iosr-JDMS   Volume-14 ~ Issue-4 ~ April-2015

Abstract: Ureteroscopy is a standard urologic technique that provides direct visualization of the upper urinary tract, facilitating both diagnostic and therapeutic interventions. Ureteroscopy is most commonly used for the treatment of ureterolithiasis and nephrolithiasis .Other common indications include evaluation of lateralizing hematuria, abnormal urinary cytology, and abnormal upper tract imaging studies. Surveillance and treatment of upper tract urothelial carcinoma may be performed using ureteroscopic techniques. Ureteroscopy may also be utilized in cases of ureteral stricture and ureteropelvic junction obstruction.This study was conducted in the Department of General Surgery of Guru Nanak Dev Hospital attached to the Government Medical College Amritsar. Total of 25 patients with diagnosis of ureteric calculi admitted were taken up for study, excluding patients below 14 years of age, patients unfit for surgery. Rigid ureteroscopy was performed in all cases for stone retrieval, and the complications encountered intra and post-operatively were noted and managed accordingly. Overall, the procedure ureteroscopy was highly satisfactory in the management of ureteric calculi. The ureteroscope used correctly, is a valuable part of the endoscopic armamentarium.

1]. Worcester EM, Coe FL. Clinical practice. Calcium kidney stones. N Engl J Med. 2010; 363(10): 954-63.
[2]. Seitz C, Liatsikos E, Porpiglia F, et al; Medical therapy to facilitate the passage of stones: what is the evidence? EurUrol, 2009; 56 (3) : 455-71. [3]. Young HH, McKay RW. Congenital valvular obstruction of the prostatic urethra. SurgGynec&Obst 1929; 48: 509. [4]. Marshall VF. Fiber optics in urology. J Urol, 1964; 91: 110. [5]. Pricop C, Dorobăt C¸ Orsolya M. Antibiotic prophylaxis in retrograde ureteroscopy: what strategy should we adopt?. Germs, 2013; 3(4): 115–21. [6]. El-Kappany H, Gaballah MA, Ghoneim MA. Rigid Ureteroscopy for the treatment of ureteric calculi: Experience in 120 cases. Brit J of Urol, 1986; 58: 499-503. [7]. Katz DS, Lane MJ, Sommer FG. Unenhanced helical CT of ureteral stones: incidence of associated urinary tract findings. Am J Roentgenol, 1996; 166(6): 1319-22.

Abstract: Background: Most of the orthopaedic surgeries are of uncertain duration, so the usage of adjuvants to local anaesthetics in Brachial Plexus block had improved block characteristics. The Dexamethasone have been used as an adjuvant to local anaesthetics in brachial plexus block, because it had been reported to prolong duration of action of local anaesthetics. Objectives: This study was under taken to assess (1) Onset and duration of sensory and motor block. (2) Complications and adverse effects.

[1]. Shrestha BR, Maharjan SK, Tabedar S: Supraclavicular brachial plexus block with andwithout dexamethasone - A comparative study. Kathmandu University Medical Journal (2003) Vol. 1, No. 3, 158-160
[2]. Ali Movafegh, Mehran Razazian, Fatemeh Hajimaohamadi et al: Dexamethasone Added to Lidocaine Prolongs Axillary Brachial Plexus Blockade. Anesth Analg 2006; 102:263–7
[3]. Lanz E, Theiss D, Jankovic D: The extent of blockade following various techniques of brachial plexus block. Anesth Analg 62:55-8, 1983
[4]. Johansson A, Hao J, Sjölund B (1990) Local corticosteroid application blocks transmission in normal nociceptive C-fibres. Acta Anaesthesiol Scand 34: 335- 338.
[5]. Marks R, Barlow JW, Funder JW (1982) Steroid-induced vasoconstriction: glucocorticoid antagonist studies. J Clin Endocrinol Metab 54: 1075-1077.
[6]. Droger C, Benziger D, Gao F, Berde CB: Prolonged intercostals nerve blockade in sheep using controlled-release of bupivacaine and dexamethasone from polymer microspheres. Anesthesiology1998; 89:969–74.

Abstract: Rate Pressure Product (RPP) is a valuable marker of cardiac function.It is the product of heart rate (HR) and systolic blood pressure (SBP) (HR x SBP/1000). RPP up to 12 at rest and up to 22 in stressed conditions is considered as normal. This study deals with RPP evaluation in60 young normal subjects of 18 to 22 years old (30 males and 30 females).HR and SBP were recorded before and after 5 min of mental stress (mental arithmetic) and physical stress (cycling) from which RPP was calculated.RPP increased significantly after mental stress in both the genders (males (M) p< 0.0001 and females (F) p< 0.0005), But there was no gender difference in the level of increase.

