iosr-JDMS   Volume-15 ~ Issue-5 ~ May-2016

Abstract: Aim: The aim of this case report is to show the combined use of platelet rich fibrin (PRF) and xenograft(DFDB) in the treatment of large periapical lesion. Background: Periapical inflammatory lesion is the response of bone around the apex of tooth that occurs after the necrosis of the pulp tissue or due to some periradicluar diseases. Regeneration is the reproduction of a lost or an injured part of the body in such a way that the architecture and function of the lost or injured tissues are completely restored......

Keywords: Periapical inflammatory lesion, platelet rich fibrin, xenograft, regeneration

[1]. Balaram Naik,Role of Platelet rich fibrin in wound healing: A critical review J Conserv Dent. 2013 Jul-Aug; 16(4): 284–293.

[2]. Boyapati L, Wang HL. The role of stress in periodontal disease and wound healing. Periodontol 2000.2007;44:195–210.

[3]. Bashutski JD, Wang HL. Periodontal and endodontic regeneration. J Endod. 2009;35:321–8

[4]. Chung CP, Kim DK, Park YJ, Nam KH, Lee SJ. Biological effects of drug-loaded biodegradable membranes for guided bone regeneration. J Periodontal Res. 1997;32:172–5

[5]. Sunitha Raja V, Munirathnam Naidu E. Platelet-rich fibrin: Evolution of a second-generation platelet concentrate. Indian J Dent Res. 2008;19:42–6.

Abstract: A tooth which failed to erupt fully or emerged partially, it is considered to be impacted. Impaction is most common with the wisdom tooth because they are the last tooth to erupt in the oral cavity. An impacted tooth remain stuck in gum tissue or bone for various reasons, as in overcrowded regions were there could be no room for them to emerge or if the jaw is too small to fit the wisdom tooth. Tooth may also become twisted, tilted or displaced as they try to emerge in closed space resulting in impaction. Inversion of the impacted tooth is a rare condition......

Keywords: 3D Reconstruction, Impacted IIIrdmolar, OPG, Reimplantation, Surgical intervention

[1]. Archer HW. Oral & Maxillofacial Surgery.Philadelphia WB Saunders 1975.
[2]. Padhye MN, Dabir AV, Girotra CS, Pandhi VH. Pattern of mandibular third molar impaction in the Indian population: a retrospective clinico-radiographic survey. Oral Surg Oral MedOral Pathol Oral Radiol 2013;116:161–6.
[3]. Kumar Pillai A, Thomas S, Paul G, Singh SK, Moghe S. Incidence of impacted third molars: a radiographic study in People'shospital, Bhopal, India. J Oral BiolCraniofac Res 2014;4:76–81.
[4]. Hattab FN, Fahmy MS, Rawashedeh MA. Impaction status of third molars in Jordanian students. Oral Surg Oral Med OralPatholRadiolEndod 1995;79:24–9.
[5]. Eshghpour M, NezadiA,Moradi A, Shamsabadi RM, Rezaei NM,Nejat A. Pattern of mandibular third molar impaction: a crosssectional study in northeast of Iran. Niger J ClinPrac 2014;17:673–7.

Abstract: It is reportedthat 3%of patients on first line Antiretroviral therapy (ART) will fail and ultimately need second line ART.There is no thirdlineART at present under the national ART program and secondlineART isthe ultimate optionforthe HIV/AIDS patients.The clinical,immunological and virologicalstatus arethe monitoringmechanismsof ART response.Though the viral load study is the cornerstone of critical clinical decision making in formulating appropriate ART, in the resource limited setting it is prohibitively expensive therefore CD4 is used as the surrogate marker to determine the immunological status of a patient..........

Keywords: Immunological, second line ART, Anti-retroviral therapy,CD4 count.

[1]. NationalGuidelinesonSecond-lineandAlternative First-lineART for Adults and Adolescents May 2013.NationalAIDS Control Organization,Ministry ofHealth & Family Welfare,Government ofIndia.
[2]. Alvin C. Powers. Diabetes Mellitus: Diagnosis, Classification, and Pathophysiology. In: Kasper DL, Fauci AS, Longo DL, Jameson JL, Loscalzo J. Editors. Harrison's Text book of Internal Medicine 19th edition. Chapter 417. New York. McGraw Hill.p. 2399.
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[4]. Mitchell H.Katz,AndrewR.Zolopa.HIV Infection &AIDS.Current Medical Diagnosis & Treatment. Lange. Papadakis, McPhee,Rabow. McGraw Hill education.p.1306-1338.

