Volume 3 Issue 05 May 2015

Title: An Investıgation of the Left Ventrıcle of Human Heart by Fluıd-Dynamıcs Modelıng

Authors: Shahla H. Ali, Abdulkadir YILDIZ, Salih M. Atroshey

Paper Index:  05.2015-69658283

In this study an echocardiography device in Azadi Scientific Hospital of Duhok, Kurdistan - Iraq has been used to mesure the Left Ventricle (LV) wall thickness of three Patient groups: control (19 patients), smoking (15 patients) and asthma (9 patients) using a simulation method based on Computational Fluid Dynamics (CFD). The study is based on the design of a computational model of the human Left Ventricle using specific data (IVSd, LVIDd, LVPWd, IVSs, LVIDs and LVPWs) taken from the 2D M-mode echocardiography of selected groups.However, the phase diastole data are used to simulate blood flow inside LV by ANSYS FLUENT V14 based on CFD technology and the information have been used to build a numerical mesh for CFD simulation which provides detail 2D LV velocity and pressure distributions in the LV cavity.  Finally, the data for the three groups are analyzed by SPSS V1 to observe how the diseases can affect on the LV two phases (systole and diastole) parameters. The effects of the diseases (asthma, smoking and control), of the Age , of the Sex  and of the Body Mass Index (BMI) have been observed.

Keywords: Computational Fluid Dynamics (CFD), LV modeling, ANSYS FLUENT V14,M-mode echo, Asthma, Smoking, LVwall thickness.

Shahla H. Ali

Medicine faculty, Duhok University

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Title: Could Phototherapy Reverse Visual Deficits in Patients with Relapsing-Remitting Multiple Sclerosis?

Authors: Shimaa Abdelalim Essa, Yousry Mahmoud Mostafa, Shereen Mohamed Fathi, Haythem Mohamed Elhafez, Ayatullah Farouk Ahmed, Neveen Mohamed ElFayoumy

Paper Index:  05.2015-43835293

Background: Multiple sclerosis is a neurodegenerative disease of the central nervous system, causing irreversible deficits of the visual pathway with no known effective treatment.

Purpose: to investigate the efficacy of two original phototherapy programs on reversing the damage caused by multiple sclerosis to the neurophysiological functions of Optic nerves.

Study Design: Repeated measures randomized control trial.

Materials and methods: 24 patients with relapsing-remitting multiple sclerosis, from both sexes completed the study, age 25-45 years; randomly assigned into four groups. 7 patients in the control group (1); received monthly Solu-Medrol. 6 Patients in group (2) received Solu-Medrol plus low intensity laser therapy LILT 850 nm. 6 patients in group (3) received Solu-Medrol plus broad band ultraviolet B radiation BB-UVBR (280-320 nm). 5 patients in group (4) received Solu-Medrol, scanner LILT and BB-UVBR; all three groups received sessions 3 days/week for 12 sessions. Visual evoked potentials (VEP) were assessed pre-treatment, post treatment, 3 months follow up.

Results: Highly significant improvement (p=.009) of the right Optic nerve was recorded in the BB-UVBR group, and was sustainable at follow up. Lesser improvements were recorded in the (LLLT+UVBR) group, VEP of the right eye showed significant improvement (p=.022). However; no statistically significant improvementwas recorded between the four groups post treatment and at follow up (p≥0.05). 

Conclusion: BB-UVBR therapy solely has the potential to efficiently ameliorate the severity of disability status and reverse Optic neuritis, rather than LILT with a counterproductive role of the combination therapy.

Keywords: Multiple Sclerosis, Phototherapy,Broad Band Ultraviolet B Radiation, Low Intensity Laser Therapy.

Shimaa Essa

Address: 41 Ahmed Kasem Jodah Street, Nasr city, Cairo. Egypt

Phone: 002024012024, Mobile: 00201223721631

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Title: Comparison of 3-Port Versus 4-Port Laproscopic Cholecystectomy- A Prospective Comparative Study

Authors: Shekhar Gogna, Priya Goyal, Prateek Thakur, Sonia Goyal

Paper Index:  05.2015-73726289

Laproscopic cholecystectomy (LC) is gold standard treatment for gall stones. Since its birth in 1987 it has undergone various changes, reduced number of ports from standard 4-port LC to 3-port LC being one of them. Three-port LC has been shown to be equal to standard 4-port LC in terms of safety, complications, pain, hospital stay. we conducted a prospective comparative study amongst these two technique. 3-port LC was found to be superior in terms f less post operative pain, less need of analgesia, shorter hospital stay and ease of dissection. We concluded that 3-port LC is a better operative technique then 4-port LC.

Key Words –3-port Laroscopic cholecystectomy, Benifits, Safety

Shekhar Gogna

Assistant Professor, Department of Surgery, PGIMS Rohtak, Haryana , India- 124001

Res: 478-GF, Omaxe city, rohatk , India 124001.

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Title: Correlation between Thyroid Dysfunction and Oxidative Stress in Undialyzed Chronic Renal Failure Patients

Authors: AV Swarajya Lakshmi, K.C.T.Naik, T.Uma

Paper Index:  05.2015-21384183

Background and Aim: Patients with chronic kidney disease (CKD) often have subclinical hypothyroidism.However, few reports have investigated changes in the status of subclinical hypothyroidism in CKD patients This study aimed to investigate the relationship between oxidative stress and thyroid hormones  status in patients with chronic renal failure (CRF).

Methods:Thyroid hormones and renal function parameters like serum urea, creatinine, and oxidative stress malandialdehyde (MDA) as oxidant and total vitamin-C  as antioxidant were estimated and correlations between thyroid hormones,oxidative stress and renal function parameters were studied in 30 undialyzed chronic kidney disease patients’ verses 30 healthy controls.

Results:We found both T3 and T4 were significantly reduced (p<0.05) whereas the serum TSH concentration was increased among those with CKD patient group compared to controls (p<0.05). We also observed that urea and creatinine were significantly increased among those with CKD patient than in the controls at (p<0.05) level. In addition, patients had lower total vitamin -c than the controls at (p<0.05) level, The MDA in the CKD patients was significantly increased than in the controls at (p<0.05) level.

Conclusion:From our data, we concluded that renal insufficiency may lead to thyroid hormone disturbances and CKD appears to enhance the oxidative stress due increased uremia levels

Keywords:chronic kidney disease, renal function markers, thyroid hormones, oxidative stress


Department of Biochemistry, Rajiv Gandhi Institute of Medical Sciences,

Srikakulam,  Andhra Pradesh, India

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Title: Effectiveness of Neuro Linguistic Programme on Level of Craving Among Patients with Alcohol Dependence Syndrome

Authors: G.Deepika, Rajeswari.H

Paper Index:  05.2015-33532739

Consuming alcohol has become a part of sedentary life style. Alcoholism is characterized by craving for alcohol and inability to stop drinking. It is accompanied by a physical dependence and an increased tolerance for alcohol.

Objectives: The aim of the present study is to assess the effectiveness of Neuro linguistic programme on level of craving among patients with alcohol dependence syndrome.

Materials & Methods: Quantitative research approach with one group Pre test post test research design was adopted for the study which was conducted in Narayana Medical College Hospital. 60 patients were recruited in the study by non probability convenience sampling technique. WHO -AUDIT scale and observational checklist was used to collect the data. Data was analysed by using descriptive and inferential statistics. Percentages of categorical variables were computed.

Results: In pre test, 60 (100%) patients had moderate level of craving. In post test 40 (66.67%) patients had mild level of craving and 20 (33.33%) patients had moderate level of craving. The pre test mean is 6.4 and standard deviation is 0.5 where as the post test mean is 4.2 and standard deviation is 0.89 with a value of z test  14.47 (1.96)*. There is a significant association between the effectiveness of Neuro linguistic programme on level of craving among patients with alcohol dependence with socio demographic variables like monthly family income and  has no significant association with age, religion, education, occupation, place of residence ,marital status , type of family, ,habit of consuming alcohol influenced by, monthly family income

Conclusion: Neuro linguistic programme is an effective intervention in decreasing the level of craving among patients with alcohol dependence.

Key Words: Craving, Neuro linguistic programme, Alcohol dependence syndrome


Professor & HOD, Department of Mental Health Nursing,

Narayana College of Nursing, Chinthareddypalem, Andhrapradesh, India.

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Title: Does Thyroid Stimulating Hormone (TSH) Levels Affect Anti-Thyroid Peroxidase Antibody (Anti TPO) Titres ?  A Hospital Based Study in a Random Population

Authors: N.Rohini MSc Med, Dr.Durdana Sayeed MD, Dr. Radhika Chowdary MD, K.Prasad Reddy

Paper Index: 05.2015-82543451

Autoimmune thyroiditis is a progressive disease of the thyroid gland characterized by the presence of antibodies directed against the thyroid, and by infiltration of the thyroid gland by lymphocytes. Thyroid  autoantibodies appear mostly with the presence of lymphocytes in the targeted organ. Anti-thyroid antibodies are auto antibodies targeted against one or more components of the thyroid.

The objective of the present study is to evaluate the relationship between TSH and Anti TPO in a random population attending to a tertiary care hospital and also to evaluate the effect of TSH levels on Anti TPO titres in females and males seperately.

The present study was a retrospective cross-sectional study carried out on 150 patients attending to Out Patient Department of Krishna Institute Of Medical Sciences a tertiary care hospital. The population included both male and female patients between the age group 3 – 80 yrs. The blood samples were randomly collected from patients with either fasting or non-fasting conditions using BD Gel vacutainers, sample measurements of TSH and Anti TPO were done.

In our study, A significant positive correlation was observed in population comprising of normal TSH and elevated Anti TPO (r = 0.334) when We also found a significant (p< 0.03) increase in Anti TPO titres with an increase in TSH levels in females when compared to males (p> 0.06).

A raised anti-TPO titer with normal TSH can indicate subclinical Hypothyroidism. We conclude that serum TSH levels correlate with Anti TPO titres. Both Serum TSH along with anti-TPO analyses are essential in determining thyroid status.

Keywords:  Autoimmune thyroiditis, ATPO, TSH, Hypothyroidism

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N.Rohini MSc Med

Assistant Professor and Clinical Biochemist

Krishna Institute of Medical Sciences, Secunderabad

Title: Clinical Pharmacist’s Interventions In Adverse Drug Reactions

Author: Sukesh Krishna Chaitanya Loka

Paper Index:  05.2015-13271372

Adverse drug reactions (ADRs) are broadly divided into predictable (related to pharmacologic actions of the drug in otherwise normal individuals) and unpredictable reactions (related to individual’s immunological response and, on occasion, to genetic differences in susceptible patients). Drug allergy is a type of unpredictable reaction. "Drug allergy" refers to immunologically mediated drug hypersensitivity reactions. These may be either immunoglobulin E (IgE)–mediated (immediate) or non–IgE-mediated (delayed) hypersensitivity reactions. The involvement of a critical care pharmacist has been shown to prevent ADE, and reduce the morbidity and today they are recognized as an integral member of critical care team along with the other health care professionals. The idea of a specialized intensive care pharmacist was first established in the world of pharmacy in 1982. I report a series of three case reports to display the interventions of clinical pharmacist in the management and further prevention of the drug reactions. Penicillin induced acute urticaria, Cefexime induced Steven Johnson Syndrome and Valproate induced Rise in Liver enzymes are three cases of drug reactions and the interventions of Clinical Pharmacist in the management and prevention of further recurrence has been reported  in the present article.

