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

Abstract: Cervical polyps are most commonly seen in the female with uterine bleeding. On the other hand, giant cervical polyps with a size greater than 4 cm are rare and until now only a few cases have been described in literature. The size and the clinical presentation can mimic uterine inversion, prolapse or a cervical neoplasia. The management is surgical and can be conservative regarding the benign pathological feature of this entity.We report the case of a giant cervical polyp of 25*20*10 cm in a 37 year old multiparous woman who clinically presented vaginal bleeding and shock.Lesions of this size and complexity are uncommon. However, after careful evaluation, simple polypectomy by electrosurgery was possible and proved curative. Good anatomical and clinical judgment is critical to successful management of these cases.

[1]. Bhatla N; Tumous of the corpus uteri. In: Jeff Coates principles of Gynaecology 5th Edition [2]. Drinville JS, Memarzadeh S. Benign disorders of uterine corpus. In : DeCherney AH,Nathan L. editors.COG diagnosis &treatment. 10th ed. New York: Lange McGraw Hill; 2007. P. 639-653.
[3]. Abramovici H, Bornstein J, Pascal B: Ambulatory removal of cervical polyps under colposcopy. Int J GynaecolObstet 1984; 22:47
[4]. Khalil AM, Azar GB, Kaspar HG, et al: Giant cervical polyp: a case report. J Reprod Med 1996; 41:619
[5]. Terruhn V: Polyps of the uterine cervix during the hormonal resting phase in childhood. GeburtshilfeFrauenheilkd 1977;37:35

Abstract: This study was conducted to compare the efficacy of magnesium sulphate and ketamine when used intravenously during propofol-nitrous oxide anaesthesia in terms of, haemodynamics, anaesthetic consumption and postoperative recovery.. Materials and Methods: 60 patients (20-60 years of both sexes and ASA I and II) who underwent short elective surgery (30 mins to 3 hours) were randomized into 2 groups. Group M patients received 30 mg/kg magnesium sulphate during induction and 8 mg/kg/hr during maintenance and Group K patients received 0.5 mg/kg ketamine during induction and 15 μg/kg/hr during maintenance. Effect of either regimen was assessed on maintenance anaesthesia with propofol infusion along with 50% nitrous oxide in oxygen. Monitoring of intra-operative hemodynamics, propofol consumption, extubation time, recovery time, and postoperative side effect profile was done and results were tabulated and analysed statistically. P value (<0.05) was considered significant.........

Keywords: Anaesthetic consumption, haemodynamic stability, ketamine, magnesium sulphate, propofol

[1]. Smith I, White PF, Nathanson M, Gouldson R. Propofol: an update on its clinical use. Anesthesiology 1994;81(4):1005-43.
[2]. Schuttler J, Schuttler M, Kloos S, Nadstaiwek J, Schwilden H. Optimal dosage strategies in total intravenous anaesthesia using propofol and ketamine. Anaesthetist 1991;40(4):199-204.
[3]. Clements JA, Nimmo WS, Grant IS. Bioavailability, pharmacokinetics and analgesic activity of ketamine in humans. J Pharm Sci 1982;71(5):539-42.
[4]. Idvall J, Ahlgren I, Aronsen KR, Stenberg P. Ketamine infusion: pharmacokinetics and clinical effects. Br J Anesth 1979;51(12):1167-73.
[5]. Badrinath S, Avramov MN, Shadrick M, Witt TR, Ivankovich AD. The use of a ketamine-propofol combination During Monitored Anesthesia care. Anesth Analg 2000;90(4):858-62.

Abstract: Objective: To determine the efficacy of oral zinc supplementation in reducing incidence of hyperbilirubinemia and level of serum total bilirubin (STB) during the first week of life in full-term and near-term high risk neonates in comparison with placebo. Method: We conducted a randomized double-blind placebo-controlled trial on 100 neonates born at ≥35 weeks of gestation with STB ≥5 mg/dl at 24 ± 6 hours of age. They were administered either 10 mg zinc acetate syrup (zinc group) or placebo (control group) in twice daily doses till day 7 of life. Incidence of hyperbilirubinemia (STB ≥15 mg/dl) anytime between day 2 to 7 of life and mean STB levels on day 7 of age were compared between the two groups. Results: Incidence of hyperbilirubinemia was significantly lower in the zinc group (8%) as compared to placebo group (26%); p= 0.033. Mean.......

