iosr-JDMS   Volume-14 ~ Issue-1 ~ January-2015

Abstract: Chondroid Syringomas are rare benign mixed tumors of skin adnexal origin and are composed of both epithelial and mesenchymal components. These tumors usually effects middle aged and older men with commonest involvement of head and neck region. There are few case reports with cytohistological correlation. We present a rare case of giant chondroid syringoma over the thigh in 44 years male with gradually increasing size. FNAC was done and aspirated material is thick and mucoid. Microscopic examination revealed chondromyxoid background with sheets and clusters of epithelial and myoepithelial cells. Based on these findings the diagnosis of Chondriod Syringoma was made. After surgical excision we received a nodular mass of 4.5 x 3.5 x 2 cm. On histopathological examination it was found that there were epithelial and myoepithelial cells with characteristic chondromyxoid stroma. Adipose tissue is also seen. Based on these findings the diagnosis of giant chondroid syringoma was made. FNAC is useful to determine the pathology before excision; however histopathological examination of the excised tissue is more reliable for definitive diagnosis.

Keywords: Adnexal tumor, Giant chondroid syringoma, Thigh region, FNAC, Histopathology

[1] Hirsch P, Helwig EB. Chondroid syringoma. Mixed tumor of skin, salivary gland type. Arch Dermatol 1961 Nov; 84:835-47.
[2] Mebazaa A, Trabelsi S, Denguezli M, Sriha B, Belajouza C, Nouira R. Chondroid syringoma of the arm: An unusual localization. Dermatol Online J. 2006; 12:14. [PubMed]
[3] Masood S, Hardy NM. Fine needle aspiration cytology of chondroid syringoma: Report of a case. Acta Cytol. 1988;32:482–4. [PubMed]
[4] Villalón G, Monteagudo C, Martin JM. Chondroid syringoma: a clinical and histological review of eight cases.] Actas Dermosifiliogr 2006; 97:573-7.
[5] Hardisson D, Linares MD, Nistal M. Giant chondroid syringoma of the axilla. J Cutan Med Surg. 1998;3:115–7. [PubMed]
[6] Bhasin T S, Mannan R, Bhatia P K, Sharma M, Bhalla A: FNAC diagnosis of eccrine variant of chondroid syringoma. Journal of Clinical and Diagnostic Research. 2010 June ;(4):2641-2644.
[7] Aparna Narasimha, R Kalyani, Harendra ML Kumar, TN Suresh, A Supreeth: Giant Chondroid syringoma with divergent differenciation : Cyto histo immuno correlation. International Journal Of Applied And Basic Medical Research, Jul-Dec 2013, Vol 3, issue 2

Abstract: Ewing sarcoma is most commonly occurring as bone tumor which has usually extended into the soft tissues at the time of diagnosis. Exceptionally, this tumor rarely can have an extra skeletal origin without relation to bone as a primary tumor. Clinical or imaging findings are non-specific and diagnosis is based on histology. We report a case of an extra skeletal Ewing sarcoma developed in the soft tissues of the abdominal wall in a 30-year-old woman who presented a painful abdominal wall tumefaction. Ultrasonography and computed tomography showed a large, well-defined soft tissue mass (? hematoma) developed in the anterior the abdominal wall. Surgical biopsy was performed and an extraskeletal Ewing sarcoma was identified histologically

Keywords: Ewing's sarcoma, soft tissue tumor, extra skeletal, abdominal wall, rosettes.

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[3] Soule EH, Newton Jr W, Moon TE, Tefft M: Extraskeletal Ewing's sarcoma – a preliminary review of 26 cases encountered in the Intergroup Rhabdomyosarcoma Study. Cancer 1978; 42:259-264.
[4] Ahmad R, Mayol BR, Davis M, Rougraff BT. Extraskeletal Ewing_s sarcoma. Cancer 1999; 85: 725_31.
[5] Paoletti H, Colineau X, Acalet L, et al. Ewing_s sarcoma of the soft tissues: apropos of 3 cases and review of the literature. J Radiol 1999; 80: 477_82.
[6] Perouli E, Chrysikopoulos H, Vlachos A, Koskinas A, Batistatou A, Polyzoidis K. Imaging findings in paraspinal extra osseous Ewing sarcoma. JBR-BTR 2006; 89: 310_2.

