iosr-JDMS   Volume-18 ~ Issue-10 ~ October-2019

Abstract: study of clinical evaluation and Management of Small bowel perforation was done between2017 1nd 2018 at Guntur medical college and Government General hospital Guntur. A study group consisted of 50 patients of different age groups. Back ground:-Perforation of small bowel is commonly observed problem in surgical practice. The different modes of clinical presentation of cases may be misleading in the diagnosis of its origin. It is required to know about current surgical practices for different types of perforations to manage such a case. A small effort has been done here, to know about the different modes of clinical presentation, diagnosis and types of management modalities for small bowel perforations. Methods:- A retros pec t ive study......

Key Words: Small bowel; Perforation; Management; Mortality; Morbidity

[1]. Taylor BA. Gastro intestinal emergencies. Glimore Ian T,Robert Shields. Spontaneous perforation of the gut.1st edition.WB Saunder company: 1992:35 9-79.
[2]. Sleisenger and Fordtran.Gastro intestinal and liver disease pathophysiology, diagnosis and management. Hamer Davidson H,Sherwood. L. Gorbach. Infectious diarrhea and bacterial food poisoning. 7th edition. Wb Saunder company: 2002:1882-85, 1889-1901.
[3]. William Schumer and Sheldono Burman. The perforated viscus,diagnosis and treatment in surgical emergencies. Nyhus Lloyd, The

[4]. Manson's Tropical diseases. Gordan Cook, Alimuddin Jumla.20th edn.W.B. Saunder's publications.849-873.
[5]. Jean Marie Eustache, David J Kras . Typhoid perforation of intestine. Archives of surgery.1983 Nov 118:1269-71..

Abstract: Occupational exposure is the exposure to blood borne infections that occurs while performing the duty during professional work. Needle stick injury (NSI) is the trauma caused by sharps like needles used for blood collection, intravenous cannulas, and different sharps used by health care professionals. NSI(58%) is the common source of exposure to blood and products, followed by exposure to non-intact skin 22.7%, contamination of mucous membrane 11.2% and cuts (8%). Among the Health care professionals, interns and undergraduate medical students are at great risk of occupational exposure. Hence this study is taken up to assess the knowledge of NSI and PEP in interns and undergraduate medical students in a medical college and tertiary care hospital.......

Key Words: Needles tick injuries, Post-exposure prophylaxis, waste sharps.

[1]. National Aids Control Organization. Ministry of Health and Family Welfare. Antiretroviral Therapy Guidelines for HIV-Infected Adults and Adolescents Including Post-Exposure Prophylaxis.
[2]. Muralidhar S, Singh PK, Jain RK, Malhotra M, Bal M. Needle stick injuries among health Care workers in a tertiary care hospital of India. Indian J Med Res. 2010;131:405-10.
[3]. Lee KL, Hassim N. Implication of the Prevalence of Needle stick Injuries in a General Hospital in Malaysia and Its Risk in Clinical Practice. Environmental Health and Preventive Medicine. 2005;10:33-41.
[4]. Matsubara C, Sakisaka K, Ali M. Prevalence and Risk Factors of Needle Stick and Sharp Injury among Tertiary Hospital Workers, Vientiane, Lao PDR. J of Occu Heal. 2017;59(6):581-5.
[5]. Sudhir, Deepa K, Ashok NC, Murali D. A Study to Assess Knowledge And Practice In Relation To Universal Precautions And Awareness Regarding Post-Exposure Prophylaxis For HIV Among Interns Of A Medical College In Mysore District, South India. Int J of Rec Scie Resea. 2013;4(10):1554-7.

Abstract: Oral leukoplakia is the most common potentially malignant disorder affecting oral cavity. Various surgical and non-surgical treatments have been reported, but currently there is no universal consensus on the most appropriate one and on the duration or interval of follow-up of patients with this condition. Management of oral leukoplakia should begin with elimination of risk factors (if any) such as tobacco abuse, betel chewing, alcohol abuse, superimposed candida infection over the lesion etc. Surgical treatment includes conventional surgery, electrocoagulation, cryosurgery, and laser surgery (excision or evaporation). In this case report we attempted conventional excision of leukoplakia with masked raw area with skintemp and evaluated healig of the lesion.

