International Archives of BioMedical and Clinical Research 2018-03-28T08:20:31+00:00 Dr. Farhan Ahmad Khan, MD Open Journal Systems <p style="text-align: justify;">International Archives of Biomedical and Clinical Research (IABCR) is an open access, international, peer-reviewed, quarterly multidisciplinary medical research journal that focuses on communicating high quality research articles, reviews, Short communications, case reports, Letter to Editor, Drug News and updates in the field of Medical, Dental and other allied health and BioMedical Sciences. The Journal publishes 4-four issues in a year.</p> <div class="page-header" style="text-align: justify;"> <h3>Connecting Researchers Globally</h3> </div> <p style="text-align: justify;">IABCR offer Researchers, Academicians a better option when it comes to Open Access Journal publishing. Our platform vies to become the standard for all open access publications, irrespective of subjects or branches and aims to bring together researchers from all over the world and under a single global organization to form a community that actively creates new data and shares it with everyone with the utmost ease and simplicity.</p> <div class="page-header" style="text-align: justify;"> <h3>Ethical guidelines for journal publication</h3> </div> <p style="text-align: justify;">The Editor-in-Chief/Editor of International Archives of BioMedical and Clinical Research (IABCR) is responsible for determining which of the research papers/articles submitted to the journal should be printed. The publication decision is based on the recommendation of the journal's reviewers. The Editor-in-Chief /Editor may be maneuvered by the policies of the journal's editorial board and constrained by such legal requirements as shall then be in force regarding libel, copyright infringement and plagiarism. The Editor-in-Chief/Editor may consult with other editors or reviewers in getting to this determination.</p> The Importance of the Blood-Derived Growth Factors in Oral Surgery 2018-03-21T10:08:18+00:00 Carlos Fernando de Almeida Barros Mourão <p>The surgical procedures evolve at all times, however dental&nbsp;surgeries, in especially dental removals and soft tissue&nbsp;management, these techniques may variate according to the&nbsp;surgeon, but the basic principles are always the same.&nbsp;After the introduction of blood-derived growth factors in&nbsp;dentistry has modified the protocol of many surgeons,&nbsp;because of this by-product of the blood, assists in two&nbsp;essential steps: trans-operative and postoperative.</p> 2018-03-20T00:00:00+00:00 ##submission.copyrightStatement## FNAC - A Diagnostic Tool in Cervical Node Enlargement in a Tertiary Care Hospital 2018-03-21T10:08:17+00:00 Ajay Chauhan Nilesh Mehta <p><strong><em>Background: </em></strong><em>Cervical lymphadenopathy is relatively common clinical observation. Cervical lymphadenopathy is a diagnostic dilemma to the surgeon. The various avenues available for the analysis of cervical node enlargement are clinical evaluation, aspiration cytology, and open biopsy. Aim: To study the role of the FNAC in diagnosis of cervical node enlargement after correlating with a lymph node biopsy.&nbsp; </em><strong><em>Methods</em></strong><em>:</em> <em>This prospective observational study was conducted in Department of Surgery, Geetanjali Medical College and Hospital, Udaipur. All the patients aged more than 15 years presented with neck swelling were enrolled. </em><em>Detailed history will be taken followed by physical examination in all the patient with cervical lymphadenopathy. <strong>Results</strong>: Majority of the cases in this study had non-neoplastic causes for cervical lymphadenopathy in which tuberculosis is most common. Male to female ratio of 1.3:1. Maximum incidence was found to be tuberculosis. Maximum number of cases was in the age group of 21 to 30 years. The diagnostic accuracy of FNAC for tuberculous lymphadenopathy is 91.66%. The diagnostic accuracy of FNAC for nonspecific lymphadenitis was 87.50%. For secondary’s neck and lymphoma were 100%, 100% respectively.&nbsp; <strong>Conclusions</strong>: FNAC is a simple and safe procedure, which can be employed on outpatient basis. FNAC is found to be a frontline investigation of choice with biopsy and histopathological examination done for confirmation.</em></p> 2018-03-20T11:36:39+00:00 ##submission.copyrightStatement## Role of Neoadjuvant Chemotherapy followed by Concurrent Chemo-radiation in Locally Advanced Cervical Carcinoma: Our Experience 2018-03-21T10:08:19+00:00 Shantanu Pendse Ashok Kumar Diwan <p><strong><em>Background: </em></strong><em>Cervical carcinoma is the second most common cancer in females in India. Majority of them are reported in advanced stage. We have given platinum based neoadjuvant chemotherapy followed by CTRT in our study to reduce the local recurrence and decrease the tumor burden. The primary objective of our study was to assess the efficacy of NACT in terms of clinical and radiological response at the end of completion of treatment. </em><strong><em>Methods</em></strong><em>:</em> <em>This was a single arm prospective study in which we enrolled 79 patients from&nbsp; 2015-2017 who received 3 cycles of NACT, triweekly Cisplatin and 5-FU followed by concurrent chemo radiation (Radiotherapy-External beam radiotherapy 50Gy/25# plus intracavitary brachytherapy). Response was assessed at 12 weeks of completion of treatment by MRI pelvis using RECIST criteria 1.1 and toxicities were assessed weekly using CTCAE 4.03</em><em>. <strong>Results</strong>: Mean age was 54 years; compliance rate was 88.6%. Complete response rate was 58.57% and partial response rate was 18.57% at 12 weeks post-treatment. Grade 2 or higher toxicities were seen in 52.85% patients during NACT and chemo radiation. Skin toxicities were seen in 37.14% followed by rectal-32.85%, haematological-27.14% and urinary bladder-24.28%. <strong>Conclusions</strong>: Neoadjuvant chemotherapy followed by Concurrent chemo radiation is a feasible treatment option with a good response rate with acceptable rate of treatment related toxicities.</em></p> 2018-03-20T12:04:02+00:00 ##submission.copyrightStatement## The Most Commonly Seen Metabolites in Intracranial Space Occupying Lesions - A Prospective Study 2018-03-21T10:08:20+00:00 Sunil Kast Karnawat Shekhar <p><strong><em>Background: </em></strong><em>Intracranial space occupying lesions are defined as lesions occurring within the cranial vault, which can be intra-axial or extra-axial. Magnetic Resonance Spectroscopy can be performed in 10 -15 minutes and combined with conventional imaging protocols. Thus MRS offers the possibility of not just visualization of the lesion but also biochemical characterization simultaneously. The present study was aimed at establishing the most commonly seen metabolites in the intracranial space occupying lesions. </em><strong><em>Methods</em></strong><em>:</em> <em>The present observational study was conducted in the Department of Radiodiagnosis, Ananta Institute of medical science and research Centre, Udaipur, Rajasthan, on a 1.5 Tesla Siemens MAGNETIC RESONANCE IMAGING equipment and 3.0 TESLA MAGNETIC RESONANCE IMAGING equipment. As reference standards, values of Cho/Cr &gt; 1.5, NAA/Cr &lt; 1.6, Cho/NAA &gt; 0.8, Lactate &gt;1.34, Lipids &gt;1.4, Glutamate &gt;2.5, Glutamine &gt;2.38, Alanine &gt;1.48 were taken as abnormal.</em> <em>Based on these the lesions were characterised as benign/ malignant and grades of malignancy was determined. The data was arranged in a tabulated version and analysed using SPSS software. </em><em>&nbsp;</em><strong><em>Results</em></strong><em>: Mean Cho/ Cr ratio was high in gliomas, metastasis and meningiomas, while it was normal in DNETs and infections. Highest Mean Cho/Cr value was seen in metastasis (3.48). Abscesses showed presence of lactate, acetone and aminoacids peaks, while acetone and aminoacids were not seen in Tuberculosis or NCC. Lipid peaks were seen in 100% of the cases of Tuberculosis.&nbsp; <strong>Conclusions</strong>: From the above study, we can conclude that presence of alanine in 100% of meningiomas makes it a useful marker for these tumors. Tuberculomas showed intense signals from lipids, and hence could be separated from Neurocysticercal cysts.</em></p> 2018-03-20T00:00:00+00:00 ##submission.copyrightStatement## To Compare the Competency of Prognostic Markers- ESR, CRP against ZN Staining in Determining Pulmonary Tuberculosis Cases 2018-03-21T10:08:20+00:00 Rashmi Chandragouda Meti Anand Nagalikar <p><strong><em>Background:</em></strong><em> Tuberculosis (TB) is a highly prevalent chronic infectious disease caused by Mycobacterium tuberculosis an aerobic intracellular binding bacterium (bacillus). Active TB disease can be fatal if left untreated. The disease today is considered curable and preventable. This retrospective study was undertaken to compare and analyzed the relationship between acute phase reactant proteins CRP (quantitative) and ESR in sputum smear positive for AFB patients and to evaluate their diagnostic and prognostic significance. </em><strong><em>Methods</em></strong><em>:</em> <em>The present prospective study was carried on a randomly selected study group comprising of 180 cases of pulmonary TB patients who were sputum smear positive for AFB and 25 normal healthy (sputum smear negative for AFB) individual were taken as control. The cases of&nbsp; PTB group was further categorized on the basis of recommendation of RNTCP grading system of AFB in Sputum ZN staining into four subgroups AFB – 3+, AFB – 2+, AFB –1+ and scanty. The control groups were negative for the Acid Fast bacilli in sputum.</em> <strong><em>Results</em></strong><em>: In our study showed that the maximum patients seen in grade III (36.11%) followed by grade II (31.66%), grade I (19.44%) and 12.77% scanty according to RNTCP grading system of ZN staining of sputum for acid fast bacilli.&nbsp; The&nbsp;&nbsp; distribution of mean values of CRP, ESR in different grades of ZN staining of sputum in AFB positive patients as well as controls. CRP mean value was 55.4, 40.8 &amp; 22.9 in grade III, grade II &amp; grade I respectively and ESR was 48.1, 38.8 &amp; 23 respectively in different grading significantly higher (p vol &lt; 0.0001) in group II there were no serious adverse reactions in either group. <strong>Conclusions</strong>: Our study concluded that during the compression of values of CRP and ESR along with the grading of sputum AFB positive patients, the CRP raised more significantly as compare to ESR; with markedly raised values in all the grades of sputum AFB positive patients.</em></p> 2018-03-20T00:00:00+00:00 ##submission.copyrightStatement## How Stigma and Discrimination are Perceived by Rural or Urban Patients Suffering from Schizophrenia? An Exploratory Cross – Sectional Study fromWestern India 2018-03-21T10:08:21+00:00 Bharat Agarwal Sunil Kumar G. K. Vankar <p><strong><em>Background: </em></strong><em>Stigma is conceptualized as an attribute which is deeply discrediting and makes the person carrying it different from other and of a less desirable kind. Current study aimed to describe the nature and direction of experienced stigma; and discrimination reported by people with schizophrenia. </em><strong><em>Methods:</em></strong> <em>One hundred and fifty patients diagnosed with Schizophrenia were selected from the Out Patient service of Psychiatry Department of a medical college general hospital. The experiences of stigma and discrimination were assessed using a semi-structured instrument developed by national working group for India by the world psychiatric association steering committee.</em> <strong><em>Results</em></strong><em>: Differences were seen between rural and urban respondents. Patients from rural background more often reported these experiences: society treats differently, ridiculing by others, offensive comments, hiding from relatives, rejecting attitude of peoples around, attribution of supernatural cause as most common source of stigma, social exploitation, not fully accepted in the family, pushed into unacceptable social situation and sexual harassment. Reported narratives provided the direct view of these patients. <strong>Conclusions</strong>: Stigma experience is pervasive: it deeply affects the social, occupational and emotional wellbeing of patients with schizophrenia and should be included in clinical management. Effective anti-stigma intervention should target on improving attitudes and the condition for social integration in the community, empowering people with schizophrenia to challenge self-stigmatization and discrimination behavior towards them.