iosr-JDMS   Volume-15 ~ Issue-8 ~ August-2016

Abstract: Tuberculosis infection control in health care settings has received increased interest following the recent occurrence of multiple drug-resistant (MDR) tuberculosis. Inadequate infection control (IC) in hospitals poses a risk to patients and health care workers .In most parts of the world, TB infection control in health care facilities remains inadequate despite the availability of international infection control guidelines. The situation is very different in low- and middle-income countries because these countries have high TB rates and limited resources including poor infrastructure in hospitals. In these countries, even low-cost strategies to reduce TB transmission in health-care facilities are seldom implemented................

Keywords: ......

.....

Abstract: The present study aimed to examine the impact of first time users of amplification devices by participants having presbycusis on tinnitus. Pure tone Audiometry along with immittance audiometry and speech Audiometry was carried out. The Tinnitus handicap inventory (THI) questionnaire, developed by Newman et al. (1996), was administered in all participants for pre and post hearing aid fitting conditions. The statistical analysis used were descriptive of mean, standard deviation, paired t-test and Welch two–sample t-test
using SPSS software. The tinnitus profile varied among the participants in terms of onset, severity, site and duration............

Keywords: Tinnitus, Hearing Aids, THI

[1]. Ahmad, N., Seidman, M. (2004). Tinnitus in the older adult: epidemiology, pathophysiology and treatment options; Drugs Aging;
21(5):297-305.
[2]. American Speech-Language-Hearing Association. (1988). Guidelines for determining threshold level for speech. ASHA, 30, 85-89.
[3]. Angelica, C. (2011). Unilateral tinnitus. Health and Fitness: Ears Hearing, from http://ezinearticles.com/?Unilateral- Tinnitus&id=6292929.
[4]. Baguley, D. M., & Atlas, M.D. (2007). Cochlear implants and tinnitus. Progress in Brain Research, 166, 34-55.
[5]. Brooks, D.N., & Bulmer, D.(1981). Survey of Binaural Hearing Aid Users. Ear and Hearing, 2, 220-224.

Abstract: Perivascular epithelioid cell neoplasms (PEComa) are rare mesenchymal tumor that can occur any part of body and have unpredictable biological behavior . They are usually benign but can be malignant. We present a case of MALIGNANT EPITHELIOID ANGIOMYOLIPOMA ,a type of malignant PEComa, an exceedingly rare diagnosis. We are reporting this case not only because of rarity but difficulty in diagnosis and management of this malignancy as till date there is hardly any standard guideline on its management........

Keywords:PEComa,epithelioid,angiomyolipoma,malignant.

[1]. Folpe AL, McKenney JK Li Z, Smith Smith SJ, Weiss SW. Clear cell myomelanocytic tumor of the thigh. Am J Surg Pathol. 2002;26(6):809-812
[2]. http://dx.doi.org/10.1097/00000478-200206000-00018.
[3]. Folpe AL, Mentzel T, Lehr H-A Fisher C, Balzer BL, Weiss SW. Perivascular epithelioid cell neoplasm of soft tissue and
gynecologic origin. Am J Surg Pathol. 2005;29(12):1558-1575. http://dx.doi.org?10.1097/01.pas.000017323222117.37.

[4]. Hornick JL, Fletcher CDM, PEComa: what do we know so far? Hispathology. 2006;48(1) 75-82. http://dx.doi.org/10.1111/j.1365-
2559.2005.02316.x.
[5]. Wagner Aj. Malinowska- Kolodziej I, Morgam JA, et al. Clinical activity of mTOR inhibition with sirolimus in malignant periavascular epithelioid cell tumors: targeting the pathogenic activation of mTORC1 in tumors. J Clin Oncol. 2010;28(5): 835-840.
http://dx.doi.org/10.1200/fCO.2009.25.2981.

Abstract: Diabetic poly neuropathy (DPN) is the most common chronic complication of type 2 diabetes. Aim of this observational cross sectional study is to establish correlation between level of TNF α and severity of DPN if any. The forty seven subjects were divided into three groups. Group1:15 healthy normal controls; Group2:12 T2DM patients without neuropathy controls; Group3:20 T2DM patients with painful neuropathy case. To measure TNF-α 5ml blood was drawn and centrifuged and then TNF-α measurement was done with Ray Bio Human TNF-α ELISA kit. Plasma TNF-α shows high correlation with progress of neuropathy; In early phases
of diabetes (group2) TNF-α shows a tendency to rise, which increases further with development of overt painful neuropathy (group3).

Keywords: Diabetic polyneuropathy, TNF-α, type-2 diabetes mellitus.

