In the developing world, there is still lack of accessibility and availability of adequate health care. In rural population this further gets limited, due to meager immediate resource at disposition and lack of availability of transports to adequate set ups. This cross-sectional study is undertaken among our rural patients who had undergone this treatment to understand what difficulties they had faced during such treatments and their acceptability toward such treatment. This study was undertaken with the aim to find out the acceptability and adaptability among the rural population for Ilizarov ring fixators.

The study consisted of 88 consecutive cases (91 lower limbs) of all age groups, who completed the treatment by Ilizarov methodology between July 2005 and July 2012. A retrospective analysis of the procedure was done through the medical records in terms of preoperative, intra­operative, and after the complete treatment. These were analyzed for limb lengthening in centimeters, correction of deformities, total wearing duration, and final outcome. Subsequently, these patients/parents were interviewed with a questionnaire to assess the self-accessibility (ease) toward self-care; self-distraction; self-adaptability–comfort during wearing time and the difficulties faced.

Overall the functional outcome was excellent in 18, good in 50, fair in 8, and poor in 4. Out of 91 patients, 67 (73.6%) followed up and could be evaluated for adaptability toward Ilizarov fixator. Overall, 91.04% were satisfied with the treatment by Ilizarov fixator. In the remaining the main reason for not accepting the Ilizarov method was difficulty in commuting in the public transport, ugly and threatening looks of fixator with so many wires crossing the leg.

Ilizarov method is a very effective tool for manag­ing the complex lower limb problems, especially among the population with low resources. It will ensure delivery of a very low-cost solution offered to the needy patients, wherein otherwise due to multiplicity of problems, integral solution is difficult to achieve within their resources.

Shrivastava S, Khan SM, Rathi R, Mundada G, Singh PK, Taywade S. Study on Outcome of Complex Lower Limb Problems treated by Ring External Fixator and Evolvement of Practices toward its Acceptability. J Med Sci 2017;3(2):35-40.

Cardiac disease in pregnancy is a major problem worldwide, particularly in developing countries. It often poses a difficult clinical scenario with the responsibility of the treating obstetrician also extending to the unborn fetus. In the present study, we aim to know the maternal and fetal outcomes in pregnancies complicated by cardiac disease.

All pregnant patients with cardiac disease who delivered at our institution during 2014 to 2016 were evaluated to look for the final pregnancy outcomes.

Out of 36 study cases, 44.44% had no maternal complications, while 88.89% had good fetal/neonatal outcome. The commonest maternal cardiac complication was sustained tachyarrhythmia/bradycardia followed by pulmonary edema, while intrauterine growth restriction was encountered in fetal outcome.

Multidisciplinary team management of cardiac disease, led by an experienced obstetrician and cardiologist, reduces the adverse outcomes in pregnancies complicated by cardiac diseases.

Sneha P, Sarojamma C, Nagarathnamma R. Cardiac Disease complicating Pregnancy: A Tertiary Care Center Experience. J Med Sci 2017;3(2):41-44.

Murthy KTV, Nadkarni MD, Amaranath N. Comparison of Efficacy of Different Doses of Clonidine with 0.5% Bupivacaine for Spinal Anesthesia in Lower Limb Orthopedic Surgeries. J Med Sci 2017;3(2):45-49.

Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality throughout the world. By 2020, the World Health Organization predicts that COPD will become the third leading cause of death and the fifth leading cause of disability worldwide. The COPD is a complex disease characterized by slowly progressive and largely irreversible airflow obstruction due to chronic bronchitis and emphysema and associated with systemic inflammation.

This study aimed to correlate the plasma levels of high-sensitivity C-reactive protein (hs-CRP) with severity of COPD and pulmonary function tests [PFTs; according to Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages] and find out the relation between hs-CRP levels and clinical parameters of age, number of pack years, and body mass index (BMI) of the patient.

A cross-sectional study of 102 male patients with clinically and spirometrically diagnosed cases of COPD was performed. Data on patient's demographic characteristics, pack years, BMI, PFTs, and hs-CRP were analyzed.

A total of 76 of the patients had moderate airflow obstruction (GOLD stages II and III), mild airflow obstruction was present in 14 patients (GOLD stage I), and 12 patients had severe airflow obstruction (GOLD stage IV). The hs-CRP was normal in 6 patients, while it was raised in 96 patients. The value of hs-CRP was correlated with age, pack years, BMI, and GOLD stages. There was a significant negative correlation between hs-CRP and BMI and a significant positive correlation between hs-CRP and age, pack years, and GOLD stages.

A raised level of CRP in COPD indicates reduced lung function; it plays an important role in systemic inflammation. This study supports the role of hs-CRP as a simple, cost-effective biochemical marker in the staging and determining the severity of COPD other than spirometry.

Patil MB, Abhishek M, Pradeep BK. Role of High-sensitivity C-reactive Protein as a Predictor of Severity of Chronic Obstructive Pulmonary Disease in Correlation with Clinical Parameters. J Med Sci 2017;3(2):50-54.

Diabetes mellitus is a common metabolic disorder. Prevalence of diabetes is increasing globally and it is one of the major health problems of the 21st century. The disturbance in serum magnesium (SMg) has been reported among patients with type II diabetes mellitus. Hypomagnesemia has negative impact on glucose homeostasis and insulin sensitivity in patients with type II diabetes mellitus.

This study was undertaken to know the prevalence of hypomagnesemia in patients with type II diabetes mellitus and its relation with glycated hemoglobin (HbA1c). The study was conducted on 200 patients with type II diabetes and 100 healthy controls at RajaRajeswari Medical College & Hospital, Bengaluru.

Out of 200 diabetic patients, 115 (57%) had hypomagnesemia. We observed mean SMg (1.7 mg) significantly low in diabetic patients compared with controls (2.1 mg). We also found HbA1c was high (9%) in hypomagnesemia patients. We found that diabetic hypomagnesemic patients had high mean fasting blood glucose (242.6 mg%) and postprandial blood sugar (313 mg%) than controls.

Rekha NH, Bharath MS, Channakeshava SP. Study of Prevalence of Hypomagnesemia in Patients with Type II Diabetes Mellitus. J Med Sci 2017;3(2):55-58.

Vidyashree J, Patil MB. Posterior Circulation Ischemic Stroke. J Med Sci 2017;3(2):59-61.