iosr-JDMS   Volume-24 ~ Issue-6 ~ June 2025

Abstract: Anal fissures are common and painful anorectal disorders, and the chronic form, especially when infected, presents a therapeutic challenge. Perianal infections are often underdiagnosed in chronic anal fissures and their proper management is crucial to reduce morbidity. This ambispective observational study aimed to outline the surgical approach for infected chronic anal fissures and evaluate its effectiveness in preventing recurrence. We included 158 patients with infected chronic anal fissures, the primary outcome being the healing rate, defined by complete re-epithelialization of the fissure with no signs of infection. The treatment plan involved a fissurectomy, complemented by a precise..........

Keywords: chronic anal fissures, perianal suppurations, coloproctology, surgery, fissurectomy

[1] Godeberge P. La Fissure Anale. EMC Traité De Gastroentérologie. Vol. 9: Elsevier, 2015:9- 087-A-10
[2] Gupta PJ. Treatment Of Fissure In Ano—Revisited. Afr Health Sci. 2004;4:58-62.
[3] Parksag,Thomson J P S.Intersphincteric Abscess.Br.Med.J.1973;2:537–9.
[4] Gupta PJ. A Study Of Suppurative Pathologies Associated With Chronic Anal Fissures. Tech. Coloproctol. 2005; 9: 104–7.
[5] Sainio P (1984) Fistula-In-Ano In A Defined Population. Incidence And Epidemiological Aspects. Ann Chir Gynaecol 73:219–224

Abstract: Background: Composites allow the possibility of preserving sound tooth structure during cavity preparation and represent a significant aesthetic treatment option, enabling the fabrication of restorations with a natural appearance. However, from time to time failures (discoloration, secondary caries, marginal ditching or simply fractures) of composite restorations do occur and the clinician must decide whether to replace or simply repair these restorations. Therefore, different....

....

Abstract: Introduction: In a flipped classroom, students engage with lectures and foundational material either print, audio, or video before arriving for class. This pre-class learning then enables class sessions to become interactive, problem-solving, and case-based learning, maximizing direct teacher support for deeper comprehension. This study is aimed to assess perceptions of implementation of flipped classroom in teaching anatomy to first phase MBBS students........

Keywords: Flipped classroom, First phase MBBS, preclass, Interactive in-class

[1] India,National Medical Commission UGMEB Regulations On Graduate Medical Education (Amendment) No. MCI-34(41)/2019-Med./161726 Dated The 4th November 2019
[2] Taylor DC, Hamdy H. Adult Learning Theories: Implications For Learning And Teaching In Medical Education: AMEE Guide No. 83. Med Teach. 2013;35(11):E1561–E1572.
[3] Echo360.(2012)Blended .Blended Learning Technology: Connecting With The Online-All-The-Time Student.
Http://Echo360.Com/Sites/All/Themes/Echo360/Files/2012_Student_Survey_WP_FINAL.Pdf..
[4] Hamdan, N., Mcknight, P. E., Mcknight, K., & Arfstrom, K. M. (2013). A White Paper Based On The Literature Review: A Review Of Flipped Learning. Retrieved 10/08/2017, From
Http://Netboardme.S3.Amazonaws.Com/Published/1663/Files/3ae28432fa9c50c4dd1a1a02a22a1b06.Pdf.
[5] Bouwmeester, R. A., De Kleijn, R. A., Ten Cate, O. T. J., Van Rijen, H. V., & Westerveld, H. E. (2016). How Do Medical Students Prepare For Flipped Classrooms? Medical Science Educator, 26 (1), 53-60..

Abstract: Background: Chronic Otitis Media (COM) is a persistent inflammatory condition of the middle ear, often resulting in tympanic membrane damage, hearing loss, and, in some cases, cholesteatoma formation. Surgical intervention, including mastoidectomy and tympanoplasty, is a standard treatment approach. This study evaluates the outcomes of intact canal wall mastoidectomy with tympanoplasty and cartilage reconstruction, focusing on anatomical and functional results.......

