Abstract

Introduction:Type 2 diabetes mellitus is generally associated with vascular complication like nephropathy, retinopathy, neuropathy, coronary artery disease and peripheral vascular disease. Microalbuminuria has a strong correlation with microvascular as well as macrovascular complications of type 2 diabetes mellitus. Establishment of peripheral vascular complications leads to early diagnosis, prevention, and treatment of renal and cardiovascular complications. This study investigated the value of ankle-brachial index (ABI) for prediction of microalbuminuria in type 2 diabetic patients.

Materials and Methods:Measurement of ABI with colour Doppler ultrasonography was carried out for 100 patients with type 2 diabetes mellitus. An ABI Index less than 0.9 were defined as a predictive marker for atherosclerosis. Microalbuminuria and risk factors of atherosclerosis were compared between the patients categorized based on the ABI values.

Results:The mean ABI was 1.1 ± 0.2 (range 0.52 to 1.6) and 20 (20%) had an abnormal ABI (< 0.9). The correlations were significant between abnormal ABI and duration of disease (p<0.001), cardiovascular event and cardiac care unit admission (p<0.001), hypertension (p<0.01), and dyslipidemia (p<0.001). There was a significant correlation between ABI and microalbuminuria (odds ratio 0.05; 95% confidence interval, 0.038 to 0.630; P <0.01).

Conclusions:The ABI is a noninvasive and reliable assay for detection of peripheral and cardiovascular complications, and also early stage of nephropathy in diabetic patients. In patients with an abnormal ABI, long-term follow-up for earlier detection and prevention of complications is helpful.

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Singh A.K

Department of Surgery

IGIMS, Patna

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Abstract

Aim: To study the assosciation  of  Diabetic retinopathy with serum lipids level in Type 2 diabetic subjects.

Settings and Design: The Cross sectional nonrandomized study.

Materials and Methods: A total 150 patients with  Type 2 diabetes mellitus were assessed for presence and severity of retinopathy and they were correlated with age, sex, duration of  Diabetic mellitus and serum lipids level. Diabetic Retinopathy was diagnosed by fundus examination using indirect ophthalmoscope  with 20D lens and slit lamp biomicroscopy with 78D lens and classified according to the Early Treatment Diabetic Retinopathy Study (ETDRS) grading system.

Results: A total 150 patients were evaluated out of which 108(72%) had diabetic retinopathy & 42(28%) were not having any Diabetic retinopathy. When Diabetic Retinopathy subjects were compared with those without Diabetic Retinopathy ,the mean serum cholesterol, serum triglycerides  and non-high density lipoprotein (HDL)-cholesterol (all having P <0.05) concentrations were higher in Diabetic Retinopathy subjects. Triglycerides & HDL were more deranged in Diabetic Retinopathy, while Triglycerides & LDL were more deranged in CSME patients.

Keywords: ETDRS,LDL,HDL,CSME, and Triglycerides.

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Corresponding Author

Dr. Divya Patel

House Number 50, Saptshrungi Nagar,

Near Silicon City, Ab Road,

Rau, Indore- 452012 (India)

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Abstract

175 eyes with Pseudo-exfoliation syndrome (PXF) undergoing cataract surgery by phacoemulsification were studied at this prospective non comparative study conducted at Mahatme Eye Bank Eye Hospital, Nagpur, India. The study aimed at finding out association if any between preoperative Axial Length, Pupillary diameter, Lens thickness and intraoperative complications during phacoemulsification.  It was found that association of axial length and lens thickness with intraoperative complications was not significant (P value = 0.58 and 0.54 respectively).The mean pupillary diameter in eyes with complications was less (4.60 ±0.98) mm as compared to 5.61 ±1.60 mm in eyes without complications. The relation between these groups was statistically significant. (P value=0.018).

Key Words: Pseudo-exfoliation syndrome (PXF), Phacoemulsification, cataract surgery, Axial Length, Pupillary diameter, Lens thickness,   intraoperative complications of cataract surgery, PCR (Posterior Capsular Rupture), zonulodialysis, iridodialysis

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Corresponding Author

Dr. Nikhilesh Wairagde

Senior Consultant

Mahatme Eye Bank Eye Hospital, Nagpur India

Abstract

Objective: To evaluate the performance of  Dimon-Hughston osteotomy using a dynamic hip screw  fixation implant in unstable trochanteric fractures of hip among geriatric patients.

Materials and Methods: This study focused on 25  patients who presented to the Department of Orthopaedics ,Government  General Hospital, Kurnool Medical College,Kurool. .Type AO 2.2 and Type AO 2.3 fractures were selected based on the  AO classification. These fractures were managed by Dimon-Hughston osteotomy with a 140s° dynamic hip screw.

Results: All 25 patients (mean age 71.2years) were able to perform full weight-bearing walking after the operation.

The mean time needed to achieve union was 16 weeks .One patient experienced hip screw cut-out and 1 patient developed superficial wound infection. All the patients came to follow up every 3 weeks  after the operation.

Conclusion: For the geriatric patients in this study, Dimon-Hughston osteotomy for unstable pertrochanteric fractures provided immediate stability for early weight-bearing.

Key Words: osteotomy, geriatric, dynamic, unstable, trochanter.

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Corresponding Author

Dr. K.Venkateswarlu

M.S (Ortho)

Associate Professor, Orthopaedics, Kurnool Medical College, Kurnool, A.P. INDIA

H.no.50/760A,127,23-24. Gayatri estates. Kurnool. AP, INDIA

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Abstract

Herpes zoster is a viral infection caused by the reactivation of the varicella zoster virus, an infection most commonly affecting the thoracolumbar trunk. Herpes Zoster Infection (HZI) may affect the cranial nerves, most frequently the trigeminal. HZI of the trigeminal nerve distribution network manifests as multiple, painful vesicular eruptions of the skin and mucosa which are innervated by the infected nerves , usually associated with severe pain. Oral manifestations of HZ appear when the mandibular or maxillary  divisions of the trigeminal nerve are affected.Reports of osteonecrosis and spontaneous tooth loss following herpes zoster infection of the fifth cranial are extremely rare. We are reporting a case of Herpes zoster involving the  left side maxillary nerve with osteonecrosis of the maxilla .

Keywords: Maxilla, Osteonecrosis, Tooth exfoliation, Varicella zoster

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Dr. Shahid Hassan

Department of Oral and Maxillofacial Surgery

Govt. Dental College & Hospital, Srinagar

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Abstract

This prospective comparative study included 300 matched patients of different grades of senile cataract. All of them willfully underwent phacoemulsification at the hands of a single experienced surgeon, performing with a single and individual technique {Woodcutter’s technique1}; half of them were implanted with a foldable intraocular lens and the other half with a non-foldable PMMA intraocular lens. All the patients undergoing phacoemulsification had an improvement in vision. There was no statistically significant difference in the surgically induced astigmatism after implanting foldable or non-foldable IOL. There was a higher rate of posterior capsule opacification following the implantation of rigid PMMA intraocular lens which was statistically significant (p=0.0113) as compared to the foldable poly HEMA lenses. However none of these required any active intervention.

Key Words: Phacoemulsification,  Cataract surgery, Foldable IOL,  Non foldable phaco IOL,  BCVA (Best corrected visual acuity), surgically induced astigmatism, PCO (posterior capsular opacification), PCR (posterior capsular rent)

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Dr. Chitra Pande

Senior Consultant

Mahatme Eye Bank Eye Hospital, Nagpur India

Abstract

Background:The increasing number of latent and manifest hyperuricemia is important concerning differential diagnosis in neurological and psychiatric diseases. The pathological importance of hyperuricemia in these diseases is particularly unknown. Previous studies have shown that uric acid estimation in cerebrospinal fluid was made with neurological and psychiatric diseases. Monitoring serum uric acid levels, a relatively inexpensive and easily available test, may prove to be a useful adjunct in the

assessment of certain indices of certain psychiatric illness. Tranquilizers like 1,4 - benzodiazepine (purinergic) are shown to decrease xanthine oxidase activity initially and may cause fluctuations in serum uric acid levels.

Objective: In the present study an attempt was made to understand the effect of tranquilizers on serum uric acid levels in different psychiatric conditions.

Methods:40 cases (22 males and 18 females) of MDP (Maniac depressive psychosis) and Schizophrenia who were undergoing treatment with different tranquilizers from the psychiatric hospital, Patna, India and 20 healthy controls (12 males and 8 females) not using any tranquilizers were included in the study.

Results:The serum uric acid levels were significantly elevated (p < 0.05) in these

patients receiving treatment with tranquilizers. The levels of uric acid in male patients were significantly higher when compared with females and also over male controls (p < 0.01).In female patients uric acids levels are raised but not significant (p > 0.05) over control females.

Conclusion:This preliminary study does indicate that serum uric acid levels do change with the administration of these drugs. The nature, gender, duration and the type of drugs used and their individual effects on different psychiatric disorders will be discussed.

Key Words: Acute psychosis, Affective disorders, Schizophrenia, Tranquilizers, Uric acid

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Corresponding Author

Dr. Syed Saif Subhani

Consultant Orthopaedic Surgeon, Juran Chapra Ortho Clinic, Muzaffarpur -842002, India

C/O Dr S M M Subhani, Zaki Hassan Campus, Deewan Road, Kalyani, Motijheel, Muzaffarpur-842002, India

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Abstract

We report a case of pancreatic tuberculosis. A 30 year  woman who presented with abdominal distention, low grade fever, night sweats  and anorexia for two month. She recovered with anti tubercular therapy. Pancreatic tuberculosis, in particular is extremely rare, and only a few cases have been reported. Diagnosis of pancreatic TB has always been a challenge, but radiological investigations and image guided intervention  helped in the diagnosis and prevention of unnecessary laparotomy.

