iosr-JDMS   Volume-17 ~ Issue-2 ~ February-2018

Abstract: High intracuff pressure in ET tube may cause tracheal lesions , which causes post operative sore throat (POST) and hemodynamic changes like change in Mean arterial pressure and Pulse rate . II. Aim Of The Study The aim of this study was to evaluate the comparative incidence of post operative sore throat (POST) and haemodynamic response of intracuff alkaline lignocaine and MgSO4...........

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Abstract: Venous ulcers are the major occurrence of chronic wounds, occurring in 70% to 90% of leg ulcer cases. Venous ulcers develop mostly along the medial distal leg, and can be very painful with significant effects on quality of life.Venous ulcers affect approximately 1% of the world's population, increasing health care expenditures and decreasing quality of life. Several hypotheses may help explain their origin. Insufficient veins or valves or impaired muscle function may lead to abnormal calf muscle pump function that can elevate ambulatory venous pressure. The aim of this study is to evaluate the efficacy of pentoxifylline in treating chronic venous ulcers specially of lower extremities.........

Keywords:Compression Therapy, Pentoixifylline, Ulcers.

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[2]. Ibrahim S, MacPherson DR, Goldhaber SZ. Chronic venous insufficiency: mechanisms and management. Am Heart J. 1996;132(4):856–860.
[3]. Coleridge Smith PD, Thomas P, Scurr JH, Dormandy JA. Causes of venous ulceration: a new hypothesis. Br Med J (Clin Res Ed). 1988;1296:1726–1727.
[4]. Stücker M, Reich S, Robak-Pawelczyk B, et al. Changes in venous refilling time from childhood to adulthood in subjects with apparently normal veins. J Vasc Surg. 2005;41(2):296–302.
[5]. Trent JT, Falabella A, Eaglstein WH, Kirsner RS. Venous ulcers: pathophysiology and treatment options. Ostomy Wound Manage. 2005;51(5):38–56.

Abstract: Introduction: Higher education including medical education has been shifting towards more active and student-centric teaching strategies. Flipped class room method gives the student scope to learn the course content at home and utilise the class time in more interactive sessions. Methodology: A descriptive cross sectional study was conducted among 163 1st year MBBS students of Andhra Medical College to determine the medical students' perceptions of flipped classroom as a teaching tool. Students were exposed to flipped classroom method of teaching on two different occasions prior to the survey. A structured questionnaire on students' perception on flipped classroom technology was used. Responses were collected using a 5 point Likert scale ranging from strongly disagree to strongly agree. Scoring was given from 0 to 4. Data was analysed using Microsoft excel. Results: Majority of.......

Keywords: Flipped Class room, medical education, teaching methods

[1]. Bernard F. Harris, Janetta Harris, Lora Reed, Maja Zelihic; Flipped Classroom: Another Tool for Your Pedagogy Tool Box Page 325 – Developments in Business Simulation and Experiential Learning, Volume 43, 2016

[2]. Jalal Nouri, The flipped classroom: for active, effective and increased learning – especially for low achievers International Journal of Educational Technology in Higher Education 201613:33
[3]. Sara Arnold-Garza, The Flipped Classroom Teaching Model And Its Use For Information Literacy Instruction; Communications in Information Literacy; Volume 8, Issue 1, 2014

[4]. Cary Moore, Students' Attitudes, Perceptions, and Engagement within a Flipped classroom model as Related to Learning Mathematics; Journal of Studies in Education; ISSN 2162-6952 ; 2015, Vol. 5, No. 3 286 -308 [5]. Navin Rajaratnam and Suzanne Maria D'Cruz ;Is the Time Right to Start Using Flipped Classrooms in Indian Medical Colleges?J Clin Diagn Res. 2015 Sep; 9(9): JL01–JL02..

Abstract: Jejunal diverticulosis is a rare entity involving small bowel. The condition is usually asymptomatic and diagnosed incidentally, although it may cause chronic symptoms and acute complications. Because of the rarity of the condition, diagnosis is often delayed. The condition should be suspected in cases of unexplained chronic pain abdomen and malabsorption to avoid unnecessary mortality and morbidity. We are thereby reporting a 40 yr old male patient who presented to surgical emergency with acute abdomen. He used to take NSAIDS for chronic back pain. On exploration thin walled jejunal diverticulae of size 5x5 cm were observed along with a prepyloric gastric perforation. Modified graham's omental patch repair was done for the gastric perforation, decision for conservative approach was made for diverticulosis segment. During the followup OPD visits, patient underwent upper GI endoscopy..........

