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

Abstract: Lifestyle factors are widely being implicated in the prognosis and recurrent development of many cancers. As the incidence of various cancers is rapidly increasing in Nigeria, with limited and expensive treatment options; lifestyle changes have been proposed to help curb the disease. The aim of this study is to elicit the salient behavioral, normative and control beliefs of Nigerian doctors regarding providing lifestyle counseling to cancer patients and developing a valid and reliable questionnaire to this effect based on the Theory of Planned Behavior.

[1]. Akinremi TO, Chidiebere NO, Ayodeji OO. Review of prostate cancer research in Nigeria. Infectious Agents and Cancer. 2011; 6(Suppl 2):S8.
[2]. Adebamowo C. Cancer Care in Nigeria Part 1: The Social Cost of Cancer. American Society of Clinical Oncology 2013.http://connection.asco.org/Commentary/Article/id/3594/Cancer-Care-in-Nigeria-Part-1-The-Social-Cost-of-Cancer.aspx (Commentary on ASCO Connection).
[3]. Eguzo K, Camazine B. Cancer Care in Resource-Limited Settings: A Call for Action. J Cancer SciTher 2012; 4: 223-226. doi:10.4172/1948-5956.1000145.
[4]. Adisa CA, Eleweke N, Alfred AA, Campbell M J, Sharma R, Nseyo O, Tandon V, Mukhtar R, Greninger A, Risi J D, Esserman L J. Biology of breast cancer in Nigerian women: A pilot study. Ann Afr Med 2012; 11:169-75.
[5]. Ugwu EO, Obi SN, Ezechukwu PC, Okafor II, Ugwu AO. Acceptability of Human Papilloma Virus Vaccine and cervical cancer screening among female healthcare workers in Enugu, Southeast Nigeria. Nigerian Journal of Clinical Practice 2013; vol 16: 2.
[6]. Oluka OC, Shi Y, Nie S, Sun Y. Boosting cancer survival in Nigeria: Self-management strategies. Asian Pac J Cancer Prev 2014a; 15 (1): 335-341.

Abstract:Schwannomas are known as neurilemmonas, the most common benign tumor of the peripheral nerve's neural sheath, arising from the Schwann cells derived from the neural crest. They are the commonest tumor of the peripheral nerves, 5% of which occur in the adults. 19% of the tumors occur in upper extremities and 45% of schwannoma occur in the head and neck and 13.5% in the lower limbs. Volar surface is affected more than the dorsal aspect and they may occur as multiple lesions or they may affect different nerves in the same extremity. Despite the classical description that schwannomas are well encapsulated and can be completely enucleated during excision, a portion of them have fascicular involvement and could not be completely shelled out. 75% of schwannoma of the upper extremity occur at elbow or distal to it. It occurs more in the mixed nerve instead of pure sensory or motor nerve.

[1]. Weiss SW, G. J.: Enzinger and Weiss's Soft Tissue Tumors. Edited, St. Louis, Mosby, Inc., 2001.
[2]. C.L.Forthman and P.E.Blazar,"Nerve tumors of the hand and upper extremity,"Hand clinics, vol.20, no.3, pp.233242, 2004.
[3]. T.K.das Gupta, R.D.Brasfield, E.W.Strong, and S.I.Hsjdu,"Benign solitary schwannomas (neurilemomas)," Cancer,vol.24,no.2,pp.355366,1969.
[4]. Jayaraj SM, Levine T, Frosh AC, Almeyda JS.Ancient schwannoma masquerading as parotid pleomorphic adenoma. J Laryngol Otol 1997; 111:1088–1090
[5]. Dayan D, Buchner A, Hirschberg A. Ancient neurilemmoma (schwannoma) of the oral cavity. J Craniomaxillofac Surg 1989;17:280–282
[6]. McCluggage WG, Bharucha H. Primary pulmonary tumours of nerve sheath origin. Histopathology 1995;26:247–254
[7]. Loke TK, Yuen NW, Lo KK, Lo J, Chan JC. Retroperitoneal ancient schwannoma: review of clinicoradiological features. Australas Radiol 1998;42:136–138

Abstract: Every endodontist may have experienced a variety of emotions associated with instrument separation during root canal treatment. The traditional methods to retrieve such obstructions often require removal of greater amounts of tooth structure, potentially leading to perforation or eventual vertical root fracture. Today, these risks can be minimized with technological advancements in vision, ultrasonics, and microtube retrieval methods. Specifically, the dental operating microscope allows clinicians to visualize most broken instruments and fulfils the age old adage "If you can see it, you can probably do it". This case reports on successful retrieval of separated instruments by two different techniques under magnification.

