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

Abstract: Maxillary central incisors are of critical value in the dental esthetics. The golden rectangle ratio concept may play a role in selecting the optimum width and length of this tooth. The aim of this study is to investigate the existence of this ratio among individuals with natural dentition and routinely used acrylic denture teeth sets and to validate its role in dental esthetics. The clinical crown length of maxillary left and right central incisor (CI) is measured, mean is calculated and combined crown width of left and right central incisors is measured. Crown width to crown length ratio of natural dentition and acrylic denture teeth sets of different manufacturers was calculated and compared with the Golden Rectangle ratio and statistically analysed. Golden rectangle was found to have a significant relationship with esthetic appearance of maxillary central incisors. The results of this study will help in proper selection of teeth for all restorative procedures.
Key words: golden rectangle proportion, esthetics,maxillary central icisors, anterior restorations,combined width of central incisors

[1]. Snow SR. Esthetic smile analysis of maxillary anterior tooth width: the golden percentage. J Esthet Dent 1999;11:177-84.
[2]. Lombadi RE. The principles of visual perception and their clinical application to denture esthetics. J Prosthet Dent 1973;29:358-82.
[3]. Maraquardt SR. Dr Stephan R Maraquqrdt on the golden decagon and human facial beauty. Interrview by Dr Gottlib .J Clin Orbod 2002:36:339-49.
[4]. Levin EI. Dental esthetics and golden proportion . J Prosthet Dent 1978;40:244-252.
[5]. Mange P, Belser porcelain restoration in anterior dentition : a biometric approch . Quintessence; 2002:57-96.

Abstract: Objectives The pathogenesis of neuropathy in type II Diabetes Mellitus is multifactorial. Hyperlipidemia may contribute to the development of diabetic neuropathy. This study aimed to assess the correlation between hyperlipidemia and diabetic neuropathy.
Material And Method: The study included 60 known cases of Type II diabetes mellitus attending diabetic OPD at GMCH, Aurangabad of age 30-60 years with duration of 5-10 years. The cases were divided into two groups; Group I included diabetic patients with normolipidemia and Group II included diabetic patients with hyperlipidemia. Biochemical investigations included HbA1c, total cholesterol and triglycerides. Nerve conduction velocity was done by computerized Micromed RMSEMG system.Stastical analysis was done by unpaired student's t test Results: The study revealed significant reduction in conduction velocity in diabetic patients with hyperlipidemia.
Key Words: Diabetes Mellitus Hyperlipidemia Nerve Conduction Velocity

[1]. Shera A.S., Jawad F ., Maqsood A, Jamal S, Azfar M , Ahmed U, Prevalence of chronic complications and associated factors in type II diabetes, J.Pak Med. Assoc. 2004;54: 54-59
[2]. Tesfaye S, Boulton AJ, Dyck P J, Freeman R, Horowitz M, Kempler P, et al. Diabetic neuropathies: update on definitions,diagnostic criteria, estimation of severity and treatments. Diabetes care. 2010;33:2285-2293
[3]. Vinik A.The approach to the management of the patient with neuropathic pain. J.Clin.Endocrinol Metab.2010; 95: 4802-4811.
[4]. Smith G.D., Ebrahim S. Is it time to call it a day. Int.J.of Epidemiology. 2001; 30(1):1-11

[5]. Vincent AM, Hinder LM, Pop-BusuiR,Feldman EL. Hyperlipidemia: A new therapeutic target for diabetic neuropathy. J Peripher Nerv Syst.2009; 14: 257-267

Abstract: Sicard and Cathelin demonstrated the first epidural anesthesia on an adult through sacral hiatus in 1901. This became known as adult caudal or low epidural anesthesia. Owing to the often distorted anatomy of sacral hiatus in adults, this remained a challenging and often unsuccessful technique. With the introduction of lumbar epidural, this method further lost its popularity in adults. But in infants and children, Caudal anesthesia through sacral hiatus still remains widely accepted .2 We hypothesized that administering caudal epidural anesthesia in adults through third dorsal foramen of sacrum instead of the sacral hiatus would improve on the success rate of this procedure while ensuring acceptable hemodynamic stability owing to less pronounced cephalic extension of the block as compared to the lumbar approach. In this study, sacral epidural anesthesia through third dorsal foramen of sacrum was administered to evaluate the merits and demerits of the method.

[1]. Capt STEVEN J.ZITO, CRNA, BS, USAF, NC. Adult caudal anesthesia: A reexamination of the technique. Journal of the American Association of Nurse Anesthetists. 1993; 61(2): 153-7
[2]. Polaner DM, Suresh S and Cote CJ. Pediatric regional anesthesia. In:Cote CJ, Ryan JF,editors. A practice of anesthesia for infants and children. 3rd Edition. Philadelphia: W.B. Saunders company; 2001. P467.
[3]. Veering BT. Immink-Speet TTM.BurmAGL. Stienstra R. Van Kleef JW. Spinal anesthesia with 0.5% hyperbaric bupivacaine in elderly patients: effects of duration spent in sitting position. Br J Anesth 2001; 87: 738-42.
[4]. Senoglu N, Senoglu M, Oksus H, Gumusalan Y, Yuksel KZ, Zencirci B et al. Landmarks of the sacral hiatus for cauda epidural block: an anatomical study. Br J Anesth 2005; 95: 692- 5
[5]. Tsui, B.C., Tarkkila, P., Gupta, S., Kearney, R. Confirmation of caudal needle placement using nerve stimulation. Anesthesiology 91: 374; 1999.

