iosr-JDMS   Volume-20 ~ Issue-10 ~ Oct. 2021

Abstract: Hirayama disease (HD) is a benign focal amyotrophy of the distal upper limbs characterized by distal asymmetric weakness and wasting of upper extremi ties mainly affecting the lower cervical and upper thoracic segmental myotomes(C7,C8,T1) . There is sparing of the brachioradialis and proximal muscles of the upper limb innervated by C5–6 myotomes. The disease most often occurs in young adults, with a male predominance . It is mostly sporadic. . It is commonly seen in Asia and rarely encountered in the Middle East countries.The condition is belived to be caused by excessive anterior movement of cervical spinal cord on flexion,resulting in anterior compression of cord against posterior vertebral column with resultant ischemia and cord atrophy. In our study four patients......

Key words: Hirayama disease ,Benign focal amyotrophy, 3D-FIESTA,Flexion MRI.

[1]. Hirayama K, Tokumaru Y. Cervical dural sac and spinal cord in juvenile muscular atrophy of distal upper extremity.Neurology 2000;54:1922-6.
[2]. Hirayama K. Nonprogressive juvenile spinal muscular atrophy of the distal upper limb. In: De Jong JM, editor. Handbook of Clinical Neurology. Amsterdam, Netherlands: Elsevier; 1991. p. 107-20.
[3]. Tashiro K, Kikuchi S, Itoyama Y, Tokumaru Y, Sobue G, Mukai E, et al. Nationwide survey of juvenile muscular atrophy of distal upper extremity (Hirayama disease) in Japan. Amyotroph Lateral Scler. 2006 Mar;7(1):38–45.
[4]. Hirayama K, Tomonaga M, Kitano K, Yamada T, Kojima S, Arai K. Focal cervical poliopathy causing juvenile muscular atrophy of distal upper extremity: a pathological study. J Neurol Neurosurg Psychiatry. 1987 Mar;50(3):285–90
[5]. Kikuchi S, Tashiro K, Kitagawa M, Iwasaki Y, Abe H. [A mechanism of juvenile muscular atrophy localized in the hand and forearm (Hirayama's disease)—flexion myelopathy with tight dural canal in flexion] [in Japanese]. Rinsho Shinkeigaku. 1987 Apr;27(4):412–9..

Abstract: The pap smear is a screening test to diagnose cervical cancer & also been used as a diagnostic test in cervical infection caused by different pathogenic organisms. The aim of the presented study is to compare the efficacy of Gram stain & Pap smear with that of Amsel's criteria in the diagnosis of BV – which is continually gaining importance in relation to morbidity problems – in cervicovaginal specimens obtained in routine controls. In this study we analysed comparison of pap smear with gram staining in cases of bacterial vaginosis. We conducted a thorough literature search in the PubMed & Google Scholar database. All the patients with vaginal discharge between the age of 18-52 years were included .Six previously published studies were compared & evaluated. Study Design: Review Article and meta-analysis

Key words: BaterialVaginosis, PAP smear & Gram stain

[1]. Gardner HL, Dukes CD. Haemophilus vaginalis vaginitis. Am J ObstetGynecol 1955; 69:962–976.
[2]. Martius J, Krohn MA, Hillier SL, et al. Relationship of vaginal Lactobacillus species, cervical Chlamydia trachomatis, & bacterial vaginosis to preterm birth. Obstet Gynecol 1988; 71:89–95.
[3]. Mazzuli T, Simor AE, Low DE. Reproducibility of interpretation of Gram-stained vaginal smears for the diagnosis of bacterial vaginosis. J Clin Microbiol 1990; 28: 1506– 1508.
[4]. Jabeen N, Soomro U. Bacterial vaginosis. Gynaecologist 2001; 5:56-57.
[5]. Sahoo B, Bhandri H, Shavma M, et al. Role of male partner in lower genitor urinary tract. Indian J Med Res 2000; 112:9-14.

Abstract: Introduction – Obstructive jaundice is not a very common disease. It is usually associated with cholelithiasis and biliary strictures. Magnetic resonance cholangiopancreatography (MRCP) is the most useful diagnostic tool for its diagnosis. Material and methods – 100 patients with obstructive jaundice underwent magnetic resonance imaging (MRI) on 3T Siemens Magnatom Vida machine to delineate the cause of obstruction and associated pathology. Observation – The disease is more common in females. It is common in middle to old age group and in rural population. The common causesare choledocholithiasis, calculus cholecystitis and pancreatitis. Discussion – In 100 patients who underwent MRCP, our diagnostic accuracy was 95-98% compared operatively. MRCP is the primary and most important investigation to diagnose causes of obstructive jaundice.

