iosr-JDMS   Volume-16 ~ Issue-9 ~ September-2017

Abstract: Aim & objective:- comparative study of predicting prognosis of obstetric patient admitted in icu by sofa and apache scores Methods:- It was a prospective study done on 50 patients in the department of obstetrics and gynecology in Gandhi hospital,Secunderabad, from January 2014 to November 2015. Comparison and analysis between APACHE 1V SCORE and SOFA SCORE for maternal outcome of patients admitted in ICU was done. Results:- In our study , for prediction of outcome in ICU, SOFA score had a sensitivity of 24.3% and specificity of 88.8% whereas for APACHE IV score the sensitivity was 66.6% and specificity was 78.1%..............

[1]. Vincent JL,Monero R, Takala J, Williatts S, De Mendonca A, Bruining H,Reinhart CK, Suter PM, Thijs. The SOFA (Sepsis related organ failure assessment) score to describe organ dysfunction or failure. On behalf of the working group on sepsis related problems of the European society if Intensive care medicine. Intensive Care Med 1996; 22: 707- 710..
[2]. Ferreira FL, Bota DP, Bross A, Melot C, Vincent JL. Serial evaluation of the SOFA scores to predict outcome in critically ill patients. JAMA. 2001; 286:1754-1758.
[3]. Knaus WA, Zimmerman JE, Wagner DP, Draper EA, Lawrence DE: APACHE-acute physiology and chronic health evaluation: a physiologically based classification system. Crit Care Med 1981, 9:591- 597. PubMed Abstract.
[4]. Knaus WA, Draper EA, Wagner DP, Zimmerman JE: APACHE II: A severity of disease classification system. Crit Care Med 1985, 13:818- 829. PubMed Abstract.
[5]. Knaus WA, Wagner DP, Draper EA, Zimmerman JE, Bergner M, Bastos PG, Sirio CA, Murphy DJ, Lotring T, Damiano A, Harrell FE: The APACHE III prognostic system: Risk prediction of hospital mortality for critically ill hospitalized adults. Chest 1991, 100:1619-1636. PubMed Abstract | Publisher Full Text..

Abstract: Introduction: Preeclampsia and eclampsia contribute greatly to the maternal morbidity and mortality.Thrombocytopenia is the most common hematological abnormality of all that occur in preeclampsia, and the frequency of maternal thrombocytopenia is dependent on the intensity of the disease process and duration of preeclampsia syndrome. Material and methods: A hospital based observational study was conducted which included 150 normotensive pregnant females as controls and 150 cases of preeclampsia of varying severity (mild preeclampsia, severe preeclampsia and eclampsia). Study subjects were studied with Haemoglobin, Bleeding time, Clotting time and Platelet count and feto-maternal outcome was compared between both study groups..........

Keywords: Bleeding time, Eclampsia, Platelet Count, Preeclampsia

[1]. Evans AT,Niswander KR. Manual of Obstetrics.6thed.Lippincot: Williams and Wilkins Publishers; 2000. P 287-298

[2]. Chamberlain G, Steer P. Turnbulls' Obstetrics. 3rd ed. NewYork: Churchill Livingstone; 2001. p. 338–44.

[3]. Kleigman RM, Behraman RE, Jenson HB, Staton BF. Nelson's text book of pediatrics, vol. 1. 18th ed. Philadelphia: Saunder'sElseveir Publications; 2007. p. 701–4.

[4]. Cunnigham F Gary et al.Williams Obstetrics 24th Edition. McGraw Hill 2014 P 738

[5]. Jasovic-Siveska E, Jasovic V, Stoilova S.Previous pregnancy history, parity, maternal age and risk of pregnancy induced hypertension.BratislLekListy. 2011;112(4):188-91.
[6]. Macdonald-Wallis C, Tilling K, Fraser A, et al. Gestational weight gain as a risk factor for hypertensive disorders of pregnancy. Am J ObstetGynecol 2013;209:327.e1-17.

Abstract: Soft tissue sarcoma are one of the most common malignancy with high incidence of lung metastasis which occur in about 80% of patient within 2 years duration. Though brain metastasis is a relatively a rare event in the natural history of soft tissue sarcomas it occurs in about 7% of the patient with soft tissue sarcoma. A direct metastasis to brain without lung metastasis s very rare and only few cases have been reported. The increasing use of chemotherapy may have caused a reduction in local relapses as well as distant failures leading to an improvement in survival, thereby allowing metachronous seeding of the brain, a sanctuary site. The purpose of this report isto increase awareness amongst clinicians regarding such a possibility.

