iosr-JDMS   Volume-17 ~ Issue-5 ~ May-2018

Abstract: Background:Elastic, stable intramedullary nailing(ESIN) with titanium nails is a promising minimally invasive treatment for displaced mid clavicular fractures, whichmay be an alternative to plate fixation (ORIF) or even non operative treatment. We describe the surgical technique and outcome in 10 patients. Patients And Method: We treated 10 patients between 25 yrs to 50yrs who had displaced midclavicular fractures with titanium elastic nails and observed for a period of 14 months. Nail was inserted through a 1.5cm incision over the medial aspect of clavicle, 2cm away from the sternoclavicular joint. In all the patients we reduced the fracture with a 1.5cm-2cm over the fracture site. Results And Complications: Significant union was reported approximately at the end of 6weeks. There was no cases of non-union. Malunion was reported in two cases. Misplaced nail was observed in two of the cases and revision nailing was done in one of the cases. Skin irritation at the medial entry point was observed in three of the patients. All the patients were followed twice weekly until 3 months and implant exit was done in six of the patients.

Key Words: Clavicle nailing, ESIN,TENS clavicle.

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[2]. BOSTMAN O., MANNINEN M., PIHLAJAMAKI H. Complications of plate fixation in fresh, displaced midclavicular fractures. J Trauma,1997, 43 : 778-783. Elastic Intramedullary Nailing of Midclavicular Fractures 431
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[4]. CANADIAN ORTHOPAEDIC TRAUMA SOCIETY. Non-operative treatment compared with plate fixation of displaced midshaftclavicular fractures. A multi-centre, randomised clinical trial. J Bone Joint Surg Am, 2007, 89 (1) : 1-10.
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Abstract: : Splenic artery aneurysm (SAA) is an uncommon and difficult diagnosis. SAA is more common in females. Only 20% of SAA is symptomatic and may present as a rupture. A ruptured SAA is rare and is associated with a 25% mortality rate if untreated. Thus, Surgeons must be prepared to perform open procedures to reduce mortality rates.Endovascular management is currently considered the optimal treatment of SAAs with its contemporary techniques. However, careful monitoring and follow-up is needed after embolization as rapid recanalization of the SAA may possibly occur, Various endovascular approaches for the treatment of splenic artery aneurysms while maintaining the flow of the parent artery has become a reliable procedure with high success rate up to 98% preventing of spleen infarction and low peri procedural morbidity.

Keywords: Aneurysm, Splenic artery, Embolization, Endovascular, Coil.

[1]. Trastek VF, Pairolero PC, Joyce JW, Hollier LH, Bernatz PE. Splenic artery aneurysms. Surgery 1982; 91:694–699.
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[4]. Rokke O, Sondenaa K, Amundsen S, Bjerke-Larssen T, Jensen D. The diagnosis and management of splanchnic artery aneurysms. ScandJ Gastroenterol 1996; 31:737–743.
[5]. Manian U, Badri H, Coyne P, Nice C, Ashour H, Bhattacharya V. Endovascular treatment of a ruptured splenic artery aneurysm using amplatzer ((R)) vascular plug. Int J Biomed Sci: IJBS 2009;5(1):81–4.
[6]. Cordova AC, Sumpio BE. Visceral artery aneurysms and pseudoaneurysms should they all be managed by endovascular techniques? Ann Vasc Dis 2013;6(4):687–93.

Abstract: PRES isclinic-radiological entitycharecterisedby Headache, Visual disturbance, Altered sensorium, Seizures and White mattervasogenicedema. PRES is associated with acute renal failure, hypertension, eclampsia, vascular and autoimmune disease, immunosuppressivedrugs and organ transplantation.Magnesium sulfateis drug of choice in eclampsia.Magnesium sulfate is given byintramuscular or intravascular route for prevention of and treatment ofeclampsia.Magnesium toxicity can be detected by signs and symptoms like loss of deep tendon reflexes, decreased respiratory rate(less than 12), decreased urine output(less than 30ml/hr), chest pain ,heart block, pulmonary edema, and respiratory distress.24 year old 2nd gravida postpartum female referred from peripherywith history of convulsions 4 hours after normal vaginal full term delivery. On admissionpatient was unconscious...........

