iosr-JDMS   Volume-17 ~ Issue-9 ~ September-2018

Abstract: Acetabular fractures are a major challenge for an orthopaedic surgeon. As with increasing incidence of such injuries due to an increase in the frequency of road traffic accidents, it is a major concern in most of the hospitals. This study was done at Patna Medical College & Hospital, Patna between 2012 to 2016, on 20 acetabular fracture patients. All cases were operated according to standard operative techniques and surgical approaches and were followed up to 26 months on average. The midterm functional results were assessed by Harris Hip Score at 18 months. In our study, 70% of the cases had good to excellent results. It was concluded that early operative intervention according to principles of intra-articular fractures, resulted in good functional outcomes in acetabular fractures.

[1]. Alonso JE and Davila R (1994). Extended iliofemoral versus triradiate approaches in management of associated acetabular fractures.
Clinical Orthopaedics and Related Research 305 81–87.
[2]. Aşık M and Eralp L (2000). Long term results of surgical therapy in acetabular fractures. Acta Orthopaedica et Traumatologica
Turcica 34 245-253
[3]. Deo SD, Tavares SP, Pandey RK, El-Saied G, Willett KM and Worlock PH (2001). Operative management of acetabular fractures
in Oxford. Injury 32(7) 581-6.
[4]. Erdoğan F, Poursani RS, Öğ üt T and Tenekecioğlu Y (1998). Results of the conservative and surgical treatment of displaced acetabular
fractures. Acta Orthopaedica et Traumatologica Turcica 32 111-5.
[5]. Giannoudis PV, Grotz MR, Papakostidis C and Dinopoulos H (2005). Operative treatment of displaced fractures of the acetabulum.
A meta-analysis, Journal of Bone and Joint Surgery - British Volume 87 2-9..

Abstract: Alveolar osteitis or dry socket is one of the most common complication after tooth extraction especially in mandibular third molars.A lot of studies have been undertaken to investigate the etiology ,pathogenesis ,preventive methods and treatment of this condition but the results are inconclusive.The article aims to give an insight into the various facets of alveolar osteitis to help the dental practitioner in discerning and eliminating the risk factors as well as preventive and symptomatic management of this condition.

Keywords: Alveolar osteitis, Fibrinolysis, Alveolagia, Management.

[1]. HeasmanPA,Jacob DJ."A clinical investigation into the incidence of dry socket".British Journal of Oral and Maxillofacial Surgery.1984,Vol 22(2);115-122.
[2]. Crawford JY."Dry Socket",Dental Cosmos,1896,Vol 38;929-931.
[3]. Torres-Logares D,Serrera-Figallo MA,Romero Riaz MM et.al."Update on dry socket:review of the literature" MedicinaOral,Pathologica Oral Y,CirugiaBuccal.2005,Vol 10(1) :77-85.
[4]. Blum IR.Contemperory review of dry socket (alveolar osteitis);a clinical appraisal of standardization,etiopathology and management- article review. Int.J.Oral and Maxillofacial Surgery.2002;3(3):309-317.
[5]. FridrichKL,Olson RAJ.Alveolarosteitis following surgical removal of mandibular third molars. Anaestesia Progress.1990; 37(11):32-41...

Abstract: Acute pancreatitis is a common and potentially lethal inflammatory process with a highly variable clinical course. Persistent organ failure develops in 10%–20% of patients, with mortality reaching 30% in this subgroup. Since the morbidity and mortality of acute pancreatitis differ markedly between mild and severe disease (mild < 5% vs severe 20–25%), the ability to identify patients at risk for persistent organ failure early in the disease course is very critical, both for triaging patients to the appropriate level of care and for designing mechanistic studies for targeted intervention. Our study aims toassess the severity of acute pancreatitis using APACHE II and HAPS (Harmless Acute...........

Keywords: APACHE II, HAPS, pancreatitis, amylase

[1]. Whitcomb DC. Clinical practice. Acute pancreatitis. N Engl J Med 2006;354:2142–2150.
[2]. Forsmark CE, Baillie J. AGA Institute technical review on acute pancreatitis. Gastroenterology 2007;132:2022–2044.
[3]. Talukdar R, Nageshwar Reddy D. Predictors of adverse outcomes in acute pancreatitis: new horizons. Indian J Gastroenterol.
2013;32: 143–51.
[4]. R, Nechutova H, Clemens M, Vege SS. Could rising BUN predict the future development of infected pancreatic necrosis?
Pancreatology. 2013;13:355-359.
[5]. Wu BU, Johannes RS, Sun X, et al. Early changes in blood urea nitrogen predict mortality in acute pancreatitis. Gastroenterology.
2009;137:129–35..