Keywords: intact canal wall mastoidectomy, tympanoplasty, cartilage reconstruction, cholesteatoma, hearing improvement

[1] "Intact Canal Wall Mastoidectomy: A Review Of The Literature" (Otolaryngol Head Neck Surg, 2018)
[2] "Cartilage Reconstruction In Middle Ear Surgery: A Systematic Review" (Laryngoscope, 2020)
[3] "Hearing Outcomes After Intact Canal Wall Mastoidectomy With Cartilage Reconstruction" (Otol Neurotol, 2019)
[4] "Complications Of Intact Canal Wall Mastoidectomy: A Retrospective Review" (Am J Otolaryngol, 2017)
[5] "Cartilage Grafting In Middle Ear Surgery: A Meta-Analysis" (J Laryngol Otol, 2018).

Abstract: Background: Colour blindness is inherited by X linked recessive manner. Partial colour blindness is more common. Red-green colour blindness is more common followed by blue-yellow colour blindness.
Materials and Methods: Medical students coming for routine eye check-up, students examined during medical camp, paramedical staff including nursing students coming for routine eye check-up during the period of January 2024 to November.......

Key Word: Colour Vision Deficiency, Red-Green Colour blindness, Ishihara Colour Vision Chart, Partial Colour Blindness, Total Colour Blindness

[1] Levin, L.A., Nilsson, S.F.E., Ver Hoeve, J., Wu, S.M., Alm, A., & Kaufman, P.L. (2011). Adler’s Physiology Of The Eye. (11th Ed.). Elsevier.
[2] Dalton, J. (1798). “Extraordinary Facts Relating To The Vision Of Colours.” Memoirs Of The Literary And Philosophical Society Of Manchester, 5, 23-45.
[3] Gao, J.G., Tian, M. (2023). Prevalence Of Color Vision Deficiency Among Chinese College Students And Their Quality Of Life. Int J Ophthalmol, 16(9), 1542-1548. Doi:10.18240/Ijo.2023.09.23. PMID:37724287; PMCID:PMC10475624.
[4] Al-Aqtum, M.T., Al-Qawasmeh, M.H. (2001). Prevalence Of Colour Blindness In Young Jordanians. Ophthalmologica, 215(1), 39-42. Doi:10.1159/000050824. PMID:11125268.
[5] Jha, R.K., Khadka, S., Gautam, Y., Bade, M., Jha, M.K., Nepal, O. (2018). Prevalence Of Color Blindness In Undergraduates Of Kathmandu University. JNMA J Nepal Med Assoc, 56(214), 900-903. Doi:10.31729/Jnma.3913. PMID:31065132; PMCID: PMC8827614.

Abstract: Background: Malignant biliary obstruction (MBO) is a common complication of biliopancreatic malignancies, often requiring endoscopic retrograde cholangiopancreatography (ERCP) for biliary decompression. However, ERCP fails in up to 15% of cases. Percutaneous transhepatic biliary drainage (PTBD), traditionally used in such cases, is associated with high morbidity. Endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) has emerged as a promising alternative. This study compares the safety, efficacy, and survival outcomes of EUS-HGS versus PTBD following failed ERCP.......

Keywords: Malignant biliary obstruction; Endoscopic ultrasound-guided hepaticogastrostomy; EUS-HGS; Percutaneous transhepatic biliary drainage; PTBD; ERCP failure; Biliary drainage; Pancreatic cancer; Cholangiocarcinoma; Interventional endoscopy

