Annals of International Medical and Dental Research (AIMDR)

E-ISSN: 2395-2822 | P-ISSN: 2395-2814

Peer-reviewed International Journal of Advanced Research on Medical and Dental Sciences

Open Access Journal

Annals of International Medical and Dental Research (AIMDR) is indexed in Index Medicus (IMSEAR), Global Index Medicus, Index Copernicus and Google Scholar

Annals of International Medical and Dental Research (AIMDR) 

Vol-7, Issue-4 | July-August, 2021

Seroprevalence of Hepatitis C Virus Antibodies among Blood Donors of North India: A Prospective Study

Arunpreet Kaur1*, Ram Niwas Maharishi2, Neerja Jindal3, Neetu Kukar4,Harkiran Arora5, Neha Syal6

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-4 | July-August, 2021| Page: 1-12

Seroprevalence of Hepatitis C Virus Antibodies among Blood Donors of North India: A Prospective Study

Arunpreet Kaur1*, Ram Niwas Maharishi2, Neerja Jindal3, Neetu Kukar4,Harkiran Arora5, Neha Syal6

Abstract

Background: Blood transfusion is an integral and life-saving intervention but simultaneously blood is one of the major sources of transmission of Hepatitis B Virus (HBV), Hepatitis C Virus (HCV), Human Immunodeficiency Virus (HIV), syphilis and many other infections. The purpose of the present study was to study the seroprevalence of anti-HCV antibodies in healthy blood donors in a hospital based blood bank in Malwa region of Punjab, North India and to compare with other studies undertaken in other parts of India to assess the epidemiology of this infection in the community. Methods: Serum samples of 10945 donors were tested for various viral markers including HIV 1 & HIV 2, HBsAg and HCV by 3rd generation ERBA LISA ELISA kits supplied by Transasia Bio-medicals Pvt. Ltd. for the period of one year. Results: Out of total 10945 blood donors tested for anti-HCV antibodies, 268 (2.44%) donors were found to be reactive. The seroprevalence of HCV in the blood donors of Malwa region of Punjab was found to be high as compared to the studies from various parts of India. Conclusion: High Seroprevalence of anti-HCV antibodies in the donor population reflects the lack of awareness regarding the spread of HCV infection in the general population.

Blood donors, Hepatitis C virus, Seroprevalence, Transfusion transmitted infections

Enhancing Intern’sCompetency for Urethral Catheterization by Directly Observed Procedural Skills (DOPS)

Jai Vinod Kumar1*

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-4 | July-August, 2021| Page: 13-15

Enhancing Intern’sCompetency for Urethral Catheterization by Directly Observed Procedural Skills (DOPS)

Jai Vinod Kumar1*

Abstract

Background: During the teaching process for undergraduates, the assessment of clinical skills is an integral part. Many of the procedures that a house surgeon (CRRI) is allowed to perform during their clinical training need to be supervised adequately. In spite of all observations, some minor procedures could also turn out with a negative outcome if the required skill were not properly imbibed into them. During the surgical rotation, catheterization of the urinary bladder via the urethra is a simple regularly done procedure which can have devastating consequences if performed incorrectly. This evaluation of workplace-based assessment study was done to assess whether directly observed procedural skill (DOPS) enhances the competency of medical interns (CRRI) to perform urethral catheterization procedure correctly and independently. Methods: In this study, the competency of 30 interns posted in the department of general surgery to perform the urethral catheterization was tested initially using a mannequin. The protocol of training included issue of a pre-test checklist to the interns,  demonstration of the procedure on a mannequin in small groups, assessment of interns performing on the mannequin followed by demonstration of the procedure on a consented patient in small groups that ended in Directly observed procedural skill (DOPS) assessment (Post-test) for each intern on an individual patient under the direct supervision of a skilled general surgeon.Results: The results of this study showed a definite improvement in the competency of the interns in performing the skill of urethral catheterization following the training with the DOPS program.Conclusion: The analysis of the observations during this study showed that there is a definite improvement in the level of competency of the interns while performing urethral catheterization after undergoing the directly observed procedural skills (DOPS) training programme.

Directly Observed Procedural Skills (DOPS), Skills Lab, Workplace Based Assessment (WBA).

“Mask Mouth’- A new malady affecting oral health in the COVID era.”

Dr. Pooja Muley-Itke1*

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-4 | July-August, 2021| Page: 16-22

“Mask Mouth’- A new malady affecting oral health in the COVID era.”

Dr. Pooja Muley-Itke1*

Abstract

Background: Presently the use face masks has become the need of the hour due to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. Although the use face mask protects the user from SARS-CoV-2 infection, it has certain adverse effects. One of the new and recently noticed side effect is on the oral health of the wearer known as ‘Mask Mouth’. This consist of symptoms like caries, gingivitis, halitosis, candidiasis and angular cheilitis. In this article, a systematic review was done, where comprehensive, critical and objective analysis of the current knowledge regarding adverse effects of using face mask on the oral health was reviewed. It was observed that prolonged use of mouth mask can cause dryness of mouth as well as bring about a change in the oral microflora and have an impact on overall oral health. Mask mouth can be prevented by maintaining proper oral and mask hygiene, avoiding mouth breathing and staying hydrated.

COVID 19, SARS Cov 2, Mouth Mask, Oral Health, Adverse Effects

A Study to correlate blood pressure with anthropometric measurements among adolescent medical students of PK Das Institute of Medical Sciences, Palakkad

Dr Nimisha V1*, Dr.  Santhosh Viswan2, Dr.Jagathlal PC3

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-4 | July-August, 2021| Page: 23-31

A Study to correlate blood pressure with anthropometric measurements among adolescent medical students of PK Das Institute of Medical Sciences, Palakkad

Dr Nimisha V1*, Dr.  Santhosh Viswan2, Dr.Jagathlal PC3

Abstract

Background: Hypertension is a risk factor for various cardiometabolic diseases. Obesity is associated with hypertension,for which various pathophysiological pathways  have been found.Hence getting an anthropometric measurement which correlates best with blood pressure will help in early diagnosis of obesity. Many new anthropometric measurements have been suggested due to the shortcomings identified with using Body Mass Index like Abdominal Volume Index, A body Shape Index and Body Roundness Index.Methods: After taking approval from institutional scientific and ethics committee this study was started. 55 adolescent students were selected by cyclic stratified random sampling. Physical parameters like Blood pressure, height, weight, waist circumference, hip circumference were taken. These values were put into various formulae to derive the anthopometric measurements like Waist Hip Ratio, Body Mass Index, Abdominal Volume Index, A body Shape Index and Body Roundness Index. These measurements were correlated with systolic and diastolic blood pressure.Results: 69.1% girls and 30.9% boys were a part of the study. A significant positive correlation was found between Systolic Blood Pressure and Waist circumference, Hip circumference, Waist hip ratio, Body Mass Index, Abdominal Volume Index and Body Roundness Index. The maximum correlation was found with Waist circumference.Conclusion: It is necessary that anthropometric measurements which take adiposity into consideration be used so that obesity can be picked up much before it exerts its ill effects like  systemic Hypertension.

Anthropometric Measurements, Adolescent, Blood pressure

Maternal and Neonatal Complications in Second Stage Cesarean Section,A Prospective Observational Study

Nadia Khurshid1, Imtiyaz Khan2, Insha Khanyari3, Faiz Shera4*, Humaira Noor5, Farah Nabi6, Rafia Aziz7

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-4 | July-August, 2021| Page: 32-36

Maternal and Neonatal Complications in Second Stage Cesarean Section,A Prospective Observational Study

Nadia Khurshid1, Imtiyaz Khan2, Insha Khanyari3, Faiz Shera4*, Humaira Noor5, Farah Nabi6, Rafia Aziz7

Abstract

Background: Caesarean deliveries done in the second stage of labor account for one-fourth of all primary caesarean sections. These are more frequent in developing countries. Caesarean sections done at full cervical dilatation with impacted fetal heads are technically difficult and are associated with higher complications. Methods: 201 patients who underwent cesarean section in the second stage were enrolled in this study. Cesarean was performed under spinal anesthesia unless contraindicated. Post procedure, patients were closely monitored. Results: The two most common indications for second-stage cesarean section were dystocia (68%) and fetal distress (28%). A trial of instrumental delivery was given in 41% of these deliveries.The mean age of the patients undergoing cesarean section in the second stage was 27.6 years. Primigravida comprised 72.1% (145) and 27.8% (56) were multigravida. Maternal morbidity outcomes included PPH, need for blood transfusion, lower segment tear, wound infection, puerperal febrile morbidity, bladder injury, hysterectomy, maternal death.The most common fetal complication seen in our study was meconium-stained amniotic fluid in 21.2% of cases. Neonatal Intensive Care Unit admission rate in our study was 10.9%.Conclusion: Second stage cesarean section is challenging not only for the obstetricians but also the patient as it is technically difficult to perform and associated with increased maternal and neonatal morbidity. However, the complications can be reduced if these deliveries are attended by consultants and strengthening the referral system in our setup.

Second stage, Cesearean section, LSCS, labor, delivery

Less Aggressive Surgical Approach to Closed Globe Injury by Firecracker Trauma- ACase Report

Epsita Gantayat1, Mukta Prasad2, Pranay Panigrahi3, Sugyani Satapathy4*

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-4 | July-August, 2021| Page: 37-41

Less Aggressive Surgical Approach to Closed Globe Injury by Firecracker Trauma- ACase Report

Epsita Gantayat1, Mukta Prasad2, Pranay Panigrahi3, Sugyani Satapathy4*

Abstract

Background:We describe a case of firecracker injury to left eye due to accidental explosion of firecracker during festival season in India.Method: A 16years male got injured while playing with firecracker during Diwali last year which accidentally exploded and caused ocular injuries. Patient came to emergency OPD within 24 hours of incident with complaint of pain and diminution of vision. On slit lamp examination, left eye conjunctiva was congested with corneal edema. Anterior chamber showed total hyphaema obscuring rest of details. Primary medical management with padding of eye and bed rest for first 24 hours of admission. Addition of topical and systemic steroid after 24 hours resolved hyphaema dramatically. Rest topical drugs for symptomatic management continued. On reviewing by slit lamp after 72 hours, anterior capsule was breached and subtotal cortical cataract with inferior iridodialysis was appreciated. Result:We surgically managed iridodialysis with planned cataract extraction at a later date. Patient doing well on follow-up.Conclusion:Firecracker ocular trauma is an important cause of monocular blindness which could be preventable. Prompt diagnoses and treatment, are essential for the best possible prognoses.

