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

Abstract: Aim: our retrospective study aims to highlight the improvement of trans cranial and transsphenoidal surgical related morbidity and complications avoidance strategy in in every step of the surgical procedure in our centre over the past 10 years with the overall management of tuberculum sellae meningiomas. Patients and methods: we present our Serie of 75 patients presenting with tuberculum sellae meningiomas operated in the department of neurosurgery at EHS (6) Cherchell Hospital and the department of neurosurgery at EHS Ali Ait Idir Hospital (7) over the period of 10 years (2009 to 2018). We reviewed all our cases in a retrospective descriptive study. Results: Majority of our patients presented with frontal headaches (95%) associated with the main symptom of visual impairment found in 95% ranging from slight unilateral visual loss to severe bilateral deterioration. A variety of approaches......

Keywords: optic nerve, optic canal, transcranial approach, transsphenoidal approach, Tuberculum sellae meningiomas.

[1]. Paolo Cappabianca, Luigi M. Cavallo, Michael W. McDermott, Tuberculum sellae meningiomas: grading scale to assess surgical outcomes using the transcranial versus transsphenoidal approach, Neurosurgical focus vol 44 (4):E9,2018
[2]. Michael E. Sughrue, Nader Sanai, and Michael W. McDermott, Al Mefty's meningiomas Franco DeMonte, Michael W.McDermott, Ossama Al-Mefty second edition 2011
[3]. Luigi Maria Cavallo, Norberto Andaluz, Alberto Di Somma, Domenico Solari, Paolo Cappabianca Meningiomas of the Skull Base Treatment Nuances in Contemporary Neurosurgery, Paolo Cappabianca, MD, Domenico Solari, MD, PhD (ISBN 978-3-13-241286-6), 2019 Thieme Medical Publishers
[4]. José Alberto Landeiro, Mariangela Barbi Gonçalves, Rodrigo Dias Guimarães, João Klescoski, Jorge Luiz Amorim Correa, Mário Alberto Lapenta, Tuberculum sellae meningiomas, Surgical considerations, Orlando Maia Arq Neuropsiquiatr 2010;68(3):424-429
[5]. Iracema Araújo EstevãoI, Bruno CamporezeI, Giovanna MatricardiII, Pedro da Silva JúniorIII, Daniel A. GrippIII, Natally M. SantiagoIII, Paulo Henrique Pires de Aguiar MedicalExpress Tuberculum sellae meningioma: Is there an ideal approach? (São Paulo, online). 2017 Aug;4(4):M170403

Abstract: Background- The study was carried out to identify the prevalence of G6PD deficiency in newborns with NIH,to compare patients with reduced G6PD activity with those with normal G6PD activity in terms of level of indirect hyperbilirubinemia,need for exchange transfusion(ET) and development of kernicterus.Method:-In a hospital based observational study,205 neonates with NIH admitted in neonatology ward,B.S.Medical college& hospital were evaluated for this study from dec 2018 to may 2019.Results:-Incidence of G6PD deficiency was 12.68%.Incidence in male was 76.9% & in female was 23.07%.The deficient patients having lower Hb levels(p<0.01),lower hct levels(p<0.01)but higher maximum bilirubin levels(p<0.01).Max.bilirubin level was a significant risk factor for kernicterus(p<0.01)and independently related to ET(p<0.01). Conclusion:-G6PD deficiency is an important risk factor for severe NIH,so early screening programme should be instituted to avoid subsequent irreversible complications.