[1]. Kaveeshwar S A,Cornwall J.The current state of Diabetes Mellitus in India. Australas Med J. 2014; 7(1): 45–48.
[2]. Cameron N E, Cotter M A. Pro inflammatory mechanisms in diabetic neuropathy: focus on NFkB pathway. Current drug targets.
2008; 9:60-67.
[3]. Armati P J, Pollard J D. Immunology of Schwann cell.Bailliere's clin.neurol.1996;5:47-64.
[4]. Chalazonitis A, Rothman T P, Chen J, Gershon M D. Age-dependent differences in the effects of GDNF and NT-3 on the
[5]. development of Neurons and Glia from Neural Crest Derived Precursors Immunoselected from the Fetal Rat Gut : expression of
GFRalpha1 in vitro and in vivo. Devel.Biol.1998;204:385-406.

Abstract: Cerebrovascular disease represents an enormous burden of disease and disability to mankind. Intravenous thrombolysis with recombinant tissue plasminogen activator(rtpa) within 3hr of symptomonset is currently approved for treatment of acute ischaemic stroke. Though it is widely used in western countries, the use of IV(intravenous) thrombolysis in peripherally located hospital is still a problem because for its short window period of 3hr of stroke onset.Here we are reporting the first case of IV thrombolysis in RIMS with recombinant tissue plasminogen activator(rtpa) recently........

Keywords: Acute ischaemic stroke, Alteplase, IV thrombolysis

[1]. Mackay JMG, the atlas of heart disease and stroke (London, world stroke organization, 2004).
[2]. Aspland KSB, Peltonem M, From the twentieth to the twenty first century a public health perspective on stroke, in Ginsberg
MD(Ed),cerebrovascular diseasepathophysiology diagnosis and treatment(Maldem mass: Blackwell science, 1998).
[3]. Sylaja PN, Demchuk AM, Intravenous thrombolytic therapy in acute ischemic stroke : The art and science of treatment decision
making, Annals of Indian academy of neurology,11(5), 2008, 24-29.
[4]. NIH stroke scale, available at :http://www.ninds.nih.gov/doctors/nih stroke scale, Accessed on july 21, 2016.
[5]. Mahoney FI, Barthel D, Functional evaluation the Barthel index,Maryland state medical journal, 14, 1965, 56-61.

Abstract: Abdominal Tuberculosis includes tuberculosis infection of gastrointestinal tract, mesentery, lymph nodes and omentum, the peritoneum and related solid organs such as liver and spleen. The initial clinical presentations are nonspecific as the disease involves multiple sites with different morphology. No single laboratory investigation is pathognomonic. Radiology often fails to reveal the classical changes described in surgical textbooks. Bacterial culture and tissue histopathology though confirmatory are time consuming, and immunological tests though rewarding are expensive...........

Keywords: .....

.......

Abstract: The Skin on the Palmar and Plantar Surfaces is grooved by curious ridges, which form a variety of configurations. Each individual's ridge configurations are unique. The dermal ridge differentiations are genetically determined and influenced by environmental factors. It provides a simple, useful and inexpensive means for diagnostic value in several medical disorders for the last several decades.
The Surface of the skin and its deeper structures show over 35 different named linear markings. Papillary ridges (friction ridges) are confined to the palms, soles and the flexor surfaces of the digits...........

Keywords: ......

[1]. Dermatoglyphic study in type I diabetes mellitus saksena p.n. and thakur S. 1979
[2]. Evaluation of dermatoglyphics in juvenile diabetes Vera.M.,Cabrera E.,Guell R. 1995
[3]. Dermatoglyphic features in diabetes mellitus, Act paeditric Acad Soi Hung, L.V.Dzhanibekova , L.V. Lebeder N.B., Kurarva T.L
1994.
[4]. A.L.regoly merie,A,Kammererl 1978
[5]. European Association for Study of Diabetes (EASD). General Information of the EASD. http:/www.easd.org/customfiles/geninfo.htm.20042004

Abstract: Background: Studies have indicated the role of gonadal hormones in regulating structure and function of nearly every tissue and organ in the mammalian body,causing gender differences in a variety of characteristics. Objective of our study is to compare the gender differences in liver function tests in healthy individuals and to find the correlation between bilirubin and other liver markers.
Methodology: The retrospective study was conducted by collecting the data from the Clinical Biochemistry Laboratory..........

Keywords: Bilirubin, AST, albumin, gender differencey

[1]. Ivan S,AbdulRA,WolfgangEB,ChristophW,Andrew B,Gerhard B.Gender differences in kidney function.Eur J of Physiol
2007;455:397-429.
[2]. Philip Rosenthal,MatthewPincus,DanielFink.Sex- and Age-Related Differences in Bilirubin Concentrations in Serum.Clin
chem1984; 30(8): 1380-1382 .
[3]. MeraJR,DicksonB,FeldmanM.Influence of gender on the ratio of AST and ALT in patients without hyperbilirubinemias.Dig Dis Sci
2008;53(3):799-802.
[4]. Clark JM, Brancati FL, Diehl AM: The prevalence and etiology of elevated aminotransferase levels in the United States. The
American journal of gastroenterology 2003; 98(5):960-967.
[5]. Cotler S, Dhamija M, Luc B, Siqueira F, Bartram A, Layden T, Wong S: Theprevalence and clinical correlates of elevated ALT
levels in an urban Chinatowncommunity. Journal of Viral Hepatitis 2010;17(2):148-152.

