iosr-JDMS   Volume-17 ~ Issue-10 ~ October-2018

Abstract: Proximal humerus fracture remains a major challenge for treating surgeons. While non-displaced fractures can be managed conservatively, displaced ones are often treated surgically. The incidence of proximal humerus fractures has increased in last few years due to changes in life style and increase in road traffic accidents. Hence, the challenge of the modern day treatment was to get accurate reductions anatomically, fast healing and early restoration of function. Objectives: To assess the efficacy, functional and anatomical outcome of locking plate in management of two part and three part fracture of proximal humerus according to Neer's classification. Methods: This is a prospective study in which 30 patients of the proximal humerus fracture, between 25 years to 55...........

Key words: Proximal humerus fracture, Neers classification and locking plate.

[1]. Kadavkolan AS, Wasnik SS. Management of proximal humeral fractures: a review of current treatment options. Current Orthopaedic Practice.2015;26(2):169-80.
[2]. Bareggi R, Grill V, Zweyer M, Sandrucci MA,Narducci P, Forabosco A. The growth of long bones in human embryological and fetal upper limbs and its relationship to other developmental patterns.Anatomy and embryology. 1994;189(1):19-24.
[3]. Benger U, Johnell O, Redlund-Johnell I. Changes in the incidence of fracture ofthe upper end of the humerus during a 30-year period: a study of 2125 fractures. Clin Orthop. 1988;231:179–82.
[4]. Court-Brown CM, Garg A, McQueen MM. The epidemiology of proximal humeral fractures. Acta Orthop Scand. 2001;72:365–71.
[5]. Bjorkenheim JM, Pajarinen J, Savolainen V.Internal fixation of proximal humeral fractures with a locking compression plate. Acta Orthop Scand.2004;75(6):741–5.

Abstract: This study aims to develop a strategy for implementing policies to prevent deterrence in order to protect the country's entrance from various infectious diseases. It is hoped that this research can be a guideline for the port health office in carrying out its main task of preventing and counteracting infectious diseases that enter the country. This research was carried out at the Class I Port Health Office in Denpasar. This research is a qualitative research, using the phenomenological approach. Data collection techniques were carried out by means of in-depth interviews with health policy implementing informants to prevent blocking in the field to find out the support and obstacles they........

Keywords: Public Policy, Health Policy, Prevention, Port Office, and Policy Implementation Strategy.

[1]. Abidin, S. Z. (2012). Kebijakan Publik Edisi 2. Jakarta: Salemba Humanika.
[2]. Anderson, J. E., & Anderson, J. E. (2011). No Title.
[3]. Indiahono, D. (2009). Kebijakan Publik Berbasis Dynamic Policy Analisys. Yogyakarta: Gava Media.
[4]. Indiarto, W. (2007). Analisis implementasi kebijakan strategi penanggulangan HIV/AIDS dan penyalahgunaan narkoba di lembaga pemasyarakatan klas IIA Pemuda Tangerang. Pascasarjana-UI.
[5]. Indonesia, K. K. (2015). Profil kesehatan Indonesia tahun 2011...

Abstract: Abbreviations: MAM- moderate acute malnutrition SAM- severe acute malnutrition SD- standard deviation SPSS-Statistical Package for the Social Sciences Operational definition:
 Appropriate sunshine exposure- exposure for 10-20minutes, mid-mornign, with no ointment and dressing.
 Clinical features of......

Key words: - Causes, factors and treatment Reponses of Rickets.

[1]. Wondale Y, Shiferaw F, Lulseged S.A systematic review of nutritional rickets in Ethiopia: status and prospects. Ethiop Med J. 2005 Jul;43(3):203-10. Review
[2]. Thierry Craviari, John M. Pettifor, Tom D. Thacher, Craig Meisner, Josiane Arnaud, and Philip R. FischerRickets: An Overview and Future Directions, with Special Reference to Bangladesh. A Summary of the Rickets Convergence Group. J Health Popul Nutr. 2008 March; 26(1): 112–121. PMCID: PMC2740674.
[3]. Muhammad Javed, Mehnaz Munir Ahmed, Fatima Ghayas Siddiqi. The Emerging Burden of Rickets: Impact of High Rise Buildings in Karachi. The Punjab medical journal02/2009; 3.
[4]. T Belachew, H Nida, T Getaneh, D Woldemariam, W Getinet. Calcium deficiency and causation of rickets in Ethiopian children. East African Medical Journal; Vol 82, No 3 (2005)
[5]. Yimenu Wondale, Fetsum Shiferaw, Sileshi Lulseged. A systematic review of nutritional rickets in Ethiopia: status and prospects. Department of Pediatrics and Child Health, Tikur Anbessa Specialized Hospital, Faculty of Medicine, Addis Ababa University, Ethiopia. Ethiopian medical journal 08/2005; 43(3):203-10.

