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

Abstract: When choosing the route and method of hysterectomy, the physician should take into consideration how the procedure may be performed most safely and cost-effectively to fulfil the medical needs of the patient. In our study, a total of 60 patients admitted to gynecological ward requiring hysterectomy for benign diseases in the absence of uterine prolapse without suspected adnexal pathology were taken for study. There is considerable need of time and good assistant for modern gynaecologists to master this technique in advancing patient friendly minimal invasive surgeries . (from LAVH to TLH). Operating time is directionaly proportional to surgeon,s experience and better assistant during surgery.With adequate vaginal access ,with good assistance and good uterine mobility.

[1]. Kovac SR. Guidelines to determine the route of hysterectomy. Obstet Gynecol. 1995 Jan;85(1):18-23.
[2]. Sutton C. Hysterectomy: a historical perspective. Baillieres Clin Obstet Gynaecol 1997; 11:1-22.
[3]. Ransom SB, Mc Neeley SG, White C,Diamond MP. A cost analysis of endometrial ablation, abdominal hysterectomy, vaginal hysterectomy and laparoscopy – assisted vaginal hysterectomy in the treatment of primary menorrhagia. J Am Assoc GynaecolLaparosc.1996; 4(1):29-32.
[4]. Paparella P, Sizzi O, Rossetti A et al. Vaginal hysterectomy in generally considered contraindications to vaginal surgery. Arch Gynecol Obstet 2004;270:104– 9.
[5]. Unger JB. Vaginal hysterectomy for the woman with moderately enlarged uterus weighing 200 to 700 grams. Am J Obstet Gynecol.1999; 180: 1337-44.

Abstract: Abnormal uterine bleeding is one of the common gynecological problems women face and causing a serious threat to health as well as a great economic burden. Aim: The study aims to assess the efficacy of selective estrogen receptor modulatory action of Ormeloxilene in the treatment of menorrhagia. Subjects and methods The study was conducted at hospitals in Northern India from 01 January to 31 Aug 2015 on 50 patients with menorrhagia. The patients diagnosed as DUB and IUCD induced menorrhagia and perimenopausal menorrhagia were included in the study. The patients with menorrhagia for the sake of convenience had been grouped into four clinical patterns: normal cycle, prolong cycle, short cycle, and irregular cycle. The dose of a schedule of ormeloxifene followed was 120mg tablet twice weekly for twelve weeks followed by 60mg twice weekly, starting at the time of menstruation. The results were evaluated statistically......

Keywords : Menorrhagia, DUB, SERM, Ormeloxifene.

[1]. Karakoc B. Erenus M(1998) Compliance considerations with hormone replacement therapy. Journal of the North American Menopause Society, 5,102-6
[2]. Purdie DW Steel SA, Howey S Doherty SM(1996). The technical and logistical feasibility of population densitometry using DXA and directed HRT intervention a 2-year prospective study. Osteoporosis Int Suppl 3, S31-6
[3]. Collaborative Group on hormonal Factors in Breast Cancer (1997) Breast cancer and hormone replacement theory; a collaborative reanalysis of data from 51 epidemiological studies of 52705 women with breast cancer and 108411 women without breast cancer Lancet 350,1047-59
[4]. Weiderpass E, Adami HO, Baron JA et al (1999) Risk of endometrial cancer following estrogen replacement with and without progestins J Natl Cancer Inst 911131-7

Abstract: Background: Several studies on osteoporosis established that bone health is maintained by a complex interplay of hormones. The relationship between depression and bone mineral density (BMD) is yet to be ascertained. Depression globally identified as an emerging non-infectious cause of morbidity and mortality, has been found to induce changes in bone -brain -nervous system. Aim: The aim of this present study is to find the correlation between depression, serum cortisol and BMD and thereby role of hypothalamic-pituitary-adrenocortical (HPA) axis in inducing osteoporosis......

Key Words : Bone-brain -nervous system, BMD, Cortisol, Depression, HPA axis.

