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

Abstract: Background: Chronic obstructive pulmonary disease (COPD) is projected to be the third leading cause of death by 2020. Its prevalence and burden is expected to rise with rapidly increasing smoking rates in developing countries. This risk factor combined with an ageing population accounts for the actual and forecasted rapid growth in COPD. Spirometry has a role in all three prevention levels. By early detection of COPD in asymptomatic high risk population, it is possible to reduce the disease burden. Objectives: Early detection of COPD in asymptomatic high risk population by spirometry.Methods: Patients aged more than 40 years with smoking history more than 10 pack years and not clinically overt symptomatic of COPD were subjected to spirometric study. Results:The spirometric studies of all 100 asymptomatic cases are analyzed and out of which 61 cases had normal study with FEV1/FVC >70% and 39 cases had obstructive spirometric pattern with FEV1/FVC.................

[1]. Halbert RJ, Natoli JL, GanoA,Badamgarav E, Buist AS, Mannino DM. Global burden of COPD: systematic review and meta-analysis. EurRespir J. 2006 Sep 1;28(3):523-32.
[2]. Pena VS, Miravitlles M, Gabriel R, Jimenez-Ruiz CA, Villasante C, Masa JF et al. Geographic variations in prevalence and under diagnosis of COPD: results of the IBERPOC multicenter epidemiological study. Chest. 2000 oct;118(4):981-9.
[3]. Barthwal MS, and Singh S. Early Detection of Chronic Obstructive Pulmonary Disease in asymptomatic Smokers using Spirometry. J Assoc Physicians india. 2014 mar;62(3):238-42.
[4]. Zielinski J, Bednarek M. Early detection of COPD in a high-risk population using spirometric screening. Chest 2001; 119: 731-36.

Abstract: Background: Chemoradiotherapy followed by surgery followed by adjuvant chemotherapy is the mainstay of treatment in stage II and III rectal cancer.There are two approaches to pelvic RT for resectable rectal cancer: short-course radiation and long course chemoradiotherapy(CRT).Polish and Australian randomized studies compared short-course radiation and immediate surgery with long-course CRT and delayed surgery.In these studies similar long-term survival and local control have been reported for both these approaches but pathological complete response(pCR) is not better with short course RT. Moreover studies have shown better tumor downstaging with delayed surgery.So the idea is to combine the benefits of delayed surgery for improved tumor downstaging with short course RT by adding two cycles of chemotherapy between short course RT and surgery to improve pCR rates.In this...........

Key Words: Short-course RT, rectal neoplasm, chemoradiotherapy

[1]. Harnsberger JR, Vernava VM III, Longo WE. Radical abdominopelvic lymphadenectomy: historic perspective and current role in the surgical management of rectal cancer. Dis Colon Rectum 1994;37:73-87.
[2]. Phillips RK, Hittinger R, Blesovsky L, et al. Local recurrence following 'curative' surgery for large bowel cancer. I. The overall picture. Br J Surg 1984;71:12-6.
[3]. Kapiteijn E, Marijnen C, Colenbrander AC, et al. Local recurrence in patients with rectal cancer, diagnosed between 1988 and 1992: a population- based study in the west Netherlands. Eur J Surg Oncol 1998;24:528-35.
[4]. 4.Gerard JP, Conroy T, Bonnetain F, et al. Preoperative radiotherapy with or without concurrent fluorouracil and leucovorin in T3–4 rectal cancers: results of FFCD 9203. J ClinOncol 2006;24:4620–5.
[5]. Bosset JF, Calais G, Daban A, et al. Preoperative chemoradiotherapy versus preoperative radiotherapy in rectal cancer patients: assessment of acute toxicity and treatment compliance. Eur J Cancer 2004; 40: 219–224...

Abstract: Philipsen and Reichart classified ameloblastomas (AM) into 4 subtypes, according to their clinical and biological behavior: intraosseous (solid/multicystic), extraosseous, unicystic, and desmoplastic. Histopathologically, conventional ameloblastoma subdivided into 6 subtypes, plexiform, follicular, granular cell, acanthomatous, basaloid and desmoplastic ameloblastoma. According to the literature desmoplastic ameloblastoma (DA) is a rare variant of ameloblastoma. It was first described by Eversole et al, in 1984 as an "ameloblastoma with pronounced desmoplasia" and later on it was further reviewed by Wardlon and El-Mofty et al, in 1987 and by Reichart et al, in 1995. In 2005 the World Health Organization declared DA as a distinct clinic-pathological entity. DA reportedly has a site predilection for the anterior regions of the jaw unlike other Ameloblastoma. Its unique radiographic appearance is that of a mixed radiolucent-radiopaque lesion unlike the strictly radiolucent quality of other ameloblastomas..........

