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

Abstract: Jaundice is a frequent manifestation of biliary tract disorders and the evaluation and management of obstructive jaundice is a common problem faced by the general surgeon. Obstructive jaundice is strictly defined as a condition occurring due to a block in the pathway between the site of conjugation of bile in liver cells and the entry of bile into the duodenum through the ampulla. The block may be intrahepatic or extrahepatic in the bile duct.1 Despite the technical advances, the operative modes of management of obstructive jaundice were associated with very high morbidity and mortality. Yet, during the last decade significant advances have been made in our understanding with regard to the pathogenesis, diagnosis, staging and the efficacy of management of obstructive jaundice.........

[1]. Kaushik SP. Surgical jaundice, Indian J Surg 1989;51:495-500. Dorland's illustrated medical dictionary 30thed Saunders, Pennsylvania, 2000; 963,904.
[2]. Pratt DS, Kaplan MM. Jaundice In : Kasper DL, Braunwald E,Fauci AS, Hauser SL, Longo DL,Jameson JL. editors : Harrison's Principles ofinternal medicine 16thed: McGraw Hill, USA 2005:1:238-243.
[3]. Lindor KP. Jaundice and cholestasis. Garden OJ. Disease of the biliary tractIn: Shearman DJC, Finlayson N, Camilleri M, Carter D.editors : Disease of the gastrointestinal tract and liver . Churchill living stone, USA, 1997:929-949,1197.
[4]. Abrendt SA, Pitt HA. Biliary tract. Angelica MD, Fong Y. The liver. In: Townsend CM, Beachamp RD, Evers BM, Mattox KL. Sabistontextbook of surgery. The biological basis of modern surgical practice, 17th ed. Saunders, Pennsylvania USA 2004:1597,1561-1562.
[5]. Lillemoe KD, Cameron JL. Pancreatic and periampullary carcinoma. Lipsett PA, Yeo CJ. Choledochal cysts In:Zinner MJ, Schwartz SI, Ellis H. Maingot's abdominal operation 10thed. : prentice hall international Inc, united states of America, 1997:1977,1701-1715.

Abstract: Introduction: Urinary Tract Infection (UTI) is the most common childhood bacterial infection associated with high morbidity and long-term complications like renal scarring, hypertension, and chronic renal failure. Materials and Methods: This cross-sectional study was conducted at the department of pediatrics, District Hospital, Machilipatnam, from June 2017 to May 2018. 72 children who met the inclusion criteria were included in this study. Written informed consent was taken from parents/guardians for enrolment of their children in the study. Through history, particularly the nutritional history of the subject and other systemic examination was done. Detailed anthropometric measurements were done and grading of malnutrition was done according to WHO classification. Length/ height of child was measured to the nearest millimeter (mm). Weight was recorded to.......

Key Words: UTI, hypertension, and chronic renal failure.

[1]. Das RN, Chandrashekhar TS, Joshi HS GM, Shrestha N, Shivananda PG. Frequency and susceptibility profile of pathogens causing urinary tract infections at a tertiary care hospital in western Nepal. Singapore Med J. 2006;47(4):281.
[2]. Mirsoleymani RS, Salimi M, Brojeni MS, Ranjbar M, Mehtarpoor M. Bacterial Pathogens and Antimicrobial Resistance Patterns in Pediatric Urinary Tract Infections: A Four-Year Surveillance Study (2009–2012) Int J of Pediatr. 2014;2014:1–6.
[3]. Swerkersson S, Jodal U, Åhrén C, Hansson S. Urinary tract infection in small outpatient children: the influence of age and gender on resistance to oral antimicrobials. Eur J Pediatr. 2014;173:1075.
[4]. Prelog M, Schiefecker D, Fille M, Wurzner R, Brunner A, Zimmerhackl LB. Febrile urinary tract infection in children: ampicillin and trimethoprim insufficient as empirical mono-therapy. Pediatr Nephrol. 2008;23:597–602.
[5]. Kanellopoulos TA, Salakos C, Spiliopoulou I, Ellina A, Nikolakopoulou NM, Papanastasiou DA. First urinary tract infection in neonates, infants and young children: a comparative study. Pediatr Nephrol. 2006;21:1131–1137.

