Tubercular spinal epidural abscess involving the dorsal-lumbar-sacral region without osseous involvement.

Musculoskeletal tuberculosis is known for its ability to present in various forms and guises at different sites. Tubercular spinal epidural abscess (SEA) is an uncommon infectious entity. Its presence without associated osseous involvement may be considered an extremely rare scenario.

Referral profile of a child development clinic in northern India.

Objective: To delineate the demographic and clinical profile of children referred to a Child Development Clinic (CDC) of a tertiary care public hospital in India.

Methods: A retrospective review of medical records of all the cases referred to CDC in the year 2009 was conducted.

Results: Out of the 792 children referred to CDC, complete medical records were available in 641 cases, which comprised the study population.

Pneumorachis of the cervical spine with associated pneumocephalus and subcutaneous emphysema.

Pneumorachis, the presence of free intraspinal air, is an exceptional radiological finding. We present a case that sustained injury following an assault and was diagnosed to have diffuse pneumocephalus, pneumorachis and extensive surgical emphysema of the head and neck region secondary to the fracture of the cribriform plate of ethmoid bone. To the best of our knowledge pneumorachis due to fracture of the cribriform plate of ethmoid bone has not been reported before, in the English language literature.

Cowherd's injury: Traumatic retrospondyloptosis of L1 over L2 in a 7-year-old child.

Traumatic retrolisthesis of the first lumbar vertebra is a rare injury and only one case has been documented in the literature. We report a case of traumatic retrolisthesis of the first lumbar vertebra in a 7-year old child. He was injured after being dragged by a cow and presented with Frenkel grade A paraplegia.

Management of idiopathic clubfoot in toddlers by Ponseti's method.

The Ponseti method has been reported to have successful results in clubfoot patients less than 6 months of age but the literature on its efficacy in older clubfoot patients still remains sparse. In our study, we prospectively evaluated 55 clubfeet (37 patients) to determine clinically whether the Ponseti method is effective in the management of clubfoot in older children between the age of 12 and 36 months (mean: 24.8 months).

Anesthetic management of a patient with congenital diaphragmatic eventration.

Congenital diaphragmatic eventration is uncommon in adults and is caused by paralysis, aplasia or atrophy of the muscular fibers of the diaphragm. It may cause severe dyspnea, orthopnea and hypoxia in adult patients. Most symptomatic patients may be managed efficiently without the need for surgical correction, although any event that leads to an increase in intra-abdominal pressure puts them at the risk of spontaneous diaphragmatic rupture.

Atlantoaxial dislocation in a child with generalized primary dystonia.

We describe a 10-year-old boy with generalized dystonia who developed spastic quadriparesis within 1 month of dystonia onset. On neuroimaging, a craniovertebral junction anomaly with atlantoaxial dislocation and compressive myelopathy was present. We postulate that dystonia involving the neck led to atlantoaxial dislocation in this child with a craniovertebral junction anomaly.

Neglected femoral neck fractures in adults.

Purpose: To assess treatment outcomes in adults with neglected femoral neck fractures, and propose a treatment protocol based on bone quality measured by the Singh index.

Methods: 16 men and 6 women aged 18 to 48 (mean, 33) years presented with neglected (>3 weeks old) femoral neck fractures. Those with good bone quality (Singh index, >3) underwent closed reduction and valgus osteotomy and fixation with 120º double angle blade plates (group 1, n=8), whereas those with poor bone quality (Singh index, >3) and/or communition of the posterior femoral neck underwent fibular grafting and internal fixation with one or two 7-mm cannulated cancellous screws (group 2, n=14).

Pseudoaneurysm of the anterior tibial artery: A rare complication of proximal tibial steinman pin insertion.

An anterior tibial artery pseudoaneurysm is a rare and unexpected complication of Steinmann pin insertion. We describe the case of an 18-year-old boy, who sustained such an injury to the anterior tibial artery during this procedure. Diagnosis was confirmed on a magnetic resonance (MR) angiogram.

Distribution of human rotavirus G and P genotypes in a hospital setting from Northern India.

Rotavirus gastroenteritis is a major cause of severe dehydrating diarrhea in children worldwide. Rotavirus G and P genotyping is essential for epidemiological surveillance and for better formulation of candidate rotavirus vaccines. Out of 862 diarrheal stool samples collected from hospitalized children aged < 2 years during February 2005 - March 2007, 318 (36.

Transpedicular drainage of presacral abscess and posterior decompression of acute cauda equina syndrome in caries spine: a case series of 3 patients.

Study Design: We describe 3 patients with lumbosacral tuberculosis with epidural and presacral abscess who presented to us with acute cauda equina syndrome. A novel technique of draining the abscess and its results are described.

Objective: To describe a novel technique of draining the presacral abscess and to evaluate the results in the patients treated with this technique.

Functional restoration after early tendon transfer in high radial nerve paralysis.

We assessed the effect of an early transfer of pronator teres to extensor carpi radialis brevis on hand function in patients with high radial nerve paralysis. Power grip and precision grip were measured preoperatively and postoperatively using a dynamometer. Fifteen patients were operated on, of which ten could be assessed at the end of 6 months.

