iosr-JDMS   Volume-12 ~ Issue-1

Abstract: Background- Supraclavicular brachial plexus block is a popular and widely employed regional nerve block technique. Aims- To evaluate the effect of dexamethasone added to bupivacaine in supraclavicular brachial plexus block. Materials and Methods- 60 adult patients of either sex, aged 18 – 60 years,ASA physical status I or II ,posted for elective orthopedic surgeries of elbow, forearm and hand under supraclavicular brachial plexus block were enrolled in the study. Patients were randomly allocated to one of the two groups - group A and group B . Group A (n=30) –received 38 mL 0.25% bupivacaine and 2 mL dexamethasone (8 mg). Group B (n=30) –received 38 mL 0.25% bupivacaine and 2 mL 0.9% normal saline. Statistics: Using software package SPSS16 for Windows statistical analysis done. Numerical variables compared by Independent samples t-test. Categorical variables compared between groups by Chi-square test. All analysis has been two tailed and p < 0.05 has been taken to be statistically significant. Results: No statistically significant difference between the groups in respect to patients' age, height, weight, duration of surgery (Independent samples t-test; p >0.05). Onset times of sensory and motor block were similar in the two groups. Duration of sensory(1091.11± 107.42 vs 605.37 ± 58.60 ) and motor blockade (846.67 ± 102.09 vs 544.07 ± 55.40 )were significantly longer in the group A (dexamethasone group) than in the group B (control group). less number of diclofenac sodium injection required in group A. Conclusion: We conclude that addition of 8 mg dexamethasone to bupivacaine 0.25% solution in supraclavicular brachial plexus block prolongs the duration of sensory and motor blockade, reduces the requirement of rescue analgesic in postoperative period but has no effect on the onset time of sensory and motor blockade.

Keywords: Dexamethasone, Bupivacaine, Supraclavicular Brachial Plexus Block

[1]. Shrestha BR, Maharjan SK, Shrestha S, Gautam B, Thapa C, Thapa PB et al. Comparative study between tramadol and dexamethasone as an admixture to bupivacaine in supraclavicular brachial plexus block. J Nepal Med Assoc 2007; 46(168):158-64.
[2]. Golwala MP, Swadia VN, Dhimar AA, Sridhar NV. Pain relief by dexamethasone as an adjuvant to local anaesthetics in supraclavicular brachial plexus block. J Anaesth Clin Pharmacol 2009; 25(3):285- 8.
[3]. Johansson A, Hao J, Sjölund B. Local corticosteroid application blocks transmission in normal nociceptive C-fibres. Acta Anaesthesiol Scand 1990; 34:335–8.
[4]. Devor MD, Gorvin-Lippmann R, Raber P. Corticosteroids suppress ectopic neural discharge originating in experimental neuromas. Pain 1985; 22:127–37.
[5]. Castillo J, Curley J, Hotz J, Uezono M, Tigner J, Chasin M, et al. Glucocorticoids prolong rat sciatic nerve blockade in vivo from bupivacaine microspheres. Anesthesiology 1996; 85:1157–66.
[6]. Shrestha BR, Maharjan SK, Tabedar S. Supraclavicular brachial plexus block with and without dexamethasone - A comparative study. Kathmandu University Medical Journal 2003; 1:158- 60.
[7]. Stan T, Goodman EJ, Bravo-Fernandez C, Holbrook CR. Adding methylprednisolone to local anesthetic increases the duration of axillary block. Reg Anesth Pain Med 2004; 29(4):380-1.
[8]. Yadav RK, Sah BP, Kumar P, Singh SN. Effectiveness of addition of neostigmine or dexamethasone to local anaesthetic in providing perioperative analgesia for brachial plexus block: A prospective, randomized, double blinded, controlled study. Kathmandu University Medical Journal 2008; 6(23):302-9.
[9]. Movafegh A, Razazian M, Hajimaohamadi F, Meysamie A. Dexamethasone added to lidocaine prolongs axillary brachial plexus blockade. Anesth Analg 2006; 102:263–7.
[10]. Vieira PA, Pulai I, Tsao GC, Manikantan P, Keller B, Connelly NR. Dexamethasone with bupivacaine increases duration of analgesia in ultrasound-guided interscalene brachial plexus blockade. Eur J Anaesthesiol 2010; 27(3):285-8.

