Limb Salvage in Malignant Bone Tumours - A Prospective Follow-Up Study Conducted at Government Medical College, Thrissur from 2017 to 20

BACKGROUND Limb salvage surgeries - Are they useful compared to amputation in bone tumours (malignant/recurrent). Starting from 1980s, bone tumour treatment has seen a revolution with the advent of limb salvage surgeries. From an era where amputation was the only option to the current day function preserving resections and complex reconstructions has been a major advance. The surgeon must ensure adequate resection of the involved bone and soft tissue so as to minimize chance of local recurrence. At no stage must adequate disease clearance be compromised in an attempt to achieve limb salvage. We analyzed its relevance among our rural population at a tertiary level care centre. Limb salvage surgery basically involves resection and reconstruction. Reconstruction can be either biological or endo prosthetic. Biological can be autograft or allograft. Endoprosthesis can be fixed (custom-made) or modular. Expendable bones like fibula or ulna may not require reconstruction after resection. Prosthesis provide an immediate return to function and unlike bone they are not affected by ongoing adjuvant chemotherapy and radiotherapy. METHODS We conducted an 18-month prospective follow-up study on 10 patients (6 males and 4 females) who had undergone limb salvage surgeries during 2017 - 20 at Government Medical College, Thrissur. Wide excision, wide excision & biological autograft reconstruction, wide excision & modular endoprosthesis reconstruction are the different surgical modalities used. Patients were followed up clinically and radiologically in the orthopaedic out-patient department (OPD) at 6 weeks, 12 weeks and up to 1 ½ years at every 3 months. Functional scoring has been done using musculoskeletal tumour society (MSTS) - 87 scoring system. Study duration: 2017 October to 2020 October (3 years). RESULTS The average score is 64.6 % using the MSTS - 87 system. Maximum score was 83 % and the minimum was 62 %. Most of our patients are doing well and pursuing near-normal life with limb salvage surgeries with very minimal complications. One of our patients succumbed to the disease during the follow-up period. CONCLUSIONS Limb salvage is a better alternative to amputation in malignant and recurrent bone tumours in carefully selected and thoroughly evaluated patients. KEYWORDS Limb Salvage, Malignant & Recurrent Bone Tumours, MSTS - 87 Score, Wide Excision, Biological Autograft, Modular Endoprosthesis Reconstruction

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FOLLOW UP STUDY OVER A PERIOD OF SIX MONTHS WITH RESPECT TO REHABILITATION AND RECURRENCE AFTER BURN SURGICAL PROCEDURES.

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v4i1.871 ◽

2020 ◽

Vol 4 (1) ◽

Author(s):

Yashpal Ramole ◽

Badri Patel ◽

M. C. Songara ◽

Ishant Chaurasia

Keyword(s):

General Surgery ◽

Range Of Movement ◽

Rehabilitation Protocol ◽

Full Extent ◽

Medical College ◽

Follow Up Study ◽

Burn Surgery ◽

Gandhi Medical College ◽

Score Range

The study was conducted in the Department of General Surgery, Gandhi Medical College, Bhopal over the period of one & half year. Evaluation started with History and clinical examination including range of movement of joints. Scar was scored as per Clinical Assessment Score. Range of movement was measured using goniometer. Although most patients came for follow up and were compliant with the rehabilitation protocol, their compliance needs to be re-evaluated at every follow up and they should be encouraged to follow the advices strictly. Also they must be counseled that contracture may not be corrected to the full extent despite best of treatment and compliance with rehabilitation protocol but a good level of improvement can be achieved. Keywords: Burn, Surgery, Rehabilitation & Recurrence.

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Study of antioxidant status in malaria patients

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20171281 ◽

2017 ◽

Vol 5 (4) ◽

pp. 1649

Author(s):

Amit G. Tyagi ◽

Rupal A. Tyagi ◽

Prema Ram Choudhary ◽

Jaidev Singh Shekhawat

Keyword(s):