[1] Tsuyuguchi T, Takada T, Miyazaki M, Et Al. Stenting And Interventional Radiology For Obstructive Jaundice In Patients With Unresectable Biliary Tract Carcinomas. J Hepatobiliary Pancreat Surg. 2008;15:69–73. Doi: 10.1007/S00534-007-1282-X.
[2] Kurniawan J, Hasan I, Gani RA, Et Al. Mortality-Related Factors In Patients With Malignant Obstructive Jaundice. Acta Med Indones. 2016;48:282–8.
[3] Dumonceau JM, Tringali A, Blero D, Devière J, Laugiers R, Heresbach D, Costamagna G European Society Of Gastrointestinal Endoscopy. Biliary Stenting: Indications, Choice Of Stents And Results: European Society Of Gastrointestinal Endoscopy (ESGE) Clinical Guideline. Endoscopy. 2012;44:277–298. Doi: 10.1055/S-0031-1291633.
[4] Fung BM, Pitea TC, Tabibian JH. Difficult Biliary Cannulation In Endoscopic Retrograde Cholangiopancreatography: Definitions, Risk Factors, And Implications. Eur Med J Hepatol. 2021;9:64–72.
[5] Kakked G, Salameh H, Cheesman AR, Kumta NA, Nagula S, Dimaio CJ. Primary EUS-Guided Biliary Drainage Versus ERCP Drainage For The Management Of Malignant Biliary Obstruction: A Systematic Review And Meta-Analysis. Endosc Ultrasound. 2020;9:298–307. Doi: 10.4103/Eus.Eus_10_20..

Abstract: Background: In everyday orthodontic practice, studio models are the most important component in diagnosis and treatment planning. Nowadays plaster models represent a gold standard that serves to implement various orthodontic measurements and analyzes. With the advancement of technology, digital models represent an alternative that allows three-dimensional representation of teeth and dental relationships. This study describes plaster and digital models with their advantages and disadvantages, dental arch analysis, Bolton analysis, and the time needed for analysis.......

Keywords: gnathometric analysis, plaster models, digital models.

[1]. Gjorgova J, Kanurkova L, Djipunova B, Tosheska-Spasova N. Orthodontic Morphological Analysis And Diagnostics, Faculty Of Dentistry, Skopje, 2012, P.93.
[2]. Mullen SR, Martin CA, Ngan P, Gladwin M. Accuracy Of Space Analysis With Emodels And Plaster Models. Am J Orthod Dentofacial Orthop 2007; 132(3): 346-352.
[3]. Taneva E, Kusnoto B, Evans C. 3D Scanning, Imaging And Printing. Contemp. Orthod 2015; 9: 148-149.
[4]. Porto BG, Porto TS, Silva MB, Grehs RA, Pinto Ados S, Bhandi SH, Tonetto MR, Bandeca MC, Dos Santos Pinto LAM. Comparison Of Linear Measurments And Analyses Taken From Plaster Models And Three-Dimensional Images. J Contemp Dental Pract 2014:15(6):681-687
[5]. Markovic M, Bioloska Priroda Ortodoncije, Ortodonska Sekcija Srbije, Beograd,1976.

Abstract: Background: In tropical and subtropical areas across the world, dengue fever—a virus spread by mosquitoes and brought on by the dengue virus (DENV) - poses a serious threat to public health.1 Dengue fever's clinical spectrum includes both severe and potentially fatal types as well as mild, self-limiting febrile illnesses like fever, headache, retro-orbital pain, myalgia, and rash. However, a subset of patients progresses to severe manifestations, including.......

Key Word: Dengue hemorrhagic fever, dengue shock syndrome, Pleural effusion

[1]. World Health Organization. Dengue And Severe Dengue: Fact Sheet. WHO, 2024.
Www.Who.Int/News-Room/Fact-Sheets/Detail/Dengue-And-Severe-Dengue
[2]. Bhatt S, Gething PW, Brady OJ, Messina JP, Farlow AW, Moyes CL, Drake JM, Brownstein JS, Hoen AG, Sankoh O, Myers MF. The Global Distribution And Burden Of Dengue. Nature. 2013 Apr 25;496(7446):504-7.
[3]. Stanaway JD, Shepard DS, Undurraga EA, Halasa YA, Coffeng LE, Brady OJ, Hay SI, Bedi N, Bensenor IM, Castañeda-Orjuela CA, Chuang TW. The Global Burden Of Dengue: An Analysis From The Global Burden Of Disease Study 2013. The Lancet Infectious Diseases. 2016 Jun 1;16(6):712-23.
[4]. Shepard, Donald S Et Al. The Global Economic Burden Of Dengue: A Systematic Analysis. The Lancet Infectious Diseases, Volume 16, Issue 8, 935 – 941
[5]. Takeuchi T, Ohno H, Satoh-Takayama N. Understanding The Immune Signature Fingerprint Of Peritoneal Dialysis–Related Peritonitis. Kidney International. 2017 Jul 1;92(1):16-8..

