International Journal of Scientific Study

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https://imsear.searo.who.int/handle/123456789/157719

Editor-in-Chief: Dr.Swapnil Bumb
ISSN (Print): 2321-6379 (Electronic): 2321-595X

Frequency: Monthly

Language: English

Open Access Peer-reviewed journal

Web site: https://www.ijss-sn.com/

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A 3D-Computed Tomography Angiography Study to Help in Surgical Planning for Retrosigmoid Craniotomies
(International Research Organization for Life & Health Sciences (IROLHS), 2020-06) G, Mohanraj; S, Pradeep; R, Veerapandian; G, Vinay
Aims and Objectives: It is impossible to precisely anticipate the course of the transverse and sigmoid sinuses and theirindividual relationship to superficial landmarks such as the asterion during retrosigmoid approaches. This study was done todetermine the position of the asterion and the relationship between asterion and the transverse-sigmoid sinus junction (TSSJ)in making precise burr hole without damaging sinuses during retrosigmoid craniotomies.Materials and Methods: Computed tomography (CT) angiography was performed in 50 patients to obtain 3D-CT volumerendering images of cranial bone and dural sinuses. After delineating the sinuses, by simple restructuring using software andopacity modulation, bone image is reinforced. Asterion type, distance from the tip of mastoid process to asterion and root ofzygoma (ROZ) to asterion, and location of asterion in relation to TSSJ and distance between asterion and TSSJ were analyzedand measured.Results: The incidence of type 1 (presence of sutural bones) in our study was 24% and type 2 (absence of sutural bones) was76%. There was no statistically significance in the side and gender differences. The distance between the asterion and fromthe ROZ was 54.70 ± 3.68 on the right side and 54.32 ± 3.41 on the left side (P-0.612). The distance between asterion and tipof mastoid was 50.51 ± 2.67 on the right side and 50.12 ± 3.06 on the left side (P-0.716). The asterion was located on the T-Ssinus complex in 36 (72%) cases. The asterion was below the T-S sinus complex in 13 (26%) cases, and above the T-S sinuscomplex in only 1 (2%) cases.Conclusion: 3D-CT volume rendering imaging is capable of accurately visualizing the bony landmark and dural sinuses. Aneasy and simple restructured image provides precision and safety for the patient by ready and easy localization of asterionand TSSJ. This study was done to show that the previous cadaver-based anatomical studies can be done now in a moresophisticated and accurate manner with the latest technological advancements. This offers new options for anatomic researchand morphometric investigations.
3D-Guided Implant Surgery: A Case Report
(International Research Organization for Life & Health Sciences, 2023-07) Kunturkar, AB; Choukse, V; Aidasani, AN; Khavnekar, SS; Mante, KG; Borikar, PN
Placing dental implants is much easier than it ever was thanks to advances in technology and increased use of computeraided design and computer-assisted manufacturing (CAD/CAM). The location and angle of the neighboring teeth, laboratorysimulations, computed tomography with CAD/CAM simulations, and surgical guides known as stents are used to determinethe placement of implants. Every implant clinician must make the difficult decision of whether to use a surgical guide or toinsert implants by hand. The use of surgical guides for implant placement can boost confidence and be predictable with propertechnique. This case report provides an example of how 3D-guided technology was used in dental implant surgery for diagnosis,planning, and execution.
Abdominal Sacrocolpopexy for Post-hysterectomy vault Prolapse with Proline Mesh in WomenAttending in BMIMS, Pawapuri
(International Research Organization for Life & Health Sciences, 2024-05) Priya, S; Verma, R; Shilpa, S; Singh, S; Kumar, V
Introduction: Vault prolapse is a common health problem; however, severe morbidity is rare. However, it can have a marked effect on quality of life. Many surgical procedures have been described using the abdominal or vaginal approach. The procedure choice often depends on the individual surgeon’s choice and experience. The abdominal sacral colpopexy employs the interposition of a synthetic mesh or tissue graft between the vagina and sacrum. The surgical mesh consists of a flat, net-like structure that is surgically implanted to support weaknesses of soft tissue, hence its application in treating pelvic prolapses. Aims and Objectives: The aims and objectives are to evaluate abdominal sacrocolpopexy (ASC) with prolene mesh as an operative technique performed at our institution in symptomatic vault prolapse in post-hysterectomy patients. Materials and Methods: A total of 12 patients underwent ASC due to symptomatic vault prolapse after a hysterectomy between July 2021 and March 2023 at the obstetrics and gynecology department of BMIMS, Pawapuri, was retrospectively reviewed using the hospital information management system. Results: Twelve women had vault repair by ASC procedure. In three women along with sacrocolpopexy for vault prolapse, posterior colpoperineorrhaphy was done for rectocele. No major complication occurred during sacrocolpopexy in any patients. In none of these patients were blood transfusions necessary considering the small amount of blood loss. Conclusion: ASC has proven to be superior to other techniques. The choice of surgical approach depends on the preference and experience of the gynecologist. The procedure and experience of a gynecologist are important in repairing vault prolapse after total abdominal hysterectomy or vaginal hysterectomy to reduce recurrence.
