iosr-JDMS   Volume-19 ~ Issue-3 ~ March 2020

Abstract: gall stone ileus has variable presentations with symptoms presenting 4-8 days prior to obstruction, starting from migration of gall stone to impaction, usually near the ileocecal valve. The discussed case of a 45- year old lady presented with complaints of pain abdomen, vomiting and inability to pass stools in the medicine emergency since 2 days without any prior symptoms of cholecystopathy. An abdominal ultrasound was done and was reported as chronic cholecystitis with cholelithiasis and bilateral medico-renal disease, right more than left. She underwent contrast enhanced CT abdomen, which revealed pneumobilia with a choleduodenofistula and presence of calculi in the jejunum........

[1]. Clavien PA, Richon J, Burgan S, Rohner A, Gallstone ileus. Br J Surg 1990; 77:737-42.
[2]. Kasahara Y, Umemeura H, Siraha S, Kuyama T, Sakata K, Kubota H. Gallstone ileus. AM J Surg 1980; 140:437-40.
[3]. Raf L, Spagen L. Gallstone ileus. ActaChirScad 1971; 137:665-75.
[4]. Day EA, Marks C. gallstone ileus. Am J Surg 1986; 151:572-6.
[5]. Dietz DM, Standage BA, Pinson CW, McConnel DB, Krippaehne WW. Improving the outcome in gallstone ileus.

Abstract: This study discusses anatomical landmarks that are of relevance to the performance of a safe laparoscopic cholecystectomy and to determine the role of the Rouviere Sulcus, its description, its location and to evaluate the surgical relevance of the obtained data for safe Laparoscopic Cholecystectomy.The study was conducted from October 2017 to September 2019 in Department of General Surgery, Subharti Medical College, Meerut where 236 patients were evaluated who underwent classical four port Laparoscopic Cholecystectomy and careful note was made of Rouviere sulcus- presence, type, relations. Other anatomical landmarks: Gall Bladder, Hepato-Cystic triangle, Cystic artery, Cystic Duct- their anatomical variations and distortions were studied with aim to make operative surgeon aware about them and guide them during laparoscopic cholecystectomy.

Key Words: Rouviere's sulcus, Safe laparoscopic cholecystectomy, Anatomical landmarks, Cholelithiasis

[1]. Berci G, Hunter J, Morgenstern L, Arregui M, Brunt M, Carroll B, Edye M, Fermelia D, Ferzli G, Greene F, Petelin J, Phillips E, Ponsky J, Sax H, Schwaitzberg S, Soper N, Swanstrom L, Traverso W. Laparoscopic cholecystectomy: first, do no harm; second, take care of bile duct stones. SurgEndosc. 2013;27:1051–1054.
[2]. Fédération de chirurgieviscérale Risk management to decrease bile duct injury associated with cholecystectomy: measures to improve patient safety. J Visc Surg. 2014;151:241–244
[3]. Barrett M, Asbun HJ, Chien HL, Brunt LM, Telem DA. Bile duct injury and morbidity following cholecystectomy: a need for improvement. SurgEndosc. 2018;32:1683–1688.
[4]. Pucher PH, Brunt LM, Davies N, Linsk A, Munshi A, Rodriguez HA, Fingerhut A, Fanelli RD, Asbun H, Aggarwal R SAGES Safe Cholecystectomy Task Force. Outcome trends and safety measures after 30 years of laparoscopic cholecystectomy: a systematic review and pooled data analysis. SurgEndosc. 2018;32:2175–2183.
[5]. Strasberg SM, Hertl M, Soper NJ. An analysis of the problem of biliary injury during laparoscopic cholecystectomy. J Am Coll Surg. 1995;180:101–125.

Abstract: Introduction Abdominal cavity masses are often non palpable, deep seated and margins of these lesions are often undetached which makes it difficult to assess their size and shape. Ultrasound guided fine needle aspiration is a technique which is safe, rapid, accurate and simple which can be used for cyto-histologic diagnosis in abdominal masses and also for the confirmation of the suspected malignant masses in various intra abdominal locations. we present a study on ultrasound guided aspiration cytology of abdominal masses, the objective being to study the abdominal masses according to age and sex, analyze the usefulness of ultrasound guided aspiration cytology in diagnosing abdominal masses, classification of lesions according to organ involved and to evaluate theaccuracy of aspiration cytology in comparison to a histological diagnosis in available cases........

