iosr-JDMS   Volume-18 ~ Issue-4 ~ April-2019

Abstract: Introduction: Nausea and vomiting are among the commonest experiences by women during pregnancy. It may affect 70–80% of all pregnant women.1 Majority of the pregnant women experiences nausea and vomiting mostly during the first trimester. Very limited number of limited women have a prolonged course with symptoms extending until delivery.2 Materials and Methods: This study was conducted at department of Obstetrics and Gynecology, MGM Medical College and Hospital, Jamshedpur for the duration of one year from January 2018 to December 2018. Despite a high prevalence, studies exploring underlying etiology and treatments are limited. A hospital-based prospective observational study was carried out to..........

Key Words: hyperemesis Gravidarum, morbididity, mortality

[1]. Ismail SK, Kenny L. Review on hyperemesis Gravidarum. Best Pract Res ClinGastroenterol2007;21(5):755–69.
[2]. Koren G, Boskovic R, Hard M, Maltepe C, Navioz Y, Einarson A.Motherisk-PUQE (pregnancy-unique quantification of emesis and nausea) scoring system for nausea and vomiting of pregnancy. Am J ObstetGynecol 2002;186(5):S228–31.
[3]. Koren G, Piwko C, Ahn E, Boskovic R, Maltepe C, Einarson A, et al. Validation studies of the Pregnancy UniqueQuantification of Emesis (PUQE) scores. J ObstetGynaecol 2005;25(3):241–4.
[4]. Attard CL, Kohli MA, Coleman S, Bradley C, Hux M, Atanackovic G, et al. The burden of illness of severe nausea vomiting of pregnancy in United States. Am J ObstetGynecol2002;186(5):S220–7.
[5]. Bashiri A, Neumann L, Maymon E, Katz M. Hyperemesis Gravidarum: epidemiologic features, complications and outcome. Eur JObstetGynecolReprodBiol 1995;63(2):135–8..

Abstract: Introduction: Postpartum hemorrhage is important cause of maternal mortality in developing as well as developed countries. It is defined as blood loss of more than 500ml in normal vaginal delivery and more than 1000ml in a case of caesarean section or amount of blood loss that can affect hemodynamic stability of patient. It is a significant cause of maternal morbidity and mortality. Materials and Methods: This was a cross sectional observational study conducted in a Tertiary care hospital, MGM Medical College and Hospital, Jamshedpur conducted from November 2016 to June 2018 having high no of referrals from city as well as periphery. On admission.........

Key Words: Postpartum hemorrhage, maternal mortality, maternal morbidity,

[1]. Klufio CA, Amoa AB, Kariwiga G. Primary postpartum haemorrhage: causes, aetiological risk factors, prevention and management. P N G Med J. 1995;38(2):133-49.
[2]. Jaleel R, Khan A Post-partum haemorrhage--a risk factor analysis. Mymensingh Med J. 2010;19(2):282-9.
[3]. Ajenifuja KO, Adepiti CA, Ogunniyi SO. Post partum haemorrhage in a teaching hospital in Nigeria: a 5-year experience. African Health Sciences. 2010;10(1):71-4.
[4]. Dossou M, Debost-Legrand A, Déchelotte P Lémery D,Vendittelli F. Severe secondary postpartum hemorrhage: a historical cohort. Birth. 2015;42(2):149-55.
[5]. Mammen T, Shanthakumari H, Gopi K, Lionel J, Ayyappan AP, Kekre A. Iatrogenic secondary post-partum haemorrhage: apropos of two uncommon cases. Australas Radiol. 2006;50(4):392-4.

