iosr-JDMS   Volume-18 ~ Issue-8 ~ August-2019

Abstract: Regional anaesthesia for lower abdominal and lower limb surgeries is held generally to be safer than general anaesthesia. It avoids general anaesthesia related problems such as poly pharmacy, airway manipulation, misplacement of endotracheal tube, hypo or hyper ventilation, vomiting, pulmonary aspiration and metabolic complication. In this study, two groups each of 30 patientswere compared. GROUP B received INJ BUPIVACAINE 3.2 ML + 0.9% NORMAL SALINE 1 ML and GROUP L received INJLEVOBUPIVACAINE 3.2 ML + 25% DEXTROSE 1 ML. Parameters like onset and duration of sensory and motor block, highest level of sensory blockade, duration of analgesia, vitals and side effects were assessed. Our study concluded that the onset of motor block was faster, duration of motor as well as sensory block was longer and duration of analgesia was significantly prolonged in group B than in group L. Fall in systolic blood pressure was more common in group B but other haemodynamic parameters were comparable among both groups.

[1]. Casati A, Moizo E, Marchetti C, Vinciguerra F, et al. A prospective, randomized, double-blind comparison of unilateral spinal anesthesia with hyperbaric bupivacaine, ropivacaine, or levobupivacaine for inguinal herniorrhaphy.AnesthAnalg. 2004 Nov;99(5):1387-92.
[2]. Luck JF, Fettes PD, Wildsmith JA, et al. Spinal anaesthesia for elective surgery: a comparison of hyperbaric solutions of racemic bupivacaine, levobupivacaine, and ropivacaine. Br J Anaesth. 2008 Nov;101(5):705-10.
[3]. ÖzgürYagana, Nilay Tas, Ahmet Kücük, Volkan Hancı, et al. A comparison of different densities of levobupivacaine solutions for unilateral spinal anaesthesia. Rev Bras Anestesiol. 2014; 66(2): 157-64.
[4]. Lee YY, Ngan Kee WD, Fong SY, Liu JT, Gin T, et al. The median effective dose of bupivacaine, levobupivacaine, and ropivacaine after intrathecal injection in lower limb surgery.Anesthesia and Analgesia.2009; 109(4): 1331–4.
[5]. De Cosmo G, Mascia A, Clemente A,Congedo E, Aceto P. et al. Use of levobupivacaine for the treatment of postoperative pain after thoracotomies. Minerva Anestesiol2005 Jun; 71(6):347-51.

Abstract: Background: Cardiovascular diseases have become the leading cause of morbidity and mortality in India. Psychological factors are strongly associated with IHD, changing of which is known to have a positive influence on recovery. Negative affective states like anxiety and depression can have an impact on the pathogenesis of the physical disease. Understanding the psychosocial components post-IHD becomes very important for secondary prevention of IHD. Aim and Objectives: To study anxiety as a co-morbidity in Ischemic Heart Disease patients Material and Methods: Cross-sectional observational study at a tertiary care centre with institutional ethics committee approval.......

Keywords: Ischemic Heart Disease, Anxiety Disorders

[1]. Krantz DS, Schaeffer MA, Davia JE, et al. Extent of coronary atherosclerosis, type A behavior, and cardiovascular response to social interaction. Psychophysiology 1981; 18:654.
[2]. Rozanski A, Blumenthal JA, Kaplan J. Impact of psychological factors on the pathogenesis of cardiovascular disease and implications for therapy. Circulation 1999; 99:2192.
[3]. Theorell T, Lind E, Floderus B. The relationship of disturbing life-changes and emotions to the development of myocardial infarction and other serious diseases. Int J Epidemiol 1975; 4:281.
[4]. Whiteman MC, Deary IJ, Lee AJ, Fowkes FG. Submissiveness and protection from coronary heart disease in the general population: Edinburgh Artery Study. Lancet 1997; 350:541.
[5]. Jeenger, J., Wadhwa, S., Mathur, D.M. (2014) Prevalence of depression and anxiety symptoms in first attack myocardial infarction patients of mewar region: a cross sectional study. International Journal of Current Research and Review, 6:79-85..

