iosr-JDMS   Volume-15 ~ Issue-1 ~ January-2016

Abstract: Introduction: Closed reduction and percutaneous K-wire fixation is the standard modality of treatment in displaced supracondylar fractures of distal humerus in children. We report the result of a prospective study of two hundred fifty seven patients, who were treated by closed reduction and simple percutaneous K-wire fixation using two lateral pins or medial - lateral pins. Methodology: In a prospective controlled study, 257 cases of Gartland type III supracondylar humerus fractures in children were treated with closed reduction and percutaneous fixation by simple K-wires. The age group of the patients was 3 to 12 years. The fracture was immobilized for duration of three weeks. Cases were followed up for an average of eight months post operatively.

[1]. Otsuka NY, Kasser JR: Supracondylar fractures of the humerus in children. J Am Acad Orthop Surg 1997,5:19-26.
[2]. Beaty JH, Kasser JR: Fractures about the elbow. Instr Course Lect 1995, 44:199-215.
[3]. Boyd HB, Altenberg AR. Fractures about the elbow in children. Arch Surg 1944;49:213.
[4]. Casiano E: Reduction and fixation by pinning "banderillero" style fractures of the humerus at the elbow in children. Mil Med 1960, 125:262-264.
[5]. Flynn JC., Mathews JG. and Benoit RL. "Blind pinning of displaced supracondylar fractures of the humerus in children". J Bone & Joint Surg (Am),/974;56A: 263-272.
[6]. Arino VL, Llurch EE, Ramriez AM, Ferrer J, Rodriguez L, Baixauli F: Percutaneous fixation of supracondylar fractures of the humerus in children. J Bone Joint Surg Am 1977, 59:914-916.
[7]. Mostafavi HR. and Spero C. " Crossed pin fixation of displaced supracondylar humerus fractures in children". Clin Orthop, 2000; 376; 56-61.

Abstract: The present study was done to evaluate serum ADA activity as marker in acute infective hepatitis in different adult age groups. This estimation could serve as an useful and sensitive test in the early diagnosis of hepatitis. Materials & Methods: The study was undertaken from April 2012to May 2013. There are 100 clinically healthy subjects and 100 known acute infective hepatitis patients belonging to different adult age groups between 21-70 years were chosen for the test samples. Patient with signs and symptoms of acute infective hepatitis (A, B, C, D and E).

[1]. K.C Vasudha, Anirmal Kumar, T.Venlatesh: studies on the age dependent changes in serum adenosine deaminase activity and its changes in hepatitis Indian Journal of clinical Biochemistry, 2006, 21 (1) 116-120.
[2]. Zukerman AJ, Howard CR.The history of viral hepatitis in Hepatitis viruses of man. London: Academic press; 1979.pp.1-8.
[3]. Centers for Disease control and prevention. Disease burden from hepatitis A,B and C in the United states.9 October 2002.
[4]. Annemarie Wasley, Scd, Scott Grytdal, S, Gallaghar.k.Surveillance for acute viral Hepatitis- USA2006.
[5]. Piras M.A: Gakis c, Buroni M & Anderoni G, Adenosine deaminase activity in pleural effusion, an aid to differential diagnosis, Br.Med .J.2 (1978)1751.
[6]. Harrion's principles of Internal Medicine, part thirteen: Disorders of gastrointnal system: Section 2: Liver and biliary tract disease; chapter 298: Acute viral hepatitis.
[7]. Malloy, H.T and Evelyn, K.A.(1937). Estimation of serum bilirubin, Jr.of boil.chem.119.481.

Abstract: Focal foot muscle hypertrophy is a relatively rare clinical entity which can be a cause for cosmetic disfigurement and nerve entrapment. Here authors report a case of congenital hypertrophy of muscles of superficial compartment of sole region, which presented as painless foot mass and undergone magnetic resonance imaging of foot in department of Radiology. No other hypertrophic muscles noticed on this foot and none on the right foot. Various foot masses were included as differential diagnosis and discussed. Magnetic resonance imaging helps us to diagnose these conditions and plan appropriate treatment. Conclusion: Congenital intrinsic foot muscle hypertrophy, though a rare clinical entity, should be included in the differential diagnosis of foot masses. Magnetic resonance imaging provides optimal information to exclude other pathological masses and diagnose such developmental anomalies and associated neurovascular complications and for planning further treatment.

