iosr-JDMS   Volume-13 ~ Issue-12 ~ December-2014

Abstract: The effects of modified brief pulse bilateral electroconvulsive therapy (ECT) on disease profile and cognitive functions in patients of Depression, Mania and Schizophrenia. Aims & Objectives: In the patients of Depression, mania and Schizophrenia treated with modified brief pulse bilateral ECT, to assess
1. The type and amount of cognitive deficits pre and post-ECT.
2. The change in disease severity post-ECT.
Materials and Methods: Consecutive patients with DSM-IV TR diagnosis of Bipolar Mania, Depressive Disorder(Major Depressive Disorder and Bipolar Depression) or Schizophrenia admitted and posted for modified brief pulse bilateral ECT were enrolled. Those who received ECT in past 6 months, were uncooperative or unwilling to consent were excluded. The scales below were administered before ECT, within 1 day of 1st and last ECT, after 1 month of last ECT.

[1]. Gallegos J, Vaidya P, D'Agati D, et al. (June 2012). "Decreasing adverse outcomes of unmodified electroconvulsive therapy: suggestions and possibilities". J ECT 28 (2): 77–81. doi:10.1097/YCT.0b013e3182359314.PMID 22531198.
[2]. Lisanby SH, Maddox JH, Prudic J, Devanand DP, Sackeim HA (June 2000). "The effects of electroconvulsive therapy on memory of autobiographical and public events". Arch. Gen. Psychiatry 57 (6): 581–90.doi:10.1001/archpsyc.57.6.581. PMID 10839336.
[3]. Andre, Linda (2009). Doctors of Deception: What They Don't Want You to Know About Shock Treatment. Rutgers University Press. ISBN 978-0-8135-4441-0.
[4]. Sackeim HA, Prudic J, Fuller R, Keilp J, Lavori PW, Olfson M (January 2007). "The cognitive effects of electroconvulsive therapy in community settings". Neuropsychopharmacology 32 (1): 244–54.doi:10.1038/sj.npp.1301180. PMID 16936712. Available on http://www.ncbi.nlm.nih.gov/pubmed/16936712
[5]. Breggin Peter (2007). "ECT Damages the Brain: Disturbing News for Patients and Shock Doctors Alike".Ethical Human Psychology and Psychiatry. 9 (2): 83–86.doi:10.1891/152315007782021196.

Abstract: Bone tumours have been noticed to be on the increase Africa. The incidence of these tumours initially thought , to be uncommon in our environment has been on the rise. These tumours like those in any other part of the body are better managed with early diagnosis and subsequent treatment. The study was aimed at determining the pattern of presentation of bone tumours , with a view to determining the commonest types , the most involved sites of the body and the age of presentation of these tumuors.This was a retrospective study carried out at the Jos university teaching hospital. The study covered a period of ten years from 2000 to 2010. From the cancer registry at the hospital, and case folders of the patients information of patients as regards the histological type of the bone tumour, the age and sex of the patients and the site of involvement were obtained.A Total of 103 bone tumours were seen over the study period. The mean age of presentation was 29.4years+/- 16.9 years with an age range of 3 to 75 years. Benign bone tumoursaccounted for67(66.3%) of the tumours while malignant tumours were 36(33.7%) of the tumours.The benign tumours consisted of,osteochondroma 12(17.9%), Giant cell tumour 12(17.9%), fibrous histiocytoma 11(16.4%) and osteoid osteoma7 (12%) , while the malignant variety were osteosarcoma 17(50%),fibrosarcoma 10(29.4%) andChondrosarcoma 4 (11%) . The anatomical regional location of the benigntumourswere ; tibia 13(19.4%), femur 13 (19.4%) .While that of the malignant variety were; femur 10(29.4%) ,tibia 9(26.4%). Benign bone tumours make up about two thirds of the bone tumours in our environment while the rest are malignant, with osteochondroma and giant cell tuomours making up the bulk of the benign tumours and osteosarcoma the most common malignant type. The femur and the tibia were the sites mostly affected by bone tumours.
Keywords: Bonetumours, Distribution, Nigeria , Primary.

[1]. Obalum DC, Eyesan SU, Ogo CN, Enweluzo GO. Multicentre study of bone tumours. The Nigerian postgraduate medical journal. 2010;17(1):23-6.
[2]. Omololu AB, Okolo CA, Ogunlade SO, Oyebadejo TY, Adeoye AO, Ogunbiyi JO, et al. Primary malignant bone tumours in Ibadan, Nigeria: an update. African journal of medicine and medical sciences. 2009;38(1):77-81.
[3]. Pearce MS, Parker L, Windebank KP, Cotterill SJ, Craft AW. Cancer in adolescents and young adults aged 15-24 years: a report from the North of England young person's malignant disease registry, UK. Pediatric blood & cancer. 2005;45(5):687-93.
[4]. Eyesan SU, Obalum DC, Nnodu OE, Abdulkareem FB, Ladejobi AO. Challenges in the diagnosis and management of musculoskeletal tumours in Nigeria. International orthopaedics. 2009;33(1):211-3.
[5]. Ferreira N, Marais LC. Osteosarcoma presentation stages at a tumour unit in South Africa. South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde. 2012;102(8):673-6.

