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

Abstract: A hemangioma is an abnormal proliferation of blood vessels that may occur in any vascularized tissue. Considerable debate exists as to whether these lesions are neoplasms, hamartomas, or vascular malformations.. Skeletal muscle is the most common site for hemangioma of the deep soft tissue. Hemangioma of bone may be symptomatic or may be purely an incidental finding. We hereby present 3 cases of hemangioma occurring at different locations confirming the wide spectrum of hemangioma in orthopedics.

Keywords: Angiomatosis,Haemangioma: cavernous,capillary,epithelioid.

[1]. atlasgeneticsoncology.org/Tumors/HaemangiomBoneID5358.html
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[3]. A. T. Wild, P. Raab, R. Krauspe, Hemangioma of skeletal muscle. Archives of Orthopaedic and Trauma SurgeryFebruary 2000, Volume 120, Issue 3, pp 139-143 [4]. A. Cotten., R. -M. Flipo, B. Herbaux, F. Gougeon, M. Lecomte-Houcke, P. Chastanet, Synovial haemangioma of the knee: a frequently misdiagnosed lesion. Skeletal Radiology, May 1995, Volume 24, Issue 4, pp 257-261.

Abstract: Bilateral tubal pregnancies in the absence of preceding induction of ovulation are a rare event with an incidence of 1 in 725 to 1 in 1580 ectopic pregnancies. The diagnosis is usually made intraoperatively. Case: We report a 24 yrs woman without any risk factor of ectopic pregnancy had spontaneous left sided unruptured tubal ectopic and right sided ruptured tubal ectopic pregnancy. Ultrasonography revealed a 4.3 x 3.2cm left adnexal mass suggestive of ectopic pregnancy, uterine cavity was empty and large amount of fluid was seen in the pelvis. The diagnosis of bilateral tubal ectopic was made intraoperatively. Left sided sarpingostomy & right sided partial surpingectomy were performed. Histopathological examination confirmed synchronous bilateral tubal ectopic pregnancy.

[1]. A. L. Awwad, Mona M., A.L. Daham, Nora, Esset, John S. — Spontaneous un-ruptured bilateral ectopic pregnancy: conservative tubal surgery. Obstetrical and Gynaecological Survey. 54(9):543-544, 1991.
[2]. Health Canada. Canadian Perinatal Health Report, 2003. Ottawa: Minister of Public Works and Government Services Canada, 2003.
[3]. Current Trends Ectopic Pregnancy - United States, 1990-1992. MMWR 1995, Jan 27;44(03):46—8.
[4]. Rock JA, Howard WJ. Ectopic Pregnancy. In: Tel inde's Operative Gynecology, 9th Edition. Philadelphia: Lippincott, Williams and Wilkins; 2003: 507—36.
[5]. Summer FM, Reisenberger K, Bogner G, Nagele F. laparoscopic management of an unrecognized spontaneous bilateral tubal pregnancy. Acta Obstet Gynecol Scand 2002;81:366-8.
[6]. Andrews J, Farrell S. Spontaneous bilateral tubal pregnancies: a case report. J Obstet Gynaecol Can. 2008;30:51-4. PubMed PMID: 18198068.
[7]. Othman M, Karali S, Badawi K, Mossa H. Bilateral ectopic pregnancy: case report. Webmed Central Obstetrics and Gynecology. 2013;4:WMC004354.

Abstract: Introduction: Vaginal discharge is a commonest complaint among women in reproductive age group. Infective vaginal discharge can be broadly categorized into vaginitis or mucopurulent cervicitis. Vaginitis is caused by Bacterial Vaginosis, Vaginal Candidiasis, Vaginal Trichomoniasis etc. Mucopurulent cervicitis is due to Chlamydia or Gonococcal infection. Trichomoniasis caused by Trichomonas Vaginalis, diagnosis is confirmed by demonstration of actively motile organism with jerky movements on wet mount. Mucopurulent cervicitis caused by C. Trachomatis or N. Gonorrhoeae which typically produces yellowish discharge. The presence of gram-negative intracellular diplococci on gram stain gives a presumptive diagnosis of gonorrhoeae. On Pap smear Bacterial Vaginosis is diagnosed by identifying coccobacilli or clue cells, Trichomonas Vaginalis by trophozite and Candidiasis by fungal hyphae or budding yeasts.

[1]. Anderson MR, Klink K, Cohrssen A: Evaluation of vaginal complaints. JAMA 2004; 291 (11):1368-1379.
[2]. Amsel R, Totten PA, Speigel CA, et al. Nonspecific vaginitis: Diagnostic criteria and microbial and epidemiological association. Am J Med 1983; 74: 14-22.
[3]. Dunkelberg WE: Diagnosis of Haemophilus vaginalis by gram stained smears. Am J Obstet Gynecol 1965; 91:998-1000.
[4]. Oriel JD, Patridge BM, Denny MJ, et al. Genital yeast infections. Br Med J 1972; 761-4.
[5]. Briselden AM and Hiller SL. Evaluation of Affirm VP Microbial Identification test for Gardnerella vaginalis and Trichomonas vaginalis. J Clin Microbiol 1994; 32: 148-152.
[6]. Chandeying V, Skov S, Kemapunmanus M, Law M, Geater A, Rowe P. Evaluation of two clinical protocols for the management of women with vaginal discharge in southern Thailand. Sex Transm Inf 1998;74:194-201.

