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

Abstract: Pituitary Apoplexy Is A Rare Event In Iiird Trimester. A 34 Year Female Presented With Headache, Sudden Onset Blurring Of Vision With Diplopia, Ptosis, During The Third Trimester Of Pregnancy. Mri Demonstrated Pituitary Apoplexy With Chiasmal Compression And Left Optic Nerve Compression. Bilateral Internal Carotid Artery (Ica) Is Laterally Displaced. On Right Side, Lesion Is Encasing Right Internal Carotid Artery (Ica) Circumferentially And Extending Into Right Cavernous Sinus Upto Right Orbital Apex. After Giving Intravenous Beclomethasone For Lung Maturation Of Foetus, Sublabial (Oro-Rhinoseptal) Transsphenoidal Pituitary Tumour Decompression Was Done. Pre-Operatively And Intraoperatively, Uterine Relaxant Was Given. During Pituitary Surgery, Foetal Heart Rate Starts Decreasing, So Emergency Ceasarean Section Was Done And 1 Live Foetus Was Delivered.

[1]. Motivala S, Gologorsky Y, Konstandinovj, Post K 2011 Pituitary Disorders During Pregnancy. Endocronology And Metabolism Clinicsof North America.40:827-836.
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[2]. Rajsekaran S, Vanderpump M, Baldeweg S, Drake W, Reddy N, Lanyon M, Markey A, Plant G, Powell M, Sinha S 2011. Uk Guidelines For The Management Of Pituitary
[3]. Apoplexy. Pituitary Apoplexy Guidelines Development Group: May 2010. Clinical Endocrinology. 74:9-20 [5]. Semple P, Webb M, Devilliers J, Laws E 2005 Pituitary Apoplexy. Neurosurgery. 56: 65- [6]. 73.
[4]. Verrees M Arafah B, Selman W 2004 Pituitary Tumor Apoplexy: Characteristics, Treatment And Outcomes. Neurosurgical Focus. 16: Article 6.

[5]. Randeva H, Schoebel J, Bryne J, Esiri M, Adams C, Wass J 1999 Classical Pituitary Apoplexy:Clinical Features, Management And Outcome. Clinical Endocrinology. 52: 181-188..

Abstract: Background: Dry eye disease is a multifactorial disease of the tear film and ocular surface that results in symptoms of discomfort, visual disturbance and tear film instability with potential damage to the ocular surface. DED is a frequent cause of ocular irritation and wide variety of presenting symptoms that makes the patient to visit the ophthalmologist. It is often unrecognized leading cause for significant visual morbidity. It is important to detect the DED early so as to improve the patient comfort and minimize structural damage to ocular surface. There are various studies showing that the prevalence of dry eye disease with different diagnostic criteria is between 18.4% and 40.8%. The purpose of present study is to establish the prevalence of DED in patients presenting with symptoms suggestive of Dry eye. Aims and Objectives:- To determine the prevalence of dry eye in symptomatic patients and to assess the frequency of occurrence of dry eye......

Keywords: Dry eye disease (DED), Ocular surface disease index(OSDI), Tear film break-up time(TBUT), Rose-Bengal Stain,Meibomian gland dysfunction (MGD.

[1] Schaumberg DA, Sullivan DA, Buring JE, Dana MR. Prevalence of dry eye syndrome among US women. Am J Ophtha/mo/2003; 136: 318-26.
[2] Bukhari A, Ajlan R, Alsaggaf H. Prevalence of dry eye in the normal population in Jeddah, Saudi Arabia. Orbit 2009; 28: 392-7.
[3] 2007 Report of the International Dry eye Workshop (DEWS). (Special issue) Ocu/ Surf2007; 5: 65-199
[4] Shimmura S, Shimazaki J, Tsubota K. Results of a population based questionnaire on the symptoms and lifestyles associated with dry eye. Cornea 1999; 18: 408-11.
[5] Nien CJ, Massei S, l.in G, Nabavi C, Tao J, Brown DJ, et al. Effects of age and dysfunction on human meibomian glands. Arch Ophtha/mo/2011; 129: 462-9..

