iosr-JDMS   Volume-17 ~ Issue-3 ~ March-2018

Abstract: AIM & OBJECTIVES OF THE STUDY: • To evaluate the role of vitamin-D supplementation in management of diabetic retinopathy. • To assess retinal vascular changes in diabetic retinopathy patients taking vitamin-D supplementation. PATIENTS & METHODS: In the present study, role of vitamin D supplementation in management of diabetic retinopathy was analysed.47 diabetic retinopathy patients were taken according to inclusion criteria. After base line investigations 47 patients of either sex between 35-75 years were enrolled for the study and divided into two groups (group A and B). Patients with normal serum levels of vitamin D were kept under Group A (controls) & patients with low levels were kept under Group B........

[1]. "Diabetic retinopathy". Diabetes.co.uk. Retrieved 25 November 2012.

[2]. Kertes PJ, Johnson TM, eds. (2007). Evidence Based Eye Care. Philadelphia, PA: Lippincott Williams & Wilkins. ISBN 0-7817-6964-7.

[3]. Tapp RJ, Shaw JE,Harper CA,et al. (June 2003) The prevalence of and factors associated with diabetic retinopathy in the Australian population, Diabetes Care. 26 (6): 1731–7. doi:10.2337/diacare.26.6.1731 (inactive 2015-01-12). PMID 12766102.

[4]. Caroline MacEwen. diabetic retinopathy Retrieved August 2, 2011.

[5]. Engelgau, Michael, Linda Geiss, Jinan Saaddine, Jame Boyle,et.al. The Evolving Diabetes Burden in the United States Annals of Internal Medicine, 1 June 2004. Web. 22 Apr. 2014..

Abstract: Background: Management of femoral diaphyseal fractures in the age group of 6-16 years is controversial. There has been a resurgence worldwideforoperativefixation. Methods : Thirty pediatric patients in age group 6-16years with diaphyseal femoral fractures were stabilised with two titanium nails. Patients were followed up clinically and radiologically for 24 weeks. The final results were evaluated using the criteria of Flynn et al. Results : Overall results observed were excellent in 20, satisfactory in 9 and poor in 1 patients.
Hospital time averaged 13 days days in our study. All the fractures healed with an average time to union of 10 (7-14) weeks. The soft tissue discomfort near the knee produced by the nails ends was the most common problem encountered. Shortening was observed in one case and none of the cases hadsevere restriction of knee movements at the final followup......

[1] Heinrich SD, Drvaric DM, Darr K et al. The operative stabilization of pediatric diaphyseal femur fractures with flexible
intramedullary nails: A prospective analysis. J Pediatr Orthop. 1994; 14(4): 501-7.
[2] Stans AA, Morrissy RT, Renwick SE. Femoral shaft fracture treatment in patients age 6 to 16 years. J Pediatr Orthop. 1999; 19(2):
222-8.
[3] Clinkscales CM, Peterson HA. Isolated closed diaphyseal fractures of the femur in children: Comparison of effectiveness and cost
of several treatment methods. Orthopaedics. 1997; 20(12): 1131-6.
[4] Wright JG. The treatment of femoral shaft fractures in children: a systematic overview and critical appraisal of the literature. Can J
Surg. 2000; 43(3): 180-9.
[5] Flynn JM, Hresko T, Reynolds RA, et al. Titanium elastic nails for Pediatric femur fractures: A multicenter study of early results
with analysis of complications. J Pediatr Orthop. 2001; 21(1): 4-8.

Abstract: Non-depolarizing neuromuscular blocking agents like cisatracurium and atracurium differ in pharmacokinetic and pharmacodynamics parameters.Aim: To evaluate the safety profile and differences between cisatracurium and atracurium, widely used in adult patients for general anaesthesia. Materials And Methods: Adverse drug reactions (ADR) monitoringwere performed. Regardless of the type of surgery, 80 patients were randomly divided into two equal groups to receive either cisatracurium or atracurium for general anaesthesiaat Rajendra institute of Medical Science, Ranchi, Jharkhand, India during Feb 2017 to Nov 2017. Results:There was no statistical difference in the ADR prevalence in both groups. The numbers of ADR within atracurium group was higher than cisatracurium group, but this distinction was not statistically significant. Conclusions:According to our study atracurium and cisatracurium hadsimilar safety profile. In hemodynamic unstablepatients the cisatracurium was the appropriate choice.

