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

Abstract: Background: Diabetic nephropathy remains major cause of morbidity & mortality for persons with either Type l or type2 DM.1 India leads the world with largest number of diabetic subjects earning the dubious distinction of being termed the "diabetes capital of the world". Patients with type 2 diabetes comprise the largest and fastest growing single disease group requiring renal replacement therapy (nearly 50-60% of diabetic subjects receiving renal replacement therapy.2 In the past few years, numerous studies have shown that low-grade inflammation is associated with the risk of developing type 2 DM.3 Several recent studies have also shown that patients with type 2 DM and overt nephropathy exhibit high levels of diverse acute phase markers of inflammation, including C-reactive protein (CRP), serum amyloid A, fibrinogen, and IL-64,5,6,7,8 This study Was undertaken to investigate the role of subclinical inflammation in the pathogenesis of diabetic nephropathy by evaluating the association between the serum High-sensitivity CRP (HS-CRP) (marker of inflammation) and urinary albumin to urinary creatinine ratio..........

[1]. Beaglehole R, Yach D: Globalisation and the prevention and control of non-
[2]. communicable disease: The neglected chronic disease of adults. Lancet 362:
[3]. 1763-1764, 2003
[4]. Yach D, Hawkes C, Gould C, Hofman K: The global burden of chronic
[5]. diseases: Overcoming impediments to preventionand control. JAMA 291:
[6]. 26l&2622, 2004
[7]. Ritz E, Rychlik I, Locatelli F, Halimi S: Endstage renal failure in type 2
[8]. diabetes: A medical catastrophe of worldwide dimensions. Am J Kidney Dis

Abstract: Hernia is undoubtedly one of the most common cases dealt by surgeons all over the world. Of the various type of abdominal hernias, the most unique are arguably the lumbar hernias1. They are quite uncommon as compared to other ventral abdominal wall hernias, accounting for less than 1.5% of the abdominal hernias with approximately only 300 cases reported in the literature over the past 300 years2. First described by Barbette in 1672 and the first case was reported by Garangoet in 17313.

[1]. Russell RC, Norman S. Bailey and Love's Short Practice of Surgery. 25ed. London: Edward Arnold; 2007. p. 983.
[2]. Alfredo Moreno-Egea, MD; Enrique G. Baena, MD; Miguel C. Calle, MD; Jose Antonio T. Martinez, MD; Jc Luis A. Albasini, MD Controversies in the Current Management of Lumbar Hernias Arch Surg. 2007;142(1):82-88. doi:10.1001/archsurg.142.1.82. JAMA Surgery
[3]. Pachani AB, Reza A, Jadhav RV, Mathews S. A primary idiopathic superior lumbar triangle hernia with congenital right scoliosis: A rare clinical presentation and management. Int J Appl Basic Med Res 2011 Jan;1(1):60–2.
[4]. Zinner MJ, Ashley SW. Maingot's Abdominal Operations, 12ed. united states: McGraw Hill Professional; 2012. p. 148–9.
[5]. Baker ME, Weinerth JL, Andriani RT, Cohan RH, Dunnick NR. Lumbar hernia: diagnosis by CT. AJR Am J Roentgenol 1987 Mar;148(3):565–7.

Abstract: Schwannomas are benign encapsulated slow- growing tumor that orignates from the Schwann cells of the peripheral nerve sheath. It usually occurs in the head and neck regions, however, its location in the oral cavity is rare. We report a case of schwanoma in the hard palate in a 46 year old with a history of swelling in the upper jaw region for the past 2 months. He has a history of diffciluty in swelling since then.

Keywords: Palate, neurilemmoma, oral cavity, schwannoma

[1]. López-Carriches C, Baca-Pérez-Bryan R, Montalvo-Montero S. Schwannoma located in the palate: Clinical case and literature review. Med Oral Patol Oral Cir Bucal. 2009;14:465–8.

[2]. Murthy VA, Ramaswamy S, Sunita M. Schwannoma of the hard palate. Indian J Otolaryngol Head Neck Surg. 2009;61(Suppl 1):52–4.