Iridodialysis, Firework Accidents, Traumatic Cataract, Hyphaema, Cobbler’s Technique.

Ridge splitting technique followed by implant placement foratrophic ridges wrt 35- A Case Report

Dr. Sneha Singh1*, Dr. Rakesh Kumar Singh2, Dr. Abu Nafe3, Dr. Amit Sinha4

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-4 | July-August, 2021| Page: 42-45

Ridge splitting technique followed by implant placement foratrophic ridges wrt 35- A Case Report

Dr. Sneha Singh1*, Dr. Rakesh Kumar Singh2, Dr. Abu Nafe3, Dr. Amit Sinha4

Abstract

Background: A two stage approach of ridge splitting and lateral expansion in the mandible to achieve enough bone width for the purpose of dental implant placement. Methods: 32 yr old male patient reported to the department with the chief complaint of missing tooth. On examination ridge was atrophic for implant placement. So, ridge split was planned with implant placement. Results: Approximately, 85-90% of the expanded area were successful in providing an adequate width to accommodate an implant. Implant was inserted. Prosthetic loading was successfully implanted wrt to 35. Conclusion: Ridge split technique is a short and simple procedure with satisfactory results and minimum morbidity. It has low rate cost, therefore, should be employed more often.

Ridge split, Atrophic ridge, Dental implant, Bone augmentation

A Study of Management of Colon Cancer Depending Upon Staging in DMCH

Mohammad Mashiur Rahman1*,Israt Jahan2, Abdullah Md Abu Ayub Ansary3, Mohammad Emrul Hasan Khan4, Md Maniruzzaman5, MdMahfuzur Rahman Khan6, Shahana Sarwar7,Lutfunnahar8, Jobaida Parvin9

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-4 | July-August, 2021| Page: 46-55

A Study of Management of Colon Cancer Depending Upon Staging in DMCH

Mohammad Mashiur Rahman1*,Israt Jahan2, Abdullah Md Abu Ayub Ansary3, Mohammad Emrul Hasan Khan4, Md Maniruzzaman5, MdMahfuzur Rahman Khan6, Shahana Sarwar7,Lutfunnahar8, Jobaida Parvin9

Abstract

Background: Colon cancer is one of the most frequent neoplasms, as encountered by surgeons in their practice. In North America and Western Europe colorectal cancer are the third most common cancer in both men and women and approximately one third occurring in the rectum with the remainder in the colon. The incidence of colon cancer in our country is no less than the western world and there is no broad-based study regarding this.Aim of the study: To evaluate the different stages at presentation as well as hospital-based management of colon cancer.Methods: This cross-sectional studywas conducted in Department of Surgery, Dhaka Medical College Hospital during September 2012 to February2013. A total 50 patients of proved colon cancer were selected purposively according to inclusion and exclusion criteria. The result was presented by appropriate tables and graphs, data was analyzed by computer with the help of SPSS/PC software and MS Excel.Result: This study revealed that highest incidence (30%) of colon cancer was identifiedin 51-60 years age group. Tumours were located more in sigmoid colon(30%) and ascendingcolon(28%).Histopathologically 96% was adenocarcinoma and 64% was moderately differentiated. Majority of the patient presented at stage-III&IV which was accounted for 76%. Curative (stage-I & II) and potential curative resection (stage-III) was possible in 36 cases. Two patients died, 1 due to anastomotic leakage with subsequent sepsis and 2nd one due to secondary haemorrhage. There were 8 morbidities, 5 had superficial wound dehiscence, 2 burst abdomen and 1 with the bleeding from stoma. Conclusion:This study revealed that most of the patients in our country presented at advanced stage. Despite thorough pre-operative evaluation for staging of colonic cancer it was found that a significant number of patients were under staged. Curative resection was possible in early stages. Palliation was the only option in advanced stages. Population screening in high-risk patients will definitely reduce morbidity and mortality with increased chance of survival.

Colon Cancer, Staging, Management

Corneal Endothelial Cell Change after Phacoemulsification: A Comparison between Diabetic and Non-diabetic patient

Israt Jahan1*, Mohammad Mashiur Rahman2

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-4 | July-August, 2021| Page: 56-67

Corneal Endothelial Cell Change after Phacoemulsification: A Comparison between Diabetic and Non-diabetic patient

Israt Jahan1*, Mohammad Mashiur Rahman2

Abstract

Introduction: Cataract is the main cause of avoidable blindness especially in the developing world and phacoemulsification is one of the most practicing method to perform cataract surgery. Corneal clarity after cataract surgery is a special interest to the ophthalmologist which is mostly maintained by endothelium. Some degree of endothelial cell loss is inevitable after cataract surgery.Aim of the study: To evaluate the effect of diabetes mellitus on corneal endothelium after phacoemulsification with PCIOL implantation. Methods:The study was a prospective observational study and conducted on 100 diagnosed patients of age related cataract (diabetic and non-diabetic 1:1 basis) attending in the cataract clinic of National Institute of   Ophthalmology and Hospital, over the period of December, 2011 to May, 2012. Patients were selected based on specific selection criteria. All surgery was done by same surgeon of NIOH. Patient information, ocular examination and pre and post-operative endothelial cell count and morphology was recorded on a standard data collection sheet. Results were presented by appropriate table and graphs, data was analyzed by SPSS version 15. Result: Goup-1 was cataract patient without diabetes mellitus and Group-2 was cataract patient with diabetes mellitus. In Group-1 endothelial cell count per square millimeter in base line period was 2432.36, on 1st POD 2309.10, after 1 week 2272.63 and after 1 month 2251.16.  In Group -2 endothelial cell count per square millimeter in base line period was 2409.10, on 1st POD 2219.30, after 1 week 2189.30 and after 1 monthly 2164.16. Cell size variability (%) in Group-1 in base line period, on 1st POD, after 1 week, and after 1 month were -35.36, 36.76,38.60, 38.71; Group-2 in base line period, on 1st POD, after 1 week, and after 1 month were- 35.38, 38.56,39.43,40.19 respectively. Hexagonality of endothelial cell in Group-1 in pre-operative and post-operative value were 51.50 and 49.10; in Group-2 in pre-operative and post-operative value were 48.60 and 46.50 respectively. Mean Intra ocular pressure in Group 1 and Group 2 was 12.13 and 12.23 mm Hg and on 1st POD 13.96 and 15.20 mm Hg, after 1st week of operation mean IOP was declined to 12.03mm and 12.10 mm of Hg, after 1 month further declined to 11.96 and 11.82 mm of Hg respectively. Mean visual acuity expressed in log MAR, Group-1 in base line period, on 1st POD, after 1 week, and after 1 month were- 1.15, 0.45, 0.08 and 0.07 respectively. Group-2 in base line period, on 1st POD, after 1 week, and after 1 month were-1.12, 0.41, 0.07 and 0.06 respectively. Mean age in Group -1 was 55.3±5.89 years, male were 32 (64%) and female were 18 (36%). Mean age in Group -2 was 55.60±6.14 years, male were 37 (74%) and female were 13 (26%). Conclusion: Diabetes mellitus is a causative factor for more endothelial cell loss and morphological changes which are reflected by decrease in percentage of hexagonal cells and increase in cell size after phacoemulsification. So special care should be taken for diabetic patients during surgery.

Corneal Endothelial Cell, Phacoemulsification, Diabetic and Non-Diabetic Patient

To Analyze the Association between Socio-Demographic Variables and   Prescription of Anti-Epileptic Drugs in Children with Epilepsy

Amrit Pal Kaur1, Vijay K Sehgal2, Harjinder Singh3, *JasbirSingh4

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-4 | July-August, 2021| Page: 68-76

To Analyze the Association between Socio-Demographic Variables and   Prescription of Anti-Epileptic Drugs in Children with Epilepsy

Amrit Pal Kaur1, Vijay K Sehgal2, Harjinder Singh3, *JasbirSingh4

Abstract

Background:-Epilepsy has significant economic impact in terms of health-care needs and premature deaths. Access to medical care differs among socio-economic groups but less in known about inequalities in epilepsy care within a country. Objective: To analyze the association between socio-demographic variables and prescription of anti-epileptic (AED) drugs in children with epilepsy. Method: An observational-cross sectional study was done over the period of 6 months in department of Pediatrics, Rajindra Hospital attached to Government Medical College, Patiala, Punjab. Data on epilepsy, AED prescription and socio-demographic variables, wascollected from 50pediatric patients of epilepsy aged 1-17 years.Chi square test used for statistical analysis. Results: Among study population (n=50), male children (58%) were more than female children (42%). Children aged 1-6 years (n=12) were mostly treated with mono-therapy (20%) where most commonly prescribed drug was sodium valproate (14%),and rarely with poly-therapy (4%).Children aged ³6-17 years (n=38) were treated with both poly-therapy (44%) and mono-therapy (32%). There was significant difference in prescribing pattern between two age groups i.e. 1-6 years vs ³6-17 years (p = 0.013). Access to poly-therapy was greater in children belonging to middle class family, as compared to those belonging to lower class family and the difference was statistically significant (p = 0.015). Conclusion: There is wide inequality in health care services in terms of AED prescription pattern between different socio-economic classes. Every individual should be provided with good quality health care regardless of his/her socio-economic status. There should be equal treatment for individuals with equal need.

Epilepsy, Antiepileptic Drugs, Socio-Demographicvariables, Socioeconomic Status Scale.

Significance of Ascitic Fluid Cytology for the Detection of Ovarian Tumour: an experience in a Tertiary Care Centre.

 Anupa Toppo1, Harish Chandra Singh2*, Binod Kumar Sahu3, Pallavi Kumari4, Rojalin Nanda5, Subrat Kumar Sahoo6

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-4 | July-August, 2021| Page: 77-86

Significance of Ascitic Fluid Cytology for the Detection of Ovarian Tumour: an experience in a Tertiary Care Centre.