Abstract: Objective: To observe the correlation between Amniotic Fluid Optical Density (AFOD) and functional maturity status of the newborn at caesarean delivery in 16 women with Gestational Diabetes Mellitus (GDM). Methods:Amniotic Fluid (A.F) samples were collected while doing caesarean sections around 38+wks CRL gestation. Uncentrifuged fresh AF samples were used for AFOD estimations with colorimeter at 650nm. HbA1c estimations were done for all women just before caesarean sections. These women received antenatal steroids as per the RCOG guidelines1. Babies were evaluated for functional maturity status in terms of APGAR scores, development of RDS after 5mnts, adherence of vernix on skin surface, and color of the skin. Birth weights were recorded by electronic weighing machine. Results:Fourteen of these 16 women, were observed to have mature AFOD values (0.98±0.27), at differentgestational ages (GA)ranging from 36w+6d to 39w+6d2, 3. Twelve of these 14 women had good glycemic control with HbA1c values between 5.1 and 5.6.Two women had poor glycemic control with HbA1c values 7.0 and 7.1. All these babies were fully functionally mature, and their skin was mature pale brown in color with very little vernix, and none of them developed RDS.Birth weights ranged from 2.6kg to 3.9kgs. Two women had premature AFOD values (<0.40)2, 3at 36w+6d and 40wks gestation. Their glycemic control was good with HbA1c values 5.4 and 5.6 respectively. Both these babies had plenty of vernix caseosa on skin surface, and developed severe RDS with in 5mnts after delivery which required invasive and noninvasive ventilation support and surfactant therapy. Conclusion: The concept of 'individual term for each fetus'4 is also applicable in women with GDM.

Key Words: Individual term for each fetus, Amniotic fluid optical density (AFOD), Gestational diabetes mellitus (GDM).

[1]. Royal College of Obstetricians and Gynecologists, Antenatal Corticosteroids to Reduce Neonatal Morbidity and Mortality .Green-top Guideline No. 7. October 2010.
[2]. https://drive.google.com/file/d/0B9L0EY1ocMIkR1lPRV9pcFVRVVJMX0J0eUJNVEdlNEo3b044/edit?usp=sharing
[3]. Ram S et al A mniotic fluid optical density at spontaneous onset of labor and its correlation with gestational age, birth weight, functional maturity and vernix caseosa of new born. Calicut Medical Journal 2009;7(4) Vol 7 Issue 4 2009 ... www.calicutmedicaljournal.org/2009/4/e2.pdf
[4]. Samartha Ram H, Sandhya Ram S, Amniotic fluid optical density (AFOD) surge coincides with the onset of spontaneous term labor. Paper presented at 55th AICOG-2012. Varanasi, Book of abstracts: page 74.
[5]. http://www.youtube.com/watch?v=-sjTQ0OX_RA&feature=g-upl

Abstract: To conquer malaria and dengue in Kolkata, India, Atin Ghosh — Member of the Mayor-in-Council (Health and Engineering) of Kolkata Municipal Corporation — undertook several unprecedented initiatives during 2010-2013. He set up a mosquito research laboratory, allowed entomologists to work independently, formed 21 vector surveillance teams (read rapid action teams), opened five dengue detection centres, established intersectoral coordination, brought in notable changes in the tack of campaigning against mosquito-borne ailments and strengthened disease surveillance system. His efforts have yielded outstanding results. The number of malaria cases here came down to 15,656 with no death in 2013 from 1,03,236 cases with one death in 2010. Reduction in the number of dengue cases has been from 1852 cases with 2 deaths in 2012 to 238 cases with no death in 2013. To destroy Culex larvae, Mr Ghosh's department has been doing larvicidal spray along different sewerage canals of the city by using small rowing-boats as transport since 2011 on his instructions. Political leaders and the controlling health officials of different municipal corporations and states of India — who are yet to contemplate waging a real war against mosquito-borne diseases — may find this paper an eye-opener for them.
KEYWORDS: Atin Ghosh, dengue, Kolkata, malaria, political will

