iosr-JDMS   Volume-14 ~ Issue-3 ~ March-2015

Abstract: Obstetric anaesthetists are faced with the unique situation of providing anaesthesia for caesarean sections, where anaesthetists have to provide care for both the mother and the unborn baby. There has been a move towards more caesarean sections being performed under regional anaesthesia compared to general anaesthesia. New techniques for regional anaesthesia, such as the combined spinal epidural (CSE) anaesthesia and the continuous spinal anaesthesia, offer specific advantages. Maternal co-morbidities such as obesity and pre-eclampsia also present a challenge to the obstetric anaesthetists.

[1]. Black C, Kaye JA, Jick H. Cesarean delivery in the United Kingdom: time trends in the general practice research database. Obstet Gynecol 2005;106:151-5.
[2]. Guo S. Delievery settings and caesarean section rates in China. Bulletin World Health Org 2007;85:755-62.
[3]. Bucklin BA, Hawkins JL, Anderson JR, Ullrich FA. Obstetric Anesthesia Workforce Survey. Twenty year update. Anesthesiology 2005;103:645-53.
[4]. Gaiser RR. Changes in the Provision of Anesthesia for the Parturient Undergoing Cesarean Section. Clin Obstet Gynecol 2003;46:646-56.
[5]. Gogarten W. Preeclampsia and anaesthesia. Curr Opin Anaesthesiol 2009;22:347-51.
[6]. Clark VA, GH Sharwood-Smith, AVG Stewart. Ephedrine requirements are reduced during spinal anaesthesia for caesarean section in preeclampsia. Int J Obstetric Anesthesia 2004;14:9-13.
[7]. World Health Organisation. Obesity: Preventing and Managing the global epidemic. Report on a

Abstract: Inguinal Hernia is undoubtedly a very common case dealt by every surgeon all over the world. Amyand's hernia is an extremely rare variety of hernia in which the inguinal hernia sac contains the appendix. This unusual situation is estimated to occur in approximately 0.6 to one percent of adult inguinal hernia cases. Te pre-surgical diagnosis of Amyand's hernia is exceedingly difficult. This article presents a case study of this rare variant — reported for the time in our department of surgery of this district teaching institution. This article is presented for the rarity of the case and for the documentation of presence of healthy guy (appendix) to be a part of deceased scenario (hernia sac.)

Keywords: Amyand's hernia

[1]. Amyand's Hernia - Case Report and Review of the Literature. Ching-Ming Kwok,a Cheng-Hsi Su,' Wei-Kang Kwang,b and Yi-Chou ChivaCase Rep Gastroenterol. 2007; 1(1): 65-70. Published online 2007 August 24. doi: 10.1159/000107472; [free article] (PubMed)
[2]. Thomas WEG, Vowles KDJ, Williamson RCN. Appendicitis in external herniae. Ann R Coll Surg Engl. 1982;64:121-122. [PMC free article] [PubMed]
[3]. Creese PG. The first appendectomy. Surg Gynecol Obstet. 1953;97:643-652. [PubMed]
[4]. Salemis NS, et al. Perforated appendix and periappendicular abscess within an inguinal hernia. Hernia. 2007;10:528-530. [PubMed]
[5]. Ryan WJ. Hernia of the vermiform appendix. Ann Surg. 1937;106:135-139. [PMC free article] [PubMed
[6]. Hutchinson R. Amyand's hernia. J R Soc Med. 1993;86:104-105. [PMC free article] [PubMed]

Abstract: Accidental Fish bone ingestion is relatively common, however, resultant perforation of the small bowel is fortunately very rare. We present a case of a 33 year - old mentally challenging gentleman who got admitted complaining of severe abdominal pain since 3days, vomiting for 2days, and abdominal distension for 2 days. A diagnosis of small bowel fish bone perforation was made intra-operatively and the patient subsequently made a full recovery without the need for bowel resection. We present this as a rare case of small bowel fish bone perforation by a fish bone where the site of perforation was closed and treated successfully without the need for bowel resection.

