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Medicolegal cases: What every doctor should know
Thounaojam Meera
September-December 2016, 30(3):133-134
  49,790 4,995 1
Pattern of disease in palpable supraclavicular lymph node: A cytopathological perspective
Rajesh Singh Laishram, R Meyyappa Devan, Sharmila Laishram, Durlav Chandra Sharma
September-December 2012, 26(3):163-166
DOI:10.4103/0972-4958 .113238  
Objectives: To study the pattern of diseashe in palpable supraclavicular lymph node using fine needle aspiration cytology (FNAC) in Regional Institute of Medical Sciences (RIMS) Hospital, Imphal, Manipur. Materials and Methods: A retrospective study was done by critically analyzing the FNAC reports of palpaple supraclavicular lymph node in last 5 years (January 2006-December 2010) at the Department of Pathology, RIMS Hospital, Imphal, Manipur. Review of all the reports were done and diagnosis was made according to standard guidelines and correlated with patient's age, sex, and side of involvement to explore the disease pattern. Results: Out of 255 cases, 48.28% were metastatic tumors, 27.5% were tuberculous lymphadenitis, 15.3% were of non-specific reactive lymphadenitis, 4.3% were non-caseating granulomatous lymphadenitis, 2.7% were of lymphoma and 1.96% was of acute suppurative lymphadenitis. Mean age of presentation of metastatic tumor was 57 years, whereas in case of tuberculous (Tb) lymphadenitis it was 34.5 years. Females were more commonly affected than males with male female ratio of 1:1.4. Left sided involvement was seen in 50%, right sided involvement in 46% and bilateral involvement in 4% of patients. Conclusion: Enlarged supraclavicular lymph node often has some serious underlying pathology both in young adults and old patients. Further, our study highlights the importance of FNAC in the initial evaluation of enlarged supraclavicular lymph nodes.
  42,478 769 -
Ureteroscopic lithotripsy as day care procedure: Our early experience in Regional Institute of Medical Sciences
Somarendra Khumukcham, Sandeep Gupta, Bijit Lodh, Sholay Meitei Kangjam, Kaku Singh Akoijam, Rajendra Singh Sinam
January-April 2013, 27(1):52-55
Aim: The aim of this study was to report the outcome of ureteroscopic lithotripsy (URSL) under local anesthesia (LA) as a day care procedure in patients with lower ureteric calculus. Materials and Methods: Patients with lower ureteric calculus attending urology out patient department, Regional Institute of Medical Sciences (RIMS) Hospital during August 2011 to February 2012 underwent URSL under LA-analgesia as day care procedure. The results are analyzed on aspects of perioperative pain, completion of procedure, stone clearance, hospital stay, complications and patient compliance. Institutional ethical clearance and written informed consent for the procedure taken from all patients for the study. Results: A total of 30 patients with lower ureteric calculus size ranging from 8 to 15 mm underwent URSL with Double J stenting under local anesthesia in RIMS urology operation theatre. Twenty four patients completed the procedure in single session, five required two sessions (four with ureteric stricture DJ stent kept for passive dilation and one patient had edematous non visualized ureteric orifice) and another patient converted to open ureterolithotomy due to hard stone resistant to our pneumatic energy. None of the patients required hospital stay following the procedure except for two patients for IV antibiotics. Visual analog scale was mild in 15 patients, moderate in 10 and severe in five patients. Dysuria with transient hematuria was the most common complication; all were managed conservatively on OPD basis. Overall patient compliance for this procedure was excellent. Conclusion: Ureteric colic is a urological emergency in terms of the severe pain experienced by the patient. In view of the long waiting period for routine OT, fear of obstructive uropathy with urosepsis and consequent decrease in renal function, the initiative of URSL as a day care procedure started in our department and our early experience of this procedure in carefully selected patients is having encouraging results.
