iosr-JDMS   Volume-13 ~ Issue-11 ~ November-2014

Abstract: The right Lung classically has one oblique fissure and one horizontal fissure and Three Lobes namely Upper, Lower, and middle Lobes. Variations in the lung fissures and lobes have been described by many authors which have got their Surgical and Radiological importance. During Routine dissection in the Department of Anatomy, S.V. Medical College, Tirupati, we encountered an Incomplete oblique Fissure, Absence of Horizontal fissure in the Right Lung of an Adult male Cadaver. Anatomical Knowledge of the variations of Fissures of Lung are important for C.T. Surgeons performing Lobectomies, and Radiologists interpreting X-Rays. Keywords: Right Lung, Oblique Fissure, Horizontal Fissure, Incomplete lobes

[1]. Ajay Ratnakarrao Nene, Krishna Swami Gajendra, Manchiraju Venkata Ramananda SarmaLung lobes and fissures: a morphological Study October 24, 2011 doi:10.2399/ana.10.005 International journal of Experimental and Clinical Anatomy
[2]. CRAIG SR, WALKER WS (1997) A proposed anatomical classification of the pulmonary fissures. J R Coll Surg Edin, 42: 233-234.
[3]. Godwin JD,Tarver RD.Accessory fissures of the lung. AJR Am J Roentgenol.1985;144:39-47.
[4]. Hayashi K,Aziz A,Ashizawa K,Hayashi H,Nagaoki K,Otsuji H.Radiographic and CT appearances of the major fissures.Radiographics.2001;21(4):861-874.
[5]. JACOB, S. M. & PILLAY, M. Variations in the inter-lobar fissures of lungs obtained from cadavers of South Indian origin. Int. J. Morphol., 31(2):497-499, 2013.

Abstract: The study was carried out to assess the association between HDL Cholesterol levels and Prostate cancer. In the present study the total cholesterol, Triglycerides, LDL, HDL and VLDL in Prostate cancer patients was assayed and compared with the same parameters in normal subjects. The blood lipid levels were assayed by Enzymatic CHOD/ POD method using commerically available assay kits supplied by Beacon Diagnostic Ltd.

[1]. Batty GD,Kivimaki M,Clarke R, Davey G, Shiplay MJ. Modifiable risk factors for prostate cancer mortality in London; forty years of follow up the white hall study. Cancer causes control .2011: 22;311-8
[2]. Byron H, Margaret G, Pessy R, Jonathan D,Jessica S,Angela H et al.,Dysregulation of cholesterol homeostasis in human prostate cancer: Cancer Research. 2013 : 73 ;1211
[3]. Darnell JE Jr .STATs and gene regulation. Science 1997; 277:1630–1635
[4]. Dijkman GA, Debruyne FM. Epidemiology of prostate cancer. Eur Urol. 1996;30:281–295
[5]. Godwin O. Ambiguity of plasma cholesterol levels as a biomarker of prostate cancer; Molecular Biomarkers and Diagnosis; 2012; 3;5.

Abstract:A prospective study was undertaken to determine the incidence of hyperprolactinemia in a group of infertile women, and to determine the association with abnormal menstrual function and presence or absence of galactorrhea. Among 100 infertile patients, 10(10%) had elevated levels of serum prolactin. 2 (2.0%) patients with hyperprolactinemia had menstrual irregularities and galactorrhea. With this study we found that hyperprolactinemia is a common finding in the infertile population, when they present with menstrual irregularities and galactorrhea.

Keywords: galactorrhea, infertility,, irregular menstruation, prolactin

[1]. Luciano AA, clinical presentation of hyperprolactenemia. J.Reprod Med 1999; 44 (suppl 12):1085-1090
[2]. Asa SL,Ezzat S. The pathogenesis of pituitary tmours. Nat Rev Cancer 2002; 2: 836-49
[3]. Bouchard P, Lagoguey M, Brailly S, Schaison G. Gonadotropin-releasing hormone pulsatile administration restores luteinizing hormone pulsatility and normal testosterone levels in males with hyperprolactinemia. J Clin Endocrinol Metab. 1985;60(2):258–262. doi: 10.1210/jcem-60-2-258.
[4]. Lecomte P, Lecomte C, Lansac J, Gallier J, Sonier CB, Simonetta C. Pregnancy after intravenous pulsatile gonadotropin-releasing hormone in a hyperprolactinaemic women resistant to treatment with dopamine agonists. Eur J Obstet Gynecol Reprod Biol. 1997; 74(2):219–221. doi: 10.1016/S0301-2115(97)00091-2.
[5]. Billar BM,Luciano A.Crosignani PG,et al. Guidelines for the diagnosis and treatment of hyperprolactinemia. 1999. 44 (suppl12)); 1075-1084.
[6]. Hyperprolactinemia Michael O. Thorner, MD,MB BS, DSc, FRCP, MACP David C. Harrison Medical Teaching Professor of Internal Medicine, University of Virginia Health System, Endocrinology and Metabolism, Box 801411, Charlottesville, VA 22908

