bluuebunny/crossref_metadata_2025 huggingface dataset:
ATYPICAL MANIFESTATIONS OF SUBACUTE SCLEROSING PANENCEPHALITIS: CASE SERIES
Authors: Dharma Shashank , Arora Sukriti , Ganaraja V H , Mala Kavya , Kodapala Suresha
Published: December 2022

Subacute Sclerosing Panencephalitis (SSPE) is a rare, progressive degenerative disease of the brain
caused by reactivation of aberrant measles virus. Classical symptoms of SSPE are described as
behavioral changes, declining scholastic performance, myoclonic jerks etc. However, at times it presents with varied atypical
manifestations, which makes diagnosis difcult. Hereby we report two patients with unusual manifestations of SSPE. In rst
case, 14-year-old boy presented with recurrent falls of 9 months duration. Initially, it was 1-2 times per week, progressing over 9
months to frequency of 40-50 falls per day. In second case, 21-year-old gentleman presented with behavioral changes and
memory disturbance of 1-year duration. However, his family members noticed worsening of symptoms 1 month before
presentation as he started developing involuntary jerky movements involving the right upper and lower limb. In both of them
electroencephalogram (EEG) was showing long interval periodic discharges and cerebrospinal uid was showing elevated
titers of anti-measles antibody overall suggesting SSPE. Hence it needs much attention for atypical presentations and also
considering SSPE in differential diagnosis of unsolved atypical neurological presentations.
COMPARISON OF BASAL-CELL SPECIFIC MARKERS – P63 AND 34BETAE12 IN PROSTATIC GLANDULAR PROLIFERATIONS
Authors: Jessica Akoijam Ningthibi , Deepak Kumar Laishram , Khuraijam Sushma , Kaku Akoijam , Laisom Alpana
Published: December 2022

Background: The prostate is a retroperitoneal organ encircling the neck of the bladder and urethra.
Though the diagnosis of the prostatic lesions are analyzed through histopathological examination
(HPE), sometimes, diagnosis can be challenging, when pathologist are faced with certain problems such as small foci of Ca or
benign mimickers. In such situation, immunohistochemical (IHC) detection of basal cells are widely used. To Objectives:
assess the expression of basal cell markers (p63 and 34betaE12) in various prostatic glandular proliferations and to
differentiate suspicious glandular lesions as benign or malignant. A two year cross-sectional s Methods: tudy (Sept'2016
–Aug'2018) , total of 52 cases of both TURP and prostate biopsy specimens sent to the department of Pathology, RIMS for HPE
were studied using IHC markers p63 and 34betaE12, following H&E stain and the expressions of the markers were studied.
Results: Out of 52 cases, 41(78.8%) cases were diagnosed as Benign proliferative hyperplasia (BPH), 8(15.4%) cases as
prostatic carcinoma, 2(3.8%) cases as high grade prostatic intraepithelial neoplasia (HGPIN) and one (1.9%) case of
adenoleiomyobromatous hyperplasia (AMFH) on H&E section with age range of 51 to 90 years (mean age: 72 years).
Following IHC staining, 43 (97.7%) benign cases were positive for both p63 and 34betaE12, one (2.3%) case of benign lesion
was negative for both the IHCs. 8(100%) cases of malignant lesions were negative for both the IHCs. A p-value of 1.000 was
observed indicating that there is no signicant difference in the sensitivity of p63 and 34betaE12. In this cross- Conclusion:
sectional study of 52 cases of prostatic lesions, HPE and the role of basal cell specic IHC markers p63 and 34beta12 were
studied. No signicant difference was observed in the sensitivity between the two markers. Further comparative study with
larger sample size is needed to comprehend the differences in the utility of p63 and 34etaE12 in diagnosing suspicious
prostatic lesions.
PLASMA CELL GRANULOMA OF MASTOID: A RARE CASE REPORT
Authors: Bora Kumkum , Roy Uma
Published: December 2022

Plasma cell granuloma is a rare benign lesion which is found most frequently in the lungs, and rarely in
the head and neck.[1] In this study, we present 22year old male with right sided otalgia, tinnitus, hearing
loss and swelling over right postauricular region. On otoscopy, tympanic membrane was intact and dull and pure tone
audiometry showed right mild conductive hearing loss. HRCT mastoid and MRI brain suggested CSOM with cholesteatoma.
Intact canal wall mastoidectomy with debulking of tumour was done. HPE reported plasma cell granuloma (inammatory
pseudotumour) which was conrmed by Immunohistochemistry. Post operative period was uneventful. This case report is being
highlighted for its rarity and unusual presentation.
A RARE CASE OF SIGMOID TRANSECTION DUE TO BLUNT ABDOMINAL TRAUMA WITH NO PNEUMOPERITONEUM - A CASE REPORT
Authors: Kolanu Mounika , Sahiti Pavuluri Hema , Eadelli Dharani
Published: December 2022

Intestinal & Mesenteric injury in blunt abdominal trauma is infrequent & more common in penetrating
injuries [1-6]. CT is an effective imaging modality for diagnosis, but not always reliable to pick up
intestinal & mesenteric injuries. Henceforth possess a diagnostic difculty & results in therapeutic delay. Limited literature is
available in this domain. Here, we report a case of 26 year old male with blunt abdominal injury, kept initially under observation
& taken up for emergency surgery due to hemodynamic instability. Patient underwent Hartman's procedure. Currently, patient is
healthy. Purpose behind this paper, is to raise clinical suspicion of intestinal & mesenteric injuries in high impact blunt
abdominal trauma, need for additional research to aid in timely diagnosis & denitive management & decreased morbidity &
mortality.
A COMPARATIVE STUDY OF CLINICAL FEATURES AND TREATMENT OUTCOMES IN PREGNANT AND NON PREGNANT FEMALE HAVING BRONCHIAL ASTHMA
Authors: M Prakashkar Anaya , S Kachhadiya Milan , S Pandey Arvind
Published: December 2022

