iosr-JDMS   Volume-10 ~ Issue-4

Abstract: Background and Objectives: We evaluated the effect of adding dexamethasone to ropivacaine for supraclavicular brachial plexus blockade. The primary endpoints were the onset and total duration of sensory and motor block, quality of analgesia and duration of analgesia.

Keywords: Dexamethasone, Ropivacaine, Supraclavicular Brachial Plexus Block

[1]. Reiz S., Häggmark S., Johansson G., Nath S.,V Cardiotoxicity of ropivacaine – a new amide local anaesthetic agent, Acta anaesthesiol. scand., 33, 93-98, 1989.
[2]. Pitkänen M., Feldman H. S., Arthur G. R., Covino B. G., Chronotropic and inotropic effects of ropivacaine, bupivacaine and lidocaine in the spontaneously beating and electrically paced isolated, perfused rabbit heart, Reg. Anesth., 17, 183-192, 1992.
[3]. Sztark F., Malgat M., Dabadie P., Mazat J. P., Comparison of the effects of bupivacaine and ropivacaine on heart cell mitochondrial bioenergetics, Anesthesiology, 88, 1340-1349, 1998.
[4]. Scott D. B., Lee A., Fagan D., Bowler G. M. R., Bloomfield P., Lundh R., Acute toxicity of ropivacaine compared with that of bupivacaine, Anesth. Analg., 69, 563-569, 1989.
[5]. Knudsen K., Beckman-Suurkula M., Blomberg S., Sjovall J., Edvardsson N., Central nervous and cardiovascular effects of i.v. infusions of ropivacaine, bupivacaine and placebo in volunteers, British Journal of Anaesthesia, 78, 507-514, 1997.
[6]. Wakhlo R, Gupta V, Raina A, Gupta SD, Lahori VU. Supraclavicular Plexus Block: Effect of Adding Tramadol or Butorphanol as an Adjuncts to Local Anaesthetic on Motor and Sensory Block and Duration of Post-operative Analgesia. J Anaesth Clin Pharmacol 2009; 25(1): 17-20.
[7]. Gabriella I, Adnane M, Desire-Pascal D, et.al. The effects of clonidine added to mepivacaine for paronychia surgery under axillary brachial plexus block. Anesth Analg 2005; 100(4):1179-1183.
[8]. Lalla RL, Anant S, Nanda HS. Verapamil as an Adjunct to Local Anaesthetic for Brachial Plexus Blocks. MJAFI 2010; 66: 22-24.
[9]. Castillo J, Curley J, Hotz J, et al. Glucocorticoids prolong rat sciatic nerve blockade in vivo from bupivacaine microspheres. Anesthesiology 1996; 85:1157-66.
[10]. Droger C, Benziger D, Gao F, Berde CB. Prolonged intercostals nerve blockade in sheep using controlled-release of bupivacaine and dexamethasone from polymer microspheres. Anesthesiology 1998; 89: 969-74.

Abstract: Background and Objective: Burns injury is a major cause of anxiety and depression, contributing both as a risk factor and as an outcome process. This poses a great challenge in rehabilitation of burns patients. The main objective of this research is to understand better the frequency of anxiety and depression in burns victims and also assess the socio-demographic distribution of such cases.

KeyWords; Anxiety, Depression, Burns, Beck's Inventory.

[1]. P. K. Dalal, Rahul Saha, Manu Agarwal Psychiatric aspects of burns.Indian J Plast Surg. 2010 September; 43(Suppl): S136–S142.
[2]. Moore MJ, Moore PB, Shaw PJ (October 1998). "Mood disturbances in motor neuronedisease". Journal of the neurological sciences. 160 Suppl 1: S53–6.
[3]. Beck AT, Steer RA, Ball R, Ranieri W (December 1996). "Comparison of Beck Depression Inventories -IA and -II in psychiatric outpatients". Journal of Personality Assessment67 (3): 588–97.
[4]. Lal P, Rahi M, Jain T, Ingle GK. Epidemiological stud [5]. Tejerina C, Reig A, Codina J, Safont J, Baena P, Mirabet V. Anepidemiological study of burn patients hospitalized in Valencia,Spain during 1989. Burns 1992;18(1):15–8.
[6]. Attia AF, Sherif AA, Mandil AM, Massoud MN, Abou-Nazel MW, Arafa MA. Epidemiological and sociocultural study of burn patients in Alexandria, Egypt. Eastern Mediterranean Health Journal 1997;3(3):452–61.
[7]. Thomas BD, Bresnick GM, Magyar-Russell G, Lawrence JW, McCann UD, Fauerbach JA. Depression in survivors of burn injury: A systematic review. Gen Hosp Psychiatry2006;28:494–502.
[8]. Thombs BD, Hanies JM, Bresnick MG, Magyar-Russell G,Fauerbach JA, Spence RJ. Depression in burn reconstructionpatients: symptoms prevalence and association with body imagedissatisfaction and physical function. Gen Hosp Psychiatry2007;29(1):14–20.
[9]. Loncar Z, Bras M, Mickovic V. The relationships between burn pain, anxiety and depression. CollAntropol 2006;2:319–25.
[10]. Byers JF, Bridges S, Kijek J, La Borde P. Burn patients' pain andanxiety experiences. J Burn Care Rehabil 2001;22(2):144–9.