[1]. D. Biswas, Baishakhi Biswas, Bithika Mandal, A. Banerjee, T.K. Mukherjee, and J. Nandi, Evaluating school students' perception about mosquitoes and mosquito-borne diseases in the city of Kolkata, India, Dengue Bulletin, 35, 2011, 223-230.
[2]. D. Biswas, Dengue resurgence (104 Diamond Harbour Road, Kolkata- 700008: Science Association of Bengal, 2007).
[3]. D. Biswas, Basics of mosquitoes (5 SN Banerjee Road, Kolkata- 700013: Information & Public Relations Department of Kolkata Municipal Corporation, 2013).
[4]. D. Biswas, R.N. Dutta, S.K. Ghosh, S. Dey, and A.K. Hati, Breeding habits of Anopheles stephensi Liston in an area of Kolkata, Indian Journal of Malariology,29, 1992, 195-198.
[5]. Bithika Mandal, Baishakhi Biswas, A. Banerjee, T.K. Mukherjee, J. Nandi, and D. Biswas, Breeding propensity of Anopheles stephensi in chlorinated and rainwater containers in Kolkata City, India, Journal of Vector Borne Diseases, 48(1), 2011, 58-60..

Abstract: Background the interrelationship of cerebrovascular disease and cardiovascular disease has been repeatedly emphasised and the decompensation in one system can adversely affect the other. The possibility of cerebrovascular accidents (CVA) could result in cardiac rhythm disturbances or structural damage and may be associated with abnormal Electro-Cardiographic Changes (ECG) even in patients without apparent heart disease. Methods- a total of 60 CVA cases have been evaluated and associated ECG changes were analyzed.Results- in the present study, 83.3% patients showed abnormal ECG changes. All patients (100%) with cerebral haemorrhage, Sub-arachanoid Haemorrhage (SAH), Cortical Venous Thrombosis (CVT) had ECG changes whereas it was only 64.28% in Cerebral Thrombosis.Conclusion- different ECG changes are observed in CVA cases even in absence of primary cardiac disease and these ECG changes can be predictor of prognosis.
Keywords: cerebrovascular accidents, cerebral hemorrhage, ECG, prognosis, stroke

[1]. Dimant J, Grob D, Electrocardiographic changes and myocardial damage in patients with acute cerebrovascular accidents, Stroke, 8, 1977,455.
[2]. Croopp GJ, Manning GW, Electrocardiographic changes stimulating myocardial ischemia and interactions associated with spontaneous intracranial haemorrhage, Circulation, 22, 1960, 25-38.
[3]. Prosser J, Mac Gregor L, R Kennedy, D Hans- Christoph, Predictors of early cardiac morbidity and mortality after ischemic stroke, Stroke, 38, 2007, 2295-2302.
[4]. Adams RD, Victor M, Ropper AH, Cerebrovascular diseases in principles of Neurology, USA, Me Grow Hill Health Professions Divisions, 8th Ed, 2005,660- 746.
[5]. Bozluolcay M, Ince B, Celik Y, Harmanchi H, Electrocardiographic findings and prognosis in ischemic stroke, Neurology India J, 51(4), 2003,500-02.

Abstract: Chronic fatigue syndrome (CFS) is an illness characterized by persistent and relapsing fatigue, often accompanied by numerous symptoms involving various body systems. The etiology of CFS remains unclear. Despite considerable worldwide efforts, no single etiology has been identified to explain the development of chronic fatigue syndrome (CFS). It is likely that multiple factors promote its development, sometimes with the same factors both causing and being caused by the syndrome. However, a number of recent studies have shown oxidative stress may be involved in its pathogenesis. Any dysfunction in the Mitochondria, the key organelle responsible for cellular energy production can result in the excess fatigue and other symptoms that are common complaints in almost every chronic disease. Several components of this system require routine replacement, and this need can be facilitated with natural supplements. A detailed review of the literature suggests a number of marginal nutritional deficiencies may have etiologic relevance. In this review article an attempt has been made to look into these factors in relation to chronic fatigue syndrome.
Keywords: fatigue, mitochondria, ATP, energy, apoptosis, oxidative stress

[1]. Jason LA, Richman JA, Rademaker AW, et al. A community-based study of chronic fatigue syndrome. Arch Intern Med 1999;159:2129-2137.
[2]. Komaroff AL, Buchwald D. Symptoms and signs of chronic fatigue syndrome. Rev Infect Dis 1991;13:S8 S11.
[3]. Komaroff AL, Fagioli LR, Geiger AM, et al. An examination of the working case definition of chronic fatigue syndrome. Am J Med 1996;100:56-64
[4]. Melvyn R. Werbach. Nutritional Strategies for Treating Chronic Fatigue Syndrome. Alternative Medicine Review Volume 5, Number 2 ◆ 2000
[5]. S.R. Pieczenik, J. Neustadt. Mitochondrial dysfunction and molecular pathways of disease / Experimental and Molecular Pathology 83 (2007) 84–92