[1]. World Health Organization. Assessment of fracture risk and its application to screening for postmenopausal osteoporosis: report of a WHO study group [meeting held in Rome from 22 to 25 June 1992.
[2]. Kumar V, Abbas AK, Fausto N, Aster JC. Robbins and Cotran pathologic basis of disease.
[3]. Cizza G, Primma S, Csako G. Depression as a risk factor for osteoporosis. Trends in Endocrinology & Metabolism. 2009 Oct.
[4]. Thulkar J, Singh S. Overview of research studies on osteoporosis in menopausal women since the last decade. Journal of mid-life health. 2015 Jul;6(3):104. [5]. Cizza G, Primma S, Csako G. Depression as a risk factor for osteoporosis. Trends in Endocrinology & Metabolism. 2009 Oct 1;20(8):367-73.

Abstract: Background: In 1619, Varandaeus coined the term Eclampsia- Eclampsia is defined as new onset of grandmal seizures and /or coma during pregnancy or postpartum in a woman with pre-eclampsia.Severe Maternal Outcome (SMO) which includes maternal deaths and near miss and perinatal deaths are analyzed in this study with an aim to reduce its incidence. Objective: To evaluate the incidence of eclampsia and analyze the factors associated with maternal and fetal outcome. Methods: This study is a prospective observational study of 64 eclamptic women over a period of one year from Jan 2018 to Dec 2018 at Government General Hospital, Vijayawada, Andhra Pradesh. The number of deliveries during this period is 7,727......

Key words : Eclampsia, severe maternal outcome, perinatal outcome, maternal death.

[1]. Khan KS, Wojdyla D, Say L, Gulmezoglu AM, Van Look PF. WHO analysis of causes of maternal death: a systematic review. Lancet 2006;367:1066–74.
[2]. National High Blood Pressure Education Program Working Group on High Blood Pressure in Pregnancy. Report of the national high bloodpressure education program working group on high blood pressure in pregnancy. Am J Obstet Gyneco2000;183:S122.
[3]. Bhalerao A,Kulkarni S,Ghike S,Kawthalkar A,Joshi S,Somalwar S.Eclampsia:Maternal and fetal outcome.J South AsianFeder Obst Gynae 2013;5(1):19-21.
[4]. Jain R, Bindal J. Maternal and perinatal outcomes in eclampsia: a retrospective analysis in a referral hospital. Int J Reprod Contracept Obstet Gynecol 2017;6:2806-11.
[5]. Mahalakshmi G, Krishnaveni A, Nimma W, Vinusha K. The study of maternal and perinatal outcome of eclampsia in a tertiary hospital. IOSR J Dental Med Sci. 2016;15(4):123-8..

Abstract:Preterm labour is defined by the World Health Organisation as the onset of labour prior to the completion of 37 weeks of gestation in a pregnancy beyond 20 weeks of gestation1. Preterm birth is the leading cause of neonatal morbidity and mortality worldwide and accounts for 75% of neonatal deaths and 50% of long term morbidity, including respiratory disease and neurodevelopmental impairment2. Infection is implicated as theaetiological factor in 40-50% cases of preterm labour at early gestation(<30 weeks). Asymptomatic bacteriuria and systemic infections like pyelonephritis, pneumonia, acute appendicitis often lead to increased uterine activity and preterm labour3. Urinary tract infection is one of the most frequent bacterial infections4. It is the second most common bacterial infection seen during pregnancy5.

[1]. American college of Obstetrician and Gynaecologists. Preterm labour. Technical bulletin no. 206. Washington D.C. 1995
[2]. Gildenberg RL, Culhane JF, Iams JD, Romero R. Epidemiologyand causes of preterm birth. Lancet. 2008;371(9606) : 75-84
[3]. SumanaGurunath, RenuMisra. Preterm labour. In : Ian Donald's Practical Obstetric Problems, Seventh ed. New Delhi: BI Publishers; 2014. p:413.
[4]. Stamm WE, Hootan TM. Management of urinary tract infections in adults. N Engl J Med. 1993;329:1328-34.
[5]. Sampson JE, Gravett MG. Other infectious conditions in pregnancy. In: James DK, Steer PJ, Weiner CP,Govik B eds. High Risk pregnancy, management options 2nd Edition. London WB Saunders, 1999.p. 559-598
[6]. Uncu Y, Uncu g, Esmer A, Bilgel N. Should asymptomatic bacteriuria be screened in pregnancy? ClinExpObstet Gynecol. 2002; 29:281-5.

