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

Abstract: Objective: To evaluate pulse oximetry for detection of congenital cyanotic heart disease in sick neonates using echocardiography as gold standard. Methods: Pulse oximetry readings were taken at admission from 500 neonates from right upper limb and either foot with infant breathing room air. Pulse oximetry was considered abnormal if oxygen saturation at room air measured <90% or difference between right hand and foot was more than 3%. Persistent abnormality was considered positive result. Echocardiography was performed on all neonates with positive pulse oximetry (study group) as well as on neonates with negative pulse oximetry (controls) . Results: Pulse oximetry was positive in 24 neonates. It detected 9 out of 10 (90 %) true positives. The sensitivity, specificity, positive predictive value, negative predictive value and odds ratio (95% CI) of pulse oximetry was 90 %, 55.58 %, 5.62 %, 99.47 and 11.3 , respectively............

[1]. Wren C, Reinhardt Z, Khwaja K. Twenty year trends in diagnosis of life threatening neonatal cardiovascular malformations. Arch Dis Child Fetal Neonatal Ed. 2008;93:F33-7.
[2]. Vaidyanathan B, Satish G, Mohannan ST, Sundaram KR, Warrier KKR, Kumar RK. Clinical screening for congenital heart disease at birth: A prospective study in a community hospital in Kerala. Indian Pediatr. 2011;48:25-30.
[3]. Bakshi KD, Vaidyanathan B, Sundaram KR, Roth SJ, Shivaprakasha K, Rao SG, et al. Determinants of early outcome after neonatal heart surgery in a developing country. J Thoracic Cardio Vascular Surgery. 2007;134:765-71.
[4]. Brown KL, Ridout DA, Hoskote A, Verhulst L, Ricci M, Bull C. Delayed diagnosis of congenital heart disease worsens preoperative condition and outcome of surgery in neonates. Heart. 2006;92:1298-302.
[5]. Kemper AR, Mahle WT, Martin GR, Cooley WC, Kumar P, Morrow WR, et al. Strategies for implementing screening for critical congenital heart disease. Pediatrics. 2011;128:e1259-67.

Abstract: World Health Organization Has Defined Birth Asphyxia As "Failure To Initiate And Sustain Breathing At Birth." Perinatal Asphyxia Is One Of The Most Common Primary Cause Of Mortality (28.8%) And Morbidity Among Neonates In India And Is The Commonest Cause Of Stillbirths (45.1%). An Apgar Score Of <7 At 1 Min And At 5 Min Respectively Is Seen In 8.4% And 2.45% Cases In India. 1The Primary Cause Of This Condition Is Systemic Hypoxemia And/Or Reduced Cerebral Blood Flow. Birth Asphyxia Causes 23% Of All Neonatal Death Worldwide. Birth Asphyxia Is Associated Frequently With Metabolic Changes Like Hypoglycemia, Hypocalcemia, Hyponatremia, Hyperphosphatemia And Metabolic Acidosis. Glucose Is An Essential Nutrient For The Brain. Abnormally Low Level Can Cause Encephalopathy And Have The Potential To Produce Long-Term Neurological Injury.

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[3]. Tsang Rc, Light Ij, Sutherland Jm, Kleinman Li. Possible Pathogenetic Factors In Neonatal Hypocalcemia Of Prematurity. The Role Of Gestation, Hyperphosphatemia, Hypomagnesemia, Urinary Calcium Loss, And Parathormone Responsiveness. J Pediatr 1973;82:423-9.
[4]. Stoll Bj, Kleigmann Rm. The Endocrine System. In: Behrman Re, Kleigman Rm, Jenson Hb, Editors. Nelson Textbook Of Pediatrics. 20th Ed. Philadelphia: Elsevier Publisher; 2014. P. 613-6.
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Abstract: Suicide is one of the leading cause of death. Though suicidal cut throat is uncommon but it is still encountered in emergency practice of an otorhinolarygologist. A prospective study of 10 cases from January 2014 to Jan. 2018 was done in Regional Institute Medical Sciences,imphal. All patients were males in the age group of 21 to 30 years. All the patients had one or more history ofsubstance abuse while 7 patients had history of psychiatric consultation.All of them presented with hesitation cut injury over the neck. One patient underwent emergency tracheostomy, and no death was observed.

Keywords: suicide, cut throat.

