iosr-JDMS   Volume-22 ~ Issue-3 ~ March 2023

Abstract: Background :In patients with epilepsy the commonest type of shoulder dislocation following a seizure is the posterior type. Though not so common after a seizure , an anterior shoulder dislocation often merits special attention due to high incidence of recurrence and therefore the need for surgical reconstruction to treat the instability. Methodology :A cross-sectional study was conducted on patients coming to Emergency of Orthopaedics Department of a tertiary care hospital.The study period was of 6 months and total of 60 patients were evaluated. Patients of age group between......

Keywords : Recurrence ;Seizure;Shoulder dislocation; Shoulder Instability; Bankart's lesion; Hill Sach's lesion

[1]. Shaw JL . Bilateral posterior fracture-dislocation of the shoulder and other trauma caused by convulsive seizures. J Bone Joint Surg [Am]1971;53-A:1437–1440
[2]. Martin Bühler et al. Shoulder instability related to epileptic seizures J Shoulder Elbow Surg 2002 Jul-Aug;11(4):339-44.
[3]. John C. DeToledo, MD, Meredith R. L owe, MD, and R. Eugene Ramsay, MD, Miami, Fla et al. Restraining patients and shoulder dislocations during seizures www.jshoulderelbow.org/article/S1058-2746(99)90149-0
[4]. Lisa Langenbruch , Carolin Rickert et al Seizure-induced shoulder dislocations – Case series and review of the literature Seizure Volume 70, August 2019, Pages 38-42
[5]. Ulfin Rethnam et al. Post seizure anterior dislocation of shoulder—Beware of recurrence Seizure Volume 15, Issue 5, July 2006, Pages 348-349.

Abstract: Elbow dislocation associated with both radial head and coronoid fractures, termed the "terrible triad injury" (TTI) by Hotchkiss (1), was notoriously challenging for decades because of the difficulties inherent in treatment and the consistently poor prognosis (2-4). TTI was recorded as a severe injury with a lot of complications including recurrent instability, stiffness, arthritis, multiple reoperations, pain and functional limitations (4-6). The aim of TTI treatment is to recover the stability of the elbow so as to allow early rehabilitation and reduce the risk of long-term joint stiffness or disability (7, 8). This is also termed as "Complex dislocation".......

Keywords: Posteromedial dislocation, Coronoid fracture, Radial head fracture, Terrible triad, Neglected Posteromedial elbow Dislocation

[1]. Hotchkiss R. Rockwood and Green's fractures in adults. Philadelphia: Lippincott-Raven (1996).
[2]. Regan W, Morrey B. Fractures of the coronoid process of the ulna. J Bone Joint Surg Am 71 (1989): 1348-1354.
[3]. Terada N, Yamada H, Seki T, et al. The importance of reducing small fractures of the coronoid process in the treatment of unstable elbow dislocation. J Shoulder Elbow Surg 9 (2000): 344-346.
[4]. Ring D, Jupiter JB, Zilberfarb J. Posterior dislocation of the elbow with fractures of the radial head and coronoid. J Bone Joint Surg Am 84-a (2002): 547-551.
[5]. Pugh DM, Wild LM, Schemitsch EH, et al. Standard surgical protocol to treat elbow dislocations with radial head and coronoid fractures. J Bone Joint Surg Am 86-a (2004): 1122-1130.

Abstract: Background: Major abdominal procedures are linked to a variety of metabolic and inflammatory responses, which could turn into moderate to severe postoperative pain, increasing morbidity and consequences such as pneumonia and myocardial infarction. In patients undergoing major abdominal surgeries, Cesarean section, and abdominal hysterectomy, recent investigations have shown that TAP block provides good analgesia and lowers postoperative morphine use Aim: To compare the therapeutic.....

Keywords: Control group, Double tap, Postoperative analgesia,Ropivacaine, Transverse abdominis block

[1]. Kehlet H. Surgical stress. The role of pain and analgesia. Br J Anaesth. 1989; 63:189-95.
[2]. Kehlet H, Dahl JB. Anaesthesia and challenges in post operative recovery.Lancet2003; 362: 1921-8.
[3]. Lassen K, Hannemann P, Ljungqvist O, Fearon K, Dejong CH, Von Meyenfeldt MF et al. Patterns in current perioperative practice: survey of colorectal surgeons in five northern European countries. BMJ 2005; 330: 1420–1421.
[4]. Peyton PJ, Myles PS, Silbert BS, Rigg JA, Jamrozik K,Parsons R. Perioperative epidural analgesia and outcome after major abdominal surgery in high-risk patients. Anesth Analg 2003; 96: 548–554.
[5]. Paulsen EK, Porter MG, Helmer SD, Linhardt PW, Kliewer ML. Thoracic epidural versus patient-controlled analgesia in elective bowel resections. Am J Surg 2001;182: 570–577.

