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

Abstract: Penile fracture is the rupture of the tunica albuginea of the corpus cavernosum caused by trauma to the erect penis. It is an Uro-surgical emergency and can be partial involving only the tunica albuginea or complete when there is secondary injury to the urethra and neurovascular structure. Recognition and early treatment is the key to management and prevention of complication. This is the case of an adolescent boy who under the influence of alcohol sustained penile fracture following over enthusiastic sexual activity. He had earlier presented at a secondary health facility where he was referred to our facility. Following correct diagnosis of penile fracture, he had successful surgical exploration and fixation of the fracture. He had an uneventful recovery with no complication.

Key Words: Penile fracture, adolescent, sex-related alcohol expectancy, Uyo, Nigeria.

[1]. Nale DI, Nikkie P,Vukovic I, Djordjevic D, Vuksanovic A. Surgical or conservative treatment of penile fracture. Acta.Chir Lugos L.2008:55(1):107-114
[2]. Bholi R, Sood D. Signs and symptoms and treatment of penile fracture. Emerg. Nurse,2015:23(6):16-17.
[3]. De Rose AF, Giglio M, Carmignani G. Traumatic rupture of the corpora cavernosa: new physiopathologic acquisitions. Urology. 2001;2013: 319–322.
[4]. Zargooshi J. Sexual function and tunica albuginea wound healing following penile fracture: An 18 year follow up study of 352 patients from Kermanshgh. Iran J.Sex. Med. 2009;6:1140-50.
[5]. Dienye PO, Jebbin NJ, Gbeneol PK. Penile fracture following husband abuse; a case report. Am J. mens health. 2009;3:330-332..

Abstract: Background: Adequate parent education (instructions) given after the extraction of primary teeth has been demonstrated to decrease the postoperative experiences, thus improving patient satisfaction. The objective of the trial was to evaluate the parent's compliance with post-operative instructions given in verbal, written formats, and patients' satisfaction with the treatment procedure. Methodology: A total of 60 children advised for extraction of primary teeth weredivided into three groups based on the form of instructions provided to them. Group A (20): Instructions verbally, Group B (20): Instructions in written form and Group C (20): Instructions.........

Key Words: Children, Parents Compliance, Post- operative instructions, Primary teeth

[1]. Adeyemo WL, Ladeinde AL, Ogunlewe MO. Influence of Trans-operative Complications on Socket Healing Following Dental Extractions. J Contemp Dent Pract. 2007; 1: 52-59.
[2]. Blinder D, Rotenberg L, Peleg M, Taicher S. Patient compliance to instructions after oral surgical procedures. Int J Oral Maxillofac Surg. 2001; 30: 216-19.
[3]. Gonzalez JA, Escoda CG. Compliance of postoperative instructions following the surgical extraction of impacted lower third molars: a randomized clinical trial. Med Oral Patol Oral Cir Bucal. 2015; 20: 224-30.
[4]. Vallerand WP, Vallerand Ah, Heft M. The effects of postoperative preparatory information on the clinical course following third molar extractions. J Oral Maxillofac Surg. 1994; 52: 1165-70.
[5]. Adebayo ET, Dairo M. Patient's compliance with instructions after oral surgery in Nigeria. JComm Med Prim Health Care. 2005; 17: 38-44.

Abstract: Objectives: To audit retrospectively the data of our patients, who presented with hearing loss in our department. Materials and Methods: Retrospective descriptive study over a period of 2 years (April, 2016 to March, 2018), Total no of patients included into this study were 5478 who were assessed demographically and audiologically in the department of ENT , Burdwan Medical College, Burdwan. Results: 5478 patients attended our ENT OPD for audiological assessment of hearing from April 2016 to March 2018. 2786 patients found to have normal hearing. 2692 (49.14%) patients had hearing loss. 1445 (53.67%) patient out of 2692 had conductive hearing loss. Conclusion : It is very much essential to continuously monitor the prevalence of hearing loss, early identification of hearing loss , early intervention and proper rehabilitation in the community so that steps can be taken to reduce the can reduce the burden of this disability in our community.