Abstract: A rare and severe autosomal recessive disorder of bilirubin metabolism. It has been associated with consanguinity in some patients. Infants without any evidence of hemolysis, can develop severe, permanent, unconjugated hyperbilirubinemia within the first few days of life resulting in chronic kernicterus.

[1]. Nelsone 19edition
[2]. J KoreanSocNeonatol2010;17:266-9

[3]. Canu G, Minucci A, Zuppi C, Capoluongo E: Gilbert and CriglerNajjar syndromes: an update of the UDP-glucuronosyltransferase 1A1 (UGT1A1) gene mutation database.

[4]. Blood Cells Mol Dis 2013, 50(4):273-280.

[5]. Strassburg CP: Hyperbilirubinemia syndromes (Gilbert-Meulengracht, Crigler-Najjar, Dubin-Johnson, and Rotor syndrome)..

Abstract: Introduction: Maternal-fetal ABO blood group incompatibility, in which the mother has blood group O and the newborn has blood group A or B, occurs in 15-20% of all pregnancies. The hemolytic process results from maternal anti-A or anti-B immunoglobulin G (IgG) antibodies crossing the placenta and attaching to the appropriate antigens on the neonatal red cells. Rh incompatibility develops when an Rh negative mother has a baby with an Rh positive father. It is characterized by the presence of IgG antibodies in maternal circulation, which causes hemolysis.........

[1]. Pathologic hyperbilirubinemia. Available at: https://www.utmb.edu/pedi_ed/core/neonatology/pag e_30.htm
[2]. Thor WR Hansen. Chief Editor: Ted Rosenkrantz, MD; Neonatal Jaundice, 2016. http://emedicine.medscape.com/article/974786- overview hyperbilirubinemia. Indian J med Res. 1989; 306-13
[3]. Yigit S, Gursoy T, Kanra T, et al. Whole blood versus red cells and plasma for exchange transfusion in ABO haemolytic disease. Trans Med 2005; 15: 313-318.
[4]. Yaseen H, Khalaf M, Rashid N, Darwich M. Does prophylactic phototherapy prevent hyperbilirubinemia in neonates with ABO incompatibility and positive Coombs' test? J Perinatol 2005; 25: 590-594.
[5]. Kaplan M, Na'amad M, Kenan A, et al. Failure to predict hemolysis and hyperbilirubinemia by IgG subclass in blood group A or B infants born to group O mothers. Pediatrics 2009; 123: 132-137.

Abstract: BACKGROUND: Heterotrophic pregnancy is rare complication of pregnancy in which both extra uterine and intra uterine pregnancy occur simultaneously. It may also be referred to as combined ectopic pregnancy multiple sited pregnancy or coincident pregnancy. CASE SCENARIO: we report a case of 26 years old female presented with 3month of amenorrhea with complaints of severe pain abdomen since 3 days. She had obstetric score of G2A1 at 9 weeks with previous missed abortion ,and conceived by in vitro fertilization now. Physical exam revealed hemoperitoneum without shock...........

.......

Abstract: Background: The caesarean section (CS) delivery rate in India increased over last 20 years. Identifying the proportion of women in various categories as per Robson's ten groups classification system and CS rate among tem is important to bring down the increasing CS rate. Methods: The retrospective study was conducted at Niloufer Hospital for Women and Child Health, a tertiary care teaching hospital in Hyderabad, Telangana state, South India. The data was collected for the women delivered by CS during January 2017 to December 2017 in various groups as per the Robson's ten group classification system were calculated. Results: Total of 6662 women delivered during the study period, 2338 (35%) delivered by CS. Among women with previous CS, CS rate...........

