iosr-JDMS   Volume-19 ~ Issue-2 ~ February 2020

Abstract: Introduction: Nutrient foramina are the openings in the bone which leads into the canal of medullary cavity through which blood vessesls pass through and provide nutrition for the bone. Nutrient artery which is the major source of blood supply for the bone during the growth and development. Materials & Methods: The present study was conducted on 91 adult humerii, damaged and pathologically deformed bones were excluded from the study. The number, direction and location of nutrient foramen were observed with thehelp of a hand lens. Total length of the humerus and the distance of the nutrient foramen from its upper end, number and size of the nutrient foramina. Location of the nutrient foramen with respect to the surfaces,zones and the foramen index. Results: Out of 91 humerii.......

Key words: nutrient foramen, blood supply, fractures, nutrient artery.

[1]. Susan Standring - Gray's Anatomy – The anatomical basis of clinical practice. 41st ed. 2016, Elsevier,Section 1, Chapter: Bone; Pg. 89 - 90.
[2]. B.D. Churasia, Hand book of General Anatomy- 4th edition; Chapter 2, PP:43-45
[3]. Hughes H, The factors determining the direction of the canal for the nutrient artery in the long bones of mammals and birds. Acta Anat (Basel) 1952; 15:261-280.
[4]. Shanta Chandrasekaran and K.C. Shanthi, A Study on Nutrient Foramina of Adult Humerus; Journal of Clinical and Diagnostic Research. 2013 June Vol-7(6): 975-977.
[5]. Mansur DI, Manadhar P, Haque MK, Mehta DK, Duwal S, Timalsina B; A Study on Variations of Nutrient Foramen of Humerus with its Clinical Implications. Kathmandu Univ Med J 2016;53(1):78-83.

Abstract: Dietary supplements for male fertility commonly contain folic acidand zinc depending on limited prior evidence aiming improving semen quality. Never the less, there is nolarge trial has examined the efficacy of this supplements for improving semen qualityand live birth. OBJECTIVE To determine the effecacy of daily folic acid and zinc supplements on semenquality and live birth. METHODOLOGYThiswasa multicenter placebo controlled randomized clinical trial. Participants (n = 2370; men aged˃18 years and womenaged 18-45 years) seeking infertility treatment were enrolled at 5Saudi major hospitals between January 2016 and December 2019. INTERVENTIONS Men randomized to receive 5mg of folic acid and 30mg of zinc (n = 1185)or placebo (n = 1185) daily for 6 months......

Key words; Folic acid and Zinc supplementation, Semen Quality, Live births, Clinical Trial

[1]. Grand View Research. Dietary supplements market size analysis report by ingredient (botanicals, vitamins), by form, by application (immunity, cardiac health), by end user, by distribution channel, and segment forecasts, 2019-2025. industry-analysis/dietary-supplements-market.
[2]. Kantor, E., C. Rehm, M. Du, E. White, and E. Giovannucci, Trends in dietary supplement use among US adults from 1999-2012. Journal of American Medical Analysis, 2016. 316(14): p. 1464-74.
[3]. Palmsten, K., K. Flores, C. Chambers, L. Weiss, R. Sundaram, and G. Louis, Most frequently reported prescription medications and supplements in couples planning pregnancy: the LIFE study. Reproductive Science, 2018. 25(1): p. 94-101.
[4]. Incze, M. and M. Katz, Regulating the dietary supplement industry: the taming of the slew. Journal of American Medical Analysis Internal Medicine, 2018. 178(12): p. 1723.
[5]. Tucker, J., T. Fischer, L. Upjohn, D. Mazzera, and M. Kumar, Unapproved pharmaceutical ingredients included in dietary supplements associated with US Food and Drug Administration warnings. journal of American Medical Analysis Network Open, 2018. 1(6): p. e183337.

