Volume 1 – Issue 1

Title : The correlation of maternal interleukin 4 and indicators of moderate and severe preeclampsia
Authors : Ana Daneva Markova,Marija Hadzi Lega,Katerina Kasapinova,Anastasika Poposka

The purpose of this research is to study the formation of anti-inflammatory IL-4 cytokine and some indicators of moderate and severe preeclampsia, and normotensive pregnancies in the third trimester of pregnancy Material and methods This is a single center study of 100 women with third trimester pregnancies. All patients gave their informed consent prior to inclusion in the study. Patients were divided into two groups: 50 women with pregnancies complicated by varying degrees of preeclampsia and control group of 50 normotensive pregnancies. Cytokine levels in the serum were measured by the “sandwich” method of solid-phase enzyme immunoassay using double antibody. Statistical data processing was done using the SPSS 13.0 software for Windows. Logistic regression analysis (Binary Logistic Regression) was used to determine the predictive role of the parameters analyzed in the occurrence of severe preeclampsia. Results The obtained values of Pearson- coefficients’ linear correlation (r) indicate that IL-4 negatively correlates with LDH, creatinine, uric acid and proteinuria, and positively correlates with number of blood platelets. IL-4 in severe preeclampsia has a downward
trend, between 28-40 weeks of gestation it may be considered a prognostic marker for the development of severe preeclampsia

Keywords : Preeclampsia ,cytokines ,proteinuria ,indicators.
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Title : Antecedents and consequences of teenage pregnancy: a phenomonological study
Authors : Jenny D. Meneses,Claudio T. Saratan
The purpose of this study is to describe the Antecedents and Consequences of Teenage Pregnancy. The participants were 10 Teenage Mothers aged 14-19 that are selected purposively in terms of undergoing teenage pregnancy in Barangay Bambang, Bulakan, Bulacan and shared their lived experiences pertaining to this stage of their life. Phenomenological type of Qualitative Research was utilized in this study. The researcher utilized guided questionnaire that was based on literature which has been validated by 3 professionals. The main data source typically is in-depth conversations, with the researcher and informants as co-participants. Data was collected through tape recording. After the data collection, the researcher analyzed and interpreted the information obtained using IPA Methodology (Interpretative Phenomenological Analysis).The findings revealed that socio-economic phenomenon caused (antecedents) the participants to experience teenage pregnancy are Teenage Pregnancy is associated with poverty including low family income, crowded community, semi squatter dwelling type and school disengagement. Prevalence of family problems/conflicts including ruptured relationship with parents, broken family and limited parental guidance. Peer influences including hanging out with wrong barkadas, involvement in drinking sprawl and alcohol misuse. The consequences of teenage pregnancy that the teenage mothers experienced are family problems including financial problems, nourishment of the child and early responsibilities. They also experienced discrimination acts like feedback about early pregnancy and topic of rumors. Teenage mother’s unmet goals are to go abroad, to finish their studies and to support their family. The coping mechanisms of the teenage mothers are getting family support, acceptance of the  phenomenon, getting support from the husband’s family and finding employment. The Sociological Propositions that evolved from the experiences of the young adolescents who experienced teenage pregnancy as a social phenomenon is caused, and therefore it can be avoided if the causative factors can be brought to for, studied and a relevant social program can be formulate to mitigate teenage pregnancy and its consequences. To conclude, Socio-economic phenomenon plays an important role in causing teenage pregnancy. The results of the study became the basis for developing guidelines to mitigate teenage pregnancy. The study recommended that the Government should focus on improving economic opportunities to low-income families to improve their life. Teenagers need proper counseling and support from their families.
Keywords : Teenage , Pregnancy , Antecedents , Consequences , Phenomenological
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Title : Smile ethetics in dentisrtry
Authors : C. Sabarigirinathan,K. Vinayagavel,A. Meenakshi,R. SelvaRani,M. S. Jayanthy,K. Usha,P.A. Manojkumar,C. Selvamani,A. Gowri Shankar
The perception of aesthetics varies from person to person and is influenced by personal experiences and social environment. Classical cultures of Greece and Rome based their standards of beauty on set rules of proportion and composition.
Keywords : Beauty , esthetics , smile design , smile proportions
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Title : State kallikrein-kinin system in pregnant women groups infectious risk
Authors : Gulnora T. Rabbimova, N.Q. Muhamadiev
The article describes the performance of enzymes KKS infectious risk during pregnancy. A significant reduction of prekallikrein and kallikrein, and increase of TATA (total antitriptic activity), BAEE (N-benzoyl-1-arginine ethyl ether) kininase is shown that can be used as a marker of inflammation in pregnant women infectious risk.
Keywords : pregnancy , infectious complications , enzymes of kallikrein-kinin system
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Title : Brain Tumor with Pregnancy A Rare Entity
Authors : Ruchi Sinha,Ravishankar Prasad