Abstract: arise from a population of pluripotential connective-tissue stem cells. Objectives: The purpose of the study was to evaluate the efficacy of autologous bone marrow injection in the treatment of delayed union and non union of long bones. Methods: Thirty patients, twenty five delayed union and five non union of long bones were treated with this procedure. Of these, 23 had fracture tibia, 4 fracture ulna, 2 fracture humerus and 1 fracture femur. The average time duration between injury and procedure was 25.53±10.75 weeks (range 14 to 46 weeks). The bone marrow was aspirated from the anterior iliac crest and injected percutaneously in the fracture site under guidance of II tv.

[1]. Bolhofer BR, Ricci WM. Principles of nonunion treatment. In: Bucholz Heckman J, editor. Rockwood and Green's Fractures in Adults. 7th ed. Philadelphia: Lippincott-Wolters; 2010. p. 641-57. [2]. Cleveland KB. Delayed union and non-union of fractures. In: Canale and Beaty, editors. Campbells Operative Orthopaedics. 12th edition. Philadelphia: Mosby Elsevier: 2013. p. 2578-79,2982-83.
[3]. Ismaeel FT. Bone marrow injection in patients with delayed union and non-union of long bone fracture. Tikrit medical Journal 2008; 14(2): 131-4. [4]. Herzog K. Verlangerungosteoto mic unter Vernen dungdes percutan gezeit Verriegelten Markangels. Unfallheikunde 1951; 42: 226-30. [5]. McGraw WH, Harbin M. The role of bone marrow and endostium in bone regeneration : an experimental study of bone marrow and endosteal transplants. J Bone Joint Surg 1934; 14: 816-21.

Abstract: Polycystic kidney disease is one of the most common life threatening genetic disease, affecting an estimated 12.5 million people worldwide. It is a congenital disorder due to failure of excretory tubules of the metanephros to establish contact with the collecting tubules. An alternative recent view about the formation of cysts in the kidney is that they are derived from abnormally developed collecting tubules. It is of two types, one is Autosomal dominant PKD (ADPKD) and the other Autosomal recessive PKD (ARPKD). The incidence of ADPKD is 1 to 2: 1000 live births unlike ARPKD which is 1:20,000.

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[3]. Griffin MD, et al: Vacular expression of polycystin. J Am Soc Nephrol 8:616, 1997.
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[5]. Watson MC: Complications of APKD, Kidney Int 51:353,1997.
[6]. Peter C Harris, PhD and Vicente E Torres, MD. Polycystic Kidney Disease, Autosomal Dominant; NCBI Bookshelf – Initial posting: Januray 10, 2002; Last update: December 8, 2011.

Abstract: It is a cystic genetic disorder of the kidneys. It is characterized by the presence of multiple cysts however 17% of cases initially present with the observable disease in one kidney, with most cases progressing to bilateral disease in adulthood.

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Abstract: Limb anomalies form 6/10,000 live births. Polydactylism: occurs in 1 per 2,000 births. According to Barsky, Syndactylism: is the most common congenital deformity of the hand. He quoted an estimated occurrence of 1 in 3,000 births and said that it is most frequent between the middle and ring finger. Causative factors are hereditary, teratogens and combination of this with environmental factors. The most susceptible period is 4th – 5th week of intrauterine life. Eight cases of limb anomalies that we have come across have been enumerated along with the x-ray findings wherever possible.

• W.H.Hollinshead .anatomy for surgeons-.the back and limbs vol 3 Hoever & Harper.pp 486-488. (1958) NY.
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• Lineback ,P.E. a case of unilateral polydactyly in a 22mm.embryo
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• A.C Dhamangaonkar, Seth G.S medical college, parel, Mumbai Short limb polydactyly syndrome
• J.Ant.Soc.India 55(1) 78(2006) Abstract number 35. Zou H,niswander L. Requirement for BMP signaling in interdigital apoptosis and scale formation Science 272;738,(1996)

Abstract: Objectives: This study was carried out to estimate the prevalence of peripheral vascular disease (PVD) in patients of stroke and to correlate PVD with age, sex, type and risk factors of stroke. Materials and Method: This observational study was carried in AVBR Hospital, DMIMSU over a 24 months period after obtaining due ethical clearance. The study included 120 cases of stroke that were evaluated for presence of associated peripheral vascular disease by Ankle Brachial Pressure Index (ABPI), which was measured by Doppler study. The correlation of the prevalence of peripheral vascular disease in cases of stroke was evaluated. An attempt was made to correlate the PVD with age of patients, type of stroke, sex and with other risk factors like alcohol consumption, smoking, hypertension, diabetes mellitus, previous history of stroke and presence of cardiac disease. The statistical analysis test used was Z test for comparison and calculation of P-values.

