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

Abstract: Introduction: Antimicrobial stewardship is nothing but an integrated approach to improve and measure the appropriate use of antimicrobials by promoting the selection of antimicrobial drug regimen with suitable route of administration, dose and duration of therapy. Materials and methods: This study was a cross-sectional, questionnaire based survey undertaken in a tertiary teaching care hospital in India among the medical and paramedical professionals including interns, residents, lecturers, associate professors and professors. However paramedical professionals and MBBS students were excluded from study. The questionnaire was self-structured and pre-validated by the subject experts for its content and relevance...............

Keywords: Antimicrobial stewardship, knowledge, practice, ENT, medicine

[1]. Sanchez GV, Roberts RM, Albert AP. Effects of Knowledge, Attitudes, and Practices of Primary Care Providers on Antibiotic Selection, United States. Emerging Infectious Diseases. 2014;20(12):2041-7.
[2]. Khan AK, Banu G, Reshma KK. Antibiotic resistance and usage-a survey on the knowledge, attitude, perceptions and practices among the medical students of a Southern Indian Teaching Hospital. J Clin Diagn Res. 2013;7:1613-6.
[3]. Huang Y, Gu J, Zhang M. Knowledge, attitude and practice of antibiotics: a questionnaire study among 2500 Chinese students. BMC Med Educ. 2013;13:163.
[4]. Tripathi KD, Essentials of Medical Pharmacology, 7th Edition, New Delhi, Jaypee Brothers Medical Publishers (P) Ltd; 2015:686-703.
[5]. Tegagn GT, Yadesa TM, Ahmed Y. Knowledge, Attitudes and Practices of Healthcare Professionals towards Antimicrobial Stewardship and Their Predictors in Fitche Hospital. J Bioanal Biomed. 2017;9:091-7.

Abstract: Introduction: Malaria is a disease caused by infection with single celled protozoan parasite of the genus plasmodium and five plasmodium species are known to infect humans-P. falciparum, P. vivax, P. ovale, P.knowlesi and P. malariae. Of these, majority of cases reported are due to infection with P. falciparum and P. vivax. P. falciparum is associated with the most severe form of the disease. Materials and methods: This was a hospital-based, single-center retrospective surveillance study analysing the records of patients admitted with the diagnosis of Malaria and patients attended the OPD of medicine from Jan 2018 to June 2018 in a tertiary care center........

Keywords: Malaria, P. falciparum, P. vivax, P. ovale, sepsis, dengue fever, leptospirosis

[1]. Vinetz JM, Clain J, Bounkeua V, Eastman RT, Fidock D. Chemotherapy of malaria. In: Brunton L, Chabner BA, Knollman B, editors. Goodman & Gilman's The Pharmacological Basis of Therapeutics. 12thed. San Diego: The McGraw-Hill Companies; 2011.p. 1537-38.
[2]. Tripathi K. D. Essentials of Medical Pharmacology 7thed. New Delhi: Jaypee Brothers Medical Publishers; 2013. p. 8173.
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Abstract: Single tooth anterior dental crossbite is the commonly encountered malocclusion during the development of occlusion in children.Anterior dental crossbite requires early and immediate treatment to prevent anterior teeth mobility and fracture, periodontal problems, and temporomandibular joint disturbances. The current paper presents the case of an 8 year-old female which describe the successful treatment of anterior crossbite (single tooth) in children with mixed dentition using removable appliance and rigorous oral hygiene instruction.The final outcome was a correction of the cross-bite in 4 weekswithout any relapsefor 18 months. At the same time, spontaneous improvement of periodontal environment was observed .

Keywords: anterior, single crossbite, mixed , dentition.