Abstract: Infantile hypertrophic pyloric stenosis (IHPS) is the most common gastrointestinal disease occurring in the first few weeks of life presenting as gastric outlet obstruction. IHPS occurs much more frequently in males than in females. In the present study, we retrospectively analysed 44 infants with IHPS comprising 36 males and 8 females (4.5:1). Majority (61.36 %) were diagnosed in the 5th and 6th week, even though 65.9 % had the initial symptom onset in the 2nd and 3rd week with mean delay in diagnosis of 22 days. The mean age at presentation was of 40.18  11.68 days. Most patients had acid base imbalance and electrolyte imbalance; elevated bicarbonate level (HCO3>25 mmol/L) was observed in 27 patients (81.8 %), pH was above 7.45 in 26 of 33 patients (78.79 %), hypochloraemia (Cl<95 mmol/L) was found in 31 of 44 (77.27 %), hyponatraemia (<135 mmol/L) was observed in 23 patients (52.27 %), and 27 patients (61.36 %) displaying hypokalemia (<3.5 mmol/L). All infants underwent successful open pyloromyotomy. Keywords: Infantile hypertrophic pyloric stenosis, pyloromyotomy, electrolyte imbalance, acid-base imbalance.

[1]. Habbick BF, To T. Incidence of infantile hypertrophic pyloric stenosis in Saskatchewan, 1970–85. CMAJ 1989; 140:395–398.
[2]. Applegate MS, Druschel CM. The epidemiology of infantile hypertrophicpyloric stenosis in New York State, 1983 to 1990. Arch PediatrAdolesc Med,1995; 149:1123–1129.
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[4]. Willschke H, Machata AM, Rebhandl W, et al. Management of hypertrophic pylorus stenosis with ultrasound guided single shot epidural anaesthesia --- a retrospective analysis of 20 cases. Pae-diatrAnaesth. 2011;21:110---5
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[6]. Mitchell LE, Risch N. The genetics of infantile hypertrophic pyloric stenosis. A reanalysis. Am J Dis Child,1993; 147:1203–1211.
[7]. Hernanz-Schulman M. Infantile hypertrophic pyloric stenosis. Radiology,2003;227:319–331.
[8]. Feng Z, Nie Y, Zhang Y, Li Q, Xia H, Gong S, Huang H. The Clinical Features of Infantile Hypertrophic Pyloric Stenosis in Chinese Han Population: Analysis from1998 to 2010. PLoS ONE,2014; 9(2): e88925.

Abstract: AIMS & OBJECTIVES: To compare the outcome of Single incision multiport laparoscopic appendicectomy Vs Conventional laparoscopic appendicectomy in terms of :Patient recovery time ,Post operative pain in Karpaga Vinayaga Medical College And Hospital, Madhuranthagam. Materials & Methods: A randomised control study was done by alternation with sample size of 50 which divided into two groups(study group 25 and control group 25)and study period is from August 2012 to September 2014.

[1]. Ma Dolores Frutos, MD, PhD, Jesus Abrisqueta, MD, Juan Lujan, MD, PhD, Israel Abellan, MD, Pascual Parrilla, MD, PhDDisclosuresAnnals of Surgery. 2013;257(3):413-418. Prospective Study to Compare Laparoscopic Appendectomy Versus Umbilical Single-incision Appendectomy
[2]. Jie Ding, Yu Xia,Yu Xia,Zhong-Min Zhang,Zhong-Min Zhang,Guo-Qing LiaoDepartment of Gastrointestinal Surgery, Guizhou Provincial people's Hospital, Guiyang, China; Department of Gastrointestinal Surgery, Xiangya Hospital, Central South University Changsha, China. Electronic address: . Journal of Pediatric Surgery (Impact Factor: 1.38). 05/2013; 48(5):1088-1098. Single-incision versus conventional three-incision laparoscopic appendicectomy for appendicitis: A systematic review and meta-analysis.
[3]. Bong-Hyeon Kye, Junhyun Lee, Wook Kim, Dongjae Kim, and Dosang Lee. Journal of Laparoendoscopic & Advanced Surgical Techniques,Published in Volume: 23 Issue 5: April 29, 2013,431-436
[4]. Comparative Study Between Single-Incision and Three-Port Laparoscopic Appendectomy: A Prospective Randomized Trial Jin A Lee, Ki Young Sung, Jun Hyun Lee and Do Sang Lee, Published 2010 Aug;26260-264The Korean Society of Coloproctology Laparoscopic Appendectomy with a Single Incision in a Single Institute Zheng Pan,Zheng Pan,Xiao-Hua Jiang,Xiao-Hua Jiang,Jia-Hua Zhou,Jia-Hua Zhou,Zhen-Ling Ji,Zhen-Ling Ji Department of General Surgery, Zhongda Hospital, Southeast University, Nanjing, China. Surgical laparoscopy, endoscopy & percutaneous techniques (Impact Factor: 0.88). 04/2013; 23(2):208-11.

