iosr-JDMS   Volume-18 ~ Issue-9 ~ September-2019

Abstract: Pregnancy with leiomyoma is associated with number of complications like abortion, preterm labour, PROM, APH, malpresentation, increased operative deliveries and postpartum complications like PPH. Moreover, most of these complications adversely affect the perinatal outcome. The objective of the study is to know the obstetrical and perinatal outcome of pregnant mother having uterine leiomyoma. A prospective observational study was done among 51 pregnant women with USG proved uterine leiomyoma as case & 51 cases of pregnancy without leiomyoma as control, in the Department of G&O, CSS, Kolkata during the period 2017-2018. Control cases were matched with age, parity and gestational weeks. Obstetrical and perinatal outcome were compared between cases and controls..........

Key word: Leiomyoma, Prelabour rupture of membrane(PROM), Preterm labour, Malpresentation, Lower segment caesarean section(LSCS),Postpartum haemorrhage(PPH) , Low birth weight(LBW).

[1]. Rice JP, Kay HH, Mahony BS. The clinical signifance of uterine leiomyomas in pregnancy. Am J Obstet Gynecol. 1989; 160: 1212-16.
[2]. Exacoutos C, Rosati P. Ultrasound diagnosis of uterine leiomyomas and complications in pregnancy. Obstet Gynecol. 1993; 82: 97-107.
[3]. Katz VL, Dotters DJ, Droegemeuller W. Complications of uterine leiomyomas in pregnancy. Obstet Gynecol. 1989; 73: 593-96.
[4]. Burton CA, Crinces DA, March CN. Surgical management of leiomyomata during pregnancy. Obstet Gynecol. 1989:74:707-09.
[5]. Hasan F, Arumugan K, Sivanesaratnam. Uterine leiomyomata in pregnancy. Obstet Gynecol. 1991; 34: 45-8.

Abstract: Vitiligo is an acquired often progressive disorder of depigmentation characterised by circumscribed achromic macules often leading to a low self-esteem and social isolation.13 The prevalence ofvitiligo in pediatric age group has been quoted to be around 25% of vitiligo patients of all ages4,5,6,7. A Prospective observational study was designed to study clinical and epidemiological profile of vitiligo in pediatric age group in a tertiary care centre. Incidence of vitiligo in pediatric age group was found to be 34% of total vitiligo patients with female preponderance [58.9%]. Most patients presented after age of 8 years[54.9%], majority of patients [56.9%] had more than 1 year duration of disease. Presence of family history was 9.8% in first degree relatives , concomitant presence of other autoimmune diseases was 7.8%, and vitiligo vulgaris type of generalised vitiligo [51%]was most common clinical type.

Key words : vitiligo, vitiligo vulgaris

[1]. Dutta AK, Mandal SB. A clinical study of 650 vitiligo cases and their classification. Indian J Dermatol. 1969;14:103-11
[2]. Lacovelli P, Sinagra JL, Vidolin AP, Marenda S, Capitanio B, Leone G, et al. Relevance of thyroiditis and of other autoimmune diseases in children with vitiligo. Dermatology 2005;210:26-30.
[3]. Pajvani U, Ahmad N, Wiley A, Levy RM, Kundu R, Mancini AJ, et al. The relationship between family medical history and childhood vitiligo. J Am Acad Dermatol 2006;55:238-44.
[4]. Hu Z, Liu JB, Ma SS, Yang S, Zhang XJ. Profile of childhood vitiligo in China: An analysis of 541 patients. Pediatr Dermatol 2006;23:114-6.

Abstract: Background: Hyperlipidemias are recognized as one of the significant risk factors for the development of Coronary Artery Disease (CAD). Statins are themost potent lipid-lowering agents currently available that significantly lowerthe morbidity and mortality associated with CAD. Price disparity can lead tosignificant financial stress on the patients, especially when cost-related aspects are not paid heed to by the prescribing physician. This study wasconducted to compare the cost of ten most commonly prescribed preparationsof different brands of Atorvastatin forty milligrams, in Kurnool city. Methods: The present study was undertaken..........

