iosr-JDMS   Volume-22 ~ Issue-10 ~ October 2023

Abstract: In patients with extensive head and neck carcinoma invading the orbit, the role of orbital exenteration is still widely debated. The aim of treatment is complete surgical resection with negative oncologic margins. However, this is seldom possible in patients of advanced malignancy, especially in recurrent lesions. However, with improved microsurgical techniques, free flaps can be utilised to cover unsightly scars and extensive defects. Here we present a unique case of extensive maxillary carcinoma eroding the orbit, and our surgical management with a rectus femoris flap and rotational forehead free flap......

Keywords- microvascular, free flaps, advanced head and neck cancer, orbital exenteration

[1]. Wong CH, Wei FC. Anterolateral Thigh Flap. Head Neck 2010;32:529-40. [Pubmed]
[2]. Hsu CC, Loh CYY, Wei FC. The Anterolateral Thigh Perforator Flap: Its Expanding Role In Lower Extremity Reconstruction. Clin Plast Surg 2021;48:235-48. [Crossref] [Pubmed]
[3]. He J, Qing L, Wu P, Et Al. Individualized Design Of Double Skin Paddle Anterolateral Thigh Perforator Flaps To Repair Complex Soft Tissue Defects Of The Extremities: An Anatomical Study And Retrospective Cohort Study. J Plast Reconstr Aesthet Surg 2021;74:530-9. [Crossref] [Pubmed]
[4]. Fukuta T, Ichikawa Y, Mizuno H, Et Al. Split-Skin Paddle Anterolateral Thigh Flap For Reconstruction Of Giant Dermatofibrosarcoma Protuberans In Groin. Plast Reconstr Surg Glob Open 2019;7:E2528. [Crossref] [Pubmed]

Abstract: Periodontal disease is a prevalent and chronic oral health condition that poses significant challenges in its treatment and management. Traditional approaches often fail to achieve complete periodontal tissue regeneration, leaving patients with compromised oral health and function. In recent years, stem cell-based therapies have emerged as promising tools for periodontal regeneration, offering potential solutions to this complex problem. This review article explores the current state of knowledge regarding the use of stem cells in periodontal regeneration. We delve into the various types of stem cells, including mesenchymal stem cells (MSCs), induced pluripotent stem cells (iPSCs), and embryonic stem cells (ESCs), and their respective roles in regenerating.....

Keywords: Stem cells, Periodontal regeneration, Dental stem cells, Non-dental stem cells, Mesenchymal stem cells

[1]. Pejcic A, Kojovic D, Mirkovic D, Minic I. Stem Cells For Periodontal Regeneration. Balk J Med Genet. 2013;16(1):7-12. Doi:10.2478/Bjmg-2013-0012
[2]. Smith A. A Glossary For Stem-Cell Biology. Nature. 2006;441(7097):1060. Doi:10.1038/Nature04954
[3]. Lin NH, Gronthos S, Bartold PM. Stem Cells And Periodontal Regeneration. Aust Dent J. 2008;53(2):108-121. Doi:10.1111/J.1834-7819.2008.00019.X
[4]. Yamada Y, Nakamura-Yamada S, Kusano K, Baba S. Clinical Potential And Current Progress Of Dental Pulp Stem Cells For Various Systemic Diseases In Regenerative Medicine: A Concise Review. Int J Mol Sci. 2019;20(5). Doi:10.3390/Ijms20051132
[5]. Sivaram GMDS, Devi RSN. Stem Cells In Periodontal Regeneration. 2014;13(9):31-40.

Abstract: Introduction: Rhinocerebral mucormycosis (RCM) has been challenging infection specially occurring in diabetic and immunocompromised patients. Its clinical manifestation varies from mild cases to very severe fatal infection with toxemia and septicemia. Especially in the background of covid 19 RCM infections has increased drastically. Aims and objectives: We are proposing novel grading system for RCM which can help to categorize these patients and provide systemic treatment guidelines as per their stage.........

