iosr-JDMS   Volume-19 ~ Issue-1 ~ January. 2020

Abstract: Introduction: Ectopic pregnancy is defined as when the gestational sac implants itself outside the uterus, i.e. fallopian tubes, ovary, cervix and peritoneum. It is an obstetric emergency with high morbidity and mortality. It is the fifth most common cause of death according to the most recent triennial report and also the most common cause of maternal mortality in first trimester. Materials and Methods: This retrospective study was conducted in department of Obstetrics and Gynecology at Kurnool Medical College and Govt General Hospital, Kurnool, over a period of 2 years from January 2018 to December 2019. The case sheets of the patients with ectopic pregnancy were traced through the labour ward registers and operation theatre registers. Records were studied for demographic characteristics, period of amenorrhea, at time of diagnosis, presenting.....

Key Words: Ectopic pregnancy, morbidity, mortality.

[1]. Kirk E, Bottomley C, Bourne T. "Diagnosing ectopic pregnancy and current concepts in the management of pregnancy of unknown location". Hum. Reprod. Update. 2014:20(2):250-61.
[2]. Ankum VM, Mol BW, Van der Veen F. Risk factors for ectopic pregnancy: a meta- analysis, Fertil Steril. 1996;65:1093-1099.
[3]. Zane SB, Kieke BA, Kendrick JS, Bruce C. Surveillance in a time of changing health care practices: estimating ectopic pregnancy incidence in the United States. Matern Child Health J. 2002; 6:227.
[4]. Crochet JR, Bastian LA, Chireau MV. "Does this woman have an ectopic pregnancy?: the rational clinical examination systematic review". JAMA. 2013;309(16):1722-9.
[5]. Skipworth R. "A new clinical sign in ruptured ectopic pregnancy". Lancet. 2011;378(9809):27.

Abstract: Introduction: Ectopic pregnancy is a condition where in a fertilized ovum implants outside the normal uterine cavity. It is an important cause of maternal morbidity and mortality especially in developing countries where majority of the patients present to the clinician in a late life threatening state with altered and deteriorated hemodynamics. It is also a cause of fetal wastage and has been associated with recurrence and impairment of subsequent fertility. Materials and methods: This was a prospective study conducted in the Department of Obstetrics and Gynecology, Govt Medical College, Ananthapur from January 2018 to December 2019. Out of 3998 diagnosed cases of ectopic pregnancy 45 were....

Key Words: Ectopic pregnancy, salpingectomy, morbidity and mortality

[1]. Panti A, IkechukwuNE, LuckmanOO, Yakubu A, Egondu SC, Tanko BA. Ectopic pregnancy at UsmanuDanfodiyo University Teaching Hospital Sokoto: a ten-yearreview. Ann Niger Med. 2012;6(2):87–91.
[2]. Abdul FI. Ectopic pregnancy in Ilorin: a review of 278 cases. Niger J Med. 2000;9(3):92–96.
[3]. John A. Rock, Howard W. Jones III. TeLinde's Operative Gynecology. 10th edition. Lippincott, Williams & Wilkins, a Wolters Kluwer business. USA. 2008. p798.
[4]. F, Gary Cunningham, KennethJ. Leveno, Steven L. Bloom, John C. Hauth, Dwight J. Rouse, Catherine Y.Spong. Williams Obstetrics. 23rdedition. McGraw-Hill Companies. USA. 2010. p238.
[5]. Jonathan S. Berek, Deborah L. Berek. Berek& Novak's Gynecology. 15th edition. Lippincott, Williams & Wilkins, a Wolters Kluwer business. USA.2012. p627..

Abstract: Background and objective: In the past two decades, the incidence of ectopic pregnancy has been increasing dramatically, worldwide. One of the major triggering factor for this being the introduction of medical assisted procreation techniques. The present study of cases of ectopic pregnancy, is to know our experience regarding the incidence, clinical presentation, risk factors and associated maternal morbidity and mortality.Materials and Methods: All diagnosed cases of ectopic pregnancy admitted to Santhiram medical college and general hospital during a period of two years. It was a retrospective study using Contingency Table analysis and Chi-square test.....

