bluuebunny/crossref_metadata_2025 huggingface dataset:
A PARTICULAR PRESENTATION OF A DIFFUSE PEDUNCULATED LIPOMA OF THE SACRAL REGION
Authors: Berevoescu Mihaela , Barbulescu Mihai , Berevoescu Nicolae Iustin , Grama Florin Andrei , Lică Gabriela , Cristian Daniel Alin
Published: March 2020

Background. Subcutaneous lipomas are one of the most common benign soft tissue tumors seen in clinical practice. They may occur at any age, affecting men more often than women. In therapeutically neglected cases, these lesions may have unusual clinical features. Our case highlights one such form that may be found amongst subcutaneous lipomas. Case report. A 37-year-old man came to the Surgical Clinic for treatment of an ulcerated, pedunculated tumor, measuring 14.5/8/7 cm, located in the sacral region. Clinically, liposarcoma was considered as the diagnosis. Although preoperative fine needle aspiration cytology (FNAC) of the tumor showed mature adipose tissue fragments on all cytological smears, surgical excision was performed, with intraoperative extemporaneous histological examination of the tumor. Histopathological results showed a lipoma with unusual associated features: ulceration of the overlying skin and fatty tissue necrosis, with formation of abscess areas. Conclusion. Therapeutically neglected subcutaneous lipomas may have unusual clinical features, leading to difficulties for both diagnosis and therapeutic approach. This case complements the existing data, from the point of view of the clinical presentation, as well as the histopathological characteristics that a subcutaneous lipoma may have.
INCIDENCE OF MALIGNANT KIDNEY TUMOURS IN PAEDIATRIC AGE GROUP
Authors: Gupta Ahana , Gupta Ankita , Gupta Neelu
Published: March 2020

Background: Cancer is essentially a disease of adults, yet it is one of the common killers in childhood. In western countries cancer is next only to trauma as a cause of mortality in children under 20 years of age In India.

Methods: The material for present study is obtained from S. P. Medical College, Bikaner and referred cases for a period of five years from 2011-2014. The clinical history regarding duration of the disease, mode of presentation, symptoms and signs are recorded from the case papers, request forms, patient’s history, clinical data along with relevant details obtained from available hospital and departmental records. The histopathology slides and paraffin blocks are reviewed. Gross examination is done carefully noting the size, shape, extent and configuration, nodularity, consistency (solid, cystic or mixed). A minimum of 4-5 bits are selected from the representative areas of tumor. The tissue for routine microscopy is preserved and fixed in 10% neutral buffered formalin for 24 hours and processed in automatic tissue processor (Histokinette) and embedded in paraffin. The sections 3-5 μ thick, are cut and stained by haematoxylin and eosin in all cases and special stains like PAS, MTS, and RT done where ever feasible

Results: The incidence of malignant tumour in our study was 6.66% found.

Conclusion: The present study provides a fair insight into the histological patterns of lesion in paediatric age group. Most common incidence was that of wilms tumour in paediatric age group followed by renal cell carcinoma. Imaging and histologic characterization are crucial to avoid any delay in management.

Keywords: Malignant, Wilms, Histopatological tumour.
COMPARISION OF CLOSED EXPERT TIBIA NAILING WITH OPEN PLATE&SCREW FIXATION IN THE TREATMENT OF PROXIMAL TIBIA EXTRAARTICULAR FRACTURES.
Authors: Johar S.A. Mustafa , Trivedi Akshay Kumar , Sharma Mayank , Patidar Durgashankar
Published: March 2020

This study conducted at Index Medical College Hospital & Research Centre, Indore during the study period of 02 years. Patients were followed up for 01 year, evaluated radiologically and clinically with Tegnerlysholm knee scale, outcomes were used for comparison.

Malreduction was defined as a deformity of 5 degree in any plane. Out of a total of 22 patients, 01 (1 in the plating group) was excluded from the study as pt was absent for follow-up, meaning that 21 patients were included in the final study

Baseline data of 21 patients.

Use of PTLCP is associated with more intra operative blood loss, higher postoperative infection rate and longer duration of hospital stay, whereas use of IMN associated with higher rates of malunion and nonunion. However there is no difference in functional outcome between IMN and PTLCP. But it is the surgical skill that is required in such fractures.

To validate this issue further a large sample size of matching severity multicentric study done by equal level skill cadre is recommended. Overall proximal one third extraarticular tibia fracture is complicated and problematic fracture to deal with and is commonly associated with significant soft tissue damage. High grade of surgical skills are required to deal these fractures as fixation of proximal one third extraarticular tibia fracture is technically demanding surgery regardless of the implant.
VARIATION OF CBC PARAMETERS WITH STORAGE TIME AND TEMPERATURE
Authors: Rautaray Biswajita , Tripathy Sumita
Published: March 2020

This study demonstrates that it is possible to perform clinically valid CBC on K2-EDTA anti-coagulated blood 24 hours after collection on refrigerated sample, though not for differential count parameters. On 24-hour sample, MPV and RET%, MCHC should not be considered for diagnosis. HAEMATOCRIT, MCV and RDW consistently elevated with sample’s age, even at 24 hours, not to be evaluated.

After 24 hours WBC, RBC, HGB, PLATELET can be evaluated. Stability of WBC counts up to 24 hours is acceptable for all samples, except EOSINOPHIL (at 4 degree Celsius) counts not stable beyond 24 hours. Altered results obtained in manual differential count, cannot be considered a solution for differential count on aged samples.