Background: Asthma is the most common potentially serious medical condition complicating 4-8% of the pregnancies. The goals of effective
asthma management in pregnancy are to maintain the best possible asthma control and prevent exacerbations. Objectives: To compare difference
in clinical features between pregnant and non-pregnant females having bronchial asthma. To study the treatment given in pregnant and nonpregnant females having bronchial asthma. To compare the treatment outcome between pregnant and non-pregnant females having bronchial
asthma. Material and Methods: This Prospective cohort study included 35 pregnant and 35 non-pregnant females(total 70) diagnosed with
bronchial asthma attending the OPD and indoor facility of Respiratory Medicine Department in tertiary care center ,over the period of 15 months.
Results: Out of 70 females most common symptoms is dyspnea followed by Cough, Rhinitis, Fever and Chest tightness in non-pregnant and
pregnant females and there was signicant statistical difference found between two groups(p=0.02). After giving treatment in 1st follow up
symptoms were well controlled in 20 (57.14%)pregnant and 29(82.86%) non pregnant female and there was statistical difference between the two
groups (p=0.018).After 2nd follow up, symptoms were well controlled in 20(57.15%)pregnant and 31(88.57%) non pregnant there was statistical
difference in control of symptoms between the two groups(p=0.010). Conclusion: Management of asthma in pregnancy does not signicantly
differ from management in non-pregnant. Inhaled Corticosteroids remain the cornerstone of treatment in both pregnant as well as non-pregnant
females.
MAMILLA AISHWARYA RAJASEKHAR
Authors: Rajasekhar Mamilla Aishwarya , Gopala Krishna Bandaru , Kavitha G.
Published: December 2022

Duodenal atresia is the most common cause of neonatal
obstruction.Several varieties of intrinsic and extrinsic congenital
lesions can cause complete (81%) and partial(19%) obstruction of the
duodenum. The spectrum of abnormalities causing intrinsic
obstruction includes imperforate and perforate webs.
MULTIPLE HOMICIDAL STABS BY SCREW DRIVER: A CASE REPORT
Authors: Mittal Anjesh , Gupta Richa
Published: December 2022

Penetrating facial trauma presents a wide spectrum of injuries and management difculty, due to the potential injuries that can be caused by the
weapon used. This is a report of a 42-years-old man who presented with multiple penetrating facial injury by screwdriver. The attempt is given
from the front with aggressive intent. Proper examination, radiological evaluation and early decision-making with a multidisciplinary approach
provide an optimal treatment outcome in such cases
MAGNETIC RESONANCE IMAGING FINDINGS OF PERIANAL FISTULAE AND ITS CORRELATION WITH DEMOGRAPHICS, CO-MORBITIES AND SURGICAL OUTCOMES IN A TERTIARY HEALTH CARE CENTRE IN MAHARASHTRA, INDIA :A CROSS SECTIONAL STUDY.
Authors: Ghai Devyani , S. Pawar Shephali , A. Umap Rajesh
Published: December 2022

Introduction:. Perianal stulas have been traditionally imaged by conventional stulogram, CT stulography and endoanal USG. The advantages
of MR imaging include multiplanar imaging and a high degree of soft-tissue differentiation, which show the stulous track in relation to the
underlying anatomy in a projection relevant to surgical exploration, thus providing an edge over previous diagnostic modalities To . Objectives:
identify the stulous track in relation to sphincter complex. To classify the perianal stula according to St James's University Hospital
Classication. To correlate imaging ndings with demographics, commorbities and surgical outcomes. Methodology: A cross sectional,
observational study was conducted on 60 patients with clinically diagnosed perianal stulae using 1.5 Tesla HDxt MRI machine over a period of 18
months. Results MRI helped in the adequate grading of the perianal stula as per the St James University Hospital grading and further surgical
follow up showed good association in grade III, IV and V perianal stula. MRI of the peri Conclusion: anal stula provided information about the
primary stulous track and their different stulizing patterns, internal openings with great anatomic detail of the surrounding pelvic organs and the
sphincter complex
A QUALITATIVE STUDY OF UNDERGRADUATE MEDICAL STUDENTS' PERCEPTION ON THE QUALITYOF THE TEACHING INTERMS OF THE HIDDEN CURRICULUM
Authors: Sriperumbuduru V P Kumar , Dalayi Navajyothi
Published: December 2022

