iosr-JDMS   Volume-13 ~ Issue-7 ~ July-2014

Abstract: Pentalogy of Cantrell is a rare congenital malformation syndrome involving specific combination of ventral midline defects with ectopia cordis', as the most severe malformation. The complete form consists of five anatomical defects. We report a case of a one hour old female neonate delivered to a 27 year old primipara who presented with the complete form of the syndrome. She had surgery on the 4th day of life, however died 36 hours after surgery. We report this rare congenital anomally and a review of relevant literature. Keywords: Abdominal wall defect, Ectopia cordis, Pentalogy of Cantrell

[1]. Cantrell JR, Heller RJA, Ravitch MM, : A syndrome of congenital defects involving the abdominal wall, sternum, diaphragm, pericardium, and heart. Surg. Gynecol.Obstet. 1958;107(5):602–14
[2]. Robinson JN, Abuhamad AZ. Abdominal wall and umbilical cord anomalies. Clin Perinatol 2000; 27: 947-78.
[3]. Toyama WM.: Combined Congenital defects of the anterior abdominal wall, sternum, diaphragm, pericardium and heart: a case report and review of the syndrome. Pediatrics 1972, 50:778-779.
[4]. Peixoto-Filho FM, Cima LC, Nakamura Pereira M. Prenatal diagnosis of pentalogy of Cantrell in the first trimester: Is 3 dimensional ultrasonography needed? J Clin Ultrasound 2008; 37:112-14.
[5]. Bonilla-Musoles F, Machado LE. Gastrointestinal tract and internal abdominal wall. In: Kurjak A, Chervenak FA, Carrera JM (Eds). Atlas of fetal anomalies. Jaypee Brothers Medical Publisher 2007;174-94.
[6]. Chen CP. Syndromes and disorders associated with omphalocele (II): OEIS complex and pentalogy of Cantrell. Taiwan J Obstet Gynecol 2007; 46: 103-10.

Abstract: In children, ACL avulsion fractures are common as compared to adults who have midsubstance tears. [1] 40 – 50 % cases of isolated PCL avulsion occurs at tibial insertion site as compared to femoral origin or midsubstance tear. [2] Avulsion fractures as compared to intrasubstance tears can be treated operatively or nonoperatively with favourable results. [3] Isolated ACL and PCL avulsion injury in a skeletally mature knee is rare

Keywords: ACL avulsion , PCL avulsion

[1]. Remer EM, Fitzgerald SW, Friedman H , Rogers LF , Hendrix RW, Schafer MF, Anterior cruciate ligament injury : MR imaging diagnosis and patterns of injury. Radiographics 12, 1992, 901-915.
[2]. Hunter JC, Chapman JR, Isolated avulsion of the posterior cruciate ligament : an uncommon dashboard injury. AJR Am J Roentgenol 164, 1995, 1190.
[3]. White EA, Patel DB, Matcuk GR, Forrester DM, Lundquist RB, Hatch GF 3 rd, Vangsness CT, Gottsefen CJ, Cruciate ligaments avulsion fracture : Anatomy, biomechanics, injury patterns and approach to management. Emerg Radiol. 20(5), 2013, 429-40.
[4]. Capps GW, Hates CW, Easily missed injuries around the knee. Radiographics 14, 1994 ,1191-1210.
[5]. Delzell PB, Schils JP, Recht MP, Subtle fractures about the knee: innocuous appearing yet indicative of significant internal derangement. AJR Am J Roentgenol 167, 1996, 699-703.

Paper Type	:	Research Paper
Title	:	The use of the fastrak system to evaluate the independent movements of ankle, subtalar and midtarsal joints during walking
Country	:	India
Authors	:	Dr Sayaji V Bhamre, Dr Rami J Abboud, Mr Graham Arnold
	:	10.9790/0853-13720813