Keywords: Hearing loss; Conductive hearing loss; Sensori-neural hearing loss ; Mixed hearing loss

[1]. Hong JW, Jeon JH, Ku CR, Noh JH, Yoo HJ, Kim DJ. The prevalence and factors associated with hearing impairment in the Korean adults: THe 2010-2012 Korea National Health and Nutrition Examination Survey (observational study). Medicine (Baltimore) 2015;94:e611.
[2]. Dhingra PL, Dhingra S. Diseases of ear, nose and throat and head and neck surgery. Diseases of Ear Hearing Loss. 6th ed. New Delhi: Elsevier Health Sciences; 2014.
[3]. Agrawal Y, Platz EA, Niparko JK. Prevalence of hearing loss and differences by demographic characteristics among US adults: Data from the National Health and Nutrition Examination Survey, 1999-2004. Arch Intern Med 2008;168:1522-30.
[4]. Wallhagen MI, Strawbridge WJ, Cohen RD, Kaplan GA. An increasing prevalence of hearing impairment and associated risk factors over three decades of the Alameda County Study. Am J Public Health 1997;87:440-2.
[5]. Ries PW. Prevalence and characteristics of persons with hearing trouble: United States, 1990-91. Vital Health Stat Series 1994;10:1-75.

Abstract: Aims: Background: A very important barrier to achieve universal health coverage is the fact that proper and adequate attention is not being given to management and institutional reforms. To overcome this hurdle, motivated public health specialists are needed in adequate numbers. For that we need to know whether the students of MBBS are actually convinced and motivated to choose community medicine and public health as their career option and pursue higher studies in these branches. This study was carried out to find out the reasons for medical students for opting or shying out community medicine as their career option and making the students aware of the career opportunities. Objectives:......

Keywords: Community medicine, MBBS Students, Career choice, Medical College.

[1]. Kar SS, Ramalingam A, Premarajan KC, Roy G. Do Medical Students Prefer a Career in Community Medicine?.Int J Prev Med 2014;5:1468-74.
[2]. Lal P, Malhotra C, Nath A, Malhotra R, Ingle GK. Career aspirations and apprehensions regarding medicaleducation among first year medical students in Delhi. Indian J Community Med. 2007;32:217–8.
[3]. Kumar R, Dhaliwal U. Career choices of undergraduate medical students. Natl Med J India. 2011;24:166–9.[PubMed: 21786849]
[4]. Subba SH, Binu VS, Kotian MS, Joseph N, Mahamood AB, Dixit N, et al. Future specialization interests among medical students in southern India. Natl Med J India. 2012;25:226–9. [PubMed: 23278783]
[5]. Geneva: World Health Organisation; 2008. [Last cited on 2013 Aug 02]. The World Health Report 2008:Primary Health Care - Now More than Ever. Available from:
http://www.who.int/whr/2008/08_overview_en.pdf .

Abstract: Objective: To study the epidemiology, role of regular antenatal care influence of chorionicity maternal and perinatal outcome, maternal and fetal complication and plan of management in cases of twin pregnancy in our institute during study period of Jan. 2017 to Sep. 2018 Method: The study was conducted in the Department of Obstetrics and Gynecology of JLN Medical College & Associated group of hospitals, Ajmer (Raj.). 100 cases of twin pregnancy that register in Zanana Hospital during period of Jan 2017 to Sep 2018 were studied and data regarding feto-maternal outcome and the mode of delivery were collected and analyzed. Result: In our study we observed that.......

Key words: Twin pregnancy, perinatal mortality, perinatal morbidity

[1]. Umeora OUJ, AneziOkoro EA, Egwuatu VE. Higher-order multiple births in Abakaliki, Southeast Nigeria. Singapore. Med J. 2011;52(3):163-7.
[2]. Conde-Agudelo A, Belizan JM, Lindmark G. Maternal morbidity and mortality associated with multiple gestation. Obstet Gynecol. 2000;95:899- 904.
[3]. Blondel B, Kaminski M. Trends in the occurrence, determinants, and consequences of multiple births. Semin Perinatal. 2002;26:239-49.
[4]. Arias, Fernando: practical guide to high risk pregnancy and delivery reprinted 2015.
[5]. Renata Almeida de Assunção et al. perinatal outcome of twin pregnancies delivered in a teaching hospital. Rev Assoc Med Bras 2010; 56(4): 447-51.

Abstract: Gastric tumour is the fourth most common cancer and the second leading cause of death due to cancer worldwide. Gastric cancer is more common in male than in female in the ratio of 2:1. It is a disease of elderly. The histological and morphological types of gastric carcinomas are highly variable and may not correlate well with the prognosis of the patients.Molecular markers are vital in determining the disease progression and hence disease outcome, survival and prognosis.The objective of the study was to correlate the association of HER-2/Neu in Gastric adenocarcinoma with histomorphological variables. This was a retrospective study carried out in our institution on 100 cases. There was a significant association between HER-2 Neu overexpression and histological grading of adenocarcinoma.

