iosr-JDMS   Volume-20 ~ Issue-1 ~ January 2021

Abstract: This study aims to evaluate the advantage of using mosquito net (polyethylene mesh) in terms of cost effectiveness in the treatment of inguinal hernia but with similar efficacy compared to polypropylene mesh in Inguinal Hernia patients who were admitted to GKMCH,KARUR. Methods: Patients presenting with inguinal hernias in GKMCH karur were recruited in this study. The patients were seen in surgical speciality OP in emergency and routine hours and were diagnosed on the basis of history & clinical examination. After obtaining consent, patients were required to fill in a proforma. After that patients were randomly divided into two groups. In the first group Lichtenstein's hernia repair were performed by polypropylene mesh. In the second group, Lichtenstein's hernia repair were done with mosquito net (polyethylene mesh).......

Key Words: Polyethylene mesh, Lichtensteins mesh repair, Inguinal hernia

[1]. Ostow B. Guleph. What is the Most Appropriate Repair for Groin Hernias in Africa? . Surgery in Africa, Canada 2006.
[2]. Kingsnorth A, Leblanc K(2003). Hernias – Inguinal and Incisional . Lancet 362(9395) 1561- 1571.
[3]. Simons MP, Aufenacker T, Bay-Nielsen M. European Hernia Society Guidelines on the treatment of inguinal hernia in adult patients. Hernia 2009; 13:343
[4]. Taylor SG. O' Dwyer PJ. Chronic Groin Sepsis following tension free inguinal hernioplasty. Br J Surg. 1999; 86; 562-5
[5]. WILLIAM W.HOPE WILLIAM S.COBB GINA L ADRALES HERNIA SURGERY ; ISBN 978-3-319-43043-0 ;Pages 23-78

Abstract: Background: Corona Virus Disease–2019 (COVID–19) is the greatest health crisis of the 21st century claiming more than 10 lakh deaths worldwide. Numerous studies on COVID – 19 have demonstrated prevalence of hypokalaemia. The objective of the study is to characterise this hypokalaemia in context of inflammatory state and severity of Acute Respiratory Distress Syndrome (ARDS) in COVID – 19 and therefore find out whether Arterial Blood Gas (ABG) results are comparable to that of the fully Automated Chemistry Analyzer (AA) which may reduce the analysis turnaround time and guide the clinician to expedite intervention.........

Keywords- COVID-19, Hypokalemia, Arterial blood gas analysis, A.R.D.S., C-Reactive Protein

[1]. Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, et al; China Novel Coronavirus Investigating and Research Team. A Novel Coronavirus from Patients with Pneumonia in China, 2019. N Engl J Med. 2020 Feb 20;382(8):727-733. [2]. Lippi G, South AM, Henry BM. Electrolyte imbalances in patients with severe coronavirus disease 2019 (COVID-19). Ann Clin Biochem. 2020 May;57(3):262-265. [3]. Chen D, Li X, Song Q, Hu C, Su F, Dai J, et al; Assessment of Hypokalemia and Clinical Characteristics in Patients with Coronavirus Disease 2019 in Wenzhou, China. JAMA Netw Open. 2020 Jun 1;3(6): e2011122. [4]. Moreno-P O, Leon-Ramirez JM, Fuertes-Kenneally L, Perdiguero M, Andres M, Garcia-Navarro M, et al; COVID19-ALC Research Group. Hypokalemia as a sensitive biomarker of disease severity and the requirement for invasive mechanical ventilation requirement in COVID-19 pneumonia: A case series of 306 Mediterranean patients. Int J Infect Dis. 2020 Sep 17; 100:449-454. [5]. Xiong S, Liu L, Lin F, Shi J, Han L, Liu H, et al; Clinical characteristics of 116 hospitalized patients with COVID-19 in Wuhan, China: a single-centered, retrospective, observational study. BMC Infect Dis. 2020 Oct 22;20(1):787.

