Between August ‘07 and December ' 14 , 48 cases of genitourinary tuberculosis have been managed in the Department of Urology IGIMS, Patna. An audit of diagnostic criteria utilized is presented. It was observed that the irritative voiding symptoms were the commonest presentation (frequency 58.3%, Dysuria -29.1% and urge incontinence-14.5% followed by hematuria (37.5%). Significant pyuria was found in 47% of cases whereas culture test was positive for non- tubercular uropathogens in 22.9% of cases. Approximately 90% of renal units were found to be pathological on intravenous urogram (IVU). Bacteriological, immunological or histopathological test were found to be useful as supportive tests. IVU is mandatory in all cases if renal impairment is not established.

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Background: Treatment of low back ache due to prolapse intervertebral disc is still controversial. Several conservative modalities are available with varied results. Surgical discectomy may lead to failed back syndrome due to change in vertebral column anatomy and its mechanics. To prevent it, conservative means are better and Ozone discolysis is one of the non surgical methods. The indications and effectiveness of this condition is not well defined. The present study was done to correlate the clinical outcome ofthis technique. Material and methods: This was a prospective study conducted on 67 patients presenting with symptoms of back pain with and without radicular symptoms. X ray and MRI were done in all cases. Then intradiscal ozone gas was given at one level from a specialized machine under C arm guidance. For evaluation Oswestry disability index and Macnab scoring system was used. Post injection patients were evaluated at 2 weeks, 6 weeks and 6 months. Results: Sixty seven patients with mean age of 47.7years were followed up for 7.8 months. Low back pain was the commonest symptom and SLR was positive in 5.36%. The modified Macnab scoring with good and fair score improved from 16% to 89% and Oswestry Disability Index with minimal and moderate disability improved from 41% to 91% at end of 6 months. Seven patients had relapse of pain due to repeat disc prolapse. Conclusions: Ozone discolysis is better modality of treatment for low back pain with disc bulge and early disc prolapse. Keywords: low back pain (LBP), prolapsed intervertebral disc (PID), ozone discolysis, modified Macnab Scoring, Oswestry Disability Index (ODI).

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During commissioning of a modern linear accelerator (LINAC) for clinical and research purpose, medical physicists were faced with many challenges, like a variety of scientific testing methods, data accuracy etc. Since final beam data obtained during commissioning are treated as references and ultimately used for radiotherapy treatment, it is vital that collected data are of very high quality. The scientific procedure used for commissioning of LINAC at Mahavir Cancer Santhan,Patna has been described in detail in this article. The maximum beam energy of this LINAC is 15 MV for photons and 12 MeV for electrons. The approximate flux of the source are of the order 1018 photons/sec and 1020 electrons/sec with a highest delivery dose rate of 500 cGy/min for photons and 400 cGy/min for electrons at the dose maximum point in the water phantom. In this article, a complete set of measured data of the LINAC has been presented. The measured radiation data are within permissible limit. A modern linear accelerator has been commissioned and is being used for therapeutic purposes and material modification by irradiation since last three years. Some successful applications in the field of treatment and material modification of the machine have also been presented in this article.

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Kienbock’s disease is osteonecrosis of lunate which is difficult to diagnose and treat. In advance stage the treatment is difficult and usually these patients require wrist arthrodesis. We have used pronator quadratus muscle pedicle bone graft as treatment option to retain the mobility of the wrist joint. Three male patients were included in the study. Wrist pain was presenting complaint. The stage of presentation was Litchman stage IIIA .All Pateints were managed by Pronator quadratus muscle pedicle bone graft under Brachial plexus block with uneventful post operative period. Recovery were good in two cases and fair in one case. Pronator quadratus muscle pedicle bone graft is good salvage procedure in advanced stage of Kienbock’s disease.

