iosr-JDMS   Volume-16 ~ Issue-6 ~ June-2017

Abstract: Aim:  Describe the patterns of traumatic abdominal hollow viscus injuries.  Identify the organs in specific forms of injury.  Attempt to link the morbidity and mortality to the delay in diagnosis and surgery.  Detail on the deceptive presentations in blunt injury abdomen.  Produce protocol for the management of hollow viscus injury following blunt injuries in the abdomen. Materials And Methods: I have analyzed fifty cases of blunt abdominal trauma following road traffic accidents, accidental falls from height and assault by various objects admitted in trauma ward during the period of December 2011 to October 2013

Keywords: Blunt Injury Abdomen, Hollow Viscus Injury, Traumatic Peritonitis

[1]. Feliciano, David V.; Mattox, Kenneth L.; Moore, Ernest J (2012). Trauma, Seventh Edition (Trauma (Moore)). McGraw-Hill Professional. ISBN 978-0-07-166351-9.
[2]. Fitzgerald, J.E.F.; Larvin, Mike (2009). "Chapter 15: Management of Abdominal Trauma". In Baker, Qassim; Aldoori, Munther. Clinical Surgery: A Practical Guide. CRC Press. pp. 192–204. ISBN 9781444109627.

Abstract: 1. To study the factors that lead to conversion from Laparoscopic cholecystectomy to open method in regard to age, sex, clinical presentation, laboratory values, Ultrasonogram and Operative findings. 2. To assess preoperative factors that might predict the chances of conversion 3. To assess the intra operative reason that results to conversion. Materials and methods: This study was conducted in the Department of General surgery and Department of Surgical Gastroenterology in Madurai Medical College and Government Rajaji Hospital, Madurai from October 2010 to September 2012 for a period of two years. This is a retrospective study done in the Madurai Medical College and Government Rajaji Hospital.

Keywords: Cholecystectomy, Laproscopic Cholecystectomy, Open Cholecystectomy

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[2]. NIH Consensus Conference. Gallstones and Laparoscopic Cholecystectomy.JAMA 1993; 269: 1018-24
[3]. Lo CM, Fan ST, Liu CL et al. Early decision for conversionof laparoscopic to open cholecystectomy for treatment of acute cholecystitis. AmJrSurg1997; 173: 513-17.
[4]. Kama NA, Kologlu M, Doganay M et al. A risk score forconversion from laparoscopic to open cholecystectomy. AmJrSurg2001; 181: 520-25.
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Abstract: Cholecys to gastric Fistulae are a rare variety of biliary fistulae .Mostfistulae between the gallblad deran dintestinaltract become obvious[1]. But here we report a rare silent presentation of Cholecys to gastric fistula in a 51 year old female, whowas posted for routine laparoscopic cholecystectomy for long standing cholelithiasis

Keywords-: Cholecystogastric fistula, gallstones, cholelicystitis.

[1]. Blumgart's surgery of the liver, pancreas and biliary tract by William Jarnagin.

[2]. Pathology of pancreas, gallbladder extrahepatic biliary tree by Ernest Lack.

[3]. International journal of surgery vol 22. Cholecystocolonic fistula as a complication of cholelithiasis. A. Rodrigues-rivera, L. Ckarke

[4]. Cholecystogastricfistula: a brief report and review of the literature

[5]. Michael R. Boland,Gary A. Bass, Ian Robertson, Thomas N. Walsh.

[6]. Afflerbaugh JK, Cole HA (1955) Intragastric gallstone. Radiology 64:581–583.

Abstract: The standard of care for glioblastoma is surgical resection followed by adjuvant radiotherapy with concurrent and adjuvant temozolamide. However survival data and impact of temozolamide on survival in Indian population is scanty. Between January 2014 to December 2015, patients of glioblastoma who underwent surgery and had received post-operative radiotherapy(RT) with temozolomide(TMZ) were analyzed. A total of 16 patients who received RT/TMZ. Median overall survival (OS) of patients who received RT/TMZ was 11 months.............

Keywords-: Glioblastoma, radiotherapy, temozolamide

[1]. Stupp R, Mason WP, Van Den Bent MJ, Weller M, Fisher B, Taphoorn MJ, Belanger K, Brandes AA, Marosi C, Bogdahn U, Curschmann J. Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. New England Journal of Medicine. 2005 Mar 10;352(10):987-96.

