Background:Inferior turbinate hypertrophy is one of the most common causes of nasal blockage for patients to seek an otorhinolaryngologist, who is often seen in cases of allergic rhinitis, nonallergic rhinitis with eosinophilic syndrome, or iatrogenic rhinopathy. Although most cases of ITH can be managed medically but surgical intervention sometimes becomes necessary in certain non-responding patients which are managed by Submucous Inferior Turbinate Reduction (ITR) surgery. Large variation in surgical techniques available denotes lack of consensus on optimal technique. With advent of Microdebrider to Rhinosurgery by Setliff et al., many surgeons have recently started using microdebrider for the same indication.Aim: To compare the outcome following submucosal Inferior turbinate reduction using microdebrider and diathermy. Methods and results: A prospective interventional comparative clinical study between Submucosal inferior turbinate reduction using microdebrider (SITRM) and submucosal inferior turbinate reduction using diathermy (SITRD) was conducted. A total of 150 patients were included in the study. Patients were evenly randomized into Pool A and Pool B by chit allocation technique. Patients in pool A underwent SITRD and in pool B underwent SITRM. Comparisons were made between pre and post-operative NOSE score, endoscopic inferior turbinate size and mucociliary transit time and possible complications from both techniques and result were statistically significant in SITRM. Conclusion:To conclude submucosal resection with microdebrider produce better results in the treatment of inferior turbinate hypertrophy, both in the short term and long term compared to the submucosal diathermy, where the latter produce comparable results in the early postoperative period. Limitation of this study was that different etiological causes for inferior turbinate reduction were not taken into consideration and ITH due to any cause were included in the study irrespective of its cause. Another limitation of this study was that objective method of nasal patency assessment like rhinomanometry were not used due to cost restrains. A more elaborate larger randomized studies with use of rhinomanometry would definitely be helpful to confirm or refute the same.

Introduction: India is a country where many religions coexist together. Prayer & meditation form an integral part of Indian lifestyle. Also 90% of India's population lives in the rural areas. Medial compartment osteoarthritis is the most common type of arthritis in India. Total knee replacement has longer rehabilitation time, morbidity and cost. In addition, it doesn't allow squatting and sitting cross legged. With rise in unicondylar knee replacements for medial compartment osteoarthritis, patient's satisfaction is much higher. Hypothesis of this paper was to investigate whether sitting cross-legged easily on floor for prayer and meditation, contributed to higher levels of patients satisfaction in unicondylar knee replacement significantly. Material & Methods: this retrospective study was done with study population of 36 patients of which, 33 knees of unicondylar knee replacement (mean age 61.7) and 25 knees of total knee replacement (mean age 63.5). We used modified Oxford knee score to compare the functional outcome and Likert scale for grading the patient's satisfaction level. Results: study outcome after unicondylar knee replacement was extremely satisfactory for all patients measured with modified Oxford knee score and is better than total knee replacement. The mean Oxford score for 33 knees with unicondylar knee replacement is 47.18 and for 25 knees with total knee replacements is 46.35. But viewing by satisfaction index point of view, patients are highly satisfied with unicondylar knee replacement because of ability to squat and sit cross-legged used for praying and meditation and other social habits.

Introduction: Knee pain is among the commonest complaints in the outpatient orthopedic department. However the cause does not always originate from knee itself. and knee pain is used by the patient more as an umbrella term. In fact very few patients give the complete list of accompanying symptoms. They have more often than not to be coaxed out of the patient. To make matters more complex, Referred pain from the Spinal nerves, Hip and Ankle joints join the many structures around the knee to make knee pain an umbrella term for this Pandora's Box. Misdiagnosis or partial diagnosis leads to inadequate or wrong treatment and continued suffering for patient and treating doctors Materials & Methods: 78 patients with knee pain attended the OPD of Walawalkar hospital, Dervan. On x-ray, 28 were found to have different grades of osteoarthritis. Of these 25 agreed to be part of this pilot study. They underwent standing x rays & MRI of the lumbosacral spine. Results: This study found an unusually high rate of coexistent knee and spine pathologies. All patients had some degree of disc disease accompanying medial or tricompartmental osteoarthritis. It undermines the need for investigating this important contributor to the umbrella term of knee pain. The commonest affected disc segment was L4-5 i.e 92% with two patients having L5-S1 prolapse 8%. The purpose of this pilot study is only to alert the surgical and rehabilitation colleagues of the frequent coexistence of the spine and knee conditions for Counseling, consent, surgery & rehabilitation and thus improve patient satisfaction.

Introduction: OA knee is most common form of arthritis in Asian population. The medial compartment of knee is most commonly involved. Most X-ray studies have been from the Western Caucasian patients with different genetic pool, habitus and lifestyle. The accepted norm for surgical intervention like unicondylar knee replacement or High Tibial Osteotomy is bone on bone Arthritis which has simultaneous affection of both medial Tibial & Femoral compartments. We however noted a different radiological pattern also causing severe pain on medial side of knee, without bone on bone arthritis. This was labeled DERVAN RIM SIGN. Materials and Method: This pilot Study describes a new radiological sign based on standard Anteroposterior Xray of knee joint, taken in standing weight bearing position with toes and patella pointing forwards in 15 degrees of flexion. The findings of this sign and correlation to selective medial condylar femoral cartilage loss in 25 patients are confirmed with 1 MRI of knee joint 17 patients 2 Arthroscopy of knee joint 3 patients 3 Open Arthrotomy during Unicondylar knee Arthroplasty 5 patients Results: 100 percent correlation is seen in all 25 cases between the Dervan RIM sign & Eburnation and loss of Medial femoral cartilage in the three modalities of visual confirmation viz MRI, Arthroscopy or Visual examination in open surgery. Mild involvement of the Tibial condyle was noted in all cases and this was the cause of absence of bone on bone Arthritis.

Background: Diarrhoeal diseases represent a major health problem in developing countries. Conservative estimates place the global death toll from diarrhoeal diseases at about two million deaths per year (1.7 - 2.5 million deaths), ranking third among all cases of infectious disease death worldwide. The prime purpose of an outbreak investigation is to control the outbreak, limit its spread to other areas and assess how preventive strategies could be further strengthened to reduce or eliminate the risk of such outbreak in future.Methods: It was a descriptive cross sectional study of epidemic occurred in Khetiya village, Dist Barwani (MP), population of 67,500 during 17 October 2016 to 17 November 2016. All the cases reported within last one week around the market place village in Khetiya, presenting with symptoms and signs of AGE (as per standard case definition of IDSP) and willing to participate in the investigation.Results: Males were 56.96%, & female cases were 43.03%. Majority of the study subjects lied between 20-40 years. The mean age was 30.15±5 years. Majority of the cases belonged to lower middle class SES (38%). 87% population was tribal, 48% cases were labourers, 42% were farmers and 10% were others.Conclusions: Males were 56.96%, & female cases were 43.03%. Majority of the study subjects lied between 20-40 years. The mean age was 30.15±5 years. Majority of the cases belonged to lower middle class SES (38%). 87% population was tribal, 48% cases were labourers, 42% were farmers and 10% were others.