bluuebunny/crossref_metadata_2025 huggingface dataset:
Seroprevalence of markers of transfusion transmissible infections among blood donors at a tertiary care hospital blood bank: a 5 year retrospective study
Authors: Yasmeen Irm , Kour Supinder , Khurshid Imran , Malik Aasifa
Published: July 2019

Background: Transfusion transmitted infections (TTIs) can be caused by various microorganisms present in the blood of apparently healthy donors. The recipient may get infected after being transfused with the unsafe blood. It is mandatory to screen the blood for HIV 1 and 2, HBV, HCV, Syphilis and Malaria. This study was undertaken to investigate the seroprevalance of Transfusion transmitted infections among blood donors at our tertiary care centre and to compare our study with other studies conducted at different hospitals of the country as well as outside.Methods: A retrospective review of blood donor records was made over a period of 5 years with effect from January 2014 to December 2018 at blood bank, department of Blood Transfusion and Immunohaematology, SKIMS, Soura, Srinagar. Both voluntary and replacement blood donors were selected after taking proper history and examination were included in the study. Serum samples were screened for HIV 1 & 2, HBV (HBsAg) and HCV using ELISA with 3rd generation kits.Results: A total of 56325 blood donors were screened. Out of total 55346 (98.2%) were males and 979 (1.73%) were females. Among them 38969 (69.1%) were replacement donors and 17356 (30.8%) were voluntary donors. The seroprevalance of HBV (HBsAg), HCV and HIV 1and 2 was 0.24%, 0.17% and 0.01% respectively and overall seroprevalance of TTIs was 0.43%.Conclusions: Continuous improvement and implementation of newer techniques like NAT and chemilumenescence for testing of blood for TTIs will reduce the risk of acquiring these infections.lance
Hepatitis B awareness and vaccine status among allied health science students
Authors: Aasaithambi Anupriya , Manoj Mikun , Nagarajan Prabhusaran , Alagappan Uma
Published: July 2019

Background: Hepatitis B is endemic throughout the world and occupational exposure to HBV is very common among health care professionals. The main objective of the study was to assess the knowledge about HBV virus, modes of transmission and vaccination status.Methods: This was a prospective cross-sectional study which was carried out among 60 Allied Health Students in a tertiary care teaching hospital. The valediction of the questionnaire was done by a pilot study before starting the survey.Results: The respond rate was 96% and knowledge on causative agent was 93%, the organ affected 81.7% and modes of transmission were 70%. Awareness about vaccination and its importance were also assessed. The participants completed their three doses of vaccination were 12%, two doses 70% and not yet started was 18%. Awareness about other health care related infections through needle stick injuries and the risk percentage of contracting infection in the order of HIV, HBV and HCV was answered correctly by 81% of the participants.Conclusions: This study may help to impart the knowledge and awareness about HBV among the student population who lack knowledge regarding mode of transmission and fatal consequence. This study may further help the student population to inculcate health precautions during their clinical exposure in the near future.
A retrospective cross sectional study on neurological profile of children with congenital heart disease
Authors: Banerjee Asish , Mitra Meenakshi
Published: July 2019

Background: Children with Congenital Heart Disease have associated structural neurological    abnormalities and those surviving infancy are even subjected to various environmental factors   which might contribute to neurological abnormalities. Hence the objective is to study the neurological abnormalities of children with Congenital Heart Disease.Methods: A retrospective cross-sectional observation study was conducted over the period of 3 years (June 2016-May 2019). Data were collected from medical records department of 121 children of 2-12 years of age diagnosed with congenital heart disease. Neurological examination findings and neuro imaging and EEG findings where relevant    were noted. To assess the association of adverse neurological outcome and congenital heart disease, data analysis was        performed using Fisher's exact test.Results: 38% children of 2-12 years of age with congenital heart disease had adverse neurological profile. Neurological abnormalities were significantly associated with cyanotic heart disease (p value 0.0001). Statistically significant association were found between congenital cyanotic heart disease and seizure (p value=0.04), hemi paresis (p value=0.039), brain abscess (p value=0.012) and coma (p=0.01).Conclusions: Congenital cyanotic heart disease has significant associations with neurological abnormalities in children. These results demand attention for the   neurological health of the largely uncorrected cardiac disease in Indian children
Predictable factors for intervention with heparin free plasmapheresis in impending liver cell failure due to consumption of phosphorus rodenticide
Authors: Banjan Deepa S. , Sane Kavita , Wattamvar Sachchidanand , More Mahesh
Published: July 2019

