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

Abstract: Caudal epidural block is one of the most popularly used regional techniques in pediatric patients. Various drugs in different concentrations have been used for the technique. Local anesthetic like Ropivacaine produces differential neuraxial blockade with less motor block and reduced cardiovascular toxicity. To increase the duration of action of local anesthetics and thereby analgesia extending to the post-operative period, various adjuvants like Dexmedetomidine, α2 agonist has been used. Lower concentration of local anesthetics can be used for the procedure as motor blockade is not much required. Hence we have compared Bupivacaine 0.25% combined with 1μg/kg of Dexmedetomidine and Ropivacaine 0.25% combined with 1μg/kg Dexmedetomidine at a volume of 1ml/kg in children undergoing infra umbilical surgeries.

[1]. Eeva Liisa Maunuksela, Klaus T Olkkola, "Pediatric Pain Management" International Anaesthesiology Clinics 1991; 29 (1): 37-56.
[2]. Steward DJ, editor, Anatomy and Physiology relevant to Paediatric anaesthesia. In: Manual of paediatric anaesthesia. 4th ed.New York: Churchill Livingstone; 1995: 9-39.
[3]. Markakis DA. Regional anaesthesia in paediatrics. Anesthesiol Clin North America, 2000; 18 (2): 355-9.
[4]. T G Hansen et al, S W Henneberg, S Walther Larsen, J Lund, M Hansen, "Caudal Bupivacaine supplemented with caudal or intravenous Clonidine in children undergoing hypospadias repair: a double blind study" British Journal of Anaesthesia 2004; 92: 223-227.
[5]. J C Sanders, "Paediatric regional anaesthesia, a survey of practice in the United Kingdom" British Journal of Anaesthesia 2002; 89: 707-710.
[6]. D A H de Beer, M L Thomas, "Caudal additives in children-solutions or problems" British Journal of Anaesthesia 2003; 90 (4): 487-498..

Keywords: Rhabdomyosarcoma is a soft tissue sarcoma arising from cells of myogenic lineage. They can be divided into Embryonal rhabdomyosarcoma (ERMS), Alveolar rhabdomyosarcoma (ARMS) and Pleomorphic rhabdomyosarcoma. ARMS occurs in 10-25years age group and the most common sites being extremities, perirectal and perineal regions, head and neck region is frequently involved in childhood but is exceedingly rare in adults. A female aged about 55years presented in Otolaryngology department with history of left sided nasal obstruction for about 6months.

[1]. Juan Rosai. Soft tissues. Rosai and Ackerman's surgical pathology (11th edition). Elsevier Sauders. 2012
[2]. Christopher D.M. Fletcher. Diagnostic histopathology of tumors (4th edition, vol 2). Elsevier Saunders.2013
[3]. Weber, CO. Anatomische Untersuchung Einer Hypertrophieschen Zunge nebst Bemekugen uber die Nubildung querquestreifter Muskelfsern, Virchow Arch. Pathol Anat. 7:115, 1854.
[4]. Stout AP: Rhabdomyosarcoma of the skeletal muscles, Ann Surg 1946; 123: 447-472.

Keywords:Background: Acute myocardial infarction is one of the leading causes of death in developed as well as in developing nations. Present study was undertaken to correlate the site of infarction by ECG and 2D Echocardiography. Methodology: Fifty patients of myocardial infarction fulfilling the inclusion criteria coming to OPD/Wards and Emergency ward of MGUMST, Jaipur were recruited. They were subjected to detailed history (as per the performa), clinical and diagnostic examination. Data analysis was done using SPSS software.

[1]. Park K. Park's Text Book of Preventive and Social Medicine. 17th Edn., M/s BanarsidasBhanot publishers; P-272 2002.
[2]. Siddharth N. Shah. API Text book of Medicine. 7th Edn. Association of Physicians of India; P-441; 2003.
[3]. DJ Weatherall, JGG Ledingham& DA Warrell. Oxford Text Book of Medicine. Vol. II, 3rd Edn, P – 2331; 1996.
[4]. Valentin Fuster et al., Hurst's. The Heart., 11th Edn. Vol. 1, P – 5, Mc Graw Hill publications, 2004.
[5]. Hegar et al. (1979): Circulation 1991; 60(3).

Keywords: Background:Vascular anomalies are a new emerging field involving several medical and surgical specialties. Uterine arteriovenous malformation is a rare condition with fewer than 100 cases reported in the literature. Uterine arteriovenous malformations may cause life-threatening abnormal genital bleeding in women of child bearing age. Aim:The purpose of this study is to describe the role of high degree of suspicion and sonographic features of uterineArteriovenousmalformation and to describe the role and clinical outcome after arterial embolization. Color Doppler ultrasound provides a non-invasive method for diagnosing this rare condition.

