iosr-JDMS   Volume-18 ~ Issue-3 ~ March-2019

Abstract: Leiomyosarcoma is a rare malignancy of smooth muscle origin, notorious for it's aggressive nature and poor prognosis. Uterine leiomyosarcoma accounts for 1% of all uterine malignancies. Here we are presenting a rare case of uterine leiomyosarcoma at a young age of 29 years. She is para one with one living issue, underwent lower segment caesarean section, had complaints of continuous bleeding per vaginum and lower abdominal pain for 5months. Initially, she was managed conservatively as intramural fibroid. Later, the patient presented with continuous bleeding per vaginum with severe breathlessness diagnosed as Uterine Leiomyosarcoma stage IVB with lung metastasis.

Key words: Uterine leiomyosarcoma, metastasis,postpartum period.

[1]. Tavassoli FA, Devilee P (2003) World Health Classification of Tumours. Pathology and Genetics of Tumours of the Breast and Female Genital Organs, IARC Press: Lyon.
[2]. Berek JS. Berek& Novak's Gynecology. 14th ed. Lippincott Williams & Wilkins; 2007.
[3]. Brooks SE et al: Surveillance, epidemiology, and end results analysis of 2677 cases of uterine sarcoma 1989-1999.Gynecol Oncol2004;93(1):204.
[4]. Leibsohn S, d'Ablaing G, Mishell DR Jr, Schlaerth JB. Leiomyosarcoma ina series of hysterectomies performed for presumed uterine leiomyomas.Am J ObstetGynecol1990;162:968–74;discussion 974–6.
[5]. Fahim F.Leiomyosarcomas:Analysis of Clinical Presentations in 6patients.JPMA 2002.

Abstract: Aim: to estimate the prevalance of nonvariceal ugi bleed in cld patient who were admitted for ugi bleed method this is retrospective study done in department of mge stanley medical collegeby collecting data from hospital records from the period of april 2019 to september2019. Methods;all patient admitted for ugi bleed in smc hospital who underwent gastroscopywere included in study,demographic data,etiolgy of liver disease,diagnosis from endoscopyrecords were Collected.frequency wasof NVUGIB was calculated as percentage. Results :a total of patients underwent gastroscopy. Atotal of 112 patients with ugi bleed underwent gastroscopy of which 64had variceal bleed(57%)while 48 patients(42%) had NVUGIB

Keywords: UGI bleed,varicealbleed , nonvaricealUGIbleed(NVUGB).chronic liver disease)

[1]. non-variceal upper gastrointestinal bleeding in cirrhotic patients in Nile Delta.Gabr MA, Tawfik MA, El-Sawy AA.Indian J Gastroenterol. 2016 Jan; 35(1):25-32. Epub 2016 Feb 17.
[2]. Non-variceal gastrointestinal bleeding in patients with liver cirrhosis: a review.Kalafateli M, Triantos CK, Nikolopoulou V, Burroughs A.Dig Dis Sci. 2012 Nov; 57(11):2743-54. Epub 2012 Jun 4

Abstract: Introduction: Gynaecological and obstetric surgeries, potentially lead urological injuries due to close embryological and anatomical approximation of female genital and urinary tract. Acute complications like ureteric lacerations, tying of ureters, bladder lacerations and bladder incision are common. Methods and material: We have collected data retrospectively from departmental registry of Department of urology, NRS Medical College And hospital.In nine patients who had iatrogenic injury to bladder and ureter, urologist help was called for . Results : 9 cases of urological injuries from April 2017 to March 2018 who underwent hysterectomy or caesarean section were retrospectively reviewed of which 5 (55.55%) involving urinary bladder and 4 (44.45%) involving lower ureters......

