iosr-JDMS   Volume-14 ~ Issue-1 ~ January-2015

Abstract: Background: Urethral stricture is an acquired permanent narrowing of the urethra impeding the flow of urine during micturition.The aim of surgical reconstruction for urethral stricture is to provide an adequate caliber, compliant and stable urethra.This study provides insight into the aetiology of bulbar urethral stricture, the perioperative and operative management as well as surgical outcome Patients And Methods: Twenty six patients who had anastomotic urethroplasty from 2010 to 2014 at the Jos University teaching hospital were included in the study.Preoperative evaluation included; history, physical examination, urine analysis, urine culture, serum electrolyte, urea and creatinine, abdominopelvic ultrasonography, micturating cystourethrogram and retrograde Urethrogram and uroflow. Surgical management was via perineal incision with spinal or epidural anaesthesia as the preferred method of analgesia..

[1]. Mundy AR. Male urethra. In: Standring S, editor. Gray's Anatomy. Elsevier. 2005; 1295–8.
[2]. Fall B, Sow Y,Diallo Y, Sarr A,ZeondoC,Thiam A et al.Urethroplasty for male urethral strictures: Experience from a national teaching hospital in Senegal.African Journal of Urology. 2014; 20: 76–81.
[3]. Jackson MJ, Sciberras J, Mangera A, et al. Defining a Patient-Reported Outcome Measure for Urethral Stricture Surgery. Eur Urol 2011;60(1):60-68.
[4]. Santucci RA, Mario LA, McAninch JW. Anastomotic urethroplasty for bulbar urethral stricture: analysis of 168 patients. J Urol. 2002;167(4): 1715–1719.
[5]. Barbagli G, De Angelis M, Romano G, Lazzeri M. Long-term follow up of bulbar end-to-end anastomosis: a retrospective analysis of 153 patients in a single center experience. J Urol. 2007;178(6): 2470–2473
[6]. Santosh KS, Devendra SP, Atul KK, Jagmohan. Transperineal bulboprostatic anastomotic repair of pelvic
fracture urethral distraction defect and role of ancillary maneuver: A retrospective study in 172 patients. Urology Annals. 2010; 2(2): 53-57.
[7]. Beard DE, Goodyear WE. Urethral stricture; a pathological study. J Urol. 1948; 59(4): 619-626.

Abstract: Conscious sedation has undergone much change including the term conscious sedation which is now called as Moderate sedation to as new additions like SOAPME,requisites to be satisfied before patient is considered for sedation,documentation and more importantly monitoring techniques which include must have along with basic vital signs monitoring,the pulse oximetry,transcutaneous oximetrya.Recently more promising technology to detect apnea appears to be capnography and bispectaral analysis(BIS) for additional monitoring.A set of discharge criteria proposed by AAPD need to be met before discharging patient .It is also must to keep a functioning airway maintance apparatus which should be guided by a Anesthetist.A new method of delivering supplemental oxygen via saliva ejector rather than nasal cannula has also been tried which is less irritating to children.Regarding drugs ,most of todays work is focused on intranasal midazolam,though none of drugs used as far have proved ideal.In conclusion sedation is widely accepted and used and now considered as viable alternative to General anesthesia.

[1]. As cited in Pinkham " Pediatric dentistry, Infancy through adolescence" fourth edition, 2005,saunders,Elsevier
[2]. Guideline for monitoring and management of pediatric patients during and after sedation for diagnostic and therapeutic procedures,Pediatric dentistry reference manual vol 32;No 6;2010/11.
[3]. Gorski JC,Huang SM,Pinto A,et al.The effect of Echinacea(Echinacea purpurea root) on cytochrome P450 activity in vivo.Clin Pharmacol Ther 2004;75:89-100.
[4]. Neerja Singh et al.A comparative evaluation of oral midazolam with other sedatives as premedication in pediatric dentistry.JCPD 2002.26;2:161-164.
[5]. As cited in Mc Donald.Avery.Dean "Dentistry for the child and adolescent",8th edition,Elsevier
[6]. Malviya S et al.Depth of sedation in children undergoing computed tomography:Validity and reliability of the University of Michigan scale(UMSS).Br J Anaesth 2002;88:241-5.

