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

Abstract: INTRODUCTION: A father's knowledge and attitude towards exclusive breastfeeding are very important factors that contribute to the success of exclusive breastfeeding practices. MATERIALS AND METHODS: A descriptive cross sectional study was carried out among n=200 purposively selected first time expectant fathers attending antenatal clinics along with low risk term primigravidae at a tertiary care corporate maternity hospital, Jemshedpur from February 2017 to January 2018. Each subject was given a self administered pre-tested questionnaire followed by a session of health education. Data was processed using SPSS 15.0 and the variations of the knowledge and attitudes in relation to various demographic parameters of age, ethnicity, marital status, duration of marriage..........

Keywords: Breast feeding, Iowa Infant Feeding Attitudes Scale, Declaration of Helsinki.

[1]. Chandhiok N, Singh KhJ, Sahu D, Singh L, Pandey A (2015) Changes in exclusive breastfeeding practices and its determinants in India, 1992-2006: analysis of national survey data. Int Breastfeed J 10: 34.
[2]. Chinnasam B, Sundaramoorthy S, Sadasivam K, Pasupathy S (2016) Knowledge, Attitude and Practices of Mothers Regarding Breastfeeding in A South Indian Hospital. Biomed Pharmacol J 9(1): 195-199.
[3]. (2016) National Family Health Survey (NFHS 4). International Institute for Population Sciences, India.
[4]. 4. Pandey D, Sardana P, Saxena A, Dogra L, Coondoo A, et al. (2015) Awareness and Attitude towards Breastfeeding among Two Generations of Indian Women: A Comparative Study. PLoS ONE, 10(5), e0126575.
[5]. 5. Maheswari E, Vishnu Bhat B, Mohamed A, Padiyath A (2010) Knowledge, attitude and practice of breastfeeding among postnatal mothers. Curr Pediatr Res 14(2): 119-124...

Abstract: INTRODUCTION: It is important to identify modifiable factors that may lower gestational diabetes mellitus (GDM) risk. Dietary iron is of particular interest given that iron is a strong prooxidant, and high body iron levels can damage pancreatic β-cell function and impair glucose metabolism. The current study is to determine if prepregnancy dietary and supplemental iron intakes are associated with the risk of GDM. MATERIALS AND METHODS: Study was done in Obstetrics and Gynecology department, MGM Medical College, Jamshedpur. Study duration was 1 years. It was a prospective study comprising of patients who came with raised blood glucose levels on their 1st visit........

Keywords: gestational diabetes mellitus, Macrosomia, LSCS.

[1]. Helmrich SP, Ragland DR, Leung RW, et al. Physical activity and reduced occurrence of non-insulin-dependent diabetes mellitus. N Engl J Med 1991;325:147-52.
[2]. Manson JE, Rimm EB, Stampfer MJ, et al. Physical activity and incidence of non-insulin-dependent diabetes mellitus in women. Lancet 1991;338:774-8.
[3]. Wang L, Yamaguchi T, Yoshimine T, et al. A case-control study of risk factors for development of type 2 diabetes: emphasis on physical activity. J Epidemiol 2002;12:424-30.
[4]. Young JC, Enslin J, Kuca B. Exercise intensity and glucose tolerance in trained and nontrained subjects. J Appl Physiol 1989; 67:39-43.
[5]. Harding AH, Williams DEM, Hennings SHJ, et al. Is the association between dietary fat intake and insulin resistance modified by physical activity? Metabolism 2001;50:1186-92.

Abstract: INTRODUCTION: Laryngoscopy and tracheal intubation are noxious stimuli that evoke transient but marked sympathetic response manifesting as an increase in the heart rate, blood pressure, intraocular and intracranial pressure. These changes are seen maximum immediately after intubation and last for 5 to 10 minutes.1 Topical or intravenous (I.V.) lidocaine, opioids, inhaled anesthetics, vasodilators, calcium channel blockers or adrenergic blockers have been used successfully for decreasing the hemodynamic response to laryngoscopy. AIM AND OBJECTIVES: This study was done to compare the various doses of IV Esmolol in attenuating the haemodynamic stress response to laryngoscopy and endotracheal intubation..............

