iosr-JDMS   Volume-14 ~ Issue-8 ~ August-2015

Abstract: Most pruritus occurs in association with skin diseases; but gingival pruritus seldom seen in associated with oral dysesthesia. Most clinicians, including dental practitioners, do not know about how to deal with gingival pruritus. Our patient was a 74-year-old Japanese female who attended the Department of Oral Medicine, Tokushima University Hospital, because of gingival pruritus. Pregabalin was begun at a dosage of 50 mg twice daily, and increased up to 150 mg. The pruritus was improved 4 weeks after treatment initiation, and disappeared 6 weeks later. Pregabalin dosage was subsequently tapered down and withdrawn 34 weeks after initiation. The patient accomplished the treatment goal without adverse events. Pregabalin remarkably relieved gingival pruritus associated with oral dysesthesia, and may become a new therapeutic option for the treatment of gingival pruritus.

[1] G. Yosipovitch, J. D. Bernhard, Clinical practice. Chronic pruritus, N Engl J Med, vol. 368, pp. 1625-1634, 2013.
[2] A. Reich, M. Heisig, N. Q. Phan, et al, Visual analogue scale: evaluation of the instrument for the assessment of pruritus, Acta Derm Venereol, vol. 92, pp. 497-501, 2012.
[3] B. F. Shneker, J. W. McAuley, Pregabalin: a new neuromodulator with broad therapeutic indications, Ann Pharmacother, vol. 39, pp. 2029-2037, 2005.
[4] G. Porzio, F. Aielli, L. Verna, et al, Efficacy of pregabalin in the management of cetuximab-related itch, J Pain Symptom Manage, vol. 32, pp. 397-398, 2006.
[5] J. Ehrchen, S. Stander, Pregabalin in the treatment of chronic pruritus, J Am Acad Dermatol, vol. 58 (Suppl), S36-S37, 2008.

Keywords: During routine dissection in a male cadaver of about 60 years of age , left upper limb showed bifurcation in the second part of Axillary artery in to Superficial and Deep brachial arteries. Superficial brachial artery runs antero- medial to median nerve and continued its course in the arm and divided in to radial and ulnar arteries in cubital fossa. Deep brachial artery trifurcated in to anterior circumflex humeral artery, posterior circumflex humeral artery and Profunda brachii artery. Knowledge of such variation in axillary artery is important for surgeons during surgical procedures.

[1]. Adachi B. Arteren system des japaner. Kyoto 1928;1:205-10
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[3]. Cavdar S, Zeybek A, Bayramicli M. Rare variation of the axillary artery. ClinAnat2000: 13:6–68
[4]. Desai SD, Sreepadma S, Rathnakar P. Anomalous division of axillaryartery–a case report. Anatomica Karnataka2011: 5:57–60
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[6]. Jurjus AR, Correa De Aruaujo R, Bohn RC. Bilateral double axillary artery:embryological basis and clinical implications. Clin Anat 1999:12:135–140)

Keywords: Sciatic nerve palsy is a recognized but a rare complication in post-operative period of hip arthroplasty. The prevalence of the same is very low with range of 0.3% to 4%. In review of literature, multiple cases of sciatic nerve palsy after total hip arthroplasty (THA) found to be reported but only few cases of sciatic nerve palsy post bipolar hemi-arthroplasty reported in literature. Various aetiologies have been reported in literature for the same ie., direct trauma, compression from instruments, perforating parts of prosthesis, thermic effect of bone cement or cautery, due to limb lengthening or haematoma formation. Post-hip arthroplasty, neuropathy may be caused by external compression or by internal compression and ischemia due to postoperative oedema, hematoma formation or intraneural bleeding.

[1]. Amstutz H.C., Ma S.H., Jinnah R.H., Mai L.( 1982) Revision of aseptic loose total-hip arthroplasty. Clin. Orthop.; 170:21-33.
[2]. Edwards B.N., Tullos H.S., Noble P.C.( 1987) Contributory factors and etiology of sciatic nerve palsu in total hip arthroplasty. Clin.orthop.; 218: 136-241.
[3]. Johanson N.B., Pellici P.M., Tsairis P., Salvati E.A.(1983) Nerve injury in total hip arthroplasty. Clin. Orthop.; 179: 214-222.
[4]. Schmalzried T.P., Amstutz H.C., Dorey F.J.( September 25, 1991) Nerve palsy associated with total hip replacement. Presented at: "Total hip replacement : changing times; what works and what doesn't". Massachusetts.
[5]. Schmalzried T.P., Amstutz H.C., Dorey F.J.(1991) Nerve palsy associated with total hip replacement. J. Bone Joint Surg.; 73-A: 1074-80.

Keywords: International Association of Ambulatory Surgery defines day-care surgery as 'An operation or procedure, an office or outpatient operation/procedure, where the patient is discharged on the same working day'. The rapidly changing financial situation in the world has led to the increase in the incidence of ambulatory surgery. The advances in surgery, anaesthesia and pain management have allowed huge expansion of this modality of care with a consequent reduction in the need for hospitalization. The advantages of day care surgeries are to the patient, hospital and to the insurance companies. Choice of anaesthetic technique, drugs for premedication, induction and maintenance of anaesthesia are all important. Ketamine is an effective analgesic when used as an anaesthetic.

