iosr-JDMS   Volume-13 ~ Issue-5 ~ May-2014

Abstract: Chronic Kidney Disease (CKD) is becoming a major global health problem. In India, diabetes and hypertension are responsible for 40% to 50% of all cases of CKD. The present study was carried out with the objective to detect the prevalence of asymptomatic CKD in high risk groups like diabetes and hypertension. Total 86 patients of age group above 18 of both sexes were selected randomly. Glomerular Filtration Rate (GFR) was estimated by Modification of Diet in Renal Disease (MDRD) 6 equation. Observation revealed that 15 cases had GFR >90, 40 cases had GFR 60-90. And 31 cases had GFR <60 ml /min per 1.73m2. Main age groups affected were >50 years (80%).CKD was seen in 40% of hypertensive and 27.8% of diabetic subjects. Result of this study is comparable with the study of Timothy HM et al who has also shown that 20.4% of his subjects had CKD, and higher prevalence among hypertensive than diabetic (69% and 30% respectively).The mean BMI of subjects having CKD is 23.8 ± 3.159 and mean BMI of subjects not having CKD is 25.1± 4.353. This observation shows that patients with CKD are having high normal BMI.CKD is a recognized risk factor of ESRD and cardiovascular death, which is a leading cause of death in developing countries. An increase in BMI is a significant factor independently associated with CKD. In the present study, the differences in BMI are relatively small and have an insignificant P value between those with and without CKD. An interventional approach is necessary to prevent development of CKD at every level, especially in high risk groups to prevent CKD and development of End Stage Renal Disease (ESRD).

[1]. Narula B AS. Chronic Disease: The Looming Threat. MJAFI 2008; 64: 2-3.
[2]. Modi GK and Jha V. The incidence of end stage renal disease in India: A population – based study. Kidney International 2006; 70: 2131-2133.
[3]. Frank CB, Thomas HH, Elie K, Mark MM Sharon MM. Detection of Chronic Kidney Disease in patients with or at increased risk of cardiovascular Disease. Hypertension 2006; 48: 751-755.
[4]. Moorthy AV. Early detection of Kidney disease is Important. India's National Magazine 2004; 21: 5-18.
[5]. Agarwal SK. Chronic Kidney Disease and its Prevention in India. Kidney International 2005; 68: 41-45.

Abstract: The oral cavity has been considered as a site of colonization of respiratory pathogens.The colonization of respiratory pathogens appears to be a risk factor for lung infection in high risk subjects.The mechanism of lung infection could be due to aspiration of the pathogens into the lungs. Edentulous patient are less likely to be affected compare to dentulous patient or patient who are using dentures.Most common pulmonary disease associated with periodontitis are Chronic obstructive pulmonary disease and pneumonia.These review underline the importance of improving oral hygiene among patients who are at risk.

[1] Oral Health and Respiratory Infection Philippe Mojon, DMD, PhD •
[2] Russell SL ,BoylanRJ,KaslickRS,ScannpiecoFA,Katz RV Respiratory pathogen colonization of the dental plaque of institutionalized Elders.Spec care dentist 1998;19:128-34
[3] ScannpiecoFA,MylotteeJM.relationship between periodontal disease and bacterial pneumonia.J.periodontal 1996;67:1114-22
[4] Periodontitis as a potential risk factor chronic obstructive pulmonary disease :A retrospective study.VikasDeo,ManoharBhongade,SalmanAnsari,Ramesh S chavan.
[5] Savage, Amir; Eaton, Kenneth A.; Moles, David R.; Needleman, Ian (2009). "A systematic review of definitions of periodontitis and methods that have been used to identify this disease". Journal of Clinical Periodontology 36 (6): 458–467. doi:10.1111/j.1600-051X.2009.01408.x. PMID 19508246

Abstract: Stem cell biology is currently one of the most exciting areas of biomedical research, as enthusiasm for the application of this technology toward regenerative medicine continues to expand. The application of stem cells in a therapeutic fashion may become a natural extension of the presumed potential of these unique cell populations with wide-ranging capabilities. As with many new and exciting technologies, much remains to be tested, proved, and delivered to separate the hope from the hype. In this review, we attempt to deliver the current "state of the art" in stem cell research and to provide a conceptual framework that can be used by surgeons as a basis for critical assessment of this quickly expanding and fascinating field.

[1]. Asahara T, Kalka C, Isner JM. Stem cell therapy and gene transfer for regeneration. Gene Ther. 2000;7(6):451-457.
[2]. Bianco P, Riminucci M, Gronthos S, Robey PG Bone marrow stromal stem cells: nature, biology, and potential applications. Stem Cells 2001;19:180–192.
[3]. Greco SJ, Liu K, Rameshwar P .Functional similarities among genes regulated by Oct4 in human mesenchymal and embryonic stem cells. Stem Cells .2007; 25:3143–3154.
[4]. Jones DL, Wagers AJ. No place like home: anatomy and function of the stem cell niche. Nat Rev Mol Cell Biol .2008; 9:11–21
[5]. Jorgensen C, Djouad F, Apparailly F, Noel D . Engineering mesenchymal stem cells for immunotherapy. Gene Ther .2003;10:928–931.

