iosr-JDMS   Volume-13 ~ Issue-6 ~ June-2014

Abstract: Squamous cell carcinoma of the tongue is a malignant tumor derived from epithelial mucosa of the oral cavity and is largely a type of epidermoid carcinoma. The purpose of the study is to identify and analyze the effect of the flavonoid fraction of ant nests (Myrmecodia pendans) as an anti-cancer barrier against proliferation through Akt signaling and barrier mechanism of NF-KB in cancer cells SP-C1 of the tongue. The results of the study showed that the cytotoxicity test had the highest concentration of 1000 μg/ml to the lowest concentration of 7.8125 μg/ml in ethyl acetate fraction, ethanol, hexan fraction and water generates significant percentage data of the tongue cancer cell death SP-C1. Ethyl acetate flavonoid fraction in a concentration of 1000 μg/ml caused the percentage of cell death as much as 64.60%, and the lowest concentration of 7.8125 μg/ml led to cell death as much as 15.80 %. LC50 values of ethyl acetate fraction, ethanol fraction, hexan fraction and water fraction, respectively for 452.059 μg/ml; 937.562 μg/ml; 2691.535 μg/ml; 12302.69 μg/ml. Analysis antiproliferative flavonoid fraction and ethyl acetate fraction of ethanol based on concentration and incubation time to absorption optical density SP-C1 cells was statistically highly significant (p=0.00).
Keywords: Tongue squamous cell carcinoma SP-C1, ant nests' flavonoid fraction, proliferation.

[1]. King RJ, Robing MW. Cancer biology. 3rd ed. England; Pearson Education Limited: 2006. p. 209-29
[2]. Soendoro T. Laporan Riskesdas 2007. Kementerian Kesehatan Republik Indonesia: 2008
[3]. Regezi JA, Sciubba JJ. Oral pathology, clinical pathologic correlations. 3rd ed. Philadelphia; WB Saunders Co.: 1999. p. 76-90
[4]. Hasibuan S. Prosedur deteksi dini dan diagnosis kanker rongga mulut. Digitized by USU digital library: 2004. p. 1-7
[5]. Subroto A, Saputro H. Gempur penyakit dengan sarang semut. Jakarta; PT Agromedia Pustaka: 2007
[6]. Simanjuntak P, Fanny, Subroto MA. Isolasi senyawa aktif dari ekstrak hipokotil sarang semut (Myrmecodia pendans) sebagai penghambat xantinoksidase. Jurnal Ilmu Kefarmasian Indonesia. 2010: 49-54

Abstract: Human sparganosis is a rare parasitic disease as a result of infection by plerocercoid larva (sparganum) of Spirometra species. In this case report, a 31-year-old man presented as a subcutaneous nodule in the axilla for 5 months, which was excised. Characteristic plerocercoid larvae accompanied by sinus tract and abscess in the subcutaneous tissue were discovered under microscopic examination of the excised tissue. This report aims to highlight the existence and presentation of sparganum infection which is considered to be rare in Indian subcontinent. Also this case report reveals an atypical picture where the larval forms was not identified on gross examination of the excised tissue and the diagnosis was confirmed on the basis of microscopy.

Keywords: Sparganosis, sparganum, spirometra, rare parasitic disease, subcutaneous nodule

[1]. Garcia, L., and Bruckner, D.A. Diagnostic Medical Parasitology. Herndon, VA: ASM Press, 2007
[2]. Walker, M.D., and Zunt, Z.R.."Neuroparasitic Infections: Cestodes, Trematodes, and Protozoans." Seminars in Neurology 25.3 (2005): 262-277.
[3]. Apatow SM. Humanitarian Resource Institute Biodefense Reference Library Foreign Animal and Zoonotic Disease Center One Medicine: One Health (Zoonotic Disease) Online Course. University of California, Santa Barbara. http://www.humanitarian.net/biodefense/fazdc/zdc1/zoores_cestode.html.
[4]. Song, T., Wang, W.S., and W.W. Mai. "CT and MR Characteristics of Cerebral Sparganosis." AJNR. 28 (2007): 1700-1705.
[5]. Rengarajan S, Nanjegowda N, Bhat D, Mahadevan A, Sampath S, and Krishna S: Cerebral sparganosis: a diagnostic challenge. Br J Neurosurg; (2008) Dec;22(6):784-6

