COMPARISION OF CLOSED EXPERT TIBIA NAILING WITH OPEN PLATE&SCREW FIXATION IN THE TREATMENT OF PROXIMAL TIBIA EXTRAARTICULAR FRACTURES.

This study conducted at Index Medical College Hospital & Research Centre, Indore during the study period of 02 years. Patients were followed up for 01 year, evaluated radiologically and clinically with Tegnerlysholm knee scale, outcomes were used for comparison. Malreduction was defined as a deformity of 5 degree in any plane. Out of a total of 22 patients, 01 (1 in the plating group) was excluded from the study as pt was absent for follow-up, meaning that 21 patients were included in the final study Baseline data of 21 patients. Use of PTLCP is associated with more intra operative blood loss, higher postoperative infection rate and longer duration of hospital stay, whereas use of IMN associated with higher rates of malunion and nonunion. However there is no difference in functional outcome between IMN and PTLCP. But it is the surgical skill that is required in such fractures. To validate this issue further a large sample size of matching severity multicentric study done by equal level skill cadre is recommended. Overall proximal one third extraarticular tibia fracture is complicated and problematic fracture to deal with and is commonly associated with significant soft tissue damage. High grade of surgical skills are required to deal these fractures as fixation of proximal one third extraarticular tibia fracture is technically demanding surgery regardless of the implant.

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SIGNIFICANCE OF PLACENTAL HISTOPATHOLOGICAL FINDINGS IN PRETERM/TERM BIRTH

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v4i5.1143 ◽

2020 ◽

Vol 4 (5) ◽

Author(s):

Monika Kushwaha ◽

Sanjeev Narang

Keyword(s):

Preterm Birth ◽

Comparative Study ◽

Pregnancy Outcome ◽

Neonatal Morbidity ◽

Research Centre ◽

College Hospital ◽

Cross Sectional ◽

Chorionic Villi ◽

Term Birth ◽

Medical College

Background: This study is cross-sectional, observational and comparative study, at Index Medical College, Hospital & Research Centre, Indore, Madhya Pradesh from July 2017 to July 2019 with sample size 100 placentae. Method: The placenta received was evaluated blinded of maternal pregnancy outcome. The pattern of morphology was evaluated both qualitatively (type of lesion) and quantitatively (number of lesions). Result: In Present study 79% of the deliveries were term deliveries and 21% were preterm deliveries. On placental macroscopy, placenta weight was significantly low among the neonates of preterm deliveries (370.00±60.49) as compared to term deliveries (440.89±55.22). Preterm placenta had higher number of abnormal placental lesion compared to term pregnancies. Conclusion: The uteroplacental insufficiency defined as placental infarct, fibrosis of chorionic villi, thickening of blood vessels, and poor vascularity of chorionic villi. Placental histopathological lesions are strongly associated with maternal under perfusion and uteroplacental insufficiency. These are the reasons for preterm birth. Thus, knowledge of the etiological factor can be use to reduce maternal and neonatal morbidity and mortility. Keywords: Placenta, Term & Preterm.

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Outcome of Percutaneous Nephrostomy in Children With Ureteropelvic Junction Obstruction

Bangladesh Journal of Urology ◽

10.3329/bju.v20i2.49654 ◽

2020 ◽

Vol 20 (2) ◽

pp. 61-64

Author(s):

Mohammad Mahfuzur Rahman Chowdhury ◽

Rifat Zaman ◽

Md Amanur Rasul ◽

Akm Shahadat Hossain ◽

Shafiqul Alam Chowdhury ◽

...

