Introduction:Decompressive craniectomy as a surgical treatment for brain edema has been performed for many years and for several different pathophysiologies, including malignant middle cerebral artery (MCA) infarct. The purpose of this article was to share author's experience with decompressive craniectomy in malignant MCA infarct with special emphasis on patients older than 60 years and those operated outside 48 h after onset of stroke.Materials and Methods:Totally, 53 patients who underwent decompressive craniectomy after malignant MCA infarction between January 2012 and May 2014 at tertiary care hospital were analyzed for preoperative clinical condition, timing of surgery, cause of infarction, and location and extension of infarction. The outcome was assessed in terms of mortality and scores like modified Rankin scale (mRS).Results:Totally, 53 patients aged between 22 and 80 years (mean age was 54.92 ± 11.8 years) were analyzed in this study. Approximately, 60% patients were older than 60 years. Approximately, 74% patients operated within 48 h (25 patients) had mRS 0–3 at discharge while 56% patients operated after 48 h had mRS 0–3 at discharge which is not significant statistically. 78% patients aged below 60 years had mRS 0–3 at discharge while only 38% patients aged above 60 years had mRS 0–3 at discharge which was statistically significant (P < 0.008).Conclusion:Decompressive craniectomy has reduced morbidity and mortality especially in people aged below 60 years and those operated within 48 h of malignant MCA stroke though those operated outside 48 h of stroke also fare well neurologically, there is no reason these patients should be denied surgery.

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56-year-old man presented to us with progressive weakness of upper and lower limbs. He had gradually progressive neurological deterioration in the form of quadriparesis. MRI was suggestive of cervical cord SOL. The clinical, radiological, and surgical findings are discussed together with a brief critical review of the literature. The patient had no other associated anomalies. The intradural extramedullary component of cyst was removed totally with debulking of intramedullary part with good neurological recovery. The clinical presentation was rather atypical for neurenteric cyst. Neurenteric cyst should be considered in the differential diagnosis of an intradural mass lesion regardless of the age, clinical presentation or location of the lesion. HOW TO CITE THIS ARTICLE:

Background: Childhood obesity has reached epidemic levels in developed countries. Overweight and obesity in childhood are known to have significant impact on both physical and psychological health. The mechanism of obesity development is not fully understood and it is believed to be a disorder with multiple causes. There are supporting evidence that excessive sugar intake by soft drink, increased portion size and steady decline in physical activity have been playing major role in the rising rates of obesity all around the world. The aim of this study was to compare the obesity status of children (5-18 years) from the upper and middle socio-economic class.Methods: 400 children (200 boys and 200 girls) in the age group of 5-18 years from upper and middle socio-economic status (According to the modified version of Kuppuswamy’s socio-economic status scale) were selected as subjects for this study. Weight and height were measured in minimum acceptable standard clothing without shoes and socks and BMI was calculated. Because there are changes in body weight and height with age, BMI levels among children and teens need to be expressed relative to other children of the same age and sex. Number of children in each BMI-for-age-percentile-range were calculated. By using chi–square test an association of overweight/obesity with socio-economic class was studied in children.Results: The prevalence of overweight/obesity was more in upper socio-economic class boys in comparison with middle socio-economic class boys, more girls from upper socio-economic class were overweight/obese in comparison with middle socio-economic class girls and more girls were obese in comparison to boys from upper socio-economic class.Conclusions: The primary prevention could be the key plan for controlling the current epidemic of obesity and these strategies seem to be more effective in children than in adults.

Premenstrual syndrome (PMS) also called PMT or premenstrual tension refers to the cyclic recurrence of a combination of distressing physical, psychological or behavioural changes, during the luteal phase of the menstrual cycle. It is suggested that there is altered autonomic activity in the late luteal phase of their endometrial cycle. Practice of breathing exercises like pranayama is known to improve autonomic function by changing sympathetic or parasympathetic activity. AIMThe aim of study was to investigate the role of pranayama on blood pressure and heart rate in premenstrual syndrome. MATERIAL AND METHODSIn this study, 50 females suffering from premenstrual syndrome between the age group 18-45 years having 28 to 34 days regular menstrual cycle were taken as subjects. In all the subjects, a baseline recording of heart rate, systolic blood pressure, diastolic blood pressure was done. Subjects were divided into 2 groups (Group A-control group, Group B-study group); subjects in group B underwent 3 months pranayama training. After 3 months, recording of HR, SBP, DBP in both the groups was again done. RESULTS AND CONCLUSIONSThis study suggests that subjects in Group B have better control over their symptoms associated with PMS. We observed that in Group B, parameters showed a significant reduction when compared with their basal levels. Also the subjects in Group B showed significant reduction in high basal sympathetic activity in comparison with Group A.