[1]. Fleming H, Ostor AG, Picket H, Fortune DW. Arteriovenous malformation of the uterus. Obstet Gynecol. 1989; 73:209–14.
[2]. Diwan RV, Brennan JN, Selim MA, et al. Sonographic diagnosis of arteriovenous malformation of the uterus and pelvis. J Clin Ultrasound. 1983; 11:295–8.
[3]. Jain KA, Jeffrey RB Jr, Sommer FG. Gynaecologic vascular abnormailties: diagnosis with Doppler ultrasonography. Radiology 1991; 1:549–51.
[4]. Markoff G, Quagliarello J, Rosen RJ. Beckman EM. Uterine arteriovenous malformation successfully embolized with a liquid polymer, isobutyl 20 Cyanoacrylate. Am J Obstet Gynecol. 1986; 155:659–60.
[5]. Dubreuil G, Loubat E. Aneurysmecrisoide de l'uterus. Ann AnatPathol. 1926; 3:697–718.

Keywords: Introduction: A large majority of patients with history of injury over the temporal region present with traumatic perforation of tympanic membrane the ENT outpatient department or emergency department Aim: To assess the clinical outcome in patients with conservative treatment for traumatic perforation of tympanic membrane at the end of three months follow-up. Materials and methods: It a prospective study conducted at McGann Teaching Hospital, Shimoga from Aug 2014 to July 2015. 70 (72 as two patient had bilateral ear involvement ) patients who presented with injury to ear were examined and found to have traumatic perforation of tympanic membrane all patients were treated conservatively and followed up three months.

[1]. Gacek RR, Gacek MR (2003) Anatomy of the Auditory and Vestibular Systems. In Ballenger's Otorhinolaryngology Head and Neck Surgery Volume 1. Sixteenth edition. Edited by: James B Snow Jr, John Jacob Ballenger. DC Becker Inc, Ontario 1-5.
[2]. Toner JG, Kerr AG (1997) Ear Trauma. In Scott-Brown's Otolaryngology.
[3]. Volume 3: Otology 6th edition. Edited by: Booth JB, Kerr, Advisory AG, Groves J. Butterworths Meinemann, London 1-3.
[4]. Grant JR, Arganbright J, Friedland DR (2008) Outcomes for conservative management of traumatic conductive hearing loss. Otol Neurotol 29: 344-349.
[5]. Ijaduola GTA (1986) The Principles of Management of Deafness. Nig Med Pract 12: 19-25.
[6]. Afolabi OA, Aremu SK, Alabi BS, Segun-Busari S (2009) Traumatic tympanic membrane perforation: an aetiological profile. BMC Res Notes 2: 232.

Keywords: Contracting Mycobacterium tuberculosis exogenously through intralesional steroid injection for keloid is an unique phenomenon not so far mentioned in literature.Primary cutaneous tuberculosis developing at keloid following intralesional steroid(ILS) which is negative for routine bacterial cultures & insensitive to routine antimicrobials warrants high index of suspicion for Mycobacterial infection.

Keywords: Keloid, intralesional steroid, Mycobacterium tuberculosis.

[1]. Ramam M. Cutaneous Tuberculosis. In: Sharma SK, Mohan A, editors, 2 nd ed. New Delhi, India: Jaypee Brothers Medical Publishers (P) LTD; 2009. p. 384-96.
[2]. Blackwell V. Mycobacterium marinum infections. Curr Opin Infect Dis 1999;12:181-4.
[3]. Chen HY, Chen CY, Huang CT, Ruan SY, Chou CH, Lai CC, et al. Skin and soft-tissue infection caused by non-tuberculous mycobacteria in Taiwan, 1997-2008. Epidemiol Infect. 2011;139:121–9. [PubMed]
[4]. Wallace RJ, Jr, Swenson JM, Silcox VA, Good RC, Tschen JA, Stone MS. Spectrum of disease due to rapidly growing mycobacteria. Rev Infect Dis. 1983;5:657–79. [PubMed]
[5]. Singh S, Rattan A, Kumar S. Severe cutaneous Mycobacterium chelonei infection following a yellow jacket sting. Tuber Lung Dis. 1992;73:305–6. [PubMed]
[6]. Sarma S, Thakur R. Cutaneous infection with Mycobacterium fortuitum: An unusual presentation. Indian J Med Microbiol. 2008;26:388–90. [PubMed]

Keywords: Eosinophilic granuloma (EG) is a solitary, non-neoplastic proliferation of histiocytes. EG is part of a spectrum of Langerhan's cell histiocytosis, formerly known as histiocytosis X.The male to female ratio is two to one. It occurs most commonly in children aged 5 to 10 and is uncommon in blacks.EG is normally symptomatic, local pain, swelling and tenderness are common. We report this case of Eosinophilic granuloma (EG) Mono ostotic type, in a 8 years female child, because of its rarity.

