1.Effect of dexmeditomedine with levobupivacaine on duration of transversus abdominis plane blocks compared to levobupivacaine with normal saline: A prospective, randomized and double blind study

Chiruvella S.^*, Dontu B., Siva V.

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Abstract

Background:

We performed a prospective, randomised, double‑blind study to evaluate the effect of dexmeditomedine added to levobupivacaine on the duration of transversusabdominis plane block.

Methods:

Sixty American Society ofAnaesthesiologist‟s physical status I and II patients undergoing electivetotal abdominal hysterectomysurgery under general anaesthesia were randomly allocated to either Group C (control group) or Group D (dexmeditomedine group). Group C (control group) patients were received TAP block on each side using 32ml of study medication, which consisted of 30ml of levobupivacaine 0.25% and 2ml of normal saline. Group D (dexmedetomedine group) patients were received TAP block on each side with 32ml, in which dexmedetomidine 0.5 micrograms/kg was dissolved in 2ml of normal saline and added to 30ml of levobupivacaine 0.25%. The duration of analgesia and level of sedation and complications and sleep diturbanse were evaluated and recorded at 1hr, 4hr, 8hr, 12hrs, and 24hrs.

Results:

Demographic and operative characteristics were comparable between the two groups. The time for the first analgesic dose was longer in Group D than Group C 425.95 (18.06) vs. 78.2 (71.07) min, P<0.001) and the total doses of used fentanyl were less among Group D patients in comparison to those in Group C80.35 (19.16) vs.342 (15.89), P<0.001). Visual analog scores were significantly lower in Group D in the first 8 h post-operatively when compared with Group C, both at rest and on coughing (P<0.001). In Group D, lower heart rate was noticed from the induction time and continued for the first 24 h post-operatively. Conclusion:

Addition of dexmeditomedine to 0.25% levobupivacaine in transversusabdominis plane block significantly prolongs the duration of analgesia.

2.Pregnancy and maternal hyperthyroidism: A review

Soni M.1^*, Soni P.²

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Abstract

Thyroid disease is the second most common endocrine disorder associated with pregnancy. Graves disease accounts for most of the cases of pregnancy-associated hyperthyroidism. It is associated with an increased incidence of maternal and perinatal complications. Pre-conceptional achievement of euthyroid state is advised. Serum thyroid profile is diagnostic.The mainstay of management is anti-thyroid drugs. Other available options are beta-adrenergic blockers and subtotal thyroidectomy. Thyroid storm is an obstetric emergency and is to be managed in obstetric intensive care unit. Early diagnosis and management of maternal hyperthyroidism plays the key role in improving pregnancy outcomes.

3.Benign acute myositis associated with H1N1 (swine flu)

Kumar S.^*, Thakkar K., Sandeep B.R., Khan Z., Jakhar M., Thalor N., Barala P., Meena G.L., Gupta B.K.

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Abstract

This case report presents a diagnosis of acute benign viral myositis associated with swine flu in a 16 year old boy. Clinically presenting as acute onset paraparesis with calf muscle and hamstring muscles tenderness, preceded by fever and runny nose 2 days before presentation. Clinical features and laboratory findings were similar to previous reports of benign acute myositis induced by H1N1 as well as seasonal flu. Patient recovered within 4 days without recurrences and discharged.

4.Actinomycosis of the colon: A rare case report

Sharma D.D.^*, Sharma C., Sharma S.

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Abstract

Actinomycosis is a rare entity, caused by an anaerobic bacterium, Actinomyces israelii, which is a component of the human oral and gastrointestinal flora. The commonest site of the disease is cervicofacial region. Abdomen is the second commonest site. In abdominal actinomycosis the disease is almost always unifocal and is restricted to the right colon, especially to the caecum. We here report a case of a patient with a very rare form of this entity, characterized by multiple foci of abdominal involvement with the most severe lesion localized in the transverse colon. The clinical picture resembled a picture of colonic carcinoma and the diagnosis was made by histopathological examination of the lesion removed at surgery. No predisposing factor was found. The infection was successfully treated with a prolonged course of antibiotics (penicillin and tetracycline), after surgical removal of the lesion.

