SSIMS Times Vol 8, Jan-Mar 2013

From Principal's DeskEditorialReport:

Cover Story:

Original Article

Case Reports

Informative article

Departmental Activities

Student's activities and Achievements

Graduation DayStudent Union 2013 - Inauguration

Assault on doctors

Percutaneous Trigeminal Ganglion Block

Academy Guidelines for Nail DisordersKarl Landsteiner

Publications

Contents

Dr. Shamanur ShivashankarappaMLA, Honorary Secretary, BEA

Davangere

Sri S.S. MallikarjunaChairman

SSIMS&RC, Davangere

PATRONS

SSIMS&RCNH-4, Bypass Road, Davangere - 577 005.Phone : 08192-261805, 261806, 261807

261808, 261809 FAX : 08192-262633, 266310E-mail : [email protected] site : www.ssimsrc.com

Advisory Board:

Editor:

Editorial Board :

Executive Members

Dr. Nagaraj P.

Student Representatives :

PrincipalDirector (Medical)

Santhosh KumarDM Photographer

:

Rakesh PM ArtistBasavaraj S.G. Technician, Dept. of Physiology

Technical Support

Dr. Kalappanavar N.K.

Dr. Vidya NadigerProfessor, Department of PhysiologyPhone: 08192- 266321,e-mail: [email protected]

Dr. Chandrashekar KarpoorDr. Sunitha Kalasurmath Dr. Ravikiran KisanDr. Prasad BK Dr. Renu Lohitashwa

Dr Sindhu, Dr Kavyashree, Dr Asha, Dr. Mehak

Dr. A.V. Angadi Dr. Deshapande D.V.Dr. C.R. Mallikarjun Dr. Shasikala P.Dr. K.G. Basavarajappa Dr. Umakant PatilDr. Varadraj Rao B.A. Dr. A.M. Shiva KumarDr. Prakash V. Suranagi Dr. Prasad B.S.Dr. P.J. Prabhakar Dr. Prema PrabhudevDr. Anil Nelvigi Dr. V. Jagannath KumarDr. Arun Kumar A Dr. Ramesh DesaiDr. Naredndra Dr. Ravi B.Dr. Satyanarayana M.V.V. Dr. Prashant

Disclaimer :Views and opinions expressed in this newsletter are not

directly that of the editor or the editorial board. For anyclarification, author of the article is to be contacted.

Editorial Office : DEPARTMENT OF PHYSIOLOGYExtn. Nos. : 08192-266320, 266321, 266322

S.S. Institute of Medical Sciences & Research Centre

NEWS BULLETIN COMMITTEE

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EmergencyMedicine (EM) -Anewbranch.Majority of the hospitals in India the emergencydepartments are generally staffed by basic doctors,physicians or surgeons on a rotating basis. None aretrained to deal in emergencies of all specialities. Incase of RTA the medical person cares about notingdown the wounds in the medical records rather thantreating the patient. The EMwas born as a specialityin order to fill the time commitment required byphysician to work in the increasingly busyemergency room. The first EM residencyprogramme in the world was begun in 1970 and firstEMdepartment inmed school was founded in 1971.Emergency medicine was recognized as a separatespecialty by Medical Council of India (MCI) fromJuly 2009.Emergencymedicine is amedical specialtya field ofpractice based on the knowledge and skills requiredfor the prevention, diagnosis and management ofacute and urgent aspects of illness and injuryaffecting patients of all age groups with a fullspectrum of undifferentiated physical andbehavioural disorders.The emergency physician requires a broad field ofknowledge and advanced procedural skills oftenincluding surgical procedures, trauma resuscitation,advanced cardiac life support and advanced airwaymanagement. Emergency physicians must have theskills of many specialiststhe ability to resuscitate apatient (critical care medicine), manage a difficultairway (anaesthesia), suture a complex laceration(plastic surgery), reduce a fractured bone ordislocated joint (orthopaedic surgery), treat a heartattack (cardiology), work-up a pregnant patientwithvaginal bleeding (Obstetrics and Gynaecology),stop a bad nosebleed (ENT), place a chest tube, andto conduct and interpret x-rays and ultrasounds(radiology).Emergencymedicine include added responsibilitiesin the areas of: Management of medical andadministrative aspects of emergency servicessystem.Disaster planning andmanagement for bothNaturalandmanmade.

From the Desk of Principal Toxicology and Poison centre development.Training ofmedical students, hospital personnel andpublic. Emergency Prevention. Clinical research inresuscitationmethods and acute interventions.Conduct courses inCPR,BLS, andATLS.EM is an evolving speciality in India. There aremany challenges to establish a department and equalopportunitieswhoget in to it.

Dear friends &colleaguesSSIMS TIMES wishes its readers a very

happy”UGADI”,a festival which marks thebeginning of New year,where nature also gets a newface look with the arrival of spring season.Thisfestival is celebrated to acknowledge the day onwhichLordBrahma startedwith the task of creation.The key aspects of this festival is to leave the pastbehind& start freshwith a positive expectation.In the month of March SSIMS celebrated its 2

nd GRADUATION DAY. Tt is the most awaitedday for the fresh graduates going to be honoured as“Graduates “. The young graduates must make useof this degree not as a ticket to the good life, butmustthink it as a ticket to change the world with theirknowledge. The knowledge should not only beused to achieve success in terms of fame & moneybut rather they must put all the efforts to achieve thevalues ofmankind.Month of March also marked the occasion ofWomans day (8th march) . The theme of womansday of 2013 was “A promise is a promise; Time foraction to end violence against women' as declaredby the UN.Women of today is not fighting for rightsof equality but asks for her safety & wants theviolences on her to end .In this issuewe also bring you a article on “Assaulton doctors” Doctors are targeted easily knowingvery well that doctors too are human beings & notGod . All this happens inspite of Govt of Karnatakamaking a gazette notification inMarch 2009 ,that it

Editorial...........

SSIMS T IMESS.S. INSTITUTE OF MEDICAL SCIENCES &RESEARCH CENTRE

Dr. P. NagarajPrincipal

Vol. 8, Issue : 1, Jan - Mar 2013

2


Is non bailable offence to assault or to threatendoctor/nurses/paramedicalstaff,any damage to thehospital property againstwhich they have to

Dr. Vatsala.A.R: “A Study of branching patternof coronaryArteries inHuman cadavers”Dr.Smitha.M (P.G) : “ A study on lip-print

patterns in parents of cleft-lip individuals”

Academic body meet on 31-01-13, Topic“Autonomic nervous System in health andDisease”By,DrRavikiran.Kisan

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On 60th Diamond Jubilee NationalConference of Anatomical Society of India heldfrom26th to 29thDecember 2012 at SCB MedicalCollege, Cuttack, Odissa. Following staffmembersandPGspresentedPapersDr.Gourishankar ganga : “Study of down

syndrome and its variants” and chaired a Scientificsession onGrossAnatomyDr.Shailaja.C.Math: “Turner syndrome and its

variants”

Dr. Basavaraj. B.Dhabale (P.G) : “ The variationin the division pattern of brachial artery”Dr.Savita Budi (P.G.): “Arare multiple variation

of vessels and nerves in a cadavers upper limb”(Poster)

Congenital diaphargmatic hernia throughforamenofMorgagni- a rare presentationAcademic body meet on 31-01-13, Topic

“Cytogenetic in SSIMS&RC” an insight byDr.Shailaja.C.Math

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compensate with double the amount or undergo 3yrs of imprisonment. Negligence do happen attimes,any ways doctors must take all preventivemeasures to protect themselves.

