iosr-JDMS   Volume-18 ~ Issue-5 ~ May-2019

Abstract: Ankylosing spondylitis (AS) is a chronic inflammatory immune-mediated arthritis belongs to the so called group of axial spondylarthritis (SPA) (1).Considerably, the onset of the disease occurs in patients between the third and the fourth decade of life, and if not treated effectively it can lead to disability in about third of the patients (2–6). The pathogenesis of AS is multifactorial and results from a complex interplay between genetic predisposition and environmental triggers (7)HLA B27, from its discovery in 1973,(8) represents the central genetic factor related to disease etiopathogenesis. However, about 10-20% of defined AS patients were HLA B27 negative(9).We aimed in this review to assess the role of different factors contribute to the outcome of the disease.

Keywords : Ankylosing Spondylitis, Spondyloarthropathy, HLA B27

[1]. Garcia-Montoya L, Gul H, Emery P. Recent advances in ankylosing spondylitis: understanding the disease and management. F1000Research. 2018;7(0):1512.
[2]. Raine C, Keat A. Axial spondyloarthritis. Med (United Kingdom) [Internet]. Elsevier Ltd; 2018;46(4):231–6. Available from: http://dx.doi.org/10.1016/S0140-6736(16)31591-4
[3]. Rudwaleit M, Van Der Heijde D, Landewé R, Akkoc N, Brandt J, Chou CT, et al. The Assessment of SpondyloArthritis international Society classification criteria for peripheral spondyloarthritis and for spondyloarthritis in general. Ann Rheum Dis. 2011;70(1):25–31.
[4]. Raychaudhuri SP, Deodhar A. The classification and diagnostic criteria of ankylosing spondylitis. J Autoimmun. 2014;48–49:128–33.

Abstract: gall bladder stone is a rare finding in children. This report on the male infant who complained of vomiting since the first day of his life while he was on exclusive breastfeeding, also it is the first case reported in Benghazi medical center in Libya. It diagnosed by USS. With use of diagnostic USS, neonatal cholelithiasis may more common than previously suspected.

Key Words: Gallbladder stone, Infant, Cholelithiasis, USS.

[1]. Chabchoub I, Bouraoui A, Maalej B, Aloulou H, Mahfoudh A, Kamoun T, Hachicha M. Cholelithiasis in children: A single centre experience. Arab Journal of Gastroenterology. 2010; 11(4):215-8.
[2]. Brown DL, Teele RL, Doubilet PM, DiSalvo DN, Benson CB, Van Alstyne GA. Echogenic material in the fetal gallbladder: sonographic and clinical observations. Radiology. 1992; 182(1):73-6.

[3]. Agnifili A, Verzaro R, Carducci G, Mancini E, Gola P, Marino M, Tollis G, Rizzo FM, Criscione S. Fetal Cholelithiasis: a prospective study of incidence, predisposing factors and ultrasonographic and clinical features. ClinPediatr (Phila). 1999;38:371–3. doi: 10.1177/000992289903800610.

[4]. Palasciano G, Portincasa P, Vinciguerra V, Velardi A, Tardi S, Baldassarre G, Albano O. Gallstone prevalence and gallbladder volume in children and adolescents: an epidemiological ultrasonography survey and relationship to body mass index. Am J Gastroenterol. 1989; 84:1378–82. [5]. Gilger MA. Cholelithiasis and cholecystitis. In: Wyllie R, Hymas JS, eds. Pediatric Gastrointestinal Disease. Philadelphia:W.B. Saunders Co. 1993; pp.: 931–940

Abstract: Background: The immature brain seems more prone to seizures than the more mature brain. Seizures are more common in the neonatal period than during any other time throughout life. Seizures in the neonatal period are also the most common neurological emergency and are associated with high mortality and morbidity Objectives: To find out the clinical profile of seizures in neonates admitted in a Tertiary care hospital. Materials and Methods: The study was......

