Bone island or enostosis is an enigmatic lesion affecting the skeleton system. As these anomalies have limited clinical implications owing to an asymptomatic course with most cases diagnosed incidentally, the exact etiopathogenesis is not clearly understood. A lot has been studied regarding radiological features and morphology despite scarce clinical cases and relevant studies. More research is warranted to provide in-depth details of these lesions that has potential to enlighten us with newer aspects of bone metabolism and properties. These lesions might just not be an aberration and may offer important clues about bone behavior and morphogenesis. Bone islands, when in large number, are associated with equally fascinating disorder called osteopoikilosis. This review, however, does not include osteopoikilosis on purpose. Hand involvement, although rarer, has been described and a short review is attempted to acknowledge that apart from relevant facts on diagnosis and management.
Background -In the era of evidence based medicine, correct and relevant information should accompany any broadcast of pharmaceutical related knowledge. A substandard piece of information has potential for negative impact on care-giver and patient at large. The claims about any pharmaceutical agent with respect to its action, complications or superiority over other ones should be based on strong level of evidence for better knowledge that is aimed at positive impact on judicious decision making and good outcome of therapy. It is thus important that periodic assessment of claims made by promotional materials should be done to ensure their validity and not rely on marketing noise. A detailed study of drug promotion materials collected in orthopaedic out-patient department within a period of four months (Oct 2015 to Jan 2016) was done with special attention to presence, quality and validity of information or claims made within it. 238 random materials were collected in a defined period, out of which 120 excluded in first and 72 in second evaluation. The remaining 46 materials with 65 references in total were part of study. The references were searched over world wide web for its validity, ease of availability and correctness. Majority (26, 56.52%) of the materials were without proper references. Most of the references were about mechanism of action followed by superiority to other drugs. There was deficiency in the presented references including lack of author name, wrong volume of journal or problem with easy identification over net in most references (32, 49.23%). Pain medication were followed by antibiotics and calcium related agents in number of references present. The wrong referencing and difficult to trace the source were leading problems noted on online assessment. The quality of promotional material should quote well substantiated evidence about mechanism of action, superiority and rationale of its use. The evidence thus garnered should be of highest level or from standard reference text book. The preferable use of digital object identifier (doi) is advisable for better search of the articles to check on internet. For ease of quick navigation through referencing articles use of technology like quick response (QR) codes may be considered in the future.Keywords: promotional literature, drug marketing, orthopaedics, education, evidence, references Introduction Evidence based medicine has been a buzzword in recent times and becoming a significant issue in patient management by providing effective guidance and education to the care-giver. The doctors have traditionally been kept informed and updated about latest developments in pharmaceutical world with special regard to newer drugs and their role in various ailments by medical representatives. Direct to physician (DTP) marketing has been the traditional way of drug promotion across the globe. The print materials have been an important vehicle of correspondence in this regard. Changing times have witnessed adoption of recent technologies like web based p...
Aim: to evaluate the role of serial CRP evaluation in the diagnosis of neonatal sepsis. Materials and Methods: The present prospective observational study was conducted in the Department of Pediatrics, Darbhanga Medical College and Hospital, Bihar for the period of 1 year. A total of 97 neonates suspected of sepsis having birth-weight >1,500 g constituted the study population. CRP was measured from the serum by quantitative turbidimetric immunoassay. The CRP 1 level was measured at the time of clinical presentation; CRP 2 and CRP 3 were measured at 24 and 48 hours respectively. Results: In the present study out of total 97 subjects, there were 59 (60.8%) males and 38 (39.2%) females. CRP was found positive in 60 cases. In the present study, lethargy (100%), decreased activity (100%), poor feeding (94.7%), poor cry (94.7%), tachypnea (89.5%), hypotonia (47.4%), hypothermia (31.6%), convulsion (26.5%), prolonged CFT (21.1%) and fever (10.5%) were the various symptoms observed. Conclusion: Serial CRP measurements are useful in the diagnosis of neonatal sepsis. CRP 3 level may virtually rule out or rule in the diagnosis of neonatal sepsis, and has very good correlation with blood culture. Keywords: CRP, Sepsis, Neonates
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