Abstract: Background: Shivering is common complication reported in patients undergoing surgery in spinal anaesthesia Aim: To find out the efficacy of Dexmedetomidine to Saline for prevention of shivering during spinal anaesthesia in abdominal hysterectomy patients Materials & Method: 60 patients of either sex between age group of 18 to 60 yrs, ASA grade 1 were enrolled for the study and were divided into two groups (Group D & Group S ) of 30 each. Group D received Dexmedetomidine and Group S received Saline intravenously. The levels of sensory block were evaluated by loss of pinprick sensation 5 minutes after giving spinal anesthesia by Hollmen Scale sensation at mid clavicular line. Motor block was assessed using a modified Bromage scale. Shivering scale was assessed by Tsai and Chu. Results: It was observed that higher incidence of shivering in the Saline group (56.7%) when compared to Dexmedetomidine group (6.7%). The difference was found significant (p≤ 0.05) confirming that Dexmedetomidine is successful in controlling shivering. Conclusion: Dexmedetomidine is better drug in prevention of shivering in spinal anesthesia for abdominal surgeries

Key Word: Shivering, Dexmedetomidine, Infusion

[1]. Katyal S, Tewari A .Shivering Anaesthetic Consideration. J Anaesth Clin Pharmacol 2002; 18:362-76.
[2]. Bhatnagar S, Saxena A, Kannan T R, Punj J et al .Tramadol for post operative shivering:A double –blind comparison with pethedine .Anaesth Intensive Care 2001;29:149-54.
[3]. Mittal G, Gupta K, Kaushal S et al. Randomised double blind comparative study of Dexmedetomidine and Tramadol for post spinal anesthesia shivering.Indian J Anesth2014; 58:257-62.
[4]. E G Elvan, B.O c, S-Uzun et al .Dexmedetomidine and post operative shivering in patients undergoing elective abdominal hyaterectomy, European Journal of Anaesthesiology 2008;25:357-364.
[5]. YongShin Kim, Kwon-Hui Seo, Hye-Rim kang Optimal dose of prophylactic Dexmedetomidine for prevention of postoperative shivering. International Journal of Medical Sceiences 2013;10:1327-32.`

Abstract: Chronic Abdominal Pain (CAP) is recurrent abdominal pain for at least 3 days/month in the last 3 months. Continuous abdominal pain, loss of daily function is some of the important symptoms of CAP. It represents around 13% of all surgical admissions internationally.1 It is a common presenting complaint by various people to the surgeons as well as physicians. Patients with CAP present difficult diagnostic dilemma. By the time of presentation, patients usually underwent various diagnostic techniques including surgery, In spite of these, the pain remains a challenge. More than 40% of CAP cases remain undiagnosed at the end of their diagnostic workup.2,3 It is a significant reason for referral to a gastroenterologist and the 4th frequent condition in the general population. CAP is associated with poor quality of life and significant levels of depressive symptoms.4 Intestinal adhesions was reported to be the most common cause5,6 followed by biliary causes7 and appendicular causes.8 Some extra-abdominal conditions such as corticosteroid insufficiency, diabetic ketoacidosis,

[1]. DeBanto JR, Varilek GW, Haas L. What could be causing chronic abdominal pain? Anything from common peptic ulcers to uncommon pancreatic trauma. Postgraduate Medicine 1999;106(3):141-146.
[2]. Camilleri M. Management of patients with chronic abdominal pain in clinical practice. Neurogastroenterol Motil 2006;18(7):499-506.
[3]. Paajanen H, Julkunen K, Waris H. Laparoscopy in chronic abdominal pain: a prospective nonrandomized long-term follow-up study. J Clin Gastroenterol 2005;39(2):110-114.
[4]. Magni G, Rossi MR, Rigatti-Luchini S, et al. Chronic abdominal pain and depression. Epidemiologic findings in the United States. Hispanic health and nutrition
[5]. Peters AA, Van den Gillard SA. The difficult patient in gastroenterology: Cchronic pelvic pain, adhesions, and sub occlusive episodes. Best Pract Res Clin Gastroenterol 2007;21(3):445-463.

Abstract: Acne vulgaris is a chronic inflammatory skin disease affecting 90% individuals between puberty and 30 years, causing significant physical & psycho-social impact. Cost of drugs are important factor influencing compliance with the treatment.To analyze the cost variation of different brands of topical acne medications available in Indian market. Minimum and maximum cost of various topical medications used in treatment of Acne vulgaris of same strength and formulation were obtained from Current Index of Medical Specialties (CIMS) October-December 2019 edition, Drug Today October 2019- January 2020edition and Pharma Sahi Daam mobile app (developed by National Pharmaceutical Pricing Authority, GoI). Drugs manufactured by only 1 company were excluded. Cost ratio (Maximum cost/ Minimum cost) and percentage cost variation ([{Max cost – Min cost}/ Min cost] * 100) were calculated.......