Key Word: urological injury, bladder injury, ureteric injury, neocystoureterostomy

[1]. Michael P., Arouson and Teresa M. Bose: Urinary tract injury in pelvic surgery. Clin.Obstetr.Gynaecol., 45: 428-38, 2002.
[2]. Lee JS, Choe JH, Lee HS, SeoJT.Urologic Complications Following Obstetric and Gynecologic Surgery. Korean Journal of Urology, 2012;53: 795-99.
[3]. Teeluckdharry B, Gilmour D,Flowerdew G. Urinary Tract Injury at Benign Gynecologic Surgery and the Role of Cystoscopy: A Systematic Review and Meta-analysis 2015, ObstetGynecol 2015;126:1161-19.
[4]. Baskett TF, Calder AA, Arulkumaran S (2007) Obstetrics Hysterectomy. In: Munro Kerr's Operative Obstetrics, (11th edn) Saunders Elsevier, Edinburgh, 309-314.
[5]. Berkmen F, PekerAE,Alagol H, Ayyildiz A, Arik AI,Basay S. Treatment of iatrogenic ureteral injuries during various operations for malignant conditions. J ExpClin Cancer Res 2000;19:441–5.

Abstract: Introduction: Ovarian neoplasms are herterogenous and manifest with wide spectrum of clinical, morphological and histological features. The complex nature, unpredictable behavior, prognosis and controversial management makes ovarian lesions fall in the line of interest. Objectives: This study was undertaken to analyse and characterize the ovarian lesions based on the histopathological features and to find out the frequency of benign and malignant neoplasms studied. Materials and methods: This is a retrospective-prospective study of ovarian lesions conducted at a tertiary care centre, over a period of four and half years..........

Key Words: Benign, malignant, ovarian, neoplasm

[1]. Pradhan A, Sinha AK, Upreti D. Histopathological patterns of ovarian tumors at BPKIHS. Health Renaissance. 2012;10(2):87-97.
[2]. Young RH. The ovary. In:Sternberg S.diagnostic Surgical Pathology. 17th Ed. New York: Raven Press:1994. P. 2195
[3]. Vaddatti T, Reddy ES, Vahini G. Study of morphological patterns of ovarian neoplasms. IOSR Journal of Detal and Medical Sciences. 2013;10(6):11-16.
[4]. Ellenson LH, Priorg EC. The Female Genital Tract. Kumar V, Abbas AK, Aster JC. In: Robbins and Cotron Pathological Basis of Diseases. 9th edn:Elseiver, 2014;2:1022-1034
[5]. Basu P, De P, Mandal S, Ray K, Biswas J. Study of 'patterns of care' of ovarian cancer patients in a specialized cancer institute in Kolkata, eastern India. Indian J cancer. 2009;46(1):28-33.

Abstract: Nervous system is commonly involved due to HIV infection. It is paramount to distinguish whether the neurologic deterioration is due to opportunistic infection or immune reconstitution or the effect of virus itself.MR imaging greatly helps in narrowing the differential diagnosis.Neurological manifestations of retropositive patients is not uncommon. We present case series of People living with HIV and AIDS (PLHA) with varied imaging manifestations. Detailed clinical examination was done, CD-4 cell counts were obtained and correlated with the imaging features.Of the cases studied,majority were opportunistic infections,predominantly granulomatous infections,liketuberculosis,followed by toxoplasmosis.One case of CNS cryptococcosis was identified.Other cases were Primary CNS lymphoma,HIV encephalopathy and Progressive multifocal leukoencephalopathy.

Keywords:AIDS(Acquired immunodeficiency syndrome),HIV(human immunodeficiency virus),infection,MRI(magnetic resonance imaging).

[1]. Senocak E, Kader KO, Özgen B, Kurne A, Özkaya G, Ünal S, Cila A. Imaging features of CNS involvement in AIDS. Diagnostic and Interventional Radiology. 2010 Sep 1;16(3):193.

[2]. Walot I, Miller BL, Chang L, Mehringer CM. Neuroimaging findings in patients with AIDS. Clinical infectious diseases. 1996 Jun 1;22(6):906-19.
[3]. Naveet Wig, J P Wali.Central Nervous System and HIV/AIDS.Journal of Indian academy of Clinical medicine.2008 Nov;5(2):164-68 [4]. Tate DF, Khedraki R, McCaffrey D, Branson D, Dewey J. The role of medical imaging in defining CNS abnormalities associated with HIV-infection and opportunistic infections. Neurotherapeutics. 2011 Jan 1;8(1):103-16.