Keywords: soft tissue sarcoma, brain metastasis

[1]. Henderson TO, Whitton J, Stovall M, et al. Secondary sarcomas in childhood cancer survivors: a report from the Childhood Cancer Survivor Study. J Natl Cancer Inst 2007;99:300–308.
[2]. Gladdy RA, Qin LX, Moraco N, et al. Do radiation-associated soft tissue sarcomas have the same prognosis as sporadic soft tissue sarcomas? J Clin Oncol
[3]. 2010;28:2064–2069.
[4]. Dalal KM, Kattan MW, Antonescu CR, et al. Subtype specific prognostic nomogram for patients with primary liposarcoma of the retroperitoneum,
[5]. extremity, or trunk. Ann Surg 2006;244:381–391

Abstract: Acute onset paraparesis, though a very common entity, has a wide variety of etiologies including spinal and electrolyte disorders. One of the unusual causes of Paraparesis includes Primary Hyperaldosteronism (Conn's syndrome) and despite being a medical illness, the myopathy is readily reversible with surgical intervention. We encountered a case of 42-year old lady with hypertension and acute paraparesis with normal MRI Spine. Investigations revealed Primary Hyperaldosteronism due to unilateral Adrenal tumor. Surgical intervention by laparoscopic Adrenalectomy was carried out that relieved her symptoms. Histopathology confirmed Adrenal adenoma.

Keywords : Adrenal adenoma, Conn's Syndrome, Hyperaldosteronism

[1]. Conn JW: Primary aldosteronism, a new clinical syndrome. J Lab Clin Med; 1955;45:3-17.
[2]. Huang YY, Hsu BR, Tsai JS. Paralytic myopathy: A leading clinical presentation for primary aldosteronism in Taiwan. J Clin Endocrinol Metab 1996;81:4038-41.
[3]. Chi Chui, Wei-Hsi Chen, Hsin-Ling Yin. Periodic Drop Thumb, Hypokalemia and Adrenal Adenoma in Med Princ Pract 2014;23:80–82.
[4]. Hari Kumar K, Jha S, Jha R, Modi KD. Conns' syndrome - atypical presentations. Saudi J Kidney Dis Transpl. 2009 Mar;20(2):278-81. PubMed PMID: 19237819.
[5]. Chuang, T. H., Wang, C. H., Tseng, B. Y., Hsu, Y. H., Tsai, J. P., Hsu, B. G., & Fang, T. C. (2008). Conn's Syndrome with an Unusual Presentation of Rhabdomyolysis Secondary to Severe Hypokalemia. Tzu Chi Medical Journal, 20(4), 327-331. DOI: 10.1016/S1016-3190(08)60060-9..

Abstract: Background and objectives: Schneiderian papillomas are one of the benign neoplasms accounting for 0.4 to 4.7% of all sinonasal tumors. They have main three key characteristics: capacity for local destruction, tendency to recur and association with squamous cell carcinoma. They are classified into inverting, fungiform, and oncocytic. These should be distinguished from one another histopathologically. This study highlights the histopathological differences between the Schneiderian papilloma subtypes and papillomas with malignant transformation. Methods: This study was a descriptive study done in Department of pathology............

Keywords: Schneiderian papillomas,squamous epithelium,dysplasia,transitional epithelium

[1]. Atlas of head and neck pathology by Bruce M.Wenig.,second edition, page.no:65.,
[2]. Head and neck pathology by LESTER D.R. THOMPSON.Avolume in the series of foundations in diagnostic pathology. Series editor :John R.Goldblum, page no: 129
[3]. Surgical pathology of the head and neck by Leon Barnes,third edition ,vol:1, page no.: 367
[4]. Barnes L, Bedetti C. Oncocytic Schneiderian papilloma:a reappraisal of cylindrical cell papilloma of the sino nasal tract.Hum pathol 1984;15 :344-351.
[5]. Rosai and Ackerman surgical pathology, tenth edition,volume-1,page .no:295.

