iosr-JDMS   Volume-17 ~ Issue-1 ~ January-2018

Abstract: Urinary tract infections(UTI) is the most common bacterial infection prevalent in both males and females and contribute to second most common nosocomial infection raising the hospital stay, morbidity and various complications related to it. Urethral catheters serve as a niche for proliferation and multiplication of bacteria's and biofilm produced by them provide resistance to antimicrobials and they spread elsewhere. This cross sectional study was conducted on 1008 adult patients admitted to general medicine ward in Kolkata.The age of patients varied from 14 to 102 years and study excluded those not willing to participate in the study.Our study revealed that in total 1008 patients the prevalence rate of UTI was 23.4 percent. In them type of UTI were maximum of LUTI type 78.4%, followed..........

Keywords: Bacteria, catheterization, Escherichia coli, urinary tract infection

[1]. Naeem Akhtar., 2000. Urinary tract bacterial pathogens; their antimicrobial Susceptibility patterns at Bahawalpur. The Professional, 7(2):131-137.
[2]. Nadia Gul, Talat Y. Mujahid And Samia Ahmad, Isolation,Identification And Antibiotic Resistance Profile Of Indigenous Bacterial Isolates From Urinary Tract Infection Patients; Pakistan Journal Of Biological Sciences 7(12); 2051-2054, 2004; ISSN 1028-8880.
[3]. CDC January 2015; Urinary Tract Infection (Catheter-Associated Urinary Tract Infection [CAUTI] and Non-Catheter-Associated Urinary Tract Infection [UTI]) and Other Urinary System Infection [USI]) Events.
[4]. Savitha, T., International Journal of Current Research Vol. 2, Issue, 1, pp. 067- 072, January, 2011
[5]. Higgins, C., 1995. Microbial examination of urine in urinary tract infection. Nurs – Times. 91(11); 32-35..

Abstract: Introduction: Needle stick injuries are most common occupational hazards health care workers are faced with. These injuries usually occur during activities such as transfusion, blood sampling, needle disposal, waste collection, transferring body fluids and transferring blood. Injuries due to contact with contaminated needles may have serious physical and psychological consequences. Objectives: To estimate the prevalence of Needle stick injuries among Health care workers and reporting of needle injuries among health worker. Materials & method: A cross sectional study was conducted among 120 health workers by pre tested structured questionnaire. Results: The prevalence of needle stick injury in the present study found to be 76.7%. Conclusion: High prevalence of needle sticks injury was observed in the present study.

Keywords: Needle stick injuries, Percutaneous exposures , Tripura, Agartala

[1]. Smith AJ, Cameron SO, Bagg J, Kennedy D. Management of Needlestick injuries in general dental practice. Br Dent J.2001;190:645 – 650.
[2]. 2.Gabriel J. Reducing needlestick and sharps injuries among healthcare workers. Nurs Stand. 2009;23(22):41-4. 3. Norsayani MY, Noor Hassim I. Study on incidence of needle stick injury and factors associated with this problem among medical students. J Occup Health. 2003;45(3):172-8.
[3]. 4. Fisman DN, Mittleman MA, Sorock GS, Harris AD. Willingness to pay to avoid sharpsrelated injuries: a study in injured health care workers. Am J Infect Control. 2002;30(5):283- 7.
[4]. 5. Lee JM, Botteman MF, Xanthakos N, Nicklasson L. Needlestick injuries in the United States. Epidemiologic, economic, and quality of life issues. AAOHN J. 2005;53(3):117-33.
[5]. 6. Patel D, Gawthrop M, Snashall D, Madan I. Out of hours management of occupational exposures to blood and body fluids in healthcare staff. Occup Environ Med. 2002;59(6):415- 8.

Abstract: Pregnancy though physiological and can be associated with major maternal morbidity with potential catastrophic consequences requiring utilization of facilities of Intensive Care Unit (ICU) Reports regarding such admissions are few from developing countries. Objective: To study the indication for admission, intervention and outcome of obstetric patients admitted to intensive care unit and also to identify risk factors for admission to intensive care unit at Government General Hospital, Kakinada, AP, India. Methods: A hospital based descriptive observational study was conducted in month of April and May 2017. All obstetric admissions to the ICU up to 42 days postpartum were included. Data obtained included demography, obstetric history, pre-existing medical problems..........

