Panacea Journal of Medical Sciences

. 83-87

Authors: Gaurav Kumar Yadav, Madhuri Sunil Pandharipande, Rakhi W Joshi, Mrinalini D Motlag, K. Nagpure, PP J

The prevalence of olfactory impairment and cognitive impairment increases with age. Olfactory impairment has been associated with neurodegenerative diseases such as Alzheimer’s disease (AD) and Parkinson’s disease. The present study was carried out to find out the prevalence of anosmia in the elderly and cognitive impairment in the elderly along with the association of anosmia and cognitive impairment in the elderly. Present study is a hospital based, observational, case-control study, in which 100 elderly subjects (age >65 years, Males 64, Females 36, ratio 1.7:1), attending the geriatric OPD, were included as cases and 100 subjects (<65 years, Males54, females 46, ratio-1.1:1) as controls. Anosmia was assessed by Indian Smell Identification Test (INSIT), in which 10 essences were used and 1 point was awarded for correct and 0 for incorrect identification. A score of ≤ 4 indicates anosmia. All cases were subjected to thorough clinical examination and lab investigations. Cognitive impairment was diagnosed by 30 point mini-mental state examination (MMSE) where scores ≤ 23 indicates cognitive impairment. Statistical analysis was performed by using students ‘t’ test, chi square test p value and univariate analysis. Mean age in cases was 68.4±3.7 years and in controls is 39.4±7.9 years. Anosmia was detected in 64% of cases as compared to controls 4% (p <0.01). Mean INSIT score was significantly lower (4.02+1.88) in cases as compared to controis7.36+1.35, p< 0.01. Cognitive impairment was present in 50% of the cases and 1% control, (p<0.001). Mean MMSE score was also significantly lower in cases (20.99+5.1) than controls (27.47+1.79, p <0.001. Anosmia is found to be significantly associated with cognitive impairment in cases. Anosmia, a surrogate marker of cognitive impairment, is prevalent in elderly. Cognitive impairment is also prevalent in elderly. In elderly subjects, anosmia is associated with cognitive impairment.

54-56

Authors: Abhoya Kumar Kar, Uma Patnaik, Ruchika Mittal

To discuss the perioperative auditory rehabilitation practices in patients of profound sensorineural hearing loss, who are potential candidates for cochlear implantation and to deliberate upon the post implant therapy required in order to achieve best results, this review was undertaken. Recent findings like advancements in technology, cochlear implant design and refinements in surgical procedure for cochlear implantation, may give better surgical results and better hearing access, but it is the therapeutic rehabilitation, that would assist these patients in being able to use these devices. Though cochlear implant has established itself in patients with profound sensorineural hearing loss and the importance of a good auditory rehabilitation is recognized, there has not been a serious attempt to converse upon it and adapt it to an Indian setting. Most centers have their own protocols and there is a need to converge these into a working model that can be replicated. A comprehensive educational and habilitation program that would help an implant recipient to achieve maximum benefit is discussed. An implant rehabilitation program should be able to educate parents and caregivers as regards how to use methods in daily activities to help the recipient to develop speech and language. This would go a long way in achieving the best possible results, especially as technology is so advanced in current scenario

59-65

Authors: Vairamanikandan, P Sathyamurthy, M Rajkumar, Vaasanthi

Hypothyroidism is a highly prevalent endocrine disorder. Hypothyroidism affects almost all organs of the body, the cardiovascular system being the most sensitive one. There has been an increased usage of biochemical tests for screening of hypothyroidism. We have studied the clinical and laboratory profile of hypothyroid patients with particular emphasis on their cardiovascular manifestations. 50 patients of hyperthyroidism were included in the study. Patients with other co-morbidities which could contribute to cardiovascular manifestations were excluded from the study. In this study Females (60%) were more than males (40%), commonest general presenting symptoms were fatigue (52%) and weight gain (48%), commonest cardio vascular symptoms were palpitation (78%), followed by dyspnoea (26%) and chest pain (4%), commonest cardio vascular signs were found to be tachycardia (82%), widened pulse pressure (50%) and pedal edema (12%), commonest ECG finding was found to be Sinus tachycardia(46%) followed by atrial Fibrillation(28%), Non-Specific ST-T changes, Left Ventricular Hypertrophy, RV hypertrophy and RBBB. Systolic dysfunction and Chamber enlargement (18%) were the more prevalent echo manifestations. This study shows that because of their high prevalence and constant nature, clinical symptoms and signs of hypothyroidism cannot be over looked for screening and clinical diagnosis. Also the cardiovascular manifestations being increasingly prevalent should be routinely screened in all hypothyroid patients.

