iosr-JDMS   Volume-13 ~ Issue-6 ~ June-2014

Abstract: Herlyn-Werner-Wunderlich syndrome also known as uterus didelphys with obstructing hemivaginal septum and ipsilateral renal agenesis is a rare syndrome with only a few hundred reported cases described since 1922. Uterus Didelphys is a type of lateral fusion disorder of mullerian ducts. Mullerian duct anomalies have an incidence of 2–3%, while obstructing hemivaginal septum and ipsilateral renal agenesis constitutes 0.16–10% of these mullerian duct anomalies. A female case referred to our radiology department for evaluation of lower abdominal pain revealed Uterus Didelphys with Obstructing Hemivaginal Septum and Ipsilateral Renal Agenesis on imaging. Understanding the imaging findings, in conjunction with the clinical presentation, is critical for early diagnosis in attempting to prevent complications such as endometriosis or adhesions from chronic infections with subsequent infertility. Management depends on the presence or absence of an obstruction. Surgical removal of the vaginal septum is the preferred approach for relieving an obstruction.
Key words: Mullerian Ducts, MRI Pelvis, Uterus Didelphys, Hemivaginal Septum, Ipsilateral Renal Agenesis.

[1]. Carrington BM, Hricak H, Nuruddin RN, Secaf E, Laros RK Jr, Hill EC. Müllerian duct anomalies: MR imaging evaluation. Radiology 1990;176(3):715–720.
[2]. Pellerito JS, McCarthy SM, Doyle MB, Glickman MG, DeCherney AH. Diagnosis of uterine anomalies: relative accuracy of MR imaging, endovaginal sonography, and hysterosalpingography. Radiology 1992;183(3):795–800.
[3]. Fielding JR. MR imaging of Müllerian anomalies: impact on therapy. AJR Am J Roentgenol 1996;167 (6):1491–1495.
[4]. Troiano RN, McCarthy SM. Müllerian duct anomalies: imaging and clinical issues. Radiology 2004; 233(1):19–34
[5]. O'Neill MJ, Yoder IC, Connolly SA, Mueller PR. Imaging evaluation and classification of developmental anomalies of the female reproductive system with an emphasis on MR imaging. AJR Am J Roentgenol 1999;173(2):407–416.
[6]. Li S, Qayyum A, Coakley FV, Hricak H. Association of renal agenesis and mullerian duct anomalies. J Comput Assist Tomogr 2000;24(6):829–834.

Abstract: The ultimate aim of endodontic therapy is thorough debridement of root canal system. The aim of this review is to give a brief description of endodontic irrigation devices and their efficacy in root canal therapy. Recently developed irrigation devices and their application mode also discussed. Mechanism of these devices and the phenomenon that governs the irrigation efficacy discussed briefly.
Key Words: Newer irrigation devices, Endodontic irrigation, EndoVac, RinsEndo, Ultrasonic irrigation

[1]. Wong R. Conventional endodontic failure and retreatment. Dent Clin North Am 2004;48:265–89.
[2]. Basmadjian-Charles CL, Farge P, Bourgeois DM, Lebrun T. Factors influencing the long-term results of endodontic treatment: a review of the literature. Int Dent J 2002; 52:81–6.
[3]. Ferreira RB, Alfredo E, Porto de Arruda M, Silva Sousa YT, Sousa-Neto MD. Histological analysis of the cleaning capacity of nickel-titanium rotary instrumentation with ultrasonic irrigation in root canals. Aust Endod J 2004;30:56–8.
[4]. Walton RE. Histologic evaluation of different methods of enlarging the pulp canal space. J Endod 1976;2:304–11.
[5]. Naidorf IJ. Clinical microbiology in endodontics. Dent Clin North Am 1974;18: 329–44.
[6]. Gu LS, Kim JR, Ling J, Choi KK, Pashley DH, Tay FR. Review of contemporary irrigant agitation techniques and devices. J Endod. 2009;35(6):791-804.

