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

Abstract: Peritonitis is defined as,inflammation of peritoneum. Despite the surgical treatment, sophisticated intensive care units, broad spectrum antibiotics and a better understanding of pathophysiology, the mortality rates of peritonitis are still high and its treatment had been a challenge.Hence management continued to be a highly challenging task demanding proper knowledge, experiences, continued care and close monitoring.The outcome of an abdominal infection depends on the complex interaction of many different factors and the success obtained with the early institution of specific therapeutic procedures. It also depends upon the exact recognition of the seriousness of the diseases and an accurate assessment and classification of the patient's risk............

Keywords: factors, outcome, peritonitis, perforation, sepsis

[1]. Rajender Singh Jhobta, Ashok Kumar Attri, Spectrum of perforation peritonitis in India-review of 504 consecutive cases. World journal of emergency surgery 2006, 1:26.
[2]. Rodolfo L. Bracho-Riquelme MC, Men C, Mannheim peritonitis index validation study at the hospital general de Durango (Mexico), Cir Circuj 2002; 70:217-225.
[3]. Shantanu Kumar Sahu, Amit Gupta. Outcome of secondary peritonitis based on APACHE II score. The internet journal of surgery ISSN: 1528-8242.
[4]. Purhoit PG Surgical treatment of typhoid: perforations Experience of 1976,Sangli epidemic Indian Journal of Surgery 1978;40:227-38
[5]. Eggleston FC, Santoshi B Typhoid perforation: Choice of operation British journal of surgery 1981;68:341-2..

Abstract: Intranasal meningoencephaloceles are rare and is characterized by local Herniation of glial tissue and meninges from the cranial cavity into the nose, through a defect in the cribriform plate of the ethmoid bone. The sac like protrusion of meninges contains brain tissue and subarachnoid space, which is filled with cerebrospinal fluid, communicates freely with the cranial cavity. Nasal meningoencephalocele require a high index of suspicion for their diagnosis and biopsy of such lesions without prior imaging studies is contraindicated because of the risk of cerebrospinal fluid leak and meningitis. We present an isolated intranasal congenital meningoencephalocele, in 14 years female child presenting as a right sided nasal polyp with synechia, which is uncommon. Treatment comprises.........

Keywords: Intranasal meningoencephalocele, meningocele, congenital meningoencephaloceles

[1]. Pirsig W. Surgery of choanal atresia in infants and children: historical notes and updated review. International journal of pediatric otorhinolaryngology. 1986;11(2):153-70.
[2]. Izquierdo JM, Gil-Carcedo LM. Recurrent meningitis and transethmoidal intranasal meningoencephalocele. Developmental medicine and child neurology. 1988;30(2):248-51.
[3]. Evrard VSCP. A pathologic and anatomic analysis. acta neuropathologica. September 1975;32(3):245-55.
[4]. Woodworth BA SR, Faust RA, Bolger WE. Evolutions in the management of congenital intranasal skull base defects. Archives of otolaryngology--head & neck surgery. 2004;130:1283-8.
[5]. Rahbar R RV, Robson CD, Perez-Atyade AR, Goumnerova LC,, McGill TJ HG. Nasal glioma and encephalocele: diagnosis and management. The Laryngoscope. 2003;113:2069-77.

Abstract: Postmenopausal bleeding is frequent in gynaecology and accounts approximately 5-10% of postmenopausal women. About 10% of women with postmenopausal bleeding have a primary or secondary malignancy. Aim: To study various clinical features in a patient with post menopausal bleeding. To study the different pathological changes in the endometrium and endocervix in post menopausal bleeding. Results: The mean age at menopause was 47 years. The earliest age at menopause was 42 years. The delayed age at menopause was 58 years. The duration of menopause varied from 7 months to 12 years. In majority of cases bleeding occurred with in 2 years of menopause. Conclusion: All malignant causes of post-menopausal bleeding had their bleeding episodes greaterthan 5 years after attainment of menopause. 86 cases out of 100 had uneventful menopause, 14 cases had peri-menopausal menstrual irregularly.......