Keywords: Ectopic pregnancy, salpingectomy

[1]. Te Linde's Operative Gynaecology, 8th ed, Lippincott – Raven, Philadelphia (1997); 501-527.
[2]. Makarainen L, Ronneberg L, Kauppila A. Medroxyprogesterone acetate supplementation diminishes the hypoestrogenic side effects of Gn RH agonists without changing its efficacy in endometriosis. Fertil Steril 1990; 53:620.
[3]. Goldner TE, Lawson HW, Xia Z, et al. Surveillance for ectopic pregnancy – United States, 1970-1989. MMWR CDC Surveill Summ 1993; 42:73.
[4]. Brunham RC, Pelling R, Maclean I, Kosseim ML, Paraskevas M. Chlamydia Trachomatis – associated Ectopic Pregnancy : Serologic and histologic correlates. J Infect Dis 1992; 165:1076.
[5]. Maccato M, Estrada R, Hammill H, Faro S. Prevalence of active Chlamydia Trachomatis infection at the time of exploratory laparotomy for Ectopic Pregnancy: Obstet Gynecol 1992; 79:211.

Abstract: Aim: To compare gall bladder extraction from epigastric versus umbilical port site in terms of port site infection and postoperative pain in Laparoscopic cholecystectomy. Methods: A prospective randomized study was done from June 2019 to December 2019 at Mysore Medical College and Research Institute, Mysore in which 50 cases of cholelithiasis were considered. Cases were randomly selected and allocated into two group, group A(gallbladder extraction from epigastric port; n=25 cases) and group B(gallbladder extraction from umbilical port; n=25 cases). VAS score for postoperative pain at port site, and surgical site infection was assessed and data was analyzed. Results:Port site pain was higher when gallbladder was extracted from epigastric port over umbilical port site. Surgical site infection was noted in 2 cases, 1 in each group....

Key Words: Epigastric port, Umbilical port, Port-site pain.

[1]. Waqar SH, Shah SF, Khan IA, Ch TS, Abdullah TM, Malik ZI, Zahid MA. Two –Port Laparoscopic cholecystectomy-A new technique. J Ayub Med coll. 2008 ; 4(20): 167-168
[2]. Bisgaard T, Klarskov B, Rosenberg J, Kehlet H. Characteristics and prediction of early pain after laparoscopic cholecystectomy. Pain. 2001; 90:261-9.
[3]. Liu YY, Yeh CN, Lee HL, Wang SY, Tsai CY, Lin CC et al. Local anesthesia with ropivacaine for patients undergoing laparoscopic cholecystectomy. World Journal of Gastroenterology. 2009;15:2376.
[4]. Lee IO, Kim SH, Kong MH, Lee MK, Kim NS, Choi YS, et al. Pain after laparoscopic cholecystectomy: the effect and timing of incisional and intraperitonealbupivacaine. Canadian J Anesth.2001;48:545-50
[5]. Hunter JG, Thompson SK. Laparoscopic cholecystectomy, intraoperative cholangiography, and common bile duct exploration. in: J.E. Fischer, K.I. Band (Eds.) Master of surgery. Lippincott Williams and Wilkins; 2007: 1117-1128.

Abstract: Chryseobacterium, are a group of aerobic, nonfermentative, nonmotile, catalase positive ,oxidase positive and indole positive Gram-negative bacilli, utilizes glucose oxidatively and does not grow on MacConkey agar. The organism produces a non diffusible yellow pigment (flexirubin) and, hence, was earlier called Flavobacterium indologenes. They are rare human pathogen, but widely distributed in soil, plants, food and potable water. It can cause serious infection in immunocompromised patients, but it has been increasingly isolated from patients with bacteraemia, pneumonia and long term intravascular devices such as venous catheters, intravascular implants, urinary catheters, intubation and mechanical ventilation devices. Despite their low virulence, Chryseobacteria are inherently resistant to many antimicrobial agents including Imipenem. We reported a case of pneumonia with septicaemia caused by C.Indologenes in postoperative patient of carcinoma stomach with indwelling internal jugular vein catheter.

