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

Abstract: Many anaesthetic drugs have been used as induction agent. Propofol, although most commonly used induction agent, causes significant reduction in arterial pressure. Another agent, etomidate, has advantage of minimizing hypotension. Materials and Methods: A total of fifty patients posted for surgery under general anaesthesia were taken up for the study and were randomly allocated into two groups. All patients received intravenous fentanyl citrate (2g/kg) followed by a study drug over 30-60 seconds. Propofol group (Gr P) received 2.5 mg/kg dose of propofol, and etomidate group (Gr E) received etomidate at 0.2 mg/kg. Heart Rate, systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), and SpO2 were noted at the following time intervals: before induction, at the end of induction (loss of eyelash reflex), at the end of intubation and after 5 minutes of intubation. Adverse effects such as pain on injection and myoclonus were also recorded. Results: Mean heart rate, SBP, DBP.............

Keywords: propofol, etomidate, mean arterial pressure, myoclonus, pain on injection.

[1]. McKeating K, Bali IM, Dundee JW. The effects of thiopentone and propofol on upper airway integrity. Anaesthesia 1988;43:638–40. [2]. Kato JH. Propofol, the newest induction agent of anaesthesia. Int. J. Clin Pharmacol Ther Toxicol 1988;26:41-57. [3]. Pensado A, Molins W, Alvarez J. Haemodynamic effects of propofol during coronary bypass surgery. Br J Anaesth 1993;71:586-8. [4]. Claeys MA, Gepts E, Camu F. Haemodynamic changes during anaesthesia induced and maintained with propofol. Br J Anaesth 1988;60:3-9.
[5]. Hug CC, Jr, McLeskey CH, Nahrwold ML, Roizen MF, Stanley TH, Thisted RA, et al. Hemodynamic effects of propofol: data from over 25,000 patients. Anesth Analg 1993;77(4 Suppl):S21–9..

Abstract: Diabetes Mellitus is an ever growing global problem with lot of economic, social and health impact. Though there are plenty of tools in the armamentarium to control diabetes , personalized diabetes education is used the least, considering the large burden of disease in our country and the lack of resources. Providing a structured and personalized health education on various aspects of diabetes goes a long way in achieving better glycemic control and thus preventing complications. The aim of our study was to find the impact of structured health education delivered in a personalized manner in adult patients suffering from type two diabetes. This prospective observational study was conducted in type-2 Diabetes mellitus patients who were seen in an outpatient clinic in the southern state Kerala, in India, during the period January to April 2014. A total of 184 patients were included in the study. Glycosylated Hemoglobin( HbA1c) before, 3 months and 6 months after structured health education was performed and compared. There was significant improvement in glycemic control after the education with 70.65% of patients achieving HbA1c reduction and 40.76.............

Key words: HbA1c, structured diabetes education

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[3]. UKPDS Group . UK prospective diabetes study 24: relative efficacy of sulfonylurea, insulin and metformin therapy in newly diagnosed non-insulin dependent diabetes with primary diet failure followed for six years. Ann Intern Med 1998;128:165

[4]. Kinra S, Bowen LJ, Lyngdoh T, Prabhakaran D, Reddy KS, Ramakrishnan L: Socio-demographic patterning of non-communicable disease risk factors in rural India: a cross sectional study. BMJ2010, 341: c4974.

[5]. Chuang LM, Tsai ST, Huang BY, Tai TY: The status of diabetes control in Asia–a cross-sectional survey of 24 317 patients with diabetes mellitus in 1998. Diabet Med 2002,19(12):978–985.

Abstract: Objective: Mixed dentition is a period between primary and permanent dentition burden with numerous anomalies. This study was undertaken to determine the prevalence and characteristics of paediatric dental patient presenting with "shark teeth" like appearance. Methods:This study was a prospective study of paediatric patients attending the outpatient dental Clinic of Central Hospital Benin, Edo State, Nigeria with "shark teeth" like appearance. Interviewer-administered questionnaire which elicited information that included age, gender, presenting complaints and involved deciduous and permanent teeth was the tool of data collection. Results: A total of 62 patients out of 842 child patients seen over this period presented with two rowsof teeth giving a prevalence of 7.4% (62/842). The age of the patients seen with two rows of teeth was 4-14 years with a mean age of 6.71±2.20 years. The majority of the patients were.............