[1]. Jose M.B, Alexandra F, Diego D.L, DanutaW.Suicide and mentaldisorders – do we know enough. Br J Psychiatry. 2003: 183;382-3.
[2]. Radhakrishnan R, AndradeC.Suicide: an Indian perspective. Indian J Psychiatry, 2012: 54 (4);304-39.
[3]. Saeed A, Bashir M.Z, Khan D, Iqbal J, Raja K.S, RehmanA.Epidemiology of suicide in Faisalaba.JAyub Med Coll Abbottabad. 2002:14 (4);34-7. [4]. Sharma B.R, SharmaV, Harish D, VijK.Suicides in Northern India – causes, method used and prevention.Med Sci Law. 2003:43(3);221-9.
[5]. FukubeS, Hayashi T, Ishida Y, Kamon H, Kawaguchi M, Kimura Aet al.Retrospective study on suicidal cases by sharp force injuries.J Forensic Leg Med.2008:15;163-67.

Abstract: Ocular blunt trauma is one of the most common causes of visual morbidity. It is also a significant cause of preventable impairment of vision and unilateral visual loss worldwide. Early detection and management hold the key to prevention of further complications.Aim: Toanalyze the various prognostic factors which will influence visual outcome in patients with bluntocular trauma.Materials and Methods : This prospective observation study was conducted in all patients with blunt ocular trauma attending ophthalmology OPD in Coimbatore Medical College Hospital between June 2015 to May 2016.The results were obtained using chi-square test and ANOVA testResults:A total of 123 patients were studied, in which majority of the study population (48%) were between age group26 to 40.......

Keywords: prognostic factors, blunt trauma,visual outcome

[1]. Kuhn F, Mooris R, Witherspoon CD, MesterV.The Birmingham Eye Trauma Terminology system (BETT) J Fr Ophthalmol.27(2):2004;206-210 [2]. Négrel AD, Thylefors B. The global impact of eye injuries. Ophthalmic Epidemiol. 1998;5(3):143–169.
[3]. Raymond S, Jenkins M, Favilla I, Rajeswaran D. Hospital-admitted eye injury in Victoria, Australia. Clin Experiment Ophthalmol.38(6):2010;566–571.
[4]. Saeed A, Khan I, Dunne O, Stack J, Beatty S. Ocular injury requiring hospitalisation in the south east of Ireland: 41(1)2001-2007. Injury. 2010:86–91.
[5]. Cillino S, Casuccio A, Di Pace F, Pillitteri F, Cillino G. A five-year retrospective study of the epidemiological characteristics and visual outcomes of patients hospitalized for ocular trauma in a Mediterranean area. BMC Ophthalmol. 2008;8:6..

Abstract: Aim: To compare the central corneal thickness inindividuals with and without pseudo exfoliation syndrome. Methods: This was a hospital based cross sectional, comparative study. 50 individuals with unilateral or bilateral pseudo exfoliation syndrome (study group) and individuals without pseudo exfoliation syndrome (control group), both without any corneal pathology and glaucoma were included in the study. The CCT was measured by an ultrasonic pachymeter. The IOP was measured by Goldmannapplanation tonometer and was adjusted for the CCT values.Results: There was no significant correlation between CCT and age. The mean CCT was 0.515± 0.07 mm in the control group and 0.501 mm + 0.07 mm in study group (P value=0.001). The mean IOP was almost similar in both groups. However, the IOP after CCT adjustment was significantly higher in the study group than the control group. Conclusion: The mean CCT was significantly lower in the individuals with pseudoexfoliation than in individuals without pseudo exfoliation. There was no significant difference in the CCT between the eye with PEXF and its fellow eye in unilateral pseudo exfoliation syndrome.

Key words: Central corneal thickness, pseudo exfoliation syndrome.

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Abstract: Introduction: Tumors of the nervous system constitute less than 2% of the cancers globally. They are the second most common form of cancer in children and seventeenth most common in adults. However the morbidity and mortality due to tumors of the nervous system is high. Hence prompt and correct diagnosis is essential for early intervention. In the era of stereotactic biopsies where the amount of tissue is very small, accurate diagnosis is imperative and it can be achieved with squash cytology which is a simple, non-invasive, cost effective and rapid technique. Aim of the study: The aim of the study was to assess the diagnostic accuracy of Squash cytology for rapid Intraoperative diagnosis in tumors of nervous system by comparing histopathology. Materials and methods: This was a prospective study conducted in department of Pathology in a tertiary care teaching medical college hospital for a period of two years.............