[1]. Dormandy JD, Heeck L, Vig S. The Natural History Of Claudication: Risk To Life And Limb. In Rutherford R B (Ed). Seminars In Vascular Surgery 1999; 12: 123-137.
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[3]. Ropper AH & Samuels MA. Cerebrovascular Diseases, In Adams And Victor's Principles Of Neurology, 9th Edn. Mcgraw-Hill Company, New York, 2009; 746-845.
[4]. World Health Report-2002, World Health Organization.
[5]. Hirsch AT, Haskal ZJ, Hertzer NR Et Al. (2006). "ACC/AHA 2005 Guidelines For The Management Of Patients With Peripheral Arterial Disease (Lower Extremity, Renal, Mesenteric, And Abdominal Aortic) J. Am. Coll. Cardiol. 47 (6): 1239–312
[6]. Wild SH, Et Al. Low Ankle-Brachial Pressure Index Predicts Increased Risk Of Cardiovascular Disease Independent Of The Metabolic Syndrome And Conventional Cardiovascular Risk Factors In The Edinburgh Artery Study. Diabetes Care 2006;29(3):637-42
[7]. Mark R Nelson, Stephen Quinn, Tania M Winzenberg, Falinehowes, Louise Shiel, Christopher M Reid: Ankle-Brachial Index Determination And Peripheral Arterial Disease Diagnosis By An Oscillometric Blood Pressure Device In Primary Care: Validation And Diagnostic Accuracy Study: BMJ Open 2012;2:1- 6.

Abstract: Background: Soft tissue tumors are a diverse and heterogeneous group of tumors. The sub classification of these tumors is of importance for both prognosis and treatment. Classically, sub- categorization is based purely on histomorphological grounds , but as new techniques evolve, a more conclusive and accurate diagnosis can be made. This study records the incidence ,age ,sex and site distribution of soft tissue tumors at Narayana medical college , Nellore and to study gross, histology of both benign , malignant soft tissue tumors and confirmation of morphological diagnosis by Immunohistochemistry .The comparision of these findings with the workers doing similar studies.

[1]. Myhre, Jenson O et al. Histopathological staging in soft tissue tumours in relation to in 261 surgically treated patients. Acta Pathol, Microbial. Immunol Seana (A) 91:145.
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[3]. Angervall L et al. The diagnosis and prognosis of soft tissue tumours semin diagn. Pathol 3:240.
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[5]. Hajdu S.I. Benign soft tissue tumours. Classification & Natural history. CA 1987; 37:
[6]. Costa. J. et al. The grading of soft tissue sarcomas. Results of a clinicopathological correlation in a series of 163 cases. Cancer 1984; 53:530.
[7]. Trojaini M et al. Soft tissue sarcomas of adults, study of pathological prognostic variables & definition of histopathological grading system. Int. J. Cancer 333:37, 1984.

Abstract: Sitosterolemia is a rare, autosomal recessive inherited sterol storage disease associated with high tissue and serum plant sterol concentrations. First described in 1974 in two sisters by Bhattacharyya and Connor. Patients presents with extensive tendon and tuberous xanthomas but normal plasma cholesterol levels with elevated plant sterol levels. The high plant sterol levels were shown to be due to the increased absorption and delayed removal of plant sterols from the body. Sitosterolemia has been shown to result from mutations in the genes for 2 proteins (ABCG5 or ABCG8). Markedly increased serum concentration of plant sterols, such as sitosterol and campesterol, cause premature atherosclerosis and massive xanthomas. Known treatments for Sitosterolemia, includes a low-sterol diet, bile-salt binding resins, ileal bypass surgery and low density lipoprotein (LDL) apheresis. Recently, Ezetimibe, an inhibitor of intestinal cholesterol absorption), has been used. Ezetimibe also reduces the gastrointestinal absorption of plant sterols, thereby also lowering the serum concentrations of plant sterols. We present a case report of 2 siblings presented in our hospital with extensive tendon xanthomas. Patients are under treatment with bile salt binding resins & Ezetimibe.