Keywords: Postmenopausal bleeding, menopause, Tirupati, Histopathology, Endometrial cancer

[1]. Brand AH. The woman with postmenopausal bleeding. Australian Family Physician 2007; 30:97-192.
[2]. Khan RL. Postmenopausal bleeding. In text book of Gynaecology, 3rd edition. Medical Publications, Lahore 2000; 260-262.
[3]. Butler.W.J, "Normal And Abnormal Bleeding", chapter - 22, in Tc-Lind‟s Operative Gynaecology, John.A.Rock. and John O.Thompson (Ed), 8th edition, Philadelphia: Lippincott-Raven, 1997, 453-473.p.p.
[4]. Novak. and Richardson.E.H, 1941. Study Of Endometrium In Post Menopausal Bleeding". Med journal Obstetrics Gynaecology, 42:564.p.p.
[5]. Kinti‟s.G.A. and Calvert.W. 1982: Postmenopausal bleeding-one hospital –one year". J. Obstetrics gynecology India, 32; 676.p.p.

Abstract: Introduction: Blunt abdominal trauma is regularly encountered in the emergency department. The presence of distracting injuries or altered mental status can make these injuries difficult to diagnose and manage. Patients are frequently kept for observation following blunt abdominal trauma, despite initially negative evaluations. Blunt abdominal trauma accounts for the majority (80%) of abdominal injuries seen in emergency department, and is responsible for substantial morbidity and mortality. The prevalence of intraabdominal injuries among patients presenting to emergency department with blunt injury abdomen is approximately 13-15% (3). In this study a conscious attempt is made to develop a score by correlatimg clinical findings and investigations to diagnose intraabdominal injuries and decide on management of blunt injury abdomen.Even by using screening technology such as laboratory evaluations, ultrasound, computed tomography, it is unclear and there is always a debate about whether patients require conservative management or laparotomy...........

Keywords: Blunt Injury Abdomen, Peritonitis,Clinical Laboratory And Radiologicalfindings Of Blunt Injury Abdomen

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[4]. EISNER M.S, LEWIS J.H, «Diagnostic yield of a positive fecal occult blood test found on digital rectal examination.Does the finger count ? »,Arch.Intern.Med,1991,151,2180-218..

Abstract: Background: Mullerian duct anomalies in female result from failure of complete development of one duct and incomplete fusion of other duct during embryonic life. Bicornuate uterus with rudimentary horn (BURH) is the rarest uterine anomaly. Pregnancy in rudimentary horn is even rarer, i.e. 1:1,40,000 pregnancies.Case: A case of 21 years Primigravida presented with pain abdomen at 21 weeks with ultrasound diagnosis of secondary abdominal pregnancy taken up for exploratory laparotomy. Laparotomy revealed ruptured rudimentary horn pregnancy with fetus in the abdominal cavity and an incidental finding of Meckel's diverticulum with placenta adhered to it. Excision of rudimentary horn was done which was non-communicating. Conclusion: A high suspicion of abdominal pregnancy is to be kept in obstetrician mind because of its various presentation. Early diagnosis and management is required in this life-threatening condition. A combine approach of clinical as well as diagnostic technique is indicated.

Keywords: Abdominal pregnancy, Bicornuate uterus, Laparotomy, Meckel's diverticulum

[1]. Arun K, Deepika N (2013) Ruptured non-communicating rudimentary horn of unicornuate uterus at 14 weeks of pregnancy: a case report. Global Journal of Medicine and Public Health 2: 1.
[2]. Nahum GG (2002) Rudimentary uterine horn pregnancy. The 20th-century worldwide experience of 588 cases. J Reprod Med 47: 151-163.
[3]. Gupta P, Sehgal A, Huria A, Mehra R. Secondary abdominal pregnancy and its associated diagnostic and operative dilemma: three case reports. J Med Case Reports.2009;3:7382.Published online 2009 August 7.doi: 10.4076/1752- 1947-3-7382.
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[5]. Myerscough PR. Munro Kerr's Operative Obstetrics 9th edition, New York : Macmillan Publishing Co Inc. 1977; 649-96..