Keywords: Neonatal hyperbilirubinemia, Oral zinc, Serum total bilirubin.

[1]. Narang A, Gathwala G, Kumar P. Neonatal jaundice: An analysis of 551 cases, Indian pediatric 1997; 34:429-432.
[2]. Maisels MJ, Gifford K, Antle CE et al. Jaundice in the healthy newborn infant: a new approach to an old problem, Pediatrics 1988; 81(4):505-11.
[3]. Gourley GR. Bilirubin metabolism and kernicterus, Adv Pediatr 1997; 44: 173-229.
[4]. Bhutani VK, Johnson L, Sivieri EM. Prediction abilility of predischarge serum bilirubin for subsequent significant hyperbilirubinemia in healthy term and near-term newborns, Pediatrics 1999; 103:6-14.
[5]. Seidman DS, Ergaz Z, Revel-Vilk S, et al. The use of bilirubin measurements on the first day of life for prediction of neonatal jaundice. In: program and abstracts of the ross special conference, hot topics '96 in neonatology. columbus, oh: professional services department, ross products division, abbott laboratories; 1996:284–294.

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.........

Keywords: Blunt Injury Abdomen, Peritonitis,Clinical Laboratory And Radiological Findings Of Blunt Injury Abdomen

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Abstract: Multiple regional nerve blocks is an anaesthetic challenge but very useful in some cases. We illustrated doing a combination of dual-guided bilateral infraclavicular blocks and a subarachnoid block in a poly-traumatized elderly patient, we discussed our rationale for the anaesthesia and the pitfalls we avoided. While combination blocks are possible and becoming more frequent, careful considerations should be to avoid risk and minimize systemic local anaesthetictoxicity.

[1]. Thanni LOA and Kehinde OA. Trauma at Nigerian Teaching hospital: pattern and documentation of presentation. AfrHeatlh Sci. 2006; 6(2): 104-107
[2]. Paqueron X,Boccara G, Bendahou M,Coriat P,Riou B, Brachial Plexus Nerve Block Exhibits Prolonged Duration in the Elderly. Anesthesiology 2002; 97:1245–1249
[3]. Franco C.D, Salahuddin Z, andRafizad A.Bilateral Brachial Plexus Block. AnesthAnalg 2004;98:518 –520
[4]. Rasmussen LS. Postoperative cognitive dysfunction: incidence and prevention. Baillieres Best Practice & Research in ClinicalAnaesthesiology 2006; 20: 315–330.
[5]. Chiang E.P, Dangerfield P, Mehta J.P, Sherman M, Berger J.S. The Crucial Role of Bilateral Infraclavicular Nerve Blocks in the Anesthetic Management of a Trauma Patient. Open Journal of Anesthesiology: 2012; 2: 113-116

Abstract: Introduction: Ophthalmic ultrasound is performed when opaque media prevent direct visualisation of the ocular fundus opthalmoscopically. Intraocular and extraocular structures are to be visualized or to measure the axial length before cataract surgery. The present study was undertaken to evaluate the role of B-scan in evaluation and characterization of orbital diseases.
Methodology: We performed a cross-sectioned study of all patients who presented with suspected orbital diseases in Department of Ophthalmology and were referred for ultrasonography to Department of Radiodiagnosis, Dr. Rajendra Prasad Government Medical College, Kangra at Tanda. Himachal Pradesh from May 2016 till April 2017. Ultrasonographic diagnosis was made with general purpose ultrasound machine (GE Logiq P5) using linear high frequency probe (7.5 to 10 MHz) in conjunction with clinical and historical data. Results: In the present study 69 patients were included.........

Keywords: diagnosis, orbit, ultrasonography,vitreal disorders

[1]. Lorente-Ramos RM, Armán JA, Muñoz-Hernández A, Gómez JM, de la Torre SB. US of the eye made easy: a comprehensive how-to review with ophthalmoscopic correlation. Radiographics. 2012;32(5):E175-200.
[2]. Coleman DJ. Reliability of ocular and orbital diag- nosis with B-scan ultrasound. 1. Ocular diagnosis. Am J Ophthalmol 1972;73(4):501–16.
[3]. Aironi VD, Gandage SG. Pictorial essay: B-scan ultrasonography intra ocular abnormalities. Indian J Radiol Imaging 2009;19(2):109-115.
[4]. Silverman RH. High‐resolution ultrasound imaging of the eye–a review. Clinical & experimental ophthalmology. 2009;37(1):54-67.
[5]. Ossoinig KC, Bigar F, Kaefring SL. Malignant mela- noma of the choroid and ciliary body. A differential diagnosis in clinical echography. Bibl Ophthalmol 1975;83:141–54.

