iosr-JDMS   Volume-14 ~ Issue-12 ~ December-2015

Abstract: Intrauterine contraceptive device is one of the commonest method of contraception used . More than 100 million women worldwide have been using the IUCD. Dysfunctional uterine bleeding , abdominal cramps , pelvic inflammatory disease, spontaneous expulsion are the common complaints initially after IUCD insertion . Migration of intrauterine contraceptive device is one of the complications in women of child bearing age group . we report a case where IUCD has migrated into peritoneal cavity leading to perilesional adhesions & fibrosis causing extrinsic compression on left distal ureter leading to Hydronephrosis & Hydroureter .

1]. Tuncay YA, Tuncay E, Güzin K, et al. Transuterine migration as a complication of intrauterine contraceptive devices: six case reports. Eur J Contracept Reprod Health Care. 2004;9:194–200.
[2]. Intrauterine Contraceptive Device Migration Presenting as Abdominal Wall Swelling: A Case Report -Imtiaz Wani,1 Adil Syed,2 Muddasir Maqbool,2 Iftikhar Bakshi,1 Hilal Bhat,1 Faheem Ul Hassan Andrabi,1 and Naveed Mohsin3 , journal of Case Reports in Surgery Volume 2011 (2011), Article ID 305914, 3 pages
[3]. Ozgun MT, Batukan C, Senin IS, Ozoelik B, Bas-bug M, Dolanbay M. Surgical management of intra-abdominal mislocated intrauterine devices. Contraception 2007; 75: 96-100
[4]. Migration of intrauterine devices: radiologic findings and implications for patient care. Boortz HE, Margolis DJ, Ragavendra N, Patel MK, Kadell BM. Radiographics. 2012 Mar-Apr;32(2):335-52. doi: 10.1148/rg.322115068
[5]. Laparoscopic Removal of a Migrated IntrauterineDevice- Farzaneh Sharifiaghdas, Faramarz Mohammadali Beigi, Hamidreza Abdi-Urol J. 2007;4:177-9. Urology Journal Vol 4 No 3 Summer 2007

Abstract: Objective: To evaluate the role of cancer antigen CA15-3 as prognostic marker in breast cancer patient. Methods: The prospective study was done from November 2013 to October 2014 at Deparment of surgery, MGM Medical college and M.Y. Hospital group, Indore.This was a prospective study done on 31 patients with breast cancer. Blood samples were collected from all the patients and from the other patient also. Another samples of blood were collected from all these patients of breast cancer after two to three month to evaluate the relation between level of CA15.3 with breast cancer.

[1]. Hayes DF, Zurawsky WF, Kufe DW. Comparison of circulating CA 15-3 and carcinoembryonic antigen in patients with breast cancer. J Clin Oncol 1986; 4: 1541-50.
[2]. Todini C, Hayes DF, Gelman R, et al. Comparison of CA 15-3 and carcinoembryonic antigen in monitoring the clinical course of patients with metastatic breast cancer. Cancer Res 1988; 48: 4107- 12.
[3]. Colomer R, Ruibal A, Salvador L. Circulating tumor marker levels in advanced breast carcinoma correlate with the extent of metastatic disease. Cancer 1989; 64(8): 1674-81.
[4]. Wojtachi J, Dziewulska-Bokiniec A. Serum CA 15-3 determinations in the postoperative follow-up of breast cancer patients. Libri Oncol 1995; 24(3): 147-52.
[5]. Bombardieri E, Pizzichetta M, Verollesi P, et al. CA 15-3 determination in patients with breast cancer: clinical utility for the detection of distant metastases. Eur J Cancer 1993; 29: 144-6.
[6]. Geraghty JG, Coveney EC, Sherry B, O�Higgins NJ, Duffy MJ. CA 15-3 in patients with locoregional and metastatic breast carcinoma. Cancer 1992; 70: 2831-8.

Abstract: Background- Metastatic gall bladder cancer (GBC) is an aggressive disease and is often prone to delayed diagnosis. Chemotherapy is the modality most often employed to prolong survival and is superior to best supportive care alone.
Aim- The aim of this study was to analyse the effect of gemcitabine and cisplatin (G+C) based chemotherapy in metastatic GBC.
Design- Retrospective single institution analysis. Material and methods- Medical records of patients with a histopathologic proven diagnosis of metastatic GBC presenting from January 2014 to July 2015 to the department were reviewed, and data were collected from the departmental case files.

[1]. Park JO, Oh DY, Hsu C, et al. Gemcitabine Plus Cisplatin for Advanced Biliary Tract Cancer: A Systematic Review. Cancer Res
Treat. 2015 Jul;47(3):343-61.
[2]. Randi G, Malvezzi M, Levi F, et al. Epidemiology of biliary tract cancers: an update. Ann Oncol. 2009;20:146-59.
[3]. 3. Shukla HS, Sirohi B, Behari A, et al. Indian Council of Medical Research consensus document for the management of gall
bladder cancer. Indian J Med Paediatr Oncol. 2015 Apr-Jun; 36(2): 79–84.
[4]. NCCN Clinical Practice Guidelines in Oncology. Hepatobiliary Cancers. Version 2. 2014.Available from: http://www.nccn.org.
[5]. Sasaki T, Isayama H, Nakai Y, et al. Current status of chemotherapy for the treatment of advanced biliary tract cancer. Korean J
Intern Med. 2013;28:515-24.

