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

Abstract: OBJECTIVES: To compare the outcome of lay open versus primary closure technique of pilonidal sinus (PNS) in terms of bleeding, infection, hospital stay, wound healing and recurrence. METHODOLOGY: This study was conducted at the surgical outpatient clinic in Hyderabad ,India during the period February 2013 to February 2016. The study included Sixty four cases of pilonidal sinus. The choice of surgical procedure was given to the patient with consent form. Patients were followed up till 1 years for post complications and recurrence. Statistical analysis was done using chi square test. RESULTS: Out of 64 patients, 53 were male (83 %) and 11 were female (17%) with the mean age of 28+/-6 years. 37% patients opted lay open procedure and 27% primary closure technique. 44% of patients presented with painless discharging sinus and 31% showed only sinus without discharge. In terms of duration of stay in hospital in lay open method is of 4 Days and 2 days for primary closure technique. The statistical analysis showed significant p value. In terms of healing, it took a average of 6 weeks...........

Keywords: lay open method, primary closure, pilonidal sinus disease, postoperative bleeding, recurrence, surgical management.

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Abstract: Background: Dental anxiety as a state anxiety and a psychological barrier can affect dental health status of individuals and dentist–patient relationship. Objectives: 1.To determine personality type using Eysenck's personality test; 2.To determine the level of dental anxiety using Corah's DAS; 3.To determine the correlation between dental anxiety and attendance patterns Materials and Methods: A total of 250 questionnaires consisting of Eysenck's Personality Test, Corah's Dental Anxiety Scale and an item on attendance patterns were distributed among 250 dental patients (response rate 92.4%, n=231). Descriptive test, statistical analysis and Pearson's correlation coefficient were used to search for statistically significant correlations. Results: 140 (60.61%) of the representatives were with low DA, 65 (28.14%) - moderate DA, 14 (6.06%) - high DA and 12 (5.19%) - severe DA. as results showed there was a negative correlation between Extroversion - introversion and neuroticism-stability and........

Keywords: attendance pattern, dental anxiety, personality traits

[1]. Poulton, R., Waldie, K., Thomson, M., Locker D. Determinants of early- vs late-onset dental fear in a longitudinal-epidemiological study. Behaviour Research and Therapy 2001 Jul; 39 (7): 777–785
[2]. Poulton, R., Waldie, K. E., Menzies, R. G., Craske, M. G., & Silva, P. A. Failure to Overcome "Innate" Fear:a Developmental Test of the Non-Associative Model of Fear Acquisition. Behaviour Research and Therapy 2001Jan; 39 (1):29-43
[3]. Pohjola, V., Lahti, S., Vehkalaht, M., Tolvanen, M., Hausen, H. Age-specific associations between dental fear and dental condition among adults in Finland. Acta Odontologica Scandinavica 2008; 66: 278-285
[4]. Akarslan, Z., Erten, H., Uzun, O., İşeri E., Topuz O. Relationship Between Trait Anxiety, Dental Anxiety And DMFt Indexes Of Turkish Patients Attending A Dental School Clinic. Eastern Mediterranean Health Journal 2010; 16 (5):558-562
[5]. Fuentes, D., Gorenstein, C., Hu, L. W. Dental Anxiety and Trait Anxiety: an Investigation of Their Relationship. Br Dent J. 2009 Apr 25; 206(8):E17

Abstract: Though incidence of Gall bladder carcinoma is most common biliary tract cancers, nonspecific presenting symptom, late detection of the disease add to the dismal prognosis We tried to find association between intercellular adhesion and propagation of cancer cell in Adenocarcinoma of Gall bladder. E-cadherin (ECAD) is the strongest intercellular adhesion molecule of epithelial cells and Autocrine Motility Factor (AMFR) is known propagator of cancer cell. In retrospective study, Weevaluated simultaneous immunohistochemical expression of these two molecules in 92 cases who were treated surgically byCholecystectomy with or without lymph node dissection.NormalGall bladder mucosa reacted strongly with ECAD and weakly with AMFR. With increasing dedifferentiation of the tumour, reversal manifested- more aggressive grades showed varied......

