Journal of Evolution of Medical and Dental Sciences

Permanent URI for this collection

https://imsear.searo.who.int/handle/123456789/163767

Executive Editor: Dr. Sridhar.A.
ISSN: 2278-4802 (Print); 2278-4748 (Online)

Frequency: Biweekly

Language: English

Open Access Peer-reviewed journal

Web site: https://jemds.com/index.php

Browse

Now showing 1 - 20 of 732

A 5 Year Retrospective Study of Ovarian Tumours and Tumour-like Lesions in a Tertiary Referral Centre, Gandhi Medical College, Bhopal
(Akshantala Enterprises Private Limited, 2020-02) Jain, Pramila; Malik, Reeni; Rampuri, Varsha
Ovaries can be afflicted by various lesions, which can be non-neoplastic or neoplastic. Varied spectrum of clinical features and histopathological patterns are seen in these lesions. The present study was done to study the histopathological patterns of ovarian neoplastic and non-neoplastic lesions and their distribution in women of different age groups.METHODSThis was retrospective study of all cases of neoplastic ovarian tumours, and non-neoplastic ovarian tumours including functional ovarian cysts received during 5-year period from January 2014 to December 2018 in the Department of Pathology of Gandhi Medical College and Hamidia Hospital, Bhopal (M.P.). Data regarding age and tumour histopathology were recorded from pathology records. Routine H/E staining was performed.RESULTSA total of 541 different non-neoplastic and neoplastic lesions of ovaries were seen. Neoplastic tumours were more common (350; 64.6%) than tumour-like lesions of the ovary (191; 35.3%). Non neoplastic ovarian tumours were found to be more common than neoplastic ones in all age groups. Maximum number of ovarian tumours were seen in the age group of 21 - 50 years (272, 77.7%). Among tumour-like ovarian lesions, the most common were corpus luteal cysts (75, 13.8%). These were found to be more common in the age group of 31 – 50 years (123, 65%). Surface epithelial tumours were the most common (253, 72.2%) followed by germ cell tumours (70, 12.9%).CONCLUSIONSNeoplastic tumours of ovaries are more common than tumour-like lesions of ovary. For all age groups, benign tumours are more common than malignant ones.
A 5-Year Clinical Experience of Haemolysis, Elevated Liver Enzymes and Low Platelet Count (HELLP) Syndrome at a Tertiary Care Teaching Hospital in North Karnataka - A Retrospective Analysis
(Akshantala Enterprises Private Limited, 2020-10) Biradar, Aruna Mallangouda; Yaliwal, Rajasri G; Kori, Shreedevi Somashekar; B S, Gamini; Pujeri, Shivakumar U
Haemolysis (H), elevated liver enzymes (EL) and low platelet count (LP) i.e., HELLP syndrome is a vaguely understood condition of pregnancy which can present with rapid onset. It is commonly associated with pre - eclampsia. HELLP is also known to manifest itself without the clinical features of pre - eclampsia. The present study aims to assess the maternal and foetal complications associated with HELLP syndrome. METHODSThis retrospective study included all the pregnant women who developed HELLP / partial HELLP with gestational age of ≥ 28 weeks. The variables analyzed were obstetric history, menstrual history, antenatal complications, laboratory investigations (haemolysis, ALT / AST, LDH, CBC), mode of delivery, postnatal complications, maternal outcomes and perinatal outcomes. RESULTS72 patients were included in the present study. The mean age of pregnant women with HELLP syndrome was 23.6 ± 4.15 years. The average age of gestation was 33.17 ± 4.02 weeks. 58 % patients were primigravida. As per Mississippi triple-class system 82 % patients had partial HELLP, 18 % had complete HELLP. 4 %, 4 % & 10 % patients had HELLP class I, II & III respectively. Among the total cases, 74 % patients had antepartum onset, 10 % had intrapartum & 17 % postpartum onset of HELLP syndrome respectively. 65 % patients delivered vaginally & rest 35 % underwent caesarean section. High risk factors such as pre - eclampsia (65 %), eclampsia (3 %) & previous history of HELLP (8 %) were noted in study cases. Abruptio placentae (18 %), postpartum haemorrhage (17 %), pulmonary oedema (14 %), renal failure (14 %) & DIC (7 %) were the maternal complications noted. Maternal mortality was 7 %. The major perinatal morbidities noted were prematurity (67 %) & FGR (42 %). Intrauterine death was noted in 19 % babies. Neonatal intensive care (NICU) was required for 58 % babies, of which 42 % had respiratory distress. Neonatal death was noted in 17 %. CONCLUSIONSHELLP syndrome is a life threatening condition of pregnancy which has serious maternal and perinatal morbidities. Prompt referral, timely and appropriate interventions can save lives. Availability of Intensive Care Units (ICU) facilities, dialysis units and blood and its components along with Neonatal Intensive Care Unit (NICU) facilities can remarkably reduce the maternal and neonatal complications.
