iosr-JDMS   Volume-16 ~ Issue-2 ~ February-2017

Abstract: Giant vesico-prostatic urethral Calculi is uncommon . The decision about treatment strategy of calculi depends upon the size, shape, and position of the calculus and the status of the urethra. If the stone is large and immovable, it may be extracted via the perineal or the suprapubic approach. In most of the previous reported cases, giant calculi were extracted via the transvesical approach and external urethrotomy. A 60-year-old male patient presented with complaints of lower urinary tract symptoms. Further investigations showed a giant vesico-prostatic urethral calculus secondary to stricture of bulbo-membranous part of the urethra. Surgical removal of calculus was done via transvesical approach. Two calculi were found and extracted. One was a huge dumbbell calculus and the other was a smaller round calculus. This case was reported because of the rare size and the dumbbell shape of the stone. Giant urethral calculi are better managed by open surgery.

[1]. M. L. Stoller, "Urinary stone disease," in Smith's General Urology, E. A. Tanagho and J. W. McAninch, Eds., p. 246, McGraw Hill Lange, 17th edition, 2008.
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[3]. Shanmugam TV, Dhanapal V, Rajaraman T, Chandrasekar CP, Balashanmugam KP. Giant urethral calculi.Hosp Med. 2000;61:582.
[4]. Young H. Prostatic urethral calculi. J Urol. 1934;32:660.
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Abstract: Schizophrenia has been observed in closed indoor people. There was improvement with antipsychotics for positive symptoms. Clozapine is newly discovered antipsychotic, with the improvement for positive and negative symptoms. Observed there were certain adverse effects like agranulocytosis. Hence there should be certain vision on treatment.

[1]. Siskind, D; McCartney, L; Goldschlager, R; Kisely, S). "Clozapine v. first- and second-generation antipsychotics in treatmentrefractory schizophrenia: systematic review and meta-analysis.". The British journal of psychiatry : the journal of mental
science.2016; 209: 385–392
[2]. Hartling, L; Abou-Setta, AM; Dursun, S; Mousavi, SS; Pasichnyk, D; Newton, AS. "Antipsychotics in adults with schizophrenia:
comparative effectiveness of first-generation versus second-generation medications: a systematic review and meta-analysis.". Annals of Internal Medicine.2012; 157 (7): 498–511.
[3]. Healy, David. The Creation of Psychopharmacology. Cambridge: Harvard University Press. pp.2004; 238–42.
[4]. Crilly J . "The history of clozapine and its emergence in the US market: a review and analysis". History of Psychiatry.2007; 18 (1):
39–60.
[5]. Griffith, R.W.; Saameli, K. "CLOZAPINE AND AGRANULOCYTOSIS". The Lancet. 2015;306 (7936): 657

Abstract: Cultural beliefs prevalent in the society have a very severe impact on the mind and behavior of the person. There are many misbeliefs and misconceptions about sexuality prevalent in our society. Many cultures believe semen to be a very precious body fluid and its unnecessary loss to cause severe harm on the health of the person.1 Cultural myths in relation to semen loss can induce physical and psychological symptoms in a man which together as a syndrome termed as Dhat syndrome.3"Dhat" is derived from the word "dhatu". The word"Dhatu" is a Sanskrit word which means "Metal" or "Elixir".2-4There is description of seven "Dhatus" [Chyle (Rasa), Blood (Rakta), Flesh (Maans), Fat (Meda), Bone (Asthi), Marrow (Majja), Se-men (Shukra)], out of which most important considered is "Shukra Dhatu (semen)"..........

[1]. Verma A, Priyadarshi S, TomarV.Analysis of Patients Presenting with Dhat Syndrome and its Impact on Society.IJSR4(12),
December 2015;982-987.
[2]. Prakash O. Lessons for postgraduate trainees about Dhat syndrome. Indian J Psychiatry 2007;49:208-10.
[3]. Shushruta S. Vaidya YadavjiTikamjiAcharya.Bombay:NirnayaSagar Press;1938.
[4]. Money J, Prakasam KS, Joshi VN. Semen-conservation doctrine from ancient ayurvedic to modern sexology theory. Am J
Psychother 1991;45:9-13.
[5]. Koushik Sinha Deb, Yatan Pal Singh Balhara. Dhat Syndrome: A Review of the World Literature. Indian J Psychol Med. 2013 Oct-
Dec; 35(4): 326–331.

