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

Abstract: Sub clinical hypothyroidism (SCH), also called mild hypothyroidism is a term used for a condition in which there are small elevations in Thyroid stimulating hormone (TSH), yet normal circulating levels of thyroid
hormones and is essentially a laboratory diagnosis. Effect of SCH on peripheral nerves and muscles has been a matter of debate and conflicting results have been found by different workers. The purpose of this study was to
find any abnormality in nerve function that may occur in patients of SCH, by the help of nerve conduction study, which will contribute to early diagnosis and further management. Nerve conduction study of median
nerve, sural nerve and tibial....

Key Words:subclinical hypothyroidism (SCH), Nerve conduction velocity (NCV), Thyroid stimulating hormone(TSH)

[1]. Unnikrishnan AG, Menon UV. Thyroid disorders in India: An epidemiological perspective. Indian J Endocrinol Metab 2011;15:S78‑ 81.
[2]. Fatourechi V. Subclinical hypothyroidism : An Update for Primary Care Physicians . Mayo Clin Proc. 2009; 84(1):65-71.
[3]. Cooper DS (1987). Subclinical hypothyroidism. Journal of American Medical Association 258 246-7.
[4]. Bashir Ahmad Laway. Fayaz Ahmad War et al. Alteration of Lipid Parameters in Patients With Subclinical Hypothyroidism. Int J Endocrinol Metab. 2014 July; 12(3): e17496.
[5]. Kimura, J., 1986. Electrodiagnosis in diseases of nerve and muscle. Principles and Practices pp: 109-118.

Abstract:Aim: To present a rare case of squamous cell carcinoma of the conjunctiva Methods: A 56 years old female presented to the Outpatient Department of Ophthalmology with complaints of a
painless mass in her left eye since 3 months which was gradually progressive in size. The mass was excised with a 2 mm clear margin by the "no – touch" technique and sent for histopathological examination.
Results: On examination, a pale brown mass measuring 6x 9mm was seen on the nasal conjunctiva encroaching 3 mm of the cornea. Biopsy showed sheets of round to polygonal, pleomorphic cells with hyperchromatic nuclei
and few epithelial pearls. Tumour tissue was seen infiltrating into the underlying fibromuscular connective tissue, suggestive of a well differentiated squamous cell carcinoma....

[1]. Dandala PP, Malladi P, Kavitha. Ocular surface squamous neoplasia (OSSN): A retrospective study. J Clin Diagn Res 2015;9:NC10-3
[2]. Bitner D, Stone DU. Topical therapy for ocular surface squamous neoplasia. US Ophthalmic Rev 2013;6:154-7
[3]. Mittal R, Rath S, Vemuganti GK. Ocular surface squamous neoplasia – Review of etio-pathogenesis and an update on clinicopathological diagnosis. Saudi J Ophthalmol2013;27:177-86.
[4]. Chauhan A, Sharma SD. Squamous cell carcinoma of the conjunctiva: A rare case report. Clin Cancer Investig J 2016;5:460-2.
[5]. McKelvie PA, Daniell M, McNab A, et al Squamous cell carcinoma of the conjunctiva: a series of 26 cases British Journal of Ophthalmology 2002;86:168-173

Abstract: Introduction : Pancreatic pesudocyst is one of the common complication arising from pancreatitis. It forms walled off collection of sterile pancreatic fluid in the pancreatic parenchyma. The sac matures over a
period of 6 weeks and becomes amenable to various surgical modalities. The size of the cyst plays an important role in deciding the appropriate management. Starting from conservative line to Whipples procedure, the
surgical option varies. The distribution of cyst through the parenchyma calls for the proper intervention. Aims and objectives : The aim of this study is to analyze the different outcome in the management of pseudocyst
of pancreas.....

Keywords: pancreatitis, pancreatic pesudocyst, pancreatic abscess.

[1]. Kloppel G. Pseudocysts and other non-neoplastic cysts of the pancreas. Semin Diagn Pathol 2000;17:715.
[2]. Bradley EL 3rd. A clinically based classification system for acute pancreatitis. Summary of the International Symposium on Acute Pancreatitis, Atlanta, Ga, September 11 through 13, 1992. Arch Surg 1993;128:58690.
[3]. Pitchumoni CS, Agarwal N. Pancreatic pseudocysts. When and how should drainage be performed? Gastroenterol Clin North Am 1999;28:61539.
[4]. D'Egidio A, Schein M. Pancreatic pseudocysts: a proposed classification and its management implications. Br J Surg 1991;78:981
[5]. Nealon WH, Walser E. Main pancreatic ductal anatomy can direct choice of modality for treating pancreatic pseudocysts (surgery versus percutaneous drainage). Ann Surg 2002;235: 7518.1998 ; 43: 300 – 301.