Key words Pancreatic tuberculosis, Fine needle aspiration cytology, Polymerase chain reaction

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Dr.Vishal Dalvi

Chief  Resident

Department of Medicine, Mahatma Gandhi Mission’s Medical College and Hospital,

CIDCO, N-6,Aurangabad, Maharashtra, India – 431003.

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Abstract

Background: Dengue is the most rapidly spreading mosquito borne viral disease in the world. There is an increase in incidence of dengue in adult population in South Asian countries in recent years.

Objective: To study the pattern of dengue in pregnancy and the impact of dengue on the natural course of pregnancy.

Materials & Methods: All pregnant patients admitted with fever and features suggestive of dengue infection were included in the study. The demographic data, clinical features, hematological and biochemical parameters were collected. Serological testing for dengue virus specific antigen and antibody was done for the diagnosis of dengue fever. The World Health Organization classification and case definitions 2009 was used to categorize the dengue patients. The variable pattern of the disease and the effect of dengue infection on the natural course and outcome of pregnancy and labour was studied.    

Results: Of the 49 pregnant patients admitted with suspected dengue infection, 16   were diagnosed serologically with dengue. Of these 6 (37.59%) had primary dengue and 10 (62.5%) had secondary dengue infection. Eight patients were diagnosed with dengue in the second trimester. Number of patients who had dengue ± warning signs and severe dengue were 14 (87.5%) and 02 (12.5%) respectively. Skin rashes were seen in 09 (56.2%) patients, vomiting in 4 (25%) patients. Severe thrombocytopenia was seen in 2 (12.5%). Preterm labour was seen in 8 (50.0%) patients.

Conclusion: This study highlights the clinical pattern and the natural course of dengue in pregnancy. The clinical presentation of dengue in pregnancy is almost similar to dengue in non pregnant adults. There is increased association of dengue with preterm delivery and low birth weight. The treatment of dengue in pregnancy is mainly conservative as in non pregnant adults

Keywords: Dengue, pregnancy, thrombocytopenia, preterm labour

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Corresponding Author

Dr. Neelakandan Ramya

Associate Professor,

Department of General Medicine

Aarupadai Veedu Medical College& Hospital, Pondicherry, India

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Abstract

Introduction: Specular microscopy is used to view and record non-invasively the image of the corneal endothelial cell layer. Aim: study was undertaken to document the effect of cataract surgery on specular microscopic corneal status of patients in different age group.

Material and Methods: Four hundred fifty seven patients were included in this study, the patients Who underwent cataract surgery. The patients were examined before surgery & after 6 weeks of surgery on follow up visits. Corneal endothelial examination was done non-contact specular microscope (Topconsp-2000p) after detailed ocular examination.

Results: Cell loss after surgical trauma was seen in older age group (Table 11). Proportional hexagonality analysis showed that the age groups 71-80 and > 80 years had more proportional Hexagonality change (Table 14).Proportional change analysis of mean average cell size after cataract surgery in different age group reveled that ACS increased significantly more in the higher age groups as compared to young patients (p<0.05) (Table16).Postoperative CV increased across all age groups indicating polymegathisn.(Table 17). Pre and post CCT showed that older corneas had significantly more corneal swelling postoperatively.

Conclusion: To conclude in absence of significant corneal changes the visual recovery after cataract surgery was satisfactory.

Keywords: Specular microscopy, Corneal endothelium, Cataract surgery.

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Deepesh Kumar

Department of Microbiology

SMMH Medical College, Saharanpur U.P, India.

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Abstract

Health is a basic pre-condition for happiness and progress in life of an individual and quality health care is lifeline for the growth of any nation. The metabolic disorders we know today is increasing day by day due to modernization, change in life style, mental stress, improper eating habits, faster pace of life, loss of physical exercises etc thereby culminatively contributing to chronic disorders. Dietary management is the key to good health and vigour. Dietary management approaches followed by the subjects related to food habits, adaptation of alternative system (medication), changes in this life style, work pattern, change in approach, sleeping pattern, type of stress, exercise, diet and pranayama were collected through a well structured interview schedule. In dietary management practices of subject suffering from hypertensive disorders, the consumption of restricted foods was higher in group-I (Allopathy) compared to group-II (Ayurvedic) and group-III (Naturopathy). Non-consumption of restricted foods, fruits and vegetables was highest in group II compared to group I and group III. In case of subjects suffering from Diabetes mellitus consumption of restricted foods namely rice, fruits and vegetables was highest in group II compared to group I and group III. Under group I subjects suffereing from cardiac vascular disease consumed higher amount of fried foods and non-vegetarian foods compared to other groups.

Keywords: Dietary management, chronic disorder, diabetes mellitus, hypertension, cardiovascular disease.

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Shoba. S

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Abstract

Acute organophosphorus Compound poisoning (OPC) usually manifest in 3 different phases of toxic effects like, acute cholinergic crisis, intermediate syndrome (IMS), lastly delayed neuropathy. Poisoning other than by ingestion is rarely seen in clinical practice. Here we report a 22 year male who presented in altered sensorium and erythema with induration in left arm. Treatment was started with high clinical suspicion of OPC poisoning. History of injecting about 15ml of parathion into his left arm was revealed after the patient regained consciousness. He developed features of IMS with necrosis and infection at the site of injection. He required ventilator support. He recovered after prompt administration of Pralidoxime and Atropine along with broad spectrum antibiotics and wound debridement. Parenteral administration of organophosphorus poison can cause severe toxicity especially with delayed manifestations and early recognition and treatment is essential for recovery.

Keywords: Intermediate syndrome, Organophosphorus Poisoning Parenteral

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Dr. K. Vengadakrishnan

Sri Ramachandra Medical College, Porur, Chennai

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Abstract

Impaction of permanent teeth is a relatively common occurrence and can involve any tooth in the dental arch. Impacted mandibular second molars are less frequently encountered, but when they occur they may present a challenging treatment procedure for the orthodontist and oral surgeon, they may require auxiliary appliances. Generally the definitive treatment of these Impactions is carried out at the age of 11-to 14- years old range. These impaction ma by associated with a third molar impaction.

The possibilities of second molar impaction treatments is surgical removal of second molar and allowing third molar to erupt, transplantation of third molar to the second molar space, surgical repositioning of second molar with or without third molar extraction. The most promising results was seen in cases of repositioned second molar. The timing of treatment and the biomechanics involved determine the success

Purpose of this article to describe the surgical repositioning of second molar with third molar extraction

Key words:impaction, second molar, surgical uprighting, surgical exposure 

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Dr. Benjamin Shlomi

The Sourskz Medical Center, University of Tel- Aviv

Tel Aviv, Israel

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Abstract

Key Words: Recurrent, dislocation, alignment, dysplastic

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Corresponding Author

Kurukunda Venkateswarlu

Kurnnol Medical College, Kurnool, A.P. INDIA.  Pin-518002

H.No.:50/760A,127,23-24.Gayatri Estates, Kurnool A.P. INDIA

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Abstract

Background: Childhood obesity and hypertension are major problems worldwide. Obesity is the leading cause of hypertension and hence preventing obesity has a good impact on controlling hypertension. Thus it is important to find any association between obesity and blood pressure in adolescent children which in turn can help in the identification of those at risk.

Objective: To study the association of Body Mass Index (BMI) and Waist-Hip Ratio (WHR), with Blood Pressure of children.

Methodology: The study covered 187 school children of 13-15 years age from a rural area. Height, weight, waist circumference, hip circumference and two recordings of systolic and diastolic blood pressure of each child were recorded. Body mass index, waist-hip ratio and mean blood pressure were calculated. The data were collated and analyzed using chi-square test.

Results: The study population of 187 had a higher proportion of boys (60.4%). 36.4% of children with a higher BMI were found to be hypertensive as compared to 19.4% and 23.6% children with low and normal BMI respectively. Hypertension was found in 27.8% of those children with a waist-hip ratio on the obese side.

Conclusion: The study revealed a positive association between obesity and blood pressure in adolescent children. Overweight children, according to both body mass index and waist-hip ratio were found to have a higher blood pressure than the other children.

Keywords: Childhood obesity, overweight, hypertension, body mass index, waist hip ratio.

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Corresponding Author

Rhea Anna Kurian

3^rd year MBBS Student

MOSC Medical College,

Kolenchery, Ernakulam, Kerala

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Abstract

Development of a pseudocyst of the pancreas after an attack of acute pancreatitis is a known phenomenon. The natural history of the pseudocyst is extremely variable ranging from complete resolution to the development of chronicity. Understanding the natural history of pseudo cysts is therefore pivotal in determining the best therapeutic option at each stage of the disease along the natural course of the disease. The paper outlines the various options at each successive stage of the disease process.

Key words: Pancreas, pseudo cysts, management

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Corresponding Author

Dr Ketan Vagholkar

MS, DNB, MRCS, FACS.

Professor

Department of Surgery, D.Y.Patil University School of Medicine

Navi Mumbai 400706, MS. India

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

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Abstract

Introduction: Hepatitis B and HIV infections are serious global public health problems. Many of the countries with high HIV burden are also affected by high prevalence of hepatitis B infection, leading to frequent HIV/HBV coinfection.

Objectives: To determine the prevalence of HBV among HIV infected individuals in comparison with blood donors.

Methods: All patients attending ICTC centre were screened for HIV and HBsAg. During the same period blood donors were screened for HBsAg and HIV. HIV-HBV coinfection   in blood donors were noted during the study period. 

Results: A total of 2804 HIV seropositive cases were studied. 53 (1.89%) were positive for HBsAg. Among 21,779 blood donors, 206(0.94%) individuals were positive for HBsAg, 31(0.14%)  for HIV and 3(0.013 %) had HIV - HBV coinfection.