Abstract:Methods:
Two hundred fifty patients were analyzed following either laparoscopic or open appendectomy. The main outcome measures were postoperative complications. Secondary outcome measures included evaluation of pain and activity scores at base line preoperatively and on every postoperative day, as well as resumption of diet and length of hospital stay. Activity scores and quality of life were assessed on short-term follow-up.
Results: There was no mortality. The overall complication rate was similar in both groups (17.5% versus 16% in the laparoscopic and open groups respectively), but some early complications in the laparoscopic group required a reoperation. Operating time was significantly longer in the laparoscopic group (60 minutes versus 40 minutes; P = 0.000) while there was no difference in the pain scores and medications, resumption of diet, length of stay, or activity scores. At 2 weeks, there was no difference in the activity or pain scores, Appendectomy for acute or complicated (perforated and gangrenous) appendicitis had similar complication rates, regardless of the technique (P = 0.181).

[1]. Semm K. Endoscopic appendectomy. Endoscopy. 1983;15:59–64.
[2]. Majeed AW, Troy G, Nicholl JP, et al. Randomized, prospective, single-blind comparison of laparoscopic versus small-incision cholecystectomy. Lancet. 1996;347:989–994.
[3]. McBurney C. The incision made in the abdominal wall in case of appendicitis with a description of a new method of operating. Ann Surg.1894;20–38.
[4]. Guller U, Hervey S, Purves H, et al. Laparoscopic versus open appendectomy: outcomes comparison based on a large administrative database. Ann Surg. 2004;239:43–52.
[5]. Attwood SE, Hill AD, Murphy PG, et al. A prospective randomized trial of laparoscopic versus open appendectomy. Surgery. 1992;112:497–501. 6. Cox MR, McCall JL, Toouli J, et al. Prospective randomized comparison of open versus laparoscopic appendectomy in men. World J Surg. 1996;20:263–266

Abstract: Background: With the advancement of age people suffer from various illnesses which demand a regular health care support and that must also be accessible. There is a dearth of information regarding the status of health care accessibility in rural West Bengal. In this perspective the study was planned to assess the morbidities and health care accessibility among the elderly people in a block of Purba Barddhaman district, West Bengal, India. Materials and Methods: A community based observational study was conducted in Bhatar block of Purba Barddhaman district during July 2016 to December 2016 among the people aged 60 years or above, who were selected through multistage sampling. Data on morbidity and health care accessibility were collected through interview of the study subjects and record review........

Keywords : elderly, morbidities, health care accessibility.

[1]. Verma R, Khanna P. National Program of Health-Care for the Elderly in India: A Hope for Healthy Ageing. International Journal of Preventive Medicine 2013; 4(10): 1103- 1107.
[2]. Raju S. Ageing in India in the 21st Century: A Research Agenda [monograph on the internet].Mumbai: The Harmony Initiative; 2006.
[3]. Park K. Health problems of the aged. Preventive Medicine in Obstetrics, Paediatrics and Geriatrics. Textbook of Preventive and Social Medicine, 23rd Ed. Jabalpur. M/s Banarasidas Bhanot Publishers; 2015, 594-5.
[4]. Rechel B, Doyle Y, Grundy E, McKee M. How can health systems respond to population ageing? Copenhagen: WHO Regional Office for Europe; 2009: 17.
[5]. Ministry of Health and Family Welfare, Govt. Of India. Operational Guidelines- National Program for Health Care of the Elderly, Policy and Strategy Framework For implementation. New Delhi: Directorate General of Health Service; 2011: 1-3.

Abstract: Background : Neonatal seizures are defined as paroxysmal alteration in motor activity, behavior or autonomic function that results from abnormal electrical activity of brain in the neonatal period. Seizures are the most frequent sign of neurological dysfunction in the neonatal period. Seizures during the neonatal period are relatively common, occurring in approximately 1.1 to 8.5 per 1000 live births, with greater frequency in premature or low birth weight babies as compared to term babies. Methods: The aim was to determine the various etiological factors associated with neonatal seizures, describe the clinical profile of neonatal seizures and study the short term outcome. It was a hospital based prospective cross-sectional study conducted in the Department of Pediatrics, RIMS Imphal on 71 neonates with < 28 days of life with seizures.......