[1] Congenital hypertrophy of multiple intrinsic muscles of the foot.Shiraishi T1, Park S, Niu A, Hasegawa H. (rare and 6cases in literature). http://www.ncbi.nlm.nih.gov/pubmed/23822188 Department of Plastic Surgery, Shizuoka Children's Hospital, Shizuoka.
[2] Hypertrophy of the abductor digiti minimi muscle simulating a localised soft tissue mass - Raab P1, Ettl V, Kozuch A, Nöth U. 15 yr old male case. http://www.ncbi.nlm.nih.gov/pubmed/19083612
[3] University of Wuerzburg, Department of Orthopedic Surgery, König-Ludwig-Haus, Würzburg, Germany. p-raab.klh@mail.uni-wuerzburg.de
[4] Value of MR findings in predicting the nature of the soft tissue lesions: benign, malignant or undetermined lesion? Soler R1, Castro JM, Rodríguez E.http://www.ncbi.nlm.nih.gov/pubmed/8930469 Department of Radiology, Hospital Juan Canalejo, La Coruña, Spain.

Abstract: "Petrified ear" or calcification of auricular cartilage is a rare condition commonly associated with local trauma, frost bite, and repeated inflammation, without visible changes in the appearance of the ear. Adrenal insufficiency is the most frequent systemic disease associated with auricular calcification. A case of idiopathic adult-onset petrified ear with unilateral auricular calcification was seen in our out-patient department. Recognition of the association between auricular calcification and adrenal insufficiency can be an important step towards identification of a life-threatening cortisol deficiency.

Keywords: Adrenal insufficiency, auricular calcification, auricular ossification

[1]. Novick WH. Calcification of auricular cartilage in Addison's disease. Arch Otolaryngol. 1960;72:448–9.[PubMed] [2]. Strumia R, Lombardi AR, Altieri E. The petrified ear- a manifestation of dystrophic calcification.Dermatology. 1997;194:371–3. [PubMed] [3]. Lautenschlager S, Itin PH, Rufli T. The petrified ear. Dermatology. 1994;189:435–6. [PubMed] [4]. Howlett TA, Levy MJ, Robertson IJ. How reliably can autoimmune hypophysitis be diagnosed without pituitary biopsy? Clin Endocrinol (Oxf) 2010;73:18–21. [PubMed] . [5]. Larson P, Weinstock M, Welch R. Calcification of the auricular cartilage: A case report and literature review. Cutis. 1992;50:55–7. [PubMed] [6]. González-Sixto B, García-Doval I, Conde A, Mayo E, Pardavilo R, de la Torre C. Osificación bilateral del cartilage auricular. Actas Dermosifiliogr. 2006;97:134–5. [PubMed] [7]. Barkan A, Glantz I. Calcification of Auricular cartilages in patients with Hypopituitarism. J Clin Endocrinol Metab. 1982;55:354–7. [PubMed] .

Abstract: Infection within the subarachnoid space or throughout the leptomeninges is called meningitis. Based on host's response to the invading microorganism it is divided into two major categories: purulent and aseptic meningitis. Bacterial organisms are usually the cause of purulent infections. An important host defense mechanism within the CNS is the blood-brain barrier.¹ There is an urgent need for the laboratory diagnosis of suspected bacterial meningitis, bacterial meningitis is life threatening infection and requires appropriate antibiotic therapy at the earliest possible moment.² patient suspected of having meningitis should have a specimen of cerebrospinal fluid (CSF) examined in the laboratory by Direct antigen detection systems (LAT) for detection of the polysaccharide capsular antigens having specificity and sensitivity in the 90-97% range and when used in conjunction with the direct staining techniques often provide rapid presumptive diagnosis on which specific antibiotic therapy can be based. CSF white blood cell count and differential count were the best predictors of meningitis.