A case of brain tumor with pregnancy in third trimester is reported. The literature is reviewed to show the effect of pregnancy on these tumors, the method of diagnosis and management. The presence of a brain tumor in pregnancy is a state of a diagnosis of scarce presentation in the medical practice. A high clinical suspicion on the part of the obstetrician is the key to timely diagnosis as the symptoms of headache, vomiting and blurred vision are often encountered in pregnancy with or without pre-eclampsia.

Keywords : Brain tumor , glioma , astrocytoma
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Authors : Oluwaremilekun Ajakaye

This study was carried out to determine the current prevalence of urinary schistosomiasis in relation to epidemiological factors in two communities in Ile Oluji/Oke Igbo Local Government Area (LGA) of Ondo state. A total of 760 individuals comprising 356 males and 404 females were examined and of the number examined, 126(16.6%) were infected with S. haematobium. Oke Igbo community had more infected individuals than Ile Oluji. Infection peaked at individuals in the age groups 10-19 and 20-29 years. The secondary school category with respect to the highest level of education had the highest prevalence. High prevalence was recorded among individuals who had knowledge of schistosomiasis and have had prior infection. Statistical analysis showed that age, sex, highest level of education, knowledge and history of schistosomiasis infection were significant demographic and socio economic factors. These findings show that the study area is endemic to urinary schistosomiasis despite school children chemotherapy.