Conclusion: HBV prevalence among HIV infected individuals is more, compared to blood donors.  Screening of HIV patients for HBsAg is off importance. All high risk groups should be compulsory vaccinated, blood samples should be effectively screened before transfusion. 16

Keywords: Blood Donors,Coinfection, HBV, HIV, Seroprevalence

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Dr. Vedavati B I

Mysore Medical College and Research Institute, Mysore

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Abstract

Background: the reactive oxygen species (ROS) are involved in multiple reproductive processes – maturation of oocyte, fertilization, development of embryo, pregnancy and parturition. However, the optimal levels and interplay of oxidants and antioxidants is crucial for a positive pregnancy outcome. Pregnancy induced hypertension (PIH) is shown to have defective trophoblast invasion leading to high pressures in utero-placental circulation; thus this stress imposed on placenta may disturb the oxidant-antioxidant balance.

Aim: the purpose of this study was to assess the oxidative stress during uncomplicated pregnancy and pregnancy associated with hypertension in primi-gravida women.

Materials and methods: a total of 90 women were enrolled and divided into 3 groups. Group 1: Healthy non-pregnant women (n=30), Group 2: Normotensive primi-gravida women (n=30) and Group 3: Pre-eclamptic primi-gravida women (n=30). Blood samples were analyzed for levels of malondialdehyde (MDA), superoxide dismutase (SOD), total anti-oxidant capacity (TAC) and uric acid using appropriate biochemical methods. ANOVA was used for assessing the difference between the groups and statistical significance was fixed at p<0.05.

Results: in the present study, levels of MDA, SOD and uric acid were significantly increased in pregnant compared to non-pregnant women and to a greater extent in pre-eclampsia women compared to normal pregnant women.TAC levels were significantly decreased in pregnant when compared to non-pregnant and much more decreased in pre-eclampsia women compared to normal pregnant women.

Conclusion: high pressures in feto-placental circulation can lead to increased elaboration of oxidative radicals which may cause oxidative damage to placenta and other organs.

Keywords: oxidative stress, pregnancy, pre-eclampsia

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Corresponding Author

Dr. Usha Rani .Damerla

Assistant Professor,

Department of Physiology,

Apollo institute of medical sciences& Research

Jubileehills, Hyderabad-500033,

Andhra Pradesh, India.

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Abstract

Universal Immunization Programme aims at completing primary immunization for all infants before they complete one year of age. Preventable infections are major cause of childhood mortality and morbidity in South Asia. 

Research question: To assess and compare the awareness about immunization among Hindu and muslim mothers in a rural area.

Setting: Rural health training centres attached to Department of Community Medicine, Bankura Sammilani Medical college and Hospital, Bankura 

Study design: Cross-sectional 

Participants: Mothers of children aged between 12 and 23 months attending rural training centres. 
Methods: Data was collected for period of six months by administering structured and pre tested questionnaire to eligible mothers registered at rural health training centres. 

Statistical analysis used: Descriptive statistics using IBM SPSS 20.0

Results: Awareness regarding DPT, HBV, Meseals and additional vaccines, were significantly higher [p<0.001] in Hindu mothers. Awareness regarding the schedule for administering BCG and OPV was highest and HBV lowest among all mothers in both groups. Hindu mothers were more aware in terms day of immunization, next visit and recommending immunization. Anganwadi workers were the main source of information regarding immunization. Higher educational status played significant role in awareness about day of immunization in both areas

Key words: Immunization, Awareness, Hindu and Muslim Mother, HBV, Measles

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Corresponding Author

Dr. Samir Kumar Roy

R.M.O. cum Clinical Tutor, Department of Pediatrics, Bankura Sammilani Medical College,

Gobindanagar, Bankura.PIN -722102

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Abstract

Background: Onychomycoses denotes infection of the nail caused by dermatophyte fungi, Non Dermatophytic moulds or yeast. Onychomycoses affects approximately 5% of population worldwide.

Objective: This study was done to know the etiological agent of onychomycoses.

Materials and Methods: A total of 60 patients with clinically suspected onychomycoses considered for treatment were included in the study. Nail scrapings and nail clippings were collected after cleaning with 70% alcohol to remove contaminants. Samples were subjected to KOH for direct microscopic examination and culture was done using Sabouraud’s Dextrose Agar with and without antibiotics.

Results: Direct microscopy with KOH, 28(47%) were positive and by culture 25 (42%) were positive. Most common Dermatophyte was Trichopytonrubrum (24%) and among Non Dermatophyte moulds Aspergillus was the most common agent. E. Floccosum was not isolated.

Conclusion: Non Dermatophyte Moulds was most common etiological agent causing onychomycoses. KOH mount was found to be more sensitive than culture and helps in instituting early treatment. 

Keywords: Onychomycoses, Dermatophytes, Non Dermatophytic Moulds.

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Corresponding Author

Dr.Tejashree A

Department of Microbiology

JSSMC, S.S Nagar, Bannimantap, Mysore 570015

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Abstract

Research Question: What is the maternal mortality rate in  Faridkot District and what are the determinants of maternal mortality?

Aims & Objectives:

Ø  To study the incidence of maternal mortality inDistt. Faridkot.

Ø  To find out the determinants of Maternal mortality.

Ø  To plan  strategies to reduce the number of maternal deaths.

Methods: The present study is a retrospective analysis of the maternal Death Review of district Health Office to find out the MMR & its determinants. This study was carried out in GGS Medical College & Hospital Faridkot . The data was collected from District Health Authorities from a time period of March 2010 to May 2013.

Results: There were total thirty eight maternal deaths which were reported in Maternal Audit in District Hospital during this period. Mean age of Patients was 24.5yrs. Two patients were of teenage pregnancy. There were six deaths (15.8 %) in antenatal period.  Out of 38 maternal deaths, Twelve  mothers  (31.57 %) were from urban area & twenty six  women  (68.4 %) were from rural background .Seventeen  patients (44.74 %) died within 6 hours of delivery in post partum period . 63 % deaths were  because of obstetric Causes &  36.5 % were from indirect causes . Indirect Causes were medical Conditions like Lung infection, Cardiac disorders, Deep vein Thrombosis, Blood Dyscrasias& Epilepsy. In eighteen out of Thirtyeight deaths (47.37%) the mothers were anaemic. Haemmorhage and Toxemia of Pregnancy were the main  Causes  of  maternal mortality .

Recommendations:  The network system at root level should be strengthened. The medical Causes should be picked up early and treated in time. Institutional   deliveries should be encouraged. The ambulance 108 has improved the early transport but still a lot is required to improve the system especially in rural areas to reduce the incidence of maternal mortality.

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Dr. Nishi Garg

MD. MICOG. FICMCH, Assistant Professor

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Abstract

To elaborate on the uses of chitosan in various field of dentistry. Along with its properties and mechanism of action.Chitosan is a linear polysaccharide composed of randomly distributed β-(1-4)-linked D-glucosamine (deacetylated unit) and N-acetyl-D-glucasamine. Chitosan is a sugar that is obtained from the hard outer skeleton of shellfish, including crab, lobster, and shrimps. It has a number of commercial and possible biomedical uses (1). In medicine, it may be useful in bandages to reduce bleeding and as an antibacterial agent; it can also be used to help deliver drugs through the skin, hemodialysis, cholesterol control, calcium absorption, bilirubin absorption, and hypertension control(2).

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Corresponding Author

Mr Kentrick Roymond Ang

120 Boys Hostel,Saveetha Dental College,

Poonamallee High Road, Saveetha Dental College, Chennai,

Tamilnadu 600077 India

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Abstract

Aim: To study the risk factors and  clinical features of  rhegmatogenous retinal detachment

Material & Methods: An observational study was conducted among 50 patients who were diagnosed with rhegmatogenous retinal detachment attending the retina OPD. Evaluation of patients consisted of detailed history pertaining to the risk factors for retinal detachment and  ophthalmic examination.

Observation & Results: The most important risk factor for rhegmatogenous retinal detachment was blunt trauma-28% followed by lattice degeneration-18%, myopia and cataract surgery-16%. 88% of cases had retinal detachment with macula off. The break was mostly single-46% and horse shoe in type-34%

Conclusion: The results of the study highlighted that blunt ocular trauma is the most important risk factor for development of rhegmatogenous retinal detachment. Majority of patients showed retinal detachment with macula off. The macula off patients was higher in our study than in studies conducted in developed countries, which could be due to delayed presentation.

Key words: rhegmatogenous retinal detachment, risk factors, clinical features,b lunt trauma, macula off, horse shoe tear

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Corresponding Author

Dr Sridevi Prakash T

Dr. B.R. Ambedkar Medical College, Bengaluru,-560045, Karnataka,India

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Abstract

A prospective and descriptive study on ocular manifestations of leprosy and its management was conducted at Department of ophthalmology, Narayana Medical College & Hospital, Nellore, Andhra Pradesh. This study was conducted with 46 leprosy patients with ocular manifestations were analyzed. The ocular manifestations were predominantly (91.66%) seen after treatment. Ocular involvement is bilateral in greater number (79.16%) of cases except in some cases (lagophthalmos, scleritis, episcleritis), where unilateral involvement is more common. Madrosis is the most common adnexal manifestation observed. Lagophthalmos is most common sight threatening adnexal condition. Decreased corneal sensations are observed in (45.83%) nearly half of cases. Exposure keratitis is most common (20.83%) corneal condition. Acute and chronic anterior uveitis are seen equally, which are granulomatous uveitis in all cases. Corneal involvement is seen in 29.16% of patients. Uveal involvement is seen in 20.83% of patients. Majority of the patients had normal fundus. At the time first presentation, most of the cases (62.50%) are having normal vision according to WHO gradings. 70% of various ocular inflammations are responded well to medical treatment.  33.33% of cases came for no follow up .45.83% of cases came for 1 -2 follow ups. Only 20.83% of cases came for 3 -5 follow ups. Treatment response was considered in patients who came for at least 3 follow ups.