Key Words:-Neonatal Hyperbilirubinemia,G6PD,kernicterus,screening

[1]. Slusher TM,Angyo IA,Bode TF..Trnscuteneous bilinrubin measurements and serum total bilinrubin levels in indigenous African infants.Paediatrics 2004;13:1636-1641.
[2]. Haque KM,Rahman M,an unusual case of ABO-hemolytic disease of newborn.Bangladesh Med Res Counc Bull.2000.Aug 26(2):61-4.
[3]. Weng YH,Chiu YW,Clinical characteristics of G6PD deficiency in infants with marked hyperbilirubinaemia.Pediatr Hematol Oncol.2010;32:Atay11-14.
[4]. Atay E,Bozaykut A,Ipek IO.Glucose-6-phosphate-dehyrogenase deficiencyin neonatal indirect hyperbilirubinaemia.J Trop Pediatr.2006;52:56-58.
[5]. Rice AC,Shapiro SM,A new animal model of hemolytic hyperbilirubinaemia-induced bilinrubin encephalopathy(kernicterus) Pediatr Res.2008;64:265-269.

Abstract: COPD is characterized by the presence of airflow limitation resulting from airways inflammation and remodeling often associated with parenchymal destruction and the development of emphysema. In this
observational study of 84 patients, non-smokers (21%) with COPD had less impairment in airflow limitation, chronic cough, and sputum compared with their smoking counterparts (50%).

Key Word: COPD,SMOKERS, EMPHYSEMA, SPIROMETRY.

[1]. Barnes PJ, Celi BR. Systemic manifestations and comorbities of COPD. EurRespir J. 2009;33(5):1165-85.
[2]. Global Initiative for Chronic Obstructive Lung Disease Global Strategy for the Diagnosis, Management and Prevention of COPD, Global Initiative for Chronic Obstructive Lung Disease 2017.
[3]. Balkissoon R, Lommatzsch S, Carolan B, Make B. Chronic obstructive pulmonary disease:a concise review.MedClinNorthAm.2011;95:1125–1141
[4]. Eisner MD, Anthonisen N and CoultasD.An official American Thoracic Society public policy statement:novel risk factors and the global burden of chronic obstructive pulmonary disease.AmJRespirCritCareMed.2010;182:693–718.
[5]. Lamprecht B, McBurnie MA and Vollmer WM.COPD in never smokers:results from the population-based burden of obstructive lung disease study.Chest.2011;139:752

Abstract: Introduction: Scalp blocks with local anesthetic agents are increasingly being used along with general anesthesia in neurosurgical practice to reduce pin and incision response along with providing intraoperative and postoperative analgesia. Insertion of skull pins is a strong nociceptive stimulus even under deep anesthesia. Blockade of the nerves that supply the relevant region of the scalp in order to blunt these noxious stimuli could be highly valuable in reducing hypertension and tachycardia. Different anesthetic and pharmacologic techniques, including local anesthetics, narcotics, antihypertensive, and deepening of anesthesia with inhalational anesthetics, have been used to blunt.....

[1]. Mathieu D, Beaudry M, Martin R,McLelland H, Robert B, Kenny B. effect of the local anesthetic agent bupivacaine prior to application of the skull pin holder for craniotomies. J Neurosurg 2003;33:277-9
[2]. Hillman DR, Rung GW, Thompson WR, Davis NJ. The effect of bupivacaine scalp infiltration on the hemodynamic response to craniotomy under general anaesthesia. Anesthesiology 1987; 67:1001-1003.
[3]. Dhanasekaran R, Prashath PN, Selvi T. A prospective randomized controlled study to assess the efficacy of gabapentin in attenuating the hemodynamic responses during skull pin insertion in patients undergoing elective craniotomy. IOSR J Dent Med Sci 2015; 14:55-63.
[4]. Mathieu D, Beaudry M, Martin R, McLelland H, Robert B, Kenny B. effects of the local anesthetic bupivacaine prior to application of the skull pin holder for craniotomies. J Neurosurg 2003; 98:1194-7.
[5]. Geze S, Yilmaz AA, Tuzuner F. The effect of scalp block and local infiltration on the haemodynamic and stress response to skull-pin placement for craniotomy. Eur J Anaesthesiol 2009;26:298-303.

