iosr-JDMS   Volume-14 ~ Issue-12 ~ December-2015

Abstract: A modern tool like biofeedback is less often tried as an assessment tool to measure the effectiveness of an age old technique like alternate nostril breathing (Nadi Shodhana Pranayama). Also there is a pressing need to address the stress among medical undergraduates through a feasible, effective and practicable relaxation technique which can be adopted into their current curriculum. This study set out with an objective to measure the effectiveness of alternate nostril breathing in reducing stress in medical students using Biofeedback parameters as assessment tool. 30 medical students belonging to various phases of MBBS were assessed through biofeedback instrument and baseline parameters like pulse rate, respiratory rate, EMG, EEG, GSR and temperature were recorded.

[1] Harvey R, Peper E. Future directions in applied psychophysiology: skills not pills. In: Edmonds WA (Ed), Case studies in applied psychophysiology: Neurofeedback and biofeedback treatments for advances in human performance. (Chichester: Wiley-Blackwell, 2012) 275-92.
[2] Mann DTY, Janelle CM. Psychophysiology: Equipment in research and practice. In: Edmonds WA (Ed), Case studies in applied psychophysiology: Neurofeedback and treatments for advances in human performance. (Chichester: Wiley-Blackwell, 2012) 257-74.
[3] Āraṇya H. Yoga Philosophy of Patanjali,(State University of New York Press,1983)230-236.
[4] Telles S, Sharma SK, Balkrishna A. Blood pressure and heart rate variability during yoga-based alternate nostril breathing practice and breath awareness. Med Sci Monit Basic Res. 2014 Nov 19;20:184-93.
[5] Bansal R, Gupta M, Agarwal B, Sharma S. Impact of Short Term Yoga Intervention on Mental Well Being of Medical Students Posted in Community Medicine: A Pilot Study. Indian J Community Med. 2013 Apr-Jun; 38(2): 105–108.
[6] Shiralkar MT, Harris TB, Eddins-Folensbee FF, Coverdale JH. A systematic review of stress-management programs for medical students. Acad Psychiatry. 2013 May 1;37(3):158-64.

Abstract: Worldwide, Pneumonia is the leading infectious cause of death in children, accounting for 15% of all deaths of children under 5 years old. Pneumonia killed an estimated 9, 35,000 children under the age of five in 2013 and can be prevented by immunization, adequate nutrition and by addressing environmental factors. The aim of study was to determine the role of Zinc as an adjunct therapy in paediatrics with severe pneumonia. This study is a randomized, double blinded, placebo-controlled clinical trial conducted between March 2014 to September 2014 at Department of Paediatrics. Children aged 1month-6years who were diagnosed with severe pneumonia are randomly assigned with zinc and placebo supplementation in 1:1 ratio.

[1]. Pa Tamba Ngom, Stephen Howie, Martin O.Ota and Andrew M. Prentice. The potential role and possible immunological mechanisms of zinc adjunctive therapy for severe pneumonia in children. The open immunology journal, 2011, 4, 1-10.
[2]. Anuradha Bose, Christian L Coles, Gunavathi, Hemanth John, Prabhakar Moses, P Raghupathy et al. Efficacy of zinc in the treatment of severe pneumonia in hospitalized children <2 y old. Am J Clin Nutr 2006; 83:1089-96.
[3]. Sazawal S, Black RE. Meta-analysis of intervention trials on case-management of pneumonia in community settings. Lancet 1992:340; 528-33.
[4]. Scrimshaw NS, SanGiovanni JP. Synergism of nutrition, infection, and immunity: an overview. Am J Clin Nutr 1997; 66(suppl): 464S–77S.
[5]. Brundtland GH. Nutrition and infection: malnutrition and mortality in public health. Nutr Rev 2000; 58:S1– 4.
[6]. Caulfield LE, de Onis M, Blossner M, Black RE. Under nutrition as an underlying cause of child deaths associated with diarrhoea, pneumonia, malaria, and measles. Am J Clin Nutr 2004; 80: 193–8.

Abstract: The anatomy of the adrenal glands was described almost 450 years ago by Bartholomeo Eustacius1 and the zonation of the gland elucidated shortly thereafter. Many interesting features of suprarenal gland have generated keen interest in its structure and blood supply. Suprarenal glands are among the most vascular organs in the body. Thorough knowledge of variations in vessels of suprarenal gland is essential for correct approach and proper homeostasis during any surgery on or around the glands.

[1]. Bartolommeo eustachius Tabulae anatomicae, Rom 1783
[2]. Gagnon R.1957, 1964The arterial supply of human adrenal gland. Rev. Canada.Biol.16: 421: 423,
[3]. Middle Suprarenal artery in man. A statistical study of two hundred human adrenal glands. Rev.Canad.Biol. 23:461
[4]. Cunningham's Text Book of Anatomy, 1978 Ed.11.
[5]. Fowler O.S. 1934The Anatomical and Functional disturbances of the adrenal gland in general visceroptosis. Jr. of Urology. Vol .3
[6]. Piersol 1923 Human Anatomy, 8th Edn vol.2, 1083.
[7]. Merklin R.J and Michel's N.A 1958. 1960

Abstract: Schizophrenia is a severe mental disorder affecting about 1% of the human population with relatively uniform distribution throughout the world. Being chronic and often incapacitating, it extracts tremendous cost from patients, caregivers and society. Caregivers of patients with schizophrenia face stress and emotional hardship and are frequently forced to assume lifelong care-taking roles. For many families having a relative with mental illness can be stressor. Ignorance and misconceptions among the care givers of patients, de-institutionalization policy and lack of resources cause serious burden of disease among the care givers. Many families believe that they do not have the necessary coping strategies to help with managing the mental illness of their relative.