Abstract: To compare Tympanic membrane temperature and Rectal temperature in Febrile pediatric patients and compliance for the subjective methods. Design: Prospective observational descriptive study. Setting: children between the age group of 6 months to 12 years who were admitted with fever were randomly taken for the study for a period from Jan 2013 to July 2014) in Institute of Child and Women Health, Niloufer Hospital, Osmania Medical College, Hyderabad.

[1]. Sahib El-Radhi, James Carroll, and Nigel Klein: Clinical Manual of Fever in Children:2009.
[2]. Al-Mukhaizeem, F., Allen, U., Komar, L., Naser, B., Roy, L., Stephens, D.Schuh, S. (2004). Comparison of temporal artery, rectal and esophageal core temperatures in children: Results of a pilot study. Paediatrics& Child Health, 9(7), 461-465.
[3]. Fadzil, F. M., Choon, D., &Arumugam, K. (2010). A comparative study on the accuracy of noninvasive thermometers. Australian Family Physician, 39(4), 237-239.
[4]. Farnell, S., Maxwell, L., Tan, S., Rhodes, A., & Philips, B. (2005). Temperature measurement: Comparison of non-invasive methods used in adult critical care. Journal of Clinical Nursing, 14(5), 632-639.
[5]. Fauci AS, Braunwald E, Isselbacher KJ, Wilson JD, Martin JB, Kasper DL et al. Harrison's principle of internal medicine. In Charles A Dinarello.
[6]. Tandberg D. Sklar D. Effect of tachyapnea on the estimation of body temperature byan oral thermometer. New Engl J Med 1983; 308:945-946.

Abstract: All clinical samples (e.g. Pus, urine, sputum, blood, tracheal aspirate, peritoneal fluid, catheter tip, ET tip tracheostomy aspirate) etc are sent for culture and antibiotic sensitivity in a clinical microbiology laboratory to achieve etiological diagnosis. Aims: The study was done to detect the AmpC β-lactamase and ESBL producing gram negative bacteria from different clinical samples. This study included AmpC disc screening test and found out that the modified three dimensional tests using whole cell growth gives clearer result.

[1]. Abraham, E. P., and E. Chain. 1940. an enzyme of bacteria able to destroy penicillin. Nature 146:837.
[2]. Eriksson-Grenberg, K. G. 1968. Resistance of Escherichia coli to penicillins. II. An improve mapping of the AmpA gene. Genet. Res. 12:147-156.
[3]. Eriksson-Grenberg, K. G., H. G. Boman, J. A. Jansson, and B. C. Herold. 2006. Resistance of Escherichia coli to penicillins. I. Genetic study of some ampicillin-resistant mutants. J. Bacteriol. 90:54-62.
[4]. Ambler, R. P. 1980. The structure of β-lactamases. Philos. Trans. R. Soc. Lond. B. 289:321-331.
[5]. Bush, K., G. A. Jacoby, and A. A. Medeiros. 1995. A functional classification scheme for β-lactamases and its correlation with molecular structure. Antimicrob. Agents Chemother. 39:1211-1233
[6]. Galleni, M., and J. M. Frere. 1988. A survey of the kinetic parameters of class C β-lactamases. Cephalosporins and other β-lactam compounds. Biochem. J. 255:123-129.

Abstract: We present a case series of thyrotoxicosis carried out on 7 patients who were observed, investigated and treated for a period of 1 yr ie.., from october 2014 to october 2015 who presented to Out patient department of Government General Hospital, Guntur. The study was carried out on the age group of 11 to 20 years age group patients while the most common age of presentation being 25-50 years. We consider this study to focus on rare presentation with regard to age ie.., youger than the usual group. We have considered age of presentation, clinical signs and symptoms at presentation, response to the treatment and the final outcome of the patients in the 1 year period considered.

Key Words: Thyrotoxicosis, Graves disease, T3, T4, TSH, Anti TSH Ab, Acute Progressive Optic Neuropathy

[1]. Bahn Chair, RS; Burch, HB; Cooper, DS; Garber, JR; Greenlee, MC; Klein, I; Laurberg, P; McDougall, IR; Montori, VM; Rivkees, SA; Ross, DS; Sosa, JA; Stan, MN (June 2011). "Hyperthyroidism and other causes of thyrotoxicosis: management guidelines of the American Thyroid Association and American Association of Clinical Endocrinologists.". Thyroid : official journal of the American Thyroid Association 21 (6): 593–646
[2]. "Hyperthyroidism". www.niddk.nih.gov. July 2012. Retrieved2015-04-02. [3]. "Depression and Psychosis in Neurological Practice.". Bradley's neurology in clinical practice. (6th ed.). Philadelphia, PA: Elsevier/Saunders. 2012. pp. 102–103. [4]. Faculty of Medicine & Dentistry (2006). "Course-Based Physical Examination - Endocrinology -- Endocrinology Objectives (Thyroid Exam)". Undergraduate Medical Education. University of Alberta. Retrieved 28 January 2007

