SRMS JOURNAL OF MEDICAL SCIENCE

COMPARISON OF ASTIGMATIC OUTCOMES AFTER PHACOEMULSIFICATION WITH SUPERIOR, TEMPORAL OR OBLIQUE CLEAR CORNEAL INCISIONS: A RANDOMIZED PROSPECTIVE TRIAL

Sun, 30 Jul 2017 00:00:00 +0200

Introduction : A variety of modalities are available presently to deal with astigmatism in relation to phacoemulsification surgery. Of these, toric intraocular lenses are expensive, limbal Paper Submission Daterelaxing incisions are unpredictable and both of these cater to a limited dioptric range and type of astigmatism. Simply planning the incision according to pre-existing corneal astigmatism is an economical and rationale way of addressing this issue. To compare residual post operative astigmatism after phacoemulsification with foldable IOLsimplantation with different sites of clear corneal incision in patients with pre-existing astigmatism. Material and Methods: Study was done to evaluate residual corneal astigmatism after July 2017 phacoemulsification with foldable intraocular lens implantation from Jan 13 to May 14. A total of 90 eyes of 85 patients were selected having visually significant cataract. Incision was planned on steeper axis on basis of preoperative keratometric values and divided into 3 groups namely, WTR who received superior clear corneal incision (CCI), ATR who received temporal and OBQ received superotemporal or superonasal CCI respectively. Surgically induced astigmatism (SIA) was also calculated by SIA calculator using the vector method. Statistical analysis used is Kruskal Wallis test, Chi-square test, F-test. Results: Residual corneal astigmatism among the three groups was found to be nonsignificant. Comparison of mean preoperative and postoperative corneal astigmatism between 3 groups came out be statistically significant. Conclusion: The study concludes that preoperative astigmatism should always be assessed and addressed preoperatively by suitable incision sites to provide the best results.

IMPACT OF SOCIO-DEMOGRAPHIC VARIABLES AND MORBID CONDITIONS ON PERCEIVED MENTAL HEALTH COMPONENTS USING SF-36 QUESTIONNAIRE

S. K. Sharma, V. P. Shrotriya, D. Imtiaz, S. B. Gupta — Sun, 30 Jul 2017 00:00:00 +0200

Introduction: Perceived Health is a subjective assessment of the physical as well as mental health and includes so many aspects as mentioned in SF-36 form that are difficult to capture clinically such as incipient disease, physiological, psychological reserves and social functions. To assess the impact of Diabetes Mellitus, Hypertension and other socio-demographic factors on the Social Functioning component of mental health of the patients attending a tertiary care hospital in Bareilly. Material and Methods: Perceived health status of the patients was assessed by the Social Functioning dimension of the Mental Component Summary (MCS) using the SF-36 form. Results: The presence of both Diabetes Mellitus and Hypertension was associated with lower Social Functioning scores compared to those with diabetes (p = 0.013) and hypertension alone. Age was negatively related with Social Functioning scores (p less than 0.001) but male gender (p>0.000) and higher income(p less than 0.424) were all associated with higher Social Functioning scores. Rural subjects were found to have better SF score compared to urban. Conclusion: Age, gender and morbidity was found to have profound influence on Social Functioning scoring of the subjects. However, the results should be interpreted in terms of the studys limitations.

COMPARISON OF STATURE AND FOOT LENGTH IN ADULTS IN SRMS IMS BAREILLY

Sun, 30 Jul 2017 00:00:00 +0200

Introduction: Estimation of stature plays an important role in forensic anthropometry as it helps in estimating the identity of an individual. Many studies for estimating the stature from measuring long bones, with derivation of formulas are there. The present study is an attempt to evaluate a possible correlation between stature of an individual and foot length in adults. Material and Methods: A sample of 100 medical students; 50 males and 50 females studying in Shri Ram Murti Smarak Institute of Medical Sciences was considered and measurements were taken for height and foot length. Result: It was found that both the parameters showed a correlation with each other. Mathematical formulae for estimating stature were developed through basic linear regression. Conclusion: It can be concluded that the present study has provided regression equations for stature and foot length of an individual that can be used for stature estimation.