Key Words: Adverse Drug Reactions,  Cefexime, Penicillin, Valproate, Clinical Pharmacists role

Sukesh Krishna Chaitanya Loka

Plot No: 2-1/28, II floor, Opp KVR towers B block,

Widia Colony, Cine town lane Miyapur,

Hyderabad- 500049, Telangana, India

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Title: Assessment of Cardiovascular Autonomic Functions in Normal Healthy Young Adults

Authors: Dr. Mazharul Haque, Dr. Wasima Jahan

Paper Index:  05.2015-13271372

The portion of the nervous system that controls most visceral functions of the body is called the Autonomic Nervous System (ANS). The effects of the ANS on heart rate are called “chronotropic effects”.  Briefly, sympathetic stimulation increases heart rate and parasympathetic stimulation decreases heart rate. Our cardiovascular system is governed by autonomic nervous system. Since women have a lower cardiovascular risk , this study is aimed to determine the normal values of cardiovascular functions in normal healthy individuals & to determine effects of age & gender in these values. 50 healthy young subjects (35 males and 15 females) of age 18 to 22 years are subjected to a set of cardiovascular AFTs. The results were Valsalva ratio in males is 11.13±1.12 while in females is 0.94±0.78 with a P value of 0.0009 which is very highly significant. Deep breathing ratio in males is found to be 0.99±0.79 while in females is 0.93±0.7 with a P value of 0.05. DBP change to posture was found to be more in males than in females (P=0.007). This is a very significant change indicating dominant sympathetic activity among males. DBP change to handgrip was also found to be more in males than in females (P=0.01). This is a significant change again indicating predominant sympathetic activity among males. Comparing standing and supine postures, cardiac autonomic nervous activity was so variable among participants that not much significant differences could be detected. However, heart rate and arterial systolic and diastolic blood pressures all were significantly greater in the supine position than standing, indicating sympathetic dominance during supine position and BP was also higher in supine posture.

Dr. Mazharul Haque

Department of Physiology

University College of Medical Sciences, Delhi

Title: Comparison of serum Cardiac Troponin I and Creatine Kinase MB concentrations in Perinatal Asphyxia

Authors: Ahmed Thabet Mahmoud MD, Dalia Monir El lahony MD, Al Sayed Saleh Ali Shehab M.B.B.Ch.

Paper Index:  05.2015-65316749

Background: Perinatal asphyxia considered one of the most important causes of neonatal morbidity and mortality. Perinatal asphyxia results in hypoxic and/or ischemic injuries to various organs of the newborn mainly kidneys, heart, lungs, liver and brain. Myocardial dysfunction is relatively common in asphyxiated neonates.Creatine Kinase MB had been the marker protein of choice for diagnosis of acute myocardial injury for many years. Recently, cardiac troponin I has been an area of interest in the assessment of the magnitude of myocardial injury in asphyxiated neonates.

Aim of the work: This study aiming to compare serum creatine kinase myocardial bound (CK-MB) concentrations and cardiac troponin I (cTn I) concentrations as predictors and diagnostic markers of myocardial injury caused by perinatal asphyxia. 

Patients and Methods: Umbilical cord blood samples were collected from 40 asphyxiated neonates and 20 healthy controls, and then tested for Blood gases, cardiac troponin I and CK-MB. After 24 hours other samples were taken from both studied groups and tested for serum CRP, serum electrolytes (Na, K, and Ca), BUN, serum creatinine, AST and ALT.

The results: Asphyxiated neonates had significantly higher concentrations of cTnI and CK-MB than controls (P<0.001). Serum cTnI concentrations were significantly higher in asphyxiated who died than those who survived (P<0.001).

Conclusion: Cardiac troponin I, was more sensitive and specific than CK-MB in prediction of mortality and morbidity of perinatal asphyxia.

Key words: Cardiac troponin I; CK-MB enzyme; myocardial damage; perinatal asphyxia.

Ahmed Thabet Mahmoud (MD). (Prof)

Menouf, Menoufia,

Telephone number: 01225683702

Sponsor for Corresponding Author (Assistant Prof.)

Dalia Monir El lahouny (MD)

Menouf, Menoufiya

Telephone number: 01000650670

Title: Case of Successful Pregnancy in Wilson’s Disease

Authors: Lavina Chaubey, Madhu Jain

Paper Index:  05.2015-26449848

Wilson’s disease or Hepatolenticular degeneration is an inherited condition of autosomal recessive type wherein the copper transporting gene ATP7B is variably affected leading to copper overload in the body. Two main manifestations are seen. The hepatic, which generally presents earlier,and the neuropsychiatric form. The incidence ranges between 1 in 5000 to 1 in 30000. Untreated female patients additionally suffer from subfertility, the reason for which is not very clear. However, treatment of the disease usually corrects the problem and successful pregnancy may ensue. Here, we present a rare case of successful pregnancy in Wilson’s disease on treatment with zinc.

Keywords:Wilson’s disease, Hepatolenticular degeneration, Pregnancy.

Lavina Chaubey

Assistant Professor, Dept of Obstetrics & Gynecology

Institute of Medical Sciences (IMS)

Banaras Hindu University (BHU), Varanasi (U.P.), India

Mob. No. 09415204849

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Title: Metal Exposure and Oxidative Stress Induced Parkinson’s Disease

Authors: Adnan Bashir Bhatti, MD, Muhammad Usman, MBBS

Paper Index:  05.2015-93861723

Parkinson’s disease (PD) is a neurodegenerative disorder characterized by dopamine deficiency and loss of neurons in the SubstantiaNigra (SN) of brain. The deficiency of dopamine, thereafter, presents in the form of a number of motor and non-motor deficiencies and complications. Our understanding about PD is still evolving and treatments available for this disease are still quite basic. Therefore, better understanding of the pathological events linked with this disease may help us devise better treatment protocols of the disease.

Increased production of reactive oxygen species (ROS), oxidative stress, seems to be the centerpiece of PD pathology. Increased oxidative stress in PD is mainly the result of by-products generated from dopamine metabolism, mitochondrial dysfunction, and inadequate activity of the brain’s antioxidant system. Once generated, ROS cause damage to the brain due to its high unsaturated fatty acid content, which makes it quite sensitive to oxidative injury.

In our daily life we’re exposed to different metals and metals have been long linked as risk factors for PD development. Therefore, in this article we’ve considered three important metals (iron, aluminum, and copper), most of which we encounter time to time in domestic, occupational and environmental standpoints. This review, therefore, is concerned with discussing the role of these metals with increased oxidative stress in brain. Moreover, this review will also discuss how this increase in oxidative stress is linked to various component of PD pathology.  

Adnan Bashir Bhatti, MD

Department of Medicine

Capital Development Authority (CDA) Hospital, Islamabad, Pakistan

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Title: A Study of Refractive Errors on School Going Children in Govt. Medical College Jagdalpur

Author: Dr Pranda Shukla

Paper Index:  05.2015-93215638

Purpose: To study refractive error in school going children and its relation to age, sex, schools, area and type of refractive error.

Materials and Methods: This study was conducted in a government Medical college and associated Hospital jagdalpur. Total 150 students (300eyes) of age group 5-18years were selected .Visual acuity of 6/9 or less was considered as defective vision.

Visual acuity was taken with snellens visual acuity chart. Unaided visual acuity, with pinhole and best corrected visual acuity was recorded. Refraction was assessed with the help of autorefractometer. Direct ophthalmoscopy was done in all the cases. Retinoscopy and postmydriatic test was done only in some cases. Spectacles were prescribed to children.

Results: Out of 150 students 86(57.33%) girls and 64(42.67%) boys, 78%(n= 117) from urban area and 22%(n=33) from rural areas, 34% were studying in Government schools and 66% in private schools,38% wore spectacles and 62% were not wearing spectacles. Astigmatism was the commonest refractive error seen in 68.67% of eyes followed by myopia in 22..66%, hypermetropia in 6% and 10.66% eyes had amblyopia.

Conclusion: Astigmatism was the commonest refractive error, barriers to refractive error correction services should be identified and school screening programme and health education for eye health care is recommended.

Keywords: Refactive error, myopia, hypermetropia, astigmatism, amblyopia

Dr Pranda Shukla

Associate Professor Department of Ophthalmology,

Late B R KM Government Medical College

Jagdalpur (Chattisgarh)

Title: Blunt Traumatic Diaphragmatic Injuries - An Experience of 5 Years

Authors: Priya Goyal, Shekhar Gogna, Prateek Thakur, Sonia Goyal

Paper Index:  05.2015-85196559

Traumatic diaphragmatic rupture is caused by blunt and penetrating force. It is associated with high morbidity and mortality. High index of suspicion is required to not to miss this injury. Comprehensive combination of Chest x-ray, clinical features and CECT suffice to detect this injury. Early surgery still remains the gold standard investigation and treatment of choice. The purpose of this study was to present our experience with the management of this injury.

Shekhar Gogna

Assistant Professor, Department of Surgery,

PGIMS Rohtak, Haryana , India- 124001

Email: This email address is being protected from spambots. You need JavaScript enabled to view it., +919896379623

Title: Objective Structured Clinical Examination (OSCE):  An Excellent Tool for Testing Clinical Competence

Authors: Dr. Ketan Vagholkar, Dr. Minal Doulatramani

Paper Index: 05.2015-24839193

Assessment of clinical competence is the mainstay of any examination process. With the rapid evolution of medical sciences and growing expectations from the patient community, assessment of clinical competence poses the greatest challenge to medical educationists. The search for newer and better methods of assessment continues. OSCE is one such methodology of testing which satisfies most of the criteria to be adopted as a standard testing system. The feasibility of using OSCE pattern for testing clinical competence was studied in undergraduate medical students after completion of their surgical clerkships. The results are tabulated. The advantages and shortcomings of the OSCE pattern are discussed. OSCE is an excellent way of testing clinical competence cutting across all the domains of learning.

Keywords: OSCE, assessment, evaluation

Dr.Ketan Vagholkar

MS, DNB, MRCS, FACS, Professor, Department of Surgery,

D.Y. Patil University School of Medicine, Navi Mumbai, MS. India

Annapurna Niwas, 229 Ghantali Road. Thane 400602 MS. India

Email: This email address is being protected from spambots. You need JavaScript enabled to view it., Mobile: 9821341290

Title: Acute Myocardial Infarction in a 23 Year Old Smoker Man: A Rare Entity

Authors: Sunil Kumar Goel, Vinay Sindhu

Paper Index:  05.2015-68236623

In the present case study, patient had myocardial infarction at a young age of 23 years. Patient was a cigarette smoker. His body mass index was 31.09 kg/m2. Physical inactivity, lack of green vegetables-fruits in their meal and use of junk food in his life style was common. Unlike other studies, in the present case study, patient was not suffering from diabetes mellitus, hypertension and dyslipidemia. Patient was residing in urban area of Bulandshahr. The present case study strongly suggesting that the effect of cigarette smoking as coronary risk factors is pervasive. Unfavourable effects are enhancement of thrombosis formation, coronary artery disease including onset of myocardial infarction. Knowledge of association of cigarette smoking and coronary artery disease is essential for every medical health care professional to prevent premature deaths due to myocardial infarction. A target oriented programme for the encouragement of youths to stop smoking to improve physical fitness is needed. Improving lifestyle with tobacco cessation, diet with more fruits-vegetables and avoiding junk foods are important to decrease the risk of death due to myocardial infarction.