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Corresponding Author

Dr. R. Sudha

Asst. Professor, Dept of Ophthalmology,

Narayana Medical College & Hospitals, Nellore

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Abstract

We present a rare case of pleomorphic lipoma, a bilateral sub conjunctival mass. In 62 years male, clinical futures  and biopsy consists with Pleomorphic lipoma. The lesions were excised for symptoms and cosmetic reasons. Histopathology raveled pleomorphic & Floret pattern scattered multinucleated cells which confirmed the diagnosis of Pleomorphic lipoma. We described the surgical   technique. Followed the case upto one year, there is no recurrence of the mass.

Keywords: Acquired, palpabral, lipoma

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Dr Veera Venkata Satyanarayana Kunche

C-208 Jeevan Visakha Apartments

MMTC Colony, Visakhapatnam, Andhra Pradesh 530 022 India

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Abstract

Patients with head and neck Squamous cell carcinoma are at increased risk for the development of a second primary malignancy (SPM), defined as a second malignancy that presents either simultaneously or after the diagnosis of an index tumor. Here, we report a case of a rare synchronous presentation of follicular variant of Papillary carcinoma (FVPC) of thyroid and Squamous cell carcinoma (SCC) of cricopharynx.  A 35 year old female presented with swelling in front of neck since 8 months. Ultrasonography revealed hypoehoic lesion in both lobes of thyroid and lymph node enlargement.  Patient underwent thyroidectomy and modified neck dissection. A diagnosis of follicular variant of papillary carcinoma thyroid was made with metastasis from thyroid in two out of five (2/5) lymph nodes and one  lymph node showed Squamous cell carcinoma deposits.SCC was found to be from cricopharynx by endoscopy and postop­erative histopathological examination of cricopharynx.

Keywords:synchronous, follicular variant of papillary thyroid carcinoma, cricopharynx, squamous cell carcinoma.

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Dr. Rajani.V

Assistant Professor

Department of Pathology

Rangaraya Medical College, Kakinada

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Abstract

We reported a case of 24 yrs old male clerk referred to our medicine department with complaint of high grade fever for 10 days associated with episodic red urine of 4 days. On the basis of clinical examination and laboratory parameters he was finally diagnosed a case of enteric fever and improved on antibiotic therapy. The cause of episodic red urine was consumption of much beet roots as advised by local practitioner. Patient was counselled for red urine due to beet consumption and not due to disease. He was explained nutrient value of beet root so he can take it without worry. He was discharged on 10th day of admission.

Keywords; Abnormal Urine, Colour, Odor, Turbidity, Specific Gravity

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Anju Dinkar

Senior Resident

Department of Microbiology

Sanjay Gandhi Postgraduate Institute of Medical Science, Lucknow, UP, India

Abstract

GTD is still an important reproductive health problem worldwide. The problem is that much information of GTD has come from less developed countries, where proper diagnostic tools and up to date treatment cannot be employed. Maternal age, previous hydatiform mole, race and geographical region have been identified as clear risk factors for GTD. Etiological factors of GTD have long been studied but no definite causes have yet been found. 

As per latest ESMO guidelines post molar GTN needs different investigation profile compared with non-molar GTN. There is no consensus on the best chemotherapy regimen for initial management of low-risk gestational trophoblastic neoplasia (GTN), and first-line regimens vary by geography and institutional preference. Most regimens have not been compared head-to-head, and the level of evidence for efficacy is often limited. Even if there are differences in initial remission rate among the regimens, salvage with alternate regimens is very effective.

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Dr Ansar Hussain

MD, DM Scholar, Dept of Medical Oncology SKIMS Srinagar

Nawabagh, Baghwanpora, Lal Bazar, Srinagar, Kashmir, India, 190023

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Abstract

Background: Synovial inflammatory conditions of knee joint is one of the most common non traumatic disorders of knee joint. Diagnosis of synovial inflammatory conditions by advance methods like Arthroscopic guided selective biopsy and histopathological examination of synovial tissue provides accurate diagnosis without any complications.

Methods: A prospective study was performed on 40 patients at Government General Hospital, Kurnool Medical College , Kurnool for 2 years from 2011 to 2013. The age of the patients ranged from 20 to 50 years.We have used standard Arthroscopic equipment with all the necessary accessory instruments.

Results: Among 40 cases ,25 cases were diagnosed chronic non-specific synovitis,6 cases as Tuberculosis,5 cases of Rheumatoid synovitis,1 is Crystal synovitis, 1 is Pigmented villonodular synovitis,1 is Synovial chondromatosis,1 is Synovial sarcoma. Among 6 cases of TB synovitis 4 cases are associated with arthritis,2 cases with Medial menisceal tear.

Conclusion: Arthroscopic operation is a qualified method of treatment with low morbidity. The rate of intra and postoperative complications are less.Post-operative pain is very less, functional restoration of knee joint movement is quick. However execution of arthroscopic procedure is technically demanding, it requires comprehensive knowledge and vast experience in the field of arthroscopy.

Keywords: Synovitis,arthroscopy,biopsy,villonodular              

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Dr. K.Venkateswarlu

M.S (Ortho)

Associate Professor

Orthopaedics Kurnool Medical College, Kurnool

H.No:50/760A,127,23-24. Gayatri Estates.Kurnool

A.P..INDIA

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Abstract

Objectives: H. pylori is detectable in nearly 100% of adult patients with duodenal ulcer and about 80% of patients with gastric ulcer. An association between H. pylori and gastric cancer is confirmed. In developing countries, where most children become infected by the age of 10, gastric cancer rates are very high. Diagnosis of Helicobacter pylori is achieved by invasive or non-invasive methods such as upper endoscopy, antral biopsies, H. pylori PCR of antral biopsies, H. pylori ELISA and H.  pylori  antigen  detection  in  stool  through  ELISA technique. The  aim of  the current  study is  to  compare  the  diagnostic  performance  of  invasive  and  non- invasive diagnostic methods in the Kingdom of Saudi Arabia.

Design & Methods: Patients between with dyspeptic symptoms were enrolled from the  Salman Bin Abdel Aziz University Hospital, Al Kharj, Saudi Arabia between Oct/2 0 13 and Sept/2014. Patients responded to a questionnaire to investigate possible dyspeptic symptoms and then underwent.    Besides the gastric biopsy, established as the gold standard test, the stool ELISA test and H. pylori ELISA serology were also applied.

Results: The diagnostic performance of the HP stool antigen assay was as follows (Table 2):

sensitivity  of  94.5%,  specificity,  96.2%;  positive-predictive  value,  93%;  negative-  predictive value, 94%; and concordance of 90.4%.  The diagnostic performance of the H. pylori ELISA assay was also high, with a sensitivity of 90.5% and specificity of 92%.   Combining the HP stool antigen with the ELISA assay raised the sensitivity to 98%, the specificity to 97%, PPV to 96% and NPV to 95%.

Conclusions: The ROC curve showed a good correlation between the compared methods. The standardization of the ELISA test for the detection of H. pylori in stool specimens constitutes a non-invasive diagnostic alternative.

Key words: Helicobacter pylori, serology, stool antigen test, endoscopy

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Ibrahim M. Abdel Aziz;

Professor of Gastroenterology & Hepatology

Salman Bin Abdul Aziz University Hospital, College of Medicine,

Al Kharj, Saudi Arabia.

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Abstract

Objective:  For detecting underline ovarian pathology. Ultrasound has been proven to be useful. The main aim of this study was to find out percentage of ovarian torsion in patients suffering from acute lower abdominal pain undergoing ultrasonography and to assess the role of ultrasound in the prediction of ovarian torsion in patients with acute lower abdominal pain related toclinicallysuspected ovarian torsion.

Methods: Patients of acute lower abdominal pain were considered under this study. Total 66 patients suffering from acutc lower abdominal pain had  under gone ultrasonographic examinaion. Patients were categorized in two groups according to their age i.e. group A and group B. In group A patients between age group of 12 years to 17 years were taken. In group B patients from age of 18 years and above were taken. According to situation patients were examine transabdominally and transvaginally. In this study 2.5 MHz to 5 MHz convex transducer was used for transabdominal ultrasonography. For transvaginal ultrasonography examination 7.5 MHz transducer was used. All patients were examined in  supine position

Results: In this study total 66 cases were clinically suspected for ovarian torsion, out of which 56 cases (84.84%) were diagnosed as ovarian torsion by ultrasonography examination.In the age group of 12-17 years, 13cases (23.21%) and above 18years of age 43 cases (76.78%) were suffering from ovarian torsion. The ovarian torsion found in 46 married cases (82.14%) and in unmarried cases it was found in 10 cases (17.80%).Two cases (3.57%) were reported in pregnant women while 54 cases (96.20%) were reported in non-pregnant cases. In all cases (100%) pain in lower abdomen were reported, but radiating pain to back and loin were reported in 8 cases (14.28%). Vomiting and/0r nausea was found in 36 cases (64.28%) whereas no nausea and vomiting was observed in 20 cases (35.71%).The cyst was found in 52 cases (92.85%) while in 4 cases (7.14%) no cyst was found. Involvement of right side ovary in ovarian torsion was found in 49 cases (87.50%) whereas left ovarian involvement was observed in 7 cases (12%).

Conclusion: From the collective findings of this study and considering its limitations in terms of sample size it is concluded that the definitive diagnosis of ovarian torsion remains challenging. Both clinically and sonographical evaluation of acute lower abdominal pain should be considered for the diagnosis of ovarian torsion.  

Keywords: Acute lower abdominal pain ultrasonography,ovarian torsion

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Aruna R. Pawar

Govt. Medical College

Yavatmal, Maharashtra, India, Pin-445001

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Abstract

The blunt abdominal trauma have become increasingly common in this era of speed and hurry. The machines now occupied position of master of man rather than man who was the master of machine. The speed , unwanted hurry, shortage of time  leads to error of judgement while driving, hence all types of high momentum deceleratio injuries occurs  to human body including abdomen. The blunt trauma abdomen  poses a formidable challenge to the modern science and particularly surgeon for managing multitude of  solid organ ,hollow visceral and  other internal injuries.