Abstract: Healthy humans walk with bipedal gait, which is a coordinated series of movements occurring through the body and, in lower limb. The ankle and foot play an important role in gait cycle. It is necessary to study biomechanics of the ankle and foot as it provides powerful tools in studying both normal and pathological gait, for example cerebral palsy, neuromuscular disorders, and traumatic conditions like ankle injuries(Scott and winter,1991). In normal gait the lower limb undergoes various complex mechanism, but the significant mechanism of foot function can be explained by studying the biomechanics of three particular joints; the ankle, the subtalar and midtarsal joints(Bevan, 1992). Movements of the ankle, subtalar and midtarsal joints during normal walking have not been studied independetly until now. The ankle and foot undergo a very complex mechanism of various movements during the gait cycle. This take place about joint axes, which occur in one, two, or three body planesat a time. with conventional method it is not possible to measure joint movements in all three planes at a time. Method such as three dimensional video(Vicon system) gait analysis are both time consuming and expensive. The Fastrak system is an electromagnetic device which determines the position and orientation of an object in space three dimensionally. With the fastrak system it is possible to calculate three palmer movements of the joints. Compare to other devices the Fastrak system is inexpensive, reliable, less time consuming and proved to be repeatable (Rendall and Abboud, 1999).

[1]. Abboud RJ, Agarawal SK, et al. Adirect method for quantitative measurement of ankle proprioception. The Foot; 9:27-30,1999
[2]. Ahmed SA. assesement and comparision of shoulder movements using the fastrak and vicon system. MCh degree thesis;University of dundee,2005
[3]. Bevan JS. Biomechanics: A review of foot function in gait. The Foot; 2:79-82,1992
[4]. Lundberg A,Svensson OK, Bylund C. Kinematcs of the foot/ankle complex-part2: pronation and supination. Foot and Ankle: 9(5):248-253,1989
[5]. Milgrom C, Giladi M, Simkin A. The normal range of subtalar inversion and evesion in young males as measured by three different techniques. Foot And Anle;6(3):143-145,1985

Abstract: A Total knee replacement is an established procedure in management of osteoarthritis and rheumatoid arthritis. we are presenting our experience with this procedure .24 patients underwent TKA at KLE's hospital Belgaum between august 1999 to august 2001,of these three patients underwent bilateral TKR(total 27). The main indication for TKR was OA(17 patients) followed by RA(6 patients and one pateint with post traumatic OA. the follow up period ranged from 6 months to 2 years. Pre operatively each patient assessed clinically and radiologically. The functional disability was recorded according to knee scociety clinical rating system in terms of pain,raange of motion,instability and functional capacity. genu varus was present in 24 patients,maximum correction being 40 degree,fixed flexion deformity in 7 patients maximum was 40degree. Knee instability was present in 2 patients and extension lag in 5 patients. The mean preoperative score was 45 which improved to 90 after surgery. A score of 85-100 represented excellent result. the complications included periprosthetic fracture of femur during manipulation for post-op stiffnessof joint in one patient and foot drop following surgery in one patient which recovered within 4 weeks.On radiological examination over all alignment averaged 4.9 valgus,mean femoral angle was 95 degree and mean tibial angle 90 degree. Mean femoral flexion was 12 degree. Mean lateral tibial angle 87.5 degree. no radiolucencies seen after two year follow up. This report reveals 81.5% excellent, 14% good And 3.7%fair clinical result. there were no poor results.
Keywords: Total knee arthroplasty

[1]. Aaron P.K., Scott R, Supracondylar fracture of the femur after total knee arthroplasty, Clin. Orthop.,219:136,1987
[2]. Andriacchi T.P., Galante j.o. et al, The influence of toatal knee replacement design on walkind and stair climbing, JBJS, 64-A:1328,1982.
[3]. Asp JP, Rand JA: peroneal nerve palsy after total knee arthroplasty, Clin, Orthop. 261:233,1990.
[4]. Ecker F.C et al., The knee society total knee arthroplasty roentgenographic evaluation and scoring system, Clin. Orthop., 248: 9,1989.
[5]. Insall JN, Dorr LD, et al., The rational of knee society clinical rating system. Clin Orthop., 248:13,1989.
[6]. Insall JN, Lachiewicz PE, Burstein AH et al., the posterior stabilized condylar prosthesis, A modification of the total condylar design,JBJS, 64-A:1982

Abstract: Zinc is an essential micronutrient for human health. In spite of the proven benefits of adequate zinc nutrition, approximately 2 billion people still remain at risk of zinc deficiency. Zinc is found as component of more than 300 enzymes and hormones and plays a crucial part in the health of our skin, teeth, bones, hair, nails, muscles, nerves and brain function as well as it is essential for growth. Zinc controls the enzymes that operate and renew the cells in our bodies. The formation of DNA, the basis of all life on our planet, would not be possible without zinc. Zinc deficiency is an important public health problem, affecting large number of women and children in India and worldwide. Zinc deficiency is the fifth leading risk factor for disease in the developing world. In a recent survey by WHO, zinc deficiency is found in most of the Indian population and zinc supplement is used commonly to enhance wound healing and treatment of pneumonia. The element is important in maintaining the healthy growth of the human body, especially for infants and young children. Keywords: Zinc, human health, Zinc deficiency

