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

Abstract: Abstract: Background: Spontaneous pneumothorax (SP) is one of the common acute chest problems encountered in day to day clinical practice. Clinico-epidemiological profile of SP is less well studied in Indian scenario. Objective: to describe sociodemographic correates of pneumothorax, to study the clinical profile and medical causes of SP. Method And Materials: a cross sectional descriptive study involving seventy six SP patients treated in in-patient-department of Pulmonary and General Medicine of Bankura Sammilani Medical College & Hospital, West Bengal, India during January 2011 to December 2013 was carried out. Information pertaining to socio-demographics, previous morbidity etc. was gathered by interview using a predesigned and pretested questionnaire. Cinical features of the present morbidity (SP) and its medical causes were established by clinical examination including anthropometry as well as relevant laboratory investigations. Data regarding the treatment modality and the final outcome were also collected.

[1]. Laennec RTH. Traite de l‟auscultationmediate et des maladies des poumons et du coeur. Tome Second. Paris, 1819.
[2]. Schramel FM, Postmus PE, Vanderschueren RG. Current aspects of spontaneous pneumothorax. Eur Respir J. 1997; 10(6):1372–9.
[3]. Sahn SA, Heffner JE. Spontaneous pneumothorax. N Engl J Med. 2000; 342(12):868–74.
[4]. Chambers A, Scarci M. In patients with first-episode primary spontaneous pneumothorax is video-assisted thoracoscopic surgery superior to tube thoracostomy alone in terms of time to resolution of pneumothorax and incidence of recurrence? Interact Cardiovasc Thorac Surg. 2009; 9(6):1003–8. doi: 10.1510/icvts.2009.216473.
[5]. Chen JS, Hsu HH, Kuo SW, Tsai PR, Chen RJ, Lee JM, et al. Effects of additional minocycline pleurodesis after thoracoscopic procedures for primary spontaneous pneumothorax. Chest. 2004; 125(1):50–5. doi: 10.1378/chest.125.1.50.
[6]. Chen JS, Hsu HH, Chen RJ, Kuo SW, Huang PM, Tsai PR etal. Additional minocycline pleurodesis after thoracoscopic surgery for primary spontaneous pneumothorax. Am J Respir Crit Care Med. 2006; 173(5):548–54. doi: 10.1164/rccm.200509-1414OC.

Abstract: It is stated that the acute phase protein levels increased during the inflammatory reactions such as trauma ,aseptic necrosis and infections. Present study is to study the levels of acute phase protein synthesis in the liver disorders like cirrhosis of liver and infective hepatitis. Materials And Methods: 50 cases of liver disorders and 10 normal individuals were chosen for the present study. Determination of serum ceruloplasmin, transferrin, A/G ratio, serum total bilirubin, alanine amino transferase, alkaline phosphatase, HDL cholesterol, total cholesterol is done.

[1]. Am.Assoc.Clin.Chem.1(9); 1-8; 1984 Nagashima.M. and Schreiber.G. Changes in specific proteins during acute inflammation.
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Abstract: The bursa is a fluid filled sac which spans the area of friction between tendon and skin , and between tendon and bone. The bursae are usually not seen, not felt on clinical examination unless there is more amount of fluid collection, inflammatory collection which make them visible and palpable with local signs of inflammation. Some burse communicate with a joint and contain the fluid collected in the joint space for various responses coming in from the joint. We report a case of a cystic swelling over the antero inferior aspect of the knee joint which developed with an insidious course in a patient having an acquired varus deformity of the knee joint. The cystic swelling was communicating with the knee joint, in which the patient has painful limitation of movements, joint line tenderness and varus deformity. Deep and superficial infra patellar bursae are prone for showing a variety inflammatory and traumatic responses in a variety of conditions. In this case the cystic swelling has occurred due to degenerative changes in the joint with which it is communicating.