Abstract: Classical empyema of gall bladder has undergone a change in clinical presentation and is now presenting as chronic calculus cholecystitis only to be confronted operatively as a chronic empyema making laproscopic cholecystectomy difficult and with an increased conversion rate to an open procedure.

Keywords: Calculus cholecystitis, Classical empyema gall bladder, Chronic empyema gall bladder, Laproscopic cholecystectomy

[1]. Robson AWM, Dobson JF. Diseases of the gall-bladder and bile-ducts, including gall-stones. London: BailliereTindall, 1904: 85.
[2]. Moynihan BGA. Gall-stones and their surgical treatment. Philadelphia: W B Saunders, 1905: 196.
[3]. Weiss S. Diseases of the liver, gall bladder, ducts and pancreas – their diagnosis and treatment. New York: Hoeber, 1935: 668.
[4]. Harding Rains AJ, Ritchie HD. Bailey and Love's short practice of surgery. London: H K Lewis, 1981.
[5]. Jones PF. Acute cholecystitis: a case for early surgery? Br Med J 1982: 285: 1376-7.

Abstract: Background and Objectives: Acute Appendicitis is the commonest general surgical emergency, which needs early surgical intervention, to improve the outcome. The rate of misdiagnosis of appendicitis and the rate of appendicular perforation has remained constant, inspite of increased use of ultrasonography, computed tomography scanning and laparoscopy. For early and accurate preoperative diagnosis, acute appendicitis still remains an enigmatic challenge and is a reminder for the art of surgical diagnosis.......

Keywords: ..........

[1]. O' Connel PR. "The Vermiform Appendix". In: Williams NS, BulstrodeCJK, O'Connell PR (Ed.). Bailey and Love's - Short practice of surgery. 25 ed. London:Arnold: 2008;p. 1204-8.
[2]. Smink DS, Soybel DI. "Appendix and Appendectomy". In: Zinner MJ, Stanely W (eds) Maingot‟s abdominal operations. 11th ed. Ashely: McGraw Hill; 2007. p. 589-612.

[3]. John Maa. "The Appendix". In Townsend CM, Beauchamp RD, EversBM, Mattox KL, eds. Sabiston Textbook of Surgery. 18thed. Philadelphia, Pa: Saunders Elsevier; 2008. p: 1333-1347.
[4]. Deutsch A, Shani N, Reiss R. Are some appendectomies unnecessary: an analysis of 319 white appendices. J R CollSurgEdinb 1983; 28: 35-40.
[5]. Piper R, Kager E, Nasman P. Acute appendicitis a clinical study of 1018 cases of emergency appendicectomy. ActaChir Scand. 1982; 148:51-62.

Abstract: Background : lower limb diabetic ulcers are very difficult to treat due to the poor vascularity and brittle granulation tissue formed during the healing phase. So a novel method is needed apart from conventional dressings to enhance the healing process. Such a method is to do dressing of ulcers using 200IU/ml of sodium aqueous heparin dressings. Methods : In this prospective study conducted from may-2016 to october-2016 at department of general surgery, coimbatore medical college the diabetic ulcer foot patients were divided into two groups, one will be treated with conventional saline dressing and the other using topical aqueous heparin.........

Keywords: Diabetes, Heparin, Antibiotic, neovascularisation.

[1]. Saliba M.J., Escamillo A.R., Ramakrishnan K.M., Jayaraman V., Zhao-fan Xia, Xu Lin Chen, Zayas J.G., da Costa M.G., Thomas C., Mlcak R., Oh J.S., Venakatachalapathy T.S., Kumar M. Syllabus of Proceedings, Sixth International Heparin Therapy In Burns, Fifth Asian Pacific Burns Congress, Shanghai, China, November 2005.
[2]. Azizkhan R.G., Azizkhan J.C., Zetter B.R., Folkman J. Mast cell heparin stimulates migration of capillary endothelial cell in vitro. J. Exp. Med. 1980;152:931–931. [PMC free article][PubMed]
[3]. Macaig T. et al. Heparin binds endothelial cell growth factor, the principal endothelial cell mitogen in bovine brain. Science. 1984;225:932–932.[PubMed]
[4]. Folkman J., Shing Y. Control of angiogenesis by heparin and other sulphated polysaccharides. Adv. Exp. Med. Biol. 1992;313:355–364.[PubMed]
[5]. Zapat-Sirvant R.L., Hansbrough J.F., Greenleaf G.E. et al. Reduction of bacterial translocation and intestinal structure alterations by heparin in a murine burn injury model. J. Trauma. 1994;36:1–6.[PubMed]