</em></p> 2018-03-20T20:40:27+00:00 ##submission.copyrightStatement## Assessment of Peri-procedural Myocardial Injury in Patients of Post-percutaneous Coronary Intervention: Diagnosis through Serum Biomarkers as Cardiac Troponin T and Creatine Kinase Myocardial Isoform 2018-03-21T10:08:21+00:00 Malay Acharyya Swapan Kumar Haldar Dipankar Mukhopadhyay <p><strong><em>Background: </em></strong><em>Cardiac troponin (CTnT) and creatinine kinase myocardial isoform (CKMB) are suitable marker for myocardial injury following percutaneous coronary intervention (PCI). Elevation of these markers lead to major adverse cardiac events (MACEs). The objective was to detect the elevation of serum CTnT and CKMB during post-PCI period and identify MACE during six-month followed up among patients in eastern Indian. </em><strong><em>Methods</em></strong><em>:</em> <em>In present study, 100 patients were randomly selected for coronary angioplasty between April2012 to March2013. All the cases were referred to catheterization laboratory for elective PCI for single vessel or multivessel in native coronary artery. The CTnT and CKMB parameters were estimated as per standard protocol. The categorization was done on the basis of baseline (normal value), ≤3time and &gt;3time elevation for both the biomarkers and respective MACEs as MACE-1, MACE-2, MACE-3, MACE-4 and MACE-5 were determined. </em><strong><em>Results</em></strong><em>: There were more MACE in patients in six month follow up who sustainned &gt;3times elevation in CTnT and CKMB during pos-PCI period. There was highly significant correlation (P&lt;0.001 and P&lt;0.01) with increasing trend of CTnT and CKMB elevation and risk of MACEs. MACEs were significantly (P&lt;0.001 and P&lt;0.01) correlated with diabetes mellitus, hypertension, renal dysfunction, fluoroscopy time, stent length, left ventricular ejection fraction and type of lesion. It was also observed that more hospital stay led to elevation of CTnT and CKMB. <strong>Conclusions</strong>: It is concluded that the elevation of CTnT and CKMB in serum during post-PCI can predict MACEs in six-month follow up in stable ischaemic heart disease. </em></p> 2018-03-20T21:26:17+00:00 ##submission.copyrightStatement## Prevalence of Vitamin D Deficiency among Geriatric Patients 2018-03-21T10:08:22+00:00 Keshavamurthy Ganapathy Bhat Manvinder Pal Singh Marwaha Bhupinder Kaur Anand Sapna Jaiswal Shalini Ray Anil Redhu <p><strong><em>Background: </em></strong><em>Vitamin D deficiency is recognized as a global public health problem. In India Vitamin D Deficiency is prevalent, a finding that is unexpected in a tropical country with abundant sunshine. This study evaluated prevalence of vitamin D deficiency among geriatric patients.</em><strong><em>Methods</em></strong><em>:</em> <em>The present study was a hospitalized based cross sectional study conducted among geriatric patients attending the ortho. OPD of CIMS, Lucknow. Those elderly (&gt;60 yrs) consenting to participate were including in this study .Patients who were on vitamin D3 &amp; calcium supply (6 month) were excluded. </em><strong><em>Results</em></strong><em>: In this study we have taken 200 sample size. Geriatric patients who were not on vitamin D and calcium supplements for last 6 months were included for the study. Out of 200 participants, only 27(13.5%) participants had normal vitamin D levels and 173 (86.5%) study participants had low vitamin D levels among them 112 (56%) participants had vitamin D deficiency, 61(30.5%) participants had vitamin D insufficiency. <strong>Conclusions</strong>: Present study confirmed that Vitamin D deficiency is a major public health problem among geriatric age group.</em></p> 2018-03-20T21:34:36+00:00 ##submission.copyrightStatement## Recent Prescribing Trends of Anti- Microbial Agents and their Sensitivity Pattern in an Intensive Care Unit of a Tertiary Care Teaching Hospital 2018-03-21T10:08:23+00:00 Iram Shaifali Saurabh Kumar Hari Om Kumar Singh <p><strong><em>Background: </em></strong><em>Due to the injudicious and indiscriminate use of Anti-Microbial Agents (AMAs) among hospitalized patients especially in ICUs, it is extremely imperative to monitor and refine the prescribing pattern of antibiotics regularly. Hence an effective surveillance team consisting of a physician, a pharmacologist and a microbiologist should develop and implement an antimicrobial stewardship program based on the local antibiogam to increase the therapeutic benefits and curb the menace of Anti-Microbial Resistance (AMR).</em> <strong><em>Aims</em></strong><em>:-To study the prescribing pattern of Anti-Microbial Agents and to evaluate the antimicrobial sensitivity pattern of common bacterial isolates in Medical ICU (MICU) of a tertiary care hospital. </em><strong><em>Methods</em></strong><em>:</em> <em>After taking approval from the Institutional ethical committee, this prospective observational study was conducted in the department of Pharmacology and Microbiology over a period of six months. Patient records were reviewed and analyzed to assess the prescribing pattern of antibiotics and Culture-sensitivity reports of various specimen from MICU were collected to determine the antibiotic sensitivity pattern. </em><strong><em>Results</em></strong><em>: Ceftriaxone (26%) was the most commonly prescribed drug followed by Metronidazole (16%). Fixed drug combinations such as Piperacillin+Tazobactam (14%), Amoxicillin + clavulanic acid (10%) and Cefoperazone + Sulbactam (8%) were also frequently used. The most predominant organism isolated was Klebseilla species (25%) followed by Acenitobacter species (19.4%). Colistin /Imipenem and Vancomycin/Linezolid depicted100% sensitivity for Gram-Negative (GNIs) and Gram-Positive Isolates (GPIs) respectively. <strong>Conclusions</strong>: The need of the hour is to preserve the power of the almost exhausted antimicrobial armamentarium against the rampantly emerging multidrug resistant organisms.</em></p> 2018-03-20T21:41:05+00:00 ##submission.copyrightStatement## A Prospective Study on Klinefelter Syndrome: A Basket of Multiple Systemic Disorders in a Tertiary Care Hospital 2018-03-21T10:08:24+00:00 K R Sharma Samil Sajal Harshit Sharma Smita Verma Y K Bolya <p><strong><em>Background: </em></strong><em>When one or more extra X chromosome is added to a normal male karyotype (46-XY), then a new aneuploidy appears called Klinefelter Syndrome (KS). Every day approximately more than 50 new such cases are added in the male population of India. Traditionally they are lean, thin, tall, azoospermic, hypogonadic, infertile males with low social and educational profile. As the age advances level of testosterone decreases and many new symptoms of multiple systemic disorders appear in these cases<strong>. </strong></em><strong><em>Methods</em></strong><em>:</em> <em>A well designed questionnaire of infertile males attending the above- mentioned OPD’s was filled with history, clinical examination and semen analysis (twice as per the WHO criteria). </em><em>&nbsp;</em><strong><em>Results</em></strong><em>: In our series of 500 azoospermic males, we encountered 56 classical KS cases (11.2 %) of 47-XXY karyotype, who were hypergonadotrophic hypogonadic and diagnosed with multiple diseases when evaluated in detail. <strong>Conclusions</strong>: Hence, every KS must receive androgen replacement therapy, which should begin at puberty and continue for lifelong that helps in preventing the development of high comorbidity rate and premature deaths because these are very high in such condition as compared to normal male population. </em></p> 2018-03-20T21:47:55+00:00 ##submission.copyrightStatement## Diagnosis of Knee Osteoarthritis Risk through Abnormal Musculo-postural Features 2018-03-21T10:08:25+00:00 Apurba Ganguly <p><strong><em>Background: </em></strong><em>In several parts of the globe, knee osteoarthritis (KOA) occurs as a painful chronic disease. The aim of the study was to determine the risk factors for musculo-postural abnormalities by detecting abnormal anatomical leg parameters caused by knee-osteoarthritis (KOA).</em> <strong><em>Methods</em></strong><em>:</em> <em>Baseline data were collected and evaluated from 207 patients aged between 40-65 years (58.94% females) with KOA and an equal number of subjects without-KOA. Anatomical measurements included the gap at the knee between the short head of the biceps femoris and the level of the bed (KGB), diameter of muscles at the thigh (DTM), the calf (DCM) and 4cm above and below the patella (DAP and DBP) and flexion supine, prone and standing (KFS, KFP and KFSt) and extension supine, prone and standing (KES, KEP and KESt) in different postural positions for both legs of both groups using appropriate instruments and Body Mass Index (BMI). The study was also correlated with radiological images.&nbsp; </em><strong><em>Results</em></strong><em>: </em><em>Risk factors for KOA based on abnormal leg anatomical-features were observed with statistical significance (P&lt;0.001) and R<sup>2 </sup>(97-100%). The present results were evaluated after analyses of anatomical and flexion and extension range of motion measurements in different postural positions for both legs with KOA along with radiological features. The BMI of the experimental group was higher than that of the control group with high statistical significance (P&lt;0.001).</em> <strong><em>Conclusions</em></strong><em>: </em><em>Abnormal muscle morphology and musculo-postural-features of the legs may be a suitable diagnostic protocol for the detection of early progression and risk of KOA.</em></p> <p><strong>&nbsp;</strong></p> 2018-03-20T21:58:35+00:00 ##submission.copyrightStatement## Evaluation of Patwardhan Technique in Second Stage Caesarean Section 2018-03-21T10:08:26+00:00 Manju Lal Priyanka Goyal Saba Shamim <p><strong><em>Background: </em></strong><em>Caesarean sections done at full cervical dilatation with impacted fetal head are technically very difficult and are associated with increased incidence of maternal and fetal morbidities. The objective of this study was to compare the maternal and neonatal morbidities between the Patwardhan technique and the Push method for extraction of the fetus in second stage caesarean section. </em><strong><em>Methods</em></strong><em>:</em> <em>This is retrospective analysis of all caesarean sections done in the second stage at tertiary care centre at Dehradun, UK, India from 2014 to Dec 2016. Women with single fetus, with anterior vertex, at term with a deeply impacted fetal head into pelvis, in whom decision of caesarean section was already taken, were included in the study. </em><strong><em>Results</em></strong><em>: </em><em>The patients were divided into two groups, Group 1 (study group) consists of all cases in which extraction of fetus was done by Patwardhan technique and group 2 (control) in whom extraction of fetus was done by push method and extracted as vertex. Complications like extension of the incision, injury to surrounding&nbsp; organs , PPH,&nbsp; need for blood transfusion and neonatal&nbsp; outcome&nbsp; in terms of weight , APGAR&nbsp; and NICU stay were compared in both groups Out of these 120 cases,56&nbsp; belonged to group A .( Patwardhan)&nbsp; and 64 belonged to group B (push method ). Traumatic PPH and blood transfusions were significantly less in Patwardhan as compared to Push method (3%,16%,p=.0049). There were significantly less uterine incision extension seen in Patwardhan group as compared to Push method (5%, 22%, p=.0031).Baby outcome was almost similar in both the groups. While complications are inherent in both the techniques Patwardhan method has been shown to cover considerable advantage in prevention of maternal morbidities. </em><strong><em>Conclusions</em></strong><em>: </em><em>Patwardhan is a useful manoeuvre in intra operative disengagement of fetal head in second stage CS and it should be learnt and practiced as the primary technique.&nbsp; </em></p> 2018-03-20T22:20:19+00:00 ##submission.copyrightStatement## Local Injection of Autologous Platelet Rich Plasma and Corticosteroid in Treatment of Plantar Fasciitis in Female Patients 2018-03-21T10:08:27+00:00 Prashant Garhwal Bimla Choudhary <p><strong><em>Background:</em></strong><em> Chronic plantar fasciitis is the commonest cause of foot complaints in India. The incidence of plantar fasciitis peaks in people between the ages of 40 to 60 years with no bias towards either sex. Numerous methods have been advocated for treating plantar fasciitis, including rest, non-steroidal anti-inflammatory medication, night splints, foot orthosis, stretching protocols and extracorporeal shock wave therapy. The aim of this study to compared the functional outcome of Local Steroid and PRP in Plantar Fasciitis. <strong>Methods</strong>: A prospective randomized control trial done on 63 patients with complaint of plantar fasciitis coming to SMS Medical College &amp; Hospitals, Jaipur, who were attain the inclusion criteria in the study. Patient coming to OPD were randomly allocated C.R. number. Patients with Odd C.R. number were given PRP and those with even number were given Steroids.&nbsp; Patients were followed at 12 weeks and 24 weeks after the injection to look for the effect of PRP and corticosteroid. Then the results were obtained on mean VAS score and AOFAS score in both the groups. <strong>Results</strong>: The present study showed that the mean age was 40 years in group I and 39 years in group II. Maximum females were housewife (41.26%) in both groups. The difference of mean in between groups, VAS score &amp; AOFAS was insignificant in first visit (P=0.8642 &amp; P=0.3400) and statistical significant after 12 weeks (P&lt;0.0001*** each) and 24 weeks (P&lt;0.0001***each). <strong>Conclusions</strong>: We believe that PRP injection is safe and can be an excellent alternative to corticosteroid injection in plantar fasciitis, not responsive to conservative means. The findings of this preliminary study can be very relevant in clinical practice.</em></p> 2018-03-20T00:00:00+00:00 ##submission.copyrightStatement## Perinatal and Maternal Outcome in Pregnant Women with Polyhydramnios: A Hospital Based Study 2018-03-21T10:08:27+00:00 Sushila Rathi <p><strong><em>Background: </em></strong><em>Polyhydramnios is the term for abnormal increase in the amniotic fluid. It has been shown that AFI is quite reliable in determining normal or elevated volumes. The aim of this study to evaluated the perinatal and maternal outcome in pregnant women with polyhydramnios.</em></p> <p><strong><em>Material &amp; Methods</em></strong><em>: This analytical study was conducted on 300 unselected pregnancies attending in Mahatma Gandhi Hospital, Bhilwara, Rajasthan. Most of the cases of polyhydramnios were admitted in the hospital till they delivered, other patients were followed up as outpatient and they were admitted to the hospital for delivery. Pregnancy outcome were recorded for the patients who were classified as having an excess amount of amniotic fluid.