bluuebunny/crossref_metadata_2025 huggingface dataset:
STUDY OF IRON DEFICIENCY IN INFANTS BY MEASURING SERUM FERRETIN LEVELS
Authors: Jauhri Dr. Neeraj
Published: March 2020

Introduction: In human body for many metabolic processes to take place as a mineral iron is necessary element.  It is a part of haemoglobin which is important and essential for the delivery of oxygen to the cells of body. Worldwide especially in developing countries Nutritional anaemia is problem with the highest prevalence. When the hemoglobin and/or hematocrit are two standard deviations below the mean for that particular age and sex then a child is said to be anemic. This national problem of iron deficiency (ID) without anemia is worldwide concern which lead to long term neurodevelopment and behavior disorders that may be irreversible. Anaemia is consider as serious condition because it impair in behavioral and motor development, impairments in cognitive performance, coordination, language development, and scholastic achievement as well as increased morbidity from infectious diseases. This is most endangered in age group of 6- 24 months of age.

Aim: The main objective of this study is to prevalence of iron deficiency in infants by measuring serum ferretin levels.

Material and Method: Total 70 patients with various age groups from 1 month to 24 months of age group attending to Pediatrics department of this college were included for study. For each patient various physical examinations were carried out to rule out other causes of anaemia like hemolytic anaemia, anaemia of chronic disease etc. laboratory investigations like CBC, Hb indices and peripheral smear carried out. In all the patients Serum ferritin levels were estimated.

Result: Prevalence of anaemia (Hb<11gm/dl) in 1- 12 months age group was 82.3%, in 13- 18 months age group was 79.5% and in case of 19-24 months age group was 85.4%. Overall, 82.7% of infants were found to be anemic.  Amont the total anaemic patients 45 infants (64.3%) among 70 infants had mild anaemia, 19 infants (27.1%) had moderate anaemia, 6 infants (8.6%) had severe anaemia. 48 (68.6%) out of 70 patients had low serum ferritin levels and only 21(30%) had normal levels. Out of 70 patients 48 had low serum ferritin levels. However though not all infants having low MCV had iron deficiency but all iron deficient infants have low MCV value. 2 of 70 infants had serum ferritin level >400ng/ml.

Conclusion: In this study there is significantly Association between iron deficiency and low MCV. This study emphasis need for iron supplementation aim all healthy infants as early as 6 months.  More and more studies on a larger population of children should be carried out to determine the role of other factors is needed.

Keywords: Infants, iron deficiency, serum ferretin, Haemoglobin level, MCV
EVALUATION OF DIFFERENT TYPES OF CROWNS USED FOR RESTORATION OF ENDODONTICALLY TREATED TEETH
Authors: Shreya Dr. Shivangi
Published: March 2020

Endodontically treated teeth (ETT) have been problematic in most cases as a result of dental caries, fractures, previous restorations and endodontic procedures. Several post system techniques and materials are currently used to build up ETT with moderate or severe loss of coronal tooth structure and to retain final restorations. Following root filling, the custom-made cast metallic post and core with metal-ceramic crowns was the traditional restoration of choice, but this has changed. The patients’ primary motivation for seeking superior dental aesthetics, particularly in the anterior aesthetic zone, has prompted the development of non-metallic restorations. Several new types of polymeric and more aesthetic quartz and glass-fibres posts, combined with direct resin composite cores, provide an aesthetic foundation for an all-ceramic crown and have overcome the aesthetic limitations of metallic posts and cores in the anterior teeth. Until recently, there has been controversy in the dental community regarding which material or technique is the most favourable for the restoration of ETT. It seems that the amount and retentive capacity of the remaining tooth structure, the position of the tooth in the dental arch, the functional or para-functional loading on the tooth, and the treatment plan to restore aesthetics and function all influence the selection of the most appropriate post system for each case.  Hence the present study was planned for Evaluation of Different Types of Crowns Used For Restoration Of Endodontically Treated Teeth.

The present study was planned in Department of Conservative Dentistry and Endodontics, Buddha Institute of Dental Science and Hospital, Patna, Bihar, India. The 40 cases of maxillary anterior endodontically treated teeth (ETT). The roots were restored with reinforced GFPs (Relaxy Fiber Post, 3M ESPE, Germany), and composite resin cores (Tertic-N-Ceramic, Ivoclar Vivadent, Lichenestine).

The survival of ETT is contingent on the residual sound tooth structure that remains after the endodontic access and caries removal are performed consequently the most important factors upon restoring ETT become the maximum preservation and conservation of enamel, dentin and the dentinoenamel junction. Hence, bonded partial restorations are always preferred over full coverage cementable crowns. More clinical studies comparing adhesive crowns bonded to postless build-ups or post and -core build-ups are needed for a better understanding of postless approaches in biomimetic restorative dentistry.

Keywords: Endodontically treated teeth, Crown, cores, post, etc.
CLINICAL EVALUATION OF THE TOOTH LOSS IN PERIODONTAL DISEASE IN DIABETIC PATIENTS
Authors: Kumari Dr. Pallavi
Published: March 2020

Help in detecting diabetes may come from an unlikely source like a dentist as an allied health team, as it is rightly said ‘oral cavity is the mirror of the body system’. They may diagnose undetected cases of diabetes and may refer to a physician for further evaluation and treatment. Research studies have found a link between periodontal (gum) disease and diabetes. Symptoms of the disease often appear in the mouth, while almost one-third of people with diabetes have severe periodontal disease. This is believed to be a result of the diabetic patient’s greater susceptibility to developing infections. Conversely, severe periodontal disease may increase the risk of developing diabetes, and may make it more difficult to manage blood sugar levels. However, studies have found that patients who receive treatment for periodontal disease may be able to control the condition with less insulin. Dentists often detect symptoms of diabetes during routine oral health examinations. Foamy saliva, unusually dry and irritated tissue, poor periodontal conditions inside the mouth are tell-tale signs of the condition. And, diabetic patients often lose more teeth compared to patients without the disease. Proper and effective management of patients with diabetes requires that the practice evaluate all aspects of patient interaction. Systems need to be customized so that all procedures and patient communication scripts are implemented consistently to meet the distinct needs of patients with diabetes. Hence based on above findings the present study was planned for clinical evaluation of the tooth loss in periodontal disease in diabetic patients.