Abstract: Background: The present study was undertaken to estimate the 5'-nucleotidase enzyme in drug induced liver cirrhosis and alcoholics. The oxidative stress, antioxidants and their correlation with 5'-nucleotidase was also included in this study. Methods: The blood samples of 25 subjects (age and sex matched) each from group I (control), group II (alcoholic) and group III (drug induced cirrhotic) was taken and centrifuged for separation of plasma for analysis of 5'-nucleotidase. The separated cells were washed thrice with 0.9 % w/v cold normal saline and used for the analysis of glutathione, malondialdehyde and superoxide dismutase. Results: The activity of serum 5'- nucleotidase was significantly increased in both drug induced cirrhotics and alcoholics. The levels of malondialdehyde were also significantly increased in both drug induced cirrhotic and alcoholic patients. The levels of glutathion and superoxide dismutase were significantly decreased in both drug induced cirrhotics and alcoholics.........

Keywords: Alcoholics; Antioxidant effects; Cirrhotics; 5'- nucleotidase; Oxidative stress.

[1]. Pagani F, Panteghini M. 5‟-Nucleotidase in the detection of increased activity of the liver form of alkaline phosphatase in serum. Clin Chem 2001; 47: 2046-48.
[2]. Smith K, Varon HH, Race GJ, Paulson DL, Urschel HC, Mallams JT. Serum 5‟-nucleotidase in patients with tumor in the liver. Cancer 1996; 19: 1281-1285.
[3]. Al-Mudhaffar SA, Saadalla V. Kinetics of 5-nucleotidase in sera of liver cirrhotic and normal Iraqi individuals. Biochem Exp Biol 1978; 14: 339-45.
[4]. Dinkov L, Krainikova M, Brailski KH. Serum 5‟-nucleotidase activity in chronic hepatobiliary diseases. Vultr Boles 1979; 18: 39-46.
[5]. Belfield A, Goldberg DM. Application of a continuous spectrophotometric asay for 5‟-nuceotidase activity in normal subjects and patients with liver and bone disease. Clin Chem 1969; 15: 931-939.

Abstract: Many different techniques have been attempted for cleft repair. The most significant of these is Millard's "rotational advancement" technique devised in 1958. However, some of the few disadvantages of this technique are the nostril size discrepancy and a prominent scar on the cleft side. We describe a slight variation of this technique for treatment of several cases of unilateral cleft lip. Methods: The preoperative design of the surgical method was drawn on the skin, the vermilion, and the oral mucosa. After completion of the preoperative marking, the wide dissection was performed to separate the orbicularis oris muscle completely from the abnormally inserted bony structure and the enveloped skin-mucosal flap. The freed orbicularis oris muscle was then reconstructed with full width. On the cleft side alar crease incision is avoided and the incision is taken on the nasal mucosa only to construct nasal floor and avoid scar Results: Unilateral cleft lip repair using this technique was conducted in 42.........

Keywords: unilateral cheiloplasty, unilateral cleft lip, Straight-Line Advanced Release Technique

[1]. Millard DR. Cleft Craft: The Evolution of Its Surgery, Boston, MA: Little, Brown, 1976.
[2]. Noordhoff MS. Reconstruction of vermilion in unilateral and bilateral cleft lips. Plast Reconstr Surg. 1984;73:52–61.
[3]. Onizuka T. A new method for the primary repair of unilateral cleft lip. Ann Plast Surg. 1980;4:516–524.
[4]. Onizuka T, Ichinose M, Hosaka Y, et al. The contour lines of the upper lip and a revised method of cleft lip repair. Ann Plast Surg. 1991;27:238–252.
[5]. Mulliken JB, Martinez-Perez D. The principle of rotation advancement for repair of unilateral complete cleft lip and nasal deformity: technical variations and analysis of results. Plast Reconstr Surg. 1999;104:1247–1260.