[3]. Verocay J. Zur Kenntnis der Neurofibrome. Beitr Pathol Anat. 1910;156:1–68.

[4]. Masson P. Experimental and Spontaneous Schwannomas (Peripheral Gliomas): I. Experimental Schwannomas. Am J Pathol. 1932;8:367–388.

[5]. Buric N, Jovanovic G, Pesic Z, Krasic D, Radovanovic Z, Mihailovic D. Mandible schwannoma (neurilemmoma) presenting as periapical lesion. Dentomaxillofac Radiol. 2009;38:178–81.

Abstract: Background and purpose: In unstable communited distal radial fractures that are impossible to reduce or to maintain in reduced position, the treatment of choice is operation. The type of operation and the choice of implant, however, is a matter of discussion. Our aim was to compare between external fixator with Ligamentotaxis and open reduction and internal fixation with volar plate in respect of anatomical and functional variables. Methods: 30 patients with an unstable or comminuted distal radius fracture were selected ,15 were treated with closed reduction and bridging external fixation and 15 were treated with open reduction and internal fixation using volar plate. Patients were reviewed for follow up after 1 week with check X-ray, then in every 2 weeks upto 6 weeks. Patients were evaluated on 3rd and 6th month after surgery for analyzing results..........

[1]. William PC: Fractures of the distal radius: A modern based classification.OCNA. 1993; IIA: p 211-6.
[2]. Bucholz , Robert WH, James D, Brown C, Charles M: Fractures of distal radius & ulna: Rockwood & Green's Fractures in Adults.
6th ed. Philadelphia: Lippincott Williams and Wilkins; 2006. Chapter 26: p 910-62.

[3]. Jupiter, JB: Current concepts review: Fracture of the distal end of the radius. JBJS. 1991; 73-A: p461-9.
[4]. Jupiter JB., Masem M: Reconstruction of Post-Traumatic Deformity of the distal radius and Ulna. Hand Clin.1988; 4: p377-90.
[5]. Arle I, Jupiter JB: The rationale for precise management of distal radius fracture.OCNA.1991; 24/2: p205- 211.

Abstract: A prospective observational study included 100 women with unhealthy cervices who attended outpatient department in 150 bedded Government Victoria Hospital a maternal hospital affiliated to Andhra medical College, Visakhapatnam, from January 2016 to December 2016. In the present study maximum patients (48%) were in the age group of 30-39 years,67% belonged to the Hindu religion and 78 % belonged to Class IV and Class V socioeconomic status,54% were Multi and Grandmulti Parous.69% got married below the age of 19 years, most common presenting symptom was leucorrhoea (65%)most common cytological observation was inflammatory smear (73%),most common colposcopic finding was aceto white epithelium(70%).most common vascular pattern was punctuation, and most common ECC observation was inflammatory (52%),and most common histological observation was chronic nonspecific cervicitis.14% of subjects positive for malignancy in group A and where as 18% were positive for malignancy in group B...........

Keywords: Carcinoma Cervix, Visual inspection, Cytology, Colposcopy, Biopsy.

[1]. Ferlay J, Soerjomataram I, Ervik M, Dikshit R, Eser S et al. Globocon 2012: Cancer Incidence and Mortality Worldwide: IARC Cancer Base No. 11, Lyon, France: International Agency for Research on Cancer 2013.
[2]. Shastri S S, Dinshaw K, Amin G, et al Concurrent evaluation of visual cytological and HPV testing as screening methods for the early detection of cervical neoplasia in Mumbai,India. Bulletin of World Health Organisation 2005:83(3):186-194.
[3]. Kathy S, Emma O, Patricia C et al.Comprehensive cervical cancer control:A guide to essential practice World Health Organization,2006
[4]. Kholi B, Arya BS. Comparison of Pap smear and colposcopy in detection premalignant lesions of cervix. J South Asian Fed Menopause Soc. 2014; 2:5-8.
[5]. Shaws text book of Gynaecology.

