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Bardet-Biedl Syndrome- A Rare Case Presenatation In Marathwada Region Of India Bardet-Biedl综合征-印度马拉特瓦达地区一例罕见病例
Pub Date : 2017-07-01 DOI: 10.9790/0853-1607014952
Kharche Jyoti, P. Vikrant, Yadav Pawan, Quazi Kashifuddin, K. Amit
Bardet-Biedl syndrome (BBS) is a rare, genetic disorder (autosomal recessive ciliopathy) with involvement of multiple systems and wide spectrum of clinical features. Characteristic features of this disorder are cone-rod dystrophy, postaxial polydactyly, truncal obesity, kidney abnormalities and learning difficulties. It may also be associated with diminished size and decreased function of the testes in males (hypogonadism) and complex genitourinary abnormalities in females. Bardet-Biedl syndrome is inherited mostly as an autosomal recessive trait. It affects males and females equally. This syndrome is usually diagnosed in childhood based upon thorough clinical evaluation and detection of characteristic findings (e.g., visual problems due to retinal dystrophy, obesity, polydactyly). Genetic testing may assist in diagnosing the disorder in selected cases (e.g., individuals with certain BBS1 and BBS10 gene mutations). The treatment of Bardet-Biedl syndrome is directed toward the specific symptoms that are apparent in each individual. Treatment may require the co-ordinated efforts of a team of specialists.We present a case of 28yrs female patient with Bardet-Biedl syndrome who presented in out-patient department with episodes of loose motions, vague abdominal pain,swelling all over body and decreased urine outut. She had history of obesity, diminished vision and polydactyly. On investigations she had anemia of chronic disease, deranged renal fuction tests and retinitis pigmentosa.
Bardet-Biedl综合征(BBS)是一种罕见的遗传性疾病(常染色体隐性纤毛病),涉及多个系统和广泛的临床特征。这种疾病的特征是锥杆营养不良,轴后多指畸形,躯干肥胖,肾脏异常和学习困难。它也可能与男性睾丸体积缩小和功能下降(性腺功能减退)和女性复杂的泌尿生殖系统异常有关。Bardet-Biedl综合征是一种常染色体隐性遗传性状。它对男性和女性的影响是平等的。这种综合征通常是在儿童时期根据彻底的临床评估和特征性发现(例如,由于视网膜营养不良、肥胖、多指畸形引起的视力问题)诊断出来的。基因检测可能有助于在特定情况下诊断该疾病(例如,具有某些BBS1和BBS10基因突变的个体)。Bardet-Biedl综合征的治疗是针对每个人明显的特定症状。治疗可能需要一组专家的协调努力。我们报告一例28岁的Bardet-Biedl综合征女性患者,她在门诊表现为运动松散,腹痛不清,全身肿胀和尿量减少。她有肥胖、视力减退和多指畸形史。经调查,她有慢性贫血、肾功能紊乱和视网膜色素变性。
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引用次数: 0
Titanium asa Biomaterial For Dental ImplantsandIts Corrosion Rate- An Animal Stud 钛作为牙种植体生物材料及其腐蚀速率的动物研究
Pub Date : 2017-07-01 DOI: 10.9790/0853-1607024045
R. S. Gugwad, Savita Chakote, DrSharanbasappa CNagaral, DrGoslaShrinivas Reddy
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引用次数: 0
Beliefs and Perceptions about Cancers among Patients Attending Radiotherapy Out Patient Department of a Tertiary Care Hospital 某三级医院放射治疗门诊部患者对癌症的信念与认知
Pub Date : 2017-07-01 DOI: 10.9790/0853-1606134655
P. Jana
Aims and objectives: 1. To assess the beliefs and perceptions about cancer and its treatment among cancer patients. 2. To find out the care-seeking behaviour of cancer patients. 3. To determine socio-demographic correlation. Materials and methods: This is a cross sectional observational study over one year (April 2016 – April 2017) in the Department of Radiotherapy, Bankura Sammilani Medical College, a tertiary care, teaching hospital in Bankura. Total 100 patients over 18 years of age were included in the study. Date were analysed in Excel sheet and tests of significance were applied wherever applicable by SPSS 20 ® . Results: Present study revealed Male: Female ratio (1: 1) with majority of the patients from 46-60 years of age group (44%) and below poverty line (71%). About 64% patients were unaware of their disease. Seventy three percent patients believed that cancer is curable, 21% patients believed that it is preventable. Among them 98% patients had no family history of cancer. No statistical significance were found in association of education status and belief on preventability, contagiousness, knowledge of consumption of tobacco with cancer. However belief on early death in cancer with education status and false belief on positive outcome in cancer (Male: 62% and Female: 38%) in male and female patients were found to be statistically significant. Conclusion: The study revealed some of the beliefs and perceptions prevalent among the cancer patients. Most of them were unaware about the diagnosis of their illness as cancer. Some of them still believe irreligious activity, supernatural powers as risk factors of cancers and rituals, worshipping, exorcism, repenting for sins as curative. Education was found to be an important issue in these beliefs and perceptions as these were more found in persons with lower educational qualification. Influence was not affected by economic condition.
