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

Abstract: Introduction :Neurulation ( Formation and closure of neural tube) when incomplete results in a tubular structure defect with openings in spinal cord and brain early in human development resulting in neural tube defects (NTD). These may beopen or closed types. Objectives: Analytical study of incidence and associated causes of NTD in Jharkhand population. Material and method: After Ethical committee clearance 2000 patients were examined by ultrasonography ,age ranging between 18-35 in their 1st and second trimester of pregnancy. Result: Total 30 cases of NTD were found with 15 cases of anencephaly. Prevalence was higher in cases belonging to low socioeconomic group....

[1]. Anthony VD Antoni. Ankle and foot, In :Standring S (ed)41st.Grey's Anatomy,The anatomical basis of clinical practice. Elsevier Churchill Livingstone:2016:1424-1426.
[2]. Honein MA, Paulozzi LJ, Mathews TJ, et al: Impact of folic acid fortification of the US food supply on the occurrence of neural tube defects. JAMA 2001;285:2981-2986.
[3]. NakatsuT,UwabeC,Shiota K; Neural tube closure in humans initiates at multiple sites:evidence from human embryos and implications for the pathogenesis of neural tube defects.AnatEmbryol (Berl)2000 Jun;201(6):455-66.
[4]. Jennifer AM, Paul AR, LixianS,Richard SO and the National Birth Defects Prevention Study;Periconceptional Maternal Alcohol Consumption and Neural Tube Defects : Birth defects research. PartA,Clinical And molecular teratology:2013 March; 97(3)152-60.
[5]. Van Allen MI,Kalousek DK, Chernoff GF etal;Evidence for multi-site closure of the neural tubes in humans:Am J Med Genet.1993 Oct;47(5):723-43

Abstract: Unstable Trochanteric Fracture of Femur in the Elderly require osteosynthesis. Proximal femur fracture in itself an tough entity to manage. Proximal Femur Nailing is considered to be ideal construct for these fractures.However there is different methods of salvage ,and also Bipolar Replacement Arthroplasty now a days on increasing trends. Research Question: Proximal Femoral Nail fixation methods and technique when used judiciously can improve the quality and stability of reduction and fixation in these fractures, even in osteoporosed elderly . Objective :- The present study (systematic review and meta analysis)was conducted to determine the methods and quality of reduction and fixation techniques of Proximal Femoral Nailing. Outcomes:- Primary......

Key words: Proximal Femoral Nail, unstable intertrochanteric fracture, elderly, osteoporotics. Compliance with ethical standards

[1]. Clinic of Ortho Surgery 2010 won sik choy ; Joe hoon Ahn They treated these fracture with bipolar replacement arthroplasty.
[2]. International Journal of Surgery ,2017.xiangping Luo.S.He. Qi.Li. et al.They had study comparing Use of P F N a2 Vs Hemiarthroplasty , for such fractures, and found pfn to be better in terms of intra op. blood loss , medical complication and blood loss.
[3]. Hopkins,Dimon et al. also produced similar results..

Abstract: Dystonia is a condition characterized by prolonged co-contraction of the agonist and the antagonist musculature, which lead to slow, repetitive, involuntary and twisting movements that lead to sustained abnormal postures that become fixed. One of the major causes of dystonia is use of antipsychotics and usually antipsychotic-induced acute dystonic reaction presents within 72 hours of beginning antipsychotics or after a substantial increase in dosage (Lehan et al, 2004).If untreated, acute dystonic reaction may last hours or days. Cervical dystonia, also called as spasmodic torticollis, is a painful condition in which involuntary contraction of neck musculature causes the head to pull to one side and remain fixed in this posture.It is one of the most common forms of focal dystonia.....

[1]. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders.
[2]. Ayd FJ. A survey of drug-induced extrapyramidal reactions, J.A.M.A., 1961; 175: 102-108.
[3]. Keepers GA, Casey DE. Use of neuroleptic-induced extrapyramidal symptoms to predict future vulnerability to side effects, American Journal of Psychiatry, 1991; 148: 85-89.
[4]. Volkow ND, Ruben CG, Wang GJ, Fowler JS, Moberg PJ, Ding YS, et al. Association between decline in brain dopamine activity with age and cognitive and motor impairment in healthy individuals, American Journal of Psychiatry, 1998; 155: 344-349.
[5]. Nobutomo Yamamoto, Toshiya Inada. Dystonia Secondary to Use of Antipsychotic Agents, 2012..