Keywords : Epidemiology , urinary schistosomiasis , prevalence , ondo state , nigeria
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Title : Improvement of vitamin-d deficient rachitis treatment in children
Authors : Shoira M. Ibatova,Nurali Q. Muhamadiev,Shohruh O. Axmedov,Sayyora N. Muhamadieva
INTRODUCTION: Significant changes of the highest fatty acids content were revealed in the blood serum in children ill with rachitis. The depth of changes of the highest fatty acids content depended on the degree of the pathologic process severity. The revealed disturbances of the highest fatty acids content was corrected by means of apricot oil and the results of therapy were presented. Efficacy of the presented method of treatment in children with rachitis was shown in optimal doses of apricot oil. METHODS: 67 patients ill with Vitamin-D deficient rachitis and 10 practically healthy children of the control group were enrolled in the study. The 1st degree of the disease was diagnosed in 30 (44,8%) and the 2nd degree in 37 (55,2%) children.The content of the highest fatty acids in blood serum of the studied patients was determined by means of gas- liquid chromatography. For identification of separated methyl aether fatty acids the method of “witness” and “sorbentsorbat”method based on structural group contents were used. RESULTS: 67 babies were studied. In children with Vitamin-D deficient rachitis the content of such fatty acids as palmitinic, strearic and linolic acids increases and palmitoleinic, oleic, linoleic and arachidonic acids decreases and that is the evidence of lipid exchange disturbance in rachitis. It motivates the necessity to correct lipid exchange in this pathology and to add vegetable oils. In order to eliminate dysmetabolism of the highest fatty acids in children with rachitis it is recommended to administer apricot oil as therapeutic agent. CONCLUSION: In order to eliminate the highest fatty acids dysmetabolism in children ill with rachitis it is recommended to administer apricot oil that results in restoration of the highest fatty acids metabolism and provides high therapeutic effect.
Keywords : Apricot oil , efficacy , fatty acids , improvement , rachitis , treatment.
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Title : A Study of Metabolic Syndrome in the Rural Population of Haryana…
Authors : Shruti Seth,Suvarna Prasad
Metabolic Syndrome (MS) is the clustering of risk factors for cardiovascular disease. It is estimated that the burden due to cardiovascular disease (CVD) will markedly increase in developing countries particularly in the Indian subcontinent.Because both under nutrition and over nutrition are seen simultaneously in developing countries, the double burden of diseases makes the situation more difficult. The study included 100 subjects of the age group 20 -60 yrs attending the OPD of MMIMSR. The cross-sectional study was done for a period of 3 months from the month of January 2011 to April 2011. Simple Random sampling methods was adopted for the selection of subjects. According to NCEP definition, maximum overall percentage of MS was 20.5% and gender specific for males and females was 30.1% and 26.7% respectively. Prevalence of obesity and the metabolic syndrome has shown a rapid rise in developing countries in the past few decades and has led to increased risk of CVD and consequent morbidity and mortality.
Keywords : Metabolic Syndrome , NCEP ATP III , Rural Population , Cardiovascular disease
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Title : Lactating Mothers’ Weaning Practices in Lamingo, Plateau State, Nigeria
Authors : Lar Luret Albert,Banwat Mathilda Edmund,Wash-Pam Anna Awukun,Abubakar Joshua Difa,Lar Lungfa Albert

Background: Weaning is the introduction of the first solid foods to infants and maintenance of breastfeeding by demand up to two years of age. The first months of infants’ life are characterized by rapid growth and development and cultural, occupational and educational factors could influence these various weaning practices. This descriptive, cross-sectional, community-based study among 219 breastfeeding mothers, in Lamingo assessed weaning practices among them. Methodology: The participants were selected using multistage sampling technique. Data was collected using pre-tested, semi- structured, interviewer-administered questionnaires and analysed using Epi-Info version 3.4.5 software. Results: Most 104(47.0%), of the respondents had a good knowledge on weaning practices. One hundred and sixty seven (76.3%) of them introduced weaning foods at the age of 6 months. Majority 87(39.7%) of the respondents gave their children ‚gwete, a local porridge made from hungry rice with vegetables‛ as the first food. The knowledge of weaning practices was significantly influenced by the mothers’ level of education (p=0.0045). Conclusion: This study showed that most of the respondents had good knowledge on weaning practices, but were ignorant on what weaning meant. Therefore, it was recommended that mothers should be educated on the importance of weaning to
the growth and development of the child.

Keywords : weaning practices , Lactating Mothers , Lamingo , Nigeria
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Title : Clinical Outcomes in Angiographic Documented Coronary Artery Disease Managed with Optimal Medical Therapy in Current Era – One Year Follow Up
Authors : Om Prakash,Vijay Pathak,Rashmi Gupta,Manish Ruhela

