iosr-JDMS   Volume-10 ~ Issue-1

Abstract: Stickler syndrome is a rare genetic connective tissue disorder ( incidence 1 in 7500 births) related to mutations in the collagen genes. One out of 4 patients with Stickler syndrome has a Pierre Robin sequence- detected at birth by a combination of retrognathia, micrognathia, cleft palate and retroglossoptosis. Ocular abnormalities, craniofacial anomalies, bone and joint symptoms and hearing loss are the main manifestations of Stickler syndrome. Early onset osteoarthritis with a prevalence of 15% before 20 years of age and 75% after 50 years of age presents with a variety of features including metaphyseal-epiphyseal dysplasia with broadening and stiffness of joints, pronated feet and moderate arachnodactyly – all of which were present in the 40 day old male infant that we are reporting. The unusual occurrence of arthropathy involving bilateral knee and shoulder joints with stiffness and broadening of affected joints detected so early in life, has not been reported so far to the best of our knowledge. This baby also presented with megalocornea and glaucoma together with other phenotypic abnormalities specific for Stickler syndrome. The early recognition of arthropathy and ophthalmopathy in the neonatal period in association with features of Pierre Robin sequence helped us to make the diagnosis of Stickler syndrome by 45 days of age. The idea of reporting this case is not only to make the pediatrician aware about the probability of diagnosis of Stickler syndrome in a newborn with Pierre Robin sequence as also to stress the need for regular follow up by an ophthalmologist and a test of hearing soon after birth and audiograms at diagnosis and at regular follow-ups. Regular monitoring from early infancy and through the teens for the above-mentioned problems with prompt interventions will go a long way in improving the quality of life in children with Stickler syndrome.

Keywords: Glaucoma ,Megalocornea, Osteoarthritis , Pierre Robin sequence , Stickler syndrome

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[5] Couchourona T, Massonb C. Early-onset progressive osteoarthritis with hereditary progressive ophtalmopathy or Stickler syndrome. Joint Bone Spine 2011;78(1):45e9.
[6] Soulier M, Sigaudy S, Chau C, Philip N. Prenatal diagnosis of PierreeRobin sequence as part of Stickler syndrome. Prenat Diagn 2002;22:567e8.
[7] Evans AK, Rahbar R, Rogers GF, Mulliken JB, Volk MS. Robin sequence: a retrospective review of 115 patients. Int J Pediatr Otorhinolaryngol 2006;70:973e80.
[8] Elzen APM, Semmekrot BA, Bongers EMHF, Huygen PLM, Marres HAM. Diagnosis and treatment of the Pierre Robin sequence: results of a retrospective clinical study and review of the literature. Eur J Pediatr 2001;160:47e53.
[9] Rose PS, Levy HP, Liberfarb RM, et al. Stickler syndrome: clinical characteristics and diagnostic criteria. Am J Med Genet 2005;9999:1e9.
[10] Stickler GB, Hughes W, Houchin P. Clinical features of hereditary progressive arthro-ophthalmopathy (Stickler syndrome): a survey. Genet. Med. 2001; 3: 192–6.

Abstract: Background and objective: Incisional hernia is one of the most common problems encountered by general surgeons worldwide. Many forms of repair have been adopted with their own merits and demerits. In thisretrospective study,an attempt is made to evaluate theoutcome of preperitoneal mesh repair of incisional hernia with reference to technicaldifficulty, convalescence, wound infection, bowel adhesions, intestinal obstruction, intestinal fistula formation and recurrence.

Keywords: preperitoneal, incisional hernia, complications, recurrence.

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Abstract: Introduction: Physical activity is defined as any bodily movement produced by skeletal muscles that requires energy expenditure. Physical inactivity has been identified as the fourth leading risk factor for global mortality causing an estimated 3.2 million deaths globally. Objectives: To find the physical activity status of the adolescent girls and to know their body image perception. Materials And Methods: The study was conducted at the Bagbazar Slum of Urban Field Practice Area of R.G.Kar Medical College. A total of 107 girls from 10 to 19 years of age residing in this slum participated in this study. A pre-designed, pre-tested questionnaire was used for data collection. For determining physical activity status Global Physical Activity Questionnaire (GPAQ) was used and the results were compared with the WHO guidelines for physical activity for adolescents. METs (Metabolic Equivalents) are used for the analysis of GPAQ data. MET is the ratio of a person's working metabolic rate relative to the resting metabolic rate. One MET is defined as the energy cost of sitting quietly and is equivalent to a caloric consumption of 1 kcal/kg/hour. Therefore, when calculating a person's overall energy expenditure using GPAQ data, 4 METs get assigned to the time spent in moderate activities, and 8 METs to the time spent in vigorous activities. Results: Only 14.28% of girls in the age group 10 to 17 years and 67.56% of girls above 17 years had physical activity above recommended guidelines. 57% of girls had no recreation involving physical activity of any kind. 47.7% of girls were not satisfied with their body image. Conclusion: Physical activity should be promoted among adolescent girls to prevent occurrence of NCD and lead a healthy life.