Abstract: Aim: To evaluate technique of laparoscopic tubal sterilization in patients with previous caesarean section with respect to age, parity, time required , technical difficulty, operative time, intra-postoperative complications , conversion rates to conventional laparotomy and its reasons to be identified . Methods: A prospective study of laparoscopic tubal ligation done at teaching Medical College and in camp from January 2018 to June 2109.Total 53 cases were operated under spinal anesthesia. Laparoscopic tubal sterilization were performed in interval and postabortal cases. Data were analyzed with respect to age, parity, operative time, technical difficulty , intra/postoperative complication.....

Key words: Lap TL, Caesarean Section, Adhesion, Pffanenstial Scar

[1]. Jayakrishnan K, Baheti SN. Laparoscopic tubal sterilization reversal and fertility outcomes. J Hum Reprod Sci. 2011 Sep;4(3):125–9.
[2]. Grunert GM, Drake TS, Takaki NK. Microsurgical reanastomosis of the fallopian tubes for reversal of sterilization. Obstet Gynecol [Internet]. 1981 Aug [cited 2020 Jan 28];58(2):148–51. Available from: http://www.ncbi.nlm.nih.gov/pubmed/7254725
[3]. Singh K, Patel V. Safety of Laprascopic Tubal Ligation in patients with Previous Casarean Section. NMed Res. 2016;6(2):124–6.
[4]. Versage JL. Laparoscopic Tubal Ligation Technique: Introduction of the Laparoscope,Tubal Ligation Technique, Finishing the Procedure [Internet]. MEDSCAPE. 2018. Available from: https://emedicine.medscape.com/article/1848429-technique#c3
[5]. Gupta N, Sharma J. Laparoscopic tubal ligation in women with previous pelvic or abdominal surgery. Acta Medica Int [Internet]. 2016 [cited 2019 Dec 1];3(1):75. Available from: http://www.actamedicainternational.com/text.asp?2016/3/1/75/209725.

Abstract: Aim: To compare gall bladder extraction from epigastric versus umbilical port site in terms of port site infection and postoperative pain in Laparoscopic cholecystectomy. Methods: A prospective randomized study was done from June 2019 to December 2019 at Mysore Medical College and Research Institute, Mysore in which 50 cases of cholelithiasis were considered. Cases were randomly selected and allocated into two group, group A(gallbladder extraction from epigastric port; n=25 cases) and group B(gallbladder extraction from umbilical port; n=25 cases). VAS score for postoperative pain at port site, and surgical site infection was assessed and data was analyzed. Results: Port site pain was higher when gallbladder was extracted from epigastric port over umbilical port site. Surgical site infection was noted in 2 cases, 1 in each group.....

Keywords: Epigastric port, Umbilical port, Port-site pain

[1]. Waqar SH, Shah SF, Khan IA, Ch TS, Abdullah TM, Malik ZI, Zahid MA. Two –Port Laparoscopic cholecystectomy-A new technique. J Ayub Med coll. 2008 ; 4(20): 167-168
[2]. Bisgaard T, Klarskov B, Rosenberg J, Kehlet H. Characteristics and prediction of early pain after laparoscopic cholecystectomy. Pain. 2001; 90:261-9.
[3]. Liu YY, Yeh CN, Lee HL, Wang SY, Tsai CY, Lin CC et al. Local anesthesia with ropivacaine for patients undergoing laparoscopic cholecystectomy. World Journal of Gastroenterology. 2009;15:2376.
[4]. Lee IO, Kim SH, Kong MH, Lee MK, Kim NS, Choi YS, et al. Pain after laparoscopic cholecystectomy: the effect and timing of incisional and intraperitoneal bupivacaine. Canadian J Anesth.2001;48:545-50
[5]. Hunter JG, Thompson SK. Laparoscopic cholecystectomy, intraoperative cholangiography, and common bile duct exploration. in: J.E. Fischer, K.I. Band (Eds.) Master of surgery. Lippincott Williams and Wilkins; 2007: 1117-1128

Abstract: Background: Cervical cancer is the commonest cancer causing death among women in developing countries. Key to reduce cervical cancer morbidity and mortality is early detection and treatment of cervical pre-cancerous lesions.Knowledge and awareness of cervical cancer are important determinants of participation in cervical cancer prevention and control. Objectives:To assess the knowledge, attitude and practice related to cervical cancer and its prevention among women of reproductive age group (15-49 years) in Bishenpur, Manipur.Methods:Community based cross-sectional study among 500 women belonging to reproductive age group. Data were collected.......

