iosr-JDMS   Volume-15 ~ Issue-11 ~ November-2016

Abstract: Xanthogranulomatous pyelonephritis (XGP) is a rare histological subset of pyelonephritis characterized by being a chronic destructive granulomatous inflammation of the renal parenchyma with presence of lipid laden macrophages (xanthoma /foam cells) on histology. We report two cases of this condition, both having Type II diabetes mellitus and urinary infections where preoperative diagnosis was suggested with the help of combination of clinical, microbiogical, pathological and imaging findings with subsequent confirmation on postnephrectomy histology, highlighting the importance of multipronged diagnostic strategy in such rare pathologies, resulting in prompt treatment and improved prognosis.

Keywords: XGP, CT, Microbiology, Histology

[1]. Shah HN, Jain P, Chibber PJ. Renal tuberculosis simulating xanthogranulomatous pyelonephritis with contagious hepatic involvement. Int J Urol.2006; 13(1):67 – 68.
[2]. Abiad YEL, Dehayni Y, Qarro A, Balla B, Ammani A, Alami M. Xantogranulomatous pyelonephritis: the missed diagnosis. Int J Surg Case Rep.2016;18:21 – 23.
[3]. Foxman B. Epidemiology of urinary tract infections: incidence, morbidity, and economic costs. Am J Med.2002;113:5S–13S. [4]. Ghoz HM, Williams M, Perepletchikov A, James N, Babeir AA. An unusual presentation of xanthogranulomatous pyelonephritis: psoas abscess with reno-colic fistula. Oxf Med Case Reports.2016;(7):150-3.
[5]. Korkes F, Favoretto RL, Broglio M, Silva CA, Castro MG, Perez MDC. Xanthogranulomatous pyelonephritis: clinical experience with 41 cases.Urology.2008: 71(2);178 –180.

Abstract:This paper reviews the diagnosis and treatment of temporal bone meningoencephalocele , defined as the herniation of meninges or brain tissue into empty spaces within the temporal i.e tympanic or mastoid cavity , through the tegmen tympani or antri respectively. Imaging is the mainstay of the diagnostic process. Management of the condition is surgical , special emphasis on the transmastoid approach. The tegmen was repaired with a multi-layered technique using cartilage , temporalis fascia and tympanomeatal flap.p.

Keywords: Temporal bone, meningoencephalocele, cerebrospinal fluid leak, transmastoid approach, multilayered closure

[1]. Brown NE, Grundfast KM, Jabre A, Megerian CA, O'Malley BW jr, Rosenberg SI. Diagnosis and management of spontaneous
cerebral fluid –middle ear effusion and otorrhoea. Laryngoscope 2004;114;800-5
[2]. KamererDB ,Caparosa RJ: temporal bone encephalocele- diagnosis and treatment. Laryngoscope1982; 92: 878-882.
[3]. Glasscock ME 3rd, Dichinsjr , Jackson CG , Wiet RJ, Feenstra L : surgical management of brain tissue herniation into the middle ear
and mastoid. Laryngoscope 1979;89:1743-1754.
[4]. Gottlieb MB,Blaugrund JE, NiparkoJK : imaging quiz case 1. Tegmental encephalocele. Arch otolaryngol head neck surgery 1998;
124: 1274,1276-1277.
[5]. Ba MC, KabreA ,Badiane SB, et al: fronto- ethmoidal encephaloceles in Dakar. Report of 9 cases. Dakar med 2003;48: 131-133.

Abstract: Supplemental Or Extra Oxygen Is One Of The Most Widely Used Therapies For Patients Admitted To The Hospital. In View Of Its Increasing Demand, An Observational Descriptive Study On Medical Gas Supply System In A Rural Tertiary Care Hospital Was Undertaken With An Objective To Study The Utilization Pattern And Costing Of Oxygen In Critical Care Units And Operation Theatre For Improving Efficiency Of Medical Gas Supply System In The Hospital. The Hospital Under Study Is A Large Tertiary Care Teaching Hospital Rendering Healthcare Services To Rural Population And Has A Well-Established Central Medical Gas Supply System Functioning Effectively.

Keywords: Costing, Oxygen, Utilization.

[1]. Kunders GD. Hospitals: Facilities planning and management (New Delhi: Tata McGraw-Hill Education Publishing company; 2004. p.436-441.)
[2]. Lundy B, Stapleton M, Bewley S. Basic Medical Gas Safety. Salford Royal NHS Foundation Trust; 2012.
[3]. Linda K. Bennington CNS. Medical Gases Health Article. Gale, Detroit: The Gale Group Inc; 2002.
[4]. Grainge C. Breath of life: the evolution of oxygen therapy. J R Soc Med. 2004, Oct; 97(10): 489–493.

5]. Shultz SM, Hartmann PM. George E Holtzapple (1862-1946) and oxygen therapy for lobar pneumonia: the first reported case (1887) and a review of the contemporary literature to 1899. J Med Biogr. 2005 Nov;13(4):201-6..