Abstract: Tumour lysis syndrome (TLS) is a common problem in patients on treatment for malignancies; Spontaneous tumour lysis syndrome, however is a rare condition and should be suspected in patients with unexplained renal failure having typical biochemical abnormalities of hyperuricemia, hyperphosphatemia, hyperkalemia and hypocalcemia. It may sometimes be the first manifestation of an underling malignancy. Herein we present a case of spontaneous tumour lysis syndrome with Acute kidney injury, requiring hemodialysis, as the initial manifestation of Acute lymphoblastic leukemia (ALL). He responded well to hemodialysis and was able to tolerate the subsequent chemotherapy.

Key words: Spontaneous tumour lysis syndrome, hyperuricemia, hyperphosphatemia, hypocalcemia, Acute kidney injury

[1]. Cairo MS, Bishop M. Tumor lysis syndrome: New therapeutic strategies and classification. Br J Haematology 2004;127:3-11.
[2]. Coiffier, B., Altman, A., Pui, C.H., Younes, A. & Cairo, M.S; Guidelines for the management of pediatric and adult tumor lysis syndrome: An evidence-based review. Journal of Clinical Oncology, 2008 ,26, 2767–2778
[3]. Scott C. Howard, M.D., Deborah P. Jones, M.D., and Ching-Hon Pui, M.D; The Tumor Lysis Syndrome:N Engl J Med 2011; 364:1844-1854
[4]. Cairo MS, Coiffier B, Reiter A, Younes A; TLS Expert Panel; Br J Haematology. 2010 May;149(4):578-86
[5]. Patrizia Tosi et al, Recommendations for the evaluation of risk and prophylaxis of tumour lysis syndrome (TLS) in adults and children with malignant diseases: an expert TLS panel consensus. Haematology December 1, 2008 vol. 93 no. 12 1877-1885
[6]. Jasek, A. M. and Day, H. J. Acute spontaneous tumor lysis syndrome. Am. J. Hematol., 1994, 47: 129–131
[7]. Gemici C, Tumor lysis syndrome in solid tumors. Clin Oncol 2006;18: 773-80.
[8]. Mateusz Opyrchal, Travis Figanbaum, Amit Ghosh, Vincent Rajkumar, and Sean Caples, Spontaneous Tumor Lysis Syndrome in the Setting of B-Cell Lymphoma, Case Reports in Medicine, vol. 2010, Article ID 610969, 3 pages, 2010
[9]. Samer alkhuja,Harry ulrich; Acute renal failure from spontaneous acute tumor lysis syndrome: A case report and review; Renal failure: 2002 24:2, 227-232
[10]. Sharma SK, Malhotra P, Kumar M, Sharma A, Varma N, Singh S; Spontaneous tumor lysis syndrome in acute lymphoblastic leukemia.: J Assoc Physicians India, 2005; 53:828 -30.

Abstract: Objective: To evaluate the predictive value of roles of gray-scale, color-Doppler ultrasound, and sonoelastography for the assessment of thyroid nodule to determine whether nodule size affects the differential diagnosis of benign and malignant, with fine needle aspiration cytology analysis as the reference standard. Methods: A total of 270 consecutive patients (mean age, 35±55 years; range, 30-50 years; 25males and 245 females) with 300 thyroid nodules were examined by gray-scale, color-Doppler ultrasound, and 100 patients examined by sonoelastography in this prospective study. All patients underwent surgery and the final diagnosis was obtained from fine needle aspiration cytology analysis. Results: Three hundred nodules (206 benign, 94 malignant) were divided into small (SNs, ≤1cm, n=124) and large (LNs, >1Cm, n=178) nodules. Microcalcifications were more frequent in malignant LNs than in malignant SNs, but showed no significant difference between benign LNs and SNs. Poorly-circumscribed margins were not significantly different between malignant SNs and LNs, but were less frequent in benign LNs than in benign SNs. Among all nodules, marked intranodular vascularity was more frequent in LNs than in SNs. By comparison, shape ratio of anteroposterior to transverse dimensions (A/T) ≥1 was less frequent in LNs than in SNs. Otherwise, among all nodules, marked hypoechogenicity and elasticity score of 4-5 showed no significant difference between LNs and SNs. Conclusions: The predictive values of microcalcifications, nodular margins, A/T ratio, and marked intranodular vascularity depend on nodule size, but the predictive values of echogenicity and elastography do not depend on nodule size.

