iosr-JDMS   Volume-6 ~ Issue-2

Abstract:Protein-energy malnutrition (PEM) is a common condition among patients admitted to hospitals, and it is associated with a worse prognosis and increased mortality. Although several screening systems are now available, PEM is still poorly recognized especially in the rural settings as there is no consensus on which test is more reliable and feasible in clinical practice. Prealbumin (PAB) is a potential useful PEM marker because its serum concentrations are closely related to early changes in nutritional status. We studied PEM prevalence and PAB serum concentrations in 120 hospitalized patients. The Detailed Nutritional Assessment (DNA) was used as the reference method to determine PEM. PAB performance was compared with that of 2 other methods, the Subjective Global Assessment (SGA) and the Prognostic Inflammatory and Nutritional Index score (PINI). According to the DNA reference method, 51% of patients were classified with mild malnutrition and 23% with severe malnutrition. PAB showed the best concordance with the standard DNA method (concordance index, 80%) and a good sensitivity/specificity profile (84.9%/78.9%) compared with SGA and PINI. We conclude that PAB could represent a feasible and reliable tool in the evaluation of nutritionalstatus, especially in rural settings where it is difficult to obtain a more detailed and comprehensive nutritional assessment such as the DNA.

Keywords: Protein-energy Malnutrition, Prealbumin, Admitted-adult-patients, rural- hospitals, Rivers State.

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Abstract: Epilepsy is sometimes called a seizure disorder. It is characterized by recurrent unprovoked seizures. There are over 40 different types of epilepsy and it affects people of all nations and cuts across all races. The Epilepsy Foundation of America defines it as, "a physical condition that occurs when there is a sudden, brief change in how the brain works". Not all seizures are due to epilepsy. There are about fifty million people worldwide at any point in time with this disease and it is not contagious. According to a publication of the National Dissemination Center for Children with Disabilities, 2004, "about two million Americans have epilepsy; of the 125,000 new cases that develop each year, up to 50% are children and adolescents". In most cultures, people with epilepsy have been discriminated against, stigmatized, shunned, or even imprisoned due to misconceptions and ignorance about the true nature of this disease condition. Epilepsy can occur in animals other than humans.

Keywords: Epilepsy, seizures, convulsants, contagious, palliative and curative.

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Abstract: Objective: Though sinu-nasal neoplasms comprise of a small percentage of head neck tumours, they areincreasing in incidence due to rapid industrialization and an increase in life expectancy. Further in many cases they present at an advanced stage and data from studies on them from eastern region of the country is limited, encouraging this study. The aim of this study to evaluate the clinical and demographic profile as well as the histological variation of sinunasal neoplasms and it relation with occupation and addiction. Methods: Design: Prospective study Setting: Tertiary government teaching hospital Participants: All patients presenting with neoplastic lesion in nasal cavity between December, 2009 to May, 2011 Results: Eighty two(82) patients-- 57 (69.51%) male and 25 (30.49%) female aged upto 80 years, were included, displaying male predominance and clustering in the fifth decade of life. Benign lesions (44 cases , 53.66%) were more common than the malignant lesions (33 cases , 40.24% ) and 5 cases (6.10%) were seen indeterminant for malignancy/low-grade malignant potential. Most common anatomical location was nasal cavity(57.32%) and farmers were mostly affected by sinonasal neoplasm (30%). Commonest clinical presentation was epistaxis (31.71%). Conclusion: Sinonasal neoplasms have wide range of possibilities. Commonly, patients present with nasal obstruction and epistaxis. Early diagnosis with the help of newer diagnostic modalities with prompt treatment is necessary for these patients. Histopathological diagnosis is necessary for any neoplastic lesion in nasal cavity. This will guide us for further management of these lesions

Keywords: Paranasal sinus ; Neoplastic lesion ; Nasal obstruction ; Epistaxis ; Sinonasal neoplasm