Abstract: Second hand tobacco smoke exposure is a risk factor for asthma. Also use of open fire for cooking purpose is a significant risk factor for asthma symptoms. Asthma is a prevalent disease in Sub-Himalayan Terai Region of North Bengal and so is the presence of smoking habit and use of smoke emitting biomass fuel for cooking. Therefore this study has been carried out to know the prevalence and risk of environmental tobacco smoke and cooking smoke exposure in childhood asthma patients..........

Keywords: Asthma, childhood asthma, cooking smoke, environmental tobacco smoke, risk factors

[1]. Paramesh H, Subramanyam L, Somu N. Bronchial asthma. In IAP Text Book of Pediatrics. Parthasarathy A (edi); Jaypee Brothers Pvt. Ltd. 3rd ed : 2006; pp – 462-463.
[2]. Jaakola JK, Gissler M. Are Girls More Susceptible to the Effects of Prenatal Exposure to Tobacco Smoke on Asthma? Epidemiology 2006; 18:573-6.
[3]. California Environmental Protection Agency. Identification of Environmental Tobacco Smoke as a Toxic Air Contaminant. Executive Summary. June 2005.
[4]. California Environmental Protection Agency. Review of the California Ambient Air Quality Standard for Ozone. Staff Report 2005, March 11, 9-168.
[5]. Warren CW, Jones NR, Peruga A, Chauvin J, Baptiste JP, Costa de Silva V, el Awa F, Tsouros A, Rahman K, Fishburn B, Bettcher DW, Asma S: Global youth tobacco surveillance, 2000-2007. MMWR Surveill Summ 2008, 57:1-28.

Abstract: A prospective study of total hip replacement done through posterolateral approach was conducted at Skims medical college, on 86 cases from December 2010 to april 2016. Introduction:Since its inception in 1960,Total hip arthroplasty has revolutionised the treatment of painful hip arthritis 1.The concept of replacing the abnormal joints shas long been recognised by surgeons,but efforts were hampered by the lack of suitable materials and imprecise surgical technique....

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[3]. Habermann ET.Total joint replacement an overview.semin Roentgenol 1986;21;7-19
[4]. Freiberger RH.Evaluation of the hip prosthesis.semin Roentgenol 1986;21;20-28
[5]. Charnley J.The long term results of low –friction arthroplasty of the hip performed as a primary intervention.J Bone Joint Surg Br 1972;54;61-66

Abstract: Objectives:- To observe the cardiovascular changes, to study the magnitude of changes in normotensive patients and to observe the effects in attenuating the cardiovascular responses to laryngoscopy and intubation comparing two drugs. Methods: The study was carried out on 60 adult patients of either sex, in the age group 20-60 years. Patients were divided into 2 groups of 30 patients each.....

Keywords:- Esmolol, laryngoscopy, intubation.

[1]. Reid, L. Corson, and Donald E. Brace. "Irritation of the respiratory tract and its reflex effect upon the heart." SurgGynecolObstet 70 (1940): 157-62.
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[3]. Kindler CH, Schumacher PG, Schumacher PG, Scheneider MC, UrwylerA.Attenuating the cardiovascular responses to laryngoscope and intubation, and to assess whether a combination of both more effective than either drug alone". J ClinAnesth 1996Sep;8(6):491-6
[4]. Roerig D, KampineJP.The effectiveness of a single preinduction intravenous (IV) bolus of esmolol in blunting hemodynamic response to rapid sequence induction and tracheal intubation J ClinAnesth Jul-Aug;2(4):1990 243-52
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Abstract: Tetanus, an infectious disease, characterized by progressive spastic paralysis of multiple groups of muscles, is caused by a gram positive, obligate, anaerobic organism, Clostridium tetani. The organism produces a neurotoxin, tetanospasmin, which interferes with neurotransmitter release to block inhibitor impulses thereby leading to unopposed muscle contraction, spasms and peripheral muscle rigidity. The spores of Clostridium tetani which are ubiquitously distributed in environment can contaminate the wound and lead to tetanus. Since culture of Cl.tetani is labor intensive, the diagnosis is entirely clinical......

