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

Abstract: The aim of this study was to compare Fluorescent(auraminO rhodamine,AO)method ,Ziehl-Neelsen (ZN hot method)and kinyoun(cold method) staining techniques for the diagnosis of Mycobacterium tuberculosis. Materials And Methods: 186(on 3 consecutive days) sputum samples were collected from 62 suspected pulmonary tuberculosis patients, processed by petroffs method, and subjected to direct microscopy by three methods Fluorescent (auramin O rhodamine) method ,Ziehl- Neelsen (ZN hot method)and kinyoun (cold method) staining techniques for the diagnosis of tuberculosis. Results: out of 62 patients 30.35%,17.8%and 17.8% were found positive,by AO,ZN and Kinyouns methods respectively. AO was found to be superior to ZN and Kinyoun methods in several aspects. AO was also able to detect more pauci-bacillary cases than ZN. Conclusion: Direct Microscopy is still the most simple and reliable method for diagnosis of Tuberculosis.In laboratories equipped with Fluorescent Microscope FLUOROCHROME Staining is more sensitive than ACID FAST staining for identification of Tubercle bacilli.

Keywords: Mycobacterium tuberculosis, Ziehl – Neelsen, Auramine O rhodamine,and Kinyoun.

[1]. Heifets L 1997. Mycobacteriology laboratory. Clin Chest Med 18: 35-41 .

[2]. Janda WM 1997. Mycobacteria. In EW Koneman, SD Allen (eds), Colour Atlas and Textbook of Diagnostic Microbiology, 5 ed., JB Lippincott Co., Philadelphia, p. 893-949.

[3]. Holst E, Mitchson DA, Radhakrishna S 1959. Examination of smears for tubercle bacilli by fluorescence microscopy. Ind J Med Res 47: 495. [4]. Lempert H 1944. Fluorescence microscopy in the detection tubercle bacilli. Lancet 2: 818.

[5]. Ozturkeri H, Demir MA, Balli S, Aydilek R 1997. Comparative evaluation of different staining methods in the diagnosis of tuberculosis. Bull Microbiol 31: 231-236.

[6]. Guthie W, Kitui F, Juma ES, Obvana DO, Mwai J, Kwamanga D 1993. A comparative study on the reliability of the fluorescence microscopy and Ziehl-Neelsen method in the diagnosis of pulmoner tuberculosis. East Afri Med J 70: 263-266.

Abstract: This study was done to investigate the pattern of presentation of breast cancer among tribal female of Bankura district of West Bengal where demographic parameters are largely different from other part of the state. The present study also tried to have a comparative analysis among the sensitivity, specificity and positive predictive value of Ultrasonography and Fine needle Aspiration Cytology in the detection of breast cancer among this tribal population. 92 tribal females attending surgical outdoor with breast lumps were included in the study. There demographic parameters, mode of presentation, time lapse since first noticed, presence and absence of well-known breast cancer risk factors were studied. All patients were subjected to FNAC & USG and the findings of these two investigations were compared with the Histopathology reports when the patients came for a follow-up.

[1]. Susan G. Komen Breast cancer foundation. Racial and ethnic differences in breast cancer. www.komen.org. [2]. Courtney M. Townsend Jr., R. Daniel Beauchamp, B. Mark Evers, Kenneth L. Mattox. Sabiston Textbook of Surgery: The Biological Basis of Modern Surgical Practice. 19th Edition. Elsevier Saunders; 2012. [3]. F.Brunicardi, Dana Andersen, Timothy Billiar, David Dunn, John Hunter, Jeffrey Matthews, Raphael E. Pollock. Schwartz's Principles of Surgery. 9th Edition. McGrawHill; 2010.
[4]. Xi-Wen Wang& ,Yun-Hui Xiong2 &, Xiao-Qing Zen, Hai-Bo Lin,Qing-Yi Liu. Diagnostic Accuracy of Ultrasonograph Guided Fine-needle Aspiration Cytologic in Staging of Axillary Lymph Node Metastasis in Breast Cancer Patients: a Meta-analysis. Asian Pacific J Cancer Prev, 13 (11), 5517-5523.
[5]. K. Glanz, R. T. Croyle, V. Y. Chollette, and V. W. Pinn, "Cancer-related Health Disparities in Women," American Journal of Public Health 93, no. 2 (February 2003): 292–98; Centers for Disease Control and Prevention (hereinafter CDC), Division of Cancer Prevention and Control 2008/2009,"HealthDisparitiesCancer,http://www.cdc.gov/cancer/HealthDisparities/pdf/0809_hf_fs.pdf (accessed 25 May 2007); J. Swan and B. K. Edwards, "Cancer Rates among American Indians and Alaska Natives," Cancer 98, no. 6 (2003): 1262–72.