Abstract: Pregnancy with jaundice is regarded as high risk pregnancy so it is considered very important sign during antenatal check up . Incidence of jaundice in pregnancy is 0.4-0.9/1000 in India. It complicates 3-5% of pregnancies and is one of the important causes of maternal and neonatal morbidity and mortality worldwide. The normal physiological and hormonal profiles may alter throughout the pregnancy. The present retrospective study was carried out in the Department of Obstetrics and Gynecology, KLE's Dr. Prabhakar Kore Hospital and research centre from September 2011 to August 2012 to determine the causative factors responsible for jaundice in pregnant women and to assess its consequences in pregnancy. During 3 years of retrospective study, 9612 deliveries were conducted. Among them 9167 were live birth and 445 were stillbirth. Overall 37 (0.4%) women had clinical and biochemical evidences of jaundice. Their mean age was 24.78±3.66 years and the mean period of gestation (34.7±3.42 weeks). Among them predominant cause of jaundice was HELLP 24(64.86%) followed by acute viral hepatitis and Leptospirosis 5(13.51%) of each. Severe PIH was the most common co-morbid conditions observed in 20(54.05%) of the pregnant women. And the commonest cause of maternal mortality 15 (53.57%) was HELP followed by severe anaemia 3(10.74%). Among 37 births, 53.85% were live births, 28.21% were fresh still births and 17.95% were macerated still births. Among the 53.85% of live births, foetal mortality was seen in 4.76%. Pregnancy with liver disorder results in very high foetal as well as maternal morbidity and mortality. HELLP was found to be the predominant cause of Jaundice and associated mortality in pregnancy. It might cause mild to severe complication in pregnancy. Pregnancy with liver disorder results in high foetal as well as maternal morbidity and mortality. Thus early diagnosis and proper management is essential to reduce the high maternal mortality in pregnant women with jaundice.
Key Words: Liver disorder, maternal mortality, foetal mortality, pregnancy, HELLP, Jaundice.

[1]. R.K. Jain. Management of jaundice in pregnancy. Medicine update 2010, 20, 470-6.
[2]. C.L. Ch'ng, M. Morgan, I. Hainsworth J.G. Kingham. Prospective study of liver dysfunction in pregnancy in Southwest Wales.Gut 2002; 51: 876–80.
[3]. T. Nagaria, S. Agrawal, Fetomaternal outcome in jaundice during pregnancy, J Obstet Gynecol India, 2005, 55(5), 424-7.
[4]. M.S. Khuroo, S. Kamili, Aetiology and prognostic factors in acute liver failure in india, J viral Hepat., 2003, 10, 224 -31
[5]. Y.B. Yang, X.M. Li, Z.M. Shi, L. Ma, Pregnant women with fulminent hepatic failure caused by hepatitis B virus infection: A case report, World J Gastroenterol, 2004, 10 (15), 2305-6.

Abstract: Diastematomyelia, or split cord malformation, a complete or incomplete sagittal division of the neural axis into halves, is seen in association with many other congenital anomalies. Among these anomalies, intradural spinal teratoma is extremely rare. Diastematomyelia is a well-recognized although unusual clinical syndrome in children, but it is rarely reported in the adult. We report a case of 19 year old girl who presented with pain and distal left-leg weakness as well as neurogenic claudication for 1 month. The patient underwent radiological examinations, and diastematomyelia and an intradural lumbar teratoma were diagnosed. she underwent surgery with definite anaesthesia management. This is the first case of an adult who simultaneously presented with diastematomyelia and an intradural teratoma with hemivertebrae. We hereby discuss the anaesthetic plan and management of the same.

[1]. Dias MS & Pang D. Split cord malformations. Neurosurgery Clinics of North America 1995; 6: 339–58.

[2]. Ersahin Y, Mutluer S, Kocaman S, Demirtas E. Split spinal cord malformations in children. Journal of Neurosurgery 1998;

[3]. Pang D, Dias MS, Ahab-Barmada M. Split cord malformation: Part I. A unified theory of embryogenesis for double spinal cord malformations. Neurosurgery 1992;

[4]. English WJ & Maltby GL. Diastematomyelia in adults. Journal of Neurosurgery 1967

[5]. Hood RW, Riseborough EJ, Nehme AM, Micheli LJ, Strand RD, Neuhauser EBD. Diastematomyelia and structural spinal deformities. Journal of Bone and Joint Surgery. American Volume 1980;

Abstract: Cystic lymphangioma of the small bowel mesentery is a rare manifestation of an intra- abdominal tumor particularly in adults. 1, 2, 3 The clinical features of intra abdominal lymphangioma are diverse ranging from an asymptomatic abdominal tumor to symptoms of acute abdomen , thus a mass may be discovered incidentally during abdominal examination for an unrelated illness. We hereby present the case of a young adult male with cystic lymphangioma of the jejunal mesentery who presented with an abdominal mass and history of sitophobia.

