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

Abstract: Apert syndrome is one of the rarest of the craniosynostosis syndrome. It was named for the French physician Eugene Apert in 1906. It is an autosomal dominant genetic disorder characterized by premature fusion of certain skull bones (craniosynostosis), craniofacial anomalies and severe symmetrical syndactyly of hands and feets. Most of the cases are sporadic, may result from new mutations in FGFR2 (fibroblast growth factor receptor 2) gene. Incidence is 15 per 1,000,000 live births with no sex predilection. The case report describes a 12 year old boy clinically and genetically diagnosed with apert syndrome displaying all the classic features of the syndrome..

Keywords: Apert syndrome; Craniosynostosis; Syndactyly; Fibroblast growth factor receptor 2 gene

[1]. Paravatty RP, Ahsan A, Sebastian BT, Pai KM, Dayal PK. Apert syndrome: A case report with discussion of craniofacial features. Quintessence Int 1999;30:423-6.
[2]. Madhura D, Naresh S. Apert's syndrome: A rare case report. J Indian Acad Oral Med Radiol. 2010;22:232-5.
[3]. Upadhyaya V, Upadhyaya DN, Sarkar S. Apert's syndrome: A case report. Indian J Radiol. Imaging 2005;15:477-80.
[4]. Apert E. De l' acricephalosyndactylie. Bull Soc Med Hop Paris 1906;23:1310‑30.
[5]. Cohen MM Jr, Kreiborg S. New indirect method for estimating the birth prevalence of the apert's syndrome. Int J Oral Maxillofac Surg 1992;21:107-9.

Abstract: Introduction: Pterygium is a common ocular surface degenerative condition, pathologically demonstrating elastoid degeneration of the conjunctiva, presenting as wing-shaped fibrovasculartissue,arising from the bulbar conjunctiva and invading on to the cornea. Materials and methods: This was a prospective observational study. Patients with primary pterygium attending the outpatient department at Regional eye hospital, Kurnool were randomly selected and divided into two groups of 50 each. Results: In the present study complications are Graft oedema, Graft edge retraction, Postoperativeinfection, Scleral thinning andnecrosis and Cornealscarring was observed in 3,2,0,0,0 and 7 patients in the conjunctivalautograft group and......

Keywords: Pterygium, Amniotic membrane graft, conjunctivalautograft

[1]. Garg A, Toukhy EE, Nassaralla B A, MorekarS.Surgical and Medical Management of Pterygium. Jaypee Brothers Medical Publisher, New Delhi 2009, 1sted.:1
[2]. Hill JC, Maske R (1989) Pathogenesis of pterygium. Eye (Lond)3:218-226.
[3]. Demartini DR, Vastine DW. Pterygium.Surgical interventions Corneal and External diseases. Orlando, USA: Grune and Straton; 1987.P.141
[4]. Asokan R, Venkatasubbu RS, Velumuri L, Lingam V, George R Prevalence and associated factors for pterygium and pinguecula in a South Indian population. Ophthalmic Physiological Optics 2012;32:39-44.
[5]. Nangia V, Jonas JB, Nair D, Saini N, Nangia P, et al. (2013) Prevalence and Associated Factors for Pterygium in Rural Agrarian Central India. The Central India Eye and Medical Study.PLoS ONE 8(12):e82439

Abstract: Introduction: Over the last 48 years since independence, Bangladesh has made lot of strides in the Health Sector. 1A huge and thriving network of private physicians stretched and spread to all over the country is trying to meet the needs of day to day medical problems.2 In every day, there have a huge number of patients attending in the department of orthopedics, JRRMCH, Sylhet. Diseases along with different consequences considers their pattern and recovery in the hospital. Objective: The study was to identify the disease pattern of the patients and its epidemiologic and demographic analysis who are coming to receive service from the hospitals. Methods: The study was retrospective by nature and performed in the department of Orthopedics, Jalalabad Ragib Rabeya Medical College hospital (JRRMCH), during the period......