Key words: Statins drugs, Atorvastatin forty milligrams, Pharmacoeconomics, Monthly cost, Yearly cost.

[1]. Siva S, Shalini Mary John; Drug Utilization Evaluation of HMG-COA Reductase Inhibitors in a Tertiary Care Teaching Hospital; Indian Journal of Pharmacy Practice.2017;10(4):251-259.
[2]. Rajanya VA. Cost comparisons of five leading brands of the Anti platelet drug, Clopidogrel, available in an Indian town. Int J Basic Clin Pharmacol 2019;8:1734-7
[3]. Koenig-Oberhuber V, Filipovic M. New antiplatelet drugs and new oral anticoagulants. BJA: Br J Anaesthesia. 2016;117(suppl_2):ii74-84.
[4]. Sakthivel Selvaraj. How effective is India's drug price control regime?. Harvard T. H. Chan School of Public Health. Available at: https:// www.hsph.harvard.edu/takemi/*les/2012/10/RP256.pdf. Accessed 5 May 2019.
[5]. Sahay A, Jaikumar S. Does pharmaceutical price regulation result in greater access to essential medicines? Study of the impact of drug price control order on sales volume of drugs in India. IIMA. 2014;34(4):64-5.

Abstract: Introduction: Hydrostatic reduction under ultrasound guidance is a well-recognized alternative method for reduction of childhood intussusceptions. The various forms of enema in use for ultrasound guided liquid enema in use include portable tap water, normal saline or Ringers lactate solution. we did hydrostatic reduction of childhood intussusception using saline under US guidance, Material &Methods: This prospective study was conducted in Government Generai Hospital, Srikakulam during December 2017 to April 2019. The children who presented with excessive cry and red current jelly stools and nausea were admitted and investigated.............

Keywords- Hydrostatic reduction, intussusceptions, children

[1]. Ogundoyin OO, Atalabi AM, Lawal TA, Olulana DI. Experience with sonogram – guided hydrostatic reduction of intussusception in children in south West Nigeria. J West Afr Coll Surg. 2013;3:76–88.
[2]. Khorana J, Singhavejsakul J, Ukarapol N, Laohapensang M, Wakhanrittee J, Patumanond J. Enema reduction of intussusception: the success rate of hydrostatic and pneumatic reduction. Ther Clin Risk Manag. 2015;11:1837–42.
[3]. Digant SM, Rucha S, Eke S. Ultrasound guided reduction of an ileocolic intussusception by a hydrostatic method by using normal saline enema in paediatric patients: a study of 30 cases. J Clin Diagn Research. 2012;6:1722–5.
[4]. Khong PL, Peh WCG, Lam HL, Chan KL, Cheng W, Lam WWM et al. Ultrasound -guided hydrostatic reduction of childhood intussusception: technique and demonstration. Radiographics 2000;20:e1. https://doi.org/10.1148/radiographics.20.5.g00see11
[5]. Kim YG, Choi BI, Yeon KM, Kim JW. Diagnosis and treatment of childhood intussusception using real time ultra-sonography and saline enema: preliminary report. J Korean Soc Med Ultrasound. 1982;1:66–70.

Abstract: INTRODUCTION: Diagnosis of pulmonary tuberculosis in sputum negative HIV infected patients. It is fact that 50% -60% patients of pulmonary tuberculosis are sputum negative microscopically.smear microscopy is easiest ,commonest and widely employed tool for confirmatory diagnosis of tuberculosis,but it has low sensitivity and specificity.sputum culture for mycobacterium tuberculosis bacteria can increase the diagnostic yield by 20-40%,but it take long duration of 2-8 weeks when solid media are used or 10-14 days when radiometric system in liquid media are used.Delayed diagnosis causes increased rate of disease transmission in the community.the role of newly introduced cartridge based nucleic acid amplification test (CBNAAT) in the community. The role of newly introduced cartridge based nucleic acid amplification test (CBNAAT) in the revised national control............