Abstract: Objectives :The aim of this in-vitro study was to compare the accuracy of dies generated from metal and plastic dual arch trays impressions using two different viscosities of polyvinyl siloxane impression material and comparing the results to that obtained using a conventional full arch custom impression technique. Materials and method: Seven set of impressions were made of an experiment model using different combinations of, dual arch trays and viscosities of impression materials and the dimensions of the dies thus obtained were compared with those obtained from conventional full arch custom arch tray and medium viscosity impression material. Results: The gypsum dies prepared, from the complete arch custom tray technique and the dual arch impression technique using plastic and metal dual arch trays were generally larger in bucco-lingual dimension and shorter in mesio-distal dimension. Conclusions: All the seven types of impression techniques produced clinically successful impressions of standard brass die and dies so developed were within clinical standards to produced clinically successful restorations.

Key Words: Closed mouth impression Dual arch tray, Impressions, Triple tray.

[1]. E.G.Wilson , S.R Werrin. Double arch impressions for simplified dentistry. JPD 1983(49)198-202
[2]. Davis R D ,Schwartz R S. Dual- arch and custom –tray impression accuracy.JADA 1991(4)89-92
[3]. Bass E V, Kafalias M C Dual arch impressions Aust Dent J 1992(37)1-5
[4]. Davis R D , Schwartz R S. Marginal adaptation of castings made with dual-arch and custom trays. Am J Dent 1992(5)253-4
[5]. G.J.Kaplowitz. Troubleshooting dual arch impressions. JADA 1996(127):234-40
[6]. Kaplowitz. Trouble shooting dual arch impressions –II. JADA 1997 (128) : 1277- 81.
[7]. COX J R. A clinical study comparing the marginal and occlusal accuracy of crowns fabricated from dual arch and complete arch impressions. Aus Dent.J 2005(50):90-4.
[8]. Jeffrey AC, Glen HJ, Lepe.X. The effect of tray selection, viscosity of impression material, and sequence of pour on the accuracy of dies made from the dual arch impressions. JPD 2003(90): 143-9.
[9]. M.H.Parker, S.M.Cameron, J.C.Hughbanks. comparison of occlusal contacts in maximum intercuspation for two impression techniques. JPD 1997(78):255-9
[10]. S.R.Werrin. The 2- minute impression technique. Quintessence International. 1996(270:179-81.

Abstract: Identification of sex of an unknown individual from the skeletal remains is the first and the most important step encountered by the forensic experts and archiologists. The hip bone is considered as an ideal bone for sex determination as it provides the highest accuracy levels. Many workers have studied various metric parameters for sexing of hip bone. The present study was done with an aim to find out the sex of hip bone using various parameters of greater sciatic notch. For this purpose, 100 dry hip bones were collected from the Department of Anatomy, VIMS, Bellary. Seven different parameters of the greater sciatic notch were used for the study: Maximum width, Maximum depth, Posterior segment, Index I, Index II, Total angle and Posterior angle. All the parameters (especially posterior segment, posterior angle and index II) were found to be highly indicative of sex hip bone by t- test (p<0.005) except the depth. Key Words: Hip bone, Greater sciatic notch, Posterior segment, Posterior angle and Index II.

[1] G.I. Trancho, B. Robledo, L.I. Bueis and I.A. Sanchez, Sexual determination of femur using discriminant functions: Analysis of a Spanish population of known sex and age. J. Forensic Sci., 42(2), 1997, 181-185.

[2] J.L. Scheur and N.M. Elkington, Sex determination from metacarpals and first proximal phalanx, J Forensic Sci., 38(4), 1993, 769-78.

[3] A. Leong, Sexual dimorphism of the pelvic architecture; a struggling response to destructive and parsimonious forces by natural and mate selection, McGill J Med., 9(1), 2006, 61-66. [4] B.M. Willium, Recent developments in the identification of human skeletal material, Am J PhysAntrop.,30, 1979, 459-62.
[5] S. Shah, A. Zalawadia, S. Ruparelia, S. Patel, S.P. Rathod and S.V. Patel, Morphometric study of greater sciatic notch of dry human hip bone in Gujarat region, NJIRM, April; 2(2), 2011, 27-30.

[6] T.W. Phenice, A newly developed visual method of sexing the os pubis, Am. J. of Phys. Anthropology, 30, 297-301.

[7] G. Singh, S. Singh and S.P. Singh, Identification of sex from tibia. J. Anat Soc India, 24, 1975, 20-24.

[8] T.A. Black, A new method for assessing the sex of fragmentary skeletal remains: Femoral shaft circumferences. Am J Phys Anthrop.,48, 1978, 27-31.

[9] I. Ari, Morphometry of GSN on remains of male Byzantine skeletons from Nicea, Eur J Anat. 9(3), 2005, 161-5.

[10] Takahashi, Curvature of GSN in sexing of human pelvis, Anthropological science, 114(3), 2006, 187-91.