Keywords: Fishbone; Perforation;

[1]. Small-bowel perforation caused by fish bone; Sheng-Der Hsu, De-Chuan Chan, Yao-Chi Liu; World J Gastroenterol 2005;11(12):1884-1885;www.wjgnet.com World Journal of Gastroenterology ISSN 1007-9327;The WJG Press and Elsevier.
[2]. Pinero MA, Fernandez Hernandez JA, Carrasco PM, Riquelme RJ, Parrilla PP. Intestinal perforation by foreign bodies. Eur J Surg 2000; 166: 307-309.
[3]. Ell SR, Sprigg A. The radio-opacity of fishbone ;species variation. Clin Radio! 1991; 44:104-107
[4]. Chang JJ, Yen CL. Endoscopic retrieval of multiple fragmented gastric bamboo chopsticks by using a flexible overtube. World J Gastroenterol 2004; 10: 769-770.
[5]. Webb WA. Management of foreign bodies of the upper gastrointestinal tract. Gastroenterology 1988; 94: 204-216.

Abstract: Hernia is undoubtedly one of the most common cases dealt by surgeons all over the world. Of the various type of abdominal hernias, the most unique are arguably the lumbar hernias. Lumbar hernia is an extremely rare variety of hernia with approximately only 300 cases reported in the literature. This unusual situation is relatively a rare defect of the posterior abdominal wall. This article presents a case study of this rare variant reported for the first time in the department of surgery of this district teaching institution. The pre-surgical diagnosis of primary Grynfeltt-Lessaft type of Lumbar hernia — Type A was made in our reported case. This article is presented for the rarity of the case and for the documentation of types and discussion of management of this rare entity.

Keywords: Lumbar hernia.

[1]. Hafner CWylie J JrBrush BE Petit's lumbar hernia: repair with Marlex mesh. Arch Surg1963;8618 186 PubMed
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[3]. Geis WPHodakowski GT Lumbar..hernia. Nyhus LMCondon REHernia. 4th ed. Philadelphia, Pa Lippincott1995;412- 423
[4]. Alfredo Moreno-Egea, MD; Enrique G. Baena, MD; Miguel C. Calle, MD; Jose Antonio T. Martinez, MD; Jc Luis A. Albasini, MD Controversies in the Current Management of Lumbar Hernias Arch Surg. 2007;142(1):82-88. doi:10.1001/archsurg.142.1.82. JAMA Surgery
[5]. Salameh JRSalloum EJ Lumbar incisional hernias: diagnostic and management

Abstract: Background: In this 21st century over weight and obesity had become an epidemic due to sedentary lifestyle with less physical activity and more eating. Under weight is more common in certain poverty areas and in people with less eating and due to certain diseases. Aim: This is to study the prevalence of obesity, overweight, normal weight and underweight by using Body Mass Index in medical students(third semester) of Sri Venkateswara Medical College, Tirupati. Materials and methods: In 200 medical students height and weight measurements were taken. Body mass index calculated and categorized into obese, overweight, normal weight and underweight

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Abstract: Gingival replacement is often a component of comprehensive prosthodontics. A fixed prosthesis gives the patient significant comfort and peace of mind as well as self confidence. Gingival pink porcelain is easy to fabricate in fixed prosthesis and offer predictable and satisfactory results in the management of lost interdental papillae. The case discussed here highlights a clinical situation where gingival porcelain helped in achieving optimum esthetics and patient satisfication which is simple treatment modality.

Keywords: Esthetics, Gingival porcelain, Gingival replacement, Periodontal surgery Prosthetic design.

