iosr-JDMS   Volume-18 ~ Issue-1 ~ January-2019

Abstract: Introduction: Tetanus is a preventable disease caused by Clostridium tetani. Tetanospasmin, an exotoxin is responsible for it's clinical manifestation. In developing countries like India it has great importance. Otogenic tetanus is mainly due to poor hygiene, lack of knowledge in health education and tetanus prophylaxis. Materials & Methods: During the year 2011 to 2017 total number of 523 tetanus cases were admitted at Infectious Disease & BG (ID&BG) Hospital, Kolkata and otogenic cases were studied from ward and case sheets. Results: Among total 523 cases otogenic tetanus cases were 61 (11.66%). Male Female ratio was 1:1. Duration of..........

Keywords: Otogenic tetanus, clinical presentation, complications

[1]. Greding DN, Jhonson S, Clostridium infections. In Goldman L, Schafer AI eds, Goldman- Cecil's Medicine, 24 th ed, Philadelphia, PA: Elsavier Saunders, 2011, chap 304
[2]. Reddy P, Bleck TP, Clostridium tetani(Tetanus). In Mandell GL, Bennet JE, Dolan R eds. Mandell Doglus and Benett's Principles and Practice of Infectious Diseases, 7th ed, Philadelphia, PA: Elsavier Saunders, 2009, chap 244
[3]. Cretanovic B et al, Bull WHO, Suppl 1, 1978, vol 56, 28—29
[4]. Ogunkeyede SA, Daniel A, Ogundoyin O, Pediatric Otogenic Tetanus : an evidence of poor immunization in Nigeria. The Pan African Medical Journal, 2017,26,177
[5]. Jack L, Mahoney MD, Otogenic tetanus in Zaire, Laryngoscope,1980, 90, 7,1196-99

Abstract: Background: Fine Needle Aspiration cytology (FNAC) is the first line technique in the diagnosis of lymph node swellings. It is quick, simple, inexpensive, minimally invasive. Fine Needle Non aspiration technique (FNNAC) have also been introduced.
Objectives: To compare FNAC and FNNAC techniques in lymph node swellings.
Methods: The study was conducted in tertiary centre for one year of duration. Cases of lymph nodes were sampled using both FNAC and FNNAC techniques. They were compared using Mair's point scoring system. Statistically analysis was done using student's t- test.
Results: Most of the cases of lymph node swellings, 78/208 (37.50%), were falling in the age group of 20-29 years with male to female ratio of 1:1.7. All lymph nodes...........

.

Key words: Cytology, aspiration, non-aspiration, lymph node, lymphoma.

[1]. Cohen MB, Miller TR, Bottles K. classics in cytology: note on fine needle aspiration of the lymphatic glands in sleeping sickness. ActaCytol 1986;30(4):451-2.
[2]. Briffod M, Gentile A, Hebert H. Cytopuncture in the follow-up of breast carcinoma. ActaCytol. 1982;26:195-200.
[3]. More SA, Bhalara RV, Shah PM, Talwelkar SR, Dhruva GA. FNACC of cervical lymph nodes. Asia Pacific Journal of Research Vol: I Issue XVIV. 2014 Nov.
[4]. Vats S, Manchanda B, Gupta K, Sharma P, Kansal R, Goel S, Sharma VK. Spectrum of Lymphadenopathies on Fine Needle Aspiration Cytology in and around Muzaffarnagar. Indian Journal of Public Health Research & Development. 2018 Jan 1;9(1).
[5]. Sreedevi P, K Kumar, Parankusa N C. Diagnostic Role of FNACC in Evaluation of Head and Neck LesionI IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) 2016;15(9)11-13..

Abstract: Selecting the best from various approaches used to expose the orbital skeleton to facilitate open re-duction and internal fixation or other orbital procedures , depends on good accessibility , better aesthetics and fewer complications . This study compares the subciliary, lower eyelid, infra orbital, trans conjunctival ap-proaches and evaluates various parameters like accessibility, peri orbital fat interference, wound dehiscence, scar visibility, scleral show, ectropion, entropion, paresthesia, hematoma, epiphora and restricted ocular mo-vements.. The result shows even though trans conjunctival approach gives good esthetics, lower eyelid approach gives better esthetic, less intra operative and post operative complications. Subciliary approach provides less exposure and post operative problems like ectropion, scarring whereas infra orbital approach provides good exposure with poor esthetics..