[1]. Mark S. Scher. Neonatal Seizures.In H. William Taeusch, Roberta A. Ballard and Christine A.Gleason. Avery's Disease of the Newborn. 8th Edition.P1005-1025.
[2]. BERG A, JALLON P, PREUX P. The epidemiology of seizure disorders in infancy and childhood: definitions and classifications. In: O Dulac et al (Eds), Handbook of Clinical Neurology. Pediatric Neurology, Part 1 (3rd edition), pp 381-398. Elsevier, Amsterdam, Netherlands, 2013.
[3]. Alcover-Bloch E, Campistol J, Iriondo-Sanz M. Neonatal seizures, our experience. Rev Neurol. 2004; 38:808–812
[4]. Malik AR, Quddusi AI, Naila. Neonatal seizures, experience at Children Hospital and Institute of Child Health Multan. Pak J Med Sci 2013; 29(5):1128-1131
[5]. Sabzehei MK, Basiri B, Bazmamoun H. The Etiology, Clinical Type, and Short Outcome of Seizures in Newborns Hospitalized in Besat Hospital/ Hamadan/ Iran. Iran J Child Neurol. 2014 Spring 8(2):24-28...

Abstract: Aim:- Urolithiasis is a global phenomenon. Accurate determination of a urolith yields fundamental information on calculogenesis, choosing treatment modalities and preventing recurrences. Integrated petro logical analysis provide the necessary signature for certainty and composition of a urolith. Methodology:- Urinary calculi have been analyzed and studied by different techniques with diverse merits and demerits. Uroliths are stones with crystalline and non-crystalline components. Petro logical analysis yield more information texture mineralogical features and greater accuracy in knowing the composition of urinary calculi. Result: - Chemical spot test" showed 2% error in detecting calculi components. Petro logical assessment by X-ray diffraction based.......

Key words: - Urolith, Urinary calculi, Petrography, X-ray diffraction, Chemical spot test, Polarized transmission Microscopy, Moh's Hardness Scale.

[1]. Winer, J.H and Mattice, M.R. : Routine analysis of Urinary calculi, rapid , simple method using spot test. J.Lab & Clin. Med , 28:898-904;1943. Quoted by Beeler et al 1964.
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Abstract: Background: Oral antihyperglycemic drugs are integral for glycemic control in diabetes. Non-adherence to drugs can alter blood glucose levels, resulting in complications. Adherence to oral antihyperglycemic drugs reported by diabetes patients were explored. Methods: This cross-sectional study was done among type II diabetes mellitus patients attending the General Medicine OPD of GGH, Vijayawada,AP. Consecutive patients were selected,data regarding their medication adherence was collected using a questionnaire. Data analysis was carried out using SPSS-20. The t test was performed to examine the associations between categorical variables; a P Value < 0.05 was considered significant. Results: A total of 100 patients participated in the study (21% males; 79% females). The mean age (standard deviation) of the respondents was 52 years (SD 0.77). The self-reported.......

Key words: diabetes mellitus, Glycemic control, oral antihyperglycemic drugs, patient adherence, questionnaire.

[1]. Guariguata L, Nolan T, Beagley J, Linnenkamp U, Jacqmain O. IDF Diabetes Atlas Federation, International Diabetes Federation 6th Edn,2013
[2]. Jared Diamond.Diabetes in India. N AT U R E 2 7 Januar y 2 0 1 1 ; 4 6 9: 4 7 8,4 7 9.
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[4]. Gottlieb H. Medication nonadherence: finding solutions to a costly medical problem CME. Drug Benefit Trends 2000;12:57–62.
[5]. Zoungas S, Chalmers J, Ninomiya T, et al. Association of HbA1c levels with vascular complications and death in patients with type 2 diabetes: evidence of glycaemic thresholds. Diabetologia 2012;55:636–43.