Keywords: Eclampsia, Intensive care unit, obstetrics, obstetric haemorrhage.

[1]. Karnad DR, Lapsia V, Krishnan A, et al. Prognostic factors in obstetric patients, admitted to an Indian intensive care unit. Crit Care Med 2004;32:1294-9.
[2]. Maine D, Chavkin W. Maternal mortality: global similarities and differences. J Am Med Womens Assoc 2002;57:127-30.
[3]. Nagaya K, Fetters MD, Ishikawa M, et al. Cause of maternal mortality in Japan. JAMA 2000;283:2661-7.
[4]. Hazelgrove JF, Price C, Pappachan VJ, et al: Multicenter study of obstetric admissions to 14 intensive care units in southern England. Crit Care Med 2001; 29:770-775.
[5]. Mirghani HM, Hamed M, Ezimokhal M, et al: Pregnancy-related admissions to the intensive care unit. Inj J Obstet Anesth 2004;13:82-85.

Abstract: Schizencephaly is a congenital condition characterized by cerebrospinal fluid-filled clefts that extend from the pia surface of the cerebral hemisphere to the ependymal surface of the ventricle. The margins of the cleft are lined with heterotropic, dysplastic gray matter. Magnetic resonance imaging is the modality of choice for its diagnosis. The condition is present at birth and present early in life. Here we present an adult patient with schizencephaly presenting with first onset seizure..

Keywords: schizencephaly, lateral ventricle, magnetic resonance imaging.

[1]. Bird CR, Gilles FH. Type 1 schizencephaly: CT and neuropathologic findings. Am J of Neuroradio 1987;Vol 8,(3):451-4
[2]. Barkovich AJ, Norman D. MR imaging of schizencephaly. AJR Am J Roentgenol 1988;150:1391-6.

[3]. Sarnat HB. Role of human fetalependyma. Pediatr Neurol. 1992;8:163–78

[4]. Kopyta I, Jamroz E, Marszal E, Kluczewska E. Schizencephaly--clinical and radiological presentation of pediatric patients. WiadLek. 2006;59:471–6.
[5]. Sarnat HB, Curatolo P. Malformations of the Nervous System. 1st ed. Edinburgh: Elsevier Publishers, Science Health Division; 2007. p. 235..

Abstract: A comparative study on nasal index was carried out on subjects from ham and adara tribes of kaduna state, nigeria. a total of two hundred and thirty-five (235) apparently healthy subjects within the age range of 15 - 65 years were employed for this study; ham (n=120) and adara (n=115) of kaduna state. subjects were indigenes of ham or adara whose great grandparents are also from ham or adara respectively. nasal breadth (nb) and nasal height (nh) were measured using the vernier caliper. nasal index (ni) were calculated using the formula (ni=nb/nh*100) proposed by williams et al. (1995). data was analyzed using sigmastat® statistical package. student's t-test was used to test for the............

Keywords: adara, ham, nasal indices, platyrrhine, hyperplatyrrhine

[1]. Akpa A.O.C., Ugwu C., Maliki A.O., Maliki S.O. (2003). Morphometric study of the nasal parameters in Nigerian Igbos. Journal of Experimental and Clinical Anatomy. 2(2):24-25.
[2]. Carleton D.C. (1989). The race of Europe. The European Anthropometry 5th edition, Macmillian publishers. pp. 9-93.
[3]. Costa J.R., Pirates J.C., De Castilho H.T and Santos R.A. (2005). Estudio Graneometrico de los hues os. Nasals proceso frontal de la maxilla. International journal of morphology, 23(1):9-12.
[4]. Hall R.L., Hall D.A. (1995). Geographic variation of native people along the Pacific Coast. Human Biology. 67(3): 407-426.
[5]. Last R..J. (1981). Anatomy Applied and Regional 6th Edition. Churchill Livingstone. pp. 398-403..

