iosr-JDMS   Volume-16 ~ Issue-8 ~ August-2017

Abstract: The diagnosis of acute appendicitis is mainly based on clinical examination. Various diagnostic scores are available to aid in the diagnosis of acute appendicitis with varying success rates. We assessed Alvarado scoring systems for the diagnosis of acute appendicitis and their negative appendectomy rate in 100 patients of appendicitis. We observed that Alvarado scoring system a good clinical parameter score for diagnosis of acute appendicitis with accuracy rate of 79% in this study. In this study, the sensitivity and specificity value of this score was 82.42% and 44.44% while positive predictive value and negative predictive value of Alvarado score was 93.75% and 20% respectively. The negative appendectomy rate of the Alvarado score was 6.3%.

Key Words: Appendicitis, Appendectomy, Alvarado Score, RIPASA Score.

[1]. Kumar V, Cotran RS, Robbins SL. Appendix. In: Robbins basic pathology. 5th ed. London: WB Saunders 1992.p.502-2.
[2]. Gilmore OJ, Browett JP, Griffin PH. Appendicitis and mimicking conditions. A prospective study. Lancet; 1975; 2: 421-4.
[3]. Alvarado A. A practical score for the early diagnosis of acute appendicitis. Ann Emerg Med; 1986; 15: 557-64.
[4]. Stephens PL, Mazzucco JJ. Comparison of ultrasound and the Alvarado score for the diagnosis of acute appendicitis. Conn Med; 1999; 63: 137-40.
[5]. Seal A. Appendicitis: A historical review. Can J Surg; 1981; 24: 427-33.
[6]. McBurney CM. Experience with early operative interference in cases of disease of the vermiform appendix. N Y Med J; 1889; 50: 676-84.

Abstract: Condylar and inter condylar parameters of tibiae of north coastal AP population is inadequately available in literature in order to formulate a baseline data useful for surgical utilities. This is very much useful for guiding clinicians in total knee replacement surgeries. Deformities of knee are not uncommon in this part of India. Materials And Methods: Study was conducted in 100 dry human tibiae obtained from department of anatomy Rangaraya medical college Kakinada, KIMS Amalapuram. Measurements of medial and lateral condyles, intercondylar areas and circumfererance of upper end of tibia are meticulously recorded with the use of digital vernier calipers and were tabulated............

Keywords-: Tibia, medial condyles, lateral condyles, total knee replacement

[1]. K Jacobsen,S.Mehta,R.Kalra. Area intercondylaris tibiae: osseous surface structure and its relation to soft tissue structures and applications to radiography. J Anat. 1974; 17:605-18[PMC free article] [pummed]
[2]. Susan standring editor in chief of 40th edition and Churchill living stone, 2008 Grey's Anatomy the Anatomical basis of clinical practice, section 9 pelvic girdle and lower limb pp 1397-99
[3]. RL.Last Regional Anatomy, 1977 3rd edition pp 126
[4]. E.Servien, M.Saffarini, S Lusting, S.Chomel, P.Nevret. Lateral versus medial tibial Plateau. Morphometric analysis and adaptability with current tibial component design. J kneesurg 2008: 16: 1141-45(pub med).
[5]. DS Kwak , S. Sunderan, YH Pengalleeri, SE Park; KN Choi, P.Gopinathan et al Morphometry of the proximal tibia to design the tibial component of total knee arthroplasty for Korean population. Knee 2007; 14: 295-300[ pub med]

Abstract: Castleman's disease is a rare benign lymphoproliferative disease. The most common sites of the disease are mediastinum, neck and axilla. Considering its lymphatic origin, the disease can occur theoretically anywhere in the human body. The location of the disease in mesentery is rare and usually associated with generalized form and is multifocal. We report a rare presentation of isolated mesenteric Castleman's disease in a young 28 year old male presenting as sub-acute intestinal obstruction. The final diagnosis was made after resection of the diseased intestine on histopathological examination as unicentric mesenteric Castleman's disease of the hyaline vascular type.

