iosr-JDMS   Volume-14 ~ Issue-10 ~ October-2015

Abstract: Hepatitis B infection with its long term consequences, in some with associated morbidity and mortality is a big concern worldwide, more so in developing countries. Sexual transmission being one of important modes oftransmission more a probability in Intermediate and Low endemicty areas for HBV like in India. Different studies in India showedHBsAg positivity ranging from 2 to 4.7%. Our study revealed HBsAgprevalence of 3.52%,.out of 13,246 who attended STD clinic and tested for HBV during 5 years (April,2011 to March,2015),467persons werepositive(331 males and 136 females)People with multiple partners had higher positivity. Males predominated with 70.87%. 43 males with HBsAg positivity gave homosexual contact history.

[1]. World Health Organization (2012). Hepatitis B. World Health Organization Fact Sheet 2004 (Revised August 2008). [online] Available from http://who.int/inf-fs/en/fact204.html. [Accessed Sep 2012].
[2]. Goldstein ST, Zhou F, Hadler SC, et al. A mathematical model to estimate global hepatitis B disease burden and vaccination impact. Int J Epidemiol.2005;34:1329-39.
[3]. World Health Organization (2012). Introducing Hepatitis B Vaccine in Universal Immunization Programe in India. A Brief Scenario. [online].
[4]. Te HS, Jensen DM. Epidemiology of hepatitis B and C viruses: a global overview. Clin Liver Dis. 2010;14:1-21.
[5]. Kane M, Clements J, Hu D.Hepatitis B. In: Jamison DT , Mosley WH, Measham AR, et al, eds. Disease control priorities in developing countries. Oxford: World Bank, Oxford University Press, 1993:321-30.

Abstract: Teeth with vertical root fractures (VRF) have complete or incomplete fractures that begin in the root and extend toward the occlusal surface. The most common causes of VRFsare trauma, inadequate endodontic treatment, iatrogenic causes, for e.g. excessive canal shaping, excessive restorative procedures, excessive forces of lateral condensation of obturation, etc. Diagnosis is difficult but invariably, treatment is extraction of the tooth/root. The sudden loss of an anterior tooth due to aforementioned reasons can be psychologically and socially damaging to the patient. This paper describes the immediate replacement of an endodontically treatedvertically fractured left central incisor with the natural tooth crown as a ponticusing composite resin. This technique allows the abutment teeth to be conserved with minimal or no preparation, and thus, keeps the technique reversible. Also, it can be completed chair-side, thereby avoiding laboratory costs. Hence, it canbe used as an interimprosthesis to prevent psychological trauma to the patient.

[1]. Endodontics: Colleagues for excellence. Cracking the cracked tooth code. Chicago, IL: American Association of Endodontists; 2008. FallWinter. American Association of Endodontists.
[2]. Fuss Z, Lusting J, Katz A, Tamse A. An evaluation of endodontically treated vertical root fractured teeth: Impact of operative procedures. J Endod 2001;27:46-8.
[3]. Toure B, Faye B, Kane AW, Lo CM, Niang B, Boucher Y. Analysis of reasons for extraction of endodontically treated teeth: A prospective study. J Endod 2011;37:1512–5.
[4]. Peciuliene V,Rimkuviene J. Vertical Root Fractures in Endodontically Treated Teeth: A Clinical Survey. Stomatologija, Baltic Dental and Maxillofacial Journal. 2004; 6:77-80.
[5]. Meister F, Lommel TJ, Gerstein H. Diagnosis and possible causes of vertical fractures. Oral Surg Oral Med Oral Pathol 1980; 49: 243-53.

Abstract: Introduction: "Primary vaginal hydrocele is defined as abnormal accumulation of serous fluid in tunica vaginalis." It is one of commonest disease occurring worldwide. The common complications observed during the surgery of hydrocele are bleeding, injury to the cord structures and epididymis, torsion of the testis due to faulty positioning during surgery. There are many number of types of operations performed for hydrocele, which needs comparision to select best of them.