Keywords: ameloblastoma, collision tumor, desmoplastic, intraosseous, osteoplasia.

[1]. Gardner DG .A Pathologist's Approach to the treatment of Ameloblastoma, J Oral Maxillofac Surg 1984;42:161-66.
[2]. Marx RE , Stern D. Oral and Maxillofacial Pathology: A Rationale for Diagnosis and Treatment 2nd ed .Quintessence Publishing Co, Inc; 2012
[3]. Philipsen HP, Ormiston IW, Reichart PA. The desmo- and osteoplastic ameloblastoma Histologic variant or clinicopathologic entity? Case reports. Int. J. Oral Maxillofac. Surg. 1992; 21: 352-7.

[4]. Philipsen HP ,Reichart PA ,Takata T.Desmoplastic ameloblastoma(including "hybrid‟‟ lesion of ameloblastoma).Biological profile based on 100 cases from the literature and own files. Oral oncology . 2001;37:455-60.

[5]. Sivapatha sundharam B, Einstein A, Syed RI. Desmoplastic ameloblastoma in Indians. A report of 5 cases and a review of literature. Indian J Den Res 2007;18 :218-21..

Abstract: Introduction: Gestational diabetes mellitus is a common medical complication of pregnancy with several fetal and maternal complications. There are several screening tools for detecting gestational diabetes mellitus including recent DIPSI criteria of non-fasting single plasma 2 hour value after 75 grams glucose. Aims: present study was aimed at comparing sensitivity and specificity of non fasting single plasma 1 hour value after 50 grams vs non fasting single plasma 2 hour value after 75 grams glucose for screening of gestational diabetes mellitus. Materials and methods: This was a prospective comparative randomized study conducted from December 2013 to July 2015. Women with period of gestation 24-28 weeks were included. Both groups i.e. Group A (50 g) and Group B (75 g) were tested by OGTT for confirmation. Prevalence rates, sensitivity, specificity, positive predictive value and negative predictive value of both groups were studied. Results: Prevalence rate, sensitivity, specificity...........

[1] ADA. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2009;32:S62-7.
[2] World Health Organization: Prevention of Diabetes Mellitus: Report of a WHO Study Group. Geneva, World Health Org., 1994(Tech. Rep. Ser., no. 844).
[3] Metzger BE, Gabbe SG, Persson B, et al. International Association of Diabetes and Pregnancy Study Groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy. Diabetes Care. 2010;33(3):676-82.
[4] The Guideline Development Group. Management of diabetes from preconception to the postnatal period: summary of NICE guidance. BMJ. 2008;336:714-717.
[5] American Diabetes Association. Diagnosis and Classification of Diabetes Mellitus. Diabetes Care. 2008;31:S55-S60.

Abstract: Introduction : Meningitis is a life threatening infection of protective membranes covering the brain and the spinal cord, known as meninges. It is a common disease worldwide with high mortality and morbidity and remains a major international health problem. It is one of the common cause of hospital admission. It can present with fever, headache, neck rigidity, seizures, lethargy, drowsiness or coma in varied combinations. Objective : To study the epidemiology of meningitis in adults and role of Creatine kinase and lactate Dehydrogenase in its diagnosis. Methodology : A observational, cross sectional and institution based study conducted among 50 patients above 12 years of age admitted in a tertiary care centre with features suggestive of meningitis. 25 individuals were taken.......

Keywords: Meningitis, Cerebrospinal fluid, Creatine Kinase, and Lactate Dehydrogenase

[1] Karen RL, Kenneth TL. Meningitis, Encephalitis Brain Abscess, and Empyema. In: Harrison's Principle of Internal Medicine. 18th ed. 2:3410-3420.
[2] Koedel U, Klein M, Pfister HW. New understandings on the pathophysiology of bacterial meningitis. Curr Opin Infect Dis. 2010;23(3):217-23.
[3] Parakh N, Gupta IR, Jain. Evaluation of enzymes in serum and CSF in cases of stroke. Neurol India 2002;50(4):518-9.
[4] Roger MK, Liebman W. Creatinine phosphokinase activity in central, nervous system disorders. AMJ Dis Child. 1970;120:543-6.
[5] Pasaoglu A, Pasaoglu H. Enzymatic changes in the CSF as indices of pathological change. Acta Neurochirurgica. 1989;97(1-2):71-6...

