iosr-JDMS   Volume-18 ~ Issue-11 ~ November-2019

Abstract: Introduction: Spleen is an essential organ in the body for its haematopoietic, immunological and scavenger action. It is seen that those persons without spleen –either congenitally or spleen removed anytime later in life for any reason are facing many problems- one of them is depressed immunity. Splenectomised patients have all range of infections- starting from minor chest or urinary tract or wound infection to life threatening OPSI, leading to increased morbidity and mortality- seen in both paediatric as well as adult patients. Materials and Methods: Immunocompromised patients(with HIV, Hepatitis B, Hepatitis C infection) with splenomegaly and sero negative cases with splenomegaly who needed splenectomy for any reason attending Pediatric Surgery OPD and admitted to Paediatric Surgery department of MCH for splenectomy. Total number of patients with immunocompromization and splenomegaly admitted to paediatric surgery Department of MCH during our study period,was 25 cases .We have considered 25 sero negative cases who had undergone splenectomy for any indication during this period, as the control group.....

Keywords: Spleen, OPSI, HIV, Hepatitis, mortality, morbidity

[1]. Moynihan B. The surgery of the spleen. Br J Surg. 1920;8:307.
[2]. McClusky DA III, Skandalakis LJ, Colborn GL, et al. Tribute to a triad: history of splenic anatomy, physiology, and surgery-part 1. World J Surg. 1999;23:311-325.
[3]. McClusky DA III, Skandalakis LJ, Colborn GL, et al. Tribute to a triad: history of splenic anatomy, physiology, and surgery–part 2. World J Surg. 1999;23:514-526.
[4]. Aristotle. De Paribus Animalium [On the Parts of Animals].A.L. Peck, translator. Cambridge: Harvard University Press;1961.1901:164.
[5]. Morgenstern L. A history of splenectomy. In: Hiatt JR, Philips EH, Morgenstern L, eds. Surgical Disease of the Spleen. New York: Springer; 1997..

Abstract: Introduction: Anaemia is a haematologic disorder presenting with ocular manifestations. It can affect all parts of the eye and adnexa, conjunctival pallor and retinopathy being common manifestations of nutritional anaemia. Retinal damage occurs due to hypoxia, venous stasis, angiospasm and increased capillary permeability. Incidence of retinopathy is increased with severity of anaemia.Themain aim of the study is to observe the involvement of different parts of the eye in anaemia and the eye manifestations in anaemia. The study included 120 patients diagnosed with anaemia due to various aetiologies. Materials and Methods: This hospital-based cross-sectional study was conducted in 120 patients diagnosed with anaemia of various aetiologies attending medicine, gynaecology and surgery departments. The study was done in the Department of Ophthalmology in Mahatma Gandhi Medical College, Jamshedpur, and Jharkhand during the period from July 2018.....

Key Words: Anaemia, Retinopathy, Conjunctival Pallor, Fundus Examination

[1]. Carraro MC, Rosetti L, Gerli GC. Prevalence of retinopathy in patients with anaemia or thrombocytopenia. Eur J Haematol 2001;67(4):238-44.
[2]. Imai E, Kunikata H, Udono T, et al. Branch retinal artery occlusion a complication of iron deficiency anaemia in a young adult with a rectal carcinoid. Tohoku J Exp Med 2004;203(2):141-4
[3]. Beck RW, Smith CH. Neurophthalmology: a problem oriented approach. Boston: Little, Brown and Co., 1988.
[4]. Lowenstein JI. Retinopathy associated with blood anomalies. In: Jakobieck F, edr. Clinical Ophthalmology. Revised edn. Philadelphia: Lippincott 1995: p. 995-1000.
[5]. Rubenstein RA, Yanoff M, Albert DM. Thrombocytopenia, anaemia and haemorrhage. Am J Ophthalmol 1968;65(3):435-9

Abstract: Background: Deep Vein Thrombosis (DVT) is a major source of morbidity and mortality among patients undergoing prolonged surgery. Most of post-operative DVT can be prevented by simple preoperative thromboprophylaxis after assessing the risk of patient. Caprini risk scoring is a simple preoperative risk assessment tool for predicting DVT in surgical patients. This study was undertaken to assess prediction of DVT in postoperative patient using Caprini score and effect of thromboprophylaxis in preventing postoperative DVT in high risk individuals. Materials and methods: A total of 150 patients admitted in various surgical specialties undergoing prolonged surgical procedures of more than two hours were included in the study. All patients were assessed using Caprini scoring and comparison between patients given preoperative thromboprophylaxis and those who did not receive......