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Abstract: AIMS & OBJECTIVES: To determine the fetal outcome and mode of delivery in patients with meconium stained liquor during labour.MATERIALS & METHODS: This retrospective study was conducted from January 2012 to December 2012 on patients admitted to Labour ward,PSGIMSR. Out of 2124 deliveries,250 patients who met the inclusion criteria were enrolled in our study.The data was collected in a predesigned proforma.RESULTS: The results of fetal outcome and mode of delivery were analysed statistically using SPSS version 19. The Chi Square test was applied between Grades of Meconium and APGAR Score.p value< 0.05 which was statistically significant. Also, the study between Grades of Meconium and CTG pattern proved to be significant with p value < 0.05.CONCLUSION: Meconium Stained Liquor alone is not assosiated with an adverse neonatal outcome,86% of babies remained asymptomatic .Increasing Grade of MSL is associated with increased adverse outcome. Association of MSL with abnormal CTG is assosiated with poor outcome, Increased caesarean section rate, increased neonatal complications.

Keywords: APGAR Score, CTG, Meconium Stained Liquor, Meconium Aspiration Syndrome

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Abstract: Background: This was a study to determine the diameter of the common bile duct (CBD) in Nigerian adults. It was intended to be used as a Normogram. Methods: A hospital based prospective descriptive study was carried out between September and December 2011 on consecutive subjects presenting for ultrasonography at Federal Medical Centre, Makurdi. Ethical approval was obtained from the institute's Ethics Committee. Informed written consent was obtained from each participant. Patients with history of pancreatic, liver or biliary disease or surgery and excessive bowel gas were excluded. Sonographic examination was done using Sonoscape SS1-1000 machine incorporated with electronic calipers. Each patient was scanned in a supine position after an overnight fast. Using Behan and Kazan's description, the diameter of the CBD was measured proximally at the porta hepatis and distally at a site at least 2cm superior to the head of the pancreas. The mean of three measurements was recorded. All measurements were done by the same sonologist. Bio data and body mass index of the subjects were recorded. The data was entered into an Excel sheet and analyzed using SPSS Statistics software version 17.0 for mean, median and range. Results: Two hundred subjects were recruited for this study. One hundred and ninety six (98%) made up of 61 males (31.1%) and 135 females (68.9%) completed the study. The M: F ratio was 1:2. The median age of the study population was 32.5 years with a range of 15-74 years. CBD diameter in all subjects was between 2-9mm. Majority had CBD diameter of 5-7 mm. Conclusion: This study showed that normal CBD diameter in this environment was 2 to 9 mm, with a median of 5 to 7 mm.

Key words: Common Bile Duct, Ultrasound, Normogram, correlates.

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Abstract: Many appliances in orthodontics such as fixed functional appliances, open coil springs, etc. depend upon some or the other means of activating the appliances. These activations are usually carried out through the way of activation beads been supplied by the manufacturers. The disadvantage of these beads includes its cost and its limited availability. Thus a new method of activating the fixed functional appliances is been described in here. Also, this method has its applicability for activation of other orthodontic appliances requiring activations.

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[2]. A Korrodi Ritto, Fixed functional appliances-A classification (updated) The orthodontic cyber journal. www.ocj.com / june 01/ Rittoffa.Htm
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Abstract: Introduction: Dacryocystorhinostomy (DCR) has been the standard procedure for acquired nasolacrimal duct obstruction. Lacrimal sac can be approached (1) Conventional External (Ex-DCR) or (2) Endoscopic (EN-DCR) Objective : To compare success rate , complication rate between the procedures Materials and Methods: Study design, prospective, interventional , clinical study was conducted in department of otorhinolaryngology in conjuction with ophthalmology,AMCH ,Duration of study : One year , from july 2011 to june 2012 , No. of cases : 60 cases(30 Endo-DCR,30 Ex-DCR) . Data were analysed by graphpad prism version 6.01 for Microsoft, Independent-sample t test &, chi square test with Yates correction was applied for comparison between groups , P value of <0.05 was considered stastically significant . Results and Observations : Total 60( 47 females,13 males) cases randomised into 30( 27females, 3males) endoscopic dcr, 30( 20females,10 males) external dcr, Mean age (32.367 )with range 18-55 yrs. in endoscopic dcr, Mean age (37.534 )with range 16-66 yrs. in external dcr. Present study shows success rate of 86.67% for En-DCR & 90% for Ex-DCR with P-value 0.557 CONCLUSION : The present study clearly shows that En- DCR is having results comparable EX-DCR , Keywords Keyword 1: En-DCR : Endoscopic Dacryocystorhinostomy Keyword 2: Ex-DCR : External Dacryocystorhinostomy Keyword 3: NLD : Nasolacrimal duct