Key words: Rhinocerebral mucormycosis (RCM), diabetes, immunocompromised, covid 19, grading system

[1]. Rasoul Mohammadi, Mehdi Nazeri, Sayed Mohammad Amin Sayedayn, and Hassan Ehteram. A successful treatment of rhinocerebral mucormycosis due to Rhizopus oryzae
[2]. Infectious Diseases Agents of Mucormycosis (Microbiology) Res Med Sci. 2014 Jan;19(1): 72–74. [3]. Prabhu Rm, Patel R. Mucormycosis and entomophthoramycosis: A review of the clinical manifestations, diagnosis and treatment. Clin Microbiol Infect. 2004;10:31–47.
[4]. Ammari L, Kilani B, Tiouiri H, Kanoun F, Goubontini A, Mnif E, et al. Mucormycosis: Four case reports. La Tunis Med. 2008;86:165–8.
[5]. Peleg AY, Weerarathna T, McCarthy JS, Davis TM. Common infections in diabetes: Pathogenesis, management and relationship to glycaemic control. Diabetes Metab Res Rev. 2007;23:3–13. [PubMed]

Abstract: The term sexually transmitted diseases refers to a variety of clinical syndromes and infections caused by pathogens that are acquired and transmitted through sexual activity. Sexually transmitted diseases have significant prevalence in general population as well as pregnant women. Changes during pregnancy such as relative immunosuppression and anatomical and hormonal modifications may affect the course of sexually transmitted infections in pregnancy. Pregnancy modifies the manifestations of many STIs and presents unique problems for diagnosis and management.......

Key Words: Sexually Transmitted Infections, Pregancy, Fetal and maternal outcome.

[1]. Rowley J, Vander Hoorn S, Korenromp E, Low N, Unemo M, Abu-Raddad LJ. Chlamydia, Gonorrhoea, Trichomoniasis And Syphilis: Global Prevalence And Incidence Estimates, 2016. Bulletin Of The World Health Organization. 2019 Aug 1;97(8):548-62P.
[2]. Centers For Disease Control And Prevention. Sexually Transmitted Disease Surveillance. Atlanta, GA: US Department Of Health And Human Services, 2019.
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[5]. Adachi K, Nielsen-Saines K, Klausner JD. Chlamydia Trachomatis Infection In Pregnancy: The Global Challenge Of Preventing Adverse Pregnancy And Infant Outcomes In Sub-Saharan Africa And Asia. Biomed Res Int 20169315757, Doi:Http://Dx.Doi.Org/10.1155/2016/9315757.

Abstract: There are more than 30,000 species of spiders, most of which cannot inflict serious bites to humans because of their delicate mouthparts and impotent or prey-specific venoms. However, some spiders produce toxic venoms that can cause skin lesions, systemic illnesses, and neurotoxicity. These bites usually progress to ulcerating dermo necrosis at the bite site (1) Spider bites are not very common in India. They bite humans only when they are trapped or crushed against the skin.

[1]. Common Spider Bites. Diaz Jh, Leblanc Ke. Am Fam Physician. 2007 Mar 15;75(6):869-73. Pmid: 17390599
[2].
Dimosthenis Mantopoulo, Andrew J. Hendershot, Colleen M. Cebulla, And David K. Hirsh Bilateral Optic Neuropathy Following Bite From Brown Recluse Spider (Loxosceles Reclusa) Sivaperuman C, Rathore Ns. [3]. Spiders In The Desert National Park. Faunal Ecology And Conservation Of The Great Indian Desert. 2009, Pp 49-52
[4]. Jarvis Rm, Neufeld Mv, Westfall Ct. Brown Recluse Spider Bite To The Eyelid. Ophthalmology 2000; 107:1492-96. [5]. Bilgili Sg, Karadag As, Karadag R, Et Al. A Case Of Spider Bite Localized To The Eyelid.

Abstract: Introduction: Patients admitted to Intensive Care Units (ICUs) may endure a variety of discomforts, which may or may not be detected. These discomforts may be caused by the environment may be associated with ICU care and discomfort associated with the patient's health status and critical care actions. Aim: Identifying....