Accidental Blunt Abdominal Injury Causing Multiple Small Bowel Loops’ Avulsion from the Mesentery and Dismembered Colon
(International Research Organization for Life & Health Sciences (IROLHS), 2019-06) Sondarva, Nilesh Punjabhai
A 50-year-old male, truck driver, met with an accident with blunt steering wheel injury to the abdomen with no external marks ofinjury over the abdominal wall. He had severe abdominal pain with tossing up in bed. As the abdomen showed no external marksof injuries, strikingly, abdominal palpatory findings were prominent with severe tenderness in the left side umbilical and pelvicregions. He had consumed heavy food with liquids within an hour before the accident. He collided with another stationary lorry;thus, he received massive blow to his abdomen with the steering wheel. He displayed the signs of hemorrhagic shock on arrivalto the emergency care. Computed tomography scan confirmed moderate hemoperitoneum with multiple bowel perforations. Onexploratory laparotomy, multiple jejunal and ileal loops were found completely avulsed from the base of the mesentery, makingthem completely devascularized along with dismembered descending colon from the sigmoid. Resection of nonviable smallbowels and end-to-end jejunoileal anastomosis was done. Colocolic anastomosis was performed after adequate descendingcolon mobilization with protective loop ileostomy in the right lower quadrant. The patient had developed wound infection; hence,he was put on daily dressing. Gradually, the patient improved and was discharged with functioning ileostomy.
Accuracy and Correlations of Cervical Cytology: Cervical Pap Smears Screening and Detection of Abnormal Cytology in Southern Indian Population in Tertiary Centre of Karwar Institute of Medical Sciences, Karwar, Karnataka
(International Research Organization for Life & Health Sciences, 2024-12) Rampada, SP; Vijay, PM; Biyani, A.
Introduction: Cervical carcinoma in women is the 3rd most prevalent cancer of the world. It is also considered as 2nd most common carcinoma in reproductive age group. Cervical Pap smears is used as prediagnosis for early screening and detection of the diseases. Objective: 1. Screening of cervical PAP smears, 2. Evaluation of the Pre malignant lesions. 3. Study of spectrum of changes seen in cervical PAP smears with ages. Methodology: This was a prospective study done from September 2022 – September 2023.Cervical pap smears were sent from OBG department for routine screening which were stained and prepared for cytological evaluation with reporting based on Bethesda system of reporting cervical cytology. Results:In the present study, total 357 cases were analyzed with most common age group were between 41-50 years old with most common cases were of asymptomatic routine 119(33%), followed by WDPV 57cases (16%) and abdominal pain 33 cases (9%). 234 smears (65%) belong to NILM, 63 smears (17%) Inflammatory changes and 31 smears (8.68%) of atrophic related changes. Conclusion: This study concludes that premalignant and malignant lesions were less prevalent in our institution. Among all cases, WDPV and abdominal painwere most common symptoms among the visiting patients in the Hospital with most smears were of NILM, Inflammatory and atrophic related changes been reported.
