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

Abstract: Background: Tuberculosis can affect any part of the gastro-intestinal (GI) tract including anus, peritoneum and hepatobiliary system. The clinical manifestations of abdominal tuberculosis are non-specific and mimic various GI disorders and cause delay in diagnosis and management. The present observational study was carried out with the aim to evaluate the various clinical presentations, diagnosis and various methods of management. Materials and methods: This study consists of 27 cases of abdominal tuberculosis, who were treated in various surgical units in Pandit Deendayal Upadhyay Medical College, Rajkot, Gujarat, India. The cases were included from September 2016 to September 2018.All patients who were diagnosed as abdominal tuberculosis, a detailed clinical history, through clinical examination and previous history of treatment for tuberculosis were taken; relevant laboratory, microbiological and radiological investigations were done. When operated, histopathological.....

[1]. Darbari A, Jauhari A, Darbari G, Shrivastava V, Shrivastava A. Abdominal tuberculosis: a study of 50 cases. Int J Res Med Sci 2014;2:1453-61.
[2]. Krishnaswamy J, Rahman K, Reshma S, Bharath N. Abdominal tuberculosis: a clinical study in a tertiary care hospital. Int Surg J 2017;4:3423-6.
[3]. Urabinahatti KA, Singh AK, Nayak A, Gupta R, Jain M, and Dubey C, et al. Abdominal tuberculosis: an epidemiological profile and management of 40 cases in a tertiary set up. Int Surg J 2016; 3:1502-8.
[4]. Bali RS, Jain R, Zahoor Y, Mittal A. Abdominal tuberculosis: a surgical emergency. Int J Res Med Sci 2017;5:3847-50.
[5]. Charokar K, Garg N, Jain AK. Surgical management of abdominal tuberculosis: a retrospective study from Central India. Int Surg J 2016; 3:23-31.

Abstract: Atresia of the colon is the rare types of all gastrointestinal atresias. The transverse colon is the rarest site of all the colonic atresias.we report a case of 4-day old female baby who presented with the feature of distal intestinal obstruction. At laparotomy type 3 atresia of the transverse colon, with proximal dilatation of caecum and ascending colon and distal part of transverse as well as descending and sigmoid colon being microcolon is noticed. Newborn underwent exploratory laparotomy and primary ileostomy.

Keywords: colonic atresia; ileostomy; Abdominal Distension

[1]. Benson CD, Lotfi MW, Brogh AJ (1968) Congenital atresia and stenosis of the colon. J Pediatr Surg3: 253-257.
[2]. Karnak I, Ciftci AO, Senocak ME, Tanyel FC, Buyukpamukcu N (2001) Colonic atresia: surgical management and outcome. Pediatr Surg Int 17: 631-635.
[3]. Etensel B, Temir G, Karkiner A, Melek M, Edirne Y, et al. (2005) Atresia of the colon. J Pediatr Surg 40: 1258-1268.
[4]. Ruggeri G, Libri M, Gargano T, Pavia S, Pasini L, et al. (2009) Congenital colonic stenosis: a case of late-onset. Pediatr Med Chir 31: 130-133.
[5]. Boles ET Jr, Vassy LE, Ralston M (1976) Atresia of the colon. J Pediatr Surg 11: 69-75.

Abstract: Spontaneous rupture of uterine varix is an extremely rare condition with an incidence of 1 in 10000 pregnancies leading to significant fetal and maternal mortality. Its definitive diagnosis is extremely difficult at presentation and etiology is unknown. Most common etiology considered is increase in venous pressure. Most commonly this complication presents in third trimester and poses significant clinical dilemma. This is a case of a 30-year-old patient with severe backache and abdominal pain since few hours limiting daily routine activities. She had acute fetal distress at admission and was suspected to have early placental abruption. Emergency laparotomy revealed 2.5 liters of hemoperitoneum with confirmation of diagnosis of spontaneous rupture of uterine varix..