Abstract: Background: Although gestational hyperthyroidism is uncommon (0.2%), Hypothyroidism occurs in 2.5% to 3% of women and is predictive of reduced neonatal and child neuropsychological development and maternal obstetric complications. Postpartum thyroid dysfunction occurs in 5-9% of women and is associated with anti thyroid peroxidase antibodies in 10% of women in early pregnancy. Therefore, screening of thyroid dysfunction in pregnancy should be considered. T4 and TSH measurements could be used to screen for hypothyroidism, which would require levothyroxine treatment. T4 supply is crucial for maturation of fetal nervous system...............

Keywords: Hypothyroidism, Hyperthyroidism, T3, T4, TSH, Levothyroxine, Propyl thyouracil.

[1]. Guyton C,Hall j.Thyroid metabolic hormones.Textbook of medical physiology 11 th ed,New Delhi:Elsevier,Reed Elsevier India
Private Ltd:2007:931-943.
[2]. Jameson J,Weetman A.Disorders of thyroid gland .In:Fauci A,BraunwaldE,kasper D,Hauser S,Longo D,Jameson J,et al;eds
Harrison‟s principles of Internal medicine 17thed USA.
[3]. Marieb E,Hoehn K. The Endocrine system Human anatomy and physiology .7th ED San Francisco,CA;Pearson Education
Inc;2007:620-625.
[4]. The function of thyroid gland.Learning info .http://health.learning info.org/function thyroid gland.htm.Accessed March 10,11 A..D.
[5]. Joshi S Laboratory evaluation of thyroid function JAPI.2011;59(supplement):14-20.

Abstract: Background : India leads the World with largest number of Diabetic subjects. Diabetes mellitus is one of the fastest growing chronic disease in world and India the "Diabetes capital of the World" is home to estimated 46 million people and predicted to be 79.4 million by the year 2030. Materials&Methods: VO2max and HbA1c were studied in Total 100 subjects of age group 35-45 years. Study
groups comprised of 50 known case of Type-2 diabetic subjects having Diabetes since  3 years whereas control group comprised of 50 healthy normal subjects not involved in any regular physical exercise. VO2max evaluated by Astrand- Astrand Nomogram, Glycated Hemoglobin levels (HbA1c) measured by cation – exchange resin Method.............

Keywords: Aerobic Work capacity , , HbA1c , Type-2 diabetic subjects, VO2max..

[1]. World Health Organization. Global Report on Diabetes. Isbn [Internet]. 2016;978:88. Available from:
http://www.who.int/about/licensing/%5Cnhttp://apps.who.int/iris/bitstream/10665/204871/1/9789241565257_eng.pdf
[2]. Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes: Estimates for the year 2000 and projections for 030.
Diabetes Care 2004; 27:1047-53.

[3]. The current state of diabetes mellitus in India Seema Abhijeet Kaveeshwar 1 and Jon Cornwall 2 Australas Med J. 2014; 7(1): 45–
48. Published online 2014 Jan 31. doi: 10.4066/AMJ.2013.1979
[4]. Park K. Diabetes mellitus. Park's textbook of preventive and social medicine. 20th ed. Jabalpur: M/s Banarasidas Bhanot; 2009:
p.311-15, 327-30
[5]. Chaudhuri SK. Physiology of Exercise. Concise Medical Physiology.6th ed. Kolkata: New Central Book Agency; 2008: 504-5.

Abstract: Introduction and objectives -Thyroid diseases are amongst the commonest endocrine disorders worldwide. India too is no exception. In India sub Himalayan belt extending from Kashmir to Assam is well a recognized area of endemic iodine deficiency. The main aim of the study was to find out the prevalence of thyroid disorders amongst the adult population of Barpeta town and to create awareness among the population about the disorder. Material and methods- The current study was a cross sectional study conducted in the Barpeta district, Assam at Fakhruddin Ali Ahmed Medical College and Hospital................

Keywords: TSH, T3, T4, hypothyroidism, hyperthyroidism.

[1]. Vahab Fatourechi (2006) .what is normal TSH? Mayo clinic college of Medicine , US
[2]. (Heuk cc, Kallen A, Kanegasabapathy AS, Riesen w. WHO document ( WHO/DIL/00.4" On diagnosis and monitoring of diseases
of thyroid 2000 13).
[3]. Available from :http//wwwias.ac.in/currsci/oct25000/20 kochu pillai .PDF
[4]. Chatterjee, M.N.and Shinde, R.Medical Biochemistry, 2nd edn. P734(1995).
[5]. New Delhi: Background Papers- Burden of diseases in India; 2005. National commission on macroeconomics and Health Ministry
of Health And Family Welfare, Government of India..

