iosr-JDMS   Volume-15 ~ Issue-2 ~ February-2016

Abstract: Recent data indicate that psychological and emotional disorders may play an important role in the natural history of cardiovascular diseases. Studies indicate that anxiety and panic disorders in cardiac patient influences mortality and morbidity. Panic disorder, a subtype of anxiety disorder, has been associated with increased risk of fatal myocardial infarction and sudden cardiac death in epidemiological studies. Anxiety and panic attacks may accelerate different direct and indirect pathways involved in the pathogenesis of cardiovascular disorders such as lifestyle risk factors, hypertension, myocardial perfusion, autonomic nervous system or hypothalamus-pituitary-adrenal axis, and other inflammatory processes. Panic disorder seems to correlate particularly with sudden death: which suggests that it may be considered one of the main inducers of life-threatening arrhythmias, rather than to be linked to the development and progression of ischemic heart diseases. Keywords: Panic disorder, anxiety, cardiovascular diseases, epidemiology, pathophysiology, treatment.

[1]. Diagnostic and Statistical Manual of Mental Disorders (DSM-5). American Psychiatric Association. 2013.
[2]. Maurizio G, Abrignani, Nicolò R, Abrignani V, Raffa A, Salvatore N, et al. Panic disorder, anxiety, and cardiovascular diseases. Clinical Neuropsychiatry 2014; 11(5): 130-144.
[3]. Kawachi I, Colditz GA, Ascherio A, Rimm EB, Giovannucci E, Stampfer MJ, et al. Prospective study of phobic anxiety and risk of coronary heart disease in men. Circulation 1994;89:1992–7.
[4]. Esler M. Heart and mind: psychogenic cardiovascular disease. J Hypertens 2009;27:692–5.
[5]. Ketterer MW, Mahr G, Goldberg AD. Psychological factors affecting a medical condition: ischemic coronary heart disease. J Psychosom Res 2000;48:357–67.
[6]. Frasure-Smith N, Lesperance F, Gravel G, Masson A, Juneau M, Bourassa MG. Long-term survival differences among low-anxious, high-anxious and repressive copers enrolled in the Montreal heart attack readjustment trial. Psychosom Med 2002;64:571–9.

Abstract:Proteus syndrome is a congenital disorder with a variable clinical spectrum. The cause is mostly unknown, but a genetic mutation that is viable only in a mosaic pattern, has been postulated. Here we present a case of a 28 yrs female, presented with Splenomegaly, Gigantic right lower limb. The clinical findings are in conformity to the criteria for the Proteus syndrome.

Key Words: Gigantic limb, Proteus, mutation

[1]. Orloff MS, Eng C. Genetic and phenotypic heterogeneity in the PTEN Hamartoma Tumour Syndrome.Oncogene. 2008;27:5387–
97.
[2]. Lyons K, Ezaki M. Molecular regulation of limb growth. J Bone Joint Surg Am. 2009;91:47
[3]. Biesecker L. The challenges of Proteus syndrome: Diagnosis and management. Eur J Hum Genet.2006;14:1151–7.
[4]. Lindhurst MJ, Sapp JC, Janie K, Johnston JJ, Finn EM, Peters K, et al. A mosaic Activating Mutation in AKT1 Associated with the
Proteus Syndrome. N Engl J Med. 2011;365:7.
[5]. Hamm H. Cutaneous mosaicism of lethal mutations. Am J Med Genet. 1999;85:342–5
[6]. Turner J, Biesecker B, Leib J, Biesecker L, Peters KF. Parenting children with Proteus syndrome: Experiences with, and adaptation
to, courtesy stigma. Am J Med Genet A. 2007;143A:2089-97.
[7]. Cruz R, Nunes ALS, Fortuna CMM, Pimentel HM, Teixeira E. Síndrome de Proteus: relato de dois casos e revisão da literatura.
Rev Bras Ortop. 1999;34:299-303.
[8]. Slavotinek AM, Vacha SJ, Peters KF, Biesecker LG. Sudden death caused by pulmonary thromboembolism in Proteus syndrome.
Clin Genet. 2000;58:386-9.