</em></p> <p><strong><em>Results</em></strong><em>: In our study showed that out 0f 300 patients, 168 (56%) were in the age group of 21-25 yrs, 62.3% cases were multigravida in our study. In our study 73% of the cases were delivered vaginally. Out of which 15% were induced and 58% were delivered spontaneously. 27% of the cases were delivered by LSCS, out of which 16% were emergency LSCS and 11% were elective LSCS. In our study there were many perinatal complications. Out of them preterm birth was the most common complication.</em></p> <p><strong><em>Conclusion</em></strong><em>: The conclusion of this prospective study was occurrence of polyhydramnios is directly related to advanced maternal age with multigravida. Caesarean section as a mode of delivery was found to be higher in cases of polyhydramnios.</em></p> 2018-03-20T22:46:36+00:00 ##submission.copyrightStatement## Assessment of Quality of Life in Post − Menopausal Women: A Questionnaire Study 2018-03-21T10:08:28+00:00 Sharad Mishra Shankar Singh Gaur <p><strong><em>Background: </em></strong><em>Menopausal women may experience vasomotor, urogenital and psychological symptoms as well as sexual dysfunction. These problems are often attributed to hormonal changes during midlife and are projected as health risk. The present study was conducted to assess the quality of life (QOL) and determinants in postmenopausal women.</em></p> <p><strong><em>Materials &amp; Methods: </em></strong><em>The present study was conducted on 140 postmenopausal women age ranged 45- 60 years of age. All women were provided with a pre-designed questionnaire containing 24 questions about quality-of-life in menopause. Scores for vasomotor aspect ranged from 0 to 6, for psychosocial aspect from 0 to 18, for physical aspect from 0 to 42 and for sexual aspects from 0 to 6. </em></p> <p><strong><em>Results: </em></strong><em>60 women were &lt;50 years and 80 were &gt;50 years. Psychosocial score of 5-15 was observed in 42 women, vasomotor score of 2-5 was seen in, physical score of 24-33 was seen in 12 and sexual score of 2-4 was seen in 32 women. 65 women had more than 5 years of menopause while 75 had less than 5 years. 110 women exercise in the form of brisk walking while 30 do not. In 90 women, relation with husband deteriorated after menopause and 50 women never complained of this. 80 were living with their children while 60 not. 50 women had support from their children while 90 had not. 75 women had good perception of her heath while 65 had average perception. All domain showed significant difference in QOL. </em></p> <p><strong><em>Conclusion: </em></strong><em>Post-menopausal women who fall in a transitional population between the reproductive age group and geriatric population need special attention. Their quality of life is highly determined by physical domain and psychosocial domain</em></p> 2018-03-21T04:44:07+00:00 ##submission.copyrightStatement## A Study of Type of Chronic Daily Headache in Tertiary Care Population: A Hospital Based Study 2018-03-21T10:08:29+00:00 S. P. Agiwal <p><strong><em>Background: </em></strong><em>Chronic daily headache (CDH) is a broad term which includes groups of headache disorders and it is not a diagnosis. Primary and secondary chronic daily headache are the two common types of headaches. We planned the present study to assess and evaluate Chronic Daily Headache &amp; its subtype’s distribution according to age &amp; sex.</em></p> <p><strong><em>Materials &amp; Methods: </em></strong><em>The present study included assessment of pattern of Chronic Daily Headache in Tertiary Care Population. Consecutive patients with chronic daily headache (CDH) attending the neurology and medicine Out Patient Department were enrolled for the study. Here chronic daily headache refers to a group of disorders. So we could not define it but it characterizes by very frequent headache each around for 4 hours (≥15 days a month) including headache associated with medication overuse. CDH group include various primary and secondary headaches. All the results were recorded on excel sheet and analyzed by SPSS software. <strong>Results: </strong>A total 200 patients with Chronic Daily Headache have been studied. The maximum number of the patients (65%) was seen in the age group of 21-40 years. No patients were seen in 61-65 years. All 78 patients with Medication overuse Headache had either Chronic Migraine or Chronic Tension Type Headache. Mean age of CM patients was lower as compared to mean age of Chronic Tension Type Headache (CTTH) patients, this difference was statistically significant. <strong>Conclusion: </strong>Chronic daily headache frequency &amp; its sub type CM &amp; CTTH are higher in females as compared to males. Female to male ratio is higher in Chronic Migraine (CM) (5.3:1) as compared to CTTH (1.9:1). </em></p> 2018-03-21T04:47:50+00:00 ##submission.copyrightStatement## Comparative Evaluation of Efficacy of Various Antibiotics in Treating Patients with Diarrhea: A Hospital Based Study 2018-03-21T10:08:29+00:00 Harish Chandra Sharma <p><strong><em>Background: </em></strong><em>Diarrhea is a condition of altered intestinal water and electrolyte transport. The pathophysiologic mechanisms of diarrhea include osmotic, secretory, inflammatory, and altered motility. Hence; we planned the present study to assess and compare the efficacy of ofloxacin and combination of Norfloxacin and metronidazole (Nor Metrogyl) in treating patients with acute watery diarrhoea. <strong>Materials &amp; Methods: </strong>The present study was conducted in the department of general medicine of RBM Hospital, Bharatpur, Rajasthan and included comparative evaluation of efficacy of ofloxacin and combination of Norfloxacin and metronidazole (Nor Metrogyl) in treating patients with acute watery diarrhoea.&nbsp; A total of 24 patients with chief complaint of acute watery diarrhea were included in the present study and were randomly divided into two study groups; group A and group B. group A included subjects who were treated with ofloxacin therapy while group B included subjects who were treated with Nor Metrogyl. All the results were analyzed by SPSS software. <strong>Results: </strong>A total of 24 patients were included in the present study and were randomly divided into two study groups with 12 patients in each group. We observed non-significant results while comparing the clinical success and biological success among patients of both the study groups. <strong>Conclusion: </strong>Both the treatment regimens are equally effective in treating diarrhea patients.</em></p> <p><em>&nbsp;</em></p> 2018-03-21T04:51:12+00:00 ##submission.copyrightStatement## Assessment of Liver Disorders in Patients of Type 2 Diabetes Mellitus: A Hospital Based Study 2018-03-21T10:08:30+00:00 Ramesh Kumar Goenka <p><strong><em>Background: </em></strong><em>Non-alcoholic steatohepatitis (NASH) is commonly associated with type 2 diabetes mellitus (DM). Prevalence of NASH in type 2 DM has not been well studied and there is an epidemic rise in type 2 DM in Asian and Western populations. Its association with chronic liver disease in the form of NASH makes it an important health problem. Hence, we have studied its prevalence and correlation of biochemical parameters with histological grades of non-alcoholic fatty liver disease (NAFLD) in otherwise asymptomatic type 2 DM patients.</em></p> <p><em>&nbsp;<strong>Materials &amp; Methods: </strong></em><em>One hundred and twenty-five individuals were screened. N=30 individuals were excluded due to history of alcohol intake or liver disease as a result of other causes. N=95 non-alcoholic individuals with type 2 DM underwent abdominal ultrasonography (US abdomen). N=28 patients had evidence of fatty liver on US abdomen, and 16 of these 28 patients underwent liver biopsy.</em></p> <p><strong><em>Results: </em></strong><em>Out of 125 patients enrolled with the suspicion of Nonalcoholic Fatty Liver Disease (NAFLD) and Non-alcoholic steatohepatitis in patients of Type 2 Diabetes Mellitus, female patients were </em><em>70 (56%) and male patients 55 (44%). The prevalence of NAFLD was found to be more in females n=40 than males n=30. N=16 patients were undergone liver biopsy for the suspicion NASH. Out of 22 patients suspected, only 9 patients were found to be having NASH.</em></p> <p><strong><em>Conclusion: </em></strong><em>We conclude that the prevalence of NASH is high in type 2 DM patients and liver biopsy is the only investigation to differentiate between non-alcoholic fatty liver and steatohepatitis.</em></p> 2018-03-21T04:54:26+00:00 ##submission.copyrightStatement## To Determine the Bacteriological Profile and Antibiotic Sensitivity Pattern of the Isolates Causing Ventilator Associated Pneumonia in ICU Patients 2018-03-21T10:08:30+00:00 Neha Garg <p><strong><em>Background: </em></strong><em>Ventilator associated pneumonia (VAP) is a type of nosocomial pneumonia occurring in patients who are mechanically ventilated for more than 48 hours. VAP is the most common nosocomial infection occurring in the intensive care units and its incidence varies from 8% to 28%.</em></p> <p><strong><em>AIMS &amp; OBJECTIVES</em></strong><em>- This study was done to determine the bacteriological profile and antibiotic sensitivity pattern of the isolates obtained from the endotracheal aspirates of the clinically suspected patients of VAP in ICU. </em><em>&nbsp;<strong>Materials &amp; Methods: </strong></em><em>Ventilator associated pneumonia (VAP) is a type of nosocomial pneumonia occurring in patients who are mechanically ventilated for more than 48 hours. VAP is the most common nosocomial infection occurring in the intensive care units and its incidence varies from 8% to 28%. <strong>AIMS &amp; OBJECTIVES</strong>- This study was done to determine the bacteriological profile and antibiotic sensitivity pattern of the isolates obtained from the endotracheal aspirates of the clinically suspected patients of VAP in ICU. </em><strong><em>Results: </em></strong><em>Out of 110 patients included in the study, only 85 patients were diagnosed as VAP patients based on clinical and microbiological criteria. Pseudomonas aeruginosa (35.55%) was the most common gram-negative isolate obtained in VAP cases followed by Escherichia coli (27.77%) and Acinetobacter baumanni (16.66%). Among Gram positive bacteria, Staphylococcus aureus 40 (80%) was the most common isolate. The most active antibiotic against the gram-negative isolates was imipenem (82.2%), followed by piperacillin-tazobactum (77.7%) and amikacin (63.3%). All the Gram-positive isolates were susceptible to vancomycin and linezolid. </em><strong><em>Conclusion: </em></strong><em>Due to the increasing incidence of multi drug resistant pathogens in ICU, early and correct diagnosis of VAP is an important challenge for critical care physicians. Hence, knowing the bacteriological profile causing VAP and their routine antibiotic susceptibility pattern can improve the patient’s clinical outcome.</em></p> 2018-03-21T05:01:21+00:00 ##submission.copyrightStatement## A Correlation of Cerebral Malaria with Different Changes in Hepatitis: A Hospital Based Study 2018-03-21T10:08:30+00:00 Pratap Singh <p><strong><em>Background: </em></strong><em>Ventilator associated pneumonia (VAP) is a type of nosocomial pneumonia occurring in patients who are mechanically ventilated for more than 48 hours. VAP is the most common nosocomial infection occurring in the intensive care units and its incidence varies from 8% to 28%.</em></p> <p><strong><em>AIMS &amp; OBJECTIVES</em></strong><em>- This study was done to determine the bacteriological profile and antibiotic sensitivity pattern of the isolates obtained from the endotracheal aspirates of the clinically suspected patients of VAP in ICU. </em><em>&nbsp;<strong>Materials &amp; Methods: </strong></em><em>The study was conducted in the department of general medicine of the Haridev Joshi Hospital, Dungarpur, Rajasthan, India. The present study included 52 patients who had serum bilirubin &gt; 3 mg%. So, after excluded patient the study group included 45 patients. All patients were underwent a set of investigations, including conjugated and unconjugated bilirubin, and serum AST and ALT levels. All the patients with cerebral malaria underwent detailed ultrasonography to check the size and echo-texture of the liver. </em><strong><em>Results: </em></strong><em>A total of 45 patients with malaria were included in the study. The mean serum bilirubin level was 11.23<u>+</u>6.8 mg %, mean AST levels was 298.42<u>+</u>242.21 IU/l and mean ALT levels was 382.21<u>+</u>298.12 IU/l. 17 patients were diagnosed having cerebral malaria. The patients with cerebral malaria were directed to undergo USG abdomen. Enlarged size if liver was seen 14 patients.&nbsp; </em><strong><em>Conclusion: </em></strong><em>Within the limitations of our study we conclude that significant hepatitis findings are seen in patients with cerebral malaria. Required supportive and anti-malarial treatment should be provided to the patients with specially taking care of the hepatic health.</em></p> <p><em>&nbsp;</em></p> 2018-03-21T05:10:46+00:00 ##submission.copyrightStatement## Un-United Fracture Neck Femur Results of Treatment with Close Reduction, Cancellous Screw Fixation & Fibular Strut Graft 2018-03-21T10:08:31+00:00 Kailash Parihar Praveen Kumar Garg <p><strong><em>Background: </em></strong><em>Ununited, femur neck fractures are a common problem in the developing countries like India where medical facilities are already deficient and ignorance, illiteracy and poverty further delay the patients in seeking proper treatment. The struggle to find the best treatment continues as relentlessly as it did half a century ago. The study was undertaken to evaluate the results of close reduction, cancellous screw fixation and fibular graft in ununited fractures of femoral neck in young adults with regards to achievement of fracture union, effect of this procedure on pre-existing AVN and establishment of relatively easy new surgical technique.