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

Abstract: Introduction: For the conduct of general anaesthesia, an ideal induction agent and effective premedication required that is the one without any serious systemic perturbations. Dexmedetomidine & Fentanyl has been used for blunting the haemodynamic pressor responses during laryngoscopy and endotracheal intubation but its use for attenuating the haemodynamic responses during laparoscopy is limited. Aims & Objectives: To assess the haemodynamic responses during laryngoscopy and tracheal intubation after premedication with Dexmedetomidine & fentanyl..............

Keywords: Dexmedetomedine, fentanyl,laproscopic surgeries, premedication, pneumoperitoneum

[1]. Smith HS. Rapid onset opioids in palliative medicine. Ann Pal Med 2012;1(1):45-52.
[2]. Lindgren L, Yli- Hankala A, Randell T, Kirvela M, Scheinin M, and Neuvoven PJ. Hemodynamic and catecholamine responses to
induction of anaesthesia and tracheal intubation comparison between propofol and thiopentone. Br J Anaesth 1993; 70: 306-310
[3]. Vaibhav Jain, Aruna Chandak, Alok Ghosh, Mayuri Golhar. Comparison of dexmedetomidine and fentanyl for attenuation of the
hemodynamic response to laryngoscopy and tracheal intubation . Ain-Shams Journal of Anesthesiology 2015, 08:236–243
[4]. Dr Sagar Gandhi ,Dr VigyaGoyal , et al Comparison of Dexmedetomidine with Fentanyl in Attenuation of Pressor Response during
Laryngoscopy and Intubation IOSR Journal Of Pharmacy (e)-ISSN: 2250-3013, (p)-ISSN: 2319-4219.
[5]. Ghodki PS, Thombre SK, Sardesai SP, Harnagle KD. Dexmedetomidine as an anesthetic adjuvant in laparoscopic surgery: An
observational study using entropy monitoring. J Anaesthesiol Clin Pharmacol 2012;28:334-8.

Abstract: Maintaining deciduous teeth in function until their exfoliation is absolutely necessary.Basic aim in doing endodontic treatment in children is as same as in adults i.e.for the removal of infection and inflammation and thus the relief of associated pain. Pulp therapy is oneof the ways in saving the primary dentition. Pulp therapy is carried out in two ways either by vital or non-vital treatment. The article discusses about the aid in diagnosis,objectives and different modalities of treatment procedures of pulp therapy in primary dentition

Keywords: Direct and Indirect pulp capping, Non-vital pulp therapy,pulpotomy,pulpectomy, vital pulp therapy

[1]. Fanning,E.Effect of extraction od deciduous molarson the formation and eruption of their successors. Angle orthod32:44, 1962.
[2]. BSPD and IAPD .UK national guidelines in paediatric dentistry .Int.Jpediatr dent 2002;12;151-153.
[3]. Arauo FB, Ely LB Pergo HF :AClinical evaluation of 2% buffered gluteraldehyde in pulpotomy of human deciduous teeth : A 24
month study .Brazilian dental journal,1956 ;6:9(1):41-44.
[4]. Camp JH. Overview of Paediatric Endodontic Alpha Omegan1991;12:192-196 and FUKS AB , EidelmanE.Pulp therapy in primary
dentition . CurrOpin Dentin .1991;1:556-557.
[5]. Anderson G.Effective treatment with indirect pulp capping. Dent Stud. Nov/ Dec 1982;22-25.

Abstract: Coccidioidomycosis is dimorphic fungus that is confined primarily to the western hemisphere. The infection is acquired by inhalation of infective anthroconidia of coccidioidomycosis. The diagnosis of coccidioidomycosis may be done by culture, molecular technique, or histopathology of tissue showing characteristic spherule. Disease in non endemic area is reported very rarely. Here we present a case of 10 year old male child with conjunctival mass which histologically shows coccidioidomycosis spherule and positive serum IgG antibodies for it who had no history of travel to endemic zones.

Keywords: Coccidioidomycosis, Coccidioides, Conjunctival mass, Histopathology, incidence, risk factors.

[1]. Galgiani JN, Ampel NM, Blair JE. Coccidioidomycosis. Clin infect Dis 2005;14 : 1217-23.
[2]. Textbook of Microbiology Immunology, Subhash Chandra Parija, page no.603.
[3]. Harrison,s Principles of Internal Medicine, 17thedition ,Page no.1247.
[4]. Charlton V,Ramsdell K, Sehring S. Intrauterine transmission of coccidioidomycosis.Pediatr Infect Dis J.1999; 18 (6): 561-563
(pubmed).
[5]. Davis BL, SR , Smith CE. An epidemic of coccidioidal infection. (Coccidioidomycosis) JAMA , 1942; 118:1182-1186

Abstract: Introduction: Metabolic Syndrome is a complex of various conditions which indicates future risk of various non-communicable diseases. Dysfunctional Uterine Bleeding (DUB) is defined as abnormal, irregular bleeding i.e., excessive, prolonged or frequent intervals of bleeding in the absence of demonstrable pelvic disease, complications of pregnancy or systemic disease. Most of the risk factors of DUB were risk factors of Metabolic Syndrome also. Based on this background the current study was conducted with an aim to assess the association of DUB with Metabolic Syndrome............