Keywords: Two row, mixed dentition, paediatric dental patient

[1]. Denloye O. Eruption sequence of first permanent teeth in some Nigerian children. Pediatr Dent J 2008; 18(1):1-4.
[2]. IAPD. Children 6-10 years of age. http://www.iapdworld.org/parents/super_pages.php?ID=parents3#7
[3]. Temilola DO, Folayan MO, Fatusi O, Chukwumah NM, Onyejaka N, Oziegbe E, Oyedele T, Kolawole KA, Agbaje H. The prevalence, pattern and clinical presentation of developmental dental hard-tissue anomalies in children with primary and mix dentition from Ile-Ife, Nigeria. BMC Oral Health. 2014; 14:125. doi: 10.1186/1472-6831-14-125.
[4]. Onyeaso CO. Incidence of retained deciduous teeth in a Nigerian population: an indication of poor dental awareness/attitude. Odontostomatol Trop. 2005; 28(111):5-9.
[5]. Ize-Iyamu IN. Prevalence of retained primary teeth among children with anterior arch crowding in Benin City, Nigeria. Ann Biomed Sci 2011; 10(2):18-28.
[6]. Osaghae IP, Azodo CC. Characteristics of patients requesting for tooth extraction in a Nigerian secondary health-care setting. Indian J Oral Health Res 2016;2:72-6.

Abstract: Background: Oral Submucous Fibrosis (OSF) is a premalignant disorder, mainly caused by arecanut chewing in various forms. OSF is predominantly seen in Indian Sub continent due to the habit of arecanut chewing. OSF is a chronic, progressive premalignant disorder which can lead to Squamous Cell Carcinoma. Aim: The purpose of the study was to retrospectively evaluate the epidemiologic profile of patients with OSF. Materials and Methods: OSF cases were retrospectively analyzed for a period of one year from December 2015 to 2016, for age, gender, habits, duration, symptoms, stage, interincisal mouth opening and associated oral lesions like squamous cell carcinoma and leukoplakia. The findings were formulated to chart the trends in patients reported to Department of Dental Surgery, Stanley Medical College & Hospital...........

Key words: Oral Submucous Fibrosis, areca nut, chewing habits.

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[5] Caniff JP and Harvey W (1981) The etiology of OSF: the stimulation of collagen synthesis by extracts of areca nut. Int. J Oral Surg 10: 163-7

Abstract: Primary extra-gastrointestinal stromal tumor (EGISTs) arising in the pancreas is extremely rare: only 32 cases have previously been reported in the English literature. We report a further case of EGIST of the pancreas. A 49 -year-old woman presented with abdominal pain localized in the right hyphocondrium. Magnetic resonance imaging (MRI) showed well-demarcated, heterogeneous solid-cystic mass of pancreatic head measured 25mm without invasion of the surrounding tissues. Subtle but distinct flat plane was noted between the mass and pancreatic tissue. At laparotomy, a well-demarcated nodule was identified in the head of the pancreas; no attach with the duodenal wall was found. Careful enucleation of the tumor was successfully performed. Histopathology and immunohistochemical examination confirmed the final diagnosis of EGIST of the pancreas (CD117+), with one mitosis per 50 high-power fields. EGIST with low risk of malignancy has been placed. She did not receive any adjuvant therapy after surgery; 9 months later she is in good general condition and there is no evidence of recurrent disease............

Keyword's : Gastrointestinal stromal tumour, extragastrointestinal, pancreas.