Abstract: Diabetes mellitus is one of the most common chronic diseases worldwide and is associated with high morbidity and mortality1. This metabolic disorder causes damage in multiple organs. The normal role of
polymorphonuclear leukocytes, leukocyte adherence, chemotaxis, and the processes of phagocytosis may all be compromised2. Antioxidant systems involved in bactericidal activity can also be impaired3. Two patterns of
susceptibility to pneumonia in patients with diabetes have been noted2. Infections caused by certain micro organisms occur with increased frequency. Infections due to other microorganisms are associated with increased
mortality and morbidity. The increased incidence of tuberculosis in diabetics is thought due to malfunction of monocytes in diabetic patients with increased susceptibility to tuberculosis and/ or a worse prognosis4.

[1]. American Diabetes Association. Standards of medical care in Diabetes 2012. Diabetes Care. 2012 Jan;35 Suppl1:S11-63.
[2]. Koziel H, Koziel MJ. Pulomonary complications of Diabetes Mellitus. Pneumonia. Infect Dis Clin North Am.1995 March;9(1):65- 96.
[3]. Muchova J et al. Antioxidant systems in polymorphonuclear leucocytes of Type 2 Diabetes Mellitus. Diabet Med.1999 Jan;16(1);74-8.
[4]. Klekotka RB, Mizgala E, Krol W. The etiology of lower respiratory tract infections in people with Diabetes. PneumonolAlergol Pol.2015;83(5):401-8.
[5]. Bettegowda S, Iyengar VS, Gosain V, Naik VG, Vuyyuru S, Bandreddi GK. Clinical profile and spectrum of infections in type 2 Diabetes Mellitus patients : a retrospective study from rural tertiary care hospital of south Karnataka,india. Scholars journal of
applied medical sciences.2014;2(6G):3331-3336.

Abstract: Introduction: The term polyp when applied to the nasal cavity is purely a descriptive one, referring to the appearance of an abnormal pedunculated lesion[1]. Functional endoscopic sinus surgery (FESS) offers surgery tailored to the disease of each individual in order to restore sinus function through maximal preservation of normal sinus anatomy[2] .Oral Steroids by exerting its anti-inflammatory effect within the nasal cavity lining, reduces tissue oedema and by activating on the adrenergic receptors, causes vasoconstriction of the microcirculation [3].Objectives:1).To assess the effect of steroids over sinonasal mucosa and polyp during operation.2).To assess the effect of steroids in intraoperative bleeding and surgical field visibility. Design of study:Hospital based longitudinal prospective interventional analytical study.Materials and methods:The entire study included recruitment, data collection, data analysis and reporting from March 2019 to December 2019 in the Department of ENT.....

Key words: Sinonasal polyp, Functional Endoscopic Sinus Surgery (FESS),Oral Steroids, Intraoperative bleeding .

[1]. Logan turner's Diseases of the nose, throat and ear, Head and Neck Surgery. Eleventh edition 2016 p55-59.
[2]. Stammberger H. Surgical treatment of nasal polyps: past, present and future. Allergy 1999;54:7-11.
[3]. Sieskiewicz, A. et al: Preoperative corticosteroids oral therapy and intraoperative bleeding during functional endoscopic sinus surgery in patients with severe nasal polyposis; a preliminary investigation. Ann Otol Rhinol. Laryngoscopy, 2006;115(7)490-94.
[4]. Assaduzzaman AKM,Uddin MM : A comparative study on association of Allergy between Ethmoidal and Antrochoanal polyps ,Journal of Armed Forces Medical College Bangladesh 44(1):35-39 · June 2011.
[5]. Cingi C1, Demirbas D, UralA.Nasal polyposis: an overview of differential diagnosis and treatment. Recent Pat Inflamm Allergy Drug Discov. 2011 Sep;5(3):241-52.

Abstract: Aim: To describe the etiology and management of eyelid injury in a tertiary care hospital. Methods: A prospective interventional study was conducted at Department of Ophthalmology, Sri
VenkateswaraRam Narayan Ruia Government General Hospital attached to Sri Venkateswara Medical College, Tirupati.Total of 106 cases with eyelid injuries fulfilling the inclusion criteria were examined and results were
analyzed. Results:Out of 106 cases, majority of the patients weremales(67.92%) in the age group of 30-39yrs accounting for 39.62%. Most common mode of injury was road traffic accident(67.92%),most common type of laceration
was partial thickness laceration(60.37%), unsighty scar was the most common complication(5.66%). Discussion: In our study males outnumbered females with RTA being the most common mode of injury and most
of the eyelid injuries being partial thickness lacerations....

