iosr-JDMS   Volume-19 ~ Issue-2 ~ February 2020

Abstract: Background: Supracondylar fractures of the humerus is the second most common fracture in children and accounts for about 60-75% of all fractures about the elbow in children. Management of such displaced fractures is challenging even with various options to choose from. In this study we present our findings of management of displaced supracondylar fractures of humerus by open reduction and crossed K-wire fixation with the medial approach with special emphasis on ulnar nerve injury, anatomical reduction and long term outcome. Materials and Methods: From October 2011 to March 2013, fresh, closed, displaced (Gartland's type III) supracondylar humerus fractures in children aged between 3-14 years were managed by open reduction and crossed K-wire fixation with the medial approach under general anaesthesia. Patients were followed up for a minimum period of three years. Results were......

Key Word: Supracondylar, displaced-fracture, medial-approach, humerus

[1]. Cheng JC, Shen WY. Limb fracture pattern in different pediatric age groups: a study of 3350 children. J Orthop Trauma 1993; 7: 15-22.
[2]. Gartland JJ. Management of supracondylar fractures of the humerus in children. Surg Gynecol Obstet 1959; 109:145-154.
[3]. Vaidya SV. Supracondylar Humerus Fractures in Children: Epidemiology and Changing Trends of Presentation. International Journal of Paediatric Orthopaedics July-Sep 2015 1(1):3-5.
[4]. Slobogean BL, Jackman H, Tennant S, Slobogean GP, Mulpuri K. Iatrogenic ulnar nerve injury after the surgical treatment of displaced supracondylar fractures of the humerus: number needed to harm, a systematic review. J Pediatr Orthop 2010; 30(5):430-6.
[5]. Lyons, James P. M.D.; Ashley, Edwin M.D.; Hoffer, M. Mark M.D. Ulnar Nerve Palsies After Percutaneous Cross-Pinning of Supracondylar Fractures in Children's Elbows. J Pediatr Orthop.1998:18, 43-45.

Abstract: Introduction: Although nasopharyngeal carcinoma (NPC) is rare in many parts of the world, it is endemic in certain regions, especially in Southeast AsiaParticularly Bangladesh. Radiotherapy is the mainstay treatment for NPC. In recent years, IMRT has gradually replaced conventional radiation therapy as the main radiotherapy technology used to treat NPC.Objective: The aim of this study was to explore the patterns of retropharyngeal lymph node (RLN) metastasis innasopharyngeal carcinoma (NPC) and their impact on the clinical target volume (CTV) delineation in radiotherapy. Methods: A total of 190 patients with untreated, nonmetastatic NPC received MRI scans of the nasopharynx and neck before treatment at the Department of Oncology, Enam Medical College.....

Keywords: Nasopharyngeal Carcinoma (NPC), Retropharyngeal Lymph Node (RLN), Radiation Therapy, Clinical Target Volume (CTV).

[1]. Dirix P, Nuyts S. Evidence-based organ-sparing radiotherapy in head and neck cancer [J]. Lancet Oncology, 2010, 11 (1): 85-91.
[2]. Feng F Y, Kim H M, Lyden T H, et al. Intensity-modulated chemoradiotherapy aiming to reduce dysphagia in patients with oropharyngeal cancer: clinical and functional results. [J]. Journal of Clinical Oncology Official Journal of the American Society of Clinical Oncology, 2010, 28 (16): 2732.
[3]. Feng F Y, Kim H M, Lyden T H, et al. Intensity-modulated radiotherapy of head and neck cancer aiming to reduce dysphagia: early dose-effect relationships for the swallowing structures. [J]. Int J Radiat Oncol Biol Phys, 2007, 68 (5): 1289-1298.
[4]. Wang X S, Yan C, Hu C S, et al. Study of the medial group retropharyngeal node metastasis from nasopharyngeal carcinoma based on 3100 newly diagnosed cases [J]. Oral Oncol, 2014, 50 (11): 1109-1113.
[5]. Tang L, Mao Y, Liu L, et al. The volume to be irradiated during selective neck irradiation in nasopharyngeal carcinoma: analysis of the spread patterns in lymph nodes by magnetic resonance imaging. [J]. Cancer, 2009, 115 (3): 680-688..

