Abdulaziz Al-Sawai,
27318 Views
Abdulfatai B. Olokoba, Olusegun A. Obateru, Lateefat B. Olokoba,
25391 Views
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Type 2 Diabetes Mellitus: A Review of Current Trends
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Abdulfatai B. Olokoba,1* Olusegun A. Obateru,2 Lateefat B. Olokoba3
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DOI 10.5001/omj.2012.68 |
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1Division of Gastroenterology, Department of Medicine, University of Ilorin Teaching Hospital, Ilorin, Nigeria. 2Department of Medicine, Irrua Specialist Teaching Hospital, Irrua, Nigeria. 3Department of Ophthalmology, University of Ilorin Teaching Hospital, Ilorin, Nigeria. Received: 10 Mar 2012 Accepted: 08 May 2012 *Address correspondence and reprints request to: Abdulfatai B. Olokoba, Division of Gastroenterology, Department of Medicine, University of Ilorin Teaching Hospital, Ilorin, Nigeria. E-mail: drabolokoba@yahoo.com |
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Abstract
Type 2 diabetes mellitus (DM) is a chronic metabolic disorder in which prevalence has been increasing steadily all over the world. As a result of this trend, it is fast becoming an epidemic in some countries of the world with the number of people affected expected to double in the next decade due to increase in ageing population, thereby adding to the already existing burden for healthcare providers, especially in poorly developed countries. This review is based on a search of Medline, the Cochrane Database of Systemic Reviews, and citation lists of relevant publications. Subject heading and key words used include type 2 diabetes mellitus, prevalence, current diagnosis, and current treatment. Only articles in English were included. Screening and diagnosis is still based on World Health Organization (WHO) and American Diabetes Association (ADA) criteria which include both clinical and laboratory parameters. No cure has yet been found for the disease; however, treatment modalities include lifestyle modifications, treatment of obesity, oral hypoglycemic agents, and insulin sensitizers like metformin, a biguanide that reduces insulin resistance, is still the recommended first line medication especially for obese patients. Other effective medications include non-sulfonylurea secretagogues, thiazolidinediones, alpha glucosidase inhibitors, and insulin. Recent research into the pathophysiology of type 2 DM has led to the introduction of new medications like glucagon-like peptide 1 analogoues: dipeptidyl peptidase-IV inhibitors, inhibitors of the sodium-glucose cotransporter 2 and 11ß-hydroxysteroid dehydrogenase 1, insulin-releasing glucokinase activators and pancreatic-G-protein-coupled fatty-acid-receptor agonists, glucagon-receptor antagonists, metabolic inhibitors of hepatic glucose output and quick-release bromocriptine. Inhaled insulin was licensed for use in 2006 but has been withdrawn from the market because of low patronage.
Keywords: Type 2 diabetes mellitus; Diagnosis; Management; Newer drugs.
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Ajay Krishnan, Sumit Kar,
20817 Views
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Scrotal Dermatitis - Can we Consider it as a Separate Entity?
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Ajay Krishnan* and Sumit Kar
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DOI 10.5001/omj.2013.91 |
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Department of Dermatology, Venereology and Leprosy, MGIMS, Sewagram, Wardha, Maharashtra-442012, India. Received: 22 Jun 2013 Accepted: 16 Aug 2013 *Address correspondence and reprints request to: Ajay Krishnan, Department of Dermatology, Venereology and Leprosy, MGIMS, Sewagram, Wardha, Maharashtra-442012, India. E-mail: akof2k@yahoo.com |
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Abstract
Scrotal dermatitis is a very common condition that has been easily overlooked by most dermatologists and treating physicians. The condition is easily mistaken for the common skin disorders affecting the area, like fungal infections. Scrotal dermatitis is not considered a separate disease entity and is usually considered a condition similar to the contact dermatitis occurring elsewhere. This article attempts to classify the condition as a separate disease entity and explains the various etiological factors and the pathogenesis of the condition. The various stages of the condition are also explained in detail. Newer treatment modalities like the use of narrow band UVB for the management of scrotal dermatitis is also highlighted in this article.
Keywords: Dermatitis; Scrotum; Narrow band.