Abstract: Aim: Fournier's gangrene is a fulminating form of infective necrotizing fasciitis of the perineal, genital or perianal regions which commonly affects men but can also occur in women and children. Case series have shown a mortality rate of 20% to 40% with an incidence of as high as 88% in some reports. This study was aimed to share my experience in the management of Fournier's gangrene and to identify the risk factors that affect mortality with a Grading system introduced. Method : The retrospective study was done on 64 patients with Fournier's gangrene who presented in Nalanda Medical College and Hospital and Anupama Nursing.....

Keywords: Fournier's gangrene, Necrotizing fasciitis, Mortality, Outcome

[1]. Baurienne H. Suruneplaiecohtuseques'estterminee par le spaceledc la scrotum J.MedChir Pharm 1764; 20: 251-6
[2]. Fournier J.A. Gangrene Foudroyante de la verge. Semaine Med 1883. 3:45-8
[3]. D.K. Rajan and K.A.Scharer, '' Radiology of Fournier Gangrene ''AJRVol 170; No. l 1998, pp 163-168
[4]. R.N. Uppot, H.M. Levy and P.H. Patel ''Forunier Gangrene'' Role of Imaging Radiogrophics, Vol 28, 2008 PP 519-528.
[5]. Paty R, Smith A.D. : Gangrene and Fournier's gangrene ebrol. Clin. North Am 1992,19 : 149-162

Abstract: Background : Pigmented lesions are stigmatic as they will catch the attention of the patient and the clinician likewise. Pigmented lesions can either present as hyperpigmented or hypopigmented lesions and they can also be either melanocytic or nonmelanocytic in origin. Hyperpigmented lesions are one of the most common presentations in a dermatology outpatient clinic. India, being a tropical country, exposure to sunlight and likewise UV radiation may result in development of hyperpigmented lesions. Hyperpigmented lesions can be classified as inflammatory, hamartomatous, benign and malignant. With the increasing age the risk for development of malignant lesions like malignant melanoma and basal cell carcinoma increases, where the presentation is usually as a hyperpigmented lesion over the exposed areas. Though hyperpigmented lesions can be identified and classified clinically by a dermatologist, histopathological evaluation is of utmost importance not only for confirming and classifying but for further evaluation of these lesions along with their treatment and clinical outcome..

Keywords: Basal cell carcinoma, Hyperpigmentation, lichen planus, Melanoma

[1]. Arakkal GKiran, Vani S, Kasetty HKumar, Varala S. Leprosy: An unusual presentation. International Journal of Medicine and Public Health. 2015;5(1):118-120
[2]. Edwards SL, Blessing K. Problematic pigmented lesions: approach to diagnosis. J Clin Pathol. 2000;53(6):409–418. doi:10.1136/jcp.53.6.409
[3]. Dr. Suvernakar. S. V , Dr. Shweta. R. Harwani , Dr. Deshpande. S. A Clinicopathological Study of Pigmented Skin Lesions IOSR Journal of Dental and Medical Sciences ,2014; 13 ( 5),pages 70-73
[4]. Ferrara G, Argenziano G, Soyer HP, Corona R, Sera F, Brunetti B, et al. Dermatoscopic and histopathologic diagnosis of equivocal melanocytic skin lesions: an interdisciplinary study on 107 cases. Cancer 2002;95:1094–100
[5]. Joanna Jaworek-Korjakowska and Paweł Kłeczek, "Automatic Classification of Specific Melanocytic Lesions Using Artificial Intelligence," BioMed Research International, vol. 2016, Article ID 8934242, 17 pages, 2016.