Key words: Gastric carcinoma,HER-2 Neu

[1]. "Cancer (Fact sheet N°297)".World Health Organization. February2009.http://www.who.int/mediacentre/factsheets/fs297/en/
[2]. Correa P. Human gastric carcinogenesis: A multistep and multifactorial process — First American Cancer Society Award Lecture on Cancer Epidemiology and Prevention. Cancer Res 1992;52:6735-40.
[3]. Bosman FT, Carneiro F, Hruban RH, Theise ND. WHO Classification of Tumours of the Digestive System. 4th ed. Lyon, Frane: IARC Press; 2010. p. 45-64. 4
[4]. Hamilton S R, Aaltonen L A. Pathology and genetics of tumours of the digestive system. World Health Organization Classification of Tumours. 2000; 44,45
[5]. Tanner, M., et al., Amplification of HER-2 in gastric carcinoma: association with Topoisomerase IIalpha gene amplification, intestinal type, poor prognosis and sensitivity to trastuzumab. Ann Oncol, 2005. 16(2): p. 273-8..·.

Abstract: Background: Ultra sound guided supraclavicular block can be achieved either using single injection (SI) or double injection(DI) techniques. Local anesthetic (LA) deposition at the corner pocket through SI technique provides competent anesthesia but sparing of the upper trunks can occur. Our study hypothesized DI technique provides better blockade quality than single injection technique. Objective: To compare the success rate of blockade in SI versus DI techniques and to compare the total anesthesia related time in the two groups...........

Keywords: single injection technique (SI),double injection technique(DI), Ultra sound guided supra clavicular block, Ropivacaine.

[1]. Marohfer P, Greher M, Kapral S, Uutrasound guidance in regional anaesthesia. Br J Anaesthesiology2005;94:7-17.
[2]. Marofer P, Schrogendorfer K, Waiiner T, Koinig H, Mayer N, Kapral S, Ultrasonographic guidance reduces the amount of local anaesthetic for 3 in 1 blocks.Regional Anaesthesia pain medicine 1998;23:584-8.
[3]. Soares LG,Brull R,Lai J,Chan VW. Eight ball,corner pocket:the optimal needle position for ultrasound-guided supraclavicular block. Regional Anaesthesia pain medicine 2009;34:420-4.

[4]. Tran DQH, Mufloz L,Zaouter C, Russo G,Finlayson RJ. A Prospective, randomized comparison between single and double injection. Ultrasounded supraclavicular brachial plexus block. Regional Anaesthesia pain medicine.2009;34:420-4.
[5]. Tran DQH, Dugami S,Correa JA, Dyachenko A,Alsenosy N,Finlayson RJ. Minimum effective volume of lidocaine for ultrasound guided supraclavicular block.Regional Anesthesia pain medicine 2011;36:466-9..

Abstract: The management of Multiloculated pleural effusion and empyema with closed pleural aspiration and intercostal tube drainage fails most of the time due to the presence of thick viscous fluid and multiple septations . We extra plot that MESNA (2-mercaptoethane sulfonate Na) is an agent which is easily available, effective, safe and less expensive and due to its proved action as a mucolytic, chemical dissector and fibrinolytic along with our practical experience, we propose the hypothesis that MESNA can be an intrapleuralfibrinolytic agent which can overcome many limitation of presently available agents. Materials and Methods:........

Keywords:Multiloculated effusion , Multiloculated empyema ,MESNA ,Septations

[1]. Venkateswara Reddy Tummuru, PradyutWaghray, A.N. V. KoteswaraRao, V Veena, ChetanRaoVaddepally, HasnaniRikinBahadurbhai. Effectiveness of Intrapleural Instillation of Mesna for Adhesiolysis in Multi Loculated Pleural Effusions, Para Pneumonic Effusions and Empyema: Our Experience. International Journal of Therapeutic Applications.2015; 23: 5-9.
[2]. Karkhanis VS, Joshi JM. Pleural effusion: diagnosis, treatment, and management. Open Access Emerg Med. 2012;4:31-52.
[3]. V. Courtney Broaddus, Richard W. Light, Disorders Of The Pleura, 79 Pleural Effusion. Murray &Nadel's (Sixth edition) Textbook of Respiratory Medicine.
[4]. Bartlett JG, Gorbach SL, Thadepalli H, Finegold SM. Bacteriology of empyema. Lancet. 1974;1(7853):338-340.
[5]. Bartlett JG, Finegold SM. Anaerobic infections of the lung and pleural space. Am Rev Respir Dis. 1974;110(1):56-77..

