Cysts ; complications ; pathology ; Epithelial Cells ; pathology ; Humans ; Male ; Middle Aged ; Recurrent Laryngeal Nerve Injuries ; Thyroid Diseases ; complications ; pathology ; Voice Disorders ; etiology

Background: Headache disorders represent a major public health problem globally. It is more so in developing countries with rising trend in young adults affecting negatively their quality of life. There has been very little information on the epidemiology of headache disorder in Kashmir India which has witnessed prolonged and large scale militancy related disturbance. A prospective population based study was undertaken in Srinagar district of Kashmir to determine the prevalence of headache disorder. Methods: The study was a cross sectional survey using cluster sampling with a culturally adapted version of pretested questionnaire translated into local language, in Hazratbal Community Block of Srinagar. In the first phase households were screened. Individuals with headache were then examined by a senior neurologist for migraine and non migraine disorder. Results: The overall prevalence of headache was 66.2 % with female preponderance. Occurrence of headache was as high as 79.90 % in adults of 19-45 years. The prevalence rate declined after the age of 45 years in both the genders. Women had higher prevalence rate than men in all age groups and for all headache categories. Age distribution showed prevalence rate of migraine of 45.69% in young adults of 19-45 years; females 55.44% and males 32.79 %. Non migraine headache was more common than migraine type, and was more prevalent in young age group in both the genders, highest in adolescents (74.20 %). Conclusion: The high prevalence rate of headache both migrainous and non migrainous in Kashmir may be related to the stress the community has been subjected to from militancy related conflict since 1990.
Headaches

Goitre is a slow-growing thyroid mass, rarely presenting as an emergency. However, a superimposed infection or acute intralesional bleeding can cause the mass to increase rapidly in size. We report a patient with long-standing multinodular goitre who presented with bleeding from the left thyroid mass. Despite all appropriate measures, the continuous bleeding finally stopped upon thyroidectomy.

Bilateral abductor vocal cord palsy is comparatively a rare vocal cord lesion, especially in a patient with no history of neck mass, previous surgery or trauma. Many patients are not stridulous. A patient presenting with stridor may need emergency airway management before the other treatment is commenced. We report a case of bilateral abductor palsy which required an emergency tracheostomy and subsequently a laser posterior cordectomy.

Carcinoma, Ductal ; pathology ; surgery ; Female ; Head and Neck Neoplasms ; pathology ; surgery ; Humans ; Middle Aged ; Neck Dissection ; Salivary Ducts ; pathology ; surgery

Purpose: This study was aimed to assess the feasibility of laparoscopic rectal surgery, comparing quality of surgical specimen, morbidity, and mortality. Methods: Prospectively acquired data from consecutive patients undergoing laparoscopic surgery for rectal cancer, at 2 minimally invasive colorectal units, operated by the same team was included. Locally advanced rectal tumors were identified as T3B or T4 with preoperative magnetic resonance imaging scans. All the patients were operated on by the same team. The 1:1 propensity score matching was performed to create a perfect match in terms of tumor height. Results: Total of 418 laparoscopic resections were performed, out of which 109 patients had locally advanced rectal cancer (LARC) and were propensity score matched with non-LARC (NLARC) patients. Median operation time was higher for the LARC group (270 minutes vs. 250 minutes, P=0.011). However, conversion to open surgery was done in 5 vs. 2 patients (P=0.445), reoperation in 8 vs. 7 (P=0.789), clinical anastomotic leak was found in 3 vs. 2 (P=0.670), and 30-day mortality rates was 2 vs. 1 (P>0.999) between LARC and NLARC, respectively. Readmission rate was higher in the NLARC group (33 patients vs. 19 patients, P=0.026), due to stoma-related issues. There was no statistically significant difference in the R0 resection between the 2 groups (99 patients in LARC vs. 104 patients in NLARC, P=0.284). Conclusion This study demonstrates that standardized approach to laparoscopy is safe and feasible in LARC. Comparable postoperative short-term clinical and pathological outcomes were seen between LARC and NLARC groups.

