Idiopathic perniosis presenting as acral purpuric lesions: Clustering of cases before COVID-19 pandemic and their comparison with chilblain like lesions reported in the literature.

Perniosis/chilblains are the acral inflammatory skin lesions developing in susceptible individuals as an abnormal reaction to cold. In the absence of a discernible cause, it is labeled as idiopathic perniosis (IP). With the ongoing COVID-19 pandemic, there was an upsurge of reports of chilblain like lesions (CLL) especially in young patients possibly implicated to the SARS-CoV-2 virus.

Overcoming the health system barriers to early diagnosis and management of multidrug-resistant tuberculosis in a rural setting in North India.

India contributes a quarter of the global burden of multidrug-resistant tuberculosis (MDR-TB) and has inadequate diagnostic infrastructure and institutional capacities for drug susceptibility testing. Subsequently, this leads to a large number of undetected and untreated cases of MDR-TB. In this report, we describe a case of a 55-year-old man from rural North India presenting with complaints of continued symptoms of chronic cough, fever and dyspnoea despite being recently diagnosed with recurrent tuberculosis and receiving treatment from the local community health centre.

The opinion of post graduate students on objective structured clinical examination in Anaesthesiology: A preliminary report.

Background And Aims: The scenario in medical education is changing with objective structured clinical examination (OSCE) being introduced as an assessment tool. Its successful implementation in anaesthesiology postgraduate evaluation process is still limited. We decided to to evaluate the effectiveness of OSCE and compare it to conventional examinations as formative assessment tools in anaesthesiology.

Treatment options for unstable trochanteric fractures: Screw or helical proxima femoral nail.

Purpose: To compare treatment outcome of screw proximal femoral nail (PFN) system with that of a helical PFN.

Methods: The study included 77 patients with closed unstable intertrochanteric fracture classified as AO 31A2&31A3, between June 2008 to August 2011. Inclusion criteria were: all mature skeletons above 50 years of age; closed unstable trochanteric fracture classified as AO 31A2&A3.

Application of WHO 'Near-Miss' Tool Indicates Good Quality of Maternal Care in Rural Healthcare Setting in Uttarakhand, Northern India.

Introduction: Women who experienced and survived a severe health condition during pregnancy, childbirth or postpartum are considered as 'near-miss' or severe acute maternal morbidity (SAMM) cases. Women who survive life-threatening conditions arising from complications related to pregnancy and childbirth have many common aspects with those who die of such complications.

Aim: To evaluate health-care facility preparedness and perfor-mance in reducing severe maternal out comes at all levels of health care.

Multiple eschars in scrub typhus.

An eschar is highly suggestive of scrub typhus in a case of fever. Multiple eschars are rare in scrub typhus. We present a picture of multiple eschars in scrub typhus.

Application of lipoarabinomannan antigen in tuberculosis diagnostics: current evidence.

Tests based on the detection of mycobacterial lipoarabinomannan (LAM) antigen in urine have emerged as potential point-of-care tests for tuberculosis (TB). We aimed to assimilate the current evidence regarding the diagnostic performance of LAM assays and to ascertain their clinical indication in settings with high and low prevalence of HIV-TB co-infection. Owing to suboptimal sensitivity, the urinary LAM assays are unsuitable as general screening tests for TB.

Endoscopic Trans-Nasal Trans-Sphenoidal (TNTS) Approach For Pituitary Adenomas: Our Experience.

Advances in optics, miniaturization, and endoscopic instrumentation have revolutionized surgery in the past decade. Current progress in the field of endoscopy promises to further this evolution: endoscopic telescopes and instruments have improved upon the optical and technical limitations of the microscope, and require an even less invasive approach to the sella. Pituitary surgery is traditionally within the realm of the neurosurgeon.

Waldenstrom macroglobulinemia presenting as isolated persistent epistaxis: a very rare presentation.

Nose bleed is the most common rhinological emergency. There are multiple risk factors for the development of epistaxis and it can affect any age group, but it is the elderly population with their associated morbidity who often require more intensive treatment and subsequent admission. Most cases of epistaxis occur in the Little's area, a location readily accessible and treatable by cautery or anterior nasal packing.

Postoperative pain and long-term functional outcome after administration of gabapentin and pregabalin in patients undergoing spinal surgery.

Study Design: Prospective, double-blind study, randomized control trial.

Objective: To evaluate and compare the analgesic efficacy, adverse effects, and clinical utility of gabapentin and pregabalin in postoperative pain management, long-term functional outcome, and quality of life in patients undergoing spinal surgery.

Summary Of Background Data: Patient outcome after lumbar discectomy for radicular low back pain is variable and the benefit is inconsistent.

Fungus cerebri (brain fungus): a rare complication of mastoidectomy.

Fungus cerebri is a relatively rare disease. The various reasons attributed to such pathology are, long standing mastoiditis, previous temporal lobe fracture, spontaneous herniation and most important common cause is post operative to mastoidectomy. The diagnosis is mainly clinical and supplemented by imaging studies.

Clinico-etiolological study of vocal cord paralysis.

The purpose of this study was to identify patients of vocal cord paralysis and to establish an etiological diagnosis. Patients with vocal cord paralysis have been followed prospectively at a tertiary referral center. 120 patients identified with vocal cord paralysis by laryngeal endoscopy were evaluated clinically, radiologically and pathologically to make an etiological diagnosis.

Transbronchial needle aspiration with rapid on-site evaluation: a prospective study on efficacy, feasibility and cost effectiveness.