Abstract: Objectives: 1. To Know the Effect of location of incision site on surgically induced astigmatism. 2. To Evaluate the Pre and Postoperative astigmatic profile of cataract surgery patients Materials and Methods: 100patients undergone manual small incision cataract surgeries, were evaluated for pre and postoperative astigmatic profile and the effect of surgical incisions on the postoperative astigmatism during the period from June 2015 to June.2016. The incision was placed on the steep axis in cases where the astigmatism was >1D and either superiorly or temporally in cases where the astigmatism was <1D. The astigmatism was assessed by keratometry on 1stday, 1week, 6weeks and 12 weekspostoperatively..........

Keywords:SIA(Surgery induced astigmatism), ATR (Against the rule), WTR(With the rule), MSICS(Manual small incision cataract surgery)

[1]. Atchison DA, Charman WN. Thomas Young's contribution to visual optics: the Bakerian Lecture "on the mechanism of the eye". J Vis. 2010 Oct 15;10(12):16. doi: 10.1167/10.12.16
[2]. Airy G. B.(1827). On a peculiar defect in the eye, and a mode of correcting it. Transactions of the Cambridge Philosophical Society, 2, 267–271.
[3]. Calculating curves : Keratometera and ophthalmometers : Br J Ophthalmol 2010;94:1144 doi:10.1136/bjo.2010.192781.
[4]. Nigel Morlet, Darwin Minassian, and John Dart : Analysis of astigmatism correction: Br J Ophthalmol published online September 16, 2009 .
[5]. Donders FC. On the anomalities of accomodation and refraction of the eye,London. New Sydenham Society, 1864:334-9

Abstract: The Interstitial Lung Diseases Are A Clinically Challenging And Diverse Groups Of Over A 150 Disorders Characterized By Varying Degrees Of Fibrosis And Inflammation Of The Lung Parenchyma Of Interstitium. The Interstitial Lung Diseases Represent Many Features In Common Such As Similarities Of Symptoms, Comparable Appearance Of Chest Imaging Studies, Consistent Alteratios In Pulmonary Physiology And Typical Histological Features

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Abstract: Objectives : To associate selected demographic variables (age and sex) with incidence of chronic leg ulcers and to determine the factors contributing to and etiology of chronic leg ulcers. Methods: The study included 60 cases pertaining to leg and foot ulcers admitted to K R Hospital, Mysore. Detailed history taking, thorough evaluation of risk factors and clinical examination, baseline investigations followed by specific investigations after taking written informed consent and diagnosis of primary cause of ulcer was done and the results analysed.........

Keywords: Chronic leg ulcer, clinical study, etiology

[1]. Moloney M, Grace P. Understanding the underlying causes of chronic leg ulceration. J Wound Care 2004;13:215–8.
[2]. Dealey C. The Care of Wounds: a guide for nurses. 3rd ed. UK Blackwell Publishing Ltd, 2005;143–58.
[3]. Greaves NS, Iqbal SA, Baguneid M, et al: The role of skin substitutes in the management of chronic cutaneous wounds. Wound Repair Regen 21:194–210, 2013.
[4]. Sgonc R, Gruber J: Age-related aspects of cutaneous wound healing: A mini-review. Gerontology 59:159–164, 2013.
[5]. Thangarajah H, Yao D, Chang EI, et al: The molecular basis for impaired hypoxia-induced VEGF expression in diabetic tissues. Proc Natl Acad Sci U S A 106:13505–13510, 2009.

Abstract: Background :Chronic Obstructive Pulmonary Disease (COPD) has considerable effects on cardiac function, including those of the right ventricle, left ventricle and pulmonary blood vessels. Most of the mortality in COPD is related to heart3. Aim :To assess the functional changes of left ventricle in patients with COPD with normal Right Ventricular Function and to find out the correlation between the left ventricular changes and the severity of COPD . Materials &Methods:51 COPDpatients with unknown severity were taken into the study. Patients were categorised into four groups based on GOLD Staging. Echocardiographic assessment of right ventricular and left ventricular function were done using Ejection fraction, diastolic function, Tei index, Global function and Respiratory variation...........

Keywords: Copd, Tei Index, Pulmonary Hypertension, Lv Ejection Fraction.

[1]. C. Tei, R.A. Nishimura, J.B. Seward, et al, Noninvasive Doppler derived myocardial performance index: correlation with simultaneous measurements of cardiac catheterization measurements, J. Am. Soc. Echocardiogr. 10 (1997) 169–178.
[2]. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease, Global initiative for chronic obstructive pulmonary disease (GOLD), 2010. Available from: <http://www.goldcopd.org>.
[3]. B. Burrows, L.J. Kettel, A.H. Niden, M. Rabinowitz, C.F. Diener, Patterns of cardiovascular dysfunction in COPD, N.Engl. J. Med. 286 (1972) 912–918
[4]. V. Bhargava, K.S. Sunnerhagen, Left ventricular asynchrony in patients with pulmonary hypertension, J. Appl. Physiol. 69 (2) (1990) 517–522
[5]. R.G. Barr, D.A. Bluemke, F.S. Ahmed, et al, Percent emphysema, airflow obstruction, and impaired left ventricular filling, N. Engl. J. Med. 362 (3) (2010) 217–227.