Keywords: Smoking, CAD, Infarction, Risk factor

Sunil Kumar Goel

Assistant Professor, Department of Medicine

Saraswathi Institute of Medical Sciences, Hapur 245304 (U.P)

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Title: Nanoparticles in Irrigation and Disinfection of the Root Canal System – A Review

Authors: Rucheet Purba, Snehal Sonarkar, Vidya Mokhade, Varsha Uttarwar, Manjusha Pradhan

Paper Index:  05.2015-58752948

This article discusses use of nanoparticles in disinfection of the root canal system. the various nanoparticles discussed here are chitosan, silver, zinc oxide, bioactive glass and polylacticoglycolic acid nanoparticles. Further it describes the mechanisms of action in eradication of bacteria present in the dentinal tubules. This paper also describes the mechanism of nanoparticle delivery.

Dr. Snehal Sonarkar

Department of Conservative Dentistry and Endodontics,

VSPM’s Dental College and Research Center, Digdoh hills, Hingna road, Nagpur (MH), India 440019

Email: This email address is being protected from spambots. You need JavaScript enabled to view it., +919967111642

Title: A Syndrome of Prolapsed Leaflets

Authors: Dr. Shivashankara T H, MD, Dr, Deepak pujar MD, Dr. Cholenahally Nanjappa Manjunath MD, DM

Paper Index:  05.2015-44916557

Marfan syndrome is a variable autosomal dominant disorder with characteristic cardiovascular, eye and skeletal features. Progressive aortic dilatation, usually maximal at the sinus of Valsalva, associated with aortic valve incompetence leads to aortic dissection or rupture and is the principal cause of mortality. We report a case of marfan syndrome with prolapse of all valves with severe aortic regurgitation. Occurrence of prolapse of all cardiac valves is not commonly seen.

Key Words:  Marfan syndrome; mitral valve prolapsed; aortic root dilation; aortic regurgitation

Dr.Shivashankara T H, MD

Sri Jayadeva Institute of Cardiovascular Sciences and Research,

Banneru ghatta Road, Jayanagar 9th Block, Bangalore, Karnataka, India 560069

PH: 9886230507, Fax: Fax: +91-80-2653-4477

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Title: Practice Parameters for Managing Children with Febrile Convulsion

Author: Dr Anwar T Elgasseir

Paper Index:  05.2015-74841916

Objectives: This study intended to determine and evaluate the care of children with Febrile Convulsion seen at Misurata Teaching Hospital, using some of the measures regarding the appropriate documentation of hospital records, adverse outcome, inappropriate investigations and the unnecessary treatment.

Patients and Methods: Descriptive study (Longitudinal hospital based study) in paediatric department Misurata Teaching Hospital where hospital records of patients admitted for febrile convulsion, from January 2012-December 2012 were prospectively reviewed. All hospital admissions, of children presented with febrile convulsion aged 6 months to 5 years are included in the study. We define basic standards practice parameters in management of children of febrile convulsion to which our clinical practice can be compared and we evaluate our care using these standards.

Results: 91 patients were admitted for febrile convulsion during January 2012-December 2012 (7.7 % from the total hospital admission). 71 (78%) had simple febrile convulsion (Complex febrile convulsion 22% and 3.2% with Status febrile convulsion) and 23 patients (25.3%) had family history of febrile convulsion in first-degree relatives. Accurate description of seizure was observed in 72%, while only 63% of records had complete information about the presence/absence of signs of meningitis. Routine blood investigations, complete blood count, blood glucose, electrolytes, and urea were completed for over 90% of cases. We have just one patient in the study group require computed tomography scan but no child with simple febrile convulsion required neuro-imaging studies. 74 patients (81%) were given regular antipyretics every 4 to 6 hours, regardless of body temperature. 9 patients (10%) of children received antibiotics for their underlying febrile illness.

Conclusion: This study shows clear gap between our hospital practice parameters and the recommended basic standards Practice parameters in terms of appropriate information in hospital records, and concerning the use of unnecessary investigations and treatment which remain common in our practice.

Keywords: Febrile Convulsion; Hospital Practice Parameters; Hospital Records; Clinical Practice; Basic Standards.

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Dr Anwar T Elgasseir

Department of Paediatric, Misurata Teaching Hospital, Faculty of Medicine,

Misurata University, Misurata, Libya, Tel: 0925443430.

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Title: Role and Prevention of Tobacco for Oral Health Care. Where Are We Now???

Authors: Vaibhava Raaj, Poonam Kumari, Abhishek Gautam, Manisha Singh, Abhishek

Paper Index: 05.2015-17247266

Tobacco use in India continues to promote various diseases and kill several individual but still no significant steps are been taken to get rid of this threat. Not only cancer but tobacco plays as the key factor for various diseases. While the impact of tobacco use on health is alarming being free from tobacco use and its various form can let us away from several effects. Quitting tobacco and getting away from chronic orofacial pain, oral and pharyngeal (throat) cancer, oral tissue lesions, birth defects such as cleft lip and palate, and other diseases are going our major goal in near future.

Keywords:- Tobacco, oro-facial pain, pharyngeal cancer, lesions.

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Dr. Vaibhava Raaj

Janki Kutir, Singhi dalan Colony, Opp Khajekalan Thana, Patna City, Bihar, India

Contact Number: +91-9835081541/ +91-9431077714

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Title: Spectrum of Histopathological Changes of Endometrium in Dysfunctional Uterine Bleeding - A Hospital Based Study

Authors: Dr Aparna  Langthasa, Dr.U.C.Dutta

Paper Index:  05.2015-72984734

DUB is the most common complaint in gynaecology outpatient department. Histopathological evaluation of endometrial tissue plays a significant role in the diagnosis of DUB. The study was carried out to determine the spectrum of histopathological changes of endometrial tissue in women in the age group of 20 40 years  presenting with DUB.  Formalin fixed specimens (endometrial curettings and hysterectomy specimens) were examined grossly, processed routinely and sections were stained with H&E stain and microscopic findings were noted. A total of 106 cases were analyzed. Normal cyclical endometrium was seen in 55(52%) cases, followed by abnormal endometrium 48(45%)cases and others(endometritis, product of conception) 3(3%) cases. Of the 55 cases of normal cyclical endometrium, proliferative endometrium was highest with 38(69%) cases, followed by secretory endometrium 13(24%) cases, anovulatory endometrium 4(7%).Out of 48 cases of abnormal endometrium,35 (73%) cases was of endometrial hyperplasia, atropic endometrium 6(13%)cases, endometrial carcinoma 4 (8%) cases and endometrial polyp 3(6%).

Histopathological evaluation of endometrial curettage and hysterectomy specimens is specially recommended in patients with dysfunctional uterine bleeding to rule out the possibility of any preneoplastic or neoplastic conditions.

Keywords: Normal cyclical endometrium, Endometrial Hyperplasia, Endometrial Carcinoma.


Assistant Professor, Pathology Department

Gauhati Medical College, Guwahati

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Title: Uncommon Coexistence of Aortopulmonary Window With Interrupted Bovine Aortic Arch and  Patent Ductus Arteriosus in An Adult: A Case Report and Review of Literature

Authors: Dr. Abhishek Gupta, Dr. Bharat Gupta, Dr M. L. Meena, Dr N. K. Kardam, Dr K. B. Gehlot

Paper Index:  05.2015-58188338

Aortopulmonary window is an opening between the aorta and the pulmonary trunk. Interrupted aortic arch is defined as a loss of luminal continuity between the ascending and descending portions of the aorta . Bovine aortic arch is the most common variant of aortic arch and occurs when the brachiocephalic shares a common origin with the left common carotid artery. The rarity in our case lies in the co-existence of these rare congenital cardiac anomalies with a delayed age of presentation i.e. 27 years which was diagnosed entirely by MDCT and Echocardiography and to the best of our knowledge this co-existence has not been reported so far.

Dr. Abhishek Gupta

3rd Yr.Resident, Dept. of Radiodiagnosis

RNT Medical College, Udaipur 

Title: Clinical Study of Soft Tissue Sarcoma Cases in A South-Indian Teaching Hospital

Authors: Dr.D.Abhivardhan, Dr Ch.V.Sivakumar, Dr Lakshmi Reddy

Paper Index:  05.2015-76975621

Background:The purpose of present study is to know the incidence, clinical presentation and management of soft tissue sarcoma cases and to observe the outcome of the same. Extremity swellings are suspected to be Mesenchymal origin but other areas like Trunk, abdominal wall, Retro peritoneum also may be sites for Soft tissue Sarcomas. The pathological diagnosis by careful tissue study is pivotal. Early recognition, correct histological diagnosis by dedicated Pathologist and early surgical intervention are the most important points regarding the prognosis for the patient which is otherwise very gloomy.

Methods: A prospective study of Soft tissue sarcomas in patients attending Government General Hospital, under Rangaraya Medical College has been undertaken from 2012 to 2014. Forty-six patients with soft-tissue sarcomas have been included in the study. out of which 28 Male and 18 female patients were proved to be having Soft Tissue Sarcomas at various sites. Core-needle biopsy showing Soft-tissue sarcoma of various cell types in both sexes have been included in the study, Exclusion criteria are patients reluctant for follow-up.

Results: 46 patients of various age groups were selected .The peak incidence is between 3rd to 6th decades.The site of Sarcomas have been recorded to be extremities (50%), Trunk (23%), Viscrea(13%) and Retroperitoneum(10%), have been in that order the site of Sarcomas.Most common presentation is Asymptomatic swelling followed by recurrent swelling.Wide excision with Post-operative radiotherapy is the most common management protocol that was followed.

Conclusions:Soft tissue sarcomas are a group of lesions that arise from the extra Skeletal connective tissue of the body. They include all the non epithelial extra skeletal tissues with the exception of glia of central nervous system, reticulo endothelial system and the supporting tissue of various parenchyma organs. A high index of suspicion with a Histopathological study is very important. Soft tissue imaging with MRI is an important pre-operative investigation to determine the extent, integrity and neurovascular involvement. Incision is to be well planned to include the entire swelling .A size more than 5 centimetres, infiltration into surrounding structures, involvement of neurovascular bundle, enlargement of loco-regional lymph nodes  are all signs of high risk and poor prognosis. A wide local excision with tumour free margins is very important as local recurrences are to be avoided. Post operative follow up is mandatory and moderate to poorly differentiated sarcomas need Local radiotherapy and chemotherapy.

