iosr-JDMS   Volume-19 ~ Issue-7 ~ JuLy 2020

Abstract: Methotrexate is the most commonly used disease-modifying antirheumatic drug (DMARD) in the treatment of rheumatoid arthritis. The most common cause of acute Methotrexate (MTX) toxicity is an accidental overdose of MTX tablets by the patient or physician's prescription error. Here's a case of accidental overdose of MTX (15mg daily for 10 days) by a geriatric patient. This case report is intended to create awareness that MTX toxicity can be fatal. The risk of fatality increases with increase in age.

Keywords: Methotrexate, Rheumatoid arthritis, DMARD's, leucovorin, Overdose

[1]. Chan E.S.L., Cronstein B.N. Mechanisms of action of methotrexate. Bull. NYU Hosp. Jt. Dis. 2013;71:S5–S8.
[2]. Farber S, Diamond LK, Mercer RD, Sylvester RF Jr,Wolff JA. Temporary remissions in acute leukemia in childrenproduced by folic acid antagonist, 4-aminopteroyl-glutamic acid(aminopterin). N Engl J Med 1948;238(23):787–793.
[3]. Kawai S. Current drug therapy for rheumatoid arthritis.J Orthop Sci 2003;8(2):259–263.
[4]. J.S. Smolen, R. Landewe, F.C. Breedveld, M. Dougados, P. Emery, C. Gaujoux-Viala, et al.
[5]. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs. Ann Rheum Dis, 69 (2010), pp. 964-975

Abstract: Minimally invasive or the endolight concepts reviews traditional endodontics and modifies it to cater to maximum preservation of the existing structures. Treatment starts with a proper diagnosis treatment planning and meticulous execution of the principles mentioned in the articlefor successful outcomes. This requires not only a thorough knowledge of the dental anatomy but also clinical expertise and upgradation of knowledge about recent advancements in the field. This article reviews strategies involved in this aspect and protocols that aid in attainment of favorable results for the longevity of treatments underwent by the patient. For this review all relevant textbooks and bibliographies of important articles and data bases from Medline, PubMed were scrutinized.

Key words: Endolight concept, Pericervical Dentin, Ninja access, Calla lilly, Dynamic access

[1]. Ingle JI, Bakland LK, Baumgartner JC. Ingle‟s endodontics.6th ed. India: CBS; 2013
[2]. Wolters WJ, Duncan HF, Tomson PL, Karim IE, McKenna G, Dorri M, Stangvaltaite L, van der Sluis LW. Minimally invasive endodontics: a new diagnostic system for assessing pulpitis and subsequent treatment needs. Int Endod J. 2017 Sep 1;50(9):825-9.
[3]. Hargreaves KM, Cohen S. Cohen‟s pathway of the pulp. 10th ed. India: Elsevier; 2011
[4]. Asgary S et al. Five-year Results of Vital Pulp Therapy in Permanent Molars with Irreversible Pulpitis: A Non-Inferiority Multicenter Randomized Clinical Trial. Clin Oral Investig. 2015 Mar;19(2):335-41
[5]. Jun Fay Low et al. Magnification in endodontics: A review of its application and acceptance among dental practitioners Eur J Dent. 2018 Oct-Dec; 12(4): 610–616

Abstract: Erectile dysfunction : a brief overview Erectile dysfunction is the inability of men to get and maintain an erection throughout the sexual activity. Maintaining erection at times may be common, but during erectile dysfunction the symptoms are persistent and include:.....

[1]. DARAB MEHRABAN, SH Shabaninia, GH H NADERI, F Esfahani. The IRANIAN JOURNAL OF SURGERY 14 (136), 25-31, 2006
[2]. DARAB MEHRABAN, SH Shabaninia, GH H NADERI, F Esfahani. The IRANIAN JOURNAL OF SURGERY 14 (136), 25-31, 2006.