Key words: Elastography; Thyroid nodules; Ultrasound. Malignant. Nodule size.

[1]. Tumbridge WM, Evered DC, Hall R, et al. The spectrum of thyroid disease in a community: the Whick-ham Survey. Clin Endocrinol (Oxf) 1997;7:481–93
[2]. Hong Y, Liu X, Li Z, Zhang X, Chen M, and Luo Z. Real-time Ultrasound Elastography in the Differential Diagnosis of Benign and Malignant Thyroid Nodules. JUM July 1, 2009 vol. 28no. 7 861-867

[3]. Kim EK, Park CS, Chung WY, et al. New sonographic criteria for recommending fine-needle aspiration biopsy of nonpalpable solid nodules of the thyroid. AJR Am J Roentgenol 2002;178:687–91 [4]. Park JY, Lee HJ, Jang HW, et al. A proposal for a thyroid imaging reporting and data system for ultrasound features of thyroid carcinoma. Thyroid2009;19:1257–64

[5]. Sipos JA. Advances in ultrasound for the diagnosis and management of thyroid cancer. Thyroid 2009;19:1363–72

[6]. Hong YJ, Son EJ, Kim EK, et al. Positive predictive values of sonographic features of solid thyroid nodule. Cli Imaging 2010;34:127–33

[7]. Moon HJ, Kwak JY, Kim MJ, et al. Can vascularity at power Doppler US help predict thyroid malignancy? Radiology 2010;255:260–69

[8]. Choi YJ, Yun JS, Kim DH. Clinical and ultrasound features of cytology diagnosed follicular neoplasm. Endocr J 2009;56:383–89

[9]. Hagag P, Strauss S, Weiss M. Role of ultrasound-guided fine-needle aspiration biopsy in evaluation of nonpalpable thyroid nodules. Thyroid1998;8:989–95
[10]. Luo S, Kim EH, Dighe M, Kim Y. Screening of thyroid nodules by ultrasound elastography using diastolic strain variation. Conf Proc IEEE Eng Med Biol Soc. 2009;2009:4420-3. doi: 10.1109/IEMBS.2009.5332744.

Abstract: Gastroschisis represents herniation of abdominal contents through a paramedian full-thickness abdominal wall fusion defect without involving the umbilical cord. Evisceration, usually, contains only intestinal loops and not covered by membrane unlike in Omphalocele. Gastroschisis with other serious birth defects is unusual. Neonates with Gastroschisis have better prognosis than those with an Omphalocele. Very rarely gastroschisis is associated with herniation of major viscus and their presence makes the prognosis worst. This is a rare case because of Left sided Gastroschisis with evisceration of major viscera and association of Left side upper limb abnormality and a duplicate limb.

Key words: Gastroschisis, Herniation, Left sided, limb abnormality, duplicate limb.