1]. Chilvers CR, Goodwin A, Vaghadia H, Mitchell GW. Selective spinal anesthesia for outpatient laparoscopy: Pharmacoeconomic comparison vs general anesthesia. Can J Anaesth. 2001; 48:279–83.[PubMed]

[2]. Stierer TL, Wright C, George A, Thompson RE, Wu CL, Collop N. Risk assessment of obstructive sleep apnea in a population of patients undergoing ambulatory surgery. J Clin Sleep Med. 2010; 6:467–72.[PMC free article] [PubMed]

[3]. Hutchison A, Malltby JR, Reid CR. Gastric fluid volume and pH in elective patients. Part 1: Coffee or orange juice versus overnight fast. Can J Anaesth.1998; 3; 512–5. [PubMed]

[4]. Waters RM.The down- town anaesthesia clinics. Am J surg 1919; 33:71-73.

Keywords: Ropivacaine Is A New Intermediate-Acting Amide Local Anesthetic Which Is Structurally Closely Related To A Chemical Group Of Amino Amides In Present Clinical Use E.G. Bupivacaine And Mepivacaine. Ropivacaine Has Pharmacodynamic And Pharmacokinetic Properties In Animals Resembling Those Of Bupivacaine(1,2,3). In Human Volunteers, Ropivacaine Has Been Shown To Be Less Prone Than Bupivacaine To Produce Mild Central Nervous System And Cardiovascular Changes After Intravenous Infusion.

[1]. Akerman B, Hellberg I-B, Trossvik C. Primary Evaluation Of The Local Anaesthetic Properties Of The Amino Amide Agent Ropivacaine (LEA 103). Acta Anaesthesiol Scand 1988; 32: 571-8.
[2]. Feldman HS, Covino BG. Comparative Motor-Blocking Effects Of Bupivacaine And Ropivacaine, A New Amino Amide Local Anesthetic, In The Rat And Dog. Anesth Analg 1988; 67: 1047-52.
[3]. Arthur GR, Feldman HS, Covino BG. Comparative Pharmacokinetics Of Bupivacaine And Ropivacaine, A New Amide Local Anesthetic. Anesth Analg 1988; 67: 1053-8.
[4]. Rut~En AJ, Nancarrow C, Mather LE, Ilsley AH, Runciman WB, Upton RN. Hemodynamic And Central Nervous System Effects Of Intravenous Bolus Doses Of Lidocaine, Bupivacaine, And Ropivacaine In Sheep. Anesth Analg 1989; 69: 291 9.
[5]. Scott, DB, Lee A, Fagan 1), Bowler GMR, Bloomfield P, Lundh R. Acute Toxicity Of Ropivacaine Compared With That Of Bupivacaine. Anesth Analg 1989; 69: 563-9.
[6]. Katz JA, Bridenbaugh PO, Knarr DC, Helton SH, Denson DD. Pharmacodynamics And Pharmacokinetics Of Epidural Ropivacaine In Humans. Anesth Analg 1990; 70: 16-21.

Keywords: Giant inguinal hernias are rare . A case of giant inguinal hernia in a 67-year-old male with discomfort in performing his daily chores is reported. Patient had a giant inguinal hernia (Rt) which was irreducible, non tender & had no cough impulse. Elective hernia repair via inguinoscrotal approached revealed small & large intestines, omentum as contents. Orchidectomy, omentectomy & reduction of contents into abdominal cavity with the help of infraumbilical midline incision & right meshplasty was done without any complication.

[1]. Sarakbi W.Al., Agrawal A, Taffinder A. A giant inguinoscrotal hernia: a case report and review of the literature. Grand rounds 2005;5:46-48.
[2]. Burke TP, Joyce KM, Ahmed K, Waters PS, Khan W, Barry K. Giant inguinoscrotal hernia: An emergency presentation with life threatening sepsis.2014;5(6):456-58(A1)
[3]. Patsas, A., Tsiaousis, P., Papaziogas, B.,Koutelidakis. I., Goula, C. & Atmatzidis, K.(2010). "Repair of a Giant Inguinoscrotal Hernia," Hernia.2010;14(3):305-7.(A2)
[4]. Ikhwan SM, Saiful AS, Ibariyah MI, Zaidi Z. Giant Inguino- scrotal Hernia: Repair and Management. Journal of Dental and Medical sciences.2013;4:42-5.
[5]. Tahir M., Ahmed F.U., Seenu V. Giant inguinoscrotal hernia: case report and management principles. Int J Surg. 2008;6:495–97.

Keywords: Granulomatous prostatitis is a rare benign inflammatory condition of prostate. It is mistaken for prostatic carcinoma. Clinically it presents as hard nodule on digital rectal examination with raised serum prostate specific antigen (PSA) levels and reduced free PSA levels. We report a rare case of non-specific granulomatous prostatitis clinically diagnosed as carcinoma prostate.

