iosr-JDMS   Volume-16 ~ Issue-12 ~ December-2017

Abstract: MCI regulatory code for doctors has made generic prescription mandatory. However, physician's perceptions about generic medications may represent an important barrier to greater generic use. Hence this study was conducted to know about knowledge, attitude and practice of generic medicines among physicians. Methods: A prospective, cross-sectional, questionnaire based study was conducted in general practitioners (n = 100) of either gender from different pathies but also practicing allopathy in Pune region. They were interviewed using structured, validated questionnaire of 20 multiple choice questions to obtain information about knowledge, attitude and practice of generic drugs..............

Keywords –Generic drug, Knowledge, Attitude and Practice.

[1]. Jamshed SQ, Hassali MA, Ibrahim MI, Babar ZU. Knowledge attitude and perception of dispensing doctors regarding generic medicines in Karachi, Pakistan: A qualitative study. J Pak Med Assoc. 2011;61:80–3. [PubMed]
[2]. Rao MG, Choudhury M. Health Care Financing Reforms in India. 2012-100. 2012;34.available at http://www.nipfp.org.in/media/medialibrary/2013/04/wp_2012_100.pdf cited on Oct15, 2017
[3]. Bakthavathsalam G. Generic drugs: cost effective alternative to branded drug. Health Administrator 2006;19:16-19.
[4]. Costas H. Kefalas, Arthur A. Ciociola. The FDA's Generic-Drug Approval Process: Similarities to and Differences from Brand-Name Drugs. Am J Gastroenterol 2011;106:1018–1021.
[5]. Kesselheim AS, Misono AS, Lee JL, et al. Clinical equivalence of generic and brand-name drugs used in cardiovascular disease: a systematic reviewand meta-analysis. JAMA 2008;300:2514-26..

Abstract: IntroductionCervical Dysplasia & cervical Cancer remain important health problem. Cervical cytology by Papanicolaou (Pap) smear is an effective means of screening for cervical premalignant & malignant conditions. Aim :The aim of this study was to assess the trend of cervical dysplasia & cervical cancers in perimenopausal women in tertiary care centre of Madhya Pradesh and to assess the association (if any) of Neoplastic/dysplastic changes. Material & Methodsa total of 3,610 cases were enrolled in 4 year study cervical scrape smears were collected & stained using Rapid-Pap method. The emphasis was on epithelial abnormalities classified in accordance with the Bethesda System. The cases belonged to the perimenopausal age group (41-50 years). results :Trend of Cervical Dysplasia - 20.5% (2013), 11% (2014), 10.5% (2015), 8% (2016) Trend of SCC -2.5% (2013), 1.8% (2014), 1% (2015), 0.5% (2016)........

[1]. Boyle P,Ferlay J. Cancer incidence and mortality in Europe,2004.Ann Oncol 2005;16:481-8
[2]. Tristen C ,Bergstrom S. Cancer in developing countries. A threat to reproductive health. Lakartidningen 1996;93:3374-6
[3]. Juneja A,Sehgal A, Sharma S, Pandey A. Cervical cancer screening in India: Strategies revisited . Indian J Med Sci 2007;61:34-47
[4]. Murty NS, Chaudhary K ,Saxena S. Trends in cervical cancer incidence – Indian Scenario. Eur J Cancer Prev 2005;14:513-8
[5]. Solomon D, Davey D,Kurman R, Moriarty A,O'Connor D, Prey M,et al. Forum Group Members ,Bethesda2001 Workshop. The 2001 Bethesda system: Terminology for reporting results of cervical cytology. JAMA 2002;287:2114-9.