Abstract: Introduction: Enterobius vermicularis is one of the commonest parasitic infestations worldwide but its association with acute appendicitis (AA) remains controversial. It is very rarely encountered during appendectomy. Aim: The aim of this paper is to report a case of AA caused by E vermicularis. Material and method: An 8 year old girl presented with a right lower abdominal pain for the past 2 days. Clinical examination showed abdominal tenderness in the right lower quadrant. Ultrasound examination reported multiple mesenteric lymphadenopathies with non visualized appendix. The patient was diagnosed as a case of suspected acute appendicitis and operated under general anaesthesia. Open appendectomy was done through right grid iron incision on 20th January 2020. Appendix was found inflamed and histopathologically found Enterobius vermicularis.....

Key Word: Acute Appendicitis, Enterobius vermicularis, Abdominal Tenderness, Open Appendectomy, Histopathological Examination

[1]. Ilhan E, Senlikei A, Kizanoglu H: Do intestinal parasitic infestations in patients with clinically acute appendicitis increase the rate of negative laparotomy? Analysis of 3863 cases from Turkey. Prz Gastroenterol, 2013: 8: 366-369.
[2]. Dey S, Mohanta PK, Baruah AK: Alvarado scoring in acute appendicitis – a Clinicopathological correlation. Indian J Surg. 2010: 72: 290-293.
[3]. Flum DR, McClure TD, Morris DD: Misdiagnosis of appendicitis and the use of diagnostic imaging. J Am Coll Surg. 2005: 201: 933-939.
[4]. Nasiri S, Mohebbi F, Sodagari N: Diagnostic values of ultrasound and the modified Alvarado scoring system in acute appendicitis. Int J Emerg Med. 2012: 5:26-29.
[5]. Kirkil C, Karabulut K, Aygen E: Acute appendicitis scores may be useful in reducing the costs of treatment for right lower Quadrant pain. Turkish J Trauma Emerg Surg 2013: 19:13-19.

Abstract: Introduction: Intertrochanteric fractures are common in elderly osteoporotic population. Our study aims to analyse the clinico radiological outcome in these fractures operated using Proximal Femur Nail. Materials & Methods: This is a prospective study conducted multiple department involving 52 patients between June 2015 to June 2017. All patients more than 18 years of age with intertrochanteric fractures less than 2 weeks of injury were included. Pathological fractures, patients with previous hip surgeries, polytrauma and associated neurological problems like stroke were excluded. Fractures classified by AO system and fixed using Proximal Femur Nail. Optimal position of cervical screw in immediate postop and mean lateral sliding of cervical screw during every follow up were analysed. Harris Hip Score is used to analyse the functional outcome at 1 year. Results: Optimal Placement of screw achieved in 76% of patients with mean clinico radiological union time of 15.4 weeks. Lateral sliding of lag screw is more in unstable A3 fractures with mean lateral slide of the lag screw at the end of 1 year was 4.9mm.

Keywords: Intertrochanteric fractures, PFN, Harris hip score, screw cut out, "Z" effect

[1]. Dimon JH, Hughston JC. Unstable intertrochanteric fractures of the hip. J Bone Joint Surg Am. 1967; 49(3):440–50.
[2]. Morihara T, Arai Y, Tokugawa S, Fujita S, Chatani K, Kubo T. Proximal femoral nail for treatment of trochanteric femoral fractures. Journal of Orthopaedic Surgery. 2007 Dec;15(3):273-7
[3]. Kawaguchi S, Sawada K, Nabeta Y. Cutting-out of the lag screw after internal fixation with the Asiatic gamma nail. Injury 1998;29:47–53
[4]. Herrera A, Domingo LJ, Calvo A, Martinez A, Cuenca J. A comparative study of trochanteric fractures treated with the Gamma nail or the proximal femoral nail. IntOrthop 2002;26:365–9.
[5]. Schipper IB, Steyerberg EW, Castelein RM, van der Heijden FH, den Hoed PT, Kerver AJ, et al. Treatment of unstable trochanteric fractures. Randomised comparison of the gamma nail and the proximal femoral nail. J Bone Joint Surg Br 2004;86:86–94

Abstract: Background Pre- emptive analgesia is one of the prerequisites for modest postoperative outcome. It provides optimal physiological effect after a stressful intraoperative period. Different pharmaceutical forms of the same analgesic differ in their onset of action at the target sites. Materials and Methods In this study, two pharmaceutical forms of the drug diclofenac are compared regarding their effectiveness. The sample size was 50 each for diclofenac100mg transdermal patch and diclofenac 100mg suppository in post LSCS patients where surgery was done under LSAB......