[1]. Petrou, Steven P; David M. Pinkstaff; Kevin J. Wu; Kenneth J. Bregg (November 2003). "Leukoplakia of the Bladder". Cliggott Publishing. Archived from the original on 10 September 2017. Retrieved 6 May 2013. [2]. E. Schwimmer, ―Die idiopathischenSchleimhautplaques der Mundhöhle (Leukoplakia buccalis),‖ Archives of Dermatology—Syphilis, vol. 9, pp. 570–611, 1877.
[3]. Anna Starzynska et al. Estimation of oral leukoplakia treatment records in the research of the department of maxillofacial and oral surgery, medical university of Gdansk. PostepDermAlergol 2015; 2: 114-122. [4]. World Health Organization. World Health Organization classification of tumours. In: Barnes L, Eveson JW, Reichart P, Sidransky D, editors. Pathology and Genetics. Head and Neck Tumours. Lyon: International Agency for Research on Cancer Press; 2005. pp. 177–9. [5]. S. Warnakulasuriya, N. W. Johnson, and I. van der Waal, ―Nomenclature and classification of potentially malignant disorders of the oral mucosa,‖ Journal of Oral Pathology and Medicine, vol. 36, no. 10, pp. 575–580, 2007.

Abstract: Humanitarian action itself is defined by the ICRC as a range of activities that seek to alleviate human suffering and protect the dignity of all the victims of armed conflicts and catastrophes, carried out in a neutral, impartial and independent manner, free of charge and framed under International Humanitarian Law. The first is now well known: a non-government forensic anthropology organization created in the aftermath of the regime which ruled Argentina between 1976 and 1983, to investigate the whereabouts of the "disappeared‟. The second source of HFA is international law, specifically International Humanitarian Law and Human Rights Law. Without communication with the dead, a fully humanitarian action is impossible. International humanitarian law applies to armed conflicts.

Key Words: ICRC, HPA, EAAF, ZIPNET, NDRF

[1]. Using forensic science to care for the dead and search for the missing: In conversation with Dr Morris Tidball-Binz. International Committee of the Red Cross. [Internet]. 2019. [Cited 2019 Sep 28]. Available from: https://www.icrc.org/en/international-review/article/using-forensic-science-care-dead-and-search-missing-conversation-dr
[2]. Cordner SM, Tidball-Binz M. Humanitarian forensic action- Its Origins and future. J Forsciint [Internet]. 2017; Aug:279. doi: 10.1016/j.forsciint.2017.08.11. [Cited 2019 Sep 29]. Available from: https://www.researchgate.net/publication/ 319202827_Humanitarian_forensic_action_-_Its_origins_and_future
[3]. Reddy KSN. The Essentials of Forensic Medicine and Toxicology. 33rd edition; 2014. India: Jaypee Brothers Medical Publishers. p. 26.
[4]. Guharaj PV, Gupta SK. Forensic Medicine and Toxicology. 3rd edition; 2019. India: Universities Press. p. 167.
[5]. The Conversation. (2019). Humanitarian forensic scientists trace the missing, identify the dead and comfort the living. [Internet]. 2019. [Cited 2019 Oct 1]. Available from: http://theconversation.com/humanitarian-forensic-scientists-trace-the-missing-identify-the-dead-and-comfort-the-living-115623

Abstract: Introduction: Medical education can impose significant psychological stress on undergraduates1 . Considerable degree of psychological morbidity has been reported among medical students ranging from stress, interpersonal problems and suicidal ideation to psychiatric disorders2 ,3, 4 and they tend to have greater psychological distress than the general population. Now-a-days,anxiety is most commonly found among medical students. Materials and Methods: A semi-structured questionnaire based study to test the level of anxiety,was conducted among 155 second year MBBS students at Kurnool Medical College ,Kurnool. The questionnaire used was hamilton anxiety rating scale (HAM-A) and.......

Key Words: hamilton anxiety rating scale (HAM-A),anxiety scoring,medical students.

[1]. Mosley TH, Jr, Perrin SG, Neral SM, Dubbert PM, Grothues CA, Pinto BM. Stress, coping, and well-being among third year medical students. Acad Med. 1994;69:765–7.
[2]. Aktekin M, Karaman T, Senol YY, Erdem S, Erengin H, Akaydin M. Anxiety, depression and stressful life events among medical students: a prospective study in Antalya, Turkey. Med Educ. 2001;35:12–7.
[3]. Dyrbye LN, Thomas MR, Shanafelt TD. Systematic review of depression, anxiety, and other indicators of psychological distress among U.S. and Canadian medical students. Acad Med 2006;81:354-73.
[4]. Shah M, Hasan S, Malik S, Sreeramareddy CT. Perceived stress, sources and severity of stress among medical undergraduates in a Pakistani medical school. BMC Med Educ 2010;10:2.
[5]. Eller T, Aluoja A, Vasar V, Veldi M. Symptoms of anxiety and depression in Estonian medical students with sleep problems. Depress Anxiety. 2006;23:250–6.

