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

Abstract: Diabetes Mellitis is a metabolic disorder of carbohydrate protein, lipid metabolism characterized by increased blood glucose level more then 126 mg / dl in fasting condition and more than 200 mg / dl in post prandial or random condition. Pregnancies affected by gestational diabetes mellitus (GDM) are at risk of developing a number of serious obstetric complications such as fetal growth abnormalities, shoulder dystocia, birth injury, prematurity and increased Caesarean section rate as well as having long-term implications for the well-being of mother and infant. The risk of adverse perinatal and maternal outcomes is directly proportional to the degree of hyperglycemia with a linear relationship between maternal glucose and various neonatal outcomes. HbA1c is a fragment of haemoglobin...........

[1]. Gabbe SG, Graves CR. Management of diabetes mellitus complicating pregnancy. Obstet Gynecol. 2003;102:857–868. [PubMed] [2]. Nielsen LR, Ekbom P, Damm P, Glumer C, Frandsen MM, Jensen DM, Mathiesen ER. HbA1c levels are significantly lower in early and late pregnancy. Diabetes Care. 2004;27:1200–1201. [PubMed]

[3]. O'Kane MJ, Lynch PL, Moles KW, Magee SE. Determination of a diabetes control and complications trial-aligned HbA(1c) reference range in pregnancy. Clin Chim Acta. 2001;311:157–159. [PubMed]

[4]. Mosca A, Paleari R, Dalfra MG, Di Cianni G, Cuccuru I, Pellegrini G, Malloggi L, Bonomo M, Granata S, Ceriotti F, Castiglioni MT, Songini M, Tocco G, Masin M, Plebani M, Lapolla A. Reference intervals for hemoglobin A1c in pregnant women: data from an Italian multicenter study. Clin Chem. 2006;52:1138–1143. [PubMed]

[5]. Versantvoort AR, van Roosmalen J, Radder JK. Course of HbA1c in non-diabetic pregnancy related to birth weight. Neth J Med. 2013;71:22–25. [PubMed].

Abstract: All breast lesions are not malignant, and all the benign lesions do not progress to cancer; however the accuracy of diagnosis can be increased by a combination of preoperative tests (like physical examination, mammography, fine-needle aspiration cytology, and core needle biopsy). These modalities are more accurate, reliable, and acceptable when compared with a single adopted diagnostic procedure despite of having their own technical limitations. "As fine-needle aspiration (FNA) has become a critical component in the investigation of palpable breast masses; false-negative diagnoses have become a major concern, prompting re-evaluation of the definition of specimen adequacy. Although cytopathologists agree that a number of parameters relate to the adequacy of an FNA specimen, there is no concsensus on the role of epithelial cell quantitation in the determination of an adequate FNA. To better understand the significance of epithelial cellularity, false-negative FNA samples from palpable breast lesions were reviewed..........

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Abstract: Introduction: Pre-eclampsia is one of the major causes of maternal and fetal morbidity and mortality. Though the etiology is obscure, recent studies indicate that serum levels of calcium and magnesium may have a role in pre-eclampsia. Materials and methods: The study included 60 subjects of age group 18-35 years, attending the Department of Biochemistry, M.G.M Medical College, Jamshedpur, out of which 30 were pre-eclampsia women with gestational age of ≥20 weeks (Case group) and rest 30 were normal pregnant women of same gestational age (Control group). Results: The serum calcium concentration was significantly lower in the pre-eclamptic group compared to normotensives (8.47 ± 0.27 mg/dl Vs 9.60 ± 0.57 mg/dl) whereas the levels of serum magnesium showed a marginal difference in......

Keywords: pre-eclampsia, Serum calcium, magnesium and uric acid..

[1]. Zhang J, Zeisler J, Hatch MC, et al. Epidemiology of pregnancy-induced hypertension. Epidemiologic Reviews 1997;19(2):218-32.
[2]. Euser AG, Cipolla MJ. Magnesium sulfate treatment for the prevention of eclampsia: a brief review. Stroke 2009;40(4):1169-75.
[3]. Bainbridge SA, Roberts JM. Uric acid as a pathogenic factor in preeclampsia. Placenta 2008;29(Suppl A):S67-72.
[4]. Magnussen EB, Vatten LJ. Pregnancy cardiovascular risk factor as predictor of preeclampsia. Journal of Medicine 2007;1(4):335-9.
[5]. Golmohammad LS, Amirabi A, Yazdian M, et al. Evaluation of Serum Calcium, Magnesium, Copper and Zinc levels in Women with Pre-eclampsia. Iran J Med Sci 2008;33(4):231-4..