Key words: Thromboprophylaxis, DVT, Caprini Score, Risk scoring, Prolonged surgery

[1]. Obi AT, Pannucci CJ, Nackashi A, Abdullah N, Alvarez R, Bahl V, et al. Validation of the Caprini Venous Thromboembolism Risk Assessment Model in Critically Ill Surgical Patients. JAMA Surg. 2015 Oct 1;150(10):941–8.
[2]. Scarvelis D, Wells PS. Diagnosis and treatment of deep-vein thrombosis. Can Med Assoc J. 2006 Oct 24;175(9):1087–92.
[3]. Wells PS, Anderson DR, Rodger M, Forgie M, Kearon C, Dreyer J, et al. Evaluation of D-Dimer in the Diagnosis of Suspected Deep-Vein Thrombosis. N Engl J Med. 2003 Sep 25;349(13):1227–35.
[4]. Barker RC, Marval P. Venous thromboembolism: risks and prevention. ContinEducAnaesthCrit Care Pain. 2011 Feb 1;11(1):18–23.
[5]. Attia J, Ray JG, Cook DJ, Douketis J, Ginsberg JS, Geerts WH. Deep vein thrombosis and its prevention in critically ill adults. Arch Intern Med. 2001 May 28;161(10):1268–79.

Abstract: Background: Among the treatment options available for MSSA and MRSA, clindamycin is no doubt an important one. However, staphylococcal isolates can develop inducible clindamycin resistance, and from such isolates, spontaneous constitutively resistant mutants have arisen both in vitro testing and in vivo, during clindamycin therapy. Reporting of clindamycin susceptible Staphylococcus aureus without testing for inducible resistance may result in treatment failure. Aim: This study was conducted to detect inducible clindamycin resistance among Staphylococcus aureus isolates and to explore its relationship with methicillin resistance......

Keywords: Clindamycin resistance, constitutive MLSB phenotype, inducible MLSB phenotype, MRSA, MS phenotype

[1] Deotale V, Mendiratta D K, Raut U, Narang P. Inducible clindamycin resistance in Staphylococcus aureus isolated from clinical samples. Indian J Med Microbiol 2010;28:124-6.
[2] Srinivasan A, Dick JD, Perl TM. Vancomycin resistance in staphylococci. Clin Microbiol Rev 2002;15:430-8.
[3] Johnson AP, Woodford N. Glycopeptide-resistant Staphylococcus aureus. J Atimicrob Chemother 2002;50:621-3.
[4] Eliopoulos GM. Quinupristin-dalfopristin and linezolid: Evidence and opinion. Clin Infect Dis 2003;36:473-81.
[5] Delialioglu N, Aslan G, Ozturk C, Baki V, Sen S, Emekdas G. Inducible clindamycin resistance in staphylococci isolated from clinical samples. Jpn J Infect Dis 2005;58:104-6...

Abstract: This study is regarding to compare the outcome of both open and laparoscopic inguinal mesh repair, time taken for surgical procedure, patient's duration of postoperative hospital stays, postoperative pain and other complication, recurrence in first postoperative year between open lichtenstein hernia repair and laparoscopic transabdominal preperitoneal (TAPP) hernia repair in inguinal hernia patients. We encountered100 cases of inguinal hernia, 50 cases operated by laparoscopic repair and 50 cases were operated by open repair during a period of 2 years, between July 2017 to July 2019, at P.D.U. medical college, Rajkot. Hence the study showed that after laparoscopic inguinal hernia repair, postoperative pain and other complications, postoperative hospital stay were less in comparison to that after open inguinal hernia repair. While duration of surgical procedure was more in laparoscopic hernia repair in comparison to that in open inguinal hernia repair.

[1]. Rutkow IM. A selective history of groin Herniorrhaphy in the 20th century. SurgClin North Am. 1993; 73:395-411.
[2]. Abrahamson J. Hernias. Maingot‟s Abdominal operations 10th ed. McGraw Hill, 2001; 479-580.
[3]. Wantz GE. Abdominal wall hernias. In: Seymour 1. Schwartz. Principles of surgery, 7th ed. McGraw Hill, 1999; 1585-1611.
[4]. Sinnatamby Cs. Anterior abdominal wall. Last‟s anatomy regional and applied, 10th ed. Churchill Livingstone, 2000; 215-226.
[5]. Russell RCG, Williams NS, Bulstrode CJK. Hernias, umbilicus and abdominal wall, Bailey & Love‟s – short practice of surgery, 27th ed. London, Arnold, 2018; 1029- 1030.