Abstract: Background: Obesity and overweight have reached epidemic levels in developed countries and the prevalence is rising in developing nations. This study seeks to determine the prevalence of obesity in a tertiary institution in Nigeria and its association with socio-demographic factors. Method: In a cross-sectional survey, by a cluster sampling method, 471 subjects were selected between the ages of 16 – 68years. A structured questionnaire was used to collect socio-demographic data. The body weight (kg) and height (m) of subjects were measured and the body mass index (BMI) calculated. Results: The prevalence of obesity was 9.1% and that of overweight was 26.2%. Obesity was significantly associated with female gender (χ2 = 27.884, p < 0.001) ; age < 40years (χ2 = 25.915, p < 0.001) ; being married (χ2 = 46.819, p < 0.001) and low socioeconomic status (χ2 = 18.314, p = 0.005). Obesity was not significantly associated with educational status (χ2 = 5.404, p = 0.145). Conclusion: The determinants of obesity in this tertiary institution are female sex, young age, marriage and low socio-economic status.

Key words: Obesity, overweight, prevalence, socio-demographic, tertiary institution.

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Abstract: Aim: To determine the impact of age, gender and smoking on the clinicopathological characteristics of histologically confirmed bladder cancer in the tribal population of Eastern India. Materials and Methods: From January 2008 to December 2012, records of patients with bladder cancer were evaluated for age and gender at presentation, clinical symptoms, cystoscopic finding, history of smoking, and histopathological characteristics. A total of 264 patients were identified from the hospital information system and the case files of patients. Results:. The incidence of 4.85 % among the total cancer patients is slightly higher than the national average . The median age was 57 years old and the male to female ratio was 6.2:1. Most common presenting symptom was painless hematuria (91%). Transitional cell carcinoma (TCC) was the most common histological variety (96.59%). A total of 38.25% of the patients had muscle invasive disease at the time of presentation. Low grade tumors were higher in females and non- smokers being statistically significant. Conclusion: TCC is the predominant cancer, with significant male preponderance among tribal populations in Eastern Indians. Younger-aged, females and non smoker patients have low-grade disease. Hematuria is the most common presentation and greater awareness is needed not to overlook bladder cancer.

Keywords: Bladder cancer. transitional cell carcinoma,smoking

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Abstract: OSMF is a chronic, progressive precancerous condition of oral mucosa, predominantly seen in the Indian subcontinent. A progressive inability to open the mouth fully, is an important feature in oral sub mucous fibrous due to the formation of fibrous bands especially in the buccal mucosa. In extreme cases, surgical excision of the fibrotic bands is the only treatment modality, but relapse is the major problem. This article describes the use of oral screen prosthesis used as an adjunct to surgery to prevent relapse.

Key Words: Oral sub mucous fibrosis, Nasolabial Flap, Oral Screen.

[1] Shafer WG. A textbook of oral pathology.4th ed. Philadelphia: WB Saunders Co; 1983. p. 86-229.
[2] Huang IY, Wu CF, Shen YS, Yang CF, ShiehTY, Hsu HJ, et al. Importance of patient's cooperation in surgical treatment for oral sub mucous fibrosis. J Oral MaxillofacSurg2008; 66:699-703.
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[5] Borle RM, Borle SR. Management of oral sub mucous fibrosis: a conservative approach. J Oral MaxillofacSurg 1991; 49:788-791.
[6] Khanna JN, Andrade NN. Oral sub mucous fibrosis: a new concept in surgical management. Report of 100 cases. Int J Oral MaxillofacSurg 1995; 24:433-9.
[7] Yeh CJ. Application of the buccal fat pad to the surgical treatment of the oral sub mucous fibrosis. Int J oral MaxillofacSurg 1996; 25:130-3.
[8] Pravinkumar G. Patil, Rambhau D. Parkhedkar. New graft-stabilizing clip as a treatment adjunct for oral sub mucous fibrosis. J Prosthet Dent. 2009; 102:191-192.
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[10] Cunha-Gomes D, Kavarana NM, Choudhari C, Rajendraprasad JS, Bhathena HM, Desai PB, et al. Total oral reconstruction for cancers associated with advanced oral sub mucous fibrosis. Ann PlastSurg2003; 51:283-9.

Abstract: We report a case of Reactive Arthritis with Neuropsychiatric Syndrome in an adult associated with Group A beta haemolytic streptococcal infection 1. "PANS" (Paediatric Acute Onset Neuropsychiatric Syndrome) is an immune mediated neuropsychiatric syndrome secondary to Group A beta haemolytic streptococcal infection which includes usually abrupt onset of obsessive-compulsive disorder, often pre-pubertal in onset, separation anxiety & abnormal movements during attack 2. PANS is very common in children especially pre-pubertal age group. However the existence of neuropsychiatric syndrome as a post-streptococcal manifestation in adults is rare & long debated. There has been only one case report in the literature of post-streptococcal neuropsychiatric syndromes in adults 3,19. We discuss the aspects of immune mediated post-streptococcal neuropsychiatric syndrome in adult.