Abstract: Diabetes education and lifestyle modification are critical components in controlling blood glucose levels of people with diabetes mellitus. Despite abundant study focused diabetic epidemiology and its complications, very few studies in Bangladesh emphasis the role of structured diabetic education and its effect on glycemic control. To observe the impact of structured diabetic education on achieving glycemic control in patient with uncontrolled Diabetes Mellitus admitted in tertiary care hospital. The interventional study was carried out from September 2017 to August 2018, following ethical approval at the in-patient department of Endocrinology, BIRDEM General Hospital, Dhaka. Total 100 adult diabetic population of all socioeconomic strata admitted in the study sit. The study............

Key words: Diabetes education, epidemiology, intervention group, self-management.

[1]. Holt, R.I.G. et al. (2017). Textbook of Diabetes. 5th Ed. West Sussex: Blackwell Publishing Ltd.
[2]. AADE7 Self-Care Behaviors American Association of Diabetes Educators (AADE) Position Statement Issued December 3, 2014.
[3]. Islam, M. R. (2017). "Association between Socio-Demographic Factors and Blood Sugar Levels in Type 2 Diabetes Mellitus Patients in Bangladesh‟, Journal of Diabetes Mellitus. 07. pp. 151–159.
[4]. Wild, S. et al. (2004). Global Prevalence of Diabetes: Estimates for the year 2000 and projections for 2 030. Diabetes Care .27.pp.1047-1053.
[5]. Latif Z., Jain, A. and Rahman, M. (2011). Evaluation of management, control, complications and psychosocial aspects of diabetics in Bangladesh: DiabCare Bangladesh 2008. Bangladesh Med Res Counc Bull. 37.pp.11-16.

Abstract: Introduction: Computed Tomography (CT) has been found to be extremely useful in the diagnosis and treatment of renal masses. It provides an accurate morphologic picture of the renal mass. The precise contrast resolution makes identification of the characteristic attenuation values possible. Renal Cell Carcinoma (RCC) is the most common malignant tumour of the kidney, accounting for 85% -90% of adult renal malignancies, and 1% -2% of all malignancies. Although radical surgery remains the only efficient and curative treatment both in localized and advanced RCC, surgical techniques have evolved over the years. Materials and Methods: This study was carried........

Keywords: Computed Tomography, renal masses, RCC

[1]. Bajwa RPS, Sandhu P, Aulakh BS, Sandhu JS, Saggar K, Ahluwalia A. Helical CT Evaluation of Renal Mass Lesions: A Prospective Study. Jiacm 2007;8(3):262-4.
[2]. Hatimota P, Vashist S, Aggarwal K, Kapoor A, Gupta NP. Spectrum of US and CT findings in renal neoplasms with pathological correlation. Ind J Radiol Imag 2005;15:1:117-25.
[3]. Lindblad P. Epidemiology of renal cell carcinoma. Scand J Surg. 2004;93(2):88-96.
[4]. Lipworth L, Tarone RE, McLaughlin JK. The epidemiology of renal cell carcinoma. J Urol. 2006 Dec;176(6 Pt 1):2353-8.
[5]. Ng CS, Wood CG, Silverman PM, Tannir NM, Tamboli P, Sandler CM. Renal cell carcinoma: diagnosis, staging, and surveillance. AJR Am J Roentgenol. 2008 Oct;191(4):1220-32. doi: 10.2214/AJR.07.3568

Abstract: Background: Average length of stay(ALS) is used to assess efficiency, hospital resource utilisation and quality of care. Hospital utilisation statistics play an important role in managerial operation and one of the main indicators is length of stay. Objective: To determining the factors responsible for the prolonged hospital stay and to find out remedies to reduce prolonged hospital stay. Methodology: This study was a hospital based prospective cross sectional study conducted from April 2018 to September 2018 in Department of Paediatrics and Neonatology, Rajendra Institute of Medical Sciences, Ranchi. In this study, 357 patients are categorised........

Keywords: ALS.