Abstract: Context: Injury has been a constant companion of mankind since the times immemorial. Although the modern trauma care has scaled new heights vis-a vis the infrastructure and the technical expertise, trauma remains defiant and continues to pose a huge challenge to the modern society in view of ever increasing magnitude. Material and methods: A series of 100 patients admitted with blunt trauma abdomen over a period of one year in Government Medical College, Jammu was enrolled in the study design..........

Keywords: Blunt trauma, Abdomen, Visceral injury, Accident

[1]. Probst M. Early treatment of abdominal injury. Langenbecks Arch Chir, Suppl., Kongressbd, 1991: 84-87
[2]. 2 Kumar M M, Venkataramanappa M, Venkataratnam I., Kumar N V., Babji K. Prospective evaluation of blunt abdominal trauma
by computed tomography. Indian J Radiol Imaging 2005; 15:167-73
[3]. Lone G N, Peer G Q, Warn K A. et al. An experience with abdominal trauma in adults in Kashmir. J K Practitioner 2001; 8:225-
230.
[4]. Deodhar S D, Patel N P, Shah K B. et al. Blunt and penetrating abdominal injuries- a study of 51 cases. JPGM. 1983; 29:96-99.
[5]. Mohapatra S., Pattanayak S P., Rao KRRM., Bastia B. Options in the management of solid visceral injuries from blunt abdominal
trauma. Indian J Surg 2003;65:263-8.

Abstract: Background:Malnutrition and weight loss are prevalent among 20-80% of cancer patients, hence assessment of nutritional status and timely intervention curbs the mortality associated with the malnourishment of cancer. The scored PG-SGA has been accepted by the Oncology nutrition dietetic practice group of American Dietetic Association as the standard for nutritional assessment for patients with cancer. Objectives:1)To study the socio-demographic profile of the study population. 2)To assess the nutritional status
using anthropometry and PG-SGA score. 3)To identify the level of nutritional intervention required according to PG-SGA score..........

Keywords: Cancer patients, Malnutrition, Nutritional status, PG SGA Score

[1]. N khoshnevis, F Ahmadizar, M Alizadeh ,M E Akbari ,Nutritional assessment ofcancer patients in Tehran , Iran, Asian Pacific
Journal of Cancer Prevention, Vol 12,2012;13:1621-1629
[2]. J Bauer ,S Capra , M ferguson. Use of PG-SGA as a nutrition assessment tool inpatients with cancer. The Wesley research institute
,Brisbane, Australia. EuropeanJournal of Clinical Nutrition. 2002 Aug;56(8):779-85.
[3]. Breda Laky , Monica Janda ,Geoffrey Cleghorn ,Andreas Obermair, Comparison of different nutritional assessments & body
comparison measurements in detecting malnutrition amongGynecologic cancer patients. American Society for Clinical Nutrition
2008;87:1678-85.
[4]. ArribadL ,hurtos L ,Mila F, Fort E ,Peiro I , Predict factors associated with malnutrition from PG-SGA in head & neck cancer
patients. Nutrition Hospital 2013 Jan-Feb;28(1):155-63.
[5]. Isenring E, Bauer J, Capra S.The scored Patient-generated Subjective Global Assessment (PG-SGA) and its association with quality
of life in ambulatory patientsreceiving radiotherapy. European Journal Clinical Nutrition. 2003 Feb;57(2):305-9.

Abstract: Use of natural tooth (autologous or homologous) as pontic for resin bonded bridges in anterior region of jaws, present many advantages in cases where other treatment options are precluded due to poor economic condition of the patient. Two methods are used to connect the natural tooth pontic to abutments i.e. either by directly bonding the pontic to abutment teeth using composite resin, or by use of bonded metal framework to attach pontic to abutment teeth. In either case high long term failure rates are reported to be due
to inadequate retention & support to the pontic. A technique is illustrated to improve retention & support of natural tooth pontic in the following clinical report.

Keywords: Resin bonded bridges, Natural tooth pontic, Pontic support, Pontic retention.