Keywords: OCD (Obsessive Compulsive Disorder), PANS (Paediatric Acute Onset Neuropsychiatric Syndrome), PANDA (Paediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections), PITANDS (Paediatric Infection-Triggered Autoimmune Neuropsychiatric Disorders), SC (Sydenham's chorea)

[1] Susan E. Swedo, James F. Leckman and Noel R. Rose, From Research Subgroup to Clinical Syndrome: Modifying the PANDAS Criteria to Describe PANS (Pediatric Acute-onset Neuropsychiatric Syndrome), Pediatr Therapeut 2012, vol 2 issue 2, page 1-8.

[2] Susan E. Swedo, M.D., Henrietta L. Leonard, M.D., Marjorie Garvey, M.D.,Barbara Mittleman, M.D., Albert J. Allen, M.D., Ph.D., Susan Perlmutter, M.D.,Lorraine Lougee, L.C.S.W., Sara Dow, B.A., Jason Zamkoff, B.A., and Billinda K. Dubbert, M.S.N Pediatric Autoimmune Neuropsychiatric Disorders Associated With Streptococcal Infections: Clinical Description of the First 50 Cases, Am J Psychiatry 155:2, February 1998, 264-71.
[3] Sara M Bodner, Syed A Morshed, Bradley S Peterson, The question of PANDAS in adults, Biological Psychiatry 1 May 2001 volume 49, Issue 9, page 807-810

[4] PANDAS Network.org. PANDAS/ANS Statistics 2012. Accessed at pandasnetwork.org/wp content/uploads/2012/08/Statistics.pdf.

[5] Hanna Rhee, Daniel J Cameron, Lyme disease and paediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS): an overview, International Journal of General Medicine, 21 February 2012, page 163-174.

[6] Church AJ, Dale RC, Antistreptolysin-O titers: implications for adult PANDAS. Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections, Am J Psychiatry. 2002 Feb; 159(2):320.

[7] Swedo SE, Sydenham's chorea. A model for childhood autoimmune neuropsychiatric disorders, JAMA, 1994 Dec 14; 272(22):1788-1791

[8] Kingston D, Glynn LE, Anti-streptococcal antibodies reacting with brain tissue. I. Immunofluourescent studies, Br J Exp Pathol. 1976 Feb; 57(1):114-28

[9] Pavone P, Bianchini R, Parano E, Incorpora G, Rizzo R, Mazzone L, Trifiletti RR, Anti-brain antibodies in PANDAS versus uncomplicated streptococcal infection, Pediatr Neurol, 2004 Feb;30(2):107-10.

[10] Musser JM, Hauser AR, Kim MH, Schlievert PM, Nelson K, Selander RK. Streptococcus pyogenes causing toxic-shock-like syndrome and other invasive diseases: clonal diversity and pyrogenic exotoxin expression. Proc Natl Acad Sci U S A. Apr 1 1991; 88(7):2668-72.

Abstract: Osteochondroma is the most common benign tumor of bone. It has been seen that this tumor presents itself in various way both clinically and radiologically. Surgical excision is the treatment of choice with less recurrence rates and less chances of malignant transformation. Here is a very unusual presentation of osteochondroma as a solitary loose body within the knee joint in a 45 year male without any other swelling elsewhere in body treated successfully surgically. Such presentation of osteochondroma has not been reported prior to the best of our knowledge.

Key words: Intra-articular osteochondroma, loose body.

[1]. Taneda Y, Nakamura K, Yano M, et al. Popliteal artery aneurysm caused by osteochondroma. Ann Vasc Surg 2004; 18:121–123.
[2]. Ogura K, Gotu T, Nemoto T, Imanishi J- " Para-articular osteochondroma of the infrapatellar fat pad. J knee surg, 2011;24:209-13.
[3]. Chen HH, Huang GS, Lee JH, Chou TY. Soft tissue condroma: case report. Chung Hua I Hsueh Tsa Chih (Taipei) 1991;48:397-399.
[4]. F. BOTTNER, R. RODL, I. KORDISH, W. WINKLEMANN, G. GOSHEGER, N. LINDNER- " Surgical treatment of symptomatic osteochondroma- 3-8 years follow-up study.J Bone Joint Surg [Br] 2003;85-B:1161-5.
[5]. Jong In Kim, Jae Ho Kwon, Yong Lee Park et al- Arthroscopic Excision of Solitary Intra-articular Osteochondroma of the Knee. Knee Surg Relat Res. 2013 March; 25(1): 36–39.
[6]. Takahashi M, Nishihara A, Ohishi T et al -Arthroscopic resection of an intra-articular osteochondroma of the knee in the patient with multiple osteochondromatosis. Arthroscopy. 2004 Jul;20 Suppl 2:28-31.
[7]. Demir M, Unlu E, Usta U- A curious mass of anterior compartment of knee- The British Journal of Radiology, 82 (2009), 435–437
[8]. Argin M, Arkun R, Parildar M, Selen B- Solitary osteochondroma causing popliteal pseudoaneurysm that presented as a mass lesion.Diagn Interv Radiol 2007; 13:190–192
[9]. De Maio F, Potenza V, Farsetti p et al- Giant intra-articular, extra-synovial osteochondroma of Knee- a report of two cases.The Open Orthopaedics Journal, 2011, 5, 368-371
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Abstract: Eye defects constitute a major portion of maxillofacial defects. An attempt has been made to rehabilitate the lost eye with a great challenge by the skills and materials available. A custom made orbital prosthesis using silicon to replace soft tissue, acrylic for sclera and papillary part and adhesive for retention is good alternative.