</em></p> <p><strong><em>Materials &amp; Methods: </em></strong><em>This study was conducted in Government hospital, Pali, Rajasthan. It includes 25 cases treated by close reduction, cancellous screw fixation and fibular strut graft who have non-united fracture. The patients are systemically interrogated for personal details, mode of injury, time elapsed after injury, complaints, any other associated injury, any previous treatment taken and other systemic illness. Grading of fracture (Garden’s classification) resorption of neck and avascular necrosis changes are based on roentgen graphic findings.</em></p> <p><strong><em>Results: </em></strong><em>Our study showed that the mean age of patients was 35.19 years and maximum patients were seen in 21-40 years of age (72%), male to female ratio was 2.57:1. Average union time in our series was 19 weeks. In present series good to excellent results found in 96% of cases; in only one case (4%) result was poor that was because of failure of procedure.</em></p> <p><strong><em>Conclusion: </em></strong><em>We concluded that the cancellous screws fixed in closed reduced fracture and supplemented with fibular strut graft is one of the good methods as far as union and functional results are concerned in ununited fractures of femoral neck.</em></p> 2018-03-21T05:30:27+00:00 ##submission.copyrightStatement## Bacteriological Profile and Antibiotic Sensitivity Pattern in Community Acquired Neonatal Sepsis in Rajsamand – A Hospital Based Prospective Study 2018-03-21T10:08:31+00:00 S K Tak Anup Paliwal Sameer Jagrwal <ol> <li>Shankar MJ, Aggarwal R, Deorari AK, Paul VK. Symposium on AIIMS protocol in Neonatology -ш. Indian J Pediatr 2008;75:261-6.</li> <li>Baltimore RS. Neonatal nosocomial infections. Semin Perinatal 1998;22:25-32.</li> <li>Wolach B. Neonatal Sepsis: Pathogenesis and supportive therapy. Semin Perinatal 1997;21:28-38.</li> <li>Lawn JE, Cousens S, Zupan J. Four million neonatal deaths: when? where? why? Lancet 2005;365:891-900.</li> <li>Lawn JE, Cousens S, Darmstadt GL, Bhutta ZA, Martines J, Paul et al. One year after The Lancet Neonatal Survival Series-was the call for action heard? Lancet 2006; 367:1541-7.</li> <li>Stoll BJ. Neonatal Infections: a global perspective. In: Remington JS, Klein Jo,eds. Infectious diseases of fetus and the newborn infant. 5<sup>th</sup> edn .Philadelphia:WB Saunders Company,2001.p.1371-1418.</li> <li>Bryce J, Boschi-Pinto C, Shibuya K, Black RE; WHO child heath epidemiology Reference Group. WHO estimates of the causes of death in children. Lancet 2005;365:1147-52</li> <li>Report 2002-2003.National Neonatal Perinatal Database Network. New Delhi National Neonatology Forum of India, 2004.</li> <li>Srivastava SP, Kumar A, Kumar ojha A. Verbal Autopsy determined causes of neonatal deaths: Indian Pediatrics 2001;38:1022-5.</li> <li>Singhal YD. Neonatal mortality and morbidity in ICDS urban slum, Indian Pediatr 1990;27:485-8.</li> <li>Ahmed AS, Chowdhury MA, Hoque M, Darmstadt GL. Clinical and Bacteriological Profile of Neonatal Septicemia in a Tertiary Level Pediatric Hospital in Bangladesh. Indian Pediatr.2002;39:1034-39</li> <li>Mathur NB. Neonatal Sepsis. Indian Pediatr.1996;33:633-74</li> <li>Aftab R, Iqbal I. Bacteriological Agents of Neonatal Sepsis in NICU at Nishtar Hospital, Multan. J coll Physicians Surg Pak.2006;16(3);216-9</li> <li>Joshi SG, Ghole VS, Niphadkar KB. Neonatal Gram –negative Bacteremia. Indian J Pediatr.2000;67(1):27-32.</li> <li>Clinical Laboratories Standards Institute. Performance Standards for antimicrobial disk susceptibility tests. Approved Standards, 11thed.CLSI document M2A12. CLSI, Wayne, PA:CLSI 2012.</li> <li>Begum S,Baki MA, Kundu GK, Islam I,Kumar M, Haque A. Bacteriological profile of neonatal sepsis in a tertiary care hospital in Bangladesh. J Bangladesh CollPhysSurg 2012,30:66-70.</li> <li>Khatna SP, Das AK, Chaterjee BD. Neonatal Septicemia. Ind J Pediatr 1986;53:509-14</li> <li>Premlata DE, Koppad M, Halesh LH, Siddesh KC, Prakash N. The bacterial profile and antibiogram of neonatal septicemia in a tertiary care hospital. Int J of recent trends in Sc and technology; 2014:451-5</li> <li>Karathikeyan G, Prem Kumar K. Neonatal sepsis. Staphylococcus aureus as the predominant pathogen. Indian J Pediatr.2001;68:715-7.</li> <li>Mustafa M, Ahmed SL. Bacteriological Profile and Antibiotic Susceptibility Patterns in Neonatal Septicemia in view of emerging drug resistance. J Med Allied Sci 2014;4(1):02-08.</li> <li>Kaistha N, Mehta M, Singla N, Garg R, Chander J. Neonatal Septicemia isolates and resistance patterns in a tertiary care hospital of North Indian. J Infect DevCtries 2009;4:55-7.</li> </ol> 2018-03-21T05:43:34+00:00 ##submission.copyrightStatement## Ultrasonographic Study on Size and Echotexture of Spleen in Normal and Diseased Adult Population in Kosi Region of Bihar 2018-03-21T10:08:32+00:00 Anand Kumar Anita . Vishal Prakash Giri <p><strong><em>Background: </em></strong><em>The spleen is the largest organ in the reticuloendothelial system. A number of disorders are accompanied by altered spleen size, including infective, infestation, infiltrative, immunologic, and malignant conditions. Ultrasonography affords a useful noninvasive role in evaluating the spleen and used for best advantage, it can demonstrate the existence and composition of splenic masses, disruption of splenic texture or outline, progressive changes in masses and the size of the spleen. </em></p> <p><strong><em>Materials &amp; Methods: </em></strong><em>166 subjects were selected from the Departments of Medicine, Surgery and Radiology, from a tertiary care teaching hospital and from the other clinics of Kosi region like Purnea, Araria and Madhepura districts during the period of June 2016 to May 2017.</em></p> <p><strong><em>Results:</em></strong> <em>The splenic length decreased at a slow rate up to the age of 50 years after which it decreased rapidly in both sexes. The splenic length was greater in males than in female in each age group. Mean splenic width in the first age group i.e. 21 30 years was 60.9 ± 8.4 mm, in the second age group i.e. 31 - 40 years was 56.4 ± 7.9 mm, in the third age group i.e. 41 – 50 years was 46.6 ± 4.3 mm, and in the fourth age group i.e. 51 – 60 years was observed to be 44.6 ± 8.0 mm.</em></p> <p><strong><em>Conclusion: </em></strong><em>The ultrasonography affords a useful noninvasive role in evaluating the spleen, it can demonstrate existence and composition of splenic masses, disruption of splenic texture or outline; and also progressive changes in masses and size of spleen.</em></p> 2018-03-21T05:47:54+00:00 ##submission.copyrightStatement## Assessment of Efficacy of Various Treatment Regimes in Patients with Typhoid Fever: A Prospective Study 2018-03-21T10:08:33+00:00 Ikram Hussain F. H. Gauri Anwar Ali Tak Nusrat Gauri <p><strong><em>Background: </em></strong><em>Typhoid fever is caused by&nbsp;Salmonella enterica&nbsp;serovar Typhi (S typhi), a Gram negative bacterium. Typhoid fever is among the most common febrile illnesses encountered by practitioners in developing countries. Hence; we planned the present study to evaluate the efficacy of various treatment regimes in treating patients with typhoid fever.&nbsp; </em></p> <p><strong><em>Materials &amp; Methods: </em></strong><em>The present study included assessment of efficacy of different treatment regimes in treating patients with typhoid fever. A total of 40 patients were included in the present study and were broadly divided into two study groups with 20 patients each group. Group 1 included patients who were treated ceftriaxone therapy while group 2 included patients who were treated with chloramphenicol. Bacteriological culturing of the blood, stool and urine samples was done for confirming the diagnosis at the start of the treatment. Repetition of the blood and stool culture was done on day 5 and day 12 after the discharge of the patient. All the results were analyzed by SPSS software. </em><strong><em>Results: </em></strong><em>Complete clinical cure occurred in 17 and 19 patients of group 1 and group 2 respectively. Positive blood culture for S. typhi on day 5 occurred in 0 and 10 days of group 1 and group 2 patients respectively. </em><strong><em>Conclusion: </em></strong><em>In treating patients with typhoid fever, Ceftriaxone could be safely used.</em></p> <p><strong><em>&nbsp;</em></strong></p> 2018-03-21T05:53:34+00:00 ##submission.copyrightStatement## Prevalence of Overweight and Obesity in Children of Rural Population: A Prospective Study 2018-03-21T10:08:33+00:00 Mohd. Rafik Praveen Kumar Garg <p><strong><em>Background: </em></strong><em>Obesity is generally classified as generalized obesity (GO) and abdominal obesity (AO). Individuals with obesity have higher rates of mortality and morbidity compared to non-obese individuals. Globally, the prevalence of childhood obesity has risen in recent years. The International Association for the Study of Obesity (IASO) and International Obesity Task Force (IOTF) estimate that 200 million school children are either overweight or obese. <strong>Aim of the study: </strong>To evaluate the prevalence of overweight and obesity in children of rural population.</em></p> <p><strong><em>Materials &amp; Methods: </em></strong><em>For the study we selected subjects from the local government schools in the rural area. A total of 180 subjects with age ranging from 5-17 years were included in the study. The body weight was measured without shoes using a measuring scale and height to the nearest centimeter was taken. Body Mass Index (BMI) was calculated as weight (in kilograms) divided by height (in meter squared). &nbsp;</em><strong><em>Results:</em></strong> <em>In the study group, no. of obese patients was 12, no. of overweight subjects was 26 and no. of non-obese subjects was 142. We observed that maximum no. of obese children were seen in the age of 10 years (n=3) followed by age of 6, 14 and 15 years (n=2). No. of obese boys was 8 and no. of obese girls was 4. No. of overweight boys was 16 and no. of overweight girls was 10. </em><strong><em>Conclusion: </em></strong><em>The high frequency of obese and overweight children is observed in rural area. We found higher frequency of obesity in boys as compared to the girls. Obesity is a serious problem, which requires immediate attention, creating awareness program in the schools and parents encouraging their children to be involved in more physical exercises, sports and outdoor activities<strong>.</strong></em></p> <p><strong><em>&nbsp;</em></strong></p> 2018-03-21T05:58:04+00:00 ##submission.copyrightStatement## Visual Outcome After Cataract Extraction in Open Globe Injury 2018-03-21T10:08:34+00:00 Dhawal Agrawal Kaiser Ali Azra Ali <p><strong><em>Background: </em></strong><em>Penetrating ocular trauma is a well-known cause of visual impairment in young adults and children. Cataract is the commonest complication following ocular injury.</em></p> <p><em>Aims: The findings of the present study are expected to help in appropriate management of traumatic cataract cases.</em></p> <p><strong><em>Materials &amp; Methods: </em></strong><em>This is a prospective study of 5yrs in patients of penetrating ocular trauma. Detailed history and full ophthalmic evaluation of patients was done. Most patients were operated 15 days after trauma, so inflammation gets settled. Self-sealing 2.8mm incision was made and capsulorhexis was tried and cortical aspiration was done. Children less than 12 yrs posterior capsulorhexis and anterior vitrectomy was done. If posterior capsule is torn, we tried to convert the tear in posterior capsulorhexis and anterior vitrectomy was done. Three piece and single piece lens were implanted depending upon status of capsular bag. Statistical analysis used: SSPE software</em></p> <p><strong><em>Results:</em></strong> <strong><em>Males(63.9%) and 11-30 yrs(46.1%)</em></strong><em>&nbsp; age group constitute majority. Common causes of injury in children(&lt;10years), young (11-30years) and adult (31-50 years) were wooden stick (40%), thorn(44%) and iron flying object and knife/sharp instruments(42.5%) used in household respectively. Anterior capsulorhexis was done in 15% of patient and posterior chamber lens were implanted in 97% of patients. The visual acuity at presentation was ‘the perception of light to 3mfc ' in 80.0% of cases while after surgery, it was found that 82.0% of patients had regained useful vision. </em><strong><em>Conclusion: </em></strong><em>ocular trauma, penetrating injury, traumatic cataract.</em></p> 2018-03-21T06:02:21+00:00 ##submission.copyrightStatement## Comparative Evaluation of Efficacy of Clindamycin and Trimethoprim - Sulfamethoxazole for Treating Patients with Uncomplicated Skin Infections 2018-03-21T10:08:34+00:00 Madan Singh Batar <p><strong><em>Background: </em></strong><em>The most common bacterial causes of skin and soft tissue infections (SSTI) are group A Streptococcus (GAS) and Staphylococcus aureus, the key bacterial agents of impetigo, cellulitis, abscesses, and wound infections. <strong>Aim of the study: </strong>To compare efficiency of clindamycin and trimethoprim-sulfamethoxazole for treating patients with uncomplicated skin infections. </em><strong><em>Materials &amp; Methods: </em></strong><em>The study was conducted in the department of general medicine of the Government S.K. Hospital, Sikar, Rajasthan, India. . For the study we selected subjects from the surgical ward of the hospital of the medical institute. The patients diagnosed with uncomplicated skin infection were included in the study. A total of 42 patients were selected for the study.