[1]. Hodgkinson CP, Christensen RC, Hemorrhage from ruptured utero-ovarian veins during pregnancy: report of 3 cases and review of literature. Am J Obstet Gynae 1950 May:59(5):1112-7
[2]. Subedi S, Banerjee Spontaneous peritoneum: a case report. NJOG 2012 Jul-Dec; 7(2): 50-51
[3]. Marrow AE, BJOG, An International Journal of Obstetrics and Gynecology 1960;67 (5): 792-795.

Abstract: Purpose: The aim of this preliminary study was toevaluate the effect of placement four implants following All-on-4 concept on anterior bone resorption in the upper completely edentulous patients opposing class I removable partial denture. Materials and methods: Six patients with total edentulous maxillary ridges and partially edentulous mandibular ridges (class I Kennedy classification) werereceived maxillary fixed prosthesison 4 implants according to the All on four protocol and mandibular distal extension RPD (Study group). The control group consisted of six patients whom received conventional maxillary dentures and distal extension mandibular RPD without any implant treatment.Evaluation of maxillary bone resorption for both groups was made at time of prosthesis insertion (T0) and 5 years later (T2) using the proportional area measurements made on digital panoramic radiographs for anterior2..

[1]. Kelly E. Changes caused by a mandibular removable partial denture opposing a maxillary complete denture. J Prosthet Dent. 1972;27:140-150.
[2]. Cune MS, de Putter C HJ. Treatment outcome with implant-retained overdentures: Part II--Patient satisfaction and predictability of subjective treatment outcome. J Prosthet Dent. 1994;72:152-158.
[3]. Maló P, Rangert B NM. "All‐on‐Four" Immediate‐Function Concept with Brånemark System® Implants for Completely Edentulous Mandibles: A Retrospective Clinical Study. Clin Implant Dent Relat Res. 2003;5:2-9.
[4]. Krekmanov L, Kahn M, Rangert B LH. Krekmanov L, Kahn M, Rangert B, Lindstrom H. Tilting of posterior mandibular and maxillary implants for improved prosthesis support. Int J Oral Maxillofac Implants. 2000;15:405-414.
[5]. Ahuja S CD. Defining available restorative space for implant overdentures. J Prosthet Dent. 2010;6:104:133.

Abstract: Background:One of the major factor contributing to the success of the immunization program is the proper handling of cold chain and vaccine logistics. Improper cold chain practices can affectthe efficacy of vaccines and enhance wastage. Madhya Pradeshis one of the high-priority states for maternal and child health programs in India Aim and objective: To assess the condition of cold chain equipment, cold chain maintenance related practices, and the knowledge of the cold chain handlersin public health facilities in Satna district.Methodology:A cross-sectional study was conducted fromJanuary to March2019 in the public health facilities of the district which were having cold chain points.Anenumeration all two Civil Hospitals, nine Community Health Centres and 12 randomly selectedPrimary Health Centres was carried out. Standard cold-chain monitoring checklist and interviewer-administered questionnaires.....

Key Words: Monitoring, Cold chain Practices, Vaccine, Primary health centers.

[1]. United Nations Children's Fund [Internet]. Vaccine Wastage Assessment: Field assessment and observations from National Stores and five selected states in India. April 2010. Available at: http://www.unicef.org/india/Vaccine_Wastage_Assessment_India.pdf.
[2]. GAVI, the vaccine alliance [Internet]. India's immunization milestone: national action, global impact. Available at:
[3]. http://www.gavi.org/library/news/gavi-features/2014/indias-immunisation-mileston-national-action-global-impact/
[4]. Reddy H, Pradhan MR, Ghosh R, Khan AG. India's progress towards the Millennium Development Goals 4and 5 on infant and maternal mortality. WHO South-East Asia Journal of Public Health 2012;1(3);279-289
[5]. World Health Organization [Internet]. Expanded Programme on Immunization:

Abstract: There has been a remarkable change in the diagnosis protocol of acute appendicitis (AA) with the use of ultramodality imaging techniques. In few developing countries like India where there are few skilled radiologist and even rarely accessible technologies, X-ray becomes a crucial investigation as a paramedic can operate it. This study was undertaken to find out the efficacy of X-ray in diagnosing AA.This is a prospective study, carried out at a tertiary health centre from April 2017 to October 2018. The study was approved by the Institute Ethics Committee. Written and informed consent was obtained from all patients before enrolment into the study. 100 patients were enrolled in the study fulfilling the inclusion criteria and were subjected to a detailed clinical history and relevant investigations operative X-ray abdomen erect was taken and findings were noted which were later correlated with histopathological diagnosis.Maximum patients were in the age group of 21-30 years. 66% were males. Pain in right iliac and nausea/vomiting were present in more than 70% patients. On the basis of Alvarado scoring, almost 54 % had high probability of this disease. Most common finding in X-ray abdomen erect was haze in right lower quadrant followed by blurring of pro-peritoneal fat line, which was followed by obliteration.

Keywords: Acute appendicitis, RIF – Right iliac fossa, USG – Ultrasonography, VA – Vermiform Appendix, GALT - Gut-associated lymphoid tissue.

[1]. Ferris M, Quan S, Kaplan BS, Molodecky N, Ball CG, Chernoff GW, et al. The Global Incidence of Appendicitis-A Systematic Review of Population-based Studies. Ann Surg 2017;266:237–241.
[2]. Addis DG, Shaffer N, Fowler BS, Tauxe RV. The epidemiology of appendicitis and appendectomy in the United States. American Journal of Epidemiology 1990;132:910-925.
[3]. Chaudhari Y P, Jawale P G. Prevalence of appendicitis at surgery inpatient department of a tertiary care hospital:A descriptive study. International Medical Journal 2015;2(11):768-770.
[4]. Wagner JM, McKinney WP, Carpenter JL. Does this patient have appendicitis? JAMA.1996;276;1589-1594.
[5]. Flum DR, Koepsell T. The Clinical and Economic Correlates of Misdiagnosed Appendicitis 2002;137:799-804.

Abstract: Accessory parotid gland tumor is a rare entity presenting as mid-cheek swelling or infra zygomatic swelling. Its anatomical location usually associated with stensen's duct, lying on masseter muscle, and it is away from the main parotid gland. Blood supply is generally from the transverse facial artery, and it empties into stensen's duct via accessory duct. We report a case of mid cheek swelling arising from the accessory parotid gland, a pleomorphic adenoma. In the literature, the incidence of accessory parotid gland tumors is around 1-7.7%. Only a few cases were reported till now. Diagnosis and surgical management are very crucial for accessory parotid gland tumors, as they are notorious for recurrence.....

Keywords: Accessory Parotid Gland,Stensen's Duct,Blair's Incision

[1]. Frommer J. The human accessory parotid gland: its incidence, nature, and significance. Oral Surg Oral Med Oral Pathol. 1977 May;43(5):671–6.
[2]. Popescu EI, Costan V-V. Extended Parotid Tumors with Origin in the Parotid Tissue. In: Costan V-V, editor. Management of Extended Parotid Tumors [Internet]. Cham: Springer International Publishing; 2016 [cited 2019 Nov 13]. p. 13–20. Available from: https://doi.org/10.1007/978-3-319-26545-2_2
[3]. pubmeddev, RH JF and S. Tumors arising in accessory parotid tissue. - PubMed - NCBI [Internet]. [cited 2019 Nov 13]. Available from: https://www.ncbi.nlm.nih.gov/pubmed/484786
[4]. Perzik SL, White IL. Surgical management of preauricular tumors of the accessory parotid apparatus. Am J Surg. 1966 Oct;112(4):498–503.

Abstract: Renal leiomyoma is a rare benign mesenchymaltumor. It arises from the smooth muscle cells of the kidney and renal capsule is its most common location.Small tumor may be asymptomatic and usually appears as a well circumscribedperipherally located solid mass. Large tumor may manifest with pain, palpable flank mass orhematuria. Intersecting fascicles of spindle cells showingimmunoreactivity to actin or desmin are characteristic histologic features..