[1]. Bailey & Scott's Diagnostic Microbiology, 13th edition. 2007.
[2]. Mackie & McCartney Practical Medical Microbiology, 14th edition. 2008.
[3]. WHO recommended standards for surveillance of selected vaccine preventable diseases in Bacterial meningitis?
[4]. Koneman's diagnostic microbiology, 5th edition, 1997.
[5]. Col PL Prasad, Brig MNG Nair, Lt Col AT Kalghatgi. Childhood Bacterial Meningitis and Usefulness of C - reactive protein. MJAFI 2005; 61:13-15.
[6]. Attia J, Hatala R, Cook DJ, Wong JG. "The rational clinical examination. Does this adult patient have acute meningitis?" July 1999; 282(2):175-181.
[7]. Arthur Earl Walker, Edward R. Laws, George B Udvarhelyi. Infections and Inflammatory involvement of the CNS. The Genesis of Neuroscience. Thieme. 1998; pp 219-21.

Abstract: Background: Assessment of vertical jaws relation is so important in diagnosing orthodontic cases. This study aimed to find the relation among different methods used to evaluate the vertical relation. Materials and methods: Fifty students (25 males and 25 females) from the college of dentistry, university of Baghdad were selected having normal sagittal and horizontal jaw relation with class I dental relation. Digital true lateral cephalometric radiographs were taken for each individual and analyzed using AutoCAD program 2007. Seventeen angular and linear parameters determined the vertical jaw relations were measured for both genders. The relation among these parameters was obtained using Pearson's correlation coefficient.

[1]. Tweed CH. The Frankfort mandibular plane angle in orthodontic diagnosis, classification and treatment planning and prognosis. Am J Orthod Oral Surg 1946; 32(4):175-230.
[2]. Björk A. The face in profile. An anthropological X-ray investigation on Swedish children and conscripts. Svensk tandläkare-Tidskrift 1947; 40(5B) Suppl.: 1-180.
[3]. Riedel RA. A cephalometric roentgenographic study of the relation of the maxilla and associated parts to the cranial base in normal and malocclusion of the teeth. Thesis, Northwestern University Dental School, 1948.
[4]. Downs WB. Variations in facial relationship: their significance in treatment and prognosis. Am J Orthod 1948; 34(10): 812-40.
[5]. Wylie WL, Johnson EL. Rapid evaluation of facial dysplasia in the vertical plane. Angle Orthod 1952; 22(3): 165–82.
[6]. Steiner CC. Cephalometrics for you and me. Am J Orthod 1953; 39(10): 729-55.

Abstract: Cigarette smoking is major risk factor for the development of atherosclerosis, coronary heart disease, acute myocardial infarction and sudden cardiac death. Cessation of smoking is associated with reduced cardiovascular mortality and morbidity. Cigarette smoking alters baseline sympathetic and vagal modulation of the S Anode and peripheral sympathetic vascular control. A cross-sectional study on autonomic function tests was performed on 40 smokers of age range between 20-50 years. These smokers were compared with normal healthy 40 non-smokers age and BMI matched. Autonomic function tests included were 30;15 ratio, valsalva maneuver, Deep breath difference ,orthostatic tolerance test(OTT),isometric hand grip test(IHG).Resting pulse rate and IHG was significantly lower (p<0.01,p<0.001) in smokers indicating decreased sympathetic reactivity in them. OTT was significantly increased (p value<0.001) in smokers compared to non-smokers this is again suggestive of decreased sympathetic reactivity in them.

[1]. Bulletin of the WHO. International journal of public health.2006;84(6):495.
[2]. WHO report: Tobacco could kill one billion by 2100,Science Daily.2008;24:71.
[3]. Yach D. Partnering for better lung health: Improving Tobacco and Tuberculosis control. Int J Tuberc Lung Dis.2000;4:693-7.
[4]. Yu J J ,Shopland D R. Cigarette smoking behaviour and consumption characteristic for the Asia-Pacific region. World smoking health.1989;14:7-9.
[5]. Auerbach O, Hammond E C ,Garfinkel L. Smoking in relation to atherosclerosis of the coronary arteries. N Eng J Med.1965;273:775-779.
[6]. Doll R, Hill A B. Mortality of British doctors in relation to smoking: observation on coronary thrombosis. Natl Cancer Inst Monograph.1966;19:205-215.
[7]. Khan H .A. The dorn study of smoking and mortality among U.S. veterans:Report on eight and one half years of observation. Natl Cancer Inst Monograph.1996;19:1-27.

