iosr-JDMS   Volume-17 ~ Issue-5 ~ May-2018

Abstract: Needle stick injury is a major occupational health and safety issue among the health care workers. The Objectives of the present study were to evaluate the knowledge and attitude regarding safe injection practices and to explore the occurrence of needle stick injuries among the nursing personnel in a tertiary care hospital in Kolkata. It was a cross-sectional, descriptive study conducted in Medical College, Kolkata. Total 63stuff nurses were studied during the 3 month study period (Feb 2014-April 2014).The mean age of the nursing personnel was 36.78± 7.58 years (range 25 to58 years). Out of the study population 92.05% were vaccinated against Hepatitis B and 56(88.88%) had received training of "safe injection practice" in last 2 years. Among them 90.47% (57) had knowledge regarding "safe injection practice" and 82.54% (52) had knowledge regarding necessary to wear gloves during injection procedure............

Key Words: Safe injection practices, needle stick injuries (NSI), nursing personnel

[1]. Safe Injection Global Network (SIGN) Initial Meeting Report October 4-5, 1999 WHO headquarters, Geneva, Switzerland.
[2]. Needle stick injuries. 2003 (cited January 23, 2008); Available from: http://www.jr2.ox.ac.uk/bandolier/Extraforbando/needle.pdf.
[3]. Rampal L, Zakaria R Sook L. Needle stick and sharps injuries and factors associated among health care workers in a Malaysian Hospital .European Journal of Social Sciences .2010;13(3):354-60.

[4]. Manzoor I, Daud S, Hashmi N R, Sardar H, Babar M S, Rahman A et al. Needle Stick Injuries in Nurses at a tertiary health care facility; J Ayub Med Coll Abbottabad .2010;22(3):174-77 .
[5]. Simard EP, Miller JT, George PA, Wasley A, Alter MJ, Bell BP, et al. Hepatitis B vaccination coverage levels among healthcare workers in the United States, 2002-2003. Infect Control Hosp Epidemiol. 2007; 28:783–90.

Abstract: : Acute appendicitis is a common surgical emergency. Though it is a clinical diagnosis,to avoid negative laparotomy various scoring systems are used. As USG is considered extended tool of surgeon,this study compared the efficacy of Tzanakis and modified Alvarado score in diagnosis of acute appendicitis in female patients presented with RLQ abdominal pain. 60 female patients admitted with RLQ abdominal pain suspected acute appendicitis where included in thisstudy .This study carried out from June 2008 to January 2011in K.A.P.V.Medical college hospital,Trichy. Final diagnosis of acute appendicitis was based on histological findings. Hence forth the above study showed that Tzanakis score is an effective modality to establish the accurate diagnosis of acute appendicitis. of choice.

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Abstract: We compared outcome and complications after uncomplicated ureteroscopic treatment of distal ureteral calculi with or without the use of ureteral stents. 80 patients, prospectively divided into two groups to receive a double j stent (group 1, 42 patients), no stent (group 2, 38 patients), underwent ureteroscopic treatment of distal ureteral calculi. Stone characteristics, operative time, postoperative pain, lower urinary tract symptoms (LUTS), analgesia need, rehospitalization, stone-free rate, and late postoperative complications were all studied. There was no significant difference between the two groups regarding hematuria, fever, flank pain, urinary tract infection, and rehospitalisation. At 48 hours and 1 week, frequency/urgency and dysuria were significantly less in the nonstented group. When comparing group 1 and group 2, patients with double j stents had statistically significantly more bladder pain (P-0.003), frequency/urgency (P-0.002), dysuria (P-0.001), and need of analgesics (P-0.001). All patients who underwent imaging postoperatively were without evidence of obstruction or ureteral stricture.

[1]. G. M. Preminger, H. G. Tiselius, D. G. Assimos et al., "2007 guideline for the management of ureteral calculi," European Urology, vol. 52, no. 6, pp. 1610–1631, 2007. View at Publisher · View at Google Scholar
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[3]. .H. B. Joshi, N. Newns, A. Stainthorpe, R. P. MacDonagh, F. X. Keeley Jr., and A. G. Timoney, "Ureteral stent symptom questionnaire: development and validation of a multidimensional quality of life measure," Journal of Urology, vol. 169, no. 3, pp. 1060–1064, 2003. View at Publisher · View at Google Scholar · View at Scopus
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[5]. H. B. Joshi, A. Stainthorpe, R. P. MacDonagh, F. X. Keeley Jr., and A. G. Timoney, "Indwelling ureteral stents: evaluation of symptoms, quality of life and utility," Journal of Urology, vol. 169, no. 3, pp. 1065–1069, 2003. View at Publisher · View at Google Scholar · View at Scopus

