iosr-JDMS   Volume-16 ~ Issue-9 ~ September-2017

Abstract: Background: Laparoscopic cholecystectomy (LC) is one of the most common laparoscopic procedures being performed by general surgeons all over the world. Preoperative prediction of the risk of conversion is an important aspect of planning laparoscopic surgery. The purpose of our prospective study was to analyze various risk factors based clinical history, laboratory investigations and imaging and their association with conversion to open. With the help of accurate prediction, high risk patient may be informed before hand regarding the probability of conversion and hence they may have a chance to make arrangements accordingly. On the other hand, surgeons also may have to schedule the time and team for the operation appropriately. Surgeons can also be aware about the possible complications that may arise in high risk patients...........

Keywords: Laparoscopic cholecystectomy, risk factors, conversion.

[1]. Trownbridge R L, Rutkowski N K, Shojania K G: Does this patient have acute cholecystitis? JAMA 289; 80-86, 2003.
[2]. Kama N A, Dogary M, Dolapa M. Reise, Attli M, et al! Risk factors resulting in conversion of laparoscopic cholecystectomy to open cholecystectomy. Surgical endoscopy, Springer New York : V5 965-968.
[3]. Daradkeh S, laparoscopic cholecystectomy: What are the factors determining difficulty? Hepatogastroenterology. 2001 JanFeb; 48(37): 76-78.
[4]. Pastulka P S, Bistrian B R, Benotti P N, et al: The risks of surgery in obese patients. Ann intern med 104: 551-556, 1985.
[5]. J. S. Randhawa . A. K. Pujahari, preoperative prediction of difficult lap chole: a scoring method. Indian Journal of Surgery, volume 71, number 4, July- August 2009, PP:198-201..

Abstract: Glomus tumors are rare benign lesions, characterized by hamartomatous proliferation originated in the neuromyoarterial glomus bodies.The most common site for glomus tumor development is the distal phalanx, particularly beneath the nails; however, this tumor can be found anywhere on the body.Glomus bodies are highly specializedarteriovenous anastomoses responsible for the thermoregulation by regulating the skin. These bodies can be found in the reticular layer of the dermis throughout the body although they are most numerous in digits, hand palms and feet soles.Glomus tumor was first described by Wood as early as 1821,but the characteristic histological description was given byMasson.Typically, a glomus tumor of the finger presents with a triad of localized tenderness, severe paroxysmal pain (out of proportion to size) and sensitivity to cold. They have a benign clinical course.The clinical signs........

[1]. Vasisht B, Watson HK, Joseph E, Lionelli GT. Digital glomus tumors: A 29-year experience with a lateral subperiosteal approach. Plast Reconstr Surg 2004;114:1486-9.
[2]. Girisha BS, Shenoy MM, Mathias M, Mohan R. Glomus tumor of the nail unit. Indian J Dermatol 2011;56:583-4
[3]. McDermott EM, Weiss AP. Glomus tumors. J Hand Surg [Am] 2006;31:1397-400.

Abstract: Acute poisoning is one of the most common cause for emergency hospital admissions. Poison is defined as any substance(solid ,liquid , gas) which when introduced through any manner inside the body interferes with the normal body functions and causes ill health by its systemic or local effects or both.It is caused by excessive single dose or several small doses taken over a short interval of time.India has shown increasing incidences in accidental , homicidal and suicidal poisoning because of greater use and easy availability of chemicals for industrial and domestic purposes. Knowing the pattern of poisoning in a region not only helps to take the preventive measures but also helps in early diagnosis and treatment. Poisoning is the most common method adopted in India to commit suicide.Sometimes findings of poison in the stomach is neither obtained on autopsy nor detected by chemical analysis. In such..........