Abstract: Objective: Type 2 diabetes mellitus(T2DM) is a progressive disease, pharmacotherapy with a single agent does not generally provide durable glycaemic control over the long time. In this study two dipeptidyl peptidase-4 inhibitors vildagliptin and linagliptin was used for comparative study as add on therapy in type 2 diabetes mellitus patients inadequately controlled with dual combination metformin and glimepiride. Material And Methods: The study was a prospective, randomized, open label comparison. A total of 234 T2 DM patients who failed to achieve glycaemic control with metformin and glimepiride were recruited to receive vildagliptin or linagliptin as an additional drug. Patients were divided into two groups. One group received..............

Keywords: Glycated haemoglobin, Dipeptidyl peptides -4 inhibitors, vildagliptin, linagliptin

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Abstract: Background: Beta-blocker therapy has a proven benefit in patients with hypertension, heart failure and Coronary Artery Disease (CAD) and have been considered contraindicated in patients with Chronic Obstructive Pulmonary Disease (COPD). Although beta-blockers improve cardiovascular outcomes, COPD patients not receive them because possible adverse pulmonary effects. We aimed to identify factors associated with beta-blocker used in this setting and to determine whether their use is associated with decreased in-hospital mortality. Methods: Randomised, blinded, controlled trials of single dose or one year duration that studied the effects of cardioselective beta-blockers on.......... .

[1]. Mannino, DM COPD: epidemiology, prevalence, morbidity and mortality, and disease heterogeneity. Chest 2002; 121(suppl):121S-126S
[2]. Vilkman S, Keistinen T, Tuuponen T, Kivela SL. Survival and cause of death among elderly chronic obstructive pulmonary disease patients after first admission to hospital. Respiration 1997; 64:281-284
[3]. Kuller LH, Ockene JK, Townsend M, Browner M, Meilahn E, Wentworth DN. The epidemiology of pulmonary function and COPD mortality in the multiple risk factor intervention trial. Am Rev Respir Dis 1989; 140:S76-S81
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Abstract: Right ventricular (RV) infarction imposes a higher risk of adverse events in inferior wall myocardial infarction (IWMI). In this study, we have attempted to correlate various indices of RV function assessed by echocardiography with presence of proximal right coronary artery (RCA) stenosis in patients with first episode of acute IWMI. Methods: 102 patients with first episode of acute IWMI underwent echocardiographic assessment within 24 h of symptom onset and RV function was assessed by RV fractional area change (RVFAC), tricuspid annular plane systolic excursion (TAPSE), myocardial performance index (MPI) and tissue Doppler velocities from RV free wall were measured. Patients underwent coronary........

Keywords: Right ventricular function, Right coronary artery stenosis, Right ventricular infarction.

[1]. Mehta SR, Eikelboom JW, Natarajan MK, et al. Impact of right ventricular involvement on mortality and morbidity in patients with inferior myocardial infarction. J Am Coll Cardiol. 2001;37:37e43.
[2]. Shiraki H, Yoshikawa T, Anzai T, et al. Association between preinfarction angina and a lower risk of right ventricular infarction. N Engl J Med. 1998;338:941e947.
[3]. Braat SH, Brugada P, de Zwaan C, et al. Value of electrocardiogram in diagnosing right ventricular involvement in patients with an acute inferior wall myocardial infarction. Br Heart J. 1983;49:368e372.
[4]. Tei C, Dujardin KS, Hodge DO, et al. Doppler echocardiographic index for assessment of global right
[5]. ventricular function. J Am Soc Echocardiogr. 1996;9:838e847..

Abstract: Slipped capital femoral epiphysis (SCFE) is a common adolescent hip disorder presenting as a painful hip in the adolescent population. The major management concern is the precarious blood supply to the femoral epiphysis. A surgical procedure fulfilling the requirement was brought by Ganz as a method of safe surgical dislocation of hip into limelight. This procedure gives credential to the vascular supply of femoral head at all stages. Ganz safe surgical dislocation made possible 360 degrees' visualization of theacetabulum and the femoral head. This also helps in anatomical realignment of femoral epiphysis over the metaphysis. In this study weanalyse the patients with slipped capital femoral epiphysis (SCFE) treated by Ganz safe surgical dislocation and subcapital realignment of epiphysis and assess the functional, radiological outcome and complications of the surgical procedure..

