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

Abstract: Background Stroke is the second commonest cause of death and fourth leading cause of disability worldwide. Genetic causes may be underlying stroke more frequently in the young than do in the elderly patients, indicating a need for genetic counseling. To the best of our knowledge, the present study is the largest study of stroke in young patients from North coastal Andhra Pradesh. Materials And Methods This was a prospective, descriptive study evaluating 107 patients diagnosed to have stroke in the age group of 15-45 years admitted to King George Hospital, Visakhapatnam from December 2010 to December 2012. The patients were divided into 3 groups, 15-24, 25-34 yrs and 35–45 years of age, to study the risk factors, etiological profile, ischemic stroke subtypes in these subgroups......

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[4]. Adams HP Jr. Kappelle LJ, Biller J et al: M. Ishemic stroke in yound adults.Experience in 329 patients enrolled in the Iowa Registry of stroke in young Adults. Arch Neurol, 1995; 52(5): 491-95
[5]. Berlin L et al cerebral thrombosis in young adults NEJM 1995;252-162-166.

Abstract: Background: Facial melanosis is one of the common dermatological disorder that comprises a group of heterogenous conditions of varying etiology, clinically characterised by discolouration of face and thus resulting in distress of cosmetic disfigurement and in turn affecting the quality of life. Aims: To assess various spectrum & etiology of facial pigmentary disorders. Methods:This is a prospective observational hospital-based study, conducted in a tertiary center over period of 6 months, One hundred ninety consecutive patients with facial pigmentary disorders were included in the study after taking informed consent. Detailed history, clinical examination were recorded, & relevant investigations were done wherever necessary......

Key words: facial melanoses,melasma,vitiligo

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[2]. Pawaskar MD, Parikh P, Markowski T, McMichael AJ,Feldman SR, Balkrishnan R. Melasma and its impact onhealth‑related quality of life in Hispanic women. J DermatologTreat 2007;18:5‑9.
[3]. Achar A, Rathi SK. Melasma: A clinico‑epidemiological studyof 312 cases. Indian J Dermatol 011;56:380‑2.[4]. Goh CL, Dlova CN. A retrospective study on the clinicalpresentation and treatment outcome of melasma in a tertiarydermatological referral centre in Singapore. Singapore Med J1999;40:455‑8.
[5]. Hassan I, Aleem S, Bhat YJ, Anwar P. A clinicoepidemiologicalstudy of facial melanosis. Indian J DermatolVenereolLeprol 2015;2:34-40.

Abstract: Background: Cardiac autonomic neuropathy (CAN) is a critical intricacy of diabetes mellitus. Autonomic neuropathy is postulated to be an indicator of impending demise. It is not very easy to detect the diabetic autonomic neuropathy at an earlier stage. The objective of this study was to weigh up the affiliation between autonomic neuropathy and the heart rate variability (HRV) in Type 2 Diabetics. HRV can indicate early subclinical manifestation of autonomic dysfunction, and this could be of value from clinical perspective to understand the risk associated with the subject and further management. In other words, having HRV insight may influence the aggressiveness of the intervention and the choice of therapy when dealing with hyperglycaemia and the complications.....

Key words: Cardiac autonomic neuropathy(CAN), Diabetes Mellitus, Heart Rate Variability (HRV)

[1]. Trivedi Gunjan Y, Hemalatha R, Ramani KV. Chronic Diseases and Mind Body Management, An Introduction (Technical Note), Reference No: CMHS0044TEC. Indian Institute of Management; May, 2018.
[2]. Brownlee M. Biochemistry and molecular cell biology of diabetic complications. Nature 2001;414:813-20.
[3]. Brennan E, McEvoy C, Sadlier D, Godson C, Martin F. The genetics of diabe nephropathy. Genes (Basel) 2013;4:596-619.
[4]. Wilson NM, Wright DE. Inflammatory Mediators in Diabetic Neuropathy. J Diabetes Metab 2011;S5004. Doi:10.4172/2155-6156.S5-004.
[5]. Fowler M. Microvascular and macro vascular complications of diabetes. Clin Diabetes 2008;26:77-82.