Abstract: Since the dawn of time when the pathologies of salivary glands were unknown to mankind, various imaging modalities have played instrumental role in their identification. The diagnostic algorithm for imaging salivary gland includes Plain Film Radiography, Contrast Enhanced Radiography, Sialography, Scintigraphy, Computed Tomography (non-enhanced and contrast enhanced), Magnetic Resonance Imaging (non-enhanced and contrast enhanced), Nuclear Medicine and Ultrasonography. In radiographic evaluation, patients are exposed to multiple radiographs which can result in radiation effects at the tissue and organ level. Though Sialograpy is a conventional diagnostic tool but it is invasive due to cannulation and injection of contrast material.

[1]. AkinI, Esmer N, GercekerM, Aytac S, ErdenI. Sialographic and ultrasonographic analyses of major salivary glands. ActaOtolaryngol(Stockh) 1991;111:600-6
[2]. LandwehrP, Hohmann D, Krahe T, LacknerK.Wertigkreit derdigitalen Subtraktionssialographie im Vergleich mit Konventioneller Sialographie Speicheldrtisen sonographie und Operation befund. Fortschritte auf demGebeite der Rontgenstrahlen und der NeuenBildgebendenVerfahren 1992;156:437-42
[3]. Yousem DM, Kraut MA, Chalian AA. Major salivary gland imaging. Radiology 2000;216:19– 29.
[4]. David K.B. Li. Ultrasound – Principles and Instrumentation. In: Runack CM, Chardoneau W, eds. 1st ed, Livingston: Mosby; 1998:12-22.
[5]. Carotti M, Salaffi F, Manganelli P, ArgaliaG. Ultrasonography and color Doppler sonography of salivary glands in primary Sjogren syndrome. Clin Rheumatol 2001;20:213-9
[6]. Yoshikura K, Yuasa K, Tahata O, Araki K, Yonetsu K, Nakayama E et al. Reliabilty of ultrasonography and sialography in the diagnosis of Sjogren'ssyndrome. Oral surg Oral Med Oral Pathol Oral Radiol Endod.1997;83:400-7

Abstract: Postoperative pain in paediatric population is challenging. Regional anaesthesia techniques provide a good postoperative pain relief with minimal adverse outcomes. Bupivacaine has been extensively used for paediatric caudal analgesia. Ropivacaine, an s-enantiomer has less cardiovascular and neurological toxicity and less motor block when compared to Bupivacaine, which makes it more suitable for intraoperative and post operative pain relief in paediatric population.
Aim of the study: To evaluate the analgesic effects of caudal Bupivacaine (0.2%) versus Ropivacaine(0.2 %) for Intraoperative and Post operative pain relief in paediatric age group for patients posted for infra umbilical surgeries.

[1]. Sethna NF, Berde CB. Pediatric Regional Anesthesia. In: Gregory GA, editor. Pediatric Anesthesia. 4th ed. New York: Churchill Livingstone Inc; 2003. p 267-8.
[2]. Markham A, Faulds D. Ropivacaine: A review of its pharmacology and therapeutic use in regional anaesthesia. Drugs 1996;52:429- 49.
[3]. Reiz S, Häggmark S, Johansson G, Nath S. Cardiotoxicity of ropivacaine: A new amide local anaesthetic agent. Acta Anaesthesiol Scand 1989;33:93-8.
[4]. Mc Clure JH. Ropivacaine. Br J Anaesth 1996;76:300-7.
[5]. Knudsen K, Beckman Suukula M, Blomberg S, Sjovall J, Edvardsson N. Central nervous and cardiovascular effects of i.v. infusions of ropivacaine, bupivacaine and placebo in volunteers. Br J Anaesth 1997; 78: 507-14.
[6]. Scott DB, Lee A, Fagan D, Bowler GM, Bloomfield P, Lundh R. Acute toxicity of ropivacaine compared with that of bupivacaine. Anesth Analg 1989;69:563-9.

Abstract: Intravenous Regional Anesthesia (IVRA) provides reliable and rapid anesthesia of the extremities distal to the tourniquet, but tourniquet pain and absence of post-operative analgesia are major disadvantages. Hence the present study, to compare the α2 agonists, clonidine and Dexmedetomidine as adjuncts to IVRA with respect to block characteristics, tourniquet pain and post-operative analgesia was conducted as these (α2 agonists) are known to potentiate peripheral nerve blocks.