[1]. Ku JH, et al. The excisional placation and internal drainage techniques : A comparison of results for idiopathic hydrocele. BJU Ent 2001; 87(1) : 82-84.
[2]. Albercht W, Hohl. The best operation for hydrocele? Br. J Urol 1991;68(2):187-9.
[3]. Shah PA, et al. Ambulatory hydrocele surgery – a review of 50 cases. Jr Coll Surg Edinb 1992; 37(6): 385-6.
[4]. Dunaeuskii Iaz, Gorokhov. A comparative evaluation of surgical methods for treating hydrocele. Urol (Mosk) 1990; 1: 59-62.
[5]. Singh DR, Gupta SK, Gupta S, Lord‟s procedure a curative outpatient operation for primary hydrocele. J Indian Med. Assoc 1996; 94(4):141-2.
[6]. 106

Abstract: Civilization ushered in high injury rates with increased fracture pattern by virtue of high speed transportations accidents, industrial accidents, sports and recreational injuries. Fractures of the neck of femur have always presented great challenges to orthopaedic surgeons and remain in many ways even today the unsolved fracture as far as the treatment and results are concerned. With life expectancy increasing with each decade our society is becoming more and more geriatric society with significant numbers of hospitalised and nursing home patients suffering from femoral neck fractures and their sequale.

[1]. Garden RS. Low angle fixation in fractures of the femoral neck. J Bone Joint Surg.1961;43B:647–663.

[2]. G.W. Leadbetter. A treatment for fracture of the neck of the femur. J. Bone Joint Surg., 15 (1933), p. 931

[3]. L.D. Smith. Hip fractures. J. Bone Joint Surg., 35A (1953), p. 379

[4]. R. Watson-Jones. Treatment of Fractures and Joint Injuries (5th ed.), vol. 2, Livingstone, London (1976), p. 773

[5]. R. Whitman. Orthopaedic Surgery, Kimpton, London (1927)

[6]. R. Barnes, J.T. Brown, R.S. Garden, et al. Subcapital fractures of the femur. J. Bone Joint Surg., 58B (1976), p.

Abstract: Background: Scrub typhus is prevalent in India although definite statistics are not available. Recent reports from several parts of India indicate that there is a resurgence of scrub typhus. There have been only few studies on scrub meningitis, most are case report. Methods: A prospective study done in Sir Padampat Mother and Child Health Institute, SMS Medical College, Jaipur to find cases of scrub typhus from August 2014 to December 2014. Diagnosis was made by a combination of an acute febrile illness with a positive scrub IgM ELISA. Lumbar puncture performed in patients with headache, vomiting, meningeal signs, seizures, or altered sensorium.

[1]. Mahajan SK. Scrub Typhus. J Assoc Physicians India 2005; 53:954-8.
[2]. Chaudhry D, Garg A, Singh I, Tandon C, Saini R. Rickettsial diseases in Haryana: Not an uncommon entity. J Assoc Physicians India 2009; 57:334-7.
[3]. Mathai E, Rolain JM, Verghese GM, Abraham OC, Mathai D, Mathai M, et al. Outbreak of scrub typhus in southern India during the cooler months. Ann N Y Acad Sci 2003; 990:359-64.
[4]. Prabagaravarthanan R, Harish BN, Parija SC. Typhus fever in Pondicherry. J Commun Dis 2008; 40:159-60.
[5]. Ittyachen AM. Emerging infections in Kerala: A case of scrub typhus. Natl Med J India 2009; 22:333-4.
[6]. Isaac R, Varghese GM, Mathai E, J M, Joseph I. Scrub Typhus: Prevalence and diagnostic issues in rural Southern India. Clin Infect Dis 2004; 39:1395-6.
[7]. Saifudheen K, Kumar KG, Jose J, Veena V, Gafoor VA (2012) First case of scrub typhus with meningoencephalitis from Kerala: An emerging infectious threat. Ann Indian Acad Neurol 15: 141–144.

Abstract: Background: Psychological stress among medical students is common when compared to other professional courses. The prevalence of stress among medical students affects not only their academic performances but also to some extent their health. Objective: The present study was undertaken to determine the prevalence of self – perceived psychological stress among Under-Graduate medical students, to identify probable factors responsible for it and to suggest possible interventions

[1]. Leo Goldberger and Shlomo Breznitz. "Handbook of stress: Theoretical and Clinical aspects". Free press 1982;987
[2]. Hans Selye. "The stresses of life, New York", MC Graw Hill 1956;1523-1567.
[3]. Firth-Cozens J. "Stress in medical undergraduates and house officers". Br J Hosp Med 1989; 41:161-4.
[4]. Aktekin M, Karaman T, Senol YY, Erdem S, Erengin H, Akaydin M. " Anxiety, depression and stressful life events among medical students: a prospective study in Antalya, Turkey". Med Educ 2001; 35:12-7 .
[5]. Sherina MS, Rampal L, Kaneson N. Psychological stress among undergraduate medical students. Med J Malaysia. 2004; 59:207-11.
[6]. Supe AN: A study of stress in medical students at Seth G.S. Medical College. J Postgrad Med 1998; 44:1-6.