Key Words: Adolescent, Perception, Body Image, Physical Activity

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[5]. Swati Dixit, GG Agarwal, JV Singh, Surya Kant, Neelam Singh. A Study on Consciousness of Adolescent Girls About Their Body Image. Indian J Community Med. 2011 Jul-Sep; 36(3): 197–202.
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Abstract: Background: Child labour in India is the practice where children are engaged in Economic activities. Poverty, lack of good school infrastructures and growth of informal economy are considered as the important causes of child labour in India. According to UNICEF India has the highest number of labourers in the world under 14 years of age. Objective: To describe the job pattern of Child labourers in a rural Block of West Bengal and to assess the socio-demographic characteristic of child labourers under study .Materials and Methods: A Cross sectional Observational study was conducted in Paharhati Block in the district of Burdwan, West Bengal from December 2012 to February 2013 among children aged 5 to 14 years. Assuming 6.8% of the 5-14 years population engaged in child labour , the estimated study population would be about 2080. About 5% of this estimated study population i.e. 104 would be involved in the study. With design effect of 2, the number would be 208 and was selected through 30 cluster sampling and about 7 child labourers per cluster were gathered by 'Snowball' technique was used for for data collection .

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Abstract: Hypertension is an iceberg disease. It is the main risk factor for stroke and renal failure. Elevated levels of triglyceride, cholesterol and LDL-C are documented as risk factors for atherogenesis. LDL-C in its oxidized or acetylated form has been identified as a major atherogenic particle. Fifty four women between 20-35 years of age attending Katihar medical college hospital OPD were used in this study. Their height, weight, systolic and diastolic blood pressures were recorded. Body Mass Index (BMI) was calculated by using their height (m2) and weight (kg). On the basis of BMI, all participants were divided into three groups that is under weight whose BMI was less than 19 kg/ m2, Normal who's BMI was between 19 and 26 kg / m2and overweight who's BMI was more than 26 kg / m2. The mean BMI of the three groups in the 54 participants was 150.1 mg/dl ±31.7, mean LDL-C was 91.6 mg/dl±22.6, mean HDL-C was 39.7 mg/dl ±9.1 and mean triglycerides were 93.9 mg/dl ±41.6. Mean systolic blood pressure was 114.1mmHg±11.8 and mean diastolic blood pressure was 74.1 mmHg ±7.9. There were significant differences in mean serum HDL-C, triglycerides, systolic and diastolic blood pressure among three BMI groups (P<0.05) but none in mean serum cholesterol and LDL-C. No significant correlation was found between any of the lipid profile variables and blood pressure variables with BMI. The importance of this finding is to enable "care-givers" in hypertension pay more attention to the control of obesity so that several complications associated with it might be prevented. Key words: Hypertension, body mass index and cholesterol

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Abstract: Placental morphometry and fetal growth trajectory are directly related to maternal health profile. Inutero environment influences the placental morphometry and the foetal growth, any imbalance in the equilibrium of this triad leads to adverse pregnancy outcome and long term risk of chronic diseases in the newborn. Present study was conducted on 164 consecutive singleton deliveries from a teaching hospital of North Karnataka, India from Sept 2012 to Jan 2013. The study was designed to explore the influence of the adverse pregnancy symptoms and conditions on the birth weight and placental morphometry. The Mean and standard deviation (SD) of placental morphometry; weight, volume, surface area and thickness were 414.7± 110.5gm, 363.1±113.2ml, 223.7±54.7sqcm, and 2.1±0.5 cm respectively with birth weight mean±SD 2536.1±675.5gm. Mild vomiting exhibited increase in birth weight and placental morphometry. Rise in either systolic or diastolic blood pressure exhibited positive and significant relationship with; placental weight, thickness ( p<0.01) volume, and birth weight (p<0.05). Mild oedema, severe anaemia and protienuria were associated with decreased birth weight and placental morphometry, but not significantly. The results of the present study will help clinicians to correlate the adverse pregnancy symptoms and conditions with growth of placenta and fetus. Severe adverse pregnancy symptoms and conditions lead to abnormal placental morphometry and birth weight reflecting the worsening of pregnancy outcome.