Key Words: Posterior Reversible Encephalopathy Syndrome, Posterior Revrsible Leucoencephalopathy Syndrome, Hypertension, Eclampsia, Acute Kidney Injury, Septicemia, Magnesium Toxicity

[1]. Hinchey j, Chaves c, Appignani B, Breen j, Pao L, Wang A, A Reversible encephalopathy syndrome. New engl j med 1996 Feb 22;334:494-500
[2]. D.C.Dutta's textbook of obstetrics page no: 207-227
[3]. Bartynsky WS, Boardman JF. Distinct imaging patterns and lesions distribution in posterior reversible encephalopathy syndrome
[4]. Harrison's book of internal medicine ;19thedition;posterior reversible encephalophathy syndrome; page no.1793,2568,2584
[5]. Pitchard JA, Management of preeclampsia and eclampsia.KIDNEYInt 1980;18:259-66
[6]. Harrison's manual of internal medicine;19the;magnesium for eclamptic seizures;46

Abstract: Objective: Inspite of being clinically important, literature is scanty about Tibiofemoral (TF) angle, in Indian population and most reports are on other populations. This angle is important for correction of varus or valgus deformities by osteotomies in clinical orthopedic surgery, so present study is an attempt to formulate a baseline data of Tibiofemoral angle among healthy Maharashtrian females with reasonable accuracy, so that later on it can be compared In different regions of India............

Keywords: Tibiofemoral angle, female Maharashtrian population, genu varus, osteotomies.

[1]. Igbigbi PS, Kwatampora. Lower limb angles of East African subjects. West African Journal of Anatomy 1997; 5: 9-15.
[2]. Nigel P, Derek F, Roger S. The hip joint. In: Anatomy and human movement- structure and function. Oxford: Butterworth-Heinemann 1998; 3rd edition: Pg (432-438).
[3]. Didia BC, Igbigbi PS, Dimkpa CD. The tibiofemoral angle in Nigerians. West African Journal of Anatomy 1999; 6: 29-30.
[4]. Engel GM, Staheli LT. The natural history of torsion and other factors influencing gait tibial torsion. Knee angle, hip rotation and development of arch in normal children. Clinical Orthopedics 1974; 99: 12-17.
[5]. Heath CH, Staheli LT. Normal limits of the knee angle in white children: genu varum and genu valgum. Journal of Pediatric Orthopedics 1993; 2: 259-262.

Abstract: Introduction: Caesarean section is one of the most commonly performed surgical procedures all over the world associated with high maternal and fetal morbidity and even mortality. Aims and objects: To determine the fetomaternal outcomes in pregnancy with previous two or more caesarean sections. Materials and methods: We performed an observational clinical study over 9 months on patients with previous two or more caesarean sections. Maternal complications and fetal outcomes were evaluated. Results: Total 102 (1.48%) had previous two or more caesarean sections out of which only 1 patient had previous three caesarean sections. 92.2% cases were booked at RIMS antenatal clinic with three or more antenatal visits and 7.8% cases were unbooked. 68.6% patients underwent elective caesarean section while 31.4% patients underwent emergency caesarean section..........

Keywords: multiple caesarean sections, maternal morbidity, fetal outcomes.

[1]. Cunningham FG, Lenovo KJ, Bloom SL, Spong CY, Dashe SJ, Hoffman BL, et al. Williams Obstetrics. 24th ed. New Delhi: McGraw Hill; 2014.
[2]. Ghosh S, James K. Levels and trends in caesarean births : Cause for concern? Economic & Political Weekly 2010;45(5):19-22.
[3]. Shellhaas CS, Gilbert S, Ladon MB, Varner MW, Lenovo KJ, Hauth JC, et al. The frequency and complication rates of hysterectomy accompanying caesarean delivery. Obstet Gynaecol 2009;114:224-9.
[4]. Makoha FW, Felimban HM, Fathuddien MA, Roomi F, Ghabra T. Multiple caesarean section morbidity. Int J Obstet Gynecol 2004;87;227-32.
[5]. Sobande A, Eskandar M. Multiple repeat caesarean sections: complications and outcomes. J Obstet Gynaecol Can 2006:28(3):193-197.

