The Journal of Datta Meghe Institute of Medical Sciences University VOLUME 11 NUMBER 4 October to December 2016

Multi Disciplinary Medical Journal Official Publication of Staff Research Society Datta Meghe Institute of Medical Sciences (Deemed University) Sawangi (Meghe), Wardha, Maharashtra, India 442004.

Original Articles

375 Severity of Injuries and Outcome of Patients who Sustained Injuries during Rahukaalam and Yamagandam
Author : Ramamohan P
There is plenty of literature which discusses the relationship between the time and relative risk to sustain injuries. 1-6 According to ancient Indian culture, forecasting were used for business, economics and engineering. Similarly, certain types of negative events was discussed to be time associated was trauma and accidents. 7 According to Indian Mythology in our solar system, all planets rule on each allotted day of the week. Whereas Rahu and Kethu do not have dedicated day for themselves and instead, they rule for 90 minutes every day in the form of Rahukaalamand Yamagandam. There is an increased risk of acute negative events in life during them. Raahukaalam is the time set aside for Raahu whereas Yamagandam is the time set aside for Kethu. Any bad action that happens during this time will bring bad results to the doer. This study is designed to study the effect of Rahukaalam and Yamagandam or Kethukaalam (R-K) on the trauma cases according day and time of injury
379 Ethical Issues During end of Life Decision in Neonatal and Paediatric Intensive Unit in a Tertiary Care Hospital
Author : Sinhal Tushar
Ethics are a set of principles relating to what is morally right or wrong and provide a standard of conduct [1]. The ethical decisions are based upon a system of moral values that serve the best interests of society. The physicians are both morally and legally accountable to society and sometimes develop conflict between these legal, moral, economic, social issues, raising ethical dilemmas during decision making while treating critically ill patients. This process becomes still more complicated in pediatric population who are rarely able to comprehend a complex medical decision or long term risks or benefits fully. Knowledge about this may help to formulate a systematic plan of action whenever such a situation arises.
382 To Evaluate the Safety, Feasibility and Benefits of Performing Primary Caeserean Section without Indwelling Urinary Catheter
Author : Joshi Sulbha
Being female is one of the risk factors for Urinary Tract Infection as women have shorter urethra, which cuts down on a distance that bacteria must travel to reach the bladder (1). Physiological changes in urinary tract during pregnancy increase the chances of Urinary Tract Infection during pregnancy (2). Caesarean Section is the most common major surgical procedure performed in women(3). One of the most common preoperative procedure for Caesarean section is placement of indwelling catheter in urinary bladder
386 To Study Prevalence of Prediabetes in Medical Staff in Acharya Vinoba Bhave Rural Hospital
Author : Malpani Vipul
Diabetes in its early stage is categorized as Prediabetes1and is a leading risk factor for diabetes. An individual is considered to be pre-diabetic if he/she has a blood glucose level that is above normal but below the diagnostic threshold for diabetes mellitus. Prevalence of pre-diabetes is also increasing worldwide. 79 million people had pre-diabetes in United Sates as per American Diabetic Association-Jan 26 20112. In india 77.2 million people had pre-diabetes ,in 2011.3
400 Role of Oral Physician in Oral Cancer Palliative Care
Author : Mohod Swapnil
Palliative care is a specialized area of health care that focuses on relieving or preventing sufferings of patients. The term suffering is holistic one that adequately addresses all the elements of chronic illness and pain management. A world health organization statement describes palliative care as “an approach that improves the quality of life of patients and their families facing the problems associated with life threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychological and spiritual.”(1)However, the term “palliative care” may refer to any care that alleviates symptoms; whether or not there is hope of a cure by other means in terminally ill patient.
404 Prevalence of Urinary Tract Infection in Diabetes Mellitus
Author : Khalge Vijay