Key words: Caesarean section, Robson's ten group classification

[1]. Appropriate technology for birth. Lancet Lond Engl. 1985 Aug 24;2(8452):436–7.
[2]. Althabe F, Belizán JM. Caesarean section: the paradox. Lancet Lond Engl. 2006 Oct 28;368(9546):1472–3.
[3]. Robson S, Carey A, Mishra R, Dear K. Elective caesarean delivery at maternal request: A preliminary study of motivations
influencing women's decision-making. Aust N Z J Obstet Gynaecol. 2008 Aug 1;48(4):415–20.
[4]. Wax JR, Cartin A, Pinette MG, Blackstone J. Patient choice cesarean: an evidence-based review. Obstet Gynecol Surv. 2004
Aug;59(8):601–16.
[5]. Minkoff H, Chervenak FA. Elective primary cesarean delivery. N Engl J Med. 2003 Mar 6;348(10):946–50.

Abstract: Objective: To evaluate the indications of paediatric tracheostomy and associated morbidity within our patient population over the last one and a half years. Methods: We conducted a retrospective study of patients below 12 years of age, undergoing tracheostomy at our tertiary ENT Hospital from April 2016 to December 2017. Patient age, sex, emergency or elective tracheostomy, indications, complications and decannulation were assessed. Results: 27 paediatric patients who underwent tracheostomy were investigated. 17 were males, and 10 were females. The most common indication for tracheostomy was Laryngeal diphtheria, followed by recurrent respiratory papillomatosis. 5 cases were successfully decannulated............

Keywords: Paediatric tracheostomy, laryngeal diphtheria, decannulation.

[1]. Gilmore BB Jr, Mickelson AS. Pediatric tracheotomy: controversiesinmanagement.OtolaryngolClinNorthAm.1986; 19:141-51.
[2]. Pereira KD, MacGregor AR, Mitchell RB. Complications of neonataltracheostomy:a5-yearreview.OtolaryngolHeadNeck Surg.
2004;131:810-3.
[3]. Ruggiero FP, Carr MM. Infant tracheotomy: results of a survey regarding technique. Arch Otolaryngol Head Neck Surg. 2008;
134:263-7.
[4]. 4.WetmoreRF.Tracheotomy.In:BluestoneCD,StoolSE,AlpesCM, Arjmand EM, Casselbrant ML, Dohar JE, et al., editors. Pediatric
otolaryngology. 4th ed. Philadelphia: Saunders; 2003. p. 1583-98.
[5]. Gooddal EW. The story of tracheotomy. Br J Child Dis. 1934;31: 167-76..

Abstract: Diabetes is a global burden and diabetic neuropathy is a very common complication. The incidence of prediabetes is becoming higher and the risk of developing complications is more. Diabetic neuropathy is a troublesome complication of diabetes mellitus. Prediabetes is increasingly being viewed as an important contributor to neuropathy. Neuropathy can be assessed by nerve conduction studies .It can be detected by studying the nerve conduction velocity. This study aims to assess the nerve conduction velocity of sural nerve. Nerve conduction velocity of sural nerve for diabetic and prediabetic were decreased when compared with non diabetic . Nerve conduction velocity is an important parameter to diagnose neuropathy. Prediabetes may even contribute to cause early neuropathy.

Keywords: Nerve conduction study, Prediabetes, Nerve conduction velocity, Sural nerve, Diabetic neuropathy

[1]. Papanas N,I Aaron , Vinik, Dan Ziegler. Neuropathy in prediabetes: does the clock start ticking early? Nat.Rev.Endocrinol
.2011;7:682-690.
[2]. AnilKapur, Economic analysis of diabetes care. Indian J Med Res 2007 Mar; 125: pp 473-482
[3]. Pradeepa R, Rema M, Vignesh J, Deepa M, Deepa R, Mohan V. Prevalence and risk factors for diabetic neuropathy in an urban
south Indian population: the Chennai Urban Rural Epidemiology Study (CURES-55). Diabet Med. 2008 Apr;25(4):407-12.
[4]. Tabak AG,Herder C, Rathmann W,et al. Prediabetes: a high risk state for diabetes development. The Lancet. 2012;379(9833): 2279-
90.
[5]. Anjana RM , Pradeepa R, Deepa M, et al:Prevalence of diabetes (Impaired fasting glucose and/or impaired glucose tolerance) in
urban and rural India: phase 1 results of the Indian council of medical research- India diabetes (ICMR-INDIAB)study.Diabetologia.
2011; 54(12): 3022-7.

