iosr-JDMS   Volume-14 ~ Issue-2 ~ February-2015

Abstract: Paragonimiasis is a food-borne zoonotic disease caused by the genus Paragonimus which usually results from the intake of uncooked or undercooked freshwater crab or crayfish. Manipur is a northeastern state of India which is endemic for paragonimiasis where the first Indo-Japan joint research on Paragonimus and paragonimiasis was conducted to study the life cycle, pathobiology, and morphological characterization of Paragonimus species in India. Diagnosis of paragonimiasis is often difficult due to lack of awareness and atypical presentation which usually mimic other chronic pulmonary illness such as tuberculosis. Diagnosis of paragonimiasis is by detection of ova in the sputum,pleural fluid or tissue specimen or serology. The disease can be successfully treated by praziquantel. Here we report a case of pulmonary paragonimiasis presented as right sided massive eosinophilic pleural effusion from an area endemic for paragonimiasis which was initially mistaken as smear negative pulmonary tuberculosis.

Keywords: Pleural effusion, Peuropulmonary, Paragonimiasis.

[1]. Singh TS, Sugiyama H, Rangsiruji A. Paragonimus&paragonimiasis in India. Indian J Med Res 2012;136: 192-4.
[2]. Singh TS, Mutum S, Razaque MA, Singh YI, Singh EY. Paragonimiasis in Manipur. Indian J Med Res 1993; 97 : 247-52.
[3]. Doanh PN, Le NT, Tat D. Paragonimusand paragonimiasis in Vietnam. In: Arizono N, Chai JY, Nawa Y, Takahashi Y, editors. Asian Parasitology 1. Food-borne helminthiasis in Asia. Chiba, Japan: Federation of Asian Parasitologists; 2005. p. 149-53.
[4]. Vidamaly S, Choumlivong K, Keolouangkhot V, Vannavong,N, Kanpitaya J, Strobel M. Paragonimiasis: A common cause of persistent pleural effusion in Lao PDR. Trans R Soc Trop Med Hyg 2009;103:1019-23
[5]. Mukae H, Taniguchi H, Matsumoto N, Iiboshi H, Ashitani J, Matsukura N, et al. Clinico-radiologic features of pleuropulmonary Paragonimuswestermani on Kyusyu Island, Japan. Chest 2001;120:541-50.
[6]. Sharma DC. Paragonimiasis causing diagnostic confusion with tuberculosis. Lancet Infect Dis 2005;5:538.

Abstract: Context:Prevalence of hypothyroidism is 2-4% in women in the reproductive age group. Hypothyroidism can affect fertility due to anovulatory cycles, luteal phase defects, hyperprolactinemia, and sex hormone imbalance. Objectives: To study the effect of clinical/sub-clinical hypothyroidism on fertility in infertility case and the response of treatment for hypothyroidism on fertility in cases of infertility. Methods: A total of 200 infertile women visiting the infertility clinic for the first time were investigated for thyroid stimulating hormone (TSH) and prolactin (PRL). Infertile women with hypothyroidism alone or with associated hyperprolactinemia were given treatment for hypothyroidism with thyroxine (12.5-150μg). Results: Of 200 infertile women 24% were hypothyroid (TSH >4.2 μIU/ml.).After treatment for hypothyroidism 77.08% infertile women conceived within 6 weeks to 1 year. Infertile women with both hypothyroidism and hyperprolactinemia also responded to treatment and their PRL levels returned to normal.

[1]. Poppe K, Velkeniers B, Glinoer D. The Role Of Thyroid Autoimmunity In Fertility And Pregnancy. Nat Clin Pract Endocrinol Metab. 2008;4:394-405.
[2]. Poppe K, Velkeniers B. Thyroid Disorders In Infertile Women. Ann Endocrinol. 2003;64:45-50.
[3]. Akhter N, Hussan SA. Subclinical Hypothyroidism And Hyper Prolactinemia In Infertile Women: Bangladesh Perspective After Universal Salt Iodination. [Last Accessed On 2011 Aug 16]; Internet J Endocrinol. 2009
[4]. Lincoln R, Ke RW, Kutteh WH. Screening For Hypothyroidism In Infertile Women. J Reprod Med. 1999; 44:455-7.
[5]. Krassas GE. Thyroid Disease And Female Reproduction. Fertil Steril. 2000; 74:1063-70.
[6]. Anderson S, Pederson KM, Bruun NH, Laurberg P. Narrow Individual Variations In Serum T4 And T3 In Normal Subjects; A Clue To The Understanding Of Subclinical Thyroid Disease. J Clin Endocrinol Metab. 2002; 87:1068-72.

