iosr-JDMS   Volume-16 ~ Issue-6 ~ June-2017

Abstract: We evaluated 21 patients with unilateral MTLS by using DTI, MRI, clinical and EEG parameters to assess changes in DTI metrics in hippocampal formation, white matter tracts and gray matter nuclei. Out of these 10 were Right sided and 11 were left sided MTLS. We compared the mean diffusivity (trace D) and fractional anisotropy (FA) from symmetrical voxels by sampling the following areas namely hippocampus, parahippocampal white matter, fimbriae and fornix middle cerebellar peduncle, corpus callosum ,uncinate fasciculus, inferior fronto occipital fasciculus, superior longitudinal fasciculus, ,anterior and posterior cingulum, thalamus, internal capsule, caudate and lentiform nucleus. There was statistically significant decrease in FA values with increased mean diffusivity was seen in ipsilateral hippoc..............

Keywords: DTI -Diffusion Tensor Imaging, MTLS -Unilateral mesial temporal lobe sclerosis, FA - Fractional anisotropy, MD-Mean diffusivity.

[1]. Lerner A, Mogensen M.A, Kim P.E, Shiroishi M.S, Hwang D.H ,Law M. Clinical Applications of diffusion tensor imaging ,Journal of World Neurology.2013.07.083
[2]. Assaf B.A, Mohamed F.B, Abou-Khaled K.J et al. Diffusion Tensor Imaging of Hippocampal Formation in temporal lobe epilepsy, AJNR Am J Neuroradiol 24:1857-1856, October 2003.
[3]. Thivard L , Lehericy S , Krainik A , Adam C , Dormonr D,Chiras J et al . Diffusion tensor imaging in medial temporal lobe epilepsy with hippocampal sclerosis. Journal .Neuro image.2005.06.04
[4]. Yin X .-y Qiu S .-J Liu. Z . –Y, Wang H.-z, Xiong W .-f, Li S.-s, wang Y. Extra temporal abnormalities of brain parenchyma in young adult with temporal lobe epilepsy; a diffusion tensor imaging study. Clinical radiology 69(2014) 589e 596.
[5]. Kim C.H, KOO B-B, Chung C.K , LEE J-M, Kim J.S, Lee S.K Thalamic changes in temporal lobe epilepsy with and without hippocampal sclerosis: a diffusion tensor imaging study. epilepsy research(2010)90,21,-27

Abstract: Objective: The purpose of this study was to review our operative experience and to assess the symptomatic outcome of patients with arterial Thoracic outlet syndrome who underwent decompression of the thoracic outlet. Methods: This is a prospective study of patients with arterial thoracic outlet syndrome treated with cervical rib excision and scalenectomy with or without Subclavian artery revascularization at Institute of Vascular Surgery, Madras Medical College, Chennai. Results: Patients were a mean age of 37.8 years. 36.2% (n=21) of patients had only compression with no arterial lesion. Subclavian artery aneurysm (44.8%) was the commonest arterial lesion when compared to dilatation (13.7%) and occlusion (13.7%). All patients underwent thoracic outlet decompressin of which there were 93.4% (n=54) Cervical rib, 3.4% (n=2) first rib excision and 3.4 %( n=2) soft tissue resection. Subclavian artery reconstruction was performed in 63.7% (n= 37) of patients. One patient (1.7%) who had advanced ischemia underwent above elbow amputation in the postoperative period. Subclavian artery patency was 100% with no dilatation, aneurysm or embolism.................

Keywords-: cervical rib, endartrectomy, interposition graft, subclavian aneurysm, Thoracic outlet syndrome.

[1]. Urschel, HC and Razzuk, MA. Management of the thoracic outlet syndrome. N Engl J Med. 1972; 286: 1140–1143
[2]. Maru S, et al: Thoracic outlet syndrome in children and young adults. Eur J Vasc Endovasc Surg 38:560–564, 2009.
[3]. Chang K, et al: Spectrum of thoracic outlet syndrome presentation in adolescents. Arch Surg 146:1383–1387, 2011.
[4]. White JC, Poppel MH, Adams R. Congenital malformations of the first thoracic rib. Surg Gynecol Obstet 1945; 81643.59.
[5]. Chang K, et al: Spectrum of thoracic outlet syndrome presentation in adolescents. Arch Surg 146:1383–1387, 2011

Abstract: Purpose: The purpose of this cross sectional study was to study the frequency of meibomian gland dysfunction (MGD) in patients of diabetes mellitus. Methods: This was across sectional study conducted in patients visiting theoutdoorunit of Department of Ophthalmology ,Maharani Lakshmi Bai Medical College Jhansi between February 2017 and April 2017. 100 patients of diabetes mellitus (Random blood sugar >200mg/dl or patients with history of diabetes) were assessed for MGD by noting the symptoms and slit lamp examination and determining the meibomian gland expression scale for volume and viscosity, and ocular surface staining with Lissamine green, and Fluorescein sodium. All the subjects were graded for the severity of MGD..................

Keywords-: Dry Eye, Meibomian Gland Dysfunction, Meibomian Gland Expression Scale

[1]. McCulley JP, Shine WE, Meibomian gland function and the tear lipid layer. Ocular Surface 2003; 193): 97-106.
[2]. Chug CW, Tigges M, Stone RA, Peptidergic innervations of the primate meibomian gland. Invest Ophthalmol Vis Sci 1996; 37: 238-245.
[3]. Krenzer KL, Dna MR, et al. Effect of androgen deficiency on the human meibomian gland and ocular surface. J Clin Endocrinol Metab 2000; 85: 4874-4882.
[4]. McCulley JP, Dougherty JM, Deneau DG. Classification of chronic blepharitis. Ophthalmology 1982; 89: 1173-1180
[5]. Wilhelmus KR, Inflammatory disorders of the eyelid margins and eyelashes. Ophthalmol Clin North Am 1992; 5: 187-194.