Most reliable haematological results are obtained from samples analysed same day within 5-8h, soon after collection. When immediate analysis is not possible, sample stability (only CBC parameters except MPV; not differential count) can be prolonged up to 48 hr. on refrigeration. A sample with borderline eosinophil or basophil count stored under refrigeration, still can give report of significant increase in parameters with prolonged storage. Thus refrigeration can’t be considered as a solution to prolong storage time in case of bloodsamples, requiring differential count for clinical diagnosis.

Keywords: CBC variation, Temperature, Time, Aged Sample, Refrigeration.
A STUDY OF CLINICO-MYCOLOGICAL CORRELATES OF ONYCHOMYCOSIS
Authors: Jain Chandni , Chaudhary Savita , Shukla Priyanka , Agarwal Soumya , Shaafie Harris Ishtiyaq , Khalid Ayesha , Tripathi Aditya
Published: March 2020

Onychomycosis (OM) is one of the most common problems affecting the nails and has shown to have an extreme variability in clinical presentation, risk factors and etiology. The aim of our study was to study the clinico-etiopathological profile of OM in patients at a tertiary care centre in North India. A total of 100 cases of OM attending the Dermatology OPD were enrolled in the study. Their demographic profile, exposure to risk factors and medical history was recorded. Clinical examination was done and the pattern of disease was recognised. Nail and skin scrapings were obtained and subjected to KOH mounting and culture assessment. Data was analysed using SPSS 21.0, Chi-square and ANOVA tests. Age of patients ranged from 13 to 75 years (Mean age 35.53±15.46 years). Majority of the patients were males (64%). Laborers/farmers and housewives comprised the majority of patients (29% +23%). DLSO (63%) was the most common pattern. Co-morbidities were seen in 17% cases. 89% were either KOH or culture positive, 36% were both KOH and culture positive, 1% was only KOH positive and 52% were only culture positive. A total of 11% cases were both culture and KOH negative. Dermatophytes (47%) were the most common species, followed by yeast/yeast-like isolates (28%) and non-dermatophytes (13%). Among dermatophytes, T. rubrum (n=40), C. albicans (n=16) and Aspergillus niger (n=4) were the most common Dermatophytes, Yeast and non-Dermatophyte species respectively. A significant association of clinical pattern was observed with sex and site of involvement. KOH positivity was significantly associated with culture positivity for different isolates. The clinicopathological spectrum of OM was quite diverse. The study emphasised the need for comprehensive diagnostic work-up of these patients in view of diverse etiology and clinical spectrum.
NECK COMPRESSION ASPHYXIAL DEATHS BY LIGATURE – A DEMOGRAPHIC PROFILE OF WESTERN RAJASTHAN
Authors: Sharma Navneet , Kumar Shalender
Published: March 2020

The tripod of life comprises of three vital organs namely brain, heart and lungs. Serious pathological and morphological abnormalities of any part of the body prove fatal due to direct or indirect involvement of either or all of the organs of tripod of life. Essential structures of neck including nerves, blood vessels, and other have a direct or indirect control on the function of respiratory, circulatory and nervous system. The compression of the neck involving the important structures may prove fatal. One of the major modes of death is asphyxia and type of asphyxia most commonly encountered in medico legal practice is mechanical asphyxia. Among the means of producing mechanical asphyxia, constriction around the neck plays a major role.

Backgroubd: Hanging is one of the most common methods of suicide in India; other types of hangings are homicidal hanging, judicial hanging, and autoerotic hanging (camps et al, 1976)3. Hanging differs from strangulation in which the neck is constricted irrespective of any effect caused by the weight of the body. The various structures damaged in hanging and strangulation include the soft tissues like skin, subcutaneous tissue, fascia, muscles, blood vessels, lymph nodes and the bony and cartilage tissues like the hyoid bone and larynx  (A. Keithmant, 1984)1.

Various forms of strangulations are ligature strangulation, throttling, mugging, garrotting, bansdola etc (Simpson and knight, 1988)13.

As till now very less studies has been carried out in western Rajasthan on demographic pattern of deaths due to compression of neck by ligature matterial. A study of asphyxial  deaths by ligature matterial that is hanging and ligature strangulation in relation of sex, age, region and religion  has been undertaken.

 Keywords: Hanging, Strangulation, Ligature, Neck, Demographic, Medico-Legal.
A A STUDY OF HISTOLOGY & HISTOGENESIS OF FETAL SPLEEN AT DIFFERENT GESTATIONAL AGES
Authors: D Srivani , Pillai J. Jayachandra
Published: March 2020

Introduction: The spleen is a largest collection of lymphoid tissue with peculiar anatomical and physiological features. Spleen plays an important role in fetal hematopoiesis and immunomodulation. The aim of the study is to perform detailed histological analysis of human fetal splenic specimens of various gestational ages  and compare the findings with earlier studies.

Material and  Methods:  The  present  study  included  40  fetal cadaveric spleen and  morphometric features i.e., weight was measured and the sections of the spleen were stained  with Haematoxylin and Eosin stain and were observed under compound light microscope

Results: In the present study the histology of spleens of prenatal group showed the well defined red pulp, venous sinusoids and diffusely spread lymphocytes at 18 weeks of gestation and the organization of lymphoid follicles was noticed at 24-28 weeks. At 32 weeks well defined white pulp was observed and the microscopic architecture of the spleen was similar to the histology of adult spleen.

Conclusion: A detailed knowledge of splenic morphometric dimensions, Histology and Histogenesis is crucial in deciphering the role of spleen in fetal development and fetal wellbeing.

