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

Abstract: Pregnancy is a special clinical state with several normal physiological changes that influence body organs including the liver. Liver disease can cause significant morbidity and mortality in both pregnant women and their infants. In our study, four cases were studied to test the efficacy of ursodeoxycholic acid in intrahepatic cholestasis of pregnancy, in relation to maternal pruritis, the biochemical abnormalities and the outcome of pregnancy. Patients with intrahepatic cholestasis of pregnancy,with intense pruritus and were assigned to receive ursodeoxycholic acid, 15mgs/KG body wt/ twice a day, orally with a drug free interval of ten days, till delivery. The follow-up was extended for 3 months after delivery. No adverse effects were detected in the mothers or in their babies. After 3 weeks of treatment, patients receiving ursodeoxycholic acid had a clinical improvement in pruritus, serum bilirubin, aspartate aminotransferase. All babies born alive, but with LBW, and were thriving normally 3 months after delivery

Keywords: abnormal liver function tests, cholestasis of pregnancy, pruritis, vitamin K', ursodeoxycholic acid.

[1]. Moses S. Pruritus. Am Fam Physician 2003;68(6):1135-42

[2]. Ambros-Rudolph CM. Dermatoses of pregnancy—clues to diagnosis, fetal risk and therapy. Ann Dermatol 2011;23(3):265-75. Epub 2011 Aug 6.

[3]. Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. ISBN 1-4160-2999-0.

[4]. Lammert F, Marschall HU, Glantz A, Matern S (December 2000). "Intrahepatic cholestasis of pregnancy: molecular pathogenesis, diagnosis and management". J. Hepatol.33 (6): 1012–21. doi:10.1016/S0168-8278(00)80139-7. PMID 11131439. Retrieved2009-10-22.

Abstract: Fungal osteomyelitis generally develops slowly and diagnosis and treatment may be delayed. Fungal osteomyelitis can be a challenging entity to treat. A review of published data revealed few reported cases of fungal osteomyelitis localized to the foot. In the present report we describe a rare case of fungal osteomyelitis localized to calcaneum treated with surgical debridement and amphotericin mixed biocomposite bone cement. The case we are reporting is a case of fungal osteomyelitis of Calcaneum treated with curettage of the lesion filling the defect with Biocomposite bone cement mixed with amphotericin.

Keywords: fungal osteomyelitis calcaneum, amphotericin , surgical debridement, biocomposite bone cement

[1]. Jain R1, Singh K2, Lamzabi I1, Harbhajanka A1, Gattuso P1, Reddy Vb3. Blastomycosis Of Bone: A Clinicopathologic Study.Am J Clin Pathol. 2014 Nov;142(5):609-16. Doi: 10.1309/Ajcpg2cfghz4urln.
[2]. Harrasser N, Banke Ij1, Hauschild M, Lenze U, Prodinger Pm, Toepfer A, Peschel C, Von Eisenhart-Rothe R, Ringshausen I, Verbeek M. Clinical Challenge: Fatal Mucormycotic Osteomyelitis Caused By Rhizopus Microsporus Despite Aggressive Multimodal Treatment.Bmc Infect Dis. 2014 Sep 6;14:488. Doi: 10.1186/1471-2334-14-488.
[3]. Romanò Cl1, Logoluso N1, Meani E2, Romanò D1, De Vecchi E3, Vassena C3, Drago L3. A Comparative Study Of The Use Of Bioactive Glass S53p4 And Antibiotic-Loaded Calcium-Based Bone Substitutes In The Treatment Of Chronic Osteomyelitis: A Retrospective Comparative Study. Bone Joint J. 2014 Jun;96-B(6):845-50. Doi: 10.1302/0301-620x.96b6.33014.
[4]. Mounasamy V1, Fulco P, Desai P, Adelaar R, Bearman G. The Successful Use Of Vancomycin-Impregnated Cement Beads In A Patient With Vancomycin Systemic Toxicity: A Case Report With Review Of Literature.Eur J Orthop Surg Traumatol. 2013 Nov;23 Suppl 2:S299-302. Doi: 10.1007/S00590-012-1062-4. Epub 2012 Aug 8.

