Aims and Objectives: Breast carcinoma is the most common malignant tumor worldwide in women while it is the second most common cancer in India. Triple assessment, including clinical assessment, radiological imaging and pathological diagnosis is the most widely accepted protocol followed for diagnosis of breast lump. Fine-needle aspiration cytology (FNAC) is the most important part of triple assessment. The purpose of our study was to establish the role of FNAC in the diagnosis of breast lump, to study the various types of breast lumps, and to observe any correlation of fine needle cytology with postoperative histopathology.
Materials and methods: The study group included 128 consecutive female patients presenting with palpable breast lump during a one year period. FNAC of patients was performed with non-aspiration technique. Smears prepared and stained with Giemsa stain and examined for cytological diagnosis. Routine histopathological examination was performed on available surgical biopsy specimens to correlate cytological and histopathological diagnosis.
Results: A total of 128 cases were included out of which 126 cases had adequate sample and 2 cases were categorised as unsatisfactory. Out of 126 adequate samples 102 were benign, 21were malignant and 3 cases were of atypical ductal hyperplasia. Fibroadenoma accounted for maximum number of cases, and infiltrating duct carcinoma was most common malignant lesion in our study. Histopathological correlation was obtained in 95 cases out of 126 cases and among these 80% were benign and remaining 20% were malignant. Out of 76 benign lesions on cytology, 75 were confirmed as benign but one case was reported as malignant on histopathological examination. All the cytologically diagnosed malignant cases were confirmed as malignant on subsequent histopathological examinations
Conclusion: The most common benign tumor in the present study was fibroadenoma and the most common malignant tumor was infiltrating duct carcinoma.. Our study showed 0% false positivity and the false negative rate was 5.26%. 27 Our study showed a sensitivity of 94.74% a very high specificity of 100%.
Conversion disorders are a borderland between psychiatrist and neurologist. These are known from ancient time and witnessed a variety of nomenclature and theories. Manifestations of conversion disorders are widely variable and may range from psychogenic movement disorders, psychogenic sensorimotor deficit to nonepileptic psychogenic seizures. Though advancement in diagnostic techniques helps in diagnosis of a number of neurological disorders, still diagnosis of conversion disorders is mostly clinical. For a neurologist, it is important to know breadth of conversion disorders and salient clinical features to differentiate from organic disorders to avoid fallacious diagnosis and its serious consequences. Treatment options include psychotherapy, hypnotic therapy, pharmacotherapy and recently transcranial magnetic stimulation. All patients of conversion disorders may not have mild course.
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Khunteta N. Pectoralis Major Rib Osteomyocutaneous Flap in Primary Mandibular Reconstruction for Oral Cavity Carcinoma in Geriatric Population: Is it Better than Fibular Free Flap?. J Mahatma Gandhi Univ Med Sci Tech 2018; 3 (1):17-20.
Oral cavity cancer in geriatric population is amongst the common cancer seen in our part of world. Squamous Cell Carcinoma is the commonest histology. Generally they come with locally advanced cancer, with multiple comorbid conditions. The morbidity of Radical resection and osteomyo cutaneous free flap reconstruction is higher than younger age group. This high morbidity can lead to mortality also in this age group.
One stage reconstruction of the mandible with soft tissue of the oral cavity and face with pectoralis major Rib osteomyocutaneous (PMROC flap) pedicle flap is one of good option than free flap. PMROC Flap reconstruction is a shorter duration procedure, less morbidity, good cosmetic and functional outcome.
In this article we will discuss our experience of four cases.
Aims and objectives: Onychomycosis is a chronic fungal infection of nails. The clinical diagnosis of onychomycosis needs to be confirmed by direct microscopy and culture for identification of specific pathogen and proper selection of antifungal treatment. The study aimed to determine the prevalence of onychomycosis and cultural positivity of onychomycosis with respect to various etiological agents.
Introduction: Dermatophytes are the most common pathogens of onychomycosis, yeasts and nondermatophyte moulds can also be found as causative agents of onychomycosis.
Materials and methods: Nail clippings from 90 clinically suspected cases of onchomycosis were collected from OPD at Department of Dermatology, Venerology and Leprology, SMS and ESIC hospital, Jaipur. Detailed history of trauma, infection, occupation, diabetes, personal habits (smoking etc.) were taken Diagnosis was based on direct microscopy by 20% KOH examination method and fungal culture on SDA and Dermatophyte Test Media.
Results: Out of 90 cases of onychomycosis patients, 80 (88.9%) were found KOH positive and 33 (36.7%) were positive in culture. In the present study, dermatophytes, nondermatophytes and yeasts were found etiological agents of onychomycosis. Distal subungual onchomycosis was found common type of onychomycosis in patients. Among the culture positive cases, Trichophyton rubrum was found the most prevalent species followed by T.mentagrophyte and T.tonsurans. Nondermatophyte molds were also isolated from white superficial onychomycosis and Candida species was isolated from Candida onychomycosis. Majority of patients were more prevalent in the age group of 41-50 and 51-60 years and males were commonly affected in our study. In the study, it was reported that, majority of patients that are infected with onychomycosis infection were service class and sportsmen followed by labours, housewives, unemployed, students and farmers.