Abstract: Background:Iatrogenic vascular injuries are uncommon during the course of proximal femur surgical procedures. We report the case of an 28-year-old male presenting with an SUBTROCHANTERIC fracture, treated by anterograde intramedullary nailing and complicated by a superficial femoral artery laceration at the level of the distal locking screw. Intraoperatively,gush of blood following distal cortical screw drilling, followed by thigh swelling 2minutes after distal locking. No perioperative & postoperative blood pressure drop or heart rhythm. Postoperative Dorsalispedis, tibialis pulse & Popliteal pulse were not felt but femoral pulse was felt.Immediate Doppler study done revealed no flow beyond.....

Key Words:Proximal femoral fracture,subtrochantericfracture,Intramedullarynailing,Vascular injury

[1]. Okcu G, Ozkayin N, Erkan S et al: Should full threaded compression screws be used in adult femoral neck fractures? Injury, 2015; 46(Suppl. 2) S24–28.
[2]. Haubro M, Stougaard C, Torfing T, Overgaard S: Sensitivity and specificity of CT- and MRI-scanning in evaluation of occult fracture of the proximal femur. Injury, 2015; 46(8): 1557–61.
[3]. Bartonicek J: [Injuries to femoral vessels in fractures of the hip]. RozhlChir, 2009; 88(4): 203–5 [in Czech].
[4]. Patelis N, Koutsoumpelis A, Papoutsis K, et al. Iatrogenic injury of profundafemoris artery branches after intertrochanteric hip screw fixation for intertrochanteric femoral fracture: a case report and literature review. Case Rep Vasc Med. 2014; 2014:694235.
[5]. Yang KH, Yoon CS, Park HW et al: Position of the superficial femoral artery in closed hip nailing. Arch Orthop Trauma Surg, 2004; 124(3): 169–72 ..

Abstract: To study the relationship between student attendance and examination performance in theory. Study design: A retrospective observational study. The students who appeared for 2nd year MBBSwere included in the study. Their attendance was compared with the marks they secured in the final examination. Materials and method: The students who appeared for 2nd year MBBSwere included in the study. 197 students were included in the study, their attendance was compared with the marks they secured in the final examination. Data was collected from Department of Pharmacology, Andhra Medical College, Visakhapatnam.Statistical analysis was performed using independent t-test.....

Keywords: Attendance; Academic performance; Pharmacology

[1]. Chilwant KS, Hundekari JC. Effect of class attendance on performance in 2nd yearmedical students. IOSR J Res Method Educ. 2013;3(3):31-3.
[2]. Jain V, Agrawal V, Biswas S, Varshney A. Impact of attendance in lectures and formativeassessments on students' performance in summative assessment. Natl J Med Dent Res.2013;1(4):24-8.
[3]. Dashputra A, Kulkarni M, Chari S, Date A. Medical student's absenteeism in class:Reasons and remedies. J Educ Res Stud. 2015;3(1):24-9.
[4]. Saeed AA, Al-Otaibi MS, Al-Ziyadib HG, Babsail AA, Shaik SA. Association betweenstudent absenteeism at a medical college and their academic grades. JIAMSE.2009;19(4):155-9.
[5]. Yusoff MS. Association of academic performance and absenteeism among medicalstudents. Educ Med J. 2014;6(1):40-4.

Abstract: Gestational gigantomastia (GG) is a very rare type of gigantomastia, occurring during pregnancy. Less than 100 cases have been reported in literature till date. Here we are reporting a 25-years old female secondgravida, Presenting as gigantomastia in the 2nd trimester. She noticed sudden enlargement of bilateral breast in her 26th week of gestation. (LMP: 6 Apr 2018) G2P1+0+0+1.This enlargement started at 12 weeks of gestation and continued to increase rapidly as the pregnancy progressed and complicated by infection, skin atrophy, marked venous engorgement, ulcerations, necrosis and subsequent hemorrhage. On examination, both breasts were extremely enlarged & she was not able to walk or even sit up properly. Hormonal studies were found to be within the normal range......