[1]. Wall PD. The prevention of postoperative pain (editorial). Pain (1988), 33:289-290.
[2]. Kissin I. Preemptive analgesia Anesthesiology 2000; 93;1138-43
[3]. Gadsden I and Harts etal Post Caeserian delivery analog. AnaesthAralog 2005.Nov 101 (5Suppl): 562-9.
[4]. James C, Peter H Severity of acute pain after child birth but not type of delivery. Predicts persistent pain and post partum depression pain 2008 November 15; 140(1): 87-94
[5]. B) Woolf CJ, Chang MS (1993) preemptive analgesia treating postoperative pain by preveting the establishment of central sensitisation. Anaesth Analog, 77: 362-379..

Abstract: Background:Appendicitis represents one of the most common causes of abdominal pain of adult patients referred to the emergency department. Appendectomy is the most frequent emergency surgery performed worldwide.A clinical decision to operate leads to the removal of a normal appendix in 15-30% of cases and this rate of negative appendicectomies can be reduced by observing equivocal cases for a period of time. Graded compression ultrasonography technique is the first line method in diagnosing appendicitis.Detection of hyperemia of appendiceal wall using colour Doppler is gaining attention in the differentiation of enlarged appendix in the absence of acute inflammation from acute appendicitis and even gangrenous appendicitis.Therefore, this study is aimed at assessing the diagnostic accuracy of colour Doppler in acute appendicitis.....

Keywords: Acute Appendicitis, Colour Doppler, Hyperemia,Ultrasonography

[1]. Ditillo MF, Dziura JD, Rabinovici R. Is it safe to delay appendectomy in adults with acute appendicitis? Ann Surg 2006 Nov 11;244(5):656–60.
[2]. Abu-Yousef MM, Bleicher JJ, Maher JW. High-Resolution sonography of acute appendicitis. Am J Roentgenol 1987 Jul 1;149(1):53-8.
[3]. Xu Y, Jeffrey RB, Shin LK, DiMaio MA, Olcott EW. Color Doppler Imaging of the Appendix. J Med Un 2016 Apr 11;35(4):2129-38.
[4]. Quigley AJ, Starface S. Ultrasound assessment of acute appendicitis in paediatric patients: methodology and pictorial overview of findings seen. Insight Im 2013 Dec 1;4(6):741-51.
[5]. Quillin SP, Siegel MJ. Appendicitis in children: color Doppler sonography. Radiology 1992 Sep 4;184(5):745-7

Abstract: Background: Distal Radius fractures are one of the common injuries encountered in any hospital emergencies and OPDs. Most commonly it occurs due to domestic fall on outstretched hand. These fractures can be managed by Closed reduction and Cast immobilization, Percutaneous k-wire fixation(two/three k-wire),External fixation(distractor),Internal fixation with volar plating, Intramedullary nail fixation, & Combination of two method(example-Distractor with k-wire). We have studied the outcome of closed reduction and percutaneous pinning as treatment of displaced distal radius fracture. Aims: This study was done to evaluate the outcome of percutaneous K-Wiring with regard to union, infection and range of motion......

Key words: distal radius fracture , k-wire, union, fixation, functional outcome.

[1]. Cui Z, Pan J, Yu B, Zhang K, Xiong X. Internal versus external fixation for distal radius fractures. An up-to-date meta-analysis. Int Orthop 2011;35:1333-41.
[2]. Cooney WP 3 rd , Dobyns JH, Linscheid RL. Complications of Colles' fracture. J Bone Joint Surg Am 1980;62:613-9.
[3]. Krukhaug Y, Gjerdet NR, Lundberg OJ, Lilleng PK, Hove LM. Different osteosynthesis for colles fracture: A mechanical study in 42 cadaver bones. Acta Orthop 2009;80:239-44..
[4]. McQueen M, Caspers J. Colles' fracture: does the anatomical result affect the final function? J Bone Jt Surg Br 1988; 70:649–651.
[5]. Clancey GJ. Percutaneous Kirschner-wire fixation of Colles fractures. A prospective study of thirty cases. J Bone Joint Surg Am 1984; 66:1008–1014.