Abstract: Background: Swimming is an aerobic exercise which helps, to train the subjects in control breathing. Strength and endurance training is common practice in swimmers, which also increase the strength of Respiratory muscle as well as elastic recoil of lungs as immersion in water increased pressure over lung & heart.
Objective: Our main aim is to know whether the short duration of swimming (six months to one year) can significantly change the cardiopulmonary efficiency in swimmers compared to sedentary subjects. Methods: This present study.......

Keywords: cardiopulmonary efficiency, comparison, male, sedentary, swimming

[1] Aaron E A, Seow K C, Johnson B D, Dempsey JA. Oxygen Cost Of Exercise Hyperpnea: Implications For Performance. J Appl Physiol 1992;72(5):1818–1825.
[2] Stager J M, Tanner D A. Central Adaptations: Heart, Blood, And Lung. In: Handbook Of Sports Medicine And Science Swimming, 2nd Edition. 2005.P. 20–34.
[3] Riding N. The Swimmer’s Heart. Aspetar Sport Med J 2015;4(October):P.440–446.
[4] Lakhera SC, Mathew L, Rastogi SK, Sengupta J. Pulmonary Function Of Indian Athletes And Sportsmen: Comparison With American Athletes. Indian J Physiol Pharmacol 1984;28(3):187–194.
[5] Akhade V, Muniyappanavar N. Comparative Study Of Pulmonary Functions In Swimmers And Sedentary Controls. Natl J Physiol Pharm Pharmacol 2014;4(2):149–152.

Abstract: Aim and Objectives: To explore a case report detailing an instance of of Wilson’s Disease with unusual presentation. Methods: A case report was made utilizing patient’s history, clinical assessment and laboratory tests. A tailored management strategy was devised to address Wilson’s Disease cases with unusual features.
Case description: An 11-year-old female with no known past psychiatric history presented to Psychiatry OPD exhibiting symptoms of involuntary.......

Keywords: Wilson’s Disease

....

Abstract: IVC duplication refers to the presence of both a right and left inferior vena cava, explained by abnormal development during embryonic life. This study presents three clinical cases illustrating the diversity of congenital IVC anomalies discovered incidentally during routine CT examinations. Two cases demonstrated classic infrarenal IVC duplication with normal-caliber right IVC and smaller left para-aortic IVC, while the third case presented an atypical retroaortic course. IVC duplication occurs in 0.08 to 3% of the population and may constitute a diagnostic trap,........

[1] Zunon-Kipré Y, Broalet E, Kakou M, Ouattara D. Une Variante Anatomique Rare : La Duplication De La Veine Cave Inférieure. Description Et Implications Chirurgicales. Rev Int Sc Méd. 2006;8(3):49-52.
[2] Sénécail B, Josseaume T, Bobeuf J, Hebert T, Wazizi R, Nonent M. Duplication Droite De La Veine Cave Inférieure. Morphologie. 2004;88:183-187.
[3] Delrue M, Fourgeaud C, Guinemer S, Aslangul E, Mahé I. Une Veine Cave Inférieure Double Associée À Des Phlébites Unilatérales Récidivantes... Et Puis Quoi Encore ? J Mal Vasc. 2017;42:113-114.
[4] Senecail B, Lefevre C, Person H, Meriot P. Radiologic Anatomy Of Duplication Of The Inferior Vena Cava: A Trap In Abdominal Imaging. A Report Of 8 Cases. Surg Radiol Anat. 1987;9:151-157.
[5] Khaledpour C, Matanovic P, Rienäcker J, Grönniger J. Anévrysme De L'aorte Abdominale Associé À Une Duplication De La Veine Cave Inférieure (VCI), De L'artère Rénale Droite (ARD) Et De La Veine Rénale Droite (VRD). Morphologie. 1990;74:21-23.