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[2]. Tuthill DP. A survey of neonatal nutrition policies and practices in the UK and Eire. Matern Child Nutr 2007; 3(2): 120-8.

[3]. Kliegman RM, Stanton B, Geme JS, Schor N, Behrman RE. Nelson Textbook of Pediatrics: Ex- pert Consult Premium Edition - Enhanced Online Features and Print. Philadelphia: Elsevier - Health Sciences Division; 2011.

[4]. Digiovine B, Chenoweth C, Watts C, Higgins M. The attributable mortality and costs of primary nosocomial bloodstream infections in the intensive care unit. Am J Respir Crit Care Med 1999; 160(3): 976-81.

[5]. Altimier L, Eichel M, Warner B, Tedeschi L, Brown B. Developmental care: changing the NICU physically and behaviorally to promote patient out- comes and costs. Neon Intens C 2004; 17(2): 35-9.

Abstract: Serum Total Amylase (TA) is a biomarker routinely used for the diagnosis of acute pancreatitis. In Chronic Kidney Disease (CKD), due to the gradual loss of renal function there may be increased serum Total Amylase, thus making the interpretation difficult. Our aim wasto compare serum total amylase levels in CKD patients with healthy controls and to assess the serum total amylase levels in different stages of CKD. A cross sectional observational study was planned to estimate the serum Total amylase obtained by IFCC recommended enzymatic colorimetric method........

Keywords: CKD, e-GFR, MDRD, Pancreatitis, Total Amylase

[1]. Singh AK, Farag YMK, Mittal BV, Subramanian KK, Reddy SRK, Acharya VN, et al. Epidemiology and risk factors of chronic kidney disease in India - results from the SEEK (Screening and Early Evaluation of Kidney Disease) study. BMC Nephrol. 2013 May 28;14:114.
[2]. Matull WR. Biochemical markers of acute pancreatitis. J Clin Pathol [Internet]. 2006 Apr 1 [cited 2018 Oct 5];59(4):340–4. Available from: http://jcp.bmj.com/cgi/doi/10.1136/jcp.2002.002923
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Abstract: The phase of provisional restoration can be the most challenging aspect of implant dentistry. There are various options available today ranging from removable, tooth-supported provisional restorations to implant retained provisional restorations. The selection of the type of provisional prosthesis should be based on esthetic demands, functional requirements, duration, and ease of fabrication. This article gives a simpler technique using an arch bar retained fixed provisional / interim prosthesis after implant therapy in long span edentulous areas in cases of delayed loading.

Keywords: Long span edentulous area, Arch bar, Provisional / interim prosthesis

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[2]. Buser D, Mericske-Stern R, Bernard JP, Behneke A, Behneke N, Hirt HP et al. Long-term evaluation of non-submerged ITI implants. Part 1: 8- year life table analysis of a prospective multicentre study with 2359 implants. Clin Oral Implants Res 1997; 8: 161-172.

[3]. Wang WCW, Hafez TH, Almufleh AS, Ochoa-Durand D, Manasse M, Stuart J Froum, et al. A Guideline on Provisional restorations for patients undergoing implant treatment. J Oral Bio.2015;2(2):7.

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[5]. Resantosa. Provisional restoration options in implant dentistry. Australian Dental Journal 2007; 52 :( 3):234-242

Abstract: Unfortunately type 2 diabetes mellitus has its limitation particularly in its focus on severity and phenotype rather than etiology and genotype. Two sub-groups of patients are currently distinguished by presence of obesity. A new kind of body habitus is found to have type 2 diabetes mellitus whose BMI is <20.25. 120 cases of type 2 diabetes mellitus (40 cases of lean; 40 cases of non-obese, 40 cases of obese) were selected from ambulatory patients attending Medicine outpatient department and admitted patients in the medicine wards from September 2017 to August 2018. 30 (75%) cases of lean, 34 (85%) cases of non-obese and 36 (90%) cases of obese responded in treatment with oral hypoglycemic agents, and 10 (25%) cases of lean, 4 (10%) cases of non-obese and 2(5%) case responded with insulin therapy, whereas only 2 (5%) case each of non-obese and obese responded with dietary restrictions at the initiation of present study. No lean patient responded with dietary restriction alone.