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Rashid Al-Abri, Amina Al-Balushi ,
18552 Views
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Patient Satisfaction Survey as a Tool Towards Quality Improvement
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Rashid Al-Abri* and Amina Al-Balushi
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DOI 10.5001/omj.2014.02 |
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ENT Division, Surgery Department, Sultan Qaboos University Hospital, Sultanate of Oman. Received: 30 Aug 2013 Accepted: 23 Oct 2013 *Address correspondence and reprints request to: Rashid Al-Abri, ENT Division, Surgery Department, Sultan Qaboos University Hospital, Sultanate of Oman. E-mail: ralabri@gmail.com |
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Abstract
Over the past 20 years, patient satisfaction surveys have gained increasing attention as meaningful and essential sources of information for identifying gaps and developing an effective action plan for quality improvement in healthcare organizations. However, there are very few published studies reporting of the improvements resulting from feedback information of patient satisfaction surveys, and in most cases, these studies are contradictory in their findings. This article investigates in-depth a number of research studies that critically discuss the relationship of dependent and independent influential attributes towards overall patient satisfaction in addition to its impact on the quality improvement process of healthcare organizations.
Keywords: Patient satisfaction; Quality improvement; Healthcare.
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Athar Abdul Samad Majeed, Mea`ad Kadhum Hassan,
16185 Views
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Risk Factors for Type 1 Diabetes Mellitus among Children and Adolescents in Basrah
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Athar Abdul Samad Majeed1, Mea`ad Kadhum Hassan2*
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DOI 10.5001/omj.2011.46 |
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1Basrah Maternity and Children Hospital 2Department of Pediatrics College of Medicine, University of Basrah Received: 07 Jan 2011 Accepted: 15 Mar 2011 *Address correspondence and reprints request to: Mea`ad Kadhum Hassan, Department of Pediatrics, College of Medicine, University of Basrah. E-mail: drmk_hassan@yahoo.com
Abstract
Objectives: Environmental factors play an important role in the pathogenesis of type 1 diabetes mellitus, many of these factors have been uncovered despite much research. A case-control study was carried out to determine the potential maternal, neonatal and early childhood risk factors for type 1 diabetes mellitus in children and adolescents in Basrah.
Methods: A total of 96 diabetic patients who have been admitted to the pediatric wards at 3 main hospitals in Basrah, and those who have visited primary health care centers over the period from the 4th of November 2006 to the end of May 2007 were recruited. In addition, 299 non-diabetic children were included, their age ranged from 18 months to 17 years.
Results: Family history of type 1 diabetes mellitus and thyroid diseases in first and second degree relatives was found to be an independent risk factor for type 1 diabetes mellitus, (p<0.001). Regarding maternal habits and illnesses during pregnancy, the study has revealed that tea drinking during pregnancy is a risk factor for type 1 diabetes mellitus in their offspring, (p<0.05). In addition, maternal pre-eclampsia and infections were found to be significant risk factor for type 1 diabetes mellitus, (p<0.001). Neonatal infections, eczema and rhinitis during infancy were also significantly associated with development of type 1 diabetes mellitus. Moreover, the results revealed that duration of <6 months breast feeding is an important trigger of type 1 diabetes mellitus.
Conclusion: Exposure to environmental risk factors during pregnancy (tea drinking, pre-eclampsia, and infectious diseases), neonatal period (respiratory distress, jaundice and infections) and early infancy are thought to play an important role in triggering the immune process leading to B-cell destruction and the development of type 1 diabetes mellitus.
Keywords: Type 1 Diabetes Mellitus; Risk factors; Children; Adolescents.
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Leo F. Tauro, Geover J. Lobo, Hilda Fernandes, Celine George, P. Sathyamoorthy Aithala, Divakar Shenoy, Prathvi Shetty,
14617 Views
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A Comparative Study on Fine Needle Aspiration Cytology versus Fine Needle Capillary Cytology in Thyroid Nodules |
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Leo F. Tauro,1 Geover J. Lobo,1 Hilda Fernandes,2 Celine George,1 P. Sathyamoorthy Aithala,1 Divakar Shenoy,1 Prathvi Shetty1 |
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DOI 10.5001/omj.2012.31 |
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1Department of Surgery, Fr. Muller Medical College Hospital, Kankanady, Mangalore-2, Karnataka. India.2Department of Pathology, Fr. Muller Medical College Hospital, Kankanady, Mangalore-2, Karnataka. India. Received: 24 Nov 2011Accepted: 18 Jan 2012 Address correspondence and reprints request to: Leo F. Tauro, Professor, Department of Surgery, Fr. Muller Medical College Hospital, Kankanady, Mangalore-2, Karnataka. India.E-mail: drlftauro@rediffmail.com |
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Abstract
Objectives: Fine needle aspiration cytology (FNAC/FNA) is the primary investigation for thyroid nodules. Fine needle capillary cytology (FNCC/FNC) is an alternative technique not commonly used, though it is easy to perform. Both the techniques have their own advantages and disadvantages. This study aims to compare these two cytological techniques for better specimen and cytological diagnosis.