[1]. Sinha A, Madhavan S, Ravindra S, Bhat S. Gingival Veneer: Non esthetics to esthetic smile. IOSR journal of dental and medical science. 2014;13(11):26-9.
[2]. Barzzilay I, Tamblyn. Gingival prosthesis- A review. Journal of the Canadian dental association 2003;69(2):74-8.
[3]. Antony VV, Khan R. Gingival mask-Restoring the lost smile . IOSR journal of dental and medical science 2013;5(3):20-2.
[4]. Shah A. Gingival veneer: Non –Invasive approach in the management of lost interdental papilla. Int J Dent Case Reports 2012;2(3):54-8.
[5]. SA Mule, Dange SP, Khailkar AN, Vaidya SP. Gingival prosthesis: An aesthetics solution for a periodontically compromised patient – A case report. J Indian Dent Assoc 2011;5(5):652-3.
[6]. Friedman MJ. Gingival masks: A simple prosthesis to improve the appearance of teeth. Compend Contin Educ Dent 2000;21(11):1008-10.

Abstract: Introduction: Breast Tuberculosis is rare form Tuberculosis. Usually occurs in women between 20-50 years of age, unilateral breast involvement. Incidence is more common in underdeveloped countries as compared to developed countries. It is often missed in early presentation or presents like carcinoma breast. Case Presentation: 48 year old woman presents with lump in theright breast located in lower inner quadrant and clinical and mammographic finding indicative of carcinoma breast. Patient underwent FNAC and excision biopsy revealed Tuberculosis. Patient received anti TB drugs for 6 months without any complications. Conclussion: Tuberculosis breast is extremely rare. Oftendiagnosis as carcinoma of breast or pyogenic abscess. Its important to diagnose because it can be treated conservatively by anti tubercular drugs. Surgery can be avoided.

[1]. Zandrino F, Monetti F, Gandolfo N: Primary tuberculosis of the breast. A case report. Acta Radiologica 2000, 41:61-63.
[2]. Oh KK, Kim JH, Kook SH: Imaging of tuberculous disease involving breast. Eur Radio 1998, 8:1475-1480.
[3]. Shukla HS, Kumar S: Benign breast disorders in non-western populations: Part II – Benign breast disorders in India. World J Surg 1989, 13:746-749
[4]. Kalac N, Ozkan B, Bayiz H, Dursum AB, Demirag F: Breast tuberculosis. Breast 2002, 11:346-349.
[5]. Tewari M, Shukla HS: Breast Tuberculosis: diagnosis, clinical features and management. Indian J Med Res 2005, 122:103-110.
[6]. Khanna R, Prasanna GV, Gupta P, Kumar M, Khanna S, Khanna AK: Mammary tuberculosis: report on 52 cases. Postgrad Med J 2002, 78:422-424.
[7]. Harris SH, Khan MA, Khan R, Haque F, Syed A, Ansari MM: Mammary tuberculosis: analysis of thirty-eight patients. ANZ J Surg 2006, 76:234-237.

Abstract: Hematoma is a mass of coagulated or extravasated blood in a cavity or closed tissue space. It can induce many infections if exposed to the exogenous or endogenous pathogens. High risk of infection after trauma is related to several factors: poor perfusion, shock, tissue viability following necrosis or hemorrhage, the number and virulence of organisms and host resistance. The presence of hematoma or accumulation of serum, and devitalisation and ischaemia of injured tissue, provides a favorable environment for growth of pathogens, including anaerobic bacteria, with decreased access of immune response. In the reported case, the post traumatic hematoma got infected and the patient developed cellulitis, which spread to the other spaces in the neck and caused difficulty in airway, speech and mastication. Antibiotics were prescribed to curb the infection and serratiopeptidase enzyme was administered for the purpose of suppressing and eliminating the post traumatic bleeding and hematoma. The main objective here was to prevent airway obstruction and avert a serious, life threatening condition.