Keywords: Gall bladder carcinoma, E- cadherin , Autocrine Motility factor Receptor

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Abstract: PSP-Progressive supranuclear palsy is a clinical syndrome comprising of supranuclear palsy,postural instability and mild dementia. Since the first description of PSP several distinct clinical syndromes have been described.The aim of our study was to find out the prevalence of these clinical subtypes and their clinical course among patients with PSP(10 Italic).

Keywords: PSP, tau protein, PSP-P,PAGF,PSP-CBS,PSP-PNFA

[1]. HauwJJ,Daniel SF,Dickson D et alPreliminary NINDS neuropathologic criteria for Steele Richardson Olszewski Syndrome-Neurology 1994,44;2015-2019
[2]. Williams DR.Lees AJ,Wheeeeeeerrett JR,SteeleJC,J.Clifford Richardson and 50 years ofsupranuclearpalsy,Neurology008;70;566-73
[3]. Williams DR,HoldenJL,StrandK.Lees AJ.Pure akinesia with gait freezing;A third clinical phenotype of progressive supranuclear palsy Movement disorder 2007;22;2235-41
[4]. Ahmed Z,Josephs KA,Gonzles J,Delle Donne A,Dickson DW;clinical and neuropathological features of supranuclear palsy with severe pallid nigro luysial degeneration and axonal dystrophy,Brain 2008;131;460-72
[5]. Joseph KA,BoeveBF,Duffy JR,SmithGE,KnopmanDS,Parisi JE,etal-Atypical Progressive supranuclear palsy underlying progressive apraxia of speech and nonfluent aphasia,Neurocase 2005;11;283-96

Abstract: With modern surgical techniques and perioperative antibiotics, spinal infection after surgery is relatively uncommon. Certain patient and surgical treatments are however at higher risk and should be treated with extra caution. Surgical site infection (SSI) following spine surgery is a dreaded complication with significant morbidity and economic burden. SSIs following spine surgery can be superficial, characterized by obvious wound drainage or deep-seated with a healed wound. Staphylococcus aureus remains the principal causal agent. There are certain pre-operative risk factors that increase the risk of SSI, mainly diabetes, smoking, steroids, and peri-operative transfusions. Additionally, intra-operative risk factors include surgical invasiveness, type of fusion, implant use, and traditional instead of minimally invasive approach. A high level of suspicion is crucial to attaining an early........

Keywords: Surgical Site Infection,Spinal Wound Infection,post-procedural discitis, imaging, risk factors, Staphylococcus aureus, inflammatory markers.

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Abstract: Trypan Blue used to stain the anterior capsule in the step of capsulorrhexis inadvertently stained the cornea intrastromally in a 44-year-old male patient. It resulted in pockets of blue dye and air in the corneal stroma. Case was postponed in view of poor visibility for performing further steps. Stromal edema and bluish discoloration almost completely disappeared on 15th day following conservative management with topical antibiotic-steroid, sodium chloride eye drops, and cycloplegics. The patient was operated after 15 days and had a good postoperative vision. This was a rare complication of cataract surgery that occurred due to improper paracentesis, when Trypan Blue was injected under air bubble by placing the cannula at the edge of the wound..

Keywords: anterior capsule, capsulorrhexis, paracentesis, stromal edema, trypan blue

[1] MellesGR, de WaardPW, PameyerJH, Houdijn BeekhuisW. Trypan blue capsule staining to visualize the capsulorrhexis in cataract surgery. J Cataract Refract Surg, 1999; 25:7–9.
[2] Fritz W et al. Fluorescent blue light assisted capsulorrhexis for mature and hypermature cataract. J Cataract Refract Surg 1998; 24:19-20.
[3] PandeySK, WernerL, Escobar-GomezM, Roig-MeloEA, AppleDJ. Dye-enhanced cataract surgery. Part 1: anterior capsule staining for capsulorhexis in advanced/white cataract. J Cataract Refract Surg 2000;26:1052–1059.
[4] TebaFA, MohrA, EckardtC, et al. Trypan blue staining in vitreoretinal surgery. Ophthalmology 2003;110:2409–2412.
[5] FeronEJ, VeckeneerM, Parys-Van GinderdeurenR, Van LommelA, MellesGR, StalmansP. Trypan blue staining of epiretinal membranes in proliferative vitreoretinopathy. Arch Ophthalmol 2002;120:141–144

