JOURNAL OF
CHALMEDA ANAND RAO INSTITUTE OF MEDICAL SCIENCES

ISSN: 2278-5310 (Print)

ISSN: 2395-0188 (Online)



 
ISSN: 2278-5310 (Print)

ISSN: 2395-0188 (Online)
Frequency: Bi-annual
Editor-in-Chief: P. Shanmuga Raju 

ABOUT THE JOURNAL

Journal of Chalmeda AnandRao Institute of Medical Sciences is non-profit, scientific peer reviewed, open access journal. It is published bi-annually (January-June, July December). The journal covers subject on basic sciences, medicine, surgery, super specialties and allied health sciences. Journal of CAIMS is to publish scientific articles like original articles, review articles, clinical case reports, short communication articles, editorials, book reviews, and pictorial CME. Editorial board of journal of Chalmeda AnandRao Institute of Medical Sciences works under the principles of the International Committee of Medical Journal Editors (ICMJE), Committee on Publication Ethics (COPE), Council of Scientific Editors (CSE), and The World Association of Medical Editors (WAME).

 
 
 
 
 
 
 
                        
 
 
 
 
 
 
 
 

JOURNAL OF CHALMEDA ANANDRAO

INSTITUTE OF MEDICAL SCIENCES

AIMS AND SCOPE

Journal of Chalmeda AnandRao Institute of Medical Sciences (J CAIMS) ISSN: 2278-5310 (print), ISSN: 2395-0188 (online) is an indexed, peer reviewed Journal. It is published bi-annually (January-June, July- December) and formerly known as “CAIMS Medical Bulletin (2008-2010)”. The main aim is to encouraging scientific research papers and providing a platform for young researchers, academicians and Post Graduate students in the field of Medicine and Allied Medicine.

ARTICLE TYPES

Journal of CAIMS is to publish scientific articles like original articles, review articles, clinical case reports, short communication articles, editorials, book reviews, pictorial CME and letters to the editor.

ARTICLE PROCESSING CHARGES

No article process fee or publication free is required to publish in the journal.

JOURNAL OF CAIMS COVERAGE INCLUDES

Basic Sciences, Medical, Surgical and Rehabilitation.

AUDIENCE

Researchers in the field of medicine, surgery and super specialties, educators, postgraduate Students, Clinicians and Allied Health Professionals.

ETHICS POLICIES

Editorial and publication processes of the journal are shaped in accordance with the guidelines of the international organizations such as the International Council of Medical Journal Editors (ICMJE), the World Association of Medical Editors (WAME), the Council of Science Editors (CSE), and the Committee on Publication Ethics (COPE).

INDEXING/ABSTRACTING

The Journal of Chalmeda AnandRao Institute of Medical Sciences is indexed/abstracted in

•  Academic Keys
•  Chemical Abstracts Service(CAS)
•  Cite factor
•  Indian Science Abstract 
•  Indian Citation Index 
•  Cosmos impact factor
•  Index Copernicus
•  ISPJE
•  NLM Catalog
•  Locator Plus
•  National Science Library
•  J-Gate
•  World Cat
•  OCLC
•  Ulrich’s Web

SUBSCRIPTION INFORMATION

All published volumes in full text and Archive are free at www.caims.org/journal 
Print ISSN:    2278-5310¸ USD 80.00 (Institutional)/ USD 50.00 (Individual) 
Online ISSN: 2395-0188 – All Full text issues are free.

Address:

Chalmeda AnandRao Institute of Medical Sciences
Bommakal village,
Karimnagar-505001 
Telangana, India.

Phone:    0878-2285565, 2285565, 2285297
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Web page:     www.caims.org/journal

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MATERIAL DISCLAMIER

The author(s) are responsible from the articles published in the journal of Chalmeda AnandRao Institute of Medical Sciences. The editor, editorial board and publisher do not accept any responsibility for the articles.

ACID-FREE PAPER

The Journal of Chalmeda AnandRao Institute of Medical Sciences is printed on an Acid-Free Paper.

EDITORIAL BOARD MEMBERS

 

GOVERNING BODY

 CHIEF PATRON

Chalmeda AnandRao

 
PATRON

C.Lakshmi Narasimha Rao, Chairman

 

EDITOR EMERITUS

V. Bhoom Reddy

 

RESEARCH & DEVELOPMENT EDITOR

V. Suryanarayana Reddy

 

EXECUTIVE EDITORS

T. Surender

Syed Ali Aasim

 

EDITOR-IN-CHIEF

P. ShanmugaRaju

 

ASSOCIATE EDITORS

E RamaDevi

Madoori Srinivas

Ezhilarasi Ravindran

 

ASSISTANT EDITORS

Ravinder Thota (Pathology)

Rajamouli (SPM)

 

 NATIONAL ADVISORY BOARD

Sanjeev  Misra,  Director, AIIMS, Jodhpur

Rajesh Malhotra, AIIMS, New Dehi

 Prasanta Kumar Mitra, SMIMS, Gantok

Parvaiz A Koul, SIKIMS, Srinagar   

A U Siddiqui, AIIMS, Raipur.

Vikas Bhatia, AIIMS, Bhubaneswar

Pragna Rao ,Kasturba Medical College, Manipal

Janaki, M.G, M.S. Ramaiah Medical College, Bangalore

G.Bhasker, Osmania General Hospital, Hyderabad.

Prashant Kokiwar, MRIMS, Hyderabad.

J. MohanaKrishan, JIPMER, Puducherry.

 

 INTERNATIONAL ADVISORY BOARD 

Madhu SudanReddy Yakkanti, USA

Devendar Katkoori, USA


Volume 12 (2): July- December 2016_2

ORIGINAL ARTICLES

Study of Various Co-Morbid conditions in 6 months to 60 months in Age Group Children with Severe Acute Malnutrition

Manohar B, Mallikarjuna M, Padmini Priya B, Surendra Reddy N, NaveenKumar C, VenkataRamanaiah D

A Study of Maternal and Foetal Outcomes in Abruptio Placenta A Prospective Observational Study at CAIMS, Karimnagar

Pranathi Reddy L, Ramadevi E

Effect of Oral Clonidine as Premedication on Perioperative Haemodynamic response for Patients undergoing Laparoscopic Cholecystectomy

Syed Ali Aasim, Vimalatha P, Srikanth Reddy, Anilkumar K, Vishnuvardhan Reddy, Maheshwar Reddy

A Study of Cyto-Histological Correlation in the Diagnosis of Thyroid Swelling

Venkataramana N, Mangilal V, SasidharaRao, Prashanth S, Manoj, Aruna T

Study of Histopathological changes of Endometrium in Abnormal Uterine Bleeding

Aruna Kumari Pagalla, Shyam Sunder Kasapa

A Study to Assess Knowledge on Active Management of Third Stage of Labour (AMTSL) among Nurses in Labour/Delivery and Postnatal Units

Veronika Jones B, Padma B, Gigi Chacko, Shaik Shaffi Ahamed

A Clinical study on Nutritional Health status of Adolescent Girls studying in Urban Government Schools

Srinivas Madoori, Shesha Giri, Shanmuga Raju P, Subhan Basha, Praneet Reddy

Bacteriology of Urinary Tract Infection and Antibiotic Susceptibility Pattern at a Tertiary Care Hospital, Karimnagar

Archana Battula, Swetha G

A Study of State and Trait Anxiety in Medical College Students

Vishal A, Chilasagaram Shanthi, Preeti G, Nikhil Ravindranath T

CASE REPORTS

Gaint Lipoma of Thigh: A Case Report

Ramlingam P, Ashrith Reddy Ch, Dhanunjaya Rao Ginjupally

Xanthogranulomatous Oophoritis A Case Report

Sravanthi Yerragolla, Sumalatha Kasturi, Renuka Barkam, Vinuthna C, Sravani Ramaa Modey, Ravindra Thota

PICTORIAL CME

Strongyloidosis of Duodenum

SumalathaKasturi, Renuka Barkam, SravanthiYerragolla, Ravinder Thota

2016

   

Vol. 11(1): Jan-Jun 2016

 

 

Vol. 11(1): Jan-Jun 2016

EDITORIALS

The revised guidelines of the medical council of India for academic promotions: Need for a rethink

Rakesh Aggarwal, Nithya Gogtay, Rajeev Kumar, Peush Sahni

ORIGINAL ARTICLE

Management of subtrochanteric fractures of femur with proximal femoral nail: A prospective study

Nagamuneendrudu K, SriRanga Rao M, Sridhar S

Management of Subtrochanteric Fractures of Femur with Proximal Femoral Nail : A Prospective study

Nagamuneendrudu K, SriRanga Rao M, Sridhar S

ABSTRACT

Aim : The study aim was conducted to evaluate the outcome of management of 30 adult patients with sub trochanteric femoral fractures using proximal femoral nail(PFN).

Materials and Methods: This prospective study included 30 patients with sub trochanteric fracture admitted to Osmania General Hyderabad, who underwent intramedullary fixation with PFN from September 2012 to September 2014. Only fresh fractures within one week of injury were included in the study. Pathologic fractures, multiple fractures, fractures in children, old neglected fractures were excluded from the study.

Results: : In our study of 30 patients, mostly are of young patients average age is 37.53 years (range from 21-40 years), there were 25 male and 5 female. 73.33% of the patients admitted were road traffic accidents, 16.66% due to fall from height and 10% due to trivial fall with right side being more common side affected. Russell and Taylor type IB fracture accounted for 46.66%, 1A30%, 11A 23.33% of cases. Mean duration of hospital stay was12.6 days and mean time of full weight bearing was 14 weeks in our patients. All 30 patients, were followed up. Good to excellent results were seen in 83.33% of cases in our study.

Conclusion: PFN is a viable treatment option for sub trochanteric fractures with high rate of fracture union and minimal soft tissue damage. Intra medullary fixation has biological and biomechanical advantages, but the operation is technically demanding. Gradual learning and great patience is needed in order to make this method truly minimally invasive.

Keywords: PFN, Sub trochanteric fractures, russell and taylor


Efficacy of the addition of modified pilates exercises to a minimal intervention in patients with chronic non specific low back pain

Mahendran P, Nikitha Shekhar Amale, Milind Pimprikar, Sonali Dharurkar

Efficacy of the Addition of Modified Pilates Exercises to a Minimal Intervention in Patients with Chronic Non Specific Low Back Pain

Mahendran P, Nikitha Shekhar Amale, Milind Pimprikar, Sonali Dharurkar

ABSTRACT

Background : The Pilates method has been used to improve function and reduce pain in patients with chronic non specific low back pain, although there is little evidence that describes its efficiency.

Objective: The purpose of the study was to investigate the effectiveness of the addition of modified Pilates exercise to minimal intervention in patients with chronic low back pain.

Subjects: 30 patients with chronic non specific low back pain participated in the study.

Materials and Methods: All participants received an educational booklet containing information about low back pain and were randomly allocated to receive 12 sessions over 6 weeks of exercises based upon Pilates principles or of education alone.

Results: Improvements were observed in pain, disability in favor of pilates group after intervention.

Conclusion: The addition of the modified pilates exercises to an educational booklet provides small benefits compared with education alone in patients with chronic non specific low back pain.

Keywords: Modified pilates, non specific low back pain, roland- morris disability scale, oswestry low back pain scale


Randomized double blind comparative study of tramadol and dexmedetomidine for post spinal anaesthesia shivering

Syed Ali Aasim, Srikanth Reddy A, Vishnuvardhan Reddy, Maheshwar Reddy, Chandrakanth C

Randomised double-blind Comparative study of Tramadol and Dexmedetomidine for Post-Spinal Anaesthesia Shivering

Syed Ali Aasim, Srikanth Reddy A, Vishnuvardhan Reddy, Maheshwar Reddy, Chandrakanth C

ABSTRACT

Background and Aim: Dexmedetomidine (?2 adrenergic agonist) is used for prevention of post anaesthesia shivering. The aim of this study is to compare and evaluate the efficacy, adverse and haemodynamic effects of dexmedetomidine with that of tramadol, when used for control of post-spinal anaesthesia shivering.

Materials and Methods: A randomised, prospective, and double-blind study was conducted in 60 American Society of Anaesthesiologists Grade I and II patients of age between 18 and 65 years,either gender, scheduled for various surgeries under spinal anaesthesia. The patients were randomised in two groups of 30 patients each to receive either dexmedetomidine 0.5 ?g/kg or tramadol 0.5 mg/kg as a slow intravenous bolus. Onset of shivering, grade of shivering, time for cessation of shivering, response rate, recurrence and adverse effects were observed at scheduled intervals. Unpaired t-test was used for analysing the data.

Results: Nausea and vomiting was observed only in tramadol group (28% and 20% respectively).Time taken for cessation of shivering was significantly less with dexmedetomidine when compared to tramadol. There was not much difference in the sedation profile of both the drugs.

Conclusion: We conclude that although both drugs are effective, the time taken for cessation of shivering is less with dexmedetomidine group when compared to tramadol group. Moreover, dexmedetomidine has negligible adverse effects when compared to tramadol which is associated with significant nausea and vomiting.

Keywords: Dexmedetomedine , Tramadol , Post-spinal anesthesia shivering.


Dosimetry study for Post-Mastectomy Breast Cancer in Intensity Modulated Radiotherapy plans and Field in Field (FiF) forward plans

Chidambaram V, Ezhilarasi R, ShanmugaRaju, Anand Kumar P, Narayan Behera, Sunil Kumar V

Dosimetry study for Post-Mastectomy Breast Cancer in Intensity Modulated Radiotherapy plans and Field in Field (FiF) forward plans

Chidambaram V, Ezhilarasi R, ShanmugaRaju, Anand Kumar P, Narayan Behera, Sunil Kumar V

ABSTRACT

Aim: The aim of this study, to correlate the planning and delivery efficiency between three dimensional conformal radiotherapy, field in field forward planned intensity modulated radiotherapy (FIF-PF-IMRT) and inverse planned intensity modulated radiotherapy (IP-IMRT).

Materials and Methods: Treatment plans of 20 post mastectomy patients with left and right side breast cancer, treated to a prescribed dose of 50 Gy to the chest wall and to the supra clavicle fossa in 25 fractions. Treatment plans of 3DCRT, FIF-FP-IMRT plans were created by combining two open fields with three to four segments in two tangential beam directions and one anterior field, posterior oblique. Six to seven different beam directions were chosen to create IP-IMRT plans and were inversely optimized. The homogeneity of dose to planning target volume (PTV) and the conformity index were similar for 3DCRT and FP-FP-IMRT, whereas the IP-IMRT plans had better conformity index at the cost of less homogeneity. The 3DCRT and FIF-FP-IMRT plans gives the similar savingthe critical organs. In IP-IMRT gives heart and ipsilateral lung dose was higher than 3DCRT and FIF-FP-IMRT. Also contra lateral Breast receive low dose (0.1-3 Gy) in 3DCRT and FIF-FP-IMRT. Also in IP-IMRT opposite breast getting more than 5 Gy.

Results and Conclusion: Compared with 3DCRT and IP-IMRT, FIF-FP-IMRT gave a simple and good planning technique for breast irradiation. It gives dosimetric advantages of the minimal hotspot and good coverage to PTV. It felt that FIF-FP-IMRT needed less planning time and easy field placements.