[1]. Fleet JC. Zinc, Copper, and Manganese. In: Stipanuk MH , editor .Biochemical and Physiological aspects of Human Nutrition . New York; Saunders: 2000. p.741-759
[2]. King JC, Keen CL. Zinc. In. Shils ME, OlsonJA , Shike M, Ross CA, editors. Modern Nutrition in Health and Disease. 9th Ed. NewYork ; Lippinkott Williams& Wilkins: 2003. p.223-239
[3]. Bhowmik D, Chiranjib KP, Kumar S. A potential medicinal importance of Zinc in human health and chronic disease. Int J Pharm Biomed Sci 2010; 1(1):5-11
[4]. Maverakis E, Fung MA, Lynch PJ, DraZincin M, Michael DJ, Ruben B, Fazel N. Acrodermatitis enteropathica and an overview of zinc metabolism. J Am Acad Dermatol 2007; 56:116–24
[5]. Maret W, Krezel A. Cellular zinc and redox buffering capacity of metallothionein/thionein in health and disease. Mol Med 2007; 13(7-8):371-5

Abstract: Background: Ovarian lesions are one of the most frequent lesions in women .The pre-operative diagnosis relies mainly on clinical and radiological findings while post-operative diagnosis is made by histo-pathological examination. With the advent of accurate imaging techniques like USG and CT scan, guided FNAC can prove to be an efficient diagnostic modality for ovarian neoplasm. Aims & Objectives: To evaluate the utility and accuracy of cytological diagnosis in ovarian lesions either non-neoplastic or neoplastic. Material and Methods: A retrospective study was carried out over a period of 3.5 years. Total 125 cases were reported in cytology during this period. Diagnosis was established by FNAC performed under image guidance and confirmed by Histo-pathological examination. Cytology smears were stained by Pap and H&E stain. Histology slides were stained with H&E stain. Result: Of the total 125 cases, cytological diagnosis was offered in 110 cases of which 17 were non-neoplastic, 50 benign and 43 malignant. Cytological correlation with histopathological specimens was possible in 69 cases only. Concordant diagnosis was achieved in 63 cases while 6 were discordant. Sensitivity and specificity of cytological diagnosis were 77.2% and 97.9% respectively. Conclusion: Guided FNAC for ovarian lesions is a relatively quick, easy and patient friendly procedure with fair diagnostic accuracy and minimal patient mortality. Cytological diagnosis can be used as a preoperative diagnosis for management of patient. Histopathology remains the gold standard procedure.

Key words: ovarian lesions, cyto-histopathological correlation, cytology, histopathology.

[1]. Russel P, Bannatyne P: Surgical pathology of the ovaries, Edinburg, Churchill Livingstone. 1989.
[2]. Hajdu S, Melamed MR. Limitations of aspiration cytology in the diagnosis of primary neoplasms. Acta cytol.1984;28:337-45.
[3]. Ahmad SS, Akhtar K, Akhtar S, Abrari A, Nasir A, Khalid M, et al. Ultrasound guided fine needle aspiration biopsy of abdominal masses. JK Science 2006;8:200-4.
[4]. Ferran A, Gallardo J, Padilla C, Combalia N, Mellado F, Rey M. Fine needle aspiration of benign uterine adnexal lesions. Acta Cytol 1995;39:291.
[5]. Geier GR, Strecker JR. Aspiration Cytology and E2 content in ovarian tumors. Acta Cytol 1981; 25: 400-6.

Abstract: Tonsillectomy is the most common surgery performed by an ENT surgeon & it is the most risky surgery as its complications are sometime life threatening. So far not much effort has been focused in training the junior residents in tonsillectomy using the models, like temporal bone dissection for ear surgeries, whereas lot of live ENT surgical workshop are conducted other than tonsillectomy to train junior residents in different ENT surgeries. An attempt has been made to develop the model for tonsillectomy taking into account all the parameters one encounters during tonsillectomy & train the junior residents with handmade convenient, economical & practical model. We are successfully training the resident doctors with this model that improves their orientation, surgical skills & reduces the operating time & complications of tonsillectomy.