Abstract: Background: Though rabies is a global burden, India alone contributes an estimated 20000 deaths with 17.4 million exposures to animal bite occurring every year. It is estimated that in the absence of the post exposure prophylaxis about 3,27,000 people would die annually. Rabies, an invariably fatal viral disease, is transmitted to humans through animal bites, mostly dogs. Of the estimated 25,000 deaths due to rabies in SEAR, a majority are in India and Bangladesh. Rabies is a fatal disease of the central nervous system caused by the bites of warm-blooded animals. Rabies is a fatal viral zoonosis and serious public health problem. It is 100% fatal yet 100% preventable disease...........

Keywords: Rabies, Immunization, Animal Bite, Stray Dogs, Anti Rabies Vaccine

[1]. Eslamifar A, Ramezani A, Razzaghi- Abyaneh M, Fallahian V, Mashayekhi P, Hazrati M et al. Animal Bites in Tehran, Iran. Arch Iranian Med 2008;11(2):200-2.
[2]. Operational guidelines for rabies prophylaxis and intra- dermal rabies vaccination in kerala, 2009.Available at
[3]. http://rabies.org.in/rabies/wp-content/uploads/2009/11 / Operational-Guidelines-for- Rabies-Prophylaxis-and-Intra-Dermal- Rabies- Vaccination-in-Kerala.pdf .Accessed on Oct 23rd, 2015
[4]. Gadekar Rambhau D. and DhekaleDilip N. Profile of Animal Bite Cases in Nanded District of Maharashtra State, India. Indian Journal of Fundamental and Applied Life Sciences 2011. 1(3), 188-193.
[5]. WHO Expert Consultation on Rabies: first report (2004). Available at http://whqlibdoc. who.int/trs/ WHO _ TRS_ 931_ eng. pdf Accessed on November 22nd, 2012

Abstract: Caesarean section is one of the common surgical procedure in Obstetrics and subarachnoid block is a time tested anaesthetic technique for analgesia. Use of single drug and avoiding polypharmacy is the Goal.Earlier 5% Xylocaine was being used, now 0.5% Bupivacaine is the choice of medication for spinal anaesthesia. Adding Opioids like fentanyl will have faster onset, prolonged analgesia without causing much of side effects. In our study have chosen fentanyl in 2 different doses to see which is more effective and with less side effects.

Keywords: Bupivacaine, Caesarian Section, Fentanyl, Subarachnoid block.

[1]. Shasikala T.K, Srinivas V.Y A clinical study of effect of spinal fentanyl on subarachnoid block in parturients. JEMDS
2014;34(3):8980-8990.
[2]. Prabha P, Shreyavathi R, Raghavendra R, Akshatha R. Comparative Study of Intrathecal Bupivacaine and Levobupivacaine with
Fentanyl for Caesarian Section. Sch. J. App. Med. Sci., 2014; 2(4B):1255-1259.
[3]. Venkata HG, Pasupuleti S, Pabba UG, Porika S, Talari G. A randomized controlled prospective study comparing a low dose
upivacaine and fentanyl mixture to a conventional dose of hyperbaric bupivacaine for cesarean section. Saudi J Anaesth
2015;9:122-7.
[4]. Seyedhejazi M, Madarek E. The effect of small dose bupivacaine-fentanyl in spinal anesthesia on hemodynamic nausea and
vomiting in cesarean section . Pakistan journal of medical sciences 2007;23(5):1681-715.

Abstract: Shivering is seen in the immediate postoperative period due to the effect of medications that may cause vasodilatation; cold intravenous fluids that can cause drop in temperature and due to air conditioning in the operation theatre. The temperature should be optimal in the operating room, fluids to be warm to prevent Shivering. Opiods can be used to prevent shivering along with the above precautions. In our study we are comparing effect of Buprinorphine and Granisetron to prevent shivering in the postoperative period.

Keywords: Buprinorphine, Granisetron, Shivering

[1]. Buggy D, Higgens P, Moran C, O'Donovan F, Mc Carroll M. Clonidine at induction reduces shivering after general anesthesia. Can
J Anaesth 1997; 44: 263-7.
[2]. Piper SN, Rohm KD, Suttner SW, Maleck WH, KrankeP, Boldt J. A comparison of nefopam and clonidine for the prevention of
postanesthetic shivering: A comparative, double blind and placebo controlled dose ranging study. Anaesthesia 2004; 59: 559-64.
[3]. Crossley AWA. Peri-operative shivering. Anaesthesia 1999; 47: 193-5.
[4]. Powell R, Buggy D. Ondansetron given before induction of anesthesia reduces shivering after general anesthesia. AnesthAnalg
2000; 90: 1413-7.
[5]. Ciofolo MJ, Clergue F, Devilliers C, Ben Ammar M, Viars P. Changes in ventilation, oxygen uptake and carbon dioxide output
during recovery from isoflurane anesthesia. Anesthesiology 1989; 70:737-41.