Keywords:Diabetes, Dysfunctional Uterine Bleeding, Lifestyle diseases, Metabolic Syndrome, Noncommunicable diseases

[1]. Gupta M, Singh N, Verma S: South Asians and cardiovascular risk: what clinicians should know. Circulation 2006, 113:e924-e929.
[2]. Misra A, Misra R, Wijesuriya M, Banerjee D: The metabolic syndrome in South Asians: continuing escalation and possible
solutions. Indian J MedRes 2007, 125:345-354.
[3]. Raikkonen K, Mattews KA, Kuller LH: The relationship between psychological risk attributes and the metabolic syndrome in
healthy women: antecedent or consequence? Metabolism 2002; 51:1573-1577.
[4]. Boutayeb A (2006).The double burden of communicable and non-communicable diseases in developing countries. Trans R Soc
Trop Med Hyg, 100 (3): 191-9.
[5]. Hildrum B, Mykletun A, Hole T, Midthjell K, Dahl AA: Age-specific prevalence of the MS defined by the IDF and national
cholesterol education program: the Norwegian HUNT 2 study. BMC Publ Health 2007, 7:220.

Abstract: Head injuries are commonly encountered in clinical practice.Assesment and monitoring of the level of consciousness in head injury is a very important tool in managing these cases.In 1974 Teasdale and Jennett devised a very objective and quantitative method for assessment of level of consciousness known as the Glascow Coma Scale (GCS).Ever since various other scales have been devised with their own limitations,a major limitation in any coma scale has been the differences in assessment by various persons,otherwise called interobserver variation.Hence an attempt has been made to compare the coma scales - Glascow coma scale and Innsbruck coma scale with regard to inter-observer agreement among them.

Keywords: Glascow coma scale, Head injury, Innsbruck coma scale, Inter-observer agreement.

[1]. Jennett B,The Glascow coma scale:History and current practice.Trauma 4: 2002; 91-103.
[2]. Jennett B,Bond M. Assessment of outcome after severe brain damage.Lancet 1: 1972;734-737.
[3]. Jennett B, Teasdale G : Management of head injuries.Philadelphia:FA Davis,1981; 308-310.
[4]. Benzer A, Mitterschiffthaler G, Marosi M, Luef G, Pühringer F, De La Renotiere K, Lehner H, Schmutzhard E. Prediction of nonsurvival after trauma: Innsbruck Coma Scale. 1991 Oct 19;338(8773):977-8.
[5]. Graham Teasdale, Andrew Maas, Fiona Lecky, , Geoffrey Manley, , Nino Stocchetti, Gordon Murray, The Glasgow Coma Scale
at 40 years: standing the test of time.The Lancet Neurology,2014;Volume 13,No.8,844-854.

Abstract: Introduction: Inflammation (Latin, inflammation, to set on fire) is the complex biological response of vascular tissues to harmful stimuli, such as pathogens, damaged cells, or irritants. Drugs that inhibit inflammation are called Non steroidal anti-inflammatory drugs (NSAIDS). Presently selective cox-2 inhibitors are used. But these are also having cardio-vascular complications. Macrolides are showing anti-inflammatory property by inhibiting pro inflammatory cytokines from phagocytes. The main aim of this study is to compare the anti-inflammatory effect of newer macrolides with etoricoxib in 0.1ml of 1% carrageenan induced rat hind paw oedema.............

Keywords: Anti-Inflammatory, Azithromycin , Clarithromycin, Digital Plethysmograph, Etoricoxib, Macrolides, Roxithromycin

[1]. Ferrero-Miliani L, Nielsen OH, Andersen PS, Girardin SE; Nielsen; Andersen; Girardin). "Chronic inflammation: importance of NOD2 and NALP3 in interleukin-1beta generation". Clin. Exp. Immunol,. 2007, vol: 2, page no: 147.
[2]. Dallob A, Jawkey, CJ, Greenberg H, et al. Characterization of etoricoxib, a novel, selective COX-2 inhibitor. J Clin Pharmacology 2003, Vol:43,Page no:573-585.
[3]. Aoshiba, K., Nagai A. & Konno, K. Erythromycin shortens neutrophil survival by accelerating apoptosis, Antimicrobial Agents and Chemotherapy, 1995, vol : 39, page no : 872-7.
[4]. Anderson, Erythromycin and roxithromycin potentiate human neutrophil locomotion in vitro by inhibition of leukoattractant-activated super oxide generation and auto oxidation, R J Infect Dis, 1989, vol: 159, page no: 966-973.
[5]. F.Scaglione and G.Rossoni, Comparative anti-inflammatory effects of roxithromycin, azithromycin and clarithromycin, Journal of antimicrobial chemotherapy, 1998, vol: 41, page no: 47-50.

Abstract: Objective: To study the effect of flour dust exposure on respiratory symptoms and Pulmonary function tests in flour millers. Material and Methods: The study was carried out in sixty flour millers chronically exposed to flour dust and sixty five non exposed control group . Work history and information on respiratory symptoms was recorded by a standard questionnaire followed by spirometric evaluation of pulmonary functions. Results: Cough and breathlessness was more pronounced in workers, similarly wheezes was a commonly encountered sign .FEV1%, FVC, FEV3/FVC,MVV, PEFR showed a significant decline in workers. Conclusion: A definite reduction in expiratory flow rates was observed. Periodic examination and Pulmonary function assessment can be helpful in implementing timely interventional measures and adopting preventive strategies.