Key words: Intubation, Esmolol, Heart rate

[1]. Goodman, Gilman's. The pharmacological basis of therapeutics. Adrenergic agonist and antagonist Chapter 10, 2006;11th ed:271-91.
[2]. Miller's Anaesthesia. Pharmacology of Esmolol Chapter 16, 2005;6th ed:653-8.
[3]. Robert K Stoelting. Anaesthesia and co-existing disease. Anaesthesia and Analgesia Chapter 5, 2003;4th edn:p 102.
[4]. King BD, Harris LC, Creinfenstein FE, et al. Circulatory responses to direct laryngoscopy and endotracheal intubation. British Journal of Anaesthesiology 1951;65:216-9.
[5]. Ebert JP, Pearson JD, Gelman S, et al. Circulatory response to laryngoscopy–the comparative effects of placebo, fentanyl and esmolol. Canadian Journal of Anaesthesia 1989;36(3 Pt 1):301-306..

Abstract: INTRODUCTION: Magnesium is well known to inhibit catecholamine release and attenuate vasopressin-stimulated vasoconstriction. We investigated whether i.v. magnesium sulphate attenuates the haemodynamic stress responses to pneumoperitoneum by changing neurohumoral responses during laparoscopic cholecystectomy. AIM AND OBJECTIVES: The main objective of this study is to determine the effect of magnesium sulfate in attenuating artirial blood pressure in elective laparoscopic abdominal surgeries. MATERIALS AND METHODS: 100 patients who underwent laparoscopic abdominal surgery were randomly divided in to two groups, group A and group B. Group A received magnesium sulphate 50 mg/kg diluted in normal saline to total volume of 20 ml at 240 ml/hour over 5 minutes. The control group (group B) received same amount of normal saline (20 ml)..........

Key words: magnesium sulfate, normal saline, BP.

[1]. Vecchio R, MacFayden BV, Palazzo F (2000) History of laparoscopic surgery. Panminerva Med 42: 87-90.
[2]. Nicholson ML, Elwell R, Kaushik M, Bagul A, Hosgood SA (2011) Healthrelated quality of life after living donar nephrectomy: a randomised controlled trial of laparoscopic verses open nephrectomy. Transplantation 91: 457-461.
[3]. Joris JL, Chiche JD, Canivet JL, Jacquet NJ, Legros JJ, et al. (1998) Hemodynamic changes induced by laparoscopy and their endocrine correlates: effects of clonidine. J Am CollCardiol 32: 1389-1396.
[4]. Sharma KC, Brandstetter RD, Brensilver JM, Jung LD (1996) Cardiopulmonary physiology and pathophysiology as a consequence of laparoscopic surgery. Chest 110: 810-815.
[5]. Millers Anesthesia Chapter 68-Anaesthesia for laparoscopic surgery..

Abstract: Blood pressure control in essential Hypertension can be achieved by blocked of Renin Angiotensin and Aldosterone system (RAAS) at various stages of the biochemical cascade. The essential hypertension effects 15-25% of adult in most countries and is associated with an increased risk of coronary heart disease (CHD) and cerebrovasular disease. Reducing morbidity and mortality of HTN represents major Challenges. The blocked of RAAS at Various levels of biochemical cascade can be control the blood pressure in essential hypertension. The ACEI are the potential drugs to inhibits the conversion of inactive Angiotension I to acetive Angiotension II . Generally the effect of administration have Cough and Angioneurotic edema are mild. Valsartan is a new potentially selective AT1 receptor blocker. It shows remarkable efficacy and tolerability when administered as 80mg............ .