Key-Words: Core needle Biopsy, MRI study of extremity soft tissue swellings, Recurrent swelling Wide local excision.

Dr. D.Abhivardhan, MS

H.No 2-49C-1, Endowment Colony

Bhanugudi, KAKINADA-533003[AP]

Phone: 9848473655

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Title: Acute Urinary Retention Caused by Large Incarcerated Posterior Fibroid

Author: Lavina Chaubey

Paper Index:  05.2015-53178334

Incidence of acute urinary retention in women is 7 per 100,000 populations per year. The male to female ratio is 13:1.The basis of obstruction is subdivided into urethral compression, bladder neck distortion or luminal occlusion [1]. Several predisposing factors of acute urinary retention include uterine malformations, endometriosis, and intramural fibroids. All these factors favour incarceration of the uterus in the pelvic cavity, leading to acute urine retention as a result of urethral compression. An impacted pelvic mass has also been described as a rare cause of urinary retention. Given the high risk of bladder rupture or neuromuscular dysfunction, the first action to take after a rapid physical examination is the drainage of the bladder by catheterization [2]. If a uterine fibroid is suspected as the aetiology of urinary retention and fertility is not desired, hysterectomy is the mainstay of management [3].

Keywords-Urinary retention, Uterine incarceration, Fibroid

Lavina Chaubey

Assistant Professor,Dept. Of Obstetrics & Gynaecology,Institute of Medical Sciences (IMS)

Banaras Hindu University (BHU) Varanasi (U.P.) - 221005, India

Mob. No. 09415204849

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Title: Waardenburg Syndrome – A Case Report

Authors: Dr Shabana Borate, Dr Prasad Kulkarni, Dr S.D.Gangane

Paper Index:  05.2015-54138968

Waardenburg syndrome is an autosomal dominant disorder often characterised by pigmentary anomalies of skin and hair and various defects of neural crest tissues. It accounts for 1-3% of all cases of congenital deafness. Here we describe two siblings, congenitally mute and deaf with heterochromia irides. Case I; is one and half year old male with complete heterochromia irides and associated Hirschprung’s disease. Case II is seven year old female with bilateral partial heterochromia irides.

Key Words: Waardenburg syndrome (WS), Neural crest, Heterochromia irides, Hirschprung’s disease, dystopia canthorum.

Title: Non-Syndromic Oligodontia: A Rare Case Report

Authors: Muhamad Abu-Hussein, Nezar Watted, Azzaldeen Abdulgani, Michael Alterman

Paper Index: 05.2015-45768499

Dental agenesis is a term referred to the absence of one or more teeth. However, oligodontia is a severe type of tooth agenesis involving six or more congenitally missing teeth, excluding the third molars. Oligodontia has a low prevalence and is a very rare condition. The aim was to show this case report of a 13-year-old female patient who presented oligodontia with absence of six permanent teeth and condylar atrophy on left side. The patient had no history of any syndrome or systemic disease according to the anamnesis. Is very important to know oligodontia features to perform a carefully treatment plan.

Key words: Agenesis, Anodontia, Developmental Anomalies, Hypodontia,  Oligodontia, Oral Abnormalities

Dr.Abu-Hussein Muhamad


123Argus Street, 10441 Athens, Greece

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Title: Analysis of Blood Urea and Serum Creatinine in Controls and Type-2 Diabetic Patients

Authors: Dr. N. Sridevi,Dr. K. Vijayakumar

Paper Index: 05.2015-71144453

Diabetes mellitus is a chronic metabolic disorder that can lead to cardiovascular, renal, neurologic and retinal complications. Type 2 diabetes mellitus has quickly become a global health problem due to rapidly increasing population growth, ageing, urbanization and increasing prevalence of obesity and physical inactivity.  A total of 40 individuals of both normal and diabetic, aged between 35 to 70 years were included in the study. Blood glucose, blood urea and serum creatinine were estimated and analyzed .Blood glucose was estimated by GOD – POD method. Estimation of serum creatinine was done by the modified Jaffe’s method. Blood urea was estimated by Urease-Berthelot’s method. There was significant increase in levels of blood urea and serum creatinine (p<0.001) in diabetic patients compared to healthy controls. Blood urea and serum creatinine are widely accepted to assess the renal functions in diabetics. Good control of blood glucose level is absolute requirement to prevent progressive renal impairment.

Keywords: Blood urea, serum creatinine, blood glucose, Diabetes

Dr. N. Sridevi

Associate Professor of Biochemistry

Guntur Medical College, Guntur

Title:Severity of Scorpion Sting Manifestations

Authors: Dr.Veerabhadraiah.K., Dr.V.Sreenivas

Paper Index: 05.2015-49358714

Scorpion environment is an important public health hazards in tropical and subtropical regions. Envenomation by scorpions can result in a wide range of clinical effects, including cardiotoxicity, neurotoxicity and respiratory dysfunction. Recent advances in path physiology and therapy the mortality remains high in rural areas due to lack of access to medical facilities.

Scorpion sting are a common emergency in India and many other tropical countries. In India the red scorpions are more prevalent and their venom is more likely to cause Myocardial dysfunction.

A descriptive study was conducted on severity of scorpion sting manifestations among 100 admitted cases in Government General Hospital, Anantapuramu from January 2014 to December 2014.All the subjects 100(100 percent) have pain at the site of scorpion bite. Majority of the subjects 85(85 percent)  experienced tachy cardia, most of the subjects had peripheral circulatory failure and pulmonary edema which needs immediate identification and therapy. Delays in treatment may leads to higher morbidity and mortality. The present study describes severity of Scorpion sting manifestations and envenomation complications in our emergency ward and ICU, Government General Hospital.

Key Words: Scorpion sting, Envenomation, Pulmonary edema, Mesobuthustamulus.


M.D. Associate Professor

Government Medical College, Anantapuramu

Title: Toxicological Pathology of Aflatoxn B1 on Liver and Kidney in Broiler Chicks for Short Term

Author: Al-Sereah Bahaa. A.

Paper Index: 05.2015-24442983

A short term toxicological pathology study was done for six weeks on broiler chicks by feeding them on contaminated diets with aflatoxin B1, the birds were 14 days old at the start of the study there were macroscopic changes as enlarged and pale yellow liver, enlarged and hemorrhage of kidneys in most of the treated especially at the high dose level, histopathological changes were vacuolated hepatocytes and subcapsular region with areas of liver cell necrosis and  areas of  hemorrhage,periportal fibrosis and congestion of portal vein, septal fibrosis and mononeuclear cells also renal lesions with tubular necrosis, congestion, atrophy glomerular and  degenerate vacuolate corticle tubules. In addition, there was hepatic  bile duct proliferation with foci of hepatic oval cell proliferation too, those could reflect  the carcinogenic effect of aflatoxin B1, as it could induced malignant liver cell tumor if the study continued for longer period.

Keywords- Aflatoxin, liver, kidney, broiler chicks.

Al-Sereah Bahaa. A.

Dep. of Pathology & Poultry Diseases,

Univ. of Basrah, College of Veterinary Medicine, Iraq

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Title: The Changing Trend of Forensic Odontology in India- A Review Article

Authors: Gupta Shalini, Gautam Prateek, Singh Bindu

Paper Index: 05.2015-11425148

The importance of dental identification is on the increase year after year. The concept of using dental evidence in forensic investigation has kindled so much interest in the recent past that forensic odontology is even suggested as the single positive identification method to solve certain forensic cases.

The most commonest role of the forensic dentist is to identify the deceased individuals.

Dental identifications have always played a key role in natural and manmade disaster situations, and in particular, the mass casualties normally associated with aviation disasters. Under these conditions, the bodies of the victims become mutilated to a level that it cannot be recognized & where the dental surgeons plays an important role in the identification.

Because of the lack of a comprehensive fingerprint data, dental identification plays an important role   in the world. The aim of this article was to emphasis the changing trend of forensic odontology in upcoming years and its role in day to day clinical diagnosis.

Keywords:- Forensic odontology, limitations, knowledge, changing trend.

Gupta Shalini

Department of Anatomy

BRD Medical College Gorakhpur

Title: Assessing Anxiety Levels in Working Women Basing on their Marital Status’’ By Using Zung Anxiety Self-Assessment Scale

Authors: Prabhanjan Kumar Vata, Abdu Hassen Musa, Solomon Hailemariam

Paper Index: 05.2015-41429715

"Women develop these anxiety disorders at approximately twice the rate that men do and we really don't have a good explanation for why that happens," says Felmingham.

The primary objective of the present study is to assess the impact of out-of-home employment on anxiety levels of both married and unmarried women. The current study was conducted on working women of Dilla region of Ethiopia on total of 146 women in which 84 respondents are married and the rest 62 are unmarried. In the present study working married women were compared with unmarried working women in respect to their anxiety levels, measured by using Zung Self-Assessment Anxiety Scale.

Zung Self-Assessment Anxiety Scale is a 20-item self-report assessment questioner built to measure anxiety levels. From the present analysis, it can be concluded that in overall respondents, 74.65% are normal with no anxiety and 21.24% are mild to moderate anxiety levels and 4.11% marked to severe anxiety levels and there is no respondents with extreme anxiety levels. It is also observed that the level of anxiety is high in married women compared to unmarried women.

Key words: Anxiety, marital status, working women, Zung Self-Assessment Anxiety Scale.

Prabhanjan Kumar Vata

College of Health Sciences and Medicine

Dilla University, PO Box 419 Dilla, Ethiopia

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Title: Study of Association of Modifiable Risk Factors and Hypertension by Community Based Case Control Study

Authors: Dr.Sreelatha.C.Y, Dr, Palachandra.A., Dr.Sumana.M

Paper Index: 05.2015-15641132

Background: Hypertension is an important public health problem as it is common, asymptomatic, readily detectable and often leading to lethal complications if left untreated. As a consequence, high blood pressure is often called the “Silent Killer” by WHO.  There is a strong correlation between changing lifestyle factors and increase in hypertension in India. Many of the studies done in this regard are mainly descriptive or cross sectional barring few being analytical. Here is an attempt to identify some of the modifiable risk factors for hypertension in the rural areas of Hassan Taluk, by conducting an analytical case control study.

Objectives: To assess the association of selected modifiable risk factors with  hypertension by community based case control study in rural population of Hassan Taluk

Methodology: A community based case control study was carried out in the villages of Hassan Taluk from July 2013 to September 2013. A multi stage sampling procedure was used to select the subjects. 110 cases were divided equally among the 30 villages, approximately 4 cases from each village were randomly selected in the age group of >35 years. 1:1 pair matching has been done, 110 controls were selected from the same village, matching for age (+/-5 years) and sex.

Results: Summarily, the present study found obesity as risk factors for Hypertension with significant association, in the age group of > 35 years, in both sexes. Tobacco consumption and Alcohol consumption are found to be marginally associated with hypertension.