Key words- Hematoma, infection, cellulitis, life threatening condition

[1]. Miller SJ: "Edema, Hematoma, and lnfection," in McGlamry, ED (ed) Comprehensive Textbook of Foot Surgery,Williams & Wilkins, Baltimore, Maryland, 1 0l 5, 1031 , 1034, 1987. [2]. Neuman MI, Eriksson E (2006). "Facial trauma". In Fleisher GR, Ludwig S, Henretig FM. Textbook of Pediatric Emergency Medicine. Hagerstwon, MD: Lippincott Williams & Wilkins. Retrieved 2008-10-19.
[3]. Seyfer AE, Hansen JE (2003). "Facial trauma". In Moore EE, Feliciano DV, Mattox KL. Trauma. Fifth Edition. McGraw-Hill Professional. pp. 423–24.
[4]. M Hohlrieder, J Hinterhoelzl, H Ulmer, W Hackl, E Schmutzhard, R Gassner Maxillofacial fractures masking traumatic intracranial hemorrhages. International journal of oral and maxillofacial surgery 2004; 33: 389-394.
[5]. Rees TD, Lee YC, Couburn RJ. Expanding hematoma after rhytidectomy: a retrospective study. Plast Reconstr Surg 1973;51:149-53. [6]. Takumi Hasegawa, Masahiko Miwa, Yoshitada Sakai, Takahiro Nikura, Sang Yang Lee, Keisuke Oe, Takashi Iwakura, Masahiro Kurosaka, Takahide Komori Mandibular hematoma cells as a potential reservior for osteoprogenitor cells in fracture. Journal of oral and maxillofacial surgery, 2012; 70: 599-607

Abstract: Tuberous sclerosis is a neuro-cutaneous syndrome characterized by abnormalities of both the integument and central nervous system. We present a case of tuberous sclerosis with rhabdomyoma present in monozygotic twins. These were 1.5 year old male monozygotic twins with multiple seizures and rhabdomyoma in heart. Magnetic resonance imaging brain and 2D ECHO findings were consistent with diagnosis.

Keywords – tuberous sclerosis, monozygotic twins, rhabdomyoma

[1]. Islam MP, Roach ES. Neurocutaneous syndromes. In: Bradley WG, Daroff RB, Fenichel GM, Jankovic J, editors. Neurology in Clinical Practice. 5th ed. Vol. 69. Elsevier health sciences Publishers; 2010. pp. 1822–7.
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Abstract:Introduction: Chemoradiation (CRT) is an integral part of management of advanced stage solid tumors. Though effective, chemoradiation treatment has its own side effects. Aims & Objective: To analyse the experience of patients undergoing chemoradiation treatment at our centre. Material &Methods: 200 post-CRT patients were interviewed using a set of questionnaire regarding their experience during treatment, side effects felt and supportive care received during treatment. Results were analysed using SPSS software version 20.
Results: M:F was 3:1.Mean age group involved was 49 years. 94.5% of the patients had prior information of the various do's and don't's during treatment and regarding the possible side effects of the treatment,97% patients were satisfied with the supportive care given to them during treatment. Common side effects experienced and reported during treatment were mucositis, vomitings and dry mouth, besides other less common side effects.

[1]. Jemal A, Bray, F, Center, MM, Ferlay, J, Ward, E, Forman, D. "Global cancer statistics". CA: a cancer journal for clinicians 61 (2), 69–90.
[2]. WHO (October 2010). "Cancer". World Health Organization. Retrieved 5 January 2011.
[3]. American Cancer Society. Cancer Facts and Figures 2008. http://www.cancer.org. Accessed June 25, 2010.
[4]. Ahlberg K, Ekman T, Gaston-Johansson F The experience of fatigue, other symptoms and global quality of life during radiotherapy for uterine cancer. Int J Nurs Stud 42(4), 2005, 377–386.
[5]. Bansal M, Mohanti BK, Shah N, Chaudhry R, Bahadur S, Shukla NK,Radiation-related morbidities and their impact on quality of life in head and neck cancer patients receiving radical radiotherapy. Qual Life Res 13(2), 481–488.
[6]. Epstein JB, Emerton S, Kolbinson DA, Le ND, Phillips N, Stevenson-Moore P, Osoba D,Quality of life and oral function following radiotherapy for head and neck cancer. Head Neck 21(1), 1–11.