5.Management of PUJ obstruction

Chugh A.^*, Agarwal P.N., Singh R., Mishra A., Jain V., Meena M

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Abstract

Pelvi--ureteric junction (PUJ) obstruction is a well-recognized entity that may present at any time – in fetal life, infancy, childhood, or early or late adulthood. As the most common site of obstruction in the upper urinary tract. There has been an improved understanding of the pathophysiology of primary congenital PUJ obstruction that has been reflected in the evolution of surgical options, from open surgical repair to minimally invasive surgery. This article discusses the surgical management of this condition alongwith the pathogenesis, clinical presentation, and diagnosis of PUJ obstruction.

6.A Stab Wound of Occipital Region of Skull, Simple in Nature: A Unique Case

Garg V.1^*, Simatwal N.², Sharma D.K.², Shaikh I.², Vyas P.C.²

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Abstract

Stab wounds are produced by pointed instruments. But in this case stab wound on the suboccipital region of the skull on the left side, 12 cm deep and did not disturb any vital structure. All parameters were within normal range. Finally the injury was simple in nature & weapon was pointed sharp.

7.Stress audit of medical and paramedical students

Parikh Hemant Chimanlal.^*, Barhatt Jayshree^**.

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Abstract

Introduction:

Since Hans Seyle first described stress, physicians and psychologists are studying stress and its various manifestations. However like proverbial ‘elephant to the blind’, stress and her management still remains a mystery to many persons.

In pursuit of happiness, man has tried to eliminate stress from his life, but in vain!! Stress affects almost all of us some or the other time. In chronic form, it causes psycho somatic diseases in man.

Material and Methods:

Based on symptoms and signs of stress, we devised a questionnaire for stress audit of participants. In present study, we did stress audit of students of 800 students of medical and paramedical branches; by giving them a questionnaire to fill up. Comparison of stress levels was done between students of Physiotherapy (year 1), General Nursing and Midwifery (year 2) and MBBS (year 1). Results:

30% students had stress scores higher than 16, suggestive of distress. They were offered pranayam, dhyan and yog, as remedial measures.

8.Role of Upper Gastrointestinal Endoscopy in children of Recurrent Abdominal Pain without a known cause

Barupal R., Jora R.^*, Sharma P., Vikrant

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Abstract

Background:

To study the role of Upper Gastrointestinal Endoscopy in evaluation of recurrent abdominal pain in children without a known cause.

Methods:

We have enrolled 150 patients in our study. Out of these 50 patients excluded from study because in these cause of pain abdomen is other than Gastrointestinal. In all Patients we have done complete hemogram with ESR, liver functions tests, complete urine and stool examination and USG abdomen to rule out other causes of pain abdomen. All patients of RAP subjected to Upper Gastrointestinal Endoscopy and two biopsy samples from antral part of stomach were taken, one was sent for histopathological examination and other subjected to Rapid Urease Test media for the diagnosis of H.Pylori infection. Results:

Maximum cases were between 4-10 years age group. On GI Endoscopy was done in 49(49%) had normal finding, while mucosal hyperaemia was seen in 18(18%). On histopathological 50 (50%) patients had normal finding, 19(19%) had superficial gastritis, 10 (10%) had lymphocytic infiltration. 28(28%) cases had RUT positive. Among the causes of RAP, H Pylori gastritis was found in 28(28%) cases, Functional abdominal pain in 22(22%), Celiac disease in 14(14%), Giardiasis in 8(8%),

Conclusion:

Pediatric Upper GI Endoscopy is a safe & useful in the diagnosis of RAP. Upper GI Endoscopy should be performed in all children with abdominal pain and alarming signs.

9.Simultaneous occurrence of conversion disorder in siblings in paediatric age group and its outcome: A follow up study

Agrawal S.^1*, Sharma D.², Sharma D.K.², Vijayvergia D.K.²

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Abstract

Conversion disorder is commonly seen in adolescents and young adult females. Its occurrence in paediatric age group is not very common. Only few cases have been so far reported in paediatric age group. Simultaneous occurrence of same conversion symptoms in two siblings at the same time has been seen in our case. Significant response after aversion therapy in both the patients signifies its role in the management of conversion disorder. All these things make this a rare case all together to be reported.

10.Isolated sphenochoanal polyp - A rare case report

Palukuri S.^*, Dhulipalla S.