.

Key words: Orbital Floor, Infra orbital Approach, Sub ciliary approach, Lower eyelid approach ,Transconjunctival approach.

[1]. Eppley BL, Custer PL, Sadove AM, Cutaneous approaches to the orbital skeleton and periorbital structures, Journal of Oral and Maxillofacial Surgery, 48(8),1990, 42-54.
[2]. Baumann A, Ewers R, Use of the preseptaltransconjunctival approach in orbit reconstruction surgery, Journal of oral and maxil-lofacial surgery, 59(3),2001, 287-291.
[3]. Zachariades N, Mezitis M, Anagnostopoulos D, Changing trends in the treatment of zygomatico maxillary complex fractures: a 12-year evaluation of methods used, Journal of oral and maxillofacial surgery, 56(10),1998,1152-1156.
[4]. Ciarallo RL, Ziccardi VB, Ochs MW, Combined trans-conjunctival lateral canthotomy approach for infraorbital nerve exploration: report of a case, Journal of oral and maxillofacial surgery, 52(1),1994,79-81.
[5]. McCord Jr CD, The correction of lower lid malposition following lower lid blepharoplasty - (Plastic and reconstructive surgery. 1999) 103(3):1036-9..

Abstract: Myocardial infarction is a major cause of mortality and morbidity worldwide. STEMI [ST segment elevation myocardial infarction] is a medical emergency condition. Reperfusion therapy like PCI [Percutaneous Coronary Intervention] is the gold standard for an early management of STEMI, which is better replaced by thrombolytic therapy. Thrombolytics available to treat STEMI include streptokinase (SK), urokinase (u-PA), alteplase (rt-PA), reteplase (r-PA), tenecteplase (TNK-tPA), lanoteplase.[3] Successful reperfusion therapy mainly depends upon the choice of thrombolytic agent. The aim of the study was to compare the safety and efficacy of Streptokinase and Tenecteplase in patients with acute ST segment elevation myocardial infarction. Time taken for drug administration after onset of symptoms and to assess the safety and efficacy of thrombolytics. Prospective observational study conducted for 6 months among 70 patients in cardiac care unit in Rajiv Gandhi Institute of medical.......

[1]. Simeon Isezuo, Vijaya kumar Subban et al. Characteristics, treatment and one-year outcomes of patients with acute coronary syndrome in a tertiary hospital in India. Indian heart journal 2014;66:156-163.
[2]. Kumolosasi E, Wong sin wei. The use of thrombolytic agents in acute myocardial infarction (AMI) patients. International journal of pharmacy and pharmaceutical sciences 2013;5:63-7.
[3]. Boland A, Dundar Y et al. Early thrombolysis for the treatment of acute myocardial infarction a systematic review and economic evaluation. Health technology assessment 2003;7(15):4.

[4]. Gruppo Italiano et al. Effectiveness of intravenous thrombolytic treatment in acute myocardial infarction. Lancet.1986; 1:397-402.

[5]. doi:http://dx.di.org/10.1016/s0140-6736(86)92368-8..

Abstract: Background: Background: Penile cancer is more common in India as compared to Western populations. The age-adjusted incidence rate of penile cancer in India ranges from 0.8 to 1.8 per 100,000. Due to fear, ignorance, and embarrassment patients neglect the penile tumor for months before presenting to a physician. Many of our patients are of low socioeconomic status and never attend the follow-up after local therapy of the penile tumor. Quite a few of these present late with inoperable regional lymph node (LN) metastases, thereby missing the opportunity of a cure. Penile cancer has been associated with old age, bad hygiene, smoking and lack of circumcision...........