Keywords: granulomatous prostatitis , non –specific granulomatous prostatitis, prostatic carcinoma

[1] Tanner FH, Me Donals JR. Granulomatous prostatitis : a histologic study of a group of granulomatous lesions collected from prostate -lands. Arch Pathology Lab Med 1943: 36: 358-370.
[2] Punia R , Amanjit , Mohan H, Bawa A S. Granulomatous prostatitis – an infrequent diagnosis: Indian J Urol 2002;19: 16-19.
[3] Stillwell TJ. Engen DE. Farrow GM. The clinical spectrum of granulomatous prostatitis : a report of 200 cases. J Urol 1987: 138: 320-323.
[4] Bryan RL. Newman J, Campbell A. Fitzgerald G. Kadow C. O'Brien JM. Granulomatous prostatitis : a clinicopathological study. Histopathology 1991; 19: 453-457.
[5] Epstein JI. Hutchins GM. Granulomatous prostatitis: distinction among allergic. non-specific and post-transurethral resection lesions. Hum Path 1984: 15: 818-825.
[6] Alpeshpuri P Goswami, Dr. G. Rupala, Dr.Nutanbala, N. Goswami, Serum PSA level in Prostatic lesions with histopathological correlation in Gujarat. NJIRM 2011 : 2(4) : 33-38.

Keywords: Objective(s): To evaluate the women presenting with post-coital bleeding by cytology, colposcopy and histopathology and to formulate the strategy for management of patients with this symptom. Method(s): This prospective study was carried out in 100 women attending Gynae outdoor with complaints of post coital bleeding by using cytology, colposcopy and colposcopic directed biopsy of suspicious lesion. Result(s): Out of 100 patients, 30 patients had normal colposcopy findings and biopsy was not taken in these patients, 13 cases had biopsy unremarkable. 29 cases had chronic cervicitis, 6 cases had cervical polyp, 11 cases had cervical intra-epithelial neoplasia, 2 cases had carcinoma in situ and 8 cases had invasive cancer of cervix. Cervical erosion was the most common benign colposcopic finding.

[1]. Albers JR, Hull SK, Wesley RM; Abnormal uterine bleeding; Am Fam Physician; 2004 April; 15; 69(8) : 1915-26.

[2]. Smith CB, pinpointing the causes the causes of abnormal uterine bleeding. Women health prim care, 1998 ; 1 : 835-844.

[3]. Shapley M, Jordan J, Croft PR, A systematic review of postcoital bleeding and risk of cervical cancer. Br J Gen Pract. 2006 Jun; volume 56 , number 527: pp 453-60 (8).

[4]. Cline, M.K. et al (1994). Papanicolaou smear discrepancy : Resolution of review. J. Am. Board Fam Pract. 1994 Jan-Feb; 7 (1) : 9-13. [5]. Abu J, Davies Q, Ireland D. Should women with postcoital bleeding be referred for colposcopy? J Obstet Gynaecol. 2006 Jan; 26(1) : 45-7.

[6]. Shalini R, Amita S, Neera MA. How alarming is postcoital bleeding : a cytologic, colposcopic and histopathologic evaluation. Gyecol Obstet. Invest. 1998; 45(3) : 205-8.

Keywords: Anaesthesia for oesophageal atresia (OA) and tracheosophageal fistula (TOF) repair poise a great challenge to the anaesthetist particularly in the preparation and optimization of the patient, meticulous intraoperative and postoperative management. We report the successful management of a four day old neonate with OA and TOF who was operated and admitted into the intensive care unit and later discharged to the paediatric surgical ward for further management. It is concluded that with proper decision making process and commitment such treatment can be managed in our hospitals despite our limited resources. Keywords: Tracheosophageal Fistula (TOF): Anaesthetic management, oesophageal atresia, tracheosophageal fistula repair, tertiary hospital.

1]. Adzick NS, Nance ML: Paediatric Surgery-First of two parts. New England Journal of Medicine 2000, 342 (22): 1651-1657.
[2]. Diaz LK, Akpek EA, Dinavahi R, Andropoulos DB: Tracheoesophageal fistula and associated congenital heart disease: implication for anaesthetic management and survival. Pediatric Anesthesia; 2005, 15: 862-869.
[3]. Rawi O, Booker PD: Oesophageal Atresia and Tracheoesophageal Fistula, Continuing Education in Anaesthesia, Critical Care & Pain; 2007, 7 (1): 15-19.
[4]. Gupta A: Tracheoesophageal Atresia and Anaesthetic Management. Indian J. Anaesth: 2002, 46 (5): 353-355.
[5]. Kumra VO: Anaesthetic considerations for specialized surgeries peculiar to paediatric age group, Indian J. Anaesth; 2004, 48 (5): 376-386.

Keywords: The Duane syndrome is a strabismus syndrome which is characterized by congenital non-progressive horizontal ophthalmoplegia which primarily affects the abducens nerve. Approximately 70% of the individuals with the Duane syndrome have an isolated disease. We have described here, a case of bilateral Duane syndrome with associated anamolies.

Keywords: Duane syndrome , Bilateral Congenital Zonular cataract , Hypertelorism , Lash Ptosis.