Abstract:Objective(S): To compare the effects of manual removal of placenta and spontaneous delivery of placenta during caesarean section. Method(S): A prospective cohort study of 1451 antenatal women at term & singleton pregnancy undergoing caesarean section was conducted in the department of obstetrics and gynaecology, SMS medical college, Jaipur. They were randomly allocated into two groups. In group A placenta was allowed to separate spontaneously followed by its removal by gentle traction. In group B manual removal of placenta was done. Blood loss during the process was noted. Patients were followed till day 5 & 6 weeks postpartum for development of anemia & other complications.

[1]. Villar J, Valladares E, Wojdyla D, Zavaleta N, Carroli G, Velazco A, et al. for the WHO 2005 Global Survey on Maternal and Perinatal Health Research Group. Caesarean delivery rates and pregnancy outcomes: the 2005 WHO global survey on maternal and perinatal health in Latin America. The Lancet 2006; 367 (9525):1796-1797.
[2]. www.sciencedaily.com
[3]. Cunningham F, Gant N, Leveno K, Gilstrap III L, Hauth J, Wenstrom K. Williams Obstetrics, 21st edition. New York: McGraw-Hill,2001.
[4]. Rose I Anorlu, babalwa Maholwana, G Justus Hofmeyr. Methods of delivering the placenta at caesarean section. Cochrane Database of Systematic Review 2008, Issue 3, Art No. : CD004737
[5]. Fareesa Waqar, Razia Nasar, Anisa Fawad. THE COMPARISON OF PLACENTAL REMOVAL METHODS ON OPERATIVE BLOOD LOSS. J Ayub Med Coll Abbottabad 2008;20(3)

Abstract: Hyperlipidaemia is the most common associated disorder of Diabetes mellitus which is a predisposing factor for cardiovascular complications leading to death. Hypoglycemic drugs are having variable influence on lipid profiles. Hence a study of each hypoglycemic drug is required and is to be compared with another cardio protective anti diabetic agent in relation to risk factors like lipid profile gives the effective information for selectivity of better drug selection basing on lipid profile features as a preliminary cardio protective measure. This study was taken up to show the effect of hypoglycemic drugs on lipid profile, taking two groups A and B with 30 patients in each, given Glibenclamide and Glimepiride drugs for 6 weeks respectively.

[1]. K.D.Tripathi ,Accesentials of Medical Pharmacology,7th Edition 2013
[2]. Allian C.A. et al, Clinical Chemistry - 20;490(1974)
[3]. Buccolo G. David M. - Clinical Chemistry - 19(1973,476) Castelli WP et al, Lancet 1, 1965(1977
[4]. Castelli WP, Garrison RJ, Wilson PWF, et al. - Incidence of Coronary Heart Disease and lipoprotein cholesterol levels. The Framingham Study. - JAMA, 256:2835-8, 1986.

Abstract: Introduction: Wounds can cause painful lengthy hospital stay, multiple stages of surgeries, and enormous financial burden. Biological dressings collagen granule dressing has advantage over conventional dressing in terms of non-immunogenic, non-pyrogenic, being natural, easy application and decreased days of healing. Objectives: To compare the efficacy and safety of collagen granule dressings and conventional dressing in deep wounds in terms of reduced healing time, number of dressing, healing quality and complications. Methods And Material: A prospective study was done between December 2012 to June 2014 in which 68 patients who presented with deep wounds were chosen by random sampling technique, and were grouped into 2 groups consisting of 34 patients.

