iosr-JDMS   Volume-13 ~ Issue-9 ~ September-2014

Abstract: TMD disorders are a collective term for masticatory muscle and joint disorder. Diagnosis of this condition involves understanding of the pathology and cause and clinical features of the underlying disease. The aid of modern diagnostic techniques also gives us a good source of conformation. This article gives the insight into etiological factors and clinical conditions and other diagnostic methods, which are reliable in giving appropriate diagnosis.

Keywords: Temporomandibular Disorder, Masticatory Muscle Disorder, Orofacial Pain Disorders, Panoramic Radiography, Cone Beam Computer Tomography

[1] Okeson JP. Orofacial pain: guidelines for assessment, diagnosis and management. Quintessence Publishing Co Inc: Chigaco; 1996
[2] Differential diagnosis of temperomandibular and other orofacial pain disorders Jeffrey P. Okeson, DMD, Reny de Leeuw, DDS, PhD Dent Clin N Am 55 (2011) 105–120
[3] Okeson JP. Management of temporomandibular disorders and occlusion. 6thedition. St Louis (MO): The CV Mosby Company; 2008.
[4] De Leeuw R. Orofacial pain: guidelines for classification, assessment, andmanagement. 4th edition. Chicago: Quintessence Publ. Co.; 2008.
[5] vanGrootel RJ, et al. Patterns of pain variation related to myogenous temporomandibular disorders. Clin J Pain 2005;21:154-65
[6] Mense S. The pathogenesis of muscle pain. Curr Pain Headache Rep 2003;7(6):419–25.

Abstract: The routine removal of orthopaedic fixation devices after fracture healing is a common practice among surgeons; however, its benefits Vis-à-vis risks remainan issue of debate. Thisstudy evaluated surgeons' perceptions about the indications, priority of implants removal, effectiveness, and risks of removal of orthopaedic implants in Nigeria. A 44-item questionnaire was distributed to 110 attendees of the Annual General Meeting and Scientific Conference of the Nigerian Orthopaedic Association, Lokoja- 2013. Data was analysed using SPSS version 21.The response rate was78/90 (86.7%), representing 70.9% ofattendees. Majority of surgeons did not agree that asymptomatic orthopaedic implants should be routinely removed for all patients (disagreement: 91.0%, agreement: 6.5%). The major indications for removals were breakage/mechanical failure, infected implants and allergic disposition with mean rating on a 5- point scale of 4.56±0.948, 4.37±0.937 and 4.15±1.139 respectively. Most surgeons accrued highest priority to removal of implants in children with a mean rating of 4.14±0.954, followed by forearm rush nails 3.82±1.079.Without a strict implant removal policy, a remarkable portion of the resources allocated for elective orthopaedic operations would be spent on routine hardware removal procedures. General recommendation for hardware removal is not justified; overall, implant removal should not be considered a routine procedure.

Keywords: Asymptomatic implants,Implant removal, Orthopaedic fixation devices

[1] Moore RM, Hamburger S, Jeng LL, Hamilton PM. Orthopedic implant devices: prevalence and sociodemographic findings from the 1988 National Health Interview Survey, J ApplBiomater, 2,1991,127-131

[2] Bostman O, Pihlajamaki H, Routine implant removal after fracture surgery: a potentially reducible consumer of hospital resources in trauma units, J Trauma, 41, 1996, 846-849.

[3] Langkamer VG, Ackroyd CE, Removal of forearm plates: A review of the complications, J Bone Joint Surg Br,72, 1990, 601–604. [4] Davison BL, Refracture following plate removal in supracondylar-intercondylar femur fractures, Orthopedics 26,2003,157-159.

[5] Hallab N, Merritt K, Jacobs JJ, Metal sensitivity in patients with orthopaedic implants, J Bone Joint Surg Am, 83,2001, 428–436. [6] Beaupre GS, Csongradi JJ, Refracture risk after plate removal in the forearm, J Orthop Trauma, 10, 1996, 87-92.

