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

Abstract: Blood stream infections related to central venous catheterization are one of the major device-associated infections reported. Patients admitted in critical care units requiring central venous catheterization and presenting with signs of septicemia during catheterization period were investigated for catheter-related blood stream infections (CRBSI). Approximately 200,000 cases of Bacteraemia occur annually with mortality rate ranging from 20% to 50%. Site of insertion of catheter and duration of catheterization did not show the influence on the CRBSI rate. Since central venous catheters are increasingly being used in the critical care, regular surveillance for infection associated them are essential.

Keywords: Central venous catheter, blood stream infections

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Abstract: Introduction : Radical cystectomy with lymphadenectomy is the gold standard treatment for nonmetastatic, muscle invasive or high risk, nonmuscle invasive Transitional cell carcinoma. Radical cystectomy entails simultaneous surgery on the urinary tract, intestines, and lymph nodes; hence, complications frequently occur after this extensive procedure. Materials & methods : A standard surgical procedure was performed in all patients, including meticulous iliopelvic lymphadenectomy with en bloc RC. All complications within 30 days of surgery were graded according to an established 5-grade Clavien Dindo system. Results : During the study period between May 2015.......

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[2]. Stenzl A, Cowan NC, De Santis M et al: The updated EAU guidelines on muscle- invasive and metastatic bladder cancer. Eur Urol 2009; 55: 815.
[3]. Shariat SF, Karakiewicz PI, Palapattu GS et al: Nomograms provide improved accuracy for predicting survival after radical cystectomy. Clin Cancer Res 2006; 12: 666
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[5]. Dahl DM and McDougal WS: Use of intestinal segments in urinary diversion. In: Campbell- Walsh Urology, 11th ed. Edited by AJ Wein, LR Kavoussi, AC Novick et al. Philadelphia: WB Saunders Co 2015; sect 15,chapt6,pp2534–2578

Abstract: This study evaluates theassociation of serum lipids and Apolipoproteins with Breast Cancer riskin pre- and post-menopausal breast cancer women. Serum lipids and apolipoproteins were estimated in patients with Breast Cancer and Benign Breast lesion, attending Oncology Department of B.Y.L. Nair Charitable Hospital, Mumbai. The study group comprised of 147 Breast Cancer patients, 27 Benign Breast lesion and 35 normal healthy subjects serving as control group. A total of 100 Breast Cancer patients had Invasive Ductal carcinoma, 17 had Ductal carcinoma in situ and 30 presented with Infiltrating Ductal Carcinoma. Stage II or Stage III Tumour, was present in 78 % patients whereas the remaining 22 % had either Stage I or Stage IV tumour.A highly significant(p=0.0001) increase in Total Cholesterol, LDL-Cholesterol, Triglycerides, Lp(a), and Apo B/Apo A1 ratio and significant decline.........

Keywords: apolipoprotein A1,apolipoprotein B, breast cancer, lipids, postmenopausal, premenopausal

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Abstract: Background : The role of Vitamin D deficiency in microvascular complications has been documented. However the effect of vitamin D deficiency on macrovascular complications are not studied extensively. Hence this study evaluate the effect of vitamin D deficiency on both microvascular and macrovascular complications in type 2 diabetes mellitus. Material and Methods : The study was conducted on 200 patients with type 2 diabetes mellitus in which 100 patients are having vascular complications of diabetes(group 1) and 100 patients without vascular complications(group 2). To compare the level of vitamin D, 100 age-sex matched controls without diabetes (group 3) are taken. 25(OH) vitamin D level was measured among all three groups from the serum by ELISA kit. All vascular complications are measured by standard techniques used worldwide...........

[1]. Herrmann M, Sullivan DR, Veillard AS, McCorquodale T, Straub IR, Scott R et al. Serum 25-Hydroxyvitamin D : A predictor of macrovascular and microvascular complications in patients with type 2 diabetes. Diabetes care 2015; 38:521-528.
[2]. Giovannucci E, Liu Y, Hollis BW, Rimm B. 25-Hydroxyvitamin D and risk of myocardial infarction in men: a prospective study. Arch intern med 2008; 168:1174-1180.
[3]. Ginde AA, Scragg R, Schwartz RS, Camargo CA Jr. Prospective study of serum 25-Hydroxyvitamin D level, cardiovascular disease mortality, and all-cause mortality in older U.S. adults. J Am Geriatr Soc 2009; 57:1595-1603.
[4]. Scragg R. Vitamin D and cardiovascular disease: a review of the epidemiological and clinical evidence. In : Vitamins in the prevention of the human diseases. Herrmann W, Obeid R, Eds, Berlin, De Gruyter, 2011; pp409-426.
[5]. Pittas AG, Lau J, Hu FB, Dawson-Hughes B. The role of vitamin D and calcium in type 2 diabetes. A systemic review and meta-analysis. J Clin Endocrinol Metab 2007; 92:2017-2029..