Assistant Professor, Department of Community Medicine,

HIMS, Hassan, Karnataka- 573201 Ph. 9035295352

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Title: Use of HRV as a Tool to Study Cardiovascular Autonomic Responses to Postural Stress in Males

Authors: Malini D, Kalpana M

Paper Index: 05.2015-99484958

Control of autonomic response due to change in posture is mediated   mostly by baroreflexes. The baroreflex function is influenced by many factors. Autonomic responses due to change in  posture are mediated  by both cardiopulmonary and arterial mechanisms and this can be demonstrated by changes in frequency  components (High frequency for parasympathetic and low frequency for sympathetic) of heart rate variability (HRV). Autonomic dysfunction due to postural changes can be found out by conducting autonomic function test which are helpful when physical examinations are inconclusive. The tilt table test can be performed to find the mixed autonomic response to postural stress by studying the changes in frequency components of HRV in different tilt angles. The present study is being done to find the cardiovascular autonomic adjustments to postural stress by doing gradual head up tilt and head down tilt test.

Keywords – Heart rate variability (HRV), High frequency (HF), Low frequency LF) , Head up tilt (HUT), Head  down tilt(HDT)

Malini Dutta

Associate Professor, Department of Physiology

Apollo Institute of Medical Sciences & Research,

Jubilee Hills, Hyderabad -96, Telangana, India

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Title: Standard Anterior Repair of Hiatus Hernia During Laparoscopic Sleeve Gastrectomy Causes a Significant Reduction in Symptoms of GERD

Authors: Nandakishore Dukkipati, Deepti Thakkar

Paper Index: 05.2015-79996912

Bariatric surgery is the most effective treatment for gastro-esophageal reflux disease (GERD) in obese patients. Published data reporting the results of laparoscopic sleeve gastrectomy (LSG) and hiatus hernia repair in patients with GERD are contradictory. In this study, we evaluate the effects of standardization of our LSG and Hiatus hernia repair technique on the incidence of postoperative symptoms of GERD. This was a retrospective study. Patients who underwent Laparoscopic sleeve gastrectomy at our centre between Jan 2012 and Dec 2013 were followed up retrospectively with a questionnaire. All patients had been evaluated for hiatus hernia (HH)  intraoperatively using a 15ml Balloon pull back technique and all hiatus hernias were repaired with anterior crural approximation. A total of 246 patients underwent surgery. All 246 patients who completed 3–24 months of postoperative follow-up were evaluated. In the study group, 79 patients (32 .1%) were diagnosed with GERD preoperatively, and Hiatus Hernia was detected in 77 patients (30.8 %) intraoperatively. Hiatus Hernia was treated by anterior repair in all pts.There is a significant remission of GERD symptoms post op in patients with hiatus hernia (p=0.003). Most patients with a hiatus hernia repair are asymptomatic post op(p=0.001). Our study confirms a substantial prevalence of GERD symptoms and HH in obese patients. Our results show that standardization of intraoperative hiatus hernia detection and repair can cause a significant reduction in symptoms of GERD patients up to 24 months after surgery and also prevent denovo GERD symptom development after LSG.

Keywords: GERD, Hiatus hernia, Laparoscopic Sleeve Gastrectomy

Deepti Thakkar

Livlife Hospitals, Jubilee Hills,

Rd No 36, Hyderabad, Telangana 500033 India

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Title: Are Psycho-educational Strategies Effective in Promoting Fluid and Dietary Adherence in Haemodialysis and Peritoneal Dialysis Patients? A Systematic Review of Literature

Authors: Chidiebere Valentine Ekuma, Joy Chidinma Agom, Dr Lesley Lappin, Dr Alison Brettle

Paper Index: 05.2015-58876317

Objectives: To identify studies involving educational interventions in promoting fluid and dietary adherence in haemodialysis and peritoneal dialysis patients; to critique the research methods, describe and summarise the effectiveness of the tested interventions.

Background: Adherence to fluid and dietary restrictions is a major integral part of the management regimen of end-stage kidney disease patients. However, no strategy has been reported in the literature as effective in achieving this.

Methods: The author searched the MEDLINE (Ovid), CINAHL (EBSCO), Psych Info and the Cochrane Library databases with no language restrictions. A total of 12 studies were reviewed based on the review question and the inclusion criteria. Each of the studies was critically appraised with respect to the sample size, study design, theoretical framework, intervention integrity and the outcomes.

Findings: Self-monitoring and self-management dietary counselling when combined with other strategies respectively offer some promise in promoting fluid and dietary compliance in dialysis patients. The calculation of IDWG was operationalized in various ways.

Conclusions: Further researches with more rigorous methodology and use of theoretical models are needed. The researches should consider reporting information on relevant variables such as co-morbidity, thirst intensity and type of sodium modelling used.

Keywords: Haemodialysis; Peritoneal dialysis; fluid; diet; adherence; patients

Chidiebere Valentine Ekuma

Doctoral Student, School of Nursing, Midwifery, Social Work and Social Sciences,

University of Salford, Manchester, M6 6PU

E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it., Phone Number: +447421153809

Title: Colon Surgery with & without Mechanical Bowel Preparation: A Comparative Study

Authors: L. Manikandan, Rajan Kumar T, Prathapan V.K, M.P.Sasi

Paper Index: 05.2015-28399961

Mechanical bowel cleansing is part of routine preoperative preparation of patients planned for colectomy worldwide. The commonly used bowel preparation agent is polyethylene glycol, but this drug causes severe morbidity. We conducted a non-randomized interventional study to assess whether colonic surgery can be safely performed without mechanical bowel preparation. In this study 50 patients planned for elective colectomy were divided into two groups of 25 each. Group A was given mechanical bowel preparation in the form of 2000 ml of polyethylene glycol (Peglec, Tablets India Ltd) while Group B was not given mechanical bowel preparation. In both these groups outcome was noted in terms of wound infection & anastomotic leak. Wound infection was defined as a wound requiring partial or complete opening for drainage of purulent collection, or erythema requiring initiation of antibiotic treatment. Anastomotic leak was identified if demonstrated by imaging or documented in surgery, or if feculent drainage was evident through a perianastomotic drain. Out of the 25 patients in Group A, 15developed wound infection & 11out of 25 developed wound infection in Group B. There was no statistical difference between the two groups in this regard. Similarly 3out of 25 in Group A &nil patients in Group B developed anastomotic leak, the difference was not statistically significant. Other parameters such as return of bowel sound & post-operative hospital stay were found to be similar. Passage of flatus post-operatively was found to be significantly earlier in Group B.

L. Manikandan

Department of General Surgery, Government Medical College, Kozhikode, India 673008

Email: This email address is being protected from spambots. You need JavaScript enabled to view it., Phone: +918129335454

Title: Time Effect Storage Artifacts of Anticoagulant EDTA on Peripheral Blood Cells

Authors: Dr. Ramu Thakur, Dr.O.P.Moorjani

Paper Index: 05.2015-43353341

Aims & Objectives: Exclude the EDTA induced storage artifacts .Identify and exclude the misinterpretation of peripheral blood smears examination .Identify the EDTA induced RBC & WBC morphological storage artifacts. Identify the EDTA induced   platelets related artifacts.

Material & Methods: Blood was collected in a sterile EDTA containing tube and processed following our established laboratory protocol .A complete blood counting including HB%,PCV, Red cell indices ,platelet count and total white cell count and differential was done by  Automated blood  cell counter and peripheral blood smear examination  then a sterile EDTA containing  blood sample tube stored at room temperature. The all cell count indices including RBC,WBC count with differential along with morphological storage artifacts and platelet count with storages artifacts, was further confirmed by manual oil immersion smear study method. Peripheral smears study was done with field A and B stain and leishman stain.

Conclusion: EDTA cause the various storage artefacts encountered on peripheral blood smear  examination when smear prepared from prolong stored sterile EDTA containing blood sample tube at room temperature. EDTA cause RBC, WBC morphological artifacts and platelets related artifacts .These artifacts lead to various misinterpretation of peripheral blood smear examination so exclude them.

Keyword- Creanated RBC, Nuclear lobe, Platelets aggregation.

Dr. Ramu Thakur

Assistant Prof, MGM Medical College with M.Y.Hospital Indore M.P

Email- This email address is being protected from spambots. You need JavaScript enabled to view it., +919977126168

Title: A Study to Compare Healing in Postoperative Wounds with Occlusive Gauze Dressing and after Omitting the Dressing

Authors: Dr. Achala Sahai Sharma, Dr. Deepika Yadav, Dr. Jyoti Bindal

Paper Index: 05.2015-35433974

Introduction: The application of dressings to surgical wounds is a custom as old as recorded history . Many studies in the past have demonstrated the safety of exposure of surgical wounds without any complications. The aim of present study was to investigate and compare the outcome of management of clean abdominal incision wound by open that is without dressing or occlusive gauze dressing from fourth day onwards till stitch removal in obstetrics & Gynecological surgeries.

Patient and Methods: This was a case control study wherein total 100 patients who were electively operated for obstetrical and gynaecological indications were and randomly divided into two groups. Group I [case group] consisted of 50 patients in whom dressing was done from 4th day onwords till stitch removal. In groupII [control group] occlusive gauze dressin was done. In all 100 patients preoperatively skin was thoroughly cleaned with savlon, betadine and spirit. At the end of surgery haemostasis was secured and all dead spaces were cautiously obliterated. Injectable antibiotics were given upto 5th postoperative day followed by oral antibiotics for next five days. In all cases after surgery dressing was done with gauze pieces and occlusive tape for 4 days. In control group occlusive dressing continued till stitch removal whereas in study group wound was left open after 4th day and only daily betadine painting with sterile gauze piece was continued. Healing of the incisional wound was compared between the two groups with respect to age, socioeconomic status, parity, builty, nutrition, personal hygiene and preoperative haemoglobin status. Also incidence of postoperative complications, resuturing, duration of hospital stay and types of antibiotics used in the two groups were also studied.

Result: It was evident that in group I with open dressing 80% of wounds were healthy and only 20% cases had postoperative wound complications. Whereas in groups II with occlusive gauze dressing only 36% wounds were healthy while 64% had one or the other wound complications. However the correlation was not statistically significant [pvalue=0.319] The incidence of resuturing in group I was zero where as in group II the resuturing was required was required in 12%. The difference in the hospital stay of the two groups was not statistically significant in group with 10-16 days hospital stay {p value=0.0127} but was significant in the group of patients with more than 16 days of stay [p value=0.0038]. Similarly the difference in the use of higher antibiotics was not found to be statistically significant [p value=0.0084] 

Conclusion:The study concluded that 1) omitting dressing of post operative wounds has better outcome than occlusive dressing in terms of lesser complication rate and less duration of hospital stay. 2) It cost and morbidity to patient.  3) It has advantage of saving surgeons time, hospital cost and manpower.   

Keywords: Wound, healing, occlusive, open.

MeSH terms: Occlusive dressing, postoperative period, wound healing.