Abstract: Introduction: Hepatobiliary carcinoma includes carcinoma of liver, pancreas, bile ducts, ampulla of Vater and gall bladder. Hepatocellular carcinoma (HCC) is the most common primary malignant tumor of the liver. It is the fourth most common cancer in the world1. Metastases are the most common malignant tumors of the liver2. Metastasis of liver is commonest ranking second only to cirrhosis as a cause of liver damage. The incidence of carcinoma of the pancreas has markedly increased over the past several decades and ranks as the fourth leading cause of cancer death in the United States3. In pathological conditions there is usually some derangement in the metabolic processes which is reflected by a change in enzymatic patterns. The detection of these biochemical agents is simple and noninvasive.........

Key words: hepatobiliary carcinoma, ALP, GGT, LAP

[1]. Seetharam S, Sussman NL, Kimoda T et al. The mechanism of elevated alkaline phosphatase activity after bile duct ligation in the rat. Hepatology 1986; 6: 374-380.
[2]. Hatoff ED, Hardison WGM. Bile acids modify alkaline phosphatase induction and bile secretion pressure after bile duct obstruction in the rat during cholestasis, Gastroenterology 1981; 80: 668-672.
[3]. Schlaeger R, Haux P, Kattermann R. Studies on the mechanism of the increase in serum alkaline phosphatase activity in cholestasis: significance of the hepatic bile acid concentration for the leakage of alkaline phosphatase from the rat liver. Enzyme 1982; 28: 3-13.
[4]. Husby NE, Torstein V. The activity of gamma glutamyl-transferase after bile duct ligation in guinea pig. Clin Chem Acta1978; 88: 385-392.
[5]. Hirata E, Inoue M, Morino Y. Mechanism of biliary secretion of membranous enzymes: Bile acids are important factors for biliary occurrence of gamma glutamyl-transferase and other hydrolases. J Biochem 1984; 96:289-297..

Abstract: Hip bone is considered as the most sexually dimorphic skeletal elements in humans.The greater sciatic notch is especially valuable because it is resistant to damageand is highly sexually dimorphic.This study was undertaken with a sample size of 44 adult human dried hip bones.A cut off value was defined for the distance between Posterior Inferior Iliac Spine and Ischial Spine (PIIS-IS) to determine the sex of a human hip bone in the North Andhra population.From the present study it was observed that the mean distance of PIIS-IS in females was 46.88mm which is higher than males which was 36.88mm which is statistically highly significant (p=<0.001). The cut-off value obtained is 41.06. This cut-off value is 84.1% accurate in differentiating male and female hip bone which can be considered as an important metric parameter for identifying the sex of an individual.............

Keywords- Dimorphism ,Hip bone, Ischial Spine,Posterior Inferior Iliac Spine, Sex determination.

[1]. Gonzalez PN, Bernal V, Perez SI. Geometric morphometric approach to sex estimation of human pelvis.Forensic Sci Int. 2009 Aug 10;189(1-3):68-74.
[2]. *Bytheway JA, Ross AH.A geometric morphometric approach to sex determination of the human adult oscoxa. J Forensic Sci. 2010Jul;55(4):859-64
[3]. Gray's: Anatomy of the human body; 40th Edition.2011:1359-1360.
[4]. Debono L, Mafart B. Sex determination from fragmented hip bones using the Bruzek's method: experience in a historic necropolis in Provence (France).Anthropologie. 2006;XLIV/2:167–172.
[5]. Philip L. Walker –" Greater sciatic notch Morphology: Sex, age and population differences." Am. J. Phys. Anthropol. (2005) 127:385-391

Abstract: AIMS : A prospective study was conducted to determine the extent of sensory deficit after sural nerve biopsy (SNBx). Materials and Methods : Patients who had SNBx between July, 2015 and May, 2017 were eligible for inclusion. But patients with sensory impairment in sural nerve territory or abnormal sural nerve conduction studies before the procedure was excluded. Touch, pain, temperature, vibration and joint position sense were tested after nerve biopsy. The extent of sensory deficit including other complications were noted. Follow up assessment was performed at 3 months and later..............