Abstract: Peripheral Primitive Neuro-ectodermal Tumors (pPNETs) are a group of rare but highly aggressive tumors which usually occur in children and adolescents with thoraco-pulmonary region being the most common site of occurrence. Patients usually present with cough, breathlessness, fever or hemoptysis. Superior Vena Cava Syndrome caused by a pPNET is a very rare clinical entity with literature limited to just a few case reports. We report a case of Thoracic PNET in a 15-year-old boy who presented with Superior Vena Cava syndrome. To the best of our knowledge, this is one of the few such cases reported in the literature

Keywords: Askin tumor, Primitive neuro-ectodermal tumors, Superior vena cava syndrome

[1]. Nag VK, Nandan D, Chatterjee A, Bhardwaj M. Primitive neuroectodermal tumor presenting with superior vena cava syndrome. J Assoc Chest Physicians 2014;2:81-3.
[2]. Kalantari M, Deyhimi P, Kalantari P. Peripheral Primitive Neuroectodermal Tumor (pPNET) of the Parotid: Report of a Rare Case. Arch Iran Med. 2015; 18(12): 858 – 860.
[3]. Benbrahim Z, Arifi S, Daoudi K, Serraj M, Amara B, Benjelloun MC et al. Askin's tumor: a case report and literature review. World J Surg Oncol 2013, 11:10.
[4]. Minne` C, Khan M. Paraspinal Primitive Neuroectodermal tumor (PNET) of the chest. South African Journal Of Radiology 2006; 10(1): 18.
[5]. Nazari S, Malek F, Madani F, Hamoud M. Askin Tumor Presenting as Superior Vena Cava Syndrome. IJBC 2015; 7(3): 197-169

Abstract: Objective: To report a case of Nevirapine induced Steven Johnson syndrome in an individual with Acquired Immuno Deficiency Syndrome . Methods:A 25 year old HIV infected female patient came to ART unit of MGM Medical college , Jamshedpur with complains of intermittent high grade fever and papulovesicular eruption all over the body with abrasion of oral mucosa on 3rd day which gradually increased in size along with eyes and vaginal mucosa involvement consistent with Steven Johnson syndrome . Drug history revealed that she was being treated with Highly Active Antiretroviral Therapy which included Nevirapine , Lamivudine and Stavudine . On examination her vital signs were normal and blood report within normal limit...........

Keywords: StevenJohnson syndrome ,Nevirapine , Anti retroviral therapy, Highly Active Anti retroviral therapy

[1]. Barvaliya M, Sanmukhani J, Patel T, Paliwal N, Shah H, Tripathi C. Drug-induced Stevens-Johnson syndrome (SJS), toxic
epidermal necrolysis (TEN), and SJS-TEN overlap: A multicentric retrospective study. J Postgrad Med 2011;57:115-9 https://rarediseases.info.nih.gov/gard/7700/stevensjohnson-syndrome/resources/1
[2]. Aronson JK. Meyler s side-effects of drugs. 15th ed. Vol 4. The Netherlands:Elsevier. 2006. p. 2498-502.
[3]. Naranjo CA, Busto U, Sellers EM. Difficulties in assessing adverse drug reactions in clinical trials. ProgNeuropsychopharmacolBiol Psychiatry 1982; 6: 651-7. PubMed Citation

Abstract: Post operative nausea and vomiting (PONV) remains one of the most common and distressing complications after surgery resulting in pain, hematoma and wound dehiscence. Furthermore, small dose of propofol was reported to possess direct antiemetic effects. Thus, a study was done to evaluate the antiemetic efficacy of propofol. Group A received Propofol 0.5mg/kg IV, Group B received Propofol 0.75mg/kg IV and Group C received Normal Saline, respectively. Incidence of nausea and vomiting was assessed by VAS score within 24 hours in PACU...........

Keywords: Post operative nausea and vomiting, propofol, visual analogue score

[1]. David RS, Frances C, Gabor M. Can Postoperative Nausea and Vomiting Be Predicted? Anesthesiology 1999;91(1):109-118.
[2]. Mehernoor FW, Paul FW. Postoperative Nausea and Vomiting: Its Etiology, Treatment, and Prevention. Anesthesiology
1992;77(1):162-184.
[3]. Kim J, Jang GD, Kim DS, Min KT. Small Dose of Propofol Combined with Dexamethasone for Postoperative Vomiting in
Pediatric Moyamoya Disease Patients: A Prospective, Observer-Blinded, Randomized Controlled Study. Korean J Anesthesiol
2013;64(2):127–132.
[4]. Kim E-G, Park HJ, Kang H, Choi J, Lee HJ. Antiemetic effect of propofol administered at the end of surgery in laparoscopic
assisted vaginal hysterectomy. Korean J Anaesthesiol 2014;66(3):210-215.
[5]. Ostman PL, Faure E, Glosten B, Kemen M, Robert MK, Bedwell S. Is the antiemetic effect of the emulsion formulation of propofol
due to the lipid emulsion? Anesth Analg 1990;71:536-40.