Dr. Achala Sahai Sharma

M.S., M.I.C.O.G., Assistant Professor, Deptt. of Obst. & Gyn., G.R.Medical College, Kamla Raja Hospital Gwalior 474001 (M.P)

Address: 42 C  Jawahar Colony, Lashkar Gwalior 474001 MP Mob. 9425110631

Title: Brachial Artery Pseudoaneurysm Causing Median Nerve Compression: A Case Report

Authors: Amit Singh, Vijendra Kumar, Shekhar Tandon

Paper Index: 05.2015-68959583

Pseudoaneurysms in the upper extremities are less frequent than in the lower extremities. They commonly cause local pain, skin ischemia, rupture, distal embolization and venous edema. Very rarely, median nerve neuropathy can be caused due to compression by a brachial artery pseudoaneurysm. We present an unusual case of median nerve neuropathy due to compression by a long standing iatrogenic giant brachial artery pseudoaneurysm in a middle aged woman, which was managed surgically by aneurysmal resection and saphenous vein graft interpositioning.

Key words: Pseudoaneurysm, Brachial artery, Median nerve.

Amit Singh

Assistant Professor, Department of Cardiovascular and Thoracic Surgery, Uttar Pradesh Rural Institute of Medical Science and Research, Saifai, Etawah, Uttar Pradesh, India-206301

Mob: 09917550631 Email: This email address is being protected from spambots. You need JavaScript enabled to view it.

Title: Retrospective and Prospective of Neonatal Obstruction

Authors: Dr Amarjit Singh Kuka, Dr. Satish Malhotra, Dr. Bawitlung Zonunsanga, Dr. Ravninder Singh Kuka

Paper Index: 05.2015-29393769

Intestinal obstruction in neonates is a common surgical emergency which requires a team approach for optimal outcome, as most cases in this age group have a congenital cause for obstruction. In our study, the aetiology and factors affecting outcome (morbidity and mortality) of surgery in neonatal intestinal obstruction were evaluated which included a retrospective period from April 1, 2011 to February 28, 2013 and a prospective period from March 1, 2013 to October 31, 2014. A total of 50 neonates were included who underwent surgery for intestinal obstruction during the three years and 8 months study period. The outcome following surgery was classified into three types namely ‘alive without complications’(I), ‘alive with complications’(II) and ‘those who died’(III). Chi- square test was used to compare the difference with and without factors causing morbidity and mortality. It was observed that 58.0% (29/50) of the total neonates were alive without complications; 18.0% (9/50) were alive with complications and 24.0% (12/50) expired. The results of our study show that anorectal malformations (58%) are the leading cause of neonatal intestinal obstruction followed by Hirschsprung’s disease (12%), Intussusception (8%), Obstructed hernia (8%), Malrotation(6%), Intestinal atresia (4%) and Hypertrophic pyloric stenosis (4%). Abdominal distension, constipation, vomiting, delay or failure to pass meconium are the common modes of presentation in neonates. It was found that gestational age, birth weight and delay in presentation significantly affected the outcome. It was also derived that mode of delivery, age at presentation, preoperative morbidity and preoperative antibiotics did not affect the final outcome of neonatal intestinal obstruction.

Keywords: Neonatal Intestinal Obstruction, morbidity, mortality

Dr Ravninder Singh Kuka

Lane no. 4, New Harindra Nagar, Opposite Police Lines, Faridkot, Punjab Pin: 151203

Email: This email address is being protected from spambots. You need JavaScript enabled to view it., Phone: +91 9876389026

Title: Study on Practice and Perception of Beneficial and Ill Health Effects of Food Items In Rural Area Of Pondicherry

Authors: K N Prasad, S. Krishna Kumar, I. Lakshmi Priya, J. Luke Martin, R. Meena, S.A. Keerthi, S. Komala Devi

Paper Index: 05.2015-34463744

Introduction: There is an agreement and disagreement among people about the effect of foods on health status of individuals.  Some attribute to systemic symptoms as they perceive it as causative factor.   It is necessary t know the prevalence of such belief in the community from time to time.  

Objectives:  To know the practice and perception of beneficial and ill health effects of food items in rural area of Pondicherry.

Methodology: It is a cross sectional study done between the time period of March and April 2015 among 317 families and their members at t their doorsteps. Pretested questionnaire was filled with the information given by the subjects after their verbal consent. Descriptive questions regarding the family’s perception Criteria like the ill health effects of those food items, effects of those foods on pregnancy, children, etc, beneficial effects of hot/cold foods and foods avoided during different seasons. 

Results: During summer season, 37.6% of the people avoided chicken and 26.6% avoided mango. During winter season, 32.6% avoided curd, 25.6% avoided ice-cream. During pregnancy, 21.6% avoided papaya and 12.6% avoided pineapple. For infants, 2% avoided mango and ice cream was avoided by 1% for the infants. It is concluded that the perception of food items as hot or cold is strong and necessary to create awareness in this community. Some of the foods were considered as benefit and harmful to specific groups in the family.

Conclusion: There are few beneficial aspect and ill effects according the community perception, misconception and misunderstanding are existing on food items. Community should be periodically educated about the myths of ill effects of hot or cold food items.

Key Words: Beneficial effects, ill effects, avoided foods, perception.

Dr K N Prasad

Professor, Department of Community Medicine,

Shri Lakshmi Narayana Institute of Medical Science, Kudapakkam, Pondicherry -605502, India

Email: This email address is being protected from spambots. You need JavaScript enabled to view it., Phone 9448464242

Title: Study of Socio-Demographic Profile and Psychiatric Morbidity among Chronic Headache Patients Visiting Tertiary Care Hospital - A Hospital Based Cross Sectional Study

Authors: *Saradhi Goud M, Sai Danakula, Pavan Kumar Venkata Thatisetti

Paper Index: 05.2015-62261662

Background: Headache is one of the most common human afflictions, which leads to seek medical advice.  Chronic headaches markedly reduce the quality of life of the sufferers and affect all aspects of their lives. The present study aims to compare personality profile; sense of subjective well being is likely to throw light on the planning of effective intervention strategies to enable these individuals to lead a better life. To this purpose we have evaluated the psychosocial estimates of chronic headache and the impact of chronic headache on employment, social performance, and comfort.

Methods: The cross-sectional study was conducted in 54 patients visiting Princess Esra Hospital, a tertiary care hospital for the period of 3 months. All the patients were screened using a questionnaire for symptoms of chronic headache. Psychosocial analysis done by using M.I.N.I scale. It is a short structured diagnostic interview of choice for psychiatric evaluation and outcome tracking in clinical psychopharmacology trials and epidemiological studies statistical analysis done between the groups by performing chi-square test. The p value less than 0.05 was measured statistically important.

Results:  Majority of the patient population belongs to low socio-economic status 39 (72.2%) ; 77.8% (42) of the individuals were married; 57.4% (31) were diagnosed with major depressive disorder and 9.3% (4) with depression disorders and Melancholia, 27.8% (15), dysthymia and  61.1% (33) with suicidal ideas. 22.3% (12) were with panic disorder, 7.4% (4) with OCD, and 70.4% (38) with GAD.

Conclusion: Majority of headache problems occurred in the age group between 20 to 40, mostly seen in married women female population. Headache sufferers are mostly with primary standard education with low Socio Economic Status. Depression and Generalized Anxiety Disorder (GAD) are by far the predominant psychiatric morbidity in this population. Psychological evaluation should focus on personality characteristics, lifestyle, and life-situation factors that account for individual differences in headache susceptibilities.

Keywords: Chronic Headache, Psychosocial factors, Depression, Migraine

Dr M.Saradhi Goud M.D

Assistant Professor, Department of Psychiatry,

Kamineni Institute of Medical Sciences & Research Center

Hyderabad, India, Ph: 9948026789

Email: This email address is being protected from spambots. You need JavaScript enabled to view it.

Title: Efficacy of Spinal Manipulation as a Part of Physical Therapy Program in Patients with Lumbar Disc Herniation: A Randomized Controlled Trial

Authors: Neveen Abdel Latif Abdel Raoof, Nevein Mohammed Mohammed Gharib, Sahar Mohammed Adel

Paper Index: 05.2015-88858931

Objective:To investigate the effect of a combined spinal manipulation plus physical therapy program on pain intensity, physical function and asymmetry of lumbar facet angles in patients with lumbar disc herniation.

Methods:This was a single blinded randomized controlled study design. Thirty patients with lumbar disc herniation from both sexes and aged between 20 – 45 years participated in the study. They were randomly divided into two groups of equal number; experimental and control groups. Patients in the experimental group received a designed physical therapy program in addition to lumbar manipulation techniques applied to L4-L5 level. Those in the control group received the same physical therapy program only. Treatment was given three days/ week for continuous four weeks. Assessment was performed before and after treatment using Visual analogue scale (VAS), Modified Oswestry low back pain disability questionnaire (ODQ) and facet joint angle asymmetry.

Results:Patients in the experimental group showed a significant improvement as compared with those in the control group. Pain intensity was 3.6±0.91 for the experimental group and 4.9±1.33 for the control group (P=0.002). Physical function measured by Oswestry disability questionnaire was 28.76±7.3 for the experimental group and 35.48±9.2 for the control group (p=0.007). There was a significant improvement in the asymmetry of facet angles between both sides in both groups (in favour of the experimental group).

Conclusions:Spinal manipulation combined with proper physiotherapy program has an objective effect on pain, physical function and asymmetry of lumbar facet angles in patients with lumbar disc herniation.

Keywords: Lumbar disc herniation; Spinal manipulation; Pain; Physical function; Facet angles asymmetry.

Sahar Mohammed Adel

Department of Basic Science, Faculty of Physical Therapy, Cairo University, Giza, Egypt

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Title: Pressure Ulcer Surface Area and Volume Response to Gallium- Arsenide Laser

Authors: Ahmed Mamdouh Mohamed Abd Al-Kader, Maha A.Hassan, Hisham Galal Mahran Elsayed, Zakaria Mowafy Emam Mowafy

Paper Index: 05.2015-71625875

This study has been conducted to evaluate the efficacy of the Gallium Aluminum Arsenide (Ga-As) laser in accelerating pressure ulcers healing. Methods of evaluation (wound surface area and wound volume).

Methods:- Thirty patients (16 males and 14 females) with complete or incomplete spinal cord injury patients and complain from pressure ulcers were randomly divided into two groups. Group (A) received Ga-As laser plus the regular wound care, duration of treatment was 10 minutes daily for two months. Group (B) (Control group) received only the regular wound care.

Results:- Result showed that the Ga-As laser was effective in decreasing ulcer surface area and ulcer volume as well as improving healing of pressure ulcers.

Conclusion: - Ga-As laser was effective in accelerating pressure ulcer healing.

Keywords(Laser, Pressure ulcers, wound surface area and wound volume).

Ahmed Mamdouh Mohamed Abd Al-Kader

National Cancer Institute – Cairo University

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Title: Chromosomal Abnormalities in Infertile Men with Azoospermia and Oligospermia

Authors: Drugkar Amol Z., More Rakhi M., Gangane S.D., Drugkar Swati A., Gosewade N.B. 