[1]. Kumar A, Sharma D, Datta B. Addition of ketamine or dexmedetomidine to lignocaine in intravenous regional anesthesia: A randomized controlled study. J Anaesthesiol Clin Pharmacol 2012; 28: 501-504.
[2]. Chatrath V, Sharan R, Rajana et al. Comparative evaluation of adding clonidine v/s dexmedetomidine to lignocaine during Bier´s block in upper limb orthopedic surgeries. J Evol Med Dent Sciences.2014; 3:15511-20.
[3]. Marashi SM, Yazdanifard A, Shoeibi G et al. The analgesic effect of intravenous neostigmine and transdermal nitroglycerine added to lidocaine on intravenous regional anesthesia (Bier´s block): A randomized controlled study in hand surgery. Int J Pharm 2008; 4: 218-222.
[4]. Siddiqui AK, Mowafi HA, Al-Ghamdi A et al. Tramadol as an adjuvant to intravenous regional anesthesia with lignocaine. Saudi Med Journal 2008; 29: 1151-1155.
[5]. Bajwa SJ, Bajwa SK, Kaur J et al. Dexmedetomidine and clonidine in epidural anesthesia: A comparative evaluation. Indian J Anaesth 2011;55: 116-121.

Abstract:Oral squamous cell carcinoma (OSCC) is the fifth most common type of cancer in the world. The effect of some etiological factors is well established in the literature, such as consumption of tobacco and alcohol. However, approximately 15 to 20% of all oral cancer cases occur in patients without the traditional risk factors, reflecting in numerous cases of OSCC in non-smokers and non-alcoholic drinkers. Also, several studies have suggested a possible association between human papillomavirus and OSCC. Considering this aspect , the purpose of this study is to address cases of oral cancer in non-smokers and non-drinkers focusing on the role of HPV, thus contributing to improve the diagnosis and monitoring of OSCC. It is important to assess patients without the potential risk factors, since this knowledge may help identifying other features associated with the occurrence of oral cancer, enabling an appropriate clinical management and monitoring.

Key Words: oral squamous cell carcinoma, smoking and alcohol, human papillomavirus.

[1]. National Institute of Cancer - INCA. Estimative 2010 – Incidence of Cancer in Brazil. Rio de Janeiro: Ministry of Health 2009;100p.
[2]. Subapriya R, Thangavelu A, Mathavan B, Ramachandran CR, Nagini S. Assessment of risk factors for oral squamous cell carcinoma in Chidambaram, Southern India: a case-control study. Eur J Cancer Prev 2007;16:251-256.
[3]. Mannarini L, Kratochvil V, Calabrese L, Gomes Silva L, Morbini P, Betka J et al.. Human Papilloma vírus (HPV) in head and neck region: review of literature. Acta Otorhinol Ital 2009;29:119-126.
[4]. Siebers TJH, Merkx MAW, Slootweg PJ, Melchers WJG, Cleef PV, Wilde PCM. No high-risk HPV detected in SCC of the oral tongue in the absolute absence of tobacco and alcohol - a case study of seven patients. Oral Maxillofac Surg 2008;12:185-188.
[5]. Dahlstrom KR, Little JA, Zafereo ME, Lung M, Wei Q, Sturgis EM. Squamous cell carcinoma of the head and neck in never smoker-never drinkers: a descriptive epidemiologic study. Head Neck 2008;30:75-84.
[6]. Feller L, Wood NH, Khamissa RAG, Lemmer J. Human papillomavirus-mediated carcinogenesis and HPV-associated oral and oropharyngeal squamous cell carcinoma. Part 2: Human papillomavirus associated oral and oropharyngeal squamous cell carcinoma. Head Face Med 2010;6:15

Abstract: Periodontal disease is one of the most prevalent disease which is caused mostly by dental plaque or biofilm which later calcified to form dental calculus.Early detection of calculus and its removal thus plays a pivotal role in preventing the progression of periodontal disease.There are currently a plethora of novel modalities in the detection as well as removal of dental calculus.Thispaper will give an overview of these umpteen modalities and its applications in the field of periodontics.