Abstract: Lymphadenopathy is one of the commonest conditions encountered in clinical practice. Fine Needle Aspiration Cytology( FNAC) has proven to be an easy, reliable and cost effective diagnostic tool for lymphadenopathies. The appropriate use of FNAC may obviate the need for an open biopsy. The purpose of the present study is to see the spectrum of cytopathological findings of FNAC of lymph node over a period of 3 years and to find out its correlation with the histopathological diagnosis. A retrospective study was conducted on cases of lymphadenopathy whose FNAC and biopsy were done during a 3 year period. FNAC was done in 1542 cases and correlation between cytopathological and histopathological..........

Keywords: Lymphadenopathy, FNAC, Biopsy, correlation

[1]. Martin HE, Ellis E.Biopsy needle puncture and aspiration Ann Surg 1930;92,169-81
[2]. Zajichek J; Aspiration Biopsy;part-I cytology of lymph node act 1974,vol-4
[3]. Pandit AA, Candes FP, Khubchandani SR. Fine needle aspiration cytology of lymph nodes. J Postgrad Med 1987; 134-136
[4]. Vidya K, Subramanya N.K. Fine needle Aspiration Cytology of Lymphadenopathies: "3 year study", journal of evidence based Medicine and Health care, Vol-2, issue 31, Aug 3,2015, P-4579-4596.
[5]. Arun Kumar Gupta, MohiniNayar, Mithilesh Chandra. Reliability and limitations of iine needle aspiration cytology of lymphadenopathies. Arranalysis of 1,261 cases. Acta Cytol 1991;35,777-782

Abstract: Introduction:The perforation of the tympanic membrane may be traumatic in origin or due to chronic suppurative otitis media. If the perforation fails to heal spontaneously or by conservative therapy, they require surgical closure. The repaired perforation restores the vibratory area of the tympanic membrane and affords round window protection, thus improves hearing. Hence surgery is the mainstay of the treatment. It can be done by myringoplasty or type 1 tympanoplasty. Biological graft materials acts as a scaffold of tissue matrix when applied to seal the perforation. Some of the commonly used autologous graft materials include vein , fat, fascia lata, temporalis fascia, perichondrium and cartilage.........

Keywords:Temporalis fascia, Tragal perichondrium, myringoplasty

[1]. Julianna Gulya A, Minor L B, Poe Dennis S. Glasscock-Shambaugh: Surgery of the Ear, Ch-28, 465-488.
[2]. Athanasiadis-Simanis A. Tympanoplasty: tympanic membrane repair. In: Gulya AJ, Minor LB, Poe DS, editors. Glasscockshambaugh
surgery of the ear. 6. Shelton: Peoples Medical Publishing House; 2010. pp. 468–478.
[3]. Mawson sr. Myringoplasty; the surgical repair of tympanic membrane perforations. J Laryngol- Otol. 1958 Jan; 72(1):56–66.
[4]. Comparative Study of Underlay Tympanoplasty with Temporalis Fascia and Tragal Perichondrium .Rakesh Kumar, Rajesh Kumar
suman, Yogesh A. Garje, Suman P. RaoIOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-ISSN: 2279-0853, p-ISSN:
2279-0861.Volume 13, Issue 5 Ver. III. (May. 2014), PP 89-98.
[5]. Frenckner P. Pedicle graft from ear canal skin for myringoplasty. ActaOtolaryng 1955; 45: 19.

Abstract: Comparative evaluation of the effectiveness of biochemical indices of blood serum and mixed saliva of patients with parenchymatous parotitis in an exacerbation period at the stage of admission with complete blood count indices as well as with the results of sialography of this group's patients was done. High correlation coefficients are discovered in biochemical fluids on the indices of complete protein, chlorides, ALT, phosphatase, amylase in all the forms of parenchymatous parotitis. Complete blood count indices happened to be noninformative for the diagnostics of the form of parenchymatous parotitis. Informative indices of mixed saliva gotten can be used in the process of patients' examination, suffering from parenchymatous parotitis in an exacerbation period for the identification of the form, severity level, prognosis of the disease and planning of an adequate treatment as a high-precision, noninvasive, pathognomonic test

Keywords:parenchymatous parotitis, sialography, parotid glands, parotid ducts, chronic parotitis, contast mass, blood serum, parenchyma, saliva's amylase

