Annals of International Medical and Dental Research (AIMDR) 

Vol-7, Issue-5 | September-October 2021

Functional Outcome of the Superior Lateral Genicular Artery Flap for Soft Tissue Reconstruction around Knee

MdShakhawat Hossain1*, Taslima Sultana2, Mst. Rezwana Khatun3

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-5 | September-October 2021 | Page: 1-7

Functional Outcome of the Superior Lateral Genicular Artery Flap for Soft Tissue Reconstruction around Knee.

MdShakhawat Hossain1*, Taslima Sultana2, Mst. Rezwana Khatun3

Abstract

Introduction: Soft tissue defect is a difficult problem. The superior lateral genicular artery flap (SLGA flap) is a fascio-cutaneous flap based on the cutaneous perforators of the SLGA to reconstruct the damaged soft tissue around knee.Aim of the study: The aim of this study was to assess the functional outcome of the Superior Lateral Genicular Artery Flap for soft tissue reconstruction around knee.Methods: Thisprospective observational study was conducted in the Department of Plastic Surgery & Burn Unit, Dhaka Medical College and Hospital, Dhaka from July 2015 to June 2016. Due to time constraint and scarcity of patients 15 patients presented with defects around the knee were enrolled in this study using purposive sampling method.Result: In this study, maximum patients (66.7%) were male. Majority of respondents (46.7%) were between the age group of 36-45 years. Mean age was 39.53±13 years. In this series, RTA (26.7%) was the main aetiology of soft tissue defect. In the present series, the most common site of defect was popliteal fossa 7(46.7%). Majority of the patients gained full range of knee movement 13(86.7%).Conclusion: Majority of the patients gained full range of knee movement after Superior Lateral Genicular Artery Flap surgery ofsoft tissue reconstruction around knee.

Functional Outcome, Superior Lateral Genicular Artery Flap and Soft Tissue Reconstruction.

Evaluation of Efficacy of Laparoscopy in Patients with Chronic Abdominal Pain

Md Shofiur Rahman1*, Md Ahsan Habib2, Jafrin Akhter3

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-5 | September-October 2021 | Page: 8-14

Evaluation of Efficacy of Laparoscopy in Patients with Chronic Abdominal Pain

Md Shofiur Rahman1*, Md Ahsan Habib2, Jafrin Akhter3

Abstract

Background: Laparoscopy has been found to have significant diagnostic and therapeutic role in patients with chronic abdominal pain.The main advantage of laparoscopic evaluationis to detect the presence or absence of intra- abdominal organic lesion. Objective: This study was aimed to Evaluate of Efficacy of Laparoscopy in Patients with Chronic Abdominal Pain. Methods: This clinical study was conducted in the Department of Surgery, Sir Salimullah Medical College & Mitford Hospital, Dhaka, Bangladesh during the period from September 1998 to September 2000. A total of 40 patients aged between 10-70 years of both sex with laparoscopy in chronic and relapsing abdominal pain. All the patients included in this study based on selection criteria and compiled in a protocol approved earlier. After the routine diagnostic work up and failing to reach a conclusive diagnosis, all the patients were subjected to diagnostic laparoscopy. Based on the findings therapeutic extension of the laparoscopy done to complete some standard procedure like laparoscopic appendicectomy or harvesting tissue samples for histopathological or other examination. Statistical analysis of the results was obtained by using window-based computer software devised with Statistical Packages for Social Sciences (SPSS-22). Results: Highest number of patients was in 5th, 6th 7th decade and above. Comparatively older age groups are more involved in this study. Male diagnostic laparoscopy is a bit in higher (52.5%) than female groups (47.5%). Out of 8 patients 3 patients (7.5%) suffers from diabetes mellitus, 1 patient (2.5%) suffers from pulmonary T.B. 2 patients (5%) suffer from hypertension, 1 patient (2.5%) suffers from bronchial Asthma and 1 patient is a known case of hypothyroid. The patient who suffers from T.B. gave positive history of taking anti tuberculous drug. Majority of the patients having upper abdominal manifestations. Conclusion: Diagnostic laparoscopy is a better, cost-effective, and efficient method of establishing the diagnosis in patients with chronic abdominal pain.

Adhesiolysis, Appendectomy, Chronic abdominal pain, Diagnostic laparoscopy

Role of Diagnostic Laparoscopy in Chronic and Relapsing Abdominal Pain

Md Shofiur Rahman1*, Md Ahsan Habib2, Jafrin Akhter3

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-5 | September-October 2021 | Page: 15-21

Role of Diagnostic Laparoscopy in Chronic and Relapsing Abdominal Pain

Md Shofiur Rahman1*, Md Ahsan Habib2, Jafrin Akhter3

Abstract

Background: Diagnostic laparoscopy is now accepted as the preferred primary approach to many disease processes. Chronic abdominal pain is a very common condition presenting to a general, surgical practices.Objective: This study was aimed to determine the scope of diagnostic Laparoscopy in indeterminate case of chronic & relapsing abdominal pain. Methods: This clinical study was conducted in the Department of Surgery, Sir Salimullah Medical College & Mitford Hospital, Dhaka, Bangladesh during the period from September 1998 to September 2000. A total of 40 patients aged between 10-70 years of both sex with laparoscopy in chronic and relapsing abdominal pain. All the patients included in this study based on selection criteria and compiled in a protocol approved earlier. After the routine diagnostic work up and failing to reach a conclusive diagnosis, all the patients were subjected to diagnostic laparoscopy. Based on the findings therapeutic extension of the laparoscopy done to complete some standard procedure like laparoscopic appendicectomy or harvesting tissue samples for histopathological or other examination. Statistical analysis of the results was obtained by using window-based computer software devised with Statistical Packages for Social Sciences (SPSS-22).Results: Highest number of patients was in 5th, 6th 7th decade and above. Comparatively older age groups are more involved in this study. Male diagnostic laparoscopy is a bit in higher (52.5%) than female groups (47.5%). Out of 8 patients 3 patients (7.5%) suffers from diabetes mellitus, 1 patient (2.5%) suffers from pulmonary T.B. 2 patients (5%) suffer from hypertension, 1 patient (2.5%) suffers from bronchial Asthma and 1 patient is a known case of hypothyroid. The patient who suffers from T.B. gave positive history of taking anti tuberculous drug. Majority of the patients having upper abdominal manifestations.Conclusion: Laparoscopic intervention could be performed in a good range of abdominal conditions as a reliable diagnostic as well as therapeutic tool.

Adhesiolysis, Appendectomy, Chronic abdominal pain, Diagnostic laparoscopy.

Correlation of Serum Adiponectin with hs CRP, eGFR and BMI in CKD Patients in Comparison to Healthy People.

Md. Shahadat Hossain1*, Sourav Saha2, Marjoa Humaira Mekhola3, Maimuna Sultana4, Mst. Hasnahena Nargis5, SharabanTahora6, MdRajibur Rahman7, Majadul Islam8, Nazma Azim9, Jinat Farjana10

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-5 | September-October 2021 | Page: 22-28

Correlation of Serum Adiponectin with hs CRP, eGFR and BMI in CKD Patients in Comparison to Healthy People.

Md. Shahadat Hossain1*, Sourav Saha2, Marjoa Humaira Mekhola3, Maimuna Sultana4, Mst. Hasnahena Nargis5, SharabanTahora6, MdRajibur Rahman7, Majadul Islam8, Nazma Azim9, Jinat Farjana10

Abstract

Introduction: Chronic kidney disease (CKD) is a unique conditionwith exceedingly high incidence of insulin resistance and cardiovascular morbidity and mortality.Aim of the study: To see the correlation of serum adiponectin with hs CRP, eGFR and BMI in CKD patients in comparison to healthy people. Material & Methods: This cross sectional study was conducted at the Department of Nephrology and Department of biochemistry of National Institute of Kidney Diseases and Urology, Dhaka. A total of 149 patients were included for the study from January 2018 to December 2018. Among them 112 were predominantly patients of CKD stage 3 to 5 and rest of 37 healthy people were enrolled in this study as Group I and Group II respectively. Purposive sampling technique was used. Statistical analysis of the results was done by using computer based statistical software, SPSS (SPSS Inc, Chicago, IL, USA). Prior to the commencement of the study, the ethical committee of NIKDU, Dhaka, approved the thesis protocol.Results: Mean age was 50.45 ± 10.45 years and 36.55 ± 8.35 years in Group I and Group II. Males were little higher in CKD groups. Serum adiponectin level was significantly higher in female both in group I and group II. 51% of our CKD patients had Glomerulonephritis as a primary cause. Serum creatinine, S. adiponectin were significantly higher and eGFR were significantly lower in Group I comparing to Group II. BMI andeGFR were found significantly lower in G5 patients comparing G3 and G4 patients. Hs CRP and Serum adiponectin were found significantly higher in G5 patients than G3 and G4 patients. Hs CRP and Serum adiponectin were found significantly higher in G5 patients than G3 and G4 patients.ConclusionAccording to the study, S. adiponectin was found significantly higher in CKD patients in comparison to healthy people. S. Adiponectin, serum creatinine and hs CRP were found higher whereas eGFR, BMI were found lower in CKD patients in comparison to healthy people.

Cardiovascular, Insulin, CKD, Adiponectin, Glomerulonephritis.

Correlation of FGF-23 with Serum Calcium, Phosphate, PTH, Vitamin D and Urinary Phosphate in Different Stages of CKD Patients

MarjoaHumaira Mekhola1*, Md. Shahadat Hossain2, Sourav Saha3, Maimuna Sultana4, Abu Ahmed Golam Akbar5, Md. Zakir Hasan6, A.B.M. Shafiuzzaman7, Shawon Shahriar8, Jinat Farjana9, Nazma Azim10

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-5 | September-October 2021 | Page: 29-35

Correlation of FGF-23 with Serum Calcium, Phosphate, PTH, Vitamin D and Urinary Phosphate in Different Stages of CKD Patients

 

MarjoaHumaira Mekhola1*, Md. Shahadat Hossain2, Sourav Saha3, Maimuna Sultana4, Abu Ahmed Golam Akbar5, Md. Zakir Hasan6, A.B.M. Shafiuzzaman7, Shawon Shahriar8, Jinat Farjana9, Nazma Azim10

Abstract

Background: Chronic kidney disease (CKD) has been recognized as a leading public health problem worldwide. The global estimated prevalence of CKD is 13.4% (11.7-15.1%).Fibroblast Growth Factor-23(FGF-23) is the bone-derived phosphatonin that has been extensively studied and was found to play a critical role in normal physiology and results in altered mineral metabolism in CKD.Aim: To see the correlation of FGF-23 with serum calcium, phosphate, PTH, Vit D and urinary phosphate in different stages of CKD patients. Methods: This cross-sectional study was conducted at the Department of Nephrology and Department of biochemistry of National Institute of Kidney Diseases and Urology (NIKDU), Dhaka. A total of 152 patients were included for the study, during July 2018 to June 2019. Among them 112 were patients of CKD from stage 1 to 5 and 40 were healthy individuals. They were assigned in Group I and Group II, respectively. Statistical analysis of the results was done by using computer based statistical software, SPSS (SPSS Inc, Chicago, IL, USA). Prior to the commencement of the study, the thesis protocol was approved by the ethical committee of NIKDU, Dhaka. Results:Mean age was 52.0 ±10.2 years and 48.0 ±10 years in Group I and Group II, respectively. Among the 112 CKD patients 8% presented in stage 1 and 2, 27.7%, 35.7% and 28.6% presented in stage 3, 4, 5 respectively. Vit D level was low in both group I and group II and further deterioration of the levels was observed in all stages of CKD, especially in stage 5. S.FGF23 (pg/ml) level were 31.6±22.9, 38.4±27.8 and 53.8±46.5 for CKD stage 3, stage 4 and stage 5 respectively. S.phosphate was significantly raised in group I patient compared to group II. The level of s.phosphate in CKD stage 3 was 3.5±1.1, 4.0±1.2 for stage 4, 5.0±1.6 in stage 5. S.phosphate levels were found to be within normal range in stage 3 and 4 but raised in stage 5. In group I, s. FGF23 level was positively correlated with s.phosphate and urinary phosphate negatively correlated with S.FGF23 level in CKD stage 3,4,5 without any statistical significance. Conclusions:Laboratory parameters for different variables with cut off values in CKD patients revealed, S. FGF23 was found raised and S. calcium decreased in stage V.

Kidney Disease, FGF-23, Vitamin D, Hypertension, eGFR.

Evaluation of the Patient Characteristics and Colonoscopic Findings in Patients Presenting with Lower Gastrointestinal Bleeding in a North Indian Center

Ashish Kumar1, Mohanvir Kaur2, Nelcy Jakhu3*, Mukul Kansal4, Anu Goyal5, Akhilesh Grover6, Dharamjit Kaur7

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-5 | September-October 2021 | Page: 36-42

Evaluation of the Patient Characteristics and Colonoscopic Findings in Patients Presenting with Lower Gastrointestinal Bleeding in a North Indian Center

Ashish Kumar1, Mohanvir Kaur2, Nelcy Jakhu3*, Mukul Kansal4, Anu Goyal5, Akhilesh Grover6, Dharamjit Kaur7

 

Abstract

Lower gastrointestinal bleed (LGIB) may present as an acute life-threatening event, intermittent hematochezia or as chronic fecal occult blood loss. There is wide variation in the etiologies of lower gastrointestinal bleed reported from different regions. In this study we evaluated patient characteristics and colonoscopic findings of patients presenting with LGIB from our region. Materials and methods: This study was carried out in a tertiary care teaching hospital (in Punjab in northern India) on 100 patients presenting with visible or suspected LGIB. Patients with suspected upper gastrointestinal source of bleed and acute infectious bloody diarrhea were excluded from the study. Clinical details of all patients were noted. All patients underwent colonoscopy ± retrograde ileoscopy after standard preparation and findings were recorded. Results: A total of 100 patients (67 male and 33 female) with mean age 46.53 +-17.34yrs were part of this study. Colonoscopy showed abnormal findings in 87% patients. The commonest diagnosis was ulcerative colitis, which was found in 29% patients. Second most common diagnosis was colorectal carcinoma found in 26% of the patients followed by haemorrhoids in 21% of the patients, colorectal polyps in 6% of the patients and non specific colitis in 5% of the patients. Anal fissure, solitary rectal ulcers and non specific ileitis were found in 2% of the patients each. Radiation proctitis and diverticulitis were found in 1% patient each. No lesion was found in 13% of the patients. Conclusion: Colonoscopy is an effective diagnostic tool in diagnosis of LGIB and it provided useful clinical information in majority of the patients. Our study reveals that ulcerative colitis, colorectal carcinoma, haemorrhoids and colorectal polyps are common causes of lower gastrointestinal bleeding in our region.