Abstract: Introduction: Borderline ovarian tumors occur during third to fourth decades of women's lives and are diagnosed as being limited to one ovary in 80% of cases. The recommended treatment is hysterectomy with bilateral salpingo oophorectomy.However 30% of these tumors occur in younger women who have not yet given birth in which preservation of fertility is to be considered. We present a case of borderline ovarian tumor in a young unmarried woman which was managed by conservative surgery and follow up.

[1]. Kottmeier HL, Kolstad P and McGarrity KA (1973) Annual Report on the results of treatment obtained in Gynaecologic cancer vol 17, 1969-1972.
[2]. Serov SF, Scully RE and Sobin LH: International histological classification of tumors no 9 Histological typing of ovarian tumors 1973; (Geneva: World health organization)
[3]. NikuriN :Survey of clinical behaviour of patients with boederline tumors of the ovary. GynecolOncol 1981;12 107-19 PMID: 6268484
[4]. Bostwick DG Tazelaar HD and Ballon SC Ovarian epithelial tumors of borderline malignancy: a clinical and pathologic study of 109 cases Cancer 1983;58 2052-64PMID 1468692
[5]. Leake JF, Currie IL and Rosenshein NB (1992) Longterm follow-up of serous ovarian tumors of low malignant potential GynecolOncol 47 150-8 DOI: 10 1016/0090-8258(92)90099-5 PMID: 1468692

Abstract: Hypothyroidism along with thyroid abscess is a very rare condition and not frequently encountered. It is an emergency as indicated with surgical emphysema and hypothyroidism along with pneumothorax and pneumomediastinum. Esophageal abscess and perforation along with pneumothorax ,pneumomediastinum and surgical cervical emphysema was diagnosed by HRCT NECK AND THORAX. The foreign body extruded after rupture of esophageal abscess and patient treated for the underlying complications.

[1]. Goh BK, Tan YM, Lin SE, et al.CT in the preoperative diagnosis of fish bone perforation of the gastrointestinal tract. Am J Roentgenol 2006; 187: 710-4
[2]. Remson K, Lawson W, Biller HF, et al . Unusual presentations of penetrating foreign bodies of the upper aerodigestive tract. Ann Otol Rhinol Laryngol 1983; 105:32-44

Abstract:Glycated haemoglobin (HbA1c) is widely used to determine levels of chronic glycaemia, to judge the adequacy of diabetes treatment and to adjust therapy. In this study we want to find out that HbA1c >/=6.5% is corroborative with the existing diagnostic criteria (FPG >126mg/dl) of diabetes mellitus (DM) or not and to find out the relationship, if any, between HbA1c and fasting plasma glucose concentration. Material & Method: 92 diabetic and 107 non-diabeticpatients are included in this present study. Fasting plasma glucose (FPG) was measured by glucose oxidase-peroxidase method and glycated haemoglobin by ion exchange resin method.
Result: It can be said that if >6.5% of HbA1C is used for the diagnosis the sensitivity and specificity would be about 92% and 91% respectively. From regression analysis, average estimated plasma glucose may be predicted from HbA1C level.Average glucose (eAG) concentration (mg/dl) = 28.184*HbA1C – 45.055 Therefore, from this study, it can be concluded that HbA1c >/=6.5% is corroborative with the existing diagnostic criteria (FPG >126mg/dl) of diabetes mellitus. Average blood glucose can be estimatedfrom HbA1c. It can be useful as simple screening tests for type 2 diabetes mellitus (Type 2DM) so patients can be identified earlier and more efficiently. Keyword-estimated average glucose, glycated haemoglobin

