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Research article:-
Baig Vaseem Naheed1*, Swarnkar Madhusudan2,Bhardwaj Ashok Kumar3, Singh Raghuveer4, Kewalramani Suresh5 & Soni Prashant6.
1Associate Professor,2Assistant Professor,3Professor,4Professor and Head, Department of P.S.M., Jhalawar Medical College, Jhalawar (Raj.), India.5Assistant Professor, Dept. of P.S.M., S. M. S. Medical College, Jaipur (Raj.),India. 6M.B.B.S., M.B.A., Maternal and Newborn health Manager, Save The Children, India.
Abstract: Background: HIV is the most prominent risk factor for progression of TB infection to disease causation and there is paucity of studies related to clinico-radiological profile of HIV-TB co-infection, this evoked us to do this study. Material and Methods: The present study is Hospital based cross sectional study done on two hundred HIV/AIDS patients (>15 year of age) attending ART Center of S.M.S. Medical College, Jaipur (Raj.). Results: Dual infection of HIV - TB was found in nearly one third (32.50%) of study individuals, co-infection was slightly more common in males (34.70%) than that of females (26.41%). Weakness was the almost universal (98.46%) symptom and muscle wasting was commonest (80.00%) sign, oral candidiasis was the most common (52.31%) complication. Of all the 65 HIV-TB co-infected patients, pulmonary TB was found in 18 patients (27.69%), extra-pulmonary TB in 27 (41.54%) patients, while 20 (30.76%) patients had both pulmonary & extra-pulmonary TB. upper zone infiltration & cavitatory lesion were seen in 47.37% while atypical features such as mid-lower zone infiltrate & exudative lesion were seen in 73.68% & 68.42%. Sputum smear positivity for AFB was found in 42.11% of pulmonary TB cases with HIV-TB co-infection. Most (90.77%) cases with HIV-TB co-infection had CD-4 count <200/ micro L.
Keywords: Extra-Pulmonary Tuberculosis, HIV-Tb co-infection, Pulmonary Tuberculosis.
References:-
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2.TB WHO Report 2004.
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9.Arora VK, Govirnath K, Rao SR. Extrapulmonary involvement in HIV infection: clinico-radiological profile and prognostic significance. Ind. J. Chest Dis.1993;35;103-12.
10.Zuber Ahmed, Syed SA, Zaheer MS, and Khan JA (2003) Clinico-radiological profile of TB in HIV-TB co-infected patients. J. Med. Science Vol.2, No.2:119-23.
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13.Lidji MF, Hendler A, Polansky V et al. Pulmonary TB in HIV infected patients. Tubercle and Lung Dis. 1995;76(2):129 (Abs).
14.Prasad R, Saini JK, Khanujia RK, Sarin S, Suryakant, Kulshrshtha R, Nag VL and Tripathy AK. A comparative study of clinico-radiological spectrum of TB among HIV sero-positive and sero-negative patients. Indian J. Chest Dis. & Allied Science 2004;46;99-103.
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Copyright © 2013 Baig Vaseem N et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Case report:- Obstetrics and Gynecology
Chaudhari shilpa N.1*, Gaikwad Vidya A.1,Mahajan Vinayak2& Bamane Shubhangi3
1M.D. (Obstetrics and Gynecology) Professor, 2M.D. (Obstetrics and Gynecology) Lecturer, 3M.B.B.S. Senior Resident, Dept of OBGY, Padmashree Dr.D.Y.Patil Medical College and Research Centre, Pimpri, Pune, India
Abstract:- There are many causes of abnormal uterine bleeding (AUB) like fibroids, polyps, endometrial hyperplasia and malignancy. But prolonged retention of fetal bones after abortion as an etiology for AUB is a rare one. Incidence given in only one study was 0.15% where fetal bones were found on Diagnostic hysteroscopy. A 24 years woman, presented with pain in lower abdomen and continuous bleeding per-vaginum for 2 months. Her transvaginal ultrasonography showed hyperechogenic shadow in uterine cavity .She underwent an office hysteroscopy which showed multiple fetal bones in the uterine cavity. They were removed in the same sitting.
Key words:- Abnormal uterine bleeding, Hysteroscopy, Retained intrauterine fetal bones, Transvaginal ultrasonography.
References:-
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2.Makris N, Stefanidis K, Loutradis D, Anastasiadou K, Hatjipappas G, Antsaklis A. The incidence of retained fetal bone revealed in 2000 diagnostic hysteroscopies. JSLS. 2006, Jan-Mar; 10(1):76-7. PMID: 16709364
3.Shalev J, Meizner I, Bar-Hava I, Dicker D, Mashiach R, Ben-Rafael Z. Fertil Steril. Predictive value of transvaginal sonography performed before routine diagnostic hysteroscopy for evaluation of infertility. 2000, Feb; 73(2):412-7. PMID 10685552.
