iosr-JDMS   Volume-14 ~ Issue-5 ~ May-2015

Abstract: Aims: To study physical expression (phenotype), congenital anomalies, elicit the degree of mental retardation and cytogenetic profile of Down syndrome patients in Manipur. Methods: The study was carried out in the Department of Anatomy on 50 suspected cases of Down Syndrome selected from mental homes of Manipur and Regional Institute of Medical Sciences hospital with due permission from the concerned authorities. All the cases were physically examined for their phenotype and karyotyping studies was carried out from peripheral blood.

[1]. Down JL. Observation on the ethnic classification of idiots. Lon. Hosp: ClinLec Res; 1866.Available from: http://www.neonatology.org/classic/down.html. Accessed on February 13, 2012. Kava MP, Tullu MS, Muranjan MN, Girisha KM. Down syndrome: Clinical profile from India. Arch Med Res 2004;35:31–5.
[2]. Kava MP, Tullu MS, Muranjan MN, Girisha KM. Down syndrome: Clinical profile from India. Arch Med Res 2004;35:31–5.
[3]. Azman BZ, Ankathil R, Siti MI, Suhaida MA, Norhashimah M, Tarmizi AB et al. Cytogenetic and clinical profile of Down syndrome in Northeast Malaysia. Singapore. Med J 2007;48:550–4.
[4]. Fryns JP, Buggenhout GV. Structural chromosome rearrangements in couples with recurrent fetal wastage. EurJ ObstetGynecol Repro Biol 1998
[5]. Wischart JG. The development of learning difficulties in Down syndrome. J IntellDisabil Res 1993; 37:389-403.

Keywords: In this study the researcher takes the students of semester 6 at the Faculty of Arts who study English as a foreign language at the University of Shendi as a sample to carry out this study. The study attempts to investigate and identify the problems facing them in using the confused prepositions (between, among, beside, besides, by, and with), to identify this problem, and to suggest suitable remedial procedures. A test was given to 33 students who represent the whole class of semester 6 at the faculty of Arts. The test results were analyzed by using (SPSS). The results revealed by the test affirmed that most of students failed to pass the test, while the others scores were very weak.Considering the findings of the study, and in order to participate in solving this problem, the researcher recommends and suggests the following:

[1]. Shehata M. 2003, Grammar, Alexandria, Dar Ebnkhaldoon.
[2]. T. J. Fitikides1980, Common Mistakes in English
[3]. Yates J 1999, the ins and outs of prepositions, New York Barron's
[4]. Educational Series
[5]. -Eckersley C.E. & Eckersley J. M. (1981) a comprehensive English Grammar, Hong Kong, Longman Group Limited
[6]. Judith F. Olson 2009, Writing skills success in 20 minutes a day, United State, Learning Express, LLC, New York.

Abstract: We report a case of 55 years old female who presented to our hospital with documented consumption of organo phosphate compound profenofos 40%, 4 days prior to hospitalisation. She had predominantly muscarinic & also nicotinic manifestations & developed delayed neurotoxicity by 3rd week .She was administered high dose of atropine (about 4800mgm) in a span of 26 days and pralidoxime as per the WHO recommendation, still with poor recovery & needed ventilatory support for a long period.

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Abstract: Secondary gynaetresia may occur as a result of trauma to the female genital tract with secondary infection and adhesions. Post traumatic s vaginal stenosis after full term vaginal delivery is rarely seen in gynaecology We report a case of 28 year old woman presenting with history of termination of 6 weeks pregnancy with probably oral mifepristone and misoprostol. On examination she was found to have vaginal atresia with a pin point cicatrized hole in the centre. She had full term vaginal delivery 2 years back with history of traumatic post partum haemorrhage in the first delivery.USG showed mixed echogenic lesion of 30×20mm suggestive of retained products of conception. Findings at surgery were vaginal septum with pin point hole in the centre.

