iosr-JDMS   Volume-18 ~ Issue-7 ~ July-2019

Abstract: Scrub typhus usually presents as a febrile illness, but sometimes it can present with dysfunction in other organs. A rare case of scrub typhus reported with bilateral subconjunctival haemorrhages. The patient improved with intravenous fluids, antibiotics, and supportive management.

[1]. Rajapakse S, Rodrigo C , Fernando D. Scrub typhus: pathophysiology, clinical manifestations and prognosis. Asian Pacific Journal of Tropical Medicine 2012;5(4):261-264.
[2]. Rajapakse S, Weeratunga P, Sivayoganathan S, Fernando SD. Clinical manifestations of scrub typhus. Trans R Soc Trop Med Hyg 2017; 00: 1–12.
[3]. Rapsang AG, Bhattacharyya P. Scrub typhus. Indian J Anaesth 2013; 57(2): 127–134.

Abstract: Introduction: Traumatic brain injury (TBI) is one of the most devastating types of injury. It affects all ages; however majority of road traffic injuries (RTI) occurs in young adults of productive age group. As per report by the ministry of road transport, Government of India (2007) 1.4 lakhs road accident happened in 2007 with 40,612 people killed and 1.5 lakhs people injured. Hence, India is leading the world in fatalities due to road accidents. TBI is also associated with significant socioeconomic losses in India as well as in other developing countries. Materials and Methods: The prospective study was conducted over a period of 24 months from July 2016 to June 2018 in Department.......

Keywords: Traumatic brain injury, Glasgow Coma Score,

[1]. Waxman K, Sundine MJ, Young RF. Is early prediction of outcome in severe head injury possible? Arch Surg. 1991;126:1237–42.
[2]. Gaddis GM, Gaddis ML. Non-normality of distribution of Glasgow Coma Scores and revised Trauma Scores. Ann Emerg Med. 1994;23:75–80.
[3]. Graham DI, Saatman KE, Marklund N. The neuropathology of trauma. In: Evans RW, editor. Neurology and Trauma. 2nd ed. Oxford: New York; 2006. pp. 45–94.
[4]. Mushkudiani NA, Engel DC, Sterberg EW, Butcher I, Juan LU, Marmarou A, et al. Prognostic values of Demographic Characteristics in Traumatic Brain Injury: Results from the IMPACT study. J Neurotrauma. 2007;24:259–69.
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Abstract: Introduction: Vestibular schwannomas manifest with very serious deficits of hearing, facial expression, lower cranial nerve, cerebellar and brain stem functions either preoperatively or as a consequence of surgical intervention. Our objective was to analyze the symptomatology and clinical signs and try to correlate with postoperative outcome and complications in the setting of limited infrastructure, therapeutic and monitoring aids and multi-surgeon involvement with varied spectrum of surgical expertise in a single large tertiary teaching institute. Materials and Methods: A retrospective analysis was done using available discharge summary database. Clinical assessment was........

Keywords: Vestibular schwannomas , Suboccipital craniectomy

[1]. Roehm PC, Gantz BJ. Management of acoustic neuromas in patients 65 years or older. Otol Neurotol. (2007) 28:708-14.
[2]. Nuseir A, Sequino G, De Donato G, Taibah A, Sanna M. Surgical management of vestibular schwannoma in elderly patients. Eur Arch Otorhinolaryngol. (2012) 269:17-23.
[3]. van de Langenberg R, Hanssens PE, Verheul JB, van Overbeeke JJ, Nelemans PJ, Dohmen AJ, et al. Management of large vestibular schwannoma. Part II. primary gamma knife surgery: radiological and clinical aspects. J Neurosurg. (2011) 115:885–93.
[4]. Mahboubi H, Sahyouni R, Moshtaghi O, Tadokoro K, Ghavami Y, Ziai K, et al. CyberKnife for treatment of vestibular schwannoma: a meta-analysis. Otolaryngol Head Neck Surg. (2017) 157:7–15.
[5]. Yang HC, Kano H, Awan NR, Lunsford LD, Niranjan A, Flickinger JC, et al. Gamma knife radiosurgery for larger-volume vestibular schwannomas: clinical article. J Neurosurg. (2013) 119(Suppl.):801–7.

