bluuebunny/crossref_metadata_2025 huggingface dataset:
PREVALENCE OF ORAL SUBMUCOUS FIBROSIS AND PERIODONTAL HEALTH STATUS IN PATIENTS CHEWING GUTKA FROM BIHAR REGION
Authors: Raman Nikita , Manish Kumar , Jain Samir
Published: March 2020

Smokeless tobacco (ST) chewing warranties special attention in India because of its popularity and widespread social acceptance. The major factors that persist to encourage people to use smokeless form of tobacco are its low price, ease of purchase, and the widely held misconception of purported medicinal value in curing toothache, headache, and in decreasing hunger. Furthermore, in contrast to smoking, there is no taboo against using ST. The lifestyle, socioeconomic status, and the standards of living of industrial workers are different from the rest of the population. Poverty, language barriers, and poor education contribute different lifestyle that encourages addictive tobacco habits. As there is a ban on smoking tobacco in most of the industrial premises, workers tend to consume more of ST products. Therefore, they form a special group who could be at a higher risk of periodontal breakdown. Hence the present study was planned for study of Prevalence of Oral Submucous Fibrosis and Periodontal Health Status in patients chewing Gutka from Bihar Region.

The present study was planned in Department of Dentistry, Anugrah Narayan Magadh Medical College and Hospital, Gaya, Bihar. Total 30 patients were enrolled in the present study. The patients were divided in three groups. The Group A included patients with a healthy periodontium. The Group B included patients with chronic periodontitis without OSMF, and Group C included patients with chronic periodontitis and OSMF.

The data generated from the present study concludes that that chewing gutka leads to periodontal destruction in patients with OSMF. The cases illustrate the significant morbidity and mortality associated with OSF and emphasize the importance of close follow-up of such cases. Because of the significant cancer risk among these patients, periodic biopsies of suspicious regions of the oral mucosa are essential for the early detection and management of high-risk oral premalignant lesions and prevention of cancer.

Keywords: oral submucous fibrosis, periodontal destruction, gutka, Bihar region, etc.
A STUDY OF KNOWLEDGE, ATTITUDES AND PRACTICES REGARDING NUTRITION DURING CARE OF TUBERCULOSIS PATIENTS AMONG NURSING STAFF OF A TERTIARY CARE HOSPITAL
Authors: Divhare Sujeet , Girish Sunita , Divhare Amit , Ingale Satyashil , Korake Rajashree
Published: March 2020

Background: Nutrients boost the host’s immune responses against various pathogens including mycobacterium tuberculosis. People with latent tuberculosis do not exhibit any clinical signs or symptoms of illness because the infection is contained by their immune system. The direct evidence of effect of nutrition on tuberculosis is difficult but the weight of evidence still favors the view that malnutrition may be an important factor in the high susceptibility and morbidity from tuberculosis.

Aim and objectives: To find out the knowledge regarding nutrition, attitude towards it and practices of nutrition among nursing staff involved in the management of tuberculosis patients.

Material and methods: This study was carried out in a tertiary care teaching hospital. A total seventy nursing staff, involved in care of tuberculosis patients either in tuberculosis wards and OPDs, participated in the study. Assessment of Knowledge, Attitude and Practices regarding nutrition was done with pretested and structured questionnaire.

Statistical analysis: Percentages, Means, Chi-square test and ANOVA using the SPSS 17.0 Software.

Results: GNM trained participants with work experience of more than 3 years were much better than B.Sc. nursing students regarding their knowledge about daily caloric requirements, dietary recommendations for tuberculosis patients and influence of dietary habits on tuberculosis outcome (p < 0.05) but there was no statistically significant difference in the mean score of their knowledge about food nutrients. Both the groups showed positive attitude towards morning breakfast and having 3 meals and snacks in a day. Skipping of breakfast was more common among the GNM staff as compared with B.Sc. nursing students (P < 0.05).

Conclusions: Results from the study indicated KA scores higher than P scores. The effect of nutritional supplementation on tuberculosis prevention and health outcomes among health care workers had not previously been systematically reviewed. This study will provide guidance on recommendations for nutritional care among health care workers who are directly involved in care of patients with tuberculosis.

Keywords: Nutrition, Tuberculosis, Knowledge, Attitudes and Practices, Nursing staff.
STUDY OF ANEMIA AMONG ADOLESCENT GIRLS
Authors: Gupta B S , Singh Yogesh
Published: March 2020

Background: In India adolescents constitute about 25% of the population and form an important physiological group whose nutritional needs demand special attention.  Adolescence is a significant period of human growth and maturation, when unique changes occur and many adult patterns are established.

Methods: This was cross-section study. All the adolescent girls studying in standards 9th - 12th class who were given consent to hemoglobin estimation were included in the study.

Results: The prevalence of anemia among adolescent girls was found as 73.00%. Out of 730 anemic girls, 520 girls were suffering from mild degree of anemia and 190 girls were having moderate degree of anemia. Only two girl was found severely anemic.

Conclusion: The prevalence of anemia among adolescent girls is alarmingly high in India.

Keywords: Prevalence, Anemia, Adolescent.
HISTOMORPHOLOGICAL STUDY OF THE UTERUS IN 64 PERIPARTUM HYSTERECTOMY SPECIMENS.
Authors: Pukhrambam Gayatri Devi , Singh O. Okendrajit , Sarangthem Babina , Gauhar Kamal Uddin
Published: March 2020

Background: Peripartum hysterectomy is a life saving procedure performed for intractable obstetric haemorrhage. Uterine atony, rupture, abnormal placentation, retained products etc. are common indications. With the rise of caesarean sections, the incidences of peripartum hysterectomies are increasing worldwide. The aim of the present study is to evaluate the histomorphological findings in peripartum hysterectomy specimens received during a five year period.

