iosr-JDMS   Volume-19 ~ Issue-6 ~ June 2020

Abstract: Objective: To evaluate the accuracy and impact of early computerized tomography ( CT ) in the diagnosis of non -traumatic acute abdomen when Ultrasonogram ( USG ) or X-ray findings are negative, equivocal or unable to provide additional information regarding the diagnosis. Materials and methods: 126 patients were included in this prospective study. Ultrasonogram was done as the initial modality in these patients and CT was done when USG findings were negative, equivocal or unable to provide additional information. Axial, coronal and sagittal reformatted images were studied. When appropriate, MIP and volume rendering techniques were also analysed. IV, oral and rectal contrast were used depending upon the clinical condition. All the 126 patients were followed up and diagnoses obtained before and after CT were compared with per-operative findings or final diagnosis at discharge......

Keywords: Acute Abdomen, Multi-detector CT

[1]. Fukuya T, Hawes DR, Lu CC, et al: CT diagnosis of small-bowel obstruction: efficacy in 60 patients. AJR Am J Roentgenol 1992; 158:765-769.discussion 771-772
[2]. Lazarus DE, Slywotsky C, Bennett GL, et al: Frequency and relevance of the "small-bowel feces" sign on CT in patients with small-bowel obstruction. AJR Am J Roentgenol 2004; 183:1361-1366.
[3]. Ha HK, Kim JS, Lee MS, et al: Differentiation of simple and strangulated small-bowel obstructions: Usefulness of known CT criteria. Radiology 1997; 204:507-512.
[4]. Na-ChiangMai W, Pojchamarnwiputh S, Le-rtprasertsuke N, ChitapanaruxT. CT findings of tuberculous peritonitis. Singapore Med J 2008; 49:488–491
[5]. Kim SW, Kim HC, Yang DM. Perforated tumours in the gastro intestinal tract: CT findings and clinical implications. Br J Radiol 2012; 85:1307–1313.

Abstract:The novel coronavirus has been a great threat to all health systems around the world.An unusual occurrence of an increased rate of pneumonia casesin Wuhan city of China is identified as SARS-CoV2(Severe acute respiratory syndrome – Coronavirus) or COVID 19. The virus started to spread globally due to the migration of infected persons. Considering the severity of this pandemic, the World Health Organisation declared a Public health emergency of International concern on January 30th, 2020. After the epidemic outbreak in china, an increased positive cases was reported from countries like Italy, America (US), Spain, Brazil, India, Japan, etc. Despite the availability of an advanced health care system, most of the developed countries struggling hard to control this pandemic. A country's demographic structure, effective preventive measures in response to the pandemic, person's immunity,co-morbid conditions,plays a vital role in determining changes in mortality rate..

Key Words: COVID19 or SARS CoV2, Demography, mortality rates, Co-morbidities

[1]. Sohrabi C, Alsafi Z, O'Neill N, Khan M, Kerwan A, Al-Jabir A, et al. World Health Organization declares global emergency: A review of the 2019 novel coronavirus (COVID-19). International Journal of Surgery. 2020 Apr;76:71–6.
[2]. Immune responses in COVID-19 and potential vaccines: Lessons learned from SARS and MERS epidemic. Asian Pac J Allergy Immunol [Internet]. 2020 [cited 2020 Jun 10]; Available from: http://apjai-journal.org/wp-content/uploads/2020/03/1.pdf.

Abstract: This study was carried out to determine the seroprevalence of Treponema pallidum among HIV positive patients attending Kogi State Specialist Hospital, Lokoja, Kogi State of Nigeria.100 patients, of which 50 were HIV positive and 50 HIV negative, were randomly selected and screened to determine the presence of syphilis. Two milliliter venous blood samples were aseptically collected and an immunochromatographic test was used to determine syphilis antibodies. Among the 100 patients screened, 78 were females and 22 males of which 4 females and 1 male tested positive to HIV co-infection with syphilis, with higher prevalence observed in females (8%) than in males (2%). In terms of occupation, business people had a higher prevalence (15%) against civil servants (8%), while patients who were single had.......