Abstract: Introduction: Accidental poisoning represents one of the most common medical emergencies encountered by young children and adolescents. The paediatric emergency toxicology is unique because of its natural division into two distinct components. Young children aged 1 to 5 years who innocently ingested small amounts of a single substance constitute the first group. Materials and Methods: A retrospective study of cases was carried out at Department of Pediatrics, District Hospital, Machilipatnam between January 2018 and December 2018 for 1 year. The study materials included all the patients with acute poisoning admitted in this institute. Patients less than 1 month, poisonous bites and stings, idiosyncratic drug reactions and food poisoning were excluded from the study. The variables which were analysed were: age, gender, time interval between.......

Key Words: Accidental poisoning, LAMA, Death

[1]. V.P. Chaudhari, R.K. Srivastava, M. Moitra& V.K. Desai: Risk of domestic accidents among under five children. The Internet Journal of Family Practice. 2009 Volume 7 Number Available from;http://www.ispub.com/journal/the-internet-journal-of-family-practice/volume-7-number-1/risk-of-domestic-accidents-among-under-five-children.html.
[2]. Ravinder K. Gupta*, Ritu Gupta**Home Related Accidents During Infancy. *Adval Pediatric Clinic, NaiBasti, Jammu Cantt. & Department of **Physiology, Govt. Medical College, Jammu (J&K). Vol. 6 No. 2, April-June 2004.
[3]. Accidents to Children. Conducted in U.K. Registered Charity No: 207823. Available. from; http://www.rospa.com/ homesafety/adviceandinformation/childsafety/accident-to-children.U.K.
[4]. Siddarth. Improving the quality of care for children. Indian Pediatrics. 2002. 39: Pp 41-7.
[5]. Steven W. Heim, karen L. Maughan, Foreign Bodies in the Ear, Nose, and Throat. University of Virginia School of Medicine, Charlottesville, Virginia Am Fam Physician. 2007 Oct 15;76(8): Pp 1185-1189. Available from; http://www.aafp.org/afp/2007/1015/p1185.html

Abstract: Patient safety is crucial to the quality of patient care and remains as a challenge. World Health Organization describes patient safety as a global issue, affecting all countries . Sri Lanka ,being a developing country, may encounter adverse events in health care system due to lack of infra structure, equipments, quality and supply of drugs and shortage of essential financial investments. By assessing the current patients safety culture in the selected Base Hospitals from the perspectives of the Healthcare Professional ,, one can identify the important issues regarding the quality service delivery of Sri Lankan Hospitals and the Government will be able to do remedial activities. Methodology-Thiscross sectional.......

Key Words: Adverse events, Patient Safety culture, Active and latent failures

[1]. AHRQ (2012) Hospital Surveys on Patient Safety Culture: 2012User Comparatives Data Base Report ;Agency for Healthcare Research and Quality.www.ahrq.gov
[2]. Amarapathy,M., Sridharan,S., Perrera,R. &Handa,H.(2013)Factors Affecting Patient Safety Culture In A Tertiary Care Hospital in Sri Lanka. International Journal of Scientific & Technology Research.Volume 02,Issue 3,March 2013 [3]. Ann E. K. Page.(2008). Patient Safety and Quality: An Evidence-Based Handbook for Nurses.Chapter 22Practice Implications of Keeping Patients Safe, National Center for Biotechnology Information, U.S. National Library of Medicine8600 Rockville Pike, Bethesda MD, 20894 USA
[4]. Brickell , T. A. & Carla, M.A. (2011). Emerging Issues and Challenges for Improving Patient Safety in Mental Health: A Qualitative Analysis of Expert Perspectives. Journal of Patient Safety, 7(1): 39-44
[5]. Christensen, C.M., Bohmer, R.&Kenagy, J.(2000). Will Disruptive Innovations Cure Health Care?Harv. Bus. Rev.2000,78, 102–112.,2(1), 24-33; doi:10.3390/systems2010024