“Serum ferritin a novel risk factor for diabetes?”Poster Presentation atAMBICON-2012byDr. SushmaB.J &Dr.Nagarajappa.K.

Dr. Sushma B.J & Dr. Shilpa S. Kasatpostgraduate students in Biochemistry underwenttraining Programme “Immunological & molecularTechniques as applied for infectious diseaseresearch” held from 28th Jan' to 2nd Feb' 2013 byDepartment of Biochemistry & JBTDRC,MGIMS,SEVAGRAM,Maharashtra.

Post graduates, Dr. Shilpa N, Dr. Shamila, Dr.Shridevi,Dr. Swati

a.Attended CME on “An Update In ThyroidPathology” on 7th & 8th February 2013, held inCMCVellore.

b.Participated in “Abhedya 2013” the 2ndState Level Quiz, conducted by KCIAPM atKempegowda Institute of Medical SciencesBangalore on 02.03.2013

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REPORT : DEPARTMENTAL ACTIVITIES

DEPARTMENT OFANATOMY

DEPARTMENT OF PHYSIOLOGY

DEPARTMENTOF BIOCHEMISTRY

DEPARTMENT OF PATHOLOGY


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Dr. Vidya NadigerEditor


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A Voluntary blood donation and awarenesscampwas conducted at Bapuji Polytechnic College,Davangere on 14.03.2013 in association with RedCross Society, Dr. Sonam Nandyal along withHouse surgeons,Dr.Abhishek, Dr.Harsha,

Dr. Praveen, Dr.Jayesh, Dr.Mitra, Dr.AfrozandBloodBank team -Mr. Ismail, MrsRajeshwari,Mr. Santosh andMr. Basavaraj conducted the camp.Atotal of 90 unitswere collected.

CPC on chronic venous congestionspleen, in a patient who presented withpancytopenia andmass abdomen.Moderators:Dr

Dr.Yogeesh babu.K.V. Conducted an integratedteaching programme for phase II IVth & V ternstudents on Dengue fever on 6th March 2013. FromDept. ofMedicalEducation forUGstudents.Dr.VinodKumarC.S.,Assistant Professor

Resource person for the CME program on“How towrite a research paper held at St John'sMedical College, Bangalore in association of IndianAcademyofTropical parasitology, India on16th Feb 2013.

4.Clinicopathological correlation:

DEPARTMENTOFMICROBIOLOGY

Veerendraswamy, HOD Surgery and DrShashikala P,HOD,Pathology on 04.01.2013.Veerendraswamy, HOD Surgery and Dr ShashikalaP,HOD,Pathology on 04.01.2013.Dr. Gowishankar Ganga gave a talk on “Study of

mucin is gastrointestinal tract in health anddisease”. Faculty from department of pathology,anatomy & surgery participated in the programmeorganized atDOME lecture hall on 23.01.2013.

. CPC on Renal cell carcinoma (incidentalfinding) in an autopsy case, with an history of RoadTraffic accident. Moderators: Dr Shashikala P.,HOD, Pathology & Dr Sunil Kadam, AssociateProfessor, Department of Forensic Medicine on 1.03.2013.

Appointed as Quality Control Officer tocarry out quality assurance of blood bags.

Has submitted the project and wassanctioned byGangagenBiotechnologies Pvt. LtdThe following staff members and PG students

attended IAMM-KC State level conference heldon 24th Feb 2013.AtKMCMangalore

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Faculty / PG

Dr.Yogeesh babu K.V.Professor

Dr.Vinod kumar.C.S

DR.KruthikaPG student

“Aerobic Bacteriological study of chronic supportive otitis media”(Poster presentation)

DR.Vishwajeet BardoloiPG student

Isolation and identification of Bacterial pathogens from blood streaminfections and role of multidrug resistant bacterial isolates in bloodstream infections (Poster presentation)

Acinetobacter baumannii as Emerging pathogenin neonatal septicemia

Role of Acinetobacter baumannii carriers among health careworkers in tertiary care hospital (Oral presentation)

RESEARCH TOPIC


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Health check up camp was organized fordisabled people atAngodu taluk. Dr. Varadaraj Rao,Prof & Head, Dept of Community Medicine, Dr.Suryakantha A.H, Professor, Dr. Bheemayya B,Associate prof, Dr. Ayesha Nawaz, Asst Prof andpost graduate students Dr. SantoshA, Dr. DevrajP and Dr. Arun Daniel participated in the camp on12-01-2013.

In IPHACON 2013, South East AsiaRegional Public Health Conference, held atKolkata. 01-02-2013 to 03-02-2013

Dr.Ayesha Nawaz (Poster presentation):“Evaluation of primary immunization coverage andfactors influencing the immunization coverage”.

Dr. Santosh A (Oral Presentation):Attitudes of Medical Students Towards OlderPeople and Willingness to Consider a Career inGeriatricMedicine inDavangere,Karnataka.

Dr. SantoshA (Poster Presentation):GeriatricDepression and its related factors -ACrosssectional study from an urban slum in Davangere,Karnataka.

Dr. Arun Daniel (Oral Presentation): Acomparative study of usefulness of Telephonesurveys over face to face surveys as a method ofData collection.

Dr.Aswin Kumar, Asst professor, visitedRashmi residential school on 09-02-2013 atDavangere and gave training on “First Aid” tochildren.

Dr. Kusum Mane, Asst prof, Dr. AyeshaNawaz, Asst Prof and Post graduate students Dr.Devaraj P and Dr. Arun Daniel from dept ofCommunity Medicine participated in the Healthcheck up of anganwadi children at Giriyapura underMathoshree programmeon16-02-2013.

Dr. SantoshAattended the eleventhMDRF

DEPARTMENT OFCOMMUNITYMEDICINE

UAB FIU International seminar on 'preventionand control of non-communicable diseases' atChennai and did a oral presentation titled “DiabetesMellitus among residents of old Age Homes ofDavangere District” between 15-02-2013 to 17-02-2013. This seminar was Organized by MadrasDiabetes Research Foundation (MDRF), Chennai,in association with Florida International University,(FIU) & University of Alabama at Birmingham(UAB), USA, Supported by National Institutes ofHealth (NIH),USA.

Dr. Kusum Mane, Asst Professor, createdawareness among high school students on “Hazardsof tobacco”, in various schools in areas underLokikere PHCbetween 18-02-2013 to 22-02-2013.

Dr. Santosh A and Dr. Devraj P Pategeworked as WHO External Monitors in the NationalPulse polio immunization programme for 4 daysfromFebruary 24 February 27, 2013.

Completion of Project work: Title: A Studyon awareness and preparedness about Globalwarming amongMedical students.By: PaiDivyaVenkatesh, SuryakanthaA.H

In the XX th Annual conference ofKarnataka Medico-legal Society at KIMS,Bangalore, during 23rd to 25thNovember 2012.