Abstract: Introduction : In present day practice of medicine and surgery every day we have cases of road traffic accidents, and direct trauma due to violence and also injuries due to sports and fall. In all the above mentioned cases injury to the arm bones and neuro vascular bundles in the arm is commonly seen. In the present study undertaken we are going to study the origin, course, branching pattern and termination of brachial artery in the upper limbs of human cadavers. Brachial artery and its variations like high division of brachial artery, superficial brachial artery , superficial brachioradial artery, trifurcation of brachial artery at its termination are commonly seen.....

Key words: Brachial artery, Superficial Brachial artery, Radial artery, Coracobrachialis

[1]. The High Origin of the Radial Artery (Brachioradial Artery): Its Anatomical Variations, Clinical Significance, and Contribution to the Blood Supply of the Hand. Haładaj R1, Wysiadecki G1, Dudkiewicz Z2, Polguj M3, Topol M1 Biomed Res Int. 2018 Jun 11;2018:1520929. doi: 10.1155/2018/1520929. eCollection 2018.
[2]. Bifurcation of brachial artery into a common radial-interosseous trunk and superficial ulnar artery: a rare variation.Narayanan S1, Murugan S2. Anat Sci Int. 2018 Jun;93(3):400-403. doi: 10.1007/s12565-017-0427-5. Epub 2017 Dec 26.
[3]. A Unique Triad of Muscular, Vascular and Nervous Variations in Upper Limb. Tamgire DW1, Sontakke YA1, Rajasekhar S1, Aravindhan K2. J Clin Diagn Res. 2017 May;11(5):AD01-AD03. doi: 10.7860/JCDR/2017/25552.9927. Epub 2017 May 1.
[4]. Accessory Flexor Carpi Ulnaris and Bilaterally Variant Vascular Anatomy of Upper Limb: An Unusual Presentation. Sakthivel S1, Verma S1. Int J Appl Basic Med Res. 2017 Apr-Jun;7(2):143-145. doi: 10.4103/ijabmr.IJABMR_326_16.
[5]. Low origin of the radial artery: a case study including a review of literature and proposal of an embryological explanation. Wysiadecki G1, Polguj M2, Haładaj R3, Topol M3. Anat Sci Int. 2017 Mar;92(2):293-298. doi: 10.1007/s12565-016-0371-9. Epub 2016 Sep 15.

Abstract: Castleman Disease (CD) is a rare, heterogeneous group of hyperimmune lymphoproliferative disorders,not very familiar to surgeons.It is characterized by non-neoplastic lymph node hypertrophy. Its incidence and etiology are not known,but has been found in association with Kaposi's Sarcoma.Unicentric Castleman Disease (UCCD) at one end of the spectrum is a localized disease, with little or no systemic symptoms. It may be an incidental radiological finding or detected while investigating for a symptomatic lymph node mass.Multicentric Castleman Disease (MCCD) is a more serious systemic condition, often associated with constitutional symptoms. Human Herpes Simplex Virus 8 (HHV8) associated MCCD is a major subgroup occurring in immunocompromised individuals due to the viral trigger......

Key words: Castleman'sDisease,Cervical Lymphadenopathy,Good Prognosis

[1]. B. Castleman, L. Iverson, V.P. Menendez, Localized mediastinal lymph-node hyperplasia resembling thymoma, Cancer 9 (4) (1956) 822–830, http://dx.doi.org/10.1002/1097-0142(195607/08)9:4<822::AID-CNCR2820090430>3.0.CO;2-4.J.
[2]. Olak, "Benign lymph node disease involving the mediastinum," in General Thoracic Surgery, T. W. Shields, J. LoCicero, C. E. Reed, and R. H. Feins, Eds., vol. 2, pp. 2366–2367, Lippincott Williams & Wilkins, Philadelphia, Pa, USA, 7th edition, 2009.
[3]. Keller AR, Hochholzer L, Castleman B. Hyaline – vascular and plasma-cell types of giant lymph node hyperplasia of the mediastinum and other locations. Cancer 1972;29(3):670-683.[Medline].
[4]. W.B. Bowne, J.J. Lewis, D.A. Filippa, et al., The management of unicentric and multicentric Castleman's disease, Cancer 85 (3) (1999) 706–717,http://dx.doi.org/10.1002/(SICI)1097-0142(19990201)85:3<706::AID-CNCR21>3.0.CO;2-7.
[5]. D.C. Fajgenbaum, T.S. Uldrick, A. Bagg, et al., International, evidence-based consensus diagnostic criteria for HHV-8-negative/idiopathic, MulticentricCastleman Dis. 129 (2017), http://dx.doi.org/10.1182/blood-2016-10-746933