宗旨和目标:评估癌症患者对癌症及其治疗的信念和认知。2. 了解癌症患者的求医行为。3.确定社会人口统计学相关性。材料和方法:这是一项为期一年(2016年4月至2017年4月)的横断面观察性研究,在班库拉Sammilani医学院放射学系,班库拉三级护理教学医院。研究共纳入100例18岁以上的患者。数据在Excel表格中进行分析,并在适用的情况下使用SPSS 20®进行显著性检验。结果:本组患者男女比例为1:1,以46 ~ 60岁年龄组(44%)和贫困以下年龄组(71%)居多。约64%的患者不知道自己患有此病。73%的患者认为癌症是可以治愈的,21%的患者认为癌症是可以预防的。其中98%的患者没有癌症家族史。教育程度、可预防信念、传染性、吸烟知识与癌症的关系无统计学意义。然而,在男性和女性患者中,受教育程度高的人对癌症早期死亡的信念和对癌症阳性结果的错误信念(男:62%,女:38%)具有统计学意义。结论:该研究揭示了癌症患者中普遍存在的一些信念和观念。他们中的大多数人不知道他们的病被诊断为癌症。他们中的一些人仍然相信非宗教活动、超自然力量是癌症的危险因素、仪式、崇拜、驱魔、忏悔是治疗方法。在这些信念和观念中,教育是一个重要的问题,因为这些信念和观念更多地出现在教育水平较低的人身上。影响力不受经济状况的影响。
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引用次数: 2
Prediction of Hypothyroidism after Hemithyroidectomy: A Biochemical and Pathological Analysis. 甲状腺切除术后甲状腺功能减退的预测:生化和病理分析。
Pub Date : 2017-07-01 DOI: 10.9790/0853-1606116163
Abhinav Rathi, D. Sharma, B. Prasad
The possibility of postsurgical hypothyroidism after hemithyroidectomy is an underappreciated complication . We intended to evaluate the incidence of development of hypothyroidism after hemithyroidectomy and to analyze the relationship of posthemithyroidectomy hypothyroidism with preoperative biochemical parameters(preoperative TSH,Thyroid antibody levels) and postoperative histopathological findings. From November 2010 to May 2011, 60 cases of hemithyroidectomized patients were analyzed. Postoperative hypothyroidism developed in 19 patients(31.66%). Preoperative TSH value was significantly higher in the hypothyroid group (2.68 μIU/ml) compared to the euthyroid group (1.39 μIU/ml). Elevated thyroid antibody(TAA) levels were observed in 53% of patients developing postoperative hypothyroidism as compared to 12% of patients who remain euthyroid (p = 0.00077) . Moreover, patients with a higher grade of lymphocytic infiltration were found to have a higher probability of developing hypothyroidism. In addition, our findings support the recommendation for regular serum TSH follow-up at least for 6 months after hemithyroidectomy.