[1]. Bremner.A.D ef.cel: Valsartan: Long term efficacy and tolerability compared to lisinoprol in elderly pts. C Essential HTN: Journal of Clinical and Experience HTN: 1997:19 (8);
[2]. Stevo Julius: Long term potential of AT1 receptor blocked for Caradio vascular production in HTN: The value trial: Cardiology:1999: 91 (1):8-13
[3]. Markhan A.Goa KL:Valsartan, A review of its Pharmacology and Therapeutic Chee in essential Hypertension: Drug 1997:54 (2):299-311.
[4]. Covera 1, Cardoni O, Fogari R.Etal.Valsartan a new angiotension II Antagonest for the treatment of essential Hypertension: A comparative study of the efficient and safety against anulodipine clin pharmacolther 21996;60:341-346.
[5]. Mclnnes Gurdon J.Clinical Advantage of Valsartan cardiology 1999 91 (suppl.1) :14-18..

Abstract: Medical education is perceived as being stressful, and a high level of stress may have a negative effect on cognitive functioning and learning of students in a medical school. Objective- To know the prevalence and the levels of stress among medical undergraduates. To know the association between the levels of stress and their academic performance and to determine most commonly used coping strategies.. methodology -This cross-sectional study was conducted among 200 medical undergraduates of 4 th and sixth semester. Results - The overall prevalence of stress in the study was found to be 83.3%.The stress levels was found to be higher in females than males..On PSS about 65% of students scored less than 20 and much higher stress i.e., more than 30 was found in 2% students. Most common stress coping strategies identified in this study were watching TV or movies, talking with family members and...........

Key words; COPING STRAGIES, MEDICAL STUDENTS, PSS SCORE, STRESS

[1]. Abdus Salam,Rabeya Yousuf,Sheikh Muhammad Abu Bakar,Mainul Haque Stress among medical students in Malaysia;International Medical journal vol.20;no.6;pp.649-655, Dec 2013.
[2]. Dr.Aditya Jain,Ramta Bansal Stress among medical and dental students:A global issue;IOSR Journal of Dental Medical sciences(JDMS) Sep-Oct 2012.
[3]. Hamza M.Abdulghani,Abdulaziz A.Alkanhal,Ebrahim S.Mahmoud,Gomida G.Ponnamperuma,Eiad A.Alfaris Stress and its effects on medical students:A cross sectional study at College of Medicine in Saudi Arabia;J Health Popul NUTR Oct 2011.
[4]. Nudrat Sohail Stress and academic performance among medical students;Journal of the College Physicians and Surgeons 2013.
[5]. Shawaz Iqbal,Sandhya Gupta,E.Venkatrao Stress,anxiety and depression among medical undergraduate students and their sociodemographic correlates ;Indian J Med Res 141,March 2015.

Abstract: Background: Community acquired pneumonia (CAP) is an acute illness acquired in the community with symptoms suggestive of lower respiratory tract infection (LRTI) together with the presence of a chest radiography of intrapulmonary shadowing which is likely to be new and has no clear alternative cause. Objective: To study the clinical presentation of community acquired pneumonia (CAP) and the risk factors associated with community acquired pneumonia. Methods: Cross sectional, prospective study done at the Institute of Internal Medicine, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai from October 2016 to May 2017. 50 patients admitted with a clinical diagnosis of pneumonia were evaluated and non-infectious causes were.....

Key Words: Community acquired pneumonia, Lower Respiratory tract infection, Consolidation

[1]. Seaton A, Seaton D, and AG Leich, Crofton & Douglas's. Respiratory diseases. 5th edition. Vol-1 Chapter 13: 356-429
[2]. Lionel A. Mandell, Richard Wunderink, Harrison's Principles of Internal Medicine, 18th edition Pneumonia. Chapter 257, page 2130-2141
[3]. Pai Dhungat AJ. API Textbook of Medicine. Pneumonias, 7th edition, Chapter 7 page 301-305
[4]. John G. Berlett. Oxford Textbook of Medicine – Pneumonia – Normal host, 4th edition, Chapter 17, 1357-1367
[5]. Medical Clinics of North America (Sep. 1993): Pneumonia.

