Vol 2 Issue 1 April 2014-September 2014

Abstract: Avulsion of one or more cervical roots of the brachial plexus causes severe, disabling pain. Various medical and surgical treatment modalities have been used to relieve such pain. Most of them offer only limited benefits. Radiofrequency thermo coagulation (RFTC) of the dorsal root entry zone (DREZ) of spinal cord is one of the most effective surgical treatments for these patients. A case of chronic refractory neuropathic pain following brachial plexus injury is described here. Cervical (C5–T1) DREZ radiofrequency ablation was carried out with good pain relief.

Keywords: Brachial plexus avulsion, Dorsal root entry zone (DREZ), Neuropathic Pain, Deafferentation pain.

Title: MANAGEMENT OF CHRONIC REFRACTORY PAIN IN A CASE OF BRACHIAL PLEXUS AVULSION INJURY - A CASE REPORT

Author: Dr. Priti Patel, Dr. Amita Jansari, Dr. Chetna Katariya, Dr. Jayshree Thakkar, Dr. Dipak Patel, Dr. B M Patel

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

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Abstract: Diabetes mellitus is fast turning into one of biggest scourges on modern age. The disease cripples not only the patient but also imposes a huge budgetary health outlay, a burden on third world countries cab ill-afford to expend on. Apart from clinical symptoms and signs, confirming diagnosis is based almost wholly on expensive laboratory investigations. Towards making the screening for disease and its diagnosis simpler, it is suggested that finger nail growth as an external indicator be used as exploited as a tool. Changes in nail shape, color, texture are usually fairly reliable external markers of disease processes. Observations on the appendage form an important component of general physical clinical examination in establishing preliminary diagnosis. Presented in this brief study present are the findings on rate of nail growth as an external clue to the presence of diabetes mellitus. The accelerated rate of growth could be a cost effective reliable mass tool in establishing preliminary diagnosis of the disease in the community. It is surmised that merely measuring the forward shift in voter’s ink mark (applied as a proof of casting a ballot during general elections) one can estimate the rate of growth of the nail – the more rapid the shift, the higher the possibilities of diabetes mellitus.

Keywords:  diabetes mellitus, nails, ectoderm, micro-angiopathy.

Title: ACCELERATED NAIL GROWTH IN DIABETICS

Author: ARUNACHALAM KUMAR

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

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Abstract: Gaint cell tumor (GCT) is a bening locally aggressive tumor with a tendency for local recurrence. GCT of metatarsal is of rare occurrence with very few cases reported so far. GCT in this location is rare and should be considered in the differential diagnosis of a destructive bony lesion. We report the case of GCT of 2nd metatarsal in a 28 year male and discuss the clinical features and the results of reconstructive surgery with enbloc resection of distal metatarsal and reconstruction with tricortical iliac graft and plate fixatation.

A 28 year old male presented with an insidious onset of pain and swelling over the dorsum of the right foot. On examination there was an ovoid, tender, firm, well defined swelling opposing the 2nd metatarsal. The 2nd toe movement was normal. X-ray showed an expansile osteolytic lesion with soap bubble appearance in the head and neck of the 2nd metatarsal. FNAC confirmed the diagnosis of GCT. En bloc resection of the tumor , reconstruction with tricortical iliac crest graft and plate fixatation done. On 1 year follow the graft has taken up well, there was no recurrence and normal foot function obtained.

Enbloc resection of the involved metatarsal with autograft and plate fixatation reconstruction is the preferred surgical technique to prevent recurrence and to restore normal foot function.

Keywords: A rare entity, gaint cell tumor,  iliac crest tricortical  graft, 2nd metatarsal.

Title: GAINT CELL TUMOR OF THE SECOND METATARSAL

Author: Dr.N.S.Raja Rajan,  Dr.I.Mubarak Basha

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

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Abstract: Evans syndrome (ES) is anecdotal and incidental combination of autoimmune hemolytic anemia (AIHA) and immune thrombocytopenia (ITP); occurrence may be simultaneous and sequential. Cushing’s syndrome along with ES is just a co-existence and very rare combination. We report a case of Cushing’s syndrome with ES in a 26 years old female who has undergone splenectomy for AIHA treatment. She was diagnosed with ITP and AIHA remission after splenectomy. Simultaneously the patient presented with Cushing’s syndrome probably due to long term steroids use. Due to its rarity, this report shed light on clinical features, investigational procedures, management and outcomes in this particular combin ation.

