Browsing by Author "S.K. Saraf"

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A clinico-epidemiological profile of non-healing wounds in an Indian hospital.
(2000) S.K. Saraf; V.K. Shukla; P. Kaur; S.S. Pandey
One hundred patients with non-healing wounds of more than six weeks' duration were studied for clinico-epidemiological factors and their correlation with healing time. The majority of subjects were aged 30-59 years; those aged 50 and over had significantly delayed healing. Most of the subjects were farmers and physical labourers. Leprosy was the most common cause of non-healing wounds, followed by diabetes, trauma and venous ulcers; the lower limbs were the most common site of involvement. Diabetic wounds were more common in those aged 40 years and above. Diabetic wounds were slower to heal than others. The time to healing was calculated from the day subjects received treatment advice at the wound clinic. Seventy-five of the study group were included for calculation of healing time. The others were lost to follow-up or excluded for other reasons.
Allogenic decalbone in glenoplasty for recurrent anterior dislocation of shoulder.
(1995) G.N. Khare; T.P. Singh; S.C. Goel; S.K. Saraf; S.V. Sharma
31 patients of recurrent anterior dislocation of shoulder treated by anterior glenoplasty using allogenic decalbone had good results. It is proposed that generalised congenital or developmental disorder may be an important etiological factor in pathogenesis of recurrence of the dislocation.
Allogenic decalbone in the repair of benign cystic lesions of bone
(Springer-Verlag, 1992) S.C. Goel; S.M. Tuli; H.P. Singh; S.V. Sharma; S.K. Saraf; T.P. Srivastava
Forty-six cases of benign cystic lesions of bone were treated by curettage and compact filling using partially decalcified allogenic bone graft (Decalbone); of these, 35 were available for study. Decalbone was prepared by partial decalcification with 0.6 N hydrochloric acid (HCl) of human bones generally obtained from freshly amputated limbs. The commonest lesions of bone were giant cell tumours (14) and aneurysmal bone cysts (15), and the commonest bones involved were the femur (23) and the tibia (12). There was one failure and four recurrences. Five cases were infected but this did not interfere with healing of the primary lesion. Radiological incorporation of the graft was seen at about 3 months in unicameral bone cysts, at 4-6 months in aneurysmal bone cysts and at 6-9 months in giant cell tumours. There was no recurrence in any case of giant cell tumour, but three aneurysmal bone cysts recurred. There was no clinical immune reaction. © 1992 Springer-Verlag.
Anomalous M. palmaris longus producing carpal tunnel-like syndrome
(Springer-Verlag, 1991) S.K. Saraf; S.M. Tuli
A case of median nerve compression due to an anomalous fleshy palmaris longus tendon is presented. © 1991 Springer-Verlag.
Autoclaved partially decalcified bone as osteogenic substances--an experimental study.
(1991) S.K. Saraf; K. Agarwal; S.M. Tuli; S. Khanna
A large osteoperiosteal gap was created in rabbit's ulna. A total of 18 allogenic decalbone grafts in left ulnar gap and 20 autoclaved allogenic decalbone grafts on right ulnar gaps were implanted. Five gaps were left unbridged to serve as controls. The results were assessed by clinical, radiological, macroscopic, histological and tetracycline fluorescent studies. It is observed that whereas the decalbone can successfully bridge a large gap in a vast majority of cases; the standard autoclaving of decalbone denatures its proteins which melt and cover the outer surface. The union, incorporation and remodelling of autoclaved decalbone grafts are slower as compared to that with unautoclaved decalbone.
Changing profile of haematogenous osteomyelitis in a teaching hospital.
(1993) S.V. Sharma; G.N. Khare; N. Bhalla; S.K. Saraf
A total of 155 consecutive patients of osteomyelitis were studied clinically, radiologically and bacteriologically. The follow up ranged from 2 1/2 to 4 1/2 yr (average 3.5 yr). Age varied from 8 months to 50 yr. Onset of the disease was acute in 106 and insidious in 49 patients. Of these 116 cases were treated conservatively which include 12 treated by incision and drainage. The rest underwent surgery (saucerization, curettage, sequestrectomy etc.). There was a trend for osteomyelitis to shift from the known incidence in early age to adulthood, acute to insidious onset and infection by Gram positive to Gram negative organisms.