Abstract: Foreign bodies in the maxillofacial region are common following trauma, but sometimes theymay be overlooked causing harm to the patient. Approximately one-third of all foreign bodies are initially missed and an undiagnosed foreign body within the soft tissue may result in chronic persistent infection, pus discharge and disfiguring fibrosis. Impalement injury of oral cavity due to a sharp objects are also not uncommon and should be taken seriously since they may turn out to be life threatening. Preoperative clinical and radiographic assessment, along with a good understanding of the nature of injury as well as the size, shape, location and composition of the foreign body will provide the surgeon with better diagnosis toidentify and retrieve the foreign materials completely.This article brings out four cases of foreign bodies in orofacial region following trauma anddiscussthesurgical approachwe usedto retrieve them

Keywords: Foreign body,maxillofacialtrauma, impalement injury, tooth fractures.

[1]. Holmes P-J, Miller JR, Gutta R, Louis PJ. Intraoperative imaging techniques: A guide to retrieval of foreign bodies. Oral Surg Oral Med Oral Pathol Oral Radiol. 2005;100(5):614-618. doi:10.1016/j.tripleo.2005.02.072
[2]. RishabhSirdesai, Jagdish C, Ramakrishna P, Pooja K, Vishal P et al. Incidence of Nasal Foreign Body Impaction in India : Determined Using Literature Search , Interviews and Surveys. Glob J Otolaryngol. 2018;15(1):555903. doi:10.19080/GJO.2018.15.555903
[3]. Mohanavalli S, J JD, Gnanam A. Rare foreign bodies in oro ‑ facial regions. Indian J Dent Res. 2011;22(5):713-715. doi:10.4103/0970-9290.93462
[4]. Halaas GW. Management of foreign bodies in the skin. Am Fam Physician. 2007;76(5):683-688.
[5]. Anderson MA, Newmeyer WL 3rd, Kilgore ESJ. Diagnosis and treatment of retained foreign bodies in the hand. Am J Surg. 1982;144(1):63-67..

Abstract: Introduction Lipid abnormalities, including low levels of all fractions of serum lipids have been repeatedly reported in all phenotypes of Beta- thalassemia patients. In the present study, the low lipid profile of various groups of thalassemia patients have been correlated with erythroid bone marrow activity. Aims and objectives The main aim of this cross sectional study is to evaluate the lipid profile in thalassemia patients common in Eastern India and its correlation with erythroid bone marrow activity. Materials and methods..........

Keywords: E-β Thalassemia ,Hypolipidemia ,Erythroid hyperplasia

[1]. Caterina Borgana Pignatti and Renzo Galanello .Wintrobe's Clinical Haematology 11th edition(2004) Vol 1;42:1319.
[2]. Caterina Borgana Pignatti and Renzo Galanello .Wintrobe's Clinical Haematology 11th edition(2004) Vol 1;42:1320.
[3]. G Amendola ,P Danise,N Todisco G D'urze,A Di Palma,R Concilio. Lipid profile in -thalassemia intermedia patients; correlation with erythroid bone marrow activity. Int Jnl Lab Hem 2007;29:172
[4]. Choremis C., Kyriakides V. , Papadakis E. Studies on the blood lipids and lipoproteins in thalassemia and sickle cell anaemia. Journal of Clinical Pathology 1961;14: 361-364.
[5]. Giardini O., Murgia F., Martino F., Mandarino O., Corrado G. , Maggioni G. Serum lipid pattern in beta thalassemia. Acta haematologica 1978; 60:100-107.

Abstract: All around the world, cancer manifesting in any form is one of the leading causes for death1. In our country approximately 1 million cancer cases are detected every year and the annual deaths due to cancer is around 0.63 million2. While lung and oral cancers are the commonest cancer for men, breast and cervical cancers are the commonest cancers for women in our country.3 Our study was undertaken to find the incidence of cancer burden in an urban cancer centre in Western Odisha. A retrospective analysis was done involving collection of data of a three year period from 1st April 2014 to 31st March 2017. Total reported number of cancer cases during this period was 2278. There was an increase of 4.80% cancer burden in the second year and 7.33% in the third year in comparison to the first year. Females were more affected with malignancies than males. Also the study showed...........