Keywords: Immune thrombocytopenia, Autoimmune hemolytic anemia, CUSHINGOID, Transfusion, Immuno globulins.

Title: CLINICAL COURSE AND MANAGEMENT OF IATROGENIC CUSHING’S SYNDROME IN A POST SPLENECTOMY EVANS SYNDROME PATIENT

Author: Dalsania J. Suraj, Ajit Singh, Ashwin Karanam, Kanav Khera, Rajat Rana, Manjunath H. Hande

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

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Abstract: Fingerprints can reflect a specific chemical history, such as that of exposure to certain explosives. These are clearly distingusihed from overlapping and interfering latent fingerprints, using infra-red spectroscopis imaging techniques and multivariate analysis.

Keywords: Infra-red Spectroscopic Imaging, specific chemical history, associated Forensic Evidence.

Title: Infra-red Spectroscopic Imaging of Latent Fingerprints and associated Forensic Evidence

Author: Enya Mc Grahan

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

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Abstract: The purpose of the study was to find out the influence of asanas and combination of asanas and pranayama on selected physiological variable in Respiratory rate among college men. To achieve the purpose of the study, sixty students were selected from RKM Vivekananda college students, Chennai as subjects at random and their age was ranged from 17to 22 years. The subjects were divided into three equal groups. The subjects (N=60) were randomly assigned to three equal groups of twenty men students each. The groups were assigned as experimental group-1 experimental group-2 and control group in an equivalent manner. Training programs for experimental group were designed separately. The scientifically designed programmes were given to the subjects of experimental group. The subjects of the control group were not participated in training. The treatment groups underwent the programme four days a week for a period of sixteen weeks with sixty minutes per session. In order to find out whether the obtained difference between the means of the selected variables in  the pre test, mid test and post test are statistically significant, Repeated measures  ANOVA was applied,. When the F ratio was found to be significant Newman-Keuls post hoc test was applied to test which of the possible comparison among the means are significant. Analysis of Covariance was applied to determine the significant difference among the three groups namely Asanas training group, Asanas with Pranayama training group and the control grouping the development of selected variables after 16 weeks of training. If the mean difference was significant, the pairs of adjusted final group means was tested for significance by applying Scheffe’s post-hoc test. The results of the study reveal that the asanas training, asanas with pranayama training and control group had differed significantly in respiratory rate. The asana training group and asanas with pranayama training group had significantly decreased the respiratory rate than the control group, and the asanas with pranayama training group had significant decrease in respiratory rate than the asanas training group. In the context of the present trend, the rational use of asanas training and asanas training with pranayama training is essential to decrease the respiratory rate.

Keywords: Asanas, pranayama training, scientifically designed program, respiratory rate.

Title: Influence of Asanas and Combination of Asanas and Pranayama on Respiratory Rate among College Men

Author: A. Sellaperumal, Dr. V.S.T. Sai Kumar

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

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Abstract: Blood groups play a vital role in immunologic safety of whole blood or blood components transfusion. The ABO and Rhesus (Rh) blood group are the major blood group systems. The frequencies and distribution of ABO and Rhesus-D blood groups vary from one population to another in different regions of the same country and also in different parts of the world. The main objective was to document the frequency and distribution of ABO and Rhesus (D) groups in and around Tumkur, Karnataka, India. In the present study, 4823 subjects were examined for blood groups.The commonest blood group was O (37.90%), followed by group B (31.85%) and group A (21.54%). The least common blood group was AB (8.71%). The prevalence of Rh positive and negative distribution in the studied population was 94.65% and 5.35% respectively.

Keywords: Blood groups, ABO, Rh

Title: Frequency and Distribution of ABO and Rhesus (D) Blood groups in and around Tumkur, Karnataka – Study from Teritiary care teaching hospital

Author: Dr. Krishna M C, Dr.Sharadha.M S, Dr Raman M Hulinaykar, Dr.Harish S G

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

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Abstract: We report a 28-year-old primigravida who presented in 34 weeks of pregnancy with seizures, unconsciousness, hemiparesis and blindness, scheduled f or emergency caesarean section. She was managed under general anaesthesia and shifted to intensive care unit. Postoperative computed tomography brain revealed an intra-axialhy podensity involving predominantly white matter regions of bilateral parieto-occipital lobes, caudate nucleus and cerebellum, suggestive of PRES. MRI confirmed the diagnosis. Clinical improvement with complete resolution of visual disturbances was observed with supportive treatment. The importance of prompt suspicion and management in preventing short- and long-term neurological deficits in reversible condition like PRES is highlighted.