[1]. Powers AC. Diabetes Mellitus. In: Fauci AS, Kasper DL, Longo DL, Braunwald E, Hauser SL, Jameson JL, et al., editors. Harrison's Principles of Internal Medicine 17th ed: The McGraw-Hill Companies; 2008. p. 2275-304.
[2]. Buse JB, Polonsky KS, Burant CF. type 2 diabetes mellitus. In: Kronenberg HM, Melmed S, Polonsky KS, Larsen PR, editors. Williams Textbook of ENDOCRINOLOGY11th ed: SAUNDERS ELSEVIER; 2008. p. 1329-58.
[3]. Anjana R, Ali M, Pradeepa R, Deepa M, Datta M, Unnikrishnan R. The need for obtaining accurate nationwide estimates of diabetes prevalence in India - rationale for a national study on diabetes. The Indian journal of medical research. 2011 Apr;133:369
[4]. IDF Diabetes Atlas Update2012.
[5]. Kaveeshwar SA, Cornwall J. The current state of diabetes mellitus in India. Australas Med J. 2014 Jan 31;7(1): 45-8.
[6]. GUPTA R, MISRA A. Type 2 diabetes in India: regional disparities. Br J Diabetes Vasc Dis. 2007;7:12-6.
[7]. Abstracts of the 64th Scientific Sessions of the American Diabetes Association. 2004 June 4-8.
[8]. SA M, MJ D, BT S, ME C, D W, K K. Should glycated haemoglobin (HbA1c) be used to detect people with type 2 diabetes mellitus and impaired glucose regulation? Postgrad Med J. 2010;86(1021):656-62.

Abstract: The study consists of 50 infertile women for a period of 2yrs after excluding male factors and ovulatory factors. The tubal test is done by sion test & the tubal patency is examined. Patients who exhibit tubal block .are subjected for laparoscopy chromotubation.The study shows 82% of tubal patency & 18% tubal block. Those 18% patients are subjected to laproscopy. In that 55% shows unilateral patency 45% shows bilateral block. Other causes of infertility I.e fibroid, polyp, polysystic ovaries, uterine anomalies are detected with this sion test. The management of the study is discussed.

Keywords: Infertility, laparoscopy, sion test ( Hydro Sono salpingography) tubal block and tubal patency.

[1]. M. Nabil El-Tabbakh,Md and peter slam k a, MD, Transvaginal Sonohysterography (Tv-Sh), Versus Hysterosalpingography (Hsg) And Laparoscopy, Obgyn.net July 05, 2011
[2]. FERNANDO BONILLA-MUSOLES, FRANCISCO RAGA, JAVIER BLANES, LUIZ A. BAILAO, and NEWTON G. OSBORNE .Sonohysterosalpingography with Transvaginal color Doppler and Three-Dimensional Ultrasound: State of the Art ,Journal of Gynecologic Surgery Feruary 2, 2009
[3]. Seal Subrata Lall, Ghosh Debdatta, Saha Debdas, Bhattacharya Ajit Ranjan, Ghosh Suhash, Mitra Supratim Comparative evaluation of sonosalpingograophy hysterosalpingograophy, and laparoscopy for determination of tubal patency, The Journal of obstetrics and gynaecology of India,, March/April 2007
[4]. Volpi E, Zuccaro G, Patriarce A, Rustichelli S, Sismondi P Transvaginal sonographic tubal patency testing using air and saline solution as contrast media in a routine infertility clinic setting , .researchgate.net 1996 Jan: 7

Abstract: Objectives: To evaluate the various effects of programmed labour protocol on maternal and fetal outcome. Study Design: It is a prospective Study. Study Area: Department of Obstestrics & Gynaecology, Government General Hospital, Guntur, affiliated to Guntur Medical College. Material & Methods: 100 uncomplicated Primi Gravida in active phase of labour were selected and randomized into study and control group of 50 each study group received programmed labour protocol and the control group received conventional labour protocol. Rate of labour progressing, duration of labour, pain relief score, maternal and foetal outcome were studied.

[1]. Daftary programmed labour - An Indigenously developed protocol of labour management. Int J Gynecol Obst Ind 2003; 6;47-49.
[2]. Chauhan R, Gupta R, A Clinical study of programmed labour and it's outcome. J. Obstet Gyneacol & Family welfare 2003: 5;8-9.
[3]. Jyothi M, Singhal P, Choudhary D. Programmed labour J. Obstet Gynaecol India 2006; 56 :53-55.
[4]. Veronica Irena Yuel, Vanect Kaur, Dil preet Kaur – Programmed Labour for optimizing labour and delivery. JK Science 10(2); 62-64, April –June 2008.
[5]. Mishra SL, Toshniwal A, Banerjee R. Effect of drotaverine on cervical dilatation : A comparative study with epidosin (Valethamate bromide). J Obstet Gynecol India 2002; 52(3): 76-79.
[6]. Singh KC, Jain P et al . Drotavenine hydrochloride for augmentation of labour Ind J of Gynaecol Ost 2004; 84;17-22.
[7]. Long J, Yue Y Patient controlled intravenous analgesia with tramodol for labour pain relief. Chin Med J (Engl) 2003; 116 : 1752-55.