  38,131 585 1
Hemoglobin status of children in the age group 0-14 years
Rajkumari Rupabati Devi, Ksh. Chourjit Singh
September-December 2016, 30(3):189-190
  31,781 455 -
Conservative management of placenta accreta with injection methotrexate to preserve fertility
Sumit Sukla Das, L Sushila Devi, L Ranjit Singh, Rameshwor Singh
May-August 2014, 28(2):125-127
Placenta accreta is described as anchoring placental villi directly contact the myometrium resulting in firm attachment of the placenta to the myometrium. The incidence of placenta accreta is increasing parallel to raising cesarean section rate. Women at greatest risk of placenta accreta are those who have myometrial damage caused by a previous cesarean delivery with either an anterior or posterior placenta previa overlying uterine scar. Control of bleeding is the main goal in such cases, which usually necessitates hysterectomy or hypogastric artery ligation; embolization of uterine artery that is done by expert interventional radiologists. However, alternative methods are useful when retaining fertility is important in young women with low parity. We present a 28-year old G5P2+0+2+2 who was admitted at 33 weeks of period of gestation for antepartum hemorrhage (APH) with previous cesarean. Even after conservative treatment for APH, she delivered still born preterm baby at 34 weeks with retained placenta where manual removal of placenta failed to remove the placenta. Placenta was removed piecemeal leaving major portion of placenta, which was morbidly adherent. After 13 days of delivery ultrasonography (USG) showed plenty of placental tissue in the uterine cavity with peripheral vascularity and increased serum beta-human chorionic gonadotrophin (β-hCG) level (1980mIU/ml). Injection methotrexate was administered on the 18 th post-partum day following the regime of 1, 3, 5 and 7 days. Repeat USG after 1 week of treatment showed decrease size in placental mass with a decrease in serum β-hCG level and after 6 th post-partum week D&E done with complete removal of placental tissue and at 8 th post-partum week USG shows normal with no retained products of conception and the patient was stable. Hence, methotrexate can thus be helpful as conservative treatment for placenta accreta in conserving the uterus and hence, the fertility.
  20,146 839 -
The Mid Day Meal scheme: A holistic initiative to augment the nutritional and educational status of the children
Saurabh R Shrivastava, Prateek S Shrivastava, Jegadeesh Ramasamy
January-April 2014, 28(1):38-39
The World Health Organization has estimated that in the year 2012, out of the 6.5 million deaths reported worldwide in the under-five year age group, around 2.4 million were from India alone. All these nutrition-related indices clearly reflect that the nutritional status of under-five children is still bad and needs concerted efforts from the policy makers and the health care professionals in the country. In response to the poor nutrition indicators in the children, the Ministry of Human Resource Development, India, launched the Mid Day Meal scheme in the year 1995. Currently, it is the world's largest school feeding program that caters to about 120 million children in over 1.2 million schools and other centers. Although progress is being observed in the country's commitment to successfully achieve the Millennium Development Goals -1 and 4, the overall achievement is far from the expected. To conclude, the Mid Day Meal Scheme is one of the country's national flagships feeding scheme initiated to improve the nutritional and educational status of the vulnerable children. However, the sustainability of the scheme depends on the political will, community participation, and continuous monitoring of the program.
  18,758 586 1
Tonsillar malignancy - Review of clinico-pathological presentation, diagnosis, and current treatment modalities: A case series
Ashwath P Babu, Pradip Mallik, Subhrachandan Pradhan, P Sobita, TH Sudhiranjan, Nim N Bhutia
May-August 2013, 27(2):147-150
Oropharyngeal malignancy is the second most common malignancy of the head and neck surpassed only by carcinomas of the alveo-buccal complex in India (excluding thyroid malignancy). More than 75% of these oropharyngeal carcinomas occur in the tonsillar area. Two-thirds of the patients with tonsillar carcinomas present at advanced stages because early lesions are generally asymptomatic when small. A total of 5 cases of tonsillar malignancy (2 undifferentiated carcinomas, 2 non- Hodgkin's lymphomas, and 1 squamous cell carcinoma were reported and treated in the last 1 year. Four out of 5 cases presented with advanced disease (stage 4) at the time of their first visit to the hospital. A good response was seen in majority with primary radiotherapy or combined chemoradiation. This case series is an attempt to define the presentation, diagnosis, currently available treatment, and prognosis of these tumors.
  18,621 666 -
"Scrotal pearl" or calculus in hydrocele
Ankit Shukla, Ramesh Bharti, Rakesh B Anand
September-December 2015, 29(3):172-173
"Scrotal pearl" or calculus in the hydrocele fluid is found incidentally during an operation, ultrasound or clinical, if large in size. The exact etiopathogenesis of the disease is not clear but is linked to inflammation, injury, necrosis, and infections by parasites. It is a benign asymptomatic condition and a rare complication of hydrocele. A stone in hydrocele does not change the management or prognosis; however, if the stone is adherent to the tunica albuginea and does not change position on ultrasonography the possibility of a tumor has to be borne in mind.
