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

Abstract: The most common cause of acute abdomen is Appendicitis. The diagnosis of acute appendicitis is based on clinical history and physical examination. It is difficult to diagnose in cases of retrocaecal or retro ileal appendix. Appendicectomy is the most commonly performed abdominal surgery. 15-30% of appendicectomy specimen found to be normal.In order to decrease the number of unnecessary appendicectomy, significance of labarotory investigations like White Blood Cells,,CReactive Protein, etc have been emphasised.Ultrasonagram abdomen has been widely accepted as the diagnostic tool for appendicitis.Many number of scoring system were developed to arrive the diagnosis. These scoring systems are based on clinical features, laboratory investigations. Some examples are Alvarado, Modified alvarado, Ripasa. Still there is no definitive laboratory marker for acute appendicitis and appendicular..........

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Abstract: Background: Aim. The present study has been conducted to analyse the results of Injection sclerotherapy using Polidocanol alone or in combination with Thiersch's Stitch in the early management of Rectal Prolapse (RP) in children. MATERIAL AND METHOD: -All the patient's upto 14 years of age presenting with a diagnosis of idiopathic RP in the outpatient department or in the emergency wing of the Govt Medical College Hospital Jammu for the first time were enrolled for the study. There were total 30 children and were divided into two groups for deciding the mode of treatment Group 'A' – children with mucosal/ partial/ intermittent RP which got reduced on its own after defecation / straining and Group 'B' – children with complete prolapse which had to be reduced manually after defecation....

Keywords: Rectal Prolapse, Injection Sclerotherapy, Polidocanol, Thiersch's Stitch

[1]. Shah A, Parkh D, Jawaheer G, Gornall P. Persistent rectal prolapse in children: sclerotherapy and surgical management. Paediatr Surg. Int. 2005; 21: 270-273.
[2]. Calkins CM, Oldham KT. Acquired anorectal disorder. In Holocomb III GW, Murphy JP, Ostlie DJ (eds), Ashcroft's Paediatric Surgery (2014), 6th edn. Saunders, Elseiver, London, New York, pp 525-530.
[3]. Chaudhry MA, Khan A, Khan P. Rectal prolapse in children; A comparative study of 5% phenol with almond oil verses 15% hypertonic saline for its treatment. Ann. Pak, Inst. Med. Sci. 2016; 12(4): 262-266.
[4]. Wu JS. Rectal prolapse a historical perspective. Curr Probl Surg. 2009; 46: 602-716.
[5]. Flum AS, Golladay ES, Teitelbaum DH. Recurrent rectal prolapse following primary surgical treatment. Paediatr Surg. Int. 2010; 26(4): 427-431.

Abstract: Human immunodeficiency virus (HIV) is the causative agent of Acquired Immunodeficiency Syndrome (AIDS). Due to the large scale of morbidity & mortality it causes, HIV is fast becoming a major threat in developing/third world countries (1). HIV is characterized by progressive damage to the body's immune system which results in the development of many opportunistic infections and complications. The hematological complications of HIV-infected patients include anaemia, neutropenia, lymphopenia and thrombocytopenia. Anemia is the most commonly encountered hematological abnormalities in HIV patients (2). Approximately 15% of........

[1]. Rombauts B. Farmaceutische Microbiologie (met inbegrip van de farmaceutische technologie van steriele geneesmiddelen). Cursus 1 ste graad apotheker VUB 1997;11:14-16.
[2]. Spivak JL, Bender BS, Quin TC. Hematological abnormalities in the acquired immune deficiency syndrome. Am J Med 1984;77:224-8.
[3]. Zauli G, Davis BR, Re MC. Fat protein stimulates production of transforming growth factor – beta-1 by the bone marrow macrophages: A potential mechanism for human immunodeficiency virus-1-induced hematopoietic suppression. Blood 1992;80:3036-43.
[4]. Zon LI, Groopman JE. Hematological manifestations of human immune deficiency virus (HIV). Semin Hematol 1988;25:208.
[5]. Castella A, Croxson T, Midvan D. The bone marrow in AIDS. A histologic, hematological and microbiologic study. Am J Clin Pathol 1985;84:425-32..