[1]. Chen CW, Hsu SD, Lin CH, Cheng MF, Yu JC. Cystic lymphangioma of the jejunal mesentery in an adult: a case report. World J Gastroenterol. 2005;11:5084–5086.
[2]. Rieker RJ, Quentmeier A, Weiss C, Kretzschmar U, Amann K, Mechtersheimer G, Bläker H, Herwart OF. Cystic lymphangioma of the small-bowel mesentery: case report and a review of the literature.Pathol Oncol Res. 2000;6:146–148
[3]. Hanagiri T, Baba M, Shimabukuro T, et al. Lymphangioma in the small intestine: report of a case and review of the Japanese literature. Surg Today. 1992;22:363–7.
[4]. Weeda VB, Booij KA, Aronson DC. Mesenteric cystic lymphangioma: a congenital and an acquired anomaly? Two cases and a review of the literature. J Pediatr Surg. 2008 Jun;43(6):1206-8. doi: 10.1016/j.jpedsurg.2008.01.075. [5]. Stein M, Hsu RK, Schneider PD, Ruebner BH, Mina Y. Alcohol ablation of a mesenteric lymphangioma. J Vasc Interv Radiol. 2000 Feb;11(2 Pt 1):247-50.

Abstract: Lymphangiomas are benign hamartomatous malformation of lymphatic vessels which contain clear protein rich fluid with few lymphcells. These malformations can occur at any age and involve any part of the body but have marked predilection to occur with head & neck region (50 to 70%). Occurrence of oral lymphangioma is rare and the tongue involvement is even rarer[1]. The Prognosis of lymphangiomas is good in most patient but respiratory obstruction is a feared complication of these lesion at head, neck and oral region as seen in our case, which may be fatal if not managed promptly.

[1]. Mehar R, Garg A, Raj A, Singh I. Lympangioma of Tongue. the internet journal of otorhinolaryngology. 2005; 3(2).
[2]. S. Sunil, Devi Gopa Kumar, and B.S. Shrinivasan, Oral Lymphangioma. The contemporary clinical dentistry 2012 Jan-Mar; 3(1): 116-118.
[3]. Giguere CM, Bauman NM, Smith RJ (December 2012). "New Tretment Options for Lymphangioma in infant and children." The Annals of Otology, Rhinology and Laryngology 111 (12pt 1): 1066-75.
[4]. V Naveen Shanker, Ashwini. N Shankar, Praveena V. Shanlar J. Lymphvasculogenesis and Lymphangioma an update. Cancer Sci Ther. 2011; 3(6): 149-153.

Abstract: Lacrimal sac is the closed upper end of the nasolacrimal duct and has a fibro-elastic wall lined internally by mucosa that is continuous with the conjunctiva through the lacrimal canaliculi and within the nasal mucosa through the nasolacrimal duct. Primary lacrimal sac tumors are rare compared to other orbital tumors. Mucoepidermoid carcinoma is a tumor that contains both neoplastic mucin producing and epidermoid cells. Mucoepidermoid carcinoma of the LS is very rare. Early treatment of these tumors is essential because they tend to be infiltrating tumors.Multiplanar CT imaging of the paranasal sinuses and orbit is essential for defining the extent of the tumor and for finding evidence of bony destruction of the lacrimal fossa.
Keywords: Lacrimal sac, Mucoepidermoid carcinoma, CT

[1]. Montalban A,LietinB,LourierC,RussiesM,KemenyJL,MomT,GilamL,malignant lacrimal sac tumours.Eur AM otorhinolaryngol Head neck Dis 2010;127:165-172
[2]. Stefanyszyn MA,HidayatAA,PeerJJ,etal,lacrimal sac tumors.opthalplastreconstrsurg 1994;3:169-184
[3]. Parmar DN, Rose GE. Management of lacrimal sac tumours. Eye2003;7:599Y606
[4]. Stefanyszyn MA, Hidayat AA, Pe'er JJ, et al. Lacrimal sac tumors.OphthalPlastReconstrSurg 1994;10:169Y184
[5]. Flanagan JC, Stokes DP. Lacrimal sac tumours.Ophtalmology1978;85:1282Y1287

Abstract: Gleich syndrome is a distinct clinical entity characterized by episodic angioedema, hypereosinophilia and increased body weight. Being a rare cause of hypereosinophilia, extensive diagnostic evaluation has to be carried out to rule out the other common causes like allergic diseases, Idiopathic hypereosinophliic syndrome (HES), connective tissue disorders, parasitic infestations, lympho-proliferative disorders and neoplastic conditions. We report a rare case of Gleich syndrome in a young Indian female. It usually runs a benign course and shows a good response to low dose corticosteroid therapy.
Keywords: Episodic angioedema, Gleich syndrome, hypereosinophilia, interleukin-5 (IL-5), recurrent urticaria, weight gain.

[1] Abouzahir A, Chaurin P, Coutant G and Garcin JM, Gleich syndrome- A case report and review of the literature, Rev Med Interne, 26(2), 2005, 137-40.
[2] Gleich GJ, Schroeter AL, Marcoux P, Sachs MI, O'Connel EJ and Kohler PF, Episodic angioedema associated with eosinophilia, N Engl J Med, 310, 1984, 1621-6.
[3] Takanori S, Yoshio U, Hirotsugu T and Seiji A, A case of episodic angioedema associated with eosinophilia, The J of Med. Investigation, 44, 1997, 103.
[4] Shimasaki AK, Five cases of nonepisodic angioedema with eosinophilia, Rinsho Ketsueki, 42(8), 2001, 639-43.
[5] Nasser RD, Sajid M, Khalid K, Amjad S and Shahid M, Recurrent urticaria, blood eosinophilia and eosinophilic ascites- A new variant of Gleich's syndrome, J of Army Medical Corps, 3, 2008, 1-4.

