bluuebunny/crossref_metadata_2025 huggingface dataset:
Study various clinical manifestations and biochemical parameter for liver dysfunction in association with Plasmodium vivax malaria
Authors: Banthia Bajranglal , Shakir Saad Mohammad
Published: July 2020

Background: Malaria is a parasitic disease which is majorly caused by the bite of an infected Anopheles mosquito. It has been estimated that the most common type of malaria affecting the human race is known as Plasmodium vivax. Human malaria is a global burden with 3.4 billion people at risk over 91 endemic countries. According to the WHO, the involvement of liver dysfunction in Plasmodium vivax malaria is not an uncommon phenomenon. Aim of the research was to study various clinical manifestations and biochemical parameter for liver dysfunction in association with Plasmodium vivax malaria.Methods: It was an observational study carried out at Teerthanker Mahaveer Medical College and Research Centre, a tertiary care hospital situated in Moradabad for a period of 1 year (March 2017-Feb 2018). Total of 200 patients aged above 15 years, with either sex were part of it. All the patients having mixed malaria with dengue, pregnant women and the patients who did not give written consent for being a part of the study were excluded from the study. A detailed clinical examination was done, including all the hematological and biochemical examinations.Results: The results depicted that the number of male patients was 95, and the number of female patients was 105. The majority of the patients belonged to 15-30 years of age group. The major clinical features of the patients suffering from P. Vivax were fever and jaundice. The number of patients with serum bilirubin >3 mg/dl was 55.Conclusions: In light of the above results, it was evident that Plasmodium vivax has the capability of producing jaundice, hepatic dysfunction and anemia. The doctors must be very vigilant while treating the patients with Plasmodium vivax for any symptoms of jaundice as they are often misunderstood as hepatitis.
Prevalence and correlates of microvascular complications among patients with diabetes mellitus: a cross sectional study
Authors: Kumar Ashok , Singh Ardaman , Tanwar Vikram S. , Govil Nikhil
Published: July 2020

Background: Diabetes mellitus is a metabolic disorder of multiple etiology, characterized by chronic hyperglycemia and associated with various microvascular, macrovascular and nonvascular complications leading to increasing morbidity and mortality. Microvascular complications are daibetes specific and their relation with associated comorbidities studied worldwide. To estimate the prevalence of microvascular complications in diabetic patients and to find their relation with various comorbid conditions.Methods: A total of hundred diagnosed patients of diabetes mellitus with age ranging from 18 to 75 years were enrolled in the study. Patients were assessed for the presence of microvascular complications and associated comorbidities. The effect of various comorbidities on frequency of microvascular complications was also determined. Data collected was statistically analyzed.Results: In this study, the mean age of the study group was 55.77±11.75 years. Mean age of onset of the disease was 48.89±11.50 years. Mean duration of the disease in the study group was 6.86±5.02 years. Diabetic retinopathy, neuropathy and nephropathy was found in 76%, 63% and 69% patients, respectively. Among patients with hypertension, 91.7%, 83.3%, and 81.7% cases were found to have retinopathy, neuropathy and nephropathy, respectively. The corresponding figures for those with comorbid IHD were 91.1%, 83.9% and 76.8% respectively whereas among patients with coexisting metabolic syndrome, 92.5%, 80.6%, and 79.1% were found to have retinopathy, neuropathy, and nephropathy, respectively.Conclusions: The most frequent microvascular complication reported by this study was diabetic retinopathy. comorbid conditions like hypertension, ischemic heart disease, and metabolic syndrome were associated with higher prevalence of microvascular complications in diabetic patients.
The incidence and pattern of geriatric limb fractures in Ibadan, Nigeria
Authors: Ogunrewo Tolulope O. , Oyewole Olugboyega A. , Omoyeni Richard A. , Iken Chuka T. , Ogunlade Samuel O.
Published: July 2020

Background: Individuals within the geriatric age group sustained different types of fractures as such the need to determine the incidence and pattern of limb fractures among patients 65 years and above admitted through the accident and emergency department of the University College Hospital Ibadan.Methods: A retrospective hospital-based study in which patients 65 years and above admitted through the accident and emergency department of the University College Hospital Ibadan over a 42-month period were involved in the study. Using a proformal completed from the electronically stored data that captures the patient’s history, examination findings, X-ray film and treatment offered which was collected on a weekly basis.Results: 12.58% of the patients reviewed within the study period were geriatric patients. A total of 98 geriatric patients were reviewed. There were 59 female and 39 male with a ratio 1.5:1. The fractures were mostly secondary to a trivial fall within their homes (68.37%) while traumatic injury from motor vehicle and motor bike crashes accounted for 11.22% and 16.33% respectively. The most commonly fractured bone is the femur and the proximal third is the most affected part. Comminuted fracture is the most common pattern observed.Conclusions: More than 10% of the reviewed population was in the geriatric age group and the proximal femur was the most commonly fractured bone in this age group. They usually follow trivial falls.
The prevalence of vertigo among high school students and an evaluation of quality of life
Authors: Saglan Ramazan , Goktas Saniye , Emiral Gulsum Ozturk , Unal Egemen , Arslantas Didem , Unsal Alaettin
Published: July 2020