[1]. Ibsen RL. Fixed prosthetics with a natural crown pontic using an adhesive composite: case history. J South Calif Dent Assoc
41:100, 1973.
[2]. Rochette AL. Attachment of a splint to enamel of lower anterior teeth. J Prosthet Dent 30; 418, 1973.
[3]. Ashley M, Holden V. An immediate adhesive bridge using the natural tooth. Br Dent J. 1998 Jan 10; 184(1):18-20.
[4]. Binkley TK, Noble RM, Wilson DC. Natural teeth pontic for a cast metal resin bonded prosthesis. J Prosthet Dent. 1986 Nov;
56(5):531-5.
[5]. Northeast SE, Van Noort R, Shaglouf AS. Tensile peel failure of resin bonded Ni/Cr beams: an experimental & finite element study.
J Dent. 1994 Aug; 22(4): 252-6.

Abstract: Introduction: Obesity is a global problem, epidemic in some areas and on the rise in others. One of the most important, yet preventable health hazards worldwide. Obesity causes a multitude of skin changes, which gives us clue of underlying obesity. These include acanthosisnigricans, acrochordons, striae distensae, keratosis pilaris, adiposis dolorosa, increased infections . Aim: To study the incidence of various dermatological manifestations seen in obese subjects and to correlate between the severity of obesity and skin changes.......

Keywords: obesity, acanthosis nigricans, BMI, skin tags, dermatophyte infections

[1]. James WPT,Reeds PJ.Nutrient partitioning.In :Bray GA ,Bouchard C,James WPT,editors.Handbook on obesity.New York:Marcel
Dekker,1997:555-571.
[2]. Pen a M,Bacallao J.Obesity and poverty.Washington:Scientific publication no.576.Pan American Health Organization,2000,41-49
[3]. Pi-Sunyer F.X: The obesity epidemic: pathophysiology and consequences of obesity.Obes Res10.(suppl 2):97S-104S.2002
[4]. Hud JA,Cohen JB ,Wagner JM,et al.Prevalence and significance of acanthosis nigricans in an adult obese population.Arch
Dermatol.1992;128:941-944.
[5]. Garcia –Hidalgo L, Orozco TR,Gonzalez-Barranco J,et al.Dermatoses in 156 obese adults.Obesity Research. 1999;7:299-302

Abstract: Back Ground: Estrogen is the sex hormone that causes the development and maintenance female secondary sexual characters. Post menopausal women increasing in vulnerable to depression due to the reduced estrogen production. The activity of estrogen on serotonin has anti depressant characteristics. A higher level serotonin activity is associated with Positive mood while decreased activity is associated with depressive mood. Estrogen boosts the activity of serotonin. Objectives: To determine the brain serotonin and its major metabolite 5HIAA in ovariectomized rats at different day intervals and after estradiol treatment..........

Keywords: .......

[1]. Weissman, M.M., ( 1996 ) Epiderminology of major , depression in women , presented at the American psychiatric association
annual meeting May 4, 1996 New York. Mc Ewen, B.S. ( 1999 )
[2]. The modular and neuroanatamical basis for estrogen effects in the central nervous system J Clin Endocrinol Metab, 84(6): 1790-
1797
[3]. Stefens, D.C., Norton , M.C., Plassman, B.L., Tschanzs, J.A., Wyse, B.W.,Welsh (1999 ) Enhanced Conginitive performance with
estrogen us in non demented community dwelling order women.
[4]. J.Am Gerials Soc.47 : 1171 -1175. Halbreich,U., Chakravarthy.S.G.(1997)
[5]. The influence of estrogen on monoamine oxidize activity. Psychopharmacholy Bull, 33: 227-33

Abstract: Introduction: Our study includes the comparision of post menopausal symptoms in rural and urban Indian women. Methods: Random sample of 400 females aged between 45-70 years in post menopausal period were taken as participants for the study. The rural sample was taken from different villages of Guntur district. The urban sample was taken from Guntur city in Andhra Pradesh. To measure the severity of post menopausal symptoms, MRS (Menopausal Rating Scale) is taken as the Health Related Quality of Life scale (HRQoL). MRS includes a structural questioner containing eleven post menopausal symptoms which are divided into three sub scales (somatic, psychological and urogenital).........

Keywords:Post menopausal symptoms, HRQoL, Rural health, MRS

[1]. Ganong's Review of Medical Physiology, 23rd edition, Pg.no.400.
[2]. Text book of Medical Physiology, Guyton and Hall, Eleventh edition, Pg.no. 1017.
[3]. Text book of Physiology, Prof. A.K.Jain, Third edition, Pg.no.825.
[4]. Perimenopausal and Postmenopausal Complaints in Paramedics Assessed by Menopause Rating Scale in Indonesia, Muhammad
Fidel Ganis Siregar1 1(Division of Reproductive Endocrinology and Fertility Medicine - Department of Obstetricss dan Gynecology Faculty of Medicine – University of Sumatera Utara, Indonesia) eISSN: 2279-0853, pISSN: 2279-0861. Volume 13,
issue 12 Ver.I (Dec 2014), PP 38-42.
[5]. Urban-rural differences in Spanish menopausal women. Martínez JA1, Palacios S, Chavida F, Pérez M. 1. Rural Remote Health.
2013 Apr Jun;13(2):1865. Epub 2013 May 2..