Keywords: Tonsillectomy model, VIMS,

[1]. Lowe D, van der Mullen J, Cromwell D, et al. (2007) Key messages from the
[2]. National Prospective Tonsillectomy Audit. Laryngoscope 117: 717-724.
[3]. Hall L, Lee M (2011) Training for tonsillectomy: home-made Negus knot pusher.
[4]. Clin. Otolaryngol. 36: 99-100.
[5]. Raja MK, Haneefa MA, Chidambaram A (2008) Yorick's skull model for
[6]. Tonsillectomy ties training. Clin. Otolaryngol. 33: 187-188.
[7]. Street I, Beech T, Jennings C (2006) The Birmingham trainer: a simulator for
[8]. ligating the lower tonsillar pole. Clin. Otolaryngol. 31:79.

Abstract: A time motion study was conducted to know the time taken in different service delivery points in outpatient department and to assess the perception of beneficiaries regarding the total time spent in the OPD. The study was conducted at Tarakeswar rural hospital from January to April 2014. About 192 patients were included in the study. According to 46.88 % population, total time was too long. 42.70 % population were not satisfied about the total time taken in the OPD. 29.16 % population had given the suggestion. 42.86 % of the population (who had given any suggestion) suggested appointing more doctors. Much more in-depth research work on Time Motion study is required for proper time management in different health care delivery system and subsequent remedial steps can be taken accordingly.

Key words: Time motion study, OPD, patient satisfaction, rural hospital

[1]. Chattopadhyay A, Ghosh R, Maji S, Ray TG, Lahiri SK. Atime motion study in the immunization clinic of a tertiary care hospital of Kolkata, West Bengal. Indian J Community Med 2012; 37(1): 30-3
[2]. Gowler D and Legge K. Writing and the Advent of Scientific Management: The Case of Time and Motion Studies. Scandinavian Journal of Management[Internet]. [Cited on 2013, Dec 10th]. 12(1): 41-55
[3]. Baumgart A. Neuhauser D. Frank and Lillian Gilbreth: Scientific Management in the Operating Room. Quality Safety Health Care. [Internet] [cited on 2013, Dec 12th] 2009. 18(2); 413-415
[4]. John N. Murthy GV. Vashisht P. Gupta SK. Work capacity and surgical output for cataract in the national capital region of Delhi and neighbouring districts of North India. [ Internet]. Indian J Public Health. 2008. 52(3);177-84

Abstract: Maintenance of normal fluid-electrolyte balance is desirable for maintenance of homeostasis. Much is now known about the metabolism of sodium and potassium and their effects on the body when these electrolytes are deficient. Their loss through skin, kidney and bowel has been studied. But less is known about their excretion through artificially created stoma of the bowel. Further not much work was done in this respect in this rural part of the West Bengal with extreme climate and great swing in temperature dryness. This compounds the problem of such patients due to increase losses of fluid and electrolytes through the skin and lungs. In our study we estimated serum electrolytes, namely serum sodium and serum potassium post operatively at 24hrs (1st post operative day), 72 hrs (3rd post operative day) and 120 hrs (5th post operative day) during the post operative study period, no patient expired and all the patients resuscitated adequately in pre operative period, and maintained an adequate urine output. All the patients in this study had their stoma created on operation for emergency condition. We concluded that patients having high output ileostomy (≥1000ml/day), there was a significant decrease in serum sodium and serum potassium on 5th post operative day. And we recommend that all patients who undergo ileal resection along with ileostomy, or who have high ileostomy output, should be closely monitored for electrolyte derangement from the 3rd post operative day onwards.

Key words: Ostomies, Ileostomy dejecta,

[1]. Hill GL, Mair WSJ, Goligher JC. Cause and management of high volume output salt depleting ileostomy. Br J Surg 1975; 62: 720- 726.
[2]. Hill GL, Goligher JC, Smith AH, Mair WS. Long term changes in total body water, total exchangeable sodium and total body potassium before and after ileostomy. Br J surg 1975; 62: 524-7.
[3]. Journal of Dept. of General Surgery, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, India.
[4]. Wilson AO, B.Sc., M.B, Ch.B., F.R.C.S.E.,Observation on serious disturbance of water and electrolyte metabolism in patient with terminal ileostomy Dept of Surgery, Post Graduate Medical School of London.
[5]. Abbot, WE, Krieger H, Babb. Metabolic alteration in surgical patients I. The effects of altering the electrolyte, carbohydrates, and amino acid intake. AMA Annals of Surgery, 1963; 138: 434.