Abstract: Distal tibial fracture is one of the commonest fracture following accidents in over 15% of total fracture cases.The triumph key in managing these niggling fractures is to proficiently preserve, reconstruct the soft tissues, acceptable reduction & early mobilization.AO/OTA classification system is used now a days to classify these fractures.The concept of "biological osteosynthesis", a terminology introduced to designate a new & novel type of osteosynthesis leading to a sufficiently stable fixation of bone fragments allowing early mobilization, and that too without major disturbance of the vascular supply.The advantages of distal tibiallocking plates (DTLP) apply most directly to highly comminuted fractures, unstable metadiaphyseal segments, and osteoporotic fractures.

Key Words: DTLP, biological osteosynthesis, distal tibial fractures.

[1] Ruedi T, Allgower M. Fractures of the lower end of the tibia into the ankle joint. Injury 1969; 1: 92-9.
[2] Orthopaedic Trauma Association Committee for Coding and Classification. Fracture and dislocation compendium. J Orthop Trauma 1996; 10(1):1.
[3] Broos PL, Sermon A. From unstable internal fixation to biologicalosteosynthesis. A historical overview of operative fracturetreatment. ActaChirBelg 2004;104(4):396-400.
[4] Smith WR, Ziran BH, Anglen JO, Stahel PH. Locking Plates: TipsandTricks J Bone Joint Surg Am 2007;89:2298-307.
[5] Sommer C, Gautier E, Muller M, Helfet OL, Wagner M. First Clinicalresults of the Locking Compression Plate (LCP). Injury 2003;34(2):B43-54.

Abstract: Spina bifida literally means "spine in two parts" or "open spine". Spinal dysraphism involves a spectrum of congenital anomalies resulting in a defective neural arch through which meninges or neural elements are herniated, leading to a variety of clinical manifestations. They are divided into aperta (visible lesion) and occulta (with no external lesion). Meningocele, myelomeningocele, lipomeningomyelocele, myeloschisis and rachischisis are the usual names associated depending on the pathological findings. Meningocele by definition involves only the meninges with no neural involvement; others have variable extent of neural involvement. The spina bifida aperta is usually associated with skin defect with an impending risk of CSF leak constituting "open defects," whereas the occult forms have normal skin cover. Both forms demand different approaches in their management. The clinical importance of occult lesion has grown tremendously in the recent years..............

Keywords: MRI, Spinal Dysraphism, Lumbar Myelomeningocele, Diastematomyelia, Open Spinal Dysraphism with Osseous Hamartoma, Tethered Cord, Dermal Sinus.

[1]. Muhammad Nafees, Muhammad Hamid Akram, et al. MR image spectrum of spinal dysraphism in a military hospital in journal of army medical corps. Issue Year: 2012, Issue Number: 1, Issue Month: March.
[2]. Mohammed Fathy Dawoud, et al. Role of MRI in diagnosis of spinal congenital anomalies. Radiology and neurosurgery, Tanta Medical Sciences Journal, Vol (2), No(1), January 2007; PP 182-193.
[3]. Raj Kumar, Singh SN. Spinal dysraphism: Trends in Northern India Journal: Paediatric Neurosurgery - Pediat Neurosurg. Vol. 38, No. 3, Pp. 133-145, 2003.
[4]. Tahira Nishtar, Attiya Elahi, Naveed Iqbaletal. To determine the frequency of accuracy of MRI in diagnosis of rare disorder of spinal dysraphism. J Med Sci (Peshawar, Print) October 2011; Vol 19, No 4: 195-199.
[5]. Zuppani HB1, Guedes Bde V, da Silva CJ, et al. Lipomyelocele with osseous dysraphic hamartoma in a child: a case report. J Pediatr Orthop B. 2010 Jul;19(4):382-4.

Abstract: Background: ECG changes have been widely reported in stroke patients, but these have neither been adequately interpreted, nor they have been studied along with the nature of the stroke or its location. Aims & Objective: To study the incidence and pattern of ECG changes in patients with cerebrovascular accidents. Material & Method: Result:.