Background & Aim: The hidden curriculum concept is established on identifying what student absorbs or the outcome that may or may not be the
part of the formal course of study. Thus, “hidden curriculum is described as “hidden” because it is usually unacknowledged or unexamined by
students, educators, and the community. The hidden curriculum has also been described as the unofcial expectations, unintended learning
outcomes, the construction of social relations” (1). Objective:The quality of teaching in terms of the hidden curriculum has been identied to be an
important and effective component in the educational process. This is a qualitative study that investigates the awareness of hidden curriculum
among undergraduate medical students and to correlate the relationship with students' perception and academic performances. Materials &
Methods: This is the cross-sectional study and we used a semi-structured interview to examine the undergraduate medical students' perceptions
about the quality of teaching in terms of hidden curriculum. The questionnaire developed based on Dundee Ready Education Environment
Measure (DREEM) which is a reliable inventory that claims to be collective to undergraduate health professions education. Result:Among the 300
students, 76 (25.3%) were male and 224 (74.7) were female. The results showed that positive was greater than negative perceptions among the
medical students about the quality of teaching in terms of the hidden curriculum. Conclusion:This qualitative study conducted among the medical
students in a university revealed that the medical students are aware of the components of the hidden curriculum as a basic part of their education.
The students enrolled in medical sciences courses in the university generally perceived positive feedback from the educational environment.
NEONATAL SEPSIS
Authors: Vimal Kumar , Srivastava Diksha , Lal Murmu Shyam , Biswas Sumangala
Published: December 2022

Septicemia in neonates refers to generalized bacterial infection documented by positive blood culture in the rst four weeks of life and is one of the
four leading causes of neonatal mortality and morbidity in India. Although it is a global problem in developing countries is enormous because of the
lack of clear guidelines for organizing the condition, the lack of standard laboratory procedures, and the impulsiveness of the physician to switch to
antibiotics for any minor deterioration. The source of infection in the baby can be from the mother called early-onset sepsis or from the community
or hospital called late-onset sepsis. Appropriate identication and knowledge of the causative microorganism can help in deciding the correct
antibiotic and causative microorganisms in one area or hospital will be different from another area and therefore it is prudent to try to identify the
disease-causing organism. Treatment requires well judged use of antibiotics with appropriate dosage and duration along with proper choice of
antibiotics. Overuse of antibiotics should be discouraged because of the risk of complications and resistance development
HEMATOLOGIC MANIFESTATIONS OF SYSTEMIC LUPUS ERYTHEMATOSUS IN A TERTIARY CARE CENTRE
Authors: Maheshwari Sakshi , Agrawal Sumedh , Gupta Prashant
Published: December 2022

Background: Systemic lupus erythematosus (SLE) can present with hematologic manifestations alone or with features of systemic involvement.
Diagnosis may be delayed or missed at presentation time, especially in those with hematologic abnormalities as the initial manifestation, with low
index of clinical suspicion or inadequate follow-up. Aim And Objectives: To study the prevalence and the type of hematologic manifestations in
SLE from pathologist's perspective. Setting And Design: Retrospective observational study. Material And Methods: Study was done in 63 SLE
patients in a tertiary care hospital in Secunderabad for duration of one and half years, from January 2018 to June 2019. Hematological parameters of
the same were retrieved. Results :It was observed that anemia was the most common hematologic nding with iron deciency anemia (IDA) being
the commonest cause followed by hemolytic anemia. Leucopenia with predominant lymphopenia was the most common WBC abnormality and
thrombocytopenia was seen in majority of the patients. Bi and pancytopenia was also observed. Raised erythrocyte sedimentation rate (ESR) was a
common nding. Deranged coagulation prole was seen due to secondary anti-phospholipid antibody (APLA) syndrome, hemolysis and sepsis on
anticoagulant. Bone marrow studies showed varied ndings including hypocellularity, dyspoiesis in the erythroid, myeloid and megakaryocytic
series and abnormal localisation of immature precursors (ALIP) aggregates. Conclusion: This study was conducted to estimate the proportion of
patients with hematological abnormalities as the manifestation of SLE and to study the nature of hematological problems, so that the empirical
treatment can be started.
SYNERGISTIC POTENTIAL OF HONEY BEE PRODUCTS WITH RIVASTIGMINE AS NOVEL NEUROPHARMACOLOGICAL APPROACH IN RODENT MODEL OF SCOPOLAMINE-INDUCED DEMENTIA
Authors: Dalal Ramkesh , Kulshreshtha Akanksha , Kumar Lamiyan Ashish , Ram Kumar Neelima , Piplani Poonam
Published: December 2022

The appearance of cognitive decline as a major hallmark of neurological and neurodegenerative disorders make it an intriguing pathophysiological
state for which there is an urgent need for the development of effective pharmacotherapy. Decades of research have uncovered a multitude of
promising factors that can serve as the starting point for research and development in this domain of research. Depleted cholinergic
neurotransmission and oxidative damage are two such causative factors for cognitive impairment associated with neurodegeneration. Approved
treatments for neurodegenerative disorders like Alzheimer's Disease (AD) provide only symptomatic relief and are known to cause unwanted side
effects. Honeybee products are made up of bioactive substances, which have long been known for their medicinal and health-promoting effects.
The purpose of the present study was to explore the neuroprotective potential of bee venom and bee propolis separately and in combination with the
standard drug rivastigmine as a novel treatment regimen against scopolamine-induced cognitive decits. Intraperitoneal administration of bee
venom (0.5 mg/Kg), propolis (250 mg/Kg, oral) and rivastigmine (0.5 mg/Kg) or their combinations showed improved cognitive functions in
scopolamine exposed mice as assessed by passive avoidance test. Administration of honeybee products (venom and propolis) alone and in
combination signicantly decreased the activity of acetylcholinesterase in the brain of scopolamine treated animals. Bee products either alone or in
combination further decreased the lipid peroxidation with a concomitant increase in the activity of antioxidant enzymes (SOD, catalase, GPx, GR,
and GST) in the brains of the animals treated with scopolamine. The data obtained suggests that the treatment with combination of bee venom and
propolis could be developed into a novel and effective therapy against cognitive dementia associated with neurological and neurodegenerative
disorders including Alzheimer's disease.
COMPARATIVE ANALYSIS OF REGULATORY FRAMEWORK OF PHYSIOTHERAPY IN INDIA WITH THAT OF AUSTRALIAAND NEW ZEALAND
Authors: Damke Umanjali , Mishra Ved Prakash
Published: December 2022