Abstract: Objective: This study was undertaken to describe and evaluate the outcome of trans-obturator tape (TOT) operation using Outside-In technique without cystoscopy. This procedure was carried out either solely or as a part of pelvic reconstructive surgery. Design: Retrospective cohort study with follow up objective and subjective assessment. Population: 84 women were presented with urodynamic stress incontinence at North Cumbria NHS Trust. They were treated with transoturator tape operation using outside-in technique between the years 2007 and 2008............

Keywords: MONARC technique, Stress Incontinence, TOT operation.

[1]. Delorme E (2001) Transobturator urethral suspension: mini-invasive procedure in the treatment of stress urinary incontinence in women. Prog Urol; 11:1306–1313
[2]. De Leval J (2003) Novel surgical technique for the treatment of female stress urinary incontinence: transobturator vaginal tape inside-out. Eur Urol; 44:724–730.
[3]. Whiteside JL, Walters MD (2004) Anatomy of the obturator region: relations to a trans-obturator sling. Int Urogynecol J Pelvic Floor Dysfunct;15:223–226.
[4]. David-Montefiore E, Frobert JL, Grisard-Anaf M, Lienhart J, Bonnet K, Poncelet C, et al (2006) Peri-operative complications and pain after the suburethral sling procedure for urinary stress incontinence: a French prospective randomised multicentre study comparing the retropubic and transobturator routes. Eur Urol;49:133–138
[5]. Naidu A, Lim YN, Barry C, Goodwin S, Corstiaans A, Rane A

Abstract: Objective: To compare the effectiveness of percutaneous catheter drainage (PCD) and percutaneous needle aspiration (PNA) in the management of medium to large (>5 cm diameter) sized liver abscesses. Method: Seventy-two patients with liver abscess (amoebic 48, pyogenic 24) were randomly allocated to PCD or PNA (36 each), which were done within 24 hours of admission. Both groups received parenteral antibiotics for atleast 10 days. PNA was repeated every third day if the cavity size had not declined to 50% of the original for up to three times..........

Keywords: Amebic liver abscess, Entamoeba histolytica, Pyogenic abscess of liver, Percutaneous catheter drainage,. Percutaneous needle aspiration

[1]. Sharma MP, Ahuja V. Management of amebic and pyogenic liver abscess. Indian J Gastroenterol 2001;20(Suppl 1):C33–6.
[2]. Thompson JE Jr, Forlenza S, Verma R. Amebic liver abscess: a therapeutic approach. Rev Infect Dis 1985;7:171–9.
[3]. Seeto RK, Rockey DC. Pyogenic liver abscess: changes in etiology, management and outcome. Medicine (Baltimore) 1996;75:99–
113.
[4]. Wong KP. Percutaneous drainage of pyogenic liver abscess. World J Surg 1990;14:492–7.
[5]. Rajak CL, Gupta S, Jain S, Chawla Y, Gulati M, Suri S. Percutaneous treatment of liver abscesses: needle aspiration versus catheter
drainage. Am J Roentgenol 1998;170:1035–9.

Abstract: Background: In the human history weight gain and fat storage has been viewed as signs of health and prosperity, but recent trend shows a shift in its prevalence from higher to lower socioeconomic level. Aim and Objective: To Describe Socio-Demographic Factors Related To Obesity In Rural Adult Population Of Namkum Block In Ranchi District. Material and Methods: Cross-sectional community based study was conducted at areas of Namkum Block of Ranchi District from September 2013 to December 2015. The adults who gave consent for the study were interviewed regarding the socio-demographic determinants (age, sex, education, marital status, occupation, income)..........

Keywords: Obesity, Socio demographic factors.

[1]. Pednekar MS.Association of body mass index with all cause and cause-specific mortality : Findings from a Prospective cohort
study in Mumbai,India.Int J Epidemiol 2008;37:524-535.
[2]. World Health Organization. Preventing chronic diseases: A vital investment. World Global Report. Geneva: 2005.
[3]. David W,Haslam,W Philip T James.Obesity.lancet 2005; 366 : 1197-1209.
[4]. Park K.Park's Textbook of Preventive and Social Medicine.19 th ed .Jabalpur,India: M/s Bananridas Bhanot publishers 2007: p.
332-335.
[5]. Obesity: preventing and managing the global epidemic. Technical Report SeriesNumber 894. Geneva; WHO: 2000

Abstract: Detection of chromosomal abnormalities in myelodysplastic syndromes enables classification according to WHO Classification and risk stratification according to IPSS and R-IPSS, providing physicians with data regarding personal therapy approach. Detection of the chromosomal abnormalities in our cohort study was performed with the method Multiplex Ligation-dependent Probe Amplification is similar to multiplex PCR reactions, but in this case the target-sequences are amplificated, but MLPA probes hybridized for themic..........