Keywords-Sural Nerve biopsy, complications, sensory deficit

[1]. Bosch, Smith BE. Disorders of Peripheral Nerves. In : Bradley WG, Daroff RB, Fenichel GM, Marsden CD, editors. Neurology in Clinical Practice. 3rd Ed. Boston : Butterworth-Heinemann; 2000. P. 2045-126.
[2]. Gabriel CM, Howard R, Kinsella N, Lucas S, MeColl I, Saldanha G, et al. Prospective study of the usefulness of sural nerve biopsy. J Neurol Neurosurg Psychiatry 2000; 69 : 442-6.
[3]. Neundorfer B,l Grahmann F, Engelhardt A, Harte U. Postoperative effects and value of sural nerve biopsies : A retrospective study. Eur Rappaport WD, Valente J, Hunter GC, Rance NE, Lick S, Lewis T. et al. Clinical utilization and complications of sural nerve biopsy. Am J Surg 1993; 166 : 252-6.
[4]. Oh SJ. Diagnostic usefulness and limitations of the sural nerve biopsy. Yonsei Med J 1990; 31 : 1-26.
[5]. Brunelli GA. Prevention of damage caused by sural nerve withdrawal for nerve grafting. Hand Surg 2002; 7 : 163-6.

Abstract: Pterygium is a common worldwide external eye disease especially affecting population in tropical and subtropical areas.It is a wing shaped fold of conjunctiva encroaching upon the cornea from either side within the interpalpebral fissure.pterygium has a worldwide distribution with multiple predisposing factors such as ultraviolet radiation,tear film abnormalities,hot and dry climate and outdoor work.recent studies suggest that it is also associated with stem cell deficiency.limbus act as a functional zone between cornea and conjunctiva.defect in renewal and repair of ocular surface as a result of limbal stem cell deficiency are known to cause various ocular surface disorders in which pterygium is one of the cause.localised corneal stem cell dysfunction as a loss of limbal barrier against conjunctival invasion has been proposed as a pathogenic factor in pterygium growth and recurrence...........

[1]. Liu L., Wu J., Geng J., Yuan Z., Huang D. Geographical prevalence and risk factors for pterygium: a systematic review and meta-analysis. BMJ Open. 2013;3(11)[PMC free article] [PubMed]
[2]. Carmichael T., Ntuli S., Kitinya J. Chronic inflammatory cells and damaged limbal cells in pterygium. Afr Health Sci. 2013;13(3):725–730. [PubMed]
[3]. D'ombrain A. The surgical treatment of pterygium. Br J Ophthalmol. 1948;32(2):65.[PubMed]
[4]. Hirst L.W. The treatment of pterygium. Surv Ophthalmol. 2003;48(2):145–180.[PubMed]
[5]. Ti S.E., Tseng S.C. Management of primary and recurrent pterygium using amniotic membrane transplantation. Curr Opin Ophthalmol. 2002;13(4):204–212. [PubMed]

Abstract: Uncorrected Refractive error is one of the most common causes of blindness around the world. About 80% of blindness is treatable or preventable. Refractive errors are one of the common causes of this treatable blindness. Globally, the major causes of blindness are cataract, uncorrected refractive errors and glaucoma and their prevalence are 33%, 43% and 2% respectively. • An estimated 19 million children are visually impaired worldwide of which 12 million are due to refractive errors which could be easily corrected. • Refractive error is one of the commonest causes of visual impairment around the world. Around 2.3 billion people worldwide is estimated to have refractive errors and of these 1.8 billion have access to adequate eye examination and affordable corrections..............

[1]. WHO (2012) visual impairment and blindness fact sheet. No 282, June 2012
[2]. Dandona R, Dandona L. Refractive error blindness. Bull World Health Organ. 2001;79:237–243.
[3]. GP Kantha, Sonam Sethi. Prevalence of refractive errors in school children (12–17 years) of Ahmadabad city. Indian Journal of Community Medicine. 1987;24:23-30.
[4]. DR Fredrick, 'Clinical review: Myopia', British Medical Journal. 2002;324:1195-1199.
[5]. Mutti DO, GL Mitchell, ML Moeschberger, LA Jones and K Zadnick. Parental myopia, nearwork, school achievement, and children's refractive error, Investigative Ophthalmology and Visual Science, 2002;43,2002:3633- 3640

Abstract: Internal hernia is a rare cause of small bowel obstruction. A 45 year old male presented with acute intestinal obstruction for 2 days. On exploratory laparotomy, a mesenteric defect of 7*8 cm was present 90 cm distal to duodeno- jejunal junction with small bowel herniating through that defect. The part of bowel herniating was gangrenous. Resection of the gangrenous segment was done and end to side anastomosis between jejunum and transverse colon was done. Post-operatively the patient remained stable and was discharged under all satisfactory conditions. Internal hernia is one of the rare causes of small bowel obstruction. It is reported that 0.2–0.9% of patients of small bowel obstruction have internal hernia. A high index of suspicion for congenital mesenteric defects is warranted in patients who present with features of intestinal obstruction in the absence of obvious external hernia or previous abdominal surgery...