Keywords: Castleman's disease, mesenteric lymphadenopathy, intestinal obstruction, hyaline vascular type.

[1]. Castleman B, Iverson L, Menendez VP. Localized mediastinal lymph node hyperplasia resembling thymoma. Cancer 1956; 9(4) : 822-830.
[2]. Keller AR, Hochholzer L, Castleman B. Hyaline – vascular and plasma-cell types of giant lymph node hyperplasia of the mediastinum and other locations. Cancer 1972;29(3):670-683.[Medline].
[3]. Lee JP, NgaiRL : Mesenteric giant lymph node hyperplasia – report of a case and review of the literature. AustralasRadiol. 1990, 34:162-164. 10.1111/j. 1440-1673.
[4]. Talat N, Belgaumkar AP, Schulte KM. Surgery in Castleman'sdisease : a systematic review of 404 published cases. ANN surg. 2012 Apr. 255 (4) : 677-84.[Medline].
[5]. Wei BP, Taylor R, Chan YF, waters K, Alex G. Mesenteric Castleman's disease in childhood. ANZ J Surg 2004; 74: 502 – 504

Abstract: Induction of labor involves methods to initiate uterine contractions in pregnant woman to bring about progressive cervical dilatation with the aim of vaginal delivery with good maternal and fetal outcome.Various methods like mechanical, surgical and drugs like PGE1,PGF2alfa are available today. But study on isosorbide mononitrate is conducted as it has very minimal side effects and good maternal and fetal outcome. Methods: This is an interventional study conducted over 100 pregnant woman at Gandhi hospital for one year period with isosorbide mononitrate -40mg-2 doses with 12hrs apart for induction of labour............

Keywords-: Ismn,Tg,Nvd,Induction,Lscs, Weeks, Gestational Age.

[1]. ZhangJ, YanceyMK, HendersonCE.National trends in labor induction 1989-98
[2]. JReprodMed2002;47:120Chandraharan E, Kumaran SA, editor The management of labour. 2nd ed., Orient Longman Company, p.1-22.
[3]. Macdonald D. Surgical induction of labour. Am J ObstetGynaecol 1970; 107 :
[4]. BISHOP EH. Pelvic scoring for elective induction ObstetGynaecol1964 ; 24:266-68.
[5]. Royal college of Obtetricians& Gynaecologists. Induction of labour. Evidencebased clinical guideline No.9 London: RCOG press

Abstract: This is a prospective analytical study done in a group of 50 patients with perforative peptic ulcer Government Rajaji Hospital, Madurai. The objective of the study is to analyze the two scores, PULP score and JABALPUR score. Study compares the positive predictive value and reliability of the prediction of the two scores. PULP scores overwhelms JABALPUR score there by making it a more simple, reliable and feasible scoring system.

Keywords: Peptic ulcer perforation, mortality prediction, pulp score, Jabalpur score

[1]. Jordan PH. Duodenal ulcers and their surgical treatment: Where did they come from? Am J Surg. 1985;149:2-14.
[2]. Johnson AG. Peptic ulcer - stomach and duodenum. Morris PJ, Wood WC. Oxford Textbook of Surgery. 2nd ed. Oxford: Oxford University Press, 2000. pp.997
[3]. Wangensteen OH. Non-operative treatment of localized perforation of the duodenum. Minnesota Med 1935;18:477-480.
[4]. Taylor H. Perforated peptic ulcer treated without operation. Lancet1946;2:441-4
[5]. Franksson C. Selective Abdominal Vagotomy. Acta Chir. Scandinav. 1948;96:409.