Abstract: Fetus papyraceous is defined as a compressed fetus, mummified, parchment-like remains of a dead twin or triplet that is retained in-utero after intrauterine death in the second trimester. We report a case of two fetus papyraceous (FP) in triplet pregnancy with no maternal and fetal complications during pregnancy or the post-partum period.

Keywords: fetus papyraceous, twin pregnancy, triplets, fetal death, pregnancy outcome.

[1]. Fisk NM. Multiple pregnancy. In: Edmonds DK, editor. Dewhurst's Textbook of Obstetrics and Gynaecology for Postgraduates. Oxford: Blackwell; 2007. pp. 181–91.
[2]. Bush M, Pernoll ML. Multiple pregnancy. In: DeCherney AH, Nathan L, editors. Current Obstetric and Gynecologic Diagnosis and Treatment. New York: McGraw-Hill; 2003. pp. 315–25.
[3]. Fusi L, Gordon H. Twin pregnancy complicated by single intrauterine death. Problems and outcome with conservative management. Br J Obstet Gynaecol. 1990;97:511–6. [PubMed]
[4]. Hommel H, Festge B. Triplet pregnancy with papyraceous foetuses (author's transl) Zentralbl Gynakol.1979;101:845–7. [PubMed]
[5]. Jellife DB. Prematurity. In: Lawson JB, Stewart DB, editors. Obstetrics and Gynaecology in the tropics and developing countries. London: Edward Arnold (Publishers); 1979. pp. 253–76.
[6]. Maternal health and obstetric fistula Nigreian demographic and health survey2008. Abuja, Nigeria: National Population Commission and ICF Macro; 2009. National Population Commission (NPC) [Nigeria] and ICF Macro; pp. 125–141.
[7]. Teliga-Czajkowska J, Dadalska E, Sopliński A. Triplet pregnancy complicated by intrauterine death of two fetuses: Case report. Ginekol Pol. 2003;74:1302–5. [PubMed]
[8]. Mittal Prabuddh Sheel, Khanna MonicaTwo papyraceous fetuses in a triplet pregnancy .J Obstet Gynecol India Vol. 57, No. 1 : January/February 2007 Pg 77-78.

Abstract:Background:
1. Absconding, or going absent without leave, is a common feature within psychiatric wards, with rates of between 34% and 39% cited
2. Some of the adverse consequences of absconding include loss of treatment, violence to others, self-neglect, self-harm, and suicide.
3. Unauthorized absence of a patient from the ward arouses genuine concern on the part of the professionals responsible for their care.
Objective: To elicit the reasons of the absconds and to enhance the family ward admissions in government hospital for mental care, Visakhapatnam.

[1]. Sheikhmoonesi F1,et al conduct A prospective study of patients absconding from a psychiatric hospital in Iran.
[2]. Muir-Cochrane, E. &Mosel, K. (2008). Absconding: A review of the literature 1996–2008. International Journal of Mental Health Nursing, 17, 370–378.
[3]. Bowers L, Jarrett M, Clark N: Absconding: a literature review. J Psychiatr Ment Health Nurs 1998, 5:343-353. PubMed Abstract | Publisher Full Text
[4]. Khisty, N., Raval, N., Dhadphale, M., Kale, K. & Javadekar, A.(2008). A prospective study of patients absconding from a General hospital psychiatry unit in a developing country.Journal of Psychiatric and Mental Health Nursing, 15, 458–464.

Abstract: Background: Biomarkers are useful in diagnosing many illnesses, the biomarker (salivary proteins) which are used in this study might help in confirming the diagnosis of schizophrenia. Hypothesis: Variations in optical densities of salivary proteins in schizophrenia are diagnostic. Aims & Objectives: 1) To record optical densities of salivary proteins in schizophrenia. 2)To compare the optical densities of salivary proteins in schizophrenia with salivary proteins of individuals not having any psychiatric disorder.

[1]. Aguirre A., Testa-Weintraub L.A., Banderas J.A, Haraszthy G.G., Reddy-M.S., Levine M.J. Sialochemistry: a diagnostic tool?// Crit. Rev. Oral. Biol. Med. 1993. 4 (3-4): 343-350.
[2]. Banderas-Tarabay JA, Zacarias-D-Oleire I.G., Garduno-Estrada R., Aceves-Luna E., Gonzalez- Begne M. Electrophoretic analysis of whole saliva and prevalence of dental caries. A study in Mexican dental students // Arch. Med. Res. 2002 33:5 499-505.
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Abstract: Extraosseous Ewing Sarcoma (EES) is rare, aggressive, rapidly growing soft tissue tumor that shares morphological features with its osseous counterpart. EES has a wide age range, from infancy to the elderly and can involve soft tissues at any location, common sites being paravertebral and intercostal regions, followed by extremities. The osseous tumor is a relatively uncommon primary malignant bone tumorthat occurs often in children and adolescents. It is known to be more common in men. With the recent advances in EES treatment protocols, cytology has gained importance for rendering an early and accurate diagnosis, thereby avoiding a more invasive open surgical biopsy. Here we discuss the cytological appearance of EES in three middle aged patients, two of whom were females. These patients presented with soft tissue mass at different locations, without the involvement of the underlying bone.