Abstract: Background: Coronary artery disease (CAD) is one of the top causes of death worldwide. In South Asia, people tend to develop CAD earlier and with more severe complications. Diabetes mellitus (DM) makes CAD worse through complicated changes in the body’s metabolism. However, how diabetes, abnormal blood fats (dyslipidaemia), and CAD severity interact in this high-risk group has not been well studied.......

Keywords: Coronary artery disease, Diabetes mellitus, Dyslipidaemia, Blood sugar, Cholesterol, Haemoglobin, Angiograms, Bangladesh

[1] World Health Organization (WHO). Cardiovascular Risk In Newly Diagnosed Patients With Type 2 Diabetes Mellitus: A Nationwide, Facility-Based, Cross-Sectional Study In Bangladesh. Int J Cardiol Cardiovasc Risk Prev. 2025 Apr 4; 25:200399. Available From: Https://Pubmed.Ncbi.Nlm.Nih.Gov/40248520/
[2] International Diabetes Federation. IDF Diabetes Atlas. Available From: Https://Diabetesatlas.Org/
[3] International Diabetes Federation. Facts & Figures. Available From: Https://Idf.Org/About-Diabetes/Diabetes-Facts-Figures/
[4] Global Burden Of Cardiovascular Diseases: Projections From 2025 To 2050. Eur J Prev Cardiol. 2025; 00:1–15. Available From: Https://Doi.Org/10.1093/Eurjpc/Zwae281
[5] American Heart Association. 2024 Heart Disease And Stroke Statistics Update Fact Sheet. Available From: Https://Www.Heart.Org/-/Media/PHD-Files-2/Science-News/2/2024-Heart-And-Stroke-Stat-Update/2024-Statistics-At-A-Glance-Final_2024.Pdf.

Abstract: Hospital-acquired infections (HAIs) represent a significant cause of morbidity and mortality in intensive care unit (ICU) patients. Recent research has highlighted the critical role of the gut microbiome in modulating host immunity and maintaining barrier function, suggesting that microbial dysbiosis may contribute to increased susceptibility to HAIs in critically ill patients. This study aims to evaluate the association between gut microbiome alterations and the incidence.......

Keywords: Gut microbiome, ICU, hospital-acquired infections, dysbiosis, microbial diversity, 16S rRNA, critical care, antibiotic resistance

[1] Petrof EO, Dhaliwal R, Manzanares W, Johnstone J, Cook D, Heyland DK. Probiotics In The Critically Ill: A Systematic Review Of The Randomized Trial Evidence. Crit Care Med. 2012;40:3290–302. Doi: 10.1097/CCM.0b013e318260cc33. [DOI] [Pubmed] [Google Scholar]
[2] Buffie CG, Pamer EG. Microbiota-Mediated Colonization Resistance Against Intestinal Pathogens. Nat Rev Immunol. 2013; 13:790–801. Doi: 10.1038/Nri3535. [DOI] [PMC Free Article] [Pubmed] [Google Scholar]
[3] Rowland I, Gibson G, Heinken A, Scott K, Swann J, Thiele I, Et Al. Gut Microbiota Functions: Metabolism Of Nutrients And Other Food Components. Eur J Nutr. 2018;57:1–24. Doi: 10.1007/S00394-017-1445-8. [DOI] [PMC Free Article] [Pubmed] [Google Scholar]
[4] Iacob S, Iacob DG, Luminos LM. Intestinal Microbiota As A Host Defense Mechanism To Infectious Threats. Front Microbiol. 2019;9:3328. Doi: 10.3389/Fmicb.2018.03328. [DOI] [PMC Free Article] [Pubmed] [Google Scholar]
[5] Chen Y, Zhang F, Ye X, Hu JJ, Yang X, Yao L, Et Al. Association Between Gut Dysbiosis And Sepsis-Induced Myocardial Dysfunction In Patients With Sepsis Or Septic Shock. Front Cell Infect Microbiol. 2022;12:857035. Doi: 10.3389/Fcimb.2022.857035. [DOI] [PMC Free Article] [Pubmed] [Google Scholar]