Background: The purpose of the study is to determine the prevalence of vertigo among secondary and high school students, to examine the variables thought to be related and to evaluate the quality of life.Methods: This study was carried out between 1st November-30th December 2016 on secondary and high school students in Beylikova and Sivrihisar counties which is located at the research area of the Department of Public Health Eskisehir Osmangazi University. Those who had dizziness within the last three months have been assumed as having vertigo. Visual Analog Scale has been used in order to evaluate the severity of vertigo. The life quality of children has been evaluated through Quality of Life Scale (QoL) for Children.Results: The study group has been composed of 911 males (46.5%) and 1.047 females (53.5%). The prevalence of vertigo has been determined as 30.8%. The most common concomitant symptoms of students are headache (22.6%), staggering while walking (15.8%), and tinnitus (10.3%).It has been found that the QoL of students having complaints of vertigo is lower than that of those not having complaints of vertigo. The most common type of vertigo within the study group has been Orthostatic Dizziness (70.0%). There has been no correlation between types of vertigo and QoL; however, when the severity of vertigo is considered, it has been found within our study group that the QoL of the students having mild vertigo is higher than that of those having moderate or higher severity of vertigo(p<0.05.Conclusions: Vertigo is one of the most common symptoms among children and adolescents and may result from many factors. It may be useful to carry out screening with the purpose of early diagnosis and treatment parentheses, direct diagnosed cases to specialist physicians and organize events to create awareness. More comprehensive studies are needed to reveal the relationship between vertigo and QoL.
Prospective study of clinical profile of acute ischemic stroke in a tertiary care hospital of North India
Authors: Shakya Shobhit , Vaish Arvind , Singh Pratibha
Published: July 2020

Background: Owing to the recent demographic shifts and negative lifestyle changes, stroke is one of the leading causes of mortality across every income group in most of the countries. It is of the utmost importance to devolve into the clinical profile, etiology and management of patients with acute ischaemic stroke.Methods: It is a prospective case control study. Data was collected using a pre-tested pro forma meeting the objectives of the study. Patients who consented were divided into two groups and complete examination and investigations were carried out.Results: There were 94 patients with AIS enrolled for the study. The mean age was 56.2 years, of which 68.08% were males and 31.92% were females. The mean time for these patients to reach the health facility was 12.6 hours and only 36.17% of patients reached in the window period of 4.5 hours and were eligible for thrombolysis. Hypertension, Diabetes and smoking were the most common risk factors in this order among others.Conclusions: There is poor awareness regarding identification of stroke related symptoms and warning signs as majority of patients were unable to reach the hospital in the window period making them ineligible for thrombolysis. The leading etiology runs in the direction of modifiable risk factors which can be corrected at a primary prevention level.
A rare case of hematohidrosis in a patient with paranoid schizophrenia
Authors: Gayal Tejas D. , Devi M. Gowri
Published: July 2020

Hematohidrosis is a very rare yet fascinating clinical entity in which blood is excreted in sweat under extreme physical or emotional stress. The causes can be attributed to variety of etiological factors such as systemic disorders, vicarious menstruation, excessive exertion, and psychogenic and idiopathic causes. Although the episodes are usually self-limiting and do not affect the health status of the patient, the very phenomenon can be quite scary for the patient and family members. Amongst the psychogenic causes, various mental illnesses can result in Hematohidrosis, but it is more commonly reported so far with anxiety spectrum illnesses and depression. The distinctive feature of the case presented by authors is its association with Hematohidrosis and its symptoms of Paranoid Schizophrenia. Objective of this study the association between symptomatology of Paranoid Schizophrenia and its effect on Hematohidrosis After due consent from the patient, relatives and permission from the ethics committee of the institution, clinical history was obtained from the patient interviews. The case was followed longitudinally on each follow up. Appropriate blood investigations were done. Information obtained was compiled to form a case report. The improvement in psychotic symptoms corresponded with reduced frequency of bleeding episodes. As anti-psychotic treatment was initiated, patient started showing improvement in psychotic symptoms. This co-incided with the reduced severity and frequency of Hematohidrosis. Improvement in anxiety associated with psychotic symptoms was most probably responsible for improvement in symptoms of Hematohidrosis.
Hip pain in children dilemmas in diagnosis and management a case report
Authors: Baskaran Lakshmipriya , Ramanathan Ashok Thudukuchi
Published: July 2020

Atraumatic hip pain in growing children is of varied etiology from developmental to infection and tumor. Differential clinical presentation of symptoms and investigation modalities like blood parameters and radiological imaging remains inconclusive at times with differential diagnosis. Biopsy remains the final say in conclusive of establishing final diagnosis unless proved otherwise. Bony lytic lesion of proximal femur in children without systemic illness mimicking benign bone tumor initially (osteiod osteoma) turned out to be chronic osteomyelitis on histopathologically following CT guided biopsy of the lesion which alters the course of management.
An unusual cause of haemoptysis: hepatobronchial fistula
Authors: Suman Sonu
Published: July 2020