Abstract: In the era of urbanization, civilization and HIV/AIDS a study is made to look into prevalence and pattern of Ectoparasites(S. scabiei and P.pubis) infestation on genitalia among people attending Dermatology, Venereology and Leprosy department of Gandhi medical College, Secunderabad, Telangana. Objective: To determine the clinical epidemiological aspects of Ectoparasitic infestations on genitalia among patients attending DVL department. Methodology: All the patients attending the DVL department with complaints of itching and all the attendees of STI clinic from October2009 to October2015 were taken up for this study. Demographic details, detailed history, similar symptoms in family contacts taken, detailed clinical examination was done to note morphological lesions and efforts were made to demonstrate the parasites under microscope. Data analysed.

[1]. M. Takano-Lee, J. D. Edman, B. A. Mullens, and J. M. Clark, "Home remedies to control head lice: assessment of home remedies to control the human head louse, Pediculushumanuscapitis (Anoplura: Pediculidae)," Journal of Pediatric Nursing, vol. 19, no. 6, pp. 393–398, 2004. View at Publisher · View at Google Scholar · View at Scopus
[2]. Ficher I, Morton RS. Phthirus pubis infestation. Br J Vener Dis.1970;46:326–9.56. [3]. Munkvad IM, Klemp P. Co-existence of venereal infection and pediculosis pubis. ActaDermVenereol. 1982;62:366–7. [4]. Poudel SK, Barker SC. Infestation of people with lice in Kathmandu and Pokhara, Nepal. Med. Vet. Entomol. 2004;18:212–213. [PubMed] [5]. 5.Walker GJ, Johnstone PW. Interventions for treating scabies. Cochrane Database Syst Rev 2000;(3):CD000320. View at Google Scholar [6]. 6. O. Chosidow, "Scabies and pediculosis," The Lancet, vol. 355, no. 9206, pp. 819–826, 2000. View at Google Scholar · View at Scopus

Abstract: Aim: The aim of this case report is to describe a rare case of multiple xanthomas of the tendon sheath on the dorsal aspect of the thumb in a 60 year old female. Case Report: A 60 year old female presented with multiple swelling on the dorsal aspect of the left thumb without history of trauma. These were then excised using two incisions and the sample subjected to histopathological examination. Discussion: In the present case we describe multiple xanthomas on the dorsal aspect of the thumb and its subsequent work up and excision. Conclusion: The case has been reported keeping in mind the rarity and its successful treatment with surgery.

Key Words: Multiple, giant cell, dorsal, thumb.

[1]. Phalen GS, McCormack LG, Gazale WJ. Giant-cell tumor of tendon sheath (benign synovioma) in the hand: evaluation of 56 cases. Clin Orthop. 1959;15:140-51.
[2]. Jones FE, Soule EH, Coventry MB. Fibrous xanthoma of synovium (giant-cell tumor of tendon sheath, pigmented nodular synovitis). J Bone Joint Surg Am. 1969;51(1):76-86. 3. Walsh EF,
[3]. Mechrefe A, Akelman E, Schiller AL. Giant cell tumor of tendon sheath. Am J Orthop (Belle Mead NJ). 2005;34(3):116-21
[4]. Wright CJE. Benign giant-cell synovioma. An investigation of 85 cases. Br J Surg. 1951;38(151):257-71.
[5]. Rao AS, Vigorita VJ. Pigmented villonodular synovitis (giant-cell tumor of the tendon sheath and synovial membrane). A review of eighty-one cases. J Bone Joint Surg Am. 1984;66(1):76-94.
[6]. Glowacki KA, Weiss APC. Giant cell tumors of tendon sheath. Hand Clin. 1995;11(2):245-53.
[7]. Grover R, Grobbelaar AO, Richman PI, Smith PJ. Measurement of invasive potential provides an accurate prognostic marker for giant cell tumour of tendon sheath. J Hand Surg Br. 1998;23(6):728-31.

Abstract: Perimenopausal bleeding is one of the common conditions for which patients seek advice in the gynecology outpatient department. Histopathological characteristics of endometrial biopsy material for patients with perimenopausal bleeding, by light microscopy remains the gold standard for diagnosis of endometrial pathology. A total of 200 endometrial curetting samples received during a 2 year period in Department of Pathology, Tirunelveli Medical College, Tamilnadu, India were assessed for the histopathological pattern and Estrogen and Progesterone receptor status on those samples showing endometrial hyperplasias.

[1] Munro MG. Abnormal uterine bleeding. Part I—pathogenesis and clinical investigation. J Am Assoc Gynecol Laparosc 1999; 6:391–418.