The Acidity of Non-alcoholic Beverages in Australia: Risk of Dental Erosion
(International Research Organization for Life & Health Sciences (IROLHS), 2020-05) Schmidt, Jeremiah; Huang, Boyen
Introduction: Extrinsic acids play a key role in the etiology of dental erosion (DE), particularly acidic beverages. Of the factorsconsidered, pH appears to be the most significant influencing a beverage’s ability to cause DE. This study tested the pH andsubsequent erosive potential of non-alcoholic beverages commercially available in Australia.Purpose: Internationally, the consumption of non-alcoholic beverages is increasing. Regional differences in beverage availabilityand manufacturing processes may alter beverage pH. To date, little research outside of the United States has been conductedinvestigating the erosive potential of non-alcoholic beverages. This information should serve as a resource to professionals tofacilitate dietary counseling and identify potentially acidic beverages that have not been previously identified in the literature.Methods: A total of 177 commercially available non-alcoholic beverages were purchased from a supermarket in Orange,Australia, and their pH tested in triplicate at room temperature, using a temperature calibrated benchtop pH meter and probe.Beverages were classified by beverage type and subsequent erosive potential. The mean and median pH of beverage typeswas taken where appropriate.Results: As high as, 93.8% of the beverages had a potential to cause DE. These included 34 (19.2%) extremely erosive(pH < 3), 114 (64.4%) erosive (3 ≤ pH < 4), and 18 (10.2%) minimally erosive beverages (4 ≤ pH ≤ 5.5). Only 11 beverages(6.2%) were unlikely to be erosive (pH > 5.5).Conclusions: Of the beverages tested, most beverages (93.8%) had the potential to cause some degree of DE. The resultsprovided could serve as a resource to health professionals to facilitate dietary counseling and healthy dietary decisions amongconsumers
Acute Hepatitis: An Unusual Presentation of Adenovirus Infection
(International Research Organization for Life & Health Sciences, 2023-07) Joshi, T; Anand, T.
Adenovirus is a long known human infection presenting mostly in the form of upper and lower airway disease, pharyngitis,gastroenteritis, conjunctivitis, and hemorrhagic cystitis. However, adenovirus infection presenting in the form of hepatitis is aninfrequent presentation, particularly in immunocompetent host. We hereby report a case of unexplained hepatitis with lowerrespiratory infection in a 6-year-old boy later confirmed on RTPCR to be adenovirus infection.
Advances in Protein Characterization by High-Resolution Mass Spectrometry
(International Research Organization for Life & Health Sciences (IROLHS), 2019-09) Mishra, Asha
High-resolution mass spectrometry has become an indispensable tool for a variety of biological research areas, includingprotein chemistry. The coupling of electrospray ionization to the MS has revolutionized the approaches for the identification ofnew proteins. Some examples of these applications include the identification of proteins involved in the virulence of pathogenicbacterial strains. MS played an important role in advancing protein folding studies, identification of new biomarkers for thedetection of diseases in early stages. A recent development in MS technique called fast photochemical oxidation of proteinssignificantly advanced the protein structural analysis.
The Aftermath of Corona Pandemic on the Psychosocial Life of Coimbatore South Population: A Cross-sectional Study
(International Research Organization for Life & Health Sciences (IROLHS), 2020-06) OR, Jeff Walter Rajadurai; S, Mohan; M, Somasundaram; S, Karthick Raja; S, Rashmi
Introduction: Coronavirus disease is an infectious disease caused by a newly discovered coronavirus. Since the new coronaviruscan spread unnoticed so easily, many governments have felt the best way to ensure people having minimal contact with eachother is to order total lockdowns. This study is performed a month after lockdown to evaluate the impact of corona pandemicon the psychosocial life of Coimbatore south population.Materials and Methods: A cross-sectional randomized study was conducted at Coimbatore South, Tamil Nadu, India, betweenApril 26, 2020, and April 30, 2020. The sample size was 600. Pre-tested structured and self-structured e-questionnaire wassent to the study population and the answers were viewed using separate email id.Results: Of the 600 people, 59.5% were males and 40.5% were females. The majority (82.5%) of people felt that they weresafe during the pandemic majority of people (61%) felt that the modern lifestyle was the cause for the pandemic and 66.9% ofthe people increased the usage of traditional and natural remedies during the lockdown.Conclusion: We infer that the majority of the people (55%) enjoyed the break from their routine with an eye on their educationand career.
