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  Citation statistics : Table of Contents
   2016| July-December  | Volume 5 | Issue 8  
    Online since January 3, 2017

 
 
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ORIGINAL ARTICLES
Prevalence of hepatitis a virus and hepatitis e virus in the patients presenting with acute viral hepatitis at a tertiary care hospital Jaipur Rajasthan
Anshu Mittal, Rameshwari Bithu, Nitya Vyas, Rakesh K Maheshwari
July-December 2016, 5(8):47-50
DOI:10.4103/2250-9658.197436  
Background: Hepatitis A virus (HAV) and hepatitis E virus (HEV) causes a self-limiting viral infection, transmitted by feco-oral route. These infections are major health problem worldwide, with a higher incidence in developing countries. Exposure rate of HAV and HEV over a period are different in different parts of country. Objectives: This study was conducted to determine the seroprevalence of HAV and HEV, its seasonal trend and their correlation with serological markers of liver damage at a tertiary care hospital Jaipur Rajasthan. Materials and Methods: A total of 3093 serum samples were tested for IgM HAV and IgM HEV. Relevant data were also collected. Results: A total of 3093 patients were included in the study. Of the 3093, 1654 and 1439 serum samples were tested for IgM HAV and IgM HEV, respectively. Of these, 7.67% and 14.9% were positive for IgM HAV and IgM HEV, respectively. Range of elevated bilirubin in both type of acute hepatitis varied from 1.4 mg% to 37 mg%. In IgM HEV positive patients, bilirubin level was increased in 70.69% cases, whereas aspartate aminotransferase (AST), alanine aminotransferase (ALT), and alkaline phosphatase (ALP) levels were elevated in 68.37%, 58.13%, and 31.16% cases, respectively and in IgM HAV positive patients bilirubin level was increased in 57.48% of patients whereas AST (or serum glutamic oxaloacetic transaminase), ALT (or serum glutamic pyruvic transaminase) and ALP levels were elevated in 55.11%, 59.84%, and 42.51% of patients, respectively. Conclusions: The best means of reducing the spread of infection is by promoting simple measures of personal and community hygiene. However, these data will be useful for planning of future vaccination strategies and for better sanitation program in country.
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CASE REPORTS
Turret exostosis of proximal phalanx of thumb
Ganesh Singh Dharmshaktu, Tanuja Pangtey
July-December 2016, 5(8):64-65
DOI:10.4103/2250-9658.197441  
The osteochondromatous lesion of the skeleton is common occurrences and may have many variants, the knowledge of which is crucial for identification and treatment. Acquired osteochondroma, also known as Turret exostosis is one such lesion. The clinico-radiological picture often mimics that of a solitary osteocartilagenous exostosis, but the history of minor trauma as triggering event and histopathological correlation concludes the ubiquitous diagnosis. We present a case of Turret exostosis of thumb proximal phalanx on medial aspect with appropriate management.
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Staphylococcal scalded skin syndrome in a neonate following prolong labor
Zarak Hassan Khan, Haider Ghazanfar, Hamza Hassan Khan
July-December 2016, 5(8):66-68
DOI:10.4103/2250-9658.197442  
Staphylococcal scalded skin syndrome (SSSS) encompasses a spectrum of superficial blistering skin disorders caused by the exfoliative toxins (ETs) of some strains of Staphylococcus aureus. In this case report, we present a case of SSSS in an 8-day-old neonate. Furthermore, we tried to highlight the importance of early diagnosis by history and physical examination and isolation of the infected neonates because of the risk of spread of infection to other neonates in the Neonatal Intensive Care Unit.