[1]. Park JH, Kim TW. Anterior crossbite correction with a series of clear removable appliances: A case report. J Esthet Restor Dent 2009;21:149‐59.
[2]. Karaiskos N, Wiltshire WA, Odlum O, Brothwell D, Hassard TH. Preventive and interceptive orthodontic treatment needs of an inner‐city group of 6‐and 9‐year‐old Canadian children. J Can Dent Assoc
2005;71:649.
[3]. Keski‐Nisula K, Lehto R, Lusa V, Keski‐Nisula L, Varrela J. Occurrence of malocclusion and need of orthodontic treatment in early mixed dentition. Am J Orthod Dentofacial Orthop2003;124:631‐8.
[4]. Mc Donald, Dentistry for the Child and Adolescent, 8th Ed.,Elsevier, a division of Reed Elsevier India Pvt. Ltd., 2005, chap.27 pg. 651-653.
[5]. Lee BD. Correction of crossbite. Dent Clin North Am. 1978 Oct; 22(4):647-68.

Abstract: Background: Central Nervous System(CNS) neoplasms are unique in histomorphology and also have high influence on the patient as space occupying lesions due to their location in vital organs. Both the benign and malignant tumors together form a wide spectrum. The study of the CNS primary tumors is helpful to know the frequency and thereby the problem load on the society, biological behaviour of the tumors and prognosis of various tumors. Aim: to study the spectrum of the CNS primary tumors and to correlate with the clinical and radiological findings. To correlate with the other similar studies. Materials and Methods: study design – Prospective, Observational and Cross section study. Study period – four years duration ( July 2015 to June 2019 ) Inclusion criteria – all the CNS primary tumors reported in Royal Diagnostics & Research Center, Vijayawada, Andhra Pradesh.........

Keywords: Primary neoplasms, glioblastoma, meningioma, Immunohistochemistry, biological behaviour, medulloblastoma, pheochromocytoma and pituitary adenoma.

[1]. Wohrer A. Epidemiology and Brain Tumours: Practical Usefulness. Eur Assoc Neurooncol Mag 2013;3(2):56-60.
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[3]. Scheithauer WB. Development of the WHO Classification of Tumors of the Central Nervous System. Brain Pathol 2009 October; 19 (4): 551 – 64.
[4]. Tandon PN. Supratentorial Astrocytoma. In Ramamurthi B. Tandon PN eds. Textbook of Neurosurgery, vol II, 3rd edition, B I Churchill Livingstone, 2008: 888 – 905.
[5]. Yeole BB. Trends in the Brain cancer incidence in India. Asian Pac J Cancer Prev 2008;9:267-70.

Abstract: BACK GROUND: In ENT practice the neck mass is one of the commonest presentation and also one of the difficult situation to diagnose and manage, because of its highly complex anatomy and physiology. This requires multidisciplinary approach to know the etiopathological diagnosis. AIMS :1. To study the incidence of neck mass in gender and age variation 2. To know the incidence of different neck masses in our region . MATERIALS AND METHODS:The study was conducted in the Govt. ENT Hospital, tertiary referral hospital in Andhra Pradesh for a duration of 2 years from May 2017 to April 2019. In about 76800 patients, attended during the above period to the Outpatient department, 3312 patients complained of symptoms of head and neck disease. 845 patients attended with neck masses alone............

KEY WORDS: Neck masses,Thyroid masses,Cysts of neck, Lymphnode masses.

[1]. Turkylimaz Z,Karabulut R., et al Congenital neck masses in children and embryologic and clinical features.B-ENT 2008;4(1)7-18
[2]. D. Rice DH,Salivary gland disorders.neoplastic and non neoplastic Med Clin North Am ,1999;83(1);197-218
[3]. Ramen Talukdar, Rajkumar S Yalawar,et al., CT Evaluation of neck masses.,IOSR journal of dental and Medical sciences,vol 14 issue 12 ver 1X (Dec 2019),pp 39-49
[4]. M.Tanriverdi, Salih Bakir., et al., Neck masses: retrospective analysis of 981 cases., Turkiye klinikleri J Med Sci 2012:32(5).,1267-72
[5]. Rosenberg TL.,Brown JJ,et al., Evaluating the child patient with a neck mass.Med Clin North Amer 2010:94:1017-1029

Abstract: Suicidal poisoning by OPI is however a major clinical and public health concernRed cell distribution width measures variability in RBC size. That means it reflects anisocytosis. It can easily be assessed in a complete blood count. It is found to be elevated heart failure, acute coronary syndromes and pancreatitis. In organophosphate poisoning too there can be acute inflammation and oxidative stress. This too may cause a change in structure and size of RBC. So there is an expected increase in red cell distribution width. The level of elevation is associated with the level of inflammation and oxidative stress. Hence RDW can be assessed as a prognostic marker in organophosphate poisoning.

