1.Influence of Sitting and Prone Lying Positions on Proprioceptive Knee Assessment Score in Early Knee Osteoarthritis
Vijay Batra ; Vijai Prakash Sharma ; Meenakshi Batra ; Girdhar Gopal Agarwal ; Vineet Sharma
Malaysian Journal of Medical Sciences 2011;18(2):40-46
Background: Knee proprioception is compromised in knee osteoarthritis. There are several
ways of measuring proprioceptive acuity, but there is lack of consensus over the ideal testing
position. The study aimed to evaluate the influence of 2 testing positions (sitting versus prone lying)
on proprioceptive knee assessment score in patients with early knee osteoarthritis.
Methods: The study included 70 subjects who came to the Out-Patient Department with a
diagnosis of early knee osteoarthritis. The subjects were assessed for their proprioceptive acuity
scores in both the test positions at 30° and 60° of knee flexion using proprioceptive knee assessment
device. They were asked to perform 5 trials in both testing positions with appropriate rest intervals.
After initial assessment, the subjects were randomly allocated among group 1 and group 2. Treatment
implementation was done for 8 weeks followed by re-evaluation: group 1 received context-specific
proprioceptive retraining along with multijoint coupling strategies and group 2, conventional
treatment.
Results: The subjects were compared using difference of pre- and post-treatment
proprioceptive acuity scores. The difference of proprioceptive acuity impairment scores of the left
knee at 30° and 60°, and the right knee at 60° in prone lying position were statistically significant,
with P value ranging from less than 0.001 to 0.028.
Conclusion: It was found that the prone lying testing position was more sensitive than sitting
position for assessing proprioceptive acuity for knee osteoarthritis.
2.Modulating Tone to Promote Motor Development Using a Neurofacilitation of Developmental Reaction (NFDR) Approach in Children with
Vijay Batra ; Meenakshi Batra ; Ravindra Mohan Pandey ; Vijai Prakash Sharma ; Girdhar Gopal Agarwal
Malaysian Journal of Medical Sciences 2015;22(5):50-56
Objective: To compare the efficacy of a Neurofacilitation of Developmental Reaction
(NFDR) approach with that of a Conventional approach in the modulation of tone in children with
neurodevelopmental delay.
Methods: Experimental control design. A total of 30 spastic children ranging in age from 4
to 7 years with neurodevelopmental delay were included. Baseline evaluations of muscle tone and
gross motor functional performance abilities were performed. The children were allocated into two
intervention groups of 15 subjects each. In groups A and B, the NFDR and conventional approaches
were applied, respectively, for 3 months and were followed by subsequent re-evaluations.
Results: Between group analyses were performed using independent t test for tone and
primitive reflex intensity and a Mann-Whitney U test for gross motor functional ability. For the
within-group analyses, paired t tests were used for tone and primitive reflex intensity, and a Wilcoxon
signed-rank test was used for gross motor functional ability.
Conclusion: The NFDR approach/technique prepares the muscle to undergo tonal modulation
and thereby enhances motor development and improves the motor functional performance abilities
of the children with neurodevelopmental delay.
3.Rare case of impalement of two occupants of a vehicle by the same object: insights into the management of complex thoracic impalements.
Maneesh SINGHAL ; Madduri-Vijay KUMAR ; Prem PRAKASH ; Amit GUPTA ; Subodh KUMAR ; Sushma SAGAR
Chinese Journal of Traumatology 2012;15(1):50-53
Thoracic impalement injuries are very rare and the majority of patients do not survive to reach a medical care facility. In this case report, we describe the successful outcome of a case of double thoracic impalement by two steel tors, of which one steel tor had impaled two patients simultaneously. The case report highlights all aspects of managing such rare and complex cases right from prehospital care; extrication process which happened under controlled environment at the trauma centre itself, till the definitive management of the impaled thoracic objects. Thoracic impalement injuries are dramatic and appear very challenging. However presence of mind of the managing team, coordinated team effort and availability of adequate facilities can lead to a successful outcome.
Humans
;
Thoracic Injuries
;
Wounds, Penetrating
4.Recurrent Kawasaki disease presenting as acute airway obstruction.
Xinyin Anna SEE ; Vijay PRAKASH ; Kun Kiaang Henry TAN
Singapore medical journal 2012;53(12):e264-6
Kawasaki disease is a common paediatric vasculitide. It is usually diagnosed by its classical constellation of mucocutaneous signs. Recurrent Kawasaki disease is a rare phenomenon that occurs in approximately 3% of all patients diagnosed with Kawasaki disease. Its presentation is usually similar to the first episode of Kawasaki disease, and early diagnosis with prompt treatment is key in preventing associated cardiovascular morbidities. Recurrent Kawasaki disease is not well reported, and atypical presentations have not been previously reported in medical literature. Here, we report the case of a young girl with recurrent Kawasaki disease who presented atypically with acute airway obstruction secondary to retropharyngeal phlegmon.