Key words: Penile Neoplasms; Circumcision, Male; Smoking;

[1]. Parkin DM, Whelan SL, Ferlay J, Teppo L, Thomas DB. In: Cancer Incidence in Five Continents Vol. 8. IARC (WHO) Scientific Publications; 2002.p. 631.
[2]. Curado MP, Edwards B, Shin HR, Storm H, Ferlay J, Heanue M, et al. Cancer Incidence in Five Continents. France: International Agency for Research on Cancer (IARC). World Health Organization; 2007p.
[3]. Jemal A, Siegel R, Ward E, Murray T, Xu J, Thun MJ. Cancer statistics, 2007.CA Cancer J Clin. 2007 Jan-Feb;57(1):43-66.
[4]. Parkin DM, Ferlay J, Curado MP, Bray F, Edwards B, Shin HR, et al. Fifty years of cancer incidence: CI5 I–IX. Int J Cancer. 2010 Dec 15;127(12):2918-27.
[5]. Velazquez EF, Cubilla AL. Penile squamous cell carcinoma: anatomic, pathologic and viral studies in Paraguay (1993-2007). Anal Quant CytolHistol.2007 Aug;29(4):185-98.

Abstract: Osteochondroma or exostosis is a benign tumor arising from the bone involving the long bones most commonly, pelvis, ribs and the scapula at rare instances. It can run in families called as multiple hereditary exostosis(MHE) which is different from solitary exostosis in terms of malignant transformation. MHE has a higher chance of malignant transformation. In our study 7 cases of solitary scapular exostosis were studied and followed up. The size of the tumor in relation to the forces acting on it were assessed. Pain was also a feature in this study without malignant transformation, but suspicion of malignancy needs needle biopsy and later complete excision as like any malignant tumour.

[1]. Campanacci M. Bone and soft tissue tumors. Bologna: Springer-Verlag Wien GmbH; 1990.
[2]. Schmale GA, Conrad EU, III, Raskind WH. The natural history of hereditary multiple exostoses. J Bone Joint Surg Am. 1994;76A:986e92. [PubMed]
[3]. Ryckx A, Somers JF, Allaert L. Hereditary multiple exostosis. Acta Orthop Belg. 2013;79(6):597–607.[PubMed]
[4]. Shapiro F, Simon S, Glimcher HJ. Hereditary multiple exostoses. Anthropometric, roentgenographic, and clinical aspects. J Bone Joint Surg Am. 1979;61A:815e24. [PubMed]
[5]. Wicklund CL, Pauli RM, Johnston D, Hecht JT. Natural history study of hereditary multiple exostoses. Am J Med Genet. 1995;55:43e6. [PubMed]

Abstract: Small central perforation ( Those central perforations which are less than 5 mm or 25% of pars tensa )associated with chronic suppurative otitis media of safe variety needs to be treated as early as possible to prevent recurrence and associated morbidity. Emphasis is given to surgically repair of these perforations at the earliest possible time . However managing small central perforation is a challenging task. A conventional Myringoplasty is at times too big a surgery for this small lesion and patching of small perforation is also associated with some limitation i.e. multiple sittings. In this prospective study we have compared 3 different techniques in the management of these perforations, The age range is 15-60 years. The.......

.

Key words: Small central perforation, myringopasty, fat plug myringoplasty, and paper patching

[1]. U. Chalishzar , Fat Plug Myringoplasty ,'' Indian Journal of Otolaryngology and Head Neck Surgery, Vol.57,No 1,2005 ,pp.43-44
[2]. J.C.Ringerberg "Closure of Tympanic Membrane Perforation by the Use of Fat,"Laryngoscope, Vol.88,No 6,1978,pp. 982-993 .
http://dx.doi.org/10.1288/00005537-197806000-00010
[3]. W.R. Wilde and A. Hewson, "Practical Observations on Aural Surgery and the Nature and Treatment of Diseases of the Ear," Blanchard $ Lea, Philadelphia, 1853, pp.292-293.
[4]. S. Jadia, et al., Office Procedure for the Management of Central Perforation: A Comparative Study." Indian Journal of Otology, Vl.16,2010,pp5-9.
[5]. E.L. Derlacki, "Office Closure of Central Tympanic Membrane Perforation: Quarter Century Experience," Transaction of the America Academy of Ophthalmology, Vol. 77, 1973, pp.53-56..