Abstract: This research was aimed to assess the effect on visual acuity following Nd: YAG laser capsulotomy, total amount of laser energy required for capsulotomy, and to assess the complications of fallowing laser capsulotomy. It included 70 patients with posterior capsular opacification admitted in M.L.B. Medical College, Jhansi between July 2016 to April 2017 .The study group patients were asked relevant history, examination of the eye with the help of slit lamp, refraction, Best corrected visual acuity, tonometry, and fundus examination, and Nd:YAG laser capsulotomy was done. In this study 33 male and 37 female were taken. Mean age was 58.41 years. Most of the patients presented with visually significant posterior capsular opacification 6-12 months of the cataract surgery. Percentage of patients achieved the final visual acuity (BCVA) of 6/6 to 6/12 were 58.57% and percentage of patients with no visual improvement..........

Keywords: IOP spike, Nd: YAG laser, Posterior capsular opacification, Best corrected visual acuity, Iritis..

[1]. Schaumberg DA, Dana MR, Christen WG, Glynn RJ. A systemic overview of the incidence of posterior capsule opacification. Ophthalmology 1998; 105: 1213-21.
[2]. Apple DJ, Solomon KD, Tetz MR, Assia EI, Holland EY, Legler UF, et al. Posterior capsule opacification. Surv Ophthalmol 1992; 37: 73-116.
[3]. Apple DJ, Rabb MF. Ocular Pathology. Clinical applications and self-assessment. 5th ed. Missourie. Mosby YearBook, Inc; 1998:174-6.
[4]. Ram J, Apple DJ, Peng Q. Update on fixation of rigid and foldable posterior chamber intraocular lenses. Part I: Elimination of fixation- induced decentration to achieve precise optical correction and visual rehabilitation. Ophthalmology 1999;106:883- 90.
[5]. Ram J, Apple DJ, Peng Q. Update on fixation of rigid and foldable posterior chamber intraocular lenses. Part I: Elimination of fixation- induced decentration to achieve precise optical correction and visual rehabilitation. Ophthalmology 1999;106:883- 90..

Abstract: Intestinal lymphangiectasia, characterized by dilatation of intestinal lacteals, is rare. The major treatment for primary intestinal lymphangiectasia is dietary modification. Surgical management is to be considered in presence of obstructive features, to relieve symptoms and to clarify the underlying etiology, also when medical treatment has failed or not possible. This article reports a 35 year old woman with segmental jejunallymphangiectasia, who presented with obstructive features- fullness of abdomen associated with epigastralgia, nausea and vomiting with history of loose motion alternating with constipation . Her symptoms are aggravated by taking food persisted with medical treatment. Surgery was finally performed to relieve the symptoms and to exclude the existence of underlying etiologies, with satisfactory effect. In conclusion, jejunal lymphangiectasia can present clinically asfullness of abdomen associated with epigastralgia, nausea and vomiting . Surgical management should be considered in presence of obstructive features to relieve pain and other symptoms and to exclude underlying diseases in some patients..

[1]. Rubin DC. Small intestine: anatomy and structural anomalies In: Yamada T, ed. Textbook of gastroenterology. 3rd ed. Philadelphia: Lippincott Williams Wilkins. 1999:1578–1579.
[2]. Vardy PA, Lebenthal E, Shwachman H. Intestinal lymphagiectasia: a reappraisal. Pediatrics. 1975;55:842–851. [PubMed]
[3]. WALDMANN TA, STEINFELD JL, DUTCHER TF, DAVIDSON JD, GORDON RS. The role of the gastrointestinal system in "idiopathic hypoproteinemia". Gastroenterology. 1961;41:197–207. [PubMed]
[4]. Boursier V, Vignes S: Lymphangiectasiesintestinales primitives (maladie de Waldmann) révélées par unlymphoedème des membres. J Mal Vasc. 2004, 29: 103-106.
[5]. Tift WL, Lloyd JK: Intestinal lymphangiectasia long-term results with MCT diet. Arch Dis Child. 1975, 50: 269-276..

