iosr-JDMS   Volume-16 ~ Issue-5 ~ May-2017

Abstract: Background: Anomalous origin of multiple coronary ostia from a single coronary sinus are very rare findings. Proficiency in the anatomy of coronary arteries and their variations is significant for proper interpretation of the coronary angiographies, assessment of the complexity and result of coronary insufficiency as well as surgical myocardium revascularization. Anomalous coronary ostia has severe clinical manifestation including sudden death in young athelets so taking into consideration its importance this study is carried out to study in detail the normal and variant anatomy of coronary ostia and its clinical significance in the living subjects. Method: This study is carried out in 50 embalmed human hearts by fine dissection method with the help of pointed forceps. We find out origin of multiple ostia of coronary arteries from a single coronary sinus. The courses of arteries arising from these anomalous ostia are also studied in detailed..............

Keywords: Anomalous, Artery, Coronary arteries, Ostia,

[1]. Alexander RW and Griffith GC (1956). Anomalies of the coronary arteries and their clinical significance. Circulation 14: 800-805.
[2]. Aggarwal P, Kazerooni EA.Dual left anterior descending coronary artery.CT findings. A J R, AM J 2008;191 :1698-1701
[3]. Angelini P (1989). Normal and anomalous coronary arteries: Definitions and classification. Am Heart J, 117: 418-434.
[4]. Bekedam, M.A. and Vligen, H.W. (1999) : Diagnosis and management of anomalous origin of right coronary artery from the left coronary sinus. International Journal of cardiologic Imaging 15 (3) : 253 - 258.
[5]. Caetano, A. G and Lopes, A.C. (1995) : Critical analysis of the clinical and surgical importance of the variations in the origin of sino-artrial node artery of the ssssssshuman heart. Rev. Assoc Med Brass 41 (2) : 94 - 102..

Abstract: This study has undertaken to promote and protect the health and prevent the disease to some extent and thus help in implementing the need based preventive measures in affected community by aiming to study the social implications among the population residing in the endemic area of fluorosis. Patient details including age, sex, address, literacy, occupation, socioeconomic status, knowledge, attitude, practices towards fluoride related products or water and its social implications were collected..........

Keywords: Endemic fluorosis, Social implications

[1]. AG Sharpe, Inorganic chemistry, 3rd edition. 1992. ELBS publications, pp. 400.
[2]. IS : 10500-1991. Indian Standards specification for drinking water. Bureau of Indian stnadards (BIS) New Delhi, India.
[3]. A Mittal, N Trivedi, SK Gupta, S Kumar, RK Gupta, Radiological spectrum of endemic fluorosis : relationship with calcium intake,
[4]. AK Susheela, Treatise on Fluorosis, revised 2nd ed. Published by Fluorosis research and rural development foundation, New Delhi, 2003.
[5]. P Granjean and G Thompsen, Reversibility of skeletal fluorosis, Br J Ind Med, 40, 1983, 456-461

Abstract: Background:Yoga is practiced in India and all over the world for over thousands of years.Increased awareness of health and natural remedies, yogic techniques are gaining importance and receiving worldwide acceptance. Objective: To determine the effect of a set of yoga on sympathetic nervous system. Methods: The study was conducted in fifty (50) normal females of Manipur undergoing three (3) months yoga training,in the age group 15-50 years.The study was a prospective study where sympathetic nervous system was assessed before the start of yoga training and after 3(three) months of yoga training under expert guidance............

Keywords:Sympathetic nervous system, Yoga training, hypothalamo-pituitary axis,cardiovascular morbidity and mortality.

