INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY 2021-10-07T04:07:26+00:00 International Journal of Scientific Study (IJSS) Open Journal Systems <p><strong><span style="color: #5040ae;">SCOPE OF JOURNAL</span><br><br><span style="color: #2a2a2a;">-&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; International Journal of Scientific Study (IJSS) is an open-access, freely accessible, online monthly journal publishing research articles after full peer review and aims to publish scientifically sound research articles. Journal publishes articles of&nbsp;</span>all specialties.<br><br><span style="color: #2a2a2a;">-&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; IJSS tries to inform its readers about latest research developments and key issues from all disciplines. 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The presence of IANAL was identified by carefully observing the course of mandibular canal and reverse looping upward and backward. The length of IANAL and interforamen and interloop distances was measured using digital ruler.<br>Results: Among a total of 236 radiographs, IANAL was visualized in 54 (22.9%) subjects, of which 33 (61%) were males and 21 (39%) females. The length of IANAL was significantly greater in males than females (P = 0.000). There was no statistically significant difference found in interloop distance between males and females (P = 0.361). The interforamen distance was significantly greater in males than females (P = 0.000).<br>Conclusions: The occurrence of IANAL was found to be 22.9%. The males had greater occurrence of IANAL than females. Interforamen distance was significantly greater in males than females. Author recommends a distance of around 5 mm from the most anterior point of mental foramen could be considered safe for placing implants among Saudi population of Aseer province.</p> 2021-10-05T00:00:00+00:00 Copyright (c) 2021 INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY Study of Anatomical Variations in Middle Cerebral Artery 2021-10-05T04:24:04+00:00 R Jeyakumar R Veerapandian <p>Introduction: Middle cerebral artery (MCA) is the largest and most complex arterial system of the brain. An attempt has been made in this study to enhance our perception of the variations in the microvascular anatomy of MCA in our population.<br>Aim: The aim of the study was to study the variations in the microsurgical anatomy of the MCA in our population and to compare the variables with the studies on Western population and to discuss its importance with anatomic and surgical considerations.<br>Materials and Methods: A total of 15 fresh adult cadavers of both sexes were studied in the autopsy room in Madurai Medical College, Madurai, between June 2008 and January 2009. The different variables with regard to the MCA in our population were analyzed and compared with the studies in Western population as well as with other Indian studies.<br>Results: The mean length of the MCA in this study was 16.37 mm. It was also found to be shorter in length with bifurcating MCA and longer with trifurcating MCAs. The perforators were found to arise predominantly from the inferomedial aspect of the M1 segment. The branching pattern of MCA showed bifurcation in 73% and trifurcation in 27%.<br>Conclusion: MCA is larger of the two branches of internal carotid artery (ICA), and it is direct continuation with the ICA which favors any emboli to get lodged or secondaries to get deposited or abscess formation. Thorough knowledge of the microvascular anatomy and the myriads of variations are very essential for the operating surgeon to choose the ideal technique to avoid any catastrophe during and after surgery and to give the best possible functional outcome for the patients.<br><br></p> 2021-10-05T04:24:04+00:00 Copyright (c) 2021 INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY Study of Histopathological Pattern and Frequency of Ovarian Tumors in Western Region of India: A Study at Tertiary Care Centre 2021-10-05T04:32:34+00:00 Palak J Modi Jignasa N Bhalodia Nilesh M Shah <p>Objective: The objective of the study was to study and analyze the various histopathological pattern and age distribution of ovarian neoplasms.<br>Materials and Methods: This is a study of ovarian neoplasm at tertiary care hospital over a period of 5 years. A total of 308 ovarian lesions were studied. Specimens were received in formalin, and hematoxylin and eosin stained slides were examined.<br>Results: Out of 308 total ovarian lesions studied, 100 (32.46%) were found neoplastic lesions. Out of which 88% were benign, 4% borderline and 8% were malignant. Except four cases, all 96 cases were unilateral neoplasms. Benign neoplasms were more common than borderline and malignant neoplasms in all age groups.<br>Conclusion: All kind of neoplastic lesions were most common in 20–59 years of age. Mature cystic teratoma was the most frequent neoplasm observed.</p> 2021-10-05T04:32:34+00:00 Copyright (c) 2021 INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY A Retrospective Comparative Study on Use of Slow Speed Micro Drill Versus Hand Held Micro Burr Drill for Stapedotomy in Otosclerosis Patients 2021-10-05T04:43:00+00:00 Pingili Harish Chandra Reddy K Kamreddy Ashok Reddy <p>Background: Stapedotomy is the standard procedure adopted in the surgical treatment of otosclerosis. In spite of advanced methods like laser being used in higher centers, handheld burr and low-speed drill remain the choice of method for the beginners.<br>Aim of the Study: The aim of this study is to compare the two methods of stapedotomy: Handheld burr and slow-speed drill in stapedotomy in terms of results and complications.<br>Materials and Methods: A retrospective study of 68 stapedotomy procedures performed in the past 6 years was reviewed. Both handheld burr and slow speed micro drill were used in creating stapedotomy. Post-operative evaluation was done using audiometric results (air-bone gap closure and pure tone audiogram). The immediate and late complications were noted and analyzed. In Group A, slow-speed drill was used to cut the posterior crus of stapes as close to the footplate as possible. Fenestration is made in the central area of the footplate using the micro drill. In Group B, handheld 0.2 mm burr was used to drill an initial hole followed by enlargement using a right-angled pick. In both the groups, appropriate size Teflon piston was used.<br>Conclusions: There was no statistical significant difference in the auditory gain in both the groups. Both procedures were safe for stapedotomy and the natures of complications were similar and manageable without permanent long-term effects.