iosr-JDMS   Volume-16 ~ Issue-4 ~ April-2017

Abstract: Scrotal swellings were earlier considered to be an area over unaided clinical expertise. Scrotal swelling can occur in males at any age. Scrotal masses may be intratesticular or extratesticular, either solid or cystic.A prospective study was done on 50 patients presenting to our hospital over 1 years with complaint of scrotal swelling. Factors such as age, presenting complaint, laterality were analysed, a definite diagnosis was made on the basis of USG, Colour Doppler and Histology. Collected data was then analysed and compared to previous studies.

Keywords: scrotal swellings, ultrasonography scrotum

[1]. Singh AK. Clinico pathological Study of Cystic Swellings of Scrotum. Asian Journal of Biomedical and Pharmaceutical Sciences, 6(57), 2016, 42-44.
[2]. Office for National Statistics. Cancer statistics registrations, England, series MB1, no. 41, 2010, 2012
[3]. Office for National Statistics. Cancer survival in England – patients diagnosed 2005–2009 and followed up to 2010, 2011.
[4]. Garner MJ, Turner MC, Ghadirian P, Krewski D. Epidemiology of testicular cancer: an overview. Int J Cancer 2005;116(3): 331–9.
[5]. Cramer BM, Schlegel EA, and Thueroff JW: MR imaging in the differential diagnosis of scrotal and testicular disease. Radiographics, 11, 1991, 9–21.

Abstract: Introduction: High Resolution Computed Tomography (HRCT), a modification of routine CT, provides a direct visual window in the temporal bone providing minute structural details. Purpose of the present study was to evaluate the normal variations, pathological processes and their extent involving the temporal bone along with their complications on HRCT and to correlate these imaging findings surgically, wherever available. Methodology: The prospective study included 30 patients who were referred to the radiology department with clinically suspected temporal bone or ear pathologies. After detailed clinical examination, the patients were subjected to high resolution computed tomography (HRCT) examination..............

Keywords: Acoustic neuroma, High Resolution Computed Tomography, Meningioma, Temporal bone.

[1]. Brogan M, Chakeres DW. Computed tomography and magnetic resonance imaging of the normal anatomy of the temporal bone. Semin Ultrasound CT MR. 1989; 1010:178–94.

[2]. Howard JD, Elster AD, May JS. Temporal bone: Three dimensional CT. Radiology. 1990; 177(2):427–30.

[3]. Chakeres DW, Augustyn MA. CT and MR Imaging of the Whole Body. 4th ed. Ohio: Mosby; 2003. Temporal bone. In: Haaga JR., Lanzieri CF, Gilkeson RC; pp. 495–512.

[4]. Lloyds GAS, Phelps PD and Du Boulay GH. High resolution computerized tomography of the petrous bone. Brit. J. Radiology 1980; 53: 631.

[5]. CTcharacteristics of the tumors of the temporal bone and cerebellopontine angle. H Imhof ,C B Henk, A D Irisamer, C Czerny et al in 2003 radiology journal.

Abstract: Hypertensive patients after 15-20 years develop hypertension resistance. The blood pressure in these patients is always 150 mm of Hg of systolic pressure. These patients regularly use ACEI, CCB and thiazide diuretic. Hypertension resistance definetely not respond to thiazide diuretic. In few patients it progresses to hypertensive complecations like Cerebro Vascular Disease. These patients usually respond to aldosterone receptor blocker (ARB), loop diuretics. ACEI = Angiotensin converting enzyme ,CCB = Calcium channel blocker ,ARB = Aldosteron receptor blocker ,CVD = Cerebro vascular disease

Keywords: Hypertension Resistance, cerebro vascular disease, thiazide diuretic

[1]. Prineas RJ, Jacobs D. Quality of Korotkoff sounds: Bell vs diaphragm, cubital fossa vs brachial artery. Prev Med 1983;12:715–9.
[2]. Londe S, Klitzner TS. Auscultatory blood pressure measurement—effect of pressure on the head of the stethoscope. West J Med 1984;141:193–5.
[3]. Prineas RJ. Blood pressure in children and adolescents. In: Bulpitt CJ, ed. Epidemiology of hypertension. New York: Elsevier; 2000, 86–105.
[4]. Mourad A, Carney S, Gillies A, Jones B, Nanra R, Trevillian P. Arm position and blood pressure: A risk factor for hypertension? J Hum Hypertens 2003;17:389–95.
[5]. Netea RT, Lenders JW, Smits P, Thien T. Both body and arm position significantly influence blood pressure measurement. J Hum Hypertens 2003;17:459–62.

Abstract: Background: As HIV is the world´s infectious killer and the Guntur District belongs to Andhra Pradesh, India was categorized as "A" basing on the high antenatal HIV prevalence for the last two years as studied by NACO (National AIDS Control Organization), India, has to be given priority to study regarding the risk behaviour of HIV positives. Objectives: 1. To know the risk behaviour towards transmission and spread of HIV among the positives attending Government General Hospital, Guntur. 2. To identify the HIV and health status of study subjects. Study Design: It is a cross-sectional study.................

