iosr-JDMS   Volume-17 ~ Issue-7 ~ July-2018

Abstract: Most women who present at the breast clinics have benign breast conditions which range from nonspecific breast pain to discrete lumps such as fibroadenoma. The term "benign breast diseases" encompasses a heterogeneous group of lesions including developmental abnormalities, inflammatory lesions, epithelial and stromal proliferations and neoplasm. Quantifying breast pain may be difficult because of its variability. Aims and objectivesTo estimate and compare the proportion of patient relieved from mastalgia in three groups using each drug separately.To compare the effect of three medicines in reducing the size of nodularity of benign breast diseases.To find out the extent of compliance and pattern of adverse events among three group of patients.To ascertain the cost effectiveness of therapy between the above mentioned therapeutic options...........

[1]. Ader DN, Browne MW. Prevalence and impact of cyclic mastalgia in a United States clinic-based sample. Am J Obstet Gynecol. 1997;177:126-132.
[2]. Asch RH, Greenblatt RB (1971) the use of an impeded androgen danazol in the management of benign breast disorders. Am J ObstetGynecol 127:130-134.
[3]. American College of Radiology (ACR) BI-RADS Atlas (2003) 4th edn. http://www.acr.org/Quality-Safety/ Resources/BIRADS.
[4]. American College of Radiology (ACR) (1998) Illustrated breast imaging report and data system (BI-RADS TM ), 3rd edn. American College of Radiology, Reston, pp 180–181.
[5]. Arshad M, Sengupta S, Ghosh R, Sawlani V, Singh MM. In vitro anti-resorptive activity and prevention of ovariectomy-induced osteoporosis in female Sprague-Dawley rats by ormeloxifene, a selective estrogen receptor modulator. J Steroid Biochem Mol Biol 2004 Jun; 91(1-2):67-78.

Abstract: Workers practicing good work safety culture (WSC) will have less accidents at their workplace. This principle applies in public institution as well.Work safety culture is usually studied in the dangerous sectors, but studies on work safety culture among staff of public university setting in Malaysia is scarce. The main objective of this study was to determine the proportion of knowledge, attitudes and practice (KAP) on work safety culture (WSC) and predictors for knowledge, attitudes, practice of work safety culture and its associated factors among the staff of a public university in Malaysia. A cross-sectional study was conducted on 220 randomly selected Malaysian employees who worked for at least one year intwo different faculties. The self-administered questionnaire was used to collect information..........

Keywords: Safety culture, KAP of safety culture, associated factors, Malaysia.

[1]. Abdou, H. A., and Saber, K. M. (2011), A Baseline Assessment of Patient Safety Culture Among Nurses at Student University Hospital, World Journal of Medical Sciences. 6(1), 17-26.
[2]. Ahmed Selmi Hamouda's (2013). Attitude towards safety culture among employees at theintensive care unit in the government hospital of Gaza city. Retrieved April 2, 2018, from http://library.iugaza.edu.ps/thesis/110337.pdf.
[3]. Amarapathy, M., Sridharan, S., Perera, R., Handa, Y. (2013). Factors Affecting Patient Safety Culture In A Tertiary Care Hospital In Sri Lanka. Int J SciTechnol Res. 2, 3-9.
[4]. Anna, N., Kersiti, T., Bodil, W.L., Gun, N. (2013). Perception of patient safety culture in hospital settings and factors of importance for this. Open Journal of Nursing, 3, 28-40.
[5]. Brun., Emmanuelle., Milczarek., Malgorzata. (2007). Expert forecast on emerging psychosocial risks related to occupational safety and health and European Agency for Safety and Health at Work. Retrieve September 3, 2016, from https://osha.europa.eu/en/tools-andpublications/publications/reports/7807118.

Abstract: Objective: To determine the precipitating factors of hepaticencephalopathy (HE) in patients with liver cirrhosis Background and Objectives: Hepatic encephalopathy is an extra hepatic complication of impairedliver function and is manifested as neuropsychiatric signs and symptoms associated with acute or chronic liver disease in the absence of other neurological disorders. This study aims to ascertain the spectrum of precipitating factors of hepatic encephalopathy in patients with cirrhosis of liver.