Material and Method: In this hospital based cross-sectional study during a five year period (Jan 2014 –Dec 2018), 64 peripartum hysterectomy specimens received in the department of Pathology, RIMS, Imphal, Manipur were included. The gross and histomorphological findings were evaluated, studied, statistically analysed and compared with other studies.

Results and Observation: The various histomorphological findings were abnormal placentation 28 (43.7%), uterine atony 15 (23.5%), uterine rupture 14 (21.8%), retained placenta/product 6 (9.3%) and subinvolution 1(1.5%).  Abnormal Placentation and Placenta cretas were the most common finding in the present study. The lower uterine segment was the most common abnormal site of placental implantation. The age ranged from 21 to 45 years, with majority of the cases were in the          30-39years age group. History of previous caesarean section was noted in 20 cases (31.2%). The relative risk of abnormal placentation was 2.5 times higher in those cases with prior history of caesarean section. Rupture was most commonly associated with multiparous women. Co-morbid overlapping features were seen in few cases.

Conclusion: Histopathological diagnosis not only confirmed the clinico-radiological impression, but also highlighted the other co-morbid associations that caused the intractable haemorrhage which warranted a peripartum hysterectomy.  

Keywords: Peripartum Hysterectomy, Abnormal placentation, caesarean section, chorionic villi.
TO CO RELATE THE QUALITY OF RECONSTRUCTION WITH THE AFFECTED HIP FUNCTION AND QUALITY OF LIFE IN PATIENTS UNDERGOING THA POST ACETABULUM FRACTURE
Authors: Sharma Manish , Sen Ramesh Kumar , Aggarwal Sameer , Prakash Mahesh
Published: March 2020

Background: Hip fractures rank in the top ten of all impairments worldwide in terms of loss in disabilityadjusted years for people 50+ years old

Methods: The study was carried as a retrospective study, from February 2013 to July 2014. After getting the approval from the Ethics Committee of the Institute (Annexure I) and the consent from the patients the study was conducted on 49 patients who underwent Total Hip Arthroplasty after fracture acetabulum.

Results: The mental scores were significantly higher in the group where safe range of inclination was achieved. Therefore the quality of life is dependent on the safe range of inclination.

Conclusion: We found that the patients who were treated with ORIF following the fracture acetabulum had better physical and mental scores.

Keywords: Hip, Physic, Mental Arthroplasty, Reconstruction
A 3 YEARS HISTOPATHOLOGICAL STUDY OF GALLBLADDER AFTER CHOLECYSTECTOMY IN A TERTIARY CARE HOSPITAL
Authors: Devi M. Reeta , Nabina L. , Ronal R.K.
Published: March 2020

Background: Diseases of the gallbladder are pretty common. Most of the cases admitted in hospitals required surgical intervention and removal. Histopathological routine examination of the resected gallbladder shows a wide range of changes, from inflammatory to different variants and from premalignant to malignancy. This study is undertaken to find the changes in the cholecystectomy specimen along with their gender and age distribution.

Methods: The present retrospective study was conducted in the cholecystectomy specimen received in the department of Pathology, Regional Institute of Medical Sciences (RIMS), a tertiary care hospital during the period of January 2014 to December 2016.

The corresponding blocks are retrieved from the archives of the department, sections are cut and slides are stained with Hematoxylin and Eosin stain,Three representative slides of each specimen are examined.

The aim of this study is to analyse the different histopathological changes of the gallbladder and their distribution in different age groups and as well as  in gender.

Results: A total of 1506 cholecystectomy specimen were received in the histopathology section of the department. Out of which, 1282 cases (85.12%) were females while 224 cases (14.88%) were male patients. Female to male ratio is 6:1.

The most common histopathological diagnosis of cholecystectomy specimen was chronic cholecystitis followed by chronic cholecystitis with focal evidence of cholesterolosis and xanthogranulomatous cholecystitis. There were 3 cases of incidental diagnosis of adenocarcinoma gallbladder.

Conclusion: Chronic cholecystitis is the most common disease affecting the gallbladder which with a high rate of occurance all over the world. The study firmly recommends thorough histopathological examination of all resected gallbladder. Incidental diagnosis of adenocarcinoma further warrents the need for thorough histopathological examination to help in treatment and prognosis.

Keywords: Chronic cholecystitis, cholesterolosis, xanthogranulomatous cholecystitis,  incidental adenocarcinoma.
COMPARISON OF CLONIDINE AND DEXMEDETOMIDINE AS AN ADJUVANT TO 0.5% BUPIVACAINE IN SUPRACLAVICULAR BRACHIAL PLEXUS BLOCK: A RANDOMISED PROSPECTIVE DOUBLE-BLIND STUDY
Authors: Jethani Kushal , Sahu Preeti , Ann Seethal
Published: March 2020

Background and Objectives: Alpha-2 agonists are used as adjuvant with local anaesthetic agents to prolong the duration of spinal, epidural and peripheral nerve blocks as well as to prolong the duration of post operative analgesia. We performed a study to compare clonidine(1ug/kg) and dexmedetomidine (1ug/kg) as an adjuvant to 0.5% bupivacaine in supraclavicular brachial plexus block.