Keywords- Flexirubin, Immunocompromised ,Imipenem

[1]. P.Olbrich,M.Rivero-Garv´ıa,M.D.Falc´on-Neyraetal.,"Chryseobacterium indologenes central nervous system infection in infancy: an emergent pathogen?" Infection, vol. 42, no. 1, pp. 179–183,2014.
[2]. Hsueh PR, Hsiue TR, Wu JJ, Teng LJ, Ho SW, Hsieh WC, et al. Flavobacterium indologenes bacteremia: clinical and microbiological characteristics. Clin Infect Dis 1996;23:550–5.
[3]. Bayraktar MR, Aktas E, Ersoy Y, Cicek A, Durmaz R. Postoperative Chryseobacterium indologenes bloodstream infection caused by contamination of distillate water. Infect Control Hosp Epidemiol 2007;28:368–9.
[4]. Nemli SA, Demirdal T, Ural S. A case of healthcare associated pneumonia caused by Chryseobacterium indologenes in an immunocompetent patient. Case Rep Infect Dis 2015;2015:483923.
[5]. Chang, Y.C.; Lo, H.H.; Hsieh, H.Y.; Chang, S.M. Identification, epidemiological relatedness, and biofilm formation of clinical Chryseobacteriumindologenes isolates from central taiwan. J.Microbiol. 2015, 48, 559–564

Abstract: Fractures of the distal femur often pose challenges to the orthopaedic surgeon because of the proximity to the knee joint.Distal femoral LCP has shown promising results in both intra and extra-articular fractures specially in osteoporosis1. Retrograde ILN shares many assets of locking plate and have been claimed to have high healing rates as well1. Pre-contoured LCP has advantage of uni-cortical fixation and least chance of plate back out and it acts as internal external fixator2.Retrograde ILN has got advantages like preservation of fracture hematoma, decreased blood loss, minimal soft tissue dissection, manipulative reduction is easy, less operative time, reduced rate of infection and also it aligns the femoral shaft with condyles reducing the varus movement at the fracture site3. Debate continues around choice of implant for fixation of metaphyseal–diaphyseal fractures. In thisstudy, we evaluated and compared clinical and radiological outcomes of distal femur fracture stablization using RN or LCP techniques.

[1]. Hierholzer C, von Rüden C, Pötzel T, Woltmann A, Bühren V. Outcome analysis of retrograde nailing and less invasive stabilization system in distal femoral fracture: a retrospective analysis. Indian J Orthop. 2011;45:243-50.
[2]. Nayak RM, Koichade MR. Minimally invasive plate osteosynthesis using a locking compression plate for distal femoral fractures. J Orthop (Hong Kong). 2011;19:185-90.
[3]. Gurkan V, Orhun H, Doganay M, Salioğlu F, Ercan T, Dursun M, et al. Retrograde intramedullary interlocking nailing in fractures of the distal femur. Acta OrthopTraumatolTurc. 2009; 43:199-205.
[4]. Smith WR, Ziran BH, Anglen JO, Stahel PF. Locking plates: tips and tricks. J Bone Joint Surg Am. 2007; 89(10):2298-307.
[5]. Higgins TF, Pittman G. Biomechanical analysis of distal femur fracture fixation: fixed angle screw plate construct versus condylar blade plate. J Orthop Trauma. 2007:2143-6.

Abstract: Background: Japanese Encephalitis is one of the most common causes of encephalitides in the world with an estimated yearly prevalence being 30-50,000 and mortality accounting to 10-15,000. Even in patients who recover there is a high prevalence of residual neurological deficit, hence early diagnosis and management play a crucial role in reducing the morbidity and mortality. MRI has a high sensitivity for picking up typical neuroparenchymal abnormalities and in cases where the diagnosis is a dilemma, it aids in confirming the disease thereby reducing the disease burden....