Keywords: OPC, poisoning, rdw, hypoxia, insecticide

[1]. Lippi, G., Targher, G., Montagnana, M. et al, Relationbetween red blood cell distribution width andinflammatory biomarkers in a large cohort ofunselected outpatients. Arch Pathol LabMed. 2009;133:628–632.
[2]. Churi, S., Bhakta, K., Madhan, R. Organophosphatepoisoning: prediction of severity and outcome byGlasgow Coma Scale, poisoning severity score,Acute Physiology and Chronic Health Evaluation IIscore, and Simplified Acute Physiology Score II. JEmergNurs. 2012;38:493–495
[3]. Patel, K.V., Ferrucci, L., Ershler, W.B. et al, Red bloodcell distribution width and the risk of death inmiddle-aged and older adults. Arch InternMed. 2009;169:515–523
[4]. Shaikh Mohammed Aslam ,AkhilaArcotVadivelanRed Cell Distribution Width as Prognostic Markerinorganophosphorous Compound PoisoningIOSR JDMSe-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 14,Issue 9 Ver. III (Sep. 2015)
[5]. Peter JV, Thomas L, Graham PL, et al. Performance ofclinical scoring systems in acute organophosphatepoisoning. ClinToxicol (Phila) 2013;51:850–4.
[6]. Churi S, Bhakta K, Madhan R. Organophosphatepoisoning: prediction of severity and outcome byGlasgow Coma Scale, poisoning severity score, AcutePhysiology and Chronic Health Evaluation II score, andSimplified Acute Physiology Score II. JEmergNurs2012;38:493–5.

Abstract: Dyslipidemiais a major risk factor for atherosclerotic cardiovascular disease (ASCVD) and it has become a worldwide public health problem. In India, only limited number of large-scale studies exist on prevalence of dyslipidemia and the prevalence varies widely according to socioeconomic, ethnic and cultural differences. This was a cross-sectional hospital-based study done at the Biochemistry Department of Jawaharlal Nehru Institute of Medical Sciences, Imphal. Lipid Profile of subjects aged ≥20 years from May 2018 to April 2019 were consecutively studied. Serum total Cholesterol, Triglyceride, HDL-C, LDL-C were included in study to assess pattern and status of dyslipidemia in 940 individuals...............

[1]. Snehalatha, C.; Nanditha, A.; Shetty, A.S.; Ramachandran, A. Hypertriglyceridaemia either in isolation or in combination with abdominal obesity is strongly associated with atherogenic dyslipidaemia in Asian Indians. Diabetes Res. Clin. Pract. 2011, 94, 140–145.
[2]. Tziomalos, K.; Athyros, V.G.; Karagiannis, A.; Mikhailidis, D.P. Dyslipidemia as a risk factor for ischemic stroke. Curr. Top. Med. Chem. 2009, 9, 1291–1297.

[3]. Stamler, J.; Daviglus, M.L.; Garside, D.B.; Dyer, A.R.; Greenland, P.; Neaton, J.D. Relationship of baseline serum cholesterol levels in 3 large cohorts of younger men to long-term coronary, cardiovascular, and all-cause mortality and to longevity. JAMA 2000, 284, 311–318.
[4]. World Health Organization. The global burden of disease: 2004 update. Geneva World Health Organization, 2008.
[5]. World Health Organization. Global health risks: Mortality and burden of disease attributable to selected major risks. Geneva, WHO, 2009.