Abstract: Basilic vein used as an alternative conduit for AV access Background: The primary use of AV access for chronic hemodialysis is recommended by national kidney foundation. Many surgical methods have been described to create AV vascular access, one of which is B.B transposition. B.B transposition fistula provides an excellent access in difficult cases. The purpose of the study is to present and discuss the usefulness of basilic vein transposition as an alternative method to AV grafting., Materials and Methods: In this retrospective analysis, a total of 875 surgeries were done for AV access. Most of them had a central venous catheter. Of these 875, Basilic vein transposition were 27 and others were radiocephalic fistula 495,brachiocephalic 351,arteriovenous graft 2. Of the 27 cases of Basilic vein transposition , Basilic forearm....

Keywords: Basilic; arteriovenous; avf; Brachial

[1]. Hirth RA, Turenne MN, Woods JD, et al. Geographic and demographic variations in vascular access. In: Henry ML, Ferguson RM eds. Vascular Access for Hemodialysis. 5th ed. Chicago, IL: WL Gore and Precept Press, 1997. Pp 23-31.
[2]. Butterworth PC, Doughman TM, Wheatley TJ, et al. Arterio- venous fistula using transposed basilic vein. Br J Surg 1998;85:653-654.
[3]. Murphy GJ, Saunders R, Metcalfe M, et al. Elbow fistulas using autogenous vein: patency rates and results of revision. Postgrad Med J 2002;78:483-486.
[4]. Sidawy AN, Gray R, Besarab A, Henry M, et al. Recommended standards for reports arteriovenous hemodialysis accesses. J Vasc Surg 2002;35:603-610.
[5]. Brescia MJ, Cimino JE, Appel K, et al. Chronic hemodialysis using venipuncture and a surgically created arteriovenous fistula. N Engl J Med 1996;275:1089-1092..

Abstract: Résumé: La cholangite à IgG4 (SC-IgG4) est une maladie fibro-inflammatoire des voies biliaires de cause inconnue, caractérisée par une augmentation de la concentration sérique en IgG4 et une infiltration hépatique de plasmocytes à IgG4 associée à une fibrose dense de la paroi. La cholangite à IgG4 peut être isolée mais elle est souvent associée à une pancréatite auto-immune de type 1, plus rarement aux autres manifestations systémiques de la maladie à IgG4 (atteinte salivaire, fibrose retropéritonéale, atteinte rénale). Elle atteint surtout des hommes d'âge moyen à avancé et se révèle souvent par un ictère. Le diagnostic différentiel se discute principalement avec le cancer du pancréas, le cholangiocarcinome (CC), la cholangite sclérosante primitive (CSP) ou secondaire. L'atteinte biliaire, qui.....

Key words: SC-IgG4, CC, CSP, IRM, corticothérapie et immunosuppresseur

[1]. Deshpande V, Zen Y, Chan JK, Yi EE, Sato Y, Yoshino T, et al. Consensus statement on the pathology of IgG4-related disease. ModPathol 2012;25:1181–92.
[2]. Stone JH, Khosroshahi A, Deshpande V, Chan JKC, Heathcote JG, Aalberse R, et al. Recommendations for the nomenclature of IgG4-related disease and itsindividualorgan system manifestations. ArthritisRheum 2012;64:3061–7.
[3]. Ohara H, Okazaki K, Tsubouchi H, Inui K, Kawa S, Kamisawa T, et al. Clinical diagnostic criteria of IgG4-related sclerosingcholangitis 2012. J HepatobiliaryPancreatSci 2012;19:536–42.
[4]. Kamisawa T, Zen Y, Pillai S, Stone JH. IgG4-related disease. Lancet 2015;385:1460–71.
[5]. Nakazawa T. Diagnosis of IgG4-related sclerosingcholangitis. World J Gastroenterol 2013;19:7661–70.

Abstract: Background:Root canal therapy (RCT) is a process that involves treating diseases of the pulp and periapex of a diseased tooth. The ultimate goal of RCT is to give a hermetic seal of root canal right up to the apical constriction and any instrumentation and obturation beyond the apical constriction will lead to inflammatory reactions of the periapical zone. The accurate working length determination, one of the most challenging steps is a prerequisite to successful root canal therapy. Accurate working length determination reduces the chance of insufficient cleaning of the canal or damaging the periapical tissues from over instrumentation. It also helps to limit the extend of obturation.This study aims to determine any association between height of individual and working length of teeth.....