Keywords: Jejunal diverticulosis, gastric perforation, exploratory laparotomy, NSAIDS

[1]. Williams R.A., Davidson D.D., Serota A.I., Wilson S.E. Surgical problems of diverticula of the small intestine. Surg. Gynecol. Obstet. 1981;152:621–626.

[2]. Michael J Zinner, Stanley W Ashley, Jejunoileal diverticula. In; Maingot's Abdominal Operations: 12th edition: The McGraw Hill Companies, Inc. 2013. p. 642-643.

[3]. Ross C.B., Richards W.O, Sharp K.W. Diverticular disease of the jejunum and its complications. Am. Surg. 1990; 56(5):319–324. [4]. Woods K, Williams E, Melvin W, Sharp K. Acquired jejunoileal diverticulosis and its complications: a review of literature. Am Surg. 2008;74:849-854.

[5]. Kassahun WT, Fangmann J, Harms J, et al. Complicated small bowel diverticulosis: a case report and review of literature. World J Gastroenterol. 2007;13:2240-2242..

Abstract: Introduction : Incidence of acute encephalitis is high in children and associated with high mortality and sequalae. It is critical to evaluate the child immediately to reduce mortality and sequalae and to identify the cause of Acute Encephalitis Syndrome (AES). Aim of the study was to document the clinical profile, short term outcome, find out possible etiologies of AES and effect of different prognostic markers in outcome of AES at the end of hospital stay. Methods : This prospective observational study was conducted in the pediatric department of NRS medical College & Hospital, Kolkata for period of one year (1st April 2015 to 31st March 2016) on a sample size of 140 patients presenting with fever and altered sensorium (between ages one month to 12 years) and etiology of AES was determined on the basis of history, clinical examination, relevant investigations. Outcome of patients was graded with functional outcome score (Glasgow outcome scale)..........

Keywords: Japanese encephalitis, AES, Coma, neurological manifestations

[1] J. Granerod, N. S. Crowcroft, "The epidemiology of acute encephalitis,"NeuropsychologicalRehabilitation,vol.17,no.4-5, pp.406–428, 2007.
[2] Bansal A, Singhi SC, Singhi PD, Khandelwal N, Ramesh S. Non traumatic coma. Indian J Pediatric.2005; 72:467–73.
[3] Khodapanahandeh F,Najarkalayee NG, Etiology and Outcome of non-traumatic Coma in Children Admitted to Pediatric Intensive Care Unit, Iran J pediatr. 2009; 19:393–98.
[4] Khinchi YR, Kumar A, Yadav S. Study of acute encephalitis syndrome in children. J College of Med Sci-Nepal 2010; 6: 7-13.
[5] CM Bokade,RR Gulhane, AS Bagul, SB Thakre, Acute Febril Encephalopathy in Children and Predictors of Mortality.J Clin Diagn Re . Aug 2014; 8(8): PC09–PC11..

Abstract: Coronal tooth fracture, especially in maxillary anterior teeth are mostly common in children and adolescents but can occur in any age group. Trauma to maxillary anterior teeth affects the patient both socially and psychologically, so the immediate treatment of such patients is must. If the fractured tooth fragment is available (clean and hydrated) then the reattachment of such fragment is the best treatment option available, as such treatment will result in original anatomic form, color and surface texture. Reattachment of complex tooth fracture requires reinforcement by fiber post and adhesive system. This article discusses a case report regarding successful reattachment of fractured tooth fragment.

Keywords: Crown Fracture; Fragment Reattachment; Adhesive Technology

[1]. Bruschi, et al. "Reattachment of anterior fractured teeth: Effect of materials and techniques on impact strength". Dental Trauma-tology 26.4 (2010): 315-322.
[2]. Aggarwal V., et al. "Complicated crown fractures-management and treatment options". International Endodontic Journal 42.8 (2009): 740-753.
[3]. Villat C., et al. "Multidisciplinary approach to the immediate esthetic repair and long-term treatment of an oblique crown-root fracture". Dental Traumatology 20.1 (2004): 56-60.
[4]. Meiers JC and Kazemi RB. "Chair side replacement of posterior teeth using a prefabricated fiber-reinforced resin composite framework technique: A case report". Journal of Esthetic and Restorative Dentistry 17.6 (2005): 335-342.
[5]. Murchison DF., et al. "Incisal edge reattachment: indications for use and clinical technique". British Dental Journal 186.12 (1999): 614-619...