[2] Chabra S, Jaswal M, Nangia V. Uterine size, Endometrium Fertility in women with dysfunctional uterine hemorrhage. J. Obstet Gynaecol India, 1992; 42:692-694.

[3] Cardoso PM, D'Silva EA. Dysfunctional uterine bleeding- A review Obs&Gynae Today 2004; 9 (1): 47-50.

[4] G Emons et al, Hormonal interactions in endometrial Cancer, Endocrine Related cancer (2000); 7: 227–242.

[5] Kurman RJ, Kaminski PF, Norris HJ. The behavior of endometrial hyperplasia. A long-term study of ―untreated‖ hyperplasia in 170 patients. Cancer 1985; 56:403-12.

[6] Barnes DM, Hanby AM, Estrogen and Progesterone receptor in breast cancer Past, present, future. Scoring system for ER, Histopathology 2001;38:271-274.

Abstract: Introduction: The use of Procalcitonin (PCT) as a bacterial diagnostic marker is controversial in patients on hemodialysis (HD). Infections account for considerable morbidity and mortality in patients on HD. Hence, early diagnosis of bacterial infections is important to make a prognostic assessment of its severity. If PCT can be used as a primary marker for bacterial infections in patients on HD, these infections can be diagnosed and treated early. Therefore, we investigated whether PCT could function as a primary diagnostic marker of bacterial infections in patients on HD.

[1]. Coresh J, Selvin E, Stevens LA, Manzi J, Kusek JW, Eggers P et al. Prevalence of chronic kidney disease in the United States. JAMA 2007;298(17):2038–47.

[2]. Collins AJ, Foley R, Herzog C, Chavers B, Gilbertson D, Ishani A et al. excerpts from the united states renal data system 2007 Annual data report. Am J Kidney Dis. 2008;51(1 suppl 1):S1-320.
[3]. Sarnak MJ, Jaber BL. Mortality caused by sepsis in patients with end-stage renal disease compared with the general population. Kidney Int 2000;58(4):1758–64.

[4]. Sarnak MJ, Jaber BL. Pulmonary infectious mortality among patients with end-stage renal disease. Chest 2001;120(6):1883–7.

[5]. Sitter T, Schmidt M, Schneider S, Schiffl H. Differential diagnosis of bacterial infection and inflammatory response in kidney diseases using procalcitonin. J Nephrol 2002;15(3):297–301.

[6]. Herget-Rosenthal S, Marggraf G, Pietruck F, Hüsing J, Strupat M, Philipp T et al. Procalcitonin for accurate detection of infection in hemodialysis. Nephrol Dial Transplant 200;16(5):975–9.

Abstract: Background: Malnutrition goes hand in hand with immunosuppressed children. There are few studies describing the prevalence and determinants of malnutrition among children with HIV/AIDS in India. Aim: The present study is to determine the prevalence of malnutrition in HIV positive children in the age group of 0 – 5 yrs in tertiary care center and to correlate the immune status with malnutrition in these children. Material and Methods: From 2011 to 2012, we conducted a cross-sectional study among 213 ART-treated HIV-positive children in the age group of 0-5 years who were referred to Niloufer Institute for women and child health, India. We measured the children's anthropometrics, socio-demographic factors, food security, dietary habits, diarrhea episodes, economic status, and HIV clinical stage. Data were analyzed using both univariate and multivariate methods.

[1]. FANTA (2003). Nutritional Care for Young Children infected with HIV or born to HIV-infected mothers. Nutrition and HIV/AIDS: A Training Manual.
[2]. WHO AND FAO (2002). Living well with HIV/AIDS. A manual on nutritional care and support for people living. Rome.
[3]. National Conference On Nutrition and HIV/AIDS: From Knowledge to Action(Thursday, February 14- Friday, February 15, 2008) ,Pride Hotel, Nagpur ,Conference Report.
[4]. ―Nelson textbook of pediatrics – 19TH edition part 17, section 13, 268 chapter, page -1158-115.
[5]. Kumar N, Gupta N, Kishore J. Kuppuswamy's socioeconomic scale: Updating income ranges for the year 2012. Indian J Public Health 2012;56:103-4
[6]. World Health Organization WHO case definitions of HIV for surveillance and revised clinical staging and immunological classification of HIV-related disease in adults and children. World Health Organization, Geneva: 1-52. Available online at www.who.int/hiv/pub/guidelines/hivstaging150307.pdf, 2007

Abstract: Epidural analgesia has many beneficial effects in paediatric patients. In clinical practice, it is commonly used to augment general anaesthesia and to manage postoperative pain1,2. Effective postoperative pain relief from epidural analgesia has numerous benefits including early mobilization; reduced time spent in a catabolic state and lowered circulating stress hormone levels with less emergence reaction3. Precise placement of epidural needles and catheters for single-shot and continuous epidural anaesthesia ensure the dermatomes involved in the surgical procedures are selectively blocked, allowing for lower doses of local anesthetics and sparing of unnecessary blockade in the regions where blockade is not desirable.