Abstract: Foramen Vesalius is a small, variable and an inconstant foramen located in the greater wing of sphenoid, anteromedial to the foramen ovale, in the middle cranial fossa. This foramen is also known as emissary sphenoidal foramen as it transmits a small emissary vein which drains Cavernous sinus. The importance of this foramen lies in the fact that an infected thrombus from an extracranial source may reach cavernous sinus. The present study was undertaken to observe the incidence of foramen Vesalius in the adult human crania in north India. For this purpose, 200 macerated skulls of unknown age and sex were observed. These skulls were obtained from the departments of Anatomy in TeerthankarMahaveer Medical College & Research Center (Moradabad), King George Medical College (Lucknow), Shri Ram MurtiSmarak Institute Of Medical Science (Bareilly) and Govt. Medical College Kannauj. The foramen Vesalius was found to be present in 68 skulls (ie 34%); out of which it was bilaterally in 28 skulls (14%) and unilaterally in 40 skulls (20%)- in 16 skulls on right side and in 24 skulls on left side. The knowledge of foramen Vesalius is important for neurosurgeons and anatomists and anthropologists.
Keywords: Foramen Vesalius, middle cranial fossa ,skull, sphenoid

[1]. WillamsPL.,BannisterLH,Martin MM et al.(1998) Gray' Anatomy(39ed.) Churchill Livigstone, London, pp-455-461.
[2]. Hast MH, Garrison DH.(2000) "Vesalius on variability of the Human Skul"l: Book I, Chapter V of De humanicorporisfabrica. ClinAnat 2000; 13:311-20
[3]. K. Kodama, K. Inoue, M. Nagashima, G. Matsumura, S. Watanabe, and G. Kodama, "Studies on the foramen vesalius in the Japanese juvenile and adult skulls," Hokkaido IgakuZasshi, vol. 72, no. 6, pp. 667–674, 1997.
[4]. N. Gupta, B. Ray, and S. Ghosh, "Anatomic c haracteristics of foramen vesalius," Kathmandu UniversityMedical Journal, vol. 3, no. 10, pp. 155–158, 2005.
[5]. Decker Gag and du Plesis DJ (1986) McGregor's synopsis of surgical anatomy. 12th edn. John wright & sons ltd. bristol. pp:328-333.

Abstract: Weber syndrome is a rare disorder that occurs sporadically with a frequency of1:50,000. It is characterized by facial nevus, seizures, hemiparesis, intracranial calcificationand mental retardation. We report here a case of Sturge-Weber syndrome who presentedwith features suggestive of this syndrome having facial nevus extending to other half of the forehead and upper part of eyelid. MRI showed the leptomeningealangioma with atrophy is noted ipsilateral to the leptomeningealangiomatosis and left lateral hemiatrophy with prominent sulcus spaces and extra cerebral CSF spaces. Calcifications produce a characteristic double contoured "tram-line" appearance following the convolutions of cerebral cortex. Brushfield and Wyatt stated that these tram- line calcifications are pathognomonic of SWS.
Keywords: Sturge-Weber syndrome, LeptomeningealAngiomatosis, Sporadic NeurocutaneousDisease, Brushfield and Wyatt, Nevus Flameus or Port-wine stains

[1]. Thomas-Sohl KA, Vaslow DF, MariaBL. Sturge-Weber syndrome: a review.PediatrNeurol2004; 30: 303-10.
[2]. Baselga E. Sturge-Weber syndrome.SeminCutan Med Surg2004; 23:87-98.
[3]. Haslam R. Neurocutaneous syndromes.In: Behrman RE, Kliegman RM, JensonHB, editors. Nelson Textbook ofPediatrics, 17th edn. Philadelphia: WBSaunders; 2004. p. 2015-9.
[4]. Moe P, Seay AR. Neurologic andmuscular disorders. In: Hay WW,Hayward AR, Levin MJ, SondheimerJM, editors. Current PediatricDiagnosis and Treatment, 16th edn.Singapore: McGraw Hill; 2003. p. 717-92.
[5]. Riviello JR, Baumann R, Talavera F,Mack KJ, Benbadis SR, Lorenzo N.Sturge-Weber syndrome. [online] 2005[cited 2005 Sep 27]. Availablefrom:URL:http://www.emedicine.com/n euro/topic356.htm.

Abstract: Objective-To study the adverse drug reactions in paediatric age group in a tertiary care hospital. Methods-A retrospective study was undertaken to analyse adverse drug events in paediatric department of a tertiary care hospital.Medical record sheets were analysed and adverse event marked as ADR by the paediatrician was included in the study. Causality, preventability and severity were analysed by 2 Pharmacologists. Other parameters like male to female ratio, most common class of drug causing ADR, common types of ADRs, commonly involved systems, polypharmacy were studied. Results- 64 cases of ADRs were identified in study duration(overall incidence 4.4%) of which 56% were females and infants the commonest age group. Antinfectives were the commonest drug class(68%) causing ADRs,with skin the commonest involved organ. 81% of ADRs were of moderate degree as compared to 1% of severe degree.76% cases fell in probable category of preventability where as 3% were definitely preventable.76.5% cases scored into probable category according to Naranjo's scale of causality assessment. 86% cases were prescribed polypharmacy. Conclusion- Incidence of Iatrogenic harm is rising and due to suboptimal ADR reporting practices only the tip of iceberg is seen. Though more vulnerable, paediatric age group is neglected in various aspects. To ensure safety we need to judiciously use drugs, strengthen ADR reporting and conduct more studies & awareness programmes.
Keywords: Adverse drug reactions, Causality, Paediatrics, Pharmacovigilance, Polypharmacy

