Dermatoglyphics is a study of configurations of epidermal ridges on certain body parts, namely, palms, fingers, soles, and toes. The term is derived from ancient Greek: derma = skin, glyph = carving. Dermatoglyphic patterns begin to develop in the 10^th week of gestation and are complete by the 24^th week. Fingerprints of both hands are not the same and persist lifelong unless dermis is damaged. They are mainly under genetic control and can be used in the diagnosis of congenital malformations. Their uniqueness has led to the analyses of one's potential and preferences. During development, various creases develop on the brain and are reflected on fingerprints representing various regions of the brain and are commonly being used in dermatoglyphics mental intelligence test. Some parents have started analyzing their children' fingerprints in early age to understand their innate characters and learning potential in terms of personal, educational, or for preference in any other enterprise.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

Upper gastrointestinal (GI) endoscopy is a safe procedure in the present gastroenterology practice. There are few complications related to the procedure and medications, which need to be observed carefully. We report a case of acute swelling of the right parotid gland which developed immediately after upper GI endoscopy.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]

Background: Hemophilia is underdiagnosed in India, and there is lack of state specific data on the extent and morbidity. This article provides the real world demographic and clinical data of patients with hemophilia (PwH) in a resource-constrained setting in Punjab, India. Patients and Methods: This is a retrospective analysis of PwH in the institutional hemophilia registry over 9 years. Eligible patients who had a confirmed diagnosis at our institute were included in the analysis. Demographic, clinical, and treatment data used in the current analysis were extracted from medical records using a standardized data collection form. Results: A total of 211 patients were from Punjab, comprising 175 PwH A (91.3%) and 36 with PwH B for uniformity. The mild, moderate, and severe hemophilia in the cohort were 32 (15.1%), 45 (21.3%), and 132 (62.5%), respectively. No patient was on continuous prophylaxis. Inhibitors were positive in 7.9% of patients. Joint deformity was found in 83.5% of severe PwH. Transfusion-transmitted infections were found in 24 (18.3%). There were no statistically significant differences between hemophilia A and B groups with regard to demographic or clinical characteristics. The current median age of the group was 22 years against a national average of 27.6 years. Only 7.4% of the estimated cases of PwH are diagnosed in Punjab. Conclusion: There are significant underdiagnoses, increased incidence of transfusion-transmissible infection, and joint deformity among PwH in Punjab. Therefore, it warrants an immediate need to develop a registry, increase awareness about hemophilia, and provide comprehensive care.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]

Context: A single case of thiamine deficiency seen in a population reflects a public health problem which is preventable and easily treatable. Aim: This article describes suspected thiamine deficiency among peripartum women in a rural population in Assam presenting as clinically overt peripheral polyneuropathy. Materials and Methods: A retrospective review of the clinical presentation and electrodiagnostic features of peripartum women presenting with peripheral polyneuropathy during a 6-month period, showing improvement in clinical symptoms after administration of thiamine. Results: The clinical profile of 24 peripartum women described is consistent with features of thiamine deficiency presenting with peripheral polyneuropathy and/or cardiopathy. Of the patients followed up after thiamine supplementation, 90% (18) reported either improvement of neurological deficits or improvement in nerve conduction studies after an average of 10 days. Predominant use of polished rice, thiamine poor diet and habitual use of tea, betel nut, and fermented fish are observed to have precipitated the disease. Limitations of the study include the lack of biochemical measurement of tissue thiamine stores in patients. Conclusions: The observations made among peripartum women in this population assumes public health importance as thiamine deficiency is a preventable and easily treatable illness. There is an urgent need to initiate prospective studies including population surveys to conclusively prove the existence of clinically overt thiamine deficiency in this rural population and its likely causes so that effective public health strategies can be formulated to prevent the morbidity associated with this clinical entity.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]

Background: Hypertension is one of the most important risk factors for coronary heart disease, stroke, heart failure, and end-stage renal disease. It remains an important public health challenge, despite effective medical therapies for its management, patients' poor adherence remains a global problem. Aim: The main objective of this study is to determine the relationship between family functioning and medication adherence among hypertensive, attending a tertiary care center in South-West Nigeria. Materials and Methods: This was a descriptive cross-sectional study. The systematic sampling method was used to select 420 patients attending the outpatient clinic of the tertiary hospital. Relevant data were collected using interviewer-administered pretested semi-structured questionnaires. Results: Four hundred and twenty people participated in the study. The mean age of respondents was 60.97 ± 11.28 years, and a slight female preponderance (M:F = 1:1.7). Three hundred and forty-nine (83.1%) were married, 273 (65.0%) were from a monogamous family and 375 (89.2%) had a family size of >4. More than half of the study participants had a functional family (66.4%) and were adherent (61.2%) to their medication. Increased medication adherence proportion was observed in patients with a functional family. Adherence to medication is three times (odds ratio = 2.585, 95%CI = 1.636, 4.084) higher among patients with functional family. Conclusion: The structure and nature of family relationships, both of which determines family functioning, are important to medication adherence. A functional family enhances adherence to medication. Primary care physicians should create a positive treatment alliance with their patients to better family functioning.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]

