iosr-JDMS   Volume-16 ~ Issue-3 ~ March-2017

Abstract: Background: Stable non-osteoporotic intertrochanteric fractures recover well with dynamic hip screws and trochanteric nails. Osteoporotic comminuted unstable intertrochanteric fractures which are treated with proximal femoral nails have limitations, early mobilization can be detrimental, have postoperative complications. Hence converting unstable osteoporotic intertrochanteric fractures in to stable by cemented bipolar hemiarthroplasty followed by calcar reconstruction with tension band wiring gives good results. Aims and objectives of the study: To reduce the post operative complications of unstable osteoporotic intertrochanterics fractures by converting them in to stable fractures by hemiarthroplasty and calcar reconstruction..........

Keywords: bipolar hemiarthroplasty, calcar reduction reconstruction, tension band wiring, dynamic hip screws, trochantric nails.

[1]. Kannus P1, Parkkari J, Sievänen H, Heinonen A,Vuori I,Järvinen M. Epidemiology of hip fractures.bone 1996; 18:57s-63.
[2]. Chandrashekar j thakkar, sayasachi thakkar, rajshekar t kathalgere, malhar n kumar ;Calcar femorale grafting in the
hemiarthroplasty of the hip for unstable intertrochantric fractures. Indian journal of orthopaedics, nov 2015/vol49/ issue 6.
[3]. Cooper C1, Campion G, Melton LJ .. Hip fractures in the elderly: a world-wide projection. Osteoporos Int. 3rd 1992 Nov;2(6):285- 9.
[4]. Gupta A Osteoporosis in India--the nutritional hypothesis. Natl Med J India. 1996 Nov-Dec;9(6):268-74.
[5]. Radford PJ, Needoff M, Webb JK A prospective randomised comparison of the dynamic hip screw and the gamma locking nail.J
Bone Joint Surg Br. 1993 Sep;75(5):789-93.

Abstract: Dedifferetiated liposarcoma is a malignant adipocytic neoplasm containing a non- lipogenic sarcoma of variable histologic grade along with well differentiated liposarcoma . Liposarcoma is the most frequent soft tissue sarcoma in adults but may also occur in adolescents and children. We report a case of dedifferentiated liposarcoma of the retro-peritoneum in a 47 years old male. Tumor showed dedifferention into meningothelial like whorls and metaplastic bone. The excised specimen was large, multi -nodular , firm, yellowish to tan gray on cut surface . The purpose of this report is to emphasize the histological features in dedifferentiated liposarcoma..

Keywords:Dedifferentiated, Liposarcoma , Meningothelial, Retroperitoneal and whorl .

[1]. Dahlin DC, Beabout J W .Dedifferentiation of low grade chondrosarcoma. Cancer 1971:28:461-6.
[2]. Evans H L .Liposarcoma :A study of 55 cases with reassessment of its classification .Am J Surg pathol 1979:3:507-23.
[3]. Enzinger FM, Weiss. sw. soft Tissue , 3rd ed .st Louis: CV Mosby, 1995.p.431-66.
[4]. Liposarcoma with meningothelial –like whorls: a study of 17cases of a distinctive histological pattern associated with dedifferentiated liposarcoma ; J C Fanburg –smith & M Miettinen; Histopathology ,1998; volume 33, Issue 5, pages 414-42.
[5]. Dedifferentiated liposarcoma with a peculiar meningothelial like whirling & metaplastic bone formation ; Ann. Diagn .pathol, 2009 Aug ; 13(4) :278-284.

Abstract: A hospital based cross-sectional study was undertaken in the medicine OPD of a tertiary health care facility in Guwahati, Assam, India to delineate prescription practices and extent of rational drug therapy. We report here the result of a prescription audit to check for the prescribing behaviour of medical practitioners and to identify prescribing errors using WHO indicators. A total of 300 patients attending the medicine OPD with history of short duration illness were selected using purposive sampling and data was collected for a one month period on alternate days. The results reveal the prescribing patterns of the medical practitioners as irrational as
polypharmacy was resorted to often. The average number of drugs per prescription was 2.5 ...........

Keywords: Antibiotic usage, cross-sectional study, polypharmacy, rational prescribing.