Abstract: Hypertension affects nearly one billion people worldwide and kills approximately nine million people every year. Greater sympathetic drive has been established in early stages of essential hypertension. Heart rate variability (HRV) analysis is a specific, sensitive and non invasive tool to evaluate cardiac autonomic functions. The study included a total of 73 participants in age group 29-48 years, of which 38 had newly diagnosed essential hypertension and 35 were healthy volunteers. NN interval time series was extracted from ECG records it by removing all non sinus beats and HRV analysis performed to obtain time domain & frequency domain measures. Results showed a significant fall in absolute values of time domain parameter RMSSD (p<0.05), NN50 (p<0.05) & highly...........

Keywords-: Hypertension, heart rate variability, symapthovagal imbalance

[1]. WHO: a global brief on hypertension, silent killer, global public health crisis, Document number: WHO/DCO/WHD/2013.2 published by WHO, 2013.
[2]. World health organization, regional office for South-East Asia; Non communicable diseases in the South-East Asia Region: situation and response 2011. ISBN 978-92-9022-413-6
[3]. Chobanian AV et al, Seventh report of JNC on prevention, detection, evaluation, and treatment of high blood pressure; Pub Med; Hypertension 2003 Dec 42(6) 1206-52.
[4]. Elliott R. Carthy ; Autonomic dysfunction in essential hypertension: A systematic review, Annals of Medicine and Surgery ; 2014; 2-7
[5]. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology; Heart rate variability: standards of measurement, physiological interpretation and clinical use. Circulation 1996; 93:1043–1065

Abstract: Objective: To study the effect of Intravenous fluid supplementation along with Phototherapy in reducting bilirubin in neonates > 35 weeks with significant jaundice. Design: Randomized trial Setting& Participants: Neonates of > 35 weeks gestation with serum bilirubin >18 mg/dl and less than 25 mg/dl admitted to the Neonatology Division, Department of Pediatrics, Coimbatore Medical College Hospital, Coimbatore, tertiary care hospital in Tamilnadu. Methodology: Eligible neonates were randomly allocated using Computer-generated randomization sequence by the principle investigator to 2 different groups A, B. Group A received phototherapy alone and group B received Phototherapy intravenous fluid supplementation . The percentage fall in serum bilirubin after 24 hours of phototherapy was evaluated...............

Keywords-: Fluid supplementation, Phototherapy, Neonate, Hyperbilirubinemia.

[1]. Bhutani, V. K., Johnson, L. H., & Keren, R. (2004). Diagnosis and management of hyperbilirubinemia in the term neonate: For a safer first week. Pediatric Clinics of North America, 51(4), 843–861
[2]. Ebbesen, F., Andersson, C., Verder, H., Grytter, C., Pedersen‐Bjergaard, L., Petersen, J. R., et al. (2005). Extreme hyperbilirubinaemia in term and near‐term infants in Denmark. Acta Paediatrica, 94, 59–64.
[3]. Manning, D., Todd, P., Maxwell, M., & Platt, M. (2007). Prospective surveillance study of severe hyperbilirubinaemia in the newborn in the UK and Ireland. Archives of Disease in Childhood, Fetal and Neonatal Edition, 92, F342–F346.
[4]. Solana C, Meritano J, Conti C, Nieto R, Martinez J. Efficacy of LEDs phototherapy comparing two levels of high irradiance.Pediatric Academic Society, Vancouver, Canada; May 1–4, 2010
[5]. Vandborg PK, Hansen BM, Greisen G, EbbesenF.Pediatrics. 2012 Aug;130(2):e352-7. doi: 10.1542/peds.2011-3235. Epub 2012 Jul 16.

Abstract: The optimal duration of exclusive breastfeeding is one of the crucial public health issues that the World Health Organization (WHO) has been continously emphasising.Continued and frequent breastfeeding protects child health by reducing risk of morbidity and mortality. Methodology: This cross sectional study was conducted from April 1st 2017 to May 31st 2017 in slum areas of Guntur city. Mothers of all infants between 0- 6 months were selected by Purposive sampling technique. Subjects were interviewed using a pretested semi structured questionnaire. A Total 100 mothers were interviewed...........