Abstract: Intestinal obstruction following Internal herniae is rare accounting for less than 4%, of which Paraduodenal hernias are the most common. A 42 yr male presented with abdomen pain & distension for two days, vomiting and obstipation for one day. Abdomen was distended with a tender mass in the left hypochondrium. X-ray showed dilated bowel loops. CT abdomen confirmed the diagnosis of small bowel obstruction. At laparotomy, impending gangrene of small bowel was visualized. A hernia sac to the left of 4th part of the duodenum was made out, with herniation of small bowel loops & twisting of the bowel along its axis resulting in vascular occlusion.

[1]. Al-khyatt W, Aggarwal S, Birchall J, Rowlands TE Acute intestinal obstruction secondary to left paraduodenal hernia: a case report and literature review. World J Emerg Surg 2013;8:5.
[2]. Brehm V, Smithuis R, Doornebosch PG. A Left Paraduodenal Hernia causing acute bowel obstruction: a case report. Acta Chir Belg 2006;106: 436-37.
[3]. Shetty P, Selvaraju K, Singh S. A left paraduodenal hernia causing recurrent small bowel obstruction : a case report. Webmed Central gastrointestinal 2010;1:WMC001308
[4]. Munir A, Saleem SM, Hussain S. Paraduodenal hernia - a case report. J Pak Med Assoc 2004;54:16263.
[5]. Surgical Anatomy : Skandalakais 2004 edition.
[6]. Mozaffar M, Hasani M, Fallah M, Sobhiyeh MR, Adhami F. A Left Paraduodenal Hernia causing bowel obstruction: a case report. Gastroenterol Hepatol Bed Bench 2013;6(1):48-51

Abstract: les métastases buccales d'un cancer du sein sont très rares. Peu de cas ont été rapportés dans la littérature. A travers cet article nous rapportons un cas rare de cancer du sein multifocal soumis à une chirurgie type patey. Dix ans après la mammectomie, la patiente a consulté pour une métastase gingivale et mandibulaire homolatérale.

Keywords : carcinome, immunohistochimie, métastase gingivale, mammectomie.

[1] Hirshberg A, Buchner A, Metastatic tumours to the oral region. An overview, Eur J Cancer B Oral Oncol.,31B(6), 1995, 355-60.

[2] Amit Thorawat , Venkatesh G Naikmasur , Preeti Patil , Priya Perumal, Secondary Metastasis to the Mandible From Breast Carcinoma –A Rare Case Report, Journal of Clinical and Diagnostic Research, Vol-9(7), 2015 ZD25-ZD26.

[3] Ryba F, Rice S, Hutchison IL, Numb chin syndrome: an ominous clinical sign, Br Dent J. 208, 2010, 283-85.

[4] Sarra Bouslama, Monia Omezzine, Habib Khochtali, Métastases mandibulaires : présentation de 8 cas, Med Buccale Chir Buccale, 16,2010, 247-253

[5] Stavropoulos MF, Ord RA, Lobular adenocarcinoma of breast metastatic to the mandibular condyle: report of a case and review of the literature, Oral Surg Oral Med Oral Pathol, 75, 1993, 575-78.

Abstract: Introduction: Hyponatremia is a common electrolyte disturbance in acute central nervous system disease and its potential for neurological sequelae make its diagnosis mandatory before any therapeutic intervention.Due to lack of consensus on this subject, fluid management and management of hyponatremia in CNS infections is still not well defined.The present study was hence taken up to outline the probable incidence, etiology and prognostic value of hyponatremia with acute CNS disorders in children.

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[4]. Von Vigier RO, Colombo SM, Stoffel PB, Meregalli P, Truttmann AC, Bianchetti MG. Circulating sodium in acute meningitis Am J Nephrol 2001;21(2):87-90
[5]. Subba Rao SD,ThomasB. Electrolyte abnormalities in children admitted to pediatric intensive care unit Indian Pediatr 2000;37:1348-1353
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[7]. Menon RK, Sharma V, Siddiqui HH, Bhide NK, Ghai OP. Syndrome of inappropriate secretion of antidiuretic hormone (SIADH) in children with meningoencephalitis. Indian J M Res 1983; 77:373-6.

Abstract: Introduction: The human organs and tissues function under a tightly controlled pH in the range of 7.35 to 7.45. Depending on the degree of deviation of pH outside this narrow range, several homeostatic responses are activated in an effort to restore normal acid base status. Objective: To study the acid - base disturbances in sick neonates admitted in NICU of Niloufer hospital, Hyderabad. Materials And Methods: Hundred neonates (from first hour to one month of age) attending pediatric emergency services with various ailments. Arterial blood gas (ABG) analysis was estimated in these neonates. Ethical committee approval was taken.