Abstract: Anthropometry is a precise method for evaluation of different measurements of dried bones and has been used as a technique to bring out regional and racial differences all over the world. Being an important anatomic unit, different morphological studies have been undertaken on the tibia. A cross-sectional study with 83 human tibia bones was carried out for one month to estimate different morphometric parameters of tibia in Bankura district of West Bengal and to compare between the parameters of right and left sided tibia. Data were collected by anthropometry using requisite instruments and predesigned proforma. Collected data were summarized to compute six parameters of tibia bone. Unpaired 't' test was used for analyses of data. The estimated values (mean±SD) of Cross- Section Index, Cnemicus Index, and Length- Thickness Index of right and left tibia were found to be 80.85± vs 76.17±, 80.43± vs 75.59± and 30.05± vs 29.71±, respectively. Cross- Section Index and Cnemicus Index were found to be significantly different across the side.

Key words: Anthropometry, tibia, cross- section index, length thickness index, Cnemicus index

[1]. Varalakshmi V S,Mehmood S,Gopichand PVV,Kumar D. Anthropometry: As A Tool in Learning Living Anatomy. Sch. J. App. Med. Sci., 2017; 5(5C):1938-1944. DOI: 10.21276/sjams
[2]. Bokariya P, Sontakke B, Waghmare JE, Tarnekar A, Tirpude BH, Shende MR. The anthropometric measurements of tibia. Journal of Indian Academy of Forensic Medicine. October 2012 .34(4); 322-3.
[3]. Pelin IC, Duyar I. Estimating stature from tibia length: a comparison of methods. J Forensic Sci 2003 Jul; 48(4):708-12.
[4]. Nazir F, Bhat GM, Khan SA. Morphometric study of tibia in north indian population and its clinical. International Journal of Current Research2017; 9(05):49947-9.
[5]. Moore K L, Dalley A F, Agur A M R. Lower limb. Clinically Oriented Anatomy. 6th ed., Lippincott Williams Wilkins. Baltimore.2010: 520-521

Abstract: Introduction: Distal both bone fractures are one of the most common injury of an elderly who falls with flexed elbow, landing on the wrist. There is a wide variety of treatment options such as closed reduction and POP cast, internal fixation, external fixation and percutaneous pin fixation in many configurations to treat both bone fracture of forearm however the comorbidity of the elderly precludes the methods of internal fixation in many situations. Hence we devised a novel percutaneous 4 pin configuration of K wires for management of distal both bone fractures of the elderly, where closed reduction is possible, and the ulna is re-constructible. This study reports the outcomes of this technique. Methods: All patients who are more than age of 50 and who presented with distal both bone fracture during the period of 3 years Jan 2015 toDec 2017 managed were included in the study. They are managed by closed reduction and 4-pin fixation and were evaluated for complications including wire loosening and infection, tendon or nerve injury, reflex sympathetic dystrophy and functional outcome.........

Keywords: Distal both bone fractures, Percutaneous K-wire fixation, 4-Pin fixation, Elderly

[1]. Keast-Butler O and Schemitsch EH. Biology versus mechanicsin the treatment of distal radial fractures. J OrthopTrauma 2008; 22: S91–S95.
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[3]. Koh S, Andersen CR, Buford WL Jr, et al. Anatomy of the distal brachioradialis and its potential relationship to distal radius fracture. J Hand Surg Am 2006; 31: 2–8.
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[5]. Frykman G. Fracture of the distal radius including sequelae – shoulder-hand syndrome, disturbance of the distal radio-ulnar joint and impairment of nerve function. A clinical and experimental study. ActaOrthopScand1967; 108(suppl): 1–153.