Abstract: Background: This randomised study was conducted to evaluate clinical, patient based outcomes after RFA and conventional surgery in a selected population. Methods: This study was conducted in the Department of Cardiothoracic Surgery, Rajendra Institute of Medical Scinece, Ranchi, India. Results: In present study, it was reported that 150 patients in total were assessed in the study, out of which, 110 were randomised, 100 underwent the intervention as a daily procedure. 50 patients underwent RFA and 50 patients had conventional surgery.......

Key Words: RFA, Varicose vein, Endovenous laser ablation

[1]. Merchant RF, DePalma RG, Kabnick LS. Endovascular obliteration of saphenous reflux: a multicenter study. J Vasc Surg. 2002;35:1190-6.
[2]. Weiss RA, Weiss MA. Controlled radiofrequency endovenous occlusion using a unique radiofrequency catheter under duplex guidance to eliminate saphenous varicose vein reflux: a 2-year follow-up. Dermatol Surg. 2002;28:38-42.
[3]. Pera¨ la¨ J, Rautio T, Biancari F, Ohtonen P, Wiik H, Heikkinen T et al. Radiofrequency endovenous obliteration versus stripping of the long saphenous vein in the management of primary varicose veins: 3-year outcome of a randomized study. Ann Vasc Surg. 2005;19:669-72.
[4]. Darwood RJ, Theivacumar N, Dellagrammaticas D, Mavor AI, Gough MJ. Randomized clinical trial comparing endovenous laser ablation with surgery for the treatment of primary great saphenous varicose veins. Br J Surg. 2008;95:294-301.
[5]. Lurie F, Creton D, Eklof B, Kabnick LS, Kistner RL, Pichot O et al. Prospective randomised study of endovenous radiofrequency obliteration (closure) versus ligation and vein stripping (EVOLVeS): twoyear follow-up. Eur J Vasc Endovasc Surg. 2005;29:67-73.

Abstract: Background: As the emphasis has been on faster recovery during the early postoperative period, recent trends in pain management protocols following arthroscopic knee surgeries have shifted toward effective analgesia with minimal complications.Based on its excellent analgesic effect, FNB has gained widespread use as part of arthroscopic knee surgeries pain control regimens. However, FNB is associated with a significant decrease in the strength of quadriceps muscles which may prolong mobilization. Adductor canal block on the other hand is currently considered as an effective alternative to FNB to FNB that produces a predominantly sensory block besides preserving the strength of quadriceps. This study was conducted to explore practical issues for ACB and to compare analgesic.......

Key Words: Adductor canal block, femoral nerve block,arthroscopic knee surgery, multimodal pain management.

[1]. Fischer HBJ, Simanski CJP, Sharp C et al. A procedure-specific systematic review and consensus recommendations for post-operative analgesia following total knee arthroplasty. Anaesthesia 2008; 63:1105-23.
[2]. Korean Knee Society. Guidelines for the management of postoperative pain after total knee arthroplasty. Knee Surg Relat Res. 2012;24:201-7.
[3]. Parvizi J, Miller AG, Gandhi K. Multimodal pain management after total joint arthroplasty. J Bone Joint Surg Am.2011;93:1075-84.
[4]. Pelt CE, Anderson AW, Anderson MB, Van Dine C, Peters CL. Postoperative falls after total knee arthroplasty in patients with a femoral nerve catheter: can we reduce the incidence? J Arthroplasty. 2014;29:1154-7.
[5]. Memtsoudis SG, Dy CJ, Ma Y, Chiu YL, Della Valle AG, Mazumdar M. In-hospital patient falls after total joint arthroplasty: incidence, demographics, and risk factors in the United States. J Arthroplasty. 2012;27:823-8.

