iosr-JDMS   Volume-16 ~ Issue-11 ~ November-2017

Abstract: Aim: To evaluate the effect of topical Anesthesia on the results of Schirmer's I Test(S I t) in normal Eyes. Methods: Totally, 200 eyes in 100 Normal individuals, male (34) and female (66), (with a mean age of 59 years) were examined. S I t without anesthesia was performed firstly, and 15 minutes later it was applied in the same person after topical anesthesia with 0.5% Proparacaine Hydrochloride eye drops. Results: The wetting length in S I t after topical anesthesia was significantly lower than that in S I t without anesthesia (P<0.05). Conclusion: Schirmer I test is used to detect the true basal secretion of tears and this study shows that topical anesthesia usage is better in detecting true basal secretion as Schirmer's I test without anesthesia shows an apparently increased wetting due to some amount of reflex secretion.

Keywords –Schirmer I test, with and without topical anesthesia

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Abstract: Periodontal diagnosis is an important label that clinicians place on patients periodontal condition or disease. A well structured and detailed history with a comprehensive and complete examination helps establish an accurate diagnosis. The prognosis and treatment plan for the patient relies almost entirely on proper clinical diagnosis. Despite extensive research to develop novel techniques for improved diagnostic quality the traditional methods clinical diagnosis still remains the mainstay of diagnosis. A good understanding of patient history and findings help provide a customized treatment plan, attending to all specific needs of the individual patient. This article provides details ; on the history of the patient with respect to medical , dental, personal, family aspect as well as thorough clinical examination assessing different components of the periodontium.

Keywords:Clinical Diagnosis, Periodontal, Examination, History, Case

[1]. Newman Michael G, Takei Henry H, Klokkevold Perry R et al. Carranza's clinical periodontology.11th ed. South Asia: Elsevier Saunders ; 2012.Chapter 30- Clinical diagnosis ,Chapter -7 gingival inflammation,Chapter 9- Gingival enlargement. Chapter 13- Periodontal pocket, Chapter 32- Clinical risk assessment, Chapter 34- The treatment plan.
[2]. Gary C Armitage .The Complete Periodontal Examination.Perio2000;2004:22-33.
[3]. Mea Weinberg,Stuart J Forum.The dentist's drug and prescription guide.Rosewood drive,Danvers: Blackwell publishing;2013.
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Abstract: The presence of hyperpigmented sessile polypoid growth present over the posterior vaginal wall, which was found to be an incidental finding in a woman of reproductive age group during regular gynecological examination. To find the origin, and the pathology involved and the nature of the lesion ,biopsy of the hyperpigmented growth was done and the specimen sent for histopathology.

Keywords: Hyperpigmented sessile growth, posterior vaginal wall, supra basal bullous lesion

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Abstract: Aim:To assess the effectiveness of inferior conjunctival autograft with respect to recurrence rates in the management of primary pterygium. Methods: 100 patients with primary nasal pterygium of >2mm in horizontal diameter without any other ocular or systemic disease were included in the study. Under peribulbar anaesthesia, patients underwent pterygium excision. All patients underwent inferior conjunctival autografting using sutureless glueless technique. Patients were followed up on 1st day, 1month, 3 months, 6months and 1 year. Results: Out of 100 patients, M:F = 68:32, post operatively 55 patients had vision improvement, 45 patients had static vision . 03 patients of inferior conjunctival autograft had recurrence of Grade 1 in 1 month, 03 patients had retracted graft requiring repositioning, 01 patient had graft edema on the 1st post op day. Recurrence rate was 3%. Conclusion: This method is highly efficient in terms of post op patient symptoms, safety, efficacy, economy and low recurrence rates and is preferred because the superior bulbar conjunctiva is intact for eventual future surgical intervention.

[1]. Coroneo, MT (November 1993). "Pterygium as an early indicator of ultraviolet insolation: a hypothesis". Br J Ophthalmol 77 (11): 734–9. doi:10.1136/bjo.77.11.734.PMC 504636. PMID 8280691
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Abstract: Introduction: Fractures of the clavicle account for 2.6–4 % of all adult fractures, 35 % of all injuries to the shoulder girdle, and 69–82 % of these fractures occur in the middle-third and are usually treated non-operatively. There is an increasing trend toward their surgical fixation. The aim of our study was to evaluate the clinical, functional and radiological outcome following titanium elastic stable intramedullary nailing (ESIN) for midshaft non-comminuted clavicle fractures with >20 mm shortening/displacement. Materials and Methods: 50 patient with mid shaft clavicular fracture, which met inclusion criteria, were fixed with titanium intramedullary elastic nail under image intensifier control between July 2013 and June 2017. There were 33 males and 17 females. The mean age was 33 years. Elastic nail introduce from 1cm lateral to sternoclavicular joint to fix the fracture. Outcomes assessed on the basis of Constant score..............