Abstract: Background: Emotional distress in cancer patients may interfere with the ability to cope effectively with cancer, its physical symptoms and its treatment. This in turn causes significant increase in psychiatric morbidity leading to poor outcome in the patients. Objective: To assess prevalence of anxiety and depression and to study effects of socio demographic and cancer variables causing emotional distress. Materials and Methods: The present cross-sectional hospital based study was conducted at Oncology department of tertiary care hospital after an approval from institutional ethical committee. The participants were included by random sampling method. Total 100 patients diagnosed by oncology physician or surgeon were interviewed after obtaining informed consent. The detailed information of study was given to every participant. Hospital Anxiety Depression Scale (HADS), a well validated, easy to administer and acceptable scale was used for measuring anxiety & depression level. On HADS cut off score of >07 was taken as possible cases. Data collected was compiled, tabulated in Microsoft excel sheet and analyzed by SPSS software 16.0 versions with the help of a statistician. Results: Thus 100 consecutive consenting diagnosed patients of cancer attending oncology department were studied. On Hospital Anxiety & Depression Scale the mean anxiety and depression scores were 7.73 (SD - 4.57) & 6.63 (SD - 4.23) respectively. The range of scores on anxiety subscale was 0-18 & 0-16 on depression subscale. 47% had anxiety & 39% were having depression with cut off score of >07 on each subscales. 23% of cancer patients were having scores in moderate to severe category on both HAD subscales. Total HADS score had range of 0-34 with mean of 14.21. 42% cases were having emotional distress on HADS score (Total Score of HADS >15) Conclusion: On the basis of the study we would recommend that cancer patients require not only medical treatment approach but psychological measures as well to cope up with associated emotional distress. Early recognition and management of emotional distress will significantly decrease the burden on health care cost and improve the quality outcome in cancer treatment.
Key words: Anxiety, cancer, depression, emotional distress, psychological measures.

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Abstract: Background and Aims: Different kinds of adjutants are used with local anesthetics during intrathecal procedure for prolongation of action. However, they are not completely free from side effects. Fascia Iliaca Compartment Block (FICB) is useful for the same purpose. Method: After administering 20ml 0.5% injection Bupivacaine in FIC (Fascia Iliaca Compartment) on the fractured side before anesthesia as pre-operative medication, 50 elderly patients got relief of pain.< Results: 50 patients of mean age and weight 68.38±8.08 years and 55.04±3.02 Kg respectively showed postoperative analgesia of average 15.82±2.34 hours with mean systolic blood pressure112.32±7.62 mm of Hg. Patients felt comforts with FICB. Conclusion: Preoperative, intra-operative and postoperative analgesia provided by FICB is of high quality to relieve pain on movement before surgery, to act as an adjuvant with spinal anesthesia during surgery and prolonged analgesia after surgery without adverse reaction.

[1]. Vloka J, Hadzic A, Drobnik L, Ernest A, Reiss W, Thys D. Anatomical landmarks for femoral nerve block: a comparison of four needle insertion sites. Anesthesia & Analgesia. 1999;89(6):1467.
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Abstract: Background: Stroke is defined as a rapidly developing symptoms and/or signs with global loss of brain function, lasting for more than 24hrs , or leading to death, with no apparent cause other than vascular origin. A significant number of stroke patients are having co-existent cardiac abnormalities,. Aim: To find the association between cardiac abnormalities (both symptomatic and asymptomatic) and ischemic stroke, in terms of clinical parameters and ECG. Method: 50 patients diagnosed to have acute ischemic stroke during the period of December 2011 to September 2013. Data was collected by relevant history, clinical examination, investigations. Results: The mean age of the patients was in the age group 51-70 years, with a male –female ratio of 7:5. Chest pain (12%), palpitations(2%), orthopnoea (6%) were the main presenting cardiac symptoms. ECG abnormalities noted were T-wave inversion in 38%, ST segment depression/elevation in 20%, QTc prolongation in 8%, AF in 6%. Conclusion: The observations of this study suggest that ECG abnormalities in patients with acute ischaemic stroke are common and cardiac evaluation could have prognostic importance.
Key Words: Ischaemic Stroke, ECG.