</p> 2021-10-05T04:43:00+00:00 Copyright (c) 2021 INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY Functional Outcome of Primary Total Elbow Arthroplasty for Intra-articular Distal Humerus Fractures in Elderly Patients: A Prospective Study 2021-10-05T04:54:36+00:00 Sudarsan Behera Prasanta Kumar Saha Sagnik Ray Ananda Kisor Pal <p>Introduction: Treatment of fractures of distal humerus after the age of 50 years is challenging due to osteoporotic bone and comminution of the articular surface. Distal humerus has complex anatomy with limited options for internal fixation. Open reduction and internal fixation carry risks of loss of fixation, stiffness, infection, and non-union. Arthroplasty carries the risk of loosening, infection, and periprosthetic fractures. The aim is to study the functional outcome of primary total elbow arthroplasty (TEA) for intra-articular distal humerus fractures.<br>Design: This was an institution-based prospective study.<br>Patients: A total of 15 patients in the age group more than 50 years having distal humerus fractures that required surgical treatment with minimal clinical follow-up of 1 year were selected. All fractures were OTA classification 13.C2 or 13.C3. No patient lost the follow-up.<br>Intervention: We used Bakshi’s sloppy hinge elbow prosthesis (3rd generation) as the intervention procedure.<br>Main Outcome Measurement: Mayo Elbow Performance Score was used.<br>Results: Among total elbow replacement group after 1 year, all the patients satisfied (14 excellent and 1 good result). No patients treated with TEA require revision surgery.<br>Conclusion: We recommend TEA which may be a viable option for intra-articular distal humerus fracture in the patients with age more than 50 years. Our study population is small and also the follow-up period is short. Further study with large population with longer duration follow-up is needed.</p> 2021-10-05T04:54:36+00:00 Copyright (c) 2021 INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY Psychogenic Status as a Risk Factor in Minimal Pathological Conditions of the Vocal Cords - A Clinical Study in a Tertiary Teaching Hospital of Telangana 2021-10-05T04:59:55+00:00 Kamreddy Ashok Reddy K Pingili Harish Chandra Reddy <p>Background: Voice disorders are encountered in patients of all ages, gender, and social status. The risk factors are often multifactorial and cannot always be fully described in anatomical or functional terms. Furthermore, voice disorders are much more varied than mere hoarseness. Psychosocial factors can be risk factors and affect the voice in patients with some types of the minimal associated pathological lesions (MAPLs) of the vocal folds.<br>Aim of the Study: The aim of this study is to evaluate patients with MAPLs of the vocal folds to understand the role of psychogenic stress as a risk factor and pathogenesis of this clinical entity.<br>Materials and Methods: A total of 72 patients with MAPLs of the vocal folds were included and evaluated with voice and psychiatric protocols, and the results obtained were compared with a control group of 50 subjects who were also evaluated with the same voice and psychiatric protocols.<br>Conclusions: There was a statistical significance between the both groups in relation to some of the psychiatric scales. The results obtained showed clear evidence of psychogenic background acting as a risk factor in the pathogenesis of certain types of MAPLs of the vocal folds, vocal folds nodules, vocal folds polyps, and contact granuloma.</p> 2021-10-05T04:59:55+00:00 Copyright (c) 2021 INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY A Prospective, Randomized Study Comparing Bupivacaine and Levobupivacaine through Ultrasound-guided Supraclavicular Block in Patients Undergoing Elective Upper Limb Surgeries 2021-10-05T05:08:46+00:00 A Rajendran J Venkateswaran M Gobinath Heber Anandan <p>Introduction: Levobupivacaine is a pure S-enantiomer of bupivacaine, and it has similar anesthetic profile with racemic bupivacaine but reduced toxic potential. We conduct the present study to evaluate and compare the intraoperative hemodynamics and onset and duration of sensory and motor blockade.<br>Aim: This study aims to compare ultrasound-guided supraclavicular block using bupivacaine or levobupivacaine in patients undergoing elective upper limb surgery.<br>Methods: After clearance from ethics committee, single-blinded randomized study carried out on ASA-PS І and ІІ patients, undergoing elective upper limb surgeries under supraclavicular block, was randomly assigned two groups Group A - supraclavicular block with 0.5% bupivacaine (0.4 ml/kg) and Group B - supraclavicular block with 0.5% levobupivacaine (0.4 ml/kg).<br>Results: The duration of sensory and motor blockade was prolonged with levobupivacaine. The onset of sensory and motor blockade and intraoperative hemodynamics was same as bupivacaine. Complete failure and toxicity were not reported in both groups.<br>Conclusion: Levobupivacaine is safer and longer acting local anesthetic and its clinical profile is similar to racemic bupivacaine with reduced toxicity.</p> 2021-10-05T05:08:46+00:00 Copyright (c) 2021 INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY Transarterial Embolization of Renal Vascular Lesions after Percutaneous Nephrolithotomy 2021-10-05T05:15:43+00:00 T Chandru R Neelakandan K Natarajan <p>Introduction: Percutaneous nephrolithotomy (PCNL) is a safe and effective procedure in the surgical management of renal stone disease. Hematuria is one of the most common complications following PCNL. In most cases, the bleeding is self-limited and do not require surgical intervention. Renal arteriography with selective angiographic embolization is required in patients with massive hemorrhage or continuous hematuria. Our aim was to evaluate the effectiveness of percutaneous transarterial embolization for the treatment of renal pseudoaneurysms following post-PCNL bleeding.<br>Materials and Methods: A total of 852 patients who underwent PCNL for renal calculus, between March 2014 and October 2017 and included 12 patients who had undergone renal embolization due to significant post-PCNL renal artery bleeding. The site, number, and type of bleeding lesions, and the result of the embolization procedure were recorded. We report on the incidence, treatment, radiological and clinical results of these serious vascular injuries at our institution.<br>Results: Our study has included a large group of patients, the 100% angiographic success rate confirming that percutaneous transcatheter embolization is a valuable treatment for most renal vascular injuries. Renal angiography revealed pseudoaneurysm in 10 patients, arteriovenous fistula in 1, and arterial laceration in 1 patients. Significant risk factors on univariate analysis for severe hematuria requiring superselective angiography were multiple/staghorn calculi, upper calix puncture, and history of pyelonephritis. The severity of the hematuria after PCNL is influenced by many factors, including mean stone size and mean operative time, and is correlated with duration of hospitalization and mean hemoglobin drop.<br>Conclusions: Percutaneous transarterial embolization of the injured vessel is an effective,f minimally invasive and relatively easy procedure in experienced centers, with a high rate of success and immediate benefits, thus saving the patient from the morbidity that result from severe renal bleeding.