Keywords:- ultrasound guided FNAC, Abdominal masses, benign, malignant

[1]. Martin HE, Ellis EB. Biopsy by needle puncture and aspiration. Ann Surg 1930;92:169-81.
[2]. Rowley VA, Cooperberg PL. Ultrasound Guided Biopsy. Intervention Ultrasound in E Vansonnenberg, editor. Clinics in Diagnostic Ultrasound Vol.21. New York:Chuechill Livingstone; 1987.p.59-76.
[3]. Kedar RP, Patel VH, Merchant SA, Aggarwal V, Pandit AA. Ultrasound guided aspiration cytology- a valuable diagnostic aid. J PostgradMed 1991;37:84-7.
[4]. Hemlata Al, Sumana SV, Sushma S, Sum JK, Varna I, Anubha A. Ultrasound guided FNAC of Abdominal-Pelvic Masses-The pathologist perspective. J Clindiagn Res 2013 Feb;7(2): 273-77
[5]. Joao Nobrega and Guimaraes dos Santos. Aspirative cytology with fine-needle in the abdomen, retroperitoneum and pelvic cavity: a seven year experience of the Portuguese Institute of Oncology, Centre of Porto. European Journal of Surgical Oncology

Abstract: Introduction: In the orthopedic treatment arenatibialopen fracture is a common occurrence. Open fractures of tibia are classified into Type I, II, IIIA, IIIB and IIIC. Illizarov method is a popular method of treating open tibial fractures after debridement and open reduction. It is comparatively a newer method and has many advantages. As there are very few information regarding Illizarov method is available we had conducted this study. Aim of the study: The aim of this study was to evaluate thepatterns of tibial open fractures treated by Illizarov technique in a tertiary care hospital. Methods: This was an observational prospective study and it was conducted in the Department of Orthopedics,Shaheed M. Monsur Ali Medical.......

Keywords:Illizarov, Tibial, Fractures, Proximal,Distal,Fixator

[1]. Cannada LK, Anglen JO, Archdea- con MT, Herscovici D Jr, Ostrum RF. Avoiding complications in the care of fractures of the tibia. Instr Course Lect 2009; 58:27-36. [19385517]
[2]. Whittle AP, Wood ІІ GW. Fractures of lower extremity. In: Canale ST. Campbell's operative orthopaedics. 10th ed. Philadelphia, 2003; p. 2754-2773.
[3]. Webb LX, Bosse MJ, Castillo RC, MacKenzie EJ; LEAP Study Group. Analysis of surgeon-controlled vari- ables in the treatment of limb threaten- ing type-ІІІ open tibialdiaphysealfrac- tures. J Bone Joint Surg 2007;89: 923-28. [17473126] [http://dx.doi. org/10.2106/JBJS.F.00776]
[4]. Petrisor BA, Bhandari M, Schmitsch E. Tibia and fibula fractures. In: Bu- cholz RW, Court-Brown CM, Heck- man JD, Tornetta ІІІ P. Rockwood and Green's fractures in adults. 7th ed. Philadelphia; Lippincott Williams &Wilikins 2010; p.1867-1923.
[5]. Wani N, Baba A, Kangoo K, Mir M. Role of early Ilizarov ring fixator in the definitive management of type ІІ, ІІІA and ІІІB open tibial shaft frac- tures. IntOrthop 2011; 35:915-23. [20445978] [http://dx.doi.org/10.100 7/s00264-010-1023-7]

Abstract: Introduction: Hypertension (HTN) is one of the most common diseases of the cardiovascular system. It is an increasingly important medical and public health problem. Hypertension is regarded as an indicator for erectile dysfunction. That is why problems with erectile function are an important concern in the treatment of hypertension. Objective: To investigate the frequency and severity of erectile dysfunction among hypertensive and normotensive married men attending a tertiary care hospital of Bangladesh. Material & Methods: It was a cross sectional comparative study. The study was done in the Department of Internal Medicine, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka. The study was done from date of IRB approval (June 2017) to March, 2018. The protocol was approved by the Institutional......