Haemoptysis is a common clinical problem but a non-specific symptom and can occur in about 100 different clinical conditions. Diagnosing aetiology is not always straight forward. Authors present a case of Hepatobronchial fistula (HBF) which initially diagnosed as tuberculosis due to its atypical presentation and rarity of HBF.
Pulmonary rehabilitation in pulmonary alveolar proteinosis: a case report
Authors: Pereira Grace C. , Rangwala Zoeb K.
Published: July 2020

Pulmonary alveolar proteinosis is a rare lung disease in which surfactant accumulates in the alveoli causing impairment of gas exchange, pulmonary circulation, restrictive lung functions, respiratory and muscular dysfunction. Pulmonary rehabilitation is a core aspect in the management of patients with chronic respiratory diseases. However so far there are no documented studies on the effects of pulmonary rehabilitation in pulmonary alveolar proteinosis. Here authors report the case of a 20 year old female diagnosed with pulmonary alveolar proteinosis and having considerable activity limitations. Pulmonary rehabilitation program of 24 weeks was designed for her after a thorough assessment. The 6-minute walk distance (6 MWD), forced vital capacity (FVC), diffusion capacity for carbon monoxide (DLCO), exercise induced desaturation (SPO2) and QOL were evaluated using the SF-36 questionnaire. All parameters were recorded pre, post and at a follow up at 6 months after pulmonary rehabilitation. The 6MWD, FVC, DLCO, exercise induced desaturation and QOL improved considerably after 24 weeks of PR. At a follow up at 6 months all measures expect the FVC remained maintained. The authors thus conclude that Pulmonary Rehabilitation is effective in improving the exercise capacity, lung functions and quality of life in pulmonary alveolar proteinosis.
Bone marrow involvement as a rare manifestation of relapsed choroidal melanoma
Authors: Bashir Nusrat , Manzoor Farzana , Musharaf Bilal , Reshi Ruby
Published: July 2020

Choroidal Melanoma is the most common primary intra-ocular malignancy. Incidence of primary choroidal melanoma is about 6 cases per 1 million population. It disseminates hematogenously. The most common site of metastasis is liver. Metastatic melanoma involving the bone marrow is rare, occurring in 5% of patients with disseminated disease. However, Choroid melanoma with bone marrow involvement is very rare. Only a few case reports are published in literature.  Authors present a case of bone marrow metastasis from choroid melanoma in 55 years old female who has been treated for primary choroidal melanoma by enucleation of left eye three years back. In the evaluation of symptomatic anemia, features suggestive of bone marrow infiltration by choroidal melanoma were observed on bone marrow aspiration and biopsy. The diagnosis was confirmed by positivity of immune-histochemistry markers HMB-45 and Melana.
An intraorbital foreign body with paradoxical radiological interpretations to dive in or not? a surgeon’s dilemma
Authors: Deuri Arup , Dam Bikram , Kumar Naveen
Published: July 2020

A 10-year-old girl presented to our O.P.D. with intra-orbital trauma. On radiological workup following admission, USG B Scan, MRI Brain and 3D reconstructed faciomaxillary imaging were indeterminate for presence of foreign body, whereas CT scan showed a hyperdense lesion suggestive of intra-orbital foreign body. In this condition of imaging dilemma, surgical exploration was decided since there was no improvement in clinical symptoms via lateral orbital approach. Two small wooden pieces were detected in orbital exploration. This case highlights the role of history taking, clinical judgement in all cases of intraorbital tumour more so in paediatric population than solely going by the investigative modalities.
Shadow pandemic: domestic violence and child abuse during the covid-19 lockdown in India
Authors: Ravichandran Prabhadevi , Shah Anuradha Kunal , Ravichandran Prabhu
Published: July 2020

For many women and children around the world, staying at home is no longer a safety aspect during the Covid-19 pandemic. There is a surge in the number of cases of inter-personal violence and child abuse during the lockdown. The stigma and socio-cultural norms create hesitance in subjecting the family and its intimate relationships to public scrutiny. Therefore, building awareness around domestic violence is vital.
Laboratory biosafety measures in receiving, preparation and processing of pathology specimens in suspected and positive coronavirus infection
Authors: Sekaran Anuradha , Yandapally Niharika R. , Vanere Veena P.
Published: July 2020

COVID-19, caused by SARS-CoV-2 virus which is declared as a pandemic by the WHO on March 2020 has made a huge difference in the practice and daily activities of the laboratory services. There are high chances of receiving potentially infectious samples to the laboratory for various tests. Authors propose a few biosafety measures in the preparation and processing of various pathology specimens received to the lab during this pandemic time in correlation with guidelines given by WHO. These safety measures aim at protecting and safe guarding the laboratory staff, trainees, and pathologists by minimizing the exposure to COVID-19.
Indian scenario and an institutional experience of fatalities in COVID-19: a narrative review
Authors: Singh Naresh P. , Singh Amit , Kumar Raj , Yadav Ramakant , Singh Anamika , Takhelchangbam Nilima D.
Published: July 2020

The coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is an ongoing global pandemic that has devastated our globalized economic system. Apart from infecting 12,102,328 human beings and taking a toll of over 551,046 lives globally by the 11th of July 2020, it has fundamentally affected the way we live, work, travel, and relate to each other. Despite imposing early preventive measures, India has crossed a total caseload of 820,916 with a total death of 22,123 till-date, ranking third in the descending list of worst-affected nations. Although comparatively lower, the case fatality rate in India is 2.72% against the global fatality of 4.53%. It is an empirical fact that every process and institution must evolve to meet the needs of its time. A model for categorization of fatality among real-time reverse transcriptase-polymerase chain reaction (RT-PCR) positive COVID-19 patients has been developed at Uttar Pradesh University of Medical Sciences (UPUMS), to address the issue of patients being transferred very late in the course of the disease to level-3 facilities. The UPUMS model of categorization of fatalities of COVID-19 patients at level-3 center comprises of category-1 as ‘Institutional COVID-19 fatalities’, category-2 as ‘Imported COVID-19 fatalities’ and category-3 being ‘Imminent with Incidental COVID-19’ fatalities. This endeavor of categorizing COVID-19 fatalities is an opportunity to analyze facts and contemporary science to assess our response to this pandemic and thereby take lessons to prepare better for the future. Following proper analysis, we noted that most of these fatalities (64%) at the higher center are because of delayed referrals hence termed as imported fatalities, which need a modality of early attention and referral. However, there are fatalities which occur because of severe systemic illness like liver failure, cardiovascular accident (CVA), myocardial infarction (MI), etc. They need due treatment at a regional center. These constitute up to 18%. Authors found that actual COVID-19 deaths constitute only 18% of the total projected fatalities.
Serious discordance between MTBC trace positivity by Xpert MTB/RIF ultra and follow up culture
Authors: Roy Partha , Anand Ankita
Published: July 2020

Authors wish to report a major discordance between Xpert MTB/RIF Ultra Trace positivity (GeneXpert, Cepheid) and follow up by liquid culture.
Risk factor assessment and outcome analysis in elderly (≥60 years) patients of severe head injury
Authors: Gopal N. N. , Kumar Ashish , Singh Amit Kumar , Dubey Saurabh Anand
Published: July 2020

Background: Incidence of head injuries is rising all over the world. Only few studies have been performed regarding severe head injury in elderly people. We aimed to study the epidemiology, mode of injury, management, co-morbidity, associated injuries which affects the outcomes. Severe head injury is unconsciousness >6 hours and GCS 3-8. In India 6.63% of the total population above 60 years is considered elderly. Falls are the major contributor to TBI in elderly but in India RTA is still the main contributor. Outcomes of TBI, both in terms of mortality and function, are significantly worse in the elderly.Methods: Objective of this study was to find the risk factors affecting the outcome in severe head injury. This was a prospective study and carried on 56 patient in Department of surgery of M. L. N. Medical College, Prayagraj from September 2018 to September 2019.Results: Male were most commonly affected but the gender had no significant prognostic effect on outcome. RTA were the most common cause of head injury. GCS at admission was directly related to outcome. Bilateral non-reactive pupils had poor outcome. Type of hematoma and midline shift had also affected the outcome. Operated cases had better outcome than non-operated cases. Any associated injury with TBI had worsened the outcome in patient. Any co-morbid condition associated with brain injury had slower recovery and worsen the outcome. Overall mortality in this series was 64.28% and unfavourable outcome was 76.79%.Conclusions: Severe head injury in elderly people had worst outcome.
A prospective study of injury pattern and outcome of blunt trauma abdomen patients in a tertiary care hospital in eastern part of India
Authors: Pandey Vinod Kumar , Shahi Hanuman Prasad , Singh Rahul , Pratap Prakhar
Published: July 2020

Background: Abdominal trauma continues to account for a large number of trauma-related injuries and deaths. The evaluation and treatment of abdominal injuries are critical components in the management of severely injured trauma patients. The study was done to study pattern and outcome of BTA patients in a tertiary care hospital in eastern part of India as few studies exist in this part of the country.Methods: Prospective descriptive study conducted in in SRN Hospital, Prayagraj over a period of one year with all cases of blunt injury abdomen included with respect to inclusion criteria.Results: In our study mean age was 23.2±17.6 years. 92% were male and 8% were female RTA are responsible for most number of cases (78%). Conservative management done in 34 (68.0%) and Operative Intervention done in 16 (32.0%) cases. In our study, X-ray erect had 75% accuracy total subsets of 336 organ scans were performed on ultrasound specific injury was seen in total 50 cases and total 210 CT scans performed was able to pick up 59 injuries (p=0.0002). CECT forms the core investigation of choice in dealing with blunt injury abdomen cases. In our present study, paralytic ileus (prolonged) (31%) and pelvic intraabdominal abscess (31%) as postoperative complications.Conclusions: CECT abdomen is the investigation of the choice with RTA being the most common mode of BTA. So effort should be made to implement traffic rules. Hemodynamic instability with radiological findings useful in deciding operative versus conservative management of blunt trauma patients.
A prospective study of assessment of prognostic factors in early and late wound dehiscence in midline vertical incision
Authors: Gupta Ramashankar , Shrivastava Surendra Kumar , Malpani Prateek , Songra M. C.
Published: July 2020