Abstract: Introduction: India is among the countries reporting regular outbreaks of Dengue infections. The clinical & epidemiological profile of Dengue infection changes from time to time. Present study describes clinical & laboratory manifestations of dengue cases from a tertiary care centre. Methods: It is a descriptive observational study. Study duration was two years from Sep 2011 to Aug 2013. All the dengue patients admitted during this period were included and classified as per new WHO-2009 classification into: Dengue Fever without warning signs (DFWOWS), Dengue Fever with warning signs (DFWWS) and Severe Dengue (SD). The clinical & laboratory parameters were studied and described. Results: From the total of 150 cases, 128 cases (85.33%) were DFWWS, 15 cases (10%) were SD and 7cases (4.67%) were DFWOWS. The commonest age group affected (34 %) was between 11- 15 years. The male: female ratio of cases was 1.73:1. Clinical manifestations were fever (100%), rash (85.33%), arthralgia & myalgia (65.33%), vomiting (64.67%), pain in abdomen (54%), retro orbital pain (43.33%) & convulsions (6.67%). On examination 52% cases had hepatomegaly, 46.67% cases had hemorrhagic manifestations and Tourniquet test was positive in 34.67% of cases. In our study, 54.67% of total cases were positive for NS1 antigen, 28.67% cases were IgM positive and 16.66% cases were positive for both. Maximum number of patients had platelet counts between 40,000 to 1,00,000 (56%). Commonest complication was Encephalitis followed by ARDS. During study period, there was a single death and it was due to ARDS.

Keywords: Dengue fever, NS1 antigen, platelet count, severe dengue

[1]. World Health Organisation. Dengue haemorrhagic fever: diagnosis, treatment, Prevention and control. 2nd ed. Geneva; WHO: 1997.
[2]. Abdul Kader MS, Kandaswamy P, Appavoo NC, Anuradha. Outbreak and control of dengue in a village of Dharmapuri, Tamil Nadu. J Commun Dis. 1997;29:69–72.
[3]. Konar NR, Mandal AK, Saha AK. Hemorrhagic fever in Kolkata. J Assoc Physicians India. 1966;14:331–40.
[4]. Aggarwal A, Chandra J, Aneja S, Patwari AK, Dutta AK. An epidemic of dengue hemorrhagic fever and dengue shock syndrome in children in Delhi. Indian Pediatr. 1998;35:727–32.
[5]. Narayanan M, Aravind MA, Thilothammal N, Prema R, Sargunam CS, Ramamurty N. Dengue fever epidemic in Chennai-a study of clinical profile and outcome. Indian Pediatr. 2002;39:1027–33.

Abstract: Background: Neglected and relapsed club feet deformities remains a difficult problem even for the most experience surgeon .Our purpose of this studies was to evaluate the role of jess and illizarov for correction of deformities in neglected / relapsed ctev . Methods and Material: This prospective study was conducted in SMS hospital attached to SMS Medical College, Jaipur from April 2012 – September 2013. 21 patients (n=28 feet) were included. Average age was below 8 year (range 3 to12 years). Unilateral feet and male were more in this study. Results: Severity of the deformities and outcome was assessed by dimeglio score. In Illizarov group (n=15) result were excellent (27%), good(23%), fair (13%) and poor (20%).in Jess group( n=11), result were excellent(15%) , Good(23%), fair(23%) and poor(39%) . Conclusions: External fixators are versatile technique for correction of deformities in neglected/relapsed CTEV

Key-words: ctev, deformities, illizarov frame, jess

[1]. Jason A. Freedman, Hugh Watts, and Norman Y. Otsuka , The Ilizarov Method for the Treatment of Resistant Clubfoot: Is It an Effective Solution J Pediatric Orthop 2006; 26:432-437 .
[2]. Wael Yousif El-Adly · Khaled M. Mostafa .Ilizarov external fixator in treatment of severe recurrent congenital talipes equinovarus deformity Eur J Orthop Surg Traumatol (2009) 19:565–570.
[3]. C. F. Bradish, S. Noor.The Ilizarov method in the management of relapsed club feet J Bone Joint Surg [Br] 2000;82-B:387-91. [4]. M. CN .Joshi's External Stabilization System (JESS) Application For Correction Of Resistant Club-Foot. The Internet Journal of Orthopaedic Surgery. 2010: 18 10.5580/1408.
[5]. Sujit Kumar Tripathy ,ragav saini ,pebam sudes ,mandeep singh Dhillon ,shivinder singh gill et al. Application of the Ponseti principle for deformity correction in neglected and relapsed clubfoot using the Ilizarov fixator . J Pediatr Orthop 2011 B 20:26–32
[6]. Ajai Singh , Evaluation of Neglected Idiopathic CtevManaged byLigamentotaxis Using Jess: A Long-TermFollowupSAGE-Hindawi Access to ResearchAdvances in Orthopedics 2011 :218489 ,6