Keywords: Post-mastectomy breast cancer, contra lateral breast, 3DCRT, field in field breast plans, intensity modulated radiation therapy, organ at risks


Review Article

Diabetic Ketoacidosis in children: A Systematic Review

Madoori Srinivas, Ramya C, Sridevi D, Dikshitha K

Diabetic Ketoacidosis in Children: A Systematic Review

Madoori Srinivas, Ramya C, Sridevi D, Dikshitha K

ABSTRACT

Diabetic ketoacidosis (DKA) is an acute life threatning complication of diabetes. It is the most common cause of death in children with type 1 diabetes and unfortunately majority of them present with DKA as an initial presentation. The objective of this article is prevention of DKA through early diagnosis and meticulous management of diabetes in children. Children with T1DM and their parents must be educated regarding DKA, in general and during stressful conditions like infections.

Keywords: Diabetic ketoacidosis, diabetes mellitus, children, prevention


CASE REPORT

Mucocele of appendix: case report and review of literature

Mangilal V, Suryanaryana Reddy, Sumalatha, Prashanth S, Manoj Kumar D

Mucocele of appendix: case report and review of literature

Mangilal V, Suryanaryana Reddy, Sumalatha, Prashanth S, Manoj Kumar D

ABSTRACT

Appendiceal mucocele is a rare disease. Sometimes it is discovered accidentally and sometimes it resembles acute appendicitis. Correct diagnosis before surgery is very important for the selection of adequate surgical treatment to avoid intraoperative and postoperative complications. Ultrasonography, and particularly computed tomography, should be used extensively for this purpose. If mucocele is treated incorrectly pseudomyxoma peritonei, which is characterized by malignant process, may develop.

We present a case of a 64-year-old woman who was admitted to the emergency department with the signs of acute appendicitis. Open surgery was performed. At the time of surgery cystic mass of appendix with dimensions 6.9X2.5cm, with inflamed walls, but without perforation was discovered in right iliac fossa. Only appendectomy was performed because no pathologic process was found in the base of the appendix and lymph nodes were not increased in size. Histopathologic diagnosis was mucosal hyperplasia of Appendix.

Keywords: Mucocele , pseudomyxoma peritonei, appendicitis


Secretory carcinoma of the breast

Sreenivas V, Arafeen Aisha , Ravinder T

Secretory carcinoma of the breast

Sreenivas V, Arafeen Aisha , Ravinder T

ABSTRACT

Secretory carcinoma of the breast is a rare variant with excellent prognosis and indolent clinical behavior. At the microscopic level, the presence of intracellular and extracellular secretory material is the most remarkable feature.We report a case of secretory carcinoma of the breast in a 90 year old female, with classic cytological findings.

Keywords: secretory carcinoma, cytological findings


Scalp arterio-venous malformation: Case report & review literature

Renuka Rao D, PVK Kishore, Jahnavi, Vinay

Scalp arterio-venous malformation: Case report & review literature

Renuka Rao D, PVK Kishore, Jahnavi, Vinay

ABSTRACT

Scalp arterio-venous malformation (AVM) is a rare condition that usually need surgical treatment. We report a rare case of scalp arterio-venous malformation(AVM). A 35 year old lady presented with a history of pulsatile palpable mass on right parieto-occipital region of scalp. Magnetic Resonance Anigiogram(MRA) of the scalp showed AVM over the right parieto-occipital region.

Keywords: Scalp arterio-venous malformation, magnetic resonance anigiogram(MRA), cirsoid aneurysm


LETTER TO THE EDITOR

Vestibular stimulation: A Neurophysiological intervention for parkinson’s disease

Archana R, Kumar Sai Sailesh, Jinu KV, Mukkadan JKs

2015

   

Vol.9(1):Jan-June 2015

Vol.10(2): July-Dec 2015

 

CONTENTS

ORIGINAL ARTICLES

Posterior Cervical Arthrodesis by Lateral Mass Screws Fixation A Long term Follow up Study

Bhaskar G, Sharath Kumar Maila, Lakshman Rao A, Mastan Reddy A

Posterior Cervical Arthrodesis by Lateral Mass Screws Fixation A Long term Follow up Study

Bhaskar G , Mastan Reddy A1, Sharath Kumar Maila2, Lakshman Rao A3, Mastan Reddy A4

ABSTRACT

Aim : Posterior cervical arthrodesis using lateral mass fixation by screws and rods is a very well known technique which has gained much popularity in the last two decades. We present here clinical results of 27 patients who were operated for cervical instability of different etiologies by lateral mass fixation at our institution. Results with long term follow up were analyzed.

Materials and Methods: All the patients admitted with cervical spine instability and having indication for posterior stabilization were subjects of the study. A total of 27 cases were operated during February 2010 to January 2015. A standard posterior lateral mass screw fixation and or pedicle screw fixations were done according to the requirement. Results were analyzed during regular followup which ranged from 6 months to 2 years.

Results: Neurologic improvement to the extent of self ambulation was seen in 8 of the 14 patients with traumatic quadriparesis. All patients in the non trauma group showed good clinical improvement. There were 6 deaths in this series in the peri-operative period, not related to the surgical procedure but due to the attendant medical problems. Good fusion was achieved in all the cases at the end of 3 months. There was no evidence of hard ware failure at the end of 2 year follow-up.

Conclusion: This study concludes a good clinical improvement and stable construct with good fusion during the log term follow up. This procedure has several advantages over traditional wiring techniques. Over all it is very safe and efficacious procedure in the hands of an experienced surgeon.

Keywords: Lateral mass fixation, posterior cervical arthrodesis, neurovascular relation


Efficacy of Dip Slide in Diagnosis of Urinary Tract Infection among Children

Kalavathy M, Earnest Daniel Prasad P, Kokiwar PR

Efficacy of Dip Slide in Diagnosis of Urinary Tract Infection among Children

Kalavathy M1,   Earnest Daniel Prasad P2, Kokiwar PR3

ABSTRACT

Background : In practices, clinicians await confirmation of urinary tract infection (UTI) with a written report which results in delay in diagnosis and treatment. Moreover if a heavy mixed growth is obtained, a repeat culture is warranted. If antibiotic therapy has been initiated already, a confident diagnosis cannot be made and unnecessary investigations and follow up are considered despite lack of clear evidence of initial infection. Empirical antibiotic therapy is also initiated during the week-ends when laboratory facilities are unavailable.

Aim : To study the applicability of dip slide in diagnosing UTI in children.

Subjects : This study includes 60 persons whose mean age was 73.17±5.81 years.

Materials and Methods : Subjects of the present study were selected from the hospital admissions of Kasturba Medical College, Manipal for a period of 9 months. Patients were selected employing the suitable selection criteria. Diagnostic methods like bacteria / HPF, urine analysis, dip slide, and bacteruria were used. Data analysis was done using proportions, sensitivity and specificity.

Results : There was a male preponderance. Fever and failure to thrive were the commonest symptoms (68.8%). Of the 21 cases of UTI 12 correlated with leukocytosis and 15 with fever. Hydronephrosis was the commonest abnormality detected in those cases with proven UTI.

Conclusion : The dip slide is an efficient, easy and reliable method of detecting UTI with a high specificity (100%) and sensitivity (90.4%) rate. The p value of dip slide in this study was 0.0000 which is statistically, highly significant.

Keywords : Urinary tract infection, dip slide, antibiotic therapy, diagnosis, efficacy


Knowledge, Attitude and Practices of Contraception in Rural area of Chhattisgarh

Kishori Nisal, Rekha Ratnani, Poonam Ghormode, Jindal M

Knowledge, Attitude and Practices of Contraception in Rural area of Chhattisgarh

Kishori Nisal1, Rekha Ratnani2, Poonam Ghormode3, Jindal M4

ABSTRACT

Background : In recent years, the need for knowledge, attitude and practices (KAP) studies to understand the factors determining the fertility and family planning acceptance and practices by particular communities has been felt, so that more specific knowledge can be gained about factors determining family planning acceptance by particular communities, which can then be used for developing suitable program for them.

Objectives : To study the knowledge, attitude and practices related to contraceptive methods.

Materials and Methods: A community based cross sectional study was conducted among 1000 women in the reproductive age group in the rural area of Chhattisgarh. Data was collected in the pre designed study questionnaire. Analysis was done by using proportions.

Results: Female sterilization was the most widely known method of contraception (98%) followed by male sterilization (95%). Mass media (television, newspapers) was the most common source of information about contraceptive methods (70.5%) followed by information from health personnel (55%). Contraceptive advice was accepted by 91% of the candidates. Most common reason for not using contraception was want of more children followed by religious reasons.

Conclusion: Knowledge of primary methods of contraception was good compared to the modern methods. Mass media (television, newspapers) is found to be playing a significant role in spreading awareness among rural population. 91% of the rural women were practicing the contraceptives.

Keywords : Contraceptive knowledge, attitude, sterilization, oral contraceptive


An Analysis of Setup Errors Using OnBoard Imager Technique in External Beam Radiotherapy for Different Cases in Radiation Oncology

Chidambaram V, Ezhilarasi R, Prashant G

An Analysis of Setup Errors Using OnBoard Imager Technique in External Beam Radiotherapy for Different Cases in Radiation OncologyCaims, Karimnagar

Chidambaram V1, Ezhilarasi R2, Prashant G3

ABSTRACT

Aim : The aim of this study was carried to verify the patient setup errors and immobilization reproducing on the aspects of quality assurance based. The treatment delivers to isocenter on different days and to document efficiency of reproducibility setup errors of treatment.

Materials and Methods: Retrospective study was done out of 80 patients in each cases of radiation treatment such as brain, head and neck, breast and pelvis from this 515 Kv images including CBCTs are taken from the OBI. This Kv images are obtained from OBI system which is attached in linear accelerator. Varian anatomy matching software was used and displacements of three dimensions X, Y and Z were noted to study the patient setup.

Results and Conclusion : This study was shown the probable range of systematic and random errors that occurs in the patient setup during the radiotherapy treatment. In that displacement we calculated mean and average values for different cases such as 4 mm mean deviation for lateral and longitudinal and vertical directions.

Key words: Onboard imager, Kv images, LINAC, immobilization mask, Varian anatomy software.


A Study to Assess the Knowledge and Practices on Nitrous Oxide as Labour Analgesia among Nurses in Labour and Delivery Units

Veronika Jones B, Padma B, Maranda Hernandez, Tengsy Thomas

A Study to Assess the Knowledge and Practices on Nitrous Oxide as Labour Analgesia among Nurses in Labour and Delivery Units

Veronika Jones B1, Padma B2, Maranda Hernandez3, Tengsy Thomas4

ABSTRACT

Aim:The aim of present study is to assess the knowledge and practice related to the administration of nitrous oxide as labour analgesia among staff nurses and midwives and to identify the gaps in knowledge and practice.

Materials and Methods: The overall aim of this study is to achieve safe administration of Nitrous oxide to the women in labour and to reduce the associated risks for the employees with administration. The research design was quasi experimental one group pre - test post – test by observation method using purposive sampling technique. A total of 34 nurses working in labour and delivery units in King Khalid University Hospital were selected. To test the statistical significance paired sample t - test was used and to test the relation between the demographic variables and the test scores, independent t- test and ANOVA were used.

Results: The results were compared with the latest scientific evidences to identify gaps in the nursing practice on safe administration of Nitrous oxide to the women in labour. A nursing protocol on safe administration of nitrous oxide in labour and delivery was prepared in line with the most recent and updated research findings for the desired outcome. There is significant difference in the pre and post test scores on knowledge of nurses with a mean difference 8.64 in scores, and is highly significant with a much higher ‘t’ value 14.450 and the ‘p’ value of <0.001.

Conclusion: The data over last 6 months shows 5-10% of women in labour are opting for epidural analgesia, while there is no record of information on usage of other modes of analgesia more specifically- Nitrous oxide in labour and delivery. The nurses in labour units have not been trained and educated specifically to the administration of entonox, hence it is been considered as an interesting area to be dealt with because of the wide application in the area.

Keywords: Nitrous oxide, entonox, labour analgesia, active labour.


CASE REPORTS

An Unusual Presentataion of Malakop lakia - Synchronous Affliction of Ureter and Bladder

Tyagi A, Vasanth Rao P, Bhavani Shankar G, Satish Babu P, Syama Sundara T

An Unusual Presentataion of Malakop lakia - Synchronous Affliction of Ureter and Bladder

Tyagi A1, Vasanth Rao P2, Bhavani Shankar G3, Satish Babu P4, Syama Sundara T5

ABSTRACT

Malakoplakia is an unusual inflammatory disease known to affect the genitourinary and gastrointestinal tracts, skin, lungs, bones, and mesenteric lymph nodes. Malakoplakia of the bladder and ureter is quite rare. A 26 year old male patient presented with complaints of right flank pain and history of urgency and frequency since 6 months and was diagnosed to have recurrent urinary tract infections. He was evaluated and found to have persistent right hydroureteronephrosis, multiple ureteric strictures. Bladder biopsy showed evidence of malakoplakia. Patient was initially treated with percutaneous nephrostomy and later by right double ‘J’ stenting. Post operative follow up showed no evidence of hydronephrosis and he was relieved of his complaints. This rare case of urinary bladder and ureter malakoplakia in a young male is presented to emphasize up on the fact that malakoplakia can still occur in young male with recurrent urinary tract infection especially in developing countries like India.

Keywords:  Malakoplakia, right double ‘J’ stenting, ureter, bladder


Falciparum Malaria with Multiple Neurological Complications A Case Report

Yogi M, Surender K, Prathibha P, Nagesh A

Falciparum Malaria with Multiple Neurological Complications A Case Report

Yogi M1, Surender K2,  , Prathibha P3, Nagesh A4

ABSTRACT

Malaria remains the common cause of childhood infections. A 2 year-old female child from a malaria endemic area was admitted to our hospital with high grade fever for 3 days, multiple episodes of generalized tonic clonic seizures (GTCS) for 1 day and altered sensorium on day 4. We report a case of falciparum malaria in a 2 year old girl presenting with seizures and other neurological deficits like hemiplegic, aphasia and cortical blindness.

Keywords: Falciparum malaria, neurological complications, plasmodium falciparum (PF) hemiplegia


A Rare Case of Multiple Soft Tissue Metastases from Carcinoma Breast

Aruna T, Sreedhar Ragi, Aruna Kumari Pagalla, Arun Katari, Neha Gaur, Ravinder Thota

A Rare Case of Multiple Soft Tissue Metastases from Carcinoma Breast

Aruna T1, Sreedhar Ragi2, Aruna Kumari Pagalla3, Arun Katari4, Neha Gaur5, Ravinder Thota6

ABSTRACT

We are presenting a case of multiple soft tissue metastases from carcinoma breast. 52 year old patient presented with multiple swellings situated over chest, abdomen, axilla, neck and forearm. The patient was giving past history of lumpectomy right breast 4 years back for which histopathological diagnosis is not available. Histopathology, FNAC and IHC confirmed the diagnosis as soft tissue metastases from carcinoma breast. Multiple soft tissue metastases from carcinoma breast even though is a rare occurrence, can present in an advanced stage of the disease as in our case.