Background: Transbronchial needle aspiration (TBNA) has an established role in diagnosis of hilar and mediastinal lesions. Rapid on-site evaluation (ROSE) of TBNA smears can determine the adequacy of TBNA smears that can obviate the need for repeat procedures, thus avoiding added cost. There is paucity of data from India showing efficacy and cost-effectiveness of ROSE.

Model for end-stage liver disease score versus Maddrey discriminant function score in assessing short-term outcome in alcoholic hepatitis.

Background And Aims: The Maddrey Discriminant Function (mDF) score and the Model for End-Stage Liver Disease (MELD) score are standard prognostic scores for predicting disease severity and mortality in alcoholic hepatitis (AH).This prospective study compared the MELD score and the mDF score as predictors of short-term outcome in AH.

Methods: The admission MELD score and the mDF score were assessed in 47 patients with a diagnosis of AH in the Himalayan Institute Hospital, Dehradun, India and the concordance (C) statistics of the two scores for 28-day mortality were determined and compared.

The influence of the 2:1 yogic breathing technique on essential hypertension.

In 2:1 breathing exhalation is twice of inhalation. The study was performed to study the influence of 2:1 yogic breathing technique on patients of essential hypertension. 30 patients of essential hypertension between ages of 20-50 years were selected.

A retrospective analysis of anesthetic experience in 2917 patients posted for cleft lip and palate repair.

Context: Anaesthesia during cleft lip and palate surgery carries a high risk and difficult airway management in children.

Aim: to study the perioperative anesthetic complications in poor children with cleft abnormalities.

Settings And Design: Retrospective analysis.

Initial default among sputum-positive pulmonary TB patients at a referral hospital in Uttarakhand, India.

Background: Initial default is a serious issue which can enhance the transmission of TB. We determined the magnitude of and the causative factors for initial default among sputum-positive pulmonary TB (PTB) patients.

Methods: In this prospective study, 2310 patients attending a referral hospital in Uttarakhand state, north India, with presumptive TB were investigated and 555 patients with sputum-positive PTB were followed-up for initiation of anti-TB treatment (ATT) during 2010-2012.

Dengue hepatitis sans dysfunction: experience of a single tertiary referral centre in the north Indian state of Uttarakhand.

Hepatic involvement is uncommon in dengue viral infections and is traditionally thought to be associated with severe disease in terms of morbidity and mortality. This study was conducted in order to assess the liver function in patients with dengue virus infection and to analyse its effect upon patient outcome. Three hundred and twenty-seven consecutive patients with dengue virus were categorized into groups A, B, C and D on the basis of elevation of either of the hepatic transaminases (normal, <3, 3-10 and >10 times, respectively).

Edaravone - citicoline comparative study in acute ischemic stroke (ECCS-AIS).

Background: Two new neuro-protective agents, Edaravone and Citicoline were recently found to be beneficial in acute ischemic stroke (AIS). But there is no study to compare these two agents on same protocol in AIS. This study was aimed to compare these two neuroprotective agents in AIS.

Acute myocarditis in vivax malaria: an extremely rare complication.

We report on the occurrence of pulmonary oedema due to acute myocarditis in an adolescent girl, from the northern Indian state of Uttarakhand, with Plasmodium vivax infection after parasite clearance. Apart from pancytopenia, there were no other features of severe malaria. With the emergence of literature about the complications encountered in P.

Plasmodium vivax malaria complicated by acute kidney injury: experience at a referral hospital in Uttarakhand, India.

Background: Acute kidney injury (AKI) is a serious complication of Plasmodium vivax malaria, worsening its prognosis.

Methods: This prospective study assessed the incidence, clinical spectrum, prognostic factors and outcome of AKI in P. vivax malaria.

Mucoepidermoid carcinoma of the larynx with transglottic involvement in a child: a case report.

Mucoepidermoid carcinoma (MEC) of the larynx is one of the rarest tumors in the pediatric age group. Our review of the English-language literature found only 1 previously reported case of a laryngeal MEC in a child. We present what to the best of our knowledge is the first case of a pediatric MEC of the larynx with transglottic involvement.

Current understanding of the literate versus illiterate patient's knowledge about anesthesiologists: A comparative study.

Context: There is a widespread ignorance among the public about the role of anesthesiologists and their responsibilities inside or outside the operating room both in developed and developing countries.

Aims: The present study was conducted to assess the knowledge of literate and illiterate patient about the role of anesthesiologists and their concerns regarding anesthesiology.

Setting And Design: This is a prospective study conducted in a preoperative anesthetic clinic of a large tertiary care hospital.

A retrospective clinical audit of 696 central venous catheterizations at a tertiary care teaching hospital in India.

Background: Malpositions after central venous cannulation are frequently encountered and may need a change in catheter. The incidence of malpositions are varied according to various studies and depend on the experience of the operator performing the cannulation.

Aim: To access the incidence of malpositions and related complications associated with landmark-guided central venous cannulation in a 15-bedded medical surgical ICU over a period of three years.

Febuxostat: a novel agent for management of hyperuricemia in gout.

Gout is a metabolic disorder characterized by elevated uric acid levels in the body, associated with painful arthritis, tophi and nephropathy. The most frequently used pharmacologic urate lowering strategies involve reducing urate production with a xanthine oxidase inhibitor and enhancing urinary excretion of uric acid with a uricosuric agent. Urate lowering agents are limited in number, availability and effectiveness.