Abstract: Tennis elbow is commonly diagnosed in patients with pain over the lateral aspect of elbow, worsened or aggravated by repetitive or excessive movement of wrist, with the elbow in extension. Tenderness over the lateral epicondyle, and resisted wrist extension worsens the pain. Tennis elbow is more prevalent in patients of 4th and 5th decade, with no gender preference, and involves the dominant elbow in 70% of patients. (1) Recently the non-inflammatory nature of tendinopathy has been stressed (2,3) and it has become clear that tennis elbow does not involve an inflammatory process of common extensor origin (CEO). KRAUSHAAR AND NIRSCHL (4) proposed that the pathology is angio-fibroblastic hyperplasia of CEO, especially of the tendon of extensor carpi radialis brevis(ECRB), in line of the overuse tendinopathy. While direct comparative studies have not been performed, the histology in upper limb tendinopathy does not appear to be dissimilar from that of lower limb tendinopathy. (5) Operative management of tennis elbow..........

[1]. Allander E (1974) Prevalence, incidence and remission rates of some common rheumatic diseases or syndromes. Scand J Rheumatol, 3, 145–153.
[2]. Khan KM, Cook JL, Kannus P, Maffulli N, Bonar SF (2002) Time to abandon the 'tendinitis' myth. BMJ, 234, 626–627.
[3]. Maffulli N, Khan KM, Puddu GC (1998) Overuse tendon conditions: time to change a confusing terminology. Arthroscopy, 14, 840–843.
[4]. Kraushaar BS, Nirschl RP (1999) Tendinosis of the elbow: clinical features and findings of histological, immunohistochemical and electron microscopy studies. JBJS Am, 81, 259–278.
[5]. Khan KM, Cook JL, Maffulli N (2000) Tendinopathy in the active person: separating fact from fiction to improve clinical management. Am J Med Sports, 2, 89–99..

Abstract: Introduction: Nodal metastases have a great impact on treatment and prognosis in head and neck cancer. This study aimed to assess the findings of contrast enhanced computed tomography (CECT) findings in enlarged malignant cervical lymph nodes with histopathological / cytopathological correlation and to identify the site of primary tumor in metastatic lymph nodes wherever possible. Materials and Methods: We evaluated 150 cases. CECT findings including distribution, size, shape, outline, hilum, internal architecture, calcification, intranodal necrosis, matting, enhancement pattern and final diagnosis. All of CECT findings were correlated with cytopathological/ histopathological findings. Results: CECT Findings: Out of 150 cases......

Key Word: Cervical lymphadenopathy, contrast enhanced computed tomography, malignant nodes

[1]. Jenny K. Hoang,Jyotsna Vanka, Benjamin J. Ludwig, Christine M. Glastonbury.Evaluation of Cervical Lymph Nodes in Head and Neck Cancer With CT and MRI: Tips, Traps, and a Systematic Approach.AJR 2013; 200:W17–W25.
[2]. Van den Brekel MWM, Stel HV, Castelijns JA. Cervical lymph node metastasis: Assessment of radiologic criteria. Radiology 1990; 177: 379-84.
[3]. Van den Brekel MWM, Castelings JA, Snow G. Detection of lymph node metastases in the neck: radiologic criteria. Radiology 1994; 192: 617-8.
[4]. Shah JP, Cendon RA, Farr HW, Strong EW. Carcinoma of the oral cavity: factors affecting treatment failure at the primary site and neck. Am J Surg 1976; 132: 504-7.

[5]. PT Figueiredo*,1, AF Leite1, AC Freitas2, LA Nascimento3, MG Cavalcanti4, NS Melo5 and EN Guerra5.Comparison between computed tomography and clinical evaluation in tumour/node stage and follow-up of oral cavity and oropharyngeal cancer. Dentomaxillofacial Radiology (2010) 39, 140–148..