Abstract: Introduction: Ectopic pregnancy is defined as any intra or extra-uterine pregnancy in which the fertilized ovum implants at an aberrant site which is in conducive to its growth and development.1 It is catastrophic and life threatening condition and one of the commonest acute abdominal emergency in day to day practice affecting approximately 2% of all pregnancies.2 Materials and Methods: This retrospective study was conducted over a period of two years from February 2015 to January 2018 in department Of Obstetrics and Gynecology at MGM Medical College and Hospital, Jamshedpur, India. It is a tertiary care center getting referrals from nearby cities and other hospitals. A total of 29 cases reported during this frame with........

Key Words: Ectopic pregnancy, morbidity, Mass education

[1]. Rajkhowa M, Glass MR, Rutherford AJ, Balen AH, Sharma V, Cuckle HS. Trends in the incidence of ectopic pregnancy in England and Wales from 1966 to 1996. BJOG. 2000;107:369-74.
[2]. Stovall TG, Ling FW, Buster JE. Outpatient chemotherapy of unruptured ectopic pregnancy. Fertil Steril. 1989;51:435-8.
[3]. Stovall TG, Ling FW, Gray LA, Carson SA, Buster JE. Methotrexate treatment of unruptured ectopic pregnancy: A report of 100 cases. Obstet Gynecol. 1991;77:749-53.
[4]. Vasquez G, Winston RML & Brosens IA. Tubal mucosa and ectopic pregnancy. BJOG. 1983;90:468.
[5]. Karaer A, Avsar FA, Batioglu S. Risk factors for ectopic pregnancy: a case-control study. Aust N Z J Obstet Gynaecol. 2006;46:521-7.

Abstract: Introduction: Maternal mortality is defined as the death of any woman while being pregnant or within 42 completed days of termination of pregnancy, irrespective of the duration or site of pregnancy, from any cause related to or aggravated by pregnancy, but not from accidental or incidental causes.1 Maternal mortality ratio (MMR) is defined internationally as the maternal mortality rate per 1 lakh live births. Materials and Methods: A retrospective hospital based study was conducted in the Department of OBG, M.G.M Medical College, Jamshedpur, India over a period of 2 years from January, 2017 to December, 2018. All booked or unbooked maternal deaths admitted at the time of pregnancy.....

Keywords: Maternal mortality, primiparous, hypertensive disorders, Haemorrhage

[1]. Yerpude PN, Keerti S Jogdand. A 5 year retrospective study of pattern of maternal mortality in a tertiary care hospital in South India. Int J Recent Trends Sci Technol 2014;11(3):310-2.
[2]. mmr_bulletin_2011-13 census (SRS) 2011. [Online]. Available at
http://www.censusindia.gov.in/vital_statistics/mmr_bulletin_2011-13. pdf. [Cited 2015 Nov 22].
[3]. Wadhwa L, Gupta S, Jain A. Demography and aetiological profile of maternal mortality cases at a tertiary care centre of India-five and a half years retrospective analysis 2013 July-Dec. Indian J Med Specialities 2013;4(2):238-42.
[4]. Zaman S, Begum AA. Maternal mortality at a rural medical college of Assam: a retrospective study. J Obstet Gynaecol Barpeta 2014;1(1):46-51.
[5]. Mukherjee S, Mukherjee S, Sarkar RR. A six year retrospective study of maternal mortality at a tertiary teaching institute in Uttarpradesh. Int J Med Sci Public Health 2014;3(11):1407-9.

Abstract: Aims& Objective - To find out efficacy of preoperative incentive spirometry on patients of ischaemic heart disease with chronic obstructive pulmonary diseases posted for off pump coronary artery bypass grafting surgery. Materials & Methods -Total 120 COPD patients randomly allocated in three groups. Each groups again divided on the basis of FEV1 % case(n=20; A1,B1,C1) and control(n=20 ; A2,B2,C2) .All the cases received pre-operative incentivespirometry and under went GA with similar agents. Postoperative changes in inspiratory capacity, extubationtimenoted and analysed statistically. Results/Discussion- There were no significant differences among study groups in terms of age, weight & height .Patients in A1 group had better post operative.......