[1] Vivekananda Kendra, Yoga the exercise of holistic living, Chennai: Vivekananda Kendra Prakashan Trust, 2005.
[2] Nagendra HR, Yoga its basis and application, Bangalore: Swami Vivekananda Yoga Prakashan, 2005.
[3] Raichur RN, Kulkarni SB, Rahul RR, Aruna GB, Sridevi RR, Effect of meditation training on pulmonary function tests, Rec Res Sci Tech, 2(11), 2010, 11-16.
[4] Pal GK, VelkumaryS ,Madanmohan, Effect of short-term practice of breathing exerciseson autonomic functions in normal human volunteers, Indian J Med Res, 120, 2004, 115-121.
[5] Desh D, Sinha AN, Gusain VS. A study on effects of meditation on parasympathetic nervous system functional status in meditators, Intl J Res Pharma Biomed Sci,3(2) 2012, 772-779.

Abstract: Introduction: Chronic suppurative otitis media is one of the most common infectious disease worldwide. Also its known for its recurrence and persistence despite adequate treatment. It is caused by a wide variety of microorganisms, both aerobic and anerobic. To add on to it, there is emergence of specific antibiotic resistance due to inadvertent use of these drugs. Aims And Objectives Of The Study: This study is a hospital based study aimed at re-evaluating the current bacteriological profile of chronic suppurative otitis media (CSOM) and the sensitivity pattern to most of the currently available antibiotics...........

Keywords: Antibiogram, Drug resistance, Chronic Suppurative Otitis media, Pseudomonas Aeroginosa, Staphylococcus aureus.

[1]. FT Orji and BO Dike, Observations on the Current Bacteriological Profile of Chronic Suppurative Otitis Media in South Eastern Nigeria, Annuals of Medical Health Sciences Research, 2015 Mar-Apr; 5(2): 124–128.

[2]. Monasta L, Ronfani L, Marchetti F, Montico M, VecchiBrumatti L, Bavcar A, et al. Burden of disease caused by otitis media: Systematic review and global estimates. PLoS One. 2012;7:e36226.

[3]. Acuin J. Chronic suppurative otitis media: Burden of illness and management options. Geneva, Switzerland: World Health Organization; 2004

[4]. Mohammed JamiuKazeem, RuqayyahAiyeleso, Current bacteriological profile of chronic suppurative otitis media in a tertiary facility of Northern Nigeria, Indian Journal of Otology, 2016, vol 2, Issue 3, Pg 157-161.

[5]. Hassan O, Adeyemi A study of bacterial isolates in cases of otitis media in patients attending Oautch, Ile-Ife. Afr J ExpMicrobiol. 2007;8:130–6.

Abstract: Diabetes mellitus is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action or both. Hyperglycemia along with hyperlipidemia leads to microvascular and macrovascular complications of diabetes mellitus. Leptin is an adipose tissue derived hormone which primarily acts on hypothalamus to regulate hunger and satiety. The aim of this study is to see the leptin levels in non-obese diabetes mellitus patients and its association with chronic complications. The difference in serum leptin levels among gender in the...........

Keywords: Leptin, Type 2 Diabetes mellitus, chronic complications

[1]. Kitabchi, AE; Umpierrez, GE; Miles, JM; Fisher, JN. "Hyperglycemic crises in adult patients with diabetes.".Diabetes Care.2009;32 (7): 1335–43.

[2]. Sprague, Jennifer E., and Ana María Arbeláez. "Glucose Counterregulatory Responses to Hypoglycemia." Pediatric endocrinology reviews . 2011;463–475.

[3]. Giacco F, Brownlee M. Oxidative stress and diabetic complications.Circ Res.2010.29;107(9): 1058 -70
[4]. Seufert J, Kieffer TJ. Leptin inhibits insulin gene transcription and reverses hyperinsulinemia in leptin-deficient ob/ob mice. Proc. Natl. Acad. Sci. 1999;96:674–679.

[5]. Myers MG, Leibel RL, Seeley RJ, Schwartz MW. Obesity and Leptin Resistance: Distinguishing Cause from Effect. Trends in endocrinology and metabolism.2010;21(11):643-651.