Abstract: Diabetes is fast gaining the status of a potential epidemic in India with more than 62 million diabetic individuals currently diagnosed with the disease.1 At present India topped the world with the highest number of people with diabetes mellitus.1 Diabetes is a common disease affecting about 14.8% in rural and 19.7% in urban dwellers in India1. India has highest prevalence of diabetes in world and accounts for almost 1/6 of the diabetic patients1. Wagner's classification is the simplest, best known for evaluation and management of diabetic foot ulceration.2 Background 1) To Re evaluate role of Wagner's classification in the study and management of 100 diabetic foot in patients admitted in government general hospital guntur 2) To investigate the surgical strategy of diabetic foot and analyze the therapeutic efficacy..........

Keywords: 1. diabetic foot, Wagner's classification 2. ulcer, conservative treatment 3. gangrene, amputation

[1] Park's text book of preventive and social medicine, 22nd edition, page no. 362-365.
[2] Diabetes metab Res Rev2008;May-Jun vol 24 Suppl 1 (issue ) : pp S7-S13
[3] Park text book of preventive and social medicine,2007,19 edition, m/s banarasidas bhanot publication chapter 6,page 329. joslins diabetes mellitus, 2006, 14 edition, lippincott Williams and Wilkins publication, chapter 67, page 1123
[4] Del Aguila, M.A., Reiber, G.E., Koepsell, T.D. How does provider and patient awareness of high-risk status for lower-extremity amputation influence foot-care practice? Diabetes Care1994;17:1050–1054
[5] Andrew JM, Bpoulton,Vileikyte L. Diabetic foot problems and their management around the world. Levin o neal "the diabetic foot" 6th edition mosby,inc 2001;266. J ayub med coll abbottabad 2003 jul-sep;15(3);39

Abstract: Hypocalcaemia following thyroid surgery is the most common complication following thyroid surgery. This study will evaluate the risk factors and predictors of hypocalcaemia either transient or permanent. Design: Prospective analysis of 50 consecutive patients undergoing thyroid surgeries. Materials & Methods: All patients undergoing any thyroidectomy in the department of general surgery were followed for a period of 3 months. The type of surgery, Histopathology and clinical diagnosis to predict the outcome of post-operative hypocalcaemia was validated. The influences of Patient factors, intra-operative identification of RLN and parathyroid were also observed......

Key words: Hypocalcaemia, Hypoparathyroidism, Parathyroid, Thyroidectom

[1]. Unnikrishnan AG, Menon UV. Thyroid disorders in India: An epidemiological perspective. Indian J Endocrinol Metab. 2011 Jul; 15(Suppl 2): s78-81.
[2]. Agarwal GS, MK Singh M. The prevalence of thyroid dysfunction among South Indian women with Metabolic Syndrome. J Clin Diagn Res. 2011; 5(2)(2): 213-6.
[3]. Urbano, FL. Signs of hypocalcemia: Chvostek's and Trousseau's signs. Hosp Physician. 2000 Mar; 43-45.
[4]. C.Gopakrishnan Nair, Mishra J.C.Babu, Rijju menon, Pradeep Jacob Hypocalcemia following total thyroidectomy. Indian J Endocrinol Metab. 2013 Mar-Apr; 17(2): 298-303.
[5]. Nemade SV, Chirmade AP. Post-thyroidectomy early serum ionic calcium level: Predictor of prolonged hypocalcemia. Ear Nose Throat J. 2013 Aug;92(8):382- 90...

Abstract: Aim: To assess the pattern of failure of patients with endometrial cancer and to analyze the variables predictive of the risk of local and distant disease recurrence. Materials And Methods: The clinical and pathologic case records of patients with histologically proven carcinoma endometrium treated at Department of Radiotherapy Father Muller Medical College between 2014 to 2017 were reviewed. Out of 45 patients who took radiotherapy (which include either EBRT OR Vaginal brachytherapy) 33 patients were included in the analysis. Results: The median age of the 33 patients was 57.6 years. Out of the 33 patients selected 16(48%) belong to stage I, 2(6%) belong to stage II and 15(45%) belong to stage III.All patients underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy +/- pelvic.........