[1]. Bernal W, Hall C, Karvellas CJ, Auzinger G, Sizer E, Wendon J. Arterial ammonia and clinical risk factors for encephalopathy and intracranial hypertension in acute liver failure. Hepatology 2007;46:1844-52
[2]. Worobetz LJ. Hepatic encephalopathy. In: Thomson AR, Shaffer EA, editors. First principles of gastroenterology. 3rd ed. Toronto: University of Toronto press; 2000. p. 537-39
[3]. Alam I, Razaullah, Haider I, Humayun M, Taqweem MA, Nisar M. Spectrum of precipitating factors of hepatic encephalopathy in liver cirrhosis. Pakistan J. Med. Res. 2005;44(2):96-1003.
[4]. Sheikh S. Portal systemic encephalopathy in chronic liver disease: Experience at People Medical College, Nawabshah. J Coll Physician Surg Pak 1998;8:53.
[5]. Hameed A, Rehman M, Saeedi I, Shah D. Factors precipitating hepatic encephalopathy in cirrhosis liver. Postgrad Med Inst 2001;15:91..

Abstract: Aim: To study outcomes of endoscopic dilatations in various cases of stricture esophagus. Materials & methods : Retrospective study done in Paediatric Surgery Department, Coimbatore Medical College Hospital, 2012-2016. Number of cases – 12 ( 7 males and 5 females). Age group – 1-12years of age (proven cases of stricture esophagus , diagnosed by contrast studies or Upper Gastrointestinal Endoscopy (UGIE) directly). The cases included post Tracheo esophageal fistula (TEF) stricture (8), corrosive stricture(2), foreign body strictures(FB)(1) and peptic stricture(1). Dysphagia / vomiting was the presenting complaint in most of the cases. Mid esophageal stricture was present in 9 cases and lower esophageal stricture in 3 cases. Dilatation was effective in most cases with 7 being totally cured (TEF – 4, corrosive- 2,FB -1), 2 on regular follow up (TEF), 2 of them underwent surgery (Acid Peptic Disease.........

Keywords: Endoscopic dilatation ,Esophageal stricture,Tracheo esophageal fistula (TEF), Upper Gastrointestinal Endoscopy (UGIE ).

[1]. Stringer MD. Oesophageal substitution: Editorial comment. Pediatric surgery international. 1996 Apr; 11(4):213.
[2]. Broor SL, Lahoti D, Bose PP, Ramesh GN, Raju GS, Kumar A. Benign esophageal strictures in children and adolescents: etiology, clinical profile, and results of endoscopic dilation. Gastrointestinal endoscopy. 1996 May; 43(5):474-7.
[3]. Broto J, Asensio M, Jorro CS, Marhuenda C, Vernet JM, Acosta D, et al. Conservative treatment of caustic esophageal injuries in children: 20 years of experience. Pediatric surgery international. 1999 Jul; 15(5-6):323-5.
[4]. Saleem MM. Acquired oesophageal strictures in children: emphasis on the use of string-guided dilatations. Singapore medical journal. 2009 Jan; 50(1):82-6.

[5]. Park KS. Evaluation and management of caustic injuries from ingestion of acid or alkaline substances. Clin Endosc. 2014;47:301–307..

Abstract: Background: Biomedical Waste means any waste, which is generated during diagnosis, treatment or immunization of human beings or animals, or in research activities pertaining thereto or in the production or testing of biological, and including categories as mentioned in the Bio-medical Waste (Management and Handling) Rules, 1998. This is now a statutory requirement for Indian Hospitals. Aim: To Study the implementation of various processes to comply with the statutory provisions of Bio-Medical Waste Management Rules, 2016. Objective: To assess the current status of Bio-Medical Waste Management at N.C. Medical College and Hospital, Gap Analysis vis-a-vis Bio-Medical Waste Management Rules, 2016, To initiate necessary interventions for ensuring compliance..........

Keywords-Biomedical waste, hospital, infection, segregation, transport and treatment.

[1]. Sharma, A.K., Bio-Medical Waste (Management and Handling) Rules, 1998.suvidhalaw House, Bhopal.
[2]. Pruss, A., Cirouit,E. And Rushbrook, P., Safe Management of Waste from Health Care Activities,WHO,1999.
[3]. Javadekar,P., New Bio-Medical Waste Management Rules, PIB, 2016.
[4]. BAN and HCWH. (1999). Medical Waste in Developing Countries. An analysis with a case study of India, and A critique of the Basel -TWG guidelines. Basel Action Network (BAN) secretariat, Asia_Pacific Environmental Exchange, 1827 39th Ave. E., Seattle, WA. 98112 USA.
[5]. Moritz, J.M. (1995). Current legislation governing clinical waste disposal. Journal of Hospital Infection, 30 (supplement), 521-530..