[1]. Gerald S. Lazarus, Diane M. Cooper, David R. Knighton, David J. Margolis, Roger E. Pecoraro, George Rodeheaver, Martin C. Robson . Definitions and Guidelines for Assessment of Wounds and Evaluation of Healing .Arch Dermatol 1994;130:489-493
[2]. Stuart Enoch ,David John Leaper. Basic Science Of Wound Healing. Surgery 26:2 , 2007 Elsevier Ltd.31-37.
[3]. F. Charles Brunicardi, Dana K. Anderson, Timothy R Billiar, David L. Dunn, John G. Hunter, Jeffery B. Matthews et al. Schwartz‟s Principles of Surgery. Mc Graw Hill. 9th Edition: 210-234
[4]. Kevin R.Knox,Ramazi O.Datiashvili,Mark S.Granick.Surgical wound bed preparation of chronic and acute wounds.Clin Plastic Surg 2007;34:633-641
[5]. Clinton K. Murray, Mary K. Hinkle, And Heather C. Yun . History Of Infections Associated With Combat-Related Injuries .J Trauma 2008;64:S221–S231.
[6]. Steed DL. Wound-healing trajectories. Surg Clin North Am 2003; 83; 547–55
[7]. Townsend, Beauchamp, Evers and Mattox. Wound healing. Sabiston Textbook Of Surgery: The Biological basis of modern surgical practice 19th Ed, chapter 7, vol 1:151-177

Abstract:This is a descriptive cross-sectional study conducted in Alshikh Mohamed Ali Fadul hospital in Omdurman City-Sudan during September 2013 - September 2014. The main aim was to identify the association of placenta previa with multiparity and previous caesarean section in pregnant women. In antenatal clinic as per protocol 200 pregnant women were scanned in their second and third trimester for foetal wellbeing and placental localization after taking a detailed obstetrical history and clinical examination. All women with or without symptoms of placenta previa showing placental implantation in lower uterine segment on
ultrasound scan were documented. After completion of the two years data regarding the detailed obstetrical
and surgical history were recorded in a questionnaire and analyzed using SPSS Software. Sixty five women were diagnosed as cases of placenta previa. The overall incidence of placenta previa was found to be 32.5% (65 women). Out of these 7 were primigrvidas, 12 were multiparous, 34 were grand multiparous. It was clearly evident from the study that placenta previa is associated with multiparity and previous caesarean section. Placenta previa was highly significantly associated with previous caesarean section (P =0. 000 <0.05). As well as, with multiparity and the association was found to be as high as previous caesarean section (P =0. 000 <0.05).

Keywords: caesarean section, Development, Placenta previa, Parity, Ultrasound.

[1]. Cunningham FG, Leveno KJ, Bloom SL. et al. Obstetrical hemorrhage. In: (ed.) Cunningham FG, Leveno KJ, Bloom SL. et al. Williams Obstetrics, 23rd ed. New York: McGraw-Hill. 2009:757-803.
[2]. Crane JMG, Van Den Hof MC, Dodds L,et al.Neonatal outcomes in placenta previa. Obstet Gynecol1999;93:541.
[3]. Martin JA, Hamilton BE, Ventura SJ, et al.Births: Final data for 2001. National Vital Statistics report. Hyattsville: National Center for Health Statistics, 2002.
[4]. Gilliam M, Rosenberg D, Davis F. The likely-hood of placenta previa with greater number ofcesarean deliveries and higher parity. Obstet Gynecol2002;93:973.
[5]. Frederiksen MC, Glassenberg R, Stika CS,et al.Placenta previa: A 22-year analysis.Am J Obstet Gynecol1999;180:1432.

Abstract: Background: Occupational noise exposure is likely to contribute in very high proportion of cases of sensorineural hearing loss in workers who are continuously exposed to high frequency noise being emitted from industrial machines Objectives: 1-To estimate the proportion of noise induced hearing loss among study participants. 2-To study the different types of hearing loss among study participants.3-To study non-audiological health problems related to noise exposure among the study participants.