Abstract:Direct inguinal hernia presenting as a scrotal abdomen is rare. Amongst the hernias in men, only 40 % of cases are direct. Out of these, complete scrotal hernias develop less than 5 %. We report a case of direct hernia that presented as a huge scrotal swelling. The patient is a case of aspergilloma of the right lung, who presented with a hernia, which was repaired with a mesh. Association of chronic cough with aspergillous lung disease might be the reason for this rare occurrence. To conclude,direct hernia can also cause large scrotal hernia especially in patients with chronic lung disease like tuberculosis, COPD and aspergillosis. Primary treatment of lung disese follwed by hernia repair with proper posterior wall strenghtening and mesh repair is the treatment protocol to be followed.

Key words:inguinal hernia , scrotal abdomen , direct hernia , aspergilloma with hernia

[1]. Anaissie EJ, McGinnis MR, Pfaller MA. Clinical Mycology. Churchill Livingstone. (2009) ISBN:1416056807
[2]. Müller NL, Franquet T, Lee KS et-al.Imaging of pulmonary infections.Lippincott Williams & Wilkins. (2007) ISBN:078177232X.
[3]. AHMED HOSSAIN et-al,pulmonary aspergilloma, J MEDICINE 2009; 10 : 149-151 [4]. Necdet ÖZALP, Ali Osman AKTEN, Mesut TEZ Department of 5th General Surgery, Ankara Numune Teaching and Research Hospital, Ankara, Turkey.Giant scrotal hernia in an elderly man. Eur J Surg Sci 2011;2(1):23-25
[5]. Vasiliadis K, Knaebel HP, Djakovic N, Nyarangi-Dix J, Schmidt J, Büchler M. Challenging surgical management of a giant inguinoscrotal hernia: report of a case. Surg Today 2010; 40: 684-7

Abstract: Supernumerary teeth or hyperdontia is a common developmental alteration. It may be defined as any teeth or tooth substance in excess when compared to the normal dental formula.1 The reported prevalence of this abnormality varies between 0.1% - 3.8% in permanent dentition in comparison with 0.3% - 0.6% in deciduous dentition. Higher frequency is seen in males than in females.2 Supernumerary teeth can occur in the maxilla, mandible or both, but majority are found in the maxilla, 90-98%. Supernumerary premolars are considered as second most common supernumerary tooth after mesiodens. However, their prevalence is quite low in mandibular premolar region, 0.14% - 0.9%.

[1]. Orhan A I, Ozer L, Orhan K.Familial occurrence of non-syndromal multiple supernumerary teeth. Angle Orthod. 2006; 76(5):891-7.
[2]. Solares R, Romero MI. Supernumerary premolars: a literature review. Pediatr Dent. 2004; 26(5):450-8.
[3]. O'Dowling, I.B. Supernumerary pre-molar teeth in the mandible. JIDA 2009; 55(6):293-5
[4]. Cochrane S M, Clark J R, Hunt N P. Late developing supernumerary teeth in the mandible. Br J Orthod. 1997; 24: 293-6.
[5]. Hyun H K, Lee S J et al. Non-syndromic multiple mandibular supernumerary premolars. J Oral Maxillofac Surg. 2008; 66: 1366-9.

Abstract: Background: Rhinitis is inflammation of nasal mucosa leading to rhinorrhea, nasal obstruction, sneezing, itching etc. Although considered trivial, it has major impact on quality of life. The objective is to study the prevalence of Allergic rhinitis and non Allergic rhinitis in hospitalized patients with special reference to non respiratory cases and the association of perinatal events with Allergic rhinitis if any. Material And Method: An observational study was conducted among patients (aged 1 year to 14 years) admitted to S.C.B. medical college during study period of January 2014-June 2014. Patients were enquired as per a predesigned questionnaire as per Allergic rhinitis and its impact on asthma (ARIA) guideline and were investigated to establish Allergic etiology.

[1]. C. Bachert, Persistent rhinitis – allergic or nonallergic, Allergy 2004: 59 (Suppl. 76): 11–15

[2]. 2.Quillen David M, and Feller David B, Diagnosing Rhinitis: Allergic vs. Nonallergic, American Family Physician 2006;73: 1583-90

[3]. Blaiss MS. Allergic rhinoconjunctivitis: burden of disease. Allergy Asthma Proc. 2007;28:393–397

[4]. Skoner DP. Allergic rhinitis: definition, epidemiology, pathophysiology, detection, and diagnosis. J Allergy Clin Immunol. 2001;108(suppl):S2–S8

[5]. Bousquet J,Van-Cauwenberge P, Khaltaev N,and the ARIA group. Allergic Rhinitis and Its Impact on Asthma. J Allergy Clin Immunol 2001;108(suppl):S147-S333

[6]. The International Study of Asthma and Allergies in Childhood (ISAAC) Steering Committee. Worldwide variation in prevalence of symptoms of asthma, Allergic Rhino-conjunctivitis, and atopic eczema: ISAAC. Lancet 1998;351:1225-32.

