iosr-JDMS   Volume-13 ~ Issue-10 ~ October-2014

Abstract: Background: The nature of the relationship between depression and alcohol use is of interest to mental health professionals. Failure to detect such disorders in the hospital settings denies them access to adequate treatment. This study therefore, aimed to assess the presence of depression in patients with problematic alcohol use presenting at the General Out-patient clinic and the ability of the physicians to detect such disorders. Methods: It was a cross-sectional descriptive study. Consecutive and voluntarily consenting patients attending the clinic over a period of eight weeks were recruited and administered the alcohol section of the patient health questionnaire. Those that met criteria for problematic alcohol use were then screened for depression using the depression section of the patient health questionnaire. Results: Two hundred and nine (31.1%) out of 672 that were recruited into the study met the criteria for problematic alcohol use. Sixty-five (31.1%) of them screened positive for depression. Female gender (p=0.000), unemployment (p=0.002) and been married (p=0.027) tend to be associated with depression. Physicians were only able to make diagnosis relating to psychopathology in 19.1% of the participants. Conclusion: There is a need for screening for co-morbidity of depression with alcohol by primary care physicians in General Outpatient Units due to high rate of patients with such problems. Such screening will help in early intervention and consequent treatment.

[1]. Kuria MW, Ndetei DM, Obot SI et al. The Association between Alcohol Dependence and Depression before and after Treatment for Alcohol Dependence. International Scholarly Research Network ISRN Psychiatry, 2012 (2012), 482802.
[2]. Grant BF and Harford TC. Co-morbidity between DSM-IV alcohol use disorders and major depression: Results of a national survey. Drug and Alcohol Dependence, 1995; 39(3): 197–206.
[3]. Boden JM and Fergusson DM. Alcohol and Depression. Addiction, 2011; 106(5):906-914
[4]. Berner P, Lesch OM and Walter H. Alcohol and Depression. Psychopathology 1986;19(suppl 2):177–183
[5]. Mueller TI, Lavori PW, Keller MB et al. Prognostic effect of the variable course of alcoholism on the 10-year course of depression. American Journal of Psychiatry, 2004; 151 (5):701-706.

Abstract: Plasma is the fourth state of matter and other states of matter are liquid, gas, and solid4. Plasma occurs as a natural phenomenon in the universe in the form of fire, in the polar aurora borealis and in the nuclear fusion reactions of the sun and also can be created artificially which has gained importance in the fields of plasma screens or light sources1. There are two types of plasma: thermal and non-thermal or cold atmospheric plasma. Thermal plasma has electrons and heavy particles (neutral and ions) at the same temperature. Cold Atmospheric Plasma (CAP) is said to be non-thermal because it has electron at a hotter temperature than the heavy particles that are at room temperature. . Cold Atmospheric Plasma is a specific type of plasma that is less than 104°F at the point of application4. So the bright future of dentistry with help of cold plasma.

Key word:- cold plasma, non thermal atmospheric plasma,

[1]. Raizer YP. Gas Discharge Physics. Springer, Berlin, Germany; 1997.
[2]. Conrads H, Schmidt M. Plasma generation and plasma sources. Plasma Sources Science and Technology. 2000;9:441-54.
[3]. Hoffmann et al. Medical Gas Research 2013, 3:21
[4]. Laroussi M. The biomedical application of plasma: Santosh kumar ch1, p sarada2, sampath reddy ch3, surendra reddy m4, nagasailaja dsv Journal of Clinical and Diagnostic Research. 2014 Jun, Vol-8(6): ZE07-ZE10
[5]. A brief history of the development of a new field of research.IEEE Trans Plasma Sci 2008;36:1612-14.
[6]. Laroussi M. Sterilization of contaminated matter with an atmospheric pressure plasma. IEEE Trans Plasma Sci 1996;24: 1188-91.