Key words to paper: Eosinophilic granuloma, Monoostotic, Bone lytic lesion, Histiocytosis X.

[1]. Lichtenstein L, Jeffe HL. Eosinophilic granuloma of bone: With report of a case. Am J Pathol. 1940;16:595–604. [PMC free article] [PubMed]
[2]. Azouz EM, Saigal G, Rodriguez MM, Podda A. Langerhans' cell histiocytosis: pathology, imaging and treatment of skeletal involvement. Pediatr Radiol. 2005;35:103–15. [PubMed]
[3]. Haouimi AS, Al-Hawsawi ZM, Jameel AN. Unusual location of eosinophilic granuloma. Saudi Med J.2004;25:1489–91. [PubMed]
[4]. Park SH, Park J, Hwang JH, Hwang SK, Hamm IS, Park YM. Eosinophilic granuloma of the skull: a retrospective analysis. Pediatr Neurosurg. 2007;43:97–101. [PubMed]
[5]. Yang JT, Chang CN, Lui TN, Ho YS. Eosinophilic granuloma of the skull-report of four cases. Changgeng Yi Xue Za Zhi. 1993;16:257–62. [PubMed]

Keywords: Pretreatment characteristics can assist orthodontists in accurately estimating treatment duration. The most frequent question asked by neworthodontic patients is: How long will I need to wear my braces? Several factors can influence the answer to this question. The purpose of this retrospective study was to identify some of the factors that influence orthodontic treatmentduration. Few studies have attempted to evaluate these factors.

[1]. Beckwith F R , Ackerman R J , Cobb C M , Tira D (1999) An evaluation of the factors affecting duration of orthodontic treatment . American Journal of Orthodontics and Dentofacial Orthopedics ; 115 : 439 – 447
[2]. Fink D, Smith R(1992) The duration of orthodontic treatment. American Journal of Orthodontics and Dentofacial Orthopedics ;102: 45 – 51
[3]. Vig P S, Weintraub J A, Brown C, Kowalski C(1990) The duration of orthodontic treatment with and without extractions: a pilot study of five selected practices. American Journal of Orthodontics and Dentofacial Orthopedics ;97 : 45 – 51
[4]. Vig K, et al.(1994) Predictors for Class I and II treatment duration differences. Journal of Dental Research ;73 : 273 (Abstract)
[5]. Allan TK, Hodgson EW(1968). The use of personality measurements as a determinant of patient cooperation in an orthodontic practice. American Journal of Orthodontics; 54:433-40.

Keywords: This study aimed at evaluating the effects of aExcite DSC bonding agent and two self-adhesive resin cements Panavia F 2.0, Variolink II on the pull-out bond strengths of FRC posts to root canal dentine, and to compare the effects of different cementation thicknesses.

[1]. Peroz I, Blankenstein F, Lange KP, Naumann M (2005) Restoring endodontically treated teeth with posts and cores—a review. Quintessence Int 36:737–746
[2]. Hatzikyriakos AH, Reisis GI, Tsingos N (1992) A 3-year postoperative clinical evaluation of posts and cores beneath existing crowns. J Prosthet Dent 67:454–458
[3]. Torbjörner A, Karlsson S, Odman PA (1995) Survival rate and failure characteristics for two post designs. J Prosthet Dent 73:439–444
[4]. Kremeier K, Fasen L, Klaiber B, Hofmann N (2008) Influence of endodontic post type (glass fiber, quartz fiber or gold) and luting material on push-out bond strength to dentin in vitro. Dent Mater 24:660–666
[5]. Balbosh A, Ludwig K, Kern M (2005) Comparison of titanium dowel retention using four different luting agents. J Prosthet Dent 94:227–233

Keywords: Celiac disease is an immune mediated enteropathy of small intestine triggered by gluten containing diet in genetically susceptible individuals. Early diagnosis in strongly suspected patients presenting with gastrointestinal symptoms, weight loss and malabsorption can be done with the help of serological tests followed by duodenal biopsy from the lower duodenum as gold standard for the definitive diagnosis. Gluten free diet will lead to rapid improvement in clinical symptoms and in nutritional and hematological parameters. These subjects need prolonged follow up to assess adherence to gluten free diet and assess long term consequences of celiac disease.

