Current Issue Volume 29, Number 2 , April-June 2018

EDITORIAL
Henry Prakash

Expnding PM&R: Ideas to ponder

[Year:2018] [Month:April-June] [Volumn:29 ] [Number:2] [Pages:30] [Pages No:iv]



One of the largest industries in the world is the healthcare industry. Indian healthcare system is experiencing 22-25% growth in medical tourism and is expected to double its size from present to US$ 6 billion in a year or two (Indian brand equity foundation). 20-25 years have been added to the average life span of Indians in the last 50 years. More people are going to need our care and services. I don’t see any dearth for patients or competition for mere survival, both in the corporate and other health sectors. The pressures of our work and economy will help create new models of health care and rehabilitation to evolve for better care with effective outcomes.


ORIGINAL ARTICLE
Vishal A Chafale, Alak Pandit, Satish A Lahoti, Tajendranath Kundu, Goutam Ganguly

Guillain–Barré Syndrome: Profile of 120 Patients with respect to Response to Various Modalities of Treatment

[Year:2018] [Month:April-June] [Volumn:29 ] [Number:2] [Pages:30] [Pages No:31-36]



Introduction: Guillain-Barré Syndrome (GBS) is an inflammatory polyradiculoneuropathy with varied clinical manifestation and often dismal prognosis if not promptly treated. Recommended treatment modalities [intravenous immunoglobulin (IVIG) and plasma exchange (PE)] are costly and the role of steroids is controversial.

Materials and methods: In this study, we reviewed the clinical and laboratory findings of consecutive patients with GBS (n = 120) and explored factors associated with outcome. We also compared response to different modalities of treatment including steroids.

Results: There was no significant difference between the treatment outcomes of IVIG and PE and we found a nonsignificant trend toward improvement with intravenous (IV) steroid. We observed 4.17% mortality and most common cause of death was respiratory failure.

Conclusion: Increasing age, delay in starting treatment, early peak disability, autonomic dysfunction, bulbar weakness, and reduced compound muscle action potential (CMAP) were associated with a poorer outcome. Group of patients treated with IVIG and plasmapheresis showed more improvement than the IV methylprednisolone group.

Keywords: Clinical profile, Guillain-Barré syndrome, Intravenous steroid, Prognosis, Treatment.

How to cite this article: Chafale VA, Pandit A, Lahoti SA, Kundu T, Ganguly G. Guillain-Barré Syndrome: Profile of 120 Patients with respect to Response to Various Modalities of Treatment. Indian J Phy Med Rehab 2018;29(2):31-36.

Source of support: None

Conflict of interest: None


ORIGINAL ARTICLE
Dinesh Kumar, Sunil K Raina, Ashok K Bhardwaj

Explaining the Variability of Responses to an Abridged Version of International Classification of Functioning, Disability, and Health Tool in Community Settings of Northern India

[Year:2018] [Month:April-June] [Volumn:29 ] [Number:2] [Pages:30] [Pages No:37-42]



Introduction: The International Classification of Functioning, Disability and Health (ICFDH) gives a valid assessment for assessing the extent of impairment, level of capacity, performance, and functions along with the role of the environment. In the current study, an abridged version of ICFDH was developed and studied for its applicability in the general population for quantification along with summarizing the pattern of correlations among observed variables.

Materials and methods: Descriptive study was carried out among 72 (36 in rural and urban area each) subjects with a response to 20 variables on 14 areas of the ICFDH. Principal component analysis (PCA) using R studio package (version 3.4.4) was done to detect a set of variables forming coherent subsets that are independent of each other.

Results: Study subjects had mean age of 35 [standard deviation (SD) ± 5.4] years and 58.0% were males. The average score indicates mild level of impairment, mildly and moderately affected performance and capacity for learning and applied knowledge, and communication. Environmental support was observed with an average score of 2.78 for products and technology, 3.47 for supports and relationships, 3.42 for attitude toward others, and 3.29 for services, systems, and platforms. Sizes of correlation were significant in the matrix, with statistically significant Bartlett’s test of sphericity (p=0.00) with good factorability (Kaiser-Meyer=0.76). First two components explains maximum (55.0%) of variance with high loading of 15 variables on the first principal component.

Conclusion: Included variables are observed to be coherent with the theoretical construct of the ICFDH, and the study tool is quite feasible to administer in community-based settings.

Keywords: Community, Correlation, Feasibility, International Classification of Functioning, Disability and Health.

How to cite this article: Kumar D, Raina SK, Bhardwaj AK. Explaining the Variability of Responses to an Abridged Version of International Classification of Functioning, Disability, and Health Tool in Community Settings of Northern India. Indian J Phy Med Rehab 2018;29(2):37-42.

Source of support: Nil

Conflict of interest: None


ORIGINAL ARTICLE
Mohit Kataruka, Mandeep Saini, Manas Pattnaik

Demographic Profile of Sports Injury among Cadets of National Defence Academy, Pune, Maharashtra, India

[Year:2018] [Month:April-June] [Volumn:29 ] [Number:2] [Pages:30] [Pages No:43-46]



Introduction: Injuries are recognized as a leading health problem in professional physical training. Many of these involve physical damage caused by microtrauma (overuse) in recreation, sports, training, and job performance. The National Defence Academy (NDA) is one of the precious training institutions of India. During 3 years of vigorous physical training, cadets undergo different musculoskeletal injuries. The purpose of this study was to determine the incidence of training-related musculoskeletal injuries and to classify different injuries.