Keywords: ABCG5, ABCG8,Ezetimibe, Sitosterolemia, Xanthomas,

[1]. Patel SB, Salen G, Hidaka H, et al. Mapping a gene involved in regulating dietary cholesterol absorption. The sitosterolemia locus is found at chromosome 2p21. Journal of Clinical Investigation 1998;102(5):1041-1044.
[2]. Bhattacharyya AK, Connor WE. β-Sitosterolemia and Xanthomatosis: A NEWLY DESCRIBED LIPID STORAGE DISEASE IN TWO SISTERS. Journal of Clinical Investigation 1974;53(4):1033-1043.
[3]. Pullinger CR, Kane JP, Malloy MJ: Primary hypercholes-terolemia: genetic causes and treatment of five monogenic disorders. Expert Rev CardiovascTher, 2003; 1: 107-119
[4]. Alam M, Garzon MC, Salen G, Starc TJ. Tuberous xanthomas in sitosterolemia. PediatrDermatol 2000;17(6):447-9.
[5]. Kalidas K, Behrouz R. Inherited metabolic disorders and cerebral infarction. Expert Rev Neurother 2008;8(11):1731-41.
[6]. Cobb MM, Salen G, Tint GS, Greenspan J, Nguyen LB: Sitosterolemia: opposing effects of cholestyramine and lovastatin on plasma sterol levels in a homozygous girl and her heterozygous father. Metabolism, 1996; 45: 673-679.
[7]. Salen G, Starc T, Sisk CM, Patel SB. Intestinal Cholesterol Absorption Inhibitor Ezetimibe Added to Cholestyramine for Sitosterolemia and Xanthomatosis. Gastro enterology. May 2006;130(6):1853

Abstract:Introduction: Low birth weight (LBW) is a major public health problem which needs to be addressed on an urgent basis. Data on low birth weight is important for several reasons; rational and regional estimates of the incidence of LBW are internationally recognized indicators of the well-being of neonates and women of reproductive age. The present study was undertaken to know the incidence of LBW and maternal factors affecting birth weight. Methodology: This study was a hospital based cross-sectional study at King George Hospital, Visakhapatnam. A total of 200 mothers were included in the study. Information was collected from the mothers by pre tested semi structured questionnaire. Data was analyzed by preparing master table and represented in the form of tables.

1]. SK Azimul, AMatin, JH Shabnam, S Shamianaz, M Bannerje. Maternal factors affecting low birth weight in urban area of Bangladesh. J Dhaka Med Coll. 2009; 18(1) : 64-69
[2]. H.S.Joshi, S.H. Subba, S.B. Dabral, S. Dwivedi, D. Kumar, S. Singh. Risk factors Associated with Low Birth Weight in Newborns. Vol.30, No.4(2005-10-2005-12)
[3]. Malik S, Ghidiyal RG, Udani R, Waingankar P. Maternal biosocial factors affecting low birth weight. Indian Journal Paediatrics.1997 May-June;64(3):373-7
[4]. M .M. Nagargoji, SS Chaudary, JS Deshmukh, SC Gupta, SK Misra. A case control study of risk factors for LBW in Nagapur city of Maharasthra. Indian Journal of Community Health Vol.22 No.2 (2010-11).
[5]. Haley D. Jackson, Yudan Wei, Fan Chen. Quantitative data analysis of multiple factors associated with low birth weight in Bibb country, Georgia. Journal of the Georgia public health association, Vol 1. No.1. 2008; 24-32

Abstract:The development of a baby is quite an intricate journey. From the moment that the egg and sperm meet, a baby is beginning the developmental process. This early part of development lays the foundation for a healthy pregnancy and the birth of a healthy baby. Ultrasounds can be used to visually monitor the development taking place in the uterus and to measure the progress. In the present study, 100 women in early pregnancy were evaluated sonographically. Along with a detailed history taking to know the LMP and other abnormal symptoms, they were clinically examined thoroughly to find out the duration of pregnancy as well as any complications associated

[1]. Stovall TG, Kellerman AL, Ling FW, Buster JE.Emergency department diagnosis of ectopic pregnancy. Ann Emerg Med.1990;19(10):1098-1103.
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[3]. Buckley RG, King KJ, Disney JD, Gorman JD, Klausen JH. History and physical examination to estimate the risk of ectopic pregnancy: Validation of a clinical prediction model.Ann Emerg Med.1999;34:589-594.
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[6]. Shih CH. Effect of emergency physician-performed pelvic sonography on length of stay in the emergency department. Ann Emerg Med.1997;29(3):348-351.

Abstract:Background: There is much debate regarding the optimal treatment of displaced, unstable distal radial fractures and there has been a trend toward open reduction and internal fixation of these fractures. Objectives: The purpose of this study was to evaluate the efficacy of a fixed-angle locking plate applied through a single incision volar approach in maintaining the radiographic alignment and functional outcome of unstable distal radius fractures. Methods: This is a prospective study in which 30 patients with persistent displacement of distal radius fractures after an initial attempt at reduction, between the ages of twenty and seventy years who provided written informed consent to participate in the study were included, and were treated using the fixed-angle volar plate through a single incision volar approach from September 2012 to August 2014. Outcome measures included radiographic parameters, wrist range of motion, Disability Arm Shoulder and Hand (DASH) questionnaire and Modified Green and O'Brien scoring.