Abstract: Aims And Objective: Role of cranial ultrasonography to evaluate intracranial abnormalities in preterm and term neonates.
 To ascertain the clinical course of intracranial haemorrhage and to determine the short- term outcome of the affected baby neonates who develop intracranial complications of prematurity.
 The utility of real-time ultrasonography in the diagnosis of neonatal periventricular leukomalacia.
To asses utility of cranial colour Doppler in preterm and term neonates.
 To evaluate cerebral blood flow velocities in ACA, MCA and PCA in preterm and term neonates.
 To evaluate developmental interval changes in cerebral postnatal hemodynamic variation in the blood flow velocities in the preterm and term neonates

Key Words: Cranial USG, Cranial Doppler, neonates

[1]. Perlman JM , Rollins N, Burns D, Risser R. Relationship periventricular intraparenchymal echogenicitiy and germinal matrix- intraventricular haemorrhage in the very low birth weight infant. Pediatrics. 1991; 91: 474-480.
[2]. Perlman JM, Risser R, Broyles RS . Bilateral cystic periventricular leukomalacia in the premature infant: associated risk factors . Pediatrics. 1996; 97:822-827.
[3]. Vople JJ. Neurology of the Newborn. 3rd ed. Philadelphia , Pa: WB Saunders Co; 1995: 403-467.
[4]. Levene MI, Starte DR. A longitudinal study of post-hemorrhagic ventricular dilatation in the newborn. Arch Dis Child . 1981; 56: 905-908.
[5]. Ahmann PA , Lazzarra A, Dykes FD, Brann AW Jr , Schwartz JF. Intraventricualr haemorrhage in the high risk preterm infant : incidence and outcome. Ann Neurol. 1980; 118-124.

Abstract: Although iatrogenic ureteral injuries are uncommon, but continues to poses a great challenge of potencial injuries to the gyanaecologists and young surgeons, especially during difficult abdominal and pelvic surgeries. We present two cases of ureteral injuries in our centre which occurred during challenging gynaecolgical procedures. Extensive abdomino-pelvic adhesions and large pelvic tumours were the main risk factors in the two index cases . Sites of injuries and the risk factors were discussed. Thorough preoperative evaluation in anticipation of iatrogenic injuries, sound knowledge of surgical anatomy with experience, ureteral stenting before the main procedure, meticulous dissections and discouraging "blind clamping" during bloody procedures among others can prevent such injuries. High index of suspicion is important for early detection of the injuries.

Keywords: gynaecological, iatrogenic, ureter, injuries,

[1]. Vito Leanza, Antonia Francesca Di Prima, Gianluca Leanza, Maria Cristina Teodoro, Antonio Carbonaro, et al. How to Prevent Ureteral Injuries during Pelvic Gynaecological Procedures. Journal of Applied Medical Sciences, 2013; 2(3): 2241-2328.
[2]. Carlton CE, Scott R, Guthrie AG: The initial management of ureteral injuries: a report of 78 cases. J Urol 1971 Mar; 105(3): 335-40.
[3]. Davis, D M: Intubated ureterotomy: a new operation for ureteral and ureteropelvic strictures . Surg Gynecol Obstet 1943; 76: 851-866.
[4]. Manoel Afonso Guimarães Gonçalves, Fernando Anschau, Daniela Martins Gonçalves and Chrystiane da Silva Marc: "Ureter: How to Avoid Injuries in Various Hysterectomy Techniques" Text book of Hysterectomy, chapter 18, page 286
[5]. James Kyle Anderson, Jeffrey A. Cadeddu: Surgical Anatomy of the Retroperitoneum, Adrenals,Kidneys and Ureters; Campbell-Walsh Urology, 10thEdition, Vol.1, chapter1,p.31

