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Case report:- Pathology
Amrit Kaur Kaler1*, Raja Parthiban2, Madhusmitha Jena3, Gandhi N3 & Shantha B4 1Assistant Professor, 2Associate Professor, 3Professor, Shantha, IInd year, Post graduate of Pathology, MVJMC & RH, Bangalore, India.
Abstract:- The α-thalassemias are the most common inherited disorders of hemoglobin (Hb) synthesis due to deletions or point mutations affecting 1 or more α-globin genes leading to decreased or absent α-globin chain synthesis. The α thalassemias involve the genes HBA1 and HBA2 located on chromosome 16(16p13.3) and inherited in an autosomal recessive fashion. The normal complement of four functional alpha-globin genes may be decreased by 1, 2, 3 or all 4 copies of the genes, explaining the clinical variation and increasing severity of the disease. Compound heterozygotes and some homozygotes have a moderate to severe form of α thalassaemia called HbH disease. Patients with non-deletional types of HbH disease are more severely affected than those with the common deletional types of HbH disease. It can also be acquired, under rare circumstances. Due to the low occurrence of α -thalassemia, the disease can be mistaken for iron deficiency anemia.
Key words:- Haemoglobin H disease, Alpha Thalassemia, Iron deficiency anemia.
References:-
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3.Bernini LF. Geographic distribution of alpha thalassemia. In: Steinberg M, Forget B, Higgs D, et al., eds. Disorders of hemoglobin. New York, NY: Cambridge University Press; 2001:878-94.
4.Desai S, Colah R. Alpha-Thalassemia Syndromes In India. Indian J Hum Genet 1997; 3: 1-9.
5.Mitra S.S. The clinical and haematological profile of thalassaemia and haemoglobinopathies in Indian Pediatr. 1983; 20: 701–13.
6.Cornelis L Harteveld and Douglas R Higgs. αethalassaemia. Harteveld and Higgs Orphanet Journal of Rare Diseases 2010, 5:13.
7.Weatherall DJ, Clegg JB: The Thalassaemia Syndromes. 4th edition. Oxford ,England: Blackwell Science Ltd 2001.
8. Delft van P, Lenters E, Bakker-Verweij M, de KM, Baylan U, Harteveld CL, Evaluating five dedicated automatic devices for haemoglobinopathy diagnostics in multi-ethnic populations. Int J Lab Hematol 2009, 31:484-95.
9.Nooitgdag JE et al. A new deletion defect leading to alpha-thalassemia in large Dutch Caucasian family. Br J Hematol 2007; 106(4): 662-5. 10.Cohen AR, Galanello R, Pennell DJ, Cunningham MJ, Vichinsky E: Thalassemia. Hematology Am Soc Hematol Educ Program 2004:14-34.
Copyright © 2013 Kaler et al.. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Research article:- Anaesthesia,
Meera Rani Nayak*
Assistant Professor, Department of Anaesthesia, Sree Balaji Medical College & Hospital, #7, Works Road, Chromepet, Chennai - 600 044.Tamil Nadu, India.
Abstract:- This study was carried out in 60 adult ASA I &II patients to evaluate prolongation of postoperative spinal analgesia by clonidine. Addition of intrathecal clonidine at the doses of 75µg & 37.5µg to 0.5% hyperbaric Bupivacaine prolongs both sensory blockade of spinal anaesthesia & time interval to first request for supplemental analgesia. Incidence of hypotension & bradycardia was more with higher doses of intrathecal clonidine (75µg) which was managed by I.V fluids, inj. Mephenteramine & inj. Atropine sulphate satisfactorily. Sedation – maximum with higher dose (75µg) of intrathecal clonidine.
Key words:- Intrathecal clonidine, Post operative analgesia, Lower abdominal surgeries.
References:-
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3.Filos KS, Goudas LC, Patroni, Polyzou V. haemodynamic & analgesic profile after intrathecal clonidine in Humans. A dose response study. Anesthesiology 1994; 81: 591-601.
4.Niemi L. Effects of intrathecal clonidine on duration of Bupivacaine spinal anaesthesia , hemodynamics, postoperative analgesia in patients undergoing knee artroscopy. Acta Anaesth Scand 1994; 38:724-8.