Abstract: This is an unusual case of chronic ectopic pregnancy which presented very late. A 35-year old South Indian woman presented to our OPD in SBMCH with lower abdominal pain and irregular menstrual cycles for 1 year . Her clinical findings and supportive investigations favoured Left sided complex Tubo-Ovarian mass. She had normal beta HCG levels and CA 125 was normal. Diagnostic laparoscopy was proceeded and excision of Tubo-Ovarian mass done. The other tube and ovary were normal. Histopathology report was suggestive of Chronic Ectopic Pregnancy. Chronic Ectopic pregnancy presents diagnostic dilemmas due to lack of classic symptoms or signs and also the varied timing of presentation. A very high index of suspicion is required in all cases of Tubo-Ovarian masses

Keywords-: Chronic ectopic, Tubo ovarian mass, laparoscopy

[1]. jeffcoate's principles of gynecology,7 th edition jaypee brothers publishers,byprataplaumer,narendramalhotra(1,2,3,4)
[2]. berek and novaks gynecology ,14 thedition,jonathen s. berek(5)
[3]. Williams gynecology 2nd edition,Hoffman,schorge,schaffer,hallvorson,bradshan,cunningham

Abstract: The prosthetic rehabilitation of patients with an edentulous maxilla opposing mandibular anterior natural teeth is one of the most challenging situations that a clinician encounters. Occlusal forces from the opposing natural teeth may cause fractures in the maxillary prosthesis and also result in residual ridge resorption of the edentulous maxilla. Prosthodontists try overcoming this Combination syndrome by careful treatment planning, which may require a multi-disciplinary approach involving surgical intervention followed by metallic denture base prosthesis, implant supported fixed prosthesis, implant supported overdentures etc. Even conventional prosthodontic techniques with special consideration for flabby tissues, over denture prosthesis and removable cast partial denture may be used.................

Keywords-: Hybrid Denture, Implant supported FPD, Combination Syndrome

[1] Kelly E. Changes caused by a mandibular removable partial denture opposing a maxillary complete denture. The Journal of Prosthetic Dentistry 1972;27(2):140-50.
[2] The glossary of prosthodontic terms. J Prosthet Dent 2005 Jul;94(1):10-92.
[3] Palmqvist S, Carlsson G. The combination syndrome: a literature review. The Journal of Prosthetic Dentistry 2003;90(3):270-5.
[4] Mish CE, Wang HL, Mish CM, et al. Rationale for the application of immediate load in the implant dentistry: part1. Implant Dentistry 2004;13:207-17.
[5] Zarb GA,Missouri. Cox J F. The longitudinal clinical efficacy of osseointegrated implants a 3 year report, International Journal Oral and Maxillofacial Implants1987;2:91-100.

Abstract: Present days, the life expectancy has increased because of increased awareness about self care and improved medical facilities including use of various medications for prophylaxis and treatment purpose. Medications benefit our general health but they also carry some adverse effects and can be harmful to oral health also. This can vary from single hyper pigmented spot to marked destruction of both soft and hard tissue in oral cavity. As uses of various medications are unavoidable these days their adverse effects on oral environment are very common and often un/underdiagnosed or less cared by patient.................

Keywords-: Angioedema, gingival hypertrophy, oral pigmentation, xerostomia, myelosuppression, radionecrosis of jaw.

[1] Robin A. Seymour, Effects of medications on the periodontal tissues in health and disease, Periodontology 2000, Vol. 40, 2006,
120–129.
[2] Terry D. Rees, Drugs and oral disorders,Periodontology 2000, Vol. 18, 1998, 21-36.
[3] Sebastian G. Ciancio, Gingival Hyperplasia and Diphenylhydantoin, JPeriodontol 1996; 67:1055-1059.
[4] Iva Stamatova & Jukka H. Meurman,Probiotics and periodontal disease, Periodontology 2000, Vol. 51, 2009, 141–151.
[5] Louis F. Rose,periodontics medicine, surgery, and implants.

Abstract: Background: Pain is one of the most emotional sensation known to mankind. It frequently exceeds its protective nature and makes postoperative period a suffering. The pain in the postoperative period demands relief not only on humanitarian ground but also to reduce physical morbidity following the operation. So relief of pain in postoperative period extends the anaesthesiologists interest beyond the confines of the operating theatre. Epidural anaesthetic and analgesic techniques are commonly used for various operative procedures, obstetric analgesia, postoperative pain and chronic pain management. Ropivacaine has increasingly replaced bupivacaine because of its similar analgesic properties.................

Keywords-: Clonidine, Epidural block, Postoperative pain, Ropivacaine, Urological Surgeries