Methods: This prospective study was conducted on 50 patients attending the FR Muller Medical College Hospital from May 2006 to April 2008. The patients with thyroid nodules (diagnosed by palpation) were subjected to both the cytological techniques; FNA and FNC. The specimen and results were compared and then correlated with the final histopathological findings wherever surgical specimens were available (38 cases).
Results: The mean age of the patients was 39.16 with a female predominance. The majority of cases were diagnosed to have nodular goiters. The FNC technique yielded 88% diagnostic superiority and adequate specimens compared to 94% by FNA. Sensitivity was 50% for FNC and 100% for FNA while specificity was 100% for both techniques; accuracy score was 97.4% for FNC and 100% for FNA in predicting malignancy. While sensitivity was 75% for FNC and 100% for FNA; specificity was 100% for both techniques, and accuracy score was 97.4% for FNC and 100% for FNA in the prediction of neoplasia.
Conclusion: The results indicated that there was no significant difference between the two techniques; if done in tandem can give better and accurate cytological diagnosis. In highly cellular lesions, in which abundant material was obtained, FNC was more likely to be diagnostically superior, but FNA can diagnose most of the lesions. In less cellular lesions, FNA is more likely to be diagnostically superior to FNC.
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Adamu Ahmed, Garba Stephen, Yahaya Ukwenya,
14432 Views
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Spontaneous Rupture of Umbilical Hernia in Pregnancy: A Case Report
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Adamu Ahmed, Garba Stephen, Yahaya Ukwenya
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DOI 10.5001/omj.2011.70 |
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Department of Surgery, Ahmadu Bello University Teaching Hospital, Zaria Nigeria. Received: 18 May 2011 Accepted: 07 Jul 2011 *Address correspondence and reprints request to: Dr. Adamu Ahmed, Department of Surgery, Ahmadu Bello University Teaching Hospital, Zaria Nigeria. Email: mrahmed1010@yahoo.com |
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Abstract
A 28 year old woman presented with a spontaneous rupture of an umbilical hernia in her seventh month of pregnancy. She had four previous unsupervised normal deliveries. There was no history of trauma or application of herbal medicine on the hernia. The hernia sac ruptured at the inferior surface where it was attached to the ulcerated and damaged overlying skin. There was a gangrenous eviscerated small bowel. The patient was resuscitated and the gangrenous small bowel was resected and end to end anastomosis done. The hernia sac was excised and the 12 cm defect repaired. Six weeks later, she had spontaneous vaginal delivery of a live baby. We advocate that large umbilical hernias should be routinely repaired when seen in women of child bearing age.
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Roshina A. Khan,
14231 Views
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Peri-mortem Cesarean Delivery... A Reality not Fiction
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Roshina A. Khan
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doi:10.5001/omj.2010.98
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ABSTRACT
Antepartum hemorrhage is one of the leading causes of mortality around the world. It can result in hypovolemic shock leading to circulatory arrest during pregnancy. A well planned strategy is required for its management in all hospitals. To deliver a woman in this situation is a dilemma which needs very prompt decision and a swift speedy action. Not only the woman’s life is in danger, the fetus is also at risk and urgent delivery may be life saving for both mother and the fetus. All obstetricians should be trained to deal with such situation with full understanding and awareness of the condition.
From the Department of Obstetrics and Gynecology, Ibri Regional Referral Hospital, Ibri, Sultanate of Oman.
Received: 17 Jul 2010
Accepted: 21 Aug 2010
Address correspondence and reprint request to: Dr. Roshina A. Khan, Department of Obstetrics and Gynecology, Ibri Regional Referral Hospital, Ibri, Sultanate of Oman.