Background: Wound dehiscence is separation of some or all layers of incision. It may be partial or complete. It is called as complete when all layers of the abdominal wall have been separated with or without evisceration of viscous. The study aims to find out and record the prognostic factors for wound dehiscence in vertical midline laparotomy.Methods: This was a prospective study in 1400 laparotomies that developed wound dehiscence operated in Gandhi Medical College, Bhopal from august 2017 to august 2019. All the patients with burst abdomen operated during emergency or elective setting by midline vertical laparotomy were included.Results: Wound dehiscence was most common in 51-60 years age group (26%). Majority patients were males (62%). Emergency laparotomy showed maximum incidence (71%). Bursts were seen mostly during 6th to 10th postoperative day. 78% patients presented as partial wound dehiscence and remaining as complete wound dehiscence. 46% presented as early wound dehiscence (7 days).Conclusions: Post laparotomy wound dehiscence has multifactor etiology. Respiratory infections, anemia, and hypoproteinaemia are the contributing factors. Improper haemostasis during surgery and poor surgical technique are the predisposing factors.
Laparoscopic orchidopexy and its outcome in the management of nonpalpable testis
Authors: Prasad Dinesh , Jivani Savan
Published: July 2020

Background: Management of impalpable testis represents a significant diagnostic and operative challenge. The aim of this work was to present the superior value of laparoscopy as a single tool for the diagnosis and treatment of impalpable testis.Methods: 51 patients with 58 nonpalpable were included in our study. Study design was case series. We have conducted this study at Surat Municipal Institute for Medical Education and Research, Surat. For each patient laparoscopy orchidopexy was performed and either testis or blind ending cord structure are searched for. The testis either brought down to the scrotum or removed depending on the condition. The patients were followed up for 12 months.Results: On diagnostic laparoscopy the number of testis found normal 54, followed by 3 hypoplastic and 1 atrophic. There were 8 testis found to be present at high intraabdominal (>2 cm from deep ring), 46 were present at low intra-abdominal (<2 cm from deep ring), intracanalicular 4. Postoperative complication included minor wound infection in one patient, none of them were diagnosed scrotal hematoma, port site hernia, and testicular atrophy.Conclusions: Laparoscopy seems to offer a safe and reliable diagnostic and therapeutic option to patients with nonpalpable testis. Intraabdominal dissection allows more testis to be brought down to scrotum. Laparoscopy clearly demonstrate the anatomy and provide visual information upon which a definitive decision can be made.
Role of topical use of natural honey in chronic non healing ulcer: a prospective non randomized comparative trial on 150 patients
Authors: Kochar Mahinder Pal
Published: July 2020

Background: Natural honey procured from any source on topical application on chronic non-healing ulcer has unique property to reduce pain, inflammation, oedema, deodorization, rapid disinfection, stimulate desloughing, promote neo vascularization, granulation, collagen synthesis, epithelialization and thus boost the process of ulcer healing.Methods: In this study a prospective, non-randomized trial was done on 150 patients divided in two groups of 75 each (group-A with honey dressing and group-B without honey dressing), of different age and sex having chronic non healing ulcers situated on various parts of the body. Natural honey available from various sources was used.Results: Most of the patients fall in their most productive and active 3rd and 4th decade of life. Pain and fever were the main reason of restricted mobility and absence from work reflecting productivity. Bacterial contamination, presence of necrotic tissue, bed ridden condition, old age, debility, DM, ulcer present in the vicinity of joint were found major cause of delay in the process of healing. The cost effectiveness, easy availability, ease of application makes natural honey a better alternative in the management of chronic non healing ulcer.Conclusions: Cost effectiveness, easy availability, ease of application, increasing healing process makes natural honey a better alternative in the management of chronic non healing ulcer and safe to use in diabetic patients as well.
Management of forgotten double-J stent in a tertiary care center with ten years of experience: a retrospective study
Authors: Mahmood Khalid , Singh Kamalkant Harishankar , Upadhyay Rohit , Kumar Vijoy , Kumar Amit , Singh Deelip K.
Published: July 2020

Background: Forgotten double-J (DJ) stents is documented commonly in urological cases with consequences varying from encrustation, UTIs, pyelonephritis, hydronephrosis and non-functioning kidney. This study aimed to present the experience of managing patients with forgotten DJ stents (>3 months) over a period of ten years.Methods: The study conducted a retrospective review of patients with forgotten DJ stents from January 2009 to December 2019. The details reviewed included indications for stent placement, indwelling time, presenting complaints, reason for non removal, radiological investigations, management techniques, and complications.Results: 52 patients with forgotten DJ stents for >3 months were reviewed. Mean age was 32.1 years. The majority were literate (73.1%). Ureteroscopy was the most common primary surgery performed (53.8%). The mean indwelling time was 38.96 months. Presence of the ureteric stone, bladder stone, and renal stone was observed in 45 (86.5%), 42 (80.7%), and 28 (53.8%) patients, respectively. The DJ stent was fragmented in 13.4% of the patients. The commonest complaints were pain (88.4%) and dysuria (63.4%). The stents were managed by combinations of various endourological techniques including cystoscopic stent retrieval (CPE), PCNL, URSL, ESWL with cystoscopic stent retrieval, PCLT (percutaneous cystolithotripsy). Cystolithotomy was used for very large bladder stones. Nephrectomy was needed in 2 cases due to nonfunctional kidneys while one required open ureterolithotomy and stent retrieval after failure of endoscopic approach.Conclusions: Forgotten DJ stents have severe consequences and management approach requires combination of various endourological procedures with ESWL, URSL, PCNL, open ureterolithotomy and cystolithotripsy.
Pattern of anorectal malformation in a tertiary care hospital of Bihar
Authors: Hasan Zaheer , Thakur Vinit Kumar , Yadav Ramdhani , Chaubey Digamber
Published: July 2020

