Title: A Clinical Study to See the Relationship Between CNS Tuberculosis and Various Demographic Factors in a Population Attending a Tertiary Hospital in Northern India
Authors: Basharat Mubeen, Mohsin Ul Rasool, Sajad Hamid, Sheefa Haq, Rumana Hameed, Nayal Khursheed, Khalil M Baba
Introduction: Tuberculosis is a granulomatous disease caused by Mycobacterium tuberculosis AIM: Tuberculosis is very common in our part of world. Though a lot of study has been done on this topic but regarding CNS tuberculosis we have only few prospective studies available. There is a desperate need for such a study in our part of country.
Materials and Methods: The study was conducted in Department of Pathology, in a tertiary care Institute in Northern India. The study was retrospective for a period of 8 years (May 2001 to May 2009) and prospective for a period of 2 years (May 2009 to May 2011).
In retrospective the slides of all the CNS tuberculosis cases diagnosed were searched from the records section of the department. In prospective study all cases of histologically proven cases of CNS tuberculosis were included in the study. Age was no bar for inclusion in the study. Patients with features of meningitis were excluded from the study. The clinical details of these patients were noted especially patient particulars, history (present,past & relevant),clinical features& investigations done. Blood and CSF PCR was done for detecting mycobacterium tuberculosis. In cases where there was abscess formation, abscess fluid was sent for PCR. Patients suffering from tubercular meningitis were excluded from this study.
Observations: In the present series which included a retrospective study of 8 years and a prospective study of 2 years, a total no of 90 cases of CNS tuberculosis were analysed. The age range for CNS tuberculosis was13-73 years with a mean age of 37.98 years. Age range for brain tuberculosis was 15-65 years with a mean age of 40.63 years. Out of total 90 patients 58(64.4%) were males and 32(35.5%) were females with a male to female ratio of( 1.8:1).In brain tuberculosis 21(65.6%) were males and11(34.3%) were females with a ratio of(1.91:1). The predominant age group was 21-40 years with 40(44.4%) patients falling in this age group. Twelve (13.3%) of the patients were below the age of 20 years and 06(6.66%) patients were above 60 years
Summary: It has been observed that prevalence of tuberculosis of CNS is high in this part of country. The age range of our patients was 13-73 years with a mean age of 37.98 years. Male to female ratio was found to be 2:1.Past history of tuberculosis was the major risk factor for development of CNS Tuberculosis. So the emphasis is proper management of every tuberculous patient so that future risk of CNS involvement is minimized.
Key Words: Tuberculosis, CNS, Granulomatous Disease
Title: Implant Dacryocystorhinostomy (DCR) using Modified Pawar Implant
Authors: Dr M D Pawar
Dacryocystorhinostomy (DCR) is an operative procedure performed for obstructed nasolacrimal passage. The procedure has a failure rate of 10% due to postoperative infection, granulation tissue formation and inadequate closure of anastomosis ostium in conventional DCR. Author has developed Pawar Implant - a silicon implant in 19851,2 which has undergone some modifications over the years. The new modified Implant has no chances of getting expelled post operatively due to haptics of the collar. Implant DCR is indicated in the patients complaining of epiphora due to the obstruction in nasolacrimal duct due to Chronic Dacryocystits; Mucocoel / Pyocoel; Lacrimal-fistula; failed cases of conventional and other varieties of DCR.
Keywords: Dacryocystitis, dacryocystorhinostomy (DCR), dacryocystectomy (DCT), nasolacrimal duct, lacrimal gland, congenital dacryocystitis, nasolacrimal implant; mucocoel, pyocoel, Pawar Implant
Title: Roth Spots – A Case Report
Authors: Mukul B M, Kanthamani K, Narendra P Datti, Sugaranjini G
Roth spot presents with retinal hemorrhages with white centers. The etiological factors are many, most commonly in infective endocarditis.
In this case report we present a severely anemic patient with multiple Roth spots on initial fundus examination. After blood transfusion a dramatic drop in the number of retinal hemorrhages was noted in the subsequent follow up.
Keywords: Roth spots
Title: Incidence and Evaluation of Congenital Malformations in Victoria Govt. Hospital Visakhapatnam, Andhra Pradesh
Authors: Dr. R. Subhashini, Dr. N. Uma, Dr. Neeraja
Retrospective analysis conducted in 150 bedded Government Victoria Hospital, a Maternity hospital at Visakhapatnam, Andhra Pradesh during the period between Aug. 2011 – Aug .2012. This paper was focused on incidence of structural congenital malformations detectable at birth among 6590 deliveries, evaluation of associated risk factors and the fetal outcome. In our study we found 134 fetal malformations, Incidence is 2.03%. Most commonly affected is craniospinal system; risk factor is H/O Consanguinity, Malnutrition and previous h/o abortions.
Key words: Congenital malformations, craniospinal system, Malnutrition.
Title: Effect of Radiotherapy on Oxidative Stress and Serum Adenosine Deaminase Levels in Carcinoma Cervix Patients
Authors: Vasundhara Devi. I., Sujatha. C., Helena Rajakumari. J.
Carcinoma cervix is the most prevalent genital tract cancers in the world including India. Low levels of antioxidants induce the generation of free radicals leading to DNA damage and further mutations. Alterations in enzyme levels like adenosine deaminase (ADA), an enzyme of the purine salvage pathway, has been found to be elevated in various malignancies. The present study was done to evaluate the oxidative stress & adenosine deaminase (ADA) levels in carcinoma cervix (CaCx) patients. Malondialdehyde (MDA), glutathione-s-transferase (GST) & adenosine deaminase (ADA) levels were estimated before and after radiotherapy with Cobalt 60(Co60) in 20 patients. They were compared with age and sex matched healthy controls. Significantly increased levels of MDA (p<0.001) was observed, whereas the activity of GST (p<0.001) and ADA (p<0.05) were significantly decreased in CaCx patients as compared with healthy controls. Upon radiotherapy a significant reduction in MDA levels, with a significant increase in GST levels was observed. Though ADA levels were found to be increased after radiotherapy it is not significant. Thus it may be concluded that oxidative stress is present among CaCx patients, and radiotherapy was found to decrease the oxidative stress in CaCx patients.
Keywords: Cacinoma cervix(CaCx), Radiotherapy, Malondialdehyde(MDA), Glutathione-S-Transferase(GST), Adenosinedeaminase (ADA), Cobalt 60(Co60)
Title: Study of Blood Pressure in Medical Students in Kolkata and Its Variation with BMI, Waist Circumference, Waist-To-Hip Ratio and Waist-To-Height Ratio
Authors: Dr Sagarika Sarkar, Dr Md Mahboob Alam, Dr Biman Ray, Dr Gautam Chaudhuri
Background: Obesity, a global health problem is a well-recognized risk factor for hypertension and various other diseases. Both obesity and hypertension have their contribution to the development of cardiovascular disease, an important cause of morbidity and mortality throughout the world.
Objective: The study was conducted to determine the frequency of hypertension and to understand the relation between blood pressure and obesity indicators.
Materials and methods: A cross-sectional study involving 200 medical students, aged 19-23 years was carried out. Their blood pressure, height, weight, BMI, waist circumference, waist-hip ratio, waist-height ratio was measured. The data was analyzed by statcalc software. P<0.001 was considered significant.
Result: With respect to BMI, systolic and diastolic blood pressure was significantly higher in male overweight and obese subjects and in female obese subjects. In case of male, those overweight with respect to any of WC, WHpR and WHtR, had significantly higher SBP and DBP. In case of female, those who were overweight with respect to any of WC and WHtR had significantly higher SBP and DBP. Both SBP and DBP correlated most with WHpR in case of males and with BMI in case of females.
Conclusion: Periodic anthropometric measurements can be used to assess the development and progression of risk factor.
Title: Steroid Use in Tourniquet Paralysis
Authors: Dr. Yash Shah, Dr. Rohan Khavte, Dr. Srinivas Shintre, Dr. Vikas Rokade
Introduction: Tourniquet paralysis is an infrequent but devastating complication and a real nightmare for a treating orthopaedic surgeon. Most likely this is due to a neuropraxia. . Mechanical pressure seems more important in the injury than distal ischaemia
Methods: 90 patients were studied in Government Hospital Miraj over six month interval and the patients were followed fortnightly up till 3 months of surgery. 8 cases of tourniquet palsy were studied.
These patients were followed up for nerve healing and functional recovery. All patients of nerve injury were treated with intravenous Dexamethasone 8mg twice a day for 3 days, and this gradually being tapered off. All patients were given vitamins for a month.
Results: All the cases had tourniquet time more than an hour.
6 cases (75%) were associated with Esmarch bandage. Females were affected more than males. 6/8 (75%). Upper limb was more involved than lower limb. 5/8 (62%). The average time for recovery in our study after giving steroids was 4 weeks.
Conclusions: One must not forget the remote possibility of a nerve paralysis after a tourniquet application. A pneumatic tourniquet is preferred as compared to an Esmarch bandage. Steroids are certainly helpful in reducing the average recovery time. Almost all cases of tourniquet paralysis have a complete recovery.
Keywords: Tourniquet, Esmarch, Steroids, Palsy.
Title: Omental Prolapse Presenting 72 Hours after Delivery. Delayed Manifestation or Delayed Presentation: An Enigma
Authors: Dr Dalia Rafat, Dr Zehra Mohsin
Vaginal birth after caesarean section (VBAC) is a safe and effective method to reduce the rate of repeated CS and its associated morbidity and mortality but its success depends on many factors. Omental prolapse secondary to uterine rupture is a rare and dreaded complication in women attempting VBAC and its late presentation is much more rarer. A unique case of uterine rupture was discovered when a woman presented 72 hours after delivery with pain abdomen and on examination omentum was noted protruding through the vagina. Whether the uterine rupture followed by omental prolapse, occurred late or patient presented so late remains unexplained in our case.This case also highlights the importance of the patient education and counselling for institutional delivery and failure of heath care professionals in achieving it.
Keywords: Omentum, Uterine Rupture, Postpartum, Caesarean section
Title: Comparative Study of Complications in Routine Phacoemulsification Procedure and Bimanual Phacoemulsification (Micro-phaco)
Authors: Dr. Nikhilesh Wairagade, Dr. Sudha Sutaria, Dr. Nitin Dhok, Dr. Vikas Mahatme, Dr. Chitra Pande
Phacoemulsification surgery for cataract is the most preferred technique as on today. Smaller the incision, less are the complications. On this dictum discovery of Micro-phaco is a revolutionary leap in cataract management - it allows cataract surgery via 2.2 mm incision only.In the present comparative prospective study intra and postoperative complications were compared in routine Phacoemulsification technique and bimanual phaco (Micro-Phaco). 60 eyes were studied. There was no statistically significant difference in complications by either method.. There was difference in surgically induced astigmatism (SIA) but it was not statistically significant.
Keywords: Phacoemulsification, complications, woodcutter’s nucleus cracking technique, Micro-phaco, Bimanual Phaco, MICS, PCR, CME, woundburn, endothelial cell loss, surgically induced astigmatism – SIA
Title: A Prospective study of fixation of lateral end Clavicle with Tension band Wiring
Authors: Ramprasad Rallapalli, Ankur Mittal, Siva Prasad Y, Kumar Babu B.L.S.
Background: Displaced lateral end clavicle fractures have high incidence of delayed union or non-union, hence several authors suggested operative management for these fracture. Adequate reduction and minimal soft tissue dissection during implant placement and early removal is ideal for these fractures. METHODS: 20 patients with displaced lateral end clavicle fractures were included in our study. The fracture were reduced by open reduction and fixed with 2 K-wires and additional TBW with SS wire. Implant removal was done after six months.
Results: All 20 fractures united. The mean average age was 27.5 years ranging from 20years to 55 years. The mean average time of union was 8.6 weeks ranging from 6 weeks to 14 weeks. All patients regained near normal range of motion and 15 patients had excellent constant murley score, 3 had good and 2 had fair results.
Conclusion:The clinico-radiological outcome of displaced lateral end clavicle fractures treated by K-wires with TBW is encouraging and comparable with earlier studies.
Keywords: Lateral end clavicle fractures, tension band wiring (TBW), Stainless Steel wire (SS wire).
Title: Correlation between Histopathological Type and Grade of Different Ovarian Tumors with Their Blood CA125 Levels
Authors: Dr. Samir Kumar Roy, Kusumita Mandal, Kamalika Mandal
Introduction: Women with ovarian carcinoma experience poor survival because symptoms are vague and diagnosis is unlikely at an early stage. Early detection is utmost important both for treatment and survival CA-125 is the most frequently used biomarker for ovarian cancer detection. In this study, the authors evaluated 60 distinct cases of benign and malignant primary ovarian tumors, of different cell lines and degrees of differentiation, aimed at assessing the relationship between serum levels of CA125 and the biological behavior and/or the histological degree of these neoplasms.
Materials & Methods: patients were selected for study after clinical suspicion fallowed by radiological evaluation .Serum sample for CA 125 sent preoperatively. Patients were operated and ovarian tissue sent for histopathological examination for typing and grading in pathology department. The study carried out with sixty patients for one year duration.