[1]. Lekhwani S, Shanker V, Gathwala G, Vaswani ND. Acid-base disorders in critically ill neonates. Indian J Crit care Med 2010; 14:65-9 [2]. Rocktaeschel J, Morimatsu H, Uchino S, Goldsmith D, Poustie S, Story D, et al. Acid-base status of critically ill patients with acute renal failure: analysis based on Stewart-Figge methodology. Crit Care 2003; 7:60-6
[3]. Otieno H, Were E, Ahmed I, Charo E, Brent A, Maitland K. Are bedside features of shock reproducible between different observers? Arch Dis Child 2004; 89:977-9.
[4]. Indian j Crit Care med April –June 2010 Vol 14 issue 2 page 57-64.Interpretation of ABG Pramod sood, Sandeep Puri
[5]. Disorders of Acid Base Status by E.AL Khadra, Chapter 2, pages 20-30, Pediatric Nephrology in the ICU.
[6]. Acid-base disorders,dr. Bibhukalyani Das,Indian J. Anaesth. 2003:47 (5): 373-379 373
[7]. Henderson LJ, The theory of neutrality regulation in the animal organism. Am J Physiol 1908; 21:427-48

Abstract: Body mass index (BMI), fat mass index (FMI) and fat free mass index (FFMI)areusually widely used to assess the prevalence of obesity.Abdominal obesity is associated with high plasma triglyceride and with low plasma high density lipoprotein cholesterol levels. Anatomical adipose tissue distribution patterns are reported to relate to plasma lipids and risk of cardio metabolic diseases. The present study examined the association of BMI, FMI,FFMI and metabolic markers as cardio-metabolic risk factors of mid age men in West Bengal, India. A total of 40 mid age men of sedentary habits aged 35-55 years participated in this study. Age, height, weight were measured as personal data. Body mass index (BMI), fat mass index (FMI) and fat-free mass index (FFMI) were calculated by standard equations.The metabolic parameters, namely fasting blood glucose (FBG), triglyceride (TGc), Cholesterol (Ch), high-density lipoprotein (HDL), low-density lipoprotein (LDL) and very low-density lipoprotein (VLDL) were measured in the clinic.

[1]. Schreiner, P. J., Terry, J. G., Evans, G. W., Hinson, W. H., Grouse II, Jr. Heiss, G. (1996). Sex specific associations of magnetic resonance imaging-derived intra-abdominal and subcutaneous fat areas with conventional anthropometric indices. American Journal Epidemiology, 144, 335-345.
[2]. Sanchez-Castillo, C. P., Valazquez-Monroy, O., Berber, A., Lara-Esqueda, A., Tapia-Conyer, R., James, W. P. (2000). Anthropometric cutoff points for predicting chronic diseases in the Mexican. National Health Survey Obes Res, 11, 442-451.
[3]. World Health Organization (2000). WHO Technical Report Series 894. Geneva. Obesity: Preventing and Managing the Global Epidemic. Reprto of a WHO Consultation.
[4]. Frankenfield, D. C., Rowe, W. A., Cooney, R. N., Smith, J. S., Becker, D. (2001). Limits of body mass index to detect obesity and predict body composition. Nutrition, 17, 26-30.
[5]. Simpson, J. A., Lobo, D. N., Anderson, J. A., Macdonald, I. A., Perkins, A. C., Neal, K. R., et, al. (2001). Body water compartment measurements: a comparison of bioelectrical impedance analysis with tritium and sodium bromide dilution techniques. ClinNutr, 20, 339-343.

Abstract: Emphysematous pyelonephritis (EPN) is a severe acute necrotizing infection of the renal parenchyma and peri-renal tissue, characterized byintraparenchymal gas formation. EPN predominantly affects female diabetics, and can occur in insulin-dependent and non-insulin-dependent patients in the absence of ureteric obstruction. Nondiabetic patients can also develop EPN, but often have ureteric obstruction and do not seem to develop such extensive disease. Patients with EPN show relatively vague symptoms initially, but frequently undergo a sudden deterioration in their condition, necessitating urgent medical attention. We present four cases of EPN, two of whom were male and two were female. Of theses, 3 were diabetic and one presented as EPN, and on evaluation had type 2 DM. 3 were unilateral EPN and 1 was bilateral EPN. Early detection, use of higher antibiotics, control of blood sugar levels, management of fluid and electrolyte balance and early surgical intervention when required helped to reduce the morbidity and mortality of all the patients.

Keywords: Emphysematous pyelonephritis, Hyperglycaemia,Impaired fasting glucose, Renal failure

[1]. Carvalho M, Goulão J, Monteiro C, et al. Pielonefriteenfisematosa: revisão da literatura a propósito de um casoclínico. ActaUrol 2006;23:75–80.

[2]. Junior M, Ferreira G, Lopes H, Amaral K. Pielonefriteenfisematosa: revisão e atualização da abordagemterapêutica. HU Revista (Juiz de Fora) 2010;36:161–5.

Abstract: Aim: To study anisometropia and its relationship with amblyopia in the population of Manipur. Materials And Methods: This cohort study was undertaken among 150 anisometropic patients attending Eye OPD in the Department of Ophthalmology, Regional Institute of Medical Sciences, Imphal, Manipur for a duration of 2 years..