[1]. [http://www.who.int/mental_health/management/schizophrenia/en/retrieved on June 2014. Schizophrenia [Internet].Geneva (Switzerland): World Health organization;
[2]. Wageeh Abdel et al. Burden and coping strategies in caregivers of schizophrenic patients. Journal of American Sciences. 2011; 7(5):802-811.
[3]. National Institute of Health and Care Excellence. Psychosis and schizophrenia in adults: treatment and management guideline update. London: NICE; 2014.
[4]. Tan SC et al. Burden and coping strategies experienced by caregivers of persons with schizophrenia in the community. Journal of Clinical Nursing. 2012 September; 21(17-18):2410-8.
[5]. Thara R, Padmavati T N. Focus on psychiatry in India. British Journal of Psychiatry. 2004 April; 184:366-73.
[6]. Park K. Park‟s Text Book of preventive and social medicine.22nd edition. Jabalpur, India: Banarasidas Bhanot; 2013.

Abstract: Subtotal and total thyroidectomy are the surgeries commonly performed for benign thyroid disorders. Total thyroidectomy was not routinely performed in the past as it was believed that complications like hypoparathyroidism and recurrent laryngeal nerve injury are more common after total thyroidectomy. However subtotal thyroidectomy is associated with recurrence of the disease which warrants a second surgery. Reoperation has higher rate of above mentioned complications. The aim of our study was to compare the post operative complications in patients undergoing subtotal thyroidectomy with those undergoing total thyroidectomy. Our study involved 140 patients out of which 37 and 103 patients underwent subtotal and total thyroidectomy respectively. Post operative complications, mainly hypoparathyroidism and recurrent laryngeal nerve injury were compared between the study groups. The incidence of complications were almost similar in both the groups and was slightly higher in patients with total thyroidectomy.

[1]. A MISHRA, A AGARWAL, G AGARWAL AND S K MISHRA. TOTAL THYROIDECTOMY FOR BENIGN THYROID DISORDERS IN AN ENDEMIC REGION, WORLD JOURNAL OF SURGERY 25, 2001, 307-310.
[2]. Bailey And Love, Short Practice Of Surgery. 26th Edition. (Crc Press, New York, 2013).
[3]. Pappalardo G, Guadalaxara A, Frattaroli Fm, Illomei G And Falaschi P. Total Compared With Subtotal Thyroidectomy In Benign

Abstract: Micro-albuminuria refers to the excretion of albumin in the urine at a rate that exceeds normal limits and is considered to be a earliest marker of diabetic nephropathy. If left untreated it will eventually lead to end stage renal disease (ESRD). The current study was conducted to establish the prevalence of micro-albuminuria in a sequential sample of diabetic patients attending hospital and OPD Clinic to determine its relationship with known and putative risk factors, to identify micro and normo-albuminuric patients in their sample for subsequent comparison in different age, sex, weight and creatinine clearance of the micro- and normo-albuminuric patients, This crossectional analytical study was conducted in one hundred patients at Sarswathi Institute of Medical Sciences, Anwarpur Hapur U.P. Patients having diabetes mellitus in deferent age group ranging from 30 to 70 years were selected. Data was analyzed by SPSS software.

[[1]. Fajans S S, cloutier M C, Crowther R L. The Banting memorial lacture 1978. Clinical and etiologic heterogeneity of idiopathic diabetes mellitus, diabetes 1978;27:1112-1125.
[2]. Huizinga M M, rothman R L. Addressing the diabetes pandemic: A Comprehensive approach.indian J Med Res 2006;124:481-484.
[3]. Kingh H Auberti R E, Herman W H. global burden of diabetes, 1995-2025. Prevelance, numerical estimated and Projection. Diabetes care 1998; 2;1414-31.
[4]. Ramchandran A, Snehlatha C, latha E, et al. Rising prevalence of NIDDM in an urban population in india. Diabetolgia 1997; 40; 232-7.
[5]. Mohan V, Sandeep S, Deepa R, Shah B, & Varghese C. Epidemology of diabetes : Indian Scenario. The Indian J Med Res 2007; 125 (3): 217-230.
[6]. Delcourt C, Vauzelle-Kervroedan F, Cathelineau G, Papoz L, Low prevalence of long term complication in no-insulin dependent diabetes mellitus in france: A multicenter study. Journal of diabetes and its complication. Mar-Apr 1998;12(2); 88-95.

Abstract: In a dengue endemic area like India , Dengue fever might be confused with other febrile illness like enteric fever, leptospirosis, typhus fever, malaria, chikungunya etc. Many of these illnesses can present in significant numbers after rains, and because of similar early presentations, can cause confusion in decision-making. With global warming, these diseases can assume significant proportions even in non-endemic areas. Recognition of these diseases is important to diagnose them and treat them early, in order to avoid potentially fatal complications. This study is an attempt to highlight important clinical and laboratory features to differentiate between dengue and dengue fever-like illnesses(DLI).

1]. Leelarasamee A, Chupaprawan C, Chenchittikul M, Udompanthurat S. Etiologies of acute undifferentiated febrile illness in Thailand. J Med Assoc Thai 2004;87: 464 – 72.
[2]. Blacksell SD, Sharma NP, Phumratanaprapin W, Jenjaroen K, Peacock SJ, White NJ, et al. Serological and blood culture investigations of Nepalese fever patients. Trans R Soc Trop Med Hyg 2007;101:686 – 90.
[3]. Suharti C, van Gorp EC, Dolmans WM, Groen J, Hadisaputro S, Djokomoeljanto RJ, et al. Hantavirus infection during dengue virus infection outbreak in Indonesia. Acta Med Indones 2009;41:75 – 80.
[4]. Libraty DH, Myint KS, Murray CK, Gibbons RV, Mammen MP, Endy TP, et al. A comparative study of leptospirosis and dengue in Thai children. PLoS Negl Trop Dis 2007;1:e111.
[5]. Ellis T, Imrie A, Katz AR, Effl er PV. Underrecognition of leptospirosis during a dengue fever outbreak in Hawaii, 2001 – 2002. Vector Borne Zoonotic Dis 2008; 8:541 – 7.
[6]. LaRocque RC, Breiman RF, Ari MD, Morey RE, Janan FA, Hayes JM, et al. Leptospirosis during dengue outbreak, Bangladesh. Emerg Infect Dis 2005;11:766 – 9.