Abstract: Congenital Diaphragmatic Hernia (CDH) is defined as the herniation of abdominal contents through an orifice in the diaphragm. Most common type of CDH is the Bochdalek hernia; other types include Morgagni hernia, posterior hernia and Central hernia of the diaphragm. Defect in the diaphragm allows the abdominal organs to push into the proper lung formation leading to hypoplastic lungs and abnormal vessels that cause respiratory insufficiency and persistent pulmonary hypertension with high mortality. The incidence is 1 in 2,500 live-births. This case report is about a full term male baby who died of respiratory distress within a few hours of birth. On dissection, a left-sided posterolateral diaphragmatic hernia with associated intestinal malrotation was found, suggestive of Bochdalek's hernia.
Keywords: Dextrocardia, Diaphragmatic hernia, Mediastinal shift, Pulmonary hypoplasia.

[1] Adzick NS, Harrison MR, Glick PL, Nakayama DK, Manning FA, de Lorimier AA. Diaphragmatic hernia in fetus: prenatal diagnosis and outcome in 94 cases. J Pediatr Surg. 1985; 20: 357–361.
[2] Arvind Sehgal, Jagdish Chandra, Varinder Singh, A. K. Dutta and Deepak Bagga. Indian J Chest Dis Allied Sci 2002; 44: 57-60.
[3] Furuta Y, Nakamura Y, Miyamoto K. Bilateral congenital posterolateral diaphragmatic hernia. J Pediatr Surg. 1987; 22: 182–183.
[4] Clark RH, Hardin WD Jr, Hirschl RB, Jaksic T, Lally KP, Langham MR Jr, Wilson JM: Current surgical management of congenital diaphragmatic hernia: a report from the Congenital Diaphragmatic Hernia Study Group. J Pediatr Surg 1998, 33:1004-1009.
[5] Kufeji DI, Crabbe DC. Familial bilateral congenital diaphragmatic hernia. Pediatr Surg Int. 1999; 15: 58–60.

Abstract: A community-based, cross-sectional observational study was conducted during August 2013 – November 2013 to assess breastfeeding practices in Bankura District, West Bengal, India. In total 350 women were selected for the study. Among them 70.8% were found to be full breastfeeders, 24% were mixed breastfeeders ( mixed feeders ) and 5.2% were found to be practicing only artificial feeding ( formula and animal milk ). The main factors observed in this study interfering with exclusive breastfeeding were apprehension that the breast milk was not adequate for the baby, cesarean delivery and neonatal hospitalization. The attitude of the study population towards exclusive breastfeeding was however found to be positive in general.
Key Words: Breastfeeding; cross-sectional study; observational study; Exclusive breastfeeding; Artificial feeding; India.

[1]. Sinhababu A, Mukhodhyay D.K, Panja T.K, Soren A.B, Mondal N.K, Biswas A.B. Infant and young child feeding practices in Bankura district, West Bengal, India, J. Health Popul Nutr. 2010;28(3):294–99.
[2]. UNICEF report on current status of Baby Friendly Hospital Initiative [http://www.unicef.org/programme/ breastfeeding/assests/statusbfhi.pdf]
[3]. Li R, Hsia J, Fridinger F, Hussain A, Benton-Davis S, Grummer-Strawn L : public beliefs about breastfeeding policies in various settings. J. Am Dief Assoc 2004;104:1162-1168.
[4]. Binnns CW, Scott J A : Breastfeeding : Reasons for starting, reasons for stopping and problems along the way. Breastfeed Rev 2002,10:13-19.
[5]. World Health Organization, Global strategy for Infant and young child Feeding. Geneva: World Health Organization 2003. 41p.

