bluuebunny/crossref_metadata_2025 huggingface dataset:
The THE ENHANCED LIVER CIRRHOSIS TEST (ELF) ACCURATELY IDENTIFIES CIRRHOSIS IN PATIENTS WITH CHRONIC LIVER DISEASE
Authors: Amer Abdulrahman Hefdhallah , Shah Dr.  Hitesh N
Published: June 2019

Chronic liver disease (CLD) is the leading cause of death worldwide. That caused by Viral Hepatitis B and C (HBV, HCV), Alcoholic Liver Disease (ALD) and Non-Alcoholic Fatty Liver Disease (NAFLD). The present article provides an overview of the literature reporting some relevant biomarkers (ELF test) that have been found to be associated with liver fibrosis and that potentially may be used to predict the onset and/or monitor the progression of liver cirrhosis alternative the liver biopsy. This article provides an overview of the current published evidence on the clinical utility of the ELF test. This review collects the main evidence on the emerging role of Enhanced Liver Fibrosis (ELF) score as a prognostic marker of hepatitis, cirrhosis, and other liver diseases as the marker in cases of intoxication with organ phosphorus compounds and myocardial infarction or acute infections, and evidence that proves to use the Enhanced Liver Fibrosis as clinical practice presents an attractive alternative to both biopsy and imaging modalities that require significant high costs, also trained clinician.The most recent study proves that enhanced liver fibrosis score can be used instead of liver biopsy test and Transient Elastography for diagnosing liver fibrosis.

Keywords: Enhanced Liver Fibrosis Score, Transient Elastography, Liver, Liver Biopsy, Liver Diseases Alcoholic Liver Disease (ALD) and Non-Alcoholic Fatty Liver Disease (NAFLD).
WOULD MANDATORY TEACHING OF BLS, ACLS AND PALS IMPROVE THE KNOWLEDGE, ATTITUDE AND PRACTICE OF MEDICAL STUDENTS IN EMERGENCY CARE?
Authors: James Treasa , K.N. Dr. Mohammad Fabin , Mutalik Dr. Anirudh V , P Dr. Ubaid N. , Cherian Dr. N C , V Mrs. Reshma
Published: June 2019

Background and objective: The medical students should be trained in BLS/ACLS/PALS in order to attain the skills for emergency patient management. The objective of the study is to compare the knowledge, attitude and practice about BLS/ACLS/PALS among the interventional and non-interventional groups both before intervention and after intervention.

Methods: This interventional study was done among final year medical students and house surgeons in six Medical colleges of Northern Kerala.The study subjects were categorized into two groups,Category 1 received an orientation class on BLS/ACLS/PALS and students belonging to category 2 did not receive the orientation class. A pre-validated pretested questionnaire to assess the Knowledge, Attitude and Practice of medical students regarding BLS/ACLS/PALS was distributed after the orientation class.The control group (category 2) who did not receive the orientation class also were given the questionnaire same as that of other group.

Results: Total of 608 students participated in this study.Out of which 325 received an orientation class. Unpaired t-test done in pretest among interventional and non-interventional group showed p value>0.01 which implied that both groups were comparable. The mean scores of Knowledge, attitude and practice in the post test increased to 8.111±1.507, 2.328±.743, 2.065±.297 among house surgeons and an increment to 6.260±1.087, 2.277±.474, 1.659±.659 among final years in the interventional group as when compared with the scores of the non-interventional group. Paired t test also showed significant difference among interventional group while there was no change in the non-interventional group.(p>0.05).

Conclusion: BLS/ACLS/PALS training among undergraduates can improve the Knowledge, Attitude and Practice of medical students thereby increasing the resuscitation as well as the survival of patients in emergency care.

Keywords: BLS, ACLS , PALS, Resuscitation
EVALUATION OF ONE STAGE MODIFIED MATHIEU’S URETHROPLASTY FOR DISTAL PENILE HYPOSPADIAS IN BIHAR POPULATION
Authors: Satyapal Dr. Shyam Kumar
Published: June 2019

With an incidence of 1:300, hypospadias is one of the most common genital anomalies in male newborns. Hence the present study was planned to evaluate the one stage Flip- flap procedure to repair Distal Penile Hypospadias. Mathieu’s technique (peri-meatal based flap) makes use of the urethral plate in the repair of anterior hypospadias, thereby creating an almost natural neo-urethra. In a circumcised baby or after previous unsuccessful repair, Mathieu’s flap may be one of the few options left to repair anterior hypospadias.

A total of fourteen patients were included in this study. Their age ranged from 1-13 years, mean age was 4.9 years. Construction of neourethra is generally recommended to be completed before the school going age. The 14 cases of hypospadias are primary repaired by modified Mathieu’s  Flap technique to achieve both cosmetic and functional normality. An overall success rate of 87.5% was achieved and In the remaining 14% of the cases, success was achieved with only one additional procedure.

The protocol followed the recommended guidelines of surgery. The present study was planned in the Department of Plastic Surgery, Pulse Emergency Hospital, Patna, Bihar. Total surgeries done from Oct 2016 to Nov 2017 were included in the present study.

The present study concludes that in a developing country like India with rural patients having poor access to good healthcare facilities. One stage Repair is beneficial in many ways. The follow-up compliance of poor rural patients is extremely poor because they need to come to the urban cities for treatment. The authors have seen multiple cases where the patients have gone for the Chordee Correction (first stage of a two-stage repair) in childhood and then reported after a decade.

Keywords: Hypospadias, MAGPI, Mathieu flap, Single-stage repair, etc.
SUBSTANCE ABUSE AMONG IMMIGRANT CONSTRUCTION WORKERS
Authors: Meena Dr. Rattiram , Acharya Dr. Rekha , Acharya Dr. Aarti
Published: June 2019

Background: Substance abuse can simply be defined as a pattern of harmful use of any substance for mood-altering purposes. "Substances" can include alcohol and other drugs (illegal or not) as well as some substances that are not drugs at all.