Abstract: Objective: The present study was planned to access the efficacy of Hour Glass compression suture which is easy, can be applied faster and avoids the need of hysterectomy in patients with atonic postpartum hemorrhage. Materials and methods: This observational study was carried out from Jan 2010 to October 2012 at Gynaecology and Obstetrics Departments, Bankura Sammilani Medical College &Hospitals, West Bengal, India. All patients included in this study with primary PPH, hour-glass suture were given using No. 1 Chromic Cat gut with a straight needle. Two suture in a shape of hour glass( figure of 8) on either side of uterus were given, 10 patients presented by severe atonic PPH. In all 10 patient, routine initial measures (uterine massage, oxytocin infusion, methergine, carboprost ,if not contraindicated, and misoprostol) were done and when failed, compressing uterine suture was performed. Results: All 10 cases had an uneventful postoperative recovery. All the cases had evidence of uterine atony which was not responded to conventional uterotonics. The estimated blood loss ranged from 1000 ml to 2,000 ml. In all cases this technique successfully stopped the bleeding and the patient's uterus was preserved. No complication like pyometra, amenorrahoea/oligomenorrahoea, suture cut down through myometrium was faced during the procedure. Regular menstruation returned within 3-4 months follow up after operation, except in one case where the patients conceived during the period of lactational amenorrhoea. Later she opted for medical termination of pregnancy.None of them require hysterectomy. Conclusion: The technique is easy, rapid and requires less skill and this simple procedure be tried first before other complex measures like uterine artery ,ovarian artery ligations are undertaken particularly for those obstetricians who lack sufficient training and skill.
Key Words: Hour Glass compression suture, Postpartum hemorrhage, Hysterectomy.

[1]. Hayman R G, Arulkumaran S, Steer P J. Uterine compression sutures: Surgical management of
postpartum haemorrhage. Obstet Gynecol 2002; 99:502-6
[2]. Li XF ,Fortney JA, Kotelchuck M, Glover LH(1996) The post partum period ;the key to maternal mortality. Int J Gynaecol Obstet 52:1-10
[3]. B-Lynch C, Coker A, Lawal A, Abu J, Cowen M. The B-Lynch surgical technique for the control of massive postpartum haemorrhage: an alternative to hysterectomy? Five cases reported. Br J Obstet Gynecol 1997;104:372–5
[4]. Allam MS, B-Lynch C. The B-Lynch and other uterine compression suture techniques. Int J Gynaecol Obstet 2005;89:236–41
[5]. B-Lynch C. Partial ischemic necrosis of the uterus following a uterine brace compression suture. BJOG 2005;112:126–7.

Abstract: Objectives: To compare the efficacy of bisoprolol and atenolol in hypertension, myocardial infarction and effect on lipid levels. Materials and methods18 patients whose blood pressure was above 95mm Hg (Diastolic) or higher were recruited from hypertension clinic. They were given either A or B alternatively. B.P.were recorded both supine and standing position at 30 minutes interval after 2 weeks again B.P. was recorded. In the same way 14 patients were recruited for myocardial infarction. Before giving the drug E,C.G. and blood for lipid profile were taken. After 4weeks again the same procedure were repeated. Results were tabulated and comparison and significance were tested by unpaired students't' test and their 'p' value was calculated. Results were also shown graphically. Results Bisoprolol had consistently significant effect than atenolol in hypertension,myocardial infarction and in reducing lipid profile levels Summary and conclusion:In this double blind study, bisoprolol had consistently greater antihypertensive effect than atenolol(p<0.05>0.02) in supine and in standing (p<0.01>0.001).In Myocardial infarction ,bisoprolol worked more quickly than atenolol.Bisoprolol statistically significant in reducing blood triglycerides and LDL levels. So the efficacy of Bisoprolol is more both in hypertension and in myocardial infarction.
Key words: Atenolol. bisoprolol, hypertension ,Myocardial infarction

[1]. Chang P C., Vanveen S, Vander Krogt JA, Vermei J.P., Vanbrummelen P. Β1 adren oceptor selectivity of single oral doses of Bisoprolol and Atenolol J Cardiovas Pharmacol 1988 12: 317
[2]. Andrew Whelton M.D., F.A.C.P. F.C.P., Jack M.D and David J. Wagner M.S Sustained Antihypertensive activity of Diltiazerm SR: Double blind placebo controlled study with 24 hrs. Ambulatory blood pressure monitoring, J. of clin Pharm 1992, 32: 808-815
[3]. Brachetti D A double blind comparison of Bisoprolol and captopril for treatment of essential Hypertension in the elderly. Cardiovas. Drugs: ther: 1990, 4: 261.
[4]. Bughler F R Double blind comparison of the cardiosetective β blockers, Bisoprolol and ATenolol in Hypertension. The bisoprolol International multicentre study J of Cardiovas Pharmacol 1986 8 (Supp: 11) 5122.
[5]. Weiner L Fritz G Anti hypertensive effect of Bisoprolol during once daily administration in patients with essential hypertension. A Dose ranging studies with parallel groups. Europ J of clinic Pharm: 1986, 29: 517-21.