Abstract: Hepatitis E virus is one of the leading causes of acute liver failure in clinical situation especially in immune-compromised patients , it has a high incidence in Asian countries and many people died due to lack of proper treatment . In this study , steroid (prednisolone ) was used as therapeutic challenge in such patients and significant improvement in clinical and biochemical parameters were found ( SGPT , prothrombin time and total bilirubin ) . This observational study highlights the possibility of steroid treatment as a therapeutic rescue in patients with hepatitis E. Further studies are required to evaluate whether steroid treatment has a supportive role for patients with HEV induced acute liver injury and improves their spontaneous outcome..

Keywords: hepatitis E , steroid (prednisolone ) , SGPT , Prothrombin time

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[3]. Bernal W, Wendon J. Acute liver failure. N Engl J Med. 2013;369:2525–2534

[4]. Khuroo MS, Kamili S. Aetiology and prognostic factors in acute liver failure in India. J Viral Hepat. 2003;10:224–231

[5]. Alam S, Azam G, Mustafa G, et al. Natural course of fulminant hepatic failure: the scenario in Bangladesh and the differences from the west. Saudi J Gastroenterol. 2009;15:229–233.

Abstract: Aim- To assess the parental knowledge and awareness about malocclusion in their children. Method- Parents of 500 children (289 male and 211 females) aged between 6-16 years, coming to the Department OPD were included in this study. Questionnaires were presented to the parents and their knowledge and awareness regarding malocclusion in children were assessed. Result- Out of 500, 88.4% didn't aware about irregular teeth in a child. 58.8% parents agreed that problems of primary teeth can affect permanent teeth. 84.2% of parents were not aware of maintaining primary teeth to prevent irregular arrangement of teeth in a child. However, for 61.4% maintaining space was the main purpose of primary teeth and preserving carious primary teeth was more favoured rather than extraction. Most of the parents didn't know any kind of oral habit causing irregular teeth in children. Aesthetics was chosen.......

Keywords: Irregular teeth ,KAP Study, Malalignment, Questionnaire.

[1]. Pandey M. Singh J, Mangal G, Yadav P. Evaluation of awareness regarding orthodontic procedures among a group of pre-adolescents in a cross sectional study. J Int Soc Prevent Communit Dent, 4, 2014, 44-7.
[2]. Kaur B. Evaluation of oral health awareness in parents of pre-school children. Indian I Dent Res, 20 (4), 2009, 463-465.
[3]. Green W, Kreuter M, Health promotion planning: an educational and ecological approach. 3rd edition. Mountain view, CA: Mayfield Pub. Co., 1999.
[4]. Chhabra N. and Chhabra A. parental knowledge, attitudes and cultural beliefs regarding oral health and dental care of pre- school children in an Indian population: a quantitative study. European Archives of Paediatric Dentistry ,13 (2), 2012, 76-82.
[5]. Okada M , Kawamura M, Kaihara Y et al. Influence of parents on oral health behaviour on oral health status of their school children: an exploratory study employing a casual modelling technique. Int J Paediatr Dent 12, 2002, 101-08.

Abstract: A total of 50 eyes of 25 healthy subjects, comprising 20 eyes with moderate to high myopia (spherical equivalent [SE] >-3.00 D) and 30 eyes with low myopia (SE between -0.50 D and -3.00 D), were analyzed in this cross-sectional study. Total average and mean quadrant RNFL thicknesses were measured by Stratus OCT and associations between RNFL measurements and spherical equivalent refraction were evaluated by linear regression analysis. The RNFL measurements were significantly lower in the moderate to high myopia group compared with those of the low myopia group. Significant correlations were evident between RNFL measurements and the spherical equivalent. The average RNFL thickness decreased with increasing negative refractive power ( P = 0.000). Out of 50 eyes 13 were classified as below normal limits and 15 as borderline with reference to the.......