Methods: This cross sectional study was conducted among the migrant workers working in Bikaner Rajasthan, over the time duration of 3 months. All migrant laborers above the age group of 18 years were included in the study. Data was collected from ante-natal register using Predesigned, pretested, validated and structured proforma.

Result: In our study prevalence of substance abuse was found to be among 84.00% of participants. 44.8% of the study participants were consuming alcohol, 50.2% of the study participants were chewing tobacco.

Conclusion: The result of the present study suggests that substance abuse among migrant workers was very high. Policy makers must pay extra attention to the health of migrants by implementing safety measures and organizing intense behaviour change communication.

Keywords: Alcohol, Smoking, immigrant construction workers
EPIDEMIOLOGY AND OUTCOMES OF ELECTRIC BURN INJURY AT TERTIARY CARE CENTER IN JODHPUR, RAJASTHAN
Authors: Saraswat Bharti , Yadav Ashok , Maheshwari Krishna Kumar
Published: June 2019

Background- Electric burns and injuries are the result of electric current passing through the body. Temporary or permanent damage can occur to the skin, tissues, and major organs.

Methods- This prospective study was carried out on patients admitted in burn unit of department of surgery M.G. Hospital associated with Dr. S.N. Medical College Jodhpur. Records of the patients admitted from January 2018 to December 2018 were studied. Bed head tickets of the patients evaluated in detail.

Results- In our study out of 113 patients maximum no. of patients were in age group of 21-30 years 44 (38.94%) followed by age group <11 years in 21 (18.58%) patients and age group of > 60 years in only 3 (2.65%).39 (34.51%) patients were farmer and 15 (13.27%) were electrician in out of 113 total patients, while 37 (32.74%) were without any occupation. 65 (57.52%) cases of high voltage (HV) electrical injury and 48 (42.48%) cases were of low voltage (LV) electrical injury.

Conclusion- Morbidity leading to permanent disabilities make the person physically dependent on others. It can be prevented by educating the people about the proper handling to electric circuits & devices. Proper communication among the electricians may help in lowering such accidents. Proper rehabilitation of the handicapped person & employment to the member of the affected family may reduce the social burden caused by such electricity concerned accidents.
KNOWLEDGE, ATTITUDE AND PRACTICES RELATED TO CERVICAL CANCER
Authors: Saxena Ruchi , Saxena Gajendra
Published: June 2019

Background:   Cervical cancer is the second most common cancer among women worldwide.   Eighty-six percent of all cervical cancer diagnosed and 88% of death due to cervical cancer occur in developing regions of the world

Material and methods: A facility based cross sectional study was done 500 women of reproductive age group (15-45 years).

Results:  A total of 500 women are approached for interview, in which 420(84.00%) had not heard about cervical cancer, only 16.00% women had knowledge about cervical cancer. About 80.00% women had positive attitude about cervical cancer screening & it’s vaccine.

Conclusions: Women need more information about cervical cancer risk factors, symptoms and screening program.
EFFECTS OF THYROID DYSFUNCTION ON LIPID PROFILE
Authors: Kumar Dr. Vinod , Mathur Dr. S.L. , Tuteja Dr. Rajat Kumar
Published: June 2019

Background: Thyroid function regulates a wide array of metabolic parameters. Thyroid function significantly affects lipoprotein metabolism as well as some cardiovascular disease (CVD) risk factors, thus influencing overall CDV risk.

Methods: A cross sectional study has been conducted to assess the association of subclinical hypothyroidism and overt hypothyroidism with lipid abnormalities.

Results: Serum HDL cholesterol in group A was 37.97±7.97 mg/dl, that  in group B was 37.62±6.67 mg/dl, while in group C it was 36.27±5.79 mg/dl. Serum LDL cholesterol in group A was 150.9±29.70 mg/dl, that  in group B was 115.2±22.02 mg/dl, while in group C  it was 93.07±19.88 mg/dl. Serum total cholesterol in group A was 223±32.69 mg/dl, that in group B was 179.67±27.50 mg/dl, while in group C it was 152.4±21.47 mg/dl. Serum VLDL cholesterol in group A was 34.12±11.06 mg/dl, that in group B was 26.85±4.01 mg/dl, while in group C it was 23.05±3.09 mg/dl. Serum VLDL cholesterol in group A was 167.42±47.83 mg/dl, that in group B was 134.37±20.22 mg/dl, while in group C it was 115.17±15.66 mg/dl.

Conclusion: Thyroid dysfunction can have an important effect on lipid profile. Biochemical screening for thyroid dysfunction is critical in all dyslipidemic patients, as well as in all patients with unexpected improvement or worsening of their lipid profile.

Keywords: LDL,HDL,Cholesterol.
CRYPTORCHIDISM WITH BILATERAL SYNCHRONOUS TESTICULAR GERM CELL TUMOUR
Authors: Choudhary Dr. Garima , Kumar Dr. Vanita , Dawan Dr. Sharda , Fatima Dr. Qadir , Gupta Dr. Neelu
Published: June 2019

Cryptorchidism or undescended testis is a very common anomaly of the male genitourinary system. It is one of the established risk factors for testicular tumour. The commonest malignancy noted in cryptorchidism is seminoma testis. The presence of bilateral synchronous testicular tumour in cryptorchidism is very rare.
SERUM PROLACTINE LEVEL IN PATIENTS OF PSORIASIS VULGARIS AND ITS CORRELATION WITH DISEASE SEVERITY: A CASE-CONTROL STUDY
Authors: Saini Pawan Kumar , Yadav Devendra , Badyal Rozy , Jain Suresh , Singh Arti , Vijay Mamta
Published: June 2019

Background: Psoriasis is an autoimmune chronic inflammatory disorder affecting the skin mediated by T-lymphocytes resulting in production of cytokines which cause hyperproliferation of keratinocytes.  Several factors and hormones like Prolactin have an action similar to these cytokines in promoting the multiplication of keratinocytes and other cells like lymphocytes and epithelial cells may have a role on the etiopathogenesis of psoriasis.