</p> 2021-10-05T05:15:43+00:00 Copyright (c) 2021 INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY Comparative Evaluation of Fracture Resistance of Endodontically Treated Teeth with Epoxy Resin-based Sealer AH Plus and Zinc Oxide Eugenol: An In Vitro Study 2021-10-05T05:20:19+00:00 M Harihara Sabari <p>Introduction: Endodontic treatment while trying to save a tooth reduces the tooth structure which, in turn, reduces the fracture resistance of the tooth. Certain root canal sealers by improving the bond between the root canal filling materials and the tooth structure increase the fracture resistance of the tooth.<br>Aim: This study aims to evaluate and compare the fracture resistance of endodontically treated teeth obturated with gutta-percha using two sealers, AH Plus and zinc oxide eugenol.<br>Materials and Methods: A total of 60 single-rooted mandibular premolars, decoronated at cementoenamel junction, were divided into two groups (n = 30 each). Cleaning and shaping of root canals were done using ProTaper rotary files and 3% sodium hypochlorite irrigation. Obturation was done using sealers, AH Plus in Group 1 and zinc oxide eugenol in Group 2 and gutta-percha. The teeth were subjected to vertical loading using a universal testing machine, and the readings were recorded at the point at which fracture of the roots occurred.<br>Results: According to the study, it was found that AH Plus showed better fracture resistance than zinc oxide eugenol. Statistically significant difference was found between the two groups.<br>Conclusion: AH Plus showed better fracture resistance than zinc oxide eugenol when used as root canal sealer with gutta-percha.</p> 2021-10-05T05:20:19+00:00 Copyright (c) 2021 INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY A Study of Canal Wall down Mastoidectomy with Soft-wall Reconstruction 2021-10-05T05:29:55+00:00 C Ravikumar K Priyatharisini M Senthil Kanitha D Rajkamal Pandian Heber Anandan <p>Introduction: CSOM is a common clinical disease seen in an outpatient setting which causes social disability due to accompanying hearing loss. Treatment may be medical or surgical but aims to limit the disease and improve hearing loss.<br>Aim: Aim of this study is to evaluate the outcome of canal wall down (CWD) mastoidectomy with soft-wall reconstruction using cartilage in an unsafe ear.<br>Method: Prospective study conducted in 38 patients who had the atticoantral disease (cholesteatoma and granulations in attic). Clinical examination, pure tone audiogram was done before and after surgery.<br>Results: Of 38 patients 84% had significant hearing improvement following surgery. After surgery, 79% showed well-healed ear with 10% showing no significant hearing outcome. 8% had ear discharge after surgery while 2% showed recurrence.<br>Conclusion: Early identification of cholesteatoma and intervention with soft-wall reconstruction lead to auditory and cosmetic improvement.</p> 2021-10-05T05:29:55+00:00 Copyright (c) 2021 INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY Relationship Between Cholesterol and Gallstones, is There Really a Link? A Review of 80 Cases 2021-10-05T06:20:45+00:00 Naveen Alexander Rufus Ranjit Singh Edwin Prabhu Purushothaman Saravanan Sanniyasi <p>Background: Cholelithiasis or gallstones and symptomatic or incidental forms a major chunk of general surgical outpatient population, with laparoscopic cholecystectomy being a very commonly done procedure. Many risk factors have been associated with the development of gallstones. The authors study a possible link between gallstones and levels of the different components of cholesterol.<br>Objective: This study aims to identify and establish a positive link between gallstones and cholesterol by analyzing of lipid profile.<br>Materials and Methods: This is a prospective study done from October 2015 to August 2017 and included 80 patients with cholelithiasis or choledocholithiasis diagnosed through radiological studies. Fasting lipid profiles were done for all of them.<br>Results: A total of 80 patients were evaluated in this study. 12 patients had hypercholesterolemia contributing to 15% of the study population, equivalent to similar studies on general population. 23 patients (28.7%) had high triglyceride levels, equivalent to general population prevalence. 79/80 patients had a low high-density lipoproteins (HDLs), much higher than general prevalence of 72.3%, showing a strong correlation between gallstones and decreased HDL levels. 35/80 had high levels of low-density lipoproteins (LDLs) (43.8%), compared to national level 11.8%, showing a strong correlation between gallstones and increased LDL.<br>Conclusion: With the above data, it was surprisingly proved that low HDL levels and high LDL levels played a more important role in the formation of gallstones. This is of more importance because serum LDL and HDL levels can be controlled by change of lifestyle and dietary patterns.</p> 2021-10-05T06:20:45+00:00 Copyright (c) 2021 INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY Effect of Employees’ Communication Skills on the Development of Health Services Management in the Jordanian Hospitals 2021-10-05T06:27:07+00:00 Mohammad-Noor Said Deeb Okour <p>At any organization, communication between the employees plays a significant role in improving its operations. In hospitals, communication between employees is more critical since they are dealing with lives of patients, where a single error could be devastating. In hospitals, communication between the employees plays a significant role in enhancing the health services through patients handling between the different teams and in knowledge sharing that have many advantages including saving effort and time, avoiding repeated procedures, raising the experience, and increasing the patients’ satisfaction.</p> 2021-10-05T06:27:07+00:00 Copyright (c) 2021 INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY Evaluation of Anatomical Variations in Ostiomeatal Unit by Computed Tomography 2021-10-05T06:37:28+00:00 Sushilkumar Kale K Preetha <p>Introduction: The ostiomeatal unit has a lot of anatomical variations. Evaluation of these variations is important in patients who undergo computed tomography (CT) scan for their Rhinological complaints. These anatomical variants are responsible for chronic ailments like rhinosinusitis, and their knowledge is essential to not only reduce complications during procedures like functional endoscopic sinus surgery but also to explain the disease recurrence and allow surgeons to decide their operative approach.<br>Purpose: The purpose of the study was to evaluates and determine the incidence of anatomical variations of ostiomeatal unit on CT and to assess the relation of these variations with sinonasal mucosal diseases.<br>Materials and Methods: This is a prospective cross-sectional study done at the Department of Radiodiagnosis in a tertiary care center over a period of 24 months with 100 subjects having sinonasal complaints which were referred from various departments for CT scan.