Diabetes is group of metabolic disorder characterized by hyperglycaemia resulting from defect in insulin secretion, insulin action or both.[1] Diabetes mellitus is one of the most common endocrine diseases, and its global prevalence for all age groups worldwide was estimated to be 2.8% in 2000 and is predicted to reach 4.4% in 2030.The total number of people with diabetes is projected to rise from 171 million in 2000 to 366 million by 2030.[2] Diabetes is a serious illness with multiple complications[3,4] and premature mortality, and it accounts for at least 10% of the total health care expenditure in many countries.[5] Patients with diabetes are at increased risk of infections [6,7] particularly those originating in the urinary tract.[3] Diabetes can also cause several changes in the host defence system, including defects in neutrophil function,[8] increased bacterial adherence to the uroepithelial cells of diabetic patients[9] and decreased antibacterial activity as a result of glycosuria.[10] As a result, diabetic patients tend to have a higher incidence and prevalence of bacteriuria[11] and they are at a higher risk for developing ser ious consequences , such as emphysematous cystitis, pyelonephritis, renal papillary necrosis, and abscess.
410 Randomized Controlled Trial to Compare Sevoflurane Vs Desflurane in Off Pump CABG Surgery for Intraoperative Haemodynamic Maintenance
Author : Taware Manisha
The perioperative period imposes physiological stress on heart by surgery and anaesthesia for patient with coronary artery disease leading to serious complications .Bypass grafting has been associated with many cardiac compliations including ishaemia, acute myocardial infarction and death.Myocardial protection noted following the administration of volatile anesthetics has been attributed to reduction in ischaemia reperfusion injury or to the post conditioning effects on the myocardium.
415 Co-relative Study of AgNOR Score in Different Grades and Histological Types of Carcinoma of Breast
Author : Naik Dhananjay
Worldwide, breast cancer is the most common form of cancer in women and second leading cause of cancer death among women. Every year 75,000 new cases of breast cancer are diagnosed in Indian women. It is regarded as the most common cancer in women in many metropolitan cities, and 2nd most common cancer in rest of country.1 Nucleolar organiser regions (NORs) are loops of DNA responsible for ribosomal RNA (rRNA) transcription. They are located in nucleoli of cells and in the chromosomes 13,14,15 and 21,22 in association with protein. As rRNA moecules are the main sites of protein synthesis, it follows that the number of NORs in each cell nucleus reflects cellular activity
418 Peripheral Retinal Findings in High Myopia in a Tertiary Hospital
Author : Tidake Pravin
The refractive error is one of the common cause of defective vision and myopia accounts for major percentage of it. It is defined as that dioptric condition in which incident parallel rays coming from infinity come to focus anterior to the light sensitive layer of retina with accommodation being at rest. It is classified on various etiological and clinical varieties. Clinical variety includes- Congenital, Simple/Developmental/ Pathological/Degenerative, Acquired myopia. Its prevalence has increased over the past decades, leading to a growing concern among the public and scientific community. The prevalence of myopia varies in different parts of the world. Generally speaking, myopia is much more prevalent in industrialized countries and in cities as compared to rural areas. The rapid increase in the prevalence of myopia provides strong evidence that current environmental factors must have a considerable influence on the development of myopia that cannot be explained by a genetic model.
423 Effectiveness of Traditional Demonstration Technique and 3-D Animated Video: A Comparative Study
Author : Chimurkar Vilas
The use of media to enhance teaching and learning complements traditional approaches to learning. Effective instruction builds bridges between students` knowledge and the learning objectives of the course. Using media engages students, aids student retention of knowledge, motivates interest in the subject matter, and illustrates the relevance of many concepts (1). Technology mediated learning requires adjustments in the teaching/learning process for both instructors and students (2). This study draws on the concepts of system theory to explain how interdependence, permeable systems, boundaries, and parallelism can alter the teacher`s role in fostering a climate that maximizes technology-mediated learning. Creating an inviting classroom atmosphere, modifying instructional design and content, listening to feedback, and evaluating the course provide the foundation for revising the teaching/learning process for use with interactive video network (IVN) (3-6).
426 Knowledge Regarding Home Management of Diarrheal Diseases among Mothers of Under Five Children
Author : Taksande Archana
Diarrhea is defined as the passage of loose, liquid or watery stools. These Liquid stools are usually passed more than three times a day. However, it is the recent change in consistency and character of stool rather than the number of stools that is more important. The term “diarrheal diseases” should be considered only as a convenient expression not as a epidemiologically entity for a group of diseases in which the predominant symptom is diarrhea. The treatment package focuses on two main elements, as outlined in a 2004 joint statement from UNICEF and WHO: 1) fluid replacement to prevent dehydration 2) zinc treatment. Important additional components of the package are continued feeding, including breastfeeding, during diarrhea episodes and the use of appropriate fluids available in the home if oral rehydration solution are not available, along with increased fluids in general