Abetalipoproteinemia - A Rare Disease Presenting as Bleeding Disorder
(Akshantala Enterprises Private Limited, 2020-10) Vidyadharan, Geeta; Kurian, Bitty; Sivadas, Suchitra; Nampoothiri, Sheela; Yesodharan, Jyotsna
A 5-month-old child presented to the Paediatric Outpatient Department with complaints of fever, loose stools, blood in stool, and multiple subcutaneous swellings over the chest wall. The patient was given antibiotics and treated for acute gastroenteritis with a possibility of component of cow’s milk allergy also being considered. The routine blood counts revealed platelet count of 4.94 K / mL, along with Hb 10.2 g / dL, MCV - 80 fL, WBC - 13.6 x 109 / L. An LDH of 512 U / L (normal up to 451 U / L) and ESR of 2 mm / 1st hr. Liver function tests were within normal range. Her preliminary coagulation screening test showed both PT as well as aPTT to be prolonged beyond 120 sec each. She was further sent for complete laboratory evaluation for bleeding disorder. In view of the history of foul smelling stools, suggesting malabsorption, stool sample was analysed which showed presence of fat globules. USG was reported as normal study. Blood group was O positive.Abetalipoproteinemia is a very rare metabolic, autosomal recessive disease resulting from mutations encoding microsomal triglyceride transfer protein (MTP) leading to deficiencies in the apolipoproteins B-48 and B-100 with reported prevalence of less than one case per 100,000. Typical manifestations are failure to thrive, hypocholesterolaemia and fat malabsorption. Other features like fatty liver, acanthocytosis, and anaemia are usually present in infancy and neuro-ocular complications during adolescence. Early diagnosis and management can prevent disease progression
Absorbable versus Non-Absorbable Sutures in Paediatric Facial Trauma - A Cosmetic Assessment
(Akshantala Enterprises Private Limited, 2020-09) Pargal, Pinki
Paediatric age group is most vulnerable to trauma. Children often suffer facial injuries. Though many topical skin adhesives and strips are available in the market which have given excellent cosmetic results, deeper injuries especially along the lines of high tension need suturing both with buried and skin sutures. Different variety of sutures are available in the market which are used as per the choice of the surgeon. Children are more apprehensive when it comes to suture removal. So use of absorbable sutures in place of non-absorbable sutures in skin can save the children from this fear factor. MethodsA prospective study was done in the department of plastic surgery from May 2012 to Dec. 2013 with an objective of studying the outcome of plain catgut suture as skin sutures versus non-absorbable skin suture Nylon in facial trauma in the paediatric age group. Chromic catgut was used as buried suture in both groups. All the patients presenting in emergency department with facial trauma with age 10 years or less were included in the study. Skin sutures, where needed removal, were removed on 5th post-operative day followed by follow up on 7th post-operative day, 3rd month and 8th month during which cosmetic assessment of scar was done. 25 patients who presented first in emergency and fulfilled the study criteria were sutured with 5 - 0 chromic catgut buried sutures and skin suture used was 6 - 0 Nylon and this group was labelled group A. Next 25 patients who presented in emergency for suturing were sutured with 5 - 0 chromic catgut as buried and plain catgut as skin suture. This group was labelled as Group B. Cosmetic outcome was assessed on 7th post-operative day, 3rd month and 8th month by using Beusang E cosmetic scar assessment scale based on two parameters which included colour and texture of scar.1 Statistical analysis was done with continuous variables expressed as Mean ± S.D. and categorical variables were expressed as count (percentage). Chi-square was used to compare the categorical variables between groups or Fisher exact test was used. ResultsOn 7th post-operative day follow up, out of 50 patients, 25 patients (50 %) in whom nylon was used as skin suture, 4 patients (16 %) had mismatch of colour. All scars were smooth in texture. In rest 25 patients (50 %) in whom plain catgut was used as a skin suture, 1 (4 %) patient had mismatch of the colour. None of the patients had frank pus in both groups & hypertrophic scar was seen in one patient. On 3rd month follow up, Group A patients with nylon as skin suture, 1 (4 %) patient showed hypertrophic scar whereas in Group B (8 %) patients had hypertrophic scar. On 8th month follow up, both group A & B had colour mismatch of 12% with firm texture of scar in 8% patients. ConclusionsThere is no long-term differences in cosmetic outcomes and complication rates between absorbable catgut suture and commonly used nylon sutures in the repair of facial trauma in paediatric age groups. So, absorbable sutures are acceptable alternative to non-absorbable suture especially in paediatric age group, keeping in mind their apprehensive nature and fear of suture removal.