Key Words: Cost analysis, Acne vulgaris, Percentage cost-variation, Pharma Sahi Daam

[1]. A . M. Layton. Disorders of the Sebaceous Glands. In: Burns T, Breathnach S, Cox N, Griffiths C,editors. Rook's Textbook of Dermatology.8th edn.USA:Wiley– Blackwell Publication : 2010 .p.42.1 - 42.89
[2]. Zaenglein AL, Graber EM, Thiboutot DM, Strauss JS. Acne Vulgaris and acneiform eruptions In:Wolff K, Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, editors.Fitzpatrick's Dermatology in General Medicine.7th edn. USA: McGraw Hill; 2008. p.690-703
[3]. Zaeglein A, Graber EM, Thiboutot D, Staruss JS. Disorders of Sebaceous Glands - Acne Vulgaris and Acneiform Eruptions. In : Wolff K, Goldsmith LA, Katz SI, Gilchrest BA, Paller AS , Leffell DJ, editors. Fitzpatrick's Dermatology in Medicine. 7th ed. New York: McGraw-Hill. 2008. p. 690-703.
[4]. James WD. Acne. New England J of Medicine 2005; 325: 1463 - 72
[5]. Hay RJ, Johns NE, Williams HC et al. The global burden of skin disease in 2010: an analysis of the prevalence and impact of skin conditions. J Invest Dermatol.2014;134(6):1527-34.

Abstract: Introduction: Diagnosis of cystic lesions of pancreas in the contemporary generation are rapidly escalating. Substantial number of cystic lesions have been recognized due to recent evolution and persistent use of imaging modalities.1 Accurate characterization of cystic lesions is necessary to discriminate cystic neoplasms of pancreas from pseudocysts, as they are widely misdiagnosed.2 For inceptive identification, characterization of pancreatic cysts, Multi-detector computed tomography is the desired imaging modality.
Materials and Methods: This is a retrospective study done over a period of 5 years.94 patients with cystic lesions of pancreas were selected and analysed. All patients had proven final diagnosis by surgery, by endoscopy guided aspiration or by follow up. Various parameters of the cysts were studied like the age and sex distribution, incidence, size of the lesion, location, thickness of septations, nature of calcification, pancreatic duct dilatation if any, size of the largest cyst within the lesion, approximate number......

Key Word: cystic lesions, Multi-detector computed tomography, IPMT

[1]. HrubanRH, Pitman MB, KlimstraDS. Atlas of tumor pathology. Washington, DC: American Registry of Pathology and Armed Forces Institute of Pathology 2007.
[2]. van Asselt SJ, de Vries EG, van Dullemen HM,et al. Pancreatic cyst development: insights from Von Hippel-Lindau disease. Cilia 2013;2(1):3.
[3]. Valsangar NP, Morales-Oyarvide V, Thayer SP, et al. 851 resected cystic tumors of the pancreas:a 33-year experience at the Massachussets general hospital. Surgery 2012;152(3 Suppl 1):S4-S12.
[4]. Fernández-del Castillo C. Mucinous cystic neoplasms. J GastrointestSurg 2008;12(3):411-3.
[5]. de Jong K, Bruno MJ, Fockens P. Epidemiology, diagnosis, and management of cystic lesions of the pancreas. Gastroenterol Res Pract2012;2012:147465.

Abstract: Background: Antibacterial restorations increase the success rate of minimal invasive techniques where incomplete caries removal is done, in these cases pulp treatment is avoided preserving as much tooth structure as possible and increasing the longevity of teeth. This study was conducted to test the clinical performance of chitosan modified glass ionomer in carious primary teeth. Materials and Methods: In this prospective randomized controlled study, the sample consisted of 26 primary molars of 4-8 years old patients, where they were randomly allocated into 2 groups, each group received a glass ionomer(GIC) restoration in at least one primary molar. Group A received a GIC with its liquid modified with chitosan Group B received unmodified Glass ionomer. After 6 months follow-up the patients were recalled, and the clinical performance was measured using the Modified United States Public Health Service (USPHS) Ryge Criteria.......