Abstract: Purpose: Our purpose is to study the use of buck's fascia and dartos fascia to reinforce urethral suture line in hypospadias surgery to decrease the fistula rate and post op complications.
Introduction:-The most common congenital penile anomaly in children is hypospadias (68./.) followed by chordee (8.6./.) and hypospadias with chordee (5./.). Fistula and glans disruption are still the most frequent complications of hypospadias surgery.Neourethral coverage is a mandatory step in this challenging surgery; it reduces the rate of fistula. This coverage can be bucks fascia, dartos fascia& tunica vaginalis, Glue, etc. there is limited studies how compares dartos fascia with bucks fascia......

Key Words: Dartos flap, fistula, hypospadias, intermediate layer, spongiosum

[1]. Retik AB, Borer JG. Hypospadias. In: Retik AB, Darracott VE,Wein AJ, editors. Campbell's Urology. Pennsylvania: Saunders;2002. p. 2284‑333.
[2]. Shanji O, Shuming H, Shengxing W, Xiaohui P, Tingyun L,Haoyong L, et al. The application of different dartos tissues forcovering new urethra in tubularized incised plate urethroplasty.TranslAndrolUrol 2012;Supp 1:CU14.
[3]. Kamal BA. Double dartos flaps in tubularized incised platehypospadias repair. Urology 2005;66:1095‑8.
[4]. Abdallah MR, Naga MI, Alnosair AA, Al‑Salem AH. Thevalue of double dartos flaps to protect tubularized incised plateurethroplasty. J PediatrSurg Spec 2014;8:12‑6.
[5]. Bertozzi M, Yıldız A, Kamal B, Mustafa M, Prestipino M,Yiğiter M, et al. Multicentric experience on double dartos flapprotection in tubularized incised plate urethroplasty for distal andmidpenile hypospadias. PediatrSurg Int 2011;27:1331‑6.

Abstract: Introduction-Microbiological flora of the female genital tract is dynamic, complex example of microbial colonisation, the regulation of which is not fully understood. Vaginal infection is very common in women of reproductive age group all over the world especially in developing countries. It is caused by an imbalance of the organisms naturally existing in the vagina. It can be due to bacterial vaginosis, candidiasis and trichomoniasis. Aims&Objective- To evaluate the microbiological profile of symptomatic vaginal discharge of female of reproductive age group, who attended the Obs.&Gynae department of RIMS, Ranchi during July 2016 to June 2018. Material & methods- A total of 200.......

Key Words: vaginal swab, vaginal discharge, bacterial vaginosis, candidiasis, trichomoniasis

[1]. Anna Cherian and Sasikumari, O. 2017. Microbial Profile of High Vaginal Swab from Women of Reproductive Age Group in a Tertiary Care Hospital. Int.J.Curr.Microbiol.App.Sci. 6(7): 2366-2370. doi: https://doi.org/10.20546/ijcmas.2017.607.338.
[2]. Ravishankar M. Prakash, N. (2017). Antibiogram of Bacterial Isolates from High Vaginal Swabs of Pregnant Women from Tertiary Care Hospital in Puducherry, India. International Journal of Current Microbiology and Applied Sciences. 6. 964-972. 10.20546/ijcmas.2017.601.114.
[3]. Gopal Kumar, Kalpana Singh Microbial Profile of High Vaginal Swab From Symptomatic Women of Reproductive Age Group:(2013): Volume 4 Issue 7, July 2015
[4]. SitiNorbayaMasri, SabariahMd Noor, Lailatul A kmar Mat Nor, Malina Osman, and MM Rahman Candida isolates from pregnant women and their antifungal susceptibility in a Malaysian tertiary-care hospital, Pak J Med Sci. 2015 May-Jun; 31(3): 658–661. [5]. Masand, D. L., Patel, J., & Gupta, S. (2015). Utility of microbiological profile of symptomatic vaginal discharge in rural women of reproductive age group. Journal of clinical and diagnostic research : JCDR, 9(3), QC04–QC7. doi:10.7860/JCDR/2015/12161.5623

