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

Abstract: Acromioclavicular injuries are very often missed and given less importance by patients. Here We have used a innovative technique for reparing acromioclavicular ligament both in acute and neglected acromioclavicular joint injuries. We studied a series of five cases in which we did acromio clavicular ligament reconstruction using semitedinous graft .out of the five cases one case was 3 months old neglected injury and others were acute injuries. We analysed the patients functional outcome by means of clinical improvement in shoulder range of motion, improvement in pain, radiological reduction acromio clavicular joint distance

Key words: Ac joint injuries, STG graft,

[1]. SACCOMANNO MF, FODALE M, CAPASSO L, CAZZATO G, MILANO G. Reconstruction of the coracoclavicular and acromioclavicular ligaments with semitendinosus tendon graft: a pilot study. Joints. 2014;2(1):6-14.
[2]. El-Soufy M, Abdel-Dayem A. Anatomic reconstruction of the coracoclavicular ligament in a recent acromioclavicular joint dislocation. Egypt Orthop J 2013;48:156-62

Abstract: Background: A review of both Western and Indian literature shows that there are few comprehensive studies on pancytopenia. InIndia, thecauses ofpancytopeniaarenotwelldefined. Thisdata, would help in planning the diagnostic and therapeutic approach in patients with pancytopenia. AimTo evaluate the cases of pancytopenia by peripheral smear and/ orbonemarrowaspirationandbonemarrowbiopsytofindoutthe etiology, clinical, haematological, and histomorphologic features of pancytopenia. Materials and Methods:Total 86 cases were selected anddetailed haematological investigations including complete hemogram, peripheral smear examination, bone marrow aspiration, and biopsy examination were done.Results: The most common cause of pancytopenia in our study was megaloblastic anaemia (50%), followed by nutritional anaemia (16.3%) and hypoplastic...........

Key words: Aplastic anaemia, megaloblastic anaemia, pancytopenia

[1]. Kar M, Ghosh A. Pancytopenia Journal. Indian Academy of Clinical Medicine. 2002;3:29–341. [2]. Ishtiaq O, Baqai HZ, Anwer F, Hussai N. Patterns of pancytopenia patients in a general medical ward and a proposed diagnostic approach. [Last accessed on 2007]. Available from:http://www.ayubmed.edu.pk/JAMC/PAST/16-1/osama.htm-206K-6/24/2007. [PubMed] [3]. Guinan EC, Shimamura A. Wintrobe's Clinical Hematology. In: Greer JP, Foerster J, Lukens JN, Rodgers GM, Paraskevas F, Glader B, editors. Acquired and inherited aplastic anemia syndromes. 11th ed. Philadelphia: Lippincott Williams and Wilkins; 2004. pp. 1397–419.

Abstract: Introduction: Stone disease is a world‑wide health problem.We evaluated the efficacy of nifedipine and alfuzosin in the medical treatment of symptomatic, uncomplicated lower ureteral stones.Materials & methods: This was a randomized controlled prospective study to determine the efficacy of alfuzosin and nifedipine as medical therapy, to increase the stone‑expulsion rates in distal ureteric calculus of size less than 10 mm. Patients were randomly divided into three equal groups of 70 patients each. Patients in Group I received nifedipine 30 mg/day, Group II received alfuzosin 10 mg/day and Group III received a placebo in same dose frequency. Patients were followed‑up weekly until the patient was stone free or up to 28 days. Statistical analysis was performed and P < 0.05 was considered to be significant.Results: Stone‑expulsion was observed in 60%, 85.7% and 20% patients in Group I, II and III respectively. A statistically significant difference was noted in between Groups I versus III, Groups II versus............