  14,599 262 -
Management of children with special health care needs (SHCN) in the dental office
Charan Kamal Kaur Dharmani
January-April 2018, 32(1):1-6
Children represent the future of our society and ensuring their healthy growth and development ought to be a prime concern of all. The dental condition of children with special health care needs (SHCN) may be directly or indirectly related to their disabilities. Children with SHCN relatively have poor oral hygiene and increased prevalence of gingival diseases and dental caries. Unfortunately, the importance of dental care for these children has often been overlooked by the health planners. Parents of disabled children usually do not seek dental treatment as they also have the burden of medical treatment. In the past, the emphasis was based on providing basic dental care, but in recent years, the dental profession has shown increased concern in providing complete oral health care to the mentally- or physically-challenged children. The specialty of pediatric dentistry provides both primary and comprehensive, preventive and therapeutic oral health care to children with SHCN. These special children are entitled to the opportunity to achieve appropriate rehabilitation, to enable them to realize their maximal level of functioning, and to assist them in not only “normalizing” their lives but also lengthening their life span.
  11,946 1,768 3
Management of breast abscess by repeated aspiration and antibiotics
Gojen Singh, Gojendra Singh, L Ramesh Singh, Rahul Singh, Sharatchandra Singh, K Lekhachandra Sharma
September-December 2012, 26(3):189-191
DOI:10.4103/0972-4958 .113249  
Objective: The aim of this study is to avoid psychological distress to the mother and baby by avoiding General Anaesthesia and overnight hospital stay which will be required, if the abscess is to be drained by incision drainage and to avoid leaving an ugly scar on the breast. Materials and Methods: In our prospective study, 50 patients with breast abscesses were treated by needle aspiration of pus, oral antibiotics, and repeat aspiration, if necessary. All were outpatients, and treated in Department of Surgery, Regional Institute of Medical Sciences, Imphal. Ultrasonography was not used. Out of 50 patients, 31 were lactating mothers. Results: The mean age of the patient was 32 years (19-80 years). Staphylococcus aureus was the most common organism isolated in both lactating and non lactating cases. Of the 50 cases, 39 (78%) resolved well without recurrence. Eight (16%) cases failed to respond to repeated aspiration and underwent incision and drainage. Three (6%) cases had recurrent abscess occurring 1 month after the last aspiration. Conclusion: Needle aspiration with antibiotic is an effective treatment for breast abscesses.
  13,057 551 -
Medico-legal issues in radiology: Indian context
Shoibam Subhaschandra Singh, Naveen Jayaram
September-December 2015, 29(3):129-134
The growing number of legal issues in the various fields of medical specialities in the current era has been no different in radiology. Errors in diagnosis and interventional procedures are the areas of legal liability in the practice of radiology. The complexity associated with such issues has been the major concern of practicing radiologist. In this article, an attempt has been made to focus the legalities in the field of radiology with emphasis on the Indian set up and existing Laws governing such actions.
  11,126 856 1
Adrenal gland cyst: A diagnostic conundrum: Report of a case with review of literature
Jyoti Ramnath Kini, Keyoor Gautam, Alfred Augustine
May-August 2014, 28(2):123-124
Cystic lesions of the adrenal gland are uncommon and mostly asymptomatic. They demonstrate a spectrum of histological changes and may vary from pseudocysts to malignant cystic neoplasms. Adrenal pseudocysts are rare cystic lesions surrounded by a layer of fibrous tissue that lack a recognizable lining layer. They are most often discovered incidentally during radiological studies or at autopsy. The radiographic appearance of adrenal pseudocysts though characteristic, can be difficult to distinguish an adrenal pseudocyst from an adrenal neoplasm with prominent cystic change, presenting as diagnostic conundrums. Extensive sampling of resected tissues is important to rule out malignancy in patients, with cystic adrenal lesions. Herein, we present a 47- year-old male with a non functional and asymptomatic left adrenal pseudocyst. The literature is reviewed and the different diagnostic and management options are discussed.