Abstract: Background: Iron deficiency anemia is the most prevalent nutritional deficiency of the world, especially in developing countries. It is estimated that 1.3 billion people suffer from anemia, of which most is due to iron deficiency. Children between 6 to 35 months are particularly high risk group for development of iron deficiency due to low content of bioavailable iron in the weaning foods of developing countries. Obviously for supplementing such young children medicinal iron can be used only in liquid form as drops and syrup formulations. However, there is considerable confusion in deciding on a suitable liquid iron preparation in terms of (a) bioavailability (b) side effect (c) cost effectiveness...........

Keywords: Therapeutic efficacy, Iron polymaltose complex ,Ferrous sulphate ,Iron deficiency anaemia.

[1] Report. National Family Health Survey (NFHS-3, 2005-2006) India. International Institute for Population Sciences, Mumbai.
[2] World Health Organization. Report of working group on iron deficiency anemia .1992; 1:17-20.
[3] Hokama T, Gushi Ken M, Nosoko N. Iron deficiency anemia and child development. Asia Pac J Public Health 2005; 17:19-21.
[4] Adamson JW. Iron deficiency and other hypoproliferative anemia .In: Braunwald E, Fauci AS, Kasper DL, et al, eds .Harrison's Principales of Internal Medicine, 15th edition.Mc Graw Hill, 2001, 660-66.
[5] Nagpal J, Chaudhuri P. Iron formulation in paediatric practice .Indian Pediatric 2004; 41:807-815.
[6] Jayaram S , Khandeparkar P , Dingankar NS, Shetty RS.Efficacy and tolerability of iron polymaltose complex in the treatment of iron deficiency anemia. Indian Medical Gazette 2002; 134:234-237

Abstract: During sleep, a person does not response to the surrounding environment. Sleep disorders affect personal life of the individuals. In brain,various neurotransmitters are responsible for the sleep and wake cycle. Acetylcholine, serotonin, dopamine, histamine and orexin promote wakefulness while GABA neurotransmitters promote sleep. Two subtypes of histamine are involved in sleep/wake cycle. Histamine release is decreased by the activation of H3 receptor which encourages sleep, while H1 receptor promotes wakefulness.Dopamine D2 receptors are responsible for controlling sleep/wake cycle...........

Keywords: GABA A; GABA B; Sleep awake cycle; Neurotransmitters; Brain receptors

[1]. Milner CE, Cote KA. Benefits of napping in healthy adults: impact of nap length, time of day, age, and experience with napping.
Journal of sleep research. 2009 Jun 1; 18(2):272-81.
[2]. Toth LA, Bhargava P. Animal models of sleep disorders. Comparative medicine. 2013 Apr 1; 63(2):91-104.
[3]. Fuller PM, Gooley JJ, Saper CB. Neurobiology of the sleep-wake cycle: sleep architecture, circadian regulation, and regulatory
feedback. Journal of biological rhythms. 2006 Dec 1; 21(6):482-93.
[4]. Lu J, Sherman D, Devor M, Saper CB. A putative flip–flop switch for control of REM sleep. Nature. 2006 Jun 1; 441(7093):589-94.
[5]. McCarley RW, Sinton CM. Neurobiology of sleep and wakefulness. Scholarpedia. 2008 Apr 10; 3(4):3313.
[6]. Aston-Jones G, Gonzalez M, Doran S. Role of the locus coeruleus-norepinephrine system in arousal and circadian regulation of the
sleep–wake cycle. Brain norepinephrine: Neurobiology and therapeutics. 2007:157-95.

Abstract: In dentistry we encounter numerous differences in the dentofacial characteristics of individuals, even among family members. The three most common problems in dentistry today remain dental caries, periodontal diseases and malocclusion. A multifactorial aetiology for all three conditions has generally been assumed, with both genetic and environmental contributions to observe variability .This article describes the some of the dental disorders and its genetic etiology.