[1]. Park K. Park's Textbook of Preventive and Social Medicine. 21st ed. Jabalpur: Banarasidas Bhanot; 2011. p. 489, 497.
[2]. WHO/UNICEF. Global strategy for infant and young child feeding. Geneva, World Health Organization, 2002.
[3]. Molbak K, Gottschau A, Aaby P, Hojlyng N, Ingholt L, Silva AP. Prolonged breast feeding, diarrhoeal disease, and survival of children in Guinea-Bissau. BMJ. 1994 May 28; 308 (6941):1403-6.
[4]. Kulkarni RN Anjenayas, Gujar R, breatsfeeding practice in an urban community of Kalambeli, Navi Mumbai Indian J of community med 2004;29 (4):179- 80.
[5]. Gupta P, Srivastava V.K, Kumar V, Jain S, Masood J, Ahmad N. et al. New born Care Practices in Urban slums of Lucknow City, UP, Indian Journal of Community Medicine,2010;35(1):82-85.

Abstract: In the modern day surgical practice, we come across situations in abdominal surgery, where we require resection and anastomosis of bowel. In small bowel resection and anastomosis, conventionally, two layer suturing technique i.e., inner layer with absorbable suture material in continuous fashion and outer layer with non absorbable suture material in a continuous or interrupted fashion, was considered secure. Recently, it has been advocated that anastomosis of small bowel with a single layer suturing using a non absorbable monofilament suture material in a continuous fashion has the same outcome when compared to double layer suturing technique. In our study, we have compared the advantages of single layer anastomosis of small bowel, over double layer anastomosis.

[1]. Schwartz's Principles of Surgery 9th Edition.
[2]. Maingot's – Abdominal Surgeries.
[3]. Bailey and Love, short practice of surgery, 25th edition 2009.
[4]. Single Vs Two Layer intestinal anastomosis : A meta – analysis of Randomized controlled trials – Satoru Shikata et al – Dept. of Digestive Surgery, Kyoto prefectural University of Medicine, Kyoto, Japan – BMC Surgery - 2006
[5]. Single Layer Vs Two Layer intestinal ananstomosis - A prospective Study Muhammad Ayub et al, Dept. of surgery Unit – II Dow University of Health Sciences and Civil Hospital, Karachi – Oct. 2005
[6]. Comparison of Single Layer and Double Layer anastomosis in Ahwaz Educational Hospital (2005 – 2006) –Internet journal of surgery ISSN 1528 - 8242

Abstract: This study is aiming to find out the recent trend in PICU admission because of the resurgence of dengue and like illnesses. This is a retrospective study of case records of PICU and HDU in a tertiary level referral teaching hospital in Western Tamil Nadu over 6 months from January 2017. All cases fulfilled admissions criteria were included. Among total of 1066 admissions in PICU and HDU, 725 cases were admitted with VHF (fever, thrombocytopenia, elevated HCT, clinical, lab, and radiological evidence of plasma leakage), Constituting 68%.Other cases admitted were 32%. Mostly.............

[1]. Nelson text book of paediatrics, 20 th edition 2016.
[2]. WHO Dengue Guidelines for diagnosis,Treatment, prevention and control 2009.
[3]. Sujay Kumar Earan1 , Lakshminarayanan Dhandapani1 , Arulkumaran Arunagirinathan2 , Shilpa Kantamneni3 -Clinical Spectrum and Epidemiological Profile of Patients Admitted to Pediatric Intensive Care Unit at a Tertiary Care Centre in South India –IJSS-JUN 2016 – vol 4.
[4]. Dr. J. Rukmani1 ,Dr. N. Kumar2 1MD Paed, Clinical profile and outcome of PICU in a tertiary care hospital in south India–RAJAR -May-2017: vol-3: P- 902-907.
[5]. Blessing I. Abhulimhen-Iyoha1, Suneel Kumar Pooboni2 and Nanda Kishore Kumar Vuppali2 - Morbidity Pattern and Outcome of Patients Admitted into a Pediatric Intensive Care Unit in India.2014-mar-24:

Abstract: Aims And Objectives : To study prevalence of cardiovascular risk factors (diabetes, hypertension and BMI) in patients with psoriasis. Observations :The present study was undertaken to determine the presence of diabetes, hypertension and BMI in patients previously diagnosed with psoriasis. A total of 65 cases and 66 age and sex matched controls were enrolled in the study in accordance with inclusion and exclusion criteria previously mentioned. All patients were subject to detailed history and examination as well as blood and anthropometric tests. The highest number of subjects were in the age group 21-30 (case -25 [37.88%]) (control – 37(40%) )In comparing the BMI , it was found that in the control group, 23(34.85%) subjects were obese where 34(52.31%) subjects were found to be obese in the case group.............

Keywords: CVS, Hypertension, Diabetes,BMI,Psoriasis.

[1]. National Psoriasis Foundation. About Psoriasis: Statistics. Available at: http://www.psoriasis.org/about/stats.
[2]. Reed WB, Becker SW, Rohde R, Heiskell CL. Psoriasis and arthritis. Clinicopathological study. Arch Dermatol. 1961; 83: 541-548.
[3]. McDonald and Calabresi. "Complication of Psoriasis." JAMA. 1973 Apr 30;224(5):629.
[4]. McDonald and Calabresi. "Occlusive Vascular Disease in Psoriatic Patients." N Engl J Med. 1973 Apr 26;288(17):912.
[5]. Gelfand et al. "Risk of Myocardial Infarction in Patients with Psoriasis." JAMA. 2006 Oct 11;296(14):1735-41.
[6]. Gelfand JM, Dommasch ED, Shin DB et al. The risk of stroke in patients with psoriasis. J Invest Dermatol 2009; 129: 2411-2418.
[7]. Dreiher J, Weitzman D, Davidovici B, Shapiro J, Cohen AD (2008) Psoriasis and dyslipidaemia: a population-based study. ActaDermVenereol 88: 561–565.

Abstract: Background: There are probably only few types of specific inflammatory hyperplasias affecting the gingiva, there is considerable confusion because of histological variations and overlap. It is possible that specific histologic appearances are due to triggering of a specific response resulting in a specific pathologic entity or it is possible that the different histologic pictures are that of a single lesion in different stages of repair. Objectives: To review the clinical features of the lesions grouped on the basis of histologic features for clinic-pathologic correlation. Methodology: A series of patients reporting to the out patient department of Govt. Dental College, Trivandrum were examined for localised gingival mass till 100 cases of reactive lesions were obtained. The patients were subjected to a thorough clinical examination followed by other diagnostic methods like radiography, routine hematologic examinations and finally biopsy................

Keywords-: Fibrous hyperplasia, pyogenic granuloma, peripheral fibroma, peripheral giant cell granulomas

[1]. Barker DS, Lucas RB. Localised fibrous overgrowths of the oral mucosa. British Journal of Oral Surgery. 1967 Jul 1;5(2):86-92.
[2]. Eversole LR, Rovin S. Reactive lesions of the gingiva. Journal of Oral Pathology & Medicine. 1972 Jan 1;1(1):30-8.
[3]. Vally IM, Altini M. Fibromatoses of the oral and paraoral soft tissues and jaws: Review of the literature and report of 12 new cases. Oral surgery, oral medicine, oral pathology. 1990 Feb 1;69(2):191-8.
[4]. Sciubba JJ, Zola MB. Odontogenic epithelial hamartoma. Oral Surgery, Oral Medicine, Oral Pathology. 1978 Feb 1;45(2):261-5.
[5]. Oles RD. Incidence and distribution of various connective tissue fibers in oral fibromas. Oral Surgery, Oral Medicine, Oral Pathology. 1968 Oct 1;26(4):487-96.
[6]. Kfir Y, Buchner A, Hansen LS. Reactive lesions of the gingiva: a clinicopathological study of 741 cases. Journal of periodontology. 1980 Nov;51(11):655-61.