Abstract: Diffuse idiopathic skeletal hyperostosis (DISH) is a disorder characterised by excessive ossification at ligamentous and tendinous attachment sites to the bone. Bony proliferation results in a distinctive pattern of ossification involving the spine and extra spinal structures. Aim: Because axial skeleton is most commonly affected we conducted an anatomical study in dried vertebrae to observe the exact anatomical changes occurring in spine and compare with radiological changes studied in patients. Materials and methods: The vertebrae collected in osteology section of anatomy department of our institute were taken as study material. After excluding damaged, degenerated and unossified specimen we included 392 cervical, 1114 thoracic and 399 lumbar vertebrae and examined for ossification at the attachment sites of ligaments. We estimated the frequency of involvement and severity of pathological changes in different regions and compared them with findings of studies done in patients.........

Keywords: Anterior longitudinal ligament, hyperostosis, periosteal ossification, exostosis, bony spur

1. Apley's system of orthopaedics and fracture, 9th edition. Pg. 69,Luis Solomon, David Warwick,Sevladurai Nayagam, CRC press, Tailor & Francis group, London & New York.
2. Resnick D, Shapiro R F, Wisner K Bet al. Diffuse idiopathic skeletal hyperostosis. Semin arthritis Rheum 1978:7;153-187
3. Resnick D,Niwayama G. Radiographic and pathologic features of spinal involvement in diffuse idiopathic skeletal hyperostosis. Radiology. 1976;119:559-568.
4. J Mijuno, H Nakagawa, J Song. Symptomatic ossification of anterior longitudinal ligament with stenosis of cervical spine: A report of 7 cases. The journal of bone and joint surgery.
5. Standering S. Gray's Anatomy. The Anatomical basis of clinical practice. Ligaments of vertebral column 40th ed. London: Elsevier, Churchill Livingstone Edinburgh; 2008: pg-728..

Abstract: Liver biopsy being the 'gold standard' is an invasive investigation; many non-invasive markers are being investigated for prediction of hepatic fibrosis. We aim at assessing the liver fibrosis by Transient Elastography and APRI (AST to PLATELET RATIO) in Chronic Liver Disease. 64 patients of CLD and 64 healthy subjects were included in the study. Transient Elastography was done using FIBROSCAN® and APRI score was calculated. Predominant etiology was CALD (50%) followed by HBV (32.8%) and HCV (17.2%). The mean LSM and APRI score for cases and control was 36.06±24.18kPa, 2.47±2.05 and 3.96±0.97kPa, 0.45±0.16 respectively. AUC (95%CI) for diagnosis of significant fibrosis by Transient Elastography and APRI was 0.99 (0.98-1.01) and 0.91 (0.85-0.96) respectively.The optimal LSM value was 4.5 kPa for diagnosis of significant fibrosis with specificity, sensitivity.........

Keywords: APRI, Liver Biopsy, Liver Fibrosis, LSM, Transient Elastography.

[1]. Sherlock S. Hepatic Cirrhosis : Disease of the liver and biliary system , ed 12th oxford: Blackwell scientific publication, 1993;103-120
[2]. Iwaisako K., Brenner D.A., and Kisseleva T.: What's new in liver fibrosis? The origin of myofibroblasts in liver fibrosis. J GastroenterolHepatol 2012; 27: pp. 65-68
[3]. Cross Ref (http://dx.doi.org/10.1111/j.1440-1746.2011.07002.x)
[4]. RockeyDC , Caldwell SH , Goodman ZD et al. Liver Biopsy:AASLD position paper . Hepatology2009 ;49: 1017 – 1044 .
[5]. RockeyD , Bissell D . Noninvasive measures of liver fibrosis..

Abstract: Peripheral ossifying fibroma is a benign gingival overgrowth characterized by a high degree of cellularity usually exhibiting bone formation, although occasionally cementum-like material or rarely dystrophic calcification may be found instead. The peripheral ossifying fibroma can occur at any age, although it appears to be somewhat more common in children and young adults. Here we are presenting a case of peripheral ossifying fibroma in the anterior mandible region in a 32 year old female.