[1]. Fasano A, Berti I, Gerarduzzi T, Not T, Colletti RB, Drago S, et al. Prevalence of celiac disease in at-risk and not-at-risk groups in the United States: a large multicenter study. Arch Intern Med. 2003;163:286–292.
[2]. Fasano A, Berti I, Gerarduzzi T, et al. Prevalence of celiac disease in at-risk and not-at-risk groups in the United States: a large multicenter study. Arch Intern Med 2003;163:286-92.
[3]. Biagi F, Klersy C, Balducci D, Corazza GR. Are we not over-estimating the prevalence of celiac disease in the general population? Ann Med 2010;42:557-61.
[4]. Gupta R, Reddy DN, Makharia GK, et al. Indian task force for celiac disease: current status. World J Gastroenterol 2009;15:6028-33
[5]. Rubio-Tapia A, Van Dyke CT, Lahe BD, et al. Predictors of family risk for celiac disease: a population-based study. Clin Gastroenterol Hepatol 2008;6:983-7.

Keywords: Replantation is widely accepted as an effective treatment option for an avulsed tooth. However, the long-term fate of replanted teeth is unpredictable; it is dependent on various factors such as the time interval between avulsion and replantation and the storage method of teeth during the extra-alveolar period The appropriate use of storage media is an important clinical factor affecting the postoperative prognosis of avulsed teeth following replantation. Hanks Balanced Salt Solution (HBSS) or chilled milk are considered to be the most appropriate and clinically recommended storage media for avulsed teeth.

[1]. Ingle JI, Bakland LK, Baumgartner JC. Ingle's endodon- tics. 6th ed. Hamilton, ON: B.C. Decker Inc; 2008.
[2]. Blomlöf L. Milk and saliva as possible storage media for traumatically exarticulated teeth prior to replantation. Swed Dent J Suppl 1981; 8: 1–26.
[3]. Khademi AA, Saei S, Mohajeri MR et al. A new storage medium for an avulsed tooth. J Contemp Dent Pract 2008; 9: 25–32.
[4]. Krasner PR. Avulsed teeth: improving the diagnosis. Dent Prod Rep 2007; 2: 52–64.
[5]. Hammarström L, Pierce A, Blomlöf L, Feiglin B, Lind- skog S. Tooth avulsion and replantation – a review. Endod Dent Traumatol 1986; 2: 1–8.
[6]. Fagade OO. Extra-alveolar storage media for tooth autotransplants and replants. Internet J Dent Sci 2005; 2: 1–10.

Keywords: Sickle cell disease (SCD) poses a major public health challenge in sub-Saharan Africa particularly Nigeria and other parts of the world. Bone pain crisis (BPC) is a major clinical manifestation of SCD among others. BPC rate has not been evaluated in SCD subjects in our environment. Objective: This study aimed at assessing the rate of BPC among Nigerian SCD subjects in Benin City, to identify possible associated factors and control practices in the study group.

[1]. A Lal, EP Vinchinsky. Sickle cell disease. In: AV Hoffbrand, D Catovsky, EGD Tuddenham, AR Green (eds). Postgraduate Haematology. 6 ed 2011. Blackwell Publishing Ltd. 7: pp 109 – 125. [2]. E Beutler. Disorders of haemoglobin structure: sickle cell anaemia and related abnormalities. In: Williams Haematology, MA Lichtman et al (eds) McGraw-Hill 2006. 47:667 – 700.
[3]. B Modell, M Darlison. Global epidemiology of haemoglobin disorders and derived service indicators. Bull World Health Organ. 2008; 86(6): 480 – 487.
[4]. FB Piel, AP Patil, RE Howes, OA Nyangiri, PW Gething, M Dewi, WH Temperley, TN Williams, DJ Weatherall, SI Hay. Global epidemiology of sickle haemoglobin in neonates: a contemporary geostatistical model-based map and population estimates. Lancet 2013; 381: 142–51.

Keywords: Personal identification is the most important part of investigation and examination in cases of mass disasters, where disintegrated and amputated body organs are frequently found. The norms regarding determination of sex, age and race are well established. Studies on foot length, foot breadth and foot height have been carried out by many researchers in different populations. So the aim of the study was to do the Metric Analysis of the Foot of Yoruba Students at the University of Maiduguri and to find out racial characteristics of their own. The study was carried out on sixty (60) males' and sixty (60) females' Yoruba students of University of Maiduguri.

[1]. Kanchan T, Krishan K, Sharma A, Menzes RG. A study of correlation of hand and foot dimensions for personal identification in mass disasters. Forensic Sci. International. 2010; 199:1–3, 112.1–112.6.
[2]. Iloeje SO. Trophic limb changes among children with developmental apraxia. Dev Med Child Neurol 1988; 30(6):791-6.
[3]. Ferrario V.F, Sforza C, Randelli F, Miani AJr, Pizzini G. Femoral asymmetry in healthy adults: elliptic Fourier analysis using computerized tomographic scout views. Ital J Anat Embryol 1998; 103(2):95-105.
[4]. Sforza C, Fragnito N, Serrao G, Ferrario VF. Harmonic analysis of footprint symmetry in healthy adolescents. Ann Anat 2000; 182(3):285-91.
[5]. Ewunonu EO. Sexual Dimorphism in Foot Anthropometry among the Adult Igbo People of Southeastern Nigeria. Journal of Biology Agriculture and Healthcare (JBAH). Accepted June, 2013.