Aim:-The aim of study is to compare the serum Prolactin levels in patients of psoriasis with a control group.

Setting and study design: This is a case-control study conducted in the department of Dermatology, Venereology and Leprosy GMC, Kota over a period of 1year from July 2017 to June 2018

Material and method: The study included 100 cases of psoriasis (60 males and 40 females) and 100 controls similar for age and sex. Serum Prolactin levels were measured by ECLIA and results were obtained.

Statistical analysis: Mean and standard deviation were calculated for each variable. Statistical significance of the results was analyzed using correlation analysis (Pearson correlation coefficient) and independent samples t-test.

Statistical significance was assumed at p value<0.05.

Result: Serum Prolactin level was significantly higher in cases of psoriasis compared to controls (p-value <0.001). PASI score and serum Prolactin levels were found to have a positive correlation (r value = 0.337; p-value: 0.001). No significant  correlation was found between serum levels of Prolactin and duration of disease r value= -0.034, P value =0.733). Serum Prolactin level was higher in male patients compared to females patients.

Conclusion:- High serum Prolactin may be a biological marker of disease severity in psoriasis and may have a role in the pathogenesis of psoriasis. Further studies with large sample size are required to confirm this hypothesis.
STUDY OF SERUM LIPID PROFILE LEVEL IN CORONARY ARTERY DISEASE PATIENTS
Authors: Patel Shesharam , Patel Kanaram
Published: June 2019

Background: Adverse lipid profile has been recognized as an independent risk factor for atherosclerosis and coronary artery disease (CAD).

Materials and Methods: 100 subjects aged between 35 to 65 years, comprising of 50 normal control and 50 patients suffering from CAD were studied.

Result: The mean total cholesterol level was found to be 174.2±21.05 mg/dl with a range of 150-200 mg/dl present in normal subjects and mean concentration of cholesterol level was increased to 254.23±45.70 mg/dl in CAD patients. The mean Triglyceride level was found to be 117.58±44.16 mg/dl with a range of 75-150 mg/dl present in normal subjects and mean concentration of Triglyceride level was increased to 184.24±42.02 mg/dl in CAD patients.  

Conclusion: This cross sectional study showed that high serum cholesterol, LDL, triglyceride and low HDL cholesterol were clinically significant in all the age groups.

Keywords:  Coronary artery disease (CAD), Cholesterol, Triglyceride, LDL, HDL.
ANALYSIS OF CERVICAL PAP SMEARS AS PER BETHESDA SYSTEM IN A TERTIARY CARE CENTRE.
Authors: Ajmera Dr. Arpita , Kucheria Dr. Mohini , Kathed Dr. Vivek , Farooque Dr. Taiba , Sharma Dr. Nidhi , Chourasia Dr. Sushma
Published: June 2019

Background: The value of exfoliative cervical cytology is undisputed today.  Most studies focus on the application of pap smears to detect precancerous and cancerous lesions but pap smears are also significant in detecting inflammatory lesions and etiology wherever possible which can help the clinician in the management and prevent further dysplasias.

Aim & Objectives: To find out the prevalence of various non-neoplastic and neoplastic lesions of cervix as per the Bethesda system 2014 and to find out the etiology of inflammation wherever possible.

Methodology: This study was conducted over a period of one year from January 2017 to January 2018. 1518 pap smears received in the Department of Cytology were stained with pap stain & reported according to 'The 2014 Bethesda System for reporting cervical cytology'.

Results: 1518 pap smears were screened in which 28 (1.8%) smears were unsatisfactory for evaluation and 1490 (98.2%) were satisfactory. NILM was the predominant finding seen in 1473(98.86%) smears. Among the specific infections, the most common was bacterial vaginosis in 128 (8.59%) smears, trichomonas vaginalis in 10 (0.67%), candida infection in 7 (0.47%) smears and 26 (1.75%) smears showed reactive changes associated with inflammation. Atrophic changes were found in 50 (3.36%) cases. Epithelial cell abnormalities were seen in 17 (1.17%) cases in which 9 (0.6%) cases were reported as ASCUS, 2 (0.13%) cases as LSIL and HSIL was seen in 1 (0.07%) case. Squamous cell carcinoma (SCC) was diagnosed in 4 (0.27%) cases and Adenocarcinoma in 1 (0.07%) case.

Conclusion: Cervical cytology is a simple and cost effective test and should be established as a routine diagnostic aid.

Keywords: Atypical squamous cells of undetermined significance (ASCUS), Bethesda System, High grade squamous intraepithelial lesion (HSIL), Low grade squamous intraepithelial lesion (LSIL), Negative for intraepithelial lesion or malignancy (NILM),  Papanicolaou smears.
TO COMPARE THE MORBIDITY AND MORTALITY PATTERN OF LATE PRETERM AND TERM NEONATES.
Authors: Eske Dr. Gunwant Singh , Dehariya Dr. Rashmi Ekka
Published: June 2019

This is a hospital based prospective observational study, carried out at Gajara Raja Medical College, Gwalior. All the inborn late preterm babies have been included in the study. Selection of late preterm neonates is done by determination of gestational age.

In our study Neonatal convulsions were more common among the late preterm neonates as compare to term group.

In our study jaundice, septicemia, respiratory distress and hypoglycemia were found as major morbidities, among late preterm the rate was found to be 9%,7.8%,7.6% and 6% respectively while in term group the rate was 3.34%, 3.38%, 3.41% and 2.56% respectively. Occurrence of these morbidities among late preterm neonates as compared to term group is at higher aspect.