Anupa Toppo1, Harish Chandra Singh2*, Binod Kumar Sahu3, Pallavi Kumari4, Rojalin Nanda5, Subrat Kumar Sahoo6

Abstract

Background: Ascitic fluid cytology is a simple and non – invasive method for the diagnosis of various pathological conditions including ovarian malignancy. The detection of ovarian tumours by the conventional cytological smear method is quite challenging. This study aimsto evaluate the accuracy of ascitic fluid cytology in the diagnosis of ovarian tumours and its histopathological correlation. Methods: A retrospective study was done for 4 years from January 2016 to December 2019 in a tertiary care centre in Western Odisha. The asciticfluids with suspicion of malignancy clinically and radiologically were processed as per conventional method and histopathologically correlated. The sensitivity, specificity, negative and positive predictive values were calculated. Results: Out of 144 cases, 58 cases were diagnosed as benign ovarian tumours, 3 borderline and 83 cases as malignant ovarian tumours. The histopathology of these cases showed 4 false-positive cases and 32 false-negative cases. The sensitivity, specificity, positive predictive value, and negative predictive value in our study were 62.8%, 93.1%, 93.1% and 62.8% respectively. The diagnostic accuracy was calculated as 75%. Conclusion: Ascitic fluid examination is a highly specific and relatively sensitive test for detecting ovarian carcinoma, especially in stage 3 and 4 tumours. As patients usually present late, it helps in the staging of tumour and the prognosis of patients.

Ascitic Fluid Cytology, Histopathology, Ovarian Carcinoma.

A Comparative Study of Transabdominal Pre-Peritoneal (TAPP) & Totally Extraperitoneal (TEP) Laparoscopic Techniques for Inguinal Hernia Repair.

Dr. Deb Prosad Paul1*, Dr.Debashis Paul2, Dr. A S M Zahidur Rahman3, Dr. Karina Rahman4, Dr. Debasish Das5, Dr. Md.Mahfuzul Momen6, Dr. Sonia Akter7

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-4 | July-August, 2021| Page: 87-95

A Comparative Study of Transabdominal Pre-Peritoneal (TAPP) & Totally Extraperitoneal (TEP) Laparoscopic Techniques for Inguinal Hernia Repair.

Dr. Deb Prosad Paul1*, Dr.Debashis Paul2, Dr. A S M Zahidur Rahman3, Dr. Karina Rahman4, Dr. Debasish Das5, Dr. Md.Mahfuzul Momen6, Dr. Sonia Akter7

Abstract

Background: The most frequently used laparoscopic techniques for inguinal hernia repair are transabdominal preperitoneal (TAPP) repair and totally extraperitoneal (TEP) repair. Aim of the study: The aim of this comparative study was to compare the laparoscopic totally extraperitoneal (TEP) and laparoscopic transabdominal preperitoneal (TAPP) techniques of laparoscopic inguinal hernia repair. Methods: The comparative study was conducted between May 2017 and March, 2020 in the Department of Surgery in Anam Medical College & Hospital. There 100 patients who were suffering from uncomplicated primary groin hernia included for the study from the Herniamed registry. Patients were divided into Group I (TEP) and Group II (TAPP). In TEP group had 60 study subjects and 40 study subjects includes in TAPP. Data compilation were done in an organized manure. All data analyses were performed with the software SPSS 20 & MS Excel-2016. Results: There were significant differences between the two patient groups in respect of a number of other patient characteristics. There found 8.33% for TEP and 7.50% for TAPP, in the intraoperative complications associated with the two surgical techniques. More complications were noted within the first 30 postsurgical days in the TAPP group (15.00%). These were mainly due to the difference in the postoperative seroma rate (TEP 5.00% vs TAPP 12.50%). The coronary heart disease (5.00%), diarrhea (2.50%), exitusletalis (2.50%) found only in TAPP method. Conclusion: In the present study, TEP had a significant advantage over TAPP. As there found some complications more in TAPP as TEP. The other intraoperative complications, postoperative complications, and cost were similar in both groups. In terms of results, both repair techniques seemed equally effective, but TEP had an edge over TAPP.

TEP, TAPP, Intraoperative Complications, Postoperative Complications, Inguinal Hernia Repair.

Study of Patients with Early Postoperative Complications Following Abdominal Surgery Admitted into Rajshahi Medical College Hospital.

Md Maniruzzaman1*,Lutfunnahar2, Mohammad Mashiur Rahman3, Israt Jahan4, Abdullah Md Abu Ayub Ansary5, Shahana Sarwar6 , Md Shahid-ul-Islam Khan7, Md Nadeem Sarkar8

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-4 | July-August, 2021| Page: 96-109

Study of Patients with Early Postoperative Complications Following Abdominal Surgery Admitted into Rajshahi Medical College Hospital.

Md Maniruzzaman1*,Lutfunnahar2, Mohammad Mashiur Rahman3, Israt Jahan4, Abdullah Md Abu Ayub Ansary5, Shahana Sarwar6 , Md Shahid-ul-Islam Khan7, Md Nadeem Sarkar8

Abstract

Background: Postoperative complications are a significant source of morbidity and mortality. The rising cost of health care is given increasingly importance worldwide. A major factor affecting hospital cost is complications following surgery. Each of the postoperative complications are associated with substantial increases in total hospital cost, financial burden of both government and people and increases in work load for doctors and other health related staffs even after adjusting for type of surgery, urgency of surgery and preoperative patient comorbid conditions. Aim of the study: To study the incidence of admission of patients with early postoperative complications following abdominal surgery in RMCH. Methods: The study was a prospective observational study and conducted on Department of Surgery, Rajshahi Medical College Hospital, from March, 2013 to August, 2013. The cases were selected on the basis of history, clinical findings, relevant investigations, exploration of abdomen and histological confirmation (in selected cases). All patients more than 12 years old with early postoperative complications following abdominal surgery admitted into general surgery department of RMCH. 96 Cases with early postoperative complications following abdominal surgery admitted in surgery department during this study period. Purposive sampling technique used. Results were presented by appropriate table and graphs, data was analyzed by SPSS version 15. Result: A total of 96 out of 3613 (that is 2.66%) cases of postoperative complications were admitted during the period of study. The mean age was 39.44 years (14years-70years) with the male to female ratio of 1:1.4.Peak age group of postoperative complications is 21-30 years about 28.1%. The major incidence of postoperative complications after abdominal surgery among admitted patients are wound infection (10.4%), Pyoperitoneum (9.4%), Pelvic abscess (8.3%), Fecal fistula (8.3%), Burst abdomen (7.3%), Missed diagnosis (7.3%) and Sub hepatic abscess (6.2%). The mortality rate was 7.3% (n= 7). Conclusion: Patients with postoperative complications consume considerably more health care resources. Initiatives that target prevention of these events, even if costly to implement would significantly improve quality of care and patient safety.

Early Postoperative Complications, Abdominal Surgery, Primary Level Hospital, Secondary Level Hospital.

Maternal Risk Factors and Perinatal Outcomes of Premature Rupture of Membranes(PROM).

Jahanara Rahman1*, Shahana Pervin2, Nasreen Sultana3

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-4 | July-August, 2021| Page: 110-119

Maternal Risk Factors and Perinatal Outcomes of Premature Rupture of Membranes(PROM).


Jahanara Rahman1*, Shahana Pervin2, Nasreen Sultana3

Abstract

Background: Premature rupture of membranes (PROM) is defined as rupture of foetal membranes before the onset of labour. PROM is a common obstetric problem which can cause serious maternal as well as foetal complications. Several risk factors lie behind the cause of PROM. Methods: This cross sectional descriptive study was carried out in the In-patient Department of Obstetrics and Gynecology at Dhaka National Medical College Hospital between March 2016 and February 2017.Objectives: The objectives of the study were to determine socio-demographic factors among the pregnant women developing PROM, to find out maternal risk factors of PROM and to observe the outcome of newborns of PROM pregnancies.Results: During this study period 1240 deliveries took place in this department. Sixty-four of them were admitted with complains of PROM. The prevalence of PROM was found 5.2%. Among them 34% was preterm PROM. The maternal age the women developed PROM ranges from18 to 32 years and mean maternal age was 24.82± 3.71 years. The most common age group was 20 to 30 years. Educational status revealed 95% of the women and about 97% of husbands were literate. About 86% women were housewives. Husbands were service holders and businessmen 56% and 33% respectively. Only 9.38% of the study population was from low socioeconomic condition. Others were from middle (15.63%), higher middle (42.18%) and affluent (32.81%) socio-economic condition. Antenatal checkup was received regularly by 68% of mothers. Supplementary iron, calcium, vitamins and minerals taken regularly and irregularly by 68.75% and 25% pregnant mothers respectively. Only 6.25% did not take any supplementary during their antenatal period. About 74% women took balanced diet during their pregnancy period. Sixty nine percent of the PROM cases were primigravida. History of abortion and PROM in previous pregnancy was present in 34% and 6% women respectively. Women with PROM were suffering from Hypertension (7%), Diabetes (5%), Respiratory tract infection (15%), Urinary tract infection (3%), Hyperpyrexia (7%), and Vaginitis (20%). Anemia was detected as mild, moderate and severe degree in 25%, 23.4% and 3% of women respectively. Majority (71%) of the mothers delivered by caesarian section. Rest delivered spontaneously (26%) and by medical induction or augmentation (3%). Indications of caesarian sections were foetal distress (31.82%), high head (22.73%), mal-presentation (11.36%), oligohydramnios (11.36%), intrauterine growth retardation (IUGR) 6.89%, and history of previous twice caesarian section (4.54%), prolonged labour (2.27%) and more than one indication (13.33%). Fifty two percent babies were male and 28% were of low birth weight (LBW). Respiratory depression was noticed among 32% newborns at 5th minute of birth by APGAR scoring. Perinatal death occurred in 14% neonates due to respiratory depression (77.78%) and septicemia (22.22%). Twenty-nine percent newborns needed to be admitted in NICU. Mean interval of PROM and hospitalization of PROM patients were 8.5 hours. Mean interval of PROM and delivery was13.2 hours.Conclusion: The study found no significant influence of socio-economic status and antenatal care on PROM. Maternal risk factors like: maternal systemic illness, infection, hyperpyrexia and vaginitis were detected as factors of PROM. History of abortion in previous pregnancy, maternal infection and vaginitis significantly influenced PROM. Neonatal outcome was unfavorable in preterm PROM.

PROM, Risk Factors, Perinatal Outcome.