Keywords: Deep infra patellar cyst, knee joint, osteoarthritis, varus deformity

1]. Bevers K, Zweers MC, van den Ende CH, Martens HA, Mahler E, Bijlsma JW, Wakefield RJ, van den Hoogen FH, den Broeder AA. Ultrasonographic analysis in knee osteoarthritis: evaluation of inter-observer reliability.Clin Exp Rheumatol. 2012 Sep-Oct;30(5):673-8. Epub 2012 Oct 17.

[2]. Hoffmann R, Brunner U.Imitation of acute, deep venous thrombosis of the lower leg by a ruptured Baker's cyst. Vasa. 1989;18(1):74-7.

[3]. Bevers K, Bijlsma JW, Vriezekolk JE, van den Ende CH, den Broeder AA. Ultrasonographic features in symptomatic osteoarthritis of the knee and relation with pain. Rheumatology (Oxford). 2014 Sep;53(9):1625-9. doi: 10.1093/rheumatology/keu030. Epub 2014 Apr [4]. Leth S, Jensen-Fangel S. Infrapatellar bursitis with Mycobacterium malmoense related to immune reconstitution inflammatory syndrome in an HIV-positive patient.BMJ Case Rep. 2012 Nov 27;2012. pii: bcr2012007459. doi: 10.1136/bcr-2012-007459.

[5]. Iagnocco A1, Vavala C, Scirocco C, Rutigliano IM, Gattamelata A, Valesini G. Unilateral painful, swollen and erythematosus knee. Case report.Med Ultrason. 2012 Sep;14(3):251-3.

[6]. Le Manac'h AP1, Ha C, Descatha A, Imbernon E, Roquelaure Y. Prevalence of knee bursitis in the workforce. Occup Med (Lond). 2012 Dec;62(8):658-60. doi: 10.1093/occmed/kqs113. Epub 2012 Jul 9.

Abstract: Background: Allergic Rhinitis(A.R.) is an Ig E mediated hypersensitivity disease of the mucous membranes of the nasal airways characterized by Sneezing, Itching, watery nasal discharge, nasal congestion, sensation of nasal obstruction for > 1 hr on most days either seasonally or throughout the year. Drugs used for this condition are oral antihistamines, topical corticosteroids, oral corticosteroids, topical anticholinergics and immunotherapy (Desensitization). Aim/Objective: To compare the efficacy of Fluticasone Nasal Steroidal Spray(F.N.S.S.) and Oral Levocetrizine in Allergic Rhinitis Patients. Materials & Methods: 60 Patients with A.R. received Fluticasone NSS and 60 patients (Group B) received oral Levocetrizine for 15 days.

[1]. Baroody (FM-Cheng CC. moyla). Arch otolaryangol head neck surg. 2001, Feb; 193-9 absence of nasal mucosal atrophy and increased mucosal thickness with fluiticasone aqueous nasal spray.
[2]. Bennet P.N. Brown M.J. Laurence, clinical pharmacology, 9th edition, Respiratory System, Chapter 27, P.554. Histamine H1 and H2 – Receptor Antagonists.
[3]. Bernard P. Schimmer and Keith L. Parket. Adrenocorticotophic hormone; Adrenocortical Steroids of their synthetic Analogues. Chapter 59 Goodman and Gillman's the pharmacological basis of therapeutics 11th edition 2006, page no.1587 to 1610.
[4]. Bertram G. Katzung M.D., Ph.D Histamine, Serotonin and the Ergot Alkaloids section IV Chapter 16. Basic & Clinical pharmacology, 9th edition, 2004 P-263-268.
[5]. C. Hablet E.R. Chievers P.A. Corris. Diseases of the nasopharynx, Davidson's principles and practice of medicine year 2002, page 566.
[6]. Craig TH. Allergy Asthma Proc. 2003 Jan-Feb; 24(1) :53-8. The effect of topical nasal fluticasone on objective sleep testing and the symptoms of rhinitis, sleep and day time somnolence in perennial allergic rhinitis.