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Hypertension is the commonest cardiovascular disorder and one of the leading causes of global burden of diseases. Medical students are significant investment to the society and increasing emergence of hypertension among them is a topic of interest today. With this background a study was conducted to assess the prevalence of hypertension and its correlates of lifestyle habits among the MBBS students of AGMC, Agartala. In this cross sectional study total 200 MBBS students were selected (50 students from each year) using stratified random sampling method. Data was obtained using a pre-designed semi structured questionnaire; weight and height was measured and to show association Chi square test, Pearson’s correlation test, univariate logistic regression model was used. In this study we found the prevalence of hypertension among study participants was 10%, also there was statistically significant correlation found between systolic blood pressure and age, height, weight and BMI of the respondents. Although in our study no significant association was found among hypertension and its correlates of lifestyle habits. Still the prevalence of pre-hypertension was 48.5% among the study participants which is a risk factor for development of hypertension in future, therefore dietary and lifestyle modification programmes directed especially to them is necessary.

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Background: Cervical cancer, mainly due to persistence Human Papilloma virus (HPV) infection, is second most common cancer among Indian women.Need of screening programs is very essential for reducingthe incidence and mortality of cervical cancer significantly. For spreading the awareness among women about the cervical cancer, community based approach is a very important way. Visual inspection withLugol’s iodine (VI LI) and Pap’s smear are two main methods used for screening of cervical cancer.The objective of the present study is to comparison of VILI (Visual inspection by Lugol’s Iodine) with cytology by Pap smear for early detection of carcinoma of cervixand correlation of these results with the reference of standards (biopsy). Material & Methods: Present study was conducted among 275women of the age 20 to 65 year, during the period of May 2012 to May 2013, treated under Gynecology service unit of Regional Cancer Centre, IGIMS Patna. Data was analyzed by using Epi Info 7 for Windows to comparison the results of test. Results: Sensitivity, Specificity, Positive predictive value and Negative predictive value of Pap test was 63.15%, 97.62%, 80%, 97.30% respectively,and that of VILI test was 100%,89.91% 51.92%, 100% respectively. Conclusion VILI and Pap test can be used effectively for detection of precancerous lesion of cervix at hospital set up as well as community level, butPAPS can be replaced by VILI in our country and any other developing countries, where it is difficult to enroll majority of population in cervical cancer screening program, as VILI can be used as “see and treat policy”as it is easily appreciable and can be done by paramedical staff too.

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Background: The phenomenon of low birth weight takes its origin during the antenatal period. According to the World health Organisation, any baby, irrespective of gestational age, weighing less than 2.5Kg is termed as a low birth weight baby. Low birth weight is a leading cause of high infant mortality. Objective: We aim to identify the association of various maternal factors on the very low birth weight Vs low birth weight of institutionally delivered newborns. Material and Methods: A hospital based cross sectional study was undertaken over a period of one year in a north eastern town (Katihar) of Bihar, employing data collection from hospital records and interviews of 907 mothers of low birth weight babies available during the regular visits for this study. Results: 22.7% of the recorded deliveries resulted in low birth weight. Various factors like maternal age (p<0.05), weight (p<0.05) and height (p<0.05) were found to have a significant association with the birth weight. Parity (p>0.05) on the other hand was insignificantly associated. Conclusion: Since multiple factors influence its causation, no intervention can be foolproof. However, modification of certain known risk factors may lead to a significant decline in the incidence of low birth weight in such setups.

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Trauma is the leading cause of morbidity and mortality in the paediatric age group.Complications associated with an intramural hematoma of the bowel, is a relatively rare condition as most of the intramural hematomas resolve spontaneously with conservative treatment and thus the patient’s prognosis is good. However, if the symptoms do not resolve or worsen, surgical intervention might become necessary. We present a case of an eleven years old girl with blunt trauma to the abdomen with symptoms of bowel obstruction not improving on conservative measures. CT scan revealed a duodenal and jejuna hematoma. She was operated due to worsening of symptoms and resection of 3rd and 4th part of duodenum and proximal part of jejunum was done. End to side hand sewn single layered interrupted duodenojejunostomy was done. Reverse duodenostomy and feedingjejunostomy was done. The patient has recovered and is healthy.