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[3]. Koochaki E, Arami M. Eletrocardiogarph Changes in Acute Ischemic Cerebarl Stroke. The Journal of Applied Research. Vol.12,No.1,2012.
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Abstract: Background: Primary dysmenorrhea is defined as difficulty in menstrual flow in the absence of any pelvic pathology. It is the most common gynaecological problem among adolescent females. Incidence of primary dysmenorrhea was reported to be between 50% and 90% in different societies. Several studies have shown that the reduction of dysmenorrhea in women, who regularly exercise may be due to effects of hormonal changes on uterine epithelial tissues or an increase in endorphin levels. It appears that exercise has analgesic effects that act in a non-specific way. Study aim: To compare the effect of stretching and core strengthening exercises on primary dysmenorrhea. Material and Methods: The present experimental study included 105 girls of age 19-25 years with primary dysmenorrhea were selected from lovely professional university and government college, Phagwara.The students were non Athlete and Volunteered for the study, the participants were randomly divided into 3 groups,2 Experimental gp (1st exp gp n=35,2nd exp gp,n=35) and control gp (n=35). In the Intervention group the subjects were requested to complete active stretching and core strengthening protocol for 8 weeks (4 days per week, 2 times a day,10 min) at home. In the Pre-test & post test all the subjects were examined for pain intensity (NPRS), pain duration and use of sedatives tablets during menstruation cycle and side bridge test. Results:. Pain intensity is decreased significantly in both experimental groups that is in Gp1 (p=.0001) and Gp2 (p=.0001) with NPRS and PDQ in Gp 1(p=.0001) and in Gp2 (p=.0001) after post readings of 4 weeks (p1) and of 8 weeks (p2) but the results of control group is non significant< Conclusion: The present result suggested that active stretching and core strengthening both can be safely used as an alternative therapy for pain relief in dysmenorrhoea and this action is not mediated through progesterone. Because we are dealing with a functional problem that is not a disease state, so can truly focus on a holistic approach.
Keywords: Primary Dysmenorrhea, active stretching, core strengthening

[1]. Reis Concelcao,Hardy Eleen,Souse Maria, The effectiveness of connective tissue massage in the treatment of primary dysmenorrhea among young women, RECIFE[2010]vol10[2],247-256
[2]. Jerdy Shahnaz ,Hosseini Rahman,Gh Maghsound ,Effects of stretching exercises on primary dysmenorrhea, Biomedical human kinetics[2012] vol [4]127-132.
[3]. Karampour Elham,Khoshnam Ebrahim, The influence of stretch training on primary dysmenorrhea, advances in environmental biology[2012]vol6[12]3069-3071.
[4]. Chaudhari Aditi,Singh Amarjeet,Dhaliwal Lakhbir,A randomised controlled trial of exercise and hot water bottle in the management of dysmenorrhea in school girls of Chandigarh,india,Indian J physical pharmocol[2013]vol57[2]114-122.
[5]. Saadatabadi Fatehmeh, Bambaichi Esfaryani fahimeh,Effects ofsix weeks flexibility training on dysmenohrrhea, Journal of Isfahan medial school[2010] vol28,no.109
[6]. Gumus Iiknur et all Impact of home based exercise on quality of life of women with primary dysmenorrhea,SAJOG,[2012]vol 18,NO.

Abstract: Irreducible posterolateral knee dislocations are extremely rare and pose a significant diagnostic challenge to orthopaedic surgeons. Lack of awareness of this entity and its presentation, commonly result in a missed diagnosis and delayed treatment. We present a case of 40 year old man who had a low energy trauma to his knee and was initially diagnosed and treated as a case of patellar dislocation. Only after a thorough review of mechanism of injury, clinic-radiological findings and literature we could diagnose and treat this injury correctly.
Key words: Irreducible knee dislocation, Posterolateral, Dimple sign, Low energy trauma.