[1]. Morgan and Seaton: Occupational lung diseases, 2nd edition.
[2]. Donald and Hunter: The diseases of Occupations,5th edition ,1050-1055
[3]. Kleinfeld M A Comparative Clinical And Pulmonary Function Study Of Grain Handlers And Bakers.Ann N Y Acad Sci,1974;221
:86-96
[4]. Musk A W Crook B,Nunn A J Respiratory symptoms lung function and sensitisation to flour in a British bakery.Br J Ind Med ,Sept 1989:46 (9): 636—642
[5]. Odaric M Cvetanov Incidence of allergic manifestations and phenomena of pulmonary spastic syndrome in workers exposed to
flour and floury dust. Allergy and asthma 1969;15 (6):364-373

Abstract: Objectives: To compare flexible sigmoidoscopy and colonoscopy in hemorrhoid patients to rule out colorectal pathology Methods: Comparative study, Purposive sampling technique based on inclusion and exclusion criteria with a sample size of 40 under flexible sigmoidoscopy group and 30 under colonoscopy group, study carried in hospitals under KMC, Mangalore Paients and out come assessment: All the patients who come with complaitnts of haemorrhoids of age more than 25 years are advised for flexible sigmoidoscopy. Colonoscopy is done in patients who have findings with flexible sigmoidoscopy or the patients who come with haemorrhoids and other bowel related symptoms...........

[1]. Loder PB, Kamm MA, Nicholls RJ, Phillips RK. Haemorrhoids: pathology, pathophysiology and aetiology. Br J Surg 1994; 81:
946-954 2
[2]. Morgado PJ, Suárez JA, Gómez LG, Morgado PJ. Histoclinical basis for a new classification of hemorrhoidal disease. Dis Colon
Rectum 1988; 31: 474-480 3
[3]. Aigner F, Gruber H, Conrad F, Eder J, Wedel T, Zelger B, Engelhardt V, Lametschwandtner A, Wienert V, Böhler U, Margreiter R,
Fritsch H. Revised morphology and hemodynamics of the anorectal vascular plexus: impact on the course of hemorrhoidal disease.
Int J Colorectal Dis 2009; 24: 105-113 4
[4]. Chung YC, Hou YC, Pan AC. Endoglin (CD105) expression in the development of haemorrhoids. Eur J Clin Invest 2004; 34: 107-
112 5
[5]. Goenka MK, Kochhar R, Nagi B, Mehta SK. Rectosigmoid varices and other mucosal changes in patients with portal hypertension.
Am J Gastroenterol 1991; 86: 1185-1189 6

Abstract: Objective: To determine the incidence and prevalence of thyroid disorders in pregnancy and to study and compare pregnancy outcomes in the same. Methods: 500 antenatal patients visiting Goa Medical College outpatient department in the first trimester were randomly selected in this prospective observational study. A subgroup of additional 50 pregnant patients who presented in the later half of pregnancy(2nd and 3rd trimester),mostly referred patients with uncontrolled thyroid disorders were also studied. Results: The prevalence of thyroid disorders was 13.2%,prevalence of subclinical hypothyroidism was 7%,overt hypothyroidism was 3.4%,subclinical hyperthyroidism 1.6%,overt hperthyroidism was 0.8%.Patients with uncontrolled thyroid disorders...........

[1]. 1.Thyroid disorders during pregnancy. LeBeau SO, Mandel SJ Endocrinol Metab Clin North Am. 2006 Mar; 35(1):117-36, vii.
[2]. 2.Nambiar V, Jagtap VS, Sarathi V, Lila AR, Kamalanathan S, Bandgar TR, et al. Prevalence and impact of thyroid disorders on maternal outcome in Asian-Indian pregnant women. J Thyroid
[3]. 3.Sahu MT, Das V, Mittal S, Agarwal A, Sahu M. Overt and subclinical thyroid dysfunction among Indian pregnant women and its effect on maternal and fetal outcome. Arch Gynecol Obstet. 2010;281:215–20
[4]. 4.Mestman J, Goodwin TM, Montoro MM. Thyroid disorders of pregnancy. Endocrinol Metab Clin N Am 1995;24:41-71
[5]. Dhanwal DK, Prasad S, Agarwal AK, Dixit V, Banerjee AK. High prevalence of subclinical hypothyroidism during first trimester of pregnancy in North India. Indian J Endocr Metab 2013;17:281-4.

Abstract: Alkalinization of 1.5% lignocaine hydrochloride with adrenaline leads to alternation in its onset of action and duration of action.60 patients requiring upper limb surgery between the age group of 20-60 years of either sex, falling under ASA grade I and II and were randomly allocated into two groups. Group A received 32ml of lignocaine hydrochloride with adrenaline (1:200000) solution (pH=4.37).Group B received 32ml of alkalinised standard solution of lignocaine hydrochloride with adrenaline (1:200000) prepared by addition of 2ml 7.5% (w/v) sodium bicarbonate (pH=7.24). Supraclavicular brachial plexus block technique was used for administration of drug.............