Abstract: INTRODUCTION :Obesity is defined as a Body Mass Index(BMI) greater than 30. The WHO states that abdominal obesity is defined as a waist-hip ratio above 0.90 for males and above 0.85 for females.It is one of the leading chronic,multifactorial and complex diseases which poses a major public health issue increasing the risk of non - communicable diseases like Type 2 Diabetes Mellitus, Cardiovascular diseases and Hypertension. It is considered to be a disorder of energy balance and it has recently been suggested that some form of obesity is associated with chronic low-grade inflammation. The present study aimed toemphasize the burden of obesity in inflammation by associating with elevated levels of high sensitivity CReactive Protein (CRP) in obese females.CRP is an independent risk factor for cardiovascular disease and is positively associated with body weight in obese individuals........

Key Words: BMI, WHR, OBESITY, HS CRP.

[1]. Klein J, Perwitz N, Kraus D, Fasshauer M. Adipose tissue as source and target for novel therapies.TrendsEndocrinolMetab. 2006; 17:26–32.
[2]. David Soyoye1, BabatopeKolawole, Rosemary Ikem&AdenikeEnikuomehinRelationship between high-sensitivity C-reactive protein and anthropometric indices of obesity Endocrine Abstracts (2015) 38 P235 | DOI:10.1530/endoabs.38.P235
[3]. Organization WH. Obesity: Preventing and managing the global epidemic. WHO Consultation.2004. ISBN: 9241208945. 1. Ng M, Fleming T, Robinson M, Thomson B, Graetz N, Margono C, et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2014. Epub 2014/06/02. DOI:10.1016/S0140-6736(14)60460-8.
[4]. Ding Ding, Min Wang, Dongfang Su, Changjiang Hong, Xinrui Li, Yunou Yang, Yuan Zhang, Gang Hu,andWenhua Ling Body Mass Index, High-Sensitivity C-Reactive Protein and Mortality in Chinese with Coronary Artery Disease PLoSOne. 2015; 10(8):e0135713.Published online 2015 Aug 17. doi: 10.1371/journal.pone.0135713 PMCID: PMC4539189

Abstract: The ossifying fibroma of bone is a central neoplasm of bone. Central ossifying fibroma a tumor accepted by most investigators as being odontogenic in origin. These are neoplasms consisting of fibrous tissue containing varying amount of mineralized materials. In this presentation, we have described 2 case series, 1.A male aged 57 year with clinical findings of pulsatile socket & expansion of cortical bone with mandibular left side. 2. A female aged 43 year asymptomatic patient who presented an impacted 38, 48 and accidently we have found radiographic changes on OPG. We have done CBCT (3D Carestream) scan and radiographically diagnosis was confirmed. Radiographic imaging such as intraoral, panoramic & CBCT had been performed and radiographic diagnosis of Central ossifying fibroma of bone was made. CBCT extending its arm to explore easier possibilities of diagnosis.

Key Words: Central ossifying fibroma, Fibrous lesions, CBCT Scan

[1]. Khan SA, Sharma NK, Raj V, Sethi T. Ossifying fibroma of maxilla in a male child- Report of a case and review of the Literature. Natl J Maxillofac surg 2011;2:73-9
[2]. Bal Reddy P, Sridhar Reddy B, Prasad N, Kiran G, Patlolla K. Central ossifying fibroma of the Mandible – An unusual case Report. J clin Diag Res 2012;6(3):539-41.
[3]. Varghese T, Byju M, Nambrath S, Issac A. Central ossifying fibroma of the maxilla (Matured type): Report of a rare case. IJSS case Reports and Reviews 2015; 1(12):15-8.
[4]. Henrique M, Dominguete L, et al. Extensive presentation of Central Ossifying Fibroma treated with conservative surgical excision. Case reports in Dentistry 2014; 2014:1-4.
[5]. Brannon M, Fowler CB. Benign fibro-osseous lesions: a review of current concepts. Advances in Anatomic pathology 2001; 8(3):126-43.