Keywords: Leukoencephalopathy, posterior leukoencephalopathy syndrome, posterior reversible encephalopathy syndrome.

Title: Posterior Reversible Encephalopathy Syndrome in a Parturient Posted For Cesarean Section

Author: Dr. SunitaYashvant Shende

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

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Abstract: International surrogacy is a booming business. At the same time nations all across the globe are condemning commercial surrogacy which was legalized by Supreme court in India in India in 2002 in an effort to stimulate medical tourism, the emerging practice of travel across international borders to obtain cheaper health care. According to a 2012 study by the Confederation of Indian Industry (CII), the sector is worth $2 billion. Countries such as India wish to build a reputation as international surrogacy Mecca’s by providing quality medical care at a low cost and by attempting to provide the most comprehensive legal protections for intended parents. From Baby Manji to the baby-selling scandal in California, we are reminded that tremendous ethical concerns surround international commercial surrogacy and demonstrating gaps in the current surrogacy laws and regulations and also the case exposed the lack of clear guidelines and laws related to international surrogacy in India.  This article highlights some of the issues regarding state of child born out of surrogacy arrangement. Identity of the Child – There are also ethical considerations that are brought to mind in terms of informing the child of his or her surrogate mother, as doing so may have an effect on the child's self-identity.

There is no transparency in surrogacy contract and chances of legal problems are high. Cross border surrogacy leads to problems related to nationality, motherhood and rights of child.

Keyword:  child rights, surrogacy, ART bill, law, Confederation of Indian Industry (CII), Ethics.

Title: DOES SURROGACY INVOLVE MAKING FAMILIES OR SELLING BABIES?

Author: Vinita Singh, Pushpawati Thakur, Byasdev, Anjum

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

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Abstract: Anaesthesia to newborn poses many challenges to the anaesthesiologist and that for occipital encephalocele adds to it. It includes securing a difficult airway, prone position and blood loss. We describe a successful management of huge occipital encephalocele for excision.

Title: ANAESTHETIC MANAGEMENT OF A HUGE OCCIPITAL ENCEPHALOCELE IN A NEONATE

Author: DR. SUNITA YASHVANT SHENDE

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

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Abstract: Diagnostic Related Group (DRG) codes are used to classify hospitalized patients into groups with predefined payments, and to control medical expenses. The National Health Insurance Administration, Ministry of Health and Welfare (NHI) has implemented 155 DRG code groups since 2010, and will complete implementation in five years. When a hospital implements this payment system, it needs to control costs. But it cannot just lower outcomes or increase staff workload because this affects service quality. In addition, it cannot discharge patients early because this incurs medical complaints or readmissions. Hospitals should study the major outcomes to refine it or to make suggestions to NHI.

This paper investigates at the expensive tests included in DRG124: cardiac catheterization with complex diagnosis. We focus on patients in 2010 and 2011 whose medical expenses are higher, and track back through their medical records to analyze data alongside their medical histories. Methods developed in this study can also be applied to other DRGs to improve performance of hospitals.

This study finds that medical expenses relate to referral source of patients, inpatient days and related expenses, principle diagnosis, and test items. Patients with heart failure, emergency admission, and ICU stays are the most costly group. For patients and hospitals, it is important to screen for related syndromes and actively control progression. For NHI, we suggest dividing this code into two DRGs according to disease type: coronary artery syndrome (4111, 4140) or heart failure (42X.*), to clearly define reasonable expenses.

Keywords: Diagnostic Related Group, cardiac catheterization, medical expense, hospitalization days, coronary artery syndrome.

Title: A MEDICAL EXPENSE STUDY OF IMPLEMENTING DRG 124 IN A REGIONAL HOSPITAL

Author: Chun-Lieh Chen, Chin-Shu Tsuan, Yaw-Jen Lin

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

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Abstract: A middle aged man presented with intermittent worsening type of pain abdomen for two days in the upper right half of the abdomen. Pain mimicked other causes of pain abdomen in that region. Patient underwent computed tomography imaging which established the diagnosis of omental infarction. Patient was put on conservative treatment but the pain worsened. So patient underwent diagnostic laparoscopy which identified the part of torsioned gangrenous omentum adherent to anterior abdominal wall, which was excised and patient was asymptomatic and discharged the next day. In this report, we want to emphasise the role of laparoscopy for diagnosis and early treatment of the above condition.