<br>Results: The attachment of the uncinate process had many variations with attachment to the lamina papyracea being 84%, attachment to the skull in 8%, attachment to the middle turbinate in 6%, and free lying in 2%. The uncinate process pneumatization was seen in 6% cases. Giant ethmoid bullae were noted in 11% cases while hypoplastic ethmoid bullae were seen in 4%. In terms of association with sinusitis, only uncinate process pneumatization was found to have a significant statistical association.<br>Conclusion: The most common ostiomeatal unit anatomical variant was varied attachment of the uncinate process. The least common variant noted was the uncinate process pneumatization; however, only this variant was found to have a positive correlation with sinusitis in comparison to other ostiomeatal unit variants.</p> 2021-10-05T06:37:28+00:00 Copyright (c) 2021 INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY Intravenous Infusion of Ketamine in Children Undergoing Strabismus Surgery - A Prospective Study 2021-10-05T06:44:54+00:00 R Radhakrishnan R Mala Gowtham Ganesan Heber Anandan <p>Introduction: Strabismus surgery may be associated with significant post-operative pain. Conjunctiva is the main source of this pain.<br>Aim: The aim of the study was to study the effects of intravenous infusion of ketamine in children undergoing strabismus surgery.<br>Materials and Methods: A total of 40 patients were enrolled in the study. 20 patients were infused 1–3 mg/kg/h ketamine, (a bolus of 0.1–0.2 mg/kg and a maintenance infusion of 0.0025–0.02 mg/kg/min) after giving fentanyl 1 mic/kg and atracurium 0.5 mg/kg patient were intubated (ketamine group) and for other 20 patients after giving fentanyl 1 mic/kg and atracurium 0.5 mg/kg patient were intubated and supplemented with sevoflurane 2% (control group).<br>Results: The consumption of anesthetics and antiemetics, the incidence of oculocardiac reflex (OCR) in these patients was significantly low. The recovery time, Ramsay sedation score, and face pain scale were significantly lower in ketamine anesthesia.<br>Conclusion: The ketamine infusion is more advantageous and safer in pediatrics for strabismus surgery with an insignificant incidence of intraoperative OCR and post-operative pain, post-operative nausea and vomiting.</p> 2021-10-05T06:44:53+00:00 Copyright (c) 2021 INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY Comparison of Three Different Tests for Diagnosis of Enteric Fever 2021-10-05T06:50:04+00:00 Mallika Sengupta Manideepa Sengupta <p>Background: Enteric fever is a systemic illness caused by Salmonella Typhi and Salmonella Paratyphi. The different methods for diagnosis of enteric fever are blood, bone marrow, rarely stool and urine culture, nucleic acid detection, antibody detection by Widal test, and other rapid diagnostic tests.<br>Aim: The study was performed to evaluate the performance of tube Widal test, Typhiwell enzyme-linked immunosorbent assay (ELISA) test, and Typhifast, an immunochromatographic (ICT) test.<br>Materials and Methods: This study was carried out in the Department of Microbiology in a tertiary care center for 1 year (January–December 2015). The serum samples were collected from the patients with fever who had positive blood culture report. A total of 50 samples were included, of which 21 were positive for S. Typhi, 9 were positive for S. Paratyphi A, and 20 samples were positive for other organisms such as Escherichia coli (8 isolate), Klebsiella pneumoniae (8 isolate), and Staphylococcus aureus (4 isolate) by blood culture. The serum samples were used for doing the various tests for diagnosis of enteric fever such as tube Widal test, Typhiwell, ELISA test, and Typhifast, an ICT test.<br>Results: The three serological tests were performed and compared with blood culture, and it was found that Typhifast had a sensitivity of 70% and specificity of 100%, Typhiwell had a sensitivity of 90% and specificity of 75%, and Widal test had a sensitivity of 83.3% and specificity of 80%.<br>Conclusion: Widal test had a fairly good sensitivity and specificity, whereas Typhifast had a very good specificity but a lower sensitivity.</p> 2021-10-05T06:50:04+00:00 Copyright (c) 2021 INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY Prevalence and Clinical Presentation of Fissure-in-ANO in A Tertiary Care Centre 2021-10-05T06:56:17+00:00 M S Varadarajan P S Sony Heber Anandan <p>Introduction: Fissure-in-ano is a common proctologic problem encountered. It is a tear in anal mucosa distal to dentate line usually seen in the posterior midline. Hypertonia of internal anal sphincter and local ischemia is thought to be the pathology behind anal fissures.<br>Aim: The present study aims at determining the prevalence and clinical presentation of fissure-in-ano.<br>Materials and Methods: This study is a cross-sectional study conducted at Tirunelveli Government Medical College in patients with anorectal ailments who were randomly selected in this study. The diagnosis was made on the basis of anorectal examination which included inspection, digital rectal examination, and proctoscopic examination.<br>Results: Our study found out that out of the 325 patients with anorectal ailments, 100 patients (30.7%) were having anal fissures. Out of them, 54 were males and 46 were females, majority were under 40 years age. Pain during defecation, bleeding and constipation were reported as the common clinical symptoms. 76% of patients with fissure-in-ano had an acute presentation and the most common location was reported to be posterior midline (98%).<br>Conclusion: Our study reveals that fissure-in-ano is a common proctologic disease. Lifestyle modification plays a major role in cure of this condition as constipation, and low fiber diet are the direct etiological factors.</p> 2021-10-05T06:56:17+00:00 Copyright (c) 2021 INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY Perception of Anesthesiology Students of Zahedan University of Medical Sciences from Clinical Learning Environment 2021-10-05T07:05:48+00:00 Gholam Hossein Sargazi Asadollah Kykhaee Fatemeh Piri Hamed Faghihi <p>Introduction: An appropriate learning environment is crucial for delivering quality education. Students’ expectations from the clinical learning environment differ from the real environment. The purpose of this study is to determine the perception of anesthesiology students of Zahedan University of Medical Sciences from clinical learning environment in the academic year of 2016–2017.<br>Methodology: This is descriptive, cross-sectional study in the academic year of 2016–2017 on 100 anesthesiology students of Faculty of Paramedics of Zahedan University of Medical Sciences, Iran. They all had passed at least two courses of internship in the operating room. A researcher-designed questionnaire of clinical perception was employed to evaluate the students’ perception. To develop the questionnaire, the questionnaire for nursing students’ perception of clinical learning environment by Mirzaee et al. (2009) was used.