Key words: Carcinoma endometrium, Recurrence patterns, Radiotherapy, Brachytherapy, Chemotherapy

[1]. Morrow CP, Bundy BN, Kurman RJ, Creasman WT, Heller P, Homesley HD and Graham JE: Relationship between surgical pathological risk factors and outcome in clinical stage I and II carcinoma of the endometrium: a Gynecologic Oncology Group study. GynecolOncol 40: 55-65, 1991.
[2]. Mariani A, Webb MJ, Keeney GL, Calori G and Podratz KC: Hematogenous dissemination in corpus cancer. GynecolOncol 80: 233-238, 2001.
[3]. Mariani A, Webb MJ, Keeney GL, Aletti G and Podratz KC: Predictors of lymphatic failure in endometrial cancer. GynecolOncol 84: 437-442, 2002.
[4]. Mariani A, Webb MJ, Keeney GL, Lesnick TG and Podratz KC: Surgical stage I endometrial cancer: predictors of distant failure and death. GynecolOncol 87: 274-280, 2002.
[5]. Mariani A, Webb MJ, Keeney GL, Aletti G and Podratz KC: Endometrial cancer: predictors of peritoneal failure. GynecolOncol 89: 236-242, 2003...

Abstract: To collected and concluded a literature review on the diagnosis and management of facial fibrous dysplasia in head and neck region. Materials And Methods: The review was searched and collected from many sources about fibrous dysplasia, to discussed the all revealing to diseases as clinical features radiographic image, cytogenetic, histopathology, and immunohistochemistry as master keys and parameters for perfect diagnosis of diseases. The database of Literature was collected through used the search of PubMed, Cochrane Library, and scholar Google databases. The keywords used for the search were fibrous dysplasia, physiopathology, radiography histopathology, cytogenetics, and immunohistochemistry. A manual search to many of the reference lists of the identified articles and the authors' article files and recent reviews was made to finding additional publications. Those studies that showed new features about fibrous dysplasia were included in this review.........

Key words: fibrous dysplasia, physiopathology, radiography histopathology, cytogenetics, and immunohistochemistry

[1.]. Riminucci M, Kuznetsov SA, Cherman N, Corsi A, Bianco P, Gehron Robey P. Osteoclastogenesis in fibrous dysplasia of bone: In situ and in vitro analysis of IL-6 expression. Bone. 2003;33(3):434-442. doi:10.1016/S8756-3282(03)00064-4.

[2]. Farzaneh AH, Pardis PM. Central giant cell granuloma and fibrous dysplasia occurring in the same jaw. Med oral, Patol oral y cirug??a bucal. 2005;10 Suppl 2(1):130-132.

[3]. Ashrafi SKA, Asim, Khambaty Y, Suhail Z. Fibrous dysplasia of mandible. J Coll Physicians Surg Pakistan. 2012;22(11):728-729. doi:11.2012/JCPSP.728729\r040579197 [pii].

[4]. Leet AI, Collins MT. Current approach to fibrous dysplasia of bone and McCune-Albright syndrome. J Child Orthop. 2007;1(1):3-17. doi:10.1007/s11832-007-0006-8.

[5]. DiCaprio MR. Fibrous Dysplasia<sbt aid="1027210">Pathophysiology, Evaluation, and Treatment</sbt> J Bone Jt Surg. 2005;87(8):1848. doi:10.2106/JBJS.D.02942.

Abstract: Extractions in orthodontics remains a relatively controversial area. It is not possible to treat all malocclusions without taking out any teeth. The factors which affect the decision to extract include the patient's medical history, the attitude to treatment, oral hygiene, caries rates and the quality of teeth. Extractions of specific teeth are required in the various presentations of malocclusion. In some situations in young patients, careful timing of extractions may result in spontaneous correction of the malocclusion. Certain malocclusions require orthodontists to be capable of establishing a diagnosis in order to determine the best approach to treatment. The purpose of this article was to present clinical..........

