Introduction: Young paramilitary recruits, who undergo strenuous exercise during basic training, are often presented with stress fractures, which could be due to an inadequate vitamin D (25-hydroxyvitamin D) intake. This study aimed to find the prevalence of stress fracture among young paramilitary trainees visiting the orthopedic outpatient department of a paramilitary hospital. Methods: This was a descriptive cross-sectional study done among paramilitary trainees in a paramilitary Hospital of Nepal between April 2019 to April 2021. The study was approved by the Ethical Review Board (Reference number: 1003) of the Nepal Health Research Council. Convenience sampling was used. Anthropometric variables, serum 25-hydroxyvitamin D level, and bone mineral density of spine and hip were determined. Data analysis was performed using the Statistical Package for the Social Sciences software version 17.0. Point estimate at 95% Confidence Interval was calculated along with frequency, proportion for binary data and mean, standard deviation for continuous data. Results: Among 417 young paramilitary trainees, 24 (5.76%) (3.52-7.99 at 95% Confidence Interval) were found to have a stress fracture. The stress fracture patients had a serum 25-hydroxyvitamin D level of 21.47ng/mL±6.98. Similarly, the bone mineral density value of the spine and hip among the patients was -1.34g/cm2±1.37 and 0.36g/cm2±1.24, respectively. Conclusions: The prevalence of stress fracture among young paramilitary trainee was high compared to previous studies. Additionally, average Vitamin D and the bone mineral density value of the spine and the total hip among stressed fractured patients were also low.
Introduction: Tympanoplasty is the procedure of choice for surgical correction of tympanic membrane perforation triggered by either chronic otitis media or trauma. Various types of autologous grafts have been used to close tympanic membrane perforations among which temporalis fascia and tragal cartilage are preferred, due to their anatomic proximity, ease of harvesting and suppleness. Aims: To compare clinical and audiological outcomes of type 1 tympanoplasty where temporalis fascia and tragal cartilage were used as the graft material. Methods: A prospective study was conducted on 50 patients of ages ranging from 10 to 50 years with Chronic Otitis Media - Mucosal. All the patients underwent type 1 tympanoplasty and were categorized into Group-A (Temporalis fascia graft) and Group-B (Cartilage graft), each group comprising of 25 patients. Graft uptake rate, hearing gain and air bone gap closure were compared between the groups in 4 and 8 weeks after surgery. Results: Out of total 50 patients, 20 were male and 30 were female. The average age of the patients was 28.20 years. The total hearing gain in the whole series was 14.94 dB while the total air bone gap closure was 14.78 dB respectively. The difference between pre and post-operative hearing was statistically significant for both air bone gap and air conduction, (P<0.05) in the whole series. There was 15.56 dB improvement in mean hearing threshold and 15.64 dB mean air bone gap closure in the fascia group, compared to 14.32 dB improvement in mean hearing and 13.92 dB mean air bone gap closure in the cartilage group. Graft uptake rate in the temporalis fascia group was 84% and the cartilage group was 92 % with significant difference in the graft uptake rate between the groups. Conclusion: The graft uptake rate and hearing results of tragal cartilage are comparable to those of temporalis fascia. Cartilage tympanoplasty has a higher graft uptake rate with low failure rate and also shows a high degree of reliability in high risk cases. Both cartilage and fascia tympanoplasty provided similar improvements in the hearing outcome post-operatively. Thus, cartilage tympanoplasty is recommended as an alternative option.
Introduction: Hearing impairment is the most common congenital abnormality that occurs in 1 to 4/1000 newborns. It has a profound effect on their optimal development of language, speech and cognitive skill. Early detection in order to achieve effective treatment is essential. An association between low birth weight and hearing loss is commonly associated with multiple risk factors that can alter hearing in a synergistic fashion. Universal neonatal hearing screening programs have become widely implemented aiming for the screening, confirmation of the diagnosis and intervention by 1, 3 and 6 months respectively. Transient Evoked Otoacoustic emissions is one of the test found to be a quick, objective, non-invasive, accurate and easy test for early detection of this problem. Aims: Early detection of hearing loss in neonates focusing on low birth weight for early optimum rehabilitation. Methods: A comparative case control study conducted in 100 neonates under 2 groups. 50 neonates with low birth weight and 50 with normal birth weight who were born at NGMCTH, Kohalpur. Their hearing evaluation was done with Transient Evoked Oto Acoustic Emission (TEOAE). Results: The total referral rate was 12 % and pass rate was 88 %. The referral rate in LBW group was 20 % and 4 % in normal weight neonates. The pass rate in low birth weight was 80 % and 96 % in normal weight babies. Conclusion: Hearing impairment is a severe consequence in neonates with low birth weight. To decrease the economic and social burden of effects of hearing loss, it is assumed that newborn screening can immeasurably improve the future of newborn with early rehabilitation.
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