[1]. World Health Organization. Collaborating Centre for International Drug Monitoring. Geneva: World Health Organization. 1984, WHO publication DEM/NC/8

[2]. Chien J.Y., Ho R.J. Drug delivery trends in clinical trials and translational medicine: evaluation of pharmacokinetic properties in special populations. J. Pharm. Sci.2011; 100:53–58.

[3]. Montastruc J.L., Sommet A., Lacroix I., Olivier P., Durrieu G., Damase C., Lapeyre-Mestre M., Bagheri H. Pharmacovigilance for evaluating adverse drug reactions: value, organization, and methods. Joint Bone Spine. 2006;73:629–632

[4]. Arulmani R., Rajendran S.D., Suresh B. Adverse drug reaction monitoring in a secondary care hospital in South India. Br. J. Clin. Pharmacol. 2008;65:210–216
[5]. Kaushal R, Jaggi T, WalshK, etal.Peditric medication errors: whatdo we know? What gaps remain?AmbulPediatr. 2004;4:73-81
[6]. Walsh KE, Kaushal R, ChessareJB.How to avoid paediatric medication errors: a user's guide to the literature. Arch Dis Child.2005; 90:698-702.

Abstract: Background Diabetic retinopathy is the commonest complication of diabetes. In India , of diabetic retinopathy varies from 16.6% to 26.8%. About 10% of diabetics at any point of time will have vision threatening retinopathy requiring specialist ophthalmological management. Aim: To study the awareness regarding the necessity of regular eye check up among the diabetic patients. Methodology: A total of 105 patients attending diabetes clinic in a tertiary care hospital were included. A pretested, semi structured questionnaire was administered. Study variables include age, gender, literacy status, occupation, family history of diabetes, awareness regarding diabetes etc. Results: The age group of the study population ranged from 22 years to 74 years with mean age of 55.43 years. Only 37.14% of diabetics were aware of necessity of regular eye checkups. Only 6 males and 3 female diabetic patients were having regular eye checkup. Awareness of regular eye check up was more among those who have diabetes for > 5 years duration and those who had family history of Diabetes. It was also observed that awareness regarding eye check ups was increasing with increase in educational status. Conclusion: Our results suggest that awareness regarding eye check up among diabetic patients is very poor. Delivering ophthalmic care to diabetic patients at appropriate time can reduce the suffering caused by visual impairement and blindness.
Key Words: Awareness of eye checkups, Diabetes, Ophthalmic care

[1]. Anjana RM,Pradeepa R,Deepa M, Dutta M,Unnikrishnan R et al. "Prevalence of diabetes and pre diabetes in urban and rural India:phase 1 result of the Indian Council of Medical Research –India Diabetes (ICMR-INDIAB) study" Diabetologica 54.12 (2011): NCBI.web.march 2013.
[2]. KleinR.Klein BE,Moss SE. Visual impairement in diabetes. Ophthalmology 1984;91:1-9
[3]. Macky TA,Khater N,Al-Zamil MA et al.Epidemiology of diabetic retinopathyin Egypt:A hospital based study. Ophthalmic res 2011;45:73-8
[4]. WHO: Global burden of diabetes:Press release WHO/63:WorldHealthOrganisation;Sept 1998
[5]. Verma L,Elankumaran P,Prakash G,Venkatesh P,Tewari HK. Awareness of diabetic retinopathy among diabetics. Indian journal of ophthalmology 2002;50:355

Abstract: Objective: Neonatal septicemia is a major cause of morbidity and mortality in newborn inborn. As the clinical manifestations are vague and nonspecific, it is pertinent that an early diagnosis is made to prevent serious morbidity and mortality. So, an attempt was made to establish correlation between sepsis screening & blood culture in neonate presenting with features of sepsis to accelerate the diagnostic process. Research and Methods: In our study we tried to study (1) early indicators of sepsis screen & their statistical correlation with blood culture (considered as gold standard); (2) different aspects of outcome in neonatal sepsis. Results: Though individual sepsis screen parameters showed little correlation with blood culture status, yet on combination it was found that specificity and positive predictive accuracy increased while sensitivity decreased them individual tests. Also combination of tests yield better results than single tests. Conclusion: The combination of parameters yielded better results than single tests and proved to be an invaluable aid for early diagnosis of neonatal sepsis.
Keywords : Blood culture, CRP, neonatal sepsis, sepsis screen

[1]. National Neonatology Forum. Report of National Neonatal Perinatal Database 2000, New Delhi.
[2]. Singh Meherban. Perinatal Infections. In: Care of Newbown. 7th Edition. Sagar Publication, New Delhi; 2010: p 223-233.
[3]. Buetow KC. Septicemia in premature infant. American Journal of Diseased Child 1965; 110-29.
[4]. Bhakoo ON. Neonatal bacterial infections at Chandigarh. A decade of experience. Indian Journal of Pediatrics 1980; 47 : 419-424.
[5]. Waaga A, Brandtzaeg P, Hatstensen P. The complex patter of cytokines in serum from patients with meningococcal septic shock. J Exp Med 1989; 169: 333-8.