[1]. Morgan GE, Mikhail MS. Paediatric Anaesthesia. In: Morgan GE, Mikhail MS, ed. Clinical Anaesthesiology Appleton & Lange. 1996; 726-742. [2]. Dalens B, Hasnaoui A Caudal anesthesia in paediatric surgery: success rate and adverse effects in 750 con¬secutive patients. Anesth Analg 1989; 68:83-89. [3]. Weldon BC, Bell M, Craddock T. The effect of caudal analgesia on emergence agitation in children. Anesth Analg. 2004;98:321–326. [4]. Wolf AR, Valley RD, Fear DW, Roy WI, Lerman J. Bupivacaine for caudal analgesia in infants and children: The optimal effective concentration. Anaesthesiology 1988 ;69:102-106. [5]. Ozkan S ,Pocan S, Bahar A, et al .The effect of caudal bupivacaine vs tramadol in posoperative analgesia in paediatric patients. The Journal of International Medi¬cal Research2003; 31:497-502. [6]. Nagiub M, Sharif AM, Seraj Iv1 ElGammal M, Dawlatly AA Ketamine for caudal analgesia in children: com¬parison with caudal bupivacaine. Br J Anaesth 1991; 67:559-564.

Abstract: Aim: Human heart valve is a vital structure and knowledge about the normal anatomy of heart valve circumference is important for assessing the valve pathologies and also in valve replacement surgery for a deceased valve. Thus the present study was done to assess the exact dimension of the annular circumference of all the valves in formalin fixed human hearts. Materials and Methods: The study was carried out in 50 formalin fixed hearts procured from human cadavers. Circumferences of all the valves were measured in all the specimens. Results: The Average annular circumference of the tricuspid valve was found to be 10.372 cm, mitral valve was 8.285 cm, aortic valve was found to be 7.542 cm and the pulmonary valve was 6.823 cm.

[1]. Vanhanian A, Baumgartner H, Bax J, Butchart E, Dion R, Filippatos G et al. Guidelines on the management of valvular heart disease. The taskforce on the management of valvular heart disease of the European Society of Cardiology. Europ Heart J 2007; 28:230–68.
[2]. Suman Bhandari, K Subramanyam, N Trehan. Valvular Heart Disease: Diagnosis and Management. JAPI • vol. 55 • August 2007.
[3]. Gupta C., Shetti VR, Manju BVM. Dimensions of the human adult mitral valve in the embalmed cadaver. Journal of Morphological Science, 2013, vol. 30, no. 1, p. 6-10.
[4]. Kouji Chida et al. A morphological study of normally ageing heart.Cardiovasc Pathol 1994 Jan-Mar; 3(1):1-7
[5]. Westaby S, Karp RB, Blackstone EH, Bishop SP. Adult human valve dimensions and their surgical significance. Am J Cardiol. 1984 Feb 1; 53(4):552-6.
[6]. Krishnaiah M and Mrudula C. Aortic Orifice Measurement – Cadaveric and Echocardiographic Study. October -December 2012 RJPBCS Volume 3 Issue 4 :914-920

Abstract: A 4 year male child born to 3RD degree consangious parents presented with fever and loss of head control since morning,the loss of head control was sudden and was associated with pain.Preliminary examination revealed hypokalaemia and ABG revealed metabolic acidosis with normal anion gap. Urinary studies suggested ph is 6.0,urinary electrolytes suggested normal anion gap. Calcium creatinine ratio was high(1402.4mg/g) creat. Renal tubular acidosis (RTA) is a constellation of syndromes arising from different derangements of tubular acid transport. The case reported here has features of distal renal tubular acidosis with normal anion gap metabolic acidosis and urinary normal anion gap.

Keywords: RTA(RENAL TUBULAR ACIDOSIS)

[1]. Albright F, Burnett CH, Parson W. Osteomalacia and late rickets; the various etiologies met in the United States with emphasis on that resulting from a specific form of renal acidosis, the therapeutic indications for each etiological sub-group, and the relationship between osteomalacia and Milkman's syndrome. Medicine 1946. Dec;25(4):399-479 10.1097/00005792-194612000-00002 [PubMed] [Cross Ref]

[2]. Batlle D, Moorthi KM, Schlueter W, Kurtzman N. Distal renal tubular acidosis and the potassium enigma.Semin Nephrol 2006. Nov;26(6):471-478 10.1016/j.semnephrol.2006.12.001 [PubMed] [Cross Ref]

[3]. Karet FE. Inherited distal renal tubular acidosis. J Am Soc Nephrol 2002. Aug;13(8):2178-2184 10.1097/01.ASN.0000023433.08833.88 [PubMed] [Cross Ref]

[4]. Karet FE, Finberg KE, Nelson RD, Nayir A, Mocan H, Sanjad SA, et al. Mutations in the gene encoding B1 subunit of H+-ATPase cause renal tubular acidosis with sensorineural deafness. Nat Genet 1999. Jan;21(1):84-90 10.1038/5022 [PubMed] [Cross Ref]