The present study was planned in Department of Public Health Dentistry, Buddha Institute of Dental Sciences, Patna ,Bihar for a period of six months from January 2019 to June 2019. Total 40 patients were evaluated during this period . Out of that 20 cases are of Diabetic patients were enrolled in first group and another second group consist of 20 control patients without any diseases.

The data generated from the present study concludes that there is significant difference in teeth loss amongst diabetics and non-diabetics. People with diabetes should be aware about the periodontal complications associated with it and should go for regular dental visits. Therefore it is the need of the hour to educate the dentists, general physicians and specialists about the association of systemic diseases with oral health and vice versa as many of the systemic diseases may be prevented and improved by improving oral hygiene.

Keywords: Tooth Loss, Periodontal Disease, Diabetic Patients, etc.
TO STUDY THE ONSET AND PROGRESSION OF AIRWAY ABNORMALITY IN TERMS OF ALTERATION IN PFT IN ASYMPTOMATIC SMOKERS.
Authors: Solanki Dr. Hitesh Kumar , Yadav Dr. Omnath P , Gojiya Dr. Anita J
Published: March 2020

The study was conducted in department of physiology, B J Medical College, Ahmedabad from Mar. 2012 to Feb. 2013. This was a cross-sectional study to evaluate the effect of smoking on lung   function and serum lipids in asymptomatic smokers   and comparable non   smokers.

The mean of the various spirometric parameters were calculated of the subjects for both the groups. The mean FVC in group I and group II was 2.60 ± 0.62 L and 4.10 ± 0.64L respectively. The mean FEV1 in group I was 1.91 ± 0.57L and     3.19 ± 0.77L in group II Group I had mean FEF25% - 75% and PEFR of 1.98 ± 0.67L/sec and 4.50 ± 1.57L/sec respectively. Group II had mean FEF25 – 75% of 4.22 ± 1.23L/sec and a mean PEFR of 7.22 ± 1.42L/sec.

In young smokers and asymptomatic, still the spirometric values were significantly deranged as compared to controls. Even smokers with history of less pack years of smoking also had significant abnormalities of lung function. All he spirometric values in the two groups had statistically highly significant difference and were higher in non-smokers as compared to smokers. The spirometric values were reduced in smokers with history of smoking for as low as two pack years.

Keywords: Progression, PFT, Asymptomatic & Smokers
COMPARATIVE STUDY OF PLATELET-RICH PLASMA AND CORTICOSTEROID INJECTION IN THE TREATMENT OF PLANTAR FASCIITIS
Authors: Johar Dr. S. A. Mustafa , Parmar Dr. Rajeev , Ghodawat Dr. Tushaar
Published: March 2020

Background: Plantar fasciitis is defined as localized inflammation due to chronic repeated microinjury to the substance of plantar aponeuroses and the patients present to the clinic for pain in heel. In this study, autologous platelet-rich plasma (PRP), a concentrated bioactive blood component rich in  growth factors, was compared to traditional steroid injection usually methylprednisolone  in the treatment of plantar fasciitis resistant to traditional nonoperative management.

Methods: Eighty patients with plantar fasciitis were included in the study and randomly categorised into group A (steroid inj) and Group B (prp inj). 3 cc PRP or 40 mg DepoMedrol injected into plantar aponeurosis at maximum point of tenderness, in both groups separately. Results of both groups comparedand Score of both the groups tellied by using vas score.

Study Design and Time: Prospective cohort study of 6 months duration.

Inclusion criteria: All cases of plantar fasciitis except cases of metabolic disorder

Exclusion criteria: other plantar pathologies and deformities. calcaneum fractures Old treated with injections.

Results: The instillation of PRP found to be more effective than Steroids injection in terms of pain and functional results in the treatment of plantar fasciitis. Clinical evaluation was performed before treatment and at the 6th week, 12th week and 24th weeks from instillation of PRP/steroid in follow up visits. Visual analog scale were used in the clinical evaluation.

Keywords: Platelet-Rich, Plasma, Corticosteroid, Plantar & Fasciitis.
A STUDY OF PULMONARY FUNCTION TESTS IN A PATIENTS WITH TYPE 2 DIABETES MELLITUS AND THEIR ASSOCIATION WITH GLYCAEMIC CONTROL AND DURATION OF DIABETES AT TERTIARY CARE HOSPITAL
Authors: Gupta Dr. Sonam , Gupta Dr. Yadvendra
Published: March 2020

Background- The pulmonary and other late complications of diabetes share a similar microangiopathy mechanism. Since, they share common mechanisms there may be associations between lung function and markers of microangiopathy. Therefore, we aimed to determine the association of pulmonary function with diabetes and the correlation of pulmonary function abnormalities with microvascular complications.

Methods- This was a cross sectional comparative study carried out in a tertiary care teaching hospital in Jaipur,Rajasthan, India. Eligible participants included 100 adults below 60 years of age with T2DM attending the outpatient clinics or admitted to the wards during the study period, and an equal number of non-diabetic adults matched for age and gender who served as the comparative controls.