Keywords: Cytology,Ewing sarcoma, Extraosseous.

[1]. ALennart, and F. M. Enzinger. "Extraskeletal neoplasm resembling Ewing's sarcoma." Cancer 36.1. 1975, 240-251.

[2]. X Chun-Fang, M-Z Liu, and M Xi. "Extraskeletal Ewing's sarcoma: a report of 18 cases and literature review." Chinese journal of cancer29.4. 2010, 420-424.

[3]. Ahmad, R., Mayol, B.R., Davis, M., &Rougraff, B.T. Extraskeletal Ewing's sarcoma. Cancer, 85(3). 1999, 725-731. [4]. Buch, A.C., Panicker, N.K., Sarawagi, S., Anwekar, S., &Kharat, A.T. Fine needle aspiration cytology diagnosis of paravertebral extraosseus Ewing's sarcoma. Journal of cytology/Indian Academy of Cytologists, 27(4). 2010, 146.

[5]. Guiter, GE.,Gamboni MM, Zakowski MF. "The cytology of extraskeletal Ewing sarcoma." Cancer Cytopathology 87.3. 1999, 141-148.

[6]. Manduch, M., Dexter, D.F., Ellis, P.M., Reid, K., Isotalo, P.A. Extraskeletal Ewing's sarcoma/primitive neuroectodermaltumor of the posterior mediastinum with t (11; 22)(q24; q12). Tumori, 94(6).2008, 888.

[7]. Javery, O., Krajewski, K., O'Regan, K., Kis, B., Giardino, A., Jagannathan, J et al A to Z of extraskeletal Ewing sarcoma family of tumors in adults: imaging features of primary disease, metastatic patterns, and treatment responses. American Journal of Roentgenology, 197(6).2011,W1015-W1022.

Abstract: To assess the prevalence of cardiomyopathy in patients with HIV and its correlation with CD4 count and duration of disease. Materials And Methods: A total of 50 HIV were selected randomly. Anthropometric parameters were recorded, age, CD4, BMI, duration of HIV and the echocardiographic examinations were performed in all patients according to standard techniques. Ejection fraction (EF) was calculated by the formula LVEF% = (LVID)2 – (LVIDS)2. Left ventricular EF was consider normal when EF was 55 to 75%. Diastolic dysfunction was calculated by measuring E and A transmitral inflow velocity. Left ventricular mass in grams is calculated by the formula: LVM(gm) =1.04x 0.8[(LVID + PWT + IVST)3 – LVID3]+ 0.6. Results And Conclusion: HIV Cardiomyopathy was found in 15 patients(30%) of the total study, 9 males(60%) and 6 females(40%).

Key Words: Cardiomyopathy, echocardiography , HIV.

[1]. Fischers SD, Lipsultz SE Cardiovascular abnormalities in HIV infected individuals. In: Zipes DP, Libby P, Bonow RO, Btraunwald, Heart Disease: A text book of cardiovascular medicine. 7th Ed.
[2]. Lipshultz SE, Fischer SD, Lai WW, Miller TL Cardiovascular risk factors, monitoring and therapy for HIV infected patients AIDS. 2003;17(Suppl 1): S96-S122
[3]. Kearney DL, Perez- Atayde AR, Easley KA, et al Post mortem cardiomegaly and echocardiographic measurements of left ventricular size and function in children infected with the human immune deficiency virus.
[4]. The prospective P2C2HIV multicenter study, Cardio Vase Pathol. 2003; 12 :140-148
[5]. Herskowitz A, Willoughby SB, Vlahov D, Baughman KL, Ansari AA Dilated Heart muscle disease associated with HIV infection ,Eur Heart J. 1995; 16(Suppl O) : 50-55

Abstract: Aim: Main purpose of this study was to assess the self – medication practices, the common type of illnesses for which self-medication has been taken among medical undergraduate students and to identify frequently used drugs, determinants of self – medication, drug information resources, the side effects encountered and attitude towards self-medication. Materials & methods: This study has been conducted in a teaching hospital in Visakhapatnam, Andhra Pradesh. This study is an observational study with the help of a questionnaire (mentioning different groups of drugs) among the medical undergraduates. Among a sample of 156 students, 95% of the students used self-medication for their symptoms in the last 6 months. But the major concern in this study is even with exposure to the knowledge of drugs and disease, 20% of the students used anti-pyretics (like paracetamol) and 18.8% used antibiotics.