Abstract: Accurate diagnosis of nature of the pregnancy (viable/non-viable) by ultrasound can avoid unnecessary complications and misdiagnosis in first trimester bleeding, thereby helps in appropriate management. The objective of our study is to evaluate the role of ultrasound in the accuracy of diagnosis and management of first trimester bleeding. We studied 102 cases of pregnant women who presented with bleeding per vaginum during the first trimester who referred to department of radio diagnosis in NMC and evaluated with clinical history, clinical examination, and ultrasonography.

[1]. Creinin MD, Schwartz JL, Guido RS, et al. Early pregnancy failure–current management concepts. Obstet Gynecol Surv. 2001; 56(2):105–113.
[2]. Chen BA, Creinin MD. Contemporary management of early pregnancy failure. Clin Obstet Gynecol. 2007; 50(1):67–88.
[3]. Paspulati RM, Bhatt S, Nour SG. Sonographic evaluation of first-trimester bleeding. Radiol Clin North Am. 2008; 46(2):437.
[4]. Mark Deutchman, Amy Tanner Tubay, David K. Turok. First trimester bleeding. Am Fam Physician. 2009 Jun 1; 79(11):985-992.
[5]. Rumack CM, Wilson SR, Charboneau JW, Levine D, editors: Diagnostic Ultrasound, 4th Edition, Volume 2. U.S.A, Mosby (an affiliate of Elsevier); 2011; pp 1041-1088.
[6]. Levi CS, Ultrasound in prenatal diagnosis: polemics around routine ultrasound screening for second trimester fetal malformations. Prenat Diag 2002; 22: 285- 295.

Abstract: Introduction: Multiple-choice questions (MCQs) are most widely used test format in health sciences today. The efficiency of MCQs as an efficient tool for evaluation solely rests upon theirquality which is best assessed by item and test analysis. Objectives:Toassess item and test quality and to explore the relationship between difficulty index (p-value) and discrimination indices (DI) with distractor efficiency (DE).

[1]. Cizek GJ, O'Day DM. Further investigations of nonfunctioning options in multiple-choice test items. EducPsycholMeas1994; 54(4):861-72.
[2]. Saudi Commission for Health Specialties. Item writing manual for multiple-choice questions. [Internet] [cited 2015 June 12]. Available from:http://www.scfhs.org.sa/education/HighEduExams/Guidlines/mcq/Documents/MCQ%20Manual.pdf
[3]. Hotiu A.The relationship between item difficulty and discrimination indices in multiple-choice tests in a Physical science course [MSc thesis]. Boca Raton, Florida: Florida Atlantic University; 2006 [cited 2015 June 14]. Available from:http://www.physics.fau.edu/research/education/A.Hotiu_thesis.pdf
[4]. Designing and managing MCQs: Appendix C: MCQs and Blooms taxonomy. [Internet] [cited 2015 June 15]. Available from:http://www.u.arizona.edu/~jag/POL602/Designing-Managing-MCQs.pdf
[5]. Case SM, Swanson DB. Constructing written test questions for the basic and clinical sciences [internet].Philadelphia: National Board of Medical Examiners; 1998 [cited 2015 July 16]. Available from:http://www.uclouvain.be/cps/ucl/doc/adef/documents/EVA_Res_Ext_Questions_QCM.pdf
[6]. Understanding item analysis reports. [Internet] [cited 2015 July 4]. Available from: http://www.washington.edu/oea/services/scanning_scoring/scoring/item_analysis.html

Abstract: Background: The aim of this study was to review the profile of secondary glaucoma cases visiting a tertiary eye care centre.To study causes and risk factors of secondary glaucoma, management strategies and outcomes in secondary glaucoma. Methods: In this retrospective observational study, completed case records of patients with secondary glaucoma who presented to glaucoma clinic from 2009 to 2013 were included. Out of the 500 case records screened, 219 cases were found to eligible for inclusion in the study on the basis of follow up at least 6 months or more duration.The evaluation included a detailed history and examination performed including vision, anterior segment examination, intraocular pressure (IOP), gonioscopy and fundus evaluation.Diagnosis of secondary glaucoma was made on the basis of presence of a secondary cause for presence of raised IOP.

[1]. Kingman S. Glaucoma is second leading cause of blindness globally. Bull World Health Organ 2004;82:887–8.
[2]. Quigley HA, Broman AT. The number of people with glaucoma worldwide in 2010 and 2020. Br J Ophthalmol 2006;90:262–7.
[3]. Yih-Chung Tham, Xiang Li, Tien Y. Wong, Harry A. Quigley ,Tin Aung. Global Prevalence of Glaucoma and Projections of Glaucoma Burden through 2040.A Systematic Review and Meta-Analysis. Article in press Ophthalmology 2014;1-10

Abstract: Four-strand hamstring autograft is a common choice for anterior cruciate ligament (ACL) reconstruction. Advocates for its use cite a decreased potential for catastrophic extensor mechanism complications and a decreased incidence of anterior knee pain associated with central-third bone patellar tendon bone (BPTB) autograft. In addition, biomechanical testing of 4-strand gracilis and semitendinosus autograft has shown a higher load to failure than that with BPTB autograft.Most importantly, clinical outcomes have been equivalent using 4-strand hamstring autograft and using BPTB autograft. A potential disadvantage of hamstring autograft for ACL reconstruction is the inherent variability in graft diameter. Biomechanical testing has shown a correlation between graft cross-sectional area and maximum load to failure. Historically, authors have recommended the use of grafts at least 7 mm in diameter, although limited evidence supports this recommendation.

