients. The type of trauma included compression injury in 243 (64.42%) patients, instrumental injury in 88 (25.14%) patients, and blast injury in 19 (5.42%) patients. Tinnitus was the most common complaint, followed by aural fullness, impaired hearing, otalgia, bleeding from ear and vertigo. 217 (62%) patients presented with conductive hearing loss in the range of 20-35 dB, 77 (22%) patients with <20 dB, 28 (8%) patients presented with >35 dB hearing loss, and 28 (8%) patients presented with no air-bone gap. Grade I perforation (<25% TM involvement) was seen in 91 (26%) patients, Grade II perforation (25-50% TM involvement) was seen in 221 (63.14%) patient, and Grade III perforation (>50% TM involvement) was present in 38 (10.90%) patients. Complete healing was observed within 2-6 weeks in 172 (49.10%) patients and within 7-9 weeks in 112 (32.20%) patients. 35 (10%) patients showed complete healing within 10-12 weeks. The minimum time taken to heal was 21 days and maximum time 72 days. Complete healing was observed in 319 (91.10%) patients. The intervention was only performed when spontaneous healing failed to occur after observing the patients for 1 week and included tympanoplasty in 8 (2.30%) patients, trichloroacetic acid cauterization in 14 (4%) patients. Residual perforation was observed in 9 (2.5%) patients. Conclusion: In our experience, traumatic TM perforation is still very common. Slap, instrumentation, road traffic accident, and blast injuries are common etiologies seen. It affects all age groups. Tinnitus and hearing loss are commonest symptoms. The masterly inactivity should be religiously followed and unnecessary surgical intervention should be discouraged. © 2016 Indian Journal of Otology | Published by Wolters Kluwer - Medknow.


Lone R.,SKIMS Medical college and Hospital | Bashir D.,SKIMS Medical college and Hospital | Ahmad S.,J and K Health Services | Syed A.,SKIMS Medical college and Hospital | Khurshid S.,SKIMS Medical college and Hospital
Journal of Clinical and Diagnostic Research | Year: 2013

Background: Onychomycosis is a major public health problem with a high incidence, associated morbidity and a long lasting treatment with anti-fungal agents. This study was carried out to know the clinico-mycological pattern of onychomycosis, which could help in the control of this infection. Aims: The aim of this study was to determine the prevalence of various causative agents of onychomycosis and to study the clinical and mycological patterns of onychomycosis. Material and Methods: This was a prospective study which was carried over a period of one year, from 1st February 2011 to 31st January 2012 on samples from 150 patients with clinically suspected nail infections, who attended the Dermatology Department of SKIMS Medical college, Kashmir, India. The nails were evaluated clinically and the nail samples were subjected to direct microscopy and culture. results: 60% samples were found to be positive by direct microscopy and culture. Males were infected more than females. The commonest age group which was infected was the 21-30 years age group. Finger nails were affected more frequently than toe nails and distolateral subungal onychomycosis was the most common clinical type of infection which was seen in 64.44% patients. The aetiological agents were dermatophytes (61.66%), Non-Dermatophyte Moulds (NDM) (31.66%) and yeasts (6.66%). Among dermatophytes, T. rubrum was the commonest aetiological agent. conclusion: Although dermatophytes were the main causative agents, NDM and yeasts were also not uncommon aetiological agents of onychomycosis. This study also emphasized the need of performing both a direct examination and culture to improve sensitivity. Since onychomycosis can cause physical, psycological and occupational problems, the clinico-epidemiological data can be helpful in development of preventive and diagnostic strategies.


PubMed | SKIMS Medical college and Hospital
Type: Journal Article | Journal: Journal of clinical and diagnostic research : JCDR | Year: 2013

Onychomycosis is a major public health problem with a high incidence, associated morbidity and a long lasting treatment with anti-fungal agents. This study was carried out to know the clinico-mycological pattern of onychomycosis, which could help in the control of this infection.The aim of this study was to determine the prevalence of various causative agents of onychomycosis and to study the clinical and mycological patterns of onychomycosis.This was a prospective study which was carried over a period of one year, from 1(st) February 2011 to 31(st) January 2012 on samples from 150 patients with clinically suspected nail infections, who attended the Dermatology Department of SKIMS Medical college, Kashmir, India. The nails were evaluated clinically and the nail samples were subjected to direct microscopy and culture.60% samples were found to be positive by direct microscopy and culture. Males were infected more than females. The commonest age group which was infected was the 21-30 years age group. Finger nails were affected more frequently than toe nails and distolateral subungal onychomycosis was the most common clinical type of infection which was seen in 64.44% patients. The aetiological agents were dermatophytes (61.66%), Non-Dermatophyte Moulds (NDM) (31.66%) and yeasts (6.66%). Among dermatophytes, T. rubrum was the commonest aetiological agent.Although dermatophytes were the main causative agents, NDM and yeasts were also not uncommon aetiological agents of onychomycosis. This study also emphasized the need of performing both a direct examination and culture to improve sensitivity. Since onychomycosis can cause physical, psycological and occupational problems, the clinico-epidemiological data can be helpful in development of preventive and diagnostic strategies.

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