Dr.Dileep Kumar R, 2nd year Postgraduate, presented a scientific paper titled'Estimation of stature of percutaneous ulna length'

Dr. Pavan Kumar G, 1st year Postgraduate, has presented a scientific paper titled'Prediction of stature and their correlation based onhand length'

Dr. Sunil S Kadam,Associate Professor, co-chaired the scientific paper presentation session inXXIV th annual national conference of IndianAcademyofForensicMedicine, held atMangalore

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DEPARTMENT OF FORENSICMEDICINE & TOXICOLOGY


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from1st to 3rdFebruary.In association with Department of

Neurosurgery, General surgery and Pathology, thedepartment of Forensic Medicine has organized aClinicoPathological case discussion atDOME.On

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DEPARTMENT OF MEDICINE

1st March 2013. The case discussion was aboutNeurosurgical,Autopsy and Histopathological caseprofile of an incidental renal cell carcinoma in adeceased of head injury following road trafficaccident.

CME in cardiologywas conducted in Saturday 23rdMarch 2013 by Department of Medicine inassociationwithNarayanaHrudayalaya.TheCMEwas inaugurated byDr.H.Gurupadappa

and Prinipal Dr. P.Nagaraj, Dr. N.K.Kalappanavar,Dr. S. S.Bhat and team of speakers. The followingtopicswere discussed by teamof speakers:

Dr. K.S. SomashekarConsultant CardiologistDavangere Heart Hospital

Dr. B.P.VenkateshConsultant CardiologistCity Central Hosptial

Dr. Prakash HiremathCardio Thoracic SurgeonS.S.Narayana Hrudayalaya

Dr. B.SreenivasaAssoc Prof of CardiologySSIMS&RC

Dr. R.S.DhananjayaConsultant CardiologistS.S.Narayana Hrudayala

Dr. Madhusoodan BhoviConsultant CardiacAnaesthesiologistS.S.Narayana Hrudayala

Speaker

Recent STEMI Guidelines

Management of Heart Failure- Newerconcepts

Current Concepts in Surgical Approach tocongenital heart disease

Valvular heart disease - When to intervene?

Sudden cardiac death

Awake CABG - Anaesthetic Considerations

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Thiswas followed by case discussions byDr.A. Sameeth Shetty andDr. SureshDamodaran and aworkshopforGeneral Surgeon andOrthopaedics surgeonswas organised.


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DEPARTMENT OF SURGERY.

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Arranged a Guest lecture: Topic: “DiabeticFoot Forum”bySpeaker: Dr. SunilKariSurgery Conference at Raichur.-Poster

presentation “Bowel inBone”Dr.Tilak.Assistant professor in Surgery.

Dr. Gayatri L .Patil Professor attended AllIndia Conference of Obste tr icians andGynaecologists January 2013 held at Mumbai andpresented a paper on “Comparing reproductive andSexual health among urban and rural adolescentgirls”.

Dr. Prema Prabhudev gave lecture on“Management of pregnancy after expected date ofdelivery” at Library Lecture hall, Bapuji Hospitalduring guest lecture arranged by OBG dept.,JJMMC and OBG Society, Davangere on15/02/2013.

Attended National TOT on Mission Uday2013 workshop at Kolkata on 13th Jan 2013, asNational trainer.

Attended National Executive Boardmeeting on 16th,17th Jan 2013 as Executive Boardmember fromKarnataka.

Attended national Paediatric Conferenceand delivered talk on 'Pneumonia in children' asfaculty on 19th Jan 2013 atKolkata.

Participated as faculty during CME atBellary IAP district Branch on 23.01.2013.Delivered talk on 'ChildhoodPneumonia and

DEPARTMENT OFOBSTETRICS & GYNAECOLOGY

DEPARTMENT OF PAEDIATRICS

CurrentVaccines “.Delivered talk on 'Asthma in Children'

duringCMEatChitradurga on 24th Feb 2013.Participated as faculty during National

Conference on Paediatric allergy and appliedimmunology at Bangalore on 2nd and 3rd March2013.Topicwas ' Indoor air Pollution'.Appointed as member of 'Indian College ofPaediatrics' for the period 2013-2015 by NationalIAP,NewDelhi

Attended the National PALS InstructorCourse successfully as Observer (Preinstructorship requirement) held at CHI Chennai inFeb - 2013.

. Attended Paediatric Radiology CME, atBCHI&RC,Davangere on 23rdFebruary.

. Attended Shimoga IAP IMA Membermeet on 02-03-13, gave a Guest Lecture on“Nutritional Management of Low Birth Weight(LBW)babies”.

On occasion of “WORLD GLAUCOMAWEEK” 10-03-2013 to 16-03-2013, Department ofOphthalmology of SSIMS&RC & JJMMC,Davangere Ophthalmic Society & DistrictBlindness Control Society conducted a GlaucomaWalkathon to create awareness among the public.

. It was inaugurated by our belovedPrincipal, Dr. P. Nagaraj and Dr. Madhav Honnatti(President Karnataka Ophthalmological Society).Dr. S. V. Ravindranath (President DavangereOphthalmic Society & Professor and HOD,Department ofOphthalmology, JJMMC),Dr. Prakash V. Suranagi (Secretary DavangereOphthalmic Society & Professor and HODDepartment ofOphthalmology, SSIMS&RC),Dr. Nanda (Programme manager DBCS), andattended by other teaching faculty andPostgraduates fromDept ofOphthalmology ,Interns and students participated in thewalkathon.

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Director of Neonatology & ProfofPaediatrics.

DEPARTMENTOFOPTHALMOLOGY


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GlaucomaWalkathon at JJMMCwas reinforced byDr. Manjunath Alur, Principal JJM MedicalCollege.All the members of Davangere ophthalmicsociety, faculty and Postgraduates joined the rally atNijalingappa admimistrative block JJMMC. TheWalkathon continued with various banners ofKarnataka Ophthalmological society, DavangereOphthalmic Society, District Blindness Controlsociety, highlighting the theme of the WorldGlaucomaweek- 2013 (Theworld is awonder to seeevery day- so don't let Glaucoma get in the way).The students raised voice for various slogans inKannada and English to make public “be aware” ofGlaucoma. The rally moved via Gundi circle toChigateriGeneralHospital.

A Street play was conducted byDepartment of Ophthalmology, SSIMS&RC inwhich the Students of 3rd year participated.

A free glaucoma camp was conducted bythe Department of ophthalmology, SSIMS&RC atS.S.Speciali ty Clinic, Modi Compound,Davangere, between 10 AM-1 PM where in 47patients were screened & the glaucoma suspectswere referred to SSIMS&RC for further evaluation&management.

Guest Lecture was organized on the topic“New Science of Man”. Dr. B.M. Hedge, formerVice Chancellor, Manipal University and PadmaBhushan Awardee, spoke on the occasion on11.01.2013. Staff members and postgraduates ofSSIMS & RC and JJMMC attended the lecture.

Experiential Learning Lectures 2, Faceoffwith Sanjay Sahay Inspector General Police,EasternRange,Davangere, gave a series of lectures

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DEPARTMENTOFMEDICALEDUCATION

No of OTPatients

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HuchangidurgaLokikereArasapura

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16/01/201320/02/201320/02/2013

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On “Creating your own identity- personal websiteDevelopment” on 23.01.2013 and 24.01.2013. Aninteractive session on “Fulfillment in life & careerand “Leading through conflict” workshop forleaders, conducted at Auditorium and open Airtheater, Bapuji college of Business schools,Davangere. Dr. Shashikala P. Professor & HOD,Dept of Pathology delivered the Inaugural addressand Dr. P. Nagaraj, Principal SSIMS & RC gracedthe occasion. Staff and postgraduate students ofSSIMSR&RCattended the lecture.