[1] Graft Size and Patient Age Are Predictors of Early Revision After Anterior Cruciate Ligament Reconstruction With Hamstring AutograftRobert A. Magnussen, M.D. ,J. Todd R. Lawrence, M.D., Ph.D. ,Ryenn L. West, B.S. ,Alison P. Toth, M.D.,Dean C. Taylor, M.D. , William E. Garrett, M.D., Ph.D. j.arthro.2011.11.24.

[2] Hamstring Tendon Grafts for Reconstruction of the Anterior Cruciate Ligament: Biomechanical Evaluation of the Use of Multiple Strands and Tensioning Techniques*DYSON L. HAMNER, M.D.; CHARLES H. BROWN, JR., M.D.; MARK E. STEINER, M.D.; AARON T. HECKER, M.S.; WILSON C. HAYES, PH.D., BOSTON, MASSACHUSETTSJ Bone Joint Surg Am, 1999 Apr; 81 (4): 549 -57 .

[3] Five-Strand Hamstring Autograft for Anterior Cruciate Ligament Reconstruction Kyle P. Lavery, M.D., Jeffrey F. Rasmussen, M.D., and AmanDhawan, M.D. Arthroscopy Association of North America 2212-6287/13691.

[4] Wilson TW, Zafuta MP, Zobitz M. A biomechanical analysis of matched bone-patellar tendon-bone and double-looped semitendinosus and gracilis tendon grafts. Am J Sports Med 1999;27:202-207.

Abstract: Background: Narrow band ultraviolet B (NB-UVB) phototherapy has been used successfully for the treatment of vitiligo. Recently, Vitiskin a topical antioxidant complex gel used successfully as complementary treatment to NB-UVB. Objective: To assess the clinical efficacy of NB-UVB plus Vitiskin in the treatment of vitiligo in comparison with Narrow band UVB Radiation alone. Patients and Methods: This is a case, controlled, comparative, therapeutic trial that was conducted in the Department of Dermatology , Baghdad Teaching Hospital, Medical City, Baghdad, Iraq from March 2010-March 2011.
Forty five patients with generalized vitiligo were enrolled in this study. NB-UVB alone was given to 25 patients (Group I) twice weekly, and NB-UVB plus Vitiskin (Group II) twice daily was given to 20 patients The response to treatment was evaluated after 8 sessions and then after each 16 sessions of therapy.

[1]. Wolff K, Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ: Fitzpatrick TB, Freedberg IM, Eison AZ, Wolff K, Austenk F, Goldsmith LA, Katz SI(eds.).Fitzpatrick's Dermatology in General Medicine 7thed. New York, McGraw-Hill –Company ,2008 ;72:617-22
[2]. Sharquie KE, Ahmed S, Naji Abbas, Al Azawi H. Inflammatory changes in vitiligo. AMJ Dermatopatholo. 26, 2, April 2004.
[3]. Shaffrali FCG, Gawkrodger DJ. Management of vitiligo. Clin Exp Dermatol 2000; 25: 575-579.
[4]. Ostavari N: Lack of efficacy tacrolimas in treatment of vitiligo in absence of UVB exposure .Arch Dermatol , 2006; 142:252.
[5]. EO Goktas, Aydin F, N Senturk. Combination of NB_UVB and topical calcipotriol for the treatment of vitiligo.JEADV,2006:553-557.
[6]. Schallreuter K: State of the art on the treatment of vitiligo with pseudocatalase. JEADV 2003;17 Suppl:30.
[7]. Humbert P, Aubin F. Assessment of vitiskin tolerance effect with and without UVB treatment on subjects suffering from vitiligo. English French International J. 2008, 410-412.

Abstract: Anaerobic bacteria are important pathogens in many different infections. Empiric antimicrobial therapy is frequently used in the treatment of anaerobic infections as it might take several days for bacterial cultures to grow and, in many cases, the patient needs care without delay. The patient's condition and the nature of the infecting microorganisms are of extreme importance.Since anaerobic infections are generally polymicrobial, where anaerobes are mixed with aerobic organisms, therapy should provide coverage of both types of pathogens. The isolation of anaerobes requires appropriate methods of collection, transportation and cultivation of specimens. The lack of use of any of these methods can lead to inadequate recovery of anaerobes and inappropriate therapy.

[1]. Bharadwaj R. Anaerobic microbiology: Time to rejuvenate. Indian J Med Microbiol. 2012; 30:3-5.

[2]. Bartlett JG. An update on mixed aerobic and anaerobic infections. Adv Stud Med 2002; 2:104-9.

[3]. Brook, I.: "Anaerobic Infections Diagnosis and Management". A Textbook. Informa Healthcare USA, Inc. New York. 2007.

[4]. Kamat SR, Kadalkar SS, Maydeo DV, Walimbe S, Kulkarni KG, Hanmantgad RR, et al. A Prospective Study of One Hundred Cases of Chronic Empyema In Bombay. Bombay Lung India 1985; 3:15-9.

[5]. Finegold SM. A century of anaerobes: A look backward and a call to arms. Clin Infect Dis 1993; 16Suppl 4:S453-7.

[6]. Christine B. Anaerobic Blood Cultures Revisited – Again? BD Lab; Microbiology News & Ideas 2010; 21:3.

[7]. Hentges DJ. The anaerobic microflora of the human body. Clin Infect Dis 1993; 164:S175–80.

Abstract: India witnessing an increasing trend in the number of people suffering from hypertension. Behavioural risk factors for hypertension are widely prevalent in all societies in our country. This study was done to describe the association between selected behavioural risk factors and hypertension in a rural community in Jharkhand. A descriptive cross sectional study in rural field practice area of RIMS was conducted. Total 500 people were interviewed from the area. Subjects 20 years and above were taken for study from both sex. Pre-tested semi structured questionnaire were used for data collection. Template was generated in MS excel and data analysis was done using SPSS software. Prevalence of hypertension and pre hypertension found to be 19.8% and 27.6% respectively.