4.Verma U, et. al. Fetal bones retained in uterine cavity as a rare cause of chronic pelvic pain: Case Report. J Reprod Med 2004, Oct; 49(10):853-5. PMID: 15568412.
5.Chervenak FA, et. al. Symptomatic intrauterine retention of fetal bones. Obstet Gynecol 1982; 59:58–61. PMID: 7088429.
6.Chan NS. Intrauterine retention of fetal bone. Aust N Z J Obstet Gynaecol. 1996, Aug; 36(3):368-71. PMID: 8883773
7.Vercellini P, Cortesi I, Oldani S, Moschetta M, De Giorgi O, Crosignani PG. The role of transvaginal ultrasonography and outpatient diagnostic hysteroscopy in the evaluation of patients with menorrhagia. Hum Reprod. 1997, Aug; 12(8):1768-71. PMID: 9308809
8.Towbin NA, Gviazda IM, March CM. Office hysteroscopy versus transvaginal ultrasonography in the evaluation of patients with excessive uterine bleeding. Am J Obstet Gynecol. 1996 Jun; 174(6):1678-82. PMID: 8678126.
Copyright © 2013 Chaudhari shilpa et al.. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Research article:- Anaesthesia,
Meera Rani Nayak*
Assistant Professor, Department of Anaesthesia, Sree Balaji Medical College & Hospital, #7, Works Road, Chromepet, Chennai - 600 044.Tamil Nadu, India.
Abstract:- This study was carried out in 60 adult ASA I &II patients to evaluate prolongation of postoperative spinal analgesia by clonidine. Addition of intrathecal clonidine at the doses of 75µg & 37.5µg to 0.5% hyperbaric Bupivacaine prolongs both sensory blockade of spinal anaesthesia & time interval to first request for supplemental analgesia. Incidence of hypotension & bradycardia was more with higher doses of intrathecal clonidine (75µg) which was managed by I.V fluids, inj. Mephenteramine & inj. Atropine sulphate satisfactorily. Sedation – maximum with higher dose (75µg) of intrathecal clonidine.
Key words:- Intrathecal clonidine, Post operative analgesia, Lower abdominal surgeries.
References:-
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2.Eisenach J, De kock M, Klimscha W. alpha 2 adrenergic agonists for regional anaesthesia: aclinical review of clonidine (1994 - 1995). Anesthesiology 1996; 85:655-74.
3.Filos KS, Goudas LC, Patroni, Polyzou V. haemodynamic & analgesic profile after intrathecal clonidine in Humans. A dose response study. Anesthesiology 1994; 81: 591-601.
4.Niemi L. Effects of intrathecal clonidine on duration of Bupivacaine spinal anaesthesia , hemodynamics, postoperative analgesia in patients undergoing knee artroscopy. Acta Anaesth Scand 1994; 38:724-8.
5.Bonnet F, Brun –Bisson V, Saada M. Dose related prolongation of hyperbaric tetracaine spinal anaesthesia by clonidine in humans. Anaesthe Analg 1989; 68; 619-22.
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7.Sites BD, Beach M, Biggs R , Rohan C, Wiley C, Rassias A, et al. Intrathecal clonidine added to a bupivacaine – morphine spinal anaesthetic improves postoperative analgesia for total knee artroplasty. Anesth Analg 2003;96:1083-8.
8.Vaghadia H, McLeod DH, Mitchell GW, Merrick PM, Chilvers CR. Small-dose hypobaric lidocaine –fentanyl spinal anaesthesia for short duration out patient laparoscopy. I. A randomized comparison with conventional dose hyperbaric lidocaine. Anesth Analg 1997; 84:59-64.
9.Eisenach JC, De Kock M, Klimscha W, Alpha(2) – adrenergic agonists for regional anesthesia. A clinical review of clonidine (1984-1995).Anesthesiology 1996;85:655-74.
10.Kaabachi O, Zarghouni A, Ouezini R, Abdelaziz AB, Chattaoui O, Kokki H.Clonidine 1 microg/kg is a safe and effective adjuvant to plain bupivacaine in spinal anesthesia in adolescents. Anesth Analg 2007; 105:516-9.
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12.Nader ND,Ignatowski TA,Kurek CJ,Knight PR, Spengler RN. Clonidine suppresses plasma and cerebrospinal fluid concentrations of TNF-alpha during the perioperative period. Anesth Analog 2001; 93:363-9.
