Indraprastha Apollo Hospital is an Indian hospital owned by Apollo Hospitals group, India's largest healthcare chain. Established in 1995, it is the third super specialty tertiary care hospital set by the Apollo Hospitals Group, jointly with the Government of Delhi. It is a 695-bed hospital, with the provision for expansion to 1000 beds in future. The hospital is spread over 15 acres, and has a built-up area of 600,000 square feet.
Aims:The aim of this study was to evaluate the impact of peroneus longus tendon (PLT) harvest on gait biomechanics following anterior cruciate ligament (ACL) reconstruction. There is scarce evidence in the literature about the safety of PLT as a potential graft for ACL reconstruction, and no long-term studies with gait assessment exist. We analyzed changes in spatiotemporal parameters (STPs) using a computerized gait analysis system and assessed functional ambulation over time. Methods:This prospective cohort study included 31 patients, including 23 males and eight females. The mean agewas 32.61 years (SD 10.60), with a mean clinical follow-up of 18.34 months (SD 6.25). The mean height, weight, and BMI were 160.23 cm (SD 8.08), 72.39 kg (SD 10.95), and 28.32 kg/m2 (SD 4.74), respectively. Gait analysis was performed preoperatively and postoperatively at six months and one year. Various STPs along with Functional Ambulation Profile (FAP) scores were assessed. Comparison of study variables between different time intervals was done using repeated measures analysis of variance followed by Bonferroni post-hoc test. A p-value < 0.05 was considered statistically significant. Results:Cadence, FAP score, single-leg support time, step time, and velocity increased significantly over different time intervals (p < 0.001). No significant difference in stride length, double support time, stance time, and swing time were noted over different time intervals. Conclusion:Despite overall improvements in functional gait, PLT harvest for ACL reconstruction resulted in subtle gait alterations, notably prolonged single-leg support time. Although compensatory mechanisms help to preserve gait function, these changes require careful consideration, particularly in athletes. Incorporating targeted ankle rehabilitation may help to reduce potential long-term effects. Further research is necessary to evaluate its impact on foot biomechanics and stability.
Osteoporosis and chronic bone pain (CBP) are prevalent complications in thalassemia, significantly affecting their quality of life. This study aimed to evaluate the efficacy of Denosumab in improving bone mineral density (BMD) and reducing CBP in thalassemic patients with osteoporosis. Single-arm interventional study. Twenty-three thalassemic patients with osteoporosis were enrolled. Dual-energy X-ray absorptiometry (DEXA) was performed at baseline and after two doses of Denosumab to assess T-scores/Z-scores and BMD at the lumbar spine (L1–L4) and left hip. Twelve patients received two additional doses and underwent repeat DEXA scans. Fracture history was recorded. CBP was evaluated using the Huskisson Visual Analog Scale (VAS) before treatment and after two and four doses for 23 and 12 patients, respectively. Statistical analysis was performed using the Wilcoxon signed-rank test, with p < 0.05 considered significant. Baseline median T-scores/Z-scores were−3.2 (L1–L4) and−2.6 (hip). After two doses, scores improved to−2.5 and−2.2, respectively (p < 0.001) with significant improvement in BMD. In 12 patients receiving four doses, scores improved further to−1.75 (L1–L4) and−2.0 (hip) from a median of−3.45 and−2.8 respectively with significant p-value. Among 14 patients reporting CBP, VAS scores declined from a median of 5.0 cm at baseline to 2.5 cm after two doses (p = 0.001). It further reduced to 2 cm after four doses in a subset of 12 patients (p = 0.017). Denosumab significantly improved BMD and reduced CBP in thalassemic patients with osteoporosis. These findings support its role as a promising therapeutic option in this population.
INTRODUCTION:This study aimed to examine the impact of metabolic and bariatric surgery (MBS) on key micronutrients in patients with obesity over 10 years. PATIENTS AND METHODS:A retrospective chart review was carried out for individuals who had MBS from February 2013 to May 2022 at 11 centres. The micronutrient (iron, Vitamin B12, Vitamin D3 and calcium) levels were collected before surgery and up to 10 years afterwards. RESULTS:The data from 1675 individuals with a mean age of 43.09 ± 11.93 years were analysed. The study population comprised 34.81% of males and 65.19% of females. There was an increase in the serum iron levels over 1 year (P < 0.01), 3 years (P < 0.01), 5 years (P = 0.2175), 7 years (P < 0.01) and 10 years (P = 0.0998) after surgery. Similar results were observed for Vitamin B12 levels at 1 year (P < 0.01), 3 years (P < 0.01), 5 years (P = 0.3083), 7 years (P = 0.2817) and 10 years (P = 0.2645). Vitamin D3 levels increased at 1 year (P < 0.01), 3 years (P < 0.01), 5 years (P < 0.01), 7 years (P = 0.0069) and 10 years (P = 0.8179). However, calcium levels exhibited a downwards trend at 5 years (P = 0.0008) post-surgery. CONCLUSIONS:A high prevalence of micronutrient deficiency was observed amongst patients preoperatively, which improved following MBS.
Objectives:Frailty and intrinsic capacity (IC), central constructs in the WHO healthy ageing framework, reflect vulnerability and resilience, respectively. Although both are linked to adverse outcomes, population-level evidence from India examining their relationship remains limited. This study explored the association between IC and frailty among older Indian adults. Methods:Data from 26,943 community-dwelling adults aged ≥60 years from the Longitudinal Ageing Study in India (LASI Wave 1) were analysed. Frailty was assessed using Fried's phenotype. IC was measured across cognition, locomotion, sensory, vitality, and mood domains, generating a composite score (0-10). Associations between IC and frailty status were examined using chi-square tests and multinomial logistic regression adjusted for sociodemographic factors and comorbidities. Results:Median age was 67 (63-72) years, and 48.4% were male. Frail individuals had lower median IC scores [6 (5-7)] than pre-frail and robust participants [7 (6-8); p<0.001]. Higher IC scores were inversely associated with pre-frailty (RRR: 0.79, 95% CI: 0.75-0.84) and frailty (RRR: 0.67, 95%CI: - 0.64-0.71). Poor cognition, locomotion, vitality, and mood were significantly associated with frailty, whereas sensory impairment was not. Conclusion:Lower IC is strongly associated with frailty among older Indian adults, supporting IC-based geriatric assessment for early identification of frailty progression.