Keywords: Clostridium tetani, Creatinine phospho kinase, Neurotoxin, Tetanus, Trismus.

[1]. Pink book, Tetanus - Epidemiology of vaccine preventable diseases, www.cdc.gov/vaccines/pubs/pinkbook/tetanus/ html, Sep 8, 2015 - C

[2]. Petrus Rudolf de Jong, Thea de Heer-Groen, Cornelis Hendrik Schröder, Generalized tetanus in a 4-year old boy presenting with dysphagia and trismus: a case report, Published online 2009 Apr 29.

[3]. www.michigan.gov/documents/mdch, Tetanus, MDCH Vaccine-Preventable Disease Investigation Guidelines – Tetanus Revised 2014

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[5]. https://books.google.co.in/books, Progress in Medicinal Chemistry Thiago Lisboa, Yeh-Li Ho, Gustavo Trindade, Guidelines for the management of accidental tetanus in adult patients, www.scielo.br/scielo.php - 2011

Abstract: Introduction: MRSA infections have been increasing in Indian hospital ICU's and wards many of which are resistant to antibiotic treatment. Aims: To study the prevalence rate and antibiogram pattern of MRSA from various clinical samples in tertiary care hospital, Visakhapatnam.......

Keywords: Methicillin resistance, MRSA, Vancomycin, Linezolid, Hospital acquired infections

[1]. D. J. Diekema, M. A. Pfaller, F. J. Schmitz, Bell J. J Smayevsky, R. N. Jones, M. Beach, SENTRY Participants Group: Survey of infections due to Staphylococcus species: frequency of occurrence and antimicrobial susceptibility of isolates collected in the United States, Canada, Latin America, Europe, and the Western Pacific region for the SENTRY Antimicrobial Surveillance Program, 1997–1999. Clinical Infection Disease 2001, 32 (Suppl 2):114-132.
[2]. Palavecino E. Clinical, epidemiological, and laboratory aspects of methicillin-resistant Staphylococcus aureus (MRSA) infections. Methods in Molecular Biology. 391:1 1, 2007
[3]. Centre for Disease Control and Prevention, "MRSA: Methicillin-resistant Staphylococcus aureus in Healthcare Settings, 2007

Abstract: Background and Objective: Malaria has been emerging as a major national health problem with considerable morbidity and mortality. Since blood group are an expression of genetic constitution, it was decided to study their influence on susceptibility to malaria. To establish whether there is a relationship between A, B, O blood groups and malaria, blood group frequencies in malaria patients........

Keywords: Malaria, ABO blood group

[1]. Tyagi SP. Distribution of ABO blood groups in Uttar Pradesh. Journal of the Indian Medical Association. 1968; Vol 51, No: 2, 57
– 59.
[2]. Singh T. Malaria and ABO blood groups. Indian Pediatr. 1985. Nov, 22 (11) : 857 – 8.
[3]. Wood CS, Harrison GA, Dorec, Weiner AS. Selective feeding of Anapheles according to ABO blood group status. Nature 1972;
239 – 165.
[4]. Athreya BH, Coriell LL. Relation of blood group to infection. Am J. Epidem 1967; 86 : 292 – 295.
[5]. Vogel F. blood groups and diseases. Am J Hum Genet 1970; 22 : 464 – 470.

Abstract: Velopharyngeal incompetence is one of the contributing factors for speech disorders. This condition usually follows certain disorders like cleft palate, soft palate paralysis and neurologic disorders. Cleft palate is one of the major contributing factors for the velopharyngeal incompetence. Various treatment modalities have been proposed including prosthetic management, surgical correction and speech therapy.......

Keywords: cleft palate, hypernasality, palatal lift prosthesis, velopharyngeal incompetence.

[1]. Skolnick M L, McCall G N, Barnes M. The sphincteric mechanism of velopharyngeal closure. Cleft Palate J.1973; 10:286-305.
[2]. Cotton RT, Willging JP. Velopharyngeal Insufficiency. In: Bluestone CD, Stool SE, Kenna MA, editors. Pediatric Otolaryngology, 3rd Edition, Philadelphia; WB Saunders Company; 1995. p. 1621-31.
[3]. Sell D, Mars M, Worrell E. Process and outcome study of multidisciplinary prosthetic treatment for velopharyngeal dysfunction. Int J Lang Commun Disord 2006; 41:495-511.
[4]. Gibbons, P., and Bloomer, H. H.: The Palatal Lift; a Supportive-Type Speech Aid, J.Prosthet. Dent 1958; 8: 362-369.
[5]. Shprintzen RJ, Schwartz RH, Daniller A, Hoch L. Morphologic significance of bifid uvula. Pediatrics. 1985;75(3):553-61.