[5]. Smith AB, Smirniotopoulos JG, Rushing EJ. Central nervous system infections associated with human immunodeficiency virus infection: radiologic-pathologic correlation. Radiographics. 2008 Nov;28(7):2033-58.

Abstract: Background: Pancytopenia is a triad of anemia, leucopenia and thrombocytopenia. The initial symptom would be generalized weakness. Etiology ranges from benign to malignant conditions. Accurate workup is essential for the appropriate management. Aim: To studythe clinical presentation, bone marrow picture andthe causes of pancytopenia. Materials and methods: This study is carried out in Government General Hospital, Kakinada which is a tertiary care center. All the patients with pancytopenia admitted in the Department of General Medicine were considered in the present study. 50 cases presented with pancytopenia were analyzed. The clinical findings, blood investigations and bone marrow examination findings were recorded.The various causes of pancytopenia were tabulated and analyzed..........

Key Words: anemia, bone marrow examination, pancytopenia, splenomegaly.

[1]. Ishtiaq O, Baqai HZ, Anwer F, Hussai N. Patterns of pancytopenia patients in a general medical ward and a proposed diagnostic approach.JAyub Med Coll Abbottabad.2004;16(1):8-13
[2]. Pathak R, Jha A, Sayami G. Evaluation of bone marrow in patients with pancytopenia. J Patho Nepal. 2012;2:265-71.
[3]. Khunger JM, Arculselvi S, Sharma U, Ranga S, Talib VH. Pancytopenia-A Clinico-hematological study of 200 cases. Indian J Pathol Microbiol. 2002;45:375–9.
[4]. Kumar R, Kalra SP, Kumar H, Anand AC, Madan M. Pancytopenia-A six year study. J Assoc Physicians India. 2001;49:1079–81.
[5]. Knodke K, Marwah S, Buxi G, Vadav RB, Chaturvedi NK. Bone marrow examination in cases of pancytopenia. J Academy Clin Med. 2001;2:55–9.

Abstract: Background: The incidence of umbilical hernias has been reported to be as high as 2% in the adult population and comprises 10% of all hernia repairs performed annually.(1) Umbilical hernias in infants are congenital and are common. It is due to leukocyte adhesion molecule deficiency. They close spontaneously in most cases by the age of 2 years. Those that persist after the age of 5 years are frequently repaired surgically. Umbilical hernias in adults are largely acquired. These hernias are more common in women and in patients with conditions that result in increased intra-abdominal pressure, such as pregnancy, obesity, ascites, or chronic abdominal distension..........

Key words: Hernia , laparoscopy, umbilical.

[1]. MJ. Colon, R. Kitamura, D.A. Telem, S. Nguyen, C.M. Divino, "Laparoscopic umbilical hernia repair is the preferred approach in obese patients", The American Journal of Surgery (2013) 205, 231-236. [2]. Ashu EE, Leroy GM, Aristide BG, et al. Double half-cone flap umbilicoplasty for proboscoid umbilical hernia in a 2 years old child with satisfactory results 2 years later. Pan Afr Med J. 2015;22:44. Published 2015 Sep 17. doi:10.11604/pamj.2015.22.44.7818
[3]. Lau H, Patil NG. Umbilical hernia in adults. Surg Endosc. 2003 Dec;17(12):2016–20.
[4]. Kurzer M, Belsham PA, Kark AE. Tension-free mesh repair of umbilical hernia as a day case using local anaesthesia. Hernia. 2004 May;8(2):104–7.
[5]. Hilling DE, Koppert LB, Keijzer R, Stassen LP, Oei IH. Laparoscopic correction of umbilical hernias using a transabdominal preperitoneal approach: results of a pilot study. Surg Endosc. 2009 Aug;23(8):1740–4.

Abstract: A temporary anchorage device (TAD) is a device that is provisionallysecured to the bone with the motive of increasing the anchorage in orthodontic treatment either by supporting the teeth of the reactive unit or by eliminating the need for the reactive unit entirely, and can be easilydetached after use. The location of implant can beendosteally, transosteally, orsubperiosteally and can be secured to bone either biochemically i.e. osseointegrated or mechanically i.e. cortically stabilized.

