Biomedical subjects

Ketan C Pande

Publications and source records attributed to Ketan C Pande.

6 recordsLinked to original sources

PubMed2006

Normative reference database for bone mineral density in Indian men and women using digital X-ray radiogrammetry.

Osteoporosis is a major healthcare problem around the world and its importance lies in the fractures that result. A variety of devices are available in India and other Asian countries for bone mineral density (BMD) assessment, but their clinical utility is limited because of non-availability of local normative database. The purpose of this study was to establish the normative reference database for BMD in Indian women and men using digital x-ray radiogrammetry (DXR). Radiographs of the non-dominant hand were obtained on 262 women and 178 men between 20 and 79 years of age following strict inclusion and exclusion criteria. The radiographs were analysed by DXR using pronosco x-posure system V.2 to estimate the BMD (DXR-BMD). The peak value for DXR-BMD in women was 0.588 g/cm2 at age 35 years and 0.602 g/cm2 in men at age 42 years. There were statistically significant differences in BMD in women and men across all age ranges. An age dependent decline in BMD was seen in both women and men over the age of 50 years. The use of DXR should broaden the availability of fracture risk assessments in places where DXA is not available.

Absorptiometry, Photon↗

PubMed2005

Limited clinical utility of pain drawing in assessing patients with low back pain.

OBJECTIVE: The aim of this study was to assess the use of pain drawing by studying its ability to identify patients with low back pain and abnormal psychological profile. The intraevaluator repeatability of the penalty point method of scoring of pain drawing was also evaluated. METHODS: A total of 331 consecutive patients with low back pain were prospectively recruited. The psychologic profile was assessed using the Hospital Anxiety and Depression Scale. The pain drawings were scored with the penalty point method. The ability of pain drawing to identify patients with significant anxiety and depression was assessed by calculating the sensitivity, specificity, and positive predictive value. The intraevaluator repeatability was calculated for scoring done at an interval of 1 month using the kappa statistic. RESULTS: There were statistically significant differences in the anxiety and depression scores in patients with normal (n = 200) and abnormal (n = 131) pain drawing (anxiety: 9 +/- 4 vs 10.3 +/- 3.7; depression: 8.1 +/- 3.5 vs 8.8 +/- 3.6; P < 0.005). The pain drawing had a low sensitivity for detecting patients with any degree of anxiety (43%) or depression (40%). The positive predictive value of pain drawing for anxiety and depression was 78% and 69%, respectively. The kappa value for intraobserver assessment was 0.6 (P < 0.05). CONCLUSION: Though there are differences in anxiety and depression scores in patients with normal and abnormal pain drawing, the performance characteristics of pain drawing are less than acceptable and therefore limit its use in clinical practice.

Anxiety↗

PubMed2004

The role of bed rest in acute low back pain.

Acute low back pain is a common problem and clinicians from a number of different disciplines are involved in its management. Advice on daily activities constitutes an important part in the management of low back pain. In spite of evidence against its efficacy, bed rest continues to be a cornerstone of treatment. The purpose of this review is to present evidence from literature to determine the effectiveness of bed rest for patients with acute low back pain together with comparison of bed rest versus advice to stay active, bed rest versus other treatment modalities and shorter periods of bed rest (2 to 4 days) versus longer periods (more than 4 days) of bed rest. There is strong evidence to suggest that bed rest is not effective in the management of acute low back pain.

Acute Disease↗

PubMed2002

Graf ligamentoplasty: a 7-year follow-up.

Graf ligamentoplasty is seen as a means of stabilising and reducing the mobility of one or more severely symptomatic motion segments associated with degenerative disc disease. It is a less invasive procedure than fusion and appears to have a similar or slightly better success rate. Some studies have reported mixed results at early follow up; generally, they have suffered from poorly defined indications for the procedure, which are now much clearer. Reports on the first 50 patients undergoing Graf stabilisation in 1990/1991 were published in the European Spine Journal in 1995, with a 2-year follow-up. In the present study, the results of which were independently reviewed by the second author (K.C.P.), a spinal research fellow from an unrelated centre, we were able to establish postal contact with 40 of those patients, of whom 31 still had Graf instrumentation in situ. Examination of the clinical records of the ten non-responders when last seen indicated no particular bias of the results. The average age at surgery and average follow-up were 41.8 years (range 17.2-60 years) and 7.4 years (range 5.6-8.5 years) respectively. Excellent and good subjective results were reported in 62% of patients; 61% reported significant or total relief of low-back pain and 77% never or occasionally used analgesics. Patients were evaluated using the Oswestry Disability Score and the MSPQ (Modified Somatic Perception Questionnaire) and Zung Depression Index with the DRAM (Disability and Risk Assessment Method). Additional information was obtained from the clinical notes and radiographs at last review. The mean Oswestry Disability Score was 59+/-10% pre-operatively and 37.7+/-14% after 7 years. There was a statistically significant correlation between the Oswestry scores and the subjective outcome (P=0.009). The results of this study suggest that the beneficial effects of Graf ligamentoplasty are sustained in the longer term in spite of the presence of an established degenerative process.

Adolescent↗

PubMed2002

Atypical spinal tuberculosis.

Typical spinal tuberculosis is readily diagnosed and treated. Certain atypical clinical and radiologic presentations of spinal tuberculosis are described. Failure to recognize these presentations may lead to delay in diagnosis and initiation of treatment. In some atypical forms of the disease, this may have disastrous consequences. The current authors present a new classification for atypical spinal tuberculosis and describe the various presentations. The role of advanced imaging studies such as computed tomography scanning and magnetic resonance imaging and imaging-guided aspiration cytology is discussed.

Diagnosis, Differential↗

PubMed2002

Prevalence of low bone mass in healthy Indian population.

Osteoporosis is a major problem of health care delivery services, both in the developed and developing countries. The first normative reference database of bone mineral density in the Indian women and men was established using digital x-ray radiogrammetry. Further analysis of this database revealed that 29.9% of women and 24.3% of men between the age of 20 and 79 years had low bone mass. About 50% women and 36% of men over 50 years of age were noted to have low bone mass. The observations of this study suggest that there is higher prevalence of low bone man in the Indian population compared to the western population.

Bone Density↗