</em></p> <p><strong><em>Results:</em></strong> <em>A total of 42 patients were enrolled, 21 in group 1 and 21 in group 2. We observed that clinical cure at 17-20 days was 78.03 % in Group 1 and 74.31 % in group 2. Clinical cure at one month follow up was 71.22% in group 1 and 65.21% in group 2. Clinical cure in adults in group 1 was 76.2% and in group 2 was 74.84%. Clinical cure in pediatrics was 83.29% in group 1 and 79.35% in group 2. Clinical cure rate of abscess for group 1 was 77.96% and for group 2 was 81.21%. <strong>Conclusion: </strong>Within the limitations of the study we conclude that both the drug combinations i.e., clindamycin and trimethoprim-sulfamethoxazole are equally effective in treating uncomplicated skin infections. </em></p> 2018-03-21T06:06:56+00:00 ##submission.copyrightStatement## Comparison of Spinal Anaesthesia Vs General Anaesthesia for Lower Spinal Surgeries 2018-03-21T10:08:35+00:00 Alok Gupta Avanish Kumar Saxena Amrita Gupta Atiharsh Mohan Ankur Saxena Chandroday Kumar <p><strong><em>Background: </em></strong><em>Both General and Regional anaesthesia can be&nbsp;&nbsp; used for lower Lumbar Disc surgery but SPINAL ANAESTHESIA is also a better alternative as it is accompanies by less blood loss and haemodynamics instability. </em><strong><em>Materials &amp; Methods: </em></strong><em>60 patients were randomly assigned to receive either General Anaesthesia( GA group) or Spinal Anaesthesia(SA group).&nbsp; Patients were supplemented with i.v. Propofol sedation in Spinal anaesthesia&nbsp; group. The values were recorded preoperative, intraoperative &amp; postoperative. HR, MAP, amount of blood less, surgeon Satisfaction were noted. The severity of nausea, vomiting, duration of recovery and total analgesic use was also recorded. </em><strong><em>Results:</em></strong> <em>Total anaesthesia, surgical time and blood loss is less in spinal anaesthesia group as compared to general Anaesthesia group. Intraoperative hypertension and tachycardia is more in GA group. Surgeon satisfaction and cost effectiveness is more in SA group. Postoperative nausea ,vomiting is more in GA group.</em></p> <p><strong><em>Conclusion: </em></strong><em>Spinal&nbsp; anaesthesia is better ,safe and economical alternative to general anaesthesia for lower spinal surgery </em></p> 2018-03-21T06:11:06+00:00 ##submission.copyrightStatement## Prospective Study on Low-Dose Mifepristone for the Treatment of Leiomyoma: A Hospital Based Study 2018-03-21T10:08:35+00:00 Sabita Sukla Das <p><strong><em>Background: </em></strong><em>Fibroid or myoma is the commonest reported tumor of uterus, and is one of the important reasons for hysterectomy in our setting. Medical Management of fibroid uterus can be done by Mifepristone, a progesterone antagonist. This study was commenced to study the effect of mifepristone on the symptoms and size of fibroids, especially using a low-dose regimen for 6 months. In addition, any symptomatic improvement of menorrhagia and dysmenorrhea was also studied</em><em>. </em><strong><em>Materials &amp; Methods: </em></strong><em>The study was designed as an observational prospective study done on women diagnosed with uterine fibroids attending OPD of </em><em>Dept. of Obstetrics &amp; Gynaecology, Pataliputra Medical College, Jharkhand</em><em>. A total of 48 patients were enrolled in the study. Out pf 48, only 36 patients completed our study.&nbsp; 50 mg of mifepristone weekly used, and patient assessed at 1 and 6 month. They were a follow up period of 3 months after stopping the drug to observe the changes in menstrual pattern, fibroid volume, hemoglobin and liver function tests. </em><strong><em>Results:</em></strong> <em>Majority of the study population comprised of perimenopausal women, i.e., 36–45 years (48 %). Fifty percent of the patients were Para 2 and belonged to the perimenopausal age-group (18 out of 36). The dominant presenting symptom was menorrhagia associated with dysmenorrhea and pelvic pain. After 6 months of treatment with mifepristone, the mean fibroid volume reduced from 204.33 to 113.16 cm3 (n = 33), and the percentage mean volume reduction of the fibroid in the study population was 44.57 %. Immediate reduction in bleeding PV was observed in 100 %, and 88.89 % (32/36) patients attained amenorrhea. The mean hemoglobin increased from 9.18 to 10.82 g/dl. </em><strong><em>Conclusion: </em></strong><em>To conclude, 6 months therapy with 50 mg of mifepristone given weekly is efficacious and acceptable for the treatment of symptomatic leiomyoma, especially in a select group of patients.</em></p> <p><em>&nbsp;</em></p> <p>&nbsp;</p> 2018-03-21T06:16:42+00:00 ##submission.copyrightStatement## Assessment of Efficacy of Comparison of Total I.V. Anaesthesia Using Propofol with an Inhalation Technique: A Hospital Based Study 2018-03-21T10:08:36+00:00 Chandresh Bhooshan Bhardwaj <p><strong><em>Background: </em></strong><em>Postoperative nausea and vomiting can be particularly problematic in ambulatory surgery as it may lead to delay in discharge or unscheduled admission to hospital. Additionally, it has been reported as the anaesthetic complication that is of most concern to patients. Multiple factors, including the anaesthetic agent delivered, are associated with an increased incidence of PONV and the optimal strategy for preventing PONV continues to be debated. <strong>Aim of the study: </strong>To assess the efficacy of comparison of total I.V. anesthesia Using Propofol with an Inhalation Technique. <strong>Materials &amp; Methods: </strong>The study was conducted in the department of anesthesia of R.B.M. Hospital, Bharatpur, Rajasthan, India. For the study we selected patient’s admitting to the surgical ward of the medical hospital of the institute. A total of 16 patients were selected for the study. An informed written consent was obtained from each patient after explaining them the procedure and significance of the study verbally. The patients were randomly grouped into two groups, Group 1 and Group 2. Patients in Group 1 underwent anesthesia by IV procedure and patient’s in Group 2 underwent anesthesia by inhalation method. Patients were followed up and monitored for pain, sedation score, nausea and vomiting in the post-operative period for 48 h. <strong>Results:</strong></em> <em>A total of 16 patients were included in the study. The patients were randomly grouped into Group 1 and Group 2. We observed that mean age of patients in group 1 was 36.31<u>+</u>12.21 years and in group 2 was 32.21<u>+</u>10.98 years. Number of male patients in group 1 was 5 and in group 2 were 4. We observed that majority of cases had Grade 0 and 1 operative area. <strong>Conclusion: </strong>The hat total I.V. anesthesia using Propofol offers no significant advantage over inhalation anesthetic technique.</em></p> 2018-03-21T06:32:11+00:00 ##submission.copyrightStatement## Comparative Evaluation of Collagen Dressing Versus Conventional Dressing in Burns and Chronic Wounds: A Comparative Study 2018-03-21T10:08:36+00:00 K. C. Panwar Abhishek Panwar <p><strong><em>Background: </em></strong><em>Burn injuries to the skin result in loss of its protective function as a barrier to micro-organisms leading to the high risk of infection. Various dressing materials have been used for dressing the burn wounds. Hence; we planned the present study to evaluate and compare the efficacy of Collagen Dressing and Conventional Dressing in Burns and Chronic Wounds. </em><em>&nbsp;</em><strong><em>Materials &amp; Methods: </em></strong><em>We did evaluation and comparison of efficacy of Collagen Dressing and Conventional Dressing in Burns and Chronic Wounds. A total of 50 patients were included in the present study and were broadly divided into two study groups; Group A and Group B. Group A included patients who were treated with collagen dressing while group B included patients who were treated with conventional dressing. We collected all the data details from the patients including the size of the wood, edge and floor characteristics of the wound. We cultured swab and pus culture after four days as per hospital’s protocol. Patient’s response to the treatment in both the study groups were recorded and evaluated by SPSS software.</em></p> <p><strong><em>Results:</em></strong> <em>Most common type of wound encountered in both the study groups was decubitus type. We didn’t observe any significant difference while comparing the number of cases completely treated after seven weeks. <strong>Conclusion: </strong>In terms of complete healing, no significant difference exists in between collagen dressing and conventional dressing.</em></p> <p><em>&nbsp;</em></p> 2018-03-21T06:37:31+00:00 ##submission.copyrightStatement## To Evaluate the Difference in Mean CCT among POAG and Ocular Hypertension: A Hospital Based Study 2018-03-21T10:08:37+00:00 P. C. Dhaka Nusrat Gauri F. H. Gauri <p><strong><em>Background: </em></strong><em>Measurement of the accurate IOP is important not only for classification, but for the clinical management of the glaucoma patients. The aim of this study to determine the difference in mean CCT among POAG and Ocular Hypertension. </em><strong><em>Materials &amp; Methods: </em></strong><em>A hospital based comparative type of observational study done on 120 eyes of 60 patients was conducted under Department of Ophthalmology, Government D.B. Hospital, Churu, Rajasthan. To be safe and accurate, following factors should be checked before making a glaucoma diagnosis. The preliminary eye examination included the visual acquity and slit lamp biomicroscopy of the anterior segment, to rule out any corneal pathology and refraction. The intraocular pressure was recorded by using Goldmann Applanation Tonometry (GAT). </em><strong><em>Results:</em></strong> <em>Our study showed that the most of the study subjects in POAG group (46.6%) were in &gt;50 years age group, while most of the subjects in OH group (46.6%) were in 41-50 years age group and there were 19 (63.3%) male in POAG group while in OH group there were 23 (76.7%) males. The mean CCT in right eye &amp; left eye was higher in OH group (568.4 &amp; 562.2 respectively) as compared to POAG group (507.8 &amp; 504.2 respectively) and this difference was found to statistically significantly on application of unpaired t test (P&lt;0.001&amp; P&lt;0.001 respectively) and IOP was also statistically significant(P&lt;0.001) in both eyes.</em><em> <strong>Conclusion: </strong></em><em>We concluded that the measurement of the central corneal thickness aid the ophthalmologist in making a correct diagnosis and in a better management of glaucoma and the glaucoma suspects, especially when their corneal thickness differs markedly from the normal thickness. AQ</em></p> 2018-03-21T06:46:10+00:00 ##submission.copyrightStatement## Study of Incidence of Peptic Ulcer Perforation in Young Adults: A Hospital Based Study 2018-03-21T10:08:37+00:00 Dinesh Kumar Sarda Praveen Kumar Garg <p><strong><em>Background: </em></strong><em>Peptic ulcer formation affects about 2-10% of world population every year with higher incidence in younger individuals. Being a surgical emergency, it has higher mortality and morbidity. Thus, the aim of our study was to evaluate the incidence of peptic ulcer perforation based on gender, age and also to study its associated risk factors, clinical presentations, site along with surgical management and complications.</em></p> <p><em>&nbsp;</em><strong><em>Materials &amp; Methods: </em></strong><em>75 patients diagnosed with perforated peptic ulcer were included and this study was conducted in the department of Surgery Government Bangur Hospital, Pali, Rajasthan, India. Structured performa was prepared to obtained details of patients and ethical clearance from the institute was also taken prior to the study.</em></p> <p><strong><em>Results:</em></strong> <em>76% of patients in our study were males and 24% were females with male and female ratio 1:3.16. The prevalence of perforation was high in age group 20-30 years (30.7%). 62.7% of cases had positive family history and the incidence was in the patients who consumed non-vegetarian (84.8%), spicy (61.4%) and oily (69.5%) foods. Frequently observed clinical presentation were abdominal pain followed by tenderness and rigidity and gas under diaphragm. The common site of perforation was duodenum (62.7%) and most of the cases were treated by closure with omental patch (81.3%). The post-surgical complications frequently observed were wound infection (30.6%) and chest infection (28%).</em></p> <p><strong><em>Conclusion: </em></strong><em>Peptic ulcer perforation is common disorder of gastrointestinal tract, now affecting younger adults with male preponderance. It is associated with unwanted health and economic issues. Therefore, earlier management is only the way to minimize complications and mortality.&nbsp; </em></p> 2018-03-21T06:51:07+00:00 ##submission.copyrightStatement## A Comparative study on Adenosine and Magnesium Sulphate with Bupivacaine in Infraclavicular infusion for Postoperative Analgesia 2018-03-21T10:08:37+00:00 Manoj Kumar Upadhyay Anurag Agarwal Chandrashekhar Singh Rajiv Ratan Singh Shivshankar Tripathi Deepak Malviya <p><strong><em>Background: </em></strong><em>Brachial plexus piece has reformed the field of regional anaesthesia for upper limb surgeries. Infraclavicular subcoracoid approach gives complete block without significant difficulties. <strong>Aim: </strong>To compare the additives adenosine and magnesium sulphate with bupivacaine in infraclavicular infusion for upper limb surgeries and postoperative analgesia.</em> <strong><em>Materials &amp; Methods: </em></strong><em>This Prospective study was done at the Department of Anaesthesiology, Govt. Medical College, Azamgarh</em><em>. Around </em><em>24 patients scheduled for elective unilateral upper limb surgeries involving distal arm/ elbow/ forearm/hand divided into two groups A (n-12) and B (n-12) randomly. Group A - adenosine 6mgs with 28 ml 0.5% bupivacaine bolus followed by infusion of 0.25% bupivacaine 28ml with 6mgs of adenosine (2ml) at a rate of 5ml/hr. Group B - magnesium sulphate 75 mgs (in 2ml) with 28ml of 0.5% bupivacaine bolus followed by infusion of 0.25% bupivacaine 28ml with 75mgs of magnesium sulphate (in 2ml) at a rate of 5ml/hr in USG guided placement of infraclavicular catheter. </em></p> <p><strong><em>Results:</em></strong> <em>Our Study revealed&nbsp; that&nbsp; Group&nbsp; A&nbsp; had a&nbsp; faster Onset time of sensory and motor block and faster recovery when compared to group B. Group A needed more rescue analgesia than group B. </em><strong><em>Conclusion: </em></strong><em>The addition of magnesium sulphate as an additive to bupivacaine in brachial plexus block may be a better choice when prolonged postoperative analgesia is required.