Keywords:  Multiple soft tissue lesions, metastasis, carcinoma breast.                   


A Rare case of Instestinal Obstruction due to Meckels Diverticulum with band in Post operative Appendectomy Boy

Mangilal V, Suryanarayana Reddy V, Prashant G, Satyadev, Rajeev Reddy, Vamshikrishna

A Rare case of Instestinal Obstruction due to Meckels Diverticulum with band in Post operative Appendectomy Boy

Mangilal V1, Suryanarayana Reddy V2, Prashant G, 3, Satyadev4, Rajeev Reddy5, Vamshikrishna6

ABSTRACT

Meckel’s diverticulum is the commonest type of congenital anomaly of small intestine, commonly seen in 2% of the population, seen two feet away from the ileo-caecal junction, with 2 cm in length and usually consisting of two types of heterotrophic mucosa. In our case report, we deal with a presentation of the condition in post appendectomy boy, clinical course, surgical management and post-operative care for meckel’s diverticulum with band. We also briefly review on the latest literature and investigative modalities for the conditions along with best management modalities.

Keywords:  Meckel’s diverticulum, explorative laparotomy.


A Rare case of True Broad Ligament Leiomyoma Mimicking an Ovarian Tumor

Kavitha V, Rama Devi E, Leela R, Sasi priya A

A Rare case of True Broad Ligament Leiomyoma Mimicking an Ovarian Tumor

Kavitha V1, Rama Devi E2, Leela R3, Sasi priya A4

ABSTRACT

Broad ligament is a very uncommon site for presentation of leiomyoma. On account of their size and nature (pedunculated or sessile), clinically leiomyomas may present variably. We are presenting a rare case of leiomyoma of broad ligament in a 50 year old female patient who presented with complaints of lower abdominal pain of one month duration, with normal menstrual cycles. On clinical and ultrasound examination there was a left sided mass in the pelvic region suspected to be an ovarian mass/ subserosal fibroid. MRI (magnetic resonance imaging) confirmed the diagnosis of left broad ligament fibroid and Total abdominal hysterectomy with bilateral salpingo-oopherectomy was done. On histopathology, it was confirmed to be a soft tissue tumor–Leiomyoma. We are reporting this interesting case with clinical, radiological, and histopathological findings for its rarity.

Keywords: True broad ligament, ovarian tumor.


Anaesthetic Management for Post Burn Contracture- A Unique Challenge in Airway Management

Rajeeth Kumar Reddy K, Syed Aasim Ali, Maheshwar Reddy K, Vishnuvardhan Reddy, Anil K

Anaesthetic Management for Post Burn Contracture- A Unique Challenge in Airway Management

Rajeeth Kumar Reddy K1, Syed Aasim Ali2, Maheshwar Reddy K3, Vishnuvardhan Reddy4, Anil K5

ABSTRACT

Managing the airway of post burn contracture of neck has always been challenging to anaesthesiologists as it limits the alignment of oro-pharyngo-laryngeal axes because of functional and anatomical deformities that occur as a result of long standing contractures. Post burn contracture (PBC) not only restricts the movement of neck but can also lead to restriction in mouth opening, respiratory difficulty, alteration in position of trachea and distortion of cervical spine.

Keywords : Difficulty airway, post burn contracture, airway management.


Lumbar Intradural Extramedullary Haemangioma

Kishore PVK, Hemaratnan A, Sreenivas V, Sandeep Goud, Varun Babu A, Prashanth S

Lumbar Intradural Extramedullary Haemangioma

Kishore PVK1, Hemaratnan A2, Sreenivas V3, Sandeep Goud4, Varun Babu A5, Prashanth S6

Abstract

Vascular malformations with histopathological features of more than a single type of malformation present within the same lesion have been previously described. These lesions are very rare and named as mixed vascular malformations. So far only 57 cases have been reported in the literature. We report a case of a lumbar intradural extramedullary capillary hemangioma due to its rarity.

Keywords: vascular malformation, capillary haemangioma, haemangioma.


PICTORIAL CME

Cavum Velum Interpositum Cyst

Naveen Kumar S, Vidyadhara Rani P, Shanmuga Raju P

Cavum Velum Interpositum Cyst

Naveen Kumar S1, Vidyadhara Rani P2, Shanmuga Raju P3

ABSTRACT

A 7 days old baby was referred to MRI in view of interhemispheric cystic lesion in brain diagnosed during routine antenatal obstetric scan of patient. Baby was delivered, cried immediately after birth and accepting feeds well.

CONTENTS

ORIGINAL ARTICLES

Caregiver burden and psychopathology in schizophrenia: A cross sectional study

Mirayala Gireesh Kumar, Pavan Kumar, Sai Sudha Gorthi NV, Neredumali Prasanna Kumar

Caregiver burden and psychopathology in schizophrenia: A cross sectional study

Mirayala Gireesh Kumar, Pavan Kumar, Sai Sudha Gorthi NV, Neredumali Prasanna Kumar

Abstract

Introduction : In developing countries like India where there is dearth of resources, major share and burden of caretaking of mentally ill patients is taken up by family members. Although lot of literature is available on caregiver burden and its correlates, there is only limited literature on caregiver burden in relation to various stages of schizophrenia and its implications. Our study was conducted to bridge this gap

Material and Methods: : A cross-sectional study of sixty chronic schizophrenia patients admitted to IMH, Hyderabad from January 2015 to April 2015, were studied along with their primary caregivers. Burden Assessment Schedule (BAS), Positive and Negative Syndrome Scale (PANSS) were the scales used.

Results : Negative symptoms were found to be better correlated with caregiver burden than positive or general psychopathology scores(R = 0.39, p = 0.0019). The implications of this finding were discussed.

Conclusion : Chronic stage is characterised by predominant negative symptoms and consequently high caregiver burden. Thus, different interventions are needed for both patients and caregivers in different stages.

Keywords : Care giver burden, schizophrenia, BAS, PANSS


Bacteriological profile of diabetic wound infections with special reference to drug resistance

Sabarinathan T, Aruna rajkumari V, Krishnamurthy S, Khalid Rashid, Amar CS, Yamini K

Bacteriological profile of diabetic wound infections with special reference to drug resistance

Sabarinathan T, Aruna rajkumari V, Krishnamurthy S, Khalid Rashid, Amar CS, Yamini K

Abstract

Aim : A prospective study was carried out on patients with diabetic foot lesions to determine their clinical characteristics, spectrum of microbial flora and asses their comparative in vitro susceptibility to the commonly used antibiotics.

Material and Methods: : A total number of 100 cases of diabetic wound infections were screened for aerobic and anaerobic isolates. 50 non-diabetic patients with wound infection were screened for aerobic and anaerobic isolates which is taken as control.

Results and Conclusion :Out of 100 wound swabs collected from diabetic wounds, 44 samples were culture positive. From 44 cultures positive samples 48 aerobic bacteria were isolated. Among the 44 culture positive samples 40 were monomicrobial, whereas rest of the 4 culture positives revealed polymicrobial isolates. The incidence of diabetic wound infections were more among males and prevalence is more among the age group 40 – 69 years (mean age of incidence is 59.69 ± 9.71 years).

In the present study Pseudomonas aeruginosa was the predominant isolate followed by Staphylococcus aureus, Escherichia coli, Klebsiellapneumoniae, and Staphylococcus epidermidis. The incidence of wound infection is more among the diabetic patients when compared to non-diabetic patients because several immune defence mechanisms are defective like decrease in leukocyte chemotaxis, phagocytosis and defective intracellular killing. In the present study Pseudomonas aeruginosa 7(20.59%) was the predominat ESBL producer, followed by Klebsiellapneumoniae 4(11.76%) and Escherichia coli 3(8.82%). Total ESBL producers in gram negative isolates was 41.18%. Metalobetalactamases production among the Pseudomonas aeruginosa was 16.67%. The results also had shown the polymicrobial nature of the diabetic wound infection.

Keywords : Diabetes, wound, MRSA, ESBL, MBL


Combined therapy approach of treatment for complex anal fistula: A prospective study

Bapurapu Rajaram, Araboina Upender, Dodda Ramesh Kumar, Madipeddi Venkanna, Ravula Jagadeswar Goud

Combined therapy approach of treatment for complex anal fistula: A prospective study

Bapurapu Rajaram, Araboina Upender, Dodda Ramesh Kumar, Madipeddi Venkanna, Ravula Jagadeswar Goud

Abstract

Aim : To evaluate the efficacy of combined therapy approach of treatment for complex anal fistula in terms of recurrence rate and anal incontinence

Material and Methods: : Seventy six (76) patients with complex anal fistula, were managed with combined therapy approach of treatment with Surgery, Medical(ATT-anti-tuberculosis treatment), Seton (Khshar sutra) at MGM Hospital, Kakatiya Medical College, Warangal from September 2010 to October 2015. The results were analysed.

Results : Seventy six (76) patients were treated during the five years of study period with the age (mean ± standard deviation) of 32 ± 5 years. The seton (Kshara sutra ) was tightened with a median of 5 times (3–15 times range). All (76) the cases were treated initially with Surgitherapy. 62 cases required ATT (81.5%). 14 cases required setontherapy (18.4%) .All the patients were followed up for incontinence and recurence for minimum period of six months. 71 patients were cured (93.4%), three (2.6%) patients developed mild flatus incontinence (2.6%) with ugly scar and two patients had recurrent fistula (3.8%).

Conclusion :The combined therapy approach treatment with surgery, medical (ATT), seton (khshara sutra) for complex anal fisula is safe, cost effective, low morbidity option with low recurrence rate and minimal anal incontinenece. Hence it should therefore be recomended as the standard of treatment for complex anal fistula.

Keywords : Complex anal fistula, kshara sutra, recurrence, incontinence


Skin and Pregnancy- A clinical study

Dasari Kavitha, Narender Gajula, Sirisha Varukuti, Anusha K, Sindhu V, Anji Babu J

Skin and Pregnancy- A clinical study

Dasari Kavitha, Narender Gajula, Sirisha Varukuti, Anusha K, Sindhu V, Anji Babu J

Abstract

Introduction : During pregnancy many metabolic, endocrine ,vascular and immunologic changes occur, that are responsible for the changes of the skin and its appendages. Both physiologic and pathological alterations ,ranging from trivial cutaneous changes to changes that are pathological, recurrent and specific to pregnancy can occur. Pregnancy may also alter the course of preexisting dermatological diseases and tumors.

Aim : To find out the pattern and frequency of skin changes in pregnant women.

Material and Methods: : The study was conducted on pregnant females attending the outpatient Department of Gynecology and Obstetrics of our Hospital, CAIMS Karimnagar over a period of 1 year from January 2014 to December 2014.

Results : A total of 408 pregnant women were included in this study. Of these, 202(49.5%) pregnant women were primigravida and 206(50.49%) were multigravida. Skin changes grouped into: physiological changes (all cases), specific dermatoses (11cases) and other dermatoses affected by pregnancy (59 cases). Most common physiological changes were pigmentary alterations (Linea Nigra) seen in 364 (89.2%) followed by striae seen in 350(85.78%) cases. Of the various specific dermatoses of pregnancy, pruritic urticarial papules and plaques of pregnancy (PUPPP) was the most common disorder (5 cases) followed by pruritus gravidarum (4 cases). And other specific dermatoses were Pemphioid gestationis & prurigo gestationis of Besnier. The most common dermatoses affected by pregnancy were candidal vaginitis (15 cases), acne vulgaris (11 cases), eczemas (8 cases) tinea corporis (3 cases) skin tags (3 cases).

Conclusion :: The present study highlights the physiological changes as well as specific dermatoses of pregnancy. Early diagnosis of specific dermatoses of pregnancy may prevent harmful effect on mother and fetus. The pruritic eruptions of pregnancy, which are not a rare entity, can be a source of significant distress to the pregnant female &need timely therapeutic intervention.

Keywords : Linea Nigra , PUPPP, pruritus gravidarum, pemphioid gestationis


Awareness, knowledge and attitude towards glaucoma in rural eye camps of karimnagar, Telangana - A questionnaire based study

Rahu V, JVN Reddy, Anil Kumar Bhupally, Swathi M, Rohini M, Tulasi Priya, Priyanka

Awareness, Knowledge and Attitude towards Glaucoma in Rural Eye Camps of Karimnagar, Telangana – A Questionnaire Based Study

Rahu V, JVN Reddy, Anil Kumar Bhupally, Swathi M, Rohini M, Tulasi Priya, Priyanka

Abstract

Aim : The aim of this study is to evaluate level of awareness about glaucoma and attitude towards importance of eye screening among rural population of Karimnagar.

Material and Methods: : A questionnaire based study with a sample size of 8000 randomly selected from people in surrounding villages of Karimnagar through health camps from the institute, and were interviewed face to face with a pre structured questionnaire. The questionnaire is to evaluate level of awareness and knowledge about glaucoma and their attitude towards importance of screening for the disease.

Results : Awareness about glaucoma was very poor in the rural population, and females are less aware compared to males and illiterates are less aware compared to literates. Among the 8000 people who enrolled in the survey, the responses from 7635 (95%) participants - 2596 (34%) who were aware of the term glaucoma, 1450 (19%) who know glaucoma causing blindness, 153 (2%) have proper knowledge about disease course. 2825 (37%) showed positive attitude for eye screening, participants 4810 (63%) showed negative attitude.

Conclusion :: There is lack of awareness about glaucoma causing blindness and the attitude for seeking intervention for glaucoma was not encouraging. There is unmet need of community based health education towards eye care to reduce ocular morbidity and irreversible blindness from glaucoma among rural population of Karimnagar.

Keywords : Awareness, attitude, glaucoma, knowledge, rural Karimnagar


Effect of obesity on anti oxidant enzymes and type 2 diabetes

Jhansi Rani C, Sarojini C, Vijaya Chandra Mouli, Bhagya Seela

Effect of Obesity on Anti Oxidant Enzymes and Type 2 Diabetes

Jhansi Rani C, Sarojini C, Vijaya Chandramouli, Bhagya Seela

Abstract

Introduction : Obesity has become a major health problem in both developed and under-developed countries. Obesity represents an abnormal accumulation of adipose tissue resulting from chronic over nutrition and reduced physical activity. The aim of this study was to determine the effect of obesity on anti-oxidant enzymes and type-2 diabetes.

Aim : The present work aimed at investigating the effect of obesity on type-2 diabetes and anti-oxidant enzyme activity.

Material and Methods: : A total of 50 Subjects (32 males, 18 females) aged > 35 years were selected from Chalmeda Anand Rao Institute of Medical Sciences, Bommakal, Karimnagar. Obesity is determined by the body mass index(BMI). Lipid peroxidation was determined by measurement of thio-barbituric acid reactive substances (TBARS) in plasma of the patients. The anti-oxidant enzymes superoxide dismutase was assayed.