Abstract: Background: Immune mediated vesiculobullous diseases can be diagnosed by close attention to the clinical details, histological confirmation and the clinical setting of the blistering. Confirmatory studies such as immunofluorescence will help in diagnosis of cases where histopathological features alone are not diagnostic. To evaluate clinical findings in association with histopathological findings, to study the histopathological findings in various immunobullous lesions of skin, and to confirm with immunofluorescence wherever possible Aim: The aim is to study histopathology of various Autoimmune vesicobullous..........

[1]. Khandhari KC, Paricha JS. Pemphigus in Northern India Clinical studies in 34 patients. Indian J Dermatol Venereol. 1965; 31: 62-70.
[2]. Arya SR, Valand AG, Krishna K A. Clinicopathological study of 70 cases of pemphigus. Indian J Dermatol Venereol Leprol. 1999; 168-71.
[3]. Shafi M, Khatri ML, Mashina M, Ben-Ghazeil M: Pemphigus A Clinical study of 109 cases from Tripoli, Libya. Indian J Dermatol Venereol Leprol. 1994; 60: 140-3.
[4]. Fernandez JC, Dharani JB, Desai SC. A Study of 100 cases of pemphigus – clinical features. Indian J Dermatol Venereol. 1970; 36: 1-11.
[5]. 5. Swarnalatha G, Reddy JS. Direct fluorescence on Tzanck smears: A rapid test to confirm Pemphigus. Indian J Dermatol Venereol Leprol. 2001;67:218

Abstract: The objective of this study was to evaluate the diagnostic value of skull radiograph alone in young children in screening of skeletal dysplasias and dysostoses in comparison with whole skeletal survey. It is a retrospective study which includes 1000 high risk children who undergone whole skeletal survey. 20 patients were diagnosed as dysplasia/dysostoses out of which 18 patients had skull abnormalities. The sensitivity, specificity, positive predictive value and negative predictive value for skull Xray alone was 90%,100%,100% and 99.8% respectively in making correct diagnosis.Two patients who was diagnosed as chondrodysplasia punctata had no skull abnormalities. In high risk...........

Keywords: Dysplasia/dysostoses, High risk children, skull Xray, whole skeletal survey

[1]. Panda A, Gamanagatti S, Jana M, Gupta AK, Skeletal dysplasias: A radiographic approach and review of common non-lethal skeletal dysplasias,World J Radiol, 6(10), 2014 Oct 28, 808–82.
[2]. Ronald B. J. Glass, Sandra K. Fernbach, Karen I. Norton, Paul S. Choi, and Thomas P. Naidich, The Infant Skull: A Vault of Information, RadioGraphics,24:2, 2004,507-522.

[3]. Brindhaban A1, Eze CU, Estimation of radiation dose during diagnostic X-ray examinations of newborn babies and 1-year-old infants, Med Princ Pract,15(4),2006,260-5.
[4]. Kulkarni ML,Samuel K, Bhagyavathi M, Sureshkumar C, Skeletal dysplasias in a hospital in southern India, Indian Pediatr,32(6),1995, 657-65.
[5]. Kulkarni ML, Kurian M, Consanguinity and its effect on fetal growth and development. A South Indian Study, J Med Genet, 27, 1990, 348-353..

Abstract: Background: The increase in type 2 diabetes is directly related to the environmental risk factors, especially overweight and obesity, which superimposed on genetic predisposition results in progressive beta cell failure and insulin resistance. The relative risk for type 2 Diabetes increases as the Body mass index increases. Objective: 1. To assess the effect of various grades of obesity on type 2 Diabetes mellitus. 2. To correlate the effect of dyslipidemia as a consequence of obesity on type 2 DM. Materials and Methods: About 200 subjects were included in the study. The subjects were divided into 2 groups: Group 1 – 100 obese individuals (Obese normal + Obese Diabetic) and Group 2 – 100 non obese individuals ( Non obese normal + Non obese Diabetic). The body mass index was correlated with blood sugar and lipid profile. Statistical analysis were done using students unpaired t test........