The management of patients with coronary artery disease (CAD) is complex. There is no study from India showing clinical outcomes in angiographically documented coronary artery disease in ACS and stable coronary artery disease in the current era. In most of previous studies only stable CAD patients were enrolled . Therefore the study is planned in view of above points to assess the outcome in patients with angiographically proven CAD on optimal medical therapy. Methods We conducted Hospital based observational descriptive prospective study involving 106 patients who had objective evidence of myocardial ischemia and significant coronary artery disease in at least one major epicardial vessel and not willing for either CABG or PCI, presenting to department of Cardiology, SMS Medical College from march 2013 to nov. 2013 and one year follow up was done till nov.2014. The clinical outcomes were recorded at six month and 12 months follow up. Results Most of the patients were male with a mean age of total patients’ 58.93±11.49 years (range 32 to 83 years). Of these patients, 72 had diagnosis of previously stabilized ACS and 34 had stable coronary artery disease. The baseline characteristics of the  patients were similar in the two groups. 45.28% of patients were symptomatic due to angina at 6 months. At 12 months, only 24.46% of patients had angina. There were no significant differences between the stabilized ACS group and non-ACS  group in death (overall death 6.6% 8.3% vs. 2.9% P = 0.52) hospitalization for acute coronary syndrome (19.4% vs. 11.8% P = 0.48) or myocardial infarction (overall MI 10.4%, 11.1% vs. 8.8% P = 0.98), overall hospitalization rates (27.7%vs. 11.8% P=0.09). Conclusions Previously stabilized ACS as well as patients with stable coronary artery disease had similar outcomes with OMT so an initial management approach optimal medical therapy can be implemented safely in the patients with previously Stabilized ACS as in patients with stable coronary artery disease.

Keywords : :ACS ,Angiographically documented coronary artery disease ,Non-ACSandOptimal medical therapy
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Title : Prevalence of Metabolic Syndrome in Women of Different Age Groups in Rural Population of Andhra Pradesh
Authors : Rvbs Sarma,Sajja Srikanth

Background & Objectives: The main objective of the study is to identify the prevalence of Metabolic syndrome as people with the Metabolic syndrome are at increased risk for developing diabetes mellitus, cardiovascular disease as well as increased mortality from cardiovascular disease risk factors. Materials & Methods: A total number of 60 female subjects participated in the study. The subjects were grouped into two different age groups i.e. 30-40 and 40-50 years age. The study was approved by the Institutional Ethics Committee. Lipid profile, Fasting blood glucose, Blood pressure, Height, Weight & Waist circumference were recorded in all the subjects. Results: We observed that the prevalence of metabolic syndrome was 20% in women of 30-40 age group and 63.33% in women of 40-50 years of age group based on the NCEP ATP-III criteria. Conclusion: Programs aimed at detection and treatment of dyslipidemia, hypertension, diabetes, and obesity may reduce the burden of Metabolic syndrome in our population. Metabolic Syndrome present in epidemic proportions among the elderly represents one of the major threats to longevity and healthy aging

Keywords : Diabetes , Dyslipidemia , Hypertension , Insulin resistance
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Title : Ergonomics and musculo-skeletal disorders in dentistry

In spite of recent advances in technologies, occupational health related problems are more prevalent in modern day dentistry. Musculo-skeletal disorders are one among them that frequently haunt and disable many of the contemporary dentists. The proportion of reporting of musculo-skeletal pain and seeking of medical intervention for the same are on an increase among the dentists and the dental staffs. Dental procedures, sometimes, might be laborious needing constant focus of work in areas of difficult, minimal or restrained access in oral cavity. Dental procedures involve use of potentially dangerous instruments and materials that require proper handling and disposal as well as a good assistance from patient and the supporting dental staffs apart from the dentists. Dentists have to adopt necessary safety measures as these risks cannot be engineered out of dental office always. While abstaining from such risks, dentists also face stiff challenge of maintaining proper working posture to avoid any strained muscles. Musculo-skeletal disorders potentially handicap the dentists’ health and inadvertently affect the quality of the dental practice. Proper use of the dental resources is an absolute necessity for the dentists to keep such disorders at bay and avoid incurring considerable impact on economics and good will of dental practices. It is of paramount importance for dentists to be updated with information regarding tackling of these health problems and wise use of necessary innovations. By learning the art of coping strategies for prevention of musculo-skeletal disorders, dentists can tread a fine line between maintaining health, income, technical and professional standards.