[1]. Kanchan T, Menezes RG. Suicidal poisoning in Southern in India: Gender differences. J Forensic Leg Med.2008;15:7-14.
[2]. Cairans FJ , Koelmeyer TD , Smeeton WM. Deaths from drugs and poisons. N Z Med J.1982;96:1045-8.
[3]. Tendon SK, Qureshi GU, Pandey DN,Aggrawal A.A profile of poisoning cases admitted in S N Medical College and Hospital Agra.J Forensic Med Toxicol.1996;13:10-2.
[4]. Senewiratne B , Thambipillai S. Pattern of poisoning in a developing agricultural country.Br J Prev Soc Med.1974;28:32-6.
[5]. Jamil H. Acute poisoning: A review of 1900 cases.J Pak Med Asso.1990;40:131-3
[6]. Singh S , Sharma BK, Wahi PL.Spectrum of acute poisoning in adults J Assoc Physicians

Abstract: Background & Objective: In view of increasing number of road traffic accidents and blunt abdominal injury and its lethal & fatal complications ,FAST is an essential and necessarycomponent of trauma management.Hence this study is undertaken. The ObjectivesOf Our Study Were To Asses The Diagnostic Acuracy Of Focussed assessment with sono graphy in detecting intra abdominal free fluid after blunt abdominal injuries.. Methods: Govt.Rajaji hospital ,Madurai, admits all the victims of Blunt Abdominal Trauma in Trauma ward. 50 consecutive patients with history of blunt abdominal trauma attendingor taken to our hospital 01/01/2016 to.............

Keywords : Blunt abdominal injury, focussed abdominal sonography,ultrasonography

[1]. 1 Rozycki GS, Ochsner MG, Jaffin JH. Prospective evaluation of surgeons‟use of ultrasound i. n the evaluation of trauma patients. J Trauma. 1993;34:516–27.
[2]. Dolich MO, McKenney MG, Varela JE. 2576 ultrasounds for blunt abdominal trauma. J Trauma. 2001;50:108–12.
[3]. Sloan JP, Lalanda M, Brenchley J. Developing the role of emergency medicine ultrasonography. The Leeds experience. Emerg Med J. 2002;19:A63
[4]. Dolich MO, McKenney MG, et al. Ultrasounds for blunt abdominal trauma. J Trauma. 2001;50(1):108–112. [ ]
[5]. American College of Emergency Physicians. Policy statement. Emergency ultrasound imaging criteria compendium. p 26 [ ]

Abstract: Introduction: Essential hypertension comprise more than 90% of hypertension. It is a emerging health problem in india.Many studies have shown that a positive correlation between serum sodium and blood pressure and a negative correlation between blood pressure and serum potassium. Objective: To evaluate serum sodium and potassium levels and correlate them with blood pressure in newly diagnosed patients of essential hypertension Method: Data for the study was collected from twenty five newly diagnosed essential hypertensive patients attending the medicine opd/ admitted to the clinicians ward of RIMS............

Keywords: Essential hypertension, serum potassium, serum sodium, BMI, risk factor

[1]. WHO ( 2011 ), global status report on non- communicable disease.
[2]. Govt. of india, National health report 2011, ministry of health and family welfare, new delhi. Kaplan NM. Primary hypertension: pathogenesis. In clinical hypertension. Baltimore, Williams Wilkins, 1998: 41 – 101.
[3]. Annual health survey of Jharkhand 2011 – 2012.
[4]. He FJ, MacGregor GA; A comprehensive review on salt and health and current experience of worldwide salt reduction programmes. J Hum Hypertens., 2009; 23(6):363–384.
[5]. Veith I; The Yellow Emperor's Classic ofInternal Medicine. 2nd edition, University ofCalifornia Press

Abstract: Introduction: Acute abdomen refers to signs and symptoms of abdominal pain and tenderness, a clinical presentation usually treated best by emergency surgical therapy.The proper management of patients with acute abdomen requires a timely decision about need of surgical procedure. Very often an accurate diagnosis cannot be made without surgery. A study was conducted to assess the association between clinical, radiological and operative findings in a case of atraumatic acute abdomen and thus to evaluate clinical diagnostic accuracy and radiological diagnostic accuracy.............

