Women Empowerment in India: Concept and Role of Law

During the early Vedic period Indian women enjoyed equal status with men in all field of life They enjoyed freedom in selecting their life partners They had the right to get education Remarriage of widows were permitted Men did not have the right to divorce their wives They were given the complete freedom in all aspect of family matters There was no pardha system in hindu society However their position got deteriorated during Mughal rule in India as they had not been paid sufficient attention which they deserved Thereafter the status of women in the beginning of the British rule reached at the worst level However in mid nineteenth century some socio-religious reforms movements started by Raja Ram Mohan Rai Swami Dayanand and Swamy Vivekanand Due to their efforts the position and status of women started improving in some instances Thus when the Constitution of India was being framed the constitution makers took inspiration from these eminent personalities and expressly provided special provisions in the var ious parts of the constitution which provides equality for women in all aspects of their life This paper depicts the issues and challenges in empowering the women and suggests some ways of empowering women This paper also highlights the role of law in empowering wome

Acute kidney injury as the presenting feature of sarcoidosis

Acute kidney injury is rarely the presenting feature of sarcoidosis. We report the case of a patient whose diagnosis was brought to light by the investigation of impaired kidney function. Concurrent hypercalcaemia was noted and prompted further investigation, which led to the diagnosis of sarcoidosis. This is a rare phenomenon and is an important consideration in the patient with acute kidney injury and hypercalcaemia, without an apparent explanation. Rapid improvement in both kidney function and hypercalcaemia occurred in response to treatment

Self inflicted human teeth bites: a case report

Human infighting has been a part of our civilization since times immemorial. These incidences may go unnoticed or may attract attention of law enforcing agencies depending upon the severity of the offence. Though weapons are generally employed to inflict injuries, rare cases have been reported in literature where human teeth have been used to serve this purpose. Human bites may be self inflicted or self suffered in connivance with others to level an allegation against an adversary. We are presenting here such a case where such injuries were produced to bring a false charge against a neighbor

Evaluation of clinical results and complications of internal fixation of intertrochanteric femur fracture with proximal femoral nail antirotation

Background: The purpose of the present study was to evaluate the theoretical advantages of the proximal femoral nail antirotation in cases of intertrochanteric fractures and also whether it actually alters the eventual functional outcome of the patient.Methods: The present study includes a total 30 patients with intertrochanteric femur fractures managed with proximal femoral nail antirotation between December 2014 to November 2016. In all patients similar standard physical rehabilitation therapy were followed. All complications including intra and postoperative were assessed and recorded. The patients were followed up for over 24 months. Functional outcome was assessed using the Harris hip score.Results: All of 30 cases of intertrochanteric fracture got united with good anatomical position and average time of fracture union was 14 weeks. Postoperative complications included 2 degree varus deformity (n=1, 3%), calcification at tip of greater trochanter (n=4, 13%), sensitivity over TFL (n=2, 7%), medial thigh pain (n=3, 10%). 10 patients developed femoral shortness (mean=0.22 cm, range from 0-1 cm). Average harris hip score at the end of study showed mean value of 87, ranged from 65 to 94 with almost 22 (73%) patients showing excellent or good outcome.Conclusions: Proximal femoral nail antirotation (PFNA) represents a significant treatment option in management of intertrochanteric fractures with low complication rate

ECMO: a lifesaving modality in ARDS during puerperium

Acute respiratory distress syndrome (ARDS) is an uncommon condition encountered in pregnancy. The incidence of ARDS in pregnancy has been reported to be 1 in 6229 deliveries with mortality rates to range from 24% to 39% in pregnant patients. An essential component in management of ARDS involves good communication between the obstetrics team and critical care specialist and a fundamental understanding of mechanical ventilatory support. In critically ill patients where both cardiorespiratory support is required, Extracorporeal Membrane Oxygenation (ECMO) can be used to help maintain the vital functions. ECMO is a temporary cardio respiratory or respiratory support in critically ill patients who are unresponsive to conventional management.  In present case a young female with post-partum ARDS was successfully managed with extra corporeal membrane oxygenation (ECMO)

