iosr-JDMS   Volume-15 ~ Issue-12 ~ December-2016

Abstract: Immunization is an integral component of mother and child health in India since adoption of primary health care. The UIP was introduced by govt. of India in 1985-86 to cover at least 85% of the infants against 6 vaccine preventable disease by 1990. With hope that in new millennium it will reach 100%. According to NFHSIII; we are still lagging in achieving 100% immunization. A cross sectional study was done in KT Children Hospital Rajkot, a tertiary care centre on 300 children of age group 2 months to 5 year to assess the immunization status and reason for partial immunization or nonimmunization..............

Keywords: NFHS, Immunisation status, tertiary care centre, vaccine.

[1]. National Family Health Survey-3(NFHS-III), 2005-06, Ministry Of Health And Family Welfare, Government Of India.
[2]. National Family Health Survey-4(NFHS-IV), 2015-16, Ministry Of Health And Family Welfare, Government Of India.
[3]. Urban Health Resource Centre(2008). Child health scenario in slums of Meerut, Uttar Pradesh.
[4]. Sharma R Desai, V.K.Kavishvar(2009).
[5]. Assessment of immunisation status in slums of Surat, Indian Journal Of Community Medicine, 34,2,152-155.
[6]. A.M.Kadri, Anjali Singh study on immunisation coverage in urban slums of Ahemedabad city. Health and population: Perspective
and Issues volume 33(1,50-54).

Abstract: Objective: The aim of the study, we wanted to compare the anesthetic efficacy of ropivacaine alone versus its combination with fixed dose sufentanil. We aimed to find the minimum required dose of ropivacaine when administered with a fixed concentration of sufentanil during lower limb surgeries to achieve effective anesthesia. We also attempted to find whether the combination in effective anesthetic dose produces any hemodynamic instability and/ or significant adverse effects during the surgery and in the immediate postoperative period..............

Keywords: Epidural Anesthesia, Lower Limb Surgery, Ropivacaine, Sufentanil, Up Down Method

[1]. Corning JL. Spinal anaesthesia and local medication of the cord. NY Med J. 1885. 42:483-485.
[2]. Curbelo MM. Continuous peridural segmental anesthesia by means of a ureteral catheter. AnesthAnalg. January/February 1949. 13-23.
[3]. Hattler J, Klimek M, Rossaint R, et al. The Effect of Combined Spinal-Epidural Versus Epidural Analgesia in Laboring Women on Nonreassuring Fetal Heart Rate Tracings: Systematic Review and Meta-analysis. AnesthAnalg. 2016 Aug 9. [Epub ahead of print]. PMID: 27509225
[4]. Nandanwar AS1, Patil Y2, Wagaskar VG, et al. A Comparison of Efficacy of Segmental Epidural Block versus Spinal Anaesthesia for Percutaneous Nephrolithotomy. J ClinDiagn Res. 2015 Aug;9(8):UC01-4.
[5]. Capdevilla X, Barthelet Y, Biboulet P et al. Effects of perioperative analgesic technique on the surgical outcome and duration of rehabilitation after major knee surgery. Anesthesiology 1999;91:8-15.

Abstract: Background: Vaginal bleeding in the first trimester of pregnancy is associated with spontaneous abortion /miscarriage, ectopic implantation, hydatidiform mole, preterm delivery, and lowbirth weight. Aim:The purpose of this study was to determine the perinatal outcome and pregnancy complication (preterm delivery, preterm prelabour rupture of membrane [PPROM], preeclampsia, placental abruption and intrauterine fetalgrowth restriction [FGR] of threatened miscarriage. Methods: This prospective study was carried out in our department of obstetrics and gynaecology at a tertiary care centre from June 2013 to July 2015. 100 patients were included with a history of amenorrhea and urine pregnancy test positive with bleeding per vaginum in the first trimester.............

Keywords: First-trimester, Pregnancy, Preterm birth, Vaginal bleeding

[1]. Cunningham FG, editor. Williams's obstetrics 23 edition. New York; McGraw-Hill; 2010. P-220.
[2]. Nyberg DA, Filly. RA, Duart E, Filho DL, Laing FC, et al Abnormal pregnancy:Early diagnosis by US and serum chorionic gonado
tropin levels. Radiology 1986;158: 393-6
[3]. Goldman, 1., Ashkenazi, J ., Mordechai, B.. Feldberg, D., Dicker, D., &Voliovitz, 1. (1988). First trimester bleeding in clinical IVF
pregnancies. Human Reproduction, 3, 3807-3809.
[4]. Stabile, l. (1992). Spontaneous abortion: A clinical perspective. The Female Patient, 14-30.
[5]. Yazigi, R., Saunders, E., &Gast, M. (1991, January). Hormonal therapy during pregnancy. Contemporgy OB/GYN, 61-78.