Key Words: Ultrasonic, Instrument Retrieval System, Fractured Instrument.

[1]. Arcangelo CM, Varvara G, Fazio PD. Broken instrument removal two cases. J Endod 2000;26:568-70.
[2]. Roda RS, Gettleman BH. Nonsurgical retreatment. In: Cohen S, Burns RC, editors. Pathways of the pulp, 9th ed. St. Louis: CV Mosby; 2006. p. 982-90.
[3]. Pai AR, Kamath MP, Basnet P. Retrieval of a separated file using Masserann technique: A case report. Kathmandu Univ Med J 2006;4:238-42.
[4]. Hulsmann M. Methods for removing metal obstruction from theroot canal. Endod Dent Traumatol 1993;9:223-37.
[5]. Okiji T. Modified usage of the Masserann Kit for removingintracanal broken instruments. J Endod 2003;29:466-7.
[6]. Ruddle CJ: Microendodontic nonsurgical retreatment, in Microscopes in Endodontics, Dent Clin of North Am 41:3, pp. 429-454, W.B. Saunders, Philadelphia, July 1997.
[7]. Roda RS, Gettleman BH. Nonsurgical retreatment. In: Cohen S, Burns RC, editors. Pathways of the pulp, 9th ed. St. Louis: CV Mosby; 2006. p. 982-90.

Abstract: There is rapid increase in the awareness of composition of microbiota in the gut and its pathogenecity and functionality.The sterile gut of the infant at birth is colonized by diverse microbiota depending upon the immediate environment.Feeding methods has an influence on the development of gut microbiota of the infants as the feeds,feeding equipment and the personnel handling the feeds form the extrinsic factors.Breast milk, being the natural feed for the infant, promotes the growth of more symbiotic bacteria and provide protection against autoimmune disorders and allergic reactions.Whereas feeding methods other than exclusive breast feeding promotes the development of microbiota which can arouse pathological effects with slight disturbances in the gut environment predisposing the infant to many illnesses which may be fatal.

Keywords: Infant feeding methods, gut microbiota, breast feeding, formula feeding and pathogenic effects of microbiota

[1]. DiBaise JK, Zhang H, Crowell MD, Krajmalnik-Brown R, Decker GA, Rittmann BE. Gut microbiota and its possible relationship with obesity. Mayo Clinic proceedings. Mayo Clinic.2008; 83 (4): 460–2.
[2]. Mercedes de Onis, Monika Blo¨ssner, and Elaine Borghi Global prevalence and trends of overweight and obesity among preschool children. Am J Clin Nutr 2010;92:1257–64.
[3]. Daifellah A M Al Juaid,Colin W Binns and Roslyn C Giglia. Breastfeeding in Saudi Arabia:A review. International Breast Feeding Journal.2014.9:1
[4]. Kramer MS,Kakuma R.Optimal duration of exclusive breast feeding.Cochrane Database of American Academy of Pediatrics:Breast feeding and the use of human milk. Pediatrics 2012, 129;e 827-e841
[5]. James DC, Lessen R: Position of the American Dietetic Association: Promoting and supporting breast feeding. J Am.Diet.Assoc.2009,109: 1926-1942
[6]. World Health Organization: Planning guide for national implementation of the global strategy for Infant and young child feeding. WHO, Geneva, WHO 2007

Abstract: Bone cysts are benign bone lesions. Various modalities of treatment are described with various techniques with variable results and high recurrence rates. An ideal treatment should be cost effective with minimal morbidity and a short time for bone union and no recurrence. We are presenting a case report of minimally invasive surgical technique for a bone cyst that combines percutaneous decompression and bone grafting.