Key Words: Seroprevalence, HIV, syphilis, co-infection, Nigeria

[1]. UNAIDs and W. H. O. 2011. Global HIV/AIDS response: epidemic update and health sector progress towards universal access: progress report. Tech. Rep., November 2011.
[2]. Mutua, F.M., Minunya, J.M. and Wiysoge, C.S. (2012). Genital ulcer disease treatment for reducing sexual acquisition of HIV. Cochrane.Database System review; 8: CDO07933.
[3]. WHO. World Health Organization website. http://www.who.int.
[4]. Pearce, J.M.S. (1998). A note on the origin of syphilis. Journal of Neurosurgery and Psychiatry,64:542-547.
[5]. Ophori, E.A., Atanunu, O., Jouny, E.J. and Adu, M. (2010). The seroprevalence of syphilis in apparently healthy studies from a tertiary institution in Benin City, Nigeira. Japanese Journal of infectious Diseases, 63, 437-439..

Abstract:Total anomalous pulmonary venous return(TAPVR) is a rare cyanotic congenital cardiac defect (CCHD) characterisedby the absence of direct communication between the pulmonary veins and the left atrium (LA), resulting in the pulmonary veins draining abnormally into the systemic venous circulation or into the right atrium (RA). The pathophysiology of TAPVR predisposes to the development of cerebral abscess; however, documented cases of TAPVR complicated by cerebral abscess are not commonly encountered. Both TAPVR and cerebral abscess are associated with high mortality rates, emphasising the need for early diagnosis and prompt and appropriate interventions. This is the case report of an 8 year old boy with an uncorrected TAPVR managed for multifocal cerebral abscesses with good outcome.

Key Words: total anomalous pulmonary venous return, multifocal, cerebral abscess, cranial CT

[1]. Park MK. Cyanotic congenital heart defects: total anomalous pulmonary venous return. In:Park'sPediatric Cardiology for
Practitioners. 6th ed. Philadelphia, PA: Elsevier Saunders; 2014. p. 237-42.
[2]. Kumar K. Neurological complications of congenital heart disease. Indian J Pediatr. 2000;67:287-91. [PubMed] [Google Scholar]
[3]. Mehnaz A, Syed AU, Saleem AS, Saleem AS, Khalid CN. Clinical features and outcome of cerebral abscess in congenital heart
disease. J Ayub Med Coll Abbottabad. 2006;013:21–4. [PubMed] [Google Scholar]\
[4]. Naha K, Vivek G, ShettyRK, NayakK. Late presentation of TAPVC with multiple cerebral abscesses. BMJ Case Rep.
2013:;2013:bcr2013009778.
[5]. Sharma BS, Gupta SK, Khosla VK. Current concepts in the management of pyogenic brain abscess. Neurol India. 2000;48:105-111.
[6]. Mughal Z, Rafay M, Zeeshan S. Cerebral abscess and oral antibiotics. Surgery Curr Res. 2019;9:333.doi: 10.35248/2161-
1076.19.9.333.

Abstract: Reactive oxygen species production plays an important role in the pathogenesis of periodontal disease. In periodontitis, polymorphonuclear leucocytes appear to be functionally activated and exhibit increased production of reactive oxygen species. Reactive oxygen species may lead to damage the periodontium. The use of antioxidants in the treatment of periodontitis prevent tissue damage caused by reactive oxygen species. Glutathione is the most important intracellular antioxidant for ROS detoxification and a good marker for investigating the antioxidant defense mechanism in periodontitis caused by oxidative stress.The tissue damage associated with oxidative stress, and enhancing wound healing with glutathione cannot be underestimated, so need to be evaluated further through randomized controlled trials..

Key Words: Glutathione, Reactive oxygen species, Periodontitis, Antioxidants, oxidative stress