Keywords- CBNAAT , RNTCP, pulmonary tuberculosis, mycobacterium tubercu losis, HIV

[1]. Castro AT,Mendes M,Freitas S, Roxo PC.Diagnostic yield of sputum microbiological analysis in the diagnosis of pulmonary tuberculosis in a period of 10 years .Rev Port Pneumol 2015 ;21(4):185-91.
[2]. Hopewell PC,Pai M ,Maher D ,Uplekar M ,Raviglione MC .International standards for Tuberculosis Care .Lancet Infet Dis 2006;6(11):710-25;
[3]. Conde MB,Melo FA ,Marques AM ,Cardoso NC ,Pinheiro VG ,Dalcin Pde T ,et al .III Brazilian Thoracic Association Guidelines on tuberculosis .J Bras Pneumol 2009 ;35(10):1018-48;
[4]. Tostmann A,Kik S,Kalisvaart NA ,Sebek MM,Verver S,Boeree MJ ,et al .Tuberculosis transmission by patients with smear-negative pulmonary tuberculosis in a large cohort in the Netherlands .Clin Infect Dis 2008 ;47(9):1135-42.
[5]. WHO Policy statement :Automated real-time nucleic acid amplification technology for rapid and simultaneous detection of tuberculosis and rifampicin resistance :Xpert MTB/RIF system.Geneva :World Health Organization ;2011..

Abstract: Surgical site infections (SSIs) are defined as infections occurring up to 30 days after surgery (or up to one year after surgery in patients receiving implants) and affecting either the incision or deep tissue at the operation site(1).are the most common nosocomial infections(2)& in particular are the most popular perioperative complications(3). It lead to adverse patient outcomes, including prolonged hospitalization and death(4). Strategies to prevent these infections are crucial. Evidence based measures like hand hygiene, treatment of nasal carriage of S. Aureus, surveillance, prophylactic application of antibiotics or hair removal with electric clippers are listed in national and international guidelines(3,4). A nosocomial infection is determined by plenty of factors, such as a kind of flora and its virulence..........

[1]. Owens CD1, Stoessel K.Surgical site infections: epidemiology, microbiology and prevention. J Hosp Infect. 2008 Nov;70Suppl 2:3-10. doi: 10.1016/S0195-6701(08)60017-1.
[2]. Lemmen S, Lewalter K. Myths and facts in the operating theatre.AnasthesiolIntensivmedNotfallmedSchmerzther. 2013 Sep;48(9):518-23. doi: 10.1055/s-0033-1355230. Epub 2013 Sep 18.
[3]. Sumiyama Y1, Arima Y. Surgical site infection (SSI) and postoperative infection.Masui. 2010 Jan;59(1):36-45.
[4]. Anderson DJ1.Surgical site infections.Infect Dis Clin North Am. 2011 Mar;25(1):135-53. doi: 10.1016/j.idc.2010.11.004.
[5]. Anielski R1, Barczyński M. Postoperative wound infections. III. Patient related risk factors. PrzeglLek. 1998;55(11):565-71..

Abstract: Mandibular incisors are smallest teeth in the dentition. It is assumed that mandibular incisor is the most easy tooth to treat but sometimes these teeth are difficult to treat because of presence of extra canal which is present more lingually and often misdiagnosed and leads to treatment failure. Success of root canal treatment depends on careful diagnosis of additional canal and thorough debridement of root canal space and obtaining a fluid-tight seal. Thus, this article emphasis on careful management of mandibular incisors with the bifurcated canal (type III anatomy) in a single patient.