Abstract: Aims: o To discuss the role of C.T. scan and M.R.I. in evaluation of primary malignant bone tumors.
o To determine the imaging characteristics of different primary malignant bone tumors.
o To correlate imaging with surgical and histological findings.
Materials and methods: This prospective study of 13 cases was conducted in Shri M. P. Shah Medical College and G.G .Hospital, Jamnagar. Observations: A total of 13 patients with primary malignant bone tumors were evaluated primarily with plain radiography followed by C.T. scan and M.R.I .Contrast study was performed as and when deemed necessary. Following observations were made: There were 4 cases of Ewing's sarcoma, 5 cases of osteosarcoma, a single case of each – bone lymphoma, malignant haemangioendothelioma, malignant giant cell tumor and chondrosarcoma. CT scan was better than MRI in evaluation of cortical destruction in 2 cases and both were equally efficient in 10 cases. Matrix mineralization was present in 5 cases and CT scan detected it with higher accuracy.MRI was better for evaluation of extent of bone marrow involvement in 5 cases and equal to CT scan in 5 cases. The soft tissue extent of tumor was better evaluated with MRI in 7 cases and both modalities were equally good in 6 cases. Joint involvement was present in 4 cases and was better evaluated with MRI in all of them.MRI was superior in evaluation of neurovascular bundle in 9 cases and equal to CT in 4 cases. Although MRI could demonstrate different components of tumor, there was no difference in signal intensity patterns of different histological types of tumors. Conclusions: MRI is the preferred modality to image musculoskeletal tumors and should be obtained after radiographic evaluation. Its multiplanar imaging capability helps delineation of tumor and its extent in bone and soft tissues with high contrast resolution. It is an excellent modality to determine neurovascular bundle involvement, joint involvement, local extent and staging.
Key words: CT scan, MRI, Imaging, malignant bone tumors.

[1]. George C Nomikos, Mark D Murphey, Primary Bone tumors of lower extremities Radiologic clinics of North America 2002 ;40:971-990.
[2]. Zirnrner WD, Berquist TH. McLeod RA, et al. Bone tumors: Magnetic resonance Imaging versus computed tomography. Radiology 1985; 155:709-718.
[3]. Wolfgang Schima, Gabriele Amann Preoperative staging of osteosarcoma Efficacy of MR imaging in detecting joint involvement AJR 1994 ;163 :1171-1175
[4]. Thomas H Berquist, Magnetic resonance Imaging of Primary skeletal neoplasms, Radiologic clinics of North America March 1993 31;2 :411-423.
[5]. George C Nomikos ,Mark D Murphey,Primary Bone tumors of lower extremities Radiologic clinics of North America 2002;40:971-990.

Abstract: Traditional caries management consisted of the detection of carious lesions followed by immediate restoration. Placing a restoration doesn't guarantee a sound future for the tooth. On the contrary, it will be the start of the restoration cycle in which the restorationwill be replaced several times. So a different management strategy is recommended. Based on a proper diagnosis of caries taken into an account, thedynamics and the activity of the caries should be determined. Caries risk should be determined before treatment is considered. The treatment goals in caries management should be to prevent new lesions from forming and to detect lesions sufficiently early in the process so that they can be treated and arrested by non-operative means. Such management requires skill and are time consuming. Best practices dictate that once the clinician has identified the patient's caries risk, therapeutic and preventive plan should be implemented to prevent the pathological challenge posed by the caries risk factors. This article reviews the caries management strategies in prevention and treatment.
Keywords: Dental Caries, Flourides, Prevention, Risk Assessment, Risk Factors.

[1] Mouradian WE, Wehr E, CrallJJ.Disparities in childrens's oral health and acess to dental care. JAMA.2000;284(20):2625-2631.
[2] Young DA, Featherstone JD, Roth JR, Curing the silent epidemic: caries management in the 21stcenturyand beyond. J Calif Dent Assoc.2007;35(10):681-685.
[3] Marsh PD.Microbiology of dental plaque biofilms and their role in oral health and caries.DentClin N Am.2010;54:441-454.
[4] Hara AT, Zero DT. The caries environment: saliva,pellicle,diet and hard tissue ultrastructure. Dent Clin N Am. 2010;54:455-467.
[5] Featherstone JD. The caries balance: the basis of caries management by risk assessment. Oral Health Prev Dent.2004;2(suppl 1):259-264.

Abstract: The objective of this study was to assess the outcome of patients managed laparoscopically with prediagnosis of gall bladder polyps. Methods: Study type: - Prospective. Study duration: - Six year Jan 2008 to December 2013 Study Place:-IGGMC Nagpur Sampling Frame: - Prediagnosed symptomatic cases of gall bladder polyp which are operated for the same. Sample size: - Sample is taken from above sampling frame which were according to the below mentioned inclusion criteria. Inclusion criteria:
1) Symptomatic patients having right hypochondriac discomfort.
2) Age more than 60 years.
3) Polyp diameter more than 6 mm.
4) Sessile polyps.
5) Solitary polyps.
6) Associated gallstones and primary sclerosing cholangitis.
7) HbsAg positive patients.
Exclusion criteria:
1) Incidental asymptomatic finding.
2) Age less than 60 years.
3) Polyp size less than 6 mm.
4) Cholesterol and inflammatory polyps.
5) Short pedunculated and multiple small polyps.
Result: Out of the 26 cases operated all were found to be benign on follow up. The mean age at diagnosis was 45.5 years and most of the cases were males. The mean diameter of the polyps was 6mm. Conclusion: Out of the patients operated for Gall bladder polyp 24 patients after a period of follow up for 1 year were completely alright and 2 patients continued to have mild right hypochondriac discomfort. Hence laparoscopic management is a good option for the patients fulfilling the inclusion criteria.
Key Words: Gall bladder polyp, Laparoscopic.