Key words: spleen, hematopoietic, microscopic,  fetal
CALCIUM AND IRON ABSORPTION: INVITRO STUDIES
Authors: Kwatra Bharat
Published: March 2020

Studies on human subjects have shown that Ca (Ca) will inhibit iron (Fe) absorption, regardless of whether or not it's given as Ca salts or in dairy farm products. This has caused concern as increased Ca intake usually is usually recommended for kids and girls, similar populations that are in danger of metal deficiency. However, a radical review of studies on humans during which Ca intake was considerably increased for long periods shows no changes in hematologic measures or indicators of iron standing. Thus, the repressing impact additionally be|is also} of short period and there also is also counteractive mechanisms. The interaction between Ca and metal is also a lumenal event, poignant metal uptake through DMT1 (divalent metal transporter 1) at the top membrane. However, it's additionally attainable that inhibition happens throughout metal transfer into circulation, suggesting roles for the serosal bourgeois ferroportin (FPN) and hephaestin. We explored these prospects in human enteral Caco-2 cells cultivated in monolayers. Iron transport (fifty nine Fe) and expression of DMT1, FPN, and hephaestin were assessed when one.5 and four hours with zero or a hundred μM CaCl 2. though Ca failed to have an effect on metal uptake or DMT1 expression at one.5 hours, FPN abundance at the basolateral membrane remittent, leading to increased cellular metal retention and remittent metal efflux. when four hours, DMT1 and FPN expression increased and there was an increased FPN.
A REVIEW ON THE POTENTIAL PROPERTIES OF GINSENG
Authors: Khurana Riya
Published: March 2020

Ginseng is a traditional herb mostly used in eastern world, namely the countries of Korea and China. It is believed to be a herbal elixir and useful in promotion of long healthy life. It is known to increase strength and vital capacity of the body (1). Ginsenosides are the main active compounds that constitute ginseng. They are considered to be steroidal saponins that act as anti- tumor activists (2). They have been known to show a myriad of pharmacological effects on target tissues, although the type of ginsenoside varies in each species of ginseng. This review study aims to explore the history, mechanisms, targets and effect of ginseng.
THE CORRELATION BETWEEN FOETAL MOVEMENTS COUNT AND FOETAL OUTCOME
Authors: Gangwal Mamta
Published: March 2020

Background: A reduced fetal movement is a common indication for assessment of fetal well being. A reduced fetal movement is considered as high risk pregnancy because the fetus is at high risk of hypoxia and sudden demise.

Methods: Hospital based prospective study conducted at Department of Obstetrics and Gynecology, RVRS Medical College, Bhilwara. Total 130 pregnant women were included in this study.

Results: 10.77% patients didn’t perceive fetal movements after admission. Out of 14 patients with absent DFMC, 6 babies (42.86%) died and 8 babies (57.14%) survived. The association betweenNon Stress Test and mode of delivery was found statistically significant. 83.33%) were admitted in NICU. Out of 24 patients presenting with non reactive NST, 20.83% (5) babies born with APGAR score more than 7 and 79.17% (19) babies had APGAR score 4-7.

Conclusion: The association between NST & DFMC and fetal outcome was found statistically significant.

Keywords: DFMC, NST, Fetal outcome, survived.
STUDY OF HBA1C, LIPID PROFILE AND CYCLOPHILIN-A IN DIABETES MELLITUS
Authors: Jha Rakesh Kumar , ZG Badade , Rai Sandeep , VZ Badade
Published: March 2020

Introduction: Diabetes is a chronic disease that occurs when not enough insulin is produced by the pancreas or the body does not use the insulin produced. Because of increased blood glucose levels in the body, serious heart, kidneys, blood vessels, nerves and eyes damage are caused. Report says about 400 million people suffer from diabetes. Therefore present study is aimed to assess levels of HbA1c, Lipid profile and Cyclophilin A in diabetic patient.

Material and Methods: The present study includes total 126 subjects comprising of 66 type 2 Diabetes Mellitus patients and 60 healthy individual. Blood samples are collected from the all subjects were processed for HbA1c, Lipid Profile and Cyclophilin A estimation, from OPD and General Medicine Wards. HbA1c is estimated by HPLC, lipid Profile by AU480 and the Cyclophilin A by ELISA method using commercially available Qayee-bio ELISA kit.

Conclusion: Present study showed significantly increased levels of HbA1c, Lipid Profile and Cyclophilin A in T2DM patients. The elevated lipid profile may be due to the complication of Diabetic mellitus. CyA is increased as an inflammation marker.

Keywords: T2DM: Type 2 diabetes mellitus, HbA1c: Glycosylated Hemoglobin, CyA: Cyclophilin-A
NEED FOR PSYCHOLOGICAL EVALUATION IN THE PATIENTS SUFFERING FROM ACNE: A DESCRIPTIVE STUDY
Authors: Hatila Sangeeta , Hasija Aastha Dhingra , Choudhary Vijay
Published: March 2020

Background: Chronic diseases are known to have impact on quality of life of patients as of the acne. The DLQI (dermatology life quality index) is a scale to assess quality of life of the patients with skin disease.

Objectives: The present study analyses the quality of life patients with acne attending OPD of skin department, SMS hospital.

Methods: A questionnaire-based prospective study was conducted among 150 patients with acne referred from department of dermatology, SMS hospital.

Results: The mean DLQL score was 7.28, the question about how embarrassed or self-conscious have you been because of skin had highest whereas the question about how much has your skin caused any sexual difficulties? had lowest scores.

