iosr-JDMS   Volume-19 ~ Issue-3 ~ March 2020

Abstract: A 21-year-old second gravida came to our nursing home with high blood pressure (BP) in her 16th week of gestation. She was a known case of "Severe Aortic Coarctation". She had delivered her first born at our Hospital 2 years back, after which she conceived present pregnancy in her lacatational amenorrhea. On physical examination blood pressure was 200/100 mmHg and heart rate was 92/minute. Transthoracic echocardiography showed severe form of post ductal coarctation of Aorta with Aortic arch interruption. During the pregnancy (from 16 wks to 37 wks) BP was regulated with Metoprolol& Amlodepin. Delivery was induced by sweeping the membranes at 37 weeks.......

Key Word: Aortic Coarctation (AoCo), Blood pressure (BP).

[1]. Beckman RH III. Coarctation of the aorta. In: Allen HD, Gutgesell HP, Clark EB, Driscoll DJ, editors. Moss and Adams' Heart Disease in Infants, Children and Adolescents: Including the Fetus and Young Adult, Vol. 2, 6th ed. Philadelphia, PA: Lippincott, Williams & Wilkins, 2001:988-1010.
[2]. Strafford MA, Griffiths SP, Gersony WM. Coarctation of the aorta; a study in delayed detection. Pediatrics 1982;69;159-63.
[3]. Saxena A.,` Congenital heart disease in India: A status report'; Indian J Pediatr, 2005,72:595-8.

Abstract: Arterial blood gas is a basic investigative tool in monitoring acid base balance of critically ill patients. It is also indispensible in monitoring gas exchange, diagnosing and managing oxygenation. A thorough knowledge regarding ABG interpretation is an absolute necessity for the critical care physician. However, a complete and thorough understanding of arterial blood gases and its interpretation is an arduous task and the literature to guide the interpretation are aplenty and beyond the scope of this article. Thus, this article tries to portray a systematic, realistic and authentic approach for the arterial blood gas analysis and its interpretation right from preparation of the patient to sample collection and reading of ABG. This requires a proper application of the basic concepts of acid base interpretation to appreciate the progress of the management apart from aiding in the diagnosis.

Keywords: Arterial blood gas (ABG)

[1]. Kellum JA. Making Strong Ion Difference the "Euro" for Bedside Acid-Base Analysis. Yearbook of Intensive Care and Emergency Medicine. SprBerHeid Publ. 2005;5:675. [2]. Phillips B, Peretz DI. In: National Committee for Clinical Laboratory Standards. villanova PA: NCCLS publication; 1985. Blood Gas Pre-analytical considerations. Specimen collection, Calibration, and Controls (proposed guidelines) NCCLS. [3]. Börner U, Müller H, Höge R, Hempelmann G. The influence of anticoagulation on acid-base status and blood-gas analysis. ActaAnaesthesiol Scand. 1984;28:277–9. [4]. Hutchison AS, Ralston SH, Dryburgh FJ, Small M, Fogelman I. Too much heparin: possible source of error in blood gas analysis. Br Med J. 1983;287:1131–2. [5]. Toffaletti J, Ernst P, Hunt P, Abrams B. Dry electrolyte-balanced heparinized syringes evaluated for determining ionized calcium and other electrolytes in whole blood. Clin Chem. 1991;37:1730–3.

Abstract: Introduction: Before the era of thoracoscopy, closed pleural biopsy was considered to be the procedure of choice in cases of undiagnosed pleural effusion. With the descent of thoracoscopic era,thoracoscopic biopsy has replaced closed pleural biopsy as the procedure of choice in these cases. However, it is still not readily available in resource-limited setups. Objective: This study was done to analyse the diagnostic yield and establish the safety profile of the closed needle pleural biopsy by Abrams needle or Cope needlein exudative pleural effusion. Methods:A cross-sectional study was done from July 2016 to June 2017.158 cases of pleural effusion were evaluated by complete pleural fluid examination - biochemical, microbiological and cytological examination. 52 of these patients were excluded from the study.......