Abstract: Background: Dengue is the most common disease among all the arthropod-borne viral infection. It has emerged as a significant public health concern in recent decades due to the rapid increase in the human population, lack of awareness, environmental changes, and increased breeding places of vector mosquitos. Present study has been conducted in the urban field practice area of Siddhartha medical college, Vijayawada, to create awareness among people on dengue fever. Methodology: An Interventionalstudy done among 170 people residing in the urban field practice area of Siddhartha medical college, Vijayawada, from April 2019 to September 2019. A pre-tested closed-ended questionnaire was used to collect data. The health education program was conducted, and after five months, their improvement in the knowledge on dengue fever was recorded using a post-test questionnaire. Data collected was analyzed in SPSS V.20........

Key Words: Awareness, dengue fever, Health education, urban field

[1]. National Health profile 2018 [Internet]. Central Bureau of Health Intelligence; 2019 [cited 14 October 2019]. Available from: https://cbhidghs.nic.in
[2]. Raviglione M, Maher D.Ending infectious diseases in the era of the Sustainable Developmental Goals. Porto Biomedical journal 2017;2: 140-2.doi: 10.1016/j.pbj.2017.08.001
[3]. Suguna Devi G, Dharma raj A. An awareness program on dengue fever among adults residing in an urban slum area, Coimbatore. Int J Res Med Sci 2017; 5:52426
[4]. Jogdand KS, Yerpude PN. The Community Knowledge and Practices Regarding Dengue Fever in an Urban Slum Area of South India. People's J Sci Res. 2013; 6(1):13-5.
[5]. Malhotra G, Yadav A, Dudeja P. Knowledge, awareness and practices regarding dengue among rural and slum communities in North Indian city, India. Int J Med Sci Public Health 2014;3:295-299 .

Abstract: Introduction: In this study, we aimed to determine the proportion of ketamine-propofol (ketofol), in the ratio of 1:1, for colonoscopy procedures, to maintain the hemodynamic stability, in comparison with propofol alone. Material and methods: This is a prospective and randomized trial. The first group (group 1) was administered Ketofol (Ketamine 50mg and Propofol 50 mg), induction was performed, with 1 mg/kg propofol and 1 mg/kg ketamine. For the second group (group 2) induction was performed, with 2 mg/kg propofol. Additional doses of 0.5 mg/kg bolus propofol without ketamine were administered to both groups accordingly. The heart rate, mean arterial pressure (MAP), peripheral oxygen saturation values, colonoscopy period, adverse events, recovery time, discharge time, additional propofol doses, total propofol doses, colonoscopist and patient satisfaction were recorded........

Key Words: colonoscopy, ketamine, propofol, ketofol.

[1]. Rathmel J, Rosow C. Intravenous sedative and hypnotics. In: Flood P, Rathmell J, Shafer S, ed. by. Pharmacology and Physiology in Anesthetic Practice. 5th ed. Philadelphia, USA: Wolter Kluwer; 2015. p. 160-203. [2]. Biricik E, Karacaer F, Gulec E. Comparison of TIVA with different combinations of ketamine–propofol mixtures in pediatric patients. Journal of Anesthesia. 2017;. [3]. Aydogmus M, Türk H, Oba S. A comparison of different proportions of a ketaminepropofol mixture administered in a single injection for patients undergoing colonoscopy. Archives of Medical Science. 2013;11(3):570- 576.
[4]. Jalili S, Esmaeeili A, Kamali K, V R. Comparison of effects of propofol and ketofol (Ketamine- Propofol mixture) on emergence agitation in children undergoing tonsillectomy. Afri Health Sci. 2019;19(1). 1736-1744. https://dx.doi. org/10.4314/ ahs. v19i1.50
[5]. Amornyotin, Somchai. "Ketofol: A Combination of Ketamine and Propofol." Journal of Anesthesia and Critical Care, vol. 1, no. 5, 2014, doi:DOI: 10.15406/ jaccoa.2014.01.00031

Abstract: Patients require regular oral examination to detect, diagnose and to treat pathology if any found: in order to alleviate discomfort and to normalize the physiological oral status(1). It is imperative for dentists to maintain high standard of professional etiquette in order to successfully accomplish his vocation(2).Patients grievance is to be addressed and annulled to his contentment to maintain his appreciation as a professional and to sustain the statuesque as a good serving dentist in the society. This verily justifies the statement that; patient turn over in a clinic is directly proportional to the treatment approach of the dentist.Treatment approach is an amalgamation of different aspects: it includes his competence, communication, management skill and also the professional acumen gained through experience (3,4). Regular self appraisal is a key hypothesis to access and ameliorate our mistakes so as to improve skill set. A constant self evaluation of patient satisfaction regarding the service rendered is the crux for a successful