Keywords : Musculo-skeletal pain , occupational health problems , ergonomics , musculo-skeletal disorders , posture ,dental professionals , static postures , neutral positions
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Title : Emergence of drug resistance in bacterial isolates from hospital wastewater- A potential health hazard
Authors : Hena Jamali,Abdul Malik,Sana Jamali

Introduction: Release of sewage effluent containing bacteria having elevated antibiotic resistance levels poses threat to environment. The antimicrobial selective pressure through indiscriminate use of antibiotics has played a significant role in enriching the mdr strains in the hospital practice. Materials and methods: Study was conducted at the department of agricultural microbiology, aligarh muslim university, aligarh, up (india). Wastewater samples were collected from a drain of j. N. Medical college, aligarh. Isolation of the enterobacteria was done. All isolates were tested for their sensitivity to antimicrobial agents by means of disc diffusion method[1]. Results: In the present study, a total of 50 enterobacteria were isolated from hospital wastewater. All the isolates were tentatively identified by morphological, cultural and biochemical characteristics. All the isolates were further tested for their antibiotic susceptibility (Table 2). A high level of resistance against penicillin-g (90%) was observed in strains isolated from hospital wastewater. Resistance against cloxacillin, novobiocin, nalidixic acid and polymixin b was 66%, 56%, 28%, 2% respectively (Table 3). All the isolates were sensitive to erythromycin, doxycycline, gentamycin, kanamycin and chloramphenicol. Majority of isolates from wastewater were found to be resistant to multiple drug/antibiotics. Among the fifteen antibiotics/drugs tested, seven different resistance patterns were observed in enterobacteria isolated from hospital wastewater. Conclusion: Results of this study may be beneficial to design environment-friendly techniques for the removal of antibiotics from wastewater to overcome the problem of antibiotic resistance development in the aquatic environment.

Keywords : Enterobacteria , Hospital , Wastewater , Resistance
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Title : Health and Social Wellbeing of the Workers in the Stone Quarrying and Crushing Industry
Authors : Naveen Ramesh,Bobby Joseph

Introduction: The quarry is an open excavation or a type of open pit mine, from which the stone is obtained by digging, blasting or cutting. The Indian quarries cater to the needs of railways, road construction and maintenance, housing and infrastructure building. The objectives of this were to assess the social wellbeing among quarry workers, to study the health issues peculiar to specific vulnerable population groups in the quarry, specifically under five children of quarry workers, women and the elderly and to enumerate if any health problems among workers, with specific reference to injuries and other work related morbidities. Methodology: This study was a cross sectional study done over a period of one year among people working in three quarries, situated in the peri-urban area of Bangalore. Predesigned and pretested tools were used to collect the data from various vulnerable groups working in quarries. Results and discussion: Social wellbeing, most of the workers were migrants from neighbouring states were dissatisfied with their job and isolated working conditions. Nutritional status of under five children, 95% of the children were undernourished. Status of women employees, the common health problems were musculoskeletal pain, menstrual disorders and substance abuses in the form of alcohol. Among the elderly, majority were employed, cataract and vision were the most  common problems. Most common injuries were cuts and bruises on the lower limbs. The workers in quarry had lowered lung function test as measured by the mean PEFR when compared to the standard mean PEFR among Indians.

Keywords : quarry , workers , social wellbeing , women , children , elderly
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Title : Amyotrophic lateral sclerosis: A Review
Authors : Mukesh bansal,I.J. Singhvi,Rahul Rajpurohit

Amyotrophic lateral sclerosis (ALS) also called Lou Gehrig’s disease is a rapidly progressive, invariably fatal neurological disease that attacks the nerve cells (neurons) that responsible for controlling voluntary muscles.several known ALS genes  were fund to be associated and TBK1 (the gene encoding TANK binding kinase) was identified as an ALS gene. In the  United States, more than 5,600 are diagnosed every year, and up to 30,000 Americans are currently affected. ALS is  responsible for two deaths per 100,000 people per year. Smoking, Lead exposure & Heredity are the major factor for ALS. No cure has yet been found for ALS. However, the Food and Drug Administration (FDA) approved the first drug i.e. riluzole (Rilutek)—in 1995. Riluzole is believed to reduce damage to motor neurons by decreasing the release of glutamate.  However, new medications or combinations of drugs would be beneficial for cure or prevention of diaease.