[1] Sukhminder Jit Singh Bajwa, Sukhwinder Kaur Bajwa, Jasbir Kaur, Amarjit Singh, Geetika Bakshi, Kanwalpreet Singh
and Aparajita Panda : Admixture of clonidine and fentanyl to ropivacaine in epidural anesthesia for lower abdominal surgery.
Anesth Essays Res. 2010 Jan-Jun; 4(1): 9–14.
[2] K. S. Nagesh, M. Sathesha, R. S. Prasad. "Comparative Study between Epidural Bupivacaine with Buprenorphine and Epidural
Bupivacaine for Post-Operative Analgesia in Abdominal and Lower Limb Surgery". Journal of Evolution of Medical and Dental
Sciences 2015; Vol. 4, Issue 18, March 02; Page: 3057-3064, DOI: 10.14260/jemds/2015/444
[3] R. P. GRIFFIN et al 1995, Extradural anaesthesia for Caesarean section: a double-blind comparison of 0.5 % ropivacaine with 0.5
% bupivacaine . British Journal of Anaesthesia 1995
[4] Sukhminder Jit Singh Bajwa, Sukhwinder Kaur Bajwa, and Jasbir KaurComparison of epidural ropivacaine and ropivacaine
clonidine combination for elective cesarean sections.Saudi J Anaesth. 2010 May-Aug; 4(2): 47–54.
[5] 5. Sukhminder Jit Singh Bajwa, Sukhwinder Kaur Bajwa, Jasbir Kaur, Gurpreet Singh, Vikramjit Arora, Sachin Gupta,Ashish
Kulshrestha, Amarjit Singh, SS Parmar, Anita Singh and SPS Goraya : Dexmedetomidine and clonidine in epidural anaesthesia: A
comparative evaluation. Indian J Anaesth. 2011 Mar-Apr; 55(2): 116–121.

Abstract: Using the ATC/DDD index to evaluate the utilization of antibiotics is a standard method and helps in comparison across wards and hospitals .This study was conducted in a government hospital with 1190 beds (which excluded pediatrics ward) .Data was recorded over twelve months from January 2013 to December 2013. Antibiotic use was evaluated using the ATC classification and DDD/100 bed-days formula and cost analysis was also done on 6 monthly basis along with restriction on antibiotic consumption (ie. January 2013- June 2013 and July2013 –December 2013). Ceftriaxone sodium was the maximally used parentral antibiotic (2.607 and 2.135 DDD/100 bed-days).................

Keywords-: Antibiotic consumption, ATC-DDD, DDD/100 bed-days, drug utilization, injectable antibiotic.

[1]. Kunin CM, Staehr Johansen K, Worning AM, Daschner F.Report of a symposium on use and abuse of antibiotics worldwide. Rev
Infect Dis 1990; 12: 12–9.
[2]. Introduction to drug utilization research / WHO International Working Group for Drug Statistics Ibnosina Journal of Medicine and
Biomedical Sciences (2012) Ibnosina J Med BS 19Methodology, WHO Collaborating Centre for Drug Statistics Methodology,
WHO Collaborating Centre for Drug Utilization Research and Clinical Pharmacological Services. Geneva: World Health
Organization; 2003. p. 8-12.
[3]. Shankar PR, Upadhyay DK, Subish P, Bhandari RB, Das B. Drug utilisation among older inpatients in a teaching hospital in
Western Nepal. Singapore Med J. 2010;51:28–34.
[4]. Sachdeva PD, Patel BG. Drug utilization studies – Scope and future perspectives. Int J Pharm Biol Res. 2010;1:11–7.)
[5]. Kuruvilla A, George K, Rajaratnam A and John KR: Prescription patterns and cost analysis of drugs in a base hospital in South
India .Natl Med J India 1994, 7:167-168)

Abstract: Introduction: The uncertainty that exists about the likely outcome after traumatic brain injury (TBI) is encapsulated in the Hippocratic aphorism: "No head injury is so serious that it should be despaired of nor so trivial that it can be ignored."[1]. Today, physicians' estimates of prognosis are still often unduly optimistic, unnecessarily pessimistic, or inappropriately ambiguous. It still remains impossible to say with certainty what will be the future course of events in an individual patient , but intensive research in the last three decades has made it possible to be much more confident about what is likely to happen, and to consider prognosis in terms of probabilities rather than prophecies. Traumatic brain injuries (TBI) are a real social problem, with an upward trend worldwide Assessing prognosis after traumatic.................

Keywords-: Traumatic brain injury, prognostic factors, outcome, prognosis

[1]. Hukkelhoven CW, Steyerberg EW, Habbema JD, Farace E, Marmarou A, Murray GD, et al.. Predicting Outcome after Traumatic
Brain Injury: Development and International Validation of Prognostic Scores Based on Admission Characteristics. J Neurotrauma.
2005; 22(10): 1025–1039.
[2]. Pilśniak J, Ślusarz R. Epidemiologiaurazówczaszkowo-mózgowych w materialewłasnymPogotowiaRatunkowego w Rypinie:
Badaniaretrospektywne. PielęgniarstwoNeurologiczneiNeurochirurgiczne 2013; 2(1): 4–8 (in Polish).
[3]. Salim A, Ley EJ, Cryer HG, Margulies DR, Ramicone E, Tillou A. Positive serum ethanol level and mortality in moderate to severe
traumatic brain injury. Arch Surg. 2009; 144(9): 865–871.
[4]. Tagliaferri F, Compagnone C, Korsic M, Servadei F, Kraus J. A systematic review of brain injury epidemiology in Europe.
ActaNeurochir. 2006; 148(3): 255–268.
[5]. Thurman DJ, Alverson C, Dunn KA, Guerrero J, Sniezek JE. Traumatic brain injury in the United States: A public health
perspective. J Head Trauma Rehabil. 1999; 14(6): 602–615.

Abstract: Background: Non-alcoholic fatty liver disease (NAFLD) is emerging as a significant cause of chronic liver disease among patients with otherwise no risk factors for cirrhosis. Diabetes mellitus is an important predisposing factor for development and progression of NAFLD. Assessment of liver stiffness by transient elastography in Diabetic patients with fatty liver could provide a non-invasive estimate of the presence of underlying liver disease at a fairly early stage. Aim: To assess the prevalence of the various stages of liver fibrosis in patients with Type 2 Diabetes mellitus and fatty liver on ultrasonography and to study its correlation with biochemical and metabolic parameters................

Keywords-: Diabetes Mellitus, Fatty liver, Fibrosis, Transient Elastography

..............