Keywords: Genetics, dental caries, periodontal disease, malocclusion, Oro-facial clefts

[1]. Griffiths AJ, Jeffrey HM, David TS, Richard CL, Gelbart. Genetics and the Organism: An Introduction to Genetic Analysis. 7th ed. NewYork: W.H. Freeman And Company; 2000
[2]. Carey G. Human Genetics for the Social Sciences. 4th ed. Sage Publications; 2010.
[3]. Gangane S. Human Genetics. 2nd ed New Delhi: Churchill Livingstone 2000
[4]. Graber, Vanarsdall, Vig. Genetics and orthodontics. In orthodontics: Current Principles Techniques. St.Louis: Elsevier Mosby 2000.
[5]. Sandford RN. "Clinical Genetics" Davidson‟s Principles andPractice of Medicine. 2002 Churchill Livingstone. Butler PM. Studies of mammalian dentition & differentiation of canine dentition. Proc Zool Soc Lond (Series B) 1939;109:1.

Abstract: Kikuchi's disease, also known as Kikuchi Fujimoto Disease or histiocytic necrotising lymphadenitis is a rare idiopathic, usually self-limiting cause of lymphadenitis. It was first described in in 1972 in japan. Clinically Kikuchi's Disease most commonly presents as cervical lymphadenopathy with or without systemic signs and symptoms and is usually self-limiting. Clinically and histologically, the disease can be mistaken for lymphoma or systemic lupus erythematosus. Owing to its rarity we report a 27 year old female presenting with fever and cervical lymphadenopathy who was diagnosed to have Kikuchi's Disease and was confirmed by histopathological examination.

[1]. Kikuchi M. Lymphadenitis showing focal reticulum cell hyperplasia with nuclear debris and phagocytes: a clinic-pathological study. ActaHaematolJpn 1972; 35:379-80.
[2]. Fujimoto Y, Kozima Y, Yamaguchi K. Cervical subacute necrotising lymphadenitis: a new clinic-pathologic entity. Naika 1972; 20: 920-7.
[3]. Bosch X, Guilabert A, Miquel R, Campo E. Enigmatic Kikuchi- Fujimoto Disease: a comprehensive review. American journal of clinical pathology 2004; 122: 141-52.
[4]. Unger PD, Rappaport KM, Strauchen JA. Necrotising lymphadenitis (kikuchi's disease): report of four cases of an unusual pseudolymphomatous lesion and immunologic marker studies. Arch pathol lab med 1987; 111: 1031-4.
[5]. Spies J, Foucar k, Thompson C, Leboit P. The histopathology of cutaneous lesions of kikuchi's disease: a report of five cases. American journal of surgical pathology 1999; 23: 1040.

Abstract: Local or regional disease recurs or distant metastasis occur after resection in a significant proportion of those with gastric cancer.The reduce the risk of recurrence and mortality, adjuvant chemoradiotherapy has been proved to increase relapse-free survival and overall survival importantly.there is no knowledge about pancreas even it's effected by most of the radiotherapy dose since it's in close vicinity of stomach and dose levels which may adversely effect the pancreatic function are not defined. Therefore, the purpose of this study patients who referred to our clinic with opere gastric cancer and underwent adjuvant chemoradiotherapy were appraised prospectively and effects of pancreatic RT doses and outcomes were studied. The association among pancreatic functions...........

Keywords: Chemoradiotherapy, Gastric cancer, Pancreatic enzymes, Pancreas volume

[1]. Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D. Global cancer statistics. CA Cancer J Clin, 61, 2011, 66-90.
[2]. Torre LA, Bray F, Siegel RL, Ferlay J, Lortet-Tieulent J, Jemal A. Global cancer statistics. CA Cancer J Clin, 65, 2015, 87-108.
[3]. Colquhoun A, Arnold M, Ferlay J, Goodman KJ, Forman D, Soerjomataram I. Global patterns of cardia and non-cardia gastric cancer incidence in 2012. Gut, 64, 2015, 1881–1888.
[4]. D'Angelica M, Gonen M, Brennan MF, Turnbull AD, Bains M, Karpeh MS. Patterns of initial recurrence in completely resected gastric adenocarsinoma. Ann Surg, 240, 2004, 808-816.
[5]. Lim DH, Kim DY, Kang MK, Kim YI, Kang WK, Park CK, et al. Patterns of failure in gastric carcinoma after D2 gastrectomy and chemoradiotherapy: a radiation oncologist's view. Br J Cancer, 91, 2004, 11–17.
[6]. Macdonald JS, Smalley SR, Benedetti J, Hundahl SA, Estes NC, Stemmermann GN, et al. Chemoradiotherapy after surgery compared with surgery alone for adenocarsinoma of the stomach or gastroesophageal junction. N Engl J Med, 345,2001, 725-730.