Abstract:Snake venoms are made up of numerous proteinacious products and has varied functional effects on different cells of the body. Since the toxic components found in the venom does vary between species, the victims
can present with numerous life‐threatening manifestations related to the neurotoxic and haemotoxic effects of venom. Thus, snakebite is one of the world's most neglected tropical diseases. Some of the snake venoms show
strong haemotoxic properties that has effects on blood pressure, clotting factors and platelets, and thereby causing haemorrhage......

Keywords: haemotoxic, snakebite, South India

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[3]. Mohapatra, B. et al., Snakebite mortality in India: a nationally representative mortality survey of 1.1 million homes; for the MillionDeath Study Collaborators, PLoS. Negl. Trop. Dis., 2010.
[4]. Anuradhani Kasturiratne, A.Rajitha Wickremasinge, Nilathi de Silva, N Kithsiri Gunawardena, Arunasalem Pathmeswaran, Ranjan Premaratna, Lorenzo Savioli, David G Lalloo, H Janaka de Silva. The Global Burden of Snakebite: A Literature Analysis and Modelling based on Regional Estimates of Envenoming and Deaths P Los Med. 2008.
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Abstract: Background: Making career plan creates strong motivation in students. A study of a comprehensive career plan of young doctors also helps to assess the healthcare needs of the nation. Objectives: The objectives of the present study was to describe socio-demographic and academic profile, details of career planning, obstacles and motivation in career path of young doctors included in the study. Methodology: It was a descriptive epidemiological, cross-sectional study, conducted among 83 Internee of R. G. Kar Medical College, during August – October 2019. A pre-designed and pre-tested questionnaire was used to collect data. Data was compiled in Excel worksheet in computer, calculation of statistical averages and proportions, tabulation, chi-square were done for examining statistical significance at p<0.05 significance level. Result: Among 83 Junior Doctors 42.17% were female......

Key words: Career plan, junior doctors, West Bengal

[1]. Sreekar H, Nithya R, Nikhitha R, Sreeharsha H. Career intentions of medical students trained in India. Educ Health 2014;27:64-5.
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Abstract: Objective: To measure level of deficiency of serum vitaminB12 and folic acid its correlation with serum ferritin in Thalassemic patient. Material and Methods: The study of investigations were done in the Pediatricdepartment of Rajendra Institute of Medical Science, Ranchi. Fifty children of Thalassemia included in study group while fifty normal children in control group. Estimation of levels of folic acid,vitaminB12 and serum ferritin. Result: The analysis of Thalassemia group compare with healthy control group show significantly low (p<0.001)values. The statistical study of Thalassemia group with healthy control groups how significantly lowvaluesof(p<0.001) serumfolicacid,vitaminB12levelwhileraisedvaluesof serumferritin studygroups. SignificantnegativelycorrelatedtoserumferritinwithvitaminB12&folicacidinThalassemiamajorgroup.Our studyfound significant correlation offer ritinandvitamin B12& folicaciddeficiencyin Thalassemia. Conclusion: The study found a significantly lower

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Abstract: Thumb defects are not so uncommon . Causes include burn and traumatic injuries. Reconstruction of these defects require sensate flap. First dorsal metacarpal artery flap is very good option for pulp defect of the thumb. Our study was done over a period of 1 year and involved 8 cases of thumb pulp defects treated at our institution. The flap size ranged from 2 × 1.5 cm to 4 × 3 cm. We had only one complication in the form of partial flap necrosis, which fortunately healed following debridement without the need for a secondary procedure. All our cases were done under brachial block or local anesthesia with tourniquet control. All the patients had satisfactory outcome with minimal or no donor site morbidity.