1]. Geissler PW, Nokes K, Prince RJ, Achieng RO, Aagaard-Hansen J, Ouma JH. Children and medicines: Self-treatment of common illnesses among Luo school children in western Kenya. SocSci Med. 2000; 50: 1771 – 83.
[2]. Zafar SN, Reema S, Sana W, Akbar JZ, Talha V, Mahrine S, Wajeeha Y, Saman S, Sarah S. self medication amongst university students of Karachi: prevalence, knowledge and attitudes. J Pak Med Asso 2008, 58, 214-17.
[3]. World Health Organization. The role of pharmacist in Health Care System: 1998. Available from: http://www.apps.who.int/medicinedocs/en/d/Jwhozip32e [last accessed on 2009 Apr 25].
[4]. Albarran KF, Zapata LV. Analysis and quantification of self – medication patterns of customers in community pharmacies insou.

Abstract: Susceptibility to Chronic periodontitis (CP) has been associated with genetic polymorphisms in the proinflammatory cytokine, interleukin-1 (IL-1A and IL-1B) isoforms but little is known about their role in rural Africans. Therefore, the aim of this study was to resolve the association between genetic polymorphisms in IL-1A and IL-1B isoforms and chronic periodontitis in the Taita people of Kenya.

[1]. Loe H, Anerud A, Boysen H, Morrison E. Natural History Of Periodontal Disease In Man: Rapid, Moderate And No Loss Of Attachment In Sri Lankan Labourers, 14 To 46 Years Of Age. J Clin Periodontol, 1986; 13: 431–440.
[2]. Cho M And Garant PR. Development And General Structure Of The Periodontium. Periodontol 2000, 2000;24:9-27.
[3]. Armitage GC. Development Of A Classification System For Periodontal Diseases And Conditions. Ann Periodontol, 1999; 4:1-8.
[4]. Albander JM. Global Risk Factors And Risk Indicators For Periodontal Diseases. Periodontol 2000, 2002; 29: 177-206.
[5]. Michalowicz BS, Diehl SR, Gunsolleyjc, Sparks BS, Brooks CN, Koertge TE, Califano JV, Burmeister JA, Schenkein HA. Evidence Of Substantial Genetic Basis For Risk Of Adult Periodontitis. J Periodontol, 2000; 71:1699-1707.
[6]. Michalowicz BS, Aeppli D, Virag JG, Klump DG, Hinrichs JE, Segal NL, Bouichard TJ Jr, Pihlstrom BL. Periodontal Findings In Adult Twins. J Periodontol, 1991; 62:293-299.

Abstract: Fixed drug eruption is a cutaneous reaction which occurs by repetitive exposure to the offending drugs like antimicrobials, anticonvulsants and NSAIDS. Here we are presenting a case of 65 year old male of fixed drug eruptions due to administration of injections diclofenac sodium. Diclofenac is a commonly used anti inflammatory drug for relieving pain.

Keywords: Diclofenac, Fixed drug eruption, Naranjo scale.

[1]. Breathnach SM. Drug reactions. In: Burns T, Breathnach S, Cox N, Griffi ths C,editors. Rook's Textbook of Dermatology. 8th ed., Oxford: Blackwell Science; 2010.p. 28-177.
[2]. Patel RM, Marfatia YS. Clinical study of cutaneous drug eruptions in 200 patients.Indian J Dermatol Venerol Leprol 2008;74:430.
[3]. Brocq L. Éruptionerythemato-pigmentée fi xe due al'antipyrine. Ann DermatolVenereol 1894;5:308-13.
[4]. 4. Sehgal VN, Srivastava G, Fixed drug eruption (FDE):changing scenario of incriminating drugs, Int J Dermatol,45, 2006, 897-908.

Abstract: peptic ulcer disease is the common cause of upper G I symptoms in general population. Here we are presenting the study of incidence, etiological causes and the outcome of Peptic ulcer disease conducted in the Department of Gastroenterology, GGH, Guntur from 2007 -2014. Introduction: Ulcers that occur in stomach , duodenum and lower end of esophagus are called as Peptic ulcers. H. Pylori and NSAIDS are the common causes of Peptic ulcers . Smoking , alcohol intake, steroid intake are aggravating factors for ulcer disease. Systemic diseases like COPD , cirrhosis of liver ,endocrine disorders, collagen vascular diseases are associated with peptic ulcer disease.