Key words: Magnetic resonance cholangiopancreatography (MRCP), Choledocholithiasis, Calculus cholecystitis, Pancreatitis

[1]. Regan R, Khazan K et al: choledocholithiasis: Evaluation with MR cholangiography AJR 1996; 167: 1441-1445.
[2]. Karwa S, Patil VV (2017) Role of Magnetic Resonance Cholangiopancreatography in Biliary Disorders. Int J Radiol Radiat Ther 2(4): 00032. DOI: 10.15406/ijrrt.2017.02.00032.
[3]. Ahmet Mesrur Halefoglu et al : Magnetic resonance cholangiopancreato- graphy: A useful tool in the evaluation of pancreatic and biliary disorders, World J Gastroenterol 2007 May 14;13(18): 2529-2534.
[4]. Suraj Sonawane1 et al. "MRCP – A Problem Solving Diagnostic Tool in Pancreaticobiliary Pathologies. International Journal of Contemporary Medicine Surgery and Radiology. 2018;3(1):138-142.
[5]. Sundeep S, Sharma R, Pal S, Sahni S, Chattopadyay TK. Differentiationbetween benign and malignant hilar obstructions using laboratory andradiological investigations: a prospective study. HPB. 2007;9:373—3 82.

Abstract: Aloe vera is one of the plants that often used as traditional medicine. Aloe vera contains bioactive substances such as alkaloids, flavanoids, glycosides, saponins, and tannins which act as anti-inflammatory and antioxidants that influence the healing process of wounds. The purpose of this study was to determine the effect of 100%, 50% and control groups (untreated) aloe vera extract on wound closure with intentional incision wounds from the first day to the tenth day in white rats. This research is a pure experimental design with a post test-only design with control design. This study used 21 white rats divided into 3 groups of 100% aloe vera extract group, 50% aloe vera extract group, and control group (not treated). One-way Anova and Post-hoc LSD test results showed significant differences in wound closure (p <0.05) between the 100% aloe vera extract group and 50% aloe vera extract group compared to the control group (not treated). The results of the T-Test showed a significant difference (p <0.05) in wound closure in white rats between the buccal mucosa and the labial mucosa. Conclusion: This study of aloe vera extract has an effect in accelerating wound healing in the oral mucosa.

Key Words: Aloe Vera Extract, wound healing, long wound, oral mucosa

[1]. Togatorop MH, Sinusurat AP, dkk. PemanfaatanTanamanLidahBuayaSecaraTradisional dan StudiKandunganBioaktifnya. Seminar Nasional teknologiPeternakan dan Veteriner. Bogor 2003: 576
[2]. Yohana W, Suciati A, Rachmawati M. PeningkatanKetebalanEpitelMukosaBukal Setelah AplikasiEkstrakDaunSirih. Maj. Ked. Gi Ind. Juni 2015; Vol 1(1): 21-6
[3]. Novyana RM, Susianti. LidahBuaya (Aloe Vera) UntukPenyembuhan Luka. Majority J 2016; Vol 5(4): 149-53
[4]. Polito AJ, Proud D. Epithelial Cells as Regulators of Airways Inflamation. J Allergy Clin Immunol. 2015. Vol 102(5); 714-7
[5]. Wahyudi IA, Magista M, Angel M. EfektivitasPenggunaan Saliva DibandingkanPovidon-Iodin 10% terhadapPenyembuhan Luka pada KutaneusTikus Sprague Dawley. 2014. Vol 1(1).
[6]. BudiyantoMoch. AK. Efekekstraklidahbuaya(Aloe vera) terhadap diameter penyembuhanlukadecubbitus pada tikusputih. 2011: 1- 11.

Abstract: Background: Acute appendicitis is the most common surgical abdominal emergency. Delayed treatment increasestheincidenceofcomplications.Theaimofthisstudywastoinvestigatethepresentation,incidence,andpredictorsofcomplic ations, and histologic alfindingsinadultpatientswithclinicaldiagnosisofacuteappendicitis. Methods: The study was a prospective observational study and included patients aged 12 years and olderdiagnosedwithacuteappendicitis.Data collected includeddemographicdata, clinicalpresentation, durationofsymptomsan dreasons for presentationdelay ,diagnosticinvestigations, operativeandhistologyfindings,lengthofhospitalstay,a
ndmortality....

Keywords: Acuteappendicitis;Complications;Delayedpresentation;Negativeappendicectomy.