Keywords: SCFE, Ganz procedure, Safe Surgical Dislocation

[1]. Watson-Jones R. The classic: "Fractures and Joint Injuries" by Sir Reginald Watson-Jones, Vol. II, 4th ed., Baltimore, Williams and Wilkins Company, 1955. Clin Orthop Relat Res 1974; (105)
[2]. Chapman's orthopaedic surgery. Chung SMK, Batterman SC, Brighton CT. Shear Strength of the Human Femoral Capital Epiphyseal Plate. J Bone Joint Surg Am 1976;58:94
[3]. Campbell's operative orthopaedics – Fractures and dislocations in children
[4]. Loder RT, Starnes T, Dikos G, et al: Demographic predictors of severity of stable slipped capital femoral epiphyses.J Bone Joint Surg Am 2006; 88:97
[5]. Orthopaedics One review – Slipped capital femoral epiphysis – version 13 03-june 2015

Abstract: Drug promotional literatures (DPLs) are a major marketing tool of pharmaceutical companies for promoting their products. According to WHO, promotional claims need to be reliable, truthful, informative, balanced, up to date. However, the pharmaceutical companies do not adhere to the required ethical guidelines while promoting their products. This study was aimed to evaluate collected drug promotional literature (DPL) as per World Health Organization (WHO) criteria for ethical medicinal drug promotion. This observational, cross-sectional study was conducted at outpatient department of a tertiary care center attached to a medical college in Maharashtra for a period of three months. Printed...........

Keywords: drug promotional literature, WHO criteria for ethical drug promotion.

[1]. Sahne B J, Yegenoglu S, Uner M, and Wertheimer A I.Adherence of drug advertisements to the international marketin Codes. Hacettepe University Journal of the Faculty of Pharmacy. 2012;32( 1):53–66
[2]. Lal A. Pharmaceutical Drug Promotion: How it is being Practiced in India? Vol. 47, Journal of Association of Physicians of India. 999. p. 266–373.
[3]. Cooper RJ, Schriger DL, Wallace RC, Mikulich VJ, Wilkes MS. The quantity and quality of scientific graphs in pharmaceutical advertisements. J Gen Intern Med. 2003;18(4):294–7.
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Abstract: Ventilator-associated pneumonia (VAP) is common in the intensive care unit (ICU), affecting 8 to 20% of ICU patients and up to 27% of mechanically ventilated patients (Alvaro Rea-Neto et al 2008). Several risk factors have been reported to be associated with VAP, including the duration of mechanical ventilation, and the presence of chronic pulmonary disease, sepsis, Acute Respiratory Distress Syndrome (ARDS), neurological disease, trauma, prior use of antibiotics and red cell transfusions (Tejerina E et al 2006). VAP is also associated with considerable morbidity, including prolonged length of stay in ICU, prolonged mechanical ventilation, and increased costs of hospitalization (Rello J et al Delayed diagnosis and subsequent delay in initiating appropriate therapy may be associated with worse outcomes in patients with VAP (Iregui.M et al 2002). On the other hand, an incorrect diagnosis..........

Keywords: Vap-Ventilator Associted Pneumonia Cap-Community Acquired Pneumonia

[1]. Adam K., JacobSandra L., KoppDouglas R. ,BaconHugh, M. Smith clinical anesthesia Barash 6 th edition.2009
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[3]. Allaouchiche B, Jaumain H, Chassard D, Bouletreau P: Gram stain of broncho-alveolar lavage fluid in the early diagnosis of
ventilator-associated pneumonia. Br J Anaesth 1999, 83:845-849.
[4]. Alvaro Rea-Neto, Nazah Cherif M Youssef, Fabio Tuche, Frank Brunkhorst1, V Marco Ranieri, Konrad Reinhart1 and Yasser
Sakr1 2008
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Intensive care Med 1996; 22-387-94.

Abstract: Introduction: Ultrasonography(US) and magnetic resonance imaging (MRI) are both capable of diagnosing rotator cuff pathology. Objectives: To evaluate the diagnostic value of US and (MRI) in the detection of rotator cuff tears for patients with shoulder pain. Materials and methods: 87 patients with clinically suspected to have rotator cuff pathology underwent both US and MRI .The standard protocols of shoulder examinations were obtained. Sensitivity and accuracy of each modality have been evaluated and the correlation between the results of both imaging methods was deliberated using MRI as reference. The study included both genders ,their mean age was 49.40± 12.4.The study spanned during the period from 2014-2017..........