Keywords: Leiomyoma, kidney, computed tomography (CT).

[1]. Eble JN, Sauter G, Epstein JI, Sesterhenn IA, eds. World Health Organization classification of tumours: pathology and genetics of tumours of the urinary system and male genital organs. Lyon, France: IARC, 2004. [2]. Steiner M, Quinlan D, Goldman SM et al. Leiomyoma of the kidney: presentation of 4 new cases and the role of computerized tomography. J Urol 1990;143(5):994–8. [3]. Romero FR, Kohanim S, Lima G, Permpongkosol S, Fine SW, Kavoussi LR. Leiomyomas of the kidney: emphasis on conservative diagnosis and treatment. Urology. 2005;66:1319. [4]. Tamboli P, Ro JY, Amin MB, Ligato S, Ayala AG. Benign tumors and tumor-like lesions of the adult kidney. II. Benign mesenchymal and mixed neoplasms, and tumor-like lesions. AdvAnatPathol 2000;7(1):47–66.
[5]. Dionne JM, Carter JE, Matsell D et al. Renal leiomyoma associated with Epstein-Barr virus in a pediatric transplant patient. Am J Kidney Dis 2005;2:351-5..

Abstract: Background STEMI is a catastrophic event due to total occlusion of an epicardial coronary artery. Time taken to open the infarct related artery is directly proportional to adverse outcome. Due to many reasons pharmacoinvasive approach is preferred in many peripheral hospitals in India. Aim The aim was to study the impact of Door to Needle time (D-N time), time for revascularization after thrombolysis in patients of STEMI managed with pharmacoinvasive strategy.
Material and Methods It was a prospective observational study carried out at the Department of Medicine at a Tertiary Care Hospital for the period of Oct-17 to March-19. In total, 55 patients having STEMI were included in the study. Focused clinical examination, 12 lead electrocardiogram.....

[1]. Gupta RK. Manocha S. Akhoury S. Kohil U. Clinical Characteristics and Outcomes of Percutaneous Coronary Intervention in Patients with STEMI: A Single-Center Experience. Journal of The Association of Physicians of India.2019; 6:40-43
[2]. Alex AG. et al. Observational study comparing pharmacoinvasive strategy with primary percutaneous coronary intervention in patients presenting with ST elevation myocardial infarction to a tertiary care centre in India. J Postgrad Med. 2018;64(2): 80–85.
[3]. Alexander T. Juvale NJ. Dasbiswas A. Kubba S. Singh RK. Raja V. Pharmaco-invasive Therapy mTier-I Cities in India. Journal of The Association of Physicians of India. 2018;66:76-82.
[4]. Subban V, Lakshmanan A, Victor SM, et al. Outcome of primary PCI- An Indian tertiary care center experience. Indian Heart Journal 2014; 66:25–30
[5]. Victor SM. et al. Two-year follow-up data from the STEPP-AMI study: A prospective, observational, multicenter study comparing tenecteplase-facilitated PCI versus primary PCI in Indian patients with STEMI. I n d i a n h e a r t j o u r n a l 6 8 ( 2 0 1 6 ) 1 6 9 –
1 7 3.

Abstract: Background: Anemia is one of the common findings in patients irrespective of the presenting complaints and disease. Anemia is not a diagnosis itself, but it is a sign of underlying disease. Hence the evaluation of a patient with anemia is directed at elucidating the causes for the patient's reduced number and morphological changes of red blood cells. Since the diagnosis and treatment of anemic patients is based on the morphological patterns of anemia, hence this study was undertaken to study the morphological patterns of anemia in adult population. Material and methods: This crossectional study was conducted in the Department of Pathology, Government Medical College, Jammu over a period of one year on 100 anemic patients. The EDTA anticoagulated venous samples received from the patients were run on automated hematology analyzer. Smears were made from the venous blood samples collected.....