[1]. A. A. Al-Qudah & L. A. Awawdeh. Root canal morphology of mandibular incisors in a Jordanian population. International Endodontic Journal, 39, 873–877, 2006
[2]. Vertucci FJ (1974) Root canal anatomy of the mandibular anterior teeth. Journal of the American Dental Association 89, 369–71.
[3]. Mauger MJ, Schindler WG, Walker WA (1998) An evaluation of canal morphology at different levels of root resection in mandibular incisors. Journal of Endodontics 24, 607–9.
[4]. Uma CH, Ramachandran S, Indira R, Shankar P. Canal and isthmus morphology in mandibular incisors – An in vitro study. Endodontology 2004;16:7-11.
[5]. Bhat, et al.: Root canal morphology and presence of isthmus in mandibular central incisors. Endodontology / Volume 29 / Issue 2 / July-December 2017

Abstract: Cardiac arrest is a major public health issue and a cause of mortality worldwide. Higher rates of survival have been seen when cardiac arrests are witnessed.1,2 Survival can even be three times higher when cardiac arrests are attended by persons able to provide immediate resuscitation.2 However, only a minority of cardiac arrest victims receive potentially lifesaving bystander cardiopulmonary resuscitation (CPR), thus indicating the need for improvement in resuscitation education. Resuscitation science is very complex and has its own features depending on the country and culture wherein it is applied. Resuscitation education is primarily focused on ensuring widespread and uniform implementation of resuscitation science, during practice by healthcare CPR providers, to achieve the best possible performance of CPR skills...........

Keywords- Hydrostatic reduction, intussusceptions, children

[1]. Christina George et al. Basic Life Support Training among Interns and Post Graduate Entrants—Any Difference in Level of Education…….? IOSR Journal of Dental and Medical Sciences. Volume 16, Issue 12 Ver. VI (Dec. 2017), PP 08-10

[2]. De Ruijter PA, Biersteker HA. Retention of first aid and basic life support skills in undergraduate medical students— Med Educ Online. 2014 Nov 6;19:24841. doi: 10.3402/meo.v19.24841. eCollection 2014.

[3]. HALIL IBRAHIM DURAK, AGAH C¸ERTUG. Basic life support skills training in a first year medical curriculum: six years' experience with two cognitive–constructivist designs. Journal Name: Medical Teacher, Vol. 28, No. 2, 2006, pp. e49–e58. Pages e49-e58 | Published online: 03 Jul 2009 4. Basic life support training for first year medical students: Too much too soon?
[4]. Author: Anuj Chawla, MBBS, MD Armed Forces Medical College. Pune. India. 411040
[5]. Raluca Oana Tipa et al Importance of basic life support training for first and second year medical students–a personal statement. JournalofMedicineandLifeVol.3,No.4,October‐December2010,pp.465‐467.

Abstract: Thrombocytopenia is second to anaemia which is encountered during pregnancy. Causes for thrombocytopenia which are pregnancy specific are gestational thrombocytopenia, severe preeclampsia, HELLP syndrome, AFLP. In the present study we have assessed the causes of pregnancy specific thrombocytopenia and its maternal and neonatal outcome. Among all pregnant women attending OBG Outpatient department, those women with thrombocytopenia in complete blood examination were included in this study. Patients were evaluated further to find out the exact cause. The mean age of pregnant women with thrombocytopenia was 26±4.32 and...........

Keywords- Pregnancy, Thrombocytopenia

[1]. Richard F and Alexander H. Thrombocytopenia in pregnancy. 2006. www.emedicine.medscape.com/article. [ 15th jan 2011 ].
[2]. Saino S, Kekomaki R, Riikonon S, Teramo K. Maternal thrombocytopenia at term: a population-based study.Acta obstet Gynecol Scand. 2000 sep; 79(9);744-9.
[3]. Boehlen F, Hohlfeld P, Extermann P,Perneger TV, de Moerloose Platelet count at term pregnancy: a reappraisal of the threshold.Obstet Gynecol. 2000 Jan; 95(1);29-33.
[4]. Mc crae KR. Thrombocytopenia in pregnancy: differential diagnosis, pathogenesis, management. Blood rev. 2003;17(1):7-14.
[5]. Anita Rajasekhar, Terry Gernsheimer, Roberto Stasi, Andra H James. Clinical practice guide on thrombocytopenia in pregnancy. Quick Reference. American Society of Haematology. 2013..