Key Words: Closed pleural biopsy, malignant pleural effusion, thoracoscopic pleural biopsy, tubercular pleural effusion

[1]. Poe RH, Israel RH, Utell MJ, Hall WJ, Greenblatt DW, Kallay MC. Sensitivity, specificity, and predictive values of closed pleural biopsy. Arch Intern Med 1984;144:325-8.
[2]. Suri JC, Goel A, Gupta DK, Bhatia A. Role of serial pleural biopsies in the diagnosis of pleural effusions. Indian J Chest Dis Allied Sci 1991;33:63-7.
[3]. Kettel LJ, Cugell DW.Pleural biopsy. JAMA 1967;200:317-20.
[4]. Tomlinson JR, Sahn SA. Invasive procedures in the diagnosis of pleural disease.SeminRespir Med 1987;9:30-6.
[5]. Hooper C, Lee YC, Maskell N; BTS Pleural Guideline Group. Investigation of a unilateral pleural effusion in adults: British Thoracic Society pleural disease guideline 2010. Thorax 2010;65Suppl 2:ii4-17.

Abstract: Introduction: Kikuchi-Fujimoto disease, or histiocytic necrotizing lymphadenitis, is a benign disease most commonly affecting adult females. It generally causing febrile cervical lymphadenopathy, the systemic forms associated with kidney injury is not commun This diagnosis must be considered in some African country where etiology of lymph node is dominated by a high prevalence of tuberculous lymphadenitis and haematological malignancies. Case report: The authors report the case of a 35 year-old woman who presented with acute cervical lymphadenopathy associated with Gougerot sjogren disease and kidney injury due to tubulo-interstitial nephropathy. Histopathological examination of a lymph node biopsy, concluded on a diagnosis of Kikuchi-Fujimoto disease.....

Keywords: Kikuchi-Fujimoto disease, histiocytic necrotizing lymphadenitis cervical lymphadenopathy, tubulo-interstitiel nephropathy

[1]. Kikuchi M. Lymphadenitis showing focal reticulum cell hyperplasia with nuclear debris and phagocytosis. Nippon Ketsueki Gakkai Zasshi 1972:35( 4):379–380.
[2]. Fujimoto Y, Kozima Y, Yamaguchi K. Cervical subacute necrotizing lymphadenitis: a new clinicopathologic entity. Naika 1997 :(30):920–927.
[3]. Moinet F, Polomat K, Bomahou C, Boutrou M, Duflo S, Molinié V, et al. Maladie de Kikuchi: épidémiologie en Martinique et caractéristiques dans une population afrocaribéenne. Rev Med Interne 2014;35:A29.
[4]. Lame. A, Loum. B: Kikuchi-Fujimoto disease, a rare cause of lymphadenopathy in Africa.Description of the first case in Senegal and review of the literature. European Annals of Otorhinolaryngology, Head and Neck diseases 134(2017):347–349
[5]. Julian Dalton, Robert Shaw, Jane Democratis Kikuchi-Fujimoto disease : the lancet Vol 383 March 22, 2014

Abstract: Background: Bipolar disorder is a rare but very serious mental illness which has a huge impact on social personal and occupational functioning of an individual. It is characterized by episodic occurrence of symptoms of the illness. The symptoms during the episode can be of mania, or depression or can have a mixed presentation having symptoms of both mania and depression. The aim of this paper is to study the socio-demographic correlates of manic patients in the North East India. Materials and method: the study was conducted on 30 patients in mania, who were admitted in a tertiary care facility for psychiatric illness in North-East India. Purposive sampling was done after taking informed consent from the participants. Mini-International Neuropsychiatric Interview version 6.0 was applied......

Key Words: manic episode, socio-demographic factor.

[1]. Ferrari, A. J., Stockings, E., Khoo, J. P., Erskine, H. E., Degenhardt, L., Vos, T., &Whiteford, H. A. (2016). The prevalence and burden of bipolar disorder: findings from the Global Burden of Disease Study 2013. Bipolar disorders, 18(5), 440-450. [2]. Weissman, M. M., & Myers, J. K. (1978). Affective disorders in a US urban community: the use of research diagnostic criteria in an epidemiological survey. Archives of General Psychiatry, 35(11), 1304-1311. [3]. Weissman, M. M., Leaf, P. J., Tischler, G. L., Blazer, D. G., Karno, M., Bruce, M. L., & Florio, L. P. (1988). Affective disorders in five United States communities. Psychological medicine, 18(1), 141-153. [4]. Merikangas, K. R., Akiskal, H. S., Angst, J., Greenberg, P. E., Hirschfeld, R. M., Petukhova, M., & Kessler, R. C. (2007). Lifetime and 12-month prevalence of bipolar spectrum disorder in the National Comorbidity Survey replication. Archives of general psychiatry, 64(5), 543-552. [5]. Goodwin, F. K., Jamison, K. R., & Goodwin, F. (1990). Suicide. Manic-depressive illness, 227-244.