Abstract: Secondary postpartum hemorrhage is life-threatening condition, which occur after 24 hours to 12 weeks after delivery, when patient already discharged at home. It happened as a result of retainedplacenta or infection of the decidua of uterus called endometritis , especially when women came febrile =<38degree Celsius(1) . The postpartum endometrirts increase with cesarean section by 27 %( 2). In 2016,the Confidential Enquiry into Maternal Deaths in the UK report that there were seven death from urinary and genital tract infection, out of 200-pregnancy death in 2012 to 2014(3). It is associated with mulible pathogen but the major bacteria are Streptococcuspyogenes, Escherichiacoli, Staphylococcus aureus, Streptococcuspneumoniae ,meticillin-resistant S. aureus (MRSA), Clostridium septicum and Morganellamorganii. In this paper we report unusual case for young age women came with secondary postpartum hemorrhage as a result of postpartum endometritis , and unfortunately need abdominal hysterectomy .

[1]. Adair, FL. The American Committee of Maternal Welfare, Inc: Chairman's Address. Am J ObstetGynecol 1935; 30:868.
[2]. Mackeen AD, Packard RE, Ota E, et al; Antibiotic regimens for postpartum endometritis. Cochrane Database Syst Rev. 2015 Feb 2(2):CD001067. doi:10.1002/14651858.CD001067.pub3.
[3]. Confidential Enquiry into Maternal Death 2016; MBRRACE-UK
[4]. Zubor et al. BMC Pregnancy and Childbirth 2014, 14:80
[5]. http://www.biomedcentral.com/1471-2393/14/80

Abstract: Background- Tumor epidemiology is a significant part in case of intracranial tumor studies. Here, we discuss the features of intracranial tumor pathology in single centre. Aims and Objective-To analyze the age,sex and site wise distribution of different histological pattern of intracranial tumors seen in our centre. Materials and Methods-It is a retrospective study of cases of intracranial tumors seen over a period of 5 years .Altogether 160 CNS specimens were fixed in 10% Formalin and processed in automatic tissue processor. Routine Hematoxylin and Eosin stain and special stains were done and examined under the light microscope. The diagnosis is given on the basis of age,sex distribution using the WHO grading..........

Keywords: Astrocytoma, Meningioma,Glioblastoma.

[1]. Laws ER Jr, Thapar K. Brain tumors. CA Cancer J Clin.1993 ;43(5):263–271.
[2]. Werner MH, Schold SC Jr. Primary intracranial neoplasms in the elderly. Clin Geriatr Med.1987 ;3(4):765–779.
[3]. Idowu O, Akang E, Malomo A. Symptomatic primary intracranial neoplasm in Nigeria. West Afri. J NeurolSci (Turk) 2007;19(24):212-218.
[4]. GLOBOCAN.Worldwide incidence and mortality of cancer,2002 (Computer programm),Lyon, France: IARC Press; 2002.
[5]. De Angelis LM. Brain tumours. N Engl J Med. 2001 Jan 11;344(2):114-23.

Abstract: The existence of fire in water refers to an unprecedented appearance of a material in an unexpected surrounding. The presence of fire in between the rain clouds when they dash with each other as a lightening is called as Vaidyuda agni is an example to quote here. The second one is the fire in between the sea waters. This is meant to protect the earth from excess flow of sea water to the land by drying it by which it is kept under control. This fire is referred as bā̤ḍava agni. The third one is the fire in between the secretory juices meant for digestion in all livings beings which is called as jāṭharāgni in Ayurveda. The substratum for these fires is water. A humble attempt is made here for the preservation of this jāṭharāgni hidden amidst water in Gastro Intestinal Tract for a sound health in human beings.

Keywords: Fire, Water, Preservation, Sound health

[1]. Unavum Panamum – S.V. Radhakrishna Sastri, 2000, S.V.R. Sastri Trust.
[2]. Ashtangahrudayam - Dr.T.Srikumar – Volume – I – 4th Edition, Harisree Hospital, Thrissur, Kerala.
[3]. Charaka Samhita - R.K. Sharma and Bhagwan Dash – Volume IV Chowkhamba Sanskrit Series Office, Varanasi.
[4]. Sharngadhara Samhita – Dr.P.Himasagra Chandra Murthy – Chowkhamba Sanskrit Series Office, Varanasi

Abstract: In 2014 approximately one billion adults or 22 % of the world population have hypertension (HTN), with 9.4 million deaths in 2010.The rates of HTN in children and adolescents have increased in the last 20 years in the United States. Lowest rates of HTN in the rural India and highest in Poland. HTN results from a complex interaction of genes and environments factors. HTN is classified as primary or essential, is due to lifestyle and genetic factors, and secondary HTN is due to identifiable cause e.g. chronic kidney disease, narrowing of the kidney arteries and endocrine disorder. Several environmental factors influence HTN. High salt intake, lack of exercise, obesity, and depression. Role of caffeine, and vitamin D deficiency are less clear. Frequent symptoms include headaches, lightheadedness, vertigo, tinnitus, and altered vision. Severely elevated blood pressure equal or greater than a systolic 180 or diastolic 110 is considered as HTN emergency. HTN in gestation occurs in approximately 8-10% of pregnancies.........