[1]. Zingaretti N, De Biasio F, Riccio M, Nardini N, Mariuzzi L, Parodi PC. A case of gestational gigantomastia in a 37-years-old woman associated with elevated ANA: a casual linkage?. The Pan African medical journal. 2017;27.
[2]. Lewison EF, Jones GS, Trimble FH, da lima LC. Gigantomastia complicating pregnancy. Obstetrical & Gynecological Survey. 1960 Jun 1;15(3):338-40.
[3]. Bukhari SS, Manan H, Khan MM, Raza SS. Resolution of gestational gigantomastia with termination of pregnancy. Journal of Ayub Medical College Abbottabad. 2018 May 27;30(2):298-300.
[4]. Palmuth T. Observations Medicuarum Centinae Tres Posthumae. Braunschweig; Cent II, Obs 1684:89.
[5]. Simpson BS. Notes on a case of diffuse hypertrophy of the breasts. Edinburgh Med. 1920;24:176-179.

Abstract: Background & Objectives: Direct laryngoscopy and endotracheal intubation always trigger powerful cardiovascular responses. It may be well tolerated in healthy people, but may be hazardous in patients with hypertension, tachycardia, myocardial infarction, and other complications.Various attempts have been made to attenuate these responses. The present study has been undertaken to make a comparative study of both drugs Dexmedetomidine and Magnesium Sulphate in attenuating the haemodynamic changes during laryngoscopy and tracheal intubation. Methods: After IEC approval, a prospective, randomized, double blinded study was conducted on 120ASA I and II adult patients undergoing.....

Keywords: Dexmedetomidine, Magnesium sulphate, Laryngoscopy, Intubation, Haemodynamics

[1]. Savio KH, Tait G, Karkouti K, Wijeysundera D, McCluskey S, Beattie WS. The safety of perioperative esmolol: A systematic review and meta-analysis of randomized controlled trials. AnesthAnalg. 2011;112:267–81.
[2]. Gupta A, Wakhloo R, Gupta V, Mehta A, Kapoor BB. Comparison of Esmolol and Lignocaine for attenuation of cardiovascular stress response to laryngoscopy and endotracheal intubation. JK Science. 2009;11:78–81.
[3]. Manjunath HG, Venkatesh GS, Prima V, Jennifer LV, Sathees BC. Can calcium and sodium channel blockers attenuate hemodynamic responses to endotracheal intubation? Eur J Gen Med. 2008;5:198–207.
[4]. Kovac AL. Controlling the hemodynamic response to laryngoscopy and endotracheal intubation. J ClinAnesth 1996; 8 (1): 63- 79
[5]. Yuen VM, Irwin MG, Hui TW, Yuen MK, Lee LH. A double-blind, crossover assessment of the sedative and analgesic effects of intranasal dexmedetomidine. AnesthAnalg. 2007;105:374–80.

Abstract: Introduction: Deep neck space infections (DNSI) are serious diseases that involve several spaces in the neck. The common primary sources of DNSI are dental infections, tonsillar and salivary gland infections, malignancies, and foreign bodies. With widespread use of antibiotics, the prevalence of DNSI has been reduced. Common complications of DNSI include airway obstruction, jugular vein thrombosis, and sepsis. Treatment principally comprises airway management, antibiotic therapy, and surgical intervention. This study was conducted to investigate the age and sex distribution of patients, symptoms, presentation, sites involved, bacteriology, and management and complications of DNSI.

Key Word: Deep neck space neck(DNSI),comorbidities,odontogenic, septicaemia

[1]. J NK, Greeshma SG and. A Study on Deep Neck Space Infections. Otolaryngology Online Journal [Internet]. 2017 [cited 2020 Feb 7]; Available from: abstract/a-study-on-deep-neck-space-infections-9140.html
[2]. Sethi DS, Stanley RE. Deep neck abscesses – changing trends. The Journal of Laryngology & Otology. 1994 Feb;108(2):138–43.
[3]. Deep Neck Abscess: A Prospective Study of 54 Cases - PubMed [Internet]. [cited 2020 Feb 7]. Available from: https://pubmed.ncbi.nlm.nih.gov/15949085-deep-neck-abscess-a-prospective-study-of-54-cases/
[4]. Huang T-T, Liu T-C, Chen P-R, Tseng F-Y, Yeh T-H, Chen Y-S. Deep neck infection: analysis of 185 cases. Head Neck. 2004 Oct;26(10):854–60.
[5]. Parhiscar A, Har-El G. Deep neck abscess: a retrospective review of 210 cases. Ann Otol Rhinol Laryngol. 2001 Nov;110(11):1051–4..