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Abstract: With the increasing trends of coronary heart diseases, the knowledge of variations in the coronary arteries is of paramount importance when considering the various surgical procedures. This study was conducted to know the variations in coronary artery dominance pattern. 77 formalin fixed hearts were dissected. Origin and area of distribution of posterior interventricular artery and SA nodal artery were noted. In 64 hearts (83.11%) posterior inter ventricular artery was a branch of right coronary artery and in 13 hearts (16.88%) it was a branch of left circumflex artery. SA nodal artery was a branch of dominant artery in 46 hearts (59.74%). It arose fromnon-dominant artery in 29 hearts (37.66%). In the remaining 2 hearts (2.6%) SA nodal artery was a branch from both.
Key words: Right coronary artery, Posterior interventricular artery, SA nodal artery, Coronary dominance.

[1]. Mandal S, Saha JB, Mandal SC, Bhattacharya RN, Chakraborty M, Pal PP. Prevalence of ischemic heart disease among urban population of Siliguri, West Bengal. Indian J Community Med. 2009; 34: 19-23.
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Abstract: Background: Dysfunctional uterine bleeding (DUB) is the most common cause of abnormal vaginal bleeding during a woman's reproductive years. Regarding medical management of DUB, there is a general lack of evidence based approach, marked variation in the practice and continuing uncertainty regarding the most appropriate therapy. Ormeloxifine, a selective estrogen receptor modulator, is emerging as a safe and effective agent for dysfunctional uterine bleeding. Objective: To evaluate the efficacy and safety of ormeloxifene in medical management of dysfunctional uterine bleeding Study Design: This was a prospective study conducted on DUB patients attending outpatient clinic in a tertiary care hospital. Materials and Methods: 50 patients, on whom diagnosis of dysfunctional uterine bleeding was made, were recruited for study. Patients were given ormeloxifine 60mg twice a week for 12 weeks and then once a week for 12 weeks. The primary outcome measures were menstrual blood loss (assessed by pictorial blood assessment chart score), hemoglobin concentration and endometrial thickness. The secondary outcome measures were acceptability and side effects of ormiloxifene. Results: There was a significant reduction in median PBAC score from 322 to 54 after six months of treatment. The mean hemoglobin concentration increased significantly from 8.1 to 9.4 gms/dl with a rise of 1.3gm/dl (p < 0.05). The mean pretreatment endometrial thickness was 11mm and it decreased significantly to 8.4mm after 6 months of treatment with ormeloxifene (p < 0.05). 76% of the women showed marked subjective improvement in symptoms. The most common side effect reported was amenorrhoea (16%). Conclusion: Ormeloxifene can be considered as an effective and safe therapeutic option for the medical management of dysfunctional uterine bleeding.
Key words: Dysfunctional uterine bleeding, SERM, ormiloxifene.

[1]. S. Dadich, S, Agarwal, M.Soni and R. Jain. Role of ormeloxifene in medical management of dysfunctional uterine bleeding. Asian journal of Obs and Gynae Practice.2012;6:28-31
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[4]. Agarwal.N, S. Singh. The efficiency and safety of ormeloxifene in dysfunctional uterine bleeding. IOSR Journal of Pharmacy and Biological sciences 2013;5(5):18-21.
[5]. S.C Biswas, S. K Saha, T.S Bag, S.C Ghosh Roy, A.C Roy and S.P Kabiraj. Ormeloxifene, A selective estrogen receptor modulator for treatment of dysfunctional menorhagia. J obstet Gynecol. 54(1);2004:56-59.
[6]. Bhattacharyya. Tk, Banerji. A. Efficiency of a selective estrogen receptor modulator ormeloxifene in management of dysfunctional uterine bleeding.