Abstract: Despite increasing attention to provide clinical knowledge to preclinical medical students with early patient exposures, little is known about associated outcomes for students. In this study we have compared two groups where one group of preclinical students was faced to traditional teaching method and other group was exposed to early clinical settings. Early clinical exposure is always one of the biggest concerns for Ist year MBBS medical students who will be going to have clinical educations in future. ECE can be an important and efficient factor in improving the learning ability of students, increases motivation among students and can be a great help in the recall of knowledge in medical students. It has been also found that early clinical exposure (ECE) for medical students has been proposed as an effective factor in reducing stress and motivating toward the rest of their education as a clinical student..............

Key words: Medical Student; Attitude; Motivation, Early clinical exposure, clinical settings

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[3]. Abramovitch H, Shenkman L, Schlank E, Shoham S, Borkan J: A tale of two exposures: a comparison of two approaches to early clinical exposure. Educ Health (Abingdon) 2002, 15(3):386-90.
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[5]. Sathish kumar S, Thomas N, Tharion E, Neelakantan N, Vyas R. Attitude of medical students towards Early Clinical Exposure in learning endocrine physiology. BMC Medical Education 2007;7(1):30..

Abstract: Malignant tumors of small intestine are very rare when compared to large intestine. The aim of the study is to know the location ,morphological type of tumor, age incidence, sex distribution and using special stains and immunohistochemistry. Materials And Methods: A retrospective analysis 656 consecutive biopsy resected specimens of small intestine was studied in Department of General surgery and pathology Guntur Medical Collage / Government General Hospital , Guntur for period of ten years retrospectively. The clinical data and records were reviewed ,the paraffin blocks was collected for better sections ,special stains and immunohistochemistry was done where ever necessary............

Keywords: Primary adenocarcinoma ; NET ;GIST; IHC

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Abstract: The aim of study is to study the clinical presentations, surgical management and its outcome and complications associated with Multi nodular goitrepatients.This randomized prospective study includes 50 patients with multi nodular goitre admitted in surgical units of SiddharthaMedicalcollege/ Govt. general hospital, VijayawadafromOctober 2015 toSeptember 2017.Results:In the study, it was noted that the multi nodular goiter more commonly affects the female and middle age population (20-60yrs). Patients most commonly present with complaint of swelling in neck.Patients present with toxic features and are usually treated surgically by subtotal thyroidectomy. Conclusion:FNAC is minimally invasive, highly accurate, cost effective, pre-operative assessment of patients with thyroid lesions. Main indication of surgery is cosmetic problem. Subtotal thyroidectomy is ideal treatment of MNG..

Keywords: Multi nodular goitre, Surgical management, Complications

[1]. Standringsusan, Gray's Anatomy., 39thedition, London, Churchill Livingstone, 2005- pp 560- 561.

[2]. Ganong William F., The thyroid gland, ch 18, Review of Medical Physiology, 21st edition, Loi, do, Pretice - Hall International, Inc, 2003 pp320- 331.

[3]. Francis S, Green S. Endocrine disorders. Med clin N Am. 1991; 75: pp 195-206.

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Abstract: Background Solitary thyroid lesions are a common presentation in the surgical OPD. The significance of solitary nodule is of its malignant potential. Over all the reported rate of malignancy is 8-12%, even increasing further up to 18 to 20%. Early diagnosis and prompt treatment cures the patient since thyroid carcinoma is most curable among all cancers. Methods We reviewed a total of 245 cases with thyroid lesions from medical records of our hospital that underwent appropriate treatment from January 2012- December 2017. Out of these 245 cases 97 cases were diagnosed as solitary thyroid nodule (STN). Apart from routine investigations, thyroid functional status was assessed. All the patients underwent USG, FNAC of the nodule preoperatively. Hemi-thyroidectomy........

Key words: Fine needle aspiration cytology – FNAC, Follicular thyroid carcinoma – FTC, Papillary thyroid carcinoma – PTC, Ultrasonography – USG, solitary thyroid nodule - STN.