1]. Nijs S, Broos PLO. Fractures of the Distal radius: A contemporary Approach Acta chir bels 2004; 104: 401-12.
[2]. Cherubino P, Bini A, Marcolli D. Management of distal radius fractures: Treatment protocol and functional results. Injury 2010; 4: 1120-6.
[3]. Knirk JL, Jupiter JB. Intra-articular fractures of the distal end of the radius in young adults. J Bone Joint Surg Am 1986; 68(5): 647-59.
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[5]. Melone CP Jr. Open treatment for displaced articular fractures of the distal radius. Clin orthop 1986; 202: 103-11.
[6]. Fernandez DL. Malunion of the distal radius: current approach to management. Instr Course Lect 1993; 42: 99-113.
[7]. Taleisnik J, Watson HK. Midcarpal instability caused by malunited fractures of the distal radius. J Hand Surg Am 1984; 9 (3): 350-7.

Abstract: AIM: The present study was designed for documenting common patterns, as well as their disparity in the study population, with objective of evaluating uniqueness of the lip print pattern among the study population, as well as to evaluate the possibility of gender determination. Materials And Methods: The study sample comprises of 103 children i.e., 49 males &54 females of aged between 4 to 14 years. Lip prints were recorded with transparent overlay and transferred on to a bond paper. The impression is visualized with the use of a magnifying lens. Lip prints were later analyzed. Chi square test was used to find out degree of association between variables and to check out whether statistically significant differences exist .p value <0.05 was considered to be statistically significant. Conclusion: In our study no two lip print patterns matched each other thus establishing the uniqueness of lip prints. It was found that Type II: Branched grooves (branching Y-shaped pattern) was the predominant pattern in both males and females.

Keywords: Forensic, gender, lip print,

[1]. Nandy A. Principles of Forensic Medicine. 2nd edition. Calcutta: Central; 2003.p. 100-101.
[2]. Kasprzak J. Possibilities of Cheiloscopy. Forensic Sci Int. 1990; 46: 145-151
[3]. M. Alvarez, Cosmetic advances and criminalistics, The Study of Lip Prints Generated by Permanent Lipstick, Doctoral Thesis University of Valencia Spain, 1999.

Abstract: Background: Probiotic bacteria are live microbial food supplements that beneficially affect the host by improving its intestinal balance. Non – pathogenic microorganism, such as strains of Lactobacilli or Bifidobacteria, can occupy a space in human biofilm that otherwise would be colonized by pathogens and are thought to reduce the risk of some infectious disease. The aim of the present study was to examine whether consumption of commercially available ice-cream containing probiotics can affect the levels of salivary Streptococcus mutans, Lactobacillus and Candida albicans in young adults.

[1]. Caglar E, Kuscu O O, Kuvvetli S S, Cildir S K, Sandalli N, Twetman S. Short term effect of ice cream containing Bifidobacterium lactis Bb -12 on the number of salivary mutans streptococci and lactobacilli. Acta Odontologica Scandinavica, 2008; 66:154-158.
[2]. Stamatova I, Meurman J H. Probiotics: Health benefits in the mouth. Am J Dent 2009; 22:329-338.
[3]. Sanders M E. Probiotics. Food Technology 1999; 53(11): 67-77.
[4]. Senok A C, Ismaeel A Y, Botta G A. Probiotics: facts and myths. Clin Microbiol Infect 2005; 11: 958–966.

Abstract:Femoral hernias are challenging conditions, not only because their diagnosis is often missed, but also because if left undiagnosed and untreated, their complications are severe and often life-threatening. The authors present a case of a femoral hernia of the small intestine and omentum, following strangulation, manifested as a groin abscess.