Abstract: Introduction : Surgical pain is a universal phenomenon affecting all patients in the peri-operative and post-operative period. So it is the moral to provide adequate peri-operative & postoperative analgesia not only to suppress the adverse physiological responses of pain, but also to improve the quality of patient comfort following surgery. Aims and Objectives: The aim of this study was to compare of thoracic epidural block with Bupivacaine 0.5% and Bupivacaine 0.5% with Dexmedetomididne combination in terms of haemodynamic stability,proper peroperative anaesthesia and postoperative pain relief in adult patients undergoing open cholecystectomy Methodology: This is a A prospective randomized double blind controlled clinical trial carried out on 80 patients at the Department of Anaesthesiology & Surgery, Bankura Sammilani Medical College & Hospital from June 2015- june 2016.....

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[3]. Barash Paul G, Cullen Bruce F, Stoelting Robert K (Editor). Clinical Anaesthesia. Fourth edition. Management of Acute Postoperative Pain; Lippincott and Wilkins 2001:1407-09.
[4]. Conacher ID. Pain management in Kaplan‟s thoracic anaesthesia Ed:74-80.
[5]. Dalen BJ: Regionl anaesthesia in infants, children and adolescents, London William and Wilkin,1995..

Abstract: short rib polydactyly syndrome is a group of rare lethal skeletal dysplasias, which occur in about 2.5 to 3.3 per 10,000 births.A 24 year old primigravida was admitted in MDM hospital at 24 weeks of gestation with preterm premature rupture of membrane.On USG - breech foetus with anhydramnios with severe micromelia with narrow chest ,hypoplastic lungs ,dolicocephlic head ,dysplastic kidneys ,gross ascites ,thickened nuchal fold suggestive of skeletal dysplasia.After delivery of alive baby with very low birth weight and poor APGAR score baby died soon and after consent x-ray and autopsy done which showed short limbs , narrow thorax and polydactyly . radius ,ulna ,tibia and iliac bones were hypoplastic .karyotyping was done.Rare skeletal dysplasis like short rib polydactyly syndrome should be reported early and to avert maternal jeopardy and for judicious management ....

[1]. Malhotra N, Sood M. Recurrence of short rib polydactyly syndrome - a rare skeletal dysplasia. Eur J ObstetGynecolReprod Biol. 2000 Apr; 89(2):193-195.
[2]. Elçioglu NH, Hall CM. Diagnostic dilemmas in the short rib-polydactyly syndrome group. Am J Med Genet. 2002 Sep 1;111(4):392-400.
[3]. Gazali LI, Sztriha L, Dawodu A, Varady E, Bakir M, Khdir A, Johansen J. Complex consanguinity associated with short rib-polydactyly syndrome III and congenital infection-like syndrome: a diagnostic problem in dysmorphic syndromes. J Med Genet. 1999 Jun; 36(6):461-466.

Abstract: Purpose: The present in-vitro study was conducted to comparatively evaluate, the effect of brushing on the surface roughness and colour stability of Poly(methyl methacrylate) Heat cure denture base resin after application of surface sealant. Materials and Methods: A total of 20 Poly (methyl methacrylate) Heat cure denture base resin samples of diameter 10mm and thickness of 2 mm were fabricated. The samples were divided into two groups, as uncoated (Group I, n=10) and coated (Group II, n=10) with Denture surface sealant. The surface roughness and colour stability of each sample in both the groups were evaluated with a 2D Surface Profilometer and Spectrophotometer respectively. The test samples of both the groups were subjected to brushing using an electronic....