Abstract: Socio economic development of nation is intricately related to family planning policy.The reports of rise in contraceptive practices are not in correspondence with the similar decrease in the population number, therefore there is an urgent need to assess the cause of discrepancy.The present study is an effort to assess the knowledge, attitude and practice of contraception among Garhwal (Uttrakhand) population. The objective of the study was to assess the knowledge and acceptability of contraceptives among the women of reproductive age group.This is a cross sectional study based on sample of 418 married women of reproductive age group of 15-49 in the tertiary care hospital of Srinagar Garhwa,l Uttrakhand,India .Participants were interviewed for the knowledge and utilization of contraceptives . Throughout the study we observed that great awareness about the various contraceptive measures maximum being about sterilization (100%) irrespective of age. However the usage (77%) is not in proportion to awareness, and is highly influenced by the educational status, being 100% in graduates and postgraduates and least among high school dropouts (3.2%)

Keywords: Sterilization,Reproductive age group, Utilization

[1] Dabral S,Malik S,Department of Anthropology,University of Delhi, Delhi 110 007, India. hum ecol., 17(1):1-12(2005)

[2] Reena S,Dhirendra Kumar S,Radha S, Kumkum S, Neela S,Contraceptive knowledge attitude and practice (KAP) survey. J Obstet Gynecol India 2005; 55: (6 )550

[3] Tripathi R,Rathore AM,Sachdeva J. Emergency contraception: Knowledge, attitude, and practices among health care providers in North India.Journal of Obstetrics and Gynaecology Research 2003;29( 3):142–146.

[4] Roy M,Lahiri BC,Ghosh BN.KAP study on MTP acceptors and their contraceptive practice. Indian J Public Health.; 1978: 22(2) 189-96.

[5] Chopra I S,Dhaliwal L.Attitude and practice of contraceptive in urban population of North India.Arch Gynecol Obstet; (2010):281:273-277

[6] Sentumbwe S, Lyomoki SW, Guwattude D. Makerere. KAP study about STDs & family planning among rural youth in Uganda.African J Family Planning. 1994 ,7-12; 10:68

Abstract: Back ground: Optimal coherence tomography (OCT) is a non contactnon invasive newer diagnostic tool that can perform tomography cross sectional imaging of biological tissues with <10 micron axial resolution using light waves near infrared beam. Methodology: Hospital based study conducted on 50 patients having macular diseases who attended DR RSPR Govt. regional eye hospital, Visakhapatnam. Each patient underwent a complete ophthalmic examination including best corrected visual acuity slit lamp biomicroscopy, IOP recording and fundus evaluation by indirect Opthalmoscopy with+90 D lens. In addition fundus photographs were taken. Routine blood examination and urine examination were done. Then the patients were subjected to evaluation of posterior segment by OCT. Results: Of the 50 cases on whom the OCT was done, majority (32%) were diabetic macular Oedema, followed by central serous Retinopathy (24%) and Epiretinal membrane was seen in 10% cases. Among the study participants, 7 patients presented with macular holes. Two patients had full thickness macular holes and five patients had lamellar holes. Conclusion: Diagnosis is confirmed by OCT gives additional information regarding pathological presentation, so help in the management.It may beneficially impact the visual disability by diagnosing a disease at an earlier stage.

Key words: Optical coherence tomography, Macular diseases, diagnostic tool

[1]. ATLAS-Optical coherence Tonography of macular diseases 2004 Vishaligupta, Amod Gupta &Mangat R Dogra-First Edition Jaypee Brothers and Medical Publishers (P) Ltd.
[2]. Focus on Macular Diseases 2007 first edition –SandeepSaxena and Jaypee Brothers and Medical Publishers.
[3]. Otani T, Kishi S, Maruyama Y Patterns of diabetic macular edema with optical tomography, AM J Opthalmol (1999) 127:688-93(ISSN: 0002-9394).
[4]. HeeMR,PulifitoCA,WongC,DukerJS,ReichelE,Rutledge B Quantitative assessment of macular edema with optical coherence tomography, Arch Opthalmology,1995 August 113(8),1019-29.
[5]. HeeMR,IzlattJA,SwansonEA,HuangD,SchumanJS,LinCP,PuliafitoCA,FujimotoJG.Optical coherence tomography of the human retina. Arch Opthalmol.1995 mar;113(3):325-32.