Abstract: Introduction: The word malaria comes from Italian and literally means bad air. It was early known as ague and has been described since antiquity. Malaria continues to pose a major public health threat in India, particularly due to P.falciparum which is prone to complications. The commonly associated complications of severe falciparum malaria are-coma or cerebral malaria, severe anemia, renal failure, pulmonary edema, hypoglycemia, shock and lactic acidosis.1 We aimed to study the incidence, severity, clinical presentations, prognostic factors, complications and outcome of ARF in P.falciparum malaria cases of RIMS, Jharkhand................

Keywords-: Falciparum malaria, Arf, Haemodialysis, Jharkhand tribal

[1]. Harrison's principle of internal medicine 19th edition page -1368-1384
[2]. WHOworldmalariareport2010 (http://www.who.int/malaria/world_malaria_report_2010/en/)
[3]. Park's text book of preventive & social medicine 23rd edition 2015page no- 255-269
[4]. KH Koh, CL Tan and PH Chew, Acute renal failure in severe Falciparum malaria patients in an intensive care unit in Malaysia, The Journal of the Royal College of Physicians of Edinburgh, vol 36, pp 107-11, 2006.
[5]. Das BS, Patnaik JK, Mohanty S, Mishra SK, Mohanty D, Satpathy SK et al, Plasma antioxidants and lipid peroxidation products in Falciparum malaria, Am J Trop Med Hyg 1993;49:720-5

Abstract: 60 samples of porcelain disc dimensions 12 mm diameter×0.8 mmthickness were prepared. Specimens were divided into four groups, each group containing 15 discs. Group 1subjected to immediate cooling after firing, Group 2 subjected to intermediate speed cooling and group 3 ultra-slow cooling. All 3 groups are alumina-reinforced and group 4 is conventional porcelain. Indentations on each disc were made with a Vickers indenter with a microhardness tester loaded with 1000g for 20 seconds. Statistical analysis revealed significant differences in fracture toughness values of first three groups from 4th group. From the study it can be inferred that reinforcement with alumina not only improves esthetics but this metallic modification definitely improves deformation resistance by interacting with cracks and thus preventing their propagation.

Keywords-: Crack propagation,deformation resistance, dental porcelain,reinforcing.

[1]. Rashid, The effect of surface roughness on ceramics used in dentistry: A review of literature. European journal of dentistry, 8(4), 571. 2014.
[2]. K. J. Anusavice P. H. Dehoff, B. Hojjtie and A. Gray. Influence of tempering and contraction mismatch on crack development in ceramic surfaces. J Dent. Res. 1989 July; 68(7):1182-87.
[3]. Mattias kern and Van. P. Thompson. Sanblasting and silica coating of a glass infiltrated alumina ceramic: Vol. loss, morphology and changes in the surface composition. J Prosthet Dent;71: 1994,453-61.
[4]. P. H. Dehoff and K. J. Anusavice. Tempering stresses in feldspathic porcelain. J Dent. Res. 1989 Feb; 68(2):134-138.

Abstract: Dyspepsiaismarked by vague, uncharacteristic, subjective symptoms that manifest in the form of pain or a discomfort in the upper abdomen. ROMA III criteria have been used commonly to define dyspepsia. The presence of one or more of symptoms such as epigastric pain, epigastric burning, postprandial fullness and early satiation leads to the diagnosis of dyspepsia on the condition that the symptom starts six months before the diagnosis and lasts at least for the past three months. Epigastric pain is defined as unpleasant pain in the epigastric region with no obvious explanation. Epigastric burning is burning sensation with no obvious explanation. Postprandial fullness refers to the discomfort caused by the sensation that food persists for a long time in the stomach. Early satiation refers to the condition characterized by feeling full right after starting to eat – regardless of the amount of food – and not being able to finish the meal (1). Dyspepsia constitutes about one twentieth of patients consulting a family physician,...............

[1]. Özer B. Functionaldyspepsia. Internalmedicinejournal. 2011; 18: 153-157.

[2]. Thijs JC, Arents NL, vanZwet AA, Kleibeuker JH. Dyspepsiamanagement in primarycare. Scandinavianjournal of gastroenterology.2003 ;( 239): 44-50.

[3]. Moayyedi P, Talley NJ, Fennerty MB, Vakil N. Can theclinicalhistorydistinguishbetweenorganicandfunctionaldyspepsia?. Jama. 2006; 295(13): 1566-1576.
[4]. Ünlüoğlu İ, Bilge U, Balcıoğlu H. Familypractice in Turkey. Ankara MedicalJournal. 2016;16(1): 131-132.
[5]. Balcıoğlu H, Ünlüoğlu İ. Fundamentals of communication. Turkiye Klinikleri J FamMed. Special Topics 2017;8(2):111-115..

Abstract: The objective of this case control study was to detect discrepancy in the diagnosis of Giardia lamblia among Sudanese patients by comparing the sensitivity and specificity of copro antigen ELISA aginst microscopy and FECT. Method: 100 patients diagnosed with Giardiasis, and100 healthy controls were included in this study. Fresh stool specimens were collected from each study participants and were examined microscopically for cysts and trophozoites by wet preparation, formal-ether technique and Copro antigen ELISA. Results: No differences between wet preparation and formal ether techniques. Out of 100 true positive samples after microscopy, only 90(90%) were positive by ELISA, while 96(96%) were true negative from 100 samples of control group. Copro-antigen ELISA for detection of Giardia lamblia results a sensitivity of 90% and a specificity of 94%. With 93.8% and 90.3% PPV and NPV..............

Keywords-:Giardiasis, microscopy, Formol ether, Copro antigen Elisa.