Abstract: Background: Sleep is essential for forming and consolidating memories and it plays a key role in the formation of new neuronal connections and pruning of old ones. As there is limited research on the sleep behaviour of children and its impact on academic grade, this study was planned to obtain some information from a rural population of children. Objectives; To study the association between sleep behaviourand academic grade in school going adolescent children from a rural area. Methodology; The study covered 328 school-going adolescent children of 13-15 years in a rural area. 2 self-administered questionnaires were used: Child's Sleep Habits Questionnaire (CSHQ) was filled by parents of children and Paediatrics Daytime Sleepiness Scale (PDSS) was filled by children themselves. The average of academic grade of all 5 subjects wasobtained. Univariate and multivariate analysis were performed with academic as the dependant variable. Results;Single unit increase in CSHQ Total Score result in .18 unit reduction in academic grade and single unit increase in PDSS Score result in .505 unit reduction in academic grade, both associations being statistically significant. 3 significant predictors for academic grade; Parasomnias, Sleep Disordered Breathing and Daytime Sleepiness were identified. Conclusion; Sleep behaviour is related to educational achievement in children.Parasomnias, Sleep Disordered Breathing and Daytime Sleepiness independently effect to reduce the academic grade in children.

Keywords; sleep behaviour, academic grade, cshq, pdss

[1]. Teofilo, Lee Chiong, Sleep. Comprehensive Handbook, in the preface; John Wiley and sons publications:2006:xvii
[2]. "Do not sacrifice sleep, it is not a waste of time‟, The New Indian Express, Kochi edition, 20 Jan 2014, page 8.
[3]. Wong ML, Lau EY, Wan JH, Cheung SF, Hui CH, Mok DS, The interplay between sleep and mood in predicting academic functioning, physical health and psychological health: a longitudinal study,JPsychosom Res.74(4), 2013 Apr, 271-7.
[4]. R Narendran, Bhavneet Bharti, PrabhjotMalhi, Children‟s Sleep Habits Questionnaire (CSHQ): Psychometric validation in Indian school children,Indian J Sleep, 2008.3.3, 102-106.
[5]. Christopher Drake, Chelsea Nickel, EleniBurduvali, Thomas Roth, Catherine Jefferson, PietroBadia -The Paediatric Daytime Sleepiness Scale (PDSS): Sleep Habits and School Outcome in Middle School Children,SLEEP, 26;4, 2003, 455-58.
[6]. Curcio G, Ferrara M, De Gennaro L, Sleep loss, learning capacity and academic performance,Sleep Med Rev. 10(5), 2006 Oct, 323-37.

Abstract: The widely accepted definition of obstructive sleep apnoea (OSA) is a clinical condition in which there is intermittent and repeated upper airway collapse during sleep. This results in irregular breathing at night and excessive sleepiness during the day. Complete apnoea is defined as a ten-second pause in breathing activity. Partial apnoea, also known as hypopnoea, is characterised by a ten-second period in which ventilation is reduced by at least 50%. Risk factors include: Obesity (strongest risk factor), Male gender, Middle age (55-59 in men, 60-64 in women), Smoking, Sedative drugs, Excess alcohol consumption, Possibly genetic tendency related to jaw morphology. Type 2 diabetes mellitus (DM) and obstructive sleep apnea (OSA) share several clinical findings: obesity, hypertension, and impaired glucose tolerance. OSA may be an under-recognized comorbidity of DM. Unsurprisingly, the disorders commonly coexist.(1) Mechanistically, OSA may aggravate Insulin Resistance (IR) and type 2 diabetes via intermittent hypoxia, fragmented sleep and elevated sympathetic activity. Diabetes may contribute to OSA via neuropathy and weight gain related to insulin use. Most cross-sectional studies have demonstrated that OSA is independently associated with IR and type 2 diabetes in adult sleep clinic populations and in unselected communities, independent of age and BMI, but prospective incidence studies have been less convincing.(1)

[1]. Garun S Hamilton and Matthew T Naughton. Impact of obstructive sleep apnoea on diabetes and cardiovascular Disease. Med J Aust 2013; 199 (8): 27-30.
[2]. West SD, Nicoll DJ, Stradling JR. Prevalence of obstructive sleep apnoea in men with type 2 diabetes. Thorax 2006; 61: 945-950.
[3]. Foster GD, Sanders MH, Millman R, et al. Obstructive sleep apnea among obese patients with type 2 diabetes. Diabetes Care 2009; 32: 1017-1019.
[4]. Iftikhar IH, Hays ER, Iverson MA, et al. Effect of oral appliances on bloo pressure in obstructive sleep apnea: a systematic review and meta-analysis. J Clin Sleep Med 2013; 9: 165-174.
[5]. Obstructive sleep apnea and type 2 diabetes; Eur J Med Res. 2010 Nov 4;15 Suppl 2:152-6.
[6]. Harrison's Principles of Internal Medicine. 2013;