Keywords: Clavicle fracture, elastic stable intramedullary nailing, midshaft fractures.

[1]. Robinson CM. Fractures of the clavicle in the adult. Epidemiology and classification. J Bone Joint Surg Br. 1998;80:476–484. doi: 10.1302/0301-620X.80B3.8079.
[2]. Khan LA, Bradnock TJ, Scott C, Robinson CM. Fractures of the clavicle. J Bone Joint Surg (Am) 2009;91:447–460. doi: 10.2106/JBJS.H.00034.
[3]. Duan X, Zhong G, Cen S, Huang F, Xiang Z. Plating versus intramedullary pin or conservative treatment for midshaft fracture of clavicle: A meta-analysis of randomized controlled trials. J Shoulder Elbow Surg. 2011;20:1008–15.
[4]. Schiffer G, Faymonville C, Skouras E, Andermahr J, Jubel A. Midclavicular fracture: not just a trivial injury: Current treatment options. Dtsch Arztebl Int. 2010;107:711–7.
[5]. Pearson AM, Tosteson ANA, Koval KJ, McKee MD, Cantu RV, Bell JE, Vicente M. Is surgery for displaced, midshaft clavicle fractures in adults cost-effective? Results based on a multicenter randomized, controlled trial. J Orthop Trauma. 2010;24:426–433. doi: 10.1097/BOT.0b013e3181c3e505 1985;92:1461–70.

Abstract: Aims & Objectives: To study aetiopathogenesis of stridor with mode of presentation in different age groups and their management. Materials And Methods: Study is conducted on OPD patients of dept. of ENT in SCB MCH between 2012 to 2015. Result: Malignant growth of larynx were major cause of stridor. Commonest site being the supraglottic larynx. On histopathological study, squamous cell carcinoma was found to be the commonest type of malignancy.Male preponderance is found. Conclusion: By this study analysis of aetiopathology of stridor is done so that proper management can be done dependig on cause, type and site of obstruction. Emergency tracheostomy is done if needed.

Keywords: Squamous cell carcinoma, Stridor , Supraglottis, Tracheostomy.

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Abstract: Background: Vascular lesions show a broad variety of morphological appearances and cilinical behavior, the lesions are ranging from inflammatory, benign hemangiomas to intermediate lesion, which are locally aggressive, to highly malignant angiosarcoma. There is also the grey zone between true neoplasia and hamartoma, which makes difficulty in histopathological assessment. It is also important to decide the degree of malignancy as it can strongly influence the choice of treatment and prognosis. Materials and Methods: 98 cases of vascular lesions at the department of pathology, Siddharda medical college, Vijayawada,for a period of three years(2014 -2016) have been studied retrospectivelyand histopathological features were analyzed...............

Keywords: Vascular lesions, WHO classification, Benign, Intermediate and Malignant..

[1]. Sharon W. Weiss. Enzinger & Weiss's Soft tissue tumours, 4th Edition. Philadelphia, USA: 2001. p 837-1036.
[2]. Christopher D. M. Fletcher. Diangostic Histopathology of Tumors, 2nd Edition. London:Churchill Livingstone ; 2000. p 45-80.
[3]. Juan Rosai. Rosai and Ackerman's Surgical Pathology, 9th Edition.Singpore:Elsevier; 2004. P 2237-2330.
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Abstract: Objective: Comparative study of Diagnostic accuracy of Modified Alvarado Score and Ultrasonography in Acute Appendicitis. Materials And Methods: A total of 100 patients of age group between 7-65yrs,both male and females,with clinical features suggestive of acute appendicitis were selected non-randomly for the study. Data was collected as Alvarado score,ultrasonograpic findings and histopathological reports.Statistical analysis was performed and results of both Alvarado score and Ultrasonography were compared. Results: Of 100 patients taken,maximum percentage of patients were in age group 20 - 30yrs with males dominated the series.The sensitivity and specificity of Modified alvarado score was 96.25 % and 75 % with PPV 93.90 % and NPV 83.33 % and diagnostic accuracy of 92% respectively. Ultrasonography study revealed 70 % sensitivity and specificity of 100 %,PPV and NPV were 100 % and 45.45 % and diagnostic accuracy was 76 % respectively. Conclusions: From present study,it was concluded that Modified Alvarado score is better diagnostic tool than ultrasonography alone in diagnosis of acute appendicitis.