Keywords : Amyotrophic lateral sclerosis , TBK1 , Lead exposure , Riluzole
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Title : Menstrual characteristics and prevalence of dysmenorrhoea among female physiotherapy students
Authors : Salvi Shah,Kristina Makwana,Pravajya Shah

Background: A common gynaecological problem encountered among female students is dysmenorrhoea, which also appears to be a leading cause of absenteeism from college. Hence arises a need to evaluate the menstrual characteristics and prevalence of dysmenorrhoea along with its severity among students. Materials and methodology: This cross-sectional study was conducted between March 2014 to July 2014 at SPB Physiotherapy College, Surat, Western India. The study group included 133 female students. The data was collected by general assessment form, questionnaires regarding menstrual characteristics and dysmenorrhoea, Visual analogue scale (VAS) and Verbal multidimensional scoring system (VMSS) for assessment of dysmenorrhoea severity. Percentages and Chi-square test were used for statistical analyses. Results: The average age of the participants was 20.8 ± 1.8 years (range 17–23 years).Prevalence of dysmenorrhoea was found to be 71.2%.There was an association between dysmenorrhea and coffee consumption, choclate consumption, menstrual bleeding duration days, menstrual cycle regularity, family history of dysmenorrhoea, any gynaecological diseases (P < 0.05, for each one). Among dysmennorhic respondents, visual analog scale (VAS) for pain of dysmenorrhoea was 1-3 (n=48), 4-7(n=19), 8-10 (n=22).
Conclusion: Dysmenorrhoea is a very common problem among girls and it affects their quality of life. It can be better managed by mental preparation and by appropriate change in lifestyle like regular physical exercise and with assurance to the students. It is important to spread awareness about the causes and treatment of dysmenorrhoea to avoid undue sufferings causing absenteeism from work and studies.

Keywords : Dysmenorrhoea , Menstrual characteristics , VAS
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Title : A case of type IIa Homozygous Familial Hypercholestrolemia with cutaneous xanthomas
Authors : Michelle Serene Fernandes,Pradeep Pereira

Familial Hypercholestrolemia (FH) is characterized by presence of various types of cutaneous xanthomas with a deranged lipid profile. An 8 year old non-obese girl presented with multiple planes, tuberous and tendinous xanthomas and had associated abnormal lipid profile with elevated LDL cholesterol levels.

Keywords : Familial Hypercholestrolemia , Xanthomas
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Title : Treatment of Closed Tibial Pilon Fractures With Open Reduction, Internal Fixation and Bone Grafting. A Study Of 22 Cases Comparing the Objective and Subjective Evaluation
Authors : M. Athmaram,B. Jayachandra Reddy

The cases of twenty two fractures of the ankle joint that involved the tibial plafond were reviewed. The fractures were classified in to five types according to the severity of the injury. Open reduction and internal fixation was performed using one third tubular plate for fibula and recon plate for the tibia. Bone grafting was done to augment the fixation and maintain the reduction.For each fracture treated Objective and Subjective evaluation is done. The objective and subjective scores are compared.With this method we noticed that the Type III & IV fractures also had a good or excellent result

Keywords :Closed Tibial Plafond Fractures , Early Fixation , Bone Grafting , Early Mobilization , Prolonged NonWeight-Bearing
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Title : Anterior Arthrodesis for Tuberculosis of the Spine Using Zeta Instrumentation on Lateral Side
Authors : M Athmaram,B. Jayachandra Reddy