Key words: Orthodontics, Tooth Extraction, Therapy

[1]. Proffit WR, Fields HW. Contemporary orthodontics. 1993 C.V.Mosby, St.Louis

[2]. Angle EH. Treatment of malocclusion of the teeth and fractures of the maxillae, Angle's system. Ed 6, 1900 S.S. Philadelphia: White Dental Manufacturing Co.

[3]. Wolff J. Das Gesetz der Transformation der Knochen. Berlin: Hirschwald, 1892

[4]. Case CS. The question of extraction in orthdontia. Am J Orthod, 50, 1964, 658–691

[5]. Tweed C. Clinical Orthodontics. 1966, St Louis: Mosby.

Abstract: During the recent years, different brands of nanocomposites have been introduced and it is a matter of utmost importance to choose the one with most favorable properties. The present study aimed at comparison of compressive and flexural strength of hybrid and nanocomposites available in the market and also to compare the nanocomposites of different brands. The newer nanocomposite materials used in this study include Filtek Z350XT, Tetric N ceram & Brilliant NG. Hybrid composite include Filtek Z250. Methods: A total of 100 specimens were selected. Four groups were made of four different composite materials having 25 specimens in each group.13 in each group were subjected to compressive test and 12 in each were subjected to flexural test. The specimens were stored in distilled water at 37 ◦C, 24 h. and transferred to the universal testing machine, subjected to compressive & flexural strength analysis........

Key words: Nanocomposites, hybrid composites, compressive strength, flexural strength, universal testing machine

[1]. Mitra SB, Wu D, Holmes BN. An application of nanotechnology in advanced dental materials. The Journal of the American Dental Association 2003;134:1382-1390.
[2]. Swift EJ, Swift EJ. Nanocomposites. Journal of Esthetic and Restorative Dentistry 2005;17:3-4.
[3]. Jung M, Eichelberger K, Klimek J. Surface geometry of four nanofiller and one hybrid composite after one-step and multiple-step polishing. OperativeDentistry 2007;32:347-355.
[4]. Papadogiannis Y, Lakes R, Palaghias G, Helvatjoglu-Antoniades M, Papadogiannis D. Fatigue of packable dental composites. dental materials 2007;23:235-242.
[5]. Anusavice K. Phillips R. Phillips' science of dental materials 11th ed St Louis: Elsevier 2003..

Abstract: The objective of this investigation was to assess the effects of different denture cleansers and distilled water on color stability of self-polymerized (SP) and heat-polymerized (HP) acrylic denture base materials. Methods: Specimens were prepared from HP (Lucitone 199) and SP (Rapid Repair) acrylic resin denture base materials and distributed into different groups/15 each. Specimens were immersed in distilled water as control and in three different denture cleansers (Corega, Polident, and StainAway Plus) according to the manufacturer's specifications and immersion was repeated 7 times over 7 days. All specimens in different groups were measured for color stability using a spectrophotometer against a white background under a standard illumination of D65. Statistical analyses were performed using one and two-way analysis of variance and independent t-test............

Key words: Denture Cleansers, Color, Denture Bases, Acrylic Resins

[1]. Carlsson GE, Omar R. The future of complete dentures in oral rehabilitation. A critical review. J Oral Rehab 2010; 37:143-156.
[2]. Hersek N, Canay S, Uzun G, Yildiz F. Color stability of denture base acrylic resins in three food colorants. J Prosthet Dent 1999; 81:37-59.
[3]. Hong G, Murata H, Li Y, Sadamori S, Hamada T. Influence of denture cleansers on the color stability of three types of denture base acrylic resin. J Prosthet Dent2009; 101:205-213.
[4]. Phukela SS, Srivastava PK, Sharma N, Gupta S, Setya G, Ritwal PK. Dimensional Changes in Microwave Processed Acrylic Resin and Conventional Heat Polymerized Resin Cured by Water Bath and Microwave Energy - An In Vitro Study. J Int Oral Health 2016; 8:911-915.
[5]. Schwindling F, Bömicke W, Hassel A, Rammelsberg P, Stober T. Randomized clinical evaluation of a light-cured base material for complete dentures. Clin Oral Invest 2014; 18:1457-1465..