Abstract: Background:Hepatitis B is a serious global and public health problem. The study of its seroprevalence is important,therefore not only to assess the magnitude and dynamics of disease transmission but also for its prevention and control. Objective:This study was undertaken to estimate the seroprevalence of hepatitis B surface antigen amongst patients attending a tertiary care hospital. Materials and Methods:This was a retrospective hospital record-based study descriptive conducted between January 2015 and jun 2017. The sera were tested for hepatitis B surface antigen using HBsAg Rapid test Kit (HEPA™CARD)..............

Keywords: Hepatitis B, seroprevalence,HbsAg

[1]. World Health Organization. Hepatitis B. World Health OrganizationFact Sheet No 204 (Updated July 2014) [cited 2014 Dec Available at: http://www.who.int/mediacentre/factsheets/fs204/en/.
[2]. Lavanchy D. Hepatitis B virus epidemiology, disease burden,treatment, and current and emerging prevention and control measures.J Viral Hepat. 2004;11:97–107.
[3]. Lok AS. Chronic hepatitis B.N Engl J Med. 2002;346:1682–1683.
[4]. Goldstein ST, Zhou F, Hadler SC, Bell BP, Mast EE, Margolis HS.A mathematical model to estimate global hepatitis B disease burden and vaccination impact.Int J Epidemiol. 2005;34:1329–1339.
[5]. Qamer S, Shahab T, Alam S, Malik A, Afzal K. Age specific prevalence of Hepatitis B surface antigen in pediatric population of Aligarh, North India. Indian J Pediatr. 2004;71:965–7.

Abstract: A teratoma is a congenital tumour that may be monodermal or polydermal. Teratomas are known to contain hair, teeth, bone, and other tissues. Extragonadal teratomas are rare, and the liver is the least common location to find a teratoma. To the best of our knowledge, most cases of teratoma in the liver that have been documented to date have involved a mature teratoma. However, we present a case involving an immature teratoma. Such tumours typically produce compressive symptoms, although our patient's teratoma was an incidental finding. Introduction: Teratomas are congenital neoplasms arising from gonadal tissue that have tissues derived from ectodermal, mesodermal and endodermal germ layers. Extragonadal teratomas are extremely rare...........

Keywords: Cystic Teratoma; Dermoid Cyst; Hydatid Cyst; Immature Teratoma; Sacrococcygeal Teratoma.

[1]. Rahmat K, Vijayananthan A, Abdullah Bjj, Amin Sm. Benign teratoma of the liver: a rare cause of cholangitis. Biomed Imaging Interv J. 2006; 2(3) doi: 10.2349/biij.2.3.e20.

[2]. Martin L,Papadatos D, Michaud C, et al. Best cases from AFIP:LiverTeratoma. Radiographics. 2004;24(5):1467-1471.

[3]. Certo M, Franca M, Gomes M, Machado R. Liver teratoma. Acta Gastroenterol Belg. 2008; 71(2):275–9.

[4]. Outwater E, Siegelman E, Hunt. Ovarian teratomas: Tumortypes and Imaging Characteristics. Radiographics. 2001; 21:475-490.

[5]. Souflas V,polychrondis A, Giataromanolaki A, et al. Dermoid cyst in the hepatoduodenal ligament: Report of a case. Surg today. 2008:38:959-961

Abstract: Laparotomy is one of the common surgeries performed in general surgery.This study compares and analyses two commonly used materials for skin closure after laparotomy which are skin staples and sutures. patients who underwent midline laparotomy in both elective and emergency situations were selected. They were equally segregated into two study In one arm the laparotomy wound was closed with silk mattress suture while in other arm skin staples were used. Both the groups were compared regarding reduction in surgery time, effect of wound healing, infection rate, post operative pain, and cosmesis. Data was collected and analysed by various statistical methods.. Using skin staples for closure of laparotomy wounds significantly reduced operative time with less post op pain with no difference in appearance or rate of infection when compared to closure by sutures