[1]. http://www.answers.com/topic/rate-pressure-product 2.8.2012, 8.47 AM. Ayurvedic Heart Healer Program Natural Heart Treatment. Rate-pressure product
[2]. Selwyn, A.P. and Braunwald, E Ischemic Heart Disease in Harrison's Principles of Internal Medicine (Isselbacher et al., eds) McGraw-Hill, Inc., New York, 1994, p 1081-2.
[3]. Kasper DL, Braunwald E, Fauci AS, Hauser SL, Longo DL, Jameson JL (eds). 15th edition. New York: McGraw Hill; 2001 p . 1402)
[4]. http://www.ncsf.org/ 2.8.2012: 8.45 AM. Understanding Exercise Intensity and Rate Pressure Product (RPP) By NCSF on: Feb 17 2011)
[5]. De Meersman RE, Zion AS, Giardina EG, Weir JP, Lieberman JS, Downey JA. Estrogen replacement, vascular distensibiltyand blood pressures in postmenopausal women. Am J Physiol 1998; 274: H1539–H1544.
[6]. Sarnoff SJ, Braunwald E. Hemodynamic determinants of oxygen consumption of the heart with special reference to the tension-time index. Am J Physiol 1958; 192: 148–156).
[7]. Fletcher GF, Cantwell JD, Watt EW. Oxygen consumption and hemodynamic response of exercises used in training of patients with recent myocardial infarction. Circulation 1979; 60: 140– 144).

Abstract: Background: Congenital neck anomalies in the adult are a rare pathology encountered in clinical practice. They are related to disturbances in the development of branchial apparatus of fetus. Although some diagnoses may be evident on physical examination, others may present a diagnostic dilemma. They include branchial cysts and sinuses, thyroid gland abnormalities, and especially thymic and parathyroid gland ectopies. Some of them are inherited, however most of them are caused by environmental factors. Methods: We are presenting our experience with these anomalies, a retrospective study undertaken in the General Surgery Service,"Mother Teresa" University Hospital Center, Tirana, Albania. Because they have varied manifestations and may present at any age they should always be considered. Usually they represent as midline neck masses or lateral neck swellings (fistulae).

[1] Whetstone J, Branstetter BF, Hirsch BE. Fluoroscopic and CT fistulography of the first branchial cleft. AJNR Am J Neuroradiol. 2006;27 (9): 1817-9. AJNR Am J Neuroradiol (full text) - Pubmed citation [2] Al-ghamdi S, Freedman A, Just N et-al. Fourth branchial cleft cyst. J Otolaryngol. 1992;21 (6): 447-9. - Pubmed citation [3] Joshi MJ, Provenzano MJ, Smith RJ et-al. The rare third branchial cleft cyst. AJNR Am J Neuroradiol. 2009;30 (9): 1804-6. doi:10.3174/ajnr.A1627 - Pubmed citation [4] Benson MT, Dalen K, Mancuso AA et-al. Congenital anomalies of the branchial apparatus: embryology and pathologic anatomy. Radiographics. 1992;12 (5): 943-60. Radiographics (abstract) - Pubmed citation

Abstract: Introduction: Ensuring stone free status after ESWL is still difficult. Objective assessment of stone characteristic using noncontrast computed tomography (NCCT) like skin to stone distance (SSD), stone size and Hounsfield unit (HU) might help to predict the outcome. These factors were combined to develop a formula that could predict the success of single stage ESWL. Objective: To evaluate the role of NCCT in predicting ESWL outcome using a formula that has been computed as 'Stone size x SSD x HU /100 '. Methods: Eighty patients with uncomplicated renal or upper ureteric stones who underwent NCCT prior to ESWL were included in this study and the formula was analysed. Stones of size 0.5 to 2.5 cm, measured in maximum diameter were included in the study. About 2500-3000 shocks were given (1Hz/18kvs) by Electrohydrolic machine. Stone remnant >4mm in size by NCCT after 6 wks was considered as residual stone.