Keywords: Hypertension (HTN), Erectile Dysfunction(ED), Internal Medicine, Blood Pressure (BP)

[1]. Doumas, M.and Douma, S., 2006. The effect of antihypertensive drugs on erectile function: a proposed management algorithm.The Journal of Clinical Hypertension 8(5), pp.359-63.
[2]. Kearney, P.M., Whelton, M., Reynolds, K., Muntner, P., Whelton, P.K. and He, J., 2005. Global burden of hypertension: analysis of worldwide data. The Lancet 365(9455), pp. 217-23.
[3]. Islam, A.M. and Majumder, A.A., 2012. Hypertension in Bangladesh: a review. Indian Heart Journal 64(3), pp. 319-23.
[4]. Chobanian,A.V.,Bakris,G,L.,Black,H.R,Cushman,W.C.,Green,L.A.,Izzo,J,L.Jr,Jones,D. W., Materson,B.J.,Opari,S.,Wright,J.T.,Jr,Rocella,E.J.,2003. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension, 42, pp. 1206-52.
[5]. Nunes, K.P., Labazi, H. and Webb, R.C., 2012. New insights into hypertension- associated erectile dysfunction. Current Opinion in Nephrology and Hypertension 21(2), p.163-70.

Abstract: Background: Obesity is a potential risk factor for cardiovascular morbidity and mortality. Non-communicable disease like cardiovascular disease is becoming a public health problem that it is already present in more developing countries. As certain cardiovascular disorders are often coexist in obese person. The increased risk of associated with higher serum cholesterol levels and obesity in middle-aged group has been clearly established but young adult age group yet not known. So, the aim of this study was to determine the relationship between body mass index (BMI) and total serum cholesterol in young adult age group. Objectives: To observe serum cholesterol level in young adult students of Bangladesh institute of child health (BICH) & its association with BMI. Materials & Method: This cross sectional.......

Keywords: Physiology, Body Mass Index (BMI), Serum Cholesterol, Weight.

[1]. Jones DW, Kim JS, Andrew ME, Kim SJ, Hong YP. Body mass index and blood pressure in Korean men and women: the Korean National Blood Pressure Survey. Journal of hypertension. 1994; 12:1433-7.
[2]. Kureshi N, Qureshi F, Sajid A. Current health of quality management practices in service sector SME: A case study of Pakistan. The TQM Journal. 2010; 22:317-29.
[3]. Gallagher D, Visser M, Sepulveda D, Pierson RN, Harris T, Heymsfield SB. How useful is body mass index for comparison of body fatness across age, sex, and ethnic groups? American journal of epidemiology. 1996; 143:228-39.
[4]. Schröder H, Marrugat J, Elosua R, Covas MI. Relationship between body mass index, serum cholesterol, leisure-time physical activity, and diet in a Mediterranean Southern-Europe population. British Journal of Nutrition. 2003; 90:431-9.
[5]. Seidell JC (1995a) Obesity in Europe: scaling an epidemic. Int J Obes Relat Metab Disord 19, Suppl. 3, S1–S4.

Abstract: Background: Acute appendicitis is the most common condition encountered in general surgical practice. Alvarado and Modified Alvarado scores (MASS) are the commonly used scoring systems for its diagnosis, but its performance has been found to be poor in certain populations. Hence, we compared the RIPASA score with MASS, to find out which is a better diagnostic tool for acute appendicitis in the Indian population. Materials and Methods: We enrolled 100 patients who presented with RIF pain in the study. Both RIPASA and MASS were applied to them, but management was carried out as per RIPASA score. Final diagnosis was confirmed either by CT scan, intra-operative..........

Keywords: Acute Appendicitis, Modified Alvarado score, RIPASA score.

[1]. Richard. A. Williams, Paul Myers. MONOGRAPH – Pathology of the Appendix, 1st edition, Chapman and Hall Inc. 1994.
[2]. Chong CF, Adi MIW, Thien A, et al. Development of the RIPASA score, a new appendicitis scoring system for the diagnosis of acute appendicitis. Singapore Med J 2010; 51: 220-5.
[3]. Cuscheri A, G R Giles, A R Mossa. (Editors), The small intestine and vermiform appendix (1995) In: Essential surgical practice, Butter worth Heinman, London, p. 1325-8.
[4]. Alvarado A. A practical score for the early diagnosis of acute appendicitis. Ann Emerg Med 1986; 15:557-64.
[5]. Escala RIPASA para el diagnóstico de apendicitis aguda: comparación con la escala de Alvarado modificada.Author links open overlay panelC.Z.Díaz-BarrientosaA.Aquino-GonzálezbM.Heredia-MontañobF.Navarro-TovarbM.A.Pineda-EspinosabI.A.Espinosa de Santillanac.