Abstract: Introduction: The present study was conducted to compare the effects of prophylactic phenylephrine and ephedrine infusion on maternal haemodynamics in elective caesarean section under spinal anaesthesia. It was hypothesized that prophylactic phenylephrine infusion would maintain better maternal haemodynamics than ephedrine infusion. Methods: Seventy six patients were available for randomization into two equal groups to receive either prophylactic infusion phenylephrine 100μg/ml/min (Group P, n=38) or infusion ephedrine 8mg/ml/min (Group E, n=38) after induction.........

Keywords: Phenylephrine, Ephedrine, Spinal Anaesthesia.

[1]. Hawkins JL. Anesthesia related maternal mortality. Clin Obstet Gynecol 2003; 46: 679-87.
[2]. Riley ET, Cohen SE, Rubenstein AJ, Flanagan B. Prevention of hypotension after spinal anaesthesia for caesarean section: 6%
hetastarch versus lactated Ringer's solution. Anesth Analg 1995; 81: 838-42.
[3]. Rout CC, Rocke DA. Prevention of hypotension following spinal anesthesia for cesarean section. Int Anesthesiol Clin 1994; 32:
117-35.
[4]. Jackson R, Reid JA, Thorburn J. Volume preloading is not essential to prevent spinal-induced hypotension at Caesarean section. Br
J Anaesth 1995; 75: 262-5.
[5]. Karinen J, Rasanen J, Alahuhta S, Jouppila R, Jouppila P. Effects of crystalloid and colloid preloading on uteroplacental and
maternal haemodynamic state during spinal anaesthesia for caesarean section. Br J Anaesth 1995; 75: 531-5...

Abstract: Aim: Intraoperative frozen section analysis play an important role in modern day surgical practice. The quality assurance of this technique is vital as it is a major tool in guiding the patient surgical management. The present study was conducted to evaluate the diagnostic accuracy of frozen section results and to find out the common reasons of misdiagnosis. Method: This is a retrospective study done by retrieving the data from frozen section and routine histology registers over a period of two years. Total 163 cases were received for frozen section analysis in that period. Out of these 2 cases were deferred and analysis was done on 161 cases. Results: Out of 163 cases

Key words: Frozen section, Intraoperative, Diagnostic accuracy, Interpretation error.

[1]. Patil P, Shukla S, Bhake A, Hiwale K; Accuracy of frozen section analysis in correlation with surgical pathology diagnosis. Int J
Res Med Sci.2015 Feb ; 3(2) :399-404.
[2]. Chandramouleeswari K, Yogambal M, Arunalatha P, Bose JC, Rajendran A; Frozen and paraffin sections - Comparative study
highlighting the concordance and discordance rates in a tertiary care centre. IOSR Journal of Dental and Medical Sciences (IOSRJDMS)
2013, Nov.- Dec.;12(5): 26-30
[3]. Shrestha S, Lee MC, Dhakal H, Pun CB, Pradhan M, Shrestha S, Basyal R, Pathak T; Comparative Study of Frozen Section
Diagnoses with Histopathology. Post Graduate Medical Journal of NAMS. 2009 July-Dec; 9(2):1-3
[4]. Mishra S, Gupta M, Bharat V, Bansal R; Qualitative Comparative Study of Frozen Section with Routine Histological Technique.
National Journal of Laboratory Medicine. 2016; Apr, Vol 5(2): 44-50
[5]. de Silva RD, Souto LR, Matsushita GdeM, Matsushita MdeM; Diagnostic accuracy of frozen section tests for surgical diseases.
Rev. Col. Bras. Cir. 2011; 38(3): 149-154...

Abstract: Tuberculosis is very prevalent in India .According to WHO TB statistics about40%popoulatin of India having tuberculosis infection till 2016. Inspite of having complete course of anti-tuberculosis therapy patients has to continue treatment for post tubercular complications like restrictive and obstructive lung disease and bronchiectasis. This leads to increased treatment cost, increased morbidity and mortality. Materials & Methods: This study was done on90 patients of chronic obstructive pulmonary disease above 40 years of age with FEV1/FVC of 0.7 or less with associated symptoms of cough with expectoration and breathlessness and history of Tuberculosis noted and 40 cases of bronchiectasis with history of Pulmonary Tuberculosis. Bronchiectasis is diagnosed by HRCT in patients admitted for COPD. Results: In this study it was found that............

Key words: Bronchiectasis, COPD, Exacerbations, Morbidity, Mortality.