Key Words: Fracture,oestrogen,elbow,osteoporosis, Postoperative

[1]. Health Bulletin-2018 [2]. http://banglajol.info/bd/index.php/BMJ/article/download/26356/17685 [3]. Staheli, Lynn, Fundamentals of Pediatric Orthopedics p. 119.
[4]. https://apps.who.int/iris/bitstream/handle/10665/85396/9789241505109_eng.pdf;jsessionid=7F4685DE471DDBD5C01B5531EB0E4DA5?sequence=1
[5]. WHO Guideline : STRENGTHENING ROAD SAFETY LEGISLATION: A practice and resource manual for countries

Abstract: Testicular ruptures are mostly related to blunt injuries most of the time, while possibility of malignancies and chronic epididymo-orchitis should be ruled out in long standing ones. Though mostly testicular traumas present as an emergency, delayed presentation and diagnosis has proved to have higher rates of morbidity. Early diagnosis and definitive treatment are the key to restore the quality of life without any impairment. Conservative management may be attempted when the trauma may be trivial or in absence of haematoceles. Surgical exploration is the preferred modality of treatment when substantiated with a strong clinical suspicion of testicular rupture in spite of deficient imaging evidence.

[1]. Buckley JC, McAninch JW (2006) Use of ultrasonography for the diagnosis of testicular injuries in blunt scrotal trauma. J Urol 175:175–178
[2]. Deurdulian C, Mittelstaedt CA, Chong WK, Fielding JR (2007) US of acute scrotal trauma: optimal technique, imaging findings, and management. Radiographics 27:357–369
[3]. Molokwu CN, Doull RI, Townell NH (2010) A novel technique for repair of testicular rupture after blunt trauma. Urology 76:1002–1003
[4]. Lee SH, Bak CW, Choi MH, Lee HS, Lee MS, Yoon SJ (2008) Trauma to male genital organs: a 10-year review of 156 patients, including 118 treated by surgery. BJU Int 101:211–215
[5]. Siegel MJ (1997) The acute scrotum. RadiolClin North Am 35:959–976

Abstract: Background: Nasopharyngealcarcinoma(NPC) comprises 1-2% of all the malignant tumors of head and neck. In India, Nasopharyngeal carcinoma constitutes only 0.06% of all body cancers. But in the North-Eastern state of India,especially Manipur and Nagaland where an incidence of 1.15% has been reported. The aim of this study is to understand the aetiological factors and clinic-pathological presentation of Nasopharyngeal Carcinoma in the North-Eastern state of India. Methods: A prospective study was carried out in the Department of Otorhinolaryngology and Head & Neck Surgery, Regional Institute of Medical Sciences, Imphal between 2014 to 2018. Data was analyzed using SPSS version 21....

Key Word: Clinico- pathological, Nasopharynx, Carcinoma, North East.

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[2]. Loring MF. Malignant tumours of the nasopharynx. Am J Roentgenol and Rad Therapy. 93(1): 36-43, 1965.
[3]. Chew CT. Nasopharynx- the post nasal space. Scott Brown's Otolaryngology. Ed. Booth JB. Butterworth-Heinemann. 6th Edn. Vol 5. 13:1-30, 1997.
[4]. Baruah T. A clinical and epidemiological study of nasopharyngeal carcinoma. Indian J Otokaryngol. 42(2): 54-9, 1990
[5]. Wei WI & Sham JST. Nasopharyngeal carcinoma. Lancet. 365:2041-54, 2005

Abstract: Background: In Bangladesh, obesity is emerging as an important health problem particularly in urban areas. The prevalence of obesity is rising to epidemic proportions at an alarming rate in both developed and less developed countries around the world [6]. This study was conducted to determine the association between serumTriglyceride with Body Mass Index (BMI) group (underweight, normal, overweight& obese) in patients seen in outpatient & inpatient department of cardiology, Patuakhali medical college hospital, Patuakhali, Bangladesh. Methods: This cross sectional study was conducted over a period of 1 year (June2018 to July 2019) on a sample of 127 conveniently selected patients between 30-70 years of age. Results: The total participants were 127 patients' males and females seen in outpatient & inpatient department of cardiology, Patuakhali medical college hospital......