[1]. Branemark PI, Breine U, Adell R, et al: Intra-osseous anchorage of dental prostheses: I. Experimental studies. Scand J PlastReconstrSurg.1969;3:81-100.

[2]. Creekmore TD, Eklund MK. The possibility of skeletal anchorage. J Clin Orthod 1983; 17:266-9.

[3]. Costa A.; Raffling M,; Millstone B.: Miniscrews as orthodontic anchorage: A preliminary report. Int J Adult Orthod Orthog Surg 1998; 13: 201-209

[4]. Sugawara J: JCO interviews DrJunji Sugawara on the skeletal anchorage system. Clin Orthod 33:689-696, 2000.

[5]. Lee JS, Park HS and Kyung HM. Microimplant anchorage for lingual treatment of skeletal class-II malocclusion. J Clin Orthod 2001;35:643-647.

Abstract: Amyloidosis of the Gastrointestinal tract with biopsy proven disease is rare. We present the clinical and histopathological features of localised intestinal amyloidosis with a rare case report. The patient had nonspecific gastrointestinal symptoms including haematochezia. Prior to treatment, the patient was suspected of having colo-colic intussusception on the basis of CT scan findings. The patient was treated with right hemicolectomy for caecal mass. The postoperative pathological diagnosis determined the lesion to be deposition of amyloid material with no evidence of malignancy. It was confirmed on congo red staining. Localised gastrointestinal amyloidosis is rare in incidence, but it should be considered in differential diagnosis of gastrointestinal tumours and confirmation can be done on biopsy. Although the condition is benign, there is a tendency of recurrence as suggested by literature.

Keywords: Amyloidosis, colon, intestine, mass

[1]. Husby G. A chemical classification of amyloid. Correlation with different clinical types of amyloidosis. Scand J Rheumatol. 1980;9:60–64. [PubMed]
[2]. Lee JG, Wilson JA, Gottfried MR. Gastrointestinal manifestations of amyloidosis. South Med J. 1994;87:243–247. [PubMed]
[3]. Kim H, Jee SR, Lee SB, Lee JH, Park SJ, Park ET, Lee YJ, Lee SH, Seol SY, Chung JM. A case of secondary amyloidosis presenting as massive gastrointestinal bleeding. Korean J Gastroenterol. 2006;47:397–401. [PubMed]
[4]. Hirata K, Sasaguri T, Kunoh M, Shibao K, Nagata N, Itoh H. Solitary "amyloid ulcer" localized in the sigmoid colon without evidence of systemic amyloidosis. Am J Gastroenterol 1997; 92:356-357
[5]. 5.Tsiouris A, Neale J, Stefanou A, Sziagy EJ. Primary amyloid of the colon mimicking ischemic colitis. Colorectal Dis. 2010 Oct 19; doi: 10.1111/j.1463-1318.2010.02456.x. [Epub ahead of print] [PubMed]

Abstract: Introduction: Emotional, physical and sexual abuse constitute significant etiologic factors leading to many psychological disorders observed in clinical populations. Goals: Evaluate scores in depression, frequency of nightmares and "suicide related events" in bruxers with sexual abuse history. Methods: Clinical examination, questionnaires, psychological measures and self-reports in subjects with craniomandibular disorders, bruxing behavior and sexual abuse (n=31) which were compared with those presenting craniomandibular disorders, bruxing behavior and no abuse (n=68) and no craniomandibular disorders, some with bruxing behavior and no sexual abuse (n=38). Widely accepted criteria for craniomandibular disorders and bruxing behavior were utilized. The BDI, The Child Abuse and Trauma Scale and a novel instrument to gather information.........

Keywords: Craniomandibular disorders. Bruxing Behavior. Sexual Abuse. Depression, Suicide Related Events. Nightmares.