Key words : Seizures, neonate, term, cranium.

[1]. Olson DM. Neonatal seizures. Neo Reviews 2012;13(4):213–23.
[2]. Mosley M. Neonatal seizure. Pediatr Rev 2010;31(3):127-8.
[3]. Mizrahi EM, Kellway P. Characterization and classification of neonatal seizures. Neurology 1987;37(12):1837-44.
[4]. Johnston MV. Neonatal seizures. In: Behrman RE, Kliegman RM, Jenson HB, Stanton BF, editors. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, PA: Saunders Elsevier; 2008. p. 2471-3.
[5]. Levene M. Clinical conundrum of neonatal seizures. Arch Dis Child Fetal Neonatal 2002;86(2):75-7.

Abstract: Background: Iatrogenic biliary injury is a known and quite common complication following hepatobiliopancreatic surgeries, but spontaneous non-traumatic perforation of biliary tree is not so common. Aim. To investigate and treat the patients presenting with spontaneous extrahepatic biliary perforations. Methods: A total of 15 patients presented with spontaneous extrahepatic biliary perforation. Results: 9 patients were treated surgically and 6 patients responded with conservative management. Conclusion: Spontaneous biliary perforations should be diagnosed and treated as early as possible to prevent diffuse biliary peritonitis and sepsis, thereby reducing morbidity and mortality

Keywords: Gallbladder perforation, biliary peritonitis, abdominal paracentesis, T-tube drainage.

[1]. J.Freeland, "Rupture of the hepatic duct," The Lancet, vol. 119, no. 3062, pp. 731–732, 1882.
[2]. C. Chardot, F. Iskandarani, O. De Dreuzy et al., "Spontaneous perforation of the biliary tract in infancy: a series of 11 cases," European Journal of Pediatric Surgery, vol. 6, no. 6, pp. 341–346, 1996.
[3]. Roslyn J, Busuttil RW[1979] Perforation of gallbladder: a frequently mismanaged condition. Am J Surg 137[3]:307-312.
[4]. Simmons TC, Miller C, Weaver R. Spontaneous gallbladder perforation. Am Surg. 1989 May;55(5):311-3.
[5]. Kalliafas S, Ziegler DW, Flancbaum L, Choban PS. Acute acalculous cholecystitis: incidence, risk factors, diagnosis, and outcome. Am Surg. 1998;64(5):471–475.

Abstract: Introduction: Tibial plateau fractures are one of the commonest intra-articular fractures resulting from indirect coronal or direct axial compressive forces. Tibial plateau fractures constitute 1% of all fractures and 8% fractures in elderly. Objective: To evaluate the functional outcome of tibial plateau fractures (Schatzker Type П) treated by open reduction and internal fixation with buttress plating. Materials and methods: This were a prospective quasi experimental type of study. The study was conducted at Department of Orthopaedic Surgery, Dhaka Medical College and other private hospital at different area of Dhaka. During the period from July 2014 to June 2016. All patient with Tibial plateau fracture who underwent surgery meet the inclusion and exclusion......

Key words: Tibial condyle fractures, Internal fixation, Buttress Plating.

[1]. Cotton, F.G. and Berg. H., 1929. Fender fracture of the tibia at the knee.New Eng. J. Med, 201, pp.989-95.
[2]. Cubbins, W.R.,Conley, A.H., and Seiffert, G.S., 1929. Fractures of the lateral tuberosity of the tibia with displacements of the lateral meniscus between the fragments. Surg. Gynecol, Obstet.48, pp.106-08.
[3]. Cubbins, W.R. Conley, A.H. Callahan, J.J. and Scuderi, C.S., 1934. Fractures of the lateral condyle of the tibia – classification, pathology, and treatment. Surg. Gynecol. Obste., 59, pp. 461-68.
[4]. Sever, J.W., 1922. Fractures of the tibial spine combined with fractures of the tuberosities of the tibia. Surg. GynecolObstet, 35, pp. 558-64,
[5]. Sever, J.W., 1916. Fracture of tuberosities of the tibia. A report of three cases. Amer. J. Orthop. Surg14, pp. 299-302.