[1]. Duane A. A congenital deficiency of abduction which was associated with the impairment of adduction, contraction of the palprebral fissure and oblique movements of the eye.Arch Opth. 1905; 34:133-59.
[2]. Lee SH, Lee JH, Lee SY, Kim SY. A case of pseudo-Duane's retraction syndrome with old medial orbital wall fracture. Korean J Ophthalmol. 2009 December; 23(4): 329-31.
[3]. Gutowski MJ. The Duane syndrome. A review. European J Neurology.2000;7:145-49.
[4]. Andali D, Javadzadeh A. Lateral rectus muscle disinsertion and reattachment to the lateral orbital wall in exotropic Duane syndrome: a case report. J Med Case Reports. 2008; 2: 253.
[5]. Wang KM, Liu LJ, Zhang FH. Treatment of Duane's retraction syndrome by recession of the medial and the lateral rectus muscles, combined with a Y-splitting procedure. Chinese Journal of Ophthalmology. 2007 Nov;43(11):972-76.

Keywords: Oral diseases persist to be a major health problem around the world. Apart from dental caries and periodontal diseases which are the most important global oral health problems, other conditions like oral and pharyngeal cancers and oral tissue lesions are also of important concern.Oral health is essential to general well-being and is related to the quality of life that extends beyond the functioning of the craniofacial complex. In most developing countries, expenditure in oral health care is low; access to dental healthcare is limited and is generally restricted to emergency dental care or pain relief.

[1]. Torwane NA, Hongal S, Goel P, Chandrashekar B R. Role of Ayurveda in management of oral health. .Phcog Rev 2014;8:16-21.
[2]. Palombo EA. Traditional Medicinal Plant Extracts and Natural Products with Activity against Oral Bacteria: Potential Application in the Prevention and Treatment of Oral Diseases. J Evid Based Complementary Altern Med 2011: 1-5
[3]. Dash TR, Singh N, Gupta D, et al. Role of Medicinal Herbs in Oral Health Management.
[4]. Dent Med Res 2014;1:113-119.
[5]. Sudhir H, TorwaneNA, Pankaj G,et al. Role of unanai system of medicine in management of Orofacial Diseases. A Review. J of Clin Diagn Res2014;8:ZE12-ZE15.
[6]. Mel Borins. Traditional Medicine of India. Can Fam Physician. 1987; 33:1063-1065.

Keywords: Asthma is a chronic inflammation of the airways that causes narrowing of it with reversible episodes of obstruction due to mucous, cellular and debris accumulation. The aim of this study was to detect any risk factor for pediatric asthma development. Thirty five Iraqi asthmatic children patients enrolled in this study who diagnosed under the supervision of consultant physician. The results of this investigation were compared with 40 apparently healthy control children who matched the patients in their age range & gender. According to a questionnaire which designed & arranged to facilitate the detection of the supposed etiological, and risk factors.

[1]. Wenzel SE, Szefler SJ. & Leung DXM, ―A definition of asthma‖. Am. Rev. Respir. Dis. 146: 633-7 (2000).
[2]. William K ―Allergic and Environmental asthma‖ www.newasthma.com (2005). [3]. Robinson PD, et al., ―Asthma in childhood‖. Pediatric Clinics of North America. 56: 191-226 (2009).
[4]. Guilbert T, Krawiec M. ―Clinical feature of childhood asthma‖. Pediatric Clinics of North America. 50: 524–538 (2003).
[5]. Martinez FD. ―Development of wheezing disorders and asthma in preschool children‖. Pediatrics. 109: 362–367 (2002).
[6]. Etzel RA. ―How environmental exposures influence the development and exacerbation of asthma‖. Pediatrics. 112: 233–239(2003).

Keywords: Childhood TB is grossly under detected in most TB endemic areas due to multiple reasons. Most of the patients who go to TB centres would have already consulted General Practitioners (GP's) at one stage or other. Materials & methods: A prospective observational study in which total of 110 medical practitioners. They were provided with a pre-tested, structured questionnaire which included practitioners qualification, type of clinical practice and years of practice and the questions were framed as true/false questions and multiple choice questions on diagnosis and management of paediatric tuberculosis.

1]. Lancet Infect Dis 2003; 3: 624–32
[2]. Donald PR. Childhood tuberculosis: out of control? Curr Opin Pulm Med 2002; 8 : 178-82.
[3]. Starke JR, Correa AG. Management of mycobacterial infection and disease in children. Pediatr Infect Dis J 1995;14:455-70.
[4]. Styblo K, Rouillon A. Tuberculosis in developing coun- tries: burden, intervention and cost. Bull Int Union Against Tuber Lung Dis 1990;65:6-24.
[5]. Starke JR, Jacobs R, Jereb J. Resurgence of tuberculosis in children. J Pediatr 1992;120:839-55.

Keywords: Our study was aimed at analyzing the clinical and radiological outcome following "Primary Intramedullary Interlocking Nailing in the treatment of Open Tibial Shaft Fractures". It was a prospective study done over a period of about 3 years analyzing 31 patients in total. Our inclusion criteria was open tibial fractures classified under the gustilo and Anderson classification from grade I – grade IIIB. Grade IIIC fractures and non unions, tibial fractures not treated primarily by intramedullary devices were excluded from the study. The average age of the 31 patients was 37 years and majority being males at 28 of them. 6 patients had other associated injuries.