Abstract: Superior mesenteric artery (SMA) syndrome is a rare acquired disorder upper intestinal obstruction due to compression of the third part of the duodenum between the SMA and the aorta. We report a case of 21 years old girl who presented with upper G.I. obstruction. superior mesenteric artery syndrome to be implicated to the majority of patients without history of weight loss. Duodenojejunostomy is superior to gastrojejunostomy in SMA syndrome.. Although open and laparoscopic duodenojejunostomy have been described as the best surgical treatment options for Wilkie's syndrome.

Key words; Superior mesenteric artery syndrome, Wilkie's syndrome, arteriomesentric duodenal compression.

[1]. Rokitanski CV. Vienna. 3rd edn. Vol. 3. Braumulller and Siedel: 1861. Lehrbuch der Pathologische Anatomie; p. 187.

[2]. Wilkie D. Chronic duodenal ileus. Br J Surgery. 1921:201–254.

[3]. Wilkie D. Chronic Duodenal ileus. Am J Med Sci. 1927;173:643–649.

[4]. Baltazar U, Dunn J, Floresguerra C, Schmidt L, Browder W. Superior mesenteric artery Syndrome: an uncommon cause of intestinal obstruction. South Med J. 2000;93(6):606–608. [PubMed]

[5]. Rassi B, Taylor B, Traves D. Recurrent Superior mesenteric artery (Wilkie's) Syndrome: a case report. Can J Surgery. 1996;39:410–416. [PMC free article] [PubMed].

Abstract: Diphtheria is an acute toxin mediated contagious febrile illness, predominantly in children, caused by the locally invasive Gram positive bacillus Corynebacterium diphtheriae. In developing countries, with increasing coverage of immunization, the incidence of the disease has declined. This study was carried out to know the incidence of diphtheria among 99 patients from suspected sporadic diphtheria outbreaks, admitted in a tertiary care centre of Assam in Northeast India, over a period of three years from January, 2013 to December, 2015. Throat swabs were collected and subjected to direct smear microscopy by Gram's and Albert stains, and culture on Blood agar, Loeffler's.........

Key words; Corynebacterium diphtheriae, Kleb-Loeffler's bacillus, immunization, UIP and toxin.

[1]. Christie AB. Diphtheria. In: Infectious Diseases: Epidemiology and Clinical Practice, Vol 2. Churchill Livingstone, London. 1987:1183-209
[2]. Eskola J, Lumio J, Vuopio-Varkila J. Resurgent diphtheria – are we safe? Br Med Bull. 1998; 54(3):635-45
[3]. Vitek CR, Wenger J. Diphtheria. Bull WHO 1998; 76 (suppl 2):129-30
[4]. World Health Organization [Internet].Geneva: World Health Organization; [Date unknown] Immunization, surveillance, assessment and monitoring. [cited 2015 Oct 20]. Available from: www.who.int/immunization_monitoring/globalsummary/ timeseries/tsincidencediphtheria.html.
[5]. Kristie E. N. Clarke. US Centers for Disease Control and Prevention. Review of Epidemiology of diphtheria-2000-2016..

Abstract: Hypertension (HT) is a growing global public health problem. From a preventive point of view it is crucial to identify risk factors at an early stage. Obesity is a well –established risk factor for hypertension. Thus the aim of this study was to assess the association of general and neck obesity with hypertension (HT).This cross sectional survey was conducted among undergraduate students of West Bengal, India. The anthropometric and BP measurements were carried out on 1927 (males-732 and females-1195) students. General obesity was estimated from body mass index (BMI), and neck obesity from neck circumference (NC) and neck to height ratio (NHtR). Body height, weight, NC and BP were measured by standard methods. BMI and NHtR were estimated. The influence of BMI, NC and NHtR........

Key words; Hypertension, BMI, neck circumference, neck-to-height ratio.