[1]. Hobler, K. (Spring 1998). "Acute and Suppurative Appendicitis: Disease Duration and its Implications for Quality Improvement" (PDF). Permanente Medical Journal. 2 (2).
[2]. Harrison's principles of internal medicine(18th ed.). New York: McGraw-Hill. pp. Chapter 300. ISBN 978-0-07174889- 6. Archivedfrom the original on 30 March 2016. Retrieved 6 November 2014.
[3]. Schwartz's principles of surgery (9th ed.). New York: McGraw-Hill, Medical Pub. Division. 2010. pp. Chapter 30. ISBN 978-0-07- 1547703.
[4]. "Surgical and Clinical Review of Acute Appendicitis" (PDF). International Journal of Multidisciplinary and Current Research. 4. ISSN 2321-3124..

Abstract: Introduction Myasthenia gravis (MG) is an autoimmune syndrome caused by the failure of neuromuscular transmission, which results from the binding of autoantibodies to proteins involved in signaling at the neuromuscular junction (NMJ). These proteins include the nicotinic AChR or less frequently a muscle-specific tyrosine kinase (MuSK) involved in AChR clustering 1. The disease incidence is 3–30 cases per million per year and rising as a result of increased awareness. Medical treatment of MG includes improving neuromuscular transmission by anticholinesterases, suppressing the immune system with corticosteroids and immunosuppressants, and decreasing circulating antibodies with plasmapheresis and, in selected cases, thymectomy.2 The myasthenic patient can be a challenge to anesthesiologists.....

Keywords: General anaesthesia, Myasthenia gravis, thymectomy, thoracic epidural.

[1]. Conti-Fine BM, Milani M, Kaminski HJ (2006) Myasthenia gravis: past, present, and future. J Clin Invest 116: 2843-2854
[2]. McGrogan A, Sneddon S, de Vries CS (2010) The incidence of myasthenia gravis: a systematic literature review. Neuroepidemiology 34: 171-183.
[3]. Blichfeldt-Lauridsen L, Hansen BD (2012) Anesthesia and myasthenia gravis. ActaAnaesthesiolScand 56: 17-22.
[4]. Wilkins KB, Bulkley GB (1999) Thymectomy in the integrated management of myasthenia gravis. AdvSurg 32: 105-133.
[5]. Tripathi M, Srivastava K, Misra SK, Puri GD (2001) Peri-operative management of patients for video assisted thoracoscopicthymectomy in myasthenia gravis. J Postgrad Med 47: 258-261..

Abstract: Introduction: The principle of safe bracket debonding is to degrade the adhesive resin strength connecting the tooth and the bracket by softening or ablation.of adhesive resin from tooth surface without damaging the enamel. Aim: The aim of this study were to Compare the efficacy of erbium yttrium aluminum garnet (Er:YAG) laser and ErCr;YSGG in debonding on the metal brackets and determination if there are any adhesive remnants on the enamel surface by the stereomicroscope. Methods: Sixty metal brackets were bonded to sixty upper first premolars and they were divided into three groups, Group 1(control) debonded by conventional plier, group 2 debonded by Er:YAG laser and group 3 debonded by Er Cr:YSGG. The Enamel surface were evaluated by stereo microscope for any enamel cracks and damage.Results: Er:YAG 7W laser debond the metal brackets in a shorter time than Er Cr; YSGGandErbium Chromium Yttrium Scandium Gallium Garnet (Er Cr:YSGG) laser (6W and 7W) decreased the enamel damage compared to the Er:YAG laser and the conventional method for Debonding.

[1]. Özer T, Başaran G, Kama J D. Surface roughness of the restored enamel after orthodontic treatment. Am J Orthod Dentofacial Orthop.2010;137: 368–374.
[2]. Shuler F V. SEM-evaluation of enamel surface after removal of fixed orthodontic appliances. Am J Dentofacial Othop . 2003; 16: 390–394.
[3]. Nasiri M, Mirhashemi S, Etemadi A. Evaluation of the Shear Bond Strength and Adhesive Remnant Index in Debonding of Stainless Steel Brackets Assisted with Nd:YAG Laser Irradiation. Front Dent. 2019;16:37-44
[4]. Leśniak K, Matys J ,Dominiak M . Er:YAG Laser for Metal and Ceramic Bracket Debonding: An In Vitro Study on Intrapulpal Temperature, SEM, and EDS Analysis. Photomed Laser Surg.2018;36:595–600.
[5]. Shuler F V. SEM-evaluation of enamel surface after removal of fixed orthodontic appliances. Am J Dentofacial Othop . 2003; 16: 390–394.