甲状腺切除术后甲状腺功能减退的可能性是一个未被重视的并发症。我们旨在评估甲状腺切除术后甲状腺功能减退的发生率,并分析甲状腺切除术后甲状腺功能减退与术前生化参数(术前TSH、甲状腺抗体水平)和术后组织病理学结果的关系。本文对2010年11月至2011年5月60例甲状腺切除术患者进行了分析。术后发生甲状腺功能减退19例(31.66%)。甲状腺功能减退组术前TSH值(2.68 μIU/ml)明显高于甲状腺功能正常组(1.39 μIU/ml)。53%的术后甲状腺功能减退患者甲状腺抗体(TAA)水平升高,而12%的术后甲状腺功能正常患者甲状腺抗体水平升高(p = 0.00077)。此外,淋巴细胞浸润程度越高的患者发生甲状腺功能减退的可能性越大。此外,我们的研究结果支持在甲状腺切除术后进行至少6个月的常规血清TSH随访的建议。
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引用次数: 4
“Reverse axillary mapping in early stage breast cancer Is it oncologically safe? A feasibity study “早期乳腺癌的反向腋窝定位安全吗?”可行性研究
Pub Date : 2017-07-01 DOI: 10.9790/0853-160701110115
Balasubramanian V MCh, Sridevi, S. Vathulru, Asish Jakhetiya
Background: Arm lymphatics draining through the axilla are frequently disrupted during surgery for carcinoma breast leading to lymphedema. Techniques for differential identification of arm lymphatics might enable their preservation, and probable reduction in lymphedema. Aims: To evaluate the efficacy and oncological safety of reverse axillary mapping (RAM) in patients with early stage breast carcinoma and to correlate with post operative pathological nodal status. Methods and Material: It is a prospective pilot study, conducted at a tertiary care cancer speciality hospital, among patients with early stage breast cancer ( cT1/T2 cN1M0) planned for straight surgery, consenting to be part of the study. Patients were subjected to injection of blue dye (total 1 ml) at the time of surgery. During axillary dissection, lymphnodes taking up blue dye, were identified, dissected out and sent separately for pathological assessment . Results: RAM technique with blue dye identified arm lymphatic in ipsilateral axilla in 72.22%. Blue lymph nodes were identified in 61.11%. Postoperatively 13 out of 18 patients were staged as pN0, two as pN1, and three as pN3. RAM identified arm lymph nodes were free of diseases in all the patients with pN0,pN1 patients, only one of the three pN3 patients showed metastatic involvement . ( all pN3 patients could be identified as suspicious of having high nodal disease intraoperatively) Conclusions: Reverse axillary mapping can be used to identify the arm lymphatics in the ipsilateral axilla and these nodes are found to be free of metastatic disease in early stage breast cancer. I. Background Lymphatic drainage of the breast and ipsilateral upper limb is through the axilla. Majority of the cases, the two lymphatic pathways are different[1] Technique, that can differentially identify the upper limb lymphatic in the axilla can help preventing disruption of arm lymphatics at the time of axillary dissection for breast cancer. This may help reduce lymphedema, the most significant morbidity associated with surgical management of breast cancer. Reverse axillary mapping (RAM) technique, is a recent development, aimed at identifying the arm lymphatics in axilla at the time of axillary surgery for carcinoma breast. Various techniques have been described for the same using blue dye ,radioisotope or fluorescence imaging[2–5]. Although arm and breast