Results- The present study clearly showed a highly statistically significant p value when the lung function tests (FVC, FEV1, and PEFR) were compared between type 2 diabetics and age, sex, BMI matched controls. The duration of DM and PFT correlation was found stastically significant and HbA1c and PFT correlation was found stastically Insignificant.

Conclusion- Chronic hyperglycemia in diabetes may lead to diabetes associated systemic inflammation which results in airway and lung damage. Diabetes was more common in the sixth decade of life with slight male preponderance. The most common PFT derangement pattern in diabetic subjects is a restrictive pattern and having a significantly longer duration of a diabetic. The short-term indicators of glycemic controls were not significantly associated with a restrictive pattern of PFT.

Keywords: Diabetes, Pulmonary function test, HbA1c, Duration of diabetes.
TO MEASURE THE CORRELATION BETWEEN ULTRASONOGRAPHY MEASURED HYOMENTAL DISTANCE RATIO AND EASE OF LARYNGOSCOPY
Authors: Koundal Dr. Vishal , Kumar Dr. Mahesh
Published: March 2020

Background: Difficult and failed tracheal intubation after direct laryngoscopy is a dreaded complication of general anesthesia as it is associated with serious morbidity and mortality.

Methods: Prospective Observational conducted at Department of Anesthesiology, Dr. RPGMC Kangra at Tanda, Himachal Pradesh.

Results: In the present study, the mean hyomental distance ratio was (mean±SD:1.1.±.127 and 1.04±.018) in predicting CL grade 3 and 4 respectively (P=0.010) and 1.12±.033, 1.11±.035 in grade 1 and 2 respectively.

Conclusion: Ultrasound is better and fast in confirming endotracheal intubation.

Keywords: Ultrasound, endotracheal intubation, direct laryngoscopy.
EVALUATION OF ECTOPIC ERUPTION IN TEETH’S OF CHILDRENS FROM 5 TO 12 YEARS AGE GROUP
Authors: Rai Dr. Anurag , Kumar Dr. Tanoj , Rai Dr. Shweta , Kumari Dr. Minti , Chaudhary Dr. Pallawee
Published: March 2020

Treatment is advised to guide the tooth into a more favorable path of eruption to minimize damage to affected dentition, preserve arch length, and to maintain function. Without intervention, sequelae can include premature loss of the anteriorly affected tooth, tipping and rotation of the ectopic molar, space loss and malocclusion. Treatment will depend upon the severity of the impaction. Mildly to moderately impacted molars can be guided easily with elastic orthodontic separators. More severe impactions require more complex treatment options, including potential extraction of the anteriorly affected tooth, removable or fixed appliances, or surgical uprighting. The present study was planned for evaluation of Evaluation of Ectopic Eruption in Teeth’s of Childrens from 5 to 12 Years Age Group.

The present study was planned in Department of Orthodontics, Patna Dental College and Hospital, Patna. Total 50 childrens referred to Department of Orthodontics were evaluated for the ectopic eruptions. All the radiographs were compared in each patient, along all the usual followup time. To rule out the possibility of error due to radiographic magnification, the crown measurements in bitewing radiographs and in dental casts were compared, and no significant differences were present.

Early intervention of ectopically erupting first permanent molars is very crucial to avoid complex orthodontic treatment later on. Ectopic eruption of individual teeth tend to occur as often bilaterally as unilaterally in the same arch, except for mandibular central incisors, first molars and mandibular canines. Early diagnosis and interception of ectopically erupting teeth will allow us in preventing more complicated malocclusions in future.

Keywords: Eruption problems, Ectopic eruption, Permanent teeth, etc.
STUDY OF FOETAL ULTRASOUND OF NEUROECTODERMAL ANOMALIES IN ANTENATAL MOTHERS.
Authors: Choudhary Richa , Sinha Dr. Rishikant
Published: March 2020

Objectives: This study was to evaluate the incidence, prevalence and various types of neuroectodermal anomalies of foetuses in antenatal mothers.

Methods: All pregnant women with intrauterine pregnancy of gestational age ranging from 12 weeks to Post-term cases were included for this study. We were studied on 21450 ultrasound scan of antenatal mothers, who were come for routine check up. Among them 50 foetuses anomalies were found. 

Results: Data was analyzed by using simple statistical methods with the help of MS-office software. All data was tabulated, and percentage was calculated.  

Conclusions: Neuroectodrmal anomalies of foetuses were commonly seen in maternal age group of 30-40 years and prevalence was 0.23%. Anencephaly and hydrocephalus associated with spina bifida were seen in most of the CNS anomalies foetuses. Spina bifida in the lower lumbar region associated with a meningocoele or myelomeningocoele was the most common. Hence, ultrasound is an effective investigative modality for in utero screening of congenital anomalies. Ultrasound imaging in antenatal period practically gives an anatomical record of the developing foetus.  So that early detection of anomalies especially in first and early second trimester helps in planning termination, interventions and further management of neuroectodermal anomalies foetus.

Keywords: Antenatal mothers, Ultrasound scan, Neuroectodermal anomalies
CLINICAL FINDINGS OF 2-MONTHS-OLD BABY WITH APERT SYNDROME: A RARE CASE REPORT
Authors: Reynaldo Giovanni , Desiree Audrey , Tjakra Alfonso
Published: March 2020

Apert Syndrome is a rare congenital disorder characterized by a premature sutural fusion that can occur as a single abnormality or associated with other anomalies. Mutations are transmitted in the paternal chromosome, which is why advanced paternal age could be a risk factor. We report a 2-months old baby boy came to the ER with shortness of breath and difficulty in nutrition intake caused by choking at home. Physical examination revealed there was more than one congenital abnormalities exist on this patient, including craniosynostosis, prominent frontal region, mid-face hypoplasia, wide set eyes (hypertelorism), downslanting palpebral fissure, ocular proptosis, low-set ears, dysplasia of both ears, symmetrical syndactyly of both fingers and toes, and cleft palate which is revealed in intra-oral examination. Early diagnosis and intervention from multidisciplinary approach is important in improving the outcome of Apert Syndrome.