Keywords: Ultrasonography, MRI ,Rotator cuff tear.

[1]. Kelechi R. Okoroha, Nima Mehran, JonathanDuncan, Travis Washington, ; TylerSpiering, Michael J. Bey, ; Marnix VanHolsbeeck, Vasilios Moutzouros, (2017) Characterization of Rotator Cuff Tears: Ultrasound Versus Magnetic Resonance Imaging Volume 40 Number 1,124-130
[2]. Boenisch U, Lembcke O, Naumann T. (2000) Classification, clinical findings and operative treatment of degenerative and posttraumatic shoulder disease:what do we really need to know from an imagingreport to establish a treatment strategy? Eur J Radiol; 35:103–118
[3]. Ruotolo C, Nottage WM. (2002) Surgical and nonsurgical management of rotator cuff tears. Arthroscopy; 18:527–531
[4]. Mantone JK, Burkhead WZ Jr, Noonan J Jr. (2000) Nonoperative treatment of rotator cuff tears. Orthop Clin North Am; 31:295–311
[5]. Middleton WD, Edelstein G, Remus WA, Melson GL, Totty WG, Murphy WA. (1985) Sonographic detection of rotator cuff tears. AJR;144:349-353.

Abstract: The objectives of this study were to evaluate the effectiveness of perfusion and magnetic resonance spectroscopy in the characterization of brain tumors. The study was conducted during the period extended from 2014 up to 2017, using 1.5 Tesla superconducting Syngo MRI system at neuro-surgery and Oncology department at Jazan- Saudi Arabia. The study was designed by obtaining a spectrum, that was analyzed, and was influenced by many parameters, including chemical characteristics of each metabolite and the compounds in which they are located; N-acetyl aspartate (NAA) , choline (Cho), creatine (Cr) Cho/ NAA, Cho/ Cr, NAA/ Cr , Lactate and Lipid at the selection of the lesion area to be studied. The perfusion.........

Keywords: Brain tumors, MRI, perfusion, MRS

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[5]. Nelson SJ, McKnight TR, Henry RG (2002) Characterization of untreated gliomas by magnetic resonance spectroscopic imaging. Neuroimaging Clin N Am 12:599-613..

Abstract: Preparation of dry hollow organs like stomach, intestine and lungs is very important in understanding their 3 dimensional orientation. In this study simple balloons were used to prepare stomach and intestine; and air compressor pump for lung. The method used was very easy and also cost effective. The outcome of the final specimens was light weight, easy to handle and could be used for the teaching purpose and also could be displayed in museum.

Keywords: Air compressor pump, balloon, dry specimen, hollow organ, lung, stomach.

[1]. I. Arnautovic,, R.W. Henry, H. Pobric, R. Avdic, R. Cutahija, M. Tabakovic, and R.B. Reed, Improved method for dried anatomical specimen preparation, J. Int. Soc. Plastination, 20, 2005, 13-15.
[2]. S. Dilleswara Rao, Prasant Babu, Jagapathi Ramayya and U. Rajsekhar, Preparation of dried anatomical specimens for UG teaching, Proc. XXXI Annual Convention of IAVA and National Symposium, Department of Anatomy, Veterinary College, Hyderabad (A.P.) India, 2016

[3]. B.A. Markarian, Simple method of inflation--fixation and air drying of lungs, Am J Clin Pathol., 63(1), 1975, 20-4.
[4]. B.C. McKiernan, and S.K. Kneller, A simple method for the preparation of inflated air-dried lung specimens [Anatomy, anatomic models, anatomic specimens]. Veterinary radiology, 24, 1983, 58-62.

Abstract: Paramolar is a type of supernumerary teeth that is small and mostly situated buccally or adjacent to maxillary molars. It is a type of developmental disturbance that can occur due to varied etiology. In this case report, we present the occurrence of paramolar in a patient who reported for denture placement. We also discuss the occurrence, cause, diagnosis, complications and treatment strategies for these patients.

Keywords: Supernumerary teeth, Paramolar.