Paper Type	:	Research Paper
Title	:	Awareness of Ocular Complications of Diabetes Among Diabetic Patients In A Tertiary Hospital In Western, Nigeria
Country	:	Nigeria
Authors	:	Dr Bodunde O.T , Dr Odusan O , Dr Ogunsemi O , Dr Ajibode H. A , Dr Raimi T.H
	:	10.9790/0853-13620912

Abstract:Background:- Diabetes is no longer a disease of affluent and industrialized countries. It affects virtually all ocular structures and can lead to blindness. Routine eye examination is necessary for early detection of ocular involvement and prevention of blindness. Only few diabetics have regular eye examination. Aim:- To study the awareness of ocular complications of diabetes among diabetic patients Methodology:- A cross-sectional prospective study of 148 randomly selected diabetic patients was done. A semi structured questionnaire was administered to these patients by an interviewer who is medical personnel, not below the level of a house-officer. Informed consent was obtained from the patients before filling the questionnaires. The information obtained include the biodata, educational level, duration of diabetes, whether they were aware that diabetes can affect other parts of the body, if yes which parts, which parts of the eye can it affect, how can it affect the eye, whether or not routine eye examination is necessary in diabetics, if yes how often, how did they learn about diabetes and how they think awareness of diabetic complications can be improved. The results were collated and analyzed using SPSS version 13, with chi square done where necessary. Results:- A total of 148 patients were studied. Their ages range between 21years and 82years, with a mean of 58.53 +10.4years. Majority were between 36-60yearrs of age. Eighty-three (56.1%) had educational level within secondary level 40(27 %) tertiary education while 25(16.9 %)) do not have formal education. Most common co morbid factor was hypertension, found in 44.6%. One hundred and twenty three (83.1%) were aware that diabetes could affect other parts of the body, 41% were aware of brain affectation, 54% were aware that it can affect the kidneys, 77.7% were aware that it can affect the eyes, 39.2% blood vessels, 66.2% the legs, 40.5% the skin and 41.9% were aware that it can affect the genitals.

Key words: Awareness, Diabetes, Ocular complication, Diabetics

[1]. Global initiative for the eliminating of avoidable blindness. An informal consultation, World Health Organization, Geneva,1997,WHO/PBL/97.61
[2]. International Diabetes Federation,2005,http://www.idf.org(accessed Feb. 20th 2005)
[3]. Wild S, Roglic C, Green A, Sicrete R, King H. Global prevalence of Diabetes: Estimates for the year 2000 and projections for 2030. Diabetes Care 2004: 27:1047-1053
[4]. Akinkugbe OO{ED}. National Expert Committee on Non communicable Diseases (NCD) in Nigeria. Final report of National Survey .Federal Ministry of Health, Lagos. 1997:64-90
[5]. Fabiyi AK, Kolawole BA, Adeshinto O, Ikem RT. The impact of knowledge attitude, practice and belief of type two Nigerian diabetes on Drug compliance. Diabetes Int. 2002; 291:15-17

Abstract: Metallo-β-lactamase producing carbapenem non-susceptible multidrug resistant Pseudomonas aeruginosa creates a great challenge for treatment as the choice of antibiotics gets severely restricted .This study aimed at detecting such strains in different clinical samples in a tertiary care hospital in Kolkata. Materials and methods-Out of 169 isolates detected as Pseudomonas spp.in Microbiology laboratory 98 consecutive non-duplicate isolates phenotypically confirmed as Pseudomonas aeruginosa were selected following inclusion criteria of being resistant to≥ 3 different classes of antibiotics including Imepenem. Antibiogram with antibiotics suggested by CLSI-2011 was performed and resistance to different antibiotics was recorded .Then combined disc test with Imepenem(10μg) and Imepenem(10μg)+EDTA (750 μg)was performed.Observation - Strains showing zone difference ≥ 7mm during combined disc test were considered as metallo-β lactamase producing multidrug resistant strains and those showing<7mm increase in zone size or no increase in zone size or total zone size less than 13 mm with Imepenem+EDTA were considered as MBL non-producers.51 isolates out of 98(52.04% ) multidrug resistant oneswere diagnosed as MBL producing multi-drug resistant isolates .Sample wise distribution showed highest rate of infection with imepenem non-susceptible multidrug resistant Pseudomonas aeruginosa was seen in fluid samples(66.66%) and lowest rate (14.28%) in blood sample isolates.Conclusion-The finding of 52.04% MBLproducing isolates out of 98 multidrug resistant Pseudomonas aeruginosa is an alarming condition in the background of tertiary care hospital and may be the cause of high mortality and morbidity rate.
Key words: Pseudomonas aeruginosa,metallo-β lactamase(MBLs), multidrug resistant(MDR),phenotypic characterisation