The complete transection of gut is rare and extreme form of gut injury in blunt trauma of abdomen following usually high momentum deceleratio injuries in vehicular traffic accidents .Blunt trauma abdomen may cause solid organ or hollow visceral injuries. The complete jejunum transection is very rare in blunt trauma abdomen. We report a case of double jejunal transection that occurred when speeding motor bike struck the road divider in a town lane.

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Gurbachan  Singh

Junior resident, Department of Surgery

Govt medical College Amritsar, Punjab, India

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Abstract

Menopause is accompanied by decline in estrogen levels and a substantial rise in the incidence of hypertension in majority of women. Whether this decline is in accordance with estrogen receptor levels and associated co-morbidities need to be elucidated. Hence estrogen receptor status was assessed among selected hypertensive postmenopausal women with co-morbidities. A total of 12 postmenopausal women were selected and categorised into normotensive postmenopausal women (group-1), hypertensive postmenopausal women (group-2) hypertensive postmenopausal women with diabetes (group-3) and hypertensive postmenopausal women with renal insufficiency (group-4). Levels of estrogen receptor α and estrogen receptor β were assessed in these groups of postmenopausal women. One way ANOVA was performed using SPSS16.0 statistical software. No significant difference was found in estrogen receptor α levels between the groups. However, estrogen receptor β levels were significantly elevated in hypertensive postmenopausal women with renal insufficiency (group-4).  The expression of these receptors might depend on the availability of estradiol. ERβ levels were found to increase with co-morbid conditions.

Keywords: Estradiol, estrogen receptor, hypertension, peripheral blood mononuclear cells, postmenopause

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Salini A

Research Scholar in Biotechnology, Department of Biochemistry, Biotechnology and Bioinformatics

Avinashilingam Institute for Home Science and Higher Education for Women, Coimbatore, Tamil Nadu, India

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Abstract

Introduction: Blood transfusion is an integral and life saving procedure of modern medicine, but simultaneously it carries the risk of transmitting the life- threatening transfusion-transmissible infectious agents such as human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), syphilis and malaria. Thus ensuring the safety of blood is a major concern in transfusion therapy although the improved screening and testing of blood donors has significantly reduced transfusion-transmitted diseases The aim of the study was to find out the prevalence of transfusion transmitted infections (TTI) in voluntary donors.

Materials & Methods: A total of 14646 voluntary donors were analysed for the prevalence of TTI over a period of 1 year. HBV, HCV and HIV were tested by ELISA methods malaria also screened with rapid card test with pinciple of immunochrmatography. syphilis was screened with the principle of rapid plasma reagin test

Results: Prevalence of TTI in total donors was 3.56 % as whole, whereas in Rh negative donors it is only 1 %. Prevalence of Hepatitis B was highest (1.38) followed by Hepatitis-C (1.31), HIV (0.4), VDRL (0.32) and malaria (0.12). Distribution pattern of TTI fallows identically with the blood group distribution in Rh positive population but does not fallow in Rh negative blood group population.

Conclusion: TTI remains a important problem in blood transfusion. Proper protocol should be applied in selecting and screening donors to safeguard the health of people receiving blood transfusions. 

Keywords: Transfusion transmitted infections Blood donors, Human immunodeficiency virus, Hepatitis-B,Hpatitis-C,VDRL

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Dr. Samir Kumar Roy

R.M.O. cum Clinical Tutor,

Department of Pediatrics, Bankura Sammilani Medical College,

Gobindanagar, Bankura.PIN -722102

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Abstract

Mixed epithelial stromal tumor is rare distinctive kidney tumor which has been described over past few years. It is new entity included in WHO 2004 renal tumor classification.  Mixed epithelial stromal tumor occurring in medullary sponge kidney is very rare and to best of our knowledge, it is first case in Indian literature. We report a case of 43 year old female who presented with left renal mass and loin pain.

Keywords -- Mixed epithelial stromal tumor, medullary sponge kidney.

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Dr Patel Bhavin

301,K K Apartment,New Maneklal Estate,

Ghatkopar (West), Mumbai – 400086

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Abstract

Objective: To compare analgesic effect of  10% dextrose solution with direct breast feeding, and placebo  after DPT  vaccination   to 6week- 3month old infants.   

Participants and study Design: Infants coming for their DPT vaccination were randomized in to three groups of 50 each in a randomized, placebo controlled trial.         

Outcome Measures: The primary outcome variable was the duration of cry after vaccination. Secondary outcome variables were Modified Facial Coding Score (MFCS) and latency of onset of cry.

Results: 150 babies were equally in enrolled in breast feed group,10% dextrose  fed group and distilled water fed group. Median  duration of cry was significantly lower in direct breastfed 35.5(17-54)seconds and 10%dextrose fed babies52.5(31-67.5)seconds as compared to babies given distilled water 81.5(33.5-119.5) seconds (P<0.05).

Conclusion: Direct breasting and 10% dextrose act as analgesic in young infants undergoing DPT vaccination in young infants less than 3 months of age.

Keywords: 10% dextrose, Breasting, Duration of cry, DPT vaccination, Management,

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Yogesh Yadav

Assistant Professor, J K Lon Hospital Jaipur ,Rajasthan ,India

Email: yoge2501@gmail.com

Abstract

The study is aimed at studying the fracture patterns, mechanism of injury, union rates and functional results of supracondylar fractures of femur treated with retrograde intramedullary G.S.H.(GREEN SELIGSON AND HENRY) interlocking nail. In present study, 31 patients of supracondylar fractures of femur surgically managed by with retrograde intramedullary G.S.H. interlocking nail, between August 2012 to September 2014 in government general hospital Kurnool were included. The average age of the patient is 39.7 years, road traffic accidents being the most common mode of accident with 90.3%.Closed fractures were commonest with 90.3%,comminuted fractures were seen in 74.1%,AO type A were commonest with 70.96%. The outcome assessment showed that in 77.4% patients union was achieved in 22-24, knee stiffness was seen in 70.9%, delayed union in 9.7%, non union in 6.4% and infection in 19.3%.  By analyzing the present study data, we feel that retrograde intramedullary G.S.H. interlocking nail appears to be the implant of choice in the management of supracondylar fractures of femur.

Keywords: femur, supracondylar fracture, G.S.H. interlocking nail¹.

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Dr Raghunandan G

Professor, Department of Orthopaedics,Kurnool Medical College

Budhawar pet, , Kurnool, Andhra pradesh 518002 India

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Abstract

Aim: To study the preeclampsia levels in pregnant women

Setting and Design: The cross sectional non randomized study.

Materials and Methods: A total of 100 pregnant women were recruited into the study. These were drawn from pregnant women attending their routine antenatal clinic at Nnamdi Azikiwe University Teaching Hospital, Nnewi, South East Nigeria. Blood samples were collected and analyzed for the following electrolyte parameters: Sodium, Potassium, Chloride and Bicarbonate using standard biochemical techniques for the laboratory investigations.

Results: It was observed that bicarbonate and potassium had a significant correlation with sodium at P<0.05 and P<0.01 respectively. There was also a significant correlation between potassium and bicarbonate at P<0.01. Sodium exhibited a significant correlation with chloride at P<0.01. Potassium showed a significant relationship with only the preeclamptic subjects’ age ranges 41-45 only. Therefore, it will be of immense importance to conduct routine electrolyte check for expectant mothers especially during their third pre-trimester in order to avoid a situations where medical fit could arise either pre or post period of giving birth to new born babies.

Key words: Biochemical, Neonates, Preeclampsia, Serum electrolytes ,Stillbirth, obsteritics

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Dr. A.U. Onochie

Anambra State University, Uli, Nigeria

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Abstract

Organochlorine pesticide residueswere measured in guinea corn, maize, beans, bambara groundnut and millet. These cereals were bought from 5 markets in different locations of Anambra state, Nigeria .40g of each of the powdered cereals was used for the extraction process by the method of Carlo, et al.,(2009), while the products of extraction was analyzed using gas chromatography. The mean of the overall pesticides in μg/kg( with standard deviation) in the food samples were: Maize 0.0377 ( ±0.0041), Beans0.0359(± 0.0047), Bambara groundnut 0.0360 (±0.0039), Guinea corn0.0352(±0.0046), Millet0.0052(±0.0068). Our results revealed that foods from Onitsha generally showed the highest pesticide level. Among all the pesticides, aldrin was found to exhibit the highest concentration of the pesticides in the foods. It was observed that cereals from Anambra State were exposed to some levels of contamination of Organochlorine pesticides, although these levels may not be a serious health challenge to the public, hence there is need for a concerted effort towards continuous monitoring of these pesticide residues in our foods and environment. However, this research has opened avenues for other researchers in Anambra State and beyond to discover other frontiers towards the preservation of foods.

Keywords: Cereals, Gas chromatography, Organochlorine pesticides, Regulatory agency, Residual levels.

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Dr. A. U. Onochie

Anambra State University, Uli,Anambra State, Nigeria

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Abstract

Fractures of the scapula are very uncommon (account for 3% to 5% of all fractures about the shoulder) and most Of the scapula fractures do well with conservative treatment ^[1]. Operative treatment of scapula fractures is indicated for significantly displaced fractures or intra-articular fractures. There are several surgical approaches for exposure of scapula. In this article we are discussing about direct lateral approach and its advantages and disadvantages. This approach ensures adequate exposure of scapula for internal fixation. It causes minimal trauma to soft tissue. It ensures protection of the major neurologic structures i.e.  suprascapular nerve superior lyandaxillary nerve laterally .This approach has minimum chance injury to axillary artery as there is no subperiosteal dissection of deltoid.