Abstract: The lack of uniformity in the length, weight and mid shaft circumference of long bones of upper limb can be attributed to the type of movements performed by individual during life. The present study reports the positive evidence of Right sided dominance in the weight, length and circumference of 15 pairs of upper limb bones collected from skeletons of Telangana population in south Indian Region of India. Length was measured on an osteometric Board and weight measured on Automatic Balance. Mean length of Humerus, Radius and Ulna was greater on the right side than the left side. Mean weight of humerus, radius and ulna are also greater on right side. Mean circumference of mid part of shaft of humerus was greater on right side and for radius and ulna on right side. In overall the present study reveals that right dominance in Telangana population.

Key words: upper limb bones, length, weight, circumference.

[1]. Standring S. Gray's Anatomy. The Anatomical basis of clinical practice. 40th ed. Edinburg. Elsevier Churchill Livingstone. 2008; (5): 95.
[2]. Tonka Cuk, Petra Leben – Seljak, MarijaStefancic. Lateral Asymmetry of Human long bones.Variability and Evolution. 2001; (9): 19 – 32.
[3]. Pande BS, Singh I, One sided dominance in the upper limbs of human fetuses as evidence by asymmetry in muscle and bone weight. J Anat 1971; 109: 457 – 459.
[4]. Taylor JR, Halliday MJ, Limb Assymetry. J Anat 1977; 124: 520 – 521.
[5]. Prives MG, Influence of Labour and sports upon Skeleton structure in man. Anat Rec 1960; 136: 261.

Abstract: Background: Tumour Induced Osteomalacia is a rare paraneoplastic syndrome and often unrecognized cause of hypophosphatemia with excessive production of fibroblast growth factor 23 (FGF23) leading to chronic hyperphosphaturia . It may be associated with normal or low level of 1,25-dihydroxyvitamin-D. Case Presentation: A 48 yrs old female presented with chronic low back ache, muscle pain and weakness, bony pain as well as bilateral leg pain. On examination she was found to be suffering from TIO with a sinonasal mass in CT scan. Tumour responsible for this was removed which immediately resulted in normalization of blood parameters and other complaints. Conclusion: This case is to highlight the importance of keeping this disease in mind while assessing a case of hypophosphatamia to avoid the morbidity or even death.

Keywords: Fibroblast, Hyperphosphaturia, Hypophosphatemia, mesenchymal, Oncogenous Osteomalacia, Sinonasal.

[1]. McCance RA: Osteomalacia with Looser's nodes (Milkman's syndrome) due to a raised resistance to Vitamin D acquired about the age of 15 years. Quart J Med 1947, 16:33-46.
[2]. Pavel Komínek, Ivo Stárek, Marie Geierová, Petr Matoušek, Karol Zeleník1 Phosphaturic mesenchymal tumour of the sinonasal area: case report and review of the literature. Head & Neck Oncology 2011, 3:16
[3]. 3.Weidner N, Santa Cruz D: Phosphaturic mesenchymal tumours. A polymorphous group causing osteomalacia or rickets. Cancer 1987, 59:1442-1454.
[4]. R. Gupta, A. Sharma, A. Ksh, R. Khadgawat, A. K. Dinda Phosphaturic Mesenchymal Tumor Of The Sinonasal tract Acta Endocrinologica (Buc) 2009, vol. V, no.4 , p. 537-541
[5]. Inokuchi G, Tanimoto H, Ishida H, Sugimoto T, Yamauchi M, Miyauchi A, Nibu K. A paranasal tumor associated with tumor-induced osteomalacia. Laryngoscope 2006; 116:1930-1933