[1]. Ranga RK,Yadav S, Yadav A, Yadav N, Ranga SB.Prevalence of occupational noise induced hearing loss in industrial workers.Indian J Otal 2014;20:115-118
[2]. Dube KJ,Ingale LT, Ingale ST.Hearing Impairement among workers exposed to excessive levels of noise in ginning industries.Noise health 2011;13:348-55
[3]. PARK text book of preventive and social medicine 22th edition m/s Banarsidas bhanot publishers, India
[4]. Logan turner's diseases of nose, throat & eart-10th edition m/s taylor and francis publishers,UK
[5]. Scott brown's otorhinolaryngology and head and neck surgery-7th edition, m/s Edward Arnold publishers ltd

Abstract: A case of evisceration of gravid uterus in anterior abdominal wall defect with scar rupture. The pregnancy was further complicated by intra uterine fetal demise. The management of the case is discussed.

Keywords: evisceration of gravid uterus, anterior abdominal wall defect, scar rupture, caesarean section, caesarean hysterectomy.

[1]. Dare FO, Makinde OO, Lawal OO. Gravid uterus in abdominal wall hernia of a Nigerian woman. Int J Obstet Gynecol. 32, 1990, 377-379.
[2]. Adesunkanmi AR, Faleyimu B. Incidence and aetiological factors of incisional hernia in postcaesarean operations in a Nigerian hospital. J Obstet Gynaecol 23, 2003, 258-60.
[3]. Banerjee N, Deka D, Sinha A, Prasrad R, Takkar D. Gravid uterus in an incisional hernia. J Obstet Gynaecol Res. 27, 2001, 77-79.
[4]. Saha PK, Rohilla M, Prasad GR, Dhaliwal LK, Gupta I. Herniation of gravid uterus: report of 2 cases and review of literature. MedGenMed 8(4), 2006, 14.
[5]. Sahu L, Bupathy A. Evisceration of pregnant uterus through the incisional hernia site. J Obstet Gynaecol Res. 32, 2006, 338–340.

Abstract: Sebaceous nevi are epidermal hamartomas commonly seen over scalp and face. We report a case of sebaceous nevus with unusual presentation at an unusual site. This form of nevus sebaceous is quite rare in contrast to relatively common linear variant. Conclusion: Sebaceous nevus is rare on shoulder. Unusual location, nodular papillomatous presentation with linear extension lead to misdiagnosis. Undifferentiated hair follicles, sometimes with dilated infundibula are typical of sebaceous nevus. The divergent differentiation observed in NS is consistent with the common embryologic origin of the folliculo sebaceous apocrine unit.

Keywords: Nevus Sebaceous (NS), Shoulder, Nodular presentation

[1]. Rook's textbook of dermatology 8th edition., [2]. Jonathan L Levinsohn, Li C Tian, Lynn M Boyden, Jennifer M McNiff, Deepak Narayan, Erin S Loring et al., Whole-Exome Sequencing Reveals Somatic Mutations in HRAS and KRAS, which Cause Nevus Sebaceus. Journal of Investigative Dermatology (2013) 133,827–30;
[3]. Yoshii N, Kanekura T, Setoyama, M, Kanzaki T. Syringocystadenomapapilliferum,: report of the first case on the lower leg. J Dermatol 2004; 31: 939–942.
[4]. Ugras N, Ozgun G, Adim SB, Ozerkan K. Nevus sebaceous at unusual location: A rare presentation. Indian J Pathol Microbiol 2012;55:419-20
[5]. Iffat Hassan, Mashkoor Ahmad, Shazia Jeelani. Sebaceous naevus located in nasal cavity – a unique case. our Dermatol Online. 2012; 3(1): 33-35

Abstract: Basal Cell Carcinoma is a common cutaneous malignancy, occurring primarily on the face . It has many histological variants. We present a case of a 71- year old farmer with a nodule near outer canthus of the right eye, since six months. Histopathological examination of the excised nodule revealed a tumour composed of basaloid cells with an adenoid pattern of growth. Based on the histopathological and immunohistochemical features, a diagnosis of adenoid type of basal cell carcinoma was made. The adenoid BCC is a rare type and closely resembles the Primary Cutaneous Adenoid Cystic Carcinoma. Differentiation of these two histologically similar lesions is important as their evolution and prognosis is different.