The main advantage of the exposure is minimum soft tissue dissection, which can potentially improve rehabilitation and limit morbidity of the operation.

Key Words: scapula, fracture, approach, fixation

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Dr. Dibakar Ray

Associate Professor

BSMCH

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Abstract

Myxoid leiomyosarcoma of uterus is a very rare malignancy with only 36 cases documented worldwide and no cases reported in the Indian subcontinent. The present case is of uterine myxoid leiomyosarcoma with associated pancytopenia that has not been described previously in the south-east asia and only one such case reported in world literature. A 32 year old woman who is a known case of uterine fibromyoma discovered in her previous pregnancy , presented to the opd with heavy bleeding per vagina. On examination, she had a large abdominal mass. Her hemoglobin was 6.3 g/dl and platelet count was 80,000/cu.mm and also developed leucopenia(4500/cu.mm).She had received five units of blood transfusion, but her haemoglobin and platelet counts remained low. Her bone marrow biopsy report came out to be inconclusive. She underwent laparotomy followed by total hysterectomy with bilateral salphingo-ophorectomy, omentectomy and appendicectomy. Histopathology reports showed uterine myxoid leiomyosarcoma (FIGO stage IIIA). Her haematological profile improved considerably following the surgery and recurred with the recurrence of the disease. Hence, this is considered to be a case of pancytopenia due to paraneoplastic syndrome as a result of the myxoid leiomyosarcoma of the uterus.

Keywords: leiomyosarcoma, paraneoplastic syndrome

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Dr. Shubhadeep Bhattacharjee

MBBS,MS (O&G)

Silchar Medical College, Silchar

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Abstract

Objective: To assess the accuracy of classification of ANTERIOR CHAMBER ANGLE by using ASOCT, UBM and GONIOSCOPY.

Material And Method: We recruited 12 normal volunteers (24 eyes) and 18 subjects (36 eyes) with narrow angles Subjects with suspected narrow anterior chamber angle with or without elevated IOP. All subjects underwent OCT, UBM, and gonioscopy. AOD 500, TIA 500, TISA 500 were determined on AS OCT and UBM. The discriminative ability of OCT and UBM in identifying narrow angles was compared.

Results: Sixty eyes of 30 subjects were included in the study. Thirty six eyes (60%) were classified on gonioscopy as having narrow angles. Mean values of the angle parameters measured by UBM and OCT were very similar. Repeatability as assessed by the pooled standard deviation of the repeated measures was not significantly different between the two imaging modalities. No significant difference was found between OCT and UBM parameters. The high level of efficiency in discriminating narrow angles is illustrated by the receiver operating characteristic curve of the TISA measured at 500 μm by OCT. The AUC of 0.861 (95% confidence interval, 0.679-1.00) shows that, based on the present sample, this parameter has good discriminative ability.

Conclusion:  In this study, we have demonstrated a novel potential application for OCT at 830nm as an imaging modality for large-scale screening for PACG. The quantitative angle parameters as measured by OCT have similar mean values, reproducibility, and sensitivity-specificity profiles when compared with measurements obtained by UBM.

Key Words:- Narrow angles, Gonioscopy, AS-OCT,UBM.

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Dr. Sachin Tammannavar

Room No-14,PG Block, MGM Medical College Boys Hostel,

Musakhedi Road, Indore-452001 (INDIA)

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Abstract

The discovery of Otoacoustic emissions (OAE) opened a new dimension in audiological assessment. Transient evoked otoacoustic emissions (TEOAE) have an advantage of being its ease of usage, faster administration, objectivity, non invasive nature and also high sensitivity[2] as compared to other audiological procedures. The present study aimed to compare transient evoked otoacoustic emission response using two different click (rectangular and trapezoid) stimulus shapes.

Materials and Methods: A total of 30 ears were considered for the study. 15 normal hearing individuals (7 males and 8 females) with age ranging from 15-30 years served as Participants for the present study.

Results: The mean difference between the rectangular and trapezoid shape were 3, 3, 3, 1 and 2dB at the 1, 2, 3, 4 and 5 KHz respectively. The SNR for rectangular shape was better than trapezoid shape. The paired sample t- test results revealed significant differences in TEOAE amplitude for all the frequency.

Conclusion: It can be inferred that there is significant difference in TEOAE amplitude for all the frequencies between two different stimuli shape. This difference could be attributed to the broader spectrum that is seen in the rectangular shape as comparison with the trapezoid stimulus. Rectangular shape produced better SNR than trapezoid stimulus shape.

Keywords:  TEOAEs, Stimulus shape, Signal to Noise ratio.

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Corresponding Author

Rashmi A. Pai

Assistant Professor, Senior Scale,

Department of Audiology and Speech Language Pathology

Kasturba Medical College, Manipal University, Mangalore

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Abstract

Research Question: What is the morbidity status of children aged 7 to 13 years in an urban slum, a typically underserved group?

Objectives: To study some epidemiological factors like socio-economic status, education of parents, personal hygiene etc. related to the health of the children in the 7 to 13 years age group.

To identify the nature and magnitude of various morbid conditions prevalent among children aged 7 to 13 years in an urban slum and to study their association with epidemiological factors.

Study design: Population based descriptive cross sectional study.

Participants: Children aged from 7 to 13 years of aged in an urban slum

Statistical Analysis: Pearson’s Chi-square Test of significance between proportions was used to evaluate associations.

Results: Diarrhoeal  disease Skin disorders, Dental disorder Upper respiratory tract infection (URTI) and Worm infestation were commonly encountered morbid conditions Our study finding suggest a strong bond of association of parental factors such as fathers and mothers education and socio  economic condition poor outcome in children.

Keywords: morbidity, education, socio economic status

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Corresponding Author

Dr. Lalit R. Sankhe

Assistant Professor

Department of Community Medicine

Grant Govt, Medical College, Mumbai- 400 008

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Abstract

Gnatho dynamic prosthesis introduces the concept of stomatognathic compatibility of a dental prosthesis. The complexity of the mandible and its relation to the maxilla and the entire cranium often create fear and apprehension amongst dental students, especially when they see complex instruments or devices that have been used to record them. This article in effect is an attempt to eliminate the use of complex instruments and present a simple technique that in effect achieves the same desired objectives. The technique is based on recording the condylar guidance using a functional chew in procedure and using the same interocclusal record to program a semi adjustable articulator. Balancing of occlusion is achieved by arranging the teeth against the records that have been functionally modified in the patient's mouth utilizing various mandibular movements.    

Keywords- gnathology, occlusion, condylar guidance, complete denture, teeth arrangement

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Dr Khurshid A Mattoo

Assistant Professor

College of Dental Sciences, Jazan University

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Abstract

Between very few preventive prosthodontic options, immediate overdenture has not used as frequently as expected and there are few studies indicating their performance. Losing a natural tooth to a convenient treatment plan is one of the major causes for immediate overdenture been scarcely used. With dual advantages the prosthesis offers a delay of edentulous state and/or delay in deterioration of residual alveolar ridges by the amount of time that it will serve in the oral cavity. This article in the form of a clinical case report explores the clinical issues associated with such prosthesis.

Keywords- extraction, template, surgery, prosthodontics, residual alveolar ridge

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Corresponding Author

Dr Khurshid A Mattoo

Assistant Professor

College of Dental Sciences, Jazan University

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Abstract

Introduction: Enchondroma is one type of benign cartilage tumour that appears inside the bone. These tumours usually begin and grow in childhood, then stop growing but remain throughout adulthood. They are often found in patients between 10 and 20 years of age. Some cases become dormant or burned out.

History: Our case was a 30 yr old female patient who presented with a hard painless swelling over right hand thumb since last five months with restriction of terminal range of motion & pain at carpo-metacarpal joint but no restriction at metacarpo-phalangeal joint.

Treatment: The growth was excised without disturbing articular margins & cavity was filled with cancellous bony strut auto graft derived from iliac crest and this reconstruction was fixed with k-wire.

Result: The patient was followed up at 2-month, 4month, 6 month and 1 year intervals. Currently she shows a good range of motion of both the metacarpo-phalangeal and the interphalangeal joint.

Keywords -Enchondroma, finger tumour, metacarpal

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Corresponding Author

Dr. Rohan Khavte

MS Ortho

Assistant Professor

Orthopaedics, Govt Medical College, Miraj, Maharashtra, India

Khavte Accident and Orthopaedics Hospital, Taluka Daund, Dist. Pune Pin 413801

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Abstract

Avulsion fracture of the anterior superior iliac spine is a rare entity which may or may not be associated with meralgia paraesthetica. It is commonly seen in the adolescent age group. Avulsion fractures results due to sudden or repetitive contraction or pull by the muscle or tendon attached to the bone. Treatment is mainly conservative depending on the displacement of the fragment, depending on the displacement surgery may be required. We present a 18 yr old boy with acute post traumatic avulsion fracture of anterior superior iliac spine with meralgia paraesthetica treated conservatively with a pelvic brace.

Key words: Meralgia Paraesthetica, ASIS Avulsion Fracture, Conservative Management

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Corresponding Author

Dr. Mishil S. Parikh

Senior Resident

Department of Orthopaedics

D Y Patil School of Medicine, Navi Mumbai

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Abstract

Erlotinib is a tyrosine kinase inhibitor and is approved in lung cancer especially in adenocarcinoma of lung with mutated EGFR. It has got minimal side effects, the most common toxicity being rash. We present a case of life threatening vasculitis caused by the same agent. This is the first case of vasculitis caused by erlotinib in the literature.