Keywords: Diabetes mellitus, lean type 2 diabetes mellitus, obese, non-obese

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Abstract: Aim: Stroke is a major cause of morbidity and mortality worldwide. Currently, non-contrast computerized tomography scan remains the primary imaging modality for the initial evaluation of patients with suspected stroke. This study aims to document the Computerized tomography (CT) findings, pattern and the demographic features of stroke in Ado-Ekiti, South-Western Nigeria. Materials and Methods: We retrospectively reviewed CT findings of 56 patients with clinical diagnosis of stroke who presented at a private diagnostic facility in Ado-Ekiti over a period of 1 year. The demographic and clinical data as well as the CT findings were recorded.....

Keywords: Computerized tomography, stroke, hemorrhage, infarction, Ado-Ekiti

[1]. Beauchamp Jr NJ, Barker PB, Wang PY, Zijt PCv. State of the Art-Imaging of Acute Cerebral Ischemia-This State of the Art describes the central role of the radiologist and neuroimaging in the diagnosis and subsequent management of acute. Radiology-Radiological Society of North America. 1999;212(2):307-324.
[2]. Kumar V, Abbas AK, Fausto N, Aster JC. Robbins and Cotran pathologic basis of disease. Philadelphia: Elsevier Saunders; 2005.
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[4]. Eze C, Okaro A, Ohagwu C. Pattern of computed tomography findings in cerebrovascular accident patients in south eastern Nigeria–a retrospective study of 480 patients. Eur J Sci Res. 2009;34:104-109.
[5]. Mullins ME. Modern emergent stroke imaging: pearls, protocols, and pitfalls. Radiologic Clinics. 2006;44(1):41-62.

Abstract: Musculoskeletal pathologies in children are many, and they affect lives as well as overall development of children. These pathologies can be amenable to medical and surgical interventions and may be prevented. Assessing and documenting the musculoskeletal pathologies in children leading to admission in a tertiary hospital is the focus of this study. It is intended that this study and documentation will be useful in providing new information concerning the treatment approaches in order to promote the health of those affected and improve health services. Medical records of children 16years and under that were admitted into the pediatricorthopedic ward of ESUT Teaching Hospital, Enugu were........

Keywords: Musculoskeletal pathology, PediatricOrthopedics, trauma, Tertiary Hospital

[1]. Wolf A.D, Pfleger B. Burden of major musculoskeletal condition. Bulletin of the world health organization. 2003: 81(9):646-56.
[2]. Gunz A C, Canizares M, Mackay C, Badly EM Magnitude of impact and health care use for musculoskeletal disorders in the pediatric: A population based study. Bmc musculoskeletal Disorder. 2012; 13:98.
[3]. Brooks P M. The burden of musculosketal disease – a global perspective. In. Rheumatol. 2006; 25(6): 778-781. Doi: 10.1007/5 10067-0240-3.
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Abstract: In India, medical students are still undergoing old methods of examination. There is a need to improve the examination methods for the medical students, taking into consideration the perception of the students. We conducted this study, to evaluate and compare different Examination methods among Medical students and find out the best examination method. This study was done on 140 medical students of third semester, of age 18-20 years. The study subjects were given a common questionnaire to fill, about various Examination methods in Pharmacology and the results were analyzed. Thirty eight percent of the students have accepted Essay questions, short questions and Multiple choice questions as the questions in their examination pattern. From this study, it is concluded that certain modifications must be done compulsorily in our current pattern of examinations as most of the students were having the same opinion. Introduction of MCQs and removal of too many essay questions are some of the modifications which are necessary.

Keywords: Examination methods, short questions, Multiple choice questions, Essay questions

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