iosr-JDMS   Volume-16 ~ Issue-11 ~ November-2017

Abstract: Patients with arterial hypertension generally exhibitexcessive pressor response to stresssuch as laryngoscopy ,intubation,surgical incision and extubation, which can lead to arrhythmias, myocardial ischemia and cerebrovascular accidents. Exchange extubation with LMA Supreme can be used to vercome or blunt the excessive pressor response following extubation.This study was aimed to compare the hemodynamic stress response between traditional awake extubation of the endotracheal tube (ETT) and that following exchange extubation of ETT by using a laryngeal mask airway (LMA Supreme) in terms of Post Extubation Heart Rate (H.R), Systolic Blood Pressure (S.B.P), Diastolic Blood Pressure (D.B.P), Mean Arterial Pressure (MAP) , to determine whether this method is easy to perform, the amount of experience needed to perform the exchange well and to calculate the time delay.......

Keywords –Exchange extubation, pressor response, LMA Supreme.

[1]. Cook TM, Scott S, Mihai R. Litigation related to airway and respiratory complications of anaesthesia: An analysis of claims against
the NHS in England 1995-2007. Anaesthesia. 2010; 65:556–63.
[2]. Mhyre JM, Riesner MN, Polley LS, Naughton NN. A series of anesthesia-related maternal deaths in Michigan, 1985-2003.
Anesthesiology. 2007; 106:1096–104.
[3]. Auroy Y, Benhamou D, Péquignot F, Bovet M, Jougla E, Lienhart A. Mortality related to anaesthesia in France: Analysis of deaths
related to airway complications. Anaesthesia. 2009; 64:366–70.
[4]. Nair I, Bailey PM. Use of the laryngeal mask for airway maintenance following tracheal extubation. Anaesthesia. 1995; 50:174–5.
[5]. Costa e Silva L, Brimacombe JR. Tracheal tube/laryngeal mask exchange for emergence. Anesthesiology. 1996; 85:218.-.

Abstract: The umbilical cord which is the life line of the fetus undergoes a lot of developmental changes during the course of pregnancy which include changes in length, diameter and coiling.Based on the length and number of coils a parameter known as "Coiling index" was derived. Knowing the normal coiling index was beneficial as abnormal coiling indices were found to be associated with adverse perinatal outcomes[10] and awareness of the coiling indices of a population would serve as risk predictors.

Keywords: (Umbilical cord, coiling index,ponderalindex )

[1]. Gupta S, Faridi MMA, Krishnan J. Umbilical Coiling Index. J. ObstetGynecol India. 2006;56(4):315–19.
[2]. Edmonds HW. The spiral twist of normal umbilical cords in twins and singlestone. Am. J. Obstet Gynecol. 1954;67:102– [PubMed]
[3]. Strong TH, Jarles DL, Vega JS, Feldman DB. The umbilical coiling index. Am. J. Obst. Gynecol Part I. 1994;170(1):29–PubMed]
[4]. Larco RV, Jones KL, Benirschke K. The umbilical cord twist : origin, directions, and relevance. Am. J. ObstetGynaecol, Part I. 1987;157(4):833–38.
[5]. Ercal T, Lacin S, Altungyurt S, et al. Umbilical coiling index : is it marked for foetus at risk? Br J ClinPract. 1996;50:254– [PubMed].

Abstract: Background: Every year 70% of neonatal deaths take place because simple yet effective interventions do not reach the needy.
Objective: To study the pre-admission factors affecting neonatal outcome. Materials And Methods: This was a hospital based study of 500 neonates admitted to NICU at Niloufer Hospital for Children, Osmania Medical College, a tertiary care centre. Results: Among the 500 neonates, only 66% of the babies were stabilized prior to referral. Referral letter was given for 82% referrals and only 10% were accompanied by trained paramedic or doctor. Ninety four percent (94%) were brought without proper warm care. At admission 60% were hypothermic, 50% hypoxemic, 10% hypoglycemic and 26% babies had prolonged capillary filling time..............