Key Surface sealant, surface roughness, colour stability, PMMA, Profilometer, Spectrophotometer

[1]. Berger JC, Driscoll CF, Romberg E, Luo Q, Thompson G. Surface roughness of denture base acrylic resins after processing and after polishing. J Prosthodont 2006; 15:180-6
[2]. Gungor H, Gundogdu M, Duymus ZY. Investigation of the effect of different polishing techniques on the surface roughness of denture base and repair materials. J Prosthet Dent 2014; 112:1271-7.
[3]. Sahin O, Koroglu A, Dede DO, Yılmaz B., Influence of surface sealant agents on the surface roughness and color stability of denture base materials, J Prosthet Dent. 2016 Oct;116(4):610-616
[4]. Ucar Y, Akova T, Aysan I., Mechanical properties of polyamide versus different PMMA denture base materials, J Prosthodont. 2012 Apr;21(3):173-6
[5]. Nguyen LG, Kopperud HM, Oilo M., Water sorption and solubility of polyamide denture base materials, Acta Biomater Odontol Scand. 2017; 3(1): 47–52

Abstract: The fibula is a lower limb long bone which is mainly used for bone grafting and the main aim of Study is to know about the variations in positions, number and directions of nutrient foramina in the fibulae. Material and methods: The study was done on 109 fibulae in which 53 were of right sided and 56 were of left sided. Every bone was carefully observed for the variations of nutrient foramina, about their numbers, position and directions. All the findings were observed and noted in the tabular form and are compared with available literatures. RESULTS: Out of 109 bones, 53 were right sided and 56 were left sided in which 84 bones showed single nutrient foramina ( 77.06%) and 10 bones showed double nutrient foramina ( 9.17 %) and 15 bones showed no nutrient foramina (13.76 %).

Keywords: Foramen, Bone graft, Direction, Location, foramen index

[1]. A.K.DATTA, Principles of General Anatomy; 5th edition- chapter 6, pg.75-76.
[2]. Gopala K, Rathna BS. The study on the incidence and direction of nutrient foramina in the diaphysis of femur bone of south Indian origin and their clinical importance. International J Basic Life Sci. 2014;2(2):11-9.
[3]. Dr BD Chaurasia hand book of general anatomy 5th edition chapter2 pg.67.
[4]. Patel S, Chaudhari J, Sarvaiya B, Jotania B, Patel SM, Patel SV. Anatomical variation in position, location and number of fibular nutrient foramen. SEAJCRR. 2014;3(5):890-6.
[5]. Gupta R, Singh KA, Rajkumar. Morphological study of nutrient foramen in human fibulae of North Indian Region. Int J Med Health Sci. 2013;2(2):205- 9 .

Abstract: Background: Skin rash, defined as the change in color, appearance or texture of skin, is the most common reason for attendance in dermatology clinics in pediatric age group. The variety of causes and presentation and non-feasibility of extensive investigations, necessitates the need for thorough history taking and a good clinical acumen to come to a diagnosis. Objective: To the know the various presentation of rash in paediatric age group and their clinical features which help us in differential diagnosis....

Key Words: Rash, children, pediatric, diagnosis, acute urticaria, popular urticaria, impetigo, scabies, viral exanthem, pityriasis rosea, SSSS, xeroderma pimentosa,psoriasis, acrodermatitis enteropathica, xeroderma pigmentosa, urticaria pigmentosa, EDV, pyoderma gangrenosum, varicella, periporitis, EMF, molluscum.

[1]. Sarkar R, Mishra K, Garg VK. Fever with rash in child in india. Indian J Dermatol Venerol Leprol 2012:78:251-62.
[2]. Jafar Saffar, hiva saffar, shahmohamadi, fever and rash syndrome. J pediatr rev. 2013;1(2):42-54.
[3]. Allmon Amanda, deane Kristen, martin Karl, Common Skin rashes in children, University of Missouri-columbia school of medicine, Am Fam physician. 2015;92(3);211-216.
[4]. Majumdar T, Bhattacharya S, Barman D, Begum R. Laboratory confirmed outbreak of meningococcal infections in Tripura. Indian J Med Microbiol 2011;29:74-6.
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Abstract: Aim: The aim of this study was to evaluate adequacy of prescription of in-patient prescriptions. Method: This is across sectional retrospective study done in May 2019 in Royal Care international hospital. Data was collected from all inpatients' medication charts in critical care section (ICU and HDU) and all wards in the hospital. It included all prescriptions on the previous day to data collection day. Data resources were 1) physician order sheet, 2) clinical pharmacist medication sheet (ICU, HDU), 3) inpatients kardex and 4) pharmacy request sheet. We designed data collection sheet based on Australian National Inpatient Medication Chart (NIMC) which addressed data related to the patient, drug and prescriber. Data was analyzed by SPSS V22. The proposal was approved............