Abstract: Introduction: Ovarian ectopic pregnancy, although is rare is nevertheless is an important cause of maternal morbidity and mortality. The incidence of ovarian ectopic pregnancy is on rise with the use of ovulation induction agents. Pre-operative diagnosis is very challenging, intra-operative and histo-pathology provides definitive diagnosis. Case report: 20 year old female gravida 2 para 1 presented with complaints of pain in lower abdomen, on clinical examination findings of ruptured ectopic pregnancy were elicited and ultrasound suggested left sided ectopic pregnancy. On OT table, it was found to be ruptured left ectopic pregnancy. Ovarian reconstruction was done. Histopathology confirmed ovarian ectopic pregnancy.....

Keywords: CEctopic, ovarian, pregnancy

[1]. Ghasemi Tehrani H, Hamoush Z, Ghasemi M, Hashemi L. Ovarian ectopic pregnancy: A rare case. Iran J Reprod Med. 2014;12(4):281–4.
[2]. Bhuria V, Nanda S, Chauhan M, Malhotra V. A retrospective analysis of ectopic pregnancy at a tertiary care centre: one year study. Int.J.Reproduct, Contracept. Obstetr Gynecol. 2016:2224–7 .
[3]. Madhuri N. Diagnostic surprises in early pregnancy: two case reports. Int.J.Res.Med.Sci. 2016;4(3):972–4.
[4]. Kraemer B, Kraemer E, Guengoer E, Juhasz‑Boess I, Solomayer EF, Wallwiener D, et al. Ovarian ectopic pregnancy: Diagnosis, treatment, correlation to carnegie stage 16 and review based on a clinical case. Fertil Steril 2009;92:392.
[5]. Scutiero G, Di Gioia P, Spada A, Greco P. Primary ovarian pregnancy and its management. JSLS. 2012;16:492-4.

Abstract: Objective: Mostly Diabetes & Hypothyroid are the two major endocrine disorders which influence each other and tend to coexist. The objective of the present study is to assess the prevalence of thyroid dysfunction among Type-2 diabetics. Materials & methods: The present study carried was carried out in 100 known cases of Diabetes mellitus attending to medical OP department of GGH. Ananthapur medical college.Ananthapur, A.P,were screened for Thyroid dysfunction by doing Thyroid profile. Results: It was confirmed that 11 cases of hypothyroidism among 100 diabetic patients which is a significant association......

Keywords: Diabetes mellitus, Hypothyroidism.

[1]. Harrisons textbook of internal medicine 18th edition,vol-2,pg-2921-22.
[2]. Sugure DD,MC EvoyM,DruryM,Thyroid disease in Diabetics.postgrad Med J .1999;91(1):680-4.
[3]. Feely,JIslesTE.Screening for thyroid dysfunction in Diabetics.Br Med J 1979;1(6179):1678.
[4]. Gursoy NT and TuncelE."The relation between the glycemic control and the Hypothalamus –pituitary-Thyroid axis in Diabetic patients",Turkish Journal of Endocrinology and metabolism 1999;4:163-168.
[5]. BeerSF,ParrJH,Temple RC and Hales CN " The effect of Thyroid disease on pro insulin and C – peptide levels"Clinical Endocrinology 1989;30(4):379-383..

Abstract: Introduction: Scrub typhus is an important cause of acute undifferentiated febrile illness in children which is defined as fever without any evidence of localized infection lasting ≤14 days The goal of this study is to provide clinical aspect of the disease in details thus helping to creat a better clinical and laboratory profile of this re-emerging disease for clinician to work with. Methods:it is a prospective observational study done in the department of pediatric medicine NRS medical college between January 2018 to October 2019 with history of acute febrile illness in whom clinical and laboratory features consistant with scrub typhus included in our study Scrub typhus was confirmed by IgM ELISA using INBIOS kit....