Keywords: First dorsal metacarpal artery flap, Thumb pulp defect, Sensate flap

[1]. Xarchas KC, Tilkeridis KE, Pelekas SI, Kazakos KJ, Kakagia DD, Verettas DA. Littler's flap revisited: An anatomic study, literature review, and clinical experience in the reconstruction of large thumb pulp defects. Med Sci Monit. 2008;14:CR 568–73.
[2]. Guelmi K, Barbato B, Maladry D, Mitz V, Lemerle JP. Reconstruction of digital pulp by pulp tissue transfer of the toe. Apropos of 15 cases. Rev Chir Orthop Reparatrice Appar Mot. 1996;82:446–52.
[3]. Woon CY, Lee JY, Teoh LC. Resurfacing hemipulp losses of the thumb: The cross finger flap revisited: Indications, technical refinements, outcomes and long-term neurosensory recovery. Ann Plast Surg. 2008;61:385–91.
[4]. Chang SC, Chen SL, Chen TM, Chuang CJ, Cheng TY, Wang HJ. Sensate first dorsal metacarpal artery flap for resurfacing extensive pulp defects of the thumb. Ann Plast Surg. 2004;53:449–54.
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Abstract: Aim: This study was aimed at understanding the epidemiology of head injury patients admitted at a tertiary care hospital situated in a semi urban area of West Bengal. Methods: This institutional based cross sectional descriptive study was carried out over a period of one year in a tertiary care centre in West Bengal catering to rural and semi urban population. Demographic and clinical data was collected from all the patients admitted with head injury in the surgical ward of the hospital. Results: Among the 300 cases of head injuries studied, the ratio of M:F was 67:33 with majority(90%) of the patients being from the rural areas. Age ranged from three months to 84 years, the maximum concentration of head injury patients being in the 0-24 years age group. Most of the people were illiterate and unemployed....

Keywords: Head Injury, trauma, epidemiology

[1]. Jennett B. Epidemiology of head injury. Journal of Neurosurgery and Psychiatry 1996; 60: 362-369
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[3]. Koskinen S, Alaranta H. Traumatic brain injury in Finland 1991-2005: a nationwide register study of hospitalized andfatal TBI. Brain Inj. 2008: 22: 205-214[4]. Emmanuel A. Oyedele, Emmanuel Andy, Solomon GM, Rifkatu L, Nanbur S. The Prevalence of Traumatic Head Injury Seen in a Tertiary Health Facility in North-Central Nigeria. International Journal of Public Health Research 2015; 3( 4): 127-129.
[5]. Shekhar c, Gupta LN, Premsagar IC, Sinha M, Kishore J. An epidemiological study of traumatic brain injury cases in a trauma centre of New Delhi ( India ). J Emerg Trauma Shock. 2015; 8(3): 131–139.

Abstract: Introduction: Apremilast is a novel oral phosphodiesterase-4 inhibitor approved for psoriasis treatment. Randomized trials have documented its efficacy and safety, but data on real world patients are scarce. Objectives: Our objective is to characterize psoriasis patients treated with apremilast in a real world setting and calculate drug survival as an important measure of efficacy and compliance. Materials and Methods: This is a descriptive study of 30 patients with psoriasis at the time of presentation, Conducted from January 2019 to August 2019 (8 months) in the Department of DVL, Kurnool Medical College & GGH, Kurnool. Patients under 12 year's age were excluded in this study. Relevant history was taken, clinical examination was done and data was analyzed....

Keywords: Apremilast, Psoriasis, PASI Score, BMI.

[1]. Palfreeman AC, McNamee KE, McCann FE. New developments in the management of psoriasis and psoriatic arthritis: a focus on apremilast. Drug Des DevelTher. 2013;7:201–210.
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Abstract: Intussusception is a rare cause of the intestinal obstruction in adults and it represents a diagnostic challenge for the surgeon. In majority of cases, presenting symptoms are not specific, making preoperative diagnosis very difficult. We present a case of a 17-year-old male patient with intestinal obstruction as a result of intussusception due to ileal(hamartomatous) polyp. For which diagnostic laparoscopy followed by exploratory laparotomy in which resection of that solitary polyp containing gut loop was done and side-to-side anastomosis was done. Postoperatively patient went into ileus but managed conservatively and then discharge satisfactory.This is an extremely rare case in which the first manifestation of the intestinal polyp was ileo-ileal intussusception.Prophylactic surveillance i.e. timely gastrointestinal tract investigations, screening of at-riskindividuals and their family members, genetic testing, and lifelong patient follow-up, are recommended.