Abstract: Pain is an inevitable consequence of any operation and proper attention to the source of pain and its control is needed. The problem of inadequate postoperative pain relief has been recognized for many years and has been the subject of considerable research. In the present research we attempted to study the effect of subdiaphragmatic and Gall Bladder bed administration of bupivacaine on post operative pain and post operative pulmonary Functions in laparoscopic cholecystectomy.

[1]. De U. Evolution of cholecystectomy: A tribute to Carl August Langnbuch. Indian J Surg 2004, 66:97-100.
[2]. Soper NJ, Stockmann PT, Dunnegan DL, Ashley SW. Laparoscopic cholecystectomy The New 'Gold Standard'? Arch Surg 1992;127:917-923.
[3]. Rezaiguia S, Jayr C. Prevention of respiratory complications after abdominal surgery. Ann Fr Anesth Reanim 1996;15:623-46.
[4]. Gharaibeh KI, Al-Jaberi TM. Bupivacaine instillation into gall bladder bed after laparoscopic cholecystectomy: Does it decrease shoulder pain? J Laparoendosc Adv Sug Tech A 2000;10:137-141.
[5]. Alptekin H, Sahin M. Gallbladder bed irrigation with bupivacaine improves pulmonary functions after laparoscopic cholecystectomy. Arch Surg 2010;395:501-4.
[6]. Weber A, Munoz J, Garteiz D, Cueto J. Use of subdiaphragmatic bupivacaine instillation to control postoperative pain after laparoscopic surgery. Surg Laparosc Endosc 1997;7:6-8.
[7]. Selvi T, Sinha P, Subramaniam PM, Konapur P. A clinicopathological study of cholecystitis with special reference to analysis of cholelithiasis. international. Journal of Basic Medical science. 2011;2:5-14.

Abstract:Enteric fever (Typhoid fever) is an acute systemic disease resulting from infection with Salmonella typhi. The peak incidence of disease is between the age of 15 and 35 years. Currently the III generation Cephalosporins like Ceftriaxone and Cefotaxime are being used in multi drug resistant typhoid fever. These drugs are bactericidal and are very effective. A second generation Cephalosporins, Cefuroxime is also active against Salmonella typhi. The aim of the present study is to compare the efficacy of Cefuroxime and Ceftriaxone in treatment of typhoid fever. Patients who attended the department of Medicine with fever were selected as per the exclusion and inclusion criteria. They were divided into two groups. 25 patients were treated with ceftriaxone under Group – I and another 25 patients were treated with cefuroxime under

[1]. Arupkumar Kundu, Drug – resistant Salmonellosis; Journal of the Indian Medical Association, (June) 2005 vol.103 p. 327.
[2]. Chitnis V, Chitnis D, Vermas, Hem Vani N – Multi drug resistant salmonella Typhi in India Lancet 1999; 354 : 514-5.
[3]. Dr. Pradip. J. Mehta, M.D., F.I.C.P. (USA), FISE, FICN, Practical Medicine, 11th edition, 1995, p. 29-30.
[4]. Edward. W. Hook Richard L. Gurrant, Salmonella infection, Harrison's Principles of Internal Medicine, 9th edition – 1980, p. 642.
[5]. Gerald T. Keush – Salmonellosis, Harrison's Principles of Internal Medicine, 14th edition, 1998 p.952.
[6]. Gerald, T. Keush – Salmonellosis, Harrison's Principles of Internal Medicine 14th edn. 1998- p. 950.
[7]. Henry F. Chambers; Antimicrobial Agents; Good Man and Gillmans, the pharmacological basis of therapeutics 10th edition, 2001, p.1249.

Abstract: Testicular tumors are rare and Intra-abdominal testicular tumors in an undescended testis constitute 10% of all testicular tumors.The rupture of an intra-abdominal testicular tumor presenting as abdominal pain is an even rarer event . We report a case of a 49 year old male presenting with bilateral direct inguinal hernia with abdominal pain caused due to rupture of an intra-abdominal seminoma in an undescended testis.