Keywords: Myopia, Retinal nerve fiber layer, Optical coherence tomography, Stratus OCT, Refractive error conflict of interest-Nil

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Abstract: Although psychiatruc ailments following childbirth have been recognised since the time of Hippocrates, there has been a lot of controversy as to its claim as a separate entity. Pregnancy and the post partum period are generally regarded as maturational crises equal in importance to those of adolescence and menopause. Post partum period is considered to be a vulnerable period since a woman is more prone to dvelop different types of psychiatric disturbances. Various studies document a marked increase in prevalence of psychosis, following childbirth. The post partum period is a time when significant increase in psychiatric disorder, especially of depressive nature are known to occur.1,2 Apart from frank psychosis, two non-psychotic disorders have been noted, a dysphoric state in early puerperium (blues) and an increased incidence of depressive symptomatology in the ensuing months. Pitt1 suggested that postnatal depression.............

[1]. Pitt, B. (1968) Atypical depression following childbirth. Brit J Psy 114;1325-1335. Pitt, B. (1973) Maternity blues. BJP April 1973, 122;431-433.
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Abstract: Tuberculosis (TB), one of the oldest known diseases and still a major cause of mortality today, many other organ systems such as the bone and central nervous system are manifested and affected by the disease. It is caused by a closely-related group of organisms, all of which form the Mycobacterium tuberculosis complex. These organisms include M. tuberculosis, M. bovis, M. africanum, M. microfti and M. canett. A cross sectional comparative study was conducted to assess the efficacy of the different diagnostic method of pulmonary tuberculosis of sputum samples from patients suspected of pulmonary tuberculosis. The study was conducted in the period from Feb 2015 to May 2016. Early morning sputum samples were collected in clean, sterile, leak proof, wide mouth containers and sent to the laboratory without delay........

Keywords: Auramine O , Flourescent , Genexpert , Tuberculosis, Ziehl-Neelsen.

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[2]. Ba F and Rieder HL (1999) A comprision of flurescence microscopy with the Zeihl-Neelson technique in the examination of sputum for acid-fast bacilli, Int J Tercle Lung Disease.; 3 (12): 1101-5.
[3]. Abdul Hakeem, Muhammad Shahbaz Hussain , Muhammad Imran Sarwar Gene Xpert MTB/RIFANovel Diagnostic Tool for Tuberculosis in Pulmonary Samples IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-ISSN: 2279-0853, p-ISSN: 2279-0861. Volume 8, Issue 2 (Jul.- Aug. 2013), PP 01-03 www.iosrjournals.org www.iosrjournals.org 1 | Page .
[4]. Mostaza J L, Garcia N, Fernandez S, Bahamonde A, Fuentes M I, Palomo M J. Analysis and predictor of delay in suspicion and treatment among hospitalized patients with pulmonary tuberculosis. An Med Interna. 2007.
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Abstract: The nutritional status of preschool children in urban and rural areas of Benin City, Edo State was investigated. Preschool children aged between 3 and 5 years were selected from nursery schools in urban (n= 150) and rural (n= 150) areas. Nutritional status was assessed using anthropometric measurements of height, weight and arm circumference and was compared with NCHS standards. Dietary assessment was based on weighed inventory method and 24 hours recall obtained from their mothers. The nutrient intakes were compared with the RDA. Validated questionnaires were also used to collect data on their socioeconomic status obtained from the mothers. Data was analyzed using SPSS version 10. There were no significant differences between the males and females in both the rural and urban.......