Key Word: Awareness, cervical cancer, prevention, reproductive age group women, screening

[1]. Denny L. Cervical cancer: prevention and treatment. Discov Med. 2012;14:125–31.
[2]. India-Human Papillomavirus and Related Cancers, Fact Sheet 2018. Available at: URL:https://www.hpvcentre.net/statistics/reports/IND_FS.pdf?t=1558348728059. Accessed on May 20, 2019.
[3]. ICO Information Centre on HPV and cancer. Human Papillomavirus and Related Diseases in India (Summary Report 2014-08-22); 2014.
[4]. Human Papilloma virus and Related Diseases Report Asia. Available at: URL:https://www.hpvcentre.net/statistics/reports/XSX.pdf?t=1558348305301. Accessed on May 20, 2019.
[5]. A report on cancer burden in North Eastern states of India. 2017. Available at: URL:https://http://www.ncdirindia.org/All_Reports/Reports_Ne/NE2012_2014/Files/Chapter4.pdf. Accessed on May 20, 2019.

Abstract: Introduction-Laparoscopic Cholecystectomy(LC) is the gold standard procedure for symptomatic cholelithiasis .There are many forms of laparoscopic cholecystectomy Single incision laparoscopic cholecystectomy(SILC) being one of them..SILC has some documented advantages in comparison to four port LC.Use of Harmonic Ace in SILC has improved the efficiency of this procedure further and complications rate has been decreased, thus making SILC a promising surgical technique in treatment of symptomatic cholelithiasis. Methods-Patients of symptomatic cholelithiasis were randomised into 2 groups with 25 patients in each group.one group underwent dissection of gall bladder from liver with help of harmonic ace and other group underwent conventional electrocautery assisted......

[1]. Litynski GS. Highlights in the History of Laparoscopy. Frankfurt, Germany: Barbara Bernert Verlag; 1996:165–168.
[2]. One-wound laparoscopic cholecystectomy.Navarra G, Pozza E, Occhionorelli S, CarcoforoP, Donini I Br J Surg. 1997 May; 84(5):695.
[3]. Shai Shinhar, MD;Bret M.Scotch,DO;Walter Belenky,MD;David Madgy,DO;Michael Haupert,DO.Harmonic scalpel tonsillectomy vs hot electrocautery and cold dissection : an objective comparison.ENT journal October 2004 , volume 83 number 10.
[4]. Randomized clinical trial of ultrasonic versus electrocautery dissection of the gallbladder in laparoscopic cholecystectomy.Janssen IM, Swank DJ, Boonstra O, Knipscheer BC, Klinkenbijl JH, van Goor H Br J Surg. 2003 Jul; 90(7):799-803.
[5]. Tsimoyiannis EC, Jabarin M, Glantzounis G, et al. Laparoscopic cholecystectomy using ultrasonically activated coagulating shears. Surg Laparosc Endosc. 1998;8:421–4.

Abstract: Fracture union is decided by many factors .The prime factor being stability of the fracture and soft tissue attachments to the fragments which are fractured. There are certain methods of fracture fixation which offer a rigid stable fixation. But in the case of fracture with comminution and avulsed butterfly fragments, certain precautions in open reduction and internal fixation are necessary to achieve fracture union. Our study is about 85 cases of fracture both bones of fore arm with comminution, treated with Dynamic compression plating. The fracture configuration definitely plays a role in the fracture union.