Abstract: Leukorrhea is a extraordinarily common phenomenon among women in Bangladesh. This symptom is the evidence of Reproductive Tract Infection (RTI) among women in this country. However frequency of RTI is proportionately low. But the symptom of vaginal discharge is reported by the women who do not have any of RTI. Genital secretions are extremely purified form of 'dhatu' according to traditional concepts of health, or bodily substance, and loss of genital secretions may result in fatal weakness or even death. A variety of somatic symptoms such as dizziness, backache and weakness is associated vaginal discharge. The link between unexplained gynaecological symptoms and mental health concerns has been explored by both psychiatrists and anthropologists in Bangladesh. Health workers are trained......

Key Words: dhat syndrome, dhatu loss, leukorrhea, reproductive tract infection, syndromic management, Bangladesh

[1]. Alter J (1997) Seminal truth: a modern science of male celibacy in North India. Medical Anthropology Quarterly 11, 275-298.
[2]. Bang R & Bang A (1994) Perceptions of white vaginal discharge. 5 In: Listening to Women Talk About Their Health (eds Gittel- sohn J, Bentley M, Pelto P, Nag M, Pachauri S, Harrison A, Landman L.) Har-Anand Publications, New Delhi, pp 79-94.
[3]. Bang RA, Bang AT, Baitule M, Chaudhury Y, Sarmukaddam S & Tale O. (1989) High prevalence of gynaecological diseases in 6 rural Indian women. Lancet i, 85-88.
[4]. Bhatia M & Malik S (1991) Dhat syndrome: a useful diagnostic entity in Indian culture. British Journal of Psychiatry 1159, 691- 695.

Abstract: Medical tourism, alternatively called health tourism and wellness tourism, is a term that has risen from the rapid growth of an industry where people from all around the world are travelling to other countries to obtain medical, dental, and surgical care while at the same time touring, vacationing, and fully experiencing the attractions of the countries that they are visiting. With countries like India, Mexico, Singapore, Brazil, Argentina, Greece, Costa Rica, Dominican Republic, Peru, Hungary, Israel, Jordan, Lithuania, Malaysia, South Africa, Thailand and the Philippines actively promoting it, the future of medical tourism is sure to be bright.1 In medical tourism, citizens of highly developed nations avoid services offered in their own communities and travel to other

[1]. Nandi VT, Nandi S. Medical tourism and economic development. 1st ed. New Delhi: Enkay; 2008.
[2]. Horowitz MD, Rosensweig JA, Jones CA. Medical Tourism: Globalization of the Healthcare Marketplace. MedGenMed. 2007; 9(4): 33.
[3]. What is medical tourism. Available at: http://www.discovermedicaltourism.com/what-is-medical-tourism/ (accessed on 2018 February 5).
[4]. Kamath K, Hugar S, Kumar V, Gokhale N, Uppin C , Hugar SS. The business and pleasure of teeth: Dental tourism. Int J Contemp Dent Med Rev. 2015; 1-4.
[5]. Top 10 reasons why medical tourism is popular. Available at: https://www.healthbase.com/hb/pages/Top-10-Reasons-Why-Medical-Tourism-is Popular.jsp (accessed on 2018 February 8).

Abstract: Asbestosis is a serious lung condition which characterized by the scarring in the lungs. It is caused by prolonged exposure to asbestos.Several industrial sectors have been associated with asbestos exposure. When the asbestos dust is breathed in, the asbestos fibres enter the lungs and they gradually damage the lungs over time. But that would also need prolonged exposure to asbestos fibres, usually over several years, before the features of asbestosis develop. Here, we have a case of 32 year old male who had a relatively short duration of ship exposure diagnosed as asbestosis. This case reinforces the importance of occupational exposure to ships even in the current era of asbestos free ships.