Abstract: Introduction: The Thyroid gland is a highly vascular organ, situated at the front and sides of the neck shaped like a butterfly. Its name is derived from Greek, which means 'shield gland'. The adult thyroid weights about 15-20gms, being slightly heavier in females and increasing in menstruation and pregnancy. The hormones produced by the gland are found in the thyroid and the serum. They are two physiologically potent amino acids L-thyroxine (tetraidothyronine) T4 L-triiodothyronine T3 PathoPhysiology: Hypothyroidism: Hypothyroidism may manifest as growth failure intellectual impairment, goiter, pubertal abnormalities (early or delayed), weight gain memorrhagia, and oilgomenorrhea. The diagnosis is usually established by a combination of TSH and free T4. Antithyroid antibodies (antithyroid peroxides and antithyroglobulin) antibodies usually establishment the etiology of autoimmune thyroiditis.

[1]. Fauci . Braunwald. Kasper. Hauser. Longo. Jameson. Loscalzo.
[2]. Harrison's Principles of Internal Medicine, 17th Edition Volume II, 2224 – 2232
[3]. C.R.W. Edwards / I.A.D. Bouchier/ C.Haslett/ E.R.Chilvers, Davidson's Principles and practice of Medicine, 17th Edition, 692-696.
[4]. Ramzi S. Cotran, Vinay Kumar, Tacker Collins, Robbin's Pathologic Basis of Decease.
[5]. Robert K. Murray, Daryl K. Granner, Victor W. Rodwell, Harper's illustrated Biochemistry, 27th Edition 453-456.
[6]. Rafi, Text Book of Biochemistry for Medical students, 2nd Edition 703-707.
[7]. Dr. S.K. Guptha, Text Book of Medical Biochemstry 804-808.

Abstract:Pityriasis versicolor is a chronic superficial skin disease involving the stratum corneum of skin and the sebaceous glands. The main complain of the patients being cosmetic and itchiness on profuse sweating.Most common causative agent is Malassezia species. Materials And Methods: Skin scrapings were collected from 88 consecutive patients from Dermatology OPD, RGKMCH .Most samples were available during summer and rainy season.Speciation done in Microbiology laboratory,RGKMCH.Direct smear preparation with 10%KOH and culture inoculation primarily in SDCA and MDA was done, followed by LCB mount and biochemical tests for speciation. Observation: In the present study, higher incidence was found during the month of April to September and the most common species being Malassezia furfur.

[1]. Bigby, M. and Casulo, C. Pityriasis versicolor....In:Burns, T., Breathnach, S., Cox, N. and Griffiths, C. (Eds.) Rook's textbook of dermatology. Oxford: Blackwell Science.2008; 8th edn.vol 2:36.10-36.14.
[2]. Harrison's Principles of Internal Medicine. Tinea Versicolor .18th edition, vol 1, chapter 52, page 402.
[3]. Midgley, G., Gue´ho, E. and Guillot, J.Diseases caused by Malassezia In: Topley and Wilson_s Microbiology and Microbial Infections (Ajello, L. and Hay, R.J., Eds.).1998; Vol. 4, pp. 201–211.
[4]. Crespo-Erchiga, V. and Gue´ho, E. Superficial diseases caused by Malassezia species. In: Topley and Wilson_s Microbiology and Microbial Infections, Mycology (Hay, R. and Merz,W., Eds.), Arnold, London, UK.2005 .Vol. 5, 10th edn.
[5]. Midgley G. The lipophilic yeasts: State of the art and prospects. Med Mycol 2000; 38 Suppl 1:9-16.
[6]. Crespo Erchiga V, Ojeda Martos A,Vera Casano A, Crespo Erchiga A, Sanchez Fajardo F. Malassezia globosa as the causative agent of Pityriasis Versicolor. Br J Dermatol . 2000: 143: 799-803.