Dr. Pragati VChavanAssociate Professor incommunity Medicine attended the 66th NationalCourse on Educational Science for Teachers ofHealth Professional held from 07.02.2013 to16.02.2013 at Jawaharlal Institute of Post GraduateMedical Education and Research (JIPMER)Puducherry.

Dr. Jayaraj Professor, Dept of medicine,Dr.Mahesh Neginahal, & Dr.Praveen KumarDevarbhavi, Assistant Professor Department ofMedicine, attended the Basic Course Workshop onMedical Education Technologies, from 12th to 14thFebruary 2013, conducted at J.N.Medical College,Belgaum under the auspices of MCI recognizedRegional training centre.

Experiential learning lectures series -4 :Ethikos for Medicos Lecture by Sanjay Sahay IGP,Eastern range, was organized by Department ofMedical Education andDept of ForensicMedicine.Eventwas a grand success andwas unique in its ownkind attended by more than 350 members fromvarious Medical, Dental Colleges, Advocates,Biotechnology Institute, Pharmaceutical and Policeforce representatives on 23.02.2013.

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6. Dr V.L.Jayasimha (Microbiology), Dr.Vijaykumar Jatti (ForensicMedicine), Dr.RavikiranKisan (Physiology) and Dr. Venkatesh (ENT)attended the workshop on “Student Assessment” atJN Medical College Belgaum on 5th & 6th March,2013, organized by KLE University, Department ofEducation for Health Professional (UDEHP).Eminent resource persons like Dr. Sitalakshmi, DeptofMedical Education St. John'sMedical College, Dr.N.Mahantashetty JNMC spoke on this occasion. Theworkshopwasmade interestingwith


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Group activity and exercises related to “Studentassessment”

A lecture on “Student Assessment” wasconducted on 19.03.2013. Dr. Vijay Kumar Jatti,welcomed the gathering & spoke on the details ofworkshop on student assessment conducted byDOMEBelgaum on 5th & 6thMarch. He spoke ondefinition, need, and Principles &Characteristics ofideal student assessment. Dr. V.L. Jaysimhahighlighted the need, advantages & disadvantagesof essay question, dynamics of question papersetting, advantages and importance of structuredessay question, importance of essay question andthe importance of objectivity in correcting answerscripts of various departments. The programmewasconcluded by Dr. Ravikiran Kisan with a hope thatevery dept will take the message of objectivity incorrecting answer scripts.

Swami Nirbhayananda Saraswathi president,RamakrishnaVivekanandaAshram,Gadag, Bijapurgave discourses on 16.01.2013 on Occasion of150th Birth Anniversary of “Swami Vivekananda”.

Dr. Deepti Pruthvi delivered a lecture on“Prevention of Dengue Fever” on 16.01.2013 atComrade Lenin Girl's high School, Nittuvalli,Davangere. She also spoke on personal hygiene.

Dr. Kavita G.U. delivered a lecture on“Prevention of Dengue Fever” on 17.01.2013 atComrade Lenin Girl's high School, Nittuvalli,Davangere. She also discussed on safety of girls.

Dr. Shashikala P. was a resource person forMeenamela and Training Programme conducted byEducation Department Davangere South at SarkariNoukararaBhavan, on 1st Feb 2013.

Interactive session, discussion on girlsHealth, education and protection was organized byBirla School Harihar on 02.02.2013.Dr. ShashikalaP andDr. Jayalaxmi spoke on health, hygiene & lawrelated to protection of females.

Health Education Programme wasconducted on “First AID” at Rashmi ResidentialSchool” on 09.02.2013. The following were theresource persons involved in the programme. Dr.Shashikala P. Prof&Head Dept of Pathololgy,

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YOUTH RED CROSSWING

Dr.ArunKumar, Prof&Head Dept ofAnaesthesia,Dr. Chirag Assistant Prof Dept of Anaesthesia, Dr.Sagar, Assistant Prof Dept of Anaesthesia, Dr.Aswin Kumar Assistant Prof Dept of CommunityMedicine,

Lecture on “How to Face Examination” wasdelivered at Aditya Birla School for PUC and highschool students byDr. Shashikala. Pon 19.02.2013.

Infection control officerConducted a carrier study among health

care workers from ICUs along with Mr. JayanthS.S. and the report was communicated to MedicalDirector for needful action.

Conducted a hospital wide survey ofHand washing antiseptics in open containers(bowls) along with Mis. Namaratha and the reportwas communicated to Medical Director for needfulaction.

Conducted Air sampling study fromdifferent ICUs and the report was communicated toMedical director for needful action.

Study on “Role of pre-VAP Cultures inPredicting the Pathogen of Ventilator AssociatedPneumonia” is accepted for Oral presentation atInternational conference, 5th Congress of EuropeanMicrobiologists Conference to be held in Leipiz,Germany.

Attended “Infections & antimicrobialstewardship” held at Yenepoya Medical CollegeMangalore, Feb 2013. And discussed in detailburning problems of hospital infection control withDr.Robert Pickles Infections diseases specialistAustralia.

Attended Hospital Infection Society ofIndia Conference HISICON conducted by KEMHospital Bombayon8th and 9th February 2013.

Attended in the CME of HISICONTitled“Surveillance of Health care associated infections”.KEMHospital Bombayon7thFebruary 2013.

1.Dr.YogeshBabuKV.i.

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HOSPITAL INFECTIONCONTROL COMMITTEE (HICC)


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PUBLICATIONS OF SSIMS - ites


Author/s Title Database Journal Department

Dr. Iqbal Ahmed Shariff A Clinicolpathologial Studyof Encephalitis in ChildrenWith Special Reference inJapanese Encephalitis

Vol 5, issue, 01,pp, 250-254,January 2013

International Journalof Current Research Pathology

Dr. Sushma B.JDr. Nagarajappa KDr. C. R Mallikarjun

Serum Paraoxonase-1 activity,Oxidative stress & LipidProfile in Patients with ChronicLiver Disease

IJPBS/vol 3/issue1/Jan-Mar/2013/01-06

International Journalof Pharmacy &Biological Sciences

Biochemistry

Dr. Leela PDr. C. R MallikarjunDr. M. PrafullaDr. Swapnali

Effect of Pranayama & yogaon Apolipoproteins, LipidProfile & Atherogenic Indexin Healthy Subjects

Vol 1(2)Jan/Feb 2013

International ResearchJournal of Pharmacy& Plant Science

Dr KavyashreeDr Vidya Nadiger

Biochemistry

Reaction Time in TelevisionWatching School Children

March 2013(In Press)

International Journalof Physiology

Physiology

Dr. ChandrashekharKarpoor

Effect of Six weeksYogasana Training onSelected PhysiologicalParameters

2013; 1(1):17-21

Biochemistry

Dr. Shilpa S. KasatDr.M.SubhashchandrappaDr. C. R MallikarjunDr. Swapnali

Malondialdehyde, TotalAntioxidant Capacity &Vitamin E Levels in Pretermand Term Infants

Vol 1(2),Jan/Feb 2013

International ResearchJournal of Pharmacy& Plant Science

International Journalof Physiology

Physiology

Dr. Vijaykumar B Jatti,Dr. Nagesh Kuppast,Dr. Pavan Kumar Gand other Post Graduates

Prediction of stature and theircorrelation based on handlength of population at andaround Davangere

Jan 2013 V care life science-An internationalindexed journal

Forensic medicineand Toxicology

Dr.Sunil S Kadam,Dr.RavishankarAssistant ProfessorDept of Anatomy,RIMS, Raichur

Correlation of Splenic lengthwith the height of an individual-A cross sectional study

Published Jan-June2013, vol 13,No 1

Medicolegal update-An internationalindexed journal


Dr.Nagesh KuppastAssistant Professor

Credibility of Public length,Ischium length and Ischio-Pubic index in Identificationof gender

Published July-Dec 2012 vol 6,No 2, 115-118.