[1]. Fraser RS, Muller NL, Colman N, Pare PD. Diagnosis of diseases of the chest 4th ed. Philadelphia, Pa: Saunders, 1999. [2]. McLoud TC. Conventional radiography in the diagnosis of asbestos-related disease. RadiolClin North Am 1992; 30:1177-1189. [3]. Staples CA. Computed tomography in the evaluation of benign asbestos-related disorders. RadiolClin North Am 1992; 30:1191-1207. [4]. Aberle DR, Gamsu G, Ray CS, Feuerstein IM. Asbestos-related pleural and parenchymal fibrosis: detection with high-resolution CT. Radiology 1988; 166:729-734. [5]. Akira M, Yokoyama K, Yamamoto S, et al. Early asbestosis: evaluation with high-resolution CT. Radiology 1991; 178:409-416.

Abstract:Introduction William Campbell syndrome is a rare congenitaldisorder which is characterised by the deficiency of cartilage in the sub-segmental bronchi leading to collapse of distal airways and bronchiectasis.It is also known as bronchomalacia. There have been few reports in recent years of adult patients being affected by diminished cartilage, saccular bronchiectasis and para-cicatricial emphysema, all of which are characteristic features of Williams–Campbell syndrome. Case presentation Here we present a case of a 45-year old male having chronic cough, dyspnoea, and sputum production since 30 years. The clinical.......

[1]. Nandi VT, Nandi S. Medical tourism and economic development. 1st ed. New Delhi: Enkay; 2008.
[2]. Horowitz MD, Rosensweig JA, Jones CA. Medical Tourism: Globalization of the Healthcare Marketplace. MedGenMed. 2007; 9(4): 33.
[3]. What is medical tourism. Available at: http://www.discovermedicaltourism.com/what-is-medical-tourism/ (accessed on 2018 February 5).
[4]. Kamath K, Hugar S, Kumar V, Gokhale N, Uppin C , Hugar SS. The business and pleasure of teeth: Dental tourism. Int J Contemp Dent Med Rev. 2015; 1-4.
[5]. Top 10 reasons why medical tourism is pop

Abstract: Aim: To identify the prognostic factors in open globe injuries. Materials and Methods: Retrospective interventional study at JLN medical College, Ajmer and PDU medical College, Churu Rajasthan, India in year 2019, patients presented to casualty department of eye and undergone intervention with follow-up period of 1 to 3 months or till better recovery. Results: Total 62 patients, 44 (71%) were males and 18 (21%) were females. Mean age was 24 years (with range: 2.5-62 years). Factors affecting final outcomes in ocular trauma are nature and mechanism of injury, presenting conditions, initial visual acuity, timing of presentation and timing of intervention, segmental involvement as anterior or posterior segment and zone of injury. Conclusion: These predicting factors helps in counseling and explaining the prognosis and also the deciding the line of treatment.

Keywords: Ocular trauma, open globe injuries, predicting factors.

[1]. Parver LM. Eye trauma: The neglected disorder (editorial). Arch Ophthalmol 1986;104:1452. Back to cited text no. 1
[2]. Rupesh Agrawal1, Girish Rao2, Rishikesh Naigaonkar2, Xiaoling Ou1, Satish Desai2. Prognostic factors for vision outcome after surgical repair of open globe injuries. Indian journal of Ophthalmology. Year : 2011 | Volume : 59 | Issue : 6 | Page : 465-470
[3]. De Juan EJ, Sternberg PJ, Michels RG. Penetrating ocular injuries: Types of injuries and visual results. Ophthalmology 1983;90:1318-22. Back to cited text no. 3
[4]. Issac DL, Ghanem VC, Nascimento MA. Prognostic factors in open globe injuries. Ophthalmologica 2003;217:431-5. Back to cited text no. 5
[5]. Pieramici DJ, Mathew W, MacCumber, Humayun MU. Open globe injury: Update on types of injuries and visual results. Ophthalmology 1996;103:1798-803. Back to cited text no. 8

Abstract: Epimedium contain active compounds exhibiting wide pharmacological activities especially in bone healing. Primary bone tissue cells are osteoblasts, osteocytes and osteoclasts. Bone is a highly dynamic tissue which is continuously formed by osteoblasts and resorbed by osteoclasts. This is a highly complex process maintaining equilibrium in healthy tissue. Any imbalance between the activity of these cells result in pathological conditions like osteoporosis, periodontitis, etc. Such conditions require bioactive molecule with effective delivery vehicle to promote bone healing and maintain tissue homeostasis. Icariin extracted as the main active ingredient of Epimedium has osteoinductive effects which when used with effective delivery system is of huge therapeutic importance as it is proven to possess wide range of osteoprotective effects. This review article highlights various methods available to effectively deliver icariin to targeted tissue and achieve bone repair.