This is a prospective study of twelve patients who are diagnosed to have tuberculosis of spine with some form of neurological deficit. In the present study, the progression of kyphosis and the fate of the bone graft and final outcome over an average twelve month follow up after radical anterior debridement, bone grafting and application of Zeta Instrumentation on the lateral side of the vertebral body is performed. Supplementation with an implant to the procedure of bone grafting after radical debridement is a good choice as a primary procedure. It was noted that It is easy to place the implant on the lateral aspect of the bodies of the spine. There is no need of a second procedure in the form of posterior instrumentation and posterior fusion at a later date. Can be used by surgeons, where the facilities for pedicular screw fixation are not present.
There is no progression of the deformity.

Keywords : Tuberculosis , Spine , Drug Therapy , Chemotherapy
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Title : A Cross-Sectional Prevalence Study Of Disc Degeneration In A Rural Population And It’s Relation With Age, Body Mass Index And Back Pain
Authors : Harsh vardhan,Nidhi Agrawal,Chandra Raychaudhari,Deepak Vinod,Ray Mehta,Viral V. Patel,Diva S. Shah

The prevalence of degenerative discs (DD) in 59 male, 41 female patients belong to rural population of Anand district having mean age of 48.29 years, mean BMI (Body Mass Index) 22.196 kg/ m2 associated with pain, radiculopathies and neurological deficit presenting to the various in & out patient departments of Shree Krishna Hospital & Pramukh Swami Medical College, Karamsad, Gujarat. Magnetic resonance imaging (MRI) performed with a sagittal T2 image of the lumbar spine using closed type Superconductive 1.5 Tesla Magnetom Symphony Maestro (Manufactured by Siemens AG, Erlangen Company). Patients with sedentary life style had maximum number of degenerative disc pathologies, while had ambulatory life style had maximum percentage of infective/inflammatory disc pathologies. 98.3 % male patients had degenerative lesions while 92.5 % of female patient had degenerative changes. Age group 61-70 years to be maximum involved. In the lumbar region maximum changes were seen at L5-S1 level (25.7 %), cervical region at C5-C6 level (12.2 %) and at thoracic region at D12-L1 level (24.2 %). B.M.I. group II (18-25 kg/m2 ) to have maximum number of disco genic pathologies. All Congenital / developmental disc anomalies cases were associated with degenerative disc. It can be concluded that MRI is a highly sensitive imaging modality, which closely reflects histological changes. Grade III changesare mostly present in sedentary life style patient with high Body Mass Index.

Keywords : MRI Spine , Intervertebral Disc , Herniation , Bulge
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Title : A Randomised Control Study on Effect of Octreotide in Managemnt of Acute Pancreatitis with Varying Severities
Authors : Soumen Das,Susnata De

Background: Acute pancreatitis is an acute inflammatory process of the pancreas with variable involvement of other regional tissues or organ systems. Theories on pathogenesis of acute pancreatitis suggest that autodigestion of the gland and peripancreatic tissues by activated digestive enzymes is a key component. Octreotide is a potent inhibitor of pancreatic secretion, but the benefits of octreotide in acute pancreatitis in humans is still inconclusive. Aim: To study the effect of octreotide in acute pancreatitis with different severities. Method: 284 patients were assigned into two groups randomly, the study group comprising of 138 patients received inj octreotide 100 μg S.C. 8 hrly. The other aspects of the treatment protocol were similar in both groups. Severity of the disease was evaluated initially according to Ranson criteria, APACHE II SCORING, CRP values & Balthazar grading. Both the groups were observed prospectively and outcome of treatment was evaluated. Results: The results were analysed after dividing both the study and control group into 5 groups each according-to increased severities. The complication rate was 10% in group 1 and 28% in group 2 according to APACHE II among the study group, whereas it was 23% and 46% in the conrol group respectively. The values in patients stratified according to other criterias were also comparable. The results in cases of severe pancreatitis were poor, complication rates varying from 56% to 100% in the 3’d and 5 th group according to Ranson criteria among the study group and 62% to 100% respectively among the control group. Mortality of the study and control group also did not show any significant changes. Conclusion: Inhibition of secretory function in the early course of the disease especially in mild and moderate cases of pancreatitis has been shown to improve final outcome. As in case of acute pancreatitis it is very difficult to estimate the severity and disease progress at the very onset, and as the majority of cases are mild to moderate in severity, it will be beneficial to start with octreotide in any treatment protocol along with supportive resuscitative measures.