Abstract: Temperament is a very important aspect of functioning that needs to be understood in children with HIV. Temperament significantly influences the manner in which a child interacts with the environment over the long term. Temperamental traits may be an early sign of vulnerability to later development of psychological problems. The aim of this study was to analyze the temperamental traits associated with children with HIV. Three groups of thirty each of children with HIV staying with family, children with HIV staying at orphanage homes away from family attending outpatient services at paediatric..........

Keywords: Temperament, HIV children, psychological problems

[1]. National AIDS Control Organization Annual Report 2016-17, Ministry of Health & Family Welfare, Government of India. Available at: http://nacoonline.org.
[2]. Meyers, A., & Weitzman, M. (1991). Pediatric HIV disease: The newest chronic illness of childhood. Pediatric Clinics of North America, 38, 169-194.
[3]. J Williamson, Finding a way forward: Principles and strategies to reduce the impacts of AIDS on children and families, in C Levine & G Foster (eds), The orphan generation: The global legacy of the AIDS epidemic, Cambridge University Press, Cambridge, 2000.
[4]. R Forehand, R Steele, L Armistead, E Morse, P Simon & E Clarke, The Family Health Project: Psychosocial adjustment of children whose mothers are HIV-infected, Journal of Consulting and Clinical Psychology , 66, 1998, pp 513–520.
[5]. V Makame, C Ari & S Grantham-McGregor, Psychological wellbeing of orphaned children in Dar El Salaam, Tanzania, Acta Paediatrica , 91, 2002, pp 459–465.

Abstract: Necrotizing lesions of the periodontium are considered to be unique in their clinical presentation and course and are found to have a low frequency of occurrence. A triad of pain, ulceration and bleeding are reported among individuals presenting with the same. This case report presents a necrotising lesion of the gingiva of lower anteriors in a systematically healthy adult. Of the many procedures advocated to manage necrotizing ulcerative gingivitis (NUG), the use of hydrogen peroxide mouth rinse, antibiotics and oral prophylaxis has provided a direct solution.

Key Words: Antibiotics, Mechanical debridement, Necrotizing ulcerative gingivitis, Necrotising ulcerative periodontitis, Vincent's disease

[1]. Novak MJ. Necrotizing Ulcerative Periodontitis. Annals of Periodontology 1999;4:74-77.
[2]. Johnson BD, Engel D. Acute necrotizing ulcerative gingivitis. A review of diagnosis, etiology and treatment. J Periodontol 1986;57:141-150.
[3]. Goldhaber P. Present concepts concerning etiology and treatment of acute necrotizing ulcerative gingivitis. Int Dent J 1964;14:468-496.
[4]. Grupe HE, Wilder LS. Observations of Necrotizing Gingivitis in 870 Military Trainees. Journal of Periodontology 1956;27:255-261.
[5]. Moulton R, Ewen S, Thieman W. Emotional factors in periodontal disease. Oral Surgery, Oral Medicine, Oral Pathology;5:833-860.

Abstract: : The aim of the present study is to evaluate various causes, clinical features of small bowel perforations along with various surgical procedures and corresponding outcomes intheir surgical management.Patients and methods: This hospital based prospective study includesfifty patients diagnosed with small bowel perforation and admitted to surgical wards at Siddhartha Medical College and Govt. General Hospital, Vijayawada from January 2016 toMay 2017. Results: Pain abdomen was the most common presenting symptom in small bowel perforation followed by vomiting, abdominal distension, fever and constipation. X-ray erect abdomen, USG abdomen and CECT abdomen in selected cases are very useful investigations for diagnosis ofsmall bowel perforation.The most common cause of small bowel perforation was Ileal perforation. Typhoid illness was the most common cause of ileal perforation.Resection and anastomosis was the most common procedure employed. The most common complication in this series was surgical site infection. Mortality rate in our study was 12%.

Keywords: Small bowel Perforation; Surgical Management; Ileal perforation; Resection anastomosis.