Abstract: • Tuberculosis (TB), one of the oldest diseases known affecting humans and is likely to have existed in pre hominids, is a major cause of death worldwide.
• This disease is caused Mycobacterium tuberculosis complex and usually affects the lungs, although other organs are involved in up to one-third of cases.
• If properly treated, TB caused by drug-susceptible strains is curable in virtually all cases. If untreated, the disease may be fatal within 5 years in 50–65% of cases.
• Corpulmonale, also referred to as pulmonary heart disease, is broadly defined by altered RV structure and/or function in the context of chronic lung disease and is triggered by the presence of pulmonary hypertension.........

[1]. Gandhi MJ. Corpulmonale and pulmonary hypertension. In: Shah SN, editor. API Text Book of Medicine. 7t h ed. Mumbai: The Association of Physicians of India, 2003, 487-490.
[2]. Kapoor SC. Corpulmonale in pulmonary tuberculosis: a preliminary report of 66 patients. Ind J Tuberc. 1959; 6(2):51-64.
[3]. White J, Bullock RE, Hudgson P, Gibson GJ. Neuromuscular disease, Respiratory failure and Corpulmonale. Postgraduate Med J. 1992; 68:820823.
[4]. John B, Pier G, Agaston. Corpulmonale. In: Murray Nadel, editor. Text Book of Respiratory Medicine. 2nd ed. Philadelphia: W.B Saunders Company. 1988; 2:1779-1798.
[5]. Newman JH. Chronic Corpulmonale. In: Fuster V, Alexander RW, O Rourke RA, Roberts R, King SR, Wellen HJJ, editors. Hurst's the Heart.10th ed. USA: McGraw Hill. 2001; 2:1645-1654

Abstract: Clinical diagnosis of abdominal masses remains a challenge to this day; in spite of the availability of advanced imaging facilities, we fail to reach a definitive diagnosis in a few cases and have to resort to a laparotomy, which reveals unexpected findings. Ovarian remnant syndrome (ORS) is a rare condition, in which the ovarian tissue is inadvertently left behind after difficult oophorectomy. The most common pre-existing conditions associated with this complication include endometriosis, pelvic inflammatory disease, and prior abdominal surgery; as in these conditions, removal of ovarian tissue becomes difficult. This is likely due to the presence of the dense fibrotic.............

Keywords: Exploratory laparotomy, intestinal obstruction, oophorectomy, ovarian remnant syndrome.

[1]. Shemwell RE, Weed JC. Ovarian remnant syndrome. Obstet Gynecol. 1970; 36:299‑303.
[2]. Lafferty HW, Angioli R, Rudolph J, Penalver MA. Ovarian remnant syndrome: Experience at Jackson Memorial Hospital, University of Miami. Am J Obstet Gynecol. 1996; 174:641‑5.
[3]. Kho RM, Abrao MS. Ovarian remnant syndrome: Etiology, diagnosis, treatment and impact of endometriosis. Curr Opin Obstet Gynecol. 2012; 24:210‑4.
[4]. Marconi G, Quintana R, Rueda‑Leverone NG, Vighi S. Accidental ovarian autograft after a laparoscopic surgery: Case report. Fertil Steril. 1997; 68:364‑6.
[5]. Dereska NH, Cornella J, Hibner M, Magrina JF. Mucinous adenocarcinoma in an ovarian remnant. Int J Gynecol Cancer. 2004; 14:683‑6.

Abstract: Diastemas are one of the most common forms of malocclusion seen frequently in the midst of the maxillary central incisors. Along with midline diastema, there can be generalized spacing in anterior teeth, especially in the maxillary arch. The etiology for the same is considered to be multifactorial. These spaces lead to an unpleasant smile, impairment of phonetics, and hindrance in maintaining oral hygiene. These can be managed either by surgical, orthodontic, periodontal, restorative, and prosthodontic procedures or by a combination of procedures to fulfill patient's esthetic and functional demands. This article presents a case of management of multiple diastemas with orthodontics, gingivectomy and veneers.