Conclusion: Acne has moderate effect of quality of life of the patients. There is need for psychological intervention to improve the quality of life of the patients.

Keywords:  Acne, dermatology life quality index, quality of life.
STUDY OF PREVALENCE AND PATTERN OF HEARING LOSS IN PATIENTS OF HEPATITIS B
Authors: Mondal Kapildev , Saha Poulomi
Published: March 2020

Hepatitis B has been documented to cause various extra hepatic manifestations along with known hepatic complications. It has been reported that hepatitis-B patients are more susceptible to inner ear damage and hearing loss. The aim of this study is to evaluate hearing loss among patients of   hepatitis B {all 6 categories Hepatitis B infection: chronic Hepatitis B  infection , hepatitis B cirrhosis ,Hepatitis B virus carriers , occult chronic Hepatitis B and Hepatitis B infection with poly arthritis nodosa, hepato cellular carcinoma with hepatitis B}compared with healthy subjects.

METHOD: In this case control study 100 Hepatitis B positive patients and 100 age and gender-matched healthy individuals were included over the period of 5 years. All of them were known cases of chronic hepatitis B positive for   HBsAg at least for 18 months. All   patients were aged 18 to 50 years to exclude presence of presbycusis. After base line investigations, they were subjected for all cases and controls were subjected otoscopic examination and hearing assessment using standard pure tone audiometry. Descriptive statistical analysis has been carried out in this study.

RESULT: In patients of Hepatitis B (94 patients,6 patients had of  natural death ) pure tone average (mean thresholds 250,500, 1000,2000,4000 &8000 Hz) was 28.4 dB in the right ear and 27.3 dB in the left (hearing loss).In the control group(96 patients,4 patients dropped out), PTA average was 9.9 dB in the right ear and 9.3dB in the left (normal hearing). In both groups, Speech Discrimination score (SDS) was100% in both ears. The percentage of hearing loss in the right and left ear over the total of six frequencies differed significantly in the two groups. Out of 94 patients of control group, 38 patients (40.4%) patients presented with Chronic Liver Disease (CLD), 14 patients (14.8%) patients presented with cirrhosis with Hepatitis B, 6 (6.3%) patients had Poly arthritis Nodosa with Hep-B, 18(19.1%) patients were diagnosed as carrier of Hepatitis-B , 11(11.7%) patients had occult Hepatitis-B and 7(7.4%) patients were diagnosed with hepato cellular carcinoma.

Hearing loss was maximum in patients of   PAN with Hep-B. Second highest mean SNHL was seen in patients of Hep-B with cirrhosis .Third highest mean hearing loss was noted in patients with HCC .Forth highest mean hearing loss was noted in patients with occult Hep-B. Fifth highest mean hearing loss was noted in carriers of Hep-B.Lowest group with SNHL was chronic liver disease.

CONCLUSION: Regular audiometric tests are recommended for patients with HBV infection to assess their hearing ability and enable the earlier detection of SNHL. We also suggest that HBV presenting with the sudden onset of hearing loss should be examined for the possibility of acute exacerbation of chronic HBV infection.

KEYWORDS: Mean, Sensorineural, Hearing loss, Cirrhosis.
A COMPARATIVE STUDY OF BLOOD PRESSURE IN MEDITATORS AND NON MEDITATORS
Authors: Vidyullatha A.R. , Lavanya D. , Sanfrancisco G.Benny
Published: March 2020

Aims and Objectives: Cardiovascular disease (CVD) is the leading cause of death and disability in industrialized nations, as well as in developing countries, Leading to premature morbidity and mortality, and to preventable losses of employment, earnings, and quality of life. The present study includes the effect of meditation on blood pressure.

Material and Methods: The study population of 100 subjects out of which 50 were Non-meditators and 50 were meditators attending sainath pathanjali yoga centre. Using sphygmomanometer and stethoscope Blood pressure response to standing was recorded.

Results: The improvements in autonomic functions are seen meditators in this study which are similar to other studies done on meditation and yoga.

Conclusion: In present study Blood pressure response to standing difference of both systolic &diastolic was significantly higher in meditators than in nonmeditators on change of posture from supine to erect indicating decreased sympathetic dominance.

Keywords: Cardiovascular disease, Systolic blood pressure, Diastolic blood pressure.
A RETROSPECTIVE EVALUATION ON THE SURGICAL MANAGEMENT OF CHRONIC ANAL FISSURE WITH DIFFERENT METHODS OF ANAESTHESIA
Authors: Grover Subhash Chander
Published: March 2020

Introduction: Fissure-in-Ano or Chronic Anal Fissures (CAF) is a linear ulcer in the squamous epithelium of the anus, distal to the dentate line & one of the most common and painful anorectal conditions encountered in surgical practice. Surgeons working in a rural setups and First Referral Units are faced with several challenges and limitations. Patients undergoing surgery under spinal anaesthesia have to undergo a battery of blood tests and imaging as a result for poorer patients the cost of treatment becomes manifold. This retrospective study was aimed to compare the outcome of lateral anal sphincterotomy (LAS) for chronic anal fissure, done under Spinal Anaesthesia and Local Anaesthesia.

Methods: This Retrospective study involved Prior Consent from the Hospital Authorities & was found to be within ethical standards. Data of 200 patients were selected which were proven cases of Chronic Anal Fissures admitted to the local surgical units in last 4 years. Subjects included both the genders, all age groups including pediatric and geriatric age group and all classes of socio economic strata.