Abstract: Accurately determining pre-therapeutic staging is an important factor in the treatment planning and prognosis in squamous cell carcinoma of tongue. While clinical examination allows direct visualization, it cannot evaluate deeper extension of disease. Cross-sectional imaging has become the cornerstone in the pretreatment evaluation of these cancers and provides accurate information about the extent and depth of disease that can help decide the appropriate management strategy and indicate prognosis. Magnetic resonance imaging (MRI) can produce excellent-quality images and direct multiplanar formats without ionizing radiation.Early cancers can be treated with either surgery or radiotherapy while advanced cancers are offered a combination of surgery, radiotherapy and chemotherapy. Imaging can decide resectability, help plan the precise extent of resection, and indicate whether organ conservation therapy should be offered. Quality of life issues necessitate preservation of form and function and pretreatment imaging helps plan appropriate reconstruction and counsel patients regarding lifestyle changes. This review aims to familiarize the radiologist with the relevant anatomy of the tongue, discuss the specific issues that influence prognosis and management at the above subsite, the optimal imaging methods, the role of imaging in accurately staging these cancers and in influencing management.

Keywords: Computed tomography, Magnetic resonance imaging, TNM staging, tongue carcinoma

[1]. Million RR, Cassisi NJ, Mancuso AA. Oropharynx. In: Million RR, Cassisi NJ, Editors. Management Of Head And Neck Cancer. Philadelphia: Lippincott; 1994. Pp. 401–30.
[2]. Million RR, Cassisi NJ, Mancuso AA. Oral Cavity. In: Million RR, Cassisi NJ, Editors. Management Of Head And Neck Cancer. Philadelphia: Lippincott; 1994. Pp. 321–400.
[3]. Sobin LH, Wittekind C (Eds.) 6th Edn. New York: Wiley; 2002. UICC TNM Classification Of Malignant Tumors.
[4]. Arakawa A, Tsuruta J, Nishimura R, Et Al. Lingual Carcinoma: Correlation Of MR Imaging With Histopathological Findings. Acta Radiol. 1996;37: 700–7. [Pubmed]
[5]. Po WYA, Lam KY, Lam LK, Et Al. Prognostic Factors Of Clinically Stage I And II Oral Tongue Carcinoma-A Comparative Study Of Stage, Thickness, Shape, Growth Pattern, Invasive Front Malignancy Grading, Martinez-Gimeno Score, And Pathologic Features. Head Neck. 2002; 24:513–20. [Pubmed]

Abstract: Objective to analyzecaesarean section (CS) rate, classify according to the Robson's Classification and interpret them clinically. Methods:The study was conducted in a tertiary hospital attached to medical college Mysuru, Karnataka. Totaldeliveries during2013 were 15182, CSdone were 3917.Womenwere classified according to Robson's classification in 10 Group Classification System (TGCS).Summary:TheCS rate was 25.80% - higher than stipulated WHO 15%, but lesser than other Asian countries.Group 1+2 (nulliparous,single,>37weeks,in spontaneous labour,nulliparous single,>37weeks,induced or CSbeforelabour)size was 53.73% suggesting high number of people in the group. Ratio of Group 1+2 indicates low rate of induction and low pre-labour CSrate in this group.CSrate is slightly high in Group 1 .In Group 3(multiparous excluding previous CSsingle cephalic >37weeks in spontaneous labour)CSrate is 12.99%which should not have been >3%.CS rate Group 4(multiparous (excluding previous CS)>37weeks, induced or CSbefore labour) washigh at 38.68%. It contributed only 2.27% of overallCSrate.Relative size of Group 5 (previous CS, single cephalic >37weeks) 8.7% suggests low CS rates in previous years .CS rate contributed heighest in Group 5 at 8.48%.

[1]. Cyr RM.Myth of ideal caesarean section rate:commentary and historic prospective. Am J Obstet Gynaecol.2006;194:932-6 .
[2]. WHO(1985)appropriate technology for birth.Lancet 2:436-437.
[3]. World Health Organization. Monitoring emergency obstetric care: A handbook. Geneva, Switzerland; 2009.
[4]. Grace Neville, Micheal Robson, Caesarean Section Rates: Much Ado about Nothing or a Marker of Quality Care?,in John Studd, Seang Lin Tan. Frank A.Chevenak, Current progress in Obstetrics&Gynaecology Vol-2 (Mumbai : Tree Life Media – Kothari Medical Subscription Services Pvt. Ltd.2014) 151-162.
[5]. Lawrence HC,CopelJA,O,KeeffeDF,etal.Quality patient care in labor and delivery:a call to nation.AmJObstet Gynaecol.2012;207:147-148.
[6]. Method of achieving and maintaing an appropriate caesarean section rate.MichaelRobsonDr .Lucia Hartigan,Dr Martina Murphy,RM,Best Practices &Reasearch Clinical Obstetrics and Gynaecology27(2013)297-308