Abstract: INTRODUCTION: The combined spinal epidural technique involves intentional subarachnoid blockade and epidural catheter placement during the same procedure. Ideally it combines the best features of spinal and epidural blockade and avoids their respective disadvantages. With the combined spinal epidural techniques, surgical anaesthesia was rapidly established saving 15 to 20 minutes, compared with epidural anaesthesia. AIMS & OBJECTIVES: 1. To evaluate the safety and efficacy of combined spinal-epidural anaesthesia in lower limb surgeries 2. To find the regional anaesthetic technique that provides adequate surgical anaesthesia and analgesia with minimal side effects............

Keywords: BUPIVACAINE, BUTORPHANOL, FENTANYL, CSE..

[1] Puolakka, R, Pitkanen, M T and Rosenberg, P H , "Comparison of the technical and block characteristics of different combined spinal and epidural anaesthesia techniques" Reg-Anesth -Pain-Med. 2001; 26 (1) : pp 17-25.
[2] Narinder, Rawal, et al., "The combined spinal epidural technique. Anaesth Clin of North America, June 2000; vol. 18(2): pp 267-295.
[3] Gallinger, EIV, et al., "Combined spinal epidural anaesthesia in operations on the vessels of the lower extremities". Anesteziol-Reanimatol; 1999 (5) : pp 44-48.

[4] Holmstrom, B, et al.,"Combined spinal epidural block versus spinal and epidural block for orthopaedic surgery". Can J Anaesth, 1993; 40(7): pp 601-606.
[5] Tsutsui, T, Maranaka, K and Setoyama., K . "Clinical evaluation of combined spinal-epidural anaesthesia by needle- through -needle approach in 485 surgical cases/' Masui, 2000; 49(9): pp 970-5..

Abstract: Background: Sexual assault is an evil trend on women since long in society. Young girls and children are most vulnerable to this heinous crime which has recently increased in number over a decade. Evidence suggest that it is a public health problem of substantial proportion. There is lot of scope to understand the phenomenon and to prevent it. Objectives: This study was conducted to evaluate the epidemiological, demographical profile and medico legal aspect of sexual assault victim. Methodology:It is aretrospective study which was conducted on the victims of alleged sexual assault who were brought by police for medical examination at one stop centre of Dr Baba SahebAmbedkar medical college and hospital, New Delhi, over 18 months (1 July 2015 to 31 Dec 2016) period. Results:A total of 467 cases were included..............

[1] B. L. Himandu. Radhika Arora. N.S. Prashanth, Whose problem is it anyway? Crimes against women in India. Global Health Action. July 2014, 7:10.3402
[2] K. Kannan. K. Mathiharan, Sexual offences, Modi- A textbook of medical Jurisprudence and toxicology, 24th Edition, Chapter 31, 637-638
[3] One Stop Centre scheme, Implementation guidelines, Ministry of women and child development, Government of India, August 2016
[4] Kumar Pal. Sharma A. A study of sexual assaults in Northern range of Himachal Pradesh, International Journal of medical toxicology and Forensic medicine 2015; 5(2); 64-72
[5] Soumyajyot., Somanjana Ghosh, A study on sexual assault victims attending a tertiary care hospital of East India, IOSR Journal of Dental and medical sciences,May 2013;6;16 -19.

Abstract: Preterm premature rupture of membranes (PPROM) is the spontaneous rupture of the fetal membranes during pregnancy before 37 weeks gestation in the absence of regular painful uterine contractions 1. It increases the risk of prematurity and leads to other perinatal and neonatal complications with 1-2% risk of fetal death 2.PPROM is an important cause of perinatal morbidity and mortality because it is associated with brief latency from membrane rupture to delivery, perinatal infection and umbilical cord compression due to oligohydramnios7. Study was conducted on one hundred forty women who were admitted for management of preterm premature rupture of membrane at ≥34 to ≤37 weeks of gestation of pregnancy. They were randomized using block randomization with sealed...........

