iosr-JDMS   Volume-21 ~ Issue-4 ~ April 2022

Abstract: Congenital Myotonia is rare genetic disorder in which abnormality of normal voluntary skeletal muscle fibres causes an unusual exaggerated response to stimulation. Affected individuals have difficulty relaxing certain muscles after contracting them (myotonia), muscle stiffness (rigidity) and associated symptoms. Thomsen and Becker types myotonia congenita are thought to affect males and females in relatively equal numbers. The reported incidence of these disorders is 1 per 10,00,000 people in the general population. Thomsen disease which is the autosomal dominant type is more prevalent than the autosomal recessive Becker type. We present here a case report of a 15 yr old boy who came with the complaints of difficulty in walking which was gradually progressive. Clinical Examination were.......

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[3]. Nelson Textbook of Pediatrics. 16th ed. Philadelphia, Pa: W.B. Saunders Company; 2000:1879-80.
[4]. Principles of Neurology. 6th ed. New York, NY: McGraw-Hill Companies, Inc.; 1997:1476-82.
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Abstract: Background: Hypertension is a chronic elevation in blood pressure (BP) 140/90. It is subjected to various disorders which produce alterations in the morphology of kidneys with renal artery blood flow. Doppler ultrasound (US) of the renal artery is sensitive for evaluating the kidneys and provides the accurate diagnosis of early kidney function ,morphology, and blood flow effects. The aim of this study is to determine whether there were different renal artery Doppler indices in young adult hypertension with control group. Methods: This is a cross-sectional study conducted from October 2019 to October 2021 and this study make in Khartoum Sudan The Health Ministry of Khartum Hajj.......

Key words: renal artery Doppler ,adult hypertension, Doppler index

[1]. dennisL .kasper el at . 2005.Harrison's manual of medicine ,ed 16th , Mc G raw new york , 163.
[2]. Carvalho, T. B. O., Cancian, L. R. L., Marques, C. G., Piatto, V. B., Maniglia, J. V., & Molina, F. D. (2010). Six years of facial trauma care: an epidemiological analysis of 355 cases. Brazilian journal of otorhinolaryngology, 76(5), 565-574.
[3]. George Madubueze1 and Emmanuel Ugwa. 2018. A comparative ultrasonographic evaluation of intrarenal artery resistive index among hypertensive and normotensive adults in a black African population compared to a European populationActaRadiologica Open 7(1) 1–6.
[4]. Hanamura, Kikuno, et al. "The resistive index is a marker of renal function, pathology, prognosis, and responsiveness to steroid therapy in chronic kidney disease patients." International Journal of Nephrology 2012 (2012).
[5]. Gaurav K, Yalavarthy U, Chamberlain N, Pugh S, Panda M. Correlation between Renal Resistive Index and Estimated Glomerular Filtration Rate in Patients with Hypertension. Journal for Vascular Ultrasound. 2008;32(2):82-84

Abstract: Background: Caudal epidural analgesia is one of the most commonly performed regional blocks in paediatric anaesthesia for intra and post-operative analgesia. However, the mean duration of analgesia provided by local anaesthetics alone is limited. Methods: This study was conducted in Nmch, Patna. Department of Anaesthesiology, among 60 children in the age group of 5 – 10 years coming for various elective infraumbilical surgical procedures. They were divided into two groups of 30 each. Group A received caudal 0.25% bupivacaine (1ml/kg) and group B received caudal 0.25% bupivacaine (1ml/kg) with clonidine (1.5μg/kg). The various parameters studied.......

Keywords: Caudal, bupivacaine, clonidine;,children

[1]. International association for study of pain, Subcommittee on Taxonomy. Pain terms: a list with definitions and notes on usage. Pain 1979; 6: 249-252.
[2]. Anand KJ, Craig KD. New perspectives on the definition of pain. Pain 1996; 67:3- 6.Discussion 209–211, 1996.
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Abstract: Background: The provision of adequate analgesia is necessary after any surgery and is all the more important in children. Pain after surgery is inevitable. It has been recognized for some time that management of acute pain, especially postoperative pain, has been consistently and systematically inadequate, situation being worse in children. Methodology: After careful pre-anaesthetic check-up children posted for elective sub-umbilical surgeries between age groups of 3-8yrs of ASA I & II were randomly divided into 2 equal groups.Group L received levobupivacaine 0.25% 1ml/kg + 2mcg/kg clonidine and Group R received ropivacaine 0.25% 1ml/kg + 2mcg/kg clonidine. Following.......