Key words: Surgical technique, Bone Cyst, Curettage, Autologous bone graft

[1]. CohenJ. etiology of simple bone cyst.J Bone Joint Surgery Am 1970;52:1493-97
[2]. Virchow R. On the formation of Bone cysts.In:Uber die bildung von knochencysten berlin: S-B AkadWiss 1876:p369-81
[3]. Campanacci M. CapannaR,PiccinP.unicameral and Aneurysmal bone cysts. ClinOrthop 1986:204:25-36
[4]. Neer CS 2nd,Francis KC,MArcoveRC,Terz J, Carbonara PN,Treatment of Unicameral Bone cyst A follow up study of one hundred seventy-five cases jbjs Am 1966:48:731-45
[5]. Oppenheim WL, Galleno H , Operative treatment vs Steroid injections in the management of unicameral bone cysts. J pediatrOrthop 1984;4:1-7
[6]. Hashemi-Nejad A, Cole WG, Incomplete healing of simple bone cysts after steroid injections. J Bone Joint Surg Br 1997;79:727-30
[7]. Lokeiz F, Ezra E,Khermosh O, Weintrob S Simple bone cysts treated by percutaneous autologous bone grafting J. Bone Joint Surg Br 1996;78:934-37
[8]. Yandow SM, Lundeen G, Scott SM, Coffin C Autogenic Bone marrow injections as a treatment for simple bone cysts . J paediatrOrthop 1998;18:616-20

Abstract: Tibial shaft fractures are the most common long bone fractures in adults and are usually caused by high-energy trauma. The management of tibial diaphyseal fractures has always been a challenge on account of its subcutaneous location [8], associated severe soft tissue injuries and many of these being open fractures. E.A.Nicoll [33]stated that, "Fractures of the tibia are important for two reasons: (1) they are common, and (2) they are controversial, and anything which is common and controversial must be important".

[1]. Abbas Hallaj Karldani, Hans Granhed, Bjorn Edshage, Ragar Jerre and Jorma Styf; Displaced tibial shaft fracture, A prospective randomized study of closed tramedullary tibial nailing versus cast treatment in 53 patients. Acta Orthp. Scand. 2000 April; 71(2):160-7.
[2]. Alberts KA, Loohagen G, Einarsdottir H.; Open tibial fractures: faster union after unreamed nailing than external fixation. Injury. 1999 Oct; 30(8): 519-23.
[3]. Alho A., Molster A., Thorensen N.R. Gjerdet, Ekeland A., Folleras G., Haukebo A., Stromsoe K. & Viste A.; the effect of rotational stability of the intramedullary nailing on bone healing. Acta. Orthop. Scand. 57, 575, 1986.
[4]. Anglen JO, Blue JM; A comparison of reamed and unreamed nailing of the tibia. J. Trauma. 1995 Aug; 39(2): 351-5.
[5]. Barry L.Riemer, MD, Shaul Sagiv, MD, Spencer L.Butterfield, MD, Charles J.BurkeIII, MD; Tibial Diaphyseal Nonunions After External Fixation Treated with Nonreamed Solid Core Nails. Orthopaedics.1996 Feb; 19(2); 109-16.
[6]. Bhandari M, Guyatt GH, Swiontkowski MF, Schemitsch EH.; Treatment of open fractures of the shaft of the tibia. JBoneJointSurgBr.2001Jan; 83(1): 62-8.

Abstract: We are reporting a rare case of giant fibroadenoma in a 15 year adolescent girl. The provisional diagnosis of the patient was made on FNAC which showed a benign proliferative brest lesion. Total excision of the mass was done preserving nipple and areola. Histopathology features were suggestive of giant fibroadenoma