[1]. WHO. Model list of essential drugs. Geneva: World Health Organization, 1988
[2]. The selection of essential drugs. Report of a WHO Expert Committee. Geneva, World Health Organization,1977, 7-35 (WHO
Technical Report Series, No.615).
[3]. The rational use of drugs. Report of the Conference of Experts, Nairobi, 25-29 November 1985. Geneva, World Health
Organization, 1987
[4]. R Krishnangshu, JM Ghosh, SB Chandhri, A Mandal, S Prasad. Prescription audit analysis-A study of drug prescription practices in
India. Calcutta: Voluntary Consumer Action Network (V-CAN), Consumer Utility & Trust Society, 1996
[5]. HV Hogerzeil et al. Field tests for rational drug use in twelve developing countries, Lancet, 342, 1995, 1409-1410.

Abstract: Background: Breast Carcinoma is the most common cause of cancer related mortality among females. Various prognostic factors have been studied among which evaluation of microvessel density provides additional information regarding the biological profile of the tumor. Aim : To detect the intratumoral Microvessel Density of breast carcinoma microscopically and to detect the tumor angiogenesis using the endothelial marker, Vascular Endothelial Growth Factor,. Also to correlate VEGF and MVD with tumour grade.......

Keywords: Idc-Nos, Mvd, Vegf

[1]. Agarwal G, Ramakant P, Breast Cancer Care in India: The Current Scenario and the Challenges for the Future. Breast Care 2008;
3(1):21-27.
[2]. Breast cancer incidence and mortality worldwide in 2008, Cancer fact sheet, Globocan 2008, P1-3.
[3]. Mansour EG, Ravdin PM, Dressler L: Prognostic factors in early breast carcinoma. Cancer 1994; 74:381-400.
[4]. Uzzan B, Nicolas P, Cucherat M, et al. Microvessel density as a prognostic factor in women with breast cancer : A systematic
review of the literature and meta-analysis. Cancer Res 2004;64:2941-2955.
[5]. Angiogenesis of Breast Cancer : JCO (2005) 23(8): 1782-1790.

Abstract: Background:Peptic ulcer disease is the most common disease among the Asian population. Perforation of the peptic ulcer being the second most common complication next to bleeding, continues to be real emergencies in surgery, which requires prompt diagnosis and immediate surgical management to save the patients life. Aims: To assess Risk Stratification using Peptic Ulcer Perforation (PULP) scoring system in patients with perforated peptic ulcer.............

Keywords: Perforated Peptic Ulcer (PPU), PULP score, Perforation Operation time Interval(POI)

[1]. Maingot's Abdominal Operations, 12th edition ; Stomach and Peptic Ulcer disease : Pg 443 – 463.
[2]. Farquharson's Textbook of Operative General Surgery, 10th edition ; General Surgical considerations in Upper Gastrointestinal
emergencies, Perforated Peptic Ulcer : Pg 300 – 303.
[3]. Master Techniques in Surgery, Gastric Surgery ; Operations for Peptic Ulcer, Operation for Patch closure of Perforation,
Laparoscopic repair : Pg 109 – 123.
[4]. Saudi Med J. 2008 Feb;29(2):245-50.Management of perforated peptic ulcer in patients at a teaching hospital, Bin-Taleb
AK1, Razzaq RA, Al-Kathiri ZO.
[5]. Acta Anaesthesiol Scand. 2012 May;56(5):655-62. doi: 10.1111/j.1399-6576.2011.02609.x. Epub 2011 Dec 23.The Peptic Ulcer
Perforation (PULP) score: a predictor of mortality following peptic ulcer perforation. A cohort study. Møller MH1, Engebjerg
MC, Adamsen S, Bendix J, Thomsen RW...

Abstract: Introduction:Cervical cancer is a largely preventable disease, yet it remains the third most common cancer worldwide with over 5,30,232 (8.8%) new cases and mortality of 2,750,087(8.2%) annually.[1]The present study aims to compare and correlate colposcopy findings with pap smear taking histopathology as gold standard. Materials &Methods:The present study is an observational prospective study whichwas carried out in Command Hospital AirForce (CHAF), Bangalore in Department of Obstetrics and Gynaecology.100 patients with unhealthy cervix attending the OPDwere selected who fit the inclusion criteria........