Abstract: In this era of increasing life expectancy and change in the lifestyle, osteoarthrosis of weight bearing joints, particularly the knee joint has become the most common Orthopaedic problem of enormous magnitude. Medial opened wedge tibial osteotomy fixed with standard ring fixator will be very useful for them as being of low cost and giving them immediate pain free mobilization, so that they can carry out their routine activities freely and as early as possible. Aim and Objectives: To study clinicoradiological findings in cases of Medial compartment osteoarthritis of knee joint. To evaluate the role of Medial opened wedge tibial osteotomy aiming to relieve pain, correct deformity and improve function. To study Biomechanics of knee joint with special reference to knee in osteoarthritis. To study the relevant literature. To compare the results with other available series. Results: 23 cases of medial compartmental osteoarthrosis of knee joint, who were subjected to Medial open wedge high tibial osteotomy, were studied. Osteoarthrosis of knee joint was found to be common in patients between 45 to 65 years of age [82.60%] Most of the patients had right sided involvement [65.22%]. In some patients, patello-femoral arthritis became less severe. In the present study 52.81 % patients had 5 to 8degree varus angulation and one patient had 2degree of valgus angulation pre-operatively. Excellent relief of pain in knee can be achieved in patients who presented earlier i.e. whose complaints were of less than 1 year duration. 30 to 50 of over correction are essential t3o unload the medial compartment of the joint. The knee which maintains 5° to 14° of Valgus angulation post-operatively ended with radiologically satisfactory results [78%]. 82.58% patients obtained clinically worthwhile relief of pain following Medial opened wedge tibial osteotomy

[1]. Lawrance and Sebo; "Geography of osteoarthritis" in the Aetiopathogenesis of Osteoarthritis, edited by Nuki - 1980 [London-Pitman] Page No. 155
[2]. Koshino Tomihisa - Clinical, findings and aetielogy of osteoarthrosis of the knee Asian Medical Journal Vol. -10 No. 11 Nov. 1987
[3]. Jackson J.P., Waugh w. , Green J.P; "High Tibial Osteotomy for Osteoarthritis of the Knee" JBJS 51-B, P 88, 1969
[4]. Gibson P.J., Good fellow J. - stress radiography in degenerative arthritis of the knee JBJS Vol. 68 - B No.4 Aug. 1986. P. -608
[5]. Coventry M.B; "Osteotomy of the Tibia for Osteoarthritis of the knee" JBJS 47 - A, P 984-90, 1965
[6]. Insall J.N. , Shoji H, Mayer V; "High Tibial Osteotomy - 5 year evaluation"JBJS 56-A, P 1397,1974
[7]. Maquet P.G.J; CORR - No. 120, P143, 1976

Abstract: AIM AND OBJECTIVES: 1. To study clinicoradiological findings in cases of Medial compartment osteoarthrosis of knee joint. 2. To study Biomechanics of knee joint with special reference to knee in osteoarthrosis. 3. To compare the results with other available series METHODOLOGY: The patients for the present study of A clinical study of role of Medial opened wedge tibial osteotomy in medial compartment osteoarthrosis of knee were selected from cases of osteoarthrosis of knees attending Orthopaedic O.P.O. of Pravara Rural Hospital, Loni India. Clinical and radiological assesement and grading was done. Results: Osteoarthrosis of knee joint we found to be common in patients between 45 to 65 years of age [82.60%], in over weighted patients it was earlier and was more severe. Majority Le. 69.57% patients were females and 31.43% were males. Most of the patients had right sided involvement [65.22%]. In Medial compartment osteoarthrosis varus deformity of varying degree was commonly found. Most of the patients had complaints about osteoarthrosis of more than 1 year duration [69.57%]. Many of the patients of present study had patella femoral arthritis [43.48%] and could be responsible, at least to some extent, for the persistent or recurrence of pain following osteotomy. In the present study 52.81 % patients had 5 to 8degree varus angulation and one patient had 2degree of valgus angulation pre-operatively. Results of the present series are comparable to other published series of high tibial osteotomies.

Key words: Osteoarthrosis, knee joint

[1]. Lawrance and Sebo; "Geography of osteoarthritis" in the Aetiopathogenesis of Osteoarthritis, edited by Nuki - 1980 [London-Pitman] Page No. 155
[2]. Koshino Tomihisa - Clinical, findings and aetielogy of osteoarthrosis of the knee Asian Medical Journal Vol. -10 No. 11 Nov. 1987
[3]. Jackson J.P., Waugh w. , Green J.P; "High Tibial Osteotomy for Osteoarthritis of the Knee" JBJS 51-B, P 88, 1969
[4]. Gibson P.J., Good fellow J. - stress radiography in degenerative arthritis of the knee JBJS Vol. 68 - B No.4 Aug. 1986. P. -608
[5]. Coventry M.B; "Osteotomy of the Tibia for Osteoarthritis of the knee" JBJS 47 - A, P 984-90, 1965
[6]. Insall J.N. , Shoji H, Mayer V; "High Tibial Osteotomy - 5 year evaluation"JBJS 56-A, P 1397,1974
[7]. Maquet P.G.J; CORR - No. 120, P143, 1976