Keywords: Giant fibroadenoma, Adolescent girl, Breast tumor

1. Dehner LP, Hill DA, Deschryver K. Pathology of the breast in children, adolescents, and young adults. Semin Diagn Pathol 1999. Aug;16(3):235-247. [PubMed]
2. Foxcroft LM, Evans EB, Hirst C, Hicks BJ. Presentation and diagnosis of adolescent breast disease. Breast 2001. Oct;10(5):399-404.10.1054/brst.2001.0292 [PubMed] [Cross Ref]
3. Arca MJ, Caniano DA. Breast disorders in the adolescent patient. Adolesc Med Clin 2004. Oct;15(3):473-485.10.1016/j.admecli.2004.06.003 [PubMed] [Cross Ref]
4. West KW, Rescorla FJ, Scherer LR, III, Grosfeld JL. Diagnosis and treatment of symptomatic breast masses in the pediatric population. J Pediatr Surg 1995. Feb;30(2):182-186, discussion 186-187.10.1016/0022-3468(95)90557-X [PubMed] [Cross Ref]
5. Fallat ME, Ignacio RC., Jr Breast disorders in children and adolescents. J Pediatr Adolesc Gynecol 2008. Dec;21(6):311-316.10.1016/j.jpag.2007.10.007 [PubMed] [Cross Ref]

Abstract: Curing of composites is a complex mechanism. Light is used to activate the photo-initiator system in the light curing units. Ideal requirements for curing light have been mentioned in the article. The article also sums up the various generations focusing on advantages, disadvantages and various advances in the same field. It has been concluded that an appropriately polymerized material has a positive influence on both the physical and biological properties of the restoration and should aid in promoting clinical success. Keywords : Light Cure Units, LED, Composites.

[1]. Malhotra N, Mala K. Light-curing considerations for resin-based composite materials: a review. Part I. Compendium of continuing education in dentistry 2010;31(7):498-505.
[2]. Strassler HE. Cure depths using different light units. Dental Town Magazine 2002, August:22-24.
[3]. Frederick A, Rueggeberg. State of the art: Dental photocuring-A review. Dental materials. 2011; 27: 39-52
[4]. Oyama N, Komori A, Nakahara R. Evaluation of Light Curing Units Used for Polymerization of Orthodontic Bonding Agents. Angle Orthodontist. 2004 Dec;74(6):810-815.
[5]. Knezevic A et al. Degree of conversion and temperature rise during polymerization of composite resin samples with blue diodes. Journal of Oral Rehabilitation. 2005 May;32(5):362-367.

Abstract: Objective: The aim of this study was to evaluate the role of ultrasound in evaluation of focal liver lesions, to study the imaging spectrum of focal hepatic lesions, to study the relative prevalence of different focal hepatic lesions, and to correlate the ultrasound findings with FNAC and/or CT scan. Methods: The study was prospective and was carried out between September 2014 and November 2014 at the Department of Radiology, P.D.U. Govt. Medical College and Civil Hospital, Rajkot. Abdominal ultrasound and ultrasound guided-fine needle aspiration cytology and/or CT scan of 50 patients with clinical diagnosis of hepatic focal lesions or incidentally discovered focal hepatic lesions was performed.

1]. Kuligowska E, Noble J. Sonographic features of hepatic abscess. Semin Ultrasound. 1983;4: 102-116.
[2]. Gossin KB. Intrahepatic focal liver lesions –Differential diagnosis. Am J Roentgenol.1981; 137: 763-767.
[3]. Edmonston HA, Peters RL . Tumors of the liver – Pathological features. Seminars in Roentgenology. 1983; 18(2): 75-83.
[4]. Gaines P A, Sampson M A. The prevalence and characterisation of simple hepatic cysts by ultrasound examination. Br.J.Radiol. 1989;62:335-7.
[5]. Liang P, Cao B, Wang Y, Yu X, Yu D, Dong B. Differential diagnosis of hepatic cystic lesions with grey-scale and colour Doppler sonography. JClin Ultrasound. 2005;33(3):100-5.
[6]. TareqSinan, Mehraj Sheik, Abdulla Behbdoni, Fayaz A Chisti, Zafar Sheik, PR Hira et al. Diagnosis of abdominal hydatid cyst: The role of ultrasound and ultrasound guided fine needle aspiration cytology. International Journal of Medical Principles and Practice. 2002; 11(04).

Abstract:Background and Aims: Different kinds of adjutants are used with local anesthetics during intrathecal procedure for prolongation of action. However, they are not completely free from side effects like postoperative hypoxia and cardiovascular instability. But subsequently, the use of preoperative femoral nerve block on surgical side provides beneficial analgesia to relieve fracture pain before operation, to make cooperative during administration of spinal anesthesia, to act as adjutants to intrathecal procedure and lastly to provide postoperative analgesia without side effect like central depression.