Keywords: Apert Syndrome, Craniosynostosis, paternal, multidisciplinary
A RANDOMIZED COMPARATIVE STUDY OF PROGRESS OF LABOUR AND FETAL OUTCOME OF DELIVERY AMONGST SPONTANEOUS VERSUS INDUCED LABOUR IN TERM PREGNANCY PRIMI GRAVIDA OF USING MODIFIED WHO PARTOGRAPH IN THE DEPARTMENT OF OBSTETRICS AND GYNECOLOGY SMS MEDICAL COLLEG
Authors: Chouhan Yeshwant Singh , Sharma Anju , Agrawal Megha
Published: March 2020

Background: Childbirth is the period from the onset of regular uterine contraction until expulsion of placenta. The process by which this normally occurs is called labour. Induction of labour is the artificial initiation of uterine contraction prior to their spontaneous onset, leading to progressive dilatation and effacement of the cervix and delivery of the baby. Labour induction is indicated where the benefits to either the mother or the fetus outweighs the benefit of continuing pregnancy.

Methods: Hospital based Prospective type of cross sectional study conducted at Department of Obstetrics and Gynaecology, S.M.S Medical College, Jaipur, Rajasthan. We assessed the following perinatal outcomes: at 1st and 5th minute APGAR score; birth weight; birth injuries; respiratory distress syndrome; admission to the  NICU; number of days in NICU; neonatal deaths taking place in hospital within the first week of life; stillbirth or intrauterine death.

Results: The highest percentage of babies were in the weight category of 2500 to 3499 grams in both groups, 83.3% in spontaneous and 76.7% in induced group, followed by ≥3500 gram and <2500 gram  respectively. There is no statistical significant difference in weight of babies between the groups (P=0.64). In induced group ≤7 APGAR Score at 1 minute is 1.1%, and 7.8% in spontaneous group. There is statistically significant increase in Spontaneous group (P < 0.05). In induced group ≤7 Apgar score at 5 minutes is 0%, and 5.6% in spontaneous group. ≤7 APGAR score at 5minutes is significantly higher in Spontaneous group (P < 0.05). 3.3% of Induced group babies needed Admission to NICU compared to 2.2% in Spontaneous group, there is no statistically significant difference between groups (P = 0.684)

Conclusion: We conclude from this study that though requirement of Augmentation for progress of Labour was more in induced group and Instrumentation rate of Caesarean section was also high in induced group. But the Neonatal outcome of Labour if monitored with modified WHO Partograph is less than Spontaneous group and also duration of labour is shorter in induced labour.

Keywords: WHO Partograph, Induction, Neonatal outcome.
GRANULOMATOUS MASTITIS IS NOT ALWAYS TUBERCULAR: ROLE OF FINE NEEDLE ASPIRATION CYTOLOGY IN EVALUATION OF GRANULOMATOUS MASTITIS
Authors: Auplish Ridhima , Singh Sneha , Singh Prem , Khanna Shiv Pankaj , Gupta Aditi
Published: March 2020

INTRODUCTION AND OBJECTIVES:

Granulomatous mastitis is rare chronic inflammatory benign breast lesion, which clinically and radiologically resembles carcinoma breast thus creating a diagnostic dilemma. The term granulomatous mastitis includes two broad categories namely specific granulomatous mastitis for which aetiological factors can be defined such as infectious causes like Mycobacterium tuberculosis, blastomycosis, cryptococcosis, histoplasmosis, actinomycosis and filarial infection. Other factors include association with autoimmunue diseases such as Wegner’s  granulomatosis and giant cell arteritis and there are other rare causes such as include duct ectasia, foreign body reaction and fat necrosis which also leads to granulomatous lesions of breast.

Cytological features of granulomatous mastitis(GM) have not been widely discussed and described in literature, so through this study we have made an attempt to thoroughly discuss cytological spectrum of granulomatous mastitis.

MATERIALS AND METHODS:

A retrospective study was performed over a period of four years from 2016 to 2019. A total of 465 cases of breast lump reported to cytopathology section out of which 24 cases of GM diagnosed on FNAC were included in our study. Results of Erythrocyte sedimentation rate (ESR) and Mantoux test along with TB-PCR were recorded. FNAC slides were retrieved pertaining to study period.

Granulomatous lesions of breast were further categorized broadly into IGM/ NGM, granulomatous mastitis without caseous necrosis and tubercular mastitis where diagnosis were made definite on basis of demonstration of AFB or positive TB-PCR .

RESULTS:

Patient age ranged from 23 years to 55 years with the mean age of 36.6 years with maximum of patients falling in second decade followed by third decade. Granulomatous lesions were broadly categorized into Idiopathic/ Non specific granulomatous mastitis(11 cases,45.8%), GM with caseous necrosis(8 cases, 33.3%) and tubercular mastitis(5 cases, 20.9%). Histopathology was available in 7 cases(29.2%). TB-PCR was sent in all cases of granulomatous mastitis diagnosed on cytology and was positive in 10 cases(41.7%).