Keywords: chromosomal abnormalities , myelodysplastic syndromes, MLPA

[1]. Flandrin G. Classification of myelodysplastic syndromes, Atlas Genet Cytogenet Oncol Haematol. May 2002.
[2]. Bennett JM, Catovsky D, Daniel MT, et al. Proposals for the classification of the myelodysplastic syndromes. Br J Haematol. 1982; 51:189–199.
[3]. Vardiman JW, Thiele J, Arber DA, et al. The 2008 revision of the World Health Organization [WHO] classification of myeloid
neoplasms and acute leukemia: rationale and important changes. Blood 2009; 114:937–951.
[4]. 233. Greenberg P, Cox C, LeBeau MM, Fenaux P, Morel P, Sanz G, Sanz M, Vallespi T, Hamblin T, Oscier D, Ohyashiki K,
Toyama K, Aul C, Mufti G, Bennett J. International scoring system for evaluating prognosis in myelodysplastic syndromes. Blood.
1997; 89: 2079-2088.

Abstract: The caudate lobe of the liver is anatomically distinct from left and right hepatic lobes. Kumon first divided it into three parts: Spiegel lobe, paracaval portion and caudate process. The present study was conducted to note the extra hepatic branching pattern of PV and its distribution to various parts of caudate lobe and to note its variations. Eighty six cadaveric livers were studied. Number of branches from extra hepatic part of portal vein supplying different parts of caudate lobe, their origin from right branch (RPV) or left branch of portal vein (LPV) or from hilar bifurcation (HB) was noted. Their distribution to the parts of caudate lobe and diameter at origin was noted.........

Keywords: Caudate lobe, Portal vein, Spiegel lobe, Caudate process

[1]. Brown BM, Filly RA, Callen PW. Ultrasonographic anatomy of the caudate lobe. J Ultrasound Med; 1, 1982, 189-192.
[2]. Standring S. (Ed). Gray's Anatomy: the Anatomical basis of clinical practice(40thedn. London, UK:Elsvier ltd, 2008) 1165.
[3]. CouinadeC.Portal segmentation. In: Couinad C, (Ed). Controlled hepatectomies and exposure of the intrahepatic bile ducts(Paris:
1981) 9-27.
[4]. Kogure K, Kuwano H, Fujikama N, Makuuchi M. Relation among portal segmentation, proper hepatic vein and external notch of
the caudate lobe in the human liver. Annals of surgery 231(2),2000, 223-228.
[5]. Wen ZQ, Yan YQ, Yang JM, Wu MC.Precautions in caudate lobe resection: Report of 11 cases. World J Gastroenterol
14(17),2008, 2767-2770.

Abstract: Background: To compare onset and duration of analgesia and hemodynamic changes between 0.25% Ropivacaine and 0.25% Bupivacaine along with 25ug fentanyl in 60 patients, who underwent elective lower abdominal and lower limb surgeries. Aim: This study has been conducted to compare:  The onset and duration of postoperative analgesia & the hemodynamic changes Methods: Randomly divided into 2 groups, Group R and Group B, of 30 each..........

Keywords: 0.25% Bupivacaine with fentanyl 25 μg, 0.25% Ropivacaine with fentanyl 25 μg.

[1]. Pouzeratte Y, Brunat G, Boccara G, Vergne C, Jaber S, Fabre J.M Patient controlled epidural analgesia after abdominal surgery:-
ropivacaine versus bupivacaine Anesthesia Analgesia 2001;93: 1587 -92.
[2]. Casati A et al : Intraoperative epidural anesthesia and postoperative analgesia with levobupivacaine for major orthopedic surgery: a
double-blind, randomized comparison of racemic bupivacaine and ropivacaine. J Clin Anesth. 2003 Mar;15(2):126-31.
[3]. Brown DL, Carpenter RL, Thompson GE: Comparison of 0.5% ropivacaine and 0.5% bupivacaine for epidural anesthesia in
patients undergoing lowerextremity surgery. Anesthesiology. 1990 Apr;72(4):633-6.
[4]. Liu SS, Moore JM, Luo AM, Trautman WJ, Carpenter RL: Comparison of three solutions of ropivacaine/ fentanyl for postoperative
patient-controlled epidural analgesia. Anesthesiology. 1999 Mar;90 (3):727-33.
[5]. Brockway M.S, Bannister J, McClure JH, McKeown D, Wildsmith JA: Comparison of extradural ropivacaine and bupivacaine. Br J
Anaesth.1991 January; 66 (1) 31-7.