Key words: Root canal treatment, males, females, working length

[1]. Pagavino G, Pace R, Baccetti T. A SEM study of in vivo accuracy of the Root ZX electronic apex locator. Journal of Endodontics. 1998; 24:438–441.
[2]. Hughes T, Dempsey P, Richards L, Townsend G .Genetic analysis of deciduous tooth size in Australian twins. Arch OralBiol. 2000; 45(11): 997-1004.
[3]. Kabban M, Fearne J, Jovanovski V, Zou L. Tooth size andmorphology in twins. Int J Paediatr Dent. 2001; 11(5): 333-39.
[4]. Jayawardena CK, Abesundara AP, Nanayakkara DC,Chandrasekara MS. Age-related changes in crown and root length in Srilankan Sinhalese. J Oral Sci. 2009; 51(4): 587-92.
[5]. Smitha Reddy, Bhuvan Shome et al; A clinical correlationbetween stature and posterior tooth length. Pan Afr Med1j; 2017 vol26

Abstract: Background: Distal radius fractures are the most common fractures encountered by the treating orthopedic surgeon. Reduction of this fractureis important to restore the normal biomechanics of the wrist joint. The aim of this study is to report the morphometry of the distal radius in Kashmiri population in North India and give a comparison to similar studies of other races and populations. Methods: This is retrospective, unicentric, observational, analytic study. We studied 212 normal wrist posteroanterior and lateral radiographs from our hospital radiology data, and calculated these 4 morphometric measurements namely radial height, radial inclination.......

Key words: Distal radius, radiological morphometry, radial tilt, ulnar variance, radial height, radial inclination

[1]. Chan CYW, Vivek AS, Leong WH, Rukmanikanthan S. Distal radius morphometry in the malaysian population. Malays Orthop J
2008;2:27–30.
[2]. Short WH, Palmer AK, Werner FW, Murphy DJ. A biomechanical study of distal radial fractures. J Hand Surg Am 1987;12:529–
34.
[3]. De Smet L. Ulnar variance: facts and fiction review article. Acta Orthop Belg 1994;60:1–9.
[4]. Palmer AK, Werner FW. Biomechanics of the distal radioulnar joint. Clin Orthop Relat Res 1984;187:26–35.
[5]. Casagrande DJ, Morris RP, Carayannopoulos NL, Buford WL. Relationship between ulnar variance, cortical bone density, and load
to failure in the distal radius at the typical site of fracture initiation. J Hand Surg Am 2016;41:461–8.

Abstract: A wide variety of techniques and graft types are now available for the reconstruction of ACL. The development of new surgical techniques and recent advances in instrumentation has enabled surgeons to achieve better results. However, varying opinion exist among experts with regard to the ideal technique and graft type to be used. Arthroscopic ACL reconstruction using quadrupled semitendinosus tendon autograft with fixation in the femoral tunnel using endobutton and in the tibial tunnel with hybrid fixation using suture disc and anchored with a cancellous screw and washer is a relatively new technique. We have undertaken this study to analyse the postoperative outcome in our experience with this procedure.......

[1]. Moore KL. The Knee Joint In: Clinically oriented anatomy. 2nd ed. Williams & Wilkins 1985:p.523-41.
[2]. Corner EM. The exploration of the knee joint: with some illustrative cases. Br J Surg 1914;2:p.191–204.
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[5]. Strobel MJ, editor. Anterior cruciate ligament. In: Textbook of manual of arthroscopic surgery. 1st ed. Heidelberg Berlin; Springer-Verlag 1998:p.67-9..

Abstract: Background: Perinatal asphyxia is a serious problem and is a common cause of neonatal mortality and morbidity. Various predictors have been used to predict perinatal asphyxia but correlation between the clinical and biochemical markers have been poor. Nucleated red blood cell count of cord blood has been found as a possible marker of perinatal asphyxia. Aim of study: To assess nucleated RBC count as marker of perinatal asphyxia. Methods: This prospective case control study was conducted in Lalla-Ded hospital GMC Srinagar from Mar 2019-Mar 2020. We studied 200 patients......