Abstract: There are many techniques used for the detection of the activity of the cells. One of these measures is detection of the presence and activity of cell's enzymes using histo-chemical method. One of these enzymes is Uridine Diphospho-Galatose 4-Epimerase. It's activity could be estimated using simultaneously coupling method of Diculescu et al method. However this method has technical problem. This problem is the incubation medium is turbid which leads to get tissue slide with a lot of artifact and debris giving false positive result. To overcome this problem, many solvents had been used to have clean incubation medium, without inhibiting the activity of the enzyme, and to get clean and clear tissue slide could be obtained. The abstract should summarize the content of the paper. Try to keep the abstract below 200 words. Do not make references nor display equations in the abstract. The journal will be printed from the same-sized copy prepared by you. Your manuscript should be printed on A4 paper..........

Keywords: Uridine Diphospho Galactose 4-Epimerase, simultaneous coupling method of deculescu

[1]. P.J Stoward. and A.G Pearse.(Eds.), Epimerase enzyme. In: Histochemistry, vol III Churchill Livingstone, 4th ed:610-611. 1991.
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[3]. Liu Y, vanhooke J. L, Frey P.A., UDP-galactose 4 epimerase: NAD+ content and charge-transfer band associated with substrate –induced conformational transition. Biochemistry 35; 23:7615-7620. 1996.
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[5]. L.Chi hney wong, sharon , maynie and George M.,Whitesides, Enzyme – catalyzed synthesis of N-acetyllactosamine with insitu regeneration of uridine 5-diphosphate glucose and uridine 5-diphosphate galactose. J. org. chem ; 47 (27) : 5416 – 5418. 1983

Abstract: Background- To identify the role of Malocclusion, Parafunctional habits, other factors associated in causing TMDs and also to establish the most prevalent type of TMD in various Age group and gender. Method-Cross-sectional study conducted among 21,623 patients based on clinical examination and constructed questionnaire. Data subjected to Pearson Chi-Square Analysis and Statistical analysis carried out using SPSS release 20 package. Results- The results of present investigations showed that 55.3% of the patients had TMD of which 73% were females. Patients below the age of 20 years were found to be most commonly affected (53%) followed by the age group of 21to 40years (26%). Various factors contributing to TMD were also established. Conclusion-The present study showed a high risk of developing TMDs among the younger age group especially in females. This demands further investigations to identify the risk factors associated with TMD in order to establish various measures in preventing and managing the disease..

Key Words: Temporomandibular disorder, Parafunctional habits, Masticatory muscles

[1]. Okeson JP. Management of temporomandibular disorders and occlusion. 7th ed. St. Louis: Elsevier;2013.
[2]. Cairns BE. Pathophysiology of TMD pain–basic mechanisms and their implications for pharmacotherapy. Journal of Oral Rehabilitation 2010;37:391–410.
[3]. Romero-Reyes M, Uyanik JM. Orofacial pain management: current perspectives. Journal of Pain Research 2014;7:99-115.
[4]. Manfredini D, Guarda-Nardini L, Winocur E, Piccotti F, Ahlberg J, Lobbezoo F. Research diagnostic criteria for temporomandibular disorders: a systematic review of axis I epidemiologic findings. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011;112:453–462.
[5]. Schiffman et al. Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for Clinical and Research Applications: Recommendations of the International RDC/TMD Consortium Network and Orofacial Pain Special Interest Group. Journal of Oral & Facial Pain and Headache. 2014; 28(1):6-27....

Abstract: Introduction: The child's first impression about a paediatric dental set up may have a lasting impact on his dental behaviour and attitude. Paediatric dental services can provide an enhancedchild-friendly experience with a relaxed environment by incorporating certain preferences of children and parents. However, few studies have addressed their perspective for a paediatric dental setup. Aim: The aim of this study was to assess the scenario based preferences of children and parents towards a paediatric dental setup. Methodology:60 children between 6 to 12 years of age and their parents were recruited for the study. A PowerPoint based study tool was developed to include pediatric dental clinic and related scenarios. The participants chose, rated or ranked their preferences as per the scenario-based age appropriate questionnaire. The highest preferences were chosen as final.........