Abstract: Aim: To evaluate liver stiffness measurement as a non-invasive predictor of presence and grade of esophageal varices (EV) in patients with hepatitis C virus infection(HCV)- related liver cirrhosis. Methods: This is a prospective, single-center study that lasted 4 and a half years including all patients with HCV-related liver cirrhosis, compensated or not, and treated at Hassan II University Hospital in Fez, Morocco. Upper endoscopy associated with liver stiffness measurement by FibroScan® are performed by different operators.........

Keywords: Liver cirrhosis; hepatitis C virus infection; portal hypertension; liver stiffness; non-invasive tools; upper gastrointestinal endoscopy, screening for EV.

[1]. EASL Clinical Practice Guidelines: Management of hepatitis C virus infection ; Journal of Hepatology 2014 vol. 60. 392–420
[2]. G. Garcia-Tsao. Prevention and Management of Gastroesophageal Varices and Variceal Hemorrhage in Cirrhosis. AASLD PRACTICE GUIDELINES. HEPATOLOGY, Vol. 46, No. 3, 2007.
[3]. Prediction of the first variceal hemorrhage in patients with cirrhosis of the liver and esophageal varices. A prospective multicenter study. The North Italian Endoscopic Club for the Study and Treatment of Esophageal Varices. N Engl J Med 1988;319:983–989.
[4]. D'Amico G, Pagliaro L, Bosch J. Pharmacological treatment of portal hypertension: an evidence-based approach. Semin Liver Dis 1999;19:475–505.
[5]. R. de Franchis. Revising consensus in portal hypertension: Report of the Baveno V consensus workshop on methodology of diagnosis and therapy in portal hypertension ; Journal of Hepatology 2010 vol. 53. 762–768..

Abstract: Introduction: Fibroscan allows non-invasive study of liver fibrosis and has recently been proposed in the follow-up of patients treated with methotrexate (MTX) in the long term for chronic inflammatory diseases. The purpose of this study is to evaluate by Fibroscan the degree of liver fibrosis induced by MTX in patients with various inflammatory diseases, comparing patients who received MTX to those naive or at the beginning of treatment. Materials and methods: This is a prospective, descriptive and analytical study carried out in the gastroenterology, dermatology and rheumatology departments of Hassan II university hospital center, Fés-Morocco, from January 2011 to December 2012, including all adult patients who received different cumulative doses of MTX being explored........

Keywords: Fibroscan, liver fibrosis, methotrexate, chronic inflammatory diseases. The authors disclose no conflict of interest.

[1]. Tolman KG, Clegg DO, Lee RG, Ward JR. Methotrexate and the liver. J Rheumatol.1985;12(suppl):29-34.
[2]. van de Kerkhof PCM, Hoefnagels WH, van Haelst JG, Mali JW. Methotrexate maintenance herapy and liver damage in psoriasis. Clin Exp Dermatol. 1985;10:194-200.
[3]. Kremer JM, Alarcon GS, LightfootRWJr, et al, for the American College of Rheumatology. Methotrexate for rheumatoid arthritis: suggested guidelines for monitoring liver toxicity. Arthritis Rheum. 1994;37:316-328.
[4]. Erickson AR, Reddy V, Vogelgesang SA, West SG. Usefulness of the American College of Rheumatology recommendations for liver biopsy in methotrexate-treated rheumatoid arthritis patients. Arthritis Rheum. 1995;38:1115-1119.
[5]. Laharie D, Zerbib F, Adhoute X, Boue-Lahorgue X, Foucher J,Castera L, Rullier A, et al. Diagnosis of liver fibrosis by transient elastography (FibroScan) and noninvasive methods in Crohn's disease patients treated with methotrexate. Aliment Pharmacol Ther 2006;23:1621—8.

Abstract: Background: Polycystic ovary syndrome is the commonest endocrine disorder in women of reproductive age. It affects round 4-9% of women in reproductive age. Aim of the Work: to investigate the effect of pyridostigmine on the ovulation rate in clomiphene resistance PCOS women. Patients and Methods: This clinical trial was conducted on 246 women with clomiphene resistant polycystic ovarian syndrome at Ain-Shams University Maternity Hospital on the period from November 2014 till August 2018. Each woman received clomiphene citrate 100 mg orally from day 3 until day 7. In addition to the clomiphene citrate, each patient received pyridostigmine, 60mg twice daily orally...........