Abstract: Background: Hypothyroidism is a common condition; it causes symptoms that reduce the functional capacity of the bodily systems and negatively affects the quality of life. The risk of CHD and other forms of atherosclerotic vascular disease increases with elevated plasma levels of cholesterol. So, we have designed the study to see the effects of thyroid dysfunction on lipid parameters and cardiovascular disease (CVD) risk factors. Material & Methods: A Case Control Study was conducted on Patients with thyroid disorder, attending both OPD and IPD in the Department of Medicine in Mahatma Gandhi Medical College, Jaipur, Rajasthan between December 2015 to December 2016. A total of 80 Subjects, 40 subjects with thyroid disorder and 40 euthyroid controls were included in the study. Presence of thyroid dysfunction was defined as per American Thyroid Association's Guidelines..........

Keywords: Hypothyroidism, TSH, FT3, FT4, Lipid profile

[1] Greenspan FS. The thyroid gland. In: Greenspan FS & Gardner DG (eds). Basic & Clinical Endocrinology. 7th edn. New York: The McGraw-Hill Companies, 2004:215-294. [2] Dr Aggarwal. Prevalence of thyroid disorders increasing in India.2017
[3] Boon NA, Fox KAA, Bloomfield P, Bradbury A. Cardiovascular disease. In: Haslett C, Chilvers ER, Boon NA, Colledge NR (eds). Davidson's principles and practice of medicine. 19th edn. London: Churchill Livingstone, 2002:357-481.
[4] Tsimihodimos V, Bairaktari E, Tzallas C, Miltiadus G, Liberopoulos E, Elisuf M. The incidence of thyroid function abnormalities in patients attending an outpatient lipid clinic. Thyroid 1999; 9:365-368.
[5] Razvi S, Weaver JU, Vanderpump MP, Pearce SH. The incidence of ischemic heart disease and mortality in people with subclinical hypothyroidism: reanalysis of the Whickham Survey cohort. J Clin Endocrinol Metab. 2010; 95: 1734-1740..

Abstract: Qay'al-Haml (Nausea and vomiting in pregnancy) is defined as the symptom of nausea and/or vomiting during early pregnancy. It occurs in up to 80% of pregnant.The physical problems of coping with qay'al-haml can lead to emotional problems, which can in turn exacerbate the physical problems, having a significant reduction in quality of life. The first line of treatment being doxylamine –pyridoxine combination; although effective has reported side effects. Various unani drugs mentioned for the treatment of qay'al-haml include gulqand, sharbate anar sheerin, sikanjabeen lemooni, jawarishe anarain etc, although studies proving their effectiveness are scarce. The aim of the study is to evaluate the efficacy of sikanjabeen lemooni in qay'al-haml.........

Keywords: NVPQOL Score, PUQE Index, qay'al-haml, sikanjabeen lemooni.

[1] Magee L, Shrim A, Koren G. Diagnosis and management of nausea and vomiting in pregnancy. Fetal and Maternal Medicine Review. 2006; 17: 145–167.
[2] Koren G, Maltepe C, Phelan ST. Nausea and vomiting of pregnancy. APGO continuing Series on Women's Health Education. 2011; 1-27.
[3] Balikova M, Buzgova R. Quality of women's life with nausea and vomiting during pregnancy. Osetrovatelstvi a Porodni Asistence. 2014; 5(1): 29-35.
[4] Niebyl NR. The pharmacologic management of nausea and vomiting during pregnancy. Supplement to the Journal of Family Practice. 2014; 63(02): S31-S38.
[5] Smith C, Crowther C, Willson K, Hotham N, McMillian V. A randomized controlled trial of ginger to treat nausea and vomiting in pregnancy. Obstet Gynecol. 2004; 103(4): 639-45.

Abstract: OBJECTIVES: Trauma is among the leading causes of death. Medical management of blunt abdominal trauma (BAT) relies on judging patients for whom laparotomy is mandatory. This study aimed to determine BAT patients'signs, as well as paraclinical data, and to clarify the accuracy, sensitivity, specificity, positive and negative predictive value of clinical abdominal scoring system (CASS), a new scoring system based on clinical signs, in predicting whether a BAT patient needs laparotomy or not. METHODS: Totally 100 patients suspected of BAT that arrived at the emergency department of govt. Rajaji hospital,Madurai fromJanuary 2017 to December 2017were included in this study. They were evaluated for age, sex, type of trauma, systolic blood pressure, Glasgow coma scale (GCS), pulse rate, time of presentation after trauma, abdominal clinical findings, respiratory rate, temperature, hemoglobin (Hb) concentration, focused abdominal sonography in trauma (FAST) and CASS.......