Reconstruction of Sacral Pressure Sore defects by Gluteus Maximus MyocutaneousV-Y Advancement Flaps

Dr. Mohd. Fazle Rubby1*, Dr. Mohammad AbulKalam Azad2, Dr. Romana Parvin3, Dr. Md. Toriqul Islam4

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-4 | July-August, 2021| Page: 120-127

Reconstruction of Sacral Pressure Sore defects by Gluteus Maximus MyocutaneousV-Y Advancement Flaps

Dr. Mohd. Fazle Rubby1*, Dr. Mohammad AbulKalam Azad2, Dr. Romana Parvin3, Dr. Md. Toriqul Islam4

Abstract

Background: Sacral region is a common site for pressure sore development in paraplegic patients. Wound excision in sacral pressure sores often result in large soft tissue defects. Skin graft, local flaps, muscle flaps and free flaps have been applied to reconstruct such defects. This study was to evaluate the efficacy of gluteus maximus myocutaneous v-y advancement flap for reconstruction of sacral pressure sore defects.Aim of the study:To evaluate the efficacy of reconstruction of sacral pressure sore defects by Gluteus Maximus Myocutaneousv-y advancement flaps.Methods: This prospective observational study was conducted in the Department of Burn, Plastic and Reconstructive Surgery, Enam Medical College Hospital(EMCH), Savar, Dhaka over a period of March 2020 to August, 2020. A total of 20 cases were included for the study. Sample was selected by purposive sampling technique. The operation was done under spinal anaesthesia. The skin was designed as V-Y advancement, with its base along the sacrum and its sides along the superior and inferior border of gluteus Maximus converging on its insertion in the greater trochanter. Standard formulae was used and statistical analysis of the result was obtained by using window-based computer software devised with Statistical package for Social Science (SPSS-17).Results: Age distribution shows that 15(75%) patients were below 40 years old. The mean age patients was 30.8 years and range was 14 and 52 years. Study of characteristics of the lesion shows that 90% of the ulcers were in Stage-IV. The mean horizontal and vertical lengths of the defect before excision were 9.075 and 8.45 cm respectively. The medial advancement of the flap was 5.73 cm. The mean operative time was 227.25 minutes. About 85% of the patients exhibited excellent outcome. Only one patient developed recurrence at 03 months of period.Conclusion: It could be concluded that the Gluteus Maximus Myocutaneous flap produces good result in majority of the patients with paraplegia having large sacral sores with few complications or recurrences.

Pressure Sores, Paraplegic, Closure, Flaps.

Cellphone Based Remote Consultation in Reproductive Endocrinology and Infertility: A Covid-19 Pandemic Experience

Shakeela I1*, Farzana D2, Nurjahan B3, Shaheen A4, Jesmine B5

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-4 | July-August, 2021| Page: 128-137

Cellphone Based Remote Consultation in Reproductive Endocrinology and Infertility: A Covid-19 Pandemic Experience

Shakeela I1*, Farzana D2, Nurjahan B3, Shaheen A4, Jesmine B5

Abstract

Background: There was a difficult time of COVID-19 pandemic and lockdown. People around the country were forced to stay home. Hospitals were deeply concerned about managing the exposure to COVID-19 virus.Aim of the study: To evaluate the cellphone based remote consultation in reproductive endocrinology and infertility.Material & Methods: The observational cross sectional study was carried out in the Department of Reproductive Endocrinology & Infertility for about 6 months from July 2020 to December 2020. Following approval of Institutional Review Board of Bangabandhu Sheikh Mujib Medical University, we decided to call the patients who had attended our consultation from 1st January 2020. The Department of Reproductive Endocrinology & Infertility attends every working day approximately 50-60 new patients of infertility and related problems of reproductive endocrinology in outdoor. The COVID-19 pandemic halted the interaction of the patients with us for indefinite period. Remote consultation with cell phone was applied to maintain the continuity of care of the patients.  Statistical Package of Social Sciences (SPSS) version 22 was used for quantitative analysis.Results: A total of 965 calls were made, of which 222 were answered. Almost half (55.4%) of the patients were non-compliant with the drugs prescribed to them before the pandemic. The common reasons for non-compliance were pregnancy, lockdown or indecision of the patients whether to continue. Presenting complaints like abdominal pain, abnormal uterine bleeding and others were present in 10.8% women. Pregnancy was reported in 14.41% women, mostly following ovulation induction and optimization. Among the patients 83.33% had no problem with comprehensibility, 89.94% was satisfied absolutely with remote consultation and 77.48% was willing to pay for remote consultation. Experience of cell phone based consultation regarding adequate communication, patients’ involvement and respect for patients’ values were assessed on Likert scale 1-3: most were satisfied. The consultants’ experience regarding whether the remote consultation was helpful to counsel about health issues, dealt things which mattered most and allowed shared decision making as to what to do next was assessed on Likert scale 1-5: the experience was mostly satisfactory.Conclusion: In conclusion, cell phone based remote consultation of patients with reproductive problems is largely satisfactory for the patients as well as the consultants.

COVID-19, Lockdown, Pandemic, Reproductive Endocrinology, Infertility.

Evaluation of Pre-operative Ultrasonography in Gall Stone Disease to Predict Technical Difficulties during Laparoscopic Cholecystectomy at Surgery Department of ShSMCH.

Dr. Karina Rahman1*,Dr. Sonia Akhter2,Dr. Mahfuzul Momen3, Dr. Deb Prosad Paul4, Dr. Asaduzzaman Nur5

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-4 | July-August, 2021| Page: 138-147

Evaluation of Pre-operative Ultrasonography in Gall Stone Disease to Predict Technical Difficulties during Laparoscopic Cholecystectomy at Surgery Department of ShSMCH.

Dr. Karina Rahman1*,Dr. Sonia Akhter2,Dr. Mahfuzul Momen3, Dr. Deb Prosad Paul4, Dr. Asaduzzaman Nur5

Abstract

Background: Laparoscopic cholecystectomy is the gold standard in the treatment of gallstones. Gallstones are one of the major causes of morbidity in Western society. Prevalence of people with gallstones, whether symptomatic or asymptomatic, varies from 5 to 22%.Aim of the study:To evaluate the efficacy of pre-operative ultrasonography in assessing technical difficulty faced during laparoscopic cholecystectomy in gallstone disease.Methods: This observational study was conducted in the department of Surgery, Shaheed Suhrawardy Medical College Hospital (ShSMCH). A total of 80 patients were included in the study. The sample was selected by the purposive sampling technique. Collected information is compiled, analyzed and edited using the software SPSS (version 24.0) (IBM) Chicago, Illinois. After receiving approval from the ethical review committee of Shaheed Suhrawardy Medical College Hospital, Dhaka, the present study was conducted.Results: In this study, there was a total of 80 cases, among which 33 (41.25%) were in the group between 41-50 years, the commonest. The mean age was 41.8±11.7 years. 60 (75%) were female, and 20 (25%) were male. 45 (56.25%) turned out to have undergone normal laparoscopic cholecystectomies. 35 (43.75%) were difficult, among which 3 (3.75%) were converted to open cholecystectomies. 85% patients with gallbladder wall thickness <3mm and 12/80 (15%) patients >3mm. 66 (97%) had no adhesions, but the other two (3%) did. The mean level of difficulty of Calot’s triangle dissection was in 0.25 + 0.44 patients. 79% had undergone easy gallbladder bed dissection, and 21% had undergone difficult gallbladder bed dissection. The mean level of difficulty in holding gallbladder was in 0.25 + 0.44 patients. Among the 62 patients with a normal gallbladder, there was no difficulty in holding gallbladder in 53 (85.5%) cases, whereas there was difficulty in holding the gallbladder in 9 (14.5%) cases. Mean bleeding occurred in 0.35 + 0.53 patients.Conclusion: From this study, we conclude that pre-operative ultrasonography is a good predictor of difficulty in laparoscopic cholecystectomy in most cases and should be used as a screening procedure.

Gallstones, Laparoscopic Cholecystectomy, Ultrasonography, Technical.

ImmunohistochemicalOverexpression of p16INK4a is Predictive of High Risk Human Papilloma Virus infection in VIA Positive Cervical Lesions

Dr. Labiba Yasmin Rahman1*, Dr. Rezaul Karim Dewan2,Md.Bahanur Rahman3, Dr. FahmidaAkter Rima4, Dr. Tahmina Sultana5, Dr.Naila Awal6, Dr. Arebia Rahman7

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-4 | July-August, 2021| Page: 148-160

ImmunohistochemicalOverexpression of p16INK4a is Predictive of High Risk Human Papilloma Virus infection in VIA Positive Cervical Lesions

Dr. Labiba Yasmin Rahman1*, Dr. Rezaul Karim Dewan2,Md.Bahanur Rahman3, Dr. FahmidaAkter Rima4, Dr. Tahmina Sultana5, Dr.Naila Awal6, Dr. Arebia Rahman7

Abstract

Background:  Cervical cancer is a major health problem worldwide. Epidemiological studies have clearly established High-Risk (HR) Human Papilloma Virus(HR-HPV) as a central cause of invasive cervical cancer. Expression of E6 and E7 oncogenes of HR-HPV affecting the Rb-p16 pathway, leads to p16INK4a protein upregulation. It is widely reported that, immunohistochemical overexpression of p16 indicates persistent infection by HR-HPV in a high percentage in cervical premalignant and malignant lesions. Objective: To evaluate the predictive value of p16 to identify the HR-HPV infected cervical premalignant and malignant lesions. Methods: This descriptive cross-sectional study was carried out in the Pathology Department of DMC with collaboration of BSMMU and BAU, Mymansingh, during July 2016 to June 2018.Total 40 VIA positive and clinically suspected premalignant and malignant patient’s attendant at DMC included study population. Results: The mean age was 43 years. The most common symptoms were per vaginal whitish discharge (95%), lower abdominal pain (87%), irregular p/v bleeding (60%) and post coital bleeding (7.5%). By colposcopic examinations, the diagnoses were CIN I in 57.5%, carcinoma cervix in 30%, CIN II in 10 % and CIN III in 2.5%. Chronic cervicitis 10(25.0%), CIN I 12(30.0%), CIN II  5(12.5%), CIN III  1(2.5%), invasive squamous cell carcinoma 11(27.5%) and adenocarcinoma in 1(2.5%) case. Out of 40 cases, p16 was intensely positive (>50% cells) in total 22 cases including all cases of invasive cancers. Among 22 p16 positive cases, 12 cases were positive for HR-HPV (16, 18). In addition, p16 showed sensitivity 73.3%, specificity 100%, accuracy 80%, PPV 100% and NPV 55.6%. Conclusion: The results of this study confirmed that, immunohistochemical overexpression of p16 is associated with HR-HPV infected cervical lesions. Therefore, along with the conventional screening methods, p16 can be used as a useful biomarker in identifying HR-HPV infected cervical premalignant and malignant lesions.