Abstract: Isolated post traumatic bladder neck disruption defects are very rare in paediatric age group. Most of the urethral and bladder injury in the paediatric age group is associate with pelvic trauma[1]. Here we present a case series of three patients with isolate bladder neck disruption defects following pelvic trauma

[1]. Goldman SM, Sandler CM, Corriere JN, McGuire EJ, Blunt urethral trauma: A unified, anatomical mechanical classification J Urol 1997 157:85-89.
[2]. McAninch JW, Voelzke B, Managing urethral trauma in children European Urological Review 2008 :118-121.
[3]. Philipraj SJ, Delayed repair is the ideal management for posterior urethral injuries- FOR the motion Indian Journal of Urology 2010 26(2):305-09.
[4]. Routh JC, Husmann DA, Long term continence outcomes after immediate repair of pediatric bladder neck lacerations extending into the urethra J Urol 2007 178:1816-18.
[5]. Balkan E, Kilic N, Dogruyol H, The effectiveness of early primary realignment in children with posterior urethral injury Int J Urol 2005 12(1):62-66.

Abstract: L'ingestion de corps étranger (CE) est une situation fréquente. Elle peut être accidentelle ou volontaire. Chez l'adulte, elle survient souvent chez les sujets âgés édentés, les patients ayant des troubles psychotiques ou encore les prisonniers. L'ingestion de corps étranger est volontaire dans le milieu carcéral car les prisonniers cherchent à être hospitalisé et quitter temporairement le milieucarcéral, chez d'autre c'est une façon de protester contre les conditions de détention. Les corps étrangers du tractus digestif sont le plus souvent bénins mais peuvent présenter un danger immédiat ou retardé lors de l'élimination ou encore lors de l'extraction. La mortalité liée à l'ingestion de corps étrangers est inférieure à 1% depuis 1995. Ces résultats s'expliquent par l'amélioration des prises en charge, et surtout des techniques d'extraction endoscopique (1).

[1]. Yasser m, abu-safiehf.food and foreign body impaction in upper gi tract. Gastrointestinalendoscopy2004; 59, 5: 242
[2]. Sahota a, shandil r, barmaki a. R, salama p, simpsonnl.Foreign body ingestions: characteristics and outcomes in a lowersocioeconomicpopulation. Gastrointestinalendoscopy2006; 63, 5: 154
[3]. 3. Barros jl, caballero a, jr, ruedajc, monturioljm. Ingestion de corps étrangers: gestionde 167 cas. World j surgery. 1991; 15 (6): 783-8.
[4]. M djodjo1, k botti1, kmev ebouat1, p ohayon2, h yapo-etté1, g qautrehommeprise en charge medicale des detenus ayant ingere volontairement des corpsetrangers:experience de l'ucsa de la maison d'arret de nice relative a 83corps etrangersingeres.revintscméd 2013; 15,3:171-177 © educi 2013
[5]. May bisharat , 1 mark e o'donnell , 1, 3 niallgibson , 1 michaelmitchell , 2 sigi r refsum, 1 p declancarey , 1 royajspence , 1, 3 et jack lee 1.ingestion de corps étrangers chez les détenus -l'expérience de belfast, ulster med j.2008 mai; 77 (2): 110-114.