Abstract: Objective: Acid-base disorders (ABDs) are usually correlated with high rates of morbidity and mortality. The objective of this study was to analyze the causes, outcomes, and types of ABDs in patients presenting at the Respiratory intensive care unit (RICU). Material and Methods: We prospectively analyzed data from 80 patients who presented between july2012 and august 2014. Data on age, gender, chief complaint, diagnosis and outcomes in the RICU were collected for ABD cases. Results: Of the 80 cases with an ABD, 32 patients (40%) had simple ABD and 48 patients (60%) had mixed ABD. The most common ABD was a mixed respiratory acidosis and metabolic alkalosis (RACMAL) (n=28, 35%). All ABD types were most commonly observed in patients over 60 years of age. In cases of ABD, COPD was the most common diagnosis (30%). Of the ABD cases, 44 patients (55%) were treated and discharged without needing ventilator support (invasive or noninvasive). 20 patients (25%) improved with NIV (non invasive ventilation), 7 patients (8.75%) recovered after receiving IV (invasive ventilation) while 9 patients (11.25%) died even with IV. Death was more commonly observed in cases with mixed metabolic and respiratory acidosis (MACRAC) (n=4). The most common etiology among intubated and survived cases is COPD (chronic obstructive pulmonary diseases) (n=5, 71.42%), and among intubated and expired cases is ARDS (acute respiratory distress syndrome)/ sepsis (n=7, 77.78%) Conclusion: ABDs are quite common in patients presenting at the RICU, especially among patients in a critical condition (71%). Mixed RACMAL was the most commonly noted ABD. COPD was the most common diagnoses in ABD patients followed by pneumonia and ARDS. Mortality was more common in cases with a mixed MACRAC. High mortality was seen in the ARDS/sepsis cases. This knowledge may provide important information concerning the diagnosis, treatment and early prognosis of patients.

Key words: Acid-base disorders, types, RICU, etiology, outcomes

[1] Austin K, Jones P. Accuracy of interpretation of arterial blood gases by emergency medicine doctors. Emerg Med Australas, 22, 2010, 159-65.
[2] Kelly AM. Review article: Can venous blood gas analysis replace arterial in emergency medical care. Emerg Med Australas 22, 2010,493-8.
[3] Walmsley RN, White GH. Mixed acid-base disorders. Clin Chem, 31,1985,321-5.
[4] Boniatti MM, Cardoso PR, Castilho RK, Vieira SR. Acid-base disorders evaluation in critically ill patients: we can improve our diagnostic ability. Intensive Care Med, 35(13), 2009, 77-82.
[5] Song ZF, Gu WH, Li HJ, Ge XL. The incidence and types of acid-base imbalance for critically ill patients in emergency. Hong Kong J Emerg Med 19(1),2012,3-7.

Abstract: Gallbladder injury after blunt abdominal trauma is rare. Isolated gall bladder perforation due to blunt abdominal trauma is even rarer. The clinical presentation of gallbladder injury is variable resulting in delay in diagnosis and treatment .Early diagnosis is thus essential but still remains a challenge. We present a case of 12 year old child with isolated gall bladder perforation following trivial blunt trauma to the abdomen.
Keywords: Abdominal trauma, Gallbladder, Paediatric, Perforation

[1]. Theodoros E Pavlidis, Miltiadis A Lalountas , Kyriakos Psarras, Nikolaos G Symeonidis,Anastasios Tsitlakidis, Efstathios T Pavlidis, Konstantinos Ballas, Nikolaos Flaris, Georgios N Marakis and Athanassios K Sakantamis, Isolated complete avulsion of the gallbladder (near traumatic cholecystectomy): a case report and review of the literature, Journal of Medical Case Reports 2011, 5:392.
[2]. Penn I, injuries of the gallbladder, British journal of surgery 1962 ;( 49); 636
[3]. Soderstrom c.a, mekawa k, du priest rw jr, crowly ra, gallbladder injuries resulting from blunt abdominal trauma, ann. Surg. 1981 ;( 193); 60-66
[4]. Wiener I, Watson lc, walma fj, Perforation of the gallbladder due to blunt abdo.trauma, arch surg., 1982 ;( 117); 805-807
[5]. Bainbridge j, shaaban h, kenefick n,Armstrong cp, Delayed presentation of an isolated gallbladder rupture following blunt abdominal trauma: a case report, j med case reports 2007;1(52) ; 294-295