13.Larsen B, Dorscheid E, Macher-Hanselmann F,Buch U.Does intrathecal clonidine prolong the effect of spinal anesthesia with hyperbaric mepivacaine? A randomized double-blind study. Anesthesist 1998; 47:741-6.
Copyright © 2013 Meera Rani Nayak. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Original research:-General Surgery
Yogesh Kumar1,Basavaraj G.Veerapur2,Sunil Kumar Math3 & YP Raghavendra Babu4* 1Professor, Department of General Surgery,2Assistant Professor, Department of General Surgery,3Postgraduate, Department of General Surgery,4Associate Professor, Department of Forensic Medicine and Toxicology, Kasturba Medical College (A Constituent College of Manipal University), Mangalore, India.
Abstract:- Background:Studies on the clinical outcome & biochemical alterations in the postoperative follow-up period in cases with Roux-en-Y jejunostomy compared with loop jejunostomy cases in upper GI surgeries are not many. Materials & Methods: In this observational study, a total of 28 cases undergoing upper GI Surgeries with eitherRoux-en-Y jejunostomy orloop jejunostomy method were included. Jejunal loop anastomosis or Roux en Y jejunal anastomosis was used as per the indications for case. During the follow up clinical evaluation, biochemical analysis, quality of life was obtained. Results: There was one mortality and four patients had significant morbidity. The average follow-up period was 16 months (range 3months – 16 months). Patients with Roux-en -Y anastomosis were significantly asymptomatic and had greater Visick I grading than patients with loop jejunal anastomosis. Clinical outcomes & quality of life was better in Roux-en-Y group. Biochemical analysis showed loop anastomosis group had significant post operative hypokalemia, hypoproteinemia with longer hospital stay. Conclusion: This pilot study showed that Roux-en-Y anastomosis is significantly better than jejunal loop anastomosis in upper GI surgeries with the subjective and biochemical analysis under evaluation. However further studies is required to confirm the findings.
Keywords:- Roux-en-Y; Jejunostomy; GI surgery; loop jejunostomy.
References:-
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2.Hoya Y, Mitsumori N, Yanaga KThe advantages and disadvantages of a Roux-en-Y reconstruction after a distal gastrectomy for gastric cancer.Surg today 2009;39(8):647-51.
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5.Imaizumi T, Hatori T, Tobita K et al.Pancreaticojejunostomy using duct-to-mucosa anastomosis without a stenting tube. J Hepatobiliary Pancreat Surg. 2006;13(3):194-201.
6 Csendes et al. Latest Results (12-21 years) of a Prospective Randomized Study Comparing Billroth II and Roux-en-Y Anastomosis after a Partial Gastrectomy Plus Vagotomy in Patients with Duodenal Ulcers. Annals of Surgery. 2009;249(2):189-94.
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14.Rieu PN, Jansen JB, Joosten HJ, et al. Effect of gastrectomy with either Roux-en-Y Billroth II anastomosis on small-intestine function. Scand JGastroenterol. 1990;25:185–92.
15.D'Amato A, Montesani C, Cristaldi M, Giovannini C, Pronio A, Santella S, Ventroni G, Ronga G, Ribotta G. Restoration of digestive continuity after subtotal gastrectomy: comparison of the methods of Billroth I, Billroth II and roux en Y. Randomized prospective study. Ann Ital Chir 1999 Jan-Feb; 70(1):51-6.
Copyright © 2013 YP Raghavendra Babu et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Original article:- anatomy
K. Satheesh Naik 1*, G.M. Mahesh2 & Sudharani. P3
Department of anatomy, Basaveshwara Medical College & Hospital, Chitradurga - 577502 Karnataka, India.
Abstract:- In a 55 years old male cadaveric dissection for medical undergraduate students on right side we observed there was no communication between radial and ulnar arteries in the formation of Superficial Palmar Arch, On left side no such variation was found. Superficial palmar branch of radial artery supplied lateral two and half fingers by common and proper arteries, but the artery to radial side of index finger received one communicating branch from radial artery, supplying ulnar side of thumb. We also observed the superficial branch of ulnar artery supplied medial two and half fingers by common and proper arteries. Knowledge in variation of vascular Pattern of hand gaining more importance in Microsurgical techniques, & Reconstructive hand surgeries.
Keywords:- Reconstructive hand surgeries, Superficial palmar branches of radial & ulnar arteries, Communicating branch from radial artery.
References:-
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Copyright © 2013 K. Satheesh Naik, G.M. Mahesh & Sudharani.P. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.