Online ISSN: 2515-8260

Current Issue
Volume 9, Issue 1

Volume 9, Issue 1, Winter 2022


Functional Outcome of Column Specific Fixation for Intraarticular Distal Radius Fractures with K Wires

Dr. A Manikandarajan, Dr. Dhanpal Singh, Dr. M.Gurumoorthy,Dr. J B Beffrin Rex,Dr. M.Gurumoorthy .

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 1-7

Background: Distal radius fractures shows Bimodal distribution about 25% of the fractures in paediatric age group and 18% fractures in adults. The goals of treating distal radius fractures include articular congruity, radial alignment and length, functional mobility, stability.
Aim: To assess the functional outcome of column specific fixation for intraarticular distal radius fractures with k wire
Material and Methodology: Study was conducted between July 2019 and July 2021 in department of orthopaedics, RMMCH, 23 patients with intra articular distal radius fracture were included in our study. Follow up was done for a minimum of 6 months period, functional outcome was assessed using the Quick DASH scoring system
Results: Of the 23 patients based on our quick DASH scores

Excellent to good results were obtained in 20 patients
Satisfactory results were seen in 3 patients
None of the patients had poor results
Two patients had wrist stiffness attributed to the non compliance with physiotherapy for mobilisation
One patient had mal union due to malreduction attributed to the late presentation to hospital

Conclusion: Column specific fixation with k wire is a less invasive method of treatment of intraarticular distal radius fractures. Although complications like stiffness and malunion were noted it was due to non compliance and late presentation. Hence we would like to conclude that column specific fixation of intraarticular distal radius fractures with k wire shows good long term functional outcome.

Identification of the External Branch of Superior Laryngeal Nerve during Thyroid Surgery – an Observational Study

Dr. R.Jayaraman, Dr. Palanikumar.B .

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 8-11

Background: Thyroid swelling is a condition commonly encountered by General Surgeons. Some patients need only Medical Management, whereas others need Surgical management in the form of Hemi or Total Thyroidectomy. Compared to RLN the EBSLN is less studied in terms of course and relation to thyroid gland intraoperatively. In our study we observed the course and relation of EBSLN with respect to the thyroid gland during surgery.
Materials and Methods: A prospective analysis of 60 patients who underwent thyroidectomy in General Surgery department in Rajah Muthiah Medical College was done. Intraoperatively, the EBSLN was visually identified and preserved before proceeding to ligate the superior thyroid vessels. The nerve was classified according to the Cernea classification.
Results: In 60 patients, 95 nerves were planned to be identified. The nerve was type 1 in 28/95 (29.5%), Type 2a in 46/95 (48.5%), and Type 2b in 11/95 (11.5%) patients. The nerve could not be identified in 10/95 (10.5%) patients.
Conclusion: The course and relation of EBSLN with respect to thyroid gland varies in different thyroid pathologies.

Functional and Radiological Outcome of Proximal 1/3rd Tibial Fractures Managed with Intramedullary Through Suprapatellar Approach

Dr.M.Gurumoorthy, Dr Dhanpal Singh, Dr A.Manikandarajan, Dr S. Dharani .

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 12-24

Aim: To evaluate the clinical and radiological outcome of proximal third tibia fractures managed by intramedullary nailing in knee semi-extended position via the suprapatellar approach.
Methodology: Our study consists of proximal one third tibial shaft fractures which were treated with nailing via suprapatellar approach. The study was done under Rajah Muthiah Medical College and hospital, Duration of the study from May 2019 to December 2021. The patients were followed at intervals of 1 and 6 months and 1 year. Patients were observed for affect in daily day to day activities, union, shortening. The functions were assessed using Lower Extremity Functional Scale (LEFS).
Results: In 20 patients of proximal 1/3rd fracture of tibia within the study with a mean follow-up of 1 year. On an average of 6-7 months the fractures united radiologically. At the top of 1 year, the typical LEFS was 86%. 4 patients had delayed union in that 1 patient had significant bone loss followed by bone grafting and transpositional gastrocnemius flap was done, one patient pre-operatively had anterior skin discolouration which was debrided. Eventually all the fractures were united. There were no post-operative knee pain seen.
Conclusion: Suprapatellar nailing performed with proper instrumentation, proper surgical technique is a viable option in management of proximal 1/3rd tibial fractures. Which has excellent radiological and clinical outcomes with lower complications on comparing to other management. This may be a viable option for proximal 1/3rd (extra-articular) tibia fractures thanks to its inbuilt advantages of placement, perfect nail entry and positioning.

The effects of addition of dexmedetomidine to intrathecal hyperbaric 0.5% bupivacaine in elective lower segment caesarean section:A prospective, randomized, double blinded, placebo-controlled study

Dr. Ajay V Patil,Dr. SangameshKunakeri,Dr. Subodh S Kamtikar,Dr. Rajkumar GB

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 25-30

Background: Spinal anaesthesia is the most commonly used technique for lower abdominal
surgeries as it is very economical and easy to administer. Dexmedetomidine, a new highly
selective α2-agonist, is under evaluation as a neuraxial adjuvant as it provides stable
hemodynamic conditions, good quality of intraoperative and prolonged postoperative
analgesia with minimal side effects.
Methods: Prospective double blinded, placebo-controlled study was undertaken in 60
patients allocated randomly by envelop method, divided into 2 groups (30 in each) between
18-50 years of age of either gender belonging to ASA class I and II scheduled for elective
lower segment caesarean section. Group A received 2 mL of 0.5% hyperbaric bupivacaine
and 0.2ml dexmedetomidine and Group B received 2ml of 0.5% hyperbaric bupivacaine with
0.2ml normal saline. The comparison was studied using the Chi-square test or Fisher's exact
test as appropriate, with the P value reported at the 95% confidence interval. P<0.05 was
considered statistically significant.
Results: The addition of dexmedetomidine resulted in a dose dependent prolongation of
sensory regression to S1 segment, prolonged motor block, the time to first analgesic rescue
was significantly prolonged in Group B as compared to Group A and showed Lower pain
scores as compared to placebo group.
Conclusion: Based on study results we recommend addition of dexmedetomidine 5 μg to
intrathecal hyperbaric 0.5% Bupivacaine 9 mg in elective lower segment caesarean section.

Effect of priming principle on the induction dose requirement of propofol-a randomized clinical trial

Dr. Rajkumar GB,Dr. Subodh S Kamtikar, Dr. SangameshKunakeri,Dr. Ajay V Patil

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 31-36

Background: Based on well-known properties of propofol over last few years this study was
undertaken to evaluate whether priming principle applied for the induction dose of propofol
would affect the total induction dose requirement and reduce the associated side effects.
Methods: The prospective randomized study was undertaken in 100 patients allocated
randomly by envelop method, between 18-55 years of age of either gender belonging to ASA
class I and II scheduled for elective surgeries under general anaesthesia. In group I Inj.
fentanyl 2 μg/ kg administered over a period of 30 seconds intravenously and then induced
with the calculated dose of Inj. Propofol 2mg/kg until the loss of eyelash reflex. In group II,
30 % of the total calculated dose of Inj. propofol 2mg/kg 30 seconds after the administration
of Inj. Fentanyl 2μg/kg over 30 seconds, which will be followed by the administration
remaining calculated dose till the loss of eyelash reflex. Statistical analysis of the
demographic data was done using chi-square test. Comparison between the groups for the
induction dose and haemodynamic parameters was done using student ‘t’ test.
Results: The average induction dose required was 1.53mg/kg with a mean reduction of
23.89%in the induction dose requirement of propofol was observed in the study group. The
haemodynamic parameters were better in study group II compared to the control group I.
Conclusion: Based on study result we recommend application of ‘priming principle’ for
induction dose of propofol.