[1]. Lippincott William and Wilkins Baltimore, Maryland. Stedman's medical dictionary. 28thed; 2006.p. 841.
[2]. Lawson JB. Acquired gynaetresia. In: Lawson JB, Stewart DB. (eds). Obstetrics and Gynaecology in the Tropics and developing countries. First edition, London. Edward Arnold Limited; 1967.
[3]. Unuigbe JA, Ojobo S, Orasanye AU. The challenges of vaginal stenosis. The Nigerian experience. Int. J Gynaecol.Obstet. 1984; 22: 1- 4.
[4]. Ozumba BC. Acquired gynaetresia in Eastern Nigeria. Int. J Gynaecol. Obstet. Scand.1978: 89-96.

Abstract: BACKGROUND: Esophageal carcinoma is an aggressive cancer affecting worldwide population with very high incidence and mortality. The 5-year survival rate is still low even after years of development in the diagnostic and treatment regimens. The aim of this study is to evaluate the efficacy and safety of endoscopic submucosal dissection (ESD) and endoscopic mucosal resection (EMR) in the treatment of superficial esophageal cancer (SEC).

[1]. MA Gui-fen MQ, CHEN Shi-yao (2011) Evidence-Based Practice in A Patient with Superficial Esophageal Cancer. The Journal of Evidence-Based Medicine 11: 355-374.
[2]. Tachibana M, Kinugasa S, Shibakita M, Tonomoto Y, Hattori S, et al. (2006) Surgical treatment of superficial esophageal cancer. Langenbecks Arch Surg 391: 304-321.
[3]. Pennathur A, Gibson MK, Jobe BA, Luketich JD (2013) Oesophageal carcinoma. Lancet 381: 400-412.
[4]. Zhang Y (2013) Epidemiology of esophageal cancer. World J Gastroenterol 19: 5598-5606.
[5]. Schlemper RJ, Riddell RH, Kato Y, Borchard F, Cooper HS, et al. (2000) The Vienna classification of gastrointestinal epithelial neoplasia. Gut 47: 251-255.

Abstract: Background: The aim is to study whether increased serum calcium level is a risk factor in acute myocardial infarction or not. METHOD: Fifty (50) patients with acute myocardial infarction without taking treatment were included in the study. Twenty five (25) healthy controls were also included in the study for comparison. Results: Calcium levels were increased in patients of myocardial infarction with 11.3+0.59 mg/dl (mean + SD) when compared to controls with 9+0.23 mg/dl (mean + SD) with a statistically significant 'p' value of <0.0001. CK-MB values were also increased in cases with 68.38±5.52 IU/L( mean+SD ) compared to controls with 16.68+1.93 IU/L( mean+SD ) with a statistically significant 'p' value of <0.0001. Conclusion: Increased serum calcium level appears to be a risk factor for myocardial infarction. Keywords: Myocardial infarction, calcium, CK-MB

[1]. Elliott M, Antman, Andrew P, Selwyn, Eugene Braunwald, Joseph Loscalzo. Harrison‟s Principles of Internal Medicine 17thed, volume 2 ,McGraw Hill Medical, chapter 237, p 1514.
[2]. TsujitaK, Kaikita K, Soejima H, Sugiyama S, Ogawa H (April 2010). "Acute coronary syndrome-initiating factors". Nippon Rinsho(in Japanese).68(4);607-14.
[3]. DohiT, Daida H (April2010) . "Change of concept and pathophysiology in acute coronary syndrome" Nippon Rinsho( in Japanese) 68(4); 592 -6.
[4]. Woollard KJ, Geissmann F (February2010) "Monocytes in atherosclerosis : subsets and function" Nature Reviews Cardiology .7(2) 77-86 doi; 10.1038/nrcardio,2009 ,228.PMC 2813241PMID 200659514.
[5]. Greenland P, LaBree L, Azen SP, Doherty TM, Detrano RC (2004) " Coronary artery calcium score combined with Framingham score for risk prediction in asymptomatic individual" JAMA 291 (2). 210 - 5doi:10.1001/jama. 291. 2. 210 PMID14722147.