Results: After histopathological examination it was confirmed that 37 (61.6%) cases were suffering from benign ovarian tumor. 6 (10%) cases were suffering from borderline ovarian tumor and 17 (28.3%) cases from malignant ovarian tumor. Majority of patients with benign tumor (35/37, 94.59%) have their serum CA125 value <35 U/ml and most of patients with borderline & malignant tumors (18/23, 78.2%) have their serum CA125 value >35 U/ml. Again 7/17 (41.17%) of patients with malignant tumor have their serum CA125 value > 100 U/ml. 100% of patient with borderline tumors have their serum CA125 value in between 35-65 U/ml. The present study revealed that 100% of the patient having epithelial borderline/malignant tumors of grade I had their serum CA125 values within 35-65 U/ml. (6/7, 85.7%) of patients having epithelial borderline/ malignant tumor of grade III had their serum CA125 values >100 U/ml. Another important finding was that epithelial malignant tumor including Mucinous cystadenocarcinoma, Serous cystadenocarcinoma had their mean value more than 100 IU.
Conclusion: Patients with borderline/malignant epithelial tumor had higher pre-operative serum CA125 value (>35U/ml) than benign ovarian tumors.CA125 had ascending relation with higher grade of tumor. With very high value of serum CA 125, one should think about serous or mucinous epithelial ovarian tumor.
Keywords: Benign Ovarian tumor, Borderline/Malignant Ovarian Tumor, Serum CA 125, Tumor grade
Title: Study of Functional Outcome of Arthroscopic Bankart Repair using Caspari Technique in Recurrent Anterior Shoulder dislocation
Authors: Ramprasad Rallapalli, Vidyasagar J.V.S, Ankur Mittal, Anil Kumar D, Subrahmanyam B, Bhartah Reddy, Praveen Kumar
Objective: The purpose of this study is to evaluate functional outcome of arthroscopic bankart repair using caspari technique in recurrent anterior shoulder dislocation.
Methods: A prospective study was done which include 20 patients of shoulder instability to evaluate the results of arthroscopic repair of the Bankart lesion of shoulder with Trans Glenoid suture technique with reference to results of Rehabilitation program and final Surgical and Functional outcome.
Results: None of the 20 patients had episode of recurrent dislocation or anterior translation or apprehension. Range of movement-external rotation in 90º of abduction improved in 17 patients (85%). There is complication of wound infection in only 1 patient.
Conclusions: We conclude that Arthroscopic Bankart repair with caspari technique in recurrent anterior shoulder dislocation is a reliable and cost effective procedure with respect to shoulder function, recurrence rate and range of movement.
Keywords: Anterior shoulder instability ; Arthroscopic translgenoid suture; Caspari technique.
Title: Molecular Genetic Confirmatory Testing for the Sickle cell Anaemia Using Restriction Fragment Length Polymorphism (RFLP) in Sudan
Authors: Nadia, M . M., Shamseldein. H. Ahmed, Galal, M. Yousif
Background: Molecular diagnosis of the disease, genetic and family studies of patients becomes an important tool for management of sickle cell disease patients.. In this study we compare the efficiency of agarose gel electrophoresistechniques with recently developed molecular biology methods. (RFLP) for the diagnosis of in Sudanese patients with SCD.
Methods and Results: This study was conducted in Khartoum state between 2007 to 2008.in hundred and fifty patients with homozygous SCD of age between 6 month –40 years. Questionnaires were used to collect demographic and clinical data. About 3 ml of venous ant coagulated blood were collected for DNA extraction. Each extracted DNA samples was subjected to PCR reaction.. Polymerase chain reaction was carried out for DNA amplification., The results of RFLP In this method after the amplification of DNA with primers1 (mutant), primer 2 (normal primer), the 281bp fragment was achieved, after that we digested this fragment with DdeI restriction enzyme in two fragment (200bp&81 bp) so +/+ shows that our sample is normal and we had 200 & 81 bp both of them but we couldn't see 80 bp so we just had 200 bp! For heterozygous carrier we had 3 bands 200&281&81 that we saw just 2 bands (200 and 281), that was -/+! for homozygous disease we had just one band 281 bp that shows our restriction sits disturb and our enzyme couldn't digest it.
The study thus demonstrates the accuracy and precision of Restriction Fragment Length Polymorphism (RFLP)techniques in molecular genetic confirmatory testing for the sickle cell anaemia
Keywords: Restriction Fragment Length Polymorphism (RFLP), sickle cell anaemia, electrophoresis.
Shamseldein. H. Ahmed
College of Veterinary Medicine
Sudan University of Science and Technology - Sudan
Title: Maternal and Fetal Outcome in Cases of Oligohydramnios Diagnosed By Ultrasonography after 34 Weeks of Gestation
Authors: Dr Shubhadeep Bhattacharjee
The present study “obstetric outcome in cases of oligohydramnios diagnosed after 34 weeks of gestation” is a prospective study and Silchar Medical College & Hospital, Silchar during the period 1st August 2012 to 31st July 2013.
A total of 200 patients were studied from the antenatal cases attending the OPD, antenatal ward and labour room of SMCH, Silchar. 100 cases and 100 controls were identified and they were confirmed ultrasonographically.
All the cases were singleton pregnancies after 34 weeks of gestation in the age group of 18-32 years. Single deepest liquor pocket was < 3 cm (Crowley and O’herlihy)
All the controls were singleton pregnancies after 34 weeks of gestation in the age group 18-32 years. They had single deepest liquor pocket depth between 3-8 cm.
Majority of cases (60%) and controls (58%) were in the age group 23-27 years. The mean age of incidence was 24.6 years.
Most of the cases (70%) and controls (72%) were primigravidas
88% cases and 86% controls were booked cases.
Patients were monitored carefully for mode of onset – spontaneous or induced, course of labour, mode of delivery, caesarean section etc.
To note the fetal outcome, Apgar score of 1 and 5 min, birth weight, incidence of C.S for fetal distress, NICU admissions, stillbirth, neonatal deaths etc. were monitored. Statistical analysis was done between case and control groups.
Fundal heights and abdominal girths were considerably lower in cases than the control groups. This association was found to be statistically significant (p<0.05)
30% cases had associated hypertensive complications as compared to 26% controls. Anemia was seen in 22%, Rh negative in 6% and others in 4%. But most common group was uncomplicated or idiopathic with 38% cases and 43% controls. No significant relationship between oligohydramnios and any of these complications was noted. (p>0.05).
18 % cases and 14% controls had malpresentation at the time of delivery.
Only 16% cases delivered spontaneously among cases whereas 83% controls delivered spontaneously. 22% cases were induced and the corresponding rate among controls was 5%. Oligohydramnios was significantly associated with increased rates of induction (p<0.05).
The rates of C.S were 62% among cases compared to 12% in controls. 70.96% of these was due to fetal distress in the case group whereas only 16.67% in the control was due to fetal distress. The rates of C.S were significantly higher in cases (p<0.05)
Liquor was meconium stained in 48% cases and 12% controls. 93.5% of C.S in cases was emergency compared to 83.3% in controls.
The percentage of cases with birth weight <2.5 kg was 42% compared to only 12% controls. Also, 1-min apgar score <7 was seen in 70.44% of cases and only 19.08 % controls. 5-min apgar score <7 was seen in 37.46% of cases where as it was only 5.14% in controls. The association was found to be statistically significant (p<0.05)
The NICU admissions were required in 33% cases ageist 5% controls.
It was observed that adverse maternal and fetal outcome were associated with the cases i.e., oligohydramnios which was statistically significant.
Dr Shubhadeep Bhattacharjee
C/O Mr. Partha Pratim Bhattacharjee
National Insurance Company Limited (Div Office),
Club Road, Silchar, Assam 788001 India
Title: Hemichorea: A Rare Manifestation of Acute Rheumatic Fever
Authors: Rajesh Rai, Pallavi Gahlowt, Keya Lahiri, Anand Bhattar, Fehmida Najmuddin
Acute Rheumatic Fever (Acute RF) is an immunological response to group A beta hemolytic streptococcal pharyngitis. There has been a decline in the incidence and severity of the disease in developed as well as developing countries. Sydenham's Chorea (SC) is one of the major clinical manifestation of Acute RF. The other major manifestations of Jones Criteria are carditis, migratory polyarthritis, subcutaneous nodules and erythema marginatum. We are reporting a rare case of a 9-year-old female child of Acute RF presenting as hemichorea.
Key Words: Sydenham’s Chorea, Acute Rheumatic Fever, Hemichorea, Involuntary movements
Title: Comparative Study of Functional Outcome of Compression Plating and Interlocking Nailing for Fracture Shaft Humerus In Adults
Authors: Dr. Akshay H. Shah, Dr. Amit B. Dhond, Dr. Mishil S. Parikh, Prof. R. G. Khedekar, Prof. Sunil H. Shetty
Aim:The aim of our study is to find the difference between the functional outcome between the dynamic compression plating (DCP) and the intramedullary interlocking nailing in diaphyseal fractures of the humerus in adults, as measured by the DASH questionnaire, the mean duration of union and associated complications.
Materials and Methods: From November 2012 to November 2014, 38 patients with diaphyseal fractures of the humerus were treated with compression plating using dynamic compression plate or with intramedullary interlocking nail after randomizing with the help of computer generated list. Postoperatively both groups received same type of physiotherapy (mobilization). They were followed up regularly every two weeks until radiological union. The time taken for radiological union in the two groups was compared. After satisfactory radiological union, the functional outcome was assessed by the “Disabilities of Hand, Shoulder and Elbow (DASH)” Questionnaire.
Results: Primary radial nerve palsy was seen in 3 patients, out of which 2 patients recovered completely. Associated injuries were seen in 20 patients. The functional outcome was better in DCP group compared to interlocking nailing group which was statistically significant (P= 0.024). A marginal difference was noted in the time taken for union. The average time taken for union in the DCP group was 16.06 weeks and in the interlocking group it was 14.05 weeks. The average time for union in all the 34 patients was 15.05 weeks .Two fractures treated with DCP remained un-united. The complication associated with interlocking group was more than the DCP group.
Conclusion: We are of the opinion that when surgery is opted as a choice of treatment, both the modalities of treatment i.e. dynamic compression plating and interlocking nailing are good as far as union of the fracture is concerned, but considering the number of complications and functional outcome, we opine that dynamic compression plating offers better result than antegrade interlocking nailing with respect to pain and function of the shoulder joint. We therefore conclude that in cases where both dynamic compression plating and antegrade interlocking nailing can be done, we would prefer to use dynamic compression plating, as the results are better than antegrade interlocking nailing.
Keywords: Diaphyseal Humerus Fracture, Dynamic Compression Plate, Interlocking Nail, DASH Score.
Title: Study of Urinary Stones by Making Chemical Analysis in the eastern Region of Uttar Pradesh in India
Authors: Dharmveer Sharma, Poonam Gupta, Narendra N
Objectives: Chemical composition of urinary stones and serum is important in understanding the pathogenesis and medical management of calculus disease.
Methods: The studies of 50 patients with urinary stones (44 males & 06 females) were collected from different parts of Allahabad region in different age group between 10-60 years. We studied quantitative chemical analysis of urinary stones and serum calcium, oxalate, inorganic phosphate and uric acid in urolithiasis cases using colorimetric and enzymatic methods.
Result: The overall incidence of different types of stones were found in following order: Kidney > Ureter > Bladder stones. Incidence of kidney stones was higher in the age group 31-40 years than ureter and bladder stones. In present study calcium in kidney and ureter stone were found to be in all100% and in bladder stones 99.2% while inorganic phosphate 97.2% in kidney, 99.5% in ureter and 98.5% in bladder stones respectively. Serum oxalic acid content was found higher in 18 cases. Higher serum calcium value was found in 22 cases out of 50 cases. Serum inorganic phosphate higher value was in 06 cases. In our study 12 stones formers had associated hyperuricemia.
Conclusion: Crystalline component calcium oxalate was found in most of the cases. Males are more prone to urinary stones disease than females. The incidence of kidney stone was found more as compared to ureter and bladder.
Title: Evaluation of Lasik in Correction of Myopia
Authors: Dr. Nikhilesh Wairagade, Dr. Sudha Sutaria, Dr. Atul Borkar, Dr. Vikas Mahatme, Dr. Chitra Pande
The study comprised of retrospective and prospective evaluation of 137 eyes treated with LASIK at Mahatme Eye Bank Eye Hospital, Nagpur India. Our results show that LASIK is safe, effective and predictable procedure in correcting myopia and myopic astigmatism in mild to moderate range. Most of our patients obtained excellent UCVA and were within +/- 1.0 D of intended correction.
Keywords: Myopia, refractive surgery, Lasik, PRK, refraction, keratome, hansatome, spherical equivalent (SE) refraction, BSCVA (Best surgically corrected visual acuity)
Title: Dyke-Davidoff-Masson Syndrome: A Rare Case In Children
Authors: Dr.Vijay Baburao Sonawane, Dr.V.A Kotrashetti, Dr.Mumtaz Shariff, Dr. Kapil Bainade, Dr.Ajay Harit
Cerebral Hemiatrophy is rare in clinical practice of children. We reporta case of 10 years old male child, who presented inanunusual manner with behavioral abnormalities like aggression and self-mutilating behavior and recurrent seizures while CT angiography of the brain revealed characteristic features diagnostic of Infantile type of Cerebral Hemiatrophy or Dyke-Davidoff-Masson Syndrome (DDMS).