Key-words: Eye Prosthesis, Silicon Elastomers, Moulage Key Messages: Lost eyes have been replaced with prosthesis for many years in the form of stock or custom ocular prosthesis. Great evolution in field of maxillofacial material has made it possible to nearly duplicate patient's features in prosthesis.

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[4]. Supriya M, Ghadiali B. Prosthetic rehabilitation of a patient with an orbital defect using a simplified approach. J Indian Prosthodont Soc. 2008; 8:116-8.
[5]. Patil SB, Meshramkar R, Naveen BH, Patil NP. Ocular Prosthesis: a brief review and fabrication of an ocular prosthesis for a geriatric patient. Gerodontology. 2008; 25(1):57-62.
[6]. Guttal SS, Patil NP, Nadiger RK, Basutkar B. Use of acrylic resin base as an aid in retaining silicon orbital prosthesis. J Indian Prosthodont Soc. 2008; 8: 112-5.
[7]. V. A. Chalian, R. W Phillips. Maxillofacial prosthetic material. J Biomed Mat. Sep 2004; 8(4):349-363.
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[10]. Mark S. Chambers, James C. Lemon, Jack W. Martin. Anterior key method for indexing orbital prosthesis. J Prosthet Dent. 2002; 87: 102-5.

Abstract: Descending thoracic aortobifemoral bypass via novel anterior subcutaneous tunnel approach was evaluated in 31 patients. Indications for this approach were; infrarenal aortic block with no site for infrarenal aortic clamping(18 cases), calcified infrarenal aorta(11 cases) and history of laparotomy(2 cases). Duration of surgery was 1.5 to 3 hours and blood loss was 300ml to 1000ml. There was mortality of 2 patients. Reexploration due to bleeding was done in 3 patients and 3 patients required prolonged ventilatory support for 2 days. This approach is recommended in selected patients where conventional approach to the abdominal aorta is not feasible. Follow up of 27 pateints had patent grafts in 24 patients and blocked grafts with no symptoms in 3 patients. 2 patients were lost to follow up.

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[7]. Mii S, Mori A, Sakata H, Kawazoe N. Fifteen-year experience in axillofemoral bypass with externally supported knitted Dacron prosthesis in a Japanese hospital. J Am Coll Surg 1998;186:581–8.
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Abstract: Dental anxiety has been managed using pharmacological techniques in clinical situations. These treatment methods are not without side effects which sometimes could be hazardous. The present study assessed the effectiveness of relaxation therapy, and cranial electrotherapy stimulation (CES) in the treatment of dental anxiety. In this study, 40 respondents (Mean Age =33.05; SD=11.12) who scored high on dental anxiety (𝑥 =14.25) participated in the intervention programmes. Ten respondents were assigned to each of the control and experimental groups (Control =10, Relaxation group =10, CES group =10, Combined treatment group =10). Two hypotheses were tested in the study. Percentages and means, the t-test for independent samples, and one - way ANOVA were used for analyses. Results show that exposure to therapy significantly reduced dental anxiety at post- test than at the pre-test (t (164) = 11.33, p<.01). Respondents who were exposed to relaxation therapy (𝑥 =10.70; p< .05), CES treatment (𝑥 =10.20; p< .05), and the combined treatment (𝑥 =9.40; p< .05) reported significantly lower dental anxiety compared to those in the control group (𝑥 = 18.30). In conclusion, the combination of relaxation and cranial electrotherapy stimulation significantly reduced dental anxiety and found beneficial for alleviating dental anxiety among dental patients.

Keywords: Cranial electrotherapy stimulation, Dental anxiety, Oral pain perception, Relaxation therapy, Nigeria

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Abstract: Bochdalek hernia is a congenital defect of the diaphragm that is usually diagnosed in the neonatal period and incidentally in asymptomatic adults. Volvulus with perforation of colon in a right sided Bochdalek hernia is exceptional.

Case presentation: An 11 yr old girl was admitted with acute dyspnoea,tachycadia., hypotension and fever.On admission, chest x-ray was done and was interpreted as right pleural effusion and pneumothorax with mediastinal shift to the left side. The thoracoabdominal CT examination suspected an intestinal incarceration through a right diaphragmatic defect. At laparatomy,a right sided Bochdalek hernia was confirmed with volvulus and perforation of the ascending colon. Right hemicolectomy with ileocolic anastomosis was done and she made an uneventful recovery. Conclusion: Intrathoracic perforation with volvulus of ascending colon is a rare occurrence, for which our patient was treated successfully. Even though rare, this disorder should be recognized, examined and treated appropriately to avoid complications.

[1] M.J. Ramdass , S.Kamal, A.Paice and B.Andrews , " Traumatic diaphragmatic herniation presenting as a delayed tension faecopnuemathorax," Emergency medicine Journal volume 23, no.10,p. e 54, 2006.

[2] Rout. S , Foo F J, Hayden JD, Guthrie A, Smith AM, : RT sided Bochdalek hernia obstructing in an adult : case report and review of literature. Hernia2007, 11 : 359- 362.