Abstract: Aim -To evaluate the efficacy, safety and major and minor complications of percutaneous Nephrolitho to my (PCNL) Methodology: A total of 100 per cutaneous nephrolithotomies were done at meenakshi medical college and research institute,Kanchipuram,Tamil nadu,India from august 2013 to april 2015.Stone parameters, PCNL complications, and stone-free rate were evaluated.Complications were classified by the modified Clavien grading system.

[1]. Fernström I, Johansson B. Percutaneous pyelolithotomy. A new extraction technique. Scand J Urol Nephrol. 1976;10:257–259.
[2]. Preminger GM, Assimos DG, Lingeman JE, Nakada SY, Pearle MS, Wolfe JS., Jr AUA Nephrolithiasis Guideline Panel. Chapter 1: AUA guideline on management of staghorn calculi: diagnosis and treatment recommendations. J Urol. 2005;173:1991–2000.
[3]. Clavien PA, Sanabria JR, Strasberg SM. Proposed classification of complication of surgery with examples of utility in cholecystectomy. Surgery. 1992;111:518–526.
[4]. Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of a 6336 patients and results of a survey. Ann Surg. 2004;240:205–213.
[5]. El-Nahas AR, Eraky I, Shokeir AA, Shoma AM, El-Assmy AM, El-Tabey NA, et al. Long-term results of percutaneous nephrolithotomy for treatment of staghorn stones. BJU Int. 2011;108:750–754.

Abstract: Here is a case of 22 year old female primigravida with term gestation with non progression of labour for emergency caesarean section. Advances in surgical technique, prosthetic heart valve design, and anticoagulation have contributed to an overall improvement in morbidity and mortality in women with heart valve prostheses as well as increased feasibility of pregnancy. Several reports have been published of successful pregnancies in patients with prosthetic valves. The numbers are still comparatively small, however, and a further case is reported in which the outcome was favourable for both mother and fetus.

Keywords: Pregnancy, Prosthetic heart valves.

[1]. Buxbaum, A., Aygen, M. M., Shahin, W., Levy, M. J., And Ekerling, B. (1971). Pregnancy In Patients With Prosthetic Heart Valves. Chest, 59, 639.
[2]. Hirsh, J., Cade, J. F., And O'Sullivan, E. F. (1970). British Medical_Journal, 1, 270.
[3]. Littler, W. A. (1970). British Heart Journal, 32, 416.
[4]. Ueland, K., Tatum, H. J., And Metcalfe, J. (1966). Obstetrics And Gynecology 27, 257.
[5]. Akbarian, M., Austen, W. C., Yurchak, P. M., And Scannell, J. G. (1968). Thromboembolic Complications Of Prosthetic Cardiac Valves. Circulation, 37, 826.

Abstract: Ovarian epithelial tumors are common in adult women but infrequent in children and rare before puberty. These tumors constitute a dilemma to the clinician because no general consensus exists regarding their treatment protocol in adolescent girls. In young patients with ovarian cysts requiring removal, a conservative approach of ovarian cystectomy is advocated to enable retention of functioning ovarian tissue for endogenous hormone production and future conception. However, incidence of recurrences are high in such cases. Borderline tumors in adolescents are usually associated with a favourable prognosis. We report two cases of mucinous borderline tumor in adolescent girls aged 15 and 14 years respectively, one of whom presented with a recurrent ovarian mass previously treated twice with cystectomy.

