iosr-JDMS   Volume-18 ~ Issue-6 ~ June-2019

Abstract:Heart valve replacement is a definitive surgical procedure performed in a selective set of patients having heart valve disease. Though there are innumerable designs and types of prosthetic valves being used , there is no single ideal prosthetic valve which has equal the durability and efficiencyof a natural valve and the search for an ideal prosthetic heart valve is still continuing in various parts of the world.

Keywords: Rheumatic Heart disease, Prosthetic valve, Valve replacement

[1]. Krishna KR , Tandon R . Rheumatic fever & rheumatic heart disease. Indian J med res. 2013;137:643-658.
[2]. Ravisha MS, Tullu MS, Kamat JR.Rheumatic fever and rheumatic heart disease – clinical profile of 550 cases in india .Arch Med Res.2003;34(5):382-7.
[3]. Srinivasan M , Venketadevanathan M ,Padmanabhan C . Ten years outcome of Chitra heart valves. Indian J of Thorac and cardiovasc Surg. 2011;27:24-7.
[4]. Maria A. Haemodynamic evaluation of TTK Chitra Valve by Doppler Echocardiography at mitral and Aortic position. International J Advanced Research . 2014;2:111-121.
[5]. Pawan K , Bharat D , Ragavendra C , Pranav K, Rajesh P, Vinod A , et al. TTK Chitra tilting disc valve – Haemodynamic evaluation. Ind J Thorac Cardiovasc Surg. 2004 ; 20 : 117-121

Abstract: Rhomboid (limberg) flap is the most versatile and easiest flap which can be used anywhere in the body. The aim of this paper is to prove the versatility of this flap by presenting a case of multiple limberg on the face for multiple BCC following wide local excisions.

[1]. Vaneesa Smith, Shernaz Walton, Treatment of facial basal cell carcinoma: A review. Journal of skin cancer. 2011,april 27.
[2]. Deeptisinghjawa, Keya Sircar Rani Somani .Gorlin- Goltz syndrome. Journal of Oral and maxillofacial pathology. 2009 jul-dec; 13(2):89-92
[3]. Evans DG, Sims DG, Donnai R. Family implications of neonatal Gorlin's syndrome. Arch Dis Child. 1991;66:1162–3.
[4]. Leslie R Chasmar, The versatile rhomboid (Limberg) flap, Can J PlastSurg 2007 summer 15(2); 67-71.
[5]. AdilGandevivala, Dinesh H Shah , Modified Rhomboid flap for reconstruction of defect of cheek after excision of BCC, Journal of conservative dentistry.

Abstract: Introduction : The expectations and demands of the citizens during crises periods from the health system are increased. The need for quality not only in the medical-clinical work of oncology patients but all the departments providing administrative or financial services is high and there are many factors that affect patients'. One of the most modern ways of investigating the quality of health care is the measurement of the patients' opinion as users of services. Objective : To assess the level of satisfaction among patients who have utilized the O.P.D. services provided in the Secondary care level health institution and to determine the relationship between some........

Key Words: Patient Satisfaction, Health Care Facility

[1]. Kumari R, Idris MZ, Bhushan V, Khanna A, Agarwal M, Singh SK. A Study on Patient Satisfaction in Government Allopathic Health Facilities of Lucknow District, India. Indian Journal of Community Medicine 2009; vol 34(1):35-42.
[2]. Brundtland G.H. Improving Health Systems‟ Performance. OECD 2001: pg 4.
[3]. Repert MI, Babakus E. Linking Quality and Performance: Quality orientation can be a competitive strategy for health care providers. J. Health Care Mark 1996;16:39-43.
[4]. Gombeski WR, Jr Miller PJ, Hann JH, Gillete CM, Belinson JL, Bravo LN, Curry PS. Patient Call Bak Program: a quality improvement, customer service marketing tool. J Health Care Mark 1993; 13:60-65
[5]. www.wbgov.health.in. Retrieved on 17.04.2011, 10 AM..