Background: Yellow phosphorus containing rodenticide poisoning are common in Adult critical care. They cause coagulopathy and liver cell failure in humans. Till date, only liver transplants had been advocated as the final treatment of fulminant liver failure occurring as a complication of rodenticide poisoning. In this study, an innovative Treatment approach was given to liver cell failure cases who had consumed yellow phosphorus paste.Methods: Retrospective analysis of case records of liver cell failure cases due to the consumption of phosphorus containing Rodenticide poisonings, were analysed for a period of 1 year from January 2018 to January 2019 in a public hospital. Medical case records were obtained from records department and Postmortem registers. Symptoms, signs, investigations, treatments, complications, and outcomes were tabulated.Results: Total 11 cases were studied. 8 cases of liver cell failure and coagulopathy in whom therapeutic heparin free plasmapheresis was given, recovered completely from liver cell failure. A significant drop in Haemoglobin, platelet count, PT INR Ratio and rise in serum alkaline phosphatase, were the predictable factors used for the intervention of therapy with 5 cycles of heparin free plasmapheresis to eliminate toxic effects of phosphorus on liver cells and in the blood. A comparative analysis of untreated cases (n=3) vs treated with plasmapheresis (n=8), showed a significant statistical difference (P <0.005) in outcomes with a degree of freedom=2.Conclusions: Plasmapheresis can be a therapeutic treatment for liver cell failure caused due to the consumption of yellow phosphorus.  Predictable factors for impending liver cell failure in whom plasmapheresis will be of benefit are dependent upon prothrombin time, INR ratio, Liver enzymes and time interval between consumption and onset of liver cell failure.
Clinico-pathological and radiological correlation of CNS tumors along with role of Ki 67 proliferative index in grading Astrocytoma and Meningiomas
Authors: Boni Lakshmi Saraswathi , Kondapalli Mounika , Kotni Venkata Swarajya Lakshmi , Botta Venkata Satya Kartheek , Prasad Uma , Atla Bhagyalakshmi
Published: July 2019

Background: CNS neoplasms are a heterogenous group contributing to <2% of all the malignant neoplasms. Imaging and histopathology play a great role in diagnosing these lesions. Aim of the study is to correlate radiological findings with that of histopathology and evaluate the role of Ki 67 proliferative index in various grades of Astrocytomas and MeningiomasMethods: This is an observational study for a period 2 years from July 2015 to June 2017 in Department of Pathology Andhra Medical College. The total number of specimens of CNS tumors received during this period were126. The specimens were routinely processed and stained with H&E. The tumors were classified based on WHO 2016 classification. In total 71 cases-45 cases of meningiomas and 26 cases of astrocytomas, the expression of Ki 67 labelling index was recorded in various grades of these tumors and results tabulated.Results: Among 126 cases, tumors predominantly encountered were of meningeal origin accounting to 45 cases (35.71%) followed by tumors of neuroepithelial origin 35 cases (27.78%). Tumors were seen in all age groups, but common was among 41-50 years of age group with metastatic tumors being seen in >60 year group. Tumors were more common in males with male: female ratio being 1.25:1. Ki 67 proliferative index increased as the grade of tumor increased in both astrocytomas and meningiomas.Conclusions: Grading of meningiomas and astrocytomas are very much essential with reference to prognosis and therapy. Histopathology plays a great role in grading these lesions but Ki 67 proliferative index adds as an adjunct and helps in confirmation and predicting the recurrence of these lesions.
Comparison of pulmonary function of women in 2nd trimester and non-pregnant women, in central Uttar-Pradesh, India
Authors: Khan Humail , Jaiswal Kirti Jaiswal , Sant Santosh K. , Kumar Sandip
Published: July 2019

Background: Pregnancy is nothing but a process of maternal adaptation to meet the increasing needs of the growing foetus. Significant changes in the highly sensitive respiratory system occurs during pregnancy to fulfil increased demands as well as to combat stress of pregnancy. Although many studies have been done in India to study the Pulmonary Functions during pregnancy, but due to paucity of such study in central Uttar-Pradesh this study was planned.Methods: This study was carried out on 353 2nd trimester pregnant women coming to ANC clinic of Obstetrics and Gynaecology Department of Uttar-Pradesh University of Medical Sciences, Saifai, Etawah, pulmonary function parameters were recorded using Computer based Digital Spirometer. Data were compared with pulmonary function parameters of age matched 353 Non-Pregnant controls. Parameters studied were FVC, FEV1, FEV1/FVC, PEFR and MVV.Results: FVC, FEV1, FEV1/FVC and PEFR was found less in pregnant women as compared to Non-pregnant women, difference was statistically highly significant (P<0.01). MVV was also found less in pregnant women but it was insignificant (P >0.05).Conclusions: All parameters of PFT are deranged in pregnancy. Matching of other attributes of cases and controls like height, pre-pregnancy weight of cases and weight of controls, Haemoglobin, BMI, could possibly further explain the established relationship of pregnancy and PFT parameter derangements. Perhaps, a longitudinal study in expectant mothers by measuring their PFT parameters in non-pregnant states and then serial follow-up PFT measurement during their pregnancy would be a better approach to look for the effects of pregnancy on PFT parameters.
Sexual dimorphism: metric measurements based study in human talus bone
Authors: Dagar Tarun , Sharma Luv , Khanna Kunal
Published: July 2019

Background: Identification is the act of establishing the identity of an individual. This is a dynamic process and human remains in form of bones can serve as an excellent tool for establishing the sexual identity of the deceased, along with other methods such as DNA, fingerprints, blood group identification etc. Metric analysis of various bones can serve as a viable alternative in cases when morphological analysis is not possible due to damage to the skeletal remains or as an additive analytical tool to establish a positive identity.Methods: Metric analysis of various parameters of randomly selected 100 pairs of human talus bones (50 male and 50 female) as a means of establishing sexual identity from skeletal remains obtained from unidentified and unclaimed dead bodies brought for autopsy.Results: In the present study we found that the values of all the various dimensions measured were higher among the male subjects as compared to that in female samples as was expected. On further analysis, this difference was found to be statistically significant (p<0.001). For the right sided and left sided talus bone, the probable accuracy for various parameters ranged between 83.3% to 100% each, thus indicating strong correlation between sex of the subject and various measurements.Conclusions: The tarsal and their dimensions are highly sexually dimorphic and are useful in determining sex in individuals of this region.
Anatomical study on sciatic nerve variations in Andhra Pradesh, India
Authors: Kumari K. Lakshmi , Sushma M. , Raja A. , Latha D. Asha
Published: July 2019