Abstract: Air Passage through nasopharynx and nose is limited by its shape and size. Nasal obstruction & mouth breathing can be caused by multiple factors, one of them being hypertrophied adenoid and tonsils. It is perhaps one of the most widely debated reasons for partial airway obstruction and related respiratory abnormalities. Otolaryngolists are increasingly getting involved in assessment of upper airway obstructions and its effect from an orthodontic perspective. Also, surgical intervention in such cases might not be the best route given the variance of malocclusion across patients. In this paper, we shall review some of the precursors which can serve as indicator for need of surgical and/or orthodontic intervention to reduce the dentofacial abnormalities in cases of hypertrophied adenoid and tonsils. Such precursors can also help in identification of patients' susceptibility to Obstructive sleep apnea (OSA). Further, we will review the interaction between airway problems and expressed mandibular morphology as documented in historic literature. The article aims to bridge the communication between Orthodontist and medical fraternity by providing a lucid illustration of issues pertaining to obstructive breathing and its implication on craniofacial growth.

Key words: adenoid hypertrophy, hypertrophied tonsils, obstructive sleep apnea, orthodontics

[1]. Aboudara C, Nielsen I, Huang JC, Maki K, Miller AJ, Hatcher D. Comparison of airway space with conventional lateral headfilms and 3-dimensional reconstruction from cone-beam computed tomography. Am J Orthod Dentofacial Orthop. 2009 Apr; 135(4):468-79. [2]. Souki MQ, Souki BQ, Franco LP, Becker HM, Araújo EA. Reliability of subjective, linear, ratio and area cephalometric measurements in assessing adenoid hypertrophy among different age groups. Angle Orthod. 2012 Nov; 82(6):1001-7.

[3]. Hellings P, Jorissen M, Ceuppens JL. The Waldeyer's ring. Acta Otorhinolaryngol Belg. 2000; 54(3):237-41.

[4]. Diamond O. Tonsils and adenoids: why the dilemma? Am J Orthod. 1980 Nov; 78 (5):495-503.

[5]. Linder-Aronson S, Woodside DG. Excess face height malocclusion: Etiology, diagnosis and treatment. 1st ed. Quintessence Pub; 2000.

Abstract: This research was carried out to follow-up the microbial growth-down rates of the inflammatory periodontal pockets using radiotherapy, Taif Region, KSA. The patients (Pts.) under study were (No.=25pts.),they had chronic pockets periodontitis, they were divided into 20Pts. as study group (SG) and 5Pts. as control group (CG). SG had received radiotherapy (RT) and CG had received irrigation with normal saline instead of RT. The proses period had taken (2monthes=8weeks), that were divided into: stage1 (baseline proses) at (1st week), stage2 (treatment proses) at (2nd, 3rd, 4th, 5th and 6th week), and stage3 (follow up proses) at(7th and 8th week). Microbial specimens were collected from periodontal pockets to detect microbial growth rates (MGRs). SG and CG were revealed mean microbial growth rates as 73.3% for both at stage1 (baseline proses during 1st week). SG were (53.3, 46.7, 33.3, 20, 13.3%) and CG were (60, 53.3, 40, 33.3 and 26.7%) at stage2 (treatment proses during 2nd, 3rd, 4th, 5th and 6th week). SG were (6.7 and 00%) and CG were (20 and 13.3%) at stage3 (follow-up proses during 7th and 8th week) respectively. RT revealed anti-microbial effect and reduction of inflammation in periodontal pockets, also, supports healing of periodontal pockets through microbial eliminating. Key words: Microbial Growth-down Rates, Inflammatory periodontal pockets, Patients (Pts.), Number (No.), Study group (SG), Control group (CG), Radiotherapy (RT), Microbial growth rates (MGRs).