Keywords-: Laparotomy, Skin staples, Suture, Infection, Time

[1]. Eldrup J, Wied U, Anderson B. Randomised trial comparing Proximate stapler with conventional skin closure. ActaChirurgScand1981; 147:501-502.
[2]. Brickman KR, Lambert RW. Evaluation of skin stapling for wound closure in the emergency department, Ann Emerg Med1989 Oct;18(10): 1122-1125
[3]. Huskisson EC. Measurement of pain,Lancet 1974;ii: 112731.
[4]. Ranaboldo CJ, Rowe-Jones DC. Closure of laporatomy wounds: skin staples versus sutures. Br.J.Surg.1992; 79:1172-1173.
[5]. Harvey CF , Logan J. A prospective trial of skin staples and sutures in skin closure. Ir J Med Sci.1986; 155:194-196.
Burke JF, Infection, in Hunt TK, Dunphy JE (eds) Fundamentals of wound Management,(New York, Appleton – Century – Crofts, 1979), pp 170-241.

Abstract: We are presenting a rare case of isolated traumatic perforation of meckel's diverticulum which was identified incidentally during our emergency laparotomy on a patient who presented to our hospital trauma ward as a case of blunt injury abdomen by means of assault. Isolated traumatic perforation of meckle's diverticulum is a very rare entity which is usually detected incidentally during surgery. The treatment of this condition is Primary resection and anastamosis of meckel's diverticulum and adjacent small bowel. The post operative period of the patient was un-eventful and the patient was discharged after he was treated conservatively with Intra-venous antibiotics , Analgesics and daily wound care. The patient was discharged on the fifth post operative day without any post operative complications.

Key words: Meckel's diverticulum , resection , emergency

[1]. Turgeon DK, Barnett JL. Meckel's diverticulum. Am J Gastroenterol. 1990;85:777-781.

[2]. Elsayes KM, Menias CO, Harvin HJ, Francis IR (July 2007). "Imaging manifestations of Meckel's diverticulum". AJR Am J Roentgenol. 189 (1): 81–8. PMID 17579156. doi:10.2214/AJR.06.1257.

[3]. J. F. Meckel. Über die Divertikel am Darmkanal. Archiv für die Physiologie, Halle, 1809, 9: 421–453. [4]. Schoenwolf, G. C., & Larsen, W. J. (2009). Larsen's human embryology (4th ed.). Philadelphia: Churchill Livingstone/Elsevier.

[5]. F. Charles Brunicardi, Dana K. Anderson, Timothy R. Billiar, et al. Small Intestine. In: Ali Tavakkoli, Stanley W. Ashley, Michael J. Zinner: Schwartz's Principles of Surgery. 10 ed. United states: McGraw-Hill;2015

[6]. Tan, Y. M., & Zheng, Z. X. (2005). Recurrent torsion of a giant Meckel's diverticulum. Digestive Diseases and Sciences, 50(7), 1285–1287.

Abstract: Statement of problem: all-ceramic onlay has become more popular in dental clinics due to their lifelike appearance, durability, and biocompatibility. However, their drawbacks include fracture susceptibility and inadequate marginal fit. Purpose: The aim of this systematic review was to identify from in vitro studies the fracture resistance of the posterior teeth restored with different ceramic Onlay restoration. Materials and methods: The articles identified were screened by two reviewers according to inclusion and exclusion criteria. The reference lists of articles advanced to second round screening were hand searched to identify additional potential articles............