Abstract: Objective:-To compare the serum AMH levels in PCOS and normo-ovulatory women and investigate the correlation between clinical, hormonal, ultra-sonographic parameters and AMH levels in both groups. Method:-A comparative cross sectional study was conducted at Pacific Medical College and Hospital, Udaipur, Rajasthan during the period 15 October 2015 to April 2016 . A total of 64 women of reproductive age (21–35 years) were recruited for study after taking informed consent and were divided into 32 Case (PCOS patients defined by the Rotterdam criteria) and 32 Control (non-PCOS patients) groups. Menstrual history, clinical manifestations of hyperandrogenism, transvaginal ultrasound assessments for ovarian follicles , and the levels of AMH, LH, FSH, and estradiol were collected.................

Keywords: AMH,Diagnosis of PCOS .HA , PCOS, Prognosis of PCOS, PCO

[1]. Leon Speroff. Clinical gynecologic endocrinology and infertility. Lippincott Williams 2005;12:485–513.
[2]. Josso N, Cate RL, Picard JY, Vigier B, di Clemente N, Wilson C, et al. Anti-mullerian hormone: the Jost factor. Recent ProgHorm
Res 1993;48:1–59.
[3]. (3). ESHRE/ASRM. ESHRE/ASRM rotterdam consensus meeting revised 2003 consensus on diagnostic criteria and long-term
health risks related to polycystic ovary syndrome (PCOS). Hum Reprod. 2004;19:41–7.
[4]. (4). Fruzzetti F, Perini D, Lazzarini V, Parrini D, Genazzani AR. Adolescent girls with polycystic ovary syndrome showing
different phenotypes have a different metabolic profile associated with increasing androgen levels. FertilSteril. 2009;92(2):626–34.
[5]. (5).Knight PG, Glister C. TGF-β superfamily members and ovarian follicles development. Reproduction. 2006;132:191-206.

Abstract: Background: Intracranial infections are among the most important problem in pediatric age. In about 30-35% of children we face diagnostic difficulty as whether the child has pyogenic, tubercular and, or viral meningitis. We will discuss clinical feature of meningitis and their radiological findings and correlation between them in this study. Objective: Current study aims: (a) To evaluate the clinical feature and radiological findings and their correlation in differential diagnosis off meningitis.................

Keywords: Meningitis, seizure, CT scan.

[1]. Taneja PN & Ghai OP (1955) Pyogenic meningitis. Indian Jounal of Paediatrics 22, 99–106.
[2]. Paul SS (1963) Pyogenic meningitis in children. A study of 48 cases. Indian Journal of Child Health 12, 98–103.
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[4]. Achar ST & Rao GR (1953) Meningitis in infancy and childhood other than tubercular meningitis; an analysis of 98 consecutive cases in Madras during 1950–51. Indian Journal of Pediatrics 20, 55–66.
[5]. Reddi YR, Rao VS, Subhash R, Reddy C & Ramchander N (1973) Pyogenic meningitis in infants and children. A clinical and bacteriologic study. Indian Pediatrics 10, 413–418.

Abstract: Mammography is used as a screening tool for detection of carcinoma breast above the age of 35 years. FNAC is an established technique for the detection of breast malignancies. Myoepithelial cells are important marker for identification of breast carcinoma. p63 immunostaining has gained wide popularity for identification of myoepithelial cells. We planned this study to compare the effectiveness of mammography and p63 in detection of carcinoma breast.Total 50 cases were included in the study. Clinical features, mammography, FNAC and p63 immunostaining were performed. Results of mammography and p63 immunostaining were compared with the FNAC diagnosis................

Keywords: Immunostaining, infiltrating ductal carcinoma ,mammography, myoepithelial, p63.