A study on comparison of anthropometrical measurements in oraon and non-oraon boys

Dr. Kunj Bihari Patel, Dr. Meet Krishna, Dr. Avinash Thawait

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 37-45

A few studies based on published data have indicated patterns of anthropometric variation
along ethnic, geographic, latitude, longitude and altitude, nutrition and several confounding
variables.Many growth studies have been published for the tribal populations of Chhattisgarh.
However, no study, especially with regard to the growth status of the Oraons of Chhattisgarh
has been undertaken. Cases taken in this study were registered cases in government schools
of Jashpur district. 200 boys (100 Oraon and 100 Non Oraon) were included in the study
according to inclusion and exclusion criteria. Age range was 5-18 yrs. At most of the ages
BMI was less for OT boys than NO boys, except at the age periods of 17+ and 18+ where the
BMI of OT boys was more than NO boys. In the age period of 15+ the BMI of OT and NO
boys was found to be same. The difference was statistically significant at age periods of 7+,
8+ and 10+and highly significant in age period of 17+

PSYCHOLOGICAL MORBIDITY IN PREGNANCY DURING COVID-19 LOCKDOWN

Dr.Saima Sadiq,Dr. Rajesh Chandel,Dr.Heena Mir,Dr. Anil Mehta, Dr Sonali Sharma,Dr Rouf Gul6,Mr.Pawan kumar,Mr. Ravi kumar

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 46-53

AIM: Study aimed to assess the burden of psychological morbidity due to lockdown in
the pregnant females.
MATERIAL AND METHODS: It was an observational study conducted in the
department of obstetrics &gynecology, GMC Kathua during the covid lockdown period
from June 2020 to August 2020. 100 antenatal patients attending OPD were included
in the study after excluding those with hypertension, diabetes, heart disease, bleeding
pv,IUGR,oligohydramnios,threatened preterm labour, known psychiatric illness or
taking psychotropic medication, prior sleep disorder. The patients were assessed using a
questionnairewhich was framed using various scales such as PHQ-9 for Depression,
GAD7 for anxiety, Perceived Stress Scale and Insomnia severity index , in addition to
incorporating various sociodemographic and obstetrical details.The arbitrary division
of PHQ‑ 9 scores into ratings of minimal (0–4),mild (5–9), and moderate to severe
depression (≥10) suggested by Reddy et al. was used in this study. Cutoff points of 5, 10,
and 15 were interpreted as representing mild, moderate, and severe levels of anxiety on
the Generalized Anxiety Disorder-7 (GAD-7). Insomnia severity index scored on a fivepoint
Likert’s scale (0 = no problem to 4 = very severe problem). Score of 0–7 depicted
absence of insomnia, 8–14 showedsubthreshold insomnia, 15–21 represented moderate,
and 22–28 showed severe insomnia.

To Evaluate The Role Of Early Vs Delayed Laparoscopic Cholecystectomy In Mild And Moderate Acute Gallstone Pancreatitis

Dr SandipkumarChaudhari, Dr NayanPancholi, Dr LatifBagwan

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 54-59

Aim: To evaluate the role of early Vs delayed laparoscopic cholecystectomy in mild and
moderate acute gallstone pancreatitis
Methods:This randomized prospective study conducted in the Department ofSurgery after
taking the approval of the protocol review committee and institutional ethics committee. 100
patients were included in the study. They were divided into two groups with 50 patients in
each group. Patients with mild and moderate acute gallstone pancreatitis were included in this
study.
Results: The age distribution in both the groups was comparable with no statistically
significant difference observed. The mean age in Group A was 42.9±9.24 years and in Group
B was 43.025±9.56 years (p=0.857). Out of 100 cases 21 were males and 79 were females.
There was no statistically significant difference in the sex distribution between the two
groups. There was no statistically significant difference between the two groups with p-value
=0.079 and 0.707 for amylase and lipase respectively. Modified CECT severity index was
used to assess severity of acute pancreatitis. Group A had a mean score of 3.2±1.20 and
Group B had mean score of 3.3±1.28 p-value=0.757 and there was no statistically significant
difference between two groups. 16% in Group A and 22% in Group B underwent preoperative
ERCP and the difference was statistically not significant. There was no recurrence
of pancreatitis in group A, however 16% cases of group B had recurrent pancreatitis and
the results were statically significant which are tabulated as under.There was no
recurrence of cholecystitis in group A, however 16% cases of group B had recurrent
cholecystitis and the results were statistically significant which are tabulated as under.
Conclusion: We conclude that, early laparoscopic cholecystectomy in the index admission in
mild and moderate gallstone induced pancreatitis is a feasible and a safe modality for the
treatment of acute mild and moderate gallstone pancreatitis and early cholecystectomy
decreases the incidence of recurrent episodes of pancreatitis and cholecystitis in patients with
gallstones.

Design and Implementation of AR/VR (Mixed Reality) For Education

Mr. Kushal A. Sawadhakar, Prof. S. A. Murab, Prof. A.A. Kolpykwar

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 60-66

Students in today’s generation used technological gadgets a lot. Engaging these tech-savvy students in the
learning process with their preferred learning style is a daunting task. The differences in teaching and learning
styles result in problems such as disengagement of students, loss of learning aptitude, and loss of knowledge
retention. Recent innovations in visualization technologies such as Virtual Reality (VR)and Augmented reality
(AR) provide avenues that allow these students to engage in a social, collaborative and active learning
environment. AR/VR refers to an immersive digital environment that simulates physical presence in places in
the real or imagined worlds whereas MR represents the merger of real and virtual worlds to produce new
environments and visualizations. Using three controlled experiments these two emerging technologies are
investigated to enhance the educational experience. The results indicated that these technologies significantly
enhance the learning experience and engage students in an active learning process.

To evaluate the fundus changes in patients with hypertensive disorders of pregnancy: Gestational hypertension, preeclampsia, eclampsia

Dr. Tania Sadiq, Dr.Saima Sadiq, Dr.Erum Khateeb

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 67-73

Aim: To evaluate the fundus changes in patients withGestational
hypertension,preeclampsia oreclampsia.
Methods: All the patients who fulfilled the diagnostic criteria of Gestational
hypertension, preeclampsia or eclampsia(>20 weeks of pregnancy, high arterial blood
pressure of more than or equal to 140/90 , proteinuria more than or equal to
300mg/day or protein creatinine ratio more than or equal 30 mg/mmol or evidence of
maternal organ dysfunction or uteroplacental dysfunction , convulsions or coma) were
included in this study. After taking history for any eyesymptoms, anterior segment was
examined with torch light on the bed itself. Both pupils were dilated with 1%
tropicamide eye drops and fundus examination was done by ophthalmologist with direct
ophthalmoscope in a semi dark room in the ward. Hypertensive retinopathy changes
seen in right or left or both eyes, was taken as positive findings in that patient.
Results: A total of 100 patients were examined. The mean age of patients was 31.2±6.2
years (range 20-50 years). The gestation period ranged between 25 and 41 weeks. 45
(45%) were primigravidas , 33 (33%) were multigravidas and 22(22%) were
grandmultiparas. 41(41%) had mild preeclampsia, 56(56%) had severe preeclampsia
and 3(3%) had eclampsia. Retinal changes (hypertensive retinopathy) were noted in
58(58%) patients . There was statistically significant positive association between the
presence of retinal changes and blood pressure (P =0.001), proteinuria (P=0.021) and
severity of hypertensive disorders( P=0.027). However, age(P = 0.44), race ( P=0.89) and
gravida (P =0.37 were not associated with occurrence of retinopathy in our study.
Conclusion: Fundus examination in gestational hypertension , preeclampsia and
eclampsia is important in monitoring and managing cases as it correlates with severity
as it indirectly implies severity of changes in placental micro-circulation that can help to
predict the foetal outcome and ocular morbidity.