Keywords: Pain: Sedation: Stressful extubation

[1]. Ballard KS. Identification Of Environmental Stressors For Patients In A Surgical Intensive Care Unit. Issues Ment Health Nurs. 1981;3(1-2):89-108. Rotondi AJ, Chelluri L, Sirio C, Mendelsohn A, Schulz R, Belle S,
[2]. Et Al. Patients' Recollections Of Stressful Experiences While Receiving Prolonged Mechanical Ventilation In An Intensive Care Unit. Crit Care Med. 2002;30(4):746-52. Nelson JE, Meier DE, Oei EJ, Nierman DM, Senzel RS, Manfredi PL, Et Al.
[3]. Self-Reported Symptom Experience Of Critically Ill Cancer Patients Receiving Intensive Care. Crit Care Med. 2001;29(2):277-82. Kalfon P, Mimoz O, Loundou A, Geantot MA, Revel N, Villard I, Et Al.
[4]. Reduction Of Self-Perceived Discomforts In Critically Ill Patients In French Intensive Care Units: Study Protocol For A Cluster-Randomized Controlled Trial. Trials. 2016;17:87. Https://Doi.Org/10.1186/S13063-016-1211-X Dubois MJ, Bergeron N, Dumont M, Dial S, Skrobik Y.
[5]. Delirium In An Intensive Care Unit: A Study Of Risk Factors. Intensive Care Med. 2001;27(8):1297-304. Van Rompaey B, Elseviers MM, Schuurmans MJ, Shortridge-Baggett LM, Truijen.

Abstract: The article explores the complex diagnostic landscape of Pyrexia of Unknown Origin (PUO) and its evolution over time. It highlights the significance of indirect clues in diagnosis. Three case reports illustrate the challenges and successes in managing PUO. The cases underscore the dynamic nature of medical conditions and the value of reinvestigating variable factors. The article also discusses the implications of toxic vacuolization in white blood cells, the persistence of toxic vacuolations in treated patients, and the reverse approach of deriving diagnostic clues from therapeutic responses. The study concludes by highlighting the ongoing advancements in diagnostic methodologies and the nuanced considerations in managing undiagnosed PUO cases.

Keywords :Pyrexia of Unknown Origin (PUO), Elevated body temperature criteria, Hyperpyrexia

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[6]. El-Radhi AS. Fever In Non-Infectious Diseases. Clinical Manual Of Fever In Children. 2018:141-77..

Abstract: BACKGROUND – Groin dissection is an essential part in management of carcinoma penis. Either immediate or delayed dissection, the wound morbidity is so high and many measures taken historically to decrease the morbidity is not much of use. OBJECTIVE – our objective is to compare the operative characteristics and post op morbidity between primary closure and Tensor Fascia Lata flap cover following groin dissection in carcinoma penis cases METHODS – we did a retrospective study from January 2020 to December 2022 (data taken from our cancer registry) which included carcinoma....

KEYWORDS – Tensor Fascia Lata, groin, penis, primary closure and morbidity

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[2]. Nelson BA, Cookson MS, Smith Jr JA, Chang SS (2004). Complications Of Inguinal And Pelvic Lymphadenectomy For Squamous Cell Carcinoma Of The Penis: A Contemporary Series. The Journal Of Urology; Aug;172(2):494-7
[3] Murthy V, Gopinath KS (2012). Reconstruction Of Groin Defects Following Radical Inguinal Lymphadenectomy: An Evidence-Based Review. Indian Journal Of Surgical Oncology Jun;3(2):130-8.
[4]. Abraham V, Ravi R, Shrivastava BR (1992). Primary Reconstruction To Avoid Wound Breakdown Following Groin Block Dissection. British Journal Of Plastic Surgery; Apr;45(3):211-3.
[5]. Nahai F, Hill HL, Hester TR (1979). Experiences With The Tensor Fascia Lata Flap. Plastic And Reconstructive Surgery; Jun;63(6):788-99.

Abstract: Early diagnosis and treatment are essential for managing sepsis, an illness that can be fatal. Therefore, it's crucial to identify emergency room patients who are most at danger of passing away. Finding the high-risk patients will enable additional care attention and assist in choosing the recipient of the transfer. . An evidence-based risk-stratification score can be used to pinpoint patients who are very susceptible to dying. Any score that is used should be simple to calculate utilising easily accessible variables is must. Sepsis is defined objectively as an increase of at least two points in the Sequential Organ Failure Assessment.....