Abstract: Background: The mycoses caused by dermatophytes are called as dermatophytosis. Dermatophytes are moulds that can invade the stratum corneum of skin and other keratinized tissues such as hair and nails. As various aspects of dermatophytosis are likely to differ markedly in different regions, the present study was undertaken to know the pattern of dermatophytosis in Rural area. Material and Methods: The present study was carried out in the Department of Microbiology, S. R. T. R. Govt. Medical College, Ambajogai. A total of 160 clinically diagnosed cases of dermatophytosis attending the skin and venereal disease Outpatient department (OPD) were included. Skin, hair, nail specimens were taken from relevant clinical lesion examined by direct microscopy and culture.

[1]. Mandell, Douglas B. Principles and practice of Infectious diseases. Vol 2. Part III. 6th ed

. [2] Jagdish Chander. Textbook of Medical Mycology. 2nd ed. Mehta Publishers; 2002.

[3] Rippon JW. Medical Mycology. The pathogenic fungi and the pathogenic actinomycetes. Dermophytosis and Dermatomycosis. Philadelphia: W B Saunders Co; 1982.

[4] Johnson RA. Dermatophyte infections in human immune deficiency virus (HIV) disease. Jam Acad Derm 2000;43(5):S135–40.

[5] Parimala P, Shivananda PG, Shrinivas CR, subramanya K NR. Dermatophytosis in and around Manipal. Ind J Dermatol Venereol Leprol 1987;53:217–8.

[6] Sumana V Singhacharya MA. Dermatophytosis in Khamman (Andhra Pradesh) India. Ind J Pathol Microbiol 2004;47(2):287–9.

Abstract: Implantation of blastocyst anywhere else, other than uterine cavity is considered as an ectopic pregnancy. About 95%ofEctopicpregnanciesare implanted in the various segments of the fallopian tubes. Of these most of the implantations are ampullary. The present study aims to analyze the distribution of the ectopic pregnancies at various sites. This is a study done in collaboration with Department of Obstetrics and Gynaecology at Kamineni Institute of Medical Sciences (KIMS) hospital, Narketpally. Twenty three cases of ectopic pregnancies were evaluated in 2years from January 2012 to December 2013. The study included tubal pregnancies (22) and one rare variant ofbilateral ectopic pregnancy.

[1]. Cunningham ,Leveno, Bloom , Hauth ,Rouse , Spong. Williams obstetrics,Ectopic pregnancy , 23rd Edition 2010 ; 10:238-254.
[2]. PrapasMeethong ,ManusChalermsanyakorn , Full Term Primary Ovarian Pregnancy with Living Child and Mother: case report, Journal of Obstetrics and Gynaecology ,January 2008, Vol. 16, pp. 71-7661-167.
[3]. Huang J, Jing X, Fan S, Fufan Z, Yiling D, Pixiang P, XiaomengX.Primaryunruptured full term ovarian pregnancy with live female infant: case report,ArchGynecolObstet 2011 Mar;283 Suppl 1:31-3.
[4]. Spiegelberg criteriaFrom Wikipedia, the free encyclopedia http://en.wikipedia.org/wiki/Spiegelberg_criteria
[5]. Bouyer J, Coste J, Fernandez H, Pouly JL, Job-Spira N. Sites of ectopic pregnancy: a 10 year population-based study of 1800 cases. Hum Reprod2002; 17: 3224-3230.
[6]. Gerin-Lajoie L. Discussion of Gerin-Lojoie L. Ovarian pregnancy. Am J ObstetGynecol1951; 62: 920.

Abstract: Introduction: Female urethral stricture is an under diagnosed cause of bladder outlet obstruction in females. The possible aetiology may be idiopathic, infection, difficult catheterisation with subsequent fibrosis, prior urethral surgery or trauma. We present our technique and results of dorsal onlay full thickness vaginal graft urethroplasty for stricture urethra in females.