Context: To bring the prevalence of osteoporosis in rural India to the forefront of health care, to increase awareness and encourage proactive diagnosis of osteoporosis in a cost-effective manner. Settings: A retrospective observational study was designed to analyze a cohort of adult population attending outpatient clinic at a rural mission hospital. 350 patients with low back pain were evaluated for osteoporosis using the Singh's Index (SI). Methods: Sample size was calculated with 95% confidence level, with confidence interval of five. Three hundred and eighty-four radiographs were graded as per SI. Adult patients 40 years of age and above, with low back ache were included in the study. Patient data were retrieved using Doc 99 Hospaa3 HIMS software. Radiographs for all patients were evaluated using Medsynapse PACS software. Thirty-four radiographs were excluded from the study due to poor image quality. Results: Sample included 181 females and 169 males. Two hundred and eighty-five (84%) radiographs were graded as Grade 3 or below indicating definite osteoporosis. A total of 141 males (84%) and 144 females (80%) were graded as Singh's Grade 3 or less indicating definite osteoporosis. Conclusions: The rural physician must exercise a high clinical index of suspicion of osteoporosis and should encourage routine evaluation and diagnosis of osteoporosis using cost-effective means such as SI in resource-limited areas of the rural India. Limitations: This study highlights the prevalence of osteoporosis among healthcare-seeking adult population and cannot be extrapolated to the general population.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]

Background and Objectives: Shopkeepers due to their sedentary lifestyle and lack of physical activity are more likely to suffer from high level of stress which, in turn, may increase the risk of various chronic diseases among them. The study aims to assess the stress level and its associated factors among shopkeepers. Materials and Methods: The study was a cross-sectional community-based study conducted from May to July 2016, among 147 shopkeepers in a permanent marketplace of Kolkata with a structured schedule. Data were analyzed using appropriate statistical methods by the Statistical Package for the Social Sciences, SPSS (version 16). Results: The mean stress score of the study participants was 8.1 ± 2.3. Only 43.7% of them were doing a moderate physical activity (≥600 MET-min/week). There was moderate correlation between stress and physical activity (ρ = 0.374, P = 0.000). Other significant correlates of stress were age (t = 2.132, P = 0.035), tobacco consumption (ρ = 0.167, P = 0.043), body mass index (ρ = 0.299, P = 0.000), and hypertension (ρ = 0.165, P = 0.046). Conclusions: Stress level among the study population was high with only two-fifths of them doing a moderate amount of physical activity. Health education regarding the importance of maintaining a healthy lifestyle, i.e., regular physical activity, weight reduction, and quitting addiction should be given to them regularly to reduce their stress level and reduction of their risk of developing various chronic diseases.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]

Background: Ultrasonography is a safe, reproducible, and accurate diagnostic imaging modality in the evaluation of the effects of sickle cell anemia (SCA) on the sizes of liver and spleen. The study is aimed at determining the size of liver and spleen in SCA patients compared with that of healthy age-matched known normal hemoglobin genotype (HbAA) volunteers and also to correlate with some hematological parameters. Materials and Method: This is a prospective cross-sectional study conducted over a period of 1 year. A total number of 237 SCA patients attending the outpatient sickle cell clinic of Federal Teaching Hospital, Gombe and an equal number of apparently healthy known age-matched HbAA from the general public were recruited by a convenient sampling technique. Results: The mean size of liver span and spleen length in SCA patients was 13.12 ± 2.05 cm and 6.50 ± 1.75 cm, respectively, while that of the controls was 11.77 ± 1.491 cm and 7.62 ± 1.827 cm, respectively (P = 0.00 for both liver and spleen). The liver span in SCA patients was higher among all the ages, while the spleen length reduces after the first 10 years of age. There was a strong positive correlation between liver span and the age, weight, and height (r = 0.767, 0.830, and 0.826, respectively) in SCA patients. The liver span showed a significant relationship with packed cell volume, red blood cell, white blood cells, mean corpuscular hemoglobin (MCH), MCH concentration, and mean corpuscular volume (r = −0.181, −0.266,−0.299, 0.316, 0.206, and 0.309). There was no correlation between spleen size and hematological parameter. Conclusion: Ultrasound is a veritable tool in the estimation of liver and spleen sizes in SCA patients.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]