Keywords: Adrenaline, Alkalinization, Brachial plexus block, Lignocaine hydro chloride, Sodium bicarbonate 7.5

[1]. Strobel GE, Bianchi CP. The effects of pH gradients on the action of procaine and lidocaine in intact and desheathed sciatic nerves.
The Journal of Pharmacology and Experimental Therapeutics 1970; 1-17.
[2]. Hglier M.Alkalinization of bupivacaine for brachial plexus block. Regional Anaesthesia 1985; 10; 59-61.
[3]. Bedder MD,Koozdy R, Craig DB.Comparision of bupivacaine and alkalinized bupivacaine in brachial plexus anaesthesia.
Anaesthesia and Analgesia 1988;67: 48-52.
[4]. Berman S, Rosenquist RW, Finucane BT. Alkalinization of mepivacaine for axillary brachial plexus block . Canadian journal of
Anaesthesia 1988;35(suppl); 93.
[5]. Tetzlaff JE, Yoon HJ, O‟hara J, Reaney J, Stein D ,Grimes-Rice M. Alkalinization of mepivacaine accelerates onset of
interscalene block for shoulder surgery.Regional anaesthesia 1990; 15; 242-4

Abstract: Background: There are different modalities of treatment of fracture shaft of femur in adolescents. The optimal treatment is much debated due to the peculiar skeletal age distribution in adolescents. Objective: To evaluate the outcome and complications of fracture shaft of femur using locking compression plate osteosynthesis in adolescents (10-18 years). Materials and methods: The study was conducted at Regional Institute of Medical Sciences,Imphal, Manipur ,India. This is a prospective study in which 30 adolescents patients (10 to 18 years) with femoral shaft fractures were operated using locking compression plate between October 2014 to August 2016 .Outcomes were evaluated using clinical assessment , radiological assessment and functional assessment by Schmits criteria........

Keywords: Fracture shaft of femur, adolescents, locking compression plate, osteosynthesis.

[1]. Beaty JH, Kasser JR. Femoral shaft fractures. In: Bucholz RW, Heckman JD, Brown CC, editors. Rockwood and Wilkins' fractures
in children. 6th ed. Philadelphia: Lippincott Williams and Wilkins; 2006. p. 894-934.
[2]. Hedequist D, Bishop J, Hresko T. Locking plate compression fixation for paediatric femur fracture. J Pediatr Orthop 2008;28(1):6-
9.
[3]. Hammad A. Locking plate construct for femoral shaft fractures in skeletally immature patients. Acta Orthop Belg 2008;74(5):630-
35.
[4]. Ramseier LE, Joseph A, Weir S, Narayanan UG. Femoral fracture in adolescence: A comparison of four methods of fixation. J
Bone Joint Surg Am 2010;92(5):1122-29.
[5]. Mahesh DV, Vishwanath G. Management of distal femoral fracture by locking compression plate. Int J Health Sci Res
2014;4(5):235-40.

Abstract: Parkinson's disease (PD) is a progressive neurologic disorder causing tremor, muscle rigidity, bradykinesia and postural instability. Generally, PD patient has oral health problems, such as xerostomia or sialorrhea, burning-mouth syndrome, more missing teeth, caries and poor oral hygiene. Involuntary of orofacial-pharyngeal muscles, tremor of mouth and chin may lead to difficulty of PD patient treatment. This case report describes preparation before treatment, modification of technique and material for PD patient with fabrication maxillary immediate complete denture, mandibular overdenture and telescopic denture. A female patient, 60 years old, was referred to Dental Hospital University

Keywords: Parkinson's disease (PD), immediate complete denture, overdenture, telescopic denture.

[1]. Parkinson‟s Disease Society. Proffesional‟s guide to Parkinson‟s disease. London: Parkinson‟s Disease Society of the United Kingdom. 2007: 1-3.
[2]. Scully C. Medical problems in dentistry. 6th ed. China: Elsevier. 2010: 329-31.
[3]. Hoehn MM, Yahr MD. Parkinsonism: onset, progression, and mortality. Neurology 1998; 50: 318–334.
[4]. Bakke M, Larsen SL, Lautrup C, Karlsborg M. Orofacial function and oral health in patients with Parkinson‟s disease. Eur J Oral Sci 2011:119:27-32.
[5]. Rajeswari CL Prosthodontic consideration in Parkinson disease. People‟s Journal of Scientific Research. 2010; 3(2): 45-7.

Abstract: Objective: This study was carried out to know the awareness of non-psychiatric clinicians working in teaching tertiary hospital regarding psychiatric problems in their practice and their reference to psychiatric consulting doctors. Methods: The study population consists of clinicians available in the tertiary hospital. A structured questionnaire was designed for the study consisting of 9 questions .The clinicians were contacted to answer the questions. Results: A total 48 non-psychiatric clinicians participated in the study ,50% of the clinicians felt that their patients have 10-20% have psychiatric disorder .Nearly 75% of the clinicians refer all the patients with psychiatric problems to a psychiatric consultant .75% of the clinicians are of the opinion that psychological factors were the main cause for the psychiatric morbidity. Majority of the clinicians find psychotropic drugs were useful............

Keywords: Psychiatry morbidity, tertiary teaching hospital, psychiatric referral, psychiatric education ,psychotropic drugs.

[1]. Strain, J J. &Taintor, Z (1989) Consultation liaison psychiatry. In Comprehensive Textbook of Psychiatry, Sthed (eds. H.I. Kaplan & B.J. Sadock). pp. 1272- 1279. Baltimore : Williams and Wilkins.
[2]. Almeeri.S A M Knowledge and attitude of non-psychiatric physicians for management of mental disorders : august 2003.
[3]. Freyne, A., Buckley, P., Larkin, C & Walsh, N (1992) Consultation liaison psychiatry within the general hospital : referral pattern and management. Irish Medical Journal, 85, 112 – 114
[4]. Lloyd, G. G. (1993) Psychiatry in general medicnie. In companion to Psychiatric Studies, 5th ed (eds. R. E. Kendell& A. K. Zealley) pp.779-792. Edinburgh : Churchill Livingstone.
[5]. Chadda.R.K and Shome.S Psychiatric aspects of clinical practice in general hospitals: a survey of non-psychiatric clinicians; Indian J. Psychiat., 1996, 38 (2), 86-93.