[1]. Matos AS, Baptista HN, Pinheiro C, Martinho F. Gallbladder polyps: How should they be treated and when? Rev Assoc Med Bras. 2010;56:318–21.
[2]. Inui K, Yoshino J, Miyoshi H. Diagnosis of gallbladder tumors. Intern Med. 2011;50:1133–6. PubMed.
[3]. Kwon W, Jang JY, Lee SE, Hwang DW, Kim SW. Clinicopathologic features of polypoid lesions of the gallbladder and risk factors of gallbladder cancer. J Korean Med Sci. 2009;24:481–7. [PMC free article].
[4]. Park JY, Hong SP, Kim YJ, Kim HJ, Kim HM, Cho JH, et al. Long-term follow up of gallbladder polyps.J Gastroenterol Hepatol. 2009;24:219–22. [PubMed]
[5]. Kim SY, Lee HS, Lee YS, Chung KW, Jang BK, Chung WJ, et al. Prevalence and risk factors of gallbladder polyp in adults living in Daegu and Gyeongbuk provinces. Korean J Gastroenterol.2006;48:344–50. [PubMed]

Abstract: A 33-year-old male patient was referred to the OPD with the chief complaint of pain and swelling in the posterior part of the upper jaw region. A screening Panoramic radiography disclosed no frank changes. A complete excision was achieved by removing the tumor . Histologically, Antoni-A tissue was the predominant microscopic pattern, but it occasionally alternated with Antoni-B areas. Immunohistochemical staining for S-100 proteins showed diffusely positive findings. An examination confirmed a diagnosis of an intraosseous schwannoma of the maxilla.
Key words: schwannoma, infra temporal region.

[1]. BaniA, Gilsbach JM: Incidence of cerebrospinal fluid leak after microsurgical removal of vestibular schwannomas. ActaNeurochir (Wien) 144:979- 982;discussion 982, 2002
[2]. JadvygaS .An early diagnosis of spinal cord schwannoma: the value of the pain syndrome MEDICINA (2002) Vol. 38, No. 11, 1086-8
[3]. Avani Gandhi Dikshit, Arun Subramaniam, A rare intra-osseous Schwannoma- A diagnostic challenge. Indian Journal of Dentistry, Vol 2, Issue 4, Oct-Dec 2011, 165-171
[4]. Kurtkaya-Y,Scheithauer.B, and Woodruff.J.Y. The pathobiology spectrum of Schwannomas. HistolHistopathol (2003) 18: 925-934
[5]. Gharabaghi, A.; Samii, A.; Koerbel, A.; Rosahl, S. K.; Tatagiba, M. & Samii, M. (2007), 'Preservation of function in vestibular schwannoma surgery. Neurosurgery 60(2 Suppl 1), ONS124 – 7; discussion ONS127-8.

Abstract: Background: Obesity is a global epidemic and is on the rise. Obesity is defined as a body mass index (BMI) which is equal to or more than 30kg/m2. It is one of the modifiable risk factors of type 2 diabetes. This study was undertaken to assess the relationship between BMI, WHR, RBS and BP. Method: This cross-sectional study included 776 apparently healthy adult individuals who met the inclusion criteria. Random blood samples were collected to measure RBS using glucometers. Data on BMI, waist and hip circumference and blood pressure were collected from apparently healthy individuals. Result: The mean BMI was in the overweight range, 25.49±5.15 kg/m2 and was higher in females. About two-thirds (62.8%) of the participants had abnormally elevated WHR. RBS, SBP and DBP increased significantly with increasing BMI status (p=0.000, p=0.000 and p=0.007 respectively) and were significantly higher with abnormally elevated WHR than in participants with normal WHR (p=0.000, p=0.000 and p=0.000 respectively). However, overweight individuals tended to have a higher RBS than the obese. There was a significant correlation between BMI and RBS (0.083, p=0.020), SBP (0.206, p=0.000) and DBP (0.152, p=0.000). There was a slightly stronger correlation between WHR and RBS (0.093, p=0.009), SBP (0.273, p=0.000) and DBP (0.217, p=0.000). Conclusion: BMI and WHR are positively correlated with RBS and blood pressure in Nigeria. The Nigerian population is therefore at risk of Obesity and its related conditions (hyperglycemia and hypertension).
Keywords: Blood pressure, Body mass index, Obesity, Random blood sugar, Waist Hip ratio.