Keywords: Eyelid injury, road traffic accident, partial thickness laceration

[1]. NithinVichare. Management of Lid Lacerations. Delhi Ophthalmological Society -Times Vol.20, No.8 February, 2015;33-8.
[2]. Lt Col Avinash Mishra, Col V.K. Baranwal, Brig J.K.S. Parihar, SM, VSM Brig A.K. Verma. Simple laceration wound of the eyelids? Always remember to look under the lids!. Medical Journal Armed Forces India 69, 2013;301-04.
[3]. Shane Havens, BS, M4 OmofolasadeKosoko-Lasaki, M.D., MSPH, MBA Millicent Palmer, M.D. Penetrating Eye Injury: A Case Study. American Journal of Clinical Medicine, Winter 2009, Volume Six, Number One; 42-9.
[4]. Ali Tabatabaei, AbolfazlKasaei, MojganNikdel, SaeedShoar, Sara Esmaeili, MostafaMafi et al. Clinical Characteristics and Causality of Eye Lid Laceration in Iran. Oman Medical Journal, 2013 Vol. 28, No. 2; 97-101.
[5]. SelamYektaSendul, HalilHuseyinCagatay, BurcuDirim, MehmetDemir, SonmezCinar, CemileUcgul et al. Reconstructions of Traumatic Lacrimal Canalicular Lacerations: A 5 Years Experience. The Open Access Journal of Science and Technology 2015
Vol.3; 1-6.

Abstract: Background: Prophylactic drainage of wounds is aimed to reduce the wound complications and thereby morbidity. Obesepatients are at more risk. The objective of the present study was to determine whether
subcutaneousdrainage can reduce such complications in elective abdominal surgery in obesepatients. Materials and Methods: It is a prospective open comparative study carried over a period of one year. Patients
were randomized before surgery and divided into two groups by systemic random sampling. Total sample size 150 with 75 in each group.All patients will receive same preparations. The outcome is measured with the
following parameters such as seroma, hematoma, pain and surgical site infectionbetween the two groups Results:Wound complications observed in 6 patients with subcutaneous drain which forms 8% of the total
patients with subcutaneous drain. Wound.....

Key Word: subcutaneous drain, obesity, elective surgery, SSI

[1]. Dindo D, Muller MK, Weber M et al (2003) Obesity in general elective surgery. Lancet 361:2032–2035
[2]. Alexander JW, Korelitz J, Alexander NS. Prevention of wound infection. A case for closed suction drainage to remove wound fluids deficient in opsonic proteins. Am J Surg1976;132:59e63
[3]. Pitkin RM. Abdominal hysterectomy in obese women. Surg Gynecol Obstet 1976;142:532e6.
[4]. Gallup DC, Gallup DG, Nolan TE, Smith RP, Messing MF, Kline KL.Use of subcutaneous closed drainage system and antibiotics in obesegynaecologicalpatients. Am J Obstet Gynecol1996;175:358e62
[5]. Allaire AD, Fisch J, McMahon MJ (2000) Subcutaneous drain vs. Suture in obese women undergoing caesarean delivery. A prospective, randomized trial. J Reprod Med 45:327–33.

Abstract: Psoriasis is chronic papulosquamous disorder with remissions and exacerbations. Most commonly presents as chronic bilaterally symmetrical dry, erythematous , red well defined , scaly, papules and plaques.1 It occurs with equal frequency in both males and females. It has bimodal distribution with first peak occur at 15 to 20 years of age .Second one at 55 to 60 years. Mean age of onset was found to be 29 to 37 years.2 Psoriasis is associated with several extracutaneous manifestations like psoriatic joint disease which usually develops 5 - 10 years after skin disease onset, but has been reported as preceding classic skin findings in a minority of cases. Psoriatic arthritis, a seronegative, HLA-B27-associated spondyloarthropathy (SpA) is an inflammatory arthritis associated with psoriasis, symptoms of which have been reported in up to 30% psoriatic patients . There is a known association of uveitis and HLA-B27......

[1]. Rooks text book of dermatology IADVL, Fitz Patricks
[2]. Epidemology of psoriasis in a clinic from north india .Indian J Dermatol Venereol Leprol.1986;52:20812
[3]. Stuart JA. Ocular Psoriasis. Am J Ophthalmol 1963; 55:615-7.
[4]. Chandran NS, Graves M, Gao F, Lim L, Cheng BCL.Psoriasis and the eye; prevalence of eye disease in Singaporean Asian Patients with psoriasis; J Dermatol;2007;34(12):805-10.