Abstract: Introduction: Skin can be the site of manifestations of many systemic diseases. Morphea which is also includes thickening & hardening of skin & sub cutaneous tissues may have a varying range of manifestations. Surgery is rarely indicated. Case Report: A 30 year old female came with complaints of dark brown sclerotic plaque over the upper half of the right thigh with restriction of movements at the right hip joint. X-Ray of the pelvis was suggestive of mottled calcifications & biopsy proved the diagnosis of morphea with calcinosis circumscripta. Excision of the lesion with split skin grafting was done. Conclusion: Morphea is a rare disease & surgical intervention results in successful outcome when indicated

Keywords: Morphea, calcinosis, excision

[1]. Peterson LS, Nelson AM, Su WP, Mason T, O'Fallon WM, Gabriel SE. Epidemiology of morphea (Localized Scleroderma) in Olmsted Country 1960-1993. J.Rheumatol. 1997; 24 (1): 73-80.

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[3]. Peterson LS, Nelson AM, Su WP. Classification of morphea (localized scleroderma). Mayo Clin Proc. 1995;70(11):1068-76

[4]. Micalizzi C, Parodi A, Rebora A. Morphea with nodular lesions. Br J Dermatol 1994; 131: 298-301.

[5]. Goldsmith, Katz, Gilchrest, Paller, Leffel, Walff. Disorders of the dermal connective tissue. Fitzpatricks dermatology in general medicine: Mc Graw Hill 2012; 8th ed (1): 692-701.

[6]. Lakhanpal S, Ginsburg WW, Michet CJ, Doyle JA, Moore SB. Eosinophilic fasciitis: clinical spectrum and therapeutic response in 52 cases. Semin Arthritis Rheum. May 1988;17(4):221-31. [7]. Cosnes A, Anglade M-C, Revuz J et al. Thirteen megahertz ultrasound probe: its role in diagnosing localized scleroderma. Br J Dermatol 2003; 148: 724-9.

Abstract: Background and objective: Proximal humerus is the second most common site of fracture in the upper limb. The four-part proximal humerus fractures are severe and complex, make the management challenging especially in elderly. However controversy exists regarding the optimum treatment for four-part fracture and four-part fracture dislocation. The present study describes the efficacy of functional outcome of shoulder hemi arthroplasty in patients with four-part fracture and four-part fracture dislocation.

[1]. Magovern B, Ramsey ML. Percutaneous fixation of proximal humerus fractures. Orthop Clin North Am 2008;39:405-16.
[2]. Cadet ER, Ahmad CS.Hemiarthroplasty for three- and four-part proximal humerus fractures. J Am Acad Orthop Surg 2012;20(1):17-27.
[3]. Muncibì F, Paez DC, Matassi F, Carulli C, Nistri L, Innocenti M. Long term results of percutaneous fixation of proximal humerus fractures. Indian J Orthop 2012;46(6):664-7.
[4]. Lenarz C, Shishani Y, McCrum C, Nowinski RJ, Edwards TB, Gobezie R.Is reverse shoulder arthroplasty appropriate for the treatment of fractures in the older patient? Early observations. Clin Orthop Relat Res 2011;469(12):3324-31.
[5]. Kumar C, Gupta AK, Nath R, Ahmad J. Open reduction and locking plate fixation of displaced proximal humerus fractures. Indian J Orthop 2013;47(2): 156-60.

Abstract:Ocular trauma is the leading cause of ocular morbidity in children and young adults.Ocular injuries can occur in almost any setting including recreational and sports activities, at workplace, at home, in rural agricultural settings, motor vehicle accidents and with intention of compensation. In addition to the visual concerns, ocular trauma leaves a tremendous financial penalty, in terms of both direct and indirect costs.Of the approximate 2.4 million ocular injuries annually, males are involved ~9 times more often than females, and most victims are younger than 40 years of age[1].