[1]. Giannoudis PV, Papakostidis C, Roberts C. A review of the management of open fractures of the tibia and femur. VOL. 88-B, No. 3, March 2006;281-9
[2]. Gustilo RB, Anderson JT. Prevention of infection in the treatment of on thousand and twenty five open fractures of long bones: retrospective and prospective analyse. JBJS Am 1976;58:453-458
[3]. Keating JF, Blachut PA, O'Brien PJ, Court-Brown CM.Reamed Nailing Of Gustilo grade-IIIb Tibial Fractures JBJS Vol 82-B, No.8, November 2000,1113-1116.
[4]. Smith, J.E.M.: results of early and delayed internal fixation for tibial shaft fractures. A review of 470 fractures. J. Bone and joint Surg., 56-B(3): 469-477,1974.
[5]. Hamza, K. N.; Dunkerley,G. E.; and Murry, C. M. M.: fractures of the tibia. A report on fifty patients treated by intramedullary nailing. J. Bone and Joint Surg., 53-B (4): 696-700, 1971
[6]. Smith, J.E.M.: results of early and delayed internal fixation for tibial shaft fractures. A review of 470 fractures. J. Bone and joint Surg., 56-B(3): 469-477,1974.

Keywords: Background: The objective of this study was to compare the efficacy and tolerability of nab paclitaxel (NP) and carboplatin based induction chemotherapy (IC) for advanced head neck squamous cell carcinoma patients. Methods: 32 patients with advanced head and neck cancer who underwent three cycles IC with NP and carboplatin were retrospectively analysed for the response and tolerability. Results: 28 patients completed the planned course of IC. The number of patients achieving complete response; partial response; stable disease;progressive disease at the primary and neck nodal site were 10/16/2/0 and 7/8/0/1 respectively. The most common adverse effects encountered were fatigue (71%), peripheral sensory neuropathy (53.57%) , Gastrointestinal( 32.14%) and anemia (17.85%).

[1]. Siegel R, Ma J, Zou Z, Jemal A (2014) Cancer statistics, 2014. CA Cancer J Clin 64(1):9–29.
[2]. Howlader, N., A. M. Noone, M. Krapcho, J. Garshell, D. Miller, S. F. Altekruse, et al. eds. 2012. SEER Cancer Statistics Review, 1975–2009(Vintage 2009 Populations).National Cancer Institute, Bethesda, MD.
[3]. Schell A, Ley J, Wu N, Trinkaus K, Wildes TM, Michel L, Thorstad W, Gay H, Lewis J, Rich J, Diaz J, Paniello RC, Nussenbaum B, Adkins DR. Nab-paclitaxel- based compared to docetaxel-based induction chemotherapy regimens for locally advancedsquamous cell carcinoma of the head and neck Cancer Med. 2015 Apr;4(4):481-9.
[4]. Posner, M. R., D. M. Hershock, C. R. Blajman, E.Mickiewicz, E. Winguist, V. Gorbounova, et al. 2007. Cisplatin and fluorouracil alone or with docetaxel in head and neck cancer. N. Engl. J. Med. 357:1705–1715.
[5]. Vermorken, J. B., E. Remenar, C. van Herpen, T. Gorila,R. Mesia, M. Degardin, et al. 2007. Cisplatin, fluorouracil,and docetaxel in unresectable head and neck cancer. N.Engl. J. Med. 357:1695–1704.

Keywords: Objective:We wish to present an interesting case of a young male who is a chronic alcoholic who presented with abdominal pain to our outpatient department. In this case patient had liver cirrhosis with acute pancreatitis complicated by infective endocarditis. Design:He had clinical, laboratory and radiological features of acute pancreatitis and chronic liver disease at time of admission. Results:He was treated and discharged. He came back with high grade fever and hypotension. A repeat CT scan of abdomen showed sequelae of acute pancreatitis including developing pseudocyst. As he continued to have high grade fever despite antibiotics an echocardiogram was done which was suggestive of severe mitral regurgitation with vegetation on the mitral valve. Patient received treatment for same.

[1]. Lee Goldman, Andrew I Schafer,Guadalupe Garcia-Tsao: Cirrhosis and its sequelae;Cecil text book of medicine;chapter 156:999-1006 25th edition, Saunders An Imprint of Elsevier.
[2]. Mark Feldman , Lawrence S Freidman, Lawrence J Brandt, Scott Tenner and William M. Steinberg. Acute pancreatitis; Sleisenger and Fordtran9th edition; 959-983, Saunders An Imprint of Elsevier.
[3]. Lee Goldman, Andrew I Schafer,Vance G Fowler, JR., Arnold S. Bayer, Larry M. Baddour. Infective Endocarditis:Cecil textbook of medicine 25th Edition:474-483,Saunders An Imprint of Elsevier.
[4]. Johnson DH ,Cunha BA:Infections in cirrhosis.Infect Dis Clin North Am 2001;15:363-71
[5]. Borzio M, SalemoF,Piantoni L, et al: Bacterial infection in patients with advanced cirrhosis; a multicentre prospective study. Dig Liver Dis 2001; 33:41-8

Keywords: Aim Our study aimed at evaluating the role of MDCT for the detection and characterization of various neck lesions and characterization of lymph nodes as benign or malignant. Material and methods- This study was carried out in 100 patients of neck lesions suspected clinically or by previously performed ultrasonography in the Department of Radio-diagnosis, Dr. D. Y. Patil Medical College and Research Centre, Pimpri, Pune after approval from the ethics committee on 'Philips Ingenuity 128 Slice CT Scanner. The CT findings of neck lesions were analyzed on plain and contrast study.