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[2]. Rhodes A, Evans LE, Alhazzani W, Et Al. Surviving Sepsis Campaign: International Guidelines For Management Of Sepsis And Septic Shock: 2016. Crit Care Med 2017;45:486–552.
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[4]. Vincent J-L, Moreno R, Takala J, Et Al. The SOFA (Sepsis-Related Organ Failure Assessment) Score To Describe Organ Dysfunction/ Failure. Intensive Care Med 1996;22:707–10.
[5]. Seymour CW, Liu VX, Iwashyna TJ, Et Al. Assessment Of Clinical Criteria For Sepsis: For The Third International Consensus Definitions For Sepsis And Septic Shock (Sepsis-3). JAMA 2016;315:762–74.

Abstract: Appendicectomy is the most common emergency abdominal Surgery performed worldwide. Appendicitis is characterised by inflammation of vermiform appendix. Prompt diagnosis and timely intervention are essential to prevent complication such as perforation, abscess formation and peritonitis. Emergency appendectomy is typically performed within 24 48 hours after the onset of symptoms. Primary goal of this procedure is to prevent the progression of acute appendicitis to complication. Delayed appendectomy refers to the surgical removal of appendix performed beyond the initial acute phase of the diagnosis. Histopathological examination of the appendectomy.....

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[4]. Xharra S, Et Al. Correlation Of Serum C-Reactive Protein, White Blood Count And Neutrophil Percentage With Histopathology Findings In Acute Appendicitis. World J Emerg Surg 2012 Aug 6;7(1):27
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Abstract: Anti-NMDA receptor encephalitis is an immune-mediated paraneoplastic encephalitis. It mainly affects young women, with a high frequency of ovarian teratoma, indicating the underlying paraneoplastic pathogenesis. The clinical presentation is protean and evolves in several stages. We report here a 31-year-old immunocompetent patient with a history of toxemia of pregnancy, hospitalized for memory disorders evolving for 4 months. The neuropsychological evaluation showed a massive deficit of retrograde and anterograde memory, a severe alteration of episodic memory, false recognitions, a discrete dysexecutive syndrome, a lack of access to lexicons, with the preservation....

KEYWORDS – encephalitis, anti-NMDA receptor antibody, teratoma, cryptococcal meningitis, dysautonomia

[1]. Venkatesan A, Benavides DR. Autoimmune Encephalitis And Its Relation To Infection. Curr Neurol Neurosci Rep. 2015 Mar; 15(3):3. Doi: 10.1007/S11910-015-0529-1. PMID: 25637289
[2]. Bicanic T, Harrison TS. Cryptococcal Meningitis. Br Med Bull. 2005 Apr 18; 72:99-118. Doi: 10.1093/Bmb/Ldh043. PMID: 15838017
[3]. Titulaer MJ, Mccracken L, I Gabilondo, Armangué T, C Glaser, Iizuka T, Et Al. Treatment And Prognostic Factors For Long-Term Outcome In Patients With Anti-NMDA Receptor Encephalitis: An Observational Cohort Study. Lancet Neurol. 2013 Feb;12(2):157-65. Doi: 10.1016/S1474-4422(12)70310-1. PMID: 23290630
[4]. Viaccoz A, Desestret V, Ducray F, Picard G, Cavillon G, Rogemond V, Et Al . Clinical Specificities Of Adult Male Patients With NMDA Receptor Antibodies Encephalitis. Neurology. 2014 Feb 18; 82(7):556-63.Doi: 10.1212/WNL.0000000000000126. PMID: 24443452.
[5]. Graus F , Titulaer MJ , Balu R , Benseler S , Bien CG , Cellucci T, Et Al . A Clinical Approach To Diagnosis Of Autoimmune Encephalitis. Lancet Neurol . 2016 Apr; 15(4):391-404. Doi: 10.1016/S1474-4422(15)00401-9. PMID: 26906964.