Abstract: Neem tree (Azadirachtaindica) is a very common tree and belongs to the family Meliaceae. It is a tall evergreen tree with clear foliage originally native of India. Azadirachtaindicais one of the most widespread tree species in Nigeria.1Medicinal plants are rich source of novel drugs that form ingredients in traditional system of medicine, modern medicine, pharmaceuticals intermediate, bioactive principles and lead compounds in synthetic drugs.2.........

[1]. L.E. Wolinsky, S. Mania, S. Nachnaniand S. Ling. The inhibiting effect of aqueous azadirachtaindica (neem) extract upon bacterial properties influencing in vitro plaque formation. J Dent Res 1996;75(2): 816-22.
[2]. M. RaveendraPai ,Leelavathi .D. Acharyaand N. Udupa. Evaluation of antiplaque activity of AzadirachtaIndica leaf extrat gel- a 6week lineal study. J. Ethnopharmacol 2004; 90: 90-103.
[3]. S. Sri Kavi, S. Widowati, and S. Siti. The effect of different concentrations of Neem (Azadiracthaindica) leaves extract on the inhibition of Streptococcus mutans (In vitro). Med. Ked. Gigi (Dent .J);38(4):176-79.
[4]. S.Widowati, B. SitiSunarintyas, N. Marahiro and H. Taizo. The difference of antibacterial effect of neem leaves and stick extracts. Int Chin J Dent 2007;7: 27-29.
[5]. Prashant GM, Chandu GN, Murulikrishna KS andShafiulla M. The effect of mango and neem extract on four organisms causing dental caries: Streptococcus mutans, Streptococcus salivavius, Streptococcus mitis, and Streptococcus sanguis: An in vitro study..

Abstract: Thisis a prospective randomised study where 120 patients of either sex are scheduled for elective surgery under general anaesthesia were randomly allocated into three groups. Group A consist of patients who received priming with 0.1mg/kg atracurium and intubating at 90 seconds after giving intubating dose of 0.6mg/kg atracurium . Group B patients received placebo with saline and intubation at 90 seconds after single dose of atracurium. Group C patients received priming with 0.1mg/kg atracurium and intubation at 120 seconds after second dose of 0.6 mg/kg.In this study we assess the effect of priming on intubating conditions produced by atracurium at 90 and 120 seconds.Intubating conditions were assessed with parameters like jaw relaxation, response to intubation [coughing, straining or muscular movement] hemodynamic responses to intubation-rise in blood pressure and pulse.............

[1]. Robert. K. Stoelting. " Pharmacology and Physiology in Anesthetic Practice". Lippincott-Raven;1999.
[2]. Mohamed Naguib, Cynthia A. Lien. Pharmacology of Muscle Relaxants and Their Antagonists. In: Miller RD, Anaesthesia. Pennsylvania: Churchill Livingstone 2005,504.
[3]. Basta S J, Ali H H, Savarese J J et al. Clinical Pharamacology of Atracurium besylate. A new non-depolarizing muscle relaxant. AnesthAnalg 1982; 61: 723.
[4]. Payne J P, Hughes R. Evaluation of atracurium in anaesthetized man. Br J Anaesth 1982; 53:45.
[5]. Mehta M P, Choi W W,Gergis S D et al. Facilitation of rapid endotracheal intubation with divided doses of non-depolarizing neuromuscular blocking drugs. Anesthesiology1985; 62: 392-5..

Abstract: 20 year old female diagnosed with Tubercular meningitis (TBM) with hydrocephalous treated with VP Shunt Surgery; initially she showed improvement with Anti-tubercular Therapy (ATT) and shunting but later deteriorated for which Decompressive Craniotomy was performed. Multi-Drug Resistant (MDR) TB was suspected and second line ATT was started. She did not improve much and developed multiple brain abscesses for which multiple tapping was done and sent to pathology. Sensitivity was done and rifampin sensitivity was found. So, fixed regime was stopped and mixed drugs were given. This case highlight the difficulty in the diagnosis of TBM possibly due...........