[1]. Alberico RA, Husain SH, Sirotkin I. Imaging in head and neck oncology. Surg Oncol Clin N Am. 2004 Jan;13(1):13-35.
[2]. Pushpender G, Satish KB, Gopesh M, Vineeta R. Role of Multislice Spiral CT in the Evaluation of Neck Masses. JIMSA 2013;26(1):51-4.
[3]. Wippold FJ. 2nd, Head and Neck Imaging: The Role of CT and MRI. J Magn Reson Imaging 2007;25(3):453-65.
[4]. Ozkiris M, Kala M. Histopathological examination of patients operated on for a neck mass:4-year follow-up results. Turkish J of pathol 2011;27(2):1347.
[5]. Abhinandan B , Chakraborty A, Purkaystha P. Prevalence of head and neck cancers in the north east - an institutional study. Indian Journal of Otolaryngology and Head and Neck Surgery 2006;58(1).
[6]. Lasrado S, Prabhu P, Kakria A, Kanchan T, Pant S, Sathian B. Clinico-pathological Profile of Head and Neck Cancers in the Western Development Region, Nepal: A 4-Year Snapshot, Asian Pacific Journal of Cancer Prevention,2012; 12.
[7]. Maurea S, Cuocolo A, Reynolds JC, Neumann RD, Salvatore M. Diagnostic imaging in patients with paragangliomas - Computed tomography, magnetic resonance and MIBG scintigraphy comparison. Q J Nucl Med. 1996;40(4):365-71.

Keywords: Diffuse and focal thyroid disease is common thyroid disorder. Incidence of nodularity within thyroid is high (50-70%).Ultrasound is the most sensitive imaging test available for the examination of the thyroid gland. It confirms presence of a thyroid nodule when the physical examination is equivocal and differentiate between thyroid nodules and cervical masses from other origin. Incidence of thyroid cancer is low (<1% of all malignancies). The dilemma for the radiologist is how to identify the few thyroid cancers present within a multitude of benign thyroid nodules.

[1]. Kochupillai N. Clinical endocrinology in India. Current Science 2000;79(8):1061-7.
[2]. Cooper DS, Doherty GM, Haugen BR, Kloos RT, Lee SL, Mandel SJ, Mazzaferri EL, McIver B, Sherman SI, Tuttle RM; American Thyroid Association Guidelines Taskforce. Management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid. 2006 Feb;16(2):109-42.
[3]. Walker J, Findlay D, Amar SS, Small PG, Wastie ML, Pegg CA. A prospective study of thyroid ultrasound scan in the clinically solitary thyroid nodule. Br J Radiol. 1985 Jul;58(691):617-9.
[4]. Taylor KJ, Carpenter DA, Barrett JJ. Gray scale ultrasonography in the diagnosis of thyroid swellings. J Clin Ultrasound. 1974 Dec;2(4):327-30.
[5]. Phuttharak W, Somboonporn C, Hongdomnern G. Diagnostic performance of gray-scale versus combined gray-scale with colour doppler ultrasonography in the diagnosis of malignancy in thyroid nodules. Asian Pac J Cancer Prev. 2009;10(5):759-64.

Keywords: 'Non-carious cervical lesion' (NCCL), is defined as any non-carious loss of hard tissue at the cervix of the tooth that have a wide variety of size, shape, symmetry, and location. They occur predominantly on the buccal surfaces of teeth, but may occur on the lingual or proximal surfaces or both. Clinically NCCLs have been classified according to the causes factors to Abression, erosion, and abfraction.

[1]. Bader, J., et al., Case‐control study of non‐carious cervical lesions. Community Dent Oral Epidemiol, 1996. 24(4): p. 286-291.
[2]. Levitch, L., et al., Non-carious cervical lesions. J Dent, 1994. 22(4): p. 195-207.
[3]. Frank, R. and J. Nalbandian, Structure and ultrastructure of dentine, in Teeth. 1989, Springer. p. 173-247.
[4]. Braem, M., P. Lambrechts, and G. Vanherle, Stress-induced cervical lesions. J Prosthet Dent, 1992. 67(5): p. 718-722.
[5]. Kitchin, P.C., The prevalence of tooth root exposure, and the relation of the extent of such exposure to the degree of abrasion in different age classes. J Dent Res, 1941. 20(6): p. 565-581.

Keywords: Dentin sensitivity can cause considerable pain for patients. This condition is frequently encountered by periodontists and endodontists. The management of this condition requires a good understanding of the complexity of the problem, as well as the variety of treatments available1. This review considers the etiology, mechanism and management of dentinal hypersensitivity.