Abstract: Objectives: To obtain information about basic knowledge towards mental disorders and to evaluate attitude of caregivers towards mental disorders. Methods: Questionnaires which collected basic demographic information, opinions about causation of mental disorders, potential stigmas and myths, role of treatment and rehabilitation of mentally ill were delivered to caregivers of patients attending Psychiatry outpatient and inpatient wards of a tertiary care hospital in Karnataka. Results: Completed questionnaires were collected from 100 participants. Caregivers were better informed about treatment than to nature and etiology of the disease. The belief that mental illness is incurable and self inflicted prevailed among caregivers...............

Keywords: Stigma, mental illness, attitude, caregivers.

[1]. Siu BMW, Chow KKW, Lam LCW, Chan WC, Tang VWK, Chui WWH. A Questionnaire Survey on Attitudes and Understanding towards Mental Disorders. East Asian Arch Psychiatry. 2012; 22: 18-24.
[2]. World Psychiatric Association. The WPA global programme to reduce the stigma and discrimination because of schizophrenia. Schizophrenia — open the doors training manual. Geneva: World Psychiatric Association; 2005.
[3]. Ikeme C. The stigma of a mental illness label: attitudes towards individuals with mental illness. 2012.
[4]. Byrne P. Stigma of mental illness and ways of diminishing it. Adv Psychiatr Treat. 2000; 6: 65–72.
[5]. Aromaa E. Attitudes towards people with Mental Disorders in a General Population in Finland.

Abstract: Introduction: Acute meningitis is a frequent syndrome encountered in emergency rooms. Viral meningitis is a common infectious disease of the central nervous system (CNS) that occurs worldwide. It can occur at any age but is most common in young children. Viral meningitis caused by herpes simplex virus (HSV) is a self-limited illness of 2–5 days' duration characterized by CSF findings of pleocytosis and an elevated protein level with a normal glucose level10. Although Herpes simplex I and II account for only 31% to 4%1of all cases of aseptic meningitis, and/or meningoencephalitis caused by HSV I and II are more important due to their potentialclinical severity in the case of meningoencephalit.................

Keywords: Aseptic meningitis, HSV-1, HSV-2, children, Iraq , Real time PCR

[1]. Kupila L, Vuorinen T, Vainionpaa R, Hukkanen V, Marttila RJ, Kotilainen P: Etiology of aseptic meningitis and encephalitis in an
adult population. Neurology 2006, 66:75–80.
[2]. Brown B, Oberste MS, Maher K, Pallansch MA. Complete genomic sequencing shows that polioviruses and members of human
enterovirus species c are closely related in the noncapsid coding region. J Virology 2003; 77:8973-8984.
[3]. Granerod J, Tam CC, Crowcroft NS, Davies NW, Borchert M, et al. (2010) Challenge of the unknown. A systematic review of
acute encephalitis in nonoutbreak situations. Neurology 75: 924–932.
[4]. Logan SA, MacMahon E (2008) Viral meningitis. BMJ 336: 36–40. Glaser CA, Honarmand S, Anderson LJ, Schnurr DP, Forghani
B, et al. (2006) Beyond viruses: clinical profiles and etiologies associated with encephalitis. Clin Infect Dis 43: 1565–1577.
[5]. Mailles A, Stahl JP (2009) Infectious encephalitis in france in 2007: a national prospective study. Clin Infect Dis 49: 1838–1847.

Abstract: Aim: To compare the characteristics of spinal blockade following intrathecal administration of isobaric 0.5% levobupivacaine (12.5mg) to 0.5% isobaric levobupivacaine (10 mg) with 25μg fentanyl and 0.5% hyperbaric bupivacaine (12.5mg) in patients undergoing elective sub umbilical surgery. Methodology: This is a prospective double blinded comparative study involving 120 patients assigned into 3 groups, Group A- Isobaric 0.5%levobupivacaine (12.5mg) to Group B - 0.5% hyperbaric bupivacaine (12.5mg) and Group C - 0.5% isobaric levobupivacaine (10 mg) with 25μg fentanyl. All patients received a standard volume of 2.5 ml for subarachnoid blockade and the following sensory and motor parameters were analyzed - time to achieve T10 level blockade, maximum level............

Keywords: Isobariclevobupivacaine,Isobaric levobupivacaine and Hyperbaric levobupivacaine ,infraumbilcal surgeries

[1]. Bier A. Versuche über Cocainisirung des Rückenmarkes. Dtsch Zeitschrift für Chir. 1899;51(3-4):361-369.
[2]. Hiller a., Karjalainen K, Balk M, Rosenberg PH. Transient Neurological Symptoms After Spinal Anaesthesia with Hyperbaric 5% Lidocaine or General Anaesthesia. Surv Anesthesiol. 1999;43(6):343-344.
[3]. Foster R, Markham A. Levobupivacaine. Drugs. 2000;59(3):551-579.
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[5]. Van de Velde M. There is no place in modern obstetrics for racemic bupivacaine. Int J Obstet Anesth. 2006;15(1):38-41.