The study aims at studying the Regulatory framework of Physiotherapy in India (NCAHP) as compared to Australia (HPRNL) and New Zealand
(HPCAA). The study highlights the similarities and differences in the regulations of the two countries with India (NCAHP) with respect to 1)
registrations of professionals and 2) Practice Standards for the profession and come up with recommendations that may be incorporated in future
amendments in the NCAHP. The research methodology used is Rapid Appraisal literature review. On comparative analysis it is found that the
Provisions on General, Provisional, Specialty, Limited and student Registration, scope of practice, Fitness to practice and Health and Competence
Performance are not observed in NCAHP and are key requirements to ensure that health professionals are competent and t to practice their
professions and hence come out as key recommendations for inclusions in the future amendments of NCAHP
A COMPARATIVE STUDY BETWEEN BIER'S BLOCK AND SUPRACLAVICULAR BRACHIAL PLEXUS BLOCK FOR UPPER LIMB BELOW ELBOW SURGERIES
Authors: Sanghamitra A. Kamakshi , Reddy K. Madhusudhan , Nagaraju T.
Published: December 2022

Aim: To evaluate the onset of analgesia, degree of sensory and motor blockade, duration of analgesia and complications. Introduction: Brachial
plexus block provides a useful alternative to general anaesthesia for upper limb surgeries. Intravenous Regional anaesthesia is a simple method of
producing analgesia of the arm or leg by intravenous injection of a local anaesthetic, while the circulation is occluded.Materials And Methods:A
prospective, randomised single-blinded study was undertaken in patients posted for upper limb below elbow surgeries. 80 patients aged 15-50 yrs
with ASAclass I and II were randomly grouped into two groups. Group 1 – were anaesthetized by supraclavicular brachial plexus block. Group 2 –
were anaesthetized by IVRA Results: Group II patients had a faster onset of action, grade I degree of sensory and motor blockade and lesser
duration of action. Discussion: The addition of dexamethasone 8mg to bupivacaine 0.5% speeds the onset of sensory and motor blockade also
prolongs the duration thus provides better analgesia and reduces the requirements of rescue analgesics. Conclusion: IVRA appears to be a better
alternative with regards to onset, quality of analgesia and degree of motor blockade. But the duration of analgesia is little more with Brachial plexus
block
DISSOCIATIVE TRANCE AND POSSESSION DISORDER IN A MULTIPAROUS FEMALE WITH BAD OBSTETRIC HISTORY – A CASE REPORT
Authors: Gupta Riya , Singh Rishika , Solanki Yashdeep
Published: December 2022

Dissociative trance and possession disorder is common in clinical settings and is difcult to differentiate
from psychotic disorder by clinicians. It has also been associated with non-suicidal self-injurious
behaviours. A case of 24-year-old married female who is 4 months ANC was diagnosed with a case of trance and possession
disorder with a bad obstetric history. She received treatment on OPD basis.
UNDERSTANDING ACCESS TO MATERNAL HEALTH SERVICES IN FUNTUA, NIGERIA
Authors: Ismail A , Amzat, J
Published: December 2022

The study aimed at analysing the extent to which women access maternal health services in Funtua, Nigeria. Most births take place outside health facilities and without the presence of skilled attendants. Katsina State records a high level of maternal mortality with an estimated maternal mortality rate of over 1,000 maternal deaths per 100,000 live births, because a high percentage of births take place outside health facilities. This cross-sectional study sampled 384 mothers of under-fives through a quantitative method. The study found that 55.2% of the respondents found it challenging to access maternal health services, and 38% pointed out long waiting-time as the major problem they faced during their antenatal care visits. The tested hypotheses indicated a relationship between maternal education, independent income and antenatal care attendance. The study recommends women empowerment and improved political will to expand the coverage of maternal health services. Outreach programs to provide vital information on the importance of facility based deliveries should be reinforced.
Analysis of Posterior Interventricular Artery in Post Mortem Hearts-A Hospital Based Study
Authors: Sohely Dr. Mamotaj , Khan Dr. Rakibul Hasan , Mahboob Dr. Sarwar , Banik Dr. Chandan , Saha Dr. Biplob Kumar
Published: December 2022