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Dr Ansar Hussain Hakeem

MD, DM Scholar Medical Oncology

SKIMS Srinagar 

Add: Nawabagh, baghwanpora, lal bazar, Srinagar, 190023

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Abstract

Introduction: Perinatal mortality is a measure of the combined fetal and early neonatal mortality. The perinatal period covers the period leading up to birth and the first week of life; deaths occurring in this period are largely due to obstetric causes. More than 3.3 million stillbirths and over 3 million early neonatal deaths are estimated to take place every year. In the year 2000, over 6.3 million perinatal deaths occurred worldwide: almost all of them (98%) occurred in developing countries and 27% in the least developed countries. Perinatal mortality rates vary widely and may be below ten for certain developed countries and more than ten times higher in developing countries. Globally perinatal mortality rate (PNMR) is 52 per thousand live births, whereas in Bangladesh PNMR is 80.

Aims and objective: To find out the incidence of PMR in admitted cases. To sort out the cause of perinatal death. To reduce the PMR

Study design: Prospective, cross sectional study. Study setting: In the department of Obstetric and Gynaecology, Dhaka National Medical College Hospital (DNMCH). Participants: All perinatal deaths happened in DNMCH during the study period.

Methods: simple statistical method.

Results: Perinatla mortality is 21.54%, total number of births 2507, total number of still birth 31, total number of early neonatal death 23 and total perinatal death 54. Main factor behind the perinatal mortality rate were evaluated. One of the main factor was inadequate ANC, there is no birth plan during ANC, no linkage of ANC with emergency Obstertric Care (EOC) services.        

Conclusion: Present study found many factors responsible for higher perinatal mortality rate which are preventable. Lack of ANC and delay in taking decision is the most important factor identified which can be addressed by increasing awareness among public and health care provider at primary and secondary level.

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Dr. Most. Sufia Begum

Assistant Professor

Obs-Gynae

Dept Delta Medical College & Hospital Mirpur-1, Dhaka, Bangladesh

Abstract

This study focused on the antimicrobial activity of alcohol (ethanol) and aqueous extracts of Moringa olifera seed and leaf on Staphylococcus aureus, Escherichia coli and Pseudomonas aeruginosa.  The ethanol and aqueous extracts of the seed and leaf at concentration of 10g/100ml and the diluted ethanol and aqueous extracts at concentration of 0.1g/ml, 0.2g/ml, 0.4g/ml, 0.6g/ml and 0.8g/ml were impregnated into sterilized filter paper discs.  Also, ethanol alone was impregnated into sterilized filter paper discs and use as control. Agar disc diffusion method was adopted to obtain zones of inhibition. The zones of inhibition obtained for ethanol extract of Moringa olifera seed for Staphylococcus aureus was 12mm, Escherichia coli was 13mm and Pseudomonas aerucginora was 10mm.  The ethanol extract of Moringa olifera leaf gave an inhibitory zone of 11mm for Staphylococcus aureus, 10mm for Escherichia coli, 9mm for Pseudomonas aeniginosa .Different degrees of inhibition was observed for the diluted ethanol extracts of Moringa olifera seed. The diluted ethanol extracts of Moringa olifera leaf were resistant to the test organisms at concentration of 0.1g/ml, 0.6g/ml but was sensitive at concentration 0.8g/ml. The aqueous and diluted aqueous extracts of Moringa olifera seed and leaf were resistant to the test organisms. The zones of inhibition obtained for ethanol alone on the test organisms ranged between 8mm – 10mm. The degree of zone of inhibition differs, however the ethanol extracts exhibited the highest inhibitory effect than the aqueous extracts. This study revealed that Moringa olifera seed and leaf extracts are potential antimicrobial agents.

Keyword: Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, microorganism, antiboitic.

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Nwagu Chinyere

Department of Medical Laboratory Science

Imo State University, Owerri

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Abstract

Rapid Diagnostic Test (RDT) for the laboratory diagnosis of Malaria was compared with Microscopy (Gold Standard/ Reference Method) using 120 pregnant women aged 22-39 attending Braithwaite Memorial Specialist hospital, Port Harcourt. The prevalence of malaria among the subjects was 63>33%. Slide positivity was 76(63.33%) while RDT positivity was 44(36.67%). Rapid Diagnostic Test method in detection of Plasmodium falciparum as compared to microscopy gave results of 48.9% sensitivity, 100% specificity, positive predictive value of 100% and negative predictive value of 39.5%. Accuracy was 0.6 and J index (Reliability) 0.5. A Chi square value of 17.07 (95% confidence interval) was obtained which showed a significant difference (p<0.05) between the two test methods. Although the use of Rapid Diagnostic tests is rapid, convenient, less demanding and recommended for use in malaria endemic areas, microscopy remains the Gold standard for laboratory diagnosis of malaria. 

Keywords: Rapid Diagnostic Test, Malaria, plasmodium falciparum

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Nwagu Chinyere

Department of Medical Laboratory Science

Imo State University, Owerri

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Abstract

Ischemic chest pain is considered to be the hallmark of acute coronary syndromes (ACS).The  character , location and duration of chest pain can be markedly different in different types of ACS. Patients with ACS canhave  other symptoms like dyspnea  ,diaphoresis ,  nausea , vomiting and palpitations .ST elevation Myocardial infarction( STEMI )is more likely to  have prolonged chest pain and Inferior Wall Myocardial Infarction is more  associated  with gastrointestinal  symptoms. It was the  purpose of our study to identify  the differences in symptoms between the types of ST elevation myocardial infarction as well as between STEMI and Unstable Angina / Non ST Elevation Myocarddial infarction ( UA/NSTEMI ). A total of 209 patients with acute coronary syndromes were evaluated (NSTEMI – 102; STEMI – 107). It was found that only less than seventy percent of patients experienced a chest pain during a myocardial infarction. Certain chest pain characteristics were associated with the likelihood of ST elevation MI (viz squeezing, stabbing, pain lasting for > 30 minutes). Patients with STEMI and NSTEMI showed significant differences regarding several presenting symptoms like giddiness, palpitations and fatigue.

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Sethu Babu

Associate Professor

Department of Emergency Medicine

Pushpagiri Medical College, Thiruvalla, Kerala

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Abstract

Hemangiomas of tongue are rare congenital disease associated with difficult airway and present some hazardous complication like bleeding causing airway emergency. Here we present a case report of Successful airway management in a patient having bleeding hemangioma of tongue with light wand after a failed fiberoptic intubation attempt.

Key Words- hemangioma tongue, fiberoptic, light wand

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Dr Alok Kumar Sahoo

M.D, Assistant Professor,

Dept of Anaesthesiology and Critical Care

S.C.B Medical College, Cuttack, Orissa

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Abstract

Plantar fasciitis is most common cause of heel pain. More than 90% of patients are managed by conservative treatment. Chronic recalcitrant cases of plantar fasciitis not responding to other treatment modalities can be managed by Hyperosmolar dextrose injections with no or minimal complications. Hyperosmolar dextrose injection has been shown to increase Beta-1 platelet derived growth factor expression and upregulation of multiple mitogenic factors that may act as signaling mechanisms in tissue repair. We recommend Hyperosmolar dextrose solution for the management of chronic plantar fasciitis in place of local corticosteroid injection, so as to avoid the complications like rupture of plantar fascia and fat pad atrophy which are associated with local corticosteroid injections.

Keywords: Plantar Fasciitis, Hyperosmolar dextrose solution, Heel pain

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Ansarul Haq Lone

MBBS MS Ortho

Resident at Bone and Joint Hospital Barzulla Srinagar

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Abstract

Sudden intraoperative hypotension can prove to be a lethal emergency. Awareness of the possible causes and risk factors is essential to prevent this complication. Close monitoring of the patient during the procedure followed by aggressive resuscitation by a team effort can only prevent an intraoperative mortality.

Key Words: Intraoperative Hypotension Diagnosis Treatment

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Dr. Ketan Vagholkar

MS, DNB, MRCS, FACS

Professor Department of Surgery

D.Y.Patil University School of Medicine

Navi Mumbai -400706, MS, India

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

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Abstract

Incontinentia Pigmenti (IP) or Bloch-Sulzberger syndrome is an uncommon X-linked dominant disorder that affects mostly females and is usually lethal in males.  It is associated with skin (100%), dental (90%), skeletal (40%), central nervous system (40%), and ocular (35%) abnormalities. We report a florid case of a 9-year-old female who presented with convulsion and inflammatory vesicular skin lesion soon after birth which evolved into hyper-pigmented lesions along the lines of Blaschko over trunk, upper and lower extremities. Her teeth were peg-shaped and the skeletal examination confirmed scoliosis and hypoplastic mandible. She had quadriplegic spastic cerebral palsy, microcephaly with global developmental delay and mental retardation. Ocular examination revealed hypertelorism with micro-ophthalmia of left eye. She also had avascularity of left peripheral retina. On further investigation, MRI revealed gliotic areas in frontal and parietal region suggestive of microvascular vaso-occlusive insult. Histopathology of skin demonstrated pigment incontinence in upper dermis consistent with the diagnosis. Our patient had sporadic mutation as mother and sibling were normal. We report this case because of its rarity.

Key Words: Genodermatoses, Incontinentia Pigmenti, Bloch-Sulzberger syndrome, Lines of Blaschko

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Anand Bhattar

Department of Paediatrics

D.Y. Patil School of Medicine,

Nerul, Navi Mumbai, India

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Abstract

Epidemiological studies and preventive measures for cancer have engaged most of the scientists and doctors for several decades and the research has come forth a long way now. Several heavy metals like arsenic have been linked with different types of cancer, one of which is ovarian cancer (Oca). Higher mortality rate of Oca signifies the gravity of the case. Moreover, arsenic is also believed to invoke generation of free radical and the consequences are even exacerbated. Early diagnosis of Oca is presently quite feeble and CA-125 alone seems to be insufficient and capricious. However, CA-125 along with other diagnostic parameter satisfies most of the pathologists and clinicians. For determination of oxidative stress, Malondialdehyde (MDA) was chosen as the marker and arsenic estimation was performed with the help of Atomic Absorption Spectrometer (AAS). RBC count, Heamoglobin, SGPT, SGOT and Alkaline phosphatase levels were performed according to standard protocol. Higher level of arsenic increases MDA level, decreases CA-125 level, decreases RBC and Haemoglobin level and increases SGPT, SGOT, ALP levels and vice versa for no arsenic in the Oca patients with significance <0.0001, <0.001, <0.005, <0.020, <0.001, >0.05, and <0.002 respectively. Concludingly, arsenic is one of the major causative agents for oxidative stress and hence leading to cancer including Oca. CA-125 was estimated to be very higher in Oca patients than normal ones and RBC count, Heamoglobin, SGPT, SGOT, ALP levels also seemed to be varied from normal.