Abstract: Background: Dermatophytosis, also known as tinea ; is one of the most common superficial fungal infections present in tropical countries. Due to changes in lifestyle and risk factors, epidemiology is changing even in rural India. Methodology: This observational study was conducted to examine risk factors, epidemiology and clinical profile of dermatophytic superficial fungal infections in patients of rural area.100 symptomatic patients who attended teaching hospital's OPD and were from villages of Whagodia taluka which is situated at Vadodara District, Gujarat, India, were selected. This was hospital based study coupled with community visits...........

Keywords: Superficial fungal infections, dermatophytosis , tinea , Over The Counter (OTC) preparations, fomite

[1]. Phipot CM. Some aspects of epidemiology of tinea. Mycopathologica. 1977; 62:3-13
[2]. Mohammedamin RS, van der Wouden JC, Koning S, Schellevis FG, van Suijlekom-Smit LW, Koes BW. Reported incidence and
treatment of dermatophytosis in children in general practice: a comparison between 1987 and 2001. Mycopathologia. 2007 Dec;
164(6):271-8.
[3]. Reichert-Pénétrat S, Contet-Audonneau N, Barbaud A, Schurra JP, Fortier B, Schmutz JL.Epidemiology of dermatophytosis in
children living in northeast France: a 5-year study. Pediatr Dermatol. 2002 Mar-Apr;19(2):103-5.
[4]. Sarkar R,Kanwar AJ.Three common dermatological disorders in children (scabies, pediculosis and dermatophytoses). Indian
Pediatrics 2001; 38: 995-1008
[5]. Phipot CM. Geographical distribution of the dermatophytes: a review.J Hyg(Lond.) 1978 Apr;80(2):301-13

Abstract: Palmaris longus muscle, a weak flexor of the hand at the wrist, is well known for its morphological variation and records an agenesis of 10%. Two upper limbs lacking Palmaris Longus Muscle also exhibited incomplete Superficial Palmar Arch [SPA]. Upon reviewing the literature, it was found that only few such cases were reported. Hence, an attempt has been made to study the relationship between the absence of Palmaris longus muscle and occurrence of incomplete SPA. The outcome shall benefit anatomists, hand surgeons,
orthopaedicians and cardiologists alike.

Keywords: Palmaris longus absence, Superficial Palmar Arch variation, Ulnar artery.

[1]. Mangala M. Pai, Latha V. Prabhu, S. R. Nayak, S. Madhyastha, Rajanigandhavadgaonkar, A. Krishnamurthy, A. Kumar. The
Palmaris Longus Muscle: Its Anatomic Variations And Functional Morphology. Romanian Journal Of Morphology And Embryology 2008, 49(2):215–217
[2]. Coleman SS, Anson BJ. Arterial patterns in the hand based upon the study of 650 specimens. Surg Gynecol Obstet. 1961; 113: 409– 424.
[3]. Azian A. Latiff ; FaizahOthman ;Farihah H. Suhaimi ; Srijit Das. Anomalous superficial palmar arch: A cadaveric study with
clinical implications. 2008. Archives of Medical Science, 4(2), 197-199.
[4]. Srinivasa Rao, VenkataRamanaVollala, Narendra Pamidi, SomayajiNagabhooshana, and Bhagath Kumar Potu. Variant formation
and distribution of the superficial palmar arch. Indian J Plast Surg. 2010 Jan-Jun; 43(1): 116–117.
[5]. Showri. R, SenthilKumar. S. A study on ulnar dominant complete superficial palmar arch. Int J Anat Res 2016;4(3):2587-
2589.DOI: 10.16965/ijar.2016.281s.

Abstract: Coronary Artery Disease (CAD) is a major cause of morbidity and mortality affecting mostly young and middle aged population. Acute Myocardial Infarction (AMI) is an entity of CAD which is defined as a part of Acute Coronary Syndrome consisting of chest pain, dyspnoea. Recently it has been observed that trace elements and free radicals may play an important role in the development of AMI. The aim of the study was to estimate the levels of trace elements like serum copper, iron and zinc and oxidative stress in patients of AMI and to compare with the healthy controls and to find out the correlation between atherogenic index (AI), cardiac risk ratio (CRR) with malondialdehyde(MDA)........

Keywords: AMI, Zinc, Copper, Iron, Oxidative stress

[1]. Report by WHO expert committee, Prevention of Coronary Heart Disease ((1982),Tech.Rep.ser- 678,p.5.
[2]. Mendis, S., Wissler, R.W., Bridenstine, R.T. And Podbielski, F.J. (1989 ).The effects of replacing coconut oil with corn oil on
human serum lipid profile and platelet derived factors active in atherogenesis. Nutrition Reports International, Oct.1989, No.4,40.
[3]. Myocardial infarction redefined – a consensus document of Joint European Society of Cardiology / American College of
Cardiology committee for redefinition of myocardial infarction. (2000) Jem Coll Cardiol 36:959-69.
[4]. Reddy K.K.,Rao A.P,Reddy TP.,Socioeconomic status and the prevalence of coronary heart disease risk factors ,Asia Pac J Clin
Nutr;2002;11(2):98-103.
[5]. Gupta R,Gupta V.P,Sarna M,Bhatnagar S,Thanvi j,Sharma V, Singh AK,Gupta JB,Kaul V.,Prevalence of coronary heart disease
and risk factors in an urban Indian population; Jaipur Heart watch -2.Indian Heart J;2002;54 ( 1):59-66.

