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Background: Iliopsoas bleed is a serious complication in people with hemophilia (PWH), with significant morbidity. Studies examining the profile, incidence, and outcomes in psoas bleeds are scarce and will shed more light and increase awareness about its management. Material and Methods: Data of 453 PWH with confirmed iliopsoas bleed treated at Bangalore Medical College were retrospectively analyzed. Results: Eighty-five (18.8%) PWH presented with total of 154 psoas bleeds. Their mean age was 21.96 years. Common symptoms were thigh/ hip/groin pain (100.0%), hip flexion spasm (41.2%), numbness/tingling in quadriceps muscle (5.9%), abdominal tenderness (3.5%), hematuria, and anemia requiring blood transfusion in 2.4% each. Long-term complications were quadriceps atrophy (9.4%), permanent abnormal posture (10.6%), transient paresthesia in the distribution of femoral nerve (3.5%), and pseudo tumor in pelvis (1.2%). The overall average duration of therapy with clotting factor concentrate was 1.7 days with a mean duration of therapy of 1.4 days in patients without inhibitors and 2.8 days in patients with inhibitors (p=0.010). The overall mean duration of hospitalization was 7.2 days with 5.3 days in PWH without inhibitors and 8.3 days in PWH with inhibitors (p=0.342). Conclusion: Pain in hip joint/groin/hip flexion spasm suggests the possibility of an iliopsoas hematoma and early factor replacement therapy should be started to prevent complications. Early treatment at first sign of discomfort reduces the duration of treatment, and prevents severe complication and invasive interventions. Patients with inhibitors were overrepresented in the cohort who needed longer duration of factor replacement therapy. [ABSTRACT FROM AUTHOR]

Purpose: To assess the caries experience and periodontal health status among children with haemophilia in New Delhi.Materials and Methods: This case control study was conducted in New Delhi over a 14-month period. Data were collected from 110 children, of which 55 children had haemophilia and 55 were healthy. Caries was assessed in terms of decayed, missing and filled teeth, according to WHO criteria, while periodontal health status was assessed regarding plaque present, and recorded by utilising the Silness and Löe plaque index.Results: In children with haemophilia, overall caries experience was low in the primary dentition as compared to healthy children, with mean dmft of 2.02 ± 2.4 and mean dmfs of 4.71 ± 7.3, as well as in the permanent dentition with a mean DMFT of 0.47 ± 0.87 and mean DMFS of 0.56 ± 1.167. Thus, caries experience was lower in the permanent than in the primary dentition. There was no significant difference between the two groups regarding the periodontal health. The overall dental health in children with haemophilia was better than in healthy children, as there was a significant influence of parental toothbrushing habits on children with haemophilia.Conclusion: Caries experience was significantly lower in children with haemophilia as compared to healthy children. The periodontal health status of children with haemophilia was found to be comparable to that of the healthy children. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the functional independence of children with hemophilia A and its correlation to radiological joint score.Methods: The present cross sectional study was conducted at SPMCHI, SMS Medical College, Jaipur, India. Children in the age group of 4-18 y affected with severe, moderate and mild hemophilia A and with a history of hemarthrosis who attended the OPD, emergency or got admitted in wards of SPMCHI, SMS Medical College were examined. Musculoskeletal function was measured in 98 patients using Functional Independence Score in Hemophilia (FISH) and index joints (joints most commonly affected with repeated bleeding) were assessed radiologically with plain X rays using Pettersson score.Results: The mean FISH score was 28.07 ± 3.90 (range 17-32) with squatting, running and step climbing as most affected tasks. The mean Pettersson score was 3.8 ± 3.2. A significant correlation was found between mean Pettersson score and FISH (r = -0.875, P < 0.001) with knee and elbow having r = -0.810 and -0.861 respectively, but not in case of ankle with r = -0.420 (P 0.174).Conclusions: The FISH and radiological joint (Pettersson's) scores may be extremely useful in the clinical practice in the absence of magnetic resonance imaging (MRI), which is considered very sensitive to detect early joint damage, but at a cost that makes it relatively inaccessible. FISH seems to be a reliable tool for assessment of functional independence in patients with hemophilia A. [ABSTRACT FROM AUTHOR]

Presents a case of a patient with pseudotumor of the paranasal sinuses and developed visual impairment due to compression of optic nerves in India. Response to combined treatment with radiation therapy and factor VIII replacement; Destruction of bony laminae; Radiation dose used in the treatment.