Accessibility and Utilization of Emergency Obstetric Care in Rural Settings of Wardha District- Beneficiaries Perspective
(Akshantala Enterprises Private Limited, 2020-02) Dakhode, Sarika; Gaidhane, Abhay; Choudhari, Sonali
In India, Emergency Obstetric Care services were started under RCH-II with the goal to reduce MMR to less than 100/lakh live births, and increase institutional deliveries to 80% by 2010. Strategy was to enhance availability and access to EmOC, for averting unpredictable death during pregnancy and childbirth. We wanted to determine the perception of beneficiary women about accessibility and utilization pattern of EmOC at peripheral health care facilities. METHODSThe present qualitative study was conducted in one of the eight blocks of Wardha (Maharashtra) from May to October-2017. Data was collected by in-depth interview of service users (21 beneficiaries). Notes were transcribed and then translated into English. Respondents’ verbatim that are significant and illustrative as per theme of study were used for analysis.RESULTSFacilitators for EmOC were found to be birth preparedness, promotion of institutional delivery, registration for JSY/JSSK through health workers along with provision of some EmOC services. Socio-cultural beliefs, leading to delay in recognition of danger signals to access care, transportation delay due to poor access of ambulance and identified vehicles along with insufficient coverage of JSSK program, were the main barriers. Beneficiaries who required EmOC were dissatisfied due to frequent referral & travelling, expenditure on transport & food, loss of daily wages, managing dependent family members and domestic work.
Accuracy of Infrared Forehead Skin Thermometry in Newborns - A Comparison with Digital Axillary and Rectal Mercury Thermometers.
(Akshantala Enterprises Private Limited, 2020-02) Hajela, Rita
Temperature is an important vital sign especially in neonates. Providing thermal comfort to baby is part of essential newborn care. The ideal temperature measurement method should be accurate, safe, noninvasive, time efficient, easy to operate and non-disturbing to baby. Mercury thermometers have been banned; rectal measurements are hazardous. Digital axillary thermometers although widely accepted, also have their limitations and sometimes produce questionable results in newborn. Infrared forehead thermometry is a promising tool with controversial results; hence this newer technology needs to be repeatedly tested and validated.METHODSThis is a prospective comparative study conducted in a tertiary care hospital situated in the hilly areas of Solan district of Himachal Pradesh. We simultaneously recorded three temperatures at three sites by different methods and different thermometers Forehead skin temperature was recorded in apparently normal newborns by INNOVA infrared thermometer and axillary temperature was recorded by digital thermometer and rectal temperature was recorded by mercury in glass thermometer.RESULTS260 newborns were included in the study. Data was analysed for correlation by Pearson r coefficient and for agreement by Bland-Altman method. A strong correlation was found between infrared forehead temperature and digital axillary temperature with a Pearson r of 0.826 and 0.801 between infrared forehead temperature and rectal mercury thermometer. Bland-Altman analysis of difference produced a mean difference of 0.49 and level of agreement of -1.67 and +2.65 when axillary digital and infrared forehead thermometry measurements were compared. Mean difference of 0.15 with level of agreement as -2.09 and +2.40 were obtained when rectal mercury and infrared forehead temperatures were compared.CONCLUSIONSAlthough a strong correlation of infrared skin thermometry was found with both axillary digital and rectal mercury temperature measurements. The level of agreement has a wide variation which is not clinically acceptable hence infrared forehead skin thermometry is not recommended for use in newborns.