[1]. Sadler T. W. Langmans medical embryology, eleventh edition 2011:227.
[2]. Lyekeoretin Evbuomwan, Kokila Lakhoo, Congenital Anterior Abdominal Wall Defects: Exomphalos and Gastroschisis, chapter 56 page 348-351.
[3]. Sara M. Durfee, Cynthia D. Downard, Carol B. Benson. Jay M. Wilson, Postnatal Outcome of Fetuses with the Prenatal Diagnosis of Gastroschisis. J Ultrasound Med 2002; 21:269–274.
[4]. Randall T. Loder, Jean-Paul Guiboux,Ann Arbor, Michigan, Musculoskeletal Involvement in Children With Gastroschisis and Omphalocele. Journal of Pediatric Surgery, 1993; Vol28. No 4: 584-590.
[5]. Torfs C, Curry C, Roeper P. Gastroschisis. J Pediatr 1990; 116:1–6.
[6]. Moore TC, Stokes GE. Gastroschisis: report of 2 cases treated by a modification of the gross operation for omphalocele. Surgery 1953; 33:112–120.
[7]. Bair JH, Russ PD, Pretorius DH, et al: Foetal omphalocoele and gastroschisis: A review of 24 cases. AJR 1986; 147: 1047
[8]. Chabra S, Gleason CA. Gastroschisis: Embryology, pathogenesis, epidemiology. NeoReviews 2005;6:493-9.
[9]. Stoll C, Alembik Y, Dott B, Roth MP. Omphalocele and gastroschisis and associated malformations. Am J Med Genet A 2008;146A: 1280-5.
[10]. Boyd PA, Bhattacharjee A, Gould S, Manning N, Chamberlain P. Outcome of prenatally diagnosed anterior abdominal wall defects. Arch Dis Child Fetal Neonatal Ed 1998; 78:F209–F213.

Abstract: Over the past 4 decades, the capabilities of ultrasound flow imaging in medical management, especially in obstetrics, have increased enormously, with color flow imaging now in commonplace and facilities such as 'power' or 'energy' Doppler providing new ways of imaging flow 1,2. With such versatility, it is tempting to employ the technique for ever more demanding applications and to try to measure increasingly subtle changes in the maternal and fetal circulations3. Pre-eclampsia and intrauterine growth restriction remain important causes of maternal and perinatal morbidity and mortality4,5.

[1]. Merritt H, Putman T, Sodium diphenyl hydantoinate in the treatment of convulsive disorders. JAMA, 111, 1938, 1068-1103.
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Abstract: Isolated fracture of the capitellum is rare. We present clinical and radiological data on a single case of fracture of capitellum. We came across a 62 year old woman who sustained an isolated Hahn-Steinthal type of fracture. It was treated by open reduction and internal fixation using cannulated cancellous screw. The elbow was immobilized for 3 weeks. Patient attained full range of movements at 3 months. We recommend that anatomical reduction and fixation is the appropriate treatment for these types of fracture.

Keywords: Capitellum, Hahn Steinthal fragment, Open reduction & internal fixation.

[1]. Harrington JP, Mckee MD(2000)Coronal shear fractures of the Capitellum and trochle.Tech Shoulder and Elbow surg 1(4):240-246
[2]. Jupiter JB, Morrey BF(1993) Farctures of the distal humerus in the adult. In: Morrey BF(ed) The elbow and its disorders, 2nd edn. WB Saunders, Philadelphia, pp 328-366
[3]. Silveri CP, Corso SJ, Roofeh J(1994) Herbert screw fixation of capitellum fracture: a case report and review. Clin Orthop 300: 123-126
[4]. McKee MD, Jupiter JB, Banberger HB(1996) Coronal shear fractures of the distal end of the humerus. J Bone Joint Surg(Am)78:49-54
[5]. Mighell MA, Harkins D, Klein D, Schneider S,Frankle M(2006)Technique of internal fixation of capitellum and trochlea fractures. J Orthop Trauma 20(10):699-704
[6]. Ruchelsman DE, Tejwani NC, Kwon YW, Egol KA(2008) Open reduction and internal fixation of capitellar fractures with headless screws. J Bone Joint Surg(Am)90:1321-1329
[7]. Hahn NF, Fall von einer besonderen Varietat der Frakturen des Ellenbogens. Zeitschrift fur Wundartze and Geburtshelfer 1853:6:185-9
[8]. Hardy P, Menguy F, Guilot S, Arthroscopic treatment for capitellum fractures of the humerus. Arthroscopy 2002;18(4):422-6

