iosr-JDMS   Volume-9 ~ Issue-3

Abstract: Background And Objectives: Laryngoscopy with or without tracheal intubation amounts to a highly noxious stimulus to the homeostasis of the patient. Many a times under lighter planes of anaesthesia it elicits a defence mechanism in the form of haemodynamic response to stress, which involves activation of adrenocortical system. This study was conducted to compare the effects of oral Clonidine and IV Clonidine premedication on haemodynamic response to laryngoscopy and endotracheal intubation. Method: One hundred normotensive patients between 18-45yrs of age (ASA Grade I & II) scheduled for elective surgery were sub-divided into two groups with 50 patients in each group. Group-I received oral Clonidine 4μg/kg and Group-II received intravenous Clonidine 3μg/kg 60 minutes and 15 minutes before induction respectively. Induction was done with inj Propofol 2mg/kg and inj Atracurium 0.5mg/kg or inj Vecuronium 0.1mg/kg. Heart rate(HR), Systolic blood pressure(SBP) , Diastolic blood pressure(DBP), Mean blood pressure(MBP) were recorded at preinduction, post-induction (pre-laryngoscopy) and post-laryngoscopy (1minutes, 3minutes, 5minutes, 10minutes & 15minutes). Results: Heart rate, Systolic blood pressure, Diastolic blood pressure, and Mean blood pressure increased by 3minutes post-laryngoscopy in both groups. But the response was significantly less in the IV Clonidine group as compared to the Oral group. All the variables returned towards baseline values by 10-15minutes post-laryngoscopy in either groups. Conclusion: IV Clonidine 3μg/kg premedication effectively blunted stress response to endotracheal intubation in ASA physical status I and II patients without causing adverse reactions. Oral Clonidine 4μ/kg was less effective in blunting haemodynamic stress response.

Key words: attenuation of haemodynamic response; diastolic blood pressure; endotracheal intubation; heart rate ; IV Clonidine; laryngoscopy; mean blood pressur;Oral Clonidine; Premedication; systolic blood pressure;

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[3]. Vincent J Collins. Principles of Anaesthesiology. General and Regional anaesthesia, 3rdedition ,Vol I and II Philadelphia: Lea and Fabigee

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[6]. Wycoff Charles. Endotracheal intubation;effects on blood pressure and pulse rate. Anaesthesiology.1960(Mar-Apr);21(2):153-157.

[7]. Dipak L.Raval, Malini K. Mehta. Oral clonidine premedication for attenuation of haemodynamic response to laryngoscopy and intubation. Ind J Anaesth. 2002; 46(2): 124-129.

[8]. Wright P.M, Carabine U.A, McClune S, Orr D.A, Moore.J. Pre-anaesthetic medication with Clonidine. Br. J. Anaesth. 1990; 65:628-632.

[9]. Laurito CX. Baughman, Becker ,Cunningham F, Pygon BH. Oral Clonidine blunts the haemodynamic responses to brief but not prolonged laryngoscopy. J Clin Anaesth. 1993;5:54-7.

[10]. .Giles TD, Thomas MC, Quirol A, Rice JC, Plauche W, Sander GE: Acute and short-term effects of Clonidine in heart failure. Angiology. 1987;38:53-48.

Abstract:Background: Dyslipidemia is a known risk factor for atherosclerotic cardiovascular disease and it appears that regional fat distribution plays a role in determining the type of dyslipidemia present in an individual. The present study aims at determining the relationship between dyslipidemia and anthropometric measures in an adult Nigerian population. Method: In a cross-sectional community based study, 229 subjects were selected by a stratified random sampling method. Body mass index (BMI), Waist Circumference (WC), and Waist to height ratio (W/Ht) were the anthropometric indices measured to determine their relationship with lipid profile which include total cholesterol(TC), triglyceride(TG), high density lipoprotein cholesterol(HDL-C), and low density lipoprotein cholesterol(LDL-C). Results: Anthropometric measures showed no correlations with lipid parameters but however correlated with systolic and diastolic blood pressures with WC having the strongest correlation.The overall prevalence of dyslipidemia in the study population was 58.1%. The pattern of dyslipidemia was as follows: 42.8% had low HDL-C, 21.4% had elevated TG, 2.6% had elevated TC and 1.7% had elevated LDL-C. Conclusion: Anthropometric measures can predict hypertension better than dyslipidemia. There is a high prevalence of dyslipidemia in Nigeria and this is mainly due to low HDL-C and elevated TG.