Results: Data of total 200 patients were obtained, out of 200 participated 127 were women and 73 were men. A total of 100 patients (50%) underwent LAS under local anaesthesia and 100 patients (50%) underwent LAS under spinal anaesthesia. The mean age of the patients was 41.37 years with Standard Deviation of 3.42 years. There was No Statistical Difference between the two groups in terms of Intraoperative and Postoperative Complication like Pain, Incontinence & Infection after follow up.

Conclusion: Lateral anal sphincterotomy (LAS) provides very good healing of Chronic Anal Fissure. Few distinct advantages were noted in the study while doing LAS under LA. It provides adequate pain relief for the procedure apart from the advantage of easy palpability of the sphincter. It can be done as an Outpatient procedure without the need for an anesthetist, and carries a significant cost benefit to the patient especially in lower socio-economic settings. There is no significant difference in the complications or the healing of the fissure when compared with SA.

Keyword: Fissure-in-Ano , Lateral anal sphincterotomy, Spinal Anaesthesia , Local Anaesthesia , Retrospective Study.
DENGUE FEVER: A TRIGGERING FACTOR FOR IMMUNE THROMBOCYTOPENIC PURPURA IN ADULT FEMALE- A RARE CASE REPORT
Authors: Shah Arth , Kumawat D.C
Published: March 2020

Immune thrombocytopenic purpura (ITP) can be both primary and secondary. The secondary form of this disease may occur in association with systemic lupus erythematosus, antiphospholipid antibody syndrome, immunodeficient states, lymphoproliferative disorders, viral infections and using drugs such as quinidine, sulfa and heparin.
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Authors: G A
Published: March 2020

Abortion is a sensitive and contentious issue with religious, moral, cultural, and political dimensions. It is also a public health concern in many parts of the world, as it raises questions about basic beliefs regarding life and death, the sanctity of life, the beginning of life, and a woman’s individual legal right. Abortion is illegal in some countries such as Jordan, Oman, Qatar, Senegal and the Philippines, and legal in other countries such as Great Britain, Greece, Poland, Israel, and Turkey. Ethically, opponents considered abortion as equivalent to murder and that such killing of a fetus is deprived of future value, and no matter how much women may suffer, women can’t be allowed to kill their fetuses. Whereas, proponents considered abortion as morally justified and that the pregnant woman has the fundamental right to terminate her pregnancy. The current authors are against abortion to preserve dignity and respect for a fetus and regard the killing or termination of human life as morally wrong. The purpose of this paper is to present arguments on abortion from the legal and ethical views of opponents and proponents.

Keywords: abortion, legal, ethical, opponents, proponents, argumentations.
A STUDY ON QUALITY OF LIFE IN PATIENTS WITH CATEGORY-II PULMONARY TUBERCULOSIS IN A CENTRAL INDIAN DISTRICT
Authors: Agrawal Nipun , Jain Swapnil , Jain Anukool , Agrawal Jagdish
Published: March 2020

Background: Pulmonary Tuberculosis (PTB) is a contagious, airborne infection that develops when M. tuberculosis infect the lungs. PTB is totally curable infection. However, an early diagnosis and antibiotic treatment is needed to get the desired outcomes. Despite availability of treatment, stigmatization and negative emotions resulting from the illness could hamper the psychological well-being of patients which may eventually result in poor compliance, work absenteeism thus effecting economic productivity and prosperity.

Methods: This was a cross-sectional study conducted over a period of one year. A total of 231 category II DOTS patients were recruited for the study. Quality of Life (QOL) was assessed after 3 months of the intensive phase. For QOL WHO based QOLBREF was used.

Results: In the present study patients scored lowest in the psychological domain (7.82 ± 1.86) followed by physical (8.21 ± 1.98).

Conclusion: HRQOL is significantly reduced in patients with PTB.
RESTORATION OF ENDODONTICALLY TREATED TEETH WITH DIFFERENT CROWNS: A COMPARATIVE STUDY
Authors: Raman Nikita , Manish Kumar , Jain Samir
Published: March 2020

The optimal way to restore teeth after endodontic treatment continues to remain a controversial topic of heated debate to this day. Endodontically treated teeth (ETT) present with significantly different mechanical properties compared to vital teeth. The modifications in the biomechanical properties and structural integrity of the teeth are most-likely attributed to the volumetric loss of the hard tissues, extent of carious lesion, fracture propagation, final cavity preparation in addition to the access cavity prior to endodontic therapy.

Hence based on above findings the present study was planned for comparative evaluation of Restoration of Endodontically Treated Teeth with Different Crowns.

The study was planned in Department of Dentistry, Anugrah Narayan Magadh Medical College and Hospital, Gaya, Bihar.  The 60 cases of the Endodontically treated teeth (ETT) were enrolled in the present study. The patients were divided in the 4 groups as per different material and restorations given.

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.
EVALUATION OF SENSORINEURALHEARING LOSS IN TUBOTYMPANIC TYPE OF CHRONIC SUPPURATIVE OTITIS MEDIA
Authors: Babu Dr. P. Surendra
Published: March 2020

Background:

To know the prevalence of sensorineural hearing loss among chronic suppurative otitis media patients

To study the correlation between duration and clinical findings of CSOM with the degree of hearing loss.

Materials and Methods

Hospital based cross sectional study of patients aged between 10 to 45years with unilateral chronic suppurative otitis media attending Tirumala Super speciality Hospital, Kadapa from December 2015 to November 2017 with sample size of 100 cases were taken.