Abstract: Background & Objectives: Supraclavicular brachial plexus block is a popular technique for providing anaesthesia for upper extremity surgeries.Perineuraladministration of dexmedetomidine and magnesium sulphate are known to enhance the effect of local anaesthetics. The purpose of this study was to compare the impact of perineuraldexmedetomidine and magnesium sulphate on the onset and duration of supraclavicular brachial plexus block using bupivacaine. Methods: After IEC approval, a prospective, randomized, double blinded study was conducted on 60 ASA I and II adult patients undergoing upper limb surgeries under supraclavicular brachial plexus block. Patients were randomly divided into two groups. The first group [Gr M] was administered magnesium sulphate 150 mg and the second group [Gr D] was administered dexmedetomidine100μg along with 0.5 % Twenty five ml of bupivacaine. The onset time.....

Keywords: Brachial plexus block; Bupivacaine; Dexmedetomidine; Midazolam

[1]. Kathuria S, Gupta S, Dhawan I. Dexmedetomidine as an adjuvant to ropivacaine in supraclavicular brachial plexus block. Saudi J Anaesth 2015;9:148-54.
[2]. Butterworth JF IV. Clinical pharmacology of local anesthetics. In: Cousins MJ, Horlocker TT, Bridenbaugh PO, Carr DB (eds) Neural blockade in clinical anesthesia and pain medicine,4th ed. Philadelphia:Lippincott Williams & Wilkins;2009:96-113.[3]. Brummett CM, Norat MA, Palmisano JM, Lydic R. Perineural administration of dexmedetomidine in combination with bupivacaine enhances sensory and motor blockade in sciatic nerve block without inducing neurotoxicity in rat. Anesthesiology 2008;109:502-11
[4]. Crews JC, Vincent WSC. Perioperative management of patients and equipment selection for neural blockade. In: Cousins MJ, Horlocker TT, Bridenbaugh PO, Carr DB (eds) Neural blockade in clinical anesthesia and pain medicine,4th ed. Philadelphia:Lippincott Williams & Wilkins;2009:160-80.
[5]. Esmaoglu A, Yegenoglu F, Akin A, Turk CY. Dexmedetomidine added to levobupivacaine prolongs axillary brachial plexus block. AnesthAnalg 2010;111:1548-51.

Abstract: Background: An inherent risk in the treatment of open fractures is the occurrence of Infection, Bone loss, Loss of Soft tissue coverage, and Non-union. The rate of infection ranges from 5% for type 1,10% for type 2 fractures and 18-38% for type IIIa-c fracture01,02,03. Immediate internal fixation adds insult to devascularisation and mixed infection. Multiple failed surgeries lead to Infection, fibrosis, shortening, Deformity. Multiple operative attempts at Non-union will exhaust bone graft donor sites. The bony gap results initially from an acute traumatic bone loss at the site of the injury, later from repeated debridements. Persistent infection at the Non-union site decreases the chance of wound healing and fracture union. Prolonged bed rest postoperatively leads to osteopenia with delay in resuming work leading to social isolation. Orthopaedic surgeon needs skills in Bone transport techniques, limb.....

Key Word:Non Union : Bone Loss : Ilizarov External Fixator : Infection

[1]. Bose D, Kugan R, Stubbs D, McNally M. Management of infected nonunion of the long bones by a multidisciplinary team. The bone & joint journal. 2015 Jun;97(6):814-7.
[2]. Schenker ML, Yannascoli S, Baldwin KD, Ahn J, Mehta S. Does Timing to operative debridement affect infectious complications in open long-bone fractures?: A systematic review. JBJS. 2012 Jun 20;94(12):1057-64.
[3]. Jacoby L. Does Timing to Operative Debridement Affect Infectious Complications in Open Long-bone Fractures?: Schenker ML, Yannascoli S, Baldwin KD, Ahn J, Mehta S. J Bone Joint Surg Am 2012; 94: 1057–64. Journal of Emergency Medicine. 2012 Oct 1;43(4):767.
[4]. Graves DT, Paglia DN, Alblowi J, Lin S, O'Connor JP. Impact of Diabetes mellitus on Healing of fracture. J Exp Clin Med 2011;3(1):3-8.18.
[5]. Kugan R, Bose D, Stubbs D, McNally M. Management of infected non-union of the long bones by a multidisciplinary team. The bone & joint journal. 2015 Jun;97(6):814-7.