Abstract: Purpose: The best approach to the body of the lumbar vertebrae is from the anterior aspect. The lower lumbar vertebrae are more prone to mechanical and degenerative changes. The disadvantage is that the front of the lower lumbar vertebrae are related intimately to important neurovascular structures like the abdominal aorta, inferior venacava, sympathetic chain etc. There is a need for the preoperative evaluation of the vascular structures related to the lumbar vertebrae. Methods: The abdominal cavity of the cadavers were opened, the intra abdominal structures were retracted to expose the posterior abdominal wall. The structures related to the anterior aspect of the lumbar vertebrae were dissected and cleaned to expose the great vessels, the Abdominal Aorta and the Inferior Vena cava. The sacral promontory was identified and the level of the bifurcation of the AA and IVC formation were identified with respect to the lumbar vertebrae. Variations were also looked for. Results: The bifurcation of Aorta was seen at the body of L4 (55%) and L3 (27.5%). The IVC formation was seen on the body of L5 and L5-S1 spine. The IVC was more prone to variation when compared to AA. The variation observed with IVC was mainly in the form of multiple unnamed tributaries draining into the IVC. The variation observed in the abdominal aorta was high level of bifurcation at L3 body which is unusual. Conclusion: Preoperative evaluation of the vascular anatomy of the lower lumbar vertebra is essential to avoid postoperative complications.

Keywords: Aortic Bifurcation, Inferior Vena cava, Lumbar vertebral body

[1]. Susan Standring, Posterior Abdominal Wall and Retroperitoneum, Gray's Anatomy, 39th
[2]. Edition, Elsevier Churchill Livingstone, 2006, 1116-1117.
[3]. Chang Hee Lee, Bo Kyoung Seo, Young Chil Choi, Hyun Joon Shin, Jeong Hee Park, hae Jeong Jeon, Kyeong Ah Kim, Cheol Min Park, Baek Hyun Kim, Using MRI to Evaluate Anatomic Significance of Aortic Bifurcation, Right Renal Artery and Conus Medullaris When locating Lumbar Vertebral Segments. American Journal of Roentgenology. 2004;182:1295-1300.
[4]. Kimaporn Khamanarong MD*, Surachai Sae-Jung MD**, Chunsri Supa-adirek MD***, Supawadee Teerakul*, Parichat Prachaney PhD, Aortic Bifurcation: A Cadaveric Study of Its Relationship to the Spine, Med Assoc Thai 2009; 92 (1): 47-9.
[5]. Kajorn Lakchayapakorn MD*, Yongyut Siriprakarn MD**, Anatomical Variations of the Position of the Aortic, Bifurcation, Iliocava Junction and Iliac Veins in, Relation to the Lumbar Vertebra, J Med Assoc Thai Vol. 91 No. 10 2008.

Abstract: Ankyloglossia or tongue tie is a developmental anomaly of the tongue characterized by an abnormally short, thick lingual frenum resulting in limitation of tongue movement. Ankyloglossia can adversely affect feeding, speech articulation, and oral hygiene maintenance. The lingual frenum is interposed between a highly mobile tongue and a richly vascular floor of mouth. In such situation, frenectomy with laser is more advantageous over conventional scalpel method. This case reports of a 35-year-old male with tongue-tie who complained of difficulty in speech following which he underwent lingual frenectomy procedure with laser, without any complications. Finally, he was given speech therapy sessions.

Keywords: Ankyloglossia, LASERs, Lingual frenectomy, Tongue tie.

[1]. AF Wallace. Tongue tie. Lancet 1963;2:377–8.
[2]. AH Messner. Ankyloglossia: incidence and associated feeding difficulties. Arch Otolaryngol Neck Surg. 2000; 126:36-9.
[3]. DM Laskin. Oral and Maxillofacial surgery, Volume 1. The CV Mosby Company, 1989: page no. 360.
[4]. LA Kotlow. Ankyloglossia (tongue-tie): A diagnostic and treatment quandary. Quintessence Intl 1999;30:259-62.
[5]. SE Fisher, JW Frame. Electrosurgical management of soft tissues and restorative dentistry. Dent clin North Am 1980;24:297-9.
[6]. H Wigdor, J Walsh, JDB Featherstone, S Visuri, et al. LASERs in dentistry. LASERs Surg Med 1995;16:103–33.
[7]. H Bader. Use of LASERs in periodontics. Dent Clin North Am 2000;44:779–92.