Abstract: Chlamydia trachomatis has currently emerged as one of the most common sexually transmitted pathogen. C. trachomatis infection in the genital tract is a common cause of urethritis, epididymitis, mucopurulent cervicitis, pelvic inflammatory disease (PID), ectopic pregnancy and tubal infertility etc. Keeping these facts in mind, this cross sectional study was performed to assess the prevalence of Chlamydia trachomatis infections in women of reproductive age group in the eastern part of India.This is an experimental study where female patients of the reproductive age group were selected for a clinical trial. 50 patients complaining of excessive vaginal discharge were selected as the test sample. 20 women of the same age group presenting with complaints other than excessive vaginal discharge were selected as the control population.This study was carried out at the department of Microbiology of Mata Gujri Memorial Medical College and Lions Seva Kendra Hospital, Kishanganj, Bihar. Patients were referred..........

Keywords: Chlamydia, LPS, Rapid test

[1]. Harrison's Principles of Internal Medicine Vol.I 17th Ed. Chapter 169 McGraw Hill.
[2]. Dewhurst's tTextbook of Obst. & Gynaec. 5th Ed. Blackwell Science.
[3]. Practical Medical Microbiology 14th Ed. Mackie & McCartney Churchill Livingstone.
[4]. Betha K, Robertson JM, Tang G, Haggerty CL. Prevalence of Chlamydia trachomatis among Childbearing Age Women in India: A Systematic Review. InfectiousDiseases in Obstetrics and Gynecology. 2016;2016:8561645.
[5]. Thappa DM, Kaimal S. Sexually transmitted infections in India: Current status (except human immunodeficiency virus/acquired immunodeficiency syndrome). Indian J Dermatol 2007;52:78-82.

Abstract: Bacterial vaginosis is the most common cause of abnormal vaginal discharge among women in the reproductive age group with complex changes in vaginal flora and is associated with low birth weight infant and preterm birth.This study was done with the aim of detecting different bacteria causing vaginosis in 18 – 49 years age group of women in Southern Odisha.A study on 120 women presenting with abnormal vaginal discharge attending the Gynaecology OPD was conducted from August 2016- July 2017. Two high vaginal swabs were taken. One was used for Gram stain, pH testing and Whiff test. Second swab was used for culture on blood agar and Columbia blood agar. Diagnosis was done using the Nugent scoring system. Total 120 patients were studied. Maximum no. of patients with vaginal discharge belonged to 18 to 28 years(56%). Vaginal pH more than............

Keywords : Bacterial Vaginosis, Gardrenellavaginalis.

[1]. SardaTiyyagura."Bacterial vaginosisin Indian women in Reproductive age group" 2012 International Journal of Biomedical Research, pp 371 -373
[2]. Shaw Gynaecology text book 16th edition pp384-385.
[3]. P Nugent, A Krohn and L. Hiller "Reliability of Diagnosing Bacterial Vaginosis is Improved by Standaized Method of Gram stain Interpretation" Journal of clinical microbiology vol 29, No2, 1991 pp 297 301
[4]. R. Amsel, A. Totten, D. Eschenbach and K. Hohnes "Non specific Vaginitis, Diagnostic Criteria microbial and Epidemiologic in Microbiology, 2013," American Journal of Medicine, vol 74, No1, 1983 PP 14 – 22
[5]. Bailely& Scott's Diagnostic Microbiology Thirteenth 13 Edition pp 940 - 941
[6]. J. Nzomo. " Bacterial Vaginosis and Correlates in Women of Reproductive Age in Thika, Kenya" Advances in Microbiology, 2013, 3, 249 – 254.

Abstract: The aim of our study was to determine the size of normal adrenal glands in Indian population. Measurements of the adrenal glands were obtained from computed tomographic (CT) images in 70 patients , who were undergoing CT for routine clinical indications. Patients with focal adrenal nodular lesions and mass lesion are excluded from this study. The following dimensions were measured: the maximum width of body of adrenal gland, and maximum width of the medial limb and lateral limbs of both adrenal glands. The mean thickness was measured by using computed tomography images and the mean values are as follows right medial limb measured 2.90 mm (SD:0.61), right lateral limb 3.10 mm (SD:0.69), right body thickness 5.39 mm (SD:1.28), left medial measured 3.34 mm (SD:0.9), left lateral limb measured 3.15 mm (SD:0.78) and left body thickness measured 6.1mm (SD:1.23).