Acute Disease
;
Airway Obstruction
;
diagnosis
;
etiology
;
Child, Preschool
;
Diagnosis, Differential
;
Female
;
Humans
;
Lymph Nodes
;
diagnostic imaging
;
pathology
;
Mucocutaneous Lymph Node Syndrome
;
complications
;
diagnosis
;
Neck
;
Recurrence
;
Tomography, X-Ray Computed
5.An unusual case of symmetric quadruple limb fractures.
Vivek VIJAYAKUMAR ; Hemant BANSAL ; Kamran FAROOQUE ; Vijay SHARMA
Chinese Journal of Traumatology 2023;26(5):303-307
A 19-year-old man had an accidental fall from the 2nd floor and sustained multiple injuries. On radiological evaluation, the patient had symmetrical quadruple limb involvement with bilateral humerus shaft, bilateral olecranon, bilateral femur shaft, and bilateral patella fractures. The patient was actively managed using damage control orthopaedics, and a sequence of skeletal fixation was planned based on the hemodynamic stability and periodical serum lactate assessment. Symmetrical quadruple limb fractures are very rare, which could be associated with higher mortality. A meticulous clinical evaluation, periodical blood parameter assessment and strict adherence to the principles of damage control orthopaedics can be conducive to prevent life-endangering complications.
Male
;
Humans
;
Young Adult
;
Adult
;
Femoral Fractures/complications*
;
Femur
;
Fracture Fixation
;
Accidental Falls
;
Radiography
6.Giant Carotid Pseudoaneurysm.
Leonard Leong Litt YEO ; Julian WONG ; Prakash PALIWAL ; Arunesh MAJUMDER ; Elaine YH CHEE ; Eric TING ; Vijay K SHARMA
Journal of Cardiovascular Ultrasound 2015;23(2):118-118
No abstract available.
Aneurysm, False
;
Carotid Artery Injuries*
7.Acute femoral artery pseudoaneurysm due to lesser trochanter fragment: an unusual complication of an intertrochanteric fracture.
Gaurav SHARMA ; Ravijot SINGH ; Atin KUMAR ; Vijay SHARMA ; Kamran FAROOQUE
Chinese Journal of Traumatology 2013;16(5):301-303
False aneurysm of the femoral artery is a rare complication of intertrochanteric fracture. Most of these situations are due to iatrogenic trauma or the trauma itself and are rarely caused by dislocated bone fragments. Here we report a case of a 72-year-old man who presented acutely with a pseudoaneurysm of the superficial femoral artery from the spike of a lesser trochanter fragment. Percutaneous endovascular treatment of the pseudoaneurysm with a covered stent was undertaken on an urgent basis. Five days later, the patient was operated upon and the lesser trochanter fragment was excised through an anterior incision and the intertrochanteric fracture was fixed using dynamic hip screws. The fracture was united at 10 weeks. At one-year's follow-up, there were no graft-related complications. This case illustrates that an intertrochanteric fracture with a displaced lesser trochanter fragment can present acutely with bleeding and a pseudoaneurysm of the femoral artery.
Aged
;
Aneurysm, False
;
etiology
;
surgery
;
Femoral Artery
;
Hip Fractures
;
complications
;
surgery
;
Humans
;
Male
8.Long-term outcomes of ischaemic stroke patients with diabetes in a multi-ethnic cohort in Singapore.
Ei Zune THE ; Mei Yen NG ; Geelyn JL NG ; Bernadette GC ER ; Amy ML QUEK ; Prakash PALIWAL ; Leonard L YEO ; Bernard CHAN ; Vijay K SHARMA ; Hock Luen TEOH ; Eric YH KHOO ; Raymond CS SEET
Annals of the Academy of Medicine, Singapore 2021;50(1):16-25
INTRODUCTION:
Diabetes increases the risk of ischaemic stroke especially among Asians. This study aims to investigate contemporaneous long-term cardiovascular outcomes of ischaemic stroke patients with diabetes in a multi-ethnic Asian cohort.
METHODS:
Consecutive patients with ischaemic stroke were recruited from the National University Hospital, Singapore. Data on age, gender, ethnicity, risk factors (including diabetes status and body mass index [BMI]), stroke severity and mechanisms were collected. These patients were followed up until the day of the first cardiovascular event or July 2016, whichever was earlier. The primary endpoint was the time from enrolment to the first occurrence of a composite of cerebrovascular and coronary artery events.
RESULTS:
Between July 2011 and December 2013, 720 patients (mean age 60.6 years, 71% men, 43% with diabetes, median National Institute Health Stroke Severity scale 2) were enrolled and followed up. A total of 175 cardiovascular events occurred during a median follow-up of 3.25 years (6.90 events per 1,000 person-month), comprising 133 cerebrovascular and 42 coronary artery events. The adjusted hazard ratio of diabetes was 1.50 (95% CI 1.08-2.10). In a multivariable Cox proportional hazards model, Malay and Indian ethnicities, BMI <23kg/m2 and a prior diagnosis of diabetes were identified as independent predictors of recurrent cardiovascular events.
CONCLUSION
Our study provides quantitative data on the event rates of ischaemic stroke patients with diabetes. These findings provide insights on stroke predictors in a multi-ethnic Asian population, which may have implications in the design of future interventional studies.