Abstract: Oral mucosal lesion (OML) is known as any abnormal alteration in color, surface aspect, swelling, or loss of integrity of the oral mucosal surface(1). Although a proportion of OMLs are benign and require no active treatment, some may present with significant pathology. Of particular importance are oral potentially malignant disorders which may progress into malignancies(2). Besides, OMLs can interfere with daily quality of life in affected patients through impact on mastication, swallowing, and speech with symptoms of burning, irritation, and pain. OMLs have many etiologies as bacterial or viral or fungal infections, local trauma or irritation, systemic diseases, and excessive consumption of tobacco, betel quid, and alcohol(3).Oral malignancies collectively form the sixth most common type of cancer in the world(4). The Indian subcontinent has long been regarded as the epicentre of oral cancer.....

[1]. dickwell SM, Schimelpfening S, Palinkas LA. ′Betelmania′. Betel quid chewing by Cambodian women in the United States and its potential health effects. West J Med 1994;160:326-30.
[2]. van der Waal I. Potentially malignant disorders of the oral and oropharyngeal mucosa; terminology, classification and present concepts of management. Oral Oncol 2009;45:317-23.
[3]. Chiba I. Prevention of betel quid chewers′ oral cancer in the Asian-Pacific area. Asian Pac J Cancer Prev2001;2:263-9.
[4]. Hazarey VK, Erlewad DM, Mundhe KA, Ughade SN. Oral submucous fibrosis: Study of 1000 cases from central India. J Oral Pathol Med 2007;36:12-7.
[5]. Gupta PC, Ray CS. Smokeless tobacco and health in India and South Asia. Respirology2003;8:419-31.

Abstract: Background & Objectives: Spinal anaesthesia is a popular technique for providing anaesthesia for lower limb and infraumblical surgeries. Intrathecaladjuvant is given along with local anaesthesia to prolong duration of block. Intrathecal administration of dexmedetomidine and magnesium sulphate is known to enhance duration of block without causing significant side effect. The purpose of this study was to assess the impact of intrathecaldexmedetomidine and magnesium sulfate on the onset and duration of spinal anaesthesia using bupivacaine......

Keywords: Spinal Anaesthesia; Bupivacaine; Dexmedetomidine; Magnesium sulfate; Infraumblical surgery

[1]. Elin RJ. Magnesium: the fifth but forgotten electrolyte. Am J ClinPathol 1994; 102: 616±22
[2]. Altura BM. Importance of Mg in physiology and medicine and the need for ion selective electrodes. Scand J Clin Lab Invest 1994; 217: 5–9
[3]. Iseri LT, French JH. Magnesium: nature's physiological calcium blocker. Am Heart J 1984; 108:
[4]. Elin RJ. Assessment of magnesium status.ClinChem 1987; 33: 1965±70
[5]. Ebel H, Gunther T. Magnesium metabolism: a review. J ClinChemClinBiochem 18: 257–270, 1980.

Abstract: Purpose: Toanalyse quantitative assessment of Non-Diabetic Macular Oedema after various treatment modalities. Methods: A prospective observational study was carried on 27 eyes of 23 patients.
Results: Vascular occlusion cases treated with intravitreal anti VEGF injection (p=0.0005) and shown significant reduction inCFT between baseline and at 3 months, but there was no significant reduction with anti- VEGF followed by laser(p=0.2287) and laser alone(p=0.2007).Vascular occlusion cases treated with intravitreal anti VEGF injection, shown significant improvement in BCVA between baseline and 3rd months(p=0.0493) but there was no significant improvement with anti VEGF followed by laser(p=0.29) and laser alone(p=1). one female patient was having macular oedema due to CRVO treated with intravitreal anti-VEGF followed by dexamethasone......