Indian journal ofForensic Medicineand Toxicology-Anindexed journal


Dr.Nagesh KuppastAssistant Professor

Calculation of Regressionequation for Estimation ofStature from Ulna Length

Published Jan-June2013 vol 6,No1

Medico Legal update-An Internationalindexed journal



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STUDENT’S ACTIVITY&ACHIEVEMENTS

strong impression. The against team werevictorious, for their commendable confidence andspeaking skills which fortified their reasons well.The best speaker award was given to Sneha of 2ndYr, and Sonali of 1st year as the 2nd best speaker forbrilliance in fluency and retaliatory skills.And as forthe topic, like Joseph Joubert rightly said, “It isbetter to debate a question without settling it than tosettle a questionwithout debating it.”

ICMR STS project titled “Study of carriers ofPseudomonas aeruginosa, Klebsiella spp. andAcinetobacter spp. Among health care workersfrom intensive care units in a tertiary care hospitalby Mr. Jayanth, under the guidance of Dr. Yogeshbabu.K.V. has been accepted.

ICMR STS project titled “Prevalence of burnwound infections with aerobic and anaerobicbacteria and their antimicrobial susceptibilitypattern at tertiary care hospital byMr.Ashrith Bhatt,under the guidance ofDr.Vinodkumar C.S. has beenaccepted.

Recipients as graduates. Dr. ShamanurShivashankarappa, Honorable secretory, BapujiEducation Association, graced the occasion anddelivered his presidential address. Governingcouncil member of BEA and chairman of MBAcollege Sri A.S.Veeranna was also present on theoccasion. Dr. Jayadutt Pawar represented the classof 2007 and shared his thoughts and experienceabout the college. Dr.Arun KumarAjjappa, Prof &HODAnesthesiology delivered the Vote of thanks.The programme concluded with the NationalAnthem. The proceedings of the programme wereconducted by Dr. Kavita G.U. Prof. Dept ofPathology and Dr. Sunita Kalsurmath, AssociateProf. Dept of Physiology. Parents of graduates,graduates and staff members of SSIMSRC alsoattended the function.Dinnerwas hosted for parentsof graduates, graduates and staff who graced theoccasion.

COVER STORY

Duel of the Minds. Desmond Tutu once said, don'traise your voice, improve your argument. Thisquote highlights the importance of good healthydebates which help put forth ideas withoutunnecessary emotional agents. On 19th of February2013, students and staff of SSIMS&RC werewitness to a duel of minds, a debate on the topic“Celebrities make bad role models”. 2 teamscomprising 4 members per team competed againsteach other listing out the pros and cons of theinfluence of celebrities on the masses in general.Both teams showed exceptional debating skills withfierce exchange of words making sure they putacross their opinion to not only the judges, but alsothe audience in the auditorium who activelyparticipated in the competition. The audience askedeach speaker a question regarding the topic and hisor her speech expecting an answer which wouldjustify their stance in the topic effectively. Speakersfrom the "for" team supporting the topic showedpoise and had good arguments, but against a muchmore formidable opponent, they couldn'tmake a

S.S. Institute of Medical Science and ResearchCentre, Davangere, organized the 2nd graduationday for the class of 2007 at the college premises on09-03-2013. The programme started with PhotoSession and procession of the Graduates, Heads ofall the Departments, Vice principals, Principal,Chief Guest & Guests of Honour followed byInvocation. Principal Dr P Nagaraj welcomed thegathering. Chief guest Dr. D.Prem Kumar,Registrar, RGUHS, Bangalore addressed thegathering and distributed the certificates to thegraduates. Heads of the Departments handed overthe certificates to the individual subject toppers.Hippocratic oath was administered by Dr.Shashikala P, Vice Principal and Prof & HOD ofPathology. Dr. Ravindra Banakar, senate andSyndicatememberRGUHS, declared the certificate

2ND GRADUATION DAY CELEBRATIONAT SSIMSRC:


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STUDENT UNION 2013 - INAUGURATION

On the beautiful and colourful day of Holi, 27thMarch was the inaugural function of Student Union2013. The programwas inaugurated by Chief GuestH.R.Chandrashekhar, FormerPrincipal,JJMMC,Davangere by lighting the lamp along with ourPrincipal,Dr. P.Nagaraj, Chairmanof Student

Union 2013, Dr Manjunath.J and the Chairmanof.various other committees. It was followed by ablend of various cultural programs which includedDance, Skit, Poetry and the performance of our veryown College Band- LUCID DREAMS. As a wholethis program being the first was a grand success onthe part of the newStudentUnion

StudentUnion 2013

ORIGINAL ARTICLE

“Assault on doctors” Nowadays (Commonest Scenario).

Dr. G. M. Raju.Associate professor,Department of Forensic Medicine and Toxicology,

M.B.B.S., M.D

ABSTRACT:

INTRODUCTION:

Patient's attender assault the treating doctor is thecommonest scenario. Nowadays this has been verymuch highlighted in the print & visual media. Butstill this problem is being continued in goodrepututed hospitals. When patients consult a doctorfor his illness, there is a healthy doctor patientrelationship with mutual trust that is essential forsuccessful management. Seldom senior doctors arealso attacked even in their own private hospitals.And here are some suggestions for the prevention ofthe situation. Prevention is better than gettingassaulted.

Key Words: Illness; assault; doctors- patientrelationship;

Assault on doctors now a day has become a commonscenario in most of the hospital. i.e highlighted inthe print & visual media. And the causes for suchsituation can arise from many sources, some ofwhich are:1)Doctors.2)Hospital authorities.3) Patient's attenders.4) Illness factors.

DOCTORS:It is the doctor's duty to ensure that every patient isgiven due care e.g: case (Dogra & Rudra, 2005).One of the reasons for misunderstanding betweenthe doctor and the patient is lack of propercommunication. The doctor may feel that I amperforming the best care in existing circumstancesbut if that is not appreciated by the attenders, andthen it is useless (Mathiharan&Patnaik, 2006).

Body language of the doctor matters a lot whiletreating any patient. Doctor's version is that they arebusy in treating the patient and they have little timeto spare for the attenders. Doctors sometimesmisinterpret the attender's behavior as beingauthoritative and react with anger for beingdominated, leading to heated arguments. One oftenmade remark is that the doctor does not bother toattend to the patient or to arrange alternativeconsultant when requested. Some doctors giveinstructions to the staff nurse, from their place byphone, without even seeing the patient (Parikh,2004).