Abstract: Background and Objective: Preeclampsia is a multi system disorders that can affect every maternal organ predominantly the cardio-vascular system, kidneys, brain and liver. The present study was conducted to compare the liver function tests in preeclampsia with normotensive pregnancy. Methodology: The present case control study was carried out at the department of obstetrics and gynaecology of Bankura Sammilani Medical College, Bankura to find the serum bilirubin and serum levels of liver enzymes ALT, AST and ALP in 100 pregnant women (50 preeclampsia and 50 normotensive pregnant women). Results: The mean BMI of cases was 28.02 ± 3.67kg/m2 and that of control was 24.48±3.09 kg/m2. The mean value of serum bilirubin in cases was 10.62±3.72 mol/L and in control it was 7.81±2.37 mol/L (p<0.001). The mean value of enzyme ALP in cases was 55.78±30.93 U/L and in control it was 15.21±3.40 U/L (p<0.001). The mean value of enzyme AST in cases was 40.58±10.75 U/L and in control it was 8.21±2.60 U/L (p<0.001). The mean ALP level of cases before delivery was 458.15±241.68 U/L and in control it was 182.32±64.72 U/L (p<0.001). Conclusion: Elevated levels of serum bilirubin and liver enzymes ALT, AST and ALP were found in preeclampsia cases.

Keywords: Liver function test, Pre-eclampsia

[1]. National High Blood Pressure Education Program. Working Group on High Blood Pressure in Pregnancy. Report of the National High Blood Pressure Education Program. Working Group on High Blood Pressure in Pregnancy. Am J Obstet Gynecol 2000; 183(1):S 1-22.
[2]. ACOG Committee on Obstetric Practice. ACOG practice bulletin. Diagnosis and management of preeclampsia and eclampsia. Obstet Gynecol 2002;99(1): 159-67.
[3]. Kwiatowski S, Kwiatkowska E, Czajka R, Ciechanowski K, Kedzierska K, Bober J, et al. The activity of erythrocyte sodium-proton exchanger in women with pregnancy-induced hypertension. Hypertens Pregnancy 2006;25(l):37-46.
[4]. Lenfant C; National Education Program Working Group on High Blood Pressure in Pregnancy. Working Group Report on High blood pressure in pregnancy. J Clin Hypertens (Greenwich) 2001 ;3(2):75-88.
[5]. Angel Gracia AL. Effect of pregnancy on pre-existing liver disease Physiological changes during pregnancy. Ann Hepatol 2000;5(3): 184-6.
[6]. Simith LG Jr, Moise KH Jr, Dildy GA III, Carpenter RJ Jr. Spontaneous rupture of liver during pregnancy: current therapy. Obstet Gynecol 1991;77:171-5.
[7]. Lopez-Jaramillo P. Casas JP, Serrano N. Preeclampsia: from epidemiological observation to molecular mechanism. Broz J Med Biol Res 2001 ;34( 10): 1227-35.
[8]. Kaaja R. Predictors and risk factors of preeclampsia. Minerva. Gynecol 2008;60(5):421-9.
[9]. Hauger MS, Gibbons L, Vik T, Belizan JM. Pregnancy weight status and risk of adverse pregnancy outcome. Acta Obstet Gynecol Scand2008;87(9):453-9.
[10]. Noreen A, Rana G. Women with pregnancy induced hypertension: epidemiological difference between normotensive pregnant women. Professional Med J 2006; 13(2):310-2.

Abstract: Peripheral giant cell granuloma (PGCG) is an infrequent exophytic lesion of the oral cavity, also known as giant cell epulis, osteoclastoma, giant cell reparative granuloma, or giant-cell hyperplasia. Lesions vary in appearance from smooth, regularly outlined masses to irregularly shaped, multilobulated protuberances with surface indentations. Ulcerations of the margin is occasionally seen. The lesions are painless, vary in size, and may cover several teeth. It normally presents as a soft tissue purplish-red nodule consisting of multinucleated giant cells in the background of mononuclear stromal cells and extravasated red blood cells. This article reports a peripheral giant cell granuloma arising at maxillary anterior region in 56 years old patient.