[1]. Lee K-T, Chen C-M, Huang S-T, Wu Y-M, Lee H-E, Hsu K-J, et al. Patient satisfaction with the quality of dental treatment provided by interns. Journal of Dental Sciences. 2013;8(2):177-83.
[2]. Mahrous MS, Hifnawy T. Patient satisfaction from dental services provided by the College of Dentistry, Taibah University, Saudi Arabia. Journal of Taibah University Medical Sciences. 2012;7(2):104-9.
[3]. AlMutairi MA. Parents' satisfaction with pediatric dental care provided by dental college, Riyadh. Journal of International Society of Preventive & Community Dentistry. 2016;6(6):542.
[4]. Sachdeo A, Konfino S, Icyda RU, Finkelman MD, Gulati H, Arsenault P, et al. An analysis of patient grievances in a dental school clinical environment. Journal of Dental Education. 2012;76(10):1317-22.
[5]. Othman N, Razak IA. Satisfaction with school dental service provided by mobile dental squads. Asia Pacific Journal of Public Health. 2010;22(4):415-25.

Abstract: Takayasu's arteritis (TA), also known as "young female arteritis," is a rare and chronic inflammatory disease of the large vessels. The disease mainly affects women of reproductive age and Asian origin. Pregnant patients are at increased risk of cardiovascular complications, including hypertension and congestive heart failure, which may jeopardize both maternal and fetal outcomes. We present a case of pregnant woman with Takayasu arteritis whose disease and fetal complications during pregnancy was challenging and managed well by our multidisciplinary team

[1]. Recent advances in the clinical management of giant cell arteritis and Takayasu arteritis. Koster MJ, Matteson EL, Warrington KJ. Curr Opin Rheumatol. 2016; 28:211–217.
[2]. Pregnancy and Takayasu arteritis: a single centre experience from North India. Suri V, Aggarwal N, Keepanasseril A, Chopra S, Vijayvergiya R, Jain S. J Obstet Gynaecol Res. 2010; 36:519–524.
[3]. Takayasu's arteritis in pregnancy complicated by peripartum aortic dissection. Lakhi NA, Jones J. Arch Gynecol Obstet. 2010;282:103–106
[4]. Takayasu arteritis in pregnancy: an analysis from eastern India. Mandal D, Mandal S, Dattaray C, et al. Arch Gynecol Obstet. 2012;285:567–571
[5]. Watts R, Al-Taiar A, Mooney J, Scott D, MacgregorA. The epidemiology of Takayasu arteritis in the UK. Rheumatol. 2009;48(8):1008-11.

Abstract:Background:The emergence of Photodynamic therapy (PDT) in recent years as a non-invasive treatment modalityfor managing infectious diseases especially Periodontitis has gained interest. PDT is an oxygen-dependent photochemical reaction that generates cytotoxic reactive oxygen metabolites. Aims:The main aim of this study was to compare and evaluate the efficacy of Photodynamic therapy as an adjunct to Phase I therapy in treating Chronic Periodontitis.
Methods and Material:It is a single centred randomized controlled trial, a total number of 5 patients were enrolled in a split mouth design into two groups as Group I (control group) SRP only and Group II (Test group) SRP with adjunctive PDT using 1% methylene blue as photosensitizing agent.......

Key Words: Photodynamic therapy (PDT), Subgingival Scaling and Root planing (SRP), Methylene blue, Generalized Chronic Periodontitis.

[1]. Page RC, Offenbacher S, Schroeder HE, Seymour GJ, Kornman KS. Advances in the pathogenesis of periodontitis: summary of developments, clinical implications and future directions. Periodontol 20001997;14:216-48. [2]. Kotwal B, Mahajan N, Jindal V. Non surgical periodontal therapy: A recapitulation. LAP LAMBERT Academic Publishing; 2013. [3]. Kamath VK, Pai JB, Jaiswal N, Chandran S. Periowand: photodynamic therapy in periodontics. Universal Research Journal of Dentistry. 2014;4:133-8. [4]. Kikuchi T, Mogi M, Okabe I, Okada K, Goto H, Sasaki Y, Fujimura T, Fukuda M, Mitani A. Adjunctive application of antimicrobial photodynamic therapy in nonsurgical periodontal treatment: a review of literature. Int J Mol Cell Med2015;16:24111-26.
[5]. Malgikar S, Reddy SH, Babu PR, Sagar SV, Kumar PS, Reddy GJ. A randomized controlled clinical trial on efficacy of photodynamic therapy as an adjunct to nonsurgical treatment of chronic periodontitis. Journal of Dental Lasers 2015;9:75-9.