Keywords: Body Mass Index, Lipid Profile.

[1]. S. Z. A. Shah, B. R. Devrajani .Frequency of dyslipidemia in obese versus non - obese in relation to body mass index (BMI), waist hip ratio (WHR) and waist circumference (WC). Pakistan Journal of Science (Vol. 62 No. 1 March, 2010).
[2]. A Misra, P Chowbey.Consensus Statement for Diagnosis of Obesity, AbdominalObesity and the Metabolic Syndrome for Asian Indians and Recommendations for Physical Activity, Medical and Surgical Management JAPI • VOL. 57 • FEBRUARY 2009
[3]. Kelishadi R, Alikhani S, Delavari A et al. Obesity and associated lifestyle behaviors in Iran: Findings from the first national non-communicable disease risk factor surveillance survey. Public health Natr 2008; 11: 246-51.
[4]. Hajian-Tilaki KO, Heidari B. Prevalence of obesity, central obesity and associated factors in urban population aged 20- 70 years, in the north of Iran. A population- based study and regression approach. Obes Rev 2007; 8:3-10.
[5]. Ezzati M, Martin H, Skjold S, Vander Hoorn S et al. Trends in National and State-Level Obesity in the USA after correction for self-report bias Analysis of Health Surveys. J R Soc Med 2006; 99:250-7.

Abstract: Background: Laparoscopic cholecystectomy (LC) is considered the gold standard treatment for most of the Gallbladder diseases. The advantages are many though at times LC will become difficult. It is very difficult to predict preoperatively, whether it is going to be easy or difficult. Materials and Methods: This is a prospective study conducted over a period of 12 months among the patients aged 16 to 60 years, presenting with symptoms and signs of Cholelithiasis /Cholecystitis and diagnosed by USG examination. The study was aimed to assess various preoperative predictors {history/ clinical/ imaging} and develop a scoring method for difficult laparoscopic cholecystectomy....

Key Word: Cholelithiasis; Laparoscopic cholecystectomy; Open cholecystectomy.

[1]. Randhawa JS, Pujahari AK. Preoperative prediction of difficult lap chole: a scoring method. Indian J Surg 2009;71:198-201.
[2]. Dhanke PS, Ugane SP. Factors predicting for difficult laparoscopic cholecystectomy: a single institution experience. Int J Stud Res 2014;4:3-7.
[3]. Lal P, Agarwal PN, Malik VK, Chakravarti AL. A difficult laparoscopic cholecystectomy that requires conversion to open procedure can be predicted by preoperative ultrasonography. JSLS : Journal of the Society of Laparoendoscopic Surgeons/Society of Laparoendoscopic Surgeons. 2002;6:59–63
[4]. Vivek MA, Augustine AJ, Rao R. A comprehensive predictive scoring method for difficult laparoscopic cholecystectomy. Journal of minimal access surgery. 2014;10:62–7.
[5]. Nachnani J, Supe A. Pre-operative prediction of difficult laparoscopic cholecystectomy using clinical and ultrasonographic parameters. Indian J Gastroenterol 2005;24:16-8. 7) The Southern Surgeons Club, Meyers WC (1991) A prospective analysis of 1518 laparoscopic cholecystectomy. N Engl J Med 324:1073–1078

Abstract: Initial non-operative regimen with selective interval appendicectomy is the standard management of appendiceal mass in children. This approach has recently been questioned due to its failure in 10-20% cases, leading to complications such as abscess and perforation peritonitis, which are more difficult to manage and have higher morbidity.[1] It is also associated with the need for longer hospitalisation, increased cost of treatment and loss of school days in children.[2] These patients may need second admission for interval appendicectomy, and often tend to delay their surgery and need readmission for another acute episode. Another disadvantage of non-operative management is the increased chance....