lymphatics have been postulated to have differential drainage crossover has been documented in 2-18% [1,5–7] with pathologically proven involvement of nodes draining the arm by metastatic carcinoma from breast in 043%[5,7–11]. Most common complication associated with this procedure has been local tattoing lasting from few weeks to as long as 6 months. We aim to evaluate the efficacy of identification of arm lymphatic using low volume methylene blue injection (1-1.5 ml) and the degree of involvement of RAM identified nodes by metastatic disease among women with early stage breast cancer. II. Methods
背景:在乳腺癌手术中,经腋窝引流的上臂淋巴管经常中断,导致淋巴水肿。鉴别手臂淋巴管的技术可能使其得以保存,并可能减少淋巴水肿。目的:探讨逆行腋窝定位(RAM)在早期乳腺癌患者中的疗效和肿瘤安全性,并与术后病理淋巴结状态的相关性。方法和材料:这是一项前瞻性试点研究,在一家三级护理癌症专科医院进行,患者为计划进行直接手术的早期乳腺癌(cT1/T2 cN1M0),同意成为研究的一部分。患者在手术时注射蓝色染料(共1ml)。腋窝清扫时,发现染有蓝色的淋巴结,分别清扫后送病理检查。结果:蓝染RAM技术对同侧腋窝淋巴的鉴别率为72.22%。蓝色淋巴结占61.11%。术后18例患者中13例为pN0型,2例为pN1型,3例为pN3型。在所有pN0和pN1患者中,RAM发现手臂淋巴结无病变,3例pN3患者中只有1例出现转移灶。(所有pN3患者术中均可发现疑似高淋巴结病变)结论:早期乳腺癌可采用腋窝逆测图识别同侧腋窝的上臂淋巴管,这些淋巴结无转移性。背景:乳房和同侧上肢的淋巴引流通过腋窝。多数情况下,两种淋巴通路不同[1]。鉴别腋窝内上肢淋巴的技术,有助于预防乳腺癌腋窝清扫时上肢淋巴的破坏。这可能有助于减少淋巴水肿,这是与乳腺癌手术治疗相关的最重要的发病率。逆腋窝定位(RAM)技术是近年来发展起来的一项技术,目的是在乳腺癌腋窝手术时识别腋窝内的上臂淋巴管。已经描述了使用蓝色染料、放射性同位素或荧光成像的各种技术[2-5]。虽然手臂和乳房淋巴管被认为有不同的引流交叉,但有2-18%的文献证明[1,5 - 7],病理证实043%的淋巴结被乳房转移癌累及[5,7 - 11]。这种手术最常见的并发症是局部纹身,持续时间从几周到长达6个月。我们的目的是评估使用小体积亚甲基蓝注射(1-1.5 ml)识别手臂淋巴的有效性,以及早期乳腺癌女性转移性疾病对RAM识别淋巴结的侵犯程度。2方法采用前瞻性非随机对照研究。它是在我们三级保健中心外科肿瘤科乳腺肿瘤科进行的。研究对象:符合排除标准的早期乳腺癌(cT1/T2)女性患者,经常规转移性检查后临床可触及软淋巴结(cN1),同意参与研究。用当地语言向患者索取书面知情同意书,说明手术过程和可能的并发症。研究共纳入18例患者。“早期乳腺癌的反向腋窝定位安全吗?”一项可行性研究“DOI: 10.9790/0853-160701110115”排除标准:年龄< 18岁和70岁以上医学上不适合手术的患者不同意成为研究的一部分既往有同侧腋下或手臂手术史的患者。临床N2/N3淋巴结患者技术腋窝反向定位方案:纳入研究的患者在手术开始前,在全身麻醉下注射亚甲基蓝,总体积为1-1.5 ml(皮内和皮下注射的组合)。胰岛素注射器皮内注射,26纱布针2 ml注射器皮下注射。所有注射均在臂上和中三分之一交界处内侧的肌间沟进行。记录注射至腋窝解剖时间。在腋窝清扫开始时仔细细致地寻找蓝色淋巴管,以确定上臂淋巴管。淋巴结的位置与腋窝静脉、胸背蒂和肋间臂神经有关。 切除蓝色淋巴结,分别送去做组织病理学分析,并进行常规腋窝清扫,包括1、2和3层,将清扫限制在腋窝静脉以下组织。术中对腋窝淋巴结病变的程度进行评估,以确定广泛的疾病,并与术后组织病理学相关。记录与手术相关的术后发病率。根据术后淋巴结状态和手臂淋巴结转移程度(pNO、pN1、pN2、pN3)对患者进行分层。统计分析:采用SPSS统计软件(version 17)进行统计分析。3结果患者中位年龄为51.44岁(34 ~ 60岁)。18例患者中有3例在室外进行了切除活检。临床T2病变13例,临床T1病变3例。根据原发肿瘤的位置,上外象限(11)是最常见的位置,其次是上内象限(4)、下外象限(1)、下内象限(1)和中央区(1)。所有患者术前均可获得恶性肿瘤诊断(细吸细胞学检查4例,穿刺活检11例,切片检查3例)。导管内癌以NOS最常见,1例伴神经内分泌分化,1例伴神经内分泌分化的低分化癌。16例为3级肿瘤,2例为2级肿瘤(表1)。18例患者中有15例行改良根治性乳房切除术,2例行保乳手术,1例单独行腋窝淋巴结清扫术(ALND)。从注射到腋窝清扫平均时间为41.07分钟。平均淋巴结清扫率为17.9(范围11-32)。5例患者在最终组织病理学评估中腋窝淋巴结阳性[2例pN1(1和2个淋巴结阳性),3例pN3(10、12和16个淋巴结阳性)]。所有3例pN3患者术中均被认为有高淋巴结受累的嫌疑。18例患者中有13例(72.22%)发现蓝色淋巴,11例(61.11%)发现蓝色淋巴结。注射至腋窝清扫开始的平均时间为41.27分钟。蓝色淋巴结/淋巴管最常位于腋窝静脉下方1厘米内,胸背蒂外侧(9/11),腋窝静脉前方(1)和静脉下方(1)。(图1)蓝色淋巴结的平均产率为1.83(范围1-3)。蓝色淋巴结的大小从4mm到1.7 cm不等。在11例发现并切除RAM淋巴结的患者中,只有1例转移性疾病阳性(有高腋窝淋巴结疾病,pN3)(图2)。18例患者中有4例在注射部位有轻微的染色,2例患者在第一次复查时(手术后2周)有轻微的疼痛,1例在注射部位有浅表表皮脱落。在全球范围内,乳腺癌是女性中最常见的癌症。多年来,乳腺癌的治疗已经从最根治性的Halstead根治性乳房切除术,到乳房保留手术,再到前哨淋巴结活检(SLNB),显著降低了与手术相关的发病率。腋窝的状态是疾病预后最重要的预测指标之一。与乳腺癌手术相关的最重要的发病率是同侧淋巴水肿。淋巴水肿的发生率与腋窝淋巴结清扫(ALND)的程度有直接关系,从根治性乳房切除术的58.4%[12]到前哨淋巴结清扫术的5%[13]不等。虽然Z0011试验显示单纯SLNB不加ALND在局部复发率和生存率方面并不差[14],但标准的“早期乳腺癌腋窝反向作图是否肿瘤安全?”一项可行性研究“DOI: 10.9790/0853-160701110115网址:iosrjournals.org 112 |页的做法是执行腋窝解剖的妇女积极SLNB。在尸体上追踪上肢淋巴的研究表明,淋巴有两条通路,浅层和深层,其中大部分流入腋窝的一个哨兵淋巴结[15]。ALND后,大多数这些通路纤维化,损害上肢的淋巴引流,在一些患者中出现新的淋巴管开放[16]。在接受ALND的乳腺癌患者中,86.7%的患者发现来自同侧上肢和乳房的淋巴管流入腋窝的情况不同[1]。文献中描述了许多技术用于鉴定腋下的手臂淋巴管,使用蓝色染料[4,6,8],放射性同位素[9]和荧光[17]。上臂淋巴管的鉴别率从33%不等。 在使用放射性同位素时,从最初的3%增加到高达91%,[8,9]。在我们的研究中,使用亚甲基蓝染料注射,在手术开始时,确定了蓝色淋巴管