Key words: Squash cytology, Tumors of nervous system, CNS tumors, Intra operative diagnosis, neurosurgery

[1]. Kleihues P, Louis DN, Scheithauer BW, Rorke LB, Reifenberger G, Burger PC, Cavenee WK. The WHO classification of tumors of the nervous system. Journal of Neuropathology & Experimental Neurology. 2002 Mar 1;61(3):215-25.

[2]. Hewitt M, Weiner SL, Simone JV. The epidemiology of childhood cancer; 2003

[3]. de Robles P, Fiest KM, Frolkis AD, Pringsheim T, Atta C, St. Germaine-Smith C, Day L, Lam D, Jette N. The worldwide incidence and prevalence of primary brain tumors: a systematic review and meta-analysis. Neuro-oncology. 2014 Oct 13;17(6):776-83.

[4]. Kuzmik G, Long A, Omay SB, Günel JM. The Usefulness of Stereotactic Neuronavigation Along with Intraoperative Imaging in Malignant Brain Tumor Surgery. InMalignant Brain Tumors 2017 (pp. 51-62). Springer, Cham.

[5]. Jindal A, Kaur K, Mathur K, Kumari V, Diwan H. Intraoperative squash smear cytology in CNS lesions: A study of 150 pediatric cases. Journal of cytology. 2017 Oct;34(4):217.

Abstract: Background: Depression is a leading cause of disability and the most common psychiatric disorder. This is a serious condition that can impact every area of women's life.Objectives: To assess the prevalence of depression and to find out its association with different socio-demographic characteristics amongst adult women in an urban slum of Purba Barddhaman district, West Bengal.Methods: It was a community based observational, descriptive study; cross-sectional in design; conducted in a slum area in Burdwan Municipality during April to October 2017. Females aged 18 years and above residing in the study area during the study period constituted the study population. Subjects were selected to participate in the study applying inclusion and exclusion criteria. House to house visits were conducted and data was collected using a predesigned, pretested interview schedule along with validated Patient...........

Keywords –Depression, Slum, Urban, Adult female.

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Abstract: Introduction: The management and prognosis of patient with acute stroke varies depending mainly on stroke subtypes. Hence it is very crucial to make a timely differentiation between the stroke subtypes. Computed Tomography is largely unavailable in rural Nepal. This study identifies the diagnostic accuracy of Besson Score to distinguish stroke subtypes in Nepalese population.Methods: It was a prospective observational cross-sectional study conducted at United Mission Hospital Tansen. It included 71 patients presenting to UMHT with acute stroke. Besson Score was calculated and was compared with Computed Tomography (CT) of head.Results: A total of 71 patients were included in this study, out of them 27 patients had hemorrhagic stroke and 44 had non-hemorrhagic stroke............

Keywords : stroke subtypes; clinical scoring system; UMHT; cardiovascular disease.

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Abstract: Invasive dental procedures including tooth extraction are considered one of the most crucial risk factors for Bisphosphonate related osteonecrosis of the jaw (BRONJ). But sometimes the tooth cannot be salvaged due to poor prognosis. Ultimately the practitioner is in a dilemma whether to go for extraction or not. A lot of literature has been written about the methods to minimize the risk of developing BRONJ in an extraction patient. But very limited studies are there to stratify which patients can land in a complication. This study is based on 29 patients undergoing 45 extractions using different bisphosphonates for various medical conditions. In all patients, extraction sockets showed wound closure without bone exposure within minimum 4 weeks, followed by normal epithelization within 6 weeks after extraction except for 2 cases in which established BRONJ developed.........

Keywords: BRONJ, zolendronate, extraction, myeloma

[1]. Ruggiero SL, Mehrotra B, Rosenberg TJ, et al. Osteonecrosis of the jaws associated with the use of bisphosphonates: a review of 63 cases. J Oral Maxillofac Surg. 2004;62:527–534.
[2]. Bagan JV, Murillo J, Poveda R, et al. Avascular jaw osteonecrosis in association with cancer chemotherapy: series of 10 cases. J Oral Pathol Med. 2005;34:120–123.
[3]. Ficarra G, Beninati F, Rubino I, et al. Osteonecrosis of the jaws in periodontal patients with a history of bisphosphonates treatment. J Clin Periodontol. 2005;32:1123–1128.
[4]. Migliorati CA, Schubert MM, Peterson DE, et al. Bisphosphonateassociated osteonecrosis of mandibular and maxillary bone: an emerging oral complication of supportive cancer therapy. Cancer. 2005;104:83–93.
[5]. Kato GF, Lopes RN, Jaguar GC, Silva AP and Alves FA. Evaluation of socket healing in patients undergoing bisphosphonate therapy: Experience of a single institution. Medicina Oral Patologia Oral y Cirugia Bucal 2013; 18:e650-656