HR-HPV, p16, cervical, CIN, Malignant, Pre-Malignant

Risk of Coronary Heart Disease in Adult Patients in Manikganj, Bangladesh.

Hossain MS1*, Goni MN2, Pervin R3, Akhtary SM4, Islam MS5, Zaman MM5

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-4 | July-August, 2021| Page: 161-168

Risk of Coronary Heart Disease in Adult Patients in Manikganj, Bangladesh.

Hossain MS1*, Goni MN2, Pervin R3, Akhtary SM4, Islam MS5, Zaman MM5

Abstract

Background: Coronaryheart disease is one of the leading causes of death worldwide. It can be present in people of all ages, but a higher incidence rate was observed in the male population compared to women. The incidence rates also increased greatly in the older population. It is influenced by many factors. Obesity is considered as one of the passive risk factors of CHD, but recent studies have determined that obesity plays a role both as a primary and secondary risk factor. Obesity is rapidly becoming a major problem for many diseases alongside CHD. Aim of the study: The aim of the study was to determine the relation between obesity and heart disease. Methods:This cross-sectional observational study was conducted at the Department of Cardiology, Colonel Malek Medical College, Manikganj, Dhaka during the period of January 2020 to December 2020. The study sample was determined as 150 participants, and a purposive sampling technique was used. SPSS software was used for data analysis. Result:The study sample was determined to be 150. 76% of the participants were male, and the male to female ratio was 19:6. 38% of the total participants were from the oldest age group of 65-74, and the youngest age group of 25-34 years had the lowest number of participants. 50% of the participants were from low-income families, and only 8% were from high-income families. The major risk factor of CHD was smoking, affecting 60% of patients. Obesity was a primary risk factor for 58% of the participants, and diabetes was present in 10% of the participants.Conclusion:The current study showed a clear relationship between obesity and CHD occurrences. The knowledge of obesity as a primary risk factor was lacking, and it was more commonly known as a secondary risk factor, causing diabetes, dyslipidemia, and hypertension, among other major risk factors of CHD.

Obesity, Coronary Heart disease, Dyslipidaemia, Central obesity

Socioeconomic Status and its Relation to Hypertension

Goni MN1*,Hossain MS2, Akhtary SM3 ,Pervin R4, Islam MS5

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-4 | July-August, 2021| Page: 169-176

Socioeconomic Status and its Relation to Hypertension

Goni MN1*,Hossain MS2, Akhtary SM3 ,Pervin R4, Islam MS5

Abstract

Background: Coronaryand cardiovascular diseases are one of the major causes of mortality worldwide. Cardiovascular diseases have many causes and risk factors, and one of the primary risk factors is hypertension, more commonly known as high blood pressure. It is one of the ailments with no clear symptoms or a cure. As a result, it is often diagnosed in the severe stage, with severe symptoms. Among many other factors, socioeconomic factors are one of the causes of hypertension. But the exact relation between socioeconomic status and hypertension has not been found, as many studies show conflicting results. The present study tried to focus on the socioeconomic status of our country and its relation to hypertension Aim of the study: The aim of the study was to observe the effects of socioeconomic status and hypertension.Methods: This was a cross-sectional observational study conducted at the Department of Cardiology, Colonel Malek Medical College, Manikganj, Bangladesh during the period of January 2020 to December 2020 with 80 patients showing stage II and abovehypertension. The patients were made aware of the study, and properly informed consent was taken from the patients about using their personal data for the study. Ethical approval was collected from the respected authority. Result: The male: female ratio was 3:5. 25% of the participants were unmarried and 75% were married. The youngest participant present in the study was 35 years old, and the oldest was 73 years old. 10% of the participants were from the youngest age group of 35-39 years. 37.5% of the participants were older than 60 years. 70% of the participants were from rural areas, and only 30% were from urban localities. Among the participants, 48.75% were illiterate, and a higher level of education was only present in 6.25% of the participants. Conclusion: The current study showed a higher prevalence of hypertension in the female population. Hypertension prevalence was inversely proportional to education and directly proportional to income. Rural areas had a much higher prevalence of hypertension compared to urban areas, and many of the socioeconomic factors were theorized to affect the mental health and stress level of the participants.

Hypertension, Hypertensive, High blood pressure, Literacy, Mental stress

Evaluation of various outcomes by histopathology among pleural effusion patients

Jagpoornima Katoch1, R. S.Negi2*, S. K. Sharma3, Malay Sarkar4

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-4 | July-August, 2021| Page: 177-183

Evaluation of various outcomes by histopathology among pleural effusion patients

 Jagpoornima Katoch1, R. S.Negi2*, S. K. Sharma3, Malay Sarkar4

Abstract

Background: The present study was conducted to evaluate various outcomes by histopathology among pleural effusion patients. Methods: 120 patients of pleural disease were screened for enrolment in the study. Smoking, previous history of anti-tubercular treatment etc. was recorded. All underwent medical thoracoscopy. Outcome was recorded. Results: 45(37.5%) were smokers, out of 79 males 39(49.36%) were smokers, out of which 20(25.3%) were heavy smokers, out of 41 females 6(14.6%) were smokers,2(4.9%)out of 6 were heavy smokers.101 (84.2%) had post- procedural hospital stay less than 5 days, whereas 19(15.8%)had post- procedural hospital stay was more than 5 days. The difference was non- significant (p> 0.05). 58 (48.3%) histopathological examination of pleural biopsy suggestive of granulomatous inflammation,35(29.2%) suggestive of adenocarcinoma,3(2.5%) suggestive of small cell carcinoma,3(2.5%)suggestive of duct cell carcinoma,2(1.7%) had spindle cells on histopathological examination of pleural biopsy. Conclusion: The medical diagnostic thoracoscopyalong with histopathology has a relatively high diagnostic accuracy in patients of undiagnosed pleural effusion.

Pleural effusion, Granulomatous inflammation, Adenocarcinoma,

Analysis of Bone Marrow Aspiration and Trephine Biopsy in Cases of Severe Anemia

Dr.VinayGauria1, Dr. Arun Puri2, Dr. Piyush Puri3, Dr. Harmohinder Kumar Attri4*

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-4 | July-August, 2021| Page: 184-190

Analysis of Bone Marrow Aspiration and Trephine Biopsy in Cases of Severe Anemia

Dr.VinayGauria1, Dr. Arun Puri2, Dr. Piyush Puri3, Dr. Harmohinder Kumar Attri4*

Abstract

Background: Hematological disorders are quite frequent in all age group. Most of this hematological disorder first present as anemia. Bone Marrow Aspiration plays a major role in the diagnosis of its underlying cause. The aim of this study was to analyze the bone marrow aspiration and trephine biopsy findings in cases of severe anemia due to various diseases causing it like nutritional deficiency, bone marrow depression or any neoplastic proliferation of blood cells. Methods: This study was carried out in the Department of Pathology Govt. Medical College, Patiala. Bone marrow examination of 50 cases of suspected hematological disorders was carried out. Results: Of the 50 cases most of the patients were found to be in the age group of 50-69 years i.e. 21 cases (42%) followed by 10 cases (20%) in the age group of 30-49 years. In the present study, out of 50 cases there were 31 males (62%) and 19 females (38%) showing male preponderance. In the present study the maximum number of cases showed hypercellularity of bone marrow i.e. 28 cases (56%). All the cases showed megaloblastic reaction and erythroid hyperplasia. The bone marrow aspiration and biopsy findings in all cases were concordant. Conclusion: Bone marrow examination is an important step to arrive at the confirmatory diagnosis of many hematological disorders.

Anemia, Aspiration, Biopsy, Bone Marrow

India and Covid-19: The Changing Trends in Epidemiology of Fracture Distal End Radius

Mohit Singla1, Iqbal Singh Ghai2, Riya Chopra3*

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-4 | July-August, 2021| Page: 191-197

India and Covid-19: The Changing Trends in Epidemiology of Fracture Distal End Radius

Mohit Singla1, Iqbal Singh Ghai2, Riya Chopra3*

Abstract

Background: Distal radius fractures (DRF) are one of the most common fractures seen in the emergency department. The aim of our study was a thorough assessment of impact of COVID-19 pandemic on epidemiological trends of DRF. There is limited data on possible changes in epidemiology of DRF in both adults and children. Methods: This retrospective observational study was performed at a tertiary trauma center in India. Data were collected from emergency admission records register. The data from 1st April 2020 to 31st December 2020 were compared with that of corresponding period of 2019 i.e 1st April 2019 to 31st December 2019. Results: In our study we observed that the total number of patients suffering from DRF that were hospitalized in 2020 were 14.6% lower than the pre-COVID 19 period (2019). There was a significant decrease in number of adults hospitalized due to DRF (from 125 to 102) in 2020 (p < 0.05).Conclusion: Our study showed a significant effect on epidemiology of DRF due to COVID-19 pandemic. The trends and results observed in our study will be helpful to health authorities in planning strategies to tackle a similar situation in future.