A comparative study of topical amorolfine, sertaconazole and terbinafine in patients with tineacorporis and tineacruris

Dr Laxman Kumar, Dr Pankaj Kumar, Dr ArshadHasan

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 74-78

common infection. The disease is caused by dermatophytes belonging to genera of
Trichophyton, Microsporum and Epidermatophyton. The present study was conducted
to compare topical amorolfine, sertaconazole and terbinafine in patients with tinea
corporis and tinea cruris.
Materials & Methods: 90 patients with tinea corporis and tinea cruris of both genders
were included. Patients were divided into 3 groups of 30 each. Group I were prescribed
topical application of amorolfine (0.25%) once daily, group II were given sertaconazole
(2%) twice daily and group III were given terbinafine (1%) twice daily. Response to
treatment was assessed after 3 weeks.
Results: Group I had 14 males and 16 females, group II had 17 males and 13 females
and group III had 12 males and 18 females. The mean value of scaling was 0.92 in group
I, 1.14 in group II and 0.78 in group III. The mean value of erythema was 0.94 in group
I, 1.42 in group II and 0.56 in group III. The mean value of pruritus was 1.12 in group I,
1.32 in group II and 0.65 in group III. The response was poor seen in 42% in group I,
22% in group II and 44% in group III. Moderate seen in 40% in group I, 46% in group
II and 48% I group III and good seen in 18% in group I, 32% in group II and 8% in
group III. The difference was non- significant (P> 0.05).
Conclusion: Sertaconazole found to be effective as compared to other agents in
management of cases of tinea corporis and tinea cruris.

Assessment of adverse drug reactions in known population

Dr Laxman Kumar,Dr Pankaj Kumar, Dr ArshadHasan

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 79-84

Background: Pharmacovigilance relates to the activities concerning the detection,
assessment, understanding and prevention of these adverse drug reactions. The present
study was conducted to asses adverse drug reactions in known population.
Materials & Methods: 250 adverse drug reactions reported in 1 year were recorded.
The data were obtained from the ADR monitoring centre. Each ADR was assessed for
demographic data, relationship to drugs as per causality assessment, and frequency of
ADRs.
Results: Age group 20-40 years had 35 male and 30 female, 40-60 years had 40 male and
55 females and >60 years had 45 male and 45 females. ADRs were reported in oncology
in 12, dermatology in 45, ENT in 30, orthopaedics in 20, general surgery in 50, general
medicine in 43, gynaecology in 35 and psychiatry in 15 cases. Type of reaction was
nausea/ vomiting in 45%, rash in 30%, headache in 12%, abdominal pain in 4%,
diarrhoea in 5% and constipation in 4%. Common drugs leading to ADRs were
NSAIDs in 35%, antibiotics in 20%, anti- hypertensive in 8%, anti- diabetics in 12%,
anti- tubercular in 15% and CNS drugs in 10%. The difference was significant (P<
0.05).
Conclusion: Common drugs leading to ADRs were NSAIDs, antibiotics, antihypertensive,
anti- diabetics, anti- tubercular and CNS drugs.

Efficacy of topical 0.05% cyclosporine in Vernal Keratoconjunctivitis

Dr. Tania Sadiq, Dr.Saima Sadiq, Dr.Erum Khateeb

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 85-89

Background: Vernal keratoconjunctivitis (VKC) is a chronic recurrent non-infectious
allergic disease that generally affects children and young adults. The present study was
conducted to assess efficacy of topical 0.05% cyclosporine in
Vernalkeratoconjunctivitis.
Materials & Methods: 86 patients diagnosed with Vernalkeratoconjunctivitis (VKC) of
both genderswere enrolled. All were prescribed topical 0.05% cyclosporine 4 times a
day. Patients underwent complete ophthalmic examination and symptoms and signs and
intraocular pressure using rebound tonometer. The patients were evaluated at weeks 4,
8 and 12 after the initiation of therapy. Symptoms and signs before and after treatment,
during the four-week intervals, were recorded and scores between 0 and 3 were
assigned.
Results: Out of 86 patients, males were 56 and females were 30. Median of symptoms
score at baseline was 11, at 4 weeks was 4, at 8 weeks was 5 and at 12 weeks was 4. Sign
score at baseline was 6, at 4 weeks was 4, at 8 weeks was 3 and at 12 weeks was 3. The
difference was significant (P< 0.05).
Conclusion: Topical cyclosporine 0.05% help to reduce corticosteroid usage, is an
effective and safe alternative for the treatment of resistant VKC.

Oxiport laryngoscope blade versus miller laryngoscope blade for intubation in neonates and infants during general anesthesia

Dr Kapil Lamba

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 90-95

Aim: To compared the oxiport laryngoscope blade versus miller laryngoscope blade for
intubation in neonates and infants during general anesthesia.
Methods: This controlled interventional single-blind study conducted in the,
Department of Anesthesiology. 60 neonates/infants in groups of 30 each posted for
surgery in paediatric operation theatre over a period of 6 months were included in the
study. Full-term neonates and infants up to 6 months of age of either sex requiring
general anaesthesia with endotracheal intubation for elective as well as emergency
surgery were included in the study.
Results: Out of the 60 patients 30 patients in Miller group and 30 patients in Oxiport
group were included. Both groups were comparable with respect to age, sex, weight,
mean time to intubation (P = 0.61) and anaesthesiologist performing the laryngoscopy
(P = 0.69).Mean lowest SpO2 recorded was 97.21% ± 3.69% in Miller group and 99.77%
± 2.63% in Oxiport group. This difference was statistically significant (P = 0.039). The
incidence of mild desaturation (SpO2 up to 90%) was 86.67% in Miller group and
93.33% in Oxiport group. The incidence of moderate desaturation (SpO2 between 85%
and 92.5%) was 3.33% in Miller group and 5% in Oxiport group. Incidence of severe
desaturation (SpO2<85%) was 16.67% in Miller group and 0 in Oxiport group.
Correlation between time to intubation and SpO2 in Miller group (Pearson’s R2 =
−0.14) was statistically not significant at P = 0.39. Correlation between time to
intubation and SpO2 in Oxiport group (Pearson’s R2 = −0.38) was statistically
significant at P = 0.001. Both groups were comparable with respect to the type of
surgery (abdominal, thoracic, miscellaneous) (P = 0.68). Abdominal surgeries were
associated with a higher number of severe desaturations (80%) compared to thoracic
(10%) and miscellaneous (10%) surgeries.
Conclusion: we concluded that the apnoeic laryngeal oxygen insufflation with Oxiport
laryngoscope blade decreased the incidence of severe desaturation while intubating
neonates and infants. This was easily done as it was non-cumbersome and did not
increase the overall cost of anaesthesia.