[1]. Athanazio R. Airway disease: Similarities and differences between asthma, COPD and bronchiectasis. Clinics (Sao Paulo) 2012;67:1335-43.
[2]. Baig IM, Saeed W, Khalil KF. Post-tuberculous chronic obstructive pulmonary disease. J Coll Physicians Surg Pak 2010;20:542-4.
[3]. Global Initiative for Chronic Obstructive Lung Disease. Disease: Comorbidities. Global Strategy for the Diagnosis Management and Prevention of Chronic Obstructive Pulmonary Disease. Ch. 6. 2015. p. 49.
[4]. Havlir DV, Getahun H, Sanne I, Nunn P. Opportunities and challenges for HIV care in overlapping HIV and TB epidemics. JAMA 2008;300:423-30.
[5]. Hnizdo E, Singh T, Churchyard G. Chronic pulmonary function impairment caused by initial and recurrent pulmonary tuberculosis following treatment. Thorax 2000;55:32-8..

Abstract: The present study was conducted to find out the clinico-epidemiological profile of Japanese encephalitis (JE) during the year 2013 to 2018 (till June) in a tertiary care teaching hospital, MMC, Malda, West Bengal. It was a retrospective study. The AES (Acute Encephalitis Syndrome) cases were tested for IgM antibodies against JE virus by using IgM Mac ELISA (National Institute of Virology, Pune). A total of 293 sera samples from the patients clinically suspected with AES were collected from the year 2013 to 2018 (till June). Out of which 30/293 (10.24%) were JE positive by IgM Mac ELISA kit, where 19 (63.33%) were male and rest 11 (36.67%) were female. Maximum number of JE cases was reported in the age group 0-15 yrs (63.33%: 40% in the age group of less than..........

Key words: Acute encephalitis syndrome, Japanese encephalitis, ELISA, Malda

[1]. Malhotra S, Sharma S, Kumar P and Hans C. Japanese Encephalitis and its Epidemiology. Journal of infectious Diseases and Therapy, 2015, vol 3(5) Doi: 10.4172/2332-0877.1000243
[2]. Huanyu Wang, Guodong Liang. Epidemiology of Japanese encephalitis: past, present, and future prospects. Therapeutics and Clinical Risk Management 2015:11:435-448
[3]. Tobias E. Erlanger, Svenja Weiss, Jennifer Keiser, Jürg Utzinger, Karin Wiedenmayer. Past, Present, and Future of Japanese Encephalitis. Emerging Infectious Diseases.www.cdc.gov/eid • Vol. 15, No. 1, January 2009.
[4]. Grant L Campbell, Susan L Hills, Marc Fischer, Julie A Jacobson, Charles H Hoke,Joachim M Hombach, Anthony A Marfin, Tom Solomon, Theodore F Tsai, Vivien D Tsui & Amy S Ginsburgi . Estimated global incidence of Japanese encephalitis: a systematic review. Bull World Health Organ 2011; 89:766–774.
[5]. Johanna Lindahl, Jan Chirico, Sofia Boqvist, Ho Thi Viet Thu, Ulf Magnusson. Occurrence of Japanese Encephalitis Virus Mosquito Vectors in Relation to Urban Pig Holdings. Am. J. Trop. Med. Hyg., 2012, 87(6): 1076–1082..

Abstract: Background: Women with PCOS had a higher prevalence of fatty infiltration of liver compared to women without PCOS. In a Hospital set up ultrasonography is the most widely used screening modality for detection of fatty infiltration of liver and for PCOS, due to its low cost, non invasiveness, easy availability, mobility and reasonable level of sensitivity. Aim and Objectives: The main aim of the present study was to identify the prevalence of fatty liver as seen on ultrasonography in patients with PCOS, corroborating with laboratory and physical parameters to determine the efficacy of Ultra sound as a screening modality, as fatty liver is precursor for chronic disease like cirrhosis and hepatocellular carcinoma in some patients and PCOS is associated with increased risk of type-2-diabetes and cardiovascular diseases. Materials and Methods: It is a Retrospective study using existing records............