[1]. Foster TD, Grundy MC. Occlusal changes from primary to permanent dentitions. J Ortho. 1986; 13: 187–93.
[2]. Broadbent BH: The face of the normal child (diagnosis, development). Angle Orthod 1937; 7:183-208.
[3]. Adams CP: Relation of spacing of the upper central incisors to abnormal frenumlabii and other features of the dentofacial complex. Am Dent J.1954; 74:72-86.
[4]. Bernabe E, Flores-Mir C. Influence of anterior occlusal characteristics on self-perceived dental appearance in young adults. Angle Orthod. 2007;77:831e836
[5]. Huang WJ, Creath CJ. The midline diastema: a review of its etiology and treatment. Pediatr Dent.1995; 17: 171–9.

Abstract: The presence of any congenital hepatobiliary anomaly or the mere suspicion of its existence demands that we exercise surgical prudence, limit the use of electrocautery and ensure that no structure be divided until a clear picture of the bile ducts and blood vessels is obtained. If necessary, perform intraoperative cholangiogram to further define the biliary system. However, if the case remains unclear or if laparoscopy does not provide enough information, open surgery should be considered although it has many undesirable complications . We conducted a study 200 cases of cholelithiasis operated in our institute to determine the incidence of gallbladder and hepatobiliary anomalies . Patients underwent Ultrasound of abdomen, empty stomach and if needed, underwent triple phase CT or MRCP or both. Subsequently patients underwent open or laparoscopic cholecystectomy.

[1]. Bronshtein M, Weiner Z, Abramovici H, Erlik Y, Blumenfeld Z. Prenatal diagnosis of gallbladder anomalies. Report of 17 cases. Prenat Diagn. 1993;13(9):851-86l.
[2]. Mcilrath DC, Remine WH, Baggenstoss AM. Congenital absence of the gallbladder and cystic duct. JAMA. 1962;180:782-784
[3]. Fujita N, Shirai Y, Ohtani T, Tsukada K, Hirota M, Hatekeyama K. Junction of the cystic duct with the left hepatic duct: report of a case discovered during laparoscopic cholecys tectomy. Surg Laparosc Endosc. 1996;6(6):445-447.
[4]. MA Carbajo Caballero, JC Martin del Olmo, JI Blanco Alvarez, R Atienza Sánchez. Gallbladder and cystic duct absence. Surg Endosc. 1997; 11:483-484.
[5]. Ogawa T, Ohwada S, Ikeya T, Shiozaki H, Aiba S, Morishita Y. Left-sided gallbladder with anomalies of the intrahepatic portal vein and anomalous junction of the pancreatobiliary ductal system: a case report. Hepatogastroenterology. 1995;42(5):645-649.

Abstract: Spinal anaesthesia is a popular technic adopted but there are some drawbacks linked with spinal anaesthesia, pain at the puncture site, fear of needles,stress factors in operation room, block level mismatch, monitor sounds and recall of the procedure. The importance of sedation is that it offers analgesia, anxiolysis, and amnesia. Dexmeditomidine and propofol for moderate sedation are best during spinal anaesthesia. AIM: The objectives are to compare Intraoperative sedation, Intraoperative hemodynamic parameters , Intraoperative respiratory stability and side effects. METHODOLOGY: Study was approved by institutional medical ethics committee and written informed consent obtained from all patients participating in the study. 150 patients of ASA grade I ,II between 18-60 years age of both sexes undergoing various surgeries under.............