Abstract: This hospital based study was conducted to determine the profile of patients coming to the general surgery outpatient department (OPD) of a tertiary care hospital. Demographic details, morbidity profile, investigations done, treatment rendered and the clinical outcomes of patients were evaluated. The difference in the rate of employment between male and female patients was statistically highly significant (X2=45.04, p<0.01). Abdominal pain was the main presenting symptom with 13 (11.82%) of the patients presenting with burning epigastric pain, 11 (10%) with.......

Keywords: Morbidity Profile, General Surgery Ward, Treatment Outcome, Complications

[1]. Jawaid M., Ahmed N., Alam S.N., Rizvi B.H., Razzak H.A., Patients Experiences and Satisfaction from Surgical Out Patient Department of a Tertiary care teaching hospital. Pak J Med Sci 2009;25(3):439-442.
[2]. Shankar R.P., Sen P.K., Upadhyay D.K., Dubey A.K., Subish P., Drug utilization among surgical outpatients, Timisoara Medical Journal 2006, Vol. 56, No. 2-3, 230-234
[3]. Lundgren A., Jorfeldt L., Ek AC., The care and handling of peripheral intravenous cannulae on 60 surgery and internal medicine patients: an observation study, Journal of Advanced Nursing, Volume 18, Issue 6, Pages: 855-1010.
[4]. Harbarth S., Fankhauser C., Schrenzel J., et al, Universal Screening for Methicillin-Resistant Staphylococcus aureus at Hospital Admission and Nosocomial Infection in Surgical Patients, JAMA. 2008;299(10):1149-1157. doi:10.1001/jama.299.10.1149
[5]. Umpierrez G.E., Isaacs S.D., Bazargan N., You X., Thaler L.M., Kitabchi A.E., Hyperglycemia: An Independent Marker of In-Hospital Mortality in Patients with Undiagnosed Diabetes, The Journal of Clinical Endocrinology & Metabolism, Volume 87, Issue 3, 1 March 2002, Pages 978–982, https://doi.org/10.1210/jcem.87.3.8341.

Abstract: Gestational gigantomastia (GG) or gravidic macromastia is a rare, severely debilitating condition characterized by massive enlargement of breasts and resulting in tissue necrosis, ulceration, infection, and, occasionally, haemorrhage. We herein report the anaesthetic management of a parturient presenting with GG, scheduled for caesarean section under single shot spinal anaesthesia. Although there is no reference in the literature regarding the anaesthetic considerations in gigantomastia, several implications must be considered, including the reduced chest wall compliance and reduced lung volumes, the increase in work of breathing, minute ventilation, and oxygen consumption. The increase in intrathoracic pressure caused by higher inspiratory pressure can impair ventricular filling and cardiac output. Moreover, breast enlargement predisposes the obstetric patient to.......

Keywords: gestational gigantomastia, caesarean section, single shot spinal anaesthesia

[1]. Mangla M, Singla D. Gestational Gigantomastia: A Systematic Review of Case Reports. J Midlife Health. 2017 Jan-Mar;8(1):40-4. [2]. Dancey A, Khan M, Dawson J, Peart F. Gigantomastia- A classification and review of the literature. J Plast Reconstr Aesthet Surg. 2008;61:493-502.

[3]. Swelstad MR, Swelstad BB, Rao VK, Gutowski KA: Management of gestational gigantomastia. Plast Reconstr Surg 2006; 118:840 – 848.

[4]. Gomez-Rios MA, Nieto-Serradilla L, Kuczkowski KM, Couceiro Naveira E. Gestational gigantomastia and anesthesia. Anesthesiology 2012 Jan;116(1):193.