[1]. Balen AH, Tan SL, Jacobs HS. Hypersecretion of luteinising hormone: a significant cause of infertility and miscarriage. Br J Obstet Gynaecol. 1993;100:1082-108.
[2]. Eden JA, Warren P. A review of 1019 consecutive cases of polycystic ovary syndrome demonstrated by ultrasound. Australas Radiol. 1999; 43:41-46.
[3]. Yeh HC, Futterweit W, Thornton JC. Polycystic ovarian disease: ultrasound features in 104 patients. Radiology. 1987; 163:111- 116.
[4]. Hann LE, Hall DA, McArdle CR, Seibel M. Polycystic ovarian disease: sonographic spectrum. Radiology. 1984; 150:531-534.
[5]. Pache TD, Wladimiroff JW, Hop WC, Fauser BC. How to discriminate between normal and polycystic ovaries: transvaginal ultrasound study. Radiology 1992; 183:421-423....

Abstract: Title: Barriers to the uptake of cataract surgery in a border district North India. Objective: To assess the barriers for the acceptance of surgery among patients with cataract in a border district north India. Materials and Methods: A short-term descriptive study was conducted in patients with cataract presenting in eye camp in a border district north India. The pretested semistructured questionnaire was used to obtain information regarding various sociodemographic variables, awareness about cataract and barriers for the surgery. Informed consent was taken from each respondent. Data was managed and analyzed by using Microsoft Excel 2011 version. Results: There were 60 patients (28 men and 32 women); Majority were found to be illiterates (70%), which were..........

Key words: Border district, cataract, barrier

[1] WHO. Universal eye health: A global action plan, 2014–2019. World Health Assembly document A66/11. 2013. Available at: www.who.int/blindness/actionplan/en/ (Cited on 15 Jan, 2015).

[2] Dua AS, National Programme for control of blindness, National Commision on Macroeconomics and Health (NCMH): Back ground papers- Burden of disease in India. 2005;299-304.

[3] Neena J, Rachel J, Praveen V, Murthy GVS. Rapid assessment of avoidable blindness in India . PLoS One 2008;3:e2867.

[4] Bettadapura GS, Datti NP, Donthi K, Ranganath BG, Ramaswamy SB, Sangeetha T. Barriers to the uptake of cataract surgery in a rural population of south Karnataka, India. Ijcrr. 2013;5:77-82.

[5] Dhaliwal U, Gupta SK. Barriers to the uptake of cataract surgery in patients presenting to a hospital. Indian J Ophthalmol 2007;55:133-6...

Abstract: Tobacco smoking has always been recognised as an important risk factor for perioperative compli-cations. Despite large scale efforts to create awareness about the hazards of tobacco smoking, this habit has greatly increased in recent times. As anaesthesiologist we encounter smokers frequently in our day to day prac-tice. Many of them do report their smoking status themselves; while a large majority denies this habit and many a times an anaesthesia resident is taken by surprise when complications do arise during the procedure. Perioperative complications in smokers have been described and studied by many people. It has been found that frequency and severity of different specific respiratory events are higher in smokers compared to non smokers. These specific respiratory events include laryngospasm, bronchospasm, aspiration, hypoventilation, hypoxemia, reintubation after planned extubation, and pulmonary edema. Risk of wound infections, marked hemodynamic changes following tracheal intubation also add to the perioperative morbidity of smokers.(1).

Key words: laryngospasm, bronchospasm, aspiration, hypoventilation, hypoxemia, reintubation , pulmonary edema, smoking, anesthetic complications.

[1]. Myles Paul S. et al. Risk of complication and wound infection in patient undergoing ambulatory surgery. Smoker versus non smok-er. Anesthesiology 2002, 97 : 842 – 7.
[2]. Dennis A, Curran J, Sherri HJ, Kinnear W. Effects of passive and active smoking on induction of anaesthesia. Br. J Anaesth. 1994 Oct 73 (4): 450-2.
[3]. Schwilk B, Bothner U, Schraag S, Georgieff N. Perioperative respiratory events in smokers and non smokers undergoing general anaesthesia. Acta Anaesthesiol Scand 1997; 41: 348-55.
[4]. Tait AR, Kyff JV, Crider B, Santibhavank V, Learned D, Finch JS. Changes in arterial oxygen saturation in cigarette smokers fol-lowing general anaesthesia. Can.J Anaesth. 1991 Sept; 38(6): 797.

[5]. Myles PS, Leslie K, Angliss M, Mezzavia P, Lee L. Effectiveness of bupropion as an aid to stop smoking before elective surgery: a randomized controlled trial. Anaesthesia 2004; 59: 1053-1058.

Abstract: High variety and complex fistula surgery is a difficult procedure but need special attention for the surgeons. We observed recurrence rates of surgical procedure of submucosal ligation with excision of the tract for complex and high variety fistula treatment. The aim of this study is to observe recurrence rate of this procedure and to develop a standard surgical technique for management of complex and high variety perianal fistula. We conducted a study at 250 bedded district sadarhospitals, Feni, Bangladesh including several private clinics in same territory from 1st January 2014 to 31st December 2017 for assessing recurrence rate of surgery of 34 patients with complex and high variety fistula. All operations were done in the selected hospitals. Datawere collected including patients' demographic details, fistula type determined by endorectal-ultrasonography and MR Fistulography...........