[1]. EUA Guidelines 2014 .
[2]. Pareek, G., Hedican, S. P., Lee, F. T., & Nakada, S. Y. (2005). Shock wave lithotripsy success determined by skin-to-stone distance on computed tomography. Urology, 66, 941–944. doi:10.1016/j.urology.2005.05.011
[3]. Ouzaid, I., Al-qahtani, S., Dominique, S., Hupertan, V., Fernandez, P., Hermieu, J.-F., … Ravery, V. (2012). A 970 Hounsfield units (HU) threshold of kidney stone density on non-contrast computed tomography (NCCT) improves patients' selection for extracorporeal shockwave lithotripsy (ESWL): evidence from a prospective study. BJU International, 110, E438–42. doi:10.1111/j.1464-410X.2012.10964.x.

Abstract: Abnormal Uterine bleeding (AUB) is a common reason for women of all ages to consult their gynecologist and is the direct cause of a significant health care burden for women, their families and society as a whole.It affects 10-30% of reproductive age women and upto 50 % of perimenopausal women. The most probable etiology of abnormal uterine bleeding relates to the patients reproductive age, as does the likelihood of serious endometrial pathology. The specific diagnostic approach depends on whether the patient is premenopausal, perimenopausal or post menopausal3. In Premenopausal women with normal findings on physical examination the most likely diagnosis is dysfunctional uterine bleeding secondary to anovulation and the diagnostic investigation is targeted at identifying the etiology of anovulation. In perimenopausal women, endometrial biopsy and other methods of detecting endometrial hyperplasia or carcinoma must be considered early in investigations.

[1]. J.obslet gynaecol can 2013; 35 (5e suppl): S1-S28
[2]. P.J.Haynes, Helema Hodgson, Anne B.M. Anderson, A.C.Turnball.Pattern of menstrual blood lossin menorrhagia; BJOG, 1977; 84(10): 763-768
[3]. Euro pub med central PMID-10524483, Oriel KA, Shrageers universiy of wiscouin school of Medicine, Madison 53715, USA. American family physician (1999, 6095):1371 -80; discussion 1381-2)
[4]. Gold stein Sr.Zeltser, horan CK.Snyder JR. Schwartz LB. Ultra sonography - base triage for perimenpausal patients with abnormal uterine bleeding. AMJ obstet Gynecol 1997; 177: 102-8
[5]. Treloar AE, Menstrual cyclicity and the pre-menopause, Maturitas 1981; 3:249
[6]. Woolock JG. Critchley HO, Munro MG, Broder MS, Fraser IS. Review of the confusion in current and historical terminology and definitions for disturbances of menstrual bleeding. fertil steril 2008;90:2269-80.
[7]. Munro MG, Critchley Ho, Broder MS, Eraser IS, for the FIGO working group on Menstrual Disorders. FIGO classification system (PALM-COEIN) for causes of abnormal uterine bleeding in non gravid women of reproduction age. Int J.Gynacol obstet.2011 Apr;113:3-13.

Abstract: Background:Myoma complicating pregnancy is a high risk pregnancy which may lead to complication with unequal gravity. Its prevalence during pregnancy has been reported to be 1-4 %. Uterine fibroids have long been implicated as a cause of adverse pregnancy events like spontaneous abortion, premature labour, soft tissue dystocia, Uterine inertia, fetopelvic disproportion, malposition of fetus, retention of the placenta, postpartum hemorrhage, pain, degeneration, placental abruption, intrauterine growth restriction. Although fibroids are associated with increased complications during pregnancy, Careful surveillance during pregnancy and labour is associated with good maternal and fetal outcome. Here we are presenting two cases of myoma complicating pregnancy which were managed successfully without any adverse maternal and fetal outcome.Case report:Case I: A 21 years primigravida with eight weeks gestation approached us for MTP as she was told of large fibroid uterus complicating pregnancy with short cervix. On examination the lady was found to be hypothyroid, hence put on Eltroxin in consultation with endocrinologist and adviced to review after two weeks for follow-up. Meanwhile she was advised complete bed rest and put on natural prosesterones.

[1]. Quyang DW.Norvitz ER. Management of pregnant women with leiomyomas. Available at: http://www.uptodate.com/patients/content/topic.do?topic key =~ewppe YOKn3st Roe.com
[2]. Bromberg JV, Gold berg J, Rychlac K, Weinstem L. The effects of uterine fibroid on pregnancy outomes. Available at: http:/or wh.od.wih.gov/health/39 – Bromberg.pdf
[3]. Umezurike c. Feyi-waboso P. successful myomectomy during pregnancy: a case report. Reprod health 2005,2(1)6. Published online 2005 August 11.dei 10.1186/1742-4755-2-6.
[4]. Comforth T. 10 things to know about uterine fibroid tumors. Available at: http://womenhealth/about.com/od/fiboidtumors/a/knowabtfibroids.htm
[5]. Qidwai GI, caughey AB, Jacoby AF. Obstetric outcome in women with sonographically identified uterine leiomyomata obstetric obstet gynecol 2006 Feb; 107 (2 pt1):376-82
[6]. Quyang DW: Economy KE Norwitz ER obstetric complications of fibroids. Obstet Gynaecol clin North Am 2006:33(1):153-69