Keywords: Attire,Childrens preference, Gender, Paediatric Dental Setup, Parents preference

[1]. Rechtschaffen A, Buchignani C. The visual appearance of dreams. In: The Europsychology of Sleep and Dreaming, ed. J Antrobus, M Bertini. Hillsdale, New Jersy: Erlbaum; 1992: pp 143–55.
[2]. Elliot A J, Maier M A.Color psychology: effects of perceiving color on psychological functioning in humans. Annu Rev Psychol. 2014; 65: 95-120.
[3]. Kellert S R. Kinship to mastery: Biophilia in human evolution and development. Island Press; 2003.
[4]. Dinis E, Duarte P, Noriega L, Teixeira E, Vilar F, Rebelo. Evaluating Emotional Responses to the Interior Design of a Hospital Room: A Study Using Virtual Reality. In: Marcus A. (eds) Design, User Experience, and Usability. User Experience in Novel Techological Environments. DUXU. Lecture Notes in Computer Science, 8014: Springer, Berlin, Heidelberg; 2013: pp. 475–483.
[5]. Charnofsky L W. Thesis: The Interrelationship between Human Behavior and Sustainability in the BuiltEnvironment (Doctoral dissertation, Kent State University); 2012

Abstract: Breast carcinoma is graded by Modified Bloom Richarson score and predictive immunohistochemical markers are estrogen receptors, progesterone receptors and HER2/neu status. Conventionally these analyses are done by immunohistochemistry( IHC) on whole sections. In our study we use tissue microarray technique(TMA) where small representative tissue samples from many cases were assembled on a single histology slide and subjected to Immunohistochemical analysis. We assessed the cost-effectiveness of IHC done on TMA slides. 50 cases of invasive breast carcinoma were included in the study. First the design for TMA construction was laid out. Paraffin..........

Keywords: Breast carcinoma, Immunohistochemistry, Manual Tissue microarray

[1] Khokhar A. Breast cancer in India: Where do we stand and where do we go? Asian Pacific Journal of Cancer Prevention. 13(10) ,2012.4861–66.

[2] Rivenbark AG, O'Connor SM, Coleman WB. Molecular and cellular heterogeneity in breast cancer -challenges for personalized medicine. The American Journal of Pathology. 183(4), 2013.1113–24.

[3] Rosai J , Breast In: Rosai and Ackerman (Ed), Surgical Pathology. 10th ed.( St. Louis: Mosby; 2011) 1659–1770.

[4] Peale FV, Hillan KJ. Tissue arrays: Construction and applications in recent advances in histopathology in David Lowe, James Underwood( Ed) Recent Advances in Histopathology .v: 20.( London: Taylor & Francis; 2003) 89–102.

[5] Hammond ME, Hayes DF, Dowsett M, Allred DC, Hagerty KL, Badve S, et al. American society ofclinical oncology/college of american pathologists guideline recommendations for immunohistochemical testing of estrogen and progesterone receptors in breast cancer. Journal of Clinical Oncology.134(7) 2010, 2784–95

Abstract: Wound dehiscence is one among the most dreaded complications faced by the surgeons. By definition, dehiscence is the separation of fascial layers early in the postoperative course.Wound dehiscence is described as partial or complete disruption of an abdominal wound closure with or without protrusion and evisceration of abdominal contents. Dehiscence of wound occurs before cutaneous healing.1 Wound dehiscence is a very serious postoperative complication associated with high mortality and morbidity. It has significant impact on health care cost, both for patients and hospitals. Prolonged hospital stay, high incidence of incisional hernia, and subsequent reoperations underline the severity of this complication.Conditions associated with increased risk of wound dehiscence are anaemia, hypoalbuminemia, malnutrition, malignancy, jaundice, obesity and diabetes, male gender, elderly patients and specific surgical procedures as colon surgery or emergency laparotomy which are associated with......

Keywords: wounddehiscence,postoperative,evisceration,incisionalhernia,anaemia,hypoalbuminemia, jaundice.