Abstract: Right common carotid is the branch of brachiocephalic trunk and left common carotid arises from arch of aorta. External carotid artery gives off eight separate branches. Variations are common in the branching pattern of facial and lingual arteries. Variations in branching of facial and lingual artery was found in a 65 year old cadaver during routing dissection of MBBS 2017- 18 batch in the Anatomy department, Indira Gandhi Institute of Medical Sciences, Patna, Bihar. Facial and lingual arteries were arises from a common trunk i.e. linguofacial trunk on the right side while on the left side facial and lingual arteries were arises separately from external carotid artery. Such anatomical variations of branching pattern of external carotid artery are important for surgeons in surgery of head and neck region and also important for radiologists in image interpretation of face and neck region.

Key Words: Linguofacial trunk, External carotid artery, Variations

[1]. Thwin SS, Soe MM, Myint M, Than M, Lwin S (2010) Variation of the origin and branches of external carotid artery in a human cadaver.Singapore Med. J.51(2): 40-42
[2]. Kishve PS, Kishve SP, Joshi M, Aarif SM, Kalakoti P (2011) An unusual branching pattern of common and external carotid artery in a human cadaver. Australian Medical Journal.4(4): 180-182.
[3]. Williams PL, Bannister LH, Berry MM (1995). Gray's Anatomy. In: Arteries of limbs and cardiovascular system. 38th ed. London: Churchill Livingston, p. 1516-17.
[4]. Standring S. Gray's Anatomy. The Anatomical basis of clinical practice. 39th Ed. Edinburg. Elsevier Churchill Livingstone. 2005; 31: p.543-544.
[5]. Bergman RA, Afifi AK, Miyauchi R; Illustrated Encyclopedia of Human Anatomic Variation: Opus II: Cardiovascular System: Arteries: Head, Neck, and Thorax. Common Carotid Arteries. 2013..

Abstract: Objective: Oral sildenafil, a phosphodiesterase 5 inhibitor,is now accepted mode of therapy for symptomatic Pulmonary arterial hypertension(PAH).As the pathobiologic mechanisms are different in primary and secondary PAH, we undertook this study to find out any significant difference in efficacy of oral sildenafil therapy in primary versus secondary PAH. Materials and Methods: It was an unicentric parallel group longitudinal study. After selection and baseline investigations,all the patients of primary and secondary PAH were given sildenafil in fixed doses (50 mg thrice daily). Study parameters: 1. Distance covered in 6 minute walk test (6MWT), 2.Pulmonary arterial pressure (PAP) by trans-thoracic Doppler.....

Keywords: primary pulmonary hypertension, secondary pulmonary hypertension, sildenafil, pulmonary arterial pressure, 6 minute walk test.

[1]. Gaine SP, Rubin LJ. Primary pulmonary hypertension, Lancet; 1998, 352: 719-725
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[4]. Rich S, McLaughlin VV. Pulmonary hypertension; Zipes DP, Libby P, Borow RO, Braunwald E, Braunwald's Heart Disease 7th ed. 2007, Elsevier, Saunders.
[5]. Humbert M, Morrell NW, Archer SL, et al. Cellular and molecular pathobiology of pulmonary arterial hypertension study. Am J Med; 1951, 11:686.

Abstract: In a prospective study for a period of 24 months from jan 2017 to dec 2018, 25 patients with upper third leg and knee defects exposing bone and tendons were managed with gastrocnemius muscle flaps.Reconstruction was done for 15 patients with gastrocnemius muscle flap and 10 patients with denervated gastrocnemius muscle flaps as elective procedure . Among these 20 patients were associated fractures involving both tibia and fibula for which 12 patients underwent IMIL nailing and 8 patients had external fixation.........