Abstract: Background: Surgical site infection (SSI) accounts for 15% of all nosocomial infections and represents the most common nosocomial infection. Objectives: to access effectiveness of surgical prophylaxis in prevention of post-operative infections and expenditure on antimicrobial agents used for treatment of post-operative infections. Methods: A prospective, observational study was conducted in 600 surgical cases from General surgery, Obstetrics and Gynaecology and Orthopaedics departments in a tertiary care hospital. Data were collected from medical case sheets about antimicrobial agents (AMA) used for surgical prophylaxis and for post-operative infection............

Keywords: Surgical prophylaxis, expenditure, effectiveness, post-operative infections

[1]. Watanabe A, Kohnoe S, Shimabukuro R. Risk factors associated with surgical site infections in upper and lower gastrointestinal surgery. Sur Today. 2008; 38:404-12.
[2]. Woods R K, Dellinger E P.Current Guidelines for antibiotic prophylaxis of surgical wounds. Am Fam Physician 1998; 57:2731-40.
[3]. Singh S, Chakravarthy M, Rosenthal VD, Myatra SN, Dwivedy A, Bagasrawala I, et al. Surgical site infection rates in six cities of India: Findings of the International Nosocomial Infection Control Consortium (INICC). Int Health. 2015;7(5):354–9.
[4]. Tripathi KD. Essentials of medical pharmacology.7th Ed.New Delhi:Jaypee;2013. Chapter 49: Antimicrobial drugs: General consideration;Pg:701-05.
[5]. Burke JP.Maximizing Appropriate Antibiotic Prophylaxis for Surgical Patients: An Update from LDS Hospital, Salt Lake City, S78.CID 2001;2:33-37.
[6]. Rehan HS,Kakkar A,Goel S.Surgical antibiotic prophylaxis in a tertiary care teaching hospital in India.Int J Infect Contol 2010;06( 2):1-6.

Abstract: Background: Hysterectomy is most common gynaecological surgery done for various indications varying from AUB, fibroid uterus to malignancies. There are various approaches for performing hysterectomy ranging from laparotomy, laparoscopic to vaginal hysterectomy in both descent and non-descent cases. Incidence of hysterectomies in india is reported to be low compared to developed countries.Most common indication for hysterectomy being excessive menstrual blood loss due to hormonal reasons or fibroids (size more often not exceeding 12 weeks) .The need for safer and less expensive route of surgery would be a better option for these kind of patients. In this context, we analysed our experience with a less morbidNon-descent vaginal hysterectomy with regards to safety and feasibility........

Keywords: Non -descent vaginal hysterectomy(NDVH), Morcellation, Fibroid, Coring

[1]. R. Dewan, S. Agarwal, B Minocha, S.K. Sen, Non-descent Vaginal Hysterectomy – An Experience, J Obstet Gynecol Ind, 54(4), 2004, 376-378.
[2]. S. Bharatnur S, Comparative study of abdominal versus vaginal hysterectomy in Non-Descent cases, The internet journal of Gynaecology and Obstetrics, 15(2), 2011, 1528-1539.
[3]. ACOG Committee Opinion No. 444, Choosing the Route of Hysterectomy for Benign Disease, Obstet Gynecol, 114, 2009, 1156-1158.
[4]. B. Bhadra, A.P. Choudary, A. Tolassaria, N. Nupur, Non-Descent Vaginal hysterectomy (NDVH): Personal experiences in 158 cases, AL Ameen J Med Sci, 4(1), 2011, 23-27.
[5]. J.B. Unger, Vaginal hysterectomy for the woman with moderately enlarged uterus weighing 200 to 700 grams, Am J Obstet Gyneco, 180, 1990, 1337-44.