Abstract: Introduction: Nasal index is a sensitive anthropometric index. It also exhibits sexual differences and it has become a useful tool in Forensic Medicine and reconstructive surgery. It is an important anthropometric parameter for classifying the race and sex of an individual whose identity is unknown. Aim: The present study was undertaken to provide baseline data of the nasal ergonomics for male and female of Hindu community of Gwalior region. Material and Method: A random sample of males of 19 to 45 years age group was chosen for examination. Nasal length, nasal breadth, nasal height and nasal depth were measured with the help of Digital Vernier Caliper. Nasal index (NI) were calculated as NB/NH×100. The data was analyzed statistically using Unpaired Student t-test.< Result: Our results are comparable with other studies with mean NI ± SD of 80.59±9.122 in male which was significantly higher (p<0.05) than that of females who has NI ± SD of 77.29±8.472. Except for nasal depth, the other nasal parameters shows sexual dimorphism. Conclusion: Based on the mean NI, the predominant nose type is Mesorrhine in 63.73% of male and female (Hindu community) of Gwalior region. This study provides a baseline data for people of Gwalior region which will be valuable in nasal anthropometry for clinical practice, in reconstructive surgery, rhinoplasty and in forensic science. This study should be subjected to further investigation.
Key words: Nasal Index, Nasal Anthropometry, Rhinoplasty, Mesorrhine

[1] Madison G. Part I language and Nationality. In: The Passing of the Great Race 2004; 2:1-6.
[2] Oladipo GS, Olabiyi AO, Oremosu AA, Noronha CC. Nasal indices among major ethnic groups in Southern Nigeria. Scientific Res. Ess. 2007; 2(1): 20- 22.
[3] Zhang XT, Wang SK, Zhang W, Wang XF. Measurement and study of the nose and face and their correlations in the young adult of Han nationality. Plast Reconstr. Surg. 1990; 85(4):532-536.
[4] Xu B, Wang Y, Ma J, Li M, Xu L. A computer-aid study on the craniofacial features of Archang race in Yunnan province of China. Hua Xi Kou Qiang Yi Xue Za Zhi. 2011; 19(6):394-96.
[5] Hansen B, Mygind N. How often do normal persons sneeze and blow nose? Rhinol. 2002; 40(1):10-12.

Abstract: Background: We evaluated the knowledge and attitude to Self-monitoring of blood pressure amongst adult patients in a hospital in the Niger Delta so as redirect efforts to improve patients' knowledge and attitude to self-monitoring of blood pressure. Materials and Methods: 100 patients with essential hypertension attending the Cardiology Clinic of the Niger Delta University Teaching Hospital were recruited consecutively over a two-month period (September to November 2013). Demographic data, knowledge and attitude to Self-monitoring of blood pressure were obtained using self-administered questionnaire. Simple percentages and Chi square were used to analyze data obtained. P<0.05 was considered statistically significant. Results: A total of 100 patients were studied and 54.7% of them know about self-monitoring of Blood Pressure. 88% of the patients agreed that self-monitoring of Blood Pressure is important. Civil servants were more likely to know about SMBP or think that it is important. Those with primary or no education were four times less likely to know about SMBP. Conclusion: The results of our study suggest suboptimal knowledge about Self-monitoring of Blood Pressure. It is important that clinicians and health care providers intensify efforts to improve patients' knowledge about SMBP for better hypertensive management outcome.
Key words: Self-monitoring of Blood Pressure, civil servants, education

[1]. Kerry S, Markus H, Khong T, Doshi R, Conror R, Oakeshott P. Community based trial of home blood pressure monitoring with nurse-led telephone support in patients with stroke or transient ischaemic attack recently discharged from hospital. Trials 2008, 9:15doi:10.1186/1745-6215-9-15.[internet]Available from:http://www.trialsjournal.com/content/9/1/15 Assessed on April 6, 2014
[2]. Victor O. Adika, P.P.K. Joffa and Franco A. Apiyanteide. Hypertension Knowledge among Non-Academic Employees of Niger Delta University, Bayelsa State, Nigeria. International Journal of Tropical Medicine 2011, 6: 113-120
[3]. Imai Y, Otsuka K, Kwano Y, Shimada K ,Hayashi H , Tochikubo O, Miyakawa M, Fukiyama K. Japanese Society of Hypertension (JSH) Guidelines for Self-Monitoring of Blood Pressure at Home. Hypertens Res 2003; Vol. 26: No. 10
[4]. Cappuccio F P, Kerry S M, Forbes L, Donald A. Blood pressure control by home monitoring: meta-analysis of randomized trials. BMJ June 2004, doi:10.1136/bmj.38121.684410.AE
[5]. O'Brien E, Asmar R, Beilin L, Imai Y, Mancia G, Mengden T, et al on behalf of the European Society of Hypertension working group on blood pressure monitoring. European Society of Hypertension recommendations for conventional, ambulatory and home blood pressure measurement. J Hypertens 2003; 21:821-48.