Keywords: Multi detector Computed tomography, Medial limb, lateral limb and body of adrenal gland, Size of adrenal glands,.

[1]. Montagne, J-P, Kressel, HY, Korobkin, M et al, Computed tomography of the normal adrenal glands. American Journal of Roentgenology. 1978;130:963–966.
[2]. Karstaedt, N, Sagel, SS, Stanley, RJ et al, Computed tomography of the adrenal gland. Radiology. 1978;129:723–730.
[3]. Brownlie, K, Kreel, L. Computer assisted tomography of normal suprarenal glands. Journal of Computer Assisted Tomography. 1978;2:1–10.
[4]. Wilms, G, Baert, A, Marchal, G et al, Computed tomography of the normal adrenal glands: correlative study with autopsy specimens. Journal of Computer Assisted Tomography. 1979;3:467–469.
[5]. Herbut, PA. Adrenals. in: Herbut PA (Ed.) Urological pathology. Vol 2. Lea & Febiger, Philadelphia; 1952:695–755.

Abstract: AcceleDent vibratory device can increase the rate of tooth movement when used in conjunction with conventional Orthodontic force. during OTM their will lead to stimulate cell of periodontium to release many mediators like inflammatory mediators as cytokines in addition to proteins such as Osteocalcin into the oral fluid as (saliva & gingival crevicular fluid). Aim of this study is to evaluate the influences of orthodontic tooth movement on the salivary level of OC during the early stage of OTM by using Acceledent vibration device in addition to fixed orthodontic appliance. Methods: Thirty adult Iraqi patients with age range (18-23) years olddiagnosed as CL I dental malocclusion.The subjects were equally and randomly allocated to two treatment groups. The first 15 subjects continued with the standard treatment (control group), while the second group received Acceledent.............

Keywords: Acceledent, Orthodontic tooth movement, Osteocalcin

[1]. Jan G, Wim T, Marc Q, Sofie St. Longitudinal changes in gingival crevicular fluid after placement of fixed orthodontic appliances. Am J Orthod Dentofacial Orthop. 2011; 139: 735-44.
[2]. Krishnan V, Davidovitch Z. "Cellular, molecular, and tissue-level reactions to orthodontic force," Am J Orthod Dentofacial Orthop, 2006; 129(4):469.
[3]. Kavadia-Tsatala S, Kaklamanos EG, Tsalikis L. Effects of orthodontic treatment on gingival crevicular fluid flow rate and composition: clinical implications and applications. Int J Adult Orthod Orthognath Surg 2002;17:191-205.
[4]. Hofbauer LC, Lacey DL, Dunstan CR, Spelsberg TC, Riggs BL, Khosla S. Interleukin-1 beta and tumor necrosis factor-alpha, but not interleukin-6, stimulate osteoprotegerin ligand gene expression in human osteoblastic cells. Bone 1999;25:255-9.
[5]. Stylianou E, Saklatvala J. Interleukin-1. Int J Biochem Cell Biol 1998;30:1075-9.

Abstract: objective: Perianal fistula is an important condition that causes substantial morbidity. It occurs in 10 of 100,000 persons and has a tendency to recur despite seemingly adequate surgery. This study was undertaken to assess the role of MRI in the detection and classification of Perianal Fistula and correlation of preoperative MRI findings with the findings on surgery. Materials And Methods: This prospective study contained 40, MRI were performed and the results were ensured by surgical results, sensitivity, specificity and predictive values of MRIs were determined.RESULTS: 36 patients with perianal sepsis were included in this study, eight cases grade 1 (simple linear intersphincteric fistula), five cases grade 2 (intersphincteric fistula with abscess or secondary track), nine cases grade 3 (trans-sphincteric fistula), twelve cases grade 4 (trans-sphincteric fistula and two cases grade 5 (supralevator and translevator disease one case for each).......