Abstract: Routine electronic fetal monitoring of fetal heart rate in labour has become an established obstetric practice in world.But with few monitors available there is a need to find a method without compromising fetal outcome.Admission test may serve to address this problem.Objective was to access admission test during labour as a predictor of fetal outcome.In this test admission test was conducted in 100 cases for a period of 1 year among which 50 cases were of high risk group and 50 cases were of low risk group.Out of 50 high risk cases 31 were reactive ,10were suspicious and 9 were ominous on trace.Among 50 low risk cases 42 were reactive,6 were suspicious and 2 were ominous pattern.In high risk cases,among reactive group,6 cases developed fetal distress later on while in suspicious group,4 cases developed fetal distress and in ominous group 7 cases developed fetal distress.Among 50 low risk group,in reactive group 4 cases developed fetal distress,while in suspicious group 1 case developed fetal distress and in ominous group no case developed fetal distress.By going for admission test ,there will be decrease in the load of continous monitoring and can identify patients likely to develop adverse fetal outcome.Ominous and suspicious pattern require vigilant monitoring.Admission test can detect fetal distress already present on admission and unnecessary delay in intervention can be avoided.

[1]. FIGO guidelines for the use of fetal monitoring Int J Obstet Gynecol 1987;25:159-167.
[2]. Col Sood Atul Kumar,Lt Col Singh Sanjay .Vibroacoustic Stimulation andModified Fetal Biophysical Profile for Early Intrapartum Fetal Assessment. J of Obstet Gynecol of India 2011:vol .61;291-295.
[3]. Das V,Katiyar N,Malik GK.Role of admission test.J Obstet Gynecol India 2001;51:48-50.
[4]. Jophy R,Thomas A,Jairaj P.Admission test as a screening procedure for perinatal outcome.J Obstet Gynecol India 2002;52:26-9.
[5]. Buckshee K,Deka D,Padmaja V,Bhatla N.Admission test as a predictor of fetal outcome.J Obstet Gynecol India 1999;49:36-7.
[6]. Desai P,Gadhvi U.Admission CTG as screening test for fetal distress:not reliable.J Obstet Gynecol India 2004;54:260-62.

Abstract: Background: Hemoglobinopathies are disorders affecting the structure, function, or production of hemoglobin. It is estimated that 8000-10000 children are born with thalassemia major every year in India. There are around 65000 thalassemia patients in our country at any given time. Objectives: To assess the prevalence of thalassaemia and other hemoglobinopathies in a northern district of West Bengal, India. Material And Methods: The Study was conducted at Malda Medical College, West Bengal – a rural tertiary care Health Care Institution during the period of january2012 to January 2013. High-performance liquid chromatography (HPLC), complete blood count (CBC) and hemagglutination technique were performed for the assessment of abnormal hemoglobin variants .

[1]. Michael R. DeBaun, Mellissa Frei Jones, and Elliott Vichinsky Hemoglobinopathies Chapter-456, in Nelson Text Book of Pediatrics, 19th edition, 2012;2:1662-1677.
[2]. MR Lokeswar Thalassemia Syndrome Chapter11.5 in IAP Text Book of Pediatrics, 5th edition; 2013:660-670.
[3]. Red Blood Cell and Bleeding Disorder, Chapter 14, in Robbin's Pathologic Basis of Disease 8th edition;2010:639-675.
[4]. Edward J. Benz Jr. Disorders of Hemoglobin Chapter 104, in Harrision's Principle of Internal Medicine,18th edition,2011;1:852-861. [5]. Modell B, Darlison M. Global epidemiology of hemoglobin disorders and derived service indicator. WHO. Bulletin of the World Health Organization. June 2008; volumes 86 No. 6, p 417-496. [6]. Mondal B, Maiti S, Biswas BK et al. Prevalence of hemoglobinopathy, ABO and rhesus blood groups in rural areas of West Bengal, India. J Res Med Sci. 2012 Aug;17(8):772-6. [7]. Jain BB, Roy RN, Ghosh S et al. Screening for thalassemia and other hemoglobinopathies in a tertiary care hospital of West Bengal: implications for population screening. Indian J Public Health. 2012 Oct-Dec;56(4):297-300.