Abstract: La migration trans-utérine d'un dispositif intra-utérin (DIU) est une complication peu fréquente. Nous rapportons ici un cas de stérilet ayant totalement migré dans la vessie. Il s'agissait d'une patiente de 39 ans, G2P2 contracté sous stérilet mise en place il y a 5 ans. Elle a consulté initialement pour des douleurs abdomino-pelviennes associées à des brûlures mictionnelles rebelles au traitement et sensation de boule intra vaginale sans hématurie ni autres signes associés. Le diagnostic de migration totalement intra vésicale a été affirmé par l'échographie et la cystoscopie. Une TDM-AP a recherché une éventuelle atteinte digestive. Une extraction du stérilet par une mini-laparotomie transversale sus-pubienne a été réalisée avec succès.

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Abstract: Purpose: Oncoplasticbreast surgery (OPS) is now considered as the ideal surgery in treatment of breast cancer. This study wasdone to evaluate the patient satisfaction and cosmetic outcome of volume displacement oncoplastic breast surgery in women treated at a tertiary care cancer hospital in south India.. Methods: This is a prospective study of 23 patients who had volume displacement OPS between January 2018 and December 2019. The Patient satisfaction and Cosmetic outcome was evaluated by patients' questionnaire and a doctor. The satisfaction was assessed by a questionnaire divided into four categories; satisfaction with breast cosmesis, satisfaction with reconstruction method, satisfaction on operative method, side effects, and preference of operative method. Results.....

Keywords: Breast Cancer, Oncoplastic Breast Surgery, Cosmetic Outcomes

[1]. Fisher B, Anderson S, Bryant J, Margolese RG, Deutsch M, Fisher ER, et al. Twenty-yearfollow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med 2002; 347:1233-41.
[2]. Veronesi U, Cascinelli N, Mariani L, Greco M, Saccozzi R, Luini A, et al. Twenty-year follow-up of a randomized study comparing breast-conserving surgery with radical mastectomy for early breast cancer. N Engl J Med 2002;347:1227-32.
[3]. Garcia-Etienne CA, Tomatis M, Heil J, Friedrichs K, Kreienberg R, Sumin Ha et al. • Mastectomy trends for early-stage breast cancer: a report from the EUSOMA multi-institutional European database. Eur J Cancer 2012;48:1947-56.

Abstract: Precise marginal seating and internal fit of cast restorations are essential factors to fulfill the biological, physical and esthetic requirements of the restoration, taking this into consideration, the present study aimed to evaluate and compare the marginal fit and internal adaptation of cast copings fabricated with pattern wax and autopolymerized pattern resin materials invested at different intervals of time. Materials And Methods: A master metal Die was designed using CAD software and milled using Ni-Cr alloy. 3D printer was used to design a customized special tray for making impressions of master die. A total of 52 working dies were duplicated from the master metal die. The study included four groups; Group 1 included 13 samples fabricated using inlay wax by immediate investment. Group 2 included 13 copings fabricated using inlay......

Keywords: Marginal fit, Internal fit, Pattern resins, Inlay wax, Investment.

[1]. HarishV,AliM,JagadesanN,IfthikarM,SenthilS,BaskarD.et.al.
[2]. Evaluation of internal and marginal fit of two metal ceramic system- In vitro study. J clin Dian Res. 2014;8(12):53-6.
[3]. Rai R, Arun S, Prabhu R, Thillari R, Tanveer F. Evaluation of marginal and internal gaps of metal ceramic crowns obtained from conventional impressions and casting techniques with those obtained from digital techniques. Indian J DentR.
[4]. Ito M, Yamagishi T, Oshida Y, Munoz CA. Effect of selected physical properties of waxes on investments and casting shrinkage. The Journal of prosthetic dentistry. 1996 Feb1;75(2):211-6.
[5]. Sheikh SA, Chandra PK, Lekha K, Rao, M, Taneja P.A comparative evaluation of marginal and internal adaptation of complete cast copings fabricated using different pattern materials-a invitro study. Annals of dental specialty 2014;2:118-123.