Abstract: Now a days vitamin A deficiency is prevailing more because of poor diet habits and other causes. Oral formulations of vitamin A are showing better results by increasing compliance than other type of formulations whereas in topical formulations application problems are common which intern shows less efficacy. This study was conducted for six months duration in the dermatology department. Patients were followed for 3 months with one month interval. At each follow up patients were assessed for prognosis of the disease through oral interview and physical.........

Keywords: Phrynoderma, Lichen Spinulosus, Keratosis Pilaris, Keratinization, Vitamin A.

[1]. Akram M et al., Vitamin A: A review article, J. of med pla res. Vol. 5(20), pg.no: 4977-4979 ,(2011).
[2]. Vitamin A | Linus Pauling Institute | Oregon State University, available from http://lpi.oregonstate.edu/mic/vitamins/vitamin-A accessed on28/5/16
[3]. McCollum, E.V.; Davis, M et al, The necessity of certain lipids during growth, J. Biol. Chem., vol-15, pg.no: 167–175, (1913).
[4]. Arlappa N et al, Vitamin A Deficiency is Still a Public Health Problem in India Ind. J.ofPedia, Volume 48 , page no:853-854, (2011).
[5]. Nishimura Y et al, A case of carotenodermia caused by a diet of the dried seaweed called Nori, J.Dermatol., Vol-25(10):pg.no :685-687,(1998)..

Abstract: Building on the unique study on Virtual Patients in Psychiatry by the author, a computer generated model of depression is sought to be generated. To this end a machine learning model for the depressed facies, body language and features of depression needs to be developed for which its opposite Mania as a 3D computer graphic generated model is studied as compared to a Schizophrenia model. These are evaluated by 90 medical students on 5 dimensions each. When statistics were applied to their observations it was found that in the case of Mania only Elated mood was the significant predictor of Mania where as in Schizophrenia Delusions, Passivity phenomena and living in one's own world were the predictors on regression analysis while Auditory Hallucinations also had significance in the correlation analysis. The inference has profound implications for machine learning as a paradigm versus human learning in depression which is discussed at length.

[1]. Radhakanth C., Virtual Patients in Psychiatry: A Study of Mania And Schizophrenia. IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 15, Issue 10 Ver. II (October. 2016), PP 43-49
[2]. Machine Learning., Wikipedia
[3]. Scott Patterson (13 July 2010). "Letting the Machines Decide". The Wall Street Journal.
[4]. Vinod Khosla (January 10, 2012). "Do We Need Doctors or Algorithms?". Tech Crunchmedical
[5]. When A Machine Learning Algorithm Studied Fine Art Paintings, It Saw Things Art Historians Had Never Noticed, The Physics at ArXiv bloginfluence of Art5.

Abstract: Background : Body mass index (BMI) is a good indicator for measurement of bone mineral density (BMD) which measures the density of minerals present in the bones. Dual energy X- ray absorptiometry (DEXA) is the most accurate way to measure BMD. Objectives : This study was performed to evaluate the relationship between BMI and BMD of lumbar spines in women. Material and Methods : This study was conducted on 41 healthy women between the age group of 20 and 45 years. The height (m) and weight (kg) of all the subjects were recorded and BMI was calculated. BMD of lumbar spine was measured using enCORE based X ray bone densitometer (Lunar Prodigy Advance, GE Medical Systems, USA) based on DEXA.......

Keywords: BMI, BMD, DEXA scan, Osteoporosis, Women

[1]. Consensus Development Conference. Diagnosis, prophylaxis, and treatment of osteoporosis. Am J Med. 1993;94(6):646-50.
[2]. Pande KC. Prevalence of low bone mass in healthy Indian population. J Ind Med Assoc. 2002;100(10):598-600.
[3]. Fawzy T, Muttappallymyalil J, Sreedharan J, Ahmed A, et al. Association between body mass index and bone mineral density in patients referred for dual energy X-ray absorptiometry scan in Ajman, UAE. J Osteoporos. 2011;1-4.
[4]. El- Tawab SS, Saba EK, Elweshahi HM, Ashry MH. Knowledge of osteoporosis among women in Alexandria (Egypt): a community based survey. Egypt Rheumatol. 2016;38:225-31.
[5]. Unnanuntana A, Gladnick BP, Donnelly E, Lane JM. The assessment of fracture risk. J Bone Joint Surg Am. 2010; 92(3):743- 53...