Results: Out of the 100 cases, 10 patients were having sensorineural hearing loss. Thus the percentage is 10%. Out of the 10 cases of sensorineural hearing loss, no cases with sensorineural hearing loss between 10-15yr and 16-20yr age group. 2 were between in the age group of 26-30yr, 31-35yr and 36-40yr age group and 4 patients were in the age group of 41-45yr. Out of 100 patients 52 were males and 48 were females. Out of 10 patients with sensorineural hearing loss 6 were males and 4 were females. The duration of ear discharge ranged from 3 months to more than 15 years. Among the 100 patients studied 64 had ear discharge from 3months to 5yr. 16 had ear discharge from 6-10yr, 11 had ear discharge from 11-15yr and 9 had ear discharge of more than 15years.

Conclusion: Our study shows presence of significant (10%) sensorineural hearing loss in patients with chronic suppurative otitis media.

Duration of ear discharge correlates well with sensorineural hearing loss.

No significant correlation between sex and sensorineural hearing loss.

Keywords: Chronic suppurative otitis media, tubotympanic disease, sensorineural hearing loss.
SPECTRUM OF FUNGAL INFECTIONS IN THE ELDERLY AGE GROUP
Authors: Saxena Kshitij , Shukla Priyanka , Shaafie Harris Ishtiyaq , Palliwal Garav , Jain Chandni
Published: March 2020

ABSTRACT

INTRODUCTION:

Fungal infections have become a common problem in the elderly age group. As age advances, the skin becomes dry, thin, wrinkled and with less number of hair follicles, sweat glands and sebaceous glands therefore, making it more susceptible to opportunistic pathogens. Superficial mycosis account for nearly 25% of the global burden of skin mycoses. The aim of this study is to identify the various superficial mycosis occurring in the elderly age group > 60 years attending a tertiary care hospital in North India.

MATERIALS AND METHODS:

Prospective, observational study conducted on 540 patients over the age of 60 years attending the Dermatology OPD at a tertiary care centre. Patients on antifungal agents were excluded from the study. Samples collected included skin and nail scrapings, nail clippings and hair along. The collected samples were divided into two parts one for culture and other for direct microscopy. Direct microscopy of the specimens was performed in 10% potassium hydroxide + 40% Di-methyl sulfoxide. Culture media used included Sabouraud’s dextrose agar (SDA) and Sabouraud’s dextrose agar containing Cycloheximide (0.5 mg/ml ). Cultures were incubated at both 25ºC and 37ºC for four weeks. Further species identification was done by Microslide culture technique. 

RESULTS:

The M:F ratio was 1.36:1. Onychomycosis accounted for the majority of superficial mycosis (25%) followed by Tinea mannum (14.65%) and Tinea pedis (15.51%). The most common dermatophyte isolate was Trichophyton rubrum (27.58%), followed by T.mentagrophytes (22.41%) and T.verrucosum (17.24%).

KEY WORDS:

Dermatophytes, Superficial Mycosis, Elderly age group, Slide culture
COMPARISON OF PLATELET COUNTS SHOWN BY AUTOMATIC HAEMATOLOGY ANALYSERS AND COUNTS MEASURED MANUALLY IN POPULATION OF MOUNTAINOUS HILLY REGION OF CHENAB VALLEY ATTENDING OPD ON ROUTINE BASIS IN GMC DODA. ASSOCIATED HOSPITAL
Authors: Khurshid Sumat Ul , Tabbasum Nazia
Published: March 2020

In clinical practice it is very important to perform the platelet counts.  The estimation of platelet counts from peripheral blood smears is an accurate method and provides adequate quality assurance in traditional methods as the automated cell counters are not available at all hospital setups especially in rural areas. In modern era use of   automated analyzers based on impedance technology has resulted in   improvement of accuracy and helps in measurement of platelet indices such as Mean Platelet Volume (MPV) Plateletcrit (PCT) and Platelet Distribution Width (PDW). However, both the methods have certain limitations. Platelet counts were estimated on a 5-part Differential Automated Hematology Analyzer and manually on Leishman stained peripheral blood SMEAR.

Aims & Objective: 1. This study was conducted to compare platelet counts by peripheral blood  smear method and automated method in patients  attending OPD on routine basis in a mountainous hilly region of  J&k .

It also aims to study the relation, if any, between the platelet count (automated) and platelet indices like Mean Platelet Volume (MPV) and Platelet Distribution Width (PDW) and to assess the possible role of these parameters in certain defined situations.

Materials and methods: A prospective study was conducted in a tertiary care hospital on 200 Ethylene Diamine Tetra Acetic acid (EDTA) anticoagulated blood samples. Samples were evaluated by 5-Part differential automated hematology analyser using impedance counting method and by examination of peripheral blood smear method (PBF).

Results: In thrombocytopenic patients, the platelet count assessed by automated analyzer revealed an inverse relation with Mean Platelet Volume (MPV) and Platelet Distribution Width (PDW) and showed large granular and giant platelets on PBS.

Conclusion: Automated hematology analyzer is essential   for immediate   and accurate complete blood count evaluation but blood samples showing erroneous results or low platelet counts on analyzer should be confirmed on peripheral blood smear. The platelet indices like Mean Platelet Volume (MPV) and Platelet Distribution Width (PDW) can point to the underlying pathology especially in cases of thrombocytopenia.