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Abstract

Choanal polyps are solitary benign tumours which come from one of the paranasal sinuses. Isolated polyp originating from the anterior wall of the sphenoid sinus or from its interior and extending as choanal polyps into the nasopharynx are extremely rare. We report a case of 17 year old female presenting with progressive unilateral nasal obstruction, intermittent nasal discharge and headache. The diagnosis of sphenochoanal polyp was made by endoscopy and confirmed by CT scan paranasal sinuses. It was removed endoscopically via transnasal sphenoidotomy.

11.Age at menarche in adolescent Chakma Girls of Tripura

Saha S.^*, Sil S.K.

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Abstract

Menarche is the onset of menstruation and is one of the milestones in women’s lives. Data on age at menarche have been collected using retrospective method of recall among 346 Chakma girls of North Tripura attending School and Colleges. The mean age at menarche of Chakma girls of Tripura was 13.72 ± 0.76 years. The early onset of menarche was recorded in 2.31% and late onset in 60.98% of the Chakma girls. The mean age at menarche of this population was influenced by their socio economic condition.

12.Embryonic decompression with vascular disruption - A case report

Gaur V.^*, Mathur A.

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Abstract

The present case report is regarding the incidental finding of the new born with numerous congenital malformation which includes: Hydrocephalous, Syndactyly, Cloacal Anomaly, Deformed upper and lower limb and dextrocardia .

The foetus was born to the mother through normal vaginal twin delivery; one baby was healthy and normal in weight and characters while the other baby had multiple congenital malformations.

13.Study of glycemic control impairment during Indian festival holi in diabetes mellitus patients in Jodhpur region

Jodha R.^*, Rawtani J., Mathur R.

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Abstract

Diabetes Mellitus is the most common endocrine metabolic disorder of glucose metabolism. During festival season there is increased consumption of carbohydrate rich diet that provide additional glucose which likely to influence metabolic control. 25 clinically established Diabetes Mellitus patients were compared with 25 healthy controls attending Out Patient Department of Dr S.N. Medical College, Jodhpur. Fasting and Post Prandial blood glucose level was measured by GOD-POD method. Mean Fasting and Post Prandial blood glucose values were significantly elevated in Diabetes patients (p<0.0001, p<0.0001, p<0.0001 and p<0.0001, p<0.0001, p<0.0001) as compared to Healthy control subjects studied 10 days before Holi, During Holi festival, 10 days after Holi festival, respectively. Thus during Festivals there is increased consumption of sweets that impaires glycemic control in Diabetes Mellitus patients.

14.Characterisation and antifungal susceptibility testing of Candida isolates in Mucocutaneous Candidiasis

Dadhich D.^1*, Saxena N. ¹, Dadhich H.K.²

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Abstract

Background and Objectives:

The last two decades have seen a significant rise in the infections caused by drug resistant Candida species in various centers in India. The objective of this study was to isolate and speciateCandida species from various clinical samples, to detect their antifungal susceptibility pattern and to note down the risk factors.

Methods:

Candida species isolated from various clinical samples were subjected to speciation using standard yeast identification protocol and CHROM agar. Antifungal susceptibility testing was done by the disc diffusion method to amphotericin B, fluconazole, nystatin, itraconazole, ketoconazole and clotrimazole. Clinical details and risk factors of the patients were noted down.

Results:

Among the 100 culture positive cases,various species of Candida were reported as C. albicans (54%), C. tropicalis (22%), C. glabrata(12%), C. krusei (06%), C.parapsilosis (04%) and C. kefyr(02%).Resistance for Candida in present study was 26% for fluconazole, 24% for itraconazole, 29% for clotrimazole, 18% for ketoconazole and 10% for nystatin. No resistance was seen to amphotericin B.

Conclusion:

Candida albicans was the predominant isolate. Accurate identification of different species of Candida is essential not only for epidemiological purposes but for diagnostic and prognostic value to patients because all species do not respond to same antifungal drugs. The development of resistance to commonly used antifungal drugs indicate need for rational use, preferably after in- vitro antifungal susceptibility testing.

15.Variation of Q angle with reference to age and sex - A study in central Rajasthan

Gaur V.^*, Sharma B.K., Goyal A.

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Abstract

An understanding of the normal anatomical and biomechanical features of the patellofemoral joint is essential to any evaluation of knee function. One important concept in patellofemoral joint function is the quadriceps femoris muscle angle, better known as the "Q angle".