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[4] ASorsby,G A Leary, M J Richards, The optical components in anisometropia,, Vision Res, 2, 1962,43-51.

[5] SDadeya,Kamlesh, F Shibal , The effect of anisometropia on binocular visual function, Indian J Ophthalmol,49, 2001, 261–3.

[6] A Bradley ,R D Freeman , Contrast sensitivity in anisometropic amblyopia, Invest Ophthalmol Vis Sci, 21(3),1981,467-76.

[7] M XRepka, J M Holmes, Lessons from the amblyopia treatment studies, Ophthalmol, 119(4), 2012, 657-8.

Abstract: Early diagnosis and treatment of neonatal septicaemia is important to reduce the mortality associated with it. In this cross sectional study, 155 clinically suspected cases of neonatal septicaemia were collected for CRP screening & to study their etiological profile with antibiotic sensitivity pattern. Sensitivity of CRP was found to be 93.22%, specificity 84.38%, positive predictive value 78.57 % & negative predictive value 95.29%. Majority 59.32% of the cultures isolated gram negative bacilli, most commonly Klebsiella. Among these bacilli most effective antibiotics were imepenem and amikacin.

[1]. Kayange N, Kamugisha E, Mwizamholya DL, Jeremiah S and Mshana SE, Predictors of positive blood culture and deaths among neonates with suspected neonatal sepsis in a tertiary hospital, Mwanza-Tanzania, BMC Pediatr 2010;10: 39.
[2]. Roy I, Jain A, Kumar M, Agarwal S K. Bacteriology of neonatal septicaemia in a tertiary care hospitalof northern India. Indian J Med Microbiol 2002;20:156-159.
[3]. [Sprung CL, Sakr Y, Vincent JL, Le Gall JR, Reinhart K, Ranieri VM, Gerlach H, Fielden J, Groba CB,Payen D, An evaluation of systemic inflammatory response syndrome signs in the Sepsis OccurrenceIn Acutely Ill Patients (SOAP) study, Intensive Care Med 2006;32: 421-427.
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[6]. Tsering DC, Chanchal L, Pal R, Kar S, Bacteriological Profile of septicemia and the risk factors in Neonates and Infants in Sikkim, J Glob Infect Dis 2011; 3(1): 42-45.
[7]. Winn WC, Allen SD, Janda WM, Koneman EW, Procop GW, Schreckenberger PC, et al . Koneman'scolor atlas and textbook of diagnostic microbiology. 6th ed. Philadelphia: Lippincott Williams &Wilkins; 2006.
[8]. Clinical and Laboratory Standards Institute. Performance Standards for Antimicrobial Susceptibility Testing; 24 th Informational Supplement (M100-S24). Wayne, PA: Clinical and Laboratory StandardsInstitute; 2014.

Abstract: The purpose of this review is to fill the gap in knowledge of etiopathogenesis of human virus in periodontal diseases. Viruses may play an important role in pathogenesis of periodontal diseases. The role of viruses is significant, as they may induce abnormalities in the adhesion, chemotaxis, phagocytosis, and bactericidal activities of polymorphonuclear leukocytes. Associated with one another, viruses and bacteria have stronger periodontopathogenic potential than individually. It has also been suggested that gingival infection with certain herpes viruses, decreases the resistance of the periodontal tissue, thereby permitting subgingival overgrowth of periodontal pathogenic bacteria and thus, indirectly leading to periodontitis. For full understanding of viruses in periodontal disease, it is significant to know all etiologic factors and such an insight would lead to the better treatment of the disease.

Keywords: Etiopathogenesis, Herpes virus, Human Papilloma Virus, Human Immunodeficiency Virus, Periodontitis.

[1] Teles R, Teles F, Frias-Lopez J, Paster B and Haffajee A, Lessons learned and unlearned in periodontal microbiology, Periodontology 2000, 62, 2013, 95–162.
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[3] Yi-Ling Lin, Pei-Ching Chang , Yixiang Wang, and Mengtao L, Identification of Novel Viral Interleukin-10 Isoforms of Human Cytomegalovirus AD169, Virus Res., 131(2), 2008, 213–223.
[4] Contreras A, Botero J and Slots J, Biology and pathogenesis of cytomegalovirus in periodontal disease. Periodontology 2000, 64, 2014, 40–56.
[5] Pawar B, Tejnani A, Marwar P, Mani A, Herpes virus: A key missing piece of the periodontopathogenic jigsaw puzzle, Chronicles of young scientists, 3(4), 2012, 245-250.
[6] Contreras T, Zadeh, Nowzari H, Slots J, Herpesvirus infection of inflammatory cells in human periodontitis, Oral Microbial immunol 1994, 14, 206.

Abstract: There is a concern that laparoscopic appendicectomy for complicated appendicitis is associated with high incidence of intraabdominal abscess. But conflicting results are reported in the literature. Interestingly more and more appendicectomy are performed laparoscopically where resources are available. In this study we endeavoured to assess the incidence of intraabdominal abscess post appendicectomy for complicated appendicitis.