Keywords: Cementum, Fibroma, Gingiva, Periodontal , Peripheral

[1]. L. R. Eversole and S. Rovin, "Reactive lesions of the gingiva," Journal of oral pathology, vol. 1, no. 1, pp. 30–38, 1972.
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[3]. S.N. Bhaskar and J. R. Jacoway, "Peripheral fibroma and peripheral fibroma with calcification: report of 376 cases," The Journal of the American Dental Association, vol. 73, no. 6, pp. 1312–1320,1966. [4]. Rajendran R, Sivapathasundharam B. Shafers's textbook of oral pathology. 7th ed. Noida, India: Elsevier; 2009. P566-571.
[5]. Kenney JN, Kaugars GE,Abbey LM. Comparison between the peripheral ossifying fibroma and peripheral odontogenic fibroma Journal of Oral and Maxillofacial Surgery.1989; 47(4):378–382..

Abstract: Aims &objectives: To study the factors responsible for development of small pupil with cataract, to study the pharmacological and surgical treatment of small pupil with cataract Materials methods: A prospective study of 100 cases was done on the management and visual outcome in small pupil with cataract from December-2014 to JULY-2016 on the patients attending the Government General Hospital, Kakinada. Results: In this study 31 cases (31%) had posterior synechia, 25 cases (25%) had pxf and 44 cases (44%) had spasmodic pupil as a cause for small pupil. Discussion:Pseudoexfoliation syndrome is more.......

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[3]. Pandey S K, Werner L and David Apple. Evolution of modern intraocular lens surgery. In: Dutta L C -Modern ophthalmology, 3rdEdn; Jaypee Brothers publications, New Delhi; 2005; 335-338.
[4]. Trivedi N, Learning curve in small incision cataract surgery: In Garg A Fry L L, Pandey S K, Gutierrez-Carmona F J: Clinical practice in small incision cataract surgery (Phaco Manual) 1st Edn; Jaypee Brothers publications, New Delhi: 2004; 241-243.
[5]. Masket S. Avoiding complications associated with iris retractor use in small pupil cataract extraction. J Cataract Refract Surg..

Abstract: Objective: To study the role of congenital uterine anomalies in adverse pregnancy outcome Materials and methods: Retrospective analysis of case sheets of patients with uterine anomalies at government maternity hospital, Tirupati from January2014 to December 2015 was done. The information was collected in standard format and adverse maternal and fetal outcome analysed. Results: Incidence of uterine anomalies was 0.36% with most of them having bicornuate uterus (35%) followed by septate uterus (29%). Most common presentation among the study group was breech 47.36% followed by cephalic presentation (38.1%). Recurrent miscarriages were noted in 35.1% and ectopic pregnancies in 2 women. 20.8% women had preterm deliveries. Postpartum.........

[1]. Yan Z, Yang-Yu Z, Jie Q; Obstetric outcome of women with uterine anomalies in China. Chin Med J., 2010; 123(4): 418-422.
[2]. American Fertility Society. The American Fertility Society classification of adnexal adhesions, distal tubal occlusion, tubal occlusion secondary to tubal ligation, tubal pregnancies, müllerian anomalies and intrauterine adhesions. Fertil Steril. 1988;49(6):944-955(11)
[3]. Golan A, Langer R, Wexler S, Segev E, Niv D, David MP; Cervical cerclage--its role in the pregnant anomalous uterus. Int J Fertil., 1990; 35(3):164-170.
[4]. Airoldi J, Berghella V, Sehdev H, Ludmir J; Transvaginal ultrasonography of the cervix to predict preterm birth in women with uterine anomalies, Obstet Gynecol., 2005;106(3): 553-556.
[5]. Tsafrir A, Rojansky N, Sela HY, Gomori JM, Nadjari M; Rudimentary horn pregnancy-firsttrimester prerupture sonographic diagnosis and confirmation by magnetic resonance imaging. J Ultrasound Med., 2005; 24: 219-223

Abstract: Micronutrient deficiencies are recognized as a major public health problem, affecting more than 2 billion people worldwide. (1) The magnitude is much larger in low- and middle-income countries. (2) The objective of our study is to study the impact of a nutritional supplement on the nutritional and neurocognitive health status of anemic children. Our study population is made up of 49 students diagnosed with anemia in Chefchaouen province. The school children were 8 to 14 years old, including 14 girls and 35 boys with an average weight of 37.63 kg ± 7.76 and an average height of 145.96 cm ± 9.53. Each student was clinically examined by the team doctor for signs suggestive of anemia, and received a multi-micronutrient daily for one month. A battery of measurements and tests was........