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[3]. Cokkeser Y. Evereklioglu C, Er H. Comparative external versus endoscopic dacryocystorhinostorny: results in 115 patients (130 eyes). Otolaryngology Head and Neck Surgery 2000; 123(4):488-491.
[4]. Nishi Gupta. Endoscopic Dacryocystorhinostomy: A Revolution, 2nd Edition.

Abstract: A young female of postpartum pancreatic encephalopathy is described who presented with convulsions and coma . She had deranged lipase levels in blood, and cerebrospinal fluid along with abnormal white matter signals in MRI brain . As the patient improved with medical management, deranged blood lipase levels and abnormal MRI signals also improved. Pancreatic encephalopathy is a rare complication of pancreatitis in the setting of postpartum period. In any atypical neuropsychiatric condition with abdominal symptoms the possibility of pancreatic encephalopathy should be considered after certain exclusions.

Key Words : encephalopathy,metabolic, pancreatic, postpartum

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[8]. Guo-Hui Sun,Yun-Sheng Yang,Qing-Sen Liu,Liu-Fang Cheng ,Xu-Sheng Huang .pancreatic encephalopathy and Wernicke encephalopathy in association with acute pancreatitis:A clinical study. World J of gastroenterology 2006 July 14;12(26):4224-4227

Abstract: Objective: Non – alcoholic fatty liver disease (NAFLD) is a sonological entity without alteration of liver enzymes. The insulin resistance is measured from homeostasis model assessment (HOMA) as (HOMA-IR), calculated from estimations of fasting glucose(mg/dl) x fasting insulin (U/l) /405.The purpose of this case – control study was to corelate C-reactive protein to non-alcoholic fatty liver disease with and without insulin resistance. Method: This study was done at the Department of Medicine,DR. PSIMS & RF Chinaoutpally, A.P. India between Jan 2012 to Dec 2012.1 200 patients (00 cases, 100 controls) above 18 years of age were included in this study. Results: The mean fasting insulin levels in cases were 14.71050+8.70280 statistically significant than controls 5.27556+3.65791 (p: 0.05). The mean HOMA IR levels in cases were 3.18 + 0.24statistically significant than controls 1.09 + 0.07 (p: < 0.05). The mean CRP levels in cases were 3.06 + 1.61statistically significant than controls 1.03 + 0.86 (p: 0.05). Conclusions: Patients with Non – alcoholic fatty liver disease with high fasting insulin levels and high insulin resistance have higher serum C-reactive protein levels than controls.

Key words: NAFLD, insulin resistance, C-reactive protein,

[1] Marchesini G, Bugianesi E, Forlani G, Cerrelli F, Lenzi M, Manini R, et al. Nonalcoholic fatty liver, steatohepatitis, and the metabolic syndrome. Hepatology 2003;4: 917-923

[2] Kristina M. Utzschneider and Steven E. Kahn: The Role of Insulin Resistance in NonalcoholicFatty Liver Disease: The Journal of Clinical Endocrinology & Metabolism 91(12):4753– 4761