Keywords: Anemia, Normocytic Normochromic, Microcytic hypochromic, Macrocytic, Dimorphic Anemia

[1]. De Benoist B, McLean E, Egli I, Cogswell M. Worldwide Prevalence of Anaemia 1993-2005. ITS Global Database on Anemia. Geneva: WHO 2008. Available at:http://www.who.int/nutrition/publications/micronutrients/anaemia_iron_deficiency/9789241596657/en/ cited on October 2017
[2]. Swaroop Raj BV, Sunita BS, Vanmalinitewari, Divya C. Is Peripheral Blood Smear an Obsolete Art? Int J Rec Scie Res 2015; 6(3): 3059-62.
[3]. Adewoyin AS, Ogbenna AA. Morphologic Evaluation of Anemia – I. Biol Med Aligarh 2016; 8(6):322
[4]. Ejaz F, Ahmed M, Hassan NA. Comparative study in the diagnosis of anemia by Sysmex KX-21N hematology analyzer with peripheral blood smear. Int J Endor Health Sci Res 2013; 1(2):89-92.
[5]. Jones KW. Evaluation of cell morphology and introduction to platelet and white blood cell morphology. In: Harmening D (ed) Clinical Hematology and fundamentals of hemostasis, Philadelphia, 2009: 93-116..

Abstract: Introduction: Under RCH Programme, special emphasis is placed on the good quality of care. Therefore it is necessary to ensure that all services, provided at the health functionaries, are of good quality and acceptable to the clients. This can be achieved by ensuring adoption of the technically correct procedure by the health personnel. Present study was conducted to assess the quality of essential obstetric care at different levels of health care delivery system of a district in state of West Bengal and to find out its relation with the acceptance of essential obstetric care services. Materials and Methods: A health service type of research, in connection with essential obstetric care was conducted at the different levels of health.....

Key Words: Antenatal mothers, Care, Quality

[1]. RCH Programme document accessed from www. nhmmp.gov.in
[2]. RMNCH+A Approach programme document, accessed from www. nhp.gov.in
[3]. Reproductive, maternal, newborn, child and adolescent health programme – accessed from www. mohfw.gov.in.>files
[4]. Operational Research on Reproductive Health – World Health Organisation – accessed from www. Searo.who.int> PDS
[5]. Indicator wise RCH report Accessed from www. Data.gov.in

Abstract: Supracondylar spur or process is a hook-shaped bony projection from the anteromedial surface of the lower part of the humerus. Its length varies from 2 to 20mm. The ligament of Struthers connects the process to the medial epicondyle. The incidence of supracondylar process ranges from 0.1% to 2.7%. The median nerve and or brachial artery passing under the process or ligament of Struthers may be compressed by the them. The study was taken up to find the incidence of supracondylar process in the dry humerus bones. The study was conducted in the Department of Anatomy, Regional Institute of Medical Sciences, Imphal on 70 dried humerus bones. The humeri were inspected for presence of supracondylar processes and size and location were measured. supracondylar process was found in 1 (1.4%) left humerus. It was present on the anteromedial aspect about 5 cm above the tip of the medial epicondyle and had a length of 1 cm. The process may be detected radiographically. Excision of the process and the Struthers' ligament is the treatment in symptomatic patients.....

Key Words: Supracondylar process, ligament of Struthers, humerus, supracondylar syndrome

[1]. Standring S (Chief Editor). Gray's Anatomy: The Anatomical Basis of Clinical Practice. 40th edition, Edinburgh:Elsevier 2005.
[2]. Camerlinck M, Vanhoenacker FM, Kiekens G. Ultrasound demonstration of Struthers' ligament. J Clin Ultrasound. 2010;38(9):499–502.
[3]. Opanova MI, Atkinson RE. Supracondylar process syndrome: case report and literature review. J Hand Surg Am. 2014;39(6):1130–5.
[4]. Shon HC, Park JK, Kim DS, Kang SW, Kim KJ, Hong SH. Supracondylar process syndrome: two cases of median nerve neuropathy due to compression by the ligament of Struthers. Journal of Pain Research 2018;11:803-806. [Accessed at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5907893/pdf/jpr-11-803.pdf dated 12/11/2019]. [5]. Parkinson C. The supraconbdylar process. Radiology 1954;62:556-8.