Keywords: Dyke-Davidoff-Masson Syndrome, Hemiatrophy
Title: IFN-γ A/T Alleles Frequency Among Anti Toxoplasma IgG Seropositive and Seronegative Pregnant Women.
Authors: Abdelhaleem A A, Hershan A A, Ageely H M, Abdelmoula A M, Aysha Alvi, Elhassan I M.
Background: Toxoplasma gondii is an obligate intracellular opportunistic protozoan parasite that can infect different vertebrate hosts including humans. Cell mediated immunity has a crucial role in the evolution of toxoplasmosis disease. TH1 cytokines and particularly, IFN-γ plays an important role in resistance to toxoplasmosis. Cytokines genes polymorphisms have been shown an association with susceptibility to parasitic diseases.
Objective: the aim of this study was to detect the frequency in the gene encoding IFN-γ (+874T/A) among Toxoplasma gondii seropositive and seronegative pregnant women.
Methods: This study was included 94 pregnant women divided into two groups: anti T. gondii IgG sero-positive group 44(46%) and anti T. gondii IgG sero-negative group 50(54%). Presence and absence of IFN-γ A, and T alleles were detected by PCR using specific primers.
Results: The differences between A and T alleles distributions were not statistically significant between the seropositive and seronegative pregnant women p value (>0.05), whereas T allele was slightly increased among seronegative group.
Conclusion: a seropositive pregnant women that carrying a single A genotype could be associated with a high risk of infection reactivation against T. gondii.
Keywords: IFN-γ , T. gondii infection in pregnant women.
Title; Influence of Handgrip Exercise on Intraocular Pressure
Authors: Ezhilnila.S, Prince.J.Samuel, Shyamala.R
Purpose: The aim of this study is to investigate the effect of handgrip exercise on intraocular pressure (IOP) in young healthy adult males in Tamilnadu population.
Background: Several studies support the fact that lifestyle modification like exercise has capacity to lower the intraocular pressure and this effect can be used in the management of glaucoma or ocular hypertension along with medication. Most of the previous studies targeted on effect of whole body Isotonic exerciseon IOP. This study was initiated to assess the effect of isometric exercise on IOP, a simple measure to postpone the development of glaucoma and its complications.
Methods: In this quasi experimental study, 44 young healthy adult male subjects of age 18 to 25years were selected, who fulfilled the inclusion and exclusion criteria. Baseline IOP was measured in both eyes using non-contact tonometer. The subjects were instructed to hold Smedley’s handgrip dynamometer with 20% of maximum voluntary contraction in a sustained manner for the period of minimum 2minutes or until fatigue sets in (Isometric exercise). IOP was measured immediately after the isometric exercise. IOP variation was analysed using paired t test.
Result: A small but significant decrease in IOP noted immediately after handgrip (isometric) exercise in both eyes with average fall in right eye of 1.70mm of Hg and in left eye of 1.65mm of Hg.
Conclusions: This study showed that IOP significantly decreased in both eyes after the Isometric exercise using hand grip dynamometer in healthy adult males which can be extrapolated and clinically applied to treat glaucoma patients and its prevention.
Keywords: Intraocular pressure, handgrip, exercise
Title: Isolated Fracture of the Trapezium : A Case Report
Authors: Dr. Rajendraprasad. R. Butala, Dr. Mishil S. Parikh, Prof. Sunil H. Shetty, Prof. R. G. Khedekar
Trapezium fractures are rare injuries which should not be taken casually. We report a case of a 30 year old left hand dominant housewife who sustained a left sided closed transverse trapezium fracture without any carpometacarpal joint dislocation which was treated with closed reduction and Percutaneous External Fixation, a technique. Two frames were made and connected with the help of a connecting rod. Satisfactory functional outcome was achieved at final follow-up.
Key Words: Trapezium Fracture, External Fixator, Closed Reduction
Title: Study of Retinol Binding Protein 4 Level in Chronic Hepatitis C Patients and Correlate its Level with the Antiviral Therapy
Authors: Ghada A. Salem, Heba F. Pasha
An association between hepatitis C virus (HCV) infection and lipid metabolism demonstrated that LDL-receptor is one of the HCV receptors and experiments in vitro showed competitive inhibition of binding between HCV and LDL-receptor by LDL-cholesterol. Lipoproteins play an important role in the process of complexing of the virus to VLDL-C or LDL-C could promote endocytosis of HCV via the LDL receptor.
Retinol-binding protein 4 (RBP4) is a protein serving as a carrier of retinol in the blood. Liver is the primary source of RBP4 synthesis and it has been reported as an adipocytkine contributing to insulin resistance.
Patients with chronic liver disease showed a significant different (RBP4) level. The relation between (RBP4) and HCV has been needed to be investigated and the impact of disease progression and severity on (RBP4) in HCV deserves to be clarified.
Results revealed that HCV RNA differences among the three groups showed that it is higher in responders and breakthrough than relapsers (574±351, 1542.9±651, 287.1±194.6 KIU respectively (P=0.001)) RBP4 before treatment was lower in the high viral load group vs the low viral load group (48.5±17.5 ng/ml vs 46.5±19 ng/ml respectively) and after treatment it was lower in high viral load vs the low viral load and that was statistically significant (t=-8.88,P<0.01). Variation of RBP4 level within each group showed that, in the responders group there is a progressive and significant decrease (62.7±7, 53±18, 41.5±11.7, 39.5±7.8 ng/ml respectively & F=5.9, P=0.002) before treatment, at 24th w, at 48th w, 72th w. This decrease may be due to recovery of the metabolic disturbance caused by the virus and that was coincident with viral clearance denated by PCR at 24, 48, 72 weeks. In the relapsers group, there was a significant reduction of the RBP4 level at 24th w but it peak at 48th w and that was statistically significant 32.9±6.8 vs 52.3±29 ng/ml respectively. In the breakthrough group, there is high level of RBP4 level at 24th w 39±12 ng/ml and more increase at 48th w and was statistically significant 55.6±18.9 ng/ml. Age, ALT, AST, PT, PLT, FBS, TGs, FRT, UA, RNA and albumin were considered as variables closely related to RBP4 level, from which we can predict its value as shown in table 6.
It can be concluded that, the metabolic state due to HCV can influence the level of RBP4 and indirectly affect and correlate with the response to therapy.
Title: Bilateral Symmetrical Idiopathic Multiple Pigment Epithelial Detachments (IMPED); Visual Deterioration Following Confluence of Central Macular Lesions: A Case Report
Authors: Prakash Kumar, Prashant Bhusan, R.P.Maurya, M.K.Singh, V.P.Singh, G.S.Patnaik
Introduction- Bilateral IMPED in a middle aged women are a rare entity , majority of cases are idiopathic and have reasonably good visual prognosis, Few case reports of idiopathic multifocal retinal pigment epithelial detachments can be found in literature, all suggesting a good visual prognosis and a benign course.
Case Report: A fifty year old female presented to the department of ophthalmology of a tertiary care hospital in northern India with gradual progressive diminution of vision.
Methods-We evaluated a middle aged woman who did not have any known systemic illness, ocular problem or drug intake history .No family history of similar illness was present. She was Indian medicine practioner .She had complain of defective vision which was slowly progressive since one year .We retrospectively evaluated the medical reports.
Results: On checking the previous medical records her best corrected visual acuity was 20/40 one year back in both eyes, now her vision is 20/120 in both eyes.
Discussion: On literature search no such case of bilateral symmetrical idiopathic multiple PED was reported in Indian subcontinent.
Conclusion: Bilateral symmetrical multifocal PEDS are idiopathic in nature with normally good visual prognosis .But confluence of central macular lesions can lead to significant visual deterioration
Title: A Retrospective Study of Appendicitis as a Cause for Acute Abdomen in Dengue Fever
Authors: Dr. K.Ravichandran, Dr. R.Ramesh, Dr. K.C.M.Rajkumar
Aim: To study the incidence and emphasize the importance of Acute appendicitis as a cause of Acute abdomen in Dengue fever and the role of conservative and surgical management and its outcome.
Background: The incidence o f appendicitis is a common acute abdominal surgical emergency encountered in surgical practice. Very rarely it is due to viral disease like Dengue in endemic areas. Its occurrence in Dengue, is a dreaded complication.
Materials and methods: This is a retrospective hospital based study of Appendicitis as a cause for Acute abdomen in Dengue fever in 10 patients out of 42- symptomatic patients of Acute abdomen in Dengue, admitted between November 2010-November 2014 in surgical ward of Rajah Muthiah Medical College. All these patients were diagnosed with confirmatory tests, analysed, findings and outcome studied and the findings were observed by laparoscopic/open appendicectomy.
Results: All the admitted 10 cases of Acute appendicitis in Dengue were treated conservatively but for 2 cases which were operated. Outcome was good and no mortality.
Conclusion: Do not miss or under estimate Appendicitis in Dengue. Priority should be given and timely surgical intervention is a must, when conservative management fails.
Keywords: Appendicitis, Apendicular Mass, Peyers Patches, Dengue, Acute abdomen, Leucopenia, Thrombocytopenia.
Title: Incidence of Early Onset Septicemia, Isolation and Resistant Patterns of Causative Organisms: A Study in a Tertiary Care Hospital A.P. (Original Research Paper)
Authors: Muni Lakshmi Ponugoti, M.Venkatakrishna, K.Jithendra, P.Sreenivasulu Reddy
Septicemia is a major problem in neonates with multiresistant organisms.
Aim: This study is aimed to know the prevalence and resistant patterns of the isolated organisms.
Materials & Methods: A total of 426 neonates(< 1week of age) suspected septicemia admitted in NICU enrolled over a period of 6 months.1-2 ml of blood collected in aseptic conditions inoculated immediately into 5 ml of brain heart infusion broth with 0.025% Sodium polyanethol sulfonate as anticoagulant. The broths were subcultured after overnight incubation on chocolate agar, MacConkey agar and 5%sheep blood agar. organisms isolated kept for biochemical tests for confirmation then checked for Antibiotic sensitivity by Kirby-Bauer disk diffusion method.
Results: Out of 426 cases studied, growth of bacteria was obtained in 44.1% of blood samples. Most frequent organism was Klebsiella spp (25.5%). followed by E. coli (22.3%) Enterobacter spp (18.6%), CONS (14.8%), S. aureus (11.7%).There is significant association with maternal & fetal risk factor like preterm labour and LBW. The antimicrobial susceptibility testing revealed that resistance to penicillin was frequent. Resistance to amikacin was not common for GPC. None of the gram positive isolates were resistant to the glycopeptides - vancomycin and teicoplanin. Most of the gram negative isolates of Enterobacteriaceae family were resistant to ampicillin and amoxicillin. Resistance to amikacin was less frequent than resistance to gentamicin. Enterobacteriawere less frequently resistant to ciprofloxacin.
Conclusion: Our study highlights the need of empirical therapy in neonates with risk factors and importance of knowledge about the causative agents and their sensitivity patterns to reduce the mortality rate of neonates.
Key Words: Septicemia, Kirby-Bauer disk diffusion, Antimicrobial resistance, Enterobacteriaceae.
Title: Influence of BMI in Pulmonary Function Test in Diabetic Subjects
Authors: S. Latha, R. Sanjay Andrew, R. Shaymala, S. Brinda
Obesity is associated with higher incidence of diabetes mellitus (DM). A variation in anthropometric indexes influences co-dependent relationship of pulmonary function and diabetes. Studies have shown that decrease in glycemic control was observed in diabetic patients with altered pulmonary functions. However, the exact correlation of body mass indices with diabetes and pulmonary function is not clear. The present study was done to assess the influence of body mass index (BMI) on pulmonary function in obese diabetic patients. Total number of type 2 diabetic patients underwent the study = 75 and they were divided into three groups: Group 1: lean, 2: overweight, 3: obese. Pulmonary function test (PFT) was done with computerized digital spirometer. Statistical analyses were done to compare the correlation of BMI on PFT and diabetes. No significant correlation was observed in PFT among the patients. However, there was significant decrease in PFT, observed when the comparison was made between BMI and diabetic restrictive lung disorder patients. The current study shows that, altered lung function is not due to obesity but it could be due to inadequate glycemic control and lung disorders. Hence, assessed parameters could be used to categorize the lung disorder in diabetic patient. Additionally this study shows that diabetic subjects have mixed ventilatory and restrictive ventilatory defect.
Keywords- Type 2 diabetes, PFT, HbA1C, BMI, Restrictive disorder, mixed ventilator defect
Title: Curing Role of Underutilized Plants at Household Level
Authors: Dayal Bhawana, Singh Neetu
The world is precariously dependent on a limited number of food crop species despite its wealth of traditional, locally-adapted underutilized species. These plants have many advantages like easier to grow and hardy in nature, producing a crop even under adverse soil and climatic conditions. These neglected and underutilized species (NUS) play a crucial role in the food security, income generation and food culture of the rural poor. They are also often more resilient than staple crops, because they are better adapted to grow in marginal areas, with little need for irrigation, pesticides and fertilizers. Yet the lack of attention by mainstream research and development programs means their potential value is under-estimated and under-exploited, with many under threat of disappearance. The belief behind this mode of eating underutilized fruit crops is good for health and acts as a remedy for various ailments like relief of strain muscle, laxative, sedative, herbal hair lotion shampoo for antioxidant, dysentery, diarrhoea, jaundice, cough etc. This could be attributed due to the presence of phytochemical in these minor fruit crops that enhance the power of immunity of human body.