[1]. Kaya B, Sana B, Eriş C, Kutaniş R. Immediate appendectomy for appendiceal mass.UlusTravmaAcilCerrahiDerg. 2012;18:71–4. [PubMed]
[2]. Blakely ML, Williams R, Dassinger MS, Eubanks JW, 3rd, Fischer P, Huang EY, et al. Early vs interval appendectomy for children with perforated appendicitis. Arch Surg. 2011;146:660–5. [PubMed]
[3]. Garg P, Dass BK, Bansal AR, Chitkara N. Comparative evaluation of conservative management versus early surgical intervention in appendiceal mass — a clinical study. J Indian Med Assoc. 1997;95:179–80. 196. [PubMed]
[4]. Shindholimath VV, Thinakaran K, Rao TN, Veerappa YV. Laparoscopic management of appendicular mass. J Minim Access Surg. 2011;7:136–40. [PMC free article] [PubMed]
[5]. Goh BK, Chui CH, Yap TL, Low Y, Lama TK, Alkouder G, et al. Is early laparoscopic appendectomy feasible in children with acute appendicitis presenting with an appendiceal mass? A prospective study. J Pediatr Surg. 2005;40:1134–7. [PubMed]

Abstract: Aim And Objectives Of Study.. To manage pelvic inflammatory disease effectively.  To relieve symptoms. Material And Methods: 100 cases with provisional clinical diagnosis of Pelvic Inflammatory Disease were given Kit 6 and efficacy of Kit 6 was studied after 1 month.This is a prospective non randomised study conducted atGovernment Victoria Hospital for Women and Children, Visakhapatnam, Andhra Medical College for a period of one year from 1-4-2018 to 31-3-2019 were studied. Most of the cases are taken after careful history and clinical examination , investigated and treatment was given for 1month , results are studied and observations are recorded.

Key Word: Pelvic Inflammatory Disease , kit 6 , CRP ,leukocytosis ,vaginal discharge

[1]. NOVAC'S 16th editionChapter 16 PAGE NO.549
[2]. SHAWS GYNECOLOGY 17th edition chapter 27 PAGE NO.337
[3]. TE LINDE'S OPERATIVE GYNECOLOGY 12TH editionChapter 30,PAGE NO.660
[4]. JEFFCOATE'S PRINCIPLES OF GYNAECOLOGY 9th edition chapter 20, PAGE NO.416
[5]. Center for Disease Control.Sexually Transmitted Diseases Treatment Guidelines 2006.MMWR- Morbidity and Mortality Weekly Report 2006;55(RR-11):56-60

Abstract: Background: Fever with altered mentation is a common problem in clinical practice and often poses a diagnostic challenge to the clinician. On that ground, the study was planned to assess theclinico-aetiological spectrum of patients present with fever and altered sensorium. Methods: A total 50 patients admitted to the department of Medicine, Mymensingh Medical College Hospital through the emergency department with complaints of fever along with altered sensorium were included in this study. The socio-demographic variables, clinical features and disease descriptions were recorded in detail. To evaluate aetiological spectrum detailed biochemical, microbiological and radiological investigations were done. Separate case record form was....

Keywords: Fever, Altered sensorium, Non traumatic comma, consciousness.

[1]. Dorsett M, Liang SY. Diagnosis and Treatment of Central Nervous System Infections in the Emergency Department. Emerg Med Clin North Am. 2016;34(4):917–42.
[2]. Modi M, Goyal M. Acute onset Fever and Altered Sensorium: Acute Febrile Encephalopathy. Updat Trop fever Indian Coll Physicians. 2015;60–74.
[3]. Bhalla A, Suri V, Varma S, Sharma N, Mahi S, Singh P, et al. Acute febrile encephalopathy in adults from Northwest India. J Emergencies, Trauma Shock. 2010;3(3):220–4.
[4]. Khan R, Quaiser S, Alam S. Clinical profile and prognostic markers of acute febrile encephalopathy (AFE) in adult patients presenting to a North Indian tertiary care hospital. Int J Nutr Pharmacol Neurol Dis. 2015;5(3):95–102.
[5]. Marx GE, Chan ED. Tuberculous Meningitis: Diagnosis and Treatment Overview. Tuberc Res Treat. 2011;2011:798764.