Abstract: Introduction: High Uric acid levels are Associated with development of Many disorders like Gouty Arthritis , Chronic Kidney Disease , Cardiovascular Diseases with increased morbidity. Increased dietary Purines is important cause of hyperuricemia. Animal sources have more uric acid content. So aim of our study is to measure the levels of Uric acid in vegetarians and nonvegetarians to know the impact of diet on Serum uric acid levels.Materials and methods: Study included 100 participants . Divided into two groups based on their diet. Study group I included 50 participants , 25 each of male and female in the age group of 30-50 yrs who are consuming vegetarian purine rich food atleast......

Key Words: Uric Acid, Vegetarians , Non vegetarians.

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[2]. Feig DI (2009) Uric acid: A novel mediator and marker of risk in chronic kidney disease? CurrOpinNephrolHypertens 18: 526–530.
[3]. Gagliardi AC, Miname MH, Santos RD (2009) Uric acid: a marker of increased cardiovascular risk. Atherosclerosis 202: 11–17.
[4]. Zoppini G, Targher G, Bonora E (2011) The role of serum uric acid in cardiovascular disease in type 2 diabetic and non-diabetic subjects: a narrative review. J Endocrinol Invest 34: 881–886.
[5]. Strasak AM, Lang S, Kneib T, Brant LJ, Klenk J, et al. (2009) Use of penalized splines in extended cox-type additive hazard regression to flexibly estimate the effect of time-varying serum uric acid on risk of cancer incidence: a prospective, population-based study in 78,850 men. Ann Epidemiol 19: 15–24.

Abstract: Carotid intima media thickness is commonly used as a diagnostic marker for atherosclerosis. CIMT which we measure is a tool which is non-invasive and helps to identify the complications of diabetes. Patients with type 2 diabetes mellitus mostly suffer from premature and severe atherosclerosis. The present research was carried out to study the carotid intima thickness in type 2 diabetic patients. The results showed that there was a significant increase in the carotid intima medial thickness observed in DM with Metabolic syndrome without BP component patients as compared to DM without Metabolic syndrome and also measuring the IMT of the common carotid artery can be a simple non-invasive method to measure generalized atherosclerosis and can be considered as marker of cardiovascular and cerebrovascular events in future

[1]. Touboul.P.J, Hennerici. M.G, Meairs.S, et al. Mannheim Carotid Intima-Media Thickness Consensus (2004–2006). An Update On Behalf Of The Advisory Board of the 3rd and 4th watching The risk symposium, 13th and 15th European Stroke Conferences, Mannheim, Germany, 2004, and Brussels, Belgium, 2006. Cerebrovasc Dis. 2007; 23(1):75–80.
[2]. Jacoby .D.S, Mohler.I.E, Rader .D.J. Non-invasive Atherosclerosis Imaging for Predicting Cardiovascular Events and Assessing Therapeutic Interventions. CurrAtheroscler Rep. 2004;6(1):20–26.
[3]. O‟Leary .D.H, Bots. M.L. Imaging Of Atherosclerosis: Carotid Intima-Media Thickness. Eur Heart J. 2010:31(14):1682–1689.
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[5]. Sibal.L., Agarwal. S.C, Home .P.D. Carotid Intima-Media Thickness As a Surrogate Marker of Cardiovascular Disease in Diabetes. Diabetes MetabSyndrObes. 2011;4:23–34.

Abstract: Aims and objectives-To study the incidence of meningiomas and its pattern of variation in histopathology in relation to WHO grading system Materials & Methods-It is a retrospective study for a period of 3 yrs done in the department of pathology,Kurnool medical college,Kurnool.62 cases were analysed during 2016 to 2019 period. Observation & results-Common age group of presentation was between 41-50 yrs with M:F ratio being 1:1.8. Most common variant was Meningothelial.......