[1]. Stafne, E.C.: Supernumerary teeth, Dent. Cosmos, 74, 653-659, 1935
[2]. Luten, J.R.: The prevalence of supernumerary teeth in primary and mixed dentitions, J. Dent. Child., 34,34653, 1967
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Abstract: Objectives: To evaluate the result of dorsolateral onlay buccal mucosal graft (BMG) urethroplasty in different type of long segment anterior urethral stricture. Materials and Methods: In this retrospective study total number of patients was 30 from January 2014 to December 2015. This study was carried out at NRS Medical College, Kolkata in dept. of Urology in patients who presented with long anterior urethral stricture at OPD. Preoperatively they were assessed by complete history, physical examination, uroflowmetry, retrograde urethrography and voiding cystourethrography and cystoscopy. They were managed by dorsolateral BMG urethroplasty with or without hypospadiac meatus. In follow–up period they were assessed by uroflowmetry 3 monthly for.........

Keywords: urethral stricture, buccal mucosal graft, dorsolateral approach, follow up.

[1]. Barbagli G, Morgia G, Lazzeri M. Dorsal onlay skin graft bulbar urethroplasty: Long-term follow-up. EurUrol 2008; 53: 628–33.
[2]. Al-Ali M, Al-Hajaj R. Johanson's staged urethroplasty revisited in the salvage treatment of 68 complex urethral stricture patients: Presentation of totalurethroplasty. EurUrol 2001; 39: 268–71.
[3]. Schreiter F. Two-stage urethroplasty.UrologeA 1998; 37: 42–50.
[4]. Bouchot O, Cassé C, Bochereau G, Prunet D, Buzelin JM. Urethroplasty in 2 stages using skin grafts. Prog Urol. 1995; 5: 551–5.
[5]. Peterson AC, Webster GD. Management of urethral stricture disease: developing options for surgical intervention. BJU Int. 2004;94:971–976.[PubMed].

Abstract: Thyroid cancer (TC) affects more women than men and those of Asian descent. Environmentalexposure to ionizing radiation from natural and artificial sources plays a significant role. Genetic causes include endocrine neoplasia type 2, particularly of the rare medullary form of the disease. Initial symptom is enlarged nodule, pain, changes in voice due to involvement of laryngeal nerve. Hyperthyroidism or hypothyroidism may be associated with a large or metastatic well differentiated tumor. Physical examination, ultrasound, and fine needle aspiration cytology confirms a definitive diagnosis.TCs are classified according to their histological characteristics, i.e. Papillary(75% to 85%),follicular(10% to 20%),medullary(5% to 8%),poorly differentiated and anaplastic thyroid cancer(< 5%)............

Keywords: Thyroid cancer, Nodule, Radiation exposure, FANC.

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Abstract: Forensic odontology usually involves the cooperation & coordination of law enforcement officials, forensic pathologists, forensic odontologists, forensic anthropathologists, serologists, criminalistics, & other specialists. This branch of dentistry helps the law in solving crimes by various methods of dental investigation which includes radiographic investigation, human bite marks analysis, anthropologic examination and during mass disasters. It has helped in solving cold cases and plays a vital role in solving cases in court of law. The present study was done to analyse the importance of forensic odontology in India and its relevance in world statistics. The prevalance of using forensic odontology worldwide is very minimal when compared to forensic medicine. Thus, practitioners must be aware of the importance of forensic dentistry & should also maintain premortem dental record, which is a useful tool & help legal authorities during an identification process.

Keywords: Crime Cases, Dental identification,Forensic Odontology.

[1]. Verma AK, Kumar S, Rathore S, Pandey A. Role of dental expert in forensic odontology. Nat J Maxillofac Surg 2014;5:2-5.
[2]. Ramaswamy C. A Select List of International Cases Involving Forensic Odontology (49-2013 AD)
[3]. 3) Saranya V, Malathi. N. Forensic Odontology: A Brief Review. SRJM 2014;7:22-28.
[4]. 4) Soodan K S, Priyadarshni P. Scope and Application of Forensic Dentistry. The International Journal of Science and
Technology 2014;2(5):292-297.
[5]. 5) Luciana C, Isadora AdS and Rafael GL. Forensic Dentistry: An Overview of the Human Identification's Techniques of this
Dental Specialty. J Forensic Res 2014;5:256.