International Archives of Integrated Medicine

1-17

Authors: Ghosh PK, Ray D, Chatterjee B, Acharya S, Adhikary S, De A

Background and purpose: People with knee Osteoarthritis (OA) sometimes report episodes of knee instability that limit their activities of daily living. Proprioception and balance are important aspects of osteoarthritis treatment because of their strong correlation with function in the knee. The purpose of this study is to evaluate the effects of balancing exercises and strengthening exercises to improve functional ability in knee osteoarthritis patients and also it may be helpful to identify the use of best treatment protocol for OA knee. Material and methods: Thirty OA knee patients randomly allocated into two groups and received either balancing exercises (Group A) or strengthening exercises (Group B). Both the groups received TENS and taken treatment for 4 days a week for 4 weeks. The outcome measures were VAS and WOMAC. VAS was used to measure intensity of knee pain and WOMAC was used for assessment of perceived pain, stiffness and functional ability. Results: After 4 weeks of treatment, significant reduction in the WOMAC score and VAS was found in both the Groups. The result showing statistical improvement is more in Group A than Group B. Conclusion: The results of the study shows that balancing exercise is more effective than strengthening exercise to improve the functional ability of OA involving knee joint. The improvement in Group A is more than Group B and having statistically highly significant.

22-27

Authors: Galketiya KB, Pinto MVG, Kumarasinghe N, Shaminda RAA, Abayasinghe AHMAH, Premadasa BAM, Galahawela GWGDD

Background: A wide variety of intra-abdominal procedures are performed by laparoscopy with reduced morbidity than open procedures. Dissection and hemostasis specially in complex surgeries is a challenge. The methods available are blunt, scissor, diathermy and ultra-sonic dissections whilst bipolar diathermy can be used to assist hemostasis. Aim: An evaluation was done of the efficacy of ultra-sonic dissector for tissue dissection in comparison with scissor and monopolar diathermy. Material and methods: An analysis was done on the usage of ultra-sonic dissector comparative to scissor and monopolar diathermy. The time of dissection and blood loss were evaluated. The procedures performed were oesophagectomy, Hellers cardomyotomy, Nissen fundoplication, splenectomy, cholecystectomy, distal pancreatectomy, laparoscopy assisted pancreatico-duodenectomy, adrenalectomy, right hemicolectomy, anterior resection and abdomino-perineal resection. Observation: Hundred and ninety five patients underwent cholecystectomy and preferred technique of dissection was monopolar diathermy hook assisted with Merrylands dissector. In hundred and fourteen patients who underwent complex abdominal surgeries dissection on planes which are vascular ultrasonic dissector with bipolar assistance was quicker than bipolar and scissor, whilst providing good hemostasis. Conclusion: Using ultra-sonic dissector with bipolar assist was preferred to use of ultra-sonic dissector alone. The hybrid approach provides better hemostasis whilst reducing the usage time of ultra-sonic dissector allowing longer usage of probes. On less vascular planes monopolar diathermy is adequate. Selective use of ultrasonic dissector will reduce cost of surgery.

32-35

Authors: Shah K, Shah M, Singh H

Hydatid disease, a parasitic infection is caused by cestode tapeworm Echinococus granulosus which is endemic in cattle grazing areas including India. Dogs are the definitive host. In human, commonly involved organs are liver and lungs. Peritoneal hydatidosis secondary to liver hydatid diseases is not uncommon but peritonial hydatidosis herniating to inguinal canal mimicking irreducible inguinal hernia is rare. Patient on clinical examination appears normally with complain of progressive abdominal pain and distention and irreducible cystic swelling in the inguinal region. Patients also gave history of contact with animals. Laboratory findings were not constant. Imaging and investigation necessary for establishing diagnosis were done. There always choice between ultrasound and computed tomography. Treatment includes conservative and surgical intervention. In case of single, symptomatic and large cyst was surgically treated. Small asymptomatic cysts, some daughter cysts, and peritoneal secondary cysts and splenic cysts may also be effectively conservatively treated. We reported here two cases of multiple hydatidosis at unusual location. In all patients large and symptomatic cyst was excised and all patient recover clinically. This case series emphasized that current understanding of disseminated multiple hydatidosis etiology still very little known. Study for additional risk factor may be necessary.

42-45

Authors: Singla D, Rathod GB

Plasma cell leukemia (PCL) is a rare disease and is the least common variant of multiple myeloma accounting for 2-3% of all plasma cell dyscrasias. Histogenetically, plasma cell leukemia is derived from terminally differentiated B cells. It is diagnosed by presence of absolute plasma cell count >2000 per cm or >20% circulating plasma cells. Here we report a case of plasma cell leukemia, who presented with easy fatigability, weakness and high grade fever since 1 month. Hematological investigation revealed leukocytosis with plasmacytosis (7420/ mm3). On bone marrow examination, >45% plasma blasts were seen. Biochemical analysis showed high LDH level (4236 U/L) and serum calcium level was also raised (12.3 mg/dl). Final diagnosis of plasma cell leukemia was made. As PCL is rare disease and it is even rarer to find them in a 32 years old. Here we are able to find and document the typical features of PCL.

49-53

Authors: Parmar P

Reconstruction of crime is very much essential to solve any mystery for police and investigative agencies. Correlation of victim, accused, weapon of offence, scene of crime, human behaviour, environmental evidences etc. are very important for the same. A crime reconstruction must require keen observation, understanding of science, recognition of evidences, and application of critical thinking with logic.