[1]. Nasreen H Hafez, Neveen S Tahoun. The role of p63 immunocytochemistry for myoepithelial cells in the diagnosis of atypical and
suspicious cases in Breast Fine needle aspiration cytology. Journal of the Egyptian Nat Cancer Inst,22(2), 2010,123-134.
[2]. B Chaiwan, N Sukhmwang, S Lekawanjit, K Sukapan, S Rangdaeng, M Muttarak, P S Thorner. Atypical and suspicious categories
in fine needle aspiration cytology of the breast: histological and mammographical correlation and clinical significance. Singapore
Med J 46(12),2006,706-709.
[3]. Taeko Nagao, Yoshimi Bando, Mitsunori Sasa, Tadaoki Morimoto, Nobuya Sano, Toshiyanki Hirose, Akira Tangoku. False
positives in Fine needle aspiration cytology of breast disease can be reduced with p63 immunostaining- A preliminary report.
Anticancer Research 26,2016, 4373-4378.
[4]. Rahman MZ, Sikdar AM, Nabi SR. Diagnosis of breast lump by fine needle aspiration cytology and mammography. Mymensingh
Med J20(4), 2011,658-64.
[5]. Arisio R, Cuccorese C, Accinelli G, et al. Role of fine-needle aspiration biopsy in breast lesions: Analysis of a series of 4110 cases.
Diagn Cytopathol.18, 1998, 462-7.

Abstract: Gestational Diabetes Mellitus (GDM) is an important public health problem given its high prevalence and its association with adverse maternal and fetal outcomes. Recent evidence has confirmed that the risk of adverse outcomes is a continuum, increasing as maternal blood glucose levels rise [1] furthermore, women with prior GDM are a high-risk group for the future development of diabetes, metabolic syndrome and cardiovascular disease[2] GDM has adverse outcomes of pregnancy including preeclampsia, caesarean section rates(which varies from 30-40%)perinatal mortality(2-fold increased),birth defects, metabolic complications in Neonates and morbidity associated with subsequent childhood obesity. Furthermore, the recurrence risk with future pregnancies has been reported as high as 68% [3] and 26%[4] risk of developing type two diabetes at 15 years of follow up.

[1]. HAPO Study Cooperative Research Group,Metzger BE,Lowe LP,Dyer AR,Trimble ER,et al.(2008)hyperglycemia and adverse
pregnancy outcomes.N Engl J Med 358:1991-2002.
[2]. NoctorE,Crowe C,Carmody,Kirwan,O'DeaA,etal.(2015)ATLANTIC DIP:
[3]. prevalence of metabolic syndrome and insulin resistance in women with previous gestational diabetes mellitus by International
Association of Diabetes in Pregnancy Study Group criteria.Acta Diabetol 52:153-160.
[4]. Spong CY,Guillermo,Kuboshi eJ,etal.Recurrence of gestational Diabetes Mellitus:identification frisky factors.Am J
Perinatol.1998;15(1):29–33.
[5]. LeeAJ,HiscockRJ,WeinP.Gestational diabetes mellitus:clinical predictors and long term risk of developing type 2 diabetes:a
retrospective cohort study using survival analysis.Diabetes Care.2007;30:878–83.

Abstract: Background: Down syndrome subjects complain of many pulmonary dysfunctions that adversely affect the general health and quality of life. Objective: The aim of this study was to detect the effect of pulmonary rehabilitation program on respiratory functions and exercise tolerance in Down syndrome subjects. Subjects and Methods: Forty Down syndrome subjects (22 males and 18 females) with age ranged from 18-25 years and IQ level ranged from 55-65% were enrolled in the present study and were assigned into two equal groups, group (A) received pulmonary rehabilitation program included breathing exercises via resisted diaphragmatic breathing by abdominal weights in addition to aerobic exercise on treadmill 3 times per week for successive 2 months, while group (B) received no intervention and was considered as a control group. Measurements of vital capacity (VC...............

Keywords: Pulmonary Rehabilitation, Pulmonary Function, Exercise Tolerance, Down syndrome.

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[2]. Morris J, Alberman E. Trends in Down‟s syndrome live births and antenatal diagnoses in England and Wales from 1989 to 2008: analysis of data from the National Down Syndrome Cytogenetic Register. BMJ. 2009; 339: b3794.
[3]. Pitetti KH, Boneh S. Cardiovascular fitness as related to leg strength in adults with mental retardation. Med Sci Sports Exerc. 1995; 27(3):423–428.
[4]. Fernhall B, Pitetti K. Limitations to physical work in individuals with mental retardation. Clin Exerc Physiol. 2001; 3:176–185.
[5]. Baynard T, Pitetti KH, Guerra M, Unnithan VB, Fernhall B. Age-related changes in aerobic capacity in individuals with mental retardation: a 20-yr review. Med Sci Sports Exerc. 2008; 40(11):1984–1989