Keywords- Internal Hernia, Acute intestinal obstruction.

[1]. Padhy BP. Congenital internal hernia a rare cause of acute intestinal obstruction. Indian J Surg. 2013:75(2);156-8.
[2]. Chaudhary P, Rao M, Kumar A, Khandelwal S, Gupta N, Arora MP. Spontaneous Transmesentric Hernia: A rare cause of small bowel obstruction in an adult. Clin Pract. 2013:3(1);e6.
[3]. Hashimoto D, Hirota M, Sakata K, Yagi Y, Baba H. Adult transmeseneteric hernia: report of two cases. Surg Today. 2012:42;489-92.
[4]. ur Rehman Z, Khan S. Large congenital mesenteric defect presenting in an adult. Saudi J Gastroenterol. 2010:16;223-5.
[5]. Katagiri H, Okumura K, Machi J. Internal hernia due to mesenteric defect. Journal of Surgical Case Report. 2013:5;rjt037.

Abstract: Osteoarthritis (OA) is a chronic, degenerative disorder of multiple aetiology, characterized by loss of Articular cartilage and Periarticular bone remodelling followed by restricted joint movement. Pain is the most common symptom. Our study aims to assess the prescribing pattern of medication used for the management of Osteoarthritis.100 prescription duplicates were obtained from the patients presenting with OA knee and analyzed for the prescription pattern ; the drug formulation, route, and concomitant medications. The commonly prescribed was Diclofenac. Other classes of drugs used concomitantly were proton pump inhibitors, calcium supplements, steroids and opioids..

Keywords- Osteoarthritis (OA),Diclofenac, Prescription pattern analysis, Tertiary care hospital.

[1]. Sita gurung et.al. A study on prescribing pattern in the management of osteoarthritis and rheumatoid arthritis in the department of
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[4]. Alacqua M, Trifiro G, Cavagna L, Caporali R, Montecucco CM, Moretti S. Arthritis & Rheumatism. 2008; 59(4):568–74.
[5]. Bennet PN.Brown MJ.Pain and Analgesics. In: clinical pharmocology. NewYorks, Churchil Livingstone 2004;9: 319-43.

Abstract: Introduction: Hypertension is one of the major causes of cardiovascular morbidity and mortality. However, community based studies in the rural areas of India and specifically in West Bengal on the prevalence of hypertension and its associated risk factors is scarce. Hence, an investigation was undertaken with specific objectives. Objective: To find out prevalence of hypertension and correlates among adult population living in a rural area of West Bengal. Methodology : This community based cross sectional study was conducted in Domjur block of Howrah A sample of 406 (45-59 years) individuals was selected by the standard 30 cluster systematic random sampling technique. Chi-square test and multiple...........

Keywords- Hypertension, Prevalence, Awareness, West Bengal, Correlates.

[1]. Marcia Russell, M. Lynne Cooper, Michael R. Frone, Robert S. Peirce: A Longitudinal Study of Stress, Alcohol, and Blood Pressure in Community-Based Samples of Blacks and Non-Blacks: Alcohol Research & Health, Winter, 1999
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Abstract: A serious public health problem which remain the major cause of morbidity and mortality worldwide is found to be Diabetes Mellitus (DM) 1. The most common complication associated with uncontrolled DM is Foot ulcer, Retinopathy, Neuropathy, Macro Vascular Complications (MVC) 2, 3. Of all the complications of DM, foot ulcers impose a heavy burden on health service 4. Peripheral Neuropathy (PN), muscle atrophy and foot deformity remains the reason for developing diabetic foot ulcer in 20% of patients with uncontrolled DM. This ulcer may lead to diabetic foot infection which leads to gangrene formation. Charcot joint fracture is the major risk factor for Amputation 5...........

[1]. Sivaraman Umadevi et all, Microbiological study of diabetic foot infections, INDIAN JOURNAL OF MEDICAL SPECIALITIES 2011;2(1):12-17.
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[4]. Gulam abbas Z et all, clinical outcome of diabetis patient hospitalized with foot ulcer,Diabedmed 2002;19:575-9.
[5]. Rooh-Ul-Muqim et all, evolation and management of dm foot accorfing to wagners classification, 2003;15:39-42

Abstract: This study is aimed to evaluate the knowledge, attitude and practices of rural children towards oral health and dental care as well as to assess the oral hygiene status among them. Children studying in Andhra Pradesh Tribal welfare Residential Schools were included in the study. The children completed an interview to evaluate knowledge and attitude. Oral hygiene Status was measured using the oral hygiene index Results: Children were aware about caries as one of the common problem associated with mouth and teeth and only few students were aware of gum diseases. Though 61% children were aware that sweets and chocolates cause dental problems 34% were unaware of how these problems could be prevented. Oral hygiene habits of the children were found to be...........