Background: The sciatic nerve is the largest and widest nerve in the body and is derived from ventral rami of spinal nerves L2 to S3. Sciatic nerve appears in the Gluteal region below Piriformis from Pelvic cavity by passing through Greater Sciatic foramen. In between the Ischial tuberosity and greater trochanter of Femur, it reaches the back of the thigh. At the superior angle of Popliteal fossa, it divides into Tibial and common Peroneal (fibular) nerves. The division varies, and it may occur within the pelvis, Gluteal, upper, mid and lower part of thigh. The anatomical variations of the level at which the Sciatic nerve divides is considered important by Neurosurgeons, Anaesthetists, Orthopaedicians and Surgeons.Methods: This study was conducted on 52 lower limbs to determine the level of sciatic nerve bifurcation and its variations on 26 embalmed human cadavers. The data was analyzed manually using numbers, frequencies and percentages.Results: The findings of this study states that in 2 limbs (3.84%) the nerve divided in the gluteal region; in 4 limbs (7.69%) in the pelvic region; in 10 limbs (19.23%) at the junction between upper and middle thigh. The highest incidence of division occurs in 36 limbs (69.23%) at the superior angle of the popliteal fossa.Conclusions: The findings of this study revealed that the majority of sciatic nerve divisions occur   at the superior angle of popliteal fossa while some divided into other regions such as Pelvis, Gluteal and thigh regions.
Prevalence of multiple myeloma and its complication in a tertiary medical college at Calicut district, India
Authors: N. Ramani P. , V. Sreeraj , Binub Kanniyan
Published: July 2019

Background: Multiple myeloma is a blood cancer that develops in the bone marrow, which is soft, spongy tissue found in the center of many bones where blood cells are produced. In myeloma, plasma cells, which are normal antibody-producing cells, transform into cancerous myeloma cells. The objectives of this study was the prevalence and complications of multiple myeloma.Methods: A cross sectional study was conducted in a tertiary hospital at Calicut. Semi structured questionnaire was used to study the prevalence and associated complications of multiple myeloma. History taking, physical examinations and investigations like hemoglobin estimation, peripheral smear, electrophoresis, renal function test, calcium estimation, X-ray of thoracic, lumbar spine, humerus, hip region was done. There was also an attempt to find co-morbidities hypertension, diabetes mellitus and neurological abnormalities. The variables was entered into excel and data were expressed in tables. Results: The prevalence of multiple myeloma in Calicut was found to be 77.90% of the bone marrow results were consistent with multiple myeloma. Urine Bence jone protein was positive for 22.9% of cases. Electrophoresis was done and M Band was seen positive for 78.6%. Serum blood urea value was more for 25.7% patients and 22.95% had elevated serum creatinine value. Spine compression was found among 41.4% and osteoporosis was seen in 21.4% patients. Hypertension was seen among 90% cases and Diabetes Mellitus in 4.7% of males.10 % of the patient has valvular heart disease.Conclusion: The study was able to find out the prevalence and project complications of multiple myeloma at Calicut. As there are cases in the district, present medicos who are the future doctors should be trained appropriately to diagnose and treat the disease.
Aluminium phosphide induced pancreatitis
Authors: Nadeem Mir , Phogat Vishal , Waseem Mir , Shah Tabinda Ayub
Published: July 2019

Aluminium Phosphide (AlP) is a commonly used agricultural pesticide. It is cheap, effective, and easily available. Aluminium Phosphide is used as a rodenticide, insecticide, and fumigant to preserve stored cereal grains, also known as "Wheat pills". In Iran, it is known as the rice tablet. There, have been frequent incidents of accidental or intentional deaths. There have been only a few case reports on aluminum phosphide-induced pancreatitis in the literature available. In this report, we present the case of a young man who developed acute pancreatitis following ingestion of aluminum phosphide pellet in the absence of the usual risk factors and after exclusion of other possible causes of pancreatitis. 35-year-old male came to the ER of SGT Hospital, Gurugram, one hour after ingestion of a single 3 g tablet of Aluminium Phosphide (Celphos) at home, with a suicidal intent. He had three episodes of Vomiting on the way to the hospital. On Day 1 of admission, USG abdomen showed heterogeneity of head and the body of pancreas with minimal peri-pancreatic fluid, suggestive of Pancreatitis. Serum Amylase and lipase levels were raised throughout the hospital course. CT images were suggestive of pancreatitis. The signs and symptoms of Acute AlP Poisoning are non-specific, dose dependent and evolve with time. After ingestion, toxic features usually develop within a few minutes. The major lethal consequence of AlP ingestion is profound circulatory collapse, secondary to direct effects of toxins on cardiomyocytes, fluid loss, and adrenal gland damage. Our patient was diagnosed with acute pancreatitis in first 24hours of admission with high suspicion of pancreatitis and managed well with iv fluids and supportive treatment and was discharged after 3 weeks of in hospital stay.
Case of acute abdomen due to acute pancreatitis: a uncommon presentation of leptospirosis
Authors: Sharma Zubin Pradeep , Sharma Divya , Sharma Ravindra
Published: July 2019