[2]. Curran Jr WJ, Scott CB, Horton J, Nelson JS, Weinstein AS, Fischbach AJ, Chang CH, Rotman M, Asbell SO, Krisch RE, Nelson DF. Recursive partitioning analysis of prognostic factors in three Radiation Therapy Oncology Group malignant glioma trials. JNCI: Journal of the National Cancer Institute. 1993 May 5;85(9):704-10.

[3]. Mirimanoff RO, Gorlia T, Mason W, Van den Bent MJ, Kortmann RD, Fisher B, Reni M, Brandes AA, Curschmann J, Villa S, Cairncross G. Radiotherapy and temozolomide for newly diagnosed glioblastoma: recursive partitioning analysis of the EORTC 26981/22981-NCIC CE3 phase III randomized trial. Journal of Clinical Oncology. 2006 Jun 1;24(16):2563-9.

[4]. Jalali R, Basu A, Gupta T, Munshi A, Menon H, Sarin R, Goel A. Encouraging experience of concomitant Temozolomide with radiotherapy followed by adjuvant Temozolomide in newly diagnosed glioblastoma multiforme: single institution experience. British journal of neurosurgery. 2007 Jan 1;21(6):583-7.

Abstract: Evaluation of non febrile seizure disorder on MRI with correlation with seizure type and EEG records in children. Objectives: The aim of this retrospective study was to investigate the spectrum of abnormality on MRI, to correlate MRI findings with the seizure type and EEG findings wherever available in children presenting with non febrile seizure disorder. Patients And Methods: A retrospective hospital based study was done of 271 children who underwent brain MRI for seizure disorder with exclusion of febrile conditions, recent trauma and metabolic conditions from the study. The MRI findings were interpreted independently and subsequently correlated with clinical history and EEG findings wherever available from patients' records.

[1]. Van der Berg BJ, Yerushalmy J.Studies on convulsive disorders in young children. I. Incidence of febrile and nonfebrile convulsions by age and other factors.Pediatr. Res.1969;3:298-304.
[2]. Doescher JS, deGrauw TJ, Musick BS, Dunn DW, Kalnin AJ, Egelhoff JC, et al. Magnetic resonance imaging and electroencephalographic findings in a cohort of normal children with newly diagnosed seizures. J Child Neurol 2006;21:491– 5.
[3]. Hsieh DT, Chang T, Tsuchida TN, Vezina LG, Vanderver A, Siedel J, et al. New onset afebrile seizures in infants.Role of neuroimaging. Neurology 2010;74(2):150-6.
[4]. Shinnar S, O'Dell C, Mitnick R, Berg AT, Moshe SL. Neuroimaging abnormalities in children with an apparent first unprovoked seizure.Epilepsy Res. 2001;43(3):261-9.
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Abstract: Introduction: Cervical lymphadenopathy is one of the most common causes of mass in head and neck region. Patients either present with palpable neck masses or with malignancy of the head and neck where the preoperative detection of the involved nodes is essential. Ultrasound and color/power Doppler are used to localize the node and evaluate their multiplicity, size, shape (roundness index), hilum status, margin, calcification, necrosis (>3 mm), and peri lymphnodal edema. Color and power Doppler is used to know the pattern of vascularity and doppler indices [resistive index (RI) and pulsatility index (PI)]..............

[1]. Ahuja AT, Ying M. Sonographic evaluation of cervical lymph nodes. AJR Am J Roentgenol 2005;184:1691-9. 2.
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[3]. Haque MA, Talukder SI: Evaluation of fine needle aspiration cytology (FNAC) of lymphnodes in Mymensingh. Mymensingh Med J. 2003, 12 (11): 33-5.PubMedGoogle Scholar
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Abstract: Aims: To develop a micro-method for biotinidase estimation using dried blood spots based on the colorimetric assay developed by Heard et al. Results: A novel micro-method for biotinidase assay from dried blood spots was developed and validated using Heard et al method for plasma (n=35) and Yamaguchi et al method for dried blood spot (n=22).The correlation coefficients obtained by plotting the values obtained by novel method against the values by Heard et al and Yamaguchi et al methods were 0.86 and 0.90 respectively..................

Keyword: Biotinidase, diagnostic test, dried blood spots, micro-method, newborn screening, regression analysis

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[5]. Bressman S, Fahn S, Eisenberg M, Brin M, Maltese W. Biotin-responsive encephalopathy with myoclonus, ataxia, and seizures. Adv Neurol. 1986;43:119-25.