<br>Findings: Evaluations show that 53% of the students are female and 47% are male. 26.8% of the participants were married, while 73.2% were single. The age of the students ranged from 18 to 23 years. In terms of gender, 55 were female and 45 were male. From the perspective of the students, the most effective factor in clinical training is supported learning by the trainer. “Ward’s environment,” “supervisory relationship,” “personalization,” and “independence” are also found to be important.<br>Discussion: Research shows that students claim that clinical training is the most stressful course. Most medical students believe that clinical experiences are the cause of anxiety. In this study, trainer is the most important factor in clinical training from the perspective of students. 41.29% of students believe that the clinical trainer is on time in clinical environment and 97.3% state that trainers care about the students’ timely presence in the clinical environment.</p> 2021-10-05T07:05:47+00:00 Copyright (c) 2021 INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY A Study on the Risk Factors for Conversion of Laparoscopic Cholecystectomy to Open Cholecystectomy 2021-10-05T07:14:20+00:00 Goparaju Shanti Kumar Nagabandi Vinay Babu Reddypally Naga Sudha Ashok Divvela Mohan Das <p>Background: Cholecystectomy is the most commonly performed surgery for gallbladder (GB) diseases. Presently Laparoscopic Cholecystectomy is performed routinely due its advantages over Open Cholecystectomy. However in certain conditions conversion to Open Cholecystectomy is required. Knowledge regarding the underlying reasons for conversion could help surgeons during pre-operative assessment and obtain consent of patients with all information provided to them about the conversion to be done if required so that they could have adequate psychological preparation and planning of convalescence. The prediction of a high risk of conversion or a difficult laparoscopic procedure would also allow efficient and appropriate arrangement of the operating schedule and the availability of experienced laparoscopic surgeons for the procedure. It would also allow an earlier intra- operative decision to convert if difficulty is encountered.<br>Study Design: The study design is of case series.<br>Aim of the Study: The aim is to study and identify the risk factors for conversion of LC to OC in Indian conditions (Telangana) and to determine the predictive factors of conversion in patients undergoing LC.<br>Results: This study was done prospectively over a period of 2 years, from September 2014 to September 2016, among 206 patients who underwent LC for symptomatic GB disease in all Surgical Units of Mahatma Gandhi Memorial Hospital, Warangal. Among the 206 patients in the study, 23 (11.16%) patients were converted to OC. The most common reasons for conversion are severe adhesions caused by tissue inflammation (12 patients [52%]) and inability to define anatomy due to fibrosis of Calot’s triangle (5 patients [21.7%]). Conversion to OC due to intraoperative hemorrhage occurred in three patients. Conversion was enforced due to uncontrolled bleeding from GB bed in one patient (4.35%), which occurred during diathermic dissection of GB. In another two patients (8.7%), there was uncontrolled bleeding from Calot’s triangle, which occurred during dissection of cystic duct and artery. Conversion to OC was required to achieve successful hemostasis, as they could not be controlled laparoscopically. Conversion to OC caused by injury of the common bile duct (CBD) occurred in one patient (4.35%), and the injury is identified intraoperatively and repaired over a T-tube. In one patient (4.35%), conversion to OC was required to perform CBD exploration for suspected choledocholithiasis, based on laparoscopic finding of dilated CBD; pre-operative liver function tests (LFTs) and ultrasound were normal in this patient, and intraoperative OC facility was unavailable. Conversion to OC occurred due to equipment failure in one patient (4.35%). Conversion was due to inability to establish and/or maintain sufficient pneumoperitoneum during the course of LC and due to clip applicator failure.<br>Conclusions: (1) In this study, the following factors are identified as significant risk factors for conversion of LC to open cholecystectomy. (i) Advanced age (&gt;60 years), (ii) obesity (body mass index &gt;27.5 kg/m2), (iii) leukocytosis, (iv) abnormal LFT; ultrasonography findings (1) thickened GB wall &gt;4 mm, (2) evidence of pericholecystic fluid; (v) LC done in emergency setting for acute cholecystitis; no significant risk factors: (a) Gender, (b) previous upper abdominal surgery, (c) comorbidities; (2) In patients with these risk factors, management can be improved by (i) pre-operative counseling of the patient regarding these risk factors and high chances of conversion and (ii) early conversion to OC.</p> 2021-10-05T07:14:19+00:00 Copyright (c) 2021 INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY An Easy Method to Reduce Complex Second Metacarpophalangeal Joint Dislocation 2021-10-05T07:20:40+00:00 D ThirumalaiPandiyan P Venkatesan <p>Introduction: Dislocation of metacarpo phalangeal joint of index finger is an uncommon injury encountered in day today practice. Though closed reduction is tried, the head of the metacarpal bone is button holed within capsule- ligamentous attatchments resulting in the need of surgical intervention. In this study, we advocate a percutaneous dorsal approach to reduce the dislocation.<br>Aim: To evaluate the effectiveness of percutaneous dorsal incision over open surgical intervention in the patients with metacarpophalangeal joint dislocation.<br>Materials and Methods: This prospective study was done in Thanjavur medical college from 2010-2017 for a period of seven years after getting approval from the ethical committee. Twenty patients with complex MCP joint dislocation were included in the study. Informed and written consent is obtained from the participants. All the patients were subjected to X-ray examination of the hand to assess the bony injuries and joint status. Percutaneous dorsal incision was made to reduce the dislocation. All the patients were followed up for 3 months and the results were analysed.<br>Results: The final results showed good joint mobility without stiffness in 16 patients, stiffness of the joint in 4 patients and no recurrent dislocations were noted.<br>Conclusion: Complex dislocation of Metacarpophalangeal joint of index finger which is irreducible by closed manipulation is best approached by percutaneous incision. This technique is easier, simpler with minimal neurovascular injuries. Further clinical evaluation is to be done to assess the effectiveness of this method.