Key words: Dentinal hypersensitivity, desensitizing agents, cervical sensitivity.

[1]. Branstorm M Astrom The hydrodynamics of the dentine, its possible relationship to dentinal pain Int.Dent J 1972;22:219-27.
[2]. Dababneh RH, KhouriAT,Addy M et al: Dentine hypersensitivity: Dentine hypersensitivity an enigma? A review of terminology,mechanisms, aetiology and management. Br Dent J 1999; 187(11): 606-611
[3]. GriffithsH,Morgan G, G, Williams K, et Aj. The measurement in witro of streaming potential wiyh fluids flow across dentine and hydroxyapatite.J periodontal Res 1993 28: 59-65.
[4]. Matthews B, Vongsavan N. Interaction between neural and hydrodynamic mechanisms in dentin and pulp. Arch oral Bioi 1994 39(supplement): S87-S95. Managing dentin hypersensitivity.
[5]. alexander DC. First ever recommendations for treating a common but underdiagnosed condition.JCDA 2003, issue 3.
[6]. orchardson R, gillamDG .: J Am Dent Assoc. 2006; 137(7): 99-8; 1028-9.
[7]. jacobsen PL. clinical dentine hypersensitivity: understanding the causes and prescribing a treatment. J of contempor Dent pract 2001; 2(1): 1-8

Keywords: Obstructive sleep apnoea is a sleep disorder that involves intermittent cessation or significant decrease in airflow in the presence of breathing effort due to recurrent episodes of upper airway collapse during sleep. Patients with undiagnosed sleep apnoea represent a major public health problem. Dental professionals can help them in recognizing the sleep disorder and co-managing the patients along with a physician or a sleep specialist. Oral appliance therapy is an important treatment modality for sleep apnoea patients.

Keywords: Sleep Apnoea, Airway, Malocclusion, Oral Appliance

[1]. Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research. The Report of an American Academy of Sleep Medicine Task Force.Sleep. 1999;22:667– 689.
[2]. Olson LJ, Somers VK. Sleep apnea: implications for heart failure. CurrHeart Fail Rep. 2007;4:63–69.
[3]. Eliot A Phillipson. Sleep Apnea Harrison's Priciples of Internal Medicine 16th Edition, McGraw Hill MedicalPublishing division ; 2005; Vol II :1573-1576.
[4]. Cephalometric assessment in obstructive sleep apnea Nonglak Pracharktam, DDS, MSD, Suchitra Nelson, PhD, Mark G. Hans, DDS, MSD, B. Holly Broadbent, DDS, Susan Redline, MD, MPH, Carl Rosenberg, MD,andKingman P. Strohl, MD Cleveland, Ohio ; Am J Orthod Dentofac Orthop 1996;109:410-9.
[5]. Hans MG, Nelson S, Luks VG, Lorkovich P, Baek SJ. Comparisonof two dental devices for treatment of obstructive sleep apnea syndrome (OSAS). Am J Orthod Dentofacial Orthop 1997;111:562-70.

Keywords: Choledochal cyst is the congenital abnormality that almost invariably requires surgical intervention to prevent hepaticobiliary & pancreatic complications. Although majority of these patients present in infancy & childhood, about 20 – 30% are diagnosed in adults. This study was both retrospective & prospective in 30 patients from Jan, 2011 to Feb. 2014 admitted in the Department of General Surgery.

[1]. Devris et al choledochal cysts: age of presentation symptoms and late complication related to Todane's classification, journal of paed. surg. 2002; 37: 1568 – 1575.
[2]. BABBIT P D. Choledochal cyst: A concept of etiology: AJR: 1973; 119: 57 – 62.
[3]. Tan Ke, Howard Fr.choledochal cyst ; a 14 year surgical experience with 36 patient – BJS 1988; 75 : 892 – 895.
[4]. Todani T Walanable Y et al. Congenital bile duct cyst. Classification operative procedure and review of thirty seven cases including cancer arising from choledochal cyst. Arch. J. Surge 1977; 134; 263 – 269.
[5]. Todani T, Watan able Y et al. Carcinoma related to Choledochal cyst with internal drainage operation ( Gynae. Obst. 1987); 164; 61 – 64.

Keywords: Introduction: Refractive error may be defined as a state in which the optical system of the non-accommodating eye fails to bring parallel rays of light to focus on the retina. Especially myopia, which is not only inherited but also caused by excessive reading and other close work. Objective: A systematic cross-sectional study was conducted in OSMANIA MEDICAL COLLEGE to establish refractive errors as a plebeian problem in young medical students. Aim: The aim of the present study is to know the prevalence of myopia and factors which may be responsible for early onset of myopia among the students and to know the knowledge on healthy eye habits and eye care among the children.

