iosr-JDMS   Volume-19 ~ Issue-1 ~ January. 2020

Abstract: Introduction: During induction of general anaesthesia, there is a possibility of haemodyanamicvariabilities especially in patients with cardiovascular risk factors and those with haemodyanamic instability. So, a safe induction agent with fewer adverse effects is desirable. In the present study we intend to compare propofol and etomidate for their effect on haemodyanamic response to laryngoscopy and intubation and other adverse effects. METHODS: 80 patients in the age group 20 to 60 years, ASA class I and II, posted for elective surgeries were divided into two groups (group P and group E) of 40 each. Group P received propofol 2mg/kg and group E received etomidate 0.3mg/kg for induction. Haemodyanamic parameters at induction, laryngoscopy and then upto 5 minutes post intubation were recorded and compared. Pain on injection and myoclonus.....

Key Words: Propofol, etomidate, induction agent, laryngoscopy, endotracheal intubation

[1]. Sakles JC, Laurin EG, Ramtappa AA, Panacek EA. Airway management in emergency department: a one-year study of 610 tracheal intubations.Ann Emerg Med 1998;31:325-32.
[2]. Stevenson AG, Graham CA, Hall R, Korsah P, McGuffie AC. Tracheal intubation in the emergency department: the Scottish district hospital perspective. Emerg Med J 2007;24:394-97.
[3]. Montes FR, Giraldo JC, Betancur LA, Rincon JD, Rincon IE et al. Endotracheal intubation with a light wand or a laryngoscope results in similar hemodyanamic variations in patients with coronary artery disease. Can J Anaesth 2003;50:824-28.
[4]. Aggarwal S, Goyal VK, Chaturvedi SK, Mathur V, Baj B, Kumar A. A comparative study between propofol and etomidate in patients under general anesthesia. Rev Bras Anestesiol 2016;66:237-41.
[5]. Shinn HK, Lee MH, Moon SY et al. Postoperative nausea and vomiting after gynecologic laparoscopic surgery: comparison between propofol and sevoflurane. Korean J Anesthesiol 2011;60:36-40.

Abstract: The study was conducted on 100 cases of fatal road traffic injuries of all age groups. The pattern and distribution of head injuries in dead bodies due to RTI with or without helmet and other associated risk factors was analyzed. A preponderance of victims in the age group 31-40 years (52%) with M:F ratio 7.33:1 was observed. 38% of cases of RTI died on the spot and 14% cases died while shifting or within one hour of admission to the hospital. 74% of victims were not using helmets. Majority died were the riders (84%), followed by pillion riders (14%). Contusion of the scalp was more common (98%) as compared to the laceration (38%). Contusion of brain was seen in 100% cases and laceration in 26% cases. Fissure fracture was seen in 64% cases. The commonest variety of intracranial hemorrhage was subdural (98%) followed by subarachnoid (96%).

Key Words: Road Traffic Injury, Head injury, Two wheelers

[1]. Park K. Epidemiology of Chronic Non-communicableDisease and Conditions. In: Park's Textbook of Preventive and Social Medicine. 20th ed. M/s Banarsidas Bhanot Publishers, Jabalpur, India. 2009. p. 353.
[2]. Accidental Deaths and Suicides in India-2008. NationalCrime Record Bureau Report-2008. p. 13-14. http://ncrb.nic.in/ADSI2008/accidental-deaths-08.pdfaccessed on 12/05/2010.
[3]. Bahera C, (Lt. Col.) Rautji R, Lalwani S and Dogra TD. A comprehensive study of motorcycle fatalities in South Delhi. J Indian Acad Forensic Med. 2009; 31(1): 6-10.
[4]. Dandona R, Kumar GA, Raj TS and Dandona L. Patternsof road traffic injuries .in a vulnerable population in Hyderabad, India. Inj Prev. 2006; 12(3): 183-88.
[5]. Khajuria B, Sharma R and Verma A. A profile of theautopsies of road traffic accident victims in Jammu. J Clin Diag Res. 2008; 2(1): 639-42.