  11,296 455 2
Cimetidine-induced Hyperprolactinemia
Oinam Joychandra Singh, Thokchom Imoba Singh, Varkung Valte
September-December 2013, 27(3):165-168
Pharmacologic hyperprolactinemia is a problem of underestimated prevalence. This is due to lack of externally visible symptoms, patients' reluctance for embarrassing disturbs, and/or clinicians' lack of awareness. The secretion of prolactin is mainly controlled by hypothalamus over lactotrophs of anterior pituitary through D2 receptor along with many inhibitory and excitatory transmitters particularly serotonin, histamine, and estrogen. Here, the role of histamine receptors (H1 and H2) and their antagonists in the change of serum prolactin level with special reference to the mechanism of action of cimetidine is discussed. It may also conclude with the modifying role of histamine in inducing prolactin secretion through dopamine- GABA-serotoninergic system or modifying PRFs or other unknown mechanism. Therefore, proper evaluation of the hyperprolactinemia, particularly in infertile women, is recommended before extensive diagnosis and therapeutic procedures as hyperprolactinemia may be associated with normal pituitary function. Based on this basic idea, the role of histamine receptor (H 1 and H 2) and cimetidine is discussed. It is concluded that cimetidine may be acting on modifying the role of histamine-induced prolactin secretion, which in term is through dopamine GABA-serotoninergic system/modifying PRFs/other unknown mechanism.
  9,461 1,933 2
Patterns of hemoglobinopathies diagnosed by high-performance liquid chromatography in and around Pune (Western Maharashtra, India): A pilot study
Archana Buch, Banyameen Iqbal, Rajiv Bordawekar, Ambuj Jain, Pratik Jariwala, Hetal Rathod
May-August 2016, 30(2):111-115
Background: Hemoglobinopathies are one of the major public health problems in the state of Maharashtra, India. Their prevalence shows regional and ethnic variations. Pune, now becoming educational and IT hub cater populations from different regions. Aim: To study the pattern of hemoglobinopathies diagnosed by high-performance liquid chromatography (HPLC) in Western Maharashtra, India. Settings and Design: This pilot study was aimed to find the prevalence of hemoglobinopathies in and around Pune (Western Maharashtra, India) and identify the change in the demographic profile Materials and Methods: A total of 3465 cases received from January 2012 to December 2014 for hemoglobin variant analysis at the referral laboratory were studied for hemoglobinopathies. Samples were received from various private hospitals and laboratories in and around Pune. The samples were run on instrument manufactured by Bio-Rad Laboratories based on the principle of HPLC. Based on retention time and proportion of hemoglobin (Hb) variants different hemoglobinopathies were diagnosed and their prevalence were analyzed. Results and Conclusions: Out of total 3465 patients screened for suspected hemoglobinopathies 175 (5.05%) were found positive for abnormal Hbs with maximum number in the age group 20-30 years. We found that a maximum number of patients was of thalassemia trait with a prevalence of 3.7%, followed by double heterozygous states of Sickle cell with beta thalassemia trait, sickle cell trait, and sickle cell disease in decreasing order. Other rare variants such as Hb E disease, Hb D disease, Hb E trait, double heterozygous Hb SD, and Hb SC were also identified. We found more heterozygous states as compared to homozygous states. Prevalence was on the lower side of the normal range. Conclusion: Continuous awareness programs, mass screening of the population especially childbearing age and school going children will help in early detection of heterozygous states. This further helps in preventing severe hemoglobinopathies and reducing the morbidity and mortality.
  10,096 950 -
Proposed amendments in the Medical Termination of Pregnancy Act in a nutshell
Memchoubi Phanjoubam
January-April 2017, 31(1):1-2
  10,095 675 -
Prevalence of piriformis syndrome among the cases of low back/buttock pain with sciatica: A prospective study
Usham Shyamkesho Singh, Raj Kumar Meena, Ch Arun Kumar Singh, A K Joy Singh, A Mahendra Singh, Roel Langshong
May-August 2013, 27(2):94-99
Aim: The aim of this study was to find out the prevalence and causes of piriformis syndrome in patients with complain of low back pain/buttock pain with sciatica attending Regional Institute of Medical Sciences (RIMS), Imphal. Materials and Methods: All the patients in the study group attending Orthopedic and Physical Medicine and Rehabilitation Out-patient Department in RIMS, Imphal were examined. Those with increased symptoms on sitting, localized significant tenderness on palpation of the muscle, presence of one or more of the following tests: Freiberg, pace, beatty, and FAIR (Flexion , Adduction and Internal Rotation) maneuvers with negative X-ray, ultrasound, computed tomography and magnetic resonance imaging findings were subjected to piriformis muscle injection of lidocaine (2%) 2 ml and methyl prednisolone 2 ml (40 mg) for confirmation of diagnosis. Result: Out of 2910 patients, 182 cases (M: 28, F: 154) in the age range of 19-75 years with a mean age of 43 years were clinically diagnosed as piriformis syndrome. Prevalence of piriformis syndrome was 6.25%. Conclusion: Piriformis syndrome is one of the differential diagnoses of low back/buttock pain with Sciatica. Individuals of all activity levels can be affected. Females are more affected than males. Causes are overuse, prolonged sitting, trauma, and vigorous massage. Diagnosis is by exclusion of other causes. Simple injection with local anesthetic and steroid in the piriformis muscle is both therapeutic and confirmatory of diagnosis. Early diagnosis and treatment with injection of piriformis muscle can prevent further complications and risks of surgery, which is also not 100% curative. With proper care, piriformis injection can be carried out without any complication. Long-term study is needed to evaluate the recurrence after injection treatment.