Keywords: Underutilized plants, value added products, disease prevention
Title: To Make a Definitive Diagnosis of Obstructive Sleep Apnea in Snorers by Polysomnography Attending A Tertiary Care Hospital (Research Study)
Authors: Dr. M.Umar Majid, Dr. Sangeeta, Dr. Ibrar Bashir Shirazi, Dr. Sajad
Introduction: Obstructive Sleep Apnoea(OSA) is one the most potential ccauses of increased upper airway resistance resulting in snoring , so needs to be confirmed and and properly managed. Polysomnography is considered as the gold standard in diagnosis of OSA.
Aims and objectives: To make a definitive diagnosis of OSA in snorers and assess its prevalence, as well as to compare its prevalence in obese versus non-obese people.
Materials and Methods: A total of 300 patients met the criteria and were included. Medical records and data of patients who underwent Polysomnography (PSG) were reviewed retrospectively.
Results: Prevalence of obstructive sleep apnoea among snorers in the study is 67.3%.Its prevalence among obese and non-obese are 79% and 59.7% respectively. There were no untoward effects during the study.
Conclusion: Undiagnosed OSA is quite prevalent in our country. Polysomnography is the gold standard in diagnosis of OSA. Though obesity is one of the risk factors of OSA, non obese persons with symptoms suggestive of OSA should also be evaluated with PSG.
Key Words: Obstructive sleep apnoea, Polysomnography, obese,non-obese
Title: A Rare Variant of Prostate Cancer in a Young Adult Male of Asian Origin
Authors: Dr Piyush Gupta, Dr Uday S Dadhwal
Prostatic cancer is a disease seen commonly in elderly males. Small cell carcinoma of prostate is a rare variant and its occurrence in young men is extremely rare. This aggressive malignancy may develop in previously diagnosed prostatic adenocarcinoma or as a recurrence after surgery or radiotherapy. Thus, it poses a diagnostic dilemma at the time of presentation and even if diagnosed, limits the management in view of rapid loco-regional and systemic spread. This is case report exemplifies one such unusual occurrence and the challenges confronted in small cell carcinoma of prostate in a young adult. The prognosis remains poor as the treatment is yet not standardized. Chemotherapy may have some role in the management.
Keywords: Carcinoma prostate, Ca prostate in young Small cell carcinoma prostate.
Title: Study the Effects of Lead on Thyroid Functions in Alexandria Occupationally Exposed Workers
Authors: Aliaa Ali Elaghoury, Mohammed Rezk, Eman Zaki Azzam, Mohammed EL shafei, Faten Mohammed
This study aimed to explore the effects of lead on the thyroid function of Alexandria occupationally exposed workers. One hundred male workers occupationally exposed to lead in a factory for bullets and shots were investigated. The level of blood lead was measured by atomic absorption spectro photometry .Thyroid-stimulating hormone, free thyroxine, free triiodothyronune and anti thyroid peroxidase in serum were estimated by enzyme immunoassay. Thyroid ultrasound was performed by an expert radiologist using 5-10HZ probe device.
The workers with higher level of blood lead (40-60 micrograms/dl) showed high Thyroid-stimulating hormone level (0.81 – 9.30 mIU/ml) and abnormal ultrasound findings; volume and echo texture changes. No changes in free thyroxine, free triiodothyronune and anti thyroid peroxidase were observed. We concluded that higher level of blood lead may cause certain damage to thyroid function leading to subclinical hypothyroidism, with no evidence of thyroid immune dysfunction.
Title: A Clinical Study on Ocular Manifestations of Leprosy
Authors: Dr. M. Premanandam, Dr. G. Narendranatha Reddy
From september 2012 to october 2013, during this period we have selected 100 leprosy patients as a sample for study of ocular manifestions of leprosy. There people were living in leprosy colonies in kurnool,others were admitted in leprosy ward of Govt. General hospital kurnool, and leprosy patients attending regional eye hospital outpatient department.kurnool, in the juridiction of the kurnool medical college kurnool, Andra pradesh state. In our study of sample (61%) of leper's had ocular manifestations between the age group of 41-61’ years this is the maximum prevalence in our study. 78% leprosy patients were make predominance shown due to lepromatoues type of the disease (77.08%) patients had ocular manifestations. Age wise ( 41-61 year) 65.6% effected by ocular involument. With the infected period 6-10 year’s duration 69.38% shown ocular manifestations. In our further study of the sample ocular manifestations were as follows below madarosis 75.44%, lagophthalmus 39.44% cornel leasinons 44.28%, anterioruveitis 34.44, ectropion 11.48, lens changes 58.84% noticed respectively. In positive lepra reaction of 25 cases ocular involument were observed 41%. Regarding visual impairment 61 patients affected (72.16%),
i)BCVA 6/36-CF3mts(U/L) 28 cases 45.92%
ii)BCVA6/36-CF3mts(B/L) 16 cases 26.24%
iii) BCVA<CF 3mts (U/L) 5 cases of 8.2% shown visual impairment.
Remaining cases were bilateral cataract. And finally comparative study of ocular manifestions discused in table from.
According their ocular problems and systemic disease wise we refer the cases to the ophthalmology, dermatology, plasticsurgry, medicine departments respectively for further management.
Title: Evaluation of Intravaginal Misoprostol for Cervical Priming in First Trimester
Authors: Dr Sharan J Pal, Dr Usha Sadashivan, Shilpa Mulki, Jagadevi S
Women often resort to surgical abortion because they lack information on contraception or fear the side effects of medical methods of abortions. A safe medical or combined medical and surgical method is the need of hour and would save many lives. An effective cervical priming agent would aid surgical abortions or would be effective alone.
Objective: To compare various dosage, regime and safety of intravaginal misoprostol (posterior fornix) prior to surgical evacuation for cervical priming in first trimester.
Materials & Methods: It was a prospective study which consisted of 75 patients divided into 3 groups, 25 patients each, with control group of 75 patients who did not have cervical priming .Both groups underwent surgical evacuation.
Group 1: 200 microgram of misoprostol inserted, 6 hours prior to procedure.
Group 2: 200 microgram of misoprostol inserted, 12 hours prior to procedure.
Group3: 400microgram of misoprostol inserted, 12 hours prior to procedure.
Results: Successful priming defined as passage of no.10 Hegar’s dilator without resistance was noted in 96% in group 3 compared to 88% in group 2 and 60% in group 1.Success rate was significant in 8-12 weeks period of gestation. Only 4% needed operative dilation in group 3 compared to 16% in group 2 and 36% in group 1. Nausea, vomiting and abdominal cramps were noted in 12% in group 1, 4% in group 2 and none in group 3. Blood loss was less in group 3 compared to other groups.
Conclusion: Misoprostol has proved to be a safe , cost effective, easily acceptable cervical priming agent in the first trimester termination of pregnancy in the dose of 400micrograms vaginally 12hours prior to surgical evacuation.
Keywords: Misoprostol, abortion, cervical priming, vacuum aspiration.
Title: Study of the Role of Plating In Fractures of Distal One-Third of Humerus Via Posterior Approach
Authors: Dr.Partap Singh, Dr.Nishant Choudhary, Dr.Mohit Bansal, Dr.Vishant Gawri
Introduction: Distal humerus fracture in adult is very difficult to treat. It is very difficult to achieve alignment, anatomical reduction, rigid fixation, immediate mobilization and fracture union in such patient. The aim of present study was to evaluate the results of open reduction and internal fixation with plating in fractures of distal 1/3rd of humerus via posterior approach.
Material and Method- A total of 30 patients of age group 15 and above of either sex with fractures of the distal 1/3rd humerus were fixed with plating using posterior approach. 16 cases were fixed with dual reconstruction plates, 9 cases with single reconstruction plate and other 5 with narrow dynamic compression plate. Data was analyzed both with regards to the clinical and radiological outcome to evaluate the effectiveness, functional outcome and morbidity associated with the procedure.
Result- 23 patients were able to achieve >1000 arc of motion and 7 patients had in between 50-1000. 25 patients were having excellent to good score according to mayo elbow performance index.
Conclusion- It was concluded that anatomical reduction and rigid fixation of the fracture with reconstruction of the congruous joint surface can be achieved only with early open reduction and internal fixation and for good open reduction and internal fixation adequate exposure of the fracture is must which is best provided by posterior approach with negligible complications.
Keywords-Distal one-third, humerus, posterior approach
Title: Role of Diagnostic Laparoscopy for Undiagnosed Abdominal Pain
Authors: Dr. Natarajan Ramalingam, Dr. Loganathan Mannu, Dr. Habeeb Mohammed Shajahan, Dr. Karunanithi Ramaiah
Background: Many patients with long standing abdominal pain remain undiagnosed in spite of various out-patient visits and a spectrum of investigations. This study was undertaken to assess the efficacy of laparoscopy as a diagnostic tool in the patients with chronic undiagnosed abdominal pain for more than 6 months.
Methods: Among300 patients with chronic abdominal pain presented over a period of 2 years, 58 patients, who fulfilled our inclusion criteria, were selected for our study, and they underwent diagnostic laparoscopy using standard operational procedures. The patient’s demographic data, duration of pain, investigative findings, intraoperative findings, interventions, and follow up were studied.
Result: 58 patients (41 females, 17 males) with mean age of 31.9 yrs underwent diagnosed laparoscopy for undiagnosed chronic abdominal pain. Findings included abdominal tuberculosis as the leading cause of abdominal pain followed by appendicitis. 8 patients had no identifiable pathology. 5 patients were lost on follow-up. Out of the remaining 53 patients 47 (88.6%) patients had significant pain relief following diagnostic laparoscopy and appropriate intervention based on the pathology found.
Conclusions: Laparoscopy has a definitive role in diagnosis of patients with chronic undiagnosed abdominal pain
Keywords: Undiagnosed abdominal pain, Diagnostic Laparoscopy, Abdominal Tuberculosis, Appendicitis
Title: Incidence of Color Blindness among State Junior High School 1 Medan Students in 2014
Authors: Nurchaliza Hazaria Siregar, Annisa Nidya Rahmatika Sitepu
Purpose: Color blindness is the inability to distinguish the perception of some colors or all colors, which normal person can do. Color blindness is a condition that generally is inherited genetically, but can also be obtained due to damage of the eye, nerves, or brain. Color blindness is genetically determined by X chromosome in females, and passed on to their children.This study was aimed to determine the incidence of color blindness among students of State Junior High School 1 Medan in 2014, according to their gender, family history, or according to the classification of color blindness.
Methods: The study was a descriptive study and was performed using total sampling technique (n= 242, male 113, female 129). Data collection was done by examining color blindness using the Ishihara Chart (38 Plates). Data analysis was performed by using descriptive analysis.
Results: The results of this study shows that among 242 total samples, 10 male students and one female student were found to be color blind, in which two of them are protanopia, 8 persons are deuteranopia, and one person is red-green deficiency. Of the 11 persons with color blindness, one of them had a family history of color blindness.
Key Words: Color blindness, students, Ishihara Plates.
Title: Anti- Inflammatory Effect of Low Level Laser Therapy on Tissue Injury (By Using C - reactive protein)
Authors: Dr. Hareth. H. Kaskos, Dr Jiyar M.Naji Mohammed
The aim of this experimental study was to assess the effect of low level laser therapy LLLT (He-Ne) on the degree of inflammation by using C-reactive protein as parameter.
Materials & Methods: Twenty healthy rats of both sexes were used ,they were received the surgical procedure by doing one incision on the dorsum surface of the animal for adepth of full thickness cutaneous tissue depth .They were divided into two groups, the control group including (10) rats received the surgical procedure without exposure to laser irradiation and the experimental group including (10) rats received the surgical procedure with laser irradiation at the dose of 0.15 J/cm2 for 5 days.
Results: statistically using Duncan multiple range test, they showed that there were only significant differences at the day 2 and 3 post operatively.
Conclusion: The laser irradiation to the tissue injury can reduction the time but not suppressed the inflammatory phase.
Key words: Low level laser, anti inflammatory, healing.
Title: Antiseptic Vaginal Preparation before Cesarean Delivery to Reduce Post Operative Infection: A Randomised Controlled Trial
Authors: Dr Jayanta Kumar Nandi, Dr Dipta Prasun Saha, Dr Sangita Pal, Dr Sougata Barman, Dr Anirban Mitra
Postoperative infection is one of the important complications of cesarean section. Post cesarean infection is usually polymicrobial and caused by ascending infection from vaginal flora. Vaginal antiseptic preparation with povidone iodine is likely to reduce the bacterial load which may reduce the incidence of post operative infection.
Aim of our study is to determine the role of preoperative vaginal preparation with povidone iodine to reduce post cesarean infectious morbidities.
This is a randomized case control study based on mothers undergoing cesarean delivery from January 2013 to July 2014. Women were categorized in to two groups – who received vaginal antiseptic preparation with povidone iodine before cesarean section and those who did not receive. Age, gestational age, BMI, Hb%, birth weight, cervical dilatation, membrane status was compared between the two groups. Outcome was measured in term of endometritis, abdominal wound infection and readmission for late infection.
In conclusion vaginal antiseptic preparation is not significantly effective in reducing post cesarean infectious morbidities in present day obstetrics.
Key words: Antiseptic vaginal preparation; cesarean section; post operative infection.