[1]. Beltrameet al:Extra-gastrointestinal stromal tumor of the pancreas: case report and review of the literature. World J Surg Oncol. 2014 Apr 23; 12:105.
[2]. Akbulut S et al: Pancreatic extragastrointestinal stromal tumor: A case report and comprehensive literature review. World J Gastrointest Surg. 2014 Sep 27; 6(9):175-82.
[3]. Reith JD, Goldblum GR, Lyles RH, Weiss SW: Extragastrintestinal (soft tissue) stromal tunor s: an analysis of 48 cases with emphasis on histologic predictors of outcome. Mod Pathol 2000, 13:577–585.
[4]. Elgeidie A et al: Pancreatic gastrointestinal stromal tumor: A case report. Int J Surg Case Rep. 2016; 29: 67–70.
[5]. Sakurai S, Hishima T, Takasawa Y,Sano T, Nakajima T, Saito K, Morinaga S, Fukayama M (2001) Gastrointestinal stromal tumors and KIT-positive cells in the omentum. PatholInt 51:524–531,

Abstract: Background: Diabetes Mellitus (DM) is associated with abnormalities in carbohydrate, fat, and protein metabolism. Pharmacoeconomic studies are pertinent to the decision-making process when trying to balance the costs of specific alternatives. Objective: To assess and compare the safety, efficacy, and cost of Glimepiride 2mg Vs Glipizide 5mg as an add-on therapy in patients receiving Metformin 500mg. Method: A prospective comparative study was conducted for a period of 6 months on T2DM patients, subjects were recruited and grouped into 2 categories i.e. Group-A (metformin 500mg + glimepiride 2mg) and Group-B (metformin 500 mg + Glipizide 5mg). Efficacy of both treatments was assessed by using blood sugar levels data. The safety profile was assessed based on ADRs produced. Cost analysis was performed by using cost-effective analysis............

Keywords: Glipizide, Glimepiride, Metformin, Type2 Diabetes Mellitus, Safety, Efficacy

[1]. Joseph. T. Dipiro, Pharmacotherapy, 7th Edition, 2008, Published By The Mc Graw Hill Companies. Pg No.147, 1206.
[2]. Till Seuring, Olga Archangdidi, Marc Suhrcke. The Economic Costs of Type 2 Diabetes: A Global Systematic Review. PharmacoEconomics 2015;33(8):811-31
[3]. Anna Paulade Sa Borges, Camilo Molinoguidoni, Osvaldo De Freitas, Leonardo Regis Leura Perusa. Economic Evaluation of Outpatients with Type 2 Diabetes Mellitus Assisted By A Pharmaceutical Care Service. Arq Bras Endocrinol Metab 2011;55(9):686-91
[4]. Dnei Endarti, Suri Ari Kristina. A Review On Published Pharmacoeconomic Studies In South East Asian Countries. Int J of Pharm And Clin Res 2016; 8(8): 245-53
[5]. Chantal Pharand. How to Evaluate Pharmaeconomic Data: The Example Of Enoaxparin In Acute Coronary Syndrome. The Canadian journal of hospital pharmacy 2002;55:114-22..

Abstract: Background: Mental disorders are on the increase due to changing life styles. Materials and Methods: A cross sectional study was conducted in which 423 people were screened with the help of a pretested questionnaire by SRQ-20. All the subjects who scored 7 and more in SRQ-20 were further evaluated using M.I.N.I. Plus (Mini International Neuropsychiatric interview plus). 101 people were observed to have CMD for the second phase. Result: Prevalence of common mental disorders was 238.7/1000 population. 76.12% reported typical response within 7 in SRQ-20 scoring. 22.76% of the subjects were found to be Depressive with 15.84 % Depressive females. Alcohol related disorders were found to be 24.75% which is predominantly found in males. On the other hand drug dependence/abuse 33.66% were..........

Keywords: Common mental disorder, Urban slum, SRQ-20, M.I.N.I

[1]. Chandrashekar R, Sudhir kumar C T, 'Epidemiology of Mental disorders' in Vyas and Ahuja. Textbook of Postgraduate Psychiatry, 2nd Edition 2004 pg no 28-41.
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[4]. T.S Sathyanarayana Rao, Darshan M.S et al An epidemiological study of psychiatric disorders in south Indian rural population. Indian J Psychiatry 2015; 56(3): 238-245.