Abstract: La transfusion sanguine est un acte qui sauve des vies, mais elle n'est passans risque, Ainsi intervient la sécurité transfusionnelle qui est assurée par une maitrisede toutes les étapes de la chaine transfusionnelle. Le présent travail a été réalisé dans lebut d'analyser l'opérationnalisation des activités de sécurité sanguine dans deux zonesde santé Kenya et Katuba à Lubumbashi. Nous avons mené une étude descriptive transversale etavons utilisé la méthode d'échantillonnage exhaustif, notre population d'étude étaitconstituée de 41 structures qui réalisaient la transfusion sanguine au sein des deux zones desanté. La technique de collecte utilisée a été l'interview semi-dirigée avec une fiche de récolte des données préétablie et reprenant toutes les variables d'intérêt, saisies etanalysées à l'Epi info 7 et le logiciel Excel. Nous avons observé que (70,3%) des structures enquêtées n'avaient pas unapprovisionnement en sang de qualité, et (75,6%) des structures déclaraientbien.....

Key Words: Analyse – Transfusionnelle – Sécurité - Lubumbashi/RDC.

[1]. AFSSAPS. Transfusion de globules rouges homologues : produits, indications, alternatives. http:// afssaps.sante.fr/pdf/5/ rbp/glreco.pdf Le 23/05/2009
[2]. BOBOSSI-SERENGBE G. ; NDOMAKRA A.B. ; FIBOY R. ; OUITEMBONA C. ; KOZEMAKA A. ; SIOPATHIS R. M. (2006), Les problèmes transfusionnels en milieupédiatrique centrafricain : cas du Complexe Pédiatrique de Bangui, Médecine d'Afrique Noir, vol 53, no5, pp. 273-276 (4 Page (s)
[3]. Catherine T., Julia K. (2007), Les cinq étapes du processus transfusionnel, Institut National de la transfusion Sanguin Polycopié national de sécurité transfusionnelle, Université Médicale Virtuelle Francophone, 13 pages.
[4]. Chadi, S., Brakez, Z., Belhachmi, A., Izabel, H., (2007) polymorphisme du système ABO dans la population du Sousse, Anthropo, 15, 49-53. 02/07/2009.
[5]. CHATMI A (2003). Epidémiologie, Presses universitaires de Lubumbashi. 192 pages CNTS (2005) Manuel de formation en transfusion sanguin, Kinshasa, CNTS 2ème Edition, 74 pages

Abstract: Acute hypoxemic respiratory failure (AHRF) is one of the leading cause of morbidity and mortality among patients presenting to the Emergency Department. AHRF increases hospital and ICU admissions. There has been conflicting evidence regarding the use of Non Invasive Ventilation (NIV) in the management of patients with acute hypoxemic respiratory failure. More recent data is now available, encouraging the use of high-flow nasal cannula as a useful alternative to conventional oxygen therapy in management of patients with AHRF. Despite its use in pediatric patients as a first-line treatment for respiratory distress syndrome and apnea of prematurity, its clinical application in adults is still limited as there are no established clinical benefits which would encourage its use. Therefore, this review provides more recent evidence on the clinical benefits of high-flow nasal cannula in adult patients with de novo acute hypoxemic respiratory failure including mechanism of clinical benefits......

Keywords: Efficacy, high flow nasal cannula, high flow oxygen nasal therapy, de novo acute hypoxemic respiratory failure, and acute hypoxemic respiratory failure.

[1]. Rochwerg, B., et al., Official ERS/ATS clinical practice guidelines: noninvasive ventilation for acute respiratory failure. Eur Respir J, 2017. 50(2). [2]. Scala, R. and L. Heunks, Highlights in acute respiratory failure. Eur Respir Rev, 2018. 27(147). [3]. Lee, C.C., et al., High flow nasal cannula versus conventional oxygen therapy and non-invasive ventilation in adults with acute hypoxemic respiratory failure: A systematic review. Respir Med, 2016. 121: p. 100-108. [4]. Masclans, J.R., P. Perez-Teran, and O. Roca, The role of high flow oxygen therapy in acute respiratory failure. Med Intensiva, 2015. 39(8): p. 505-15. [5]. Nishimura, M., High-Flow Nasal Cannula Oxygen Therapy in Adults: Physiological Benefits, Indication, Clinical Benefits, and Adverse Effects. Respir Care, 2016. 61(4): p. 529-41.

Abstract: The syndrome of anti-synthetases (SAS) is a rare disease, it presents 30% of inflammatory myopathies, and frequently associated with pulmonary involvement (especially parenchymatous type of diffuse infiltrative pneumopathy, and more rarely vascular (pulmonary hypertension)), Characteristic cutaneous abnormalities of fissile and erythematous hyperkeratosis of the lateral surface of the fingers, Raynaud's syndrome, inflammatory polyarthritis, and the presence of antinuclear autoantibodies called anti-aminoacyl-tRNA synthetases. We report an observation of a 55-year-old patient who was treated for progressive exacerbation dyspnea, muscle weakness, arthralgia, Bilateral crepitoles with pulmonary auscultation, and typical skin lesions. The CT scan confirms the presence....