[1]. Taylor BA. Gastro intestinal emergencies. Glimore Ian T, Robert Shields. Spontaneous perforation of the gut.1st edition. WB Saunder company: 1992:359-79
[2]. Sleisenger and Fordtran. Gastro intestinal and liver disease pathophysiology, diagnosis and management. Hamer Davidson H, Sherwood. L. Gorbach. Infectious diarrhea and bacterial food poisoning. 7th edition. WB Saunder company: 2002:1882-85,1889 1901.
[3]. William Schumer and Sheldono Burman. The perforated viscus, diagnosis and treatment in surgical emergencies. Nyhus Lloyd, The surgical clinics of North America 1972;52(1): 231-38.
[4]. R. Scott Jones. Courtney M. Townsend Jr. Trauma. Sabiston. Textbook of surgery. 17th ed, Vol.1, Pg. 819-820, Saunders. 2004.
[5]. Rao D C M, J C Mathur, D Ramu, M Anand. Gastrointestinal perforations –A study of 46 cases. Ind J Surg, Feb 1984; 94-96.

Abstract: Background: Subclinical hypothyroidism (SCH) defined as an elevated serum Thyroid Stimulating Hormone (TSH) level with a normal serum free thyroxine (fT4) concentration 1. SCH can progress to overt hypothyroidism. In this study we can see effect of metformin among SCH patients. Methodology: The study was conducted at Midnapore Medical College. This unicentric, hospital based single arm prospective interventional study included 96 new cases of SCH patients age 18-60 years with TSH level 5-10 mIU/L and normal fT3 & fT4. Metformin prescribed 2,000 mg daily into two divided doses for 12 weeks 2. Serum fT3, fT4 and TSH level were measured by ELISA. Statistical comparisons performed by "Paired t test". Results: 96 patients (15 male, 81 female) mean age was 36.18±11.57 years. Comparison...........

Key Words: Metformin, Subclinical hypothyroidism, Thyroid Stimulating Hormone.

[1]. Gregory A. Brent, P. Reed Larsen, and Terry F. Davies. Hypothyroidism & Thyroiditis. Williams Text book of Endocrinology, Eleventh Edition, 2007;12:378.
[2]. Garber AJ, Duncan TG, Goodman AM, Mills DJ, Rohlf JL. Efficacy of metformin in type II diabetes: results of a double-blind, placebo-controlled, dose-response trial. Am J Med. 1997;103(6):491-497.
[3]. Cooper DS. Clinical practice. Subclinical hypothyroidism. N Engl J Med. 2001;345(4):260-265.
[4]. Hollowell JG, Staehling NW, Flanders WD, Hannon WH, Gunter EW, Spencer CA, Braverman LE. Serum TSH, T(4), and thyroid antibodies in the United States population (1988 to 1994): National Health and Nutrition Examination Survey (NHANES III). J Clin Endocrinol Metab. 2002;87(2):489-499.
[5]. Nystrom E, Caidahl K, Fager G, Wikkelso C, Lundberg PA, Lindstedt G. A double-blind cross-over 12-month study of L-thyroxine treatment of women with "subclinical‟ hypothyroidism. Clin Endocrinol (Oxf). 1988;29(1):63-75.

Abstract: Background – Lipid Abnormalities Are Common In Hiv Infected Patients Due To Hiv Infection Itself And Antiretroviral Therapy, So We Tries To Study Pattern Of Lipid Profile In People Living With Hiv Infection And Changes In Different Fraction Of Lipid Profile In These Patients After Six Months Of Initiation Of First Line Art Regimen As Per Naco In A Tertiary Care Centre. Methods- This Observational Prospective Study Was Conducted For A Period Of Eighteen Months, On 75 Newly Registered Hiv-1 Infected Art Naive Patients Who Were Normotensive, Non-Diabetic, Non-Smoker, Non-Alcoholic. Out Of Which 48 Patients Were Males And 27 Patients Were Females Of Age Group ≥ 15 Years With Appropriate Inclusion And Exclusion Criteria, Attending............

Keywords: Art, Hdl Cholesterol, Ldl Cholesterol, Total Cholesterol, Triglyceride.

[1]. Grunfeld C,Kotler Dp, Hamadeh R, Tierney A,Wang J,Pierson Rn.Hypertriglyceridemia In The Acquired Immunodeficiency Syndrome. Am J Med. 1989;86:27-31.

