iosr-JDMS   Volume-19 ~ Issue-12 ~ December 2020

Abstract: A 69-year-old male with past history of bilateral inguinal mesh hernioplasty and left sided mesh removal presented in emergency with intestinal obstruction. On index laparotomy,resection anastomosis of stricturous part of ileum was done. A relaparotomy for acute generalized peritonitis due to anastomotic leak was done and Reanastomosis with proximal diverting jejunostomy was fashioned. Post operatively the patient developed high output high intestinal stoma which was managed with aggressive TPN and early restoration of bowel continuity.Post operatively the patient developed low output controlled enterocutaneous fistula which closed spontaneously after 2 months..

Key words: jejunostomy, anastomotic leak, high output stoma

[1]. Irene Silberstein; Rolando Rolandelli. Suturing, Stapling and Tissue adhesives. Shackelford's Surgery of the alimentary tract vol.1, pg. 921.
[2]. D. Aniruthan, AmudaRavichandar, PranaviGubbi,Shamanna, SreenathVikramKate. Efficacy of single layered intestinal anastomosis over double layered intestinal anastomosis-an open labelled, randomized controlled trial.International Journal of SurgeryVolume 78, June 2020, Pages 173-178https://doi.org/10.1016/j.ijsu.2020.04.066
[3]. Irene Silberstein; Rolando Rolandelli. Suturing, Stapling and Tissue adhesives. Shackelford's Surgery of the alimentary tract vol.1, pg. 920.
[4]. Vicky S.Budipramana, Putu AyuSaraswati. BISHOP–KOOP modification technique following proximal jejunal anastomosis: A case report. Annals of Medicine and Surgery 56(2020) 121-124 https://doi.org/10.1016/j.amsu.2020.06.027

Abstract: Severe atrophy of residual alveolar ridges poses a serious clinical challenge forsuccessful prosthodontic rehabilitation. Increased inter-ridge space due to resorption of alveolar ridges results in fabrication of heavy complete dentures.Heavier dentures exert continuous pressure upon the residual ridges even at rest and cause accelerated resorption of the residual ridges.This article presents a new technique for fabricating hollow mandibular denture for a completely edentulous patient with severe mandibular ridgeresorption.Fabrication of hollow dentures which is of light weight aids in preservation of the existing residual alveolar ridge. The technique used for fabrication of hollow denture overcomes the disadvantages of other methods.

Key Word: Complete denture, Hollow mandibular denture, Severly resorbed ridges

[1]. Bhat AM. A hollow complete denture for severely resorbed mandibular ridges. The Journal of Indian Prosthodontic Society. 2006 Jul 1;6(3):157. [2]. Aggarwal H, Jurel SK, Singh RD, Chand P, Kumar P. Lost salt technique for severely resorbed alveolar ridges: An innovative approach. Contemporary clinical dentistry. 2012 Jul;3(3):352. [3]. Caculo SP, Aras MA, Chitre V. Hollow dentures: Treatment option for atrophic ridges. A clinical report. Journal of Prosthodontics: Implant, Esthetic and Reconstructive Dentistry. 2013 Apr;22(3):217-22. [4]. Shetty V, Gali S, Ravindran S. Light weight maxillary complete denture: A case report using a simplified technique with thermocol. Journal of Interdisciplinary Dentistry. 2011 Jan 1;1(1):45.
[5]. O'Sullivan M, Hansen N, Cronin RJ, Cagna DR. The hollow maxillary complete denture: A modified technique. The Journal of prosthetic dentistry. 2004 Jun 1;91(6):591-4.

Abstract: Background: Scorpion stings, though not a big problem in many developed countries, it is a major public health problem in underdeveloped and in some developing countries all over the world. In India, many people are stung by the red scorpion (Mesobuthus tamulus) with recorded fatalities in both adults and children. Scorpion sting is considered as a life threatening medical emergency of villagers in India. Numerous envenomations go unreported. Hence, true incidence is frequently unavailable. Among the eighty six scorpion species in India, Mesobuthus tamulus and Palamneus swammwe-dami are of medical importance. Aims and Objectives: To study the clinical spectrum and electrocardiographic changes in scorpion sting envenomation.......

Key words: scorpion sting envenomation, ECG abnormality, Sinus tachycardia

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[4]. Santhanakrishnan BR, et al : Cardiovascular manifestations of scorpion sting in children. Indian Pediatr 1977;15:353-356.
[5]. Handergal NH, Malleraja Gowda K, Ramnath TE, Ramesh Babu KA: A clinical study of one hundred cases of scorpion sting. J Assoc Phys India 1986;34:27-40..