[1]. Lalwani N, Shanbhogue AK, Vikram R, Nagar A, Jagirdar J, Prasad SR. Current update on borderline ovarian neoplasms. AJR Am J Roentgenol 2010;194(2):330–336. [2]. A.Horiuchi, K.Kameoka, K.Sato Y Yamamoto, Y Watanabe. Huge mucinous borderline ovarian cystadenoma in a premenarchal girl. Open Journal of Pediatrics, Vol.2 No.1, 2012
[3]. Kurman RJ, Shih IeM. Pathogenesis of ovarian cancer: lessons from morphology and molecular biology and their clinical implications. Int J Gynecol Pathol 2008; 27:151–160 [4]. Baksu, B, Akyol, A, Davas, I, Yazgan, A, Ozgul, J, Tanik, C (2006) Recurrent mucinous cystadenoma in a twenty year old woman: was hysterectomy inevitable?. J Obstet Gynecol Res 32: pp. 61 [5]. Park, J.Y., Kim, D.Y., Kim, J.H., Kim, Y.M., Kim, Y.T. and Nam, J.H. (2009) Surgical management of borderline ovarian tumors: The role of fertility-sparin g surgery. Gynecologic Oncology, 113, 75-82

Abstract: One of the most commonly faced problems among long term denture wearers is the reduction in the denture foundation. Prosthetic Rehabilitation of a patient with severely resorbed ridge is the most challenging therapy. In order to have a favourable prognosis for the denture therapy, impression technique selected should be based on the present state of the basal tissue support. Also occlusal schemes can be modified to enhance stability of denture and hence overall function can be improved. However it is difficult to make records for programming Hanau articulator in order to achieve balanced occlusion in patient with resorbed ridges. In this case McCord's impression technique, concept of Neutral zone (NZ) and Balanced occlusal scheme being incorporated in an effort to achieve successful complete denture therapy.

Keywords: Neutral zone, Resorbed ridges, Impression technique, Balanced occlusion Stability.

[1]. Fish E. Using the muscles to stabilize the full lower denture. J Am Dent Assoc. 1933;20(12):2163-9.
[2]. Brill N, Tryde G, Cantor R. The dynamic nature of the lower denture space. The Journal of Prosthetic Dentistry. 1965;15(3):401-18.
[3]. E.M. The polished surfaces. Br Dent J. 1961;111(5):407-11.
[4]. Grant A, Johnson W. An introduction to removable denture prosthetics: C. Livingstone; 1983.
[5]. Wright SM. The polished surface contour: a new approach. Int J Prosthodont. 1991;4(2):159-63.

Abstract: Thanatophoric dysplasia Type I is a rare form of neonatal lethal skeletal dysplasia. Here we report a 25 years old gravid womenwho came to our department for routineanamolyscan .Anamoly scan at 18 weeks showed features of short limbs,curved femur,hydrocephalus and narrow thorax.According to these findings we suspected diagnosis of thanatophoric dysplasia. Further radiological investigtion was performed with fetal MRI for complete assessment. Due to lethality of the skeletal dysplasia the fetus was aborted. Subsequently abortus was radiographically examined, before fetal autopsy.

Key words: Thanatophoric dysplasia Type I,skeletal dysplasia,Anamoly scan ,narrow thorax, curved femur

[1]. Enid GB. Skeletal system. In: Enid GB, editor. Potter's Pathology of the Foetus, Infant and Child. 2nd ed. Philadelphia: Mosby Elsevier; 2007.
[2]. Maroteaux P, Lamy M, Robert JM. Thanatophoric dwarfism. Presse Med 1967; 75:2519-24
[3]. Vajo Z, Francomano CA, Wilkin DJ. The molecular and genetic basis of fibroblast growth factor receptor 3 disorders: The achondroplasia family of skeletal dysplasias, Muenkecraniosynostosis, and Crouzon syndrome with acanthosis nigricans. Endocr Rev 2000;21:23‑39.
[4]. Naveen NS, Murlimanju BV, Kumar V, Pulakunta T, Jeeyar H. Thanatophoric dysplasia: A rare entity. Oman Med J 2011;26:196‑7.
[5]. Noe E.J, Yoo H.W, Kim K.N, Lee S.Y. A case of thanatophoric dysplasia type 1 with an R248C mutation in the FGFR3 gene. Korean J Pediatrics 2010; 53(12):1022-25.