Abstract: Introduction: Modafinil is a stimulant drug widely used to promote wakefulness in a variety of psychiatric and neurological conditions. It is generally prescribed for narcolepsy associated with Obstructive Sleep Apnea (OSA) syndrome. But it is also getting popularity among the prescriptions for those students who complain of having daytime sleepiness before exams.Modafinil-induced severe dermatologic reactions are uncommon but serious side effects may occur like Stevens Johnson Syndrome..........

Keywords: Modafinil, Naranjo scale, fixed drug eruption

[1]. Healy M (May 2, 2013). "Use of wake-up drug modafinil takes off, spurred by untested uses – Los Angeles Times". LA Times.
Retrieved December 31, 2013.
[2]. Kesselheim AS, Myers JA, Solomon DH, Winkelmayer WC, Levin R, Avorn J (February 21, 2012). Alessi-Severini S, ed. "The
prevalence and cost of unapproved uses of top-selling orphan drugs". PloS One. 7 (2): e31894. doi:10.1371/journal.pone.0031894.
PMC 3283698 . PMID 22363762.
[3]. Ballas CA, Kim D, Baldassano CF, Hoeh N (Jul 2002). "Modafinil: past, present and future". Expert Review of Neurotherapeutics.
2 (4): 449–57. doi:10.1586/14737175.2.4.449. PMID 19810941.
[4]. Breathnach SM. Drug reactions. In: Burns T, Breathnach S, Cox N, Griffiths C, editors. Rook's Textbook of Dermatology. 8th ed.
Oxford: Blackwell Science; 2010. pp. 28–177.
[5]. Brocq L. Éruptionerythemato-pigmentée fixe due al'antipyrine. Ann DermatolVenereol. 1894;5:308–13

Abstract: Introduction: Mid - Day Meal scheme was started as a centrally sponsored scheme on 15th August, 1995 with the aim of universalization of primary education by increasing enrolment, retention and attendance and simultaneously impact on Nutrition of Students in Primary Classes. From 2006 the food being served has been enriched by raising its 450 calories and 12grams protein in primary schools. Food Safety encompasses selection, handling, preparation and storage of food in ways that prevent food borne illness and contamination...........

[1]. Page 1, chapter 1, EVALUATION OF MID DAY MEAL PROGRAMME IN MCD SCHOOLS, by Sushma et al, Nutrition
Foundation of India, Scientific Report 18, 2006
[2]. About Mid-Day Meal Scheme by Ministry of Health and family Welfare, http://mdm.nic.in/aboutus.html, accessed on 1/10/2016.
[3]. GUIDELINES ON FOOD SAFETY AND HYGIENE FOR SCHOOL LEVEL KITCHENS UNDER MID-DAY MEAL (MDM)
SCHEME, Ministry of Health and Family Welfare. New Delhi, 13th February, 2015
[4]. Page 6, Notes on required sample sizes for CSAS and similar coverage surveys VALID International Ltd. Version 0.32, July 2006
[5]. https://www.cdc.gov/epiinfo/index.html

Abstract: Enteric fever still remains a cause of significant morbidity and mortality, particularly in children. In countries with poor resources and inadequate access to basic health care system, like ours, where widespread antibiotic availability and prescribing leads to low sensitivity of blood cultures and where bone marrow cultures are difficult to perform, early detection of suggestive clinical features and initial changes in simple blood tests and relatively cheaper and non-invasive serological tests may have significant value in diagnosis and management of this condition. We conducted a cross-sectional study over a period of one year involving 170 clinically suggestive enteric fever cases. Out of 170 under 12 years children, confirmed typhoid........

Keywords: Enteric fever, children, clinical, serology, diagnosis

[1]. Pang T, Bhutta ZA, Finlay BB, Altwegg M. Typhoid fever other salmonellosis a continuing challenge. Trends microbial
1995;3:253-5.
[2]. Patel TA, Armstrong M, Morris-Jones SD, Wright SG, Doherty T. Imported Enteric Fever: Case Series from the Hospital for
Tropical Diseases, London, United Kingdom. Am J Trop Med Hyg. 2010 Jun; 82(6): 1121–1126.
[3]. Crump JA, Luby SP, Mintz ED. The global burden of typhoid fever. Bull World Health Organ.2004;82:346–353.
[4]. Mweu E, English M. Typhoid fever in children in Africa. Tropical Medicine and International Health 2008; 13(4 ):532–540.
[5]. Ascroft MT. Typhoid and paratyphoid fever in the tropics. J Trop Med Hyg 1964;67:185- 189.