Even though, Leptospiral infection is not rare, it can have different rare presentations. Acute pancreatitis is one such uncommon gastrointestinal manifestation of acute pancreatitis. Apart from the classic clinical features, elevated serum lipase, along with radiological proof and positive leptospiral serology confirms this infrequent association.
Bacillus pumilus severe wound infection in a healthy ten years old child: a rare case report
Authors: Intra Jari , Sarto Cecilia , Andreotti Massimo , Marino Achille , Varisco Tiziana , Brambilla Paolo
Published: July 2019

Bacillus pumilus is commonly isolated from a wide variety of soils, plants and environmental surfaces, but rarely from human specimens. In this report, we describe a case of infection caused by B. pumilus in a healthy 10-years-old child. The microorganism was recovered from a severe wound of the left knee after three days from trauma. Pathogen identification was carried out by mass spectrometry. The patient's outcome was positive following an ampicillin/sulbactam treatment without complications.
An under studied co-relation of diabetes and lung function
Authors: Das Dona , Sridhar R. V.
Published: July 2019

The World Health Organization estimates that more than 180 million people worldwide have diabetes, and by 2030 it is expected that this number will have doubled. There is an alarming increase in the incidence and prevalence of diabetes mellitus (DM) in Asian Indians. Epidemiology of Diabetes in India. The prevalence of diabetes is rapidly rising all over the globe at an alarming rate . Over the past 30 years, the status of diabetes has changed from being considered as a mild disorder of the elderly to one of the major causes of morbidity and mortality affecting the youth and middle aged people. Pulmonary function test (PFT) is a complete evaluation of the respiratory system including patient history, physical examinations, and tests of pulmonary function. with insulin-dependent diabetes compared with age-matched control subjects, all lifelong non-smokers. Lung CO transfer capacity is significantly affected by the integrity of lung capillary endothelium and, therefore, the findings of Sandler et al. focused attention on pulmonary vascular changes. The concept of the lung as a target organ for diabetic microangiopathy received continuing attention. Reports of lung function tests in patients with diabetes over the next 15 years have focused largely on pulmonary microangiopathy with relatively few studies of pulmonary mechanical function which leads to a restrictive lung pattern. Diabetes and Lung Function Test : Some studies showed that all the pulmonary parameters, that is, FVC, FEV1, FEF25, FEF50, FEF75, FEF25–75, FEF0.2–1.2, and PEFR were significantly reduced except FEV1/FVC in patients of type 2 DM as compared with the healthy controls. It can be concluded from our narrative review that the Type II or Type I diabetes is definitely having decreased lung functions assessed by spirometry not only because of diabetic complications like pneumonia or other but also due to long term effect of diabetes may be because of micro-angiopathy or decreased elastic recoil capacity of lungs.
Quality improvement in anaesthesiology
Authors: Gupta Maruti
Published: July 2019

In recent times, numerous efforts have been made in the field of medicine to improve the methodology of measuring and reporting the quality of care delivered to patients. Most of these efforts have been executed in the western population, because of an efficient system of Incident Reporting. Quality Measurement in healthcare typically means quantifying processes of care that have a direct relationship to positive health outcomes. Quality in anaesthesia is usually measured by perioperative mortality, morbidity and Incidents. Quality measurement is not only important for the clientele but also for the employer, to make choices and healthcare provider to introspect his performance. It is an effective method of giving feedback to anaesthesiologists, doctors and paramedical staff to address quality issues and bring about improvement. Without Quality Measurement, improvement in quality, if at all, would be expected to be very slow and clientele would be blindfolded in taking important decisions pertaining to health care. The concepts of quality assurance and quality control are rapidly gaining popularity in surgical sciences as the society is heading towards social, technical and clinical advancements globally. In times to come, quality of anaesthesia services will be closely monitored by quality indicators and will become a benchmark for assessment of the healthcare provider and the hospital. At present, the need of the hour is to devise ways and means to measure the quality of care being provided by the healthcare provider and adopt these evolutionary practices aimed at improving anaesthesia delivery services in a medical setup.
Conservative management of penetrating abdominal trauma (stab wound)
Authors: Loulah Magdy Ahmed , Mostafa Asem Fayed , El-Balky Osama Soliman , El-Meligi Abdel-Rahman Mohamed Mohamed Mohamed
Published: July 2019

Background: The aim of the study is to study the reliability of selective conservative management of the penetrating stab abdominal wounds. Trauma is one of the most important reasons of mortality. The mechanism that underlies the penetrating trauma relates to the mode of injury. The early diagnosis of hollow viscus injuries is difficult and a delay in the diagnosis of such injuries may be associated with increased morbidity and mortality. Focused assessment with sonography for trauma (FAST) is an effective for screening and initial classification of stable patients and confirmed by CT scan. The management of stable patients was either surgical exploration or selective non-operative interference with the optimal management of patients is yet to be fully elucidated for abdominal stab wounds (ASW).Methods: A prospective study of 40 patients with penetrating abdominal stab wounds between June 2017 and February 2018, at Damanhour Medical National Institute.Results: The mean age of our patients was 51.9±13.3 years with predominance of males and without predominance of any side to be affected and non-significant deviation from the normal values of hemodynamic signs. The presence of air under diaphragm in X-ray films signify abdominal penetration and ultrasonographic examination (FAST) document the diagnosis and help in following up of cases. Most of hemodynamically stable patients passed conservatively with a little rate of laparotomy.Conclusions: We concluded that there is still a role for conservative management in managing stable cases of penetrating stab abdominal wound.
Scar formation and patient satisfaction after thyroidectomy with and without surgical drains
Authors: Kim Hyo Young , Kim Ho Seong , Kim Hong Il , Park Jin Hyung , Yi Hyung Suk
Published: July 2019