[3] Hamaguchi M, Kojima T, Takeda N, Nakagawa T, Taniguchi H, Fujii K,Omatsu T, Nakajima T, Sarui H, Shimazaki M, Kato T, Okuda J, Ida K2005The metabolic syndrome as a predictor of nonalcoholic fatty liver disease. Ann Intern Med 143:722–728

[4] Marchesini G, Brizi M, Bianchi G, Tomassetti S, Bugianesi E, Lenzi M,McCullough AJ, Natale S, Forlani G, Melchionda N2001 Nonalcoholic fattyliver disease: a feature of the metabolic syndrome. Diabetes 50:1844 –1850

[5] Bugianesi E, Gastaldelli A, Vanni E, Gambino R, Cassader M, Baldi S, Ponti V, Pagano G, Ferrannini E, Rizzetto M2005 Insulin resistance in non-diabetic patients with non-alcoholic fatty liver disease: sites and mechanisms. Diabetologia 48:634 – 642

[6] Seppala-Lindroos A, Vehkavaara S, Hakkinen AM, Goto T, Westerbacka J, Sovijarvi A, Halavaara J, Yki-Jarvinen H2002 Fat accumulation in the liver is associated with defects in insulin suppression of glucose production and serum free fatty acids independent of obesity in normal men. J Clin Endocrinol Metab 87:3023–3028

[7] Flegal KM, Carroll MD, Ogden CL, Johnson CL2002 Prevalence and trends in obesity among US adults, 1999 –2000. JAMA 288:1723–1727

[8] Moran JR, Ghishan FK, Halter SA, Greene HL 1983 Steatohepatitis in obese children: a cause of chronic liver dysfunction. Am J Gastroenterol 78:374 –377

[9] Baldridge AD, Perez-Atayde AR, Graeme-Cook F, Higgins L, Lavine JE1995 Idiopathic steatohepatitis in childhood: a multicenter retrospective study.J Pediatr 127:700 –704

[10] Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC:Turner, Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 1985, 28:412-419.

Abstract: Knowledge attitude and practice (KAP) studies have been widely used and valued around the world for at least forty years in public health, water supply and sanitation, family planning, education and other programs. This study was conducted to determine previous knowledge about histology practical, emotional instabilities and unwanted practices at histology practicals. A cohort survey using interviewer-administered structured questionnaires was conducted among 217 preclinical students of Universities of Abuja and Maiduguri between from June 2009-October, 2010. The results showed that many were confused, jittered and feel that the practical was uninteresting on seeing microscopes and magnifying lens for the first time. Many of them affirmed that microscope was difficult to adjust before use; can be damaged; tissues are tiny to be visualized and identified; tissue slide can break; practical processes are tedious and time consuming; using microscope and magnifying hand lens can affect the eye. The preclinical students also admit that practical materials were not properly handled, and they make noise/gossip at practicals. We concluded that there were gross deficiencies in KAP of these students. A formal course on KAP before first histology practicals incorporated in medical curriculum and caution of students for wrong practices is advised. KAP study of histology practicals may differ from location to location and needs further evaluation. Keywords - Knowledge, Attitude, Practice, Preclinical Students, Histology Practical, Nigerian

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Abstract: Aims: To Determine The Effects Of Aqueous Leaf Extract Of Cannabis Sativa On The Cerebral Cortex Of Wister Rats. Study design: Experimental study. Place and Duration of Study: Department of Human Anatomy, University of Maiduguri Borno State, Nigeria, between June 2010 and July 2011

Keywords: [Cannabis sativa; cerebral cortex; wister rats; aqueous extract}

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Abstract: Aim of conservative surgical technique to achieve complete removal of cyst and early mobilization in the management of pulmonary hydatid cyst. Material and method:-The prospective study was conducted at Indira Gandhi Government medical college, Nagpur. During the study period seventy two patients operated upon for hydatid disease were evaluated pre and postoperatively. Results: - 47 male and 25 female patients were treated with enucleation 33(45.83 %), cystostomy 26 (36.11 %), segmentectomy 05(6.94 %), pericystectomy 04 (5.56 %) and lobectomy in 04(5.56%) patients. In 51(70.83%) patients capitonnage was performed. Mortality in one patient (1.39%) with 11.11% morbidity was observed in the present study. Conclusion: - From the present study we conclude that conservative surgical procedure achieved complete removal of cyst and early mobilization in the management of pulmonary hydatid cyst. Bronchial communication should be closed by purse string sutures. These simple procedures are safe, reliable and successful. However radical procedures should only be carried out in selected patients with specific indications.