Abstract: Background: Fracture neck femur in young patients continues to be a difficult problem to treat even for the most experienced. In-spite of the advances made in Orthopedics this fracture remains an unsolved problem. Various treatment modalities and their modifications have been proposed to improve the outcome of treatment. Osteosynthesis and primary valgus angulation osteotomy is one of them. Technique and outcome in a series of recent intracapsular femoral neck fractures in young adults is presented. Materials and Methods: Ten patients of recent (<3 weeks old) displaced intracapsular fracture neck femur (Garden III and IV, Pauwels III, with or without comminution) in the age group 20-40 years (mean 27.5 ) were subjected to osteosynthesis and primary valgus intertrochanteric osteotomy using dynamic hip screw with side plate and a derotation screw. The patients were followed up from three to five years (mean 4.6 years). Results: Union at the fracture site was achieved in ten out of ten (100 %) patients within 12 months of surgery. One case, which had undergone previous surgery with multiple screw fixation, developed avascular necrosis(10%). Repeat surgery rate was 10% (for patient with AVN) however, none of the patients required repeat surgery for achieving union. None of the ten patients had poor outcome. All patients can sit cross legged and squat and are back to their previous jobs. Conclusion: The DHS method is economical and readily available. It produces satisfactory results employing a device and instrumentation that is more familiar to orthopedic surgeons. The technique is reproducible and has been used successfully in this series of 10 patients.
Key words: Fracture neck femur, young adult,valgus osteotomy,DHS.

[1]. Christodoulou NA, Dretakis EK. Significance of muscular disturbances in the localization of fractures of the proximal femur. Clin Orthop Relat Res.1984;187:215–7.
[2]. Robinson CM, Court-Brown CM, McQueen MM, Christie J. Hip fractures in adults younger than 50 years of age: Epidemiology and Results. Clin Orthop Relat Res. 1995;312:238–46.
[3]. Zetterberg CH, Elmerson S, Andersson GB. Epidemiology of hip fractures in Goteborg, Sweden, 1940-1983. Clin Orthop Relat Res. 1984;191:43–52.
[4]. .Protzman RR, Burkhalter WE. Femoral-neck fractures in young adults. J Bone Joint Surg Am. 1976;58:689–95.
[5]. Leighton RK. Fractures of the neck of femur. In: Bucholz RW, Heckman JD, Court-Brown C, editors. Rockwood and Green's fractures in adults. 6th ed. vol. 2. Philadelphia: Lippincott Williams and Wilkins; 2006. pp. 1753–91.

Abstract: In this study among the semi urban population in Chennai, prevalence of alcoholism among men was 42.65% .Using CAGE criteria , problem drinking was found to be present in 38.88 % among 90 respondents. Daily alcohol consumption was in 38.8%, and 59.5% consumed more than 175 ml per day; Those drinking for more than 5 years was 56.95%. The commonest reason given for drinking was to overcome stress or tiredness. De-addiction was attempted only by 9.5% and 17.2% exhibited a negative change in health seeking behavior. Hypertension was present in 13.8% diabetes in 9.5% and gastritis in 33.%. Around 29.3% families felt neglected and half the families (40.5%) felt afraid of the man when he drinks; 84.5% of families experienced quarrels.
Keywords: Alcoholism, problem drinkers, health and social aspects, healthcare, family impact.

[1]. American Society of Addiction Medicine 1990 Public Policy Statement on the Definition of Alcoholism The Definition of Alcoholism (NCADD/ASAM),September 1, 1976; rev. February 1, 1990, http://www.asam.org/docs/publicy-policy-statements/1definition-of-alcoholism-2-902.pdf?sfvrsn=0
[2]. Antonia Abbey, Ph.D., Tina Zawacki, M.A., Philip O. Buck, M.A., Monique Clinton, M.A., and Pam McAuslan, Ph.D. 1996 , Alcohol and Sexual Assault http://www.hawaii.edu/hivandaids/Alcohol%20and%20Sexual%20Assault.pdf [3]. CDC, Fact Sheets- Alcohol Use and Your Health.Alcohol Use and Your Health Ganesh kumar et al (http://www.jpgmonline.com/text.asp?2011/57/1/9/74284.)
[4]. Ganesh KuMar S.1, PreMarajan K.C.2, Subitha L.3, SuGuna e.4, VinayaGaMoorthy5, Veera KuMar Prevalence and Pattern of Alcohol Consumption using Alcohol Use Disorders Identification Test (AUDIT) in Rural Tamil Nadu, IndiaCommunity Medicine Section.. 6eria J Clin Diagn Res. Aug 2013; 7(8): 1637–1639. Published online Aug 1, 2013. DOI: 10.7860/JCDR/2013/5521.3216
[5]. Girish, R Kavita, G Gururaj, and Vivek BenegalAlcohol Use and Implications for Public Health: Patterns of Use in Four Communities Indian J Community Med. Apr 2010; 35(2): 238–244.doi: 10.4103/0970-0218.66875 PMCID: PMC2940178.

Abstract:The loss of all or part of one X sex chromosome during embryogenesis results in Turner's syndrome (TS). Certain studies showed specific cognitive deficits and psychiatric manifestations like mood and anxiety disorder .There are case reports of concomitant TS with schizophrenia. We present here a case of TS with clinical features of delayed attainment of secondary sexual characters, short stature, overweight, wide carrying angle and short bilateral 4th metacarpals and metatarsals. Her ultrasound of abdomen and pelvis, showed hypoplastic infantile uterus and streak like ovaries. The TS patient had psychiatric manifestation of obsessive compulsive disorder, which has not been reported so far. The co-existence of Turner's syndrome and OCD gives a clue of any possibility of genes related to aetiology of OCD. It is important for the practitioners to understand the clinical spectrum and natural courses, including the development of psychiatric disorder in TS.