Abstract: The aim of this prospective randomized observational study was to identify and explain the relationship between stride length and foot pressure distribution during walking in normal adults. The objectives of the study were to collect the gait and pressure data for the normal adult subjects walking at different stride lengths and to examine whether the pressure distribution have been affected by the stride lengths. Total twenty five male adult subjects were invited to participate in this study. They were required to walk at three types of walk, i.e. self-determined longer, normal and shorter stride lengths. Their gait parameters and pressure data were synchronically recorded using GAITRite® and Pedar® systems respectively. The stride lengths were normalized by the subject leg length to avoid the confounding effect of leg length on the stride length. In comparison of three types of walk, it was found that the peak pressure in the masked areas of the big toe, the second and third toes, the fourth and fifth toes, the first metatarsal, the second metatarsal, the medial heel and lateral heel are significantly different in three types of walk, but almost similar in the regions of the third metatarsal, the fourth metatarsal, the fifth metatarsal, the medial mid-foot and the lateral mid-foot. In the whole sole, the peak pressure is the highest in the walk with longer stride length and the lowest in the walk with shorter stride length, and the middle in the walk with normal stride length. The maximum mean pressure have the same distrubutions as those in the peak pressures. It was found that the speed, cadence and normalized stride lengths were significantly different among three types of walk. Thus we conclude that stride length is directly proportional to peak pressure and maximum mean pressure in the foot. It is suggested that in a further study, walking speed should be kept in a constant when a subject walks at different stride lengths in order to reduce the effects from velocity.

[1]. Whittle,M.W. (2002) Gait analysis: An introduction, Butterworth Heinemann, Oxford, 0-750652-62-4.
[2]. Gage, J.R. (1990) An overview of normal walking. Instr Course Lect; 39:291-303.
[3]. 3) Perry, J. (1992) Gait Analysis: Normal and pathological function, SLACK incorporated, Thorofare, N.J, 1-556421-92-3.
[4]. Putti AB, Arnold GP, Cochrane L, Abboud RJ. (2007) The Pedar in-shoe system:repeatability and normal pressure values. Gait posture 25(3):401-5.

Abstract: Many epilepsy clinics are mainly concerned with seizure control, treatment and neurological deficits with epilepsy but it is vitally important that we are able to recognize the symptoms of anxiety and, in particular, those of depression. Depression lowers quality of life significantly yet it is an eminently treatable condition. Depression can directly increase seizure frequency through the mechanism of sleep deprivation; failure to recognize depression or inadequate treatment can lead to suicide. Besides this; peri-ictal expression of depression or some time atypical expression of depression is seen in epileptic patients. Depression also often worsens concordance with antiepileptic medication. Multifactorial variables play a pathogenic role in the high comorbid occurrence of these two disorders.Animal models of depression in which the kindling process is facilitated. Neurobiological aspects and data from structural and functional neuroimaging studies in humans provide a further understanding of potential common pathogenic mechanisms operant in depression and epilepsy that may explain their high comorbidity.

Key Words: Depression, Epilepsy, Peri-ictal depression, Neurobiological aspect, Neuroimaging studies, comorbidity.

[1] Temkin O. The falling sickness. Baltimore: Johns Hopkins University Press; 1950

[2] Robertson MM, Trimble MR. Depressive illness in patients with epilepsy: a review.Epilepsia 1983;24(Supplement 2):S109–16

[3] Robertson MM, Trimble MR. Depressive illness in patients with epilepsy: a review.Epilepsia 1983;24(Supplement 2):S109–16

[4] Robertson MM. Suicide and epilepsy. In: Engel J, et al, editor. Epilepsy, a comprehensivetext book.New York: Raven Press; 1996. p. 2141–52

[5] FDA, US Department of Health and Human Services. Statistical review andevaluation: antiepileptic drugs and suicidality; May 23 2008. Washington.