Keywords: Primary hypertension, Emergencies in hypertension, Management, Prevention

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Abstract: 18 years old thin built girl from delhi was admitted to Indraprastha Apollo hospitals, New delhi with chief complaint of insidious onset breathlessness on exertion for 4-5 months. She also had low grade intermittent episode of fever, dry cough, weakness and fatigue for same duration. On physical examination, she was conscious, alert; Pulse-118; BP-90/60; Respiratory rate-26/min; Spo2-71% (On room air); digital clubbing present; Chest-bilateral vesicular breath sound equal; Abdomen- splenomegaly present. On investigations: arterial blood gas analysis showed type-1 respiratory failure. Liver function was deranged. Abdominal ultrasound and CT angiography report were suggestive of cirrosis of liver with splenomegaly. Pulmonary CT angiography showed pulmonary arterial dilatation. Diagnosis of hepatopulmonary syndrome was made. So, in any patient having unexplained exertional breathlessness with liver disease, this syndrome has to be thought..

Keywords: breathlessness, cirrhosis, angiography, hepatopulmonary syndrome

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[5]. Michael J. Krowka, Michael J. Krowka. Hepatopulmonary Syndrome. CHEST journal. May 1994Volume 105, Issue 5, Pages 1528–1537.

Abstract: Back ground: Pterygium is a common external Ocular disease in tropical countries like India. Excision of the pterygium is the only modality of the treatment for pterygium. Recurrence of pterygium is the most common complication following excision with the bare sclera technique. This was minimized by using autoconjunctival graft with sutures in primary pterygium surgery, but this is associated with sutures related complications. Fibrin glue is used to minimize the suture related complication in auto conjunctival graft surgery. AIM:To evaluate the safety and efficacy of conjunctivalautograft using fibrin glue, which minimize the suture induced complications .Material & methods:It is a prospective study conducted in Ophthalmology dept. S.V. medical college Tirupati. 50 eyes of 50 patients with..............

Keywords: Pterygium, conjunctival auto graft, firbin glue.

[1]. Raju VK, Abhishek Chandra, Rahul. Management of Pterygium – aBrief review. Kerala journal of Ophthalmology. 2008; 1: 63-65.
[2]. ZeeshanKamil, Syeda Aisha Bokhari, FawadRizvi. Comparison of conjunctivalAutograft and Intra-Operative application of Mitomycin-C in treatment of Primary Pterygium. Pak J Opthalmol.201;27(4): 221-225.
[3]. Hiwt,L. Distribution, risk factors and epidemiology. In Taylor H.R. (ed) pterygium, Vol. 2, Kugler publications: the Haghe, Netherlands, 2000, pp. 15-28.
[4]. Dushku, N., Reid, T.W. immunohistochemical evidence that human pterygia originate from an invasion of vimentin expressing altered limbal epithelial basal cells. Cuur. Eye Res. 1994, 13: 473-481
[5]. Mohamed A Fakhry. The use of mitomycin C with autologous limbal-conjuctivalautograft transplantation for management of recurrent pterygium. Clin Opthalmol. 2011; 5: 123-127..

Abstract: Background: Ectopic pregnancy remains one of the important cause of maternal morbidity and mortality, if not diagnosed in time it will result in rupture leading to emergency laparotomy or laparoscopy endangering the mother's life. Due to increased incidence of infertility, ART, STI, early diagnostic procedures like ultrasound, there is a rising trend of ectopic pregnancies. Aims and Objective: The aim is to study the incidence, clinical presentation risk factors, site of ectopic, management modalities at Govt. General Hospital Kurnool, Andhra Pradesh. Methods: This study was conducted at Govt. General Hospital Kurnool from January 2017 to December 2017. It is a retrospective observational......

Key Words: Ectopic pregnancy, ART, STI, shock.

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