Keywords:pyridostigmine, ovulation rate, clomiphene citrate, polycystic ovary syndrome

[1]. Homburg R (2002) What is polycystic ovarian syndrome? A proposal for a consensus on the definition and diagnosis of polycystic ovarian syndrome. Hum Reprod;17:2495-9.
[2]. Rotterdam ESHRE/ASRM – Sponsored PCOS consensus Workshop Group (2004) Revised 2003consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Hum. Reprod; 19:41-47.
[3]. ESHRE Capri Workshop (1997) Female infertility: treatment options for complicated cases. Hum. Reprod;12: 1191–1196.
[4]. Brown J, Farquhar C, Beck J, Boothroyd C, Hughes E (2009) Clomiphene and anti-oestrogens for ovulation induction in PCOS. Cochrane Database Syst Rev. 2009;4:CD002249.
[5]. Ernest Hung Yu Ng, Nelson Ming Sun Wat and Pak Chung Ho (2001) Effects of metformin on ovulation rate, hormonal and metabolic profiles in women with clomiphene-resistant polycystic ovaries: a randomized, double-blinded placebocontrolled trial. Hum Reprod ;16:8:1625–1631...

Abstract: Background & Objectives: Awareness about infections transmitted through endoscopes is increasing. Every incident is due to a breach in cleaning and disinfection protocol. No study in India evaluated the bio burden on endoscopes and the effectiveness of cleaning and disinfection of endoscopes. Methods: A cross-sectional study, 30 endoscopes (20 gastroscopes and 10 colonoscopes) were conveniently sampled at the department of gastroenterology in a tertiary care center in Coimbatore. Sterile water flushed through the suction biopsy channel - after use, post water cleaning, post manual cleaning and post disinfection - were collected for microbiological analysis.........

Key Words: Bio burden, cleaning, disinfection, endoscope reprocessing. *CFU/ml – Colony Forming Units / ml

[1]. Bond WW, Ott BJ, Franke KA, McCracken JE. Effective Use of Liquid Chemical Germicides on Medical Devices: Instrument Design Problems. In: Block SS, editor. Disinfection, Sterilization, and Preservation. 4th ed. Philadelphia: Lea & Febiger; 1991: 1097–1106.
[2]. Favero MS, Bond WW. Chemical disinfection of medical and surgical materials. In: Block SS, ed. Disinfection, sterilization, and preservation. Philadelphia: Lippincott Williams & Wilkins, 2001:881-917.
[3]. Rutala WA, Weber DJ, the Healthcare Infection Control Practices Advisory Committee (HICPAC). Guideline for disinfection and sterilization in healthcare facilities, 2008. Available at: http://www.cdc.gov/hicpac/Disinfection_Sterilization/3_0disinfectEquipment.html. Accessed December 30, 2015.
[4]. Alfa MJ, Sitter DL. In-hospital evaluation of orthophthalaldehyde as a high level disinfectant for flexible endoscopes. J. Hosp. Infect. 1994;26:15-26.
[5]. Chu NS, McAlister D, Antonoplos PA. Natural bioburden levels detected on flexible gastrointestinal endoscopes after clinical use and manual cleaning. Gastrointest. Endosc. 1998; 48: 137–42..

Abstract: Le leiomysarcome des cavités nasales est une entité très rare.Moins de 100 cas ont été rapportés dans la littérature.C'est est une tumeur mésenchymateuse agressive développée à partir des muscles lisses et ne représentepas plus de 7% des sarcomes des tissus mous.Les principaux sites d'origine sont l'utérus, la peau, et le rétro-péritoine.Nous présentons un cas de léiomyosarcome intéressant la cavité nasale. Les caractéristiques cliniques, radiologiques et histo-pathologiques, ainsi que les options thérapeutiques sont discutées.

[1]. Fletcher CDM, Bridge JA, Hogendoorn PCW, Mertens F. World Health Organisation Classification of tumours of soft tissue and bone. 4. Lyon: IARC Press; 2013.

[2]. Dr. Pete S. Batra,, Dr. Robert C. Kern, Dr. Harold J. Pelzer, Dr. G. Kenneth HainesLeiomyosarcoma of the Sinonasal Tract: Report of Case, Scientific Poster Session at the Annual Meeting of the American Academy of Otolaryngology-Head and Neck Surgery, Washington, DC, September 2000.

[3]. DOBBEN GD.Leiomyosarcoma of the nasopharynx, AMA Arch Otolaryngol. 1958 Aug;68(2):211-3.

[4]. Kahn J, Korol H. Pathologic quiz, case 2.Arch Otolaryngol Head Neck Surg. 1989;115-117.
[5]. Alexander Kuruvilla, ; Bruce M. Wenig,; David M. Humphrey, ; et alDennis K. Heffner, Leiomyosarcoma of the Sinonasal TractA Clinicopathologic Study of Nine Cases , Arch Otolaryngol Head Neck Surg. 1990;..