[1]. WHO, (2014).Global Burden of isease.http://www.who.int/healthinfo/global_burden_disease/GBD._report_2014.update_part2.pdf. [2]. Edward Buzigi (2015).Prevalence of Intestinal Parasites, and its Association with Severe Acute Malnutrition Related Diarrhoea.IISTE.5: 2.
[3]. Thompson, R.C. (2000). Giardiasis as a re-emerging infectious disease and its zoonotic potential.Int. J. Parasitol. 30: 1259-1267.
[4]. Lasek-Nesselquist and Welch, D.M. (2010). The identification of new Giardia assemblage in human.Int J Parasito.40(9):1063-74.
[5]. Yang, R., Reid, A., Lymbery, A. and Ryan, U. (2010 b).Identification of zoonotic Giardia genotypes in fish.Int J Parasitol. 40: 779-785..

Abstract: Many neuroanatomical studies of normal brain character have been reported. The brain stem is the most important anatomical structure in the posterior fossa .Investigations of aging effects on the brain stem is important, in order to understand normal aging process. Sex differences in brain stem neuroanatomy have been observed in several studies.In the current study, the objectives were to study the sex differences and the agerelated morphological changes of the brain stem on mid-sagittal MRIs. According to radiologists’ reports, midsagittal MRIs of 275 normal individuals were evaluated in this study. Mean age: 36.33±23.75 years old (max=91.00years, min=1.00 year).There were 126 males and 149 females. By measuring the brain stem, (mid brain, pons and medulla oblongata) results were saved in the computer. Calculation of all regions was performed in the screen monitor of MRI machine and the collected data were statistically analyzed by using SPSS software programme version 16. Students’s t-test was applied for gender comparisons. To determine the associations between age and measurements, person correlation coefficients were calculated. Norms for brain stem were established. No significant gender difference was recorded in the brain stem favoring midbrain (p<0.088) ,pons (p˂0.940) and medulla oblongata(p˂0.485)..............

Keywords-: Cbrain stem, magnetic resonance, neuroscience

[1]. Christian Lambert , Rumana Chowdhury ,Thomas H.B.Fitz Gerald ,Stephen M.F leming, Antoine Lutti , Chloe Hutton, Bogdan Draganski , Richard Frackowiak and John Ash burner .Characterizing aging in the human brain stem using quantitative multimodal MRI analysis. Frontiers in Human Neuroscience .2013|Volume7|Article462| 1-11
[2]. Bilgic,B., P fefferbaum , A., Rohlfing,T., Sullivan,E.V., and Adalsteinsson, E. (2012). MRI estimates of brain iron concentration in normal aging using quantitative susceptibility mapping. Neuroimage 59, 2625–2635.
[3]. Vaillancourt, D.E., Spraker, M.B., Prodoehl, J., Zhou,X.J., and Little, D. M. (2012).Effects of aging on the ventral and dorsal substantia nigra using diffusion tensor imaging .Neurobiol. Aging 33, 35–42.
[4]. Woodruff-Pak, D.S., Foy, M.R., Akopian ,G.G.,Lee, K.H., Zach, J., Nguyen,K.P., etal.(2010).Differential effects and rates of normal aging in cerebellum and hippocampus. Proc.Natl.Acad.Sci.U.S.A. 107, 1624–1629.
[5]. Draganski,B., Ashburner, J.,Hutton, C.,Kherif, F., Frackowiak,R.S., Helms, G., etal. (2011).Regionalspecificity of MRI contrast parameter changes in normal agein g revealed by voxel- based quantification (VBQ). Neu- roimage 55, 1423–1434..

Abstract: Introduction: Locally advanced head and neck carcinomas (HNSCC) constitute a substantial proportion of cancer patients in India. This is treated by combined multimodality which includes surgery, radiotherapy, and chemotherapy. Aims: To investigate tumor response and toxicity in HNSCC using hypofractionated schedule compared with conventional fractionation. Material and Methods: In conventional arm (Arm A), each patient received 70 Gy/2 Gy/fraction/7 weeks. In hypofractionated arm (Arm B), each patient received 55 Gy/2.75 Gy/fraction/4 weeks. Both arms received weekly cisplatin (40 mg/m 2). The end points were tumor response, acute and late toxicities, and overall survival (OS). Results: 17 patients (68%) in a conventional arm (Arm A) achieved a complete response (CR) and 15 patients (60%) in hypofractionated arm (Arm B) had a CR (p=0.55). The acute skin toxicity (grade≥2) was significantly higher in Arm B than in Arm A (28% vs. 17%;................

Keywords-:Head and Neck, Locally advanced, Radiotherapy, Conventional, Hypofractionation.

[1] http://globocan.iarc.fr/Pages/fact_sheets_population.aspx
[2] James ND, Robertson G, Squire CJ, Forbes H, Jones K, Cottier B, et al A national audit of radiotherapy in head and neck cancer. Clin Oncol (R Coll Radiol) 2003;15:41-6.
[3] Williams MV, James ND, Summers ET, Barrett A, Ash DV, Audit Sub-Committe, Faculty of Clinical Oncology, et al. National survey of radiotherapy fractionation practice in 2003. Clin Oncol (R Coll Radiol)2006;18:3-14
[4] Bourhis J, Overgaard J, Audry H, Ang KK, Saunders M, Bernier J, et al. Hyperfractionated or accelerated radiotherapy in head and neck cancer: A meta-analysis. Lancet 2006;368: 843-54.
[5] Pignon JP, Bourhis J, Domenge C, Designé L. Chemotherapy added to locoregional treatment for head and neck squamous-cell carcinoma: Three meta-analyses of updated individual data. MACH-NC Collaborative Group. Meta-Analysis of Chemotherapy on Head and Neck Cancer. Lancet 2000;355:949-55..