[1]. Usha Menon V, Sundaram KR, Unnikrishnan AG, Jayakumar RV, Nair V, Kumar H. High prevalence of undetected thyroid disorders in an iodine sufficient adult south Indian population. J Indian Med Assoc 2009; 107:72-7.
[2]. Balalji Dhanaram, Jyothi Arunachalam, Bhaskaran Muthukumaraswamy; clinicopathological study of solitary nodule of the thyroid. Int Surg J 2017; jul;4(7) 2288-2290.
[3]. Amitab Jena, Rashimi Patnayak , Jaya Prakash, Alok Sachan, Amarchala Yadagiri Lakhmi. Malignancy in solitary nodule: A clinicoradiopahtological evaluation. Indian J endocr metab; 2015; 19:498-503.
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[5]. Rahul Chetan V, Veeresalingam B, Kishore kumar M, Prabhas Teja Durbesula, Pasupuleti Sreenivasa Rao. A study on the clinical manifestations and the incidence of benign and malignant tumours in a solitary thyroid nodule. Int J Res Med Sci. 2013Nov; 1 (4)429-434.

Abstract: Hearing loss is a devastating condition, lack of hearing leads to lack of development of higher functions. Detecting loss early enough can prevent the social and financial burden to the society. This study is designed to look at formulating and executing a feasible protocol for screening that can be used as a model to smaller hospitals and remote areas. Easily and effectively screenable test of DPOAE is used in this study. Every born child is subjected to non invasive screening process and re screening depending on the results. A descriptive study conducted from July 2015 to December 2017 screening 2092 neonates who were born were screened for hearing loss, a total number of 136 were detected to have hearing loss and needed further evaluation, we also had 54 neonates lost to follow up..

key words: neonatal screening, OAE.

[1] . Augustine A, Jana A, Kuruvilla K, Danda S, Lepcha A, Ebenezer J et al. Neonatal hearing screening — Experience from a tertiary care hospital in Southern India. Indian Pediatrics. 2013;51(3):179-183.

[2] . Jose D, Renjit R, Manonmony S. Prevalence of hearing impairment among high risk neonates- A hospital based screening study. International Journal of Biomedical and Advance Research. 2016;7(3):131.

[3] . Paul AK. Early identification of hearing loss and centralized newborn hearing screening facility-The Cochin experience. Ind Pediatr 2011; 48: 355-9.

[4] . Kapoor S, Kabra M. Newborn screening in India: Current perspectives. Indian Pediatrics. 2010;47(3):219-224.
[5] . Fortnum HM, Summerfield. AQ, Marshal DH, Davis A,Bamford M. Prevalence of permanent childhood hearing impairment in United Kingdom and implications for universal neonatal hearing screening: Questionnaire based ascertainment study BMJ. 2001;323:536-40.

Abstract: AIM: Aim of our study is to know the management and outcome of various open globe injuries with different types of intraocular foreign bodies at our tertiary centre. Materials And Methods: 21 patients of open globe injuries with intraocular foreign bodies (IOFB) who presented to our institute were reviewed retrospectively by collecting data from medical records. Best corrected visual acuity, wound integrity, slit lamp and fundus examination were done in all patients. Patients with hazy media due to vitreous opacities were advised B Scan. Patients with intraocular foreign bodies detected on B Scan were advised CT Scan for proper location , size , shape and material of the foreign body. Wound repair/ exploration, prophylactic scleral buckle,parsplana vitrectomy, Intra ocular foreign body removal after endolaser and silicone oil tamponade was done .

[1]. An overview of penetrating ocular trauma with retained intraocular foreign body
[2]. Awwadh Al-Thowaibi,⁎ Mohan Kumar, and Ibrahim Al-Matani
[3]. Saudi J Ophthalmol. 2011 Apr; 25(2): 203–205.
[4]. Published online 2011 Nov 1. doi: 10.1016/j.sjopt.2011.01.0
[5]. de Juan, E. Jr, Sternberg, P. Jr, and Michels, R.G. Penetrating ocular injuries. Types of injuries and visual results. Ophthalmology. 1983; 90: 1318–1322

Abstract: To study the effect of nickel chloride on bone composition of mice, a number of biophysical and biochemical parameters have been made use. The animals were divided into control and experimental and further subdivided into three groups I, II and III according to the dose of nickel chloride (NiCl2) administered to them i.e. 5.8, 12.8 and 28.2 mg/kg body weight, respectively. Femur bones were obtained by sacrificing the animals three weeks after weaning them once a week. The percentage loss between the wet weight and dry weight of femur in control animals was found to be 32.5+1.5 .In the three experimental groups I,II and III, the percentage loss was 30.4+1.4, 35.3+2.3 and 38.9+2.2 respectively. The percentage loss between the wet weight in wet water and dry weight in wet water was 36.1+2.3 in the controls and 36.6+1.9, 39.5+2.2 and 51.1+3.1 respectively in the three experimental groups.

Key words: Nickel Chloride(NiCl2), femur, Bone. .