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Abstract: Context: The most common cause of bladder outlet obstruction in male infants is posterior urethral valves (PUV) which causes functional impairment of kidney and bladder. Aims: This study was planned to analyze various clinical presentations, complications, surgical management and outcome of PUV. Methods and Material: 30 patients treated for PUV in the Department of Urology, Nil Ratan Sircar Medical College and Hospital, Kolkata from January-2015 to November-2017, have been retrospectively evaluated. Results: A total of 30 patients with mean age at diagnosis of 6.7 years were included in this study. The most common presenting symptom was dribbling of urine in 93.33% while 83.3% had a palpable bladder. Abdominal ultrasonogram detected bilateral hydronephrosis in 66.6% patients and thickened bladder wall in 56.66%. VCUG done in all patients revealed a dilated........

Key words: posterior urethral valves, presentation, endoscopic ablation, outcome, children, India

[1]. Smith GH, Canning DA, Schulman SL. Long-term outcome of posterior urethral valves treated with primary valve ablation and observation. J Urol 1996;155(5):1730-4
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[5]. Hutton KAR. Management of posterior urethral valves. Curr Pediatr 2004;14:568-75...

Abstract: Background:Urine stone disease is increasingly becoming a common diagnosis in Sub-Saharan Africa. Different factors have been outlined as the cause. The incidence of associated renal function loss is also on the increase. Different management protocols and techniques have been proposed. Availability of newer technological adjuncts is not universal. Aim: to present management of urinary tract stones in a resource limited centre. Material and methods: A ten-year retrospective study of patients treated for urolithiasis was conducted in the University of Port-Harcourt teaching hospital from Jan 2007 to Nov 2017. Data on the age, sex, underlying clinical condition, location of the stone as well as surgical procedures done were collected. Qualitative analysis of the stones was carried out. Data was analysed with SPSS version 20.0.........

Keywords: Urinary tract stones, urolithiasis, risk factors, Nigeria

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[4]. Dursun I, Poyrazoglu HM, Dusunsel R, Gunduz Z, Gurgoze MK, Demirci D, Kucukaydın M. Paediatric urolithiasis: an 8-year experience of single centre. International urology and nephrology. 2008 Mar 1;40(1):3-9.

[5]. Moe OW. Kidney stones: pathophysiology and medical management. The lancet. 2006 Jan 28;367(9507):333-44.

Abstract: Atherosclerosis is the underlying cause of coronary artery disease, which in turn results from raised oxidized lipoprotein levels. This study was aimed to find out the effect of an anti-oxidant, Alpha-tocopherol, on serum lipoprotein level in rats. Alpha-tocophopherol was administered orally daily in a dose 60mg/kg body weight for 90 days to groups of control and hyperlipidemic rats, and the serum lipoprotein levels (total cholesterol, triglyceride, LDL, HDL, VLDL) were measured on 0, 30, 60 and 90 days of drug administration and compared. The results showed that Alpha-tocopherol in a dose of 6mg/100gm body weight daily orally for 90 days prevented serum lipid parameters to shift in favour of atherosclerosis, both in normal and hyperlipidemic rats.Hence, Alpha-tocopherol has significant hypolipidemic activity in animal model.

Keywords: dyslipidaemia vitamin E hyperlipidemic diet.

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Abstract: In present scenario, Dental implants serve as very promising and popular tooth replacement option for the missing natural tooth. Success or failure probabilities of implant are guided by certain local and systemic factors. Initial interaction between implants and surrounding biological tissues depends on the surface characterstics. Surface roughness in particular has attracted huge attention in the past few years to aid in achieving beneficial interaction between the implant and bone. Various attempts have been made to treat implant surface by different materials and methods so as to induce rapid osseointegration. Although such researches claim that these treatments aid in bone healing especially during early healing phase after implant surgery but implant selection should be guided by evidence available and particular case requirement. Present paper reviews the literature on different surface treatments by analyzing various studies about different options available nowadays.