Abstract: Paroxysmal supraventricular tachycardia is episodes of rapid heart rate that start in a part of the heart above the ventricles from time to time. There are several risk factors that may provoke PSVT they include: alcohol use, caffeine use, smoking and illicit drug use. Paroxysmal supraventricular tachycardia (PSVT) is a common arrhythmia occurring with an incidence of 2.5 per 1000 adults. PSVT can occur at any age in absence of structural heart disease, but most commonly presents between ages 12 and 30. Most patients with atrioventricular nodal re-entrant tachycardia (AVNT) or atrioventricular re-entrant tachycardia (AVRT) do not have associated structural heart disease, although exceptions (e.g., Epstein's anomaly, familial pre-excitation) do exist. A 12 lead ECG during tachycardia is helpful for defining the mechanism of PSVT. In patients with self terminating episodes, 24 hours holter monitoring is the most effective way. Supraventricular tachycardia's are the most frequent cause of hospital visits with the common ones being...............

[1]. https://medlineplus.gov/ency/article/000183.htm
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[3]. Eric Good SVT: What's important to know & New Treatment Update, TUCSON 2009 American college of Osteopathic Internists
[4]. Jeremy Brywczynski, Journal of Emergency Medicine(JEMS) 2012;Volume 37: Issue 9, www.jems.com/articles/print/volume-37/issue-9/patient-care/patient-cardiac-rhythm-important-ems-ade.html
[5]. Witter LK et al. Adenosine for treatment of PSVT in the pre-hospital arena: efficacy of 6mg dosing regimen. Pre-hospital disaster medicine 1997;12(3):237-9

Abstract: Background: PRKAG2 syndrome is a rare, early onset autosomal dominant inherited disease, characterized by ventricular pre-excitation, supraventricular arrhythmias, and cardiac hypertrophy. In cardiomyocytes the enzyme regulates the glucose and fatty acids uptake, storage and utilization.1 Case report: We present a 44years old female patient, who came to Wuhan Union hospital with the following presenting complains, chest pain, awareness of heart beat and dizziness for 3 weeks, she denies history of hypertension and diabetes mellitus, she has a strong family history of heart diseases where two nephews were diagnosed of Hypertrophic Cardiomyopathy and one niece was diagnosed of having PSVT-WPW and a cousin with bradycardia. Clinical history and ECG and ECHO findings are suggestive of PRKAG2.............

Keywords-:PRKAG2- protein kinase amp activated non catalytic subunit gamma 2, HCM- hypertrophic Cardiomyopathy, ECG-electrocardiogram, ECHO-Echocardiogram, PSVT-paroxysmal Supraventricular tachycardia, WPW- wolf Parkinson white syndrome, RBBB-right bundle branch block.

[1]. Andrea G Porto, et al. Clinical Spectrum of PRKAG2 syndrome. Circulation Arrhythmia Electrophysiology. 2016;9:c003121.DOI:10.1161/CIRCEP.115.003121
[2]. Lev M, et al. Anatomic findings in a case of ventricular pre-excitation terminating in complete AV block. Circulation. 1966;34:718-733
[3]. Zaha V YL. Amp-activated protein kinase regulation and biological actions in the heart. Circulation Research. 2012;111:800-814
[4]. Gulotta SJ et al. Familial occurrence of sinus bradycardia, short PR interval, intraventricular conduction defects, recurrent supraventricular tachycardia, and cardiomegaly. American Heart Journal. 1977;93:19-29
[5]. Laforet P, et al. A new mutation in PRKAG2 gene causing hypertrophic Cardiomyopathy with conduction system disease and muscular glycogenosis. Neuromuscular disorder 2006;16:178-182.doi:10.1016/j.nmd.2005.12.004

Abstract: Palliative care in dentistry has been defined as the study and management of patients with active, progressive, far-advanced disease in whom the oral cavity has been compromised either by the disease directly or by its treatment; the focus of care is quality of life. Palliative care is an imperative need worldwide for people with cancer. Head and neck cancer impacts uniquely on the health and well-being of patients, which accounts for approximately 6% of cancers worldwide. Many oral conditions, such as poor oral hygiene, broken teeth, defective restorations and periodontal disease, are likely to precipitate complications during and after a course of radiation therapy.Hence a multidisciplinary approach including general physician, oncologist, radiotherapist and oral physician, may reduce the oral & general debilities that influence the patient's ability to speak, eat or swallow.................

[1]. Hebbar PB, Shesha Prasad R, Pai A. Palliative Care in Oral Medicine; Sch. J. App. Med. Sci., 2014; 2(4D):1383-1384.
[2]. GiriPhalke D. Knowledge regarding palliative care amongst medical and dental postgraduate students of medical university in western Maharashtra, India. CHRISMED Journal of Health and Research. 2014;1(4):250.
[3]. Nagaraj E. Defining the role of Oral Physicians. Indian Journal of Dental Research. 2011;22(5):620.
[4]. Frydrych A. Expertise Regarding Dental Management of Oral Cancer Patients Receiving Radiation Therapy Among Western Australian Dentists. TODENTJ. 2012;6(1):197-207.
[5]. Knowledge into Action Cancer Control WHO Guide for Effective Programmes; Palliative care; 2008.

Abstract: Background: ovarian neoplasms is a heterogenous group of benign and malignant tumours of epithelial , stromal and germ cell origin. Ovarian cancer is the second most common of all genital cancers and accounts for 10-15 % of all gynaecological cancers in developing countries. Most of the ovarian tumours cannot be easily distinguished from one another on the basis of their clinical or gross characteristics alone. Therefore cytological interpretation of the ovarian neoplasms is both interesting and challenging. Imprint cytology is a rapid cheap and simple procedure to study the cytology of tissues. Material and methods: The present study " evaluation of intraoperative cytology in ovarian tumours " was carried out in the Department of Obstetrics and Gynaecology in collaboration with the department of Pathology , RIMS, Ranchi, in the period between May 2013 to October 2014. Sample size were 100...............