Abstract: INTRODUCTION: caudal epidural analgesia is commonly practiced regional block technique in children undergoing infraumbilical surgeries but has a short duration of action after single shot local anaesthetic injection. The aim of this study was to determine effect of caudal morphine and fentanyl addition to ropivacaine in pediatric infraumbilical surgery. MATERIALS AND METHODS: 80 pediatric patients undergoing various elective lower abdominal surgeries like circumcision, orchidopexy, herniotomies, etc. And belonging to ASA Grade I and II were selected for this study for convenience. This study was conducted in Department of Anesthesia, Mahatma Gandhi Memorial Medical College, Jamshedpur, Eastsingbhum.......

Keywords: Postoperative Analgesia, Ropivacaine, Morphine, Fentanyl,

[1]. Dobereiner EF, Cox RG, Ewen A, Lardner DR. Evidence-based clinical update: Which local anesthetic drug for pediatric caudal block provides optimal efficacy with the fewest side effects? Can J Anaesth. 2010;57:1102–10.

[2]. Doctor TP, Dalwadi DB, Abraham L, Shah N, Chadha IA, Shah BJ. Comparison of ropivacaine and bupivacaine with fentanyl for caudal epidural in pediatric surgery. Anesth Essays Res. 2013;7:212–5.

[3]. Krishnadas A, Suvarna K, Hema VR, Taznim M. A comparison of ropivacaine, ropivacaine with tramadol and ropivacaine with midazolam for post-operative caudal epidural analgesia. Indian J Anaesth. 2016;60:827–32.

[4]. Yildiz TS, Ozdamar D, Bagus F, Solak M, Toker K. Levobupivacaine-tramadol combination for caudal block in children: A randomized, double-blinded, prospective study. Paediatr Anaesth. 2010;20:524–9.

[5]. Kaur M, Singh PM. Current role of dexmedetomidine in clinical anesthesia and intensive care. Anesth Essays Res. 2011;5:128–33.

Abstract: INTRODUCTION: Various adjuvants including α-2 adrenergic agonist have been used to prolong the action of local anaesthetics in epidural anaesthesia. Now a days dexmedetomidine is most commonly used adjuvant in epidural anaesthesia but still it may produce side effects like hypotension and bradycardia.There is limited study on efficacy of epidural dexmedetomidine and neostigmine used as adjuvant to ropivacaine in lower limb surgeries. MATERIALS AND METHODS: This was a prospective, randomised and single blind study conducted on 100 patients divided in 2 groups viz. Group RD and RN. This study was conducted in Department of Anesthesia, Mahatma Gandhi Memorial Medical.............

KEY WORDS: Dexmedetomidine, Neostigmine, epidural ropivacaine

[1]. Nimmo SM. Benefit and outcome after epidural analgesia. Contin Educ Anaesth Crit Care Pain.2004;4(2):44-7.
[2]. Kaur S, Attri JP, Kaur G, Singh TP. Comparative evaluation of ropivacaine versus dexmedetomidine and ropivacaine in epidural anesthesia in lower limb orthopedic surgeries. Saudi J Anaesth 2014;8(4):463-469.
[3]. Richards JT, Read JR, Chambers WA. Epidural anaesthesia as a method of pre-emptive analgesia for abdominal hysterectomy. Anaesthesia 1998;53(3):296-8.
[4]. Arunkumar S, Hemanth Kumar V, Krishnaveni N, Ravishankar M, Jaya V, Aruloli M. Comparison of dexmedetomidine and clonidine as an adjuvant to ropivacaine for epidural anesthesia in lower abdominal and lower limb surgeries. Saudi J Anaesth. 2015;9(4):404-408.
[5]. Moyse DW, Kaye AD, Diaz JH, Qadri MY, Lindsay D, Pyati S,et al.Perioperative Ketamine Administration for Thoracotomy Pain. Pain Physician. 2017 Mar; 20(3):173-184.

Abstract: Background : Early detection & screening of type 2 Diabetes Mellitus (DM) is essential to delay its complications. However, testing for DM often requires invasive and painful blood testing which deters the people from undergoing an investigation and they remain undetected for a very long time. So, there is a need for non-invasive testing. Aim : This study aimed at estimating and correlating fasting salivary glucose and fasting plasma glucose in type 2 diabetics and non-diabetics; so as to assess if salivary glucose can be used as a non-invasive tool, to evaluate blood glucose levels, and could it also be used as a biomarker for large scale screening of diabetes. Method : 50 type 2 diabetic and 50 non-diabetic participants were selected according to inclusion & exclusion criteria. Quantitative estimation of blood and salivary glucose were performed by glucose oxidase method. Pearson's correlation coefficient test was applied to assess the correlation between salivary glucose level and plasma glucose level.......