Key Word: Chitosan; Glass ionomer cement; Indirect pulp capping; incomplete caries removal

[1]. Petersen PE, Lennon M. Effective use of fluorides for the prevention of dentalcaries in the 21st century: the WHO approach. Community Dent Oral Epidemiol. 2004;32:319-321.
[2]. Kakehashi S, Stanley HR, Fitzgerald RJ. The effects of surgical exposures of dental pulps in germfree and conventional laboratory rats. J South Calif Dent Assoc. 1966;34(9):449-451. doi:10.1016/0030-4220(65)90166-0
[3]. Christensen GJ. The advantages of minimally invasive dentistry. J Am Dent Assoc. 2005;136(11):1563-1565. doi:10.14219/jada.archive.2005.0088
[4]. Smales RJ, Yip HK, Smales MDS RJ, Hak-Kong Yip BDS F. The atraumatic restorative treatment (ART) approach for primary teeth: review of literature. Pediatr Dent. 2000;22(4):294-298.
[5]. Schwendicke F, Frencken JE, Bjørndal L, et al. Managing Carious Lesions: Consensus Recommendations on Carious Tissue Removal. Adv Dent Res. 2016;28(2):58-67. doi:10.1177/0022034516639271

Abstract: Background: End stage renal disease is a chronic disease that exerts a great negative impact on patients' health-related quality of life. Objectives: To assess the health related quality of life (HRQOL) of adult Libyan patients undergoing hemodialysis and to explore the association between the HRQOL and patients' sociodemographic and clinical characteristics Materials and Methods: A descriptive cross-sectional study was carried out at hemodialysis unit in National Heart Center, Tripoli. QOL was assessed using the WHOQOL-BREF questionnaire. Analysis was performed using SPSS (version 22) package. Appropriate inferential statistics was used with 0.05 level of significance. Results: The patients' mean age was 49.79±15.039 years, 67% were males, 20% were highly educated, and 35% of the cases were employed. Hypertension was the main......

Key Word: Hemodialysis, Quality of life, WHOQOL-BREF, Libya

[1]. Collins AJ, Foley RN, Chavers B, Gilbertson D, Herzog C, Johansen K, et al. United States Renal Data System 2011 Annual Data Report: Atlas of chronic kidney disease & end-stage renal disease in the United States. Am J Kidney Dis. 2012;59(Suppl 1):A7, e420.
[2]. BarsoumRS. Burden of chronic kidney disease: North Africa. Kidney international supplements, 2013;3:164-166
[3]. Friedman DJ. Genes and environment in chronic kidney disease hotspots. Curr Opin Nephrol Hypertens. 2019;28(1):87-96.
[4]. Ahrari S, Moshki M, Bahrami M. The Relationship Between Social Support and Adherence of Dietary and Fluids Restrictions among Hemodialysis Patients in Iran. J Caring Sci. 2014;3(1):11–19.

Abstract: Back ground: Perfusion weighted MRI and MR Spectroscopy are advanced non-invasive imaging techniques.Advanced MR imaging techniques provide physiological information which complements the conventional imaging findings in preoperative glioma grading. Histopathology is gold standard, but invasive technique. Relative cerebral blood volume (rcbv) measurements derived from perfusion MR imaging and metabolite ratios from MR spectroscopy are useful in predicting glioma grading. AIM: To evaluate the role of Perfusion weighted MRI and MR SPECTROSCOPY in preoperative grading of gliomas.......

[1]. Ostrom QT, Gittleman H, Liao P, Rouse C, Chen Y, Dowling J, Wolinsky Y. CBTRUS statistical report: primary brain and central nervous system tumours diagnosed in the United States in 2007- 2011. NeuroOncol 2014; 16 (4): iv1-63. [2]. Wen PY, Reardon DA. progress in glioma diagnosis, classification and treatment. Nature Reviews Neurology. 2016; 12(2): 69–70. [3]. Weller M, van den Bent M, Hopkins K, Tonn JC, Stupp R, Falini A et al.EANO guideline for the diagnosis and treatment of anaplastic gliomas and glioblastoma. Lancet Oncology.2014;15(9):e395–e403.
[4]. Smits M. Imaging of oligodendroglioma. Br J Radiol 2016;89:1060. [5]. Scott JN, Brasher PM, Sevick RJ, Rewcastle NB, Forsyth PA. Forsyth. How often are nonenhancingsupratentorial gliomas malignant? A population study. Neurology. 2002;59:947–949.