Keywords: Calculus,spectro-optical, autoflourescence,ultrasonics,laser

[1]. Costerton JW, Lewandowski Z, Caldwell DE, Korber DR, Lappin- Scott HM. Microbial biofilms. Annu Rev Microbiol 1995;49:711-745
[2]. Darveau RP, Tanner A, Page RC. The microbial challenge in periodontitis. Periodontal 2000 1997;14: 12-32.
[3]. Fischman SL. The history of oral hygiene products: how far have we come in 6000 years? Periodontol2000 1997;15: 7-14
[4]. Mandel ID, Gaffar A. Calculus revisited- A review. J ClinPeriodontol 1986;13: 249-257.
[5]. Hoyer I, Gaengler P, Bimberg R. In vivo remineralisation of human enamel and dental calculus formation. J Dent Res 1984;63: 1136-1139.
[6]. Newmann, Takei, Klokkevold, Carranza: Clinical periodontology. 10th Edition. Noida: Elsevier; 2009

Abstract: Aim This study was designed to determine the prevalence of hepatitis B virus (HBV) infection among pregnant women in a rural hospital of tripura. Material and Methods: A cross-sectional hospital-based study was done from at Kulai District Hospital,Tripura. Blood samples of 87 pregnant women were collected. A case sheet proforma was prepared and data (demographic profile,clinical feature, investigation) from all patients were collected and analyzed. Result: Out of 87 patients 2(2.29%) samples were found positive for Hepatitis B Virus Infection. Anemia was present in 16 (18.4%) patients, out of which 3(3.4%) patients had severe anemia.

[1]. M.D. Hunt, Christine, "Liver Disease in Pregnancy", American Family Physician, Feb 15, 1999
[2]. Hepatitis and Other Liver Diseases During Pregnancy', Atlanta Maternal-Fetal Medicine, Volume 4, Number 1 – January 16, 1996
[3]. Hepatitis B Virus (HBV)"from the Baby Center Online prenatal Health Index Tucker, D.E., MRCOG,"Hepatitis B and Pregnancy", Sept. 1998, Women's Health, UK
[4]. Important Safety Information", Rebetron.com.
[5]. Gupta, N., Gautam, V., Sehgal, R., Gill, P.S., Arora, D.R. 2003. Screening by VDRL test to detect hidden cases of syphilis. Indian J. Med. Microbiol., 21: 118 120.
[6]. Mittal, S.K., Rao, S., Rastogi, A., Aggarwal, V., Kumari, S. 1996. Hepatitis B, potential of perinatal transmission in India. Trop. Gastroenterol., 17: 190 192.
[7]. Sehgal, A., Gupta, I., Sehgal, R., Ganguly, N.K. 1992. Hepatitis B vaccine alone or in combination with anti-HBs immunoglobulin in the perinatal prophylaxis of babies born to HBsAg carrier mothers. Acta Virol., 36: 359 366.
[8]. Gupta, I., Sehgal, A., Sehgal, R., Ganguly, N.K. 1992. Vertical transmission of hepatitis B in North India. J. Hyg. Epid. Microbiol. Immunol., 36: 263 267.
[9]. Panda, S.K., Ramesh, R., Rao, K.V.S., Gupta, A., Zuckerman, A.J., Nayak, N.C. 1991. Comparative evaluation of the immunogenicity of yeast derived (recombinant) and plasma derived Hepatitis B vaccine in infants. J. Med. Virol., 35: 297 302.

Abstract: It is a comparative study of renal effects of smoking by creatinine clearance method. Like any other organ, kidney is also a target organ for the consequence of smoking. 25 smokers and 25 non-smoking control groups in the age group of 20-50 years were selected as per criteria for the study. Specified instructions are given to those who are undergoing the study and from investigations mean creatinine clearance was calculated