Keywords-:ovarian tumour, imprint cytology,.

[1]. VG Padubidri/SN Daftary: Shaw's textbook of gynaecology 15th edition p.422,372
[2]. Jemal A, Seigel R, Ward E , HaoY, Xu J, Murray T and Thun MJ. Cancer statistics, 2008. CA Cancer J Clin 2008;58: 71-96..
[3]. Hiremath PB,Bahubali G, Meenal C, Sachin Narvekara NM Bobby "clinical profile and pathology of ovarian tumours"/ Int J Biol Med Res. 2012;3(2): 1743-46.
[4]. Bonfiglio TA, Yene S E. Gynaecologic Cytology . Philadelphia, Lippincott-Raven. 1997 p.157-64.
[5]. Mathur SR- Ovarian cancer- role of cytology, Ind J of Med & Paed Oncol (2007)vol 27 suppl 1; 5-6.

Abstract: Introduction: Community acquired pneumonia (CAP) is a common but serious problem. Diabetes mellitus (DM) not only puts patients on increased risk of CAP but also results in higher mortality. We aimed to understand the clinico-epidemiological profile of patients who presented to our hospital with bacterial pneumonia and diabetes mellitus.
Methodology: After taking approval of the institutional ethics committee, we enrolled all patients of bacterial pneumonia aged 14 years of more with a confirmed diagnosis of DM at the Department of Chest Medicine at MVP's Dr. Vasantrao Pawar Medical College, Nashikfrom August 2014 till December 2016. Using a pre-designed pretested questionnaire, we collected patient related socio-demographic and clinical information. The data were entered in statistical software and analysed using appropriate statistical techniques................

Keywords-:complications, community acquired pneumonia, diabetes, epidemiology.

[1]. Musher DM, Thorner AR. Community-acquired pneumonia. N Engl J Med 2014; 371:1619.
[2]. Fishman JA, Rubin RH. Infection in organ-transplant recipients. N Engl J Med 1998; 338:1741.
[3]. Joslin EP. A half-century's experience in diabetes mellitus. British medical journal. 1950 May 13;1(4662):1095.
[4]. Joshi N, Caputo GM, Weitekamp MR, Karchmer AW. Infections in patients with diabetes mellitus. New England Journal of Medicine. 1999 Dec 16;341(25):1906-12.
[5]. Knapp S. Diabetes and infection: Is there a link?-A mini-review. Gerontology. 2013;59(2):99-104.

Abstract: Introduction: Cases of meningitis are medical emergencies which need rapid diagnosis. CRP and ADA can be used as rapid tests to diagnose and differentiate meningitis. Objective: 1) To estimate C-reactive protein (CRP) and adenosine deaminase (ADA) level along with other diagnostic parameters in cerebrospinal fluid of patients with meningitis. 2) To evaluate whether CRP and ADA level could be used to differentiate the various types of meningitis. Method: CSF samples were collected from 108 patients who presented to M.O.P.D of our hospital during the period of 2014-2015. Diagnosis of meningitis was based on clinical presentation and CSF analysis. Results: Out of 108 patients, highest no. of patients i.e. 46 patients (42.59%) were diagnosed as tubercular meningitis followed by 32 cases (29.62%) of viral meningitis and 28 cases (25.92%) of pyogenic meningitis. 65 cases (60.18%) were males and 43 cases (39.9%) were females..............

Keywords-:Cerebrospinal fluid, Adenosine Deaminase, Meningitis, Tubercular meningitis, C-reactive protein, Viral meningitis, Pyogenic meningitis.

[1]. Prasad Rajendra, Kumar Anil, Khanna BK, Mukherji PK, Aagarwal SK, Kumar A, Srivastava VML. Adenosine deaminase in cerebrospinal fluid for diagnosis of tuberculous meningitis. Ind J Tub 1991; 38: 99-102
[2]. Kashyap RS, Kainthla RP, Mudaliar AV, Purohit GJ, Taori GM, Daginawala HF. Cerebrospinal fluid adenosine deaminase activity: a complimentary tool in the early diagnosis of tuberculous meningitis. Cerebrospinal fluid research 2006 March 30
[3]. Gautam N, Aryal M, Bhatta N, Bhattacharya SK, Basal N, Lamsal M. Comparative study of cerebrospinal fluid Adenosine deaminase activity in patients with meningitis. Nepal Med Coll J 2007; 9(2):104-6
[4]. Pettersson T, Klockars M, Weber TH. Diagnostic value of cerebrospinal fluid adenosine deaminase determination. Scand J Infect Dis 1991; 23: 97-100.
[5]. Chotmongkol V, Teerajetgul GY, Yodwut C. Cerebrospinal fluid adenosine deaminase activity for the diagnosis of tuberculous meningitis in adults. Southeast Asian J Trop Med Public Health. 2006; 37(5): 948-52..

Abstract: Myofascial pain syndrome is a common regional musculoskeletal pain syndrome that can cause local or referred pain. There is a lack of specific diagnostic criteria for Myofascial pain syndrome. Electrodiagnostic and morphological findings have been identified; however, they cannot be practically applied in the clinical setting due to cost and time constraints. This adds to the difficulty of definitive treatment. In a clinical setting with limited diagnostic approach, a myofascial pain mimics fibromyalgia and often is a complex problem to be solved. It can be better approached by pharmacological methods like oral pregabalin and local trigger point injections.