[1]. Rodgers A, Lawes C, MacMahon S. Reducing the global burden of blood pressure-related cardiovascular disease. JHypertensSuppl2000; 18: S3-S6 [PMID: 10939783]
[2]. Sharma AK, Bhardwaj S, Chaturvedi S. Predictors of hypertension in an urban Indian population. Indian Heart J 2006;58:21-7.
[3]. World Health Organization. Global Health Repository. Available from: URL: http://www.who.int/gho/ncd/risk_factors/blood_pressure_prevalence_text/en/index.html
[4]. WHO, World Health Statistics, 2012. Available from URL http://www.who.int/gho/publications/world_health_statistics/2012/en/
[5]. Midha T, BholaNath, Kumari R, Rao YK, Pandey U. Prevalence of hypertension in India: A meta-analysis. World J Meta – anal, 2013, August26;1(2): 83-89.
[6]. K Park. Park's Textbook of Preventive and Social Medicine. Non Communicable Diseases: Hypertension; 22nd edition. Jabalpur: M/s BanarsidasBhanot; 2013:p 344-348.
[7]. Anand MP. Epidemiology of hypertension India. Indian Heart J. 2010;62:378-383.
[8]. Menotti A, Keys A, Blackburn H, Kromhout D, Karvonen M, Nissinen A, Pekkanen J, Punsar S, Fidanza F, Giampaoli S, Seccareccia F, Buzina R, Mohacek I, Nedeljkovic S, Aravanis C, Dontas A, Toshima H, Lanti M. Comparison of multivariate predictive power of major risk factors for coronary artery disease in different countries: results from eight nations of the Seven Countries Study, 25 year follow-up. J Cardiovasc Risk. 1996; 3:69 –75.

Abstract: Cancer of the head and neck cancer in Nigeria with a population of over 167 million is a major health problem because of its high incidence and the limited infrastructure necessary for treatment. This study aims to examine the presentation and management of this disease in Nigeria. This is a retrospective study among head and neck cancer patients with histology of Lagos University Teaching Hospital in Nigeria.

[1]. Garfinkel L: Perspective on cancer prevention. Cancer J Clin 1995, 45:5-9.
[2]. Tobias JS: Cancer of the head and neck. BMJ 1994, 308:961-966.
[3]. Price P, Sikora K, IIIidge T. Treatment of Cancer. 5th Edition 2008 Edward Arnold (Publishers) Ltd . Ch 16
[4]. Opubo B da Lilly-Tariah, Abayomi O, Somefun and Adeyemo WL. Current evidence on the burden of head and neck Cancers in Nigeria. Head Neck Oncol 2009: 1:14.
[5]. Bhatia PL: Head and neck cancer in Plateau State of Nigeria. West Afr J Med 1990, (9): 304-310.
[6]. Otoh EC, Johnson NW, Danfillo IS: Primary head and neck cancers in North Eastern Nigeria. West Afr J Med 2004, (23): 305-313.
[7]. Amusa YB, Olabanji JK, Ogundipe OV: Pattern of head & neck malignant tumour in a Nigerian teaching hospital: a ten year review. West Afr J Med 2004, (23): 280-285.

Abstract:Background: There is little information regarding childhood and adolescent obesity, hypertension and diabetes epidemical situation and ABO blood group risk factors in Nigerians. The present study aimed to explore the association and distribution of ABO blood group and the risk of hypertension, diabetes, obesity, and coexistence of prehypertension and pre-diabetes among school aged children and adolescents and its future uses for programming health plans.

[1]. Sorof JM, Lai D, Turner J, Poffenbarger T and Portman RJ(2004 ) Overweight, Ethnicity, and the Prevalence of Hypertension in School-Aged Children. Pediatrics 113 (3) 475 -482
[2]. Lifestyles statistics team, Health and Social Care Information Centre. Statistics on Obesity, Physical Activity and Diet: England 2014. www.hscic.gov.uk
[3]. Ogden CL, Carroll MD, Kit BK, Flegal KM (2014) Prevalence of childhood and adult obesity in the United States, 2011-2012. Journal of the American Medical Association 311(8):806-814.
[4]. Riley M and Bluhm B (2012) High Blood Pressure in Children and Adolescents Am Family Physician. 85(7):693-700.
[5]. High Blood Pressure in African-Americans. American Heart Association, Inc 2015
[6]. U.S. Department of health and human services, National Institute of Diabetes and Digestive and Kidney Diseases (2014): What African Americans with Diabetes or High Blood Pressure Need to Know

Abstract: Blood and blood component transfusions have become integral part in day- to- day practice but are associated with higher incidence of complications such as FNHTR, CMV transmission, HLA allo- immunization and platelet refractoriness which are usually due to WBCs in transfused blood, fragmentation of WBCs and release of cytokines on storage. This can be overcome by pre- storage leuco- reduction using 4th generation leucocyte filters in which WBCs are reduced to > 5 x 106 cells/ unit. The outcome is enhanced patient safety, decreased transfusion requirements, decreased hospitalization and reduction in the incidence of FNHTR, allo- immunization in patients with aplastic anemia, MDS with myelofibrosis and Thalassemia. Thus, leuco- reduction of blood product serves as an effective tool in the reduction of post- transfusion complications, cost of hospitalization and mortality.

[1]. http://www.mayoclinic.org/tests-procedures/blood-transfusion/basics/risks/prc-20021256 [2]. R. R. Sharma and Neelam Marwaha; Leukoreduced blood components: Advantages and strategies for its implementation in developing countries; Asian J Transfus Sci. 2010 Jan; 4(1): 3–8.
[3]. Karen E. King, R. Sue Shirey, Sandra K. Thoman, Debra Bensen-Kennedy, Warren S. Tanz, and Paul M. Ness; Universal leukoreduction decreases the incidence of febrile nonhemolytic transfusion reactions to RBCs; TRANSFUSION Vol 44, Jan 2004 [4]. Y.M. Bilgin, L.M.G. van de Watering , A. Brand; Clinical effects of leucoreduction of blood transfusions; Neth J Med. 2011 Oct;69(10):441-50.