428 Comparison of Knowledge regarding Selected Obstetric Drugs among the Nurses Working in Obstetric Ward and other Wards
Author : Sakle Pradnya
Childbirth is one of the most meaningful, unique, and exciting times for the labouring women and her partner.1 Many people can accompany and greet the woman from either side, but she has to face it by herself. Most women describe pregnancy as an exciting time in their life but the development of an unexpected complication can suddenly change this description dramatically. When complications arise during labour, both risk for maternal as well as fetal morbidity and mortality increases.2 Childbirth is the culmination of a human pregnancy or gestational period with the birth of a baby from woman`s womb. It is an inherently dangerous and risky activity which may subject the mother and baby to many complications
431 Evidence of Chlamydial Infection in Infertile Women with and without Tubal Factor, in Central Rural India
Author : Dewani Deepika
Infertility affects relatively large number of couples both globally as well in India.According to WHO Infertility is “a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse.” The tubal factor is the most frequent (25–35%)cause of female infertility along with ovarian. Sexually transmitted infections are generally considered the leading preventable cause of infertility worldwide, especially in developing countries
436 A Study to Assess the Knowledge regarding Urinary Tract Infection during Pregnancy among the Antenatal Mothers in Selected ANC OPD at Wardha
Author : Teltumbde Archana
Urinary tract infections (UTIs) are the most common bacterial infections during pregnancy. Asymptomatic bacteriuria (ASB) is a major risk factor for the development of urinary tract infections during pregnancy and with further risk of preterm birth & pyelonephritis if untreated. UTI is a common bacterial infection during pregnancy and a significant cause of perinatal and maternal morbidity and mortality. The causative bacteria have remained virtually the same although with variations in individual prevalence. There has been an increasing resistance by these bacteria to the commonly available antibiotics1
438 Role of Herbal Antioxidant Therapy on Healing of Traumatic Oral Ulcers and Oxidative Stress : An Animal study
Author : Patel Aditya
Ulcers can be defined as breach in epithelium or mucosa. Oral mucosal ulcers are sores or open lesion in the mouth which can be caused by various disorders1. The estimated point prevalence of oral ulcers worldwide is 4%, with aphthous ulcers being the most common, affecting as many as 25% of the population worldwide2. Minor ulcers (less than 1cm) may affect almost 80% population in some part of their life2. These ulcers can be caused be caused by wide variety of conditions and diseases like trauma, infections, vesico-bullous diseases, neoplasia, nutritional deficiencies, apthous stomatitis, gastrointestinal diseases etc1. The immune response of the body towards these ulcers is to close the wound and prevent infection. Ulcers resulting from traumatic injuries are probably the most common types of ulcers encountered in clinical practice
443 Effects of Psychological Stress and Dietary Arrayon Acne : A CrossSectional Evaluation of Medical Undergraduate Students` Perception
Author : Shanthakumar Swamy Ravindra
Acne is a skin disease that involves the sebaceous (oil) glands at the base of hair follicles. These glands produce sebum, an oily liquid which carries dead skin cells through the follicles to the surface of the skin. Acne grows when these follicles get blocked, resulting in an accumulation of oil under the skin. It commonly occurs during puberty when the sebaceous glands enter active secretory phase while stimulated by male hormones produced by the adrenal glands of both males and females. Acne tends to appear on the face, back, chest, shoulders and neck in human.
445 Assessment of Nutrition in Patients of Chronic Kidney Disease and its Outcome in a Tertiary Care Rural Hospital
Author : Gajendra Manakshe
Chronic kidney disease(CKD) is a slow, progressive, and irreversible loss of kidney function(1). The total number of cases has markedly increased during the last three decades(2,3), and its prevalence has reached epidemic proportions .Around 10% - 13% of the population of Korea, Taiwan, Iran, Japan, China, Canada, India and the USA being affected(4). As the loss of renal function is slow and progressive, it results in an adaptive process in which the patient remains asymptomatic for long period(5)