[1]. Ortem SR, Ritz E, Scurier RW. Renal risks of smoking kidney Intl. 1997; 51:1669-1677.
[2]. Gambaro-G; Masiero-M; Che cchetto-S; Baggie-B: Renal Impairment in Chronic Cigarette Smokers: J.Am. Soc.Nephrol. 1998 Apr.; 9 (4):562-7.
[3]. John H. Horbrook : Nicotine addiction, Anthony S. Fauci, Eugene Braunwald, Kurt J. Isselbacher et al. Harrison's Principles of Internal Medicine 18 McGraw Hill Company,( New York, 1998); Vol.2:2519
[4]. Jean Michel Halimi, Claude Philippon, Albert Mimaran.Contrasting renal effects of nicotine in smokers and non-smokers. Nepurol. Dial. Transplant.1998 13:940-944.
[5]. Pawlik WW, Jacobson ED, Banks RO: Action of nicotine of renal function in dogs. Proc. Soc. Exp. Bio. Med.178:585-590, 1985.
[6]. Parchet HC, Benowitz NC, Sheiner LB. pharmacodynamic model of tolerance: application of nicotine. J. Pharmacol. Exp. Ther. 1987; 244:231-244.
[7]. Hultberg B, Isaksson A, Brattstrom L et.al. Elevated urinary excretion of b-hexosaminidase in smokers. Eur. H. Clin. Chem. Biochem.30:131-133, 1992.

Abstract: Introduction : Postpartum haemorrhage continues to be leading cause of maternal mortality and morbidity, accounting for more than 125000 deaths per year across the world. Prompt identification of high risk cases and effective action are crucial to prevent postpartum haemorrhage. Aims and objectives: To evaluate the efficacy of uterine compression sutures and bilateral uterine artery ligation for the prevention of postpartum haemorrhage during Caesarean section in high risk women.

[1] Department of Health, Scottish Executive Health Depatment, and Department of Health, Social Services and Public Safety, Northern Ireland. Why Mothers Die. Sixth report on confidential enquiries into maternal deaths in the United Kingdom, 2000-2002. London: RCOG Press: 2004.
[2] Coombs CA, Murphy El, Laros RK.Factors associated with postpartum hemorrhage with vaginal birth. Obstet Gynecol 1991; 77: 69-76.
[3] Koh E, Devendra K, Tan LK. B-Lynch suture for the treatment of uterine atony. Singapore Med J 2009; 50(7):693-69
[4] Daniel M. Avery. Review of Medical and Surgical Management of Postpartum Hemorrhage. American Journal Of Clinical Medicine. Winter 2011. Volume Eight. Number one.
[5] B-Lynch C, Coker A, Lawal AH, AbduJ, CowenMJ. The B-Lynch surgical technique for control of massive postpartum hemorrhage: an alternative to hysterectomy? Five cases reported. Br j Obstet Gynecol 1997; 104: 372-5.

Abstract: Peripheral ameloblastoma (PA) is abenign extraosseous odontogenic soft tissue tumour that is found confined to the gingiva or alveolar mucosa. Although PA is less aggressive than other classical subtypes it has the same histological characteristics of intraosseous ameloblastoma. We report a clinical case of PA of alveolar mucosa covering the left posterior maxillary tuberosity having the clinical presentation of an ulcer thereby highlighting the importance of histological examination in diagnosis.

Keywords: Benign,Peripheral ameloblastoma, Odontogenic tumour, Palatal lesions

[1]. Philipsen HP, Reichart PA, Nikai H, Takata T, Kudo Y. Peripheral ameloblastoma: biological profile based on 160 cases from the literature. Oral Oncol 2001;37:17-27.
[2]. Gardner D, Heikinheimo K, Shear M, Philipsen H, Coleman H. Ameloblastoma. In: Barnes L, Eveson J, Reichart P, Sidransky D, editors. World Health Organization- Classification of Tumours Head and Neck Tumours Pathology & Genetics. Lyon: IARC Press; 2005. p. 296-300.
[3]. Nonaka CF, de Oliveira PT, de Medeiros AM, de Souza LB, Freitas ReA. Peripheral ameloblastoma in the maxillary gingiva: a case report. N Y State Dent J 2013;79: 37 -40.
[4]. 4.Reichart PA, Philipsen HP, Sonner S. Ameloblastoma: biological profile of 3677 cases. Eur J Cancer B Oral Oncol 1995;31B:86-99.
[5]. Buchner A, Merrell PW, Carpenter WM. Relative frequency of peripheral odontogenic tumors: a study of 45 new cases and comparison with studies from the literature. J Oral Pathol Med 2006;35:385-391.