Characterization of biomimetically synthesized Hap-Gel nanocomposites as bone substitute
(2008) Tanmay Bera; A.N. Vivek; S.K. Saraf; P. Ramachandrarao
There is an increasing demand for an affordable and easy-to-fabricate material to help patients having a long bone gap. In this paper, we describe the biomimetic synthesis of Hap-Gel in situ nanocomposite powders with varied proportions. Their biocompatibility and bone regeneration abilities were assessed on a rabbit model. The use of Hap crystals and Gel molecule, the soluble form of bone protein, makes the nanocomposites comparable to natural bone in constituents. The application of biomimetic principles improves crystal morphology and the interaction of Hap crystals with the Gel molecules as seen through in vitro characterizations. Out of the various compositions studied, one with 80:20 proportions of Hap to Gel proved to be closest to the characteristics of natural bone. The immunological response to this composite, assessed through intradermal inoculation, did not reveal any reaction. The in vivo implantation studies in the femoral condyle of the animals, as assessed by serial post-operative follow-up radiography and the histological evaluation, revealed a good biocompatibility and bone-regeneration ability of the material. Thus, nanocomposites of Hap-Gel have a great potential for serving as an effective and affordable biomaterial for bone grafting applications. © 2008 IOP Publishing Ltd.
Effect of etoricoxib on fracture healing - an experimental study
(2011) Ajit Singh; S.K. Saraf; R.S. Garbyal; S. Shekhar
Non-steroidal anti-inflammatory drugs (NSAIDs) including selective cyclo-oxygenase-2 (COX-2) inhibitors are some of the most commonly prescribed medications worldwide. Non-selective cyclo-oxygenase (COX) inhibitors impair bone healing by inhibiting prostaglandin synthesis. The purpose of this study was to evaluate the long-term effect of etoricoxib, a new selective COX-2 inhibitor, on bone healing in rabbits, when given in therapeutic doses. Left femur was osteotomized and fixed with K wire in 36 rabbits. One group was fed etoricoxib (3mg/kg body wt/day) orally, while other group served as control. Radiological, morphological, histological and biomechanical analysis of both groups was done at 4, 8 and 12 weeks. An analysis of various parameters of study showed that etoricoxib, a selective COX-2 inhibitor, has significant inhibitory effect on bone healing at 4, 8 and 12 weeks of follow up. So it was concluded that etoricoxib significantly inhibited bone healing in rabbits especially at earlier phases of fracture healing.
Effect of simvastatin on fracture healing-an experimental study
(2007) S.K. Saraf; Ajit Singh; R.S. Garbyal; Vakil Singh
Left femur was osteotomized and fixed with K wire in 21 rabbits. One group was fed simvastatin (120 mg/kg body wt/day) orally, whereas another group without medication served as control. Both groups were assessed radiologically, morphologically, histologically and biomechanically at 4, 8 and 12 weeks. An analysis of various parameters of study showed that simvastatin treated group had improved bone healing at 4 and 8 weeks of follow up, however, the difference was not significant statistically at 12 weeks. So it is concluded that Simvastatin favourably hastened the process of fracture healing in the rabbits at earlier phases.
Effect of size and shape of the allogeneic bone grafts in bridging experimental ulnar gap in rabbits.
(1994) S.K. Saraf; A. Kumar; S.M. Tuli; S. Khanna
Partially decalcified allogeneic bone matrix was cut into the sizes and shapes of cylinders, bone strips and pulverized bone powder. Large osteoperiosteal gaps were created in rabbit's ulnae. A total of 14 gaps were filled with bone strips, 20 with powder, six with cylinders and two were left unbridged to serve as control. The healing of gap was assessed at intervals with a maximum follow up of 24 weeks. Clinically at 12 weeks the bone strips could not be moved separately from each other, the whole tubular bone had also united whereas gaps filled with bone powder did not diminish in size. Radiologically union occurred earlier (around 12 weeks) in bone strips as compared to cylinders (approx-18 weeks). With bone powder only a faint line of the remnants was visible. Gross examination findings of the grafted area were in concurrence with the clinical and radiological findings. Overall the gaps filled with bone strips had 100 per cent success with early osteo induction and remodelling as compared to long cylinders whereas gaps filled with bone powder had complete failure.