Case Series

447 Breast Tuberculosis : Case Series with Literature Review
Author : Chandak Suresh
Tuberculosis (TB) has traditionally been regarded as a pulmonary disorder. However, nearly 17.9% of TB cases have only extra pulmonary manifestations.1 Breast and skin are considered to be rare sites of extra pulmonary mycobacterial infection, comprising 0.1% to 0.5% of all TB cases, respectively.2 Tuberculous mastitis is an uncommon lesion1 even in countries where the incidence of pulmonary and extra pulmonary TB is still very high.3 The clinician may confuse TB of the breast with either breast carcinoma or abscess.4-6 Although the usual form of the disease is unilateral, it occasionally presents bilaterally

Case Reports

451 USG, Color Doppler and Elastography in Oral Squamous Cell Carcinoma : A Case Report
Author : Dhande Rajasbala
Most cancers of the oral cavity are oral squamous cell carcinomas (OSCC), and tobacco, alcohol and betel use the main risk factors for these and many potentially malignant lesions (PML)(1,2). The main high risk groups are older adult males who use tobacco and alcohol. It is expected that early diagnosis of PML can reduce mortality(3,4). Early diagnosis of OSCC can speed proceeding to treatment and can improve the prognosis(5). This requires patients to seek an oral and dental examination at an early stage
454 Fibrous Dysphasia of the Temporal Bone : Case Presentation and Review of Literature
Author : Samudrala Veda Dhruthy
Fibrous dysplasia is a benign but progressive disorder of the bones with unknown etiology where cellular fibrous and connective tissue replaces the normal bone matrix. 1 Involvement of the temporal is not common in fibrous dysplasia with only few reported cases in literature. 26Inpresent case we report involvement of the temporal bone and discuss the challenges in making a diagnosis and management of this uncommon presentation of fibrous dysplasia.
457 Hereditary Tertrapolydactyle With Gangrene of Post-Axial Polydactyly of Right Upper Limb : A Rare Case Report
Author : Chandak Suresh
Polydactyly is a common congenital digital variation of the hand and foot, which is characterized by supernumerary digits. This condition can occur in one limb or can be exceptionally present in all four limbs; a condition called tertrapolydactyle. It may appear as isolated or in association with other birth defects. Polydactyly might be pre-axial, post-axial and central type, the post-axial being the commonest one [15]. Surgical intervention in polydactyly are indicated for various reasons.
460 Total Laparoscopic Management of Colouterine Fistula
Author : Naval Rucha
Though Noecker first reported a colouterine fistula secondary to diverticulitis in 1929, so far 18 cases have been reported in the world literature.[1] Approximately 20% develop diverticulitis as a result of infection and inflammation of the diverticula. The complications of diverticulitis are bleeding, perforation, stricture and fistula formation. Fistula constitutes up to 20% of the complications. The most common type of fistula is a colovesical fistula followed by a colovaginal fistula arising from the sigmoid colon. Uterus is a thick muscular organ and thus protects against invasion of benign or malignant disease. In this case uterus and colon are involved