[1]. Kafas P, Dalabiras S, Handoon Z. Chronic Temporomandibular joint dysfunction: an area of debate. Hard Tissue 2012; 10: 1-9.
[2]. The Academy of Prosthodontics. The Glossary of Prosthodontic Terms. J Prost Dent 2005; 94: 10-29.
[3]. MargoobMA, Hussain A, Dar FA, Mustafa T, Wani ZA, Khan AY et al. Adult life consequences of childhood sexual abuse: Case report study. Practitioner 2006; 13: 79-81.
[4]. Hall M, Hall J. The long-term effects of childhood sexual abuse: Counseling implications. Vistas 2011; 19: 1-7.
[5]. Rondón JE. Depression: review of its definition. MOJ Addiction Medicine and Therapy.2018; 1: 1-2.

Abstract: Introduction: Subjects with sleep bruxing behavior may present with morning awakening with pain in multiple anatomic areas. Awakening with pain may be influenced to a certain extent by previous or current use of Selective serotonin reuptake inhibitors. Aim: Evaluate frequency of selective serotonin reuptake inhibitors in sleep bruxers with craniomandibular disorders, assess frequency of anatomic areas reported with pain on awakening in the morning. Methods: Clinical examination, palpation of masticatory muscles and temporomandibular joints, use of questionnaires and self-report to gather data in 53 subjects currently using selective serotonin reuptake inhibitors, 31 subjects with history of past SSRIs use, 21 subjects who reported that used or were using another antidepressant type and 39 who never used antidepressants. Data from all these subjects were reviewed retrospectively..........

Keywords: Sleep Bruxism. Craniomandibular Disorders. Selective Serotonin Reuptake Inhibitors. Pain on awakening.

[1]. Praveena KS, Rathika R, Easwaran MA, Easwaran B. Temporomandibular disorders clinical and modern methods in differential diagnosis. IOSR Journal of Dental and Medical Sciences 2014; 13: 1-7.
[2]. GuptaR, Gupta P, Gupta S, Gupta T. Temporomandibular joint pain and dysfunction. Int J Applied Dent Sci 2015; 1: 31-34.
[3]. Prisco V, Iannaccone T, Di Grezia G. Use of buspirone in selective serotonin reuptake inhibitor-induced bruxism. Eur Psychiatr 2017; 41: 855-56.
[4]. Fitzgerald K, Healy D. Dystonias and dyskinesias of the jaw associated with the use of SSRIs. Human Psychopharmacol 1995; 10: 215-19.
[5]. Wise MEJ. Citalopran-induced bruxism. Br J Psychiatr 2001; 178: 182.

Abstract: Spontaneous cerebrospinal fluid leaks with meningoencephaloceles restricted to the sphenoid sinus are rare clinical findings.Patients presenting with this special clinical entity usually do not have any history of trauma, tumour or iatrogenic injury. Persistent Sternberg's canal, extensively pneumatised sphenoid sinuses, elevated intracranial pressure and obesity are believed as possible reasons for spontaneous CSF rhinorrhea and meningoencephaloceles in this region.The aim of this study was to define Sternberg's canal as a potential source for spontaneous CSF-leaks and menignoencephaloceles in this region and to describe their endoscopic endonasal management.

Key words: CSF (Cerebrospinal fluid), Endoscopic repair, Lateral recess of sphenoid sinus,Rhinorrhea.

[1]. Abdelazim MH, Ismail WF, Taha A. Multilayered Endonasal endoscopic repair of CSF leaks of sphenoid sinus.

[2]. Deenadayal DS, Vidyasagar D, Kumar MN, Sudhakshin P, Chandra SS, Hameed S. Spontaneous CSF rhinorrhea our experience. Indian Journal of Otolaryngology and Head & Neck Surgery. 2013 Aug 1;65(2):271-5.
[3]. Mahmoud N. El Tarabishi, Hossam M. Rabie, Tamer A. Youssef,Mohamed M. El-Sharnouby, Samia A. Fawaz, Ihab M. Nada,Mohamed S. Hasab-Allah. The transnasal endoscopic management of spontaneous cerebrospinal fluid rhinorrhea from the lateral recessof the sphenoid sinus. The Egyptian Journal of Otolaryngology.2016, 32:13–20.
[4]. Forer B, Sethi DS. Endoscopic repair of cerebrospinal fluid leaks in thelateral sphenoid sinus recess. J Neurosurg 2010; 11 2:444–448.