[1]. Martin HE, Ellis E.Biopsy needle puncture and aspiration Ann Surg 1930;92,169-81
[2]. Zajichek J; Aspiration Biopsy;part-I cytology of lymph node act 1974,vol-4
[3]. Pandit AA, Candes FP, Khubchandani SR. Fine needle aspiration cytology of lymph nodes. J Postgrad Med 1987; 134-136
[4]. Vidya K, Subramanya N.K. Fine needle Aspiration Cytology of Lymphadenopathies: "3 year study", journal of evidence based Medicine and Health care, Vol-2, issue 31, Aug 3,2015, P-4579-4596.
[5]. Arun Kumar Gupta, MohiniNayar, Mithilesh Chandra. Reliability and limitations of iine needle aspiration cytology of lymphadenopathies. Arranalysis of 1,261 cases. Acta Cytol 1991;35,777-782

Abstract: Background: The society of Paediatric Anaesthesia, on its 15th annual meeting at New Orleans, Louisiana (2001) clearly defined the alleviation of pain as a "basic human right", irrespective of age, medical condition, treatment, primary service response for the patient care or medical institution.1 Finely et al observed that many types of so called "minor" surgery (e.g. circumcision) can cause significant pain in children.2 One of the most commonly used regional anaesthetic techniques in paediatric surgeries is the caudal epidural block. Its main disadvantage remains the short duration of action. Hence, different additives have been used. Dexmedetomidine is a potent as well as highly selective α2 adrenergic receptor agonist. The aim of this randomized, double-blinded, study was to compare the duration of postoperative analgesia of caudal dexmedetomidine versus tramadol in combination with ropivacaine in paediatric patients undergoing lower abdominal or perineal surgery...........

Keywords: Ropivacaine, caudal block, dexmedetomidine, tramadol, postoperative analgesia

[1]. Frank HK. The society of Paediatric Anaesthesia: 15th annual meeting, New Orleans, Louisiana. Anaesthesia Aanalgesia.
2002;94:1661-8.
[2]. Finley GA, Mc Granth PJ, Forward SP, et al. Parents management of children pain following "minor" surgery. Pain. 1996;64:83-7.
[3]. Deng XM, Xiao WJ, Tang GZ, Luo MP, Xu KL. The minimum local anesthetic concentration of ropivacaine for caudal analgesia
in children. Anesth Analg. 2002;94:1465-8.
[4]. Birbicer H, Doruk N, Cinel I, Atici S, Avlan D, Bilgin E, et al.Could adding magnesium as adjuvant to ropivacaine in caudal
anaesthesia improve postoperative pain control. Pediatr Surg Int. 2007;23:195-8.
[5]. Anand VG, Kannan M, Thavamani A, Bridgit MJ. Effects of dexmedetomidine added to caudal ropivacaine in paediatric lower
abdominal surgeries. Indian J Anaesth. 2011;55:340–6

Abstract: Introduction: Hiv/Aids patients are increasing in number in india. Human immunodeficency virus causes it. Recently there is a slight decrease in incidence of HIV due to easy access to ANTI RETROVIRAL THERAPY. Objective: To monitor creatinine levels in HIV patients taking HAART Method: Data for the study was collected from ART CENTRE RIMS RANCHI who were on HAART therapy. A total of 68 patients were included and their creatinine value was taken for 2 times at 6 month interval. Result: Total 68 patients creatinine level was taken at 6 month interval. Their mean was calculated and analysed. Conclusion: Creatinine level was significantly improved in 2nd reading than the 1stone. It means haart therapy can significantly improve renal functions.

Keywords:aids, creatinine, haart( stavudine+lamivudine+nevirapine), nephropathy

[1]. Okolie MN, Eghafona NO, Omoregie R. Anti-human immunodeficiency virus agents. J Med Lab Sci. 2003; 12: 1-14
[2]. Odunukwe N, Idigbe O, Kanki P, Adewole T, Onwujekwe D, Audu R, Onyewuche J. Haematological and biochemical response to
treatment of HIV-1 infection with a combination of nevirapine + stavudine +lamivudine in Lagos, Nigeria. Turkish J Haematol.
2005; 22: 125-131.
[3]. Johnson VA, Brun-Ve´zinet F, Clotet B, Conway B, D'Aquila RT, Demeter LM. Update of the drug resistance mutations in HIV-1.
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antiretroviral therapy. Adv Lab Med Int 1: 25–31.

Abstract: A review of data on interactions between Mental illness and Diabetes taking into account the multifactorial causation, sustanence of illness and outcome variables together makes absolutely confusing reading. An attempt has been made to mention only that material where the controversies regarding the stated facts are relatively less.

Keywords: Schizophrenia, Depression, Bipolar Disorder, Fasting glucose

[1]. Arroyo C, Hu FB, Ryan LM, et al: Depressive symptoms and risk of type 2 diabetes in women. Diabetes Care 27:129–133, 2004.
[2]. Brown S, Birtwistle J, Roe L, et al: The unhealthy lifestyle of people with schizophrenia. Psychol Med 29:697–701, 1999.
[3]. Bushe C, Holt R: Prevalence of diabetes and impaired glucose tolerance in patients with schizophrenia. Br J Psychiatry
47(suppl):S67–S71, 2004.
[4]. Bushe C., Leonard B.,. Association between atypical antipsychotic agents and Type 2 Diabetes: Review and prospective clinical
data. Br J Psychiatry 184 (suppl 47):s87–s93, 2004.
[5]. Bjorntorp P, Rosmond R: Obesity and cortisol. Nutrition 16:924–936, 2000.