Keywords: Adenoid variant, Basal cell carcinoma, Cutaneous Adenoid Cystic Carcinoma.

[1]. Requena L, Kutzner H, utr MA, et al. Malignant tumours with apocrine and eccrine differentiation. .In: LeBoit PE, Burg G, Weedon D, Sarasin A (Eds.) World Health Organization Classification of tumours. Pathology and Genetics of Skin tumours ( IARC Press: Lyon) 2006. pp. 135-36.
[2]. Abulafia J. Epiteliomas cutaneos ensayo de classificacion histogenetica. An Bras Dermatol 1963;38 :14-31.
[3]. Bastiens MT, Hoefnagel JJ, et al .Differences in age, site distribution and sex between nodular and superficial basal cell carcinomas indicate different types of tumors. J Invest Dermatol 1998;110:880-84.
[4]. Tambe SA, Ghate SS, Jerajani HR. Adenoid type of basal cell carcinoma: Rare histopathologic variant at an unusual location. Indian J Dermatol 2013;58:159.
[5]. Hussain I, Soni M ,Khan MD. Basal cell carcinoma presentation. Histopathological features and correlation with clinical behavior. Pak J Opthalmol 2011; 27:3-7.

Abstract: Chronic renal failure (CRF) results from progressive and irreversible destruction of nephrons, regardless of the cause. Patients with CRF are a major cardiac population. The diagnosis of Myocardial Infarction (MI) is difficult in these patients as they exhibit base line changes in electrocardiogram, echocardiogram and atypical cardiac symptoms. They are not fit for exercise tolerance test. Hence the diagnosis is by Biochemical markers.The present study considers the use of serum cardiac markers for the diagnosis of acute coronary syndromes in patients with CRF without ischemic heart disease with focus on CK MB and AST/SGOT.50 patients with CRF admitted into Government General Hospital and Nagarjuna Hospitals, Vijayawada were assessed for CK MB and AST. Of the 50 patients, 30 of them were on chronic maintenance hemodialysis and 20 were on conservative treatment.

[1]. Keoman J.P., Leunissen K.M.L. Cardiovascular aspects in renal disease. Curr. Opin. Nephrol.Hypertens. 1993; 2:791-7.
[2]. Char D. M., Israel E., ladenson J., Early laboratory indicators of acute myocardial infarction, Emerg. Med. Clinics North Am.: 1998; 16: 519-539.
[3]. Latner B.P., Skale J.S., Buns W. Measuring creatine kinase isoenzyme in a maintenance hemodialysis population: Chemiluminometric immunoassay and electrophoresis compared : Clin Chem. 1989; 35 : 1965-8.
[4]. Kibe O, and Nilsson, N.J: Acta Med. Scand., 182:597, 1967
[5]. Immunoinhibition and automated column chromatography compared for assay of creatin kinase MB isoenzymes activity in long term hemodialysis patients Arch. Intern. Med1981; 141: 164-6.

Abstract:Immune Reconstitution Inflammatory Syndrome(IRIS) is defined as paradoxical deterioration in clinical status after Anti Retroviral Therapy(ART) initiation despite improved immune function due to inflammatory response against infectious agent, which may or may not be diagnosed at initiation of ART. Tuberculosis is most common opportunistic infection in HIV patients. Though it can present at any stage of HIV infection, it appears more commonly when CD4 count is around 350cells/microL. In advanced stages of AIDS, tuberculosis remains quiescent and may not present clinically or radiologically. With initiation of ART, tuberculosis may appear as IRIS. We report a case of tuberculosis presenting as IRIS in HIV-1 infected patient who had no previous history of mycobacterial infection. The patient was kept on ART with a baseline CD4+ count of 63 cells/microL. Ten days after initiation of ART patient had massive pericardial effusion leading to cardiac tamponade with pleural effusion and fever. His repeat CD4 count increased to 100 cells/mm3. On analysing pericardial and pleural effusions, a diagnosis of tuberculosis was made and patient was started on anti-tuberculosis therapy (ATT) along with ART and systemic steroids. Tuberculosis is commonest opportunistic infection presenting as IRIS.
Keywords: HIV, Immune reconstitution inflammatory syndrome, Tuberculosis.