Achievement of Functional Independence in a Patient with Sickle Cell Disease with Autoimmune Hepatitis, Osteomyelitis, Wilson s Disease, and Pathological Fracture Following Physiotherapy
(Akshantala Enterprises Private Limited, 2020-10) Vaidya, Laukik; Naqvi, Waqar; Awasthi, Abhiram; Kumar, Kiran; Phansopkar, Pratik
Acute B Virus Hepatitis with Fulminant Hepatic Failure Precipitating Crisis in Sickle Cell Disease.
(Akshantala Enterprises Private Limited, 2020-01) Pratapa, Sree Karthik; Acharya, Sourya; Gupte, Yash; Shukla, Samarth
Sickle cell disease (SCD) is a hemoglobinopathy which involves multiple organs in the body. Hepatobiliary manifestations in SCD are many. Acute and chronic HBV infection may be transmitted through multiple blood transfusions in SCD. We report the case of a 36-year-old male with sickle cell disease who presented to us in acute liver failure and sickle cell crisis due to acute hepatitis B virus infection. Sickle cell disorder is a broad category under which all the patients who have a point mutation (haemoglobin S-HbS) on at least one Beta chain due to substitution of valine in place of glutamic acid at position 6 are included. Due to this substitution, HbS molecules have a sticky site allowing the molecules to aggregate. This aggregation worsens in deoxygenated state leading to the development of long polymers, sickling of erythrocytes and haemolysis. The most commonly affected site in SCD is the hepatobiliary system. The presentation due to this involvement varies from benign hyperbilirubinemia to a spectrum of manifestations termed “sickle cell hepatopathy”.1
Acute Disseminated Encephalomyelitis (ADEM) versus Multiple Sclerosis (MS)- A Diagnostic Challenge in an Adult.
(Akshantala Enterprises Private Limited, 2020-05) Lahole, Swapnil; Acharya, Sourya; Bakshi, Sanket; Shukla, Samarth; Hulkoti, Vidyashree
Acute Disseminated Encephalomyelitis (ADEM) is a demyelinating disease of Central Nervous System (CNS). It usually is followed by infection and vaccinations. It commonly occurs in the paediatric age group. Its occurrence in adults is rare. When present in adults, a diagnostic dilemma always occurs between ADEM and Multiple Sclerosis (MS), because of overlapping clinical, and neuroimaging features. We present a case of a 46 year old female who presented to us with variable neurologic manifestations and later was diagnosed with ADEM. This case tries to embark on arguments so as to differentiate ADEM from MS while dealing with such cases.Acute Disseminated Encephalomyelitis (ADEM) and Multiple Sclerosis (MS) are both considered as immune mediated inflammatory demyelinating diseases of the central nervous system.1,2 Although considered as different conditions, the clinical presentation of both these conditions may overlap. The only gold standard differentiation is pathologically determined. Perivenous demyelination is a feature of ADEM and discrete confluent demyelination (plaque) is signature of MS. Still hybrid cases showing pathological features of both ADEM and MS may co-exist.ADEM, typically though not always is preceded by some infection or vaccination. The course of ADEM is usually monophasic and prognosis is better than MS which commonly presents with a relapsing and remitting course. Each exacerbating event worsens the clinical course in MS. Different clinical and/or radiological criteria to differentiate between the two spectrums of diseases have been proposed, but none of those unequivocally differentiate them.Hartung and Grossmann hypothesized that ADEM may be a part of the MS spectrum, rather than a different entity.3 The characteristic demyelination in ADEM is perivenous as opposed to MS where the demyelination is confluent. 4Acute Disseminated Encephalomyelitis (ADEM) is a demyelinating disease associated with inflammation and demyelination of the Central Nervous System (CNS) in a monophasic pattern. ADEM occurs commonly in paediatric age group often following viral infections, bacterial infections, or vaccinations.[5,6] The clinical characteristics include a sub-acute development of focal neurologic deficits, accompanied by encephalopathy. 5,6 It can rarely occur in middle-aged or elderly adults. The course is usually fulminant, but typically there is recovery in 50–75% of cases, with progression to multiple sclerosis in up to 20% of cases.[5,6]
Acute Emamectin Benzoate Poisoning- A Fatal Case Report.