[1]. Gerwin RD. Diagnosis of myofascial pain syndrome. Phys Med Rehabil Clin N Am. 2014;25:341–355.
[2]. Lavelle ED, Lavelle W, Smith HS. Myofascial trigger points. Anesthesiol Clin. 2007;25:841–851, vii-iii.
[3]. Skootsky SA, Jaeger B, Oye RK. Prevalence of myofascial pain in general internal medicine practice. West J Med. 1989;151:157–160.
[4]. Kaergaard A, Andersen JH. Musculoskeletal disorders of the neck and shoulders in female sewing machine operators: prevalence, incidence, and prognosis. Occup Environ Med. 2000;57:528–534.
[5]. Alvarez DJ, Rockwell PG. Trigger points: diagnosis and management. Am Fam Physician. 2002;65:653–660...

Abstract: Composite resins are among the tooth-colored restorative materials of choice for many dentists due to their high acceptance by patients and their excellent esthetic properties (Ibrahim et al., 20091; Mazaheri et al., 2013)2. Aesthetic restoration material as Nano filled composite resin is being used widely in anterior as well as posterior teeth. (RajkumarK,et al,2011)3.
Color change of dental resin composite were due to intrinsic and extrinsic factors. (Bencourt S, et al, 2009)4 such as Roughness of the surface (Bagheni R, et al,2005)5 duration of the contact time with coloring agents(Reis AF, et al,2003)6,coloring agent(omataY,et al,2006)7 and type of composite restoration(Aba-Bakr,et al,2000)8 these findings are most important factor affecting the color stability and long term success of composite resin restoration.(Ren YF,et al,2012)9.Though, the quality of composite resin restoration has been significantly improved over last decades through innovation of Nano................

[1]. Ibrahim et al., 2009; (Ibrahim MA., et al. "A comparison of staining resistant of two composite resins". Archives of Orofacial Sciences 4.1 (2009): 13-16.)
[2]. Mazaheri R., et al. "Effect of Common Drinks on the Color Stability of Microhybrid and Nanohybrid Composites in Children". Journal of Mashhad Dental School 37.2 (2013): 163-176.
[3]. Rajkumar K, Kumar S, Mahalxmi S, Ragavi P, Mageshwaran TA. Color stability of resin composite after emersing in coffee of different temperature- an in virtostudy. SRM University Journal of Dental Sciences 2011, 2:91-95
[4]. Bencourt S, et al. Characterization of water sorption, solubility and filler particles of light cured composite resin. Braz Dent J 2009; 20(4):314-318
[5]. Bagheri R, Burrow MF, Tyas M. Influence of food-simulating solutions and surface finish on susceptibility to staining of aesthetic restorative materials. Journal of Dentistry 2005; 33: 388-398

Abstract: Tripple deformity of elbow in association with cubitus varus can be treated by dome osteotomy. In this study we assess the strength of fixation after a dome osteotomy for cubitus varus associated with triple deformity in terms of union and complications. We conclude with this study that dome osteotomy has its own advantages in correcting the deformity for cosmesis and also by not leaving the prominent lateral condyle after deformity correction unlike other osteotomies. Securing the osteotomy with 2 plates provide sufficient rigidity allowing functional mobility and thereby good outcome;................

[1]. Amspacher JC, Messenbaugh JF Jr. Supracondylar osteotomy of the humerus for correction of rotational and angular deformities of the elbow. South Med J 1964;57:846-50.
[2]. Bellemore MC, Barrett IR, Middleton RW, Scougall JS, Whiteway DW. Supracondylar osteotomy of the humerus for correc- tion of cubitus varus. J Bone Joint Surg Br 1984;66:566-72.
[3]. Laupattarakasem W, Mahaisavariya B, Kowsuwon W, Saengnipanthkul S. Pentalateral osteotomy for cubitus varus. Clinical experiences of a new technique. J Bone Joint Surg Br 1989;71:667-70.
[4]. Levine MJ, Horn BD, Pizzutillo PD. Treatment of posttraumatic cubitus varus in the pediatric population with humeral osteotomy and external fixation. J Pediatr Orthop 1996;16:597-601.
[5]. Yamamoto I, Ishii S, Usui M, Ogino T, Kaneda K. Cubitus varus deformity following supracondylar fracture of the humerus. A method for measuring rotational deformity. Clin Orthop 1985;201:179-85

Abstract: Frozen shoulder or Periarthritis is a common, painful, and disabling condition affecting the shoulder joint which occurs in 2% to 5% of the general population, and majority of patients are females1. Frozen shoulder has also been documented to be more common and more difficult to treat effectively in patients who have diabetes 2, thyroid disease 3, 4and autoimmune diseases 5.Nevasier was first credited for identifying the pathology by histological and surgical examination of patients with frozen shoulder. He reported that frozen shoulder was not periarthritis but a "thickening and contraction of the capsule which becomes adherent to the humeral head". He named it "adhesive capsulitis 6,7. Later various studies supported this finding and conclude that it is result of contracted collagenous tissue8............................

[1]. Binder AI, Bulgen DY, Hazleman BL, Roberts S. Frozen shoulder: a long-term prospective study. Ann Rheum Dis. 1984; 43(3):361-364.
[2]. Bridgman J. Periarthritis of the shoulder and diabetes mellitus. Ann Rheum Dis 1972; 31:69–71.
[3]. Bowman C, Jeffcoate W, Patrick M. Bilateral adhesive capsulitis, oligarthritis and proximal myopathy as presentation of hypothyroidism. Br J Rheumatol 1998; 27:62–4.
[4]. Wohlgethan J. Frozen shoulder in hyperthyroidism.Arthritis Rheum 1987; 30:936–9.
[5]. Bulgen D, Binder A, Hazelman B. Immunological studies in frozen shoulder. J Rheumatol 1982; 9: 893–8.