[1]. Keegan KA, Nanigian DK, Stone AR. Female urethral stricture disease. Curr Urol Rep. 2008;9:419–23. [PubMed: 18702927]
[2]. Defreitas GA, Zimmern PE, Lemack GE, Shariat SF. Refining diagnosis of anatomic female bladder outlet obstruction: Comparison of pressure-flow study parameters in clinically obstructed women with those of normal controls. Urology. 2004;64:675–81. [PubMed: 15491697]
[3]. Smith AL, Ferlise VJ, Rovner ES. Female urethral strictures: Successful management with long-term clean intermittent catheterisation after urethral dilatation. BJU Int. 2006;98:96–9. [PubMed: 16831151]
[4]. Migliari R, Leone P, Berdondini E, De Angelis M, Barbagli G, Palminteri E. Dorsal buccal mucosa graft urethroplasty for female urethral strictures. J Urol. 2006;176:1473–6. [PubMed: 16952664]

Abstract: Surgery provides a stress response resulting in various biochemical and hormonal changes. Hormonal interplay is the key role, in the evolution of stress response, which has been estimated as hyperglycemic response The aim of the study is to prove that well balanced anesthesia in controlled diabetic mellitus patients; the rise of blood sugar is not significant when compared to non diabetic patients The study was conducted on controlled diabetics and non diabetic patients during surgery under general anaesthesia with muscle relaxant technique to evaluate the degree of rise of blood glucose intraoperatively and compared. Study includes Fifty ASA grade 1 and grade 2 patients of either sex between 35-55 years age group scheduled for various elective surgical procedures of 1-2 hours of duration like laporatomy, thyroidectomy, upper limb orthopedic procedures elective ENT procedures.

[1]. Allison SP ; Tomin PJ ; Chamberlain Mj. Some effects of anaesthesia and surgery on carbohydrate and fat metabolism Br.J.Anaesth.1969 ;41,588-592.

[2]. Anand KJ, Hickey PR Halothane morphine compared with high dose sufentanil for anaesthesia and post operative analgesia in neonatal cardiac surgery.N.Engl.J.Med.326;1-9,1992.

Abstract: Spinal anaesthesia is the preferred technique in caesarean section. Hypotension during spinal anaesthesia for caesarean section remains a common scenario in our clinical practice. Intravenous crystalloid prehydration has poor efficacy; thus, the focus has changed toward co-hydration and use of colloids.. This study has been undertaken to assess the efficacy of volume preloading with RL and to compare the relative efficacy of RL co loading. The study include 60 health pregnant women with ASA grade I and II undergoing caesarean delivery between 18 to 25 years, divided into two groups. GROUP P – Parturients in this group received 15ml per Kg of RL as preload over 20 minutes before subarachnoid spinal block with 1.8ml of 0.5% Bupivacaine GROUP C – Parturients in this group received 15ml per Kg of RL as coload as fast as possible, starting as soon as CSF is tapped.

[1]. Shnider SM, Levinson G. anaesthesia caesarean section, chapter 12, anaesthesia for obstetrics, 3rd, william' and wilkins 1993: pp 211-239.
[2]. Rout CC, Rocke DA, Levin L, Gouws E, Reddy D. A reevaluation of the role of crystalloid preload in the prevention of hypotension associated with spinal anaesthesia for effective caesarean section. Anaesthesiology 1993; 79: 262-269.
[3]. Jackson R Reid JA, Thorburn J. Volume preloading is not essential to prevent spinal induced hypotension in caesarean section. Br. J Anaesth 1995; 75: 262-265
[4]. Chan WS, Irwin MG, Tong WN. Prevention of hypotension during spinal anaesthesia for caesarean section: ephedrine infusion versus fluid preload .Anaesthesia 1997; 52: 908-13
[5]. French GWG, White JB, Howel HJ, Popat M. Comparison of pentastarch and hartmann's solution for volume preloading in spinal anaesthesia for elective caesarean section. Br J Anaesth 1999; 83: 475-77

Abstract: Acute myocardial infarction (MI) involving only the right ventricle is an uncommon event. Right ventricular myocardial infarction has been an independent predictor of major complications and mortality. Electrocardiogram (ECG) through right precordial leads (V4R) is a useful & convenient tool of diagnosing right ventricular infarction. Standard surface ECG by using V4R could aid clinical recognition of concomitant right ventricular infarction in patients with inferior wall myocardial infarction. Increasing age, male sex & previous history of ischemic heart disease were found to be important risk factors for the occurrence of right ventricular infarction. Keyword: electrocardiography, inferior wall myocardial infarction, myocardial infarction, right ventricular function. Myocardial performance index, Tricuspid annular motion.