(Akshantala Enterprises Private Limited, 2020-01) Godhiwala, Parth; Nirmal, Apoorva; Bakre, Anand; Wanjari, A. K.; Kumar, Sunil
Emamectin benzoate is a broad-spectrum insecticide for vegetables having wide margin of safety as reported in animal studies, due to its low gamma-aminobutyric acid receptor affinities and very poor penetration to the blood-brain barrier. Not a single case has been reported about fatal human exposure in India. This case highlights about 40-year-old man who succumbed in intensive care unit even after all supportive treatment as well as with Flumazenil and Lipid emulsion. Emamectin benzoate is a semisynthetic avermectin, a class of natural fermentation products of Streptomyces avermitilis (soil microorganism).
Acute Exacerbation of COPD Triggered by Pneumonia, and Secondary Spontaneous Pneumothorax (SSP).
(Akshantala Enterprises Private Limited, 2020-08) Acharya, Sourya; Andhale, Amol; Gupte, Yash; Hulkoti, Vidyashree; Annadatha, Akhilesh
Secondary Spontaneous Pneumothorax (SSP) can rarely complicate Chronic Obstructive Pulmonary Disease (COPD). Infections are common triggers for exacerbations of COPD. COPD with acute exacerbation presents with increasing dyspnoea. We present a rare case of a 75 year old female, who was a known case of COPD and developed right middle lobe pneumonia with partial collapse of the middle lobe along with a secondary spontaneous pneumothorax.
Acute Kidney Injury Masquerading as Acute Pancreatitis - Role of Serum Amylase and Lipase in Patients with Blunt Abdominal Trauma
(Akshantala Enterprises Private Limited, 2020-09) Sonawane, Sharad; Godhiwala, Parth; Naik, Srinivas; Ansari, Iftekhar; Kumar, Sunil
Blunt trauma to abdomen is one of the common causes for morbidity and mortality. In blunt abdominal trauma, there may be trauma to the pancreas, tear of bowel and hollow viscous, which can result in elevated levels of serum amylase and lipase. Serum amylase and mainly serum lipase are diagnostic markers for pancreatitis according to some literature. We report a young male, who presented with complaints of acute abdominal pain, constipation and vomiting after blunt abdominal trauma with elevated serum amylase and lipase levels with normal pancreas. Initial assessment of intra-abdominal pathology due to blunt abdominal trauma is often challenging as many injuries may not manifest during the treatment period. The manifestations may vary from being simply asymptomatic to life threatening injuries due to unavailability of accurate information about the nature of trauma. Hence, accurate diagnosis becomes very important in the management. Injury to the pancreas is not common and can result from direct penetration or through the transmission of blunt force to the retroperitoneum. Some studies report an incidence of 0.2 % cases for blunt trauma up to 1.1 % cases for penetrating trauma.1 The role of ultrasonography (USG) and Computed Tomography (CT) in management of Blunt abdominal trauma is well established. But the role of laboratory tests in the evaluation of these patients is controversial.2 In cases of Blunt trauma to abdomen, lot of causes found to cause serum amylase and serum lipase levels tend to raise. Some of these causes can be pancreatic, rupture of hollow viscus or bowel, facial and brain injury.3 It has also been found that reduced clearance of lipase can be caused by renal impairment. Thus non‐pathological raise in level of pancreatic enzymes, and other miscellaneous causes such as diabetes mellitus, drugs and infections shall be included as alternative pancreatic diagnoses.3
Acute Liver Failure and Intravascular Haemolysis in Zinc Phosphide Poisoning.