Prolonged duty hours and excessive work loadmake the doctors exhausted leading to tiredness andmood changes (Chandrashekharan, 1999).Unrestricted entry of attenders into the Emergency,ICU wards and treating area leads to chaoticatmosphere there. Both of these lead to inefficiencyinwork.

Hospital authorities:


12


Delegating the responsibility of managing a busyemergency ward by junior doctors alone withoutadequate supervision by seniors' is troublesome e.g.case (Gupte, 2005).

Not providing the minimum expected facilities tothe doctors for treating the patient hinders theperformance of doctors (Chandrashekharan, 1999).Seldom the attending staff nurse and theparamedical staff can also induce or aggravate theexisting problem.

They have very high expectations about qualityand time taken for improvement of patient. Theywant complete and quick improvement. Some ofthem will be in an emotionally charged state,especially, anxious about the diagnosis andprognosis of patient's illness (Chandrashekharan,1999). This leads to persistent enquiries with thedoctors & staff nurse which is irritating. Attendersexpect to be periodically updated about patient'scondition. After having paid huge amounts for thetreatment attenders & relatives are worried aboutthe proper implementation of treatment. In theunfortunate event of death of the patient, grief inrelatives is expressed as anger (Jaiswal, 2004). Realor perceived negligence on part of doctor leads toanger by relatives.

There may be difficulty in diagnosis of the illness(Fauci, 2008). Patient may not respond to treatmentas expected.Unexpected complications can crop up.There may be sudden deterioration in patient'scondition. Patient may require additionalinvestigations or surgeries than planned earlier. Allthis if not communicated properly may lead toanger.

Achange is needed in the attitude and behavior of allparties concerned.

Doctors should never assure 100% cure andavoiding negligence (Reddy, 2004). Each patient

Patients and theirattenders:

Illness factors:

DISCUSSION:

Doctors:

should be adequately examined, investigated andtreated. If a patient is not improving, doctors shouldask the question “Is there anything else to be done tothis patient?” update recent medical knowledge ordiscuss with colleague & do not criticize theprofessional ability of another doctor in presence ofthe patient.Doctors should not only handle the illness in thepatient but handle the attenders also. It is thedoctor's responsibility to explain to the attenders thenature of the illness, investigations needed, line ofmanagement and probable course and outcome in away that is understood by them.Periodic updating of the condition of the patient tothe attenders is necessary (Rao, 2000).Overconfidence or toomuch cautiousness in patientcare is to be avoided.

A realistic appraisal of the situation and its clearcommunication is needed. Whenever appropriateattenders should be involved in decisions aboutpatient care andmanagement.

Doctors may become insensitive to the needs of thepatient and attenders. Each case has to be handledwith due care and enthusiasm as the other.Commitment to the profession is the need of thehour.

Doctors should cultivate and maintain empathywhile interacting with them. Doctors should firsttreat on humanitarian grounds. Do not instruct thenurse to give any injections without doctor'ssupervision. Empathy is the capacity to put oneselfin the other person's position and understand histhoughts and feelings about the situation(Chandrashekharan, 1999).

Patience play vital role for doctors & staff nurses.Anger should not be respondedwith anger. Here liesthe importance of psychology and psychiatry inmedical curriculum which can enable buddingdoctors to develop proper communication skills andempathy..Nurses should be trained better to handle thepatient's emotion and attender's doubts.


13


Paramedical staffs are also given some training inhandling the situation gently. Attending nursesshould be well trained in such situations so thatwhile assisting the treating physician, they shouldbe able to manage the attenders. Nurses are giventraining in such a way that even in the absence oftreating Physician, they should be able to handle byexplaining the details about the patient to theattenders. And sometimes soothing words to thepatient and to the attenders will make the situationbit easy going for one and all. The same can be doneto the other paramedical staff also.

If the doctors feel that they are too busy to give timeto the patient's relatives, can we think of a LiaisonOfficer? Who can brief the relatives about theessential aspects of the case periodically? For thisthe liaison officer should be trained in medicalaspects. The cost of treatment will increase if aliaison officer is employed. He can at best onlysupplementary to the doctor but cannot replace thedoctor patient relationship. They can reduce theburden on the doctors if used appropriately.

Duty roster and hours should be plannedscientifically so that there is less scope for physicaland psychological exhaustion in the treating doctors& staff nurse round the clock (Indian MedicalCouncil Regulations, 2002).

There should be adequate supervision and supportfor the junior doctors by the senior doctors.

A representative of the hospital from theadministrative side should be available round theclock to sort out non medical issues. Entry in to theemergency, ICUwards and also treating area shouldbe restricted and managed by efficient securitypersons. Basic minimum facilities for patient careshould be provided. To appoint adequate staff nurseas prescribed by the Nursing Council. (Potter-Perry,2006). One Nurse should take care of two patients,one ward boy for four patients care. In addition,training the nurses and other paramedical staff inhandling such sensitive issues will also be anadditive support to prevent such situations.

Hospital authorities:

Patient's attenders:

Conclusion:

REFERENCES:

They should have realistic expectations aboutcourse and outcome of the illness in the patient.They should see that their behavior would notimpede treatment. Getting emotionally charged andtaking law into one's own hands is of no use. Suchrepeated incidents make the doctors overcautiousand result in not taking up a case for treatment. It hasto be appreciated that medicine is not an exactscience and doctors have their limitations (Jaiswal,2004). Whether negligence has occurred or notshould be decided by competent authorities and lawshould be allowed to take its course.

This is an effort to identify the problems arising inIndian scenario, where Doctors are being assaultedvery frequently. The origin of the problem may befrom Doctors & staff nurse body language,misinterpreting relatives' - behaviour. Prolongedduty hours being posted by the hospital authorities,unrestricted entry of attenders and presence of onlyJunior Doctors without adequate supervision bySenior Doctors add to the burning factor. Not onlythese but also high expectations and complete,quick improvement from patient and their relatives,with illness factor are adding toAssault onDoctors.

Therefore, theDoctors should ensure that there is nonegligence on their part to avoid suchcircumstances. He should maintain good rapportwith patient as well as relatives. For this hospital,authorities can have a Liaison Officer. Moreover,duty roaster should be planned round the clock withSenior a doctor that minimizes the scope forphysical and psychological exhaustion on treatingdoctor.

1.

2.

Parikh CK (2004). Parikh's Textbook of MedicalJurisprudence Forensic Medicine and Toxicology, 6th ed.,NewDelhi; CBSpublisher.Fauci (2008). Disorders of Sexual development. Harrison'sPrinciples of InternalMedicine. 17 th edition.3.

4.

McGraw-Hill's. New York. Indian Medical CouncilRegulations (2002). (Professional conduct, etiquette andethics)Jaiswal JVN (2004). Doctors in the Dock;1st ed.,New

Delhi; Jaypee.


14


5.

6.

Mathiharan KA, Patnaik (2006). Modi's MedicalJurisprudence and Toxicology. 23rd ed. New Delhi;Butterworth pp.105-23.ReddyKSN (2004). The essentials of forensicmedicine andtoxicology. 23rd edn.

7.

8.

9.