Keywords: Strangulation, femoral, hernia, abscess

[1]. Whalen HR, Kidd GA, O'Dwyer PJ. Femoral Hernias. BMJ 2011;343:d7668
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[3]. Dahlstrand U, Wollert S, Nordin P, Sandblom G, Gunnarsson U. Emergency femoral hernia repair. A study based on a national register. Ann Surg 2009;249:672-6
[4]. Patel RB, Vasava N, Hukkeri S. Non-obstructed femoral hernia containing ascending colon, caecum, appendix and small bowel with concurrent bilateral recurrent inguinalhernia. Hernia 2012 Apr;16(2):211-3
[5]. Duari M. Strangulated femoral hernia—a Richter's type containing caecum and base ofappendix. Postgrad Med J 1966 Nov;42(493):726-8
[6]. Frankau C. Strangulated hernia: A review of 1487 cases. Br J Surg 1931 Oct; 19(74):176-191

Abstract:Background: Obstetric anaesthesia has a vital role in the outcome of obstetric surgeries and in the past three decades, the pattern has changed from predominantly general anaesthesia to regional, mostly spinal, anaesthesia. The objective of this study was to investigate the trends in obstetric anaesthesia practice in a Federal Medical Centre and offer explanation for any change observed.

1]. Davies JM. Obstetric Anesthesia Closed Claims — Trends Over Last Three Decades. ASA Newsletter 2004; 68: 12-14.
[2]. Edem BE,Anzaku SA,Agan TU, Oku OO. Audit of epidural anaesthesia service at a district hospital in Nigeria. Highland Med Res J 2014; 14: 35-38.
[3]. Hawkins JL, Gibbs CP, Orleans M, et al. Obstetric anesthesia workforcesurvey, 1981 versus 1992. Anesthesiology1997; 87:135-143.
[4]. Hawkins JL, Koonin LM, et al. Anesthesia –related deaths during obstetric delivery in the United States, 1979-1990. Anesthesiology1997; 86: 277-284.
[5]. Fyneface-Ogan S. Anesthesia for Cesarean Section. In: Salim R (ed) Cesarean Delivery. InTech, Available from http://www.intechopen.com/books/cesareandelivery. Accessed on 23/10/14.

Abstract:Introduction: Pyrethroids insecticideMortein (M) composed of allethrin, imiprothrin and phenothrin is commonly used in the annihilation of household insects in Nigeria. These chemicals have been associated with the development of some respiratory diseases. This study was carried out to assess the histological effects of Pyrethroids insecticide "M" on the lungs of adult Wistar rats. Materials and Methods: twenty five healthy adult Wistar rats of both sexes were acquired from the animal house of Faculty of Basic Medical Sciences, Delta State University Abraka and used for the experiment. The rats were randomly assigned into five groups. Groups' I-III was orally given a sub-lethal dose of 2250mg/kg/bw of M for 7, 21 and 40 days respectively, IV was given tap water as placebo while V was given olive oil. At the end of the experiment, the rats were sacrificed, lungs harvested and fixed in 10% formal saline. The lungs tissues were processed for histology and the slides were microscopically analyzed for histological changes across the groups.

[1]. Bassil KL, Vakil C, Sanborn M, Cole DC, Kaur JS, Kerr KJ, (2007). 'Cancer health effects of pesticides: systemic review' Can. Fam. Physician53 (10): 1704-11.
[2]. Aziz MH, Agrawel AK, Adhami VM, Shukla Y. and Seth PK, (2001). Neurodevelopmental Consequencies of Gestational Exposure (GD14-GD20) to Low Dose Deltamethrin in Rats. Neurosci. Lett. 300:161-165.
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Abstract:The aim of this paper is to introduce and study the notion of a fuzzy pre-open set, fuzzy θ- open set , fuzzy δ-open , fuzzy 𝜸- open set , fuzzy M-open set , fuzzy Z-open set , fuzzy Z*-open set , fuzzy e-open set , fuzzy e*-open set and some properties , remarks related to them .

[1]. Maximilian Ganster Appeared In:Kyungpook,Preopen Sets And Resolvable Space Math (1987 ) .
[2]. A.I.El-Magharabi And A. M. Mubarki Z-Open Sets And Fuzzy Continuity In Topological Spaces International Journal Of Mathematical Archive-2(10), 2011.
[3]. El. Magharabi, Mohammed A. Al –Juhani New Types Of Functions By M-Open Sets Of Taibahuniversity For Science Journal In 2013
[4]. Mubarkiali M.M Al-Rshudi M.A.Al-Juhaniβ* -Open Sets And Β*-Continuity In Topological Spaces.Of Taibah University For Science Journal In 2013.
[5]. Seenivasan, K. Kamla, Fuzzy E- Continuity And Fuzzy E-Open Set.In 2014.