Results : The mean and S.D of Malondialdehyde of controls is 240 + 1.14 as compared to 619 + 0.91 in cases. The mean S.D. of superoxide dismutase of controls 100.2 + .67 and the mean S.D. of cases 50.04+4.69. The mean and S.D. of fasting serum glucose in controls is 88.33+ 6.78 as compared to 146.30 + 11.68 in cases. The mean and S.D of serum total cholesterol, triglycerides, VLDL-C LDL-C in controls are 163.28 + 5.98, 136.88 + 14.62, 26.68 + 2.32, 90.04 + 6.14 respectively as compared to 214.16 + 10.77, 190.56 + 13.77, 38.08 + 2.69, 141.36 + 11.32 in cases. The mean and S.D of serum non HDL-C and TG/HDL-C in controls are 118 + 12.88 and 2.88+ 0.40 respectively as compared to 179.4 + 11.30 and 5.85 + 0.66 respectively in cases. The mean and S.D. of TC/HDL-C in controls is 3.5 + 0.35 as compared to 6.54 + 0.69 in cases.

Conclusion :: Our study was concluded that obesity even in the absence of smoking, renal or liver disease can decrease the body’s protective anti-oxidants and enhance the systematic oxidative stress.

Keywords : Obesity, antioxidant enzymes, oxidative stress, type 2 diabetes


Surgical management of doso-lumbar spinal injuries with posterior instrumentation

Jhatosh Ventateshwarlu, Venkateshwar Rao T, RamKumar Reddy K, Hanmandlu B

Surgical management of doso-lumbar spinal injuries with posterior instrumentation

Jhatosh Ventateshwarlu, Venkateshwar Rao T, RamKumar Reddy K, Hanmandlu B

Abstract

Introduction : Thoracolumbar segment is second most commonly involved segment in the spinal cord following spinal injuries followed by cervical segment. The goal of treatment of every spinal injury is restoration of the patient to maximum possible function with disability free life. In this study, we stabilize the cases of the unstable thoracolumbar spine injuries with or without decompression and pedicular screw & rod instrumentation. We have evaluated all patients for maintenance of spinal correction and neurological improvement after posterior instrumentation in thoracic and lumbar spinal fractures and clinical outcome in terms of spinal scoring system called as Denis work and pain scale.

Material and Methods: : Twenty adult patients (13 male and 7 female) who underwent posterior instrumentation with pedicle screw and rod system for acute thoracolumbar injuries at single institution were included in this prospective study. The average age of the study group was 38 years.

Results : Fall from height was the main mode of injuries. The most common vertebrae involved in this series were between T11 - L2 to the extent up to 75%. In 75% of the patients, the fractures were reduced by using polyaxial implants and in 25% of the patients both monoaxial and polyaxial implants were used. The average regional angle during pre-operative stage was 16.50 ± 5.020 and 4.450 ± 4.150 during 1 year post-operative period. There was a significant difference between pre op and post-operative regional angles. The mean difference of vertebral height between pre and 12th postoperative week was 8.8 mms, pre and 24th postoperative week was 7.95 mm and pre and 1 year post-operative period was 7.95 mm. During 1 year post-operative period, ASIA grade A was 5%, grade B was 0%, C was 5%, D was 20% and E was 70%. Among all the subjects 20% of the patients returned to their previous work or physically challenging job and 35% were able to return to previous employment to heavy labour with some restriction. About 45% of the patients had no pain and 30% had occasional minimal pain with no need for medication at the end of one year follow up period.

Conclusion :There is restoration of vertebral body height, mean regional angle and mean anterior wedge angle with posterior instrumentation in thoracolumbar fractures. Neurological recovery was seen significantly when all cases with neurological deficits were clubbed together as per ASIA grading. Improved clinical outcome, in terms of work capacity and decrease in pain according to Denis work scale and Denis pain scale respectively.

Keywords : Thoracolumbar fractures, posterior instrumentation, pedicle screw


A study on evaluation of immunization status under five years and breast feeding practices under RHTC area Karimnagar District

Rajamouli J, Ravinder A, Madhusudan S

A study on evaluation of immunization status under five years and breast feeding practices under RHTC area Karimnagar District

Rajamouli J, Ravinder A, Madhusudan S

Abstract

Introduction : Community based cross sectional study was conducted in the field practice area of Rural Health Training Centre (RHTC) to find out the immunization status of under five children and breast feeding practices among below poverty line and above poverty line group (A.P Classification)from 1st June 2014 to 30th September 2014.

Objectives : 1) To evaluate immunization status of under five children in rural health training centre (RHTC) practicing area.

2) To assess the breast feeding practices under RHTC - Manakondur 1st and 2nd sub centres and Annaram sub centre.

Material and Methods: : Community based cross sectional study was conducted in the field practice area of Rural Health Training Centre(RHTC), Karimnagar.

Results : Mean age of children in the study is 40.7 months with standard deviation of 22.52. Children were immunised (94.37%) up to date. At birth immunisation of children is 99.5%, whereas there is drastic fall (69.3%) in the immunisation of booster doses of DPT,OPV with comparison previous years. Only one child in the present study was not immunized for second dose because of fear of previous reactions. Up to date immunisation status is little lower in below poverty line when compared with above poverty line socio-economic group. The study findings revealed that all the children were breast fed (100%). Initiation of breast feeding within an hour was practiced by only a few mothers (10%). 95% babies were exclusively breast fed till six months. 69% of mothers have continued breast feeding when child is suffering from diarrhoea. only 40% of mothers are aware about birth spacing by contraception

Conclusion :Breast feeding was popular in rural women, though their knowledge it needs to be improved the feeding practices which directly influences the health of the child. To achieve 100 % Full Immunisation has to be improved though at birth immunisation is 99.5% but full immunisation along with booster doses has to be improved by BCC methods. The information regarding the advantages of full immunisation needs to be provided for the community as a whole. Special health education camps and community mobilisation may help in identifying and referring the children for vaccination.

Keywords : Immunization status, breast feeding practice


Use of cardiotogram (CTG) as an admission test as predictor of fetal outcome in labour in low risk group

Ramadevi E, Madhavi GB, Pranathi Reddy L, Anusha Rao P

Use of Cardiotocogram (CTG) as an Admission Test as Predictor of Fetal Outcome in Labour in Low Risk Group

Rama Devi E, Madhavi GB, Pranathi Reddy L, Anusha Rao P

Abstract

Introduction : Intrapartum fetal morbidity and mortality is not uncommon in a low risk population. If for some reason continuous monitoring cannot be applied, alternative ways of using monitors might be of interest. Such an alternative is the admission test. Objective of the study was to evaluate the role of cardiotocogram (CTG) and to study fetal outcome in low risk group.

Material and Methods: : The study population consisted of 200 low risk patients in labor admitted at Chalmeda Anand Rao institute of medical sciences, Karimnagar during the period of 2013-2015. Patients were subjected to admission test using Philips Avalon FM20 fetal monitor at speed of 1cm/min for 20 minutes. The trace thus obtained will be classified as normal, suspicious and pathological AT. Admission test results were compared with various labor outcome variables i.e., Incidence of fetal distress, mode of delivery, neonatal outcome in relation to AT result.

Results : In this study, there were 168 patients (84%) with normal AT, 14 patients (7%) with suspicious AT, 18 patients (9%) with pathological AT and therefore, a total of 16% patients had abnormal AT. The incidence of fetal distress (88.88% vs. 7.73), caesarean section rate (94.44% vs. 7.73%), low Apgar score at 5’ (50% vs. 4.87%), NICU admission (55.55% vs. 4.76%) was higher in pathological AT group than in normal AT. The sensitivity of the admission test in predicting fetal distress was 57.89%, specificity was 93.82%, and the positive & negative predictive values were 68.75% & 90.47% respectively.

Conclusion :The admission cardiotocography is a simple noninvasive test that can serve as screening tool to detect fetal distress already present or likely to develop and prevent unnecessary delay in intervention. The test has high specificity and can help in ‘triaging’ fetuses in obstetric wards of developing countries with a heavy workload and limited resources. Admission test in this study was helpful in reducing the neonatal morbidity by early intervention in pathological admission test group even when its sensitivity is low in detecting distressed fetus

Keywords : CTG, fetal distress, low risk pregnancy, apgar score, perinatal outcome


Management of fracture of distal end of femur by of different methods: Prospective comparative study

Nagamuneendrudu K, Prabhudheer, Rakesh, Ramakrishna Reddy

Management of fracture of distal end of femur by of different methods: Prospective comparative study

Nagamuneendrudu K, Prabhudheer, Rakesh, Ramakrishna Reddy

Abstract

Aim : This study is done to elucidate current treatment strategies as well as their evidence based rationale. The commonly done surgical techniques with internal fixation are outlined, the rationale of indications are discussed and the rationale of selection of the procedures are concluded.

Material and Methods: : In this prospective study, carried out at Osmania General Hospital, Dept. of Orthopaedics, Hyderabad from August 2011to July 2013. A total of 52 patients were identified based on defined inclusion and exclusion criteria and constituted the sample. The following variables of each patient record were analyzed, Age, sex, mechanism of fracture, type of fracture according to the AO/ ASIF classification, surgical treatment modality, during the follow-up at postoperative weeks 4, 8 and 12 the following variables were recorded: range of motion of the knee joint, radiologic evidence of healing, and complications. The results obtained at 6th month were assessed using the Neer scale 20.

Results : 52 patients are treated with different with three deferent implants, buttress plating (18cases), Locking plating (17 cases), Retrograde nailing (17 cases). The mean age of the patients was 29 years (range, 18–79 years). 43 are men and 9 women. 22 are supracondylar (AO type A) fractures 7 partial articular(AO Type B)and 23 intercondylar (AO type C) fractures (Table). 17 fractures were open (Gr 1 & 2), and the remaining cases are closed fractures. 38 cases are high velocity and 14 cases are of low velocity. The mean time required to achieve union was 4.3 months (range, 3.0–12.6 months).The healing is good the functional outcome is good, in all cases.

Conclusion : The MIPO-Minimally Invasive Plate Osteosynthesis, LISS less invasive stabilization system is preferred. In the elderly patients with a thin metaphyseal cortex and osteoporotic bone, and wherever one expects to find osteopenic bone, LCP is preferred. Supracondylar nailing is useful for fixation of supra- condylar and less comminuted inter condylar fractures. The simplicity of the procedure also facilitates fracture fixation in patients with multiple trauma, No significant differences were found in the degree of bone healing. The recovery range movement is better with plating, more so with minimally invasive technique, of the two methods of plating locking plate is mechanically more advantageous over the buttress plate, more useful in osteopenic bones and in fractures with comminution.

Keywords : Fracture of distal of femur, neer scale, ASIF


CASE REPORTS

A rare case of herlyn werner wunderrich syndrome- Role of MRI in diagnosis

Santhosh Babu R, Praneeth Kumar K, Narender Reddy P, Ravi Kiran G, Naveen Kumar S

A Rare Case of Herlyn Werner Wunderlich Syndrome - Role of MRI in Diagnosis

Santhosh Babu R, Praneeth Kumar K, Narender Reddy P, Ravi Kiran G, Naveen Kumar S

Abstract

Herlyn werner wunderlich syndrome (HWWS) is a rare congenital mullerian ductal Anomaly (MDA) characterised by the triad of uterus didelphys, obstructed hemivagina and ipsilateral renal agenesis. It generally occurs at puberty and exhibhits non-specific and variable symptoms with acute or chronic pelvic pain shortly following menarche, causing a delay in diagnosis. Moreover, the diagnosis is complicated by the infrequency of this syndrome, because mullerian ductal anomalies are infrequently encountered in a routine clinical setting. We report here a 15 -year-old female presenting with secondary amenorrhoea and pain abdomen where magnetic resonance imaging (MRI) suggested the diagnosis of HWWS.

Keywords : Herlyn-Werner-Wunderlich syndrome, Magnetic resonance imaging, Mullerian ductal anomaly


An overview of delayed presentation of traumatic diaphragmatic hernia

Mangilal, Lalith, Vamshikrishna, Prashanth S

An Overview of Delayed Presentation of Traumatic Diaphragmatic Hernia

Mangilal, Lalith, Vamshikrishna, Prashanth S

Abstract

The first traumatic diaphragmatic hernia was reported by Sennertus in 1541. The first two deaths were described by Ambrose Paré in 1578, one from strangulated bowel. The diaphragm is the major muscle of respiration. Diaphragmatic excursion and chest wall expansion increase the negative intrathoracic pressure required for inhalation. The sequelae from diaphragmatic rupture and subsequent herniation of intra-abdominal contents are associated with significant morbidity and mortality. Diaphragmatic hernias can be divided into the following two categories: Congenital defects, Acquired defects.

Congenital diaphragmatic hernias (CDHs) occur because of embryologic defects in the diaphragm. Most patients with CDH present early rather than late in life; however, a subset of adults may present with a congenital hernia that was undetected during childhood. Acquired diaphragmatic hernias stem from all types of trauma, with blunt forces accounting for the majority.

Keywords : Diaphragmatic hernia, strangulated bowel


PICTORIAL CME

Pneumocystits jeroveci pneumonia

Sumalatha Kasturi, Santhosh Babu Rendla, Sandhya Rani Bojjam

Pneumocystis Jeroveci Pneumonia

Sumalatha Kasturi, Santhosh Babu Rendla, Sandhya Rani Bojjam

40 year old male presented with fever, productive cough and shortness of breath for 2 months. Chest x-ray showed bilateral opacification with doubtful mass lesion in right upper lobe. Right upper lobectomy was done and the specimen sent for histopathological examination. Cut section of specimen showed gray white to gray brown areas without a mass lesion.


2014

   

V.7 (1): 1-74 Jan-Jun

V.8 (2): 77-145 Jul-Dec

CONTENTS

ORIGINAL ARTICLES

A comparative evaluation of 0.5% hyperbaric ropivaccine with 0.5 hyperbaric bupivaccine for subarachnoid block elective below umbilical surgeries

MA Qadeer Khan, Syamsundara Rao B, SA Aasim

A Comparative Evaluation of 0.5% Hyperbaric Ropivacaine with 0.5% Hyperbaric Bupiva-caine for Sub-Arachnoid Block for Elective below Umbilical Surgeries

MA Qadeer Khan1, B Syamasundara Rao2, SA Aasim3

ABSTRACT

Aim : To compare the onset and duration of sensory and motor blockade of intrathecal 0.5% hyperbaric ropivacaine  and 0.5%  hyperbaric bupivacaine for elective below umbilical surgeries.

Materials and Methods: A prospective randomized study was conducted with forty ASA (American society of Anaesthesiologist) grade I and II patients undergoing lower-abdominal or lower-limb surgery under subarachnoid who were selected to receive 3ml of 0.5% hyperbaric ropivacaine  (Group R) or 3 ml of 0.5% hyperbaric bupivacaine (Group B)  randomly. The onset, duration of sensory and motor block and side-effects were observed.

Results: The sub-arachnoid block with the study drugs in both the groups was adequate for the surgery, but there were significant differences in mean time of onset of sensory block.The level of sensory blockade was tested by pinprick and time taken for onset of analgesia at T10 was more rapid in Group R (2.9 + 1.04 minutes) than for Group B (5.3 + 1.34 minutes). In group R, the maximum level of block attained was T7 in 50 % of the cases, whereas it was T6 in 60 % of cases in group B. The total duration of sensory block was shorter in Group R (P=0.0001). The degree and duration of motor block were greater in group B when compared to group R. Mean time taken for complete regression of sensory block was (160 + 9.65 minutes) with group R compared with (201 + 8.65minutes) with group B.