Abstract: Pertrochanteric fracture is a severe and frequent injury with consequent high morbidity and mortality. Dynamic hip screw is an effective treatment modality for stable intertrochanteric hip fractures. It is based on "tension band principle" which allows compression of fracture fragment when the patient bears weight with consequent high rates of union and restoration of hip function to pre injury level. This study determined the epidemiological pattern, care, complications and functional outcome of pertrochanteric fractures following treatment with dynamic hip screw. Retrospective data was obtained over a 5 year period from January, 2007 to December, 2012. All patients with pertrochanteric hip fractures treated with dynamic hip screw were consecutively selected. Data was analysed using SPSS version 21. The total number of patients was 48 of whom were 28 males and 20 females with a mean age of 63.8±15years. The commonest mechanical complication encountered was lag screw cut through in 4 (8.3%) patients. Post-operative hip functional status done according to Postel and Merle d Aubigne scoring system at 4 – 6 months postop revealed that majority (90.0%) had satisfactory hip function with minimal morbidity. Careful patient selection, proper training of surgeons as well as attention to detail is vital and may minimize failure rates.
Keywords: clinical outcome, dynamic hip screw, pertrochanteric fractures.

[1] Hoffmann R, Hass NP. Trochanteric fractures; Principles of Management, Acta Orthop Belg, 66(1), 2000, 34-39.

[2] Finsen V, Benum P. Trochanteric fractures, Clin Orthop Relat Res, 218(1), 1987, 104-110.

[3] Finsen V, Johnsen LG, Trano G, Hansen B, Sneve KS. Management of pertrochanteric fractures. Clin Orthop Relat Res, 419(1), 2004, 173-180.

[4] Kyle RF, Gustilo RB, Premer RF, Trochanteric fractures, J Bone Joint Surg Am, 61, 1979, 216.

[5] Broos PLO, Fourneau I. Trochanteric fractures, Acta Orthop Belg, 66(1), 2000, 34-40.

[6] Rûedi TP, Murphy WM. American Society of Anesthesiologists New classification of physical status. Anesthesiology, 24, 2009, 111-118.

Abstract: Anterior cruciate ligament (ACL) tear is the most common ligamentous tear of knee joint. The goal of reconstruction of ACL is to restore the stability of knee joint. This study is to evaluate the functional outcome of Arthroscopically assisted ACL reconstruction using Bone patellar tendon bone graft and quadrupled hamstring graft. Our study of 30 cases of arthroscopic ACL reconstruction(21 Bone patellar tendon bone graft, 9 Quadrupled Hamstrig Graft). We have evaluated th knee function pre and post operatively using international knee documentation committee(IKDC) and Lysholm score. Our study showed that Arthroscopically assisted ACL reconstruction could effectively improve stability and function of knee joint. Our results were almost similar to the results obtained in the standard published literature.

Key Words: Anterior cruciate ligament, Bone patellar tendon bone graft, I nternational knee documentation committee, Quadrupled hamstring graft, Lysholm score.

[1]. Miyasaka KC, Daniel DM, Stone ML. The incidence of knee ligament injuries in the general population. Am J Knee Surg 1991; 4: 3-8.
[2]. Noyes FR, Bassett RW, Grood ES, Butler DL. Arthroscopy in acute traumatic hemarthrosis of the knee. Incidence of anterior cruciate tears and other injuries. J Bone Joint Surg(Am) 1980; 62: 687-95, 757.
[3]. Levy IM, TorzilliPA,WarrenRF. The effect of meniscectomy on anterior-posterior motion of the knee. J Bone Joint Surg (Am) 1982; 64: 883-8.

[4]. Jomha NM, Pinczewski LA, Clingeleffer A, Otto A. Arthroscopic reconstruction of anterior cruciate ligament with patellar-tendon autograft and interferrence screw fixation. The results at seven years. J Bone Joint Surg(Br) 1999; 81: 775-9.
[5]. Barrack RL, Bruckner JD, Knist J, Inman WS, Alexander AH. The outcome of non-operatively treated complete tears of the anterior cruciate ligament in active young adults. Clin Orthop1990; 259: 192-9.