Introduction: Coronary artery recurrently develops over periods. Symptoms may go hidden until a substantial blockage causes complications or a heart attack takes place. The particular anatomy of the myocardial blood supply varies significantly from person to person and generally, there are two prime coronary arteries, the left and the right. The coronary arteries mainly rise from the upper section of the sinus where the wall is fibroelastic and expands up to 16% in systole According to the origin of the posterior interventricular artery (PIVA) if it arises from RCA, then it is right dominance and if PIVA arises from LCA, it is left dominance. Methods: A cross-sectional study was carried out in the Department of Forensic Medicine of Dhaka Medical College and Hospital from September 2017 to January 2019. A total of 120 dead patients' hearts (N=120) were used in this study. All observations were noted in the clinical data sheet. Completed data forms were reviewed, edited, and processed for computer data entry. The data analysis was performed using Statistical Package for the Social Sciences (SPSS) Version 25.0. Result: Among the study population (N=120), one hundred hearts were male & of them, seventy males belonged to Group A (20 to 40 years), sixteen belonged to Group B (41 to 60 years), fourteen belonged to Group C (61 to 75 years) and twenty hearts were of female & of them fourteen belonged to Group A, six belonged to Group B, but no one belonged Group C. In Group A, the posterior interventricular artery arose from the right coronary artery in sixty-four males (64,91.4%), & the left coronary artery in six males (6,8.6%) and, the posterior interventricular artery arose from the right coronary artery in twelve females (12,85.7%). In Group A, the posterior interventricular artery terminated in the distal half of the posterior interventricular groove in fifty- six males (56,80.0%), in the proximal half of the posterior interventricular groove in twelve males ..........
Ostomy Bag and Betel Leaf in Pediatric Stoma Care
Authors: Das Dr. Bipul Bhusan , Huq Dr. Md. Ashraf Ul , Islam Dr. Md. Tawhidul , Masud Dr. Sadruddin Al
Published: December 2022

Background: Construction of a stoma is a common procedure in pediatric surgical practice. For care of these stomas, commercially available devices such as Ostomy bag, either disposable or of longer duration are usually used. These are expensive, particularly in countries like Bangladesh, and proper-sized ones are not always available. We have found an alternative for stoma care, betel leaf, which is suitable for Bangladeshis. Objective: The main objective of this study was to compare between Ostomy bag and betel leaf in Pediatric stoma care and also comparison of skin excoriation between Ostomy bag and betel leaf using in pediatric stoma care & comparison of cost and care givers satisfaction of the study groups. Materials and Methods: A total of 60 patients having various types of stoma within the age of 12 years were included in the study and randomly assigned to 2 groups – group 1 with Ostomy bag (30 patients) and group 2 with Betel leaf (30 patients). After construction of stoma, at first zinc oxide paste was applied on the Peristomal skin. A betel leaf with shiny, smooth surface outwards & rough surface inwards was put over the stoma with a hole made in the center according to the size of stoma. Another intact leaf covers the stomal opening. When bowel movement occurs, the overlying intact leaf was removed & the faecal matter was washed away from both. The leaves were reused after cleaning. Use of commercially available Ostomy bag (e.g., Convatec ostomy bag) with Adhesive paste (Stomahesive) will be applied on the Peristomal skin. Results: Out of 60 pediatric patients, 20 had pelvic colostomy, 19 had transverse colostomy and 21 had ileostomy. Of 60 patients under stoma care Mild excoriation had seen 21.7% cases of ostomy bag group and 13.3% cases of betel leaf group. Only 5% cases of ostomy bag group had moderate excoriation (P value was 0.116 which was not significant).Out of 40% excoriation, 30% occurred in ileostomy (p value <0.0001, hence significant). .....
Visceral Malignant Melanoma: Wilderness of a Black Hole
Authors: P Mahendran , Z Denise , Prem K , Voon Kelvin
Published: December 2022

Malignant melanoma (MM) is malignancy of melanocytes, with the commonest primary site being skin. Mucosal melanomas make less than 1% and prognosis is poor if not detected early. Identifying the primary lesion can be challenging and a small percentage of patients falls under the category of melanoma of unknown primary (MUP). We herein report a rare case of an 86- year- old male who presented with frank hematuria and multiple pigmented naevi over bilateral lower limbs. A Computed Tomography Urography (CTU) revealed a bladder tumour at lateral wall, which then proceeded with a transurethral resection of bladder tumour (TURBT). He was discharged well pending histopathological examination (HPE) report. He presented again with small bowel obstruction and a CT showed small bowel intussuscepting tumour with several lungs and right adrenal gland lesions requiring a laparotomy, small bowel resection and anastomosis. A black pigmented tumour was found to be a lead point of the intussusception. Patient recovered well from surgery and was discharged well. HPEs of both the surgeries revealed malignant melanoma, unable to identify the primary tumour. This case shows the notorious behaviour of MM to metastasize without symptoms. Coupled with the similar HPE of both sites of bladder and bowel, it makes it difficult to establish the primary site. CT imaging should be the mainstay choice of investigation to identify primary disease and evidence of metastasis. Initial management of MM should be complete surgical resection of suspected primary lesion. In the unfortunate event of patient developing distant metastasis, role of adjuvant therapy in visceral melanoma is evolving with clinical trials focusing on immunotherapy, tyrosine kinase inhibitors and dacarbazine.
Complications Patients Faces while Fixation, in Terms of Pain Relief, Walking, Sitting
Authors: Chowdhury Dr. Md. Abdus Sattar , Islam Dr. Muhammad Najibul , Sayeed Dr. Amreen Sadika , Firdaus Dr. Zannatul , Alam Dr. Abu Saleh Mohammad Monirul
Published: December 2022

