Tennis is one of the major global sports, with over 75 million players participating in the game in more than 200 countries affiliated with the International Tennis Federation. The upper extremity is particularly susceptible to injury in tennis because of the use of the racquet, which acts as a lever, and due to the effect of repetitive stroke play on the dominant limb.

Between July 2009 and October 2010, in a prospective study involving players at a local tennis academy, 219 tennis players were evaluated for wrist injury. A specialized injury proforma was filled up for these players and parameters, such as injury type, mechanism of injury, forehand racquet grip (eastern, western and semiwestern), missed time from game, and treatment (medical or surgical) were recorded. The players were grouped into low-intensity players (those with average daily practice hours < 2.5) and high-intensity players (with ≥ 2.5 daily average practice hours). Statistical analysis was performed to assess the association of different wrist injuries with type of forehand handgrip.

Out of 219 players, 14 players were lost to follow-up. Out of the remaining 205 players, a total of 157 (76%) players were aware of the type of handgrip they were using, while 18 (9%) players did not have any knowledge of their handgrip. The remaining 30 (15%) players were found to be confused as far as handgrip was concerned. Out of 157 players who had knowledge regarding handgrip, 102 players were using the semiwestern grip, 44 were using the western grip, and the remaining 11 were using the eastern type of handgrip. There were seven injuries sustained in the wrist and hand. Due to the relatively small number of wrist injury cases, no statistical correlation could be derived between handgrip use and specific injuries in the upper limb.

In tennis players with wrist injuries, different grips of the racquet are not related to the anatomical site of the lesion. Previous studies have correlated the type of handgrip with the pattern of wrist injuries. Though we have 219 players in our study, the players who sustained wrist injuries were less (7). Thus, we were unable to find any correlation between type of handgrip and pattern of wrist injuries. Further studies are required so as to understand the biomechanics of tennis injuries.

Prabhakar S, Dhillon MS, Meena DS, Dhillon H, Dhillon S. Does Forehand Racquet Handgrip influence Incidence and Type of Wrist Injury in Tennis? A Preliminary Study in Indian Tennis. J Postgrad Med Edu Res 2018;52(1):1-4.

To assess the oral health status and felt needs of patients admitted to medical/surgical wards.

The cross-sectional study included 346 patients who were recruited from medical/surgical wards. Dental parameters were recorded using the World Health Organization (WHO) Oral Health Assessment Form for Adults, 2013.

Mean age of patients was 40.77 [standard deviation (SD) ± 14.4] years; 36.4% aged > 45 years and 32.9% educated beyond 10 years of education. 77.2% used toothbrush and 75.7% toothpaste for cleaning of teeth. 91% brushed their teeth at least once a day and 77.7% performed tongue cleaning. Greater number of decayed teeth (3.43 ± 3.38) were seen in those educated ≤ 10 years when compared with those educated beyond this level (2.43 ± 2.55). Participants with low education attainment and higher age group (>45 years) had significantly more teeth missing due to caries/other reasons, and with deeper periodontal disease. Conversely, higher educated and younger aged group (<45 years) participants had significantly greater mean number of sound teeth and teeth without gingival and periodontal abnormalities. There was no significant difference between smokers and nonsmokers, those who ever visited a dentist or not, practicing or not practicing oral hygiene, using tobacco or not, those with diabetes mellitus and/or hypertension or without these conditions. Nearly 80% of the patients felt no requirement for dental treatment.

Despite adherence to oral hygiene practices, the oral health status of patients admitted to medical/surgical wards was poor.

Avasthi A, Sogi GM, Veeresha KL. Oral Health Status and Treatment Needs of Inpatients at a Medical College Hospital in Haryana. J Postgrad Med Edu Res 2018;52(1):5-11.

Research into pathway to care (PC) in mental health in India has focussed on severe mental illness in mental hospitals.

To assess PC in a cohort of health care seeking subjects from a predominantly rural background approaching weekly community mental health satellite clinics in three towns in North India.

104 consecutive patients over a period of 6 months were included in the study. PC was assessed using a validated instrument.

A majority of the participants were diagnosed with common mental disorders (CMD). The mean duration of symptoms was 22.97 months and the mean number of treatment contacts was 1.11. Primary care physicians were the most common initial point of contact rather than native/religious healers.

In a CMD predominant treatment seeking population in a rural community where affordable mental health care and primary health care is available, there is high acceptability and utilization of such services.

Community psychiatry services should ideally be situated alongside primary health care services

Singh SM, Kumar E, Saroj R, Satapathy A, Nanjayya SB, Sharma A. Pathways to Care in Patients approaching Community Mental Health Satellite Clinics in North India. J Postgrad Med Edu Res 2018;52(1):12-15.