Approach to Multiple Injuries of Foot and Ankle (Single stage procedure for lisfranc injury, pan metatarsal fractures with distal tibia fracture and medial malleolus fracture): A rare case report

Dr.K.Vijaya shankar, Dr.A.Senthilnathan, Dr.R.Prabhakar, Dr.M.Chakravarthi .

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 96-101

Objectives:

Outlines the necessity of early diagnosing and management of lisfranc injury and metatarsal fracture to avoid chronic instability.
Advantages of plate fixation for (proximal) fifth metatarsal fracture in addition to k-wire.
To assessing the functional outcome and duration of union using MIPPO technique in the management of distal third tibia fracture.

Materials and Methods:
Case Report: We report a case of 32 year old man presenting with multiple injuries to foot and ankle diagnosed as comminuted distal third tibia fracture (with medial malleolus fracture) with panmetatarsal fracture with lifranc dislocation of right lower limb. A single stage procedure done for fixation of all these injuries.
Result; The patient follow up for one year, mean duration union of all fractures noted radiologically by 11±2 weeks. Patient allowed to weight bear after 3 months, Functional range of motion improved from the end of 3 months to 8 months. Prospective functional evaluation of this patient assessed by American orthopaedic foot and ankle society score (AOFAS) 96/100 at the end of 6 months and Pain relief is evaluated periodically by visual analogue scale.
Conclusion: Best results are obtained by immediate anatomical reduction and fixation of lisfranc injuries. In addition to k-wire, plate fixation for fifth metatarsal provides alignment with high union rate, especially when the fracture is comminuted. MIPPO technique is reliable fixation in fracture of distal tibia preserving most osseous (periosteal) blood supply and haematoma  in fracture site and in turn provides  more biological repair.

Fixing an open volar radiocarpal fracture dislocation -a narrow literature to debate

Dr.K.Vijaya Shankar, Dr.A.Senthilnathan, Dr.R.Prabhakar, Dr.R.Rajheiman .

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 102-107

Introduction: In the overview of literature studies, radiocarpal fracture dislocations are very rare injuries and accounts only 0.2% 1 of dislocations. The mechanism of injury includes motor vehicle accident, fall from height and work place injuries. These injuries were thought to have poor outcomes and high morbidity.
Purpose of study:-

To enumerate the practical difficulties in fixing a volar radiocarpal fracture dislocations.
To give a functionally mobile joint and prevent the complications of osteoarthritis and arthrosis.

Case report: A 56 years old male, electrician by occupation sustained a self fall from height                (10 feet) while climbing an electric post. He had an open injury to left wrist joint, radius and ulna were dislocated volarly. It was classified as Type 2 radiocarpal fracture dislocation. We fixed it with k-wires and external fixator via dorsal and volar approaches.
Conclusion: Our case study as an adjunct to previous literatures, the outcome came to be good. Radiocarpal fracture dislocation with ulna dislocation needs an earlier intervention with proper preoperative planning. DRUJ instability was common in these patients and required radioulnar pinning.

SURGICAL MANAGEMENT OF ADHESIVE OTITIS MEDIA AND OUTCOME

Dr. Dharmendra Kumar, DrSurbhi .

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 108-112

Introduction: Tympanic  membrane forms a important part of middle ear hearing mechanism .Long standing middle ear inflammation leads to atelectasis of the membrane which gradually results in adhesive otitis media .Material and methods : This is a prospective research was done over 50 candidates of adhesive otitis media to study the outcome of the management of adhesive otitis media tympanoplasty with or without canal wall up mastoidectomy .Results : Both the group showed comparable results with improvement in hearing and state of middle ear on subsequent long term follow up .Conclusions :The outcome of surgical management of adhesive otitis media depends upon patient’s factor and surgeon competency .Moreover it depends patient’s benefit from different approaches

PATTERN OF DRY EYE IN POSTMENOPAUSAL WOMEN IN A TERTIARY CARE HOSPITAL IN JAMMU REGION

Dr. Pallavi Sharma, Dr. Amit Sharma, Dr. Sanjay Kai

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 113-117

Background: Dry eye is one of the most important causes of ocular
morbidity.Postmenopausal women often present with dry eye symptoms. The purpose of
this study is to assess the pattern of dry eye in post menopausal women attending
ophthalmology OPD in GMCJammu.
Material and methods:A cross-sectional study was conducted on 200 patients attending
ophthalmology OPD in GMCJammufrom June 2018 to December 2018.After the detailed
history,patients were subjected to complete ophthalmic examination,dry eye tests for
example schirmer’s test and tear film breakup time were done, for the assessment of dry
eye.
Results:Out of the 200 patients,most commonly dry eye was seen in the age group 61 to 65
years and mostly in patients engaged in outdoor occupation.
Conclusion: If the symptoms are detected early,patients can be benefitted. The optimal care
includes early detection and adequate use of lubricants in these patients.

Efficacy of topical 0.05% cyclosporine in Vernalkeratoconjunctivitis

Erum Waris Khateeb, Tania Sadiq, Sheikh Sajjad

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 118-122

Background: Vernal keratoconjunctivitis (VKC) is a chronic recurrent non-infectious
allergic disease that generally affects children and young adults. The present study was
conducted to assess efficacy of topical 0.05% cyclosporine in Vernalkeratoconjunctivitis.
Materials & Methods:86 patients diagnosed with Vernalkeratoconjunctivitis (VKC) of both
genderswere enrolled. All were prescribed topical 0.05% cyclosporine 4 times a day.
Patients underwent complete ophthalmic examination and symptoms and signs and
intraocular pressure using non contact tonometer. The patients were evaluated at weeks 4,
8 and 12 after the initiation of therapy. Symptoms and signs before and after treatment,
during the four-week intervals, were recorded and scores between 0 and 3 were assigned.
Results: Out of 86 patients, males were 56 and females were 30. Median of symptoms score
at baseline was 11, at 4 weeks were 4, at 8 weeks were 5 and at 12 weeks were 4. Sign score
at baseline was 6, at 4 weeks were 4, at 8 weeks were 3 and at 12 weeks were 3. The
difference was significant (P< 0.05).
Conclusion: Topical cyclosporine 0.05% help to reduce corticosteroid usage, is an effective
and safe alternative for the treatment of resistant VKC.

A comparative study between Nifedipine and magnesium sulfate for treatment of preterm labor

DikshaAmbedkar, VimleshKushwaha

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 123-128

Aim: A comparative study between Nifedipine and magnesium sulfate for treatment of
preterm labor.
Methods: Eligible women with preterm labor between 24-37 week gestations were selected
for the study. Nulliparous and multiparous pregnancies with intact membranes, showing
clinical signs of preterm labor were included in this study. The diagnosis of preterm labor is
based on the presence of 4 uterine contractions or more over 30 minutes, each lasting at least
30 seconds, and documented cervical change (dilatation of 0-4 cm and effacement of at least
50%).
Results: 5 patients (5%) after 24 hours, 9 patients (9%) after 48 hours, 7 patients (7%)
after 72 hours and 54 patients (54%) after 7 days had delivery in the nifedipine group and 11
patients (11%) after 24 hours, 5 patients (5%) after 48 hours, 5 patients (5%) after 72 hours
and 62 patients (62%) after 7 days had delivery in the magnesium sulfate group. This
characteristic was not statistically different between the two groups. In this study, 28 patients
(28%) in nifedipine group and 14 patient (14%) in magnesium sulfate group had a failure
treatment (contractions did not subside) and needed to take other tocolytic medications. This
characteristic was also not statistically different between the two groups.
Conclusion: we concluded that the oral nifedipine is a suitable alternative for magnesium
sulfate with the same efficacy and side effects in the management of preterm labor.