Aggressive Recurrent Basal Cell Carcinoma: A Case Report
(International Research Organization for Life & Health Sciences (IROLHS), 2020-06) Shaikh, Ahemer Arif; Dhondge, Rajendra; Roy, Sirshendu; Nagarkar, Rajnish; Markanday, Aditya
Basal cell carcinoma (BCC) was first described in 1824 by Jacob who called it “ulcus rodens”: Its current nomenclature wasproposed by Krompecher in 1903. It is the most common type of nonmelanoma skin cancer and the most common malignancyin humans. BCC is typically slow-growing tumor, for which metastases are rare, it can be locally destructive and disfiguring. Thecurrent mainstay of BCC treatment involves surgical modalities such as excision, electrodessication and currettage, cryosurgery,and Mohs’ micrographic surgery. The rates of recurrence are variable in the literature, between 10% and 40 %.
Alteration in Serum Lipid Profile in Oral Squamous Cell Carcinoma
(International Research Organization for Life & Health Sciences (IROLHS), 2019-10) Vaish, Sajan; Gupta, Uma; Saini, Jawahar Singh; Meena, Archnakumari; Dahiya, Meenakshi; Bajiya, Manju
Background: Alteration in the pattern of serum lipid profile has been associated with a variety of cancers and precancerousconditions. Low levels of serum lipid serve as a prognostic marker in the early detection of oral precancerous and cancerousconditions because lipid plays an important role in new membrane biogenesis and maintains cell integrity.Aim: The aim of our study is to evaluate the alteration in serum lipid profile in oral squamous cell carcinoma (OSCC) andcompared it with control group.Materials and Methods: A total of 80 subjects were selected from the Department of Oral Pathology and Microbiology,RUHS College of Dental Sciences, Jaipur (GDC-Jaipur). Among 80 subjects, 40 individuals were diagnosed with squamouscell carcinoma and other 40 individuals were taken in healthy control group selected randomly from other departments. Thetotal parameters assessed include total cholesterol (TC), high-density lipoprotein cholesterol (HDLC), low-density lipoproteincholesterol (LDLC), very LDLC, and triglycerides (TGLs). Statistical analysis was carried out by Chi-square and one-wayANOVA test to evaluate parameters.Results: There was a significant decrease in TC, HDLC, and TGL in the oral cancer group as compared with the control group.Conclusions: There was an inverse relationship between serum lipid profile and OSCC. The lower serum lipid status may beconsidered a useful prognostic biochemical indicator for initial changes occurring in the neoplastic proliferating cell.
Ambu AuraGain versus Intubating Laryngeal Mask Airway (Fastrach) as Conduits for Blind Intubation – A Prospective Randomized Study
(International Research Organization for Life & Health Sciences, 2023-06) Arora, HS; Mohan, B; Badhan, A; Kaur, H
Introduction: The original laryngeal mask airway (LMA) was the first supraglottic airway introduced into clinical practice and wasinvented by DR. Archie Brain in 1981. There have been several modifications to the LMA over the years – camera attachments,conduits for endotracheal intubation, gastric channel, and so on. The present study was done to compare the efficacy of newsecond-generation SGA Ambu®AuraGain (AAG) and Intubating LMA as conduits for blind intubation.Materials and Methods: This prospective study was carried out in the “Department of Anesthesiology, Government MedicalCollege, Amritsar,” on 60 patients in the age group of 18–60 years of either sex and the American Society of AnesthesiologistsGrade I and II. The patients were randomly divided into two groups of 30 each and were comparable in terms of age, sex, duration,and nature of the procedure they underwent. The two groups were comparable in demographic data and patient characteristics.Results: The successful intubation rate through FT-LMA and AG-LMA was 96.66% and 33.33%, respectively. The differencein the overall success rate of intubation between both groups was highly significant with P < 0.05.Conclusion: Fastrach LMA has a higher success rate of intubation than AAG
Analysis of Antibacterial Activity of Graded Concentrations of Teicoplanin Mixed With Acrylic Bone Cement in Staphylococcal (Methicillin-resistant Staphylococcus aureus) Infections and to Compare itwith Vancomycin: An In Vitro Study
(International Research Organization for Life & Health Sciences (IROLHS), 2019-05) Goyal, Vinita; Agrawal, Pankaj; Desai, Mohan M.