Keywords: anxiety, compulsive, hypoplastic, obsessive, X chromosome.

[1] Lippe B. Turner syndrome. EndocrinolMetabClin North Am 1991;20:121–52
[2] Saenger P. Turner's syndrome. N Engl J Med 1996; 335:1749–54
[3] Elsheikh M, Dunger DB, Conway GS, et al. Turner's syndrome in adulthood. Endocr Rev 2002; 23:120–40
[4] Skuse DH, James RS, Bishop DV, et al. Evidence from Turner's syndrome of an imprinted X-linked locus affecting cognitive function. Nature 1997;387:705–8
[5] Delooz J, Van Den Berghe H, Swillen A, et al. Turner syndrome patients as adults: a study of their cognitive profile, psychosocial functioning and psychopathological findings. Genet Couns 1993;4: 169–79
[6] Graca Cardoso, Robert J. Daly, Nazli A. Haq, et al.Current and lifetime psychiatric illness in women with Turner syndrome.GynecolEndocrinol 2004;19:313–319.

Abstract: Objective: We performed a hospital based cohort study to compare neonatal and maternal outcomes of the primary caesarean section performed in first stage versus second stage of labour. Methods: At least 100 cases underwent caesarean delivery in the second stage of labour were taken. For each case two consecutive cases underwent caesarean delivery during the first stage of labour were taken as control for the study. Primary maternal outcomes of interest were uterine atonia, transfusion requirements, urinary system injury and requirement for uterine artery/ hypogastric artery ligation.

[1]. Dumont, L. de Bernis, M. H. Bouvier-Colle, and G. Breart, "Caesarean section rate for maternal indication in sub-Saharan Africa: a systematic review," The Lancet, vol. 358, no. 9290, pp. 1328-1333, 2001.
[2]. S. F. Murray and F. S. Pradenas, "Health sector reform and rise of caesarean birth in Chile," The Lancet, vol. 349, no. 9044, p. 64,1997.
[3]. M. Pai, P. Sundaram, K. K. Radhakrishnan, K. Thomas, and J. P. Muliyil, "A high rate of Caesarean sections in an affluent section of Chennai: is it cause for concern?" National Medical Journal of India, vol. 12, no. 4, pp. 156-158,1999.
[4]. Allen VM, O‟Connell CM, Basket! TF. Maternal morbidity associated with cesarean delivery without labor compared with spontaneous onset of labor at term. Obstet Gynecol 2003;102:477-482.
[5]. S. Gifford, S. C. Morton, M. Fiske, J. Keesey, E. Keeler, and K. L. Kahn, "Lack of progress in labor as a reason for cesarean," Obstetrics and Gynecology, vol. 95, no. 4, pp. 589-595,2000.

Abstract: Background: In this twenty first century the work experience of medical students has become demanding.Medical students(medicos) face long working hours and competitive work demand.Medicos like any other students suffer from maladies. Aim: This study is to evaluate the most commonly occuring diseases and most commonly used drugs by medicos. Methods: This is a retrospective study done on 100 medicos of various semesters(1to9)and age group 18 to 25.The study subjects were given a quesionnaire to identify diseases suffered by them and drugs used by them in the past one year.The statistical analysis of data was performed using SPSS version 17.0. pvalue was calculated using chisquare test.

1]. General Medical Council (2009) Tomorrow‟s Doctors London, GMC, paragraphs 124 and 126
[2]. Dyrbye LN, Thomas MR, Shanafelt TD (2006) Systematic review of depression, anxiety, and other indicators of psychological distress among U.S. and Canadian medical students Acad Med 81(4): 354–73
[3]. Sport, Disability and an Original Definition of Health. Zenit.org (February 27, 2013). [4]. McWhinney IR (April 1987). "Health and disease: problems of definition". CMAJ 136 (8): 815. PMC 1492121. PMID 3567791
[5]. "Drug." Dictionary.com Unabridged (v 1.1), Random House, Inc., via dictionary.com. Retrieved on 20 September 2007. [6]. Weisstein, Eric W., Test.html "Chi-Square Test", MathWorld. [7]. Yates, F (1934). "Contingency table involving small numbers and the χ2 test". Supplement to the Journal of the Royal Statistical Society 1(2): 217–235.JSTOR 2983604

Abstract: Introduction Anotia is a condition when ears are completely absent while microtia is a congenital anomaly of the face in which the ears are malformed since birth and it ranges in severity from mild structural abnormalities to complete absence of the ear and its parts. Case presentation We report a case of unilateral microtia in a newborn of hypothyroid mother. The mother had severe preeclampsia and her LSCS was done for uncontrolled blood pressure .No other apparent congenital anomaly was detected. The family history of the patient showed that both patient and her father have deafness. Their BERA (brain evoked response audiometry) test showed severe hearing loss on right side and moderate hearing loss on left side.