Lower Gastrointestinal Bleeding, Colonoscopy, Inflammatory Bowel Disease, Colorectal Carcinoma, Hemorrhoids

Subacute Thyroiditis After SARS-Cov-2-First Study From Madhya Pradesh,India

Sandeep Negi1, Lakshmi Bala2, Munesh Kumar Sharma3*

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-5 | September-October 2021 | Page: 43-47

Subacute Thyroiditis After SARS-Cov-2-First Study From Madhya Pradesh,India

Sandeep Negi1, Lakshmi Bala2, Munesh Kumar Sharma3*

Abstract

Background: Subacute thyroiditis is a viral or postviral thyroid disease.The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak, which began in Wuhan, China, has spread fast throughout the world, also affected almost all states of India. Objectives: The present work is the first report of  Subacute thyroiditis after SARS-CoV-2 Infection from Dewas, region of Madhya Pradesh, India. Methods: In the present study is about the clinical,laboratory diagnosis, and radiological findings of25years old female, who came to our hospital with symptoms like fever, neck pain radiated to the jaw and palpation which wasnoticed one month after positive report for SARS-CoV-2 by RT–PCR technique.Coronavirus disease 2019(COVID-19)was mild positive and the woman had recovered completely withina week.Results: Increased heart rate and painful and enlarged thyroid on palpation were noticed during physical examination. The laboratory test findings indicated high values of free thyroxine andfree triiodothyronine.Total leukocyte count and inflammatory markers were also increased. Neck ultrasound reported enlargement of both the lobes of the thyroid with multiple isoechoic & hypoechoic nodules.FNAC examination suggested a case of subacute thyroiditis. Finally, Subacute Thyroiditis was diagnosed.In the treatment,the patient has started prednisone(25 mg/d).Neck pain and fever recovered within 2-3 days and the remaining symptoms within 1 week. Thyroid function and inflammatory markers normalized in one month. Conclusions:The present study is the first reportofSubacute Thyroiditis from the Dewas region of Madhya Pradesh, India. This study will be alert to clinicians and other medical practitioners for Subacute Thyroiditis and its clinical manifestationsin association with COVID-19.

FNAC,COVID-19,free thyroxine and free triiodothyronine,CRP

Role of Manuka Honey on the Postoperative Sequelae of Mandibular Third Molar Disimpaction -A Prospective Analysis

Bhavna Malik1, *Munish Kumar2, Jyoti Mittal3, Parnika Kuthiala4, Rishabh Kasrija5, Vikrant Gothi6

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-5 | September-October 2021 | Page: 48-54

Role of Manuka Honey on the Postoperative Sequelae of Mandibular Third Molar Disimpaction -A Prospective Analysis

Bhavna Malik1, *Munish Kumar2, Jyoti Mittal3, Parnika Kuthiala4, Rishabh Kasrija5, Vikrant Gothi6

Abstract

Introduction: This work is aimed at the function of honey in the soft tissue management of the post-extraction socket. The aim of study to evaluate the application of honey in postoperative soft tissue curing of the extraction socket.Materials and methods: The present study incorporated 50 acquainted and approved vigorous patients. Two test groups were made, respectively, the test group (Group A) acknowledged Manuka honey as an intra-alveolar medicament in the extraction socket preceding the suturing. In contrast, the control group (Group B) had the principal securing, devoid of any medicament in the extraction socket. Postoperative pain was measured by VAS; edema by measurements of pre-op specified landmarks and the mouth opening was noted and evaluated with preoperative measurement on first, third, and seventh postoperative days.Results: The first and second postsurgical days of VAS scores of the control group were extensively elevated as measured up to the Manuka group (P < 0.05; Table 1). There was no momentous group difference in VAS scores at the third, fourth, fifth, sixth,   and seventh postsurgical days (P=0.05).Conclusion: It has been demonstrated in this study thatpostsurgical extraction of impacted lower third molars intra socket application of Manuka honey is a productive process for reducing sharp postsurgical pain.

Manuka honey, surgical extraction, third molars, postsurgical pain, VAS scores.

Prevalence of Radix Entomolaris in Permanent Mandibular First Molars in Kashmiri (North Indian) Population

Samriti Sharma1*,Riyaz Farooq2,Aamir Rashid Purra3

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-5 | September-October 2021 | Page: 55-60

Prevalence of Radix Entomolaris in Permanent Mandibular First Molars in Kashmiri (North Indian) Population

Samriti Sharma1*,Riyaz Farooq2,Aamir Rashid Purra3

Abstract

Introduction: The aim of this study was to evaluate the prevalence of permanent mandibular first molar teeth withthree roots among Kashmiri (North Indian) population and to assess any gender predilections along with the side (right or left) predominance. Materials and methods: This study was conducted in the Department of Conservative Dentistry and Endodontics, Government Dental College and Hospital, Srinagar (Jammu and Kashmir). A total of 280 patients (160 males and 120 females) were included in the study. Periapical radiographs were taken and evaluated for the presence of third root (Radix Entomolaris) in mandibular first molar. The prevalence of radix entomolaris was compared between male and female patients and predominance was compared on the right and the left sides. The results were then statistically analyzed using the Chi‑square test. Result: The overall prevalence of individuals with radix entomolaris was 12.14%. There was statistically no significant difference in the prevalence of three rooted mandibular first permanent molars between males and females (p > 0.05). Mandibular first molars on right side showed higher incidence of third root as compared to the left side but the difference was not statistically significant. Conclusion: The clinician should be familiar with the ethnic variations in root morphology while treating the mandibular first molars so as to reduce failures caused by missed canals and roots. A careful clinical and radiologic evaluation is needed to ensure long term success of endodontic treatment of permanent molars.

Radix Entomolaris, Mandibular first molars, Anatomic Variations, Root canal treatment

Efficacy and Safetyfor the combination of Montelukast and Levocetirizine in patients of allergic rhinitis: Post Marketing Surveillance study

Mayuresh Kiran1, Lalit Pawaskar2*, Shaheen Sheikh3, Pramita Waghambare4

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-5 | September-October 2021 | Page: 61-70

Efficacy and Safetyfor the combination of Montelukast and Levocetirizine in patients of allergic rhinitis: Post Marketing Surveillance study

Mayuresh Kiran1, Lalit Pawaskar2*, Shaheen Sheikh3, Pramita Waghambare4

Abstract

Introduction: When patients exposes to allergen, histamine gets released from mast cells due to hypersensitivity towards allergens. Antihistamines can be used to treat allergic rhinitis as it blocks histamine receptors from nerve terminals that produces relief from allergic rhinitis. As monotherapy of antihistamines cannot reduce all the symptoms of allergic rhinitis like nasal congestion or inflammation, hence antihistamines can be combined with leukotriene receptor antagonist like Montelukast which inhibits leukotriene, allows the patient to breathe normally and reduces swelling. This post marketing surveillance study was conducted to evaluate theefficacy and safety for allergic rhinitis patients for the fixed dose combination of Montelukast 10 mg and Levocetirizine 5 mg per tablet (investigational product) in Indian Population. Method: Out of180 enrolled trial subjects,164 trial subjects completed the study. Efficacy was evaluated by decrease in total symptom score (TSS) where trial subjects were asked to rate the symptoms on 11 point scale ranging from 0 (no symptoms) to 10 (severe symptoms) which wasfurther extrapolated to four-point Likert-type-symptom-severity scale. Safety was analysed by the reported adverse events.  Results: Reduction in TSS was from 6.60 (day 1) to 3.28 (day 5) to 0.56 (day 10).  Nearly all the trial subjects had more than 50% reduction in TSS at all visits and the majority of trial subjects had complete relief from the symptoms.Also, no serious or unexpected adverse event was observed during study. Conclusion: The investigational product was found to be efficacious and safefor the treatment of allergic rhinitis.

Allergic rhinitis, Montelukast, Levocetirizine, Efficacy, Safety

Serum Uric Acid Levels and Musculoskeletal Manifestations

K.Vamshidhar Reddy1, G.Venu2*, A.Pavan Kumar3, Veer Abhishek Goud4, S.Shyam Sunder5, Mustafa Hussaini6

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-5 | September-October 2021 | Page: 71-80

Serum Uric Acid Levels and Musculoskeletal Manifestations

K.Vamshidhar Reddy1, G.Venu2*, A.Pavan Kumar3, Veer Abhishek Goud4, S.Shyam Sunder5, Mustafa Hussaini6

Abstract

Background: To assess serum uric acid levels in patients with musculoskeletal complaints and study its prevalence and correlation with the complaints. Materials & methods: Total 1123 patients complaining of unexplained musculoskeletal problems for duration of more than 4 weeks were enrolled in the study. Patients with known rheumatologic autoimmune disease known gouty arthritis, malignancy, evident cardiovascular disease or any associated endocrine gland disorder apart from diabetes mellitus were excluded.All patients were subjected to full history taking, clinical examination, laboratory tests.Anthropometric measurements were done for assessment of body mass index and central obesity. Results: Out of 1123 patients, 657 patients (58.5%) had elevated SUA whereas 466 patients (41.5%) had normal SUA. Elevated SUA were positively correlated with musculoskeletal complaints. Among the study population, around 40% had soreness, bodyaches, 17.9% had interphalangeal& wrist joint pain, stiffness, 13.86 % had bilateral knee pain, 11.4% had low backache and stiffness. Others contributed to <10% each. Prevalence of elevated SUA was higher in male patients than female patients with significant p-value (p<0.0001). 619 patients (55.12%) were alcoholics, and mean SUA levels among alcoholics are higher when compared to non- alcoholics which was statistically significant with p value of <0.00001.  266 patients (23.69%) had co-existing diabetes mellitus. Conclusion: Majority of the cases with unexplained musculoskeletal complaints were associated with elevated SUA level. Hence, hyperurecemia plays a significant role in the pathophysiology and development of various musculoskeletal manifestations.

Serum Uric Acid, Musculoskeletal Complaints, Diabetes, Alcoholism

Correlation of MIS with hsCRP, S. Prealbumin, TIBC, BMI among Patients on CAPD

Sourav Saha1*, MarjoaHumaira Mekhola2, Md. Shahadat Hossain3, Maimuna Sultana4, Abu Ahmed Golam Akbar5, Md. Rajibur Rahman6, Md. Mahmudul Hassan7, JinatFarjana Major8, Nazma Azim9

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-5 | September-October 2021 | Page: 81-86

Correlation of MIS with hsCRP, S. Prealbumin, TIBC, BMI among Patients on CAPD

Sourav Saha1*, MarjoaHumaira Mekhola2, Md. Shahadat Hossain3, Maimuna Sultana4, Abu Ahmed Golam Akbar5, Md. Rajibur Rahman6, Md. Mahmudul Hassan7, JinatFarjana Major8, Nazma Azim9

Abstract

Introduction: Continuous ambulatory peritoneal dialysis (CAPD) is one of the therapeutic options at ESRD. The Malnutrition Inflammation Score (MIS) is an easy scoring system to assessthe nutritional status and inflammatory condition of a patient. It includes 7 components of the subjective global assessment, body mass index, and serum albumin and transferrin concentrations. Aim of the study:To see the correlation of MIS with hs-CRP, S. Prealbumin, TIBC, and BMI among patients on CAPD.Material & Methods: This cross-sectional study was conducted at the Department of Nephrology of National Institute of Kidney Diseases and Urology. A total of 69 patients were included for the study during July 2018 to Jun 2019. Purposive sampling technique was used. Statistical analysis of the results was done by using computer based statistical software, SPSS (SPSS Inc, Chicago, IL, USA). Prior to the commencement of the study, the thesis protocol was approved by the ethical committee of NIKDU, Dhaka. Results: Out of 69 patients 39 were male (56.5%) and 30 were female (43.5%). Mean age of patients is 58.3 ± 13.7 years. Mean BMI is (kg/m2) 26.1 ± 4.0. Mean prealbumin was 0.30 ±0.11 (ng/ml). Mean TIBC was 165.8 ± 59.5. Mean CRP was 23.73 ± 26.67.  Mean Duration of dialysis is 9.75 ± 14.7. S-albumin, S-prealbumin, BMI & TIBC were significantly lower in patients with Malnutrition Inflammation Score >5. CRP was found higher in patients with MIS >5.Conclusion: According to the study findings,S. Prealbumin, BMI and TIBC were significantly lower in patients with higher Malnutrition Inflammation Score (>5). CRP was significantly higher in patients with high MIS.

CAPD, PeritonealDialysis, MIS,Prealbumin, TIBC, hsCRP.