Keywords: Peptic ulcers, NSAIDS, Gastroscopy, Protonpump Inhibitors, G.O.O, UGI bleed .

[1]. Kuipers EJ, Blaser MJ. Acid peptic disease. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 141.
[2]. Chan FKL, Lau JYW. Peptic ulcer disease. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2010:chap 53.
[3]. Chey WD, Wong BC. American College of Gastroenterology guideline on the management of Helicobacter pylori infection. Am J Gastroenterol. 2007;102:1808-1825.
[4]. Lanza FL, Chan FK, Quigley EM; Practice Parameters Committee of the American College of Gastroenterology. Guidelines for prevention of NSAID-related ulcer complications. Am J Gastroenterol. 2009;104:728-738.
[5]. McColl KEL. Helicobacter pylori infection. NEJM. 2010;362:1597-1604.

Abstract: Tibial plateau fractures involve the articular surface of the tibia resulting from a combination of axial loading with varus or valgus stress. Inadequate and inappropriate treatment may result in significant functional loss.The purpose of this study was to determine the functional outcome of internal fixation in tibial plateau fracture. Between June 2011 to May 2013, 30 tibial plateau fractures which were treated operatively according to the principles advocated by AO/ASIF. Patients were reviewed at an 6 week, 3 month and 6 months post-operatively. Functional outcome was assessed using Rasmussen's functional system. At the end of 6 months we had 87% of excellent,10% of good and 3% of fair results. The mean Rasmussen's functional score was 28.53 (range 15-30). All patients had union with range of 9 -18 weeks(average 12 weeks).We believe that internal fixation in closed and grade I and II open tibial plateau fracture give excellent functional results.

[1]. Schatzker J. Fractures of the tibial plateau. In: Schatzker J, Tile M, eds. Rationale of operative fracture care. New York: Springer-verlag, 1987:279
[2]. Rasmussen PS. Tibial condylar fractures: impairment of knee joint stability as an indication for surgical treatment. J Bone Joint Surg [Am] 1973;55-A:1331-50.
[3]. Thimmegowda M, Kurpad S R, Kurpad K, Srinivasan K. Management and follow up of tibial plateau fractures by 'T' clamp external fixator and limited internal fixation. Indian J Orthop 2005;39:163.
[4]. Sangwan S, Siwach R, Singh R, Mittal R. Minimal invasive osteosynthesis: a biological approach in treatment of tibial plateau fractures. Indian J Orthop 2002;36:246-50

[5]. Raza H, Hashmi P, Abbas K, Hafeez K. Minimally invasive plate osteosynthesis for tibial plateau fractures. J Orthop Surg (Hong Kong). 2012;20(1):42-7.

[6]. Sament R, Mayanger JC, Tripathy Sujit K, Sen RK. Closed reduction and percutaneous screw fixation for tibial plateau fracture. J Orthop Surg (Hong Kong) 2012;20:37-41

Abstract:Whether to cement the hemiarthroplasty in fracture neck femur is a matter of debate . Though cementing gives good initial fix it has the risk of bone intraoperative hypotension .On the other hand uncemented implants are associated with periprosthetic fractures and are expensive . Femoral head can be use as source of autologous bone graft to fill the medullary cavity of femur .50 patients of fracture neck femur were randomly distributed into 2 groups of 25 each . In group A we did bipolar with bone graft while in Group B we did cemented bipolar.At the end of one year, in the Bone Graft group 3 patients (12%) had excellent results; 17 patients (68%) had good results; 4 patients (16%) had fair results and 1 patient(4%)had poor result; whereas in the cemented group 4 patients (16%) had excellent results; 19 patients (76%) had good results; 2 patients (8%) had fair results. There was no statistically significant difference in the functional outcome between cemented bipolar and bipolar with bone graft.
Keywords: Bipolar hemiarthroplasty, bone graft, cemented.

[1]. Parker MJ, Gurusamy K. Arthroplasties (with and without bone cement) for proximal femoral fractures in adults. Cochrane Database Syst Rev. 2006;3:CD001706.
[2]. Parvizi J, Holiday AD, Ereth MH, Lewallen DG. The Frank Stinchfield Award. Sudden death during primary hip arthroplasty. Clin Orthop 1999 ; 369 : 39-48.