Faculty evaluation by resident physicians is uncommon in postgraduate medical education. This study is designed to conduct process evaluation of an online faculty evaluation by postgraduate residents at Aga Khan University Hospital in Karachi, Pakistan.

Action research design was utilized, and qualitative assessments were conducted between April and May 2013 at a private tertiary care hospital in the city of Karachi, Pakistan. Data were collected from the pediatric faculty and residents through focus group discussions (FGDs). The transcribed data were analyzed using computer software QSR NVivo version 10.0, and themes and subthemes were drawn.

A total of five FGDs were conducted, three with faculty members and two with residents. The participants agreed that faculty evaluation is a critical element of the residency program, as it not only facilitates in identifying areas of improvement, but also contributes toward faculty's professional growth. However, ambiguity about the purpose of evaluation, lack of understanding of the components of the online evaluation form, and problems with rating scale and review process were reported. A large majority of participants recommended arranging motivation sessions for faculty and residents, ensuring privacy of rating by residents, modifying the rating scale and analysis, and defining the process of reviewing and sharing the feedback with faculties.

Process evaluation was an important exercise and it helped to understand and improve the online faculty evaluation in the pediatric residency program.

Humayun KN, Qamar FN, Saeed S, Memon F, Khowaja AR. Process Evaluation of introducing Online Faculty Evaluation by Residents at a Tertiary Care Hospital in Pakistan. J Postgrad Med Edu Res 2018;52(1):16-21.

Rajan D, Dhillon MS, Cheema U, Chouhan DK. Evolution and Current Status of Arthroscopic Surgery in India. J Postgrad Med Edu Res 2018;52(1):22-25.

Virk JS, Garg SK, Aggarwal P, Kundu R, Bohat R. Pseudotumor in Metal-on-metal Total Hip Arthroplasty: An Unusual Complication. J Postgrad Med Edu Res 2018;52(1):26-30.

Desmoids are rare tumors. Abdominal wall desmoids are more common in women of reproductive age, especially postpartum women. Here we present a case of desmoid tumor in a 37-year-old multiparous woman, who came with the complaint of a slowly growing painless abdominal lump.

A 37-year-old multiparous female presented with the complaint of a gradually increasing, painless abdominal lump. On physical examination, a well-defined, firm, mobile mass was palpated in the suprapubic region. Ultrasound revealed a homogeneous hypoechoic lesion in the right anterolateral abdominal wall. Computed tomography (CT) of the abdomen showed a well-defined homogeneous mass in relation to the inferior aspect of right rectus abdominis muscle. These clinical and imaging features were highly suggestive of abdominal wall desmoid, which was confirmed on fine needle aspiration cytology and postoperative tumor histopathology.

Desmoids are uncommon benign, locally aggressive fibrous lesions that have an insidious course. Conventionally, these are classified as abdominal desmoids (occurring in abdominal wall, mesentery, or retroperitoneum) and extra-abdominal desmoids (affecting shoulder girdle, trunk, lower extremities, etc.). The definitive diagnosis of desmoid has to be established on histopathology. Wide local excision remains the definitive treatment of abdominal wall desmoids. Radiation therapy, chemotherapy, and endocrine therapy are the other treatment options.

Garg M, Prabhakar N, Prakash M, Dahiya D, Khandelwal N. Desmoid Tumor: Rare Abdominal Wall Lump in a Multiparous Woman. J Postgrad Med Edu Res 2018;52(1):31-33.

Yellow-colored cerebrospinal fluid (CSF) suggestive of xanthochromia can be due to elevated CSF protein and can be one of the causes of papilledema.

We observed a 55-year-old lady with papilledema with yellow-colored CSF which was hypercoagulable along with elevated CSF protein and no cells. Her systemic and nervous system examination was unremarkable except for the eye findings. Her contrast-enhanced brain magnetic resonance imaging (MRI) showed multiple meningiomas, and on imaging of the spine, she had multiple contrast-enchancing intradural, extramedullary lesions. Her eye findings were attributed to Froin syndrome found in patients with spinal tumors.

Our case stresses the need to keep the possibility of Froin syndrome in mind while evaluating patients with papilledema and it may be pertinent to perform a spinal imaging, especially when no apparent cause for papilledema is found.

Choudhary A, Goyal MK, Modi M, Mukherjee KK, Ahuja CK, Lal V. Froin Syndrome. J Postgrad Med Edu Res 2018;52(1):34-35.

Laldayal D, Utpat K, Joshi JM. Unusual Coexistence of Pulmonary Tuberculosis and Hydatid Disease. J Postgrad Med Edu Res 2018;52(1):36-39.