Key word: Cord blood, Hypoxia, nucleated red blood cells, perinatal asphyxia.

[1]. John H. Menkes, MD: Neurolodical complications of perinatal asphyxia; Psychiatric Times, Nov.2007vol3,No 11
[2]. Low JA. Intrapartum fetal asphyxia: Definition, Diagnosis and classification. AM J ObstetGynecol 1997;176:956-9.
[3]. Gilstrap LC, Kenneth J, Levono Burris J, William ML, Little BB: Diagnosis of birth asphyxiaon the basis of fetal pH, Apgar score and newborn cerebral dysfunction. Am J Obstet and Gynecol 1989;161:825-30.
[4]. Korst LM, Phelan JP,Ahn MO. Nucleated red blood cells: An update on the marker for fetal asphyxia. Am J ObstatGynecol 1996; 175:843-6.
[5]. Hanlon Lundberg KM, Kirby RS: Nucleated red blood cells as a marker of academia in term neonates. Am J ObstetGynecol 1999;181:186-201.-

Abstract: Background: Corona virus has been a pandemic problem all over the world. Scientists and researchers are struggling to find treatment/vaccine for corona virus. Because of this pandemic the world is suffering economically. The number of cases of COVID 19 is rising not only in Saudi Arabia but also in other countries. COVID-19 is a disease caused by a new corona virus that emerged in China sometime in December 2019 (Al-Tawfiq, J.F et al. 2020) 2. The World Health Organization (WHO) declared that most people infected with the COVID-19 virus will experience mild to moderate respiratory illness. Older people and those with underlying medical problems like cardiovascular disease, diabetes, chronic respiratory disease, and cancer are more likely to develop serious illness 2....

Key word: Corona virus, awareness, transmission, prevention, test, treatment

[1]. Almutairi KM, Al Helih EM, Moussa M, Boshaiqah AE, Saleh Alajilan A, Vinluan JM, Almutairi A. Awareness, Attitudes, and Practices Related to Coronavirus Pandemic Among Public in Saudi Arabia. Europe PMC. Family & Community Health, 01 Oct 2015, 38(4):332-340
[2]. A-Tawfiq, J.A and Memish, ZA. 2020) COVID-19, Guide to infection control in healthcare setting. International Society https://isid.org/guide/pathogens/covid19/
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https://www.questionpro.com/blog/likert-scale-examples/
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Abstract: Two days old baby was diagnosed to have Valvular Atresia, intact septum, severe TR, Severe PAH. PDA was supplying the branch Pas. This baby was born in Dr YS Parmar Government Medical college Nahan, HP. Baby was transferred to Artemis hospital Gurugram. It was 4 hours journey.Transannular RVOT Patch (Autologus Pericardium), PDA Ligation, RV Overhaul, TV Repair, PFO Narrowed was done . Baby was discharged home after 7 days. And thriving.

[1]. Allen, Hugh D., ed. Moss and Adams Heart Disease in Infants, Children, and Adolescents: Including the Fetus and Young Adult. 8th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2013.
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[3]. Awori, Mark Nelson, Nikita P. Mehta, Frederick O. Mitema, and Naomi Kebba. "Optimal Z -Score Use in Surgical Decision-Making in Pulmonary Atresia With Intact Ventricular Septum." World Journal for Pediatric and Congenital Heart Surgery 8, no. 3 (May 2017): 385–88.
[4]. Leung, Maurice P., Che-Keung Mok, and Ping-Wai Hui. "Echocardiographic Assessment of Neonates with Pulmonary Atresia and Intact Ventricular Septum." Journal of the American College of Cardiology 12, no. 3 (1988): 719–725.
[5]. Chikkabyrappa SM, Loomba RS, Tretter JT. Pulmonary Atresia With an Intact Ventricular Septum: Preoperative Physiology, Imaging, and Management. SeminCardiothoracVascAnesth. 2018 Sep;22(3):245-255. [PubMed].-