Keywords : Acute Pancreatitis , Management , Octreotide
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Title : Bone marrow biopsy picture in a patient with marfanoid habitus and anorexia nervosa
Authors : Vidhya Lakshmi,Pavethira Ponmudi,Prasanna N Kumar

Gelatinous marrow transformation (GMT) is a rare disorder of bone marrow characterized by deposition of extra cellular gelatinous material. There is atrophy of the marrow adipocytes and loss of hematopoietic elements. It is also called as osseous atrophy of the bone marrow. It is not a specific disease but it is seen associated with chronic illness like malnutrition, anorexia nervosa, HIV infection and administration of cytotoxic drugs. Here, we report a case of gelatinous transformation of bone marrow in a 17 year old female presented with severe weight loss and anemia.

Keywords : Gelatinous Marrow Transformation , Bone Marrow Biopsy
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Title : Efficacy of intramuscular electrical stimulation with dry needle over classical trigger point dry needling in non-traumatic shoulder pain and dysfunction A randomized controlled pilot study
Authors : Sukumar Shanmugam,Lawrence Mathias

Background: Myofascial Pain Syndrome (MPS) is a common condition in most of the painful shoulder conditions and it is effectively treated with trigger point dry needling of shoulder muscles. Very few studies on Intra muscular electrical stimulation were documented the effects of IMES with dry needle in treating MPS. This study was conducted to establish the clinical importance of IMES with dry needle in Myofascial pain syndrome of non traumatic shoulder disorders. Methods: 30 subjects with unilateral non-traumatic shoulder pain and dysfunction were selected and divided into two groups, 15 subjects in each group. Experimental group (7 male and 8 female subjects) treated with IMES with dry needle and control group (7 male and 8 female subjects) treated with classical trigger point dry needling twice in a week for consecutive 3 weeks. Pain, range of motion, and shoulder disability were assessed with VAS, Goniometry, and DASH-Questionnaire respectively at the end of 1st, 2nd, 3rd week, and end of 3rd month. Results: Descriptive characteristics of pre and post intervention VAS and DASH-Q, score and shoulder range of movements suggesting improvement in intramuscular electrical stimulation with dry needle. Within group comparison of VAS score and DASH-Q score in both groups in all observations shown the p value=.001 and between group comparison VAS score shown the mean 5.70 ± 1.02 standard deviation in the 1st week post intervention and DASH-Q score shown the mean 49.66 ± 9.69 standard deviation in the 1st week, mean 61.76 ± 7.30 standard deviation in the 2nd week intervention. Shoulder range of motion within group comparison was shown the p=.000 in both groups and between group comparison of shoulder abduction was shown the mean difference of 13.7 (p=.033) and 20.4 (p=.028) in the 1st and 2nd week and for shoulder external rotation shown the mean difference of 8.40 (p value= .01), and 9.60 (p=.01) in the 1st and 2nd week post intervention. Conclusion: This pilot study result suggests that both IMES with dry needle and classical trigger point dry needling are effective in treating pain and dysfunction. And subjects treated with IMES with dry Needle more effective in producing early recovery from pain and dysfunction of shoulder compared to the Classical Trigger Point Dry Needling in myofascial pain syndrome due to Non-Traumatic Shoulder pain and dysfunction.

Keywords : dry needling , intra muscular electrical stimulation , shoulder pain and dysfunction , adhesive capsulitis , myofascial trigger points , dry needling physiotherapy
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