Keywords: omentum, infarction, torsion, diagnostic laparoscopy.

Title: OMENTAL INFARCTION: AN UNUSUAL CAUSE FOR ACUTE ABDOMEN

Author: Nataraj Naidu R, Ramalingeswar.K, Hemanth.V, Satish Kumar.R, Madhushankar.L

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

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Abstract: Health care comes under the basic need of the human being; it is a responsibility of state to provide these facilities through health care units to prevent from common and fatal diseases to the society. Human capital is very unique and the most important element for the development of nations; healthy minds can change the world around them with their creativity, efficacy and productivity. The primary goal of the tertiary care hospital as a highest level of health care provision is to provide best possible health care to the patients.

The research study investigates various problems that are faced by patients in Dhubri civil hospital, Assam. Under the elaborated dimensional analysis, public sector hospitals are generally considered poor service providers, mismanaged and politicized units and also identify the scarcity of facilities situated in research area through structured interview schedule in order to record the perception of respondents regarding health problems in Dhubri civil hospital. This study also aims to access the satisfaction level of the patients approaching public hospitals for health care services with a deep focus upon socio-demographic status of the patients.

It has been found that patients in Dhubri civil hospital face variety of problems in health sector in regard of facilities and treatment. It has been suggested that proper attention of government, provision of sound infrastructure, proper medical equipments and skilled employees will reduced to existing problems at Dhubri Civil Hospital.

Keywords: Health, Care, Service, infrastructure and Problem.

Title: AN ANALYTICAL STUDY ON PATIENTS SATISFACTION AND MEDICAL FACILITIES PROVIDED BY PUBLIC HOSPITAL: WITH SPECIAL REFERENCE TO DHUBRI CIVIL HOSPITAL, JHAGRARPAR

Author: Mr. Sudip Ghosh

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

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Abstract: In comparative protection against Pasteurella multocida infection in rabbits evaluated by compare the efficacy of mucosal immune response to systemic immune response. Rabbit groups were immunized intranasally and subcutaneously with a bacterin vaccine and cell lysate of P. multocida serotype B: 2. Mucosal protection in rabbit groups immunized intranasally with the bacterin and cell lysate was measured by the indirect haemagglutination testing of nasal lavages. Subcutaneous immunization of rabbits with the two vaccines induced protection in rabbits. The protection was demonstrated in serum samples collected from immunized animals and examined for antibody titer by the indirect haemagglutination test IHA. Protection of immunized rabbits was further proved by challenge inoculation of the animals with viable P. multocida. The survival rate in all subcutaneously vaccinated group was 100%. While the survival rate in intranasally immunized groups was 100%, and 75% with bacterin and cell lysate respectively. This study concluded that immunization of rabbits intranasally with P. multocida induces an effective protective immune response against P. multocida.

Keywords: P. multocida; immunity; rabbits; vaccine; adjuvant.                               

Title: MUCOSAL VERSUS SYSTEMIC IMMUNITY AGAINST P. MULTOCIDA INFECTION IN RABBITS

Author: Mortada. M. Yagoub, K. M. Suleiman

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

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Abstract:  Executions, word itself drives the mind towards its question of existence in present era. A vast number of organizations and commissions try to put an end to the capital punishments from all constitutions. But a very few focus towards the methods of executions. There is no doubt that the methods for lawful killing of a criminal change from time to time with advancement of technologies. Where in past, the motive behind the creation of methods of executions was not only to end one’s life but also to take his life in such a manner that to make horrible examples for the public. With evolution in methods of capital punishments, it seems that these existing methods are more humane or are they just claimed to be more humane? From so many examples of botched executions till date, it seems that technology and research towards development of appropriate method is far more behind than it should be.

Keywords:  Methods of Executions, Capital Punishment.

Title: Executions: Ancient Methods and Evolution

Author: Dr. Sunil M. Doshi, Dr. Lavleshkumar, Dr. Binaykumar Bastia

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

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