[1]. Squires RA, Postier RG. Acute Abdomen. In: Sabiston textbook of surgery. Townsend CM, Beauchamp RD, Evers BM, Mattox KL, editors. 19thed. Vol ii. Philadelphia: Elsevier Saunders; 2012.47:P.1141-59.
[2]. De Dombal FT: diagnosis of acute abdominal pain, 2nd ed. Churchill Living stone, London, 1991.
[3]. Purcell TB., Nonsurgical and extraperitoneal causes of abdominal pain. Emerg Med Clin North AM. 1989;7:721.
[4]. Silen W: Cope‟s early diagnosis of the acute abdomen 20th ed. Oxford University press, New York, 2000.
[5]. Brewer RJ, Golden GT, Hitch DC et al., Abdominal pain: an analysis of 1,000 consecutive cases in a university hospital emergency room. Am J Surg. 1976;131: 219..

Abstract: Pancreatitis means inflammation of pancreas. It could be better divided into acute and recurrent pancreatitis. It is studied extensively because of grave prognosis in which stand at 9.8 per 100000 of the population. Of all the abdominal emergencies this particular condition carries the highest mortality & morbidity. The etiology of pancreatitis is attributable to many factors like alcohol, gall stones, ductal causes, vascular, trauma both blunt and surgical, autoimmune disease, metabolic, parasitic and many more. In this study the prime etiological factor is alcohol. The individuals in lower socio economic strata are the one most affected. Whatever may be the etiological agent.............

Keywords: pancreatitis, alcohol, inflammation.

[1]. EL Opie; The etiology of acute hemorrhagic pancreatitis. Bull Johns Hopkins Hosp, 12 (1901), pp 182-188
[2]. Ali Nawaz Khan, John Karani,"Chronic Pancreatitis Imaging". Medscape.
[3]. New developments in understanding of pathophysiology, diagnosis and treatment of severe acute pancreatitis A. Izakson1, T. Ezri2*, Dana Weiner3, Diana Litmanovich4, E.V. Khankin4 JurnalulRomân de AnestezieTerapieIntensivã 2012 Vol.19 Nr.1, 39-50
[4]. Pathophysiology of Acute Pancreatitis.Madhav Bhatia Fei Ling Wong Yang Cao Hon Yen Lau Jiali Huang PadmamPuneet Lakshmi Chevali.Department of Pharmacology, National University of Singapore, Singapore. Pancreatology 2005;5:132–144,DOI: 10.1159/000085265.
[5]. American College of Gastroenterology Guideline:Management of Acute Pancreatit Scott Tenner , MD, MPH, FACG1 , John Baillie , MB, ChB, FRCP, FACG 2 , John DeWi MD, FACG3 and SanthiSwaroopVege , MD, FACG4, Am J Gastroenteroladvance online publication, 30 July 2013; doi: 10.1038/ajg.2013.218..

Abstract: India is a developing country with one of the highest cataract surgery rate now. As a result many patients are rendered pseudophakic. Glaucoma in these pseudophakic eyes is a major cause of loss of visual function. The hospital based screening for glaucoma in patients attending ophthalmology clinic is an important measure to diagnose the glaucoma early in its course before significant damage has occurred to the visual function. While a few population based studies in India have estimated the incidence of glaucoma in pseudophakia or Aphakia as a byproduct of their studies, studies on the incidence of glaucoma in patients attending ophthalmology clinic for the cataract surgery of second eye are very few. The opportunity of detecting glaucoma in pseudophakic eyes early and preventing further loss of visual function due to glaucoma is stressed in our study.