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Abstract: The success of endodontic treatment depends on the eradication of microbes (if present) from the root-canal system and prevention of reinfection. The root canal is shaped with hand and rotary instruments under constant irrigation to remove the inflamed and necrotic tissue, microbes/biofilms, and other debris from the root-canal space.. There is no single irrigating solution that alone sufficiently covers all of the functions required from an irrigant. Optimal irrigation is based on the combined use of two or several irrigating solutions, in a specific sequence, to predictably obtain the goals of safe and effective irrigation so we are proposing a sequence for the different irrigating agents in order to achieve the best chemical preparation possible.Although some of the main irrigating solutions cannot be mixed without loss of activity or development of potentially toxic by-products, several combination products are on the market, many with some evidence of improved activity and function

Keywords - Endodontics, Irrigation ,Root canal Irrigants

[1]. Philippe Sleiman, FadlKhaled. Sequence of Irrigation in Endodontics.2005;1-7
[2]. SajedehGhorbanzadeh, Sara Arab Loodaricheh.Irrigants in endodontic treatment International Journal of Contemporary Dental and Medical Reviews 2015;1-7
[3]. Prado M, Santos Júnior HM, Rezende CM, Pinto AC, Faria RB, Simão RA, et al. Interactions between irrigants commonly used in endodontic practice: A chemical analysis. J Endod 2013;39:505-10
[4]. MarkusHaapasalo, YaShen, Wei Qian, Yuan Gao;Irrigation in Endodontics
[5]. Zehnder M, Schmidlin P, Sener B, et al. Chelation in root canal therapy reconsidered. J Endod 2005;31:817–20.

Abstract: Postpartumanaemia is caused primarily due to two causes – ion deficiency anaemia (inadequate iron intake prior to and during pregnancy) and acute peripartum blood loss which can be related to each other. Patients with postpartum anaemia have a longer average length of hospital stay, are more likely to receive blood transfusion and incur higher hospitalization costs. . The aim of the study is to compare the efficacy and safety of treatment in between intravenous ferrous sucrose and oral ferrous sulphate therapy in postpartum anaemia. So, the objectives of our study are –To compare the changes ( i.e rise or fall ) of Hb%, serum ferritin, haematocrit or packed cell volume (PCV) & mean corpuscular haemoglobin concentration.....

[1]. WHO/UNICEF/UNU. Indicators for Assessing Iron Deficiency and Strategies for its Prevention: WHO draft. Geneva: WHO, 1996.
[2]. World Health Organization. Report of a WHO Group of Experts on Nutritional Anaemias. Technical report series no. 503. Geneva: WHO 1972.
[3]. Milman N, Bergholt T, Byg K, Erissen L, Graudal N. Iron statics and iron balance during pregnancy, a ritical reappraisal of iron supplementation. ActaObstetGynecol Scand 1999; 78: 749-757.
[4]. Mahomed K. Iron and folate supplementation in pregnancy. In Cochrane Library. Issue 4. Oxford: Update Software: 2002.
[5]. Adamson John W. Iron Deficiency and other Hypoproliferativeanaemias. Harrison‟s Principal of Internal Medicine, 16th edn. 2005; 588-9.

Abstract: Back Ground: Rapidly Progressive Renal Failure (RPRF) is a clinical syndrome characterized by rapid deterioration of renal function, over a period of few weeks. The present study was conducted to evaluate the pattern of histopathology in patients presenting with RPRF and to correlate the outcome of the patients with reference to the histological pattern. Materials and Methods: A prospective observational study was conducted in the department of nephrology, Andhra Medical College and King George Hospital , Visakhapatnam over a period of 2 years between 2017 January to December.......

Key words: Rapidly Progressive Renal Failure , histological diagnosis, ESRD, Andhra Medical College.