[1]. Wei B; Qi CL; Chen TF; Zheng ZH; Huang JL; Hu BG; Wei HB. Laparoscopic versus open appendectomy for acute appendicitis: a
metaanalysis. SurgEndosc. 2011; 25(4):1199-208 (ISSN: 1432-2218)
[2]. Asarias JR; Schlussel AT; Cafasso DE; Carlson TL; Kasprenski MC; Washington EN; Lustik MB; Yamamura MS; Matayoshi EZ;
Zagorski SM.􀀁Incidence of postoperative intraabdominal abscesses in open versus laparoscopic appendectomies.SurgEndosc.
2011; 25(8):2678-83 (ISSN: 1432-2218)
[3]. Ferranti F; Corona F; Siani LM; Stefanuto A; Aguzzi D; Santoro E. Laparoscopic versus open appendectomy for the treatment of
complicated appendicitis.G Chir. 2012; 33(8-9):263-7 (ISSN: 0391-9005)
[4]. Wang X; Zhang W; Yang X; Shao J; Zhou X; Yuan J.Complicated appendicitis in children: is laparoscopic appendectomy
appropriate? A comparative study with the open appendectomy--our experience.J Pediatr Surg. 2009; 44(10):1924-7 (ISSN: 1531-
5037)
[5]. Pokala N; Sadhasivam S; Kiran RP; Parithivel V. Complicated appendicitis--is the laparoscopic approach appropriate? A
comparative study with the open approach: outcome in a community hospital setting.Am Surg. 2007; 73(8):737-41; discussion 741-
2 (ISSN: 0003-1348)

Abstract: Objective: Our purpose was to determine the value of 3Dimentional CT in tibial plateau fractures of knee for characterization and to know the amount of displacement of fracture fragments for preoperative evaluation and surgical planning. This article shows the advantage of 3DCT over radiography and conventional C T in evaluation of plateau fractures . Materials And Methods: Thirty patients of knee trauma underwent CT with 3 dimentional CT reconstruction.The type of fractures and displacements are evaluated in all cases.

[1]. Diass J. J, Stirling. A. J, Finlay DBL, Gregg P.JET,:Computerised axial tomography for tibial plateau fractures, J 1987 British Editorial Society of Bone and Joint Surgery
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[5]. S.wickyP.F.Blaser,C.H.Blank,P .Flevvraj,P.schnyder, R.A.Meuli compared between standard radiography and spiral CT with 3D reconstruction in the evaluation, classification and management of tibial plateau fractures. EuropeanRadiology.2000;10(8):1227-1232

Abstract: Obstetric fistulas still occur in low and middle income countries due to a myriad of factors. The vesico-vaginal fistula and the recto-vaginal fistula are among the most common of the obstetric fistulas. We present the case of a cutaneo-vaginal fistula co-existing with a vesico-vaginal fistula in a patient who had an emergency caesarean section for prolonged obstructed labour. The socio-economic factors that led to her morbid state also prevented her from continuing her care.

Key words: Cutaneo-vaginal fistula, obstetric fistula, obstructed labour, Yenagoa.

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[5]. Guo S, DiPietro LA. Factors Affecting Wound Healing. Journal of Dental Research. 2010;89(3):219-229. doi:10.1177/0022034509359125.
[6]. Browning A (2004) Obstetric Fistula in Ilorin, Nigeria. PLoS Med 1(1): e2.

Abstract: People with mental illness frequently face stigma, prejudice and discrimination by both public and health care providers throughout the world. This study was taken up with objectives of studying influence of knowledge and sociodemographic factors on stigma and attitudes towards mentally ill patients.A study sample of 60 medical students each in first year and internees were administered Social distance scale(SDS) and Dangerousness scale(DS) to assess stigma and Medical condition regard scale (MCRS)to assess attitudes towards mental illness. A Semi structured proforma was used to note sociodemographic data and knowledge of study subjects towards aetiology, clinical features and diagnosis of mental illness.

[1]. WHO.World health organization mental health gap.Action programme (MHGAP)2008.available http//www.whoint/ mental_health/mhgap/en.

[2]. Math SB,Chandrasekhar CR,Bhugra D. Psychiatric epidemiology in India. Indian J Med Res 126,2007,186-92.

[3] . Khandelwal SK,Jhingan HP,Ramesh S,Gupta RK,Srivastava VK.lndian mental health Country profile. Int Rev Psychiatry ,16,2004,126-41.

[4]. Saxena S.Mental health Atlas chapter4.2.Geneva WHO;2011.Human resources work force p56-7. [5]. Corrigan PW,Markowitz F E and Watson AC .Structural levels of mental illness :Stigma and discrimination.Schizophrenia bulletin ,20(3),2004,481-491.

[6]. Wahl OF.News media portrayal of mental illness .American Behavioral Scientist,46,2003,1594-1600.