Keywords: PLWHA (People living with HIV/AIDS), Risk behaviour, S.T.D, Spouse, Guntur

[1]. Lederburg J, Slope RE, Oake SC; Eds, Emerging infections; Microbial Threat to Health in the United States, Washington DC; National Academy of Sciences, 1992.
[2]. WHO (1986), Techn, Rep. Ser. 736.
[3]. Global statistics- AIDS.gov; Information from WHO, UNAIDS and the Kaiser family Foundation´s Global Health policy Division, Nov13, 2014.
[4]. World Aids Day 2013-HIV and AIDS in India, Nirmalya Dutta, Nov 29, 2013.
[5]. HIV/AIDS situation and response in Guntur District; Epidemiological appraisal using data triangulation by Indian Institute of Public Health, Hyderabad. July 2010. Collaborators; DAPCU, Guntur, APSACS, Hyderabad. NACO, New Delhi.

Abstract: Aim: To estimate the prevalence of thyroid dysfunction in patients with liver cirrhosis. Materials and Methods: Early morning fasting serum thyroid stimulating hormone (TSH), serum total free thyroxine (FT4) and free triiodothyronine (FT3) was measured by radioimmunoassays in 111 index patients with liver cirrhosis who did not have history of thyroid diseases. Study period wasoctober 2014 to december 2016. The age of study population was in the range of 25-60 years. Out of 111 patients, 80 were males and 31 were females.Out of 111 patients 64 had ethanol related liver disease, 21 had Hepatitis B positivity, 5 had hepatitis C positivity, 5 had autoimmune hepatitis, 4 had wilson disease and 12 had crytogenic cirrhosis...............

Keywords: Liver cirrhosis, Hypothyroidism, Ethanol related liver disease, Hepatitis B related liver disease, CTP score.

[1]. The Liver in Systemic Disease, Fagiuoli S., Van Thiel D. H., 1993
[2]. Associations between diseases of the thyroid and the liver, Babb R. R., Am. J. Gastroenterol., 1984
[3]. Thyroid hormone homeostasis and the liver, Salata R., Klein I., LeveyG..Semin. Liver Dis., 1985
[4]. Changes in thyroid hormone concentration in liver disease Huang M. J., Liaw Y. F., J. Formosan Med. Assoc., 1989
[5]. Clinical associations between thyroid and liver diseases. Huang MJ1, Liaw YF., JGastroenterolHepatol. 1995 May-Jun;10(3):344-50.

Abstract: On The basis of history and practical value , cesarean section continues to be one of the most important surgeries performed in the speciality obstetrics and Gynaecology in the interest of both mother and baby. Casarean section is defined as the delivery as the delivery of the fetus after the period of viability through an incision on an intact uterus .It excludes the removal of fetus in cases of rupture uterus and abdominal pregnancy. Life saving value of cesarean section to both mother and fetus has increased over the decades. Nowadays , cesarean section is done for multivarious indications viz., fetal distress, cephalopelvic disproportion and others in others in order to reduce the perinatal mortality and morbidity and maternal morbidity.

[1]. American College Obstetricians and Gynaecologists, ACOG Executive Summary : Evaluation of Cesarean Delivery : Washington DC, ACOG, 2000.
[2]. Anuradh Kumar Sita Thakur H.K. Premi. K.B. Gupta. Radhawa Ashaque : Maternal complications in Cesarean Deliveries, Journal of O & G of India Vol.49, No.3, June 1998, P.No.36-40
[3]. ACOG : Financial influences on Mode of delivery – Committee opinion No.149, Washington DC, ACOG, 1994.
[4]. Ayromlooi J, Garfinkel R.1980. Impact of fetal scalp blood pH on the incidence of Cesarean section performed for fetal distress. Intl.J.Obstet & Gynaecol. 17 (4) : 391 – 392.
[5]. Bhatt, R.V. 1989. Antepartum and Postpartum hemorrhage. In : Menon MKK, Devi PK, Rao KB, (eds) Postgraduates Obstetrics and Gynaecology, 4th edn, Madras : Orient Longman 106-120.

Abstract: Preventive Prosthodontics emphasizes the importance of any procedure that can delay or eliminate the future Prosthodontic problems. The overdenture is a logical method for the Dentist to use in preventive Prosthodontics. This article presents a case report of fabrication of overdenture using access post system and implant. The advantage of the overdenture post system lies in its patented, thick walled hollow tube design, stabilizing flanges, and undercuts of the shank which offers strength, retention due to nylon caps, and stability for the prosthesis. The mandible is well suitable for implants particularly in the inter canine region because of the superior bone quality. It gives better retention and stability to mandibular denture

Keywords: Access post, Implant, Nylon cap, Overdenture, Stability

[1]. David R. Burns. The mandibular complete overdenture. Dent Clin North Am 2004;48:603-23

[2]. Musikant BL, Cohen BI, Deutsch AS. The Clinical use of an access post overdenture attachment. Dent Today 1998;17:120-121.

[3]. Cohen BI, Musikant BL, Deutsch AS.The access post and its clinical use. Dent Today 1995;14:88-89.

[4]. Cohen BI, Deutsch AS, Musikant BL. Cyclic fatigue testing of six endodontic post systems. J Prosthodont 1993;2:28-32.

[5]. Cohen BI,Condos S, Deutsch AS, Musikant BL. Cyclic fatigue testing of seven endodontic post systems. J Dent Res 1993;72:305.

[6]. Rovatti L, Dallari D, Mason PN. A new system of endodontic retention. J Atttualita Dentale 1994:18.