Sugunadevi K. Rao NG (2000). Textbook of ForensicMedicine andToxicology; 1st ed.,NewDelhi;JaypeePotter-Perry (2006). Fundamental of Nursing. 6th ed.,

Mosby;Missouri pp. 631-46.Chandrashekharan R (1999). Textbook of Postgraduate

Psychiatry.

CONGRATULATIONS!!!!!The Principal and all the staff congratulates

Dr. VinodKumar C.S.for successfully completing his secondPhD from Rajiv Gandhi University of Health Sciences,Bangalore. This work was done at St John's Medical College,Bangalore under the guidance of Dr Srinivasa H, Professor,Department of Microbiology. He received the PhD certificatefrom former President of India, Dr. APJ Abdul Kalam

Dr. K.G. BasavarajappaProfessor & Head,Department of Microbiology for being elected as Vice President ofINDIANASSOCIATION OF MEDICALMICROBIOLOGISTSKarnataka Chapter for the year 2013-14

Dr. Prema PrabhudevProfessor & HODfor being selected as Vice President of OBG society,Federation of Obstetric and Gynecological Societies of India(FOGSI),Davangere branch.


15


CASE REPORTS

INTRODUCTION:Trigeminal neuralgia is an unilateral facial pain &has an annual occurrence rate of 3-5 per lakh people.It is characterised by lancinating, paroxysms of painin the lips, gums, cheeks or chin & usuallyprecipitated by physical triggers in the distributionof trigeminal nerve (fig.A).

Trigeminal neuralgia was treated for the first timeby alcohol injection into the nerve by Pitres in 1902,followed by Schloser in 1905. Percutaneoustransforamen ovale approach to trigeminal ganglionusing absolute alcohol was first introduced byHartelin in 1912. In early 1930's Kirschner began touse radiofrequency neurolysis of trigeminalneuralgia pain & later retrogasserian glycerolinjection done by Hakauson and percutaneousballoon compression byMullah in 1978. In additionto idiopathic trigeminal neuralgia, facial pain

resulting from terminal cancer or multiple sclerosismay also be treatedwith these approaches.

CASEREPORT:

PROCEDURE:

A 67 years old male patient diagnosed withidiopathic trigeminal neuralgia since 5 years &treated with multiple analgesic medication haspersistent pain with gradual increase in severity andrestrict ing his daily activit ies. Routineinvestigationswerewithin normal limits,MRI brainrevealed normal study; ruling out neurologicalcause, hence patient was taken up for trigeminalganglion block.

Consent was taken. The patient premedicated withanalgesic and anxiolytic. Patient was placed insupine position on the table with head in extendedposition, with C-arm radiography machine towardshead region. Under aseptic precaution, under localanaesthesia, entry point of needle was taken at 3cmlateral to the angle of mouth and directed 3cmanterior to external auditorymeatuswhen seen fromthe front of the face (fig.B).

Under fluoroscopy, oblique projection revealedmentonian arch which is upper internal quadrant tothe foramen ovale. Lateral projection is done tocalculate the insertion of cannula into the bonytunnel of the foramen ovale.The tip of the cannula isadjusted not to exceed 2mm in distance from the

DR. GIRIRAJ PATIL 1st year post graduate student, Dept of AnaesthesiaDR. ARUN KUMARAJJAPPA Prof & Head, Dept of Anaesthesia

Percutaneous Trigeminal Ganglion Block


16


plane of clivus. The direction of needle insertion isverified under fluoroscopy in submental, lateral &posterio-anterior view's. When the needle enteredthe foramen ovale, the fluoroscopy turned laterallyto reveal the needle direction towards the angleproduced by the clivus and the petrous ridge of theTemporal bone. The depth of needle inside theMeckels cave is verified in lateral view.After negative aspiration, upto 0.3ml of1%lignocaine was injected, the patient hadimmediate pain relief, confirming the diagnosis oftrigeminal neuralgia. This was followed byinjection of 0.4ml of glycerol. Post procedure, brainstem functions evaluated to determine if the localanaesthetic solution has not reached brain stem. Theprocedure was followed by placing the patient insitting position for 90minutes.

Trigeminal neuralgia is more common in females,most common from age 50-69 years, withpreponderance for right side of face. Mostcommonly found inmaxillary andmandibular

DISCUSSION:

division. There is no specific test to make adiagnosis of trigeminal neuralgia and a clinicalexamination including assessment of cranial nervefunction is mandatory. MRI brain is useful inexamining patient with neurological abnormalityand MRA to rule out any vascular lesion triggeringtrigeminal neuralgia.As the exact cause is not known, various treatmentmodalities are available. Medical treatmentremaining the mainstay of treatment. Surgicaldecompression and per cutaneous ganglion block isdone for patients, who do not respond topharmacological therapy or have worsening ofsymptoms or more frequent recurrences. Posttrigeminal ganglion block pain relief varies from91-97%.

:Percutaneous procedure involving transforamenovale trigeminal ganglion block are carried out tofacilitate acute pain relief. In our case, 5 monthfollowuphad revealed pain reliefmore than 90%.

CONCLUSION

INFORMATIVE ARTICLE

ACADEMYGUIDELINES FOR NAILDISORDERSGuidelines/Outcomes committee: Lynn ADrake MD.

Dr. Jagannath Kumar V Prof HOD, Department of Dermatology

Definition

Scope

Nail disorders include those abnormalities thataffect any portion of the nail unit. The nail unitincludes the plate, matrix, bed, proximal and lateralfolds, hyponychium, and some definitions includethe underlying distal phalanx. These structures maybe affected by heredity, skin disorders, infections,systemic disease, the aging process, internal andexternal medications, physical and environmentalagents, trauma, and tumors, both benign andmalignant.

Nail disorders comprise approximately 10% of alldermatologic conditions.Under certain

circumstances the space beneath the nail plate, asomewhat protected area, has been shown to harborboth fungal microorganisms and the scabies mite.With respect to fungi, such a reservoir could be asource of infection elsewhere in the person,particularly cutaneous spread to the feet in cases ofonychomycosis. Because of scratching, thesubungual presence of scabies may reinoculatepreviously treated skin and result in recurrence ofthe infestation. The nail unit may show specificchanges that are markers for a wide range ofsystemic disorders. These include collagenvascular, liver, renal, endocrine, cardiac, andneoplastic diseases.Nail disorders respond very slowly to therapybecause of the inherent slowgrowth of the nail unit


17


because of poor absorption and impaired deliveryof dedications to the diseased portion andmedications of the nail unit. Although there aremany medical treatments currently available for thecontrol of nail disease, often surgical techniquemaybe concomitantly utilized to achieve a maximumbenefit. Congenital anomalies may require surgicalcorrection.Diagnostic criteria

General medical history, onset, duration,progression of disorders, location.

Precipitating and/or alleviating factors,Trauma, other cutaneous and systemic disorders.

Nail cosmetics and procedures.Post and present medications and drug

allergies.

Vascular compromise, bleeding diathesis,collagen vascular disorders

MedicationsDiabetesmellitus,ArthritisPast infections, Past surgical procedures

Nail cosmetics may need to be removed foradequate examination. In some instances, all 20nailsmayneed to be examined.

General physical examination, asappropriate

Dominant hand and changes in theproximal and lateral nail fold

Involvement of one or more fingernails,one or more toenails, and presence or absence ofbony abnormalities.