Abstract: Wernicke's encephalopathy (WE) remains largely underdiagnosed clinically despite a true prevalence of 0.8-2.8% revealed by autopsy studies, primarily due to clinical presentation variability, with the classic triad present in only 16% of patients. This study presents a case of WE in an 18-year-old adolescent who developed confusion, oculomotor disorders, and ataxia in the context of post-cholecystectomy malnutrition, and examines the contribution of modern neuroimaging. Brain MRI revealed characteristic hyperintensities of the thalami and mammillary bodies on diffusion........

[1] Sechi G, Serra A. Wernicke's Encephalopathy: New Clinical Settings And Recent Advances In Diagnosis And Management. Lancet Neurol. 2007;6(5):442-55.
[2] Reed LJ, Lasserson D, Marsden P, Stanhope N, Stevens T, Bello F, Et Al. FDG-PET Findings In The Wernicke-Korsakoff Syndrome. Cortex. 2003;39(4-5):1027-45.
[3] White ML, Zhang Y, Andrew LG, Hadley WL. MR Imaging With Diffusion-Weighted Imaging In Acute And Chronic Wernicke Encephalopathy. AJNR Am J Neuroradiol. 2005;26(9):2306-10.
[4] Jung YC, Chanraud S, Sullivan EV. Neuroimaging Of Wernicke's Encephalopathy And Korsakoff's Syndrome. Neuropsychol Rev. 2012;22(2):170-80.
[5] Sullivan EV, Pfefferbaum A. Neuroimaging Of The Wernicke-Korsakoff Syndrome. Alcohol Alcohol. 2009;44(2):155-65.

Abstract: Introduction: Sepsis is an important cause of neonatal mortality. Developing countries bear a higher burden of neonatal mortality due to neonatal sepsis. Early diagnosis by identifying the clinical signs and symptoms and starting evidence-based empirical antibiotic therapy is key to a better outcome of neonatal sepsis. Thus, identifying the bacteriological profile and their antibiotic sensitivity pattern is important to formulate the antimicrobial policy.......

Keywords: neonatal sepsis; antibiotic resistance; EOS; LOS; gram-negative sepsis; gram-positive sepsis

[1] Seale AC, Blencowe H, Manu AA, Nair H, Bahl R, Qazi SA, Zaidi AK, Berkley JA, Cousens SN, Lawn JE., Psbi Investigator Group. Estimates Of Possible Severe Bacterial Infection In Neonates In Sub-Saharan Africa, South Asia, And Latin America For 2012: A Systematic Review And Meta-Analysis. Lancet Infect Dis. 2014 Aug;14(8):731-741
[2] Liu L, Johnson HL, Cousens S, Perin J, Scott S, Lawn JE, Et Al. Child Health Epidemiology Reference Group Of WHO And UNICEF. Global, Regional, And National Causes Of Child Mortality: An Updated Systematic Analysis For 2010 With Time Trends Since 2000. Lancet. 2012; 379:2151–61. Doi: 10.1016/S0140-6736(12)60560-1.
[3] Kimberlin DW, Brady MT, Jackson MA, Long SS, Editors. American Academy Of Pediatrics. Group B Streptococcal Infections. Red Book:2018 Report Of The Committee On Infectious Diseases. 31st Ed. Itasca, IL: American Academy Of Pediatrics; 2018. P. 762.
[4] Dong Y, Speer CP. Late-Onset Neonatal Sepsis: Recent Developments. Arch Dis Child Fetal Neonatal Ed. 2015;100:F257–63. Doi: 10.1136/Archdischild-2014- 306213.
[5] V. Stevens, K. Geiger, C. Concannon, R.E. Nelson, J. Brown, G. Dumyati. Inpatient Costs, Mortality And 30-Day Re-Admission In Patients With Central-Line- Associated Bloodstream Infections. Clinical Microbiology And Infection 2014; 20(5):318-20..