Abstract: Background:- Jaundice is an important problem in the 1st week of life affecting approximately 60% of term and 80% of preterm infants. It is commonly managed by phototherapy. Phototherapy may result in the development of hypocalcemia & create serious complications including seizures & other condition. Objective:- To study the effect of phototherapy on serum calcium is neonatal hyperbilirubiniea. Design: - Prospective hospital based comparative study Material and Methods :- This was a prospective hospital based comparative study at Neonatal Intensive Care Unit (NICU) of Rajendra Institute Of Medical Sciences, Ranchi from June 2015 to may 2016 after taking ethical committee approval................

Keywords: Hyperbilirubinemia, Phototherapy, Hypocalcemia, Neonates

[1]. Rennie, J.,et al., Neonatal jaundice: summary of NICE guidance. British Medical Journal 2010;340:240-2499.
[2]. Fanaroff A, Wlash M. Neonatal-Perinatal Medicine,Diseases of the Fetus and Infant, 9th edn, Elsevier Mosby, 2010;Pp:1443-1481.
[3]. Porter ML, Dennis BL, Hyperbilirubinemia in the term newborn. Am Fam Physician. 2002;65;599-606.
[4]. Xiong T, Qu Y, Cambrier S, et al. The side effects of phototherapy for neonatal jaundice: What do we know? What should we do? Eur J Pediatr; 2011;170(10): 1247-55.

Abstract: Alkaline agar gel electrophoresis is a basic manual laborious technique for identifying Hemoglobin variants in the screening for Hemoglobinopathies. It's a cheaper alternative to the now preferred method of detection of Hb variants, i.e., HPLC. In this study, at a government hospital clinical biochemistry laboratory setup, we try to compare and emphasize the importance of this manual procedure. We have done this observation from the archives of lab and case sheet data for the past four and half years; that 1891 electrophoresis were done and 65% were normal, 20% shown Thalassemia trait, and 6% were Thalassemia major and 8% were shown sickle Hb pattern. Majority correlated clinically with the electrophoresis report and in doubtful cases (1.32%), HPLC confirmed the electrophoresis report.............

Keywords : Agar gel alkaline electrophoresis; HPLC, High Performance Liquid Chromatography; SCD, Sickle cell disease; Thalassemia.

[1]. Kutlar F. Diagnostic approach to hemoglobinopathies. Hemoglobin. 2007;31(2):243-50.
[2]. Alla Joutovsky, Joan Hadzi-Nesic, and Michael A. Nardi . HPLC Retention Time as a Diagnostic Tool for Hemoglobin Variants and Hemoglobinopathies: A Study of 60 000 Samples in a Clinical Diagnostic Laboratory. Clinical Chemistry 2004; 50:10: 1736–1747
[3]. Working Party of the General Haematology Task Force of the British Committee for Standards in Haemotology. Guideline: the laboratory diagnosis of haemoglobinopathies. Br J Haematol 1998;101:783–92.
[4]. Bain BJ. Hemoglobinopathy diagnosis. Oxford, England: Blackwell Science Ltd., 2001:260pp.
[5]. Clarke G, Higgins TN. Laboratory investigation of hemoglobinopathies and thalassemia: review and update. Clin Chem 2000;46:1284–90.

Abstract: Background The presence of a wide range of tests of ovarian reserve suggests that no single test provides a sufficiently accurate result. Many tests are used without reference to an evidence base.So far, individual studies conducted on these tests are too small to give precise estimates of prognostic accuracy. Objective: The current study was designed to compare ovarian volume& antral follicle count (A.F.C) & day 3 FSH level, with respect to their ability to predict ovarian response of infertile women to ovulation induction agents Material and Methods: This is a prospective observational study in which 52 infertile women who were attending the Obst & Gynae Dept,PMCH UDAIPUR, were recruited. Blood samples were collected on day 2/day 3 for assessment of Se...............

Keywords: AFC(Antral Follicle Count), AR (Assistted Reproduction), HMG(Human Menopausal Gonadotropin) OR(Ovulatory Response), S.FSH (Serum Follicle Stimulating Hormone) , TVS(Transvaginal Ultrasound)

[1]. Vural B, Cakiroglu Y, Vural F, Filiz S. Hormonal and functionalbiomarkers in ovarian response. Arch Gynecol Obstet 2014;289(6):1355–1361
[2]. Galliano D, Bellver J, Díaz-García C, Simón C, Pellicer A. ART and uterine pathology: how relevant is the maternal side for implantation Hum Reprod Update 2015;21(1):13–38
[3]. Castro EC, Borges ALF, Rezende KN, Amaral WN. Antral follicle count in predicting appropriate dose of gonadotropin in in-vitro fertilization cycles. Reprod Clim. 2014;29(3):136–14
[4]. Beltadze K, Barbakadze L. Ovarian reserve in women of late reproductive age by the method of treatment of PCOS. Iran JReprod Med 2015;13(5):263–268
[5]. Bentzen JG, Forman JL, Larsen EC, et al. Maternal menopause as a predictor of anti-Mullerian hormone level and antral follicle count in daughters during reproductive age.HumReprod 2013;28(1):247–255

Abstract: Background: Propofol induction dose is reduced with concomitant use of opioids as a result of a possible synergistic action. Objective: To study the effects of fentanyl and butorphanol on induction dose of propofol in adults. Methods:One twentypatients of either sex, of ASA(American society of anesthesiologist) I and II, undergoing elective surgery under general anaesthesia was taken and randomly allocated into three groups of 40 each. Group I received intravenous fentanyl 2μg/kg, Group II 20μg/kg and Group III 40μg/kg butorphanol. Induction of anaesthesia was done with propofol (30mg/10s) till the loss of response to verbal commands...............