Keywords: Intra-abdominal testicular tumor, seminoma, spontaneous rupture, undescended testis.

[1]. Spontaneous rupture of an intra abdominal seminoma is a very rare finding in a cryptorchid testicular tumor with only two cases reported in literature
[2]. Watkins GL: haemoperitoneum resulting from rupture of seminoma in an undescended testicle. J Urol; 1970; 103: 447-448.
[3]. Kücük HF, Dalkilic G, Kuroglu E, Altuntas M, Barisik NO, Gülmen M: Massive bleeding caused by rupture of intra-abdominal testicular seminoma: case report. J Trauma; 2002; 52:1000-1001.}

Abstract: AIDS (acquired immunodeficiency syndrome) is one of the most destructive pandemics in the history of medicine with 6800 people infected afresh with HIV virus and more than 5700 deaths everyday across the globe. In India 2.39 million people are suffering with HIV/AIDS . Death rate is dropping down due to the availability of treatment freely in ART centres under NACO. The HIV/AIDS patients are treated with combination of 3 antiretroviral drugs as one regimen in all ART centres. The two regimens commonly used in ART centres are ZIDOVUDINE +LAMIVUDINE +NEVIRAPINE (Category A) and STAVUDINE+LAMIVUDINE+NEVIRAPINE (Category B). Though these drugs have been decreasing death rate, they have many side effects. So we studied and compared the side effects of two regimens. We have enrolled 650 patients visiting ART centres at Siddhartha medical college,Vijayawada and Guntur medical college,Guntur from october 2006 to march 2008. The results showed category A has less side effects than category B. Keywords: AIDS, ART centre, HIV, NACO

[1]. Anthony S. Fauci, H. Engene Brauwald, Dennis L.Kasper, Stephen L, Hanser, Dan.L.Longo, J.Lammy Jamson, Joseph Loscalzo, H.Chifford lane. AHuman Immuno deficiency virus disease : AIDS and Related Disorders@ B Harrisons Principles of Internal Medicine, 17th ed. chapter 182, Vol.I, P. 1137-1203.
[2]. K.park ,@Epidemiology of communicable diseases-AIDS@ Park's text book of preventive and social medicine- chapter-5,17th ed.,p.259-267.
[3]. National AIDS control organization>HIV Data page 1/1 Available from URL http://www.nacoonline.org/quick-links/HIV-data/
[4]. Anthony S.Fauci, H.Clifford lane, Human immunodeficiency virus disease, epidemiology: HIV infection and AIDS worldwide: Harrison's Principles of Internal Medicine 17th ed. P.1146
[5]. National AIDS control Organisation>HIV fact sheets based on HIV sentinal surveillance data in India 2003-2006 pages 13-16/106 Avaialable from URL: http://www.nacoonline.org/upload/NACO/20pdf/HIV_fact sheets_2006.pdf

Abstract:Introduction: Small intestine intussusception in adults is a rare clinical event and should arouse a suspicion of genetic syndromes like Peutz Jeghers syndrome. Case Report: We present a 28 year old man with recurrent episodes of pain abdomen with oral hyper pigmented patches. He was diagnosed to have multiple small intestine polyps with intussusception. He underwent an explorative laparotomy and resection of the involved jejunal segment due to impaired vascularity. Conclusion: Peutz Jeghers syndrome is a rare cause of small intestine polyps and intussusception and obstruction especially in young adults.
Keywords: Peutz Jeghers syndrome, Intussusception.