[3] Kanazawa A, Yoshioka Y, Inoi O, Murase J, Kinoshita H: Acute respiratory failure caused by an incarcerated right sided adult Bochdalek hernia: report of a case. Surg today 2002, 32:812-815.

[4] Kocakusak A, Arikan S, Senturk O, Yeel AF : Bochdalek "s hernia in an adult with colon necrosis. Hernia 2005, 9:284-287

[5] Niwa T, Nakamura A, Kato T, Kutsuna.T, Tonegawa K , Kawai A , Itoh M : An adult case of Bochdalek hernia complicated with hemothorax. Respiration 2003, 70: 644-646.

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[8] Day, B. Later appearance of Bochdalek hernia. Br Med J 1972, 1:786.

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Abstract: Objective: To determine the prevalence of microalbuminuria among patients with essential hypertension and its relationship with age of the patient, prevailing blood pressure and duration of illness. Methods: One hundred patients with essential hypertension attending clinics of the University of Nigeria Teaching Hospital, Ituku-Ozalla, in Enugu State, Southeast Nigeria who gave their informed consent, participated in the study. Their random urine samples were analyzed. Samples that gave positive test result for overt proteinuria as well as those negative for both microalbuminuria and proteinuria were noted. Standard method was used to assay for microalbumin in the rest of the samples. Results: Out of the one hundred patients, 24 (24%). 54 (54%) and 22 (22%) had overt proteinuria, neither overt proteinuria nor microalbuminuria and microalbuminuria respectively. There was no significant difference among these three groups in their mean ages, Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP) and Duration of illness. The rate of excretion of albumin did not correlate significantly with the blood pressure, age or duration of illness. Conclusion: A 22% prevalence rate of microalbuminuria recorded in this study is thought to be high since the patients were on drug treatment that was expected to reduce the figure. Frequent screening of patients of essential hypertension is indicated in order to prevent hypertensive nephropathy.

Key words: end-stage renal failure, hypertension, Microalbuminuria, proteinuria.

[1]. Guyton AC & Hall JE (2000) The Circulation: Medical Physiology. 2000 Edition. WB Saunders Company. USA. Pp 143 – 262
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[7]. American Diabetes Association (2003). Diabetic nephropathy. Diabetes Care. 26: (Suppl 1) S94 – S98).
[8]. Azinge EC, Mabeyoge MO and Sofola OA (2003). Evaluation of microalbuminuria as a marker for risk factors in hypertensive Nigerian patients. Nig. Med. Pract. 13: 64-67.
[9]. Jensen JS, Feldt-Rasmusen B, Borch-Jonsen K, Clausen P, Appleyand M, Jensen G (1997). Microalbuminuria and its relation to cardiovascular disease and risk factors. A population based study of 1254 hypertensive individuals. J. Hum. Hypertension. 11: 727-733.
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Abstract: Background: Type 2 diabetes mellitus has been shown to be associated with certain endocrine disorders in men. We therefore investigated the levels of male sex hormones in serum of patients with type 2 diabetes mellitus (DM2) and non-diabetic controls (NDMC) with a view to establishing the effect of diabetes mellitus on their endocrine system. Methods: One hundred and twenty five male type 2 diabetic subjects and 50 apparently healthy non-diabetic male individuals within the age of 32 – 70 years were recruited into this study. Fasting plasma glucose (FPG), male sex hormones (follicle stimulating hormone (FSH), prolactin, luteinizing hormone (LH), and testosterone), and body mass index (BMI) were determined. Results: The mean value of FPG, FSH and prolactin were significantly higher in diabetic subjects when compared with the NDMC, but there was no significant difference in the levels of LH and BMI. The level of testosterone was significantly lower in diabetics than in NDMC. There was no significant correlation between duration of diabetes and male sex hormones (FSH, LH, Prolactin and Testosterone). Results also showed that male sex hormones, BMI, FPG, are independent of age. Conclusion: This study revealed decreased levels of testosterone with insignificantly high levels of luteinizing hormone which is suggestive of abnormal feedback mechanism in the hypothalamic-pituitary-testicular axis of these diabetic men. The study also revealed a significant raised serum prolactin levels in type 2 diabetic patients without a definitive cause. We therefore, recommend further studies to elucidate the possible underlying mechanisms involved in these abnormalities so that correct strategies for treatment can be employed.

Key words: Body Mass Index, hypogonadism, Prolactin, Testosterone, Type 2 diabetes mellitus.

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[5]. Dhindsa S, Prabhakar S, Sethi M, Bandyopadhyay A, Chaudhuri A, Dandona D. Frequent occurrence of hypogonadism in type 2 Diabetes. J Clinical Endocrinol Metab 2005; 90:1903
6. Obesity linked to low testosterone in men. [http://www.livescience.com/6403-obesity-linked-testosterone-men.html. 20/3/2012].
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[9]. Sandeep D, Sathyavani P, Manak S, Arindam B, Ajay C, Paresh D. Frequent Occurrence of Hypogonadotropic Hypogonadism in Type 2 Diabetes. Clin Endoc and Metab 2004; 89: 5462-8.
[10]. Ballister J, Carmen Munoz M, Dominguez J, Rigau T, Guinovart J, Rodriguez-Gil J. Insulin-Dependent Diabetes Affects Testicular Function by FSH- and LH-Linked Mechanisms. J. Androl 2004;25:705-719.