ROLE OF AUDIOLOGICAL SCREENING (PURE TONE AUDIOMETRY AND DISTORTION PRODUCT OTOACOUSTIC EMISSIONS) IN PATIENTS UNDERGOING CONCURRENT CHEMORADIATION FOR HEAD AND NECK CANCERS

Anisha Kocchar, Rohit Sharma, Piyush Kumar, Vineet Sharma, Kumar Shubhanshu — Sun, 30 Jul 2017 00:00:00 +0200

Introduction: Chemoradiation is an important component in the management of Head and Neck Cancers, which has hearing loss as a major adverse effect. This is due to the inclusion of ear structures in the radiation field and Cisplatin, an anti-neoplastic drug which can cause ototoxicity. The role of audiological screening in the form of Pure Tone Audiometry and Distortion Product Otoacoustic Emissions is hereby studied in these patients. Material and Methods: The present study was undertaken to highlight the effects of concurrent chemoradiation on the audiological profile of Head and Neck Cancer patients. The patients underwent pre-treatment and post treatment Pure Tone Audiometry and Distortion Product Otoacoustic Emission. The results were statistically analysed. Results: 36 patients who underwent concurrent chemoradiation for Head and Neck Cancers were enrolled. Post treatment PTA values were significantly different from Pre-treatment values especially at 500Hz. DPOAEs also indicated significant changes in cochleotoxicity grading after concurrent chemoradiation. Conclusion: Concurrent Chemoradiation exerts a significant effect on hearing status of the patients. Simple screening tests like DPOAE can detect cochlear damage prior to detection with Pure Tone Audiometry. Addition of these tests is recommended as routine screening during Concurrent Chemoradiation.

TRANSVAGINAL SONOGRAPHY VERSUS SALINE INFUSION SONOHYSTEROGRAPHY FOR EVALUATION OF ABNORMAL UTERINE BLEEDING IN PERIMENOPAUSAL AGE GROUP

Sun, 30 Jul 2017 00:00:00 +0200

Introduction: The present study was conducted to evaluate the validity of Transvaginal Sonography (TVS) in perimenopausal women with abnormal uterine bleeding (AUB), validity of saline infusion sonohysterography in perimenopausal women with abnormal uterine bleeding and to compare the diagnostic accuracy of the above mentioned modalities. Material and Methods: It was a prospective comparative study of TVS and Saline Infusion Sonohysterography (SIS) in 100 perimenopausal women presenting with AUB. The findings of TVS and SIS was compared with histopathology. Result: The sensitivity of TVS for submucosal fibroid, polyp, intramural fibroid and endometrial hyperplasia was found to be 50%,44.44%, 40%, 33.33% respectively while specificity being 88.29%, 95.60%, 88.88%, 95.60% respectively. The sensitivity of SIS for endometrial hyperplasia and submucosal fibroid was found to be same (66.66%) whereas for polyp and intramural fibroid was 55.55% and 50% respectively. Specificity of SIS for polyp, endometrial hyperplasia, intramural fibroid and submucosal fibroid was found to be 98.90%,95.60%,92.2% and 90.42% respectively. Overall sensitivity and specificity of TVS was 79.4% and 75.8 % respectively whereas for SIS is 82.4% and 80.3% respectively. Conclusion: SIS is simple, highly sensitive and specific technique to detect intrauterine pathology.

EARLY TRACHEOSTOMY IN HEMORRHAGIC STROKE: DOES IT HELP IN PATIENT MANAGEMENT?

Shashank Sah, Divyant Rawal — Sun, 30 Jul 2017 00:00:00 +0200

Introduction: Airway protection is often required in the management of stroke patients for the reason of low consciousness levels and associated risk of aspiration and pneumonia. This has Paper Submission Datebeen achieved either through endotracheal intubation or tracheostomy both having their separate indications and advantage/ disadvantage. Material and Methods: This prospective study was done on 26 patients getting admitted to neurosurgical unit with hypertensive intra cerebral hemorrhage. Based on projected recovery time, tracheostomy was performed if recovery was expected to take a long course. Evaluation Paper Publication Date was done- if tracheostomy helped in early weaning from ventilator, incidence of sepsis and July 2017 overall ease of patient management. Result: Tracheostomy was performed in 26 patients of hemorrhagic stroke over a period of 30 DOI months. All the tracheotomies were performed within first 8 days of hospital stay. In 14 cases it was done within 3 days of hospital stay. 19 out of 26 cases (8/14 in early tracheostomy vs 11/12 in late tracheostomy group) required ventillatory support for variable time period- ranging from less than a day to 8 days.Overall incidence of sepsis was approximately 65%. Conclusion: Tracheostomy if done early, may reduce the need for prolonged ventilation apart from easing patient management- both in and out of ICU settings.