Keywords: Vaginal Misoprostol, Dinoprostone (PGE2) Gel, Preterm Birth, Premature Rupture of Membrane

[1] Fowlie A. Preterm pre-labour rupture of membranes, In: Arukumaran S, Symonds IM, Fowlie A (eds): Oxford Handbook of Obstetrics and Gynaecology. 2nd edition New Delhi, Oxford University Press 2004; 247-249.
[2] Shucker JL, Mercer BM. Midtrimester PROM. Semin Perinatol 1996; 20:389-400.
[3] American College of Obstetricians and Gynecologists, authors. Premature Rupture of Membranes. Washington, DC: American College of Obstetricians and Gynecologists; 1998. (ACOG Practice Bulletin No. 1).
[4] ACOG Committee on Practice Bulletins-Obstetrics, authors. Clinical management guidelines for obstetrician-gynecologists. (ACOG Practice Bulletin No. 80: premature rupture of membranes). Obstet Gynecol 2007; 109:1007-1019 [PubMed].
[5] Dale PO, Tanbo T, Bendvold E, Moe N. Duration of the latency period in preterm premature rupture of the membranes. Maternal and neonatal consequences of expectant management. Eur J Obstet Gynecol Reprod Biol. 1989; 30:257-262[PubMed]..

Abstract: Perinatal asphyxia is one of the most important causes of neonatal morbidity and mortality in our country. Easily available biochemical markers are still not used routinely in diagnosis of perinatal asphyxia. Our study aims to use urinary uric acid to creatinine ratio to diagnose perinatal asphyxia and its severity. This prospective study was conducted at Dr. BSA Hospital, Delhi from March, 2015 to March, 2016. A total of fifty (50) asphyxiated and fifty (50) non-asphyxiated term newborns were included in the study. It was found that the urinary uric acid to creatinine ratio (UUA/Cr) is significantly (p<0.001) increased in asphyxiated newborns and its level is directly related to the severity of perinatal asphyxia. The above study shows that the spot urinary uric acid to creatinine ratio may be used as a biochemical marker for diagnosing and predicting the outcome of perinatal asphyxia.

Key words: Perinatal asphyxia, urinary uric acid/creatinine ratio

[1] [Value of biochemical markers for outcome in term infants with asphyxia. - PubMed - NCBI [Internet]. [cited 2018 Mar 14]. Available from: https://www.ncbi.nlm.nih.gov/pubmed/15519113
[2] Neuron specific enolase in asphyxiated newborns: association with encephalopathy and cerebral function monitor trace. [Internet]. [cited 2018 Mar 14]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2528422/
[3] Levene MI, Sands C, Grindulis H, Moore JR. Comparison of two methods of predicting outcome in perinatal asphyxia. Lancet Lond Engl. 1986 Jan 11;1(8472):67–9.
[4] Bjerre I, Hellström-Westas L, Rosén I, Svenningsen N. Monitoring of cerebral function after severe asphyxia in infancy. Arch Dis Child. 1983 Dec;58(12):997–1002.
[5] Wilcox WD. Abnormal serum uric acid levels in children. J Pediatr. 1996 Jun;128(6):731–41...

Abstract: Posterior capsular opacification (PCO) is an important cause of diminution of vision after cataract surgery. Nd YAG laser capsulotomy is a safe, non invasive procedure of choice for PCO. Raised intraocular pressure( IOP) is a frequent complication after Nd YAG laser capsulotomy. But is usually a transient complication. So this study is conducted to find rise in IOP after Nd YAG laser capsulotomy. Materials and methods : A total of 50 Pseudophakic (PCIOL) patients with a complaints of diminution of vision with PCO were selected for the study. IOP rise after Nd YAG laser capsulotomy was measured with Applanation tonometry. Statistical analysis was done using t test. Results : On statistical analysis, Mean IOP pre procedure 11.98 mm Hg and Mean IOP 2h post procedure 12.98 mm Hg. On applying t test differance in IOP was significant (p<0.05). On follow up visits rise in IOP was normalized to pre procedure levels............

Keywords: Capsulotomy, Glaucoma, IOP, PCO, Pseudophakia.

[1] National program for control of blindness, Ministry of health and family welfare, government of India. 2016
[2] Auffarth G, Brezin A, Caporossi A, Lafuma A, Mendicute J, Berdeaux G, Smith A. comparison of Nd YAG capsulotomy rates following phacoemulsification with implantation of PMMA, silicone, or acrylic intra ocular lenses in four european countries. Ophthalmic epidemiology. 2004 Jan 1;11(4):319-329.
[3] Ram J, Kumar S, Sukhija J, Severia S. Nd YAG laser capsulotomy rates following implantation of square- edged intraocular lenses:polymethyl methacrylate versus silicone versus acrylic. Canadian Journal of Ophthalmology. 2009 Apr 1;44(2):160-4.
[4] Winslow R, Taylor B. Retinal complications in posterior eye segment after Nd: YAG laser capsulotomy. 1985;92(6):785-89.
[5] Shetty NK, Sridhar S. Study of Variation in intraocular pressure spike (IOP) Following Nd YAG Laser capsulotomy. Journal of clinical and diagnostic research: JCDR. 2016 Dec;10(12):NC09