[1]. Mariana Castenhier,Mark A Toleman ,Ronald N.Jones et al. Molecular Characterization of a Beta-lactamase gene,blaGIM-1 Encoding a new subclass of MBLs. Antimicrobial agents and chemotherapy Dec 2004 ;48(12):pg4654-4661.

[2]. Gales,A.C , R.N.Jones , J.Turnidge et al.Characterisation of Pseudomonas aeruginosa isolates : occurrence rate, antimicrobial susceptibility pattern and molecular typing in the global SENTRY. Antimicrobial surveillance programme 1997-1999:Clinical infectious Disease:32 (suppl:2)S146- S155.

[3]. Yochi Hirakata, Koichi Izumikawa et.al . Rapid detection and evaluation of clinical characteristics of Emerging Multidrug resistant Gram Negative Rods carrying metallo-beta-lactamaseGeneblaIMP.Antimicrobial agents and chemotherapy Aug 1998 ; (8) : pg 2006-2011.

[4]. Johann D.D.Pitout, Daniel B.Gregson,LaurentPoirel et al. Detection of Pseudomonas aeruginosa Producing Metallo-Beta-Lactamases in a large centralised Laboratory . Journal of Clinical Microbiology July 2005;43:(7):pg 3129-35 .

[5]. HorishSederil,ZohrehKarmil et.al. Phenotypic detection of Metallo-β-lactmases producing Pseudomonas aeruginosa strains isolated from burned patients. Iranian Journal of Pathology.2008 ; 3: (1) :822-25.

Abstract: Now a days increasing number of adult patient come for Orthodontic treatment who wants their braces off as early as possible. Adults are more concerned about their aesthetics even with braces. To overcome this kind of psychological or psychosocial problem, new Orthodontic techniques have emerged to reduce treatment duration without compromising stability. There have been theories suggested by various authors for rapid tooth movement. One of such theories is periodontically accelerated osteogenic Orthodontics (PAOO) which is patented by Wilckodontics, which is said to harness the regional acceleratory phenomenon (RAP). PAOO technique definitely reduces treatment time than conventional orthodontic treatment. Studies also shows that, it increases alveolar bone thickness due to bone grafting, enhancing post orthodontic stability with lesser chances of root resorption.
Keywords: Adult Orthodontic, PAOO, Regional Acceleratory Phenomenon (RAP), Wilckodontics

[1]. T.G. Rappaport, M.H. Shalis and E. Gazit. Psychosocial reward of orthodontic treatment in adult patients. European Journal of Orthodontics, 32(4), 2010, 441–446.
[2]. Ong MM, Wang HL. Periodontic and orthodontic treatment in adults. Am J OrthodDentofacialOrthop 2002;122:420‑8.
[3]. Mathews DP, Kokich VG. Managing treatment for the orthodontic patient with periodontal problems. SeminOrthod 1997;3:21‑38
[4]. Wilcko WM, Wilcko MT, Bouquot JE, et al: Rapid orthodontics with alveolar reshaping: Two case reports of decrowding. Int J Periodontics Restorative Dent 21:9, 2001 [5]. Frost HM : A 2003 update of bone physiology and Wolff's Law for clinicians: Angle Orthod. 2004 Feb;74(1):3-15
[6]. Gantes B, Rathbun E, Anholm M. Effects on the periodontium following corticotomyfacilitated orthodontics. Case reports.J Periodontol 1990;61:234‑8