Background: Orthopedic infections by methicillin-resistant Staphylococcus aureus (MRSA) are becoming more frequent afterdevice implantation, and often resistant to many commonly used antibiotics. The new line of antibiotics such as vancomycin,meropenem, and teicoplanin is being used for the treatment of such infections intravenously. However, these antibiotics canalso be used along with bone cement as a local antibiotic spacer.Aims: The aim of the study was to compare in vitro antibacterial activity of vancomycin and teicoplanin and to know the optimumconcentration of teicoplanin at which there is maximum inhibition of bacteria.Materials and Methods: Three different brands of bone cement discs (Palacos-R + G, surgical Simplex P, and CMW1) withvancomycin and teicoplanin of different concentration used. Inoculating media with bacterial isolates of Staphylococcus aureus(Methicillin-resistant) of strain ATCC 2593 with known minimum inhibitory concentration were used. In each media two discs ofone formulation were placed and labeled accordingly. Readings were taken at 24 h, 48 h, and 6 days.Results: All the cement brands eluted vancomycin equally well, but the zone of inhibition for palacos was marginally highercompared to the other two. Teicoplanin when increased from 400 mg to 1200 mg concentration showed a dose-dependentinhibition of MRSA with an increase in the zone of inhibition in all cements, with palacos being highest.Conclusion: Teicoplanin in higher concentration is a better alternative to vancomycin in MRSA bone infection.
An Analysis of Demography and Clinical Spectrum of Chronic Kidney Disease: A Tertiary Hospital-based Study
(International Research Organization for Life & Health Sciences (IROLHS), 2019-05) John, Sanju Daniel; George, Sabin
Background: Chronic kidney disease (CKD) is a condition characterized by a gradual loss of kidney function over a periodof time. Patients with CKD stages 1–3 (glomerular filtration rate [GFR] >30 mL/min/1.73 m²) are frequently asymptomatic;absence of symptoms associated with a reduction in GFR; without clinically evident disturbances in water or electrolytebalance or endocrine/metabolic derangements. In general, these disturbances become clinically manifest with CKD stages4–5 (GFR < 30 mL/min/1. 73 m²).Aim of the Study: The aim of the study was to analyze the symptoms, signs, and laboratory investigations of patients with CKD.Materials and Methods: Atotal of 178 consecutive patients of CKD were included in the study. The presenting clinical symptomsand signs were observed and analyzed. Related laboratory investigations were undertaken and analyzed for the benefit ofidentifying and correlating with the clinical spectrum of the disease.Observations Results: A total of 178 consecutive patients of CKD admitted in five medical units of a tertiary teaching hospital ofNorth Kerala state were included in the study. There were 106/72 males (59.55%) and 29/72 females (40.44%). The male to femalegender ratio was 1:1.47. Patients belonged to the age group between 18 and 78 years with a mean age of 51.35 ± 2.75 years.87/178 (48.87%) patients belonged to the age group of 39–58 years. Gastrointestinal tract related symptoms such as anorexiawere seen in 76/178 (42.69%), nausea in 52/178 (29.21%), and vomiting in 57/178 (32.02%) patients. Pallor due to anemia wasobserved in 91/178 (51.12%) patients and hypertension (HTN) (blood pressure >140/90 mmHg) was present in 54/178 (30.33%)patients. Edema was observed in 65/178 (36.51%) patients, left ventricular hypertrophy in 45/72 (25.28%) patients.Conclusions: Glomerulonephritis, HTN, and diabetes mellitus were the most common risk factors in causing CKD. The mostcommon clinical presentations were anemia, fatigue, anorexia, nausea, vomiting, dyspnea, hiccups, itching, HTN, and edema.As the clinical spectrum of CKD is diverse, further studies are needed to recognize the various presentations of this disease atan early stage in the local population. Early diagnosis and management of these conditions may prevent or delay the progressto end-stage renal disease.