Keyword: Epimedium, Icariin, bone, Alkaline Phosphatase, Sustained .

[1]. Zhang X, Liu T, Huang Y, Wismeijer D, Liu Y. Icariin: Does It Have An Osteoinductive Potential for Bone Tissue Engineering? Phytotherapy Research. 2013Apr; 28(4):498–509. [2]. Liu Y, Huang L, Hao B, Li H, Zhu S, Wang Q, et al. Use of an Osteoblast Overload Damage Model to Probe the Effect of Icariin on the Proliferation, Differentiation and Mineralization of MC3T3-E1 Cells through the Wnt/β-Catenin Signalling Pathway. Cellular Physiology and Biochemistry. 2017;41(4):1605–15. [3]. Huang J-G, Pang L, Chen Z-R, Tan X-P. Dual-delivery of vancomycin and icariin from an injectable calcium phosphate cement-release system for controlling infection and improving bone healing. Molecular Medicine Reports. 2013Sep;8(4):1221–7. [4]. Li C, Li Q, Mei Q, Lu T. Pharmacological effects and pharmacokinetic properties of icariin, the major bioactive component in Herba Epimedii. Life Sciences. 2015;126:57–68. [5]. Sun X, Wei J, Lyu J, Bian T, Liu Z, Huang J, et al. Bone-targeting drug delivery system of biomineral-binding liposomes loaded with icariin enhances the treatment for osteoporosis. Journal of Nanobiotechnology. 2019;17(1).

Abstract: Verrucous carcinoma is an extremely well-differentiated variant of squamous cell carcinoma. Local invasion is the rule and extension to bone is frequent but nodal metastases are exceptional.1We present a unique case of a 75 year old male with extensor aspect of little toe involvement leading to management with wide local excision.

[1]. Rosai and Ackerman's Surgical Pathology, 11th Ed., Chapter: Tumors and tumor like conditions of the skin.
[2]. Ackerman LV. Verrucous carcinoma of the oral cavity. Surgery. 1948;23(4):670-78.
[3]. Schwartz RA, Burgess GH. Verrucous carcinoma of the foot. J SurglOncol 1980; 14:333–9.
[4]. Coldiron BM, Brown FC, Freeman RG. Epitheliomacuniculatum (carcinoma cuniculatum) of the thumb: a case report and literature review. J DermatolSurgOncol 1986; 12:1150–5.
[5]. Aird I, Johnson HD, Lennox B, Stansfeld AG. Epitheliomacuniculatum a variety of squamous carcinoma peculiar to the foot. Br J Surg 1954; 42:245–50.

Abstract: Anemia is a very common clinical problem in patients with chronic kidney disease and it is associated with more hospitalizations,increased morbidity and mortality and decreased quality of life in patients undergoing dialysis. Anemia in CKD is usually normocytic and normochromic. Although CKD and EPO deficiency are strongly correlated, if other causes of anemia are present, therapy with recombinant human erythropoietin (rHuEPO) alone will likely not correct it and this is the concern which defines erythropoietin resistance. А significant number of patients do not respond to the treatment with recombinant human erythropoietin. The main cause of hyporesponsiveness in these patients is iron deficiency. However, there are other causes of resistance: inflammation, acute or chronic infection, malnutrition, inadequate dialysis, severe hyperparathyroidism and aluminum toxicity. Dialysis modality and biocompatibility of dialysis membranes can also interfere.