Abstract: Introduction: Assessment of quality of life in children with Cerebral Palsy needs to be measure by CP- specific questionnaire. Objectives: To assess quality of life in children with cerebralpalsy using CP specific questionnaire and tocorrelate the quality of life(QOL) with various demographic factors and clinical profile in these children. Material & Methods: This study was a prospective and observational study and was conducted in department of Pediatrics at R.N.T. Medical College Udaipur and in various institutes. 102 patients of Cerebral Palsy between age of 2 to 18 years both male and female child, were included in the study and free from any other significant chronic illness. Results: CP-QOL..........

Keywords: Parents, Cerebral Palsy and Quality of Life

[1]. Michael V. Johnston.Cerebral Palsy.Nelson-text book of paediatrics-19th edition.2061-2065.
[2]. Backs M, Goldstein M, Rosenbaum P, et al. Proposed definition and classification of cerebral palsy, April 2005. Dev Med Child Neurol. 2005;47(8):571–6. [PubMed]
[3]. Rosenbaum P, Paneth N et al. A report: the definition and classification of cerebral palsy, April 2006. Dev Med Child Neurol. 2007;49(Suppl.109):8–14. [PubMed]
[4]. Pharoah POD, Platt MJ, Cooke T. The changing epidemiology of cerebral palsy. Arch Dis Child Fetal Neonatal Ed 1996; 75:F169-73.
[5]. Swaiman K,Ashwalet al. Swaiman's pediatric neurology;principles and practice.5thedition. Amsterdam: Elsevier; 2012,999-1008.

Abstract: Cholecystocolic fistula is a rare but possible complication of cholelithiasis. Symptoms of cholecystocolic fistula are usually minimal and/or non-specific, and preoperative diagnostic tools often fail to show such a rare condition, hence diagnosis is often achieved intraoperatively. We report a case of 54-year male presented to us with complaints of right upper abdomen pain. Provisional diagnosis of cholelithiasis was made and intraoperatively a cholecystocolic fistula was found for which cholecystectomy and primary repair of colonic opening of the fistula was done. Post-operative stay of patient was uneventful and patient was discharged successfully.Cholecystocolic fistula is a rare entity which requires a high degree of suspicion to diagnose it preoperatively. Even if it is diagnosed intraoperatively, it can be managed appropriately with surgery..

Key words: Cholecystocolic fistula, cholelithiasis

[1]. AngrisaniL,CorcioneF,TartagliaA et al.Cholecystoenteric fistula (CF) is not a contraindication for laparoscopic surgery,
[2]. SurgEndosc.2001;15:1038-41.
[3]. Glenn F, Reed C, Grafe WR.Biliary enteric fistula.SurgGynecol Obstet.1981;153:527-31.
[4]. Arvanitidis D, Anagnostopoulos GK, Tsiakos S, Margantinis G, Kostopoulos P.Cholecystocolic fistula demonstrated by endoscopic retrograde cholangiopancreaticography. Postgrad Med J.2004;80:526..

Abstract: Peripheral nervous system (PNS) development plays a crucial role for normal motor performance of the child. Maturation of PNS starts before birth and continues till 5 to 6 years of age. Evolution of Peripheral motor nerves as detected by different Nerve Conduction Study (NCS) parameters are different for upper and lower limbs and also varies according to different motor nerves irrespective of extremity. Our aim was to evaluate howmuch the peripheral motor nerve NCS parameters differed from upper versus lower limbs and their pattern of maturation from birth to 6 years of age. For this a cross-sectional prospective study was undertaken on 63 normal infants and children in the department of Physiology of I.P.G.M. E & R in collaboration with pediatrics department of the same institute and Bangur Institute of Neurology, Kolkata. Compound Muscle Action Potential (CMAP) amplitude.........

.

Key words: PNS; NCS; CMAP; MNCV.

[1]. Shin J Oh, Clinical electromyography and nerve conduction studies Baltimore : University Park Press, 1984, P 107 –139.