Abstract: Beta Thalassemia major (thalassemia) is a heterogeneous inherited disorder of haemoglobin synthesis1. There is ineffective erythropoiesis and anemia2. Regular blood transfusions and chelation therapy has noticeably prolonged survival in thalassemic patients1 however they suffer growth, multiple endocrine and metabolic abnormalities. There is gross derangement of Calcium homeostasis in multi- transfused thalassemic patients. Both defective syntheses of 25 OH vitamin D (25OH D) and/or hypoparathyroidism are seen in these patients, which negatively affects their bone metabolism3. Sixty Beta Thalassemia children (cases) and an equal number of age, sex matched apparently healthy children (controls) were included in this study. After recording of history and thorough clinical examination blood samples from cases and controls were collected and tested for Vitamin D level, Serum Parathyroid level. Results...........

[1]. Basha KP, ShettyB, Shenoy UV. Prevalence of Hypoparathyroidism (HPT) in Beta Thalassemia Major. Journal of Clinical and Diagnostic Research. 2014 Feb; 8(2):24-26.
[2]. Fahim MF, Saad K, Askar EA, et al. Growth Parameters and Vitamin D status in Children with Thalassemia Major in Upper Egypt. IJHOSCR. 2013 Oct 1; 7(4):10-14.
[3]. Soliman A, De Sanctis V, Yassin M. Vitamin D status in thalassemia major-an update. Mediterr J Hematol Infect Dis. 2013; 5(1): e2013057.
[4]. Burtis CA, Ashwood ER, Bruns DE. Tietz Fundamentals of Clinical Chemistry. Optical techniques. 6th ed. St.Louis, Missouri: Elsevier; 2008. p.79-80.
[5]. Bauer PJ. Affinity and stoichiometry of calcium binding by arsenazo III. Anal Biochem. 1981;110:61-72

Abstract: Background : Theatre staff who are asymptomatic carriers of MRSA play a vital role in the acquisition of surgical site infections caused by MRSA in post-surgical patients. Screening and eradication of MRSA from the colonized HCWs has been identified and recommended as an important tool in infection control policy for this organism. The study aimed to determine the nasal carriage rate of MRSA and associated risk factors among theatre staff. Materials and methods: Nasal swabs were obtained from 109 healthy staff working in the operating theatre and inoculated on Manitol salt agar and subcultured on blood agar. Each isolated Staphylococcus aureus was screened for Methicillin resistance by the Kirby-Bauer method by using..........

Key words; Methicillin resistant Staphylococcus aureus, Theatre, Infection, Port Harcourt

[1]. Diekema DJ, Pfaller MA, Schmitz FJ, Smayevsky J, Bell J, Jones RN, Beach M. Survey of infections due to Staphylococcus species: frequency of occurrence and antimicrobial susceptibility of isolates collected in the United States, Canada, Latin America, Europe, and the Western Pacific region for the SENTRY Antimicrobial Surveillance Program, 1997–1999. Clinical Infectious Diseases. 2001 May 15;32(Supplement 2):S114-32.

[2]. Engemann JJ, Carmeli Y, Cosgrove SE, Fowler VG, Bronstein MZ, Trivette SL, et al Adverse clinical and economic outcomes attributable to methicillin resistance among patients with Staphylococcus aureus surgical site infection. Clinical infectious diseases. 2003 Mar 1;36(5):592-8.

[3]. Cosgrove SE, Sakoulas G, Perencevich EN, Schwaber MJ, Karchmer AW, Carmeli Y. Comparison of mortality associated with methicillin-resistant and methicillin-susceptible Staphylococcus aureus bacteremia: a meta-analysis. Clinical infectious diseases. 2003 Jan 1;36(1):53-9.

[4]. Hiramatsu K, Cui L, Kuroda M, Ito T. The emergence and evolution of methicillin-resistant Staphylococcus aureus. Trends in microbiology. 2001, 1;9(10):486-93.
[5]. Karen C. Carroll,Jeffery A. Hobden. The Staphylococci. In: Jawetz, Melnick and Adelberg's Medical Microbiology 27th ed. McGraw-Hill education; 2016. p. 208-209.