Case Report on Unilateral Testicular Infarction Secondary to Epididymoorchitis

Nazma Matania1*, Mohanvir Kaur2, Kanwardeep Kaur3, Monika Kalyan4

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-5 | September-October 2021 | Page: 87-91

Case Report on Unilateral Testicular Infarction Secondary to Epididymoorchitis

Nazma Matania1*, Mohanvir Kaur2, Kanwardeep Kaur3, Monika Kalyan4

Abstract

Testicular infarction secondary to chronic severe epididymooorchitis is anuncommon urologyical emergency in clinical practice. Very few case reports has been written highlighting testicular infarcts as a complication of chronic epididymoorhitis.In epididymoorhitis, it rarely leads to abscess formation and ultimately causes testicular infarction. Ultrasonography is an important modality to detect fluid collection and ischemic changes in addition to physical local examination. In this case report we discuss a case of 37 yrs old male who presented initially with pain in groin region due to epididymitis,lateron with scrotal abscess formation and ultimately resulting into testicular torsion.We also discuss the importance of early recognition of warning signs and symptoms of ischemia.High level of clinical suspicion is required in cases of epididymoorchitis.Early medical and surgical reperfusion interventions can be helpful in testicular salvage from their devastating testicular complication of epididymorhitis.

Epididymoorchitis,Epididymitis,Testicular torsion etc.

Outcome of Early and Delayed Repair of Bile Duct Injury

Abnish Kumar Karn1*, Perwez Alam Khan2

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-5 | September-October 2021 | Page: 92-97

Outcome of Early and Delayed Repair of Bile Duct Injury

Abnish Kumar Karn1*, Perwez Alam Khan2

Abstract

Background: To assess outcome of early and delayed repair of bile duct injury. Materials & Methods: One hundred twelve patients age ranged 20-60 years of either gender with bile duct injury were divided into two groups. Group I were of early repair (acute (<48 hours from index procedure) and group II were of delayed repair (>48 hours after index procedure). In all patients, operative findings such as injury classification and procedural variables, mortality were recorded. Results: A non- significant difference was observed between parameters (P> 0.05). Etiology was cholecystectomy in 30 in group I and 25 in group II, non-biliary abdominalprocedures20 in group I and 22 in group II and abdominal trauma6 in group I and 9 in group II. Strasburg-Bismuth classificationE1was seen maximally in both groups (24 in group I, 20 in group II), E2(22 in group I, 28 in group II). Conclusion: There were equivalent outcomes for patients undergoing early and delayed repair of CBDI.

Common bile duct injury, cholecystectomy, Early outcome, Delayed outcome

Morphology of Iliotibial Tract and its Clinical Significance

Rupa Chhaparwal1*, Subhash Joshi2, Sharda Joshi3

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-5 | September-October 2021 | Page: 98-104

Morphology of Iliotibial Tract and its Clinical Significance

Rupa Chhaparwal1*, Subhash Joshi2, Sharda Joshi3

Abstract

Background: The iliotibial tract (ITT) is present only in human beings. It seems to appear with the development of the upright posture. It stabilizes the knee both in extension and in partial flexion; therefore, used constantly during walking and running. Iliotibial Band Syndrome is a common thigh injury  associated with running, cycling or hiking. The anatomy and functional significance of ITT is complex and controversial. Considering the significance of the knowledge of morphology for surgeries and keeping in mind the ever evolving and yet unexplored facets of this subject as there was paucity, the present study was undertaken to shed more light on this topic. Methods: The study was carried out on 17 embalmed cadavers. Fascia lata was cleaned and ITT was identified on anterolateral aspect of thigh. Various measurements were recorded. Results:Average length of segment of ITT below the level of TFL & G. Max is 32 cm and 28.9 cm. The total length of ITT was 52.1 cm. Width of ITT at mid-thigh level was 4.4 cm. Conclusions:The various parameters that have been studied in the present work in central Indian population have not been carried out in such great details.

Iliotibial band, Friction syndrome, Fascia Lata, ITT, Maissiat’s band.

Comparison of Vasopressor Effects of Bolus Infusions of Phenylephrine and Ephedrine for Maintenance of Maternal Arterial Pressure during Spinal Anaesthesia in Caesarean Section.

Tulika Singh*

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-5 | September-October 2021 | Page: 105-109

Comparison of Vasopressor Effects of Bolus Infusions of Phenylephrine and Ephedrine for Maintenance of Maternal Arterial Pressure during Spinal Anaesthesia in Caesarean Section.

Tulika Singh*

Abstract

A comparative study was performed on 60 patients to observe the effect of bolus phenylephrine versus ephedrine during hypotension after subarachnoid block for maintenance of arterial pressure during spinal anaesthesia in caesarean section. The patients were divided into two groups of 30 each and were randomly allocated to receive an IV bolus of any of the two drugs. Phenylephrine was administered as 500 µg in 1ml bolus IV and Ephedrine was administered as 6mg Inj. Ephedrine Hydrochloride in 1ml bolus IV. It was observed that systolic arterial pressure was elevated significantly for first six minutes of bolus dose in Phenylephrine group as compared to Ephedrine group.

Phenylephrine, Ephedrine, Spinal Anaesthesia, Caesarean Section, Hypotension

Outcome of Tadalafil in Comparison to Tamsulosin in Management of Symptomatic Benign Prostatic Hyperplasia

Abul Bashar Shahriar Ahmed1*, MdMahfuzur Rahman2, Rajiv Mazumder3, Firoj Mondal4

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-5 | September-October 2021 | Page: 110-122

Outcome of Tadalafil in Comparison to Tamsulosin in Management of Symptomatic Benign Prostatic Hyperplasia

Abul Bashar Shahriar Ahmed1*, MdMahfuzur Rahman2, Rajiv Mazumder3, Firoj Mondal4

Abstract

Background: The high incidence of lower urinary tract symptoms due to benign prostatic hyperplasia is common in older men. Numerous authors evaluated the actions of PDE5i in improving the symptoms of BPH related LUTS. Tadalafil is being investigated for the treatment of lower urinary tract symptoms suggestive of benign prostatic hyperplasia.Aim: To assess the outcome of tadalafil 5mg/day vs tamsulosin 0.4mg/day in patients with symptoms of LUTS due to BPH. Methods: A randomized control trial was conducted from March 2019 to February 2021 in the department of urology, Enam Medical College and Hospital. Sixty men, older than 45 years with history of symptomatic BPH for six months or more were randomized into two groups. One group received tadalafil 5 mg/day and the other were given tamsulosin 0.4mg/day for twelve weeks. International Prostatic Symptoms Score (IPSS), IPSS quality of life (IPSS-QOL), maximum flow rate (Q max), post voidal residual volume (PVR) were assessed before & after administration of drugs. Results:Out of sixty patients, fifty-six patients completed the study. Two patients from each groups dropped out because of drug related adverse effects. Improvements of IPSS total score and IPSS-QOL were significant in both groups. Improvement was noted following first week of therapy and continued upto 12 weeks. Both regimens similarly improved Q max and decreased the PVR volume from the baseline (p<0.001) with no significant difference between tadalafil 5mg/day and tamsulosin 0.4mg/day. Conclusions:Monotherapy with low dose daily tadalafil 5mg resulted in significant improvement of LUTS in symptomatic BPH.

Tadalafil, Tamsulosin, Symptomatic, Prostatic & Hyperplasia.

Fiber Optic Nasal Endotracheal Intubation in Maxillofacial Surgeries: An Analysis of Circulatory Response

Archna Sharma1, Manish Kumar Sharma2*, Ajay Sood3

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-5 | September-October 2021 | Page: 123-128

Fiber Optic Nasal Endotracheal Intubation in Maxillofacial Surgeries: An Analysis of Circulatory Response

Archna Sharma1, Manish Kumar Sharma2*, Ajay Sood3

Abstract

Purpose: The purpose of the study was to check the hemodynamic response of fiber optic nasal intubation during maxillofacial surgeries. Material and methods: After taking approval of the hospital ethical committee on research, 30 consenting adult patients, of either sex, of ASA physical status 1 and 2, in the age group of 18-60 years coming for oropharyngeal and maxillofacial surgery were included in the study. After induction of general anaesthesia patients were intubated nasally by flexible fiber optic intubation technique. Results: When heart rate and mean arterial pressure were compared before and after intubation, significant increase in heart rate and mean arterial pressure were observed.  Conclusion: From this study it was concluded that fiber optic nasal intubation can cause significant change in hemodynamic parameters.

Endotracheal intubation, Fiber optic intubation, Heart  rate, Mean arterial pressure.

Study of Functional Outcome of Surgical Management of Floating Knee with Intramedullary Nailing

Suhail Malhotra1, Anil Gupta2*, Manish Singh3

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-5 | September-October 2021 | Page: 129-136

Study of Functional Outcome of Surgical Management of Floating Knee with Intramedullary Nailing

Suhail Malhotra1, Anil Gupta2*, Manish Singh3

Abstract

Background: Floating knee is a condition resulting from high energy trauma usually associated with multiple injuries making it challenging to treat. Main aim and objective of study was to assess functional outcome of surgical management of patients have ipsilateral tibia and femur fracture using Karlstrom and Oleruds criteria.Material and Methods: A prospective study was conducted on 20 patients of floating knee injury who underwent surgical treatment in orthopaedics department of tertiary care hospital over a period of one and half years.Results: Final range of motion at knee joint was more than 100 degrees in 85% cases out of which 35% had range of motion >125 degrees. Final outcome using Karlstrom criteria was good to excellent in 50% cases. Poor final outcome was related to type of fracture (open, severe communition) in same. Conclusion: Internal fixation of floating knee with intramedullary nailing followed by early rehabilitation gives better functional outcome.

floating knee, intramedullary nailing, outcome.

Rare case of Atrial Septal Aneurysm presenting as Atrial Fibrillation and Cariogenic Shock

Gurminder Singh*

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-5 | September-October 2021 | Page: 137-139

Rare case of Atrial Septal Aneurysm presenting as Atrial Fibrillation and Cariogenic Shock

Gurminder Singh*

Abstract

Normally, we see Atrial Fibrillation as a result of hypertension, coronary artery disease, sick sinus syndrome, viral infection, and few do not have any heart defects or damage. But very rarely Atrial Septal Aneurysm is the cause of Atrial Fibrillation presenting as a Cardiogenic Shock. Here, we report a 45-year-old female who was non-diabetic, non-hypertensive presented with shortness of breath along with hypotension. In search for the cause of Cardiogenic shock in view of Atrial Fibrillation in her ECG revealed her having Atrial Septal Aneurysm as a precipitating cause.

Atrial septal aneurysm, atrial fibrillation, cariogenic shock

Profile and Endoscopic Ultrasonography findings in Chronic Pancreatitis patients

*Karan Chhabra1, Suresh Kumar2, Siddharth Srivastava3, SmitaNath4, Saood Malik5, Ashraf Kesarani6

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-5 | September-October 2021 | Page: 140-145

Profile and Endoscopic Ultrasonography findings in Chronic Pancreatitis patients

*Karan Chhabra1, Suresh Kumar2, Siddharth Srivastava3, SmitaNath4, Saood Malik5, Ashraf Kesarani6

Abstract

Background: To assess endoscopic ultrasonography findings in chronic pancreatitis patients.Materials & Methods: Seventy- two cases of chronic pancreatitis of both genders were enrolled in the study. Parameters such as age, sex, abdominal symptoms was recorded. Abdominal symptoms were defined as including abdominal or back pain/discomfort, weight loss, appetite loss, and jaundice. The diagnosis of chronic pancreatitis was established if there was evidence of pancreatic calcification on abdominal ultrasonography.Results: Maximum cases were seen in age group 20-35 years (males- 26, females- 15) followed by 35-50 years (males- 16, females- 15). Common clinical findings were pain in 58, calcification in 12, diarrhea in 35, jaundice in 23, lump in 17, vomiting in 40 and GI bleed in 32. A significant difference was observed (P< 0.05). Parenchymal features  were hyperechoic foci with shadowing in 60, lobularity with honeycombing in 54, hyperechoic foci without shadowing in 36, stranding (Minor): hyperechoic lines ≥3 mm in length in 48. Ductal features were main pancreatic duct (MPD) calculi in 71, irregular MPD contour in 23, dilated side branches in 15, main pancreatic duct dilatation in 38 and hyper echoic duct margin in 44. A non- significant difference was observed (P> 0.05).Conclusion: Endoscopic ultrasound is the most sensitive imaging modality for diagnosing pancreatic disorders, it can demonstrate subtle alterations in the pancreatic parenchymal and ductal structure even before traditional imaging and functional testing demonstrate any abnormality.

Chronic pancreatitis, Endoscopic ultrasound, hyperechoic lines, Pancreatic duct

Retrospective Study of Predictor of CPAP Failure in Neonates

Priyanka Jain1*, Ashish Jain2

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-5 | September-October 2021 | Page: 146-151

Retrospective Study of Predictor of CPAP Failure in Neonates

Priyanka Jain1*, Ashish Jain2

Abstract

Background: To assess predictor of CPAP failure in neonates. Methodology: Two hundred seventy preterm infants less than 37 weeks of gestation with respiratory distress (RD) of both genders were selected. CPAP was delivered using bubble CPAP device. Baseline maternal and infant characteristics, CPAP care practices, morbidities and adjuvant therapies were recorded. The morbidities and outcomes were compared among infants with CPAP failure and CPAP success. Results: Male infant were110in group I and 30 in CPAP group II, birth weight < 750 g was seen in 9 in group I and 2 in group II, birth weight was 1280 grams in group I and 1194 grams in group II. Small for gestation was 30 in group I and 6 in group II, cesarean section was seen in 201 in group I and 45 in group II, antenatal steroids was seen in 198 in group I and 43 group II, 5 min APGAR was seen 8 in both groups, FiO2 at starting CPAP was 0.41 group I and 0.41 group II, CPAP (cm of H2O) pressure at initiation of CPAP was 5 in each group. Type of interface was fisher and paykel prongs was 16 group I and            3 in group II, Hudson prongs was 190 group I and 45 group II and Benveniste prongs 14group I and 2 group II, surfactant was used in 110 group I and 40 in group II. A significant difference was seen in both groups (P< 0.05). Conclusion: Early starting of CPAP, early surfactant administration, and lower FiO2 at beginning of CPAP were predictors of CPAP failure in neonates of respiratory distress syndrome.