1]. Kathleen R.Page. John Hopkins HIV Guide, Management Of HIV Infection And Its Complications. 2012;Pg 6-8. [2]. Daniel J Sexton, Brian C Pein. Immune Reconstitution Inflammatory Syndrome.Available From :Http://Www.Uptodate.Com/Contents/Immune-Reconstitution-Inflammatory-Syndrome. Accessed On 12th Jan 2014.
[3]. Visenegarwala F, Darcourt J, Gravissa EA, Giordane TP, White AC Jr, Et Al. Incidence And Risk Factors For Immune Constitution Inflammatory Syndrome During Highly Active Antiretroviral Therapy. AIDS 2005; 19:399-406.
[4]. Sharma SK, Dhooria S, Barwad P, Kadhiravan T, Ranjan S, Miglani S, Et Al. A Study Of TB-Associated Immune Reconstitution Inflammatory Syndrome Using The Consensus Case-Definition. Indian J Med Res 2010; 131 : 804-8.
[5]. Karmakar S, Sharma SK, Vashishtha R, Sharma A, Ranjans, Gupta D, Et Al. Clinical Characteristics Of Tuberculosisassociatedimmune Reconstitution Inflammatory Syndromein North Indian Population Of HIV/AIDS Patients Receivinghaart. Clindevimmunol2011; 2011 : 239021

Abstract: Glaucoma is the condition where the intraocular pressure of the eyeball increases more than normal.There are mainly two types of glaucoma 1 . Primary open angle glaucoma, 2. Primary angle closure glaucoma Population affected with primary open angle glaucoma is large. Treatment includes alpha selective adrenergic agents, sympatholytic agents and other drugs. The most commonly used drugs in the Govt General Hospital, Vijayawada, A.P were sympatholytic agents and alpha selective adrenergic drugs .So we carried out the study comparing the efficacy cost effectiveness and adverse drug reactions between timolol 0.5% eye drops and brimonidine tartarate 0.2% eye drops in primary open angle glaucoma.

[1]. Josef flammer ,M.D.,Glaucoma 2nd revised edition,2002 pg no : 15
[2]. Albert & Jakobiee,Principles & practice of ophthalmology 2nd edition vol :4 pg 2684
[3]. Wilcons Journal of pharmacy society May/June 2001, pg no: 33,34
[4]. AHEPA-AMJ.Ophthalmology 2001 June 131(6) 729-33
[5]. Holmes KT-Sur.Ophthalmology 1996,Nov 41,Suppl: S 27-37.

Abstract: Prompt initiation of treatment for malaria is an important factor for the reduction of morbidity and mortality of the disease especially in children under five years of age. Mothers, being the primary care givers in the home, are in the best position to initiate this treatment. Therefore, the health-seeking behavior of mothers for the treatment of malaria in this age group contributes significantly to the reduction of the malaria burden. Materials and Method: A multistage sampling method was used to select 500 respondents for the study. Well-structured questionnaires were administered to the respondents and returned thereafter for data analysis and presentation. Data entry and analysis were done using Statistical Packages for Social Sciences (SPSS) version 11. Frequency distribution of tables was used in data presentation.