Factors influencing the pain relief obtained with epidural methylprednisolone in low-back pain and sciatica
(1994) V. Rastogi; M. Krishna; S.K. Saraf; S.C. Goel; S.B. Singh
One hundred and twenty-four patients suffering from low-back pain were allocated to two groups: a study group comprised of 104 patients to be treated with epidural Depomedrol (methylprednisolone depot) in saline and a control group of 20 patients who were to be given only saline. Seventy-nine patients (75.3 per cent) in the study group showed good relief of pain in comparison with five patients (25 per cent) in the control group, a statistically significant difference (P ≤ 0.05). Patients with localized pathology responded better (86.5 per cent) than those with generalized pathology (65.4 per cent). Response was also better in patients in whom the pain was of an acute (84.6 per cent) rather than chronic (48 per cent) nature (P ≤ 0.05). The caudal route of medication had an edge over the lumbar epidural one as 87 per cent showed good relief. A higher concentration of drug (8 mg/ml) showed slightly better but statistically insignificant (P ≤ 0.05) relief of pain. Thirty-six (34.6 per cent) patients who were given epidural methylprednisolone showed pain relief lasting for more than 1 year.
Familial childhood parathyroid adenoma
(1994) Madhukar Rai; J.K. Agrawal; V. Sasikumar; S.K. Singh; S.K. Saraf; Mohan Kumar; H.S. Shukla
A family in which both the father and son had parathyroid adenoma in childhood is presented, along with a brief review of the literature. © 1994.
Limb lengthening in children by periosteal stripping
(1992) S.K. Saraf; A.K. Gupta; S.M. Tuli
[No abstract available]
Malunited fracture of the first rib with congenital fusion of anterior part of the first and second ribs
(2004) G.N. Khare; S.K. Saraf; S.C. Goet
An unusual case of malunited fracture of the left first rib presenting as lump in the supra clavicular area of neck is reported for its rarity. The mechanism of injury in these cases is discussed and the literature on the subject is reviewed. This patient also had congenital fusion of the anterior parts of the first and second ribs on the left side.
Myeloma in young age
(2005) Usha; Neeta Agarwal; Prachi Kumar; Madhukar Rai; R.G. Singh; Monika Seth; S.K. Saraf
Total 14 cases of myeloma in young age group (<40 years) have been reported out of 178 cases of myeloma in a time period of 7 years (1993-1999). Males predominated over females. Like adult myeloma, patients presented mostly with the backache, pain in pelvis, lower spine and weakness in about 60% of cases followed by swelling of bone in 40% of cases. One case presented with bleeding gum, malena and hepatosplenomegaly and was diagnosed as plasma cell leukemia. Radiological examination revealed lytic lesion in almost all the cases with fracture femur and rib in 28.57% of cases. Anaemia and raised ESR was noted in all the cases. Myeloma typing revealed IgG myeloma in 10 cases, light chain myeloma in 3 cases and IgA myeloma in one case. None of the patient was traceable after 2 years. Thus our study concludes that myeloma in the young age in India occurs in increased frequency and clinically presents just like adult and elderly myeloma, but serologically are predominantly of IgG type. There is also an increased frequency of solitary plasmacytoma as compared to adult myeloma.
Osteoarticular tuberculosis in children.
(1992) S.B. Singh; S.K. Saraf; L.I. Singh; T.P. Srivastava
One hundred and four cases of osteoarticular tuberculosis were studied. There were 74 boys (71.2%) and 30 girls (28.8%). The mean age at the onset of symptoms was 7.3 years, ranging from 9 months to 18 years. Seventy four cases (71%) reported 3 months after onset of symptoms. The spine was the commonest site involved (43%) followed by hip (14.9%) and knee joints (10.3%). Evidence of active or inactive pulmonary tuberculosis was found in 16.2%. All cases were treated by three drug regimen of rifampicin, isoniazid and ethambutol; rifampicin was discontinued after 6 months, ethambutol after 12-14 months. In 12 cases (11.5%) isoniazid was continued for 18 months. Along with chemotherapy suitable braces, splints, tractions, exercises and other form of physical therapy produced satisfactory results. Seventy eight patients (75%) showed clinical and radiological improvement with one year of treatment. The follow up period ranged between 4 months to 24 months with an average of 17 months. Children because of capacity to grow, showed progressive deformity in knee in 3 cases (2.8%), hip in 98 cases (8.6%), shortening of limbs in 14 cases (13.4%) and kyphosis in 13 cases (12.5%).