Keywords: Morbidity, Mortality, Preterm, Term & Neonates
ASSESSMENT OF FLOW MEDIATED DILATATION OF BRACHIAL ARTERY BY ANGIODEFENDER DEVICE AS COMPARED TO BRACHIAL ARTERY ULTRASOUND IMAGING.
Authors: Sharma Mukesh Kumar , Chandan Chandra Bhanu , Shukla Abhishek , Ameta Deepak , Kurmi Pradeep
Published: June 2019

Aims & Objectives: To demonstrate, Angiodefender device, is comparable to “Brachial artery ultrasound imaging” (BAUI) in their abilities to quantify percentage flow mediated vasodilation (FMD) of the brachial artery. Methods: Study was conducted on 100 patients, flow mediated vasodilation was measured by BAUI as well as by the Angiodefender device and the results were compared.

Results: The mean %FMD measured by the BAUI was found to be 7.46 ±  4.21 whereas mean %FMD measured by the Angiodefender was 8.24 ±  2.46, (p value 0.113). Positive correlation was found between both the tests with correlation coefficient of 0.65, p value < 0.0001 which is highly significant.

Conclusion: Results obtained by both the methods were comparable there was no significant statistical difference. Positive correlation was highly significant between both the tests with correlation coefficient of 0.65.

Keywords: Brachial artery ultrasound imaging, Angiodefender, Flow mediated vasodilation
CYTODIAGNOSIS OF HEPATIC LESIONS AND THEIR ASSOCIATION WITH SERUM ALPHA FETOPROTEIN LEVELS
Authors: Tamanna Sehgal , Anuradha Kusum , Vivek Ahuja
Published: June 2019

Background: Liver is a common organ for lodgement of various infections and metastasis from other parts of body. Fine needle aspiration cytology (FNAC) plays a major decisive diagnostic role and combined with USG diagnostic accuracy is 90-95% minimizing the need of biopsy. An increased in serum AFP concentration has been observed in Hepatocellular Carcinoma (HCC) and is an important serum tumor marker. Methods: The present study was done, with the aim of studying the cytomorphological features of hepatic lesions and their association with serum Alpha Fetoprotein (AFP) levels. Study was conducted on 56 patients who underwent USG guided FNAC for diagnosis of liver lesions. Cytomorphological pattern of liver lesions were studied and serum AFP levels of the same cases were measured. Results: Maximum number of cases was in age group of 61-70 years. Male: Female ratio was 1.4:1. 82.1% cases were malignant. Most common malignancy was Metastatic deposits of Adenocarcinoma (MDA). HCC was diagnosed in 5.4% cases. Serum AFP levels in HCC were 459.93 ± 41.69 ng/mL.15.4 % of the cases of MDA and 8.3% of the cases of Metastatic deposits of Poorly Differentiated Carcinoma (MDPDC) showed raised serum AFP levels. Association between cytodiagnosis and serum AFP range was statistically significant. Sensitivity=100%, specificity=81.4%, PPV=27.3% and NPV= 100% were obtained when serum AFP was used to differentiate metastatic lesions with HCC taking < 8.5ng/mL as cut off. Conclusion: USG guided FNAC of the liver is a rapid, reliable and economical screening test. Serum AFP has been the most widely used tumor marker for diagnosing HCC but raised levels are also seen in other hepatic lesions decreasing its specificity.

Keywords: Liver, FNAC, Serum Alpha fetoprotein levels
MOLECULAR AUTOPSY: EVALUATION OF SUDDEN UNEXPECTED DEATH CASES IN TERMS OF “KCNQ1” GENETIC VARIATION
Authors: Kaya Kenan , Gülmen Mete Korkut , Serin Ayşe , Çekin Necmi , Hilal Ahmet
Published: June 2019

Background: Deaths occuring without a known disease and/or a known cause, deaths with non-lethal diseases are interpretated as sudden-unexpected-suspected deaths. Autopsy should always required to evaluate the cause of death. Some of the cases can be termed as negative autopsy since the cause of death can not be determined. This is one of the main interests of the future forensics. Molecular autopsies are one of the main practices of to reduce the negative autopsy ratios. Thus, post-mortem KCNQ1 genetic variation tests are done in sudden unexpected death cases.

Material and methods: In this study 0 – 50 years old sudden-unexpected deaths autopsy cases were handled. Samples taken from cases were evaluated and “KCNQ1” genetic variation tests were done in our Department.

Results: This study included 47 cases of 42 sudden unexpected death cases (0 – 50 age group) and 5 control group. 15 cases were between 40 – 50 age group and number of cases were increasing with age. 29 of cases (% 69) were male. Evaluation of body-mass index of cases were done and normal weighted cases were the most common with 21 cases (% 50). According to death locations; 17 cases had died (% 45,9) at home. Death location records of 5 cases couldn’t be found. Pathological examinations of all cases were done. We had identified fibrosis and fatty change appearances in SA node of 9 cases (% 21,4) and AV node of 13 cases (% 30,9) especially in conduction tissue examinations. As the result of KCNQ1 genetic analysis of cases, we identified sequence variations in 1638th nucleotid of exon 13 and 1986th nucleotid of exon 16.

Conclusion: Cases with conduction system pathology and sequence variations of KCNQ1 genetic analysis shows that we are in need of these tests among routine practice to reduce negative autopsy ratios.

Key words: KCNQ1, molecular autopsy, sudden unexpected death, conduction system, negative autopsy.
TO STUDY THE ETIOLOGICAL PROFILE IN CHRONIC KIDNEY DISEASE PATIENTS
Authors: Choudhary Dr. Sukh Dev , Lakhotia Dr. Manoj , Choudhary Dr. Himanshi , Gandhi Dr. Ronak
Published: June 2019

Background: Chronic Kidney Disease (CKD) is determined by the presence of kidney injury and by the level of renal function, assessed according to the glomerular filtration rate.