Keywords: Danger signs, Neonatal mortality, Pre referral stabilization, Transport, Warm care

[1]. Siddhartha Gogia, Siddharth Ramji, Piyush Gupta, Tarun Gera, Dheerajshah, Joseph L Mathew et al Indian Pediatrics 2011:48;537-46.
[2]. SRSBulletinhttp://www.censusindia.gov.in/vital_statistics /Vital Rates/Vital_rates.aspx.
[3]. World health organization; managing newborn problems; 2003.
[4]. Baqui AH, Darmstadt GL, Williams EK; Rates, timing and causes of neonatal deaths in rural India: implications for neonatal health programs. Bulletin WHO 2006: 706-713.
[5]. NNFclinicalpracticeguidelines.http://www.nnfi.org/images/pdf/nnf_cpg_consolidated_filejanuary102011. pdf

Abstract: Suicide refers to an act by which person wishes to be dead, intents to die, and weather directly or through the actions of another person, he or she acts to achieve own death. The study is aimed to provide more insight about fatalities resulting from suicides among females in and around Kurnool district, Andhra Pradesh. A Retrospective descriptive study was done over the period of one year at Department of Forensic Medicine, Kurnool Medical College, Kurnool on females suicidal deaths. Cause of Death and Timing of death were reported and recorded in files after completing autopsy.............

Keywords: Females, Suicidal deaths

[1]. M.Brown,K.Comtois, M.Linehan, Reasons for suicide attempts and nonsuicidal self-injury in women with borderline personality disorder, Journal of Abnormal Psychology,111(1),2002,198–202
[2]. Suicide prevention (SUPRE) World Health Organization (2012).
[3]. Suicides in India. The Registrar General of India, Government of India (2012).
[4]. ADSI 2012 Annual Report Glossary, Government of India.

[5]. PS.Yip, KY.Liu, The ecological fallacy and the gender ratio of suicide in China, Br J Psychiatry,189,2006,465–6.
[6]. SS.Canetto, D.Lester, The epidemiology of women's suicidal behavior. In: Canetto SS, Lester D, editors. Women and Suicidal Behaviour, New York: Springer Publication, 10,1995,35–57.

Abstract: Mortality due to sudden out-hospital cardiac arrest is common and has become health care problem worldwide.Emergency medical system is expected to implement five chains of survival effectively. The continuous PAROS (Pan Asian Resuscitation Outcome Study) has showed variation in pre-hospital service. Thus, there are room for improvement in pre-hospital service system. Eventually, mortality due to out-hospital cardiac arrest can be reduced. The objective of this study is to identify pre-hospital factors affecting survival time in cardiac arrest patients and to analyze the impact of survival time in hospital equipped with EMS (emergency medical services) and non-EMS hospital. This study was an observational analytic study with cross sectional approach. The data were taken from...........

Keywords: sudden cardiac arrest, Prehospital, initial heart rhytm, survival time

[1]. Adrian, Puttgen 2011, ' Predicting neurological outcome following cardiac arrest', Journal of the Neurological Sciences, vol 26, no 4, pp. 108 - 117 [2]. Axelsson, C., Claesson, A., Engdahl, J., Herlitz, J.,Hollenberg, J., Lindqvist, J., Rosenqvist, M. and Svensson, L., 2012. Outcome after out-of-hospital cardiac arrest witnessed by EMS: changes over time and factors of importance for outcome in Sweden. J.Resuscitation, 83(10), pp.1253-1258.
[3]. Berdowski, J, Beekhuis, F, Zwinderman, AH, Tijssen, JG & Koster, RW 2009, 'Importance of the first link description and recognition of an out-of-hospital cardiac arrest in an emergency call': Sytematic review of 67 prorpective studies. J. Circulation, vol. 119, no. 15, pp. 2096-102.
[4]. Berg, RA, Hemphill, R, Abella, BS, Aufderheide, TP, Cave, DM, Hazinski, MF, Lerner, EB, Rea, TD, Sayre, MR & Swor, RA 2010, 'Part 5: Adult basic life support 2010 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care', Circulation, vol. 122, no. 18 suppl 3, pp. S685-S705.
[5]. Bobrow, BJ, Zuercher, M, Ewy, GA, Clark, L, Chikani, V, Donahue, D, Sanders, AB, Hilwig, RW, Berg, RA & Kern, KB 2008, 'Gasping during cardiac arrest in humans is frequent and associated with improved survival', J. Circulation, vol. 118, no. 24, pp. 2550-4.