[1]. Albuali WH. Evaluation of oxidant-antioxidant status in overweight and morbidly obese Saudi children. World J ClinPediatr 2014; 8:6–13.
[2]. Azuma T, Tomofuji T, Endo Y et al. Effects of exercise training on gingival oxidative stress in obese rats. Arch Oral Biol 2011; 56:768–774.
[3]. AlkadasiB; GaafarS; HosnyM; Shaker O; AbdomonaimW and Hosny M. The effect of adjunctive use of n-acetyl cysteine on soluble receptor activator nuclear factor kappa-b ligand (sRANKL) level in gingival crevicular fluid in chronic periodontitis patients. E.D.J. Vol. 59, No. 3 August, 2013.
[4]. AlkadasiB; Abdulrab S, GaafarS; kalakonda B, HosnyM; Shaker O; and Hosny M. The effect of adjunctive use of systemic antioxidant therapy (N-acetyl cysteine) on soluble receptor activator nuclear factor kB ligand level in gingival crevicular fluid following surgical periodontal treatment for chronic periodontitis. Journal of oral science, October 2017
[5]. Borges JrI, Moreira EAM, Filho DW, Bittencourt de Oliveira T, Spirelle da Silva MB and Fröde TS. Proinflammatory and oxidative stress markers in patients with periodontal disease. Mediators of Inflammation 2007; 1-6..

Abstract: BACKGROUND: Any skin closure technique aims at opposing the skin edges precisely without tension for sufficient time to allow healing to take place. The ease and speed with which the skin closure is completed, the level of patient discomfort, the complication rate, and the final cosmetic result are the factors which has to be considered in making a comparison of different types of wound closure. This study aims at comparing staplers, subcuticular and conventional sutures for wound closure after thyroid surgery based on assessment of post-operative pain, cosmetic appearance and wound healing......

Keywords: Neck incisions, thyroidectomy, wound closure

[1]. Hochberg J, Meyer KM, Marion MD. Suture choice and other methods of skin closure.Surg Clin North Am 2009;89:627-41.
[2]. Cohen IK. A brief history of wound healing 1st ed. Yardley. PA: Oxford clinical communications Inc 1998.
[3]. Madden J.W. Text book of Surger: The biological basis of modern surgical sutures. 11th ed. Philadelphia: WB. Saunders and company 1977: 271.
[4]. Goslen JB. Wound healing for the dermatologic surgeon. J Dermatol Surg Oncol 1988;14:959-72.
[5]. Robert J Boucek. Factors affecting wound healing. Otolaryngological Clinics of North America 1984;17: 243..

Abstract: In this age of Chemoradiation for carcinoma of laryngopharynx,post-operativepharyngocutaneousfistula (PCF) is has become quite common. It results in significant morbidity and prolonged patient stay. Although conservative management is the mainstay of its treatment, it causes tremendous psychological impact on the patient due to repeated visits to hospital, in ability to take oral feeds, social stigma because of neck wound. We have explored literature to present various risk factors associated with this complication and how to treat it. The technique of pharyngeal closure during a laryngectomy surgery has an important role in preventing a pharyngocutaneous fistula. All surgeons dealing with laryngopharyngeal malignancies need to know the available evidence and described techniques in literature to minimize the incidence of post-operative fistulae. We present to you an extensive literature review regarding pharyngoplasty techniques..

Key Words: pharyngocutaneous fistula, pharyngoplasty, laryngectomy, pharyngeal closure.

[1]. Boscolo-Rizzo P, De Cillis G, Marchiori C, Carpenè S, Da Mosto MC. Multivariate analysis of risk factors for pharyngocutaneous fistula after total laryngectomy. Eur Arch Oto-Rhino-Laryngology. 2008;265(8):929–36.
[2]. Wang M, Xun Y, Wang K, Lu L, Yu A, Guan B, et al. Risk factors of pharyngocutaneous fistula after total laryngectomy: a systematic review and meta-analysis. Eur Arch Oto-Rhino-Laryngology. 2020;277(2):585–99.
[3]. Liang JW, Li ZD, Li SC, Fang FQ, Zhao YJ, Li YG. Pharyngocutaneous fistula after total laryngectomy: A systematic review and meta-analysis of risk factors. Auris Nasus Larynx . 2015;42(5):353–9.
[4]. Gonçalves AJ, De Souza JAL, Menezes MB, Kavabata NK, Suehara AB, Lehn CN. Pharyngocutaneous fistulae following total laryngectomy comparison between manual and mechanical sutures. Eur Arch Oto-Rhino-Laryngology. 2009;266(11):1793–8.
[5]. Papazoglou G, Terzakis G, Doundoulakis G, Dokianakis G. Pharyngocutaneous fistula after total laryngectomy: Incidence, cause, and treatment. Ann Otol Rhinol Laryngol. 1994;103(10):801–5.