Methods: This observational case study will be conducted among patients of newly diagnosedor known cases of chronic kidney disease admitted or attending outdoor clinic at Mahatma Gandhi Hospital Jodhpur.

Results: Twenty three patients out of 75 were diabetic, 19 patients had chronic kidney disease of unknown etiology and 12 had both DM and HTN, only one patient had CKD because of RCC.

Conclusion:  Most common etiologies of CKD patients on hemodialysis are Diabetic nephropathy.

Keywords: Chronic Kidney Disease (CKD), Hypertension, Diabetes.
EFFICACY OF CRYSTALLOIDS AND COLLOIDS AS PRELOADING FLUIDS TO PREVENT HYPOTENSION IN SPINAL ANESTHESIA IN ELECTIVE C-SECTIONS
Authors: Yadav Dr. Seema , Verma Dr. Rajendra
Published: June 2019

Background: Different crystalloids commonly used in preloading are Ringer lactate, normal saline and colloids that are used in preloading are gelatin, dextran, hetastarch, pentastarch, tetrastarch. This study was aimed to compare the efficacy of both as preloading infusion to prevent hypotension, requirement of vasopressors and requirement of total fluid given during surgery to maintain stable hemodynamics

Methods: This randomized control trials was conducted in the Department of Anaesthesia , R.V.R.S. Medical College, Bhilwara.  60 patients between 18- 40 years of age, belonging to American society of anaesthesia grade I or II going for elective caesarian section under spinal anesthesia were screened for the study eligibility criteria

Results: In group (I), in 20 females, efficacy was achieved while in 10 females efficacy could not be achieved because of drop in BP. In group (II), in 22 females, efficacy was achieved while in 8 females, efficacy could not be achieved. The difference between both groups was statistically insignificant but there were more females in group II in which efficacy was achieved. (p-value=>0.05)

Conclusion: According to this randomized trial we did not find any significant difference between both groups for prevention of hypotension.

Keywords: Anesthesia, coload, hypotension, preload, spinal
PROSPECTIVE STUDY OF DIAMETER OF APPENDIX IN DIAGNOSIS OF ACUTE APPENDICITIS
Authors: Nath Dr. Kedar , Meena Dr. Deepika , Meena Dr. G. L.
Published: June 2019

Background: Acute abdominal pain is a common complaint among emergency department patients. Diagnostics of one of the most common pathologies behind acute abdominal pain, acute appendicitis, has radically changed over the last decades.

Methods: The source of data was from pretested proforma which takes into account clinical history, general physical examination, relevant investigations, imaging modalities.

Results: In our study appendix diameter test sensitivity was 95.02%, specificity was 86.24 %, positive predictive value was 97.24%, negative predictive value was 64.66% and diagnostic accuracy was 94.00%.             

Conclusion: Measuring appendix diameter by USG pre-operatively reducing the rate of negative explorations

Keywords: Appendix diameter, Appendectomy, negative explorations
A CROSS SECTIONAL STUDY OF TREATMENT INCLUDING LIFESTYLE MODIFICATION ADHERENCE IN PATIENTS WITH TYPE II DIABETES MELLITUS AND FACTORS AFFECTING TREATMENT ADHERENCE
Authors: G Niraimathi , S Sivaraman
Published: June 2019

Diabetes mellitus is a growing cause of disease burden worldwide. In order to maintain the glycemic control, multifaceted management and pharmacotherapy are playing vital role. Data related to medication adherence among the affected patients are not much recorded in developing countries like India. In this study, the level of adherence and factor influencing non-adherence to diabetic medication among patients with type II diabetes was assessed. This is a hospital based cross sectional study among adult patients receiving diabetic care. The medication adherence was assessed using the Medication compliance questionnaire. Factors associated with non-adherence to medication were determined using basic and adjusted multivariable logistic regression models. A total of 101 patients with type II diabetes were recruited for this study. Most of the patients told that they practiced both aerobic exercises and diet along with their medication for diabetic management. Nearly 90% of the patients adherent to diet and maximum of 73% patients took oral hypoglycemic agents (OHA) alone followed both combination of OHA and insulin. Out of 101 patients, 67 had co-morbid psychiatric illness including mood disorders, neurotic stress and somatoform disorder. Adherence to treatment with diabetic is moderate in this study with more than half of participants being non-adherent. Urgent interventions are required to tackle this problem in combined efforts to stem this looming diabetes epidemic.

Keywords: Diabetes mellitus, life style modifications, treatment adherence
FUNCTIONAL OUTCOME OF SUB- TROCHANTRIC FRACTURE TREATED BY LONG PFN
Authors: Pipal Dr. Rajendra , Yadav Dr. Seema
Published: June 2019

Background: Hip fractures are a growing concern for the orthopedic surgeons all over the world because the incidence of hip fractures is increasing dramatically and these fractures impose a significant challenge in their efficient management.

Methods: It was a prospective study on 50 cases of proximal femoral fractures. The fractures were classified according to Seinsheimer classification. Salvati and Wilson Score were used for functional assessment.

Results: According to Salvati and Wilson scoring system excellent results were seen in 80% of cases (40 patients), good results in 16% cases (8 patients), fair result in 4% cases (2 patients) and poor results in (0% patients).

Conclusions: PFN is safe, effective and patient friendly device useful for the treatment of all subtrochanteric fractures irrespective of their comminution.

Keywords: Proximal femoral nail, Subtrochanteric fractures, Proximal femur fracture
EVALUATION OF RESULTS OF INTERNAL FIXATION OF CLOSED, DISPLACED, RECENT FRACTURE SHAFT OF HUMERUS BY MIPPO TECHNIQUE
Authors: Datta Alok Sobhan , Velagada S. , Haque A.
Published: June 2019

BACKGROUND: The humerus shaft fracture is the second most common fracture of the upper extremity. The predominant causes of humerus shaft fractures include low energy trauma such as fall from a standing height in older population, while in the younger population it is caused by high energy trauma.