CPAP, Neonates, Respiratory distress syndrome, Surfactant

Assessment of Profile of Complications in Pterygium Surgery- A Clinical Study

Ashish Jain1*, Priyanka Jain2

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-5 | September-October 2021 | Page: 152-156

Assessment of Profile of Complications in Pterygium Surgery- A Clinical Study

Ashish Jain1*, Priyanka Jain2

Abstract

Background: To assess complications of pterygium surgery. Methods: Fifty- six patients who underwent pterygium surgery in last 1 year of both genders were selected. Pterygium was graded in four stages, grade 1, grade 2, grade 3 and grade 4. Postoperative complications were recorded.Results: Out of 56 patients, males were 30 (53.7%) and females were 26 (46.3%). Grade 1 was seen in 4, grade 2 in 28, grade 3 in 16 and 4 in 8 patients. Common clinical features was progressive in 34, vascular in 26, atrophic in 14, symblepharon in 12 and ocular motility restriction in 4 cases. Treatment performed was bare sclera in 5, primary closure in 6, AMT in 10, CAG in 22, CAG+ AMT  in 7 and primary closure+ MMC in 6 cases. Common complications were corneal thinning in 2, corneal perforation in 4, bleeding in 5, partial graft dislocation in 2 and graft hematoma in 1 case. A significant difference was observed (P< 0.05). Conclusion: Common complications of pterygium surgery were corneal thinning, corneal perforation, bleeding, partial graft dislocation and graft hematoma.

Corneal thinning, Corneal perforation, pterygium surgery, Sclera

To Evaluate the Subjective Outcome of Nasal Obstruction in MicrodebriderAssisted Turbinoplasty Using Medial Flap Technique

Ravinder Singh Nagi1, Satinder Pal Singh2*

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-5 | September-October 2021 | Page: 157-164

To Evaluate the Subjective Outcome of Nasal Obstruction in MicrodebriderAssisted Turbinoplasty Using Medial Flap Technique

Ravinder Singh Nagi1, Satinder Pal Singh2*

Abstract

Objective: To evaluate the subjective outcome of nasal obstruction in microdebrider‑assisted turbinoplasty using medial flap technique. Materials and methods: A retrospective study was conducted on 60 patients with a diagnosis of turbinate hypertrophy from March 2018-20 in the department of ENT, Government Medical College, Amritsar,India. All of these patients had symptoms and signs of nasal obstruction and stuffiness related to congested turbinate mucosa that was not responding to medical treatment for a minimum 4 weeks. All patients enrolled were taken in for microdebrider‑assisted turbinoplasty using medial flap technique. Patient-scored nasal obstruction (1 to 5) along with blindly assessed nasal airway patency ratings (1 to 4) was done at 3 and 12 months postoperatively.Results: A total of 60 patients were recruited in the study. The mean age was 28.44±3.36 years. Average follow-up period was 11.9± 3.3 months. Medial flap technique was highly significant in the subjective outcome with 93.3% of patients were improved nasal obstruction (without /occasional decongestants) and nasal patency were improved in 97.1% (no/mild obstruction) patients. (P < 0.001) with the major complications, like nasal bleeding 7.6% crusting 3.3%, adhesions 1.6%) Conclusion: The medial flap inferior turbinoplasty is a straight forward procedure that provides a more effective and satisfactory improvement in nasal obstruction subjectively to the patients, without significant risk of complications.

Microdebrider Assisted Inferior Turbinoplasty, Medial Flap Turbinoplasty, Nasal Obstruction.

Outcome of Distal Tibial Fractures Managed by Minimally Invasive Percutaneous Plate Osteosynthesis (Mippo) Technique

Maninder Singh1, Manpreet Singh2*, Ranbir Singh3

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-5 | September-October 2021 | Page: 165-173

Outcome of Distal Tibial Fractures Managed by Minimally Invasive Percutaneous Plate Osteosynthesis (Mippo) Technique

Maninder Singh1, Manpreet Singh2*, Ranbir Singh3

Abstract

Background: The Treatment Of Distal Tibia Fracture Is Very Challenging Due To Limited Soft Tissue, Subcutaneous Location Of Large Portion Of Tibia And Precarious Blood Supply. The Main Aim Of Treatment Of Distal Tibia Freacture Is To Maintain Normal Alignment And Articular Surface. Closed Reduction And Mippo With Distal Tibia Locking Plate Has Emerged As A New Treatment Option In Treatment Of Distal Tibia Fracture. This Study Was To Evaluate The Results Of Mippo Technique With Distal Tibia Locking Plates. Methods: 30 patients with distal tibia fracture with or without intra articular extension were treated in our department, Govt. Medical College and Hospital, Amritsar with MIPPO with DTLP and were prospectively followed for average duration of 6 months. The outcome was evaluated using American Orthopedic Foot and Ankle Society(AOFAS) score. Results: There were TOTAL 30 patients in the study including 24 males and 6 females of mean age 38.04 years. The mean follow up period of our patients was 6 months. All fractures united at an average of 18.13 weeks (range 16-24 weeks) except two cases of Acceptablemalunion,1 case of non-union and 1 case of deep infection. Conclusions: – minimally invasive percutaneous plate osteosynthesis(MIPPO) is an excellent method for treatment of distal tibia fracture. The use of a small incision, indirect reduction technique, time of operation, early healing and decrease incidence of infections have the advantage over the conventional osteosynthesis.

Distal tibia fracture, MIPPO,AOFAS

A Study of Total Cholesterol Level in Depressive Females in Tertiary Care Hospital of Aligarh

Mohammad Hifzur Rehman1*, Mobarak Hossain2, Abu Qamar Siddiqui3

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-5 | September-October 2021 | Page: 174-179

A Study of Total Cholesterol Level in Depressive Females in Tertiary Care Hospital of Aligarh

Mohammad Hifzur Rehman1*, Mobarak Hossain2, Abu Qamar Siddiqui3

Abstract

Background: Depression is a common illness worldwide, with more than 264 million people affected. It can cause the affected person to suffer greatly and function poorly at work, at school and in the family. At its worst, depression can lead to suicide. Close to 800 000 people die due to suicide every year. Suicide is the second leading cause of death in 15-29-year-olds. Cohort and case control studies have found that lower serum total cholesterol is associated with depression. Methods: A total of 25 depressed patients and matched non-depressed controls were included in the study. The patients were diagnosed according to the DSM-IV criteria in the OPD by the consulting psychiatrist. Severity of depression was graded by 17-point Hamilton rating scale for depression. Results: Out of the 25 patients with depression, 7 patients were studied in the first episode of major depression, 18 patients met DSM-IV criteria for recurrent unipolar depression. The results for total serum lipids are shown in table. The total serum lipid for group A is 158.39+-22.05 and for group B is 170+-38.26. The level of total serum cholesterol is lower in group A but the difference is not significant by independent sample “t” test. Discussion: A decrease in total cholesterol levels was observed in depressive patients, and this decrease was not significant (p>0.05). This decrease is in accordance with Shiny SY and Giltay EJ. Shiny SY also recommended that lipid levels of depressive patients should be monitored as it has been reported that the risk of suicide is higher in patients with major depression with low total cholesterol levels.

Total Cholesterol Level, Depression, Suicide

Comparison of Proseal Laryngeal Mask Airway versusEndotrachealtube in Anaethetized Adult Patients

Ritika Jindal1*, Rahul Midha2

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-5 | September-October 2021 | Page: 180-192

Comparison of Proseal Laryngeal Mask Airway versusEndotrachealtube in Anaethetized Adult Patients

Ritika Jindal1*, Rahul Midha2

Abstract

Background: Endotracheal intubation is the gold standard for maintenance of airway patency. But it is not without complications.Objectives: We therefore aimed at comparing Proseal LMA with endotracheal tube for insertion characteristics, cardiovascular responses, and efficacy of oxygenation, ventilation and complications. Methods: 60 patients of ASA I and II between 18 to 60 years of either sex posted for elective surgery under general anaesthesia were randomly divided into two equal groups.Group A (30) – PLMA Insertion, Group B (30) – ETT InsertionResults: Easy insertion was noted with Proseal LMA 24 (80%) v/s 21(70%) with endotracheal tube. Insertion in first attempt was seen in 24(80%) for Proseal v/s 23(76.7%) for endotracheal tube. Both groups were comparable with number of attempts at insertion. The mean insertion time with Proseal LMA was 36.87±16.19 v/s 42.2±17.42 seconds with endotracheal tube. Haemodynamic parameters were maintained better with Proseal LMA. Ventilation, oxygenation, intraoperative and postoperative complications were comparable in both the groups.Conclusion: Placement of ProsealLMA is relatively easy, simple, rapid and is as good as endotracheal tube in providing general anaesthesia.

Ease of Insertion, Endotracheal Intubation, Haemodynamics, ProsealLma

A Comparative Study of Adductor Canal Block versus Femoral Nerve Block for Analgesia after Total Knee Arthroplasty

Gaurav Misra1, AamirLaique Khan2*, Dheeraj Saxena3

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-5 | September-October 2021 | Page: 193-198

A Comparative Study of Adductor Canal Block versus Femoral Nerve Block for Analgesia after Total Knee Arthroplasty

Gaurav Misra1, AamirLaique Khan2*, Dheeraj Saxena3

Abstract

Background: To compare adductor canal block versus femoral nerve block for analgesia after total knee arthroplasty.Methods: Seventy patients of primary TKA were equally divided into 2 groups containing 35 patients each. Group A patients received adductor canal block (ACB) and group B patients received femoral nerve block (FNB). Parameters such as duration of surgery, VAS at rest and at 45degree flexion of knees, amount of blood loss, muscle strength and the TUG test preoperatively and at 24 hours postoperatively. Results: The mean blood loss was 40.5 ml in group A and 25.7 ml in group B, duration of surgery 84.2 minutes in group A and 71.3 minutes in group B, preoperative VAS painscore at rest, mm was 28 in group A and 22 in group B, preoperative VAS pain score at45 degrees flexion of the knee, mm was 16 in group A and 12 in group B. The quadriceps muscle strength % in group A was 50.2 and in group B was 18.2 and for adductor muscle was 63.1 in group A and 70.6 in group B. A significant difference was observed between both groups (P< 0.05). Habitual analgesics was paracetamol used by 32% in group A and 14% in group B, weak opioids in 10% in group A and 17% in group B and none 58% in group A and 69% in group B. A significant difference was observed between both groups (P< 0.05). Conclusion: Adductor canal block was found to be superior as compared to femoral nerve block. ACB preserved quadriceps muscle strengthbetter than FNB.

Adductor Canal Block, Femoral Nerve Block, Total Knee Arthroplasty, Quadriceps

Histopathology of Carcinoma Penis: An Institutional Experience

Harish Chandra Singh1, *Gitimadhuri Dutta2, Sunanda Nayak3, Kaustav Mohapatra4,Rojalin Nanda5

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-5 | September-October 2021 | Page: 199-203

Histopathology of Carcinoma Penis: An Institutional Experience

Harish Chandra Singh1, *Gitimadhuri Dutta2, Sunanda Nayak3, Kaustav Mohapatra4,Rojalin Nanda5

Abstract

Background: Carcinoma penis is a rare malignant tumour in male patients in United States with incidence rate less than 1%. Higher incidence rate is seen in Asia, Africa and South America. Highest incidence rates were seen in Paraguay, Brasilia and in Uganda. Association of HPV 16 and 18 is seen in most of the cases of penile carcinoma. Invasive squamous cell carcinoma(SCC) is the most common variety of carcinoma penis. Apart from SCC, basalcell carcinoma, malignant melanoma and sarcoma can occur as malignant lesions of penis. Methods: This is a retrospective study conducted in the Department of Pathology, VIMSAR, Burla from January 2017 to December 2019.  All the patients’ detailslike age, site and size of lesion, type of surgery done, inguinal lymph node status, stage of disease and histological grade were collected from Histopathology records. Hematoxylin and eosin stained slides were studied. Results: Total number of 25 patients with penile lesions were included in the study group out of which 23 cases showed invasive carcinoma and two lesions were in-situ carcinoma. 21 lesions were invasive SCC and 2 lesions were verrucous carcinoma.80.95% cases were well differentiated SCC.Mean age of presentation was 54.33years. Maximum number of cases were seen in sixth decade.69.56%cases showed proliferative lesions and most of the lesions were seen in glans penis. Conclusion: Penile carcinoma causes both psychological and clinical morbidity. Improvement of genital hygiene, patienteducation is essential for prevention of carcinoma penis. Early diagnosis by clinical examination, histopathological diagnosis and proper treatment can reduce both mortality and morbidity.

Penile Carcinoma, Squamous Cell Carcinoma, Verrucous Carcinoma

Assessment Of Echocardiographic Parameters, Left Atrial Volume And Left Atrial Volume Index As Markers Of Cardiovascular Involvement In Patients With CKD.

Rakesh Chander1*,Surbhi Mahajan2, Shiv Charan3

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-5 | September-October 2021 | Page: 204-212

Assessment Of Echocardiographic Parameters, Left Atrial Volume And Left Atrial Volume Index As Markers Of Cardiovascular Involvement In Patients With CKD.