[5]. Nicoletta JA, Schwartz GJ. Distal renal tubular acidosis. Curr Opin Pediatr 2004. Apr;16(2):194-198 10.1097/00008480-200404000-00014 [PubMed] [Cross Ref]

Abstract: A 2 month male child born to 3RD degree consangious parents presented for convulsions 2 hour before admission.Preliminary investigations revealed low blood glucose.Further Investigations revealed hyperinsulinemichypoglycemia,Child was managed with intravenous glucose. Persistent hyperinsulinemic hypoglycemia of infancy (PHHI) represents the most common cause of hyperinsulinism in neonates.Severe recurrent hypoglycemia associated with an inappropriate elevation of serum insulin, C-peptide, and proinsulin levels defines congenital hyperinsulinism.If left untreated,congenitalhyperinsulinismcan lead to mortality and morbidity. Keywords: PersistentHyperinsulinemic hypoglycemia(PHHI),Neonatal hypoglycaemia

[1]. Mazor-Aronovitch K, Gillis D, Lobel D, Hirsch HJ, Pinhas-Hamiel O, Modan-Moses D, Glaser B, Landau H: Long-term neurodevelopmental outcome in conservatively treated congenital hyperinsulinism. [2]. Eur J Endocrinol 2007, 157(4):491-497. PubMed Abstract | Publisher Full Text [3]. Stanley CA, De Leon DD: Monogenic Hyperinsulinemic Hypoglycemia Disorders. 1st edition. Basel: Karger; 2012. [4]. Touati G, Poggi-Travert F, Ogier de Baulny H. Long-term treatment of persistent hyperinsulinaemic hypoglycemia of infancy with diazoxide: a retrospective review of 77 cases and analysis of efficacy-predicting criteria. Eur J Pediatr. 1998;157(8):628–633. et al.

Abstract: Objective: The present study evaluates the correlation among vertical dimension of occlusion, eye - ear distance of both right and left sides and the length of the little finger of the right hand. Material and methods: A cross-sectional study was conducted on 200 dentate subjects selected both males and females were involved in the study. Measurements of vertical dimension of occlusion were recorded clinically using modified digital vernier caliper, with the person is seated correctly on the dental chair in an upright position; and instructed to close his teeth in centric occlusion. The ear-eye distances were recorded for the right andleft sides. In the same way, length of little finger of right hand was measured from tip of finger to the further most point on palmer digital crease. The measurements were taken with the hand straight and flat.

[1]. Glossary of Prosthodontic terms 8th Ed. J Prosthet Dent 2005; 94:10-85.
[2]. Jackson C. Prediction of hemispheric asymmetry as measured by handedness from digit length and 2D:4D digit ratio. Laterality 2008; 13:34-50.
[3]. Unger J.W. Comparison of vertical morphologic measurements on dentulous and edentulous patientsJProsthet Dent 1990; 64:232-234.
[4]. McCord J.F., Grant A.A., Registration stage II inter-maxillary relation. Brit Dent J 2000; 188:601-606.
[5]. Millet C., Jeannin C. Vertical dimension in complete denture. J EMCO dont 2005; 1:13-28.
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Abstract: Introduction: Myopia is one of the most prevalent disorders of the eye. High myopia is associated with comorbidities that increase risks of severe and irreversible loss of vision, such as retinal detachment, subretinal neovascularization, dense cataract, and glaucoma. In recent years, reports from population-based prevalence studies carried out in various geographical areas now give a clear picture of the current distribution of refractive error. This could lead to varied clinical presentation seen in different regions of the world. Objectives: This is a comparative study to know the frequency of fundal changes in different degrees of high myopia.

[1] Duke-Elder and Abrams D, System of ophthalmology Vol.5, Ophthalmic optics and Refraction (St.Louis, the CV. MosbyCo., 1970).
[2] Sperduto RD, Seigel D, Roberts J, Rowland M, Prevalence of myopia in the United States, Arch Ophthalmol. 101,1983, 405–407. [3] Wu HM, Seet B, Yap EP, Saw SM, Lim TH, Chia KS, Does education explain ethnic differences in myopia prevalence? A population-based study of young adult males in Singapore, Optom Vis Sci. 78,2001, 234–239. [4] French AN, Morgan IG, Burlutsky G, Mitchell P, Rose KA, Prevalence and 5- to 6-year incidence and progression of myopia and hyperopia in Australian schoolchildren, Ophthalmology.120(7), 2013, 1482–1491. [5] Wang Q, Klein BE, Klein R, Moss SE, Refractive status in the Beaver Dam Eye Study, Invest Ophthalmol Vis Sci. 35(13),1994, 4344–4347. [6]Katz J, Tielsch JM, Sommer A, Prevalence and risk factors for refractive errors in an adult inner city population, Invest Ophthalmol Vis Sci. 38(2), 1997,334–340.