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Abstract: Background: Positioning of the patients head and neck for best visualization of glottis is the prime need before laryngoscopy and intubation. The study was conducted to compare traditional sniffing position with head elevation/neck flexion position to find out which position provides better laryngoscopy and intubation in patients undergoing elective surgery under general anaesthesia. Materials and Methods: One hundred patients were randomly allocated to two groups. In Group I (n=50), laryngoscopy was done in sniffing position, while in Group II (n=50), laryngoscopy was done in simple head extension with head flat on operating table. Glottic visualization was assessed by Cormack-Lehane grading and Intubation Difficulty Scale..........

[1] Adnet F, Borrow SW, Dumas JL, Lapostolle F, Cupa M, Lapundry C. Study of the sniffing position by magnetic resonance imaging. Anesthesiol 2001; 94(1): 83-6.
[2] Adnet F, Baillard C, Borron SW, Denantes C, Lefebvre L, Galinski M, et al. Randomized study comparing sniffing position with simple head extension for laryngoscopic view in elective surgery patients. Anesthesiol 2001; 95(4): 836-41.
[3] Caplan RA. The closed claimed project: Looking back, looking forward. ASA Newsletter 1999; 63(6): 7-9.
[4] Practice guidelines for management of the difficult airway. An updated report by the American Society of Anesthesiologists task force on management of the difficult airway. Anesthesiol 2003; 98: 1269-77.
[5] Mangal V, Sinha MK, Nigam R, Agnihotri P. Comparative evaluation of glottic visualisation and ease of intubation using sniffing position and simple head extension during laryngoscopy in elective surgical procedures – a randomised prospective observational study Central J ISA 2017; 1(2): 57-63.

Abstract: Hepatitis B is one of the most important causes of acute and chronic hepatitis world over. Children with malignant disease are at an especially high risk for developing hepatitis B virus (HBV) infection. The increasing potential for the cure of childhood malignant diseases emphasizes the need for a method of reducing hepatitis and its sequelae in these children. The efficacy of this HBV vaccine among Leukemic children in Tripoli Medical center (TMC), Tripoli, Libya is the aim of this study. Study was conducted at TMC, Tripoli, Libya in 2016 with 399 healthy (255) and leukemic (144) children. All cases were treated with HBV vaccine of 3 doses. Venous blood collected and examined for AntiHBST...........

Key words: HBV Vaccine, Leukemia, Children, Libya

[1] Adalet M, Betul S and Unsal G (2000) Efficacy of immunization against hepatitis B virus infection in children with cancer. Paediatric Blood and Cancer 35(1):47-51.

[2] Alavian SM, Fallahian F, Lankarani KB (2010) Implementing strategies for hepatitis B vaccination. Saudi J Kidney Dis Transpl. 2010;21:10–22.

[3] Böcher WO, Herzog-Hauff S, Schlaak J, Meyer zum Büschenfeld KH and Löhr HF (1999) Kinetics of hepatitis B surface antigen-specific immune responses in acute and chronic hepatitis B or after HBs vaccination: stimulation of the in vitro antibody response by interferon gamma. Hepatology 29: 238-244.
[4] Derry R and Wolff LJ (2009) Active immunisation of children with Leukemia and other malignancies. Leukemia and Lymphoma 177-192.
[5] Elzouki AN (2007) Hepatitis B, C and HIV infection in Libya. Libyan J Infect Dis.,1:132-133.

Abstract: Background: Acute Kidney Injury(AKI) in children is associated with significant morbidity and mortality. Peritoneal dialysis (PD) is the preferred and convenient treatment modality for acute kidney injury (AKI) in children and hemodynamically unstable patients. Aim :To study the incidence and clinico-etiological profile of paediatric acute kidney injury patients and the outcome following peritoneal dialysis. Study Design: Retrospective observational study done from November 2007 to August 2016. Materials &Methods :All children aged 1day to 18 years of age with clinical symptoms or abnormal laboratory parameters suggesting acute kidney injury were included in the study. Renal failure classified by pRIFLE. The outcome of acute kidney injury following acute Peritoneal Dialysis was studied in 160 children.Data was analyzed by descriptive statistics.Chi square test is used as test of significance..........

Keywords: Acute Kidney Injury ;pRIFLE ; outcomes; peritoneal dialysis

[1] Cerdá J, Bagga A, Kher V, Chakravarthi RM. The contrasting characteristics of acute kidney injury in developed and developing countries. Nat ClinPractNephrol. 2008;4:138–53.
[2] Askenazi DJ, Feig DI, Graham NM, Hui-Stickle S, Goldstein SL:3-5 year longitudinal follow-up of pediatric patients after acute renal failure. Kidney Int 69: 184–189, 2006
[3] Mammen C, Al Abbas A, Skippen P, Nadel H, Levine D, Collet JP,Matsell DG: Long-term risk of CKD in children surviving episodes of acute kidney injury in the intensive care unit: A prospective cohort study. Am J Kidney Dis 59: 523–530, 2012
[4] Sinha R, Nandi M, Tullus K, Marks SD, Taraphder A: Ten-year follow-up of children after acute renal failure from a developing country. Nephrol Dial Transplant 24: 829–833, 2009.
[5] KDIGO clinical practice guideline for acute kidney injury: modality of renal replacement therapy for patients with AKI. Kidney IntSuppl2012; 2:107–10.