Abstract: Background and aims: Type 2 diabetes mellitus is one of the most common chronic diseases in almost all the countries, and continues to increase in numbers and significance, as changing lifestyles lead to reduced physical activity. Adipocyte is also an important endocrine gland, a metabolic factor that produce a wide variety of adipocytokines such as adiponectin, resistin, tumor necrosis factor, leptin, and interleukin. Leptin, the satiety hormone,made by adipose cells helps to regulate energy balance by inhibiting hunger. Leptin is opposed by the actions of the hormone ghrelin, the hunger hormone. Both hormones act on receptors in the arcuate nucleus of the hypothalamus to regulate appetite to achieve energy homeostasis. The objective of the study is to find out whether leptin level......

Keywords: Leptin, Type 2 diabetes mellitus, Fasting blood sugar, Glycated hemoglobin (HbA1c), Lipid profile, Urea.

[1]. Shaw JE, Sicree RA, Zimmet PZ. Global estimates of the prevalence of diabetes for 2010 and 2030. Diabetes Res Clin Pract 2010; 87(4): 4-14.
[2]. The expert committee on the diagnosis and classification of diabetes mellitus: Follow up report on the diagnosis of diabetes mellitus. Diabetes care 2003; 26(2): 3160-7.
[3]. Ahmed AM. History of diabetes mellitus. Saudi Med J 2002; 23(4): 373-8.
[4]. Powers AC. Diabetes Mellitus. In: Jameson JL, Longo DL, Braunwald E, Hauser SL, Kasper DL, Fauci AS, editors. Harrisons' Principles of Medicine 17th ed. USA:McGraw Hill Companies; 2008. p.2275-304.
[5]. Melmed S, Polonsky KS, Larsen PR, Kronenberg HM. Williams textbook of endocrinology. 12thed. Philadelphia: Elsevier/Saunders; 2011.

Abstract: To compare the efficacy of chlorhexidine–alcohol and povidone–iodine as preoperative antiseptic skin preparation for prevention of surgical site infection (SSI) Materials and methods: A total of 311 eligible Patient who underwentSurgery were recruited in the study after fulfilling all the eligibility and exclusion criteria. Patients were randomized into two groups (153 in chlorhexidine– alcohol group and 158 in povidone–iodine group) by a computer-generated randomization table. Patients were followed for a period of 30 days in postoperative period to monitor for SSI. Results: The rate of SSI in the chlorhexidine–alcohol group is 5.4% and that of the povidone–iodine group is 8.6%. E. coli, K. pneumoniae, and Acinetobacter baumannii were the most common organisms isolated. E. coli was found in 9.5% of the total SSI cases.......

[1]. Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR. Guideline for prevention of surgical site infection, 1999. Centers for Disease Control and Prevention (CDC) Hospital Infection Control Practices Advisory Committee. Am J Infect Control. 1999;27(2):97–132.
[2]. Sullivan SA, Smith T, Chang E, Hulsey T, Vandorsten JP, Soper D. Administration of cefazolin prior to skin incision is superior to cefazolin at cord clamping in preventing postcesarean infectious morbidity: a randomized, controlled trial. Am J Obstet Gynecol. 2007;196:455.e1–5.
[3]. Betrán AP, Ye J, Moller A-B, Zhang J, Gülmezoglu AM, Torloni MR. The increasing trend in caesarean section rates: global, regional and national estimates: 1990-2014. PLoS One [Internet]. 2016;11(2):e0148343 Available from: http://www.ncbi.nlm.nih.gov/pubmed/26849801.
[4]. Madeira de A, Zélia M, Trabasso P, Madeira de A, Zélia M, Trabasso P. Surgical site infections in women and their association with clinical conditions. Rev Soc Bras Med Trop. 2014 Aug;47(4):457–461.
[5]. Astagneau P, Rioux C, Golliot F, Brücker G. INCISO Network Study Group. Morbidity and mortality associated with surgical site infections: results from the 1997-1999 INCISO surveillance. J Hosp Infect. 2001 Aug;48(4):267–74. https://doi.org/10.1053/jhin.2001.1003.

Abstract: It is a chronic mucocutaneous debilitating inflammatory disease affecting skin, nails, mucosa. It is histologically characterized by infiltration of T cell response in epidermal keratinocyte apoptosis. It is CD 8+ cell mediated cytotoxic response through MHC Class 1 induction in a co culture model. JAK-2 and signal transducer and activator of transcription factor (STAT 1) ,but not JAK 1 or STAT-2 signaling. Using drug prediction algorithms identification of JAK inhibitors served as promising therapeutic agents in LP and demonstrate that JAK ½ inhibitor baricitinib fully protects keratinocyte cytotoxic responses . SERUM AND SALIVARY IFN-y AND IL-4 LEVELS IN PATIENTS OF ORAL LICHEN PLANUS : The signature cytokines of district T-Cell differentiation are indicated to be of fundamental importance in mucosal immunity . A component......

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