Keywords: Glaucoma screening, pseudophakia, cataract surgery complications, aetiopathogenesis of Glaucoma, early detection of Glaucoma

[1]. Kratz RP, MazzoccoTR, Davidson B et al : A comparative analysis of anterior chamber,iris-supported, capsule-fixated and posterior chamber intraocular lenses following cataract extraction by phacoemulsification. Ophthalmology,1981:88: 56-58.
[2]. Kolker A.E., Hetherington J .Secondary Open Angle Glaucoma: Postoperative glaucoma.in Becker-Shaffer's Diagnosis and Therapy of the Glaucomas.CV Mosby, St Louis; 1983:293-297.
[3]. Tuberville.A.W., Nissenkorn.I., Tomoda.T.et al , Postsurgical Intraocular pressure elevation. Am.Intraocular Implant Soc J.1983:9:309-312.
[4]. Savage J.A.,Thomas.J.V.,Belcher.C.D. et al, Extracapsular Cataract extraction and posterior chamber intraocular lens implantation in glaucomatous eyes. Ophthalmology, 1985:92:1506-1516.
[5]. Hoskins.H.D.,Management of pseudophakic glaucoma in E.L.Greve(Ed) Surgical Management of Coexisting Glaucoma and Cataract.Kugler Publications, Amsterdam; 1987:41-7.

Abstract: Aim: The aim of our study was to access the attitude of general dentists, and specialist dentists in and around Mumbai city about the methods they use to determine working length during root canal treatment. Materials and method-A crosssectional contact survey was conducted including 500 dental professionals in and around Mumbai city who performed root canal treatments. Specially prepared format to record and determine what working length method was adopted and preferred. Data was tabulated in Microsoft excel and analyzed using SPSS 22.0 software Conclusion: From the survey we determined thatrecently graduated dentists and many Endodontistsprefer apex locators and radiographs. There is apparently less knowledge of benefits and proper usage of apex locator in routine practice. Continuing dental education should be given from the base level for the same.

Keywords: electronic apex locator,radiographs, survey,working length.

[1]. Bhat KV, Shetty P, Anandakrishna L. A Comparative Evaluation of Accuracy of New-generation Electronic Apex Locator with Conventional Radiography to determine Working Length in Primary Teeth: An in vivo Study. Int J Clin Pediatr Dent 2017; 10(1):34-36.
[2]. Glossary. Contemporary terminology for endodontice.6th Ed. Chicago: American Association of Endodontics; 2010.P.135-140.
[3]. Working length determination, Dr. Thomas L, slideshare.in.
[4]. https://www.slideshare.net/mobile/liyathomas/working-length-determination-49832641
[5]. Janeczek M, Kosior P, PaNczyszyn D , KrzysztofDudek,Chrószcz A ,CzajczyNska-Waszkiewicz A, Kowalczyk-Zajdc M ,Gabren-Syller A, Kirstein K , Skalec A, BryBa E, DobrzyNski M. The Effect of File Size and Type and Irrigation Solutions on the Accuracy of Electronic Apex Locators: An In Vitro Study on Canine Teeth. BioMed Research International Volume 2016, Article ID 8594087, 7 pages.

Abstract: Background: Avascular necrosis (AVN) is a relatively common disease characterized by death of cellular elements of bone or marrow. The hip (femoral head) is the most commonly affected site for clinically significant AVN. The classification system introduced by Ficat & Arlet is possibly the most commonly used. Aim is to study functional outcome of core decompression in avascular necrosis of femoral head (Ficat & Arlet and Arlet stage 1 and II) using The Harris Hip Score & to evaluate the radiological progress after core decompression of femoral head. Methodology: A Prospective Study done in Department of Orthopaedics in Government Medical College Nizamabad, with a sample size of 35 hips in 26 patients during period from September...........

Keywords: Avascular necrosis, Core decompression, femoral head, Ficat & Arlet classification.

[1]. Babhulkar S.S. Osteonecrosis of the femoral head (in young individuals). Indian J Orthop. 2003; 37(2):2.

[2]. Sen R.K. Management of avascular necrosis of femoral head at pre-collapse stage. . Indian J Orthop. 2009; 43(1): 6–16.

[3]. Shannon BD1, Trousdale RT. Femoral osteotomies for avascular necrosis of the femoral head.Clin Orthop Relat Res. 2004 Jan; 418:34-40.

[4]. Phemister DB. Treatment of the necrotic head of the femur in adults. J Bone Joint Surg.1949; 31:55–66.

[5]. Boettcher WG, Bonfigilo M, Smith K. Non-traumatic necrosis of the femoral head: II. Experiences in treatment. J Bone Joint Surg [Am] .1970; 52-A: 322-329..

Abstract: Background: The benign prostatic hyperplasia is of significant importance to public health, affecting tens of millions of older men globally. Objectives: To determine the prevalence, investigate risk factors, and to clarify the complications associated with benign prostatic hyperplasia. Methods: A cross sectional hospital based survey, was conducted among attendees of primary health care clinics in the King Fahd Military Medical Complex, Dhahran (KFMMC), Eastern Region, Kingdom of Saudi Arabia (KSA). The study included 300 patients, with a mean age of 49.18 ± 11.40 years and range (31-82 years)...........

Keywords: Benign prostatic hyperplasia, prevalence, risk factors, primary health care clinic, KFMMC

[1]. Auffenberg GB, Helfand BT, McVary KT. Established medical therapy for benign prostatic hyperplasia. UrolClin North Am. 2009;36:443–59.
[2]. McNeal J. Pathology of benign prostatic hyperplasia. Insight into etiology.UrolClin North Am 1990;17:477-86.
[3]. National Kidney and Urologic Disease Information Clearinghouse (2012): Prostate Enlargement: Benign Prostate Hyperplasia. Retrieved October 19, 2013, from http://kidney.niddk.nih.gov/kudiseases/pubs/ prostateenlargement/
[4]. Taylor BC, Wilt TJ, Fink HA, et al. Prevalence, severity, and health correlates of lower urinary tract symptoms among older men: the MrOS study. Urology 2006; 68:804–809.
[5]. Cunningham R G, Kadmon D, O'Leary P M, Park L (2014): Epidemiology and pathogenesis of benign prostatic hyperplasia. http://www.uptodate.com/contents/epidemiology-and-pathogenesis-of-benign-prostatic-hyperplasia

Abstract: Fibrous dysplasia is a disorder where normal bone and marrow is replaced with fibrous tissue, resulting in formation of bone that is weak and prone to expansion. FD can be manifested as a single lesion (monostotic) or as multiple lesions (oligostotic or polyostotic). The vast majority of clinically significant bone lesions are detectable by age 10 years, with few new and almost no clinically significant bone lesions appearing after age 15 years . In this report, we describe a rare case of fibrous dysplasia in an infant. A 6 month old child presented with complains of bony swelling over right tibia. Radiological examination revealed osteolytic lesion of proximal part of right tibia. In histopathology............

Keywords-: Fibrous dysplasia, infant, monostotic, proximal tibia.

[1]. Lichtenstein L. Polyostotic fibrous dysplasia. Arch Surg. 1938;36:874–898. doi: 10.1001/archsurg.1938.01190230153012.

[2]. Ippolito E, Bray EW, Corsi A, De Maio F, Exner UG, Robey PG, Grill F, Lala R, Massobrio M, Pinggera O, Riminucci M, Snela S, Zambakidis C, Bianco P. Natural history and treatment of fibrous dysplasia of bone: a multicenter clinicopathologic study promoted by the European Pediatric Orthopaedic Society. J Pediatr Orthop B. 2003;12:155–177.

[3]. McCune DJ, Bruch H. Osteodystrophia fibrosa: report of a case in which the condition was combined with precocious puberty, pathologic pigmentation of the skin, and hyperthyroidism, with a review of the literature. Am J Dis Child. 1937;52:806–848. doi: 10.1001/archpedi.1937.01980040110009.