Abstract: Background:Many prognostic systems have been developed to stratify perforative peritonitis patients. Many are complex and cannot be used in developing countries as the prognostic system depends on
sophisticated investigations. So, a simpler scoring system is developed to stratify those patients Materials and Methods: Our study included 50 patients who presented with features of peritonitis due to peptic
ulcer perforation and underwent emergency laparotomy for the same in Coimbatore medical college hospital. Results: Mortality and morbidity steadily increases with increase in the Jabalpur score. All the parameters in
Jabalpur score are individually significant in predicting the outcome. For a score of 9, sensitivity is 87.5%, specificity is 83.3%, positive predictive value is 50% and negative predictive is 97.2%.
Conclusion: Jabalpur score is a simple and effective scoring system to predict the mortality and morbidity in peptic ulcer perforation patients..

Key words: Perforation, mortality, morbidity, Jabalpur score.

[1]. The identification of various predictors for prognosis in duodenal perforation can help in risk stratification of individuals and thus signify the need of early prompt therapeutic measures in such individuals
[2]. Lee CW, SarosiJr GA. Emergency ulcer surgery. SurgClin North Am. 2011;91:1001–13. doi:10.1016/j.suc.2011.06.008.
[3]. SarosiJr GA, Jaiswal KR, Nwariaku FE, Asolati M, Fleming JB, Anthony T. Surgical therapy of peptic ulcers in the 21st century: more common than you think. Am J Surg. 2005;190:775–9.
[4]. Lau JY, Sung J, Hill C, Henderson C, Howden CW, Metz DC. Systematic review of the epidemiology of complicated peptic ulcer disease: incidence, recurrence, risk factors and mortality. Digestion. 2011;84:102–13. doi:10.1159/000323958.
[5]. Buck DL, Vester-Andersen M, Møller MH. Accuracy of clinical prediction rules in peptic ulcer perforation: an observational study.
Scand J Gastroenterol 2012; 47: 28-35

Abstract: Often terminal finger tip loss cause reconstructive surgeon in dilemma, in choosing the options to provide aesthetically near normal sensate finger tip. The local flaps are neither in adequate to cover the defect
nor do distant flaps- often over burden the tip with excess tissue. Reverse homo digital artery island flap is providing 'just enough' tissue to cover the defects and better solution to this problem by overcoming the
disadvantages with pleasing results. In this article we have shared our experience in three cases that were operated between 2017 to 2020, GGH, Department of Plastic Surgery, Vijayawada......

[1]. Shepard GH (1983) The use of lateral V-Y advancement flaps for fingertip reconstruction. J Hand Surg Am 8(3): 254-259.
[2]. Lai CS, Lin SD, Yang CC (1989) The reverse digital artery flap for fingertip reconstruction. Ann Plast Surg 22(6): 495-500.
[3]. Yan Feng Li, Shu Sen Cui (2005) Innervated reverse island flap based on the end dorsal branch of the digital artery: Surgical Technique. J Hand Surg Am 30(6): 1305-1309.
[4]. Han SK, Lee BI,Kim WK. The reverse digital artery island flap: clinical experience in 120 fingers. Plast ReconstrSurg 1998;101:1006-11.
[5]. Niranjan NS, Armstrong JR. A Homodigital reverse pedicle island flap in soft tissue reconstruction of the finger and the thumb. J Hand Surg Br 1994;19:135-41.

Abstract: OBJECTIVE: To f ind the as sociat ion between Cord blood Gas analysi s and outcome in the immediate neonatal period.STUDY DESIGN: Prospect ive observat ional
study. A total of 104 term newborns are included, and thei r Cord Blood gas values are analy zed. For ty- six had an acidic pH (<7.25) . Outcomes looked at are NICU admi ss ion,
need for resusci tat ion , convuls ions, encephalopathy.RESULTS: Stat i st ical signi f ican ce was found among var i ables l ike NICU....