Key words: Anthropometric measure, blood pressure, dyslipidemia.

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Abstract: Objectives: Various stretching techniques have been used to improve muscle flexibility in rehabilitation and sports. Mechanisms involving the efficacy of a stretching technique were studied and certain conclusions indicate one technique better than the other. Passive stretching is one most commonly used method and the recent inclusion of other techniques like ballistic stretching, Proprioceptive Neuromuscular Facilitation (PNF) techaniques with its variants and Mulligan's Bent Leg Raise (BLR) have created more scope for researchers to compare and conclude better methods for improving flexibility. The aim of the present study was to measure hamstrings flexibility after a single bout of passive hamstring muscle stretching and BLR and comparing the effects between the two techniques. Methods: 78 asymptomatic individuals with bilateral hamstring tightness were randomized to one of the two groups - passive stretching (n=39) and BLR (n=39). Hamstring flexibility was measured using Back Saver Sit and Reach Test before and after the tests for both right and left lower limbs. Results and Conclusion: Analysis using dependent revealed that both passive stretching and BLR groups improved hamstring flexibility on both sides with improvements of 3.7cm and 4cm on right and left side respectively in BLR group and 1.3cm and 2cm on right and left side respectively in passive stretching group. However results of between group comparisons using independent t tests were not significant (p=.992 and .729 respectively for right and left sides) which suggests that passive stretching is equally effective as BLR technique in improving hamstrings length.

Keywords: Hamstring flexibility, Mulligan's Bent Leg Raise, passive stretching, Back Saver Sit and Reach test, passive knee extension test

[1]. Wiemann K, Hahn K. Influences of strength, stretching and circulatory exercises on flexibility parameters of the human hamstrings. Int J Sports Med 1997;18(5):340-6.
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[3]. Matsuo S, Suzuki S, Iwata M, Banno Y, Asai Y, Tsuchida W, et al. Acute effects of different stretching durations on passive torque, mobility, and isometric muscle force. J Strength Cond Res 2013.
[4]. Costa PB, Ryan ED, Herda TJ, Walter AA, Defreitas JM, Stout JR, et al. Acute effects of static stretching on peak torque and the hamstrings-to-quadriceps conventional and functional ratios. Scand J Med Sci Sports 2013;23(1):38-45.
[5]. Halbertsma JP, van Bolhuis AI, Goeken LN. Sport stretching: effect on passive muscle stiffness of short hamstrings. Arch Phys Med Rehabil 1996;77(7):688-92.
[6]. Halbertsma JP, Mulder I, Goeken LN, Eisma WH. Repeated passive stretching: acute effect on the passive muscle moment and extensibility of short hamstrings. Arch Phys Med Rehabil 1999;80(4):407-14.
[7]. O'Hora J, Cartwright A, Wade CD, Hough AD, Shum GL. Efficacy of static stretching and proprioceptive neuromuscular facilitation stretch on hamstrings length after a single session. J Strength Cond Res 2011;25(6):1586-91.
[8]. Streepey JW, Mock MJ, Riskowski JL, Vanwye WR, Vitvitskiy BM, Mikesky AE. Effects of quadriceps and hamstrings proprioceptive neuromuscular facilitation stretching on knee movement sensation. J Strength Cond Res 2010;24(4):1037-42.

Abstract: Lung cancer is one of the commonest cancers in the world as well as in our country like India where smoking is that much prevalent. Epithelial lung cancers are common in smokers and one of its commonest manifestations is DIC especially chronic DIC. Our aim is to find out the prevalence of DIC in epithelial lung cancers so that DIC related catastrophes can be minimized and better treatment protocols can be formulated. Complete hemogram, PT, APTT, platelet count, and FDP D`Dimer assay is done on 35 patients with diagnosed lung cancers of epithelial origin and on 35 healthy controls to prove the accuracy. It is found that 19 (54.28%) cases show raised FDP D`Dimer and other findings like normal PT & APTT in most of the cases confirms chronic DIC. It can be concluded that chronic DIC is a common event in epithelial lung cancers and proper recognition of this event may further improve treatment protocols.