Abstract: In this world of diversity and rapid growth it's difficult for anyone to do things alone. This is especially true in health where constantly rising prices, changing disease patterns, and increasing use of sophisticated technology for diagnosis and treatment have made it virtually impossible to imagine any single organization providing services without some type of institutional partnership(1). This study looks at profile of the patients being referred to private sectors as a part of public and private partnerships in heath sector in a tertiary care ESI (Employee State Insurance) hospital in Delhi. It was a descriptive record based study done between August to October 2016. Data of patients being referred to private sector for admission and management for different diseases were taken from record between 1st January 2016 to 30thJune 2016. A total of 5085 patients were referred in which 53.6% were males and 46.4% were females...........

Keywords: outsourcing, Public private partnership, ESIC

[1]. An Overview of Public Private Partnerships in Health page 1.Mitchell .

[2]. www.esic.nic.in

[3]. Becker's Hospital Review E-weekly

[4]. A survey of decision-making factors, benefits and obstacles .Outsourcing in health. Volume 10, Issue 1 /2008. Socrates J. Moschuris and Michael N. Kondylis

[5]. Human Resources: Staff Retention. Volume 11, Issue 1 / 2009. Thilo Ullrich,

Abstract: Left ventricular hypertrophy (LVH) measured by either electrocardiography (ECG) or echocardiography in hypertensive patients has been shown to be associated with substantially increased risk of cardiovascular morbidity and mortality. In view of its widespread availability and low cost, the ECG has traditionally been the routine method recommended to recognise this target organ damage in the heart. This was a prospective cross-sectional study designed to determine the prevalence and correlates of ECG LVH in
hypertensive patients at a specialist clinic in Ghana. Three hundred and forty two (342) hypertensive patients were selected using simple random sampling...........

Keywords: ECG LVH, left atrial enlargement, hypertension, blood pressure, prevalence, correlates

[1]. Bosu WK. Epidemic of hypertension in Ghana: a systematic review. BMC Public Health. 2010 Jul 14;10(1):418.
[2]. Cappuccio FP, Micah FB, Emmett L, Kerry SM, Antwi S, Martin-Peprah R, et al. Prevalence, detection, management, and control
of hypertension in Ashanti, West Africa. Hypertension. 2004 May;43(5):1017–22.
[3]. Agyemang C. Rural and urban differences in blood pressure and hypertension in Ghana, West Africa. Public Health.
2006;120(6):525–33.
[4]. Addo J, Amoah AG, Koram KA. The changing patterns of hypertension in Ghana: a study of four rural communities in the Ga
District. Ethn Dis. 2006;16(4):894–9.
[5]. Ayodele OE, Alebiosu CO, Salako BL, Awoden OG, Abigun AD. Target organ damage and associated clinical conditions among
Nigerians with treated hypertension. Cardiovasc J South Afr Off J South Afr Card Soc South Afr Soc Card Pract. 2005;16(2):89.

Abstract: Aim: To compare the dentinal defect incidences of HyFlex CM, Extreme CM R3 and SANI S3 NiTi files during root canal preparation of maxillary first premolar teeth. Materials and Methods:Eightymaxillary first premolars were selected. Twenty teeth were left unprepared and served as a negative control and the remaining 60 teeth were shaped with the following experimental groups with an apical size #25 file: HyFlex CM 25/.04, Extreme CM R3 25/.06 and SANI S3 25/.06. After root canal preparation, all of the roots were sectioned perpendicular to the long axis at 3, 6, and 9 mm from the apex, and the sections were then observed under a stereomicroscope. The absence/presence of cracks was recorded, and the data were analyzed with a chi-square test. The significance level was set at P = 0.05..........

Keywords: Endodontics,Extreme CM R3, HyFlex CM, Nickel Titanium, SANI S3

[1]. Shemesh H, Bier C, Wu MK, Tanomaru-Filho M, Wesselink P. The effects of canal preparation and filling on the incidence of
dentinal defects.Int Endod J. 2009;42(3):208-213.
[2]. Wilcox LR, Roskelley C, Sutton T. The relationship of root canal enlargement to finger-spreader induced vertical root fracture. J
Endod 1997;23(8):533-534.
[3]. Shemesh H, van Soest G, Wu MK, Wesselink PR. Diagnosis of vertical root fractures with optical coherence tomography. J
Endod2008;34(6):739-742.
[4]. Sathorn C, Palamara JE, Messer HH. A comparison of the effects of two canal preparation techniques on root fracture susceptibility
and fracture pattern. J Endod 2005;31(4):283-287.
[5]. Kim H-C, Lee M-H, Yum J, Versluis A, Lee C-J, Kim B-M. Potential relationship between design of nickel-titanium rotary
instruments and vertical root fracture.J Endod2010;36(7):1195-119