Keywords: Cancer, Incidence, Western Odisha

[1]. Globocan W. Cancer Factsheet. International Agency Res Cancer; 2012
[2]. WHO. World Cancer Report. International Agency Res Cancer; 2008.
[3]. Dikshitetal,Million Death Study Collaborators.Lancet. 2012 May 12; 379(9828):1807-16.
[4]. Murthy NS, Chaudhry K, Rath GK. Burden of Cancer andProjections for 2016, Indian Scenario: Gaps in the Availability of Radiotherapy Treatment Facilities. Asian Pacific Journal of Cancer Prevention. 2008; 9: 671-677.
[5]. Bhatia B. 50,000 die of cancer every year in Bihar. times of India [Internet]. 2013 [cited 2 October 2018];:8-10. Available from:https://timesofindia.indiatimes.com/city/patna/50000-die-of-cancer-every-year-in-Bihar/articleshow/25397879.cms.

Abstract: Background: Acute viral hepatitis is a global public health problem, particularly in resource-poor countries. India is known to have a large burden of viral hepatitis. Almost all cases of acute viral hepatitis (AVH) are caused by one of the five viral agents: hepatitis A virus (HAV), hepatitis B virus (HBV), hepatitis C virus (HCV), the HBV-associated delta agent or hepatitis D virus (HDV) and hepatitis E virus (HEV). Aims and Objective: The aim of this study was to know the etiological spectrum of AVH, prevalence of hepatotropic viruses and their co-infections in AVH patients. Material and Methods: This prospective study was conducted during October 2015 to September 2016 in VRDL, ICMR, Department of Microbiology, RIMS, Ranchi. One hundred and eighty three (183) blood samples were taken from patients presented with clinical sign and symptoms of acute viral hepatitis, serum separated and tested for anti-HAV IgM...........

Keywords: Acute viral hepatitis, etiological spectrum, hepatotropc viruses, prevalence

[1]. Viral Hepatitis- The Silent Disease Facts and Treatment Guidelines www.ncdc.gov.in/writereaddata/linkimages/guideline_hep20158117187417.pdf p 1-3
[2]. Viral Hepatitis Surveillance — India, 2011–2013,http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6428a3.htm 1/4 ,Weekly
July 24, 2015 / 64(28);758762Tripurari Kumar, MPH1; Aakash Shrivastava, MD2; Anil Kumar, MD2; Kayla F. Laserson
[3]. Acharya SK. This is hepatitis: know it, confront it. Indian J Med Res 2013;138:8–10.
[4]. John TJ, Dandona L, Sharma VP, Kakkar M. Continuing challenge of infectious diseases in India. Lancet 2011;377:252–69.
[5]. Batham A, Gupta MA, Rastogi P, Garg S, Sreenivas V, Puliyel JM. Calculating prevalence of hepatitis B in India: using population
weights to look for publication bias in conventional metaanalysis. Indian J Pediatr 2009;76:1247–57..

Abstract: Background: Neonatal intestinal obstruction is one of the most common emergencies which presents with symptoms like vomiting, abdominal distension and failure to pass meconium. Early diagnosis with prompt resuscitation and exploration, if required is necessary to minimise resultant morbidity and mortality. Aim: To do a prospective study of the pattern of neonatal intestinal obstruction in jammu region of jammu and Kashmir with emphasis on diagnostic workup, treatment modalities and their outcome. Design and Place: This is a prospective observational study conducted on patients admitted in Post Graduate Department of Surgery, Govt. Medical College, Jammu. This study was conducted from 17th January 2016 to 16th January 2017............

Keywords: Neonatal intestinal obstruction

[1]. Ghory HJ, Sheldon CA. Newborn surgical emergencies of the gastro intestinal tract. The Surgical Clinics of North America. 1985; 65:1083-1097.
[2]. Ikeda K, Goto S. Diagnosis and treatment of Hirschsprung's disease in Japan .Annals of Surgery.1984;199:400-405.
[3]. Pottts SR, Thomas PS, Garstin WIH, et.al. The duodenal triangle: A plain film sign of midgut malrotation and volvulus in the neonate. Clinical Radiology. 1985;36:47-49.
[4]. Santullli TV,Amoury RA. Congenital anomalies of gastrointestinal tract. The Pediatric Clinic of North America. 1967; 14;29-38.
[5]. Louw JH, Barnard CN . Congenital intestinal atresia: Observation on its origin. Lancet. 1955 ;2:1065-1067.