Title: Comparative Study of Efficacy of Ciprofloxacin and Ceftriaxone in Typhoid Fever
Authors: Dr. M. Usha Rani, Dr. Ch. Jhansivani
Typhoid fever is an acute systemic disease. It is caused by Salmonella typhi. The disease is unique to humans. In 1880, Ebreth first isolated the causative organism. The disease has worldwide in distribution and endemic in Tropical Countries. Between 15 and 35 years of age incidence of disease is more. Typhoid had been prevalent in many parts of India and is resistant to chloramphenical, ampicillin, co-trimaxazole. The use of quinolones in children has been prevalent. The Ciprofloxacin used in children are not free from adverse effects.
The resistant cases requires Cephalosporins. Currently the III generation cephalosporins like ceftriaxone and cefotaxime are used in multi drug resistant typhoid fever. These drugs are bactericidal and are very effective.
The aim of the present study is to compare the efficacy Ciprofloxacin and Ceftriaxone in treatment of Typhoid fever. Patients who attended the department of Medicine with fever were selected. They were divided into two groups.
25 patients were treated with ceftriaxone under Group – I and another 25 patients were treated with Ciprofloxacin under Group – II. The results of both groups were recorded. There were significant differences observed among patients in the two groups with regard to age, sex, duration of fever before admission and clinical findings. The mean number of days for patients to become afebrile was significantly lowered in those receiving ceftriaxone (P < 0.001) than in those receiving Ciprofloxacin. Ceftriaxone in the treatment of typhoid fever was proved safe and effective in the present study
Key Words: Cephalosporins, Ceftriaxone, Ciprofloxacin, Typhoid fever, quinolones.
Title: Bone Turnover Markers in Post Menopausal Osteoporosis- A Case Control Study
Authors: Madhavi Latha.N, Suresh Reddy.S, Sujatha.C, Helena Rajakumari.J, Vasundhara Devi.I
Osteoporosis is a major health problem worldwide and is projected to increase exponentially due to aging. In post-menopausal women rapid bone loss occurs due to hormonal factors leading to enhanced bone fragility and consequent increased risk of fractures. Measurement of serum and urinary bone turnover markers provide valuable information for diagnosis and monitoring of metabolic bone disease. Bone resorption marker urinary hydroxyproline and bone formation markers serum and urinary calcium, phosphorous were analysed to assess the skeletal turnover in the present study. Significantly increased excretion of hydroxyproline and calcium in urine, significant decrease in serum calcium and increase in serum phosphorous was observed in post-menopausal women when compared to controls. Hence this study suggests that simple, common bio-chemical markers can be used to assess the bone turnover and the risk of developing osteoporosis and fractures in postmenopausal women.
Keywords- Post-menopausal osteoporosis, Bone turnover markers, Urinary Hydroxyproline, Calcium, Phosphorous.
Title: Two Sides of a Face is not Equal – A Case Study
Authors: Dr Surjeet Sahoo, Mrs. Snehalata Choudhury
Body dysmorphic Disorder is characterized by a preoccupation with an imagined or exaggerated defect in physical appearance that causes significant distress or impairment in important areas of functioning. A slight anomaly is excessive and bothersome to the patient. One Study found that an average patient had concerns about four body regions during the course of the disease. “ The body dysmorphic disorder patient is really miserable in the middle of his daily routines, conversations while reading, during meals, in fact everywhere and all the time worried by the fear of deformity which may reach a very painful intensity even to the point of weeping and desperation” (Enirico Morselli-1981). We present a case study of a woman who had experienced similar symptoms and reported that her both cheeks are not equal in shape and falling down.
Keywords: Body dysmorphic Disorder, Body dysmorphic syndrome, Dysmorphophobia.
Title: A Scenario: How Much Trainee Nurses Knows about the Breast Cancer and Breast Self Examination?
Authors: Mrs. Farha Azmi, Dr Munawwar Husain
The idea for this study came to the mind of the authors by spate of incidences in which the aggrieved mob destroyed the health as property of the individual day by day by decreasing, the ignorance of detecting the both breast can maximize the chances of death after breast cancer. study is to assess knowledge regarding breast cancer and breast self examination among trainee nurses of college with a view to prepare health education programme at Moradabad. objectives are, To assess knowledge regarding breast cancer, breast self examination and prepare health education programme among nursing students of a college. The research approach selected for this study is a descriptive approach as per the nature of the study. The research design is based on descriptive research non experimental survey method. The population of present study comprises of first year and second year students of college of Nursing, sample is trainee nurses, sample size is 37. The sample was collected by using convenient method. Knowkedge for breast cancer percentage of good knowledge is 25%. Average Knowledge is 31.25%. Poor knowledge score is 43.75%. Knowledge for breast self examination,Good knowledge score is 15.62%. Average knowledge is 28.12%. Poor knowledge score is 56.25%.
Keywords:Knowledge, Trainee nurses, health education programme, Breast self examination,
Ms. Farha Azmi
Lecturer, Government College of Nursing, GSVM, Kanpur
U.P India 208014
Title: To Study the Prevalence of Non Alcoholic Fatty Liver Disease among Overweight and Obese Persons Undergoing Preventive Health Checkups in a Tertiary Care Hospital
Authors: Smita Gupta, Tanvi Sood, Neeraj Kapoor, AB Mowar, Piyush Keriwal, Pranesh Nigam
Introduction: Raised Body Mass Index (BMI) is on an increasing trend nowadays, associated with various complications. The present study was planned to determine the prevalence of Non Alcoholic Fatty Liver Disease (NAFLD) among overweight and obese persons undergoing preventive health checkups and to compare the various risk factors among NAFLD and non-NAFLD population at a tertiary care center in north India.
Methods: A hospital based prospective study was done on 200 persons both male and female with BMI >23 kg/m2according to WHO criteria for the Asians. They underwent a detailed history and clinical examination, blood examination including sugar levels, serum lipid profile and liver function tests along with ultrasonographic (USG) examination for hepatobiliary system.
Results: Out of 200 persons having BMI >23 kg/m2, 130 (65%) were males and 70 (30%) were females. Ultrasonography revealed NAFLD in 114 persons (57%) out of which 68.4% were males and 31.5% were females with mean age of male 45.88+/-49 years and of female 46.40+/-11.43 years. NAFLD in overweight category was 50.7% and among obese was 70.9% (p=0.007). Prevalence of risk factors among NAFLD persons was significantly higher than the non NAFLD group with 50.8% (p=0.024) having systolic blood pressure≥130mmHg, 43.8% (p=0.002) having diastolic BP ≥ 85mmHg, 50.8% (p=0.001) had fasting sugar ≥ 100mg/dl and ALT was found to be elevated in 54.3% (p=0.006) of subjects.
Conclusion: It can be concluded from our study, earlier the discovery of fatty liver in routine checkups was considered to have no significance but now it is well established that obesity is a high risk factor for development of NAFLD. Other risk factors like raised blood pressure, elevated fasting sugar and serum triglyceride and low HDL levelsmay be associated in these patients which may further lead to NAFLD. These risk factors are preventable and reversible.
Key Words: NAFLD, fatty liver, obesity, BMI, overweight
Assistant Professor, General Medicine
Department of General Medicine
Shri Ram MurtiSmarak Institute of Medical Sciences,
Bhojipura, Bareilly, Uttar Pradesh 243202
Title: A Case Report: An Accessory Mental Foramen
Authors: Dr. Rakesh Kumar Shukla, Dr. Ranjan Kumar Dixit, Dr. Sajjad Jafer Khan
Aim: The aim of this article is the presentation of a case report on an accessory mental foramen.
Introduction: Any foramen which is in addition to Mental Foramen (MF) is considered as an Accessory Mental Foramen, (AMF) and it is usually located below the 1st molar teeth. This accessory mental foramen may transmit the branches of the mental nerve. Presence of the accessory mental foramen would be of much use for dental surgeons while they do surgical procedures on the mandible.
Report: Seventy (70) mandible analyzed in a study of Morphometric analysis of mental foramen in dry human mandible in the region of North India, where five accessory mental foramen was found. Three on left side and two on right side of mandible.
Summary: Variation in the existence of accessory mental foramen was studied and statistical analysis, to find out the minimum and the maximum incidences of accessory mental foramen was performed.
Key Words: Mental foramen, Accessory mental foramen, Anatomical variation, Mental nerve block, Surgical Procedure to Mandibular Premolar and 1st Molar tooth.
Title: Bacteriological and Haematological Profile of Neonatal Sepsis in Rural Teaching Hospital in Central India
Authors: Vijay C. Ambade, Ankit O. Gupta, Jagdish Z. Pakhare, Sanjay S. Joshi
Aim: This study was aimedto determine the bacteriological profile with their antimicrobial susceptibility as well as haematological profile related to neonatal sepsis.
Materials and Methods: In this prospective study conducted during August 2012 to July 2014, the blood samples collected from total 405 newborns suggestive of suspected sepsis were subjected to blood culture and initial sepsis screen. The identification of causative organisms was carried out by standard microbiological tests and antibiotic sensitivity testing as per Clinical Laboratory Standards Institute (CLSI) guidelines.
Results: Of the 405 neonates with suspected sepsis, 29.38% had positive blood culture among which Gram negative organisms (68.06%) predominated over Gram positive organisms (31.93%) with Klebsiella species (35.29%) as the commonest bacterial pathogens. Both Gram negative and Gram positive organisms exhibited high to considerable resistance to commonly used antibiotics and found susceptible to meropenem, piperacillin-tozabactum and cefoperazone-sulbactum, vancomycin, linezolid respectively. The sepsis screen parameters showed varied results among culture positive and culture negative cases.
Conclusions: Blood culture as well as sepsis screen should be carried out in neonates suspected of sepsis. The Gram negative bacterial predominance and high to considerable resistance against commonly used antibiotics in the present study makes it necessary to useantibiotics wisely and continuous surveillance to determine the varied pathogen causing neonatal sepsis with their resistance pattern to revise antibiotic policy accordingly.
Key words: Antimicrobial susceptibility, blood culture, Bacteriological profile, haematological profile, neonatal sepsis, sepsis screen
Title: Bone Mineral Density and Fracture Risk Assessment in Type II Diabetic Patients
Authors: Saima Ejaz, Shireen Jawed, Nagah M. Abo-ElFetoh, Atif Mahmood, Hafeezullah Wazeer
Objectives: To assess BMD and its association with fracture risk in elderly type II diabetic patients by using Fracture Risk Assessment Tool as a standard predictor of fracture risk.
Introduction: Diabetes mellitus is the most common health problem worldwide and is estimated to be 6 - 8% of the overall population world over. A change in bone health is one of the many complications of this metabolic disorder. Most of the studies reported reduced bone mineral density (BMD) in Type 1 diabetes with increased risk of osteoporotic fractures. However, there have been conflicting results on the effects of type II diabetes on BMD and incidence of osteoporotic fracture due to the pathogenic complexity of the condition. Fracture Risk Assessment (FRAX) tool is a standard predictor of fracture risk assessment and assesses the ten-year risk of osteoporosis fracture based on individual risk factors, with or without BMD.
Methodology: A case control study was conducted on a purposive sample of 252 type II diabetic and non-diabetic patients from different health care centers of Karachi. The participants were asked to fill a detailed questionnaire about their personal, present and past medical history and risk factors of osteoporosis were assessed. Type II diabetics with a history of at least 3 years were included in the study. Patients with history of drug and hormone intake that affects bone metabolism or any disease or surgery involving any joint; cancer and renal failure were excluded from the study. BMD measurements were done by Bone Densitometer (SONOST 3000). BMD was calculated by combining BUA and SOS which yields the QUI index. Calcaneus bone of right heel was used for measurement. T scores were used to evaluate BMD and risk of osteoporosis and Osteopenia were assessed by FRAX tool.
Results: The mean age of the diabetic patients was 60.16% (± 8.06) years whereas 59.8 (± 6.2) years in non-diabetic patients. Mean BMI among diabetic patients was 25.9 ± 5.7 kg/m2 while 24.4(± 4.43)Kg/m2 was in non-diabetic patients. Mean waist/hip ratio of the diabetic patients was 0.93 (+ 0.11) while of non-diabetic patients was 0.89 + 0.087. The mean SOS and BUA in diabetic population was 1509 (± 21.12) and 81.23 (± 16.725) while in non-diabetic was 1414 ± 30.5 and 71.88 ± 13.73 respectively. Of the respondents, 13.1% were males and 86.9% were females. 30.5% had a family history of osteoporosis and 69.5% didn’t have a family history of osteoporosis. The mean T score in diabetic patients was -1.46 ± 0.95 while in non-diabetic patients was -4.7 + -0.7. The major osteoporotic fracture risk and hip fracture risk was 9.3 ± 7.26% and 7.1 ± 5.2% in diabetics whereas 2.6 ± 0.5% and 1.3 ± 0.4% in non-diabetic patients respectively. A weak negative correlation (-0.32) has been observed between BMD and Hip Fracture risk among diabetic patients.
Conclusion: Type 2 diabetic patients have increased risk for hip fractures despite of higher BMD.
Key words: Type II diabetes, BMD, Fracture risk assessment, Osteopenia, Osteoporosis, FRAX tool
Title: Case Report: Management of Hemophilia-A for B/L TKR
Authors: Dr Parshuram Chauhan, Dr Ravinder Dhanerwa, Dr H. K. Mahajan
This report describes successful management of 36 yrs old patient with hemophilia-A, who received general anaesthesia for B/L TKR. He was given Anti-Haemophilic Factor (AHF)-VIII starting before the surgery and continued for till his full recovery.