Abstract: Introduction: Cardiovascular disease (CVD) is a leading cause of death worldwide and has shown increase in its prevalence since the 19th century.The increase in prevalence was attributable to epidemiologic transition with westernization and changing life style patterns with resultant increase in the risk factors for cardiovascular diseases.This study was carried out to determine the pattern of cardiovascular disease admissions in Murtala Muhammad Specialist hospital, (MMSH) Kano, North – west Nigeria. Methods:Methods: The study was retrospective covering the period from January 2013 to December 2015. Statistical Package for Social Sciences (SPSS) version 19 software was used to analyze data. Results: Out of 4834 patients(males, 2526 and females, 2308) admitted in to the medical wards, 2,119 were recruited in to the study. Stroke (54.6%), congestive cardiac failure(CCF)26.6(%) and hypertension(15.7%) were the most prevalent admitted CVDs...........

Key Words: Cardiovascular disease, Admissions, North – western Nigeria.

[1] World Health Organization (WHO) Non – communicablediseases country profiles 2011, 'WHO Global Report, Geneva, Switzerland, September 2011, http://whqlibdoc.who.int/publications/2011/9789241502283.eng.pdf.
[2] S.Kadiri. 'Tackling cardiovascular disease in Africa,' British Medical Journal,vol. 331, article711, 2005.
[3] Ezeala – Adikaibe B, Aneke E, Orjioke C, Ezeala – Adikaibe N. Admissions at Enugu State University of science and technology. Med Health Sci Res. 2014; 4(3):426 – 31.
[4] Ogunmola OJ, Oladosun OY. Pattern and outcome of admissions in medical wards of tertiary health center in a rural community of Ekiti State, Nigeria. Am Afr Med 2014; 13: 195 -203.
[5] Okunola OO, Akintunde AA, Akinwusi PO. Some emerging issues in medical admission pattern in the tropics. Niger J ClinPract 2012; 15:51 – 4.

Abstract: Composites are widely used materials in restorative dentistry. But like other materials they do have their disadvantages for example polymerization shrinkage which gradually leads to, stress at the tooth-restoration margins causing marginal discoloration, post- operative sensitivity and recurrent caries. The composite restorations are also subject to masticatory forces and flexural stresses. So, the analysis of volumetric shrinkage, elastic modulus and flexural strength, is crucial in predicting the clinical success of composites.Some new materials have been introduced nowadays, which claim to overcome such shortcomings, eg silorane-based composite and ormocer-based composites.The purpose of this study is to compare the volumetric shrinkage,elastic modulus and flexural strength of silorane and ormocer based composites to the conventional dimethacrylate based composites,and to judge the clinical worth of these materials.

[1]. Johnson LN. Composite resins as a dental restorative material. Journal of Biomedical Materials Research Part A. 1971 Mar 1; 5(2):207-23.
[2]. Cramer NB, Stansbury JW, Bowman CN. Recent advances and developments in composite dental restorative materials. Journal of dental research. 2011 Apr; 90(4):402-16.
[3]. Bausch JR, de Lange K, Davidson CL, Peters A, De Gee AJ. Clinical significance of polymerization shrinkage of composite resins. The Journal of prosthetic dentistry. 1982 Jul 1; 48(1):59-67.
[4]. Della Bona Á, Benetti P, Borba M, Cecchetti D. Flexural and diametral tensile strength of composite resins. Brazilian oral research. 2008 Mar; 22(1):84-9.
[5]. Junior R, Adalberto S, Zanchi CH, Carvalho RV, Demarco FF. Flexural strength and modulus of elasticity of different types of resin-based composites. Brazilian oral research. 2007 Mar; 21(1):16-21.