Keywords: OCT, Macular Oedema, CRVO, ARMD, Anti -VEGF

[1]. Hayreh SS, Zimmerman MB, Podhajsky P. Incidence of various types of retinal vein occlusion and their recurrence and demographic characteristics. Am J Ophthalmol. 1994;117:429-441.
[2]. Hatz K, Martinez M. Retinal vein occlusion: an interdisciplinary approach. TherUmsch. 2016;73:85-89.
[3]. Rogers S, McIntosh RL, Cheung N, et al. International eye disease consortium: the prevalence of retinal vein occlusion: pooled data frompopulationstudies from theUnitedStates, Europe,Asia,andAustralia.Ophthalmology. 2010;117:313-319.
[4]. Wong TY, Scott IU. Retinal- vein occlusion. N Engl J Med. 2010;363:2135-2144.
[5]. Finkelstein D. Argon laser photocoagulation for macular edema in branch vein occlusion. Ophthalmology 1986;93:975–7.

Abstract: Purpose: Toanalyse quantitative assessment of Diabetic Macular Oedema after various treatment modalities. Methods: A prospective observational study was carried on 53 eyes of 34 patients. Results: DME cases treated with intravitreal anti-VEGF injection(p=0.0066) and intravitreal anti VEGF followed by laser(p=0.0001)revealed significant reduction in CFT between baseline and 3 months, but there was no significant reduction in CFT between baseline and 3 months with laser alone(p=0.6392), intravitreal dexamethasone implant(p=0.1562) and conservative treatment(p=0.63). DME cases treated with intravitreal anti-VEGF injection(p=0.0216) and intravitreal anti-VEGF followed by laser(p=0.002) shown significant improvement in BCVA between baseline and last follow up , but there was no significant improvement in BCVA between baseline......

Keywords: OCT, Diabetic Macular Oedema, Anti -VEGF, DME.

[1]. Coscas G, Cunha-VazJ,Soubrane G: Macular oedema; definition and basic concepts. Dev Ophthalmol. 201047;1-9. Doi: 10.1159/000320070. Epub 2010 Aug 10.
[2]. The Diabetes Control and Complications Trial Research Group. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med 1993;329(14):977–86.
[3]. Stefansson E et al. Screening and prevention of diabetic blindness. Acta Ophthalmol Scand. 2000;78(4):374-85.
[4]. Klein R et al. The Wisconsin epidemiologic study of diabetic retinopathy. IV. Diabetic macular edema. Ophthalmology. 1984;91(12):1464-74.
[5]. Klein R et al. The Wisconsin Epidemiologic Study of Diabetic Retinopathy. XV. The long-term incidence of macular edema. Ophthalmology. 1995;102(1):7-16..

Abstract: Background: The field of soft tissue tumors (STT) is enormously vast and yet as cytologically relatively undiscovered. They pose a significant diagnostic challenge due to their morphologic overlap and biological heterogeneity. These tumors are composed of neoplastic cells admixed with entrapped cells of local host tissue which can lead to errors of interpretation .FNAC has been identified as a useful diagnostic technique in the initial diagnosis of STT. Due to absence of tissue architecture in FNAC smears it may be very difficult to categorize these lesions exactly. The current study was undertaken to explore the utility of FNAC in STT. Materials And Methods: This is a retrospective study conducted in department of Pathology from January 2017 to June 2019......

Keywords: FNAC, Soft tissue tumors

[1]. M. Akerman and H. Domanski, "Soft tissues," in Orell andSterrett's Fine Needle Aspiration Cytology, S. R. Orell and G. F.Sterrett, Eds., pp. 387–400, Churchill Livingstone, Edinburgh,Scotland, 5th edition, 2012.
[2]. Bharat Rekhi, Biru D Gorad, Anagha C Kakade and RF Chinoy. Scope of FNAC in the diagnosis of soft tissue tumors-A study from a tertiary cancer referral center in India. CytoJournal 2007, 4:20.
[3]. P. Dey, M. K. Mallik, S. K. Gupta and R. K. Vasishta. Role of fine needle aspiration cytology in the diagnosis of soft tissue tumours and tumour-like lesions. Cytopathology 2004, 15, 32–37.
[4]. Priyanka Bhatia Soni,Anand Kumar Verma,Raj Kumar Chandoke,and Jitendra Singh Nigam. A Prospective Study of Soft Tissue Tumors Histocytopathology Correlation
[5]. Henryk A. Domanski. Fine-Needle Aspiration Cytology of Soft Tissue Lesions:Diagnostic Challenges. Diagnostic Cytopathology, Vol 35, No 12