Keywords: Butorphanol, Fentanyl, Propofol.

[1]. Kanto JH. Propofol, the newest induction agent of anaesthesia. IntI J ClinPharmacolTherToxicol. 1988 Jan;26(1):41-57.
[2]. Sebel PS, Lowdon JD. Propofol: A new intravenous anaesthetic. Anaesthesiology. 1989;71:260–77.

[3]. Kaur J, Srilata M, Padmaja D, Gopinath R, Bajwa SJ, Kenneth J et al. Dose sparing of propofol by fentanyl and butorphanol: A comparison based on entropy analysis. Saudi J Anaesth. 2013 Apr- Jun; 7(2): 128-33.

[4]. Djordjevic B, Stojilikovic MP, Loncar-Stojilikovic D, Krivokapic D. Cardiovascular effects of induction doses of the intravenous anaesthetics, propofol, etomidate and thiopentone. Vojnosanit Pregl, 1999 Jan- Feb;56(1):15-9.

[5]. Smith C, Mc Ewan Al, Jhaveri R, Wilkinson M, Goodman D, Smith LR et al. The interaction of fentanyl on the Cp50 of propofol for loss of consciousness and skin incision. Anaesthesiology. 1994 Oct;81(4):820-8.

Abstract: Though tuberculous infection constitutes one of the more common causes of death and morbidity in the developing world, hepatic tuberculosis is a rare presentation. Hepatic involvement, usually in the form of multiple small-sized miliary nodules, is seen along with other organ involvement. In contrast, isolated hepatic tuberculosis is seldom encountered in clinical practice. In this article we highlight about the serohepatic tuberculosis which is a rare presentation among other hepatic tuberculosis types. Uniquely, the patient had sub capsular as well as extra-capsular involvement. Diagnosis involved imaging and histopathological examination.

Keywords: USG, CT, Tuberculoma, Hepatic tuberculosis.

[1]. Levine C (1990) Primary macronodular hepatic tuberculosis: US and CT appearances Gastrointest Radiol 15: 307 – 309. [2]. Yu RS, Zhang SZ, WU JJ et al (2004) imaging diagnosis of 12 patient with hepatic tuberculosis. World J Gastroenterol 10(11): 1639 – 1642. [3]. Singh S, Jain P, Aggarwal G, Dhiman P, Singh S and Sen R. Primary hepatic tuberculosis: A rare but fatal clinical entity if undiagnosed. Asian Pac J Trop Med 2012; 5: 498-9

[4]. Cao BS, Li XL, Li N and Wang ZY. The Nodular Form of Hepatic Tuberculosis Contrast-Enhanced Ultrasonographic Findings With Pathologic Correlation. J Ultrasound Med 2010; 29: 881-8.

[5]. Wang YT, Lu F, Zhu F, Qian ZB, Xu YP and Meng T. Primary hepatic tuberculoma appears similar to hepatic malignancy on F-18 FDG PET/CT. Clin Nucl Med 2009; 34: 528-9

Abstract: Background: Body mass index (BMI) is defined as the body mass (weight) divided by the square of the body height, and is universally expressed in units of kg/m2. Bone Mineral Density (BMD) test measures the density of minerals present in the bones. Role of obesity as a risk factor for osteoporosis and its related consequences remains unsettled. This study was conducted to analyze the interplay between body mass index and bone mineral density in men, since most of those studies were conducted on women. Materials and methods: The study was done on 60 healthy males in the age group of 20years and above. Anthropometric measurement of height (m) and weight (kg) was done. Participants were categorized into three BMI groups according to WHO criterion.............

Keywords: BMI, BMD, Osteoporosis, Osteopenia.

[1]. J.A Kanis, P.Delmas, P Burckhardt, C Cooper, DTorgerson, Guidelines for diagnosis and management of osteoporosis, Osteoporosis Int, 7, 1997, 390-406.
[2]. F.D Shuler, JConjeski, D Kendall, JSalava, Understanding the burden of osteoporosis and use of the World Health Organization FRAX, Orthopedics, 35, 2012, 798–805
[3]. D.T. Felson, Y Zhang, M.T. Hannan, J.JAnderson, Effects of weight and body mass index on bone mineral density in men and women: the Framingham study, Journal of Bone and Mineral Research, 8(5), 1993, 567–573.
[4]. T.V Nguyen, J.R Center, J.A Eisman, Osteoporosis in elderly men and women: effects of dietary calcium, physical activity, and body mass index, Journal of Bone and Mineral Research, 15(2), 2000, 322–331.
[5]. D.J.M. Van Der Voort, S. Brandon, G.J. Dinant, J.W.J. Van Wersch, "Screening for osteoporosis using easily obtainable biometrical data: diagnosticaccuracy of measured, self-reported and recalled BMI, and related costs of bone mineral density measurements," Osteoporosis International, 11(3), 2000, 233–239.

Abstract: Background: Sleep is a physiological process essential for life. Sleep loss leads excessive daytime sleepiness (EDS) which leads to many like complications like impaired memory and cognition, decreased work performance, increased chances of vehicular accidents etc .The Critical Flicker Fusion (CFF) test provides an index of central nervous system activity or cortical arousal which measures arousal and alertness. Thus, this study is carried out with aim of deciphering the effect of Excessive daytime sleepiness on Critical fusion frequency in medical students............