CONCLUSION:

Idiopathic granulomatous mastitis and tubercular mastitis are rare inflammatory diseases of breast which mimic malignancy clinically and radiologically. FNAC plays important role in diagnosis of granulomatous diseases of breast and also their differentiation from malignant tumors. Tubercular mastitis needs to be differentiated from IGM since treatment options are different in both the cases. Cytopathology plays an important role in differentiationg both the diseases supplemented by radiological and microbiological investigations.

 The present study thus highlights the importance of FNAC as an infalliable tool in diagnosis of granulomatous mastitis and its differentiation from neoplastic lesions of breast thus avoiding time consuming histopathological work up of cases.
HYPERTENSION CONTROL AND DEPRESSION A STUDY IN DATTA MEGHE MEDICAL COLLEGE AND SHALINITAI MEGHE HOSPITAL & RESEARCH CENTRE.
Authors: Sawarkar Mahendra , Ganeriwal Mukund , Kane Shriram
Published: March 2020

Introduction:  Hypertension is a major public health issue worldwide, affecting millions of patients. Although control rates have improved during the past few years, the actual rate is still unacceptably low, and control rates in more vulnerable populations, like people living with diabetes mellitus, are even lower. Optimal BP control could prevent a high percentage of coronary heart disease events, and early BP control significantly reduces the risk of stroke and cardiovascular events Depression is usually not detected at primary levels, and patients do not typically receive adequate treatment, which may not only affect their quality of life, but may also interfere with the treatment and prognosis of other chronic diseases such as ischemic heart disease and stroke. 

Material and Methods: 46 hypertensive patients undergoing antihypertensive therapy for longer than six months were included in the study. After a 5 min of rest period, measurement of BP was recorded in triplicate at 3 min intervals between measurements. Adherence to antihypertensive therapy was monitored. All patients completed the Zung Self-rating Depression Scale survey; depression was diagnosed if the patient scored >50 points (the maximum possible score using this scale was 80). The Zung Self-rating Depression Scale is said to be a sensitive measure of clinical severity in depressed patients.

Results: Out of 46 patients there were 22 (47.8%) female and 24(52.2%) male. Patients who were depressed were 20 (43.5%) of which 8(40%) were male and 12 (60%) were female. Of the total 20 depressed patients 1 male having controlled hypertension while 19 (80%) were in the group of uncontrolled diabetes. In controlled hypertension group only 1 mild depression patient was observed while in uncontrolled group of the 19 patients 10 (50%) were having mild, 8 (40%) were having moderate and 1 (20%) were having severe depression according the Zung Self-rating Depression Scale. Mean blood pressure in depressed controlled BP group was 128/73 mmHg while in depressed uncontrolled group was 149/90 mmHg. Mean blood pressure in normal controlled BP group was 121/75mmHg while in depressed uncontrolled group was 146/95 mmHg. There was a significant correlation observed between depression and systolic and diastolic blood pressure value (P<0.001).

Conclusion: Depression is common in patients having uncontrolled hypertension and screening of depression in hypertensive patients is simple and effective tool to control the hypertension.

Keywords: Hypertension, depression, controlled, uncontrolled.
FRONTALIS SLING SURGERY USING SILICON ROD: RESULTS IN CONGENITAL UNILATERAL PTOSIS AMONG NORTH INDIAN POPULATION
Authors: Choudhary Uzma , Sharma Shweta
Published: March 2020

ABSTRACT

Purpose: To evaluate the results after frontalis sling surgery in congenital unilateral ptosis.

Methods:

This was a prospective study which included 27 eyes of patients with congenital unilateral ptosis and fair to poor levator action (<8mm). A complete examination was performed including palpebral fissure height and width, lid-crease distance, margin reflex distance 1 (MRD 1) and margin reflex distance 2 (MRD 2), levator function. Fox pentagon technique was employed using silicon rod. Follow up was done at 2 weeks and at 3 months and based on the criteria recommended by Tarbet et al, the ptosis correction was catergorized into: ‘excellent’ if MRD1 measured more than 2mm or the difference in MRD1 between two eyelids was equal to or less than 1 mm, ‘good’ if MRD1 ranged from 1 to 2mm or if asymmetry was 1.5 to 2mm, and ‘poor’ if MRD1 measured less than 1 mm or if asymmetry was greater than 2mm in primary position of gaze.

Results: A total of 27 eyelids of 27 patients underwent frontalis sling surgery with silicon rod. The correction was excellent in 20 patients (74%) on both first and second follow-up visits, shown in fig1. It was good in 5 patients (19%) and poor in 2 patients (7%) based on the above mentioned criteria. Lagophthalmos was present in all patients postoperatively which improved with time.

Conclusion: This study shows that surgical repair using silicone sling is a safe and effective method of correcting congenital ptosis with poor to fair levator function.
TO OBSERVE THE EFFECT OF ORAL GABAPENTIN, THEOPHYLLINE AND CAFFEINE ON SBP, DBP, MAP AND HR.
Authors: Thakur Kunwar Singh , Meda Rahul
Published: March 2020

After obtaining approval from institutional ethics committee, and written informed consent, the present study entitled "To Observe the Effect of Oral Gabapentin, Theophylline and Caffeine on SBP, DBP, MAP and HR"  was conducted on 120 patients of ASA grade I &II scheduled for elective and emergency lower segment caesarean section under spinal anesthesia in the Department of Anesthesiology, J.A. Group of Hospitals & G.R. Medical College, Gwalior (M.P.)  after getting written informed consent from the patients.

No significant effects on haemodynamic parameters were observed with all the study drugs. Recurrence of PDPH was significantly high with caffeine treatment. No serious untoward effects or complications of study drugs were observed in the study.