Abstract: Objectives: - To assess the cumulative response of very high dose steroids and sequentially added Vigabatrin in patients of infantile West Syndrome. Methods: - This was an observational study conducted at a tertiary care hospital from August-2014 to August- 2015. Children aged 2-23 months presenting with infantile spasms with hypsarrhythmia on EEG were enrolled. The study participants were started on high dose Prednisolone (8 mg/kg/day maximum 60mg/day). Patients who did not respond to this treatment were started on Vigabatrin (50-150mg/kg/day) in sequentially increasing doses and prednisolone treatment was tapered off............

Keywords: Hypsarrhythmia, responder, cumulative, non-responder, sequential.

[1]. Hrachovy RA, Frost Jr. JD, Kellaway P. Hypsarrhythmia variations on The theme. Epilepsia.1984; 25:317–325.
[2]. Baram TZ, Mitchell WG, TournayA et al. High-dose corticotrophin (ACTH) versus prednisone for infantile spasms: a prospective,
randomized, blinded study. Pediatrics 1996;97:375-379.
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prednisolone for treatment of infantile spasms: An open- label, randomized controlled trial. Epilepsy Research. 2014; 108:1378-84.
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comparing vigabatrin with prednisolone or tetracosactide at 14 days: a multicentre, randomised controlledtrial.Lancet.
2004;364:1773–1778.
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years in infantile spasms: evidence from the United Kingdom Infantile Spasms Study. Epilepsia 2011;52:1359-64.

Abstract: Fibroma of oral mucosa is the most common benign "tumor" of the oral cavity, derived from fibrous connective tissues. Irritation fibroma/ traumatic fibroma is sub-mucosal response to trauma from teeth/ dental prosthesis presenting as painless, sessile or occasionally pedunculated swelling. Fibroma may occur at any oral site, but is commonly seen on buccal mucosa along the plane of occlusion teeth, but in this paper we present a case that reveals fibroma on lower lip, an uncommon site of occurrence............

Keywords: Excisional biopsy, Irritation fibroma

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240
[2]. Halim DS, Pohchi A, Pang EE. The prevalence of fibroma in oral mucosa among patient attending USM dental clinic year 2006-
2010. Indonesian J Dent Res 2010;1: 61-6.
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Abstract: Aim: To compare the toxicity profile of two regimens namely three weekly paclitaxel followed by FAC (fluorouracil /doxorubicin /cyclophosphamide) and weekly paclitaxel followed by FAC in patients with locally advanced breast cancer. Methods: Toxicities of both groups were recorded in the proforma following each cycle of treatment and at the end of treatment regimen. Grading of toxicities was done by WHO toxicity grading. Results: Anemia, leucopenia, nausea, vomiting, stomatitis and diarrhoea were more with three weekly Paclitaxel regimen of which nausea and diarrhea were statistically significant whereas myalgia and peripheral neuropathy were more common with weekly Paclitaxel regimen but the difference was not statistically significant. Conclusion: Patients on both regimens developed different pattern of toxicities and any one regimen cannot be considered better compared to the other regarding toxicities.

Keywords: Breast cancer, chemotherapy, Paclitaxel, WHO toxicity criteria

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ClinOncol 2011;29 (15) :627
[6]. Andrew D. Seidman, Donald Berry et al.Randomized Phase III Trial of Weekly Compared With Every-3-Weeks Paclitaxel for
Metastatic Breast Cancer, With Trastuzumab for all HER-2 Overexpressors and Random Assignment to Trastuzumab or Not in
HER-2 Nonoverexpressors: Final Results of Cancer and Leukemia Group B Protocol 9840.J ClinOncol2008; 26(10):1642-1649

Abstract: The role of Diffusion Weighted Magnetic Resonance Imaging in the evaluation of various intracranial lesions has been evolving and increasing since its initial introduction as newer uses are being explored constantly. We review the imaging features of 68 cases of intracranial tumors and evaluate the role of diffusion weighted imaging in their diagnosis. Diffusion weighted imaging provides additional information in differentiating various intracranial tumors, in differentiating arachnoid cysts from epidermoid cysts, grading of gliomas, defining cystic/necrotic components of tumors and also helps in differentiating necrotic tumors from brain abscesses.

Keywords: Apparent Diffusion Coefficient (ADC), Central Nervous System (CNS), Diffusion Weighted Imaging (DWI), Magnetic Resonance Imaging(MRI)

[1]. C.G. Filippi, et al Appearance of meningiomas on diffusion weighted images: correlating diffusion constants with histopathological findings AJNR Am J Neuroradiol, 22 pp. 6572, 2001.
[2]. Sherif A. Khedra et al, The diagnostic value of diffusion weighted imaging in patients with meningioma The Egyptian Journal of Radiology and Nuclear Medicine Volume 43, Issue 2, Pages 249– 256 June 2012.
[3]. Ahmed Farid et al, Role of diffusion weighted MR imaging in discrimination between the intracranial cystic masses The Egyptian Journal of Radiology and Nuclear Medicine 45, 869 – 875, 2014.
[4]. Intracerebral chondroma Rachid Gana, R El Maaqili, N El Fatemi, Fouad Bellakhdar Pan Arab Journal of Neurosurgery volume 12, no. 1, april 2008
[5]. Najjar MW et al, Giant Convexity Chondroma of the Dura Matter Presenting with Epilepsy. Austin J Neurol Disord Epilepsy ;1(1): 3, 2014.