Thickness, consistency, color, surfacechanges, onycholysis (separation of nail plate fromnail bed)

Nail changes according to whichcomponent of the nail unit is involved (plate, matrixbed, hyponychium folds, phalanx)

Other areas including skin, hail, andmucous membranes when indicated. Particularattention should be paid to hair abnormalities,mucous membrane and dental changes, andpresence or absence of immunologic disorders.The peripheral neurovascular status of the patientwhen indicated.

A.Clinical historymay include:1.

2.

3.4.

B. Clinical history for patients undergoing nailsurgery

1.

2.3.4.

C. Physical examination:

1.

2.

3.

4.

5.

6.

a.Diagnostic tests:Microscopic examinationi.ii.iii.

2. Culturei.

ii. iii.3. Nail unit compression and transillumination4. In vivo nailfold capillary microscopy5. Nail clippings

Treatment

a)

b)

c)

d)

1.Potassium hydroxide (KOH) testTzanck smears for viral changesStrains for bacteria (Gram Stain)

Fungal advisable to use bothcycloheximide containing medium as well asmedium without cycloheximide because yeast andnondermatophyte mold may not grow in thepresences of cycloheximide.

Bacterial Viral

A specific diagnosis should be established beforecommencing therapy whenever possible, Topical,intralesional, and/or systemic therapy is indicatedfor many nail disorders. Other modalities such assurgery, cryoptherapy, radiation, phototherapy andlaser may be indicated. Patients should be advisedthat treatment of nail disorders is often a prolongedand gradual process.Medical:

Topical therapy includes: Antifungals,antibiotics, corticosteroids, Salicylic acid, Tar,Anthralin

Systemic therapy includes: Antifungals,antibiotics, corticosteroids, corticosteroids,5-FluorouracilIntralesional therapy includes:

Corticosteroids, BleomycinSurgical procedures; Nail plate avulsion, Nail

matrix exploration, Partial or total matricectomy,Crescent-shaped biopsy of the proximal nailfold,Resection of the nail bed, Perforation of the nailplate for the relief of subungual hematoma,Cryosurgery, Laser surgery.e) Post operation care: Topical and or systemicantibiotics, Bulky loose sterile dressing

References: Journal of the American Academy ofDermatology,


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KARLLANDSTEINER (June 14, 1868 June 26, 1943)

ByDr. Sindhuja A& Dr. Kavyashree H M, Dr. Vidya M Nadiger, Dr. D V Deshpande, Department of Physiology

Karl Landsteiner was born in Vienna on June 14,1868. His father, Leopold Landsteiner, a doctor oflaw, was a well-known journalist and newspaperpublisher, who died when Karl was six years old.Karl was brought up by his mother, Fanny Hess, towhom he was so devoted that a death mask of herhung on his wall until he died. After leaving theschool, Landsteiner studied medicine at theUniversity of Vienna, graduating in 1891. Evenwhile he was a student he had begun to dobiochemical research and in 1891 he published apaper on the influence of diet on the composition ofblood ash. Returning to Vienna, Landsteinerresumed his medical studies at the Vienna GeneralHospital. In 1896 he became an assistant underMaxvon Gruber in the Hygiene Institute at Vienna. Evenat this time, he was interested in the mechanisms ofimmunity and in the nature of antibodies. From1898 till 1908 he held the post of assistant in theUniversity Department of Pathological Anatomy inVienna. Here, Landsteiner worked on morbidphysiology rather than on morbid anatomy. In 1911he becameProfessor of PathologicalAnatomy in theUniversity of Vienna. Up to the year 1919, aftertwenty years of work on pathological anatomy,Landsteiner with a number of collaborators hadpublished many papers on his findings in morbidanatomy and on immunology.

He discovered new facts about the immunology ofsyphilis, added to the knowledge of theWassermannreaction, and discovered the immunological factorswhich he named “Haptens”. It then became clearthat the active substances in the extracts of normalorgans used in this reactionwere, in fact, “Haptens”.He also showed that the cause of poliomyelitis couldbe transmitted to monkeys by injecting into themmaterial prepared by grinding up the spinal cords ofchildren who had died from this disease, .Landsteiner made numerous contributions topathological anatomy, histology and immunology;all of which showed, not only his meticulous care inobservation and description, but also his biologicalunderstanding. His name will no doubt always behonoured for his discovery of the blood groups in1901, for which, he was given the

. In 1909, heclassified the bloods of human beings into the nowwell-known A, B, AB, and O groups and showedthat transfusions between individuals resulted in thedestruction of blood cells only when a person istransfused with the blood of a person belonging to adifferent group and notwith identical group. Earlier,in 1901-1903, Landsteiner had suggested that,because the characteristics which determine theblood groups are inherited, the blood groupsmay beused to decide instances of doubtful paternity, but oflate the MN system is preferred. In 1919-1922, hepublished twelve papers on new haptens, which,on conjugation with proteins which were capable ofinducing anaphylaxis and related problems. He alsoworked on the serological specificity of thehaemoglobins of different species of animals. Incollaboration with Levine and Wiener he studiedbleeding in the new-born, leading to the discoveryof the Rh-factor in blood, which relates the humanblood to the blood of the rhesus monkey.Until the end of his life, Landsteiner continued toinvestigate blood groups and the chemistry of

Nobel Prize forPhysiology or Medicine in 1930


19


antigens, antibodies and other immunologicalfactors that occur in the blood. It was one of his greatmerits that he introduced chemistry into the serviceof serology.Rigorously exacting in the demands he made uponhimself, Landsteiner possessed untiring energy.Throughout his life he was always makingobservations in many fields other than those inwhich hismainworkwas done (hewas, for instance,responsible for having introduced dark-field

illumination in the study of spirochaetes).By nature, somewhat pessimistic, he preferred tolive away frompeople.In 1939, he became Emeritus Professor at theRockefeller Institute, but continued to work asenergetically as before, keeping eagerly in touchwith the progress of science. It is characteristic ofhim that he died with pipette in hand. On June 24,1943, he had an heart attack in his laboratory anddied two days later in the hospital of the Institute inwhich he had done such distinguishedwork.

SSIMS-ites Congratulates the following staff for their New Post

STAFFDr.Veerendra H.SDr. Nitin.A.BandekarDr. Manjula.ADr.Manjunath SarathiDr.Sanjay.DDr.Deepti PruthviDr. Raghukumar.K.GDr.B.K.VenkateshDr. Ajith.K.M

DEPARTMENTGeneral Surgery / UrologyGeneral Surgery / Plastic SurgeryPathologyPediatricsPediatricsPathologyMicrobiologyENTENT

PROMOTEDASAssociate ProfessorProfessorAssociate ProfessorAssociate ProfessorAssociate ProfessorProfessorAssociate ProfessorAssociate ProfessorAssociate Professor

SSIMS-ites Welcome the following newly joined staff to its family

STAFFDr Gopalpur S. V.Dr Vijay JattiDr Shobha JattiDr Swamy Rajeev

DEPARTMENTDermatology

AnatomyPsychiatry

Forensic Medicine and Toxicology

DESIGNATIONSenior ResidentAssociate ProfessorAssistant ProfessorAssistant Professor


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Documents

SSIMS Times Vol 8, Jan-Mar 2013