Keyword:-Pap smear, Colposcopy, Cervix, Acetic Acid

[1]. Ferlay J, Shin HR, Bray F, Forman D, Mathers C and Parkin DM. GLOBOCAN (2008) v2.0, Cancer Incidence and Mortality
Worldwide: IARC Cancer Base No. 10 [Internet]. Lyon, France: International Agency for Research on Cancer; 2010.
[2]. Vallikad E. (2006) Cervical cancer: the Indian perspective; Division of Gynaecologic Oncology, St. John's Medical College,
Bangalore, India; International Federation of Gynaecology and Obstetrics, Published by Elsevier Science Ltd.
[3]. Mathew A, George PS. Trends in incidence and mortality rates of squamous cell carcinoma and adenocarcinoma of cervix:
worldwide. Asian Pac J Cancer Prev 2009; 10:645-50.
[4]. Dinshaw KA, Shastri SS, Patil SS, Cancer Control Programme in India: challenges for the new Millennium; Health Administrator
Vol: XVII (1):10-13.
[5]. Monsoneg. J, Bosch. F.X, Coursaget. P, Franco. E, Frazer. I et al. Mini Review; Cervical Cancer Control, Priorities and new
Directions. Int J Cancer 2004; 108:329-333..

Abstract: Introduction: Acute pancreatitis is an acute inflammatory state involving the pancreas. The human and financial burden of acute pancreatitis appears to be growing. Since many years several classification systems have been developed in order to predict severity. The revised Atlanta classification system facilitated standardized reporting of clinical and imaging data, which can be used as an effective means of communication among the medical team. CECT is the imaging modality of choice in this classification system. This study assesses lesions seen on CECT as defined by the Revised Atlanta classification and to assess the occurrence of fluid collections in acute pancreatitis............

Keywords: Acute Pancreatitis; Computed Tomography; Revised Atlanta Classification.

[1]. Frossard JL, Steer ML, Pastor CM. Acute pancreatitis. Lancet 2008; 371(9607):143–52.
[2]. Rakesh K Tandon. Management of Acute Pancreatitis-Indian Guidelines and Protocols. Medicine Update. 2013; 23(59):267-270.
[3]. Sandler RS, Everhardt JE, Donowitz M, et al. The burden of selected digestive diseases in the United States. Gastroenterology
2002; 122:1500-11.
[4]. Fagenholz PJ, Fernandez-del Castillo C, Harris NS, et al. Direct medical costs of acute pancreatitis hospitalizations in the United
States. Pancreas 2007; 35:302-7.
[5]. Revision of the Atlanta classification of acute pancreatitis, April 9, 2008; Available from: http://pancreasclub.com/wpcontent/
uploads/2011/11/AtlantaClassification.pdf.

Abstract: Areca nut is the seed of the fruit of the areca palm (Areca catechu) and plays an important role in traditional practice in some regions in south and south-east Asia countries specially India.Areca nut has known to have many beneficial effects according to Ayurvedic literature, though its excessive use causes dangerous adverse effects hence the good effects are masked. Numerous studies have concluded that patients with arecanut chewing habits had low incidence of caries.Through the present study an attempt was made to understand the direct effect of Arecanut on common cariogenic bacteria,.............

Keywords: Arecanut, DMSO extract, methanol extract,S.mutans and S.sobrinus.

[1]. LingappaA,Nappalli D, Sujatha GP, Shiva Prasad S. Areca nut: to chew or not to chew?e-Journal of Dentistry, July - Sep 2011;1(3):
46-50.
[2]. Lyon. Betel-quid and Areca-nut Chewing and Some Areca-nut-derived Nitrosamines.International Agency for Research on Cancer
Monographs on the Evaluation of Carcinogenic Risk of chemicals to Humans 2004; 85.
[3]. Cyriac MB, Vidya P, Varghese I, Shantaram M, Jose M, Antimicrobial properties of Areca catechu (areca Nut) husk extracts
against common oral pathogens, International Journal of Research in Ayurveda and Pharmacy, 3, 2012, 81-84.
[4]. Vos T. Years lived with disability for 1160 sequelae of 289 diseases and injuries 1990-2010: A systemic analysis for the Global
burden of disease study 2010. Lancet.380m (9859):2163-96.
[5]. Fejerskow O and Kidd E. Dental caries. The disease and its clinical management, 2nd edition: 2008. 164-187.