Keywords: Excessive Daytime Sleepiness (EDS), Critical fusion frequency (CFF), cognitive function, cortical arousal, alertness

[1]. Sleep deprivation: Impact on cognitive performance. Alhola P and Kantola PP. Neuropsychiatric Disease and Treatment.2007;3(5):553–567.

[2]. Ramamoorthy S, Mohandas S and Premasembulingam M. prevalence of excessive daytime sleepiness among medical students. World journal of pharamaecetutical research.2014;3(4):1819-1826.

[3]. Nonato DR, Viegas CA, Abreu e Silva AA and Tavares P. Daytime sleepiness and academic Performance in medical students.Arq Neuropsiquiatr. 2002;60(1):6-11.

[4]. Schneider C,Fulda S.and Schulz.H. Daytime variation in performance and tiredness/sleepiness ratings in patients with insomnia, narcolepsy, sleep apnea and normal controls. J. Sleep Res.(2004);13:373–383.

Abstract: Background: Children are prone to malaria infection. Peroxidation of membranes lipids, hemolysis and oxidative stress due to invasion of erythrocytes by malaria parasites could worsen the disease and increase mortality. Aim: Evaluation of Malondialdehyde (MDA), Total Antioxidant Status (TAS), uric acid and bilirubin in children suffering from malaria. Materials and Method: Thirty malaria patients (age 1-5 years) were divided into two groups based on density of parasitaemia: Group1 = thirteen children scored as (+) and group2 = seventeen children scored as (++). Thirty apparently healthy children (age 1-5 years, parasitaemia score= -) served as control. Serum from groups 1, 2 and control were used to determine levels of uric acid, TAS, MDA and bilirubin by standard spectrophotometric methods................

Keywords: Malaria, Haemolysis, Oxidative Stress, Lipid Peroxidation, Antioxidants

[1]. R.W Snow, C.A Guerra, A.M Noor, H.Y. Myint, and S.I. Hay,The global distribution of clinical episodes of Plasmodium falciparum malaria. Nature. 4342005: 214–217
[2]. P. Trigg and A.V. Kondrachin, The current global malaria situation. Malaria, 4thedition, London, Butterworth Publication (1993) (11-21)
[3]. I.A. Clark and N.H. Hunt, Evidence of reactive oxygen intermediates causing haemolysis and parasite death in malaria. Infection and Immunity. 39, 1983: 1 – 6.
[4]. I.A. Clark, N.H. Hunt, W.B Cowden, L.E. MaxwellE.J. and Mackie, Radical-mediated damage to parasites and erythrocytes in Plasmoduim vinckei infected mice after injection of t-butyl hydroxide. Clinical Experimental Immunol. 56,1984: 524-530
[5]. B.S. Das and N.K. Nanada, Evidence for erythrocyte lipid peroxidation in acute falciparum malaria. Trans. Roy. Soc. Trop. Med. Hyg. 93, 1999: 58-62

Abstract: Introduction: Partial or complete retention of products of conception after delivery or abortion is referred to as "RPOC". RPOCs are suspected whenever a female presents with sustained or prolonged vaginal bleeding after a period of amenorrhea as in cases of spontaneous or induced abortion or following delivery. Besides clinical examination, ultrasound is indispensable for evaluation. Depending on the patient's general condition, symptoms and size of RPOCs, medical or surgical evacuation is planned. Complications like anemia, sepsis, drug reaction or those inherent to the surgical procedure should be diagnosed timely and appropriately managed..............

[1]. Nielsen S, Hahlin M. Expectant management of first trimester spontaneous abortion. The Lancet. 1995;345:84–86.
[2]. Royal College of Radiologists, Royal College of Obstetricians and Gynaecologists. Guidance on Ultrasound Procedures in Early Pregnancy. London: RCR/RCOG; 1995.
[3]. Ankum WM, Wieringa-de Waard M, Bindels PJ. Management of spontaneous miscarriage in the first trimester: an example of putting informed shared decision making into practice. BMJ. 2001;322(7298):1343–46.
[4]. Nanda K, Peloggia A, Grimes D, Lopez L, Nanda G. Expectant care versus surgical treatment for miscarriage. Cochrane Database of Systematic Reviews. 2006;(2):CD003518.

Abstract: The purpose of this study To study serum magnesium levels in acute gastroenteritis. 2. Correlation of severity of diarrhea with serum magnesium level. 3. Correlation of serum magnesium level in diarrhea with serum potassium and calcium levels. 4. To correlate the severity of hypomagnesemia if present with its clinical and ECG manifestations To study serum magnesium levels in acute gastroenteritis. 2. Correlation of severity of diarrhea with serum magnesium level. 3. Correlation of serum magnesium level in diarrhea with serum potassium and calcium levels. 4. To correlate the severity of hypomagnesemia if present with its clinical and ECG manif

[1]. F. Richard Bringhurst, Bone and mineral metabolism in health and disease, Harrison's principals of internal medicine 18th edition , volume 2, page 3090-91.
[2]. Elin R J, Assessment of magnesium status, Journal of clinical Chemistry 1987; page 33.
[3]. Saris NE, Mervaala E, Karen H, et al Magnesium An update on physiological, clinical and analytical disease aspects. Journal of clinical chemistry A Jan 2000; 294 page 1-26.
[4]. Al-Ghamdi SM, Cameron EC, Sutton RA. Magnesium deficiency: pathophysiologic and clinical overview. Am J Kidney Dis 1994; 24: 737-752.
[5]. R Swaminathan. Magnesium metabolism and its disorders. Clin Biochem Rev May 2003; page47-66.