Keywords: Dexmeditomidine, propofol ,sedation, general anaesthesia

[1]. Laosuwan S, Pongruekdee S, Thaharavanich R.Comparison of effective-site target controlled infusion and manually controlled infusion of propofol for sedation during spinal anesthesia.J Med Assoc Thai. 2011 Aug;94(8):965-71
[2]. Arain SR(1), Ebert TJ.Anesth Analg. 2002 Aug;95(2):461-6, The efficacy, side effects, and recovery characteristics of dexmedetomidine versus propofol when used for intraoperative sedation
[3]. Mantan, Anita Pareek, Rashmi Jain, Anju Meena, Pramila Soni, and Aditi Sharma .COMPARATIVE EVALUATION OF DEXMEDETOMIDINE, PROPOFOL AND MIDAZOLAM FOR INTRAOPERATIVE SEDATION IN REGIONAL ANAESTHESIA Journal of Evolution of Medical and Dental Sciences, vol. 6, no. 75, 2017
[4]. Pratibha Jain Shah, Kamta Prasad Dubey, Kamal Kishore Sahare, and Amit Agrawal Intravenous dexmedetomidine versus propofol for intraoperative moderate sedation during spinal anesthesia: J Anaesthesiol Clin Pharmacol. 2016 Apr-Jun; 32(2): 245–249
[5]. Kshitija Bhagavan Savant*1, Harsha Patel2 and Vimal Patel3 Sedation during spinal anaesthesia: A comparison between Dexmedetomidine and midazolam infusion

Abstract: Introduction: Ischemic heart disease (IHD) is a condition in which there is an inadequate supply of blood and oxygen to a portion of the myocardium, it occurs if there is imbalance between myocardial oxygen supply and demand. The common cause of myocardial ischemia is atherosclerosis of epicardial coronary artery/arteries which leads to regional reduction in myocardial blood flow and inadequate perfusion of the myocardium supplied by the involved coronary artery. Materials and Methods: This is a cross sectional observational study conducted on ischemic heart disease patients admitted at inpatient department of Medicine in a tertiary care teaching hospital, Kurnool. The study consisted of analysis of drug utilization pattern of prescribed drugs..........

Key Words: Ischemic heart disease (IHD), coronary artery, homogenous

[1]. Jeeso George, Padmini Devi, Deepak Y. Kamath, Naveen Anthony. Patterns and determinants of cardiovascular drug utilization in coronary care unit patients of a tertiary care hospital. J Cardiovaso Dis Res. 2013; 4(4): 214-221.
[2]. Christian R P, Rana DA , Malhotra S D, Patel VJ. Evaluation of rationality in prescription, adherence to treatment guidelines, and direct cost of treatment in intensive cardiac care unit: A prospective observational study. Indian J Crit care Med.2014; 18(5): 278-284.
[3]. Bandla Aswani, Purushothama Reddy K., P. Yanadaiah. A Study on Prescription pattern of Cardiovascular Drugs & Potential Drug-Drug Interaction in an Inpatient Cardiology Unit of a Cardiac-Care Hospital at Tirupathi. European Journal of Pharmaceutical and Medical Research. 2016; 8: 294-305.
[4]. Shivaraj Basavaraj Patil, Shrinivas R. Raikar, Sachin Patil. Prescription pattern of Cardiovascular drugs in intensive cardiac care unit patient in a tertiary care hospital. Int J Basic Clin Pharmacol. 2015; 4(6):1100-1103.
[5]. Md. Abdul Muhit, Md. Obaidur Rahman,Sheikh Zahir Raihan., Cardiovasculardisease prevalence and prescription pattern at a tertiary level hospital in Bangladesh, journal of Applied Pharmaceutical Science 02(03);2012: 80-84.

Abstract: Aim: The objective of this cross sectional study was to estimate the prevalence of pulpitis among the adult population in the tertiary care hospital in south India. Methods: Enumerated the data from the hospital records in the march month. And also identified the individuals who visited the department of conservative dentistry and endodontics. To estimate the prevalence of pulpitis all the subjects were subjected to clinical and radiological examination. The inclusion criteria were older than 18 yrs and younger than 75 yrs diagnosed with pulp inflammation [reversible and irreversible pulpitis] caused by dental caries. Results: The total prevalence rate of pulpitis among the given population is 91%. The lowest prevalence rate of reversible pulpitis observed in the females of age group 46-75 years, and the highest prevalence rate is seen among females in the age group 18-30 years.............