Background: The fracture of the trochanteric area of the femur is one of the most frequent and challenging complications orthopedic surgeons deal daily. In virtually all instances, fractures develop through the highly vascular cancellous bone and heal within 8 to 12 weeks, independent of therapy. Malunion and varus angulations are prevalent. Due to the demands placed on the patient, nursing staff, and length of hospitalization, conservative therapy is no longer acceptable. Seventy percent of intertrochanteric fractures are considered unstable. During regular exercises, the proximal femoral loading has been calculated to reach up to three times the body weight. Muscle attachments apply force vectors in several directions, hence contributing to a trend for fracture displacement. This fracture is typically accompanied by severe comminution and osteopenia. Objective: The main objective of this study is to find thecomplications patients faces while fixation, in terms of pain relief, walking, witting. Materials and Methods: Descriptive study conducted at Department of Orthopedic Surgery, Chittagong Medical College Hospital, Chittagong, with the sample size of 36 patients aged above 50 years admitted to the Chittagong Medical College Hospital with closed trochanteric fracture. The aim of the study is to find out the Effectiveness of dynamic hip screw in fixation of trochanteric fractures of femur in elderly patients. Results: The patients' ages ranged from 52 to 95 years. The majority of patients were 70-79 years old (36.1 percent), followed by 80-89 years (25 percent), 60-69 years (22.2 percent), 50-59 years (11.1 percent), and 90-99 years (5.6 percent). The mean (±SD) age of the total study patients (n=36) was 72.± 1.20 years, male (n=21) was 75.05±12.62 years and female (n=15) were 68.07±7.46 years. There are considerable disparities between the age groups of 70-79 and 90-99.Males made up the majority of patients (58.3 percent), while females made up 41.7 percent. ....
Gestational Diabetes and Its Effects on Neonatal Outcome- A Prospective Cohort Study
Authors: Chomon Dr. Farhana Afroz , Mortoza Dr. Abu Sayeed Md , Khan Dr. Sadia Jeben
Published: December 2022

Introduction: Gestational diabetes mellitus is a common chronic disease in pregnancy that impairs the health of several million women worldwide. Gestational diabetes mellitus (GDM) is a condition characterized by carbohydrate intolerance with the onset or first recognition during pregnancy. Aim of the study: The aim of this study was to examine the effects of gestational diabetes mellitus on the risk of adverse neonatal outcomes. Methods: This was a prospective cohort study and was conducted in the Department of Gynaecology and Obstetrics of Kushtia General Hospital, Kushtia, Bangladesh during the period from January, 2021 to January, 2022. There was total 100 women in our study. This study was conducted among pregnant women with gestational diabetes mellitus. The study population was categorized into two; namely, women with GDM and women without GDM. Result: In total 100 patients from both the groups completed the study. In our study we found the mean ± SD age of pregnant mothers with GDM was (30.01 ± 5.00) and non-GDM (27.05 ± 5.04) in years. The mean± SD of MUAC for women with GDM (26.59 ± 4.11) and for non-GDM (24.35 ± 2.74). The mean± SD of hemoglobin women with GDM was (12.39 ±1.77) and for non-GDM (12.73 ±1.75) which is significantly higher compared to women with GDM. Conclusion: In our study, we found that the incidence of adverse neonatal outcomes was higher among newborns from mothers with GDM than among women without GDM. GDM independently increased the risk of composite adverse neonatal outcome, fetal macrosomia, LGA, preterm birth, low Apgar score at first and fifth minute. However, GDM does not confer an increased risk of LBW and SGA.
Adaptation to the Resource Available in Construction of Stoma in Pediatric Stoma Care in Bangladesh: A Descriptive Analytical Study
Authors: Das Dr. Bipul Bhusan , Islam Dr. Md. Tawhidul , Masud Dr. Sadruddin Al
Published: December 2022

Background: Stoma construction is a routine operation in the field of pediatric surgery. Commercially accessible resources, such as ostomy bags (either disposable or with extended lifespans), are often employed to care for these stomas. These may be rather pricey, especially in places like Bangladesh, and it might be difficult to get ones in the right size. Objective: In this study our main objective is to evaluate the efficacy of resource available in construction of stoma in Pediatric stoma care in Bangladesh. Method: From January 2014 through December 2015, a total of 60 patients were included in a prospective research done by the pediatric surgery department at Dhaka Medical College and Hospital. The research group consisted of patients less than 12 years old who had temporary loop colostomy or ileostomy in the pediatric surgical units at Dhaka Medical College & Hospital throughout the study period. Zinc oxide paste was first administered to the Peristomal skin after stoma formation. The stoma was covered with a betel leaf, which had a glossy, smooth outside surface and a rough inner surface. The size of the hole in the betel leaf was adjusted to accommodate the stoma. The stoma is protected by an additional leaf that is still fully intact. When nature calls, one must remove the undamaged leaf above it and wipe away the feces before moving on. The cleaned leaves were put to further use. Ostomy bags (like those made by Convatec) and adhesive paste (Stomahesive) are used to seal the bag to the Peristomal skin. Results: During the study, both the stoma bag and betel leaf groups had a wide range of ages, from one day to 4,320 days. In addition, both group anorectal malformations found as common indication 70% vs 73.33% (stoma bag vs betel leaf) followed by in stoma bag group 23.33% had Hirschsprung’s disease and 6.67% had Colonic atresia. Where as in betel leaf group 20% had Hirschsprung’s disease and 6.67% had Colonic atresia? In stoma bag group majority had ......
Pathophysiology and Pharmacotherapeutics of Diabetic Neuropathy: A Review
Authors: Mahmood Dr. Faisal , Ahmad Dr. Saqib
Published: December 2022