Oxidative Stress ◽

Biochemical Markers ◽

Antioxidant Status ◽

Therapeutic Potential ◽

Control Group ◽

Oxygen Species ◽

Medical College ◽

Follow Up Study ◽

The Mean

Background: Oxidative stress plays an important role in the development of metabolic changes in malaria patients. During infection RBCs are exposed to continual oxidative stress. The univalent reduction of oxygen results in a series of cytotoxic oxygen species such as O2-, H2O2, OH•. Objective was to determine the level of oxidative stress in patients suffering from malaria.Methods: The present study was conducted on 551 malaria patients and 211 age-sex matched controls, in department of Biochemistry, C U Shah Medical College, Surendranagar, Gujarat from April 2012 to May 2013. In stage-I, day-1 malaria patient’s v/s control group, In stage-II, day-3 v/s day-1 after anti-malarial treatment and in Stage-III day-3 v/s day-1 after anti-malarial + antioxidant treatment.Results: The mean erythrocytic activity of SOD, CAT, GST were decreased (0.71±0.25EU, 9.9±2.4μmol/sec, and 11.7±3.9 U/gmHb% respectively), mean level of GSH and MDA were increased (42.1±6.06gm/Hb%, 10.9±2.83 respectively) significantly (P<0.001) as compared to control group. In the follow up study with anti-malarial treatment the mean levels of erythrocytic GSH and MDA (28.7±7.54gm/Hb% and 8.08±1.95nM/L) decreased significantly (P<0.001 and P<0.01 respectively), whereas mean activity of erythrocytic enzymes like SOD, CAT and GST (0.99±0.15 EU, 15.8±2.68μmol/sec and 22.5±5U/gmHb%) were increased significantly (P<0.001) as compared to day-1.Conclusions: Erythrocytic antioxidant enzymes, GSH and MDA may be considered to be reliable biochemical markers for diagnostic and therapeutic potential in malaria.

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Study of association and prognostic correlation of cardiac troponin I estimation in acute decompensated heart failure patients

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20205403 ◽

2020 ◽

Vol 8 (1) ◽

pp. 26

Author(s):

Sunil Kumar Tripathi ◽

Vikas A. Mishra ◽

Amit B. Kinare ◽

Vishwa Deepak Tripathi ◽

Ravi Shankar Sharma

Keyword(s):

Heart Failure ◽

Troponin I ◽

Acute Decompensated Heart Failure ◽

Public Health Problem ◽

Decompensated Heart Failure ◽

Major Public Health Problem ◽

Positive Group ◽

Medical College ◽

Follow Up Study

Background: Heart failure is a major public health problem since last few decades affecting significant number of people worldwide. Acute decompensated heart failure is a major cause of hospitalization in elderly people with a high mortality rate. Heterogeneity and non-specificity of symptoms makes diagnosis of heart failure by clinical presentation alone more challenging. Aim of current study was to investigate troponin biomarkers in diagnosis, prognosis and management of acute decompensated heart failure. Methods: Present study was a prospective observational study conducted on 100 patients at Department of Cardiology, Superspeciality hospital, NSCB medical college Jabalpur and Department of cardiology Superspeciality hospital, SS medical college Rewa from October 2019 to August 2020. Patients were investigated for clinical, echocardiographic parameters and NYHA classification. Cardiac functions were analyzed by color doppler echocardiography. Results: According to study findings, 65.2% of TnI positive patients were males whereas 34.8% were females. Mean age of TnI positive group was observed to be higher. Majority of troponin positive patients were in NYHA class IV. Recurrent hospitalization was observed more in TnI positive group. Logistic regression analysis depicted systolic blood pressure reduced significantly (p<0.001) on follow up study in TnI positive patients, FBS was significantly more in TnI positive patients (131.4+42.9 mg/dl) (p=0.049). LVID was significantly more in TnI positive patients (p=0.022). Reduction in EF was statistically significant (p=0.03) at the three months follow up study. Conclusions: A positive prognostic correlation was established between ADHF and troponin positivity, large prospective randomized trials are necessary to recommend quantitative troponin I determination in all patients of acute decompensated heart failure for prognosis and guiding therapy.

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Rotationplasty for limb salvage in the treatment of malignant tumors at the knee. A follow-up study of seventy patients.

The Journal of Bone and Joint Surgery (American) ◽

10.2106/00004623-199173090-00012 ◽

1991 ◽

Vol 73 (9) ◽

pp. 1365-1375 ◽

Cited By ~ 77

Author(s):

F Gottsauner-Wolf ◽

R Kotz ◽

K Knahr ◽

H Kristen ◽

P Ritschl ◽

...

Keyword(s):

Limb Salvage ◽

Malignant Tumors ◽

Follow Up Study

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Effect of exercise habits and lifestyles on changes in physical fitness in medical college students: a 3-year follow-up study.

Nippon Eiseigaku Zasshi (Japanese Journal of Hygiene) ◽

10.1265/jjh.55.618 ◽

2001 ◽

Vol 55 (4) ◽

pp. 618-626 ◽

Cited By ~ 2

Author(s):

Masahisa SAITO

Keyword(s):

College Students ◽

Physical Fitness ◽

Exercise Habits ◽

Medical College ◽

Follow Up Study

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Nine years′ follow-up of successful implementation of PPTCT program in Government Medical College, Dhule, Maharashtra

Indian Journal of Sexually Transmitted Diseases and AIDS ◽

10.4103/0253-7184.112949 ◽

2013 ◽

Vol 34 (1) ◽

pp. 61 ◽

Cited By ~ 1

Author(s):

MrudulaN Dravid ◽

Arun Moray ◽

RavindraK Khadse ◽

SuwarnaU Phute

Keyword(s):

Successful Implementation ◽

Government Medical College ◽

Medical College

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Family Perceptions of Newborn Cytomegalovirus Screening: A Qualitative Study

International Journal of Neonatal Screening ◽

10.3390/ijns7040080 ◽

2021 ◽

Vol 7 (4) ◽

pp. 80

Author(s):

Michael J. Cannon ◽

Denise M. Levis ◽

Holly McBride ◽

Danie Watson ◽

Carol Rheaume ◽

...