Keywords: Oral Gabapentin, Theophylline, Caffeine, SBP, DBP, MAP & HR.
DEMOGRAPHIC PROFILE OF HAEMOPHILIA A CHILDREN WITH JOINT INVOLVEMENT.
Authors: Solanki Pinakini P. , Patel Priti P. , Shah Vijay , Patel Pavan
Published: March 2020

Introduction: Worldwide Haemophilia A (HA) is the most common coagulation factor deficiency. It affects all populations and its prevalence varies among different countries, but roughly prevalence is estimated to be of 3-20 cases per 100,000 population. The classification of HA provides a guidance to possible types of bleeding and the rate of occurrence of hemorrhagic episodes. The hemophiliac patients with severe form, can be presented with spontaneous bleeding and hemorrhage after minor trauma about 1-6 times in a month, including hemarthrosis and intramuscular hemorrhage. In moderate form, the patients usually experience bleeding after mild to moderate injuries, while HA patients with mild form may not be diagnosed for years and bleed after surgery or major trauma. About 70% of children who have a positive history of HA in the family are diagnosed at birth or after the first bleeding episode.

Material and Methods: A complete medical history of the patient was taken with reference to the name, age, sex, address, occupation, history of present illness, duration illness, education of patient and parent. Previous history of treatment, past and personal history and socio-economic status were noted. Parents were explained the purpose of the study and the procedures involved.The Hemophilia Joint Health Score (HJHS) was used to assess joint health in children included in the study.

Results: Age of diagnosis >=12 months was observed in 28 (54.90%) of cases while in 23 (45.10%) cases age of diagnosis was < 12 months. Out of 51 cases Severe disease was observed in 45(88.23%) of cases, moderate in 4(7.84%) and mild form was observed in 2(3.95%).Out of total 51 cases 42 (82.4%) were from the nuclear family while 9(17.6%) were from the joint family. Mean HJHS was higher in patients of nuclear family as compared to joint family.

Conclusion: HJHS shows construct validity and is more sensitive for mild arthropathy and can be used for studies in children with hemophilia. No correlation of different demographic parameters in children suffering from hemophilia A was seen.

Keywords: HJHS, HA, Hemophilia A and B, CDC, HTCs, UDC,FA.
RETROSPECTIVE STUDY OF EPIDEMIOLOGY OF HEAD INJURY IN VINDHYA REGION.
Authors: Jindal Sonpal , Tiwari Vinit Kumar , Evne Sandeep
Published: March 2020

Introduction: Head injury is one of the major public health concern because it can happen to Anyone in day to day life. Nearly 50% of trauma deaths are because of head Injuries but these account for numerous cases of permanent disability.

Aims & Objectives: To know about the incidence & distribution of head injury from various causes according to age, sex, site of event, occupation, peak hours &seasonal variation.

Methodology: The present study was conducted in patients of head injury. Particulars of the patients, date & time of incidence, admission & mode of treatment received i.e. conservative or operated were recorded from hospital records, post graduate students, neurosurgeons & from other hospital staffs.

Result: Incidence of head injury was 2.82%. 84.66% of patients were managed Conservatively. Maximum patients had GCS 13 to15, the most Common age group was21-30 years. 38.66% of Patients were under the influence of alcohol &stay in hospital was 1 to3 days.

Conclusion: Head injury is one of the greatest challenge to human being, not only because of the trama but also interms of disability , morbidity and financial losses , further aggravating agony, needed to eliminate such pathetic situation by implementation of education and training among public & health professionals.

Keywords: Head injury, Epidemiology
LAPAROSCOPIC CHOLECYSTECTOMY IN SICKLE CELL PATIENTS: A NONTRANSFUSIONAL PERIOPERATIVE MANAGEMENT.
Authors: Gode Dilip S. , Padamwar Mangesh
Published: March 2020

Background: The objective of this study is to evaluate the outcome of novel perioperative management involving prophylactic antibiotic, Intra Venous fluids and Intermittent Nasal Oxygen and avoidance of preoperative blood transfusion for Laparoscopic Cholecystectomy.

Methods: A prospective study included all sickle cell disease (SCD) and trait patients who underwent Laparoscopic Cholecystectomy from January 2007 to August 2010 at Acharya Vinoba Bhave Rural Hospital, attached to Datta Meghe Institute of Medical sciences university, Sawangi, Wardha. India

Result: A total of 26 patients underwent Laparoscopic Cholecystectomy. There were two recorded episodes of acute painful crises and three patients had postoperative fever. There were no recorded episodes of Acute Chest syndrome.

Conclusion: Laparoscopic Cholecystectomy can be safely performed for sickle cell anemia (disease and trait) patients, without preoperative blood transfusion. A defined perioperative regimen including use of antibiotic, IV fluids and Intermittent Nasal Oxygenation for these patients helps to reduce SCD related complications.

Keywords: Laparoscopy, Cholecystectomy, Sickle Cell, Nontransfusion, Haemoglobinopathy.
ABDOMINAL RECTUS DIASTASIS (ARD) CORRECTION FOR PAIN REDUCTION AND IMPROVEMENT OF ABDOMINAL WALL MUSCLE STRENGTH
Authors: Waikar Kaustubh Vasant
Published: March 2020

Introduction: Rectus abdominis diastasis (RAD) can be described as a condition in which rectus abdominis muscles are separated by an abnormally wide distance i.e. any separation of more than 2 cm is considered to be abnormal. Several aetiological factors may lead to protrusion of the anterior abdominal wall. It is a common complaint in women after childbirth. Abdominal rectus diastasis (ARD) is a sequele of the expansion of the abdominal contents during pregnancy or massive weight loss and/or congenital disproportion of the collagen III/I ratio. Operative repair of ARD can improve abdominal wall function. Various methods for ARD repair have been described. These differ by approach like open versus laparoscopic, the position of suture placement, numbers of layers of sutures, suture material, and use of mesh. Also it can be combined with mesh augmentation in the IPOM technique for enhanced stabilization of the abdominal wall.

