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The studies conducted a decade ago showed that the Ponseti method, suffers from many execution-related issues-particularly in low and middle-income countries including poverty, physical distance, lack of transportation etc. The society has undergone many changes, including improvements in literacy, connectivity (both transport and digital), etc., in the last decade. Therefore, this study is designed to identify the contemporary apprehensions, concerns, and challenges of parents seeking CTEV treatment for their child through the Ponseti Method in India. A descriptive cross-sectional study of 200 parents of the children undergoing treatment at a multi-specialty hospital is carried out using an interview guide. The semi-structured interviews were conducted telephonically and recorded. The statistical analysis shows that a male child is presented late than a female child. The physical distance is associated with child discomfort during the casting and bracing phase, with the travel method affecting the follow-up. The increase in travel time may result in increased casts due to a lack of regular follow-up. Parents' income level is also strongly associated with regularity of follow-up and child discomfort during treatment. The patients traveling long distances in public transport are the most vulnerable group regardless of gender. The children in such cases are more likely to experience discomfort during the casting and bracing phase with a lack of regular follow-up. Expert doctors and brace unavailability in the local area remain vital challenges for the parents. [ABSTRACT FROM AUTHOR]

Hearing loss has long been associated with congenital hypothyroidism and, if not noticed and treated early, may result in delayed language acquisition and difficulties in comprehension. In light of the implications of congenital hypothyroidism and its associated hearing loss, we decided to conduct this study. The aim of this study was to identify the prevalence of hearing loss in congenital hypothyroidism and its relation to the severity of the disease and age of initiation of treatment. This study was conducted from July 2016 to June 2021 at a tertiary care hospital in Bhopal. The hearing status of congenital hypothyroid children and matched controls was assessed by pure tone audiometry or free field audiometry and, in selected cases, with brainstem evoked response audiometry. Eight children (25%) with congenital hypothyroidism had hearing loss, compared to one (3.12%) in the control group (p < 0.05). No statistically significant difference has been found in the gender, mean age of diagnosis, mean age of initiation of levothyroxine treatment, mean screening FT4 levels, and mean screening TSH levels between congenital hypothyroid children with and without hearing loss. Due to the high prevalence of hearing loss in congenital hypothyroidism and its impact on language and cognitive development, it is critical to create awareness among healthcare professionals that children diagnosed with congenital hypothyroidism must undergo audiological evaluation at the time of diagnosis and periodically thereafter. Alternatively, children with unexplained hearing loss must be screened for congenital hypothyroidism. [ABSTRACT FROM AUTHOR]

BACKGROUND: Self-reported food allergy is very common in asthmatics and hence these food items are frequently avoided by the patients. Food allergy is defined as an adverse immunological response to a dietary protein. Skin prick test (SPT) is a sensitive tool for identifying the presence of specific immunoglobulin E antibodies that can be associated with acute allergic reactions. However, sensitization often exists without clinical consequences, and at the same time, self-reported food allergens are frequently negative on SPT. The purpose of our study was to assess the clinical relevance of self-reported food allergy and the role of SPT in identifying food allergies in patients with bronchial asthma. METHODOLOGY: One hundred bronchial asthma patients were screened for this study, and skin prick testing for 22 food allergens frequently consumed in India, particularly Northern India was performed. RESULTS: A total of 36 subjects reported perceiving precipitation or an increase in severity of the asthmatic symptoms by one or more food items, and the most common food items mentioned in history were curd in 24%, rice in 19%, citrus fruits such as lemon in 14%, orange in 14%, banana in 8%, cold drinks in 16%, and ice creams in 16%. There were 68 patients negative for food allergens by SPT (food allergen negative [FAN] group) and 32 patients were positive (Food allergen Positive [FAP] group). Out of 36 asthmatics with self-reported food allergy, none was found to be SPT positive to the reported food allergens. However, 50% of patients with self-reported and only 21.9% with no history of food allergy were positive to one or more food allergens. Further, FAP group patients were tolerating these foods without any trouble or exacerbation of symptoms. Among the FAP group, 96.9% of patients had positive SPT for one or more other allergens also such as insects, pollens, fungi, or other aeroallergens. Only one patient had isolated food allergy by SPT. It implies that isolated food allergy is very rare in asthmatic patients. Common food allergens found positive by SPT were black gram in 12%, followed by red gram 9% and bengal gram, rice, and Baker's yeast 7% each. CONCLUSION: We concluded that the prevalence of food allergy in India among asthmatic adults though high, has a very poor correlation between patient's history of food allergens that is perceived as a precipitating or exaggerating factor for symptoms and actual sensitization as elicited by SPT. At the same time, there is high nonspecific food sensitization in self-reported patients as compared to those with no history of any perceived food allergy. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to examine effects of usage and demographics on damage to the Jaipur Foot prosthesis as well as the epidemiology and etiology of amputations performed at Santokba Durlabjhi Memorial Hospital (SDMH) in Jaipur, India. Design: Total time spent standing, total time spent wearing and total distance walked were compared against severity and location of damage to the prosthesis. Time between initial fitting and follow-up visit for damaged prosthetic was also considered in this analysis. A novel damage severity scale based on prosthesis functionality is presented along with a damage location legend. Results: Patients from 10 different states and two territories throughout India were included in the study. No main effects were found to be statistically significant in predicting severity or location of damage. Only the interaction between a patient’s total time spent standing and their total time spent wearing the prosthesis as well as the interaction between a patient’s total time spent standing and total distance walked was significant in predicting location of damage to the Jaipur Foot (p = .0327, p = .0278, respectively). Conclusions: The lack of significant usage factor effect on damage severity or location could support previous findings that lack standardization in materials and manufacturing processes, which is the major drawback of the Jaipur Foot. Implications for Rehabilitation: The Jaipur Foot is a safe, reliable and stable product as no abrupt breakage or sudden falls causing injury to the patient were noted. Hence, it is a safe rehabilitation device for lost limbs. The population can squat and sit cross-legged while wearing the prosthetic foot and it does not affect damage severity or location of damage, allowing for these activities to be performed while rehabilitating. The manufacturing of the foot needs to be standardized to improve life of foot. Total time spent standing, total time spent wearing and total distance walked were not predictive of severity or location of damage to the prosthesis, hence providing patient guidelines for activity during rehabilitation. [ABSTRACT FROM AUTHOR]