Keyword(s):

Renal Function ◽

Low Dose ◽

Ureteropelvic Junction Obstruction ◽

Percutaneous Nephrostomy ◽

Ureteropelvic Junction ◽

College Hospital ◽

Medical College ◽

Split Renal Function

Introduction and objectives: Congenital ureteropelvic junction obstruction (UPJO) is the most common cause of hydronephrosis. Management protocols are based on the presence of symptoms and when the patient is asymptomatic the function of the affected kidney determines the line of treatment. Percutaneous nephrostomy (PCN) became a widely accepted procedure in children in the 1990s. The aim of the study was to evaluate the results of performing percutaneous nephrostomy (PCN) in all patients with UPJO and split renal function (SRF) of less than 10% in the affected kidney, because the management of such cases is still under debate. Methods:This prospective clinical trial was carried out at Dhaka Medical College Hospital from January 2014 to December 2016. Eighteen consecutive patients who underwent PCN for the treatment of unilateral UPJO were evaluated prospectively. In these children, ultrasonography was used for puncture and catheter insertion. Local anesthesia with sedation or general anesthesia was used for puncture. Pig tail catheters were employed. The PCN remained in situ for at least 4 weeks, during which patients received low-dose cephalosporin prophylaxis. Repeat renography was done after 4 weeks. When there was no significant improvement in split renal function (10% or greater) and PCN drainage (greater than 200 ml per day) then nephrectomies were performed otherwise pyeloplasties were performed. The patients were followed up after pyeloplasty with renograms at 3 months and 6 months post operatively. Results: All the patients had severe hydronephrosis during diagnosis and 14 patients with unilateral UPJO were improved after PCN drainage and underwent pyeloplasty. The rest four patients that did not show improvement in the SRF and total volume of urine output underwent nephrectomy. In the patients with unilateral UPJO who improved after PCN drainage, the SRF was increased to 26.4% ±8.6% (mean± SD) after four weeks and pyeloplasty was performed. At three and six months follow-up, SRF value was 29.2% ±8.5% and 30.8.2% ±8.8% respectively. Conclusion: Before planning of nephrectomy in poorly functioning kidneys (SRF < 10%) due to congenital UPJO, PCN drainage should be done to asses improvement of renal function. Bangladesh Journal of Urology, Vol. 20, No. 2, July 2017 p.61-64

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Treatment of Pilonidal Sinus by Limberg Flap-Only Hope of Cure (Study of 50 Cases)

Journal of Surgical Sciences ◽

10.3329/jss.v22i2.44071 ◽

2020 ◽

Vol 22 (2) ◽

pp. 89-94

Author(s):

Nasir Uddin Mahmud ◽

ABM Khurshid Alam ◽

Mohammad Altaf Hossain Chawdhury ◽

Mohammad Abul Khair

Keyword(s):

Pilonidal Sinus ◽

Skin Barrier ◽

Limberg Flap ◽

College Hospital ◽

Medical College ◽

Flap Technique ◽

Unpleasant Smell ◽

Lower Morbidity ◽

Computer Operator

Background : Pilonidal sinus was first described by Dr. A.W. Anderson in 1847 and is often seen in the intergluteal region. It is a disease of mainly younger male and rarely affects after 40. Main causes for the formation of this sinus are hirsutism, sweating in the area, repeated maceration due to trauma, leading to breakage of the skin barrier, attracting hair inside which initiates a foreign body reaction leading to infection with abscess or sinus formation. Most common embarrassing situation is discharging sinus. The diagnosis is mainly on clinical ground. Though there are a lot of modalities of treatment but recurrence is still a challenge. We have adopted Limberg flap technique since 2012 with a least recurrent chance. Objectives : To prove that this procedure will be end up with lower morbidity & least chance of recurrence Methods : This prospective study was done jointly by the Department of Surgery of Central Medical College and Comilla Medical College Hospital. In this series 50 patients were selected from July 2012 to June 2017. Results : Out of 50 patients operated by Limberg flap technique 42(84%) were males and 8(16%) were females. Mean age was 27.3 years (range 18–37years). Of them,12(24%) were driver, 6(12%) police, 6(12%) teacher, 6(12%) student, 5(10%) worker, 4(8%) millitary army, 4(8%) housewife, 4 (8%)service holder, 2(4%) computer operator, 1(2%) doctor and 1(2%) were barber. In our study most common mode of presentation were chronic discharging sinuses 15(30%), beside this 12(24%) had multiple sinuses, 10(20%) had multiple pits,7(14%) had acute abscess and 6(12%) had unpleasant smell. Associated hirsutism were present in 30(60%) and absent in 20(40%) patients. One (2%) male patient had wound gap & discharge and six(12%) patients had flap edema. We have found no recurrence in follow up period. Conclusion : Pilonidal sinus is a notoriously recurrent disease, so treatment by this flap technique is the only hope of cure with lower morbidity. Journal of Surgical Sciences (2018) Vol. 22 (2) : 89-94