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Abstract: Introduction: Despite tremendous efforts to control tuberculosis (TB), it is still a major public health problem in Nigeria.Nigeria is among the six countries that contributed 60% of all new TB cases in 2015 and remains among the 22 high burden countries. National Tuberculosis Control Programme has continued to work towards controlling TB epidemic by expanding DOTS treatment and microscopic centers across the country.Data about knowledge and attitude of healthcare workers especially at the primary health care level where the majority of TB patients resides is scarce in Nigeria. Thus, a detailed understanding of the factors associated with the knowledge of and attitude towards TB among primary healthcare (PHC) workers is needed to support case detection and reduce TB-related morbidity.......

Keywords: Tuberculosis, knowledge, attitude, practice, PHC workers.

[1]. WHO. (2014). Global Tuberculosis Report 2014. World Health Organization.apps.who.int/iris/bitstream/10665/137094/1/9789241564809_eng.pd

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Abstract: Introduction: Knowledge of most prevalent uropathogens in a geographic area is vital for treating clinicians of that area to make better choice of empirical antibiotics. In addition, insight on how these frequently occurring uropathogens affect males and females of the community can be helpful for health-related decision makers to implement better preventive health approaches to decrease the prevalence of UTI in that susceptible gender. This study primarily aims to touch upon these targets. Methods: This cross-sectional study was done retrospectively using positive urine culture reports of 140 patients tested between January 2011 to January 2014 in a tertiary care health facility in........

Keywords: UTI, Uropathogens, Antibiotics, Susceptibility, Mumbai

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[5]. Prais D, Straussberg R, Avitzur Y, Nussinovitch M, Harel L, Amir J. Bacterial susceptibility to oral antibiotics in community acquired urinary tract infection. Arch. Dis. Child. 2003;88:215–8.

Abstract: Granulomatous mastitis (GM) is an uncommon chronic inflammatory disease of breast of undetermined etiology. Despite its low incidence, it has gained importance since it mimics breast carcinoma. There is still no definite treatment modality for this condition. Treatment with corticosteroids and/or wide excision is most frequent mode of therapy reported in the literature. We report a case of granulomatous mastitis in a 38-years-old female, who had presented with swelling in her left breast for 2 months. She had a past history of incision and drainage for the same complaint 3 months back. Presently, she was clinically diagnosed as a case of antibioma and underwent lumpectomy. Since it is a rare disease with chances of recurrence, ensuring appropriate diagnosis and optimum treatment is essential.

Keywords: Idiopathic granulomatous mastitis, Breast abscess, Inflammatory mastitis, Lobulocentric granulomas of breast.

[1]. Kessler E, Wolloch Y. Granulomatous mastitis: a lesion clinically simulating carcinoma. Am J Clin Pathol 1972;58(6): 642–646. [2]. Aldaqal SM. Idiopathic granulomatous mastitis. Clinical presentation, radiological features and treatment. Saudi Med J. 2004;25(12):1884-7.
[3]. Baslaim MM, Khayat HA, Al-Amoudi SA. Idiopathic granulomatous mastitis: a heterogeneous disease with variable clinical presentation. World J Surg 2007;31(8):1677–1681.

[4]. Yukawa M, Watatani M, Isono S, Fujiwara Y, Tsujie M, Kitani K et al. Management of Granulomatous Mastitis: A Series of 13 Patients Who Were Evaluated for Treatment Without Corticosteroids. Int Surg 2015;100:774–782.

[5]. Akcan A, Akyildiz H, Deneme MA, Akgun H, Aritas Y. Granulomatous lobular mastitis: A complex diagnostic and therapeutic problem. World J Surg. 2006;30:1403–1409.

Abstract: Introduction:Oral lichen planus (OLP) is a relatively common inflammatory mucocutaneous disorder that frequently involves the oral mucosa. The clinical presentation of OLP ranges from mild painless white keratotic lesions to painful erosions and ulcerations. An important complication of OLP is the development of oral squamous cell carcinoma, which led the World Health Organization (WHO) to classify OLP as a potentially malignant disorder. Objective: The present clinical study was carried out to clarify the demographic and clinical profile of 216 patients with OLP. Materials and Methods:The patients were identified based on the diagnostic criteria proposed by van der Meij et al. (2003), modified from the WHO's......