[1]. Akoi, M., 2008. Current status of clinical laser applications in periodontal therapy, General Dentistry, PP: 674-687.
[2]. Moritz, G., 1997. Bacterial reduction in periodontal pockets through irradiation with a diode laser: a pilot study, J. Cline. Laser Med. Surg., 15: 33-37.
[3]. Harris, Y., 2004. Therapeutic ratio quantifies laser antisepsis: Ablation of Porphyromon as gingivalis with dental lasers, Lasers Surg. Med., 35: 206-213.
[4]. Ciancio, C., 2006. Wound healing of periodontal pockets using the diode laser, Applications of 810nm Diode Laser Technology: A Clinical Forum, PP: 14-17.
[5]. Fontana, K., 2004. Microbial reduction in periodontal pockets under exposition of a medium power diode laser: an experimental study in rats, Lasers Surg. Med., 35:263-268.
[6]. Ciancio, C., 2006. Effect of a diode laser on Actino bacillus Actinomycete mcomitans, Biological Therapies in Dentistry, 22:233-239.

Abstract: The jugular foramen is the main route of venous outflow from the skull and is characterised by laterality based on the predominance of one of the sides. Intracranial meningiomas, paragangliomas (glomus jugulare, from the jugular ganglion of the vagus nerve), schwannomas, metastatic lesions and infiltrative inflammatory processes from surrounding structures such as the middle ear may affect the structures passing through this foramen. We studied one hundred dry, adult human skull of unknown sex and measured sagittal and transverse diameter of Jugular foramen. Jugular foramen were also observed for the presence of dome, septation and right or left dominance. Mean transverse diameter of jugular foramen was 11.61mm and mean sagittal diameter was 7.12mm.The size of the jugular foramen varied on the two sides. R>L were 75%, R<L were 31%, R=L were 2%.The jugular bulb dome was present bilaterally in 23%, on the right side only in 30%, on the left side only in 11%, and absent in 36%.Complete septation was present in 16% on the right side and 14% on the left side. Partial separation was present in 29% on the right side and in 25% on the left side. Knowledge of morphology, compartments and morphometry is important for neurosurgeons dealing with space occupying lesions in jugular foramen.
Key words: jugular foramen, jugular bulb, internal jugular vein

[1]. Wysocki J, Chmielik LP, Gacek W. Variability of magnitude of the human jugular foramen in relation condition of the venous outflow after ligation of the internal jugular vein. J Otolaryngologia 1999;53:173–77.
[2]. Navsa N, Kramer B. A quantitative assessment of the jugular foramen. Anatomischer Anzeiger 1998;180:269–73.
[3]. Hovelacque A. Osteologie. Paris. 1967;155-56. Kanemoto Y, Ochiai C, Yoshimoto Y, Nagai M. Primarily extracranial jugular foramen neurinoma manifesting with marked hemiatrophy of the tongue: case report. Surg Neurol. 1998 May;49(5):534-37.
[4]. report. Surgical Neurology 1998;49:534–37.
[5]. WOODHALL B. Anatomy of the cranial blood sinuses with particular reference to the lateral. Laryngoscope 1939;49;966-1010.
[6]. BROWDER J, KAPLAN HA. (1976). Cerebral Dural Sinuses and Their Tributaries. Springfield: Thomas

Abstract: Background:Assessment of foetal wellbeing is important, in timely diagnosis of foetalcompromise and management. Oligohydramnios is associated with increasedincidence of adverse perinatal outcomes like foetal distress, meconium stained liquor, lowAPGAR score, low birth weight, NICU admission, perinatal morbidity and mortality.Foetal biophysical profile is a well-established method of antepartumsurveillance. Classical biophysical profile needs two phase testing by ultrasound and external doppler monitor to record foetal heart rate, is more cumbersome, time consuming and expensive. The modified biophysical profile (MBPP) suggested by Nageotte et al combines non stress test (NST) as a short term marker of foetal status and the amniotic fluid index (AFI) as marker of long term placental function is easier to perform and less time consuming than classical biophysical profile. Objectives: 1) To assess the role of modified biophysical profile as a method ofantepartum foetalsurveillance test in predicting perinatal outcome in oligohydramnios cases. 2) To compare the morbidity and mortality with respect to each of the parameters ofmodified biophysical profile, that is NST and AFI individually. Methods:This study was a prospective clinical study which consisted of 60 pregnant women with oligohydramnios. The patients were evaluated with themodified biophysical profile consisting of NST recording for 20mins, followed byultrasound assessment of amniotic fluid volume, using four quadrant technique. Results:

Key words: Modified biophysical profile (MBPP), biophysical profile (BPP), non-stresstest (NST), amniotic fluid index (AFI), foetal heart rate (FHR), amniotic fluidvolume(AFV).

[1]. Mary B. Munn, MD.Management ofOligohydramniosin Pregnancy.Obstet Gynecol Clin N Am 38 (2011) 387–395.
[2]. Disorders of amniotic fluid volume,Williams Obstetrics 23rd edition; Chapter 21; p 490-496
[3]. Antepartum assessment, Williams Obstetrics 23rd edition; Chapter 15; p 342.
[4]. Bwerett JM, Sayter SL, Boehm JM.The NST.An evaluation of 1000 patients. Am J Obstet Gynaecol,1981;141-153.
[5]. Vintzileous AM, Campbell WA, Ingardie CJ et al. The foetal BPP and itspredictive value. Obstet Gynecol 1983;62:217.
[6]. Chamberlain PF, Manning FA, Morrison I, Harman CR, Lang CR. The relationship of marginal and decreased amniotic fluid volumes to perinatal outcome.Am J Obstet Gynaecol, 1984; 150: 245-9.
[7]. Crowley P, Herlihy CO, Boylan O. The value of ultrasound measurement ofamniotic fluid volume in the management of prolonged pregnancies.Br J ObstetGynecol, 1984; 91: 444-8.

Abstract: Early and accurate diagnosis of tuberculosis is extremely important for its control. The classical staining and microbiological methods lack in accuracy and speed respectively. On the other hand, the accurate and faster advanced nucleic acid amplification (NAA) methods have their own limitations and the results need to be interpreted with much caution for therapy. To balance the requirements of accuracy and speed for aiding early and correct drug prescription to the patients, we used a combined classical and molecular biological approach. Using this approach, 244 pulmonary and extra-pulmonary clinical samples from tuberculosis suspects from the Central state of India were tested for the presence of M. tuberculosis. Of these, 84 samples were finally confirmed positive for M. tuberculosis. Most positive samples were from clinical suspects in the age group of 20-24 and 35-39. Analysis of the positive samples showed that the peak at 20-24 was dominated by male while 35-39 was dominated by female gender. We also found gender based difference in the proportion of some of the different type of positive samples. We present here, the status of tuberculosis infection in Central state of India in 2012-2014 tested in our lab.

Keywords: conventional and advanced molecular methods, diagnosis, Mycobacterium tuberculosis

[1]. World Health Organization. Global tuberculosis report 2013. (2013).
[2]. Winn, W. C., Allen, S. D., Janda, W. M., Koneman, E. W., Schreckenberger, P. C., Procop, G. W., et al. Koneman‟s Color Atlas and Textbook of Diagnostic Microbiology | LWW. (Lippincott Williams & Wilkins, 2009).
[3]. López-Cortés, L. F., Cruz-Ruiz, M., Gómez-Mateos, J., Jiménez-Hernández, D., Jiménez-Mejias, E., Pachón, J., et al. Adenosine deaminase activity in the CSF of patients with aseptic meningitis: utility in the diagnosis of tuberculous meningitis or neurobrucellosis. Clin. Infect. Dis. 1995; 20: 525–30
[4]. Rao, V. G., Bhat, J., Yadav, R., Gopalan, G. P., Nagamiah, S., Bhondeley, M. K., et al. Prevalence of pulmonary tuberculosis--a baseline survey in central India. PLoS One 2012; 7: e43225
[5]. Indian Council of Medical Research. Tuberculosis in India – a sample survey, 1955-58. Special Report Series. No.34. New Delhi, India. (1959).