Key words: Diabetes Mellitus, Non-invasive, Plasma Glucose, Salivary Glucose

[1]. Powers AC. Diabetes Mellitus Chapter 344. In: Longo DL, Kasper DL, Jameson JL, Fauci AS, Hauser SL, Loscalzo J (editors). Harrison's Principles of Internal Medicine. (18th edition. New York: The McGraw-Hill; 2012. pp. 4712-4747)
[2]. IDF Diabetes Atlas 7th Edition. 2015 Executive Summary. Available from: http://www.diabetesatlas.org/resources/2015-atlas.html

[3]. Jha SK, David CM, Saluja IP, Venkatesh D, Chaudhary SU. Estimation Of Salivary Glucose Level And Plasma Glucose Level In Subjects With And Without Diabetes Mellitus: A Comparative Study. National Journal of Integrated Research in Medicine. 2014; Volume 5(3): 65-70 May-June.
[4]. Panchbhai AS. Correlation of Salivary Glucose Level with Blood Glucose Level in Diabetes Mellitus. Journal of oral & maxillofacial research. July-Sep 2012; 3(3): e3 Available from: http://www.ejomr.org/JOMR/archives/2012/3/e3/v3n3e3ht.pdf
[5]. Barry H. Ginsberg. An overview of minimally invasive technologies. Clinical Chemistry Sep 1992; 38 (9): 1596-1600

Abstract: Osteomas considered by many as benign tumors and by others as only a reactionary response of body to chronic irritation or trauma via formation of mature bones at sub- periosteal or endosteal locations1,2 ,are relatively common in the jaws but fairly uncommon in the condylar region3 . They may occur as part of Gardner syndrome wherein they are multiple in number and associated with multiple intestinal polyposis 4.Multiple Osteomas may prove to be the first sign of Gardner syndrome and hence warrant thorough assessment of the patient. This article describes a patient with isolated osteoma involving the left condyle of mandible associated with stretching and dull aching pain and another with isolated osteoma of left body of mandible region associated with decayed lower left first molar..

[1]. Herford A S , Stoffella E, Tandon R ; Osteomas involving the facial skeleton: a report of 2 cases and review of the literature :Oral Surg Oral Med Oral Pathol 2013;115:e1-e6
[2]. Ortakog K ,Gunaydin Y, Aydintug Y, Safali M. Osteoma of the mandibular condyle: report of a case with 5-year follow-up.Mil Med 2005;170:117-20
[3]. Mancini JC, Woltmann M, Felix VB, Freitas RR.Peripheral osteoma of the mandibular condyle Int J Oral Maxillofac Surg 2005;34:92-3
[4]. Chimenos-Küstner E, Pascual M, Blanco I, Finestres F.Hereditary familial polyposis and Gardner's syndrome: contribution of the odontostomatology examination in its diagnosis and a case description.Med Oral Patol Oral Cir Bucal 2005;10:402-9
[5]. Yonezu H, Wakoh M, Otonari T, Sano T, Hashimoto S, Uchiyama T.Osteoma of mandibular condyle as cause of acute pain and limited-mouth-opening: case report.Bull Tokyo Dent Coll 2007;48:193-7..

Abstract: Postoperative analgesia is an essential part of the perioperative care of any surgical patient. Knee injuries and arthroscopy assisted ligament repairs are getting more common nowadays. Systemic opioids are the mainstay of postoperative analgesia but with side effects. Complete de afferentation is also not possible with drugs. In a case series of five patients, we administered spinal anaesthesia followed by a single shot combination of adductor canal block and IPACK block (interfascial plane between popliteal artery and capsule knee) to get early postoperative analgesia. There were no side effects. These results may open out further research in such combined blocks after knee surgery.