[1]. James, William; Berger, Timothy; Elston, Dirk (2005). Andrews' Diseases of the Skin: Clinical Dermatology (10th ed.). Saunders. p. 857. ISBN 0-7216-2921-0.
[2]. P.N. Sreeramulu, Vijay P. Agrawal. A rare case of multiple intussusceptions in Peutz–Jeghers syndrome. J Med Allied Sci 2013; 3(1).
[3]. M. Pitiakoudis, K. Mimidis, A. Tsaroucha, G. Kartalis et al. intussusception of the small bowel due to Peutz-Jeghers syndrome. Ann. Ita.Chir. LXXV 1, 2004.
[4]. Schreibman IR, Baker M, Amos C, McGarrityTJ. The hamartomatous polyposis syndromes: a clinical and molecular review. Am J Gastroenterol 2005; 100(2):476-490.
[5]. Swati B. Parikh, Biren J. Parikh, Hitesh A. Prajapati, C.K. Shah, N.R. Shah. Peutz-Jeghers syndrome- A Case Report. Gujarat Medical Journal / December - 2013 Vol. 68 No. 2.
[6]. Marcela Kopacova, Ilja Tacheci, Stanislav Rejchrt, Jan Bures. Peutz-Jeghers syndrome: Diagnostic and therapeutic approach. World J Gastroenterol 2009 November 21; 15(43): 5397-5408.

Abstract: Periapical disease caused by the colonization of microrganisms in the root canal system. Microbiology implicated in endodontic disease is diverse and varied. Mircobial testing of periapical lesions can be traced back to 1890. The changes in balance of the microbiota along with other factors host resistance and viral infection can also affect the periapical disease. The various microbiology involved in periapical disease is reviewed in this article.More research needs to conducted on the bacteria involved and their interactions in order to improve the diagnosis and treatment of periapical lesions.

[1]. Love RM, Jenkinson HF. Invasion of Dentinal Tubules by Oral Bacteria. Critical Reviews in Oral Biology & Medicine 2002;13(2):171-83.
[2]. Kakehashi S, Stanley H, Fitzgerald R. The effects of surgical exposures of dental pulps in germ-free and conventional laboratory rats. Oral Surgery, Oral Medicine, Oral Pathology 1965;20(3):340-49.
[3]. MÖLLER JR Å, FABRICIUS L, DAHLÉN G, ÖHMAN ALFE, Heyden G. Influence on periapical tissues of indigenous oral bacteria and necrotic pulp tissue in monkeys. European Journal of Oral Sciences 1981;89(6):475-84.
[4]. Fouad AF. Endodontic Microbiology: John Wiley & Sons, 2009.
[5]. Nagaoka S, Miyazaki Y, Liu HJ, Iwamoto Y, Kitano M, Kawagoe M. Bacterial invasion into dentinal tubules of human vital and nonvital teeth. Journal of Endodontics 1995;21(2):70-73.
[6]. Torabinejad M WR. Principles and Practice of Endodontic. Philadelphia: W.B Saunders, 2002.

Abstract: Haemangioma is the most common benign tumor affecting the liver and are entirely benign. Hepatic haemangiomas are mesenchymal in origin and usually are solitary. Haemangiomas present a diagnostic challenge because they can be mistaken for hypervascular malignancies of the liver and can coexist with other benign and malignant hepatic lesions, including focal nodular hyperplasia, hepatic adenoma, hepatic cysts, hemangioendothelioma, hepatic angiosarcoma, hepatic metastasis, and primary hepatocellular carcinoma. Hepatic haemangiomas can occur as part of well-defined clinical syndromes. In this condition, patients are typically male and younger than 1 year. The goal of treatment is eradication of the haemangioma, with subsequent control over the patient's coagulopathy. Treatment is unnecessary unless their expansion causes symptoms. In cases of giant hepatic haemangiomas suspected on radiological investigation, intervention is necessary since clinical symptoms due to rapid growth are present or may cause complications. We report a case of 36 year old female presenting with the lump abdomen and she underwent exploratory laparotomy and histopathology confirm the diagnosis of cavernous haemangioma of liver and tuberculosis of ascending colon.