Abstract: The purpose of this study is to evaluate the effect of various solvents namely ethanol, acetone and ethanol/water on the microtensile bond strength of one bottle, total etch adhesive systems applied to dry or moist dentin. Material and Methods: Forty eight non carious human upper first molars with roots removed and randomly divided into three groups of sixteen specimens each based on the bonding agents with different solvents were used in this study..Each group was further divided into subgroup A and B, with eight specimens each based on the moist or dry dentin surface treatment. Microtensile bond strength was checked using LLOYD - universal testing machine.

[1]. Maccro F. Nunes, Edward. J. Swift, Jorge Perdigao, Effects of demineralisation depth on microtensile bond strength to human dentin, J. Adhes Dent, 3, 2001, 137-143.
[2]. David H. Pashley, Ricardo M. Carvalho, Franklin R. Tay, Solvation of dried dentin matrix by water and other Polar solvents, Am J dent, 15, 2002, 97-102.
[3]. Anne Peutzfeldt, Erik Asmussen, Adhesive systems, Effect on bond strength of Incorrect use. J. adhesive Dent, 4, 2002, 233-242.
[4]. John Kanca III, Resin Bonding to wet substrate. I. Bonding to dentin. Spl. Report, Quin Int., 23, 1992, 39-41.
[5]. Claus-Peter Ernst, Tim Kotter, Anjavictor, Marginal integirty of self and total etching adhesives in two different application protocols, J Adhes Dent,6, 2004,25-32.

Abstract: According to Biomedical waste(Management and handling ) Rules, 1998 of India Biomedical waste means any waste which is generated during Treatment, Diagnosis or Immunization of Human beings or Animal or In research Activities pertaining there to or in the production or in testing of Biological. Aims and Objectives: 1)To Asses the Knowledge of all health personnel involved in the Biomedical Waste Management .2) To know the Attitude of all health personnel involved in Biomedical Waste management .3) To Asses the practices of all health personnel involved in Biomedical Waste Management.

[1] Sharma M (2002): Hospital waste management and its monitoring, (1 st edi.), Jaypee Brothers Medical Publication.

[2] Mahmood M, Shahab S, Malik R, Azim W. A study of waste generation, collection and disposalin a tertiary hospital. Pak J Med Res, 2001;40:13-17 [3] Ather S. Hospital waste management. J Coll Physicians Surg Pak 2004;14:645-6.

[4] Uysal F, Tinmaz E. Medical waste management in Trachea region of Turke,.Waste Manag Res 2004;22:403-7.

[5] Hashmi SK, Shahab S. Hospital and biomedical waste management. In: Iliyas M, Editor, Community medicine and public health. 4th ed. Karachi: Time Publishers,2003, pp. 426-37.

[6] Gordon JG, Rein Hardt PA, Denys GA (2004): Medical waste management. In: Mayhall CG (EDs.), Hospital epidemiology and infection control, (3rd ). Lippincott Williams and Wilkins publication, pp : 1773-85.

Abstract: Gardner's syndrome is a rare autosomal dominant disease characterized by the presence of colonic polyposis, osteomas and a multitude of soft tissue tumors.The syndrome associated intestinal polyps have a 100% risk of malignant transformation. Early identification and surgical intervention when indicated are important to prolong the life of the patient. The presence of multiple osteomas, multiple unerupted teeth, can give an alarming sign to dentist to screen for other associated features in asymptomatic patients. We report two such cases to emphasize the importance of an early diagnosis of Gardner's syndrome through the detection of lesions appearing in the oral and maxillofacial area.

Key words: Gardner's syndrome, Intestinal polyposis, Osteomas.

[1]. Jonathan Butler, Claire Healy, Mary Toner, Stephen Flint. Gardner syndrome—review and report of a case. Oral Oncology Extra. 2005; 41:89–92.
[2]. Maryam Aletaha, Hamid Fateh-Moghadam. Gardner Syndrome. Journal Of Ophthalmic And Vision Research. 2012; 7(3):257-260.
[3]. A. Y. Oner and S. Pocan. Gardner's syndrome: A case report.British Dental Journal. 2006; 200(12):666-667.
[4]. Arora M, Deora SS, Arora Pand Saluja P Gardener Syndrome: A Rare Case Report Dentistry. 2014; 4:5.
[5]. Chi-hua Chang, Jeniffer yap-Chng Yung, Yi-Chia Chang, Rong-Wu Yang, Wei-Fan Chiang. Multiple Oral and Maxillofacial Osteomas are Important Early Signs of Gardner Syndrome A Case Report. Taiwan J Oral Maxillofac Surg.2013;24:101-109.
[6]. Abdulkadir Burak Cankaya, Mehmet Ali Erdem, Sabri Cemil Isler, Muhsin Cifter, Vakur Olgac, Cetin Kasapoglu, Cuneyt Korhan Oral.Oral and Maxillofacial Considerations in Gardner's Syndrome.International Journal of Medical Sciences tertilrlfeiclcieces.2012; 9(2):137-141.