Abstract: Gastrointestinal stromal tumors (GISTs) are most common(80%)mesenchymal neoplasms of GIT arise from interstitial cell of Cajal. Most common site –stomach (60%) and Jejuum , ileum (30%) and duodenum 5% and in colorectum 4%. GIST is about 0.1–3% of all GI tumors. Clinical presentation of GIST is asymptomatic (mostly) and abdominal pain , bleeding,mechanical obstruction.we repot a case of small intestinal (jejunal ) GIST in 45 years male, its diagnosis,, Differential diagnosis for Mass in RIF and treatment options.

Keywords: GIST, Mass in RIF, Appendicularmass, Resection, Anastomosis.

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Abstract: Background :Heart rate variability is used in early detection of cardiac autonomic neuropathy in type 2 Diabetes Mellitus. Aim: To study the Cardiovascular autonomic function in type 2 Diabetes Mellitus patients by doing frequency domain analysis of Heart rate Variability. Materials and methods: This is a cross sectional study done in type 2 Diabetes Mellitus patients attending Diabetic OPD of Stanley Medical College and Hospital, Chennai.The study was done in 30 healthy controls and 30 type 2 Diabetes Mellitus patients .Heart rate variability was measured in different postures and the results were compared between the two groups..........

Keywords: Type 2 Diabetes Mellitus, Cardiac autonomic neuropathy, LF,HF,LF/HF ratio

[1]. World Health Organization. "Definition, diagnosis and classification of diabetes mellitus and its complications: Report of a WHO
Consultation. Part 1. Diagnosis and classification of diabetes mellitus". Retrieved 29 May 2007
[2]. Ewing DJ, Campbell IW, Clarke BF. The natural history of diabetic autonomic neuropathy. Q J Med. 1980;193:95-108.
[3]. Aaron I. Vinik, MD,Raelene E. Maser, Braxton D. Mitchell, Diabetic Autonomic Neuropathy. Diabetes Care 2003
May; 26(5): 1553-1579.
[4]. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology 1996 Heart
rate variability: standards of measurement, physiological interpretation and clinical use. Circulation 93:1043–1065
[5]. Ewing DJ, Campbell IW, Clarke BF. Heart rate changes in Diabetes Mellitus.The Lancet.Volume 317,Issue 8213,24 January
1981,pages 183-186

Abstract: With the increased incidence of STDs and cervical cancer, lifetime screening for every women between the age group of 21 – 40 years appears to be the best approach at this moment. Screening of high – risk cases like HIV and other STDs is a must. In the present study non – viral STDs constituted 80% mixed infection 14% and viral STDs 6% which were detected on cervical cytology only. Associated squamous intraepithelial lesions constituted about 30% with nil incidence of invasive carcinomas, establishing the fact that it takes over a decade for invasive carcinoma to develop. In this study, 71 cases were HIV seropositive, with two cases (2.8%) showing invasive carcinoma in asymptomatic women and 11.2% with squamous intraepithelial lesion. Hence HIV is a likely risk factor in the etiopathogenesis of cervical cancer if the patient survives longer.

Keywords: STD, Bethesda system, Squamous intraepithelial lesion.

[1]. Abeyewickreme I : Cervical cytology screening in a sexually transmitted diseases clinic for the first time in Srilanka. Genitourinary
medicine. 1989; vol.65, 2:98-102.
[2]. Atkinson/Silverman: Atlas of difficult diagnosis in Cytopathology, 1998 ; 29-112.
[3]. Augusto Simoes – Barbosa : A six year follow up survey of sexually transmitted diseases in Brazilia, the capital of Brazil. Braz J
Infect Dis June 2002.vol.6 no.3.
[4]. Ayre JE. Selective cytology smear for diagnosis of cancer. Am J Obstet Gynecol. 1947;53:609-617.
[5]. Bethesda system for reporting cervical: vaginal cytological diagnosis. ActaCytol 1993; 37(2) : 115 – 20.

Abstract: Diseases of the nose and the paranasal sinuses can affect the middle ear by causing congestion and obstruction of the eustachian tube. Infected discahrge from the sinuses can lead to inflamation of the mucosa of the eustachian tube and there by alter the mucociliary clearance. It can also lead to changes in the middle ear pressure there by elevating the sound conduction threshold of the middle ear. This study was conducted in our institute to compare the effect of chronic rhinosinusitis in middle ear function over the past two years

Keywords: Chronic Rhinosinusitis Middle Ear Function

[1]. Huang XK1, Zhan YS, Xu G, Wang SF: Influence of chronic sinusitis on middle ear function;
[2]. Lin Chuang Er Bi Yan Hou Ke Za Zhi. 2000 Apr;14(4):166-7.
[3]. Fuad M.Baroody;How nasal function influences the eyes,ears,sinuses, and lungs;Section of otolaryngology-Head and neck
surgery,departments of surgery and pediatrics,University of Chicago Pritzer school of medicine,Chicago,Illinoa;All annals
ATSissues>Vol.8,No1,Mar 01,2011.
[4]. Stammberger H. The Messerlinger technique. In:Stammberger H (ed).Functional endoscopic sinus
surgery.Philadelphia:BC.Dekker,1991:62
[5]. Bonding P,Tos M.Middle ear pressure during pathological conditions of the nose and throat.Acta Otolaryngol1981 Jul-Aug;92(1-
2):311-324

Abstract: Olecranon fractures are usually managed as per Schatzker's Classification. Our case presented with an unusual pattern which was not fitting with Schatzker's Classification (Fig-1). It was managed as per standard AO principle of fracture management. It showed satisfactory result.