Abstract: Background: Ulcerative conditions are common and are observed in almost 25% of the younger generations including children and young adults, which requires profound attention. Among the available topical therapeutics in treatment of oral ulceration is pure nicotine. It is an alkaloid derived and found in the Solanaceae plants and exerts its effects through suppression of inflammatory pathway. The therapeutic role of pure nicotine on regression of oral ulcers has been studied and showed effectiveness in reducing pain and ulcer erythema. The most appropriate channel for delivering local drug therapy to the oral cavity seems to be gel based topical formulations. Pentoxifylline is an anti-inflammatory xanthine derivative that has been approved nowadays for peripheral arterial disease therapy, moreover it exhibits an anti-tumor necrosis factor (TNF)-α effect, reverses fibroblast proliferation and may act to decrease the oral ulcers pain and duration.
Materials and Methods: Thirty six male.....

Key Word: Ulcer;Pure nicotine; Pentoxiphylline; Keratinization; Anti-Inflammatory

[1]. Kuriyama Y, Shimizu A, Toki S et al: Two cases of chronic oral ulcers effectively treated with systemic corticosteroid therapy: Circumorificialplasmacytosis and traumatic ulcerative granuloma with stromal eosinophilia. Journal of Dermatology 2019; 46: 48–51.
[2]. Jin X, Wang Y, Zhang X, et al: Gene mapping and functional annotation of GWAS of oral ulcers using FUMA software. Scientific reports. 2020; 10:12205.
[3]. Motamedi MR, Golestannejad Z. Use of pure nicotine for the treatment of aphthous ulcers. Dent Res J. 2015 Mar-Apr; 12 (2):197-8.[4]. Mai Zakaria, and Aliaa El-Meshad: Clinical efficacy of nicotine replacement therapy in the treatment of minor recurrent aphthous stomatitis. J Arab Soc Med Res. 2018; 13:106–112.
[5]. Wei Xiong Wen, Siang Yin Lee, RafaellaSiang, RhunYianKoh. Repurposing Pentoxifylline for the Treatment of Fibrosis: An Overview. AdvTher .2017;34: 1245–1269..

Abstract: Background: Breast cancer is the fifth common cause of cancer deaths and one of the most common causes of cancer death in women. Among imaging techniques mammography (MG) helps in diagnosing asymmetry, neo-density and distortion of fibro-glandular architecture where ultrasonography(USG) plays a key role in differentiating cystic and solid masses. The present study evaluated palpable breast masses using mammography and ultrasound. Aim of the study:The aim of this study was to assess theaccuracy of combined mammographic and sonographic evaluation of breast mass than of either used one. Methods:This was a descriptive.....

Keywords: Breast cancer, Mammography, Sonography. Evaluation

[1]. Clarke D, Sudhakaran N, Gateley CA. Replace fine needle aspiration cytology with automated core biopsy in the triple assessment of breast cancer. Ann R CollSurg Engl. 2001;83 (2):110-2.
[2]. Taori K, Dhakate S, Rathod J, Hatgaonkar A, DisawalA,Wavare P et al. Evaluation of breast masses using mammography and sonography as first line of investigation.OJMI 2013;3:40-9.
[3]. Parkin DM, Bray F, Ferlay J, Pisani P. Estimating the world cancer burden: Globocan 2000. Int J Cancer. 2001;94 (2):153-6.
[4]. Wendie A. Berg, MD, PhD, Lorena Gutierrez, MD, Moriel S. NessAiver, PhD, W. Bradford Carter, MD2, MythreyiBhargavan, PhD, Rebecca S. Lewis, MPH and Olga B. Ioffe, MD Diagnostic Accuracy of mammography, Clinical Examination, US, and MR Imaging in Preoperative Assessment of Breast Cancer1 radiology. rsnajnls.org/cgi/content/abstract/233/3/830
[5]. Kerlikowske K, Smith-Bindman R, Ljung BM, Grady D. Ann Intern Med. 2003 Aug 19; 139(4): 274–84. Evaluation of abnormal mam- mography results and palpable breast abnormalities. Ann Intern Med. 2003 Aug 19; 139(4): 274–84.

Abstract: Introduction: Increased production of reactive oxygen species (ROS) and down regulation of the endogenous antioxidant response can cause increased incidence of atherosclerosis. Formation of atherosclerosis is strongly associated with chronic oxidative stress. Antioxidants can stabilize free radicals before they attack cells. For maintenance of optimal cellular and systemic health and well-being antioxidants are absolutely necessary. Our study has been done to see the effect of ethanolic extract of leaves of Averrhoea carambola L. (EELAC) on serum antioxidant level in RABBITS which are receiving high fat diet Result: In our study we have observed.....