Abstract: Back Ground: In ENT practice the neck mass is one of the commonest presentation and also one of the difficult situation to diagnose and manage, because of its highly complex anatomy and physiology. This requires multidisciplinary approach to know the etiopathological diagnosis. Aims :1. To study the incidence of neck mass in gender and age variation 2. To know the incidence of different neck masses in our region . Materials And Methods :The study was conducted in the Govt. ENT Hospital, tertiary referral hospital in Andhra Pradesh for a duration of 2 years from May 2017 to April 2019. In about 76800 patients, attended during the above period to the Outpatient department, 3312 patients complained of symptoms of head and neck disease. 845 patients attended with neck masses alone. These patients were distributed depending upon gender and age variation.........

Key Words : Neck masses,Thyroid masses,Cysts of neck, Lymphnode masses.

[1]. Turkylimaz Z,Karabulut R., et al Congenital neck masses in children and embryologic and clinical features.B-ENT 2008;4(1)7-18
[2]. D. Rice DH,Salivary gland disorders.neoplastic and non neoplastic Med Clin North Am ,1999;83(1);197-218
[3]. Ramen Talukdar, Rajkumar S Yalawar,et al., CT Evaluation of neck masses.,IOSR journal of dental and Medical sciences,vol 14 issue 12 ver 1X (Dec 2019),pp 39-49
[4]. M.Tanriverdi, Salih Bakir., et al., Neck masses: retrospective analysis of 981 cases., Turkiye klinikleri J Med Sci 2012:32(5).,1267-72
[5]. Rosenberg TL.,Brown JJ,et al., Evaluating the child patient with a neck mass.Med Clin North Amer 2010:94:1017-1029

Abstract: Acute coronary syndrome (ACS) is a major cause of morbidity and mortality worldwide where inflammation plays a very important role in the pathogenesis. Studies have shown that neutrophilia and lymphocytopenia along with Neutrophil to lymphocyte ratio(NLR) a recent and novel prognostic marker in ACS1. It is economical and easily obtainable from the routine complete blood count. Fragmented QRS in a 12 lead electrocardiogram was proven to be a novel marker2. Fragmented QRS complexes are novel ECG signals which are associated with varied conduction abnormalities and the delay of peri- infarct conductions due to myocardial scarring or necrosis2and develops mostly within 48 hours during acute myocardial infarction3. Some studies also point out that presence of a fragmented............

Keywords: Acute coronary syndrome- fragmented QRS-neutorphil to lymphocyte ratio-thrombolysis-STEMI.

[1]. Budzianowski J, Pieszko K, Burchardt P, Rzeźniczak J, Hiczkiewicz J. The Role of Hematological Indices in Patients with Acute Coronary Syndrome. Disease Markers.2017;2017:3041565.
[2]. Das MK, Suradi H, Maskoun W, et al. Fragmented wide QRS on a 12-lead ECG: A sign of myocardial scar and poor prognosis. CircArrhythmElectrophysiol 2008;1:258–268
[3]. DasMK, Khan B, Jacob S, et al. Significance of a fragmented QRS complex versus a Q wave in patients with coronary artery disease. Circulation. 2006;113:2495–2501
[4]. Das MK, Saha C, El Masry H, et al. Fragmented QRS on a 12-lead ECG: a predictor of mortality and cardiac events in patients with coronary artery disease. Heart Rhythm2007;4:1385–1392
[5]. Mahenthiran J. et al. Fragmented QRS complexes not typical of a bundle branch block: A marker of greater myocardial perfusion tomography abnormalities in coronary artery disease. Journnuc card2007;5:347-351

Abstract: The orthognathic surgery is a procedure that aims at improvement of masticatory function, esthetic harmony and structural balance. The Le Fort I osteotomy for the upper jaw repositioning is the most used for correction of vertical maxillary excess. The surgical jaw impaction allows correction of the gingival smile, long face syndrome, certain types of skeletal open bite and labial sealing. The maxillary impaction results in self-rotation of the jaw, accompanied by skeletal and soft tissue changes observed in sagittal advance and vertical shortening of the lower face. This review attempts to organize the existing published literature regarding the effects of LeFort I Maxillary Impaction Surgery on hard tissues as well as soft tissues and on temporomandibular joint in Vertical Maxillary Excess patients.