Abstract: 18 year old male presenting with acute onset of abortive seizures, giddiness, diagnosed by Magnetic Resonance imaging as demyelination encephalopathy, received Intravenous immunoglobulin of 10gms, and he recovered. Consumption of prawns, water living, fish without scales, gills and essential fatty acids deprived diet as sunflower refined oil consumption, were present as etiology. 15 year old female of 30kg weight, presenting with thickened, bound down skin, positive antinuclear antibody, diagnosed as progressive systemic sclerosis, received intravenous immunoglobulin 15 grams, marvelously the skin reverted to pliability, soft beauty was restored . Consumption of prawns, water living, fish without scales, gills and essential fatty acids deprived diet as sunflower refined oil consumption were present as etiology. 24 year old female of 40 Kg weight, presenting with joint pains, positive antinuclear antibody, diagnosed to have systemic lupus erythematosus, received 20 gm of intravenous immunoglobulin and her symptoms and laboratory parameters improved. Consumption of prawns, water living, fish without scales, gills and essential fatty acids deprived diet as sunflower refined oil consumption were present as etiology.

[1]. Bevra Hannahs Hahn : Systemic lupus erythematosus; Harrison`s Principles of Internal Medicine, 18th edition 2012,volume 2 page 2724-2725 McGraw hill New York
[2]. John Varga : Progressive systemic sclerosis; Harrison`s principles of Internal Medicine, 18th edition, 2012, volume 2, page 2757-58 McGraw hill New York
[3]. Allan H Ropper, Robert H Brown : Multiple sclerosis and allied demyelinative diseases; Adams and Victor`s Neurology , 8th edition, 2005, page 775 McGraw Hill New York
[4]. Douglas S Goodin, Stephen L Hauser: Neuro myelitis optica; Harrison`s Principles of Internal Medicine 18th edition, 2012, page 3407 McGraw Hill New York
[5]. Bruce C Gilliland: Progressive systemic sclerosis; Harrison`s principles of Internal Medicine 11th edition 1987 volume 2 1429 McGraw Hill New York
[6]. John MendelSohn: Tumor cell biology, Harrisons Principles of Internal Medicine, 11th edition, volume 1 page 423
[7]. ElizabethJS : Autoimmunity and fragmented Germ cells; IOSR-Journal of Dental and Medical Sciences, volume 13, Issue 9, version 1 September 2014 pp 99-103

Abstract: Background: Oesophageal cancer believed to be rare in Africa is now assuming prominence in cancer incidence. Studies in some parts of the world showed that Blacks are at higher risk of oesophageal cancer than non-Blacks .The risk factors though similar with what obtain in developed nations( tobacco,obesity,long standing gatro-esophageal reflux),in Africa the role of local alcoholic drinks, poorly preserved grains and general low immunity couple with high rate HIV and AIDS are associated. AIm: Is to review the histological features of eosophageal carcinoma and provide a brief review of pathogenesis of pre-malignant and other risk factors associated with carcinoma of the eosophagus in African setting. The study will provide the basis for further epidemiological studies.

[1]. Mukta MW, La IT. Carcinoma of the esophagus and colon: In vitro models for
[2]. Cancer research CRC SERIES 1985: 1:4-7
[3]. Day NE, Munoz N. Esophagus. In: Schottenfeld D, Fraumeni JF, eds. Cancer epidemiology and prevention. Philadelphia: W.B.
Saunders Co., 1982: 596-623.
[4]. Rose, EF: Esophageal cancer in Transkei -the pattern and associated risk factors. In: Cancer of the Esophagus (Pfeiffer CJ, ed).
Boca Raton, FL: CRC Press, 1982; 19-28.
[5]. Yang CS. Research on esophageal cancer in China: a review. Cancer Res 1980, 40: 2633-2644.
[6]. Van Rensburg SJ. Epidemiology and dietary evidence for a specific nutritional predisposition to esophageal cancer. J Natl Cancer
Inst. 1981: 67(2):243-51.
[7]. Daly JM, Karnell LH, Menck, HR. National Cancer Data Base report on esophageal carcinoma. Cancer. 1996 Oct 15; 78(8):1820-
1828.