Abstract: Post operative nausea and vomiting (PONV) are common even with the use of conventional antiemetics prophylactically. In a randomized double blind study, 90 patients aged 20-65 years belonging to ASA I or II class, undergoing laparoscopic cholecystectomy patients under general anesthesia were divided into 3 groups of 30 patients each and received either 40 mcg/Kg of Granisetron plus dexamethasone (Group A) or 0.1mg/Kg of Ondansetron plus dexamethasone (Group B) or 6ml of 0.9% Saline (Group C) pre- operatively. Patients were observed for 24 hours post operatively. The incidence of PONV was recorded to be 56.66% when no anti-emetic prophylaxis was used. A cumulative complete response (no nausea, no retching, no vomiting and no need of rescue anti emetic) was observed in 80% patients in granisetron-dexamethasone group as compared to 83.33% patients in ondansetron-dexamethasone group and only 43.33% in placebo group. Only 7(23.33%) patients in granisetron-dexamethasone group and 6(20%) patients in ondansetron-dexamethasone group required rescue anti emetics as compared to 15(50%) patients in placebo group. It was concluded that the incidence of PONV is significantly reduced by the prophylactic use of ondansetron-dexamethasone and granisetron-dexamethasone.

Keywords: Dexamethasone, Granisetron, laparoscopic cholecystectomy, Ondansetron, PONV,

[1]. Gan T J . Risk factors for post-operative nausea and vomiting. Anesth Analg 2006; 102:1884-1898. [2]. Habib AS, White WD, Eubanks S, Pappas TN, Gan TJ. A Randomized Comparison of a Multimodal Management Strategy versus Combination Antiemetics for the Prevention of Postoperative Nausea and Vomiting. Anesthesia & Analgesia 2004; 99 (1): 77-81.
[3]. Naguib M, Elbakry A K, Khoshi M H, Channa A B, Gamal M E L, Attia M, Saddique A . Prophylactic anti-emetic therapy with ondansetron, tropisetron, granisetron and metoclopramide in patients undergoing laparoscopic cholecystectomy: A randomized, double blind comparison with placebo. Can J Anesth 1996; 43: 226-231.
[4]. Watcha M F, White P F . PONV: Its etiology, treatment, and prevention. Anesthesiology 1992; 77:162-184.
[5]. YOGENDRAN S, SUNTHERA LINGHAMY Y: A prospective randomized double blinded study of the effect of intravenous fluid therapy on adverse outcomes in outpatient surfer. Anesth Analg 1995; 80:682 – 686
[6]. Nale R, Bhave S, Divekar D S A comparative study of ginger and other routinely used anti-emetics for prevention of post-operative nausea and vomiting. Journal of Anaesthesiology Clinical Pharmacology 2007; 23:405-410.

Abstract: Insomnia is a complaint of difficulties falling asleep, frequent and/or prolonged awakenings and/ or consistently unrefreshing sleep that occurs despite adequate sleep opportunity. Persistent insomnia is associated with wide ranging adverse consequences including decreasing quality of life, increased risk for psychiatric disturbances, increased work absenteeism and poor interpersonal functioning.