Keywords: grit blasting, plasma spray, osseointegration, Bone morphogenicprotiens, Silver nanoparticles

[1]. Jivraj, Saj&Chee, W. (2006). Rationale for dental implants. British dental journal. 200. 661-5
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Abstract: Introduction:-Breastfeeding has an important role in the prevention of different forms of childhood malnutrition, including wasting, stunting, over- and underweight and micronutrient deficiencies. Objective:- To study the influence of breastfeeding on malnutrition. Materials & Methods:- Thepresentstudywasacross-sectionalstudytakenupinruralfieldpracticeareaofDepartmentof CommunityMedicine,Santhiram MedicalCollege, Nandyal. Sample Size: 455 children. Sampling technique: simple random sampling. Dataanalysis: The following softwares were used for the data analysis: Microsoft Excel -2013 for entering the data. SPSS version 21 for cross tabulation and analysis. WHO anthro version 3.2.2 for grading the malnutrition. Results:- 19% are malnourished how have not received breast milk, which is statistically highly significant. 18.3% of children had breast milk after one year are malnourished, which is statistically highly significant. Discussion:- In the present study out of 455 children 17.3%.............

Keywords: breast feeding, malnutrition, weaning

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[2]. BlossEmily,WainainaFidelisandBaileyRobertC;prevalenceandpredictorsof underweight,stunting and wasting among children aged 5 and under in western Kenya, Journal of tropical pediatrics; 2004, Vol.50 (5): 260-270.
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Abstract: Extrapontine myelinolysis is an acute demyelination involving other than central pontine regions due to rapidly fluctuating serum osmolality. Here we report a case 7 months old chid presented as severe hypernatremic dehydration, resulting extrapontine myelinolysis during the correction.

Keywords: Demyelination, Hypernatremic dehydration, MRI, ADC.

[1]. Babanrao SA, Prahladan A, Kalidos K, Ramachandran K. Osmotic myelinolysis: Does extrapontine myelinolysis precede central pontine myelinolysis? Report of two cases and review of literature. Indian J Radiol Imaging. 2015 Apr-Jun;25(2):177-83. doi: 10.4103/0971-3026.155870.
[2]. Brito AR, Vasconcelos MM, Cruz Júnior LC, Oliveira ME, Azevedo AR, Rocha LG. et al. Central pontine and extrapontine myelinolysis: report of a case with a tragic outcome. J Pediatr (Rio J). 2006 Mar-Apr;82(2):157-60.

[3]. Leung C, Chang WC, Yeh SJ. Hypernatremic dehydration due to concentrated infant formula: report of two cases. Pediatr Neonatol. 2009 Apr;50(2):70-3. doi: 10.1016/S1875-9572(09)60036-X.

[4]. Han MJ, Kim DH, Kim YH, Yang IM, Park JH, Hong MK. A Case of Osmotic Demyelination Presenting with Severe Hypernatremia. Electrolyte Blood Press. 2015 Jun;13(1):30-6. doi: 10.5049/EBP.2015.13.1.30. Epub 2015 Jun 30.

[5]. Martin R. (2004). CENTRAL PONTINE AND EXTRAPONTINE MYELINOLYSIS: THE OSMOTIC DEMYELINATION SYNDROMES. Journal of Neurology, Neurosurgery, and Psychiatry, 75(Suppl 3), iii22–iii28. (http://doi.org/10.1136/jnnp.2004.045906)..

Abstract: Operations research (OR) focus on the application of analytical methods to facilitate better decision-making. Regardless of its convenience and multiplication of papers in the scholarly writing, there are as yet significant issues around getting OR models generally acknowledged and utilized as a component of standard basic leadership by clinicians, wellbeing supervisors and approach producers. This paper expects to raise the attention to medicinal services administrators concerning handy OR applications.