A comparative study of Bilateral Accessory Renal Artery in Male and Females with different parameters

Dr. Bhimsen Tyagi, Shaily Saxena, Dr.(Major)Vinay Kumar

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 129-139

Background- Accessory renal arteries are very common variant in humans, it may be or not
bilateral, vestigial structure that develops during the ascent of the kidney from the pelvis to
the lumbar region. The purpose of this study to evaluate and compare the frequency, Length,
Diameter of Accessory renal artery in male and females of Western U.P. Population.
Method and Material- The data was collected by using CT Scan machine G.E 64 slice with
software Syngo angiography of 100 patients was collected. CT angiography scan was made
and thin slices (0.6 mm) axial images were obtained. The frequency of accessory renal
arteries, Length and Diameter can be evaluated & compared in male and females subjects. A
correlation is considered significant when p < 0.05. For comparing continuous variables, the
t-test was applied. All the statistical analysis was done by SPSS software.
Result- In this study, Ct angiogram more than 50 males and 50 females subjects were
included and 37 ARA out of 100 subjects is present. Accessory renal arteries are present in
31% of cases. 5% ARAs present at Rt side, 20% ARAs present at left side, and 6% ARAs
present Bilaterally. The frequency of accessory renal arteries are present in male cases(21%)
more than female(10%).
Mean length of ARA in RT side in case of male is 41.57±10.41mm and in case of female
39.32±11.7mm. and on LT side length of ARA in male is 48.36±15.44mm and female is
44.33±12.17mm. Diameter of ARA from origin in RT side in case of male is 2.30±0.40 mm
and in case of female is 1.82±0.45mm and on LT side in case of male is 2.26±0.78mm and in
case of female is 2.38±0.78mm.
Conclusion- This Publication highlights the importance of the recognition of the presence of
renal artery variants if surgical procedures are indicated in Western UP. Moreover, CT
Angiography can reveal pathologies of the renal arteries of the kidneys.

PATTERN OF DRY EYE IN POSTMENOPAUSAL WOMEN IN A TERTIARY CARE HOSPITAL IN JAMMU REGION.

Dr. Pallavi Sharma, Dr. Amit Sharma, Dr. Sanjay Kai

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 140-144

Background:Dry eye is one of the most important causes of ocular
morbidity.Postmenopausal women often present with dry eye symptoms. The purpose of
this study is to assess the pattern of dry eye in post menopausal women attending
ophthalmology OPD in GMCJammu.
Material and methods:A cross-sectional study was conducted on 200 patients attending
ophthalmology OPD in GMCJammufrom June 2018 to December 2018.After the detailed
history,patients were subjected to complete ophthalmic examination,dry eye tests for
example schirmer’s test and tear film breakup time were done, for the assessment of dry
eye.
Results:Out of the 200 patients,most commonly dry eye was seen in the age group 61 to 65
years and mostly in patients engaged in outdoor occupation.
Conclusion: If the symptoms are detected early,patients can be benefitted. The optimal care
includes early detection and adequate use of lubricants in these patients.

Efficacy of topical 0.05% cyclosporine in Vernalkeratoconjunctivitis.

ErumWaris Khateeb, Tania Sadiq, Sheikh Sajjad

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 145-149

Background: Vernal keratoconjunctivitis (VKC) is a chronic recurrent non-infectious allergic disease that generally affects children and young adults. The present study was conducted to assess efficacy of topical 0.05% cyclosporine in Vernalkeratoconjunctivitis. Materials & Methods:86 patients diagnosed with Vernalkeratoconjunctivitis (VKC) of both genderswere enrolled. All were prescribed topical 0.05% cyclosporine 4 times a day. Patients underwent complete ophthalmic examination and symptoms and signs and intraocular pressure using non contact tonometer. The patients were evaluated at weeks 4, 8 and 12 after the initiation of therapy. Symptoms and signs before and after treatment, during the four-week intervals, were recorded and scores between 0 and 3 were assigned. Results: Out of 86 patients, males were 56 and females were 30. Median of symptoms score at baseline was 11, at 4 weeks were 4, at 8 weeks were 5 and at 12 weeks were 4. Sign score at baseline was 6, at 4 weeks were 4, at 8 weeks were 3 and at 12 weeks were 3. The difference was significant (P< 0.05). Conclusion: Topical cyclosporine 0.05% help to reduce corticosteroid usage, is an effective and safe alternative for the treatment of resistant VKC.

The prevalence of transfusion transmitted infections in a tertiary care centre

Dr. Ramu Thakur,Dr. Karuna Thakur,Dr. Ashok Yadav,Dr. Sachin Sharma

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 150-153

Background: The five most common transmissible infections in all the blood banks included
HIV, HBV, HCV, syphilis and malaria. This study aims to evaluate the prevalence of prevalence
of transfusion transmitted infections in a tertiary care centre.
Material and methods: The present study was conducted to assess the prevalence of transfusion
transmitted infections in a tertiary care centre. A total number of 1200 donors were analyzed for
the seroprevalence of Transfusion Transmitted Diseases over a period of 6 months. Basic
information was obtained using donor form. Physical examination was done Blood was screened
for HIV, HBV, HCV, syphilis and malaria by ELISA according to manufactures instructions.
Results: A total number of 1200 blood donations were taken in this study. In our study, Males
outnumbered females with 93.33% donations while only 6.66% donors were females. 24 (2 %)
were reactive for blood transmitted infection. In our study, HBV and HCV were the major
infections in blood donors and the seroprevalence were 1.5%, and 0.16% respectively. Only
0.33% was positive for malaria.
Conclusion:The present study concluded that 2 % donars were reactive for blood transmitted
infection. HBV and HCV were the major infections in blood donors.

Variation in the origin of renal arteries from vertebral level in Western U.P. Population: An Angiographic Evaluation.

Dr. Bhimsen Tyagi, Shaily Saxena, Dr. (Major)Vinay Kumar

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 154-162

Background- Variations of renal artery are common in general population and gained
importance because of the wide spread development in renal transplantation surgery. The
purpose of this retrospective study was to evaluate the prevalence of variations in the origin
of right and left Renal arteries at Vertebral level.
Method and materials- The data was collected by using CT Scan machine G.E 64 slice with
software Syngo angiography of 100 patients was collected. CT angiography scan was made
and thin slices (0.6 mm) axial images were obtained. The variation in the origin of renal
arteries at the level of vertebral column can be evaluate by 3-D CT angiography results were
analyzed. A correlation is considered significant when p < 0.05. Most of the possible
correlations were examined. For comparing continuous variables, the t-test was applied. All
the statistical analysis was done by SPSS software.
Result - The most frequent position of RRA origin at vertebral level L1 LP are 32 %, L1 MP
are 16%, L1UP are 8% and also L2 UP are 32%, L2 MP are 10%, L2 LP are 2% cases.
Vertebral levels of left renal arteries L1 LP are maximum in 38 % cases. Others are L2 UP in
32%, L1 MP 20%, L2 MP 6% and L1 UP & L2 LP are 2% in each cases.
Conclusion- In our study, Mostly renal arteries are arising in between upper part of L1 to the
lower part of the L2 vertebrae.