Abstract: Objective: we aimed to measure the proportion of Needle stick injury (NSI) among nursing students of Karachi Pakistan.
Methods: we conducted cross sectionalsurvey in ten nursing schools (Five private Five public) situated in Karachi and included all students of diploma nursing. A structured questionnaire was used to collect information about number of NSI during last six month. Data about the reporting of the incident and post exposure prophylaxis was also collected for those who experienced any NSI.Age was categorized into three different categories and proportion with percentage for different age group was calculated. Proportion of NSI and its 95% CI was calculated. Frequency with percentage was calculated for all other categorical variables. . Result:Over all..........

Keywords: Needle sticks injuries, nursing, students, and blood borne infections

[1]. Goel V, Kumar D, Lingaiah R, Singh S. Occurrence of needlestick and injuries among health-care workers of a tertiary care
teaching hospital in North India. Journal of laboratory physicians. 2017 Jan; 9(1):20.
[2]. Kakizaki M, Ikeda N, Ali M, Enkhtuya B, Tsolmon M, Shibuya K, Kuroiwa C. Needlestick and sharps injuries among health care
workers at public tertiary hospitals in an urban community in Mongolia. BMC research notes. 2011 Dec;4(1):184.
[3]. Lee JM, Botteman MF, Xanthakos N, Nicklasson L. Needlestick injuries in the United States: epidemiologic, economic, and quality
of life issues. Aaohn Journal. 2005 Mar; 53(3):117-33.
[4]. Isara AR, Oguzie KE, Okpogoro OE. Prevalence of needlestick injuries among healthcare workers in the Accident and Emergency
Department of a Teaching Hospital in Nigeria. Annals of medical and health sciences research. 2015; 5(6):392-6.
[5]. Amini M, Behzadnia MJ, Saboori F, Bahadori M, Ravangard R. Needle-stick injuries among healthcare workers in a teaching
hospital. Trauma monthly. 2015 Nov; 20(4)..

Abstract: A laparoscopy and dye test is an operation to help find out the cause for infertility mostly tubal patency.The dye used during diagnostic lap many a times causes allergic reaction in susceptible individuals. Methylene blue is a commonly used dye in diagnostic procedures such as detection of fistulae, delineation of body tissues during surgery and checking the patency of the fallopian tubes.1 This compound has an oxidation–reduction function and a tissue staining property. It has opposite actions on haemoglobin depending on the concentration. In high concentrations, methylene blue converts the ferrous iron of reduced haemoglobin to the ferric form to produce methaemoglobin. In contrast, low concentrations (in recommended doses) help in the conversion...........

[1]. Trikha A, Mohan V, Kashyap L, Saxena A. Pulmonary edema following intrauterine methylene blue injection. ActaAnaesthesiolScand 1996;40:382–4.
[2]. Marconi G, Quintana R. Methylene blue dyeing of cellular nuclei during salpingoscopy, a newin-vivo method to evaluate vitality of
tubal epithelium. Hum Reprod 1998;13:3414–17.
[3]. Bilgin H, Ozcan B, Bilgin T. Methemoglobinemia induced by methylene blue pertubation during laparoscopy. ActaAnaesthesiolScand 1998;42:594–5.
[4]. Rzymski P, Wozniak J, Opala T, Wilczak M, Sajdak S. Anaphylactic reaction to methylene blue dye after laparoscopic chromopertubation. Int J GynaecolObstet 2003; 81:71–2.
[5]. Nolan DG. Inflammatory peritonitis with ascites after methylene blue dye chromo-pertubation during diagnostic laparoscopy. J Am
AssocGynecolLaparosc 1995;2:483–5..

Abstract: Glaucoma is the leading cause of blindness after cataract. Individuals of Asian descent are prone to angle closure glaucoma due to shallower anterior chamber depths. People with family history of glaucoma are at higher risk. The major risk factor for glaucoma is the increased intraocular pressure. Early signs of glaucoma are gradual progressive visual field loss, and optic nerve changes. The diagnosis for glaucoma includes measurement of the intraocular pressure via tonometry. The aims of glaucoma management are to avoid glaucomatous damage and nerve damage, and preserve visual field and quality of life for patients. Poor compliance with medications and follow-up visits is a major reason for vision loss in glaucoma patients. Both laser and conventional surgeries are performed to treat glaucoma. The intraocular pressure can also have an effect, with higher pressure reducing time until blindness

Keywords: Open-angle glaucoma, intraocular pressure, Optic nerve damage, Trabeculactomy..