Abstract:Morbidly obese patient pose a real challenge for anaesthesiologist as there is increased incidence of intra operative and postoperative complications in these patients. We present a case of 60 years old female weighing 110 kg (BMI-41) with carcinoma of breast posted for left modified radical mastectomy. In post operative period she retained co2. Her intraoperative and post operative management and possible causes of co2 retention are discussed. Many factors can contribute to this postoperative co2 retention. Undiagnosed sleep apnea should also be kept in differentials of causes of postoperative co2 retention especially in obese patients. Keywords: obese, sleep apnea, co2 retention.

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[3]. Benumof JL: Obesity, sleep apnea, the airway and anesthesia. Curr Opin Anaesthesiol; 2004, 17:21-30.
[4]. Young T, Evans L, Finn L, Palta M: Estimation of the clinically diagnosed proportion of sleep apnea syndrome in middle-aged men and women. Sleep; 1997, 20:705-6. [5]. NIH conference: Gastrointestinal surgery for severe obesity. Consensus Development Conference Panel.Ann Intern Med. 1991;115:956–61.
[6]. Benumof JL. Obstructive Sleep Apnea in the Adult Obese Patient: Implications for Airway Management. Anesthesiol Clin North America 2002;20:789-811.

Abstract:Dens invaginatus results from an in-folding of the dental papilla during tooth development. Affected tooth show deep surface invagination of the crown or root that is lined by enamel. Maxillary lateral incisors are commonly affected and may occur unilaterally or bilaterally. Dens invaginatus exhibits different morphologic variations and often results in pulpal pathosis. A talon cusp on the other hand is an accessory cusp like structure occurring on the lingual or facial surfaces of deciduous or permanent anterior dentition especially the maxillary lateral incisors. It may also occur unilaterally or bilaterally. Its co-occurrence with dens invaginatus is extremely rare. The article discusses the clinical and histological features, and therapeutic considerations along with a case report of a Dens Invaginatus, which clinically presented as a Talon cusp.

Keywords: Dens invaginatus, Dens in dente, Talon cusp, Odontome

[1]. Kronfeld R. Dens in dente. Journal of Dental Research 14,1934: 49–66.
[2]. Mellor JK, Ripa LW. Talon cusp. A clinically significant anomaly. Oral Surg, 29, 1970,225-28
[3]. Hattab FN, Yassin OM, al-Nimri KS. Talon cusp in permanent dentition associated with other dental anomalies: Review of literature and report of seven cases. ASDC J Dent Child, 63, 1996, 368-76
[4]. Morfis A S, Lentzari A. Dens invaginatus with an open apex: a case report. International Endodontic Journal 22, 1989, 190–2.

Abstract:Segmental resection of the mandible commonly results in the deviation of mandible toward the defective side. Such patients present with many debilitating problems because of the deviation of mandible. The amount of deviation depends on the amount of hard and soft tissue involvement, method of surgical site closure, degree of impaired tongue function, number of remaining teeth and the extent of loss of sensory and motor innervations. It is essential to restore the oral function like mastication in such patients to ensure for an ability to have healthy diet and overall general health. The treatment options for such patients are surgical restoration of resected part, physiotherapy and/or prosthodontic intervention.

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[4]. Mankar S, Pakhan A, Thombare R, Godbole S. Twin occlusion: A prosthetic management of hemimandibulectomy patient - A case report. National Journal of Medical and Dental Research, 2012; 1:19-23.
[5]. Talib Amin Naqash. Twin Occlusion: A Solution to Rehabilitate Hemi-mandibulectomy Patient-A Case Report. International Journal of Clinical Cases and Investigations 2013; 5:68-71.
[6]. Rosenthal LE. The edentulous patient with jaw defects. D Clin N Am 1994; 8:773–9

Abstract:Acute or chronic rhinosinusitis is a common condition affecting upto 20% o the population. Acute rhinosinusitis is associated with upper respiratory tract infections such as bacterial /viral and is self limited. Chronic rhinosinusitis has a slow protracted course, and has different aetiologies, fungal infection being the major cause. Fungal organisms are one of the proposed aetiological agents and are seen in 6-12 % of these patients. A retrospective analysis of 30 cases of suspected fungal sinusitis were studied in a 7yrs duration. On histopathological evaluation the cases were classified as Non invasive and invasive fungal rhinosinusitis (FRS) depending on tissue invasion. The morphology of the fungus, H&E visibility of fungus and tissue reactions associated with fungus were assessed. Four histologic categories of FRS were identified:1) Mycetoma/fungal ball (53%). 2 )chronic invasive FRS (20%). 3) chronic granulomatous invasive FRS (20%). 4) Acute fulminant FRS (7%). Oppurtunistic infections like DM was present in 33% and Hodgkin lymphoma in 7%, remaining cases were immunocompetant. Aspergillus was most common fungal species seen in fungal ball and chronic invasive FRS, and mucormycosis was common in granulomatous invasive and acute fulminant cases. Tissue necrosis was abundant in 8 cases of mucormycosis fungal infections. Intracranial extension and angioinvasion was present in 2 cases of mucormycosis and mortality was 100% in these cases.