[2]. Berciano J, Garica A, Calleja J, Antolin FM, : Peripheral motor and sensory conduction studies in normal infants and children, Clinical Neurophysiology., 2000; III: 513 – 520.

[3]. Michelle Farrar : Peripheral nerve maturation in humans: new insights, diagnostic and pathophysiological considerations ; abstract, 12th International Child Neurology Congress and 11th Asian and Ocenian Congress of Child Neurology, May – June, 2012.

[4]. Parano Enrico , Uncini Antonio, De Vivo DC,. Lovelace Robert E ,:Electrophysiologic correlates of peripheral nervous system maturation in infancy and childhood, J. Child Neurol, 1993; 8 : 336-338

[5]. Vecchieri-Blineau MF, Guiheneuc P. : Motor nerve conduction velocity in children : normal values and application toa few athologic cases, Rev. ElectroencephalogrNeurophysiolClin. 1984 Apr ; 13 (4) : 340-348..

Abstract: Background: Reproductive tract infection is a global problem including both sexually transmitted infections and non-sexually transmitted infection of reproductive tract.A variety of factors put women at risk of RTIs as well as consequences for women arising from such morbidity.The correct knowledge and awareness of the problem among the women is very important. Objectives: To assess the socio-demographic profile of mothers attending immunization clinic of Calcutta National Medical College, to find out their awareness about RTI/STI and practices for prevention of RTI/STI, to determine the relationship of different socio-demographic factors with the knowledge score, if any. Study settings: Immunization clinic of Calcutta National Medical College, Kolkata,India. Study design: Hospital basedobservational, descriptive........

Key Words: RTI/STI, Mean Knowledge Score.

[1]. Gayatri S, Desai, and Patel R.M. Incidence of Reproductive Tract Infections and Sexually Transmitted Diseases in India: Levels and Differentials Journal of Family Welfare; Vol. 57, No.2, December – 2011.
[2]. Suryakantha A.H. Community Medicine with Recent Advances; 4th Edition, Pg- 486.
[3]. Mangala M. Bote, .Shenoy, A.G. An Epidemiological study to find out the prevalence of RTI/STI and various factors associated with it among every married women of reproductive age group in an urban slum community in Mumbai.I.O.S.R Journal, Dental and Medical Science, Vol- 13, Issue-3, March 2014, PP-09015.
[4]. Meitel M.H, Shorik L and . Gopal K. Awareness and prevalence of reproductive tract infection in North-East of India ,Health and Populations – Perspective and Issues 28(3), 132-145, 2005
[5]. Kamini .B, Kiran Kumar. D, Epari R.K, Karri.V. A Study on Knowledge, Attitude, and Practice of Reproductive Tract Morbidity among Women in a Rural Area of Tamilnadu. National Journal of Research in Community Medicine.Vol.3. Issue 3. July –Sep.2014(196-204)..

Abstract: Hypothyroidism is associated with an increase in the levels of thyroid releasing hormone (TRH) which in turn stimulates secretion of thyroid stimulating hormone (TSH) and prolactin (PRL). PRL inhibits the synthesis and secretion of gonadotropins (FSH & LH). Abnormal menstrual patterns are commonly observed in overt hypothyroidism.1 Studies considering an association between overt hypothyroidism and female reproductive hormones are not adequate particularly in eastern India. Therefore, present study is aimed to evaluate the relationship between overt and subclinical hypothyroidism and female reproductive hormones. Subjects were randomly selected having high TSH level.They were categorized into subclinical and overt hypothyroid. Results were analysed........

.

Key words: FSH, hypothyroid, LH, oligomenorrhoea, PRL.

[1]. Krassas GE, Pontikides N, Kaltsas T, Papadopoulou P, Paunkovic J, Paunkovic N, et al. Disturbances of menstruation in hypothyroidism. ClinEndocrinol (Oxf) 1999;50:655–9. [PubMed

[2]. Armada-Dias L, Carvalhe JJ, Breltenbach MM, et al. Is the infertility in hypothyroidism mainly due to ovarian or pituitary functional changes? Braz J Med Biol Res. 2001;34:1209–1215. doi: 10.1590/S0100-879X2001000900015. [PubMed] [CrossRef]

[3]. Goldsmith RE, Sturgis SH, Lennan J, et al. The menstrual pattern in thyroid disease. J Clin Endocrinol Metab. 1952;12:846–855. doi: 10.1210/jcem-12-7-846. [PubMed] [CrossRef]

[4]. Seri O, Chik CL, Ur E, Ezzat S. Diagnosis and management of hyperprolactinemia. MAJ. 2003;169(16):575–81.

