The Odyssey of publications during residency–the much needed yet challenging journey

There is no greater joy than contributing back to the field that one chooses to specialize in. This noble feat of scientific publication can, however, be a daunting task for those who are in the nascent period of their residency. They need to strike that fine balance between academic learning, patient care, and publication without burning themselves out. This exercise is best capitalized in that window period of the 2nd year of residency. They will thus be updated, forming long-term memory. The topic chosen should belong to the area of their interest, but at the same time be current and timely. They need to master electronic data base search, learning the correct use of operators and filters. An extra edge can be gained with the help of reference managers, which can summarize, retrieve, and organize all relevant literature. Writer’s block can be overcome by writing the easiest part of the paper first and using a pre-existing publication as a template. The lingo and flow ideas must be academic, scientific, and captivating, yet be simple and comprehensible. A right platform to showcase the research must be found, evading predatory journals. Effort and creativity must go hand in hand to make the article captivating. Residents must be prepared for revisions and gracefully respond. The process is simple and a lot will be learnt along the way.</jats:p

Neuropathic pain among patients with primary knee osteoarthritis: Results of a cross-sectional study from a tertiary care center in Southern India

Background: Pain in knee osteoarthritis (OA) may have a neuropathic component. We used the Douleur Neuropathique in 4 questions (DN4) questionnaire to assess neuropathic pain in knee OA and to identify factors associated with neuropathic pain. Methods: A total of 161 patients with knee OA satisfying the American College of Rheumatology 1986 classification criteria for knee OA were prospectively studied. DN4 questionnaire was administered; a score of ≥4/10 was classified as diagnostic for neuropathic pain. The Indian version of Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) was used to assess pain, stiffness, and physical function. Factors associated with neuropathic pain were explored. Results: Mean age was 55.7 ± 8.8 years. The mean total Indian WOMAC was 75.07 ± 13.8 and WOMAC pain score was 16.1 ± 3.6. Seventy-nine patients of 161 (49%) had DN4 score ≥4 (neuropathic pain present). When diabetics were excluded (n = 58), the proportion of patients with DN4 score ≥4 reduced to 45.6%. The most frequently described pain characteristic was sensation of electric shock (58.4%). Mean total WOMAC and physical function subscale were significantly higher in neuropathic pain group when compared to the group without neuropathic pain (DN4 ≤3), 77.5 ± 11.5 versus 72.6 ± 15.5, P = 0.024 and 54.3 ± 8.8 and 49.8 ± 12.6, respectively, P = 0.008. Conclusions: Neuropathic pain (DN4 ≥4) was seen in up to 49% patients with knee OA. Centrally acting drugs such as tricyclic antidepressants or duloxetine can be used to improve the quality of life and physical function of knee OA patients with neuropathic pain

Surgical modalities of treatment in vitiligo

Vitiligo is an acquired disorder of depigmentation that is associated with immense stigma and psychological burden. Although there is a myriad of options available for therapy, the repigmentation is best achieved with surgical modalities for stable disease. Once the immune attack on melanocyte is halted, surgery can be undertaken. The principles of surgery may be to introduce artificial pigment, stimulate melanocyte proliferation and migration, removal of depigmented areas or repopulation of depleted melanocytes. Broadly these can be divided into grafting, non-grafting techniques, camouflage and excision. The grafting techniques are further divided into cellular and tissue grafts. The advantage of the former being a greater donor to recipient ratio, however with added cost and equipment requirement. Grafting techniques have undergone various innovations, be it in harvesting, recipient site preparation or dressing, each with their own advantages and disadvantages. New innovations continue to crop up, including the use of stem cells and regulatory T-cell modulation. A well performed surgery is incomplete if it was not done without proper patient selection, counseling and preparation. This review article briefly outlines the various techniques; pre, intra and post-operative intricacies and the innovations in each.</jats:p

Relationship of dental caries and BMI among pre-school children of Bangalore city, India: a cross sectional study

Background: Dental caries in young children is commonly untreated representing a public health problem and has also reported to affect their anthropometric outcomes, but the evidence is conflicting. Objectives: The aim of this study was to evaluate the relationship between dental caries and BMI in pre-school children of Bangalore City.Methods: A cross-sectional study was conducted on 208 healthy preschool children with the age range of 3-5 years recruited from nursery schools of Bangalore City. The Anthropometric measurements, weight and height were evaluated by calculating the z-scores using WHO Anthro software to elucidate the subject’s status on the age- and sex-specific growth chart. Every Child who has received two Z-scores under the normal value (&lt;-2) was considered as abnormal (deficient). The data was analyzed using Statistical Package for Social Sciences (SPSS) version 19. The statistical tests used were t-test and correlation analysis.Results: Dental caries prevalence was 65.7% with a mean dental caries score of 2.24±2.57. Among the study participants 32.7% were underweight (WAZ score), 46.6% had height deficiency (HAZ score) and 47.6% had BMI deficiency (BAZ score). There was significant positive correlation found between dental caries experience and children’s WAZ (Weight for age) [r=0.102, p=0.040] and BAZ (BMI for age) [r= 0.761, p= 0.032].Conclusions: This study showed that lesser percentage of the participants had deficient height, weight and BMI. As the weight and BMI increased there was a significant increase in the number of caries and fillings among the participants. </jats:p