Abstract:Introduction Le paludisme grave est encore de nos jours un problème majeur de santé publique dans notre milieu. Sa morbidité et sa mortalité sont encore élevées surtout chez les enfants de moins de 5 ans. C'est dans la communauté que sont administrés les premiers soins et l'on n'y remarque souvent une attitude mitigée qui fait penser à une insuffisance d'information sur la maladie. Au niveau de l'hôpital, le non-respect des prescrits de l'OMS et de PNLP sur la prise en charge remet en cause les connaissances des prestataires sur le paludisme et sa prise en charge. L'objectif de ce travail était celui d'étudier la perception des mères et les raisons de non observance des recommandations sur la prise en charge du paludisme grave par les prestataires.
Méthodes.......

[1]. Ousmane SekouSamake. Etude des connaissances, attitudes et pratiques des mères d'enfants de 0 à 59 mois sur le Paludisme dans la commune V du district de Bamako. Thèses de doctorat. Université des sciences, des techniques et des technologies de Bamako. 2012-2013.
[2]. Ministère de la santé RDC. Santé et Pauvreté en République Démocratique du Congo: Analyse et Cadre Stratégique de Lutte contre la Pauvreté. Rapport d'enquête ESP. 2006.
[3]. Ministère de la Santé publique RDC. Santé et Pauvreté en République Démocratique du Congo: Analyse et Cadre Stratégique de Lutte contre la Pauvreté. Rapport sur l'état de pauvreté et santé en RDC. 2005.
[4]. Augustin M Mutombo, Eric Mukomena, Gray Kanteng, Christian Kakisingi, Guislain Mankan, Olivier K. Mukuku, Edouard Swana, Claude Mwamba, N. Michel Kabamba, Stanislas Wembonyama, Oscar Luboya, Jean-Baptiste Kakoma, Pascal Lutumba. Incidence of malaria in Lubumbashi, Democratic Republic of the Congo: An assessment of eight years. African Journal of Health Issues, eISSN: 2524-1303.
[5]. Augustin Mulangu Mutombo, Olivier Mukuku, Kristel Nzeba Tshibanda, Edouard Kawawa Swana, Eric Mukomena, Dieudonné Tshikwej Ngwej, Oscar Numbi Luboya, Jean-Baptiste Kakoma, Stanislas Okitotsho Wembonyama, Jean-Pierre Van Geertruyden, Pascal Lutumba. Severe malaria and death risk factors among children under 5 years at Jason Sendwe Hospital in Democratic Republic of Congo. Pan African Medical Journal. 2018; 29:184

Abstract: Le sarcome histiocytaire (SH) est une prolifération maligne rare des cellules histiocytaires matures, il représente moins de 1% de toutes les tumeurs malignes lympho-hématologiques. La localisation pulmonaire est exceptionnelle et rarement rapportée dans la littérature. Son diagnostic repose sur les techniques d'immunohistochimie et de biologie moléculaire. Nous rapportons le cas d'un patient âgé de 47 ans, pris en charge pour bilan d'un syndrome cave supérieure. La TDM thoraco-abdomino-pelvienne avait montré une masse médiastino-pulmonaire avec un nodule pulmonaire homolatéral et une embolie pulmonaire bilatérale, et dont la biopsie sous médiastinoscopie avec l'étude histochimique et immunohistochimique était en faveur d'un sarcome histiocytaire. La collecte des cas des sarcomes histiocytaires est importante pour obtenir de nouveaux progrès dans la prise en charge thérapeutique.

[1]. Takahashi E, Nakamura S. Histiocytic sarcoma: an updated literature review based on the 2008 WHO classification. J Clin Exp Hematop. 2013;53:1-8.
[2]. Hornick JL, Jaffe ES, Fletcher CD. Extranodal histiocytic sarcoma: clinicopathologic analysis of 14 cases of a rare epithelioid malignancy. Am J Surg Pathol. 2004;28(9):1133–1144.
[3]. Mathe G, Gerard-Marchant R, Texier JL, Schlumberger JR, Berumen L, Paintrand M. The two varieties of lymphoid tissue ―reticulosarcomas‖, histiocytic and histioblastic types. Br J Cancer. 1970;24:687-695.
[4]. Van D, Van Oostveen JW, Stel HV, van der Kwast T, Melief CJ, Meijer CJ. Phenotypic and genotypic analysis of large-cell lymphomas, formerly classified as true histiocytic lymphoma: identification of an unusual group of tumors. Leuk Res 1990;14:337—46.
[5]. Swerdlow SH, Campo E, Pileri SA, et al. The 2016 revision of the World Health Organization classification of lymphoid neoplasms. Blood. 2016;127(20): 2375–2390.