Intramedullary Nail Supplemented with Poller Screws for Proximal and Distal 1/3rd Shaft Tibial Fracture: A Prospective Interventional Study from North India

Introduction: The fracture of shaft of the tibia is the most common long bone fracture. The treatment goal for shaft tibial fracture is to achieve union with correction of both axial and rotational alignment and, maintain initial fracture length. Higher malunion rates are seen in fractures of the proximal and distal 1/3rd of the shaft of the tibia. However, Intramedullary (IM) nailing is the preferred choice of operative management of diaphyseal fractures of the lower limb. Aim: To evaluate the functional and radiological outcomes of IM nail supplemented with Poller screws for proximal and distal 1/3rd shaft tibial fractures. Materials and Methods: A prospective, interventional study was conducted in the Government Medical College, Patiala, Punjab, India from May 2020 to November 2021. A total of 30 fracture patients in the age group of 18 to 60 years were included in the study. All the subjects were treated with IM nail supplemented with Poller screws for proximal and distal 1/3rd shaft tibial fractures. Twenty cases were closed fractures and 10 were open (grade I or II according to Gustilo Anderson’s classification of compound tibia fracture). Patients were followed-up at 3 weeks, then 6 weekly till union. Patients were evaluated by Karlström-Olerud’s functional evaluation criteria.The data was statistically analysed using IBM Statistical Package for the Social Sciences (SPSS) software version 23.0. Results: The mean time of fracture union was 17.33±2.59 weeks with a maximum (n=19) patients in ≤15 weeks, followed by 15-20 weeks (n=10) and only one patient had delayed union (>20 weeks). According to Karlström-Olerud’s functional evaluation scale 18 (60%) patients had excellent outcome followed by good outcome in 8 (26.7%) patients, while 2 (6.7%) patients had satisfactory and 2 (6.7%) patients moderate outcomes. The total mean varus/valgus deformity preoperatively was 10.17±4.15° while postoperatively it was 1.63±2.3°. The total mean antecurvatum/recurvatum deformity preoperatively was 6.47±5.906° while postoperatively it was 0.20±0.61°. Postoperative complications were observed such as shortening of the leg (n=2), movement loss in the ankle (n=4), movement loss in the knees (n=3), muscle wasting (n=6) and subtalar movement loss (n=6). One patient had a superficial skin infection (oozing of purulent discharge from distal locking skin suture site), which was treated with prolonged antibiotics. Conclusion: Poller screws were found to be effective in achieving fracture alignment and hence, serve as a effective fracture reduction tool. Also helps to maintain the fracture aligned until it healed, preventing the loss of the initial reduction

Cost of hospital services in India: a multi-site study to inform provider payment rates and Health Technology Assessment

The 'Cost of Health Services in India (CHSI)' is the first large scale multi-site facility costing study to incorporate evidence from a national sample of both private and public sectors at different levels of the health system in India. This paper provides an overview of the extent of heterogeneity in costs caused by various supply-side factors. A total of 38 public (11 tertiary care and 27 secondary care) and 16 private hospitals were sampled from 11 states of India. From the sampled facilities, a total of 327 specialties were included, with 48, 79 and 200 specialties covered in tertiary, private and district hospitals respectively. A mixed methodology consisting of both bottom-up and top-down costing was used for data collection. Unit costs per service output were calculated at the cost centre level (outpatient, inpatient, operating theatre, and ICU) and compared across provider type and geographical location. The unadjusted cost per admission was highest for tertiary facilities (₹ 5690, 75 USD) followed by private facilities (₹ 4839, 64 USD) and district hospitals (₹ 3447, 45 USD). Differences in unit costs were found across types of providers, resulting from both variations in capacity utilisation, length of stay and the scale of activity. In addition, significant differences in costs were found associated with geographical location (city classification). The reliance on cost information from single sites or small samples ignores the issue of heterogeneity driven by both demand and supply-side factors. The CHSI cost data set provides a unique insight into cost variability across different types of providers in India. The present analysis shows that both geographical location and the scale of activity are important determinants for deriving the cost of a health service and should be accounted for in healthcare decision making from budgeting to economic evaluation and price-setting