  9,502 897 3
Disability among the elder population of India: A public health concern
Amit Agrawal
January-April 2016, 30(1):15-19
The Government of India adopted the National Policy on Older Persons in 1999, which defines a "'senior citizen' or 'elderly' as a person who is of age 60 years or above." In India the elderly population accounted for 8.2% of the total population in 2011 and the number is expected to increase over the next decades. The link between aging and disability is a biological fact, and disability in the elderly is an important health indicator pointing to jeopardized quality of life. But at the same time, aging should not be treated as synonymous with disability as a large proportion of older people live with good health status. There are many studies from India that have addressed disability in the elderly population; however, they lack uniformity in defining disability and largely address mostly one aspect, that is, the medical model of disability. It is well recognized that "disability and elderly" encompasses a much larger spectrum of the conditions with unique requirements and needs to be studied as a much broader concept.
  8,742 976 4
Effect of Syzygium cumini (jamun) seed powder on glycemic control: A double-blind randomized controlled trial
S Sidana, VB Singh, BL Meena, S Beniwal, K Singh, D Kumar, R Singla
September-December 2017, 31(3):185-189
Background: Diabetes mellitus (DM) is an endocrinal disorder characterized by chronic hyperglycemia. Managing DM without side effects is a challenge till date that attracts researchers toward plant-based new products. In some studies, seeds of Syzygium cumini were found to have anti-diabetic and anti-hyperlipidemic properties, attributed to saponins, glycosides, and flavonoids. Hence, it should be further explored for its benefits. Aims and Objectives: To study the effect of jamun seed powder on glycemic control in type 2 DM. Materials and Methods: Patients with type 2 DM and uncontrolled blood sugar (n = 99) were randomly divided into two groups - Group A (n = 50) was supplemented with 10 g/day jamun seed powder and Group B (n = 49) was given placebo powder. Oral hypoglycemic agents (OHAs) were continued as before. Patients and investigators were blinded about the treatment allocated. Fasting plasma glucose (F.P.G.) and post-prandial plasma (P.P.) glucose were noted at baseline and 30th, 60th, and 90th day and HbA1c on 0 and 90th day. Observations and Results: In Group A, F.P.G. decreased by 9%, 18%, and 30% and P.P. glucose by 8%, 15%, and 22% after 30, 60, and 90 days, respectively. In Group B, F.P.G. increased by 3% and P.P. glucose by 2% after 90 days. HbA1c in Group A reduced from 8.99 ± 1.39% to 8.31 ± 1.40% on 90th day (P < 0.05), while a nonsignificant rise from 8.70 ± 1.17% to 9.03 ± 1.31% was noted in Group B. Conclusion: Supplementation with jamun seed powder improves glycemic control significantly in type 2 DM with poorly controlled glycemic levels on diet and OHA. However, before recommendation, multicentric trial with larger sample size, dose, and duration should be planned.