[1]. World Health Organization. The World Health Report 2002. Geneva, Switzerland WHO, 2002.
[2]. Sawicka K, Szczyrek M, Jastrzebska L, Prasal M, Zwolok A, daniluk J. hypertension-silent killer. J PreclinClinRes. 2011; 5(2): 43-46.
[3]. Kaerney PM, Whelton M, Reynolds SK, Muntner P, Whelton PK, He J. Global burden of Hypertension: analysis of worldwide data. Lancet. 2005; 365: 217-223
[4]. National High Blood Pressure Education Program Working Group. The fourth report on the diagnosis, evaluation and treatment of high blood pressure in children and adolescent. Pediatrics. 2004; 114: 555-576.
[5]. Brady TM, Fivush B, Flynn JT, Parekh R. Ability of blood pressure to predict left ventricular hypertrophy in children with primary hypertension. J Pediatr. 2008; 152(1): 73-78..

Abstract: This study aimed to evaluate the rate of deep venous thrombosis (DVT) after fixation of fractured lower extremities .This study was carried out at Rabat Hospital in Khartoum Sudan from January 2016 and March 2018 included 176 patents with lower limbs fractures 96% of them fixated by variables types of fixations (plaster, traction, external fixation and traditional bone setter (TBS)) while 4% of them having no fixation. Each fractured extremity was assessed for the presence of DVT using Duplex ultrasonography concerning the period before restoration, fracture wound pattern and complexity, and type of fixation. The data of the study analyzed using Statistical Package...........

Key words; Lower Extremity _ Deep vein thrombosis _ Fixation_ Traditional bone setter_ Incidence.

[1]. Abelseth G1, Buckley RE, Pineo GE, Hull R, Rose MS Incidence of deep-vein thrombosis in patients with fractures of the lower extremity distal to the hip.J OrthopTrauma .1996;10(4):230-5.
[2]. Chumnijarakij T, Pashyachinda V. Post operative thrombosis in Thai women. Lancet. 1975;1:1357–1358.
[3]. Cunningham IG, Young NK. The incidence of deep vein thrombosis in Malaysia. Br J Surg. 1974;61:482–483.
[4]. Gillespie W, Murray D, Gregg PJ, et al. Risks and benefits of prophylaxis against venous thromboembolism in orthopaedic surgery. J Bone Joint Surg Br 2000;82(4):475–9.
[5]. Goldhaber SZ, Tapson VF; DVT FREE Steering Committee. A prospective registry of 5,451 patients with ultrasoundconfirmed deep vein thrombosis. Am J Cardiol 2004;93:259–62.

Abstract: The outlook for patients with ILD presenting to hospital needing respiratory support is poor be it non-invasive ventilation or mechanical ventilation. Based on the available evidence it is difficult to determine a clear role for NIV in patients with ILD. We undertook a retrospective analysis of patients with ILD admitted with acute respiratory failure requiring enhanced respiratory support. We intended to evaluate the outcome from enhanced respiratory support and to ascertain the variables that portend prognosis. 54 patients with a median age of 75.8 (±1.29) and a diagnosis of ILD needed enhanced respiratory support. 65% were male. Mortality for patients admitted to RHDU was 67%. 7% of patients died within 30 days of discharge, 9% died within 3 months and 11% survived beyond 1 year from admission. Time from diagnosis to presentation with ARF was significantly greater in the deceased group, median duration 18.7 (±3.76) vs. 8.5 (±9.33) months in the survivors (p=0.047)............

[1]. Aliberti S, Messinesi G, Gamberini S, et al. Non-invasive mechanical ventilation in patients with diffuse interstitial lung diseases. BMC Pulm Med. 2014;14:194.
[2]. Vianello A, Arcaro G, Battistella L, et al. Noninvasive ventilation in the event of acute respiratory failure in patients with idiopathic pulmonary fibrosis. J Crit Care. 2014;29(4):562-567.
[3]. Mollica C, Paone G, Conti V, et al. Mechanical ventilation in patients with end-stage idiopathic pulmonary fibrosis. Respiration. 2010;79(3):209-215.
[4]. Mallick S. Outcome of patients with idiopathic pulmonary fibrosis (IPF) ventilated in intensive care unit. Respiratory Medicine. 2008;102(10):1355-1359.
[5]. Yokoyama T, Kondoh Y, Taniguchi H, et al. Noninvasive ventilation in acute exacerbation of idiopathic pulmonary fibrosis. Intern Med. 2010;49(15):1509-1514.