[1]. Patrick J. A study of supination and pronation with special reference to the treatment of forearm fractures. J Bone Joint Surg. 1946 ; 28:737-748.
[2]. Murray C.R. The Detailed Operative Technique for Open Reduction and Internal Fixation of Fractures of the Long Bones. Journal of Bone and Joint Surgery.1944; 26: 307.
[3]. Eggers C.W.N, Shindler T.O, Pomeart C.M. The influence of the contact compression factor on osteogenesis in surgical fractures. J Bone and Joint Surg. 1949; 31-A: 693 -716.
[4]. Maurice E Muller, Martin Allgower, Robert Schneider. Manual of internal fixation: Techniques recommended by the AO-ASIF group. Springer Science & Business Media. 1990
[5]. M. Allgower, P. Matter, S.M. Perren et al., The Dynamic Compression plate. Springer-Verlag, Berlin, NewYork .1973

Abstract: Fracture femur is one of the common fractures that can be treated by many devices. The same fracture when presenting with segmental fracture pattern poses certain difficulties in reduction all the methods of fracture fixation. In the wake of increased road traffic accidents increasing high velocity accidents, there are femur fractures which show segmental pattern with different displacements, rotational deformities, comminution and butterfly fragments. Our study is designed s a prospective , observational study to know the fracture union in segmental fractures of femur treated with interlocking nails.

[1]. Johnson KD, Cadambi A, Seibert GB. Incidence of adult respiratory distress syndrome in patients with multiple musculoskeletal injuries: Effect of early operative stabilization of fractures. J Trauma. 1985;25:375–384
[2]. O'Toole RV, O'Brien M, Scalea TM, et al. Resuscitation before stabilization of femoral fractures limits acute respiratory distress syndrome in patients with multiple traumatic injuries despite low use of damage control orthopedics. J Trauma. 2009;67:1013–1021.
[3]. Braten M et al. Femoral shaft fractures treated by intramedullary nailing. A follow-up study focusing on problems related to the method. Injury: International Journal of the Care of the Injured. 1995; 26:379-303.
[4]. Chapman MW : The role of intramedullary nailing in fracture management. In : Browner BD &Edwaards CC : The science and Practice of intramedullary nailing pp17-23, Lea &Febiger, Philadelphia,1987
[5]. Watson JT, Moed BR. Ipsilateral femoral neck and shaft fractures: Complications and their treatment. ClinOrthopRelat Res. 2002:78–86.

Abstract: Introduction: Systemic hypertension is an important condition in childhood, with estimated population prevalence of 1-2% in the developed countries. Nutritional surveys, in the India show a significant secular increase in systolic and diastolic blood pressures. The causes for increase in blood pressure are attributed to obesity, change in dietary habits, decreased physical activity and increasing stress. Similar data is lacking from India; small surveys in school children suggest a prevalence ranging from 2-5 %. Materials and Methods: The present cross-sectional study was a school based survey conducted from June 2018 to August 2019 at Tagore Medical....

Key Words: Systemic hypertension, obesity

[1]. Munter P, He J, Cutler JA, Wildman RP, Whelton BK. Trends in blood pressure among children and adolescents. JAMA. 2004;291:2107–13.
[2]. Bagga A, Jain R, Vijayakumar M, Kanitkar M, Ali U. Evaluation and management of hypertension. Indian Pediatr. 2007;44:103–21.
[3]. Mohan B, Kumar N, Aslam N, Rangbulla A, Kumbkarni S, Sood NK, et al. Prevalence of sustained hypertension and obesity in urban and rural school going children in Ludhiana. Indian Heart J. 2004;56:310–14.
[4]. Chadha SL, Tandon R, Shekhawat S, Gopinath N. An epidemiological study of blood pressure in school children (5–14 years) in Delhi. Indian Heart J. 1999;51:178–82.
[5]. JNC VII Report. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatments of High Blood Pressure. JAMA. 2003;19:2560–72..