[5]. Lewison EF, Jones GS, Trimble FH, da Lima LC. Gigantomastia complicating pregnancy. Surg Gynecol Obstet. 1960;110:215–23

Abstract: Background:Extrapulmonary tuberculosis is challenging because of its paucibacillary nature. As per WHO recommendations, Gene Xpert is an initial diagnostic test for these cases.Aim of this study to compare the FNAC findings of extrapulmonary tuberculosis with ZN stain and GeneXpert. Methodology:It's a prospective study with 151 cases of clinical suspicion of tuberculosis over a period of 12 months. FNA was done and material sent to TBCD Department for Gene Xpert and microscopy, ZN Stain was done in all cases, results were obtained.........

Keywords: EPTB, FNA, Gene Xpert, ZN Stain

[1]. World Health Organization. Global tuberculosis report 2014. Geneva: WHO; 2014.
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[5]. Sharma SK, Mohan A. Extrapulmonary tuberculosis. Indian J Med Res. 2004Oct;120(4):316-53. Review. PubMed PMID: 15520485..

Abstract: BACKGROUND: Deep Vein Thrombosis is one of the common and dreaded complication of joint replacements and spine surgeries. The incidence of DVT among these cases is significant in spite of the various prophylactic measure such as physiotherapy and pharmacological measures. Materials and methods: 110 cases of arthroplasty and spine cases are divided randomly into two groups, in one group only physical measures(group A) are employed while in the second group physical and pharmacological measures(group B) and evaluated by Doppler ultrasonography on 5th and 12th post-operative day and the results are analysed. Results:.......

[1]. D. Warwick,New conceptsin orthopaedic ThromboprophylaxisJ Bone Joint Surg [Br]2004;86-B:788-92.
[2]. Jay R. Lieberman and Wellington K. Hsuprevention of venous thromboembolic disease after total hip and knee J Bone Joint Surg Am. 87:2097-2112, 2005.
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Abstract: Rehabilitation of maxillofacial defect patients is a challenging task as there has been an increase in the acquired facial defects, resulting from cancer surgeries and automobile accidents leading to facial trauma. Nonetheless, the congenital facial defects also demand for facial rehabilitation. These defects may be restored by reconstructive surgery but many a times due to multiple surgical interventions and compromised esthetic outcome rehabilitation by prosthetic means is a chosen option. The most common prosthetic treatment problem with such patients is, getting adequate retention, stability, and support. In cases of maxillofacial defect, movement of the prosthesis is inevitable. The primary objectives in rehabilitating the maxillofacial defect patients are to restore the function of mastication, deglutition, speech, and to achieve normal orofacial appearance.

Keywords: Adhesive retained, Acquired Maxillofacial defect, Silicone

[1]. Beumer J, Curtis TA, Firtell DN. Maxillofacial Rehabilitation. Prosthodontic and Surgical Considerations. St. Louis, Toronto: C.V. Mosby Co.; 1979.p. 183‑243.
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[3]. Goiato MC, Fernandes AU, dos Santos DM, Barão VA. Positioning magnets on a multiple/sectional maxillofacial prosthesis. J Contemp Dent Pract 2007;8:101‑7.
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Abstract: Recurrent pregnancy loss is defined as 2 or more failed pregnancies confirmed by either sonographic or histopathologic examination (as per American Society for Reproductive Medicine, 2008). It is classically defined as 3 or more consecutive pregnancy losses at or < 20 weeks of gestational age or with a fetal weight < 500g. Approximately 1% of fertile couples have recurrent pregnancy losses. Most of these are embryonic or early fetal losses and the remainder either are anembryonic or occur after 14 weeks1. Recurrent pregnancy loss is associated with many putative causes, however only 3 are widely accepted (1) Parental chromosomal anomalies.......