Abstract: Tumors that metastasize to paranasal sinus (PNS) and skull base are rare, with fewer than 200 cases reported worldwide. Of these, thyroid malignancies contribute 8%. We discuss here a 51 year old female with multiple PNS metastases from follicular carcinoma of thyroid who had undergone right hemithyroidectomy 10 years back. She presented with nasal obstruction, progressive loss of vision and epistaxis 2 months. CECT scan of PNS showed a large heterogeneously enhancing mass lesion in the left nasal cavity crossing midline extending to right side and inferiorly into sphenoid and cavernous sinuses, which on further evaluation was found to be metastases from follicular carcinoma thyroid. To conclude PNS metastases from thyroid cancer are rare. But it should be always kept in mind in symptomatic patients.
Key words: Carcinoma thyroid, paranasal sinus metastasis, orbital metastasis

[1]. Cohen EG et al (2003) Postoperative management of differentiated thyroid cancer. Otolaryngol Clin N Am 36:129–157.
[2]. Ramsaden J, Watkinson JC (2008) Thyroid cancer. In: Glesson M (ed) Scott Brown's otorhinolaryngology and head and neck surgery, 7th edn. 2663–2701.
[3]. İzci (2005) Brain metastasis from follicular thyroid carcinoma.Turk Neurosurg 15(3):132–135.
[4]. YAN Bo et al (2010) Papillary thyroid micro carcinoma presenting as skull base metastasis. Chin Med J 123(19):2750–2752.
[5]. Baston OV (1940) The function of the vertebral vein and their role in the spread of metastasis. Ann Surg 112:138–149.

Abstract: Pigmented lesions refer to melanocytic proliferations. Benign proliferations are often called moles or nevi. Malignant proliferations are melanomas. One of the most challenging and litigious areas of pathology is the accurate diagnosis of these pigmented lesions and differentiate them from pigmented variants of nonmelanocytic lesions. These include seborrhoeic keratosis, pigmented actinic keratosis, dermatofibroma, pigmented basal cell carcinoma and dermatofibrosarcoma. Histopathological study of 44 pigmented skin lesions was carried out in the department of Pathology, Dr. S.C.GMC, Nanded (India) for a period of one year (Jan 2012 to Dec 2012). The lesions examined included 19 melanocytic lesions i.e 12 benign nevi, 2 dysplastic nevi, 5 cases of cutaneous malignant melanoma and 25 nonmelanocytic lesions- 12 pigmented basal cell carcinoma, 10 seborrhoeic keratosis and 3 cases of actinic keratosis. The most common age group affected was 61-80 years with a male to female ratio of 1:1.1. Majority of lesions were located on head and neck region. Analysis of clinical diagnosis with histopathological diagnosis revealed a positive correlation of 84% and negative correlation of 16%. Seborrhoeic keratosis and basal cell carcinoma were the common nonmelanocytic lesions to be misdiagnosed as malignant melanoma clinically. There was lack of clinicopathological correlation in dysplastic naevus.
Keywords: Nevi, Melanoma, Nonmelanocytic lesion, Histopathological study.

[1]. Elder DE, Elenitsas R, Murphy GF, XU X. Benign Pigmented Lesions and Malignant Melanoma. In Lever's Histopathology of the Skin; 10th ed. Lippincott Williams and Wilkins; 2009.p.699-790.
[2]. Mukhopadhyay S, Ghosh S, Siddharta D, Mitra P. A clinicopathological study of malignant melanoma with special reference to atypical presentation. IJPM 2008: 51(4);485-488.
[3]. Hussain MR. Melanocytic dysplastic naevi the middle ground between benign melanocytic naevi and cutaneous malignant melanomas: emerging clues. Journal of Clinical Pathology 2005; 58(5):453-456.
[4]. LeBoit PE, Burg G, Weedon D, Sarasin A. World Health Organisation of Tumors. Pathology and Genetics. Skin Tumors. Lyon: IARC Press; 2006,p.49-118.
[5]. Crasta J, Rameshkumar K. Pigmented lesions of Nonmelanocytic Origin – A Patjological Perspective. Indian J of Dermatol 2002:47(2):84-87.