[1]. Sharma M, Bordoloi P, Das HJ,, Barman AK. Histopathological Pattern in Patients Presenting with Rapidly Progressive Renal Failure: A Single Centre Study. Int J Med Res Prof. 2016, 2(2); 150-53.
[2]. Bhowmik D, Sinha S, Gupta A, Tiwari SC, Agarwal SK. Clinical Approach to Rapidly Progressive Renal Failure. 2011;59:6.
[3]. Wiggins RC, Kershaw DB. Crescentic glomerulonephritis. Massry SG, Glassock RJ (eds), Massry and Glassock's Textbook of Nephrology 4th edition, Lippincott, Williams & Wilkins Philadelphia 2001:720-726.
[4]. Das U, Dakshinamurty KV, Prayaga A. Pattern of biopsy proven renal disease in a single centre of South India: 19 years' experience. Indian J Nephrol 2011, Vol 21, Issue 4 , 250 -257.
[5]. Lopez – Gomez JM, Riviera F. Renal biopsy findings in acute renal failure in the cohort of patients in the Spanish registry of glomerulonephritis . Clin J Am Soc Nephrol 2008; 3: 674- 681..

Abstract: It is obvious that the abuse of anabolic steroids to improve physical performance has been widely implicated in several cardiovascular events, especially myocardial infarction; However, according to the literature, there is currently no report describing myocarditis due to the abuse of anabolic steroids to our knowledge, unless animal experiments or Post mortem autopsy which were carried out at young athletes. We report two cases of young bodybuilders who were complaining about chest pain . They did not have traditional cardiovascular risk factors , however they admitted the intermittent abuse of anabolic steroids. In both instances, electrocardiography.......

Keywords: Myocarditis , Anabolic steroid, Cardiac toxicity

[1]. D. Sagoe et al. The global epidemiology of anabolic-androgenic steroid use: a meta-analysis and meta-regression analysis. Annals of Epidemiology 24 (2014) 383-398 .
[2]. Kanayama, G., Hudson, J. I., Harrison, G., & Pope, Jr. (2008). Long-term psychiatric and medical consequences of anabolic-androgenic steroid abuse: A looming public health concern? Drug and Alcohol Dependence, 98(1-2), 1- 12. Doi: 10.1016/j.drugalcdep.2008.05.004.
[3]. M. Lusetti et al. Pathological changes in anabolic androgenic steroid users Journal of Forensic and Legal Medicine 33 (2015) 101e104
[4]. McNutt RA, Ferenchick GS, Kirlin PC, et al. Acute myocardial infarction in a 22-year-old world class weight lifter using anabolic steroids. Am J Cardiol 1988; 62: 164.
[5]. Bowman S. Anabolic steroids and infarction. BMJ 1990;300: 750.

Abstract: Aims Diastolic operate typically declines before heartbeat operate, and this precedes clinical signs in patients with acute coronary syndrome. Therefore, diagnosing of beat disfunction is extremely necessary for early diagnosing, follow-up, treatment, and prognostic analysis in cardiopathy with preserved ejection fraction (HFpEF) patients. The most objective of the study was to seek out out association between prolonged QTc dispersion and left chamber beat disfunction in Non ST phase Elevation MI (NSTEMI) patients in HFpEF. Objects:This cross sectional analytical study was conducted within the Department of medicine and sixty patients were enclosed as study population from August 2016 to Gregorian calendar month 2017. Then the study population was divided...........

Keywords: Magnesium, acute myocardial infarction, QTdispersion

[1]. Bigger JT, Weld FM, Rolnitzky LM. Prevalence, characteris-tics and signi®cance of ventricular tachycardia (three or more Eur Heart J, Vol. 20, issue 2, January 1999
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[4]. Mont L, Cinca J, Blanch P et al. Predisposing factors and prognostic value of sustained monomorphic ventricular tachy-cardia in the early phase of acute myocardial infarction. J Am CollCardiol 1996; 28: 1670±6.
[5]. Mirvis DM. Spatial variation of QT intervals in normal persons and patients with acute myocardial infarction. J Am CollCardiol 1985; 5: 624±31.

Abstract: Being the foremast part of the eye, the conjunctiva is frequently exposed to foreign body and exogenous organisms. Conjunctivitis is a contagious ailment, prevalent worldwide and is the most common form of ocular infection occurring in all age groups. This cross- sectional study has been undertaken for 2 years in the Ophthalmology department, RegionalInstitute of Medical Sciences and total of 100 patients with conjunctivitis attending the outpatient department have been studied. This study showed that the maximum percentage of patients were between 31 – 40 years (27%) followed by 21 – 30 years (23 %) and were mostly male (55%). The majority of the patients were found to be Hindu (71%) followed by Muslim (20...........