Abstract: Introduction: Patients with cervical cord lesions have an increased susceptibility of developing life-threatening gastrointestinal complications1-5. The reported incidence of gastrointestinal tract complications in spinal cord injury patients ranges from 4.7%3 to 6.2%1. Case Presentation:A case of traumatic quadriperesis presented with chief complaints of abdominal distention, obstipation and pain abdomen since day1. On examination gaseous distention of abdomen with guarding, rigidity bowel sounds were absent. Liver dullness was obliterated. Digital rectal examination revealed empty rectum.

[1]. Albert TJ, Levine MJ, Balderston RA, Cotler JM. Gastrointestinal complications in spinal cord injury.Spine (Phila Pa 1976) 1991;16:S522–5. [PubMed]

[2]. Leramo OB, Tator CH, Hudson AR. Massive gastroduodenalhemorrhage and perforation in acute spinal cord injury. Surg Neurol. 1982;17:186–90. [PubMed]

[3]. Soderstrom CA, Ducker TB. Increased susceptibility of patients with cervical cord lesions to peptic gastrointestinal complications. J Trauma. 1985;25:1030–8. [PubMed]

[4]. Galandiuk S, Raque G, Appel S, Polk HC., Jr The two-edged sword of large-dose steroids for spinal cord trauma. Ann Surg. 1993;218:419–25. [PMC free article] [PubMed]

[5]. Walters K, Silver JR. Gastrointestinal bleeding in patients with acute spinal injuries. IntRehabil Med.1986;8:44–7. [PubMed]

[6]. lynch, A.,Antony, A., Dobbs, B. and frizelle, F. (2001) Bowel dysfunction following spinal cord injury. Spinal cord, 39, 193-203. Doi:10.

Abstract: It has been reported that the immune system undergoes changes due to various factors, inflammation, surgery, medication, age and gender. The aim of this study was to investigate changes of salivary IgA (S-IgA) among healthy subjects undergoing active orthodontic treatment with fixed and removable appliance. The levels of S- IgA were determined before, 3 and 6 months after active orthodontic treatment. A total of 38 healthy individuals (aged 8-14 years) were enrolled in the study. They were divided into two equal groups. Group A were treated with fixed orthodontic appliances and group B were treated with removable orthodontic appliances. Two milliliters of saliva were collected from all participants before ,three and six months after treatment. Salivary IgA levels were measured by the ELISA technique.

[1]. Dawes C.(1993) Considerations in the development of diagnostic tests on saliva. Annals of the New York Academy of Sciences; 694: 265-269.
[2]. Bokor-Bratic M.(2000) Clinical significance of analysis of immunoglobulin A levels in saliva. Medicinski pregled;53: 164-168. [Article in Croatian]
[3]. Dodds MW, Jonson DA, Yeh CK.(2005) Health benefits of saliva: a review. Journal of Dentistry; 33(3): 223-233.
[4]. Gonçalves TS, Morganti MA, Campos LC, Rizzatto SM, Menezes LM.(2006) Allergy to auto-polymerized acrylic resin in an orthodontic patient. American Journal of Orthodontics and Dentofacial Orthopedics; 129(3); 431-435.
[5]. Bernimoulin JP.(2003) Recent concepts in plaque formation. Journal of Clinical Periodontology; 30(Suppl 5): 7-9.
[6]. Marcotte H, Lavoie MC.(1998) Oral microbial ecology and the role of salivary immunoglobulin A. Microbiology and Molecular Biology Reviews; 62(1): 71-109.

Abstract: A malignant epithelial neoplasm exhibiting squamous differentiation as characterized by the formation of keratin or the presence of intracellular bridges. Inhaled or chewed tobacco is equally addictive and harmful and used daily by over 1 billion people. In addition to increased rates of coronary artery disease, stroke, peripheral vascular disease, congestive heart failure, chronic obstructive pulmonary disease and lung cancers, tobacco are the leading preventable cause of oral cavity squamous cell carcinoma. In addition to tobacco, consumption and abuse of alcohol, and betel nut quid significantly contribute to the burden of oral cavity squamous cell carcinoma. Dental visits are excellent opportunities to identify primary lesions in the oral cavity. This review highlights relevant anatomy, epidemiology, pathogenesis, evaluation and treatment options for oral cavity squamous cell carcinoma.