Paper Index: 05.2015-62979864

The present study was carried out to find out frequency of chromosomal abnormalities in infertile males with azoospermia & oligospermia.50 males referred for complaints of infertility with azoospermia & oligospermia were included in the present study. The study was carried out in the following steps. 1) Selection of patients 2) Clinical examination of patients 3) Collection of blood and karyotyping 4) Photomicrography 5) Data tabulation and Analysis. Among the total 25 azoospermic males, 8 patients showed abnormal karyotype.  Among these abnormal karyotypes, 3 patients showed 47XXY karyotype, 2 patients showed 46XX karyotype, 46XY(20%)/47XXY(80%) was found in 1 patient, 1 patient showed 47,X,i (Xq)Y  & 1 patient showed a 45,XY,-22 t (14/22) karyotype. Seventeen patients had normal karyotype. Among the total 25 oligospermic male, 3 patients showed abnormal karyotype. Among these abnormal karyotype, 1 patient showed mosaic Klinefelter i.e. 46XY(20%)/47XXY(80%), 1 patient showed a karyotype of  46,XY, inv(9) and one patient  showed 46,XY, large Y.

Key Words: Karyotype, Chromosome, Infertility, azoospermia, oligospermia

Drugkar Amol Z.

Asso. Prof., Dept. of Anatomy, C.M. Med. Col. Durg, India

Email: This email address is being protected from spambots. You need JavaScript enabled to view it.

Title: Efficacy of Polarized Light in the Treatmentof Pressure Ulcers

Authors: Ahmed Mamdouh Mohamed Abd Al-Kader, Maha A.Hassan, Hisham Galal Mahran Elsayed,  Zakaria Mowafy Emam Mowafy

Paper Index: 05.2015-55449921

Purpose: to evaluate the efficacy of the polarized light therapy in accelerating pressure ulcers healing. Methods of evaluation (wound surface area and wound volume).

Methods:- Thirty patients (18 males and 12 females) with complete or incomplete spinal cord injury patients and complain from pressure ulcers were randomly divided into two groups. Group (A)  received the polarized light therapy 10 minutes twice a day (session every 12 hours) for one month plus the regular wound care. Group (B) (Control group)  received only the regular wound care.

Results:- Result showed that the polarized light therapy was effective in decreasing ulcer surface area and ulcer volume as well as improving healing of pressure ulcers.

Conclusion:- polarized light therapy was effective in accelerating pressure ulcer healing.

Key words (Polarized light therapy, Pressure ulcers, wound surface area and wound volume).

Ahmed Mamdouh Mohamed Abd Al-Kader

National Cancer Institute – Cairo University

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Title: A Two-Year Review of the Pattern and Outcome of Medical Admissions in A Secondary Health Facility in Nigeria

Authors: Rasaq O. Shittu, Musa A. Sanni, Louis O. Odeigah, Akanbi II A.A, Abdullateef G. Sule, Okesina B.S, Salamat Isiaka-Lawal

Paper Index: 05.2015-92847695

Background: The profile of morbidity and mortality are a reflection of the prevailing pattern of diseases and the responsiveness of the health care system. In developing country like Nigeria, limited resources require that health priorities be selected wisely; hence it is pertinent to evaluate the morbidity and mortality pattern for health planning and for improving the health care services. There are limited data on the causes of hospital admission and death among adults in Nigeria. Hence, the need to provide a comprehensive reviews of the pattern of morbidity, mortality and medical outcome in Nigeria.

Methods:This is a retrospective study of 933 patients admitted to the medical wards of Kwara State Specialist Hospital, Sobi, Ilorin from December 2012 to December 2014. Data were obtained from the admission and discharge/death register, patients’ case records and the quarterly mortality reviews. The data was analyzed using the SPSS version 16.

Results: A total of 933 were admitted over the two years study period. Of these 601 (64.4%) were discharged, 131 (14.0%) referred, 108 (11.7%) died while 92 (9.9%) Discharged Against Medical Advice (DAMA). Infectious Diseases 236 (25.3%) constituted the highest morbidity and mortality. It also constituted the highest discharged against medical advice 30 (32.3%). Of the infectious diseases HIV/AIDS 105 (11.3%) predominate, followed by pulmonary tuberculosis 81 (8.7%). Cancer had the least morbidity 20 (2.1%) and mortality 3 (2.8%). Of the non-communicable diseases, neurological disorder accounted for 21.1% (197) with predominance of cerebrovascular accident 189 (20.3%). However, gastrointestinal 179 (19.2%), cardiovascular 97 (10.4%) and endocrine 52 (5.6%) were prevalent. Congestive cardiac failure 37 (4.0%) was the commonest causes of mortality in the cardiovascular group.

Conclusion: Infectious and neurological diseases are currently the leading causes of admission in Kwara State Specialist Hospital, Nigeria. Discharged against medical advice is significant.

Keywords: Morbidity, Mortality, Outcomes, Medical Ward, Family Practice, Nigeria

Dr. Shittu O. Rasaq

Consultant Family Physician,

Kwara State Specialist Hospital, Sobi, Ilorin.


The Chief Medical Director,

Oorelope Hospital (Consultant Specialist Clinics)

KM 8, Apata Yakuba, Ilorin, Kwara Sate

Email: This email address is being protected from spambots. You need JavaScript enabled to view it., TEL: +23435062687

Title: A Comparative Study of Hyperbaric Ropivacaine 0.75% and Hyperbaric Bupivacaine 0.5% in Spinal Anaesthesia for Caesarean Section

Authors: Dr. Nazima Memon, Dr Ramesh G Pathak

Paper Index: 05.2015-22834167

Background: Ropivacaine is a newly introduced amino-amide local anesthetic agent introduced in1996 (2009 in India). Ropivacaine is gaining popularity as it is less cardiotoxic than conventional bupivacaine. The use of Ropivacaine in Obstetric patients ensures safety and better hemodynamic stability.

Methods:  Sixty Parturients belonging to ASA grade I and II posted for elective Caesarean Section under spinal anesthesia were divided into two groups: Group R (received 15 mg Hyperbaric Ropivacaine) and Group B (received 10 mg Hyperbaric Bupivacaine). Block parameters like onset of sensory blockade, onset of motor blockade, duration of sensory and motor blockade and time taken from giving spinal anesthesia to skin incision were noted. APGAR score of newborn at 1 min and 5 min was also recorded to study the effect of both drugs on neonatal outcome. Hemodynamic parameters like heart rate and mean arterial pressure were monitored. Also Incidence of complications like hypotension, bradycardia, nausea, vomiting and shivering was noted.

Results: The onset of sensory and motor blockade was earlier in Group B (2.28 ± 0.62 and 3.58 ± 0.63)   than Group R (3.76 ± 0.53 and 4.03 ± 0.65). The mean duration of sensory and motor blockade was more in Group B (160.60 ± 17.27 and 141.0 ± 19.44) than Group R (132.23 ± 16.47 and 116.73 ± 5.97). However this resulted in early recovery of patients from spinal anesthesia and early ambulation. Moreover, Group R patients were haemodynamically more stable than Group B which resulted in improved outcome of patients.

Conclusion: Use of Hyperbaric Ropivacaine has increased margin of safety with less alteration in hemodynamic profile as compared to Hyperbaric Bupivacaine.

Keywords: hyperbaric, bupivacaine, ropivacaine, Caesarean section.

Dr Nazima Memon

Assistant Professor, Department of Anaesthesiology, Dr Shri Shankarrao Chavan Government Medical College Nanded

Mobile: 9324222310

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Title: Primary Adenocarcinoma of Appendix Presenting As Acute Appendicitis—A Case Report

Authors: Dr. Devajit Choudhury, Dr. Kanakeswar Bhuyan, Dr. Rabindra Kr Baishya

Paper Index: 05.2015-79195721

It is extremely rare for mucinous adenocarcinoma to develop as a primary tumour. The incidence of epithelial malignancies of the appendix has been estimated to be 0.12 per 1 million persons per year. We report a case of primary appendiceal adenocarcinoma of signet ring cell variant presenting with features of acute appendicitis. Routine investigations showed dilated appendix with peri-appendiceal fluid collection suggesting acute appendicitis. After appendicectomy, the specimen was sent for routine histopathological examination. The diagnosis came out to be signet ring cell adenocarcinoma. As a second stage procedure, right hemicolectomy was done. As it was an incidental finding, this case emphasizes that routine histopathological  examinations of all appendicectomy specimens is essential and informative.  

Keywords- Appendicitis, histopathology, mucinous, adenocarcinoma. Signet ring cell adenocarcinoma.

Dr. Devajit Choudhury

Assistant Professor of Surgery

Gauhati Medical College, Guwahati

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Title: Role of Social Worker in the Rehabilitation of Victims of Natural Disaster

Authors: Alamgeer, BSW, Dr Mohd Asrarul Haque, MBBS

Paper Index: 05.2015-19141295

The role of social worker in rehabilitation of victims of Natural Disasters is very important as they need physical and psychological support in order to achieve dignified life aftermath of crisis. Natural Disaster produces significant impact on the life of sufferers. Loss of life, property, disability, death results mental agony. Medical Social Worker plays a significant role by working in systematic and methodological approach.

Key words: Social Work, Natural Disaster, Rehabilitation, Psychological support, Public Health

Dr Mohd Asrarul Haque

Junior Resident, JNMC, AMU, Aligarh (UP), India

Email;- This email address is being protected from spambots. You need JavaScript enabled to view it., Mobile No. +918755198534

Title: Biomedical Waste Management: A Study of Knowledge, Practices and Attitude among Health Care Personnel at a Tertiary Care Hospital in Bhopal, Central India

Authors: Dr. Shashwati Nema, Ms. Akansha Singh, Dr. Kiran Tripathi, Dr. Pallavi Shidhaye, Dr. Ashok Kumar Dhanvijay

Paper Index: 05.2015-42495651

Inadequate and inappropriate knowledge of handling biomedical waste (BMW) among health care personnel may have serious health consequences and a significant impact on the environment as well. In view of this, present study was planned to assess knowledge, practices and attitude (KPA) regarding BMW management among our hospital staff. A questionnaire containing 32 questions based on KPA regarding BMW management was filled by 125 study participants [25 each of doctors, interns, nurses, technicians, class IV employees]. Data was analyzed using Stata 11.0.Chi-square test was applied and p value was obtained. Only 15.2% participants could correctly answer about BMW categories. Doctors were found to have significantly better knowledge than  auxiliary staff about measures to be taken following accidental exposure to infected blood or sharps (p=0.007). Less than 65% of them could correctly answer use of each colour coded bags. A favorable positive attitude was found among study participants on BMW management. Our study revealed that although attitude about BMW management was high among health care personnels of our hospital, the knowledge and practice was comparatively low. Therefore, all health care personnel must undergo regular training in BMW management. This should be coupled with effective implementation of rules and regular monitoring by authorities.

Key words: Attitude, Biomedical waste, Knowledge, Practices

Dr.Shashwati Nema

Associate Professor, Dept.of Microbiology,

LNMC, Bhopal (M.P.) India - 462042

Email: This email address is being protected from spambots. You need JavaScript enabled to view it., Tel. No : +91 8085850616

Title: Risk Factors Associated with Aggressive Breast Cancer Forms Seen in Young Women of Western Kenya

Authors: Torrorey Rispah, Ofulla Ayub, Mining S.K. Patel K., Busakhala N., Lugaria L., Meli E. Rono S.J., Ndede I.