Abstract: Introduction: Various studies have been conducted which show that interarch tooth size relation differ with population. The aim of this study was to find out Bolton ratio in Indian population. Methods: Measurement were taken from 50 study models of randomly selected males and females with class I molar and canine relationship with ideal overjet and overbite, who had not undergone any orthodontic or cosmetic dental treatment previously. Needle point dividers were used to measure the greatest mesio-distal diameter of all teeth. From the obtained data, the Kolmogrov-Smirnov test, standard error of mean, standard deviation, coefficient of variation, coefficient of correlation were measured and used to assign statistical significance. Results: Increased anterior ratio (79.2284) & decreased overall ratio (90.9464) in selected Indian population were found in relation to Bolton's ideal ratio. Conclusions: - Differences between original Bolton ratio and obtained ratio for Indians were significant, specific standards for Indians might be needed.

Key Words: Bolton analysis, Indian population, anterior ratio, total ratio, orthodontics

[1]. Bolton WA. Disharmony in tooth size and its relation to the analyses and treatment of malocclusion. Angle Orthod 1958;28:113-30.
[2]. Bolton WA. The clinical application of a tooth-size analysis. Am J Orthod 1962;48:504-29.
[3]. Crosby DR, Alexander CG. The occurrence of tooth size discrepancies among different malocclusion groups. Am J Orthod Dentofacial Orthop 1989;95:457-61.
[4]. Freeman JE, Maskeroni AJ, Lorton L. Frequency of Bolton tooth-size discrepancies among orthodontic patients. Am J Orthod Dentofacial Orthop 1996;110:24-7.
[5]. Smith SS, Buschang PH, Watanabe E. Interarch tooth size relationships of 3 populations: "does Bolton's analysis apply?"Am J Orthod Dentofacial Orthop 2000;117:169-74.
[6]. Paredes V. aredes V, Gandia LJ, Cibrian R. New, fast, and accurate procedure to calibrate a 2-dimensional digital measurement method. Am J Orthod Dentofacial Orthop 2005;127:518-9.

Abstract: Supratrochlear foramen(STF) is located on the bony septum that separates the olecranon fossa from the coronoid fossa, at the lower end of the humerus.The present study was conducted on 85 humerii(44 left,41 right)of unknown sex collected from the department of anatomy, A.J.Insttitute of Medical Sciences,Mangalore.The presence of a STF was noted;its shape was observed and transverse and vertical diameter were measured by using digital Vernier caliper.STF was observed in 22 (25.88% )bones.Oval shape was more predominant seen in 13 cases followed by round in 9 cases.The mean transverse and vertical diameter of right side was 4.46mm and 3.13 mm and the mean transverse and vertical diameter on the left side was 4.60mm and3.08 mm respectively. The knowledge of STF is important for orthopaedician and radiologists in their day to day clinical practice

Key words : bonyseptum,coronoidfossa,humerus,olecranonfossa,supratrochlear foramen,

[1]. Soni S, VermaM,Gulyani T, SaxenaA.Supratrochlearforamen:an incidental finding in the foothills of Himalayas.OA Case Reoports 2013 Aug 08 ;2(8):75.
[2]. JadhavMayuri,TawteApama,PawarPradeep,ManeSmitha.Anatomical study of supratrochlear foramen of humerus.Journal of Research in Medical and Dental Sciences.2013;1(2):33-35.
[3]. De Wilde V,DeMaesneer,M,LenchikL,Van Roy P,BeeckmanP.Normal osseous variants presenting as cystic or lucent areas on radiography and CT imaging:a pictorial overview.Eur J Radiol 2004 .51:77-84.
[4]. Krishnamurthy A, YelicharlaAR, TakkalapalliA, MunishamappaV, BovinndalaEB, ChandramohanM.Supratrochlear foramen of humerus-a morphometric study .IntJ Biol Med Res.2011;2(3):829-31.
[5]. SharmilaPB,DeviKS.Anatomical note of supratrochlear foramen of humerus in south costal population of Andhra Pradesh.Narayana Medical journal2012.1(2);

Abstract: We report a case of 62 year old man with single vessel disease involving the left anterior descending artery (95% proximal lesion) who underwent off-pump myocardial revascularization through antero-lateral thoracotomy (Thora--CAB). Post-operative period was uneventful with early recovery and minimal pain. He was discharged home on 5th post-operative day, doing well and is in regular follow up.