Aims and Objectives - To investigate the effectiveness of economical MIPPO technique and to determine the radiological and functional significance of MIPPO technique in the patients undergoing treatment for recent fracture shaft of humerus.

MATERIALS AND METHODS: A prospective study had been carried out from December 2012 to August 2014 in the Orthopaedics Department of SSKM Hospital, Kolkata, West Bengal, India. Thirty three patients, who presented with fracture shaft of humerus and underwent fixation of humeral shaft fractures by MIPPO technique were included in this study. Complete history was taken and full clinical examination was carried out.

RESULTS: The average age group in our study is 35.3 years. Of them 85% are male and 15% are female. In majority cases, mode of injury was road traffic accident. 85% cases had middle 1/3rd fracture shaft of humerus and the average time interval between the injury and surgery was 8.54 days.

CONCLUSION: The results obtained in this study have shown that the MIPPO technique is safe, convenient and effective, since there was minimal soft tissue injury with no major complications.

KEYWORDS: Minimally Invasive Percutaneous Plate Osteosynthesis (MIPPO); Road Traffic Accident (RTA).
IDENTIFICATION OF PREDISPOSING FACTORS FOR RECOVERY OF RANGE OF MOTION OF KNEE AFTER TOTAL KNEE ARTHROPLASTY
Authors: Datta Alok Sobhan , Velagada Sandeep
Published: June 2019

BACKGROUND: Knee joint arthroplasty is the standard treatment for severe dysfunction of the knee aiming to make the knee pain free as well as to stabilise it with an appropriate range of motion.

Aims and objectives: To assess whether the postoperative functional recovery of range of motion of total knee arthroplasty depends on objective and subjective parameters.

MATERIAL AND METHODS: A prospective study comprising of twenty six cases who underwent total knee arthroplasty had been carried out from November 2013 to October 2015, in the in the Orthopaedics Department of IPGMER and SSKM Hospital, Kolkata, West Bengal, India.

RESULTS: The mean age group in our study is 35.3 years and 69.2% were females. Left side surgeries were more common (57.7%). Mean fixed flexion deformity decreased significantly from 10.8396 to 0.7692 postoperative 1 year. Mean preoperative extension lag was 2.3077 degrees and postoperative extension lag was 4.0385 degrees.

CONCLUSIONS: Total knee arthroplasty is the standard treatment for severe destructive arthritis of the knee with an aim to provide stable, painless and mobile joint. Based on the findings of this study, preoperative arc of flexion, mediolateral laxity and preoperative tibiofemoral varus/valgus angle have a significant influence on the postoperative flexion, which means they are important factors for predicting the outcome range of motion of the knee after a total knee arthroplasty.

Keywords: Total Knee Arthroplasty (TKA).
DIFFERENT METHODS OF FIXATION OF SEMITENDINOSUS GRAFTS IN ARTHROSCOPIC RECONSTRUCTION OF ANTERIOR CRUCIATE LIGAMENT
Authors: Roy Rajiv , Datta Alok Sobhan , Roy Mritunjoy
Published: June 2019

BACKGROUND: The Anterior Cruciate Ligament (ACL) is the most commonly injured ligament in the human body. Earlier treatment of ACL injury was mainly restricted to sportsmen, but has increased over the years because of awareness and accessibility to treatment facilities. Arthroscopic reconstruction is now the gold-standard for the treatment of ACL tear.

MATERIALS AND METHODS: This study was conducted at IPGME & R, Kolkata in the department of Orthopaedics, where forty patients with single knee injury were taken into consideration, the injury being more than two months old, in the age group 20-50 years, with clinically significant knee instabilities and confirmed on MR imaging.

RESULTS: This was a prospective randomised study where 95% of the patients were male. The outcome was based on regaining pre-injury status and recovery was based on pre- and post-operative clinical and radiological findings and marked according to Tegner- Lysholm scale.

CONCLUSION: Clinical and radiological (MRI) proved knee instabilities due to standardised Anterior Cruciate Ligament injury were best treated by arthroscopic repair using semi-tendinosus graft, which provided to be the gold-standard treatment protocol.

Keywords: ACL Injury, Knee Instability, Arthroscopic Repair, Semitendinosus Graft.
ROLE OF PLASTER OF PARIS CAST IMMOBILIZATION OF SKELETAL PIN FOLLOWING SKELETAL TRACTION ABSTRACT
Authors: Datta Alok Sobhan , Ostayar Naim , Chakrabarti Sudipta
Published: June 2019

BACKGROUND: Application of skeletal traction, requires insertion of skeletal pin which inflicts an open skin wound around the pin, impending portal for entry of microbes into the pin tract. Associated notable complications are metal reactions and secondary infection, subsequently leads to pin change or removal, failure of fracture union, septic arthritis, osteomyelitis etc. Aim of the present study was to compare the pin tract infection grade of elderly patients having open pins with antiseptic dressing and cases immobilized with plaster of Paris (POP) cast.

MATERIALS AND METHODS: The study population consists of 88 patients treated with upper tibial skeletal traction, of whom 44 persons followed up by regular antiseptic dressing of open percutaneous pin would (Group 1) and the rest 44 persons having pin covered with POP cast (Group 2). Pin tracts of both groups were evaluated after 6 weeks by Checketts-Otterburn’s grading system. Primary outcome variables of infection gradation and outcome measures was compared by NNT with 95% confidence interval, proportion and percentage.

RESULTS: Mean age of patients of group 1 was 69.75, SD 7.185 and group 2 was 68.95, SD 8.177. Skeletal pin had to be removed (Grade 4 in Checketts-Otterburn’s grading system) in 10 (66.7%) of group 1 compared to only 5 (33.3%) cases of group 2. No case of osteomyelitis (Grade 6) has been seen in any group. The difference in grade of pin tract infection in the two groups was statistically significant (p =0.001).