Abstract: Preeclampsia is an idiopathic obstetric disease affecting almost 5% of pregnant women with variable visual disability, being retinal detachment a rare complication. This is a case report of 29 years old primigravida with eclampsia and HELLP syndrome (Hypertension, elevated liver enzymes and low platelets) presented with bilateral serous retinal detachment in the puerperium stage in the absence of preexisting hypertensive retinopathy. Under conservative management, bilateral retinal detachment resolved subsequently
with good visual improvement. This case showed good clinical outcome of serous retinal detachment in eclampsia with HELLP syndrome clinically managed.

Keywords: Preeclampsia, eclampsia, HELLP syndrome, serous retinal detachment(SRD)

[1]. Schonfeld CL. Bilateral exudative retinal detachment in HELLP syndrome. Case Rep Ophthalmol2012 Jan;3(1):35-7.
[2]. Vigil-De Gracia P, Ortega-Paz L. Retinal detachment in association with preeclampsia, eclampsia and HELLP syndrome. Int J
GynecolObstet 2011;114:223–5.
[3]. Sibai BM, Ramadan MK, Usta I, Salama M, Mercer BM, Friedman SA. Maternal morbidity and mortality in 442 pregnancies with
haemolysis, elevated liver enzymes, and low platelets (HELLP syndrome). Am J ObstetGynecol 1993;169:1000-6

[4]. Gundlach E, Junker B, Gross N, Hansen LL, Pielen A. Bilateral serous retinal detachment. Br J Ophthalmol 2013;97:939-940.
[5]. Celik G, Eser A, Gunay M, Yenerel NM. Bilateral vision loss after delivery in two cases: severe preeclampsia and HELLP
syndrome. Turk J Ophthalmol2015 Dec;45(6):271-3.

Abstract: Mental stress in medical students is a global phenomenon. In the present study searching for any indirect effect of mental stress we measured mental stress level through SRQ 20 and also the resting pulse rate , BP and ECG tracings of 158 medical students (cases) and 165 students pursuing non professional academic courses (controls),all of whom were found healthy through detailed clinical examination. We then allowed them to exercise on bicycle ergometer with maximal speed for 30 minutes. We again measured pulse rate BP and ECG tracings 5 minutes after exercise. There were significant increases in pulse rate, BP and decrease in RR intervals in ECG in both cases and controls post exercise, but there was significant increase in pre & post exercise pulse rate, BP & decrease in RR intervals in cases............

Keywords: Mental Stress, SBP, DBP, Pulse rate, RR interval

[1] Jenny Firth: Levels and sources of stress in medical students. British Medical Journal, 1986, Vol. 292,
1177-80.
[2] Bramness JG, Fixdal TC, Vaglum P: Effect of medical school stress on the mental health of medical
students in early and late clinical curriculum. Acta Psychiatr Scand. 1991; 84(4):340-5.
[3] Ratana Saipanish: Stress among medical students in a Thai medical school. Medical Teacher, 2003, Vol.
25, No. 5,502-506.
[4] Amritha K, Srikanth S, Srivatsa VG, Thirunaaukarasu, Susiganeshkumar E: Stressful life events– Effect
on mental health of medical students.
[5] Indian journal of medical specialities,May,2013(online).

Abstract: To study the rate of recurrence of pterygium and compare different surgical modes of treatment for primary pterygium

Keywords: Primary pterygium
• Conjunctiva
• Surgical techniques
• Recurrence.

[1] Cornea krachmer Holland and Mannis 3rd edition
[2] parsons diseases of the eye 22nd edition chapter 14 page 184
[3] Albert jackobiecs principles and practice of ophthalmology vol I ,3rd edition,page 886.
[4] Yanoff & Duker ophthalmology 4th edition chapter 4.9 page 204

Abstract: This study was conducted to assess medical prescriptions andprescribing pattern inpatients of bronchial asthma in Chest – TB department. It was prospective, cross sectional, observational study. Data of first 200 eligible consecutive prescriptions during 3 months were considered.About 26% prescriptions were lacking patient's diagnosis so effort must be made to encourage writing complete prescription with diagnosis. Dose and duration were quoted in more than 90% of prescriptions as dose and duration of drug treatment is saved and auto-generated in HMIS system. Hence..............