Abstract: This cross sectional study was aimed at determining HBcrAg and HIV seroprevalence among apparently healthy blood donors in Federal Medical Centre Nguru, Yobe State, Nigeria. Blood samples were collected from 420 apparently healthy blood donors and analyzed for HIV using Determine test kit (Abbott, U.S.A), Uni-Gold test kit (Trinity Biotech, U.S.A) and confirmed using western blot. HBcrAg analysis was done using Lumipulse f CLEIA HBcrAg assay kit (Fujirebio, Japan). Out of the 420 screened blood samples, 30 (7.1%) were seropositive to HBcrAg while 18 (4.30%) were seropositive to HIV. The association of HIV and HBcrAg seropositivity in relation to age was not statistically significant (P > 0.05) for age group 21-30 years. Infection with HIV was highest in age group 21-40 years.

Keywords: HBcrAg; HIV; Seroprevalence; Hepatitis B; CLEIA; Nguru.

[1]. Alimonti, J.B., Ball, T.B., Fowke, K.R. (2003). Mechanisms of CD4+ T lymphocyte cell death in human immunodeficiency virus infection and AIDS. Journal of General Virology 84 (7): 1649–1661.
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[3]. Dao, B., Nacro, B., Dahorou, H., Meda, N. and Van De Perre, P. (2001). HIV infection and hepatitis B coinfection: survey of prevalence in pregnant women in Bobo Dioulasso, Burkina Faso. Brussels Review of Medicine, 22:83-86.
[4]. Eke, A.C., Eke, U.A., Okafor, I.C., Ezebialu, I.U. and Ogbuagu, C. (2011). Prevalence, correlates and pattern of hepatitis B surface antigen in a low resource setting. Virology Journal 2011,8: 8-12.
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[8]. Kim, J.H., Psevdos ,G., Suh, J., and Sharp, V.L. (2008). Co-infection of hepatitis B and hepatitis C virus in human immunodeficiency virus-infected patients in New York City, United States. World Journal of Gastroenterology, 14: 6689-6693.
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Abstract: BACKGROUND: Absence of the testis in the scrotum is a common paediatric surgical disorder seen in our practice. OBJECTIVE: To examine the presentation and treatment of the empty scrotum and postulate on the aetiology of the condition. DESIGN: A ten year retrospective study (September 1998 - August 2008). SETTING: Olabisi Onabanjo University Teaching Hospital, Sagamu. METHODOLOGY: Case notes of children managed for empty scrotum during the study period were retrieved from the medical record department of the hospital. Data obtained included age of patient, at presentation, age at surgery, side of scrotum affected, investigations carried out, type of surgery done and outcome of treatment within 6 months of follow-up period. The data obtained were presented in tables and figures.

[1]. Scorer CG, The Anatomy of testicular descent-normal and incomplete. BJS 1961; 49:357-364
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Abstract: Hemophilia is an inherited bleeding disorder. In majority patients either clotting factor vii is in low level (Hemophilia A) or clotting factor ix is deficient (Hemophilia B). For the management of hemophilia, a patient needs to be transfused purified factor preparation or cryoprecipitated plasma. This makes patient susceptible to transfusion transmitted infections. In our study 115 patients were screened for HBsAg, HCV and HIV antigen markers to check safety of cryoprecipitate they receive. Only one person was found to be HBsAg positive and one person was HCV positive. No seropositivity for HIV was found. Advance procedure for virus inactivation and strictly mainting a pool of selected donors for plasma can be major causes for such rate of viral infection in hemophilic patients.

Key Words: Hemophilia, Blood Transfusion, Transfusion Transmitted Viruses

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Abstract: Congenital anomalies are common in the vertebral column. Skeletal abnormalities at the cervical region may result in severe neck pain and sudden unexpected death. During the osteology demonstration of cervical vertebrae for the MBBS students, it was observed that one of axis vertebra is fused with the 3rd cervical hemivertebrae. Vertebral bodies, pedicle, lamina of C2 and C3 were fused on right side, while on left side, C3 lack pedicle, lamina and spine. This fused vertebrae with a hemivertebrae had embryological importance and clinical implications.

Keywords: cervical vertebra, axis, fusion, hemivertebrae, lamina, pedicle , spine

[1]. Susan Standring, ed. Gray's Anatomy. 40th Ed. Elsevier Churchill Livingstone. 2008; 720–721.
[2]. Erdil H, Yildiz N, Cimen M. Congenital fusion of cervical vertebrae and its clinical significance. J Anat Soc India. 2003; 52: 125–127.

[3]. Michail Varras, Christodoulos Akrivis.Prenatal diagnosis of fetal hemivertebra at 20 weeks' gestation with literature review.Int J Gen Med. 2010; 3: 197–201.
[4]. Soni P, Sharma V, Sengupta J. Cervical vertebrae anomalies-incidental findings on lateral cephalograms. Angle Orthod. 2008; 78: 176–180.