[1]. Popping DM, Elia N, Marret E, Wenk M and Tramer MR. Opioids added to local anesthetics for single-shot intrathecal anesthesia in patients undergoing minor surgery: a meta-analysis of randomized trials. Pain.2012; 153:784-93.
[2]. Sethi BS, Samuel M, Sreevastava D. Efficacy of analgesic effects of low dose intrathecal clonidine as adjuvant to bupivacaine. Indian J Anaesth 2007;51:415-9.
[3]. Grandhe RP, Wig J, Yaddanapudi LN. Evaluation of bupivacaine-clonidine combination for unilateral spinal anesthesia in lower limb orthopaedic surgery. J Anaesth Clin Pharmacol 2008;24:155-8.
[4]. Niemi L. Effects of intrathecal clonidine on duration of bupivacaine spinal anaesthesia, hemodynamic and postoperative analgesia in patients undergoing knee arthroscopy. Acta Anesthesiol Scand 1994;38:724-8.
[5]. Dahlgren G, Hultstrand C, Jakobsson J et al. Intrathecal sufentanil, fentanyl or plaecebo added to bupivacaine for caesarean section. Anesth Analg 1997; 85; 1288-93.
[6]. Manullang TR, Viscomi CM, Pace NL. Intrathecal fentanyl is superior to intravenous ondansetron for prevention of perioperative nausea during caesarean delivery with spinal anaesthesia. Anesth Analg 2000; 90: 1162-6.
[7]. Shendi D, Cooper GM, Bowden MI. The influence of IT fentanyl on the characteristics of subarchnoid block for Caesarean section. Anaesthesia 1998; Jul 53(7): 706-10.

Abstract: Unilateral block by lumbar epidural and caudal anesthesia is a rare event, although, from time to time, it becomes essential for aged patients to minimize the drug effect and to have full benefits of epidural anesthesia. Aims: This study is scheduled to get a way to achieve unilateral lower limb block with the help of the sacral epidural anesthesia. Method: 25ml of 0.5% Ropivacaine were injected into sacral epidural space in the lateral position with slight head down tilt. The patient was kept in the same position on the operation table for 15 minutes after completion of sacral epidural anesthesia on the surgical side with the nerve stimulator needle used for detection of the epidural space.

[1]. Gallart L, Blanco D, Samso E, Vidal F. Clinical and radiologic evidence of the epidural plica mediana dorsalis. Anesth Analg 1990;71:698-701.
[2]. Peduto VA, Tani R, Marinelli L, Pani S. Bilateral analgesia and unilateral paresis after lumbar epidural blockade. Anesth Analg 1992;74:294-6.
[3]. Singh A. Unilateral epidural analgesia. Anaesthesia 1967;22:147-9.
[4]. Yamagami H, Yuda Y, Shiotani M, et al. The administration of continuous epidural block under prone position with fluoroscopic guidance. Masui 1989;38:229-35.

Abstract: Sebaceous carcinoma (SC) is a rare carcinoma arising from sebaceous gland divided into ocular and extra ocular. Ocular SC is more common than extra ocular. This tumour has a high incidence of recurrence and metastasis. Due to its rarity, it is often difficult to arrive to a diagnosis. Early diagnosis and treatment is crucial. Definitive diagnosis is only by histopathological examination. We are presenting a case of sebaceous carcinoma arising from the scalp.

[1]. Bhatia SK, Atri S, Anjum A, Sardha M, Ali SA, Zaheer S, et al. Postauricular sebaceous cell carcinoma. International Journal of Case Reports and Images 2012;3(9):29–32.
[2]. Mathur S K, Singh Sunita, Yadav Rajni, Duhan Amrita, Sen Rajeev.Extraocular Sebaceous Carcinoma - a Rare Tumour at a Rare Site.Egyptian Dermatology Online Journal 2010; 6(2):14.
[3]. Bhavarajua VMK, Shamim SE, Naik VR, Shaari S. Sebaceous cell carcinoma of scalp – Arare presentation. Malaysian Journal of Medical Sciences 2007; 14(1): 67-70.
[4]. Ghosh SK, Bandyopadhyay D, Gupta S, Chatterjee G, Ghosh A. Rapidly growing extraocular sebaceous carcinoma occurring during pregnancy: A case report. DermatologyOnline Journal 2008; 14(8): 8.
[5]. JoonHo Lee, Hea-Kyeong Shin, and Tae Jung Jang. A Case of Rapidly GrowingExtraocular Sebaceous Carcinoma 2014 Apr 15(1):32-35.