Conclusion: 0.5% hyperbaric ropivacaine provides a reliable and a good quality sub-arachnoid block with better haemodynamic stability but with shorter duration when compared to 0.5% hyperbaric bupivacaine.

Keywords: Local anesthetics 0.5% hyperbaric bupivacaine, 0.5% hyperbaric ropivacaine


Relationship between dual task performance and walking speed in elderly

Mahendran P, Kandarpa Jyoti Das

Relationship Between Dual Task Performance and Walking Speed in Elderly

Mahendran P1,  Kandarpa Jyoti Das2

ABSTRACT

Aim : Cognitive function specially attention and fast memory processing plays a major role in gait performance. But very limited studies have explored the relationship between dual task performance and walking speed in elderly. So this study is aimed to determine the relationship between dual task performance and walking speed in elderly which can be helpful in gait training to minimize the risk of fall.

Subjects : This study includes 60 persons whose mean age was 73.17±5.81 years.

Materials and Methods : Subjects cognitive function was determined by using mini-mental state examination (MMSE) and balance by Berg balance test (BBT). Those who scored MMSE>24 and BBT>45 were selected for the study and underwent walking speed evaluation for both normal and dual task.

Results : Correlation between age and walking speed in both normal and dual task were negative. There was a significant relation between cognition balance and walking speed in both normal and dual task. Correlation between normal and dual task walking speed were also positive (P>0.001). Due to the results of regression analysis in order to find out the variables most affecting the walking speed.

Conclusion : The study concluded that in elderly people walking speed decreases during dual task due to balance and cognition problem because of advancing age but balance plays a major role in dual task walking. Hence changes in performance while dual task walking could be used to identify subjects who have poor balance and are at risk of falls.

Keywords : Walking speed, elderly, dual task


Evaluation of cardioprotective effect of nigella sativa oil in daunorubicin induced cardiotoxicity in albino rats

Govardhan Reddy Kasireddy, Mohd Moshin, Ravinder T, Pushpalatha Chinnam

Evaluation of Cardioprotective Effect of Nigella Sativa Oil in Daunorubicin Induced Cardiotoxicity in Albino Rats

Govardhan Reddy Kasireddy1, Mohd Mohsin2, Ravinder T3, Pushpalatha Chinnam4

ABSTRACT

Aim : The main objective of the present study was to see the cardioprotective effect of nigella sativa oil (N.S oil) in daunorubicin (DNR) induced cardiotoxicity in albino rats

Materials and Methods: The effect of nigella sativa oil in daunorubicin induced cardiotoxicity was studied in albino rats. The animals were divided in to 4 groups with 6 rats in each group. Group I served as vehicle control, Group II animals were given only Nigella sativa oil 1ml/kg body weight/day orally for 21 days, Group III animals were given 6 doses of daunorubicin 3mg/kg body weight intraperitoneally on alternate days and Group IV animals were given Nigella sativa oil 1ml/kg body weight/day orally for 21 days + daunorubicin 3mg/kg 6 doses intraperitoneally on alternate days. The animals were sacrificed on 22nd day and heart was subjected to histopathological examination.

Results: Daunorubicin provoked cardiotoxicity was evident from histopathological changes. Supplementation of nigella sativa oil has shown improvement in histopathological changes in heart.

Conclusion: The present study showed that Nigella Sativa oil has protective effect on daunorubicin induced cardiotoxicity in albino rats.

Keywords : Nigella sativa oil, daunorubicin , cardiotoxicity


A study on prevalence of hypertension among chronic kidney disease patients admitted in the nephrology department of CAIMS, Karimnagar

Murari Rajendra Prasad, Gopal Rao Jogdan, Mahesh G, Saritha S, Divya BVSS, Mrudula G

A Study on Prevalence of Hypertension among Chronic Kidney Disease Patients admitted in the Nephrology Department of Caims, Karimnagar

Murari Rajendra Prasad1, Gopal Rao Jogdand2, Mahesh G3, Saritha S4, Divya BvSS5, Mrudula G6

ABSTRACT

Aim : Chronic kidney disease (CKD) is an increasingly recognized global health problem. Hypertension is a risk factor and complication of chronic renal disease. Studies have shown that better blood pressure control slows progression of chronic kidney disease. To study the prevalence of hypertension among chronic kidney disease patients attending to nephrology department. To know the association of other risk factors with hypertension and chronic kidney disease.

Materials and Methods: Retrospective cross sectional study was done from June to November 2013, chronic kidney disease patients admitted in the nephrology ward are included in the study. Data analyzed by spss software version 20.

Results : Total study subjects - 306, Mean age in years 46.36±11.13, Age ranging from 13 to 73yrs. Age had a significant  association with ckd (86% >40yrs). Prevalence of hypertension amongst patients with ckd is 81.35%. Hypertension is increasingly associated with an advanced stage of chronic kidney disease (90% in stage-4 ckd). Smoking was a significant risk factor for hypertension among ckd patients (88%). Alcohol consumption had a significant association with hypertension among ckd patients (89%).

Conclusion : All efforts should be made to detect and strictly control hypertension in prevention and management of ckd. As an initial step, individuals aged more than 40 years and with family history of ckd should be screened for hypertension and ckd. Increased efforts are needed to identify the reasons for inadequate control of hypertension and approaches to increase blood pressure control among patients with ckd. Ckd patients with hypertension should be regularly screened for cardiovascular disease.

Key words: Hypertension, chronic kidney disease, dialysis, life style changes.


Diagnostic role of aspiration cytology in salivary gland lesions

Vidhyadhara Rani P, Naveen Kumar S, ShanmugaRaju P

Diagnostic role of Aspiration Cytology in Salivary Gland Lesions

Vidyadhara Rani P1, Naveen Kumar S2, Shanmugha Raju P3

ABSTRACT

Aim: The aim of the present study is to examine the cytological details in aspirated smears from salivary gland swellings and to evaluate the efficacy of Fine needle aspiration cytology (FNAC) in the diagnosis of salivary gland lesions.

Materials and Methods: The present study was carried out in the Department of Pathology, Kamineni Institute of Medical Sciences, Narketpally. In this study 53 patients with salivary gland lesions diagnosed clinically in the ENT and Surgery department of Kims hospital were selected during the period from september 2008 to october 2010.Histopathological follow-up data were acquired in 37 cases. The study was carried out to observe the sensitivity, specificity, anddiagnostic accuracy of FNAC for salivary gland lesions.

Results: The male-to-female ratio was 1:1.1. Parotid gland was involved in 59.37%, submandibular gland in 34.37% and other minor salivary glands in 6.25% of patients. There were 29.73 % cases of non-neoplastic lesions,54.05% cases of benign neoplastic lesions and16.22% of malignant lesions. In our study, the sensitivity was 92.30%, specificity 100.00% and diagnostic accuracy was 94.59%.

Conclusion: The present study has indicated the diagnostic role of fine needle aspiration cytology in salivary gland lesions and its reliability. Re-aspirations and image-guided techniques, coupled with immunohistochemistry, will certainly enhance the diagnostic accuracy

Keywords: FNAC, salivary gland, histopathology, diagnostic accuracy.


Surgical management of distal end radius fractures by various methods: A prospective study

Venkateshwarlu Jhatosh, Venkateshwar Rao T, Ramkumar Reddy, Chandra Krishna Ch, Hanmandlu

Surgical Management of Distal end Radius Fractures by Various Methods: A Prospective Study

Venkateshwarlu Jhatosh1, Venkateshwar Rao T2, Ram Kumar Reddy3, Chandra Krishna Ch4, Hanmandlu5

ABSTRACT

Aim: The optimal management of fractures of distal end radius has changed dramatically over the previous two decades from almost universal use of cast immobilization to a variety of highly sophisticated operative interventions. To assess the functional outcome of the distal end radius fractures we did a prospective study on 30 patients for a follow up of  20 months duration.

Materials and Methods: All the patients with fracture distal end radius are classified according to the Universal classification after radiographic evaluation.There were 20 males and 10 females between the age group of 20 – 60 years. Injury occurred due to road traffic accident in 50% of cases. The dominant wrist (right) was affected in 60% of cases. Five patients had associated long bone fractures. The results of this study is evaluated by clinician based functional outcomes of Gartland and Werley demerit scoring system and Stewart II scoring system.

Results: Most of the extra-articular displaced fractures were treated with closed reduction under image intensifier control and fixed with percutaneous K-wire. Most of the Intraarticular fractures are treated by internal fixation with plating techniques. Bridging external fixator was the mode of management for 53% of cases of this study which were grossly comminuted fractures. Excellent to good outcomes are seen in 90% of the cases treated by various surgical methods.

Conclusion:Unstable extra-articular and intra-articular fracture were reduced anatomically, and fixed with k-wires. Intra-articular displaced volar barton’s fracture were treated by open reduction and internal fixation with Ellis ‘T’ buttress plate or locking compression plate. Grossly comminuted fractures of distal end radius and compound fractures were stabilized with external fixator.

Keywords:  Distal end radius, elli’s plate, external fixator


Study of fingertip pattern in diabetic patients

Sudagar M, Zafer Sultana, Pimpalkar DS, Tabrej MD

Study of Fingertip Pattern in Diabetic Patients

Sudagar M 1, Zafar Sultana 2,  Pimpalkar DS3,  Tabrej MD4

ABSTRACT

Aim: To study and compare fingertip dermatoglyphic patterns in the diabetic patients with the control group  and to find out, whether the specific dermatoglyphic trait exist in the patients of diabetes mellitus and whether it is significant.

Materials and Methods: The present study is undertaken with an aim to evaluate the dermatoglyphic features in diabetic patients. The study consists of 150 diabetic patients and 150 normal healthy individuals as controls. They were 75 males and 75 females in each group. Dermatoglyphic prints were taken by “Ink Method” described by Cummins and Midlo and further subjected to statistical analysis to find the variations in the dermatoglyphic features among diabetic patients and control groups.

Results: Loops are decreased in cases but not statistically significant. Loops are significantly decreased in diabetic females (P=0.032). Loops are increased in diabetic males but not statistically significant. Whorls are increased in diabetic patients but not statistically significant. Whorls are decreased in diabetic males but not statistically significant. Whorls are significantly increased in diabetic females (P=0.0482). Arches are decreased in diabetic patients but not statistically significant. Mean value of TFRC is neither increased nor decreased in diabetic patients. Mean value of AFRC is significantly increased in diabetic patients(P=0.05).

Conclusion:  From the present study, it appears that there do exists a variations in the dermatoglyphic patterns in diabetic patients with an advantage of being simple and economical ‘ink’ method. As the specific features of dermatoglyphic patterns are present in diabetic patients, it can be use for mass screening program to segregate the predicted diabetic patients.

Keywords: Loop, whorl, arch, total finger ridge count, absolute finger ridge count


REVIEW ARTICLE

Menstrual blood banking

Padma B, Mamatha N

Menstrual Blood Banking

Padma  B1, Mamatha N2

ABSTRACT

We adopt many habits to stay healthy. Everyone crave to protect themselves against diseases in their life. Due to age, injury or illness, the body’s natural ability to regenerate itself is broken down leading to degenerative diseases. Currently available medications help manage only the symptoms of these diseases but do not attack the root cause and therefore are not very effective.  Until now, menstrual blood has typically been discarded as unsanitary waste. Existing new research shows that menstrual blood is a rich source of self – renewing stem cells that have a high potential to treat ailments in the future through stem cell  therapy.  Discovering curative power of stem cells has been a revolutionary breakthrough in the field of surgery and medicine till date, which has actually given many- the precious gift of life.

This study is aimed to educate the public to hold the potential to save themselves from future ailments and understand that menstrual stem cells obtained from the menstrual blood offer the best potential to display high concentrations of stem cell growth factors.  As investigators we are happy about this new innovation and feel that it is our duty to educate women about the most miraculous thing of contributing medically to save lives through the endometrial regenerative cells (ERC) or stem cells harvested from discarded menstrual fluid.          

Keywords:  Menstrual blood, menstrual blood banking, endometrial regenerative cells.                   


CASE REPORTS

Hereditary epidermolysis bullosa A case report and review literature

Srinivas Madoori, Ramya C, Sridevi B, Rohini Ponnala, Ramya Madhuri Y

Hereditary Epidermolysis Bullosa A Case Report and Review of Literature

Srinivas Madoori1, Ramya C2, Sridevi B3, Rohini Ponnala4, Ramya Madhuri Y5

ABSTRACT

Hereditary epidermolysis bullosa(EB) is a rare autosomal dominant disorder. It is characterised by blister formation following minor trauma. Here  we report a case of 7 hours old newborn male baby  presented with bullous lesions (fluid filled cavities or blisters, larger than 0.5 cm ) over left arm and erosion of skin over left eyelid, nape of the neck and right arm since an hour after birth. After a thorough family history and complete physical examination, the clinical findings of this baby were consistent with epidermolysis bullosa simplex generalised formerly known as Koebner variant. Baby was admitted in NICU of Chalmeda Anand Rao Institute of Medical Sciences, Karimnagar and treated with strict aseptic measures, given intra venous fluids, antibiotics. Baby was discharged on 6th day of life, with proper counselling for management of blisters and prenatal diagnosis in future pregnancy.

Keywords:  Blisters, epidermolysis bullosa simplex, new born.


A case of torsion tests salvage by detorsion

Ramlingam P, Prashanth G, MA Rehman

A Case of  Torsion Testis Salvage by Detorsion

Ramlingam P1, Prashanth G2, MA Rehman3

ABSTRACT

Early diagnosis of testicular torsion is absolutely mandatary for salvage of a viable testis. we present a classical clinical presentation of a boy, in second decade with sudden onset of testicular pain accompanied by tenderness and swelling. Managed by timely manual detorsion and followed by elective orchiopexy.

Keywords: Testicular torsion, salvage by detorsion


Complete motor recovery after acute paraplegia caused by spontaneous cervicodoral epidural hematoma

Kishore PVK, Hemaratnan A, Sahil Gupta, ShanmugaRaju P, Dilip Punnam, Agastya D, Vimal Kumar, Santosh SamRat, Dasaradhi K

Complete Motor Recovery after Acute Paraplegia caused by Spontaneous Cervicodorsal Epidural Hematoma

Kishore PVK1, Hemaratnan A2, Sahil Gupta4, Shanmuga Raju P3, Dilip Punnam4, Agastya D4, Vimal Kumar4, Santosh Samrat4, Dasaradhi K4

ABSTRACT

Spontaneous spinal epidural hematoma (SSEH) is a rare entity. The incidence of SSEH has been estimated at 0.1 patients per 100,000 individuals and represents less than 1% of spinal space-occupying lesions.  Here we are presenting a case of 65 year old female patient, who presented with sudden onset of backache followed by weakness of both lower limbs, associated with bladder and bowel incontinence. Patient was subjected to MRI spine which shows extradural space occupying lesion seen in posterior spinal epidural space extending from C6- D4 level compressing the cord.  Possible causes of an Acute Paraplegia like AVM bleed, coagulapathies, hemangioma, transverse myelitis, multiple sclerosis were ruled out by relevant investigations. Patient was subjected to surgical evacuation of hematoma after 72 hours of presentation. Postoperative period was uneventful. Physiotherapy was started in immediate post operative period. Sensations improved. Motor weakness also improved from Grade 0 to Grade V in lower limbs. Patient recovered completely during the hospital stay and regained bladder bowel control.