[1]. Meurman Y. Congenital microtia and metal atresia. Arch. Otolaryngology. 1957; 66: 443.
[2]. Sadler T. Langmans Medical Embryology, 8th Edition. Baltimore, U.S.A; Lippincott Williams and Wilkins, 1997; 391.
[3]. Mastroiacovo P, Corchia C., Botto L.D.Epidemiology and genetics of microtia and anotia: A registry based study on over an million births, Ann Genet. 1989; 32: 52-54.
[4]. Harris J, Kallen B, Robert E. The Epidemiology of anotia and microtia.J Med Genet.1996; 36; 809-813.

Abstract: Objective: To determine menopausal complaint proportions and discrepancies between perimenopausal and postmenopausal paramedics assesed using the menopause rating Scale. Method: This analytical descriptive cross sectional study recruited perimenopausal and postmenopausal aged paramedics at Haji Adam Malik General Hospital and satelite hospitals, from which data were collected after filling several questionnaires. A total of 100 questionnaires each were disrtributed to the perimenopausal and postmenopausal group, the reults of which were assesed using the L-MMPI scale. The validity of this study was highly affected by honesty due to the subjective nature of the instruments used. Therefore, the L-MMPI scale is of great significance. Fifty subjects each were extracted from 60 perimenopausal and 58 postmenopausal eligible subjects with L-MMPI scores

[1]. Williams RE, Levine KB, Kalilani L, Lewis J, Clark RV: Menopause-specific questionnaire assessment in US population-based study shows negative impact on health-related quality of life. Maturitas 2009, 62(2):153-9.
[2]. Lu J, Liu J, Eden J: The experience of menopausal symptoms by Arabic women in Sydney. Climacteric 2007, 10:72-7.
[3]. Rahman A, Zainudin S, Kar mun V. Assesment of Menopausal Symptoms Using Modified Menopause Rating Scale Among Middle Age Women in Kuching, Sarawak, Malaysia. Asia Pasific Family Medicine 2010,9:5.
[4]. WHO. Women and Health : Today's Evidence Tomorrow's Agenda. Depart of Reproductive Health and Research WHO, 2009.
[5]. Buckler H. The menopause transition: endocrine changes and clinical symptoms. J Br Menopause Soc 2005;11:61–5.
[6]. Burger HG, Dudley EC, Robertson DM, Dennerstein L. Hormonal changes in the menopause transition. Recent Prog Horm Res 2002;57:257-75.
[7]. Malacara JM, Canto de Cetina T, Bassol S, et al. Symptoms at pre- and postmenopause in rural and urban women from three States of Mexico. Maturitas 2002;43:11–9.

Abstract: Background: Oral leukoplakia is a potentially malignant disorder that in a small but significant proportion of cases changes into oral cancer. Literature review suggests the association of inflammatory mediator such as cyclooxygenase-2(COX-2) with oral cancer. Expression of COX-2 gene in the oral potentially malignant disorders and oral cancer may add on a light to the existing diagnostics and therapeutics of these oro-mucosal diseases.

[1]. Axell T., Occurrence of leukoplakia and some other oral white lesions among 20,333 adult Swedish people, Community Dentistry and Oral Epidemiology,15(1), 1987,46–51.
[2]. Campisi G, Giovannelli L, Arico P, Lama A, Di Liberto C, Ammatuna P, et al., HPV DNA in clinically different variants of oral leukoplakia and lichen planus, Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics, 98(6), 2004, 705–711.
[3]. Dietrich T, Reichart PA, Scheifele C., Clinical risk factors of oral leukoplakia in a representative sample of the US population, Oral Oncology, 40(2), 2004, 158–163.
[4]. Lodi G, Sardella A, Bez C, Demarosi F, Carrassi A., Interventions for treating oral leukoplakia (Review), The Cochrane Collaboration and published in The Cochrane Library,(4), 2008.
[5]. Scheifele C, Reichart PA. Is there a natural limit of the transformation rate of oral leukoplakia?. Oral Oncology, 39(5), 2003, 470–475.

Abstract: Background: Use of exfoliative cytology and cyto-analysis is a useful early diagnostic method for epithelial atypia and for human oral neoplasm. A rare occurrence of cytological atypia appeared to be very thin, elongated, fibre like structures in oral epithelia is named as keratinized fiber cells (KFCs). In the present study, the aim is to quantify the KFCs and to analyze it morphometrically with a DIcytodiagnostic approach.

[1] R.S.K. Bhavnagar, S.K. Goje, V.K. Hazarey, S.M. Ganvir, Cytomorphometric analysis for evaluation of cell diameter, nuclear diameter and micronuclei for detection of oral premalignant and malignant lesions, Journal of Oral Biosciences, 2011, 53(2): 158–169.

[2] S. Silverman, H. Becks, S.M. Farber, The diagnostic value of intra-oral cytology. J Dent Res, 37, 1977, 195-205.

[3] N.G.Stromby, Experience with buccal smears in the general cytopathology laboratory. Cancer, 23, 1999, 3-6.

[4] H.G. Ahmed, A.M. Idris, S.O. Ibrahim, Study of oral epithelial atypia among Sudanese tobacco users by exfoliative cytology. Anticancer Res, 23, 2003, 1943-9.

[5] A. Singh, Role of exfoliative cytology in oral lesions: with special reference to rule out malignancy, Journal of college of Medical Sciences-Nepal, 6(2), 2010, 29-37.