Abstract: multifocal urothelial carcinomas are uncommon. The authors have reported a case in a forty year old male patient. It was a multifocal papillary urothelial carcinoma with extravesical extension.

Key words: multifocal, urothelial

[1]. Rosai, Ackerman. Urinary tract .In:Nelson G. Ordonez, Juan Rosai: Rosai and Ackerman's surgical pathology, 10th, ed , st. Louis;Mosby: 2011:1257-1265.
[2]. Tomonari Habuchi. International journal of urology 2005;12:709-716.
[3]. A.Lopez-Beltran etal.,in :pathology and genetics of tumors of the urinary system and male genital organs. WHO classification of tumors, John N.Eble,GuidoSauter, Jonathan I.Epstein,IsabellA.Sesterhenn(ed), lyon;2004:90.

Abstract: The loss of teeth has serious functional, esthetic disabilities, in addition to compromising the patients' quality of life. Currently, in the private sector, the status of prosthetic rehabilitation is only limited to anterior teeth due to esthetic reasons and rarely the posteriors. This could be called as inefficiency or lack of knowledge on part of few dental practitioners to understand and explain the importance of functional occlusion to the masses. Occlusion and its relationship with the temporpmandibular joint has always been debated. However, there are studies that have tried to elucidate this quite often ignored aspect of rehabilitation. The purpose of this review is to illuminate the relationship between the teeth and temporomandibular joint harmonious relationship. The authors intend to create an awareness and encourage the dentists to conduct long term trials on this controversial yet an important aspect of prosthetic dentistry.

Keywords: missing teeth, temporomandibular joint dysfunction, rehabilitation, occlusion

[1]. Okeson J.P., Management of temporomandibular disorders and occlusion, Mosby, St Luis, 2003.
[2]. Haley DP, Schiffman EL, Lindgren BR, Anderson Q, Andreasen K. The relationship between clinical and MRI findings in patients with unilateral temporomandibular joint pain. J Am Dent Assoc; 132, 2001, 476-481.
[3]. Temporomandibular disorders. In: de Leeuw R, editor. American Academy of Orofacial Pain. Orofacial pain: guidelines for assessment, diagnosis and management. 4th ed. Chicago: Quintessence; 2008,131.
[4]. Dworkin SF, Massoth DL. Temporomandibular disorders and chronic pain: disease or illness? J Prosthet Dent, 72(1), 1994; 29–38.
[5]. Engel GL. The need for a new medical model: a challenge for biomedicine. Science, 196(4286), 1977; 129–136.

Abstract: Introduction: Wilkie's syndrome is a rare disorder causing obstruction to the third part of duodenum due to acute angulation of superior mesenteric artery. It's a rare but surgically curable cause of duodenal obstruction. Case report: We present a case of 19year old male patient with chronic pain abdomen and vomiting which was correlated to obstruction of duodenum due to acute angulation of superior mesenteric artery on CECT abdomen. Patient's symptoms were dramatically improved following duodenojejunostomy. Conclusion: Wilkie's syndrome is more prevalent and underdiagnosed. Surgery is the treatment of choice.