Abstract: The axillary arch is a musculotendinous structure that arises from the latissimus dorsi muscle and crosses the axilla before inserting to the humerus, brachial fascia or coracoid process. A cadaveric study was done to know the incidence of axillary arch muscle, the extent of its different attachments and the applied aspects. In total, 84 upper limbs were meticulously dissected to locate the axillary arch. Wherever found, the arch was dissected carefully from its origin to its insertion. The nerve supply and blood supply was noted, the dimensions of the arch were measured, its relations to the structures in the axilla were studied in detail. Any additional related variations were investigated. The axillary arch was found unilaterally in two middle aged cadavers (one male and one female) and bilaterally in two female cadavers of age about 40 to 45 years. All the 6 arches arose from the anterior border of the latissimus dorsi muscle, crossed over the neurovascular bundle in the axilla and inserted to the fascia covering the deep surface of pectoralis major or the capsule of the shoulder joint.

Keywords: Achselbogen Muskel, Arcus axillaris, Axillary arch, Axillopectoral muscle, Langer's muscle, Pectodorsal muscle.

[1]. Minnie Pillay, Suja Mary Jacob. Bilateral Presence of Axillary Arch Muscle Passing Through the Posterior Cord of the Brachial plexus; Int. J. Morphol. 2009;27(4):1047-50.
[2]. Brash JC. Cunninghams' textbook of Anatomy. 9th edition, Oxford University Press, London; 1951:479.
[3]. Loukas M, Noordeh N, Tubbs RS, Jordan R. Variation of the axillary arch muscle with multiple insertions. Singapore Med J 2009;50:e88‑90.
[4]. Sachatello CR. The axillopectoral muscle (Langer's axillary arch): a cause of axillary vein obstruction. Surgery 1977; 81:610-2
[5]. Jelev L, Georgiev GP, Surchev L. Axillary arch in human: common morphology and variety. Definition of "clinical" axillary arch and its classification. Ann Anat. 2007. 189: 473–481.
[6]. Hafner F, Seinost G, Gary T, Tomka M, Szolar D, Brodmann M. Axillary vein compression by Langer's axillary arch, an aberrant muscle bundle of the latissimus dorsi. Cardiovasc Pathol 2010;19:e89‑90.

Abstract: Diabetes mellitus is a group of disease characterized by high blood glucose concentration in the blood and alteration in carbohydrate, protein and fat metabolism. People are greater risk of diabetes due to improper dietary practice, unhealthy life style, lack of physical exercise. The present study was conducted a comparative study of nutritional status among Type- 2 diabetic males and females. Multistage stratified random sampling technique was used for selecting 100 samples in both male and females and an interviewed schedule was developed to collect information regarding socioeconomic profile, dietary pattern etc. Dietary intake between males and females diabetic were highly significant but age, BMI, etc. between males and females diabetic were insignificant. Consumption of high fat and carbohydrate diet was revealed as the major contributing cause of disease in both males and females. Keywords: Diabetes, blood sugar, body mass index.

[1]. Boule Ng, Haddad E, Kenny Gpet. al(2001): Effects of exercise on glycemic control and body mass in type 2 diabetes mellitus: a metanalysis of controlled clinical trials,JAMA Sep 12, 286 (10) 1218-27.
[2]. Foreyt, J P; Poston, Ws Carlos. (Jun 1999) The challenge of diet, exercise and lifestyle modification in the management of the obese diabetic patient.Source: International Journal of Obesity & Related Metabolic Disorders. Supplement, Vol. 23, ps5. 1p.
[3]. Frit Z.T. wandellHA,PeterE.(2006) walking for exercise does three times per week influence risk factors in Type -2 diabetes?.Dia Res.Clin.Pract.71,21-27.
[4]. Mj Franz, H Warshaw, A E Daly, J Green –Pastors, Ms Arnold, J Bantle. (2003)Evolution of diabetes medical nutrition therapy Post grad Med J;79:30–35 [5]. Ronald Klein, Md; Barbara E. K. Klein, Md; Scot E. Moss, Ma; Matthew D. Davis, Md; David L. Demets, Phd(1984)The Wisconsin Epidemiologic Study of Diabetic RetinopathyIII. Prevalence and Risk of Diabetic Retinopathy When Age at Diagnosis Is 30 or More YearsArch Ophthalmol. ; 102(4):527-532.