  8,890 647 1
A study of the sympathetic nervous system in bronchial asthma
Th Pricila Devi, W Kanan, Th Shantikumar Singh, W Asoka, L Benjamin
September-December 2012, 26(3):159-162
DOI:10.4103/0972-4958 .113227  
Objective: To test sympathetic division of autonomic nervous system and observe any dysfunction in patients of bronchial asthma. Materials and Methods: Fifty four patients, 18 males, 36 females, and 30 healthy control subjects attending Respiratory Medicine out-patient department Regional Institute of Medical Sciences, Imphal were included in the study. Age ranging from 15 to 60 years were recruited for the study. Spirometry values of forced vital capacity (FVC), forced expiratory volume in first second (FEV 1 ) , FEV 1 /FVC, peak expiratory flow rate (PEFR), forced expiratory flow (FEF 25-75% ) recorded by using HELIOS 702 (Recorders and Medicare System, Chandigarh). Predicted values were taken as values for normal subjects. Sympathetic nervous system tested by measuring diastolic blood pressure response to sustained hand-grip for 2 min and from supine to standing for 3 min. Results: FVC, FEV 1 , PEFR, FEF 25-75% were significantly lower in asthmatics as compared to controls. Diastolic blood pressure response to sustained hand-grip for 2 min and from supine to standing for 3 min was higher in asthmatics as compared to controls. Conclusion: Sympathetic nervous function assessment of the patients shows that sympathetic abnormalities occur in patients of bronchial asthma.
  8,888 595 -
World health organization releases global priority list of antibiotic-resistant bacteria to guide research, discovery, and development of new antibiotics
Saurabh RamBihariLal Shrivastava, Prateek Saurabh Shrivastava, Jegadeesh Ramasamy
January-April 2018, 32(1):76-77
  8,236 1,224 53
Perioperative management of diabetes mellitus
Ranabir Salam
January-April 2014, 28(1):4-8
Patients with diabetes mellitus undergo surgery more frequently than non-diabetics. Diabetics tend to have increased morbidity and longer hospital stay following surgery, which may be due to higher risk of infection and co-morbidities such as cardiovascular complications and nephropathy. Studies have shown that pre-operative glycemic control have a significant impact on the risk of infections. Glycosylated hemoglobin below 7% is the usual pre-operative target, but values between 8% and 9% may be acceptable depending on individual circumstances. Recent guidelines from Australia and UK no longer recommend withdrawal of oral hypoglycemic agents including metformin before surgery. Cardiac-related and overall mortality are greater with increased post-operative blood glucose levels. American Association of Clinical Endocrinologists and the American Diabetes Association recommends target glucose levels <180 mg/dL in critically ill patients and <140 mg/dL in non-critically ill patients. Insulin-glucose infusion is the preferred mode of insulin therapy until patient is able to take adequate calorie orally. Sliding scale insulin is no longer recommended and supplemental insulin protocol is more appropriate. Hypoglycemia is also a major contributor to an adverse outcome and severe hypoglycemia should be avoided.
  7,948 1,360 1
Negative pressure wound therapy for post-cesarean, post-hysterectomy dehisced abdominal wounds
Shuchi Jain, Madhu Jain, Shammi Purwar, Vaibhav Jain, Pradeep Jain
September-December 2012, 26(3):171-174
DOI:10.4103/0972-4958 .113241  
Objectives: Abdominal wound dehiscence occurs in 0.5-3% of the patients following laparotomies. As the vacuum assisted closure technique is now well established to manage chronic wounds, we hereby describe an innovative approach to apply negative pressure to acute wounds. Materials and Methods: The innovative negative pressure device was applied in 5 patients, three with wound dehiscence after cesarean section and two after hysterectomy. A commercially available closed suction apparatus 14 gauge in size and 5 cm thick sponge were used. The sponge was covered with an adhesive transparent sheet. The dressing was changed every 48-72 hours depending on the amount of secretion present in the chamber. The suction device was charged as and when it got deflated. Results: All the wounds had gradually decreasing area of undermining and the discharge from the second dressing change onwards. Whereas three of them underwent a two-layered closure, the other two healed with 100% take of the skin graft. Discussion: Healing by secondary intention is a time consuming process that leads to prolonged hospital stay. The negative pressure wound therapy (NPWT) has been used to treat chronic wounds and pressure ulcers, It evacuates the drainage from the wounds and thereby decreases edema of wound margins and the adjacent areas. It also improves the blood flow to the wounds and decreases bacterial burden. The innovative device used by us is easily available, affordable, and simple to use with good outcome. Conclusion: NPWT is a valuable alternative in selected cases when a surgical closure is not indicated or not desired by the patient. The innovative device was well accepted by our patients as it did not add to their postpartum or post-operative stress. It can be used in any set-up in any patient, meeting the criteria of NPWT.