Abstract: Objective: The main objective of the study was to determine the frequency of various shapes of mandibular condyles using OPG of young adults of male and female genders (age 18-35 years). Material and methods:This were a cross-sectional study conducted in Out Patient Department of Peshawar Dental Hospital. A sample of 132 individuals with a mean age of 18-35 years was selected from a population visiting Peshawar Dental Hospital that fulfilled the inclusion criteria. OPGs were examined on an LED X Ray View box and tracing was done on a Schooler shammer tracing paper sheet for the morphology(shape) of the condyles to fit into one of the four types: rounded, angled.......

Keywords: Mandibular condyle, Temporal Mandibular Joint, Gender, Morphology

[1]. Singh M, Chakrabarty A. Anatomical variations in condylar shape and symmetry: Study of 100 Patients. Int J Sci Res. 2015;4(12):933-5.
[2]. Ashwinirani SR, Patil ST, Nair B, Rajmane Y, Kamala KA. Morphological variations of condylar process and sigmoid notch using Orthopantomograms in Western part of Maharashtra population. methods. 2018; 2:3.
[3]. Bhargava D, Gurjar P. Anatomy and Basic Biomechanics of the Temporomandibular Joint. in Temporomandibular Joint Disorders 2021 (pp. 9-21). Springer, Singapore.
[4]. Roberts WE, Goodacre CJ. The temporomandibular joint: a critical review of life‐support functions, development, articular surfaces, biomechanics, and degeneration. Journal of Prosthodontics. 2020 Dec;29(9):772-9.
[5]. Cuccia AM, Caradonna C, Caradonna D. Manual therapy of the mandibular accessory ligaments for the management of temporomandibular joint disorders. Journal of Osteopathic Medicine. 2011 Feb 1;111(2):102-12.

Abstract: Background: Childhood pigmentary dermatoses are one of the most commonly encountered conditions of which hypopigmented are important as they are associated with a significant amount of concern in parents. Materials and Methods: This is a descriptive study, conducted from March 2022 to August 2022 at PES Institute of Medical Sciences And Research, Kuppam. 121 patients with hypopigmentation who met the inclusion criteria were included in study. Results: Among 121 patients,67 were girls and 54 were boys,Majority of children belong to age group of 0-5 years(48.76%).Most common site......

Keywords: Hypopigmentary lesion,pityriasis alba,pityriasis versicolor.

[1]. Toossi P, Nabai L, Alaee Z, Ahmadi H, Saatee S. Prevalence of skin diseases and cutaneous manifestations among Iranian children: A survey of 1417 children. Arch Dermatol 2007;143:115-6.
[2]. Lapeere H, Boone B, De Schepper S, et al. Hypomelanoses and hypermelanoses. In: Fitzpatrick's Dermatology in General Medicine, 8th ed, Goldsmith L, Katz SI, Gilchrest BA, et al (Eds), McGraw-Hill Medical, New York 2012. p.804.
[3]. Tey HL. A practical classification of childhood hypopigmentation disorders. Acta Derm Venereol 2010;90:6-11.
[4]. Tey HL. Approach to hypopigmentation disorders in adults. Clin Exp Dermatol. 2010 Dec;35(8):829-34.
[5]. Soni B, Raghavendra K R, Yadav DK, Kumawat P, Singhal A. A clinic-epidemiological study of hypopigmented and depigmented lesions in children and adolescent age group in Hadoti region (South East Rajasthan). Indian J Paediatr Dermatol 2017; 18: 9-13..

Abstract: Background: Spinal anaesthesia is a temporary interruption of nerve transmission in the subarachnoid space that is produced by injecting local anaesthetic solution into cerebrospinal fluid (CSF). Levobupivacaine was commonly used in ambulatory surgeries with the advent of low-dose spinal anaesthesia technique. Opioids can provide most effective pain relief. Intrathecal opioids act synergistic with local anaesthetics and increase sensory block without influencing sympathetic block. Objective: This study was done to know the efficacy of adding nalbuphine and fentanyl to isobaric levobupivacaine spinal anaesthesia in patients scheduled for infraumbilical surgeries.......