Key Words: Vertical Maxillary Excess, LeFort I Osteotomy, Centre of Rotation of Mandible.

[1]. Bell Wh. Correction Of Maxillary Excess By Anterior Maxillary Osteotomy [Internet]. Vol. 43, Oral Surgery, Oral Medicine, Oral Pathology. 1977. P. 323–32. Available From: Http://Dx.Doi.Org/10.1016/0030-4220(77)90316-4
[2]. Öztürk M, Özkan Y, Orbak R. Gummy Smile Treatment With Botulinum Toxin And Review Of Literature- A Case Report [Internet]. Vol. 11, Atatürk Üniversitesi Diş Hekimliği Fakültesi Dergisi. 2015. Available From: Http://Dx.Doi.Org/10.17567/Dfd.02080
[3]. Saleh F, Al Hamadi W. Orthosurgical Correction Of Severe Vertical Maxillary Excess: Gummy Smile. In: Işık Aslan B, Deniz Uzuner F, Editors. Current Approaches In Orthodontics. Intechopen; 2019.
[4]. Nanda R, Uribe Fa. Temporary Anchorage Devices In Orthodontics. Mosby Elsevier; 2009. 431 P.
[5]. Linder-Aronson S, Woodside Dg. Excess Face Height Malocclusion: Etiology, Diagnosis, And Treatment. Quintessence Publishing Company; 2000. 106 P.

Abstract: Introduction: The Sentinel lymph node biopsy is a good alternative for the nodal staging in breast cancer. Sentinel lymph node biopsy is the first node in the regional nodal basin that drains a primary tumor and reflects the tumor status of the entire nodal basin. Sentinel lymph node biopsy is a reliable method. The technology is evolving rapidly but no standardization has yet been established and there is no agreement on how many nodes must be submitted for study. Objective: To analyze and evaluate the micro-metastasis in Carcinoma Breast, with the aid of Sentinel lymph node biopsy, in different early malignant breast lesions using 1% isosulphan blue; Study design: Prospective study; Place and Duration of study: Department of General Surgery &Department of Pathology, S.V. Medical College, Tirupati from January 2018 to June 2019 (18 months)..........

Key words: Biopsy, Breast cancer, Isosulphan blue, Metastasis, Sentinel Lymph node.

[1]. Veronesi U, Paganelli G, Galimberti V, et al: Sentinel-node biopsy to avoid axillary dissection in breast cancer with clinically negative lymph-nodes. Lancet 1997; 349:1864-1867

[2]. Cabanas RM. An approach for the treatment of penile carcinoma. Cancer. 1977;39:456–466.

[3]. Morton DL, Wen DR, Wong JH, et al: Technical details of intraoperative lymphatic mapping for early stage melanoma. Arch Surg 1992; 127:392-399.
[4]. Guenther JM, Krishnamoorthy M, Tan LR: Sentinel lymphadenectomy for breast cancer in a community managed care setting. Cancer J Sci Am 1997; 3:336-340.
[5]. Koller M, Barsuk D, Zippel D, et al: Sentinel lymph node involvement - a predictor for axillary node status with breast cancer – has the time come? Eur J SurgOncol 1998; 24:166-168.

Abstract: Introduction:Infected non-union of fractures is one of the major problems in orthopaedic surgery. By definition, infected non-union is a Cierny IV osteomyelitis, meaning that the fracture is unstable before and after the debridement.In the treatment of an infected ununited fracture of a long bone it often is difficult to achieve union and eradicate the infection. The goal of treatment is a well-aligned, healed, painless and functional limb. Wound debridement, stable osteosynthesis and containment of the infection is the primary procedure for all cases of infective non-union. Materials and Methods: The study was undertaken at Dept. of Orthopedics, S.V.Medical College, Tirupati for a period of one year from January 2018 to December 2018. All cases of infected non-union of femur and tibia were included in our study..............

Keywords: External fixator, Ilizarov, Malunion, Non-union, Osteomyelitis

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