Abstract: Extended spectrum β-lactamases (ESBLs) are a group of enzymes found in certain species of Gramnegative bacilli notably Klebsiella and Escherichia coli and confer upon the bacteria ability to hydrolyse β- lactam rings of third generation cephalosporins and/or aztreonam. Bacteria produce ESBLsdue to mutation of TEM-1, TEM-2 and SHV-1. Widespread use of third generation cephalosporins causes mutations leading to emergence of ESBLs.Because of extended substrate range, they are called Extended Spectrum β- lactamases.......

Keywords: Double disc synergy test (DDST), Extended spectrum β-lactamases (ESBLs), Hospital associated infections (HAI),Phenotypic confirmatory disc diffusion test (PCDDT), Third generation cephalosporins (3GCs).

[1]. Brooks GF, Butel JS, Morse SA.Antimicrobial Chemotherapy. In: Jawetz, Milnick&Adelberg'sMedical Microbiology, 23rd Edition,
(McGrawHill, International Edition, 2004), 162-165.
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[3]. Nathisuwan S, Burgess DS, Lewi's II JS. ESBLs: Epidemiology, Detection and Treatment. Pharmacotherapy 2001;21 (8):920-928.
[4]. Podschun R, Ulmann U. Klebsiella spp. as Nosocomial pathogens: Epidemiology, Taxonomy, Typing Methods and Pathogenicity
Factors. ClilnMicrobiol Rev 1998; 11:589-603.
[5]. Subha A, Ananthan S. Extended spectrum beta lactamase (ESBL) mediated resistance to third generation cephalosporins among
Klebsiellapneumoniae inChennai.Indian Journal of Medical Microbiology, (2002) 20(2):92-95.

Abstract: Japanese encephalitis is a mosquito born encephalitis caused by a group B arbovirus (flavivirus ) and transmitted by culicine mosquito . Japanese encephalitis is the leading cause of acute encephalitis syndrome in children . An estimated 50000 cases of Japanese encephalitis occur globally each year with 10000 deaths and 15000 disabled. This study was undertaken to determine the clinical and socio-demographic profile of Japanese encephalitis in children admitted in Gauhati medical college and hospital........

Keywords: Japanese encephalitis, arbovirus, demography

[1]. K Park,preventive and social medicine,22nd edition,page259-260.
[2]. L. Kabilan, S. Ramesh, S. Srinivasan, V. Thenmozhi, S. Muthukumaravel, and R. Rajendran, "Hospital- and laboratory-based investigations of hospitalized children with central nervous system-related symptoms to assess Japanese encephalitis virus etiology inCuddalore district, Tamil Nadu, India," Journal of Clinical Microbiology, vol. 42, no. 6, pp. 2813–2815, 2004.
[3]. G.Kakoti, P.Dutta, B.R.Das, J.Borah, J.Mahanta, "clinical profile and outcome of Japanese encephalitis in children admitted with acute encephalitis syndrome",biomed research international,vol2013,article id 152656,pg 1-6,2013.
[4]. K. S. Avabratha, P. Sulochana, G. Nirmala, B. Vishwanath, M.Veerashankar, and K. Bhagyalakshmi, "Japanese encephalitis in children in Bellary Karnataka: clinical profile and Sequelae," International Journal of Biomedical Research, vol. 3, no. 02, pp.100–105, 2012.

Abstract: Introduction: Paediatric blindness presents with problems of human morbidity, economic loss and social burden of which cataract accounts for 5-20 % of the cases. Aim-The purpose of this study was to identify the barriers to effective treatment of childhood cataract in Assam in lower socio economic group and to determine the outcome of cataract IOL surgery in childhood cataract. Method: School screening ,home visit and confirmation of diagnosis at secondary district eye care centre followed by a quantitative and qualitative research methodology which included questionnaires and analysis of hospital records respectively........

Keywords: Barrier analysis, childhood cataract, cataract surgery,intraocular lens, primary posteriorcapsulotomy.