Keywords: conjunctivitis, bacteriology, drug sensitivity, bacteria, ocular discharge

[1]. Padmini HR. Evaluation of ophthacare eye drops in the treatment of acute conjunctivitis. The Indian Practitioner 1998;51(12):941-4.
[2]. Buznach N, Dagan R, Greenberg D. Clinical and bacterial characteristics of acute bacterial conjunctivitis in children in the antibiotic resistance era. Paediatric Inf Dis J 2005;24(9):823-8.
[3]. Perween N, Bisht D, Aggarwal P. Bacterial conjunctivitis: microbiological profile, antimicrobial susceptibility patterns and recommendations for treatment. Journal of Communicable Disease 2016; 48(1):18-22.
[4]. Gumshi T. Bacteriological study of acute conjunctivitis [Thesis]. Imphal, Manipur University;1994. [5]. Tarabishy AB, Jeng BH. Bacterial conjunctivitis: a review for internists. Cleve Clin J Med 2008;75(7):507-12...

Abstract: Introduction: Transfusion services plays a vital role in transfusion of blood and blood products in heart transplantation. From past few years, there is an increase in the number of heart transplants being performed in India, and consequnetly, increase in demand for blood and blood products. To fulfill this, proper management of the blood inventory in blood bank is important. Aim: Analysis of management of blood components for patients undergoing heart transplant in a tertiary care hospital. Material and Methods:...........

Keywords: Heart Transplantation, Blood Management,

[1]. Barnard CN. The operation. A human cardiac transplant: an interim report of a successful operation performed at Groote Schuur Hospital, Cape Town. S Afr Med J.1967;41(48):1271-4.
[2]. Geissler RG, Rotering H, Buddendick H, Franz D, Bunzemeier H, Roeder N, et al. Utilisation of blood components in cardiac surgery: a single-centre retrospective analysis with regard to diagnosis-related procedures. Transfus Med Hemother. 2015;42(2):75-82.
[3]. Guzzetta NA. Benefits and risks of red blood cell transfusion in pediatric patients undergoing cardiac surgery. Paediatr Anaesth. 2011;21(5):504-11.
[4]. Parida S, Badhe AS. Cardiac surgery-associated acute kidney injury. J Anesth. 2013;27(3):433-46.
[5]. Bilgin YM, van de Watering LM, Eijsman L, Versteegh MI, van Oers MH, Brand A. Is increased mortality associated with post-operative infections after leukocytes containing red blood cell transfusions in cardiac surgery? An extended analysis. Transfus Med. 2007;17(4):304-11.

Abstract: Hepatitis C virus, a flavivirus, undergoes frequent mutation and establishes chronic infection in majority of the patients. Anti HCV antibody appears during acute infection but may be delayed by 3-6 weeks in some patients. ELISA for detection of anti HCV antibody may show false positive results. The study was undertaken to compare a 4th generation Rapid antibody detection test with RNA PCR for confirming ELISA positive results. The study finds that a combination of ELISA with 4th generation Rapid antibody detection test achieves specificity as high as HCV RNA detection and sensitivity higher than RNA PCR.

Keywords: HCV infection, HCV diagnosis, 3rd generation ELISA, HCV TRI-DOT

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[4]. Gupta E, Bajpai M, Choudhary A. 2014. Hepatitis C virus: Screening, diagnosis, and interpretation of laboratory assays. Asian J. Transfus. Sci. 8: 19–25.
[5]. Colin C, Lanoir D, Touzet S, Meyoud-Kraemer L, Bailley F, Trepo C. 2001.HEPATITIS Group. Sensitivity and specificity of third-generation hepatitis C virus antibody detection assays: An analysis of the literature. J. Viral Hepat. 8: 87–89.