Abstract: Comparison Of Levobupivacaine And Clonidine With Bupivacaine And Clonidine In Spinal sthesia For Lower Segment Caesarean Section Introduction: Intrathecal Levo Bupivacaine is having similar clinical profile with less cardio-toxicity than
Bupivacaine is used commonly for LSCS. Clonidine as an additive to LA provides effective, prolonged and dose dependent analgesia. In this study we compared effect of intrathecal Clonidine 30 μg and 0.5% isobaric Levobupivacaine 9 mg with Clonidine 30 μg and 0.5% hyperbaric Bupivacaine 9 mg for LSCS...........

Keywords: Levobupivacaine , Bupivacaine , Clonidine, LSCS

[[1]. Miller RD, Eriksson LI, Fleisher LA, Wiener-Kronish JP, Young WL; Anaesthesia for Obstetrics. In Miller's Anaesthesia, 7th
edition, Chapter 69, Saunders; 2009.
[2]. Bajwa s s, Kaur J, Clinical profile of Levobupivacaine in regional anaesthesia: A systematic review. J Anesthesiology clin
pharmac0l 2013;29:530-9
[3]. Saxena AK, Arava SE., Current concepts in neuraxial administration of opioids and nonopioids: An overview and future
perspectives. Indian J Anaesth 2004;48:1324
[4]. U Bakshi, S Chatterjee.SSengupta, D Gupta, .Adjuvant drugs in central neuraxial analgesia-A Review. The Internet Journal of
Anesthesiology.2009 volume 26 Number1.
[5]. Chiari A, Lober C, Eisenach JC, Wildling E, Krenn C, Zavrsky A, et al. Analgesicand hemodynamic effects of intrathecal
Clonidine as a sole analgesic agent during First stage of labor: A dose response study Anesthesiology 1999;91:3889

Abstract: Alcohol dependence affects not only patient but its deleterious effects are extended to family members. They are most vulnerable to have significant psychiatric disorders. Aims: to investigate the quality of life and the frequency and nature of psychiatric morbidity in caregiver of patients with alcohol dependence. Material and method: The study was carried out at Psychiatry OPD, P.D.U. Medical College & Hospital, Rajkot. In this cross-sectional study, 110 patients between ages 18-65, having alcohol dependence as per
diagnostic criteria of DSM - V was studied. One caregiver of each patient was also studied...........

Keywords: alcohol dependence, caregiver, caregiver burden, psychiatric morbidity, quality of life.

[1]. Kaplan & Sadock's, Synopsis of Psychiatry, 10th ed. Lippincott Williams & Wilkins, 2007.
[2]. Caroline Dias, Psychiatric disorders in wives of alcohol dependence syndrome, IJP-2013.
[3]. Kishor, Lakshmi V. Pandit, R. Raguram, Psychiatric morbidity and marital satisfaction among spouses of men with alcohol
dependence, Indian J Psychiatry, 2013 Oct-Dec, 55(4): 360–365.
[4]. Fulkunishi, Alexithymia and depression in families with alcoholics; functioning; Clinical Psychology Review, 2003 December,
23(7): 959–997.
[5]. Tomelleri C J, Marijan Herjanic, Barbara L, Herjanic, Weztel R D, The wife of Alcoholics, Currents in Alcoholism,1978;1(4):29-
30..

Abstract: Traumatic pseudoaneurysm of subscapular artery is a rare sequlae of injury in the shoulder region. Only five cases are on report and none after World War II. This rarity of the lesion is due to the anatomic location of the artery4. We report a 21 years old patient transferred for torrential bleeding from the wound of entry, followed by appearance of progressively expanding, pulsatile, painful swelling, after three days of splinter injury sustained in right scapular region while working in the field. The diagnosis was confirmed by Doppler ultrasonography and computerized tomographic angiography.........

Keywords: Pseudoaneurysm, subscuplar artery, penetrating injury

[1]. Liston, R. : Ossified Aneurysmal Tumour of the Subscapular Artery. Edinburgh Med. & Surg. J., 16 : 66, 215, 1820
[2]. McGraw, T.A. : A Case of Traumatic Aneurysm of the Subscapular Artery. New York Med. J., 41 : 569, 1885.
[3]. Makins, George H. : Gunshot Injuries of the Blood Vessels, Bristol, John Wright & Sons, Ltd., 1919.
[4]. Robert A. Wise, Traumatic Aneurysm of the Subscapular Artery, Vol. 127, Number 3, Annals of Surgery, March 1958, pg. 569-
571.
[5]. B. Dympep, S. Khangarot & N. Hadke, An unusual presentation of traumatic pseudoaneurysm of axillary artery mimicking soft
tissue tumor, JSCR 2012 10:17, Pg1-4.