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Abstract: This study aimed to assess the role of sonography in Assessment of uterussize in post-menopausal Sudanese women.Study conducted in different hospitals in Khartoum State and White Nile State to determine the uterine size in postmenopausal Sudanese women from July 2010 to Feb 2011. Atotalof 100 postmenopausal women were selected by non- probability sampling technique and had been scannedwith ultrasound machine using the international protocols.Different uterine measurementshad been taken such as Sagittal uterine length(minimum 4cm / maximum 9.3cm), antero-posterior diameter (minimum 1.6 cm and maximum 4.4cm), transverse diameter (minimum 1.5cm and maximum 4.9cm), cervical length (minimum 1.6cm and maximum 4.7cm), body to cervix ratio (minimum 1.4 and maximum 3.3) and the uterine volume (minimum 8.35cc and maximum94.46cc).All uterine measurements except cervical length were apparently decreased with increasing of age and years since menopause and that is similar to the literature (atrophy uterus occurs mainly in the body of uterus rather than cervix).

Key words: Uterine size, postmenopausal, cervix to body ratioSudanese women ,ultrasound

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Abstract: Tuberculosis is an endemic infectious disease in Sudan and other developing countries. Healthcare workers, including students, are at a great risk of exposure and possible infection. This study is conducted to determine the pattern and prevalence of positive tuberculin skin test (TST) among students of the University of Medical Sciences and Technology during distinct periods of their training, and to study the influencing factors for positive results.

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Abstract: Intravaginal foreign bodies of long duration are a rare entity but many patients are too embarrassed and will wait and try to remove them themselves rather than seek medical advice. Vaginal foreign bodies of long duration may be complicated by fistulas. This article is a report of a case of a vaginal foreign body (plastic cap) found in a 14 yr old girl. The girl presented with complaint of soiling of undergarments with urine from vagina. On examination there was an impacted plastic cap in vagina and it was removed under GA by combined abdominal and vaginal approach and repair of fistulous tract done by repairing anterior vaginal wall. A review of the relevant literature was undertaken.

Keywords- Vesicovaginal fistula, radioopaque shadow, vagina, foreign body

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Abstract: A total of 840 isolates were screened for ESBL, AmpC and MBL by double disk potentiation method. In addition double disk approximation test was also applied for detection of ESBL. The strains, where the synergy was observed between disks of ceftazidime / cefotaxime and clavulanate were considered as ESBL producers. For the detection of AmpC ceftazidime and cefazidime with APB, for the detection of MBL imipenem and imipenem with EDTA disks were used. Isolates showing enlargement of the diameter of growth inhibitory zone ≥ 5mm were considered as AmpC and MBL producers. A total of 259 of isolates were found to be ESBL positive. ESBL was detected in 139 (35%) isolates of Escherichia coli, 79 (28.7%) of Klebsiella species, 25 (22.5%) of Proteus species and 16 (28%) of Citrobactor species. The occurrence of AmpC-β-lactamase was found to be in 129 isolates out of which 73 (18.3%) isolates were Escherichia coli, 37 (13.4%) of Klebsiella species, 10 (9.0%) of Proteus species and 9 (15.7%) of Citrobacter species None of the strain were MBL positive. The results indicate double disk potentiation test to detect ESBL, AmpC and MBL in one plate was easier, reliable and rapid method.

Keywords: ESBL; AmpC; MBL; double disk potentiation

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