Keywords: Obesity,diabetes,lipid profile and body mass index

[1]. WHO Technical Series Obesity: Preventing and managing the global epidemic. Report of a WHO consultation. World Health Organization Technical Report Series, 2000; 894: 1-253.
[2]. Guh, D.P., et al. The incidence of co-morbidities related to obesity and overweight:
[3]. A systematic review and meta-analysis. BMC Public Health, 2009; 9: 88.
[4]. Ramlo Halsted BA, Edelman SV. The natural history of type 2 Diabetes: Implications for clinical practice. Prim care, 1999; 26: 771 – 789
[5]. Misra A, Khurana L. Obesity and the metabolic syndrome in developing countries. J Clin Endocrinol Metabolism 2008; 93(11 Suppl1):S9-30..

Abstract: Objective: Sudden sensorineural hearing loss (SSNHL) is a common emergency in Otology. The etiology, clinical features and treatment remains a matter of debate for over decade. The aim of this study is to evaluate the effectiveness of intratympanic steroid therapy (IST) in patients with idiopathic sudden sensorineural hearing loss (ISSHL), determining the overall hearing recovery and comparing the results with different variables. Materials and Methods: Our study consisted of 50 patients with sudden sensorineural hearing loss............

Keywords: Sensorineural Hearing loss, Intratympanic Steroid Therapy, Methylprednisolone

[1]. Haberkamp TJ, Tanyeri HM. Management of idiopathic sudden sensorineural hearing loss. Am J Otol 1999;20:587-95.
[2]. Gianoli GJ, Li JC. Transtympanic steroid for treatment of sudden hearing loss. Otolaryngol Head Neck Surg 2001;125:142-6.
[3]. Mattox DE, Simmons FB. Natural history of sudden sensori-neural hearing loss.Ann Otol Rhinol Laryngol1977;86:
[4]. Merchant SN, Adams JC, Nadol JB. Pathology and pathophysiology of idiopathic sudden sensorineural hearing loss. Otol
Neurotol 2005;26:151-60.
[5]. Rarey KE, Luttge WG. Presence of type I and type II/IB receptors for adrenocorticosteroid hormones in the inner ear. Hear Res
1989;41:217-22..

Abstract: Objective: To determine the clinical presentation, management and outcome of lens-induced glaucoma (LIG) in Govt. General Hospital attached to Govt. Siddhartha Medical College. Methods: A retrospective study was done on LIG patients who have attended ophthalmic op Govt. General Hospital attached to Govt. Siddhartha Medical College Vijayawada during the period from 2010 September to 2015 August. Exclusively Patients with LIG were included and all patients with primary glaucoma's and secondary glaucoma's were excluded. Demographic data, clinical presentations, management and outcome were recorded and analyzed...........

Keywords: lens-induced glaucoma, cataract, phacomorphic glaucoma, phacolytic glaucoma

[1]. Jain IS, Gupta A, Dogra MR. et al. Phacomorphic glaucoma Management and visual prognosis. Ind J Ophthalmol. 1983;31:648–53.
[2]. Nilo Vincent DG, florcruz II, Raquel JQ. et al. Profile of glaucoma cases seen at tertiary referral hospital. Philipp J Ophthalmol. 2005;30(4):161–5.
[3]. Zainal M, Ismail SM, Ropilah AR. et al. Prevalence of blindness and low vision in Malaysian population: Results from the National Eye Survey 1996. Br J Ophthalmol. 2002;86(9):951–6.
[4]. Sowka J. Phacomorphic glaucoma: Case and review. Optometry. 2006;77:586–9.
[5]. Jonathan PE, Ellant, Stephen A. et al. Lens induced glaucoma. Documenta Ophthalmia. 1992;(81):317–38.

Abstract: Several extraction techniques exist for extraction of upper premolar teeth, but proper selection of an appropriate instrument and technique requires understanding of the impact of manipulating the basic principles of extraction for individual cases. We recommend the below mentioned technique for extraction of upper premolar teeth, hence making extraction a doctor and patient friendly procedure.