Abstract: Hoarseness of voice is one of the commonest symptoms in otorhinolaryngological practice and it indicates diseases ranging from totally benign condition to the most malignant condition. This is a study to know the etiology, predisposing factor, and clinical profile of patients having hoarseness of voice. A prospective study comprising of 126 cases of Hoarseness was carried out in the department of Otorhinolaryngology and Head and neck surgery, Gauhati Medical College and Hospital, Guwahati from June 2016 to May 2017.Stroboscopic evaluation was done to reach the diagnosis. Age of patients ranged from 18 years to 80 years. Male to female ratio was 1.2:1. Trader constituted single largest group (22.2%). Majority of cases were from rural areas (65%). Duration of hoarseness of voice ranged from 2 weeks to 52 years. Commonest cause of hoarseness was of inflammatory or infectious nature constituting (56.3%).

Key words: Hoarse voice, aetiology, stroboscopy.

[1]. Garrett CG, Ossoff RH( 1999): Hoarseness. Medical Clinics of North America , 83 (1) : 115 - 123.
[2]. Parikh N P. Aetiological study of 100 cases of hoarseness of Voice. Indian Journal of Otolaryngology and Head and Neck Surgery; 1991; 43(2):71-73.
[3]. Koufman J.A, Isaacson G: Voice disorder Otolaryngologic Clinics of North Americavol 24 Oct 1991,985 -1253.
[4]. Baitha S, Raizada RM, Kennedy Singh AK, Puttewar MP, Chaturvedi VN (2002) Clinical profile of hoarsens of voice. Indian J Otolaryngol Head Neck Surg 54(1):14–18
[5]. Banjara H, Mungutwar V, Singh D, Gupta A (2011) Hoarseness of voice: a retrospective study of 251 Cases. Int J Phonosurg Larungol 1(1):21–27

Abstract: OBJECTIVES: To study effect of vaginal pH on cervical ripening with dinoprostone gel in terms of time to active labour,induction delivery time interval, mode of delivery and feto-maternal outcome between rural and urban primigravida. METHODS: -In a hospital based comparative study,dinoprostone gel with vaginal pH in patients with modified Bishops score ≤5 in 100 primigravida inserted and outcome noted and statistical analysis done in both group. RESULTS : - Urban primigravida required lesser time interval in terms of time to active labour, induction delivery time interval and better feto-maternal outcome as compared to rural primigravida. CONCLUSION :. – Vaginal pH has an effect on the efficacy of gel for cervical ripening.Thus reducing unnecessary labour induction, caesarean section for failed induction in a cost effective way.

KEYWORDS : Dinoprostone gel, Vaginal PH, Modified Bishop's score.

[1]. Cunningham FG, Leveno KJ, Bloom SL, Hoth JC, Rouse DJ, Sponge CY. Williams Obstetrics. 23rd Edi. New York; McGrawHill: 2010.
[2]. Hiralal Konar; D.C Dutta. Induction of Labour. A textbook of Obstetrics,8th edition. Chapter 35; page 599.
[3]. Choudhury A, Das S, Kar M. A Review on Novelty and Potentiality of Vaginal Drug Delivery. International Journal of Pharm-Tech Research. 2011; 3(2):1033-44.
[4]. Sanchez-Ramos L. Induction of Labor. Obstet Gynecol Clin N Am. 2005;32:181-200.
[5]. Vaisanen-Tommiska M, Nuutila M, Aittomaki K, Hiilesmaa V, Ylikorkala O. Nitric oxide metabolites in cervical fluid during pregnancy: further evidence for the role of cervical nitric oxide in cervical ripening. Am J Obstet Gynecol. 2003;188(3):779-85.

Abstract: Introduction :Breast diseases are at a rising trend in recent years among young women. Many cancers are diagnosed at advanced stages. Carcinoma breast that too invasive ductal variety is the most commonest of all. Aims and objectives: Earlier detection of malignancy in breasts with the aid of modified triple test which includes clinical examination,USG breast,FNAC of breast lump. Materials and methods: A prospective study done at Goovernment Mohan Kumaramangalm Medical College Hospital for a time period of 1 year from November 2016 to november 2017. A total of 103 patients were included in the study...........

KEYWORDS : Breast, clinical examination, FNAC, Malignancy, Ultrasonography.

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[3]. Meena SP, Hemrajani DK, Joshi N. A comparative and evaluative study of cytological and histological grading system profile in malignant neoplasm of breast — An important prognostic factor. Indian J Pathol Microbiol. 2006;49:199–202.

[4]. Lester SC. The breast. In: Kumar V, Abbas AK, Aster JC, Fausto N, editors. Robins and Cotran Pathologic Basis of Disease. 8th ed. Vol. 23. Philadelphia: Saunders an Imprint of Elsevier; 2010. pp. 1068–9.

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