Keywords: The oral region is an uncommon site for metastatic tumour cell colonization and is usually evidence of a widespread disease. Based on the numerous isolated case reports and large case series published by van der Waal RIF et al (2003) & Hirshberg A et al (2008), oral metastasis was found to be the first sign of the metastatic spread in 25 % of cases and was the first indication of an undiscovered malignancy at a distant site in 23 % cases. Because of its rarity & deceiving clinical presentation, the diagnosis of a metastatic lesion in the oral region is challenging.

1]. Kumar V, Abbas A, Fuasto N, Aster J. "Robbins & Cotran – Pathologic Basis of disease" 8th edition. Philadelphia: Elsevier Saunders 2010.
[2]. Vega LG, Dipasquale J, Gutta R. Head and neck manifestations of distant carcinomas. Oral Maxillofac Surg Clin N Am 2008:20;609-623.
[3]. Hirshberg A, Buchner A. Metastatic tumours to the oral region. An overview. Oral Oncol, Eur J Cancer 1995;31:355-60.
[4]. Gupta GP, Massague J. Cancer metastasis: building a framework. Cell 2006;127(4):679-95.
[5]. Hirshberg A, Shnaiderman-Shapiro A, Kaplan I, Berger R. Metastatic tumours to the oral cavity – Pathogenesis and analysis of 673 cases. Oral Oncology 2008;44(8):743-52.

Keywords: Trauma to the primary dentition present special problems and the management is often different as compared with permanent teeth. Trauma to the oral region occurs frequently and comprises 5% of all injuries for which people seek treatment. The highest prevalence was found as intrusive injuries of primary teeth. There is perhaps no single disturbance that has greater psychological impact on both the parents and children than the loss or fracture of a child's anterior teeth.

[1]. Andreasen JO. Etiology and pathogenesis of traumatic dental injuries. A clinical study of 1298 cases. Scand J Dent Res 1970;78:329-42.
[2]. Andreasen JO, Ravn JJ. Epidemiology of traumatic dental injuries to primary and permanent teeth in a Danish population sample. Int J Oral Surg 1972;1:235-9.
[3]. Ravn JJ. Dental injuries in Copenhagen schoolchildren, school years 1967-1972. CommDent Oral Epidemiol 1974;2:231-45.
[4]. Zerman N, Cavalleri G. Traumatic injuries to permanent incisors. Endod Dent Traumatol 1990;9:61-4.

Keywords: Thyroid diseases are common worldwide. Hypothyroidism is very commonly seen in females and the incidence increases with age. Due to this endocrine dysfunction ,there are various of signs and symptoms. Most common cause of hypothyroidism is autoimmune thyroiditis. In postmenopausal females, the incidence of hypothyroidism is high, leading to increase in the risk of fractures. The study was conducted in Department of Biochemistry and Orthopaedics, Govt. Medical College, Kota and attached group of hospitals. A total of 112 postmenopausal fractured females of age group 51 – 80 years are included. Duration of study is from September 2014 to May 2015. Level of Thyroid Stimulating Hormone(TSH) was measured.

1]. Praveen Kumar & Micheal Clark . Endocrine Disease – Hypothyroidism ."Essentials of Clinical Medicine"-. ELSEVIER publication.5th Edition..
[2]. Dr Heidi D Nelson, MD. Menopause. The LANCET – Volume 371, No. 9614, p760-770, 1st March 2008.
[3]. Praveen Kumar & Micheal Clark. Endocrine Disease – Female Reproduction and Sex, The Menopause. "Essentials of Clinical Medicine"-. ELSEVIER publication. 5th Edition.
[4]. Eriksen EF. Normal and Pathological Remodelling of Human Trabecular Bone: Three dimensional reconstruction of the remodelling sequence in normals and metabolic bone disease and Endocr Rev. 1986: 7(4): 379 -408.
[5]. Tagami T, Kimura H, Ohtani S, et al . Multi centre study on the prevalence of hypothyroidism in patients with hypercholesterolemia. 2011: 58(6): 449 – 457.
[6]. Rotondi M, Magri F, Chiovato L. Thyroid and obesity: Not a one way – interaction. J Clin Endocrinol Metab. 2011: 96(2); 344-346.

Keywords: Aim: To evaluate the role of Bishop score, cervical length by transvaginal ultrasound in predicting the success of induction of labour. Method: It is a prospective study done at Government general Hospital, Kurnool, Andhra Pradesh, India over a period of one year from May 2008 to April 2009. Hundred primigravidae with 37 to 42 weeks of gestation who underwent induction of labour for different indications were taken. Bishop score followed by cervical length in centimeters by transvaginal ultrasound were assessed in all patients.