</p> 2021-10-05T07:20:40+00:00 Copyright (c) 2021 INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY Study of the Level of Awareness of Chronic Kidney Diseases among Diabetic Patients in Al-Ahsa Governorate, Kingdom of Saudi Arabia (Cross-Sectional Study) 2021-10-05T07:36:36+00:00 Dawood Salman Albujays Hany Said El-barbary Abdulaziz Khalid Althafar Abdullah Hisham Almulla Marwan Abdulrahman Al-Shaikh Hussain Sayed Ibrahim Ali <p>Introduction: Chronic kidney disease (CKD) is one of the most common complications affected by diabetes mellitus (DM) in the world. It is a life-threatening complication in diabetic patients, and this will cause end-stage renal disease in developed countries. No study has been done before in the eastern region of Saudi Arabia. Making it important to do such kind of studies.<br>Purpose: The purpose of this study is to determine the level of awareness of CKD among diabetic patients in Al-Ahsa Governorate, Kingdom of Saudi Arabia.<br>Materials and Methods: This cross-sectional study was conducted in Al-Ahsa Governorate of Saudi Arabia, from March 2017 to December 2017. The researchers have done the questionnaire on 372 individuals of diabetic patients. Data analysis was done using SPSS program version 24.<br>Results: The minimum age of the participants was 19, and the maximum age was 65. More than half of them are in the age group (40–70). The number of male participants is 107 (28.8) and females 265 (71.2). The mean score of the level of awareness was 7.5 ± 3.2. However, the number of the participants who know that DM can cause CKD are 196 (52.7.9%). 100 (26.9%) were not aware of the association between CKD and uncontrolled diabetes. 76 (20.4%) of the participants did not hear about CKD. However, the majority of Saudi populations were not aware of the association between CKD and uncontrolled diabetes. We summarize our findings that our patients had poor attitude and knowledge of awareness compared to the others, which emphasize the needs for implementation of awareness campaigns, future public health, and educational interventions.<br>Conclusion: CKD is common and growing problem worldwide but not adequately recognized problem among diabetic population in Al-Ahsa Governorate, Kingdom of Saudi Arabia. As there is lack of awareness among Saudi diabetic population about this problem, there is a strong need for health and educational intervention programs to increase the knowledge level and awareness about this disease as well as the necessity of screening and periodic follow-up programs.</p> 2021-10-05T00:00:00+00:00 Copyright (c) 2021 INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY Breastfeeding and Weaning Practices Among Mothers Coming to Primary Health Care Center: An Experience From Rural Bihar 2021-10-05T08:02:13+00:00 Setu Sinha Varsha Singh Sanjay Kumar Sanjay Kumar Choudhary Shivani Sinha Birendra Kumar <p>Background: Breastfeeding is an ideal form of infant feeding. Breastfeeding and weaning are not properly practiced by many mothers in all corners of the country. There are a number of factors that influence breastfeeding and weaning practices.<br>Aim: The aim of this study was to find out the pattern of breastfeeding and weaning practices among mothers in this part of the country.<br>Materials and Methods: It was a cross-sectional study conducted at Primary Health Care Center, a Rural Health Training Center of Indira Gandhi Institute of Medical Sciences. Mothers coming for measles immunization were enrolled in the study. Interviews were conducted with semi-structured questionnaire.<br>Result: A total of 160 mothers were enrolled in the study. More than half of them (63%) were in the age group of 20–25 years and less than a quarter were illiterate. Almost all mothers (92%) started breastfeeding same day after delivery but only one-third fed colostrums to their newborn. A good number of mothers (73%) started weaning before 6 months.<br>Conclusion: Emphasis on importance of colostrum and exclusive breastfeeding need to be dispensed at the time of interaction with health-care delivery personnel.</p> 2021-10-05T08:02:13+00:00 Copyright (c) 2021 INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY Study on Retinopathy of Prematurity and Its Risk Factors in Preterm Babies and Birth Weight <2 kg Admitted in a Rural Medical College 2021-10-02T10:52:34+00:00 R Selvakumar C Vasanthamalar V Jeyaramapandian <p>Background: Retinopathy of prematurity (ROP) is a potentially blinding condition commonly seen among premature infants. The most important aspect about ROP is that it is preventable and treatable by adequate and early screening. Hence, the present study has been designed to evaluate the incidence and risk factors of ROP in premature babies.<br>Objective: The objective of this study was to study ROP and its risk factors in preterm babies (&lt;34 weeks and &lt;2 kg).<br>Methods: This is a descriptive study conducted among all preterm babies &lt;34 weeks and all preterm babies &lt;2 kg admitted during the period of August 2016–July 2017. ROP screening was done in these babies on day 28 and complete history was recorded. Every week follow-up was done for babies with ROP and the risk factors were assessed.<br>Results: Among a total of 301 babies screened, 29 babies were diagnosed to have ROP. Our study showed normal vaginal delivery, birth weight, respiratory distress syndrome (RDS), surfactant, apnea, sepsis, and blood transfusion as the statistically significant risk factors (P &lt; 0.05). The mode of oxygen delivery also played an important role. Statistically significant relationship was present between RDS and ROP.<br>Conclusion: With greater recognition of the risk factors of ROP and the understanding that timely treatment can save our vision, our community may be able to reduce the high burden of ROP, leading to morbidity.</p> 2021-10-02T00:00:00+00:00 Copyright (c) 2021 INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY Clinico-Radiological and Pathological Profile of Lung Cancer Patients: An Experience from Tuberculosis and Chest Department of Indira Gandhi Institute of Medical Sciences, Patna: A Tertiary Health Care Centre of Bihar 2021-10-02T10:53:12+00:00 Manish Shankar Kalyan Kumar Saha Praveen Kumar Saket Sharma Samir Kumar <p>Introduction: Today, lung cancer is the leading cause of cancer-related morbidity and mortality worldwide. Lung cancer especially shows varied epidemiological, clinico-radiological, and pathological profile. Majority of patients are at advanced stages before reaching to hospital. Lung cancers are growing at fast pace due to smoking habits, especially in Bihar. There are very sparse data of lung cancer patients especially in this part of the world.<br>Aim: This study aims to evaluate the clinico-radiological, demographic, and pathological profile of lung cancer patients reaching to Tuberculosis (TB) and Chest Department of Indira Gandhi Institute of Medical Sciences (IGIMS), Patna, Bihar and to assess the yield of various diagnostic processes used for the diagnosis.