Abstract: Tuberculosis is caused by Mycobacterium tuberculosis, commonly affecting the lungs, although extrapulmonary manifestations are not uncommon . Ocular involvement secondary to hematogenous spread is common. It may present as anterior uveitis and panuveitis apart from posterior segment findings such as retinitis and choroidopathy .Retinal vasculitis is associated with vitritis, retinal hemorrhage, neovascularization, and neuroretinitis .Choroidal tubercles, choroidal tuberculoma, subretinal abscess and serpiginous like choroidopathy may be seen . Mantoux and Quantiferon gold test are supportive of diagnosis. Diagnostic criteria for ocular tuberculosis include at least one or more clinical sign along with positive PCR or demonstration of AFB under microscope or culture of ocular fluids .Prognosis is variable and depends on early diagnosis and treatment........

[1]. Bouza E, Merino P, Muñoz P, Sanchez-Carrillo C, Yáñez J, Cortés C. Ocular tuberculosis. A prospective study in a general
hospital. Medicine (Baltimore) 1997;76:53–61
[2]. Shah SM, Howard RS, Sarkies NJ, Graham EM. Tuberculosis presenting as retinal vasculitis. J R Soc Med.1988;81:232–3.
[3]. Sanders MD, Graham EM. Retinal vasculitis. Postgrad Med J. 1998;64:488–96.
[4]. Gupta A, Gupta V, Arora S, Dogra MR, Bambery P. PCR positive tubercular retinal vasculitis: Clinical characteristics and
management. Retina. 2001;21:435–44.
[5]. Rosen PH, Spalton DJ, Graham EM. Intraocular tuberculosis. Eye (Lond) 1990;4:486–92.

Abstract: This is a case report of a lady who presented with Weber's syndrome. She had left oculomotor nerve palsy and right hemiparesis. The patient subsequently made a good recovery, after 1 year same patient landed into millard-gubler syndrome now she had ipsilateral paralysis of theabducent and facial palsy andcontralateralhemiplegia of the extremities.

[1]. Ferbert A, Bruckmann H, Drummen R. Clinical features of proven basilar artery occlusion.Stroke. 1990 Aug. 21(8):1135-42.
[2]. Archer CR, Horenstein S. Basilar artery occlusion: clinical and radiological correlation.Stroke. 1977 May-Jun. 8(3):383-90.
[3]. Whedon JM, Song Y, Mackenzie TA, Phillips RB, Lukovits TG, Lurie JD. Risk of stroke after chiropractic spinal manipulation in
medicare B beneficiaries aged 66 to 99 years with neck pain. J Manipulative PhysiolTher. 2015 Feb. 38 (2):93-101.
[4]. Amin-Hanjani S, Pandey DK, Rose-Finnell L, et al. Effect of Hemodynamics on Stroke Risk in Symptomatic Atherosclerotic
Vertebrobasilar Occlusive Disease. JAMA Neurol. 2016 Feb 1. 73 (2):178-85.
[5]. Amin-Hanjani S, Turan TN, Du X, et al. Higher Stroke Risk with Lower Blood Pressure in Hemodynamic Vertebrobasilar Disease:
Analysis from the VERiTAS Study. J Stroke Cerebrovasc Dis. 2017 Feb. 26 (2):403-410..

Abstract: Introduction: A/C appendicitis is a common surgical emergency which is mostly a clinical diagnosis, confirmed by investigations. But with all advanced investigations misdiagnosis and missed diagnosis are common resulting in morbidity and mortality. Recently many papers are coming up regarding hyper bilirubineamia in A/C appendicitis, more so with gangrenous and perforated appendicitis. Materials and Methods : This study was conducted on patients admitted with a diagnosis A/C appendicitis and surgery departments Govt. Medical College, Thrissur from September 2010 to Decembers 2011 with inclusion & exclusion criteria. Hyper bilirubineamia was studied in all these patients with the liver enzyme analysis...........

Keywords: Hyperbilirubinimia, A/C appendicitis

[1]. Khan S, Kathmundu university medical journal 2006 Volume 4, number 3, issue 15, pages 281-289
[2]. Joaquin J Estrada, journal of Gastrointestinal surger, springer New York, Volume 11, number 6/june, 2007, pages 714-718 published on line : 11 april 2007
[3]. Samuel Andreas Kaser, Scandinavian journal of gasteroenterology. Online on 25 march 2010
[4]. M S and F G Bechara, Holland Letz and Sand American Journal of surgery 2009, Elsevier Published online : 23 march 2009
[5]. Dr. S Khan, Original Article/Research August 2009, Vol. 3 no.4, pages 1647 – 1652.