(Akshantala Enterprises Private Limited, 2020-06) Andhale, Amol; Acharya, Sourya; Pratapa, Sreekarthik; Shukla, Samarth; Kadam, Nakul
A 37-year-old male presented with symptoms of nausea, vomiting, abdominal pain, jaundice, lacrimation and reddish brown urine discoloration since 2 hours after ingestion of 30 gms of zinc phosphide with suicidal intent 4 hours before arriving at the hospital. There was no history of hematemesis, melena, convulsions. On examination blood pressure: 140/90 mmHg, Pulse: 120 beat per minute, RR: 24 cycles/minute, temperature: 37.5°C and O2 saturation: 91 percent in room air. Visible icterus was present. Diffuse tenderness was reviled by abdominal tests. Organomegaly was not present. The neurological examination was not important. There were flapping tremors. With 0.9 percentage of NaCl solution added with activated charcoal, the patient was given gastric lavage. Table 1 displays laboratory tests in the emergency department.
Acute Physiology and Chronic Health Evaluation Apache II - An ICU Scoring Tool to Assess Critically Ill.
(Akshantala Enterprises Private Limited, 2020-02) Arshad, Abdul Majeed; Ramachandran, Deepika; Hariharan; Surya; Koganti, Sindhura; Thangasamy, Dhanasekar; Rajagopalan, B.
The Acute Physiology and Chronic Health Evaluation (APACHE II) is the severity score and mortality estimation tool developed for use in ICU’s around the world. It is calculated during the first twenty four hours of admission of the patient to an ICU. An integer score ranges from values 0 to 71. During the stay, the score is not recalculated; and by definition, is an admission score.METHODSThis is a cross sectional study done on 100 patients admitted in the medical ICU in Sri Ramachandra Institute of Higher Education and Research.RESULTSOur results showed an APACHE II score of 16.5 which was significant and values equal to and higher than that correlated with the severity of illness.CONCLUSIONSAPACHE II score is a good predictor of mortality in acute respiratory failure patients. It is a useful audit tool which helps the healthcare professionals to interpret and compare their care performance over time.
Acute Transient Hemiparesis - An Unusual Pseudo Exacerbation of Multiple Sclerosis
(Akshantala Enterprises Private Limited, 2020-10) Ghule, Aishwarya; Acharya, Sourya; Lahole, Swapnil; Andhale, Amol
Multiple sclerosis is a chronic demyelinating disease characterised by inflammation and plaque formation. Multiple sclerosis has many variants. It presents as four clinical forms, Relapsing Remitting Multiple Sclerosis (RRMS), Primary Progressive Multiple Sclerosis (PPMS), and Secondary Progressive Multiple Sclerosis (SPMS) and Primary Relapsing Multiple Sclerosis (PRMS). RRMS can present as acute attacks. They should be differentiated from pseudo-exacerbations. True exacerbation is when a new lesion appears in the brain or spinal cord, with a neurological episode lasting for more than 24 hours, with a period of clinical stability over the last 30 days.1 Any flaring up of symptoms of multiple sclerosis due to external factors such as fever, heat or infection is called pseudo-exacerbations. Pseudo-exacerbation episodes do not last for more than 24 hours and should resolve with treatment of the underlying fever or infection.2
Advance Physiotherapeutic Rehabilitation Approach for Hand Functions in a Giant Cell Tumour Patient- A Case Report on Palliative Physiotherapy
(Akshantala Enterprises Private Limited, 2020-05) Shah, Pooja Ajay; Nemade, Sneha Vilas; Naqvi, Waqar M.