Key words: Placental weight, placental volume, placental surface area, placental thickness, vomiting, blood pressure, pallor

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Abstract: Understanding the suicide profile in Mauritius is important for enhancing suicide prevention strategies. The aim of this research was to study recent trends in suicides over a decade from 2000 to 2010 to investigate the relationship of suicides with respect to gender, age-group, mode of suicide and living standards as represented by gross domestic product per capita adjusted for purchasing power parity. A retrospective analysis was conducted on all suicide cases recorded by the police for the period 2000 to 2010. For each recorded case of suicide, the following factors were studied: year of occurrence, gender, age, mode of suicide, place of residence and occupation. Results showed that suicide rates varied from 6.2 to 8.9 during the 10-year period and that the rates appeared to be decreasing with improvement in living standards. Suicide rates were higher in males and in the 20 to 29 age group. It was observed that there had been a shift in the mode of suicides over the decade with an increase in suicide deaths by hanging whilst suicides by poisoning were on a declining trend. Although possible underreporting of suicides is a limitation, findings from the study could better inform suicide prevention strategies.

Keywords-deaths, hanging, poisoning, suicides

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[3] Sarchiapone M, Mandelli L, Iosue M, Andrisano C, Roy A, Controlling access to suicide means, Int J Environ Res Public Health,8(12), 2011,4550-62.
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Abstract: Introduction: In orthodontic diagnosis and treatment planning an accurate evaluation of sagittal jaw relationship is important. To assess the antero-posterior jaw discrepancy between maxilla and mandible, numerous angular and linear measurements have been in corporate so as to reach correct diagnosis. So the purpose of this study is to compare ANB angle, Wits appraisal, Beta angle and W angle used to measure antero-posterior dysplasia and to find out which is the most reliable amongst them. Material and method: Sample comprised of 30 pre-treatment lateral Cephalogram which were divided into three groups: Group I-Class I skeletal pattern (n=10), Group II- Class II skeletal pattern (n=10) and Group III - Class III skeletal pattern (n=10) Results: - ANOVA analysis was performed and highly significant differences were found in ANB, Wits Appraisal Beta angle and W-angle in all the three Groups (Group I, Group II, and Group III). Conclusion: - it has been concluded that similar to the ANB and Wits Appraisal the Beta angle, and W-angle are also significant angles to assess the sagittal jaw relationship between maxilla and mandible.

Key Words-Sagittal Discrepancy, Beta Angle, ANB Angle, Wits Appraisal and W-Angle

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Abstract: Introduction: This cross-sectional study was designed to compare the views of dentist and patients on whether dentist should wear white coats or not. Material and methods: Patients attending a dental hospital for a consultation appointment and the dentist were asked to assess their view related to their preference for white coat and behaviors of the dental care providers using a questionnaire. The surveyed population consisted of total of 200 patients and 62 dentists. Results: The study reveals that a most of the responds felt white coat was important and that they prefer dental professionals to wear white coat. Significantly more of those aged over 60 thought their dentist should wear white coats in comparison with those under 60. Patients aged 18–30 were least likely to want their dentist to wear a white coat. Conclusion: More patients than dentist and especially those older than 60 years, felt that doctors should wear them for easy identification. However, most of the dentist views an infection risk as a hurdle in wearing white coat.

Keywords: white coat

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Abstract: Extrapulmonary tuberculosis commonly involves thoracic and lumbar spine. Sacral tuberculosis is rarely reported so far. We are presenting a case of young male student with tuberculosis of sacrum. The clinical and radiological features sugggested a sacral tumor instead of tuberculosis. The lesion could not be diagnosed until histopathological examination was done. The duration of antituberculous treatment in skeletal tuberculosis is controversial, ranging from six months to three years. The recent trends of treatment are briefly discussed with specific reference to our case.

Key words: Backache in young individuals, DOTS in skeletal tuberculosis, MRI in spinal tuberculosis, Sacral tuberculosis, tuberculosis mimicking spinal malignancy.

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[11] Ya-Ju Tsai, Yu-Chien Shiau, Diagnosis

Abstract: The extra-hepatic biliary tract includes: right and left hepatic ducts, common hepatic duct, gallbladder, cystic duct and common bile duct. The variation in this system is seen in less than 50% of the cases. This study was carried out to describe the anatomical variations of the extra-hepatic biliary tract as these variations are important during surgical procedures such as laparoscopic cholecystectomy thereby decreasing the post-operative complications.

Key words: Extrahepatic biliary tract, cystic duct, laparoscopic cholecystectomy.