Materials and methods: This retrospective case-control study was conducted at the NDA, Khadakwasla, Pune, India, from January to December 2017. All the cadets who reported sick with musculoskeletal problems were included in the study depending on inclusion and exclusion criteria. Injury profile of the cadets with which activity and how they got the injury was noted. After giving basic first aid, definitive treatment was prescribed.

Results: Male cadets between the age group of 17 and 21 years were included. Most of the injuries occurred during the early phase of training. Most common injury among cadets are knee contusion (16.23%) followed by low back ache (11.67%). Percentage of stress fracture is quite high, 14%, and mostly seen in 2nd term cadets. The incidence of upper extremity injury compared with lower extremity is 11.85%. Inflammation and pain (overuse) were the largest injury type category, including 80.03% of all injuries.

Conclusion: Considering the magnitude of training injuries in physical training, there is a substantial amount of work that remains to be performed, especially in the areas of surveillance, prevention, and treatment.

Keywords: Injury profile, Military training, National Defence Academy.

How to cite this article: Kataruka M, Saini M, Pattnaik M. Demographic Profile of Sports Injury among Cadets of National Defence Academy, Pune, Maharashtra, India. Indian J Phy Med Rehab 2018;29(2):43-46.

Source of support: Nil

Conflict of interest: None


ORIGINAL ARTICLE
Deepak Kumar, Virinder S Gogia

Prevalence of Overweight and Obesity among Adolescents in an Urban North Indian School: A Cross-sectional Study

[Year:2018] [Month:April-June] [Volumn:29 ] [Number:2] [Pages:30] [Pages No:47-52]



Introduction: Obesity and overweight have grown into a worldwide epidemic. Adolescents with overweight or obesity grow into obese adults. Hence, there is an urgent need to examine adolescents for obesity and overweight across countries and identify predisposing factors to check the menace of lifestyle diseases in adulthood.

Aims and objectives: In the present study, we have investigated the prevalence of obesity and overweight and their association with risk factors like gender, height, weight, body mass index (BMI), physical activity, eating habits like junk food, and family history of noncommunicable diseases (NCDs) and obesity.

Materials and methods: The study was carried out in a local public school in Chandigarh. Seventy-five school-going children of standard VIII to X were questioned and physically examined. Eating habits and lifestyle factors were enquired into, using a questionnaire and physical examination. Obesity and overweight were considered using Centers for Disease Control and Prevention, USA (CDC, USA) Gender-specific BMI-for-Age charts.

Results: Age-adjusted prevalence of overweight was found to be significantly correlated to female gender. Adolescent overweight and obese states were found to be significantly correlated with positive family history of lifestyle diseases.

Conclusion: Our study suggests that the children at risk be identified early and encouraged to adopt healthy lifestyle practices. India needs to develop standard BMI cut-off percentile charts for underweight/healthy weight/overweight/obese for Indian children and adolescents.

Keywords: Adolescent, Body mass index, Cardiovascular disease, Diabetes mellitus, Hypertension, North India, Obesity, Overweight, Schoolchildren, Waist-hip ratio.

How to cite this article: Kumar D, Gogia VS. Prevalence of Overweight and Obesity among Adolescents in an Urban North Indian School: A Cross-sectional Study. Indian J Phy Med Rehab 2018;29(2):47-52.

Source of support: Nil

Conflict of interest: None


CASE REPORT
Vasanthi K Sreekala

Disability Limitation in Elephantiasis

[Year:2018] [Month:April-June] [Volumn:29 ] [Number:2] [Pages:30] [Pages No:53-55]



Elephantiasis, a chronic irreversible lymphoedema of the extremities, commonly involving legs, is caused due to obstruction of lymphatic vessels by microfilariae of Wuchereria bancrofti, Brugia malayi, and Loa loa. Two of our patients of age 56 and 58 years presented with elephantiasis. One patient was bed-bound while the other patient used to manage ambulation. Both of them were advised to undergo reconstructive surgery which the ambulatory patient refused. After 5-stage surgical correction and postsurgical rehabilitation, the bedbound patient started walking with a walker 3 months after the last surgery and became independently ambulant after 6 months.

Keywords: Elephantiasis, Filariasis, Postsurgical rehabilitation

How to cite this article: Sreekala VK. Disability Limitation in Elephantiasis. Indian J Phy Med Rehab 2018;29(2):53-55.

Source of support: Nil

Conflict of interest: None


MISCELLANEOUS
Firdaus Kamal

Pictorial Continuing Medical Education

[Year:2018] [Month:April-June] [Volumn:29 ] [Number:2] [Pages:30] [Pages No:56]



A young boy presented in PMR OPD with a right forefoot pain along with difficulty to walk especially on his way back from school. On inspection it has been noticed that he has a hammer second toe in his right side (Fig.1). On palpation it has been found that he is also suffering from metatarsalgia. On further evaluation, it was noticed that his second toe was longer than his great toe, though great toe should be the longest one anatomically. He was also complaining of difficulty to accommodate his second toe in his school shoes and suffering from forefoot pain in the second half of school hours.


MISCELLANEOUS

Medical Philately

[Year:2018] [Month:April-June] [Volumn:29 ] [Number:2] [Pages:30] [Pages No:57]



Here is an image of a semi-postal stamp depicting an invalid in a wheelchair, designed by Frank Mahon, engraved by Arne Kühlmann, and issued by Denmark on May 6, 1976 to benefit the Foundation to Aid the Disabled, Scott No. B55, Facit No. 653.


MISCELLANEOUS

Postgraduate Forum

[Year:2018] [Month:April-June] [Volumn:29 ] [Number:2] [Pages:30] [Pages No:58-61]



1. David X. Cifu Henry L Lew. Rehabilitation Care: A Clinical Handbook, 1st Edition, Elsevier, June 2017.


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