Keywords: Anti-asthmatic drugs,Drug utilization studies, Global Initiative for Asthma guidelines,Rational drug use, WHO drug use indicators

[1]. Introduction to drug utilization research, WHO, 2013. Available at http://www.whocc.no/filearchive/publications/drug_utilization_research.pdf. [Accessed 07 January 2017].
[2]. Rajathilagam T, Sandozi T, Nageswari AD, Paramesh P, Jamunarani R. Drug utilisation study in bronchial asthma in a tertiary care hospital. International Journal of Pharmaceutical Applications. 2012; 3(2): 297 – 305.
[3]. Chesnutt MS, Gifford AH, Prendergast TJ. Asthma. In: Current Medical Diagnosis and Treatment 49th edition.McGraw-Hill, 2010; 216–240.
[4]. PandeyA, Tripathi P, Pandey RD. Prescription pattern in asthma therapy at Gorakhpur hospitals. Lung India. 2010;27: 8-10.
[5]. Global Initiative for Asthma. Global strategy for asthma management and prevention: NHLBI/WHO workshop report. Bethesda, MD:National heart, lung, and blood institute, 2006

Abstract: It is essential to exclude underlying meningitis in all children with febrile seizures (FS) either clinically or if uncertain by lumbar puncture (LP) because majority of such cases of meningitis are bacterial in origin and delay in diagnosing meningitis can result in serious neurological morbidity and mortality. This study was conducted with the primary objective of finding out the incidence of acute bacterial meningitis (ABM) and to determine the role of the Cerebrospinal fluid (CSF) in differentiating ABM from first simple febrile seizure (FSFS) in children between 3and 12 months. During the study period a total of 115 infants and young children between 3 to 12 months were brought consecutively............

Keywords: Fever with first time seizures, Lumbar Puncture, Meningitis

[1]. RFM. Chin, BGR. Neville, RC. Scott, Meningitis is a common cause of conclusive status epilepticus with fever. Arch Dis Child, 90,2005,66-69.
[2]. A.Fetviet, Assessment of febrile seizures in children. Eur J Pediatr, 167, 2008,17-27.
[3]. K.Armon, T.Stephenson, R.Macfaul, P.Hemingway, U.Werneke, S.Smith, An evidence and consensus based guideline for the management of a child after a seizure, Emerg Med J, 20,2003,13-20.
[4]. Steering committee on quality improvement and management, Subcommittee on Febrile seizures, American Academy of Pediatrics, Febriles seizures: clinical practice guideline for the long-term management of the child with simple febrile seizures, Pediatrics,121,2008,1281-6.
[5]. National Institute of Health. Febrile seizures: long term management of children with fever associated seizures. Pediatrics,66,1980,1009-12.

Abstract: Introduction: Cancer is a disease characterized by the unchecked division and survival of abnormal cells. When this type of abnormal growth occurs in the colon or rectum, it is called colorectal cancer. Colorectal cancer (CRC) is a formidable health problem worldwide¹. It is the third most common cancer in men (663000 cases, 10.0% of all cancer cases and the second most common in women (571000cases, 9.4% of all cancer cases²............

Keywords: colorectal cancer, annual incidence rate, anemia

[1]. Colorectal Cancer Facts & Figures 2017-2019-American cancer society
[2]. CONSENSUS DOCUMENT FORMANAGEMENT OFCOLORECTAL CANCER -2014
[3]. Jemal A, Bray F, Center MM, Ferlay J, Ward E,Forman D. Global cancer statistics. CA Cancer JClin 2011;61:69-90.
[4]. Kamangar F, Dores GM, Anderson WF. Patterns of cancer incidence, mortality, and prevalence across five continents: defining priorities to reduce cancer disparities in different geographic regions of the world. J Clin Oncol.2006;24:2137-2150
[5]. GLOBOCAN 2008 (http://globocan.iarc.fr/factsheets/cancers/colorectal.asp) (2008).

Abstract: Worldwide, approximately 65,000 children aged under 15 years develop T1DM each year. Objective: To identify & describe the frequency and severity of DKA & clinical profile at diagnosis of type 1 diabetes mellitus in children in our hospital. Material &Methods: It is a hospital based retrospective study done during January 2015 to January 2017,in children admitted in paediatric intensive care at niloufer hospital attached to Osmania medical college , Hyderabad. Results: Out of 70 children admitted during 24months period, females were 44 (64%), 42(60%) were <10 years of age and 56 (80%) were of rural background. 68% of children had DKA at diagnosis of Diabetes mellitus-1. Among the 70 admitted patients 66 (94%) improved and were discharged..............