Abstract: Introduction: Lower respiratory tract infection (LRTI) is among the serious health problems specifically in less than 5 years of age needing hospitalization and attributes to 30 % of deaths yearly worldwide especially due to pneumonia as the leading cause. LRTI is infection listed below the level of the throat and might be taken to include: Bronchiolitis, Bronchitis, Pneumonia and empyema. It is swelling of the airways/pulmonary tissue, due to viral or bacterial infection, below the level of the larynx. Materials and Methods: This was a cross-sectional study carried out in pediatric intensive care unit (PICU) and Pediatric ward at Tagore Medical College and Hospital, Chennai. All children presenting with clinical symptoms suggestive of acute lower respiratory tract infections were evaluated in detail in hospital on IPD basis. Informed consent was taken. After an informed consent (Parent or guardian) in children, a detailed history was taken, and physical examination was done. Information on socio-demographic variables including child's age, gender and also symptoms.......

Key Words: LRTI, PICU, acute CROUP syndrome

[1]. Hugen CA, Oudesluys-Murphy AM, Hop WC. Serum sodium levels and probability of recurrent febrile convulsions. Eur J Pediatr. 1995;154(5):403- 5.
[2]. Kaneko K, Shimojima T, Kaneko K. Risk of exacerbation of hypona¬tremia with standard maintenance fluid regimens. Pediatr Nephrol. 2004;19(10):1185-6.
[3]. Watanabe T, Abe Y, Sato S, Uehara Y, Ikeno K, Abe T. Hyponatremia in Kawasaki disease. Pediatr Nephrol. 2006;21(6):778-81.
[4]. Van Steensel-Moll HA, Hazelzet JA, Vander Voort E, Neijens HJ, Hackeng WHL. Excessive Secre-tion of Antidiuretic Hormone in Infections with Respiratory Syncytial Virus, Archives of Disease in Childhood. 1990;65:237-9.
[5]. Hanna S, Tibby SM, Durward A, Murdoch IA. Incidence of hyponatra¬emia and hyponatraemic seizures in severe respiratory syncytial virus bronchiolitis. Acta Paediatr. 2003;92(4):430-4.

Abstract: Purpose: The aim of this preliminary study was toevaluate the effect of placement four implants following All-on-4 concept on anterior bone resorption in the upper completely edentulous patients opposing class I removable partial denture. Materials and methods: Six patients with total edentulous maxillary ridges and partially edentulous mandibular ridges (class I Kennedy classification) werereceived maxillary fixed prosthesison 4 implants according to the All on four protocol and mandibular distal extension RPD (Study group). The control group consisted of six patients whom received conventional maxillary dentures and distal extension mandibular RPD without any implant treatment.Evaluation of maxillary bone resorption for both groups was made at time of prosthesis insertion (T0) and 5 years later (T2) using the proportional area measurements made on digital panoramic radiographs for anterior2.......

[1]. Kelly E. Changes caused by a mandibular removable partial denture opposing a maxillary complete denture. J Prosthet Dent. 1972;27:140-150.
[2]. Cune MS, de Putter C HJ. Treatment outcome with implant-retained overdentures: Part II--Patient satisfaction and predictability of subjective treatment outcome. J Prosthet Dent. 1994;72:152-158.
[3]. Maló P, Rangert B NM. "All‐on‐Four" Immediate‐Function Concept with Brånemark System® Implants for Completely Edentulous Mandibles: A Retrospective Clinical Study. Clin Implant Dent Relat Res. 2003;5:2-9.
[4]. Krekmanov L, Kahn M, Rangert B LH. Krekmanov L, Kahn M, Rangert B, Lindstrom H. Tilting of posterior mandibular and maxillary implants for improved prosthesis support. Int J Oral Maxillofac Implants. 2000;15:405-414.
[5]. Ahuja S CD. Defining available restorative space for implant overdentures. J Prosthet Dent. 2010;6:104:133.