[1]. Cunnungham FG, Leveno KJ, Bloom SL, Spong CY, Dashe JS, Hoffman BL, Sheffield JS. Williams Obstetrics. 24th ed.New York. McGraw- Hill.2014:358.
[2]. Rubio C, Simon C, Vidal F, Rodrigo L, Pehlivan T, Remohi J, Chromosomal abnormalities and embryo development in recurrent miscarriage couples. Hum Reprod.2003:18:182-8.
[3]. Chaithra PT, Malini SS, Kumar CS. An Overview of Genetic and Molecular Factors Responsible for Recurrent Pregnancy Loss. Int J Hum Genet. 2011;11(4): 217–25.
[4]. Giancotti A, La Torre R, Spagnuolo A, D'Ambrosio V, Cerekja A, Piazze J. Efficacy of three different antithrombotic regimens on pregnancy outcome in pregnant women affected by recurrent pregnancy loss. J Maternal-Fetal Neonatal Med. 2012;25(7):1191–4.
[5]. Empson M, Lassere M, Craig JC, Scott JR. Recurrent pregnancy loss with antiphospholipid antibody: a systematic review of therapeutic trials. Obstet Gynecol. 2002; 99:35-44...

Abstract: An ectopic pregnancy is the one in which the fertilized ovum becomes implanted in a site other than the normal uterine cavity. It is a consequence of an abnormal implantation of the blastocyst. The frequency with which ectopic pregnancy presents in the gynaecological departments of hospitals, the variations of its symptoms and signs and the intricacies in its diagnosis has made ectopic pregnancy both an interesting and a challenging problem. The most recent estimate by the CDC is 2%1, Ectopic pregnancy is one of the most common acute abdominal emergencies a gynaecologist has to meet in day to day practice.The incidence of ectopic pregnancy has risen in the past 20 years:.......

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[2]. Creanga AA, Shapiro-Mendoza CK,BishCL,ZaneS,Berg CJ, Callaghan WM. Trends in ectopic pregnancy mortality in the United States: 1980-2007.Obstetrics and Gynaecology 2011;117:837-43.
[3]. AkandeV,TurnerC,HornerP,etal.British Fertility Society.Impact of chlamydia trachomatis in the Reproductive setting: British Fertility Society Guidelines for practice.HumFertil(camb) 2010;13:115-125.
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[5]. Li C,Zhao W-H,Meng C-X,PingH,Qin G-J,Cao S-J et al.(2014) Contraceptive Use and the Risk of Ectopic Pregnancy: A Multi-Center Case-Control Study.PLOS ONE 9(12).

Abstract: Objective: One or two burr-hole craniotomies with subgaleal or subdural drainage system and irrigation are the most common methods for surgical treatment of chronic subdural hematoma. The aim of this study is to compare the advantages or disadvantages of these techniques used for chronic subdural hematoma. Material and methods: 50 patients were treated by burr-hole subdural drainage or subgaleal drainage system with irrigation. Our patients were classified into two groups according to the operative procedure as follows: Group I, two burr-hole craniostomies with subgaleal drain and irrigation , Group II, one burr-hole craniostomy with subdural closed drainage system without irrigation . We compared both the groups for post-operative clinical and surgical outcome.......

Keywords: Chronic subdural hematoma; subdural drainage; subgaleal drainage; Under water drain

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[3]. Mori K, Maeda M. Surgical treatment of chronic subdural hematoma in 500 consecutive cases: clinical characteristics, surgical outcome, complications, and recurrence rate. Neurol Med Chir (Tokyo) 2001;41:371–81.

[4]. Bender MB, Christoff N. Nonsurgical treatment of subdural hematomas. Arch Neurol. 1974;31:73–9.

[5]. Suzuki K, Sugita K, Akai T, Takahata T, Sonobe M, Takahashi S. Treatment of chronic subdural hematoma by closed-system drainage without irrigation. Surg Neurol. 1998;50:231–4..