Abstract: This study aims to evaluate the effects of physical training on the management of Alzheimer's disease in Tunisian male older adult patients. 21 patients were separate into two groups one of which followed a physical training program for six months and the other served as a control. Our results showed that exercise training significantly manages the cognitive function in patients such as the ADAS total, the ADAS memory and the MMSE. We conclude that physical training could be an interesting approach to the control of Alzeimer's disease in Tunisian male older adult patients.
Keywords: Alzheimer's disease; physical activity; older Adult patients

[1]. Arkin SM. 1999. Elder rehab: a student-supervised exercise program for Alzheimer's patients. Gerontologist, 39: 729-35.
[2]. Arcoverde C., Deslandes A., Rangel A. 2008. Role of physical activity on the maintenance of cognition and activities of daily living in elderly with Alzheimer's disease. Arquivos de Neuro-Psiquiatria, 66: 323-327.
[3]. Chan Y.H. 2003. Biostatistics 102: Quantitative Data-Parametric and Non-parametric Tests. Sangapore Medicine Journal, 44 : 391-396.
[4]. Coelho FGM., Santos-Galduroz RF., Gobbi S., Stella F. 2009. Ativida de física sistematizada e desempenho cognitivo em idosos com demência de Alzheimer: uma revisão sistematizada. Revista Brasileira de Psiquiatria, 31: 163-170.
[5]. Colcombe S., Kramer AF. 2003. Fitness effects on the cognitive function of older adults: a meta-analytic study. Psychological Science, 14: 125-130.

Abstract: Amelogenesis imperfecta (AI) is a hereditary disorder expressing a group of conditions that cause developmental alterations in the structure of enamel. The enamel may be hypoplastic, hypomineralized or both and affected teeth may be esthetically and functionally compromised. It has been associated with various dental anomalies, including Taurodontism, congenitally missing teeth, delayed eruption, crown resorption, and abnormal enamel thickness. Here we report a case of unusual and rare association of hypoplastic Amelogenesis Imperfecta with multiple impacted teeth. This clinical report also reviews a holisticmultidisciplinary treatment approach for the oral rehabilitation of patient with hypoplastic Amelogenesis Imperfecta with multiple impacted teeth.
Keywords: Amelogenesis Imperfecta , Hypoplastic , Full mouth rehabilitation, Impacted teeth

[1]. Peter T, Titus S, Francis G. Full mouth rehabilitation of a case with amelogenesis imperfecta. SRM University Journal of Dental Sciences; 2010: 1(3).
[2]. Shetty YB, Shetty A. Oral Rehabilitation of a Young Adult with Amelogenesis Imperfecta: a case report. J Indian ProsthodontSoc; 2010;10(4):240–245.
[3]. Collins MA etal. Dental anomalies associated with amelogenesis imperfecta: A radiographic assessment. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1999; 88:358-64.
[4]. Canger M et al. Amelogenesis Imperfecta, Hypoplastic Type Associated with Some Dental Abnormalities: A Case Report. Braz Dent J (2010) 21(2): 170-174.
[5]. Reddy S, Nisha V, Harish BN. Hypoplastic amelogenesis imperfecta with multiple impacted teeth – report of two cases. J Clin Exp Dent. 2010; 2(4):e207-11.

Abstract: Introduction: Distal Tibia fractures continue to be one of the most controversial fractures that we treat. Most of the controversy resides in the treatment techniques, as the indication for surgery is fairly clear. Plate osteosynthesis with Minimally invasive plate osteosynthesis(MIPPO) principle for fractures of the distal tibia is often associated with good healing but infection, and hardware problems.Locked intramedullary nailing is the treatment of choice for closed fractures of the tibial shaft .For proper alignment, the nail should be centrally placed in both the proximal and distal fragments ,but does not fit properly into the distal fragment of the lower third of the tibia. This places additional stress on the distal locking bolts and may lead to breakage and malalignment.AIMS AND OBJECTIVES; The main aim of the study is to compare the functional recovery of the patients who had distal extraarticular fracture ,AO type 43A treated with Intramedulary interlocking nail and plate osteosynthesis (Mippo). Also The aim of treating a fracture is to produce a stable construct which allows early mobilisation and weight-bearing, but with minimal complications.MATERIALS AND METHODS; This study was done in the department of orthopedics from June 2010 to January 2013 in young age above 18yr and below 60 yr. which includes 30 patients with distal tibia fractures. Patients having fracture of distal tibia at metadiaphysial area.1.Extraarticular fracture, minimum of 3cm of distal fragment 2.Age above 18yrs and less than 60yr old3.Open fracturegustilo Anderson type 1 and type2SUMMARY; In this study 30 cases of distal tibia fracture were treated surgically with internal fixation with IMIL nail for 15 case and ORIF plating for 15 cases. In our study of30 cases AO Type 43

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[5]. Gorczyca JT, Mckale J,Pugh K,Pienkowski D. et al.The modified tibial nail for treating distal tibia fracture.J orthop and trauma[Internet].2002jan;16(1):18-22.available from:http://www.ncbi.nlm.nih.gov/pubmed/11782627.