Keywords: Olecranon fracture; unusual pattern.

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Abstract: Supracondylar fracture of the humerus is very common among children;but open variety of this type of fracture with mangled upper limb is rare. When they present with such injury, they are usually associated with neuro-vascular loss. Here we present a case of an open Gartland Type-III supracondylar fracture with near amputation of the upper limb without any neuro-vascular injury. It was managed as per standard AO principle of fracture management. It showed satisfactory result.

Keywords: Traumatic partial upper-limb amputation, supracondylar fracture,open type.

[1]. Bumbasirevic M, Stevanovic M, Lesic A, Atkinson HD. Current management of the mangled upper extremity. Int Orthop. 2012
Nov;36(11):2189-95. Epub 2012 Aug 25.
[2]. Ring D, Jupiter JB. Mangling upper limb injuries in industry. Injury. 1999;30(Suppl 2):B5-13.
[3]. Bernstein ML,Chung KC. Early management of the mangled upper extremity. Injury. 2007 Dec;38(Suppl 5):S3-7. Epub 2007 Dec
03.
[4]. L.V.Barr. Paediatric supracondylar humarus fracture- Epidemiology, mechanism & incidence during school holidays.
J.ChildOrthop. 2014 Mar; 8(2)167-170.
[5]. J. Mangwani, R Nadarajah, J.M.H Paterson. Supracondylar humeral fracture in children- Ten years experience in a teaching
hospital. The Bone & Joint Journal; 23rd Feb,2006.

Abstract: A laparoscopic trainer has been constructed with I pad mini and Plastic box .The device can be easily made ,simple ,cheap and useful for learning basic Laparoscopic skills independently similar to conventional trainers

Keywords: Laparoscopy,Endotrainer, I pad mini, Stress ball.

[1]. Mimi M Li , Joseph George . A systematic Review of Low cost Laparoscopic Simulators .SurgEndosc.2016 .DOI 10.1007/s00464-
016-4953-3
[2]. Ram S.Madan A .Mustafa N,Kasturi S. Mobile Cam Lap EndoTrainer .J ClinDiagn Res 2016 .Jul 10 (7)PL 03-4
[3]. https://youtu.be/xO3XnisIcY0

Abstract: After extraction, space closure is an essential part of orthodontic treatment which needs thorough understanding of biomechanics used for space closure. Or thodont ic appl iances are being ref ined wi th pas sage of t ime. Thi s ref inement has reduced the physical ef fort put for th in treatment , but does not el iminate the need for an orthodont i st to think, under s tand and apply basic principles of biomechanics in a common sense manner

[1]. Burstone CJ. The segmented arch approach to space closure.Am J Orthod 1982; 82:361-78.
[2]. Smith RJ, Burstone CJ.Mechanics of tooth movement.Am J Orthod 1984; 85:294-307.
[3]. Gjessing P.Controlled retraction of maxillary incisors. Am J Orthod Dentofacial Orthop 1992; 101:120-131.
[4]. Braun S, Morcotte MR. Rationale of the segmented approach to orthodontic treatment. Am J Orthod Dentofacial Orthop 1995;
108:1-8.
[5]. Braun S, Sjursen RC, Legan HL. On the management of extraction sites. Am J Orthod Dentofacial Orthop. 1997; 112:645-655.

Abstract: Aim: The aim of this study was to assess the effectiveness of family psycho education on burden of disease and coping strategies among caregivers of patients with schizophrenia. Background: Caregiver burden refers to the negative feelings and subsequent strain experienced as a result of caring for a chronically sick person. The subject of burden has become significant with the emergence of deinstitutionalization and the practice of community psychiatry. Severe mental illness like schizophrenia has devastating impact on patients as well as their family members. The illness is of chronic nature and patients experience profound disruption to their thoughts and lives.........

Keywords:Caregivers of patients with schizophrenia, Burden of disease, Coping strategies and Family psycho education.