Material and Methods:  Eligible patients were randomized to either one of two operative procedures or a 3-month, dedicated training program which serve as a control group. ARD width was assessed clinically and confirmed with computed tomography scanning. Endpoints were assessed after 6 months for relapse of the ARD, pain, restriction of daily activities and improvement in muscle strength. Abdominal wall strengthe was assessed by Visual analogue scale (VAS).

Results: A total of 72 patients were enrolled into the study (70 female and 2 male). 24 patients were enrolled in each group. 13 patients had undergone cesarean section in the Quill group and 12 in the mesh group. According to VAS scale no statistically significant difference was seen between the two operative groups regarding perceived improvement in abdominal wall strength. But it was significantly higher in operated group as compared to training group. Abdominal muscular strength was improved in all the three groups. Improvement in abdominal wall strength was lower in training group compared to operative groups. No relapse was observed in operative groups.

Conclusion: Operative repair of ARD can provide functional stability and improvement in pain and physical parameters it also improves quality of life, and reduce functional disability.

Keywords: ARD, Quill SRS, Mesh repair, VAS, linea alba (LA)
DIAGNOSTIC ACCURACY OF THE FNAC IN STUDY OF THE LESIONS IN THE ANTERIOR TRIANGLE OF NECK IN CORRELATION WITH HISTOPATHOLOGY.
Authors: Shankar Ravi , Kumar Alok , Banerjee Bejoy Chand , Prasad Rajkumar
Published: March 2020

Method: The study consists of 516 patients with palpable anterior triangle neck masses coming to the Department of Pathology.

Result: Out of total 516 patients, 122 patients of thyroid lesions came for FNAC. Female were more affected than males with male: female ratio of 1:4.9. Most commonly affected age group was 16-30 years of age.

Conclusion: Out of the 516 FNAC, maximum number were from lymph node consisting of 360 cases (69.86%), 122 cases (23.64%) were thyroid lesions, 34 cases (6.50%)  were miscellaneous lesions from the submandibular salivary gland, soft tissue and subcutaneous tissue of anterior triangle of neck region.

FNAC is important diagnostic test for differentiating inflammatory from malignant lesions so that unnecessary surgical biopsy can be avoided and helps in proper management of the patients.

Keywords: Diagnostic, FNAC, Lesions, Ant. Triangle & Histopathology.
PREVALENCE AND PATTERNS OF THE VARIOUS HEMATOLOGICAL MANIFESTATIONS IN PATIENTS OF MYELONEUROPATHIES
Authors: Husen Nosad
Published: March 2020

Background: Patients of neuroloical syndrome (Myeloneuropathy, Myelopathy and Neuropathy) show various haematoloical manifestations. Complete clinical and early Laboratory evaluation help in early identification of these cases and help in prevention of permanent neurological damage.

Material and methods: 81 Patients of myeloneuropathies attending the outpatient’s department neurology were taken. Detailed hematological, biochemical investigations and bone marrow examination was carried-out in all patients as per the protocol.

Results: 81 cases of neurological syndrome were taken these were classified as myeloneuropathy (32), myelopathy (11) and neuropathy (38). Of these 81 patients, 55 (67.9%) were males and 26 (32%) were females (male: female ratio 2.1:1).  Peripheral blood examination, bone marrow examination and biochemical evaluation was done in all. Anemia, present in 48 patients (59.2%), Macrocytosis was defined as MCV ≥100 fl, was present in 38 patients (46.9%). Most common finding on bone marrow examination was reversal of myeloid and erythroid ratio (M:E ratio) and was  present in more than three-fourth of patients (76.5%). Megaloblastic changes in erythroid cells were present in 42 patients (51.8%). Biochemical tests revealed increased serum LDH in 56.5% of patients. Out of eighty one patients, twenty eight patients (34.5%) were found to be Vitamin B12 deficient.

Conclusions: This study included 81 patients presenting with various neurological syndromes myelopathy, myeloneuropathy and neuropathy with associated myelocognitive and neuropsychiatric features to study the hematological manifestations such as anemia, other cytopenias, macrocytosis, neutrophil hypersegmentation and megaloblastic changes in the bone marrow.
COMPARISON OF INTUBATING CONDITIONS BETWEEN ATRACURIUM PRIMING, MAGNESIUM SULPHATE PRE-TREATMENT AND COMBINATION OF TWO METHODS ON ONSET AND DURATION OF NEUROMUSCULAR BLOCKADE: A RANDOMIZED DOUBLE BLIND CONTROLLED STUDY
Authors: Jethani Kushal , Sahu Preeti , R Rakesh D
Published: March 2020

Introduction: Magnesium inhibits acetylcholine release from the presynaptic membrane at the motor end plate; and thus it enhances the effect of non-depolarising muscle relaxants. Priming technique shortens the time of onset of non depolarising neuromuscular relaxants. Thus, the combination of magnesium pre-treatment and priming may be an effective method for achieving an early tracheal intubating condition. We studied the effect of magnesium sulphate pretreatment in combination with atracurium priming on onset and duration of neuromuscular blockade, compared with these methods when used alone.