Email: roshinak@hotmail.com; tipuu@omantel.net.om
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Adil Aljarrah, Maryam Al-Hashmi, Kamran Ahmad Malik, Sawhney Sukhpal, Samir Hussein, Marwa Al-Riyami, Mansour Al-Moundhri,
13912 Views
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Mucinous Breast Cancer with Solitary Metastasis to Humeral Head: A Case Report
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Adil Aljarrah,1* Maryam Al-Hashmi,1 Kamran Ahmad Malik,1 Sawhney Sukhpal,2 Samir Hussein,2 Marwa Al-Riyami,3 and Mansour Al-Moundhri4
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DOI 10.5001/omj.2013.100 |
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1Breast Unit, Department of Surgery, Sultan Qaboos University Hospital, Al-Khoud, P.O. Box 912, PC 111, Muscat, Sultanate of Oman. 2Breast Unit, Department of Radiology, Sultan Qaboos University Hospital, Al-Khoud, P.O. Box 912, PC 111, Muscat, Sultanate of Oman. 3Breast Unit, Department of Pathology, Sultan Qaboos University Hospital, Al-Khoud, P.O. Box 912, PC 111, Muscat, Sultanate of Oman. 4Breast Unit, Department of Medicine, Oncology, Qaboos University Hospital, Al-Khoud, P.O. Box 912, PC 111, Muscat, Sultanate of Oman. Received: 18 Jul 2013 Accepted: 16 Aug 2013 *Address correspondence and reprints request to: Adil Aljarrah, Breast Unit, Department of Surgery, Sultan Qaboos University Hospital, Al-Khoud, P.O. Box 912, PC 111, Muscat, Sultanate of Oman. E-mail: aljarrah.adil@gmail.com or adilm@squ.edu.om |
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Abstract
Breast cancer is the most common cause of metastatic deposits in the skeleton, and bone is the most common site of recurrence of breast cancer. Breast cancer metastasis most commonly affects the spine, ribs, pelvis, and proximal long bones; however, only 3.5% of breast cancer patients develop long-bone metastases. The humerus is the most common upper-extremity site for bony metastasis, and pathologic fractures can result. The patient in the current study presented with breast cancer and discovered to have humeral head metastasis during initial workup. The dilemma was in investigation the modality to confirm humeral head metastasis as there are many differential diagnoses with similar findings. After staging workup, the patient was treated with neoadjuvant chemotherapy followed by modified radical mastectomy and radiotherapy of the chest wall and the shoulder. The lesion in humerus was well healed.
Keywords: Mucinous breast cancer; Solitary humeral bone metastases; Neoadjuvant chemotherapy-radiotherapy.
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Saifullah Khalid, Mohd Khalid, Samreen Zaheer, Ibne Ahmad, Ekram Ullah,
13905 Views
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Kirner’s Deformity Misdiagnosed as Fracture: A Case Report
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Saifullah Khalid*, Mohd Khalid, Samreen Zaheer, Ibne Ahmad, Ekram Ullah
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DOI 10.5001/omj.2012.53 |
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Department of Radiodiagnosis, J N Medical College, Aligarh Muslim University, Aligarh, UP-202002, India. Received: 29 Jan 2012Accepted: 14 Mar 2012 *Address correspondence and reprints request to: Saifullah Khalid, Department of Radiodiagnosis, J N Medical College, Aligarh Muslim University, Aligarh, UP-202002, India. Email: saif2k2@gmail.com
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Abstract
Kirner`s deformity or dystelephalangy is a rare entity which presents with painless, progressive, bilateral radiovolar curving of the terminal phalanges of the little fingers. It is a clinicoradiological diagnosis. Herein, we present a case where the patient was being treated as having a fracture of the distal phalanx because of misdiagnosis of Kirner`s deformity. Given the rarity of the deformity, we believe it useful to present our case report as a contribution to the literature.
Keywords: Kirner`s deformity; Fifth; Little finger; Radio-volar angulation.
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Shibani Shetty, Gokul S.,
13536 Views
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Keratinization and its Disorders
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Shibani Shetty,1 Gokul S.2
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DOI 10.5001/omj.2012.90 |
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1Senior Lecturer, Dept. of Oral Pathology and Microbiology, M. R AmbedkarDental College and hospital, Bangalore- 560005Karnataka, India2Lecturer, Dept. of Oral Pathology and Microbiology, YMT Dental College andHospital, Institutional area, Sector-4, Kharghar, Navi Mumbai-410210, India..
Received: 03 May 2012 Accepted: 08 July 2012 *Address correspondence and reprints request to: Gokul S. Lecturer, Dept. of Oral Pathology and Microbiology, YMT Dental College andHospital, Institutional area, Sector-4, Kharghar, Navi Mumbai-410210, India.E-mail: drgokuls@gmail.com |
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Abstract
Keratins are a diverse group of structural proteins that form thei ntermediate filament network responsible for maintaining the structural integrity of keratinocytes. In humans, there are around 30 keratin families divided into two groups, namely, acidic and basic keratins, which are arranged in pairs. They are expressed in a highly specific pattern related to the epithelial type and stage of cellular differentiation. A total of 54 functional genes exist which codes for these keratin families. The expression of specific keratin genes is regulated by the differentiation of epithelial cells within the stratifying squamous epithelium. Mutations in most of these genes are now associated with specific tissue fragility disorders which may manifest both in skin and mucosa depending on the expression pattern. The keratins and keratin-associated proteins are useful as differentiation markers because their expression is both region specific and differentiation specific. Antibodies to keratin are considered as important tissue differentiation markers and therefore are an integral aid in diagnostic pathology. The present review discusses the structure of keratin, the various types of keratin and their distribution and the disorders associated with keratinization with special emphasis on the disorders of the oralcavity. A brief note on the clinical significance of keratin is also mentioned.