Abstract: Fractures of the shaft of femur are a major cause of morbidity and mortality in patients who sustain high energy trauma. Morbidity arises from limb shortening, malalignment, knee contractures and other complications of fracture. Mortality is infrequent but can result from an open wound, fat embolism, adult respiratory distress syndrome or multiple organ failure especially in the poly trauma patients. Both morbidity and mortality can be diminished by prompt reduction and internal fixation of the fracture. (Robert A .Hansen T.et al. 1978.)1 Restoration of alignment, rotation and length, preservation of the blood supply to aid union and rehabilitation of the patient are the goals of treatment. The type and location of the fracture, degree of communition, the age of the patient, patients social, economic demands and other associated fractures may influence the method of treatment Currently intramedullary, interlocking nailing is considered to be the treatment of choice for complex femoral shaft fractures. (Funk .J.Wells. R et al 1968.)2.

[1]. Robert A, Hansen .T. Segmental Fracture S Of Shaft Of Femur Treated By Closed Intramedullary Nailing. T.JBJS Vol 60A 934-939. Oct 1978.
[2]. Funk.J, Wells .R Supplementary Fixation Femoral Fractures.Clin.Ortho. 60; 4-49.1968.
[3]. Thoresen BO, Alho A., Intramedullary Interlocking Nailing In Femoral Shaft Fractures A Report Of Fourty Cases. JBJS 1985; 67; 1313-1320.
[4]. Winquist RA, Hansen S. Closed Intramedullary Nailing Of Femoral Fractures. A Report Of 520 Cases. JBJS 66-A 529-539.1984.
[5]. Church Jct.Segmental Fractures Of Femure, JBJS 1971; 53(2): 355.

Abstract: Aim: To evaluate the efficacy and safety of autologous serum eye drops in treatment of severe dry eye. Material and methods: Twenty six eyes of thirteen severe dry eye patients were enrolled in this study. All patients were refractory to treatment with conventional artificial tears. Autologous serum eye drops were applied eight times a day per eye. Patients were evaluated subjectively and objectively with Schirmer's test, TBUT, Fluorescein stain at start of treatment, at two weeks, and six weeks after start of treatment. Results: Clinically and statistically significant improvement was seen both objectively and subjectively in patients of severe dry eye treated with autologous serum.

[1]. Fox RI, Chan R, Michelson JB, et al. Beneficial effect of artificial tears made with autologous serum in patients with keratoconjunctivitis sicca. Arthritis Rheum 1984; 27: 459-61.
[2]. Tsubota K, Goto E, Fujita H, et al. Treatment of dry eye by autologous serum application in Sjogren's syndrome. Br J Ophthalmol 1999; 83: 390-95.
[3]. Rocha EM, Pelegrino FS, de Paiva CS et al. GVHD dry eyes treated with autologous serum tears. Bone marrow transplant 2000; 25: 1101-03.
[4]. Geerling G, Honnicke K, Schroder C, et al. Quality of salivary tears following autologous submandibular gland transplantation for severe dry eye. Graefes Arch Clin Exp Ophthalmol 1999; 237: 546-53.
[5]. Bradley JC, Bradely RH, Mc Cartney DL, Mannis MJ. Serum growth factor analysis in dry eye syndrome. Clin Exp Ophthalmol 2008; 36(8): 717-20.

Abstract: The study was about the effect of music and different musical tempo on post-exercise recovery time following moderate exercise as there is very little information about effect of music on time taken for post-exercise recovery. Sixty volunteers (30 male, 30 female) subjected to isotonic exercise i.e. Harvard's step test, on three consecutive days, followed by rest in silence on first day, rest by hearing slow music on second day and rest by hearing fast music on third day. Parameters such as Pulse rate and blood pressure, were measured at predetermined intervals. The ANOVA test showed that with slow music, recovery time of systolic blood pressure (SBP) (7.7±2.9), diastolic blood pressure (DBP) (5.4±3.3) and pulse rate recovery (PR) (8.1±2.1) were significantly faster when compared to both no music and fast music. The study concluded that music hastens post-exercise recovery and slow music has greater relaxation effect than fast or no music, recovery time was independent of the gender and individual music preference.
Key words: musical tempo, post-exercise, recovery, young adults.

[1]. Masters KS, Ogles BM. Associative and dissociative cognitive strategies in exercise and running: 20y later, what do we know? Spot Phychol1998; 12: 253-270.
[2]. Terry, P.C. & Karageorghis, C.I. (2011). Music in sport and exercise. In T. Morris & P. C. Terry (Eds.), The new sport and exercise psychology companion (pp. 359-380). Morgantown, WV: Fitness Information Technology.
[3]. Szmedra L, Bacharach DW. Effects of music on perceived exertion, plasma lactate, norepinephrine and cardiovascular hemodynamics during treadmill running. J Sports Med 1998; 19: 32-37.
[4]. That MH, Kenyon GP, Schauer ML et al. The connection between rhythmicity and brain
[5]. function: implications for therapy of movement disorders. IEEE Eng Med Biol Mag 1999; 18: 101-108.