Abstract: Background: The burden of infectious disease is a global problem and Indian population faces a significant number of morbidity and mortality due to this. To overcome this burden antimicrobial drugs are widely used in health care settings but in past few years overwhelming practice of these drugs created unnecessary emergence of resistance and adverse drug reactions. The rationality of usage of these drugs is being faded. This study was thus undertaken to evaluate error in antimicrobial prescribing pattern so that we can suggest some possible remedies at least in our hospital settings. Methods: The prospective study was carried out for a period of 3 months in medicine outpatient department of Medical college hospital, Raigarh. The prescriptions having at least one....

Key words: Antimicrobial, rational, generic, resistance.

[1]. Niederman MS. Appropriate use of antimicrobial agents: challenges and strategies for improvement. Crit Care Med. 2003 Feb;31(2):608-16.
[2]. Ahmad A, Patel I. Schedule H1: Is it a Solution to Curve Antimicrobial Misuse in India? Annals of Medical and Health Sciences Research. 2013;3(1):55-6.
[3]. How to investigate Drug use in Health Facilities. Selected drug use indicators. Geneva: World Health Organization; 1993:10.
[4]. GARP-India Working Group. Rationalizing antibiotic use to limit antibiotic resistance in India. Indian J Med Res. 2011;134:281-94.
[5]. Indira KK, Chandy SJ, Jeyaseelan L, Kumar R, Suresh S. Antimicrobial prescription patterns for common acute infections in some rural and urban health facilities of India. Indian Journal of Medical Research. 2008 Aug 1;128(2):165.

Abstract: The loss of facial structure, such as eye, nose ,ear in an individual influences psychology to a greater level. The cause for the loss of facial structure is due to severe congenital anomalies, accident trauma,surgical intervention of destructive tumour ,or malignancies .The rehabilitation of maxillofacial defect can be done in two ways, such as autogenous and prosthodontic reconstruction .The major problem with artificial prosthesis is by the method of retention it can be achieved.- soft tissue undercut ,adhesives and implant to support the prosthesis .The implant retained auricular prosthesis has lot of advantages compared to the other method of retention. This article discuss about the clinical considerations in placing implant with two different types of implant in two patients.

[1]. Wikes.G.H ; Wolfaardt J –Auricular defects treatment options In : Osseointegraion in craniofacial reconstruction ,Chicago (IL):Quintessence :1980 p 144-149.
[2]. De–Oliveeria .MF : Auricular prosthesis In: Osseointegration in craniofacial reconstruction ,Chicago (IL),Quintesence ;1980 p213-216.
[3]. Soft tissue reaction around percutaneous implants :A clinical study on skin penetrating titanium implants used to bone anchored auricular prosthesis . K.M.Hogler ,JOMI ,1987 ;2(1):35-39
[4]. Replcement of the auricle by an implant supported prosthesis with a cast magnetic splint bar for retention –A case report .Hans stress JOMI 1988; 3( 1): 141 -144 .
[5]. Removal torque of osseointegrated craniofacial implant : A clinical study –Andres Tjellstrom JOMI 1988; 13( 4): 290-293

Abstract: Introduction: Shift work disorder(SWD) is a circadian rhythm sleep disorder characterized by insufficient or excessive sleepiness occuring in people whose work hours coincide with the typical sleep period.A shift worker is anyone who follows a work schedule that is outside of typical 9am to 5pm business day. Objective: To assess the prevalence of SWD and other related health problems among doctors in a government established tertiary teaching care hospital. Materials And Methods: Arandomised prospective study was conducted in a tertiary care teaching hospital,tirupati, andhrapradesh for 3months ,that.....

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