Unifocal Granuloma of Femur due to Langerhans' Cell Histiocytosis: A Case Report and Review of the Literature.

The radiological diagnosis of osteolytic lesions of the long bones in pediatric population constitutes a challenge when the case history and clinical data are uncharacteristic. We believe that the description of few clinically and histologically proven cases to verify the existence of radiological signs useful for diagnosis may be of interest. Here, we describe a case of Langerhans' cell histiocytosis (LCH) presenting as unifocal eosinophilic granuloma of femur along with a brief review of the literature.

Laparoscopic Nissen fundoplication is an excellent modality for GERD: early experience from a tertiary care hospital in India.

Background: Surgical management for gastroesophageal reflux disease (GERD) is indicated for reflux uncontrolled on medical therapy. Few studies have been reported from the Indian subcontinent evaluating laparoscopic fundoplication in GERD. The study was designed to evaluate laparoscopic Nissen fundoplication (LNF) in proven cases of GERD and to evaluate the procedure from using detailed symptomatic, objective parameters.

Laparoscopic management of CBD stones: an Indian experience.

Background: Common bile duct stones (CBDS) that are seen in the Asian population are very different from those seen in the west. It is not infrequent to see multiple, large, and impacted stones and a hugely dilated CBD. Many of these patients have been managed by open CBD exploration (OCBDE), even after the advent of laparoscopic cholecystectomy (LC), because these large stones pose significant challenges for extraction by endoscopic retrograde cholangiopancreatography.

Adverse drug reactions to antiretroviral therapy in AIDS patients at a tertiary care hospital in India: A prospective observational study.

Objectives: To identify the adverse drug reactions (ADRs) to antiretroviral therapy (ART) and to assess their impact on treatment compliance in patients with HIV/AIDS.

Materials And Methods: Two hundred and thirty-five (235) AIDS patients who received ART were monitored for ADRs over a period of 6 months. The incidence and nature of ADRs occurring with different ART regimens were recorded.

Iron deficiency in Indian children with attention deficit hyperactivity disorder.

A case control study was conducted at the Child Development and Early Intervention Clinic to determine the body iron status of children with ADHD, and study the correlation between the body iron status and ADHD symptoms. Serum ferritin was measured in newly diagnosed cases with ADHD and compared with that of controls. Correlation was studied between serum ferritin levels and the severity of ADHD symptoms as determined by Conners Rating Scale.

Sensitivity of the autism behavior checklist in Indian autistic children.

Objective: The autism behavior checklist (ABC) has potential utility for evaluation of autistic children in resource-poor settings. Although the original total cutoff score has been described as 67, lower cutoffs have been suggested. We evaluated the sensitivity of ABC in the diagnosis of autism in Indian children.

Locked-in syndrome: A rare manifestation of pediatric stroke.

Locked-in syndrome is characterized by upper motor neuron quadriplegia, paralysis of lower cranial nerves, bilateral horizontal gaze palsy and anarthria, with preserved consciousness. It is due to a ventral pontine lesion following a basilar artery occlusion. We report the first Indian case report of locked-in syndrome, a 10-year old girl in whom the syndome was preceded by a 'herald hemiparesis'.

Perceived breast milk insufficiency in mothers of neonates hospitalized in neonatal intensive care unit.

Objective: A) To study the frequency of perceived breast milk insufficiency in mothers of hospitalized neonates. b) To assess subsequent duration of exclusive breast feeding and growth (upto three months) in neonates whose mothers perceived breast milk insufficiency.

Methods: Neonates whose mothers were willing to breastfeed their babies were included in the study.

Primary tuberculous abscess of rectus femoris muscle: a case report.

Tuberculosis of skeletal muscle is very rare, especially in immunocompetent patients. We describe a case of tuberculous abscess of rectus femoris muscle, which presented as a tender ill-defined mass. Diagnosis was established by PCR and histology.

Malignant proliferating trichilemmal cyst: a case report with review of literature.

Proliferating trichilemmal cyst is a rapidly growing large cutaneous adnexal neoplasm occurring on the head and neck region of elderly women. Malignant transformation has rarely been reported in these lesions. We describe here a 85-year-old lady who presented with a large ulcerated growth over the scalp for one year duration.

Renal amyloidosis secondary to childhood tuberculosis: a report of two cases.

Childhood renal amyloidosis is a rare entity and is mostly secondary in nature. We describe two cases of renal amyloidosis in association with childhood tuberculosis. The first case was a 10-year-old girl who presented with abdominal tuberculosis and nephrotic syndrome, while the second case was a 5-year-old boy who presented with disseminated tuberculosis and nephrotic syndrome.

Ease of Proseal Laryngeal Mask Airway insertion and its fibreoptic view after placement using Gum Elastic Bougie: a comparison with conventional techniques.

The Proseal Laryngeal Mask Airway (PLMA) is routinely inserted by the digital and introducer tool techniques but a newer Gum Elastic Bougie (GEB) guided insertion technique has been described. The aims and objectives were to compare the ease of PLMA insertion and fibreoptic view of PLMA after placement using GEB and conventional techniques. Ninety-six ASA I or II patients of either gender aged 18 to 60 years, scheduled for elective surgery under general anaesthesia in the supine position were included in this study.