Abstract: 33.3m people were estimated to be infected with HIV globally. Out of which 22.5m were in sub-Saharan Africa and about 3m in Nigeria. In Plateau state, there was a continuous decline in HIV prevalence rates from 11.3%-3.35% (2001 to 2008) recorded and a sharp rise to 7.7% in 2010. Hepatitis B/C virus infection with a prevalence of 15.1% and 6.0% are endemic in Nigeria which could lead to chronic liver cirrhosis and cancer with high mortality and morbidity rates. This study aimed at determining the prevalence and coinfection rates of HIV, Hepatitis B and C in a rural community setting of Plateau State. After counselling and obtaining consent from 250 participants, screening for HIV, HBsAg and Anti-HCV was done. WHO/CDC national algorithm of serial testing was employed for HIV antibody. Determination of HBsAg and Anti-HCV were done using rapid test kits. Of the 250 screened specimens, 6(2.4%) were positive for HIV, 55(22.0%) for HBsAg and 31(12.4%) for Anti-HCV respectively. Coinfection rates of HIV/HBsAg/Anti-HCV was 1(0.4%),HIV/HBsAg was 2(0.8%) and HBsAg/Anti-HCV was 6(2.4%).For HIV, both sexes were equally affected with prevalence of 1.2% each, while for HBsAg the males showed higher prevalence of 34(13.6%) than the females 21 (8.4%).However, the prevalence of Anti-HCV was higher in the females with 18(7.2%) than in the males 13(5.2%).The highest prevalence rates of HIV/HBsAg/Anti-HCV were observed in the age group of 20-39(2.0%);10-39(17.6%); 30-59(8.4%). Significant P. values of 0.07, 0.9 (1.0 appx) and 0.02 for HIV, HBsAg and Anti-HCV were observed in this study. From this study, the Langtang South HIV prevalence rate has dropped from 9.7% reported in 2008 to 2.4% which is lower than the National HIV prevalence rate reported for rural settings in North Central Zone of Nigeria. This may be attributed to numerous interventions, policies, actions towards universal access to HIV prevention, treatment and care. However, the high rates of Hepatitis B/C virus may warrant focusing on adequate care and treatment of infected individuals.
Key word: Coinfection, HIV, Viral Hepatitis, Mabudi Rural Community, Langtang South, Plateau State

[1]. UNAIDS World AIDS Day Report 2012.
[2]. Federal Republic of Nigeria Global AIDS Response Country Progress Report; Nigeria GARPR 2012.
[3]. Nigeria National Agency for the control of AIDS. National HIV/AIDS strategic plan 2010 – 2015. Abuja Nigeria: NACA, 2010.
[4]. Nenfort E. Gomwalk; Lohya Nimzing; John D Mawak; Nimzing G. Ladep; Stephen B Dpiap; Demas Damshak; Esther Kim; Christiana Barau; John K Jinung; Bala M Rumtong; Yusuf A Agabi: Sero-epidemiology of human immunodeficiency virus (HIV) in Plateau State. J. infect Dev. Ctries 2012; 6(12): 860 – 869.
[5]. Ramyil MSC; Imade GE; Agbaji O; Hauwa F; Agaba P; MuazuM;Chindak L: Trend of HIV Sero-prevalence in MabudiLangtang South of Plateau State, Nigeria. General Poster Abstract 1 – 1A pdf-University of Ilorin. 567083/NACA/015:2010.

Abstract: Heart failure is one of the most common causes of death and disability encountered in clinical practice. Recently animal studies and clinical trials demonstrated additional benefits following the addition of an Angiotensin receptor blocker to existing Angiotensin converting enzyme inhibitor. It was a comparative randomized study performed on 100 patients admitted in cardiology Department, Government General Hospital, and Guntur. The study comprised of 6 weeks period for each patient .50 patients were under Enalapril and 50 patients were under combination of Enalapril and Losartan. Before and after 6 weeks, Blood studie ,E.C.G ,Chest x ray ,2D echo were done .Patients were monitored for relief of symptoms ,change in blood pressure and adverse effects. Results were tabulated, unpaired students't' test was done and p values were calculated .Results were shown graphically also.The combination therapy improved the symptoms ,ejection fraction (P < 0.001 ) and increased serum potassium significantly. (P < 0.05) . So,the present study showed that combination therapy (Enalapril plus losartan) had better efficacy than Enalapril alone in the management of congestive cardiac failure.
Keywords: Losartan ,Enalapril ,Congestive Heart Failure