Background: Children of school age group in developing countries are facing the problem of overweight and obesity because of lifestyle change, playing video games, watching television as well as consuming energy rich diet. Childhood obesity continues as obesity in adulthood. The chance of high blood pressure (BP) in overweight and obese children is more than healthy weight children. Objectives: (i) Effect of body mass index (BMI) on BP. (ii) Association of overweight and obesity with hypertension (HTN). Materials and Methods: This study included 580 students of age group 6–12 years of both boys and girls. All students were from English medium school. Measurement of height and weight was done by standard procedure. BMI was calculated by weight and height. BP measurement was done by auscultatory method. Statistical analysis was done by SPSS 16. Results: Overweight and obesity were more in boys than girls. There was significantly more BP in overweight and obese participants than healthy weight individuals. There was positive correlation between BMI and BP both systolic and diastolic BP. Prevalence of HTN in boys is more than the girls. Odds ratio suggested that overweight and obesity was associated with HTN. Conclusion: This study concludes that overweight and obese school students were prone to develop elevated BP and HTN and hence were prone to cardiovascular risk.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]

The dawn of mobile health facilitates new horizon of professional communication through WhatsApp, allowing health professionals to interact quickly and efficiently for effective patient management. Dedicated group chats can bring together novices and experts of medical and dental specialties in a common platform. This article highlights how the use of WhatsApp services help improve communication and coordination among the young graduates in remote mission hospitals and senior specialists in WhatsApp group, thereby helping in delivering superior treatment plans to underprivileged people in remote parts of India.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]

Background: Organ preservation protocols using concurrent chemoradiation therapy is increasingly utilized as a primary treatment for locally advanced head-and-neck cancers. Swallowing dysfunction has been recognized as the most common treatment-related quality of life (QoL) issue affecting 50%–60% of patients. Objective: The aim of the present study was to identify the factors that affect swallowing function after head-and-neck irradiation. Materials and Methods: From 2013 to 2014, 34 patients with squamous cell carcinoma head-and-neck region were prospectively enrolled in this study. The influence of the radiation treatment on swallowing function was evaluated using modified barium swallow test at baseline, 3 months, and 6 months. Chi-squared analysis was used to analyze the factors affecting swallowing function. Results: At 3 months following treatment, 76.5% of patients had swallowing dysfunction which decreased to 61.8% at 6 months. The statistically significant association was found between swallowing dysfunction and primary site in oral cavity and oropharynx (P = 0.04) at 3 months following treatment. Conclusions: While there is an ample literature reporting on several QoL issues for head-and-neck cancer patients, the various factors affecting swallowing dysfunction after the completion of treatment have not been fully described. Understanding the trajectory of swallowing dysfunction is important in identifying patients at high risk of protracted swallowing dysfunction. Providing appropriate early anticipatory intervention may improve patient's QoL. Longer follow-up is required to confirm these predictors of swallowing dysfunction.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]

Introduction: Gradual increase in a number of vehicular accidents globally becomes a matter of concern, and adequate policies are required to reduce such incidents. This study was conducted in Guwahati city, the gateway to North-East India, to know the various factors related to such incidents associated with fractures of skull. Materials and Methods: A total of 200 cases were selected randomly over a period of 1 year. It was a cross-sectional study and data were collected from police, relatives of the deceased, and hospital records in an especially designed pro forma (questionnaire). Results obtained were tabulated and analyzed accordingly. Results: Results showed that almost 90% (89.5%) of the victims were male and 20–29 years was the most common age group involved. Fissured fracture was the most common skull fracture found in our study (56%), and temporal bone was involved in 56% of the cases. Occupants of two-wheelers were found more vulnerable to skull fracture. About 46% of the victims died before they could reach hospital, and in 71% of the cases, rural people were involved. Conclusion: Immediate and timely first-aid measure along with setting up of tertiary health-care centers in rural areas is absolutely necessary to prevent death due to vehicular accidents as the majority of the victims died before they could reach a well-equipped hospital. Public awareness about the use of protective gears, use of footpaths, and also safe usage of mobile phones while using roads would be of great help in reducing such incidents.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]