Conclusion: Based on this study it could be concluded that, onychomycosis is an important public health problem and accurate diagnosis of onychomycosis by direct microscopy and fungal culture is an essential requirement for appropriate management of such cases.
Anemia is a major health problem worldwide and is estimated to affect 24.8% of the global population in developed and developing countries.1 The primary cause of anemia, in 50% of cases2 is iron deficiency, which is among the most important factors which contribute to the global burden of disease.33 Recently, delaying umbilical cord-clamping has been identified as one of four effective interventions to combat iron deficiency during the first 6 months of life.6 An additional 15–40 mL of blood volume per kg of birth-weight can be delivered to the infant through the umbilical cord by allowing placental transfusion of blood to complete.7,8 This can increase total blood volume by an estimated 30–50%,7,8 thus providing an additional 30–75 mg of iron at birth.7–9 Maximizing placental transfusion of blood takes approximately 3 minutes.10
Materials and Methods: This study was conducted on 150 near term (GA - 35 to 36.6 weeks) and 150 term (GA - 37 to 42 weeks) neonates delivered without any complication with uneventful pregnancies. All the patients were randomized for the timing of cord clamping at the time of birth.
Results: Our primary outcome was the neonatal Hematocrit at 6 hrs after delivery in all the groups. The secondary outcomes were neonatal hematocrit and neonatal bilirubin at 24 and 48 hrs, and any other abnormal neonatal outcome after delivery during hospital stay, maternal blood loss at the time of delivery, maternal postnatal hemoglobin and any abnormal maternal outcome after delivery (eg. PPH) during hospital stay.
Discussion: The neonatal hematocrit levels were significantly higher in DCC groups whereas prevalence of neonatal anemia was significantly higher in ECC group. There was no significant difference in the neonatal bilirubin levels at 24 and 48 hrs, in both early and delayed cord clamping groups, in both near term and term neonates. There were no significant differences in the adverse early neonatal and maternal outcomes in both early and delayed cord clamping groups.
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Chopra G, Purohit G. Prevalence of Psychiatric Morbidity in Renal Recipient Candidates: A Tertiary Care Hospital-based Study. J Mahatma Gandhi Univ Med Sci Tech 2018; 3 (1):31-33.
Objective: To assess prevalence of psychiatric morbidity in patients suffering from end stage renal disease and undergoing evaluation for renal transplant
Materials and methods: A cross-sectional study was conducted on 45 patients with ESRD who were seeking renal transplant and undergoing pre-transplantation evaluation process. General health questionnaire (GHQ-12) was applied to detect any psychopathology in participants and final diagnosis was made on the basis of ICD-10 diagnostic criteria. The data thus generated was subjected to appropriate statistical analysis.
Results: Out of the 45 patients, 77.78 % had psychiatric morbidity. The most common diagnosis amongst the participants was depressive disorder) (20%), followed by adjustment disorder (17.78%), generalized anxiety disorder (15.56%), dysthymia (13.33%), panic disorder (8.9%) and OCD (2.22%).
Conclusion: Early diagnosis and treatment of psychiatric comorbidity in these patients can have significant positive impact on outcome of renal transplantation.
Free gas under diaphragm is a very significant X-ray finding seen among patients of acute abdomen coming to the ER of any hospital. This finding usually suggests perforation of a hollow viscus and requires urgent surgical intervention. But there are some pathologies which mimic this important sign thereby necessitating the surgeon to always take a holistic view and approach any potential laparotomy with clinical suspicion. We have presented such a case seen in our emergency department wherein an internal herniation of bowel loops presented with pseudopneumoperitoneum.
No more worry for patient\'s who were unhappy with the appearance of their smiles. For all those patients who always wanted a new smile but thought that it was beyond their budget, A new option SNAP ON SMILE is answer for all their aesthetic questions.
The snap on smile is a comfortable, removable dental appliance that requires no tooth preparation, no injections and no cements or adhesive. Patient can eat and drink confidently and comfortably while wearing the appliance.
Snap on smile should be targeted to patients who want to quickly feel, look and function better.1
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Sarraf N, Sejra A, Raisingani D, Prasad AB, Srivastava H, Mital P. Smile Makeover with Porcelain Laminate Veneer: A Case Report. J Mahatma Gandhi Univ Med Sci Tech 2018; 3 (1):38-40.
One of the principle topics for contemporary dentistry is to re-establish patient lost dental esthetic appearance.
To re-establish patient\'s lost dental esthetic appearance is one of the most important topics for contemporary dentistry. New treatment materials and methods have been discovered and introduced in market in order to gain this aim. Conservative and esthetic approaches, such as direct and indirect laminate veneer restorations, instead of full-ceramic crowns for anterior are preferred by most Dentist\'s where esthetics is really important.
To correct existing abnormalities, esthetic deficiencies and discolorations, laminate veneers are used. They are processed in two different ways: direct or indirect. Direct laminate veneers are based on the principle of application of a composite material directly to the prepared tooth surface in the dental clinic. Indirect laminate veneers may be produced from composite materials or porcelain, which are cemented to the tooth with an adhesive resin. In this case report Indirect ceramic laminate veneers were used to enhance the esthetic appearance of the young patient.