[1]. Katz, J.L. (1980). The structure and biomechanics of bone in mechanical properties of biological materials. Cambridge University press, Cambridge. Pp. 137–168.
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Abstract: Osteoarthritis (OA) is a slow degenerative joint disease involving the cartilage and many of its surrounding tissues. It ultimately leads to joint failure with pain and disability, causing the greatest burden to the population as pain and stiffness in these large weight bearing joints often requires surgical intervention. Bilateral osteoarthritis of hip in a young adult is a less common disease and the following is a case report of one such patient operated upon in a tertiary health care center.

[1]. James W Harkess, John R CrockarellJr : Arthroplasty of the hip. Pg 166 Campbells Operative Orthopaedics 13e 2017

[2]. Stephen Richard Knight, RandeepAujla,Satya Prasad Biswas: Total Hip Arthroplasty - over 100 years of operative history. Orthopaedic Reviews. 2011 Sep 6; 3(2): e16. Published online 2011 Nov 7. doi: 10.4081/or.2011.e16

[3]. Nicholas J. Murphy, Jillian P. Eyles, and David J. Hunter: Hip Osteoarthritis: Etiopathogenesis and Implications for Management. Advances in Therapy. 2016; 33(11): 1921–1946.

[4]. KirstiUusi-Rasi, Radhika Patil, SaijaKarinkanta, Kari Tokola, PekkaKannus, HarriSievänen : Exercise Training in Treatment and Rehabilitation of Hip Osteoarthritis: A 12-Week Pilot Trial. Journal of Osteoporosis. 2017; 2017: 3905492.

Abstract: Background: In Nigeria, there is no national statistics on the types of obstetric health facilities and also personnel that offer obstetric service to women. Furthermore, not much is known about their knowledge, training background and therefor the quality of care that is offered. Objectives: Toascertain the categories of Obstetric Health Facilities and Obstetric Practitioners in Rivers State, Nigeria and to illustrate their implication for feto-maternal care. Method: This was a descriptive observational cross-sectional study. 234 obstetric practitioners that work in 125 Health Facilities across 4 local Government areas of Rivers State were assessed on their knowledge of obstetrics and their actual clinical practice, with particular attention paid to the WHO definition of skilled birth attendants. The assessed health facilities were chosen randomly. Data was analyzed with Epi Info 7.2.1 software package 2015 (epi-info.reviewsoft.com.)..........

Key words: Categories, Obstetric practitioners, Implications, Feto-maternal care.

[1] Nigerian National Human Resources for Health strategic plan. 2008 – 2012. Page 16-17.
[2] Osuchukwu NC, Osuchukwu EC, Eko JE, et al. Perception of the determinants of maternal mortality in Calabar South Local Government area of Cross River State, Nigeria. International Journal of Public Heath, Pharmacy and Pharmacology. 2015;1(1):1-13
[3] Evolution of programs designed to increase utilization of SBA in Nigeria. The World Bank January 2014
[4] Udoma EJ, Ekanem AD, Abasiattai AM, et al. Reasons for preference of delivery in spiritual churches – based-clinics by women of South-South Nigeria. Nigerian Journal of clinical practice. 2008; 11(2): 100-103
[5] Fawole AO, Shah A, Fabanwo AO, et al. Predictors of maternal mortality in institutional deliveries in Nigeria. African Health Sciences. 2012; 12(1): 32-40.

Abstract: Background:There have been new realities in the topography and demography of obstetric problem, which should determine the quality of care that is offered at the point of primary contact with patients. Objectives:The study sought to assess the quality of different aspects of obstetric practice in the Primary Health Centres in Ogoniland and recommend evidence-based measures to improve care. Method:This was a descriptive observational cross-sectional study whereby a stepwise multistage cluster sampling technique was used for data collection. The following were assessed by using tracer items: available obstetric services, hours of work, categories of medical staff that conduct obstetric risk assessment (ORA), referral to secondary and tertiary centers, availability of management guidelines, booking and screening tests, engagement in continuous professional development, management of pregnancy, labor and its complications and postnatal care. Data were analyzed with Epi Info 7.2.1. 2015............

Key words: Assessment, Quality, Obstetric Practice, Primary Healthcare, Ogoniland, Nigeria.

[1] Declaration of Alma-Ata International Conference on Primary Health Care, Alma-Ata, USSR, 6-12 September 1978.
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[3] National Primary Health Care Development Agency (NPHCDA): Minimum Standards for Primary Healthcare in Nigeria. Department of Planning, Research and Statistics 2010.
[4] Millennium Development Goals. 2000
[5] Trends in maternal mortality: 1990 to 2013. Estimates by WHO, UNICEF, UNFPA, The World Bank and the United Nations Population Division