Keywords: Acute appendicitis,modified alvarado score,ultrasonography

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[2]. Kanumba ES, Mabula JB, Rambau P, Chalya PL. Modified Alvarado Scoring System as a diagnostic tool for Acute Appendicitis at Bugando Medical Centre, Mwanza, Tanzania. BMC Surg. 2011 Feb 17; 11:4.
[3]. Rassam E. Raid. Modified Alvarado scoring system. How much useful? Al-Kindy Col Med J. 2011; Vol. 7 No. 2
[4]. CarenDsouza,JohnMartis&VinayVaidyanathan Diagnostic efficacy of modified alvarado score over gradedcompression ultrasonography; Nujhs Vol. 3, No.3, September 2013, ISSN 2249-7110

Abstract: Cryptococcosis is a systemic opportunistic fungal infection caused by Cryptococcus neoformans. Cryptococcus neoformans is a capsulated opportunistic yeast fungi that predominantly affects HIV infected and other immonocompromised hosts involving the CNS either as meningitis or meningo encephalitis. Central nervous system Cryptococcus is an important cause of mortality among immuno compromised patients. A prospective study was conducted on a total no. of 150 patients who were suffering from CNS symptoms with cryptococcal meningitis and other co-morbid conditions like diabetes, corticosteroid use, chronic debilitating illness and in HIV/AIDS patients. The aim of the study was detection and isolation of cryptococcus neoformans in CSF samples of immunocompromised other co-morbid conditions like diabetes..........

Keywords: Cryptococcus neoformans, cryptococcal meningitis, HIV/AIDS/CALAS immune compromised patients.

[1]. Prasad K.N. , Agarwal. J, Nag VL, Verma AK, Dixit AK, Ayyagari A. Cryptococcal infection in patients with clinically diagnosed meningitis in a tertiary care center. Neurol India 2003:51:364-6.
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[3]. Dash M, Padhi S, Sahu R, Turuk J, Pattanaik S, Misra P. Prevalence of cryptococcal meningitis among people living with human immunodeficiency virus/acquired immunodeficiency syndrome in a Tertiary Care Hospital, Southern Odisha, India. Journal of Natural Science, Biology, and Medicine. 2014;5(2):324-328. doi:10.4103/0976-9668.136176..

[4]. Baradkar, Vasant et al. "Prevalence and Clinical Presentation of Cryptococcal Meningitis among HIV Seropositive Patients." Indian Journal of Sexually Transmitted Diseases 30.1 (2009): 19–22. PMC. Web. 24 Oct. 2017.
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Abstract: The various method used to measure body temperature has both advantages and disadvantages including the age old mercury–in-glass thermometers. Currently, there are variations in measurements with different methods as well as conflicting opinions about the optimal anatomic site for measuring body temperature. However, In this study, we aimed to assess the accuracy and reliability of thermometric measurements obtained from the axilla with two different automated digital thermometer and age-old mercury-in-glass thermometer. 115 participants were involved in this study,73(33m;40f) of age 24.53±5.67 were students from an higher institution while 42(20m;22f) of age 27.25±26.51 were hospitalized patients. Simultaneous axillarytemperature measurements (n: 115) were performed with the mercury-in-glass, Omron and wellbeing digital thermometers..............

Keywords: body temperature, axilla, mercury-in-glass, Digital thermometer.

[1]. Ateş Kara, İlker Devrim, Ali Bülent Cengiz, Filiz Çelik, Hasan Tezer,Ali Kerem Uludağ, Gülten Seçmeer(2009), Is the axilla the right site for temperature measurement in children by chemical thermometer? The Turkish Journal of Pediatrics 2009; 51: 325-327
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[3]. Giuffre, M., Heidenreich, T., Cairney-Gersten, P. et al. (1990)The relationship between axillary and core body temperature measurements. Applied Nursing Research 3: 2, 52-54.
[4]. Blumenthal, I. (1992) Should we ban the mercury thermometer? Journal of the Royal Society of Medicine 85: 553-555.
[5]. Fortuna EL, Carney MM, Macy M, Stanley RM, Younger JG, Bradin SA. Accuracy of non-contact infrared thermometry versus rectal thermometry in young children evaluated in the emergency department for fever. J Emerg Nurs. 2010 Mar;36(2):101-4. Epub 2009 Sep 3.

Abstract: Thyroid disease adversely affects glycemic control in diabetes and it affects the health. In diabetic patients thyroid disorder is commonly found and associated with advanced age in type-2 diabetes. Objectives:To determine association among T3 ad T4 ,TSH level in type-2 diabetes with glycemic control. Material And Methods:This study was carried out in department of Biochemistry in association with department of General medicine & Endocrinology of Mahatma Gandhi Medical College & Hospital, Sitapura, Jaipur.100 Clinically diagnosed and biochemically confirmed cases of type-2 DM were studied. Statistical analysis:students 't' test and chi-square test were used for analysis . A p-value of < 0.05 shall be considered as statistically significant.............