Key words: Antisynthetase syndrome, Anti Jo-1, Myopathies, Interstitial pneumonitis.

[1]. Bohan A, Peter JB. Polymyositis and dermatomyositis. N Engl J Med. 1975; 292(7):344-7.
[2]. Marguerie C, Bunn CC, Beynon HL et al. Polymyositis, pulmonary fibrosis and autoantibodies to aminoacyl-tRNA synthetase enzymes. Q J Med. 1990; 77 (282):1019-38.
[3]. Marie I, Mouthon L. Therapy of polymyositis and dermatomyositis. Autoimmun Rev 2011;11:6-13.
[4]. Allali D, Seebach JD. Syndrome des antisynthétases: diagnostic et traitements. Rev Med Suisse. 2015; 11(469): 808-12.
[5]. Brouwer R, Hengstman GJD, Egberts WV et al. Autoantibody profiles in the sera of European patients with myositis. Ann Rheum Dis. 2001;60(2):116-23

Abstract: Introduction: Fissure in Ano is common ailment seen in generalpopulation. Various medical treatments are now evolving forthis painful condition along with surgical techniques like Lateral sphincterotomy. Increased tone of anal sphincter being the factor for which pharmacological modalities are used. In this studyComparison between 0.2% GlycerylTrinitrateapplication with LateralSphincterotomy was done. Material and methods: In this prospective study 60 patients with fissure inAno are divided in two groups, Group 1 are advisedto apply 0.2% GlycerylTrinitratecream and group 2 undergone Lateralsphincterotomy under anesthesia. Both groups are observed for pain, healing time, bleeding and complications for 6 weeksin government general hospital / Rangaraya medical collegeKakinada during period July 2018 to July 2019. Results: fissures were completely healed in 27 patients out of 30 in group 1. Only 3 patients had fissures even after 6 weeks.....

Keywords: Fissure InAno, 0.2% GlycerylTrinitrate, Lateral Spinchterotomy

[1]. Bailey And Love's Short Practice Of Surgery 26th Ed- 72: 1248-1249.
[2]. Farquharson's Textbook Of Operative General Surgery, 10E–24:442
[3]. Ganongs Review of Medical Physiology, 24E (2012).
[4]. Scouten WR, Et Al. Ischemic Nature Of Anal Fissure. British Journal Of Surgery. 1996;83:63–65.
[5]. Tocchi Adriano, Mazzonigianluca, Miccini Michelangelo, Cassini Diletta, BettelliElia, BrozzettiStefania. Total Lateral SphincterotomyFor Anal Fissure. International Journal Of Colorectal Disease. 2004;19:245–49.

Abstract: A descriptive cross-sectional study was carried out from January 2014 to December 2014 among 220 auto rickshaw drivers in Dhaka city to determine the level of low back pain & disability. Sampling was done purposively among the auto rickshaw drivers fulfilling the enrolment criteria. Data were collected by face to face interview using pre-tested questionnaire & check list. The age of the respondent's ranged between 25 and 60 years with a mean of 34.95 ± 7.732 years and 45.5% respondents was in 31-40 years of age group. The study showed that 36.4% of the respondent's working period was more than 10 years. The study demonstrated that maximum (62.7%) auto rickshaw drivers reported low back pain and 75.4% had minimal disability and remaining 24.6% had moderate disability and it was calculated by Oswestry Disability Index. The study revealed that not only poor posture......

Key Words: Rickshaw Drivers, Low Back Pain, Demonstrated, Spinal Disease, Back Trauma, Oswestry Disability Index.

[1]. Alperovitch-najenson, D., Santo, Y., Masharawi, Y., Katz-leurer, M., Ushvaev, D., and Kalichman, L. (2010). Low back pain among professional bus drivers: Ergonomic and occupational-psychological risk factors. Israel Medical Association Journal, 12: 26-30.
[2]. Magnusson, M.L., Pope, M.H., Wilder, D.G., and Areskoug, B. (1996). Are occupational drivers at an increased risk for developing musculoskeletal disorders. Spine, 21: 710-717.
[3]. Frank, J. W., Brooker, A. S., Demaio, S. E., Kerr, M. S., Maetzel, A., Shannon, H. S., Sullivan, T. J., Norman, W. and Wells, R. P. (1996). Disability resulting from occupational low back pain. Part II: What do we know about secondary prevention? A review of the scientific evidence on prevention after disability begins. Spine, 21(24): 2918-2929.
[4]. Roland, M., and Morris, R., (1983). A Study of the Natural History of Back pain Part I: Development of a Reliable and Sensitive Measure of Disability in Low Back, Spine, 8(2): 141-144.
[5]. Jaiswal, A., (2013). Low back pain and work-related risk factors among drivers of Pondicherry. International Journal of Scientific Footprints, 1(2): 7–16.