[1]. Bishop EH. Pelvic scoring for elective induction. J Obstet Gynaecol 1964 Feb; 24:266-268.
[2]. Jodie R, James RS. Cervical ripening. Internet J Emedicine from Web MD 2008 Aug 12 [cited 2008 Dec 21]; Available from: URL:http://emedicine.medspace.com/article/263311.overview
[3]. David PJ, Nancy RD, Allen JB. Risks of cesarean delivery after induction at term in nulliparous women with an unfavorable cervix. American J Obstet Gynecol 2003; 188:1565-72.
[4]. Ellen FF, Michel B, Daniel LF, Phillippe E, Olivier I. Reliability of the Bishop score before labour induction at term. European J Obstet Gynaecol 2004 Feb 10; 112 (2):178-81.
[5]. Rane SM, Pandis GK, Guirgis RR, Higgins B, Nicolaides KH. Preinduction sonographic measurement of cervical length in the prolonged pregnancy: the effect of parity in the prediction of induction to delivery interval. J Ultrasound in Obstet Gynaecol 2003; 22:40-4.

Keywords: Blastomycesdermatitidis has been isolated only infrequently from environmental sources and thus the ecology of B. dermatitidis remains incompletely understood. Other methods of detection of prevalence are also insensitive. Our knowledge is based on the collected reports of sporadic cases in humans and dogs as well as the studies of 11 epidemics or clusters of disease. It can mimic many diseases and may remain undiagnosed till late. In disseminated infections, without treatment mortality remains high (78%). Most cases reported from India are imported from USA. We are reporting a case of Disseminated Blastomycosis acquired in North India in a native farmer. Its diagnosis remained a challenge in our laboratory setting.

Keywords: Disseminated Blastomycosis, North India, DGI.

[1]. Randhawa HS, Chowdhary A, Kathuria S, Roy P, Chugh TD, et al. Blastomycosis in India: report of an imported case and current status. Med Mycol. February 2013.51:185-92.
[2]. Savior J, Muralidharan S, Macaden RS, et al. Blastomycosis in a South Indian patient after visiting an endemic area in USA. Med Mycol. September 2006. 44: 523-29.
[3]. Di Salvo AF, Klein BS. Blastomycosis. Topley and Wilson's Microbiology and Microbial Infections Mycology.10th ed. John Wiley and Sons. 479-97.
[4]. Bridget L. Pfaff, William A. Agger, Thomas J. Volk. Blastomycosis Diagnosed in a Nonhyperendemic Area. WMJ . February 2014. 113 (1). 11-18.
[5]. López-Martínez Rubén and Méndéz-Tovar Luis Javier. Blastomycosis.Clin in Dermatol. 2012. 30. 565–572.

Keywords: Jaundiceis theprecipitation of bilirubin in the tissues of the skin, sclera and mucous membranes causing a yellowish staining.It is pre-hepatic, hepatic or post hepatic. The post hepatic form is usually caused by obstruction of the common bile duct (CBD). Carcinoma of the head of pancreas (CPH)is a major cause of CBDobstructionsince it passes posterior to the head of the pancreas. The objective of this study is toassessthe effectiveness of the gray scale ultrasound to differentiate and diagnose the causes of obstructive jaundicewith an emphasis on the obstructive jaundice caused by CPH. Furthermore the influences of age, gender and occupation on CPH obstructive jaundice were also evaluated.

[1]. Admassie, DH, Yesus, A., Denke, A. Validity of Ultrasonography in Diagnosing Obstructive Jaundice. East African Medical Journal, 82, 379-381.
[2]. Ahmed, NMS, Elsheikh, AS, Gilani, SA, Mohamed AH. Assessing prostate pathologies with trans-abdominal ultrasound .IOSR-JDMS, 2015; 14, (4 Ver. X: 88-92. DOI: 10.9790/0853-144108892.
[3]. Dwivedi M1, Acharya SK, Tandon BN. The ultrasonographic "common channel" sign: a characteristic feature of malignant obstruction of the lower end of common bile duct. J Clin Gastroenterol., 1989; 11(2):233-235. [4]. Flamm, CR, Mark, DH, Aronson, N. Evidence-based assessment of ERCP approaches to managing pancreaticobiliary malignancies. Gastrointestinal endoscopy, 2002: 56 (6), 218-225.
[5]. Gameraddin, M., Omer, S., Salih, S., Elsayed, S.A. and Alshaikh, A. (2015) Sonographic Evaluation of Obstructive Jaundice. Open Journal of Medical Imaging, 2005; 5, 24-29. http://dx.doi.org/10.4236/ojmi.2015.51004

Keywords: Preeclampsia and intrauterine growth restriction are important causes of perinatal and maternal morbidity and mortality. Although much research into the etiology and mechanism of pre-eclampsia has taken place, its exact pathogenesis remains uncertain. Objective: To assess uterine artery Doppler findings at 18-22 weeks in predicting adverse pregnancy outcome. Methods: Special designed performa was used to collect data. The data were expressed in mean, SD, number and percentage.