Methods: Eighty ASA I and II patients scheduled for elective upper limb orthopaedic surgeries under supraclavicular brachial plexus block were divided into two  groups(n=25 each) in a randomized, double-blinded fashion. Group C received clonidine 1 μg/kg and Group D received dexmedetomidine 1 μg/kg added to bupivacaine 0.5% (30 cc). Onset and recovery time of sensory and motor block, as well as duration of analgesia were studied in both the groups.

Results: Duration of sensory block and motor block was 220.12 ±50.3 and 280.1± 20.12 min respectively in group C, while it was 410.34± 60.12 and 460.4 ± 50.56 min respectively in group D and hence both were significantly prolonged in group D.  No statistically significant difference was seen in onset of sensory and motor block between the two groups. The duration of analgesia i.e. time to requirement of rescue analgesia was 270.4± 56.7 mins and 452.7 ±64.23 mins in group C and D respectively and  this difference was statistically significant (P=0.001).

Conclusion: Addition of dexmedetomidine to bupivacaine 0.5% in supraclavicular brachial plexus block prolonged the duration of sensory and motor block as well as the duration of analgesia when compared with clonidine.

Keywords: Clonidine, dexmedetomidine, supraclavicular block
ROLE OF ULTRASONOGRAPHY & COLOUR DOPPLER IMAGING IN EVALUATION OF ADNEXAL MASSES
Authors: Solanki Kunal G , Choudhary Nikunj Vikram
Published: March 2020

Background: Adnexal mass lesions are very common among women of all age group but very common among reproductive age. Differential diagnosis of adnexal mass is difficult and complex. Recognition of the severity of the problem, appropriate and timely evaluation and treatment with good outcome is the goal. Ultrasound is the primary modality used for detection and characterization of adnexal masses. The purpose of this study is to evaluate the diagnostic accuracy of ultrasonography in patients suspected with adnexal masses.

Objectives: Understanding the characterization of adnexal masses on ultrasonography and colour doppler,and to corelate the usg findings with histopathology where ever possible,to derive simple and clinically useful usg based IOTA rules for discriminating between benign and malignant mass.

Methods: The study was conducted on 100 patients with suspected various adnexal masses in a period of 1 year from 2018-2019. Patients are selected based on Clinical history & Adnexal masses detected on pelvic ultrasound. Results of ultrasound were correlated with available histopathological findings.

Results: On histopathology, out of total 50 cases studied 14(28%) were malignant and 36 (72%) were benign. Out of 45 cases where IOTA simple rules were applicable, 16(35.5%) were malignant and 29(64.4%) were benign.

Conclusion: On comparing the findings of ultrasonogram versus histopathology, it was found that ultrasound had a high sensitivity of 91.66%, 84.84% specificity, 68.7% positive predictive value, 96.55% negative predictive value and 88.8% accuracy of detecting adnexal masses.

Keywords: TAS – Transabdominal sonography, TVS – Transvaginal Sonography, Adnexal Masses.
TO GRADE BREAST CARCINOMAS ACCORDING TO MODIFIED BLOOM RICHARDSON GRADING SYSTEM IN LUMPECTOMY AND MASTECTOMY SPECIMENS.
Authors: Shankar Ravi , Banerjee Bejoy Chand , Prasad Raj Kumar
Published: March 2020

The study was conducted in the Department of Surgical Pathology, Patliputra Medical College and Hospital, Dhanbad. Cytological study of breast lumps was done. All patients who were clinically suspected of having breast carcinoma were subjected to FNAC of breast lump under aseptic precautions after explaining the procedure, its potential complications and taking written consent. Local examination was done and details were recorded as per proforma. FNAC was performed by following technique.

It is a useful parameter to be taken into consideration when selecting mode of therapy for breast carcinoma and to predict the tumor behavior. Cytological grading is especially useful in low resource settings, where core biopsy is not routinely performed for diagnosis of breast carcinoma. The cyto-prognostic grading helps in identifying fast growing tumors (Grade III& II). Such tumors are more likely to respond to chemotherapy than the low grade, slow growing tumors, which are better suited to pre-treatment with tamoxifen. Therefore, assessment of biological aggressiveness by cytological grading without removing the tumor is valuable approach.

Keywords: Robinson’s Grade, Breast, Carcinoma & Cytological Aspirates.
STUDY OF SPECTRUM OF BENIGN THYROID LESIONS ON FNAC AT TERTIARY CARE CENTRE
Authors: Devi M. Reeta , Sarangthem Babina , . Keerthivasan
Published: March 2020

Background: Thyroid lesions are one of the commonly encountered disorders in any hospital. Majority are non neoplastic and malignancy accounts for about 5-10%. Fine needle aspiration cytology is a simple, cost effective, reliable and minimally invasive tool for the evaluation of these lesions and it can differentiate benign from malignancy.

Material and methods: This cross sectional study was conducted on the thyroid swelling attending the cytology OPD of Regional Institute of Medical Sciences (RIMS) during October, 2016 to October, 2019 a tertiary care hospital. All smears are air dried and stained with Giemsa stain.