Abstract: A case of 43 year old male, HIV infected soldier started on HAART (ZLN) presented with a large anesthetic patch in Rt elbow and Lt sole with tingling sensation and numbness in Rt forearm . On examination there was large anesthetic and hypo pigmented patch with erythematous border over Rt elbow area and similar patch in Lt sole and also a hypo pigmented scaly plaque on Lt buttock with thickened Rt ulner nerve . Slit skin smear for AFB was Negative, Skin biopsy shows numerous well epitheloid granulomas with Langhan's giant cells. Features are of chronic granulomatous lesion consistent with Hansen's disease – tuberculoid type . Wade fite faraco stain shows no acid fast bacilli. He was diagnosed as a case of BT leprosy and in the background of HAART and increasing CD4 it was considered as a case of IRIS (Immune Reconstitution Inflammatory Syndrome)

Key words: Leprosy ,HIV, IRIS, HAART, MDT

[1]. Britton WJ, Lockwood DN. Leprosy. Lancet363(9416), 1209–1219 (2004)

[2]. Global leprosy situation, 2010. Wkly Epidemiol. Rec. 85(35), 337–348 (2010) [3]. Weekly Epidemiological Record.2007. Global leprosy situation. Wkly. Epidemiol. Rec.82:225–232

[4]. Shelburne, S. A., III, and R. J. Hamill.2003. The immune reconstitution inflammatory syndrome. AIDS Rev. 5:67–79.

[5]. Leonard G, Sangare A, Verdier M, et al. Prevalence of HIV infection among patients with leprosy in African countries and Yemen. J Acquir Immune Defic Syndr 1990;3:1109e13.

[6]. Pignataro, P., A. S. Rocha, J. A. Nery, et al.2004. Leprosy and AIDS: two cases of increasing inflammatory reactions at the start of highly active antiretroviral therapy. Eur. J. Clin. Microbiol. Infect. Dis.23:408–411.

Abstract: Melanin, a brown pigment, is the most common cause of endogenous pigmentation of gingiva and is the most predominant pigmentation of mucosa. Gingival hyperpigmentation are major concerns for a large number of patients visiting the dentist. Melanin hyperpigmentation usually does not present a medical problem, but patients usually complain of dark gums as unaesthetic. This problem is aggravated in patients with a "gummy smile" or excessive gingival display while smiling. Esthetic periodontal plastic surgery is especially rewarding in such individuals with compromised esthetics. This case series represents the management of excessive gingival pigmentation with scalpel, electrosurgical, and laser techniques with review of literature regarding advantages and disadvantages of various techniques.

Key words: depigmentation, gingival pigmentation, laser, periodontal surgery;

[1]. Tal H, Oegiesser D, Tal M. Gingival depigmentation by erbium: YAG laser: clinical observations and patient responses. J Periodontol. 2003; 74(11):1660-7.
[2]. Dummett CO, Barens G. Pigmentation of the oral tissues: A review of literature. J Periodontol 1967; 38:369-78.
[3]. Shafer WG, Hine MK, Levy BM. A Textbook of Oral Pathology. Philadelphia: W.B. Saunders Co.; 1984. p. 89-136.
[4]. Cicek Y. The normal and pathological pigmentation of oral mucous membrane: A review. J Contemp Dent Pract 2003; 4:76-86.
[5]. Kathariya R, A. R. Pradeep. Split mouth de-epithelization techniques for gingival depigmentation: A case series and review of literature. Journal of Indian Society of Periodontology - Vol 15, Issue 2, Apr-Jun 2011. 161-168.
[6]. Roshna T, Nandakumar K. Anterior Esthetic Gingival Depigmentation and Crown Lengthening: Report of a Case. J Contemp Dent Pract 2005 August ;( 6)3:139-147.
[7]. Fowler EB, Breault LG, Galvin BG. Enhancing physiologic pigmentation utilizing a free gingival graft. Pract Periodontics Aesthet Dent 2000; 12:193-6.
[8]. Yeh CJ. Cryosurgical treatment of melanin-pigmented gingiva. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1998; 86:660-3.
[9]. Ozbayrak S, Dumlu A, Ercalik-Yalcinkaya S. Treatment of melanin-pigmented gingiva and oral mucosa by CO2 laser. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2000; 90:14-5.
[10]. Atasawasuwan P, Greethong K, Nimmanon V. Treatment of gingival hyperpigmentation for esthetic purposes by Nd:YAG lasers; Report of 4 cases J Periodontol 2000 71(2):315-21.

Abstract: The Introduction: With the advances in minimally invasive techniques in past decade, Endoscopic third ventriculostomy (ETV) has gained popularity and revolutionized the management of hydrocephalus with several advantages, thus became the treatment of choice of obstructive hydrocephalus and for certain selected cases of communicating hydrocephalus. The outcome of this treatment with regard to age, cause remains controversial. Aim: to analyse the demographics and perioperative and post-operative complications and surgical outcome of ETV.