Keywords: Colon, Haemangioma, Liver, Tuberculosis

[1]. Ishak KG, Goodman ZD, Stocker JT, eds. Tumors of the Liver and Intrahepatic Bile Ducts. Washington, DC: Armed Forces Institute of Pathology, 2001.
[2]. Choi BY, Nguyen MH. The diagnosis and management of benign hepatic tumors. J Clin Gastroenterol 2005;39(5):401-412.
[3]. Trotter JF, Everson GT. Benign focal lesions of the liver. Clin Liver Dis 2001;5(1):17-42, v.
[4]. Tsai HP, Jeng LB, Lee WC, et al. Clinical experience of hepatic haemangioma undergoing hepatic resection. Dig Dis Sci 2003;48(5):916-920.
[5]. Takahashi T, Katoh H, Dohke M, et al. A giant hepatic haemangioma with secondary portal hypertension: a case report of successful surgical treatment. Hepatogastroenterology 1997; 44(16):1212-1214.
[6]. Watzke HH, Linkesch W, Hay U. Giant haemangioma of the liver (Kasabach-Merritt syndrome): successful suppression of intravascular coagulation permitting surgical removal. J Clin Gastroenterol 1989;11(3):347-350.

Abstract: Aim: The objective of this present article is to prove the cytotoxicity of methyl methacrylate (MMA) released from chairside fabricated provisional restorations, which may cause mucosal and oral pathologies, and to assess the histological variations related to this substance. Case presentation: This article reports a case of a 52 year-old woman who experienced symptoms of allergic reactions which appeared few days after the placement of provisional restorations. The indicated patch testing identified the MMA as allergen in this case. The provisionals were removed and aluminum shells and polycarbonate prostheses were performed. After healing, our patient underwent a crown lengthening for retention requirements, the saved fragment had been utilized for a histological analysis. Discussion: The hypersensitivity to MMA expected in this case was confirmed by patch testing. On the other hand, the need of crown lengthening allowed a histological investigation for which showed a widely ulcerated epithelium with a granulation tissue.

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[2] Gawkrodger D. Investigation of reactions to dental materials. British Journal of Dermatology. 2005;153:479-85.
[3] Ivković N, Božović D, Ristić S, Mirjanić V, Janković O. THE RESIDUAL MONOMER IN DENTAL ACRYLIC RESIN AND ITS ADVERSE EFFECTS. Contemporary Materials. 2013;1:84-91.
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[6] Davy KW, Braden M. Residual monomer in acrylic polymers. Biomaterials. 1991;12:540-4.

Abstract:Lytic lesions of the calvarium in pediatric age group have a wide range of different
etiologies, ranging from normal variants to congenital, traumatic, inflammatory and neoplastic lesions,They manifest as palpable masses, with or without associated pain. Imaging approach frequently begins with CT and MR being complementary and the method of choice for the assessment of bone and associated soft tissue masses. We are hereby reporting two such cases with review of literature. Keywords: lytic lesion of skull, calvaria, eosinophilic granuloma, fibrous dysplasia

[1]. EwaWasilewska-TeÊluk, ZbigniewSzutkowski, AndrzejKawecki Langerhans cell histiocytosis of bone – a case report and review of the literature NOWOTWORY Journal of Oncology 2003 volume 53Number 2 161–164
[2]. Greenberger JS, Crocker AC, Vawter G. Results of treatment of 127 patients with systemic histiocytosis Letterer-Siwe syndrome, Schuller- Christian syndrome, multifocal eosinophilic granuloma. Medicine 1981; 60:311-38.
[3]. Puzzilli, Mastronardi L, Farah JO, Ruggeri (1998)Solitary eosinophilic granuloma of the calvaria.Tumori 1998;84(6):712-16
[4]. RuchiAgarwal*, ParveenRana, Amrita Duhan, Sanjay Verma, RajnishKalraEosinophilic granuloma of skull in a 7 year child: Diagnosed on fine needle aspiration cytology Cumhuriyet Med J 2013; 35: 563-567
[5]. ZahoorAhmedNaikoo,Tufale Ahmed Dass, AbrarWanisolitaryEosinophilic Granuloma of Frontal Bone:A Rare Entity www.jkscience.org/archive/volume131/15-CaseReport