[1] Setaro JF, Cabin HS, Right ventricular infarction. Cardiol Clin. 1992.
[2] Goldstein JA. Right heart ischemia: pathophysiology, natural history & clinical management. rog Cardiovas Dis.1998; 40:325- 341.
[3] Mehta S.R., Eikelboom J.W., Natarajan M.K. Impact of right ventricular involvement on mortality and morbidity in patients with inferior myocardial infarction. J Am Coll Cardiol. 2001;37:37–43. 23.
[4] Shamir R. Mehta et al; Impact of right ventricular involvement on mortality and morbidity in patients with inferior myocardial infarction; JACC 2001;37:37-43.
[5] Shiraki H., Yoshikawa T., Anzai T. Association between preinfarction angina and a lower risk of right ventricular infarction. N Engl J Med. 1998;338:941–947.
[6] Zehender M., Kasper W., Kauder E. Right ventricular infarction as an independent predictor of prognosis after acute inferior myocardial infarction. N Engl J Med. 1993;328:981–988.

Abstract: Abstract: Objective: The aim of this study was to evaluate the psychiatric morbidity amongst psoriasis patients. Method: sixty consecutive clinically diagnosed psoriasis patients were examined dermatologically and administered Mini International Psychiatric Interview (MINI). Results: Psychiatric morbidity was present in 78.33% % of patients in psoriasis. Out of 60 patients, 26 patients (43.33%) were diagnosed with Major Depressive Disorder (MDD), 5 patients (8.33%) were diagnosed as having Major depressive Disorder with anxiety and 13 patients were diagnosed with Anxiety disorders such as generalized anxiety disorder in 3 patients (5%), panic disorder in 5 patients (8.33%), Agoraphobia in 1 patient (1.66%) and social phobia in 4 patients (6.66%). 3 (5%) were diagnosed with Alcohol dependence

[1]. Rosa Parisi, Deborah P M Symmons, Christopher E M Griffiths and Darren M Ashcroft, Global Epidemiology of Psoriasis: A Systematic Review of Incidence and Prevalence; Journal of Investigative Dermatology (2013) 133, 377–385.
[2]. Barankin B, DeKoven J. Psychosocial effect of common skin diseases. Can Fam Physician 2002;48: 712‑6.
[3]. Langley RG, Krueger GG, Griffiths CE. Psoriasis: Epidemiology, clinical features, and quality of life. Ann Rheum Dis 2005; 64 Suppl 2:ii18‑23.
[4]. Fortune DG, Richards HL, Kirby B, McElhone K, Markham T, Rogers S, et al. Psychological distress impairs clearance of psoriasis in patients treated with photochemotherapy. ArchDermatol 2003; 139:752‑6.
[5]. Kumar S, Kachhawha D, Koolwal GD, Gehlot S, Awasthi A. Psychiatric morbidity in psoriasis patients: A pilot study. Indian J Dermatol Venereol Leprol 2011;77: 625.
[6]. Sheehan D, Janavs J, Baker R, Sheehan KH, Sheehan M. Mini international neuropsychiatric interview (M.I.N.I.) English Version 6.0.0. South Florida; 2009. Available from http://www.nccpsychiatry.info/File/ MINI.600.pdf.

Abstract: Background: To study the clinical presentation and coronary angiographic profile in premenopausal women with acute coronary syndrome 2. To compare with the clinical presentation and coronary angiographic profile in postmenopausal women with acute coronary syndrome Method: 43 Patients with Acute Coronary Syndrome admitted in department of cardiology King George Hospital Visakhapatnam , who undergo coronary angiography as a part of investigation . Equal number of post menopausal women with acute coronary syndrome admitted during the same period was taken at random for comparison

1. Most premenopausal women develop acute coronary syndromes in their third and fourth decade closer to menopause.

2. Premenopausal women with acute coronary syndromes most often present with chest pain which includes typical and atypical chest pain.

3. Risk factor for coronary artery disease, hypertension is less common in premenopausal women, diabetes is no different in pre and post menopausal women. LDL is significantly different in pre and post menopausal women.

4. Smoking as a risk factor is distinctly rare in women.

5. No significant difference in BMI in pre menopausal and post menopausal women with acute coronary syndrome exists.