Abstract: Introduction-Vesicovaginal fistula (VVF) is the most common acquired fistula of the urinary tract with most common etiology now being hysterectomy in developed nation.The objective of this study is to review our experience in the management of VVF over the last 5 years (2014- 2019), with an emphasis on causes, means of surgical treatment & their outcomes, and to determine the risk factors for poor outcomes. Materials and methods-A retrospective study done with a total 41 VVF cases operatedbetween 2014-2019. All medical records were reviewed, and the etiology of fistula, time to presentation, prior treatment, clinical findings on admission, means of treatment and outcomes were noted. Fistula wasapproached differently depending upon host factor...........

Keywords: Genitourinary fistula, vesicovaginalfistula(VVF), Martius flap, Modified O'Conor repair.

[1]. Gerber GS, Schoenberg HW.Female urinary tract fistulae. J Urol 1993;149(2):229–36.
[2]. Goodwin WE, Scardino PT. Vesicovaginal and ureterovaginal fistulas: a summary of 25 years of experience. J Urol 1980;123:370–4.
[3]. Kocharkarn W, Pummangura W. A new dimension in vesicovaginal fistula management: an 8-year experience at Ramathibodi hospital. Asian J Surg. 2007; 30(4): 267±271
[4]. Bodner-Adler B, Hanzal E, Pablik E, Koelbl H, Bodner K (2017) Management of vesicovaginal fistulas (VVFs) in women following benign gynaecologic surgery: A systematic review and meta-analysis. PLoS ONE 12(2): e0171554.
[5]. Sharma S, Rizvi SJ, Bethur SS, Bansal J, Qadr SJ, Modi P. Laparoscopic repair of urogenital fistulae: A single center experience. J Minim Access Surg. 2014; 10(4): 180±184.

Abstract: Knowledge of carotid arteries is essential for surgeons and radiologists while performing the surgeries and head and neck angeograms. External and internal carotid arteries are the main arterial supply of the head and neck. Understanding variable branching patterns of External carotid arteries is highly warranted for surgeons, radiologists and various medical practitioners.present study aimed to study various types of branching patterns of External carotid artery. This study was conducted in 30 well embalmed adult cadavers during undergraduate teaching carriculum for a period of 5years. Cunningham's dissection manual was followed for dissection method......

Key Word:External carotid artery, Thyrolingual trunk, Thyrolinguofacial trunk, Superior thyroid artery, Occipitopharyngeal trunk

[1]. Standring S. Gray's Anatomy. The Anatomical basis of clinical practice.39th Ed. Edinburg. Elsevier Churchill Livingstone. 2005; 31:p.543-544.
[2]. Dutta AK (1994). Essentials of human anatomy In: Head and Neck. 2nd ed.Calcutta: Current Books International 127-132.

[3]. Xu DS, Abruzzo TA, Albuquerque FC, Dabus G, Eskandari MK, Guterman LR, Hage ZA, Hurley MC, Hanel RA, Levy EI, Nichols CW, Ringer AJ, Batjer HH, Bendok BR. External carotid artery stenting to treat patients with symptomatic ipsilateral internal carotid artery occlusion: a multicenter case series. Neurosurgery: 2010; 67:314-21.

[4]. Romanes G. J. Cunningham's Manual of Practical Anatomy. Ed 15. India: Thomson Press; 2001. 35 -43.
[5]. Al-Basheer M, Ferrar D, Nelson D, Vasudevan T. Outcome of the external carotid artery following carotid endarterectomy with added external carotid artery eversion endarterectomy. Ann Vasc Dis 2011;4:225-8..