Abstract: Objective: To assess the functional outcome of shoulder , time taken for return of activities of daily living, post-operative range of motion and post-operative complications after locking plate fixation of proximal humerus fracture in osteoporotic patients. Methods: All patients selected for OT underwent pre-operative bone mineral density assessment by ultrasound evaluation of os calcis & grading of osteoporosis according to Singh`s index. After proper reduction of main fracture fragments and tuberosities and meticulous repair of rotator cuff, the fractures were fixed with Locking Proximal Humerus Plate (LPHP).

[1]. Chu SP, Kelsey JL, Keegan TH, et al. Risk factors for proximal humerus fracture. Am J Epidemiol. 2004 ;160:360–367. [2]. Broadbent MR, Will E, Mcqueen MM Prediction of outcome after humeral diaphyseal fracture. Injury. 2010 Jun;41(6):572-7.
[3]. Lind T, Kroner K, Jensen J. The epidemiology of fractures of the proximal humerus. Arch Orthop Trauma Surg. 1989;108(5):285–.
[4]. Palvanen M, Kannus P, Niemi S, Parkkari J. Update in the epidemiology of proximal humeral fractures . Clin Orthop Relat Res. 2006 Jan;442:87-92.
[5]. Hertel R (2005) Fractures of the proximal humerus in osteoporotic bone. Osteoporos Int 16(Suppl 2) :S65–S72
[6]. Szyszkowitz R, Seggl W, Schleifer P, Cundy PJ (1993) Proximal humeral fractures.Management techniques and expected results. Clin Orthop Relat Res. 1993 Jul;(292):13-25.

Abstract: The magnitudes of Caesarean section (C-section) rates are on increase in many middle and high-income countries, with better outcomes. The main aim of this study was to review the complications of emergency caesarian section during and post operative period. The study showed that more than half of the patients (57.5%) had an emergency caesarian section and that most of emergency cases belonged to the age group 15-25 years (41.8%).

[1]. Asifa Ghazi, Farah Karim, Ayesha Muhammad Hussain, Tehmina Ali and Shazia Jabbar. Maternal morbidity in emergency versus elective caesarian section at tertiary hospital. J Ayub Med Coll Abbottabad 2012, 24(1):10-13.
[2]. Belizan JM, Althabe F. and Cafferata ML. Health consequences of the increasing caesarean section rates. Epidemiology 2007, 18:485-6.
[3]. Buclin BA. Hawkins JL. Anderson JR, and Ullrich FA. Obstetric anesthesia work force survey: twenty-years-update. Anesthesiology 2005, 103(3)645–53.
[4]. Datta S, Kodali BS. And Scott Segal S. Anesthesia for caesarean delivery. In: Obstetric anesthesia handbook. New York: Springer; 2005. p.172–230.
[5]. Dimitrova V, Pandeval IT sankova M,. and Pranchev N. Post-operative complications following elective and emergency caesarean delivery. Akush Ginekol (Sofila). 2005, 44(7): 15-21.
[6]. Lulu Al Nuaim,Mohammed H. Soltan, Tariq Khashoggi, Mohammed Addar, Noori Chowdhury and Babatunde Adelusi, Outcome in elective and emergency caesarian sections: A comparative study. Ann Saudi Med 1996, 16(6):645-649.
[7]. Mehnaz Raees, Sumaira Yasmeen, Sadaqat Jabeen, Naeema Utman and Rukhsana Karim. Materna morbidity associated with emergency versus elective caesarian section. J Postgrad Med Inst; 2007, 27(1): 55-62.

Abstract: The awareness regarding the women's health has increased nowadays. A study was conducted in helping hand society BHEL to assess the oral conditions of widow women who worked there to earn their livelihood. All the subjects present on the day of examination were included in the study (100). Subjects were assessed for stress with the help of a scale ie perceived stress scale. The results indicated high stress in most of the subjects. subjects were found to have attrition (95%). Tmj disorder n oral mucosal lesions were found to be statistically significant. Other disorders found were psoriasis and lichen planus.