Abstract: Ossifying fibromas are uncommon benign lesion with aggressive local growth. These tumors thought to originate from the periodontal ligament. WHO 2005 classified juvenile ossifying fibroma (JOF) into juvenile psammomatoid ossifying fibroma and juvenile trabecular ossifying fibroma. These tumors must be treated by radical excision to prevent recurrence. We report a case of JOF of psammomatoid pattern in a 12 year old boy, the treatment was radical en bloc resection.
Keywords: Ossifying Fibroma, Juvenile ossifying fibroma, Psammomatoid ossifying fibroma

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Abstract: A 45 year old male patient with a three month old fracture shaft of femur following a fall was scheduled for femur plating. He came to the hospital with complaint of pain and swelling around the left hip. There was no significant history except for smoking. On examination respiratory system and cardiovascular system were normal. All relevant investigations were within normal limits. He was premedicated with tablet alprazolam 0.25mg a night prior and on the day of surgery. On the operating table, intra-veinous line was secured with 18 gauge cannula and monitors attached. Baseline vital parameters were recorded and under all aseptic precautions, spinal anaesthesia was given with hyperbaric 0.5% bupivacaine 2.5ml in sitting position. Once desired level of anaesthesia was achieved patient was positioned to right lateral. Patient was comfortable as surgery commenced. Vitals were maintained.

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Abstract: Background: Infection continues to be a major complication of abdominal surgeries with significant increased costs, morbidity and potential mortality. Identifying the agents of abdominal wound infection and instituting appropriate measures will go a long way in reducing this problem.< Objective: This study was conducted to identify the organisms involved in abdominal wound Infections and document their antibiotic sensitivity pattern at the General Hospital Funtua. Methods: A prospective design was used to conduct the study. Swabs of the clinically infected wounds detected in a population of 127consecutively studied patients were taken and cultured for aerobic bacteria using standard microbiologic methods. Antibiotic sensitivity pattern was also determined for the aerobic organisms cultured Results: 28(22.05%) of the 127 patients studied developed surgical site infections, based on clinical criteria and 25(19.6%) based on bacteriological criteria. Pseudomonas spp. was the most frequently cultured aerobic organism in 39% (n=11 ) of the cultures, while Klebsiella in 21% (n=6) and Staphylococcus in 17% (n=5). Over 80% of the organisms demonstrated less than 50% sensitivity to the tested antibiotics. Conclusion: The study showed that gram -negative bacteria are the major agents of abdominal surgical site infections in General Hospital Funtua, Katsina State,Nigeria. It is therefore recommended that there is need for further investigations in the field to confirm the source and microbial resistance pathogen.
Keywords: bacterial agents, abdominal surgical wounds, infection, surgery

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Abstract: Inflammatory jaw cysts comprise a group of lesions that arise as a result of epithelial proliferation within an inflammatory focus due to a number of causes. Radicular cysts are the most common inflammatory cysts. These cysts are found most commonly at the apices of the involved teeth. These cysts are seldom very large and very rarely cross the midline. There has been a review for Odontogenic keratocyst that it may grow to a very large size before it manifests clinically. Large size of OKC contributes to one of the reasons for considering it as a cystic neoplasm. In the present case, size of the cyst was enormous which was confusing which on histological examination was confirmed as a radicular cyst.
Keywords: Anachoresis, Large radicular cyst, Mimicking lesions, Odontogenic Keratocyst

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Abstract: Cancer is one of leading causes of morbidity and mortality in developed countries. Most radiologic procedures map the anatomy and morphology of tumors with little or no information about their metabolism .Positron emission tomography (PET) is a coalition of physics, chemistry, physiology, and medicine united in an effort to measure physiologic parameters noninvasively. The combination of PET and CT has matured into an important diagnostic tool. During the same period, concepts for PET scanners integrated into an MR tomography have emerged. The excellent soft-tissue contrast of MRI and the multifunctional imaging options it offers, such as spectroscopy, functional MRI, and arterial spin labeling, complement the molecular information of PET. These combination have many benefits for the evaluation and early detection of pathological characterization, and recognized individualized treatments , particularly for cancer disease .This evaluation can provide valuable and important aspects for improving the survival of cancer patients.Thisresearchpaper is focus ondescribing and explore the benefits of new development radiological techniques and discuss the various imaging characteristics for diagnosis and treatment of cancer ,offering great potential for improvements in the care of cancer patients in the near future.
Key Words: Cancer ; positron emission tomography ; technology ; PET/CT; PET/MRI ; oncology

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