Keywords: Efficacy, Fentanyl,Infraumbilical SurgeriesLevobupivacaine, Nalbuphine

[1]. Christopher M. Bernards: Epidural and spinal anaesthesia in: Paul G. Barash Clinical anaesthesia 6th edition Wolster Kluwer Lippioncot Williams & Wilkins New York 2010:927-950.
[2]. Hartmann B, Junger A, Klasen J, Benson M, Jost A, Banzhaf A, Hempelmann G. The incidence and risk factors for hypotension after spinal anesthesia induction: an analysis with automated data collection. Anesth Analg. 2002 Jun;94(6):1521-9, table of contents. [PubMed]
[3]. Brahmbhatt NP, Prajapati IA, Upadhyay MR. Combination of Low Dose Isobaric Levobupivacaine 0.5% and Fentanyl Compared with Isobaric Levobupivacaine 0.5% in Spinal Anaesthesia for Lower Abdominal and Perineal Surgeries. Int J Res Med 2015; 4(2);55-60.
[4]. Gomaa HM, Mohamed NN. A comparison between postoperative analgesia after intrathecal nalbuphine with bupivacaine and intrathecal fentanyl with bupivacaine after cesarean section. In: Egypt J Anaesth Elsevier. 2014:05:410.
[5]. Mark A, Chaney MD. Side effects of intrathecal and epidural opioids. Can J Anesth 1995(42);10:891-903.

Abstract: Background: Incidental thyroid noduleis defined as a nodule that has been found by an imaging examination that was not previously clinically noticed or suspected. Concern over a thyroid nodule that was accidentally detected and management recommendations play a significant role. The purpose of this study was to assess the frequency of incidental thyroid nodules (ITN) found incidentally on ultrasound of the neck for indications other than the thyroid gland, to describe the sonographic characteristics of the nodules, and discuss the management of incidental thyroid nodules.......

Keywords: Incidental, thyroid nodule, ultrasound, US, malignant, benign, imaging.

[1]. Gharib H, Papini E, Paschke R. Thyroid nodules: A review of current guidelines, practices, and prospects. Vol. 159, European Journal of Endocrinology. 2008.
[2]. Gharib H, Papini E, Paschke R, Duick DS, Valcavi R, Hegedüs L, et al. American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and European Thyroid Association medical guidelines for clinical practice for the diagnosis and management of thyroid nodules: Executive summary of recommendations. Vol. 16, Endocrine Practice. 2010.
[3]. Gough J, Scott-Coombes D, Fausto Palazzo F. Thyroid incidentaloma: An evidence-based assessment of management strategy. In: World Journal of Surgery. 2008.
[4]. Naik KS, Bury RF. Review Imaging the Thyroid. Clin Radiol. 1998;53.
[5]. Khurana KK, Richards VI, Chopra PS, Izquierdo R, Rubens D, Mesonero C. The role of ultrasonography-guided fine-needle aspiration biopsy in the management of nonpalpable and palpable thyroid nodules. Thyroid. 1998;8(6).

Abstract: Background: The most frequent acute abdominal condition is acute appendicitis (AA), and the most prevalent course of treatment is appendicectomy. Despite significant advancements in abdominal surgery, making decisions for patients with acute appendicitis is a global diagnostic challenge. The Modified Alvarado Scoring System (MASS) is a quick and affordable diagnostic tool for people with acute appendicitis. However, if the scores were applied to various populations and clinical situations, differences in diagnostic accuracy were seen.This study aimed to assess the Modified Alvarado Scoring System's diagnostic utility in patients with acute appendicitis in our setting.......

Keywords: Acute Appendicitis (AA); Appendicectomy; Modified Alvarado Scoring System (MASS).

[1]. Stephens PL, Mazzucco JJ. Comparison of ultrasound and the Alvarado score for the diagnosis of acute appendicitis. Conn Med. 1999 Mar;63(3):137-40. PMID: 10218289.
[2]. Cuschieri A. The small intestine and vermiform appendix. Essential surgical practice. 3rd ed. London: Butter worth Heinman. 1995:1325-8.
[3]. Jaffe BM, Berger DH. The appendix. Schwartz's principles of surgery. 8th ed. New York: McGraw-Hill. 2005:1119-37.
[4]. Dado G, Anania G, Baccarani U, Marcotti E, Donini A, Risaliti A, Pasqualucci A, Bresadola F. Application of a clinical score for the diagnosis of acute appendicitis in childhood: a retrospective analysis of 197 patients. J Pediatr Surg. 2000 Sep;35(9):1320-2. doi: 10.1053/jpsu.2000.9316. PMID: 10999688.

Abstract: Background:Controversy exists to date in the treatment of Gartland extension type-2 supracondylar fractures of the humerus. Our study aims to compare the outcomes of conservative and operative treatment for Gartland type 2 fractures in children. Materials and Methods:This prospective study included 30 patients with Gartland extension type 2 supracondylar humerus fractures.15 patients were treated conservatively and 15 were treated operatively. The functional outcome was assessed using Flynn's criteria and the radiological outcome was assessed by measuring Baumann's angle.......