Keyword: Japanese Encephalitis, MRI, Asymmetric, Thalamus, Hippocampal, caudate nucleus, Splenium, cerebral cortex, JE ELISA IgM

[[1]. Solomon T, Thao TT, Lewthwaite P, Ooi MH, Kneen R, Dung NM et al. A cohort study to assess the new WHO Japanese Encephalitis surveillance standards. Bulletin of the World Health Organization 2008;86:178–186.
[2]. Dutta P, Khan A, Khan AM, Borah J, Sarmah CK, Mahanta J. The effect of Insecticide-Treated Mosquito Nets (ITMNs) on Japanese encephalitis virus seroconversion in pigs and humans. American Journal of Tropical Medicine and Hygiene 2011;84:466-72.
[3]. RodhainF.Recent data on the epidemiology of Japanese encephalitis. Bull Acad Natl Med 1996;180(6):1325-37.[4]. Verma R.MRI features of Japanese encephalitis.BMJ Case Reports 2012;
[5]. Kumar S, Misra UK, Kalita J, Salwani V, Gupta RK, Gujral R. MRI in Japanese encephalitis. Neuroradiology 1997;39:180–4.

Abstract: Reactive perforating collagenosis ( RPC ) is characterized by transepidermal elimination of altered collagen through the epidermis. Two distinct forms of RPC are known ; rare inherited form that starts in early childhood and a common acquired form that occurs in adulthood. We report a rare case of inherited form of RPC in a female child with presence of similar lesions in her elder brother .A 9 year old female child presented with extensive dark colored skin lesions over face and extremities since 6 months. On dermatological examination , multiple closely studded skin colored and hyperpigmented crateriform lesions with central crusting were present on dorsum of hand. Discretely arranged papules with central adherent keratotic plugging were seen over trunk and extremities......

[1]. Verma R, Vasudevan B, Pragasam V, Deb P, Venugopal R, Mitra D. A rare case of familial reactive perforating collagenosis. Indian J Dermatol 2013;58:408
[2]. Kandhari R, Sharma V, Ramesh V, Singh A. Familial reactive perforating collagenosis in three siblings. Indian J Dermatol Venereol Leprol 2014;80:86-7
[3]. Kumar V, Mehndiratta V, Sharma RC, Narayan S, Koranne RV, Kakar N. Familial reactive perforating collagenosis: A case report. J Dermatol 1998;25:54-6.
[4]. Bhat YJ, Manzoor S, Qayoom S, Wani R, Baba AN, Bhat AH. Familial reactive perforating collagenosis. Indian J Dermatol 2009;54:334-7.

Abstract: Fractures of the distal end of radius are the most prevalent fractures presenting to the Orthopaedic outpatient Department and Emergency. It accounts for about One-Sixth of all fractures treated in emergency rooms1 . Fractures of the distal end of radius caused due to falling on an outstretched hand. Unstable comminuted fractures of these typically occur due to high-velocity Injuries. It usually occurs in both younger and elderly populations due to road traffic accidents, fall and its also seen in postmenopausal women. Usually, Uncomplicated fractures of this type can be treated with closed reduction and immobilization in a cast. However, unstable comminuted fractures of radius occur as a treatment challenge. Review of Literature shows a high incidence of unsatisfactory results in the treatment of unstable fractures by the plaster cast method. It causes deformity up to 60% and disappointing results in 32% of patients2 . Recently, due to the advancement of Surgical techniques, External fixation and.....