Background: Several comparative studies have documented the outcomes of negative pressure drain use after thyroidectomy. However, these previous studies did not focus on scar formation. The aim of this study was to compare thyroidectomy outcomes with and without negative pressure drain use in terms of scar formation.Methods: Nine hundred seventy-five patients who underwent thyroidectomy between January 2012 and December 2013, at Kosin University Gospel Hospital were enrolled in this study. Patients were assigned to one of two groups at the surgeon's discretion: the negative pressure drain group (n=515) or the no drain group (n=460). Medical records were reviewed, and the incidence and severity of scar formation were compared. We estimated patient satisfaction seven months postoperatively based on aesthetic and functional outcomes using the patient and observer scar assessment scale.Results: The incidence of mild scarring was higher in the no drain group, but this difference was not statistically significant (p=0.069). The incidence of severe scarring was significantly higher in the negative pressure drain group (5.83%, p<0.001). Based on the patient and observer scar assessment scale data from 205 patients, patient satisfaction was significantly higher in the no drain group (p=0.006). Itching was reported significantly less frequently in the no drain group (p=0.034). There were no significant differences between groups with respect to pain or observer scar scale score.Conclusions: This study suggests that not using a drain after thyroidectomy leads to high patient satisfaction and reduces the likelihood of severe scar formation.
Reverse darning technique: an effective and innovative method of inguinal hernia repair
Authors: George Robinson , Radhakrishna Veerabhadra , Mathew Mebin , Rahman Ashna , Thenamangalath Aswini
Published: July 2019

Background: Laparoscopic mesh repair is the standard of care for inguinal hernias. But, our center being in a rural setup catering mainly poor patients who are daily wagers and laborers, open repairs are commonly done. Lichtenstein’s tension-free mesh repair is the standard technique used worldwide. This study was performed to compare the effectiveness of Reverse darning repair over traditional mesh repair in a rural setup and to reciprocate the changes generally. The outcomes such as postoperative pain, seroma formation, postoperative analgesic use, and the recurrence rate were compared.Methods: Retrospective analysis of patients who had undergone mesh repair and reverse darning procedure between January 2013 and December 2017 was performed in a rural tertiary center.Results: The reverse darning group was found to have significantly lesser mean duration of surgery (15.7±1.7 min. vs. 31.2±2.5 min.; t=37.4, p<0.005), analgesic use (4.4±1.2 doses vs. 7.4±1.3 doses; t=12.2, p<0.005), hospital stay (39.4±8.2 hours vs. 58.1±9.5 hours; t=10.7, p<0.005), and the cost of treatment (Rs. 5188±286 vs. Rs. 7154±1290; t=11.6, p<0.005) compared to the Lichtenstein group. The Reverse daring group was also better than Lichtenstein repair in terms of seroma formation (1 vs. 7; chi-square value=7.9; p=0.005), hematoma (0 vs. 6; chi-square value=9.4, p=0.002), and secondary hydrocele (1 vs. 5; chi-square value=4.9, p=0.03).Conclusions: Reverse darning repair was found to be much better than traditional mesh repair due to its simplicity, lesser duration of surgery, hospital stay, cost of treatment, and postoperative complications.
Prenatal and neonatal diagnosis of congenital lung lesions and their management
Authors: Peeka Syam Babu , Srinivas Srirampur , Reddy Kota Ramesh
Published: July 2019

Background: The therapeutic strategy for congenital lung lesions remains controversial. The majority of the patients with congenital lung lesions do not present with complications. Some authors report that there should be no indication of surgical intervention for babies with no symptoms.Conversely, other authors recommend elective surgery, because the wait-and-see strategy might only increase the risk of abscess formation or the development of severe lung infections. The aims of the study was to evaluate cases with congenital lung lesions presented to pediatric Surgical department with an objective of assessing age and sex distribution, clinical features, diagnosis, management and outcomes.Methods: Prospective and retrospective study in Department of Pediatric Surgery, all cases of congenital lung lesions diagnosed antenatally and in neonatal period. Total 45 Patients were included.Results: Postoperative complications seen in 8 patients with morbidity about 25%. The surgical outcome is favorable, with manageable complications. Surgical intervention in asymptomatic patients is suggested. As the incidence of symptomatic, patients is highest between 1 to 6 months. Recommend elective surgery at 1 month of age. Surgery in asymptomatic patients is less invasive and in the infancy it is safer and more beneficial.Conclusions: Neonates, infants, and children presenting with respiratory distress due to these developmental anomalies may require urgent surgical intervention. Plain X-ray chest and CECT scan of the thorax are usually sufficient for diagnosis and planning of treatment. Lobectomy is the procedure of choice.
Human papilloma virus associated carcinoma penis: a comparative study for histopathological correlation and outcome analysis
Authors: Singh Akash K. , Pandey B. B. , Jangir Naresh
Published: July 2019