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Spontaneous evisceration through an incisional hernia: A rare complication in surgical practice
Ethel Osei-Tutu, Ayokunle Osonuga
July-December 2016, 5(8):69-70
DOI:10.4103/2250-9658.197444  
Incisional hernias complicate 2-20% of laparotomies. They rarely eviscerate spontaneously and pose a serious threat to the protruding bowel and the patient's life if timely intervention is not instituted. We report a case of spontaneous rupture of an incisional hernia in a 56-year-old female who underwent laparotomy 20 years before presentation at the Accident and Emergency Department of the Cape Coast Teaching Hospital. An emergency laparotomy was done where extensive adhesions between the bowel and the anterior abdominal wall were noted after initial resuscitation. The bowel was then returned into the peritoneal cavity, and the fascia closed with nylon 2. Excess lax and thinned out skin was trimmed and the skin closed with vicryl 0 and recovery was uneventful. Neglect for early operative intervention or delay in seeking the treatment for an incisional hernia increases the risk of rupture. Once ruptured, timely repair of the defect can be done if no gangrenous segment is found.
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ORIGINAL ARTICLES
Incidence of hospital-based screen-detected prostate cancer in Abuja, Nigeria
Oseremen Inokhoife Aisuodionoe-Shadrach, Olabode Peter Oluwole, Echebiri F Magnus, Amaka P Ehighibe
July-December 2016, 5(8):51-54
DOI:10.4103/2250-9658.197437  
Objective: The objective of this study was to determine the incidence of screen-detected prostate cancer (CaP) in a University Hospital in Abuja. Methodology: This is a retrospective review of all patients seen with lower urinary tract symptoms (LUTS) and or enlargement of the prostate who were screened for CaP over a 4-year period from January 2010 to December 2013. Data retrieved from the medical records of these patients were collated using a pro forma and analyzed with SPSS software Version 20. Results: The records of 103 patients were utilized for this study. The average age was 65.9 ± 9.0 years. Of this number, 99 had LUTS at presentation, while 4 had no LUTS. Digital rectal examination findings revealed a clinical suspicion of malignancy in 84.5% (n = 87) and features of benign enlargement in the remainder. Serum prostate-specific antigen was <4 ng/ml in 3.8% (n = 4), 4-10 ng/ml in 9.7% (n = 10), and >10 ng/ml in 85.4% (n = 88). Histology revealed adenocarcinoma in 50% of the patients (n = 38) with 71% (n = 27) being moderately and 29% (n = 11) being poorly differentiated. The incidence of screen-detected CaP in this series was 38.7%. Conclusions: The incidence of screen-detected CaP may be higher than it is actually reported in this part of the world. The place of opportunistic screening for the well informed may not reflect the high cancer burden. Most patients presented late in the advanced stage of the disease with moderately to poorly differentiated adenocarcinoma being the most common histological type.
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Species-level identification of Acinetobacter by 16s rRNA sequencing: Necessity today, essentiality tomorrow
Trupti Bajpai, Ganesh S Bhatambare, Meena Varma, Maneesha Pandey
July-December 2016, 5(8):55-58
DOI:10.4103/2250-9658.197438  
Purpose: When common organisms present with uncommon phenotypes, reliance on phenotype can compromise accurate identification. The use of 16s rRNA gene sequences to study bacterial phylogeny, and taxonomy has been the most common housekeeping genetic marker. The aim of our study was to identify "difficult" and notorious uropathogen such as Acinetobacter through multiple identification methods. Materials and Methods: The present prospective study was conducted for the period of 6 months in the year 2015 in the Department of Microbiology of a Teaching Tertiary Care Hospital. A total of 345 clean catch, midstream urine samples obtained from patients suspected of urinary tract infection were subjected to microscopy and culture. Uropathogens isolated from the culture-positive samples were identified to species level through conventional, automated, and molecular methods. Results: A total of 123 uropathogens were isolated from 118 culture-positive samples. Among them, 81.3% isolates were Gram-negative bacteria, 14.6% were Gram-positive bacteria, and 23.5% were Candida species. Four (3.2%) Acinetobacter isolates were detected among which three were confirmed as Acinetobacter baumannii, whereas one of them was confirmed as Acinetobacter junii by different methods of identification. Conclusion: Identification by gene sequencing is more objective, reliable, reproducible, and accurate and has the capability of defining taxonomical relations among bacteria.