Keywords: Extraction, forceps, premolar

[1]. Paul D. Robinson, Tooth Extraction: A practical guide (Varghese Publishing Company, Bristol : J. Wright, 2000)

[2]. Geoffrey L Howe.The extraction of Teeth(Varghese Publishing Company, Bristol : J. Wright, 1980)
[3]. J.R.Moore, G.V.Gillbe ,Principles of Oral Surgery ( Manchester, Manchester University Press, 1991)
[4]. Stanley F Malamed: Handbook of Local Anaesthesia( Missouri, Elsevier Mosby, 2004)

Abstract: Periapical surgery is the last resort of the treatment option in the presence of a large periapical granuloma or cyst and the first line idea is to remove periapical pathosis to achieve absolute wound healing and regeneration of soft and hard tissue including periodontium. Platelet rich fibrin (PRF) is a second generation platelet concentration with its greater potency in wound healing and aids in accelerated bone regeneration as it is rich in plenty of growth factors to achieve the structural and functional rehabilitation of the defect. This case report enlightens the use of PRF in early bone regeneration after curetting the lesion in anterior maxilla as a regenerative therapy adjunct to periapical surgery.

Keywords: Periapical Surgery, Platelet rich fibrin (PRF) Graft, Apicectomy

[1]. Chen FM, Zhang J, Zhang M, An Y, Chen F, Wu ZF. A review on endogenous regenerative technology in periodontal regenerative medicine. Biomaterials 2010;31:7892-927.
[2]. Dohan DM, Choukroun J, Diss A, Dohan SL, Dohan AJ, Mouhyi J and Gogly B. Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part II: platelet-related biologic features. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006; 101: 45-50.
[3]. Gupta V, Bains BK, Singh GP, Mathur A and Bains R. Regenerative potential of platelet rich fibrin in dentistry: Literature review. Asian J Oral Health Allied Sci 2011; 1: 22-28.
[4]. Kim S, Kratchman S. Modern endodontic surgery concepts and practice: A review. J Endod 2006;32(7):601-623.

Abstract: Background: Vitamin D deficiency and insufficiency has been frequently reported in thalassemic patients in many countries despite the presence of good sunshine. Adequate circulating level of vitamin D is essential for optimal skeletal growth and reducing fracture risk. Objective: To assess Vitamin D, Calcium, Phosphorus status and growth parameters in thalassemia major patients Methodology: This study, a hospital based case control study was conducted from January 2016 to December 2016 in Department of Paediatrics and Neonatology, Rajendra Institute of Medical Sciences, Ranchi. In this study, 60 patients of beta thalassemia major (aged from 8 months to 12 years) were compared with 60 sex and age matched children serving as control group. Anthropometric measurement, serum level of calcium, phosphorus and vitamin D (25 hydroxy cholecalciferol) were estimated for all patients & controls...........

Keywords: Thalassemia, 25 hydroxy vitamin D, Calcium, Growth

[1]. Choudhary V.P, R. Kashyap, S.K. Acharya, N. Tandon, A. Saxena : Challenges in the management of Thalassemia, Mediquest Medicl Information series- 1997: Vol.15: No.3: 1-19
[2]. Sarnaik SA. Thalassemia and Related Haemoglobinopathies. Indian J paediatrics 1975; 12: 195-199
[3]. Condamine L, Vztovsnik F, Friedlander G, Menaa C, Garabedian M. Local action of phosphate depletion and insulinlike growth factor–I on in vitro production of 1,25 dihydroxyvitamin D3 by cultured mammalian kidney cells. J Clin Invest. 1994;94:1673–1679.
[4]. Wright NM, Papadea N, Wentz B, Hollis B, Willi S, Bell NH. Increased serum 1,25 dihydroxyvitamin D after growth hormone administration is not parathyroid hormone mediated. Calcif Tissue Int. 1997 Aug;61(2):1013
[5]. Holick MF, Binkley NC, BischoffFerrari HA, Gordon CM, Hanley DA, Heaney RP, Murad MH, Weaver CM; Endocrine Society.Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2011 Jul;96(7):191130. doi: 10.1210/jc.20110385. Epub 2011 Jun 6.