Abstract: Background: Pain on injection of anaesthetic is an important cause of patient dissatisfaction and is a recognised adverse effect of propofol, incidence varying between 28 – 90% in adults. Methodology: It is a comparative study conducted on 120 patients of age 18-60 years, ASA Grade I and II, randomly allocated to two groups L and O of 60, each receiving lignocaine(L) and ondansetron(O) respectively for 3 years at Department of Anaesthesia, Osmania General Hospital using Mc Crirrick and Hunter scale. Results: Both lignocaine and ondansetron were found to decrease the injection pain significantly i.e. 73% of patients in L group & 63.3% O group did not experience pain at all, 11.7% L group and 20% in O group had mild pain, 13.3% in L group and 16.7% in O group had moderate pain, severe pain was absent in both groups..........

Keywords: Propofol, Lignocaine, Ondansetron.

[1]. Agarwal A, Ansari MF, Gupta D, Pandey R, Raza M, Singh PK, et al.Pre treatment with thiopental for prevention of pain associated with propofol injection. AnaesthAnalg. 2004;98;683-6.
[2]. Zahedi H, Maleki A, Rostami G. Ondansetron pre-treatment reduces pain on injection of propofol. Acta Med Iran. 2012;50(4):239-
43.
[3]. Klement W, Arndt JO. Pain on injection of propofol, the effect of concentration and dilution. Br J Anaesth. 1991;67(3):281-42.
[4]. Eriksson M, Englesson S, Niklasson F, Hartvig P. Effect of lignocaine and pH on propofol induced pain. Br J Anaesth.
1997;78(5):502-6.
[5]. Nathanson MH, Gajraj NM, Russell JA. Prevention of pain on injection of propofol: A comparison of lidocane with alfentanyl.
AnesthAnalg.1996;82:469- 71.

Abstract: Objective: Various cephalometric reference planes have inherent shortcomings, due to which it becomes imperative to check the reliability of these planes with respect to true horizontal plane,which is the main aim of this study. Materials and methods: Cephalometric radiographs of 90 subjects were selected and subjected to cephalometric analysis.Descriptive statistics including means and standard deviations were used to assess the variability of various planes. Results: Frankfurt Horizontal plane followed by Krogman-Walker line shows least standard deviation with respect to true horizontal.In a separate comparison between Frankfurt Horizontal plane and Sella Nasion plane ,Frankfurt Horizontal plane showed less variability with respect to true horizontal..........

Keywords:Natural Head Position, Sella Nasion plane, Krogman-Walker line, Frankfurt Horizontal plane, Basion Nasion plane, True Horizontal.

[1] Finlay LM. Craniometry and cephalometry. A history prior to the advent of radiography. Angle Orthod 1980;50,312-21.
[2] Nanda K, Sassouni V. Planes of reference in reontgenographic cephalometry 1965;35:311-19.
[3] Moorrees CF, Kean MR. Natural head position, a basic consideration in the interpretation of cephalometric radiographs. Am J Phys
Anthropol 1958;16:213-234.
[4] Bjern R. A comparison between the Frankfort Horizontal and the sella turcicanasion as reference planes in cephalometric analysis.
Acta Odontol Scand 1957;15:1-13.
[5] Downs WB. Analysis of the dentofacial profile. Angle Orthod 1956;26(4):191- 212..

Abstract: Aim : The purpose of the study was to evaluate the efficacy of Endoactivator in the removal of debris and checking apical extrusion of irrigating solution from root canal walls compared to conventional methods. Methodology: 20 extracted mature human single rooted teeth were instrumented and irrigated. Teeth were divided into 2 groups. Group 1 – Conventional irrigation was performed using 2.5% NaOCl and 17% EDTA with side vented needle. Group 2 – final activation of irrigants by Endoactivator. Results: The amount of extruded solution was measured by calibrated vial. This study showed that the debris removal efficacy of Endoactivator device is better in middle 1/3rd of canal compared to 2.5% NaOCl and 17% EDTA. The amount of apical extrusion of irrigating solution was less in endoactivator irrigation system compared to conventional methods..........