</em></p> 2018-03-21T00:00:00+00:00 ##submission.copyrightStatement## Serum Magnesium Levels in Type II Diabetes Mellitus and Its Association with the Microvascular Complications 2018-03-21T10:08:38+00:00 Anju Kochar Radheshyam Shrotriya <p><strong><em>Background: </em></strong><em>Hypomagnesemia has been associated with type 2 diabetic mellitus and is known to be a risk factor for microvascular complications. This study aimed to evaluate serum magnesium levels in patients with type 2 DM and correlate them with microvascular complications.</em></p> <p><strong><em>Materials &amp; Methods: </em></strong><em>A hospital based cross-sectional study was conducted on150 patients with type 2 diabetes mellitus were admitted in the Mahatma Gandhi Hospital, Bhilwara, Rajasthan, India. Serum magnesium levels were assessed in all the diabetic patients and they were also tested for presence of microvascular complications.</em></p> <p><strong><em>Results:</em></strong> <em>In the present study majority of the patients (71.33%) were males and male to female ratio was 2.48:1. The commonest age group was &gt; 60 years (50%) and the mean age was 60.38 ± 10.81 years. The duration of diabetes in 45.33% of the patients was between 6 to 10 years and mean duration was 7.43 ± 4.11 years. Hypomagnesemia was associated with microvascular complications including diabetic retinopathy, diabetic nephropathy and diabetic neuropathy (p&lt;0.050). Also, association was found between serum magnesium levels glycaemic control and duration of diabetes (p&lt;0.050).</em></p> <p><strong><em>Conclusion: </em></strong><em>Hypomagnesemia is widely prevalent in patients with type 2 diabetes mellitus and a major risk factor for the development microvascular complications that is, diabetic retinopathy, nephropathy and neuropathy.</em></p> <p>&nbsp;</p> <p><strong><em>Key words:</em></strong> <em>Hypomagnesemia, Diabetic nephropathy, Diabetic neuropathy, Diabetic retinopathy, Microvascular complications, Type 2 diabetes mellitus</em></p> 2018-03-21T07:21:53+00:00 ##submission.copyrightStatement## To Evaluate EEG Changes and Correlation of Biochemical Analysis in Uremic Patients: A Prospective Study 2018-03-21T10:08:38+00:00 H. S. Chhabra <p><strong><em>Background: </em></strong><em>Until today the exact etiopathologic agent responsible for clinical toxicity in uremia could not be singled out. A parallel may be drawn between the use of the electroencephalogram (EEG) in the evaluation of uremia and the use of electrocardiogram (ECG) in the evaluation of hyperkalemia. The present study has been undertaken to evaluate EEG changes &amp; correlation of biochemical analysis in uremic patients.</em></p> <p><strong><em>Materials &amp; Methods: </em></strong><em>A prospective study done on 25 cases of uremia due to varied etiology were selected from the wards of general hospital, Dungarpur, Rajasthan. The cases were diagnosed on the basis of the criteria laid down by Jean Hamburger, Richet G. et al (1968)<sup>3</sup>. Electroencephalographic tracing of all patients were made by an 8 channel EEG machine. A routine examination of hemoglobin, ESR, TLC, DLC, Complete urine examination with references to 24 hours urine volume, specific gravity and pH was done. Biochemical estimation of blood urea, serum Creatinine, sodium and potassium was also done.</em></p> <p><strong><em>Results:</em></strong> <em>All the EEG showed diminished alpha activity, slowing in less than 6 &amp; 6-8 HZ range and significant low voltage indeterminate activity more in precentral montages. In all the 9 drowsy patients the predominant background activity consisted of slow waves (less than 8 HZ) which were more in precentral as compared to postcentral montages. Correlation of serum Creatinine &amp; EEG was predominant low voltage in determinant activity is seen in all group and serum sodium &amp; potassium was showed that the abnormally is more marked in precentral leads.</em></p> <p><strong><em>Conclusion: </em></strong><em>We concluded that there was significant more slowing (theta &amp; Delta waves) in precentral leads in uremic patients irrespective of biochemical and clinical parameters which has not been mentioned by earlier workers.</em></p> <p><em>&nbsp;</em></p> 2018-03-21T07:38:15+00:00 ##submission.copyrightStatement## Incidence of Adverse Drug Events among Hospitalized Patients in Surgical Wards: A Hospital Based Study 2018-03-21T10:08:39+00:00 H. S. Sahwal Sunil Upmanyu <p><strong><em>Background: </em></strong><em>Until today the exact etiopathologic agent responsible for clinical toxicity in uremia could not be singled out. A parallel may be drawn between the use of the electroencephalogram (EEG) in the evaluation of uremia and the use of electrocardiogram (ECG) in the evaluation of hyperkalemia. The present study has been undertaken to evaluate EEG changes &amp; correlation of biochemical analysis in uremic patients.</em></p> <p><strong><em>Materials &amp; Methods: </em></strong><em>A prospective study done on 25 cases of uremia due to varied etiology were selected from the wards of general hospital, Dungarpur, Rajasthan. The cases were diagnosed on the basis of the criteria laid down by Jean Hamburger, Richet G. et al (1968)<sup>3</sup>. Electroencephalographic tracing of all patients were made by an 8 channel EEG machine. A routine examination of hemoglobin, ESR, TLC, DLC, Complete urine examination with references to 24 hours urine volume, specific gravity and pH was done. Biochemical estimation of blood urea, serum Creatinine, sodium and potassium was also done.</em></p> <p><strong><em>Results:</em></strong> <em>All the EEG showed diminished alpha activity, slowing in less than 6 &amp; 6-8 HZ range and significant low voltage indeterminate activity more in precentral montages. In all the 9 drowsy patients the predominant background activity consisted of slow waves (less than 8 HZ) which were more in precentral as compared to postcentral montages. Correlation of serum Creatinine &amp; EEG was predominant low voltage in determinant activity is seen in all group and serum sodium &amp; potassium was showed that the abnormally is more marked in precentral leads.</em></p> <p><strong><em>Conclusion: </em></strong><em>We concluded that there was significant more slowing (theta &amp; Delta waves) in precentral leads in uremic patients irrespective of biochemical and clinical parameters which has not been mentioned by earlier workers.</em></p> 2018-03-21T08:02:33+00:00 ##submission.copyrightStatement## Correlated Study of Dengue Serological markers and Platelet count 2018-03-28T08:20:31+00:00 Asim Kumar Singh Saumya Singh Mukesh Kumar Singh Mahak Jain Nisha Chaitanya <p><strong><em>Background: </em></strong><em>Dengue being the most prevalent mosquito borne arboviral infection in India, has become endemic in India with every year outbreaks. Despite substantial efforts to control the mosquito populations, dengue fever has spread, emerged and established itself rapidly.&nbsp; </em></p> <p><strong><em>Objectives</em></strong><em>: This study is to correlate the platelet count and IgM /IgG and NS1 in the acute stage of dengue infection </em></p> <p><strong><em>Materials &amp; Methods: </em></strong><em>The present study was conducted for a period of 22 months in Heritage Institute of Medical Sciences from January 2016 to November 2017. Blood samples were collected from 1347 suspected Dengue patients. In all the serologically positive cases, serological confirmation and evaluation of platelet counts of dengue infection was done.</em></p> <p><strong><em>Results:</em></strong> <em>A total of 1347 suspected cases were admitted during the study period and among them, 155 (11.51%) were found to be seropositive for dengue. Among the dengue cases, Males (61.05%) were affected more than females (38.7%). Out of 155 positive cases, 108 [69.7%] cases were positive for NS1antigen either alone or in combination with antibodies.77 [49.7%] cases were exclusively positive for NS1 antigen only. Out of 108 cases that were positive for NS1, thrombocytopenia was observed in 70 cases (64.8%) whereas when the antibodies alone were considered, thrombocytopenia was observed in 18 out of 47 cases (38.3%. In a total of 155 cases, thrombocytopenia was seen in 88 cases (56.8%). </em></p> <p><strong><em>Conclusion: </em></strong><em>The study draws attention toward diagnosis of dengue serologically by testing NS1 antigen and IgM / IgG antibodies. NS1inclusion in the diagnosis of dengue increases the chance of early diagnosis in order to avoid complications significantly</em></p> 2018-03-21T00:00:00+00:00 ##submission.copyrightStatement## A Cross-sectional Study: Bone Markers in Different Body Mass Index Groups of Newly Diagnosed Breast Cancer Females in Karachi, Pakistan 2018-03-21T10:08:40+00:00 Shamim A. Qureshi Shamsa K. Udani Mishghan Zehra Tooba Batool Tooba Lateef Farooq Ghani Muhammad Bilal Azmi <p><strong><em>Background: </em></strong><em>Pakistan is a big victim of breast cancer and vitamin D deficiency. Interestingly, bones are the common site of breast cancer metastasis and vitamin D deficiency makes this condition more worst. The present study designed to estimate bone markers and minerals in different BMI groups of newly diagnosed breast cancer patients. </em><strong><em>Materials &amp; Methods: </em></strong><em>diagnosed breast cancer females were approached and their characteristics including age, marital status, menstrual &amp; family history, receptor status, tumor grade &amp; type and presence of metastasis were noted from their medical reports. Whereas bone markers and minerals viz., alkaline phosphatase (ALP), bone specific ALP (BALP), vitamin D, carboxyl terminal collagen crosslinks (CTX), human epidermal growth factor 2 receptor (Her2) protein, albumin, calcium (Ca), phosphorus (P) and magnesium (Mg) were estimated plus body mass index (BMI) measured. </em><strong><em>Results:</em></strong> <em>Most of the recruited females found aged less than 50 yrs, wedded, belonged to plump to obese BMI groups, had invasive ductal carcinoma, expressed triple positive receptor status and tumor grade II. Very few had metastasis and family history of breast cancer. Patients in all BMI groups showed insufficient level of vitamin D but normal levels of ALP, Ca, Mg, P, albumin, Her2 protein and CTX. Whereas Ca and BALP found slightly low in underfed BMI group patients. </em><strong><em>Conclusion: </em></strong><em>The results concluded and recommended that vitamin D levels must be monitored in breast cancer patients before and after treatment otherwise it will decrease more and may affect other bone markers.&nbsp; </em></p> <p><em>&nbsp;</em></p> 2018-03-21T08:25:33+00:00 ##submission.copyrightStatement## Evaluation of Osteoporosis by Bone Mineral Density in Men: A Retrospective Study in a Tertiary Care Centre 2018-03-21T10:08:41+00:00 Nitin Kimmatkar Jaya T. Hemnani <p><strong><em>Background: </em></strong><em>Osteoporosis is a progressive bone disease that is characterized by a decrease in bone mass and density and that leads to an increased risk of fractures. Osteoporosis is highly prevalent, with an estimated 30 million women diagnosed to have osteoporosis. A bone mineral density (BMD) test measures how much calcium and other types of minerals are present in a section of bone. The absolute amount of bone as measured by bone mineral density (BMD) testing generally correlates with bone strength and its ability to bear weight. </em><strong><em>Materials &amp; Methods:</em></strong> <em>Retrospective study was done in 320 male patients, department of Orthopedics at Govt. Medical College, Nagpur, India during the 6-month study. The BMD estimation of these patients was done by quantitative ultrasonography of the calcaneal bone and the analysis done on the basis of T–scores. &nbsp;</em><strong><em>Results:</em></strong> <em>320 patients were included in the study from department of Orthopedics, at Govt. Medical College, Nagpur, India. Patients were in the age group of 20-75 yrs. Among these 20.62% (n=66) were between 20-35yrs, 50.62% (n=162) between 36-50yrs and 24.37%(n=78) between 51-65 yrs. Commonest presenting symptom in the study population was Backache which was 61.87% (n=198). 32.81% (105) presented with generalized bone pain and 11.87% (38) patients had a history of fracture after trivial trauma. Of the 320 patients included in the study, 48.43% (n=155) were osteoporotic, 30.62% (n=98) were osteopenia and severe osteoporosis 11.25%. Majority of the osteoporotic patients fell in the age group of 36-50 yrs. </em><strong><em>Conclusion: </em></strong><em>Our study shows that the osteoporosis and osteopenia is more common in males in the age group of 36-50 yrs. Early detection and prompt treatment is required to prevent pathological fractures. Quantitative ultrasonography is a standout amongst the best apparatuses for early recognition of osteopenia and osteoporosis as this is practical, needs radiation introduction and yields great outcomes, tantamount to other indicative devices like DEXA check.