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8.Vaghadia H, McLeod DH, Mitchell GW, Merrick PM, Chilvers CR. Small-dose hypobaric lidocaine –fentanyl spinal anaesthesia for short duration out patient laparoscopy. I. A randomized comparison with conventional dose hyperbaric lidocaine. Anesth Analg 1997; 84:59-64.
9.Eisenach JC, De Kock M, Klimscha W, Alpha(2) – adrenergic agonists for regional anesthesia. A clinical review of clonidine (1984-1995).Anesthesiology 1996;85:655-74.
10.Kaabachi O, Zarghouni A, Ouezini R, Abdelaziz AB, Chattaoui O, Kokki H.Clonidine 1 microg/kg is a safe and effective adjuvant to plain bupivacaine in spinal anesthesia in adolescents. Anesth Analg 2007; 105:516-9.
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13.Larsen B, Dorscheid E, Macher-Hanselmann F,Buch U.Does intrathecal clonidine prolong the effect of spinal anesthesia with hyperbaric mepivacaine? A randomized double-blind study. Anesthesist 1998; 47:741-6.
Copyright © 2013 Meera Rani Nayak. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Case report:- Obstetrics and Gynecology
Chaudhari shilpa N.1*, Gaikwad Vidya A.1,Mahajan Vinayak2& Bamane Shubhangi3
1M.D. (Obstetrics and Gynecology) Professor, 2M.D. (Obstetrics and Gynecology) Lecturer, 3M.B.B.S. Senior Resident, Dept of OBGY, Padmashree Dr.D.Y.Patil Medical College and Research Centre, Pimpri, Pune, India
Abstract:- There are many causes of abnormal uterine bleeding (AUB) like fibroids, polyps, endometrial hyperplasia and malignancy. But prolonged retention of fetal bones after abortion as an etiology for AUB is a rare one. Incidence given in only one study was 0.15% where fetal bones were found on Diagnostic hysteroscopy. A 24 years woman, presented with pain in lower abdomen and continuous bleeding per-vaginum for 2 months. Her transvaginal ultrasonography showed hyperechogenic shadow in uterine cavity .She underwent an office hysteroscopy which showed multiple fetal bones in the uterine cavity. They were removed in the same sitting.
Key words:- Abnormal uterine bleeding, Hysteroscopy, Retained intrauterine fetal bones, Transvaginal ultrasonography.
References:-
1.Kalu E, Richardson R. Retained foetal bones: an intrauterine cause of chronic pelvic pain. Arch Gynecol Obstet. 2009, Feb; 279(2): 233-4. PMID: 18506460
2.Makris N, Stefanidis K, Loutradis D, Anastasiadou K, Hatjipappas G, Antsaklis A. The incidence of retained fetal bone revealed in 2000 diagnostic hysteroscopies. JSLS. 2006, Jan-Mar; 10(1):76-7. PMID: 16709364
3.Shalev J, Meizner I, Bar-Hava I, Dicker D, Mashiach R, Ben-Rafael Z. Fertil Steril. Predictive value of transvaginal sonography performed before routine diagnostic hysteroscopy for evaluation of infertility. 2000, Feb; 73(2):412-7. PMID 10685552.
4.Verma U, et. al. Fetal bones retained in uterine cavity as a rare cause of chronic pelvic pain: Case Report. J Reprod Med 2004, Oct; 49(10):853-5. PMID: 15568412.
5.Chervenak FA, et. al. Symptomatic intrauterine retention of fetal bones. Obstet Gynecol 1982; 59:58–61. PMID: 7088429.
6.Chan NS. Intrauterine retention of fetal bone. Aust N Z J Obstet Gynaecol. 1996, Aug; 36(3):368-71. PMID: 8883773
7.Vercellini P, Cortesi I, Oldani S, Moschetta M, De Giorgi O, Crosignani PG. The role of transvaginal ultrasonography and outpatient diagnostic hysteroscopy in the evaluation of patients with menorrhagia. Hum Reprod. 1997, Aug; 12(8):1768-71. PMID: 9308809
8.Towbin NA, Gviazda IM, March CM. Office hysteroscopy versus transvaginal ultrasonography in the evaluation of patients with excessive uterine bleeding. Am J Obstet Gynecol. 1996 Jun; 174(6):1678-82. PMID: 8678126.