Keywords: Apical Extrusion, Conventional irrigation, Debris Removal, Endoactivator, SEM

[1]. Gregory Caron, Khan Nham et al. Effectiveness of Different Final Irrigant Activation Protocols on Smear Layer Removal in Curved Canals. Journal Of Endodontic. 2010 August; 36(8): 1361-1366.
[2]. Pranav Desai, BDS, DDS, and Van Himel, Comparative Safety of Various Intracanal Irrigation Systems. Journal Of Endodontic. 2009 April; 35(4): 545-549.
[3]. Cesar de Gregorio, Roberto Estevez et al. Effect of EDTA, Sonic, and Ultrasonic Activation on the Penetration of Sodium Hypochlorite into Simulated Lateral Canals: An In Vitro Study. Journal Of Endodontic.2009 June; 35(6): 891-895.

Abstract: American Society of Anaesthesiologists (ASA) physical status is commonly used system to predict the incidence of intra- and postoperative complications in surgical patients. Silverman-Holt aggregate preoperative evaluation (SHAPE™) score is based on information learned from the patient history and physical examination overcomes limitations of ASA grading. Objective was to compare the efficacy of SHAPE scoring and ASA Grading in Anesthesia risk stratification in terms of Assessment of patient's condition; risk assessment and intra-operative and postoperative complications/events. Patients admitted for elective or emergency surgeries to be done under general anaesthesia /regional were included and assessed with ASA and SHAPE scoring. The time duration for anaesthesia and surgery; any blood.........

Keywords: American Society of Anaesthesiologists , Silverman-Holt aggregate preoperative evaluation

[1] Daabiss M. American Society of Anesthesiologists physical status classification. Indian J Anaesth 2011;55:111-5.
[2] Anila DM. Anaesthesia risk stratification: Time to think beyond American Society of Anesthesiologists Physical Status Classification. Indian J of Anaesth 2011:55: 5.
[3] Thomas JH, Karthik R, Atilio B, Mark S, Rebecca S, Katherine G et al. Association between ASA physical status and postoperative mortality at 48 hours. Perioperative medicine 2016; 5: 29.
[4] Kay HF, Sathiyakumar V, Yoneda ZT, Lee YM, Jahangir AA, Ehrenfeld JM et al. The affects of American society of anesthesiologists physical status on length of stay and inpatient cost in surgical treatment of isolated orthopaedic fractures. J Orthop trauma 2014;28:153-9.
[5] Woodfield JC, Beshay NM, Pettigrew RA, Plank LD, Van AM. American society of anesthesiologists classification of physical status as a predictor of wound infection. ANZ J Surg 2007; 9: 738-41..

Abstract: Objective: To assess the association of presentation time after stroke and mortality admitted in a tertiary care hospital in north India. Methods: This was a cross sectional observational study conducted in the Emergency Department in a tertiary care hospital in north India. All eligible patients clinically diagnosed as stroke (As defined by WHO. A clinical syndrome consisting of rapidly developing clinical signs of focal (or global in case of coma) disturbance of cerebral function lasting more than 24 hours or leading to death with no apparent cause other than a vascular origin) were included in this study. In hospital mortality was noted...........

Keywords: Ischemic stroke, Delay, Mortality.

[1]. Strong K, Mathers C, Bonita R. Preventing stroke: saving lives around the world. Lancet Neurol. 2007;2:182-187.
[2]. Mehndiratta MM, Singhal AB, Chaturvedi S, Sivakumar MR, Moonis M. Meeting the challenges of stroke in India. Neurology
2013;80:2246–7.
[3]. Wielgosz ATJ, Nolan RP, Earp JA, Biro E, Wielgosz MB. Reasons for patients' delay in response to symptoms of acute myocardial
infarction. CMAJ 1988;139:853–7.
[4]. Jones SP, Dickinson HA, Ford GA, et al. Callers' experiences of making emergency calls at the onset of acute stroke: a qualitative
study. Emerg Med J. 2012;6:502-505.