Paper Index: 05.2015-79745384

Today in Africa, breast cancer cases are on the rise, seen in a much younger age, more aggressive and likely to kill compared to North America. It is not clear if risk factors associated with development of these forms of breast cancer in African women are similar to those recorded elsewhere.   

We determine established risk factors in histologically confirm breast cancer cases and suspected breast lumps in Western Kenya. Study questionnaires were used to obtain personal details, family history, reproductive factors, lifestyle behaviors and environmental factors associated with developing breast cancer. Data entry was done in excel spreadsheet and exported to Statistical package for social sciences (SPSS V.20) for analysis Results were considered significant at p=0.05.  Multiple binary logistic regression indicated that use of alcohol was a significant risk factors for breast cancer (p=0.029). Those not using alcohol were less likely to be cases (OR; 95%CI: 0.052(0.004-0.736). The Kalenjin were more likely to be cases compared to other tribes though not statistically significant. Similarly, those using injection for contraceptive are more likely to be cases. We report that tribe, place of residence, reproductive and lifestyle habits are associated with development of this disease suggesting that genetics, lifestyle and environmental risk factors could be responsible with the early onset of breast cancer in African women therefore screening for these risk factors should be done at an earlier age with the aim of early detection and treatment and thus increase chances of survival. Further research on the effects of already known and the unknown risk factors on the tumor suppressor genes need to be ascertained.  

Key Words: Risk Factors, Aggressive breast cancer, young women, Western Kenya

Rispah Torrorey

Department of Immunology, School of Medicine,

College of Health Sciences, Moi University P.O.BOX 4606-30100

Eldoret, Kenya

Email: This email address is being protected from spambots. You need JavaScript enabled to view it.   

Title: Clinical and Radiological Outcome of Titanium Elastic Nail Fixation in Diaphyseal Fractures of Tibia in Children

Authors: Jaya Someswar Narreddy, BLS Kumar Babu, Biju Ravindran

Paper Index: 05.2015-86887135

Background: In children, major tibial fractures cases managed by closed reduction and casting. From time to time, surgical intervention is needed due to excessive shortening, angulations, or malrotation at the fracture site. Titanium elastic nailing system (TENS) is a modern technique which allows secure reduction, maintenance of reduction of skeletally immature long bone fractures. To this reason we also evaluated the clinical and radiological outcome of diaphyseal fractures of tibia in children treated with titanium elastic nailing system.

Methods: This open label study was conducted at a Tertiary care hospital, Andhra Pradesh during the period of 2008-2010. Children age between 5-16 years with simple, closed; ipsilateral diaphyseal fractures of tibia admitted to orthopedics department were enrolled. Closed reduction and internal fixation with TENS nails was done.  Follow-up was done at 3,6,12 and 24 weeks. On every follow-up visit, patients were evaluated clinically, radiologically and complications were noted.  Based on these data the final outcome was assessed using Flynn’s criteria. Data was described as actual numbers and percentages using Graph pad Prism Version -5.

Results: Most patients were discharged home on postoperative day two or three. 6 weeks after surgery, casts were removed. In our series, the entire the patients achieved complete radiographic healing (evidence of tricortical bridging callus) at a Mean of 11.0 weeks (range 6–18 weeks). As expected, closed fractures healed more quickly (mean 9.7 weeks) than open fractures (mean 13.8 weeks). The common complications noted following nail insertion was irritation at the nail entry site in five patients (26%).

Conclusion: Closed pediatric tibial shaft fractures can be successfully treated with titanium elastic nails with satisfactory rate of complications.

Keywords: Pediatric tibial diaphyseal fractures, Titanium elastic nailing system (TENS), Flynn’s criteria

Dr. Jaya Someswar Narreddy M.S

Associate Professor of Orthopedics

Narayana Medical College and Hospital, Chinthareddypalem,


Email: This email address is being protected from spambots. You need JavaScript enabled to view it., Ph: 9440280925

Title: Analysis of Serum Zinc, Protein and Albumin Levels in Psoriasis: A Case Control Study

Authors: Srividya.Adapa, Bindu Pavani.Ch, Rama Rao.J

Paper Index: 05.2015-51773749

Psoriasis is a common, chronic, T-cell–mediated inflammatory disease of the skin which has both environmental and genetic components to its etiology. Psoriatic lesions are characterised by hyperproliferation of epidermal keratinocytes and hyperkeratosis, with resultant typical thickening and exfoliation of the erythematous skin .Exfoliation leads to loss of several nutrients from body resulting in deficiency states. So this study is undertaken to have an insight regarding the status of nutrients like zinc, protein and albumin levels in the serum of psoriatic patients. Serum zinc, protein and albumin levels are estimated in 50  newly diagnosed cases of psoriasis not  on systemic regime for psoriasis or any other disease and in 50 age and sex matched controls. Descriptive and inferential statistical analysis were performed using SPSS version 17.0.  Serum zinc levels are significantly lowered in patients with psoriasis compared to healthy subjects (p<0.05). In the present study, there is also significantly decreased levels of serum Total protein, albumin levels (p<0.05) and reversal of Albumin to Globulin ratio. Loss of protein and zinc through exfoliation and their increased requirement due to altered metabolism suggests adequate supplementation of proteins and zinc to improve the nutritional status and to prevent the complications.

Keywords: Psoriasis, Nutrition, Zinc ,Total protein and Albumin.

Bindu Pavani.Ch

Assistant Professor, Dept. of Biochemistry, Kamineni Institute of Medical Sciences,

Sreepuram, Narketpally, Nalgonda (Dist), Telangana,India

Telephone: 918682272018

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Title: Factors Affecting Nutritional Management of Type 2 Diabetes Mellitus in South Eastern Nigeria: A Systematic Review

Authors: Simon N. Onwe, David A. Agom, Joy C. Agom, Jude N. Ominyi, Kenneth A. Elom

Paper Index: 05.2015-85274474

Introduction: The global burden of type II diabetes mellitus is alarming. From the available statistics, the prevalence of diabetes globally is 6.4 % and type II diabetes accounts for 90 % (International Diabetes Federation 2011); in Nigeria the prevalence is  15 % and type II accounts for 10.5 % (Chukwunonye et al 2013) while in Ebonyi in South Eastern Nigeria, the prevalence of diabetes is 8.8 % and type II accounts for 7.9 % (Buowari 2013).

Aim: This is study aimed at exploring the socio-cultural and environmental factors affecting the nutritional management of type II diabetes in South Eastern Nigeria. The specific objectives include to explore the sociocultural and environmental variables influencing the nutritional management of type II diabetes, explore the experiences of the patients and identify gaps in Knowledge that require further action.

Methodology: The search strategies include the use of hand searches of published literature (primary and secondary sources) and searches of electronic databases. A systematic literature review was carried out using the following electronic databases: PSYCINFO, SCOPUS, Web of science, CINAHL and the Cochrane library.

Findings: Socio-cultural factors (social interactions, food preferences and family structure and family bound) affect nutritional management of type II diabetes mellitus South Eastern Nigeria.  Environmental factors (social process, working place condition and pattern of work such as shift duty) affect compliance to nutritional management. Method of food preparation affects the glycaemic index of the food. There is evidence from research that mushrooms contain alpha glucosidase inhibitors which lowers blood glucose level.

Keywords: The key words are type 2 diabetes mellitus, psychosocial factors, socio-cultural factors, social process, environmental factors and nutritional management.

Simon N. Onwe


Contact Number: +447438291735 (UK), +2348036576867 (Nigeria).

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Title:Anti-Parkinson’s and Neuroprotective Activity of Mentha Aquaticain 6-Hydroxy Dopamine Lesioned Rat Model

Author: Biswajit Pal

Paper Index: 05.2015-62517233

Objective: Menthaaquatica, plant which is showing monoamine oxidase-B (MAO-B) inhibition and anti-oxidant activity was assessed for anti-Parkinson’s activity in 6-hydroxy dopamine (6-OHDA) lesionedwistar rat model.

Materials and Method: Menthaaquaticaethanolextract (EMA) was obtained by using alcoholic solvent. Acute oral toxicity of Menthaaquaticaextract was carried out in wistar rats. Rats were treated with 6-hydroxy dopamine (2µg/µl) intra nigrally. After 48 hrs of induction, extract of Menthaaquatica (200 mg/kg/day, p.o.) was given to the treatment groups for 60 days. Levodopa (6mg/kg) was used as the standard drug. The possible pharmacological actions of the plant extract was evaluated by anti-catatonic activity, striatal dopamine (DA) levels, mitochondrial complex-I activity and Superoxide dismutase (SOD) assay.

Result: Menthaaquatica ethanol extract significantly (P<0.001) improved the muscle coordination, striatal dopamine level, complex-I activity and Superoxide dismutase level compare with 6-OHDA control group.

Conclusion: Menthaaquatica ethanol extract produced a significant anti-Parkinson’s activity at a dose of 200mg/kg against 6-OHDA induced neurotoxicity.

Keywords: Parkinson’s disease, 6-OHDA, Menthaaquatica, complex-I

Biswajit Pal

M. Pharm, Asst. Professor, Dept. of Pharmacology

Padmavathi College of Pharmacy, Dharmapuri-635205, Tamilnadu, India

Email: This email address is being protected from spambots. You need JavaScript enabled to view it., Cell: +918431078557

Title: Placement of Temporary Double Lumen Haemodialysis Catheters: A Rural Institutional Experience

Authors: Amit Singh, Vijay K. Verma, Khwaja S. Zafar, Shekhar Tandon

Paper Index: 05.2015-33168346

Background: The correct placement of large-bore venous catheters plays an important role in the management of patients on haemodialysis. The aim of this study is to review the complications of temporary double lumen haemodialysis catheters inserted using landmark-guided technique at the cardiovascular and thoracic surgery department of a rural Institute.

Methods: Temporary non-tunnelled double lumen haemodialysis catheters were placed in 116 patients using landmark-guided technique over an 11 month period from May 2014 to March 2015. Data collected included age, sex, indication for haemodialysis, type of vein cannulated, number of kits used, number of attempts for successful cannulation, duration of haemodialysis through the catheters, cause of removal and complications.

Results: Internal jugular vein cannulation using landmark-guided technique was successful in 99% of patients. The vein was cannulated in the first attempt in 70.7% of patients. The most common complication was exit site infection seen in 12% of patients. The arterial puncture rate was 1.7%. No case of haemothorax or pneumothorax was reported. Mean duration time of haemodialysis through the catheter was 29 days.

Conclusions: The placement of temporary haemodialysis catheter by an experienced operator using landmark-guided approach is a safe and reliable technique of obtaining venous access in the initial management of patients with chronic renal failure requiring haemodialysis. The complications related to catheter placement were similar to or lower than those reported in literature by various authors.

Key words: haemodialysis, double lumen catheter, internal jugular vein

Amit Singh

Assistant Professor, Department of Cardiovascular and Thoracic Surgery, Uttar Pradesh Rural Institute of Medical Science and Research, Saifai, Etawah, Uttar Pradesh, India-206301

Mob: 09917550631 Email: This email address is being protected from spambots. You need JavaScript enabled to view it.

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