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HISTOMORPHOLOGICAL SPECTRUM OF LESIONS OF HYSTERECTOMY SPECIMENS IN GCS MEDICAL COLLEGE, HOSPITALAND RESEARCH CENTER, AHMEDABAD : A STUDY OF 100 CASES

10.36106/ijsr/2320116 ◽

2020 ◽

pp. 80-82

Author(s):

Shweta Shah ◽

S.K. Suri ◽

Ami Shah

Keyword(s):

Retrospective Study ◽

Age Groups ◽

Total Abdominal Hysterectomy ◽

Abdominal Hysterectomy ◽

Medical College Hospital ◽

Research Centre ◽

Age Group ◽

Gynaecological Surgery ◽

College Hospital ◽

Medical College

Background: Most frequently performed gynaecological surgery is hysterectomy. The prevalence of hysterectomy varies within different regions. There are mainly two types of hysterectomies according to which part of uterus is removed. The main types of hysterectomy are total and subtotal or partial hysterectomy. The hysterectomy can be performed by three routes abdominal, laproscopic and vaginal hysterectomy. The main objective of our study is to know most common pathology and different age groups of the patients underwent hysterectomy. Materials and Methods: In this retrospective study was carried during period 6 months, at GCS medical college, hospital and research centre, Ahmedabad. Total 100 hysterectomy specimens were analyzed for histopathological lesions. We had taken the clinical and histopathological findings of these cases from the records of department of pathology, GCS medical college , hospital and research centre. Results: In our study of 100 cases, most common age group underwent hysterectomy was 40-49 years and least common age group was 20-29 years. Type of hysterectomy performed most commonly in this study was total abdominal hysterectomy with bilateral salpingoophorectomy. Most of lesions were seen in the myometrium 42 cases (42%), Endometrium 32 cases (32%), Cervix 16 cases (16%) and Ovary 10 cases (10%). Hysterectomy remains the widely used treatment modality.

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Otomycosis, frequency, clinical features, predisposing factors and treatment implications

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20201279 ◽

2020 ◽

Vol 6 (4) ◽

pp. 664

Author(s):

Manjunath K. ◽

Amardeep Singh ◽

Manjunatha Rao S. V.

Keyword(s):

Salicylic Acid ◽

Antifungal Agents ◽

Clinical Presentation ◽

Predisposing Factors ◽

Descriptive Statistics ◽

Research Centre ◽

Medical College ◽

The Difference ◽

Hospital Research

Background: The aim of this study was to determine the frequency of otomycosis, the clinical presentation, predisposing factors and treatment outcome.Methods: This observational study was conducted at ENT Department of Basaveshwara Medical College and Hospital, Research centre, Chitradurga from May 2018 to June 2019, 13 months study. There were 50 patients with documented diagnosis of otomycosis. There were 19 (38%) males and 31 (62%) females. The age of patients ranged from 3 years to 65 years with mean age of 32.5 years. Mean follow-up time was 1 year (~13 months). The frequency, predisposing factors and most common symptoms of otomycosis were recorded along with the response to different Antifungal agents were observed and results were recorded in percentages. Data were analysed using SPSS 12 software. Results are based on descriptive statistics. Results: We prescribed 1% clotrimazole drops or lotion in 58% of patients and 2% salicylic acid in 31% cases. Both of these agents are effective. Topical 1% clotrimazole drops yielded highest resolution rate with lowest recurrent rate. To analyse the efficacy of 1% clotrimazole and 2% salicylic acid. We applied Z-test to calculate the difference between two proportions of patients before treatment with those patients who remained uncured after treatment.Conclusions: Otomycosis commonly prevented with hearing loss, pruritus, otalgia and otorrhoea. It usually resolves with local toilet of ear and installation of antifungal agents.