Keywords:Cisatracurium, Atracurium, General anaesthesia

[1] Moore Ew, Hunter Jm. The New Neuromuscular Blocking Agents: Do They Offer Any Advantages. Br J Anaesth 2001; 87: 912-925.
[2] Mertes Pm, Laxenaire Mc. Adverse Reactions To Neuromuscular Blocking Agents. Curr Allergy Asthma Rep 2004; 4: 7-16.
[3] Bryson Hm, Faulds D. Cisatracurium Besilate. A Review Of Its Pharmacology And Clinical Potential In Anesthetic Practice.Drugs 1997; 53: 848-866.
[4] Sparr Hj, Beaufort Tm, Fuchs-Buder T. Newer Neuromuscular Blocking Agents How Do They Compare With Established Agents.Drugs 2001; 61: 919-942.
[5] Booij Lhdj. Neuromuscular Transmission And Its Pharmacological Blockade.Pharm World Sci1997; 19: 13-34..

Abstract: Introduction: Narcotic analgesics in spite of their disadvantages, maintain the supremacy in peripheral nerve block. Butorphenol is one of the potent narcotics used by various routes in postoperative period. Supraclavicular approach of brachial plexus block is a very popular technique of anaesthesia for upper limb surgeries. Various opioids have been used as additives to improve and prolong the perioperative analgesia. Fentanyl is commonly added to bupivacaine which results in increased duration of blockade. Materials and Methods: After exclusion criteria and informed consent 90 patients posted for routine or emergency forearm and hand surgeries were included after randomization with coin test. They were divided into 3 groups. Group 1 received 40 ml of 0.25% bupivacaine with 1 ug/kg fentanyl. Group 2 received 40 ml 0.25% bupivacaine with 30ug/kg butorphenol........

Keywords: Butorphenol

[1] Lawhorn CD et al. Caudal epidural butorphanol with bupivacaine in pediatric genitourinary procedures Journal Clinical anaesthesia 1997; 9 (2): 103-108
[2] David LB, Donald RC, Donald B et al Supraclavicular nerve block: Anatomic analysis of a method to prevent pneumothorax Anaesthesia and Analgesia 1993; 76: 530-534
[3] Nishikawa K, Kanaya N, Nakayama M, et al. Fentanyl improves analgesia but prolongs the onset of axillary brachial plexus block by peripheral mechanisms Anesth Analg 2000; 91: 384-387
[4] Karakaya D, Buyukgoz F, Baris S. Addition of fentanyl to bupivacaine prolongs anaesthesia and analgesia in axillary plexus block Regional Anaesthesia Pain medicine 2001; 26 (5): 434-438.
[5] Kapral S, Gollmann G, Waltl B et al Tramadol added to mepivacaine prolongs the duration of axillary brachial plexus block Anaesthesia and analgesia 1999; 88: 853- 856

Abstract: Background: Most children with HIV infection are not on antiretroviral drugs because their HIV status are not known. Provider-Initiated Testing and Counselling strategy aims at bridging this gap. The purpose of the present study was to determine the clinical and immunologic profile of HIV infection at presentation in the children detected to have HIV infection using PITC Strategy. Method:A hospital-based cross-sectional study. Consecutive new patients from birth to age of 15 years with unknown HIV sero-status who presented at the Paediatric Emergency Unit of FMC, Ido-Ekiti during the study period were offered HIV testing using PITC strategy.All the patients were clinically evaluated before the HIV test was done. Patients were examined for signs of HIV infectionbased on the revised WHO Paediatric Clinical Staging of HIV/AIDS Disease. Results: Common symptoms in children with HIV infection were fever, diarrhoea, fast breathing, cough, and poor weight gain/failure andcommon.......

Keywords: PITC strategy, Clinical features of HIV, Children Emergency Unit

[1] Bakaki P, Kayita J, Machado J, Coulter J, Tindyebwa D, Ndugwa C, et al. Epidemiologic And Clinical Features Of HIV-Infected And HIV-Uninfected Ugandan Children Younger Than 18 Months. J Acquir Immune DeficSyndr2001;28:35-42.
[2] Adejuyigbe EA, Oyelami O, Onayemi O, Durosinmi MA. Paediatric HIV/AIDS in Ile-Ife, Nigeria. Cent Afr J Med 2003;49:74-8.
[3] Asindi A, Ibia E. Paediatric AIDS InCalabar. Nig J Paediatr1992;19:47-51.
[4] Muganga N, Nkuadiolandu A, Mashako LM. [Clinical manifestations of AIDS in children in Kinshasa]. Pediatrie1991;46:825-9.
[5] Emodi IJ, Okafor GO. Clinical manifestations of HIV infection in children at Enugu, Nigeria. J Trop Pediatr1998;44:73-76.