{"title":"“Reverse axillary mapping in early stage breast cancer Is it oncologically safe? A feasibity study","authors":"Balasubramanian V MCh, Sridevi, S. Vathulru, Asish Jakhetiya","doi":"10.9790/0853-160701110115","DOIUrl":"https://doi.org/10.9790/0853-160701110115","url":null,"abstract":"Background: Arm lymphatics draining through the axilla are frequently disrupted during surgery for carcinoma breast leading to lymphedema. Techniques for differential identification of arm lymphatics might enable their preservation, and probable reduction in lymphedema. Aims: To evaluate the efficacy and oncological safety of reverse axillary mapping (RAM) in patients with early stage breast carcinoma and to correlate with post operative pathological nodal status. Methods and Material: It is a prospective pilot study, conducted at a tertiary care cancer speciality hospital, among patients with early stage breast cancer ( cT1/T2 cN1M0) planned for straight surgery, consenting to be part of the study. Patients were subjected to injection of blue dye (total 1 ml) at the time of surgery. During axillary dissection, lymphnodes taking up blue dye, were identified, dissected out and sent separately for pathological assessment . Results: RAM technique with blue dye identified arm lymphatic in ipsilateral axilla in 72.22%. Blue lymph nodes were identified in 61.11%. Postoperatively 13 out of 18 patients were staged as pN0, two as pN1, and three as pN3. RAM identified arm lymph nodes were free of diseases in all the patients with pN0,pN1 patients, only one of the three pN3 patients showed metastatic involvement . ( all pN3 patients could be identified as suspicious of having high nodal disease intraoperatively) Conclusions: Reverse axillary mapping can be used to identify the arm lymphatics in the ipsilateral axilla and these nodes are found to be free of metastatic disease in early stage breast cancer. I. Background Lymphatic drainage of the breast and ipsilateral upper limb is through the axilla. Majority of the cases, the two lymphatic pathways are different[1] Technique, that can differentially identify the upper limb lymphatic in the axilla can help preventing disruption of arm lymphatics at the time of axillary dissection for breast cancer. This may help reduce lymphedema, the most significant morbidity associated with surgical management of breast cancer. Reverse axillary mapping (RAM) technique, is a recent development, aimed at identifying the arm lymphatics in axilla at the time of axillary surgery for carcinoma breast. Various techniques have been described for the same using blue dye ,radioisotope or fluorescence imaging[2–5]. Although arm and breast lymphatics have been postulated to have