Key Words: Meningiomas,CNS Tumors,TRSN Lakshmi

[1]. Niranjan J,Priya VV,Shivarudrappa AS.Histopathological spectrum of meningiomas: A retrospective study.Indian J Pathol Oncol2019;6(2):256-60.
[2]. Reddy R,Praveen K,Ranveer singh.Histopathological spectrum of meningioma and its variants.Asian Pac.J.Health Sci.,2016;3(1):151-155.
[3]. Perry A,Louis DN,Scheithauer BW,Budka H,Von Deimling A.Meningiomas.WHO classification of tumors of central nervous system.2016;4:232-45.
[4]. Gattu.V.Histopathological analysis of meningiomas-A retrospective study.SAS J Surg2017;3(1):25-9.
[5]. Malik V,Punia RPS,MAlhotra A,Gupta V.Clinicopathological study of meningioma:10 year experience from a tertiary care hospital.GJRA 2018;7:1.

Abstract: Introduction: Anterior cruciate ligament(ACL) reconstruction is a surgical tissue graft replacement of the anterior cruciate ligament, located in the knee, to restore its function after an injury. Among several treatment procedure, hamstring graft or quadruplehamstring graft has been shown to be an excellent option for anterior cruciate ligament reconstruction. Aim of study:The aim of the study was toevaluate the quadruple hamstring grafts in reconstruction of the anterior cruciate ligament. Method: This was an observational prospective study. The study was conducted in the Orthopedic Department of Shaheed M. Monsur Ali Medical College,Sirajganj, Bangladesh during the period from January 2017 to December 2018. In total 46 patients with unilateral instability of the anterior cruciate ligament were finalized as the total study population......

Key Words: Quadruple, Hamstring, Grafts, Anterior, Cruciate, Ligament

[1]. Wang H, Fleischli JE, Zheng NN. Transtibial versus anteromedial portal technique in single-bundle anterior cruciate ligament reconstruction: outcomes of knee joint kinematics during walking. Am J Sports Med 2013;41:1847–56.
[2]. Mall NA, Chalmers PN, Moric M, et al. Incidence and trends of anterior cruciate ligament reconstruction in the United States. Am J Sports Med 2014;42:2363–70.
[3]. Chalmers PN, Mall NA, Yanke AB, et al. Contemporary anterior cruciate ligament outcomes: does technique really matter? Oper Tech Sports Med 2013;21:55–63.
[4]. Mardani-Kivi M, Karimi-Mobarakeh M, Keyhani S, et al. Hamstring tendon autograft versus fresh-frozen tibialis posterior allograft in primary arthroscopic anterior cruciate ligament reconstruction: a retrospective cohort study with three to six years follow-up. IntOrthop 2016;40:1905–11.
[5]. Webb JM, Corry IS, Clingeleffer AJ, Pinczewski LA. Endoscopic reconstruction for isolated anterior cruciate ligament rupture. J Bone Joint Surg [Br] 1998;80-B:288-94.

Abstract: The objective of this study is to evaluate the role of ultrasound and computed tomography in diagnosis and management of abdominal masses, study depend on the reports results, of 50 patients of abdominal mass the most common affected age was between (41-50) years old (13) patients 26%. Most common finding was the liver mass in (26) patients 52% and the kidney mass in (7) patients was14%, the classification in ultrasound was in (1) patient was 2% and in computed tomography was in (12) patients 24%, the pathology in ultrasound was diagnosed in (5) patients 10% and in computed tomography was diagnosed in (36) patients 72%.Study achieved that computed tomography was more accurate than ultrasound in detection of morphological features, calcifications, presence or absent of fat, infiltration into the surrounding organs, tumoral necrosis, regional lymphadenopathy and distant metastases..

Key Words: Abdominal mass, Computed tomography, Ultrasound

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