Keywords: Cerebral edema, DKA ,Ketoacidosis, Sick day guidelines , type 1diabetes mellitus

[1]. Szypowska, A. & Skórka, A. The risk factors of ketoacidosis in children with newl diagnosed type 1 diabetes mellitus. Pediatr. Diabetes 12, 302–306 (2011).
[2]. Curtis JR, To T, Muirhead S, Cummings E, Daneman D. Recent trends in hospitalization for diabetic ketoacidosis in Ontario children. Diabetes Care. 2002; 25:1591e1596.3.
[3]. Edge JA, Ford-Adams ME, Dunger DB. Causes of death in children with insulin dependent diabetes 1990e96. Arch Dis Child. 1999;81:318e323
[4]. Usher-Smith, J. A., Thompson, M., Ercole, A. & Walter, F. M. Variation between countries in the frequency of diabetic ketoacidosis at first presentation of type 1 diabetes in children: a systematic review. Diabetologia 55, 2878–2894 (2012).
[5]. Vanelli M, Chiari G, Ghizzoni L, et al. Effectiveness of a prevention program for diabetic ketoacidosis in children. An 8-year study in schools and private practices. Diabetes Care. 1999; 22(1):7-9.

Abstract: The occurrence of foreign bodies in air and food passages is an emerging problem both in adults & children. It has got a lot of significance as such accidents continue to take formidable toll of lives every year. To manage and prevent this critical problem an appropriate survey of cases is necessary. Hence this study is taken up to highlight age incidence, sex relation, type and site of foreign body, clinical features, radiological findings, complications and management strategies used in patients of foreign body ingestion and inhalation. Methods: A prospective clinical study of 50 cases of foreign bodies in aerodigestive tract was taken up over a period of one and half year. Careful history was taken from each patient. Appropriate examinations and radiological evaluation were performed. Details regarding age incidence of foreign bodies, sex relation, type and site of foreign bodies, clinical presentation, various investigations, modes of treatment given, post-operative complications were noted...............

Keywords: Foreign Body, Aerodigestive tract

[1]. Biswas B, Datta R. Retained oesophageal foreign bodies — report of three cases.Indian J Otolaryngol Head Neck Surg. 1999;51(Suppl 1):15–18.

[2]. Murty PSN, Ingle VS, Ramakrishna S, Shah FA, Varghese P. Foreign bodies in the upper aero-digestive tract. J Sci Res Med Sci. 2001; 3(2): 117–120.
[3]. Evans JNG: Foreign Bodies in the Larynx and Trachea. In: Scott Brown's Otolaryngology. Vol. 6. 6th Ed., 1997:438-48.

[4]. Kaur K, Sonkhya N. Bapna AS. Foreign bodies in the tracheobronchial tree: A prospective study of fifty cases. Indian Journal of Otolaryngology and Head and Neck Surgery. 2002;54(1):30–34.
[5]. Ikenberry SO, Jue TL, Anderson MA, Appalaneni V, Banerjee S, Menachem TB et al. Management of ingested foreign bodied and food impactions. Gastrointest Endosc 2011;73(6):1085-91.

Abstract: It is a cause of concern for the patient and physician alike even in the absence of symptoms. In India and some other developing countries, tuberculosis (TB) is the first differential diagnosis for a patient who presents with chronic lymph node enlargement. Nonetheless, studies have shown that more than 50% of cases of lymphadenopathyare due to non-TB causes and, in these cases, excision biopsy (EB) with histopathology and/or microbiological examination, is the only way to exclude TB. Malignancies may account for about 1% of cases of Lymphadenopathy. 40yr female presenting to respiratory medicine OPD in Motilal Nehru Medical College, Allahabad with complaints of right sided submandibular swelling............

Keywords: Tuberculosis, Lymph node, Submandibular, Muco-epidermoid

[1] Califano J, Eisele DW. Benign salivary gland neoplasms. OtolaryngolClin North Am. 1999;32:861–873.[PubMed]

[2] Luna MA. Salivary glands. In: Pilch BZ, editor. Head and neck surgical pathology. Philadelphia: Lippincott Williams & Wilkins; 2001. pp. 284–349.