Key words: Alfuzosin, distal ureteral stones, medical expulsive therapy, Nifedepine

[1]. Segura JW, Preminger GM, Assimos DG, Dretler SP, Kahn RI, Lingeman JE,et al. Ureteral stones clinical guidelines panel summary report on the management of ureteral calculi. The American urological association. J Urol 1997;158:1915‑21.
[2]. Dellabella M, Milanese G, Muzzonigro G. Efficacy of tamsulosin in the medical management of juxtavesical ureteral stones. J Urol 2003;170:2202‑5.
[3]. Obara K, Takeda M, Shimura H, Kanai T, Tsutsui T, Komeyama T, et al. Alpha‑1 adrenoreceptors subtypes in the human ureter. Characterization by RT‑PCR and in situ hybridization. J Urol 1996;155:472A.
[4]. Kinnman E, Nygårds EB, Hansson P. Peripheral alpha‑adrenoreceptors are involved in the development of capsaicin induced ongoing and stimulus evoked pain in humans. Pain 1997;69:79‑85.
[5]. Andersson KE, Forman A. Effects of calcium channel blockers on urinary tract smooth muscle. Acta Pharmacol Toxicol (Copenh) 1986;58 Suppl 2:193‑200.

Abstract: Pre-eclampsia refers to pregnancy-induced hypertension, a condition characterized by diffuse maternal endothelial dysfunction and a systemic inflammatory response with possible haemorheological changes. This study assessed haemorheologic and biochemical parameters of thirty pre-eclamptic patients admitted in University of Calabar Teaching Hospital and compared same with those of thirty normal pregnant as well as thirty apparently healthy non-pregnant controls aged 18-45 years. Weight, height and blood pressure of subjects were measured using standard instruments while body mass index was calculated. Erythrocyte sedimentation rate, relative plasma viscosity and fibrinogen concentration were used to assess haemorheology while biochemical parameters included protein in urine, total protein, albumin, globulin and uric acid concentrations. All tests were performed using standard..........

Keywords: Pre-eclampsia, haemorheology, hypercoagulation

[1]. Lewis, S. M (2002). Miscellaneous tests. In: Lewis S. M, Bain B. J & Bates I (Eds)Practical Haematology. London: Churchill Livingstone. 9: 527-542.
[2]. Roberts, J. M &Gammil, H. S (2005). Preeclampsia: recent insights Hypertension 46(6):1243-9.
[3]. O' Brien, L. M, Bullough, A. S, Owusu, J. T, Tremblay, K. A, Brincat, C. A, Chames, M. C, Kalbfleisch, J. D &Chervin, R. D. (2012). Pregnancy Onset Habitual Snoring, Gestational Hypertension, and Pre-eclampsia: Prospective Cohort Study American Journal of Obstetrics & Gynecology 207(6): 487.
[4]. Global Burden of Disease Study (2013). "Global, regional and national age-sex specific all cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis" Lancet 385:117-171
[5]. Dolea, C &AbouZahr, C. (2003). Global Burden of hypertensive disorders of pregnancy in the year 2000; Evidence and information for policy World Health Organization 1-11

Abstract: Squamous cell carcinoma (SCC) is the most common malignant neoplasm of oral cavity. It is also the most common malignancy of upper aero-digestive tract. Conventional type Oral SCC remains predictable for diagnosis but its variants offer diagnostic as well as prognostic challenge as they may be histopathologically benign or may mimic other malignant diseases. The common variants of SCC include Verrucous Carcinoma, Basaloid SCC and other rare variants (spindle cell, papillary, adeno-squamous). This article discusses the clinico-pathologic features of these unusual variants and their differential diagnosis for determining the accurate diagnosis as well as prognosis.

Key Words- Squamous Cell Carcinoma (SCC), Verrucous Carcinoma (VC), Basaloid SCC, Spindle cell Carcinoma, Papillary Squamous Cell Carcinoma.

[1]. Scully C, Newman L, Bagan JV. The role of the dental team in preventing and diagnosing cancer: 2. Oral cancer risk factors. Dent Update 2005;32(5):261–2, 264–6, 269–70.
[2]. Neville BW, Day TA. Oral cancer and precancerous lesions. CA Cancer J Clin 2002; 52(4):195–215.
[3]. L.D.R Thompson. Squamous cell carcinoma variants of the head and neck. Current Daignostic pathology(2003) 9, 384-396.
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[5]. Brennan J A, Mao L, Hruban R H et al. Molecular assessment of histopathological staging in squamous-cell carcinoma of the head and neck. N Engl J Med 1995; 332: 429--435.