<br>Materials and Methods: This is a retrospective observational study done between September 2016 and February 2018 at TB and Chest Department of IGIMS, Patna, Bihar which is a tertiary health-care institute. Around 216 of proven lung cancer patients were enrolled for the study. Their history, clinical details, radiological, pathological, and demographic profiles recorded in the departmental records were analyzed in details using SPSS software.<br>Results: A total of 216 patients were included in our study of which 154 (71.29%) were male and 62 (28.7%) were female. Most patients were in the age bracket 66–75 years (33.88%). Most of the patients belonged to rural background (65.27%). About 71.29% of patients were smokers or former smokers. Adenocarcinoma was the most common histological subtypes documented, i.e., 89 patients (41.20%).<br>Computed tomography scan and ultrasonography-guided percutaneous biopsy combined was the most common modality of successfully diagnosing lung cancer, in about 25.92%. Majority of patients reached in advanced stage 63.88% among non-small cell lung cancer before arriving to health care facility (in Stage IVA). Mass was the most common radiological diagnosis in about 42.59%.<br>Conclusion: Adenocarcinoma is the leading type of lung cancer found in this study especially in this part of the world. Moreover, there is growing trend of lung cancer among females. Smoking is still the leading cause. Majority of patients reach at an advanced stage before diagnosis. Hence, aggressive approach is needed for earlier diagnosis of lung cancer for timely management.</p> 2021-10-02T00:00:00+00:00 Copyright (c) 2021 INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY Effect of Proper Lifestyle Modifications on the Management of Type 2 Diabetes Mellitus 2021-10-07T04:07:26+00:00 Kalyan Kumar Saha Manish Shankar Amarendu Kumar Kumari Sneha Praveen Kumar Sudhir Kumar Amit Kumar Mishra Rakesh Roshan <p>Introduction: Diabetes mellitus (DM) comprises a group of metabolic disorders that share the common feature of hyperglycemia. It is closely linked to change in lifestyle such as decreased physical activity, a change in diet to the one of high-fat, high-energy intake, and rapid modernization into a western society. Patients with DM can be managed by lifestyle modifications in the form of diet, physical activity, and psychological assessment with care along with drugs.<br>In this, we studied the effects of comprehensive lifestyle modifications and their effect on glycemic control, blood pressure, lipid profile, body weight, and 24 h urinary protein for the management of DM.<br>Material and Methods: This study was performed between November 2015 and May 2016 at Indira Gandhi Institute of Medical Sciences, Patna. Lifestyle modification included diet instruction, exercise, weight reduction programs, and de-stressing session. Body weight, glycated hemoglobin (HbA1C), serum triglyceride, serum low-density lipoprotein (LDL), blood pressure, and 24 h urinary proteins were measured at baseline and after 6 months of lifestyle modification program.<br>Results: The results of lifestyle modification after 6 months of lifestyle modification were favorable with a mean reduction in HbA1C, LDL cholesterol, triglycerides, systolic blood pressure, diastolic blood pressure, and 24 h urinary protein are 0.09, 3.32, 16.88, 00.64, 3.68, 2.04, and −232.04, respectively.<br>Conclusion: Comprehensive lifestyle management is an important aspect of diabetes management.</p> 2021-10-05T08:16:03+00:00 Copyright (c) 2021 INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY Comparative Evaluation of Ropivacaine and Lignocaine with Ropivacaine, Lignocaine, and Clonidine Combination during Peribulbar Anesthesia for Cataract Surgery 2021-10-05T08:53:54+00:00 G R Rajashree K Kala Heber Anandan <p>Background: Peribulbar is the most commonly used technique of anesthesia in cataract surgery, and ropivacaine is a new amino amide local anesthetic with the safer pharmacological profile.<br>Aim: A double-blind, prospective, and randomized study carried out in our institution after getting approval from the Ethical Committee, to compare the anesthetic effects of ropivacaine with the combination of ropivacaine and clonidine in the administration of peribulbar block in cataract surgery.<br>Materials and Methods: A total of 80 patients of both sexes aged 40–80 years of ASA PS Ι, ΙΙ, scheduled for cataract surgery was included in this study. Patients were allocated to two groups 0f 40 each; ropivacaine, lignocaine group (R group) who received peribulbar block with 2.5 ml of lignocaine (2%) + 2.5 ml of ropivacaine (0.75%) + 50 units of hyaluronidase to a total volume of 5 ml and ropivacaine, lignocaine, clonidine group (RC group) received peribulbar block with 2 ml lignocaine (2%) + 2 ml of ropivacaine (0.75%) + 50 units of hyaluronidase +1 μg/kg of clonidine to a total volume of 5 ml. Heart rate (HR), mean arterial pressure (MAP), pulse oximetry (SpO2), intraocular pressure (IOP), and quality of peribulbar block were observed throughout the intraoperative period at regular intervals. Duration of analgesia was observed in the post-operative period.<br>Results: Demographic characteristics, SpO2 were comparable in both groups. The onset of sensory and motor blockade was significantly earlier in RC group. IOP does not vary significantly in both groups. The HR, MAP was on the lower side in RC group. The duration of analgesia was prolonged in RC group (6.16 h) as compared to R group (3.48 h).<br>Conclusion: On adding clonidine to local anesthetic agent augments early onset and prolonged offset of sensory analgesia. It also reduces the volume of local anesthetic requirement. They maintain the hemodynamic throughout the procedure.</p> 2021-10-05T08:53:54+00:00 Copyright (c) 2021 INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY Role of Minimally Invasive Urological Intervention in Acute Pyelonephritis - A Prospective Study 2021-10-05T09:40:40+00:00 Shivraj Bharath Kumar Velmurugan Palaniyandi Sriram Krishnamoorthy Venkat Ramanan Natarajan Kumaresan <p>Introduction: Acute Pyelonephritis (APN) is an acute bacterial infection of the renal pelvis and parenchyma. The clinical spectrum ranges from mild cystitis to severe Emphysematous Pyelonephritis where there is destruction of the parenchyma with gas formation.<br>Aim: To analyze factors determining need for Double J stenting in patients with Acute Pyelonephritis and also to study the clinical profile and predisposing factors associated with Acute Pyelonephritis.<br>Materials and Methods: A prospective study was conducted on 100 patients with pyelonephritis. These patients were subdivided into Group 1 (n=52, who had DJ stenting done) and Group 2 (n=48, who were conservatively managed).<br>Statistical Analysis: Descriptive statistics frequency analysis and percentage analysis were used for categorical variables and the mean and S.D. was used for continuous variables. To find the significance in categorical data Chi-square test and Fisher’s exact test were used.