[1]. Mieler W..F.and Seenu M. H. (2008) Overview of ocular trauma , 3rd edition edn., Principles & Practice of Ophthalmology by Albert D.M., Miller J W, Azar D.T., and Blodi B.A. 3rd edition : Elsevier Publisher (2008) page-5039.
[2]. Kuhn F, Morris R, Witherspoon CD, Heimann K, Jeffers JB, Treister G. A (1996) 'A standardized classification of ocular trauma', graefe's arch clinic expo ophthalmology,234 pp. 399-403.
[3]. Shihota R tondon R (2011) Parson‟s disease of ophthalmology , 21st edn., : Elsevier India,page no 375.
[4]. Duke Elder P.A. (1968) mechanical injuries in Duke Elders , St.louis 1972 the CV: Editor : system of ophthalmology volume X IV (14) Mosby company. 1572 – 616.
[5]. Scott WR, Lloyd WC, Benedict JV, Meredith R. :Ocular injuries due to projectile impacts. Annu Proc Assoc Adv Automot Med. 2000;44:20517.
[6]. Weidenthal DT ,Schepens CL (1996) peripheral fundus changes associated with ocular contusions "American Jr. ophthalmol 62 (3) :465-477.

Abstract: Aim: To assess the efficacy of vacuum assisted closure as compared to conventional moist wound dressings in improving the healing process in chronic wounds and to prove that vacuum assisted closure can be used as a much better treatment option in the management of chronic wounds. Study design: Randomized control trial. Place and duration of study: General Surgery Department, NRI Medical College & General Hospital, Chinakakani from October 2013 to September 2015.

[1]. Graham IDHarrison MBNelson EALorimer KFisher A Prevalence of lower-limb ulceration: a systematic review of prevalence studies. Adv Skin Wound Care 2003;16 (6) 305- 316
[2]. Vermeulen HUbbink DTGoossens Ade Vos RLegemate DA Systematic review of dressings and topical agents for surgical wounds healing by secondary intention. Br J Surg 2005;92 (6) 665- 672
[3]. Singh AHalder SMenon GR et al. Meta-analysis of randomized controlled trials on hydrocolloid occlusive dressing versus conventional gauze dressing in the healing of chronic wounds. Asian J Surg 2004;27 (4) 326- 332
[4]. Winter GD Formation of the scab and the rate of epithelization of superficial wounds in the skin of the young domestic pig. Nature 1962;193293- 294
[5]. Samson DJLefevre FAronson N Wound Healing Technologies: Low Level Laser and Vacuum-Assisted Closure. Rockville, MD Agency for Healthcare Research and Quality2004;AHRQ publication 05-E005-2
[6]. Pham CMiddleton PMaddern G Vacuum-Assisted Closure for the Management of Wounds: An Accelerated Systematic Review. Adelaide Australian Safety and Efficacy Register of New Interventional Procedures-Surgical2003;ASERNIP-S Report No. 37

Abstract: In India the incidence of Chronic Suppurative Otitis Media (CSOM) is very high. The management of CSOM had witnessed a profound change over the last 100 years. FortyOssiculoplasties were performed over a year period i.e. from july 2014 to june 2015 at a tertiary care hospital in south India.Patients of both safe and unsafe type of CSOM with good cochlear reserve and good Eustachian tube function were selected. Both intact canal wall and canal wall down procedures were included. In our study, we achieved better results with autogenous bone as compared to homograft cartilage.

Keywords: Ossicular erosion, Ossiculoplasty, Tympanoplasty, Austins classification, Reshaped incus

[1]. Austin D. F; ossicular reconstruction, Otolaryngology clinics of North America, 5; 145-160, 1972.
[2]. Proctor B (1964), The development Of the middle ear spaces and their surgical significance Journal Of laryngology and otology - 78, 631-648.
[3]. Thomsen, J. Jorgensen, M B. Bretlaw, P 8 Kirstensen, H.K (1974), Bone resorption in chronic otitis media Journal of laryngology and otology - 88, 975-992.
[4]. Ohsaki.K, Yomashita: S, Fujita A. Masuda Y.Ueda. Sugiura, Ohsaki et al (1988) Mechanism of bone destruction due to middle ear cholesteatoma as revealed by Laser Raman Spectrometry American Journal of Otolaryngology, 9. 117-126.
[5]. Wehrs RF, Homograft ossicles in tympanoplasty, Laryngoscope, 92, 540-546, 1982.
[6]. Guildford F, Repositioning Of the incus, Laryngoscope, 75: 236, 1965.
[7]. Zollner F Ole Schalleitung'splastiken Arch Otol (Stockh) 45: 168, 1955.