Keywords: Intussusception – Peutz-Jeghers syndrome – Intestinal obstruction – Polyp

[1]. Marsicovetere P, Ivatury SJ, White B, Holubar SD. Intestinal Intussusception: Etiology, Diagnosis, and Treatment. Clin Colon Rectal Surg 2017; 30(1):30–39.
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Abstract: Background/aims: To assess the efficacy of 5-dayoral azithromycin compared with 1-month continuous topical azithromycin ointment in patients with Meibomian gland dysfunction (MGD) who had failed to respond to previous conservative management. Methods: 100 patients (>40 years old) with MGD were randomly assigned to receive either oral 5-day azithromycin (500mg/day) or 1-month continuous topical azithromycin (1 % w/w preservative free with sterile base). They also continued eyelid warming/cleaning, lid massage and artificial tears. A score consisting five symptoms and seven signs of MGD was recorded prior to the treatment and at 1 week, and 15 days and 1 month after treatment. Total score was recorded afterwards which was sum of both scores (symptom score and sign score......

[1]. Nichols KK, Foulks GN, Bron AJ, Glasgow BJ, Dogru M, Tsubota K, et al. The international workshop on meibomian gland dysfunction : Executive summary. Invest Ophthalmol Vis Sci 2011; 52:1922-1928
[2]. Romero JM, Biser SA, Perry HD, Levinson DH, Doshi SJ, Terraciano A, et al. Conservative treatment of meibomian gland dysfunction. Eye Contact Lens 2004;30:14-19.
[3]. Guillon M, Maissa C, Wong S. Eyelid margin modification associated with eyelid hygiene in anterior blepharitis and meibomian gland dysfunction. Eye Contact Lens 2012;38:319-25
[4]. Igami TZ, Holzchuh R, Osaki TH, Santo RM, Kara-Jose N, Hida RY. Oral azithromycin for treatment of posterior blepharitis. Cornea 2011;30:145-9
[5]. Geerling G, Tauber J, Baudouin C, et al. The international workshop on Meibomian gland dysfunction: report of the subcommittee on management and treatment of Meibomian gland dysfunction. Invest Ophthalmol Vis SCi 2011;52: 2050-64

Abstract: MULTIPLE PERITONEAL INCLUSION CYSTS, ALSO KNOWN AS PERITONEAL PSEUDOCYSTS, MULTICYSTIC MESOTHELIOMA, AND BENIGN CYSTIC MESOTHELIOMAS, ARE A TYPE OF CYST-LIKE STRUCTURES THAT APPEARS IN RELATION TO THE PERITONEAL SURFACES AND RESULTS FROM A NON-NEOPLASTIC REACTIVE MESOTHELIAL PROLIFERATION. PERITONEALINCLUSIONCYSTSAREUNCOMMONABDOMINOPELVICCYSTSSEENINPERIMENOPAUSALWOMEN.ITISOFTEN MISDIAGNOSEDCLINICALLYASANOVARIANTUMORDUETOSIMILARPRESENTATIONANDMIMICKING FINDINGSONRADIOLOGY.WE.....

KEY WORDS: MUCINOUS CYSTADENOMA OF OVARIES, PERIMENOPAUSAL WOMEN, PERITONEAL INCLUSION CYSTS

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[3]. Lee SW, Lee SJ, Jang DG, Yoon JH, Kim JH. Comparisionof laparoscopic and laparotomic surgery for the treatment of peritoneal inclusion cyst. Int J Med Sci 2012;9:14-9.
[4]. Guerriero S, Ajossa S, Mais V, Angiolucci M, Paoletti AM, Melis GB. Role of transvaginalsonography in the diagnosis of peritoneal inclusion cysts. J Ultrasound Med 2004; 23:1193-200. [5]. Peritoneal inclusion cystDrMostafa El-Feky and Radswiki et al.(RADIOPAEDIA.COM)