Analysis of Functional Outcome of Column-specific Fixation of Complex Tibial Plateau Fractures: A Prospective Study
(International Research Organization for Life & Health Sciences (IROLHS), 2019-03) N, Thanappan; T, Saravanamuthu; Singaravel, K; Thirumurugan, M
Introduction: Most complex tibial plateau fractures are a result of the high-energy injury. Resulting comminution makesinterpreting of fracture patterns difficult. Fully understanding these fractures is the basis for successful treatment.Aim: The aim of this study was to analyze the functional and radiological outcome of column-specific fixation of tibial plateaufracture.Materials and Methods: This was a prospective cohort study; 10 patients with tibial plateau fractures with displaced complextibial plateau fractures operated at Government Rajaji Hospital, Madurai, were included in this study. The follow-up period was36 months. The fractures were evaluated by computed tomography using Lu three-column concepts and managed with lowprofile locking plate system as per column-specific fixation. Follow-up analysis was made using Modified Rasmussen’s Clinicaland Radiological Criteria.Results: In our study, 70% of the patients were in active productive age group (30–50 years). 90% of the patients were male.30% of single-column fractures (LUO) (Schatzker type IV 10% and Hohl and Moore Type I coronal split fracture 20%), 30% oftwo-column fracture (LUO) (Schatzker Type IV 20% and Type V 10%), and 40% of three-column fractures (LUO) (SchatzkerType V 40%) were included. In this study, 40% of patients had an excellent outcome, 50% of patients had a good outcome,10% of patients had poor clinical, and 10% had fair radiological outcome. One patient developed wound necrosis, for whichflap cover is done and eventually patient developed deep infection for whom implant removal was done after 6 months.Conclusion: Three-column fixation is a new fixation concept in treating complex tibial plateau fractures, especially useful formultiplanar fractures involving posterior column with excellent functional outcome.
Analysis of P53 Protein Expression in Odontogenic Cyst – An Immunohistochemical Study
(International Research Organization for Life & Health Sciences, 2023-08) Meenakshi; Sharma, G; Pabri, R; Savoriya, G; Vaish, S; Devi, M
Introduction: p53 is a tumor suppressor gene which arrests the cell cycle at G1 phase. At this phase, it allows the repair of possible DNA damage and prevents the cell cycle progression to S phase. In normal cells, it is found at low level whereas its expression is elevated in many tumor. Hence, p53 is used as a marker of neoplasia, malignancy, and tumor progression. Purpose: The aim of the study was to evaluate the expression of P53 protein in biopsy specimen of Odontogenic Keratocyst (OKCs), Dentigerous cyst (DCs), and Radicular cyst (RCs) by immunohistochemistry (IHC) to know the biological behavior of these cases. Materials and Methods: This study is carried out in histopathologically diagnosed 15 cases of OKCs, 10 cases of DCs and 10 cases of RCs that were formalin fixed, processed, and paraffin embedded. Sections of 4-micron thickness were cut from paraffin embedded tissue blocks and stained with IHC marker p53 following standardized protocol. The presence of brown colored nuclear reaction at the site of target antigen was considered immune positive for p53. Results: In our study, we found in OKCs, the intensity of p53 expression was more for supra basal layers (46% in the supra basal layers showed intense positivity) than basal and superficial layers. In DCs and RCs, the more intensity of p53 expression in basal layer than supra basal and superficial layers was found. Conclusions: p53 was over expressed in OKCs compared with other lesions. Mutations in the p53 gene yield a p53 protein which has an increased half-life, thus allowing this mutated protein to be detected immunohistochemically. p53 protein is related to cell proliferation activities in OKCs.
An Analysis of Role of Computed Tomography Scan Abdomen in Differentiating Perforated from Non-perforated Appendicitis Accurately and Comparing with Histopathology Reports
(International Research Organization for Life & Health Sciences (IROLHS), 2020-02) Jose, Kuruvilla; M, Sunil
Background: Acute appendicitis is one of the most common abdominal surgical emergencies requiring accurate diagnosis. Itis characterized by obstruction of its lumen, leading to inflammation and finally perforation. To define its prognosis, choose anappropriate surgical procedure and to decide non-surgical treatment, the pre-operative diagnosis of perforated or non-perforatedappendicitis is very important.Aim of the Study: This study aims to analyze the diagnostic accuracy of computed tomography (CT) scan abdomen indifferentiating perforated from non-perforated appendicitis using histopathology as the final diagnosis.Materials and Methods: Aprospective, cross-sectional analytical study, wherein 85 patients diagnosed with acute appendicitisreferred to the radiological department for CT scan abdomen were included