[1]. Reports into Confidential Enquiry into maternal deaths in United Kingdom 1991-1993. London: HMSO,1996:20-31
[2]. Williams textbook obstetrics , Pregnancy Hypertension, 23rd ed., 2010, chap 34:706.
[3]. Williams textbook obstetrics , Pregnancy Hypertension, 23rd ed., 2010, chap 34: 706.
[4]. Wiiliams obstetrics , Pregnancy Hypertension, 23rd ed., 2010,38:843
[5]. Paz I, Gale R, Laor A, Danon YL, Stevenson DK, Seidmans D, The cognitive outcome of full term small for gestational age infants at late adolescence. Obstet Gynecol :85, 452, 1995.

Keywords: The objective of any prosthodontic service is to restore the patient to normal function, contour, esthetics, speech and health. An optimum denture stability is difficult to achieve in conventional complete dentures especially in case of extremely resorbed mandibular ridges. Often patients with oral carcinomas have resection of the tongue, the floor of the mouth or the bone of the mandible. Post operatively, these patients encounter chewing, swallowing and speech problems. When both partial glossectomy and resorbed mandibular ridge are encountered together, oral rehabilitation of such patients is a challenge to the clinician. This case report describes management of 65yr old male patient with partial glossectomy and resorbed mandibular ridge using neutral zone technique.

Keywords: Partial glossectomy,Resorbed mandibular ridge,Oral Rehabilitation.

[1]. The neutral zone in complete dentures and partial dentures- victor E beresin Frank.j.schiesser
[2]. the neutral zone revisited-jpd 2009;101:405-412 david R.cagna, joseph j.massad
[3]. j.indian prosthodontic society- 2010 june:10[2]
[4]. enhancement of stability for mandibular complete denture- j advanced dental research, viraj patil, RB hallikcrimmah
[5]. payne AG Factors influencing the position of artificial upper anterior teeth. J prosthet dent 1971;26:26-32
[6]. Gupta KL, Agarwal S ,Salvation of a severely resorbed mandibular ridge with a neutral zone technique. [Journal Article]Indian J Dent Res 2011 Nov-Dec; 22(6):883.

Keywords: With dawn of era of minimal intervention in dentistry, surgical management of periapical lesions become controversial. Non-surgical or conservative management of periapical lesions not only cause less trauma to the tissues, but also promote faster and less eventful healing. This paper presents successful management of a periapical lesion in a 14 year old male child with calcium hydroxide paste in an oily vehicle with successful resolution of signs and symptoms both clinically and radiographically. Keywords: Calcium hydroxide, non surgical, Periapical lesions.

[1]. de Souza C A S, Teles R P, Souto R, Chaves M A E and Vieira Colombo A P. Endodontic therapy associated with calcium hydroxide as an intracanal dressing: Microbiologic evaluation by the checkerboard DNA-DNA hybridization technique. J Endod. 2005; 31(2): 79–83.
[2]. Bhosale S, Philip P, Kumar R M, Jayasree S. Non Surgical Management of Large Periapical Lesions-A Report of Two Cases. IOSR Jour Dent Med Sci. 2014; 13(2): 50-4.
[3]. Fernandes M, Ataide Ida de. Nonsurgical management of periapical lesions. J Conserv Dent. 2010; 13(4): 240–45.
[4]. Campo N. Large periapical lesion management Decompression combined with root-canal treatment. Roots. 2012; 1: 06-09.
[5]. Bhaskar SN. Periapical lesions-types, incidence, and clinical features. Oral Surg Oral Med Oral Pathol. 1996; 21: 657–71.

Keywords: Androgens play an important role in the development of male secondary sexual characteristics and androgen deficiency may result in structural abnormalities of the penis.[1-3] .[6] Nevertheless, the correlation between testosterone levels and libido is poor,[7-9] and the testosterone levels required to sustain normal sexual interest are apparently low.[7] However, Anderson et al [10] reported that increasing testosterone to supra physiological concentrations can increase sexual activity.