[1]. Wageeh Abdel,Naseer Hassan,Ikram Ibraheem Mohamed,Amira Ezzat , Abd elnaser,Nadia Ebraheim Sayed et al. Burden and
coping strategies in caregivers of schizophrenic patients. Journal of American Sciences. 2011; 7(5):802-811.
[2]. Thara R, Padmavati R, Shuba Kumar & Latha Srinivasan. Instrument to assess burden on caregivers of chronic mentally ill. Indian
Journal of Psychiatry.1998; 40 (1):21-29.
[3]. Tan SC,Yeoh AL,Choo I B,Huang A P,Ong S H, et al. Burden and coping strategies experienced by caregivers of persons with
schizophrenia in the community. Journal of Clinical Nursing. 2012 September; 21(17-18):2410-8.
[4]. Nations for Mental Health: Schizophrenia and Public Health.[Online] World Health Organization, 1996 [2013 November 23];[55].
Available from: URL:http://www.who.int/mentalhealth/media/en/55.
[5]. Wai Ton Chien. Effectiveness of psycho education and mutual support group programme for family caregivers of Chinese people
with schizophrenia. Open Nursing Journal. 2008; 2: 28–39.

Abstract: Introduction: Dentine hypersensitivity (DH) is characterized by pain after stimuli that usually provoke no symptoms. This study compared the effectiveness of GaAlAs diode laser alone and with topical calcium sodium phosphosilicate (Novamin). Materials and Methods: The study was conducted on 10 patients (age 18–60) and 60 teeth with DH assessed by air and tactile stimuli measured by Numeric Rating Scale (NRS). Teeth were randomly divided into Group A (30 teeth) treated by with calcium sodium phosphosilicate (Novamin) applied for 60 seconds on tooth surface, followed by diode laser (980 nm) application for 1 minute each; Group B(30 teeth) lased by a diode laser (980 nm) : 0.5W in no contact mode

[1]. Amit Jena, Govind Shashirekha. Comparison of efficacy of three different desensitizing agents for in-office relief of
dentin hypersensitivity: A 4 weeks clinical study: J Conserv Dent 2015;18(3): 389-393.
[2]. Mehmet Vehbi Bal, Ilker Keskiner, Ufuk Sezer, Cengizhan Ac ıkel, and Isxıl Saygun. Comparison of low level laser
and arginine-calcium carbonate alone or combination in the treatment of dentin hypersensitivity: A randomized splitmouth
clinical study. Photomedicine and Laser Surgery 2015;33(4): 200-205.
[3]. Genovesi AM, Marconcini S, Lelli M, Giammarinaro E, Barone A et al. In Vitro Comparison of three desensitizing
prophylaxis pastes: A morphological analysis. J Oral Hyg Health 2015; 3(5): 1-5.
[4]. Amin M, Mehta R, Duseja S, Deasai K. Evaluation of the efficacy of commercially available nano-hydroxyapatite
paste as a desensitizing Agent. Adv Hum Biol. 2015;5(1):34-38.
[5]. Vijaya Puthiriraj Pillai, Prasanna Neelakantan. Desensitizing toothpastes for treatment of dentin hypersensitivity.
International Journal of PharmTech Research 2013; 5(4): 1769-1773.

Abstract: Temporomandibular joint ankylosis is an anticipated difficult surgery especially when it is performed in children and same is in the intubation scenario too.TMJ ankylosis creates a difficult situation on the operating table for a surgeon. When it comes to anesthetist the awake fiber optic intubation is the safest approach to secure an airway in such a case. This is a case of unilateral temporomandibular joint ankylosis scheduled for interpositional arthroplasty. But due to non-availability of adequate sizedfiber optic scope, a flexible ureteroscope to facilitate nasotracheal intubation was used.For the interpositional arthroplasty a costocondral graft was used for this case.

Keywords: TMJ ankylosis, Gap Arthroplasty. Difficult airway, Fiber optic intubation

[1]. Mansour A. Qudah, Muawia A. Qudeimat, Jasser Al-Maaita. Treatment of TMJ ankylosis in Jordanian children – a comparison of two surgical techniques. Journal of Cranio Maxillary surgery 2005;33(1):30-36 [2]. T Sahoo, Y Patil, R Patel, L Dewoolkar. Anaesthetic Management ofa Child with Temporomandibular Joint Ankylosis with Extrahepatic Portal Vein Obstruction for Ankylosis Release. The Internet Journal of Anesthesiology 2007; 16(1).
[3]. Dr. Ramesh s. Fiberoptic airway management in adults and children. Indian.J. Anaesth 2005; 49 (4): 293-299.
[4]. T. Kawasaki, T. Sata, C.Kawasaki, M.Ogata and A.Shigematsu. Airway management of a child with Temporomandibular Joint Ankylosis following otitis media. Anesthesia 2002;57(3): 294-295
[5]. L. Calder. Murphy P. A fiber-optic endoscope used for nasal intubation. Anesthesia 1967; 22:489-91. Anesthesia 2010; 65: 1133-1136.

Abstract: Dermatofibrosarcoma is a rare, slow-growing and fibrohistocytic neoplasm. It is locally aggressive tumor and potential for distant metastasis is low. It nature is intermediate to low-grade malignancy. It is commonly seen on the trunk followed by the proximal extremities and the head and neck . We came across one such case who presented with 40yrs of age with swelling over supra umbilical midline since 23yrs, gradually increased in size, not associated with pain. No other significant complaints were noted. Excision of tumor done under General Anesthesia. Histopathology section features are suggestive of Dermatofibrosarcoma of abdominal wall. Dermatofibrosarcoma protuberans is a cutaneous malignancy that arises from the dermis and invades deeper tissue (eg, fat, fascia, muscle, bone) . Incomplete removal of these neoplastic cells results in a high local recurrence rate.