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Abstract: This paper describes how nursing education in Indonesia benchmarking nursing education in the Philippines for social development and global competitiveness. Kolaka Nursing Academy in Kolaka City, Southeast Sulawesi Province and Tri Mandiri Sakti Institute of Health Sciences in Bengkulu City were two pilot nursing schools in Indonesia for benchmarking, while Western Mindanao State University, Zamboanga City and the Philippine Women's University, Manila, and were two schools in the Philippines as benchmarks. In general, the study sought to explain the nursing education status in Indonesia and to what extent has nursing education in Indonesia contributed to social development and social welfare.

Keywords: Kolaka, Southeast Sulawesi Province, told the

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[10] Ramos, Carmen T. Upgrading Indonesia‟s Nursing Education: STIKES-TMS Bengkulu Model, Bengkulu, STIKES-TMS Publication, 2010a

Abstract: In patients undergoing surgeries, airway is most often secured with the endotracheal tube under general anaesthesia in supine position. Then position of the patient is changed according to the surgical requirement. Many surgical procedures are done in lateral position under regional anaesthesia. Because of various reasons we may have to supplement with general anaesthesia using endotracheal tube. In many situations turning the patient to supine may be difficult because of the ongoing surgery and endotracheal intubation has to be done in the lateral position. LMA and ILMA are considered safe and first choice for securing the airway in lateral position but it requires more expertise and positive pressure ventilation may be difficult. Direct laryngoscopy is still the fastest and easiest method of securing airway as it is an instrument familiar to all anaesthesiologists and readily available at every anaesthetizing location. In this study we compare the efficacy of BURP (backward, upward, rightward pressure) maneuver in improving the visualization of vocal cords in both supine and lateral positions. We also compared the ease of mask ventilation in supine and lateral positions.

Keywords: BURP maneuver, lateral, supine, mask ventilation,

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[4]. Conan LM, Harney D, Ryan M, Moran C, Kavanagh BP, Boylan JF. Airway management in lateral position: a randomized controlled trial. AnesthAnalg 2005;101:1221-5
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[6]. Henderson JJ, Popat MT, Latto I P, Pearce AC. Difficult Airway Society guidelines for management of unanticipated difficult intubation. Anaesthesia 2004;59:675-94.
[7]. Kaldewey S. failed intubation drill in obstetrics. Int J ObstetAnesth 2007 (IN PRESS)
[8]. Nair A, Alderson JD. Failed intubation drill in obstetrics. Int J ObstetAnesth 2007 (IN PRESS).

Abstract: Endocrine causes of male infertility are often referred as pretesticular causes. Impairment of fertility in these cases is secondary to either a hormone deficiency or an excess.Pubertal testicular failure or castration results in the persistence of sexual infantilism.Present study has been attempted on consecutivelyreferred119 male patients with sexual infantilism and infertility to Division of Human Genetics (DHG), Department of Anatomy, St. John's Medical College (SJMC), Bangalore, for cytogenetic investigations and counseling .In the present study Among the 44 probands, with Hypogonadism which8(40%) of them showed increase in LH and 4(20%) decrease.Out of 22 probands with FSH,12(54.5%) had increase and 5(22.7%) decrease in FSH. Out of 27 probands with testosterone, 1(3.7%)of them had shown increase and 21(77.7%) decrease in testosterone. Among the 75 probands with infertility, 12 had undergone LH of which 3(25%) of them had increase and 1(8.3%) decrease in LH. Out of 15 probands with FSH, 6(40% ) had increase and1(6.6% ) decrease in FSH. out of 9 probands with testosterone 1(11.1%) had shown increase and 5(55.5%) decrease. Out of 10 probands with prolactin 3(30%)of them showed increase in prolactin, none of them showed decrease and7( 70% )of them were normal. In the present study among 12 patients with 47,XXY karyotype, elevated levels of LH was noted in 7(87.5%), and 8(88.8%) in FSH and one (11.1%) in testosterone levels. Decreased levels of testosterone was observed among 7(77.7%). In the present study 2 probands with 46,XY /47,XXYmosaicism, 1(50%)showed increase in LH and 1(50%)in FSH and both the patients 2(100%) decrease in testosterone.This studyhighlights hormonal factor as one of the etiology that may adversely affect male reproduction in probands with infertility and hypogonadism and indicates that the measurements of FSH,LH and testosterone are useful tests in the management of male infertility.

Keywords: Chromosomal abnormality, Follicle stimulating hormone, Klinefelter Syndrome, Luteinising hormone, Testosterone

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