[1]. Abdul Arif khan Sudhir k Jain Archana Srivastav Prevalence of Dental caries among the population of Gwalior in relation to different associated factors. European journal of dentistry 2008; APR: 81-85
[2]. Agha Ch. Pashayev, Fuad U. Mammadov, Sevda T. Huseinova. An Investigation into the Prevalence of Dental Caries and its Treatment Among the Adult Population With Low Socio-Economic Status in Baku, Azerbaijan OHDM - Vol. 10 - No. 1 - March 2011
[3]. Banday N, Dogon L, Saeed F. Trend of caries experience in children registered with the Aga Khan school health care centers in Karachi. J Pak Dent Assoc 10 (2001): 193-8.
[4]. Bruna Paloma de olveria Adrea Cruzcamara Carios Manezee Agular. Prevalence of endodontic diseases an epidemiological evaluation in a Brazilian population. Braz J Oral Sci April/June 2016 Vol 15 No:2

Abstract: Immunohistochemistry has now become an important tool for prognostic predilection in clinically heterogeneous breast cancer. Present histological classifications do not fully predict the varied clinical course of this disease. Histological type, grade, tumor size, lymph node involvement, in addition to estrogen receptor α (ER), progesterone receptor (PR) and HER-2 receptor status all influence prognosis and the probability of response to systemic therapies.1 Although many advanced biological and molecular markers of breast cancer have been identified over the past two decades, traditional markers such as estrogen receptor (ER), progesterone receptor (PR), and HER-2 remain among the most useful and easily available indicators of prognosis and therapeutic response to treatment.2

[1]. LajosPusztai,aChafikaMazouni,a Keith Anderson,b Yun Wu; Molecular Classification of Breast Cancer: Limitations and Potential; Breast Cancer; The Oncologist 2006;11:868–877
[2]. NourSneige M.D; Utility of cytologic specimens in the evaluation of prognostic and predictive factors of breast cancer: Current issues and future directions; Diagnostic Cytopathology Volume 30, Issue 3, pages 158–165, March 2004
[3]. Sørlie T, Perou CM, Tibshirani R, Aas T, Geisler S, Johnsen H, Hastie T, Eisen MB, van de Rijn M, Jeffrey SS, Thorsen T, Quist H, Matese JC, Brown PO, Botstein D, Lønning PE, Børresen-Dale AL: Gene expression patterns of breast carcinomas distinguish tumor subclasses with clinical implications. ProcNatlAcadSci U S A 2001, 98:10869–10874
[4]. MariellaBonzanini, MD1; Luca Morelli, MD1; Elena Maria Bonandini, MD1; Elena Leonardi, PhD; Cytologic Features of Triple-Negative Breast Carcinoma; Cancer Cytopathology December 25, 2012; pp-401-9
[5]. Perou CM, Sorlie T, Eisen MB, et al. Molecular portraits of human breast tumours. Nature. 2000;406:747-752.

Abstract: Diabetes is considered as a global pandemic that afflicts millions of people all over the world. It is a major public health problem along with its social and economic connotations. There is a change in the pattern of expression of diabetes and newer risk factors are implicated as possible precipitating factors of Diabetes. Now pollution is considered to be an emerging risk factor for diabetes. About 3.2 million new cases of diabetes are reported to be pollution related and represents 14 % of new cases reported globally. With a vast literature flooded with diabetes research, a possible cure remains a distant dream for a diabetic patient. Therefore, in the present review the recent trends in diabetes research, care and therapy is discussed.

Key words: Diabetes, Type I Diabetes mellitus (T1DM), Type 2 Diabetes Mellitus (T2DM), insulin pill, islet cell transplantation

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[3]. Bo-Yi Yang, Zhengmin (Min) Qian, Shanshan Li, Gongbo Chen, Michael S Bloom, Michael Elliott, et al Ambient air pollution in relation to diabetes and glucose-homoeostasis markers in China: a cross-sectional study with findings from the 33 Communities Chinese Health Study. Lancet Planet Health 2018; 2: e64–73
[4]. World Health Organization (Fact sheet No 312, Sep 2006).
[5]. International Diabetes Federation. Economic impact of diabetes IDF Diabetes. Atlas, 4thedn. Brussels, Belgium (2009).