Abstract: Aim-To address the importance of a permanent lower canine with two roots for dental identification considering the internal and external morphology of the canine roots Summery-The knowledge of root canal system of different human teeth is a "road map" for the successful root canal treatment. Endodontic treatment may sometimes fail because morphological features of the tooth adversely affect the treatment procedures. Many investigators have reported the anatomical variations associated with mandibular canines. In majority of cases, mandibular canines have one root and one root canal, although 15% may have two canals. Literature report shows incidence of two-rooted canine as low as 1.7%. This article reports a clinical case of endodontic treatment of mandibular canine with two roots and two canals. The clinicians must always suspect anatomical varieties and use all the available tools to diagnose and manage their cases.

Key words: Anatomic variation, CBCT, Mandibular canine, Two roots.

[1]. Ingle JI, Backland LK, Baumgartner JC (Eds). Ingle's Endodontics (6th ed). ON, Canada: BC Decker Inc. Publishing 2008.p.151
[2]. D'Arcangelo C, Varvara G, de Faizo P. Root canal treatment in mandibular canines with two roots: A report of 2 cases. Int Endod J 2001 Jun; 34(4):331-34.
[3]. Victorino FR, Bernardes RA, Baldi JV, Moraes IG, Bernardinelli N, Garcia RB, et al. Bilateral mandibular canines with two roots and two separate canals: case report. Brazilian Dental Journal. 2009;20(1):84-6.
[4]. Ouellet R. Mandibular permanent cuspids with two roots. Journal of Canadian Dental Association. 1995;61(2):159-61.
[5]. Bharadwaj A, Bharadwaj A. Mandibular canines with two roots and two canals. Int J Dent Clin 2011;3(3):77-78.

Abstract: Aims and objectives: Haematological toxicity is common in patients with cervical cancer treated with concurrent chemoradiation, so our study aimed to assess this haematological toxicity and correlate the toxicity with the dose and volume of bone marrow included in the field of radiation. Materials and methods: Twenty five patients with histological proven cervical cancer attending the department of Radiation Oncology at Yashoda hospital, Hyderabad from June 2011 to July 2013 were the subjects of this study. Patients were treated on 15 MV linear accelerator with a radical intent, with concurrent chemotherapy using Cisplatin 40 mg/m2 weekly. The planning CT was done for all the patients before the treatment and contouring of the pelvic bone marrow apart from other organs at risk was done...........

Key words: Haematological toxicity, cervical cancer, Bone marrow, Concurrent chemoradiation.

[1]. Rose P G, Brian N Bundy, Edwin Watkins, Thigpen, Gunther, Mitchell A et al. Concurrent Cisplatin based Radiotherapy and Chemotherapy for Locally Advanced Cervical cancer. N Engl J Med. 1999; 340(15):1144-1153.
[2]. Barton M B, Frommer M, Shafiq J, Delaney G, Jacob S, Featherstone et al. Role of radiotherapy in cancer control in low income and middle income countries. Lancet Oncol. 2006;7:584-595.
[3]. Akila N. Viswanathan. Uterine Cervix. In: Perez C A, Brady W L, Halperin EL, Wazer DE, editors. Perez and Brady's Principles and Practice of Radiation Oncology. 6th ed. Lippincott Williams and Wilkins. Philadelphia; 2013.p.1367.
[4]. Thomas G M, Serkies, Grogan M, Melamed I, Dembo A, Ackerman I et al. Improved treatment for cervical cancer concurrent chemotherapy and radiotherapy. N Engl J Med.1999; 340:1198-1200
[5]. Man Manus, M.Lamborn, K Kathl, Waqar Khan, Anna Varghese, Lorin Graef et al. Radiotherapy associated neutropenia and thrombocytopenia analysis of risk factors and development of predictive model. Blood. 1997; 1(89):2303-2310.

Abstract: Background: COPD is one of the leading causes of death in the world and has become a major issue of public health importance. With increasing in-hospital admission rates due to acute exacerbations, the emphasis is high on early diagnosis, prognostication and effective management of the primary disease and its complications. This study utilizes serum electrolytes as a prognostic marker to assess the severity of the illness and help reduce mortality rates. Objectives: To assess the significance of serum electrolytes as a prognostic marker in acute exacerbations of COPD Methods: 50 patients with acute exacerbations of COPD and 50 healthy COPD controls confirmed by spirometry were taken for the study.........