Abstract: Inhalers are the main stay of treatment in asthma and COPD.Most of the patients have faulty inhaler technique and it hampers their treatment significantly. An observational cross-sectional Study was done in Dr. D.Y. Patil Medical College, Hospital and Research Centre, Pimpri, Pune-411011 from July, 2016 to September, 2018 to study the use of inhaler devices by the patients of bronchial asthma and COPD according to standard steps and errors committed in different steps of use.Results of the study showed that majority of patients were unable to use their inhalers correctly. The maximum mistakes committed, which was common for all the devices, was that 61% of the subjects had short breath hold after inhaling the drug from device, while 2nd most common mistake was 58% did not exhale to residual volume before inhaling the drug. Thus proper training at each visit should be carried out to get maximum benefit from inhalers

Key Words: Asthma , Copd , Inhalers, faulty technique

[1]. Global Strategy for Asthma Management and Prevention ,Global Initiative for Asthma (GINA),2018. Available at :http//www.ginasthma.org
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[3]. Giraud V, Roche N. Misuse of corticosteroid metered-doseinhaler is associated with decreased asthma stability. Eur Respir J 2002;19(2):246e51.
[4]. Lareau SC, Hodder R. Teaching inhaler use in chronicobstructive pulmonary disease patients. J Am Acad Nurse Pract 2012;24(2):113e20. http://dx.doi.org/10.1111/j.1745-7599.2011.00681.x.

[5]. Global Initiative for Asthma. Global Burden of Asthma. http://www.ginasthma.com.

Abstract: Aim: The Aim of the study is to evaluate following factors when Levobupivacaine 0.5% 9mg + 10mcg Fentanyl and hyperbaric Bupivacaine 0.5% 9mg + 10mcg Fentanyl given intrathecally in elective caesarean section. Study design: Randomized control trial. Place and duration of study: Anesthesia Department, Siddhartha Medical College / Government General Hospital, Vijayawada from January 2017 to June 2018. Methodology:120 parturient with American Society of Anesthesiologists I-II undergoing elective caesarean section were enrolled for study with.....

Key Words: Cesarean sections, fentanyl, hyperbaric bupivacaine, isobaric levobupivacaine

[1]. H.Blomqvist and A Nilsson, "Is glucose free Bupivacaine isobaric or hypobaric?" REGIONAL ANAESTHESIA AND PAIN MEDICINE1989;14(4) :195-198.
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[3]. M .G.Richardson and R.N.wissler "Densities of the lumbar cerebrospinalfluid in the pregnant and non pregnant humans",anasethsiology1996;85 (2):326-330.
[4]. A.C.Lui , T.Z.Polis and N.J.Cicutti , " Densities of cerebrospinal fluid and spinal anasethetic solutions in surgical patients at body temperature ," anaesthesia for caesarean section," Anaesthesia and Analgesia1988;86(5):989-993
[5]. M.R.Logan, J.H.McClure and J. A . Wildsmith ," Plain Bupivacaine : an unpredictable spinal anaesthetic agent ," British Journal Of Anaesthesia1986 ;58(3):292-296.

Abstract: 79 years old male presented to ophthalmology OPD for evaluation of a painless, progressive, superficial nodular lesion over his left upper eyelid for last 2 years. 5 years back he had similar lesion at same site which was excised after 2 years. The swelling recurred within 1 year and presented as painless, gradually progressive well-defined, irregularly marginated nodular lesion over the left upper eyelid. The overlying skin was freely mobile and there was no regional lymphadenopathy. Patient underwent excisional biopsy with 5 mm margin under local anaesthesia. Histopathology revealed a dermal tumor composed of pools of extracellular mucin and tumour cell islands having mildly pleomorphic nuclei floating into it consistent with the diagnosis of mucinous carcinoma. Primary mucinous carcinoma of the skin is a rare subtype of sweat gland tumour. Local recurrence occurs frequently.......

Key Words: Lymphadenopathy, Pleomorphic nuclei, Mucinous carcinoma, Local excision, Adnexal tumor

[1]. Lee GA, Cominos D, Sullivan TJ. Clinicopathological report: Mucinous carcinoma of the eyelid. Aust N Z J
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hidradenoma. J Pathol Bacteriol. 1952;64:865–80.
[4]. Carson HJ, Gattuso P, Raslan WF, Reddy V. Mucinous carcinoma of the eyelid: An immunohistochemical study. Am J
Dermatopathol. 2005;17:494–8.
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and electron microscopic observations. Cancer. 1979;44:1757–68..