differential drainage crossover has been documented in 2-18% [1,5–7] with pathologically proven involvement of nodes draining the arm by metastatic carcinoma from breast in 043%[5,7–11]. Most common complication associated with this procedure has been local tattoing lasting from few weeks to as long as 6 months. We aim to evaluate the efficacy of identification of arm lymphatic using low volume methylene blue injection (1-1.5 ml) and the degree of involvement of RAM identified nodes by metastatic disease among women with early stage breast cancer. II. Methods","PeriodicalId":14489,"journal":{"name":"IOSR Journal of Dental and Medical Sciences","volume":"65 1","pages":"110-115"},"PeriodicalIF":0.0,"publicationDate":"2017-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72801113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Location of the Mandibular Foramen in Dry Mandibles: A Study in Southern Odisha 南奥里萨邦干性下颌骨的下颌孔位置研究
Pub Date : 2017-07-01 DOI: 10.9790/0853-1606133235
R. Sahu, Suchitra Panigrahi, B. Rath, S. Rath
Aim and objectives: Mandibular foramen is leading to mandibular canal through which inferior alveolar nerve and vessels transmit and supply the teeth of lower jaw. Inferior alveolar nerve block is a common local anaesthetic technique, prior to dental surgeries of lower jaw. Hence a precise anatomical knowledge is highly essential to locate the mandibular foramen for this nerve block. Materials and method: 65 adult edentulous dry human mandibles of Southern Odisha of unknown age and sex were taken for descriptive study. Distance of mandibular foramen from mandibular notch, anterior border, posterior border and angle of mandible were measured by slide calliper, data were tabulated and analysed statistically. Results: The mean distance of mandublar foramen to anterior border was 17.21mm in right side and 17.0 mm in left side, to posterior border 16.1mm in right side and 16.0mm in left side, to the floor of the mandibular notch 20.8mm in right side and 21.3 mm in left side. and to gonium 21.31mm in right side and 20.34mm in left side were obtained. Conclusion: Localisation of mandibular foramen is an important pre-requisite prior to inferior alveolar nerve block during any mandibular surgery. Keyword: Anterior border, mandibular angle, mandibular foramen, ramus of mandible, slide calliper
目的和目的:下颌孔通向下颌管,下牙槽神经和血管通过下颌管传导和支配下颌的牙齿。下颌牙槽下神经阻滞是一种常用的局部麻醉技术。因此,精确的解剖学知识对于定位这种神经阻滞的下颌孔是非常必要的。材料与方法:选取南奥里萨邦65块年龄、性别不详的成人无牙干下颌骨进行描述性研究。用滑动卡尺测量下颌孔距下颌切迹的距离、前缘、后缘及下颌角,并将数据制成表格进行统计分析。结果:下颌孔距前缘平均为右侧17.21mm,左侧17.0 mm;距后缘平均为右侧16.1mm,左侧16.0mm;距下颌切迹底平均为右侧20.8mm,左侧21.3 mm。右侧为21.31mm,左侧为20.34mm。结论:在任何下颌骨手术中,下颌孔定位是下牙槽神经阻滞前的重要先决条件。关键词:前缘,下颌角,下颌孔,下颌支,滑动卡尺
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引用次数: 0
A Comparative Study to Determine the Outcome of Hepatic Encephalopathy who Have A Past History of Hepatic Encephalopathy And or Upper Gastrointestinal Bleeding Versus Who Have Not Such Using 7 Days Therapy of RifaximinAnd or Lactulose 有肝性脑病和上消化道出血病史的肝性脑病患者与无此病史的肝性脑病患者使用利福昔明或乳果糖治疗7天的预后比较研究