Abstract: The higher health education and the preparation of wellbeing experts has been protest of a few wrangles about. In this manner, there are prominent exchanges on the new learning procedures to prepare wellbeing experts, with capacities and aptitudes past the specialized scientific zone and furthermore ready to make, plan, execute and assess wellbeing approaches and activities and, in the meantime, take care of issues. Dynamic learning techniques, for example, problem-based learning, are utilized with the motivation behind important learning procurement and not only mechanical as the customary educating for a long time executes. Generally examines confirm beneficial outcomes of new showing systems and bolster the requirement for changes in higher wellbeing instruction. The aspiration behind this review is to recollect scientific health education, problem-based learning and meaningful learning which will help the budding researchers to step up and enhance their knowledge in the field to health education...........

Key words: Problem-Based Learning; Health Education; Public Health; Learning; Speech, Language and Hearing Sciences

[1]. John hubley. Communicating health, an action guide health education and health promotion, 2002.
[2]. Who, education for health. A manual on health education in primary health care, 1988, Geneva, who.
[3]. Jannie n., jane w. Health promotion foundations for practice, 2nd edition, uk, 1995.
[4]. Lramachandran, tdharmalingam. Health education, a new approach, new delhi 1998.
[5]. Epha. Public health code of ethics for ethiopia, july 2003..

Abstract: Furcal perforation is a common occurrence during endodontic treatment. Prompt intervention and use of proper repair materials is very important to improve the prognosis of involved tooth. Material qualities are also determining factor of success. Search for newer materials that are easy to manipulate, cost effective with better physical and biological properties is a never ending process. Methodology: Seventy six extracted human molars were perforated in furcation area and randomly divided into four groups. Perforations in three groups of samples were repaired with MTA, Biodentine and bioactive bone cement while as fourth group of samples was left unrepaired as control. Simultaneously samples were subjected to dye leakage test and values calculated as absorbance units with spectrophotometer. Result: Results showed that bioactive bone cement is as good as MTA in terms.....

Key words: Biodentine, Bone Cement, Dye Extraction, Furcal Perforation, MTA.

[1]. Jew RC, Weine FS, Keene JJ, Jr., Smulson MH. A histologic evaluation of periodontal tissues adjacent to root perforation filled with Cavit, Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 54, 1982, 124-35
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[5]. Rafter M, Baker M, Alves M, Daniel J, Remeikis N. Evaluation of healing with use of an internal matrix to repair furcation perforations, Int Endod J, 35, 2002, 775-83..

Abstract: The number of organisms developing resistance to commonly used antibiotics is increasing among the various generations.Klebsiella species is associated with different types of infections and there is a preponderence of multidrug resistance and ESBL production. Materials and Methods : A total number of 2,240 exudate samples collected from March 2017 to October 2017 from Govt General hospital,Guntur were included in the study . Bacterial isolates were identified by their standard Microbiologicaltechniques and were subjected to antibiotic sensitivity testing using modified Kirby-Bauer disc diffusion method. RESULTS : Of 2,240 exudate samples processed ,746 (33.30%) samples were culture positive for various organisms.Itconisisted of 599 (80%) Gram.........

[1]. P. Nordamann, G. Cuzon and T. Naas "The real threat of Klebsiella pneumonia carbapenemase-producing bacteria" , Lancet Infec Dis.,2009,9 (4):228-236.
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[4]. S.J. Cryz, R. Furer and R. Germanier "Protection against fatal Klebsiella pneumonia burn wound sepsis by passive transfer of anticapsular polysaccharide", Infect. Immun., 1985, 45: 139-142.
[5]. Elmer W. Koneman, Stephen D. Allen, Willian M. janda, Paul C.Schreckenberger and Washington C.Winn. 2006. Color Atlas And Textbook Of Diagnostic Microbiology.6th edition. Baltimore : Lippincott Williams Wilkins...