[1]. Marc S Weinburg, Adam J. einburg, ion H Zap – effectively targeting the rennin angiotensin – aldosterone system in cardiovascular and renal disease; rationale for using angiotensin II receptor blockers in combination with angiotensin – converting enzyme inhibitors – JRAAS 2000 : 1; 217-33.
[2]. M Burnier, H.R. Brunner – angiotensin iireceptor antagonists – lancet 2000; 355:637-45.
[3]. Dr. D Rama Rao – Renin – Angiotensin – Aldosterone system in congestive cardiac failure – medicine update 2002; chapter 10; page 67.
[4]. Gary S. Francis, John P. Gassler, Edmund H. Sonnenblick Pathophysiology and Diagnosis of Heart failure Hurst‟s the Heart text book: Vol-1, 10th edition, chapter 20; page – 655; 657, 658, 678, 679, 692.
[5]. Edwin K. Jackson – RENIN AANNGIOTENSIN from Goodman and Gillman‟s The Pharmacological basics of Therapeutics – 10th edition, chapter 31, page:809-833.
[6]. Marc Harrold Angiotensin converting enzyme inhibitors, Antagonists and Calcium Blockers – Part II Pharmacodynamic agents; chapter 23; page – 533-550.

Abstract: Eventration of the diaphragm (ED) is a relatively rare condition. Eventration of the diaphragm is an abnormal elevation of the dome of diaphragm in which all or part of the diaphragm is largely composed of fibrous tissue. Clinical manifestations range from asymptomatic to life threatening respiratory distress. Recurrent chest infections are also the presenting complaints in patients. We report a 7 year old boy who presented with recurrent chest infections with left diaphragm eventration treated by plication successfully.
Key words: diaphragmatic eventration; dyspnea; recurrent respiratory tract infection; diaphragmatic palsy; plication

[1] Mouroux J, Venissac N, Leo F, Alifano M, Guillot F. Surgical treatment of diaphragmaticeventration using video-assisted thoracic surgery: a prospective study. Ann ThoracSurg 2005;79:308—12.
[2] Shields TW. Diaphragmatic function, diaphragmatic paralysis, and eventration of the diaphragm. In: Shields TW, Locicero III J, Ponn RB, Rusch VW, editors.General Thoracic Surgery.Lippincot Williams & Wilkins;2005 .p. 740—5.
[3] Versteegh MIM, Braun J, Voigt PG, Bosman DB, Stolk J, Rabe KF, Dion RAE. Diaphragm plication in adult patients with diaphragm paralysis leads to long-term improvement of pulmonary function and level of dyspnea. Eur JCardiothoracSurg 2007;32:449—56.
[4] Morrison JMW. Eventration of diaphragm due to unilateral phrenic nerve paralysis. Arch RadiolElectrotherap 1923;28:72—5.
[5]. Soni A, Singh P, Singh RJ, Sood V. Eventration of Diaphragm - Embryological basis. J AnatSoc India. 2005; 54: 39-41

Abstract: Objective: To find out clinical and laboratory findings in acute malaria caused by various plasmodium species. Methods: This was a prospective study which was carried out in the department of medicine at MLB Medical College ,Jhansi from May 2012 to September 2013.In this prospective study ,401 patients of malaria were enrolled who met both inclusion and exclusion criteria. Frequencies of alterations in clinical and laboratory parameters were determined in various plasmodium species. Results: Out of 401 patients, 194 were Plasmodium falciparum, 185 were P.vivax and 22 were mixed infection. Fever (97.5%), chills and rigors (84.7%) were the most common complaint in all three varieties of plasmodium infection. Pallor (78.3%) and splenomegaly (56.6%) were often detected in individuals with malaria. Thrombocytopenia (52.8%) was most common laboratory abnormalities detected in various plasmodium species. Jaundice and anemia were more common in P.falciparum and mixed infection as compared to P.vivax Conclusion: Malaria must be considered as leading differential diagnosis in an acutely febrile patient with one or more of abnormalities like splenomegaly, fall in blood counts or rise in bilirubin etc. Fever with chills and rigors, pallor, splenomegaly and thrombocytopenia were most common manifestation in malaria.
Keywords: Malaria, clinical spectrum.