Background: Anorectal malformation (ARM) is common cause of neonatal intestinal obstruction and is one of the most common neonatal surgical emergency encountered by paediatric surgeons. There is no published study about the prevalence of ARM cases within the referral zone of the hospital. This study was done to demonstrate the burden of Anorectal malformation and their surgical intervention as seen in Indira Gandhi Institute of medical science, Patna, Bihar.Methods: Data were retrospectively collected over a period of four years between January 2015 and December 2018. The data collected were demographic status of the patient, diagnosis, associated anomaly, duration of hospital stay and their surgical intervention.Results: There were 395 cases of anorectal malformation out of 93203 OPD patients (0.42%). Male to female ratio of 3.01:1.  ARM also represented 25.3%   of neonatal emergency surgical procedures. The majority of the patient had presented in the neonatal period (51.6%) with mean weight of 2.6 kg. The most common type of ARM found in male patient was rectourethral fistula n=215 (54.4%) in which 164 (76.2%) patients were with rectobulbar fistula and 51 (23.8%) patients had rectoprostatic fistula. Sixty nine (17.4%) female patients presented with perineal fistula.Conclusions: We found a clear male preponderance of anorectal malformation in our study. Patients affected were mostly from poor socioeconomic strata of the society. Present study confirms huge work load of anorectal malformation in this region. This will be helpful in future planning and effective management including financial constraints of the treatment for our poor patients.
Accuracy of fine needle aspiration cytology and thyroid imaging reporting and data system to predict the nature of nodular goiter and its comparison with postoperative histology
Authors: Ramani Pratha Anantha , Reddy Ginni Vijay Sainath , Christopher Changala Glen , Babu Chevuri , Bhagyalakshmi Atla , Jayaraj C. , Kiran Simhadri Uday , Deevi Murali Manohar
Published: July 2020

Background: Aim of the study was to find accuracy of pre-operative fine needle aspiration cytology (FNAC) and thyroid imaging reporting and data system (TIRADS) in predicting the nature of nodular goitre and confirming it with post-operative biopsy. Objective of the study was to assess the sensitivity and specificity of FNAC compared with post-operative biopsy and to assess the sensitivity and specificity of TIRADS compared with post-operative biopsy.Methods: This retrospective study was carried out at tertiary hospital, King George Hospital, Visakhapatnam over a period of 1 year from march 2018 to march 2019. Sensitivity and specificity are calculated based on formulae.Results: Sample size calculated with 90% confidence interval for population of vizag is 96, a sample of 100 patients were taken in this study. Of the 100 cases, 16 had thyroid carcinoma. 15 of them were papillary carcinoma and 1 follicular carcinoma. 8 cases matched with cytology report after post op biopsy and 8 we mismatched with cytology report after post op biopsy. The incidence of malignancy in clinically and cytologically benign goitre is 8.69. In our study sensitivity of FNAC is 50%, specificity is 100% and accuracy of test is 92% and TIRADS has a sensitivity of 100% and specificity of 72.62% and an accuracy of 77%.Conclusions: The current study has showed the disparity we see in thyroid neoplasms in FNAC test and TIRADS, which were proved to be different diagnosis in clinical and histopathology, so even if cytology is benign, we can’t rule out malignancy. FNAC and TIRADS combined have more sensitivity and specificity than individual tests.
A study of single sight two port laparoscopic appendectomy for its feasibility, advantages and disadvantages
Authors: Prasad Dinesh , Chandanani Rajesh , Shah Kesha
Published: July 2020

Minimally invasive techniques revolutionized surgery with severe reduction of access trauma, prompt mobilization, lessened hospital stays and better cosmesis.1 Laparoscopic appendectomy can be further categorized into three port and reduced port appendectomy. All the selected cases have been put in a tabulated form on the basis of their age, clinical features and signs, ultrasonography findings, intra op complications, duration of surgery, duration of post op pain, early post op complications, cosmetic outcome and trochar size. 20 patients fulfilling inclusion and exclusion criteria, who were admitted in our hospital (SMIMER Surat) from 1st December, 2019 to 1st April 2020 and were included in the study and underwent single sight two port laparoscopic appendectomy (SSTPLA) after their consent. We have covered the entire procedure of single sight two port appendectomy, its technique, feasibility, advantages, and disadvantages. From our study, we conclude that this new technique of SSTPLA is technically safe and feasible. Our experience of this innovative surgical technique is suggestive of the fact that SSTPLA has better patient satisfaction with respect to cosmesis, decreased post-operative pain, decreased hospital stay, decreased operative time, fewer intra operative and post-operative complications and surgeon satisfaction with respect to ergonomics and decreased chances of collision of laparoscope with only single working instrument.
Single incision multiport laparoscopic appendectomy using a 2 mm alligator forceps: our experience of 60 cases
Authors: Patro Srikant , Sahoo Ashish K. , Muduli Nikhil , Mishra Ashish K. , Kumar Tapan , Mohapatra Kailash C.
Published: July 2020

