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Volume-11 (2012);
Issue 3 (July-September)
Published on Oct 25, 2012
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2012;3:1
Review |
Dhruva GA, Agravat AH, Sanghvi HK.
Atherosclerosis of Coronary Arteries as Predisposing Factor in Myocardial Infarction: An Autopsy Study. |
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Abstract: The incidence of coronary heart disease has markedly increased in India over the past few years. Ischemic heart disease, the largest cause of morbidity and mortality in the developed and developing countries today is overwhelmingly contributed by atherosclerosis. The study highlights the impact of atherosclerotic lesions in the population of Rajkot district. We studied atherosclerotic lesions in coronary arteries in cases subjected to autopsy in last 4 years, to grade and to evaluate the atheromatous plaques; and to assess the cases of myocardial infarction amongst them. The study comprises dissected specimens of heart in total 360 cases subjected for autopsy. The vessels were examined for the presence of atherosclerotic lesions which were graded according to American Heart Association and examined for evidence of myocardial infarction. The study comprises the cases in age group between 20 to 80 years. Commonest type of atherosclerosis seen was grade-4. Left Anterior Descending Coronary was most commonly involved artery. Myocardial infarction was the cause of death in 35 cases (9.72%) The data obtained may form a baseline for the forthcoming studies.
Key words: Atherosclerosis; Coronary; Plaque; Autopsy; Infarction. |
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2012;3:2
Original Article |
Hettihewa LM, Kodikara T, Manamperi R.
Cost - utility analysis of parenteral antibiotics prescribed in medical wards in a tertiary care health facility in southern province of Sri Lanka. |
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Abstract: Introduction: Parenteral antibiotic (PA) prescription pattern in a hospital will directly influence the annual budget allocation, development of bacterial resistance and occurrence of unnecessary adverse drug reactions if it is done with poor adherence to the standard guidelines of prescription. As specialist in the field we understand the need of conducting economic studies in relation to the cost and utility of PA prescription pattern. It will be helpful to predict the drug procurement plan for the next year and also to prevent unnecessary complications mentioned above. Objective: Our main objective was to analyze the cost/utility relationship of PA drugs which were used in medical wards in this hospital according to the top ten of the cost (TTTC) and the top ten of the consumption (TTCS). Materials and method : Aggregate data from the pharmacy record books were collected for year 2010 from indoor pharmacy. Unit prize was obtained from medical supplies division. Total quantity consumed by each medical ward was considered for analysis of the cost /utility relationship. Two top ten lists were prepared according to the cost and the consumption respectively for medical wards and the correlation was analyzed using non parametric testing with spearman test. Results: Regarding PA drugs used in this hospital, 7/10 PA drugs in TTTC are not included in the TTCS. Out of the total cost for TTTC, 82.6% of the cost had been spent for the PA drugs which are not in the TTCS and 17.5% of the cost of TTTC was used to purchase only three drugs from the TTCS. But these three drugs had contributed only 28% of top ten consumption. 72% of the PA drugs in TTCS were not costly drugs and highly consumed in medical wards. Correlation was significantly positive between cost and utility of PA drugs. ( r=-0.91,p<0.001) Conclusion: Majority of the consumed PA drugs are non-costly and it indicates the prescriptions had been done according to the rational guidelines including cost, availability and affordability. Correlation further confirms that majority of the PA consumption was low costly drugs. As most of the money had been spent to purchase highly expensive PA drugs for medical wards we suggest to review the clinical indications for these drugs with the microbiological evidence to be compatible with the allocated health budget for the hospital. This further suggests conducting the cost effective economic studies to evaluate the suitable drug alternatives for such indications.
Key words: Antibiotics; Health Budget. |
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This Article |
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2012;3-3
Original Article |
Gurubasavanagoud Y, Umadevi K, Bafna UD, Challa VR, Reddihalli PV, Rathod PS.
Morbidity following Surgical Management of Vulval Cancer. |
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Abstract: The objective of this study was to know the complications following vulvectomy and inguinofemoral lymphadenectomy including the time taken to complete wound healing. 42 patients who were subjected to either radical or modified radical vulvectomy for primary and inguinofemoral lymphadenectomy(80 groins) for groin metastases were analysed retrospectively. The complications analysed were wound breakdown, wound cellulits or infection, lymphocyst, limb edema and the time to wound healing. In a total of 80 inguinofemoral lymphadenectomies 55% had wound breakdown, 17.5% had wound infection/cellulitis, lymphocyst in 31% ,limb edema in 36% and time taken for complete wound healing ranged from 10-134 (average 46 days). Overall post operative morbidity was 85%.
Key words: Carcinoma Vulva; Morbidity; Inguinofemoral lymphadenectomy |
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2012;3-4
Original Article |
Sebastian S, Suresh BA, Ballraj A.