Abstract: Ovarian reserve plays a crucial role in achieving pregnancy following any treatment in subfertile women. The estimation of ovarian reserve is routinely performed through various ovarian reserve tests (ORTs) in an effort to predict the response and outcome in couples prior to In Vitro Fertilization (IVF) and counsel them. Most widely used tests are estimation of basal follicle stimulating hormone (FSH) and anti-Mullerian hormone (AMH) and antral follicle count (AFC). In our routine practice the role of different biochemical parameters to estimate ovarian reserve of subfertile women is discussed in this article..

Keywords: Subfertility, ovarian reserve tests (ORT), anti-mullerian hormone (AMH), leutinizing hormone (LH).

[1]. Scott RT, Hofmann GE. Prognostic assessment of ovarian reserve. Fertility Sterility. 1995; 63: 1–11.
[2]. Faddy MJ, Gosden RG, Gougeon A, Richardson SJ, Nelson JF. Accelerated disappearance of ovarian follicles in mid-life: implications for forecasting menopause. Hum Reproduction. 1992; 7: 1342 - 6.
[3]. Nikolaou D, Templeton A. Early ovarian ageing: A hypothesis: Detection and clinical relevance. Hum Reproduction. 2003; 18: 1137 - 9.
[4]. Hoffman BL, Schorge JO, Bradshaw KD, Holvorson LM, Schaffer JL, Corton MM. Evaluation of Infertile Couple. William,s Endrocrinology, 3rd edition. Mc Graw Hill Education, USA, 2012; 427.

[5]. Berek JS. Berek & Novak,s Gynaecology, 15th edition.Wolters Kluwer,India , 2012;1134.

Abstract: Congenital cystic adenomatoid malformations(CCAM) are rare developmental anomalies of the lung occurring in 1-4/100,000 live birth. It arises from excessive disorganized proliferation of tubular bronchial structures. It is a disease of infancy with most of the cases diagnosed within first 2 years of life. We report a case of congenital cystic adenomatoid malformation (CCAM) type1 in 5yrs old male child with features of respiratory distress.

Keywords: Congenital cystic adenomatoid malformations lung, cystic lesion, disorganized proliferation, tubular bronchial structures, respiratory distress

[1]. Liao SL, Lai SH, Hsueh C, Wong KS. Comparing late-onset and neonatally-diagnosed congenital cystic adenomatoid malformation of the lung. Chang Gung Med J 2010;33:36-43

[2]. Sahu S, Muthuvel S, Naware SS, Dhavala SS. Congenital cystic adenomatoid malformation of lung. Med J Armed Forces India. 2008;64:268–9.

[3]. Stocker JT, Madewell JE, Drake RM. Congenital cystic adenomatoid malformation of the lung. Classification and morphologic spectrum. Hum Pathol. 1977;8:155–71.

[4]. Stocker JT. Congenital pulmonary airway malformation: A new name and an expanded classification of congenital cystic adenomatoid malformation of the lung. Histopathol. 2002;41:424–31.
[5]. Wilson RD, Hedrick HL, Liechty KW, Flake AW, Johnson MP, Bebbington M, et al. Cystic adenomatoid malformation of the lung: review of genetics, prenatal diagnosis, and in utero treatment. Am J Med Genet A 2006; 140(2);151-55.

Abstract: Aim: NRIIMS is a Medical Institution catering to the Population of Bheemili which is a suburb of the coastal city of Visakhapatnam. To know the relation between diabetic parameters and lipid profile in patient of NRIIMS. Objective: Fasting blood samples for blood glucose and blood sugar levels two hours after breakfast with overnight 12 hour fasting were taken. Fasting lipids profile samples were also taken. These were done to know if any dyslipidemia was present in patients of NRIIMS. Materials and Methods: 50 symptomatic patients were taken from medical OPD of NRIIMS. And assessed for diabetic parameters and lipid profile..............