[1]. DrDamodarBachani et al.ChildhoodCataracts:Aetiology and ManagementCommunity Eye Health 2004 ; 17(50);2004
[2]. WHO, prevention of childhood blindness.GenevaWHO, 1992.
[3]. M E Wilson,S K Pandey,and J Thakur, Paediatric cataract blindness in the developing world: surgical techniques and intraocular
lenses in the new millennium,Br J Ophthalmol2003;87(1):14-19.
[4]. Paediatric Cataract Surgery – Techniques,Complications and Management –M. Edward Wilson, Rupal H. Trivedi, Suresh K.
Pandey.
[5]. AnaghaMedsinge, Ken K Nischal.Pediatric cataract: challenges and future directions.Clin Ophthalmol.2015; 9: 77–90.

Abstract: Aim: Toanalyze the histopathological profile of malignant oculoadnexal tumors among the patients treated in a tertiary referral hospital in Northeast India and to compare findings with previously reported data and seek the cause of disparity wherever possible. Material& Methods: The present study is a 10 years retrospective study(March2004 toMarch2014)carried out in the lab of Regional Institute of Ophthalmology,Guwahati in Northeast India.All the tissues sent for HPE were routinely fixed, processed and stained.......

Keywords: Oculoadnexal malignancies, retinoblastoma, squamous cell carcinoma.

[1]. Das D, Deka P, Ramachandra V, Bhattacharjee K, Das JK, Kuri GC.et al.Profile of Ocular and Adnexal Tumours at a Tertiary Institute of Northeast India. Orbit 2014;33:412–5
[2]. Sunderraj P. Malignant tumours of the eye and adnexa. Ind J Ophthalmol 1991;39:6–8.
[3]. Gogi R, Nath K, Ahuja L, Shukla M. Ocular and adnexal tumours.Indian J. Ophthalmol 1979;27:25-8
[4]. Lee SB, Eong KGA, Saw SM, Chan TK, Lee HP. Eye cancer incidence in Singapore. Br J Ophthalmol 2000;84:767–70.
[5]. Roh KK, Lee JH, Youn DH. Clinical analysis of tumours of the eye and adnexa. Kor J Ophthalmol 1998;2:27–31.

Abstract: Background: As HIV epidemic progresses through time with increasing use and better adherence to HAART, AIDS related causes of death are significantly decreasing and non AIDS related causes with associated metabolic abnormalities are increasingly becoming relatively more frequent especiallyin developing countries. Objective: To assess the metabolic profile and associated factors of body mass index and years on HAART in clinically stable HIV patients on long term HAART in a resource limited setting........

Keywords: Pilot study, metabolic parameters, HIV patients, resource limited setting

[1]. May M T, Ingle,S M, Costagliola D, Justice A C, de Wolf F, Cavassini M et al. Cohort Profile: Antiretroviral Therapy Cohort
Collaboration (ART-CC). Int J Epidemiol. 2014;43(3): 691–702
[2]. Grinsztejn B, Luz P M, Pacheco A G, Santos D V, Velasque L, et al. Changing Mortality Profile among HIV-Infected Patients in
Rio de Janeiro, Brazil: Shifting from AIDS to Non-AIDS Related Conditions in the HAART Era. PLoS ONE 2013; 8(4): e59768.
[3]. Wester C W, Koethe J R, Shepherd B E, Stinnette S E, Rebeiro P F, Kipp A M et al. Non-AIDS-defining events among HIV-1-
infected adults receiving combination antiretroviral therapy in resource-replete versus resource-limited urban setting. AIDS. 2011;
25(12):1471–1479.
[4]. Gkrania-Klotsas E, Klotsas AE. HIV and HIV treatment: effects on fats, glucose and lipids. Br Med Bull. . 2007;84:49-68.

Abstract: Supraglottic airway devices(SAD) have created a niche in the field of airway management. Furthermore, they create less haemodynamic alterations as compared to endotracheal intubation using direct laryngoscopy. The present study was designed to assess these changes while insertion of three different SAD – classic LMA, Proseal LMA & I-gel.........