Keywords: Orientiatsutsugamushi;scrub typhus, acute undifferentiated fever,IgM Elisa

[1]. Palanivel S, Nedunchelian K, Poovazhagi V, Raghunadan R, Ramachandran P. Clinical profile of scrub typhus in children. Indian J Pediatr. 2012;79(11):1459-62.
[2]. Jung H-C, Chon S-B, Oh WS, Lee D-H, Lee H-J. Etiologies of acute undifferentiated fever and clinical prediction of scrub typhus in a non-tropical endemic area. Am J Trop Med Hyg. 2015;92(2):256-61.
[3]. 3.SharmaParag, KakkarRakesh, Kaore N. Shilpa et al. Geographical distribution, effect of Season and life cycle of scrub Typhus. JK Science 2010; 12:63-65.
[4]. Kumar K, Saxena VK, Thomas TG, Lal S, 2004. Outbreak investigation of scrub Typhus in Himachal Pradesh (India). J Commun Dis 36: 277–283.
[5]. Vivekanandan M, Mani A, Priya YS, Singh AP, Jayakumar S, Purty S, 2010. Outbreak of scrub typhus in Pondicherry. J Assoc Physicians India 58: 24–28.

Abstract: Introduction: Myopia is a common refractive error. Aim: To find the prevalence of myopia among doctors joining the Armed Forces. Materials and Methods: A cross-sectional study was done on 628 doctors who were joining the Armed Forces. A comprehensive ocular examination including visual acuity (unaided and best corrected) and cycloplegic refraction and a dilated fundus examination was done. History of hours spend outdoors/computer was recorded. 1256 eyes were examined. Results: 76 % were males and the mean age of the patient was 23 years.57% patients had myopia;32 % patients had less than 2 D of myopia, 17 % patients had 2-4 D of myopia, 4 % patients had 4-6 D of myopia & 4 %.....

Keywords: Myopia, Refractive error, Diopter

[1]. Pararajasegaram R. Vision 2020—The right to sight: From strategies to action: Editorial. Am J Ophthalmol. 1999;128(3):359–60.
[2]. Morgan I, Rose K. How genetic is school myopia? Prog Retin Eye Res. 2005;24(1):1–38.
[3]. Morgan IG, Rose KA. Myopia and international educational performance. Ophthalmic Physiol Opt. 2013. May;33(3):329–38. 10.1111/opo.12040
[4]. Ryan et al. Retina. 2013 [5]. Adatia FA, Luong M, Munro M et al. ―The Other CNV: A review of myopic choroidal neovascularization treatment in the age of anti-vascular endothelial growth factor agents.‖ Survey of Ophthalmology. 2015 60; 204-215. Epub 2014 Nov 5.

Abstract: Aim: The aim of this in vitro study was to qualitatively assess the mode of failure of dual forms of resin repaired lithium disilicate ceramic. Material and Methods: Twenty two wax patterns were fabricated from customized stainless steel jig. The samples were divided into 2 groups with each group comprising of 11 samples. Group I wax patterns were heat pressed layered Lithium disilicate ceramic (IPS emax press, IPS emax Ceram Powder Dentin, Ivoclar vivadent, Schaan, Liechtenstein) and Group II wax patterns were heat press monolithic Lithium disilicate ceramic. The samples were etched with 5% HF for 20s, and one representative sample from each group was analyzed under SEM for etched surface characteristics.......

Keywords: Lithium disilicate glass ceramic, SEM analysis, Repair composite, 5% Hydrofluoric acid,shear bond.

[1]. Bona AD, Anusavice KJ, Hood JAA. Effect of ceramic surface treatment on tensile bond strength to a resin cement. Int J Prosthodont (2002);15:248-253.
[2]. Kalavacharla VK, Lawson NC, Ramp LC, Burgess JO. Influence of etching protocol and silane treatment with a universal adhesive on lithium disilicate bond strength. Operative Dentistry (2015);40(2):372-378.
[3]. Kiomarsi N, Saburian P, Chiniforush N, Karazifard MJ, Hashemikamangar SS. Effect of thermocycling and surface treatment onrepair bond strength of composite. J Clin Exp Dent (2017);9(8):945-51.
[4]. . Aboushelib MN, Elmahy WAM, Ghazy MH. Internal adaptation, marginal accuracy and microleakage of a pressable versus a machinable ceramic laminate veneers. Journal of dentistry (2012);40:670-677.
[5]. Wang YG, Xing YX, Sun YC, Zhao VJ, Lu PJ, Wang Y. Preliminary evaluation of clinical effect of computer aided design and computer aided manufacture zirconia crown. Chinese Journal of Stomatology (2013);48(6):355-358