Abstract: To report normal macular thickness measurements in Normal eyes using Fourier domain optical coherence tomography (FD-OCT) Methods: Forty eyes from 20 Normal subjects underwent a complete ophthalmologic examination, including OCT. Six radial scans, 6 mm in length and centered on the fovea, were obtained using the FD-OCT. Retinal thickness was automatically calculated by OCT mapping software. Measurements were displayed as the mean and standard deviation for each of the 9 regions defined in the Early Treatment Diabetic Retinopathy Study. Results: Foveal thickness (mean thickness in the central 1000-μm diameter area) and central foveal thickness (mean thickness at the point of intersection of 6 radial scans) on the OCT were 235.95(±21.91) and 290.92 (±11.54) μm, respectively. Macular thickness measurements were thinnest at the center of the fovea, thickest within 3-mm diameter of the center, and diminished toward the periphery of the macula. The temporal quadrant was thinner than the nasal quadrant. There was no correlation between age and foveal thickness (P = .23). Conclusions: Mean foveal thickness measurements were 38 to 62 μm thicker than previously reported values, while mean central foveal thickness measurements were 20 to 49 μm thicker than previously published values. This discrepancy should be considered when interpreting OCT scans.

Key words: Macula, OCT, Fovea, Nerve fiber layer, fast scan

[1]. Meredith TA, Kenyon KR, Singerman LJ, Fine SL. Perifoveal vascular leakage and macular oedema after intracapsular cataract extraction. Br J Ophthalmol. 1976;60:765–769. [PMC free article][PubMed]

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[4]. Shahidi M, Ogura Y, Blair NP, et al. Retinal thickness analysis for quantitative assessment of diabetic macular edema. Arch Ophthalmol. 1991;109:1115–1119. [PubMed]

[5]. Huang D, Swanson EA, Lin CP, et al. Optical coherence tomography. Science. 1991;254:1178–1181. [PubMed]

[6]. Hee MR, Izatt JA, Swanson EA, et al. Optical coherence tomography of the human retina. Arch Ophthalmol. 1995;113:325–332. [PubMed]

Abstract: Different histopathological patterns and variants of Papillary Carcinoma Thyroid have been reported to influence the prognosis of the patients. Fifty six cases of papillary carcinoma of the thyroid diagnosed at Govt .Stanley Medical college ,Department of pathology over a three year period were reviewed with the aim of identifying these variants. Forty three (76.8%) were classical papillary carcinoma. Five(8.9%) follicular variant, 4 (7.1%) micropapillary variant, 2 (3.6%) encapsulated variant, one case of oncocytic ,one case of warthin like variant were reported. The mean age at diagnosis was 37 years. Most common presentation was multinodular goiter followed by solitary nodule. In this study we reviewed the clinical presentation and the various histological patterns.

Keywords: Histopathology, papillary carcinoma .

[1]. Khan A, Nose V. In: Lloyd RV, editor. Endocrine pathology: differential diagnosis and molecular advances, 2nd ed. New York: Springer 2010; p. 181–236.
[2]. DeLellis RA, Lloyd RV, Heitz PU, Eng C, editors. Pathology and genetics of tumours of endocrine organs. In: Kleihues P, Sobrin LH, series editors. World health organization. Classification of Tumours. Lyon: IARC Press; 2004
[3]. Sabrina Gill, Sam M Wiseman, Reina Yao, Connie G Chiu, Scott S Strugnell (2011) Gender differences in thyroid cancer: a critical review. 6: 215-243.
[4]. Mazzaferri EL, Young RL. Papillary thyroid carcinoma: a 10 year follow-up report of the impact of therapy in 576 patients. Am J Med 1981;70:511-518.
[5]. Sherman SI. Thyroid carcinoma. Lancet 2003;361:501-511.
[6]. Salter KD, Andersen PE, Cohen JI, Schuff KG, Lester L, et al. (2010) Central node metastases in papillary thyroid carcinoma basedon tumor histologic type and focality. Arch Otolaryngol Head Neck Surg 136: 692-696.

Abstract: Background: The Sinonasal tract embraces nasal cavities and paranasal sinuses. This area is hearth for various non-neoplastic and neoplastic lesions. Because of its closed and complex architecture diagnosis by Fine Needle Aspiration Cytology (FNAC) was proved to be difficult. So, very few studies have been documented in literature. Aim: The aim of the study is to establish the importance of FNAC as a diagnostic contrivance for the sinonasal lesions with accommodating histopathology .This study also includes to assess the spectrum of lesions occurring in this region. Meterial & Methods: 77 cases with lesions in sinonasal tract were included in the present study. FNAC was performed and slides were stained by Haematoxylin and Eosin (H&E), Papanicolaou and Geimsa stains. The biopsy sections were processed and stained with H&E.