Abstract: Background: Elevated body iron stores have been implicated as a risk factor of coronary artery disease (CAD). Aim: To study the association of serum ferritin with CAD [acute myocardial infarction (AMI) and chronic stable angina (CSA)] and to assess the relationship of serum ferritin with established conventional risk factors. Methods: Hospital based cross sectional study, 106 CAD patients – AMI = 66 and CSA = 40 and 60 aged matched control were included in the study. Serum ferritin was estimated by ELISA method, C-reactive protein ( CRP) by latex agglutination and other risk factors by enzymatic method

[1]. Stocker R, Keaney JF. Role of oxidative modification in atherosclerosis. Physiol Rev, 84, 2004, 1381 – 478.
[2]. Morita T. Heme Oxygenase and Atherosclerosis. Arterioscler Thromb Vasc Biol , 25, 2005,1786-95.
[3]. Haidari M, Javadi E, Sanati A, Hajilooi M, Ghanbili J. Association of increased ferritin with premature coronary stenosis in men. Clin Chem, 47(9), 2001, 1666-72.
[4]. Meyers DG, Strickland D, Maloley PA, Seburg JJ, Wilson JE, McMannus BF. Possible association of a reduction in cardiovascular events with blood donation. Heart, 78, 1997, 188-93.
[5]. Delphine W, Silvia CR, Biswas S, Uthappa S, Shetty P. Ferritin a potent threat for acute myocardial infarction. JAPI, 51, 2003, 947-50.

Abstract: Objectives: The purpose of this in vitro study was to evaluate the fracture resistance of endodontically treated teeth restored by different post systems. Method: Forty-Five maxillary canines with , anatomically similar root segments were taken and then decoronated at the cementoenamel-junction. After establishing the working length 1 mm short of the apex, the canal was prepared by crown down technique using rotary protaper followed by obturation.

[1]. Mitsui FHO, Marchi GM, Pimenta LAF et al. In vitro study of fracture resistance of bovine roots using different intraradicular post systems. Quintessence Int2004 35: 612-616.
[2]. Duret B, Duret F, Reynaud M. Long-life physical property preservation and post endodontic rehabilitation with the Composipost. Comp Continuing Educ Dent 1996 17: 565-573.
[3]. Michalakis KX, Hirayama H, Sfolkos J, Sfolkos K. Light transmission of posts and cores used for the anterior esthetic region. Int J Periodontics Restorative Dent 2004;24:462-9.
[4]. Heydecke G, Butz F, Hussein A, StrubJR . Fracture strength after dynamic loading of endodontically treated teeth restored with different post-core systems. J Prosthet Dent 2002; 87: 438-445.

Abstract:This work to determine the relation of serum Alpha fetoprotein (AFP) elevated values and liver damage in chronic Hepatitis C Virus (HCV) infected patients with and without cirrhosis ( compensated and decompensated ) . A cross-sectional descriptive study was done at National liver institute in Egypt from the period of January 2014 till june 2014 Patients enrolled in study were known cases of chronic Hepatitis C Virus liver disease and were complicated by development of cirrhosis and hepatocellular carcinoma .

[1]. Giannini EG, Marenco S, Borgonovo G, Savarino V, Farinati F, et al : [2]. Alpha-fetoprotein has no prognostic role in small hepatocellular carcinoma identified during surveillance in compensated cirrhosis.Hepatology 56(4):1371-1379,2012.
[3]. Mallikarjun Patil , Keyur A and Sheth*, C : Elevated Alpha Fetoprotein, No Hepatocellular Carcinoma , J Clin Exp Hepatol ;1–3,2013.
[4]. Sangiovanni A, Prati GM, Fasani P, et al : The natural history of com-pensated cirrhosis due to hepatitis C virus: a 17-year cohort study of 214 patients. Hepatology. ;43:1303–1310,2006. [5]. Llovet JM, Peña CE, Lathia CD, Shan M, Meinhardt G and Bruix J : Plasma biomarkers as predictors of outcome in patients with advanced hepatocellular carcinoma. Clin Cancer Res;18:2290–2300,2012

Abstract: Varicose veins have been recognized as chronic disorder since ancient times. Hippocrates discussed those 2500 years ago1. About 20% of worldwide population suffers from varicose veins and another 2% have skin changes which may precede venous ulceration2. It is in the developed countries where attire reveals more than it conceals; patients turn up for treatment of cosmetic reasons. In our Indian scenario, it is the complications not the cosmetic reasons bring the patient to the doctor. That is the reason, why, though common, varicose veins remain as an ice berg phenomenon.

[1]. Cronenwett JL, Gloviczki P, Johnston KW, Krupski WC, Ouriel K, Sidawy AN et al. Rutherford's Vascular Surgery. 6th ed. Vol. 2. Elsevier Saunders; 2005.
[2]. Russell RCG, Williams NS, Bulstrode CJK. Bailey & Love's Short Practice of Surgery. 23rded. Arnold; 2000.
[3]. Beebe- Dimmer JL, Pfeifer JR, Engle JS, Schottenfeld D. The epidemiology of chronic venous insufficiency and varicose veins. Annals of Epidemiology. Mar,2005; vol.15(3):175-84.
[4]. Bountouroglou DG, Azzam M, Kakkos SK et.al. Ultrasound guided foam Sclerotherapy combined with sapheno-femoral ligation compared to surgical treatment of Varicose veins: Early results of randomized controlled trial. European J.Vascular and endovascular Surgery Jan.2006;31(1):93-100.
[5]. Campbell WB, Niblett PG, Peters AS et al. The clinical effectiveness of hand held doppler examination for diagnosis of reflex in patients with varicose veins. European J. Vascular and Endovascular Surgery. Dec.2005; vol.30(6):644-69.