Keywords: APTT, DIC, Epithelial lung cancers, FDP D`Dimer, Platelet count, PT

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Abstract: Diabetic patients are highly associated with thyroid disorders, it may disrupt in the treatment of diabetes. The present study was done in the department of physiology, RIMS, after getting approval from the institutional ethical committee. Sample was collected from the known cases of type 2 diabetic patients as well as non-diabetic cases. The study consisted of total-120 cases, out of which 50 were taken as control and 70 were known type 2 diabetic patients. Glucose level, glycosylated haemoglobin and thyroid hormone levels (T3, T4 and TSH) were estimated. The serum T3 and T4 level of type 2 diabetic patients had significantly reduced as compared to the control whereas TSH level were found high. In this study, Type 2 diabetic patients were highly associated with hypothyroidism as compared to control.

Key words: Type 2 diabetes T3, T4 and TSH Hypothyroidism

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Abstract: Background: Pregnancy and childbirth are special events in women's lives and their families. Care of women during pregnancy is the most effective health interventions for safer and healthier outcome. Accessibility, quality of care, personal attitudes and socioeconomic characteristics affect on antenatal care (ANC) service use. This study was carried out to explore ANC service utilization pattern and contributing factors in a rural area of Belgaum in relation to generate Community based data of India for addressing the contributing factors. Methods: Cross-sectional study was carried out from August 2012 to January 2013 in rural Belgaum Karnataka, India. All together 630 mothers with under one year child were interviewed by using pretested structure questionnaire after taking written consent. Analysis was done in computer based software; SPSS-20 version applying appropriate statistics. Results: Out of 630 participants; 54.6% were 20-24 years of age, 61.6% were having secondary education, 89.8% were house wives and 91.6% were Hindus. About 69.7% were from joint family with low economic status. Almost 94.8% were registered for ANC service, 85.7% visited ≥3 times, 66.0% visited during first trimester and 42.3% visited in primary healthcare Centre. Three-fifth of the participants resided ≤6 Km. far from health service facilities. Education, family income, knowledge on ANC, distance of health facility from residence and transportation cost were significant contributors (p<0.05) of ANC service utilization. Conclusion: ANC service utilization rate in rural Belgaum is higher than the national level figure available till date. Education, income, knowledge level, distances and transportation cost were significant contributors. Effort to bring about to significant change in major factors at individual and community level supports to increase the full ANC service use.

Key words: Antenatal care, contributing factors, health service utilization, rural Belgaum

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Abstract: Prevention of recurrent falls in the elderly is now increasingly important in developing countries. A cross sectional study was undertaken in Vellore, South India, to describe the knowledge, attitudes and practices regarding prevention of recurrent falls among elderly with a previous history of a fall, as well as their caregivers. 45 % of the elderly had a repeat fall after the age of 60 years owing mainly to poor vision, osteoporosis, anemia or the use of more than 3 chronic medications. Both the elderly and the caregivers were found to have poor knowledge regarding prevention of falls. Health education (OR 0.418; 95% CI: .176-.991) and compliance to a prescribed intervention for at least 6 months (OR 0.088; 95% CI: .032-.244) were found to be associated with less of repeat falls. Health education with emphasis on the benefits of compliance to prescribed interventions may help prevent recurrent falls.

Keywords: elderly, health education, intervention, prevention, recurrent fall.

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Abstract: Ocular defects that may be caused due to any maxillofacial traumatic injuries may alter not only facial appearance, but also result in psychological trauma to a sufferer. Although the basic steps of custom ocular prosthesis may be same that may be used by different maxillofacial prosthodontics, or text, but ultimate goal of aesthetics result after fabrication depends largely upon case selection, skill of technique and material used. This article describe a technique by which the state of the art custom ocular prosthesis has been fabricated in a case of traumatic injuries to eye by making accurate functional impression with fine details of the eye socket and following all the step of fabrication meticulously.

Key Word- Rehabilitation, Eye Defect., Ophthalmic Injury, Functional impression

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[9]. Benson P. The fitting and fabrication of a custom resin artificial eye. J Prosthet Dent. 1977; 38:532.