[1]. Harrison Principles of Internal Medicine, 18th Ed.; Nicholas J. White, Joel G Bremani: 1688-1694
[2]. Bashawri LAM, Mandil AA, Bahnassy AA, Ahmed MA. Malaria: Haematological Aspects. Annals of Saudi Medicine 2002; 22:372-7
[3]. Biswas R, Sengupta G, Mundle M. A Controlled Study on Haemograms of Malaria Patients in Calcutta. Indian J Malariol.1999;36:42-8
[4]. Kochar DK et al; Cerebral Malaria in Indian adults a prospective study; JAPI 2002; 50; 234-41.
[5]. Jadhav UM, Patkar VS, Kadam NN. Thrombocytopenia in Malaria- Correlation with Type and Severity of Malaria. J Assoc Physicians India.2004;52:615-8

Abstract: Musculoskeletal pain, particularly back pain, has been found to be a major health problem for dental practitioner's .While the occasional backache or neck-ache is not a cause for alarm, if regularly occurring pain or discomfort is ignored, the cumulative physiological damage can lead to an injury or a career-ending disability. Objectives: 1.To find out the prevalence of occupational low back pain among dentists and dental interns. 2. To study occupational low back pain and coping strategies among dental interns of Sinhgad Dental college and practicing dentists around Ambegaon, Pune. 3. To identify the most common pain aggravating factor. Materials and methods: This was a cross sectional study done amongst dentists and dental interns around Ambegaon, Pune during July 2013 to October 2013. Total 300 dentists and interns were selected by simple random sampling Prevalence LBP is defined as rate of study subjects who experienced LBP in the past one week. Information wasgathered by a pretested questionnaire. Roland Morris disability questionnaire was used to assess physical disability due to low back pain. Study variables included the demographic features like name, age, gender , working hours, position while working (standing, sitting or both), working experience and occupational factors(pain aggravating and relieving factors). Results & Conclusion: Prevalence of LBP was found to be 64.67%.Dentists using both the sitting and standing positions were found to have significantly less low back pain as compared to those using sitting or standing alone. The coping up strategy used by maximum dentists (80.51%) is frequent change of position to make back comfortable. Prolonged sitting was identified as the most common pain aggravating factor (89 out of 194 subjects) and holding instrumentation though reported by a very few subjects was the most painful(RMDQ mean score of 6.33).
Keywords: Dentists, Low back pain, Roland Morris Disability Questionnaire

[1] PrakashPatil. A study on Occupational Pain among Dentists of Surat city. National Journal of Community Medicine 2011; 2(1):116-118.
[2] SayliPaldhikar, SampradaBhatkar, SnehalGhodey. Incidence and Study of occupational factors associated with low back pain in dentists in Pune Region India. IOSR. Journal of Dental and Medical Sciences (JDMS). Nov-Dec 2012; 3(2):8-12.
[3] Pargali N, Jowkar N. Prevalence of Musculoskeletal Pain among Dentists in Shiraz, Southern Iran. The Int. J Occupat. Environ Med 2010;1(2).
[4] Shugars DA, Miller D, Williams D, Fishburne C, Strickland D. Musculoskeletal pain among general dentists. Gen Dent 1987;35:272-6.
[5] Rundcrantz B, Johnsson B, Moritz U. Cervical pain and discomfort among dentists: epidemiological, clinical and therapeutic aspects. Part 1—a survey of pain and discomfort.

Abstract: The purpose of this study was to evaluate and compare the effect of 35% Hydrogen Peroxide and 35% Carbamide peroxide in - office bleaching agents using plasma arc and laser light sources on colour change, enamel surface morphology and sensitivity on teeth. -in vivo study Material and method: This study was carried out on 12 patients in which four groups i.e. 35% carbamide peroxide and plasma arc (CPP), 35% carbamide peroxide and laser light source (CPL), 35% hydrogen peroxide and Plasma arc (HPP), 35% hydrogen peroxide and laser light source (HPL) were made in all the four quadrants in anterior teeth. Preoperative baseline shade and impression was taken and same was repeated post operatively. After bleaching procedure colour change was evaluated using VITA classic shade guide , change in enamel surface morphology was calculated on epoxy model using contact profilometer and tooth sensitivity was analyzed using VAS scale. Result: 35% Carbamide peroxide and plasma arc (CPP) group showed significant colour change followed by 35% hydrogen peroxide plasma arc (HPP) group, 35% hydrogen peroxide and lasers (HPL)group and 35% carbamide peroxide and laser (CPL)group whereas highest change in enamel surface morphology was observed in 35% hydrogen peroxide and laser light source (HPL) group followed by 35% carbamide peroxide and laser light source (CPL) group, 35% hydrogen peroxide plasma arc (HPP) group , 35% carbamide peroxide plasma arc (CPP) group. Conclusion: Carbamide peroxide 35 % using plasma arc presented greater colour change as compared to Hydrogen peroxide 35% using laser light source. Laser light source caused more change in enamel surface morphology as compared to plasma arc.
Keywords: Contact profilometry ,In- office bleaching, Laser, Plasma arc.