[1]. Sabiston Text book Of Surgery Hamilton Bailey's Emergency surgery: 13th edition: 2000: p446-471 Principles of surgery: Schwartz: 7thedition: vol 1: 1999:155-222p
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[3]. American College Of Surgeons Committee on Trauma:2008
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[5]. Way WL, Doharty GM: eds: Current surgical diagnosis and treatment. 11th ed. Mc Graw Hill publications; 2003.p230-66.

Abstract: AIM:To compare the efficacy of caudal Bupivacaine toDiclofenac suppositories forpostoperative analgesia inpaediatricage group.MATERIALS AND METHODS:After attaining ethical committee permission 6opaediatric patients with ASA grade I&II of either sex were divided into two groups Group B and Group R.Patients in Group B were given caudal Bupivacaine while patients in Group R were given Diclofenac suppositories after surgery.RESULTS: Patients in both groups are observed for duration of postoperative analgesia and the side effects.Results are statistically analysed and tabulated CONCLUSION:We concluded from our study that Caudal Bupivacaine produces more postoperative analgesia than Diclofenac suppositories

Keywords: Bupivacaine, Diclofenac, postoperative analgesia,caudal block

[1] James D, Justins D. Acute post-operative pain. In: Healy TE, Knight PR, editors. Wylie and Churchill Davidson's. A practice of Anaesthesia. 7 th ed. London: Arnold Publishers;2003. p. 1213-34.
[2] Woolf CJ, Chong MS. Preemptive analgesia–Treating postoperative pain by preventing the establishment of central sensitization. AnesthAnalg. 1993;77:362–79.
[3] Melzack, R., & Katz, J. (2007). A Conceptual Framework for Understanding Pain in the Human. In S. J. Waldman (Ed.), Pain Management (pp. 2-9). New York: Elsevier

[4] Costigan, M., Scholz, J., & Woolf, C. J. (2009). Neuropathic pain: a maladaptive response of The nervous system to damage. Annu Rev Neurosci, 32, 1-32.
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Abstract: Background: Febrile seizures are most common type of seizures occurring in 3 to 4% of children. Febrile seizures are to be differentiated from acute symptomatic convulsions which are caused by intracranial infection, Biochemical abnormalities (hypoglycaemia, hyponatremia, hypocalcaemia). Objectives: to correlate laboratory parameters of children with fever and febrile seizures. Methodology: case -control prospective observational study. The study was conducted over a period of 1 year from January 2014 to January 2015. Study population was composed of 120 children.60 were cases with febrile seizures and 60 were control group with febrile illness without seizures. Results: The mean age of cases at presentation was 24.51+/_ 16.09..........

Keywords: children, febrile seizures, laboratory parameters

[1] Steering Committee on Quality Improvement and Management; Subcommittee on Febrile Seizures American Academy of Pediatrics. Febrile seizures: clinical practice guideline for the long-term management of the child with simple febrile seizures. Pediatrics. 2008; 121:1281–1286.
[2] Paul SP, Blaikley S, Chinthapalli R. Clinical update: febrile convulsion in childhood. Community Pract.2012; 85:36–38
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[4] Berg AT, Shinnar S, Levy SR, Testa FM. Childhood-onset epilepsy with and without preceding febrile seizures. Neurology. 1999; 53:1742–1748.
[5] Agrawal J1, Poudel P1, Shah GS1, Yadav S1, Chaudhary S1. Recurrence Risk of Febrile Seizures in Children, J Nepal Health Res Counc. 2016 Sep;14(34):192-196..

Abstract: Intussusception following a Roux-en-Y gastrojejunostomy was first described by Agha in 1986.[1]  In adults, intussusceptions account for up to 5% of cases of bowel obstruction, and 90% are secondary to a definable lesion. In children, by contrast, 80–90% are without an identifiable cause.[2]  Retrograde intussusception is reported as being very rare with an unknown frequency of occurrence. [3]  Intussusception is an underappreciated complication of Roux-en-Y gastrojejunostomy. In one review of 15,553 gastric bypass surgeries at a single institution, 23 patients developed a retrograde intussusception.

[1] Agha FP. Intussusceptions in adults. AJR Am J Roentgenol. 1986;143:527–31.
[2] Begos DG, Sandor A, Modlin IM, et al. The diagnosis and management of adult intussusception. Am J Surg 1997;173: 88–94.
[3] Santry HP, Gillen DL, Lauderdale DS. Trends in bariatric surgical procedures. JAMA. 2005;294:1909–17.
[4] Simper S C, Erzinger JM, McKinlay RD, Smith SC. Retrograde (reverse) jejunal intussusception might not be such a rare problem: A single group's experience of 23 cases. SurgObesRelat Dis. 2008;4:77–83.
[5] R. Shackman, ―Jejunogastric intussusception,‖ British Journal of Surgery, vol. 27, pp. 475–480, 1940..