Keyword: antioxidant, Averrhoea Carambola L, ethanolic extract

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[2]. Wu MY, Li CJ, Hou MF, Chu PY. New insights into the role of inflammation in the pathogenesis of atherosclerosis. International journal of molecular sciences (Int.J. Mol. Sci.). 2017 Sep 22; 18(10):2034.
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[5]. Dasgupta P, Chakraborty P, Bala NN. Averrhoa carambola: an updated review.International Journal of Pharma Research & Review. 2013 Jul; 2(7):54-63.

Abstract: Meckel's diverticulum first described in 1808,develops due to the failure of obliteration of vitelline duct. It commonly occurs in 2 per cent of the population 2 inches in length,2 feet from the ileocecal valveand two times more common in men than women. It is true diverticulum with all layers of Ileum present on the antimesenteric border. .About 60% of Meckel's diverticulum contain heterotopic mucosa of which more than 60% found to be gastric mucosa, other tissues are pancreatic, colonic etc. Majority of Meckel's diverticula are asymptomatic, often diagnosed incidentally on imaging and laparotomy or laparoscopy for other conditions. The total lifetime complication is 4%. The known complications are inflammation.....

[1]. Menezes M, Tareen F, Saeed A, Khan N, Puri P. Symptomatic Meckel's diverticulum in children: a 16-year review. Pediatr Surg Int. 2008;24:575–577. doi: 10.1007/s00383-007-2094-4. [PubMed] [CrossRef] [Google Scholar] [2]. Kusumoto H, Yoshida M, Takahashi I, Anai H, Maehara Y, Sugimachi K. Complications and diagnosis of Meckel's diverticulum in 776 patients. Am J Surg. 1992;164:382–383. doi: 10.1016/S0002-9610(05)80909-2. [PubMed] [CrossRef] [Google Scholar] [3]. Sai Prasad TR, Chui CH, Singaporewella FR, Ong CPC, Low Y, Yap TL, Jacobsen AS. Meckel's diverticular complications in children: is laparoscopy the order of the day? Pediatr Surg Int. 2007;23:141–147. doi: 10.1007/s00383-006-1844-z. [PubMed] [CrossRef] [Google Scholar] [4]. Ueberruek T, Meyer L, Koch A, Hinkel M, Kube R, Gastinger I. The significance of Meckel's diverticulum in appendicitis—a retrospective analysis of 233 cases. World J Surg. 2005;29:455–458. doi: 10.1007/s00268-004-7615-x [5]. . [PubMed] [CrossRef] [Google Scholar].

Abstract: Background & Objectives: Like other organs, lung is also affected in diabetes mellitus due to the presence of extensive microvasculature and abundant connective tissue. (6,7) Early detection of pulmonary changes in diabetic patients through routine Pulmonary function testing(PFT) check-up may help in planning strategies to delay the progression of cardio-respiratory complications. The objective of this study was to compare the PFT parameters FVC, FEV1& PEFR recorded in the study participants with the duration of diabetes mellitus, as early as the time of its diagnosis and observe the pattern of its change with increase in its duration. Methods: 60 male patients with Type-2 diabetes.....

Keyword: Pulmonary function testing, FEV1, FVC, PEFR, diabetes mellitus duration,

[1]. Albert KGMM, Zimmet PZ for the WHO Consultation. Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus. Provisional report of a WHO consultation. Diabetic Medicine 1998; 15:539-553.
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Abstract: Background: Patients suffering from various critical illness admitted to the Intensive Care Unit (ICU) exhibit alterations in their thyroid hormone levels, collectively termed as "EUTHYROID SICK SYNDROME" or "NON THYROIDAL ILLNESS SYNDROME (NTIS). "It is characterized by low serum levels of free and total triiodothyronine (T3) and high levels of reverse T3 (rT3) accompanied by normal or low levels of thyroxine (T4) and thyroid-stimulating hormone (TSH). NTIS is caused because of alterations in the regulation of H-P-T AXIS and thyroid hormone transport and peripheral metabolism which are thought to be influenced by various inflammatory mediators released in critical care patients secondary to the underlying non-thyroidal illness. Our study was undertaken to determine the correlation between these altered thyroid hormone levels and outcomes in critical care patients....