[1]. LefflerCT,SchwartzSG,GilibertiFM,etal."What was Glaucoma called Before the 20thCentury.Ophthalmology and Eye Diseases.Libertas Academia.2015;7:21-33.
[2]. "Facts about Glaucoma" (https://nei,nihgov/health/glaucoma_facts).National Eye Institute.Archieved from the original on 28th March 2016.
[3]. QuileyHA,BromanAT.The number of people with glaucoma worldwide in 2010 and 2020.British Journal od Ophthalmology.2006;90(3):262-67.
[4]. MantravadiAV,VadharN.PrimaryCare.Saunders(Elsevier).2015;42(3):437-49.
[5]. Sommer Alfred,TeilschJM,Katz J Q,etal".Racial Differences in the Cause-Specific Prevalence of Blindness in EastBaltomore "N
Engl J Med.1991;325(20):1412-17,..

Abstract: INDRODUCTION :Ropivacaine was approved for a new route of administration, the intrathecal route, in the European Union in February 20041. Ropivacaine was introduced into clinical practice in 1996, and has consistently demonstrated an improved safety profile over Bupivacaine, with reduced CNS and cardiotoxicity .In addition it has a wide clinical utility at different doses for a wide range of indications. It has been shown to provide effective, well tolerated surgical anaesthesia via central neuroaxial block, for major and minor nerve blocks and field blocks. It has also shown to have high-quality postoperative analgesia.2 AIM OF STUDY.........

Keywords –Subarachnoid block, inguinal hernia surgery, 0.75% isobaric Ropivacaine

[1]. M.WILLE intrathecal use of ropivacaine: a review, Acta Anesthe.belg., 2004, 251-259.
[2]. McClure JH. Ropivacaine. Br J Anaesth 1996; 76: 300–7

[3]. Van Kleef J., Veering B., Burm A., Spinal anaesthesia with ropivacaine: a double-blind studyon the efficacy and safety of 0.5% and 0.75% solutions in patients undergoing minor lowerlimb surgery, Anesth. Analgesia. 78, 1994, 1125-1130.
[4]. Wahedi W., Nolte H., Klein P., Ropivacaine in spinal anaesthesia. A dose-finding study, Anesthetist, 45, 1996, 737-744.
[5]. McNamee D., Parks L., McClelland A., Scott S., Milligan K., Ahlén K., Gustafson U., Intrathecal ropivacaine for total hip arthroplasty double-blind comparative study with isobaric 7.5 mg/ml and 10 mg/ml solutions, Br. J Anesth., 87 (5), 2001, 743-747..

Abstract: Mullerian duct anomalies (MDAs) are congenital defects of the female genital tract that arise from abnormal embryological development of the Mullerian ducts. Unicornuate uterus with or without rudimentary horn is developmental anomaly which occurs due to abnormal or failed development of one of the paired mullerian duct or fusion of the ducts. Women with unicornuate uterus have increased incidence of obstetric complications like spontaneous abortions, preterm delivery and intrauterine foetal demise and gynaecological complications like infertility, endometriosis and dysmenorrhoea. A 25 years old, primigravida was admitted at her 40weeks 3 days gestational age with complaints of less fetal movement and history of subfertility. She was induced with tab Misoprostol...........

Keywords: Caesarean section, unicornuate uterus

[1]. Chan YY, Jayaprakasan K, Tan A, Thornton JG, Coomarasamy A, RaineFenning NJ: Reproductive outcomes in women with
congenital uterine anomalies: a systematic review. Ultrasound Obstet Gynecol 2011, 38:371–382.
[2]. Grimbizis GF, Campo R. On behalf of the Scientific Committee of the Congenital Uterine Malformations (CONUTA) common
ESHRE/ESGE working group, Gordts S, Brucker S, Gergolet M, Tanos V, Li T-C, De Angelis C, Di Spiezio Sardo A: Clinical
approach for the classification of congenital uterine malformations. Gynecol Surg 2012, 9:119–129.
[3]. Reichman D, Laufer MR, Robinson BK. Pregnancy out￾comes in unicornuate uteri: a review. Fertil Steril 2009 91(5):1886-94.
[4]. Hua M, Odibo AO, Longman RE, Macones GA, Roehl KA, Cahill AG. Congenital uterine anomalies and adverse preg￾nancy
outcomes. Am J Obstet Gynecol 2011; 205:558.e1-5.
[5]. Fedele L, Zamberletti D, Vercellini P, Dorta M, Candiani GB. Reproductive performance of women with unicornuate uterus. Fertil
Steril 1987; 47(3):416-9..