Background: Penile cancer prevalence is higher in the developing countries like Africa, Asia and South America as compared to western countries. HPV (human papilloma virus) DNA is detectable in about 50% of all penile cancer in India. The aim of the study was to compare tumour depth, lymph node metastasis and lymphovascular invasion and other high risk features in HPV positive penile cancer patients to HPV negative penile cancer patients.Methods: This prospective, comparative study was done at Mahavir cancer sansthan a tertiary cancer centre in Patna (India). Biopsy proven cases of HPV positive and HPV negative penile cancer were compared for histological parameters and disease free survival. Statistical analysis was performed using NCSS 12 version 12.0.5 software. Kaplan- Meir survival analysis was done for disease free survival.Results: On bivariate analysis, factors associated with HPV positivity were histological subtype (p=0.00001), grade of tumour (p=0.00698), depth of invasion (p=0.00001) and P16 status (p=0.00001). Depth of invasion (p=0.0499) and P16 status (p=0.00001) were the only independent factors associated with HPV status on multivariate analysis. There was no significant difference in 2 year disease free survival between the two groups, 91.57% vs 87.95% (p=0.4166 ).Conclusions: Large proportion of penile cancer is associated with HPV in India. HPV associated penile cancer are highly invasive with predominant warty–basaloid histology. P16 immunostaining is strongly associated with HPV tumour. There is no survival advantage in HPV associated penile cancer as compared to HPV negative penile cancer.
Role of prostatic specific antigen density and its correlation with histopathology in diagnosis of the carcinoma of prostrate
Authors: Choudhary Yashashvi , Patel Mohit Kumar , Baviskar Padmakar K.
Published: July 2019

Background: The specific threshold for prostate-specific antigen (PSA) to delineate patients who are at the highest risk has been controversial. It is wiser to refine PSA by its derivative parameter like PSAD (PSA/vol) which can be used as a better diagnostic tool in early detection of carcinoma of prostrate. To evaluate sensitivity and specificity of PSAD in diagnosis of carcinoma of prostrate.Methods: A study including 70 patients was done in Pravara Medical College and Rural Hospital, Loni. Patients were screened for prostatic diseases by DRE, blood PSA (ng/ml) estimation, prostatic volume by transabdominal ultrasonography and prostatic biopsy by FNAC or Tru cut Biopsy.Results: In the present study maximum incidence of BPH and CaP manifested in the age group of 61-70 (i.e., 35.18%) and Ca prostate were in age group of 71-80 (i.e., 50%). The maximum number of patients with BPH were having PSA values between 3-10 ng/ml, where as in CaP the value varied between 10.1-20 ng/ml. The maximum number of patients were in the range of 3-10 ng/ml in which age group 61-70 were having highest (35.71% of the pts in that range) followed by PSA range 10.1-20 ng/ml in which, age group 71-80 have shown maximum number (54.54% of the pts in that range) . The sensitivity, specificity, accuracy of PSAD in diagnosing malignant prostatic diseases were analysed and values were as follows: sensitivity: 87.50%, specificity: 92.59%.Conclusions: It was concluded that patients with PSAD >0.15 can be advised for prostatic biopsy and regular follow so that appropriate treatment is performed and mortality due to prostatic malignancy is reduced.
The role of tibialis posterior tendon transfer in foot drop by circumtibial route and evaluation of the results according to criteria
Authors: Chaurasia R. K.
Published: July 2019

Background: The transfer of the tibialis posterior tendon to the anterior aspect of the ankle not only replaces the function of the paralyzed muscles, but also removes the deforming force on the medial aspect of the foot. This study was conducted to find the role of tibialis posterior tendon transfer in foot drop by circumtibial route and with evaluation of the results according to criteria.Methods: This study was conducted in MLB Medical College and Hospital, Jhansi. Patients of paralytic foot drop due to leprosy with a moderately strong tibialis posterior muscle were selected from the outpatient department of Orthopaedics and Leprosy reconstructive surgery units. After taking informed consent, detailed history was taken. Data was analyzed using Microsoft Excel and the difference was considered to be significant if ‘p’ value was <0.05.Results: Eleven patients were operated. Majority were males (82%). Eight patients (73%) had excellent and good results which were aged less than forty years. Two cases showed excellent results after corrective surgery that had deformities from 31 to 36 months before operation. Out of six patients who were taking antileprotic treatment, one (9.1%) showed excellent and three (27.3%) showed good results.Conclusions: Method of anterior transfer of tibialis posterior for correction of foot drop has given encouraging results in a fairly large percentage of cases. The greatest utility of such a transfer is that of allowing the freedom of normal mobility in comparison to bony stabilization. After correction of deformity and disability the patient’s mental health is improved.
The cost effective role of Eschmarch tourniquet and psychosocial awareness of disease as a key factor in decompressive therapy of filarial lymphedema
Authors: Mane Arun Y. , Naik Narendra G.
Published: July 2019