</em></p> <p><em>&nbsp;</em></p> <p>&nbsp;</p> 2018-03-21T08:31:14+00:00 ##submission.copyrightStatement## Use of Tranexamic Acid to Reduce Postoperative Blood Transfusion in Total Hip Replacement Surgery: A Prospective Study 2018-03-21T10:08:41+00:00 Saleh Mohammed Kagzi Nazmuddin Jetaji R N Laddha Naveen Rathor <p><strong><em>Background</em></strong><em>: Total hip replacement surgery is one of the most advanced and technically demanding surgeries in orthopaedics in which blood loss is inevitable. Most of the patients are elderly with multiple co morbidities and the estimated one-year mortality is about 25%. Objective of the study was to assess the need of post-operative blood transfusion in total hip replacement surgery in patients given tranexamic acid versus control.</em></p> <p><strong><em>Methods</em></strong><em>: It was a randomized controlled trial. Sixty patients of both sexes undergoing total hip replacement surgery included in study on the basis of inclusion and exclusion. Equal patients 30-30 (50%) divided in two groups Tranexamic Acid group and Control Group based on a computer-generated random number table. The Tranexamic Acid group received two doses of 10mg/kg body weight of tranexamic acid just before surgery and two hours later intravenously, whereas Control group received two doses of 10mg/kg body weight of normal saline at similar intervals. Numbers of blood transfusions required postoperatively were noted based on the postoperative haemoglobin readings.</em></p> <p><strong><em>Results</em></strong><em>: Mean post-op haemoglobin for the Tranexamic acid group was 10.1±2.6 g/dl and for the Control group it was 9.1±2.4 g/dl. Seven patients (23%) in intervention group required blood transfusion compared to 13 (43%) in control group. </em></p> <p><strong><em>Conclusions</em></strong><em>: Our study revealed that Perioperative Tranexamic acid is a safe and useful method of reducing intra op bleeding and need of post-operative blood transfusion postoperatively in THR patients.</em></p> 2018-03-21T08:36:11+00:00 ##submission.copyrightStatement## Surgical Site Infection and its Relation with Prophylactic Antibiotics Prescription Pattern in a Tertiary Care Hospital of North India 2018-03-21T10:08:42+00:00 Mohammad Tariq Salman Athar Ali Md. Iftakhar Sartaj Wali Khan <p><strong><em>Background</em></strong><em>: </em><em>Contribution of antibiotic prophylaxis in reducing surgical site infection for some procedures is well known. In spite of knowledge about the effectiveness of antibiotic prophylaxis, its administrative regimens are often inappropriate.</em></p> <p><strong><em>Objectives</em></strong><em>: To study the pattern of use of preoperative prophylactic antibiotic and its relationship with surgical site infection (SSI) in a tertiary care teaching Hospital.</em></p> <p><strong><em>Methods</em></strong> <em>Hundred case records files of patients admitted in surgical wards of Jawaharlal Nehru Medical College, Aligarh who had undergone open bowel surgery, were randomly selected from the Central Record Section and analyzed for prescription pattern for prophylactic antibiotics according to World Health Organization prescribing indicators for number of antibiotics, antibiotics prescribed by generic name and antibiotics prescribed from ‘Essential Medicines’ List per encounter. Cost of antibiotics, commonly prescribed antibiotics and timing of administration were also studied. Patients who developed surgical site infection and those who did not were compared statistically.</em></p> <p><strong><em>Results</em></strong><em>: </em><em>Commonly administered antibiotics were Ceftriaxone, Metronidazole and Amikacin given intravenously just before surgery. No relationship was seen between patient’s age, type of surgery or site of disease and choice of antibiotics. No drug was prescribed by generic name. Total cost on antibiotics was Indian Rupees 73.1 to 218.0. Surgical site infection developed in 40 patients. No significant relationship found between administration of any antibiotics or their cost and development of surgical site infection. High degree of resistance to Fluoroquinolones followed by second and third generation Cephalosporins was found in infecting organisms.</em></p> <p><strong><em>Conclusions</em></strong><em>: </em><em>Prescribing pattern was not based on World Health Organization criteria for rational use of drugs and not evidence based. This study indicates the need for interventions to improve rational use of antibiotic prophylaxis in India. </em></p> 2018-03-21T08:42:27+00:00 ##submission.copyrightStatement## Acne Vulgaris and its Effect on Quality of Life: A Cross-Sectional Study 2018-03-21T10:08:42+00:00 Shafia N. Khan Seeba Hussain Mirza Aumir Beg Md Raihan <p><strong><em>Background</em></strong><em>: </em><em>Acne</em><em> vulgaris affects about 85% of adolescents, often extending into adulthood. Though considered to be merely a cosmetic problem, it is associated with considerable psychological impairment, such patients are prone to low self-esteem, low self-confidence and social dysfunction which may lead to anxiety, depression, obsessive compulsiveness and sometimes suicidal ideation.</em></p> <p><strong><em>AIM: </em></strong><em>&nbsp;This study was aimed to assess the impact of acne and its sequelae on the quality of life. </em><strong><em>Methods</em></strong><em>: </em><em>The current cross sectional study was conducted in Patients diagnosed as acne vulgaris attending OPD of HIMSR in department of dermatology for a period of 6 months. Patients aged 15 years and above were included in our study. A detailed history was taken after obtaining consent from all the participants of study. Dermatology life quality index (DLQI) was administered on patients to determine the impact of acne vulgaris on their quality of life (QOL).</em></p> <p><strong><em>Results</em></strong><em>: </em><em>This study included 200 patients with females being more in number 130 (65%) as compared to male patients which were 70 in number (35%). The mean age was 20.49 with majority of patients being in 15-20 years of age group.&nbsp; Mean DLQI score was 8.22, statistically influenced by the age of the patient, duration and grade of acne, acne scar, and post acne hyperpigmentation.</em></p> <p><strong><em>Conclusions</em></strong><em>: </em><em>This study showed significant impairment of quality of life in acne patients.&nbsp; Counseling along with early treatment of acne vulgaris both are important as to reduce disease-related psychosocial sequelae and enhancing the efficacy of treatment.</em></p> 2018-03-21T09:03:33+00:00 ##submission.copyrightStatement## Factors and Determinants of Unmet Needs: Identifying Association Between Variables and Unmet Needs Among Married Women of Child Bearing Age in Lahore, Pakistan 2018-03-21T10:08:43+00:00 Summia Khan Humaira Zareen Saadia Shahzad <p><strong><em>Background: </em></strong><em>Unmet needs for family planning is an important method to evaluate family planning programs hence this study was conducted to assess the unmet needs of contraception and its associated factors and reasons. <strong>Objectives:</strong> 1) to determine the unmet needs, its determinants and reasons among fecund and sexually active married women 2) to identify association between variables and unmet needs among fecund and sexually active married women. </em><strong><em>Materials &amp; Methods:</em></strong> <em>It was a community based cross sectional study, conducted in the catchment area of Institute of Public Health Lahore. Sample size was 200 women of Child Bearing Age (CBA) who were fecund and sexually active, with no history of hysterectomy, and living with their husbands. Simple random sampling technique was applied to recruit the sample population. Data was collected upon a structured questionnaire. Dependent variable was unmet needs; and independent variables included socio demographic variables and factors related to reproductive health. Data entered and analyzed upon SPSS version 23. Descriptive statistics calculated; Bivariate analysis was applied to identify association of variables with met and unmet needs. &nbsp;</em><strong><em>Results:</em></strong> <em>About 19.38% women had unmet needs for family planning; 8.59% for limiting and 10.79% for spacing. Family Planning knowledge, discussion about family planning between spouses and Husband’s sole role as a decision maker were significantly associated with unmet needs. Reasons for unmet needs were fear of side effects 29.5%, experience of side effects 21.6% mainly menstrual cycle disturbance and weight gain, Lack of information 13.6%, disapproval from their husbands 20.5% and by their Mother in Laws 9.1%. </em><strong><em>Conclusion: </em></strong><em>Our study indicated unmet needs for contraception comparable to latest report by Pakistan Bureau of Statistics 2015-2016 (35.5%) but still there is a scope to improve health education system, plan a structured counselling for Family Planning, reduce the impact of obstacles and address current issues to meet contraception needs. </em></p> <p><strong>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </strong></p> <p>&nbsp;</p> 2018-03-21T09:09:43+00:00 ##submission.copyrightStatement## Decompressive Hemicraniectomy Versus Medical Management in Cerebral Venous Thrombosis with Signs of Raised Intracranial Pressure 2018-03-21T10:08:44+00:00 Atulabh Vajpeyee Narendra Mal Ramakant Khan Manisha Vajpeyee <p><strong><em>Background: </em></strong><em>Mass effect is the major cause of death in cortical venous sinus thrombosis and there is no clear cut the role of decompressive hemicraniectomy. <strong>Aims:</strong> To study the outcome of patients with large venous infarct and acutely increased intracranial pressure subjected to either conservative treatment or decompressive surgery.</em></p> <p><strong><em>Materials &amp; Methods:</em></strong> <em>20 consecutive patients admitted with moderate to large venous infarct were examined for features of raised intracranial pressure (ICP) . Cranial CT and or MRI and CT venogram or MR venogram and or cerebral DSA were examined for site of Sino venous occlusion.</em></p> <p><strong><em>Results:</em></strong> <em>There were 20 patients with 10 each in conservatively and surgically treated group. Cranial CT/MRI head revealed large venous infarct with midline shift and mass effect in all patients. Overall 15 of 16 survivors had good outcome at 3 months without any significant residual deficit irrespective of mode of treatment used. There is no statistical difference between medical and surgical groups in mRS 1 month, 3 months and death with p value 0.651, 0.185 and 0.474 respectively.</em></p> <p><strong><em>Conclusion:</em></strong> <em>Patient with large venous infarct with signs of raised intracranial pressure carries good overall outcome with timely care irrespective of conservative or surgical management. </em></p> <p>&nbsp;</p> 2018-03-21T09:26:39+00:00 ##submission.copyrightStatement## A Clinical Study on Labour Analgesia in Full Term Primigravida Patients 2018-03-21T10:08:45+00:00 Rehana Najam Shubhra Agarwal <p><strong><em>Background:</em></strong> <em>Labour is defined as the progressive dilatation of cervix with co-ordinate uterine contractions that effect in and expulsion of the products of conception. Experience has shown that providing pain relief to the mother allays fear, anxiety and provides a more favourable environment for improved obstetric outcome.</em></p> <p><strong><em>Aims and Objectives: </em></strong><em>To compare the effects of programmed labour protocol with epidural analgesia and traditional method of labour.</em></p> <p><strong><em>Materials &amp; Methods:</em></strong> <em>This study is a prospective, randomized controlled study conducted in the department of Obstetrics &amp; Gynaecology at Teerthanker Mahaveer Medical College &amp; Research Centre Moradabad. 90 pregnant women in active labour were enrolled in the study. They were&nbsp; allocated to three groups after randomization . Group-A- 30 pregnant women received epidural analgesia. Group-B - 30 pregnant women received programmed labour protocol. Group-C- 30 pregnant women with traditional labour management.</em></p> <p><strong><em>Results:</em></strong> <em>There was excellent relief of pain in group A patient compared to other methods with shortening of duration of labour.</em></p> <p><strong><em>Conclusion:</em></strong> <em>Labour analgesia is a simple, effective method for painless and safe delivery and thus can reduce the number of caesarean section </em></p> 2018-03-21T09:31:17+00:00 ##submission.copyrightStatement## Study of the Relationship between Personality Traits and Academic Performance of Health Science Students 2018-03-21T10:08:45+00:00 Devashree Nikose Suresh Chari Madhur Gupta <p><strong><em>Background:</em></strong> <em>The purpose of the present study was to investigate the relationship between various personality traits and academic performance of undergraduate health science students. </em></p> <p><strong><em>Materials &amp; Methods:</em></strong> <em>A total of 400 medical, dental, physiotherapy and nursing students participated in this study. The instrument was “Big Five Inventory</em><em> Questionnaire</em><em>”. The questionnaire was validated. The data was collected and analyzed using STATA software.</em></p> <p><strong><em>Results:</em></strong> <em>The findings of the study did not shows any correlation between all the personality traits (Openness, Extraversion, Conscientiousness, Agreeableness and Neurotism).</em></p> <p><strong><em>Conclusion:</em></strong> <em>Personality traits does not influence academic performance.</em></p> 2018-03-21T09:36:20+00:00 ##submission.copyrightStatement## Abuse of Topical Corticosteroids and its Consequences: A Prospective Study 2018-03-21T10:08:45+00:00 Shafia Nissar Kakroo Mirza Aumir Beg <p><strong><em>Background:</em></strong> <em>Misuse of topical corticosteroids is a widespread among young people in India, especially women. The inadvertent use of topical corticosteroids for various common dermatological conditions is associated with significant adverse effects </em></p> <p><strong><em>Aim</em></strong><em>: To assess the steroid abuse for various common dermatological conditions and its adverse effects.