Abstract: L'apoplexie hypophysaire est une urgence rare mais grave. Le diabète insipide central survient chez moins de 5% des patients présentant une apoplexie hypophysaire. Nous rapportons le cas d'un patient âgé de 42 ans, qui s'est présenté dans notre formation dans un tableau fait de syndrome polyuro-polydipsique avec des céphalées intenses et des troubles visuels. L'IRM hypothalamo-hypophysaire avait mis en évidence une apoplexie hypophysaire avec disparition du signal normal de la post-hypophyse. L'examen ophtalmologique et le champ visuel étaient normaux...........

[1]. Achoura N, Bendaouda S, Mycinskib B, Soto Aresb G. Apoplexie d'un adénome hypophysaire responsable de diabète insipide : A
propos d'un cas. Annales d'Endocrinologie. 2014; Volume 75, Issues 5–6; Pages 442.
[2]. Raverot G, Vasiljevic A, Raverot V, Lapras V, Favrel V, Trouillas J, Jouanneau E. Adénomes hypophysaires gonadotropes. EMC -
Endocrinologie-Nutrition. 2014 ; Volume 11, n◦3 : 10-23.
[3]. Silva CM, Lima GA, Machado EO, Van Haute FR, Gadelha MR. Transient central diabetes insipidus followed by pituitary
apoplexy treated in a conservative way. Arq Neuropsiquiatr. 2008 ;66(2B):415-7.
[4]. Möller-Goede DL, Brändle M, Landau K, Bernays RL, Schmid C. Pituitary apoplexy: re-evaluation of risk factors for bleeding into
pituitary adenomas and impact on outcome. Eur J Endocrinol. 2011 Jan; 164(1):37-43.
[5]. Rajasekaran S, Vanderpump M, Baldeweg S, Drake W, Reddy N, Lanyon M, et al. UK guidelines for the management of pituitary
apoplexy. Clin Endocrinol 2011;74:9–20.

Abstract: Objectives: To assess the effectiveness of LLLT with Neural mobilization along with Exercises AND TENS with Neural mobilizations along with Exercises. By assessing the effectiveness of pain reduction using VAS scale, by assessing the effectiveness of neck ROM using UG, by assessing the effectiveness of neck disability using NDI. Back Ground: Cervical radiculopathy is a dysfunction of a nerve root of the cervical spine, most commonly caused by a cervical disc herniation, spondylotic spur, cervical osteophyte or other space-occupying lesion, resulting in nerve root inflammation, impingement or both which may lead to chronic pain and disability. The average annual incidence rate of cervical radiculopathy is 83 per 100,000 with an increased prevalence occurring in the 5th decade of life (203 per 100,000). Some reports show that it is predominant in men and others shown predominance in women...........

Keywords:Low Level Laser Therapy(LLLT, Cold Laser),Transcutaneous Electrical Nerve Stimulation(TENS), Visual Analog Scale(VAS), Neck Disability Index(NDI), Range Of Motion(ROM), Universal Goniometer(UG).

[1]. Virali R Raval, VinodBabu K, Sai Kumar N, Amrita Ghosh. "Effect of simultaneous application of cervical traction and neural
mobilization for subjects with unilateral cervical radiculopathy". Int J Physiother. December (2014); Vol 1(5), 269-278.
[2]. Ljubica M. Konstantinovic, Milisav R. Cutovic, Aleksandar N. Milovanovic, Stevan J. Jovic, Aleksandra S. Dragin, Milica D Letic,
Vera M. Miler.. Low-Level Laser Therapy for Acute Neck Pain with Radiculopathy. A Double-Blind Placebo-Controlled
Randomized Study. Wiley Periodicals, Inc. Pain Medicine 2010; 11: 1169–1178.
[3]. Wainner RS, Gill H, "Diagnosis and Nonoperative Management of Cervical Radiculopathy," Journal of Orthopedic& Sports
Physical Therapy, 2000; 30(12):728-744.
[4]. Nishant H. Nar. Effect of Neural Tissue Mobilization on Pain in Cervical Radiculopathy Patients. Indian journal of physiotherapy
and occupational therapy 2014, Vol 8;Pages: 144-148.
[5]. McMINN. Lasts Anatomy Regional and Applied. Churchill livingstone. (2003) ISBN:B0084AQDG8.

Abstract: Background:The complement system is part of the host defense response. However, considerable evidence suggests that complement plays an important role in the pathophysiology of ischemic heart disease. The relationship between C3, C4 levels and acute coronary syndromes, further suggests that the complement activation is related to myocardium necrosis. Methods: Samples were collected from cardiac patients admitted to CCU atTripoli Medical Centreand analyzed for both C3 and C4 components. Venous blood has been collected from patients and their sera were separated. The principle of assay depends on Immunoturbidimetric method .Results:Of 130 cardiac patients..............

Keywords: Cardiac patients, Complement, C3, Immunoturbidimetric, Libya

[1]. Schafer H, Mathey D, Hugof, Bath S, Deposition of the terminal C3b-9 complement complex in infracted area in human
myocardium, Immunol,1986, 137:1945-49
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[3]. Al-Tubuly AA, and Daeki AO, Immunology lecture notes,1. (Tripoli 2009) 53-57.
[4]. Roitt IM, Brostoff J, Male D, Immunology, 5 (London:Mosby1996)
[5]. Walker JM, Tan LB. Cardiovascular disease; Souhami R, Moxham J (Eds.),Textbook of Medicine, 3 (Edinburgh: Churchill living
stone 1997) 381-505.