[1]. Leonard RH, Haywood VB, Eagle JC, Garland GE, Caplan DJ, Matthews KP, et al. Nightguard vital bleaching of tetracycline-stained teeth: 54 months post treatment. Journal of Esthetic Dentistry 1999;11:265–77.
[2]. Johnny Fearon Tooth whitening: concepts and controversies INTERNATIONAL DENTISTRY SA 2007; 11- 2:31-38.
[3]. M. Suleiman An Overview of Bleaching Techniques:1. History, Chemistry, Safety and Legal Aspects. Dent Update 2004; 31: 608-616
[4]. Andrew Joiner. The bleaching of teeth: A review of the literature journal of dentistry.2006; 412 – 419.
[5]. Hegedüs, C., Bistey, T., Flora-Nagy, E., Keszthelyi, G., & Jenei, A. An atomic force microscopy study on the effect of bleaching agents on enamel surface. J Dent. 1999; 27:509-515.
[6]. Lopes GC, Bonissoni L, Baratieri LN, Vieira LC, Monteiro S Jr. Effect of bleaching agents on the hardness and morphology of enamel.J Esthet Restor Dent. 2002;14(1):24-30.

Abstract: Hypertensive retinopathy represents the ophthalmic findings of end organ damage secondary to systemic arterial hypertension. The eye is a target organ as well as an established prognostic indicator of systemichypertension. Based on ophthalmoscopically visible alterations, several classifications, the majority of them grading hypertensive fundus changes into four stages have been suggested. The recognition of hypertensive retinopathy is important in cardiovascular risk stratification of hypertensive individuals. The review evaluates the changing perspectives in classification & prognostic significance of fundal lesions.
Keywords: Hypertensive Retinopathy;Classification; Attenuation; Haemorrhage; Hard exudates

[1]. Liebreich R. Ophthalmosk opischer Befundbei Morbus Brightii. Albrecht von Graefes Arch Ophthalmol 1859; :265-268.
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[4]. Gitter KA, Houser BP, Sarin LK, Justice J. Toxemia of pregnancy. An angiographic interpretation of fundus changes. Arch Ophthalmol. 1968;80:449-54.
[5]. Fastenberg DM, Fetkenhour CL, Choromolos E, Shoch DE. Choroidal vasculature changes in toxaemia of pregnancy. Am J Ophthalmol. 1980;89:362-68.

Abstract: Medicines account for a substantial part of household expenditure. The overall budget of medicines varies widely in different states in India. The expenditure pattern of medicines of the state government shows that there is a wide range of difference across the states during 2001-2002. In all, roughly 10% of the total health budget goes into procuring medicines in India. Even then, availability of required medicines often is a big issue. The essential drugs list can help the country to rationalize the purchasing and distribution of medicines, thereby reducing costs to the health system (Sitanshu S, Himanshu S, et. al) Each drug treatment should include for each health problems, the name, dosage form, strength, average dose (paediatric and adult), number of doses per day, and number of days of treatment (STG, 2007). In the United Kingdom, in 1999, a joint formulary for primary and secondary care was developed and Separate budgets used to exist for primary and secondary care as the patient's transition between the two sectors was problematic. There were divisions in managing prescriptions between primary and secondary care. They felt that joint formularies would improve overall care and raise awareness of the need to consider overall costs within a unified national health service (Duerden & Walley). A study done by the Advanced Concepts Institute, in Philadelphia, United States of America found that both predominantly e-prescribers and traditional prescribers showed high levels of formulary compliance of 83.2% and 82.8% respectively. They also found that there was no difference in generic drug utilisation rates between e prescribers and traditional prescribers (Ross et. al, 2005). Cost minimization is usually the reason for formularies as well as the promotion of rational prescribing. Traditionally, formulary systems have also been used to control drug costs (Wade et al., 1996).