in the study. Patients aged between 15 and 70 yearswere included in the study. CT scan abdomen with and without contrast was performed on a Toshiba 64 Multislice CT scanner(Toshiba Medical Systems Corp., Tokyo, Japan) which was used for all the patients. All the CT scans were interpreted by the sameconsultant radiologists with a minimum of 5 years of experience. The radiological features for the diagnosis of non-perforatedacute appendicitis by CT were based on swollen appendix, thickened enhancing wall, and smudging of surrounding fat planes,whereas the radiological features for perforated appendicitis used were, with abscess formation, phlegmon, extraluminal air,extraluminal appendicolith, and focal defect in the appendicular wall. Histopathology of the specimen collected following surgerywas undertaken by the hospital consultant pathologist of more than 5-year experience.Observations and Results: Among the 85 patients included in this study for the analysis of CT scan abdomen features, therewere 57 (67.05%) males and 28 (32.94%) females with a male-to-female ratio of 2.03:1. The mean age of the patients was38.90 ± 6.70 years. The incidence of non-perforated appendicitis was 66/85 (77.64%) including males 44/85 (51.76%) andfemales 22/85 (25.88%). The incidence of perforated appendicitis was 19/85 (22.35%) and males were 12/85 (14.11%) and 7/85(8.23%) were female. Patients aged 15–45 years of both genders constituted to 63/85 (74.11%) of the total patients. Amongthese patients, presenting with non-perforated appendicitis was 51/85 (60%) and perforated appendicitis was 12/85 (14.11%).Conclusions: Multislice CT scan abdomen was considered as the modality of choice for acute appendicitis not only to confirmthe diagnosis but also it plays an important role in assessment of appendicular complication, particularly in the detection ofperforated appendix. Using one or more of the five radiological signs of CT scan abdomen to identify appendicular perforationraised the sensitivity significantly reaching 94.12%.
An Analytical Study on Communication Abilities and Schooling in Children with Cochlear Implantation
(International Research Organization for Life & Health Sciences (IROLHS), 2020-07) Pootheri, Sameer; Parambil, Ardra Kaithayulla; Patani, Naisi Baby
Background: As per the World Health Organization 2018, the new estimate of disabling of hearing loss is 466 million people.The State Initiative on Disabilities Survey (2015), Kerala, India, indicates that 2.32% of populations in Kerala, India, are affectedby some form of disabilities. Among them, 60,925 are hearing disabled based on the definition of hearing impairment in thePersons with Disabilities Act 1995. A cochlear implant (CI) is a surgically implanted electronic device that provides a sense ofsound to a person with severe to profound sensorineural hearing loss in both ears.Need for the Study: Even though the Sruthitharangam scheme was started by the Government of Kerala, India, in 2012, no studywas carried out to estimate the outcomes in terms of usage of CI, education placement, and mode of communication after CI surgery.Aims and Objectives: The aim of the study was to investigate the usage of CI, communication abilities, and schooling in CIchildren who have undergone surgery under Kerala Government free CI program. The current study was to report the usageof cochlear implantation, the education status, and mode of communication of the children who had undergone, free of cost CIsurgery from June 2012 to December 2015 in Kerala, India.Materials and Methods: The demographical data were collected from the register maintained at Government Medical College,Kozhikode, Kerala, India. The study was a cross-sectional study and the data were collected through the telephonic interview of 114parents or caregivers among 132 parents who had undergone free CI surgery from June 2012 to December 2015 at GovernmentMedical College Kozhikode. Eighteen parents or caregivers could not be contacted due to unavailability or change of contact numberand data collection was possible only for 114 parents among the 132 parents. All the children had attended a minimum of 2 years ofpost-implantation Auditory-Verbal Habilitation (AVH) from Sruthitharangam empanelled centers. Each subject was asked questionsto understand the current usage of the device, the mode of communication, type of schooling, and associated issues that affect theprognosis of CI is also considered. The obtained responses were scored accordingly and tabulated for further statistical analysis.Observations and Results: The result reveals that among the 114 CI recipients, 93.8% (107 recipients) were using CI and 6.14%(seven recipients) were non-users. These data found that all children were enrolled in school and attending in variety of educationalsettings. In that, 82.45% (94 children) were attending mainstream education and 17.54% (20 children) were going to specialschools. On further analysis of the communication, abilities showed that the majority of the children (75.43%) communicated orally,21.05% of them communicated through total communication and 3.5% of them used sign language.Conclusions: Kerala government Sruthitharangam CI program aid the majority of the children with severe to profoundsensorineural hearing loss in acquiring oral communication skills and also benefiting integration in normal schools. Steps shouldbe taken to reduce the number of non- users and also plan new strategies for better normal school integration for CI childrenunder the government scheme