Abstract: The prostate is an amazing challenge to the pathologist and urologists alike. The history of prostate gland dates back to 300 B.C., when Herophilos of Chalcedon, the father of anatomy coined the word PROSTATE-Pro-status-meaning to stand before-indicating that the gland stands before or guards the bladder. Prostatic pathology is deceptively simple. Benign prostatic Hyperplasia, prostatitis and prostatic carcinoma are the three principal conditions involving the prostate accounting for more than 95% of lesions. Though the morphologic diagnosis of prostatic lesions , separating benign from malignant is relatively straight forward, there are several benign proliferations and normal histo-anatomic structures of prostate which mimic malignancy and their awareness is essential to avoid diagnostic pit falls.............

[1] Cambell's urology 8 th Edn, Vol4,2002 edited by Walsh,Retick, Vaughan, Wein.
[2] John N. Eble and Jonathan. Epstein – Stage a carcinoma of prostate –contemporary issues in surgical pathology edited by David. G. Bostwick 3 rd edition.
[3] Diagnostic surgical anthology 2nd edition ; Vol 2: 1994 edited by S.S Sternberg
[4] Anderson's Pathology 10th edition ; Vol 2 : 1996 edited by Ivan Damajanov James Linder.
[5] Ellis et al: Diagnosis of prostatic carcinoma. The yield of serum PSA, digital rectal examination and transrectal ultrasonography. J.Urol 1994; 52: 1520..

Abstract: The term stroke is applied to a sudden focal neurologic syndrome, specifically the type caused by cerebrovascular disease. The term cerebrovascular disease designates any abnormality of the brain resulting from a pathologic process of the blood vessels, including occlusion of the lumen by embolus or thrombus, rupture of a vessel, an altered permeability of the vessel wall, or increased viscosity or other change in the quality of the blood flowing through the cerebral vessel.1 The intracerebral hemorrhage remains an area where different confluenting views on CT scan findings of hematoma and its effects are prevalent. Public awareness regarding various risk factors is still quite poor in our society. Many times it becomes an important task for the physician to predict the functional outcome from a single CT scan of the brain done at the time of the hospital admission. The present study was conducted out.........

Keywords: hemorrhagic stroke, site and size, prognostic significance, jharkhand

[1] Allan H. Ropper, Martin A. Samuels. Adams and Victor's Neurology, 9th edition, Chapter 34. Cerebrovascular Diseases.
[2] Feigin VL. Stroke in developing countries: can the epidemic be stopped and outcomes improved? Lancet Neurol. 2007;6(2):94–7. [3] The global burden of hemorrhagic stroke, Glob Heart. 2014 Mar;9(1):101-6.
[4] Nongkynrih B, Acharya A, Ramakrishnan L, Ritvik, Anand K, Shah B. Profile of biochemical risk factors for non communicable diseases in urban, rural and periurban Haryana, India. J Assoc Physicians India. 2008;56:165–70.
[5] Zaki Noah Hasan , Kareem M. Al Tameemi and Ghazi Ferhan Alhaji. Predictors of Outcome for Spontaneous Intracerebral Hemorrhage in Iraqi Stroke Patients. Intern Med 2:111.

Abstract: Head and neck cancer in india accounted for 30% of all cancers. approximately 90% of head and neck carcinoma over express epidermal growth factor receptor (EGFR). EGFR plays a role in predicting and modulating the response of HNSCC patients to radiation.Advanced Head and neck cancer has poor prognosis. We conducted Prospective study- Response evaluation of radiotherapy with concurrent weekly cisplatin versus concurrent weekly cisplatin plus daily geitinib in locally advanced head &neck cancer from2012 to 1015. Results of that study published in IOSR journal of dental and medical sciences on Volume 14 issue 2 feb. 16. in this study82 previously untreated patients of squamous cell carcinoma of head and neck cancer were divided into two groups- the cases group B (n=41) receiving gefitinib 500 mg OD started..........