BACKGROUND: Chronic urticaria is termed as idiopathic if there is an absence of any identifiable causes of mast cell and basophil degranulation. Various cytokines have been found to be involved in inflammatory processes associated with chronic idiopathic urticaria, including interleukin (IL) 18 and IL-6. OBJECTIVE: To evaluate any possible correlation of IL-18 and IL-6 cytokines with the clinical disease severity in chronic idiopathic urticaria (CIU). METHODS: IL-18 and IL-6 levels of CIU patients (n = 62) and healthy controls (n = 27) were assessed by commercially available enzyme linked immunosorbent assay kits following the manufacturer's protocols. RESULTS: Serum IL-18 concentration (mean ± standard deviation [SD], 62.95 ± 36.09 pg/mL) in CIU patients and in healthy controls (54.35 ± 18.45 pg/mL) showed no statistical significance (p > 0.05). No statistically significant difference (p > 0.05) was observed between autologous serum skin test (ASST) positive and ASST negative patients with regard to the serum IL-18 levels either. Similarly, serum IL-6 concentration (0.82 ± 4.6 pg/mL) in CIU patients and in healthy controls (0.12 ± 1.7 pg/mL), showed no statistical significance (p > 0.05). Also, comparison between positive and ASST negative patients with regard to the serum IL-6 levels was statistically nonsignificant (p > 0.05). However, statistical significance was found both in IL-18 and IL-6 concentrations in certain grades with regard to the clinical disease severity of urticaria. CONCLUSION: There is no significant association as such found between IL-18 and IL-6 levels with CIU, however, these cytokines may help in predicting the clinical disease severity in CIU. Hence, these cytokines may indicate a potential role as a biomarker to assess the disease severity in CIU.
Basophils ; Cytokines ; Enzyme-Linked Immunosorbent Assay ; Humans ; Interleukin-18 ; Interleukin-6 ; Interleukins ; Mast Cells ; Skin Tests ; Urticaria

PURPOSE: The purpose of this study was to investigate differences in component alignment between first and second knees in simultaneous bilateral total knee arthroplasty (SBTKA) and unilateral TKA (UTKA). MATERIALS AND METHODS: 274 SBTKAs and 198 UTKAs were included in study. Patients were divided into three groups as SBTKA on the right knee (group A), SBTKA on the left knee (group B) and UTKA (group C). Femoral and tibial component alignment was checked in both coronal plane (alpha [α] and beta [β] angles) and sagittal plane (gamma [γ] and delta [δ] angles) radiographs. RESULTS: There were no statistically significant differences among groups in the preoperative anatomical varus angle and Kellgren–Lawrence gonarthrosis classification grade (p=0.139 and p=0.329, respectively). In the coronal plane, the alignment of femoral component (α angle) and tibial component (β angle) was similar in all three groups (α angle, 95.01 vs. 95.14 vs. 94.9, p=0.945; β angle, 90.03 vs. 89.67 vs. 89.98, p=0.483). The sagittal plane alignment of femoral component (γ angle) and tibial component (δ angle) did not show significant differences (γ angle, 7.04 vs. 6.98 vs. 7.00, p=0.132; δ angle, 86.56 vs. 87.41 vs. 86.73, p=0.610). CONCLUSIONS: The angular alignment of components was similar between SBTKA and UTKA.
Arthroplasty ; Arthroplasty, Replacement, Knee ; Classification ; Humans ; Knee

BACKGROUND/AIMS: Irritable bowel syndrome (IBS) is a chronic psycho-physiological disorder. It is considered to be the most common functional gastrointestinal disorder, and about 50–90% of IBS patients have associated psychiatric co-morbidity. We aimed to study psychiatric co-morbidities in patients with IBS visiting a tertiary care center. METHODS: This was a cross-sectional case-control study conducted over a duration of one and a half years from January 2014 to July 2015. Patients were selected from the out-patient department of gastroenterology. About 160 patients with IBS who fulfilled the inclusion criteria and who gave written informed consent were selected as study cases. The healthy attendants of cases were selected as controls. A total of 200 controls were selected. Rome-III criteria were used to diagnose IBS. For diagnosing psychiatric disorders, we used the Mini International Neuropsychiatric Interview Schedule Plus. RESULTS: Mean age of our cases and controls was 39.7 ± 11.4 and 37.7 ± 9.6 years, respectively. Females outnumbered males in our cases as well as their controls by a ratio of 2:1 approximately. Psychiatric disorders were seen in 84.4% of IBS patients as compared to 41.5% in controls. Major psychiatric disorders seen in our patients were generalized anxiety disorders (30.0%) and depression (28.0%). CONCLUSIONS: The majority of patients with IBS who present to a tertiary care center have co-morbid psychiatric disorders. We need to screen these patients for such co-morbidities and develop a holistic approach for better outcome in such cases.
Anxiety Disorders ; Appointments and Schedules ; Case-Control Studies ; Depression ; Female ; Gastroenterology ; Gastrointestinal Diseases ; Humans ; India* ; Informed Consent ; Irritable Bowel Syndrome* ; Male ; Outpatients ; Tertiary Care Centers* ; Tertiary Healthcare*