Causes of Acquired Vocal Cord Palsy in Indian Scenario. |
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Abstract: Vocal cord paresis or paralysis occurs due to lesion in the vagus nerve. Vocal cord paralysis can lead to dysphonia as well as dysphagia which lead the patient to frustration and emotional problems. The literature available on the etiology and the problems faced by them in Indian population is very scanty. Hence a prospective study was done on 41 Patients with vocal cord palsy who were referred to the Department of ENT for voice assessment and management from March 1st 2012 till 1st August 2012. The medical and surgical reports were examined. They were evaluated by an otorhinolaryngologist, and a Speech Language Pathologist. Diagnosis was made based on video stroboscopic findings. We also examined voice-related quality of life (V-RQOL) outcomes in these patients. In this study, endo-tracheal intubation (15/41; 36.5%) was the major cause of vocal cord palsy. The second major cause for vocal cord palsy in our study was surgical trauma (iatrogenic) which constituted 26.8% (11/41), out of which thyroidectomy contributed to 81.81% (9/11) and cardiac surgery (Coronary Artery Bypass Grafting (CABG) contributed to 18.18% (2/11). Neurological problems caused 14.63% (6/41) of the total cases. Non-surgical trauma constituted 9.75% (4/41) of the total patients. Left recurrent laryngeal nerve paralysis was found as a complication of heart disease in 7.3%(3/41). Tuberculosis of lungs and cancer of lungs accounted to be the rarest causes. Hoarseness of voice was the most common symptom with associated dysphagia in a few. The voice related quality of life of these patients was found to be poor. They were found to have problems in the social-emotional domain and physical functioning domain.
Key words: Vocal cord paralysis; endo-tracheal intubation; Hoarseness of voice |
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2012;3-5
Original Article |
Agravat AH, Dhruva GA, Pujara KM, Sanghvi HK.
Role of Fine Needle Aspiration Cytology in Salivary Gland Pathology and its Histopathological Correlation: A Two Year Prospective Study in Western India. |
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This article is being withdrawn as it has been brought our notice that it is a complete plagiarisation of an earlier article published here. The above authors are hereafter prohibited from submitting any articles to OJHAS. The editorial board hereby expresses its unconditional apology to the authors of the Original Article, for this inadvertent error. |
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2012;3-6
Case Report |
Mahakalkar CC, Kamble AT, Kaple MN, Baitha K.
Penetrating Abdominal Injury by a Large Stone. |
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Penetrating trauma can be commonly caused by sharp objects. We report a case of penetrating injury of abdomen caused by a fairly large sized stone which is used for sharpening the objects or weapons. It pierced through the abdominal wall musculature and caused ileal transection, mesenteric tear and gastric perforation.
Key words: Penetrating trauma; Stone; Ileal transection; Gastric perforation
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This Article |
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2012;3-7
Case Report |
Jagtap SV, Nikumbh DB, Kshirsagar AY.
Adult Pure Yolk Sac Tumor of The Testis. |
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Abstract: Adult pure yolk sac tumor (YST) is extremely rare. In childhood pure yolk sac tumors are most frequently seen, whereas component of mixed germ cell testicular tumors observed in adults. They have different biological behavior (bad prognosis) than the childhood tumors. We herein report a case of adult pure yolk sac tumor of left testis in 40 years old man. Until now limited number of the cases has been reported in the literature.
Key words: Yolk sac tumor (YST); Testis; Adult |
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2012;3-8
Case Report |
Srivatsa KS, Appaji L, Aruna Kumari BS.
Wilms Tumour with Intracardiac Extension. |
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Abstract: Wilms tumour or nephroblastoma is the most common renal tumour of in children. It accounts for 6% of all pediatric tumours and is the second most frequent intrabdominal solid organ tumour in children. Inferior vena cava (IVC) involvement by Wilms’ tumour occurs in 4-10% of patients and right atrium thrombus extension in less than 1%. Using a multidisciplinary approach, overall survival is excellent in Wilms tumour. We are presenting this case because Wilms tumour with right atrial thrombus is relatively rare and continues to remain a challenge for treating physicians.
Key words: Wilms tumour; Intracardiac extension; Nephroblastoma. |
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This Article |
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2012;3-9
Case Report |
Kalloli M, Vijayakumar M, Srinivas C, Ramachandra C.
A Rare Giant Pleural Thymoma in Posterior Mediastinum. |
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Abstract: Thymoma is an epithelial neoplasm of the thymus, which commonly lies in the anterior mediastinum. Unusually, thymomas can also be found in other locations. Surgical excision, when feasible, appears to provide good results. We encountered a rare case of a thymoma that developed in the right thoracic cavity, and originating from the pleura in posterior mediastinum. We describe the clinical scenario, investigations, and our management of the patient.