COVID-19, Orthopedic Trauma, Epidemiology, Distal Radius, India

Clinical Presentation and Surgical Treatment Outcome of Retroperitoneal Sarcoma: A study in Department of Surgical Oncology, National Institute of Cancer Research Hospital, Mohakhali, Dhaka, Bangladesh

Dr. Shaila Parveen1*, Dr. Md. Rassell2, Dr. Hasan Shahrear Ahmed3, Dr. Mohammad Jayedul Islam4, Dr. K.M. Saiful Islam5, Dr. Abu Khaled Muhammad Iqbal6, Dr. Krisna Rani Majumdar7

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-4 | July-August, 2021| Page: 198-206

Clinical Presentation and Surgical Treatment Outcome of Retroperitoneal Sarcoma: A study in Department of Surgical Oncology, National Institute of Cancer Research Hospital, Mohakhali, Dhaka, Bangladesh

Dr. Shaila Parveen1*, Dr. Md. Rassell2, Dr. Hasan Shahrear Ahmed3, Dr. Mohammad Jayedul Islam4, Dr. K.M. Saiful Islam5, Dr. Abu Khaled Muhammad Iqbal6, Dr. Krisna Rani Majumdar7

Abstract

Background: Retroperitoneal sarcoma is a giant tumor usually develops in retroperitoneal space of abdomen which is a mysterious timorous lesion. It has versatile dimension of clinical presentations and surgical outcome. It contains, embedded in a meshwork of loose connective tissue, the adrenal glands, kidneys and ureters, aorta and its branches, inferior vena cava and its tributaries and numerous lymph nodes.1 Retroperitoneal sarcoma (RPS) is a rare tumor accounting for approximately 10-15 percent of all soft tissue tumors.2 Objectives: Toassess the clinical presentation and surgical outcome of retroperitoneal sarcoma. Methods: This prospective observational was conducted in the General Surgery Department in a tertiary care hospital, Dhaka, Bangladesh. The patients were enrolled by purposive sampling. All the patients underwent definitive surgery. A pre formed structured, peer reviewed data collection sheet was prepared which was used to collect data. Data were complied, edited, managed and analyzed by SPSS version 20.0. The result was tabulated and presented kin figure form. Data was done by Pearson’s chi square test and student’s t test. For significant calculation, p value considered at <0.05. Result: Out of 30 patients’, maximum 14(46.6%) patients belongs to 51-60 years’ age group, which was subsequently followed by 7(23.33%) in >60 years’ age group. 5(16.67%), 3(10%) and 1(3.33%) patients belonged to 41-50 years, 31-40years and ≤ 30 years’ age group respectively. Out of 30 patients, 25(83.33%) and 5(16.67%) were male and female respectively. The male and female ratio was 5:1. Out of 30 patients 25(83.33%) and 5 (16.67%) were male and female respectively. The male to female ratio was 5:1. Out of 30 patients 22(73.33%) and 8(26.67%) were primary and recurrent retroperitoneal sarcoma respectively. Out of 30 patients all 22 (100%) patients in primary and 8 (100%) patients in recurrent retroperitoneal sarcoma presented with abdominal mass. Butonly11(50%) in primary cases had pain or discomfort in comparison to 3(37.5%) out of 8 in recurrent cases (p=0.4). The median radiological tumor size in primary and recurrent cases were 15cm and 12cm respectively (p=0.003). Out of22 patients and 8 patients in primary and recurrent retroperitoneal sarcomere’spectively;focality and invasiveness showed statistically significant differences as well as number of resected organs /structured (p=0.006, 0.001 and 0.09respectively). On the contrary tumor resection margins, grade, histology and resection of adjacent visceral structures showednostatistically significant differences between the groups (p=>0.05). Conclusion: Retroperitoneal sarcoma is a giant abdominal tumor that takes it huge size silently. The surgical outcome of primary retroperitoneal sarcoma is relatively better than recurrent retroperitoneal Sarcoma.

Retroperitoneal Sarcoma, Abdominal Tumor, Surgical Treatment

Outcome of Premature Rupture of Membrane: A Clinical Study in 50 Cases in Enam Medical Collage and Hospital, Savar Dhaka (EMCH)

Dr. Monowara Begum1*,Prof. Sheuly Begum2,Dr. Tahamina Khanum3,Dr. Tania Akbar4

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-4 | July-August, 2021| Page: 207-215

Outcome of Premature Rupture of Membrane: A Clinical Study in 50 Cases in Enam Medical Collage and Hospital, SavarDhaka (EMCH)

Dr.Monowara Begum1*,Prof. Sheuly Begum2,Dr. Tahamina Khanum3,Dr. Tania Akbar4

Abstract

Introduction: Premature rupture of members (PROM) is one of the common complications of pregnancy that has a major impact on fetal and maternal outcome. It is one of the commonest clinical events where a traditional pregnancy can turn into a high-risk situation for the mother as well as the fetus. Premature rupture of membrane is defined as spontaneous repute of the membrane before the onset of labour. Aim of the study:To determine the incidence of premature rupture of membranes in average patients admitted in Enam Medical Collage and Hospital,Savar Dhaka. Methods: This Cross sectional type of prospective study was conducted in the department of Obstetric Unit, Enam Medical Collage and Hospital Savar Dhaka. A total of 95 patients were included for the study according to following inclusion and exclusion criteria from the period of from November 2020 toApril 2021. The present study was conducted after receiving approval from the ethical review committee of (EMCH). Results: In this study out of 49 alive babies 22 (45.83%) were affected by the consequences of PROM and birth process. Among them, 36.36% development jaundice, 29.27% development birth asphyxia and 18.118% each developed RTI and neonatal sepsis. 15(%) babies were treated conservatively and 7 (%) babies were treated in neonatal unit after admission. There were no neonatal losses.The majorities of patients were primi (56%) and multiparity constituted (44%). Study shows that mode onset of labour was spontaneous in 30 (60%) cases of which 11 (39.29) cases were multi. Induction / Augmentation was done in 20 (40%) cases, among them 17 (60.71%) were primi& 03 (13.64%) were multi. The difference is highly significant; p value is P<0.001. Conclusion: Proper health education, motivation of patient, improved health hygiene, adequate maternity and childcare services, improved transport system are needed for reduction of morbidity and mortality.

Outcome, PROM,Clinical Study

Enlarged Vestibular Aqueduct- A Rare Case Report and Review of Literature

Dr. Ranvir Singh1*,Dr.Deepak Verma2, Dr.Amit Sharma3,Dr.Uma Garg4,Dr.Nimmy Thomas5, Dr.Manish Verma6, Dr.Anand Krishanan7, Dr.Mitva Aggarwal8

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-4 | July-August, 2021| Page: 216-221

Enlarged Vestibular Aqueduct- A Rare Case Report and Review of Literature

Dr. Ranvir Singh1*,Dr.Deepak Verma2, Dr.Amit Sharma3,Dr.Uma Garg4,Dr.Nimmy Thomas5, Dr.Manish Verma6, Dr.Anand Krishanan7, Dr.Mitva Aggarwal8

Abstract

Background: Enlarged vestibular aqueduct is a one of the developmental abnormalities of inner ear and it is encountered in 1-12% of hearing impaired population. Methods: 15 year male presented to ENT OPD with decreased hearing in both ear since 6 years. Clinical examination, audiological and radiological investigations were done and diagnosis of bilateral enlarged vestibular aqueduct was made. Conclusion:The present case reports emphasizes importance of detailed radiological evaluation especially with CT scan and MRI in young patients presenting with sensorineural hearing loss on audiological evaluation.Patient was counselled and treated conservatively with hearing aids and also counselled about the requirement of Cochlear Implant in future.

Enlarged Vestibular Aqueduct, Sensorineural Hearing loss, Childhood

Radiation Exposure in Transradialvs Transfemoral Coronary Angiography: A Single Centre Experience.

Lt Col Alam A Y M Shahidul1*,Maj Gen Iqbal Syed Asif2,Brig Gen HaqueA F M Shamsul3,Col Sultana SyedaAleya4,Col MalekMd Abdul5, Lt. Col Rahman Md Wali-ur6

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-4 | July-August, 2021| Page: 222-230

Radiation Exposure in TransradialvsTransfemoral Coronary Angiography: A Single Centre Experience.

Lt Col Alam A Y M Shahidul1*,Maj Gen Iqbal Syed Asif2,Brig Gen HaqueA F M Shamsul3,Col Sultana SyedaAleya4,Col MalekMd Abdul5, Lt. Col Rahman Md Wali-ur6

Abstract

Background: Several studies found that there is an increased risk of radiation exposure during transradial coronary angiography (CAG) when compared with transfemoral CAG. We compared radiation exposure to patients during CAG through these routes. Aim of the study:This study aims to assess the difference of radiation exposure between transradial and transfemoral coronary angiography. Methods: This study was a prospective study conducted on randomly selected 100 patients who underwent coronary angiography by the same operator at a tertiary centre from August 2017 to September 2018. The study outcomes were fluoroscopy time (FT), dose area product (DAP), and total dose (TD).Results: FT (3.08 [1-9] vs 1.47 [1-17] minutes; P=.014), DAP (4807 [1947-11489] vs 3202 [1130-12826] μGy.m2;P<0.001), and TD (788 [276-2055] vs 520 [158-2424] mGy; p<0.001) were found significantly higher in TRA than TFA. A strong correlation between FT and DAP (Spearman’s rho 0.730; P<.01) and a statistically significant correlation between body mass index (BMI) and DAP (Spearman’s rho 0.446; P<.01) was observed.Conclusion:TRA is associated with higher radiation exposure when compared with TFA in patients undergoing coronary angiography.

Radiation Exposure, Transradial Coronary Angiography, Transfemoral Coronary Angiography, Fluoroscopy Time.

 

A Comparative Study of Azithromycin Pulse Therapy with Minocycline in Acne Vulgaris.

Hoq AJMS1*, SultanaF2

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-4 | July-August, 2021| Page: 231-237

A Comparative Study of Azithromycin Pulse Therapy with Minocycline in Acne Vulgaris.

Hoq AJMS1*, SultanaF2

Abstract

Background: Acne vulgaris is a very common skin disease seen primarily in adolescents and young adults.Minocycline is a newly promoted drug in treating acne vulgaris. On the other hand it is assumed that, as a long term therapy with antibiotichaving a long half-life like azithromycin can be very useful in increasing the compliance as well as efficacy in the treating acne vulgaris. But we have not enough comparative data regarding these issue. Aim of the study: The aim of this study was to compare the efficacy and safety of azithromycin pulse therapy with minocycline in treatingacne vulgaris.Methods: This was comparative study which was conducted in the outpatient department of Cumilla Medical College Hospital, Cumilla, Bangladesh during the period from January 2018 to December 2018. In total 50 patients with moderate-to-moderately severe (Grade II and III) acne vulgaris were finalized as the study population. Patients were randomly assigned to two treatment groups. In Group A in total 25 patients were selected who received 50 mg minocycline twice a day along with 0.05% topical tretinoin for 3 months whereas in Group B another 25 patients were selected who received 500 mg azithromycin once a day for 3 days per week as pulse therapy along with 0.05% topical tretinoin for 3 months. All data were collected, processed, analyzed and disseminated by SPSS version 20 and MS Office program as per need.  Result: In analyzing the changes of severity score of acne, in Group A at baseline 12%, 36% and 52% participants had the score point 2, 3 and 4 respectively whereas in final stage 64%, 32% and only 4% participants had the score point 1, 2 and 3 respectively. In Group B at baseline 8%, 32% and 60% participants had the score point 2, 3 and 4 respectively whereas in final stage 56%, 36% and the rest 8% participants had the score point 1, 2 and 3 respectively. In Group B between baseline and final score distribution the P value was found 0.064. We found in Group A among 24%, 8% cases diarrhea and nausea had been found respectively. However in Group B among 28%, 16% and 8% cases diarrhea, nausea and epigastric pain had been found respectively. Regarding the adverse events between both the groups we found a significant correlation where the P value was 0.048.Conclusion: We can conclude that, the efficacy of both the azithromycin pulse therapy and minocycline was found satisfactory. But according to the analysis of adverse events we found minocycline has got high pigmentation effect in treating acne vulgaris.