[1]. Hu F. Obesity epidemiology. Oxford: Oxford university press, 2008;87-97
[2]. World Health Organization Obesity: Preventing and Managing the Global Epidemic. World Health Organization Geneva, Switzerland,1997;786-987
[3]. Prospective Studies Collaboration, Whitlock G, Lewington S, Sherliker P, Clarke R, Emberson J, Halsey J, Qizilbash N, Collins R, Peto R. Body-mass index and cause-specific mortality in 900 000 adults: collaborative analyses of 57 prospective studies. The Lancet 2009; 373(9669): 1083–96.
[4]. WHO Global InfoBase team. Surveillance of chronic diseases and risk factors: Country level data and comparable estimates. Geneva: World Health Organization, 2005.
[5]. Bray GA. Historical frame work for the development of ideas about obesity. In: Handbook of obesity, Bray, GA, Bouchard C, James WPT (eds). New York: Marcel Dekker, Inc.; 1997.

Abstract: Introduction: Scrub typhus is a form of typhus caused by the intracellular parasite Orientia tsutsugamushi. The disease is endemic in many parts of India. Materials and Methods: This study describes the clinical profile of six scrub typhus positive cases admitted in a tertiary care hospital. Complete physical examination and all routine tests were done in all cases. In all the cases, scrub typhus was diagnosed using a rapid single step immunochromatographic assay. Results: Of the six cases three were females and three were males. Fever was the chief presenting symptom in all the cases. Other signs and symptoms were headache, myalgia, cough, hepatospleenomegaly, abdominal pain and lymphadenopathy. Only two patients had pathognomonic features of eschar and lymphadenopathy. Liver enzymes were elevated in all the patients. Hypotension, thrombocytopenia, hepatic dysfunction, hypoalbuminemia, hematuria and proteinuria were the complications observed. All the cases were successfully treated with doxycycline and there was no mortality. Conclusion: Our report emphasizes the fact that a diagnosis of scrub typhus should be suspected when a patient presents with fever and laboratory evidence of liver dysfunction, as early detection of the disease could reduce morbidity and mortality.
Keywords: Eschar, Intracellular Parasite, Hypoalbuminemia, Liver dysfunction, Typhus.

[1]. Watt G, Parola P, Scrub typhus and tropical rickettsioses, Current Opinion Infectious Diseases, 16, 2003, 429-36.
[2]. P Aggarwal, Mahesh DM, Ravi Kumar V, Pratibha Himral, SS Kaushal, BS Verma, Atypical Eschar Sites in Scrub Typhus in Sub-Himalayas, JAPI, 57, 2009, 153.
[3]. Tilak R, Ticks and mites, in Bhalwar RV (Ed.), Textbook on public health and community medicine, 13 ( 1st ed. Pune: Department of Community Medicine, AFMC 2009 ) 955-959.
[4]. Mahajan SK, Scrub typhus, J Assoc Physicians India, 53, 2005, 954-958.
[5]. Chogle AR, Diagnosis and treatment of scrub typhus - the 3. Indian scenario, J Assoc Physicians India, 58, 2010, 11-12.

Abstract: Pseudotumour or tumor like proliferation ( non-neoplastic mass ) are rare in testis and paratesticular structures. Clinically these lesions are of great intrest for the reason as they minimic as a malignancy arising from scrotal sac.[1,2]which result in treatment, often by radical orchidectomy. Their incidence among tumors arising with in scrotal sac varies according to different series from 6 – 30 % [2 ].Although fibrous pseudo tumour of testis affects patients of all ages,highest incidence is in third decade of ife.Therefore it is an important diagnostic consideration in young patients presenting with painless scrotal swelling. Here we report a rare case of fibrous Pseudotumour of right testis & left hydrocele.The purpose of this case report is to emphasis that how the practicing surgeons and pathologist may distinguish pseudotumours,the benign mimickers, from the true neoplasm so that surgeons can preserve the testis at least in some of the cases.
Key Words: Fibrous Pseudo tumor, intrascrotal mass, hydrocele testis.

[1]. F. Algaba1, 2 , G. Mikuz3ET AL , Pseudoneoplastic lesions of the testis and paratesticular structures Virchows Arch. Dec 2007; 451(6): 987–997.
[2]. Haas GP, Shumaker BP, Cerny JC (1986) The high incidente of benign testicular tumors. J Urol 136:1219–1220
[3]. Parker PM, Pugliese JM, Allen RC Jr. Benign fibrous pseudotumor of tunica vaginalis testis. Urology 2006; 68: 427.e 17-9.
[4]. Mostofi FK, Price EB. Tumors of the male Genital System.Atlas of Tumor Pathology, 2ndseries, fascicle 8. Washington DC: Armed Force Institute of Pathology; 1973: 151-4.
[5]. Oliva F, Young RH. Paratesticular tumor-like lesions. SeminDiag Pathol2000; 17: 358.