[1]. World Health Organization, WHO. What is Malaria? 2001-2010 United Nations Decade to Roll Back Malaria, Malaria Situation 1999.
[2]. Mapping Malaria Risk in Africa (MARA) Project. Towards an Atlas of malaria risk in Africa. Available at: http://www.mara.org,za/mapsinfo.htm (Accessed June 18, 2013).
[3]. Nigeria, Federal Ministry of Health, Abuja. Strategic plans for rolling back malaria in Nigeria 2001-2005.
[4]. G. Olasehinde, A.A. Ajayi, S.O. Taiwo, B.T. Adekeye and O.A. Adeyeba, Prevalence and management of falciparum malaria among infants and children in Ota, Ogun State , South Western Nigeria. Afr J ClinExperMicrobiol, 11(3), 2010, 199-163.
[5]. G. Abel. Special Focus on Malaria, Health Monitor,2(4), 2004, 8 -10.
[6]. Nigeria, Federal Ministry of Health, Abuja. National Malaria Control Programme, Strategic Plan 2009- 2013.

Abstract: The need to establish Local diagnostic reference level for adult brain computed tomography scan was considered in this study. Brain computed tomography scan is the most common Computed tomography examination performed in the hospital under study. CT scan is recognized as a high dose imaging modality. The quantities estimated in this study were volumetric computed tomography dose index (CTDIv) value, dose-length product (DLP) and the effective dose (DE) received by the patients; the data and results were compared with that of national and international established work. The study was carried out on 40 adult patients undergoing routine brain computed tomography examination. The CTDIv of 38.08mGy was obtained from the study which is below 60mGy reference value by European Commission.

[1]. Boone, M.J., Strauss, K.J., Cody, D.D. (2011). Size-Specific Dose Estimates (SSDE) in Pediatric and Adult Body CT Examinations. AAPM report No. 204.
[2]. European Commission, (1996). European Guidelines on Quality Criteria for Diagnostic Radiographic Images. EUR 16260 EN.
[3]. European Commission. (1999). Guidance on Diagnostic Reference Levels (DRLs) for Medical Exposures. Radiation Protection 109.
[4]. European Commission. (2000). European Guidelines on Quality Criteria for Computed Tomography. Luxembourg. EUR 16262.
[5]. Gray, J.E., Archer, B.R., Butler, P.F. (2005). Reference values for diagnostic International Commission on Radiological Protection radiology: application and Impact. Journal of Radiology, 235, 354-358.
[6]. International Commission on Radiological Protection (1990). Data for Protection Against Ionizing Radiation from External Sources. Bethesda, Md; ICRP Report 21; Publication 60; 1990.

Abstract: Aims and Objectives: To evaluate the association of Homocysteine (Hcy) and Lipid profile with Type 2 Diabetes Mellitus (DM) and to assess affect of age, sex and smoking status on Hcy level. Materials And Methods: The study was carried out in the department of Physiology in collaboration with Medicine and Biochemistry department, Regional Institute of Medical Sciences (RIMS), Imphal. A total of 122 diabetic volunteers fulfilling the criteria of diagnosis according to American Diabetic Association (ADA) and World Health Organization (WHO) were included in the study. Patients with congenital heart disease, signs of congestive heart failure and pericardial disease, chronic obstructive pulmonary disease, evidence of severe renal impairment, history of acute infections, thyroid dysfunction, prolong supplementation of B-complex vitamin especially Vitamin B6,B12 and folic acid, pregnancy and any seriously ill patients were excluded. Serum Hcyl were measured by ELISA and lipid profile by enzymatic colorimetric method. Student t-test and chi square test has been used for statistical analysis.

[1]. Selhub J, Miller JW. The pathogenesis of homocysteinemia: interruption of the coordinate regulation by S-adenosylmethionine of the remethylation and transsulfuration of homocysteine. Am J Clin Nutr 1992; 55: 131-8.
[2]. Champe PC, Harvey RA, Ferrier DR. Amino acid degradation and synthesis. In: Biochemistry. 4th ed. Philadelphia Lippincott Williams and Wilkins; 2008.261-76.
[3]. Powers AC. Diabetes Mellitus. In: Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson JL, Loscalzo J, editors. Harrison's Principles of Internal Medicines. 18thed.New York: McGraw-Hill; 2008.p.2969.
[4]. Kajbaf F, Ghaffari MA, Kajbaf MJ. Reduced serum homocysteine levels in diabetic patients. Iran J Pathol 2012; 7(1): 14-18.
[5]. Ramachandran, Snehalata. Epidemiology of heart disease in type 2 diabetes. Current Science 2002; 83(12):1.
[6]. Rodger W, Non-insulin-dependent (type II) diabetes mellitus CMAJ. Dec 15, 1991; 145(12): 1571–1581.