Keywords: Automated analyser, Peripheral blood smear, MPV, PDW, large granular platelets.
STUDY THE ASSESSMENT OF RISK FACTOR FOR PRIMARY CAESAREAN SECTION IN MULTIGRAVIDA
Authors: Kumar Pravin , Dhaka Mohinee , Gaur Sindhu Sudha , Pant Reena , Banerjee Krishna Priya
Published: March 2020

Background: It is a study of the assessment of risk factor of primary caesarean section in multigravida women who has had previous vaginal delivery of viable neonates.

Aim of Study: To study the risk factor of primary caesarean section in a multigravida.

Methods: Prospective study, hospital based descriptive type of observational study conducted in department of Obstetrics & Gynaecology, SMS Medical College, Jaipur, India from June 2018 to August 2019 ,1000 multipara women previous delivered vaginally  with gestational age >28 weeks with giving written and informed consent were included and excluded previous caesarean section and Labor was monitored by using partograph. Decision for caesarean section was based on clinical evaluation of progress of labor, fetal and maternal condition and complications were noted.

Statistical analysis: Continuous variable was expressed as Mean and Standard deviation. Nominally / Categorized variable was summarized as Proportion. Parametric and Nonparametric Tests used for continuous and nominal variable as per yield of data.

Result: 42.18% women in the age group of 26- 30 years and 71.90% were second gravida. 67.30% had emergency caesarean section. Among the various risk factor of caesarean section, malpresentation was commonest (12.79%).

Conclusion: There are many cases where a caesarean section becomes mandatory for her. Many unforeseen complications occur in women who previously had a normal vaginal delivery.
BLUNT ABDOMINAL TRAUMA WITH HAEMOPERITONEUM TREATED BY EXPLORATORY LAPAROTOMY VERSUS ONLY ABDOMINAL DRAINAGE: A PROSPECTIVE AND COMPARATIVE STUDY.
Authors: Panchal Dhawal , Dekhaiya Firdaus , Tailor Harin
Published: March 2020

In today’s mechanized world, Blunt Abdominal Trauma (BAT) is a common emergency which is associated with considerable morbidity and mortality. More than 75% of abdominal traumas are blunt in nature and liver and spleen are the commonest organs to be injured as a result of BAT. The aim is to analyse and compare two groups of patient of blunt abdominal trauma managed conservatively with drainage and one by exploratory laparotomy. 50 cases of blunt abdominal trauma were taken. The patient were studied  which includes age ,sex, mode of injury, initial vitals on presentation, Mortality in each group, duration of hospital stay, pre interventions and post interventions state and requirements, complications and follow up. It was observed 48% of patients were in between age group ranging from 10 to 30. Overall in terms of sex ratio, males dominated the no. of cases. RTA was most common mode of trauma. Liver and spleen was most common organ to be injured. Patients managed by laparotomy had higher mortality rate, duration of hospital stay was more, and complication were more. Early diagnosis and repeated clinical examination and use of appropriate investigation form the key in managing blunt injury abdomen patients.

Keywords:  Blunt Abdominal Trauma, Haemoperitoneum , laparotomy , Abdominal Drainage.
POST-PARTUM DEPRESSION- TREATMENT UPDATE
Authors: Choudhary Vijay , Hatila Sangeeta , Mehta Shubham
Published: March 2020

Background: Postpartum depression is a prevalent and serious mental health issue in India. This affects not only a woman but also the development of her offspring. There is a need to find out various pharmacological and non-pharmacological treatment options available for the treatment post-partum depression.

Method: This review was based on methods and results as described in the selected published articles available on PubMed and PsycINFO. We identified articles whose titles contained the following key terms in various combinations of the following: depression, depressive illness, postpartum, postnatal, treatment, prevention, therapy, pharmacotherapy, and antidepressant, the name of each antidepressant drug, hormonal therapy, estrogen, and progesterone.

Results: We reviewed treatment of post-partum depression with antidepressants randomized clinical trials as well as open label studies, hormonal treatment, prevention studies randomized clinical trials as well as open label studies, alternative pharmacological treatment including omega-3- fatty acids- both for prevention and treatment. We also reviewed internet based intervention, cognitive behavioral therapy, kangaroo mother care, effectiveness of regular exercise, role of ECT and effect of rTMS in post part depression. When it’s about safety, the psychological interventions support their use in some women, pregnant and lactating women because of devoid of side effects to new born.

Conclusion: Diverse pharmacological or psychological interventions options are available for treatment of postnatal depression. The most promising intervention is the focus on intensive and individualized approach.
TO STUDY THE INCIDENCE AND TYPE OF SURGICAL DIFFICULTIES ENCOUNTERED IN REPEAT CESAREAN SECTION IN COMPARISON WITH THE PRIMARY CESAREAN SECTIONS.
Authors: Gohil Nidhi , Parikh Rajni , Koli Deepika
Published: March 2020

Cesarean section is the most common surgery performed with over 30% of deliveries occurring via this route. This number is likely to increase given decreasing rates of vaginal birth after cesarean section (VBAC) and primary cesarean delivery on maternal request, which carries the inherent risk for intraoperative complications. Previous C-section delivery was a major indication for a repeat C-section delivery. The present study aims knowing the intra-operative difficulties encountered by an obstetrician, in this highly evolved surgical procedure called C-section especially in a repeat C-section. It was a Prospective observational study conducted on 60 cases of repeat cesarean section in c/o previous one cesarean section. Difficulties encountered while operating on cases of previous one cesarean section were noted. The intraoperative complications were compared with respect to adhesions (peritoneal, bladder, bowel, omental etc), blood loss, extension of tears over uterus, bladder injury, scar dehiscence, uterine rupture, need for hysterectomy. In present study, following intraoperative morbidities were encountered- adhesions 38.33%, advanced bladder 20%, excess blood loss 10%, placenta accrete was found in 1.67%,thinned out scar seen in 5% . Bladder injury seen in 1.67% patients. No cases of uterine rupture & bowel injury were noted. None of the patient needs caesarean hysterectomy. In modern obstetric practice, objective is safe motherhood and healthy baby by proper management. From present study, it can be concluded that repeat caesarean sections in c/o previous one cesarean section are associated with increased complications which lead to increased maternal morbidity