Abstract: This article describes a case of rehabilitation of a missing lateral incisor using a Zirconia based resin bonded fixed partial denture. An 18 year old female patient with the agenesis of lateral incisor and a peg lateral incisor in the other side presented to prosthetic department .This aspect was compromising the self satisfaction of the patient. She desired a more attractive appearance. After a comprehensive examination, adjacent teeth to edentulous area were sound with a suitable height. Implant therapy was excluded. The treatment plan included a Zirconia based resin bonded bridge in the right side. The peg lateral incisor was reshaped using a provisional restoration until growth achievement and tissues maturation

Keywords: non invasive; resin bonded fixed partial denture; bonding; Zirconia ceramic ; missing lateral incisor

[1]. Chris C.L Wyatt.Resin bonded fixed partial dentures: What's new? JCDA 2008;Vol 73, No 10:933-938
[2]. Erica Dorrigatti, Rafael Scaf de Molon,Francisco de Assis Mollo, Luiz Antonio Borelli de Barros. Multidisciplinary approach for the aesthetic treatment of maxillary lateral incisors agenesis :thinking about implants ? Oral surg Oral med oral pathol oral radiol 2012; Vol 114;N 5:22-28
[3]. Sergio Rubinstein,Alan J.Nidetz,Masayuki Hoshi.A multidisciplinary approach to single tooth replacement.Quintescence international 2004:1-19
[4]. Corky Willhite, Mike Bellerino,Jimmy Eubank. Treatment of congenitally missing lateral incisors with resin bonded fixed partial dentures. Quintescence international 2002:63-72
[5]. Yoshiyuki Hagiwara,Hideo Matsumura,Seiji Tanaka,Julian B.Woelfel. Single tooth replacement using a modified metal –ceramic resin –bonded fixed partial denture: A clinical report. The journal of prosthetic dentistry 2004;Vol 91;Num 5:414-416
[6]. Martin Sasse; All ceramic resin resin bonded fixed dental prostheses treatment planning, clinical procedures, and outcome. Quintescence international2014; Volume 45; Number 4:291-296

Abstract: Aims: This study was aimed at determining the characteristic of nasal carriage status of HIV patients. Staphylococcus aureus has emerged as a significant opportunistic pathogen among HIV and AIDS patients in both nosocomial and community settings.

[1]. Adeleke SI, Asani MO (2009). Urinary tract infection in children with nephritic syndrome in Kano, Nigeria. Ann. Afr. Med. 8: 38-41.
[2]. Adesida S, Boelens H, Babajide B, Kehinde A, Snijders S, Van Leeuwen W, Coker A, Verbrugh H, Van Belkum A (2005). Major epidemic clones of Staphylococcus aureus in Nigeria. Microb. Drug Resist. 11: 115-121.
[3]. Anah MU, Udo JJ, Ochigbo SO, Abia-Bassey LN (2008). Neonatal septicaemia in Calabar, Nigeria. Trop. Doct. 38: 126-128.
[4]. Arora S, Devi P, Arora U, and Devi B (2010). Prevalence of Methicillinresistant Staphylococcus aureus (MRSA) in a Tertiary Care Hospital in Northern India. J. Lab. Phys., 2(2): 78–81.
[5]. Bowersox, J., (1999)Experimental StaphVaccine Broadly Protective in Animal Studies".http://web.archive.org/web/20070505050641/http://www3.niaid.nih.gov/news/newsrelases/1999/staph.htm.

Abstract: Cholesteatoma is a progressive destructive ear disease. Can affect any age group. But more severe in children and young adults. It erodes the bone of middle ear, mastoid and ossicles. It causes partial to total deafness, unpleasant smelling discharge, pain, tinnitus, vertigo and facial paralysis. It can even cause meningitis, brain abscess and death.

[1]. George Browning, Scott.Brown's Otorhinolaryngology-Head and Neck Surgery,Vol.3.7th ed. Hodder Arnold,2008,CH.237C. Pg No.3407.
[2]. The otolaryngology clinics of North America Vol(22) No.5.1989.
[3]. Berenholz LP, Rizer FM, Burkey JM, Schuring AG, Lippy WH. Ossiculoplasty in canal wall down mastoidectomy. Otolaryngol Head Neck Surg 2000; 123: 30-33.
[4]. Kim HH, Battista RA, Kumar A, Wiet RJ.Should Ossicular Reconstruction Be Staged Following Tympanomastoidectomy. Laryngoscope 2006; 116: 47-51.
[5]. Shelton C, Sheehy JL. Tympanoplasty:review of 400 Staged cases.Laryngoscope 1990 Jul; 100(7) :679-81.
[6]. Sasakit.T.et all. Results of hearing tests after Total middle ear reconstruction Acta otorhinology 2007 May 127(5):474-9
[7]. Ikeda M, Yoshida S, Ikui A, Shigihara S. Canal wall down tympanoplasty with canal reconstruction for middle ear cholesteatoma: post-operative hearing, cholesteatoma recurrence, and status of re-aeration of reconstructed middle ear cavity. J Laryngol Otol 2003; 117(4): 249-255.