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Abstract: Significant aortic arcliatheromas (>4mm thick) have been identified as one of the most powerflil independent risk factors for ischemic strokes in western patients >60 years of age, but there is little published literature on frequency of aortic atheromas in Indian population. Material and Methods: The current study was aimed at assessing the frequency and risk factors of significant aortic arch atheroma in stroke patients attending a tertiary care center in south India, whose stroke mechanism was not clear even after detailed clinical assessment, and investigations including Carotid Doppler, Magnetic resonance imaging and 2D Transthoracic echocardiography.
Results: Out of 297 consecutive patients of ischemic stroke, seen between 1st January 2001 and 31st December 2001, Transesophageal Echocardiography (TEE) was performed...........

Keywords: Aortic Arch, Atheromas, Embolism, Stroke

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[5]. Feldmann E, Daneault N, Kwan E, et al. Chinese‐white differences in the distribution of occlusive cerebrovascular disease. Neurology 1990;40:1540-1540.

Abstract: Background: Elderly population is vulnerable for malnutrition and their nutritional status is usually associated with family dietary pattern. Slum dwellers being disadvantaged might be at more risk and needs to be assessed for appropriate interventions. Objectives: To determine nutritional status among geriatric population residing in slum area of a municipality and to find out association between nutritional status and family dietary pattern. Methods: A cross-sectional study was conducted during June - November 2016 in slums of a ward of Burdwan Municipality. Sample size was 132 considering 19.5% prevalence of malnutrition (as revealed by a study), 95% confidence interval, 5% level of significance, 10% absolute error and design effect of 2 for multistage sampling. Nutritional status was assessed with Mini Nutritional Assessment (MNA) tool for elderly and family dietary pattern was assessed with 24 hours recall method. MNA tool categorizes nutritional status as – malnutrition, nutrition at risk and normal nutrition. Ethical approval was obtained from institutional ethics committee of Burdwan Medical College, West Bengal............

Keywords:Family Diet, Geriatric, malnutrition, MNA Tool.

[1] Chapman IM, MacIntosh CG, Morley JE, Horowitz M. The anorexia of ageing. Biogerontology2002; 3: 67-71.
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Abstract: Giant inguinal hernias are unusual and are extremely rare nowadays because of easier access to hospital services, early diagnosis better hernioplasty techniques. They are significantly challenging in terms of surgical management. It is defined as an inguinal hernia that extends below the midpoint of inner thigh when the patient is in standing position. They can either be asymptomatic or can present with complications. We report a case of a 68-year-old male who presented with features of intestinal obstruction. The patient was found to have giant right-sided inguinal hernia with ipsilateral hydrocele for 12 yrs that was extending almost up to the patient's knee joint and it was tender, irreducible without a cough impulse. He had no cardio-respiratory illness. Emergency exploration via inguinoscrotal approach revealed that contents were the small and large intestines, omentum and mesentery. Right orchidectomy, omentectomy and reduction of contents into abdominal cavity followed by a double-layered closure of wall, and scrotoplasty were done.

Keywords: Giant inguinoscrotal hernia, scrotal abdomen, intestinal obstruction

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[2]. Karthikeyan VS, Sistla SC, Ram D, Ali SM, Rajkumar N. Giant inguinoscrotal hernia--report of a rare case with literature review. International surgery. 2014;99 : 560-4.
[3]. Sturniolo G, Tonante A, Gagliano E, Taranto F, Lo Schiavo MG, D'Alia C. Surgical treatment of the giant inguinal hernia. Hernia 1999;3(1):27–30
[4]. Coetzee E, Price C, Boutall A. Simple repair of a giant inguinoscrotal hernia. International journal of surgery case reports 2011; 2: 32-5.
[5]. Petersen LF, Luu MB. Giant inguinal scrotal hernia containing the sigmoid colon. Am Surg. 2014;80:e185–6.

Abstract: Oligodendrogliomas are the third most common CNS tumour of glial origin. Primary Oligodendrogliomas are very rare spinal cord tumours of intramedullary origin. In the literature only a few cases are reported. These are presented mostly in the old age. These occur most commonly at thoracic cord level and their location at conus caudal level are even rare. We report a case of anaplastic oligodendroglioma(WHO Grade III) in a young aged male patient presenting as a probably fast growing intramedullary spinal cord tumour, which was treated surgically.

Keywords: Anaplastic, Cauda equina, Conus medullaris, Intramedullary, Oligodendroglioma, spinalcord

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