[1]. Bray F, Ren JS, Masuyer E, Ferlay J. Global estimates of cancer prevalence for 27 sites in the adult population in 2008. International Journal of Cancer. 2013; 132: 1133-1145.
[2]. Funk GF, Karnell LH, Robinson RA, Zhen WK, Trask DK, Hoffman, HT. Presentation, treatment, and outcome of oral cavity cancer: A national cancer data base report. Head & Neck. 2002; 24: 165-180.
[3]. Warnakulasuriya S. Living with oral cancer: Epidemiology with particular reference to prevalence and life-style changes that influence survival. Oral oncology. 2010; 46: 407-410.
[4]. Watkins SS, Koob GF, Markou A. Neural mechanisms underlying nicotine addiction: acute positive reinforcement and withdrawal. Nicotine & Tobacco Research. 2000; 2: 19-37.
[5]. Petti S. Lifestyle risk factors for oral cancer. Oral Oncology. 2009; 45: 340-350.
[6]. Varela-Rey M, Woodhoo A, Martinez-Chantar ML, Mato JM, Lu SC. Alcohol, DNA Methylation, and Cancer. Alcohol Research: Current Reviews. 2013; 35: 25-35.
[7]. Brooks PJ, Theruvathu JA. DNA adducts from acetaldehyde: implications for alcohol-related carcinogenesis. Alcohol. 2005; 35: 187-193.

Abstract: Avascular necrosis is due to ischemic death of bone involving typically the femoral heads. Its incidence rate is higher in HIV infected patients and is multi factorial. Factors like dyslipidemia, alcohol use, steroid use, protease inhibitor in Highly Active Anti Retroviral Therapy regimen and HIV infection itself increases the incidence of avascular necrosis. We report a case of bilateral avascular necrosis of femoral heads in a HIV infected patient on protease inhibitor with alcohol abuse. The aim of this case report is to alert the clinicians involved in HIV care regarding avascular necrosis as a subtle yet frequent complication in a HIV infected patient with known predisposing factors when presenting with acute spontaneous non traumatic bilateral hip joint pain.

Keywords: Avascular necrosis, Femoral head, HAART, HIV, Protease Inhibitor.

[1]. J. Thomas and S. M. Doherty, ―HIV infection—a risk factor for osteoporosis,‖ Journal of Acquired Immune Deficiency Syndromes, vol. 33, no. 3, pp. 281–291, 2003.
[2]. Scribner AN, Paolo V, Troia-Cancio et al. Osteonecrosis in HIV: A Case-Control Study. JAIDS 2000; 25: 19-25.
[3]. Brown P., Crane L. Avascular necrosis of bone in patients with hguman immunodeficiency virus infection: report of 6 cases and review of the literature. AIDS 2001; 32:1221-6.
[4]. Calza L, Madfredi R, Mastroianni A, et al. Osteonecrosis and highly active antiretroviral therapy during HIV infection: report of a series and literature review. AIDS Patient Care STDs. 2001; 15:385-388.
[5]. Cagatay A.A., Diz-Kucukkaya R., Akyildiz GM., et al. Human immunodeficiency virus and avascular necrosis of the femoral head: a case report. Chin Med J 2004; 117:1437-40.
[6]. Meyer D, Behrens G, Schmidt RE, Stoll M. Osteonecrosis of the femoral head in patients receiving HIV protease inhibitors. AIDS 1999; 13:1147–8.

Abstract: The peripheral giant cell granuloma is a reactive exophitic polyploidy or multi nodular red purple nodules in the oral cavity, proliferates under local irritation and trauma. The present case was a slowly enlarging gingival mass with a reddish-purple surfaceis observed at the palatal gingiva in a school-girl of three months duration. Recently it started to interfere with mastication processas the size of the lesion was enlarged. Periapical radiography revealed crestal bone loss between the teeth 21 and 22. However, hematological examination revealed normal serum level of calcium, phosphorous and alkaline phosphatase and the condition was diagnosed as a benign peripheral giant cell granuloma after surgical excision of the mass and histopathology. A follow up schedule was arranged for the patient for checking recurrence and there was no evidence of recurrent.

Keywords: peripheral, Giant cell,reactive ,exophitic ,histopathology

[1]. Passi, S., Sharma, N., Sharma, R. & Gulati, A. Peripheral Giant Cell Granuloma. Innovative Journal of Medical and health Science, 3,2013.
[2]. Yalcin, E., Ertas, U. & Altas, S. 2010. Peripheral giant cell granuloma: a retrospective study. Ataturk Univ Dis Hek Fak Derg, 20, 2010,34-37.
[3]. Shafi, M., Reyaz Ahmed Mir, D., Khan, N., Abdullah, M. Y. & Nazir, H. Unusually large peripheral giant cell granuloma-a case report, IOSRJournalofDentaland MedicalSciences(IOSR-JDMS).Volume 12,Issue 1(Nov.-Dec.2013),PP33-36
[4]. Cloutier, M., Charles, M., Carmichael, R. P. & Sándor, G. K. An analysis of peripheral giant cell granuloma associated with dental implant treatment. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology, 103,2007, 618-622.
[5]. Etoz, O. A., Demirbas, A. E., Bulbul, M. & Akay, E. The peripheral giant cell granuloma in edentulous patients: report of three unique cases. European journal of dentistry, 4, 2010,