Abstract: Penetrating injuries caused by fishing equipments like hooks involving hands, face and eyes are common and reported by various authors. Injuries involving foot are rarely reported. We report a 17 years old fisherman with penetrating injury involving the right foot caused by a fishing harpoon. We describe the early removal of the harpoon using "Push Through And Cut Off" technique to prevent the mechanical and infective complications associated with these hooked instruments.

1. Omar Khursheed; MBBS, MS Ortho Bone and Joint Hospital Srinagar. E-mail. babaomar53@gmail.com.
2. Ansarul Haq Lone; MBBS, MS Ortho. Bone and Joint Hospital Srinagar. E-mail- imentufail44@gmail.Com.
3. Refut Arah; MBBS, MS. Registrar Postgraduate Department of Surgery Govt. Medical College Srinagar.
4. Azher Maqbool Khan; MBBS, MD, Radiodiagnosis GMC Jammu.
5. Nazeefa. MBBS GMC Srinagar

Abstract: Background: Diabetes Mellitus is a chronic disease or a group of metabolic diseases in which there are high blood sugar levels over a prolonged period. Now, it is a major public health problem in all over the world. Type 2 DM begins with insulin resistance, a condition in which cells fails to respond to insulin properly. The primary cause is excessive body weight and not enough exercise. Type 2 DM may be treated with medications with or without insulin.

[1]. Diabetes Mellitus and its risk factors: Available from:http://www.mayoclinic.org/diseases-conditions/diabetes/basics/risk-factors/con-20033091
[2]. Diabetes Mellitus: Available from: http://en.wikipedia.org/wiki/Diabetes_mellitus
[3]. Zimmet PZ, Alberti KGMM. The changing face of macrovascular disease in non - insulin - dependent diabetes mellitus: an epidemic in progress. The Lancet 1997; 350: S1 –S4.
[4]. WHO: Clinical guidelines for the management of hypertension: Available from: http://applications.emro.who.int/dsaf/dsa234.pdf
[5]. Binary Logistic Regression Analysis: Available from: http://core.ecu.edu/psyc/wuenschk/MV/Multreg/Logistic-SPSS.PDF
[6]. Senthilvel V, Radhakrishnan R, Sathiyamoorthi R. Prediction of diabetic retinopathy among diabetics using binary logistic regression approach. Ind J of Med Spec 2012; 3 (1): 18 – 20.

Abstract: Background and objectives: Management of the oral leukoplakia poses a challenge in the general dental set up. It relies heavily on clinical presentation and grading of the histopathological diagnosis.Hence this study was done to correlate oral homogenous leukoplakia with the histopathological grades. Materials and methods:Study was conducted in 126 patients with the clinical diagnosis of oral homogenous leukoplakia and histopathological diagnosis. Data on age, gender, history of habits, lesion site at the initial diagnosis were correlated with the various grades of the oral epithelial dysplasia.

[1] Warnakulasuriya S. Global epidemiology of oral and oropharyngeal cancer. Oral Oncol 2009; 45:309–316.
[2] Sankaranarayanan R, Ramadas K, Thomas G, Muwonge R, Thara S, Mathew B et al.Effect of screening on oral cancer mortality in Kerala, India:a cluster-randomised controlled trial. Lancet 2005;365: 1927–33.
[3] Warnakulasuriya S, Mak V, Moller H. Oral cancer survival in young people in South East England. Oral Oncol 2007; 43(10):982-986.
[4] Ho PS, Chen PL, Warnakulasuriya S, Shieh TY, Chen YK,Huang IY.Malignant transformation of oral potentially malignant disorders in males: a retrospective cohort study.BMC Cancer 2009; 9:260.
[5] Van der Waal I, Schepman KP, Van der Meij EH, Smeele LE. Oral leukoplakia: a clinicopathological review. Oral Oncol 1997;33(5):291-301.

Abstract: Acute intestinal obstruction due to cecal volvulus forms an uncommon cause when there is axial twist of the cecum, ascending colon and terminal ileum around their mesenteric pedicles. There are many etiologies and predisposing factors for cecal volvulus, but the exact etiology is most likely to be multifactorial in presence of mobile cecum. It is the rarity and non specific presentation that makes the preoperative diagnosis to be rarely achieved in most cases.

[1]. Peterson H. Volvulus of the cecum. Ann Surg. 1964;166:294.
[2]. Wolfer. J. A , Beaton, L. E and Anson BJ. Volvulus of the Cecum: Anatomical Factors in its Etiology:Report of a Case. SurgGynecol Obs. 1942;74:882.
[3]. Grodsinsky, C. andPonka JL. Volvulus of the Colon. Dis colon rectum. 1977;20:314.
[4]. Ruiz-Tovar J, Calero García P, Morales Castiñeiras V M, E M. Caecal volvulus: presentation of 18 cases and review of literature. Cir Esp. 2009;85:110–3.
[5]. Lau KC, Miller BJ, Schache DJ CJ. A study of large-bowel volvulus in urban Australia. Can J Surg. 2006;49:203–7.