Keywords: intersphincteric, Magnetic Resonance Imaging, Perianal fistula,supralevator, translevator

[1]. Bailey H, Love M. The anus and anal canal. In: Williams NS, Bulstrode CJ, O'connell PR, editors. Bailey and Love's Short practice of surgery. 25th ed. London: Edward Arnold(publishers) Ltd;2008.p.1262.
[2]. Bartram C, Buchanan G. Imaging anal fistula. RadiolClin N Am 2003;41:443-57.
[3]. Practice parameters for treatment of fistulain-ano: supporting documentation. The Standards Practice Task Force. The American Society of Colon and Rectal Surgeons. Dis Colon Rectum 1996;39:1363-72.
[4]. Parks AG. Pathogenesis and treatment of fistula-in-ano. Br Med J 1961;5224:463-69.
[5]. Hutan M, Hutan M Jr, Satko M, Dimov A. Significance of MRI in the treatment of perianal fistula. BrastislLekListy2009;110:162-5.

Abstract: Background: To deliver the head while doing lower segment caesarean section, the current conventional practice is to insert fingers through the uterine wound between the head and the lower uterine segment till fingers reach below the head, and then the head is levered out.This procedure,sometimes results inirregular extension of angles of the wound,which may involvethe uterine vessels,resulting in heavy bleeding. Irregular tearing of the uterine wound also leads fordifficult suturing.To avoid this, we tried a specially developed instrument called cephalic extractor to deliver the head with success. Methods: This instrument looks similar to that of a single blade of outlet forceps.Eighteen women with cephalic presentation, and two women with breech presentation, who...........

Keywords: S.R Cephalic extractor, Lower segment caesarean section.

[1]. Thomas G Weiser,a Alex B Haynes,b George Molina, et.al, Size and distribution of the global volume of surgery in 2012, Bull World Health Organ 2016;94:201–209F | doi: http://dx.doi.org/10.2471/BLT.15.159293
[2]. Kotdawala P.J., Pandya M.J; Difficulty in the Delivery of a Baby During LSCS.(eds) 'Principles of Critical Care in Obstetrics' Springer, New Delhi (2016)

[3]. Janine E. Spain, Methodius Tuuli, Molly J. Stout, Kimberly A. Roehl, Time from Uterine Incision to Delivery and Hypoxic Neonatal Outcome : Amer J Perinatol 2015; 32(05): 497-502 [4]. 4.John W Larsen Jr MD, Melissa Brunner MD, Sarah Gloria Obican MD; Barton's forceps: An effective aid in cesarean deliveries; Contemporary Obstetrics-Gynecology & Women's Health; September 01, 201

Abstract: ACL is the commonest knee ligament to be injured especially in athletes1. In contrast to other ligaments, ACL rarely heals into its anatomic or physiologic position and its deficiency results in suboptimal knee kinematics ; making it highly susceptible to further injury, chronic instability, and long-term degenerative changes2–5. This occurs both at the time of index injury and also secondarily over time in the ACL-deficient knee4,6. This Cross sectional study of arthroscopic ACL reconstruction done in 106 patients aged 15-50 yrs at government medical college Trivandrum, presents the spectrum of meniscal & chondral lesions in ACL deficient knees. The spectrum of chondral injuries varied from4.7% in trochlea to 17.9% in medial femoral condyle , with lateral femoral condyle 5.7%,medial tibial condyle 9.4%, patella 14.2% & lateral tibial condyle 17%. In meniscal injuries, 61.3%had associated lateral meniscal tears as compared to 55.7 % of medial meniscal tears. Complex tears were the commonest in medial & lateral menisci..