Key words: Spirometric lung exercise,inspiratory capacity(IC), FEV1%, SpO2, PaO2

[1]. Medalion B, Katz MG, Cohen AJ, Hauptman E, Sasson L, Schachner A. Long-term beneficial effect of coronary artery bypass grafting in patients with COPD. Ches 2004;125:56-62.
[2]. Canver CC, Nichols RD, Kroncke GM. Influence of age-specific lung function on survival after coronary bypass. The Annals of thoracic surger 1998;66:144-7.
[3]. Fuster RG, Argudo JA, Albarova OG, Sos FH, Lopez SC, Codoner MB, et al. Prognostic value of chronic obstructive pulmonary disease in coronary artery bypass grafting. European journal of cardio-thoracic surgery: Official journal of the European Association for Cardio-thoracic Surgery 2006;29:202-9.
[4]. Rosenfeld R, Smith JM, Woods SE, Engel AM. Predictors and outcomes of extended intensive care unit length of stay in patients undergoing coronary artery bypass graft surgery. Journal of cardiac surgery 2006;21:146-50.
[5]. Pasquina P, Tramèr MR, Walder B. Prophylactic respiratory physiotherapy after cardiac surgery: Systematic review. BMJ. 2003;327:1379. [PMC free article] [PubMed].

Abstract: Epidural anaesthesia is the most commonly used technique for providing not only surgical anaesthesia but also postoperative analgesia in surgical patients.[1] Early postoperative mobilization, rehabilitation, minimal pain & discomfort are the most desirable features of modern surgery.[2,3,4] Local anaesthetic agents like bupivacaine , lignocaine with or without adrenaline are in use and are the gold standard drugs.[5,6] Opioids like fentanyl , morphine ,buprenorphine are used traditionally as an adjuvant, but come with the side effects such as pruritis, urinary retention , nausea , vomiting and respiratory depression.[7,8,9] Many new adjuvants to local anaesthetics are being tried and alpha- 2 agonists are one of them. The anaesthetic and analgesic requirement get reduced to a huge extent by use of these adjuvants because of their analgesic properties as well as augmentation of local anaesthetics mediated by hyperpolarization of nerve tissues by altering transmembrane potential and ion conductance at the local coerulus...........

[1]. Schultz AM, Werba A, Ulbing S, Gollmann G, Lehofer F. Peri-operative thoracic epidural analgesia for thoracotomy. Eur J Anaesthesiol. 1997;14:600-3
[2]. Kehlet H. Acute pain control and accelerated post operative surgical recovery. Surg Clin North Am 1999;79:431-43.
[3]. Bradshaw BG, Liu SS,Thirlby RC. Standardized perioperative care protocols and reduced length of stay after colon surgery.J Am Coll Surg.1998;186:501-6.
[4]. Kehlet H, Mogensen T. Hospital stay of 2 days after open sigmoidectomy with a multimodal rehabilitation programme. Br J Surg.1999;86:227-30.
[5]. Zaric D, Nydahl PA, Philipson L, Samuelson L, Heierson A, Axelsson K. The effect of continuous lumbar epidural infusion of ropivacaine ( 0.1 %, 0.2 %,0.3%) and 0.25% bupivacaine on sensory and motor block in volunteers: A double-blind study. Reg Anesth 1996;21:14-25..·.

Abstract: Background: The burden of neonatal mortality is still high with India contributing to one fifth of under-five mortality burden and a quarter of neonatal deaths globally. In terms of absolute numbers, this translates into 1.1 million under 5 deaths, of which 630,000 happen during the first four weeks of life. Objectives: To determine the morbidity and mortality pattern of admitted babies in the Sick Newborn Care Unit (SNCU) of a tertiary teaching institute of Kolkata, West Bengal. Materials and Methods: This is a cross sectional, observational, descriptive - analytical study profiling the causes of mortality between babies born within...........