</em></p> <p><strong><em>Materials &amp; Methods:</em></strong> <em>Sixty patients who attended OPD dermatology were taken in to study. A detailed clinical history with regard to age, gender, education status, duration and frequency of use of topical steroids, type and formulation of the drug (lotion, cream, ointment), cause for using the drug and the source of the drug (by dermatologist, doctor- physician/Ayurvedic/homeopathic, over the counter (OTC) were taken. </em><strong><em>Results:</em></strong> <em>Majority of patients were between the age group of 15-30 years and females were in predominance. The common indications were facial pigmentation, dermatophytosis and acne. The source of drug were mostly from pharmacist, friends and family members. Most commonly used steroid were betamethasone valerate, clobetasol propionate and mometasone furoate. The common side effects observed were acneiform eruptions, tinea incognito, and erythema with telangiectasia, cutaneous atrophy and striae.</em></p> <p><strong><em>Conclusion:</em></strong> <em>Topical steroids should be used cautiously and judiciously. Awareness should be given regarding the indications and its consequences. Avoidance of self-medication by over the counter purchase should be stressed upon. While treating children extreme care should be given regarding the selection of potency of topical steroids.</em></p> 2018-03-21T09:42:28+00:00 ##submission.copyrightStatement## Influences of Total Life Style Changes in Leptin Level in Obese Type 2 Diabetes Mellitus 2018-03-21T10:08:46+00:00 Narendra Solanki Dilip Singh Rathore <p><strong><em>Background:</em></strong> <em>To investigate the change of leptin levels after a total life style changes&nbsp; (diet, exercise induced weight loss and behaviors modification) and the possible association between leptin and total life style changes (TLC) in obese subjects.</em></p> <p><strong><em>Materials &amp; Methods:</em></strong> <em>A total number of forty obese subjects (twenty patients of DM type 2 and twenty age and sex matched healthy obese controls) divided into two different group (twenty in each) were studied. After recording a detailed history, a complete physical examination was carried out. Fasting serum leptin levels estimated and both group total life style changes intervention (diet control and exercise induced weight loss and behaviors modification) was given and after duration of eight-week TLC intervention, all subjects were reexamined and fasting serum leptin levels were re-estimated.</em></p> <p><strong><em>Results:</em></strong> <em>Obese diabetic group shows significant reduction in leptin levels 3.15 ±&nbsp;10.87 in comparison with obese nondiabetic group 1.77 ±&nbsp;9.21.</em></p> <p><strong><em>Conclusion:</em></strong> <em>Total lifestyle changes intervention (diet control and exercise induced weight loss and behaviors modification) significantly reduces leptin levels and significantly reduces the anthropometrics values and biochemical values in obese type 2 diabetes mellitus in comparison with obese nondiabetic group.&nbsp; </em></p> 2018-03-21T09:45:56+00:00 ##submission.copyrightStatement## Efficacy of Dolichos - Biflorus in Urinary Calculus Disease: A Clinical & Biochemical Study 2018-03-21T10:08:46+00:00 Gokul Ram Prajapati <p><strong><em>Background:</em></strong> <em>Urolithiasis is a disease as old as civilization and this has been troubling mankind from the very beginning of history. Seeds as well as extract of D. biflorus have frequently been used by patients of urolithiasis for dissolution of urinary calculi or to prevent recurrence. The present project has been undertaken to evaluate its effect on urine chemistry of stone formers. </em></p> <p><strong><em>Materials &amp; Methods:</em></strong> <em>Twenty two patients suffering from radiologically proved urinary calculus disease treated at district&nbsp; Hospital, Dungarpur were included in the present&nbsp; study. A detailed history in respect to family history of calculus disease, socio-economic status, dietary habits, present and past complaints some clinical findings were recorded. The clinical trial of Dolichos biflorus was carried out in postoperative period of operated patients.</em></p> <p><strong><em>Results:</em></strong> <em>The age ranged from 9 to 70 years and men was 35.45 (<u>+</u>15) years. The body surface area ranged from 0.63 to 1.60m<sup>2 </sup>and mean was 1.53 (<u>+</u>0.25) m<sup>2</sup>. The lowest 24 hours volume in the 1st sample (pre-operative) was 320 ml. and highest was 2300 ml., mean being 2000 ml. in volume. In IInd samples (post-operative) the 24 hours urine volume ranged from 560 to 2250 ml. mean being 1338 (<u>+</u>515) ml. Three urine samples measured more than 2000 ml. in volume. In IIIrd samples (post Dolichos) the urinary volume ranged from 600 to 2620 mm1/24 hours, mean being 1494 (+ 565) ml. and four urine samples measured more than 2000 ml.</em></p> <p><strong><em>Conclusion:</em></strong> <em>We concluded that our study does not show any protective action of Dolichos biflorus ingestion on urolithiasis.</em></p> <p><em>&nbsp;</em></p> 2018-03-21T09:49:51+00:00 ##submission.copyrightStatement## Analysis of Functional Outcome of Arthroscopic Anterior Cruciate Ligament Reconstruction using Quadrupled Semitendinosus and Gracilis Autograft - A Two Year Prospective study 2018-03-21T10:08:47+00:00 S K Bhaskar Abhishek Gupta Pradeep Bagaria <p><strong><em>Background:</em></strong> <em>The knee joint is frequently involved in sports injuries, road traffic accidents and during daily living activities. Anterior cruciate ligament is a very commonly involved ligament in these injuries. More and more cases of ACL tear are being diagnosed nowadays due to the increasing awareness among orthopaedic surgeon about importance of knee ligament injuries and also increasing availability of MRI as diagnostic tool.</em></p> <p><strong><em>Materials &amp; Methods:</em></strong> <em>The prospective study is conducted in Department of Orthopaedics, J.LN. Medical College and Attached Group of Hospitals, Ajmer from November 2014 to November 2016. All young and middle-aged patients presenting with unilateral knee complaints and history of trauma to the knee were evaluated by a thorough general and local clinical examination of the knee. In a relaxed patient and in supine position, the uninjured knee is examined first to establish reference values after which the affected knee is examined.</em></p> <p><strong><em>Results:</em></strong> <em>The age of the patients ranged from 15-45 years with the mean age of&nbsp; 27.51 years.&nbsp; 37.1% of the patients in our study were in the age group of&nbsp; 20-25 years. The total of 20 cases (57.1%) of the right knees were involved and 15 cases (42.9%) of the left knee were involved in the study. The ratio of right knee to left knee involved in ACL injury was 1.33:1. After clinical, radiological and Arthroscopic examination we found that 51.4% (18 cases) patients had no associated&nbsp; injuries. Whereas rest 49.6% cases have associated meniscal injury (MM and LM or both).</em></p> <p><strong><em>Conclusion:</em></strong> <em>ACL reconstruction using single stranded quadrupled semitendinosus and gracilis tendon autograft provide an intrinsically stable knee with full range of motion without any pain and with restoration of power. </em></p> 2018-03-21T09:55:56+00:00 ##submission.copyrightStatement## Evaluation of Patients Having Ovarian Cysts, Reporting in One Year: An Observational Study 2018-03-21T10:08:48+00:00 Suresh Chand Garg <p><strong><em>Background:</em></strong> <strong><em>:</em></strong><em> Since the natural history of simple ovarian cysts is not completely understood, the proper treatment of incidental simple cysts amongst the postmenopausal women has always been uncertain. The aim of the present study was to evaluate the subjects reporting to the hospital with ovarian cysts.</em></p> <p><strong><em>Materials &amp; Methods:</em></strong> <em>The present study was conducted in the prospective manner in the department of Obstetrics&amp; Gynecology, Zanana Hospital, R.B.M. Hospital, Bharatpur, and Rajasthan. Subjects younger than 55 years of age with any other co morbidities were excluded from the study. A predesigned and pre-tested questionnaire was given to all the subjects.&nbsp; Their frequency of visit to the gynecologist was also obtained. All the data was arranged in a tabulated form and analyzed using SPSS software. </em><strong><em>Results:</em></strong> <em>The study enrolled 160 females with the mean age of 66.53+/- 5.22 years. There were 36.9 %(n=59) subjects between 55-60 years of age. There were 30 %(n=48) subjects between 61-66 years of age. About 90% (n=144) had no such history. History was not known to 1.9% subjects. There were majority of subjects (60%) who had never smoked.&nbsp; </em><strong><em>Conclusion:</em></strong> <em>In our study, there were majority of subjects between 55-60 years of age. The various aggressive surgical approaches for management of simple cyst have paved a way towards careful monitoring.</em></p> <p><em>&nbsp;</em></p> 2018-03-21T10:04:15+00:00 ##submission.copyrightStatement## Clinical Implication of ApoB (12669G/A) Gene Polymorphism and Risk of Cardio Vascular Disease in Indian Population 2018-03-21T10:08:48+00:00 Farah Siddiqui Sangeeta Singh Arun Joshi S R Saxena Ragini Srivastava Amit Jain Prasant Yadav Mirza Masroor <p><strong><em>Background:</em></strong> <em>Cardiovascular disease is rising day by day due to having high fat diet and due to genetic alterations. <strong>Materials &amp; Methods:</strong></em> <em>Study included 70 CVD patients and their peripheral blood samples were collected for genotyping by venipuncture under aseptic condition in EDTA vials (2ml) as well as in serum vials (3ml) for biochemical parameters. Genomic DNA extraction was done by phenol chloroform method from blood samples collected in EDTA vials from cases as well as controls for genotype study. <strong>Results:</strong></em> <em>The difference of genotype between cases and controls was found to be significant (p=0.0003). Study observed that high percentage of GA 29 (41.4%) and AA 8 (11.4%) genotype was found in patients compared to controls GA 10 (20%) and AA 0 (0%) while lower GG 33 (47.2%) genotype in patients compared to control GG 40 (80%) genotype. Compared to the GG genotype, the OR 3.51 (1.49-8.25) and 20.55 (1.14-369.6) for the heterozygous GA and homozygous AA genotypes were estimated, suggesting a possible dominant effect of Apo B polymorphism on CVD risk. In smokers, compared to the GG genotype, the OR 2.19 (0.69-6.88) and 1.71 (0.29-9.87) for the heterozygous GA and homozygous AA genotypes. In alcoholism, compared to the GG genotype, the OR 2.66 (0.93-7.57) and 8.4 (0.92-76.19) for the heterozygous GA and homozygous AA genotypes. Patients with mutant&nbsp; homozygous AA, heterozygous GA genotypes showed 123.3<u>+</u>14.34 (mg/dl) and 76.92<u>+</u>24.09 Apo B level in CVD patients compared to wild type GG homozygous genotypes were 70.82<u>+</u>17.12.</em> <strong><em>Conclusion:</em></strong> <em>It was observed that Apo B gene polymorphism and smoking behaviour found to be associated with increased risk of CVD in Indian population. </em></p> 2018-03-21T10:07:32+00:00 ##submission.copyrightStatement## Primary Squamous Cell Carcinoma of Pleura Masquerading as Tuberculous Abscess: A Rare Case Report and Review of Literature 2018-03-21T10:08:18+00:00 Sadaf Haiyat Ruquiya Afrose Nazoora Khan Hena Ansari <p><em>Primary pleural SCC is a rare pleural malignancy which has seldom been reported. Here we report a case of a 47 year male who presented with low grade fever, persistent chest pain and loss of appetite for 3 months along with a positive history of contact. CECT thorax demonstrated&nbsp;&nbsp; fluid collection in the pleural space along with fibrotic patch and cytology revealed extensive necrosis. Based on above findings&nbsp;&nbsp; provisional diagnosis of tuberculous abscess was made and subsequently anti- tuberculous treatment&nbsp;&nbsp; was started. Later on after 3 months patient again presented with similar complaints and physical examination revealed a bulging mass on back which was aspirated and sent for cytology which revealed features consistent with the diagnosis of&nbsp;&nbsp; poorly differentiated squamous cell carcinoma. This was later confirmed by CECT thorax, showing heterogeneous mass with pleural thickening and invasion. Histopathology eventually confirmed the diagnosis of primary pleural squamous cell carcinoma.</em></p> 2018-03-21T06:24:19+00:00 ##submission.copyrightStatement## Cortical Anarthria in An Arabic Speaking Unilingual: A Case Report 2018-03-21T10:08:19+00:00 Yousef Mowahed Alsawwaf <p><em>A 59-year-old, Arabic, right handed female with history of hypertension and ischemic heart disease presented with sudden onset anarthria associated with right arm weakness. Language examination showed Anarthira with inability to produce more than rare unintelligible single syllables. Comprehension was intact. She correctly wrote but could not verbalize object names nor read aloud. She wrote easily but made spelling mistakes with long sentences. Motor exam only revealed slight hyper-reflexia and weakness of right upper extremity. Imaging showed a lesion in the left corona radiata and bilateral subcortical white matter hyper intensities. She was diagnosed with acute ischemic stroke and received routine antithrombotic treatment. Within two days, she started producing single words, with slow, effortful and abnormal long vowels. This report describes the clinical and radiological aspects of a case of cortical anarthria in an Arabic-speaking subject.</em></p> 2018-03-21T08:50:15+00:00 ##submission.copyrightStatement##