Abstract: The fractures at distal end of radius are one of the common fractures encountered regularly. The vulnerability of distal end of radius to sustain a fracture is due to being a weak cortico cancellous junction and mode of injury can result in a variety of fractures in this region. The impact involved in the traumatic incident and the position in which the impact is received, can cause multiple fracture lines and different displacements. Our study is designed as a cross sectional study to involve fractures of distal end of Radius, that need to be treated with one of the options of fracture fixation viz., K wire, or Volar Plate or External fixation, and to know the indications for using more than one device in any given case. All together78 cases are included in the study with fractures of distal end of radius. We would like to conclude that, a combination of hardware is required when dealing with distal radius fracture, where single fixation is not reproducing radiological measurements at the distal end of radius.................

Keyword: Distal end of radius, fractures with comminution, radiological measurements, combination of hardware, stable fixation

[1]. Hand (N Y). 2017 Jun 1:1558944717708025. doi: 10.1177/1558944717708025. [Epub ahead of print] Conservative Treatment of Distal Radius Fractures: A Prospective Descriptive Study. Aparicio P1, Izquierdo Ó1, Castellanos J1.
[2]. Injury. 2014 Dec;45 Suppl 6:S21-6. doi: 10.1016/j.injury.2014.10.018. Epub 2014 Oct 27. Is it really necessary to restore radial anatomic parameters after distal radius fractures? Dario P1, Matteo G2, Carolina C2, Marco G2, Cristina D2, Daniele F2, Andrea F2.
[3]. J Hand Surg Am. 2005 Mar;30(2):289-99. Functional outcome of unstable distal radius fractures: ORIF with a volar fixed-angle tine plate versus external fixation. Wright TW1, Horodyski M, Smith DW.

Abstract: Case details: 56 year old lady came to physiotherapy department with outer elbow pain complaint. She was suffering from this condition since last 2 years. After detailed examination we found her elbow extensors were tight, scapular and shoulder muscles were weak and pain sensitivity was increased. She was treated with a tailor made physiotherapy protocols with dry needling, kinesio taping and physiotherapy techniques. Aim: Aim was to reduce the pain, to gain the normal length and strength of the affected muscles, to strengthen the proximal muscles of shoulder and to improve her daily activities. Result: Pain came down to 0.5 from 9 on NPRS. Full ROM achieved at elbow. There was absolutely no complaint in performing daily activities. Conclusion : Chronic tennis elbow can be treated with tailor made physiotherapy treatment.

[1]. Physical therapists and performances of Dry needling; an educational resource paper, American PhycialTherapy Association jan 2012.
[2]. Description of dry needling in clinical practice, an educational resource paper, American Physicaltherapy Association feb 2013
[3]. Jiten B Bhatt, Randal G.Middle and lower trapezius strengthening for the management of lateral epicondylgia. A case Report. Jospt. 2013;43, 841-847
[4]. Alireza S, Mohammmad T. Effects of tapping on pain, grip strength and wrist extensor force in patients with tennis elbow. Trauma monthly. Sept 2013, 18(2), 71-74

Abstract: Dysgerminoma is an uncommon tumor,accounting for 1-2% of primary ovarian neoplasm and for 3-5% of ovarian malignancies.Tumor may occur at any age from infancy to old age,but most cases occur in adolescence and early adult life.Dysgerminoma occur not infrequently before puberty but is very rare after menopause.Literature states that about 2% of nonpregnant patient with dysgerminoma present with elevated serum or urine level of hCG.................

Keyword: hCG,dysgerminoma,ovary,syncytiotrophoblast giant cell.

[1]. Michener, C.M. and Huh, W.K. (2012) Ovarian dysgerminomas. Medscape Drugs, Diseases & Procedures. Prat J. Prat J, ed. Pathology of the Ovary. Germ cell tumors. Philadelphia, Pa: Saunders; 2004. 251-82.
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[3]. Gimelli S, Beri S, Drabkin HA, Gambini C, Gregorio A, Fiorio P, et al. The tumor suppressor gene TRC8/RNF139 is disrupted by a constitutional balanced translocation t(8;22)(q24.13;q11.21) in a young girl with dysgerminoma. Molecular Cancer. 2009. 8:52-. [Medline].
[4]. Gershenson DM, Copeland LJ, del Junco G. Second-look laparotomy in the management of malignant germ cell tumors of the ovary. Obstet Gynecol. 1986 Jun. 67(6):789-93. [Medline].
[5]. Gershenson DM, Morris M, Cangir A, Kavanagh JJ, Stringer CA, Edwards CL. Treatment of malignant germ cell tumors of the ovary with bleomycin, etoposide, and cisplatin. J ClinOncol. 1990 Apr. 8(4):715-20. [Medline]