[1]. Bhavya K Bairy,Santhosh I Ramdurg; The study of sleep patterns in alcohol recovery patients, ijp 2014.
[2]. Bhanu Prakash Kolla,Terry Sneekloth: The course of sleep disturbances in early alcohol recovery.ajad 2014.
[3]. Morioka Itani O, Kaneita Y:Associations between sleep disturbance and alcohol drinking: A large-scale epidemiological study of adolescents in Japan.
[4]. Brower KJ, Perron BE. Prevalence and correlates of withdrawal‐related insomnia among adults with alcohol dependence: Results from anational survey. Am J Addict Am Acad Psychiatr Alcohol Addict. 2010; 19:238–244.
[5]. Brower KJ. Insomnia, alcoholism and relapse. Sleep Med Rev. 2003; 7:523–539.
[6]. Brower KJ, Aldrich MS, Robinson EA, et al. Insomnia, self‐medication, and relapse to alcoholism. Am J Psychiatry. 2001;158:399–404. 4. Foster JH, Peters TJ. Impaired sleep in alcohol misusers and dependent alcoholics and the impact upon outcome. Alcohol Clin Exp Res. 1999;23:1044–1051.

Abstract: Meticulous cleaning, shaping and filling of the root canal system are requisites for a successful root canal treatment.. Unfortunately, canal preparation is adversely influenced by the highly complex, intricate and variable root-canal anatomy. Thorough knowledge of root canal morphology and unusual anatomy of the tooth is crucial for the practitioner. Over the years, there have been numerous studies that describe the morphology of teeth, including mandibular first molars. These reports have shown that mandibular first molars have three or four canals. However, unusual root canal anatomy associated with the mandibular first molars has been reported in several studies and case reports. The following article reports the identification and systematic management of a middle mesial canal and middle distal canal in mandibular first molars in two cases.

Keywords: Molar, Root canals, Middle mesial canal, Middle distal canal

[1]. Cleghorn BM, Goodacre CJ, Christie WH: Morphology of teeth and their root canal system. In: Ingle JI, Backland LK, Baumgarthner JC: Endodontics, 6th Edition. BC Decker: Inc, 2008: pp. 151-210.
[2]. Skidmore AE, Bjorndal AM. Root canal morphology of the human mandibular first molar. Oral Surg 1971;32:778–84.
[3]. Pineda F, Kuttler Y. Mesiodistal and buccolingual roentgenographic investigation of 7,275 root canals. Oral Surg 1972;33:101–10.
[4]. Vertucci F. Root canal anatomy of the human permanent teeth. Oral Surg 1984;58:589–99.
[5]. Beatty RG, Krell K. Mandibular molars with five canals: report of two cases. J Am Dent Assoc 1987;114:802-4.
[6]. Fabra-Campos H. Unusual root anatomy of mandibular first molars. J Endod 1985;11:568-72.
[7]. Goel NK, Gill KS, Taneja JR. Study of root canals configuration in mandibular first permanent molar. J Indian Soc Pedod Prev Dent 1991;8:12-4.

Abstract: Background: Societal and behavioral shifts in recent years have resulted in a trend towards delayed child bearing which has lead to increase in infertility from 6% in women aged between 15-24 years to Less than 30% in the age group of 35 -44 yrs old .This has created a demand from patients & clinicians for a method to monitor fertility. Study Objective:To evaluate the role of Anti mullerian hormone (AMH) also known as Mullerian inhibiting Substance (MIS) and follicle stimulating hormone (FSH) as potential markers in monitoring the fertility in patients with assisted reproduction. It is a retrospective study done at KIMS hospital.

[1]. Clinical implications of ovarian reserve testing, volume 64, number 2, Obstetrical and gynecological survey, copyright © 2009, by Lippincott Williams and Wilkins.
[2]. The role of mullerian inhibiting substance in female reproduction, Curr opin obstet gynecol 20:257-264 © 2008 Wolters Kluwer Health/ Lippincott Williams and Wilkins 1040-872X.
[3]. Basal level of anti-Mullerian hormone is associated with oocyte quality in stimulated cycles.
[4]. Ebner T., Sommergruber M., Moser M., Shebl O., Schreier-Lechner E., Tews G.Human reprod., 2006, 21, 2022-6.
[5]. Assays for follicle stimulating hormone and luteinizing hormone: Guidelines for the provision of a clinical biochemistry service, Ann Clin Biochem 1987;24:246-262.Beastall GH, Ferguson KM, O'Reilly DSJ, Seth J, Sheridan B.
[6]. Relationship between ovarian steroids, gonadotropin and relaxin during the menstrual cycle. Acta Endocrinol 1983;129/2:121-125.Johnson MR, Carter G, Grint C, Lightman SL.