Results: The most common age group affected is 41-50 years of age followed by 31-40 years age group. Females outnumbered males with female to male ratio of 16.9:1. Out of 729 cases, colloid goiter constitute a total of 387 (53%), Hashimto's thyroiditis 318 cases (43.3%), adenomatous goiter (1.2%) and Graves disease contribute 1.1%

Conclusion: Thyroid Swelling are very common clinical presentation. FNAC is a cost effective, reliable, easy to perform test with commendable sensitivity. It can spare patients to undergo unnecessary surgery. It also helps in differentiating solid from cystic lesions.
VITAMIN D SUPPLEMENTATION AND HBA1C LEVELS IN TYPE 2 DIABETIC PATIENTS
Authors: Singh Mahesh Kumar
Published: March 2020

Introduction: Type 2 diabetes mellitus (T2DM) is a major public health problem, with an estimated 65 million patients in India. Studies shown that low serum 25(OH)D concentrations are associated with an increased risk of type 2 diabetes and shown the beneficial effect of vitamin D supplementation on insulin sensitivity. Vitamin D is formed in humans by subcutaneous photosynthesis from its precursor, 7-dehydrocholesterol by exposing themselves to the sun. older age is associated with a decrease in 7-dehydrocholesterol concentration in the human skin. This lifestyle habit and their natural diet of low vitamin D consumption may cause poor glucose control in diabetic patients. The purpose of this study was to examine the association between serum 25(OH)D and glycosylated hemoglobin (HbA1c) levels.

Material and Methods: This was a prospective observational study of T2DM patients aged 18 and above who attended the outpatient clinics of a tertiary center. The following variables were collected from the cases: age, sex, type of diabetes, HbA1c result. Baseline HbA1c and vitamin D levels were recorded prior to supplementation and after a period of 6 months of supplementation with vitamin D, HbA1c and vitamin D levels were recorded once again. 

Results: A total of 169 patients were included in the study and whose follow up was completed at the end of 6 months. Mean age of the study population was 46.87 ± 15.99. there were 74(43.79%) male and 95(56.21%) female.  Mean HbA1c pre-supplementation (%) was   9.58 ± 2.41 while post supplementation was 7.21 ± 1.08. There was a significant reduction of HbA1c of T2DM (P < 0.0001). Vitamin D levels pre-supplementation (nmol/L) (mean ± SD) was 38.54 ± 29.54 while, Vitamin D levels post-supplementation (nmol/L) (mean ± SD) was 38.54  ± 29.54. There was a significant increase of vitamin D levels of T2DM (P < 0.0001).

Conclusion: Significant inverse association between vitamin levels D and HbA1c in T2DM patients was observed. Also there was significant reduction in HbA1c as vitamin D levels increased. Regular screening of vitamin levels D and HbA1c in T2DM patients is advised.

Keywords: Vitamin D, diabetes, T2DM, 25-hydroxyvitamin D
EFFICACY OF ARIPIPRAZOLE IN TREATMENT OF SCHIZOPHRENIA IN POPULATION OF CENTRAL INDIA
Authors: Raichandani Omprakash , Khan Abdul Faheem , Raichandani Sapna
Published: March 2020

Background: During the past decade, there has been some progress in the pharmacotherapy of schizophrenia and schizoaffective disorder. Aripiprazole is recommended at a dose of between 10 and 15 mg/day in the treatment of schizophrenia, with a dose range considered to be effective, between 10 and 30 mg/day.

Objective: To study the efficacy and safety of Aripiprazole in low doses of 15 mg versus high doses of 30 mg in the treatment of Schizophrenia.

Methods: Total 60 new and old patients (who are not on any treatment) between 18-60 years of either gender who meet the diagnostic criteria as per DSM-IV classification for schizophrenia and schizoaffective disorder. Patients were randomly divided into 2 groups on single blind study criteria. Group-I: Aripiprazole 15 mg once a day, morning dose for 6 weeks. Group-II: Aripiprazole 30 mg once a day, morning dose for 6 weeks. Efficacy assessment included at baseline and at 6 weeks end study scoring on PANSS, EPRS and CGI.

Results: In both the groups aripiprazole showed the efficacy by improving the number of patients. In group-I, 20 patients has shown the improvement in overall scores of all scales. In group-II, 16 patients have shown the improvement in overall scores in different scales.

Conclusions: Aripiprazole is effective in schizophrenia and schizoaffective disorder, low doses of 15 mg is equally effective as high dose of 30 mg.

Keywords: Efficacy, Aripiprazole & Schizophrenia.
INCIDENCE OF DIFFERENT DELETERIOUS ORAL HABITS IN SCHOOL GOING CHILDREN FROM DARBHANGA DISTRICT, BIHAR
Authors: Kumar Keshav , Chettiankandy Tabita Joy
Published: March 2020

Oral habits ought to be of primary clinical concern to orthodontists as they may cause malocclusion and interfere with the treatment progress. Generally, habit control should be achieved earlier to correction of the malocclusion in an effort to eliminate any etiologic factors in development and maintenance of the malocclusion. It is well important for the clinician to understand that habit breaking treatment may need prolonged treatment time because habits may have been present for long periods of time and may be associated with underlying psychological problems. Hence based on above importance the present study was planned to evaluate incidence of different deleterious oral habits in school going children from Darbhanga District, Bihar.

The present study was planned in the Department of Dentistry, Darbhanga Medical College and Hospital Laheriasarai, Darbhanga Bihar. Total 50 school going children of the age 4 years to 10 years were enrolled in the present study. Samples were selected from school; simple randomized sampling technique was used. Children with orthodontic appliances, systemic disease were excluded from the study. A closed ended questionnaire was provided to children involved in survey to obtain details like age, sex, presence of habits, its duration and frequency. A detailed history was obtained from parents regarding the habit and its intensity.

The data generated from the present study concludes that all habits did not show statistically significant relationship, except tongue thrusting which showed statistically significant relationship and more prevalent in rural areas.