[1]. Wenig BM, Pilch BZ. Tumours of upper respiratory tract. In: Fletcher Christopher DM, editor. Diagnostic histopathology of tumours. 2nd ed. London: Harcourt Publishers Ltd; 2000. pp. 87–138.
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[5]. Stern S, Hanna E. Cancer of the nasal cavity and paranasal sinuses. In: MyersE, SuenJ. Cancer of the head and neck. Philadelphia: Saunders; 1996: 205–233
[6]. Helsel JC, Bardales RH, Mukunyadzi P. Fine Needle Aspiration Biopsy Cytology of Malignant Neoplasms of the Sinonasal Tract., Cancer, 2003 April; 99(2): 105- 112.

Abstract: Moyamoya (Japanese word meaning; moya-tiny) disease [MMD] is a rare idiopathic progressive occlusive cerebro-vascular disease of a terminal portion of internal carotid artery or a proximal portion of the anterior cerebral arteries and the middle cerebral arteries. These abnormal tiny vascular network seen in the base of the brain, produce 'puff of smoke' appearance on Magnetic Resonance angiography. Although MMD commonly is seen among Japanese population, it is occasionally reported in Indian population. We report a case of unilateral central retinal artery occlusion(CRAO) in a young male who was later diagnosed as a case of MMD on further radiological evaluation.

Keywords: Moyamoya disease, stroke, central artery occlusion.

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[6]. Tashima-Kurita S, Matsushima T, Kato M, Morioka T, Kuwabara Y, Hasuo K, Fukui M. Moyamoya disease. Posterior cerebral artery occlusion and pattern-reversal visual-evoked potential. Arch Neurol. 1989 May;46(5):550-3.

Abstract: Gunshot injuries are a special category of trauma with a high potential for death and hospitalization. The objective of this study is to highlight their pattern and treatment outcome. This was a prospective study of all patients admitted through the Accident and Emergency Department of the Benue State University Teaching Hospital, Makurdi, Nigeria with gunshot injuries between July 2012 and June 2014. Data obtained were analyzed using the software Statistical Package for Social Sciences for Windows version 15.0 (SPSS, Inc; Chicago, Illinois).Sixty-two patients with gunshot injuries were included in the study. There were 49 males (79%) and a male-to-female ratio of 3.8:1. Their ages ranged from 4 to 65 years and the modal age group was 20-29 years. Communal clashes (n=29, 46.8%) were the predominant circumstances surrounding the injuries, followed by armed robbery attacks (n=18, 29%) and student cult violence (n=8, 12.9%). The most commonly involved body region was the upper limb (n=20, 29%). Isolated soft tissue injuries (n=38, 55.1%) were the predominant injury type sustained by patients in this study. The patients with fractures had debridement and fracture stabilization with external fixation (n=3, 4.7%), casting (n=3, 4.7%) and percutaneous K-wire fixation (n=1, 1.6%). Majority of patients (n=54, 78.3%) were treated and discharged while four (6.5%) left against medical advice. Mortality rate was 3.2%.Gunshot injuries mostly affected adult males with communal clashes being the leading cause. Instituting efficient conflict resolution channels and establishing trauma centers to promptly treat the injured may help reduce the menace of gun violence.

Keywords: Injuries, Firearms, Gunshot, Nigeria

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[5]. Saidi HS, Nyakiamo J, Faya S. Gunshot injuries as seen at the Aga Khan Hospital, Nairobi, Kenya. East Afr Med J 2002; 79:188-192.
[6]. Ojo EO, Ibrahim AG, Alabi S, Obiano SK. Gunshot Injuries In A North Eastern Nigerian Tertiary Hospital . The Internet Journal of Surgery 2008; 16(2)

Abstract:Diabetes is a chronic disease in which the body cannot regulate the amount of sugar in the blood. It is a disease caused by deficiency or diminished effectiveness of endogenous insulin. It is characterized by hyperglycemia leading to defect in metabolism which predominantly affect vasculature. This consistent hyperglycemia is associated with long term complications like diabetic nephropathy, Cardiovascular diseases, Retinopathy, Neuropathy, etc. Diabetic nephropathy is the largest cause of chronic kidney disease. The purpose of this study is to determine the relation between type 2 Diabetes Mellitus and its complication - Diabetic Nephropathy. The study also tries to find the correlation between duration of diabetes mellitus and Diabetic nephropathy.
Keywords: Diabetes mellitus, nephropathy, hyperglycemia, insulin

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Abstract: Aim: To study the efficacy and to evaluate the outcome of fresh amniotic membrane graft vs conjunctival auto graft with stem cell transplantation in the management of pterygium. Methods: In an interventional case series, 30 patients with pterygium underwent surgical excision with transplantation of fresh amniotic membrane onto bare sclera and 30 patients with pterygium underwent surgical excision with conjunctival auto graft with stem cell transplantation on to bare sclera at Rajiv Gandhi Institute of Medical Sciences, kadapa .Patients were followed for 6 months and results were evaluated in terms of recurrent growth and other postoperative complications.