Abstract: Hypotension following spinal anaesthesia for Caesarean section is the commonest serious problem encountered by anaesthesiologists. Numerous methods have been tried to minimize hypotension which include fluid preloading, left uterine displacement and use of vasopressor drugs. This study was aimed at comparing the efficacy of three drugs Phenylephrine, Ephedrine and Mephentermine for maintenance of arterial blood pressure during spinal anaesthesia in caesarean section. 60 patients between the age group of 18-35 years undergoing elective as well as emergency caesarean section under spinal anaesthesia who developed hypotension after subarachnoid block(SAB) were selected and randomly allocated into 3 groups of 20 each to receive Group P -Phenylephrine 50mcg, Group E – Ephedrine 6 mg, and Group M –Mephentermine 6 mg as bolus IV and repeated as required. Comparability of groups were analysed with Analysis of Variance (ANOVA) test. All the 3 drugs effectively controlled SBP & DBP. On intergroup comparision rise of SBP and DBP in phenylephrine group was more than in other two groups. Tachycardia was significantly less in Group P after administration of the study drug. Phenylephrine causes reduction in heart rate, which may be advantageous in cardiac patients and patients in whom tachycardia is undesirable.

Keywords: Caesarean section, Subarachnoid block, Hypotension, Vasopressor.

[1]. 1.Pernoll ML, Mandell JE. Caesarean section. Chapter 30, Principles and Practice of Obstetric Analgesia and Anaesthesia, 2nd Edn., Bonica JJ and McDonald JS,Williams and Wilkins, 1995:968-1009.
[2]. 2. Riley ET, Cohen SE, Rubenstein AJ, Flanagan B. Prevention of hypotension after spinal anaesthesia for caesarean section : 6% hetastarch versus lactated Ringer's solution. Anaesthesia and Analgesia 1995;81:838-42.
[3]. 3. Eloner H, Barcohana J, Bartosheck AK. Influence of postsponal hypotension on fetal electrogram. American Journal of Obstetrics and Gynaecology 1960;80:560-572.
[4]. 4.Corke BC, Datta S, Ostheinar GW et al. Spinal anaesthesia for caesarean section. The influence of hypotension on neonatal outcome. Anaesthesia1982;37:658-662.
[5]. 5. Jackson R, Reid JA, Thorburn J. Volume preloading is not essential to prevent spinal induced hypotension at caesarean section. British Journal of Anaesthesia 1995;75:262-5.

Abstract: Background: Tooth loss is one of the main indicators of the overall oral health in a given population. The purpose of this study was to investigate the reasons of permanent teeth extraction and its association withage and gender in Jizanpopulation. Subjects and Methods:The data were collected by general dental practitioners from government polyclinics and primary health centers of Jizan region from patient's file who have attended the clinics from February to December 2014. The inclusion criteria were patients from both genders, above the age of 10 years and indicated for extraction of permanent tooth. The numbers of subjects were424 males and 267 females, divided into six groups according to age groups. The data were entered into SPSS program version 20.0 and results were analyzed.

[1]. Brodeur JM, Benigeri M, Naccache H, Oliver M, Payette M. Trend in the Level of Education in Quebec Between 1980-1993. J Can Dent Assoc, 1996; 62: 159-160.
[2]. Richards W, Ameen J, Coll AM, Higgs G. Reasons for tooth extraction in four general dental practices in South Wales. Br Dent J 2005; 198:275–278.
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[4]. Reich E, Hiller KA. Reasons for tooth extraction in the western states of Germany. Community Dent Oral Epidemiol. 1993;21: 379–383.
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[6]. Al-Shammari KF, Al-Ansari J, Abu Al-Melh M, Al-Khabbaz AK. Reasons for Tooth Extraction in Kuwait. Med PrincPract 2006; 15:417–422.