Keywords: ACL injury, Arthroscopic reconstruction, Meniscal lesions, Chondral lesions

[1]. Anterior Cruciate Ligament: Mechanism of Injury. Available at: https:// healthpro fessions. missouri.edu/vhct/case3505/ mech_injury.htm. (Accessed: 9th June 2017)
[2]. Lohmander, L. S., Englund, P. M., Dahl, L. L. & Roos, E. M. The long-term consequence of anterior cruciate ligament and meniscus injuries: osteoarthritis. Am. J. Sports Med. 35, 1756–1769 (2007).
[3]. Neuman, P. et al. Prevalence of tibiofemoral osteoarthritis 15 years after nonoperative treatment of anterior cruciate ligament injury: a prospective cohort study. Am. J. Sports Med. 36, 1717–1725 (2008).
[4]. Jones, H. P., Appleyard, R. C., Mahajan, S. & Murrell, G. A. C. Meniscal and chondral loss in the anterior cruciate ligament injured knee. Sports Med. Auckl. NZ 33, 1075–1089 (2003).
[5]. The Relationship between Anterior Cruciate Ligament Injury and Osteoarthritis of the Knee, Hindawi Publishing Corporation,Advances in OrthopedicsVolume 2015, Article ID 928301, 11 pages

Abstract: Impacted maxillary canines are common in orthodontic practice. Untreated impacted maxillary canines interfere with the alignment of adjacent teeth and can cause irreversible damage of external root resorption of adjacent teeth especially incisors. The purpose of the study was to investigate the location of root resorption associated with ectopic eruption of maxillary canines. CBCT scans were taken using NewTom GiANO cone beam computed tomography machine (CBCT). Location of the root resorption was taken in relation to the long axis of the involved tooth. In this study, a total of 53 impacted canines were investigated and it was found that 18 incisors were resorbed, which included 16 lateral incisors and 2 central incisors. Root resorption on permanent lateral incisors..........

Keywords: Impacted maxillary canine, root resorption, central incisor, lateral incisor

[1]. Thilander B, Myrberg N, The prevalence of malocclusion in Swedish school children. Scandinavian Journal of Dental Research, 81, 1973, 12–20
[2]. Mevlut C, Hasan K, Husamettin O, Investigation of transmigrated and impacted maxillary and mandibular canine teeth in an orthodontic patient population, Journal of Oral Maxillofacial Surgery, 68, 2010, 1001–1006
[3]. Preda L, La Fianza A, Di Maggio EM, Dore R, Schifino MR, Campani R, et al, The use of spiral computed tomography in the localization of impacted maxillary canines, Dentomaxillofac Radiol, 26, 1997, 236-41.
[4]. Rui H, Liang K, Kaijin H, Investigation of impacted permanent teeth except the third molar in Chinese patients through an x-ray study, Journal of Oral Maxillofacial Surgery, 68, 2010, 762–767
[5]. Ericson S, Kurol PJ, Resorption of incisors after ectopic eruption of maxillary canines: a CT study, Angle Orthod, 70, 2000, 415-23.
[6]. Walker L, Enciso R, Mah J. Three-dimensional localization of maxillary canines with cone-beam computed tomography, Am J Orthod Dentofacial Orthop, 128, 2005, 418-23.

Abstract: The optimal outcome for root canal treatment consists of controlled reducing of inflammation, accompanied by healing through regeneration, although sometimes repair may follow instead. The evaluation process is further complicated by the lack of direct correlation between measures of the disease process and its clinical manifestation. Objectives This research aimed to assess the opinion of Arab Dentists regarding the predictable initial root canal treatment, expected long-term outcome and the importance of placing a coronal coverage after finishing root canal treatment. Materials and Methods: An eleven questions questionnaire was sent to the Arab dentists through Emails, Facebook accounts, and phone messages...........

Keyword : Initial root canal treatment, opinion, root canal treatment success, root canal treatment outcome, survey, tooth retention

[1]. Bader Jd, Shugars Da: Variation, Treatment Outcomes, And Practice Guidelines In Dental Practice, J Dent Edu.1995 ,59:61.
[2]. Bender Ib, Seltzer S, Soltanof W: Endodontic Success: A Reappraisal Of Criteria, 1, Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1966,22:780.
[3]. Bender Ib, Seltzer S, Soltanof W: Endodontic Success: A Reappraisal Of Criteria. 2, Oral Surg Oral Med Oral Pathol Oral Radiol Endod.1966, 22:790.
[4]. Lumley Pj, Lucarotti Ps, Burke Fj: Ten-Year Outcome Of Root Fillings In The General Dental Services In England And Wales, Int Endod J.2008, 41:577.
[5]. Lazarski Mp, Walker Wa 3rd, Flores Cm, Et Al: Epidemiological Evaluation Of The Outcomes Of Nonsurgical Root Canal Treatment In A Large Cohort Of Insured Dental Patients, J Endod.2001, 27:791.