Keywords: Chronic kidney disease, Dialysis, Recombinant human erythropoietin, Iron

[1]. Avesani C.M., Carrero J.J., Axelsson J., Qureshi A.R., Lindholm B., Stenvinkel P. Inflammation and wasting in chronic kidney disease: partners in crime. Kidney Int. 2006;70:8–13. [Google Scholar]
[2]. Behler C., Terrault N., Etzell J., Damon L. Rituximab therapy for pure red cell aplasia due to anti-epoetin antibodies in a woman treated with epoetin-alfa: a case report. J Med Case Rep. 2009;3:7335. [PMC free article] [PubMed] [Google Scholar].
[3]. Betjes M.G., Huisman M., Weimar W., Litjens N.H.R. Expansion of cytolytic CD4+CD28− T cells in end-stage renal disease. Kidney Int. 2008;74(6):760–767. [PubMed] [Google Scholar]
[4]. Brugnara C. Iron deficiency and erythropoiesis: new diagnostic approaches. Clin Chem. 2003;49(10):1573–1578. [PubMed] [Google Scholar].
[5]. Cançado R.D., Chiattone C.S. Anemia de Doença Crônica. Rev Bras Hematol Hemoter. 2002;24(2):127–136. [Google Scholar]

Abstract: AIM: The study was aimed at establishing sexual dimorphism on the basis of variation in number and shape of palatine rugae in male and female sexes in Kashmiri population. MATERIALS & METHODS: A cross sectional, descriptive, in vitro type of study was carried out on old maxillary casts of patients visiting registered dental clinics in Kashmir. Maxillary dental casts made up of plaster of Paris, were obtained and were examined to fit into inclusion criteria. The sample included 65 male and 65 female casts. Casts from both the groups were given unique identification numbers and demographic data was hidden except for the sex of the person. Palatine rugae were marked using sharp graphite pencil. The rugae were analyzed for length and shape. For classifying the rugae on the basis of length, Lysell's classification was implemented. Framentary rugae were also taken.........

Keywords: Palatine rugae, sexual dimorphism, kashmiri population.

[1]. Steven N Byers. Introduction to forensic anthropology. fifth edition:p 1
[2]. Acharya A .Forensic odontology. Shafer,s textbook of oral pathology: sixth edition.Section VI, Chapter 21;p 8783.
[3]. Jindal, Dua R, Bunger E. Sex determination using arch width in north indian(punjab) population. Inter Dent J of students research.2(1);2013:10-14.
[4]. Kamala R, Gupta N, Bansal A, Sinha A. Palatal Rugae Patten as an aid for Personal identification:A Forensic Study. J Indian Academy of Oral med and Radiol. 2011;23(3):173-178.
[5]. Fahmi FM, Saleh M, shamrani A, Talic Y F. Rugae pattern in a saudi population sample of males and females.Saudi Dent J. 13 (2); 2001.

Abstract: Introduction: The treatment of class III malocclusion in adults can be approached from dental camouflage to interdisciplinary surgical treatment. The selection of treatment will depend on the expectations of the patient. Case Report: A 19-year-old female patient shows up at the campus of the Autonomous University of Baja California (UABC) Tijuana, México requesting orthodontic treatment. Diagnosis: At the extraoral inspection, mandibular prognathism, intraoral proclination of lower incisors and inclination in the superiors are observed (absence of physiological compensation). Treatment: Orthodontic treatment aimed at preparing the patient for future orthographic surgery is chosen, always having an interdisciplinary approach from the beginning with the maxillofacial surgeon. Result: The objectives set from the beginning were achieved, improving the masticatory functionality and the patient's facial appearance. Conclusion: The success of the treatment of this type of patients depended on the correct diagnosis, as well as the interdisciplinary approach.

Keywords: class III malocclusion, orthognathic surgery, mandibular prognathism

[1]. Azamian Z, S. F. (2016). Treatment options for class III malocclusion in growing patients with emphasis on maxillary protraction. Scientifica, 2016, 1-9.
[2]. Bernal Rodriguez C G, F. K. (2018). Photobiomodulation in the postoperative of bichectomy surgeries: case series. Photomedicine and laser surgery , 36, 1-4.
[3]. Estrada Ramírez A, G. V. (2016). Tratamiento ortodóncico-quirúrgico en paciente clase III esquelético: presentación de un caso. Revista mexicana de ortodoncia, 4, 103-112.
[4]. Huang C S, H. S. (2014). Systematic review of the surgery first approach in orthognathic surgery. Biomed J, 37, 184-190.
[5]. Johnston C, B. D. (2006). Class III surgical-orthodontic treatment: a cephalometric study. Am j orthod dentofacial orthop, 130, 300-309.