Background: The filiariasis is the most common cause of secondary lymphedema of the lower limb. Due to poor awareness of this disease in the people of the lower socioeconomic strata, the patient understands the importance of conservative modality of therapy very late. The cutaneous changes and its complications develop in patient due to unawareness about the nature of noncurable progressive disease. The self-negligence to their own limb also contributes to increase in the morbidity of the disease. The article discusses about cost effective role of Eschmarch tourniquet as a decompressive therapy. The disease causes socioeconomic impairments, stigmatization due to elephantiasis and job insecurity due to cosmetic and functional disability.Methods: This was a retrospective study done in 28 cases of filarial lymphedema. All patients received limb elevation and decompressive therapy by Eschmarch tourniquet.Results: Out of 28 cases, 14 cases in study group of filarial lymphedema with pitting edema (71.42%) and non-pitting edema feet with minimal cutaneous changes (28.57%) showed significant reduction in size of limb girth and satisfactory fluctuating limb girth during the follow up period in OPD respectively, by adequate limb elevation, elastic stockinet and decompressive therapy by Eschmarch tourniquet as compared to the remaining 14 patients of control who received only limb elevation. The better follow up results are noticed by proper guidance to the patient about the disease and its conservative modality of treatment.Conclusions: It is a challenge for the treating consultant to create early awareness about the nature of the filarial disease and early guidance about the conservative treatment which helps to restrict the rapid growth of limb size in filiariatic lymphedema. The eschmarch tourniquet is one of the cost effective decompressive therapy.
Varicose veins of lower limb: clinical presentation and management
Authors: Nagre Akshay , Deshmukh Satish , Akhtar Murtaza
Published: July 2019

Background: Varicose veins is a common clinical condition affecting the lower limbs. Usually patient comes for a cosmetic problem, it can cause complications giving rise to significant morbidity if not treated in time. Different options are available for surgical management. The present study has been carried out to study demographic factors, evaluate clinical presentation and outcome of various modalities of management of varicose veins of lower limb.Methods: The present study was carried out in a tertiary care academic hospital from October 2016 to October 2018 and 54 cases were enrolled. The clinical presentation of varicose veins were studied. Mean age and gender preponderance were calculated. All patients underwent clinical tests and venous doppler and accordingly appropriate treatment in the form of conservative, surgical or endovenous laser ablation was given. Complications following the procedures were studied.Results: A total of 39 (72%) patients out of 54 were below the age of 50 years. Prominent veins over lower limb was most common presentation. Sapheno-femoral junction was most commonly involved vein. Male preponderance was observed with a male to female ratio of 12.5:1. Venous Doppler had accuracy of 92.59% in detecting sapheno-femoral and perforator incompetence. Results of endovenous laser ablation are similar to surgery but with less morbidity.Conclusions: This study revealed the disease is prevalence in active phase of life with male preponderance. Majority of the patients had great saphenous vein incompetency and the complications are more when both great saphenous and perforator systems are involved. Venous Doppler is the investigation of choice as it has high accuracy.
A case report on a sporadic retroperitoneal malignant peripheral nerve sheath tumour mimicking a pelvic abscess
Authors: Vidyanendh Vijayalakshmi , Damodaran Arun , Karunakaran Amilthan , Arumugam Shri Ranjani
Published: July 2019

Soft tissue sarcomas (STS) are a diverse group of neoplasms with about 60 subtypes arising from a variety of anatomical structures across all age groups. The diagnosis of STS can prove to be challenging as it mimics a variety of non malignant conditions. Here we present one such case of a sporadic MPNST which was operated on with the main differential diagnosis of a Pelvic Abscess. Hence though STS is rare in general population it should always be kept in mind in cases of doubtful and confusing presentations.
Right iliac fossa lump: a diagnostic surprise
Authors: Chandhirasekar Balaji , Neogi Sushanto
Published: July 2019

A 42 years gentleman presented with recurrent urinary tract infection and intermittent lump in the right side of abdomen for 4 months. Clinically, soft cystic lump in the right iliac fossa with ill-defined lower margins, and disappeared on micturition. Contrast enhanced CT urography showing a large urinary bladder diverticulum of 107mm×52 mm. Cystoscopy confirmed a bladder diverticulum on left lateral wall of urinary baldder, superolateral to left ureteral orifice with no bladder trabeculations and bilateral normal ureteric orifice. Patient underwent open diverticulectomy with primary repair of urinary bladder wall done. Histopathology confirmed the presence of all layers in the wall of diverticulum. Postoperative period was uneventful. Patient resolved of symptoms in the 6 month follow up period.
Bilateral breasts metastases from gall bladder adenocarcinoma: a rare presentation
Authors: Gopal Vaibhav Raj , Yadav Shailendra Kumar , Ahmad Faraz , Kumar Surender , Shukla Saumya , Bhargav Mithlesh
Published: July 2019