Key words: Thymoma; Pleural tumor; Posterior mediastinum; Surgical excision. |
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This Article |
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2012;3-10
Case Report |
Ravikumar HN, Vani R, Santosh KV, Joji A.
Retinal Dysplasia Mimicking Retinoblastoma. |
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Abstract: Retinal dysplasia represents a congenital disorder characterized by abnormal proliferation of retinal tissue causing leukocoria. We present a case of an infant with bilateral leukocoria, clinically diagnosed as retinoblastoma, followed by enucleation of the left eye. Microscopy however, demonstrated retinal dysplasia consisting of a disorderly proliferation of retinal tissue with formation of rosettes, mimicking retinoblastoma. Microscopic features that aid in differentiating this lesion from retinoblastoma are discussed.
Key words: Retinal Dysplasia; Retinoblastoma; Leukocoria |
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This Article |
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2012;3-11
Case Report |
Dhiman P, Sharma A, Raina R, Madhabhavi I, Gupta S.
Scrub Typhus Presenting as Acute Myocardial Infarction. |
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Abstract: Scrub Typhus, or tsutsugamushi disease is a febrile illness caused by bacteria of the family Rickettsiaceae and named Orientia tsutsugamushi. Recently it has been found to endemic in Subhimalayan region of India. Scrub typhus affects skeletal muscles, skin, lungs, kidneys, brain and cardiac muscles.We report a rare case of scrub typhus presenting as acute myocardial infarction.
Key words: Scrub typhus; Myocardial infarction |
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2012;3-12
Case Report |
Shakuntala PN, Poornima M, Padmalatha VV, Rao SR.
Successful Pregnancy Outcome In Maternal Crigler Najjar Syndrome Type II. |
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Abstract: Estimated incidence of Crigler-Najjar syndrome(CNS) is 1 case per 1,000,000 births(1 million). The overall prevalence of CN syndrome is unknown, with only several hundred people reported to have this disease. It is interestingly very rare to encounter a pregnant adult women with congenital jaundice. Pregnancy in CN type II patients is a diagnostic and a therapeutic challenge because of the high risk of bilirubin encephalopathy with serious neurological damage as life-threatening complications for the fetus. To date 8 pregnancy outcome have been reported from 5 women and we report the6 woman with a successful 9 th pregnancy outcome. We have discussed detail history, presentation and management during pregnancy and care of the new born.
Key words: Crigler Najjer Syndrome type II; Unconjugated hyperbilurubinemia; Phenobarbitone; Phototherapy |
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2012;3-13
Case Report |
Challa VR, Swamyvelu K, Goud BYG, Rangappa P.
Massive Splenic Pseudocysts : Report of 2 cases. |
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Abstract: Splenic cysts can be classified as parasitic and nonparasitic. Non parasitic cysts can be further divided into true and pseudocysts. Pseudocysts of spleen does not contain an epithelial lining. Pseudocysts of spleen are usually post traumatic and they rarely grow to a large size and most of them are asymptomatic. It can be confused with cystic lesions of spleen or pancreas or from the surrounding structures. These cases require exploration and is both diagnostic and therapeutic. Conservative measures to preserve spleen can be considered only in presence of expertise and if remnant functional splenic parenchyma is more than 25 %. Here we present two cases of giant pseudocysts who were confused with malignancy and referred to our centre and were later found to be pseudocysts of spleen. We would like to report these cases as they are rare and as diagnostic dilemmas.
Key words: Splenic pseudocysts; Splenic cysts; Splenectomy. |
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2012;3-14
Case Report |
Shakuntala PN, Bafna UD, Shobha K, Rao CR, Aruna S, Umadevi K.
A Rare Case of Metastatic Intra-abdominal Melanoma Following Exenteration of Right Eye for Primary Choroidal Melanoma. |
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Abstract: The most common primary intraocular malignant tumour is choroidal melanoma. Reported incidence of intraocular melanoma is less than 1 per 100,000. Liver is the most frequent site of metastasis, and involvement of the other sites generally occurs in association with liver metastasis. The present case had an unusual presentation of, rapidly refilling massive ascites and right pleural effusion, following exenteration of the right eye 4 years earlier for primary choroid melanoma. To the best of our knowledge this is the first case of intra abdominal melanotic rapidly refilling ascites following primary choroidal melanoma masquerading as an ovarian tumour. We have discussed the atypical presentation, difficulties in arriving at a diagnosis preoperatively, intraoperative dilemmas and the post operative management.
Key words: Primary choroidal melanoma; Melanotic ascites; Debulking surgery. |
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