Copyright © 2013 Chaudhari shilpa et al.. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Research article:- Oral Pathology
Ashok V1*, Prashant Babaji2, Nagarathna S3, Dilip Dhamankar4, Kiran Keswani5 & Raghavendra M Shetty6.
1Professor & HOD, Department of Oral Pathology, Bangalore Institute of Dental Sciences, Bangalore, India.
2Associate Professor, Department of Pedodontics,5Senior Lecturer Department of Conservative Dentistry and Endodontics, Vyas Dental College, Jodhpur, India.
3Professor , Department of Periodontics, Maharana Pratap Dental College, Gwalior, India.
4Professor & HOD, Department of Prasthodontics, NIMS Dental College, Jaipur, India.
6Professor, Department of Pedodontics, Chattisgarh Dental College, Rajanandagaon, India.
Abstract:- Syndecans are a family of integral membrane proteoglycans that participate in cell-matrix interactions and growth factor binding. The down regulation of syndecan-1 may offer the cell a possibility to detach and to invade. As the differentiation of cancer decreases, the expression of syndecan-1 also decreases. In our study we evaluated 63 cases of oral cancer for Syndecan-1 expression which comprised of 36 cases of oral squamous cell carcinoma and 27 cases of verrucous carcinoma. It was seen that the syndecan-1 expression showed a definite down regulation in squamous cell carcinoma and verrucous carcinoma. The staining intensity and percentage of positive cases decreased with increase in severity of squamous cell carcinoma.
Key words:- Squamous cell carcinoma, Syndecan-1, Verrucous carcinoma.
References:-
1.Bartold P M, Narayanan A S. Proteoglycans. Biology of the Periodontal Connective Tissues, Quintessence Publication.1998
2.Bernfield M et al. Biology of the syndecans. Annu. Rev Biochem.1992; 8: 365-93.
3.Soukka T et al. Reduction of syndecan-1 expression is associated with dysplastic oral epithelium. J Oral Pathol Med. 2000; 29: 308-13.
4.Jalkanen M, Rapraeger A, Saunders S et al. Cell surface Proteoglycan of Mouse Mammary Epithelial Cells is shed by Cleavage of its Matrix – binding Ectodomain from its Membrane Associated Domain.J. Cel Biol. 1987; 105: 3087-96.
5.Inki P et al. Immunohistochemical localization of syndecan-1. In normal and Pathological Human uterine Cervix. J. Pathol.1994; 172: 349-55.
Copyright © 2013 Ashok V et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Original research:-General Surgery
Yogesh Kumar1,Basavaraj G.Veerapur2,Sunil Kumar Math3 & YP Raghavendra Babu4* 1Professor, Department of General Surgery,2Assistant Professor, Department of General Surgery,3Postgraduate, Department of General Surgery,4Associate Professor, Department of Forensic Medicine and Toxicology, Kasturba Medical College (A Constituent College of Manipal University), Mangalore, India.
Abstract:- Background:Studies on the clinical outcome & biochemical alterations in the postoperative follow-up period in cases with Roux-en-Y jejunostomy compared with loop jejunostomy cases in upper GI surgeries are not many. Materials & Methods: In this observational study, a total of 28 cases undergoing upper GI Surgeries with eitherRoux-en-Y jejunostomy orloop jejunostomy method were included. Jejunal loop anastomosis or Roux en Y jejunal anastomosis was used as per the indications for case. During the follow up clinical evaluation, biochemical analysis, quality of life was obtained. Results: There was one mortality and four patients had significant morbidity. The average follow-up period was 16 months (range 3months – 16 months). Patients with Roux-en -Y anastomosis were significantly asymptomatic and had greater Visick I grading than patients with loop jejunal anastomosis. Clinical outcomes & quality of life was better in Roux-en-Y group. Biochemical analysis showed loop anastomosis group had significant post operative hypokalemia, hypoproteinemia with longer hospital stay. Conclusion: This pilot study showed that Roux-en-Y anastomosis is significantly better than jejunal loop anastomosis in upper GI surgeries with the subjective and biochemical analysis under evaluation. However further studies is required to confirm the findings.
Keywords:- Roux-en-Y; Jejunostomy; GI surgery; loop jejunostomy.
References:-
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Copyright © 2013 YP Raghavendra Babu et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.