[1]. Malament KA, Socransky SS. Survival of Dicor glass-ceramic dental restorations over 14 years: Part I. Survival of Dicor complete coverage restorations and effect of internal surface acid etching, tooth position, gender, and age. J Prosthet Dent. 1999;81(1):23-32.
[2]. Felden A, Schmalz G. Retrospective clinical investigation and survival analysis on ceramic inlays and partial ceramic crowns : results up to 7 years. Clin Oral invest. 1998:161-167.
[3]. Cötert HS, Sen BH, Balkan M. In vitro comparison of cuspal fracture resistances of posterior teeth restored with various adhesive restorations. Int J Prosthodont. 2001;14(4):374-378.
[4]. Magne P, Knezevic A. Simulated fatigue resistance of composite resin versus porcelain CAD / CAM overlay restorations on endodontically treated molars. Quintessence Int. 2009;40(2):125-134.
[5]. Rosenblum MA, Schulman A. A review of all-ceramic restorations. J Am Dent Assoc. 1997;128(3):297-307.

Abstract: Context: HIV/AIDS patients may have renal involvement also, however, Indian data are sparse. The present study was done to find the prevalance of renal diseases in HIV/AIDS patients attending ART centre, Govt Rajaji hospital Madurai. Aim Of The Study: To find out the prevalence of Renal and electrolyte disturbances in Patients with HIV irrespective of ART. To explore the mechanism for renal involvement through literature Settings And Design Cross sectional study Materials And Methods Period of study – February 2016 to July 2016..............

Keywords-: ART –Anti retroviral therapy ,HIV - human immunodeficiency virus

[1]. NAIDS/WHO. AIDS epidemic update: November 2011. Available from:
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[3]. UNAIDS/WHO. UNAIDS report on the global AIDS epidemic. 2010. Available from: http://www.unaids.org/, accessed on May 11, 2011.
[4]. Weiner NJ, Goodman, JW, Kimmel Pl. The HIV-associated. renal diseases: current insight into pathogenesis and treatment. Kidney Int 2003; 63 : 1618-31.
[5]. Winston J, Deray G, Hawkins T, Szczech L, Wyatt C, Young. B, et al. Kidney disease in patients with HIV infection and AIDS. Infect Dis 2008; 47 : 1449-57.

Abstract: Osteoarthritis is one of the most common causes of knee pain affecting millions of people around the world. Osteoarthritis is a chronic progressive joint disorder characterized by pain commonly over the medial joint line and associated with varus and valgus deformity. Physical examination usually is marked by joint line tenderness, crepitus and painful range of movements. Several pharmaceutical approaches, such as analgesics, non steroidal anti – inflammatory drugs, COX – 2 inhibitors and steroids (Hochberg et al., 1995), have been proposed, with the aim of reducing pain and maintaining and / or improving joint function. Considering the limits of therapies at present available, drugs with minimal side effects are therefore warranted. Viscosupplementation by intra – articular injections of hyaluronic acid has been proposed as useful therapeutic option in the treatment.

Keywords-: Visual analog score(VAS), knee society score(KSS), osteoarthritis

[1]. SETH S. LEOPOLD, MD, BRIGHAM B. REDD, MD, WINSTON J. WARME, MD, PAUL A. WEHRLE, MD, PATRICK D. PETTIS, LVN, AND SUSAN SHOTT, PHDCorticosteroid Compared with Hyaluronic Acid Injections for the Treatment of Osteoarthritis of the KneeTH E JOURNAL OF BONE & JOINT SURGERY · JBJS.ORG VOLUME 85-A · NUMBER 7 · JULY 2003
[2]. Altman RD, Moskowitz R. Intraarticular sodium hyaluronate (Hyalgan) in the treatment of patients with osteoarthritis of the knee: a randomized clinical trial. Hyalgan Study Group. J Rheumatol. 1998;25:2203-12.
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[4]. Dahlberg L, Lohmander LS, Ryd L. Intraarticular injections of hyaluronan in patients with cartilage abnormalities and knee pain. A one-year double-blind, placebo-controlled study. Arthritis Rheum. 1994;37:521-8.
[5]. Creamer P. Intra-articular corticosteroid treatment in osteoarthritis. CurrOpinRheumatol. 1999;11:417-21.