Key words: Anorectal fistula, fistula-in-ano, sub mucosal, ligation.

[1]. Song KH. New Techniques for Treating an Anal Fistula. J Korean Soc Coloproctol 2012;28(1):7-12.

[2]. Rojanasakul A. LIFT procedure: a simplified technique for fistulain-ano. Tech Coloproctol 2009;13:237-40.

[3]. de la Portilla F, Rada R, León E, Cisneros N, Maldonado VH, Espinosa E. Evaluation of the use of BioGlue in the treatment of high anal fistulas: preliminary results of a pilot study. Dis Colon Rectum. 2007;50:218–222.

[4]. Barillari P, Basso L, Larcinese A, Gozzo P, Indinnimeo M. Cyanoacrylate glue in the treatment of ano-rectal fistulas. Int J Colorectal Dis. 2006;21:791–794.

[5]. Han JG, Wang ZJ, Zhao BC, Zheng Y, Zhao B, Yi BQ, Yang XQ. Long-term outcomes of human acellular dermal matrix plug in closure of complex anal fistulas with a single tract. Dis Colon Rectum. 2011;54:1412–1418...

Abstract: Nephrotic syndrome, or nephrosis, is defined by the presence of nephrotic-range proteinuria, edema, hyperlipidemia, and hypoalbuminemia. While nephrotic-range proteinuria in adults is characterized by protein excretion of 3.5 g or more per day but in children it is defined as protein excretion of more than 40 mg/m2/h or a first-morning urine protein/ creatinine of 2-3 mg/mg creatinine or greater. Prednisolone is a steroid medication used to treat certain types of allergies, inflammatory conditions, autoimmune disorders, and cancers, is very potent medication to treat children with nephrotic syndrome. The aim of this study was to evaluate the association between serum.............

Key words: Nephrotic syndrome, Hypoalbuminemia,Serum Prednisolone,Serum Albumin

[1]. Priya pais, Avner DE, Nephrotic Syndrome. In: Kliegman RM, Behrman RE, Geme JWS, Stanton BF, Schor NF, (eds.) Nelson Textbook of pediatrics. 19th edition. Philadelphia, PA, Elsevier; 2012. p.p 1801-7.
[2]. Gatti G, Perucca E, Frigo G.M. Pharmacokinetics of prednisone and its metabolite prednisolone in children with nephritic syndrome during the active phase and in remission. Br J clin Pharmac1984;17:423-31.
[3]. Madani A, Daryoush F, Esfehani TS, Mohsseni Parvin, Atayee N, Ahmedi M, Elmi F,Haddadi M.G. Glomerular diseases in Iranian children: clinico-pathological correlation. Pediatr Nephrol 2003; 18: 925-28.
[4]. Bhimma R, Adhikari M, Asharam K, Connolly C. The spectrum of kidney disease ( stage 2-5 ) in KwaZulu-Natal,South Africa. Pediatr Nephrol 2004;23(10):1841-6.
[5]. Uddin GM.Paediatric renal transplantation in Bangladesh. The Child Kidney News 2009;1(1).

Abstract: Background: Thyrotoxic Periodic Paralysis(TPP) is a potentially deadly complication of hyperthyroidism characterized by varying severity of muscle weakness to paralysis and hypokalemia. Clinical features of hyperthyroidism in patients with TPP may be subtle. Case Report: Mrs O.O is a 66 year old woman who presented with progressive weakness of the upper and lower limb for three days, with a prior history of diarrhea for a day. She was previously diagnosed with hyperthyroidism, diabetes and hypertension. On examination, she had mild anterior neck swelling, reduced muscle power, tone and reflexes of the upper and lower limbs with normal muscle bulk. She was successfully managed with Potassium replacement and anti-thyroid medication. Conclusion: Thyrotoxic Periodic Paralysis can be treated adequately and promptly to avoid complications , a high index of suspicion is needed to make a diagnosis.

Key words: Thyrotoxic Periodic Paralysis, Hyperthyroidism, Hypokalemia

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[5]. SubrataChakrabarti (2015) Normokalemic Thyrotoxic Periodic Paralysis with Preserved Reflexes- An Unique Case Report. J of Clinical and Diagnostic Res 9: OD05-OD06...