Keywords: Deleterious Oral Habits, School childrens, Bihar.
ROLE OF ANTIBIOTICS IN ELECTIVE COLORECTAL SURGERY
Authors: Kirnake Vijendra , Deshmukh Abhijit
Published: March 2020

Introduction: Surgical site infection (SSI) is a major burden for patients who are posted for elective colorectal surgery, also there is significant increase to the cost of health care.it is a major cause of morbidity after surgery and is associated with increased hospital stay, readmissions, costs, and sometimes mortality. Surgical site infections are very high in colorectal surgery and are estimated to vary from 15% to 30% of patients undergoing colorectal surgery. For colorectal surgeries, orally administered antibiotics can be used in addition to the intravenous antibiotic prophylaxis.

Material and Methods: A total of 46 patients were included in the study who were posted for elective colorectal surgery. Patients who start with the 3-day intervention period but for whom surgery is cancelled or postponed for more than 7 days, will not be evaluable for analysis. After enrolment, patients were randomly assigned to one of two treatment arms in a 1:1 ratio. Patients were blinded into two groups, group 1 (medication group) and group 2 (placebo group). Patients are instructed to take the medication four times daily, during the last 3 days prior to surgery. 

Results: There were 16 (69.6%) male and 7 (30.4%) in medication group while in placebo group male were15 (65.2%) and female were 8 (34.8%). Mean age in medication group was 46.2 ±15.24 and in placebo group was 48.2 ± 14.55. BMI (Body mass index) in medication group was 29.44 ± 3.74 and in placebo group was 28.76 ± 2.96. Operative time in group medication was 6.4±2.12 and in placebo group was 6.23 ± 1.96. This was not significant. Surgical site infection (SSI) in medication group was 3(13%) and in placebo group was 8(39%). Mean Hospital stay (days) in medication group was 13.11± 2.45 and in placebo group was 16.2±3.87, this was statistically significant. No. of antibiotics required postoperatively in medication group was .2± 1.4 and in placebo group was 6.4±2.4.

Conclusion: Administration of oral antibiotics 3 days prior to colorectal surgery can significantly reduce the surgical site infection and mean hospital stay thereby reducing the morbidity.

Keywords: antibiotics, colorectal surgery, surgical site infection
ACCURACY OF CLINICAL AND LABORATORY PARAMETERS IN THE DIAGNOSIS OF ACUTE APPENDICITIS
Authors: Agrawal Praveen
Published: March 2020

Introduction: The diagnosis of acute appendicitis is generally clinical and once it is diagnosed, operative management ensues. Abdominal pain is the main presenting complaint of patients with acute appendicitis. The diagnostic sequence of colicky central abdominal pain which is followed by vomiting with migration of the pain to the right iliac fossa. The site of maximal tenderness is often said to be over McBurney's point. Specialist investigations are rarely needed to confirm a diagnosis of acute appendicitis, and the diagnosis is predominantly a clinical one. Judicious use of urine and blood tests, for inflammatory response variables, allow exclusion of other pathologies and provide additional evidence to support a clinical diagnosis of appendicitis.

Material and Methods: Every patient with acute onset of right lower quadrant abdominal pain and without previous history of appendectomy was considered as suspected of having acute appendicitis. Every patient with right iliac fossa pain and without history of appendectomy is suspected of having appendicitis until proven otherwise were included in the study. All Clinical and laboratory tests relevant to acute appendicitis were done among study participants. In Clinical parameters appetite, diarrhea, dysuria, vomiting, signs of localized peritonitis i.e. rebound tenderness and or guarding and pain migration was observed.in laboratory parameters, CRP, complete blood count (CBC) were measured and analysed. Patient’s demographic characteristics were noted.

Results: A total of 100 patients were included in the study of which 50 were included in the control and 50 in case group. Mean age in control group was 29±7.23 years while in acute appendicetomy group was 29 ±8.77 years. In control group 44% were male and 56 % were female while in acute appendicitis 42% were male and 58 % were female. All clinical presentations were statistically significant in case and control group. CRP was positive in 8 (16%) in control group while in Acute appendicitis group it was 21 (42%)  (P=0.0071).

Conclusion: CRP did not contribute to the overall diagnostic accuracy. The successful diagnosis of acute appendicitis can be done through proper clinical examination and adequate evaluation of laboratory parameters

Keywords: Acute Appendicitis, CRP, appendicetomy
CLINICOPATHOLOGICAL STUDY OF SALIVARY GLAND SWELLING
Authors: Akulwar Akshay , Bavikatte Akshay
Published: March 2020

Introduction:

Although the salivary, sweat, apocrine, and mammary glands all have similar phylogeny and cellular phenotypes, many lesions are unique to the salivary glands.  Various studies around the world reported incidence for all salivary glands tumors to be between 0.4 and 13.5 cases/100,000. Salivary gland swellings can be broadly classified into inflammatory, non- inflammatory and neoplastic swellings. Acute inflammatory conditions generally can be diagnosed by history and physical examination alone, whereas chronic inflammatory diseases and granulomatous disorders require supplemental diagnostic information including lab tests, imaging studies and biopsy. Accurate pathological diagnosis is necessary for proper management of neoplastic disorders. In this part of the world, the problem of these tumours is more troublesome in management because of their late presentation due to poor economic condition and lack of awareness of health among the general population. It is important to note that diffuse swellings usually signify disease of inflammatory nature. Discrete swelling within the gland usually indicates neoplasia and rarely replace entire gland until very late. Submandibular gland tumours are twice as likely to be malignant, compared to parotid. Sublingual gland tumours are unusual, 80% are malignant. 