Keywords: Giant Cell, Granuloma, monocytes

[1]. Erdur O Khyan FT, Toprak MS, Aktas O. Peripheral giant cell granuloma: a case report. Bakirkoy Tip dergisi 2008;4:122-25
[2]. Yalcin E, Ertas U, Altas S. Peripheral giant cell granuloma: a retrospective study. Ataturk Univ Dis Hek Fak Derg 2010; 20 (1) : 34-37
[3]. Develioglu AH, Bostanci V, Nalbantoglu AM. Evaluation of Peripheral giant cell granuloma: a case report. Cumhuriyet Univ Dis Hek Fak Derg 9:1,2006; 9:1
[4]. Aslan M, Kaya GS, Day E, Demirci E. A Peripheral giant cell granuloma in early age (case report). Ataturk Univ Dis Hek Fak Derg 2006; 16 (3): 61-64
[5]. Giansant i JS, Waldron CA. Peripheral giant cell granuloma: review of 720 cases. J Oral Surg.1969;27:787–91
[6]. Gandara-Rey JM, Pacheco Martins Carneiro JL, Gandara-Vila P, et al. Peripheral giant-cell granuloma.Review of 13 cases. Med Oral 2002;7:254–259.
[7]. Grand E, Burgener E, Samson J,Lombardi T. Post-traumatic development of a peripheral giant cell granuloma in a child. Dent Traumatol 2008;24:124–126.
[8]. Bodner L, Peist M, Gatot A, Fliss DM.Growth potential of peripheral giant cell granuloma. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1997;83:548–551
[9]. Adlakha VK, Chandna P, Rehani U, Rana V, Malik P. Peripheral giant cell granuloma. J Indian Soc Pedod Prev Dent 2010; 28:293-6.
[10]. Carranza FA, Newman MG, Takei HH. Clinical periodontology.Ninth Edition, Chapter 202; 18:291

Abstract: The Present study makes an attempt to analyze the Breast feeding practices in normal Newborn babies in institutional Deliveries and also to investigate time of initiation of Breast feeding practices and type of feeds given to the normal newborn babies in Institutional Deliveries. The study was conducted in the Department of Paediatrics & Obstetric and Gynaecology, Gandhi Medical College, Bhopal. The study was based on primary data with help of observational study during the period from August 2008 to September 2009 with sample size 500 cases. The findings of the study revealed that, distribution of newborns according to the time of initiation of breast feeding was found to be in high within half an hour to five hours duration. The new born male babies were high (77.9 per cent) when compared to female babies (68.49 per cent) during half an hour to five hours duration. Further, study results on type of delivery revealed that, 82.6 percent of babies were delivered by normal vaginal delivery (NVD) and 17.4 percent of babies were delivered by lower segment caesarean section (LSCS). The Study also focused on type of pre-lacteal feeds given to the newborns, the outcome the study shows that, more than 50 percent of mothers practiced pre-lacteal feeds of one sort or the other which includes Cow's milk (39.8%), Tea (27.2%), Honey (14.9%), Goat's Milk (11.11%) and Glucose water (6.89%). Hence, the study suggests that, breastfeeding should be made to all normal newborns (including those born by caesarean section) as early as possible after birth, ideally within half an hour to five hours duration. The Colostrum, which is secreted within first 2-3 days, must not be leftover but should be fed to newborn as it contains high concentration of defensive immunoglobulin's and cells which provides an optimal nutrition to child and prevent from infections. Health service providers have significant role in not only promoting optimal breast feeding practices but also in ensuring these practices are followed.

Key words: Postnatal Wards, breast Feeding practices, Time of initiation and pre-lacteal feeds.