  8,403 401 -
Electrocardiographic changes in obstructive airway disease
Irom Ibungo Singh, K Susie, Sarada Ningthoujam, Florence Lalvarmawi, W Kanan, W Asoka Singh
January-April 2013, 27(1):19-24
Objectives: To grade the severity of airway obstruction in the cases of obstructive airway disease (OAD) selected for the study and to observe for any electrocardiographic changes and correlate it with the severity of airway obstruction. Materials and Methods: 50 cases of OAD, 37 of chronic obstructive pulmonary disease (COPD) and 13 of Bronchial Asthma, attending the out patient department (OPD) of Respiratory Medicine, Regional Institute of Medical Sciences (RIMS), Imphal were included in the study. Spirometry was performed and electrocardiogram (ECG) was recorded for the cases in the Department of Physiology, RIMS, Imphal. For analytical purposes, well known statistical techniques like mean, standard deviation, X2 -test and F-test are used whenever found suitable and necessary through SPSS software and accordingly interpretations are made. Results: The cases were found to have mild to moderate to severe to very severe degree of airway obstruction. The ECGs showed normal to varied findings. Conclusion: Electrocardiographic changes are found to be observed more with those who have higher grade or degree of airway obstruction. Relationship between ECG findings and degree of airway obstruction is found to be highly significant.
  7,803 530 -
Child sexual assault: A study in Manipur
Saka Koko Maring, Thounaojam Meera, Thoidingjam Bijoy Singh, Huidrom Nabachandra
September-December 2013, 27(3):187-190
Background: Children and adolescents are the most vulnerable victims of sexual assault even though no age is considered safe. The aim of the present study was to determine the socio-demographic characteristics of sexually assaulted children in Manipur, the relationship between the victim and the assailant, and the pattern of the injuries sustained by the victims. Materials and Methods: This retrospective descriptive study was carried out in our department and all cases of child sexual assault (below 18 years of age) brought for examination during January 2005 to December 2011 have been considered. The history given by the victims or parents or relatives and the police were recorded; general as well as local examination findings were noted and the data collected were analyzed. Results: Out of the total 144 cases of sexual assault, 51.4% were child victims. Nearly, 29.73% of the cases were constituted by children below 12 years while 31.08% and 39.19% were children of 12 to <15 years and 15 to <18 years respectively. The mean age of the victims was 12.4 years. Most of the cases (40.54%) occurred in the house of the assailant or his friend; however, children below 15 years (16.22%) were sexually assaulted in their houses. Almost, 78.4% of the assailants were known to the victims and only 9.5% had stranger assailants. Majority of the cases (89.15%) occurred during the afternoon or early evening. Nearly, 14.8% of the cases showed associated external injuries. Hymenal tear was present in 60.8% of the cases and 16.2% had vulval injuries. Conclusion: Child sexual offence is on the rise in this part of the country. Spreading of awareness to encourage early reporting, stringent punishment to the perpetrators and immediate proper care and protection of such innocent victims remain key factors to deal with this heinous crime.
  7,445 299 -
Induction of labor in patients with previous cesarean section with unfavorable cervix
Laishram Trinity Meetei, Vanita Suri, Neelam Aggarwal
January-April 2014, 28(1):29-33
Background and Objective: Due to increased risk of uterine rupture with prostaglandins in previous cesarean patients, its use has been discouraged as ripening agent in previous cesarean patients. This study was conducted to compare the efficacy and safety of Foley catheter with low dose oxytocin as cervical ripening agent in women with previous cesarean section (CS). Materials and Methods: This was prospective randomized study, including 60 women (30 in each group) with previous CS with unfavorable cervix who needs induction of labor after 28 weeks. Outcomes were analyzed in terms of change in Bishop score (BS), route of delivery and complications. Results: The BS before and after ripening between the two groups was similar (P > 0.05). However, the change in BS within each group was 3.07 and 3.30 in Foley and oxytocin group respectively and this was statistically significant (P < 0.001). Twenty (66.7%) patients in Foley group had a vaginal delivery and 18 (60%) in oxytocin group did so. There were two cases of scar dehiscence in oxytocin group and non in Foley group. Conclusion: Both Foley and low dose oxytocin are good cervical ripening agents in previous cesarean patients. However, the two cases of scar dehiscence in low dose oxytocin group is a concern of safety.
  7,042 557 5