Abstract: Impaired glucose tolerance and impaired fasting glucose, referred to as pre diabetes form an intermediate stage in the natural history of diabetes mellitus. Oxidative stress is a determinant of insulin resistanceand markers of systemic oxidative stress are elevated in clinical type 2 diabetes, but there are only limited data relating the degree of oxidative stress to insulin resistance in pre-diabetic state. Objective: 1. To estimate the markers of oxidative stress and inflammatory status in pre-diabetic subjects. 2. To correlate the association between oxidative stress and inflammation with pre diabetes. Materials and Methods: This was a hospital based cross sectional study and it included 100 subjects (50 cases and 50 controls). Age & sex matched normal healthy individuals between the age group 18 – 50 served as control. Markers like serum Malondialdehyde (MDA), Reduced glutathione (GSH), Glutathione peroxidase (Gpx), Catalase and C Reactive Protein(CRP) were estimated. Data was analyzed using student t test and chi square test using SPSS version 17......

Key words: Catalase, Glutathione peroxidase, Malondialdehyde, Oxidative stress, Pre diabetes, reduced glutathione.

[1]. International Diabetes Federation: Diabetes Atlas. 2006; 3rd edition, page 17.
[2]. Genuth S, Alberti KG, Bennett P, Buse J, Defronzo R: Expert Committee on the Diagnosis and Classification of Diabetes Mellitus: follow-up report on the diagnosis of diabetes mellitus. Diabetes Care 2003; 26:3160–3167.
[3]. Expert Committee on the Diagnosis and Classification of Diabetes Mellitus: Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Diabetes Care 1997; 20:1183–1197.
[4]. Stern SE, Williams K, Ferranini E, DeFronzo RA, Bogardus C, Stern MP: Identification of individuals with insulin resistance using routine measurements. Diabetes 2005; 54:333-339.
[5]. Rutter MK, Parise H, BenjaminEJ, Levy D, Larson MG. Impact of Glucose Intolerance and Insulin Resistance on Cardiac Structure and Function Sex-Related Differences in the Framingham Heart Study, Circulation. 2003; 107: 448 -454...

Abstract: Asthma is a chronic inflammatory condition of the airways characterized by hyperresponsiveness and episodic, reversible symptoms of airflow obstruction,that causes the airways to constrict and produce exccess mucus ,making breathing difficult. Bronchoconstriction led by the contraction of the bronchial smooth muscles, inflammation of the bronchial walls, and increase in mucus secretion are the causes of the airway obstruction in asthma.current treatment strategy in asthma aims ,at control of symptoms ,allowing the patient normal life Antiasthmatic medication is the most important modality to control symptoms. Inhalation therapy has been employed as the mainstay of the treatment in chronic respiratory diseases such as asthma and chronic obstructive pulmonary disease (COPD).Patients.....

Key words: Asthma, dental caries, oral health, dry powder inhaler

[1]. Mannino DM, Homa DM, Pertowski CA, Ashi-zawa A, Nixon LL, Johnson CA, et al. Surveillance for asthma--United States, 1960-1995. MMWR CDC SurveillSumm 1998 Apr;47(1):1-27.
[2]. Mannino MM, Homa DM, Pertowski CA, et al. Surveillance for asthma–United States, 1960-1995.

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[4]. Lipworth BJ. Systemic adverse effects of inhaled corticosteroid therapy: A systematic review and meta-analysis. Arch Intern Med 1999; 159: 941-55.

[5]. The British Guidelines on Asthma Management 1995 Review and Position Statement.Thorax1997 ;52 (supp 1): s1-s21.