Keywords : SSEH, epidural hematoma, paraplegia, cervico-dorsal


A rare case report of filarial pleural effusion

Rajender M, Aruna T, Shruthi Reddy A, Lokesh G, Raghukanth A, Gnaneshwar Goli

A Rare Case Report of Filarial Pleural Effusion

Rajender M1, Aruna T2, Shruthi Reddy A3, Lokesh G4, Raghukanth A5, Gnaneshwar Goli6

Abstract

Lymphatic filariasis is common in tropical countries and is endemic in India. It has wide spectrum of presentation. Filarial lung involvement is usually in the forms of Tropical Pulmonary Eosinophilia with pulmonary infitrates and peripheral eosinophilia. Pleural effusion is an uncommon manifestation, and the finding of microfilaria in the pleural fluid is very rare. We report a rare case of pleural effusion which showed microfilaria of wucherania bancrofti cytologically and on nocturnal  peripheral blood smear.

Keywords: Microfilaria, pleural effusion, filariasis.


Malignant mesothelioma of tunica vaginalis

Sreenivas Vemula, Sumalatha Kasturi, Pradeep Kumar Chitumalla, Shobib Zeeshan, Roshni Sumalini

Malignant Mesothelioma of Tunica Vaginalis

Sreenivas Vemula1, Sumalatha Kasturi2, Pradeep Kumar Chitumalla3, Shoib Zeeshan4, Roshni Sumalini5

ABSTRACT

Testicular mesothelioma is the rarest form of  mesothelioma representing 1% - 5% of all malignant mesotheliomas. To date, less than 100 cases of this type of mesothelioma have been reported. The non specific symptoms, broad age distribution and lack of tumor markers make preoperative diagnosis of malignant mesothelioma of tunica vaginalis difficult and most of the reported  cases were diagnosed at histology. A 70 year old man presented with 3 year history of hydrocele. The patient underwent orchiectomy. Gross examination of operative specimen revealed gray white  nodules studding the thickened tunica vaginalis.  Microscopic examination revealed classical malignant mesothelioma of biphasic type.  Conclusions: The diagnosis of testicular malignant mesothelioma can be difficult, both from clinical and pathological point of views. Awareness and proper recognition of this entity are essential to reach the correct diagnosis.  Radical orchiectomy should be the primary therapy. In some cases adjuvant chemotherapy or radiotherapy is given.

Keywords: Malignant mesothelioma, tunica vaginalis, hydrocele, Calretinin


Successful management of ovarian cyst torsion during pregnancy: A case report

Ramadevi E, Sharda, Padmalatha, Leela R

Successful Management of Ovarian Cyst  Torsion during Pregnancy:  A Case Report

Ramadevi E1, Sharada2, Padmalatha3, Leela R4

Abstract

In this case we report a 21 –year old primigravida with 10 weeks gestational age presenting with torsion of the ovarian cyst. She presented to the antenatal clinic with acute pain abdomen and vomitings. She was diagnosed to have torsion of ovarian cyst during pregnancy and a cystecomy was carried out. Her histopathology report showed hemorrhagic infarction, twisted right ovary with congestion of fallopian tube. Her pregnancy is being followed up and she is currently at 18 weeks of gestation. Although the safety of antepartum surgical intervention has been accepted, abdominal surgery nevertheless carries some risks to a pregnant woman and unborn fetus, and so the choice of management necessitates a weighing of risks based on characterization of the adnexal mass and gestational age.

Keywords: Ovarian Cyst Torsion, Pregnancy


Vogt koyangi Harada syndrome presenting as isolated ocular disease A case report

Raghu Veladanda, Iram Jowhar, Priyanka Datrik, Tulasi Priya Chennapalli

Vogt Koyanagi Harada Syndrome Presenting as Isolated Ocular Disease – A Case Report

Raghu Veladanda1, Iram Jowhar2, Priyanka Datrik3,  Tulasi Priya Chennepalli4

ABSTRACT

A 20 year old male patient presented to our outpatient department with the chief complaint of diminished vision of a gradually progressive and painless onset in both eyes since a week. On examination, the anterior segment was normal except that both his pupils reacted sluggishly to both direct and indirect light reflexes. His fundus in both eyes showed peripapillary and macular edema about 3 disc diameters in size with mild perivascular sheathing. Fundus fluorescein angiography (FFA) showed multifocal hyper fluorescent dots at the level of RPE and accumulation of dye in the sub retinal space. B-scan showed localized retinal detachments in both eyes. It was diagnosed as Vogt Koyanagi Harada syndrome presenting as isolated ocular disease. VKH syndrome is an idiopathic multisystem autoimmune disease featuring inflammation of melanocyte-containing tissues such as the uvea, ear and meninges.

Key words: VKH syndrome, peripapillary edema, multiple serous retinal detachments


SHORT COMMUNICATION ARTICLE

Effect of satiety over blood glucose levels: A prospective study

Sabitha K, Rajukumar, Venugopal B, Raf

Effect of Satiety over Blood Glucose levels :  A Prospective Study

Sabitha K1, Rajkumar2, B Venugopal3, Rafi4

ABSTRACT

Aim: Fasting blood glucose reflects pancreatic islet ß- cell function and stands for secretory function of basic insulin and measurement of fasting blood sugar(FBS) is used to diagnose diabetes as it has low positive results. But high levels of postprandial blood sugar(PPBS) alone is the risk factor for mortality in cardio vascular disease(CVD).  The present study aims to know the differences in the post prandial blood  sample given after having breakfast and after having lunch.

Materials and Methods: 125 samples are collected from normal healthy individuals working in Chalmeda AnadaRao Institute of Medical Sciences (CAIMS) hospital.  The samples are collected in fasting, postprandial after breakfast and postprandial after lunch and is analysed for blood glucose levels in semi auto analyzer by kinetic method.

Results and Conclusion: The mean and SD values of postprandial sample after having breakfast and after lunch are 100±5.93, p<0.01(significant). The Post prandial sample collected after having lunch is more appropriate as it gives satiety to stomach and insulin secretion will be according to the contents than postprandial collected after breakfast.   

Keywords: Postprandial blood glucose, insulin, satiety


BOOK REVIEW

Fundamentals of musculoskeletal imaging

ShanmugaRaju P, Bheemanathuni Ramesh

Fundamentals of Musculoskeletal Imaging, 4th Edition

Edited by Lynn N. McKinnis

Philadelphia, Pa 19103 F.A. Davis Company, 2014.

ISBN-13:978-0-8036-3821-1

Hardback 696 pp, $110.00


CONTENTS

ORIGINAL ARTICLES

Use of Reverse Sural Artery Flap in Lower Leg Defects in 32 Patients

Manjari P, Vimal K, Samrat GS

Use of Reverse Sural Artery Flap in Lower Leg Defects in 32 Patients

Manjari P1, Vimal K2, Samrat GS3

ABSTRACT

Aim : Soft tissue reconstruction of distal third of leg, heel and ankle region is a difficult problem because of poor vascularity and limited mobility of skin. The free tissue transfer is used to be the choice of reconstruction most of the cases. The reverse sural artery flap with its ideal flap thickness, minimal donor site morbidity, wide arc of rotation and safe vascularity makes it a better alternative for covering such defects in the peripheral outset. To study retrospectively the role of various modifications of reverse sural artery flap to reach the defect and for better survival of flaps.

Materials and Methods: 32 cases of reverse sural artery flaps operated at Chalmeda Ananda Rao Institute of Medical Sciences and other hospitals during the period of 2012 February to 2014 December. It is a retrospective study conducted in our institute. 32 cases of distal leg and foot defects, who underwent reverse sural artery flap coverage were included in the study.

Results: All the flaps were survived. Of which in 12 cases marginal necrosis and in 5 cases partial necrosis was noted. All the flaps survived during the follow up period of 1 year with good functional outcome.

Conclusion: The reverse sural artery flap with its modifications is a very useful for the defects of distal leg, heel and ankle.

Keywords: Reverse sural artery, neurocutaneous flap, peroneal perforator


A Clinical Study on Management of CTEV by JESS Fixation

Lakshminarayana S, Venkat Lakavath, Omprakash T, Pramodh Kumar S

A Clinical Study on Management of CTEV by JESS Fixation

Lakshminarayana S1, Venkat Lakavath2, Omprakash T3, Pramodh Kumar S4

ABSTRACT

Aim : Our purpose of this study was to evaluate the role of jess fixation for correction of CTEV.

Materials and Methods: This prospective study was conducted in MGM Hospital, Warangal from October 2011to April 2014. 17 patient were included, average age was 2.2 years.unilateral feet and male were more in this study. Used Hospital for joint diseases, orthopaedic institute functional rating system for club foot assessment .

Results and Conclusion : Short term followup results were exallent to satisfactory based on above system (total score of 100, excellent 85 – 100, good 70-84, fair 60-69, poor <60 at followup of 3, 6 and 9 months.)

Keywords: CTEV, deformities, JESS fixation


Prescription Pattern of Antihypertensives in Cardiology Unit at Tertiary Care Hospital

Pushpalatha Ch, Laxman Reddy N, Mohd Mohsin

Prescription Pattern of Antihypertensives in Cardiology Unit at Tertiary Care Hospital

Pushpalatha Ch1, Laxman Reddy N2, Mohd Mohsin3

ABSTRACT

Aim : The main aim of present study is to know the prescription pattern of antihypertensive drugs in the cardiac unit of hospitalized patients in tertiary care hospital.

Materials and Methods: A retrospective study was carried out in hospital from January to December 2013. A total of 284 case files were taken for the study. The analysis was done for antihypertensives in each prescription, prescribing frequency of individual drug, sex and age frequency, single and combination therapy.

Results: The prescribing frequency of diuretics was (79.2%) followed by Angiotensin converting enzyme inhibitors (30.2%), ß-blockers (26.4%), calcium channel blockers (21.1%), Angiotensin receptor blockers (15.1%), a+ß blockers (8.4%), Vasodilators (7.3%). Two drug combination was predominantly given in 115 prescriptions out of 284 total prescriptions.

Conclusion: The study concludes that most of the hypertensive patients received two drug combination among which diuretics and Angiotensin converting enzyme inhibitors were more commonly prescribed.

Keywords: Antihypertensive drugs, prescription pattern, cardiac unit


Clinical Patterns in Insect Bite Dermatitis

Rukmini Reddy P, Narendar G, Kavitha D, Geetha K

Clinical Patterns in Insect Bite Dermatitis

Rukmini Reddy P1, Narendar G2, Kavitha D3, Geetha K4

ABSTRACT

Aim : Insect bite reactions on human skin receive less attention. Arthropods produce an injury to the skin by variety of mechanisms of which one or more may be involved in a patient.

Materials and Methods: The study was carried out in the Dermatology OPD of our institute on 111 subjects of insect bite dermatitis who were questioned retrospectively about the sequence of events besides their living and environmental conditions.

Results and Conclusions :It was noted that insect bite dermatitis has no gender or age preponderance. However, risk factors were found to be areas with heavy insect manifestations, certain occupations humid conditions and people keeping their windows open at night.

Keywords: Insect bite, dermatitis, papular urticaria


Primary Bipolar Hemiarthroplasty in Unstable Comminuted Intertrochanteric Fractures in Elderly

Raghuram C, Vamshidhar Reddy K, Ramu Ch, venu G,Sridhar K

Primary Bipolar Hemiarthroplasty in Unstable Comminuted Intertrochanteric Fractures in Elderly

Raghuram C1, Vamshidhar Reddy K2, Ramu Ch3, venu G4,Sridhar K5

ABSTRACT

Aim : Unstable intertrochanteric fracture in elderly is a challenging surgical condition with a high risk of morbidity and mortality. Aim of this study is to evaluate the functional outcome of primary bipolar hemiarthroplasty as an alternative to the standard treatment of Dynamic hip screw fixation in unstable intertrochanteric fractures.

Materials and Methods: Thirty one patients with unstable intertrochanteric fractures treated with primary bipolar hemiarthroplasty were prospectively analysed. The functional outcomes were assessed based on Harris hip score.

Results: The time to full weight bearing, the rate of postoperative complication, and the functional outcomes were significantly better in primary bipolar hemiarthroplasty.

Conclusion: Primary bipolar Hemiarthroplasty for unstable intertrochanteric fractures in elderly results in early ambulation, less hospital stay, provide stable hips with good functional results.

Keywords: Unstable intertrochanteric fractures, primary bipolar hemiarthroplasty, osteoporosis, harris hip Score


Comparison of Quality of Anaesthesia with Propofol Fentanyl and Propofol Ketamine as Total Intravenous Anaesthesia Technique for Short Surgical Procedures

Aasim SA, Syamasundara Rao B, Zubair SI

Comparison of Quality of Anaesthesia with Propofol Fentanyl and Propofol Ketamine as Total Intravenous Anaesthesia Technique for Short Surgical Procedures

Aasim SA1,  , Syamasundara Rao B2, Zubair SI3

ABSTRACT

Aim : The present study was conducted to evaluate the efficacy of combination of propofol-fentanyl and propofol-ketamine as total intravenous anesthesia to assess haemodynamics, recovery profile of either groups, Postoperative nausea and vomiting and any other side effects.

Materials and Methods : A total of 50 patients undergoing elective surgeries of shorter duration were randomly allocated into two groups of twenty five each. Group A received Propofol 2mg/kg and Fentanyl 2µg/kg for induction and propofol 4mg/kg/hr and fentanyl 1µg/kg/hr for maintenance of anesthesia, Group B received propofol 2mg/kg and ketamine 1mg/kg for induction and Propofol 4mg/kg/hr and ketamine 1mg/kg/hr for maintenance of anesthesia. Hemodynamic variables were recorded at regular intervals. At the end of drug infusion, recovery was assessed by time to spontaneous eye opening and Modified Aldrete scoring system.

Results : Group A combination produced a significantly greater fall in pulse rate and in mean arterial pressure as compared to Group B after induction of anaesthesia.Time to spontaneous eye opening was comparable in both the groups. There was a slight respiratory depression in Group A but not in Group B. Modified Aldrete score was better in Group B than in Group A. Incidence of postoperative nausea and vomiting was seen in 3 patients in Group A and none in Group B.

Conclusion : Both Propofol–Ketamine and Propofol–Fentanyl combinations produce a rapid, pleasant and safe anesthesia with minimal untoward side effects and slight hemodynamic changes. Out of the two, Propofol–Ketamine group is more effective without respiratory depression, better haemodynamic stability and no postoperative nausea and vomiting.

Keywords : Ketamine, propofol, total intravenous anaesthesia, recovery, analgesia, amnesia


CASE REPORTS

Vascular Pedicle Pisiform Bone Grafting for Kienbocks Disease : A Case Report

Nagamuneendrudu K, Valya B, Vishnu Vardhan M

Vascular Pedicle Pisiform Bone Grafting for Kienbocks Disease : A Case Report

Nagamuneendrudu K1, Valya B2, Vishnu Vardhan M3

ABSTRACT

25 years old female patient presented with pain in the right wrist of 3 years duration, with mild restriction of movements, the case is diagnosed as Kienbock’s disease, the case treated with vascular pedicle pisiform bone grafting.