Pub Date : 2017-07-01 DOI: 10.9790/0853-1607025054
Dr.ShyamalKanti Pal, Dr.Subhrajyoti Naskar, Dr.Gauranga Biswas, Dr.Jadab Kumar Jana, Dr.SK. Jeauddin, Dr.Soumitra Kumar Ghosh
Introduction: Hepatic encephalopathy is a reversible neuro-psychiatric syndrome occurring in majority of patients with decompensated chronic liver disease(CLD). Prognosis of Hepatic encephalopathy (HE) depends upon past h/o hematemesis/ melena and HE but not related to the aetiology of CLD. Rifaximin and lactulose have similar efficacy for treatment of acute HE . Purpose of this study is to compare the effectiveness of 3 modes of treatment for 7 days in terms of clinical improvement / deterioration who have or have not past h/o hematemesis/ melenaand or HE. Material and methods: After ethical clearance and consent from patient parties, 90 patients of HE of any cause and grade with or without past h/o hematemesis/melena and or HE, were categorise into different grades according to West Haven criteria and randomised to treat for 7 days with divided doses by either rifaximin 30 patients, lactulose 30 patients , rifaximin plus lactulose 30 patients. At the end, clinical improvement and deterioration were noticed. Results: Alcoholic CLD (63.33%) was the commonest. Clinical deterioration were commoner in chronic HCV (66.67%) than chronic HBV, alcoholic CLD. Patients with past h/o hematemesis /melena, clinical deterioration and improvement were 26.92% and 73.08% but without such , clinical deterioration and improvement were 2.63% and 97.37% . Patients with past h/o HE , clinical deterioration and improvement were 31.25% and 68.75% but without such past illness, clinical deteriorations and improvements were 0 and 100% . Conclusion: So clinical outcome is better in patients of HE without past h/o HE and hematemesis/melena. Keyword: Hepatic encephalopathy , chronic liver disease ,Rifaximin,Lactulose
肝性脑病是一种可逆性神经精神综合征,发生在大多数失代偿性慢性肝病(CLD)患者中。肝性脑病(HE)的预后取决于过去的h/o呕血/黑黑和HE,但与CLD的病因无关。利福昔明与乳果糖治疗急性HE疗效相近。本研究的目的是比较三种治疗方式在7天内的临床改善/恶化方面的有效性,这些患者有或没有经历过h/o呕血/ melenand或HE。材料和方法:经伦理许可和患者同意后,根据West Haven标准将90例任何原因和级别的HE患者(有或没有过去的h/o呕血/黑黑和/或HE)分为不同级别,随机分为利福昔明30例、乳果糖30例、利福昔明加乳果糖30例,进行7天的分剂量治疗。最后观察临床改善和恶化情况。结果:酒精性CLD最常见,占63.33%。慢性HCV患者的临床恶化发生率(66.67%)高于慢性HBV、酒精性CLD患者。有h/o呕血/黑黑、临床恶化和改善的患者占26.92%和73.08%,无h/o呕血/黑黑、临床恶化和改善的患者占2.63%和97.37%。既往h/o HE患者临床恶化和改善分别为31.25%和68.75%,无既往h/o HE患者临床恶化和改善分别为0%和100%。结论:无h/o HE病史、无呕血/黑黑的HE患者临床预后较好。关键词:肝性脑病,慢性肝病,利福昔明,乳果糖
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引用次数: 0
A Case of Delayed Presentation of Uterine Perforation Following Unsafe Abortion As Septic Peritonitis 不安全流产后迟发表现为脓毒性腹膜炎的子宫穿孔1例
Pub Date : 2017-07-01 DOI: 10.9790/0853-1606120102
M. Dr.LogeswariB, VidhyaR, K. Dr.Saraswathi
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引用次数: 0
Findings in CSOM: Our Experience in Sudanese Population-A CT based Study CSOM的发现:我们在苏丹人口中的经验——一项基于CT的研究
Pub Date : 2017-07-01 DOI: 10.9790/0853-1606131523
Zuhal Y. Hamd, C. Ayad, M. E. Supervisor