[3] Morita N, Miyata K, Sakamoto T, Wada T. Pleomorphic adenoma in the parapharyngeal space: report of three cases. J Oral Maxillofac Surg. 1995;53:605–610. [PubMed]

[4] Vicente OP, Marques NA, Aytes LB, Escoda CG. Minor salivary gland tumors: a clinicopathological study of 18 cases. Med Oral Patol Oral Cir Bucal. 2008;13(9):582–588. [PubMed]

[5] Sergi B, Limongelli A, Scarano E, Fetoni AR, Paludetti G. Giant deep lobe parotid gland pleomorphic adenoma involving the parapharyngeal space. Report of three cases and review of the diagnostic and therapeutic approaches. ActaOtorhinolaryngol Ital. 2008;28:261–265. [PMC free article] [PubMed]

Abstract: Paratubal cysts represent remnants of the paramesonephric or mesonephric ducts. Among the two remnants, paramesonephric duct is more common. They are generally also called as "hydatid cyst of morgagni". Cyst is usually small, round, blind cyst attached by a pedicle to the fimbriated end of the fallopian tube. Case report: 15 year old girl presented to opd with h/o mass per abdomen, evaluation showed intra-abdominal tumor and was underwent laparotomy. Histopathology report showed Paratubal cyst. The case report here describes about the giant Paratubal cyst with review of literature. Conclusion: Paratubal cysts can become extremely big before causing.............

Keywords: Paratubal cysts, Hydatid Cyst Of Morgagni

[1]. Azzena A, Quintieri F, Salmaso R. A voluminous paraovarian cyst. Case report. Clin Exp Obstet Gynecol 1994;21(4):249-252
[2]. Barloon TJ, Brown BP, Abu-Yousef MM, Warnock NG. Paraovarian and paratubal cysts: preoperative diagnosis using transabdominal and transvaginal sonography. J Clin Ultrasound 1996;24(3):117- 122

[3]. Leanza V, Coco L, Genovese F, et al. Laparoscopic removal of a giant paratubal cyst complicated by hydronephrosis. Il Giornale di Chirurgia. 2013;34(11-12):323-325.
[4]. Kiseli M, Caglar GS, Cengiz SD, Karadag D, Yilmaz MB (2012). "Clinical diagnosis and complications of paratubal cysts: Review of the literature and report of uncommon cases.". Arch Gynecol Obstet 285: 1563–69. doi:10.1007/s00404-012-2304-8.

[5]. Darwish AM, Amin AF, Mohammad SA. Laparoscopic Management of Paratubal and Paraovarian Cysts. JSLS : Journal of the Society of Laparoendoscopic Surgeons. 2003;7(2):101-106.

Abstract: The current study highlight the main findings in lower limb arteries diagnosed by Computerized Tomography angiography CTA and Magnetic Resonance Angiography MRA done for Saudi Arabia populations whom were affected with diabetes, smokers and hypertension and what is the artery which were diagnosed better by CTA and which was better diagnosed by MRA. Next, to review the properties of different visualization techniques for extracting the relevant findings finally, discuss the practical application of CT and MR angiography within the context of various conditions. 100 consecutive patients in both genders were enrolled..............

Keywords: Peripheral arterial disease; Computed tomographic angiography; MRA

[1]. G Roditi and D Kusumawidjaja,Magnetic resonance angiography and computed tomography angiography for peripheral arterial disease Imaging, 21 (2009), 85–108
[2]. Martin ML, Tay KH, Flak B, Fry PD, Doyle DL, Taylor DC, et al. Multidetector CT angiography of the aortoiliac system and lower extremities: a prospective comparison with digital subtraction angiography. AJR Am J Roentgenol 2003;180:1085–91.
[3]. Amy W. Pollak, Patrick Norton, and Christopher M. Kramer, Multimodality Imaging of Lower Extremity Peripheral Arterial Disease: Current Role and Future Directions Circ Cardiovasc Imaging. 2012 November 1; 5(6): 797–807.

[4]. American Heart Association. Heart Disease and Stroke Statistics—2004. 2004; Dallas.

[5]. Prevalence of and risk factors for peripheral arterial disease in the United States. Results from the National Health and Nutrition Examination Survey, 1999–2000. Circulation. 110: 2004; 738-743.