Abstract: The Post mastectomy chestwall radiation is routinely delivered using tangential photon fields. However underlying lung is a major organ at risk and this report studies the use of single electron beam radiotherapy in these patients. To compare mean left lung dose, percentage volume of left lung receiving dose more than 20Gy. (V20Gy), percentage volume of planned target volume (PTV) receiving more than 95% of prescribed dose (V95%). There was significant difference in favour of electron-beam plans for mean lung dose (p=0.004), V20Gy of left lung (p=0.003) and there was no significant difference in mean heart dose. The difference in percentage volumeof PTV receiving more than 95% of prescribed dose (p=0.069) showed trend towards significance.

Keyword: Chestwall radiotherapy, electrons

[1]. Yu KD, Di GH, Wu J, Lu JS, Shen KW, Shen ZZ, Shao ZM: Development and trends of surgical modalities for breast cancer in China: a review of 16-year data. Ann Surg Oncol 2007, 14(9):2502–2509.
[2]. Overgaard M, Hansen PS, Overgaard J, Rose C, Andersson M, Bach F, Kjaer M, Gadeberg CC, Mouridsen HT, Jensen MB, et al: Postoperative radiotherapy in high-risk premenopausal women with breast cancer who receive adjuvant chemotherapy. Danish Breast Cancer Cooperative Group 82b Trial. N Engl J Med 1997, 337(14):949–955.
[3]. Recht A, Gray R, Davidson NE, Fowble BL, Solin LJ, Cummings FJ, Falkson G, Falkson HC, Taylor SG, Tormey DC: Locoregional failure 10 years after mastectomy and adjuvant chemotherapy with or without tamoxifen without irradiation: experience of the Eastern Cooperative Oncology Group. J Clin Oncol 1999, 17(6):1689–1700.
[4]. Ragaz J, Olivotto IA, Spinelli JJ, Phillips N, Jackson SM, Wilson KS, KnowlingMA, Coppin CM, Weir L, Gelmon K, et al: Locoregional radiation therapy in patients with high-risk breast cancer receiving adjuvant chemotherapy: 20-year results of the British Columbia randomized trial. J Natl Cancer Inst2005, 97(2):116–126.
[5]. Rudat V, Alaradi AA, Mohamed A, Ai-Yahya K, Altuwaijri S: Tangential beam IMRT versus tangential beam 3D-CRT of the chest wall in postmastectomy breast cancer patients: a dosimetric comparison. Radiat Oncol 2011, 6:26.

Abstract: Background: Thyroid hormones influences lipid metabolism, rise in serum cholesterol in hypothyroidism causes supersaturation of bile leading to depressed gall bladder contractility, hence risk of gall stone formation so we tries to correlate these changes. Material and methods: The present study has been conducted in Department of Medicine, J.A. Group of Hospitals, G.R. Medical College, Gwalior (M.P.) from period of January 2011 to January 2012. Present study comprised of 105 patients with hypothyroidism attending OPD and medicine ward. They were examined thoroughly after history taking and then subjected to routine investigation with special emphasis on lipid profile, thyroid profile and USG abdomen especially gall bladder and hepatobiliary. Association of gall bladder stone and hypothyroidism was also observed. Patients with TSH level > 5.5 were considered to having hypothyroidism, thus cases were divided into two groups. Group I with TSH level between 5.5 to 10 IU/ml (Subclinical hypothyroidism) and Group II with TSH level above 10 IU/ml (Overt hypothyroidism..............

Keyword: Subclinical hypothyroidism, overt hypothyroidism, lipid profile, cholelithiasis

[1]. Larry J, Anthony P. Disorders of thyroid glands. In: "Harrison's Principles of Internal Medicine", Fauci, Kasper, Hauser, Longo, Jameson, Loscalzo, editors. 17 th edition,Vol Il. Mc Graw Hill; 2008, pp 2224 47.
[2]. William F.Ganong. The thyroid gland. In: "Review of Medical Physiology, 22th edition. Mc Graw Hill;2003, pp 317 331.
[3]. Reed P, Terri F. Thyroid. In "Williams Textbook of Endocrinology", 10th edition. Elsevier; 2003, pp 331 73.
[4]. Galesanu C, Lisnic N, Teslaru R, Apostu L, Zbranca E. Lipids profile in a group of hypothyroid patients vs treated hypothyroid patients. Rev Med Chir Soc Med Nat Iasi 2004 Jul-Sep;108(3):554-60.
[5]. Irfan M. Khurram, Kiran S. Choudhary, Khan Muhammad, Najmul Islam. Clinical presentation of hypothyroidism: A case control analysis. J Ayub Med Coll Abbottabad 2003;15(1).