Abstract: Background: The endemicity of Hepatitis B virus (HBV) infection is leveling off in sub-Saharan Africa; it remains at an unacceptable high level (≥8%, to <2%) with global prevalence of 3·61%. The present study assessed the effectiveness of a peer-led HBV prevention education intervention in Usman Danfodiyo University Sokoto, Nigerian on youth's HBV-related knowledge, attitude, and practices. Methods: In a peer-led single blind randomized controlled community trial conducted between April and December 2015. 390 students were selected and randomized into the intervention and control arms, each arm with 195 respondents; five out of 12 faculties were selected using multi-staged random sampling.Four surveys were conducted (baseline, immediately, three and six months using self-administered questionnaire.Analysis of data were conducted using SPSS version 22..........

Keywords:Youth, Peer-led, Knowledge, Attitude, and Practice

[1]. World Health Organization ; Hepatitis Fact Sheet N204 Revised August 2008. Key facts. WhereisHepatitisB most common?Available at: www.who.int/media centre/factsheets/fs204/-29k. Accessed 15 February 2016.
[2]. World Health Organization . Global Burden of Diseases Update. Geneva. World HealthOrganization(WHO/W74/2004).Available:http://www.who.int/healthinfo/global_burden_disease/GBD_report_2004update_full.pdf.3. Accessed 10 March 2016.
[3]. Kew M . Chronic hepatitis B virus infection and hepatocellular carcinoma in Africa. S Afr Jr Sci. 1992; 88(2):524-528.
[4]. Emechebe GO, Emodi IJ, Ikemefuna AN, Ikechukuc A. Hepatitis infection in Nigeria a Review. Niger Med. J. 2009;50(1): 18-22
[5]. Francisci D, Antonelli S, Preziosi R, Mecozzi F, Stagni G, Pauluzzi S. Risk factors for acute parenterally transmitted viral hepatitis: a 20-year study. Eur J Epidemiol.1993; 9(3):625–628

Abstract: Glass Ionomer Cements have their origin in the middle of twentieth century, when a peculiar demand for a biocompatible, cost effective materialbecame evident. Considering their unique ability to bond to the tooth structure coupled with fluoride releasing potential, GIC's have graduallyemerged as material of choice for a diverse yet distinctly typical procedures ranging from restoration to rehabilitation.Glass ionomers are applicable to many restorative situations,both as stand alone restoratives and in conjunction with composite resin.Although glass ionomer cement use as a restorative material, it has some drawbacks.This article reviews about the recent advances and their properties, advantages,disadvantages, indication and contraindication. An understanding of advances is essential for the optimal incorporation of these materials into common restorative procedures..

Keywords: Glass ionomer cement, Advances in GIC

[1]. Glass ionomer cement by Alan D.Wilson and John W. Mclean
[2]. Philips science of dental materials, 11thed& 12thed
[3]. Sturdevant‟s Art and science of operative dentistry, Fifth edition
[4]. Craig‟s Restorative dental materials, Twelfth edition
[5]. G J Mount and R W Hume Text book of Minimal intervention dentistry

Abstract: Quest for newer material are never ending especially in the field of dental science. Various materials have been formulated, tested, and standardised to obtain maximum benefits for good clinical performance.1 Bioactive materials have been used in every field of dentistry and medicine.2 An ideal orthograde or retrograde filling material should seal the pathways of communication between the root canal system and its surrounding tissues. It should also be non toxic, non cariogenic, biocompatible, insoluble in tissue fluids, and dimensionally stable.1 These materials are broadly used in the field of conservative dentistry for regeneration, repair and reconstruction. These materials are available in different form and composition that acts directly on vital tissue inducing its healing and repair.

Keywords:Biomimetic, Bioactive, Bioinert, Bioresponsive

[1]. Priyalakshmi.S, Manish Ranjan; Review on Biodentine-A Bioactive Dentin Substitute; IOSR Journal of Dental and Medical SciencesVolume 13, Issue 1 Ver. III (Jan. 2014), PP 13-17 www.iosrjournals.org
[2]. Snehal Sonarkar, Rucheet Purba; Bioactive materials in conservative dentistry; International Journal of Contemporary Dental and Medical Reviews (2015), Article ID 340115, 4 Pages
[3]. STEVEN R. JEFFERIES, MS, DDS, PhD; Bioactive and Biomimetic RestorativeMaterials: A Comprehensive Review. Part I Article in Journal of Esthetic and Restorative Dentistry · December 2013
[4]. Shikha Singh,Rahul Maria,AU Palekar,Sweta Singh; MTA –MIRACLE IN DENTISTRY; NJDSR,Vol.1, January, 2012 70-74
[5]. Imran Farooq, Zonera Imran, Umer Farooq, Ali Leghari, Humera Ali.; Bioactive Glass; A material for Future: World Journal Of Dentistry, April-June201:3(2);199-201