[1]. John P Cloherty, Eric C Eichenwald, Ann R Stark. Manual of neonatal care.6th edit ion. New Delhi. WoltersklauwerPvt.Ltd; 2010.pp711-14.
[2]. Waldemar A Carlo, NarasivayamAmbalavanan (The fetus and neonatal infant) (Kleigman, Stanton, St Geme, Schor)Nelson textbook of paediatrics, 2016, pp834 -43.
[3]. MousaAhmedpour - Kacho, YadollahZahedpasha, Mohsen Hagshenas, Zahra AkbarianRad,Bahram Sadat Nasseri& Ali Bijani. Short outcome of neonates born with abnormal umbilical cord arterial blood gases. Iran J Pediatr 2015.25(3):e174.
[4]. Arch Dis Child Fetal Neonatal Ed 2014: Correlat ion between umbilical arterial pH<7.12 & early neonatal outcomes .K A Rogers, K Ramalingam
[5]. Gemma L Malin, Rachel K Morris , Khalid S Khan. Strenghth of associat ion between umbil ical cord pH & long term outcomes : systemat ic review and meta -analysis BMJ 2010;340:c1471.

Abstract: Background: The incidence of fibroepithelial lesion of Breast is found to be high. Most of the patients were found to be Asymptomatic. Of the fibroepithelial lesions, fibroadenoma and phyllodes tumour are difficult to differentiate. The lines of management of fibroadenoma and phyllodes tumour are different, as the fibroadenoma requires a simple enucleation but the phyllodes tumour requires a wide excision. So the aim of my study to put an effective investigation (i.e) the core needle biopsy to pre-operatively diagnose the phyllodes tumours. Methods:This prospective study includes 40 patients, presenting in Coimbatore Medical College and Hospitalwho were at high risk of developingphyllodes tumour, based on Paddington clinicopathological suspicion score between January....

Keywords: tumour, histopathology, excision, enucleation.

[1]. Rosen PP (2009) Fibroepithelial neoplasms. In: Rosen PP (ed) Rosen's breast pathology, 3rd edn. Lippincott Williams & Wilkins, Philadelphia, PA, pp 187–229
[2]. Tan PH, Tse G, Lee A et al (2012) Fibroepithelial tumours. In: Lakhani SR, Ellis IO, Schnitt SJ et al (eds) World Health Breast Cancer Research and Treatment 1 3 Organization classifcation of tumours of the breast. IARC Press, Lyon, pp 142–147
[3]. Morgan JM, Douglas-Jones AG, Gupta SK. Analysis of histological features in needle core biopsy of breast useful in preoperative distinction between fibroadenoma and phyllodes tumour. Histopathology 2010; 56:489–500. [CrossRef]
[4]. Guray M, Sahin AA. Benign breast diseases: classification, diagnosis, and management. Oncologist 2006; 11:435–449. [CrossRef]
[5]. Komenaka IK, El-Tamer M, Pile-Spellman E, Hibshoosh H. Core needle biopsy as a diagnostic tool to differentiate phyllodestumor from fibroadenoma. Arch Surg 2003; 138:987–990. [CrossRef]

Abstract: Purpose: Blood stream infections are very common in the paediatric age group and these are one of the common causes of morbidity and mortality in neonates and children. The incidence of bacteraemia in children varies widely. The rate of blood stream infections in children is about 20-50% in developing countries. Objectives: Therefore purpose of this study was to characterize various gram positive cocci and to know their antibiotic susceptibility pattern causing blood stream infections in children. Materials and Methods: This retrospective study was conducted in the Microbiology department of a tertiary care hospital, in Punjab. A total of 2498 paediatrics blood cultures were received from suspected cases of septicaemia in the laboratory. All the blood........

Key words: Bacteraemia, Gram positive cocci, MRSA.

[1]. De A, Saraswathi K, Gogate A, Fernandes AR. Bacteremia in hospitalized children-A one year prospective study. Indian J Med Microbiol.1995;13:72-5.
[2]. Meremkwer MM, Nwachukwu CE, Asuquo AE, Okebe J, Utsalo SJ. Bacterial isolates from blood cultures of children with suspected septicaemia in Calabar, Nigeria. BMC Infect Dis. 2005;5:110-5
[3]. Winn Jr. W, Allen S, Janda W, Koneman E, Procop G, Schrekenbeger P, et al. Guidelines for the collection, transport, processing, analysis, and reporting of cultures from specific specimen sources.In: Koneman's Color Atlas and Textbook of Diagnostic Microbiology, 6th ed. Lippincott Williams and Wilkins; 2006.97-105.
[4]. Mahon CR, Manuselis G. Textbook of Diagnostic Microbiology. 2nd ed. Philadelphia:Elsevierʼs Health Sciences;2000.p.997-1009.
[5]. Angus DC, Linde-Zwirble WT, Lidicker J, Clermont G, Carcillo J, Pinsky MR. Epidemiology of severe sepsis in the United States:analysis of incidence, outcome and associated costs of care. Crit Care Med. 2001;29:1303-10.