Keywords- Central Nervous System (CNS), Tubercular Meningitis ( TBM), Hydrocephalous, Anti-Tubercular Therapy (ATT),Multiple Drug Resistant TB( MDR TB) , Cartridge based Nuclear Acid Amplification Test (CB NAAT)

[1]. Gautam VKS, Khurana S, Singh R. Multi drug resistant (MDR) tubercular meningitis with hydrocephalous treated with ventriculo- peritoneal shunting – a review. International journal of medicine, 3(1)(2015)22-25.
[2]. Murthy J. Multi drug resistant central nervous system tuberculosis. Neurol India 2012; 60:143-145.
[3]. WHO. Global tubercular report 2014, Geneva, Switzerland.
[4]. Tripathi KD, essentials of medical pharmacology, jaypee, 6th edition.
[5]. Murthy J, tubercular meningitis: the challenge. Neurol India 2010, 58:716-722..

Abstract: Objectives: Effect of cad-cam post-core and endocrown materials on fracture resistance of endodontically treated teeth.
Materials and Methods: A total of forty mandibular premolar teeth were divided into two main groups according to the restoration. Group I: Twenty mandibular premolar teeth restored with customized CAD-CAM Post-core. Group II: Twenty mandibular premolar teeth restored with customized Endocrown. Each group was fabricated from PolyetheretherKetone (PEEK) material. All groups were cemented with dual cure Rely X U200 self-adhesive resin cement. The specimens were thermocycled (7000cycle, at 55oC). Then mounted in the Universal Testing Machine. Each specimen was loaded to failure at a crosshead speed 1mm/min. Mode of failure was also examined. Data were analyzed using one way analysis of variance (ANOVA) and Tukey's post hoc significance difference tests.............

Keywords- Post-core, Endocrown, PEEK, CAD/CAM, Fracture resistance

[1]. Ozcan N, Sahin E. In vitro evaluation of the fracture strength of all-ceramic core materials on zirconium posts. Eur J Dent. 2013; 7: 455-460.

[2]. BankoğluGüngör M, KarakocaNemli S, Doğan A, Tamam E and TurhanBal B. Cad-Cam Fabricated One-Piece Ceramic Post and Core for Teeth Supporting Fixed Partial Dentures: Report of Two Cases. J Dent App. 2015; 2: 278-281.

[3]. Rocca G, Krejci I. Crown and post-free adhesive restorations for endodontically treated posterior teeth: from direct composite to endocrowns. Eur J Esthet Dent, 2013;8:156-179.

[4]. Schwitalla A. and Muller,W.-D. PEEK dental implants: a review of the literature, J Imp.2013; 6: 743–749.
[5]. El-Damanhoury HM, Haj RN, Ali JA Plat t. Fracture Resistance and Microleakage of Endocrowns Utilizing Three CAD-CAM Blocks J Oper Dent. 2015; 40:201-210..

Abstract: IIt is an essential oil, obtained from the leaf of Eucalyptus. It is commonly known as Nilgiri oil. Eucalyptus oil is used to control several diseases derived from microbial infections. It has anti-inflammatory and antibacterial activities and can be used as a vehicle for intracanal medicaments. Studies have reported that the antibacterial activity of eucalyptus oil only in pure concentration on Escherichia coli as well as on klebsiella, proteus and staphylococcus aureus.

[1]. Takahashi T, Kokubo R, Sakaino M (2004) Antimicrobial activities of eucalyptus leaf extracts and flavonoids from Eucalyptus maculata. Lett Appl Microbiol 39:60–64.

[2]. Salari MH, Amine G, Shirazi MH, Hafezi R, Mohammadypour M (2006) Antibacterial effects of Eucalyptus globulus leaf extract on pathogenic bacteria isolated from specimens of patients with respiratory tract disorders. Clin Microbiol Infect 12:194–196.