Abstract: Introduction: Alopecia Areata (AA) is a non – scarring inflammatory hair loss disease that can affect men, women and children. Though multiple modality of treatment are available, topical therapy is preferable in view of fewer side effects, Hence this study was carried out to see the responses of two topicalmodalities of therapy. Materials And Methods:- Patients presenting with AA, to our dermatology department during the month of june 2016 were recruited.The two topical modalities were tried and results were analysed at the end of 3 month study period. (July, August, September) 2016. Results And Conclusion:- Acceptable regrowth of hair was seen in equal number of patients treated with Betasalic ointment and 5% minoxidil. The two modalities may be considered in the therapy of alopecia areata as the adverse effect was noticed was transient.

[1]. Wadhwa SL, Khopkar U. Hair and Scalp disorders. In: Valia RG ED. IADVL Textbook and Atlas of Dermatology. 2nded. Bhalani Publishing House, 2001: 1: 733- 737.
[2]. Dawber RPR, Berker Ode, Wgnarowska F. Disorders of hair, In: Champion RH, Burton JL. Burns DA. et al, eds. Textbook of Dermatology. 6thed. Oxford, England: Blackwell Science, 1998: 3: 2919- 2927.
[3]. Madani S. and Shapiro J. Alopecia areata an update. J Am Acad ofDermatol 2000; 42: 549 – 565.
[4]. Wilma FB. Hair disorders. In: Moschella and Hurley eds. Textbook of dermatology, 3rded. Saunders 2: 1545-6.
[5]. Elsie AO. Hair disorders. In: Freedberg IM, Eisen AZ, Wolff K, et al. Fitzpatricks Dermatology in General Medicine, McGraw Hill, 5th ed. 1: 737 - 9.

Abstract: Many surgeons have had the challenging experience of facing an unsolvable chronic abdominal pain and with uncertain diagnosis or staging of intra abdominal tumours. History taking, physical examinations, biochemical tests & sequences of advanced noninvasive imaging studies might provide some help but are often insufficient for an accurate diagnosis. Imaging studies cannot provide an accurate diagnosis of the aforementioned chronic abdominal conditions. Nevertheless exploratory laparotomy has inevitably Hence Diagnostic Laparoscopy is indicated in any situations when inspection of abdomino-pelvic organs will help to establish a diagnosis and for further subsequent management.

[1]. Husain M, Sachan PK, Khan S, Lama L, Khan RN. Role of diagnostic laparoscopy in chronic and recurrent abdominal pain, Trop Gastroenterol. 2013 JulSep;34(3): 1703.
[2]. Amandeep S Nar, Ashvind Bawa, Atul Mishra, and Amit Mittal, Role of Diagnostic Laparoscopy in Chronic Abdominal Conditions with uncertain diagnosis, Niger J Surg. 2014, Jul Dec; 20 (2): 75-78
[3]. Gouda M Ellabban and Emad N Hokkam, The efficacy of laparoscopy in the diagnosis and management of chronic abdominal pain, Journal of Minimal Access Surgery, 2010 Oct Dec : 6(4) : 95-99
[4]. Kinnaresh Ashwin Kumar Baria, Role of Laparoscopy in diagnosis and management of Chronic abdominal pain, Indian J.Sci.Res. 4(1) : 65-68, 2013
[5]. Laparoscopic lysis of adhesions, World J Surg 2006 Apr; 30 (4): 535 - 40

Abstract: Knowledge of root canal anatomy with possible variations is of prime concern responsible for successful endodontic therapy. Cooke and Cox were the first to document the C-Shaped canal in endodontic literature. The variation exhibits a fin or web connecting the individual root canals to form an orifice similar to letter 'C'. The irregular areas in C-shaped root canal system often may harbor soft tissue remnant or infected bacterial biofilm, leading to inadequate cleaning and root canal obturation. The use of the ultrasonics, (MTA Fillapex), thermoplasticized obturation techniques, SAF system, CBCT and Endodontic Microscopes can be successfully used to treat such cases...............

Keywords: C shaped canal, Melton classification, MTA, MTA Fillapex, fins and webs.

[1]. Management of C Shaped Maxillary Lateral Incisor- A Case Report- Dr.Shristhi Sharma, Dr.Anant Raghav Sharma, IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) Volume 16, Issue 3 Ver. VIII (March. 2017), PP 112-115
[2]. The C-shaped Root Canal Configuration: A Review Hamid Jafarzadeh, DDS, MSc* JOE — Volume 33, Number 5, May 2007
[3]. Assessment of endodontic treatment of c-shaped root canals, Johan P Woelber, Michael Bruder, swiss dental journal VOL 124 1/2014
[4]. C-SHAPED CONFIGURATION OF THE ROOT CANAL SYSTEM – PROBLEMS AND SOLUTIONS Janet Kirilova, Snezhanka Topalova-Pirinska. Journal of IMAB - J of IMAB. 2014, vol. 20, issue 1
[5]. Management of C Shaped Canals in Mandibular Molars: Two Case Reports 1 Rakhee Ramdas,2 Ramesh Kumar, IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 15, Issue 4 Ver. III (Apr. 2016),

Abstract: Introduction:Sacrum is a triangular bone forming the caudal end of the vertebral column, formed by fusion of five vertebras.Sacral hiatus is the opening present at the caudal end of sacral canal formed by the nonfusion of the lamina of the fifth (occasionally fourth) sacral vertebra.The structures passing through sacral hiatus are a pair of 5th sacral nerves, a pair of coccygeal nerves, filumterminaleexterna. Caudal.epidural block (CEB) is widely used to provide anesthesiafor various clinical procedures. Knowledgeof sacral hiatus anatomy play major role in the success of needle placement for desired results of caudal epidural block................