[1]. John JR, Edwin KS, Steven DS. Chronic obstructive pulmonary disease in Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson JL, Loscalzo J. Harrison Principles of Internal Medicine, 19th edition. New York : McGraw-Hill; 2015 p1700
[2]. Halbert RJ, Natoli JL, Gano A, Badamgrav E, Buist AS, Mannino DM. Global burden of COPD : systematic review and meta-analysis. EurRespir J.2006 Sep 1 : 523-32
[3]. Das P, Bandyopadhyay M, Baral K, Paul R, Banerjee AK. Dyselectrolytemia in Chronic Obstructive Pulmonary Disease with acute exacerbation. Nig J.Physiol. Sci 2010; 25-27
[4]. Alladi Mohan et al, Clinical presentation and predictors of outcome in patients with COPD. BMC pulm med 200; 466-77
[5]. Rabinovitz A, Raiszadeh F, Zolty R. Association of hyponatremia and pulmonary hypertension. Division of Cardiology, Journal of Cardiac Failure. 2013; 550-556.

Abstract: Introduction: Acute abdomen may be a life-threateningcondition particularly when evaluation of the patient in emergency department with acute abdominal pain is obscured by its myriad presentation, delaying or preventing the correct diagnosis, with subsequent adverse patient outcomes requiring surgery. In such patients requiring surgery, a scoring system can be used to audit and evaluate efficiency in hospital care and prevent subsequent morbidity and mortality. The objective was to study spectrum of abdominal emergencies and validate POSSUM (Physiological and Operative Severity Score for Enumeration of Mortality and Morbidity score) in government hospital setting in patients undergoing subsequent laparotomy and their prognosis. Materials and methods:Prospective study of 400 patients admitted in JA GROUP OF HOSPITAL, Gwalior and underwent laparotomy for abdominal emergencies from January 2016 to December 2017. Parameters for calculating POSSUM score were retrieved. Observed: expected (O: E) ratios for morbidity and mortality calculated using linear and exponential analysis...........

[1]. Pitts SR, Niska RW, Xu J, et al. National hospital ambulatory medical care survey: 2006 emergency department summary. National health statistics report; no 7. Hyattsville, MD: National Center for Health Statistics; 2008
[2]. Memon AA, Siddique FG, Abro AH, Agha AH, Lubina, Shahazadi, Memon AS. An audit of secondary peritonitis at a tertiary care university hospital of Sindh, Pakistan. World J Emerg Surg. 2012 Mar; 7:6.
[3]. Doherty GM, Editor. Current diagnosis and treatment, Surgery. 13th edition. New York: The McGraw-Hill Companies, Inc.; 2010:464-8.
[4]. Prytherch DR, Sutton GL, Boyle JR. Portsmouth POSSUM for abdominal aortic aneurysm surgery. Br. J Surg 2001; 88(7): 958-963.
[5]. Ohmann C, Yang Q, Hau T, Wacha H and the Peritonitis Study group of the surgical infection society Europe. Prognostic Modelling in Peritonitis. Eur J Surg. 1997; 163:53-60.

Abstract: Introduction: Kidney stones are a common problem affecting all population groups across the globe. Percutaneous extraction of renal stone has become a standard well-established procedure for the management of renal stones. Materials and methods: A total of 105 cases of renal calculi who underwent PCNL from August 1, 2016 to November 30,2017 were studied. Intraoperative findings and immediate postoperative complications were noted. They were followed up for 1 month after the surgical procedure...........

Key words: Minimally invasive, Nephroscopy, Percutaneous nephrolithotomy, Renal calculi.