Haemophilia A is an X-linked recessive hereditary disorder characterized by a deficient or defective factor VIII. Haemophilia-A is more likely to occur in males than in females as males have only one X- chromosome. Thus females are almost exclusively asymptomatic carriers of the disorder. Before the commercial availability of Factor VIII, surgery was impossible in haemophilia patients and even tooth extraction could be life threatening.
Keywords: Haemophilia, AHF VIII, General Anaesthesia.
Title: Thermal Blast Injury in Child: A Case Report and Review of Literature
Thermal Blast Injuries due to explosion of a batteries are rare and life threatening. This low voltage batteries are not free from danger as they can be easily accessed by children. If mishandled, it can lead to serious adversities butcan be prevented by proper education and counseling of the parents and children.A exceptionally rare and peculiar mode of Thermal Blast injury in a child as a result of battery explosion is reported here. This case report emphasizes the need for education to parents in handling low voltage batteries.
Key Words: Thermal Blast Injury, Battery Explosion, Low Voltage.
Title: Cost Effective Analysis: Updated Thai Red Cross Intradermal Regimen in Animal Bite Cases
Authors: Amol R. Patil, Sankhe Lalit R., Chhaya Rajguru, Swapnali Kadam
Rabies is considered one of the most fatal diseases. South East Asian countries show relatively high prevalence of rabies and considerable deaths due to rabies, which is totally preventable by simple measures like wound cleaning and prompt, complete Post exposure prophylaxis. There are currently two regimes in practice to provide PEP, one is 5 dose IM Essen Regime and the other 4 dose updated Thai Red Cross regime. This study compares the two regimes based on their cost effectiveness. Cost effectiveness is an important measure which helps policy makers to utilise the ever dwindling resources in an attempt to improve population health. The study findings indicate that the Updated Thai Red Cross regime is cost effective than the Essen Regime not only with regards to the cost of the vaccine, but also for improving the compliance of the patient and ensures completion of PEP which is essential for the prevention of Rabies and its fatality.
Key words: Rabies, Cost effectiveness, Post exposure prophylaxis.
Title: Multiple Maxillary Tuberosity Exostosis
Authors: Khurshid Mattoo, Krati Jain
Multiple intra oral bony tori and exostosis have often been reported in the literature to occur in the mandible. In the maxillary arch the tori has been reported to occur usually in the midline and has been termed as torus palatinus. The present case is novel as it reports a case of multiple exostoses on the lateral aspects of the slopes of the palate in the region of maxillary tuberosity where it rarely reported. A single bony extension also existed beneath the overlying palatine rugae. Multiple minute ulcerations were also observed distant to the site of bony exostosis.
Keywords- ulcer, hard palate, tuberosity, palatine rugae, torus mandibularis
Title: Designing a Cast Partial Denture for Patients with Open Bite
Authors: Khurshid Mattoo, Neha Garg, Lakshya Yadav
Designing a cast partial denture for a partial edentulous situation often poses challenges, especially the placement of components with respect to the existing dynamic occlusion of the patient. Whereas there are many reports of designing a Kennedy class 3 situations in normal occlusion there are no reports of designing the prosthesis in a patient with skeletally caused dental open occlusion or open bite. This case report presents designing of a cast partial denture in such a patient and discusses the effects of such occlusion on its design.
Keywords- partial edentulism, surveyor, casting, connector, retainer
Title: Speech Enhancing Prosthesis for Acquired Cleft Palate
Authors: Khurshid Mattoo, Krati Jain
Cleft of the hard palate that is acquired secondary to surgical correction of a carcinoma renders the patient handicapped relative to phonetics. Obturation of such defects, temporarily or permanently are essential initiators for rehabilitation. Impaired phonetics superimposed on a psychologically disturbed individual affect an individual’s confidence and can exaggerate the level of already existing depression. Speech correction in such patients is the second step after obturation of the defect and both procedures when carried in synergism allow patients to improve psychologically. This article describes the speech enhancement of a cleft palate patient using an acrylic plate (obturator).
Keywords- carcinoma, depression, speech therapy, self-confidence, obturator
Title: Apprehensions Associated With Wearing of Cast Partial Denture
Authors: Khurshid Mattoo, Neha Garg, Lakshya Yadav
Cast partial denture being a removable prosthesis does not enjoy being a high priority treatment option for many of partially edentulous patients. A well-constructed partial denture that incorporates sound principles of a removable partial denture can serve far better than a fixed prosthesis in already compromised partial edentulous situation. Patients who have to wear more than one partial denture require overcoming their apprehension before such prosthesis are worn by them. This article is a representation of one such case of a partial edentulous situation whose apprehension levels before treatment began were high, but were successfully managed during the course of treatment.
Keywords- judgement, patient motivation, partial edentulism, cast metal, removable prosthesis
Title: A Comparative Study on Use of Intracervical Dinoprostone Gel and Intravaginal Misoprostol for Cervical Ripening and Induction of Labour
Authors: Dr. Rathindra Nath Ray, Dr. Nupur Nandy, Dr. Teesta Banerjee, Dr. Prosenjit Das
Generally labour induction is indicated when the benefits of delivery to the mother or fetus outweigh the potential risk of continuing the pregnancy. Labour is commonly induced is response to a number of fetal and maternal situations, including post term pregnancy, premature rupture of membranes without the onset of spontaneous contraction within the next 24 hours. Induction of labour has become a common intervention with induction rate ranging from 16% to 44% . The aim of our study is to compare the dinoprostone gel and misoprostol 25mg tab in ripening and induction of labour. The improvement of Bishop’s score was more in misoprostol THAN dinoprostone gel.
The rate of vaginal delivery is 78% in dinoprostone gel and 84% in misoprostol group respectively. Three patient in dinoprostone gel groups had Forceps delivery (6%). The rate of caesarean section in group A was 20% & Group B was 16%. The interval from recruitment to ripening of cervix was shorter in misoprostol group than dinoprostone gel [Misoprostol (4.98 ± 1.86), dinorpsotoine gel (8.06 ± 2.93), p < 0.001].
The time from ripening to active labour was almost equal between these two groups.
The interval from active phase of labour to full dilation in group A (4.85 ± 1.13) group B (4.11 ± 1.32).
Key Words: Dinoprostone, Misoprostol, Intracervical, Intravaginal, Cervix, Ripening, Induction, Labour.
Title: Solid Pseudopapillary Tumor of Pancreas a Case Report
Authors:Dr. Rahulkumar N Chavan, Dr. Jayant Pednekar,Dr. Tushar L Pawar
Solid pseudopapillary tumor of pancreas is rare neoplasm which occurs commonly in young females. It grows with indolent manner and complete surgical resection is standard of care. We report a case of 22 year old female presented to us with symptoms of dyspepsia, on examination she had lump in right upper quadrant, USG revealed hypoechogenic mass between liver and right kidney. CECT scan showed hypodense and heterogeneous mass arising from head of pancreas. Patient underwent pancraticoduodenectomy with portal vein reconstruction. HPE report mentioned solid pseudopapillary tumor(SPN) of pancreas. After two years of follow up patients maintains good general condition with no signs of recurrence
Keywords- pancreatic neoplasm, women, complete excision, good prognosis
Title: A Rare Case of Cyclops Deformity From India
Authors: Lavina Chaubey, Nisha Rani Agrawal, Swati Verma
Background: Cyclopia is a disorder characterized by failure of the embryonic prosencephalon to properly divide orbits of the eye into two cavities. Chromosomal aberrations or toxins can cause problems in the forebrain-dividing process. Its incidence is 1 in 13,000 live births. The nose is either missing or replaced with a non-functional form of proboscis. Most such cases are naturally aborted.
Case: A 25 year old primigravida reported with date–size disparity (dates: 23+1, first trimester USG: 21+5, size: 16 weeks) and subsequent USG revealed a dead fetus. Patient gave history of low grade fever in the past. She was induced and expelled a dead fetus of 300 gms which showed features of cyclopia with a proboscis above the single eye. Chromosomal analyses, however could not be done as the fetus was partially macerated.
To conclude, cyclopia is a rare disorder, incompatible with life
Department of Obstetrics & Gynaecology, Institute of Medical Sciences,
Banaras Hindu University,Varanasi, Uttar Pradesh,
INDIA Pin code – 221005
Title: Clinical Study of Visual Out Come of Lens Induced Glaucomas
Authors: Dr.G.Narendranatha Reddy, Dr.M. Premanandam, Dr.G. Sudha
During the period of september 2012 to october 2013, we selected 100 patient of lamp induced glaucomas, to study the visual outcome after temporay management medically followed by surgery and weekly follow up. This study was taken in Regional eye hospital kurnool, kurnool medical college kurnool All 100 patents of LIG; were in patients.
For temporary medical management, to reduce IOP in to operable level, we used carbonic an hydrase inhibitor,(A cetazolamide 250 mg) Beta block as (Timolol maliate 0.5%), mydrictics (phenylepherine 20%),mioties(pilo carpinea 2%), followed by further use of steroids to reduce uveitis. And finally symptomatic treatment like antibiotic. Sedetive, anti inflammatory analgesic and anti pyretics were used.
Under 20% xylocaine local anesthesia by peribulbar and facial blocks for LIG cases we did extracapsular cataract extraction(ECCE), intracapsular cataract extraction (ICCE); small incision cataract surgery(SICS) accordingly IOL(Intra ocular lens implantation done.
In hundred patient of LIG'S the finaly results were as follows, between 66-75 years of patients (40%) commenly affected; left eye incidances are more 62 patients (62%), phacomorphic glaucoma were 68% phacolytic glaucoma were 24%, lens particle glaucoma 4%, subluxations and dislocation of lens 4 % symptomatic cases within one week duration 58 cases, 58% noticed.
Pre operative maximum Iop was > 40 mm of Hg in 34 cases 34%
Out of 58 cases 62% had good visual prognosis and 24% had usefull visual prognosis, 10 cases had poor visual prognosis, 1% had total loss of vision.
Statistically, chi-squaretest (x2) and proabilility values (P) were used.
P, value less than <0.05 was considered significant.
So finally to conclude in our study, we achieved good visual prognosis with in 1 week duration of the LIG patients. So early detection of the LIG and management given BCUA62%
Title: Seroprevalence of Hepatitis B Infection in Field Practice Area of Government Medical College, Srinagar Kashmir: A Community Based Cross-sectional Study
Authors: Irfa Naqshbandi, Iftikhar H Munshi, Syed Yasir Qadri, Nighat Bashir, Nighat Yasmeen
Hepatitis B virus infection is one of the major global public health problems with nearly 2 billion people infected worldwide, 75 % of whom are Asians.There are about 350 million chronic carriers in the world.The study was planned to study the socio-demographic characteristics of study participants andto estimate the prevalence of Hepatitis-B infection in Block Hazratbal, Srinagar.A cross-sectional, community-based study in the age group of 18 years and above was conducted having sample size of 1340, obtained using formula n=4pq/l2and they were screened for Hepatitis B surface antigen using Enzyme Linked Immuno-sorbent Assay kits. We had 1300 participants in our study, all Muslims. There were 970 (74.6%) females and 330 (25.4%) males.Majority of our participants (54.7%) were in the age group of 21-40 years. Most of the participants were from urban areas(68%), currently married(66.8%), illiterate(64.8), members of joint family(59%) and belonging to socio-economic class II(67.2%). The prevalence of Hepatitis B infection in Hazratbal Block was 1.2%% with higher prevalence in males (4.2%) as compared to females (0.1%).Therefore, Block Hazratbal is having low endemicity of Hepatitis B infection as per WHO classification. Keeping in view, the increasing burden of this disease, there is a need to organise health education campaigns targetting both health care workers as well as public, so that they adopt all possible measures to prevent the spread of this fatal infection.
Keywords: Hepatitis B, HBsAg, seroprevalence, risk factors, Srinagar
Title: Medico Legal Advice to the Distressed Fetus – Now A Child
Authors: Dr Mohd Asrarul Haque, Dr Md Mojahid Anwar, Dr Faiz Ahmad, Prof. Munawwar Husain, Prof. J A Usmani
Apropos the case report entitled ‘Fetal gunshot of the chest: An unprecedented surgical encounter” 1 the under mentioned authors would like to append the medico legal component to this unusual episode.
Title: Intracranial Hemorrhage in Dengue Fever; A Case Series
Authors: Jitendra Singh, Anju Dinkar, Virendra Atam, Ravi Misra, Saurabh Kumar, Kamlesh K Gupta, ML Patel
Background- Recently it is seen that clinical profile of atypical presentations in dengue fever is expending and these are being reported more frequently during last decade. Although there are many causes of Intracranial hemorrhage but dengue can also complicated to this fatal illness. We hereby reported two cases of dengue hemorrhagic fever, one of them was 45-year-old male farmer who was diagnosed as intracerebral hemorrhage and improved on conservative treatment. Other case was 30 years old male clerk and unfortunately he died because of acute subdural hematoma.