The author analyzes the present state of orthopedic services and education in India and suggests remedial solutions. He cites the poor surgeon-patient ratio where there are approximately 20,000 orthopedic surgeons available catering to about 1,250 million population with the orthopaedic surgeon population ratio getting worse in rural India. He also notes the poorly trained first responder to musculoskeletal emergencies and the scarcity of hospital settings in the rural areas.

Background: Allergic bronchopulmonary aspergillosis (ABPA) is characterized by an allergic inflammatory response to colonization by Aspergillus species, most commonly Aspergillus fumigatus., Aim: To study the prevalence of ABPA in asthmatic patients presenting to our institute., Materials and Methods: All consecutive asthma patients attending our allergy clinic Out Patient Department (OPD) over a period of 20 months were tested with skin prick test (SPT) for Aspergillus antigens and those who were found positive were further evaluated for ABPA using Greenberger's criteria., Results: Seventy consecutive asthmatic patients were screened by SPT using Aspergillus antigens. Thirteen patients (18.57%) were found to be SPT positive, out of which nine patients (12.9%) were diagnosed as having ABPA using Greenberger's criteria. ABPA was common among 25-35 age group with no gender predilection. ABPA patients had longer duration of illness, predominantly mixed pattern in PFT, higher mean absolute eosinophil count (AEC) and serum total IgE compared to non-ABPA asthmatic patients. Specific IgE for A. fumigatus was positive in all ABPA patients and serum precipitins were positive in seven patients (77.58%). Chest X-ray abnormalities were seen in five patients (55.6%) and HRCT showed central bronchiectasis in eight patients (88.9%) with varying other radiological features. None were sputum fungal culture positive and five patients (55.6%) have been misdiagnosed as pulmonary tuberculosis in the past., Conclusion: The prevalence of ABPA is significantly higher in bronchial asthma patients presenting to tertiary care centers and hence awareness is required among physicians for early diagnosis and management of ABPA to achieve better asthma control and to avoid permanent lung damage., (Copyright © 2018. Published by Elsevier B.V.)

Multifocal skeletal tuberculosis is an uncommonly reported entity, Unanimity on terminology is lacking in the literature. The article presents a series of 18 such patients encountered in our institution. All the patients were below 15 y of age. Male to female ratio was 13:5. Most of the cases presented with swellings, discharging sinuses and/or ulcers. Appendicular involvement was seen in 17 of these cases. All the cases were diagnosed histopathologically as tuberculosis. All the cases were treated with multi-drug anti-tubercular therapy with additional procedures such as incision and drainage or sinus tract curettage performed in 9 of the patients. All the lesions healed. Their clinical behaviour, result and outcome are analysed with available international literature.