CLINICO-PATHOLOGICAL AND RADIOLOGICAL PROGNOSTIC FACTORS IN CANCER CERVIX TREATED WITH CONCURRENT CHEMORADIATION

Sun, 30 Jul 2017 00:00:00 +0200

Introduction: Cervical cancer is most common cancer in the rural and second most common in urban areas of our country. It accounts for 16% of all cancers. There are various clinical, Paper Submission Datepathological and radiological factors which dictate the prognosis of these cancer cervix patients. The present study evaluates clinical, pathological and radiological prognostic factors in cancer cervix treated with concurrent chemoradiation. Material and Methods: A total of 32 patients seen between 2012 and 2014 patients planned concurrent chemoradiation were evaluated in terms of clinical (age, stage, Hb% and HPV Paper Publication Date infection), pathological (histopathology type and subtype, grade, mitotic index, lymph-July 2017 vascular invasion and necrosis) and radiological (parametrial extension, disease dimension, lymph node, hydronephrosis and vascularity of tumour) prognostic factors. After pre-DOI treatment evaluation patient was planned for 3 Dimentional-Conformal Radiotherapy (50Gy/25#/5 weeks) with concurrent chemotherapy (Cisplatin 35mg/m2) followed by 3 applications of Intracavitary radiotherapy (6Gy/fraction) with 6 months follow up. Response was accessed according to WHO response criteria and univariate analysis was done using chi-square test. Results: Clinical factors: Age better disease free survival in older patients (p value=0.003), stage - Lower stage had better survival (for stage Ib-IIa vs stage IIb p value = 0.003 and for stage Ib vs. IIIb p value = 0.0005), Hb% - 57% patients with Hb less than 10g/dl had recurrence at end of 6 months (p value=0.00001), HPV High recurrence with HPV presence. Pathological factors like high Mitotic Index had more residual disease (p=0.0009), grade - No statistical significance. Radiological factors- volume of disease - 35 % patients with volume of disease > 6 cm had disease at end of 6 months, hydronephrosis - 40 % patient with hydronephrosis had recurrence (p value = 0.0005) at end of 6 months follow up and vascularity of tumour showed statistically no difference. Conclusion: Hb less than 10%, HPV infection, Mitotic index (3-5/HPF), stage IIIB, pelvic nodes were concluded as the independent poor prognostic factors.

VARIATION IN THE INSERTION OF BICEPS BRACHII MUSCLE: A CASE REPORT

Jolly Agarwal, N. K. Arora, Anurag Agarwal — Sun, 30 Jul 2017 00:00:00 +0200

Introduction: Biceps brachii is a large, fusiform muscle of upper limb having two heads of origin; the short head arising by a thick flattened tendon from the apex of the coracoid process Paper Submission Dateand the long head from supraglenoid tubercle of the scapula. The flattened tendon at the lower end rotates as it passes through the cubital fossa to its insertion into the posterior border of tuberosity of the radius. Case History: During routine cadaveric dissection of undergraduate teaching program in SRMS IMS, Bareilly,we found rare variation in the insertion of biceps. We observed unilateral Paper Publication Date variation in the insertion of biceps muscle. The biceps tendon at its insertion was divided into July 2017 three distinct parts. Main tendon of long head inserts on radial tuberosity. This tendon of long head sends musculotendinous slip to pronator teres muscle. The short head sends DOI musculotendinous slip to flexor carpi radialis and its tendon does not insert on radial tuberosity despite formation of common belly with long head. The origin of muscle is normal and from two heads short head and long head. The muscle is supplied by musculocutaneous nerve. Conclusion: The triple tendon insertion may allow an element of independent function of each portion of the biceps, and during repair of an avulsion, the surgeon should ensure correct orientation of both tendon components.