DISCUSSION

High morbidity in conservative treatment is vastly the result of continuous pain, infection and discomfort. The present study compellingly documented non-operative management by skeletal traction is far from being the lethal procedure if the the rate of pin tract infection is reduced by covering with POP cast. In institutes that cater to a significant number of elderly population, skeletal traction with appropriate control of pin site infection is an effective alternative to more aggressive operative method.

Keywords: Skeletal Traction, Pin Tract Infection, Elderly Patients, Plaster of Paris (Pop) Cast.
CORRELATION OF STATURE IN RELATION TO HEAD LENGTH IN MEDICAL STUDENTS IN BIKANER DISTRICT RAJASTHAN.
Authors: Mani Dr. Rakesh , Choudhary Dr. Pramila , Singh Dr. Mohan , Rathore Dr. Kanika
Published: June 2019

Anthropometric measurements vary in different races, sex and age groups. Stature is one of the various parameters of identification. Estimation of stature from measurement of various body parts is of immense important to the forensic experts. It is known that there a close relationship exists between the height of an individual and various parts of the body like head, trunk, upper and lower extremities. The aim of this study is to estimate the relationship between the stature and head length. This study was conducted on 200 (100 males, 100 females) medical students of age groups 18-25 years at SPMC Medical College, Bikaner (Rajasthan). Height and head length were measured and Pearson correlation was used to see correlation. Head length and height are positively correlated among boys and girls and it is statistically highly significant. When both boys and girls were combined it also showed positive correlation which is statistically highly significant. This study shows that there is a strong association between height and head length. Simple regression equations generated from head length can be a supplementary approach for stature estimation when extremities are not available and will be useful for anatomists, archaeologists, anthropologists and forensic scientists.

Keywords: Correlation coefficient, Head length, Regression equation, Stadiometer, Spreading caliper, Stature.
A STUDY TO DETERMINE THE NUTRITIONAL STATUS OF HIGH SCHOOL CHILDREN IN RURAL AREA RAJASTAHAN
Authors: Nema Dr. Anubha , Mittal Dr. Sunil Kumar
Published: June 2019

Background: Over the past few years in India, childhood overweight and obesity is increasingly being observed with the changing lifestyle of families with inadequate exercises and unhealthy food lifestyles.

Methods: A cross-sectional study was carried out in Government High Schools (8-10th standards) with a sample size of 100. Required number of students from each class was selected using systematic random sampling.

Results: The overweight students were mainly boys and the underweight students were mainly girls. Nutritional value of the majority of students was poor due to consumption of junk foods, lack of exercise, outdoor activities, inadequate intake of food and imbalanced diet.

Conclusion: In the present study, majority of high school students in 8th, 9th, and 10th standards were underweight, and the prevalence of overweight and obesity were less.

Keywords: Overweight, Underweight, Rural
A STUDY OF PLASMA GLUCOSE AND SERUM CERULOPLASMIN IN TYPE-2 DIABETES MELLITUS (T2DM) AT A TERTIARY CARE HOSPITAL
Authors: Sharma Mukul , Bhatia Kapil , Misra Pratibha , MK Sibin , Ambade Vivek N , Mukherjee Bhasker
Published: June 2019

Introduction: Diabetes mellitus (DM) is a metabolic disorder occurring due to either defect in the secretion of insulin or defect in the action of insulin characterized by hyperglycemia. Hyperglycemia causes oxidative stress due to increased production of mitochondrial Reactive oxygen species (ROS) in T2DM. Ceruloplasmin (Cp) acts as an antioxidant through its ferroxidase activity. There is an association between the raised serum Cp levels and elevated plasma glucose levels in Type-2 Diabetes mellitus (T2DM) patients.

Aim and objectives: The aim of this study is to evaluate the correlation between the fasting plasma glucose (FPG), 2hour plasma glucose (2hPG), and serum Cp level in T2DM patients as compared to non diabetics.

Materials and methods: 165 cases of T2DM were recruited along with the 40 healthy age and sex matched controls. The blood samples were analyzed for serum Cp and FPG and 2hPG after 75-gram oral glucose.

Results: The serum Cp levels of the patient group with T2DM were significantly higher than the control group (p = 0.000). There was a significant positive association between serum Cp level and 2hPG level of the patient population (r = 0.283, p = 0.000), but there was no significant correlation found between serum Cp levels and fasting plasma glucose levels in patients (r = 0.146, p =0.061). Similar findings were seen in the sub group analysis.

Conclusion: Our study concludes a significant positive correlation between serum Cp and 2hPG levels in T2DM patients. Hence Cp levels may be considered as a part of the routine diagnostic panel to assess diabetes mellitus.

Keywords: Serum Ceruloplasmin, Type-2 Diabetes Mellitus, Fasting plasma glucose, 2hour plasma glucose
UNUSUAL PRESENTATION OF ACINIC CELL CARCINOMA OF THE RIGHT PAROTID GLAND WITH LOCOREGIONAL LYMPH NODE METASTASIS IN A 18 YEARS OLD MALE: A CASE REPORT WITH REVIEW OF LITERATURE
Authors: Kusum Dr. Anuradha , Shukla Dr. Sushil Kumar , Shirazi Dr. Nadia , Gaur Dr. Dushyant Singh , Bisht Dr. S.S.
Published: June 2019