Keyword: Intensive care unit, critical illness, Total T3, Total T4, TSH

[1]. Rothwell PM, Udwadia ZF, Lawler PG. Thyrotropin concentration predicts outcome in critical illness. Anaesthesia. 1993 May;48(5):373-6.
[2]. Docter R, Krenning EP, de Jong M, Hennemann G. The sick euthyroid syndrome: changes in thyroid hormone serum parameters and hormone metabolism. Clinical endocrinology. 1993 Nov;39(5):499-518.
[3]. De Groot LJ. Dangerous dogmas in medicine: the non-thyroidal illness syndrome. J clinical endocrinology and metabolism. 1999 Jan;84(1):151-64.
[4]. Bello G, Pennisi MA, Montini L, Silva S, Maviglia R, Cavallaro F, et al. Non-thyroidal illness syndrome and prolonged mechanical ventilation in patients admitted to the ICU. Chest. 2009 Jun;135(6):1448-54.
[5]. Kumar KV, Kapoor U, Kalia R, Chandra NS, Singh P, Nangia R. Low triiodothyronine predicts mortality in critically ill patients. Ind J Endocrinol Meta. 2013 Mar;17(2):285-8.

Abstract: Background: Fibroadenoma is the most common benign tumor of the female breast. It is a new growth composed of both fibrous and glandular tissue occurring commonly in young women before the age of 30, and probably caused by hormonal imbalance. Detailed characterizations of their sonographic appearances are necessary for differential diagnosis from other benign lesions or breast cancer. The main objective of this study was to characterize breast fibroadenomas using ultrasonography. Materials and Methods:A cross sectional descriptive study was conducted at Mohammed Aldossary Hospital K.S.A within 3 months (October-December 2019) through evaluation of 82 breast fibroadenoma female patient who were scanned by ultrasound machines (ACUSONX300 and Vuluson E6) with high frequency transducer7-18MHZ.....

Keyword: Fibroadenoma; echogenicity;echotechure; BIRADS.

[1]. Ajmal, M. and K. Van Fossen (2018). "Breast fibroadenoma."[1]
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[3]. Bevers, T. B., et al. (2018). "Breast cancer screening and diagnosis, version 3.2018, NCCN clinical practice guidelines in oncology." Journal of the National Comprehensive Cancer Network16(11): 1362-1389.
[4]. Bland, K. I. (2020). Topographic Anatomical Relationships of the Breast, Chest Wall, Axilla, and Related Sites of Metastases. Oncoplastic Breast Surgery Techniques for the General Surgeon, Springer: 35-69.
[5]. Braihi, A. J., et al. (2017). "Study the Possibility of Using an Elastomeric Blend as a Plastic Interfacial media in Ultrasonic Transducers." Journal of University of Babylon25(1): 202-211.

Abstract: Background: High skull uptake has a pivotal role in differentiation between normal and abnormal skeletal pathologies (cancer metastasis), is frequently seen in bone scan of some patients especiallyin females. The aim of this study was to evaluate a diffusely high skull uptake in breast and prostate cancer patients using bone Scintigraphy. Material and Method: Descriptive, cross sectional study has been applied at Khartoum Oncology Hospital, for total of (100) adult patients of breast and prostate cancer with normal bone scans(39 male and 61female),the patients were divided into 8 age groups(20-29,30-39,40-49,50-59,60-69,70-79,80-89,90 and above).The data collected using master data collection sheet, image were processing for the calculation of Skull uptake. The data analyzed using statistical package for social sciences program.....

Keyword: Bone scan; skull uptake; cancer; age; methylendiphosphonate

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Abstract: Gastrointestinal stromal tumor (GIST) is an uncommon mesenchymal tumor which arise mostly from the gastrointestinal tract. It accounts for 0.1-0.3% of all gastrointestinal neoplasm. The term GIST was first used in 1983 by Mazur and Clark to encompass gastrointestinal nonepithelial neoplasm that lacked the immunohistochemical features of schwann cells and did not have the ultrastructural characteristic of smooth muscle cells. The tumors arise from intestinal cells of cajal(ICC) which serve as a gut pacemaker as they create the basal electrical rhythm leading to peristalsis and segmentation of the smooth muscle. The most common site of GISTs occur in the stomach(50-60%), followed by small intestine(30-40%). The other rare site are colorectal, esophagus,mesentery, retroperitoneum and omentum. GISTs can arise at any age, but occur predominantly in the middle age or elderly individual with peak incidence in fifth and sixth decades of life. More then 80% GISTs are reported in individuals older than 50 years.

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