Key words:Medication safety, prescription, medication error, in-patient, quality improvement

[1]. Organization WH. Medication safety in polypharmacy: technical report. World Health Organization, 2019.
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[5]. Ryan C, Ross S, Davey P, Duncan EM, Francis JJ, Fielding S, et al. Prevalence and causes of prescribing errors: the PRescribing Outcomes for Trainee Doctors Engaged in Clinical Training (PROTECT) study. PloS one. 2014;9(1):e79802.

Abstract: Introduction: Infectious complications are commonly seen following perforated appendicitis. Intra abdominal abscess, pelvic abscess and wound infection are the most common sites of infection. Scrotal abscess originating from appendicitis is a rare complication. Case presentation: A 18-year-old male presented with history of a painful, red, and swollen right hemiscrotum for 2 days and right lower abdominal pain for one day,nausea and 2 episodes of vomiting. He had a temperature of 101F and a tender, red, and swollen right hemiscrotum. He was tender in the right lower abdomen. There was erythema over right inguinal region Blood tests showed a white cell count of 14,400/mm^3 and neutrophilia. Urgent right........

[1]. Rahman N, Lakhoo K: Patent processusvaginalis: a window to the abdomen. Afr J PaediatrSurg 2009, 6:116-117.
[2]. Watson DS, Sharp KW, Vasquez JM, Richards WO: Incidence of inguinal hernia diagnosed during laparoscopy. South Med J 1994, 87:23-25.
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[4]. Bingol-Kologlu M, Fedakar M, Yagmurlu A, Dindar H, Gokçora IH: An exceptional complication following appendectomy: acute inguinal and scrotal suppuration. IntUrolNephrol 2006, 38:663-665.
[5]. Ng KH, Chung YF, Cwilde C, Chee C: An unusual presentation of acute scrotum after appendicitis. Singapore Med J 2002, 43:365-366and, S. L. (2004). Women's antenatal knowledge and plans regarding intrapartum pain management at the Royal Hospital for Women. The Australian & New Zealand Journal of Obstetrics &Gynaecology, 44(4), 314–317. https://doi.org/10.1111/j.1479-828X.2004.00230.x

Abstract: Aims and objectives:To investigate the efficacy and complications of high spinal anaesthesia for upper abdominal surgeries. Methodology: This is a prospective randomised study carried out on 60 patients, posted for upper abdominal surgeriesat SGT medical College. Spinal anaesthesia was administered with 3.5 - 4 ml of 0. 5 % hyperbaric bupivacaine at L 3-4 interspinous space. Haemodynamic parameters,sensory level, complications, and satisfaction level of the patients were analysed. Results:. The procedure was well tolerated by 87% patients. The incidences of hypotension and bradycardia were 95 % and 50 % respectively, but easily........

Key words:Anaesthesia, Complications, High- spinal, Surgery- upper abdominal

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Abstract: Objective: To retrospectively analyze and compare the clinical application of CFP prosthesis and traditional straight handle prosthesis in total hip arthroplasty. Methods: From February 2013 to April 2015, patients who underwent THA with CFP prosthesis and traditional prosthesis and had perfect clinical and imaging data were followed up. There were 33 CFP prostheses with an average age of 54.2 ± 8.7 years. Thirty-two cases of traditional prosthesis were treated with an average age of 55.3 ± 9.0 years. The patients were followed up by Harris Hip Score (HHS) and Western Ontario and McMaster University Osteoarthritis Index (WOMAC). The imaging findings and the incidence of complications were routinely followed up.......

Key words: total hip replacement; femoral neck preservation; hip joint

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[4]. WACHA H, DOMSEL G, HERRMANN E J E J O T, et al. Long-term follow-up of 1217 consecutive short-stem total hip arthroplasty (THA): a retrospective single-center experience [J]. 2018, 44(3): 457-69.
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