Keywords : Kienbock’s disease, pisiform bone, vascular pedicle bone grafting.


Lichen Sclerosis with Rare Complications: Two Case Reports

Narendar Gajula, Kavitha D, Geetha K, Razia Begum, Rukmini Reddy

Lichen Sclerosis with Rare Complications: Two Case Reports

Narendar Gajula1, Kavitha D2, Geetha K3, Razia Begum4, Rukmini Reddy5

ABSTRACT

Lichen Sclerosis is a chronic, progressive, atrophic, sclerosing process involving glans and prepuce. Cause of the disease is unknown. It occurs between 20 - 65 years of age. It manifests usually as atrophic patches, plaques. In severe cases waisting, effacement or muzzling are seen. It can lead tocomplications like meatal stenosis, urethral stricture and rarely carcinoma. Case one presented with lichen sclerosis complicated by squamous cell carcinoma and second case presented with urethral stricture. These two cases are being presented because of it’s rarity and these are likely to be missed. The patients were referred to surgery and urology depts respectively for further management.

Key words: Lichen sclerosis, waisting, effacement, muzzling.


A Rare Case Report of Dengue Fever with Massive Hemothorax

Rajender M, Lokesh G, Nithin Kumar Reddy R, Shanmuga Raju P

A Rare Case Report of Dengue Fever with Massive Hemothorax

Rajender M1, Lokesh G2, Nithin Kumar Reddy R3, Shanmuga Raju P4

ABSTRACT

20 year young male patient presented with complaints of high grade fever and non productive cough since 10 days, chest radiograph showing right sided massive pleural effusion, blood investigations revealing severe thrombocytopenia with reactive dengue NS 1 antigen. On further evaluation with diagnostic thoracocentesis, pleural fluid is hemorrhagic which is consistent with blood, patient is treated with tube thoracostomy and other supportive treatment, patient is improved clinically and discharged home. We report this case for its rarity.

Keywords: Dengue, hemorrhagic fever, hemothorax.


A Rare Case of Strangulated Parastomal Hernia after 30 years of Stoma Construction

Ramlingam P, Prashanth G, Sri Balram A, Nageshwar Raju

A Rare Case of Strangulated Parastomal Hernia after 30 years of Stoma Construction

Ramlingam P1, Prashanth G 2, Sri Balram A3, Nageshwar Raju4

ABSTRACT

Parastomal hernias (PSH) are likely to increase the incidence due to more number of cases being operated for carcinoma of colon and rectum. Though there is less literature on this subject our aim is to prevent occurrence of parastomal hernia by various preventive steps like taking transverse incision, repairing with mesh, correcting the patient related risk factors. Early diagnosis and repair of obstructed parastomal hernia is necessary to prevent morbidity and mortality including recurrence.

Keywords:  Parastomal hernias, colostomy, stoma construction.


Spinal Intramedullary Dermoids: Report of 2 Cases and Review of Literature

Bhaskar G, Nagamuneendrudu, Mastan Reddy A, Lakshman Rao A, Saratchandra

Spinal Intramedullary Dermoids: Report of 2 Cases and Review of Literature

Bhaskar G1, Nagamuneendrudu 2, , Mastan Reddy A, 3,  Lakshman Rao A 4, Saratchandra5

ABSTRACT

Dermoids are rare congenital inclusion tumours of spinal canal with a reported incidence of less than 1% of all spinal neoplasms. They are commonly found in intradural location and are very rare in intramedullary compartment. Very few cases have been reported so far in literature. We report here two cases of dermoids in intradural and intramedullery location in view of the rarity of the lesions. We discuss the clinical features, imaging characters and microsurgical excision techniques along with review of the relavent literature.

Keywords: Dermoid cyst, spinal cord tumour, magnetic resonance imaging.


An Unusual Case of Rupture of Left Horn of Bicornuate Uterus at Twelve Weeks of Gestation

Madhavi G B, Ramadevi E,Mamata N,Shreya G

An Unusual Case of Rupture of Left Horn of Bicornuate Uterus at Twelve Weeks of Gestation

Madhavi GB1, Ramadevi E2,Mamata N3,Shreya G4

ABSTRACT

Rupture of uterus is a hazardous complication of pregnancy and labour, and carries a high risk for the mother and the fetus. Uterinerupture during early pregnancy is a rare complication but if there is a rupture and not suspectedwithin time, it may have a fatal outcome for the mother. Here we report a case of rupture of horn of bicornuate uterus at 12 weeks of gestation with severe anemiaadmitted with shock at ChalmedaAnandRao Institute of Medical Sciences. Patient was successfully managed by emergency laparotomy with excision of the horn.

Keywords:  Bicornuate uterus, rudimentary horn pregnancy, ultrasound.                   


Strongyloides Stercoralis Hyperinfection in an Immunocompetent

Aruna Rajkumari, Pavani N, Parveen Anjum,yamini K, Sameera Nousheen, Sabarinathan T

Strongyloides Stercoralis Hyperinfection in an Immunocompetent

Aruna Rajkumari1, Pavani N2, Parveen Anjum3,yamini K4, Sameera Nousheen5, Sabarinathan T6

ABSTRACT

Strongyloides stercoralis is a widespread, soil-transmitted helminth affecting humans. A 35-year-old female presented with diarrhea, vomiting, abdominal pain, severe malaise with low grade fever since 3-4 days. She complained of crampy, severe, upper abdominal pain, anorexia, vomiting and diarrhea. She had loss of appetite for 1 month and had lost 5 Kg weight during the period. We are reporting a case of strongyloides stercoralis hyperinfection in an immunocompetent.

Keywords:  Strongyloides stercoralis, hyperinfection, immunocompetent.


Joubert Syndrome: A Case Report

Srinivas Madoori, Ramya C, Sridevi B, Sandhya Jalagam

Joubert Syndrome: A Case Report

Srinivas Madoori1, Ramya C2, Sridevi B3, Sandhya Jalagam4

ABSTRACT

Joubert Syndrome (JS) is a very rare autosomal recessive neurodevelopmental disorder. It is characterized by cerebellar vermis hypoplasia, hypotonia and abnormal breathing pattern or abnormal eye movements. We report a case of 13 years old male child with seizures, abnormal eye movements, developmental delay and ataxia. On radiological evaluation MRI of brain revealed “molar tooth sign” and “bat wing appearance” of fourth ventricle.

Keywords: Joubert syndrome, vermian hypoplasia, bat wing appearance, molar tooth sign.


Herlyn Werner Wunderlich Syndrome

Mamatha N, Rama Devi E, Madhavi GB, Pragna Reddy K

Herlyn Werner Wunderlich Syndrome

Mamatha N1, Rama Devi E2, Madhavi GB3, Pragna Reddy K4

ABSTRACT

Uterovaginal duplication with obstructed hemivagina and ipsilateral renal agenesis is referred to as the Herlyn Werner Wunderlich (HWW) syndrome. Here, we describe a 15year old female patient with HWW syndrome, who was taken up for a diagnostic laparoscopy followed by vaginal septal resection. In addition to a definitive diagnosis, this approach helped in symptomatic relief to the patient. Prompt and accurate diagnosis and treatment of HWW syndrome can significantly prevent future complications.

Keywords : Herlyn werner wunderlich syndrome, laparoscopy, vaginal septal resection.


SHORT COMMUNICATION ARTICLE

Pagets Disease of the Breast: Study of 5 Cases with Review of Literature

Sumalatha K,SanthoshBabu R,Pradeep Kumar Ch,Ravinder Thota,Shanmuga Raju P

Pagets Disease of the Breast: Study of 5 Cases with Review of Literature

Sumalatha K1,SanthoshBabu R2,Pradeep Kumar Ch3,Ravinder Thota4, Shanmuga Raju P5

Abstract

Paget’s disease of the breast has been recognised as a distinct clinical entity. It is defined as the presence of malignant glandular epithelial cells within the squamous epithelium of the nipple and is almost always associated with underlying intraductal or invasive carcinoma of breast or both. It accounts for 1-4% of all cases of breast carcinoma. Its clinical significance, pathogenesis are topics of controversy. The main aim of this review is to describe its clinical features, pathological features, pathogenesis and differential diagnosis.

Keywords: Paget’s disease of breast, carcinoma in situ, invasive carcinoma.


PICTORIAL CME

A Case of Adenoid Cystic Carcinoma Intraorbital Extra Corneal tumor

Ezhilarasi Ravindran

A Case of Adenoid Cystic Carcinoma Intraorbital Extra Corneal tumor

Ezhilarasi Ravindran1

ABSTRACT

Adenoid cystic carcinoma (ACC) is an indolent cancer arising within glands with a poor prognosis.[1] It accounts for less than 1% of all tumors. A recent study identified 1p32-p36 as the most frequent genetic change which was also a marker for poor prognosis.[2] A young male, 26 years presented with blurring of vision and pain over right eye. Underwent surgery right fronto orbital oblotomy. HPR-adenoid cystic carcinoma. Post-operative CT Scan showed residual lesion in intraorbital extra coanal compartment. Bony defects in right lateral wall of orbit and superior right frontal bone.


BOOK REVIEW

Clinical Methods in Medicine: Clinical Skills and Practices

Edited by S N Chugh, Eshan Gupta
2/e, 564 pp., illustrated
New Delhi,
Jaypee Brothers Medical Publishers (P) Ltd, 2015
Price: $46.00
ISBN: 978-93-5025-039-6



2013

   

V.6 (1): 1- 81 Nov

        

 

2012

   

V.5 (1): 1-54 Nov

        

 

JOURNAL OF CHALMEDA ANANDRAO INSTITUTE OF MEDICAL SCIENCES

Instructions For Authors
(Updated September -2015)

TABLE OF CONTENTS

I.GENERAL INFORMATION

  • Aims/Scope
  • Frequency
  • Indexing/Abstracting
  • Publisher
  • Subscriptions information
  • Advertising
  • Material Disclaimer
  • Acid - Free Paper
  • No Publication Fees

II.MANUSCRIPT CATEGORIES

A.ARTICLE TYPES

  • Title Page
  • Abstract
  • Text
  • Acknowledgement
  • References
  • Foot notes
  • Tables
  • Figures

B.MANUSCRIPT SUBMISSION

C.MANUSCRIPT SUBMISSION CHECKLISTS

D.COPYRIGHT/PERMISSIONS

E.RESEARCH AND PUBLICATION ETHICS

  • Informed Consent form
  • Funding and Conflict of Interest disclosures
  • Human/Animal Rights

GENERAL INFORMATION

AIMS/SCOPE

The Journal of Chalmeda AnandRao Institute of Medical Sciences (JCAIMS) ISSN: 2278-5310 (print), ISSN: 2395-0188 (online) is the official journal of Chalmeda AnandRao Institute of Medical Sciences, Karimnagar, Telangana, INDIA. It is the peer- reviewed scientific journal. This Journal originally started in year 2008. Initially, it was published as the “CAIMS Medical Bulletin” in 2008. The main aim of journal is to encouraging scientific research papers and providing a platform for young researchers, academicians and PG students in the field of medicine and allied medicine. Journal of CAIMS publishes mainly articles concerning the latest Advances in Basic sciences, Clinical Specialties /Super-specialties of medical, surgical and Rehabilitation. We publish scientific articles such as original article, review article, case reports, short communication article, book review, pictorial CME and editorials.

FREQUENCY:

Bi-annual publication.

INDEXING/ ABSTRACTING

Journal of Chalmeda AnandRao Institute of Medical Sciences is indexed and abstracted in Academic Keys, Chemical Abstracts Service(CAS), Cite factor, Indian Science Abstract, Indian Citation Index, Cosmos impact factor, Index Copernicus, ISPJE, NLM Catalog, Locator Plus, National Science Library, J-Gate, World Cat, OCLC, and Ulrich’s Web.

PUBLISHER

Chalmeda AnandRao Institute of Medical Sciences,
Arihant Educational Society,
Bommakal village,
Karimnagar-505001,
Telangana, India.
E-mail: caims_edu@yahoo.com
URL:www.caims.org

SUBSCRIPTION INFORMATION

All published volumes in full text and Archive are free at www.caims.org/journal
Print ISSN: 2278-5310¸ USD 80.00 (Institutional)/ USD 50.00 (Individual)
Online ISSN: 2395-0188 – All Full text issues are free.

Address:

Chalmeda AnandRao Institute of Medical Sciences
Bommakal village,
Karimnagar-505001
Telangana, India.

Phone:0878-2285565, 2285565, 2285297
Fax:0878-2285318
Email:editorjcaims@rediffmail.com
Web page:www.caims.org/journal

ADVERTISING POLICIES

For the request concern adverting should be sent to email: editorjcaims@rediffmail.com

MATERIAL DISCLAMIER

The author(s) are responsible from the articles published in the journal of Chalmeda AnandRao Institute of Medical Sciences. The editor, editorial board and publisher do not accept any responsibility for the articles.

ACID-FREE PAPER

The Journal of Chalmeda AnandRao Institute of Medical Sciences is printed on an Acid-Free Paper.

NO PUBLICATION FEES

There is no fee for publication process. The acceptance of the article is based on the merit of quality of the manuscripts.

MANUSCRIPTS SUBMISSION

Manuscripts must follow the style of the Vancouver agreement detailed in the International Committee of Medical Journal Editors “revised” Uniform Requirements for Manuscripts Submitted to biomedical Journal editors and Editing for Biomedical Publication, as presented at: http://www.icmje.org/

Article Types:

1.Original Article

2.Review Article

3.Case Reports

4.Short Communication article

5.Pictorial CME

6.Book Review

7.Editorials

STRUCTURE OF THE MANUSCRIPT

Covering Letter:
A covering letter explaining why the paper should be published in the JCAIMS. Send the manuscript with cover letter that includes the corresponding author’s email address to the Editor-in-Chief, Journal of Chalmeda AnandRao Institute of Medical Sciences, Karimnagar-505001, Telangana, India. Office: 0878-2285565, 2285297, Fax: 0878- 2285318, E-mail: editorjcaims@rediffmail.com (please see the check list at the end of the these instructions before mailing manuscripts).
Title Page:
Type the full name and affiliations of all authors. The title should not exceed 100 characters including spaces between words. The first name/corresponding author and provide a telephone number, fax number, and email address. All pages should be numbered consecutively beginning with the title page, including an abbreviated title of not more than 40 characters.
Authors:
Journal of Chalmeda AnandRao Institute of Medical Sciences follows the International Committee of Medical Editors (ICMJE) recommendations for defining authors and contributors.
Abstract:
Abstract should be structured format as background and aim, materials and methods, results and conclusion in less than 250 characters.
Keywords:
At least, minimum 3 or 5 key words.
Text:
Journal of Chalmeda AnandRao Institute of Medical Sciences strongly encourages authors to follow EQUATOR reporting recommendations when presenting original data or findings of a systemic review (www.equator-nework.org). All submitted manuscripts should include page numbers.
Original article:
Research articles should follow the Introduction, methods, results, discussion (IMRD), conclusion format. The number of reference should not exceed 25. The main text should be limited to 3000 words.
Review Article:
Reviews that systematically find, select, critique and synthesize evidence relevant to well defined questions about diagnosis, or therapy. Review articles are limited to 3,000 words.
Case Reports:
Observations of diseases, clinical findings or treatment. The main text should be limited with 1200 words. Text should be arranged as following sub headings: abstract, case report, discussion, conclusion, acknowledgements; references. Abstract: 250 words maximum, the maximum number of references cited in a case report should be 10.
Short communication article:
Short research articles or reports of important observations or short original studies or evaluations or unique, first time reports of clinical series. Text should have acknowledgments and references 15 maximum.
Pictorial CME:
Any interesting or unusual educational images related to health care with short description (maximum word limited to 250 words). No Abstract, discussion and conclusion are required but please include a brief title.
Book Review:
Title of the book; name of the editor/authors; name and address of the publisher; year of publication; number of pages; number of illustrations; hard bound or soft bound; price, ISBN number, text of review. As a policy we do not encourage submission of reviews of books that are more than a year old.
Editorials
Current topic or on papers published elsewhere in the issue. Editorials are generally solicited by the Editor-in-Chief. The abstract is limited to 300 words.
Tables:
Each table should have a title and be numbered in the order of appearance in the text. Use superscript letters to indicate footnotes typed at the bottom of the table. Quote all tables in the text. Statistical measures such as SD or SEM should be identified in the headings. If tables have been reproduced form another source, a letter from copyright holder (usually the publisher), stating authorization to reproduce the material, must be attached to the covering letter.
Figures/Images:
All color images file must be high quality and reproductions are not acceptable. The quality of X-rays, diagrams and graphs must be good enough for reproduction. All images should be submitted separately and not as part of main manuscript. Quote all images in the text as figure numbers in Arabic numerals. Size: figures should be sized to fit within the column (82 mm), intermediate (118 mm) or the full text width (173 mm).
Figure legends:
Type figure legends on a separate page. Include definitions of any symbols used and define/explain all abbreviations and units of measurements.