Key Words: Dengue fever, Intracerebral hemorrhage, Subdural hematoma, Aedes aegypti, Atypical manifestation
Title: An unusual Presentation of Mayer‑Rokitansky-Kuster Hauser Syndrome with Rectovaginal Fistula
Authors: Dr Dalia Rafat, Dr Imam Bano, Dr Shaheen
Mayer‑Rokitansky‑Kuster‑Hauser Syndrome is a rare congenital anomaly characterised by mullerian duct agenesis resulting in hypoplastic or absent uterus and vaginal aplasia or hypoplasia with normal ovaries. Physical growth, development and secondary sexual characters as well as the external genitalia are also normal. These patients most commonly presents with primary amenorrhea and difficulty or inability of sexual intercourse. Here we report a case of 24 yearold woman with Müllerian agenesis and rectovaginal fistula following coital injury who has presented to us for secondary amenorrhea and infertility.
Keywords: Mayer Rokitansky Kuster Hauser syndrome , Rectovaginal fistula, Coital injury
Title: Role of P53 As A Tumour Marker
Authors: Dr Rupinder Kaur Multani
Tumor marker is a biochemical substance indicative of neoplasia and is ideally specific, sensitive, and proportional to tumor load. p53, is a 53 KD nuclear phosphoprotein which functions as tumor suppressor by inhibiting cell proliferation. p53 plays a dominant role in cellular apoptosis. p53 gene mutations are reported in approximately 50% of all types of cancers. The importance of its presence either in wild or in mutated form in pathogenesis of various neoplasms definitely invokes scientific attention towards this molecule, both as gene as well as protein.
Title: Evaluation of Causes of Permanent Visual Impairment in Bastar District of Chhattisgarh
Author: Dr. Pranda Shukla
Purpose: To evaluate the causes of permanent visual impairment in Bastar District of Chhattisgarh.
Materials and Methods: This was a prospective study carried out during the period of January 2014 to December 2014 by the patients attending outpatient department of ophthalmology in a government Medical college jagdalpur .Disability camps were organized in nearby primary health centres. Cases came for visual disability certificates are also included in this study .Patients with visual acuity less than 3/60 in better eye were included in this study.
Results: Total number of cases were 234 Out of this 146 Males (62.40%), 88(37.60%) Females, age group 5-18 years were46.15%,19-40 years 41.88% and more than 40 years were 11.96 %.Congenital microphthalomos (36.752%) was the commonest cause of permanent visual disability followed by corneal scar (19.658%),optic atrophy (11.11%), strabismus with amblyopia (9.401%), nystagmus with amblyopia (8.547%),diabetic retinopathy (4.7%),Retinitis pigmentosa (3.846%),bilateral chronic healed iritis with complicated cataract (3.418%) ,age related macular degeneration (2.564%).
Conclusions: Malnutrition and vitamin A deficiency are very common in this area and maternal infections are also common which may be a contributory factors for visual disability in this area therefore health education and awareness about maternal and child health care is required
Key words: evaluation,visual,disability
Title: Robertsonian Translocation – An Indication for Prenatal Diagnosis
Authors: Shabana Borate, Prasad Kulkarni, Suresh Gangane
Robertsonian translocation occurs with a prevalence of 1 in 1000 in the general population. It carries reproductive risks that are dependent on the chromosomes involved and the sex of the carrier. Here we describe two families referred to our Genetic Division for karyotyping. Chromosomal analysis was done from peripheral blood lymphocyte culture. In case I index case was referred with complaint of primary amenorrhoea. Her Karyotype revealed 45XX t (13;14), inv(9). When parents karyotype was done, mother’s karyotype revealed 46XX and father showed 45XY,t(13;14),inv(9). family had a baby, clinically diagnosed as having Down syndrome, died at 6 months of age. Karyotype of Mother revealed 45XX,t(14;21) and father had normal male chromosomal complement. In Robertsonian translocation careful risk assessment and proper genetic counselling is the most important thing.
Keywords- Carrier, chromosomal aberrations, translocation, prenatal diagnosis, karyotype
Title: Correlation between Anthropometric Measurements and Peak Expiratory Flow Rate in Healthy Young Adults
Authors: Vinaya Vijayan, Dr.N.C.Sebastian
Background: Peak Expiratory Flow Rate is a dynamic lung function test and an accepted index of pulmonary function which is widely used in respiratory medicine.
With the unplanned growth of industries and vehicular traffic the environment is getting polluted day by day. As a result respiratory problems have become a common ailment. Respiratory ailments such as bronchial asthma and emphysema have become common even among children
Aim: the purpose of this study was to assess the peak expiratory flow rate in adolescents, to correlate the peak expiratory flow rate in boys and girls and to find out the correlation between peak expiratory flow rate and anthropometric measurements such as body weight, height and age.
Materials and methods: A cross-sectional survey of student volunteers was conducted A sample of 100 healthy student volunteers comprising 44 boys and 56 girls with ages ranging from 17 to 21 were selected for the study. The following anthropometric measurements were verified in all the individuals – weight,height,BMI,BSA.
1)The participants were weighed on a weighing machine (Edryl India) using light clothing and bare foot. 2)Standing height was measured without shoes to the nearest 0.1 cm using a standard measuring scale.3) BMI was obtained using the following formula. BMI = Weight in Kg/Height in m2
1) BSA was obtained using the Dubois & Dubois formula:
BSA = (Weight0.425 x Height0.725) x 0.007184
2) The Wright’s Peak flow meter was used for the measurement of PEFR.
Results: The present study done on 100 students (44males and 56 females) shows that there is an excellent correlation between height and PEFR, weight and PEFR and BSA and PEFR. The correlation between PEFR and BMI was less significant
Conclusion: In the present study there were no significant differences by gender for any of the correlations. Peak flow is effort dependent. It primarily measures large airway function and muscular effort. Decreased PEF values should be evaluated for consistent patient effort.
Keywords: PEFR. Anthropometric Measurements, Healthy Young Adult
Title: Anti-Angiogenic Effect of Caryota Urens Fruits Extract on the Fin of Zebrafish
Authors: Vikram Shokin Bafna, Sughandha G. Chaudhari, Neethu R, Rajendra Patil, Mukesh C., Geeta B
The aim of this study is to explore Caryota urens which may lead to discovery of new therapeutic agents which may inhibit process of angiogenesis and in future which may be utilized for treatment of various disease condition like cancer, cardiovascular diseases, arthritis, diabetic retinopathy etc. where angiogenesis play a major role in modulating disease processes. With this aim, the objectives of the study includes identification of active constituent which will be crucial in understanding the mechanism of action of the said activities and to evaluate the anti-angiogenic activity of the Caryota urens fruit extract in zebra fish fin regeneration model. Zebra fishes were maintained and fish regeneration assay was done on ethanolic extract of Caryota urens (EECU) and inhibition in regeneration of zebra fish fin was observed for over a period of thirty days with regular dosing on every alternate day. Fishes were divided into groups. The groups were treated with various concentrations of test and standard drug. Area of regenerated fin was measured frequently by observation under microscope and measurement by softwares. The dose response of test and standard were plotted and inhibition in regeneration was observed accordingly. The inhibition of regeneration of fin in zebra fish was observed in test drug which may be as a result of phytoconstituents present in Caryota urens. The present study represents that the zebra fish models can be applied for studying anti-angiogenic activity and Caryota urens have potential for further exploring for its application in inhibition of process of angiogenesis.
Keywords:- Fruit extract, zebrafish, fin regeneration, angiogenesis.
Title: Hereditary Spherocytosis – A Case Report
Authors: Wasim M Khatib, Sunil V. Jagtap, Pankti M Patel, Saket Kumar, Tasneem V Bisht, Dhiraj Kumar Shukla
Hereditary spherocytosis is the most common cause of chronic hemolytic anemia. Deficiency in predominantly spectrin and also in other protein such as band 3, protein 4.2 and ankyrin is the main etiology. Clinical presentation varies from anemia, reticulocytosis, splenomegaly to symptoms and signs arising due to its complications such as chronic leg ulcers, hemolytic crisis, aplastic and megaloblastic crisis and cholelithiasis. Peripheral blood smear, reticulocyte counts, osmotic fragility studies and ultra sonography of abdomen are essential investigations for the diagnosis of hereditary spherocytosis. Milder forms of hereditary spherocytosis are asymptomatic. We present a case of a 24 year old male who presented with pain in abdomen and icterus. Investigations revealed the case to be of hereditary spherocytosis. The patient was posted for splenectomy and was on post splenectomy prophylaxis.
Keywords: Spherocytosis, anaemia, osmotic fragility, splenomegaly.
Title: Multifocal Bowen’s Disease Arising from Psoriatic Lesions – A Rare Case Report
Authors: Priya Banthavi Sivasubramanian, Balasubramani Arumugam, Manimegalai Singaram
Psoriasis is a chronic, multicentric skin disease characterized by itchy, scaly patches and plaques while Bowen's disease usually presents as a solitary, non-itchy plaque involving the head, neck or legs.
Here we report the case of a sixty year-old man, a known patient of generalized psoriasis vulgaris on irregular treatment, now presenting with ulceration, pigmentation and pedunculation of the lesions on the torso and thighs. The change in the nature of the lesions lead to a biopsy which revealed Multifocal Squamous cell carcinoma-in-situ/Bowen’s disease. The skin lesions were subsequently completely surgically excised and skin grafting was done.
This case is rare since it reveals that premalignant, multicentric Bowen’s disease can develop in improperly treated Psoriatic lesions and the possibility of Arsenic being the culprit for the premalignant change in the psoriatic lesions. This report also emphasizes the need for histopathological examination of the lesions which change their clinical presentation, to help diagnosis and treat such carcinoma-in situ changes at an early stage and thereby avoid the development of frank malignancy.
Keywords: Bowen’s disease (BD), Psoriasis, multifocal Squamous cell carcinoma- in- situ.
Title: Hypoglycemic Activity of Bridelia Stipularis on Combination of High Fat Diet and STZ Induced Diabetic Rats
Authors: Neethu R, Sugandha G Chaudhari, Vikram Bafna, Rajendra Patil, Mukesh Kumar Chavan, Geeta Basaiye
The aim of this study is to explore Bridelia stipularis which may lead to discovery of new therapeutic agents which may treat hyperglycemia and in future it may be used in diverse disease condition where hyperglycemia is the main source of amplifying and complication of other major disease processes. with the aim, the objectives of the study includes identification of active constituent which will be crucial in understanding the mechanism of action of the said activities and to evaluate the anti- diabetic activity of the Bridelia stipularis leaf extract in HFD and STZ induced diabetic models. Sprague–Dawley (SD) rats (180–200 g) of either sex were allocated for dietary regimen of water and in house prepared high fat diet for two weeks.The HFD-fed rats exhibited significant increase in body weight, basal plasma glucose (PGL), triglycerides (PTG) and total cholesterol (PTC) levels. After 2 weeks of dietary manipulation, rats were injected intraperitoneally with low dose of streptozotocin (STZ) (35 mg kg−1). In addition, the levels of PTG and PTC were further accentuated after STZ treatment in HFD-fed rats. Thus, these fat-fed/STZ-treated rats simulate natural disease progression and metabolic characteristics typical of individuals at increased risk of developing type 2 diabetes because of insulin resistance and obesity. The present study represents that the combination of HFD-fed and low-dose STZ-treated rat serves as an alternative animal model for type 2 diabetes and Bridelia stipularis can be used for treating hyper glycemia
Title: Giant Cell Tumour of the Tenosynovium - An Unusual Cause for Locking of the Knee Joint
Authors: Dr. Buchupalli Bharath Reddy, Dr. P.Chandrasekhar, Dr. Srikanth R.V, Dr. Rohit Inuganti, Dr. Mohan Babu.L
Introduction : Giant cell tumour of the synovial membrane or tendon sheath also called localised nodular synovitis are benign soft tissue masses typically found on flexor surfaces of the hand and wrist .
Case Presentation: A 22 yr male basketball player presented with complaint of swelling in front of the left knee, locking episodes, clicking sounds, recurrent episodes of swelling without any associated trauma of 6 months duration.
Discussion: Giant cell tumours of tendon sheath or synovium [GCTTS] are benign soft tissue masses typically found on flexor surfaces of the hand and wrist . More common in males with an average age of presentation 30 – 50 years.
Conclusion: This case highlights that GCTTS although rare, can be an unusual cause for locking of the knee joint .Its presentation may mimic a meniscal tear, but a history of no previous trauma to knee and painless locking are important discriminating features.
Dr. Buchupalli Bharath Reddy
Senior Resident, S.V.R.R.G.H
(Sri Venkateswara Rammnarain Ruia Govt. Hospital),
MS Orthopaedics NIMS,
Fellow in Arthroscopy
Title: Media Optimization For Lovastatin Production by Statistical Approach Using Aspergillus terreus by Submerged Fermentation
Authors: Umesh Luthra, Nishtha Singh, Archana Tripathi, Sejal Vora, Vrushali Bhosle
Lovastatin is a secondary metabolite produced by Aspergillus terreus which is used as cholesterol-lowering drugs called HMG-CoA reductase inhibitors. In the present study to increase the yield of lovastatin, production media components were optimized. The impact of media components which includes carbon, nitrogen source, organic and inorganic salts were studied with response surface methodology.