[1]. Koga S, Arakaki Y, Matsuoka M, Ohyama C. Staghorn calculi – long-term results of management. Br J Urol 1991 Aug;68(2):122-124
[2]. Sohail M, Malik MA, Khalid M, Iqbal Z. Percutaneous nephrolithotomy through upper calyceal approach for complex lower polar renal calculi. JUMDC 2015;6(3):26-31
[3]. Munver R, Delvecchio FC, Newman GE, Preminger GM. Critical analysis of supracostal access for percutaneous renal surgery. J

[4]. Hegarty NJ, Desai MM. Percutaneous nephrolithotomy requiring multiple tracts: comparison of morbidity with single-tract procedures. J Endourol 2006 Oct;20(10):753-760
[5]. de la Rosette J, Assimos D, Desai M, Gutierrez J, Lingeman J, Scarpa R, Tefekli A; CROES PCNL study group. The clinical research office of the endourological society percutaneous nephrolithotomy global study: indications, complications, and outcomes in 5803 patients. J Endourol 2011 Jan;25(1):11-17

Abstract: In maxillofacial injuries wherein patients report with panfacial fractures, airway management in these types of cases are still a challenge to the anesthesiologist. Out of different modes of intubation such as oroendotracheal intubation, Nasoendotracheal intubation, tracheostomy and submental endotracheal intubation a anesthetist and the maxillofacial surgeon have to plan the best way of intubation so they can achieve the proper intubation, best maxillofacial reduction and fixation, and less postoperative complication. In this article we present a case where we had planned the submental endotracheal intubation .

[1]. Naveen M, Neeraj B, P. Chari. Submental endotracheal intubation: A useful alternative to tracheostomy. Indian J Anesth. 2002; 46(5): 400-402.
[2]. Christophe M, Jocelyne V, Thordis K, Astrid W, Philippe B. Indication for and technical refinements of submental intubation in oral and maxillofacial surgery. J Cranio-Maxillofacial Surgery 2003; 31, 383-388.
[3]. Petr S, Hussein H. Submental intubation versus Tracheostomy in Maxillofacial trauma patients. J Oral Maxillofacial Surg2008; 66,1404-1409.
[4]. Babu I, Sagtani A, Jain N, Bawa SN. Submental tracheal intubation in a case of panfacial trauma. Katmandu University Medical Journal 2008;6(21),102-104.

[5]. Caubiet all. Submental intubation in oral and maxillofacial surgery: Review of literature and analysis of 13 cases. Med Oral Patol Oral Cir Bucal 2008;13(3):197-200..

Abstract: Autism is a disability that profoundly affects the way a child relates and communicates with other people around them. Autism spectrum disorder (ASD) is characterized by varying degrees of impairment of communication skills and social interaction, and unusual repetitive behavior. The present research work was taken up to investigate the effectiveness of gluten and casein free food products on the symptoms of autistic children. Fifteen autistic children aged between 6 to 12 years were purposive selected in this study. Formulation and sensory evaluation of gluten free and casein free food products was conducted and best was selected for supplementation. The study was followed for a period of six months. The assessment of autism symptoms was measured through different domains of Indian scale of autism, Hyderabad (ISSA) in pre and post study. Results about autistic children, who strictly followed dietary exclusion of gluten free casein free diet showed that a positive change in symptoms behavior skills, speech and language and cognitive components significantly..

Key words: Autism, Casein free, Gluten free, Psychological, Symptoms

[1]. Harris C, Card B. A pilot study to evaluate nutritional influences on gastrointestinal symptoms and behavior patterns in children with autism spectrum Disorder. Complementary Their Med 2012; 20: 437- 440.
[2]. Myers SM, Johnson CP. American Academy of Pediatrics Council on ChildrenWith Disabilities. Management of children with autism spectrum disorders. Pediatrics 2007;120:1162-1182.
[3]. Millward C, Ferriter M, Calver SJ, Connell-Jones GG. Gluten- and casein-free diets for autistic spectrum disorder. Cochrane Database Syst Rev. 2008; (2): CD003498

[4]. Vojdani A, O‟Bryan T, Green JA, Mccandless J, Woeller KN, et al. Immune response to dietary proteins, gliadin and cerebellar peptides in children with autism. Nutr Neurosci 2004;7:151-161.
[5]. Alissa EM, Ferns GA. Functional foods and nutraceuticals in the primary prevention of cardiovascular diseases. J Nutr Metab 2012: 569486.