Keyword(s):

Qualitative Study ◽

Healthcare Providers ◽

Medical College ◽

Follow Up Study ◽

Opt Out ◽

Long Term Follow Up ◽

Family Perceptions ◽

Congenital Cmv

Objectives: We sought to understand long-term retrospective parental perceptions of the utility of newborn screening in a context where many affected children never develop sequelae but where intensive support services and ongoing healthcare were provided. Study design: Qualitative study. Methods: Focus groups and interviews among parents (N = 41) of children with congenital CMV who had been enrolled in a long-term follow-up study at a large medical college for a mean of 22 years following diagnosis. Groups included parents whose children were: symptomatic at birth; initially asymptomatic but later developed sensorineural hearing loss; and who remained asymptomatic into adulthood. Results: With proper follow-up support, newborn CMV screening was viewed positively by parents, who felt empowered by the knowledge, though parents often felt that they and healthcare providers needed more information on congenital CMV. Parents in all groups valued newborn CMV screening in the long term and believed it should be embedded within a comprehensive follow-up program. Conclusions: Despite initial distress, parents of CMV-positive children felt newborn CMV screening was a net positive. Mandatory or opt-out screening for conditions with variable presentations and treatment outcomes may be valuable in contexts where follow-up and care are readily available.

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DO MEDICAL GRADUATES PREFER TO WORK IN RURAL AREAS? - A FOLLOW UP STUDY OF OLD STUDENTS OF A PRIVATE MEDICAL COLLEGE IN TAMILNADU

Journal of Evolution of Medical and Dental Sciences ◽

10.14260/jemds/1330 ◽

2013 ◽

Vol 2 (39) ◽

pp. 7513-7517

Author(s):

Shankar K ◽

Sivaprakasam P ◽

Kokila Selvaraj

Keyword(s):

Rural Areas ◽

Medical College ◽

Medical Graduates ◽

Follow Up Study

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Pediatric Herniotomy: A 2-year Follow-up Study at Nepal Medical College and Teaching Hospital

Nepal Medical College Journal ◽

10.3126/nmcj.v23i1.36229 ◽

2021 ◽

Vol 23 (1) ◽

pp. 55-59

Author(s):

Giridhar Bahadur Nhuchhe Pradhan ◽

Sunil Shrestha ◽

A Chalise ◽

S Shrestha

Keyword(s):

Inguinal Hernia ◽

Hospital Stay ◽

Teaching Hospital ◽

Total Duration ◽

Standard Of Care ◽

Common Procedure ◽

Medical College ◽

Follow Up Study ◽

Duration Of Surgery

Repair of inguinal hernia is one of the most commonly performed pediatric surgical procedures. The standard of treatment has been open herniotomy (OH). Recent trends have shown promising results with use of laparoscopy (LH) for the same. The aim of this study was to compare laparoscopic herniotomy with the standard of care at the time of the study, which has become an increasingly common procedure at our center. This was a prospective follow-up study conducted at the Department of Surgery at Nepal Medical College and Teaching Hospital. A total of sixty-four patients who underwent herniotomy were included in the study and followed up for a total duration of two years post-operatively. Immediate post-op pain was assessed with the use of visual analogue scales. Complications, recurrence, and metachronous herniation were noted in the follow up visits. Use of laparoscopy resulted in a longer operative time (36.68 min vs 22.5 min for OH, P <0.001). Pain scores were similar at immediate post-op period (LH 4.18 vs OH 3.93) but decreased significantly for LH compared to OH at 6 hours (3.68 vs 4.31, P = 0.018), 12 hours (2.71 vs 3.62, P <0.001), and 24 hours (2 vs 3.03, P <0.001). Difference in the mean hospital stay was statistically significant (LH 2.02 days vs OH 2.34 days, P <0.001). No recurrences occurred during the follow up period of the study. No patients developed contralateral metachronous hernia during the follow-up period. The cost of OH compared to LH was significantly less. LH is a safer and better alternative to OH for management of pediatric inguinal hernia when comparing post-op pain and hospital stay. However, duration of surgery and cost for the procedure favor OH at present in our setup.

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