Abstract:Lumbar hernia is a rare abdominal wall defect and misdiagnosed as lipoma over back. It is included in ventral hernias despite being dorsolateral. Here we report a case of 70 year old female with complains of pain, swelling since two years. Clinical examination revealed 6x6 cm spherical swelling in the left lumbar region. Surface is smooth, Soft in consistency, margins well defined,not freely mobile, diagnosed as Lipoma. Intraoperatively, extra peritoneal fat protruding from a parietal defect of 3x3cms in the superior lumbar
triangle seen and defect closed with prolene mesh. Post operative period of uneventful.

Key Words: Lumbar hernia, lipoma, parietal defect

[1]. Moreno Egea A, Baena EG. Controversies in the current management of lumbar hernias. Arch Surg. 2007;142:82–88. doi: 10.1001/archsurg.142.1.82.
[2]. Le Neel JC, Sartre JY, Borde L, Guiberteau B, Bourseau JC. Lumbar hernias in adults. Apropos of 4 cases and review of the literature. J Chir (Paris) 1993;130(10):397–402.
[3]. Loukas M, El-Zammar D, Shoja MM, Tubbs RS, Zhan L, Protyniak B, Krutoshinskaya Y. The clinical anatomy of the triangle of Grynfeltt. Hernia. 2008;12(3):227–231. doi: 10.1007/s10029-008-0354-4.
[4]. Zhou X, Nve JO, Chen G. Lumbar hernia; Clinical analysis of 11 cases. Hernia. 2004;8:260–263. doi: 10.1007/s10029-004-0230-9.
[5]. Astracioglu H, Sokmen S, Atila K, Karademir S. Incarcerated inferior lumbar (Petit's) hernia. Hernia. 2003;7:158–160. doi: 10.1007/s10029-003-0128-y.
[6]. Losanoff EJ, Kjossev KT. Diagnosis and treatment of primary incarcerated lumbar hernia. Eur J Surg. 2002;168:193–195. doi: 10.1080/110241502320127829.

Abstract: Intraspinal hemorrhage is very rare and intramedullary hemorrhage, also called "hematomyelia" is the rarest form of intraspinal hemorrhage. There are only few reports in medical literature. We report a case of 34 year old male having haemophilia A presented with numbness and weakness of both lower extremities and acute retention of urine resulting from thoracic hematomyelia. The patient showed gradual improvement on medical management with cryoprecipitate infusions. High degree of suspicion is required for early diagnosis and management of this rarely reported spinal hematomyelia in patients with hemophilia.

Keywords: Intramedullary spinal cord hemorrhage, Hematomyelia, Spinal cord, Spontaneous.

[1]. Hunderfund AN Leep, Wijdicks EF. Intramedullary spinal cord hemorrhage (hematomyelia). Rev Neurol Dis 2009;6:E54-61.
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[3]. Hylek EM, Singer DE. Risk factors for intracraneal hemorrhage in outpatients taking warfarin. Ann Intern Med. 1994;120:891-902.
[4]. Constantini S, Ashkenazi E, Shoshan Y. Thoracic hematomyelia secondary to coumadin anticoagulant therapy: a case report. Eur Neurol. 1992;32:109-11.
[5]. Pisani R, Carta F, Guiducci G. Hematomyelia during anticoagulant therapy. Surg Neurol. 1985;24:578-80.
[6]. Pullakart VA, Kalapura T, Pincus M, Baskharoun R. Intraspinal hemorrhage complicating oral anticoagulant therapy. Arch Intern Med. 2000;160:237-40.
[7]. Richardson JC. Spontaneous hematomyelia: a short review and a case report illustrating intramedullary angioma and syphilis of the spinal cord as possible causes. Brain 1938;61:17-36.
[8]. Pullakart VA, Kalapura T, Pincus M, Baskharoun R. Intraspinal hemorrhage complicating oral anticoagulant therapy. Arch Intern Med. 2000;160:237-40.#

Abstract: Aim: Our aim was to compare reliability of Gustafson´s and Johanson´s method of forensic age estimation in extracted thirds molars. Material and Method: 42 ground sections of third molars were evaluated according to Gustafson´ s and Johanson´s method. Patient´s age and gender was registered at time of extraction of third molar. We evaluated level of attrition, secondary dentine deposition in pulp, changes in periodontium, cementum apposition, and root resorption and root translucency. Each factor was alloted a score regarding degree of changes in the tooth. Total score was calculated and transferred to the estimated age according to Gustafson´s and Johanson´s formula. A mean difference of 5.38 and 4.97 years was obtained with Gustafson's formula and Johanson´s formula, respectively.