Keywords: chemoradiation, EGFR, gefitinib, squamous cell carcinoma head and neck, targeted therapy

[1] Adelstein DJ, Li Y, Adams GL, Wagner H et al : An intergroup phase III comparison of standard radiation therapy and two schedules of ncurrent chemoradiotherapy in patients with unresectable squamous cell head and neck cancer. J Clin Oncol. 2003:21:92–982.
[2] Brizel DM, Albers ME, Fisher SR et al: Hyperfractionated irradiation with or without concurrent chemotherapy for locally advanced head and neck cancer. N Engl J Med. 1998:338:1798–1804.
[3] Denis F, Garaud P, Bardet E et al : Final results of the 94-01 French Head and Neck Oncology and Radiotherapy Group randomized trial comparing radiotherapy alone with concomitant radiochemotherapy in advanced-stage oropharynx carcinoma. J Clin Oncol. 2004:22:69–76.
[4] Bourhis J, Sire C, Graff P et al: Concomitant chemoradiotherapy versus acceleration of radiotherapy with or without concomitant chemotherapy in locally advanced head and neck carcinoma (GORTEC 99-02): an open-label phase 3 randomised trial. Lancet Oncol. 2012:13:145–153.
[5] Pignon JP, le Maître A, Maillard E et al : Meta-analysis of chemotherapy in head and neck cancer (MACH-NC): an update on 93 randomised trials and 17,346 patients.Radiother Oncol. 2009:92:4–14.

Abstract: Introduction: Vitamin E status in newborn is not well established. Many studies showed that vitamin-E level is low in premature babies and without supplementation complications may occur including retinopathy of prematurity (ROP). So this study was aimed to estimate serum tocopherol (vitamin-E) level in infants and to find out the relationship of low serum vitamin E level with the development of ROP. Method: This cross sectional analytic study was performed in the department of Neonatology, BSMMU over a period of 6 months. Total 75 stable term (38-42wk) and preterm (30-35wk) newborn infants admitted in BSMMU were consecutively enrolled. Newborns of <30 weeks and 36-37 weeks of gestation, hemodynamically unstable or with major congenital anomalies were excluded. After informed written consent from parents, 3 ml free flow venous blood was collected at 3-5 days of life. Serum Vitamin E level estimation was done by high performance liquid chromatography (HPLC) and ROP screening was done by a qualified ophthalmologist by binocular indirect ophthalmoscope. Data was analyzed by SPSS software version 20. Level of significance was tested by appropriate statistical tests..........

Keywords: Vitamin E, ROP, Preterm and term new born infants

[1]. Groff JL, Gropper SS, Hunt SM. The Fat Soluble Vitamins. Available from: fhttp://Vitamin E-ExRx.net.// accessed on March 11, 2013.
[2]. Vitamin E.Wikipedia, the free encyclopedia available from http://en.wikipedia.org/wiki/Vitamin_E accessed on March 10, 2013.
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[4]. Dancheck B, Nussenblatt V, Kumwenda N, Lema V. Status of Carrotenoids,Vitamin A, and Vitamin E in the Mother- Infant Dayd and Anthropometric status of Infants in Malawi. J Health Popul Nutr 2005; 23(4):343-350.
[5]. Ashok K, Rajib R, Sriparna B, Khanna HD, Bhargava V. Antioxidant level in Cord blood of Low Birth Weight Newborns. Indian Pediatrics 2008; 45: 583-586..

Abstract: Background – Being one of the most common disorder faced by our society, the correct diagnosis of anemia is important for better clinical outcome. Aim & Objectives – The present study was designed to compare the findings of peripheral smear with cell counter generated parameters i.e. RBC indices and histograms. Material and methods – 500 patients with Hb<11.5g/dl were selected for the comparison of PS findings with that of cell counter parameters. Results – There was much discrepancy between the diagnosis of some anemias like hemolytic and macrocytic anemias on peripheral smear and cell counter generated parameters. Conclusion – The CBC should always be interpreted in the light of peripheral smear examination despite all the advances in laboratory sciences.

Keywords: Peripheral smear examination, RBC indices, Histograms

[1]. World Health Organization (2009) Global Health Risks: Mortality and burden of disease attributable to selected major risks.
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[3]. Dhruva GA, Agravat AH, Kotak KH. Evaluation of blood indices and peripheral smear examination in beta thalassemia patients. Journal of Basic and Applied Medical Research 2014; Vol.-3(2) :674- 78.
[4]. Kumar A, Kushwaha R, Gupta C, Singh U.S. An analytical study on peripheral blood smear in anaemia and correlation with cell counter generated red cell parameters. Journal of applied hematology 2013; vol4:issue 4.
[5]. Sullivan E. Hematology analyzer: From workhorse to thoroughbred. Lab Med. 2006;37:273–278.