[1] Van Beijnum J, Hanlo PW, Fischer K, Majidpour MM, Kortekaas MF, Verdaasdonk RM, et al. Laser-assisted endoscopic third ventriculostomy: Long-term results in a series of 202 patients. Neurosurgery 2008;62:43743; discussion 443-4.
[2] Mohanty A, Santosh V, Devi BI, Satish S, Biswas A. Efficacy of simultaneous single-trajectory endoscopic tumor biopsy and endoscopic cerebrospinal fluid diversion procedures in intra- and paraventricular tumors. Neurosurg Focus 2011;30:E4.
[3] Morgenstern PF, Osbun N, Schwartz TH, Greenfield JP, Tsiouris AJ, Souweidane MM. Pineal region tumors: an optimal approach for simultaneous endoscopic third ventriculostomy and biopsy. Neurosurg Focus 2011;30:E3.
[4] Al-Tamimi YZ, Bhargava D, Surash S, Ramirez RE, Novegno F, Crimmins DW, et al. Endoscopic biopsy during third ventriculostomy in paediatric pineal region tumours. Childs Nerv Syst 2008;24:1323-6.
[5] Oppido PA, Fiorindi A, Benvenuti L, Cattani F, Cipri S, Gangemi M, et al. Neuroendoscopic biopsy of ventricular tumors: A multicentric experience. Neurosurg Focus 2011;30:E2.
[6] Roopesh Kumar SV, Mohanty A, Santosh V, Satish S, Devi BI, Praharaj SS, et al. Endoscopic options in management of posterior third ventricular tumors. Childs Nerv Syst 2007;23:1135-45.

Abstract: Osteoporosis is a multifactorial skeletal disease that is characterized by reduced bone mineral density (BMD). BMD values depend on several factors such as age, age at menopause & duration of menopause. Aim: The present study is conducted to assess bone mineral density measured by DEXA scan among post -menopausal women in Sulaimani governorate and to assess the association between BMI with status of BMD. Method: This study selected 390 postmenopausal women, from 1500 after exclusion of those at risk of secondary osteoporosis. The data gathered was age, age at menopause, duration of menopause, height and weight for body mass index (BMI) calculation. Bone mineral density measurements were carried out using Lunar iDXA, Encore 14, model 2008. The data were analyzed using SPSS package.

[1] Farzaneh Montazerifar, Mansour Karajibani, Sara Alamian et al . Age, Weight and Body Mass Index Effect on Bone Mineral Density in Postmenopausal Women. Health Scope. 3(2): e14075 , DOI: 10.17795/jhealthscope-14075. [2] Aghaei M, Afshan B, Reza H, Qorbani M, Dashti HS, Safari R. Bone mineral density in Iranian patients: Effects of age, sex, and body mass index. Open J Prev Med . 2013;3 (1):128–31. [3] McNamara LM. Perspective on post-menopausal osteoporosis: establishing an interdisciplinary understanding of the sequence of events from the molecular level to whole bone fractures. Journal of the Royal Society, Interface, 2010, 7:353–372. [4] Jongbae J. park, Joonshik Shin, Yousuk Youn, Catherine Champagne, Eunseok Jin, Soonsung Hong, Kwanhye Jung & Sunkyu Yeom. Bone mineral density, body mass index, postmenopausal period & outcome of low back pain treatment Korean postmenopausal women. European Spine journal, 19(11),2010,1942-1947

Abstract: Dementia is a neuro-communication disorder characterized by an impairment of the semantic memory responsible for processing meaning-related knowledge. The effect of dementia on semantic comprehension skill varies based on severity of dementia. In the same context, semantic memory has been described as the form of memory that allows humans to understand the meanings of words, objects, and events; to name and to produce meaningful statements; and to behave in a manner that reflects knowledge about the objects and events that exist in the environment. No standardized test has been documented till date for measuring semantic comprehension in dementia patients in Indian languages. With Bengali being the second widely spoken language in India (Census, 2001), the development and standardization of semantic comprehension test in Bengali was envised.

[1.] Bayles, K. A., Trosset, M. W., Tomoeda, C. K., Montgomery Jr, E. B., & Wilson, J. (1993). Generative naming in Parkinson disease patients. Journal of Clinical and Experimental Neuropsychology, 15(4), 547-562.
[2.] Bozeat, S., Lambon, A., Ralph, M. A., Graham, K. S., Patterson, K., Wilkin, H., Rowland, J. (2003). A duck with four legs: Investigating the structure of conceptual knowledge using picture drawing in semantic dementia. Cognitive Neuropsychology; 20:27–47.
[3.] Breedin, S. D., Saffran, E. M., Coslett, H. B. (1994). Reversal of the concreteness effect in a patient with Semantic Dementia. Cognitive Neuropsychology.; 11:617–660.
[4.] Craik, F.I. (2000). Age-related changes in human memory. Cognitive aging: A primer, 5,75-92.
[5.] Cortese, M. J., Balota, D. A., Marshall, S. D., Buckner, R. L., Gold, B. T. (2006). Consistency and regularity in past tense verb generation in healthy aging, Alzheimer‟s disease, and semantic dementia. Cognitive Neuropsychology; 23:856–876.
[6.] Funnell, E. (1996). Response biases in oral reading: An account of the co-occurrence of surface dyslexia and semantic dementia. Quarterly Journal of Experimental Psychology; 49A:417–446.