Azithromycin,Minocycline, Acne Vulgaris,Pulse Therapy, Efficacy, Safety.

 A Comparative Study of Vitamin D3 Status in Patients with Hair Loss

Dr. Monira Yeasmin1*, Dr. KismatAra Islam2, Dr. Tasnim Kabir3

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-4 | July-August, 2021| Page: 238-246

 A Comparative Study of Vitamin D3 Status in Patients with Hair Loss

Dr. Monira Yeasmin1*, Dr. KismatAra Islam2, Dr. Tasnim Kabir3

Abstract

Background: Hair loss is a common problem faced by many younger people, which has a variety of risk factors. Among them, Vitamin D3 has a key role to play in various disorders. Some recent evidence indicates an inconsistent association between Vitamin D3 deficiency and hair loss. Aim of the study: The aim of this study was to compare the status of serum Vitamin-D3 levels between the patients with hair fall and healthy people, as case & control group. Methods: This was a prospective case-control study conducted in the Department of Dermatology & Venereology, Anwer Khan Modern Medical College, Dhaka, Bangladesh during the period from January 2019 to December 2020. In total 20 patients with hair loss were finalized as the case group and another 20 healthy people were selected as the control group participants. All the case group patients were subjected to detailed history taking and examination to detect a pattern, severity (SALT score) of hair loss. Blood samples were taken from both the group to complete blood count and to assess serum levels of Vitamin-D3, parathyroid hormone, random blood sugar, and calcium. All data were processed, analyzed, and disseminated by MS Office and SPSS version 20 as needed. Result: In analyzing the S. Vitamin D3 status of the case group (participants with hair loss) 71.43% of males and 61.54% of females were found with severe deficiency (<10 ng/ml). On the other hand, analyzing case and control group participants we observed, in case of a group, 65%, 30%, and 5% participants were with severe deficiency (<10 ng/ml), mild-moderate deficiency (10-24 ng/ml), and optimal (25-40) ng/ml Vitamin D3 levels respectively and their mean (±SD) S. Vitamin D3 level was 10.42±2.2 mg/ml.(p-Value 0.021) On the other hand, in the control group, 0%, 35%, and 65% participants were with severe deficiency (<10 ng/ml), mild-moderate deficiency (10-24 ng/ml), and optimal (25-40) ng/ml vitamin D3 levels respectively and their mean (±SD) S. Vitamin D3 level was 12.35±2.5 ng/ml. We found a significant correlation in serum Vitamin D3 levels between the patients with the hair loss case group and the control group. (p-Value was 0.033). Conclusion: Vitamin D3 deficiency may be a potential factor in hair fall. The status of serum Vitamin D3 level of patients with hair loss significantly differs from that of healthy people. Diagnostic findings regarding Vitamin D3 levels status of patients with hair fall may be considered as a potential marker of hair fall.

Vitamin D3, Hair Loss

Management of Supracondylar Fracture of Femur with Retrograde Short SIGN Nail

Dr. Md. Masoom1*, Dr. Md. Faruque Quasem2, Dr. G. M. Jahangir3

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-4 | July-August, 2021| Page: 247-257

Management of Supracondylar Fracture of Femur with Retrograde Short SIGN Nail

Dr. Md. Masoom1*, Dr. Md. Faruque Quasem2, Dr. G. M. Jahangir3

Abstract

Background: Basically knees are the largest weight-bearing joints in the human body. The distal femur articulates with upper tibia at knee joint. Supracondylar fracture of the femur which is also known as fracture of distal femur.  On the other hand, retrograde femoral nailing can be defined as a nailing starting from the intercondylartossa of distal femur. Aim of the study: The aim of this study was to assess the effectiveness of retrograde short SIGN nail in the management of supracondylar femoral fractures (Muller Type Al, A2 and A3). Methods: This was a prospective observational study that was carried out at the National Institute of Traumatology and Orthopedic Rehabilitation (NITOR), Dhaka, during the period from January 2003 to December 2004. In total 14 patients with supracondylar femoral fractures of Muller type Al, A2 and A3 were finalized by purposive sampling method as the study people of this study. A pretested and predesigned questioner containing history and examination findings of the patient, operative procedure, and follow-up was used to collect the data. All relevant statistical analysis of different variables was analyzed according to standard statistical methods. Results: In this study, we found 11 patients (78.57%) had a union in due time, 2 patients (14.29%) had delayed union, and 1 patient (7.14%) developed non-union. We found 6 patients (42.86%) had a full range of knee movement, 4 patients (28.57%) had knee motion between 110-130 degrees, and another 3 patients (28.57%) had knee movement between 90-110 degrees. In this series, we observed some complications. Nonunion and implant failure 1(7.14%), delayed union 2(14.29%), superficial infection 2(14.29%), and mild deformity 5(35.71%) were encountered in some of our cases. In analyzing final outcome of this study we found 85.71% satisfactory (excellent and good) and 14.29% unsatisfactory (fair and poor) results. Conclusion: Retrograde short SIGN nail is a reliable alternative when options in the treatment of supracondylar femoral fractures are considered. The rate of union is high, with a low incidence of complications. The simplicity of this method also facilitates fracture fixation in patients with multiple trauma. There were minimal soft tissue disruptions and good purchase of the distal bone fragment and stable fracture fixation with this method, allowing early joint mobilization.

Supracondylar Fracture, Femur, Retrograde Short SIGN Nail, Orthopedics.

C – Reactive Protein and Bacterial Antigen in Childhood Meningitis.

Dr. Saukat Ara Begum1*, Dr. Roushan Iqbal2

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-4 | July-August, 2021| Page: 258-271

C – Reactive Protein and Bacterial Antigen in Childhood Meningitis.

Dr. Saukat Ara Begum1*, Dr. Roushan Iqbal2

Abstract

Background:Meningitis may occur without warning in a perfectly normal infant or children, but there are a number of circumstances in which there is increased risk of the disease. Consequently, without proper medical treatment it carries a high mortality and morbidity. Estimation of CRP in serum and CSF as well as bacterial antigen in CSF will help to categories different types’ meningitis which will help to select proper antimicrobial therapy. Aim of the study: The aim of the study was to determinate the CRP in serum and CSF as well as detection of bacterial antigen in CSF were studied in 40 cases of childhood meningitis to evaluate their diagnostic potential.  Methods: This cross-sectional study was carried out in the Department of Paediatrics, Bangabandhu Sheikh Mujib Medical University (BSMMU) and Department of Immunology, Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic disorders (BIRDEM). Subjects were recruited randomly from the Department of Paediatrics, BSMMU, Department of Paediatric, Dhaka Medical College Hospital (DMCH) and Paediatric Medicine Unit, Dhaka Shishu (Children) Hospital during 1996 to 1997. A total 40 subjects clinically suffering from meningitis were selected randomly with inclusion and exclusion criteria.All data were analyzed by using SPSS program (SPSS for Windows, Release 7.5) and expressed as mean ± SD or in frequency or percentage unless mentioned otherwise. Results: A total 40 study subjects, a higher prevalence of meningitis was seen in the male patients in bacterial 12(30%) viral 11(27.5%) as well as female subjects 7(17.5%) found in both bacterial and tubercular group compared to4(10%) females found in viral and lowest 2(5%) male found in tubercular. Biochemical and cellular findings of CSF are also shown in table-V and figures 6-8. CSF glucose level (mg/dl, mean ± SD) was highest in viral group (52 ± 10) followed by control group (50±7), bacterial group (49±17) and tubercular group (44±9) and statistically there was significant difference among these groups (p = 0.016). Protein (mg/dl, mean ± SD) concentration in CSF was highest in bacterial group (223 ± 205) and lowest in tubercular group ((68 ± 38); whereas in control that was 106 ± 94 and in viral group 71 ± 56; there was statistical difference among these groups (p = 0.010). Cell type in CSF was predominantly lymphocyte in tubercular group (83.3%), control group (70%) and in viral group (60%); whereas predominance in bacterial group was polymorphs (42.1%) and mixed cells (42.1%). Conclusion: The estimation of CRP level in serum and CSF and detection of bacterial antigen in CSF can greatly help in distinguishing different types of meningitis. Increased level of CRP in serum or CSF favors diagnosis of meningitis in suspected cases. CSF CRP was also significantly influenced by serum CRP and bacterial antigen.

CRP, CSF, Bacterial Antigen, Meningitis

Comparative Evaluation of Ultrasonography and Computed Tomographyimaging in Diagnosis of Abdominal Masses.

Dr. Suman Bhagat1, Dr. Amanpreet Kaur2, Dr. Paramjit Singh Josh3*, Dr. Gurinder Bir Singh4

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-4 | July-August, 2021| Page: 272-283

Comparative Evaluation of Ultrasonography and Computed Tomographyimaging in Diagnosis of Abdominal Masses.