Diabetic neuropathy affects most of the patients with type I & II diabetes. Peripheral neuropathy has devastating consequences resulting in charcot joints and its related complications. American diabetes association helps to classify different type of diabetic neuropathies into groups trying to make some sense of out it for future work. There are number of cellular mechanisms that have been proposed as cause of the neuropathy including polyol pathway, advanced glycosylation end products, oxidative stress, hypoxia theory and other factors. All these have been discussed in some detail in the coming paragraphs. A number of add-on modalities have been discussed in literature to help diagnose diabetic peripheral neuropathy. Understanding the cellular mechanism of diabetic neuropathy can help come up with best therapeutic agents which may be able to arrest that cellular events behind diabetic neuropathy helping to stop it at early stages. A number of medicines are in use to treat diabetic peripheral neuropathy once it is set, however prevention of such cellular changes using medicines or by controlling glucose levels seems to be the future area of work trying to improve outcomes of this devastating illness. Most of the current recommendations for treating established diabetic neuropathy are based on comparing effects of these drugs against placebos in reducing the symptoms of diabetic peripheral neuropathy. This review article tries to find a connection between cellular mechanisms for diabetic peripheral neuropathy with available pharmacotherapeutics and defines areas for future work of pharmacological industry to help find definitive treatment and if possible definitive prevention for diabetic peripheral neuropathy.
Clinical and Laboratory Presentations of Children with First Time Febrile Seizure: Findings from a Tertiary Level Hospital in Bangladesh
Authors: Mahamuduzzaman Abu Shoyeb Md. , Rahman Md. Anisur , Ullah Md. Shafiq , Khan Md. Fazlul Kader , Tabassum Sadia , Sonia Umme Qulsum , Saleha Rawshon
Published: December 2022

Background: Seizures associated with fever are a leading cause of pediatric hospitalization. The purpose of this study was to explore the clinical characteristics and laboratory findings of children with first time febrile seizure in local settings, which are limited in Bangladesh. Methods: From July 2013 to June 2014, this Cross-sectional, Observational study was conducted at Sir Salimullah Medical College and Mitford Hospital in Dhaka. The study included all admitted children aged 6 months to 60 months who had their first febrile seizure. A thorough history, clinical examination, and laboratory investigations were performed and analyzed. Results: Among the 87 study population, mean age of presentation was 25.62 ± 12.64 months, male were predominant (56%) and 17% had family history of FS. Majority of them presented with respiratory illness-like symptoms(23%). 54% of them experienced two seizures, and 75% of the seizures were generalised. 23% of them revealed chest X-ray features consistent with lung infection, 31% had neutrophilic leukocytosis, and 8% had positive blood culture growth. Streptococcus pneumoniae in Gram stain of 2% CSF and Klebsiella in 2% of the CSF culture cases were identified. Pneumonia was the underlying cause in 20% of case; viral syndrome in17% of cases, meningitis in 13% of cases, and in 15% of cases, the underlying cause could not be identified. Conclusion: The majority of febrile seizures in our study participants were caused by various respiratory illnesses and meningitis. White blood cell counts, blood culture and cerebrospinal fluid analyses can aid in determining the underlying cause and facilitating appropriate and timely management.
Evaluation of RBC Count and Haemoglobin Concentration in Newborn of Mother with and without Preeclampsia
Authors: Sultana Dr. Mahbuba , Akhter Dr. Qazi Shamima , Ahmad Dr. Rahnuma , Akter Dr. Tahmina
Published: December 2022

Introduction: Preeclampsia (PE) is one of the commonest complications in pregnancy which is associated with perinatal mortality and morbidity. Early hematological screening of the newborn of preeclamptic mother may be helpful to diagnose and treat the newborn of preeclamptic mother for better pregnancy outcome. Aim of the Study: The aim of this study was to evaluate the RBC count and Haemoglobin concentration in newborn of mother with and without preeclampsia. Methods: This cross-sectional study was conducted in the Department of Physiology, Dhaka Medical College, Dhaka, Bangladesh from January 2017 to December 2017. Total 60 newborns were included in this study. The subjects were divided into 2 groups. Group A (Study group): Thirty (30) newborns of preeclamptic mother and Group B (Control group): Thirty (30) newborns of healthy pregnant mother. The subjects were selected from Department of Obstetrics and Gynecology, Dhaka Medical College Hospital, Dhaka on the basis of exclusion and inclusion criteria. Five (5) ml. of cord blood was collected from each newborn after delivery and was analyzed for complete blood count. These parameters were estimated in the Department of Hematology, Dhaka Medical College Hospital, Dhaka. Data were collected in pre- designed structured questionnaire form by the researcher herself. For statistical analysis Unpaired Student’s “t” test, Chi Square test and Pearson’s correlation coefficient (r) test were performed as applicable using SPSS for windows version 16.0. p value <0.05 was accepted as level of significance. Results: In this study, the mean (±SD) maternal systolic blood pressure of the study group A and control group B were 173.00 ± 19.73 and 114.83 ± 11.72 mm Hg respectively. In this study, the mean (±SD) maternal systolic blood pressure was significantly (p<0.001) higher in group A in compared to group B. The mean (±SD) maternal diastolic blood pressure of the study group A and control group B were 108.33 ± 9.52 and.............
Outcome of Upper Ureteric Stone Management by in Situ Extracorporeal Shock Wave Lithotripsy and Intracorporeal Pneumatic Lithotripsy
Authors: Hossain Dr. Mohammad Sajjad , Mamun Dr. Abu Masud Al , Chowdhury Dr. Anup Roy , Islam Dr. Mohammad Saiful , Roy Dr. Probir Kumar , Jahan Mohammad Sarwar
Published: December 2022