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The effects of sociodemographic factors on depression management
Joshua Wednesday Edefo, Waka Tony Udezi
July-December 2016, 5(8):59-63
DOI:10.4103/2250-9658.197440  
Objective: To explore the effect of sociodemographic factors on response rate to antidepressants therapy in depression management. Methods: A prospective study design of 6 follow-ups per patient after the initial contact was employed. Follow-up was done every 4 weeks for up to the 24 th week per patient that completed the study. Degree of depression was determined using the International Classification of Disease-10 criteria, whereas severity of depression was assessed using Hospital Anxiety and Depression Scale-depression (HADS-D) instrument. Outcome (depression-free) was measured at initial contact and also for each follow-up using HADS-D score. Chi-square and analysis of variance were used. Results: Fifty-one respondents out of 112 patients (46%) completed the study, and hence the sample size was 51 respondents. Females accounted for 65% (33) of the sample. Those who attained at least secondary level of education, and personal income as gave a P < 0.05 with regard to decrease HADS-D scores compare to when the study started, whereas the decrease HADS-D scores of sex and all age groups also gave a similar P < 0.05 as at the last follow-up of the study. Conclusion: Education status and personal income appear to affect the rate of response to antidepressant medications.
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Clinical profile and management outcome of diabetic foot ulcers in a tertiary care hospital in Haryana
Vishal Mago, Neetu Kochhar
July-December 2016, 5(8):42-46
DOI:10.4103/2250-9658.197434  
Background: Diabetic foot ulcers are predisposing factor in 85% of lower limb amputations. This study was done to evaluate risk factors for the development of diabetes and associated foot problems in the rural area of Khanpur Kalan and adjoining villages of Haryana to educate the rural population for the promotion of healthy foot care and footwear habits. Objective: The aim of this study was to determine major risk factors and management outcome of diabetic foot ulcers to prevent amputation. Methods: This study was conducted in the Department of Plastic Surgery, Bhagat Phool Singh Government Medical College for Women, Khanpur Kalan, Sonepat, from December 2013 to November 2015 in 64 patients who reported in our outpatient department and emergency. Results: Sixty-four patients with type 2 diabetes mellitus were enrolled in the current study with different stages of diabetic foot presentations. They underwent different methods of surgical management: debridement, amputations, and skin grafting giving good and fast results. Eight patients underwent below-knee amputations, and six were subjected to forefoot amputation. Ten great toe amputations were performed. Two finger amputations were performed. Conclusion: Early diagnosis and management of diabetic foot ulcers can improve patient outcomes and reduce health-care costs.
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REVIEW ARTICLES
Transversus abdominis plane block as an adjuvant in multimodal postoperative analgesia: Relevance and applicability in Nigeria
Hanson Osazuwa Idehen, Charles O Imarengiaye
July-December 2016, 5(8):31-38
DOI:10.4103/2250-9658.197432  
Transversus abdominis plane (TAP) block is a new regional anesthesia technique and very recent in Nigeria. Availability and access to opioids in Nigeria are erratic coupled with its associated side effects; there has been need for alternatives to the use. TAP block has been suggested as an adjunct in multimodal strategy. It provides analgesia mainly for somatic pains for procedures on the anterior abdominal wall excluding visceral pains and therefore may not be too useful as a sole anesthetic technique. TAP block can be instituted using the anatomical (landmark) approach, ultrasound-guided technique, or surgeon's assisted approach. Ultrasound-guided approach is most effective with minimal adverse outcome; wholesale adoption and adaptation would expand the options for balanced anesthesia and pain management. Thus, this article documents the clinical usefulness of TAP block in postoperative pain management so as to encourage the routine use of the technique in Nigeria.
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Subepithelial connective tissue graft with coronally advanced flap for the treatment of miller class-III gingival recession; Case report with review of literature
Mohammad Arif Khan, Saket Banchhor, Priyanka , Deepti Chandra, Vijay Krishnan
July-December 2016, 5(8):39-41
DOI:10.4103/2250-9658.197433  
Mucogingival surgery involving gingival reconstruction has become an integral part of the current periodontal practice. Gingival recession, either localized or generalized, associated with one or more surfaces, causes clinical and functional problems such as attachment loss, root exposure, poor esthetic, and poor plaque control. This case report describes a clinical case of Miller Class III gingival recession which has been successfully treated by subepithelial connective tissue graft with coronally advanced flap for complete root coverage.
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