Osteoinductive property of fluoride impregnated decalcified allogeneic bone matrix
(1991) S.K. Saraf; S.M. Tuli
[No abstract available]
Peripheral nerve complications in hemophilia
(2003) S.K. Saraf; O.P. Singh; V.P. Singh
Aim: Muscle bleed in hemophilics can result in compressive neuropathy and permanent disability if not treated properly in time. Twenty cases of peripheral nerve involvement in hemophilics are presented with an aim to highlight its features and the role of pulsed ultrasound in the management. Methodology: Between January, 1999 and 2000 June, 134 patients of bleeding disorders were examined. Twenty of them presented with features of nerve palsy. In addition to usual conservative treatment, pulse ultrasound electrotherapy of 10-15 sittings was used in all the cases. Results: Femoral nerve was involved in majority (15), followed by sciatic (4) and peroneal nerve in one case. Femoral nerve involvement was associated with iliacus bleed in 13 patients and inguinal bleed in two cases. All the four cases of sciatic nerve palsy were associated with gluteal hematoma. Only case of peroneal nerve palsy was associated with hematoma at upper leg and calf. Twelve cases improved completely within six months whereas another four recovered around 10 months. Remaining four showed only partial recovery even when followed up to 12 months. Conclusions: Recognition of nerve complications in hemophilics is important to avoid long-term disability. Conservative therapy starting early was associated with favourable results. Pulsed ultrasound therapy at the site of haematoma helped in early regression of hematoma and neural recovery.
Quantitative assessment of muscle activity and joint load in braced and unbraced osteoarthritis knee by external strain gauge sensor
(Association of Physiologists and Pharmacologists of India, 2016) O.P. Singh; I.S. Gambhir; S.K. Saraf; S.B. Deshpande; Gaurav Singh
Objectives: Altered biomechanics leads to the development of degenerative joint disease. The joint pressure and dynamic loading varies during activities of daily living. The study was undertaken to assess the muscle activation pattern of the medial and lateral knee compartments (tibiofemoral joint) during gait in osteoarthritis subjects without and with knee brace undergoing either exercise therapy or balance therapy. The joint load was assessed by the strain gauge transducer and the weight shift pattern is taken as an indicator for the muscle activation pattern. Methods: In a prospective design study on 57 male subjects diagnosed osteoarthritis knee with Kellagren- Lawrennce scale walked barefooted with and without designed offloader knee brace on a level surface for three minutes. The subjects were allocated in two different study groups i.e. Conventional (exercise therapy) (Control Group, n=31) and Structured Neuromuscular Postural Training (SNPT) group (Balance therapy) (Study Group, n=26). The subjects were sub grouped as pre-elderly (40-60 Years) and elderly (>61 years) group in both. The quantitative assessment of muscle activity and joint loading with and without knee brace was done using designed strain gauge sensor instrument. The pressure changes of strain gauges of muscles around the knee joint viz. vastus medialis (VM), vastus lateralis (VL), semi membranosus / tendinosus (Medial Hamstring) (MH), Biceps Femoris (Lateral Hamstring) (LH), gastro-soleus (GS) and tibialis anterior (TA) muscles during normal gait were observed at baseline and 6 weeks follow up after undergoing exercise therapy or balance therapy treatment as per allocation of study groups. The digital values from MATLAB were recorded and analyzed. Results: At the end of 6 weeks conventional / SNPT (structured neuromuscular postural training) treatments, medial hamstring muscle activity showed significant difference (p<0.001) in pre-elderly subgroup, while significant difference was seen in vastus laterals (VL), medial hamstring (MH) (p<0.005) and lateral hamstring (LH) muscles (p<0.001) in elderly subgroup. Further, the muscle co-contraction has been higher for vastus medialis-medial hamstring (VM-MH) pair compared to vastus lateralis-lateral hamstring (VL-LH) pair without brace at baseline. The application of offloader valgus knee brace significantly increases VL-LH co-contractions in magnitude and decreases in VM-MH co-contractions at 6 weeks follow up. Conclusion: Muscle activity increased in medial hamstring both in pre-elderly and elderly subjects. While, Vastus Laterals and lateral hamstring showed increased activities in elderly subjects. Hence, balance training and the application of off loader knee brace will be helpful to redistribute the load on medial tibiofemoral compartment. © 2016, Association of Physiologists and Pharmacologists of India. All rights reserved.
Re: A need for careful consideration of bacteriophage therapy
(Indian Council of Medical Research, 2016) C. Kishor; R.R. Mishra; S.K. Saraf; M. Kumar; A.K. Srivastav; G. Nath
[No abstract available]