[1]. Sitanshu Sekhar Kar, Himashu Sekhar Pradhan, Guru Prasad Mohanta: The concept of essential medicines & rational use in public: Indian Journal of Community Medicine, vol. 35, issue 1, 2010. Downloaded from: http://www.ijcm.org.in/article.asp?issn=0970-0218
[2]. Drug and Therapeutics committees – A Practical Guide: 3. Managing the formulary process: 3.4 Standard treatment guidelines (STGs).Download from: http://www.scribd.com/doc/25528109
[3]. Duerden, M. & Walley,T, 1999. Prescribing at the interface between primary and secondary care in the UK .Towards joint formularies? Pharmacoeconomics15 (5):43543. Available from: http://www.ncib.nlm.nih.gov/pubmed/1053796 (Accessed: 2013-02-28).
[4]. Ross, S.M., Papshev, D., Murphy, E.L., Sternberg, D.J., Taylo,r J. & Barg, R. 2005. Effects of electronic prescribing on formulary compliance and generic drug utilization in the ambulatory care setting: a retrospective analysis of administrative claims data. JManag Care Pharm 11(5):410-5. Downloaded from: http://www.ncbi.nlm.nih.gov/pubmed/15934800
[5]. Wade,W.E, Spruill, W.J, Taylor, A.T, Longe, R.L & Hawkins, D.W. 1996.The Expanding Role of Pharmacy and Therapeutics Committees.The1990's and Beyond. Downloaded from: http://www.ncbi.nlm.nih.gov/pubmed/10163415

Abstract: Risk for new opportunistic infections has dramatically increased over the past decade because of the worldwide epidemic of HIV infection. Frequent and prolonged exposure of patients to a variety of environmental conditions has resulted in the recognition of infections with new fungal opportunists. Blastoschizomyces capitatus is less common emerging opportunistic fungal pathogen. Within a host, B.capitatus is able to grow in both unicellular yeast and multicellular filamentous forms. Here we describe two healthy cases attending TB chest clinic in our hospital with Blastoschizomyces capitatus infection and we review the clinical manifestations, microbiological characteristics which will help in elimination of the underlying predisposing factors which is crucial for clinical cure. Correct and timely identification of fungal specimens in clinical isolates is an essential component in the management of patients with fungal infections scientifically.

[1]. Salkin I, Gordon M, Samsonoff W, Rieder C. Blastoschizomyces capitatus, a new combination. Mycotaxon 1985; 22:375- 380.
[2]. Wills T.S, Degrese A. et al. Blastoschizomyces capitatus pneumonia in an immunocompetant male. J South Med Assoc 2004; 97:702-704.
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Abstract: Telomeres are long repetitive DNA sequences of TTAGGG located at the end of the linear chromosomes and bound by shelterin proteins. Shelterin proteins function as the protection for the loop structure of telomere, which prevents the chromosome ends uncapped; resemble a DNA break and activates DNA repair mechanism. Telomeres are maintained by an enzyme called telomerase. Telomerase is not expressed in normal human somatic cells. Therefore, telomeres shorten with every cell division and limit the number of cell division. This limitation of cell division is termed replicative aging, which is thought to be a barrier to cancer formation. In addition, telomere shortening can induce replicative senescence which then leads to aging and human aging-associated diseases such as cancer and atherosclerosis. Several studies on human premature aging diseases such as congenital dyskeratosis and aplastic anemia also reported association between them and telomere length.
Keywords: aging, cancer, senescence, telomerase, telomeres

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Abstract: Knowledge of variations of blood vessels in the renal hilum region is important during operative, diagnostic and endovascular procedures in the abdomen. This report describes the variations found in the origin and course of the right renal and ovarian vessels. The variation was found during routine dissection in an approximately 63 years old female cadaver. The cadaver did not have any other observable anomalies in the other parts of the body. The right renal artery originated as the ventral branch of aorta and passed anterior to the inferior vena cava before reaching the hilum of the right kidney. The Right ovarian artery took its origin from the right renal artery. The right ovarian vein was very large and it received two considerably large tributaries from the pararenal pad of fat. The knowledge of variations of renal and gonadal vessels is important for surgeons doing kidney transplants.
Keywords: kidney, ovarian artery, ovarian vein, right renal artery, variations

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Abstract: Basal cell carcinoma though most common malignancy in skin but extremely rae in covered part of the body like nipple-areola complex in female breast.Like our case very few cases had been reported in English literature without any history of sun ,radiation exposure. The present case adds to the few reported cases of BCC over nipple areolar complex and thus highlights the importance of identifying BCC as a potential diagnosis in any ulcer over the nipple areola complex.
Keywords: Basal cell carcinoma(BCC),Nipple areolar complex

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