Abstract: Introduction: Stature estimation is an important part of the identification process of human skeletal remains or body parts to establish individuality of an unidentified dead, body or any mutilated part of such body by the Medico-legal expert..Aim: The present study made an attempt to estimate the stature from per-cutaneous tibial length (PCTL) by formulating simple regression equation and multiplication factor (M.F.) for people of Gwalior region. Method: A random sample of 270 male and 270 female students of G.R.Medical College, Gwalior between the age group of 18-21 years was chosen. PCTL of right and left side were measured with the help of spreading caliper. Stature was estimated from PCTL statistically using simple regression analysis and M.F. Result: On computing the data, the mean PCTL for male was found to be 38.24±2.343cm which was significantly (p<0.0001) greater than female which was 36.064±2.464cm. The observed height was 164.5±8.257cm and 155.3±5.854cm for male and female respectively. The regression formula derived for male was y0=105.971+1.53 x(PCTL) ± 7.452 and for female was y0= 103.76+1.43 x(PCTL) ± 4.69. The M.F was 4.302 for male and 4.306 for female. A significant positive correlation exists between the stature and PCTL using simple regression analysis and M.F. Conclusion: It was concluded that the stature of a deceased person whose only body part available is a mutilated leg, can be determined by using the formula derived from the present study fairly accurately to some extent. Thus the data of this study is recommended in anthropological studies for stature estimation amongst the ethnic group under study.
Key words: Forensic Anthropology, Stature, Percutaneous Tibial Length , Height Estimation, Simple Regression Equation.

[1] Trotter M, Gleser GC. Estimation of stature from long bones of American whites and negroes. Am J Phys Anthropol 1952;10:463-514.
[2] Mall G, Hubig M, Büttner A, Kuznik J, Penning R, Graw M. Gender determination and estimation of stature from the long bones of the arm. Forensic Sci Int 2001;117: 23-30.
[3] Duyar I, Pelin C. Body height estimation based on tibia length in different stature groups. Am J Phys Anthropol 2003;122:23-7.
[4] Petrovečki V, Mayer D, Šlaus M, Strinović D, Škavić J. Prediction of stature based on radiographic measurements of cadaver long bones: a study of the Croatian population. Journal of Forensic Sciences. 2007; 52 (3):547-52.
[5] Lundy JK, Feldesman MR. Revised equations for estimating living stature from long bones of the South African Negro. S Afr J Sci 1987; 83: 54-55.

Abstract: Management of Electrolyte imbalance is a known entity in post operative period and a very crucial part in early recovery of post operative patients. There have been studies regarding post operative electrolyte imbalance but the relationship with intravenous fluid (IVF) is not studied in detail. This study basically focuses on the anticipation of electrolyte imbalance and relation with the IVF used. In this study post operative electrolytes specifically in upper Gastrointestinal (GI) surgeries have been considered as there are very few studies dealing specifically with electrolyte imbalance in upper GI surgeries

[1]. McConnell EA:Fluid and electrolyte concerns in intestinal surgical procedures.Nurs Clin North Am. 1987 Dec;22(4):853-60.

[2]. Leffen R, Chawls W. Fluid and electrolyte management. In: Oldham K, Colom-bani P, Foglia R, editors. Surgery of Infants and Children. 2nd ed. Philadelphia: Lippincott-Raven; 1997. p 83-115.

[3]. Moritz ML, Ayus JC. Prevention of hospital-acquired hyponatremia: a case for using isotonic saline. Paediatrics 2003;111:227-30. [4]. Holliday MA, Friedman AL, Segar WE, Chesney R, Finberg L. Acute hospital-induced hyponatremia in children: a physiologic approach. J Pediatr 2004;145:584-7.

[5]. Holliday MA, Segar WE, Friedman A. Reducing errors in fluid therapy management. Paediatrics 2003;111:424-5.

Abstract: Background: Inguinal hernias are frequently encountered disease. When not treated may lead to their complications like obstruction and strangulation. Though there has been extensive search but no one has been able to find the ideal way to repair inguinal hernia.Aim: To evaluate and analyze the effectivity of Stoppa procedure in the management of bilateral inguinal hernia Patients and methods: study was carried out between October 2011 and January 2013. Hundred patients of bilateral inguinal hernia were operated using Stoppa Technique. Of these 12 were cases of recurrent hernia. The parameters evaluated were operative time, length of hospitalization, minor complications, recurrence and chronic groin pain. Results: The outcome at the end of 1 yr follow-up was good. Average duration of surgery was 38.5 min. In the early post operative period 3 patients had seroma, 3 patients had spinal headache, and a single case of urinary retention. 93 patients were discharged on the day after operation. At the end of 2 year follow-up none had recurrence or chronic groin pain.Conclusions: Stoppa procedure is an operation devised to cure hernias and also prevented other types of hernia occurring through myopecteneal orifice. Its low complication and recurrence rates have made it an attractive option for hernia therapy.
Keywords: Hernia repair, Stoppas,

....................................................................................!