[2]. Boccara F. Cardiovascular Complications And Artherosclerotic Manifetations In The Hiv-Infected Population. Clin Trials. 2005;6:5-24.

[3]. Mehta N, Reilly M. Artherosclerotic Cardiovascular Disease Risk In The Haart-Treated Hiv-1 Population. Clin Trials. 2005;6:5-24

[4]. Hoffmann C, Jaeger H. Cardiology And Aids-Haart And The Consequences. Ann N Y Acad Sci. 2001;946:130-44.

[5]. Leonard Eg, Mccomsey Ga. Metabollic Complications Of Antiretroviral Therapy In Childern. Pediatr Infect Dis J. 2003;22:77-84.

Abstract: INTRODUCTION:Laptops are widely used in healthcare for improved and effective care. Healthcare providers move back and forth, between computers and patients while delivering healthcare, as a part of the daily routine. Investigations have suggested that laptops may contribute to cross contamination and can serve as vehicles for infection transmission in clinical area. AIM:This study was conducted to evaluate the microbial contamination found on laptop keyboards in clinical settings of various departments of a dental school in Greater Noida. METHODOLOGY:The examination was carried out by self administered questionnaire regarding the disinfection practices by the consenting participants and the specimen were collected from laptops that were located in the clinical section of different departments..........

Keywords: Disinfection, Contamination, Laptops.

[1]. The Burden of Health Care-Associated Infection Worldwide. A Summary World Health Organization; 2010.
[2]. Srikanth.P Assessment of Aerobic Bacterial Contamination of Computer Keyboards in a Tropical Setting Journal of the association of physicians of India.2012;60:18-20
[3]. OguzKarabay, EsraKoçoglu, Mustafa Tahtaci. The role of mobile phones in the spread of bacteria associated with nosocomial infections. J Infect Developing Countries. 2007;1(1):72-73.
[4]. Maureen Schultz, Janet Gill, SabihaZubairi MT, Ruth Huber, Fred Gordin. Bacterial contamination of computer keyboards in a teaching hospital. Infection Control and Hospital Epidemiology. 2003;24(4):302-303.
[5]. Palmer SR, Bray SL. Longitudinal study of computer usage in flexible engineering education. Aust J Educ Technol. 2001; 17(3):313-329.

Abstract: Vocal Fold Medialisation By Injection Of Tissue Fillers Has Been Used To Close Small Phonatory Gaps In Cases Of Unilateral Vocal Fold Paralysis (UVFP). Some Of These Patients May Also Require Vocal Fold Medialization Using Open Thyroplasty Procedures. The Aim Of The Present Study Is To Determine Whether Temporary Vocal Fold Injection Affects The Need For Permanent Medialization Thyroplasty In Patients With Unilateral Vocal Fold Paralysis. The Study Involves A Retrospective Analysis Of 34 Consecutive Patients Meeting Inclusion Criterion Undergoing Vocal Fold Injection Medialisation Laryngoplasty For UVFP Using Two Different Tissue Fillers (I.E. Hyaluronic Acid And Agarose Gel). Rates Of Permanent Medialization Laryngoplasty In Patients Undergoing Vocal Fold Injection...........

Key words: Vocal Cord, Injection Medialization, Thyroplasty, Hyaluronic Acid, Agarose.

[1]. Cohen MS, Mehta DK, Maguire RC, Simons JP. Injection Medialization Laryngoplasty In Children. Arch Otolaryngol Head Neck Surg 2011 Mar;137(3):264-8.
[2]. Tan M, Bassiri-Tehrani M, Woo P. Allograft (Alloderm) And Autograft (Temporalis Fascia) Implantation For Glottis Insufficiency: A Novel Approach. J Voice 2011 Sep;25(5):619-25.
[3]. Umeno H, Chitose S, Sato K, Ueda Y, Nakashima T. Long-Term Postoperative Vocal Function After Thyroplasty Type I And Fat Injection Laryngoplasty. Ann Otol Rhinol Laryngol 2012 Mar;121(3):185-91.
[4]. Kanazawa T, Watanabe Y, Hara M, Shinnabe A, Kusaka G, Murayama T, Iino Y. Arytenoid Adduction Combined With Medialization Laryngoplasty Under General Anesthesia Using A Laryngeal Mask Airway. Am J Otolaryngol 2012 May;33(3):303-7.
[5]. Paniello RC, Edgar JD, Kallogjeri D, Piccirillo JF. Medialization Versus Reinnervation For Unilateral Vocal Fold Paralysis: A Multicenter Randomized Clinical Trial. Laryngoscope 2011 Oct;121(10):2172-9.