Abstract: To establish the effectiveness of mandibular canine index in predicting sex in rajasthan population. Materials and Methods: 100 subjects belonging to rajesthan population (50 males; 50 females) in the age group of 17-25 yrs were included. Impressions were made with alginate and study models prepared with dental stone and living subjects Maximum mesiodistal diameter of mandibular canines and the linear distance between tips of mandibular canines were measured using a Vernier caliper. Observed mandibular canine index (MCIo) and standerd MCI was calculated as the ratio between the maximum mesiodistal width of mandibular canine and canine arc width. Results: Left canine exhibited greater sexual dimorphism i.e. 9.05% as compared with right canine i.e. 8.782%. Sex could be predicted correctly in approximately 80% of subjects examined. Conclusion: With the standard MCI it was possible to detect sex in the population of rajesthan to an extent of about 72%. Hence it is considered as a quick, easy and reproducible method for determining the sex of an individual.
Keywords: Forensic, mandibular canine index, Canine, mesio-distal dimension, sexual dimorphism, anthropology.

[1]. Acharya BA, Mainali S. Univariate sex dimorphism in the Nepalese dentition and the use of discriminant functions in gender assessment. Forensic SciInt 2007;173:47-56.
[2]. Vahanwahal SP, Parekh DK. Study of lip prints as an aid to forensic methodology. J Ind Dent Assoc 2000;71:269-27.
[3]. Garn SM, Lewis AB, Swindler DR, Kerewsky RS. Genetic control of sexual dimorphism in tooth size. J Dent Res 1967;46:963-72.
[4]. Rao NG, Rao NN, Pai ML, Kotian MS. Mandibular canine index: A clue for establishing sex identity. Forensic SciInt 1989;42:249-54.
[5]. Yadav S, Nagabhushan D, Rao BB, Mamatha GP. Mandibular canine index in establishing sex identity. Indian J Dent Res 2002;13:143-6.

Abstract: Wash and care. These two words would probably best summarize the main aspect of hand hygiene in clinical dental practice. Not only are hands the most significant means of germ transmission, they are also the most important dental practice tools. Following the adoption of hand disinfection practice, using chlorinated lime solutions in 1861 by Semmelweis Ignaz, the incidence of hospital acquired diseases has drastically reduced. These primitive guidelines have hence been updated and are constantly reviewed in the light of available newer information. Current evidence indicates that, if recommended infection control procedures are followed, the risks of transmission of infectious diseases during dental treatment is drastically reduced. The implementation of an infection control policy and standard operating procedures requires a thorough knowledge of the risks and the practical measures to be taken using best practice guidelines and recommendations. This article reviews practical measures needed to ensure effective hand hygiene in the dental practice.
Keywords: Hand Hygiene Guidelines, Dental practice, Alcohol rub, Occupational hazards.

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Abstract: Phyllodes tumor is an uncommon fibro epithelial breast tumor with diverse biological behavior. The tumor closely resemble as fibroadenoma of the breast. On one end phyllodes is slow growing benign tumor, the other end tumor grows rapidly behave like sarcoma which metastasizes, and phyllodes can turn to frank sarcoma. Tumor can be diagnosed on clinical basis i.e. large mass with lobulated (bosselated) surface; skin is thinned out due to stretching by rapidly enlarging tumor with engorged cutaneous veins. Lump usually present in upper and outer quadrant of the breast or occupies entire breast and freely mobile within the breast. Final confirmation can be achieved by FNAC, USG and mammography and MRI. High recurrence rate is reported following limited resection where as wide excision has less recurrence. Simple mastectomy is indicated in case of large and recurrent tumor. Malignant tumor will not respond to chemo-radiotherapy. We came across four cases of phyllodes tumors almost in a decade from 2004 to 2014. The age incidence was same as mentioned in the literature. Out of four cases two phyllodes turned to sarcoma. One was giant fibro adenoma in which a section of histological picture showed phyllodes element. We are interested to publish this article because we observed the sequence of events in our cases as mentioned in the literature. Phyllodes tumor is a variant of fibroadenoma to benign phyllodes tumor, turning to sarcoma.
Keywords: Fine needle aspiration cytology (FNAC), Fibroadenoma, Phyllodes tumor, Sarcoma, Ultra sonogram (USG).

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[5]. Brath RJ Jr.,Wells WA, Mitchell SE, Cole BF; " A prospective multi institutional study of adjuvant radiotherapy after resection of malignant phyllodes tumor", Ann Surg Oncol, 2009; 16 (8): 2288-94. doi:10.1245/s10434-009-0489-2. PMID 19424757.