Abstract: Objective: This study was carried out to compare the efficacy of intravenous tramadol injection and intercostal nerve block with 0.5% bupivacaine injection for control of chest pain in multiple rib fractures. Methods: Prospective randomized study of intercostal nerve block (ICNB) with 0.5% bupivacaine group (n=30) and the intravenous tramadol (IVT) injection group (n=34). Results: There were 64 adult patients who were studied with multiple rib fractures caused by blunt chest trauma. Before analgesia, 33.3% and 66.7% of patients in the ICNB group rated their pain as moderate and severe respectively while 29.4% and 70.6% of patients in the IVT group rated their pain as moderate and severe respectively (p= 0.917). However at one hour post commencement of analgesic, 13.3%, 70%,........

Keywords: Blunt chest injury; Intercostal nerve block; Multiple rib fractures; Pain control; Systemic analgesia.

[1]. Ho AM, Karmakar MK, Critchley LA. Acute pain management of patients with multiple fractured ribs: a focus on regional techniques. Curr Opin Crit Care. 2011; 17: 323-7.
[2]. Bulger EM, Arneson MA, Mock CN, et al. Rib fractures in the elderly. J Trauma. 2000; 48: 1040–1047.
[3]. Osinowo OA, Zahrani M, Softah A. Effect of intercostal nerve block with 0.5% bupivacaine on peak expiratory flow rate and arterial oxygen saturation in rib fractures. J Trauma 2004; 56: 345–347.
[4]. Karmakar, MK., Ho, AM. Acute Pain Management of Patients with Multiple Fractured Ribs. J Trauma, Injury, Infection, and Crit Care Issue 2003; 54: 615-625
[5]. Ekpe EE, Eyo C. Overview of Blunt Chest Injury with Multiple Rib Fractures. BJMMR 2015; 12 (8): 1-15.

Abstract: Background: The Recent Studies Have Reported Outstanding Results Concerning Medical Expulsive Therapy (MET) For Lower Ureteric Stone In Terms Of Stone Expulsion And Control Of Colic Pain. Therefore We Conducted A Prospective Randomized Controlled Study To Evaluate The Role Of Tadalafil In Comparison Of Placebo In Lower Ureteric Stone Expulsion. Objective: To Evaluate The Role Of Phosphodiesterase 5 Inhibitor (Tadalafil) 10mg In Conservative Therapy For Patients With Lower Ureteral Stones. Patients And Methods: From September 2016 To August 2017, 60 Consecutive Symptomatic Patients With Unilateral Lower Ureteric Stone From The Urology And Nephrology Department In Pgims Rohtak Were Enrolled In This Randomized Prospective Placebo Controlled Study. Patients Were Randomly Divided Into Two Groups, Group 1 (N=30) And Group 2 (N=30). Group.......

Keywords: Tadalafil, Lower Ureteric Stone, Medical Expulsive Therapy

[1] Norlin A, Lindell B, Granberg PO, Lindvall N.Urolithiasis:A study of its frequency, Scand J Urol Nephrol. 1976; 10: 150-153.
[2] Manglaviti G,Tresoldi S et al. In vivo evaluation of chemical composition of urinary stone using dual energy CT.AJR Am J Roentgenol 2011; 197: W76-83.
[3] Hollingsworth, John M et al. Medical therapy to facilitate urinary stone passage: a meta-analysis. The Lancet , Volume 368 , Issue 9542 , 1171 – 1179.
[4] Ueno A, et al. Relation of spontaneous passage of ureteral calculi to size. Urology. 1977 Dec; 10(6):544-6.
[5] Porpiglia F, et al .Corticosteroids and tamsulosin in the medical expulsive therapy for symptomatic distal ureter stones: single drug or association?Eur Urol. 2006 Aug;50(2):339-44...