Keywords: Absent sacral hiatus, Caudal epidural anesthesia, Dorsal agenesis of sacral hiatus, Sacral hiatus, CEB

[1]. Esses SE, Botsford DJ (1997) surgical anatomy and operative approaches to the sacrum. In: Frymoyer JW, Ducker TB, Hadler NM
(eds). The adult spine: principles and practice. Vol. II 2nd ed. Lippincott-Raven,Philadelphia
[2]. Patil D, Jadav H ,kumar B, Mehta CD, Patel VD:Anatomical study of Sacral Hiatus for Caudal Epidural Block. National Journal of
Medical Research. Sept2012;2(3) pp 272-275

[3]. Standring S, editor. Gray'sAnatomy.The Anatomical Basis of Clinical Practice. 40th ed. London: Churchill Livingstone Elsevier;
2008. p. 724‑8
[4]. Peutrell JM, Mather SJ. Regional anaesthesia in awake children. London: Oxford Medical Publications; 1996. p. 248‑54.
[5]. Senoglu N, Senoglu M, Oksuz H et al. Landmarks of the sacral hiatus for caudal epidural block: an anatomical study. Br. J Anaesth
2005;95(5):692-5

Abstract: Surgical repair of inguinal hernias is a common procedure done in adults. However recurrence has been reported to occur in 15% of the cases and postoperative pain and disability are frequent. The strengthening of posterior inguinal wall is one of the major objectives in inguinal hernia repair. The Stoppas repair or Giant Prosthetic Reinforcement Of the Visceral Sac(GPRVS) is done by wrapping the lower part of parietal peritoneum with prosthetic mesh over Fruchauds myopectineal orifice. The mesh contributes to a physiological healing process that creates a special anatomical strengthening in the inguinal region that prevents recurrence. The purpose is to study the efficacy of stoppas repair in bilateral inguinal hernias in the department of general surgery in CMCH and to study its advantages and disadvantages.

Keywords: Stoppas procedure, GPRVS(Giant Prosthetic Reinforcement of the Visceral Sac), Fruchauds myopectineal orifice, Lichtenstein's hernioplasty

[1]. Feliu X, Torres G, Viñas X, Martνnez-Rόdenas F, Fernández-Sallent E, Pie J. Preperitoneal repair for recurrent inguinal hernia: laparoscopic and open approach. Hernia. 2004;8:113–116. Journal of American Science 2014;10(5)

[2]. Papadakis K, Greeburg AG. Properitoneal Hernia repair. In: Fitzgibbons RJ. Greeburg AG, editors. Nyhus and Condon‟s Hernia. 5th ed. Philadephia: Lippincot and Wilkins; 2002. p.182.
[3]. Schwab R, Conze J, Willms A, Klinge U, Becker HP, Schumpelick V. Management of recurrent inguinal hernia after previous mesh repair- A challenge. Chirurg. 2006; 77:523–530.
[4]. Rutkow IM, Robbins AW. Demographic, classificatory, and socioeconomic aspects of hernia repair worldwide. Surg Clin North Am. Jun 2013;73(3):413-26.
[5]. Schumpelick V, Klinge U, Klosterhalfen B. Biomaterials for the repair of abdominal wall hernia. Structural and compositional considerations. In: Fitzgibbons RJ, Greenburg AG, editors. Nyhus and Condon‟s Hernia. 5th ed. Philadeiphia: Lipponcott and Wilkins; 2002. p.182.

Abstract: Background: The duration and pattern of sleep varies considerably among individuals. Insomnia is characterised by acute or chronic inability to initiate or maintain sleep adequately at night (1). Benzodiazepinereceptor agonists are the most effective and well-tolerated class of medications for insomnia. While there are significant differences among different BZDs, in general, they hasten onset of sleep, reduce intermittent awakening and increase total sleep time. The likely hood of rebound insomnia and tolerance can be minimized by short durations of treatment, intermittent use, or gradual tapering of the dose. Aim/ Objective: To observe the effects of Tab. Diazepam and Tab. Alprazolam on Sleep pattern and sleep quality in patients with insomnia...............

Keywords: Insomnia, Diazepam, Alprazolam, pittsburgh sleep quality index scale (PSQI)

[1]. Neylan TC, Reynolds CF, Kupfer DJ. Sleep disorders. In: Yudofsky SC,. Sleep disorders. American Psychiatric Press Textbook of
Neuropsychiatry,. Washington, DC: : American Psychiatric Press,, 2000:583–606.
[2]. Evidence-based guidelines for the pharmacological treatment of anxiety disorders. Baldwin DS, Anderson IM, Nutt DJ, et al. s.l. :
British Association for Pharmacology,Psychopharmacol, 2005;19:567–596.
[3]. Insomnia in primary care patients . Shocat T, Umphress J, Isreal AG, Ancoli-Israel S. s.l. : sleep , 1999;22(Suppl 2):, Vols. S359–
S365.
[4]. Practice parameters for the nonpharmacological treatment of chronic insomnia. Chesson AL, Anderson WM, Littner M, et al. s.l. :
sleep, 1999;, Vols. 8:1-6.
[5]. Cognitive behavioral therapy vszopiclone for treatment of chronic primary Insmnia in older adults.Arandomized controlled trial.
Sivertsen B, Omvik S, Pallesen S, et al. s.l. : JAMA , 2006;295:2851–2858.