Abstract: Background: Shivering is known to be a frequent complication, reported in 40 to 70 % of patients undergoing surgery under regional anesthesia. Post-anesthetic shivering is spontaneous, involuntary, rhythmic, oscillating and tremor-like muscle hyperactivity that increases metabolic heat production up to 600% after general or regional anesthesia. The aim of this study was to evaluate the efficacy, potency and side effects of tramadol plus midazolam as compared to nalbuphine plus midazolam in control of shivering after intrathecal anesthesia.

[1]. Jan DW, Sessler DI. Perioperative Shivering: Physiology and Pharmacology. Anesthesiology, 2002 ; 96(2) : 467-484.
[2]. Sessler DI, Ponte J. Shivering during epidural anaesthesia. Anesthesiology, 1990;72:816-21.
[3]. Ozaki M, KurzA ,Sessler DI. Thermoregulatory thresholds during spinal and epidural anesthesia. Anesthesiology, 1994;81:282-8.
[4]. Rosa G, Pinto G, Orsi P, Conti G et al. Control of post anaesthetic shivering with nefopam hydrochloride in mildly hypothermic patients after neurosurgery. ActaAnaesthesiolScand, 1995; 39: 90–5.
[5]. Mahajan RP, Grover VK, Sharma SL, Singh H. Intraocular pressure changes during muscular hyperactivity after general anesthesia. Anesthesiology, 1987; 66: 419–21.
[6]. Shukla U, Malhorta K, Prabhakar T. A comparative study of the effect of clonidine and tramadol on post-spinal anaesthesia shivering. Indian J of Anaesth, 2011;55:242-6.

Abstract: We report a case of a 45-year-old woman who presented with vomiting & severe fatigue. On routine examination show iron deficiency anemia Gastroscopy revealed a large polyp in the antral region causing intermittent gastric outlet obstruction. Histopathologic examination revealed an inflammatory fibroid polyp (known also as Vanek's tumour).1
Background: Gastric polyps are usually found incidentally on upper gastrointestinal endoscopy performed for an unrelated indication and only in rare cases do they cause symptoms. Nevertheless, the diagnosis and appropriate management of gastric polyps are important, as some polyps have malignant potential.

[1]. Vanek J: Gastric submucosal granuloma with eosinophilic infiltration. Am J Pathol 1949;25:397–411.
[2]. Vanek J. Gastric submucosal granuloma with eosinophilic infiltration. Am J Pathol. 1949;25:405.
[3]. Lewin KJ, Appelman HD. Mesenchymal tumors and tumor-like proliferation. In: Rosai J, Sobin LH, eds. Tumors of the Esophagus and Stomach. Washington, DC: Armed Forces Institute of Pathology; 1996:449–453. Atlas of Tumor Pathology; 3rd series, fascicle 18
[4]. Kolodziejczyk P, Yao T, Tsuneyoshi M. Inflammatory fibroid polyp of the stomach: a special reference to an immunohistochemical profile of 42 cases. Am J Surg Pathol. 1993;17:1159–1168.
[5]. Hasegawa T, Yang P, Kagawa N, Hirose T, Sano T. CD34 expression by inflammatory fibroid polyps of the stomach. Mod Pathol. 1997;10:451–456. [6]. Livingston EH. Stomach and duodenum. In: Norton JA, Bollinger RR, Chang AE, Lowry SF, Mulvihill SJ, Pass HI, Thompson RW, editor. In Surgery: Basic Science and Clinical Evidence. New York: Springer-Verlag; 2000. pp. 489–515

Abstract: Ovarian cancer was considered to be rare in Nigeria. This study was therefore conducted to look into the current incidence and management of ovarian cancer patients cases seen in the Lagos state University Teaching Hospital, Ikeja, Lagos State. All the case notes of histologically diagnosed cases of Ovarian Cancers seen in LASUTH from 1st January 2004-Dec 31st 2013 were retrieved from the Medical records department and reviewed.Data was extracted for detailed analysis using a Data Extraction Form. Data extracted was coded and analyzed using Statistical Product and Service Solutions (SPSS) version 20.Ovarian cancer constituted 22.1% of a total of 855 histological diagnosed gynecological malignancies seen over the study period.Mean age of incidence was 40.58 years. Epithelial ovarian cancer was the commonest 67 %( 140).Serous/Papillary carcinoma accounted for52.1 %( 73) of subtypes of epithelial ovarian cancers. 66 %( 137) of thepatients hadcytoreductivesurgeries due to late presentations.

[1] United States Cancer Statistics: 1999-2009 Incidence and Mortality, Web based report. Atlanta G.A, Department of Health and Human Services, CDC and Prevention, NCI.
[2] Ovarian cancer statistics, Centre for disease control and prevention , 2013
[3] Seer Cancer Review Statistics, 1975-2010, National Cancer Institute, Bethesda, MD.
[4] Ovarian Cancer Statistics, UK Cancer research; Nov 2011.
[5] Iyoke.C.A, Ifeadike. C.O, Nnebue .C.C , A Ten-Year Review of Ovarian Cancer in Enugu, South East Nigeria; Afrimedic Journal 2011;2(1):8-12
[6] Gehrig. P.A, Varia. M, Apisarnthanarax. S et al; Ovary in Perez and Brady's Principles and Practice of Radiation Oncology, Chapter 68, 5th Edition,2008
[7] Kaku T, Ogawa S, Kawano Y et al. Histological classification of ovarian cancer.Medical Electron microscopy journal, 2003 Mar;36(1):9-17.
[8] Rabiu K.A, Akinola O.I, Adewunmi A.A et al ,Delays in presentation and management of ovarian cancer in Lagos, Nigeria. Journal of Obs and Gynecology 2013 Apr;33(3):305-8.