Abstract: Untreated dental caries or periodontal disease eventually leads to loss of tooth. Hemisection helps in retaining grossly decayed or periodontally involved tooth which otherwise should be extracted. In this paper we describe a case of grossly decayed mandibular molar managedconservatively with hemisection and prosthetic rehabilitation..

Key Word: Hemisection, Dental caries, Periodontal disease, Root canal therapy

[1]. Kost WJ, Stakiw JE. Root amputation and hemisection. J Can Dent Assoc 1991; 57(1):42–5. [2]. Ingle, J. I., Bakland, L. K., Baumgartner, J. C., & Ingle, J. I. (2008). Ingle's endodontics 6. Hamilton, Ontario: BC Decker
[3]. Saad MN, Moreno J, Crawford C. Hemisection as an alternative treatment for decayed multirooted terminal abutment: A case report. J Can Dent Assoc 2009;75:387‑90.
[4]. Shafiq MK, Javaid A, Asaad S. Hemisection: An option to treat apically fractured and dislodged part of a mesial root of a molar. J Pak Dent Assoc 2011;20:183‑6.
[5]. Shah S, Modi B, Desai K, Duseja S. Hemisection – A conservative approach for a periodontally compromised tooth – A case report. J Adv Oral Res 2012;3:31‑5.

Abstract: Amputation affects the personal and socioeconomic lifestyle altogether, and the aftermath of the same can be devastating. A young boy who met with a railway accident and suffered a high bilateral above the knee traumatic amputation. The patient was immediately managed with stabilization and then a revision amputation by performing Guillotine hip disarticulation bilaterally followed by a delayed skin grafting. Patient responded well and progressed to mobilize himself well enough with crutches and support.

[1]. Dillingham TR, Pezzin LE, MacKenzie EJ. Limb amputation and limb deficiency: epidemiology and recent trends in the United States. South Med J. 2002;95(8):875–83.
[2]. Kaufman MH, Wakelin SJ. Amputation through the hip joint during the pre-anaesthetic era. Clin Anat. 2004;17(1): 36–44.
[3]. Boyd HB. Anatomic disarticulation of the hip. Surg Gynecol Obstet. 1947;84(3):346–9.
[4]. Sugarbaker PH, Chretien PB. A surgical technique for hip disarticulation. Surgery. 1981;90(3):546–53.
[5]. Zalavras CG, Rigopoulos N, Ahlmann E, Patzakis MJ. Hip disarticulation for severe lower extremity infections. Clin Orthop Relat Res. 2009;467(7):1721–6.

Abstract: Background: Symptomatic cholelithiasis With Choledocholithiasis is rare in children. While CBD perforation is very rare entity documented . Thus, a high degree of suspicion is required for diagnosis. Case Details: Management guideline for infantile cholelithiasis and choledocholithiasis is still controversial; various the rapeutic strategies were reported successfully A 7-month-old infant from sikar, rajasthan presented to the SawaiManSingh hospital Jaipur Rajasthan on September 12, 2019 with irritability, abdominal pain, jaundice, fever and vomiting .On workup, she found to be having cholelithiasis with choledocholithiasis . She underwent laparoscopic cholecystectomy with CBD exploration on 14th of September 2019 and discharged with improved results. This is the first report of symptomatic cholelithiasis and laparoscopic cholecystectomy with CBD exploration in india at 7 months ofage.....