[5]. Schmidt RF, Choudhry OJ, Raviv J, Baredes S, Casiano RR, Eloy JA, Liu JK. Surgical nuances for the endoscopic endonasal transpterygoid approach to lateral sphenoid sinus encephaloceles. Neurosurgical focus. 2012 Jun 1;32(6):E5.

Abstract: Introduction: Occipital neuralgia is a very severe headache disorder which usually occurs concomitantly with temporomandibular disorders and facial pain. Aim: Evaluate medication use: analgesics, muscle relaxants, anti-anxiety and antidepressant drugs in a group of subjects presenting with ON and craniomandibular disorders. Methods: History of chief complaint, clinical examination, evaluation of past/current use o medication, palpation of joint and muscles, assessment of signs and symptoms of craniomandibular disorders and occipital neuralgia in 105 subjects with occipital neuralgia and craniomandibular disorders, 50 individuals with tension-type headache and 30 subjects with no craniomandibular disorders...........

Keywords: Occipital Neuralgia. Analgesics. Muscle Relaxation. Antidepressants. Anti-anxiety dugs.

[1]. Kapural L, Sable J. Peripheral nerve stimulation for occipital neuralgia: Surgical leads. J Prog Neurol Surg 2011; 24: 86-95.
[2]. Jung SJ, Moon S, Kim T, Eom K. A case of occipital neuralgia in the greater and lesser occipital nerves treated with neurectomy by using transcranial doppler sonography: Technical aspects. Korean J Pain 2011; 24: 48-52.
[3]. Beran R. Management of chronic headache. Aust Fam Phys 2014; 43: 106-10.
[4]. Kaniecki RG. Tension-type headache. Continuum Lifelong Learning Neurol 2012; 18: 823-34.
[5]. López PJ, Bretones JM, Garcia M, Sánchez E, Rodríguez MA. Occipital neuralgia: a noninvasive therapeutic approach. RLAE 2018; 26: 1-7.

Abstract: Introduction: Occipital neuralgia is a complex neurophysiological disorder usually associated with local, referred pain and paraesthesia to distant areas from the original source of pain. Aim: Assess frequency of paraesthesia, anatomic location and test the hypothesis that paraesthesia increases with longer duration of occipital neuralgia pain. Methods: Clinical examination, palpation of joint and masticatory muscles, self-reported questionnaires and pain history were used to gather clinical and epidemiological data in 105 subjects presenting with occipital neuralgia and craniomandibular disorders. The experimental subgroup was compared with two control subgroups: Tension-type headache + Craniomandibular Disorders no occipital neuralgia and No Tension-type headache no occipial neuralgia and no CMDs........

Key words - Occipital Neuralgia Craniomandibular Disorders Paraesthesia Pain Fifth Cranial Nerve

[1]. Molina OF, Simião BR, Hassumi MY, Rank RC, Junior FF, de Carvalho A. Headaches and pain referred to the teeth: frequency and potential neurophysiologic mechanisms. RSBO 2015; 12: 1-9
[2]. Choi I, Jeong SR. Neuralgias of the head: Occipital neuralgia. JKMS 2016; 31: 479-88.
[3]. Barna S, Hashmi M. Occipital neuralgia. Pain Management Rounds 2004; 1: 1-6.
[4]. Mohammadi Z. Endodontics-related paraesthesia of the mental and inferior alveolar nerves: An updated review. JCDA2010; 76: 116-20.
[5]. Sharif-Alhoseini M, Rahimi-Movaghar V, Vaccaro AR. Underlying causes of paresthesia. Intech 2012; February: 71-90

Abstract: Introduction: Severe or destructive bruxing behavior being diurnal, nocturnal or mixed is a significant problem and a challenge regarding both, restorative dentistry and pharmacological intervention. Aim:Evaluate past and current use of medication in destructive bruxers, test the hypothesis that they have a history of greater use of antidepressants and anti-anxiety medication. Methods: Clinical examination, use of self-reported questionnaires, history of chief complaint and data collection about past present use of medication in 41 subjects with both craniomandibular disorders and destructive bruxing behavior.......

Keywords: Destructive bruxism CraniomandibularDisorders Medication Anti-anxiety Drugs Antidepressants.

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