Keywords: Keratinization; Keratins; Distribution; Keratinization disorders; Keratin antibodies.
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Sudhir M. Naik, Sarika S. Naik,
13505 Views
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Tonsillo-Styloidectomy for Eagle’s Syndrome: A Review of 15 Cases in KVG Medical College Sullia |
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Sudhir M. Naik,1 Sarika S. Naik2 |
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DOI 10.5001/omj.2011.30 |
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From the 1Department of ENT, Head and Neck Surgery KVG Medical College, Sullia, India; 2Department of Anesthesia KVG Medical College, Sullia, India. Received: 13 Dec 2010 Accepted: 24 Jan 2011 Address correspondence and reprints request to: Dr. Sudhir M Naik, Department of ENT, Head and Neck Surgery KVG Medical College, Sullia, India. E-mail: sud223@gmail.com
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Abstract
Elongated styloid process causing Eagle's Syndrome is a rare clinical entity and the diagnosis is often difficult as a result of its vague symptomatology. However, palpation of tonsillar fossa with radiological demonstration of the elongated styloid process confirms the diagnosis. This is a report of a retrospective study conducted at the KVG Medical College, Hospital, Sullia, Karnataka, India where 15 patients who were surgically treated for Eagle’s syndrome in the ENT department were retrospectively studied. Fourteen patients became symptom free after surgery within three months of follow up. Tonsillo-styloidectomy is the treatment of choice for Eagle’s syndrome with a high success rate.
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P. Vasanthakumar, Pramod Kumar, Mohandas Rao,
13297 Views
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Anthropometric Analysis of Palpebral Fissure Dimensions and its Position in South Indian Ethnic Adults
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P. Vasanthakumar,1 Pramod Kumar,2 Mohandas Rao1
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DOI 10.5001/omj.2013.06 |
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1Department of Anatomy, Melaka Manipal Medical College (Manipal Campus), International Centre for Health Sciences, Manipal University, Madhav Nagar, Manipal-576104, Karnataka State, India.2Department of Plastic Surgery and Burns, Kasturba Medical College, Manipal University, Madhav Nagar, Manipal-576104,Karnataka State,India. Received: 29 Sep 2012 Accepted: 08 Dec 2012 *Address correspondence and reprints request to: P. Vasanthakumar, Department of Anatomy, Melaka Manipal Medical College (Manipal Campus), International Centre for Health Sciences, Manipal University, Madhav Nagar, Manipal-576104, Karnataka State, India.E-mail: vasan_ana@yahoo.co.in |
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Abstract
Objectives: The morphology and anatomical relationship of periorbital features vary according to age, sex and ethnicity. Standard database regarding periorbital region is available for other ethnic groups. Since there is no data available in the literature, specifically for south Indian ethnic adults, the present study was carried out to determine the normal average values for South Indian ethnic population related to gender.
Methods: Anthropometric measurements of both eyes were done on standardized frontal view photograph of 200 South Indian ethnic adults aged 18 to 26 years. Parameters included were palpebral fissure width (PFW), palpebral fissure height (PFH), palpebral fissure inclination (PFI), outercanthal distance (OCD), interpupillary distance (IPD), intercanthal distance (ICD) and comparisons were made between the genders using the independent t test.
Results: Significant sexual dimorphism was noted in the given parameters. Palpebral fissure width (male: 31.08 mm; female: 29.90 mm), palpebral fissure inclination (male: 5.053°; female: 6.102°), outercanthal distance (male: 95.55 mm; female: 92.44 mm) and interpupillary distance (male: 66.72 mm; female: 62.59 mm). The palpebral fissure height (male: 11.30 mm; female: 11.58 mm) and intercanthal distance (male: 34.27 mm; female: 33.41 mm) showed no significant sexual differences.
Conclusion: Statistically significant differences were found between South Indian ethnic males and female in certain key parameters. The present study suggests that ethnicity and gender should be considered in orbital surgery. To individualize the treatment planning and diagnosis, it is important for the surgeons to have knowledge of these local norms.
Keywords: Aesthetics; Anthropometry; Database; Orbital; Palpebral fissure.
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Abdul Hakeem Al-Hashim, Mujahid Al-Busaidi, Mujahid Al-Busaidi,
13246 Views
Senol Yavuz,
13120 Views