Dermatofibrosarcoma protuberans (DFSP) is a rare, locally aggressive soft-tissue tumor with high recurrence. Tissue biopsy, imaging, and staging form the diagnostic pathway, but sometimes investigations deter patients from low socioeconomic background. We present a case of malignant DFSP with adequate oncologic clearance despite financial constraints. A young male presented with a swelling over the right hip for 8 years. Although fine-needle aspiration, core biopsy, magnetic resonance imaging, and staging computerized axial tomography scan are the ideal management pathway, the patient refused these for an excision biopsy which would have sufficed if histology was benign. Histology reported a malignant fibrosarcomatous variant of DFSP. Wide excision of previous biopsy site and flap reconstruction was done as advised by the skin oncology multidisciplinary team (MDT) which confirmed oncologic clearance. We would ideally advocate a proper oncologic pathway, but in patients where finances restrict investigations oncologic clearance can still be achieved.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]

Introduction: Cerebral palsy (CP) is an important neurological condition that originates in early childhood but affects individuals throughout the life. It leads to specific motor skill problems, delay in developmental milestones, and physical limitations such as abnormal muscle tonus, reflexes, and persistent infantile reflexes. Periodontal disease is the most prevalent oral condition in hospitalized CP patients. These patients are at a higher risk of periodontal disease due to physical and cognitive impairment. The lack of awareness and availability of oro dental care facilities in rural areas is also a hindrance in this regard. Objective: The objective of the present study was to evaluate the periodontal health status and treatment needs of hospitalized CP patients of rural Punjab. Methodology: Periodontal health status and treatment needs of hospitalized CP patients were determined by epidemiological indices. Questionnaires were filled by the patient's parents/attendants about the home-care oral hygiene measures and dietary habits of the patient. All patients were given nonsurgical periodontal therapy with reenforcement of oral hygiene measures as a part of our treatment plan. Results and Conclusion: From this study, it was concluded that periodontal disease is prevalent in hospitalized cerebral-palsied patients. Treatment needs for such patients include assisted oral health care, pain management, and constant psychosocial support. The inclusion of a dental healthcare professional in the management team would help improve the quality of life in these hospitalized cerebral-palsied patients.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]

Pheochromocytomas are neuroendocrine tumors derived from embryonic neural crest cells. They are mostly found in the adrenal glands (pheochromocytomas) and sometimes in the extra-adrenal paraganglia (paragangliomas) of the autonomic nervous system. Paragangliomas arising from the kidney or in the renal hilus are very rare, and preoperative diagnosis is rarely made.We present the case of a 38-year-old hypertensive female, presenting with dull aching, nonradiating right flank pain for 2 months and no other symptoms. Computed tomography demonstrated a well-defined, hypodense enhanced lesion located on the hilum of the right kidney. Laparotomy was performed, and histology of the excised mass revealed an extra-adrenal pheochromocytoma. The intervention was effective, and the patient is doing fine.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]

Aicardi syndrome is a rare genetic disease characterized by a characteristic classical trio of neurological clinical abnormalities (spasms), agenesis of the corpus callosum, and ophthalmological abnormalities. Here, we present a case of Aicardi syndrome with complete dysgenesis of the corpus callosum, subependymal periventricular gray matter heterotopia, and a cyst in the interhemispheric fissure. Ophthalmological examination showed bilateral chorioretinal lacunae.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]

A 39-year-old female came for evaluation for progressive lower costochondral pain and swelling with no associated systemic or constitutional symptoms and no evidence of the involvement of any other organ system. Diagnostic thoracotomy with excision of involved rib and costochondral junction showed plasma cell-rich chronic inflammation with foci of fibrosis with no definite storiform fibrosis or obliterative phlebitis. Immunohistochemistry showed 30%–40% immunoglobulin G4 (IgG4)-positive cells/hpf with an IgG:IgG4 ratio of 30% with sterile cultures and no elevation of serum IgG4 levels. With a presumptive diagnosis of IgG4-related disease, she was started on steroids with which she had complete symptom relief and resolution of the lesion. This case highlights the importance of considering the diagnosis of IgG4 disease even in the absence of typical histopathological findings and elevated serum IgG4 levels. The authors have not found any prior reports in the English literature of IgG4 disease of the ribs and costochondral junction.

[ABSTRACT]  [FULL TEXT]  [PDF]

Abdominal cocoon is an uncommon cause of acute or subacute intestinal obstruction mostly secondary to tuberculosis. This report highlights the classic imaging features on computed tomography in a case of ileocecal tuberculosis with secondary abdominal cocoon.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]

[FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]

[FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]