Keywords: demography; diagnosis; lichen planus; oral mucosa; precancerous conditions

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Abstract: Hip pain, pelvic pain and low back pain (LBP) are common conditions during pregnancy and postpartum. Certain numbers of cases of transient osteoporosis of hip (TOH) have been reported in the literature, but its real prevalence seems to be underestimated. We report a case of 31-year-old patient who presented during postpartum period (two weeks after delivery) with severe right hip joint pain and radicular symptoms which mimics lumbar radiculopathy. On request of an Magnetic Resonance Imaging (MRI) scan of lumbar-sacral spine, short tau/TI inversion recovery (STIR) coronal sequence was also performed which ultimately led to the identification of features of TOH. The use of coronal STIR sequence in addition to the routine sequences of lumbar-sacral imaging was paramount of importance in diagnosing the condition.Patient was treated conservatively, with partial resolution of symptoms.

Keywords:Low Back Pain, Lumbar Sacral Imaging, MRI, STIR Imaging, Transient Osteoporosis of Hip

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[2]. V. Patel, S. Temkin, and M. O'Loughlin. Transient osteoporosis of pregnancy in a 34-year-old female. J Radiology Case Reports, 7(2), 2012, 646-649.

[3]. M.E. Reese, C. Fitzgerald, C. Hynes, Transient osteoporosis of pregnancy of the bilateral hips in twin gestation: a case series. J Physical medicine and Rehabilitation, 7(1), 2015, 88-93.

[4]. M.E. Klontzas, , E.E. Vassalou, A.H. Zibis, A.S. Bintoudi, A.H. Karantanas, MR imaging of Transient Osteoporosis of the hip: an update on 155 hip joints, Eur J Radiol., 84(3), 2015, 431-436.

[5]. T. Anai, K. Urata, A. Mori, F. Miyazaki, S. Okamoto,Transient osteoporosis of the hip in pregnancy associated with generalized low bone mineral density--a case report, Eur J Radiol, 76(2), 2013, 133-138.

Abstract: Secondary hyperparathyroidism (sHPTH) is one of the most common complications of CKD (chronic kidney disease), which alters the mineral balance with the development of bone mineral disorders and soft tissue calcifications. The treatment of bone-mineral disorders requires continuous monitoring of Ca-P exchange, PTH (parathyroid hormone), serum Vitamin D levels and the protein bone markers - osteocalcin, bone alkaline phosphatase - BAP. In the Clinic of Dialysis at University Hospital "St. Marina " are followed and compared serum biomarker levels - BAP, Osteocalcin, Vit D in two groups of patients-dialysis and CKD patients in 2 and 3 stage with sHPTH. The results show statistically significant differences between the mean values of the two groups and between female and male in the tested serum levels of the indicators..

Keywords: biomarkers, hemodialysis treatment , predialysis stage, secondary hyperparathyroidism

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Abstract: Background: High tibia osteotomy is a common procedure in correcting genu varum deformity. The proximal tibial osteotomy is an accepted and commonly used treatment for younger and active patients with medial unicompartmental osteoarthritis of the knee and varus deformity. The aim is to achieve 2-8 degree of valgus over correction and to achieve good long-term outcomes.Materials and Methods: A prospective analysis was performed on patients treated with high tibial osteotomy using dynamic axial fixator for tibiavarum deformity in our hospital from August 2015 to October 2017. There were 6 cases [7 knees] including 4 males and 2 females.Unilateral external fixator (dyanamic axial fixator) was placed on the medial side. In all cases incomplete percutaneous oblique infratubercle osteotomy was done. The osteotomy was gradually distracted using the fixator to achieve correction of deformity.Results: Correction of deformity was achieved in all patients without any major complications.Conclusion:Distraction of infra-tubercle osteotomy using dyanamic axial fixator for correction of genu varum by high tibial osteotomy gave good results in all the knees with the advantage of modifying the degree of correction.

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