INTRICATE ASSESSMENT OF EFFECTIVENESS OF MRI & USG PROCEDURES FOR VARIOUS PATHOLOGIES RELATED TO FEMALE PELVIC: AN ORIGINAL RESEARCH STUDY

Dr. Sunny Goyal, Dr. Prachi Jain, Dr. Dalip Singh Dhiman, Dr. Rajender Punia, Dr. Deergha Singh, Dr. Fayaz Khan H

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 163-169

Aim: To evaluate efficiencies of magnetic resonance imaging & ultrasonographyprocedures for various pathologies related to female pelvic region.
Materials & Methods: This study was performed on total sixty patients. All patients reported for various clinical issues of pelvic region. Magnetic resonance imaging & ultrasonography procedures were used as diagnostic imaging modality. Scanning outcomes of magnetic resonance imaging & ultrasonography have been categorized as group one and group two respectively. All suggestive findings of both imaging modalities were correlated with clinical diagnosis. Based on these existences of correlations, Results thus obtained was compiled and sent for basic statistical analysis. P value less than 0.05 was considered significant (p< 0.05).   
Results: Among all sixty studied patients, females were 14 in age group of 25-28 years. 13 patients were seen in age range of 33-36 years. P value was reported to be significant for this (0.01). Magnetic resonance imaging confirmed Inborn Anomalies in 3 patients. Uterine Mutilation was confirmed in 16 patients by magnetic resonance imaging. Pathologies related to Adnexa were noted in 28 patients. P value was reported to be significant for this (0.002). Endometrial Malignancies were noted in 2 patients. P value was reported to be significant for this (0.001). Pathologies related to Adnexa were noted in 25 patients by Ultrasonography. P value was reported to be significant for this (0.010).
Conclusion: Magnetic resonance imaging was able to detect and confirm almost all studied pathologies related to female pelvic region. Ultrasonography procedure was unable to detect few of those pathologies. Therefore, magnetic resonance imaging is superior and accurate option for scanning pelvis region.

Characteristics and Features of Epics in Pashto Literature

Jamshed Khan Rashidi

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 170-183

This researchdiscovers the epics and characteristics of it in Pashto literature. Epics contains
stories of war, battles, bravery, wrestling and heroism, commemorating the great deeds of heroes
and praising them, killing great animals by heroes and performing extraordinary deeds. The
mystic has supernatural and unseen powers, as well as the ability of a hero in Epic to confront
other heroes, for heroes to remain committed to national values and to accept any sacrifice for it
from various weapons and in certain circumstances. The use of deception, predictions about the
future and so on are the trademarks of Epic. In Pashto literature, Epic is considered to be one of
the earliest, but according to all the standards of writing 11th century was considered the time of
invention of Epic.

Clinical profile of patients with benign parotid disease at a tertiary care hospital

Dr. Arunkumar Tukaram,Dr. Md. Zaheeruddine Ather,Dr. Arunkumar Bhavikatti,Dr sharankumar Jabshetty

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 184-189

The analogue of the parotid gland is the first gland to form in humans. Lesions of the parotid
gland are fairly easy to recognize mainly because of the location and limited number of
structures present here. Tumors of parotid gland are believed to represent approximately 2%
of head and neck tumors. Parotid gland tumors account for 70- 80% of all tumors of salivary
glands. Patients visiting to surgery department with parotid swelling were subjected to careful
history taking, complete clinical examination, and examination of facial nerve integrity.
Clinical diagnosis made was confirmed with USG (ultra sonography) parotid and FNAC (fine
needle aspiration cytology). 14(70%) patients in antegrade group vs. 13(76.47%) patients in
retrograde group had pleomorphic adenoma, 5 (25%) patients in antegrade group vs.2
(11.76%) patients in retrograde group had Warthin’sTumor,1(5%) patients in antegrade group
vs.2 (11.76%) patients in retrograde group had Recurrent Pleomorphic Adenoma.

A study to compare retrogrades facial nerve dissection and conventional antegrade technique for parotidectomy in benign parotid disease

Dr. Arunkumar Tukaram,Dr. Md. Zaheeruddine Ather,Dr. Arunkumar Bhavikatti, Dr sharankumar Jabshetty

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 190-197

The antegrade approach is the conventional/standard technique of identification and
dissection of the facial nerve. It is usually the standard procedure for a trainee to master6. The
technique involves identification of the facial nerve trunk as it leaves the stylomastoid
foramen. This is accomplished through identification of the nerve trunk via its relationship
with the tympanomastoid suture, the tragal pointer or the posterior belly of the digastric.
During the study period of 20 month 37 patients with benign parotid disease who underwent
surgery were included in study group. Based on the surgeon expertise and familiarity with the
technique of facial nerve dissection 17 patients underwent retrograde dissection of facial
nerve for parotidectomy and was grouped as retrograde group. In retrograde group, surgeons
with a good experience of retrograde technique performed all surgery. 45% patients in
antegrade group vs. 2 (11.76%) patients in retrograde group recovered completely at 1 month
interval. We tested difference between the groups in facial nerve injury recovery at 1month
by applying Fischer’s exact test p= 0.028 and it was found to be statistically significant.

Prospective comparative study of visual internal urethrotomy and visual internal urethrotomy with intralesional triamcinolone and mitomycin c in treatment of stricture urethra

Dr. Abhilash, Dr. Srilakshmi N, Dr. Padmaraj Stalin Hegre, Dr. Kiran Kumar Nayak S

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 198-204

Urethral stricture disease has always been a challenge for urologists. Different treatment
modalities that are used for treatment of urethral stricture disease are dilatation, urethrotomy,
stent placement. Internal urethrotomy is a safe first line treatment for urethral strictures
independent of etiology and location, with an overall primary success rate of 60-70%.Visual
internal urethrotomy was done in usual manner using cold knife. Injection is prepared by
diluting triamcinolone 40mg, mitomycin 2mg in 5-10mL of saline according to length of
stricture and was injected intralesional at the site of urethrotomy using William’s endoscopic
needle. At every site 1-2mL was injected. After confirming free passage of cystoscope into
the bladder, an 16 or 18 Fr foley’s catheter was left in place for 2-3 days.In our study total of
7 patients lost follow up and among remaining 37 patients total of 10 patients had recurrence,
8 patients in group A had recurrence at end of 6 months, 1 patients at 3 months after
procedure and 7 patients at 6 months after procedure where as in group B only 2 patients had
recurrence 1 at 3 months and 1 at 6 months post procedure, both groups were statistically
comparable with respect to age stricture length,site and etiology.From our study we can
conclude that, Injection of both triamcinolone, mitomycin C at stricture site after VIU can be
considered as safe and effective adjuvant modality compared to VIU alone for short term
management of stricture urethra.

Comparative study of role of bupivacaine instillation into the operative bed for post-operative pain analgesia in modified radical mastectomy

Dr.Kiran Kumar Nayak S, Dr.Srilakshmi N, Dr.Vinay G,Dr. Abhilash

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 205-211

Surgery still has a pivotal role in the management of breast cancer, even though recent
advances in oncology are trending towards more conservative techniques followed by
chemotherapy.The consensus development conference on the treatment of breast cancer in
1979 stated that modified radical mastectomy was the standard of treatment for stage 1 and 2
disease. 60 patients of either sex between age group 30 to 60 years undergoing elective
Modified Radical Mastectomywere divided into two groups of 30 patients each randomly
who fulfilled the inclusion and exclusion criteria. In this study, When we look closer, we
could see that, despite of being statistically significant, the VAS and VRS scores at initial
intervals (1hr, 4hrs) were low in group A when compared to group B. At 8 hours and, there
was a marked increase in VAS and VRS score in group B and thereafter it was akin in two
groups.