Acinic cell carcinoma (ACC) is a slow growing and low grade epithelial neoplasm of the salivary glands, in which few tumor cells exhibiting acinar cell differentiation that is characterized by presence of cytoplasmic zymogen secretory granules in the tumor cell. Most frequently ACC occur in parotid gland with the initial presentation somewhat at younger age than other parotid gland neoplasms and preferentially more in female with female: male ratio is 3:2 and median age at time of presentation is 52 years. “Fine needle aspiration cytology (FNAC)” examination may also be useful tool for confirmation of the diagnosis. The treatment of tumor is essentially by surgical excision of the gland. In histo-pathological examination; the most common presentation of tumor is solid sheet and nesting pattern of the growth followed by microcystic, papillary-cystic and follicular pattern . The purpose of the present case is to present the clinical, cytological and histopathological features of of  ACC of the parotid glands of 18 years old male child which initially present as a benign cystic lesion of parotid gland than finally diagnosed as ACC with metastasized to regional lymph nodes. To conclude, ACC is frequently arising in parotid gland and metastasis to the intra-salivary gland lymph nodes is a very rare finding in young male. Intra­-operative frozen section might be helpful in the di­agnosis of parotid gland ACC because of low specificity and sensitivity of  CT scan and FNAC examination of ACC. The histo-morphological examination of paraffin embedded H/E stained section is the main tool to explain the microscopic findings of ACC and to classify ACC of parotid gland. Specail stain  like PAS, PAS-D and IHC  examination might useful for diagnosis of ACC. Surgery with adjuvant  post-operative radiation therapy is acceptable for final outcome of disease and the tumor should be managed uncompromisingly, despite of its slow growing and low  malignant behaviour, due to its metastatic prospective which  usually confirmed by distant metastasis and recurrence. Hence, these tumors require a long-term follow-up.

Key words: ACC: Acinic cell carcinoma
DIAGNOSTIC IMPORTANCE OF BONE MARROW ASPIRATION IN HEMATOLOGICAL DISORDERS – TERTIARY CARE CENTRE BASED STUDY.
Authors: Meena Seema , . Sukriti , Bhati Sonal , Patni Abha
Published: June 2019

Background: Bone marrow aspiration (BMA) is a minimally invasive technique performed in a variety of hematological disorders. It is considered essential for the diagnosis and management of haematological disorders. BMA is usually sufficient to diagnose nutritional anemia and most of the leukemias.

Aims & Objectives: To study the spectrum of hematological disorders diagnosed on BMA in a tertiary care centre, Udaipur.

Material & Methods:  The present study was conducted in the hematology section of department of Pathology, RNT Medical College & MB Hospital, Udaipur for a period of one year from June 2018 to May 2019. A total of 123 cases of suspected hematological disorders underwent the process of BMA from posterior superior iliac spine under local anesthesia. Exclusion criteria of our study included aspirates of dry tap. BMA smears were stained with Giemsa stain for morphologic examination.

Result: The present study included 123 cases. Male to female ratio in our study was 1.6:1. Anemia (45.5%) was the most common hematological disorder in our study, iron deficiency anemia being the most common followed by megaloblastic anemia. Chronic myeloid leukemia (26.01%) was the most common hematological malignancy in our study.

Conclusion: Bone marrow aspiration is a useful diagnostic procedure in hematological practice for the diagnosis of both hematological and non-hematological conditions. Rapid and early diagnosis of malignancies are critical for proper initiation of treatment and to control the disease.

Keywords: Bone Marrow Aspiration, Hematological disorders, Leukemias
AN UNUSUAL PRESENTATION OF THROMBOTIC THROMBOCYTOPENIC PURPURA FOLLOWING HEPATITIS A INFECTION: A CASE REPORT
Authors: Kala Mansi , Sharma Siddharth , Shukla Sushil Kumar , Akram Mohd.
Published: June 2019

Introduction: Thrombotic Thrombocytopenic Purpura (TTP) is a fulminant thromboticmicroangiopathy often manifested as clinical pentad of fever, thrombocytopenia, haemolytic anemia, renal failure and neurological abnormalities. ADAMTS13 deficiency has been noted as causative factor however secondary TTP/HUS preceded by various insult is also noted. Insults like burn, malignancy, viral infections and sepsis has been associated with TTP/HUS. Association of TTP/HUS with hepatitis A infection is rare and not reported.

Case Summary: 27 years old male was admitted with acute onset fever, drowsiness, decreased urine output and icterus. Physical examination was unremarkable except icterus. He was found to have IgM positive for hepatitis A along with evidence of microangiopathic haemolytic anemia. He was diagnosed to have Hepatitis A along with TTP/HUS and plasmapheresis was started. He improved dramatically after it. No recurrence of TTP/HUS was noted on follow up.

Conclusion: We present an interesting case of Hepatitis A as a possible trigger for Thrombotic thrombocytopenic purpura. Any haemolytic microangiopathy in hepatitis A should be carefully looked for a possibility of TTP.

Keywords: Thrombotic thrombocytopenic purpura, Hepatitis A, TTP/HUS, HAV
TO STUDY THE CLINICAL PROFILE OF CHILDREN (AGED 1MONTH-14YRS) SUFFERING FROM URINARY TRACT INFECTION
Authors: Soni Dr. Moti Lal
Published: June 2019

Background: Urinary tract infections (UTIs) are common bacterial infections in children. The diagnosis of UTI is very often missed in young children due to minimal and nonspecific symptoms.

Methods: Hospital based observational prospective study conducted 100 clinical cases.

Results: According to presenting history, maximum patients presented with abdominal symptoms (72%), urinary symptoms (23.0%), followed by respiratory symptoms in 18.0% cases, CNS symptoms (8.0%) and non-specific symptoms in 47.0% cases. Fever was the most common presenting complaint followed by vomiting, pain abdomen, oliguria, Diarrhoea, generalized swelling, burning micturition, cough, decreased appetite, respiratory distress, excessive cry, chills and rigor, abnormal body movement, yellow colour of urine, headache while least common present history was chest pain and joint swelling where 1 case each was found.

Conclusion: UTI is a common childhood illness. Females were more commonly affected than males. Fever being most common presenting symptom followed by vomiting and pain abdomen.

Keywords: Urinary tract infections (UTIs), Females, Fever.