Single incision laparoscopic surgery is an emerging branch of minimally assess surgery to reduce scar and post-operative pain. Appendicitis is a common general surgical problem encountered in day to day practice. Different methods of appendectomy have been described by different surgeons from open to laparoscopic and now single incision laparoscopic surgery has been practised. This is a prospective study carried out in our Department of General Surgery SCB Medical College, Cuttack from February 2019 to March 2020; 60 patients had undergone the procedure and the results are published noted under headings of post-operative pain at (6 hours, 12 hours, 24 hours and 48 hours), post-operative requirement of analgesia (diclofenac) at (6 hours, 12 hours, 24 hours and 48 hours), operative time, days to resume bowel activity, days of hospital stay, post-operative complication in accordance to Clavien-Dindo classification.
Double synchronous primary gastric and thyroid cancer
Authors: Almasood Abdulhakeem , Hussain Mohammed , Aljabali Mohammed , Ali Bandar Idrees
Published: July 2020

Second or multiple primary malignancies is very rare and the number of patients diagnosed with multiple primary cancers has recently been increasing due to the improved diagnostic techniques. Herein we report a very rare case of synchronous double primary cancer of the stomach and thyroid gland for the 39 years old lady who presented with a short period of abdominal pain were diagnosed to have an invasive adenocarcinoma with signet ring differentiation of the stomach by gastroscopy and biopsy. Computed tomography and positron emission tomography scan showed high fludeoxyglucose uptake of the thyroid gland were biopsied to confirm the malignancy. underwent initially for radical distal gastrectomy followed by adjuvant chemotherapy and interval total thyroidectomy. Although Synchronous tumors are defined as ≥2 primary tumors occurring within 6 months of diagnosis of the first primary tumor, our case was discovered concomitantly at the first presentation of the patient. The prognosis of patients with multiple primary cancers can be determined independently by the stage of each cancer.
Jejunal gastrointestinal stromal tumors masquerading as an appendicular mass: an unusual presentation
Authors: Choudhari Rajat R. , Raghavendra Annagiri , Kalbavi Harish Rao
Published: July 2020

Gastrointestinal stromal tumors (GISTs) are a rare variety of tumors of mesenchymal origin found in the gastrointestinal (GI) tract forming about 1% of all GI tumors. These originate from the interstitial cells of Cajal. Small bowel GISTs have been shown to present as obscure GI bleeding, obstruction and perforation in literature. We report a 57 years old female patient presenting with pain abdomen, fever and vomiting and palpable right iliac fossa (RIF) mass diagnosed as an appendicular mass and managed conservatively. She was planned interval appendicectomy and was discovered to have a jejunal GIST at laparotomy treated with resection and anastomosis. There are case reports of small bowel GISTs presenting as sources of obscure or overt GI bleeding and luminal or extra luminal mass causing small bowel obstruction. Surgery is mainstay of treatment with imatinib for adjuvant or neoadjuvant therapy. This case highlights an unusual presentation of a jejunal GIST with a sealed off perforation mimicking an appendicular mass in the RIF treated by surgical resection followed by adjuvant Imatinib therapy. GIST being an uncommon tumor with varied presentations can lead to misdiagnosis and delays in treatment. This differential should be kept in mind while evaluating small bowel pathologies to aid a timely diagnosis.
Spontaneous non-traumatic common bile duct perforation presented as an acute abdomen: a rare case report
Authors: Angadi Sneha , Biradar Vinod
Published: July 2020

The spontaneous perforation of the biliary tract (SPBT) is an extremely rare cause of peritonitis, which was first described by Freeland in 1882, to date only around 70 cases have been reported. Here we present a case of spontaneous perforation of the biliary tract, in a patient with choledocholithiasis. A 45 years old male presented to us with acute abdomen with raised amylase and lipase s/o pancreatitis, imaging showed acute on chronic pancreatitis with impacted distal lumen in situ common bile duct (CBD) calculi. Patient was planned for ERCP with CBD clearance after his acute episode subsides. Meanwhile patient developed rigidity, guarding and distension. His second CECT showed a breach in the lower lateral segment in the CBD with gross ascites. Patient was planned for laparotomy, abdominal lavage and T-tube drainage. Patient had a stormy postoperative course. Patient recovered well and was discharged with T-tube clamped and subhepatic drain in situ. Spontaneous perforation of the extrahepatic bile duct is a rare but important presentation of gall stones. Conservative surgery that is decompression of the biliary tree and repair of the leak site over T-tube is the mainstay of treatment in the acute presentation.
Mesenteric abscess presents as left iliac fossa mass in postoperative case of inguinal hernia surgery with undescended testis
Authors: Mahajan Monalisa
Published: July 2020