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Abstract: Acute pancreatitis has a number of complications. Stress related mucosal lesions in the gastrointestinal tract and pseudocysts are a few to name. Here by we present a case of a 37 yearold male patient who was admitted to the urology ward of our institute with a diagnosis of leftpyonephrosis. On evaluation a diagnosis of infected pancreatic pseudocyst was made. A surgical intervention was carried out where an external drainage of thepseudocyst was done instead of internal drainage as the patient developed intraop hypotension.As bile was seen in the drain postoperatively, an evaluation was done which led to a confirmed diagnosis of gastric perforation. There is no mention in the literature as to when a repair for gastric peroration in cases of pancreatic pseudocyst has to be carried out.In this case we carried out surgical intervention2 weeks postoperatively,but were unsuccessful in treating the patient. Hence we conclude that gastric perforation can be diagnosed post operatively in a case ofpseudocyst of pancreas, but if the patient is responding to a conservative line of treatmentit is better to delay the perforation closure.

Keywords: acute pancreatitis,gastric perforation, pseudocyst of pancreas.

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Abstract:background: Squamous cell carcinoma makes 90% of malignancies affecting the oral cavity and pharynx. Active Metabolite of vitamin D3 (1α,25(OH)2D3) is thought to have an anti -oncogenic effect . This research is a study of the effectiveness of vitamin D in protecting against Squamous cell carcinoma and its role of curbing the tumor growth by analyzing the expression of tumor curbing protein P53.
Materials and methods : Incubated 32 Syrian Hamsters of ( 2-3) months age weighing 50 -80 Grams, were divided into two groups, and the carcinogen DMPA was applied to one of them on the buccal pouch three days weekly , while in the second group was given the active form of vitamin D3 in addition to the Carcinogen three days weekly too. In the second week of the experiment , samples were taken for histoanalysis and immunohisto analysis of protein P53. This procedure was repeated systematically in the sixth, tenth, and fourteenth weeks respectively. A statistical analysis was performed using CHI-SQUARE test at a level P < 0.05 in order to detect expression differences between the two groups.

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Abstract:Airway management of patients with haemangioma of head and neck can be quite challenging for anesthetist. We are reporting here a case of big haemangioma involving lower lip and tongue with impossible conventional mask ventilation successfully managed by ventilation and inhalational induction via nasopharyngeal airway.
Keywords: Heamangioma, difficult mask ventilation, nasopharyngeal airway,

[1]. Sachin Kheterpal; Richard Han; Kevin K. Tremper; Amy Shanks; Alan R. Tait; Michael O'Reilly; Thomas A. Ludwig. Incidence and predictors of difficult and impossible mask ventilation. Anesthesiology. 2006;105(5):885-891.
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Abstract: Background: Human blood is a vital and an essential element of the human life and there are no substitutes for it .This study aims to determine gender difference in blood donation among the population in Kashmir valley, J&K, India. Material and Methods: Study was done for a period of one year in the Department of Haematology and Transfusion Medicine, SMHS Hospital, Srinagar, J&K, India. In this present prospective study, we investigated the level of female gender participation in the blood donation process by evaluating the total blood donation in year 2013-2014. Blood grouping for ABO and Rh status was done by tile agglutination method using commercially available anti-seras.

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Abstract: In middle and low-income countries, motorcycles form a common means of transport. Motorcyclists form a significant proportion of people who are affected by road traffic accidents. Regarding risk factors for motorcycle injuries, the non-use of helmet has been identified as a specific factor leading to headinjuries and fatalities resulting from motorcycle crashes.Negative attitudes towards helmet use among other factors explain the reason behind the reported low rate of use. World Health Organizationrecommended exploring local attitudes and beliefs about helmet use as a primary step in designing effective programs for increased helmet use among riders. This study was set out to help in understanding various perceptions that motorcyclists in a sub urban area of SouthwesternNigeria have about the use of helmets and their practices.

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Abstract: Objectives: To evaluate the changes in bone mineral density in a sample of Iraqi patients with premature grayness in comparison with healthy controls. Patients And Methods: A sample of one hundred Iraqi patients with premature grayness and convenient sample of one hundred healthy individuals matched for age and gender served as a control group were included in this case descriptive comparative study. These patients and controls were selected from outpatient clinic-Department of Dermatology-Baghdad Teaching Hospital as companion with patients attending the clinic of Rheumatology and Medical Rehabilitation of Baghdad Teaching Hospital and students from Faculty of Medicine of Baghdad University in Iraq. This work was conducted during the period between November 2011 and April 2012.

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