Rakesh Chander1*,Surbhi Mahajan2, Shiv Charan3

Abstract

Background: Cardiovascular morbidity secondary to Chronic Kidney Disease (CKD) is a well-established entity. However, estimation of the extent of the former has no formal criteria. The present study was taken up with the aim to study left atrial volume and left atrial volume index as markers of cardiovascular involvement in CKD. Methods:  This  cross  sectional  study  included  sixty  patients  (n=60)  from  the  randomly  selected  cases  admitted  in emergency and indoor medical wards of Guru Nanak Dev Hospital, Amritsar. The sample was divided into three groups of twenty each on the basis of GFR. Group 1 consisted of CKD stage 3 patients, Group 2 consisted of CKD Stage 4 patients and Group 3 consisted of CKD Stage 5 patients. Echocardiography were done in every patient. Values of Left Atrial Diameter (LAD), Left Atrial Volume (LAV) and Left Atrial volume index (LAVi) were assessed in each of the three groups. Diastolic Dysfunction and values of Ejection Fraction were also assessed in each of the three groups and correlated with Left Atrial Volume Index (LAVi). Results: Increased value of LAVi (>34 mL/m2) was 15% in Group 1, 40% in Group 2, and 65% in Group 3. Increased left atrial volume was significantly related to decreased ejection fraction in CKD stage 4 and 5 (p<0.05). Conclusion: Left atrial volume and left atrial volume index provide quantitative estimation of cardiovascular morbidity in patients with CKD.

CKD, Echocardiography, Left Atrial Volume, Left Atrial Volume Index

Incidence of Post Dural Puncture Headache in Obstetric Patients for Lower Segment Caesareansection Under Spinal Anaesthesia Using Small Gauge Spinal Needle

Updesh Kumar1,Mushtaq Ahmed2*, Smriti Gulati3, Smriti Anand4

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-5 | September-October 2021 | Page: 213-219

Incidence of Post Dural Puncture Headache in Obstetric Patients for Lower Segment Caesareansection Under Spinal Anaesthesia Using Small Gauge Spinal Needle

 Updesh Kumar1,Mushtaq Ahmed2*, Smriti Gulati3, Smriti Anand4

Abstract

Background: Post Dural puncture headache (PDPH) is one of the most distressing side effects of spinal anaesthesia with variable incidence rates depending upon the type and gauge of the needle used. The present study was undertaken to determine the incidence rate of PDPH in ASA II parturients undergoing Lower segment caesarean section (LSCS) under spinal anaesthesia using 26G spinal needles. Methods: Pre anaesthetic checkup of 670 study patients was done. The patients were explained the concept and procedure of this study and informed consent was obtained before the procedure. Standardized anaesthetic technique was employed for every patient after recording vitals like pulse, Noninvasive blood pressure and pulse oximetry. Intravenous line was established with 18G Cannula and patient was preloaded with 500cc of Crystalloid either Ringer lactate or 0.9% Normal saline. The Subarachnoidblock was performed with 26G Quincke needle in sitting position 2.4ml of 0.5% heavy bupivacaine without adjuvant was administered. Patients were followed up for post Dural puncture headache for 5 days postoperatively. Results: In our study, PDPH was present in only 9 (1.34%) patients and majority of the patients needed single prick. Out of them only 2 (.36%) had PDPH whereas 7 (6.19%) with double prick had PDPH.PDPH was mild in 5 (55.6%) patients, moderate in 3 (33.3%) patients and severe in only 1 (11.1%) patient. .Incidence of PDPH was less in patients with parallel orientation of bevel of needle. Few patients had Back pain followed by Nausea and vomiting and Vertigo. Conclusion: The incidence and severity  of PDPH is quite low in the obstetric patients receiving spinal anaesthesia with 26G spinal needle, the incidence being lesser with single prick as against with double prick.

Obstetric Patients, Spinal Anaesthesia, Lower Segment Caesarean Section, Post Dural Puncture Headache

Haematological Manifestations of Alcoholics in Comparison with Non Alcoholics

Surinder Kumar Salwan1, Kanwarpreet Singh2*, Tarsem Pal Singh3, Manpreet Kaur4

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-5 | September-October 2021 | Page: 220-227

Haematological Manifestations of Alcoholics in Comparison with Non Alcoholics

Surinder Kumar Salwan1, Kanwarpreet Singh2*, Tarsem Pal Singh3, Manpreet Kaur4

Abstract

Background: Alcoholism is a chronic, progressive, and potentially fatal disease. The major health risk of alcoholism includes liver disease, heart disease, pancreatitis, central nervous system disorders, disorders of hematopoietic system, and certain forms of cancer. The effects on haemopoietic system are both direct and indirect, with anemia being commonly seen in alcoholics. These hematological changes are commonly missed resulting in morbidity and mortality. Aims and Objectives: The study was done to compare the hematological parameters in alcoholics to non-alcoholic individuals. Methods: Thirty adult patients who were moderate alcoholics, thirty severe alcoholics, and Thirty Non Alcoholic patients were enrolled in the study. Hematological parameters such as hemoglobin, Red Blood Cell (RBC) count, Total Leucocyte Count, Mean Corpuscular Volume (MCV), Mean Corpuscular Hemoglobin (MCH), MCH concentration (MCHC), and Platelet (PLT) count were taken for the study. Statistical analysis was done.Conclusion: It was concluded from the study that hematological changes are common in alcoholics and correspond to the quantity of alcohol intake.

Alcoholism, Anemia, CBC, Thrombocytopenia

Prognostic Importance of White Blood Cell Count and Plasma Glucose Level on Admission in Acute Myocardial Infarction

Surinder Kumar Salwan1, Manpreet Kaur2*, Tarsem Pal Singh3,Kanwarpreet Singh4

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-5 | September-October 2021 | Page: 228-233

Prognostic Importance of White Blood Cell Count and Plasma Glucose Level on Admission in Acute Myocardial Infarction

Surinder Kumar Salwan1, Manpreet Kaur2*, Tarsem Pal Singh3,Kanwarpreet Singh4

Abstract

Background: Coronary artery disease (CAD) is the leading cause of morbidity and mortality worldwide. During recent years, many studies are directed towards the evidence that the concomitant occurrence of high white blood cell count and hyperglycemia in patients with an acute myocardial infarction (MI) enhances the risk of mortality and morbidity, with or without diabetes. Aims and objectives: To determine the relationship of admission white blood cell count and plasma glucose levels in hospital mortality in non-diabetic myocardial infarction patients. Methods: A study of 100 non-diabetic acute myocardial infarction patients was carried out in the Medicine department, Guru Nanak Dev Hospital attached to Government Medical College, Amritsar. Patients were divided among following groups – admission plasma glucose level as low (<140 mg %), medium (140-180 mg %), high (>180 mg %) and white blood cell count as high (>11000cu/mm), low (<11000cu/mm). All cases were examined and investigated and followed up for any complication like cardiogenic shock or death during their hospitalization period. Data derived was analyzed using appropriate statistical methods across the groups. Conclusion: It was concluded from the study that in non-diabetic patients on admission high WBC count and hyperglycemia are independently associated with a higher risk of in-hospital mortality.

Acute myocardial infarction, Hyperglycemia, Diabetes, Cardiogenic shock

Intraoral Vs Intranasal Steroids for Sino nasal Polyposis in Patients Undergoing FESS

Vijaylakshami1*, R, KM Jameel2

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-5 | September-October 2021 | Page: 234-239

Intraoral Vs Intranasal Steroids for Sino nasal Polyposis in Patients Undergoing FESS

Vijaylakshami1*, R, KM Jameel2

Abstract

Background: Comparison of intraoral and intranasal steroids in patients undergoing FESS treatment for sinonasal polyposis.Methods: Seventy- four patients with nasal polyposis in the age range 18-60 years of either gender were divided into 2 groups, each containing 37 patients. Group 1 patients were put on Fluticasone, 400 micrograms/day (intranasal steroid spray) and group 2 received Prednisolone 1 mg/Kg/day (oral steroid) each for 1 week. All patients underwent functional endoscopic sinus surgery (FESS). The total symptoms score, amount of blood loss, nasal endoscopic grade and quality of surgical field was recorded in both groups.Results: The mean pre symptom score in group 1 was 12.9 and in group 2 was 11.8 and post- symptoms score was 6.7 in group 1 and 6.1 in group 2. Maximum patients in group 1 (45%) and in group 2 (48%) had quality of surgical field score 6-7. A non- significant difference was observed (P> 0.05). Nasal endoscopic grade 1 was seen in 4% in group 1 and 3% in group 2, grade 2 was seen in 24% in group 1 and 11% in group 2 and grade 3 was seen in 72% in group 1 and 86% in group 2. Maximum blood loss in group 1 was 50-100 ml seen in 38% followed by <50 ml in 34%, 100- 150 ml in 22% and 150-200 ml in 6%. In group 2, maximum blood loss was 50-100 ml seen in 62%, 100-150 ml in 24%, 7% each had <50 ml and 150-200 ml blood loss. Conclusion: Oral steroids found to be superior than intranasal steroids in decreasing symptoms, amount of blood loss and improving quality of surgical field.

Functional Endoscopic Sinus Surgery, Nasal Endoscopy, Steroids, SinonasalPolyposis

COVID -19 Pandemic Scenario and planning Mastoid surgeries

Satinder Pal Singh1, Ravinder Singh Nagi2*, Arvinder Singh Maan3

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-5 | September-October 2021 | Page: 240-245

COVID -19 Pandemic Scenario and planning Mastoid surgeries

Satinder Pal Singh1, Ravinder Singh Nagi2*, Arvinder Singh Maan3

Abstract

The SARS-CoV-2 virus (COVID-19) and subsequent pandemic have rapidly changed how physicians, specifically otolaryngologists, think about personal protective equipment (PPE) and patient and surgeon safety in the operating room. Most mastoid procedures are classified as elective andshould be postponed during this time; however, a need will remain for some urgent/emergent procedures. There is insufficient data regarding the safety and timing of mastoid procedures, taking all these considerations into account, we have drafted certain guidelines regarding planninga mastoid surgery in those patients whoare already diagnosed as a case of chronic supportive otitis media (CSOM) in the present scenario of COVID-19 pandemic.Clinical data was derived from peer-reviewed primary literature and published guidelines from national or international medical organizations. In the current state of pandemic, we do not recommend proceeding with elective procedures followed routinely, but our criteria of categorizing mastoid surgeries do provide help in creating appropriate protocol for protection of the patient as well as the surgeon, thus we are able to manage safely the patients who need urgent intervention in mastoid surgery. To facilitate the decision-making in the management of CSOM, careful selection of patients and timing of mastoid surgery can be divided into two groups(groups -1 and 2) with 3 and 2 sub-groupsbased on the extent of the disease and available resources. Therefore, categorization of mastoid surgeries into various sub-groups should help in the proper planning of surgery on a case-by-case basis, during the COVID-19 pandemic along with various safety measures.

COVID-19, Personal protective equipment (PPE), Chronic suppurative otitis media (CSOM), Mastoid surgery

A Hospital Based Prospective Study to Evaluate the Correlation betweenOPG and MRI Subjects with TMJ Pathology

Vani Mehrotra1, Pankaj Singhal2, Rashi Rauka3, Saurabh Sharma4*

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-5 | September-October 2021 | Page: 246-253

A Hospital Based Prospective Study to Evaluate the Correlation betweenOPG and MRI Subjects with TMJ Pathology

Vani Mehrotra1, Pankaj Singhal2, Rashi Rauka3, Saurabh Sharma4*

Abstract

Background: Arthrography and MRI have been shown to have similar degrees of diagnostic accuracy and both techniques can provide excellent diagnostic information. The choice of soft tissue imaging technique depends on factors such as cost, availability, and patient factors described above which may contraindicate a particular technique.The aim of this study to evaluate the correlation between OPG and MRI of subjects with TMJ pathology. Material & Methods:This is a cross- sectional observational study done on 50 subjects reporting to the dental OPD with history of pain in TMJ region was conducted among the outpatients with TMJ problem visiting to the oral maxillofacial surgery department in safdarjung hospital, Delhi, India.Data collection included detailed history, clinical examination, radiological examination with OPG & then MRI examination of TMJ.Results:Our study showed that the mean age of male patients were 32.63 yrs and female patients were 31.85 yrs. No statistically significant difference was seen between male and female patients.40% patients with ADDR and 50% with ADDWR had abnormal condylar head surface and only 0% patients with ADDR and 20% patients with ADDWR had normal condylar head surface. The condylar head surface and condylar neck was statistical non-significant between abnormal and normal disc position.Conclusion:MRI is the diagnostic study of choice for evaluation of disk position and internal derangement of the joint. Understanding of the TMJ anatomy, biomechanics, and the imaging manifestations of diseases is important to accurately recognize and manage these various pathologies.

MRI, TMJ, OPG, Pathology, Articular Disc, Condylar Head, Condylar Neck.

Demographic and Clinical Features of Choledochal Cyst in Childhood: Review of 30 Cases.

Md Rejaul Karim1*, Md Ashraful Islam2, Shoyaib Samir3

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-5 | September-October 2021 | Page: 254-259

Demographic and Clinical Features of Choledochal Cyst in Childhood: Review of 30 Cases.

Md Rejaul Karim1*, Md Ashraful Islam2, Shoyaib Samir3

Abstract

Background: Choledochacyst is the cystic dilalion of the biliary chahel disorder. It may be offer intahepalic, extrahepatic of both Choledochal cysts is more common in children than adult. Early diagnosis and appropriate treatment should be ensured for the children with choledochal cysts because these patients are at a higher risk of developing chronic liver disease and poor outcome.Aim of the study: The aim of this study was to assess the demographic and clinical features of choledochal cysts in children.Methods: This retrospective study was conducted in the Department of Pediatric surgery of Enam Medical College Hospital, Savar, and Dhaka, Bangladesh during the period from July 2015 to July 2020. Result: In this study, among 30 children with choledochal cysts mean age was 4.5 years (SD± 2.2 years) ranged between1 month-15 years. Maximum children were female (70%). Type I was most common (66.7%) in the children and type IV was in 33.3% children. Abdominal pain, discomfort andcrying was most common (83.33%) among the children with 49 (81.7%) cases In this study mean alkaline phosphatase was 266 IU/L, mean AST was 82 IU/L, mean ALT was 67 IU/L, mean hemoglobin was 11.5 g/dl, mean albumin was 4.1 g/dl, mean globulin was 2.6 g/dl, mean bilirubin was 1.08 mg/dl and coagulopathy was in three (3.75%) children.Conclusion: Choledochal cysts is more common in infants than older children and in female children. Type I cyst was found in maximum children and type IV was also found. Abdominal discomfort pain was most common symptom of choledochal cysts. Clinical features found in this study were similar to other studies.