Keywords: Diabetic parameters, NRIIMS, FBS, PPBS, Total cholesterol.

[1]. DM Vasudevan,Sreekumari S,K.Vaidyanathan:Text book of Biochemistry:7th Edition:Chapter24:Pg324
[2]. .4.Stephen J Mc Phee,Maxine APapadakis,Micheal W Rabow,Current Medical Diagnosis And Treatment(CMDT),51ST Editin,2012,Chapter27,Pg1161.
[3]. American Diabetes Assosciation.Diagnosis and Classification of Diabetesd Mellitus.Diabetes Care.2011jan;34(suppl 1):S62-9
[4]. SimmonsRKetal.The Metabolic Syndrome:useful concept or Clinical tool?Report of a WHO Expert Consultation.2010Apr;53(4):600-5
[5]. KahnSE etal.Mechanism linking obesity to insulin ressistance and type2 Diabetes Mellitus.Nature.2006Dec14;444(7121);840-6

Abstract: Background:Folate is a water-soluble B vitamin that is naturally present in some foods, added to others, and available as a dietary supplement. The changes caused in gastric juice by H. pylori-induced gastritis, which can result in inadequate folate status. Objective: The purpose of this study was todetermine the association between Helicobacter Pylori infection and Serum Folatelevels. Materials and Methods: One hundred and twenty samples were included (60 samples of h.pylori infected individuals, and 60 samples of healthy individuals as control) all of them were evaluated to determine serum folate levels using Electrochemiluminescence immunoassay. Results:Mean serum folate levels was significantly reduced among cases than the controls. Conclusion: The findings indicate that serum folate levels decreased in patients with H.pylori.

Keywords: Serum folate, H.pylori, Sudan.

[1]. Bailey LB, Gregory JFr (2006). Folate. Present Knowledge in Nutrition. B. Bowman and R. Russell. Washington, DC, International Life Sciences Institute. I: 278-301.
[2]. Carmel R (2005). Folic Acid. Modern Nutrition in Health and Disease. M. Shils, M. Shike, A. Ross, B. Caballero and R. Cousins. Baltimore, MD, Lippincott Williams & Wilkins: 470-481.
[3]. Institute of Medicine. Food and Nutrition Board (1998). Dietary Reference Intakes: Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline. Washington, DC, National Academy Press.
[4]. Huether, Sue; McCance, Kathryn (2004). "20". Understanding Pathophysiology (3rd ed.). Mosby. p. 543.
[5]. Tamparo, Carol. Diseases of the Human Body (Fifth ed.). Philadelphia, PA. p. 337.

Abstract: The purpose of this literature overview is to analyze individual groups of endodontic instruments for achievement of adequate root canal preparation in order to ensure efficient irrigation and hermetic obturation. Which instrument is best suited in a particular clinical situation to achieve good clinical results is a particularly topical question arising from the broad selection of endodontic tools.

Keywords: Endodontic instruments, conicity, apical preparation.

[1]. M. Torabinejad, R. Handysides, A. A. Khademi, L. K. Bakland. Clinical implications of the smear layer in Endodontics: a review, Oral Surg Oral Med Oral Pathol Oral Radiol Endod.2002;94:658-666.
[2]. B. H. Sen, P.R. Wesselink, M. Turkun. The Smearlayer: a phenomenon in root canal therapy, Int Endod J.1995;28, 141.
[3]. С. Димитрова. Машинни инструменти в съвременната ендодонтска практика, Следдипломна квалификация и непрекъснато усъвършенстване в стоматологията, vol 5, 2006, 1, 13 – 22.
[4]. С. Димитрова. Анализ и възможности за приложение на някои основни ръчни инструменти в ендодонтията., Следдипломна квалификация и непрекъснато усъвършенстване в стоматологията, vol 4, 2005, 2, 220-230.
[5]. C. J. Kristich, Y. H. Li, D. G. Cvitkovitch, G. M. Dunny. Esp-independent biofilm formation by Enterococcus faecalis, J Bacteriol.2004;186:154-163.