Abstract: High body mass index (BMI) has been associated with an increased risk for breast cancer. We aimed to study the association between breast cancer and BMI according to staging by Breast Imaging Reporting and Data System (BIRADS) among Iraqi women (pre and post menopause) attending the Center for Early Detection, Baghdad. Patients and Methods:A cross sectional study in which BMI and BIRADS of all women 'with breast mass proved to be malignant or highly suspicious by BIRADS' attending the Breast Cancer Clinic during the period from first of September 2011 to end of May 2012were studied.

[1]. WHO; Breast cancer: prevention and control. 2012. World Health Organization Publications. http://www.who.int/cancer/detection/breastcancer/en/
[2]. Cecchini RS, Costantino JP, Cauley JA, Cronin WM, Wickerham DL, Land SR, Weissfeld JL, Wolmark N.; Body mass index and the risk for developing invasive breast cancer among high-risk women in NSABP P-1 and STAR breast cancer prevention trials.2012. Cancer Prev Res (Phila). Apr; 5(4):583-92. Epub 2012 Feb 7.
[3]. Kawai M., Minami Y., Nishino Y., Fukamachi K., Ohuchi N. and Kakugawa Y.; Body mass index and survival after breast cancer diagnosis in Japanese women. 2012. BMC Cancer, 12:149 doi:10.1186/1471-2407-12-149http://www.biomedcentral.com/1471-2407/12/149
[4]. Heber D, McCarthy WJ, Ashley J, Byerley LO.; Weight reduction for breast cancer prevention by restriction of dietary fat and calories: rationale, mechanisms and interventions.1989. Nutrition. May-Jun;5(3):149-54.

Abstract: LEIOMYOMAS are common benign tumors of uterus, incidence being 20-40% in women of reproductive age and it increases with age .However, vaginal leiomyomas remain an uncommon entity with only 330 cases reported in literature till now. Vaginal leiomyomas are most commonly located in anterior vaginal wall .They present with varied clinical features .Sometimes they are associated with leiomyomas elsewhere in the body. We report a case of primary leiomyoma of vagina arising from anterior wall and presenting with lower abdominal pain and feeling of something coming out per vaginum.

Keywords: Leiomyoma, Vagina

[1]. Young SB, Rose PG, Reuter KL. Vaginal fibromyomata: Two cases with preoperative assessment, resection and reconstruction. Obstet Gynecol. 1991; 78: 972–4.
[2]. Bennett HG Jr, Erlich MM. Myoma of the vagina. Am J Obstet Gynecol. 1941; 42: 314–20.
[3]. Shimada K, Ohashi I, Shibuya H, Tanabe F, Akashi T. MR imaging of an atypical vaginal leiomyoma. Am J Roentg. 2002; 178: 752–4.
[4]. Elsayes KM, Narra VR, Dillman JR, Velcheti V, Hameed O, Tongdee R, et al. Vaginal Masses: Magnetic Resonance Imaging Features with Pathologic Correlation. Acta Radiol. 2007; 8: 921–33.
[5]. Cobanoğlu O, Gürkan Zorlu C, Ergun Y, Kutluay L. Leiomyosarcoma of the vagina. Eur J Obstet Gynecol Reprod Biol. 1996; 70: 205–7.

Abstract: The incidence of hypoxic-ischemic encephalopathy (HIE) is reportedly high in countries with limited resources; It is one of the top 20 leading causes of burden of disease in all age groups (in terms of disability life adjusted years) by the world health organization (WHO) and is the fifth largest cause of death of children younger than 5 years(8%). The purpose of this study was to investigate variations in platelet count in blood associated with HIE and its relation with the severity of HIE. A prospective (case control) study was undertaken between august 2011 and october2013 in the neonatal intensive care unit. The study population was consisted of 50 full term infants with asphyxia (group-1) and 50 healthy new-born (group-2). During the first 48 hrs.