Abstract: Providing analgesia to military trauma patients in austere and hostile operating conditions with shortage of advance care facilities in front is very challenging. Our study aims to evaluate efficacy, safety and feasibility of Regional Block Analgesia (RBA) by first responders in war scenario.We found RBA to be simple, safe and effective with consistent results in the setting of military trauma when performed by first responders. In war, it's of huge helpin management of battle casualties. It may be easily performed in war-scenario as well as primitive field conditions by a trained first responder. In developing countries out burdened with constraints of money, material and manpower, this technique can be used with safety, speed and precision. RBA ispriceless in permitting lifesaving operations in priority one victimsandalso providing analgesia to other neglected low priority patients.Weadvocate practice of RBA for military trauma patients by first responders at the field Hospital level.

Keywords : Military trauma, extremity injury, Regional Block analgesia, first responders

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Abstract: India currently has 62.4 million people with Diabetes and 77.2 million people with pre-Diabetes. Diabetes mellitus is one of the leading causes of premature death worldwide along with other non-communicable diseases. Hence, the main aim of this study is to knowtreatment adherence of known diabetics in rural field practice area of a private medical college the objectives 1. To know the treatment adherence 2. To know the type of medication. 3. To know the reasons for adherence. Methodology:The present study was communities based cross sectional study, a sample size of 120 subjects were taken up in the villages under the field practice area of the RHTC of aprivate medical...........

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Abstract: Background and Objectives: Thyroid dysfunction is known to occur in patients with Type 1 DM, It is due to autoimmunity. The prevalence of thyroid dysfunction in patients with Type 2 DM varies between 10% - 31%. Subclinical hypothyroidism andovert hypothyroidism is the pattern commonly observed. Altered thyroid functions is associated with deranged fat metabolism. The deleterious effects on lipid profile inturn leads to adverse cardiovascular and cerebrovascular events. Hence this study aims at studying the prevalence and pattern of thyroid dysfunction in patients with Type 2 DM. Materials and Methods: This is aprospective case control study conducted in Adichunchanagiri Institute of Medical Sciences,B .G .Nagar, Nagamangala Taluk..........

Keywords : Thyroid Dysfunction, Type2 Diabetes Mellitus

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Abstract: Introduction: The present study was taken up to assess the incidence of different histological variants of bladder tumors, site, age and sex distribution, presenting symptoms and a brief comparison was done about the histopathological features of the tumors occurring in young and old individuals. Material and methods: The present study is a retrospective two year descriptive study conducted in the Department of Pathology, tertiary care hospital in Guntur. The biological materials included in the study were Trans-urethral resection of bladder tumor (TURBT) specimens, complete and partial cystectomies. The formalin fixed specimens were routinely processed and haematoxylin............

Keywords : TURBT, UROTHELIAL CARCINOMA, NILGPUC, ADENOCARCINOMA

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[2]. Chavan S, Bray F, Lortet Tieulent J, Goodman M, Jemal A. International variations in bladder cancer incidence and mortality. Eur Urol 66:59-73. PMID: 24451595 [3]. Kirkali Z, Chan T, Manoharan M, Algaba F, Busch C, Cheng L, et al. Bladder cancer: epidemiology, staging and grading and diagnosis. Urology 66(6) suppl 1:4-34. PMID: 16399414.

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Abstract: Background: Peritonitis is one of the most common infections, and an important problem that a surgeon has to face. Despite the advancement in treatment the mortality rate is still high. There is no single, easily available laboratory test that predicts severity or prognosis in patients with peritonitis Aims: The purpose of this study is to determine the efficiency of Manheim peritonitis index in determining the prognosis of patients diagnosed with peritonitis. Methodology: A descriptive study which includes all patients with peritonitis who fulfilled the inclusion criteria in Rajiv Gandhi Government General Hospital during the time period of January 2017 to December 2017. Parameters for MPI Index and the time interval between the onset of perforation and the time of surgery is noted in all patients..........