Abstract: Purpose: To compare the success rate of lacrimal sac massage and lacrimal sac massage with topical antibiotic (Tobramycin) in congenital nasolacrimal duct obstruction (CNLDO) in infant. Method: 60 patients were taken, aged from 2 to 12 months diagnosed with CNDLO (from Sept. 2015 to Dec. 2016) were included and divided into 2 equal groups; Group 1 advised for lacrimal sac massage only and Group 2-advised for lacrimal sac massage with topical antibiotic. Patient was followed up at regular intervals upto three months. Successful outcome was documented as complete remission of symptoms in subsequent visits following the conservative therepies.................

Keyword: CNLDO, Lacrimal sac massage, Nasolacrimal duct.

[1]. Young JD, MacEwen CJ. Managing congenital lacrimal obstruction in general practice. BMJ 1997;315:293-96.
[2]. Kapadia MK, Freitag SK, Woog JJ. Evaluation and management of congenital nasolacrimal duct obstruction. OtolaryngolClin North Am 2006;39:959-77.
[3]. Shuman T, Gonzales C, Mazow ML. Treatment of congenital nasolacrimal duct obstruction. Am orthoptic J 1999;49:163-8.
[4]. Petersen RA, Rom RM. The natural course of congenital nasolacrimal duct. J pediatrophthalmol strabismus 1978;15:246-50.
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Abstract: Objective: To study the dermatological adverse drug reactions (CADRs) in paediatric patients in a tertiary care teaching hospital. Methods: A retrospective study was undertaken to analyse adverse drug events in paediatric department of a tertiary care teaching hospital. Case sheets were studied and analysed for data of CADRs and dermatological adverse event marked as ADR by the consultant dermatologist and paediatrician was included in the study. Causality, preventability and severity were analysed by Pharmacologist using standard scales. Gender inclination, most common class of drug causing dermatological ADRs, types of dermatological ADRs including most common ADR, associated risk factors, mono pharmacy or polypharmacy were included in the study...............

Keyword: Adverse drug reactions, Causality, Naranjo's scale, CADRs (cutaneous adverse drug reactions), polypharmacy.

[1]. Biswas P, Biswas AK. Setting standards for proactive pharmacovigilance in India: The way forward. Indian J Pharmacol 2007;39:124-8.
[2]. Patel KJ, Kedia MS, Bajpai D, Mehta SS, Kshirsagar NA, Gogtay NJ. Evaluation of the prevalence and economic burden of adverse drug reactions presenting to the medical emergency department of a tertiary referral centre: A prospective study. BMC Clin Pharmacol 2007;7:8
[3]. Raut A, Diwan A, Patel C, Patel P, Pawar A. Incidence, severity and financial burden associated with adverse drug reactions in medicine inpatients. Asian J Pharm Clin Res 2011;4:103-11.
[4]. Khan FA, Nizamuddin S, Najmul H, Mishra H. A prospective study on prevalence of adverse drug reactions due to antibiotics usage in otolaryngology department of a tertiary care hospital in North India. Int J Basic Clin Pharmaco

[5]. Smyth R.M., Gargon E., Kirkham J., Cresswell L., Golder S., Smyth R., Williamson P. Adverse drug reactions in children-a systematic review. PLoS ONE.2012; 3:e24061.

Abstract: Anemia is a very common blood disorder associated with abnormal reduction in hemoglobin, RBC count and hematocrit values below the established reference values. It is very much prevalent and is largely undiagnosed among students in professional institute. Objectives & Aim: The objective of this study was tofind out the prevalence of anemia among females in medical college and to classify anemia based on red cell morphology. Materials and Methods: A cross – sectional medical institutional based study was conducted in the department of pathology. Information regarding diet, anthropometric parameters and menstrual history was obtained through a detailed questionnaire. Hemoglobin and RBC indices were analyzed using Horiba micros Dx auto analyzer..................

Keyword: Anemia, Young female medical students.

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