Materials and Methods: 100 patients scheduled for elective surgical procedures under general anaesthesia were divided into 4 groups. Group A (n=25) recieved priming with 0.05 mg/kg atracurium, three minutes before the intubating dose of atracurium 0.5 mg/kg, group M (n=25) was given 50 mg/kg magnesium sulphate as infusion over 10 mins before intubating dose of atracurium, group MA (n=25) received both the magnesium sulphate pretreatment and the priming dose of atracurium. Group N (n = 25) were given 0.5mg/kg atracurium alone as part of general anaesthesia. Tracheal intubation was done when the TOF stimulation showed single twitch which was measured at intervals of every 30 seconds. Parameters studied were the time to onset of neuromuscular blockade and the duration of neuromuscular blockade.

Results: The MA group had the shortest onset time (mean±SD) 114.30±20.19 sec (p < 0.001) compared to the other groups. The duration of blockade was prolonged in both Group MA and Group M compared to other groups (P<0.001). Few adverse effects were reported in groups receiving magnesium, but were clinically not significant.

Conclusion: Magnesium sulphate pretreatment in combination with atracurium priming shortens the time of onset of neuromuscular blockade when compared to magnesium sulphate pretreatment or priming used alone.

Keywords: Atracurium priming, magnesium sulphate, neuromuscular blockade
ROLE OF SACRUM IN SEX DETERMINATION IN WEST BENGAL POPULATION
Authors: Bhanarkar Ujwala , Koley Baishakhi
Published: March 2020

Background: Sex classification of a bone is possible with a degree of certainty only if it can be compared to a series of bones of known sexual dimorphism. Different parameters and indices are available based on which the sex can be determined using sacrum. Thus, it always attracted the attention of the medico-legal experts for establishing the sex, because of its contribution to pelvic girdle and associated functional sex differences. Objective: Study the sexual dimorphism and regional differences of the varied features of the sacrum in West Bengal population and compare the significant anthropometric indices with similar observations across India. Material and method: The study comprised of 50 adult sacra (35 male and 15 female), obtained from the department of anatomy and department of forensic medicine of ICARE Institute of Medical Sciences and Research and Haldia Institute of Dental Sciences and Research, Haldia, West Bengal. Different parameters viz. mid ventral straight length, mid ventral curved length, ventral straight breadth, transverse diameter of base, transverse diameter of body of S1, antero-posterior diameter of body of S1, breadth of alae were measured and indices viz. sacral index, longitudinal curvature index and corporobasal index were calculated and statistically analyzed. Result: Sacral index was found to be the most useful criterion for identification of sex followed by breadth of alae, corporobasal index and the ventral straight breadth. Conclusion: In the present study, out of the eleven parameters of the sacrum, seven parameters yielded statistical significance between the two sexes. Therefore, it can be concluded that sex determination of the sacrum with 100% accuracy may possible only when maximum number of parameters are taken into consideration.

Keywords: Sacrum, sexual dimorphism, sacral parameters, sacral index
STUDY OF CORRELATION AND EVALUATION OF EPICARDIAL FAT THICKNESS WITH ABDOMINAL VISCERAL FAT THICKNESS IN OBESE AND NON-OBESE TYPE 2 DIABETES SUBJECTS
Authors: Runwal Graurav , Daseda Saurabh
Published: March 2020

Method: FBS/PPBS done by GOD POD method IN Vitros “S”, FS machine. HBA1C Done by HPLC plus ion exchange resin. Lipid profile after overnight fasting of 12 hours blood collected in the morning about 5 ml and the serum centrifuged and kept for analysis. Serum cholesterol estimation: The CHOD-PAP method, enzymatic colorimetric test was used in Vitros “S”, FS machine.

Result: After applying Levene’s test for equality of variance, t test between mean of epicardial fat thickness and visceral fat thickness between obese and non-obese groups, shows statistically significant (p=<0.05) association. Obese patients(11.88+1.40) had significantly more epicardial fat thickness as compared to non-obese type 2 diabetes patients (10.19+1.37), t(148) = -7.39, (p=<0.05). Obese patients (58.85+10.89) had significantly more visceral fat thickness as compared to non-obese type 2 diabetes patients (46.23+9.79), t (148) = -7.34, (p= <0.05).

Conclusion: Diabetes mellitus (DM) refers to a group of common metabolic disorders lead to phenotype of hyperglycemia and caused by a complex interaction of genetics and environmental factors. We concluded that EFT and VAT were significantly correlated among obese diabetics as compare to non-obese diabetic suggesting, Obesity is an independent risk factor for visceral adipose tissue deposition both in abdomen as well as in epicardial surface.

Keywords: Epicardial, Fat Thickness, Abdominal, DM, & Obese.
A STUDY OF HAEMATOLOGICAL PROFILE IN PAEDIATRIC AGE GROUP IN NORTH-WEST, RAJASTHAN
Authors: Kulhari Sunita , Gupta Ankita , Gupta Neelu
Published: March 2020

Background: Anaemia a blood condition involving an abnormal reduction in number of red blood cells or in their haemoglobin content. Anemia is defined as decreased concentration of haemoglobin and RBC mass as compared to the values in age-matched controls .These can be due to 1) reduced proliferation of RBC which may result from deficiency of nutrients or hormones or from disease or other conditions 2) excessive destruction of RBC often a hereditary problem 3) excessive blood loss

Methods: Record based retrospective study conducted on at department of pathology.

Results: Out of total 362 cases of anemia in the present study, 275 cases (75.96%) are of iron deficiency anemia followed by 84 cases (23.20%) of megaloblastic anemia. Minimum cases 3 (0.82%) are of haemolytic anemia.

Conclusion: In the present study, Iron deficiency anemia was the most common.

Keywords: Iron deficiency anemia, megaloblastic anemia, haemolytic anemia.