[10]. Taylor TD. Clinical maxillofacial prosthetics. 1996; Quintessence pub. Pg. 265-276

Abstract: Anaemia in female during pregnancy is very common , it affects maternal blood , leading to hypoxia ,which cause changes in structure of Placenta. Aanemia also exert profound changes on the maternal circulatory system and has serious effects both on mother and fetus . Growth of the fetus is intricately linked with that of placenta , because of transfer of nutrients and oxygen through placenta . Microscopic study revealed histomorphological abnormalities due to hypoxia comprise of some changes in structure of placenta like increased capillaries per villous, thickening of capillary basement membrane and trophoblastic basement membrane , thickening of of syncytiotrophoblast , increased fibrosis and syncytial knots and appearance of vasculosyncytial membrane . All these changes occurred for maintaining sufficient efficiency of placenta due to compensatory phenomena , for fulfill demand of oxygen in the fetus .

Key Words: Anaemia, hypoxia, placenta.

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Abstract: Introduction: One of the most perplexing phenomenons in orthodontics is the crowding of anterior teeth, which brings the patient to the orthodontist seeking remedy because of its aesthetic and functional consequences. The present study was aimed to clinically evaluate and compare the efficiency of NiTi and multistranded stainless steel wire during initial levelling and aligning of crowded lower anteriors. Material and methods: 30 subjects aged between 14 -20 were chosen for the study and divided in to two groups. All the subjects were fully explained about nature, purpose and treatment. Both groups were bonded with 0.022" MBT prescription brackets. After bonding, for Group A patients 0.016" NiTi arch wire was placed and secured with elastomeric modules, similarly for Group B patients 0.0155"multistranded (SS) wire was placed and secured .Time period needed for decrowding of each group was calculated. Result: Average number of days taken by nickel titanium wire in de-crowding mandibular anteriors is 89.67 days while multistranded SS wire took 113.2 days to de-crowd. Even though multistranded wire has low stiffness, because of its shape memory and super elasticity, nickel titanium wire is clinically efficient in decrowding severely crowded lower anteriors. To conclude, a marginal advantage of NiTi wire exists in accordance to the time period taken to decrowd mandibular anteriors.

Keywords: Aligning, Decrowding, Multistranded wire, NiTi wire, Shape memory.

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[9]. Taneja P, Duncanson MG Jr, Khajotia SS, Nanda RS. Deactivation force-deflection behavior of multistranded stainless steel wires. Am J Orthod Dentofacial Orthop. Jul,124(1), 2003, 61-8.
[10]. Evans TJ, Jones ML, Newcombe RG.Clinical comparision and performance perspective of three aligning arch wires. Am J Orthod Dentofacial Orthop. Jul, 114(1), 1998,32-9.

Abstract: The prevalence of uterine malformations in general population is around 7-8%1. Abnormal fusion of mullerian ducts in embryonic life results in a variety of malformations. Here we report a case of bicornuate uterus where pregnancy was carried till 38weeks with good outcome. Initially diagnosis was made by Ultrasound, which was confirmed intra operatively by exteriorizing the uterus.

Keywords: Bicornuate uterus, mullerian anomaly

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Abstract: Research Question: Comparison of Associating factors of Dental Caries in urban and rural children in Jaipur, (Raj) India. Methodology: A cross-sectional observational study was carried out on 1600 urban and 1600 rural school children of Jaipur in year 2011. Two blocks for urban areas and two Panchayat Samities for rural areas were selected randomly for the study. Socio-demographic data were collected from parents of children and thorough dental check-up was arranged by a dentist for these children. Children with Carries were identified. Data in details were collected as per pre-designed proforma. Data collected were analysed and inferred with chi-square test. Result: 37.66% of children were diagnosed as having dental carries. Dental carries was significantly (P<0.001) lesser in rural areas (27.94%) than in the urban areas (47.38%). In urban areas age and socio-economic status were found more associated (p<0.001) with dental carries than sex, mouth ringing frequency, teeth cleaning material and teeth cleaning frequency (p<0.05). In rural areas age, teeth cleaning material and teeth cleaning frequency were found more associated (p<0.001) with dental carries than mother's education, dentist visit and mouth ringing frequency (p<0.05). Conclusion: More than one third students were having dental Carries. Urban children were having significantly more dental carries than rural. Age, mouth ringing frequency, teeth cleaning material and teeth cleaning frequency were found associated in urban as well as rural areas. In urban areas sex and socio-economic status but in rural areas mother's education and dentist visit were different associating factors with dental carries.

Key words: Dental carries, Socio-demographic, chi-square Test, P Value

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