Keywords: Levobupivacaine, Ropivacaine, Caudal, clonidine, Analgesia

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Abstract: Background: Tuberculous meningitis kills or disables more than half of those affected. The diagnosis of TBM is difficult. Delay in diagnosis and treatment are regarded as the major contributing factors in the high mortality reported. Methods: Total 50 cases of meningitis aged 18 years above were included in the study out of which 40 cases were proved to be TBM, and were studied in detail about clinical and laboratory profile. Results: Patients ranged from 18-70 years. Peak incidence was in age group 20-30 years (40%). Majority of patients had fever, headache, vomiting, altered sensorium and neck stiffness. 17.5% patients were comatose. Cranial nerve palsy was present in 40% cases, 6th nerve being the commonest. Motor deficit like hemiparesis/ plagia (10%), quadriplegia (2.5%) was present in 12.5% cases. Conclusion: TBM continue to be a serious illness mostly affecting the young adults. CSF analysis continues to be a key in establishing the diagnosis. One should not wait for the microbiological proof to start the therapy. Early diagnosis and treatment can make complete recovery even in comatose patients..

Keywords: Tuberculous Meningitis, Cerebrospinal fluid, Adenosine deaminase

[1]. G. Thwaites, TTH Chau, NTH Mai, F Drobniewski, K. McAdam, J Farrar.
[2]. Tuberculous meningitis. J Neurol Neurosurg Psychiatry 2000; 68: 289-299.
[3]. Bernaerts A, Vanhoenacker FM, Parizel PM et al. Tuberculosis of the central nervous system: Overview of neuroradiological findings. Eur Rariol 2003;13: 1876-1890.
[4]. GE Thwaites, TTH Chau, K. Stepniewska, NH Phu, LV Chuong, DX Sinh, NJ White,CM Parry, JJ Farrar. Diagnosis of adult tuberculous meningitis by use of clinical and laboratory features. Lancet 2002; 360:1287-92.
[5]. Rich AR, McCordick HA. The pathogenesis of tuberculous meningitis. Bulletin ofJohn Hopkins Hospital, 1933; 52: 5-13

Abstract: The genus Enterococcus is composed of 38 species, the most important of which are Enterococcus faecalis and Enterococcus faecium—both human intestinal colonizers. Hospitals within the United States and around the world commonly isolate these bacteria because they cause of bacteraemia, urinary tract infections (UTIs), endocarditis, wound infections, meningitis, intra abdominal and pelvic infections, and nosocomial and iatrogenic infections. Given the ubiquity of enterococci within the human population, it is important for laboratories to be able to distinguish these agents within hospitalized patients from other bacterial genera and also differentiate different species within the Enterococcus genus as well as different strains within each species. Unfortunately, the......

Keywords: enterococci, Staphylococcus, antibiotic resistance, bacteriology, microbiology

[1]. Murray P R, Rosenthal K S, Pfaller M A (2009). Enterococcus and other Gram-positive cocci. Medical Microbiology (6th Ed), 243–246.
[2]. Murray B E (1990). The life and times of the Enterococcus. Clin Microbiol Rev, 3(1): 46–65.
[3]. Facklam R (2002). What happened to the streptococci: overview of taxonomic and nomenclature changes. Clin Microbiol Rev, 15(4): 613–630.
[4]. Teixeira L M, Carvalho M G S, Shewmaker P L, Facklam R R (2011).Manual of Clinical Microbiology. Washington, D.C.: ASM Press, 350–364.
[5]. Reid K C, Cockerill F R III, Patel R (2001). Clinical and epidemiological features of Enterococcus casseliflavus/flavescens and Enterococcus gallinarum bacteremia: a report of 20 cases. Clin Infect Dis, 32(11): 1540–1546

Abstract: BACKGROUND: I-gel is new single use supraglottic airway device without an inflatable cuff. This study was designed to compare the usefulness of I -gel versus c-LMA in small children. OBJECTIVES: To compare ease of insertion, hemodynamic parameters and airway complications of I -gel with c-LMA for general anaesthesia with controlled ventilation. METHODS: 60 ASA- I and II children aged 2-14 years undergoing short surgical procedures under general anaesthesia. Children were randomly....