[1]. maryann redfoed Beyond pregnancy gingivitis : bringing a new focus to women's oral health. Journol of dental education vol 57, no 10,1993 [2]. Holmes & Rahe, 1967; George, 1980;Dube,1983; [3]. Manju Mehta, Usha Kulsshrestha, Rashmi Chowdhry: effect of widowhood on repression- sensitization tendency. Jounol of Indian academy of applied psychology: 2006, vol.32,221-225) [4]. Black Report (1, 2), [5]. DCNA).
[6]. Cohen S, KamarckT, Mermelstein R. A global measure of perceived stress. J Health Social Behavior1983:24;385-396..
[7]. westrup DA ,Keller SR,Nellis TA,et al: arousability and bruxism in male and female college students. Percept Mot Skills75:796-798,1992.

Abstract: Malaria has remained a global burden for many centuries and has resisted all efforts to eliminate or reduce the scourge particularly in the tropics. Asymptomatic malaria is a clinical condition where parasitaemia does not elicit any known diagnostic symptoms in an apparently normal person. One hundred male and female students of Imo State University Owerri who were apparently healthy were randomly recruited for the study ethical/approval was given by the Imo State University Student Affairs Department. Thick and thin films were used for parasite detection and examination of blood cells morphology respectively. Some haematological and biochemical profiles of the test subjects were determined using standard routine methods to furnish some data on their metabolic status. The mean result showed that 54% of the student population studied had malaria parasites. When the haematological and biochemical parameters were compared in malaria-positives and malaria-negatives no statistical differences were found (p>0.05). The results suggest that absence of clinical symptoms may not exclude malaria parasitaemia. This may constitute a limitation for researches that require apparently healthy persons as controls. In addition, the results tend to support post transfusion prophylaxis as a back-up.

Keywords: Asymptomatic, malaria parasitaemia, Nigeria.

1]. Yusuph, H., Bakki, B., Gashaw, W., (2005) Malaria: How much do our people know? Nigerian Biomedical Science Journal, 1:1.4-7.
[2]. Uko, E.K, Useh, M.F, Ekere, E.F (1996) The impact of Asymptomatic malaria and its influence on some haematological parameters in Calabar. Journal of Medical Laboratory Science, 5: 17-20.
[3]. Bard, J.K, Masbar, S., Bassi, H., Trtokusumo, S., Subianto, B., Hoffinan, S.L., (1998). Age-dependent susceptibility to severe disease with primary response to plasmodium falciparum. Journal of Infectious Diseases. 178: 592-595.
[4]. Usanga, E.A, Luzzatto, L., (1985) Adaptation of plasmodium falciparum to glucose 6-phosphate dehydrogenase-deficient host red cells by production of parasitic encoded enzyme. Nature 313: 793-795.
[5]. Gyan, B.A, Goka, B., Cvetkovic, J.T., Kurtzhals, J.L. Adebayeri, pentmann H., Lefvert, A.K, Akamov, BD., Troye-Blooberg, M., (2004) Allelic polymorphism in the respect and promoter regions of the interleukin-4 gene and malaria severity in Ghananian children. Clinical experimental immunology, 138: 145-150.
[6]. Nwanjo, H.U., (2004) Functional test of organs. Kolley Publishers, 56 – 58

Abstract: multiple pregnancy is considered to be a teratogenic event and has shown increase in incidence over last decades. It is associated with high maternal morbidty, perinatal morbidity and mortality. This study is undertaken to evaluate the outcome of twin pregnancy in our hospital. Methods: this is a retrospective study conduted at mandya institute of medical sciences in the department of obstetrics and gynaecology between Jul 2012 to Jun 2014. Results: most common age group was between 20- 30 years, maternal complications like preterm labour, anaemia and PIH are common,preterm babies and low birth weight are most common pernatal morbidity encountered.most common presentation was cephalic-cephalic.low Apgar score was more common with second twin..