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Mature ovarian dermoid cysts are common lesions, accounting for up to 10-25% of all ovarian neoplasms. Uncomplicated dermoid cysts are often asymptomatic and are relatively easy to diagnose on imaging and to treat. Symptoms develop once complications set in and these may cause diagnostic dilemmas. Torsion (16%) is the most common complication, while rupture, suppuration and malignant transformation are relatively uncommon. Of all these complications, spontaneous rupture into the urinary bladder is least common. The diagnosis of this condition has been through the use of cystoscopy or laparotomy in all cases reported so far. We present a rare case of ovarian dermoid cyst perforating into the urinary bladder presenting with irritative lower urinary tract symptoms characterized by urgency, frequency, dysuria, poor urine stream, and the passage of hairs and seborrhoeic gravels through the urethra for last 7 years. A clear-cut imaging diagnosis helped to allow planning of surgery in advance and a mucosa-sparing partial bladder resection could be performed.

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Ovarian neoplasm is the most common diagnosis in postmenopausal women with gigantic pelvic lump and nonspecific symptoms .But sometimes preoperative diagnosis comes out to be wrong. This case is being reported for its unusual presentation and the diagnostic dilemma in differentiating ovarian neoplasm and benign broad ligament fibroid with degenerative changes, which this case turned out to be.

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Introduction: white lesions of oral cavity are broadly divided into two categories 1. Premalignant lesion and 2.Premalignant condition. In Premalignant condition, there is greater potential that it to changes into malignant condition if not treated on time and if the offending factors are not removed. Oralsubmucous fibrosis is one of the common premalignant conditions which are found in individual having habit of taking pan masala and other tobacco products regularly. The chances of it to be turninginto malignant are quite high. Aim and objective: The present study was conducted in order to evaluate prevalence of use of pan masala and tobacco and other related products and their relation in causation of oralsubmucous fibrosis. Material and methods: The observational study was done in the Department of Dentistry, IGIMS,Patna during October, 2011 to December2014 in order to know the role of tobacco and pan-masala in causation of OSMF. The total numbers of patients screened were 4200, for their habits.The diagnostic criteria for the OSMF as laid by various authors are, patients who has complaint of burning sensation while taking hot and spicy food, vesiculation on the oral mucosa specially palate, ulceration or generalized recurrent inflammation of the oral mucosa, excessive salivation, defective gustatory sensation and dryness of mouth , blanching and stiffness with palpable bands on labial, buccal mucosa, soft palate, hard palate mucosa as well as restricted moth opening, inability to blow out cheek and difficulty in protruding tongue etc were regarded as having oral submucous fibrosis. The examinations were done using sterile mouth mirror, tweezers, sterile cotton/gauze and disposable gloves and face mask. Results: Out of4200 patients,1092 patients screened out were having habit of chewing pan masala and othertobacco products. These patients were grouped underthree categories. The total numbers of OSMF cases recorded werel80. Conclusion: The present study gives insight about the role of pan-masala and othertobacco products among the subjects and its ill effect on oral mucosa which causes OSMF and other premalignant condition.

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Schwannomas are slow growing solitary neural sheath tumors found in peripheral nerves in the limbs, head, and neck. Most schwannomas are benign, although malignant cases are known to occur. We report a benign schwannoma, at an unusual location in retroperitoneuim in a middle aged female.

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Ehlers-Danlos syndrome (EDS) comprises a group of clinically and genetically heterogeneous heritable connective tissue disorders, chiefly characterized by joint hypermobility and instability, skin texture anomalies, and vascular and soft tissue fragility. As many tissues can be involved, the underlying molecular defect can manifest itself in many organs and with varying degrees of severity, with widespread implications for anaesthesia and perioperative management. In this case report we have focused on issues for anaesthesia for elective herniotomy & mesh hernioplasty in a 2 years old male child with clinical symptoms of classic type EDS. We searched various literatures and as per recommendation we have conducted this case under GA with laryngeal mask airway safely.

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