Keywords: c-LMA-Classic laryngeal mask airway, I -gel , pediatric patients.GA-General Anaesthesia

[1]. Souza N, Carvalho WB. Compl icat ions of tracheal intubation in pediatrics. Rev Assoc MedBras. 2009 Nov-Dec;55(6) :646-50.
[2]. . Shet ty AN, Shinde VS, ChaudryLS. A comparative study of various devices as regard ease of insertionanl hemodynamic responses. Indian J Anaesth.2004;48:134 -137
[3]. Durrani HD, But t KJ, Sadaf S, Rehan A, Khan AM, Umar A.Comparison of LMA Classic and i -gel in anesthetized,spontaneously breathing patients during elective surgical procedures. Anaesth Pain & Intensive Care 2013;17(3):274 -278.
[4]. Ali A, Sheikh NA, Ali L, Siddique SA Comparison of i -gel® supraglottic with laryngeal mask airway . Professional Med J 2010; 17(4): 643-647
[5]. Janaki raman C, Chethan DB, Wi lkes AR, Stacey MR, Goodwin,N. A randomised crossover trial comparing the i -gel®supraglottic airway and classic laryngeal mask airway Anaesthesia 2009; 64(6): 674-678.

Abstract: Severe corneal ulcer is an erosion of the epithelial layer and the corneal stroma associated with one or more local or general criteria of gravity. It is a frequent and serious pathology involving the functional and anatomical prognosis of the eyeball. It poses a problem of etiological diagnosis. It is a public health problem because corneal ulcer is one of the main causes of visual impairment in sub-Saharan countries1. The aim of our study is to describe the characteristics of severe corneal ulcers encountered in our context.

[1]. Bourcier T. Abcès de cornée: que faire ou ne pas faire en urgence?.Réalités Ophtalmologiques. 2012;191(1):1-3
[2]. Mahjoub, A., Gayed, N., Krifa, F., Knani, L., & Hachemi, M. (2021). Severe corneal abscess: epidemiology and clinic bacteriological aspect. La Tunisie Medicale, 99(6), 632-637.
[3]. Schaefer F, Bruttin O, Zografos L, Guex-Crosier Y. Bacterialkeratitis : a prospective clinical and microbiologicalstudy. Br J Ophthalmol 2001;85:842—7 [4]. Ancele, E.; Lequeux, L.; Fournié, P.; Chapotot, E.; Douat, J.; Arné, J.-L. (2009). Kératites bactériennes sévères. Étude épidémiologique, clinique et microbiologique. , 32(8), 558–565 [5]. Darugar, A.; Gaujoux, T.; Goldschmidt, P.; Chaumeil, C.; Laroche, L.; Borderie, V. (2011). Caractéristiques cliniques, microbiologiques et thérapeutiques d'une série de 111 kératites bactériennes sévères. , 34(6), 362–368.

Abstract: The objective of our study was to analyze the microbiological ecology of intensive care units and its evolution between January 1, 2018 and December 31, 2021. We conducted a monocentric retrospective study in the microbiology laboratory of the CHU HASSAN II of Fez. We analyzed all the microbiological samples for diagnosis carried out over this period (identified germ, sensitivity profile), and collected the demographic characteristics of the associated population (number = 1472). Out of 1154 culture-positive samples, 645 were multidrug-resistant bacteria (56%). The proportions of the different bacterial classes (GNB / CG+) have remained stable over the last 4 years, with a predominance of Acinetobacter baumanii (55%), followed by Klebsiella pneumoniae (20%) and Escherichia coli (18%).........

Keywords: Nosocomial infection, bacterial ecology, intensive care, microbiology.

[1]. M. Mahmoud. A. Massik. Caractérisation moléculaire des Acinobacter Baumannii producteurs de carbapénémases au CHU Hassan II de Fès, Faculté de Médecine et de Pharmacie de Fès, 2022.
[2]. Société française de microbiologie EUCAST CA-SFM V 1.1 Avril 2020.
[3]. Observatoire national de l'épidémiologie de la résistance bactérienne anx antibiotiques. Rapport d'activité annuel édition mai 2020.
[4]. W. ElHadi. Pneumonie bacterienne associee a la ventilation mecanique. Université Mohamed V de Rabat. 2020.
[5]. F. Zahouani. Les pneumopathies nosocomiales chez les patients hospitalisés en réanimation (à propos de 64 cas), université Cadi Ayyad, faculté de médecine et de pharmacie de Marrakech, 2019.