Effect of ropivacaine and bupivacaine on heart rate for supraclavicular brachial plexus

Dr. Shivakumara K C, Dr. Vishal

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 212-216

The brachial plexus is enveloped by a fascial sheath, formed by prevertebral and scalene
fascia, extending from the intervertebral foramina to the upper arm. The foramina of a sheath,
at any anatomical point, will allow for the spread of local anaesthetics and subsequent
blockade. Each approach to the brachial plexus impacts specific anatomical areas of the upper
extremity. Patients were kept Nil per orally for 6 hours before the time of surgery and on the
previous night premedicated with Diazepam 5 mg and Ranitidine 150mg. 60 patients ASA I
and ASA II were randomly allocated with sealed envelope method into two different groups
of 30 each. Both observer and participant were blinded. GROUP A- received (n=30) 25 ml of
0.5% bupivacaine, GROUP B-received (n=30) 25 ml of 0.5% ropivacaine. There was no
statistically significant difference in heart rate between both groups (p>0.05). There is no
significant difference of heart rate clinically.

Morphological landmarks of proximal humerus fracture in functional outcome post fixation by philos plate

Dr.NilaySaha, Dr.M Ayyub Khan,Dr.Ajay VM

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 217-224

Proximal humerus fractures present with different configurations in patients with varying
comorbidities and expectations. Various treatment options are available for treating proximal
humerus fractures. A good functional outcome with context to the early joint mobilisation and
rigid fixation of the fracture can be achieved with PHILOS plate in proximal humerus
fractures.Patients admitted with proximal humerus fractures as inpatient in department of
orthopaedics were included in the study satisfying the inclusion and exclusion criteria.30
patients with proximal humerus fracture were treated by open reduction internal fixation with
PHILOS plate. Improvement of Constant-Murley score at 6 weeks of 47.83 to 64.67 at 12
weeks(p=<0.001), 75.27 at 24 weeks(p=<0.001) and 78.33 at final follow up(p=<0.001).
Most of the patients had excellent (43.3%) followed by good (33.3%), poor (16.7%) and fair
(6.7%) outcome. Varus malunion 6(20%) was the most common complication.Proximal
humeral internal locking system (PHILOS) is the implant of choice for treating displaced
proximal humerus fractures which leads good functional outcome in patients.

Association between second trimester maternal serum alphafetoprotein in 14-22 weeks and adverse pregnancy outcome

Heena Mir, Saima Sadiq,Sabha Malik

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 225-230

Background:Many screening tests are available for predicting adverse pregnancy outcome
and these range from non- invasive to invasive and serum alpha-fetoprotein level
estimation is one of them. The present study was conducted to assess association between
second trimester maternal serum alpha-fetoprotein in 14-22 weeks and adverse pregnancy
outcome.
Materials & Methods: 250 patients of gestational age between 14-22 weeks were included.
Maternal serum alpha-fetoprotein was measured in human serum by microplateimmunoenzymometric
assay by EIA-AFP kit. Maternal serum alpha-feto protein level was
expressed in IU/ml.
Results: 23 (9.2%) participants out of 250 developed preterm labor. 21 out of 23 had raised
value of maternal serum alpha-fetoprotein. 20 (8%) patients out of 250 patients developed
oligohydramnios. 13 out of 20 had raised value of maternal serum alpha-fetoprotein. 14
(5.6%) patients out of 250 developed pre-eclampsia, 11 out of 14 had raised values of
maternal serum alpha-fetoprotein. 7 (2.8%) patients out of 250 developed premature
rupture of membrane (PROM). 4 out of 7 had raised values of maternal serum alphafetoprotein.
Conclusion: There is an increased risk of pre-eclampsia, preterm delivery,
oligohydramnios and premature rupture of membrane with elevated maternal serum
alpha-fetoprotein levels

High and low-pressure carbon dioxide in patients undergoing laparoscopic cholecystectomy

Dinesh Maheshwari, Avinash Maheshwari, Anjali Maheshwari, Kopal Agarwal

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 231-236

Background:Laparoscopic cholecystectomy is considered the gold standard for gallbladder
removal and is the most common laparoscopic procedure worldwide. The present study was
conducted to compare high and low-pressure carbon dioxide in patients undergoing
laparoscopic cholecystectomy.
Materials & Methods:86 patients undergoing laparoscopic cholecystectomy of both
genders were classified into 2 groups of 43 each. Group I comprised of high-pressure
carbon dioxide and group II low pressure carbon dioxide. In both groups, abdominal pain,
nausea and vomiting were evaluated on the verbal rating scale (VRS) at 1, 3, 6, 12, and 24
hours.
Results: The mean nausea/vomiting score at 1 hour, 3 hours, 6 hours, 12 hours and 24
hours in group I and II was 5.6, 5.0, 4.5, 3.8 and 3.2 and 4.2, 3.4, 3.0, 2.6 and 2.0
respectively. The mean abdominal pain in group I was 7.5, 6.5, 6.0, 5.4 and 4.6 and in
group II was 6.8, 4.6, 5.2, 3.6 and 2.2 in group I. The mean shoulder tip pain was 6.2, 5.4,
4.6, 3.8 and 2.4 in group I and 6.0, 4.8, 4.4, 3.6 and 1.8 in group II respectively. The mean
pre- operative ALT level in group I was 20.5 and post- operative level was 40.5 and in
group II was 20.4 and 45.6. AST level found to be 21.4 and 38.2 and in group II was 20.4
and 45.3, ALP level was 185.4 and 170.5, BILLT level was 0.62 and 0.70 in group I and
0.61 and 0.69 in group II, BILLD level was 0.21 and 0.34 in group I and 0.23 and 0.35 in
group II respectively. The difference was significant (P< 0.05).
Conclusion: Low pressure group had less pain score and nausea and vomiting score as
compared to high pressure group. Hence, it can be considered as treatment of choice in
patients undergoing laparoscopic cholecystectomy.

Pediatric ocular trauma and its outcomes:Rajasthan,India

Dr.Prabha, Dr. Priyanka Aggarwal,Dr. Himanshu Goyal

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 237-242

Aim:To identify the trend of ocular trauma in pediatric age-group and evaluate final visual
outcome.
Materials and Methods: Prospective interventional study at Government medical College,
Bharatpur from November 2019 toOctober 2020,patients up to age 16 years attended the
casualty department of eye and undergone intervention with follow-up period of 1to3months
or till better recovery.
Results: Total 118 eyes of 115 patients were enrolled. The age-group more affected was
above 5 years (67.80%, i.e.,80 eyes)and below 5years (32.20%, i.e.,38eyes). Boys (62.71%)
were affected more than girls (37.29%). Most of the children reported to casualty within
24hours(80.50%eyes),remaining patients reported later within 2days to 1 week (19.50%eyes).
Most of the ocular injuries occurred by household objects (22.3%), blunt objects(13.56%),
playground/sports (13.56%),accidental fall(11.02%), projectile(7.63%)and others. Best
corrected visual acuity(VA)of more than 6/18 achieved in 61.02%eyes, 6/18-6/60
in18.64%eyes,<6/60-counting finger close face(CFCF)in5.93%eyes, projection of
light(PL)+perception of rays(PR)in5.93%eyes,and noPLin8.47%eyes.
Conclusion: Pediatric ocular trauma is still higher in Rajasthan. It requires early presentation
and intervention so that prognosis can be enhanced and impact of trauma can be reduced as
much aspossible.