Key Words: Anterolateral thoracotomy, Coronary artery bypass grafting, Thoracab

[1]. Edmunds LH Jr. Extracorporeal Perfusion in Cardiac Surgery in the Adult. In Edmunds LH Jr, Ed. Cardiac Surgery in the Adult. McGraw-Hill, New York 1997:255-294.

[2]. Ascione R, Angelini GD. Off-pump coronary artery bypass surgery: the implications of the evidence. J Thorac Cardiovasc Surg 2003. Apr;125(4):779-781 10.1067/mtc.2003.11

[3]. Benetti FJ, Naselli G, Wood M, Geffner L. Direct myocardial revascularization without extracorporeal circulation. Experience in 700 patients. Chest 1991. Aug;100(2):312-316 10.1378/chest.100.2.312

[4]. Buffolo E, de Andrade CS, Branco JN, Teles CA, Aguiar LF, Gomes WJ. Coronary artery bypass grafting without cardiopulmonary bypass. Ann Thorac Surg 1996. Jan;61(1):63-66 10.1016/0003-4975(95)00840-3

[5]. Srivastava SP, Patel KN, Skantharaja R, Barrera R, Nanayakkara D, Srivastava V. Off-pump complete revascularization through a left lateral thoracotomy (ThoraCAB): the first 200 cases. Ann Thorac Surg 2003. Jul;76(1):46-49 10.1016/S0003-4975(03)00034-1

Abstract: Aim: Sleep Apnoea a common disorder in young and adults has been studied extensively by pulmonologists, ENT specialists and dentists for various reasons. In the literature it is documented that Sleep Apnoea patient confirmed by polysomography have higher incidence of hook-shaped (S –type) of soft palate. The aim of our study is to correlate types of soft palate, body mass index (BMI) and apnoea hypoapnoea index (AHI) in sleep apnoea patients. Materials & Methods: This preliminary study was carried out in 20 diagnosed patients of sleep apnoea and 20 normal subjects between the age ranges of 12 to 60 yrs in VSPM'S Dental College & Research Center. The morphology of the soft palate was studied on Digital lateral cephalograms (using Kodak software-72kvp, 12mA, 1sec exposure). The BMI index, polysomography, Epworth sleepiness scale was recorded in all these patients. Results: Patients with increase BMI and severe AHI had higher incidence of butt type of palate followed by leaf type. In normal patient the commonest type was found to be leaf type followed by rat tail type. Conclusion: The present study indicated that severe sleep apnoea patient had higher incidence of butt type of soft palate.

Key Words: Sleep Apnoea, soft palate, lateral cephalogram, body mass index, apnoea hypoapnoea index

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[3]. M You, X Li, H Wang Morphological variety of the soft palate in normal individuals: a digital cephalometric study Dentomaxillofacial Radiology (2008) 37, 344-349

[4]. Yu-Fang Liao ,Ming-Lung Chuang, Chiung-Shing Huang ,Ya-Yu Tsai .Upper Airway and Its Surrounding Structures in Obese and Nonobese Patients With Sleep-Disordered Breathing .The Laryngoscope vol 114 issue 6 pages 1052–1059, June 2004
[5]. Matilde Valencia-Flores, Arturo Orea, Violeta A. Prevalence of Sleep Apnea and Electrocardiographic Disturbances in Morbidly Obese Patients .Obesity Research (2000) 8, 262–269

Abstract: Though India has major burden of cases of tuberculosis in the world, tuberculous mastitis remains to be one of the least studied entities. In this retrospective study we have emphasised clinical and demographic profile of patients diagnosed with tuberculous mastitis and their response to anti tubercular therapy. We had 10 patients diagnosed with tuberculous mastitis during the period of 2009 – 2014. All patients were in reproductive bracket commonly presenting in the age group of 30 – 35 yrs. Presentation involved equal frequency in both breasts and duration spanned over 2 days to a year. Most of them were house wives and parous women who had breast fed children. Usual presentation was breast lump whose mean size was 4.5 cms associated with dull pain. Diagnosis was confirmed by histopathology which showed granulomatous inflammation, caseating necrosis with or without demonstrable tuberculous bacillus. Patients were treated with anti tubercular therapy for 6 months resulting in complete cure of disease with no relapse or recurrence.

Key words: Anti tubercular therapy, Granulomatous mastitis, Tuberculous mastitis,Tuberculosis(TB),

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