Abstract: Considering the dental diseases worldwide, periodontal disease is one of the two diseases that has direct impact on human population. The ambitious goal of periodontal therapy is to restore the periodontal attachment apparatus to its prediseased state. Autogenous bone, long considered the gold standard of grafting materials, is currently the only osteogenic graft available to clinical practitioners. Buccal exostoses are usually found only on the facial surface of the maxillary alveolar bone, especially in the posterior segment. Resecting the exostosis provides a source of bone without creating a defect at the donor site and also provides an opportunity to restore the normal bony architecture of the alveolar bone. This case report describes the successful management of intrabony defect using an autograft harvested from exostosis on the buccal aspect of maxilla.

[1]. Kataria S, Chandrashekar KT, Mishra R, Tripathi V. Autogenous bone graft for management of periodontal defects. Journal of the International Clinical Dental Research Organization. 2016 Jan 1;8(1):70-75 [2]. Puttaswamaiah RN, Galgali SR, Gowda VS. Exostosis: A donor site for autograft. Indian Journal of Dental Research. 2011 Nov 1;22(6):860.
[3]. Reynolds MA, Aichelmann-Reidy ME, Branch-Mays GL, Gunsolley JC. The efficacy of bone replacement grafts in thetreatment of periodontal osseous defects. A systematic review. Ann Periodontol 2003; 8:227-65. [4]. Medsinge SV, Kohad R, Budhiraja H, Singh A, Gurha S, Sharma A. Buccal exostosis: a rare entity. Journal of international oral health: JIOH. 2015 May;7(5):62. [5]. Hassan KS, Al-Agal A, Abdel-Hady AI, Swelam WM, Elgazzar RF. Mandibular tori as bone grafts: an alternative treatment for periodontal osseous defects-clinical, radiographic and histologic morphology evaluation. The journal of contemporary dental practice. 2015 Mar 1;16(3):192-200.

Abstract: Background and objectives: COVID 19 causes infection ranging from mild self-limiting illness to severe cases of ARDS (Acute respiratory distress syndrome) with multi-organ dysfunction syndrome. The objective of this study is to compare LNR and NMR in predicting mortality due to COVID19. Methods: It is a cross-sectional study, done from June 2020 to August 2020. All are COVID 19 diagnosed patients admitted to KIMS hospital. Results: The mean LNR value was 0.399 in patients of category C, which was significantly lower compared to patients of category A and B which was 0.69 and 0.423 respectively. And the mean NMR value was 35.27 in category C patients which was significantly higher compared to Category A and B patients, which was 17.75 and 24.18 respectively..........

Keywords: COVID19, LNR, NMR.

[1]. Lai CC, Shih TP, Ko WC, Tang HJ, Hsueh PR Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease-2019 (COVID-19): The epidemic and the challenges. Int J Antimicrob Agents. 2020 Mar; 55(3):105924.
[2]. Zhonghua Liu Xing Bing Xue Za Zhi [The epidemiological characteristics of an outbreak of 2019 novel coronavirus diseases (COVID-19) in China]. Epidemiology Working Group for NCIP Epidemic Response, Chinese Center for Disease Control and Prevention.. 2020 Feb 10; 41(2):145-151.
[3]. Zhao K, Li R, Wu X, Zhao Y, Clinical features in 52 patients with COVID-19 who have increased leukocyte count: a retrospective analysis. Eur J Clin Microbiol Infect Dis. 2020 Dec; 39(12):2279-2287.
[4]. Belice T, Demir I, Yüksel A , Role of neutrophil-lymphocyte-ratio in the mortality of males diagnosed with COVID-19. Iran J Microbiol. 2020 Jun; 12(3):194-197.
[5]. Liu S, Su X, Pan P, et al. . Neutrophil extracellular traps are indirectly triggered by lipopolysaccharide and contribute to acute lung injury. Sci Rep. (2016) 6:37252. 10.1038/srep37252.

Abstract: A 51-year-old melanoderm patient, who complained of slow progressive loss of visual acuity in his left eye. His best corrected visual acuity was 10/10 in the right eye and 1/10 in the left eye. Slit-lamp examination revealed white and fine stellar keratic precipitates distributed all over the cornea (Fig. 1A), absence of heterochromia, superficial puncture atrophic areas in the iris giving an appearance of moth-eaten iris (Fig. 1B,C), a posterior subcapsular cataract (Fig. 1D) and vitreous opacities. The ocular tonus was nor- mal. Examination of the right eye was unremarkable. The iris heterochromia in Fuchs disease may be absent, espe- cially in brown-eyed patients, the diagnosis is then more delicate. The comparative and careful observation of the irian architecture is important, because iris atrophy is the most constant sign in the disease, which can be manifested by a moth-eaten appearance of the iris.

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