[1]. Ark. J. Jupiter, JB. The rationale for the precise management of distal radius fractures. OrthopClin North Am. 1993 Apr; 24(2) : 205 – 10.
[2]. Fernandez, DL., Jupiter, JB. Fractures of the distal radius. A practical approach to management.Springer – Verlag. Newyork ; 1995.
[3]. Zhuang Cui. Internal versus external fixation for unstable distal radius fractures : an up to data meta-analysis. IntOrthop. 2011; 35(9) :1333-1341.
[4]. N. Schmelzer-Schmied,1,2 P. Wieloch,1,2 A. K. Martini,1,2 and W. Daecke1,2,3 Comparison of external fixation, locking and non-locking palmar plating for unstable distal radius fractures in the elderly DOI: 10.1007/s00264-007-0504-9
[5]. Fractures Marco Rizzo 2007 Oct 17. DOI: 10.1007/s11552-007-9080-0
Comparison of Locked Volar Plating Versus Pinning and External Fixation in the Treatment of Unstable Intraarticular Distal Radius.

Abstract: Fabella is a sesamoid bone present in around 39% of the population. But sometimes the fabella is painful, and this is termed as a fabella syndrome. Management options vary from radical treatments like surgical excision with the reconstruction of the posterolateral corner of the knee to more conservative methods like steroid injections, splinting, analgesics or physiotherapy. We present here our experience of managing 3 such cases conservatively.

Keywords: Fabella, Fabella syndrome, sesamoid, knee pain.

[1]. Berthaume, Michael A.; Di Federico, Erica; Bull, Anthony M. J. (April 17, 2019). "Fabella prevalence rate increases over 150 years and rates of other sesamoid bones remain constant: a systematic review". Journal of Anatomy. Wiley. 235 (1): 67–79. doi:10.1111/joa.12994
[2]. Minowa T, Murakami G, Kura H, Suzuki D, Han SH, Yamashita T, et al. Does the fabella contribute to the reinforcement of the posterolateral corner of the knee by inducing the development of associated ligaments? J Orthop Sci 2004;9:59-65.
[3]. "Sore knee? Maybe you have a fabella". BBC News. April 19, 2019.
[4]. Müller W. The Knee-form, Function and Ligament Reconstruction. New York: Springer Verlag Berlin Heidelberg; 1982. p. 40, 96, 98, 192, 249, 252.
[5]. Dannawi, Z.; Khanduja, V.; Vemulapalli, K.; Zammit, J.; El-Zebdeh, M. (January 20, 2010). "Arthroscopic Excision of the Fabella –". Journal of Knee Surgery. 20 (4): 299–301..

Abstract: INTRODUCTION:According to WHO, Pharmacovigilance is defined as the science and activities relating to the detection, assessment, understanding, and prevention of adverse effects of drugs, or any other drug-related problems.The World Health Organization (WHO) defines an adverse drug reaction (ADR) as "Any response to a drug which is noxious and unintended, and which occurs at normal doses. AIM:This study aims to assess and report the possible adverse drug reactions in the patients and to appraise the role of clinical pharmacistin pharmacovigilance at a tertiary care hospital. STUDY DESIGN:A Prospective observational study......

[1]. M. ManasaRekha*, M. Manasa , Department of Pharmacy Practice, Annamacharya college of Pharmacy, A Study On Role Of Doctor Of Pharmacy In Identification And Reporting of Adverse Drug Reactions In An Antiretroviral Therapy Ward Of A Tertiary Care Teaching Hospital. PRINT ISSN: 2394-6679 | E-ISSN: 2347.
[2]. Dr. M. Madan Mohan Rao1*, et. al., On The Role Of Clinical Pharmacist In Pharmacovigilance And Drug Safety In Tertiary Care Teaching Hospital.
[3]. Kiran roy1*, Divya s1, PratibhaNadigi, Bhanuprakash2. Monitoring and Analysis of Adverse Drug Reactions in a Private Tertiary Care Teaching Hospital.Received 14 January 2015, Revised and Accepted: 03 February 2015.
[4]. VikasDhikav*, Sindhu Singh**, KS Anand*** Adverse Drug Reaction Monitoring In India. JIACM 2004;5(1).
[5]. Indian Journal of Pharmacy Practice, Vol 10, Issue 1, Jan-Mar, 2017. Fatima Tahniyath on Clinical Pharmacist-A Need for the Study..