Abstract: Background: Pregnancy is associated with tremendous changes in the maternal cardiovascular autonomic system. Some studies have reported conflicting cardiovascular autonomic activity during pregnancy.So the present study was conducted to understand the sequential changes in the maternal cardiovascular autonomic system during pregnancy. Materials and methods:A total of 25 healthy normotensive women with singleton pregnancy in the age group of 20-30 years were included in the study.Blood pressure response to isometric handgrip using a spring dynamometer was done for evaluation of sympathetic activity.............

Keywords: Pregnancy, blood pressure, heart rate, sympathetic, parasympathetic

[1]. Capeless EL, Clapp JF, Cardiovascular changes in early phase of pregnancy, Am J ObstetGynecol, 161, 1989, 1449-1453.
[2]. Ekholm EM, Piha SJ, Antilla KJ, Erkkola RU, Cardiovascular autonomic reflexes in midpregnancy, Br J ObstetGynaecol,100,
1993, 177–182.
[3]. Phippard AF, Horvath JS, Glynn EM, Circulatory adaptation to pregnancy: serial studies on haemodynamics, blood volume, renin
and aldosterone in the baboon (Papiohamadryas), J. Hypertens, 4, 1986, 773-779.
[4]. Duvekot JJ, Cheriex EC, Pieters FA, Menheere PP, Peeters LH, Early pregnancy changes in hemodynamics and volume
homeostasis are consecutive adjustments triggered by a primary fall in systemic vascular tone, Am J ObstetGynecol, 169, 1993,
1382–1392.
[5]. Ekholm EM, Piha SJ, Erkkola RU, Antila KJ, Autonomic cardiovascular reflexes in pregnancy, A longitudinal study,ClinAuton
Res, 4, 1994, 161–165.

Abstract: Two wheeler accidental deaths are one of the leading causes of morbidity and mortality in the world. The present study is based on the autopsy records of unnatural deaths occurred in and around Guntur city Andhra Pradesh, India. The cause of death in majority of cases was head injury i.e., with fracture of skull or intracranial hemorrhages or injury to brain. Extremities (upper limbs and lower limbs) were most commonly injured than any other regions of the body. Liver was more commonly injured than any other organ of the body.........

Keywords: Two wheeler accidents, head injury, unnatural deaths, timely intervention

[1]. Singh Y.N, Bairagi K, Das K. An epidemiological study of Road Traffic Accidents victims in Medico legal autopsies. JIAFM
2005:27(3):166-9.
[2]. Odero W, Garner P, Zwi A. Road traffic Injuries in developing countries: A comparative review of epidemiological studies : Trop.
Med Int. Health. 1997; 2: 445-60
[3]. National crime records bureau – statistics, 2004
[4]. Gururaj G. Road Safety in India: A Framework for Action, National Institute of Mental Health and Neuro Sciences, Publication no
83, Bangalore
[5]. Wick M, Muller EJ, Ekkernkamp A, Muhr G: The motorcyclist: easy rider or easy victim? An analysis of motorcycle accidents in
Germany Am J Emerg Med 1998; 16(3): 320-321.

Abstract: Vesiculobullous lesion are group of disorders clinically manifests as formation of blisters which can either be vesicles and bulla. They pose a diagnostic challenge due to their similar or polymorphic clinical signs and symptoms and histological limitations and unpredictable progress of the lesions. Molecular biology which deals with the study of biology at molecular level provides a link between clinical and histological presentations. Pemphigus group of diseases are characterized by auto antibodies directed against desmosomal proteins. Pemphigoid group of lesions is characterized by circulating IgG autoantibodies against either BP 230 (BPAg1) and BP 180 (BPAg2) basement membrane zone proteins........