Abstract: Premenstrual syndrome (PMS) is defined as the cyclic recurrence of a constellation of non specific somatic, psychological or behavioural symptoms that are entrained with the luteal and premenstrual phases of the menstrual cycle and are of sufficient severity to result in deterioration of interpersonal relationships, interference with normal activities or both. The present study is an attempt to correlate the changes in serum calcium levels and changes in autonomic nervous system in PMS with an aim to derive a simple remedy to the much recurrent suffering of women like supplementation of calcium available plenty in many natural foods. This study included 100 women of reproductive age group, 50 with and 50 without PMS symptoms. In both groups blood pressure and heart rate were recorded by clinical methods as a function of autonomic nervous system and serum calcium levels were estimated by Ensure biotech O-Cresolphthalein complexone (OCPC) method during pre and post menstrual phases. Statistical methods were applied to compare the results and found significant variation in both autonomic function and serum calcium levels during luteal phase of PMS and a positive correlation with serum calcium and heart rate. It may be concluded from the present study that decrease in serum calcium levels during luteal phase in PMS may cause disturbance in autonomic nervous system, in PMS.

Key words: Heart rate, Blood pressure, Serum Calcium, pre menstrual phase, post menstrual phase

[1]. KENNETH A. Ginsburg, PMS. Text book of Gynaecology 684-694.
[2]. Devisetty Aruna, Chandrakala Kambar and Chowdeswari, Study of serum calcium and magnesium levels during pre and post menstrual phases in pre menstrual syndrome compared to normal subjects. International Journal of Basic and Applied Medical Sciences ISSN: 2277-2103 (Online) An Open Access, Online International Journal Available at http://www.cibtech.org/jms.htm 2014 Vol. 4 (1) January-April, pp.116-126/Aruna et al.
[3]. Elson M.Haas MD, Nutritional Program for PMS, excerpted from Staying healthy with Nutrition, Celestial Arts.
[4]. M.V. Rode, P. Kamble, M.S. Phatak, P. Jadhao and P. Tayde ., Effect of premenstrual stress on autonomic function Annals of Neurosciences, Volume 17, Number 3, July 2010.
[5]. Ronald C. Strickler (1987). M.D. Endocrine Hypotheses for the etiology of PMS Clinical Obstetrics and Gynaecology Vol.30 No.2, June, 377.[4]

Abstract: Background and objectives: Post partum period is ideal time for family planning counseling. Accessibility to health care facility is more during this period in our country. In view of repeated pregnancies with less gap between pregnancies, the present study is planned to evaluate the efficacy, safety, compliance of immediate post-partum IUD insertion in women delivering vaginally or by caesarian section in a tertiary care facility, during a period of 2 years (ie. 2013 February to 2015 February). Methods: The women recruited had CuT-380A insertion immediately after delivery of the placenta in normal delivery or caesarean section. Women having post-partum haemorrhage (PPH), pre-labour rupture or membranes (PROM ) >18 hrs, fever >380C, congenital malformation and fibroid uterus were excluded from the study. The women were followed up at 6 wks and 6 months after delivery. Results: Total women counseled 1000, accepted 246, declined 754, lost to follow up 46, followed up 200, complications 62 (Expulsion 7, Bleeding 23, String problem 32, Removal 11, continuation 182)