Abstract: Lymphoid tumors are amongst the common tumors occurring in the ocular adnexa. Orbital lymphoma appearing in the lacrimal gland region accounts for about 11% of all orbital lymphomas. Non-Hodgkin's lymphomas (NHLs) are among the most common ocular adnexal primary tumors. We present a 48- year-old male with bilateral superotemporal orbital mass and mechanical ptosis. Orbital mage obtained by computed tomography scanning showed bilateral bulky lacrimal glands and histopathology demonstrated monomorphic small lymphocytic cells suggestive of Non-Hodgkin's lymphoma.

Keywords: Non-Hodgkin's lymphoma, lacrimal gland, tumors

[1]. Ellis JH, Banks PM, Campbell RJ, Lieseganj TJ. Lymphoid tumours of the ocular adnexa: Clinical correlation with the working classification and immunoperoxidase staining of paraffin section. Ophthalmology 1985;92:1311-24.
[2]. Freeman C, Berg JW, Cutler SJ. Occurrence and prognosis of extranodal lymphomas. Cancer.1972;29(1):252-260.
[3]. Shields JA, Shields CL, Scartozzi R. Survey of 1264 patients with orbital tumours and simulating lesions: the 2002 Montgomery Lecture, Part 1. Ophthalmology.2004;111(5):997-1008.
[4]. Sjo¨LD, Ralfkiaer E, Prause JU,et al Increasing Incidence of Ophthalmic Lymphoma in Denmark from 1980 to 2005.Invest Ophthalmol Vis Sci. 2008;49(8):3283-3288.
[5]. Coupland SE, Hellmich M, Auw-Haedrich C, Lee WR, Stein H. Prognostic value of cell-cycle markers in ocular adnexal lymphoma: an assessment of 230 cases. Graefes Arch Clin Exp Ophthalmol. 2004 Feb;242(2):130-45.
[6]. Jenkins C, Rose GE, Bunce C,et al Clinical features associated with survival of patients with lymphoma of the ocular adnexa. Eye(Lond). 2003 Oct;17(7):809-20

Abstract:Ameloblastoma can be described as an epithelial odontogenic jaw tumor which shows various single or combined patterns when observed under the microscope. It is the commonest type of jaw tumor after Squamous Cell carcinoma. Generally, it develops as early as tooth formation takes place and in adults it can develop from odontogenic cysts or cell rests. It comprises of solid tissues made up of various cystic cavities. The tumor histologically is made up of webs of ameloblasts. Radio graphically, it represents itself as unicystic or multicystic. The tumor grows gradually and is malignant locally but does not result in metastasis to the lymph nodes generally. Ameloblastoma can be treated by radical surgical removal. The jaw is the commonest site for the tumor to originate and a resection of the mandible is the best treatment in serious cases. Very rarely does the jaw need to be completely resectioned. Here is a case report on the treatment of Ameloblastoma's in the Oral and Maxillofacial Surgery department of M.R Ambedkar Dental College & Hospital located in Bangalore. In this report, there are two cases which have been treated by resection, one with and the other without the PMMC flap. The patients were regularly followed-up to look for recurrence and to find out any other complications which can arise after the jaw's resection.
Keywords: Ameloblastoma, Hemimandibulectomy, Segmental Resection

[1]. Hennry M. Cherrick .Odontogenictumors of the jaw. In: Daniel M Laskin. Ed. Oral and Maxillofacial surgery, Delhi, India: AITBS. 2009. P. 626-636.
[2]. Small IA, Waldron CA. Ameloblastoma of the Jaws. Oral Surg Oral Med Oral Pathol 1995;8:281–297.
[3]. Chaudhuri P: Ameloblastoma of the upper jaw. J Laryngol Otol. 1975;89:457–465.
[4]. Reichart PA, Philipsen HP, Sonner S. Ameloblastoma: Biological profile of 3677 cases. Oral Oncol, Eur 'j Cancer. 1995;31:86-99.
[5]. WHO classification. Oral Oncol. 2006;42:757– 758.