Material and Methods: Patients included were those admitted to surgical wards with salivary gland swellings due to obstructions of the salivary duct and neoplasia and were willing to participate in the study for investigation and treatment. Patients, hemoglobin level, bleeding time, clotting time, urine, sugar albumin, microscopy, chest screening, ECG, Blood urea, serum Creatinine, RBS was estimated. Specific investigations like FNAC, X-rays of Mandible were done for all patients in the study group. After evaluation of the swellings by clinical examination and by specific investigations, a surgical plan was formulated. The final decision was taken per operatively by the surgeon. The required specimen was sent for histopathologocal examinations. Different modalities of treatment adopted in this study were, surgery or surgery and post-operative radiotherapy.

Results: Age of the patients varied from 9 years to 80 years. Average age of the patient was 40.6 years. Out of 40 cases 15(35%) cases was of male and 25(65%) cases of female. 62.5% (25 cases) were found in the parotid gland, 30% cases (12) in submandibular gland and 7.5% cases (3) in the sublingual gland. Out of 40 cases, neoplastic lesions of 65.0 %( 25 cases) and non-inflammatory non neoplastic lesions of 37.5% (15 cases) were seen. Out of 25 salivary gland

Keywords: SALIVARY GLAND, TUMOUR, MALIGNANT, BENIGN, FNAC, HISTOPATHOLOGY
NICOLAU SYNDROME DUE TO INTRAMUSCULAR DICLOFENAC SODIUM INJECTION
Authors: Shaafie Harris I , Agarwal Soumya , Mohanty Swosti , Jain Chandni
Published: March 2020

Nicolau syndrome (NS) is a rare complication characterized by tissue necrosis that occurs after parenteral injection of drugs. The exact pathogenesis is uncertain, but there are several hypotheses, including direct damage to the end artery, acute vasospasm and cytotoxic effects of the drug. Severe pain in the immediate post injection period and purplish discoloration of the skin with reticulate pigmentary pattern is characteristic of this syndrome. Diagnosis is mainly clinical and there is no standard treatment for the disease. Herein, we present a rare case of NS due to Diclofenac Sodium (Voltaren®) injection in an 80-year-old female suffering from Lower Respiratory Tract Infection (LRTI) who was managed conservatively.

Keywords: Nicolau Syndrome, Embolia cutis medicamentosa, Voltaren, Diclofenac sodium
COMPARISON OF CLONIDINE AND FENTANYL AS AN ADJUVANT TO INTRATHECAL 0.5% HYPERBARIC BUPIVACAINE IN PATIENTS UNDERGOING KNEE ARTHROPLASTY
Authors: Jethani Kushal , Sahu Preeti , Bansal Anjali
Published: March 2020

Background and Objective: Fentanyl and clonidine as adjuvants are commonly mixed with 0.5% bupivacaine heavy, by intrathecal route, for prolonging both sensory and motor blockade as well as for enhancing postoperative analgesia in patients undergoing major abdominal or lower limb surgery. This study was undertaken to compare the intraoperative effects and postoperative analgesia of fentanyl and clonidine, used as adjuvant to intrathecal bupivacaine during knee arthroplasty.

Methodology: This prospective, randomized study was conducted on 60 patients of ASA grade I or II, between 20 and 50 years of age divided into two groups of 30 each. The patients were given 3 ml of 0.5% hyperbaric bupivacaine with either 25 mcg of fentanyl (Group F) or 50 mcg of clonidine (Group C) intrathecally. The onset of sensory and motor block, the duration of blockade, hemodynamic parameters, sedation score, total postoperative analgesia time, and side effects if any were recorded.

Results: Both the groups were statistically comparable for demographic data, onset of sensory and motor blockade, duration of blockade and hemodynamic parameters. However, the sedation score was more in clonidine group. The duration of analgesia was significantly prolonged in clonidine group when compared with fentanyl group.

Conclusion: In comparison to fentanyl, addition of clonidine to intrathecal bupivacaine prolongs the duration of postoperative analgesia and cause a higher sedation score.

Key words: Bupivacaine, clonidine, fentanyl
PROSPECTIVE STUDY OF CORREALTION OF MRI FINDINGS AND CLINCAL SYMPTOMS IN LUMBAR SPINE DEGENERATIVE DISEASE
Authors: G Solanki Kunal , M Matadar Hadin
Published: March 2020

Introduction: Degenerative disease of the lumbar spine is a broad terminology which includes disc degeneration, Modic changes, disc displacement, facet joint arthropathy and associated complications. The modality of choice for imaging degenerative disease of lumbar spine is Magnetic Resonance Imaging (MRI) due to excellent soft tissue spatial resolution and better tissue segregation.The aim of this study was to establish correlation of MRI Findings and Clinical symptoms in lumbar spine degenerative disease.

Material and Methods: This descriptive cross-sectional study involved 100 patients; lumbar MRI scans were performed through L1 to S1 Intervertebral disc spaces. Clinical presenting symptoms of the patients were noted , followed by MRI in which mainly six degenerative findings were looked at which were disc degeneration, Modic changes, disc bulge, disc herniation, central canal stenosis and nerve root compression.

Results:   Most frequent degenerative finding on MRI, in markedly symptomatic patients was disc degeneration seen in 100% of patients, followed by diffuse disc bulge (92.5%) and nerve root compression (82.5%). The least common finding was Facet Joint Hypertrophy seen in 22.9% of patients. In Degenerative imaging findings there was no significant sex difference. Degenerative findings were more common at lower lumbar levels (L4/L5&L5/S1). Disc degeneration, disc herniations, central canal stenosis and nerve root compression were common in patients with radiculopathy than in patients with low back pain only. In Minimally symptomatic patients disc herniation  was not seen in any patient.