Abstract: Neonatal sepsis is defined as a clinical syndrome of bacteremia with systemic signs and symptoms of infection in the first 4 weeks of life. This study was undertaken to determine the bacteriological profile and antibiotic sensitivity patterns of microbial isolates from blood cultures of neonates suspected with neonatal sepsis, in Coimbatore Medical College Hospital. An analysis was conducted on all blood culture reports obtained between 1st of July 2015 to the 31st of December 2015. During the study period, 797 newborns with clinical sepsis were admitted. Blood culture reports were positive in 281 cases ( 35.26%).Out of 281 cases...............

Keywords: Neonatal sepsis, antibiotic susceptibility, Blood culture

1) Stoll BJ. The global impact of neonatal infection. Clin Perinatol 1997;24:1-21

2) Klinger G, Levy I, Sirota L, et al. Epidemiology and risk factors for early onset sepsis among very-low-birthweight infants. Am J Obstet Gynecol. 2009 Jul. 201(1):38.e1-6.
3) Vergnano S, Sharland M, Kazembe P, Mwansambo C, Heath PT. Neonatal sepsis: An international perspective. Arch Dis Child Fetal Neonatal Ed 2005;90:F220-4.
4) Neonatal Sepsis: past, present and future; a review article Shalini Tripathi G K Malik et al.Internet Journal of Medical Update 2010 July;5(2):45-54
5) Gomaa HHA, Udo EE, Rajaram U. Neonatal septicemia in AlJahra hospital, Kuwait: Etiologic agents and antibiotic sensitivity patterns. Med Princ Pract 2001;10:14550

Abstract: Background:Lipomas are the commonest soft tissue tumors that arise from adipocytes. They are often located in the subcutaneous tissue and underlying fasciaof the head, neck, shoulders, back and thighs. Upper extremity lipomas are gradually becoming frequent. Current popular nosology recognizes, in addition to subcutaneous localizations, intramuscular andintermuscular, even interosseous forms. Intramuscular lipomas of the hand are rare. Case report:We deem interesting to report a peculiar case of a giant intramuscular lipoma of the thenar region in a 50-year-old patient with no antecedent of trauma...............

Keywords: Lipoma, thenar, intramuscular

[1]. Murphey MD, Carroll JF, Flemming DJ, et al. From the archives of the AFIP: benign musculoskeletal lipomatous
lesions. Radiographics 2004;24:1433-66
[2]. McTighe S, Chernev I. Intramuscular Lipoma: A Review of the Literature. Orthopedic Reviews. 2014;6(4):5618.
doi:10.4081/or.2014.5618.
[3]. Papakostas T, Tsovilis AE, Pakos EE. Intramuscular Lipoma of the Thenar: A Rare Case. Archives of Bone and Joint Surgery.
2016; 4(1):80-82.
[4]. D'Alfonso TM, Shin SJ. Intramuscular lipoma arising within the pectoralis major muscle presenting as a radiographically detected
breast mass. Arch Pathol Lab Med. 2011 Aug;135(8):1061-3. doi: 10.5858/2010-0546-CRR
[5]. Greenberg SD, Isensee C, Gonzalez-Angulo A, Wallace SA. Infiltrating lipomas of the thigh. Am J ClinPathol 1963;39:66-72.

Abstract: Background : Oral cancer is one of the most common malignancies in India. In the present study, a total number of 73 patients were included to find out the various clinical and pathological manifestations of the oral cancer Methods :This study was carried out in the Department of Otorhinolaryngology and Head & Neck Surgery, Gauhati Medical College, Guwahati during period of one year from 1st July, 2015 to 30th June, 2016.In this series, oral cancer cases with lesions in lip, alveolus, and buccal mucosa, anterior two-third of tongue, retromolartrigone, hard palate and floor of mouth were included irrespective of age and sex.Proforma was filled. It included- patients's details, presenting complaints, history of present illness, history of past illness etc................

Keywords: Oral cancer, squamous cell carcinoma, buccal mucosa, betel quid

[1]. Wahi P.N, Factors influencing oral and oesophageal cancers in India, Br Jr Cancer, 1965; 19:642.
[2]. Bhattacharjee A et al. Prevalence of Head and Neck Cancers in the North East—An Institutional Study,Indian Journal of
Otolaryngology and Head and Neck Surgery, January-March 2006; 58(1): 15-19.
[3]. Gangane N et al. Reassessment of Risk Factors for Oral Cancer, Asian Pacific J of Cancer Prev, 2007; 8; 243-248.
[4]. Bhat S.P. et al, Clinicopathological Spectrum Of Oral Cavity And Oropharyngeal Malignancies, World Articles in Ear, Nose and
Throat, 2010, Vol 3.
[5]. Khanna N.H. et al. Indian Journal of Cancer, 1975; 12:77.