Abstract: Pseudomonas aeruginosa is a gram negative bacteria with unipolar motility which causes various diseases in animals including humans. It is an aerobic bacteria and an opportunistic one for both plant and animals. It is present in water bodies, soil environment and manmade environment too. It gives positive result with citrate, oxidase and catalase test. It can prevail not only in natural environment but also in HYPOXIC atmosphere. It lives on a variety of organic matter obtained from animals and mainly infects areas with damaged tissues or with less immunity. The most basic symptoms include inflammation and sepsis. The infection in organs like lungs, kidney, urinary tract can prove to be fatal.It is also responsible for causing gingivitis in humans which results in bleeding gums and loosening of teeth.

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Abstract: The subject of the smile and facial animation as they relate to communication and expression of emotion is of great interest to in dentistry. Obtaining a beautiful smile is always the main objective of any aesthetic dental treatment. The gummy smile is a condition characterised by an excessive display of maxillary gingivae during smiling. One cause of excessive gingival display is the muscular capacity to raise the upper lip higher than average. Several surgical procedures have been reported to improve the condition, but surgery always involves risk and is costly. Botulinum toxin type A (BTX-A) (Botox; Allergan, Irvine, Calif) has been studied since the late 1970s for the treatment of several conditions associated with excessive muscle contraction or pain.Injection with BTX-A at preselected sites is a novel, cosmetically effective, minimally invasive alternative for the temporary improvement of gummy smiles caused by hyperfunctional upper lip elevator muscles.

Keywords: Botulinum toxin, excessive gingival display, unesthetic smiles,facial muscles.

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[4]. Kokich VO Jr, Kiyak HA, Shapiro PA. Comparing the perception of dentists and lay people to altered dental esthetics. J Esthet Dent 1999; 11:311-24.
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[6]. Garber DA, Salama MA. The aesthetic smile: diagnosis and treatment. Periodontol 2000. 1996; 11:18–28.
[7]. P J Sandler, F Alsayer, S J Davies. Botox: a possible new treatment for gummy smile. Virtual Journal of Orthodontics 2007 February 20; 7 (4): p. 30-34

Abstract: Since Anatomy is a volatile subject, for retention it requires repeated reading. As a result of its volatility, about a quarter of our students fail in the first attempt in the final examinations at the end of the first year. Various methods like internal assessment (mandatory), Problem based learning (PBL), Self directed Learning (SDL) etc. have been tried but they have failed to make an impact on their performance. To assess the effectiveness of Surprise test as an informal formative assessment method which will help improve the pass percentage in Anatomy during the Final examinations.

1. Dr Vasudha Kulkarni & Dr Shylaja D K Assistant Professors of Anatomy, DR B R Ambedkar Medical College, Bengaluru 45, 2. .Dr Jayashree Seeri ,Professor & Head, Department of Preventive and Social Medicine , BGS Medical college and Hospital, Bengaluru, Karnataka

Abstract: The diameter of portal vein is variable according to gender, age, weight, height, body mass index (BMI) and with factors like, respiration, postural changes and absorptive state. Therefore, this study was conducted to determine the normal portal vein diameter and to evaluate its relationship with parameters like age, gender distribution, weight, height and body mass index (BMI). A total of 108 healthy individuals age ranged from 15 to 85 years attending Radiodiagnosis department were chosen for the study. Variables were: sex, age, weight, height, basal metabolic rate (BMI), portal vein diameter respectively. Transabdominal ultrasound was done to measure the diameter of the main portal vein with average of three times measurements. In present study, the portal vein diameter in males and females were 9.17±2.33 mm and 8.55±1.90 mm respectively. The diameter correlated with weight and BMI in total adult population and females but in males none of the body parameters were correlated significantly.

KeyWords: Portal vein, Portal vein diameter, Ultrasound

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[7]. Ravi Shankar.G Shailaja Shetty , Srinath.M.G , Roopa Kulkarni. Estimation of Portal Vein Diameter in co – Relation with the Age, Sex and Height of An Individual. Anatomica Karnataka 2011;5(2):13-6.
[8]. Yazdi HR, Sotoudeh H. Assessment of Normal Doppler Parameters of Portal Vein and Hepatic Artery in 37 Healthy Iranian Volunteers. Iran J Radiol. 2006;4:213–216.

Abstract: Even when utmost care is taken in the fabrication of denture there are always unforeseen problems that arise when the patient is attempting to adjust to the new denture. These problems may be comfort , functions , esthetics and phonetics .Post insertion care plays vital role in maintaining biological health of oral mucosa. Poor hygiene maintenance leads to growth of adverse microflora, which initiates various diseased conditions like denture sore mouth or Oral thrush which is also called as denture stomatitis

[1]. J. D. Shulman , F. Rivera-Hidalgo and M. M. Beach . Risk factors associated with denture stomatitis in the United States. Journal of Oral Path & Med 2005;34:340-346.
[2]. F. R. Pires , E. B. D. Santos , P. R. F. Bonan , O. P. De Almeida and M. A. Lopes . Denture stomatitis and salivary Candida in Brazilian edentulous patients. Jour of Oral Rehab 2002;29:1115-1119.