Conclusion:. The most frequent degenerative finding in  markedly symptomatic patients  was disc degeneration followed by diffuse disc bulge and nerve root compression. Posterolateral was the most common location for disc herniation. Disc herniation, disc degeneration, canal stenosis and nerve root compression were significantly seen in patients with radiculopathy. There were no sequestered discs found in the studied patients. All degenerative findings excluding disc herniation were also seen in lesser prevalence in minimally symptomatic patients.

Keywords: Degenerative Disease, Lumbar Spine, MRI, Disc Degeneration, Disc Herniation, Modic Changes, Clinical Symptoms, Back pain
TO FIND THE INCIDENCE OF POST OPERATIVE WOUND INFECTION IN UNCOMPLICATED ACUTE APPENDICITIS CASES USING SINGLE DOSE PREOPERATIVE ANTIBIOTIC
Authors: Prashar Vishal , Singh Shamsher
Published: March 2020

Background: The current practice in our hospital after appendectomy for uncomplicated acute appendicitis is continuation of antibiotics post operatively for 3- 5 days. No study regarding the duration of antibiotic use after appendectomy for acute uncomplicated appendicitis has been done in this institution before.

Methods: This randomized control prospective study was conducted in IGMC SHIMLA from August 2017 to July 2018. Cases of uncomplicated acute appendicitis undergoing emergency open appendectomy were included in this study.

Results: Out of 50 patients in group A, 5 (10%) developed wound infection. Out of 50 patients in group B, 4 (8%) patients developed wound infection. Over all incidence of wound infection was 9%.

Conclusion: Frequency of post operative wound infection is generally very low in uncomplicated appendicitis and single dose pre operative antibiotics are effective in preventing post operative wound infection.

Keywords: Uncomplicated appendicitis, SSI, Wound.
STUDY OF SERUM ADENOSINE DEAMINASE ACTIVITY IN TYPE 2 DIABETES MELLITUS AND ITS CORRELATION WITH SERUM URIC ACID AND GLYCATED HEMOGLOBIN.
Authors: Singh Supriya , Suri Arpita , Sinha Maheep , Fiza Bushra
Published: March 2020

Background & Objectives:

Diabetes Mellitus (DM) is a metabolic disorder characterized by an absolute or relative deficiency of insulin and insulin resistance or both. Adenosine deaminase (ADA) is an enzyme, that catalyses the irreversible hydrolytic deamination of adenosine to uric acid. The present study was undertaken to evaluate the level of serum ADA, serum uric acid and correlate it with Blood Sugar Fasting and Glycated Hemoglobin in patients of Type 2 DM.

Material and Methods: A total of 100 patients diagnosed for type 2 DM visiting the Outpatient Department of General Medicine and Endocrinology at Mahatma Gandhi Medical College & Hospital, Jaipur were enrolled for the study based on predefined inclusion and exclusion criteria. Blood samples were collected for all enrolled patients and analysed for the investigations like Serum BSF, HbA1c Serum ADA and serum Uric acid.

Results: In the study, all the parameters BSF, mean HbA1c, serum ADA and serum uric acid level were significantly higher in diabetic group in comparison to control group (p=0.000). The diabetic group were further subdivided on the basis of HbA1c levels, HbA1c ≤ 8% as good glycemic control and HbA1c > 8% as poor glycemic control. BSF, mean HbA1c, serum ADA and serum uric acid levels were observed to be significantly higher in poor glycemic control group as compared to that of good glycemic control. A significant positive correlation between S. ADA and HbA1c activity (r= 0.388) and between S. ADA and serum uric acid was also seen (r=0.252).

Conclusion: From the present study, it is concluded that there is an increase in serum ADA levels and serum uric acid level with increase in Glycated hemoglobin levels (HbA1c > 8%). Increase in serum ADA level was found to be associated with increase in Glycated hemoglobin levels which may play an important role in determining the glycemic status in diabetes. Further, increase in serum uric acid in levels could be due to increased activity of ADA, an enzyme that convert adenosine to uric acid. Hence, by analysing ADA levels and uric acid level in diabetes, glycemic control and insulin resistance can be assessed.
TO COMPARE THE EFFICACY OF CONCOMITANT BOOST RADIOTHERAPY AGAINST CONCURRENT CHEMORADIATION IN LOCALLY ADVANCED HEAD AND NECK CANCER (OROPHARYNX/LARYNX/ HYPOPHARYNX)
Authors: Pal Kapil Mohan , Rana Amit , Rana Priyanka , . Shalini , Gupta Manoj , Seam Rajeev , Gupta Manish
Published: March 2020

Background: Most head and neck cancers, indeed 95% or more, are squamous cell carcinomas (SCC) and variants thereof, originating from the epithelium of the mucosal lining of the upper aerodigestive tract (UADT), and adenocarcinomas from associated secretory glands.

Methods: This prospective randomized study was conducted in the Department of Radiation Therapy & Oncology, Regional Cancer Centre, IGMC, Shimla and patients were enrolled for a period of one year, from July 2012 to July 2013.It included all the eligible, previously untreated patients of squamous cell carcinoma of Head and Neck with histologically confirmed diagnosis and no evidence of distant metastasis. The sites included were oro-pharynx, hypo-pharynx and larynx with stages III, IV A and IV B.

Results: On first follow up, overall there was complete response at nodal site in 50 patients(69.4%) 26 in CRT arm (70.3%) and 24 in ART arm(68.6%), however the difference was not statistically significant (p=0.875).

Conclusion: There was comparable locoregional disease control with the use of accelerated six fractions a week radiation therapy compared to concomitant chemoradiation with conventional fractionation.