Abstract: Les tumeurs de pénis majoritairement représentés par le carcinome épidermoide de la verge sont relativement rares dans les pays occidentaux, et dans les populations qui pratiquent la circoncision à l'enfance, mais plus fréquent dans des pays à niveaux socio-économique faible. Le traitement chirurgical apporte le meilleur contrôle tumoral mais est un geste mutilant, tout par son impact psychologique que par les séquelles opératoires potentielles. Les traitements conservateurs constituent une alternative thérapeutique séduisante. Le traitement optimal des aires ganglionnaires reste un domaine controversé. Les facteurs pronostiques péjoratifs de cette pathologie sont l'atteinte ganglionnaire, celle du corps caverneux et la faible différenciation histologique.

Mots clés: Curage ganglionnaire, IRM, Pénectomie partielle, Verge

[1] Mottet N, Avances C, Bastide C, Culine S, Ibora F, Kouri G, et al. Penile tumors [Tumeurs du penis], Prog urol 14(4 Suppl 1);2004, 903, 905-11.

[2] Mottet N. Epidemiologie du cancer du penis [Epidemiology of penile cancer], Prog Urol Suppl 2; 2003):1237.

[3] A Nouri, H Elkarni, S El Yacoubi, T Karmoun. Cancer du pénis: A propos de 6 cas avec Revue de la littérature, African Journal of urology, 18 ; 2012, 66–70.

[4] Agrawal A et coll, C. Clinical and sonographic findings in carcinoma of the penis, J Clin Ultrasound, 28, 2000, 399-406.

[5] V. Ficarra et coll. Comparaison de la qualité de vie des patients traités pour cancer épidermoïde de la verge par chirurgie ou radiothérapie, Progrès en Urologie, 9 (1999), 715-720.

[6] Machele Donats et coll . Surgery of penile and urethral carcinoma, Campelle's urology, 8th ed, 2001, 2983-2999.

[7] Christophe Avanves, Cyrill Bastide. Chirurgie des tumeurs de pénis, Progrès en Urologie, 15, 2005, 1031-1034.

Abstract: Type 1 diabetes is hypothesized to pass through several stages where patients still do not need insulin but found to have serum autoantibody against islets cell. These patients were found to be in great risk of quickly developing insulin dependency. This study aims to find the presence of islets cell autoantibody in non-insulin requiring young diabetic patients of Bangladesh. To compare the Islets Cell Autoantibody (ICA) and Glutamic Acid Decarboxylase 65 (GAD 65) autoantibody level in the non-insulin requiring young diabetic patient and non-diabetic control group we have taken 120 non-insulin requiring diabetic patient and 60 age and sex matched non-diabetic control subjects. ELISA kit was taken from DRG inc.

[1] Zimmer, P. (2000) Globalization, coca-colonization and the chronic disease epidemic: can the doomsday scenario be averted? Journal of Internal Medicine, 247. p301-310.

[2] McKeigue PM, Miller GJ, Marmot MG. (1989) Coronary heart disease in South Asians overseas - a review. Joumal o/CIi1UJ1 Epidemiology. 42. p597-609.

[3] Borg H, Amqvist HJ, Bolinder J, Eriksson JW, Nystrom L, Jeppsson JO. et 81. (2003) Evaluation of the new ADA and WHO criteria for classification of diabetes mellitus in young adult people (15-34yrs) in the Diabetes Incidence Study in Sweden (DISS). Diabetologia, 46. p 173-181.

[4] Lipton RB. (2007) Incidence of diabetes in children and youth-tracking a moving target. Journal of American Medical Association. 297. p2760-62.

[5] Mayer, A, Fabien N, Gutowski MC, Dubois V, Gebuhrer L, Bienvenu J, et al. (2007), Contrasting cellular and humoral autoimmunity associated with latent autoimmune diabetes in adults. European Journal of Endocrinology.Wl. p53-61.

Abstract: Objectives: The study was conducted to determine the effects of MCIT on the affected upper extremity among Mild - Moderate Spastic Hemiplegic children. Study Design: Randomized Control Trial (RCT) Study Settings & Participants: An experimental study was conducted on 30 participants at a renowned CP Centre in Karachi. Procedure: The participants were randomly divided into Group A that received MCITwhereas group Bwas given conventional therapy.Group Aparticipants restraint non-affected arm and involve in different activities by using the affected arm while the other group performed different selected activities using both the arms.Data was recorded in a treatment sheet where PAFTwas used as a measurement tool.Data was analyzedusing SPSS version 20

[1]. Pellegrino L. Cerebral palsy. In: Batshaw ML, Ed. When Your Child Has a Disability: The Complete Sourcebook of Daily and Medical Care. Baltimore, MD: Paul H. Brookes Publishing Co; 2000:275–287
[2]. Chabrier S, Roubertie A, Allard D, et al. New developments in spastic unilateral cerebral palsy. Rev Neurol (Paris) 2010;166:565–573.
[3]. Kirton A, de Veber G. Cerebral palsy secondary to perinatal ischemic stroke. Clin Perinatol. 2006;33:367–386.
[4]. Boyd RN, Morris ME, Graham HK. Management of upper limb dysfunction in children with cerebral palsy: a systematic review. Eur J Neurol. 2001;8:150–166
[5]. Barry M. Evidence-based practice in pediatric physical therapy. Phys Ther. 2001;9:39–51
[6]. Kurtz LA. Understanding rehabilitation therapies. In: Batshaw ML, editor. When your child has a disability: the complete sourcebook of daily and medical care. John H. Brookes Publishing Company; Baltimore, MD: 2000. pp. 109–122.
[7]. Pellegrino L. Cerebral palsy. In: Batshaw ML, editor. When your child has a disability: the complete sourcebook of daily and medical care. Paul H. Brookes Publishing Company; Baltimore, MD: 2000. pp. 275–287.