Keywords: Vesiculobullous lesions, pemphigus, pemphigoid, dermatitis hepetiformis, Linear IgA bullous dermatosis, epidermolysis bullosa aquisita

[1]. Nikitakis .G.N. Oral soft tissue lesions: A guide to differential diagnosis Part II: Surface alterations. Braz J Oral Sci. 2005 Apr- May; 4 (13): 707-715.
[2]. Thivolet J, Jablonska S. Bullous Disorders: From Histology to Molecular Biology. Clinics in dermatology. 2001 Sept- Oct; 19 (5); 533-543.
[3]. Zahur M and Asif RA . Clinical, Cellular & Molecular Biology of Autoimmune Disorders. J. Clin Cell Immunol. 2013.
[4]. E. Dabeistee. Molecular biological aspects of acquired bullous diseases. Crit Rev Oral Biol Med. 9(2); 162-178.
[5]. Scully C , Bagan JV , Black M , Carrozzo M, Eisen D , Escudier M , Farthing P , Kuffer R , Muzio L , Mignogna M , Porter SR . Epithelial biology. Oral Diseases. 2005. 11; 58-7.

Abstract: Fiber reinforced composites are high strength filling materials composed of conventional composites and glass fibres. They exhibit extensive applications in different fields of dentistry. This clinical report present a case where FRC technology was successfully used to restore central maxillary incisor edentulous area in terms of esthetic-cosmetic values and functionality........

[1]. Vallittu PK, Sevelius C. Resin-bonded, glass fiber-reinforced composite fixed partial dentures: A clinical study. J Prosthet Dent
2000;84:413-18.
[2]. Butterworth C, Ellakwa AE, Shortall A. Fiber-reinforced composites in restorative dentistry. Dent Update 2003;30: 300-06.
[3]. P. K. Vallittu, "Flexural properties of acrylic resin polymers reinforced with unidirectional and woven glass fibers," The Journal of
Prosthetic Dentistry, vol. 81, no. 3, pp. 318–326, 1999.
[4]. S. H. Kimand D. C. Watts, "Effect of glass-fiber reinforcement and water storage on fracture toughness (KIC) of polymerbased
provisional crown and FPD materials," International Journal of Prosthodontics, vol. 17, no. 3, pp. 318–322, 2004
[5]. Nezar Watted ,Abdulgani Azzaldeen ,Muhamad Abu-Hussein; AESTHETIC REPLACEMENT OF CONGENITALLY MISSING
TOOTH USING FIBER-REINFORCED COMPOSITE (FRC) Int J Dent Health Sci 2014; 1(4): 644-653.

Abstract: Pleomorphic adenoma is a benign tumor of the salivary gland that consists of a combination of epithelial and mesenchymal elements1. About 90% of these tumors occur in the parotid gland and 10% in the minor salivary glands2. Among intra oral pleomorphic adenomas buccal vestibule is among the rarest sites3. A case of pleomorphic adenoma of minor salivary glands in the buccal vestibule in a 36 year-old female is discussed4. It includes review of literature, clinical features, histopathology, radiological findings and treatment of the tumor, with emphasis on diagnosis4. The mass was removed by wide local excision with adequate margins5.......

Keywords: minor salivary gland, pleomorphic adenoma, tumor, parotid gland, vestibule, mesenchymal elements.

[1]. M Shruthi, Raghavendra Kini, Vathsala Naik, Girish Y R Naik, Nishith Kumar, Jayanth Kumar. Pleomorphic Adenoma of Palate: A
Case Report. International Journal of Advanced Health Sciences. Vol 2 Issue 1 • May 2015.
[2]. Pradhuman Verma, Suresh K Sachdeva, Kanika Gupta Verma, Kompal Sachdeva . Pleomorphic adenoma of cheek: A rare case
report and review of literature. Indian Journal of Dental Research, 25(1), 2014 .
[3]. Preeti Sethi Bakshi, Naveen Jindal, Swati Roy, Kaaveri Khanna. Pleiomorphic Adenoma of Buccal Mucosa: A Rare Case. OHDMVol.
14- No.3-June, 2015 .
[4]. Amit Aggarwal, Ravinder Singh,Soheyl Sheikh,Shambulingappa Pallagatti, Isha Singla.Pleomorphic adenoma of minor salivary
gland:a case report . RSBO. 2012 Jan-Mar;9(1):97-101 – 99 .
[5]. Taufik Dalati and Mahmoud R Hussein. Juvenile pleomorphic adenoma of the cheek: a case report and review of literature.
Diagnostic Pathology 2009, 4:32 . Page 2 of 5.