Abstract: Objectives: The aim of this in vitro study was to evaluate the effect of home bleaching (HB) and in-office bleaching (IFB) agents on the flexural strength of nano-composite resin after single and multiple exposures. Methods: 50 bar shaped samples were fabricated using nanohybrid composite resin and divided into 3 groups: home bleaching Group – 1 : Control group(n=10) placed in artificial saliva for 14 days, Group – 2 (n=10) bleached using home bleaching agent for 14 days and Group – 3 (n=10) bleached using in-office bleaching agents. Each of the experimental groups were further subdivided into 2 subgroups(2A,2B,3A & 3B) (n=10 each) based on the number of bleaching exposures such that subgroup-2A& 3A are exposed to bleaching agents once, whereas 2B & 3B are exposed for multiple times for 2 weeks and 3 weeks respectively. After bleaching treatment, a three-point bend test was performed using a universal testing machine, and flexural strength values were calculated. The data were analysed by statistical analysis.

[1]. Polydorou, O., Mönting, J. S., Hellwig, E., & Auschill, T. M. Effect of in-office tooth bleaching on the microhardness of six dental esthetic restorative materials. Dental Materials.2007;23(2):153–158. DOI:10.1016/j.dental.2006.01.004 [2]. Srinivasan, K & Chitra, S. (2015). Effects of Different Concentrations of Bleaching Agent on the Micro hardness of Restorative Materials"- An In Vitro Study. Journal of Research in Medical and Dental Science. 3. 188. 10.5455/jrmds.2015337.
[3]. Taher NM. The effect of bleaching agents on the surface hardness of tooth colored restorative materials. J Contemp Dent Pract. 2005;6:1826.
[4]. Gül, P., Harorli, O.T., Akgül, N. et al. J. Wuhan. Effect of different bleaching applications on the surface properties and staining susceptibility of dental composites. Univ. Technol.-Mat. Sci. Edit. (2016) 31: 677. https://doi.org/10.1007/s11595-016-1428-2
[5]. Hannig C, Duong S, Becker K, Brunner E, Kahler E, Attin T. Effect of bleaching on subsurface micro-hardness of composite and a polyacid modified composite. Dent Mater. 2007;23:198-203.

Abstract: Background: Non-venereal dermatoses tend to get confused with sexually transmitted diseases, which may be responsible for considerable concern to the patients as well as to the physicians. This study was done to analyze clinical pattern of non venereal diseases of genitalia. Materials and Methods: The study was conducted on 200 patients with genital lesions of all age groups during the period of December 2016 to August 2018. The patient's data was recorded in a pre structured proforma that includes detailed clinical history, general and cutaneous examination. Data collected was analysed, tabulated and conclusions were drawn........

[1]. Hillman RJ, Walker MM, Harris JRW, Taylor-Robinson D. Penile dermatoses: a clinical and histopathological study. Genitourin Med 1992; 68: 166–9.
[2]. Singh N, Thappa DM, Jaisankar TJ, Habeebullah S. Pattern of non-venereal dermatoses of female external genitalia in South India. Dermatol Online J.2008 Jan 15;14(1):1.
[3]. Acharya KM, Ranpara H, Sakhia JJ, Kaur C. A study of 200 cases of genital lesions of non-venereal origin. Indian J Dermatol Venereol Leprol. 1998;64:68–70.
[4]. Saraswat PK, Garg A, Mishra D, Garg S. A study of pattern of non venereal genital dermatoses of male attending skin OPD at a tertiary care center. Indian Journal of Sexually Transmitted Diseases and AIDS. 2014;35(2):129-134. doi:10.4103/2589-0557.142408.
[5]. Neerja Puri, Asha Puri: A study on non venereal genital dermatoses in north India. Our Dermatol Online. 2013; 4(1): 304-307.