An abscess is a collection of pus (dead and dying neutrophils plus proteinaceous exudate) that has built up within the tissue of the body. Mesenteric abscess is a rare, usually accounts for small percentage of intra-abdominal abscess after inguinal hernia surgery which is presented as left iliac fossa mass in postoperative period of open inguinal hernia surgery of left side and also presented with undescended testis of left side which is actual cause of formation of inguinal hernia of same side. Late onset mesh infection and post-operative peritonitis are very common in case of open hernia surgery. Intra-abdominal abscess cause significant morbidity and mortality. Surgery disturb the equilibrium between coagulation and fibrinolysis in the abdominal cavity in favour of coagulation system. Diminished fibrin degradation is a common pathway for the formation of abscess. We present a case of 40 years of male came with pain in left iliac fossa and lower abdomen for last 2 months with a swelling at LIF and hypogastric region for last 3 months with a previous history of hernia surgery of left side 2 month back which was  diagnosed as mesenteric abscess and  treated with exploratory laparotomy under general anaesthesia and abscess was drained.
Surgical treatment in obstructive sleep apnea syndrome: an overview
Authors: Sparacino Lucrezia , Bruschini Luca , De Vito Andrea , Fiacchini Giacomo , Berrettini Stefano
Published: July 2020

Obstructive sleep apnea syndrome is a common pathology affecting pediatric and adult population. It is caused by an increase upper airway resistance due to augmented collapsibility that cause alteration in ventilation and oxygen saturation. Sleep oxygen desaturations have multi-organ implications. Since many years, OSAS, has been recognized as a risk factors for comorbid cardiovascular disease. Well-known is the causal link with cognitive impairment and atherosclerosis. Healthcare professionals, should be trained to recognize signs and symptoms of the disease in order to send the patients forward for specialist care in centers dealing with sleep-disordered breathing. However treatment knowledge is of pivotal importance in the cultural baggage of all the physicians.  Surgical and non-surgical therapies have undergone a great number of changes. Going along with the innovations in diagnostic evaluation and phenotyping of the patients, surgeries were heightened by new developments such as advances in tailoring procedures and technologies. The aim of this overview is to describe the evolution and main characteristics of encoded procedures classified into site of surgical correction.
Factors associated with the employment status of breast cancer survivors: a single center cross-sectional study
Authors: Yildiz Fatih , Alaguney Mehmet Erdem
Published: July 2020

Background: Breast cancer survivors constitute a big proportion among all female cancer survivors and the employment status of breast cancer survivors is an important public health issue. The aim of the study is to evaluate the effects of some demographic properties and the treatment modalities used for breast cancer on patients’ employment status.Methods: This is a single-center cross-sectional study. We assessed 2550 patients with breast cancer for eligibility. Face to face interview was performed with 688 breast cancer survivors. A total of 249 patients who had an income-generating job before diagnosis and completed at least 1 year after surgery and/or adjuvant radiotherapy, chemotherapy for breast cancer were included in the study. The job loss rate of the patients was evaluated according to their demographics, clinical features and treatment methods applied for breast cancer. Univariate and multivariate analyses were used in order to show these associations.Results: The job loss rate of the whole study group was 49.4% (n=123). Adjuvant radiotherapy was associated with continued employment, however, neither adjuvant chemotherapy nor hormone therapy had no association. Higher level of education, higher household income, being a public officer, and having a breast-conserving surgery was associated with continued employment in breast cancer survivors.Conclusions: The prior employment as a private sector employee should not be a determinant for losing job. Therefore, improvements or modifications should be made for this factor in order to keep breast cancer survivors in working life.
Do beverage workers in Enugu state Nigeria comply with health safety measures? A cross sectional study of two breweries
Authors: Ezeoke Uche Enuma , Mamah John Basco Emmanual , Ndu Anne Chigedu , Mbachu Chinyere Ojiugo , Okeke Chinyere Cecilia , Kate Umeobieri Ancilla
Published: July 2020

Background: Some workplace accidents happen because workers fail to do their work in the safest possible way. Human beings have an innate desire to be safe, and their commitment to maintaining safe work environment is imperative for occupational health. However, employees’ contributions to workplace accident and injury is underexplored.Methods: Cross-sectional quantitative study was undertaken in two beverage industries in Enugu state. In order to observe a proportion of 50% in staff compliance to safety measures with precision of 5% and confidence level of 95%, 217 full-time employees were selected from each industry. Stratified sampling technique was used to select respondents across 5 units/departments. Data was collected using pre-tested structured questionnaire and analyzed using descriptive statistics. Statistical significance was set at p<0.05.Results: Use of any form of safety device was reportedly high among respondents, 413 (97.4%). However, only 278 (67.3%) reported using them on a daily basis. Aprons 103 (24.9%), helmets 163 (39.5%), and hand gloves 197 (47.4%) were the least commonly used safety devices. The only reason reported for inconsistent use of safety devices was discomfort. Consistent use of safety devices correlates significantly with demographic characteristics such as age, sex, level of education, length of years of work and unit/department (p<0.001), as well as previous history of workplace injury (p=0.01).Conclusions: Consistent compliance with safety measures among factory workers is suboptimal and correlates significantly with demographic characteristics and previous history of workplace injury.