Demographic, Clinical Features, Choledochal Cyst, and Childhood.

Usefulness of Ultrasonographic Determination of Portal Vein Diameter and Splenic Width in the Diagnosis of Oesophageal Varices in Hepatitis B Virus Related Chronic Liver Disease.

Goutam Kumar Ghosh1*, Debasish Dutta2, Seema Saha3

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-5 | September-October 2021 | Page: 260-268

Usefulness of Ultrasonographic Determination of Portal Vein Diameter and Splenic Width in the Diagnosis of Oesophageal Varices in Hepatitis B Virus Related Chronic Liver Disease.

Goutam Kumar Ghosh1*, Debasish Dutta2, Seema Saha3

Abstract

Background: Almost 90% of the cirrhotic patients develop esophageal varices.In many studies, portal vein diameter and splenic width found to be correlated with oesophageal varices in patients with hepatitis B virus related chronic liver disease. Aim of the study: The aim of the study was to evaluate the usefulness of portal vein diameter and splenic width in the diagnosis of oesophageal varices in hepatitis B virus related chronic liver disease. Methods: This method comparison study was conducted in the Department of Medicine, Dhaka Medical College Hospital, Dhaka from July 2013 to May 2014. The study included 110 sample. Result: The mean age was found 46.72±13.32 years with range from 24 to 80 years. Majority (83.6%) patients were male and 18(16.4%) were female.The mean portal vein diameter was found 12.45±1.8 mm with range from 9 to 16 mm and the mean splenic width was found 48.77±6.98 mm with range from 35 to 73 mm.the mean portal vein diameter was found 10±1.15 mm in grade I, 11.56±1.53 mm in grade II. 12.75±1.6 mm in grade III and 14.46±0.52 mm in grade IV.The validity of portal vein diameter (≥11.5) and splenic width (≥42.5 mm) for prediction of oesophageal varices. Conclusion:Ultrasonographic Determination of portal vein diameter and splenic width may be useful in detecting oesophageal varices in advanced stage of hepatitis B virus related chronic liver disease.

Ultrasonographic Determination, Portal Vein Diameter, Splenic Width, Oesophageal Varices and Hepatitis B Virus

A Comparative Study of Psychological Stress and Impact on Quality of Life of Health Care Workers Dealing with the Covid Positive Patients and the Family Members of the COVID Positive Patients During Covid-19 Pandemic.

Sumanjeet Kaur1, Priya Kaur2, Neeru Bala3, Manmeet Kaur Sodhi4, Hira Lal5*

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-5 | September-October 2021 | Page: 269-297

A Comparative Study of Psychological Stress and Impact on Quality of Life of Health Care Workers Dealing with the Covid Positive Patients and the Family Members of the COVID Positive Patients During Covid-19 Pandemic.

Sumanjeet Kaur1, Priya Kaur2, Neeru Bala3, Manmeet Kaur Sodhi4, Hira Lal5*

Abstract

Background: COVID-19 pandemic not only threatens physical health but also has psychological impact on the health care workers and the family members of these patients, influencing their mental health and affecting their quality of life. Objective: The present study is conducted to study and compare the psychological stress and impact on quality of life of the healthcare workers and family members of the COVID-19 patients during the Pandemic. Methods and Materials: A cross sectional study where DASS-21(Depression Anxiety and Stress scale-21) was applied to study psychological stress in terms of depression, anxiety and stress and WHOQOl-BREF scale was applied on all the health care workers and family members of the COVID positive patients to study the impact on their quality of life. Results: Results suggests that there is a significant difference among Depression, Anxiety and Stress across age, gender, area of working and hours of working of the healthcare workers, education and employment status of the family members. Maximum health care workers suffering from psychological stress were female resident doctors of age group 26-30 years working in COVID isolation wards. On the other hand maximum depression, anxiety and stress was found in family members of age group 26-35 years, male gender, self employed, earning less than 5000 rupees in a month and living in urban areas. Impact on the quality of life was more on the resident doctors having long duty hours and the ones working in COVID isolation wards. Quality of life was influenced more of the family members whose patients were admitted for a longer duration in the hospitals and whose patients did not survive COVID-19 infection.  Conclusion: It is evident that there are a high number of healthcare workers and the family members of the positive patients, affected by various psychological ailments such as anxiety, stress, and depression and having an impact on their quality of life. It is important that the government should take steps to ensure that HCPs’ mental health is regularly checked and that efforts are made to reduce their burden and also physical and virtual counselling sessions can be introduced for the relatives of these patients to reduce their apprehension and psychological stress. Introducing a post covid care clinic in hospitals can be undertaken which will help to reduce this psychological impact and mental health burden.

Covid, Healthcare workers, Psychological stress, Family members, Quality of life

CT Fluoroscopy Guided Fine-Needle Aspiration Cytology and Core Needle Biopsies in Solitary Lung Lesions-Experience in a Tertiary Level Hospital, Dhaka, Bangladesh

Bishwajit Bhowmik1*, Syeeda Showkat2, Nusrat Ghafoor3, Deepak Verma4, Fahmida Sharmin5, Rizwanullah Mahdi6, Wahida Begum7

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-5 | September-October 2021 | Page: 298-307

CT Fluoroscopy Guided Fine-Needle Aspiration Cytology and Core Needle Biopsies in Solitary Lung Lesions-Experience in a Tertiary Level Hospital, Dhaka, Bangladesh

Bishwajit Bhowmik1*, Syeeda Showkat2, Nusrat Ghafoor3, Deepak Verma4, Fahmida Sharmin5, Rizwanullah Mahdi6, Wahida Begum7

Abstract

Background: The frequent and widespread use of imaging in clinical practice, particularly CT, has led to a steep increase in incidental findings of asymptomatic solitary pulmonary nodules. In this situation, histocytopathological analysis is needed to confirm the diagnosis by CT guided biopsy/FNAC. So, the researcher purposively, designed this study. The aim of this study was to assess the outcomes of CT-Guided Fine-Needle Aspiration Cytology and Core Needle Biopsies of Solitary Lung Lesions. CT-fluoroscopy guidance helps in this process by accurate needle positioning thus increase the success rate. Methods: This was a retrospective study conducted at the Department of Radiology & Imaging in Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh, during January 2017 to January 2019.A total of 270 patients who were referred to the Department of Radiology& Imaging for the evaluation of suspicious solitary lung lesions after the detection of a solitary pulmonary nodule in X-ray or CT scan, were included in this study. The results of CT fluoroscopy–guided biopsy and FNAC for the included patients were analyzed to determine the diagnostic accuracy, complication rates, and independent risk factors for diagnostic failure and severe pneumothorax in this study. The factors related to the patients’ solitary lesions, and procedures were evaluated by univariate analyses using the two-sided Student t test for numeric values and Chi-squared test for categorical values where p<0.05 considered as significant. Statistical analysis were performed using SPSS, version-23.0. Results:Diagnostic accuracy rate was 95.86%, failure was 4.14%, the overall sensitivity was 92.96%, specificity was 85.23% and the statistically significant risk factors wereage (p=0.001), sex(p=0.001), smoking stats(p=0.001) emphysema(p=0.001),benign lesions(p=0.001), positioning of the patient fortheprocedure(p=0.001),location of the lesion(p=0.001) lesion size(p=0.001) pneumothorax(p=0.001) and length from the pleura to the lesion of 1.5 cm or greater,(p=0.001).Pneumothorax requiring drainage occurred in 1.48% of patients. The potential risk factors for pneumothorax requiring drainage were age of 73 years, the presence of emphysema, lesion size ≤ 2.0 cm and length from pleura to lesion of ≥ 1.5 cm. The major complications were being observed pneumothorax 15(5.63%), haemoptysis16 (6.01%), and hemothorax 03(1.12%).Conclusion:CT-Fluoroscopy Guided Fine-Needle Aspiration Cytology and biopsy has a high diagnostic accuracy; complication rates were acceptable and comparable to those of previous studies.Keywards: CT-Fluoroscopy, Fine-Needle Aspiration Cytology (FNCA), Core Neelde Biopsies, Pulmonary Noudule.

CT- Fluoroscopy, Fine-Needle Aspiration Cytology (FNCA), Core Needle Biopsies, Pulmonary Nodule.

A Retrospective Study of Maternal and Fetal Outcome with Antepartum Hemorrhageat Tertiary Care Hospital

Tania Akbar1*, Sumia Bari2, Monowara Begum3,Md. Faizur Razzaque Khan4

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-5 | September-October 2021 | Page: 308-315

A Retrospective Study of Maternal and Fetal Outcome with Antepartum Hemorrhageat Tertiary Care Hospital

Tania Akbar1*, Sumia Bari2, Monowara Begum3,Md. Faizur Razzaque khan4

Abstract

Background: Antepartum Hemorrhage (APH) has always been one of the most feared obstetric emergencies which contribute to significant maternal and perinatal mortality and morbidity. Aims and objectives: To determine the causes of Antepartum Hemorrhage. To study the maternal and fetal outcome in various types of antepartum hemorrhage. Methods: It is a study conducted in OPD,Labour room and Intensive Care Unit(ICU) admissions in Department of Obstetrics and Gynaecology, Enam Medical College& Hospital, Saver, Dhaka, Bangladesh over a period of one year from April 2019 to March 2020 were analysed retrospectively. All cases of APH with gestational age more than 28 weeks whether diagnosed previously or during antental visits or during delivery, referred from other hospitals, emergency admissions are included in the study. Data was statistically analysed using SPSS 20 software. Results: The present study included 28 patients who was diagnosed as having placenta previa, abruptio placentae or APH due to undetermined causes presented with or without bleeding per vaginum in OPD, labour room, ICU. Majorityofthepatients 17(60.71%)hadPlacentapreviawhile 10(35.71) had abruptioplacentae,onecaseofAPHisduetoundeterminedcause was 1(3.57%).11(64.71%) of the cases are unbooked cases in placenta previa and 7(70.00%) of the cases are unbooked cases in abruptio placenta but the difference is statistically not significant (p value-0.514). Postpartum hemorrhage is the second most common complication seen in 5 cases of placenta previa and 3 cases of abruptio placenta. In the present study 13 cases of placenta previa, 6 cases abruptio placenta were of low birth weight. The difference is not statistically significant (p value-0.371).11 cases of placenta previa and 5 cases of abruptio placenta were preterm. Conclusion: The most common cause of APH is placenta previa followed by abruptio placenta which was more common in unbooked cases with maternal risk factors. Antenatal booking,early identification of high risk cases and timely referral to tertiary care centres with good neonatal intensive care facilities, early intervention, blood and blood components transfusion, have a role in reducing maternal and perinatal morbidity and mortality.

APH, Placenta previa, abruption.

Treatment of Unstable Intertrochanteric Fractures with Proximal Femoral Nail: Our Experience in NITOR

Jibananda Halder1*, Mohammad Rubaiath Tashfin2, Mohammad Zahidul Haq Khan3, Md. Abul Fazal4

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-5 | September-October 2021 | Page: 316-322

Treatment of Unstable Intertrochanteric Fractures with Proximal Femoral Nail: Our Experience in NITOR

Jibananda Halder1*, Mohammad Rubaiath Tashfin2, Mohammad Zahidul Haq Khan3, Md. Abul Fazal4

Abstract

Background: Unstable intertrochanteric fractures are difficult to manage and the choice of implant is critical for fracture fixation. The purpose of this study was to evaluate the functional and radiological outcome of proximal femoral nail (PFN) in the treatment of unstable intertrochanteric fractures. Methods: We reviewed 45 patients of unstable intertrochanteric fractures, who were treated with the PFN between 2018 and 2021. at NITOR. Of which, 3 patients were absent of follow up. Hence, 42 patients were available for the study including 26 men and 16 women. The mean age was 61 years (range, 35 -90). Clinical evaluation was done using Harris hip score. The position of the blade in the femoral head was evaluated using Cleveland zones and tip apex distance. The fracture reduction was assessed using the Garden Alignment Index and postoperative fracture gap (mm) measurement. Results:The mean follow up period was 15.3 months (range, 9-27). Excellent to good results were accounted for 78% of cases according to Harris hip score. No cases of cut out or breakage of the implant noted. Implant removal was done in 2 patients due to persistent anterior thigh pain. Conclusion:We recommend PFN for fixation of unstable intertrochanteric fractures with less operative time and low complication rate. However, proper operative technique is important for achieving fracture stability and to avoid major complications.

Fixation, Harris hip score, unstable intertrochanteric fracture, intra medullary, proximal femoral nail antirotation.

Early Postoperative Solid Food Consumption after Cesarean Section with Regional Anesthesia.

Mahbuba Khanum1*, Parveen Fatima2, Sayeda Sayeeda3

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-5 | September-October 2021 | Page: 323-330

Early Postoperative Solid Food Consumption after Cesarean Section with Regional Anesthesia.