Bilateral breasts metastasis from gallbladder adenocarcinoma is very rare and has never been reported. Overall incidence of breast metastasis from other primaries as reported in literature is 0.5-3%. A 38 year female presented with progressive abdominal distension followed by lumps in the left and right breasts consecutively. Abdominal examination revealed a huge right upper quadrant lump, hard in consistency and moving with respiration. CT abdomen suggested gallbladder lump infiltrating liver, colon, duodenum and pylorus. HRUSG of breasts revealed malignant lumps. Histopathology and immuno-histochemistry of breast biopsy confirmed it to be metastatic and not the primary (mammaglobin-, GATA 3 -, CK 19+, GCDFP-). Gallbladder biopsy showed adenocarcinoma with similar marker pattern. A diagnosis of gallbladder carcinoma with secondaries in bilateral breasts was made. Patient received one cycle of platinum based palliative chemotherapy and thereafter was lost to follow up. A proper clinical, radiological and histopathological examination is essential to distinguish primary and metastatic breast lesion due to the difference in the management of both. Overall prognosis is very poor and treatment should be directed towards palliative therapy of primary malignancy.
A curious case of chest wall lump turning out to be isolated primary cutaneous aspergillosis in an immunocompetent female: a case report
Authors: Kamat Manmohan Madhukar , Singh Neeraj Pratap , Nattey Kartik , Shetye Shravani , Barman Seema
Published: July 2019

Aspergillosis is a fungal infection caused by certain types of mold. Although they are found commonly throughout nature, these molds normally don’t cause problems. Aspergillosis is an uncommon fungal infection in which primary cutaneous sites are very rare. Most cases occur in immunodepressed patients and are disseminated in the blood. We report a 32 year old female with primary cutaneous aspergillosis in an otherwise immunocompetent female with no other systemic manifestation. 32 year old female presenting with left lower chest lump fixated to chest wall. It was thought of as neoplasm clinically and radiologically mostly soft tissue neoplasm and was planned for wide excision of lump with segmental excision of involved rib segment. On histopathological examination of the specimen, it showed aspergillus organisms. It is a case of primary cutaneous manifestation of aspergillosis as fixed chest wall lump with otherwise no Broncho-pulmonary or systemic involvement in an immunocompetent patient. Primary cutaneous aspergillosis presenting as isolated chest wall lump without any Broncho pulmonary or systemic involvement in an otherwise immunocompetent individual is an extremely rare manifestation.
DAKWAH BY THE PEN: SALIM A. FILLAH’S AUTHORITY IN PRO U MEDIA
Authors: Mupida Siti , Shalihati Khoirin Nisai
Published: July 2019

This article discusses ‘dakwah’ (Islamic missionary work) with a friendly concept using rhetoric and narratives that are easily understood by various groups. The missionary work message is covered with beautiful rhetoric by Salim A. Fillah through his books published by Pro U Media. This study uses normative juridical approach with descriptive study. Data collection is condcuted by literature study. The collected data then analyzed qualitatively through deductive method. The findings of the study show that the new Islamic literature has been popularized by young Muslim writers affiliated with contemporary Islamic movements such as Hizbut-Tahrir Indonesia (HTI), Salafi, and Tarbiyah. This research shows that Indonesian Islamic thinker like Salim A. Fillah through social media and his published books uses various scientific arguments based on some classical and modern literature. Formerly Salim A. Fillah is not a person who has ever studied at pesantren (Islamic boarding school) but his religious view can be seen in his fatwas (religious advices) which affecting various communities
EMPATHY POLITICS VERSUS TERRORISM: THE NEW ZEALAND PRIME MINISTER JACINDA ARDERN’S POLITICAL LEADERSHIP COMMUNICATION
Authors: Mustaqim Andika Hendra
Published: July 2019

This research explores the political communication by New Zealand Prime Minister JacindaArdern in the face of terror attacks of two mosques in Christchurch on March 15, 2019. The emphasis of research is empathy politics in a narrow framework and broader framework, namely the humanitarian framework. The study used the method of analyzing the content of speeches and Ardern statements and case studies with qualitative approaches and critical constructivist paradigms. The results of the study are Prime Minister JacindaArdern using various models and ways to show political communication in handling terror attacks against two mosques in Christchurch. The politics of tears is played as a form of empathy politics. Protection from minorities was also shown by Ardern. Hug is a form of political action to embrace. Ardern often gives greetings typical of Muslims.
Actualización en carcinoma basocelular periocular: abordaje semiológico y diagnóstico diferencial
Authors: Amaya Nieto Luis Miguel , Sierra Patiño Luisa Fernanda , Pérez Estepa Héctor Horacio
Published: July 2019

Introducción: este artículo se basa en la revisión y profundización de conceptos actuales rela¬cionados con la semiología clínica y el diagnóstico diferencial, referentes al carcinoma basoce¬lular periocular (CBPO). Objetivo: describir las características semiológicas y los diagnósticos diferenciales del CBPO. Metodología: se realizó una revisión de literatura en las bases de datos ScienceDirect, BVS, Pubmed, SciELO y EBSCO/Medline, mediante los términos MeSH y DeCS “carcinoma”, “basal cell” y “carcinoma basocelular”, con el operador booleano “and” y el término “periocular”, en el periodo 2012-2018. Según el total de estudios relacionados con los términos de la búsqueda, fueron seleccionados artículos escritos en francés, inglés, alemán y español. La calidad de la evidencia científica fue clasificada a través de la metodología de Oxford. Resultados: se describieron las características semiológicas del CBPO y sus diagnósticos diferenciales mediante un flujograma, que permite realizar su identificación clínica. Conclu¬sión: el CBPO es la neoplasia maligna más común del párpado y podría catalogarse, debido a su alta incidencia, como una primera impresión diagnóstica ante la identificación de neoplasias malignas palpebrales. Su detección temprana y el control ante posibles recidivas conforman un objetivo principal del diagnóstico y la prevención en la praxis clínica.