Abstract: Langerhans'cellhistiocytosis (LCH) (Histiocytosis X) is a rare disease of unknown cause characterized by oligoclonal proliferation of Langerhans cells. It occurs mostly in children and young adults and involves one or more body systems such as bone, hypothalamus, posterior pituitary gland, lymph nodes, liver or various soft tissues. Owing to the relative rarity of the condition, it remains a disease in which the diagnosis is often delayed or missed and in which many questions remain unanswered, ranging from etiology and pathogenesis to therapy. This case report would increase the awareness of pediatric dentists about the dental manifestations and multisystem involvement in LCH. Key Words: LCH, histiocytes, Punched out lesions of bones..............

[1]. Komp DM. Historical perspectives of Langerhans cell histiocytosis. HematolOncolClin North Am. 1987 Mar. 1(1):9-21.

[2]. Merad M, Ginhoux F, Collin M. Origin, homeostasis and function of Langerhans cells and other langerin-expressing dendritic cells. Nat Rev Immunol. 2008 Dec. 8(12):935-47.

[3]. Egeler RM, van Halteren AG, Hogendoorn PC, Laman JD, Leenen PJ. Langerhans cell histiocytosis: fascinating dynamics of the dendritic cell-macrophage lineage. Immunol Rev. 2010 Mar. 234(1):213-32.

[4]. Satter EK, High WA. Langerhans cell histiocytosis: a review of the current recommendations of the Histiocyte Society. PediatrDermatol. 2008 May-Jun. 25(3):291-5.

[5]. Egeler RM, Favara BE, van Meurs M, Laman JD, Claassen E. Differential In situ cytokine profiles of Langerhans-like cells and T cells in Langerhans cell histiocytosis: abundant expression of cytokines relevant to disease and treatment. Blood. 1999 Dec 15. 94(12):4195-201

Abstract: The aim of the study was to assess the microleakage level and subsequent resin tag formation of various luting agents used to lute inlays. Methodology:Standardized cavity preparation with 4mm length, 3mm width and 1.5mm depth were prepared on buccal surface, 2mm above and 2mm below the cementoenamel junction. Impression of the prepared cavity was made with poly vinyl siloxane and inlay was made in the laboratory. Then the inlay was cemented and the following groups were made: Group 1: total etch, bond, lute with Rely X ARC. Group 2: enamel etch, lute with Rely X U100, Group 3: total etch, bond, lute with Rely X U100.............

Keywords: Enamel etch, total etch, resin tag, microleakage

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[3]. Indirect resin composites Nandini S - J Conserv Dent [Internet]. [cited 2017 Oct 11]. Available from:
http://www.jcd.org.in/article.asp?issn=0972-0707;year=2010;volume=13;issue=4;spage=184;epage=194;aulast=Nandini
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Abstract: The facial region has both functional and aesthetic units. Trauma to the facial region may corrupt any of these units, causing aesthetic as well as functional difficulties. The facial region also has an important role in the upper airway tract, and it must also be evaluated after facial injuries. Violent assaults, motor vehicle accidents and sports injuries may cause panfacial fractures that affect the lower, middle and upper part of the face. Post-traumatic deformities if not treated after healing, are among the most formidable challenges faced by the surgeons, apart from the psychological impact on the patients. Proper facial projection and height must be re-established with harmonious occlusion & Symmetry. This paper deals with a case report of the useful techniques for the correction of malunited panfacial fracture that we treated in two stages; firstly the refracture & reduction of the fracture fragments and secondly correction of residual orbital floor deformity by calvarium bone grafts.

Keywords: calvarium, infraorbital, mandible, orbital floor, panfacial fracture, zygomatic arch

[1]. Usha Asnani et al. Panfacial Trauma - A Case Report. International journal of dental clinics 2010:2 (2): 35-38.
[2]. Dongmei He et al. Panfacial Fractures: Analysis of 33 Cases Treated Late. American Association of Oral and Maxillofacial Surgeons. J Oral Maxillofac Surg 65:2459-2465, 2007.
[3]. Lalitha Ramanujam et al. Panfacial fractures—A retrospective analysis at M.S. Ramaiah Group of Hospitals, Bangalore. Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology 25 (2013) 333–340.
[4]. William Curtis. Panfacial Fractures An Approach to Management. Oral Maxillofac Surg Clin North Am. 2013 Nov; 25(4):649-60.
[5]. Michael A. Fritz, Md, peter j. Koltai, Md. Sequencing and organization of the repair of panfacial fractures operativetechniques in otolaryngology-head and neck surgery, vol 13, no 4 (Dec), 2002: pp 261-264.