Keywords:  Primary Cesarean section , Repeat Cesarean section ,  Caesarean Section Difficulties.
SURVEY OF PATTERN OF DRUG INTERACTIONS IN PATIENTS BEING PRESCRIBED ANTI-DIABETIC MEDICATIONS IN A TERTIARY CARE HOSPITAL: PROSPECTIVE CROSS SECTIONAL STUDY
Authors: Divhare Sujeet A. , Ingale Satyashil
Published: March 2020

Background: Potential importance of drug –drug interactions (DDIs) is increasing as polypharmacy becomes more prevalent. Because additional data on the incidence and pattern of potential DDIs among diabetic patients are lacking in India, and supplemental pharmacodynamic or clinical outcome information is needed to address importance of a drug- drug interaction.

Aim and objectives: To identify and analyze the pattern of DDIs in patients being prescribed anti-diabetic drugs in a tertiary care hospital.

Material and Methods: This prospective cross-sectional study was carried out for a period of three months in 200 Type 2 diabetes mellitus (Type 2 DM) patients who were taking at least one antidiabetic agent during the period of past six months, of any age and either sex admitted in medicine ward of a tertiary care teaching hospital. Only one prescription was included for each patient on his/her 3rd day of hospitalization in the ward.

Results: A total of 1217 drugs were prescribed in 200 prescriptions, resulting in an average of 6.1 drugs per prescription. A total of 637 potential DDIs were noted. The majority were seen in middle aged and elderly people. No overall difference was detected in the patients on insulin or metformin therapy taking or not taking additional drugs with the potential to interact. Worse control was found in the group of patients on sulphonylurea therapy taking interacting drugs (P <0.05). This difference was most marked in the group of patients over 60 years of age, who also had the highest intake of potentially interacting drugs (57%; <35 years-37%).

Conclusion: Antidiabetic drugs have numerous interactions. A good practice is to use a drug­–drug interaction checker if any questions arise, several are available online. Quality care starts with the clinician obtaining a complete medication list for each patient at the start of each visit.

Keywords: diabetes mellitus, drug interactions, hypoglycemic agents, drug therapy, co-morbidity, polypharmacy
SCENARIO BASED INSTRUCTION: A REVERSE APPROACH FOR CONCEPTUAL LEARNING IN PHYSIOLOGY.
Authors: Meshram Komal , Waghmare Lalit , Meshram Ajay , Waghmare Tripti
Published: March 2020

To evaluate the gain in knowledge of first year MBBS students with the use of scenario-based teaching a reverse approach for conceptual learning in physiology a prospective interventional study was carried out in department of physiology. Methodology: 200 first year MBBS students participated in the study. 100 students (Group-A) were taken as control group to them the topic of physiology was taught by didactic method and another 100 students (Group-B) were taken as intervention group, where the same topic was taught with scenario-based instruction a reverse approach for conceptual learning in physiology. For each lecture pre and post test was taken. Five consecutive lectures were planned with this intervention. At the same time feedback forms were given to intervention group for purpose of analyzing the results qualitatively. After this intervention crossover of groups were done only for the sake of getting benefits of intervention. Results: Data obtained was analyzed statically. Pre and post test mean were taken. The results of post test (p<0.05) were found to be statistically significant when compared with pretest. As per the results of feedback forms, 90% (n=100) students agreed that the scenario based teaching is a powerful tool to understand the topic as it improves knowledge and makes learning more interesting.

Conclusion: According to the MCQ and feedback analysis, the results showed that teaching topic with scenario based instruction is the better approach for making the students to learn, understand and to gain the knowledge of physiology lectures rather than by traditional lecture alone.
AN AUDIT OF LUNG CARCINOMAS AT A TERTIARY REFERRAL CENTRE
Authors: Dubey Anshita , Hastak Meenal , Kulkarni Bijal , Athikari Nevitha , Mistry Rajesh
Published: March 2020

A generic diagnosis of ‘small cell or non-small cell carcinoma’ was sufficient in the past when there was no clinical demand for sub classification as it had no impact on therapy. Patients with advanced stage non-small cell lung carcinoma who received chemotherapy were typically treated with a ‘platinum doublet’ of cisplatin plus gemcitabine irrespective of histological subtype. At present, in contrast, sub classification of non-small cell lung carcinoma has significant treatment implications, especially for advanced stage tumors for which chemotherapy or targeted therapy is being considered. Consequently, pathologists are asked to subtype the tumor. The demand for sub typing is driven by oncologists, who now have several new targeted therapies, the efficacy of which varies by histological subtype.

In view of demand of sub typing of lung carcinomas as well as the guidelines given by WHO 2015 classification which emphasises the importance of a separate classification for biopsies and cytology on one side and the resection specimen on the other, we have taken up this study.

Keywords: Lung carcinoma, classification, core biopsies, immunohistochemistry