Abstract: Testicular adrenal rest tumours (TART) are benign tumors made of ectopic adrenal cortex tissue.They are frequently found in males with congenital adrenal hyperplasia (CAH) with a reported prevalence of up to 94% (1). In fact, all pathologies causing a rise ACTH levels may be associated with adrenal inclusions.They are found mainly in patients with congenital adrenal hyperplasia ( CAH) of untreated or poorly treated. n adult patients with congenital adrenal hyperplasia (CAH) the presence of testicular adre is an important cause of gonadal dysfunction and infertility par apparition de troubles de la spermatogénèse (2). The objective of this study is to search the frequency of TART) in CAH and clarify clinical and progressive characteristics

[1]. Stikkelbroeck NMML, Otten BJ, Pasic A, Jager GJ, Sweep CGJ, Noordam K & Hermus ARMM. High prevalence of testicular adrenal rest tumours, impaired spermatogenesis, and Leydig cell failure in adolescent and adult males with congenital adrenal hyperplasia. Journal of Clinical Endocrinology and Metabolism 2001 86 5721–5728.
[2]. CrossRefMedlineWeb of Science
[3]. Claahsen-van der Grinten HL, Otten BJ, Hermus ARMM, Sweep CGJ, Hulsbergen-van de Kaa CA. Testicular adrenal rest tumours in patients with congenital adrenal hyperplasia can cause severe testicular damage.Fertility and Sterility 2007
[4]. Avila NA, Shawker TS, Jones JV, Cutler GB, Merke Jr DP. Testicular adrenal rest tissue in congenital adrenal hyperplasia: serial sonographic and clinical findings. AJR Am J Roentgenol 1999,172:1235-8.
[5]. Cabrera MS, Votgiatzi MG, New MI. Long term outcome in adult males with classic congenital hyperplasia. J Clin Endocrinol Metab 2001;86:3070-8. 5. Holmes Walker DJ, Conway GS

Abstract: Congenital adrenal hyperplasia (CAH) are genetic diseases with a deficit of one of the enzymes of steroidogenesis (21 hydroxylase OH, 90%). Patients are often reach a reduced growth. The mean final height of these patients was 1.38 SD score lower than the population norm, and was lower than expected given parental height. both hyperandrogenism and hypercortisolism contribute to the observed short stature . Our objective in this study was to determine the distribution of achieved height in patients with classic CAH diagnosed at infancy or early childhood and treated with glucocorticoids.

Keywords: Congenital adrenal hyperplasia, growth, short stature, hyperandrogenism and hypercortisolism

[1]. Eugster EA, Dimeglio LA, Wright JC, Freidenberg GR, Seshadri R, Pescovitz OH. Height outcome in congenital adrenal hyperplasia caused by 21-hydroxylase deficiency: A meta-analysis. J Pediatr. 2001;138:26–32. [2]. Longui CA, Kochi C, Calliari LE, Modkovski MB, Soares M, Alves EF, et al. Near-final height in patients with congenital adrenal hyperplasia treated with combined therapy using GH and GnRHa. Arq Bras Endocrinol Metabol. 2011;55:661–672
[3]. MARSHALL. W.A, TANNER. JM. Variations in the Pattern of Pubertal Changes in Girls. Arch Dis Child 1969 ; 44 = 291-303.
[4]. MARSHALL. W.A, TANNER. JM. Variations in the Pattern of Pubertal Changes in Boys.Arch. Dis Child 1970 ; 45 = 13-23. [5]. Speiser PW, Azziz R, Baskin LS, Ghizzoni L, Hensle TW, Merke DP. Congenital adrenal hyperplasia due to steroid 21-hydroxylase deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2010 Sep. 95(9):4133-60

Abstract: This is a hospital based prospective randomized controlled study conducted at Guntur Government Hospital, Guntur. Objective: To study the prevalence of Gestational Diabetes Mellitus (GDM) among Antenatal Women attending OPD by using one step procedure of 2 hr.75 gm OGTT and to evaluate and compare the occurrence of GDM in normal antenatal cases and in patients with risk factors for GDM . And also to assess the need for Universal screening. Conclusion: The prevalence of GDM in our study population using is 3.33%.This one step procedure is acceptable, economical and feasible to perform. From our study we recommend Universal Screening for GDM in all antenatal women.

Keywords: Antenatal women, GDM, one step procedure, prevalence, risk factors, Universal screening

[1]. Cheung NW, Byth. K . Population health significance of gestational diabetes. Diabetes Care 2003;26:2005-2009.
[2]. Jovanoic L, Pettitt DJ. Gestational Diabetes Mellitus JAMA 2001;286:2516-8
[3]. Vibeke A, van der Ploeg NW , Huxley RR, Bauman AE. Sociodemographic correlates of the increasing trend in prevalence of
Gestational Diabetes Mellitus in a large population of women between 1995 and 2005. Diabetes care 2008;31:2288-2293.
[4]. Beischer NA , Wein P, Sheedy MT, Steffen B. Identification and treatment of women with hyperglycemia diagnosed during
pregnancy can significantly reduce perinatal mortality rates. Aust N Z J Obstet Gynaecol 1996;36:239-247
[5]. Vinita Das , Smitha Kam. ra et al. Sreening for Gestational Diabetes and Maternal and Fetal outcome. J Obstet Gynecol Ind
Vol.54,No.5: Sept/Oct 2004,449-451