Abstract: Our study aims to examine selected baseline clinical and laboratory parameters of PMTCT clients at the Federal Medical Centre (FMC), Makurdi for follow up of the success of the intervention. Data was obtained from the treatment centre's electronic data base. This one year retrospective review of 477 clients on the PMTCT programme from 1st January to 31st December, 2010 was conducted, studying some clinical and laboratory parameters. Results obtained were analysed using SPSS windows version 17 and significance was set at a P-value of <0 .05. The mean age was 29.6 ± 5.3 (range 16-60years). Majority of clients 284 (68.9%) were in the age group......

Key Word: PMTCT, HAART, laboratory parameters, Makurdi

[1]. Lussiana C, Clemente SV, Ghelardi A, Lonardi M, Tarquino IA, Floridia M. Effectiveness of a prevention of mother-to-child HIV
transmission programme in an urban hospital in Angola. PloS one. 2012 Apr 30;7(4):e36381.
[2]. Li B, Zhao Q, Zhang X, et al. Effectiveness of a prevention of mother-to-child HIV transmission program in Guangdong province
from 2007 to 2010. BMC Public Health. 2013;13:591. Published 2013 Jun 18. doi:10.1186/1471-2458-13-591
[3]. Turan JM, Steinfeld RL, Onono M, Bukusi EA, Woods M, Shade SB, Washington S, Marima R, Penner J, Ackers ML, Mbori-
Ngacha D. The study of HIV and antenatal care integration in pregnancy in Kenya: design, methods, and baseline results of a
cluster-randomized controlled trial. PLoS One. 2012 Sep 6;7(9):e44181.
[4]. Karnon J, Orji N. Option B+ for the prevention of mother-to-child transmission of HIV infection in developing countries: a review
of published cost-effectiveness analyses. Health policy and planning. 2016 Mar 26;31(8):1133-41.
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Abstract: BACKGROUND: Gall Bladder is a very common organ to be affected by many pathological processes of which gall stones and inflammatory disorders constitute the most. More than 95% of biliary tract disease is attributable to gallstones. This spectrum also includes neoplasms and tumor like conditions which are uncommon. AIM: To study the spectrum of histopathological lesions in gallbladder in cholecystectomy specimens. MATERIALS AND METHODS: The study was conducted in the department of pathology at a tertiary care hospital for a period of two years from June 2016 to May 2018. A total of 177 specimens were studied. RESULTS: In the present study, gallstones......

Key Word: Gallstones, chronic cholecystitis, carcinoma, cholecystectomy

[1]. Theise ND. Liver and gallbladder. In: Kumar V, Abbas AK, Aster JC (Eds). Robbins & cotran pathologic basis of disease. 9th ed. New delhi: Elsevier; 2016.p821-83.
[2]. Sun L, Liu T. The gallbladder and extrahepatic biliary tree. In: Pfeifer JD, Humphrey PA, Ritter JH, Dehner LP (Eds). The Washington manual of surgical pathology. 3rd ed. Philadelphia: Wolter kluver: 2020. P255-60
[3]. 3.Rosai J, Ackerman L editors. Rosai and Ackerman's surgical pathology. 11 ed. Philadelphia: Elsevier Saunders;2018
[4]. Almas T, Murad M, Khan M, et al. (August 09, 2020) The Spectrum of Gallbladder Histopathology at a Tertiary Hospital in a Developing Country: A Retrospective Study. Cureus 12(8): e9627. DOI 10.7759/cureus.9627
[5]. Gupta K, Faiz A, Thakral RK, Mohan A, Sharma VK: The spectrum of histopathological lesions in gallbladder in cholecystectomy specimens. Int J Clin Diagnostic Pathol. 2019, 2:146-151.