Abstract: Oral hygiene is largely determined by caries experience. In special circumstances a person is not advised to brush their teeth so they maintain their oral hygiene with gargling antiseptic solution. However, long-term and continuous use of antiseptic mouthwash will have an impact on soft tissue damage of the mouth. Honey has been known to have various health benefits, especially as an antiseptic. Honey is the choice in this study is forest honey produced by apis dorsata bee high water content of 15-20%. Forest honey is thought to contain higher and varied bioactive compounds because it is produced by multiplication of bee activity. Methods: The respondents of this research are 60 students of FKG USU. This research method is pre and post test control group compare the effectiveness of forest honey 15%, 20% and 50% with chlorhexidine as positive control. The analysis used is.....

[1]. Lamont RJ, Jenkinson HF (2010) Oral microbiology at a glance. Oxford: Wiley- Blackwell: 3,9
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[3]. Prasetya RC (2008) Perbandingan jumlah koloni bakteri saliva pada anak – anak karies dan non karies setelah mengkonsumsi minuman berkarbonisasi. Indonesian Dentistry 2008;15(1):66.
[4]. Akinyele BJ, Oladejo BO, Akinyemi AL, Ezem LO (2014) Comparative study of the antibacterial effect of mouth washes and Vernonia amygdalina (del.) on some tooth decay causing bacteria. British Microbiology Research;4(7):750.
[5]. Dye BA, Evans GT, Li X, Lafolla T (2017) Dental Caries and Tooth Loss in Adults in the United States, 2011-2012. https://www.cdc.gov/Other/plugins/ (accessed 25 May 2017).
[6]. Matranga D, Castigla P, Solinas G, (2014) Italian Deprivation Index and Dental Caries in 12-Year-Old Children: A Multilevel Bayesian Analysis. Caries Research 2014; 48: 584-593

Abstract: This study examined the menace of ethno-religious conflict on economic development in Nigeria.The purpose was to; examine the nexus between ethnicity and religion and the crises that have engulfed Nigeria in the past three decades, look at the effect of ethno-religious crises on the development of Nigeria as a nation, investigate the role of religious leaders in curtailing the menace and investigate the role of mass media in escalating ethno-religious crisis. The study employed desk research which made use of literature explored to make conclusion on the study. The findings revealed that factors like struggle for land resources, traditional authority, competition for economic and political spaces, clash of values and way of lives, religion and ethnicity and religious manipulations breeds ethno-religious conflicts in Nigeria. It was also revealed that ethno-religious conflict affects economic development adversely by causing a decline in the level of agricultural investment/yield, decline in income.....

Keywords: Religious conflicts, communal conflicts, ethno-religious conflict, non- violent conflicts, violent conflicts, national cohesion, economic development.

[1]. Adebayo, R. I. (2010). Ethno-Religious Crises and the Challenges of sustainable Development in Nigeria. Journal of Sustainable Development in Africa, 12(4), 213-225.
[2]. Adeola, A.A. (2010). Religious Tolerance and Dialogue: Conditionality‟s for Peaceful Co-existence and Progress in Nigeria. International Journal on Social Science Research and National Development, 1 (1), 189-199.
[3]. Akintoye, V. A.&Opeyemi, O. A. (2014). Prospects for achieving sustainable development through the millennium development goals in Nigeria. European Journal of Sustainable Development, 3, 33-46.
[4]. Anyebe, A. A. (2015). An evaluation of implementation of poverty eradication programme in Benue State, Nigeria. University of Benin Journal of Administration and Development, 1, 1-10.
[5]. Anyim, F. C., Ufodiama, N. M.&Olusanya, O. A. (2013). Ethics in Nigeria public sector: The HR practitioners‟ perspectives. European Journal of Business and Social Sciences, 2, 132-143.