Keywords: Dermatofibrosarcoma protuberance , fibrohistocytic neoplasm , slow-growing, malignancy.

[1]. Wikipedia. https://en.wikipedia.org/wiki/Dermatofibrosarcoma_protuberans .
[2]. Key Topics in General Surgery, Second Edition , C.R. Lattimer , Soft tissue swelling , 2002, 356 .
[3]. Schwartz's Principles of Surgery, Ninth Edition, F. Charles Brunicardi, The Skin and Subcutaneous Tissue 2010 , Chapter 16.
[4]. Textbook of surgery, Joe J. Tjandra , Third edition , 2006, 341.
[5]. Handbook of Plastic Surgery , Steven E.Greer, M.D. 2006, 476.
[6]. Fiore M, Miceli R, Mussi C, et al. Dermatofibrosarcoma protuberans treated at a single institution: a surgical disease with a high
cure rate. J Clin Oncol 2005;23(30):7669.

Abstract: Background :Fine Needle Cytology (FNC) is a safe, cost effective and reliable technique for diagnosing diseases of the thyroid gland. Objectives: (1) To categorize the cytological pattern according to The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC). (2) To correlate the results of fine needle cytology with histopathological diagnosis wherever possible. Methods: Patients with thyroid swellings referred for FNC of thyroid were included. The lesions were classified according to TBSRTC. In cases where surgery was performed, the specimens sent to histopathology were studied. Age, sex, cytological features and histological types were studied. Statistical analysis was done. False positive and false negative diagnosis were reanalysed.

Keywords: Fine needle cytology, The Bethesda system for reporting thyroid cytopathology.

[1]. Richa S, Mathur DR. Diagnostic accuracy of fine needle aspiration cytology (FNAC) of the thyroid gland lesions. Int J Health Sci
Res 2012;2:1-7.
[2]. Cibas ES and Ali SZ. The Bethesda System for reporting thyroid cytopathology. Am J ClinPathol 2009; 132: 658-65.
[3]. Bongiovanni M, Cibas E, Faquin WC. The role of Thyroid fine needle aspiration cytology and the Bethesda system for reporting
Thyroid cytopathology. Diagnostic Histopathology 2011; 17: 95-105.
[4]. Muratli A, Erdogan N, Sevim S, Unal I, Akyuz S. Diagnostic efficacy and importance of fine-needle aspiration cytology of thyroid
nodules. J Cytol.2014;31:73–8.
[5]. Sinna EA, Ezzat N. Diagnostic accuracy of fine needle aspiration cytology in thyroid lesions. J Egypt Natl Canc Inst 2012;24:63-70.

Abstract: Purpose: studying variability of changes on an electrocardiogram due to localization of inflammatory process. Material and methods : We analysed 53 electrocardiograms of patients with an inflammatory cardiomyopathy (middle age 35,01±1,0). Patients were divided into two groups – 1) 21 patients - with acute forms of inflammatory cardiomyopathy (AIC), and 2 ) – 32 patients with a chronic form of inflammatory cardiomyopathy (CIC). The diagnosis was established according to recommendations of WHO experts. The control group consisted of 30 almost healthy people (middle age 32,61±1,1).............

Keywords: cardiomyopathy, heart failure, depression, hypertrophy.

[1]. Belyavsky E.A., Zyakov K.A., Narusov O. Yu., Masenko V.P., A.A., Shchedrin A.Yu. Starlings. Inflammatory cardiomyopathy: Current state of problems.//Therapeutic archive, 2010. No. 8, page 62-71.
[2]. Fighters S. A., Deryugin M. V. Non rheumatic myocardites / Guide to cardiology: Book. A grant in 3 t.//Under G. I. Storozhakov, A.A. Gorbachenkov's edition. - M.: Geotar-media, 2008. – T. 2. – page 116-145.
[3]. Gurevich M. A. Chronic heart failure. M.: MIA,-2005. Page 280.
[4]. Kurbanov R. D., Abdullaev T.A. Myocardites.//Guide to clinical cardiology, 2007 of Page 223-237.
[5]. Moiseyev V. S., Kiyakbayev G.K.Patogenesis, clinic and diagnostics of a cardiomyopathy and myocardites.//In book: Cardiomyopathy and myocardites. Kiev., 2011. - C127-230.

Abstract: Pituitary adenomas define a group of slowly growing tumors, developed at the expense of the anterior pituitary. They account for 10-15% of all intracranial neoplasms. Mostly benign, processing and its attendant monitoring are part of a surgical resection and / or specific medical treatment, which generally pose few problems in current practice. A significant number of pituitary tumors, 25-55% depending on the criteria used, can show signs of invasion of dura, bone and/or surrounding anatomical structures . However, these so-called 'invasive' pituitary adenomas display benign behavior even in the presence of marked dural invasion and are not considered malignant by current definition. Truly malignant pituitary tumors (pituitary carcinomas)...........