Abstract: The Integrated Child Development Services (ICDS) scheme was launched in 1975, to provide holistic development of children through a package of services aimed at reduction of child malnutrition, morbidity and mortality. Anganwadi Centres(AWCs) functioning in about 20,000 population of an urban area of Ludhiana were studied, to assess facilities available and services provided to the beneficiaries under the Programme. The ICDS Programme in the study area was found to have several short-comings, with inadequate facilities and infrastructure. The AWCs lacked essential equipment, and growth monitoring of the children was non-existent. The coverage of the services and attendance in the AWCs was low for children and nil for pregnant women, lactating mothers and adolescent girls. Immunization records were absent, and provision of supplementary nutrition to the beneficiaries was inadequate. 71.9% of the under-5 years old present in the AWCs were malnourished. There exists a wide gap between policy and implementation of the ICDS Programme. Periodic assessment of the Programme by independent agencies to identify and correct the Programme weaknesses and obstacles, regular in-service refresher courses for Anganwadi Workers (AWWs) to develop and reinforce their skills, and better co-ordination between the health sector and ICDS would go a long way to improve the functioning of the Programme.

Keywords: Anganwadi Center, Integrated Child Development Services, Urban slum.

[1]. India at a glance-Population Census 2011. Available at: http://www.census2011.co.in/p/glance.php. Accessed on 2.2. 2015.
[2]. National Family Health Survey –3. Available from: http://www.nfhsindia.org/nfhs3_national_report.html. Accessed on 7.6. 2011.
[3]. Gragnolati M, Bredenkamp C, Dasgupta M, Lee YK, Shekar M. ICDS and Persistent Undernutrition - strategies to enhance the impact. Economicand Political Weekly 2006; 1193-1201. Available from: http://www.bpni.org/Article/ICDS_ and_ persistent_undernutrition .pdf. Accessed on 20.5.2011.
[4]. Recommendations on ICDS – based on deliberations of the National Advisory Council on 28 August 2004. Available from: http://www.righttofoodindia.org/data/nac-icds-recos.doc. Accessed on 5.9.2011.
[5]. Sanket-Center for Budget Studies, Vikas Samvad & Right to Food Campaign Madhya Pradesh Support Group, 2009. Moribund ICDS – a study on the ICDS and Child Survival Issues in Madhya Pradesh. Available from: http://www.righttofoodindia.org/data/moribund _icds_study_oon_icds_and_child_survival_issues_mp_2009.pdf. Accessed on 30.4.2011.

Abstract: Objective: The purpose of this study is to ascertain the level of knowledge, awareness of the effective use of contraceptive methods among female secondary, higher and university students in Rivers and Bayelsa State in Nigeria. Which will enable provide useful information for future intervention strategies and the reduction of unwanted pregnancies. Methods: A cross-sectional study using 1000 sample of pretested questionnaires among female students of secondary, higher, and tertiary institutions in both states were used.

[1]. Jain Rakhi. Muralidhar Sumathi, Contraceptive method: needs, options and utilization. Journals of obstetrics and gynecology of India (November-December 2011) 61(6):626-634
[2]. Catherine S.Todd,Heidi E.Jones, Tracy C.Garber, Hoviyeh Afnan-Holmes,Helen Woolgar, Linda-Gail Bekker, andLandon Myer, Awareness and interest in Intrauterine Contraceptive Device Use among HIV-Positive Women in Cape Town, South Africa: Infectious Diseases in Obstetrics and Gynecology vol.2012, Article ID 956145.
[3]. Jewkes R, Abrahams N: The epidemiology of rape and sexual coercion in South Africa: an overview. Soc Sci Med 2002,55:1231-44.
[4]. Adedoyin M and Adegoke AA, Teenage prostitution-child abuse: a survey of Ilorin situation, African Journal of Medicine and Medical Science, 1995, 24(1):27–31; and Oladepo O and Brieger WR, AIDS knowledge, attitude and behavior patterns among university students in Ibadan, Nigeria, African Journal of Medicine and Medical Science, 1994,23(2):119–125.