[1]. Safwat A, Mohamed Momen A, Kamel Omar M, et al. Acceptability of the use of postpartum intrauterine contraceptive devices: assist experience. Med Princ Pract. 2003;12:170-5
[2]. Thomas D, Maluccio J. Fertility contraceptive choice, and public policy in Zimbabwe. World Bank Econ Rev. 1996;10(1): 189-222.
[3]. Grimes D, Schulz K, van Vliet H, et al. Immediate post-partum insertion of intrauterine devices: a Cochrane review. Hum Reprod. 2001;17(3):549-54.
[4]. Maternal and Child Health Integrated Program and PPFP activities, WHO Report. http://k4health.org/sites/default/files/PPFPMeetingReport_formatted.pdf
[5]. Celen S, Moroy P, Sucak A, et al. Clinical outcomes of early post placental insertion of intrauterine contraceptive devices. Contraception. 2004;69:279-82.
[6]. Blanchard H, Mac Kiag C. ACCESS-FP Program. 2006. Postpartum contraception: http://www.k4health.org/sites/default/files/postpartumabortion_English.pdf
[7]. Tatum HJ, Beltran RS, Ramos R, et al. Immediate post placental insertion of GYNE-T 380 and GYNE-T 380 postpartum contraceptive devices: randomized study. Am J Obstet Gynecol 1996; 175(5): 1231-5 Family planning methods and birth spacing after childbirth. Power point presentation.

Abstract: Marchhemoglobinuria is a form of hemolytic anemia due to mechanically induced damaged to red blood cells, which result in hemoglobinuria. Repetitive impacts to the body may cause mechanical trauma (hemolysis) of red blood cells. It a rare abnormal condition characterized by presence of hemoglobin in the urine, occurs after strenuous physical exertion on prolonged exercise, such as marching or distance running.

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Abstract: Apical ballooning syndrome(takotsubocardiomyopathy,andbroken heart syndrome.) is a unique reversible cardiomyopathy that is frequently precipitated by a stressful event. Most patients with stress cardiomyopathy present with chest pain, electrocardiographic abnormalities, elevated cardiac enzymes,and focal left ventricular wall motion abnormalities, It accounts for approximately 1 to2% of all troponin proven acute coronary syndromes event. The pathophysiology remains unknown, although catecholamine mediated myocardial stunning is the most favored explanation.

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Abstract: Cereals and vegetables have been sources of vitamins and energy for the survival of man, animals and birds;Zea maysis one of such cereals whose effects were studied by x-raying the bacterial contaminants, haematological and biochemical profile in male kindergarten subjects of age range 1-2yrs. Results obtained from the study indicated increment in haemoglobin concentrations, packed cell volume (P<0.05), white blood cell count (P<0.05), platelet count (p<0.05). protein level, calcium level and glucose concentrations were unaffected (P>0.05). There was no bacterial contaminants harmful to the human system isolated in the culture tests carried out. When the effect of consumption in the body is compared to that of consumption of complan milk (A factory nutritious milk) by other children (Group D), it will be observed that Zea mays extract (Pap) virtually has equal effect in the body as complan milk. It could be deduced from this study that Zea mays contain some active principles that is beneficial to the healthy being of kindergartens. Keywords: Zea mays, protein level, haemoglobin levels, glucose, pap, white blood cell count.

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Abstract: When malaria is suspected in a patient, a definitive result indicating the presence or absence of parasite, preferably showing the species should be available within 1-2 hours of receipt of the blood specimen in the laboratory. This is especially important if falciparum malaria is suspected. By the conventional method it is impossible to give a report within this short period if the parasite density is low and difficult to identify in thin smear. Thick smear preparation and staining takes more than two hours. The species diagnosis may not be possible from thick smear due to distortion of morphology. In all such cases subsequently thin smear has to be screened for a long time to detect a parasite and identify its species. In this paper two different methods for rapid thick smear preparation and staining are described which will avoid the necessity of thin smear examination and thus shortening the turnaround time. In the first method acetic acid is used to lyse the RBCs in an isotonic solution to prevent the osmotic effect of water on the cells and parasites. In the second method acetic acid is used on fixed cells which resist distortion.
Keywords: Malaria, dehemoglobinization, thick smear, rapid diagnosis, diagnosis of malaria.

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