Keywords-Arsenic, MDA, CA-125, RBC, WBC.

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Akhileshwari Nath

Research Center, Mahavir Cancer Institute, Patna

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Abstract

Background and aims:The cancer of the Gallbladder are the tumors with a poor prognosis and a lower quality of life (QoL). The aim of this study was to evaluate the survival rate in Cancer of the gallbladder patients.

Method: We prospectively enrolled 250 patients diagnosed with the cancer of the gallbladder in the cancer units of university hospital Varanasi, UP, each patient was reviewed, over a 9-month or till death with in the period of (2011-2013).  

Results: The mean age of the patients was 53 ± 10 years: 22.4% were male and 77.6% of the patients were female. Total number of patients in study were 250 at nine month only 23 patient was alive. The univariate analysis showed Age of the patients, tumor cell differentiation, Grade, preoperative lymph node metastasis, response of the patients and the surgical approach significantly correlated with median survival time, the prognosis of the patients was found to be negatively  significant (p <0.05). The results of the multivariate analysis (Cox regression) showed age, grade and the surgical approach, lymphnode involvement, patients response were independent predicators with relative risks of .74, .52, .47, and .66, respectively found to be significant (p=0.00, 0.01, 0.02, 0.00).

Conclusion: The highest 9 month survival rate was 9.2%. Slightly longer survival was recorded when surgery and chemotherapy was added as treatment surgery improved the QOL faster than other treatment. Age, grade and the surgical approach, lymphnode involvement, patients response were independent predicators of patient’s survival respectively found to be significant.

Key words: – survival – quality of life- adjuvant chemotherapy – curative surgery –prognosis- resectable

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Pandey Punam

Department of General Surgery, IMS, BHU, Varanasi, UP, India

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Abstract

From July 2011 to December 2013, we have treated 50 patients presenting with pterygium in 54 eyes at Regional Eye Hospital, Kurnool. 48 patients were presented with primary pterygium & 6 had recurrent presentation. Most common complaint was burning sensation, pain and watering in affected eye. The patients were managed based on standardized evaluation and surgical protocol. The main stay of treatment for pterygium is surgical excision and most common complication is recurrence. In the present study we have addressed the problem with conjunctival autograft after excision in all cases. All the patients in the present study showed significant visual improvement and reduction in pterygium induced astigmatism. We had no complications in present series. The results are presented, analyzed and discussed.

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Dr.A.Geetha

MS, Civil Assistant Surgeon

Department of Ophthalmology, Regional Eye Hospital

Kurnool Medical College, Kurnool , A.P 518002

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Abstract

Background: HIV is the plague of the running century.It has changed the fate of our society. Emergence of HIV threatened the economical, developmental, social welfare and public health progress not only in India but also all over the world. serosurveillance studies play a major role in success of health care programmes.

Objective: the present was undertaken to study  the serosurveillance profile in MSM targeted intervention group in AP.

Material and Methods: This study was conducted over a period of 12 months from April 2004 to April 2005. Serum samples are received from the voluntary organizations SAATI,vijayawada which is working for the welfare of MSM groups. Age, location, migration, literacy of the seropositive patients was considered.

Results: During this period consecutive non repetitive 250 serum samples received from MSM clients were tested for the serosurveillance of HIV by HIV TRIDOT KIT manufactured by J.Mitra & Co.,Ltd. Among them HIV test by TRIDOT was positive in 33(13.2%) samples.samples of age group 20-29 yrs showed highest positive percentage (15.2%) and lowest positive percentage below 20yrs age group showed (6.6%).

Conclusion: our study findings are contrary to the belief. Therefore it is recommended that large sample based studies may be taken up in which may throw better light on the seroprevalance and clinical presentation of HIV among MSM.

Key words: HIV, Serosurveillance, MSM, Intervention

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Maria Sindhura John

Department of Microbiology

Narayana Medical College, Nellore, A.P

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Abstract

Background:To compare between free conjunctival autograft and conjunctival autorotation flap technique following simple surgical excision of pterygium.

Methods: Fifty patients with pterygium attending the outpatient and in-patient department, Department of Ophthalmology, K.R. Hospital, Mysore, fulfilling the inclusion criteria framed were included under the study, between the period from June 2013 to June 2014 (1 year). Informed and written consent was taken from all the patients. After detailed history, all necessary ocular and systemic examination was done. After simple pterygium excision, 25 patients received conjunctival autograft and another 25 cases received a conjunctival autorotation flap technique. All cases were followed-up for 3 months after surgery for recurrence and complications.

Results: Surgical time was less in conjunctival autorotation flap technique with significant statistical difference (p<0.001).Recurrence was seen in 2 (8%) and 3 (12%) cases in conjunctival autograft and autorotation flap groups respectively. Post operative complications was seen in 3 (12%) cases in both conjunctival autograft and conjunctival autorotation flap groups.  No significant statistical difference was seen in recurrence and postoperative complications between the two groups.

Conclusion: Conjunctival transplants either a free conjunctival autografting or conjunctival autorotation flap technique is an effective surgical procedure in reducing the recurrences following simple pterygium excision.

Key words:Conjunctival autograft, Conjunctival autorotation flap, Pterygium excision, Recurrence.

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Dr. H. T. Venkategowda

Department of Ophthalmology

Mysore Medical College and Research Institute,

Mysore - 570001

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Abstract

Mesh migration following hernia repair is an uncommon complication, leading to erosion, infection, fistula or obstruction. Migration can occur because of primary factors like inadequate fixation or can be secondary due to erosion. Very few cases have been reported of mesh migration causing intestinal obstruction after umbilical hernia repair and ours is perhaps only the second such case resulting in strangulated bowel obstruction .Use of prosthetic materials like prolene is more liable to develop in such complications and a composit or a biocompatible mesh is less liable to develop such complications.

Key Words: Umbilical, hernia, mesh, migration, intestinal obstruction

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Dr. Abhijit Guruprasad Bagul

Associate Professor

Dept. of Surgery, D.Y.Patil School of Medicine, Nerul,

Navi  Mumbai

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Abstract

Objectives: To evaluate the efficacy of intranasal steroid in the treatment of recurrent subjective and objective upper airway obstruction secondary to adenoid hypertrophy following adenoidectomy

Materials and methods: 60 children aged 5-12 years, diagnosed with nasopharyngeal obstruction secondary to recurrent adenoid hypertrophy (symptoms>3months) post-adenoidectomy, confirmed radiographically, were included in a prospective comparative study. Nasal obstructive symptoms and radiographic adenoid size were scored. All patients received intranasal mometasone furoate spray for 12 weeks.Follow up was done at the end of 2,12 weeks, 6,12months. Symptoms were recorded, scored and totalled on all visits. Lateral nasopharynx X-ray was repeated at 12 weeks and 1 year.

Results: 33 males(55%) and 27 females(45%) met the inclusion criteria, with a male: female ratio of 1:1.Mean age of the study patients was 7.85±2.36 years.Mean total symptom score prior to initiation with intranasal steroid therapy and at 2 weeks,12 weeks,6 months and 1 year following initiation of steroid therapy was 7.11,6.73,0.91,0.92 and 0.93 respectively, with a decrease in individual mean snoring, nasal obstruction and rhinorrhoea scores.64.5% of patients showed a mild, statistically insignificant decrease in symptoms at 2weeks.88% showed a statistically significant (p<0.001) decrease in symptoms and radiographic adenoid size at 12weeks,which was sustained over the remainder of the study period. Correlation was seen between symptoms and radiographic adenoid size. No complications were seen following intranasal steroid therapy in any of the patients.

Conclusion: Intranasal steroid spray is safe and effective in the treatment of recurrent nasal obstruction secondary to adenoid hypertrophy following adenoidectomy. Maintenance therapy at low doses can be safely continued over long periods.

Keywords: Adenoidectomy; Adenoids; Anti-Inflammatory Agents; Nasal Obstruction; Nasopharynx /radiography

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Dr. Smitha S.G

Department of ENT, Kempegowda Institute of Medical Sciences,

K.R Road, V.V Puram, Bangalore-560004, Karnataka, India  

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Abstract

ABSTRACT

Background: Gastric and Duodenal perforation are one of the most common cause of acute abdomen .They are managed by different surgical techniques in emergency procedures and the outcomes are more encouraging to the community.

Aims: To study the various incidence and outcome of findings in cases with Gastric and Duodenal perforation in emergency situations –a Retrospective randomized study.

Patients and Methods: This is a retrospective hospital based study. 56- Gastric and Duodenal perforation patients diagnosed and various incidence in different aspects are categorized and the outcome is studied and analysed.

Results:  Factors deciding the outcome of Gastric and Duodenal perforation patients treated were observed  and analysed for prospective approach.

Conclusion: smaller Gastric and Duodenal perforations are easily amenable to perforation closure and heals well than large perforations. Duodenal perforations are more benign than malignant.Gastric perforations are more malignant than benign.

Keywords: Duodenal Perforation, Duodenal ulcers, peritonitis, risk factors, Gastric perforation.

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Corresponding Author

Dr K.Ravichandran

Assistant Professor of Surgery, Dept of Surgery Rajah Muthiah Medical College,

Annamalai University, Annamalainagar, Chidambaram, Tamil Nadu