Abstract: Odontgenic cysts are pathological lesions originating from tooth forming structures and they deserve critical attention due to the complications they cause. We report a study of 120 cases of dontogenic cysts with the features recorded as age, sex, site, etiology, incidence, radiological features and histological features for confirmative diagnosis.
Key words: Odontogenic cysts, developmental cysts, inflammatory cysts.

[1]. Manal A and Sheddi Al. Odontogenic cysts- A clinicopathological study. Saudi Med J 2012; 33(3): 304-308.
[2]. Avelar RL, Antones AA, Carvalho R W F, Bezerra Paulo G C F, Neto P J O and Andrade E S S. odontogenic cysts- A clinicopathological study of 507 cases. Journal of Oral Science 2009; 51(4): 581-586.
[3]. Monteiro L, Lapena J D, Fonseca L, Paiva A and Amaral B D. Odontogenic cysts- A descriptive pathological study. Braz J Oral Sci 2005; 4(12): 670-675.
[4]. Pekiner F N, Borahan O, Ugurlu F, Horasan S, Sener B C and Olgac V. Clinical and radiological features of a large radicular cyst involving the entire maxillary sinus. MUSBED 2012; 2(1): 31-36.
[5]. Toomarian L, Moshref M, Mirkarimi M, Lofti A and Beheshti M. Radicular cyst associated with a primary first molar: A case report. Journal of Dentistry, Tehran University of Medical Sciences, Tehran, Iran 2011; 8(4): 213-217.

Abstract: The expression of cell adhesion molecule CD44s was analyzed immunohistochemically in 20 odontogenic lesions. CD44s was detected in almost all the cells on the cell membrane in basal and parabasal cells of the odontogenic cystic lining of the dentigerous cysts and the radicular cysts sparing the superficial layer of the cystic lining. CD44s was expressed on the cell membrane of the peripheral columnar cells and in the stellate cells, but were very negligible in the keratinizing areas.
Key words: Ameloblastoma, CD44, Dentigerous cyst, immunohistochemistry, Radicular cyst.

[1]. Shear M, Developmental odontogenic cysts: an update. J Oral Pathol Med 1994; 23: 1-11.
[2]. Melrose R J. Bening epithelial odontogenic tumors. Semin Diagn Pathol 1999;16: 271-87.
[3]. Eversole L R. Malignant epithelial odontogenic tumors. Semin Diagn Pathol 1999; a16:317-24. [4]. Shear M. Radicular and residual cysts. Cysts of the Oral Region, 3rd ed. Bristol UK: Wright. 1992:136-162.
[5]. Som PM, Curtin HD. Head and neck imaging. Mosby Inc. (2003) ISBN:0323009425.

Abstract: In hanging suspension of body may be complete or partial. Different positions of partial hanging are noted in the forensic literature.Here we report a case of 15 year old school going boy who committed suicideby hanging in an unusual way by schooluniform neck-tie as ligature material on the play ground slide. The victim was in lying down position with his whole posterior aspect resting on surface along with head on the play slide. Medico-legal autopsy was done in department of forensic medicineatShriVasantraoNaik Government Medical College, Yavatmal to confirm the cause, mode and manner of death.Medico-legal, legal and social issues related to this rare type of unusual partial hanging case arediscussed.
Key worlds: unusual, partial hanging, playground slide, necktie.

[1]. DiMaioVJ and DiMaioD.Forensic Pathology. Second Edi. Boca Raton: CRC Press; 2001. p. 262-71.
[2]. SaukkoP and Knight B. Knight's Forensic Pathology. Third Ed. London: Arnold Publishers; 2004. p. 352-394.
[3]. Modi'sMedical Jurisprudence and Toxicology.Karmakar RN and Patnaik AK editor. Twenty-Third Ed. New Delhi: LexisNexis; 2007. p. 565-75.
[4]. Nandy A. Principles of Forensic Medicine including Toxicology. Third Ed. London: New Central Book Agency (P) Ltd; 1985. p. 517-29.
[5]. Polson CJ, Gee DJ and Knight B. The Essentials of Forensic Medicine. Forth Ed. Oxford: Pergamon Press; 1985. p. 357-89.
[6]. Khokhlov VD. Calculation of tension exerted on Ligature in Incomplete Hanging. Forensic Science International. 2001; 123:172-77.

Abstract: This study was conducted in MM Medical College, Solan on 60 patients of neck swelling who presented in Department of ENT. The aim of the study was to know the prevalence and frequency of various types of thyroid swellings and also to know the age and sex distribution of thyroid swellings. In this study, it was seen that out of 60 neck swellings, thyroid swellings were commonest -25(41.6%) in number followed by lymph nodes,tubercular and sialadenitis. Out of thyroid swellings, female to male ratio was 3.2:1.
Key words: Goitre, FNAC, T3,T4,TSH, Neck swelling, USG