ACKNOWLEDGEMENT

Acknowledge only persons who have contributed to the scientific content or provided technical support. The corresponding author must also affirm that he or she has listed everyone who contributed significantly to the work in the acknowledgments.

REFERENCES STYLE

Reference should follow the standards summerized in the National library of Medicine's Citing Medicine,2nd edition.See www.nim.nih.gov/bsd/uniform_requirements for sample references that confirm to the style specified by National Library of Medicine.


• References should be numbered in the order of appearance in the text. Each reference should include author’s name, and initials, title of article in its original language.
• Abbreviations of journal names must follow the Index Medicus/MEDLINE.
• List of authors when there are 6 or more, when there more than 7 authors and add “et al”. A list of authors should be followed by the article, journal title, year, volume and page numbers.
• Avoid citations to the unpublished scientific results in the text.

Footnotes:

Use footnotes only on the titles page and in the tables. Do not use footnotes in the text.

MANUSCRIPT SUBMISSION

We accept submissions only through online manuscript submission system (www.caims.org/journal)/;
Contact E-mail: editorjcaims@rediffmail.com

MANUSCRIPT SUBMISSION CHECK LISTS

Please see Instructions for Authors for details related to this checklist (1-12).

1. Text in MS word(.doc)
2. Type is 12 –pitch, right margin, double –spaced and numbered.
3. Cover Page (1) Complete title (2) Category (3) All author’s name, degree, designation (4) Affiliations, (5) Corresponding author contact information.
4.Abstract (aim, materials and methods, results, conclusion).
5.Keywords/terms less than 3 – 4.
6.Reference number consecutively in the order in which they are cited in the both text and graphics (eg, 1, 2, 3).
7.Tables, figures with legends.
8.Figure files are jpg format.
9.Each necessary permission statement signed by the appropriate source.
10.Institutional, ethical, and review board approval statement at the end of methods section (When reporting experiments on human subjects).
11.Acknowledgement (if appropriate).
12.Source of funding or statement that “the authors report no external funding source for this study.
13.Conflict of interest statement that “the authors declare no conflict of interest”.

ETHICAL CONSIDERATIONS

Authors must state that the protocol for the research project has been approved by a suitably constituted Ethical approval committee of the institution within which the work was undertaken and that it conforms to the provisions of the Declaration of Helsinki (as revised in Edinburgh 2000), available at:http://www.wma.net/e/policy/b3. Journal of CAIMS retains the right to reject any manuscript on the basis of unethical conduct of either human or animal studies.

All investigations on human subjects must include a statement that the subject gave informed consent. Photographs need to be cropped sufficiently to prevent human subjects being recognized (or an eye bar should be used). In general, submission of a case report should be accompanied by the written consent of the subject (parent or guardian) before publication; this is particularly important where photographs are to be used or in cases where unique nature of the incident reported makes it possible for the patient to be identified. Any experiments involving animals must be demonstrated to be ethically acceptable and where relevant confirm to national guidelines for animal usage in research.

COPYRIGHT/PERMISSIONS

All rights are reserved to the Journal of Chalmeda AnandRao Institute of Medical Sciences. The authors must secure reproduction permission from the copyright owner, if any figure(s), illustration(s), tables(s) or extended quotation(s) etc, are taken from material(s) previously published. The published material of journal of Chalmeda AnandRao Institute of Medical Sciences may not be reproduced or transmitted in any form or by any means, electronic/ mechanical including photo copy without written permission from editor-in-chief/ publisher of journal of Chalmeda AnandRao Institute of Medical Sciences.

All authors must read and agree to the conditions and the corresponding author can sign on their behalf. Acceptance of a manuscript is contingent receipt of a signed Copyright Assignment Form.

RESEARCH AND PUBLICATION ETHICS

Journal of Chalmeda AnandRao Institute of Medical Sciences follows the policies, guidance and process related to research and publication ethics developed by International Committee of Medical Journal Editors, The council of Publication Ethics and the Council of Science Editors.

STATEMENT OF INFORMED CONSENT FORM

Patient identifiers will not be published in the Journal of Chalmeda AnandRao Institute of Medical Sciences, unless written informed consent is given and the content is essential for the scientific purpose and merit of the manuscript.

Photographs of subjects showing any recognizable features must be accompanied by their signed release authorizing publication, as must case reports that provide enough unique identification of a person (other than name) to make recognition possible.

Failure to obtain informed consent of patient prior to submission would result in manuscript rejection.

INSTITUTIONAL REVIEW BOARD APPROVAL

Copies of written informed consent documents should be kept for studies on human subjects. For clinical studies of human subjects, a certificate, agreement, or approval by the Institutional Review Board (IRB) of the author's institution is required. If necessary, the editor or reviewers may request copies of these documents to resolve questions about IRB approval and study conduct.

CONFLICT OF INTEREST STATEMENT

If there are any conflicts of interest related to individual author’s commitments or project support, it should be clarified and described in the manuscript. Every author should complete the ICMJE general declaration form, which can be obtained at: htpp://www.icmje.org/coi_disclose.pdf.

SOURCE OF FUNDING

Source of funding must be acknowledged on the title page of the manuscript. All authors will disclose conflict of interest information. If there is no source of funding, state that” the authors report no external funding source for this study.

STATEMENT OF HUMAN /ANIMAL RIGHTS

All articles under consideration that experiment on human subjects and animals in research are required to have institutional review board approval in accord with ethical standards set forth in the Uniform Requirements for Manuscripts Submitted to Biomedical Journals at:http://www.icmje.org.

ONLINE EARLY

Journal of Chalmeda AnandRao Institute of Medical Sciences publishes abstract of accepted manuscripts online in advance of their publication in print. Once an accepted manuscript has been edited, the authors have submitted any final corrections, and all changes have been incorporated, the manuscript will be published online at:http://www.caims.org/journal.

For more information, please contact:
P.Shanmuga Raju
Editor-in-Chief
Journal of Chalmeda AnandRao Institute of Medical Sciences
E-mail: editorjcaims@rediffmail.com

Manuscript Check List

This checklist must be completed, signed by the corresponding author, and submitted with the manuscript.

Please see Instructions for Authors for details related to this checklist (1-13).

1.Text in MS word(.doc)
2.Type is 12 –pitch, right margin, double –spaced and numbered.
3.Cover Page (1) Complete title (2) Category (3) All author’s name, degree, designation (4) Affiliations, (5) Corresponding author contact information.
4.Abstract (aim, materials and methods, results, conclusion).
5.Keywords/terms less than 3 – 4.
6.Reference number consecutively in the order in which they are cited in the both text and graphics (eg, 1, 2, 3).
7.Tables, figures with legends.
8.Figure files are jpg format.
9.Each necessary permission statement signed by the appropriate source.
10.Institutional, ethical, and review board approval statement at the end of the methods section (When reporting experiments on human subjects).
11.Acknowledgement (if appropriate).
12.Source of funding or statement that “The authors report no external funding source for this study.
13.Conflict of interest statement that “the authors declare no conflict of interest”.

ETHICAL POLICIES/STATEMENTS

Statement of Informed Consent Form

Patient identifiers will not be published in the Journal of Chalmeda AnandRao Institute of Medical Sciences, unless written informed consent is given and the content is essential for the scientific purpose and merit of the manuscript.

Photographs of subjects showing any recognizable features must be accompanied by their signed release authorizing publication, as must case reports that provide enough unique identification of a person (other than name) to make recognition possible.

Failure to obtain informed consent of patient prior to submission would result in manuscript rejection.

Institutional Review Board Approval

Copies of written informed consent documents should be kept for studies on human subjects. For clinical studies of human subjects, a certificate, agreement, or approval by the Institutional Review Board (IRB) of the author's institution is required. If necessary, the editor or reviewers may request copies of these documents to resolve questions about IRB approval and study conduct.

Conflict of Interest Statement

If there are any conflicts of interest related to individual author’s commitments or project support, it should be clarified and described in the manuscript.

Statement of Human /Animal Rights

All articles under consideration that experiment on human subjects and animals in research are required to have institutional review board approval in accord with ethical standards set forth in the Uniform Requirements for Manuscripts Submitted to Biomedical Journals at http://www.icmje.org

JOURNAL OF CHALMEDA ANANDRAO INSTITUTE OF MEDICAL SCIENCES

PEER REVIEW PROCESS

All submitted manuscripts are reviewed initially by a journal editor. Manuscripts are evaluated according to the following criteria: material is original and timely, writing is clear, study methods are appropriate, data are valid, conclusions are reasonable and supported by the data, information is important, and topic has general medical interest. From these basic criteria, the editors assess a paper’s eligibility for publication. Other manuscripts are sent to expert consultants for peer review. Peer reviewer identities are kept confidential, but author identities are made known to reviewers. The existence of a manuscript under review is not revealed to anyone other than peer reviewers and editorial staff. Peer reviewers are required to maintain confidentiality about the manuscripts they review and must not divulge any information about a specific manuscript or its content to any third party without prior permission from the journal editors. Information from submitted manuscripts may be systematically collected and analyzed as part of research to improve the quality of the editorial or peer review process. Identifying information remains confidential. Final decisions regarding manuscript publication are made within the Editorial Team. Specifically, the peer review goes as:

1. Editorial assistants pass submitted manuscripts to the Editor-in-Chief.
2. Depending on the topic of the submitted manuscript, Editor-in-Chief passes the article to Associate Editors or a Member of the Editorial Board with related expertise.
3. The assigned Associate Editor or Member of the Editorial Board with related expertise invites external reviewers. This is done by literature search to identify the external experts.
4. External experts review.
5. External experts make recommendation.
6. External experts’ recommendation plus the assigned Member of the Editorial Board’s review.
7. The Editor-in-Chief makes a decision: accept, minor revision, major revision, re-submit, reject.

REVIEWERS INSTRUCTIONS

RESPONSIBILITY OF REVIEWERS:

A reviewer has committed to review :

Reviews must be thorough and contain a basic amount of information in order for the section editor to generate a composite review:

  • Critique of methodology
  • Statement of impact
  • Strengths
  • Significant limitations that were not addressed
  • Fatal flaws
  • Comment on the necessity and suitability of tables and figures (tables are typically at the end of the manuscript and figures under supplemental content)
  • Comment on clarity, brevity, grammar and spelling. If there are minor errors, please relate them in the review. If there are major errors as a whole, you may relate this fact without having to fix them line by line.

Reviewers must be completed within 1 week from date of the initial request.

The Editor-in-Chief or Associate Editor will register the final decision. The reviewer’s identity will remain confidential throughout the peer review process.

International Committee of Medical Journal Editors. Uniform Requirements for Manuscripts Submitted to Biomedical Journals: Writing and Editing for Biomedical Publication. Available at:www.icmje.org/index.html


Contact Details


(Please upload .docx, .doc format only in single file.)
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SUBSCRIPTION

For Institutional or Individual subscriptions, please contact:

Editor-in-Chief
Journal Section
Chalmeda Anand Rao Institute of Medical Sciences
Karimnagar-505001, Telangana
INDIA.
Phone: 0878-2285565, 9491398688, 9491398694
Fax: 0878-2285318
E-mail : editorjcaims@rediffmail.com

ADVERTISING

To advertise in the print or online issues of the Journal of Chalmeda Anand Rao Institute of Medical Sciences, please contact:

Editor-in-Chief
Journal Section
Chalmeda Anand Rao Institute of Medical Sciences
Karimnagar-505001, Telangana
INDIA.
Phone: 0878-2285565, 9491398688, 9491398694
Fax: 0878-2285318
E-mail : editorjcaims@rediffmail.com

Journal of CAIMS reserves the right to the decline any advertising.

CALL FOR PAPERS 2017- ISSUE -2

CALL FOR PAPERS

JOURNAL OF CHALMEDA ANANDRAO INSTITUTE OF MEDICAL SCIENCES

Volume 14 Issue 2: JULY to DECEMBER 2017

Journal of Chalmeda Anand Rao Institute of Medical Sciences (ISSN: 2278-5310) is peer reviewed, open access journal published bi-annually (Jan-Jun, Jul-Dec).

The Editor-in-Chief is now seeking papers for the Journal of Chalmeda Anand Rao Institute of Medical Sciences. If you are ready to submit a paper please visit our “Instructions for Authors”.

Submit your article to editorjcaims@rediffmail.com

Acceptance Notification within 2 week

Faster online peer review

Submission Deadline: Sept 27th, 2017

For more information please visit: www.caims.org/journal

Please contact the editor-in-chief directly, if you have any submission queries: editorjcaims@rediffmail.com

  CONTACT US

  J CAIMS Submissions

    Feel free to contact us for any article related questions or Inquiries can be directed to:

Editorial and Publishing Office

P. ShanmugaRaju, MPT, MIAP
Editor-In-Chief
Journal of Chalmeda Anand Rao Institute of Medical Sciences
Chalmeda Anand Rao Institute of Medical Sciences
Bommakal Village
Karimnagar- 505 001
Telangana
INDIA.
Phone: 0878-2285565, 9491398688, 9491398694
Fax: 0878-2285318

 

PUBLISHER

C. Lakshmi Narasimha Rao, BE, MBA
Chairman
Chalmeda Anand Rao Institute of Medical Sciences
Arihant Educational Society
Bommakal Village
Karimnagar- 505 001
Telangana, INDIA.
Phone: 0878-2285565, 9491398688, 9491398694
Fax: 0878-2285318