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ROLE OF ABSOLUTE EOSINOPHIL COUNT AS A MODALITY OF INVESTIGATION IN SUSPECTED CASES OF HELMINTHIC INFESTATION IN CHILDREN AGED BETWEEN 5 TO 15 YEARS WITH COMPARISON TO STOOL ROUTINE AND MICROSCOPY

10.36106/gjra/6111669 ◽

2021 ◽

pp. 112-113

Author(s):

Meghashree N ◽

Rohini D ◽

Mahendar Reddy M ◽

A.M Koppad

Keyword(s):

Eosinophil Count ◽

Stool Specimen ◽

Cross Sectional Study ◽

Research Centre ◽

P Value ◽

College Hospital ◽

Cross Sectional ◽

Mean Values ◽

Medical College ◽

Absolute Eosinophil Count

Introduction: Eosinophilia is a well-known host immune response in helminthic infestation. This study was carried out to investigate whether a correlation exists between absolute eosinophil count in children with stool specimen positive for helminthic infestation. Aim And Objective: To determine average raised absolute eosinophil count in children who were having various helminthic infestation with stool specimen positive. Materials And Methods: A hospital based cross sectional study done at Navodaya medical college hospital and research centre during 2019 October to 2020 September for a period of 12 months. Both blood and stool samples were obtained from a total of 69 suspected children after examined, categorised into 2 groups. Among them 24 cases were positive of helminthic infestation and 45 cases were negative. T-test and descriptive statistics were used to analyse the data. Results: The study revealed that children infested with helminths found to have higher absolute eosinophil count (mean 4644/µl (95%CI; 3474-4212) than not infested (mean 801/µl (95%CI; 616-945) with p value <0.001. In this helminth's family; nematodes, trematodes, cestodes showed mean values of absolute eosinophil count were 5206/µl (4806-7151/µl), 4930/µl (4500-5382/µl) and 2179/µl (2500-1669/µl) respectively. Conclusions: Raised absolute eosinophil count has been observed in stool specimen positive cases of helminths, especially more in nematodes. Therefore, should be considered for a single dose of albendazole.

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Surgical Outcomes of Haemorrhoidectomy along With Suture Haemorrhoidopexy in Multiple Haemorrhoids

Journal of Current and Advance Medical Research ◽

10.3329/jcamr.v6i2.42697 ◽

2019 ◽

Vol 6 (2) ◽

pp. 73-76

Author(s):

Mohammad Ibrahim Khalil ◽

Md Ashiqur Rahman ◽

Adnan Ahmed ◽

Samia Shihab Uddin ◽

Mohammad Alauddin ◽

...

Keyword(s):