[1]. Akhter HH, Akhter M and Azad KM, A National Barcline survey to assess the breast feeding practices in Bangladesh. Birperht Publication, Dhaka, Bangladesh, 1998; 64;20.
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[3]. Goplana,C. (1989), "Women and Nutrition in India", Some Practical Consideration, Nutrition Foundation of India (NFI) Bulletin, 1989, 10:pp1-4.
[4]. Luke C. Mullany, Joanne Katz, Breast feeding patterns time to initiation and mortality risk among newborns in Southern Nepal. J. Nutr. Mar 2008;138;599-603
[5]. Madhu K, Chowdary S, Masthi R. Breast feeding practices and newborn care in rural areas: A descriptive cross-sectional study. Indian J Community Med 2009;34:243-6.
[6]. Malek Batal and Boulghourjian C (2005). Breastfeeding Initiation and Duration in Lebanon: Are the Hospitals "Mother Friendly"? Journal of Pediatric Nursing. Vol. 20(1) pp. 53-59.
[7]. Srivastava S.P., Vijay Kumar Sharma, Breast feeding pattern in neonates journal of Indian pediatrics 1994; vol31; 1079-82.
[8]. World Alliance for Breastfeeding Action (WABA) annual results based report 2012, "Protecting, Promoting and Supporting Breastfeeding through Human Rights and Gender Equality: A Global project for Coordinated Action to Achieve Millennium Development Goals (MDGs)", 2008‐2012.

Abstract: Objective: To determine the effect of pregnancy on haematological parameters and compare the haematological parameters at different stages of pregnancy. Methods: The study involved 30 healthy pregnant women as the study group and 10 non-pregnant women as control. The age range of these women was 19-37 years. 2.5 ml of venous blood was collected from each pregnant and non-pregnant women and put into EDTA vial. Complete blood count was estimated using automated haematological analyzer. Results: The result showed that study group exhibited statistically significant lower values of haemoglobin, PCV, monocyte and lymphocyte while WBC, eosinophil and ESR were significantly elevated. There was no significant difference in all haematological parameters among the three trimesters. Conclusion: Normal healthy pregnancy may have effect on haemotalogical parameters. So it is essential to monitor these parameters during pregnancy. We also find that trimester of pregnancy have no effect on haematological indices.

Keywords: Haematological parameters, Pregnant women, Trimesters, Venous blood.

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[3]. Akingbola TS, Adewole IF, Adesina OA, Afolabi KA, Fehintola FA, Bamgboye EA, et al. Hematological profile of healthy pregnant women in Ibadan, south-western Nigeria. J Obstet, Gynecol 2006; 26(8); 763-769.
[4]. James TR, Reid I1L, Mullings MA. are published standards for haemtological indices in pregnancy applicable across populations: an evaluation in healthy pregnant Jamacian women. BMC Pregnancy Childbirth 2008; 8:8.
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Abstract: Orthokeratinized odontogenic cyst (OOC) is a developmental cyst that occurs in the jaw. it was initially defined by the world health organization as the orthokeratinized variant of odontogenic keratocyst (OKC). However, studies have shown that OOC has a peculiar clinicopathologic aspects when compared with other developmental odontogenic cysts, especially OKC's. The orthokeratinized odontogenic cyst is a distinct clinicopathologic entity and is histologically characterized by a thin, uniform, epithelial lining with orthokeratinization. Clinically, the orthokeratinized cyst is a single cyst, shows a predilection for males, and is most often found in the second to the fifth decade. It is not a dentigerous cyst but is often mistaken for a dentigerous cyst because of its association with unerrupted or impacted tooth in the posterior mandible. It exhibits lower clinical aggressiveness compared to its counterpart OKC. The purpose of the article is to present a case of large aggressive OOC in the anterior mandible and to highlight the importance of, distinguishing it from the more commonly occurring OKC or keratocystic odontogenic tumour (KCOT).

Key Words: Jaw cysts; Odontogenic cyst; Odontogenic keratocyst; Dentigerous cyst.