[1]. Kamath, Vinod Bhat,RSP Rao,Acharya Das,Ganesh K.S and AshaKamat.Prevalence of goitre in rural area of Belgaum District of Karnatka.Indian Journal of Community Med 2009, Jan 34(1);48-51.
[2]. M Aslam, SM Hasan and SA Hasan.Fine needle aspiration cytology versus histopathology in cervical lymphadenopathy. Ind. J. Otolaryngo/Head Neck Sug.Apr 2000.52(2)
[3]. I.V Renuke, G.SailaBala,C.Aparna,K.Sumanlatha.The Bethesda system for reporting thyroid cytopathology.Interpretation and guidelines in surgical treatment.IJOHNS Oct-Dec 2012,64(40;305-311.
[4]. V.Popat, D Vora, H Stal.Clincopathological correlation of neck lesions. A study of 103 cases.The internet journal of head and neck surgery.2009 ;Vol 4; number2
[5]. U Jindal, K Singh, A Baghla, A Kochar.Spectrum of head and neckswellings in the rural population of India based on Fine needle aspiration findings. The Internet journal of Head and neck surg.2012;vol5;number 2

Abstract: The basic purpose of study is to find out advantage and disadvantage of fixation nail anti rotation and gamma nail in trochanteric fracture of femur.I observed about 100 cases of unstable fracture of femur in my hospital which was treated by anti rotational fixation nail of two years and took some data of gamma nail .I did observe that in PFNA blood loss was very less and duration of surgery was short and PFNA is very good in osteoporotic patients in compare to the gamma nail 3. Reduction of the fracture was considered good in both cases and radio graphically both device position was good postoperatively. Intra operative complication was comparatively more in gamma nail than anti rotational fixation nail such as shaft fracture of the femur, blood loss, duration of surgery.Post operative complication was not seen in both cases such as nonunion, malunion.so after studying both cases I did not found so much difference between these two devices which are used in trochanteric fracture by the orthopedic surgeons but very few advantage with the proximal fixation nail.So the both intrameddulary nailing device was good compare to the extrameddulary device like dynamic screw in trochanteric fracture of femur.1, 2Recent study find out some complication with gamma nail like shaft of femurfracture3, fixationfailure4, distallocking complication need to reoperate but they are very few cases .3, 4 Gamma nail are still widely used despite of having such complication. The comparative data of gamma nail and PFNA result that PFNA is little better device in unstable proximal fracture.2, 5Something about gammanails which is used in my hospital since last three years. The proximal femoral nail antirotation (PFNA; Synthes, Oberdorf, Switzerland) was developed by AO/ASIF (Davos, Switzerland) as an alternative to the proximal femoral nail. It has small distal shaft diameter which causes less stress cocentration of tip .The PFNA blade compact the cancellous bone and provide stability and prevent retard rotation and varus collapse. Since its introduction, so many clinical studies have shown very good result with very little intraoperative problems and post operative complication.6
Key words: Intertrochanteric fracture, PFNA (proximal fixation nail antirotaion), Gamma nail.

[1]. MenezesDF,GamulinA, Noesberger B. Is proximal fixation nail suitable for treatment of all trochanteric fracture? Clin Orthop Relat Res. 2005 ;( 439):221-227.
[2]. Schipper IB, Steyerberg ED, Castelin RM, et al. Treatment of unstable fracture. Randomizedcomparison of the gamma nail and proximal femoral. J Bone Joint Surg Br. 2004; 86(1):86-99.
[3]. Kukla C, Heinz T, Gaeblet C, et al. The standard gamma nail: A critical analysis of 1,000 cases. J Trauma .2001; 51(1):77-83.
[4]. Ahrengart L, Tornkvisit H, Fornander P, et al. A randomized study of comparison hip screw and gamma nail in 426 fractures. Clin Orthop Relat Res. 2002 ;( 401):209-222.
[5]. Al yassariG, Largtaff RJ, Jones JW, et al.The AO/ASIF-Proximal femoral nail treatment of unstable trochanteric femoral fracture. Injury. 2002; 33(5):395-399.

Abstract: Burns over the head and neck form a major fraction of the many burns patients encountered in everyday anaesthesia practice. The distorted anatomy, inaccessible veins, presence of raw areas and contractures especially over the face and neck, complicate the various steps of anaesthetic management.
Difficult airway, is a usual presentation in such cases, and it's management forms the basis of the anaesthetic management planned.

[1]. Kreulen M, Mackie DP, Kreis RW, Groenevelt F- Surgical release for intubation purposes in postburn contractures of the neck- Burns. 1996 Jun;22(4):310-2.
[2]. Manju Saraswat, M. Radhakrishnan: Burns Contracture Of Neck: Two Case Reports Of Difficult Intubation. The Internet Journal of Aneasthesiology. 2001;(5),3.
[3]. Agarwal P-Safe method for release of severe post burn neck contracture under tumescent local anaesthesia and ketamine. Indian J Plast Surg 2004;37;51-54.
[4]. S. Saini, S. Hooda, Sachdeva N, C. Sehkri: Difficult Airway Management in a Maxillofacial and Cervical Abnormality with Intubating Laryngeal Mask Airway. JOral Maxillaofacial Surgery 62:510-513,2004.
[5]. Ken Yamamoto,T. Tsubokawa, Shigeo Ohmura, H. Itoh, T. Kobayashi- Left molar approach improves the laryngeal view in patients with difficult laryngoscopy;Anesthesiology 2000;92:70-4.