Operating Time ◽

Pain Scale ◽

Late Complications ◽

Anal Stenosis ◽

Safe Procedure ◽

College Hospital ◽

Primary Position ◽

Medical College ◽

Mucosal Oedema

Background: Haemorroid stapler becomes easier and safe to deal multiple and prolapsed haemorrhoid at a time. Objectives: The purpose of the present study was to evaluate the outcome of suture haemorrhoidopexy for secondary position haemorrhoids in addition to haemorrhoidectomy for primary haemorrhoids (multiple). Methodology: This prospective interventional study was performed in Dhaka Medical College Hospital, Dhaka, Bangladesh and in a private hospital in Gazipur, Bangladesh for over five (05) years from January 2012 to December 2016. Patients who were presented with secondary position haemorrhoids in addition to primary position haemorrhoids (multiple haemorrhoids) were included in this study. Open haemorrhoidectomy (Milligan-Morgan) followed by suture haemorrhoidopexy was done. All patients were followed up after 1, 2, 4, 8 weeks, 6 months and 1 yearly. Result: Total 18 patients were operated. Among those immediate complications were encountered in patients in the form of per rectal bleeding 1(5.55%), pain 3(visual pain scale 4)16.66%, mucosal oedema 6(33.33%), no patient developed early postoperative prolapse. No patient developed bowel incontinence. Late complications experienced as prolapse at 1 year follow up which was treated by conservative measures. No patient developed anal stenosis. Mean operating time was 25 minutes and duration of hospital stay was 1 day. Conclusion: Stapled haemorrhoidopexy is a safe procedure for circumferential excision of mucosa and submucosa dealing all haemorrhoids and prolapse simultaneously. Journal of Current and Advance Medical Research 2019;6(2): 73-76

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MIGRAINE: A POSSIBLE CAUSE FOR COGNITIVE DECLINE

Asian Journal of Pharmaceutical and Clinical Research ◽

10.22159/ajpcr.2017.v10i5.17436 ◽

2017 ◽

Vol 10 (5) ◽

pp. 228

Author(s):

Poornima Kn

Keyword(s):

Cognitive Decline ◽

Epidemiologic Studies ◽

Research Centre ◽

College Hospital ◽

Medical College ◽

Conflicting Result ◽

International Headache Classification ◽

The Relationship ◽

Card Test ◽

Possible Cause

Objectives:Migraine is the second most common type of headache and seventh most disabling disease worldwide. In general, obesity is often related to headache disorders in several clinical and epidemiologic studies. Obese migraine patients may have an increased attack frequency due to increase in inflammatory response. Cognitive decline is the major pitfall of migraine disorder and there exists a conflicting result between cognition and migraine and the effect of Body Mass Index (BMI) on migraine. So this study is done to find out the relationship between cognition and migraine and its association with BMI.Methods:The study protocol was approved by the ethical committee of SRM Medical College Hospital & Research Centre. The study group consisted of 30 migraine patients and 30 healthy controls aged between 18-40 years of age. Informed consent was obtained from all the participants. Diagnosis of migraine was made using the criteria of 2nd edition of International Headache Classification (IHC). Patients affected by Diabetes mellitus, Hypertension, allergy, inflammation, infection or immune disorders were excluded. Height and weight of the subjects were taken to calculate the BMI. Cognitive tests such as stroop interference trial & trial making tests (A&B) were done to evaluate working memory, mental flexibility and attention.Results:Compared to controls, cases took more time for performing stroop colour card test (106.40 ± 15.87 seconds vs. 132.17±7.027seconds, p<0.001) and trial making pattern B (54.77± 8.169 seconds vs. 56.23 ± 23.457seconds, p=0.004). Among the migraine subjects, obese individuals had an increased frequency of migraine attack per month (Correlation coefficient r=0.797)Conclusion:Cognitive decline in migraine is one of the underestimated problems in migraine. Identifying such problems early can prevent major consequences in day to day activities of migraine patients. Since there is an increased frequency of migraine with increase in BMI, obese migraine subjects can be recommended to do regular exercises.Key words: Migraine, Cognition, Stroop test, Obesity.

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Long-term efficacy of mycophenolate mofetil in myelin oligodendrocyte glycoprotein antibody-associated disorders

Neurology Neuroimmunology & Neuroinflammation ◽

10.1212/nxi.0000000000000705 ◽

2020 ◽

Vol 7 (3) ◽

pp. e705 ◽

Cited By ~ 9

Author(s):

Shengde Li ◽

Haitao Ren ◽

Yan Xu ◽

Tao Xu ◽

Yao Zhang ◽

...