[1]. Masters, WH Johnson, VE. Human Sexual Response; Boston: Little Brown & Co. 1966; Davidson JK, Moore NB (2001).
Speaking of Sexuality.
[2]. The Physiological basis of human sexual arousal Neuroendocrine Sexual Asymmetry; Ion G, Motofei& David L. Rowland; International Journal of Andrology 28:78-87 (2005).
[3]. Human Sexuality. Stephanie Annsanders, BA, MS, PhD, Associate Director Associate Scientist; Kinsey Institute for Research in Sex, Gendt, Indian University, Online Encyclopedia 2006.
[4]. Miner MM. Low Testosterone Medscape CME Expert Column Series. Issue 3: Delivering Safe and Effective Testosterone Replacement Therapy. Medscape Education. 2011
[5]. Contextual Approaches to the Physiology & Classification of Erectile Function, erectile Dysfunction & Sexual Arousal; Benjamin D. Sachs; Neuroscience & Behavioral Reviews 24(2000)541-560.

Keywords: Human identification is based on scientific principles mainly involving fingerprints, dental records and DNA analysis. Use of fingerprints has some limitations in situations where the hands are charred or mutilated. Similarly DNA isolation may be expensive and technique sensitive hence, dental records provide durable evidence in post mortem identification[1,2].

[1]. Whittaker DK. Introduction to forensic dentistry. Quintessence Int. 25(10), 1994, 723-30.
[2]. Morlang WM. Forensic dentistry. Aviat Space Environ Med. 53(1), 1982 , 27-34.
[3]. Saraf A, Bedia S, Indurkar A, Degwekar S, Bhowate R. Rugae patterns as an adjunct to sex differentiation in forensic identification. J Forensic Odontostomatol 29, 2011, 14‑9.
[4]. Bhullar A, Kaur RP, Kamat MS. Palatal rugae – An aid in clinical dentistry. J Forensic Res 2, 2011, 124.
[5]. Winslow JB.Exposure of the anatomical structure of the human body. Fisher – University of Toronto. 1732.

Keywords: Aim: To evaluate the role of Bishop score, cervical length by transvaginal ultrasound in predicting the success of induction of labour. Method: It is a prospective study done at Government general Hospital, Kurnool, Andhra Pradesh, India over a period of one year from May 2008 to April 2009. Hundred primigravidae with 37 to 42 weeks of gestation who underwent induction of labour for different indications were taken. Bishop score followed by cervical length in centimeters by transvaginal ultrasound were assessed in all patients.

[1]. Olaosun, A.O. (2014) Self-Ear-Cleaning among Educated Young Adults in Nigeria. Journal of Family Medicine and Primary Care, 3, 17-21..
[2]. Afolabi AO, Kodiya AM, Bakari A, Ahmad BM. Attitude of self ear cleaning in black Africans: Any benefit? East Afr J Public Health. 2009;6:43–6.
[3]. Lee LM, Govindaraju R, Hon SK. Cotton bud and ear cleaning: A loose tip cotton bud? Med J Malaysi.2005;60:85–8.
[4]. Hobson JC, Lavy JA. Use and abuse of cotton buds. J R Soc Med. 2005;98:360–1.
[5]. Macknin ML, Talo H, Medendrop SV. Effect of cotton-tipped swab use on ear-wax occlusion. Clin Pediatr (Phila) 1994;33:14–8.
[6]. Olajide TG, Usman AM, Eletta AP. Knowledge, Attitude and Awareness of Hazards Associated with Use of Cotton Bud in a Nigerian Community International Journal of Otolaryngology and Head & Neck Surgery.2015; 4:248-253

Keywords: Wilson's disease (WD) is an autosomal recessive inherited disorder of hepatic copper metabolism, caused by mutation in the copper-transporting gene, ATP7B leading to reduced incorporation of copper into ceruloplasmin and reduced hepatic biliary copper excretion. WD has varied clinical manifestations, most common being liver disease in younger age group and neuropsychiatric disturbances in older children. The diagnosis depends primarily on the clinical features, presence of the Kayser-Fleischer (KF) ring and biochemical parameters. We report a case of 8 year old female child who presented with anasarca and icterus for more than 3 months, which is suggestive of chronic liver disease.

[1]. Scheinberg IH. Wilson's disease. J RheumatolSuppl 1981;7:90–3.
[2]. Ala A, Walker AP, Ashkan K, Dooley JS, Schilsky 1. ML. Wilson's disease. Lancet 2007;369:397-408.
[3]. Merle U, Schaefer M, Ferenci P, Stremmel W. Clinical presentation, diagnosis and long-term outcome of Wilson's disease: a cohort study. Gut 2007;56:115-20
[4]. Scott J, Gollan JL, Samourian S, Sherlock S. Wilson's disease, presenting as chronic active hepatitis. Gastroenterology 1978;74: 645–51.
[5]. Gonzalez-Casas R, Jones EA, Moreno-Otero R. Spectrum of anemia associated with chronic liver disease. World JGastroenterol2009; 15(37): 4653-4658 [6]. Tso, M.O., Fine, B.S., Thorpe, H.E. Kayser-Fleischer ring and associated cataract in Wilson's disease. Am J Ophthalmol. 1975;79:479–488.