[1]. Keller MS, Markle BM, Laffey PA, Chawla HS, Jacir N, Frank JL. Spontaneous resolution of cholelithiasis in infants. Radiology 1985;157:345‑8.
[2]. Jeanty C, Derderian SC, Courtier J, Hirose S. Clinical management of infantile cholelithiasis. J Pediatr Surg 2015;50:1289‑92.
[3]. Nordin N, Alex G, Clarnette T, Stephens N, Oliver M. Common bile duct stones in infancy: A medical approach. J Paediatr Child Health 2012;48:705‑9.
[4]. Thomas M, Kadiwar K, Domajnko B, Santos MC. Choledocholithiasis in a 4‑month‑old infant. J Pediatr Surg 2007;42:E19‑21.
[5]. St‑Vil D, Yazbeck S, Luks FI, Hancock BJ, Filiatrault D, Youssef S. Cholelithiasis in newborns and infants. J Pediatr Surg 1992;27:1305‑7

Abstract: BACKGROUND AND OBJECTIVE: Many scoring systems are introduced to assess the severity and outcome of the patients of acute pancreatitis. To evaluate the ability of the BISAP score in predicting the patients, who are at risk of severity, that is, development of systemic complications, pancreatic necrosis and organ failure. METHODS: A prospective observational study was done from November 2017 to June 2019. 50 patients who admitted to K.R Hospital, department of General Surgery, MMC&RI, Mysuru who were diagnosed as acute pancreatitis included in the study. Full history, clinical examination, ultrasound abdomen and lab investigations were done for the patients and assigned BISAP score for every patients of acute pancreatitis...

[1]. Baig SJ, Rahed A, Sanjay Sen. A Prospective study of the aetiology, severity and outcome of acute pancreatitis in Eastern India: Tropical Gastroenterology 2008; 29:20-22.
[2]. Petrov MS, Shanbhag S, Chakraborty M, Phillips AR, Windsor JA. Organ failure and infection of pancreatic necrosis as determinants of mortality in patients with acute pancreatitis.Gastroenterology. 2010;139:813-820. [3]. The Pancreatology Working Group of Chinese Society of Gastroenterology of Chinese Medical Association. Draft criteria for diagnosis and treatment of acute pancreatitis in China. Mod Dig Interv. 2007;12(3):206–208. [4]. Sabiston Textbook of Surgery,The Biological basis of Modern Surgical Practice,Chapter 55;Acute Pancreatitis. [5]. Banks PA, Bollen TL, Dervenis C, Gooszen HG, Johnson CD,Sarr,et al. Classification of acute pancreatitis-2012: revision of the Atlanta classification and definitions by international consensus. Gut.2013;62(1):102–11. 10.1136/gutjnl-2012-302779.

Abstract: La Cyphoplastie par ballonnets est une technique chirurgicale percutanée pratiquée sous contrôle radioscopique. Le principe de la Cyphoplastie est de restaurer l'anatomie du corps vertébral de manière douce et progressive par le gonflement de ballonnets, puis d'obtenir un renforcement de la colonne antérieure de la vertèbre avec du ciment. Initialement développée pour les lésions tumorales ou ostéoporotiques, elle a trouvé sa place en traumatologie dans la prise en charge des fractures en compression pure. Elles constituent une alternative intéressante aux traitements conventionnels souvent très contraignants. Les fractures vertébrales, compliquant l'ostéoporose peuvent parfois passer inaperçues et être quasiment indolores. Elles provoquent souvent d'importantes douleurs dont la majorité des cas soulagés par le repos au lit et des antalgiques efficaces, cependant un groupe non négligeable de patients et surtout les sujets âgés gardent toujours cette douleur avec...

[1]. Galibert P, Deramond H, Rosat P, Le Gars D. Preliminary note on the treatment of vertébral angioma by percutaneousacrylicvertebroplasty. Neurochirurgie 1987 ; 33–2 : 166–8.
[2]. Belkoff SM, Mathis JM, Fenton DC, Scribner RM, Reiley ME, Talmadge K. An ex vivo biomechanicalevaluation of an infla-tablebonetampused in the treatment of compression fracture. Spine 2001 ; 26–2 : 151–6.
[3]. Lieberman IH, Dudeney S, Reinhardt MK, Bell G. Initial outcome and efficacy of "kyphoplasty" in the treatment of painfulosteoporoticvertebral compression fractures. Spine 2001 ; 26 : 1631–8.
[4]. Maestretti G, Cremer C, Otten P, Jakob RP. Prospective study of standaloneballoonKyphoplastywith calcium phosphate cement augmentation in traumatic fractures. EurSpineBlondel B, Fuentes S, Metellus P, Adetchessi T, Pech-Gourg G, Dufour H.
[5]. Severethoracolumbarosteoporoticburst fractures : Treatmentcombining open kyphoplasty and short-segment fixation. OrthopTraumatolSurgRes 2009 ; 95 : 359–64.