Keywords: Fungal Rhinosinusitis, classification, histopathology.

[1]. Chakrabarti A, Das A, Panda NK. Controversies surrounding the categorisation of fungal sinusitis. Medical mycology.2009: 47(1). S299- S308.
[2]. Chakraborti A, Denning DW, Ferguson BJ et al. Fungal rhinosinusitis: a categorisation and definitional schema addressing current controversies. Laryngscope. 2009: 119(9). 1809-1818.
[3]. DeShazo RD, Chapin K, Swain RE. Fungal sinusitis. N Eng J med. 1997:337(4). 254-259.
[4]. Micheal RC, Micheal JS, Ashbee RH, Mattews MS. Mycological profile of fungal sinusitis: An audit of specimens over a 7 year period in a tertiary care hospital in Tamil Nadu. Indian Journal of Pathology and Microbiology. 2008:51(4)493-496
[5]. Montone KT, Livosli VA, Feldman MD, Palmer J, Chiu AG, Lanza DC etal International Journal of Otolaryngology.2012;1-9.
[6]. Granvillae L, Chirala M, Cernoch P. et al . Fungal sinusitis: Histologic spectrum and correlation with culture. Human Pathol. 2004;35:474-481.

Abstract:The increased risk of osteoporosis observed in post menopausal women is explained by Biochemical marker of bone turnover profile. Though bone mineral density (BMD) measurements are gold standard in calculating bone mass, the changes are usually late and the damage is irreversible. Combined use of biochemical markers of bone turnover helps in early identification of women who are at increased risk of fracture. The study included 25 healthy postmenopausal women as cases, and 25 healthy Premenopausal women.Estimation of bone turnover markers like Alkaline Phosphatase, Serum total Calcium and Urinary Hydroxyproline was undertaken in both the groups.

[1]. Sachdeva A, Seth S, Khosla AH, Sachdeva S. Study of some common biochemical bone turnover markers in postmenopausal women. Indian J Clin Biochem 2005;20(1):
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Abstract:Objectives: To analyze the various antioxidant preparations available in the Indian market for their formulations, and cost. Materials and Methods: Anti-oxidant preparations listed in Drug Today India (2014) were analyzed for their formulations, and cost. Preparations containing vitamin A, C, E, Zn, Selenium, along with other multivitamins and minerals are Accepted formulations and not-accepted formulations were identified according to DCGI & CDSCO. Preparations which also contain phytochemicals and other plant products are considered as not-accepted formulations. Prices of accepted formulations were compared with that of not-accepted formulations. Out of 575 formulations, 79(13.7%) were accepted formulations and 496(86.3%) preparations were not-accepted formulations. Cost of accepted formulations is less than that of not-accepted formulations.

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Abstract:Aim: To identify and analyze the frequency and etiology of intestinal obstruction that might be helpful in suggesting the measures for prevention and treatment of the condition. Methods: This is a retrospective observational study of patients admitted due to acute intestinal obstruction. The period of this retrospective study is 13 years (2000-2013) Results: Of the 411 patients included in the study from the archives, 306 patients underwent operative procedure. Sex distribution of ratio of 1:1.3 and mean age of 47 yrs in males and 49 years in females were noted. 52% of the patients showed intrinsic causes that include 4% inflammatory, 32% infectiou(Kochs), 9% neoplastic and intussception,2% radiation and vascular causes and 5% traumatic. Extrinsic causes of 44% were noted out of which adhesions and bands were seen in majority of cases accounting to 64%, hernia in 16%, and 17% neoplastic and 3% intra abdominal abscess. Only 4% of cases showed intra luminal cause.

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Abstract:Empyema thoracis is an accumulation of pus in the pleural space. The management of empyema involves three core principles, prompt initiation of appropriate antibiotics, complete evacuation of suppurative pleural fluid and preservation or restoration of lung expansion. Children with uncomplicated empyema are managed with intercostal drainage procedure and appropriate antibiotics. Empyema that is organized with fibrinous deposits requires a surgical approach based on decortication. Pleural decortication can be done by either intrapleural or extrapleural approach. Empyema complicated with lung abscess, bronchopleural fistula may require lobectomy or pneumonectomy.

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