Abstract: Intentional injuries are a common presentation to Accident and Emergency (A&E) Departments and make a significant contribution to theglobal injury burden. This descriptive study aims to determine the pattern and treatment outcome of intentional injuries presenting to the A&E Department of Benue State University Teaching Hospital, Makurdi, Nigeria (BSUTH). Case records of all patients who presented to the A&E Department between July 2012 and December 2013 were analyzed for age, gender, circumstance surrounding injury, weapon used, body region injured, injury sustained, treatment offered, and outcome of treatment. Sixty patients with intentional injuries were included in the study. They consisted of 50 males (83.3%) and 10 females (16.7%) with ages ranging from 15 to 65 years with a modal age group of 20-29 years. The extremities were the most predominantly injured body regions (n=26, 43.3%) and firearms were the most common weapons employed (n=31, 51.7%). While armed robbery (n=31, 51.7%) was the most common reason for the injuries, attempted suicide (n=2, 3.3%) was the least.Soft tissue injuries and debridement were the most common injury type and treatment modality encountered respectively.The death rate was 8.3% with majority of deaths (80%) resulting from firearm injuries.

Keywords: Intentional injury, violence, Accident and Emergency, Nigeria

[1]. Krug EG et al., eds. World report on violence and health. Geneva: World Health Organization: 2002.
[2]. Houry D, Cunningham RM, Hankin A, James T, Bernstein E, and Hargarten S. Violence Prevention in the Emergency Department: Future Research Priorities Academic Emergency Medicine 2009;16:1089–95.
[3]. Chalya PL, Gilyoma JM. The burden of intentional injuries in Mwanza City, north-western Tanzania: a tertiary hospital survey. Tanzania Journal of Health Research 2012;14(3): 1-10.
[4]. Murray CJL, Lopez AD, Mathers CD, Stein C. The Global Burden of Disease 2000project: aims, methods and data sources.Geneva, WHO 2001.
[5]. Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Web-based Injury Statistics Query and Reporting System (WISQARS). Available at: http://www.cdc.gov/injury/wisqars/index.html. Accessed 1 November 2014
[6]. Miller TR, Cohen MA. Costs of gunshot and cut/stab wounds in the United States, with some Canadian comparisons. Accident Analysis and Prevention 1997;29:329–341.

Abstract: Neurosarcoidosis is an uncommon multisystem granulomatous disease which can affect the nervous ystem. The diagnosis of neurosarcoidosis is difficult in patients who lack either pulmonary or systemic manifestations of sarcoidosis. Further more the clinical featues of neurosarcoidosis are variable. We are reporting one such case of systemic sarcoidosis with neurological manifestatation. A 60 year old lady presented with headache and seizures for 6 months and imageology of brain revealed multiple dural based lesions in brain and dura.biopsy revealed chronic non caseating granulomatous lesion suggestive of sarcoidosis .

Key words: dura, headache, sarcoidosis

[1]. RohanaNaqi,MuhammadAzeemuddin. NeurosarcoidosisJ Pak Med AssocVol. 62, No. 3, March 2012: 293-294
[2]. S. Pawate, H. Moses S. Sriram Presentations and outcomes of neurosarcoidosis: a study of 54 cases QJM (2009) 102 (7): 449-460
[3]. Jeffrey L. Sponsler, Mary Ann Werz, Robert Maciunas , Mark Cohen. Neurosarcoidosis presenting with simple partial seizures and solitary enhancing mass: case reports and review of the literatureEpilepsy & Behavior xxx (2005) xxx–xxx
[4]. ZajicekJP,ScoldingNJ,FosterO,RovarisM,Evanson J, Moseley IF, et al. Central nervous system sarcoidosis–diagnosis and management. QJM 1999;92:103-17
[5]. MAHLON D. JOHNSON, MD, PHD, SUZANNE Z. POWELL, MDet alDural Lesions Mimicking Meningiomas.HUMAN PATHOLOGY Volume 33, No. 12 (December 2002)

Abstract:Aim:To assess the awareness among medical officers about dental and medical facilities available in the Primary Health Center of Amer and Jamwaramgarh tehsil, Jaipur, India. Objective:
1. To determine the extent of dental health knowledge among medical officers in PHC.
2. To assess the dental awareness and attitudes of medical officers.
3. To assess the medical awareness and attitudes of medical officers.
4. To compare the awareness of masters and graduates regarding their dental and medical practice awareness in PHC.

[1]. Al-Hussaini R, Al-Kandari M, Hamadi T. Dental knowledge, attitudes and behaviour among students at the Kuwait university health sciences centre. Medical Principles and Practice 2003;12:260-65.
[2]. ShakeelAnjum M, Parthasarathi Reddy P, SwathiChowdary K. Role of Medical Officers In Referring the Dental Patients In Primary Health Centers Of Ranga Reddy District, Andhra Pradesh, India. . WebmedCentral DENTISTRY 2012;3(10):WMC003736
[3]. Tuti NMD, Shahida MS, Zamirah ZA. Dental knowledge and self-reported oral care practices among medical, pharmacy and nursing students. Journal SainsKesihatan Malaysia 2009;7(1):13 23.
[4]. Jagadish Chandra, Chandu GN, Prashant GM, et al. Dental awareness and attitudes of medical practitioners of Davangere city. Journal of Indian Association of Public Health Dentistry 2006;8:38-43.
[5]. Sumi Y, Nakamura Y, Nagosa, et al. Attitudes to oral care among caregivers in Japanese nursing homes. Gerodontology 2001;18(1):1-6.