Efficacy of Saroglitazarin patients with diabetic dyslipidemia

Surendra Kumar Ghintala, Pradeep Kumar, Ajeetkumar Gadhwal, Ratan Kumar Agarwal

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 243-247

Background:Type 2 diabetes mellitus (T2DM) is a complex metabolic disorder
characterized by persistent hyperglycaemia due to relative insulin deficiency, insulin
resistance. This study assessed efficacy of Saroglitazar in patients with diabetic
dyslipidemia
Materials & Methods:120 patients with type 2 diabetes mellitus of both genders were
assessed for serum fasting plasma glucose, post prandial glucose, glycated hemoglobin
(HbA1c), blood urea, serum creatinine, S.G.O.T, S.G.P.T and lipid profile. Patients were
treated with Saroglitazar 4 mg once daily and the follow-up data were available for 12
months.
Results: Out of 120 patients, males were 80 and females were 40. The mean triglyceride
level was 610.4, 208.4 and 224.4, total cholesterol was 312.2, 244.7 and 172.1, non- HDLC
was 274.8, 199.6 and 126.3, LDL- C was 165.6, 116.8 and 104.17, HDL- C was 41.4, 42.1
and 42.5, HbA1C was 8.02, 7.8 and 7.1, FPG was 156.2, 130.5 and 120.4, PPG was
234.6, 172.1 and 160.5, SGOT was 46.6, 42.3 and 40.3, SGPT was 34.2, 38.4 and 37.4, S.
Creatinine was 0.7 and CPK was 74.3, 71.6 and 68.3 at baseline, 12 wees and 52 weeks
respectively. The difference was significant (P<0.05).
Conclusion: Saroglitazar is a very effective therapeutic option in diabetic dyslipidemia with
very high triglycerides level.

A Recurrent Benign Osteochondroma of ventral scapula associated with Snapping Scapula and Pseudoparalysis - A case report

Dr.K.Vijaya Shankar, Dr.A.Senthilnathan, Dr.R.Prabhakar, Dr.S.Navin Chander .

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 248-256

Introduction: Osteochondromas (often referred to as exostosis) are usually an incidental finding and are characterized by a benign bony protuberance covered with a cartilaginous surface in the metaphyseal region of long bones. Though they do not affect the patients directly; but cause indirect complications of varying degree of severity such as bursitis, neurovascular impingement, fracture of peduncle or malignant transformation. Imaging studies such as an MRI or CT, are useful aids in the diagnosis; however, biopsy is a mandatory requisite for a definitive diagnosis. Treatment modalities include open surgical or an arthroscopic resection and has good prognosis. Recurrence follows incomplete excision.
Presentation of case: In this report, we present a rare case of a recurrent, symptomatic scapular osteochondroma associated with scapular pseudowinging and snapping scapular syndrome in a 16-year-old female. Radiological findings exhibited by this tumour was highly characteristic. The tumour was then managed with surgical resection thereby resulting in an entire resolution of the patient's symptoms.
Discussion: This case was unique because she presented with recurrence 5 years after her previous surgery as she neared her age of skeletal maturity raising a suspicion of malignant transformation. And also she was having associated pain, pseudowinging and snapping scapula syndrome.
Conclusion: By reporting this rare case of a scapular osteochondroma that presented with scapular winging, we aim to increase the awareness of the unusual manifestations of osteochondroma, particularly atypical sites, signs, and symptoms. Furthermore, we've given a comprehensive description of this case and its management to help other surgeons who face similar cases.

RIPASA score in diagnosis of suspected cases of acute appendicitis

Dinesh Maheshwari, Avinash Maheshwari, Anjali Maheshwari, Kopal Agarwal

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 257-261

Background:Appendicitis occurs most commonly between the ages of 10 and 20 years and it has a male-to-female ratio of 1.4:1. The present study assessed validation of RIPASA score in diagnosis of suspected cases of acute appendicitis. Materials & Methods:86 patients with right iliac fossa pain and suspected to have acute
appendicitis of both genders were assessed. All were assessed using the RIPASA scoring system on the basis of clinical assessment and hospital protocol, histopathological correlation done with a score. A score of 7.5 was considered a cut-off value for high probability of acute appendicitis. Results: Out of 86 patients, males were 52 and females were 34. RIPASA score <5 was seen in 15, 5-7 in 20, 7.5- 11.5 in 38 and >12 in 13. Emergency appendectomy was performed on 62, positive HPE reports for appendectomy was seen in 54, negative HPE for appendectomy in 8, perforated appendix in 4 and wound sepsis in 7 cases. Conclusion: RIPASA score is a better, easy, safe, and non-invasive diagnostic method for diagnosis of acute appendicitis.

Role of X-Ray in the Evaluation Of Asthma And Wheezing Severity

Hussameddin Hasan Alali, Mohamad NourM.Nael Ammaneh, Fisal Haritani

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 262-271

Patients with asthma experience exacerbations due to the airflow obstruction caused by the narrowing of lung passages. The exacerbations vary between simple and lifethreatening, which is unpredictable. As a result, visits to the emergency department and hospitalization incur an enormous health care expenditure. Prediction on the severity of exacerbations is primarily vital to decide on the further course of treatment where conventional tests like spirometry provide mechanical aspects of the lung pathway obstruction. The advent of imaging modalities provides an advanced notion of the severity. Hence, in this review, the epidemiology of asthma, a diagnostic procedure using the different radiological techniques, various factors leading to lung pathway obstruction, and suitable medicines were discussed.

Clinical profile of patients with benign breast disease

Dr. Avinash Chandra S

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 272-276

The nomenclature of benign breast disease is very confusing.This is because over the last
century a variety of clinicians and pathologist have chosen to describe a mixture of
physiological changes and disease processes according to a variety clinical, pathological and
aetiologicalterminology. The study includes patient attending surgical out patient department
and admitted to surgical wards with breast lump during the study period. Most of patients
presented in OPD with complaints of breast lump 66 (60%) followed by patients presenting
with lump and pain of 33(30%). Some patient show engorgement of breast 8 (7.2%).Few
Patients also presented with lump, pain and discharge 3 (2.7%).

Histopathological study and management of benign breast disease at a tertiary care hospital

Dr. Avinash Chandra S

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 277-283

Benign breast disease is primarily a phenomenon seen in reproductive age group. They are
thought to be largely hormone induced. Benign breast disease is 4-5 times more common then
breast cancer. The study includes patient attending surgical outpatient department and
admitted to surgical wards with breast lump during the study period. Most of the patients
underwent excision-85 patient (77.27%) followed by microdochotomy-4 (3.63%)and I & D-4
(3.63%).Simple mastectomy also done in 4 (3.63%) patients. Wide excision biopsy was done
in 3 (2.72%) patient. Majority of the patients 90 patients (81.81%) did not have any postoperative
complications, whereas 12 patients (10.90%) had discharge from wound and 5
patients (4.54%) had wound gape due to infection.