[1]. Smits J, Monden C (2011) Twinning across the Developing World. Plos One 6:e25239. doi:10.1371/journal.pone.0025239.
[2]. Sumathipala A, Siribaddana S, De Silva N, Fernando D, Abeysingha N, et al.(2002) Sri Lankan twin registry. Twin Res 5: 424–426.
[3]. Aisien A, Olarewaju R (2000) Twins in Jos Nigeria: a seven-year retrospectivestudy. Med Sci Monit 6: 945–50.
[4]. Obiechina N, Okolie V, Eleje G (2011) Twin versus singleton pregnancies: theincidence, pregnancy complications, and obstetric outcomes in a Nigerian tertiary hospital. Int J Womens Health: 227–230.
[5]. Sultane H .Fetal and maternal outcome of twin pregnancy . a study of 50 cases .Bangladesh college Physician and Surgeond ,Dhaka 2002
[6]. Spellacy W N , Handler A , Ferre C D . a case control study of 1253 twin pregnancies from 1982 to 1987. Perinatal data base 1990;75 :198-201.

Abstract: Gossypiboma or textiloma is a mass of cotton matrix retained in a body cavity following a surgical procedure. Gossypiboma are more frequently diagnosed in the abdominal cavity following emergency surgeries especially involving gynaecological and obstetric procedures and damage control surgeries. It may manifest as an abscess, fistulae, obstruction or aseptic fibrotic reaction developing into a mass but the spontaneous intraluminal migration of retained surgical sponge into the lumen of GIT is considered a rare phenomenon. We are reporting a rare case of spontaneous migration of surgical sponge into the lumen of jejunum in a 31-year-old female, following caesarean section one year ago. Clinical examination revealed a palpable mass in the umbilical region. CT Scan revealed a GIST in the jejunal wall. On exploratory laparotomy a mass was seen arising from the jejunum along with proximal ileum involving the left ovary and fallopian tubes. Mass was excised in toto with left oophorectomy and jejunoileal anastomosis. A 30 × 30cm surgical mop was removed from the jejunal lumen.

Keywords: Gossypiboma , Intraluminal migration , Retained surgical sponge .

[1]. Lata I, Kapoor D, Sahu S. Gossypiboma, a rare cause of acute abdomen: A case report and review of literature. Int J Crit Illn Inj Sci [Internet]. 2011;1:157–60. Available from: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=3249850&tool=pmcentrez&rendertype=abstract
[2]. Silva CS, Caetano MR, Silva EAW, Falco L, Murta EFC. Complete migration of retained surgical sponge into ileum without sign of open intestinal wall. Arch Gynecol Obstet. 2001;265:103–4.
[3]. Alper Sozutek, Serdar Yormaz HK and BS. Transgastric migration of gossypiboma remedied with endoscopic removal: a case report. BioMed Cent. 2013;
[4]. Düx M, Ganten M, Lubienski A, Grenacher L. Retained surgical sponge with migration into the duodenum and persistent duodenal fistula. Eur Radiol. 2002;12.
[5]. Haddad R, Judice LF, Chibante A, Ferraz D. Migration of surgical sponge retained at mediastinoscopy into the trachea. Interact Cardiovasc Thorac Surg. 2004;3:637–40.

Abstract: In Fracture around knee joint internal fixation with plate and screw remain gold standard. biological methods of reduction involving use of indirect reduction techniques and new plate designs have been developed so as to preserve the blood supply of injured bone, increase the rate of fracture healing, thus decreasing the need for bone grafting, and incidence of infections and complications. MIPO appear to be next step in evolution of biological plating. MIPO is new technique where indirect reduction is achieved. biological plating whether done with locking or non-locking plates offers better results than conventional plating due to less soft tissue dissection, less periosteal stripping and preservation of fracture haematoma.

[1]. Rock wood and greens fractures in adults, seventh edition., Campbells operative orthopaedics, Terry canale, eleventh edition.
[2]. Hohl M. Part I : fractures of the proximal tibia and fibula. In : Rockwood C, Green D, Bucholz R, eds. Fractures in adults, 3rd ed. Philadelphia : JB Lippincott, 1991 : 1725-1761.
[3]. Thomas A. Russell, An Historical Perspective of the Development of Plate and Screw Fixation and Minimally Invasive Fracture Surgery With a Unified Biological Approach, Techniques in Orthopaedics® 22(3):186–190 © 2007 Lippincott Williams & Wilkins, Inc
[4]. Surgical approaches in orthopaedics, Stanley hoppenfeild, 3rd edition. [5]. Chang-Wug Oh, Jong-Keon Oh, Hee-Soo Kyung, In-Ho Jeon1, Byung-Chul Park, Woo-Kie Min1 and Poong-Taek Kim, Double plating of unstable proximal tibial fractures using minimally invasive percutaneous osteosynthesis technique, Acta Orthopaedica 2006; 77 (3): 524–530. [6]. Krettek C, Gerkfa T, Miclau T. A minimally invasive medial approach for proximal tibial fractures. Injury. 2001 May; 32 Suppl 1:SA4-13.

Abstract:Objective: To study the Management of the patients presenting with Epistaxis. Methods: An observational study was conducted among randomly selected 200 patients presented with epistaxis to a tertiary care hospital in south India. After the initial resuscitation of patients ,they are investigated to identify the etiology and grouped according to further management. Results: Age and sex distributions among various etiologies of Epistaxis was studied and was found to be more common in males when compared to females ( male : female = 2.7 : 1).Epistaxis is seen in all age groups more so in the adolescents and young adults .Most common cause is Trauma(37%), next common is Idiopathic(29.5%).Hypertension was the most common systemic cause for epistaxis , followed by Bleeding diathesis .Most (71%) of the cases are managed conservatively, next common intervension is Anterior nasal packing.

[[1]. Osborn A. The nasal arteries. AJR1978;130:89-97[Abstract]
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[5]. Gerald W McGarry , Scott-Brown's Otorhinolaryngology, Head and Neck Surgery , 7th Edition,VOL.2-A; Part 13,126; 1596 1599 ,1603 -1604.
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Abstract:Aim: Correlate and analyze the sagittal condylar guidance obtained by protrusive interocclusal records by extraoral Gothic arch tracing and panoramic radiograph tracing in edentulous subjects. Methodology: Sagittal condylar guidance was determined in 10 edentulous subjects by protrusive interocclusal records using Gothic arch tracing transferred to HanauTM Wide-Vue articulator(Whip Mix Corporation) after facebow transfer (HANAU™ Spring Bow, Whip Mix Corporation,). Angle of sagittal condylar guidance was determined in panoramic radiographs by joining the height of curvature of the glenoid fossa and articular eminence which was then be related to constructed Frankfurt's horizontal plane.

[1]. Rothstein JR. Condylar guidance setting on articulators from protrusive records. J Prosthet Dent. 1972;28:334–5

[2]. Shreshta P et al A comparative study to measure the condylar guidance by the radiographic and clinical methods J Adv Prosthodont 2012;4:153-7

[3]. Dos Santos Ju′nior J, Nelson SJ, Nummikoski P. Geometric analysis of occlusal plane orientation using simulated ear-rod facebow transfer. J Prosthodont 1996; 5:172-81.

[4]. Christensen LV, Slabbert JC. The concept of the sagittal condylar guidance: biological fact or fallacy? J Oral Rehabil 1978; 5:1-7.

[5]. Krishna D. Prasad, Namrata Shah and Chethan Hegde Contemp Clin Dent. 2012 Oct-Dec; 3(4): 383–387

[6]. El-Gheriani AS, Winstanley RB. Graphic tracings of condylar paths and measurements of condylar angles. J Prosthet Dent 1989 ;61:77-87

Abstract:Background: Malocclusion is considered to be a Dental public health problem. It is the second most common dental disorder in children and young adults next to dental caries. The major benefits of orthodontic treatment include improvement of physical function, prevention of tissue damage, and correction of aesthetic components. Aim & Objectives: The aim of the study was to determine the prevalence of malocclusion and orthodontic treatment needs among 12-15 year old school children according to Dental Aesthetic Index in Muradnagar, Uttar Pradesh.

[1]. Nagarjun S, Krishnappa P. The Relationship of malocclusion as assessed by the Dental Aesthetic Index (DAI) with perceptions of aesthetics, function, speech and treatment needs among 14-15 year old school children of Bangalore, India. Oral Health Prev Dent 2010; 8: 221 -228.
[2]. Angle EH. Classification of malocclusion. Dent Cosmos 1988;41: 248-264.
[3]. Pankaj S. Prevalence of malocclusion and orthodontic treatment needs among 12-15 years school children using dental aesthetic index (DAI); J Ind Assoc Public Hlth Dent 2010; 15: 81-84.
[4]. Naveen KB, Mohapatra A, Ramesh N, Ravishankar Tl. Prevalence Of Malocclusion And Orthodontic Treatment Need Among 12-15 Years Old School Children In Davangere, Karnataka, India. Pakistan Oral and Dental Journal 2010;1: 181-185.
[5]. Shivakumar KM, Chandu GN, Subha Reddy VV, Shafiulla MD. Severity of malocclusion and orthodontic treatment needs among 12 to 15 Year Old School Children of Davangere District, Karnataka, India. Eur J Dent 2010 ; 4(3): 298–307.
[6]. Otuyemi OD, Kolawole KA. Perception of Orthodontic Treatment need: Opinion comparisons of patients, parent and orthodontists. African journal of oral health 2005; 2 (1,2): 42-52.

Abstract:Aim: To determine bite force of complete denture against tooth supported overdenture Objective: To measure bite force of complete denture opposing tooth supported overdenture using gnathodynamometer at right maxillary first molar region . Methodology: Five patients were selected on the basis of possession of a maxillary complete denture opposed by tooth supported mandibular overdenture and on the ability to provide a relatively consistent bite force. Bite force data were obtained by use of a specially constructed gnathodynamometer composed of a bite element connected to a digital display.Selected patients were seated on a dental chair with head unsupported and positioned so that the Frankfort horizontal plane would be parallel to the floor. The fork was placed parallel to the arch so that biting end was positioned in the right maxillary first molar region and three consecutive reading were taken.

[1]. Sarabjeet Singh ,Ashok Utreja,Navreet.An Innovative Miniature Bite Force Recorder. IJCPD May –August 2011;4(2):113-118
[2]. Farhan Khalid,Ashraf Gebreel.Comparison Of Immediate Complete Denture ,Tooth And Implant Supported Overdenture On Vertical Dimension And Muscle Activity. Journal Of Advanced Prosthodontics May 2012 .
[3]. Van Waas .The Influence Of Psychologic Factors On Patient Satisfication With Complete Dentures. J Prosthet Dent .1990;63: 545-548.
[4]. Schwartz IS,Morrow .Overdentures .Principles And Procedures .Dent Clin North Am.1996;40:169-194.

Abstract:Septoplasty for the surgical correction of the nasal septum is one of the most common rhinology procedures. This operation can be done under both general anaesthesia and local anaesthesia with sedation. Dexmedetomidine is said to have both analgesic and sedative properties. The aim of this study is to compare the results of monitored local anaesthesia with dexmedetomidine with general anaesthesia in patients undergoing septoplasty to find out the better efficacious anaesthesia for this surgery. 40 patients planned for septoplasty were taken up for this study. 20 patients were operated under general anaesthesia and remaining 20 patients were operated under monitored local anaesthesia with dexmedetomidine.

[1]. FG, Ferraro RE, Kingsley CP, Fornadley JA. Operative times, postanesthesia recovery times, and complications during sinonasal surgery using general anesthesia and local anesthesia with sedation. Otolaryngol Head Neck Surg 2000; 122:560–566.
[2]. Fedok Eichel R, Goldberg I. Anaesthesia techniques for cataract surgery: a survey of delegates to the Congress of the International Council of Ophthalmology 2002. Clin Experiment Ophthalmol 2005; 33: 469-72.
[3]. Salmon JF, Mets B, James MF, Murray AD. Intravenous sedation for ocular surgery under local anaesthesia. Br J Ophthalmol 1992; 76: 598-601.
[4]. Hall JE, Uhrich TD, Barney JA, Arain SR, Ebert TJ. Sedative, amnestic and analgesic properties of small dose dexmedetomidine infusions. Anesth Analg 2000; 90: 699 – 705.
[5]. Fedok FG, Ferraro RE, Kingsley CP, Fornadley JA. Operative times, postanesthesia recovery times, and complications during sinonasal surgery using general anesthesia and local anesthesia with sedation. Otolaryngol Head Neck Surg 2000; 122: 560-566.