Dr. Suman Bhagat1, Dr. Amanpreet Kaur2, Dr. Paramjit Singh Josh3*, Dr. Gurinder Bir Singh4

Abstract

Background: To study the role of ultrasonography and computed tomography in the evaluation of abdominal masses and comparison of their diagnostic accuracies, evaluation of their imaging features and to know the exact site of origin and extension into surrounding structures. Methods: A prospective study of 95 patients with abdominal masses. USG was done with Mind ray and CT-Scan examination was performed in all patients on Philips 64-slice whole body CT scanner. Results: There were 29(30.20%) cases of hepatobiliary masses, renal14(14.70%)cases, pancreatic 7(7.36%)cases, 4(4.21%) cases of splenic masses and 27 (28.42%) cases of pelvic masses 14 (14.73)cases with other abdominal masses. Hepatic SOL were detected in 6(6.31%) and 8(8.42%), 5(5.26%)cases of gall bladder masses and 4(4.21%), Omental caking was seen in 2(2.10%) cases and 4(4.21%), calcification was seen in 2(2.10%) cases and 4(4.21%) cases, renal calculi were seen in 4(4.21%) cases and6(6.31%) cases, on sonography and CT examination. Peritoneal deposits were seen in 3(3.15%) cases of ovarian carcinoma and unknown malignancy on US and in 5(5.26%) cases on CT. Ascites and lymphadenopathy was more accurately detected on CT as compared to US.CT detected splenic infarcts which were missed on ultrasonography. Conclusion: Computed Tomography is more accurate and sensitive for lesion characterization evaluation in terms of site and size of lesion, presence of calcification, adjacent organ infiltration and associated lymphadenopathy. The limitations of CT are ionizing radiation, high cost and contrast administration. Therefore, ultrasound should be used for primary screening of masses and CT should be used for further characterization of these masses.

Abdominal Masses, Sonography, Computed Tomography.

Efficacy of Autologous Platelet Rich Plasma (PRP) Marginal Injections AndPRPDressings in Large Chronic Wounds–A Prospective Observational Study

Dr. Dharam Singh1, Dr. Rajesh Kapila2, Dr.Neeraj Sharma3, Dr.Gurtej Singh4*, Dr. Rakesh Sharma5, Dr. Ajay Kamat6

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-4 | July-August, 2021| Page: 284-291

Efficacy of Autologous Platelet Rich Plasma (PRP) Marginal Injections AndPRPDressings in Large Chronic Wounds–A Prospective Observational Study

Dr.Dharam Singh1, Dr. Rajesh Kapila2, Dr.Neeraj Sharma3, Dr.Gurtej Singh4*, Dr. Rakesh Sharma5, Dr. Ajay Kamat6

Abstract

Background: Platelet-rich plasma (PRP) is one of the new modalities for treatment of acute and chronic wounds. Autologous PRP gel consists of cytokines, growth factors (GFs),chemokines, and fibrin derived from the patient’s blood. The use of PRP is a safe, easy, and cost-effective method with better outcome in the management of chronic wounds.Aim & Objectives: To evaluate the efficacy of PRP dressings combined with marginal injections of PRP in large chronic wounds at different intervals after such dressings and to achieve wound healing in large chronic wounds which are otherwise very difficult to heal with routine dressing. Methods: The study was conducted on 25 patients of either sex, admitted for treatment of large chronic wounds in Orthopaedics Department, Guru Nanak Dev Hospital, Govt. Medical College, Amritsar. Three PRP dressings combined with marginal injection of PRP were given on day 0, after first week, and after 3rd week. On 2nd week, and 4th, 5th, 6th and 8th week, only saline dressings were applied at weekly intervals. On each dressing, patient’s wound was measured in length and breadth by using a scale and area was calculated. The %age of wound closure was also estimated. The data was tabulated and subjected to statistical analysis.Results: We found that 88% cases showed excellent results and 12% cases showed good results. There was significant difference in length, breadth, area of wound and %age of wound closure at different intervals (P< 0.05).Conclusion:Autologous platelet rich plasma dressing is an effective method to enhance healing in large chronic wounds/ulcers. However, further research and controlled, randomized prospective clinical trials with larger sample size are required to validate the results.

Chronic Wounds, Autologous, PRP, Marginal Injection

Study of Packed Cell Volume Transfusion Therapy in Children’s

Dr. Bela H. Shah1, Dr.Sonu Akhani 2, Dr. Dhara Gosai3, Dr. Khyati N. Satodiya4*, Dr. Anand Patel5

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-4 | July-August, 2021| Page: 292-298

Study of Packed Cell Volume Transfusion Therapy in Children’s

Dr. Bela H. Shah1, Dr.Sonu Akhani 2, Dr. Dhara Gosai3, Dr. Khyati N. Satodiya4*, Dr. Anand Patel5

Abstract

Background: Anemia is common in critically ill children and is observed in 77% of hospitalized children. The transfusion of packed cell volume can be lifesaving in hemorrhagic shock as well as in critically ill children with severe anemia .Effective packed cell volume transfusion therapy depends upon the availability of different blood components.The packed cell volume transfusion, usedcan meet the transfusion need of most patients. Aim: Is to observe usage, various indication,to study incidence,outcome in recipient. Method: Aprospective and observational study was conducted in department of paediatrics,in collaboration with department of IHBT & pathology at tertiary care hospital B.J. medical college, Ahmedabad from 01/01/2018 to 30/01/2019.Detail clinical history and physical examination was done according topredefined proforma. Laboratory investigation done for the confirmation of diagnosis.Over a period of 18 month,packed cell volume transfusion were given to patients according to indication. Result: Most of the patientswere discharged successfully.Conclusion: Early intervention, monitoring and regular follow up increases the life span.

Packed Cell Volume Transfusion,Blood Component Therapy,Blood Group Compability

Role of Deferasirox as Iron Chelator and Its Side Effects in Thalassemic Children

Dr. Garima Mehta1,Dr. Bela H.Shah2, Dr. Dhara Gosai3*, Dr. Rupal Kashiyani4

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-4 | July-August, 2021| Page: 299-305

Role of Deferasirox as Iron Chelator and Its Side Effects in Thalassemic Children

Dr. Garima Mehta1,Dr. Bela H.Shah2, Dr. Dhara Gosai3*, Dr. Rupal Kashiyani4

Abstract

Background: Thalassemia is most common haemoglobinopathy in India.Regular blood transfusion eliminate the complications of anaemia and compensatory bone marrow expansion. In parallel, transfusions result in a “second disease” -inexorable accumulation of tissue iron that without treatment is fatal in second decade of life. Iron accumulation is causing heart failure,cirrhosis, liver cancer, growth retardation and multiple endocrine abnormalities. Objectives: To study clinico-epidemiology and to observe prognosis and outcome in Thalassemic children on Deferasirox therapy.2.To analyze at what age and ferririn level Deferasirox started.3.To study quantum of whole blood tranfusion required at starting of Deferasirox therapy. Methods: present study was hospital based prospective analytical study conducted in 1.5 year in 1-12 years aged children, diagnosed with thalassemia (by history,examination,investigation and confirmation by Hb electrophoresis) and attends thalassemia clinic regularly,were put on deferasirox chelation therapy on basis of serum ferritin level and number of blood transfusion received. Results: Thalassemia incidence was higher in male,6-9 year age,presenting age between 6 months- 1 year,Most common clinical feature found was pallor, Hepatomegaly and Spleenomegaly was most common sign of iron overload, Chelation therapy started at average 2.5 years age,Ferritin level at which deferasirox started was >1000ng/ml.Efficacy of deferasirox as a chelator agent had good response on lowering S.ferritin levels.Most common side effect of deferasirox found was increase in S.creatinin and GI disturbances. Conclusion: Children having Thalassemia major need regular blood transfusion and chelation therapy lifelong. Better treatment, monitoring and regular follow up had increase the life span of Thalassemic children to 3rd- 4th decade.

Thalassemia, Deferasirox

Comparison of Coagulation Status in Women with Intrauterine Fetal Deaths with Controls

Apoorva Maheshwari1, O.P. Bhargava2*

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-4 | July-August, 2021| Page: 306-313

Comparison of Coagulation Status in Women with Intrauterine Fetal Deaths with Controls

ApoorvaMaheshwari1, O.P. Bhargava2*

Abstract

Background: The aim of this study was to investigate and compare the coagulation status of patients with Intra uterine fetal death with normal pregnant females; identify those who are at a higher risk of haemorrhage and to predict the complications earlier for better management. Method: A prospective comparative study was conducted in NSCB Jabalpur from January 2018 to June 2019. A total of 100 cases of fetal demise >20 weeks gestational age were compared with 100 normal pregnant women who were matched in baseline characters like maternal age and period of gestation.  Standard coagulation tests including PT, APTT, D-dimes, and Fibrinogen etc. were applied to all along with a basic complete blood count. Result: Most of the coagulation variables in our study had a significant change. In our study women with fetal death had significantly elevated D-dimer (208.54 ± 52.36) as compared to controls (156.84 ± 24.67). We observed that 8% normal pregnant women had an increased D-dimer level (201-500 ng/ml) as compared to 19% of women with fetal loss while 2% of cases had D-dimer values more than 500ng/ml. Platelet count showed a downward trend in cases with 6% of cases having value of <1lakh/cumm.Conclusion: There was a strong positive correlation between D dimers and Prothrombin time and a negative correlation with platelet count. It was concluded that D dimer is an important tool in the diagnosis of complications in IUFD along with hypofibrinogenemia and thrombocytopenia. Such high risk women should opt for termination of pregnancy rather than expectant management.

Intra uterine fetal death, D dimer, Platelet count, DIC, Coagulation

Accidental Ingestion of 2% Viscous Lidocaine Hydrochloride Leading To Toxicity: A Case Report

Ankita Yadav1, Virendra kumar2, Meenakshi kumar3, MadhuBala4,Ira Balakrishnan5*, Sandeep Singh Tomar6

Annals of International Medical and Dental Research (AIMDR)| Vol-7, Issue-4 | July-August, 2021| Page: 314-317

Accidental Ingestion of 2% Viscous Lidocaine Hydrochloride Leading To Toxicity: A Case Report

Ankita Yadav1, Virendra kumar2, Meenakshi kumar3, MadhuBala4,Ira Balakrishnan5*, Sandeep Singh Tomar6

Abstract

For the past 50 years, local anesthetics such as lidocaine hydrochloride have been commonly used in various clinical settings. Its use is not just limited to anesthesia and surgery but is also frequently utilized in internal medicine and in primary care setting for bedside procedures. Our case demonstrates a successful resuscitation in a 30-year-old female with systemic lidocaine toxicity after accidental ingestion of 2% viscous xylocaine.

lidocaine-induced systemic toxicity, local anesthetic toxicity, intravenous lipid emulsion