Keyword(s):

Mycophenolate Mofetil ◽

Proportional Hazards ◽

Myelin Oligodendrocyte Glycoprotein ◽

Cox Proportional Hazards ◽

Sensitivity Analyses ◽

College Hospital ◽

Relapse Risk ◽

Medical College ◽

Cox Proportional Hazards Models

ObjectiveTo investigate whether the use of mycophenolate mofetil (MMF) could reduce the relapse risk in patients with myelin oligodendrocyte glycoprotein (MOG)-immunoglobulin G (IgG)-associated disorders (MOGADs).MethodsThis prospective observational cohort study included patients with MOGAD at Peking Union Medical College Hospital between January 1, 2017, and April 30, 2019. The patients were divided into 2 groups: those with (MMF+) or without (MMF−) MMF therapy. The primary outcome was relapse at follow-up. We used Cox proportional hazards models to calculate hazard ratios (HRs) for relapse.ResultsSeventy-nine patients were included in our MOG cohort. Fifty (63.3%) were adults at index date, and 47 (59.5%) were women. Fifty-four (68.4%) were in the MMF+ group, and 25 (31.6%) were in the MMF− group. Clinical and demographic factors, MOG-IgG titer, and follow-up time (median, 472.5 days for MMF+, 261.0 days for MMF−) were comparable between the groups. Relapse rates were 7.4% (4/54) in the MMF+ group and 44.0% (11/25) in the MMF− group. Of all potential confounders, only the use of MMF was associated with reduced risk of relapse. The HR for relapse among patients in the MMF+ group was 0.14 (95% CI, 0.05–0.45) and was 0.08 (95% CI, 0.02–0.28) in a model adjusted for age, sex, disease course, and MOG-IgG titer. MMF therapy also remained associated with a reduced relapse risk in sensitivity analyses. Only one patient (1.9%) discontinued MMF therapy because of adverse effect.ConclusionsThese findings provide a clinical evidence that MMF immunosuppression therapy may prevent relapse in patients with MOGAD.Classification of evidenceThis study provides class IV evidence that for patients with MOGAD, MMF reduces relapse risk.

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Effectiveness of Light Emitting Diodes (LED) versus Conventional Phototherapy for Neonatal Jaundice

Bangladesh Journal of Child Health ◽

10.3329/bjch.v42i2.37760 ◽

2018 ◽

Vol 42 (2) ◽

pp. 62-66

Author(s):

MA Rouf ◽

Md Khairuzzaman ◽

Nur E Nazni Ferdous ◽

Md Golam Mowla

Keyword(s):

Neonatal Jaundice ◽

Total Sample ◽

College Hospital ◽

Light Emitting ◽

Medical College ◽

Led Phototherapy ◽

Modes Of Presentation ◽

Significant Difference ◽

Course Variables

Background: Phototherapy is crucially an important aspect for the management of most neonatal jaundice. Neonates are prone to develop bilirubin encephalopathy (kernicterus). LED phototherapy is a new option of managing neonatal jaundice. The objective of this study is to compare the efficacy and safety of LEDs with fluorescent phototherapy in the treatment of indirect hyperbilirubinemia.Method: The study was Experimental research design, prospective study. The Study was conducted at Neonatal unit of Shaheed Suhrawardy Medical College Hospital, Dhaka. Total sample size of the study was one hundred neonates. Fifty for conventional phototherapy and fifty for LED phototherapy. Purposive sampling method was used for the study. The data collection tool of the study was pretested structured questionnaire. The modes of presentation, the clinical examination and investigation findings at admission and during daily follow up were recorded for individual patient.Result: The rate of fall of S. bilirubin was more in those neonates who have had LED phototherapy. As a result, duration of phototherapy as well as hospital stay was less in LED group. Furthermore, higher number of neonates developed rashes in LED group than in conventional group with statistically significant difference. Of course, variables regarding other adverse events did not show any statistically significant difference between two groups.Conclusion: Management of neonatal jaundice may be more effective in LED phototherapy than conventional phototherapy. LED device require shorter duration of phototherapy, thus, shorter hospital stay.Bangladesh J Child Health 2018; VOL 42 (2) :62-66

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