[1]. SubhenduDey,AbhayCharan Pal, ParthaSarathi Das; Pattern Of Morbidity And Mortality Of Newborns Admitted In The Sick Newborn Care Unit (Snuck) Of A Rural Based Medical College Hospital In West Bengal; India; Volume 17, Issue 6 Ver. 16, 2018, PP 25-32
[2]. WHO, Maternal, newborn, child and adolescent health, January 2009.
[3]. Andi L Shane, Neonatal sepsis, VOLUME 390, ISSUE 10104, P1770-1780, OCTOBER, 2017.
[4]. AnuRammohan, Reducing Neonatal Mortality in India: Critical Role of Access to Emergency Obstetric Care, March, 2013
[5]. Mori R, Fujirama M, Shiraishi J, Evans B, Corkett M, et al. (2007) Duration of inter-facility neonatal transport and neonatal.

Abstract: Post operative woundhealing problems in the neurosurgical patient can be particularly bothersome, owing to various specific risk factors involved. These may vary from simple wound dehiscence to complex multilayer defects with cerebrospinal fluid (CSF) leakage and contamination. The latter is quite rare in practice and requires an individually titrated reconstruction strategy Optimal management of postoperative wounds in the wards is important to prevent potential complications such as surgicalsite infections and wound dehiscence from developing. As such, Resident doctors, who play an important part in the subacute management of postoperative wounds, should appreciate the physiology of wound healing and the principles of postoperative wound care.

[1]. Gilmore MA. Phases of Wound healing. Dimens Oncol Nurs 1991;5:32–34.
[2]. Broughton G 2nd, Janis JE, Attinger CE. Wound healing: an overview. Plast Reconstr Surg 2006;117(7suppl):1–32eS.
[3]. Hunt TK, Hopf H, Hussain Z. Physiology of Wound healing. Adv Skin Wound Care 2000;13:6–11.
[4]. Velnar T, Bailey T, Smrkolj V. The wound healing process: an overview of the cellular and molecular mechanisms. J Int Med Res 2009;37:1528–42.
[5]. Rivera AE, Spencer JM. Clinical aspects of full thickness wound healing. Clin Dermatol 2007;25:39–48.

Abstract: Midline sternotomy is established as the gold standard for variety of open heart operations. Sternal dehiscence after the operation is recognized devastating complication. The established closure technique uses steel wires in either figure 8 or simple interrupted suturing methods. In this typical technique, the steel wires are pushed across the each half of sternum. However peristernal and pericostal placement appears to reduce sternal damage, many surgeons use trans-sternal figure 8 wires for sternal fixation. In this study we have compare between peristernal and trans-sternal wiring. 50 cases selected prospectively. Fifty patients undergoing elective cardiac surgery via complete median sternotomy at a single institution were randomly assigned. The groups were well matched........

[1]. Tekümit H1, Cenal AR, Tataroğlu C, Uzun K, Akinci E Anadolu Kardiyol Derg. 2009 Oct; 9(5):411-6.Comparion of figure-of-eight and simple wire sternal closure techniques in patients with non-microbial sternal dehiscence.
[2]. Seyed Jalil Mirhosseini, Sadegh Ali-Hassan-Sayegh, Seyed Mohammad Yousof Mostafavi-Pour-Manshadi, Nafiseh Naderi, Maryam Hadibarhaghtalab, Mohammad Reza Lotfaliani. Figure-of-Eight Wire Sternal Closure Technique Can Reduce Post-Open Cardiovascular Surgery Chest Re-Exploration and Pain Scores in Diabetic Patients with Severe Obesity (Body Mass Index: 35-40). International Journal of Clinical and Experimental Medical Sciences. Vol. 1, No. 3, 2015, pp. 38-41.

[3]. BottioT.,Rizzoli G.,Vida V.,Casarotto D.,Gerosa G..Double crisscross sternal wiring and chest wound infections: a prospective randomized study Thorac Cardiovasc Surg, 2003, vol.26 (pg.1352-1356).