Mahbuba Khanum1*, Parveen Fatima2, Sayeda Sayeeda3

Abstract

Background: Cesarean section is the most common and Essential Obstetric Surgery across the globe. It has a definite role in the reduction of maternal and perinatal mortality in developing countries, such as Bangladesh where around 7660 women die every year from causes related to pregnancy and childbirth. Early feeding with solid food may encourage earlier and smoother interaction between mother and infant. Aim of the study: The aim of the study was to see the safety and acceptability of early solid food consumption after cesarean section with regional anesthesia.Materials & Methods: A prospective randomized controlled study design was selected. The study was conducted in Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from January to March, 2003. The sample size was 90 subjects. 42 were in the early feeding group and 48 in the control group. Statistical tools used to analyze the data included Unpaired Student’s t’ test, Chi-square test, Levene’s test, Fisher’s exact test and MS-Excel 16. Results: The mean time of first solid meal in the experimental group was 4.86±1.34 with a minimum of 4 hours and a maximum of 8 hours. On the contrary, the control group have taken their first solid meal at 24.85±5.87 with a minimum of 12 hours and a maximum of 44 hours. So, the mean time of first solid meal in the control group was about 6 times delayed. No patient in the early feeding group had any nausea or vomiting after the first solid meal or thereafter. Conclusion: Delayed resumption and slow advancement of food in a post-cesarean mother are widely practiced and considered safe. If we can feed the mother earlier, it facilitates her making a smooth interaction with her newly born baby and early breastfeeding.

Postoperative, Solid Food, Cesarean Section, Regional Anesthesia.

A Clinicopathological Co-Relation of Ludwig’s Angina in a Tertiary Care Centre

Rajat1, KVK Sudhakar2*

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-5 | September-October 2021 | Page: 331-335

A Clinicopathological Co-Relation of Ludwig’s Angina in a Tertiary Care Centre

Rajat1, KVK Sudhakar2*

Abstract

Background: To evaluate the clinicopathological co-relation of Ludwig’s angina in a tertiary care centre. Methods: The present prospective observational study was conducted among 12 patients attending the ENT department of TeerthankerMahaveer Hospital and Research Centre, Moradabad & Oral Maxillofacial Surgery department of Dental College & Research Centre, Moradabad with submandibular space infectionsfrom November 2018–April 2020.Detailed history was taken followed by complete ENT examination after proper consent from the patients.Patients were investigated by doing USG of neck & FNAC from neck. CT scan of neck was done where applicable Results: Out of 12 patients, dental infectionwas suspected in 3 patients. USG neck detected pus in in 2 patients. Diabetes mellitus and hypertension was found among 3 (25%) and 1 (8.3%) cases. Incision and drainage was donein 5 (41.66%) patients.Culture & sensitivity was sterile and it may be due to patients already took treatment for this disease and may be anaerobic bacteria.Conclusion: Prompt diagnosis and surgical drainage with broad-spectrum antibiotics and if needed tracheostomy often give much better results in the treatment of Ludwig’s angina. An early intervention of dental infection in early stages may be helpful in avoiding progression into Ludwig’s angina.

Ludwig’s angina, Tracheostomy, Odontogenic infection

Outcome of Patte Modification of Latarjet Procedure for Recurrent Anterior Instability of the Shoulder

Rabin Chandra Halder1*, Syed Khaledur Rahman2, Mahammad Mahbubur Rahman Khan3, Omar Faruque4, Md. Bahauddin Al Mamun5, Md. Al Mamun6

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-5 | September-October 2021 | Page: 336-344

Outcome of Patte Modification of Latarjet Procedure for Recurrent Anterior Instability of the Shoulder

Rabin Chandra Halder1*, Syed Khaledur Rahman2, Mahammad Mahbubur Rahman Khan3, Omar Faruque4, Md. Bahauddin Al Mamun5, Md. Al Mamun6

Abstract

Background: Glenohumeral instability & recurrent shoulder dislocation is a common clinical entity & the anterior instability is the most common among them. Different surgical technique both open and arthroscopic technique have been described for treating anterior shoulder instability. Among the open procedure, two widely applied surgical procedure: Bankart type capsule retention or reinserfion first described in 1938 and Bone bloch described by Latarjet in 1954. This Latarjet procedure is modified by Patte in 1980 in this procedure coracoacromial ligament is preserved with coracoid bone graft. Coracoid is fixed with two screw & washer & coracoaeromial ligament is ancored with capsule. Methods: The current study included sixteen (32) patients with recurrent anterior shoulder dislocation who were enrolled from July 2017 to June 2021 through non randomized purposive sampling considering the inclusion and exclusion criteria. They were surgically treated by Patte modification of Latarjet procedure and were analyzed prospectively. The average follow-up time was 6 months. Results:The mean age was 25.88 years with male dominant 13(81%). The right side was affected in 11 (68.75%) shoulders. The most common mechanism of injury was sports and RTA each 7 (43.75%) cases. The mean recurrent dislocation was 7.13 times before surgery. Among the cases 9 (56.25%) had no radiographic lesion, 4 (25%) had Hill Sachs lesion, 3 (18.75%) had Bankart lesions. The mean time interval between injuries to operation was about 3 years. There were 13 (81.25 %) cases without complications, 2 (12.50%) cases with limitation of movements and one case (6.25%) with occasional pain. At final follow up according to ROWE score for shoulder instability 10 (62.50%) with Excellent outcome, 5 cases (31.25%) with Good outcome and one case (6.25%) with Fair outcome in regards of stability, range of motion and function. Conclusions:From this study it can be concluded that, Patte modification of Latarjet procedure for recurrent anterior shoulder dislocation leads to Excellent to Good results in majority of cases.

Patte Modification, Learjet Procedure, Recurrent Anterior Instability

Role of Abram’s Punch Needle Biopsy of Pleural Tissue among Patients of undiagnosed Exudative Pleural Effusion                   

Muhammad Tanvir Mohith1*, Abdullah Md Abu Ayub Ansary2, Nusrat Jahan Choudhury3, Shahana Sarwar4, Mehdi Hassan5, Shaon Shahriar6, Suman Kanti Chowdhury7, Mostofa Kamal8

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-5 | September-October 2021 | Page: 345-354

Role of Abram’s Punch Needle Biopsy of Pleural Tissue among Patients of undiagnosed Exudative Pleural Effusion

Muhammad Tanvir Mohith1*, Abdullah Md Abu Ayub Ansary2, Nusrat Jahan Choudhury3, Shahana Sarwar4, Mehdi Hassan5, Shaon Shahriar6, Suman Kanti Chowdhury7, Mostofa Kamal8

Abstract

Background: Sometimes etiological diagnosis of pleural effusion is difficult despite cytological, biochemical and microbiological tests and labeled as undiagnosed exudative pleural effusions. Aim of present study was to make an etiological diagnosis of pleural effusion. Methods: Study group included patients of exudative pleural effusion where etiological diagnosis could not be yielded by conventional cytological, biochemical and microbiological investigations Pleural tissue was obtained by Abram’s pleural biopsy needle. Pleural biopsy was subjected to histopathology, ZN staining to find the mycobacterium tuberculosis.Results:Out of 50 patients, 34 (68%) and 16 (32%) were male and female, respectively. Age ranged from 18 to 81 years (mean 46.50). Histopathology of 18(36%) showed epitheloid granuloma with caseation necrosis. In other 18 (36%) patients, epitheloid granulomas (with or without giant cells) was reported. In 10 (20%) patients, histopathology report was of nonspecific chronic inflammation. Histopathology was reported as normal in 2 cases. In 4 (8%) patients, pleural tissue obtained was inadequate for opinions. ZiehlNeelsen (ZN) stain was positive for AFB in 4 patients. Conclusions:The role of Abram’s punch needle biopsy of pleura among patients of undiagnosed exudative pleural effusion is still accepted as a diagnostic tool, as this may lead to a specific diagnosis among 76% of cases. This is of particular importance in a developing country like Bangladesh where the facilities of thoracoscopy and imaging guided cutting needle biopsies are not easily available.

Abram’s Punch Needle Pleural Biopsy, Pleural Biopsy, Undiagnosed Pleural Effusion, Exudative Pleural Effusion.

An Assessment of the Risk Factors of Stroke in Different Socio Economic Groups in Dhaka, Bangladesh

Munabbehat Ashrafi1*, Md. Khairul Islam2, Dr. Aktar Zahan Ony3, Tahmina Haque4, Shirina Begum5, Md. Roufuzzaman6

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-5 | September-October 2021 | Page: 355-362

An Assessment of the Risk Factors of Stroke in Different Socio Economic Groups in Dhaka, Bangladesh

Munabbehat Ashrafi1*, Md. Khairul Islam2, Dr. Aktar Zahan Ony3, Tahmina Haque4, Shirina Begum5, Md. Roufuzzaman6

Abstract

Background: The global epidemic of stroke is not only the public health concern in high-income countries but also nearly 85% of all stroke deaths are recorded in low- and middle-income countries. Which results in 87% of total losses caused by stroke in terms of DALYs, measured, globally, in 72 million per year.Aim:To identify the common risk factors of stroke among the Bangladeshi people and pay attention on it. Methods: This cross-sectional analytical study was conducted in Mirpur of Dhaka city during November 2018 to April 2019. A total of 350 participants were included for the study. Non-probability convenient sampling was used. Collected data were analyzed by computer technology SPSS version 22.0. Permission from ethical review committee of Gono Bishwabidyalay was taken.Results:Out of 350 participants, 141 (40.3%) number of participants were in 55-64 age group which was followed by 115(32.9%), 45(12.9%), 36(10.3%), 13(3.7%) of 45-54 age group, 35-44 age group , ≥65 age group  and 25-34 age group respectively. Majority of the participants were male 230(65.7%) and rests of them were female 120(34.3%). Most of the participants (72.9%) comprises high-income group followed by middle-income group (25.4%) and low-income group (1.7%).  Duration of smoking habit have found significantly higher among the ischemic stroke (88%) compared to hemorrhagic stroke (12%), p<0.05. 76.3% respondents were hypertensive. Conclusions:Almost all study in Bangladesh showed that stroke affects mainly illiterate people but in this study find out that stroke occurs majority in literate person who completed HSC level of education and above. This study also finds that stroke incidence is more in high-income group in Bangladesh.

Stroke, Risk Factors, Socio Economic, Health, Concern.

An Assessment of the Physical Status in Post-Stroke Patients

Md. Khairul Islam1*, Munabbehat Ashrafi2, MdAshikur Rahaman3, Shaira Arif4, AktarZahan Ony5, Tahmina Haque6, Shirina Begum7, Md. Roufuzzaman8

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-5 | September-October 2021 | Page: 363-371

An Assessment of the Physical Status in Post-Stroke Patients

Md. Khairul Islam1*, Munabbehat Ashrafi2, MdAshikur Rahaman3, Shaira Arif4, AktarZahan Ony5, Tahmina Haque6, Shirina Begum7, Md. Roufuzzaman8

Abstract

Background: Stroke is a major cause of death and other complications worldwide. Stroke rehabilitation is an essential recovery option after stroke and should start as early as possible to avoid potential complications. It has been well documented that stroke is a major cause of death and functional impairment worldwide.Aim:To assess the physical status in post-stroke patients in Bangladesh. Methods: This cross-sectional analytic study was conducted in Bangabandhu Sheikh Mujib Medical University Hospital during November 2018 to April 2019. A total of 150 patients were included for the study. Non-probability convenient sampling was used. Collected data were analyzed by computer technology SPSS version 22.0. Permission from ethical review committee of GonoBishwabidyalay was taken.Results:Average age of the study subjects was 53.43±12.87 years. Majority of the respondents (42%) belonged to 51-65 years followed by 28% from 36-50 years, 18% from 66-85 years and 12% from 21-35 years. Male was quite double (65.30%) than female (34.70%). Average monthly family income among was 34273.33±18821.98 BDT. Three-fourth of the respondents (76%) suffered from hemorrhagic stroke and one-fourth (24%) ischemic stroke. About 97.30% of the patients suffered from hemiplegia. Active assisted exercise as means of rehabilitation was prominent (88%) and passive exercise was provided among 12% patients. Conclusions:Disability is common after stroke. Reducing disability through rehabilitation programme is demanded. Physiotherapy, using a mix of components from different approaches, is effective for the recovery of function and mobility after stroke.

Post-Stroke, Physical, Patients, Rehabilitation, Complications.

Evaluation of the Effect of SuperoxidisedWater (Oxum) V/s Povidone Iodine (Betadine) on Similar Types of Wounds

Man S Khalsa1, Mohammad Hamid2*, Gagandeep Gupta3

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-5 | September-October 2021 | Page: 372-378

Evaluation of the Effect of SuperoxidisedWater (Oxum) V/s Povidone Iodine (Betadine) on Similar Types of Wounds

Man S Khalsa1, Mohammad Hamid2*, Gagandeep Gupta3

Abstract

Background: Aim: To evaluate the effect of superoxidised water (Oxum) V/s povidone iodine (Betadine) on similar types of wounds.Methods: The present study was conducted after approval from ethical committee at gurunanak Dev hospital/GMC Amritsar to evaluate the effect of Superoxised water (Oxum) V/s Conventional dressing (Povidone Iodine) on similar type of wounds. The present study was conducted in total of 100 patients with 50 patients in each group. in Group A patients where dressing and topical management was done using superoxidised solution (oxum) while in group B patients dressing and topical management was done using betadine solution).Results:Both groups were comparable on the basis of age and sex. Equal number of cases were included for each procedure included in the present study. Survey and examination of the patients was done on day 1,5,9,18,21 for each patient. Wound reduction, periwoundsweeling, pus discharge and reepithelization was studied along with the adverse effects and showed that all the parameters were significantly less in oxum group. Conclusions:The results of the present study appears to show more favourable results for oxum then betadine The results of this study justify further research into the use of oxum in the treatment of various wounds and ulcers.

Superoxidised Water, Povidone Iodine, Wounds.