Abstract: The vertical micro gap between implant and abutment has a vital role in implant survival as well as for prosthetic success. Bacterial colonization may happen in the microgap leading to peri-implantitis. Passive fit between the implant and abutment is a pre-requisite for the prosthetic success. The study compared the microgap of Cast Nickel-Chromium and Cobalt-Chromium abutments with premade abutments made of Grade 5 titanium. 15 implant abutments were divided into 3 groups. Group-1 comprised of 5 pre-made abutments. 10 plastic abutments, of which 5 were cast in Nickel-Chromium (group-2) and 5 were cast in Cobalt-Chromium (group-3). One internal hex implant was embedded in an acrylic resin model. Each standard abutment and cast abutment was tightened on it. The abutment/implant interface for each specimen was analyzed at 6 different locations, using Mitutoyo QV Apex302 Measuring System. Data were submitted to statistical analysis (One Way ANOVA and Duncan's Multiple..........

Key words: Cast abutments, Cast Implant frameworks, Microgap, Premade abutments,Peri-implantitis, Prosthetic failure, Passive fit,Screw loosening

[1]. Jemt, T., Linden, B., andLekholm, U, Failures and complications in 127 consecutively placed fixed partial prostheses supported by Branemark implants: from prosthetic treatment to first annual check-up,Int J Oral Maxillofac Implants, 7,1992, 40-44.
[2]. Taylor, T.D, Agar, J.R., Vogiatzi, T, Implant prosthodontics: current perspective and future directions, Int J Oral Maxillofac Implants, 15,2000, 66-75.
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[4]. Kallus, T., Bessing, C, Loose gold screws frequently occur in fullarch fixed prostheses supported by osseointegrated implants after 5 years,Int J Oral Maxillofac Implants, 9,1994, 169-178.
[5]. Stefania, Carvalho, Kano., Gerson, Bonfante., Raquel, Hussne., Aline, F,. Siqueira, Use of base metal casting alloys for implant framework: marginal accuracy analysis,J. Appl. Oral Sci. Oct-Dec. 12,2004, 337-43..

Abstract: Esophagocoloplasty is a major surgery done for corrosive esophageal stricture. It is usually done with feeding jejunostomy for early enteral nutrition in the postoperative period. The common complications following esopghagocoloplasty are anastamotic stricture, adhesive obstruction, malnutrition and anemia. Here we present an unusual cause of lower gastro intestinal bleed Ina 14 year old boy who underwent esophagocoloplasty due to internal dislodgement and migration of enteral feeding tube, managed with relaparotomy and retrieval of tube

[1]. Couper G. Jejunostomy after oesophagectomy: areview of evidence and current practice. Proc Nutr Soc 2011;70:316-20.
[2]. Gupta V. Benefits versus risks: a prospective audit.Feedingjejunostomy during esophagectomy. World J Surg 2009;33:1432-8.
[3]. Tapia J, Murguia R, Garcia G, de losMonterosPE,Onate E. Jejunostomy: techniques, indications, and complications. World J Surg 1999;23:596-602.
[4]. Liao GS, Hsieh HF, Wu MH, Chen TW, Yu JC, LiuYC. Knot formation in the feeding jejunostomy tube: a case report and review of the literature. World J Gastroenterol 2007;13:973-4.
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Abstract: Background and study aims:Distal Common Bile Duct(CBD) lesions are sometimes difficult to diagnose due to the atypical nature or very small size of the lesion that is not identified on imaging modalities like Computerized tomography(CT) and Magnetic ResonanceCholangiopancreaticography(MRCP). The aim of this article is to show the pivotal role of Endoscopic Ultrasonography (EUS) in confirming the diagnosis which helps in choosing the best option of treatment. Patients and methods: In this case study 5 patients with distal CBD lesions but unconfirmed diagnosis on CT and MRCP were selected. The patients were made to undergo Endoscopic Ultrasound as an alternative imaging technique to identify the lesion. Result's and MRCP suggested possible space.......

Key words: distal common bile duct lesions; periampullarytumor; CBDimaging; Endoscopic Ultrasound; CBD stone; space occupying lesions;.

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