[1] P.E. O' Shaugnessy, Introduction to Forensic Sciences, Dent Clin North Am, 45, 2001, 217- 228.

[2] D.R. Senn, P.G. Stimson, Forensic Dentistry, Second Edition (CRC Press, 2010)

[3] L. Ciapparelli, The chronology of dental development and age assessment (Clark DH, Practical forensic odontology, Oxford: Wright Butterworth-Heinemann, 1992).

[4] KMK Masthan, Age and sex. Textbook of forensic odontology ( New Delhi: Jaypee Brothers Medical Publishers, 2009), 59-65.

[5] G. Gustafson, Age determination on teeth, J Am Dent Assoc, 41, 1950, 45-54. [6] G. Johanson , Age determinations from human teeth, Odontol Revy, 22, 1971, 1–126.

[7] K. Reppien, B. Sejrsen, N. Lynnerup, Evaluation of post-mortem estimated dental age versus real age: a retrospective 21-year survey, Forensic Sci Int, 159S, 2006, S84–S88.

Abstract: Piezosurgery has been applied in dentistry for many years. This paper reviews specifically the treatment applications that have been used in surgically assisted orthodontic treatment since the last decade. Periodontally Accelerated Osteogenic Orthodontics (PAOO) is a surgical technique which results in an increase in alveolar bone width, shorter treatment time, increase post-treatment stability, and decrease amount of apical root resorption. The aim of this case report is to compare the use of micro-motor and piezoelectric surgery unit during decortication in Periodontally Accelerated Osteogenic Orthodontics technique.

Key words: Piezoelectric surgery, piezosurgery, Periodontal regeneration , accelerated tooth movement

[1]. Abu-Hussein M., Watted N,. HegedűsV. , Borbély P;Corticotomy in the Modern Orthodontics,Journal of Dental and Medical Sciences2015, 14 (11) , 68-80 [2]. Abu-Hussein M, Watted N, Hegedűs V, Péter B, Bill J. Orthodontic Treatment of Periodontally Damaged Teeth - An Interdisciplinary Approach. J Adv Med Dent Scie Res 2015;3(3):1-6. [3]. Proffit WR, Fields HW Jr, Sarver DM. Contemporary Orthodontics. 4th ed. St. Louis, MO: Mosby Elsevier; 2007:331-340.
[4]. Vercellotti T, Podesta A. Orthodontic microsurgery: A new surgically guided technique for dental movement. Int J of Periodontics Restorative Dent 2007; 27:325-331.
[5]. Sanjideh P A, Rossouw PE, Campbell P M, Opperman L A, Buschang P H. Tooth movements in foxhounds after one or two alveolar corticotomies. Eur J Orthod 2010;32(1):106-113.
[6]. Uzuner FD, Darendeliler N. Dentoalveolar surgery techniquescombined with orthodontic treatment: A literature review. Eur J Dent. 2013;7:257-65.
[7]. Wilcko WM, Wilcko T, Bouquot JE, Ferguson DJ. Rapid orthodontics with alveolar reshaping: Two case reports of decrowding. Int J Periodontics Restorative Dent 2001;21:9-19.

Abstract: Anatomical variation of superior thyroid artery is very important for neck surgeons during surgery. It is having relationship with external laryngeal nerve. In present case study, variation is in the left superior thyroid artery arising from left common carotid artery. Variation is found during the routine dissection. Superior thyroid artery on right side was found to be normal. There is a normal relation of external laryngeal nerve of both sides. The inferior thyroid artery of both sides did not show any variation. Knowledge of arterial variation of thyroid gland is helpful to surgeons during operative procedure.

Keywords: superior thyroid artery, thyroid gland, left common carotid artery, external laryngeal nerve

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