[5]. Moloczij N, McPherson KM, Smith JF, et al. Help-seeking at the time of stroke: stroke survivors' perspectives on their decisions.
Health Soc Care Community. 2008;5:501-510.

Abstract: Background: Chloroquine resistance in Sudan lead the ministry of health to change the first line of malaria treatment from chloroquine to artemisinin, this study was designed to detect single point mutation of Plasmdium falciparum multi-drug resistance-1 (Pfmdr-1) N86Y mutant allele in three different areas in Sudan. Materials and Methods: Three hundred (300) P.falciparum positive samples were collected from three areas in Sudan, positive samples were confirmed by using direct microscopical stained blood films, DNA was extracted using Chelix method and then were amplified using Nested RFLP-PCR method to detect the Pfmdr-1 N86Y mutant allele. Data were analyzed using SPSS 16.5 by Chi-squire test........

Keywords: Pfmdr-1 N86Y, Anti-malarial resistance, Sennar, River Nile.

[1]. Petersen, I., Estman, R., and Lanzer, M. Drug resistant malaria: Molecular mechanisms and implication for public health. FEBS LETTERS. 2011. 10, 1551-1556.
[2]. Najera, J, T., Gonzalez, M., and Alonso, P, L. Some lessons for the future from the global malaria programm (1955 -1969). PLoS. Med. Hyg. 2001. 64, 12 - 17.
[3]. Eckhoff, P, A. A malaria transmission-directed model of mosquito life cycle and ecology. Coinfection with Lethal and Nonlethal Murine Malaria Parasites, Malaria Journal, 2011. 10. 303.
[4]. Atroosh et al.: The detection of pfcrt and pfmdr1point mutations as molecular markers of chloroquine drug resistance, Pahang, Malaysia. Malaria Journal 2012 11:251.
[5]. Rastaghi AE, Nateghpou M, Assmar M, Razavi MR, Kanbara H, Uemura H, Naddaf SR, Keshavarz H, Raeisi A, Mohebali M. Detection of K76T Mutation in pfcrt Gene as an Applicable Ge-netic Marker for Prediction of Chloroquine Resistant falciparum Malaria in Isolates from an Endemic District of Iran. Iranian Journal of Parasitology. 2008;3(2):48-56.

Abstract: Maxillo-facial Prosthodontics is a specialty of prosthetic dentistry that deals with rehabilitation of congenital and acquired defects of the head and neck. Prosthetic rehabilitation of the patients after surgeries is essential for the restoration of speech, mastication, swallowing, nutrition and facial appearance. Maxillo-facial rehabilitation is essentially a team effort comprising of general, plastic and onco-surgeons, oral & maxillofacial surgeon, prosthodontist, speech therapist, and psychologist. Maxillo facial Prosthesis can be broadly classified as intraoral prosthesis and extra oral prosthesis. The primary objective of intraoral prosthesis is to enhance function i.e. swallowing, mastication and speech, whereas that of an extraoralprosthesis is to enhance appearance and thereby the psychologicwell being of the individual. The most common type of intra oral prosthesis is the obturator.............

[1]. FilizKeyfObturator prostheses for hemimaxillectomypatientsJournal of Oral Rehabilitation 2001 28; 821-829
[2]. Beumer J, Curtis T, Marunick M. Maxillofacial rehabilitation: Prosthodontic and surgical considerations. St Louis: IshiyakuEuroAmerica, Inc.; 1996:240–285.
[3]. Chalian, V.A. & Barnett, M.O. (1972) A new technique for Constructing a one-piece hollow obturator after partial maxilllectomy. Journal of Prosthetic Dentistry, 28, 448.
[4]. Chalian, V.A., Drane, J.B. & Standish, S.M. (1971) MaxillofacialProsthetics. Multidisciplinary practice, pp. 133±148. The Williams& Wilkins Co., Baltimore.
[5]. Desjardins, R.P. (1978) Obturator prosthesis design for acquired maxillary defects. Journal of Prosthetic Dentistry, 39, 424.