Keywords: Healthcare; delays; queuing

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Abstract: Sensory Guillian – Barr syndrome (GBS) is an acute neuropathy that involves sensory peripheral nerves. As very few such cases have been reported till date, its clinical, neurophysiological and pathological features are still not well described and there is no consensus to consider acute sensory ataxic neuropathy (ASAN) as a variant of GBS. This study reports a 50 year old female with acute onset difficulty in walking preceeded by fever, without any motor weakness and with a sensory level over the thoracic region with positive romberg sign. Nerve coduction studies (NCSs) were suggestive of decreased sensory nerve action potential( SNAPs) in bilateral median and superficial peroneal nerves and CSF study was suggestive of albumino cytological dissociation. MRI cervico dorsal lumbar spine with contrast was not suggestive of compressive or non compressive myelopathy. Patient was then given IV immunoglobulin and had satisfactory improvement.

Keywords: Guillian Barr syndrome, sensory nerve action potentials, acute sensory ataxic neuropathy, nerve conduction studies

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Abstract: Rhegmatogenous retinal detachment (RRD)is separation of neurosensory retina from retinal pigment epithelium with accumulation of sub-retinal fluid within the potential space in between. by a full thickness break in the neurosensory retina. Vitreous synresis needs to be there for seepage of SRF and detachment. Majority of RRD cases are caused by more than one retinal break, which needs to be kept in mind for appropriate surgical management. Myopia ,peripheral retinal degenerations, PVD, ocular trauma, previous cataract surgery are important predisposing factors. Patients may have RRD or break or lattice in the fellow eye representing an important risk of blateral visual loss. Facultative events in development............

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Abstract: Introduction : Breast cancer is considered as a systemic disease. Metastatic breast disease can involve any organ of the body with different proportion. Bone, Lung and liver are the most common involved sites. Despite therapeutic advances, metastatic breast cancer remains lethal. Some patient with metastatic breast cancer die within months after detection of systemic dissemination but some live for years with a high quality of life. Until now,consensus around the treatment of metastatic breast cancer has not been yet established. Therapeutic options for metastatic breast cancer are still controversial.........

Keywords: Breast cancer, metastatic sites, treatment

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Abstract: Sickle cell anaemia,a type of Haemoglobin disorder (Haemoglobinopathy) is associated with biochemical abnormalities. This study was aimed to evaluate urea and creatinine levels with renal impaired among sickle cell anemia patients attended into Kosti & Rabak teaching hospitals during period from August to October 2017. The study subject was 75 case (50 of them were children and 25 were adults). In 50 children (urea level were abnormal (increase) in 16 patients (32%) while its normal in 34 patients (68%) and creatinine level were abnormal (increase) in 8 patients (16%) while normal in 42 patients (84%). In 25 adult patients ( the urea level were normal in 25 patients (100%) . and creatinine level , abnormal (decreased) in 4 patients (16%) while normal in 21 (84%)............

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Abstract: Purpose – To evaluate macular thickness and peripapillary RNFL thickness to analyse and monitorglaucoma patient Material and method –The present study was conducted in 200 patients who attended OPD of upgraded department of ophthalmology,NSCB Medical college during academic session October 2015-November2017.All All selected patients underwent a complete examination including visual field examination by humphrey'sautomated perimeter and macular scan with retinal nerve fiber layer (RNFL) scan by Spectral Domain-OCT (SD-OCT)after taking proper history and other necessary clinical examination. Correlation of OCT data with visual field defect was evaluated. Result –Macular thickness and RNFL thickness values were significantly reduced in glaucomatous eyes(Avg.GCIPL58±13.19μm,min.GCIPL42.93± 16.92μm and Avg.RNFL thickness58.1415±.76μm) than in healthy eyes(Avg.GCIPL 81.31±4.64μm,min.GCIPL 77.99± 4.95μm and Avg.RNFL thickness91.91. ±6.85μm )and it was correlated well with visual field global indices like MD(-9.07± 6.23) and PSD(6.34±3.36) and average CD ratio (0.75± 0.09)........

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