Keywords- Oral hygiene, Knowledge and attitude, rural children.

[1]. Chen M S. Childrens Preventive dental behavioir in relation to their mothers socio economic status, health beliefs and dental behaviours. Journal of Dentistry for Children 1986;53:105-09
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Abstract: Hypothyroidism is a common endocrinopathy which remains associated with free radical generation resulting in oxidative damage to various organs. Zinc and Copper are two essential trace elements for the human body, principally because of its role in antioxidant mechanism. Since oxidative damage has been reported to be related to the development of complications of hypothyroidism, it is prudent to identify the condition, in an attempt to retard the progress of the complications of hypothyroidism. Aims & objectives: To estimate serum Malondialdehyde (MDA), Zinc and Copper levels in Primary hypothyroid subjects and compare it with euthyroid subjects..........

Keywords- MDA, Zinc, Copper, Primary Hypothyroid.

[1]. Ambika Gopalakrishnan Unnikrishnan, Sanjay Kalra, Rakesh Kumar et al. Prevalence of hypothyroidism in adults: An epidemiological study in eight cities of India. Indian J Endocrinol Metab. 2013; Jul-Aug; 17(4): 647–652. [2]. Harrisons Principle of Internal Medicine (18th edition.) part16: Section1: Chapter 341.
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Abstract: Background: World-wide, hepatitis C infection is the chief cause of acute and chronic hepatitis. Chronic hepatitis C is treated by many agents encompasses diminution of inflammation, preclusion of fibrosis, cirrhosis and hepato-cellular carcinoma and virus annihilation. In addition, diverse anti-viral therapies i.e. all oral and sub-cutaneous drugs have been administered with variable side effects. In recent times, different Non-Invasive markers (NIM's) have been introduced for the assessment of liver fibrosis which includes APRI Index, fibro test, forns test, fibrosis 4 (FIB-4) score etc..........

Keywords- Non-invasive markers, chronic hepatitis C, all-oral drugs, Sub-cutaneous drugs, FIB-04 Score, APRI Index

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[5]. X. Hu, Y. Huang, Z. Bao et al., "Prevalence and factors associated with nonalcoholic fatty liver disease in shanghai work-units," BMC Gastroenterology, vol. 12, article 123, 2012. View at Publisher · View at Google Scholar

Abstract: Background: Several factors have been associated with the international variation in breast cancer incidence rates, these include epidemiologic, reproductive, hormonal and lifestyle factors. Trends in these risk factors are important to demonstrate changes over time.Patients and methods: This is a cross-sectional study that included 200 breast cancer patients diagnosed during the year 2015 (group III) for the aim to compare their epidemiologic, reproductive and hormonal characteristics with two previous studies conducted in 1990(group I) and 2005 (group II).Results: Over the past 25 years, the mean age of the patients at diagnosis became significantly older, p=0.009; (45.7, 46.1 and 49.1 years for group I, II and III respectively). The mean age at menarche became significantly............

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[5]. Kobayashi S, Sugiura H, Ando Y, Shiraki N, Yanagi T, Yamashita H, et al. Reproductive history and breast cancer risk. Breast Cancer. 2012;19(4):302–8.

Abstract: Uterine inversion is defined as the turning inside out of the fundus into the uterine cavity. It may be acute or chronicInversion of the uterus is an extremely rare condition in obstetric emergency and a rarest thing to be seen in a cadaver.It has never been reported so far as a cadaveric finding. During routine dissection in a 65-year-old female cadaver the fundus of uterus was not seen and the uterus was turned inside out. There was prolapse ofthe fundus through the uterine cervix.Non- puerperal uterine inversion is a rare happening with a very few cliniciansencountering it in their entire clinical practice. Since it is a diagnostic dilemma,this case reporting may help in spreading awareness of its occurrence which may save the patient from undergoing a hysterectomy..

Keywords- Bulls eye, Hysterectomy,Inversion,Leiomyoma, Non-puerperal.

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[4]. Gowri V. Uterine inversion and corpus malignancies: a historical review. ObstetGynecolSurv 2000; 55(11):703-707.

[5]. Krenning RA. Nonpuerperal uterine inversion.Review of literature. ClinExpObstetGynecol 1982; 9(1):12-15