74-78

Authors: Mohan Pandurang Joshi, Ausvi M Samina

India leads the world with largest number of diabetic subjects earning the dubious distinction of being termed as “Diabetic Capital of the world.” The prevalence of depression among diabetics is 15-20% which is three times as compared to general population. Studies have identified depression as an independent risk factor for Type II Diabetes with relative risk of developing diabetes ranging from 1.3 to 3.0. This study was carried out to study the prevalence of Diabetes mellitus in age group above 20 years in an urban slum area and to study depression as an epidemiological correlate of Diabetes Mellitus. The cross-sectional study was conducted at urban slum area of central India in adults aged 20 years and above. Diabetes was diagnosed using WHO criteria 2006. The OGTT was performed using 75 gm of glucose. Depression was assessed by administering PHQ-9 scale, a self-report Hindi version. In present study, it was found that prevalence of Diabetes as 12.75% and among incident diabetics, 2.32% had moderately severe depression, 30.23% had moderate depression and 46.51% minor depression according to PHQ-9 Scale. When depression was assessed, it was almost present in(79.06%) subjects with Diabetes Mellitus, mild depression being the commonest (46.5%). The present study identified depression (P value -0.002) as the independent risk factors for type 2 Diabetes Mellitus. The present study identified depression as the independent risk factor for type 2 Diabetes Mellitus.

88-91

Authors: Aysha Siddiqua Kalim Khan, Mohammed Faizan

In the modern era of networking, technological advances, particularly, invention of computer revolutionized our way of working. Increase in industrialization and urbanization lead to increase in health issue related to it, neck pain in computer users is one of them. 59% of WRMSDs (work related musculoskeletal disorder) reported annually by IT professionals in India, out of which 30% cases are of neck pain. Sickness absenteeism due to neck pain is 41%. The prevalence of neck pain in computer users in our study was 28%. Data was collected through questionnaire and analyzed through various statistical methods. 40% of computer users have associated complaint like upper limb pain and parasthesias which are related to neck posture. The prevalence is more in females (60%). The neck pain increased with increase in age, 66% neck pain was found in people between 50 -60 years. The prevalence of neck pain was low among those who do regular exercise, in our study only 30% of computer users do regular exercise out of which only 36% develop neck pain.

96-101

Authors: Vinita Ramnani, Saroj Gupta, Gajendra Chawla, Vijay Kumar Ramnani

The cataract and vitreoretinal disease commonly coexist in the elderly population and the presence of cataract hampers visualization in vitreoretinal surgery, thus concurrent removal of cataract helps in better visualization of retina during vitreoretinal procedures. With expanding indications of vitrectomy the need for vitreoretinal surgeries are increasing. The present study is carried out to assess the results of combined phacoemulsification with intraocular lens implantation and pars plana vitrectomy in eyes having coexisting vitreoretinal disorders with significant cataract. It is a prospective, non-comparative, consecutive, interventional study. Total 80 patients were operated for combined phacoemulsification with IOL and PPV from January 2011 to December 2013. All new cases of vitreoretinal disorders with significant cataract were included, whereas high risk diabetic retinopathy cases where two sequential surgeries were done and previous failed vitrectomy cases were excluded from study. Sixty seven followed up patients were analyzed for anatomical attachment of retina and visual acuity gain. Total 80 patients between 23 to 78 (mean age 54.22) years, 37 female and 43 male with significant operable cataract and variety of vitreoretinal disorder were operated. Out of 67 cases visual acuity improved in 43 (64.18%), deteriorated in 8 (11.94%), remained unchanged in 16 eyes (23.88%) and the anatomical attachment of retina was achieved in 59 eyes (88.06%). Postoperative complications were inflammation in 7 (10.45%) eyes and posterior capsular opacification (PCO) in 8 (11.94 %) eyes. Combined phacoemulsification with IOL and PPV is convenient, economical, single step method for treatment of coexisting cataract and vitreoretinal disorders. Phacoemulsification performed at the time of vitreoretinal surgery helps better visualization of posterior segment and facilitates surgery without added risk of complications.

104-106

Authors: Rasika Pise, Sulabha Joshi

Quadruplet pregnancy is very rare. All these pregnancies are multizygotic pregnancies. Spontaneous monochorionic quadruplet pregnancy is extremely rare, quoted incidence being 1 in 15 million. One such case is reported here where a primigravida, who conceived within one year after marriage spontaneously, remained uninvestigated till 24 weeks was then diagnosed as triplet pregnancy.

113-114

Authors: Romi Bansal, Savita Somalwar

Ruptured rudimentary horn is a life threatening obstetrical emergency where the diagnosis is either missed or delayed. We report a case of 21 years old Gravida 2 Para 1 Live 1 with previous vaginal deliverywho presented with acute abdominal pain with clinical diagnosis of ruptured ectopic pregnancy, posted for emergency exploratory laparotomy. Laparotomy revealed ruptured rudimentary horn pregnancy with fetus in the abdominal cavity. Excision of rudimentary horn was done which was non-communicating.