Universal Testing for Covid-19 of all Patients Admitted in Labour Room in a Tertiary Care Centre

Tarvinderjit Khurana1, Satinderpal Kaur2, Sangeeta Rani3*, Parneet Kaur4

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-5 | September-October 2021 | Page: 379-384

Universal Testing for Covid-19 of all Patients Admitted in Labour Room in a Tertiary Care Centre

Tarvinderjit Khurana1, Satinderpal Kaur2, Sangeeta Rani3*, Parneet Kaur4

Abstract

Background: The coronavirus disease 2019 (Covid -19) pandemic has created a need for data regarding the prevalence of severe acuerespiratiory syndrome of corona virus (SARS-COV-2) infectionin pregnant women. We decided to study to study the prevalence of SARS-COV-2 infection through universal testing of all unsuspected assymptomatic pregnant patients admitted in clean labour room.Methods: This is an observational study in which all asymptomatic women admitted in labour room between august first 2020 and September 2020 were treated for SARS COV-2. The prevalence of covid-19 infection among patients was calculated as number who tested positive out of total number of asymptomatic patients treated.Results:A total of 715 women underwent routine covid-19 testing upon admission to labour room, out of those women who were tested for SARS-COV-2, Twenty one(2.94%) women had a positive result. All twenty-one women who were positive, were asymptomatic at the time of admission. Of the women who tested negative, sixteen had history of mild fever and one had cough. No neaonate had positive SARS-COV-2 test result at twenty-four hours of life. There were no significant differences in dermographiuc profile between women with positive resulta and remainder of women.Conclusions:Universal testing prevents disease transmission to health care providers, patients and new born.

Covid-19, Pregnancy, Screening.

Comparative Study of Surgical and Non-surgical Management of Lumber Disk Herniation

Mahammad Mahbubur Rahman Khan1*, Md. Al Mamun2, Mahammad Rafiqul Islam3, Rabin Chandra Halder4, Syed Khaledur Rahman5, Tapas Mandal6

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-5 | September-October 2021 | Page: 385-390

Comparative Study of Surgical and Non-surgical Management of Lumber Disk Herniation

Mahammad Mahbubur Rahman Khan1*, Md. Al Mamun2, Mahammad Rafiqul Islam3, Rabin Chandra Halder4, Syed Khaledur Rahman5, Tapas Mandal6

Abstract

Background: Lumber disk herniation (LDH) is one of the most severe form of low back pain may causes lifetime suffering for a patient. Now a day, both surgical and non-surgical treatment methods are available for LDH patients. We have very few research-based comparative date regarding the effectiveness of surgical and non-surgical management of patients with lumber disk herniation.Aim: The aim of the present study was to compare the effectiveness of surgical and non-surgical management of patients with lumber disk herniation.Methods: This prospective, comparative study was conducted in the Department of Orthopedic Surgery, National Institute of Traumatology and Orthopaedic Rehabilitation (NITOR), Dhaka, Bangladesh during the period from January 2018 to December 2020. In total 46 confirmed cases with lumber disk herniation associated with low back pain and lower limb radiculopathy were selected as the study population. Among them 23, denoted as group 1 patients underwent to surgical treatment and other 23, denoted as group 2 patients underwent to conservative treatment for LDH. All patient data were processed, analyzed and disseminated by MS Word and SPSS version 26 programs as per need.Results:In this study, in follow-up stages, we found extremely significant correlations between the groups in 6 month’s VAS scores and in 6 month’s SF 36 (Mental) scores where the p values were less than 0.0001. Besides this, we found correlations in 2 year’s SF 36 (Physical) and 2 year’s SF 36 (Mental) scores where the p values were less than 0.05. Conclusions:Surgically treated patients with lumber disk herniation (LDH) reported substantially greater improvement at the 2-year follow-up. We can conclude that, patients with LDH benefits from surgery with a reduction within 6 months according to the VAS scores. According to the SF-36 scale it is clear that surgery ensures better quality of life for the patients.

Lumber disk herniation, VAS Score, SF 36, Pain, Oswestry Disability Index.

Practices and Perceived Importance of Informed Consent in Practice of Dentistry

Aasim Farooq Shah1*, Romshi Raina2, Irfan Ali3

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-5 | September-October 2021 | Page: 391-398

Practices and Perceived Importance of Informed Consent in Practice of Dentistry

Aasim Farooq Shah1*, Romshi Raina2, Irfan Ali3

Abstract

Background: Medical ethics are often defined as “the disciplined study of morality in medicine”. A doctor-patient, especially a dentist-patient relationship is a special one as the patient seeks help from the dentist for relief from pain and for restoration of their oral health. They permit the dentists to see, touch and manipulate structures in and around the oro-facial region and also divulge information about themselves they wouldn’t normally reveal. The various ethical principles act as guides to enable the dentist to perform his duty to the patient. Informed consent is an autonomous action by a subject or patient that authorizes a professional either to involve the subject in research or to initiate a medical plan for the patient. It is not just a form to be signed as a hospital formality, but a process which ensures respect for persons through provision of thoughtful consent for an option to decide on the best possible treatment in disease processes, so that the patient can make a rational voluntary decision regarding what he/she wants to be done. Aim: The current survey was conducted using a closed/open- ended questionnaire to understand how the dental surgeons perceive the implications and importance of informed consent and their practices towards it in dental practice.Methods: This cross sectional study was conducted in Jammu and Kashmir in government and private dental settings. A modified pretested questionnaire was used about informed consent and the ethical issues related to informed consent. The participants of this survey were dental surgeons working in Kashmir region, dentists working in different private and government health institutions and private dental clinics in Kashmir region. The questionnaire was distributed in 130 participating dental surgeons and then the filled questionnaires were collected by the author after completion on the same day. Most of the questions were bipolar. The collected questionnaires shall be evaluated and the results collated in tabular form. Results:83.84% accepted that it is necessary to take a consent from patient while 16.15 % reported that it is not important to take a consent from patient. Legal reason was the highest quoted reason for taking a consent by almost 54.61% of the respondents, 66.92% of the respondents reported that Patient can take legal action if not informed properly about treatment procedures. 79.23% reported that written consent makes dental practice difficult. 91.53 % of the respondents accepted that Taking Written consent can save them from medico legal claims by patients. Conclusions:the study revealed that dentists are more or less aware of the principles of medical ethics, but they are not adequately acquainted with the three words – respect, beneficence and justice, that describe principles of medical ethics, as it is not taught elaborately in the undergraduate level.

Consent, Dentistry.

Assessment of Patient Satisfaction with Regional Anaesthesia and General Anaesthesia in Urinary Bladder Surgeries

Bhupesh Patel1, Sunny Malik2, Pratik B Tantia3*, Ruchi Tantia4

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-5 | September-October 2021 | Page: 399-405

Assessment of Patient Satisfaction with Regional Anaesthesia and General Anaesthesia in Urinary Bladder Surgeries

Bhupesh Patel1, Sunny Malik2, Pratik B Tantia3*, Ruchi Tantia4

Abstract

Background: To assess patient satisfaction with regional anaesthesia and general anaesthesia in urinary bladder surgeries. Methods: Fifty- six patients scheduled for urinary bladder surgeries were equally divided into 2 groups. Group I (28) patients received GA and group II (28) received RA. Parameters such as patients satisfaction score, duration of surgery and pain score at 12 hours, 24 hours and 36 hours was compared. Results:There were 15 males and 13 females in group 1 and 14 males and females in group 2. ASA grade 1 was seen in 18 in group 1 and 20 in group 2, grade 2 in 10 in group 1 and 8 in group 2. There was kindness score of 7.2 and 8.6 in group 1 and group 2, information score of 8.9 and 9.5 in group 1 and group 2, feeling of safety score of 7.0 and 8.7 in group 1 and group 2, demands met score of 6.9 and 8.2 in group 1 and group 2, anxious score of 1.9 and 1.1 in group 1 and group 2, attention given score of 6.2 and 8.5 in group 1 and group 2, pain score (VAS) of 4.7 and 2.3 in group 1 and group 2, relaxed feeling scoreof 6.8 and 8.9 in group 1 and group 2, nausea score of 1.9 and 1.2 in group 1 and group 2 and wellbeing score of 6.3 and 8.4 in group 1 and group 2 respectively. A significant difference was observed (P< 0.05). Conclusion:There was better patient satisfaction, longer duration of analgesia and lesser duration of hospital stay with RA than GA.

Patients satisfaction score, regional anaesthesia, general anaesthesia, Urinary bladder surgeries.

The Syndromic Management of Vaginal Discharge Using One-Day Combination Kit Therapy: A Randomized Controlled Trial

Rashida Khatun1, Shereen Yousuf2*, Rozina Sultana3, Shahana Begum4, Noor-E-Ferdous5

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-5 | September-October 2021 | Page: 406-413

The Syndromic Management of Vaginal Discharge Using One-Day Combination Kit Therapy: A Randomized Controlled Trial

Rashida Khatun1, Shereen Yousuf2*, Rozina Sultana3, Shahana Begum4, Noor-E-Ferdous5

Abstract

Background: Reproductive tract infections (RTIs) and sexually transmitted infections (STIs) are major public health problems in developing countries.Aim: To observe the responses of improvement symptoms and to reduce the risk of complication. Methods: This randomized study was conducted at Department of obstetrics and Gynaecology OPD in Shaheed M. Monsur Ali Medical college and Hospital, Sirajganj, Bangladesh during January 2019 to June 2019. A total of 219 patients were included for the study. Couple was given one day kit containing: Fluconazole (150 mg) 1 tablet, Azithromycin (1 gm) 1 tablet, Secnidazole (2 gm) 2 tablets. The database so prepared was analyzed with the help of SPSS statistical software. Results:About two third (70.3%) of the women were in age group 16-30 years, one third of them were illiterate (37.4%), 80.4% of them were homemakers. The History of abortion-MR was present 83 (37.9%) and two third (77.2%) of the women were happen home delivery. Moderate to copious 88 (40.2%), Profuse 71 (32.4%) and Scanty 60 (27.4%). Responses for symptoms of vaginal discharge 121 (55.3%), 60 (27.4%), 17 (7.8%) and 21 (9.6%) had excellent, moderate, minimal and no responses, respectively. Pain abdomen was completely 8(28.57%), partially 18(64.29%) relieved in women. Adverse effects of kit therapy were anorexia 53(44.54%) metallic taste 39(32.77%), nausea 46(38.66%), vomiting 30(25.21%) epigastric pain 42(35.29%). The Response rate of the age group 16-30 years is higher than the age group 31-45 years for all gynecological symptoms. Conclusions:Combination kit therapy in syndromic management of vaginal discharge is cheaper, effective and is given in single doses, with excellent efficacy.

Vaginal Discharge, Syndromic Management, Combination Kit Therapy, STD, SAF.

Comparison of Covishield Versus Covaxin in COVID- 19 Pandemic

Sourav Bansal1*, Nitin Soni2, Harjeevan Kalra3, Sapinder Pal Singh4

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-5 | September-October 2021 | Page: 414-419

Comparison of Covishield Versus Covaxin in COVID- 19 Pandemic

Sourav Bansal1*, Nitin Soni2, Harjeevan Kalra3, Sapinder Pal Singh4

 

Abstract

Background: Viral diseases continue to emerge and represent a serious issue to public health. The present study compared Covishield versus Covaxin in COVID- 19 pandemic. Methods: 502 subjects were divided into 2 groups of 251 each. Group I subjects had received Covishield vaccine (both doses) and group II patients received Covaxin vaccine (both doses) too. Assessment of symptoms and any complication was recorded. Results:Symptoms in group I and group II were fever in 60% and 56%, headache in 65% and 62%, tiredness               in 70%   and 72%, body ache in 50% and 48%, joint pain in 22%      and 40%, local pain in 85% and 90%, sore throat in 25% and 10%, vomiting in 6% and 12%, diarrhoea in 14% and 11%, allergic reaction in 5% and 2%, insomnia in 3%          and 5% and chills in 35% and 22%. Both group I and II maximum symptoms were seen in females as compared to females. Age group 40-60 years had 78% in group I and 72% in group II and >60 years had 52% in group I and 48% in group II symptoms. The difference was significant (P< 0.05). Conclusion:Most common symptoms in both groups were fever, headache, tiredness, body ache and local pain. Age group 40-60 years and women had higher symptoms as compared to men.

Covaxin, Covishield, Fever.

Study of Lower End of Fibula and Its Clinical Significance

Vishal Bhadkariya1, Rupa Chhaparwal2*,Sharda Joshi3, Subhash Joshi4

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-5 | September-October 2021 | Page: 420-426

Study of Lower End of Fibula and Its Clinical Significance

Vishal Bhadkariya1, Rupa Chhaparwal2*,Sharda Joshi3, Subhash Joshi4

 

Abstract

Background: Fibula is the most slender lateral bone of the leg. It provides the surface area for the attachment of the muscles. It forms bony mortice for the ankle joint. It is an ideal cortical bone graft. Fibula plays an important role in the tibiofibular syndesmosis for the stabilization of the talocrural joint. Ankle is one of the most commonly injured joint and very few studies are available on morphometry of the articular surfaces of bones forming the tibio-fibular mortise. Looking to the significant contribution of fibula in the body economy and movements; it has hardly received much attention from the anatomist. Hence this study was undertaken. Methods: Forty six (23 Right & 23 Left) dry fibulae were obtained from the department of Anatomy. Results:Height & breadth of the articulating surface of the fibula is 19.04 mm & 17.19mm. Taler articular facet is Plane 65.21% and concavo- convex 34.77%. Average surface area of articular facets is 211.73mm. Articular facet is triangular in 76.08%. Conclusions:An attempt has been made to elucidate the details of lower end of fibula and to correlate it with its functional significance. The standard osteometry of fibula investigated in this study is novel and unique which may lead to advances in the operative management and design of prosthetics regarding the talocrural joint.

Fibula, Distal end, Talar facet, Bone graft, Talocrural joint, Malleolus.