Abstract: Background:Immunizationis a provencost-effective and relativelyinexpensive public health intervention for improving infant and childsurvival. Although,in the recentpast, immunizationcoverage rates have improvedconsiderably, wide variations stillexist in Indiaboth inter and intra states. This coverageisaffected by severalsocio-demographiccharacteristicssuch as literacy, gender of the child, socioeconomicstatus etc. Hence, thisstudywasconducted to assess the primaryimmunizationcoverageamong infants in the rural area of Amritsar district and to identify the varioussocio‑demographicfactorsassociatedwithit. Materials and Methods:It was a longitudinal study on a cohort of 99 infants who were born in the village Nagkalan, Amritsar and were followed up for a period of one year through regular home visits. Using a pre-designed questionnaire, information regarding socio-demographic characteristics of the family and the vaccines administered to the child till 1 year of age were enquired upon.......

Key Word: Primary Immunization, infants, coverage, socio-demographic determinants, drop out.

[1]. Jatti GM, Bandichhode ST, Nandimath VA, Jadhav SB. An evaluation of primary immunization coverage among 12-23 months old children in an urban area of Western Maharashtra: A communitybased study. Indian J Child Health. 2017;4(1):85-7.
[2]. UNICEF. The invisible child: a look at the urban child in Delhi. New Delhi: UNICEF; 1990.
[3]. Adhikary M et al. Determinants of Child Immunization Under Expanded Programme On Immunization. J Dhaka Med Coll. 2013; 22(2): 201-206.
[4]. National Family Health Survey [Internet]. [cited 2020 June 01]. Available from: http://rchiips.org/nfhs/factsheet_nfhs‑4. shtml
[5]. Ministry of Health and Family Welfare. District Level Household and Facility Survey -4 State fact sheet Punjab. Mumbai: International institute for population sciences, Mumbai ;2012-13:8p.

Abstract: Background: In diabetes mellitus patients there is a 15% increased lifetime risk of developing a foot ulcer. There have been many studies conducted to know the role of various risk factors that worsens the outcome in diabetic foot ulcers and among them important are reduced blood sugars levels, peripheral neuropathy, ischemia, joint deformity, and infection. This study was designed to evaluate various factors affecting on the outcome in diabetic patients with foot ulcers. Methods: A prospective study was conducted on 125 diabetic patients with foot ulcers who attended Sri Venkateshwara Ramnaraian Ruiya Government General Hospital, Tirupati. Patient age, sex, rural/urban origin, type and duration of diabetes, history........

Keywords: Diabetics, Foot ulcers, Renal failure, Risk factors, Mortality, Prevention

[1]. O'Rourke I, Heard S, Treacy J, Gruen R, Whitbread C. Risks to feet in the top end: outcomes of diabetic foot complications. ANZ J Surg 2002; 72: 282-286.
[2]. Singh N, Armstrong DG, Lipsky BA. Preventing foot ulcers in patients with diabetes. JAMA-J Am Med Assoc 2005; 293: 217-228.
[3]. Vileikyte L, Peyrot M, Bundy C, Rubin RR, Leventhal H, Mora P, Shaw JE, Baker P, Boulton AJ. The development and validation of a neuropathy and foot ulcer specific quality of life instrument. Diabetes Care 2003; 26: 2549-2555.
[4]. Ho TK, Leigh RD, Tsui J. Diabetic foot disease and oedema.British Journal of Diabetes and Vascular Disease 2013; 13: 45- 50.
[5]. Lyons TE. Management of diabetic foot complications. In:Veves A, Malik R, editors. Diabetic Neuropathy, Clinical Management. New York, NY, USA: Humana Press; 2008. pp.480-482.

Abstract:Acute pancreatitis includes a wide spectrum of disease, from one with mild self- limiting symptoms, to fulminant processes with multiorgan failure and high mortality. Given the wide spectrum of disease seen, the care of patients with pancreatitis should be highly personalized. Patients with mild acute pancreatitis generally can be managed with resuscitation and supportive care. Those with severe and necrotizing pancreatitis require intensive therapy, which may include surgical management. Because of frequent emergencies, multimodality presentation, complications, this challenging subject is taken up for the present study in which we studied the clinical profile and management of acute pancreatitis in our hospital.

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