Abstract:Pain is a sensation which makes most of the patients to move to a hospital. One of the biggest concerns for the patients undergoing surgery as well as for the anaesthetists going to anaesthetize them. The duty of an anaesthetist giving spinal anesthesia to a patient is to make the patient pain free postoperatively when effect of spinal anesthesia disappears. Many methods are being used to give analgesia postoperatively. Pre-emptive analgesia is one of them in which drugs are given before giving an incision in order to provide analgesia postoperatively. Pregabalin and Gabapentin both are effective as pre-emptive analgesia but neither of the drugs provided long term pain relief. Long term pain relief through pre-emptive analgesia will be a boon for patients if achieved. Search is still on for the pharmacological agents which can be used pre-emptively to provide adequate analgesia postoperatively.

Keywords: analgesia, Gabapentin, Hip Surgery, Preemptive, Pregabalin

[1]. Kissin I. Preemptive analgesia. Anesthesiology. 2000;93:1138– 43.
[2]. Gottschalk A, Smith DS. New concepts in acute pain therapy. Preemptive analgesia. Am Fam Physician 2001;63:1979-84,1985-6.
[3]. Tiippana EM, Hamunen K, Kontinen VK, Kalso E. Do surgical patients benefit from perioperative gabapentin/pregabalin? A systematic review of efficacy and safety. AnesthAnalg 2007; 104:1545-56.
[4]. Paech MJ, Goy R, Chua S, Scott K, Christmas T, Doherty D. A randomized placebo-controlled trial of preoperative oral pregabalin for postoperative pain relief after minor gynecological surgery; Anesth Analg 2007;105:1449-53.
[5]. Peng PWH, Wijeysundera DN, Li CCF. Use of gabapentin for perioperative pain control - A meta- analysis. Pain Res Manage. 2007;12(2):85-92.
[6]. Mathiesen O, Moiniche S, Dahl JB. Gabapentin and postoperative pain: a qualitative and quantitative systematic review, with focus on procedure. BMC Anesthesiology. 2007;7:6.
[7]. Jokela R, Ahonen J, Tallgren M, Haanpa M, Korttila K. Premedication with pregabalin 75 or 150 mg with ibuprofen to control pain after day-case gynecological laparoscopic surgery. Br J Anaesth. 2008;100: 834-40.

Abstract: Endometrial stromal sarcomas are rare malignant tumors of the uterus (0.2% of all uterine malignancies). The primary tumor can occur in extra-uterine sites like ovary, fallopian tube, cervix, vulva, vagina, omentum and retro peritoneum. There are only 18 cases reported in literature of ESS arising from cervix till date. Primary tumor arising in the cervix mimics a fibroid polyp and poses a diagnostic dilemma. A pre-operative diagnosis of ESS is difficult and the diagnosis is retrospective from histopathology of a hysterctomy specimen done for presumed benign disease.

[1]. M Usha, Aarthi R Rau, BK Sujani, T Uravashi. Low grade endometrial stromal sarcoma presenting as a cervical polyp in a young female: A rare case report. Cin Cancer Investig J 2014; 3:257-9.
[2]. Conklin CM, Longacre TA. Endometrial stromal tumors: the new WHO classification. AdvAnatPathol. 2014 Nov, 21(6):383-93.
[3]. HasiakosD,Papakonstantinou K, Kondi-Paphiti A, Fotiou S. Low-grade endometrial stromal sarcoma of the endocervix. Report of a case and review of the literature. EurJGynaecolOncol. 2007;28(6):483-6.
[4]. GeethaPuliyath, M Krishnan Nair. Endometrial stromal sarcoma: A review of literature. Indian J Med PaediatrOncol, 2012 Jan-Mar;33(1): 1-6.
[5]. Boardman CH, Webb MJ, Jefferies JA. Low-grade endometrial stromal sarcoma of the ectocervix after therapy for breast cancer. GynecolOncol. 2000 Oct; 79(1): 120-3.
[6]. Jaffe R, Altaras M, Bernheim J, Ben Aderet N. Endocervical stromal sarcoma-a case report. GynecolOncol. 1985 Sep; 22(1): 105-8.
[7]. Olusola B, Fasubaa G, OlutoinOmoniyi-Esan. Endocervical Stromal Sarcoma of the Cervix. Trop J ObstetGynaecol,2003;20: 167-169.

Abstract: Blood transfusion is a life-saving intervention and millions of lives are saved each year globally through this procedure. However, blood transfusions are associated with certain risks which can lead to adverse consequences. It may cause acute or delayed complications and carries the risk of the transmission of infections (1). Unsafe blood remains a major threat for the global spread of transfusion transmissible infections (TTIs). There is a long list of viruses, parasites and bacteria, which can be transmitted through blood transfusions. Amongst them, important ones are human immunodeficiency virus (HIV-I/II), hepatitis B virus (HBV), hepatitis C virus (HCV),

[1]. WHO Blood Safety Indicators, 2007. Geneva: World Health Organization; 2009
[2]. Choudhury N. Transfusion transmitted infections: How many more? Asian J Transfus Sci. 2010 Jul; 4(2):71–72.
[3]. Allain JP. Occult hepatitis B virus infection: implications in transfusion. Vox Sang. 2004 Feb; 86(2):83-91.
[4]. Kim MJ, Park Q, Min HK, Kim HO. Residual risk of transfusion-transmitted infection with human immunodeficiency virus, hepatitis C virus, and hepatitis B virus in Korea from 2000 through 2010. BMC Infectious Diseases 2012; 12:160.
[5]. Leung VK, Lee CK, Chau TN, Cheung WI, Lo FH, Lai KB ,et al. "A probable case of transfusion-transmitted hepatitis B virus infection in an immunosuppressed recipient caused by an occult HBV-infected donor with negative ID-NAT". Transfus Med. 2010; 11: 276–277.
[6]. Durro V, Qyra S. Trends in prevalence of hepatitis B virus infection among Albanian blood donors, 1999–2009. Virol J. 2011; 8: 96–102.
[7]. Chaudhuri V, Nanu A, Panda SK, Chand P. Evaluation of serologic screening of blood donors in India reveals a lack of correlation between anti-HBc titer and PCR-amplified HBV DNA. Transfusion 2003; 43: 1442-1448.