1]. Churg KM, Mohidin N, Prevalance of visual disorders in Chinese, Optom Vis Sci:2006; 73; 695-700.
[2]. Prevention Of Acquired Myopia Published By ImpaRehm 1974; @ 2005 International Myopia Prevention Association- The Myopia Myth- Chapter 2- D. Jackson Coleman, "Unified Model For Accommodative Mechanism,‟ American Journal Of Ophthalmology 69, No. 6(June 1970);Francis A Young "The Development Of Myopia",Contacto 15, No.2(June 1971)Arnold Sorsby, B. Benjamin, And Michael Sheridan, Refraction And Its Components During Growth Of Eye, Ser No. 301(London 1961.
[3]. Midelfart A, Kinge B, Midelfart S, et al. Prevalence of refractive errors in young and middle-aged adults in Norway. ActaOphthalmolScand, 2006; 80: 501–5.
[4]. Morgan I, Rose K, Smith W et al 2004, "Evidence for an epidemic of myopia"- July 10, 2004 issue of New Scientist.
[5]. Kinge B and Midelfart A. Refractive changes among Norwegian university students. A three year longitudinal study. ActaOphthalmolScand1999; 77: 302-305.

Keywords: This study was carried out to determine the ischiopubic index and sexual dimorphism in ischiopubic index among adults in Maiduguri, North-Eastern Nigeria. Anteroposterior radiographs of adult pelvis (age range, 18-60 years) were evaluated. One hundred and twenty (120) radiographs (60 males and 60 females) were used for the study. The morphological measurements were pubic length, ischial length and ischiopubic index. The mean values of pubic length, ischial length and ischiopubic index of males in Maiduguri North Eastern Nigeria population were 81.0mm, 91.7mm and 88.5, respectively while those of their females counterparts were 92.7mm, 87.1mm and 106.8, respectively. The mean pubic length was significantly longer in females than males in the population (p<0.05).

[1] Washburn, S.L. Sex differences in pubic bone. American Journal of Physical Anthropology 6; 1948, 199-207.
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[3] Thieme, F. and Schull, W. Sex determination from the skeleton. Human Biology. 29; 1957, 242-273.
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[5] Davivongs, V. The pelvic girdle of the Australian Aborigine: Sex differences and sex determination. American Journal of Physical Anthropology. 21(4); 1963, 443-455.
[6] Coleman, W.H.. Sex Differences in the Growth of the Human Bony Pelvis. American Journal of Physical Anthropology. 31(2); 1969, 125-151.

Keywords: Normally kidneys receive arterial supply by a pair of renal arteries which arise from abdominal aorta ,Each renal artery divides into anterior and posterior divisions at or very close to the hilum of the kidney . Further it divides into segmental arteries to supply the respective segments of the kidney. In the present case, a variation in the branching pattern of right renal artery is observed. Right renal artery immediately after arising from abdominal aorta divided in to two segmental arteries which entered the kidney at its hilum, while left renal artery was normal in its origin and course. Anatomical knowledge of renal arterial variations may help to avoid clinical complications in renal transplantation, urological procedures like complete /partial nephrectomy, interventional radiological procedures and renal vascular surgeries.

Keywords: Renal artery, early division, Nephrectomy.

[1]. Standing S (2005) Gray's Anatomy. The Anatomical Basis of Clinical Practice. Elsevier Churchill Livingstone, New York 1271-1274.
[2]. Nayak BS (2008) Multiple variations of the right renal vessels. Singapore Med J 49: 153-155.
[3]. Bergman RA., Cassel MD, Sahinoglu K, Hedger PM (1992) Human doubled renal and testicular arteries. Ann Anat 174: 313-315.
[4]. Aurora AK, Verma P, Lalit M, Mahajan A, Sharma M (2012) Variant Segmental Renal Arteries in The Right Kidney- Clinical Correlations- A Case Report. Anat Physiol 2:103. doi:10.4172/2161-0940.1000103.
[5]. He B, Hamdorf JM. Clinical importance of anatomical variations of renal vasculature during laparoscopic donor nephrectomy. OA Anatomy 2013 Oct 18;1(3):25.

Keywords: Clinical profile of 50 patients with severe community acquired pneumonia (SCAP) admitted in ICU and pulmonology ward of Government general hospital, Anantapur, Andhra Pradesh was studied with special reference to demographic variables, symptomatology, etiology, management, and treatment outcome. The purpose of this prospective observational study is to evaluate clinical profile and treatment outcome of SCAP and to understand bacteriological causes, sensitivity patterns, treatment response, complications and clinical outcome of study population.

Keywords: severe community acquired pneumonia, treatment outcome.

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[2]. Fine MJ, Smith MA, Carson CA, Mutha SS, Sankey SS, Weissfeld LA et al. Prognosis and outcomes of patients with community acquired pneumonia: A meta-analysis. JAMA 1996; 275: 134-41.
[3]. Niederman MS, Bass JB Jr, Campbell GD, Fein AM, Grossman RF, Mandell LA et al. Guidelines for the initial management of adults with community acquired pneumonia: diagnosis, assessment of severity, and initial antimicrobial therapy. American Thoracic Society. Medical section of the American Lung Association. Am Rev Respir Dis 1993; 148: 1418-26.
[4]. Mandell LA, Wunderink RG, Anzueto A, Barlett JG, Campbell GD, Dean NC et al. Infectious Diseases Society of America/ American Thoracic Society consensus guidelines on the management of community acquired pneumonia in adults. Clin Infect Dis 2007; 44: 27-72.