Keywords : Peritonitis, Manheim peritonitis index(MPI), Sepsis, Emergency Laparotomy, Mortality

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Abstract: Carcinosarcoma of the uterine cervix are very rare tumors, constituting only 0.005% of all cervical malignancies (fewer than 70 cases of cervical carcinosarcoma have been reported in the English literature). It usually presents with abnormal vaginal bleeding in post-menopausal women. The tumor has high rates of metastasis, so careful management including surgery, chemotherapy and/or radiotherapy is done for these patients. Here, we present a case of a 60 year old woman who present with an ectocervical tumor. She underwent radical hysterectomy and bilateral pelvic lymphadenectomy; the tumor was diagnosed on histopathological examination as Carcinosarcoma of.........

Keywords : Carcinosarcoma; uterine cervix; Müllerian tumor mixed; Chemotherapy; Radiotherapy

[1]. Gunsu Kimyon Comert, Osman Turkmen, Alper Karalok, Derman Basaran, Dilek Bulbul, and Taner Turan. Therapy Modalities, Prognostic Factors, and Outcome of the Primary Cervical Carcinosarcoma Meta-analysis of Extremely Rare Tumor of Cervix. Int J Gynecol Cancer. 2017; 27(9):1957-1969
[2]. Myounghwan Kim, Chulmin Lee, Hoon Choi, Ji-Kyung Ko, Guhyun Kang, Kyoung-chul Chun. Carcinosarcoma of the uterine cervix arising from Müllerian ducts. Obstet Gynecol Sci. 2015; 58(3):251-255
[3]. Yuan Lin, Hanrui Chen, Ziyin Ye, Li Ding, Qinghua Cao, Ling Xue. Synchronous carcinosarcoma of the uterine cervix with adenoid basal carcinoma and cervical intraepithelial neoplasia III: A case report and literature review. Pathology–Research and Practice. 2017; 213(5):570-573
[4]. Jessenia Guerrero, Tania Aftandilians, Bernadette Cracchiolo, MPH, and Debra S. Heller. Primary Carcinosarcoma of the Uterine Cervix: Report of a Case and Review of the Literature. J GYNECOL SURG. 2016; 32(6):354-355
[5]. Mudit Agarwal, Supriya Pradhan. Malignant Mixed Mullerian Tumor of Cervix. Annals of Woman and Child Health. 2016; 2(1): 1-4

Abstract: Introduction: Even though the skin disorders are common worldwide, the patterns of lesions differ depending upon various environmental and socioeconomic factors. In spite of lesions being diagnosed based on clinical features, histopathological evaluation plays a pivotal role in confirmation and management. Material and Method: This is a retrospective and prospective study conducted at a tertiary care teaching hospital. Histopathological evaluation of skin lesions was carried out for three years correlating with old records and histopathology slides. Relative frequency of various lesions, distribution of age and sex were analysed. Results: A total of 234 cases were included with 140 (60%) males and 93 (40%) females. The commonest lesion found was.............

Keywords : cutaneous cysts, epidermal cyst, histopathological examination, skin adnexal tumors, squamous cell carcinoma

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Abstract: A wide spectrum of disorders affect the upper gastrointestinal tract and are responsible for a huge number of morbidity and mortality. Upper GI endoscopy together with histopathology plays an important role in the accurate diagnosis and management of these disorders. Hence we conducted a 2 year prospective study in a tertiary health care centre with the aim of identifying different histopathological lesions occurring at this site.We analysed biopsies of 176 patients with respect to age, gender, site of lesion, possible underlying etiology along with findings of endoscopy and histopathology.

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Abstract: Uterine inversion is a rare obstetric emergency that can lead to neurogenic shock or even maternal death. There are many management strategies, but they are poorly dispersed in the medical literature. In our case a third gravida patient was admitted in emergency with history of delivery of living baby at home and presenting to our emergency room at B.S.M.C.H, Gynae Department with a mass protruding through the vagina .She was in gasping condition, her B.P was not recordable, pulse was 130/min, with severe degree of pallor and postpartum haemorrhage. She was promptly resuscitated with plasma volume expanders and life saving drugs with continuous CPR. Intubation done at emergency room by anaesthetist. Another resuscitative measures like uterotonics ,blood, antibiotics given. Manual reposition of uterus done under anaesthesia and she was shifted to CCU immediately. As patient couldn't be moved to operation theatre so uterine packing with sterile roller gauze with betadine done. She recovered gradually...............

Keywords- Uterine inversion, Gasping, Neurogenic shock, Blood transfusion

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