[5]. Tanaka T, Uhthoff HK. The pathogenesis of congenital vertebral malformations. A study based on observations made in 11 human embryos and fetuses. Acta Orthop Scand. 1981;52:413–425. [PubMed]

[6]. Forrester MB, Merz RD. Descriptive epidemiology of hemivertebrae, Hawaii, 1986–2002. Congenit Anom. 2006:46172–46176. [PubMed

[7]. Wax JR, Watson WJ, Miller RC, et al. Prenatal sonographic diagnosis of hemivertebrae – associations and outcomes. J Ultrasound Med. 2008;27:1023–1027. [PubMed]

[8]. Braund, K.G. (2003). "Developmental Disorders". Clinical Neurology in Small Animals: Localization, Diagnosis and Treatment. Retrieved 2007-02-04. [9]. Jeffery N, Smith P, Talbot C. "Imaging findings and surgical treatment of hemivertebrae in three dogs". J Am Vet Med Assoc.2007;230 (4): 532–6.

Abstract: Every year reported a patient with HIV is increasing. HIV can infect humans, through sexual whether heterosexual or homosexual, infection through contaminated blood flow, such as sharing drug injection equipment and infection from mother to child. HIV / AIDS, TB and injection drug use (IDU) contribute to the spread of the epidemic and increased mortality rates in communities around the world. TB is the leading cause of death among HIV-infected IDUs. In this present paper, we present the results that gained from binary logistic regression method and used to model the relationship between the ordinal outcome variable. The significant variables are chosen based on the p-value criteria which associated with the significant level of model that lies at the level of  = 0.25. Logit determination and the correlation between the variables are also discussed for further analysis. The use of mathematical software PASWand AMOS version 18 is applied in this research as an alternative calculation procedure derived from the methodology. Among the factors involved in this study were age, gender, race, level of CD4 content of less than 200/mm3, heterosexual, receiving blood infected with HIV, smoking, hepatitis, pneumonia and toxoplasmosis. This study found that there were six significant factors were age, gender, levels of CD4 less than 200/mm3, heterosexual, smoking and pneumonia. For structural equation modeling showed that the critical ratio for the diagnosis of HIV and TB patient through HIV_TB: IDU and CD4 was significant level at 0.05 and have a strong relationship. Overall, the results showed that age, gender, level of CD4 content of less than 200/mm3, heterosexual, smoking and pneumonia were contributing factors to TB infection in people with HIV-positive through injection drug use (IDU) in Kelantan. The government and relevant parties should provide ongoing effort to increase awareness about the dangers of social relations and illness with TB and HIV-positive IDUs by conducting campaigns, talks and tighten laws involving social problems.

Keywords: HIV, TB, IDU, Logistic Regression Method and Structural Equation Modeling

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Abstract: Introduction: Nitric oxide (NO) is a second messenger that regulates neurotransmitter release at the neuromuscular junction (nmj). Evidences accumulate on its potency as a neuro-modulator in CNS, PNS. This work investigates the effect of NO on (nmj) by adding L-arginine known as NO donor. Material and Methods: 30 albino rats' diaphragms divided into two groups. Both exposed to L-argnine followed by Bovine Hb and stimulated by indirect electrical stimulation. Gp 1 stimulated at 0.5Hz. Gp2 stimulated at 100Hz. The amplitude of maximum contraction (AMC) (ΔY), contraction time (ΔX) and half relaxation time (½ Rt) measured. Results: In presence of NO Gp1 showed a significant increase in (AMC) (ΔY) and (ΔX) with a significant decrease in (½ Rt). Gp2 showed a significant increase in (AMC)(ΔY). Conclusion: Nitric oxide (NO) facilitates neuromuscular transmission at presynaptic level. Bovine Hemoglobin reduces Nitric oxide's induced effects.

Key words: Hemoglobin, L-arginine, nitric oxide (NO), rat diaphragm, neuromuscular transmission.

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Abstract: Accidents were responsible for most common cause of death, followed by homicidal deaths, with suicides recorded as the least. In developing countries like India two wheeler accidents are more common than other vehicle accidents. The deaths due to head injury are inescapable in the modern way of life and their correct interpretation is vital to the reconstruction of the events of Forensic Medicine and their proper management for treatment of the injured. This prospective study was carried out on 88 victims among motorcyclists admitted to government hospital in warangal during 2009 – 2010. The objective of the study was to analyze the pattern of fatal head injuries among motorcycle riders and pillion riders.

Key Words: Motor cycle, Accidents, Head injuries.

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Abstract: The periodontal disease is an inflammatory condition of the supporting structres of the teeth. The presence of rheumatoid arthritis or other systemic inflammatory disease may increase the severity of the periodontal disease. The studies published in the past reveals that the oral bacterial infections and inflammation seemed to be linked directly to the etiopathogenesis of rheumatoid arthritis. There are findings support the impact of periodontal pathogens, such as Porpyromonas gingivalis on citrullination, and the association of periodontitis in rheumatoid arthritis patients with serospecificity toward rheumatoid factor and the anti-cyclic citrullinated peptide antibody1.In this review the common etiology, pathogenesis and immunogenetics of two chronic inflammatory conditions are discussed. Keywords: Chronic inflammatory disease, Periodontitis, Rheumatoid arthritis,

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