Giant cell tumour is a benign tumour of the bone. It is aggressive locally and has low metastatic potential.(1) Following lower end of femur and upper tibia, distal end of radius is the third most evident location for giant cell tumour (GCT) and about 10 percent of GCT involves distal radius.(2) GCT have often been identified as difficult to manage, mainly due to their close proximity to multiple tendons, median nerves, radial arteries and carpals.(3) Surgical treatment includes extended curettage of bone and replacing the cavity with bone graft, or excision of the tumour followed by reconstruction of bone with autograft or allograft.(1) Wrist fusion after ulnar translocation results in reduced range of pronation and supination movements in the forearm initially and mainly flexion and extension of the wrist joint, lag of the extensor pollicis brevis and longus tendons, abductor pollicis longus, stiffness and the risk of infections at the site.(6) Physiotherapy has been shown to be effective in the post-surgery treatment of patients. Nonetheless, the therapeutic program involves passive movement to active movements, manual joint mobilization, progressive resisted exercises, muscle energy technique and electrotherapy with adequate patient education. This has been shown to help improve patient outcomes and alleviate pain and recover full range of motion.(7)The distal end of the radius is the third most apparent site for giant cell tumour (GCT) after the lower end of the femur and upper tibia and about 10 per cent of GCT includes distal radius. After ulnar translocation and wrist arthrodesis the full range of motion cannot be regained at the wrist joint and which makes the case unique, physical therapy has been shown to be helpful for improving patient performance and quality of life in post-surgical situations. Patient main concerns were pain and oedema around wrist with loss of strength, power and range of motion. Main clinical findings found in this case were severe reduction in of range of motion at CMC, MCP and IP joints. Reduced strength in hand muscles. Loss of superficial sensation over C6, C7 in affected extremity (right). Giant Cell Tumour that was confirmed by X-Ray and histopathology as well as MRI. Nerve injury confirmed by Nerve Conduction Velocity. Therapeutic interventions are found to be beneficial in these type cases. The patient was able to achieve 4/6 activities of daily living and gain functional range of motion after continuous 10 weeks of intensive systematic physiotherapy treatment program.
Advanced Maternal Age and the Frequency of Pre-Eclampsia - A Single-Center Cross Sectional Study from Saudi Arabia
(Akshantala Enterprises Private Limited, 2020-09) Abu-Zaid, Ahmed; Alomari, Mohammed; Al-Hayani, Majed; Bazi, Abdulrahman; Almazmomy, Asim; Alsaegh, Abdulaziz; Alshawkani, Hattan; Radwan, Ashraf
Pregnancy at advanced maternal age (≥35 years) has become very common worldwide. Pre-eclampsia (PE) is a serious complication of hypertensive pregnancy that is associated with considerable morbidity and mortality to both the mother and foetus/newborn. This research aimed to inspect the prevalence of PE in a single hospital located in Jeddah, Saudi Arabia, and examine the influence of advanced maternal age (≥35 years) on the occurrence of PE in singleton deliveries. MethodsA retrospective study (January 2011 to December 2018) was carried out at King Abdulaziz University Hospital (KAUH), located in Jeddah, Saudi Arabia. Categorical variables were evaluated with χ² test. Odds ratio (OR) with 95% confidence intervals (95% CI) was used to estimate the comparative risk of developing PE (the outcome variable) according to the maternal age (the exposure variable) at the time of pregnancy. ResultsDuring the study period, 3942 singleton deliveries occurred at KAUH. The demographic characteristics (age and PE) of the study population are summarized in Table 1. Overall, there were 2426 deliveries with a maternal age <34 years (61.5%), whereas there were 1516 deliveries with a maternal age ≥35 years (38.5%). Only 167 deliveries had a diagnosis of PE, thus yielding an overall prevalence of 4.2% in this retrospective study. The percentages of PE cases in patients with maternal age <34 years and ≥35 years were 3.7% and 5.1%, respectively. Two-tailed Chi-square test of independence showed that there was a statistical significance between advanced maternal age and occurrence of PE (p=0.02). To examine the comparative risk of developing PE with relation to the maternal age, an OR analysis showed that patients with advanced maternal age (≥35 years) were 1.4 times more likely to develop PE during gestation when compared to patients with <34 years, and this comparative risk was substantial (OR: 1.4, 95% CI: 1.1-1.9, p=0.03). ConclusionsThe low prevalence of PE (3.9%) in our study was largely in agreement with the published regional and international figures. Advanced maternal age (≥35 years) is a statistically significant factor for developing PE during pregnancy.