Keywords: DM type II, thyroid disorders

[1]. Hage M, Zantout MS, Azar ST. Thyroid disorders and diabetes mellitus. J Thyroid Res. 2011;2011:439-463.
[2]. Kadiyala R, Peter R, Okosieme OE. Thyroid dysfunction in patients with diabetes: clinical implications and screening strategies. International Journal of Clinical Practice, 2010;64(8):1130–1139.
[3]. Kordonouri O, Maguire AM, Knip M et al, Other complications and associated conditions with diabetes in children and adolescents. Pediatric Diabetes, 2009;10(12):204–210.
[4]. Barker JM, Yu J, Yu L et al, Autoantibody "subspecificity" in type 1 diabetes: risk for organ-specific autoimmunity clusters in distinct groups. Diabetes Care, 2005;28(4)850–855.
[5]. Holl RW, Bohm B, Loos U, Grabert M, Heinze E, Homoki J. Thyroid autoimmunity in children and adolescents with type 1 diabetes mellitus. Effect of age, gender and HLA type. Hormone Research, 1999;52(3):113–118

Abstract: NAFLD is the most common form of chronic liver disease, it is the hepatic manifestation of metabolic syndrome. Periodontal disease may helpfully increase the risk of progression from NAFL to NASH. Effective strategies are needed to treat NAFLD and prevent progression to NASH so we conducted this study to investigate the efficacy of EPL and statin on biochemical parameters and histo-pathological finding in rats with NAFLD and periodontitis. Methods: 35 Male rats were divided into 5 groups, group 1:control group, group 2: NAFL, group 3: NAFL with periodontitis, group 4: rats with NAFL and periodontitis received EPL and group 5: rats with NAFL and periodontitis receiving statin after 30 days of treatment blood sample and mandibles were collected for biochemical analysis and histo-pathological findings...........

Keywords: Biochemical Parameters, Essential Phospholipids, Non Alcoholic Fatty Liver, Periodontitis, Statin.

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Abstract: Objective: The aim of the study is to evaluate the effectiveness of resin infiltration in the treatment of post-orthodontic white spot lesions. Materials and Methods: This was clinical trial. 9 subjects with mean age 18.25 with multiple white spot lesions in incisors and premolars area were included in this study. Lesions (44 lesions) were treated by ICON-Infiltrant with assessment of the lesions before, after application, after 3 months and after 6 months. Visual assessment of white spot lesions was done using International Caries Detection and Assessment System (ICDAS-II) for scoring dental caries. The scoring criteria according to the ICDAS-II system for Coronal Smooth Surface Caries are graded from 0 to 6. Patient satisfaction score was recorded according to patient's own selection for each quadrant before, after intervention, after 3 months and after 6 months follow up..............

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Abstract: Aim:- This is a retrospective study of ocular trauma profile related to injury cases. Aims & objectives:- To study the pattern of ocular trauma cases in Government General Hospital Guntur. Results:- It was observed in our study that 94.5% cases were blunt injuries and 0.8% were perforating injuries. Vision at presentation in 47.9% of patients was <CF 3mts. Conclusion:- Primary preventive approach such as promotion of safe riding and strict implementation of traffic rules like riding & driving at safe speed, wearing helmet and avoiding alcohol during driving/ riding are needed to decrease ocular morbidity.

Keywords:- Blunt injuries, lacerations, perforating injuries, hemorrhages, periorbital hematoma.

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Abstract: Pancreatic adenocarcinoma has high prevalence and mortality. Disease is more common in individuals over 70 and rarely occurs before the age of 40.Contributory factors for pancreatic cancer include advance age, male gender, more common in African American than African in their native Africa, smoking, obesity, family history, chronic pancreatitis, diabetes mellitus, red and processed meat, and strong evidence with heavy drinking. Pancreatic adenocarcinoma(exocrine type cancer) are more common than neuroendocrine type cancer. In the early stages there are no symptoms of the disease. Pain in the upper stomach, jaundice, unexplained weight loss, tumor may compress neighboring organs, and 50% of patients with pancreatic adenocarcinoma also have diabetes. Diagnosis by medical imaging. Treatment with surgery,radiotherapy, chemotherapy and palliative care. Prevention, not smoking, limiting the intake of red and processed meat, healthy weight, and consumption of fruits and vegetables. Early detection and treatment have better outcome. Keywords:Adenocarcinoma,non-endocrine cancer, Management,Prognosis

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