Keywords: Indices of proliferation , atypical pituitary adenomas, temozolomide, chemotherapy, surgical resection

[1]. Fernandez A, Karavitaki N, Wass JA: Prevalence of pituitary adenomas: a community-based, cross-sectional study in Banbury (Oxfordshire, UK). Clin Endocrinol 2010;72:377-382.

[2]. Daly AF, Rixhon M, Adam C, Dempegioti A, Tichomirowa MA, Beckers A: High prevalence of pituitary adenomas: a cross-sectional study in the province of Liege, Belgium. J Clin Endocrinol Metab 2006;91:4769-4775

[3]. Selman WR, Laws ER Jr, Scheithauer BW, Carpenter SM: The occurrence of dural invasion in pituitary adenomas. J Neurosurg 1986;64:402-407.

[4]. Kaltsas GA, Nomikos P, Kontogeorgos G, Buchfelder M, Grossman AB: Clinical review: diagnosis and management of pituitary carcinomas. J Clin Endocrinol Metab 2005;90:3089-3099.

[5]. Lloyd RV KK, Young WF Jr, Farrel WE, Asa SL, Truillas J, Kontogeorgos G, Sano T, Scheithauer BW, Horvath E, DeLellis RA, Heitz PU: Pituitary tumors; in WHO Classification of Tumors of the Endocrine Organs: Pathology and Genetics of Endocrine Organs. Lyon, IARC Press, 2004.

Abstract: Background: Insertion of nasogastric tube in an anaesthetized intubated patients may be difficult as patient cannot follow the swallowing instructions and therefore have a high first attempt failure rate. We hypothesized that simple modifications in technique of NG tube insertion will improve the success rate. Methods: A total 120 patients, aged 20 to 70 years, undergoing gastrointestinal surgeries, who required intraoperative NGT insertion were enrolled into our study. The patients were randomly allocated into 3 groups, group C: control group, group F: neck flexion with lateral neck pressure and group R: reverse Sellick's manoeuvre group. The number of attempts for successful NGT insertion, time taken for insertion and adverse events were noted..........

Keywords: Nasogastric tube (NGT), Reverse Sellick's manoeuvre, Neck flexion.

[1]. Appukutty J, Shroff PP. Nasogastric tube insertion using different techniques in anaesthetised patients: A prospective, randomised
study. Anesthanalg 2009;109:832-5
[2]. Mahajan R, Gupta R. Another method to assist nasogastric tube insertion. Can J Anaesth 2005;52:652-3
[3]. Mahajan R, Gupta R., Sharma A: Insertion of nasogastric tube using a modified ureteric guide wire. J ClinAnesth 2009, 21: 387-388
[4]. Mandal MC, Dolai S, Ghosh S, Mistri PK, Roy R, BasuSR,et al. Comparison of four techniques of nasogastric tube insertion in
anaesthetised, intubated patients: A randomized controlledtrial. Indian J Anaesth 2014;58:714-8
[5]. Mundy DA, Another technique for insertion of nasogastric tubes. Anesthesiology, 1979,50:374

Abstract: Pituitary tumors are rare in childhood and adolescence, with a reported prevalence of up to 1 per million children. Although pituitary tumors are rare in childhood and adolescence, and are typically histologically benign, significant morbidity may result due to their location, mass effect, and/or interference with normal pituitary hormone functions. The frequency of macro adenomas and aggressive forms reflects the difficulty of their management. The treatment is superimposable to what is done in adults. Genetic impairment is more frequent and should be discussed systematically. We report in this study phenotypic and genotypic characteristics of pituitary adenomas in 16 children hospitalized in our department of endocrinology.

Keywords: macroadenoma, headache,growth failure , disturbance of pubertal development , genetic mutation

[1]. Ezzat S, Asa SL, Couldwell WT, et al. The prevalence of pituitary adenomas: a systematic review. Cancer.2004;101(3):613–619 [2]. Kane LA, Leinung MC, Scheithauer BW, et al. Pituitary adenomas in childhood and adolescence. J Clin Endocrinol Metab. 1994;79(4):1135–1140.

[3]. Alexander JM, Biller BM, Bikkal H, Zervas NT, Arnold A, Klibanski A. Clinically nonfunctioning pituitary tumors are monoclonal in origin. J Clin Invest. 1990;86(1):336–340. Spada A, Mantovani G, Lania A. Pathogenesis of prolactinomas. Pituitary. 2005;8(1):7–15.

[4]. Ezzat S, Asa SL. Mechanisms of disease: The pathogenesis of pituitary tumors. Nat Clin Pract Endocrinol Metab. 2006;2(4):220–230.

[5]. Schlechte JA. Clinical practice. Prolactinoma. N Engl J Med. 2003;349(21):2035–2041