Abstract: Vit D deficiency most commonly occurs in infancy due to combination of poor intake, inadequate cutaneous synthesis1. Decreased maternal vitamin D also contribute both by leading reduced vitamin D content in breast milk and by lessening trans placental delivery of vitamin D. Vitamin D deficiency causes an increase of serum PTH leading to bone resorption , osteoporosis and fractures. A negative relationship exists between serum 25(OH)D and serum PTH5.High PTH in turn causes hypercalcemia and significant hyperphosphaturia2. Hypercalcemia usually defined as serum calcium concentration greater than 11mg/dl and ionized calcium greater than 5mg/dl(1.4mmol/l) and associated with several clinical entities2. It may due to iatrogenic (calcium salt),parathyroid hyperfuntion, Williams syndrome, idiopathic infantile hypercalcemia, hypervitaminosis D, phosphate depletion and bartter's syndrome...........

[1]. Robert M. Kliegman,MD, Joseph W. MD. Nelson Textbook of PEDIATRICS,19th Edition,2011.p204.
[2]. H.William, R.A.Ballard, Christine A. Gleason. Avery's Disease of The Newborn, 8th ed 2005. P.1356-1357.
[3]. Avery G, MacDonald M, Mullett M, Seshia M. Avery's Neonatology Pathophysiology and Management of the Newborn,6th ed.2005.p.865-869.

[4]. Srivastava RN, Bagga A. Pediatric Nephrology 5th ed. 2011 . p.462. 5. Lips P1 Vitamin D physiology ( Prog Biophys Mol Biol. 2006 Sep;92(1):4-8. Epub 2006 Feb 28.
[5]. Inzucchi SE.Understanding Hypercalcemia:Its metabolic basis,signs and symtoms.Postgrand Med 2004;115:6970,73-6

Abstract: A ranula is a type of mucocele, and therefore could be classified as a disorder of the salivary glands. Usually a ranula is confined to the floor of the mouth (termed a "simple ranula"). An unusual variant is the cervical ranula (also called a plunging or diving ranula), where the swelling is in the neck rather than the floor of the mouth. Plunging ranulas are associated with oral swelling in 34% of cases. Another 21% of the cases occur without any oral involvement. A variety of surgical procedures have been quoted in the literature ranging from marsupialization, excision of the ranula, sclerotherapy, and excision of the sublingual gland. The recurrence rate varies according to the procedure performed. We report a case of giant plunging ranula involving the floor of mouth treated successfully by surgical excision.

Keywords: Plunging Ranula; Salivary Gland; Cervical Swelling

[1]. Peters E, Kola H, Doyle-Chan W. Bilateral congenital oral mucous extravasation cysts. Pediatr Dent 1999;21:286– 9. [2]. Gulati HK, Deshmukh SD, Anand M, Yadav P, Pande DP. Rare case of giant plunging ranula without intraoral component presenting as a subcutaneous swelling in the neck: A diagnostic dilemma. J Cutan Aesthet Surg 2012;5(3):219-21. [3]. Gupta A and Karjodkar FR. Plunging ranula: A case report. ISRN Dentistry 2011; 1-5.
Arunachalam P, Priyadharshini N. Recurrent plunging ranula. J Indian Association of Pediatric Surgeon 2004;15: 36-38.
[4]. Zhao YF, Jia Y, Chen XM, Zhang WF. Clinical review of 580 ranulas, Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontology 2004; 98 (3): 281–7.
[5]. Balakrishnan A, Ford GR, Bailey CM. Plunging ranula following bilateral submandibular duct transposition, Journal of Laryngology and Otology 1991;105 (8), 667–9.