Abstract: Brachytherapy for cervical cancers presents the anesthetist with numerous challenges, which differ radically from those during routine surgery. Patients scheduled for brachytherapy are often elderly with comorbid diseases that may preclude major surgery and pose a high risk for perioperative complications. Intracavitary and interstitial brachytherapy procedures are extremely painful and require both profound analgesia and immobilization. Furthermore, these patients have to be shifted through radiology treatment planning and internal radiotherapy while still fully sedated and immobile.Total intravenous anesthesia (TIVA) is an ideal technique for brachytherapy as it is safe under monitored care and permits quick turnover of patients. TIVA is easy to administer, permits early return of patients to their homes and is considerably less embarrassing to the female patient group when compared to neuraxial techniques.

Keywords: Brachytherapy, cancer cervix, anesthesia, TIVA

[1] National Cancer Registry, New Delhi report for 2002. p 18-9
[2] Wollschläger K, Connell PP, Waggoner S, Rotmensch J, Mundt AJ. Acute problems during low-dose-rate intracavitary brachytherapy for cervical carcinoma. Gynecol Oncol 2000; 76: 67–72
[3] Petereit DG, Sarkaria JN, Chappell RJ. Perioperative morbidity and mortality of high-dose-rate gynecologic brachytherapy. Int J Radiat Oncol Biol Phys 1998; 42: 1025–31
[4] Lim KH, Lu JJ, Wynne CJ, et al. A study of complications arising from different methods of anesthesia used in high-dose-rate brachytherapy for cervical cancer. Am J Clin Oncol 2004; 27: 449–51
[5] Smith MD, Todd JG, Symonds RP. Analgesia for pelvic brachytherapy. Br J Anaesth 2002; 88: 270–6

Abstract: Introduction : Hemisection of a mandibular molar is a treatment modality when the decay is constrained to one root and the other root is healthy. In this, a mandibular molar is sectioned into two halves followed by removal of the diseased root along with its coronal portion. The retained root is endodontically treated and its furcation area is made self-cleansable by proper cleaning and debridement. Case report: This case report contains 3 cases with periodontally compromised mandibular molar which is not restorable by root canal treatment alone, which was managed by hemisection and with the various prosthetic treatment option. Result: The patients were followed for a period of 1 year .Adequate healing was seen with reduction of mobility. Conclusion: This treatment can produce predictable results as long as proper case selection is followed by an interdisciplinary approach with endodontic, surgical and prosthetic procedures.

Keywords: Fixed-Movable Bridge,Fixed partial denture, furcation involvement, hemisection,,Inlay

[1] Basaraba N. Root amputation and tooth hemisection. Dent Clin North Am 1969;13:121-32.
[2] Newell DH. The role of the prosthodontist in restoring root resected molars: A study of 70 molar root resections. J Prosthet Dent 1991;65:7-15.
[3] Kurtzman GM, Silverstein LH, Shatz PC. Hemisection as an alternative treatment for vertically fractured mandibular molars. Compend Contin Educ Dent 2006;27:126-9.
[4] Weine FS. Endodontic Therapy, 5 th ed. St. Louis: Mosby; 1996
[5] Kost WJ, Stakiw JE. Root amputation and hemisection. J Can Dent Assoc 1991;57:42-5..

Abstract: Chronic erythematous lesions of the penis may result from a variety of underlying causes that form a part of differential diagnosis. They are difficult to diagnose only upon clinical examination and may necessitate performing a biopsy to confirm the diagnosis and also identify the coexisting disease. We report a case of erythroplasia of Queyrat (EQ) with Zoon's balanitis and discuss the classification of the lesion through the analysis of overlapping histological features. A middle-aged uncircumcised man presented with two long-standing erythematous prepucial penile lesions unresponsive to antibiotics. Biopsy performed to establish the diagnosis revealed non-invasive severe dysplastic changes in the epithelium that is typical of EQ..

[1] Mikhail GR. Cancers, precancers, and pseudocancers on the male genitalia. J. Dermatol. Surg. Oncol. 1980; 6: 1027–35.
[2] Davis-Daneshfar A, Trüeb RM. Bowen's disease of the glans penis (Erythroplasia of Queyrat) in plasma cell balanitis. Cutis 2000; 65: 395–8.
[3] Joshi UY. Carcinoma of the penis preceded by Zoon's balanitis. Int. J. STD AIDS 1999; 10: 823–5.
[4] Mallon E, Hawkins D, Dineen M, Francis N, Fearfield L, Newson R, Bunker C. Circumcision and genital dermatoses. Arch. Dermatol. 2000; 136: 350–4.
[5] Bunker CB. Topics in penile dermatology. Clin. Exp. Dermatol. 2001; 26: 469–79.