<br>Results: Presence of turbid urine is one of the symptoms that needed DJ stenting. Patients with emphysematous pyelonephritis more often needed DJ stenting. Serum creatinine was initially high at presentation in most patients in both groups. However, in Group 2, all patients reached normal nadir levels with conservative management. In group 1, none of them had normal levels reached with conservative measures.<br>Conclusions: Factors that decided the final outcome included gross pyuria, significant fever spikes despite medication, persistent loin tenderness, persistently high total count despite medication, persistently high serum creatinine, thrombocytopenia, positive blood or urine culture and HbA1c &gt; 9.2%. The presence of 2 or more of the above factors in a patient indicates need for stenting in APN cases.</p> 2021-10-05T09:40:40+00:00 Copyright (c) 2021 INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY Value of Argyrophilic Nucleolar Organizer regions in Benign, Premalignant, and Malignant Lesions of Cervix Uteri 2021-10-05T10:10:31+00:00 Rajesh Mahobia Muktesh Khandare Rashmi Nayak Bhagwan Singh Yadav <p>Objectives: The objective of this study is to evaluate the correlation of argyrophilic nucleolar organizer region (AgNOR) count between benign, premalignant cervical intraepithelial neoplasia (CIN), and malignant lesions of cervix.<br>Method: A retrospective study of 150 cases of paraffin-embedded blocks were histologically grouped as (A): Normal cervix, (B): Benign lesions - chronic cervicitis without dysplastic change, (C): Cervix with CIN I and II, (D): CIN III (E): Squamous cell carcinoma - well-differentiated, (F): Squamous cell carcinoma - moderately differentiated, (G): Squamous cell carcinoma - poorly differentiated (small cell non-keratinizing), and (H): Adenocarcinoma of cervix. The paraffin blocks were further subjected to thin sections, and silver staining (AgNOR) was done in the dark at room temperature. The AgNOR counting was done under oil immersion (×100). The number of black dots per 100 cells was counted and averaged.<br>Result: In this study, the mean AgNOR count was found to be statistically significant (t = 3.5 –21.8) at a confidence limit &lt;0.0, clearly proving proliferative activity of the benign, premalignant, and malignant nucleoli.<br>Conclusion: AgNOR counting progressively increases directly in proportion to increased proliferative activity of the cells: (A+B) normal cervix and chronic cervicitis without dysplasia mean AgNOR count 3.5, (C): Cervix with CIN I and II mean AgNOR count 6.9, (D+E): CIN III and squamous cell carcinoma - well-differentiated mean AgNOR count 10.3, (F+G): Squamous cell carcinoma - moderately and poorly differentiated mean AgNOR count 16.16, and (H): Adenocarcinoma of cervix mean AgNOR count 21.8</p> 2021-10-05T10:10:31+00:00 Copyright (c) 2021 INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY Clinical and Epidemiological Features of Psoriasis in Patients Visiting a Tertiary Care Centre in Eastern Uttar Pradesh 2021-10-05T10:23:20+00:00 Anil Kumar Gupta Ali Mohammad Lalit Mohan Santosh K Singh Sushantika Naveen Kumar <p>Background: Psoriasis is a worldwide disease and varies in its clinical profile and epidemiology in different regions of the world. In India, it is common and few epidemiological data are available in our country.<br>Aims: The purpose of this study was to evaluate the epidemiologic and clinical features of psoriasis in Baba Raghav Das Medical College, Gorakhpur.<br>Materials and Methods: A prospective investigation of a total of 400 patients visiting the Outpatient Department of Dermatology and Venereology of Baba Raghav Das Medical College, Gorakhpur, for psoriasis was done. The parameters included were age at onset of disease, current age, sex, type of disease, and distribution of lesions. Data and statistical analysis were done.<br>Results: The mean age of patients at onset of disease was 26.4 (standard deviation = 14.3) years. M:F ratio was 1.16. Palmoplantar psoriasis (PPP) was the most common variety of the disease. Plantar surface of the foot was most commonly involved.<br>Conclusion: Psoriasis is a common dermatological disease accounting 2.9% of all dermatology patients in our center. PPP is the most common clinical subtype. The disease is more frequent in the third decade of life and has a male predominance in our region. Treatment compliance has been found to be poor.</p> 2021-10-05T10:23:20+00:00 Copyright (c) 2021 INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY Diagnostic Significance of Polymerase Chain Reaction as Compare to Culture and Direct Microscopy in Cases of Pulmonary Tuberculosis 2021-10-05T10:32:31+00:00 Deepak Kumar Warkade Kaustaubh Patil Lalit Jain <p>Background: Tuberculosis (TB) is presently an important health problem worldwide. Situation has changed in recent years due to AIDS pandemic. Hence, it urges the need to introduce specific methods for rapid diagnosis to avoid unnecessary or improper treatment. At present, sputum microscopy is the sole rapid diagnostic method available. Sputum culture may require more than 2 weeks to confirm diagnosis. Hence, detection of Mycobacterium tuberculosis by enzymatic amplification (polymerase chain reaction [PCR]) has been found useful in diagnosis of pulmonary TB.<br>Materials and Methods: The present study includes 45 sputum samples of patients presenting to TB chest OPD with productive cough for more than 2 weeks. Diagnostic tests are applied on sputum samples - direct microscopy by Ziehl–Neelsen staining, culture by modified Petroff’s method, and PCR by commercially available kit (Bio basic INC).<br>Results: Of 45 sputum sample, TB was confirmed by culture in 19 patients, acid-fast bacilli detected in 18 of 19 patients, and all of these patients were positive for PCR.<br>Conclusion: PCR is extremely helpful in detecting Mycobacterium TB in sputum sample as compare to culture and direct microscopy.</p> 2021-10-05T10:32:31+00:00 Copyright (c) 2021 INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY Correction of Transverse Discrepancy Using Rapid Maxillary Expansion with Hyrax Appliance: A Case Report 2021-10-05T10:49:40+00:00 Amol Shirkande Vidyut Prince Jiwanasha Agrawal Manish Agrawal Lalita Nanjannawar Sangmesh Fulari <p>A 14 years young patient presented for the correction of a malocclusion that included a transverse maxillary deficiency. The patient had required to expand his upper jaw to correct his malocclusion. Recent evidence indicates that rapid palatal expansion (RPE) technique can be used without surgery in young adults; the decision was, therefore, made to treat the patient with RPE. RPE of the maxillary arch was achieved by means of a Hyrax appliance. The post-treatment radiographs revealed an opening of the midpalatal suture. It is still believed by clinicians that young adult patients require orthognathic surgery for palatal expansion, despite recent evidence supporting a nonsurgical approach after closure of the midpalatal suture.</p> 2021-10-05T10:49:40+00:00 Copyright (c) 2021 INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY