iosr-JDMS   Volume-17 ~ Issue-1 ~ January-2018

Abstract: Background: Thoracic spinal anaesthesia has proven its efficacy over general anaesthesia as a routine anaesthetic technique for laparoscopic surgeries. This study aimed to compare the block characteristics of isobaric and hyperbaric bupivacaine in thoracic spinal epidural anaesthesia for laparoscopic cholecystectomies. Materials and methods: The study included 60 ASA I and II patients undergoing elective laparoscopic cholecystectomy, divided randomly into two equal groups. Both the groups were given thoracic combined spinal epidural anaesthesia (CSE) at the T9-T10 / T10-T11 interspace using 1.5 ml of isobaric bupivacaine 0.5% (5 mg/ml) + 25μg (0.5 ml) of fentanyl in group I and 1.5 ml of hyperbaric bupivacaine 0.5% (5 mg/ml) + 25μg (0.5 ml) of fentanyl in group H...........

Keywords: Baricity, hyperbaric bupivacaine, isobaric bupivacaine,laparoscopic cholecystectomy, thoracic combined spinal epidural anaesthesia

[1]. Zundert AAJ van, Stultiens G, Jakimowics JJ, Peek D, van der Ham W. G. J. M, Korsten H. H. M, Wildsmith J. A. W. Segmental spinal anaesthesia for cholecystectomy in a patient with severe lung disease, Br Jr Anaesth 2006; 96:464–66.
[2]. Tzovaras G, Fafoulakis F, Pratsas K, Georgopoulou S, Stamatiou G,Hatzitheofilou C. Spinal vs general anesthesia for laparoscopic cholecystectomy: Interim analysis of a controlled randomized trial, Arch Surg 2008;143:497-501. [3]. Møller IW, Fernandes A, Edstrom HH. Subarachnoid anaesthesia with 0.5% bupivacaine: Effects of density, Br J Anaesth. 1984;56:1191–5.
[4]. Helmi M, Uyun Y, Suwondo BS, Widodo U. Comparison of intrathecal use of isobaric and hyperbaric bupivacaine during lower abdominal surgery. J Anesthesiol 2014 ; 2014:4.
[5]. Hogan QH, Prost R, Kulier A,Taylor ML, Liu S, Mark L. Magnetic resonance imaging of cerebrospinal fluid volume and the influence of body habitus and abdominal pressure,Anesthesiology. 1996;84:1341–9.

Abstract: Introduction: Over the last few years, rituximab (RTX) has emerged as a second- line therapy and has shown a 40-48% response rate in steroid resistant and up to 80% remission rate in steroid dependent nephrotic syndrome. The better outcome of RTX therapy in dependent nephrotic syndrome compared to resistant nephrotic syndrome is possibly due to excessive loss of RTX in the urine during active state of proteinuria. Objective: To assess the therapeutic response of RTX during non-proteinuric state in children with steroid and CNIs/MMF resistance nephrotic syndrome following induction of remission by a combined therapy of Prednisolone, CNIs and MMF. Materials and Methodology: In this study we analysed the data of steroid and CNIs/MMF –resistance idiopathic nephrotic children, aged 1-14 years from January 2014 to January.........

Keywords: Rituximab, Steroid resistant Nephrotic Syndrome, second line therapy.

1. Avner E., Harmon W., Niaudet P., Yoshikawa N. Pediatric Nephrology. 6th. Vol. 1. Springer; 2009.
[2]. Vivarelli M, Moscaritolo E, Tsalkidis A, Massella L, Emma F. Time for initial response to steroids is a major prognostic factor in idiopathic nephrotic syndrome. J Pediatr. 2010;156:965–971. doi: 10.1016/j.jpeds.2009.12.020.
[3]. Safdar OY, Aboualhameael A, Kari JA. Rituximab for troublesome cases of childhood nephrotic syndrome. World Journal of Clinical Pediatrics. 2014;3(4):69-75. doi:10.5409/wjcp.v3.i4.69.
[4]. Counsilman CE, Jol–van der Zijde CM, Stevens J, Cransberg K, Bredius RGM, Sukhai RN. Pharmacokinetics of rituximab in a pediatric patient with therapy-resistant nephrotic syndrome. Pediatric Nephrology (Berlin, Germany). 2015; 30(8):1367-1370. Doi: 10.1007/s00467-015-3120-8.
[5]. Bagga A, Sinha A, Moudgil A. Rituximab in patients with the steroid-resistant nephrotic syndrome. N Engl J Med, 2007; 356:2751-2752..

Abstract: Introduction: Peptic ulcer disease (PUD) is a worldwide health problem because of its high morbidity, mortality and monetary loss. The incidence of uncomplicated peptic ulcer disease has lowered dramatically due to usage of proton pump inhibitors and H2 receptor antagonists. Complicated peptic ulcer disease is still a concern all over the world and perforation is the most common complication followed by bleeding. Material and Methods: This is a retrospective/prospective study of 60 cases of peptic ulcer perforation carried out in MediCiti institute of Medical science, from July 2012 to September 2017. Out of 60 peptic ulcer perforations, 51(85%) were males and 9 (15%) were female showing strong male predominance with male: female ratio 5.66:1. More number of cases observed in 5th...........

Keywords: Gas under diaphragm (GUD), Non steroidal anti inflammatory drugs (NSAIDs) Peptic ulcer disease (PUD), Peptic ulcer perforation (PUP).

[1]. Testini M, Portincasa P, Piccini G, Lissidini G, Pellegrini F, Greco L. Significant factors associated with fatal outcome in emergency open surgery for perforated peptic ulcer. World J Gastroenterol. 2003;6: 2338- 2340. [PCM free article] [PubMed].
[2]. Soll AH. In: Seleisenger & Fordtran's Gastrointesstinal and Liver Disease; Pathophysiology, Diagnosis, Management. 6' Feldman M, Scharschmidt BF, Sleisenger MH,editor. Philadelphia , PA: W.B. Saunders; 1998. Peptic ulcer and its complications; pp. 620-678.
[3]. Turkdogan MK, Hekim H, Tuncer I, Aksoy H, the epidemiological and endoscopic aspects of peptic ulcer disease in Van region. Eastern Journal of Medicine 1999; 6(1): 6-9
[4]. Elngib E, Mahadi SE, Mohamed E, Ahmed ME. Perforated peptic ulcer in Khartoum. Khartoum Medical College Journal. 2008; 6(2):62-64.
[5]. Makela JT, Kiviniemi H, Ohtonen P, Laitinen SO. Factors that predict Morbidity and Mortality in patients with Perforated Peptic Ulcers. EUR J Surg. 2002; 6:446- 45. [PubMed] [Cross Ref]..

Abstract: At times Laparoscopic Cholecystectomy becomes difficult. Laparoscopic Cholecystectomy may be rendered difficult by various problems encountered during surgery. Aims And Objective: To calculate the male to female ratio in case of gall stones, age distribution along with the operative difficulties and techniques in two incisions two ports and four incisions four ports laparoscopic cholecystectomy and compare the outcome of two ports and four ports laparoscopic cholecystectomy in terms of operation time, hospital stay, complication rate, cosmesis, conversion rate to open Cholecystectomy. Material And Methods: The present study will be conducted in three...........

Keywords: Gallstone Pancreatitis, Acute cholecystitis, Difficult Laparoscopic Cholecystectomy,Cosmesis

[1]. Johnson DE, Kaplan MM. Pathogenesis and treatment of gallstones. New Engl J Med 1993; 328:412-21.
[2]. Diehl AK. Epidemiology and natural history of gallstone disease. Gastroenterol Clin North Am 1991; 20:1-19.
[3]. Heaton KW, Braddon FEM, Mountford RA, Hughes AO, Emmett PM. Symptomatic and silent gallstones in the community. Gut 1991; 32:316-20.
[4]. Prakash A. Chronic cholecystitis and cholelithiasis in India. Int Surg 1968; 49:79-85.
[5]. Khurro MS, Mahajan R, Zargar SA, Javid G. Prevalence of biliary tract disease in India: a sonographic study in adult population in Kashmir. Gut 1989; 30:201-05..

Abstract: Introduction: Chronic otitis media is classified as a tubotympanic disease and is characterized by central perforation. Eustachian tube is the principal focus in middle ear disease. Pathological findings in the nose or the nasopharynx are also responsible for inadequate tubal function. Objective:To evaluate the outcomes of septoplasty followed by myringoplasty and myringoplasty without septoplasty in patients with tubotympanic diseases in terms of Graft uptake, audiological outcome and late complications. Materials and Methods: The study was conducted from January 2012......

Keywords: Central Perforation, Hearing Improvement,Myringoplasty, Septoplasty, Tubotympanic CSOM

[1]. Phyllis Carolyn Leppert, Jeffrey F.Peipert.Primary care for Women.Second Edition. (Lippincott Williams & Wilkins.2004.Pg no – 800).
[2]. Shenoi P. Management of chronic suppurative otitis media. In: Scott-Brown's Otolaryngology, 6th ed. (Oxford, London, Boston, Butterworth-Heinemann, 1987).
[3]. Passàli D., Damiani V., Passàli G.C., Bellussi L. (2004) Eustachian Tube and Otitis Media. In: Suzuki JI., Kobayashi T., and Koga K. (Eds) Hearing Impairment. Springer, Tokyo.
[4]. Pelikan. Z.Role of nasal allergy in chronic secretory otitis media. Current allergy asthma Reports. 2009; Mar 9 (2):107-13.
[5]. Zemlin W.R. (1998). Speech and Hearing science Anatomy and Physiology. 4th ed.(Needham Heights, Massachusetts: Allyn & Bacon.)..

Abstract: The aim of this study was to assess the knowledge and attitude of diabetes mellitus patients about their oral health, and its association with periodontal health. Materials And Methods: This is a cross sectional study with a sample consisting of 110 diabetic patients suffering from Type I or Type II Diabetes Mellitus for at least 6 months, belonging to both the genders. A custom made questionnaire will be prepared to explore the knowledge and awareness about periodontal health among diabetic patients. The questionnaire will consist of 11 questions. The filled responses will be then transferred to the microsoft excel sheet for appropriate statistical analysis...........

[1]. Loe, H, Anerud, A, Boysen, H, Morrison, E. Natural history of periodontal disease in man. Rapid, moderate and no loss of attachment in Sri Lankan labourers 14 to 46 years of age. J Clin Periodontol 1986; 13: 431–445.
[2]. Weinspach K, Staufenbiel I, Memenga-Nicksch S, Ernst S, Geurtsen W, Gunay H. Level of information about the relationship between diabetes mellitus and periodontitis- results from a nationwide diabetes information program. Eur J Med Res 2013; 18: 6.
[3]. Kejriwal S, Bhandary R, Thomas B. Assessment of Knowledge and Attitude of Diabetes Mellitus Type 2 Patients about Their Oral Health in Mangalore, India. Univ Res J Dent 2014; 4: 44-47.
[4]. Eldarrat AH. Awareness and attitude of diabetic patients about their increased risk for oral diseases. Oral Health Prev Dent 2011; 9: 235- 241.
[5]. Jayanthi D, Bajaj P, Srivastava N, Prakash N, Karanjkar A, Prathima B. Evaluation of Awareness Regarding Diabetes Mellitus and its Association with Periodontal Health: A Cross Sectional Study. J Int Oral Health 2016; 8(4): 508- 511..

Abstract: Epiploic appendagitis, also known as appendicitis epiploica, hemorrhagic epiploitis, epiplopericolitis, or appendagitis, is a benign and self-limited condition of the epiploic appendages. Epiploic appendages [EA] are small outpouchings of fat-filled, serosa-covered structures present on the external surface of the colon projecting into the peritoneal cavity. Each appendage encloses small branches of the circular artery and vein that supply the corresponding segment of the colon. Subserosal lymphatic channels either terminate in a lymph node within an appendage or loop through its base en route to mesenteric nodes. They have three morphologically different types: stalked appendices and others that are attached with their base in longitudinal and vertical direction to the colon axis. Although they are located throughout the colonic wall, occasionally they have also been found in the small bowel and in the parietal peritoneum. Their function is still controversial, they are presumed to serve a protective and defensive mechanism similar...........

[1]. Carmichael DH, Organ CH., Jr Epiploic disorders. Arch Surg. 1985;120:1167–1172 [PubMed]
[2]. Hansen HH, Heine H. Blood supply and histophysiology of the appendices epiploicae. Lagenbecks Arch Chir. 1976;340:191–197 [PubMed]
[3]. Mittal VK, Pierce AK, Priestley JC, et al. Infarcted small-bowel appendiceepiploica: a cause of acute abdomen. Am J ProctolGastroenterol Colon Rect Surg. 1981;32:23–24 [PubMed]
[4]. Bundred NJ, Clason A, Eremin O. Torsion of an appendix epiploica of the small bowel. Br J ClinPract. 1986;40:387. [PubMed]
[5]. Polukhin SI, Letemin GG, Povorozniuk VS. Torsion of epiploic appendages of the parietal peritoneum. VestnKhirIm II Grek. 1990;145:50 [PubMed]

Abstract: Floating elbow fracture in adults is a rare and complex injury with unpredictable outcome. The aim of our study was to assess the demography, clinical outcome and complications of classic floating elbow in adults with different treatment modalities. Method:Between 2016 and 2017 , 10 patients with floating elbow involving open injuries of the forearm were treated in orthopedics department of regional institute of medical sciences,imphal with a mean follow up of 20.6 weeks. Out of 10 floating elbow cases all were open fractures of the forearm with closed fractures of humerus........

[1]. Stanitski CL, Micheli LJ. Simultaneous ipsilateral fractures of the arm and forearm in children. Clin orthop Relat Res.1980;(153):218-22.
[2]. Solomon HB, Zadnik M, Eglseder WA. A review of outcomes in 18 patients with floating elbow. J Orthop Trauma.2003;17(8):563-70.
[3]. Simpson NS, Jupiter JB. Complex fracture patterns of the upper extremity. Clin Orthop Relats Res. 1995;(318):43-53
[4]. Yokoyama K, Itoman M, Kobayashi A, Shindo M, Futami T. Functional outcomes of floating elbow injuries in adult patients. J Orthop Trauma. 1998;12(4): 284-90
[5]. Ditsios K, Boutasiadis A, Papadopoulos P, et al. Floating elbow injuries in adults: prognostic factors affecting clinical outcomes. J Shoulder Elb SURG. 2013;22(1):74-80.

Abstract: Occupational Health is defined by the International Labor Organization (ILO) as the promotion and maintenance of the highest degree of physical, mental and social well being of workers in all occupations [1]. According to the WHO report 2002, occupational health risk is one of the leading causes of morbidity and mortality in the world in general and developing countries [2]. Occupational exposure to particulate material causes restrictive lung diseases.

Keywords: Spirometry, FEV1, FVC, FEV1/FVC, restrictive and obstructive lung diseases.

[1]. Koh, D. Work and Health: Textbook of Occupational Medicine Practice. Koh, H; Seng, C. K; Jeyaratnam, J. (eds). (2nd ed). Singapore:
[2]. World Scientific. Koningsveld, E. A. P; van der Molen, H, 2001. |
[3]. Hermanus, MA. Occupational health and safety in mining-status, new
[4]. developments, and concerns. The Southern African institute OF Mining and Metallurgy Journal 2007, (107) : 531-538.
[5]. ATS/ERS Task Force: Standardisation of spirometry. Eur Respir J 2005; 26(2): 319-338

Abstract: To analyse the risk factors and incidence of preterm delivery at Nepalgunj Medical College Teaching Hospital, Kolhapur. Method: A retrospective study was conducted at Nepalgunj Medical College Teaching Hospital, Kohalpur. All consecutive patients were included for the study and data were collected from record book of labour room and discharge book from statistic department. Results: Total no. of deliveries occurred in our hospital was 3956 during study period, overall incidence of preterm delivery was 512 accompolish (12.94%) total no. of delivery.). Incidence of preterm labour was more among primigravida 293(57.02%) as compared to less than 5th gravida 128 (38.7%) and >5th gravida 21 (4.1%). Most of the preterm delivery was occurred..........

Keywords: Preterm labour, IUFD, Neonatal outcome.

[1]. Liu L, Johnson HL, Cousens S. et al. Global, regional and national causes of child mortality: an updated systemic analysis for 2010 with time trends since 2000. Lancet 2012 ; 379:2151-61.
[2]. Slattery MM, Morrison JJ. Preterm delivery. Lancet 2002; 360: 1489–97.
[3]. Hamilton BE, Martin JA, Ventura SJ. Births: preliminary data for 2005. Health E-Stats.Hyattsville,MD,2006.http://www.cdc.gov/nchs/products/pubs/pubd/hestats/prelimbirths05/prelimbirths05. htm. (Accessed July 15, 2007).
[4]. Goldenberg RL, the Management of Preterm Labor. Obstetrics and Gynecology 2002; 100:5(I): 1020-1037.
[5]. Berhman RE, Butler AS. Preterm birth: causes, consequences and prevention. Washington DC: Institute of Medicine of the National Academies, 2006.

Abstract: Introduction: Apical root resorption is a common side effect of orthodontic treatment. Intrusion is suggested as a possible cause of root resorption affecting the prognosis of the patient. Diagnosis is usually done by radiographs. Dentine sialophosphoprotein (DSPP), a non-collagenous protein is released into gingival crevicular fluid during active root resorption. This study is aimed to identify the role of DSPP in root resorption during orthodontic intrusion using three piece base arch. Materials and method: GCF was collected from permanent maxillary central and lateral incisors of 10 control subjects with no history of orthodontic treatment and 10 experimental subjects before intrusion and 2 months after intrusion. DSPP was measured in GCF using ELISA method...........

Keywords: Root resorption, intrusion, gingival crevicular fluid, dentine sialophosphoprotein

[1]. Mah J, Prasad N. Dentin phosphoproteins in gingival crevicular fluid during root resorption. Eur J Orthod. 2004; 26:25-30
[2]. Kereshanan S, Stephenson P, Waddington R. Identification of dentin sialophosphoprotein in gingival crevicular fluid during physiological root resorption and orthodontic tooth movement. Eur J Orthod. 2008; 30:307-314
[3]. Costopoulos G, Nanda R. An evaluation of root resorption incident to Orthodontic Intrusion. Am J Orthod. 1996; 109:543-548.
[4]. Oppenheim A. Human tissue response to orthodontic intervention of short and long duration. Am J orthod oral surg.1942; 28: 263
[5]. Balducci L, Ramachandran A, Hao J, Narayanan K, Evans C, George A. Biological markers for evaluation of root resorption. Arch Oral Biol.2007; 52:203–208

Abstract: Hypertension ,also known as high blood pressure or arterial hypertension, is a chronic medical condition in which the blood pressure in the arteries is persistently . Elevated C-reactive protein (CRP) , platelet count and mean platelet volume (MPV), have been associated in hypertensive patient. Objective: To determine C- reactive protein and platelets indices in hypertensive Sudanese patients. Materials and Methods: This cross sectional study was carried out in international hospital Khartoum state, Sudan during period from Dec 2015 up to Feb 2016. Seventy subjects were enrolled in the study, fifty as case study and twenty as case control. Assessment of C- reactive protein and platelets count and mean platelet volume in hypertensive patients by using hemoanalyzer Sysmex..........

Keywords: C- reactive protein, Patelets count, Mean platelet volume ,Hypertensive

[1]. James, PA. Oparil,S. Carter, BL.Cushman ,WC . Dennison-Himmelfarb ,C. Handler J,Lackland DT, Lefevre, ML, et al. Evidence-Based Guideline for the Management of High Blood Pressure in Adults: Report From the Panel Members Appointed to the Eighth Joint National Committee (JNC 8)". JAMA 2014 ; 5: 507–20.
[2]. Lewington, S. Clarke, R. Qizilbash, N. Peto, R.Collins, R. Prospective Studies, Collaboration "Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies.". Lancet 2002; 1903–13.
[3]. Carretero, OA. Oparil, S .,Oparil. 3329.long""Essential hypertension. Part I: definition and etiology". Circulation 2002;329–35.
[4]. Laki, K. "Our ancient heritage in blood clotting and some of its consequences". Annals of the New York Academy of Sciences 1972; 202: 297–307.
[5]. Machlus, KR.Thon, JN.Italiano, JE. "Interpreting the developmental dance of the megakaryocyte: A review of the cellular and molecular processes mediating platelet formation". British Journal of Haematology 2014;165 :227–36.

Abstract: Introduction: Parents have certain value system and norms which they want their children to follow. The school curricula have become examination-oriented, promoting rote learning and overburdening the children. Pressure can have either positive or negative effects.The present study was focused on adolescents since academic pressurisation tends to mount up during this period and their urge for autonomy can make them resent parental control. The objectives of the study were to assess the perceptions of students on parental and teachers' pressure on their academic performance, to identify the students' coping strategies and to determine the association of pressure with other variables of interest like sex, class, type of family, place of residence and their academic performance...........

Keywords: Parental pressure, perceptions, performance, parents, teachers

[1]. Weiten W and Lloyd A. Psychology applied to modern life, Adjustment in the 21st century. (Singapore: Asia, 2004). Anderson J, Funk J, Elliott R and Hull SP. Parental Support and Pressure and Children's Extracurricular Activities: Relationships with Amount of Involvement and Affective Experience of Participation, Journal of Applied Developmental Psychology 2003,110-21
[2]. Gupta K and Khan B.N. Anxiety level as a factor in concept formation, J Psychol Reports, 31,1987,187-92.
[3]. Ang R.P and Huan V.S, Academic Expectations Stress Inventory (AESI): development, factor analysis, reliability and validity, Educational and Psychological Measurement, 66, 2006, 522-39.
[4]. Sreeramareddy C.T. Psychological morbidity, sources of stress and coping strategies among undergraduate medical students of Nepal, BMC Medical Education, 2007, 7- 26
[5]. Sapru S, Parenting and adolescent identity: a study of Indian families in New Delhi and Geneva, Journal of Adolescent Research,21(5), 2006, 484-513.