A “Plackett-Burman Design” was employed to evaluate the effects of different components in the media. The concentrations of Casein, Citric acid and Sodium acetate were significantly influence the Lovastatin production. The Pareto chart was employed to determine the optimal regions of these three significant factors. These three factors were optimized using central composite design (CCD) of “response surface methodology.” The optimized fermentation medium composition was as follows (g/L): Casein 25.0, Citric acid 12.0, Sodium acetate 18.0, Dextrose 40.0, Cotton seed meal 7.50, Soya flour 23.5, Magnesium sulphate (MgSO4.7H2O) 0.50, Calcium carbonate 6.25, Glycerol 5.0, PEG-400 2.85, Soya oil 5.0. The validated model can precisely predict the Lovastatin production.
Keywords-Lovastatin, Fermentation, Plackett Burman Design, Central Composite Design, Response Surface Methodology.
Title: Artisan Phakic IOL in Myopia – How Useful Is It?
Authors: Dr. Vikas Mahatme, Dr. Sudha Sutaria, Dr. Atul Borkar, Dr. Chitra Pande, Dr. Nikhilesh Wairagade
Artisan Phakic IOL is found to be effective and predictable in treating high myopia. The present study was aimed at determining the efficacy, safety, predictability and visual outcome of Phakic Artisan IOL in high myopia. This retrospective and prospective study was conducted on 22 eyes of 18 patients between October 2004 and January 2006 at Mahatme Eye Bank Eye Hospital, Nagpur, India. All of them underwent implantation of iris claw phakic IOL (Artisan) by the same surgeon. Although it is a difficult procedure to perform, our study showed that in experienced hands, there are minimal intraoperative and postoperative complications. The implantation of Phakic IOLs has been projected as an interesting alternative to corneal surgery for the correction of high refractive error. However further follow up is necessary to confirm its efficacy and to monitor long term complications and safety.
Keywords: Artisan lens, Phakic Intra Ocular Lens (PIOL), ICL (Implantable Contact Lens), Anterior chamber IOL, Iris Claw IOL,Myopia, refractive surgery, Lasik, PRK, refraction, spherical equivalent (SE) refraction, BSCVA (Best surgically corrected visual acuity),
Title: Resting Heart Rate, Heart Rate Variability and Electrocardiogram Changes in Chronic Alcoholics
Authors: Kusuma. R, Fazal M Gahlot, Nagaraja Puranik
Aim: Alcohol use is causing damage to the health. The damage may be physical or mental. Recent studies strongly suggest that long-term, alcohol abuse may have powerful implications on cardiovascular health. However, very few studies have focused on the association between long-term alcohol drinking and resting heart rate, Heart rate variability and electrocardiogram changes at rest in these individuals. Thus, the present study was conducted to establish the electrocardiogram changes, heart rate and heart rate variability in chronic alcoholics at rest and to compare the changes with that of non-alcoholic controls.
Methods: The study group consists of Fifty men, aged between 30-50 years with alcohol intake for more than 5 years of duration, without any known cardiac illness. Similarly, Fifty non-alcoholic individuals of the same age, sex and anthropometrically matched group constitute the control group. Resting heart rate was recorded while heart rate variability and ECG were monitored and recorded by using ECG –DYNATRAC system. Statistical analysis was done by using student‘t’ test.
Result: In the present study, there was a significantly high resting heart rate (tachycardia) and decreased heart rate variability in alcoholics compared to non-alcoholics.ECG in them showed significant decrease in RR interval. However, all other ECG waves, intervals and QRS frontal axis were unchanged in them compared to controls.
Conclusion: Long-term alcohol intake has deleterious effects on cardiovascular functions as it leads to increased resting heart rate, decreased HRV and ECG changes. These findings may be an early indicator of the ‘alcohol abuse’ on body system, especially on the cardiovascular system.
Keywords: Electrocardiogram; Heart rate variability; Resting heart rate; Chronic alcoholics.
Fazal M Gahlot
Assistant Professor, Department of Anatomy,
Karnataka Institute of Medical Sciences, Hubli,
Karnataka state, South India.
Pin code – 580 022. Phone No: 0836- 2370057
Extn. 284 Fax: 0836- 2278097.
Telegram: KIMS, Hubli. Cell: 09886591161.
Title: Impact of Fluconazole Prophylaxis on Oral Mucositis and Nutrition Status of Head and Neck Cancer Patients Receiving Radiotherapy
Authors: Manal Hamed El-Hamamsy, Elbassiouny M, Azza El Sayed Mansy, Marwa Helmy Abd El-Aziz
Background:Oral mucositis is one of the most significant toxicities associated with head and neck radiotherapy. Radiation related mucosal barrier injury allows for microbial colonization and infection, leading, in turn, to amplification of tissue injury.
Aim of work: Toevaluate the effect of fluconazole antifungal prophylaxis on the incidence and severity of oral mucositis induced by radiation therapy in patients with head and neck cancer and to determine the impact of this prophylaxis on their nutritional status.
Patients and methods: Eighty patients with head and neck cancer, eligible to receive radiotherapy were categorized into two groups each of 40 patient. Study groupreceived oral fluconazole 100mg/day starting from the sixth irradiation session throughout treatment course as compared to control groupwith similar radiotherapy characteristics who didn’t receive antifungal prophylaxis. Incidence and severity of oral mucositis and impact of oral mucositis on nutritional status (using malnutrition score) of this patient population were evaluated.
Results: Incidence of clinical oral mucositis wasnon-significantly lower in patients who received fluconazole antifungal prophylaxis at the end of radiation therapy (90% vs 100%). However fluconazole prophylaxis showed a very high significant reduction of the severity of mucositis (P=0.00).High incidence of oral mucositis in both groups negatively affected patient’s nutritional status, however less significantly in patients who received fluconazole prophylaxis.
Conclusions: Although fluconazole prophylaxis showed no significant effect on the prevention of oral mucositis, it significantly reduced its severity and showed significant improvement in patients’ nutritional status.
Keywords: Antifungal prophylaxis; oral/oropharyngeal candidiasis; oral mucositis, radiotherapy; head and neck cancer, malnutrition
Title: Effect of Adding Dexmedetomidine to Ropivacaine for Transversus Abdominis Plane Block: A Prospective Randomised Controlled Trial
Authors: Dr Rati Prabha, Dr Rajesh Raman, Dr Manoj Kumar, Dr Dheer Singh
We conducted this trial to study the effects of adding dexmedetomidine to ropivacaine for transversus abdominis plane (TAP) block. Sixty patients scheduled to undergo elective hernia repair with spinal anaesthesia as primary anaesthetic technique were divided into 2 groups. Group R (n=30) received 20 ml of 0.5% ropivacaine and 2 ml normal saline while Group RD (n=30) received additional 0.5µg/kg dexmedetomidine. Group RD had significantly less postoperative visual analogue score, longer duration of analgesia and needed less analgesics. We conclude that adding dexmedetomidine to ropivacaine for TAP block improves the duration of postoperative analgesia and reduces the postoperative pain and analgesic requirements when compared to ropivacaine alone. However, more studies are needed to study the side effects of dexmedetomidine when used as an adjuvant drug in TAP block.
Keywords- TAP block, Transversus abdominis plane block, Dexmedetomidine, Ropivacaine, Hernia repair, Ultrasound
Title: Acute inversion of Uterus: Our Experience
Authors: Dr. K.S.Raja Kumari, Dr. Nandini
Background: Acute inversion of the uterus means a rapid turning of the uterus inside out per via naturals. This serious complication usually occurs during the third stage, the prognosis is always very grave, the mortality varying between 23 and 80% in different series. If left alone, sloughing and/or sepsis may occur. Treatment is to replace inverted uterus as soon as possible.
Aim: To reinforce that in case of acute inversion of uterus, number of steps be taken instantaneously, and simultaneously, i.e. to call for assistance, to arrange blood, to summon anesthesiologist etc. To show any delay in treatment increases the mortality rate appreciably.
Material and methods: Total ten cases of inversion were recorded. Out of ten cases of inversion recorded, one was excluded from study as it was a chronic inversion in postmenopausal woman with fundal fibroid. Total deliveries from 2007 to 2014 were 23,927, making the incidence of puerperal inversion as1 in 2658. Out of 9 cases 3 were referred from outside and 6 were from the institute.
Results: Cases were divided into two groups. Those following vaginal delivery, and those occurred at the time of caesarean section. All 6 cases from institute were recovered without significant morbidity, and no mortality.
Keywords: acute inversion of uterus, puerperium, post partum hemorrhage, obstetrical emergency.
Title: Fungal Infection in Paediatric Cancer Patients of a Tertiary Care Hospital in North India
Authors: Anju Dinkar, Gopa Banerjee, Archana Kumar, Prashant Gupta, Mastan Singh, Jitendra Singh
Introduction-Paediatric cancer patients undergoing chemotherapy are at high risk of developing fungal infection which remains a major cause of morbidity and mortality. But the burden of fungal infection in most of our population is still not well known. Our study was aimed to estimate burden and outcome of fungal infection in paediatric cancer patients.
Objectives -To identify different fungal isolates and their antifungal susceptibility pattern in these patients.
Methodology- This study was a hospital based observational study conducted in Department of Microbiology and Paediatric cancer unit, King George’s Medical University, Lucknow, UP for a period of one year. In this study we analysed 209 symptomatic paediatric cancer patients.
Result- Out of 209 patients 78 fungal isolates were isolated from different clinical samples. Candida species were the leading pathogen (62/78) followed by Aspergillus species (16/78). A total of 19 patients of invasive fungal infection were diagnosed from positive blood culture. Only one patient was having both candidemia and candiduria from enrolled patients.
Conclusion- Though incidence of fungal infection is lower than bacterial infection but mortality rate remains high due to fungal infection. So it is necessary to introduce efficient methods of prevention, diagnosis and treatment of fungal infections in paediatric cancer patients.
Title: Dyslipidemia in Patients of Psoriasis
Authors: B.K.Agrawal, Payasvi Baweja, Shreyansh Tiwari
Background: Psoriasis is a common and recurrent proliferative inflammatory skin disease that has been associated with abnormal plasma lipid metabolism. The high prevalence of atherosclerosis has been reported in psoriatic patients. The aim of our work was to evaluate the development of dyslipidemia in psoriasis and to look for a correlation between their levels and worsening of disease.
Methods:We evaluated the fasting lipid profile in 300 clinically diagnosed psoriasis patients (Group II) which were further grouped as 200 plain psoriasis (Group IIA) and 100 psoriasis with mixed complications (Group IIB) and 200 age and gender matched healthy subjects as the controls(Group I).
Result: Patient presented risk changes in lipid profile, serum total cholesterol and LDL- cholesterol were found to be significantly increased(P<0.01) while there is no significant difference in triglyceride, VLDL- cholesterol, HDL-cholesterol levels in Group IIB psoriasis patients with mixed complications than in Group IIA plain psoriasis patients.
Conclusion:Our data suggests that high serum lipid profile level especially. Total cholesterol and LDL-cholesterol is significantly more common in psoriasis and must be considered as a group at high risk for cardiovascular accidents(CVA). It may be useful to do early screening and treatment of hyperlipidemia in psoriasis to prevent the atherosclerosis and its complications.
Keywords- Psoriasis, serum lipids, cardiovascular accident, dyslipidemia, hyperlipidemia.
Title: A Correlation between Glycosylated Haemoglobin & Lipid Profile in Type 2 Diabetes Mellitus with & Without Complications
Authors: Dr. Prabhakar Singh Bais, Dr. Prabha Verma, Dr. Priyanka Chauhan
Objective: To determine whether the prevalence of dyslipidaemia & associated complications are associated with hyperglycaemia or poor glycaemic control.
Methods: This was a prospective and analytical study. Type 2 diabetes mellitus patients who were attending the out patients clinic. 50 patients and 50 healthy subjects were included in the study. 50 clinically and biochemically confirmed cases of type 2 diabetes mellitus with and without complications of long duration, of both sexes and aged 35 to 75 years were selected.
Results: The mean age of cases was 51.46±12.71 and 52.48±12.76 in controls. The FBS level was significantly (p=0.0001) higher among cases (122.26±68.39) compared with controls (79.28±11.84). The PPBS was also higher (p=0.0001) among cases (188.20±87.27) than controls (124.12±10.96). The level of HbA1C was higher among cases (7.47±1.90) compared with controls (5.48±0.41). The increased level of TC, TG, LDL and VLDL was observed among cases than controls (p<0.01). However, decreased level of HDL was found among cases compared with controls (p>0.05). Overall, 40% of the cases had any one of the complications.
Conclusion: The rate of complications are higher in case of poor glycaemic control as compared to good glycaemic control in type 2 diabetes mellitus patients, thus, HbA1c can be used as a predictor of dyslipidemia in patients with type II diabetes in addition to its importance as glycemic control parameter.
Keywords: Dyslipidaemia, Hyperglycaemia, Diabetes
Title: Posterior Interosseous Nerve Syndrome Due to Parosteal Lipoma of Proximal Radius-A Rare Case Report
Author: Dr Sanjai Kumar Singh
47 years right handed female c/c difficulty in extending the fingers of right hand for the last 9 month.
The JMSCR is accepting manuscripts for its coming issues to be Publish January 2018 the JMSCR invites authors to submit manuscripts Reporting original medical research, original article, research article, case report, systematic reviews, or educational Innovations for publication for the coming issues that will be released in January 2018. Types of manuscripts suitable for JMSCR include: Medical research, Clinical research Educational Innovation, Brief Report, Reviews on Teaching In keeping with high quality scholarship, Read More.....