Abstract: Gastro intestinal tract is most common primary site of extra nodal non Hodgkin's lymphoma. Stomach is the common site in the GI tractfollowed by ileum, jejunum and duodenum. Colon is very rarely involved. Histologically it is B or T cell type with small or large cell variation. Diagnosis is difficult since lymphoma presents with vague abdominal pain with loss of weight and loss of appetite. It may present as lump abdomen with complications such as intestinal obstruction, bleeding, perforation and peritonitis. Perforation is the least common presentation. In our case a 48 year old male presented with pain abdomen followed by vomiting and distension of abdomen. A diffuse soft mass was occupying the umbilical region, right iliac and pelvic fossae. USG abdomen and CT scan showed large pelvic and peritoneal collections. Pelvic abscess responded to conservative treatment. Two weeks later patient developed right ileac fossa mass which was hard inconsistency. On exploratorylaporotomy mass was found in the ileo-cecal region. Right hemicolectomy was done. Histologically the specimen was reported as NHL of terminal ileum and cecum. We wish to present this case because, growth synchronously presenting in the ileum and cecum israre.NHL Lymphoma arising from two sites was reported in theileum but lymphoma arising fromboth ileum and cecum was probably not reported.
Key words: CT scan abdomen (Computerised Tomographic Scan),GI tract – gastro intestinal tract ,Non Hodgkin's Lymphoma-NHL, USG abdomen (ultra sonogram).

[1]. L YIN, CQ CHEN, CH PENG, GM CHEN, HJ ZHOU, BS HAN AND HW LI. Primary Small-bowel Non-Hodgkin's Lymphoma: a Study of Clinical Features, Pathology, Management and Prognosis, The Journal of International Medical Research 2007; 35: 406 – 415.
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Abstract: Background/Objectives: It Is Possible That Not All Women Would Want The Disclosure Of Fetal Sex Or Gender By The Sonologist During An Antenatal Or Perinatal Scan. The Objective Of This Study Was To Determine The Proportion Of Women That Wanted To Know Fetal Sex At Ultrasound, Group Them And Document Their Reasons For Wanting To Know. Methodology: This Was Descriptive Study Of Pregnanat Women Who Presented At Our Facility For Antenatal Ultrasound Diagnosis In Makurdi From June 1st To December 31st 2013. Results: One Hundred And Eighty (180) Women Were Studied Within This Period. Most Of The Women (55%) Were Of The Tiv Ethnic Group. Ibo And Idoma Women Accounted For 15% And 13.3% Respectively. Majority Of The Women Were Christians (93.3%). Ninety Six Percent (96%) Of The Women Consent To Disclosure Of Fetal Gender, While Four Percent (4%) Decline. The Main Reason For Wanting To Know Fetal Gender Was So That They Will Know What To Buy Before Delivery. Conclusion: Most Of The Women (96%) Would Want Fetal Gender Disclosure At Prenatal Ultrasound Scan. Only 4% Of The Women Did Not Want Fetal Gender Disclosure Because They Were Satisfied With Anyone. It Is Therefore Advisable For Any Sonologist To Be Careful On Fetal Gender Disclosure To Pregnant Women During The Procedure, So As Not To Hurt Those That Do Not Want.
Key Words: Fetal Sex, Prenatal Ultrasound Scan, Disclosure.

[1]. Grandjean H., Larroque D., Levis 1999. The performance of routine ultrasonographic screening of pregnancies in th eurofetus study. American Journal of Obst Gynaecol 181: 446 – 454.
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Abstract: Corneal ulceration is a leading cause of ocular morbidity and blindness worldwide. The present study was carried out by the Department of Microbiology & Ophthalmology, MMIMSR, on 60 corneal scraping samples from clinically suggested cases of corneal ulcers. Corneal scrapings were collected and subjected to microscopy and culture. Out of the 60 patients suspected of having bacterial and fungal keratitis, 43.3% were found to be culture positive. Rate of detection of bacterial and fungal and mixed growth was 30.76%, 61.53% and 7.69% respectively. Ocular trauma (68.3%) was the most common predisposing factor followed by Topical steroids (14.6%) and Diabetes mellitus (7.31%). Sugarcane leaf accounted for (37.5%) cases followed by paddy leaf, wood chip and iron piece which accounted for (12.5%) cases each. Among the clinical features, redness 81.25%), blurred/diminished vision (81.25%), pain (68.7%), irregular feathery margins (75%) was most commonly seen in fungal keratitis while Pain (75%), redness (87.5%), lacrimation (62.5%), hypopyon (37.5%) was most commonly seen in bacterial keratitis. Accurate diagnostic tests not only play a key role in patient management but also reduce the risk of the patient developing long-term complications. The definitive diagnosis of ulcers caused by multiple organisms can only be arrived at by microbiological evaluation.
Keywords: Corneal ulcer, Clinical presentations, Microbiological diagnosis, Ocular morbidity.

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