Chronic suppurative otitis media (CSOM) is one of the leading causes of hearing impairment in developing countries. Objectives: are to highlight the high resolution computerized tomography (HRCT) temporal bone findings in chronic middle ear infections with reference to it ’ s extent and complications, as well, the presented common signs, symptoms and the duration impact on the anatomical structures and pathological changes in each part and for both sides. Materials and Methods: Preliminary clinical assessment was obtained for 114 patients diagnosed with CSOM, and then they were referred for a HRCT of temporal bone which was done using multi-detector CT scanner. Results: Of the 114 patients; 63(55.3%) were males and 51(44.7%) were females: Otorrhoea is the most common symptom, and was found in 113 patients constituting (99.1%) followed by Otolegia 69(60.5%) and headache affected 53(46.5%) of the cases. CSOM is more common in low socio-economic status .In ears affected with CSOM, the maximum CT number (Hounsfield) was found to be changed and was significantly affected with increasing patients’ age. Sclerotic changes and soft tissue density increased as the duration of CSOM increased in right and left middle ears significantly (F=5.802, Sig at 0.000), and (F=23.182, Sig at .015) respectively. Partial and complete erosion were detected in both right and left ossicle in the advanced phase of disease, where the ossicle still intact in the early stage , and the correlation is found to be significant with increasing of CSOM duration (F=16.959, Sig 0.000) and (F= 3.673, Sig =0.036)for right and left ossicles respectively. Changes including total and partial opacification, sclerotic changes, soft tissue density, mucosal thickening were the findings detected in both right and left mastoid in HRCT for temporal bone scanning. Conclusions: HRCT of temporal bone is useful in identifying various findings related to the location and extent of disease.
慢性化脓性中耳炎(CSOM)是发展中国家听力损害的主要原因之一。目的:探讨慢性中耳感染的颞骨高分辨率计算机断层扫描(HRCT)表现,包括其程度、并发症、常见体征、症状及持续时间对各部位及双侧解剖结构和病理改变的影响。材料与方法:对114例确诊为CSOM的患者进行初步临床评估,并转介行颞骨HRCT,采用多探头CT扫描。结果:114例患者中;男性63例(55.3%),女性51例(44.7%),其中以耳漏最为常见,113例(99.1%),其次为耳鸣69例(60.5%),头痛53例(46.5%)。CSOM多见于社会经济地位较低的人群。在患CSOM的耳朵中,最大CT数(Hounsfield)随着患者年龄的增加而改变,并受到显著影响。随着CSOM持续时间的延长,右中耳和左中耳的硬化变化和软组织密度显著增加(F=5.802, Sig = 0.000), F=23.182, Sig = 0.015)。疾病晚期左右听骨均可见部分和完全糜蚀,早期听骨完好,且与CSOM持续时间的增加相关(F=16.959, Sig 0.000),与左右听骨的相关性显著(F= 3.673, Sig =0.036)。颞骨HRCT扫描右、左乳突均可见完全或部分浑浊、硬化改变、软组织密度、粘膜增厚等变化。结论:颞骨HRCT在识别与疾病位置和程度相关的各种表现方面是有用的。
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引用次数: 0
Assessment of the Knowledge And Awareness of Menopausal Coping Strategies Among Women In Umuowa Community, Orlu Local Government Area, Imo State Nigeria. 尼日利亚伊莫州奥鲁地方政府区Umuowa社区妇女对更年期应对策略的知识和意识评估
Pub Date : 2017-07-01 DOI: 10.9790/0853-160603113117
C. OhamaemeMoses, N. EgwurugwuJude, C. EzealaGalina, R. OhamaemeChinyere, C. EbuenyiMartha
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引用次数: 0
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IOSR Journal of Dental and Medical Sciences
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