Keywords: multi-micronutrient, hemoglobin, deductive, inductive, neurocognitive

[1]. UNICEF, and Micronutrient Initiative. "Vitamin and mineral deficiency: a global progress report." Ottawa: Micronutrient Initiative (2004): 39.
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Abstract: Quality antenatal care, one of four Pillars of Safe Motherhood in reducing maternal mortality, is an effective route to emergency obstetric care, skilled delivery and important determinant of pregnancy outcome. Objective: to assess quality of ANC provided and compliance toward it. Materials & Methods: Cross-sectional survey was conducted for one month involving 93 randomly selected pregnant women attending antenatal clinic of BSMCH. Data were collected via interview using predesigned questionnaire after obtaining informed consent. Data analysis was done by mean, standard deviation, proportion and using tables and charts. Results: 82% respondents were rural inhabitants, 53% were poor, 1/3rd were married and half got pregnant before 18 and 20 years of age. Half of respondents.........

Keywords: antenatal visit; quality of care; compliance

[1]. Ismail NIAA, Essa RM. Pregnant Women's Satisfaction with the Quality of Antenatal Care At Maternal and Child Health Centers in El-Beheira Governorate. IOSR Journal of Nursing and Health Science (IOSR-JNHS) 2017; 6(2):36-46. DOI: 10.9790/1959-0602093646
[2]. Sample Registration System, Office of Registrar General, India. 2013. Special Bulletin on Maternal Mortality in India 2010-12. Available from: www.censusindia.gov.in/vital_statistics/SRS_Bulletin/MMR_Bulletin_2010-12.pdf, accessed on August 8, 2014.
[3]. Mohamed A, Refat T. Egyptian women's satisfaction and perception of antenatal Care. International Journal of tropical diseases and Health 2012; 2(2): 145-56.
[4]. Bloom SS, Lippeveld T, David W. Does antenatal care make difference to safe delivery? A study in urban Uttar Pradesh, India. Health Policy Plan 1999; 14: 38-48.
[5]. Oyerinde K. Can antenatal care result in significant maternal mortality reduction in developing countries? J Community Med Health Educ 2013; 3 : e116...

Abstract: Fluorosis is a serious problem in many parts of the world, where drinking water contains more than 1ppm of fluoride level. The most prominent types of endemic fluorosis are dental fluorosis and musculo skeletal fluorosis in growing children, adult men and women. The present study was designed to investigate the bone markers in terms of serum calcium, inorganic phosphorous, and alkaline phosphatase along with serum flouride levels combined with levels of urinary calcium and fluoride in adult males with skeletal fluorosis living in endemic fluorotic area to know the metabolic changes in bones as consequence of skeletal fluorosis for early detection and better treatment. Material and methods: the study includes 60 adult males of age 30-50 years divided into 2 groups, group-1 includes 30 controls, normal healthy adult males living in non endemic fluorotic area and group-2 includes cases, adult males with skeletal fluorosis living.........

[1]. WHO(1984), Environmental health criteria for fluorosis pp.1-136 world health organization, Geneva.
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Abstract: Child morbidity and mortality due to preventable causes remains high in developing countries. Diseases like pneumonia can both be prevented and treated with low-cost intervention yet pneumonia remains the leading infectious cause of death for children below five years causing about 900 000 deaths per year.An analytical cross sectional design was conducted in 2 districts in Zimbabwe to determine factors associated with child morbidity. A sample of 672 mothers aged 18-49 years with at least one child below 4 years of age were selected through multi-stage cluster sampling and questionnaires were administered to them. The main outcome measure(s) for this study were factors associated with child morbidity. The study revealed that there was no association between child morbidity and birth weight (χ2=72.58; p= 0.558); mother's age (χ2=30.95; p=0.792) and marital status (χ2= 2.98; p=0.562). A statistically significant association between child morbidity and:.........

Keywords: Child morbidity; community mobilisation; child –care practice

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