Abstract: Hypercementosis is characterized by excessive deposition of secondary cementum on the root of a tooth. This paper reports a distinctive case on successful management of a coalesced hypercementosed mandibular first molar tooth. A 45-year-old woman reported to the department with severe lancinating pain, with a non contributory medical history. The radiographic examination revealed a diffuse radiopaque mass attached to the mesial & distal root of the right mandibular first molar tooth forming a coalascence, surrounded by a thin radiolucent halo. The differential diagnosis made was hypercementiosis, cementoma ( true cementoblastoma) & condensing osteitis. Considering the radiographic presentations of no well circumscribed radiopaque mass and no cortical bony expansion a final diagnosis of coalescing hypercementosis was made. Since it was grossly destructed extraction of the involved tooth was planned.A full thickness mucoperiosteal trapezoidal flap was raised from the buccal aspect, since there was an increased resistance encountered while luxation due to grossly carious lesion involving the furcation area & a bulbous mass both on mesial & distal root showing coalescence, osteotomy was done & the tooth along with the mass was extracted followed by placement of sutures. Histopathological report confirmed the final diagnosis of hypercementosis.

Keywords: Hypercementosis, coalescence, radiograph.

[1]. Consolaro, Renata B. Consolaro, Leda A. "Francischone Cementum, apical morphology and hypercementosis: A probable adaptive response of the periodontal support tissues and potential orthodontic implications " Alberto Dental Press J Orthod 21 2012 Jan-Feb;17(1):21-30
[2]. Mjör IA, Fejerskov O. O periodonto. In: Mjör I A, Fejerskov O, "Embriologia e histologia oral humana. São Paulo: Panamericana" 1990. p. 131-76. [3]. L Napier Souza, S Monteiro Lima Júnior FJ Garcia Santos Pimenta, AC Rodrigues Antunes Souza and R Santiago Gomez. "Atypical hypercementosis versus cementoblastoma". dmfr.birjournals.org. Retrieved 2009-09-08.
[4]. Monahan R. Periapical and localized radiopacities. Dent Clin North Am 1994; 38: 113–136.
[5]. Neville BW, Damm DD, Allen CM, Bouquot JE. Abnormalities of teeth. In: Neville BW, Damm DD, Allen CM, Bouquot JE (editors). Oral & Maxillofacial Pathology (2nd edn). Philadelphia: WB Saunders; 2002, pp 49–106

Abstract: Aims And Objectives: To study the acceptance, efficacy,patient compliance of DMPA and to compare it with the other methods of contraception. Methodology: A prospective study was carried out at Obstetrics and Gynaecology department of VS General hospitalamong the women's in post-delivery and postabortal period. They werecounselled well about the benefits of DMPA and other methods of contraception .Those that chose DMPA were included in the study. This study was done over a period of 16 months from august 2013 to December 2014. They were followed up on OPD basis. Result: Out of 500 cases selected 61% women's were in the age group of 26 to 35, 75% took DMPA Post-delivery and 47% took in postabortal period, 65% of them belonged to middle and lower socio-economic class. Amenorrhea found to be in 70% of them,Continuation rate was 51.1% and failure rate in present study reported to be ZERO.

[1]. www.censusindia.gov.in
[2]. Dlhs 2007-2008
[3]. Klitsch M: Injectable hormones and regulatory controversy: An end to the longrunningstory? FamPlann Perspect;1993: 25:37
[4]. Kaunitz AM: Long-acting injectable contraception with depot medroxyprogesterone acetate. Am J Obstet Gynecol;1997: 170:1543
[5]. Westhoff C: Depot-medroxyprogesterone acetate injection (Depo-Provera®): A highly effective contraceptive option with proven long-term safety. Contraception. 1990:68:75,
[6]. Trussell J, Kost K: Contraceptive failure in the United States: A critical review of the literature. Stud FamPlann ;1987:18:237.