Key words:Postoperative pain, knee, nerve blocks

[1]. Roger Chou, Debra B. Gordon, Oscar A et.Guidelines on the Management of Postoperative Pain.The Journal of Pain, 2016: Vol 17, No 2: pp 131-157.
[2]. Garimella, V., & Cellini, C. Postoperative Pain Control. Clinics in Colon and Rectal Surgery, (2013). 26(3), 191–196.

[3]. S. J. Fowler1, J. Symons1, S. Sabato1 and P. S. Myles. Epidural analgesia compared with peripheral nerve blockade aftermajor knee surgery: a systematic review and meta-analysisof randomized trials.British Journal of Anaesthesia. 2008: 100 (2): 154–64.

[4]. Choi P, Bhandari M, Scott J, Douketis JD. Epidural analgesia for pain relief following hip or knee replacement. Cochrane Database of Systematic Reviews 2003, Issue 3. Art. No.: CD003071. DOI: 10.1002/14651858.CD003071.

[5]. ElAhl, M. S. Femoral nerve block versus adductor canal block for postoperative pain control after anterior cruciate ligament reconstruction: A randomized controlled double blind study. Saudi Journal of Anaesthesia, 2015:9(3), 279–282.

Abstract: Fractures of the patella are one of the common fractures and they constitute almost 1% of all skeletal injuries, resulting from either direct or indirect trauma. Because of the subcutaneous anterior location, the biomechanical function and the high level of force transmission during extension and flexion, stable reconstruction of patellar fractures continues to represent a major surgical challenge. The poor outcomes quantified during the follow up can persist. The study group is of fractures of patella in which comminution of the fragments has been the prime inclusion criterion in 58 cases. The inclusion criterion are fracture patella of any pattern with comminuted fragments, normal pre injury status of the knee joint, normal skin on inspection. The exclusion criterion are compound fracture,......

Key words: Patella fracture, distal pole comminution, partial patellectomy, functional outcome..

[1]. J Am Acad Orthop Surg. 2011 Apr;19(4):198-207. Patellar fractures in adults. Melvin JS , Mehta S
[2]. G GMS Interdiscip Plast Reconstr Surg DGPW. 2016; 5: Doc01. Published online 2016 Jan 18. doi: 10.3205/iprs000080PMCID: PMC4717300Current concepts review: Fractures of the patella Clemens Gwinner, Sven Märdian, Philipp Schwabe, Klaus-D
[3]. J Orthop Trauma. 2015 Feb;29(2):80-4. doi: 10.1097/BOT.0000000000000201. Fix it or discard it? A retrospective analysis of functional outcomes after surgically treated patella fractures comparing ORIF with partial patellectomy. Bonnaig NS , Casstevens C, Archdeacon MT, Connelly C, Monaco N, Wyrick JD, Le TT.
[4]. J Orthop Trauma. 2012 Jul;26(7):422-6. doi: 10.1097/BOT.0b013e318228c1a1. Functional outcomes after operatively treated patella fractures. LeBrun CT , Langford JR, Sagi HC.
[5]. Ulus Travma Acil Cerrahi Derg. 2017 Mar;23(2):150-155. doi: 10.5505/tjtes.2016.46402.Repair of comminuted fracture of the lower patellar pole. Massoud EIE ....

Abstract: Introduction: Gynecological cancer is one of the most common leading cancer in worldwide as well as India. Liver function tests are helpful to evaluate patients with hepatic dysfunction. These biomarkers may be used to identify the presence of liver disease during the follow-up period. The aim of the study was to evaluate any association between liver function parameters and pattern of liver dysfunction in metastasis of female genital and gonadal cancer patients. Materials and Methods: In this study 100 female genital and gonadal cancer patients and 100 women with benign genital and gonadal diseases who attended at Out Patient Door (OPD) of IPGME&R and SSKM Hospital, Kolkata, India during the period from June, 2016 to June, 2017 were included. Liver function test (LFT)....... .

Key Words: Female genital and gonadal cancer, Liver function test, Alkaline Phosphatase

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