Analyzing the Effect of Single Intraoperative Intravitreal Bevacizumab on Central Macular Thickness in Diabetes Mellitus Patients Undergoing Phacoemulsification Under Local Anesthesia
(International Research Organization for Life & Health Sciences (IROLHS), 2020-05) Sathyamurthy, Ganesh; Kayoom, N Mohamed Abdul; Mahajan, Pavan S; Lima, V; T, Kavitha; PV, Manjusha
Aim: The aim of the study was to assess the effect of combined phacoemulsification and single intraoperative intravitrealinjection of bevacizumab on the central macular thickness (CMT) in diabetic patients.Materials and Methods: A prospective observational study was conducted on 30 eyes with diabetic retinopathy from February2018 to February 2019. All patients underwent thorough ophthalmic evaluation. Phacoemulsification performed by a singlesurgeon using either 0.5% topical proparacaine eye drops or sub-tenon local anesthesia as per the preference of the surgeonin individual case. Bevacizumab 0.05 ml (1.25 mg) was injected intravitreal using a 30-gauge needle through the pars planainto the vitreous cavity after intraocular lens implantation. Patients were followed postoperatively at day 1 then at 1 week and1 month, respectively, for recording the CMT and best corrected visual acuity at 1 month postoperatively.Results: The mean CMT for all the patients at post-operative day 1 and month 1 was 277.96 ± 142.40 μm and 289.50 ± 155.74 μm,respectively. Patients with <10 years of diabetes had mean CMT of 329.09 μm and 318.90 μm, at post-operative day 1 and at1 month, respectively, while those with diabetes more than 10 years had mean CMT of 248.36 μm and 272.47 μm, respectively.In mild non-proliferative diabetic retinopathy (NPDR) and stable proliferative diabetic retinopathy group no significant worseningoccurred in CMT thickness, while in moderate NPDR, four out of 13 cases showed significant increase in CMT (>10%) at 1 month. Insevere NPDR, out of 4 cases 1 case showed significant increase in CMT while other three cases showed modest reduction of CMT.Conclusion: Intravitreal administration of 1.25 mg bevacizumab at the time of cataract surgery is a safe and effective way inavoiding new onset maculopathy in diabetic retinopathy patients. It is also effective to treat pre-existing clinically significantmacular edema and prevent its progression to some extent in few cases.
Antenatal Ultrasonogram Detection of Fetal Urinary Tract Dilatation – Evaluation to form Guidelines for Postnatal Risk Stratification and Treatment Plan: A Single-center Study
(International Research Organization for Life & Health Sciences (IROLHS), 2019-10) T, Prince Jeba Anand; Venisha, X Infant Puspha; Vijayaraj
Introduction: The incidence of antenatally detected genitourinary abnormalities is on the rise. Although this has led to earlierinterventions and better prognosis, there is a lack of standardization and uniformity in the diagnosis of urinary tract dilatation (UTD)which has resulted in more confusion than before regarding the management. Entities such as “prominent pelvis,” “pelviectasis,”and “hydronephrosis” have been used without any objective criteria which lead to unnecessary and extensive postnatal evaluation.Aim: This study aims to study the imaging features of those infants with antenatally diagnosed fetal urinary tract dilation andto standardize the protocol for postnatal follow-up and management.Materials and Methods: A prospective study of 72 mothers who were antenatally diagnosed with fetal UTD were enrolledfor the study and postnatal follow-up done by imaging with ultrasound, voiding cystourethrogram, and intravenous urogram.Results: Among the 72 enrolled cases of 24 were categorized under UTD A1, nine children were managed conservativelywith regular follow-up. Those categorized under UTD P1, six cases had normal postnatal scans at the 1st week of life and at1 month, of which three cases had transient hydronephrosis and two had partial pelviureteric junction obstruction (PUJO). Of14 children with intermediate-risk dilation UTD P2, 11 children had complete PUJO, two had partial PUJO, and one had bilateralvesicoureteric reflux (VUR), of which patients with complete PUJO required pyeloplasty and the rest needed only observation.Among the 20 neonates with UTD P3 high-risk dilatation, 10 cases of posterior urethral valve, six cases of complete PUJO, onecase of obstructive megaureter, one case of VUR, one case of bilateral ureterocele, and one case of non-neurogenic bladder,all of which required surgical intervention except in case of VUR.

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