Keywords: Six fraction, Concomitant chemoradiation, Conventional fractionation.
EFFICACY AND SAFETY OF LOW DOSE ATROPINE 0.01% IN SLOWING OF PROGRESSION OF MYOPIA
Authors: Gupta Shalini , Gupta Poonam , Verma Rashi , Gosh Basudeb , Bhardwaj Rakesh
Published: March 2020

Background: Myopia, commonly referred to as short sightedness is a form of refractive error and is a very common cause of visual disability throughout the world.

Methods: Hospital based prospective study conducted on 100 patients of Myopia attending to Department of Opthalmolgy.

Results: There was no significant difference in the age, gender distribution, baseline myopia progression or follow-up duration between patients who used night application compared with daytime atropine. Effectiveness was better with daytime application.

Conclusion: 1% atropine eye drops were well tolerated and efficacious for the retardation of progressive myopia in Indian eyes. Effectiveness was better with daytime application. Further studies are necessary to assess the role of 1% atropine in the rapid progressors and patients poorly responding to low-dose atropine.

Keywords: Myopia, Atropine, low dose.
DYSLIPIDEMIA IN THYROID DISORDERS
Authors: Kumar Ashok , Gupta Saurabh , Nimbalkar Vaishali
Published: March 2020

Background: Thyroid hormones have profound metabolic effects, the most striking action being an increase in energy expenditure. Thyroid hormones play an important role in regulating lipid metabolism; and thyroid dysfunctions can result in lipid abnormalities which increase the risk of endothelial dysfunction, hypertension and cardiovascular disease.

Methods-A cross-sectional study was conducted on 100 patients with suspicion of thyroid disorders were taken as cases. One hundred patients with normal thyroid profile and no history of other chronic diseases were taken as control group.

Results- The serum TC, TG and LDL levels in hypothyroid individuals (both overt and subclinical) were significantly higher than euthyroid subjects but the levels were comparable between hyperthyroid and euthyroid group.

Conclusion: We conclude that, dyslipidemias are associated with thyroid disorders, so biochemical screening for thyroid dysfunction in all dyslipidemic patients. Therefore, patients presenting with dyslipidemia are recommended for investigation to explore thyroid dysfunction.

Keywords: Total cholesterol, Triglycerides and LDL.
AN AUDIT ON PATTERN OF MORTALITY IN A MEDICINE ICU AT TERTIARY CARE HOSPITAL OF NORTH-EAST INDIA
Authors: Pal Achintya , K Prashanth
Published: March 2020

Background: Mortalities in medical Intensive Care Units (ICUs) are largely variable. Intensive care medicine has developed significantly over time. But still it is unpredictable in terms of pattern of mortality.

Materials and Methods: A total of 266 patients who died in the ICU of a tertiary care Hospital over the period of one year were studied retrospectively to review the mortality pattern.

Results: Out of 266 patients Male comprised 71.8% and female 28.2 %. Patients from rural area were 70.7% where as 29.3% belong to urban society. Among the study population preexisting diabetic and hypertensive patients were 10.5% and 16.5 % whereas 12.4 % were suffering from both. 56% of the study population was from more than 60 years age group. Sepsis (26.3%) was the leading cause of death followed by stroke (19.9%) and COPD (13.9%). Mean duration of hospital stay among study population was 7.61 days.

Conclusion: Sepsis, stroke, respiratory and cardiovascular diseases are the leading causes of mortality in our study. Prospective, larger, more studies regarding ICU mortality should be carried out for policy planning to improve the healthcare resources.

Keywords:  mortality pattern, Intensive Care Unit, sepsis
EVALUATION OF FACTORS RESPONSIBLE FOR THE OCCURRENCE OF ORAL SUBMUCOUS FIBROSIS IN PATIENTS REFERRED TO DARBHANGA MEDICAL COLLEGE AND HOSPITAL
Authors: Kumar Keshav , Chettiankandy TabitaJoy
Published: March 2020

Oral submucous fibrosis (OSF) is a chronic progressive and irreversible disease affecting the oral, oropharyngeal, and sometimes the esophageal mucous. OSF is a disease that causes changes similar to those of systemic sclerosis (scleroderma) but limited to oral tissues. The disease is seen in those from the Indian subcontinent and from many parts of South-East Asia. It causes significant morbidity (in terms of loss of mouth function as tissues become rigid and mouth opening becomes difficult) and mortality (when transformation into squamous cell carcinoma occurs). The introduction of chewing tobacco containing areca nut into the market has been associated with a sharp increase in the frequency of OSF. Hence based on above findings the present study was planned for Evaluation of Factors Responsible for the Occurrence of Oral Submucous Fibrosis in Patients Referred to Darbhanga Medical College and Hospital.

The present study was carried out in the Department of Dentistry, Darbhanga Medical College and Hospital Laheriasarai, Darbhanga Bihar. In the present study 30 cases of the oral submucous fibrosis were enrolled.

Oral submucous fibrosis (OSMF) is a chronic insidious disease affecting any part of the oral cavity and sometimes the pharynx. Although, occasionally preceded by or associated with vesicle formation, it is always associated with a juxta-epithelial inflammatory reaction. It is important that preventive efforts be carried out by the concerned authorities and public health professionals in establishing tobacco cessation clinics and tobacco awareness education in such masses (especially the young generation) along with a long standing and a close knit motivation program that enables our future generations to come to avoid the menace of tobacco and its subsequent health effects.

Keywords: Oral submucous fibrosis, OSF, oral cavity, Bihar.