[1]. Bryce j, boschi-pinto c, shibuya k, black re. Who estimates of the causes of death in children.Lancet, 365(9465), 2005, 1147-1152.
[2]. Lawn j, shibuya k, stein c. No cry at birth: global estimates of intrapartum stillbirths and intrapartum-related neonatal deaths. Bull world health organ, 83(6), 2005, 409- 417.
[3]. Shah p, riphagen s, beyene j, perlman m. Multiorgan dysfunction in infants with post-asphyxial hypoxic-ischaemic encephalopathy. Arch dis child fetal neonatal ed, 89, 2004, 152-155.
[4]. Sarnat HB, Sarnat MS. Neonatal encephalopathy following fetal distress: A clinical and electroencphalographicstudy. Archives of Neur, 33, 1976, 696-705.
[5]. Nursen B, Sukru K, Recep S. Perinatal asphyxia and thrombocytopenia. O.M.U. Tip Dergisi, 16(2), 1999, 100-105.

Abstract: Understanding the mechanism of disturbance of blood flow in different stroke subtypes, their aetiopathogenic process and accurate anatomical localization are concepts essential for proper management and prognostication in stroke. As effective as thrombolysis might be in restoring blood flow after an ischaemic ictus, its application in haemorrhagic stroke can be disastrous. This review examines the current literature on the pathogenesis of the different types of stroke and the evidence basis for the use of intravenous thrombolysis as a primary treatment modality that has the possibility of restoring blood supply to the ischaemic brain.

[1]. Goldstein L. B., Bushnell C. D., Adams R., et al. ―Guidelines for the Primary Prevention of Stroke: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association‖, Stroke 42, 2011 p517-584.
[2]. Demarin V., Žikić M., Žikić T. R. ―Stroke: A Historical Overview and Contemporary Management‖, Curr Top NeurolPsychiatrRelatDiscip. 2011; Vol 19, No. 2.
[3]. World Health Organization. ―Cerebrovascular Disorders: A Clinical and Research Classification. 43‖. Geneva, World Health Organization. 1978.
[4]. Scottish Intercollegiate Guidelines Network (SIGN), ―Management of Patients with Stroke or TIA: Assessment, Investigation, Immediate Management and Secondary Prevention‖. A national clinical guideline. December 2008; Pg 1-108.
[5]. Lossef N., Brown M., and Grieve J. ―Stroke and Cerebrovascular Diseases‖, Neurology: A Queen Square Textbook. (2009; 1st ed., edited by Clarke C., Howard R., Rossor M., Shorvon S.D., Wiley-Blackwell United Kingdom).Pg 104-154.

Abstract: Several studies in the past failed to demonstrate the relationship between serum lipid profiles as a risk factor for stroke. Aim: To determine the relationship between lipid profile and ischaemic stroke. Methodology: A total of 100 patients were included in the study, with 50 acute ischaemic stroke patients and 50 non-stroke patients. Results: The non-stroke patients had statistically significant higher total cholesterol concentrations when compared to those with ischaemic stroke. There was no significant difference between the HDL, LDL and triglyceride concentrations of the ischemic stroke patients when compared to the control group.

[1]. Jones MR, Horner RD, Edwards LJ, Hoff J, Armstrong SB, Smith-Hammond CA, et al. Racial variation in initial stroke severity. Stroke 2000; 31: 563-67.
[2]. Gillum RF. Stroke mortality in blacks. Disturbing trends. Stroke 1999; 30: 1711-5.
[3]. Goldstein LB, Adams R, Becker K, et al. Primary prevention of ischaemic stroke: a statement for healthcare professionals from the Stroke Council of the American Heart Association. Stroke 2001; 32: 280-299.
[4]. Romero JR, Morris J, Pikula A. Stroke prevention: modifying risk factors. Therapeutic Advances in Cardiovascular Disease 2008; 2(4): 287-303.
[5]. Allen CL, Bayraktutan U. Risk factors for ischaemic stroke. Int J Stroke 2008; 3(2): 105-16.