Keywords: general anaesthesia, haemodynamics, supraglottic devices

[1]. King BD, Harris LC, Griefenestein FE, Elder JD, Dripps RD. Reflex circulatory response to direct laryngoscopy and tracheal intubation performed under general anesthesia. Anesthesiology 1951;12:556
[2]. Bucx MJL, Vangeel RTM, Scheck PAE, Stijnen T. Cardiovascular effects of forces applied during laryngoscopy. Anaesthesia 1992;47:1029-33
[3]. Kovac AL. Controlling the hemodynamic response to laryngoscopy and endotracheal intubation. J Clin Anesth 1996;8:63-79

[4]. Ramachandran SK, Kumar AM. Supraglottic airway devices. Respiratory care 2014;59(6):920-32
[5]. Wilson IG, Fell D, Robinson SL, Smith G. Cardiovascular responses to insertion of laryngeal mask. Anaesthesia 1992;47(4):300-2

Abstract: Objective: Comparing the effectiveness of preemptive analgesia with nimesulide, metamizole sodium or placebo in terms of postoperative edema in surgical removal of impacted mandibular third molars. Material and methods: 80 patients with impacted mandibular third molars requiring surgical treatment were enrolled in the study. This is a randomized, double-blind, placebo-controlled study. The patients were given vials marked with numbers, containing nimesulide, metamizole sodium or placebo; the patients had to take the medication 30 minutes prior to surgery........

Keywords: preemptive analgesia, third molar surgery, edema, non-steroidal anti-inflammatory drugs

[1]. Woolf Cl.,Chong Mun-Seng. Preemptive analgesia-Treating postoperative pain by preventing the establishment of central sensitization. Anest Analg 1993; 77:362-79.
[2]. McMahon SB, Cafferty WB, Marchand F. Immune and glial cell factors as pain mediators and modulators. Exp Neurol 2005; 192: 444-462
[3]. Troullos ES, Hargreaves KM, Butler DP, Dionne RA. Comparison of non-steroidal anti-inflammatory drugs, ibuprofen and flurbiprofen, to methylprednisolone and placebo for acute pain, swelling, and trismus. J Oral Maxillofac Surg. 1990; 48:945–52.
[4]. Meechan JG, Seymour RA. The use of third molar surgery in clinical pharmacology. British Journal of Oral and Maxillofacial Surgery 1993; 31(6): 360-365.

Abstract: Solitary gingival enlargements are similar in appearance and often do not show specific symptoms. Moreover in peripheral lesions we do not have radiographic findings to aid in the diagnosis. Histopathological diagnosis may vary from the clinical diagnosis to a great extent. This study was conducted to describe the clinical profile and histopathological diagnosis of solitary gingival enlargements that underwent excision biopsy over a period of one year.........

Keywords: Solitary gingival enlargements, Pyogenic granuloma, Peripheral ossifying fibroma, Peripheral cementifying fibroma, Peripheral Ameloblastoma.

[1]. Sumona Pal, Shruthi Hegde,Vidya Ajila. The varying Clinical Presentations of Peripheral ossifying Fibroma: A report of three casesRev OdontoCience2012;27(3):251-255
[2]. Kiran Kumar Ganji,Arun Kumar Bhimashankar Chakki, Sharanbasappa Chandrashelar et al.peripheral Cemento-ossifying Fibroma:Case series Literature review. Case Reports in Dentistry Vol2013 Article ID 930870,5 pages.
[3]. Amit Arvind Agarwal. Gingival Enlargements: Differntial Diagnosis and review of literatrure . World J Clin Cases 2015 september16;3(9):779-788
[4]. Mani AM, Marawar PP,Pendyala G,Mhaisekar R, Bhadange S. series of Gingival Enlargements: Case Reports. Parvara Med Rev 2014;6(1):23-28
[5]. Devanoorkar A,Guttiganur N,Dawarakanath C D, Savitha A N. Biopsy the gold standard in the final diagnosis of soliatary gingival enlargements: Case reports and an overview. Int J Oral Health Sci 2013;3:65-9

Abstract: Background: Assessment of sagittal jaws relation is a vital procedure in establishing a good diagnosis. The study aimed to find out the relation among different methods determining the sagittal jaws relationship. Materials and methods: Sixty digital true lateral cephalometric radiographs belong to dental students and patients attending the orthodontic clinic in the College of Dentistry, University of Baghdad. The radiographs were classified according to the ANB angle into 3 groups with 20 radiograph per.......

Keywords: Orthodontic diagnosis, sagittal jaws relation, ANB, Wits' appraisal.

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