[3]. Wilkinson JM, Cavanagh HM (2005) Antibacterial activity of essential oils from Australian native plants. Phytother Res 19:643–646.
[4]. Bakkali, F.; Averbeck, S.; Averbeck, D.; Idaomar, M. Biological effects of essential oils— A review. Food Chem. Toxicol. 2008, 46, 446–475.
[5]. Delaquis, P.J.; Stanich, K.; Girard, B.; Mazza, G. Antimicrobial activity of individual and mixed fractions of dill, cilantro, coriander and eucalyptus essential oils. Int. J. Food Microbiol. 2002, 74, 101–109.

Abstract: Thyroid hormones are metabolized and eliminated through kidneys. The dysfunction of kidneys may therefore affect thyroid function and vice versa. Since no standard text mentions the changes in serum Creatinine levels in thyroid disorders, this study attempts to emphasizing the utility of periodic assessment of renal parameters in thyroid patients. Aims & objectives: The present study was planned to assess the influences of thyroid dysfunction on the levels of serum Creatinine.........

Keywords- Hyperthyroidism, Hypothyroidism, Serum Creatinine

[1]. Mukesh G Gohel, Aashka M Shah, Akash M. Shah, Jemil S Makadia. A Study of Serum Calcium, Magnesium and Phosphorous Level in Hypothyroidism Patients. Int J Med Health Sci. Oct 2014; 3(4):308-12.
[2]. Fauci AS, Kasper DL, Longo DL, Braunwald E, Hauser SL, Jameson JL et. al (editors). Harrison‟s principles of internal medicine. Chapter: Disorders of thyroid gland 17th ed. Mc Graw Hill 2008; 2224-47.
[3]. Larsen PR, Davies TF, Schlumberger MJ, Hay ID. Thyroid physiology and diagnostic evaluation of patients with thyroid disorders. In: Larsen PR, Kronenberg HM, Melmed S, Polonsky K, eds. Williams‟ Textbook of Endocrinology. 10th ed. Philadelphia: WB Saunders Company. 2003; 389–516.
[4]. Shomon M.J, Guide to Thyroid Disease. 2010 edition, Kensington, MD 20895-0565- 888-810-9471.
[5]. Mittal A, Sathian B, Kumar A, et. al., The Clinical implications of thyroid hormones and its association with lipid profile: A comparative study from western Nepal, Nepal Journal of Epidemiology2010; 1(1):11–16.

Abstract: Coronary artery disease is a relatively common and asymptomatic disease in Type 2 Diabetic patients. Hence the diagnosis of coronary artery disease is difficult in initial phase of disease. This gained special attention over recent years, since it has significant morbidity and mortality and coronary artery disease is one among the most common cause of death in Diabetic individuals with mortality rate of 60 to 70 %. The incidence of Type 2 Diabetes is increasing all over the world and becoming a pandemic. But India remains the biggest contributor to global community....

[1]. Wong ND, Nelson JC, Granston T, Bertoni AG, Blumenthal RS, Carr JJ, et al. Metabolic syndrome, diabetes, and incidence and progression of coronary calcium: The multiethnic study of atherosclerosis study. JACC Cardiovasc Imaging 2012; 5: 358 – 366.
[2]. Zbinden R, Wenger U, Meier P, Gloekler S, Windecker S, Meier B, et al. Silent ischemia normalized for coronary collateral function in patients with and without diabetes mellitus. Int J Cardiol 2011; 147:319 – 321.
[3]. Rajagopalan N, Miller TD, Hodge DO, Frye RL, Gibbons RJ. Identifying high-risk asymptomatic diabetic patients who are candidates for screening stress single-photon emission computed tomography imaging. J Am Coll Cardiol 2005; 45:43 – 49.
[4]. American Diabetes Association. Consensus development conference on the diagnosis of coronary heart disease in people with diabetes. Diabetes Care 1998; 21:1551 – 1559.
[5]. Scognamiglio R, Negut C, Ramondo A, Tiengo A, Avogaro A. Detection of coronary artery disease in asymptomatic patients with type 2 diabetes mellitus. J Am Coll Cardiol 2006; 47: 65 – 71..