[1]. Crowley TE, Kaugars GE, Gunsolley JC: Odontogenic keratocysts: a clinical and histologic comparison of the parakeratin and orthokeratin variants: J Oral Maxillofac Surg: 1992:50(1):22-6.
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[3]. Eryilmaz T, Ozmen S, Findikcioglu K, Kandal S, Aral M: Odontogenic keratocyst: an unusual location and review of the literature: Ann Plast Surg: 2009:62(2):210-2.
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Abstract: Urinary tract infections are amongst the most common infections encountered in clinical practice. Antimicrobial resistance is very high among the urinary pathogens. Hence we aimed at evaluating the pathogens causing UTI in the study area and study the antibiogram. Materials and methods: Ninety eight urine specimens from symptomatic patients were processed for isolation of pathogen and antibiotic sensitivity. The antibiogram to different antibiotics were studied. Inpatient and outpatient groups were compared for antibiotic resistance and results compared. Results: Of 98 specimens 50 specimens didn't yield any pathogen. Of the 48 which grew, 40 were gram negative bacteria and 9 were Gram positive bacteria. Escherichia coli was predominant pathogen (65%). High drug resistance was noted to ampicillin (93%), Nalidixic acid (75%), Cotrimoxazole (73%), Norfloxacin (68%) and even third generation cephalosporins. Nitrofurantoin showed least resistance (15%). Drug resistance was high in inpatients than outpatients. Conclusion: E.coli were the predominant pathogens causing UTI followed by Klebsiella species. Antibiotic resistance was very high in the study hospital. Nitrofurantoin still holds good for the treatment of UTIs. Drug resistance was high in inpatients compared to outpatients. The situation warrants judicious use of antibiotics to curb the menace of antibiotic resistance.

Keywords: Antibiogram, antibiotic resistance, inpatients, nitrofurantoin, urinary tract infection

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Abstract: Background: T. vaginalis infection is present in the males where they may produce signs and symptoms. From two popular laboratories, one in Enugu and the other in Onitsha (Enugu and Anambra States), 361 consecutive young men was voluntarily enrolled into a study. Some were symptomatic and others were not. Urine, urethral smears and semen were collected and first directly examined under the light microscope, then cultured. Ethical clearance was obtained. Statistical analysis used were Simple Proportion tested by Chi Square Results: By Direct examination and by Culture, T. vaginalis was isolated in 25.2% of the population. This was mainly in traders and bus drivers / bus conductors. Only a few were secondary school students. Adolescents aged 15 to 18 years formed 11.3%. Conclusion: Males also harbor T. vaginalis infection in Nigeria. Therefore identification of the infection in females where it is relatively simpler to do so, calls for contact tracing in male partners for the relatively easy treatment in the couple(s). This may possibly assist in the prevention of the negative reproductive health consequences that may result.

Keywords: Male adolescents, STIs, T. vaginalis, contact tracing

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Abstract: Every day, millions of people consume probiotics for their perceived health benefits, but how safe are probiotics? Do probiotics cause invasive infection and if so, who is at risk? There is considerable interest in probiotics for a variety of medical conditions, and millions of people around the world consume probiotics daily for perceived health benefits. Lactobacilli, bifidobacteria, and lactococci have generally been regarded as safe. There are 3 theoretical concerns regarding the safety of probiotics: (a) the occurrence of disease, such as bacteremia or endocarditis; (b) toxic or metabolic effects on the gastrointestinal tract; and (c) the transfer of antibiotic resistance in the gastrointestinal flora. So, in order to deliver appropriate probiotic therapy both medical and dental practitioners should be aware of the adverse effects associated with probiotic use

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Abstract: Lichen planus is a fairly distinctive, chronic, immunologically mediated mucocutaneous disease, of uncertain etiology that was first described as a disease of the skin that can also affect mucosal surfaces, including those that line the oral cavity. The prevalence of LP in the general population is of the order of 0.9 to 1.2%. It is stated that approximately 40% of lesions occur on both oral and cutaneous surfaces, 35% on cutaneous and 25% on mucosal surfaces alone. Oral lichen planus known to affect both men and women, usually between the ages of 30 and 70 years. This paper presents a review on lichen planus with its, pathophysiology, clinical features, and different modes of treatment.

Key Word: Oral lichen planus; Lichen planus.

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