Abstract: Background: The mechanical removal of plaque and calculus has to be considered, together with oral hygiene instructions and motivation reinforcements, as A fundamental part of periodontal Supportive Treatment.
Aim:To document the intensity And duration of pain immediately after conventional procedure (Scaling And Curettage) followed by the same using Magnification Loupes.
Methodology:A comparative descriptive study was undertaken among 10 subjects who were chosen conveniently and were divided into 2 groups. First group received the conventional therapy (Scaling And Curettage) followed by the second group which received the Same (Scaling And Curettage)with magnification loupes. Visual Analogue Scale (Heft-Parker Scale) was used to assess pain before scaling and curettage after undergoing the procedure.........

Keywords: Distal both bone fractures, Percutaneous K-wire fixation, 4-Pin fixation, Elderly

[1]. Non-Surgical Periodontal Therapy- Revisited. Kotwal B, Mahajan N, Kalwani H, Dewan M. IOSR J Dent Med Sci. 2013;9:15-9. [2]. Braun A, Krause F, Hartschen V, Falk W, Jepsen S.Efficiency of the Vector system compared with conventional subgingival debridement in vitro and in vivo.J ClinPeriodontol. 2006 Aug;33(8):568-74.

[3]. Christgau M, Männer T, Beuer S, Hiller KA, Schmalz G. Periodontal healing after non-surgical therapy with a new ultrasonic device: a randomized controlled clinical trial. J ClinPeriodontol. 2007 Feb;34(2):137-47.

[4]. van As G. Magnification and the alternatives for microdentistry. CompendContinEduc Dent. 2001 Nov;22(11A):1008-12.

[5]. Mansueto MA, Overton JD. A clinician's guide to purchasing surgical loupes.Tex Dent J. 2007 Feb;124(2):174-86.

Abstract: Stevens Johnson Syndrome (Sjs) Is Characterized By Hemorrhagic Erosions, Erythema And Often Presents As Blisters And Detachment Of The Epidermis Because Of Necrosis. It Is A Type Iv Hypersensitivity Reaction Secondary To Medication Or Infection. Drugs Like Allopurinol, Carbamazepine, Aminopenicillins, Oxicam-Type Of Nsaids, Etc Are At High Risk Of Causing Stevens-Johnson Syndrome. Metolazone,Is A Long Acting Thiazide Like Diuretic. It Potentiates The Action Of Furesomide. Metalozone Induced Sjs Is Rarely Reported.. We Report A Rare Case Of Metolazone Induced Sjs In A 58 Year Old Male Patient.

Keywords: Stevens-Johnson Syndrome (Sjs), Mucocutaneous, Metolazone

[1]. Tomasini C, Derlino F, Quaglino P, Caproni M, Borroni G. From Erythema Multiforme To Toxic Epidermal Necrolysis. Same Spectrum Or Different Diseases? G Italdermatol. Venereol. 2014;149(2):243-61.
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[4]. Chang Ys, Huang Fc, Tseng Sh, Hsu Ck, Ho Cl, Sheu Hm: Erythema Multiforme, Stevens-Johnson Syndrome, And Toxic Epidermal Necrolysis: Acute Ocular Manifestations, Causes, And Management. Cornea 2007, 26:123-129.
[5]. Sotozono C, Ueta M, Koizumi N, Inatomi T, Shirakata Y, Ikezawa Z, Hashimoto K, Kinoshita S: Diagnosis And Treatment Of Stevens-Johnson Syndrome And Toxic Epidermal Necrolysis With Ocular Complications. Ophthalmology 2009, 116:685-690.