Aesthetic Correction of Gingival Pigmentation .Using Different Techniques
(Akshantala Enterprises Private Limited, 2020-03) Mandal, Subhapriya; Bose, Sharanya; Choudhuri, Poulomi; Chakrabarty, Himadri; Chakrabarty, Abhijit
Men and women of the present generation are extremely conscious of how they present themselves before the world and have been giving enormous importance to their aesthetics in every facet to augment their personality. An appealing smile boosts one’s individuality. The harmony of the smile is attributable to the contour, colour, and position of the teeth in conjunction with the gingival tissue. Hence undesirable gingival pigmentation can be a major drawback in the aesthetics of the patient. Gingival pigmentation is defined as the discoloration of the gingiva due to lesions analogous with extrinsic as well as intrinsic factors.[1] The five primary pigments melanin, melanoid, oxyhaemoglobin, reduced haemoglobin and carotene are the main causative factors of depigmentation.[2]
Aesthetic Rehabilitation of Maxillary Anterior Teeth with Implant Supported Fixed Partial Prosthesis
(Akshantala Enterprises Private Limited, 2020-10) Shinde, Dipak M; Godbole, Surekha R; Dhamande, Mithilesh M; Dafade, Anagha R
Aesthetic result is an essential factor for defining success in implant placement. Long term studies have shown high survival rates in single or multiple implant placement. But, in aesthetic areas of mouth, along with implant survival, aesthetic success of implant therapy is also an important factor. Many elements contribute to this “success” and can be evaluated objectively. These elements are healing capability of the individual, the conditions of soft and hard tissues present, and the provisional and final restorations. In this case report we have described the treatment plan, surgical and prosthetic procedure done to rehabilitate individuals with edentulous area in maxillary anterior region.Traumatic injury or a congenital anomaly is the common reason of tooth loss in anterior region of jaws. Various options like Removable dental prostheses, conventional fixed partial dentures (FPDs), resin-bonded FPDs, implant supported prostheses are existing for the replacement of missing teeth in anterior region.1-3The discomfiture produced by unstable dentures and a continuous effort to stabilize them have led many people to strive for implant supported restorations. These restorations are implant supported, which do not transmit load to denture bearing areas, thus it does not cause bone resorption related with tissue-borne prostheses.4 Studies have proven that long-term benefits can be provided to edentulous patients using implant supported restorations, achieved using diligent surgical skills and proper restoration.5 Implant supported FPD is an ideal treatment option, for replacing missing teeth of aesthetic areas of mouth in young adult with completed skeletal and dental growth.6In this case report we have described the treatment plan, surgical and prosthetic procedure done to rehabilitate individuals with edentulous area in maxillary anterior region.
Aetiological and Clinical Profile of Hypertension in Children
(Akshantala Enterprises Private Limited, 2020-10) Sodha, Nandini; Rajurkar, Rajshree; Kela, Gunjan
We wanted to study the clinical and aetiological profile of hypertension in children and compare the results with previous studies done in paediatric hypertension among children between 3 and 15 years of age. METHODSAll children between 3 and 15 years of age who visited the Outpatient & Inpatient Department of Paediatrics, SAIMS were screened for the presence of hypertension. Systematic investigations were done to find out the aetiology of hypertension. RESULTSMaximum number of patients were in the age group of 3 to 9 years, followed by 12 to 15 years and 9 to 12 years age groups. Males were affected more. Nephrotic syndrome was the commonest cause of hypertension in children. CONCLUSIONSIn this study, it has been observed that minimum number of patients were in age group 9 - 12 years patients (19.3 %) and maximum number of patients were in the age group 3 - 9 years (51.6 %) with a M : F ratio of 1 : 0.93. and the main aetiology of hypertension was found to be nephrotic syndrome.

Browse

Browsing Journal of Evolution of Medical and Dental Sciences by Title

Results Per Page

Sort Options