Abstract: Background: Generally, severe injuries of the male external genitalia are rare because of the location and mobility of the penis and scrotum. Although injuries to the external genitalia are typically not in and of themselves life threatening, they are commonly associated with other potentially life-threatening injuries. This study is to evaluate the mechanism and type of genital injuries, other associated injuries and management of genital injuries. Methodology: This study was carried out at the Jos University Teaching Hospital, Jos between January 2010 and June 2014.All male patients presenting with external genital trauma at the accident and emergency unit were initially resuscitated by the emergency room team using the ATLS protocol, who then invited the urologist to take over the management.The patients were evaluated for aetiology/ mechanism of injury, type of external genital injury and associated injuries. Modality of treatment was also assessed. Results: Twenty one individuals with external genital trauma were enrolled into the study. The mean age of the patients was 30.62years. There were different mechanisms for the injuries. Gunshot constituted the highest mechanism (n=12) 57.1%. Three patients had blunt injuries (14.3%), while 85.7% had penetrating genital injuries.Ten patients had penile injuries representing 47.6%. Six patients representing 28.6% had scrotal injuries. Of these 28.6%, 5 patients, representing 83.3% had testicular rupture with one patient having bilateral testicular rupture. Five patients had combined penoscrotal injury representing 23.8%. Ten patients (47.6%) had associated injuries. All the patients had surgical intervention. Conclusion: The genital organs are vital in the reproductive process as well as psychological well being of the individual, hence it becomes imperative for prompt and adequate assessment and treatment of injuries of the system.

Key words: Male genital injuries, penile, scrotal, penoscrotal.

[1] Van Der Horst C,Martinez PF, Seif C, Groth W, Jünemann KP. Male genital injuries: diagnostics and treatment. BJUI. 2004; 93( 7): 927–930.

[2] Waxman S, Beekley A, Morey A, Soderdahl D.Penetrating trauma to the external genitalia in Operation Iraqi Freedom.International Journal of Impotence Research. 2009; 21(2): 145–148.

[3] Brandes SB, Buckman RF, Chelsky MJ, Hanno PM. External genitalia gunshot wounds: a ten-year experience with fifty-six cases. J Trauma. 1995; 39(2): 266- 271.

[4] Archbold JA, Barros d'sa AA, Morrison E.Genito-urinary tract injuries of civil hostilities. Br J Surg. 1981; 68(9): 625-631.

[5] Marekovic Z, Derezic D, Krhen I, Kastelan Z. Urogenital war injuries.Mil Med. 1997; 162(5): 346-348

Abstract: Post circumcision penile epidermal inclusion cysts are rare and few cases have been reported worldwide. A five year old boy presented with a complaint of a mass located at the dorsal aspect of the penis along the circumcision scar. The mass was noticed few weeks after circumcision. On examination the mass was located at the dorsal aspect of the penis proximal to the coronal sulcus along the circumcision scar and measured about 1cm × 1.5cm. It was oval in shape with no differential warmth and non tender. The mass was smooth, firm, mobile and with well defined edges. The overlying skin was normal with no punctum. The mass was excised under general anaesthesia. Histologic sections show an attenuated cystic structure, lined by stratified squamous epithelium containing keratin debris and amorphous material. Histologic diagnosis was epidermal inclusion cyst. Post circumcision epidermal inclusion cyst is usually easy to diagnose from history and physical examination. Complete total excision is usually curative and prevents recurrence.

Key words: Post Circumcision; Epidermal Inclusion Cyst; Penis

[1]. Park HJ, Park NC, Park SW, Jern TK, Choi K-U. Penile epidermal inclusion cyst: A late complication of penile girth enhancement surgery. J Sex Med. 2008;5(9): 2238 – 2240.

[2]. Okeke LI. Epidermal inclusion cyst as a rare complication of neonatal male circumcision: a case report. Journal of Medical Case Reports.2009; 3:7321.

[3]. Ademuyiwa AO, Ojewola RW, Elebute OA, Jeje EA, Bode CO. Surgically Correctable Morbidity from MaleCircumcision: Indications for Specialist Surgical Care in Lagos: Nigerian Journal of Surgery. 2012;18(2): 71-74.

[4]. Suwa M, Takeda M, Bilim V and Takahashi K.Epidermoid Cyst of the Penis: A Case Report and Review of the Literature.International Journal ofUrology.2000; 7 (11):431-433.

[5]. Rattan J, Rattan S, GuptaDK.Epidermoid Cyst of the Penis with Extention into the Pelvis.The Journal of Urology. 1997; 158(2): p. 593.