Keywords: Elbow fractures in children, supracondylar fracture of the humerus, Gartland classification, Baumann's angle, pediatric elbow fracture treatment.

[1]. Houshian S, Mehdi B, Larsen MS. The epidemiology of elbow fracture in children: analysis of 355 fractures, with special reference to supracondylar humerus fractures. J Orthop Sci 2001;6(4):312-5.
[2]. Brubacher JW, Dodds SD. Pediatric supracondylar fractures of the distal humerus. Curr Rev Muscoloskelet Med. 2008;1(3-4):190–196.
[3]. Gartland JJ: Management of supracondylar fractures of the humerus in children. Surg Gynecol Obstet. 1959, 109:145-154.
[4]. France J, Strong M. Deformity, and function in supracondylar fractures of the humerus in children variously treated by closed reduction and splinting, traction, and percutaneous pinning. J Pediatr Orthop 1992; 4: 494-498.
[5]. Hadlow AT, Devane P, Nicol RO. A selective treatment approach to supracondylar fracture of the humerus in children. J Pediatr Orthop. 1996; 16:104–106.

Abstract: Background: Laparoscopic cholecystectomy (LC) is a minimally invasive surgery, indicated for the removal of a diseased gallbladder. It has replaced the open technique for conventional cholecystectomies since the 1990s. One previous study by Zudert conducted on Thoracic Segmental Spinal Anaesthesia (TSSA) for LC found to be effective and successful Aim:Aim of the study is to evaluate the efficacy and safety of TSSA to provide surgical anaesthesia without general anaesthesia (GA) among patients scheduled for elective laparoscopic cholecystectomy.......

Keywords: Cholecystectomy, Efficacy, Interventional study, Safety, Segmental Spinal Anaesthesia.

[1]. Kapoor T, Wrenn SM, Callas PW, Abu-Jaish W. Cost Analysis and Supply Utilization of Laparoscopic Cholecystectomy. Minim Invasive Surg. 2018;2018:7838103. [PMC free article] [PubMed] [2]. Strasberg SM. Tokyo Guidelines for the Diagnosis of Acute Cholecystitis. J Am Coll Surg. 2018 Dec;227(6):624. [PubMed] [3]. Blythe J, Herrmann E, Faust D, Falk S, Edwards-Lehr T, Stockhausen F, Hanisch E, Buia A. Acute cholecystitis - a cohort study in a real-world clinical setting (REWO study, NCT02796443). Pragmat Obs Res. 2018;9:69-75. [PMC free article] [PubMed] [4]. Kose SH, Grice K, Orsi WD, Ballal M, Coolen MJL. Metagenomics of pigmented and cholesterol gallstones: the putative role of bacteria. Sci Rep. 2018 Jul 25;8(1):11218. [PMC free article] [PubMed] [5]. Zundert AAV, Stultiens G, Jakimowicz JJ, Peek D, Ham W, Korsten HHM, et al. Laparoscopic cholecystectomy under segmental thoracic spinal anaesthesia: a feasibility study. Br J Anaesth. 2007;98(5):682– 6.

Abstract: Aims and objectives: The aim of this case report was to restore height and width of maxillary left upper incisor region by using Osseograft and Periocol GTR membrane and to replace the missing incisor with fixed prosthesis in a 20 years old female patient. Case presentation:A 20 years old girl presented with chief complaint of missing left upper anterior teeth causing aesthetic problem. Combined periodontal regenerative surgery and prosthetictreatment was performed. Conclusion: The use of bone graft and GTR membrane is one of the easiest effective ridge augmentation method for augmentation of single edentulous region.

Keywords: Ridge defect, Ridge augmentation, Bonegraft, GTR membrane, GBR

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Abstract: INTRODUCTION: Lumbar disc prolapse is significant medical problem. But efficacy of treatment and type of treatment to choose is less clear. Either conservative treatment or surgical treatment requires careful and detailed approach in management of Lumbar disc prolapse. METHODS:It was aHospital based Prospective Observational study done in the Department of Orthopedics, Maharajah's Institute Of Medical Sciences, Nellimarla, Vizianagaram during the period between January 2021 to June 2022 with Convenient sample of thirty cases of lumbar intervertebral disc prolapse patients of age between 20 to 80yrs, with clinical symptoms & signs and radiological evidence treated either conservatively or surgically.......

Keywords: lumbar disc prolapse, Visual-analogue scale, Oswestry Disability index Scores.

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