[4]. Javed Iqbal et al. Ann. Pak. Inst. Med. Sci. 2014; 10(4): 210-216 210 Original Article Comparison of Simple Wire and Figure-of-Eight Technique in Terms of Development and Outcome of Sternal Dehiscence in Patients Undergoing Coronary Artery Bypass Graft Surgery European Association for Cardio-Thoracic Surgery..

Abstract: Oral ranula is a retention cyst arising from the sublingual gland on the floor of the mouth as a result of ductal obstruction and fluid retention. Based on clinical features they are of three types; sublingual ranula, plunging ranula and sublingual plunging ranula. The diagnosis may be made based on the clinical presentation, fine-needle aspiration cytology (FNAC), ultrasonography, computed tomography (CT) or MRI. Various techniques used to manage ranulas include incision and drainage, marsupialization, excision of ranula only and excision of ranula along with the involved sublingual salivary gland. Micro-marsupialization is preferred over surgical excision because of the.........

Keywords: Micro-marsupialization, Fine-needle aspiration cytology, Lingual nerve block

[1]. Morita Y, Sato K, Kawana M, Takahasi S, Ikarashi F. Treatment of ranula-- excision of the sublingual gland versus marsupialization. Auris Nasus Larynx 2003;30:311–14.
[2]. Yang Y, Hong K. Surgical results of the intraoral approach for plunging ranula. Acta Otolaryngol Stockh 20141342201–05.
[3]. Rachana P, Singh R, Patil V. Modified micro-marsupialization in pediatric patients: A minimally invasive technique. SRM J Res Dent Sci. 2018;9(2):83.
[4]. Cedric A. Quick; Seth H. Lowell. Ranula and the Sublingual Salivary Glands. Arch Otolaryngol. 1977; 103(7):397-400.
[5]. Galloway RH Gross PD, Thompson SH et.al. Pathogenesis and treatment of ranula: report of three cases. J Oral Maxillofac Surg; 1989; 47: 299-302..

Abstract: Background and Objectives: MDCT is the modality of choice and can be employed for evaluation of both inflammatory and neoplastic conditions of the pancreas. MDCT provides high quality visualization of the parenchymal abnormalities and clearly displays the extrapancreatic spread of disease in inflammatory conditions . MDCT is the modality of choice to correctly image chronic pancreatitis due to better display and viewing of calcifications in more details. To demonstrate usefulness of Toshiba lightning aquilion 16 slice multi detector computerized tomography (MDCT) scan in acute and chronic pancreatitis. Material And Methods: The study had....

Keywords: MDCT (Multidetector computerized tomography), pancreatitis , necrosis, CECT (Contrast enhanced computerized tomography) and calcification

[1]. Wolfgang Schima. E. Jane Adam, Robert A. Morgan. The pancreas Chapter -33, In: Grainger and Allison's Diagnostic Radiology – A text book of medical imaging. Andreas Adam, Adrian K. Dixon, Jonathan H. Gillard, Cornelia M. Schaefer-Prokop edt. 6th ed., Elsevier; 2015 .p.806-813.
[2]. Andreas Adam, Adrian K. Dixon, R.G. Grainger, DJ Allison. Edt. Pancreas. Chapter 3.8, In : Grainger and Allison's Diagnostic Radiology Essentials. Elsevier; 2013 .p.372.

[3]. Balthazar EJ, Robinson DL, Megibow AJ, Ransson JH. Acute pancreatitis: Value of CT in establishing prognosis. Radiology. 1990;174:331-336.

[4]. Balthazar EJ. Acute pancreatitis: Assessment of severity with clinical and CT Evaluation. Radiology.2002;223:603-613.

[5]. Manfredi R, Brizi MG, Canade A, Vecchioli A, Marano P. Imaging of acute pancreatitis. Rays.2001;26:135–42