[5]. Katznelson L, Riskind PN, Saxe VC, Klibanski A. Prolactin pulsatile characteristics in postmenopausal women. J ClinEndocrinolMetab. 1998;83:761–64. [PubMed]..

Abstract: Parents knowledge, attitudes and socio demographic variables influence immunization seeking behaviour for their children. The Aim of this study is to evaluate the Parental concerns and attitudes towards immunization in relation to educational status, socio economic background and employment status. 125 Volunteering Parents and care giver respondents of children admitted in the Pediatric ward of Maharajah's Institute of Medical Sciences, Nellimarla were evaluated on a Checklist of 15 statements of attitude towards immunization. They were then analysed to assess the influence of education, employment, religion, sex, place of residence and socio economic status in shaping these attitudes. Analysis of the results showed that concerns and attitudes of the parents are significantly..........

[1]. Yousif MA, Albarraq AA, Abdallah MAA, Elbur Al. Parents' Knowledge and Attitudes on Childhood Immunization, Taif, Saudi Arabia.J.VaccinesVaccin; Dec 2013, vol 5(1):215.
[2]. Heba Adel Ramadan, Sahar Mohamed Soliman, Rabab Gad Abd El-kader. Knowledge, Attitude and Practice of Mothers toward Children's Obligatory Vaccination. IOSR Journal of Nursing and Health Science. Jul.-Aug. 2016; Vol 5, Issue 4, Ver 2, PP 22-28.
[3]. Kabir Bello &Abarshi Dauda Daniel. Knowledge and Attitude of Mothers towards Childhood Immunization in Bauchi Local Government, Bauchi State- Nigeria. InternationalJournal of Innovative Research in Social Sciences & Strategic Management Techniques. Sepe-2017; Vol 4 (2).
[4]. Alina Trojanowska, Danuta Zarzycka, Magdalena Brodowicz-Krol, Arkadiusz Jedrzejewski, Anna Wiktor. Children Immunization- knowledge and attitude of parents. Vol 15, No. 4(57), 2016.
[5]. Chris-Otubor, G.O., Dangiva, D.A., Ior, L.D, Anukam, N.C.Assesment of Knowledge, Attitudes and Practices of Mothers in Jos North Regarding Immunization.IOSR Journal Of Pharmacy, June 2015; Vol 5 (6). PP.34-45.

Abstract: Under supervision, there were 9 female patients with primary arterial hypertension aged 51.6±5.3 years. During the month of observation, all patients took a stable dose of the lisinopril: 7 patients – 10 mg per day (twice daily for 5 mg), 2 patients - 5 mg per day. In the beginning and in the dynamics of treatment (weekly), the sensitivity of the arterial baroreflex (BRS) was recorded. In patients with PAH, in comparison with physically healthy persons of the same age, there is a significant decrease in BRS in the low-frequency........

Keywords: hypertension, lisinopril, monotherapy, baroreflex sensitivity

[1]. Brown NJ, Vaughan DE. Angiotensin-converting enzyme inhibitors. Circulation. 1998; 97:1411-20.
[2]. Kozhanova IN, Romanova IS. [Lisinopril in clinical practice]. International Reviews: Clinical Practice and Health, 2016; 1: 44-57. [in Russian].
[3]. Cheng WH, Lu PJ, Ho WY, Tung CS, Cheng PW, Hsiao M, Tseng C. Angiotensin II inhibits neuronal nitric oxide synthase activation through the ERK1/2-RSK signaling pathway to modulate central control of blood pressure. Circ Res. 2010; 106(4):788-795.
[4]. Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic: The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial. JAMA. 2002; 288:2981-97
[5]. Cohen MA, Taylor JA. Short-term cardiovascular oscillations in man: measuring and modelling the physiologies. J Physiol. 2002; 542(3):669-683