Key words: Wilkie's syndrome, duodenojejunostomy

[1]. Avinash Shetty (2006-07-16). "Superior Mesenteric Artery Syndrome". eMedicine.WebMD. Retrieved 2008-04-09.
[2]. Baltazar U, Dunn J, Floresguerra C, Schmidt L, et al. (2000). "Superior mesenteric artery syndrome: an uncommon cause of intestinal obstruction". South. Med. J. 93 (6): 606–8.PMID 10881780.
[3]. Rokitansky, Handbuch der pathologischen Anatomie, vol. 3 Braunm¨uller & Seidel,Wien, Austria, 1st edition, 1842.
[4]. Laffont I, Bensmail D, Rech C, et al. (2002). "Late superior mesenteric artery syndrome in paraplegia: case report and review". Spinal Cord 40 (2): 88–91
[5]. P. Ylinen, J. Kinnunen, and K. Hockerstedt, "Superior mesenteric artery syndrome. A follow-up study of 16 operated patients," Journal of Clinical Gastroenterology, vol. 11, no. 4, pp. 386–391, 1989.
[6]. Birsen Ünal, Aykut Aktaş, Gökhan Kemal, et al. Superior mesenteric artery syndrome: CT and ultrasonography findings Diagn Interv Radiol 2005; 11:90-95

Abstract: Introduction: Rational antibiotic prescription is very important to prevent antimicrobial resistance. So the present study was conducted to know the rational use of drug in paediatric in-patient of Mc-Gann teaching hospital, SIMS, Shimoga. Material And Methods: A retrospective study of 2months duration was undertaken during May-June of 2013. A total number of 100 patients case sheets were taken for study from paediatric in-patients department of Mc-Gann teaching hospital. Patients were included with history of various infections. The data were analysed by using SPSS.

[1]. OP Ghai. Essential paediatrics, 4th edition, published by interprint A-16, 2010, page no-186-190.
[2]. Sanz EJ, Bergman U, Dahlstorm M. Paediatric drug prescribing. A comparison of Tenerife (canary Islands, Spain) and Sweden. Eur J clinpharmacol, 1989; 37(1):65-68.
[3]. Summers RS, Summers B. Drug prescribing in paediatrics at a teaching hospital serving a developing community. Ann Trop paediatr 1986; 6:129-133.
[4]. Paluk E, Katzentein D, Frankish CJ, Herbert CP, Miler R, Speert D et al. Prescription practices and attitudes toward giving children antibiotics. Can Fam Physician 2001;47:521-7.
[5]. Gopalakrishnan Sekharan, Ganeshkumar Parasuraman, Katta Ajitha. Assessment of prescribing practices among urban and rural general practitioners in Tamil Nadu. Indian journal of Pharmacology,2013;45(3);252-257.

Abstract: Dual tumor in an ovary is a rare entity and combination of mucinous cystadenoma with adult granulosa cell tumor (GCT) is very rare. Dual tumor represents a coexistence of two adjacent tumors but histologically distinct tumors without admixture in the same tissue or organ. Mucinous neoplasms occur rarely in association with granulosa cell tumor. GCT is low-grade malignancy and need a close follow up for recurrences which may be late. Here we present a case in 39 year old female who presented outpatient department with complaints of lower abdomen pain and dysfunctional uterine bleeding. Patient underwent hysterectomy with salphingo oophorectomy and specimen sent for histopathological examination, where it was diagnosed as mucinous cystadenoma in association with Adult granulosa cell tumor.

Key Words: Dual tumor, ovary, Mucinous Cystadenoma, Granulosa cell tumor.

[1]. Spencer HW, Mullings AM, Char G, Carpenter R. Granulosa-theca cell tumors of the ovaries. A late metastasizing tumor. West Indian Med J 1999;48:33-5.
[2]. Russell P. surface epithelial stromal tumors of ovary. In: Kurman RJ, ed. Blaustein's pathology of the female genital tract. 4th ed. New York: Springer-Verlag, 1994;724.
[3]. Ozgur B, Ahmet D, Meral KC, Mustafa S, Cagnur U et al. Collision tumor: serous cystadenoma and dermoid cyst in the same ovary. Archives of gynaecology and obstetrics 2009;279:767-70.
[4]. Dgani R, Rozenman D, Lifschitz-Mercer B. Granulosa cell tumorarising in an ovary with mature cystic teratoma. Int J Gynaecol Obstet1993;3:287-9.
[5]. Mayr D, Kaltz WC, Arbogast S et al. characteristic pattern of genetic aberrations in ovarian granulosa cell tumors. Mod Pathol 2002;15:951-7.
[6]. Nogales FF, Musto ML, Saez AI, Robledo M et al. Multifocal intrafollicular granulosa cell tumor of the ovary associated with an unusual germline p53 mutation. Mod Pathol 2004;17:868-73.