Abstract: Angiomyofibroblastoma (AMF) is a rare and benign soft tissue tumor that presents in the vulvovaginal area in women. Numerous entities such as Bartholin's cysts, aggressive angiomyxoma, cellular angiofibroma, fibroepithelial stromal polyps, and superficial myofibroblastoma can also develop in the female genital region and mimic AMF; distinguishing between these lesions can be difficult due to their morphologica similarities. Among the tumors mentioned, histological similarities add strain to AMF diagnosis. Furthermore, the immunohistochemical variability that exists within each discrete tumor category makes differentiation arduous. While challenging, it is necessary to diagnose these lesions accurately and hastily as the prognosis for each tumor differs and has influence on treatment measures.

Keywords: Angiomyofibroblastoma, benign mesenchymal tumor, immunohistochemistry, morphology, vulvar tumor

[1]. Fletcher C, Tsang W, Fisher C, Lee K, Chan J. Angiomyofibroblastoma of the Vulva. The American Journal of Surgical Pathology.
1992;16(4):373-382.
[2]. Magro, G, Salvatorelli, L, Vecchio, G, Caltabiano, R. Lipomatous angiomyofibroblastoma of the vulva: diagnostic and histogenetic
considerations. Pathologica. 2014;106(4):322-6.
[3]. Giannella, L., Costantini, M., Mfuta, K., Cavazza, A., Cerami, L., Gardini, G., & Boselli, F. Pedunculated Angiomyofibroblastoma
of the Vulva: Case Report and Review of the Literature. Case Reports In Medicine. 2011;2011:1-4.
http://dx.doi.org/10.1155/2011/893261.
[4]. Omori M, Toyoda H, Hirai T, Ogino T, Okada S. Angiomyofibroblastoma of the vulva: a large pedunculated mass formation. Acta
Medica Okayama. 2006;60(4):237-242.
[5]. Kumarapeli A, Paczos T, Azabdaftari G. Morphological and Immunohistochemical Features of Angiomyofibroblastoma: A Case
Report with Review of the Literature. N A J Med Sci. 2011;4(2):100.

Abstract: While not a new phenomenon, genital incarceration or strangulation is an infrequent urological emergency. Incarceration occurs due to constriction of the genitals by a device such as a metal ring, rubber ring, or rubber band. Localized edema, superficial ulcers, and skin loss are the most common complications of strangulation, but with prompt attention to the injury, patients can have an excellent prognosis. While the technique used to remove the constriction device varies, the urologist should act swiftly but prudently to decompress the genitals. Our case report discusses the epidemiology and anatomy of genital incarceratio by two metal cock rings, as well as a novel and safe approach, using the Midas Rex orthopedic drill, to remove the metal rings from the base of the patient's penis and scrotum.

Keywords: Genital incarceration, urological emergency, constriction device, decompression, how-to-guide

[1]. Detweiler, M. Penile incarceration with metal objects a review of procedure choice based on penile trauma grade. Scand J Urol
Nephr 2001, 35, 212-217.
[2]. Katz, D, Chin, W, Appu, S, Harper, M, et al. Novel extraction technique to remove a penilconstriction device. J Sex Med
(2012);9, 937-940.
[3]. Cassidy, D, & Mador, D. Genital incarceration: an unusual case report. Canadian Urological Association Journal 2010;4(3), E76-
E78.
[4]. Lopes, R. L., Lopes, S. I., & Lopes, R. N. Chronic penile strangulation. International Braz J Urol 2003; 29(4), 327-329
[5]. Silberstein, J, Grabowski, J, Lakin, C., et al. Case reports: Penile constriction devices. J Sex Med 2008; 5(7), 1747-1757

Abstract: Organophosphate compounds are a diverse group of chemicals used in both domestic and industrial settings. Their application is still the most effective and accepted means for the protection of plants from pests, and has contributed significantly to enhanced agricultural productivity and crop yields. Some have also been used in the medical treatment of various disease conditions. The common use of insecticides in public health and agricultural schedules has caused severe environmental pollution and potential health hazards including severe acute and chronic cases of human and animal poisonings. This cross-sectional study sought to determine the prevalence of organophosphate poisoning among the community living around Kericho County Hospital...........

Keywords: Intravaginal Misoprostol, Extra-amniotic Ethacridine lactate, mid-trimester abortion

[1]. KM Mogda, Afaf AI El-Kashoury, MA Rashed, KM, Nature and Science, 2009
[2]. Claudia Bolognesi. Mutation Research, 2003
[3]. Jan L De Bleeker, Jacques L De Reuck, Jan L Willems. Clinical Neurology and Neurosurgery, 1992
[4]. https://en.wikipedia.org/wiki/Organophosphate
[5]. https://en.wikipedia.org/wiki/Organophosphate_poisoning