Background: Ureteric stone disease is a common urological problem throughout the world. Treatment of ureteral stones depends on stone size, composition and degree of obstruction, pain, presence of infection, single kidney and abnormal ureteral anatomy. The aim of the present study is to evaluate and compare in situ ESWL and URS with pneumatic lithotripsy in terms of Stone clearance, duration of procedural time, duration of hospital stay and complications (fever, haematuria, ureteral injury, stone migration, stone clearance, steinstrasse, UTI, ureteral perforation). Methods: A total of 80 patients were included in the study. 42 of them enrolled in ESWL group and 38 in pneumatic lithotripsy group. This is a Prospective Observational study. ICPL were done as day case surgery and ESWL were done as outpatient basis. Results: Intracorporeal pneumatic lithotripsy is better than in situ ESWL for the treatment of small non-impacted upper ureteric stone because it has more stone clearance rate and less complication like fever, haematuria, steinstrasse, UTI, ureteral injury and ureteral perforation. Conclusion: At the end of the study, it can be concluded that for the management of upper ureteric stones ICPL is a better option than in situ ESWL considering its greater stone clearance and less complications.
Role of C - reactive protein for Assessment for Exploration of Acute Scrotum in Children: A Study was done in a Tertiary Care Hospital
Authors: Paul Dr. Swapan Kumar , Ghosh Dr. Paritosh Kumar , Islam Dr. Rakibul , Biswas Dr. Prosanto Kumar , Ali Dr. Md. Ayub , Rashid Dr. Md. Aminur
Published: December 2022

Background: Acute scrotum comprises a long list of differential diagnosis. The patient suffering from an acute scrotal condition requires urgent medical care. It must be evaluated promptly and accurately to make a management plan especially to save the testis from necrosis in torsion. Decision making regarding the plan for exploration is more important than reaching an exact diagnosis. Objectives: To differentiate emergency surgical acute scrotal conditions from non-surgical cases. To establish an early diagnosis of acute scrotum in children. To avoid negative exploration of acute scrotum in many cases. Methods: Sixty four patients of different age groups ranging from neonate to 12 years were underwent surgical exploration under general anesthesia (GA) between January 2016 to December 2019. The study was conducted in the Faculty of Paediatric Surgery in Bangladesh Shishu Hospital & Institute (BSH&I). A total of 72 patients were admitted with acute scrotal pain and/or swelling and evaluated by taking detailed history of presenting complaints, careful physical examinations, different laboratory investigations including serum c-reactive protein (CRP) level and radiology & imaging studies whenever appropriate and available. Results: Out of 72 cases admitted for acute scrotum, serum C - reactive protein (CRP) level estimation was done in all cases and surgical exploration was done in 64 cases. Total sample size was 64. In age incidence majority of patients were >1 year-6 years (37.5%) and >6 years-12 years (34.37%). Majority of patients came with scrotal swelling (100%), pain (93.77%) and fever (65.62%). Majority of patients came after 48 hours of onset of symptoms and exploration was performed within 6 hours to 12 hours. Blood collection was done >48 hours since complaints in majority cases (59.38%). Serum CRP level was negative in majority cases of Torsion testis (TT) and Torsion appendix testis (TAT). Total count of WBC was raised in majority of inflammatory cases ...
Outcomes of Closed Reduction and Internal Fixation (CRIF) by Cannulated Cancellous Hip Screw in Transcervical Fracture Neck of Femur in Children
Authors: Mistry Dr. Goutam Baran , Sobhan Dr. Syed Abdus , Khan Dr. MD Abdul Gaffar , Barman Dr. Shamol Chandra , Hannan Dr. Mohammad Abdul , Billah Dr. Muhammad Baqi , Paul Dr. Arun Kanti
Published: December 2022

Introduction: Fracture of the neck of the femur is one of the most common and difficult problems all over the world, for all ages. As the femur is the weight-bearing bone in the lower limbs, fracture of the neck femur creates severe problems like shortening, limping, and a painful unstable hip. The incidence of pediatric neck fractures is highest in children above the age of eleven. The most common cause is high-energy trauma such as motor vehicle accidents and falls from height, also osteogenesis imperfecta, and myelomeningocele. This study aimed to analyze the outcomes of closed reduction and internal fixation (CRIF) by the cannulated cancellous hip screw in the transcervical fracture neck of the femur in children. Methods: This prospective interventional study was conducted at the National Institute of Traumatology & Orthopedic Rehabilitation (NITOR), Dhaka, from July 2011 to June 2013. A total of 16 patients were selected for this study as per inclusion criteria. All statistical analysis of different variables was analyzed according to the standard statistical method by using SPSS. Result: In this study, the age of the patients ranged from 5-18 years with an average age of 11.25 years. The majority of the patients (56.25%) belonged to the age group 10-14 years, followed by 31.25% in the age group 5-9 years, and the rest 12.50% in the 15-18 years age group. Out of 16 patients, 10 patients (62.50%) were male and 06 patients (37.50%) were female. In the present study, the anatomical reduction was achieved in 07 (43.75%), the acceptable reduction was achieved in 05 (31.25%), and the unacceptable reduction in 04 (25.0%). The average time interval between injury and operation was 7.3 days, out of 16 study cases, 10 cases operated within 7 days of which 9 were united (90.0%), and 6 cases were operated after 7 days, of which 4 (66.66%) were united. Out of 16 patients, 12 (75.0%) regained full range of hip movement and 04 (25.0%) patients had limited range of motion. ...