[4]. Albright F, Butler AM, Hampton AO, Smith P. Syndrome characterized by osteitis fibrosa disseminata, areas of pigmentation and endocrine dysfunction, with precocious puberty in females. N Engl J Med. 1937;216:727–746. doi: 10.1056/NEJM193704292161701

[5]. Mazabraud A, Semat P, Roze R. [Report of the association of fibromyxomas of the soft tissues with fibrous dysplasia of the bones] [Article in French] Presse Med. 1967;75:2223–2228

Abstract: Introduction: The undergraduate medical curricula should be planned to prepare the students for their future work which include the selection of their major specialties and the subspecialties. We described in this report how our curriculum achieved this. Objectives: This paper describes how we introduced the concept of selective subspecialties for undergraduate medical students. Methods:Wefollowed 8 steps to plan,designand implement the selective subspecialty module. These steps include need assessment and objectives, educational strategies, course contents, teaching methods, educational environment, course management, assessment and course evaluation............

Keywords: selective subspecialty; undergraduate curriculum; clinical module

[1]. Madhuri S. Kate ,Ujjwala J. Kulkarni , AvinashSupe , Deshmukh Y.A. Introducing Integrated Teaching In Undergraduate Medical Curriculum. International Journal of Pharma Sciences and Research (IJPSR) Vol.1(1), 2010, 18-22. http://www.ijpsr.info/docs/IJPSR-10-01-01-04.pdf

[2]. Elfakey WEM, Koshak EA, Abdelaziz A, Akl U, Alqahtani F, Mady E. Evaluation of a multidisciplinary clinical module on cardiology and cardiovascular surgery at Al-Baha University: students and academic staff perceptions. Educ Med J. 2015;7(3):27–34. http://www.eduimed.com/index.php/eimj/article/view/354

[3]. Elfakey WEM, Al-Ghamdi AH. Ten steps to plan, design, and implement an endocrinology and endocrine surgery module for the Faculty of Medicine, Al-Baha University, Advances in Medical Education and Practice 2016:7 617–622. https://www.ncbi.nlm.nih.gov/pubmed/27822133

[4]. Mehmood SI, Kumar A, Al-Binali A, Borleffs JC. Specialty preferences: trends and perceptions among Saudi undergraduate medical students. Medical Teacher. 2012; 34:S51–S60. https://www.ncbi.nlm.nih.gov/pubmed/22409192

[5]. Harden RM, Sowden S, Dunn WR. Educational strategies in curriculum development: the SPICES model.Med Educ. 1984; 18(4):284-97.https://www.ncbi.nlm.nih.gov/pubmed/6738402

Abstract: Polycythemia Vera is a clonal myeloproliferative neoplastic process characterized by abnormal proliferation of erythrocytes ,megakaryocytes and granulocytes in bone marrow in the absence of an hypoxic stimulus and in the sites of extra medullary hematopoiesis like in spleen.The study is carried out in 46yr female to assess the degree of hematopoiesis to clarify the pathogenesis of splenomegaly.polycythemia Vera is a rare cause of extra medullary hematopoiesis.splenoectomy was done in this patient.Patient was diagnosed with polycythemia Vera 12yrs back.

Keywords: Extramedullary hematopoiesis,Spleen

[1]. Freedman MH, Saunders EF. Hematopoiesis in the human spleen. Am J Hematol 1981;11:271–275. | PubMed | ISI | ChemPort |
[2]. O'Keane JC, Wolf BC, Neiman RS. The pathogenesis of splenic extramedullary hematopoiesis in metastatic carcinoma. Cancer 1989;63:1539–1543.
[3]. Wilkins BS, Green A, Wild AE, et al. Extramedullary haemopoiesis in fetal and adult human spleen: a quantitative immunohistological study. Histopathology 1994;24:241–247. | PubMed | ISI | ChemPort |
[4]. Snover DC, Frizzera G, Spector BD, et al. Wiskott–Aldrich syndrome: histopathologic findings in the lymph nodes and spleens of 15 patients. Hum Pathol 1981;12:821–831. | PubMed | ISI | ChemPort |
[5]. Arnold R, Calvo W, Heymer B, et al. Extramedullary hematopoiesis after bone marrow transplantation. Scan J Haematol 1985;34:9–12. | ISI | ChemPort