iosr-JDMS   Volume-4 ~ Issue-4

Abstract: The study aims at assessing the advantages of Flexi laryngeal mask airway (Flexi LMA) over endotracheal intubation in minimizing the pressor response as well as the rise in intraocular pressure in paediatric patients undergoing ophthalmic operations
Keywords: Flexi Laryngeal Mask Airway, intubation, pressor, ophthalmic, Intraocular

[1] Forbes AM, Dally FG. Acute hypertension during induction of anaesthesia and endotracheal intubation in man.Br J Anaesth 1970;
42: 618-624.
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intraocular pressure in children. Anaesth Analg1992; 75: 355-360.
[3] Brain A. L J. The laryngeal mask new concept in airway management. British Journal of Anaesthesia 1983; 55: 801-805.
[4] Brodrick P.M., Webster N.R. and Nunn J.F. The laryngeal mask airway: a study of 100 patients during spontaneous ventilation.
Anaesthesia1989; 44: 238-241.
[5] Wood M.L.B. and Forrest E.T.S. The haemodynamic response to the inser tion of the laryngeal mask airway: a comparison of
laryngoscopy and tracheal intubation. Acta. Anaesth. Scand 1994; 38: 570-573.
[6] Devault M., Greifenstein F.E. and Harris L.G. Circulatory responses to endotracheal intubation in light General anaesthesia.
Anaesthesiology 1960; 21: 360-62.
[7] Asai T., Koga K. and Stacey M. Use of cuffed oropharyngeal airway after difficult ventilation through a facemask. Anaesthesia
1997; 52: 1236-1237.
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Anaesth. Soc. J. 1975; 22: 316-29.
[9] Puri GD, Batra YK. Effects of nifedipine on cardiovascular responses to laryngoscopy and intubation. Br J Anaesth 1988; 60 : 579-
81.
[10] Abou-Madi MN, Keszler H, Yacoub JM. Cardiovascular reactions to laryngoscopy and tracheal intubation following small and
large intravenous doses of lidocaine. Can Anaesth Soc. J 1977; 24: 9-12.

Abstract: Maternal education plays an important role in determination of child's health. It may affect the nutritional status of the child. The nutritional status depends on many factors including the incidence of morbidity and personal hygiene. Aim &objective: The aim of this study was to analyze the impact of maternal education on child's health, incidence of morbidity and personal hygiene. Materials and Methodology: 449 mothers with their children who were in the age group of 0-6 years were included in the study. Proforma was given to obtain information about the about the socioeconomic status, educational qualification. Anthropometric measurements were taken in children .Grading of PEM was done based on the weight for age using IAP classification. Results: Maternal education influences the health of the child by improving the nutritional status .However, personal hygiene and incidence of morbidity was not influenced by the educational status of the mother.

Key words– Maternal education, nutritional status

[1] Feldman, J et al. 1989. National trends in educational differentials in mortality. American Journalof Epidemiology 129, pp. 919- 933.
[2] Racine, A and Joyce, T. 2007. Maternal education, child immunisations and public policy :evidence from the US national
immunisation survey. Social science and medicine 65, pp. 1765-1772
[3] Caldwell J. Education as a factor in mortality decline: an examination of Nigerian data. Population Studies. 1979; 33: 395-413.
[4] Strauss J, Thomas D. Health, nutrition and economic development. Journal of Economic Literature. 1998; 36(2): 766-817.
[5] Barrera, A. 1990. The role of maternal schooling and its interaction with public health programs in child health production. Journal
of Development Economics 32, pp. 69-91.
[6] Stanley, I et al. 2007. Breastfeeding and maternal and infant health outcomes in developed countries. Evidence Reports/Technology
Assessments, No.153.[Online].
[7] Skafida, V. The relative importance of social class and maternal education for breast feeding initiation. Public Health
Nutrition.2009; 12: 2285-2292.
[8] Wilson, F et al. 2006. Can easy-to-read immunizations information increase knowledge in urban low-income mothers? Journal of
Pediatric Nursing 21, pp. 4–12.
[9] Sleath, B et al. 2006. Literacy and perceived barriers to medication taking among homelessmothers and their children. Am J Health-
Syst Pharm 63, pp. 346-351?

Abstract: Carotid stenosis is a major sequela of head and neck irradiation that has not received the attention it deserves. Its impact on the quality of life of patients can be substantial. This review discusses the incidence of radiation induced carotid stenosis and its role in prediction of stroke .Atherosclerotic changes of the common carotid artery(CCA) may appear like irregularities of the intima-media thickness (IMT) in B-mode ultrasound. Early detection can help to decrease or slow down the rate of prognosis of atherosclerosis and this can improve the quality, and increase the length of patient's life. The incidence of significant increase in carotid IMT following head and neck irradiation is seen. Patients with carotid stenosis are at increased risk for stroke. In this study, subjects with any other major risk factor for atherosclerosis and previous history of cerebrovascular accidents were excluded.

Key words: Ultrasound, Carotid stenosis, Neck irradiation, Atherosclerosis, Intima-media, cerebrovascular accidents

[1] S.C. Elerding, R. N. Fernandez , J. C. Grotta , R.D. Lindberg, L.C. Causay, M. J. McMurtrey, Carotid artery disease following
external cervical irradiation, Ann Surg,. 194 (5 ),1981,609-15.
[2] Framingham Heart Study: www.framinghamheartstudy.org.
[3] K. Abayomi Olubunmi, Neck irradiation, carotid injury and its consequences, Oral Oncol., 40, 2004, 872–8.
[4] L. E. Chambless, A. R. Folsom, L. X. Clegg, et al., Carotid wall thickness is predictive of incident clinical stroke: The
Atherosclerosis risk in communities (ARIC) study, Am. J. Epidemiol., 151, 2000, 478-87.
[5] M. L. Bots, A. W. Hoes, A. Hofman , J C M Witteman, D. E. Grobbee, Cross-sectionally assessed carotid intima–media thickness
relates to long-term risk of stroke, coronary heart disease and death as estimated by available risk functions, Journal of Internal
Medicine, 245, 1999, 269–276.
[6] L. J. King, S. N. Hasnain, J. A. W. Webb, J. E. Kingston, E. A. Shafford, T. A. Lister, J. Shamash, R. H. Reznek, Asymptomatic
carotid arterial disease in young patients following neck radiation therapy for hodgkin lymphoma, Radiology, 213, 1999, 167–172.
[7] N. M. C. So, W. W. M.Lam, P. Chook, et al., Carotid intima–media thickness in patients with head and neck irradiation for the
treatment of nasopharyngeal carcinoma, Clin. Radiol., 57, 2002, 600–3.
[8] M. Shariat, A. Alias, B. M. Biswal, Radiation effects on the intima media thickness of patients with head and neck malignancy the
common carotid artery in post-radiotherapy, Postgrad. Med. J., 84, 2008, 609-612.

Abstract: Calvarial tuberculosis is a rare manifestation of extra pulmonary tuberculosis. Primary calvarial tuberculosis, with no evidence tuberculosis elsewhere in the body is a rarer entity. We discuss the clinical presentation and management of two such patients subjected to investigations for any evidence of tuberculosis elsewhere in the body. Radiological images including CT scan and MRI of the brain were utilized. Histopathological examination of the granulation tissue and lytic bone established this diagnosis. A prompt surgery and anti tubercular therapy planned for patients and improved after a year. Early diagnosis and appropriate management plan of calvarial tuberculosis require high index of suspicion and knowledge. Radiological investigations help in diagnosis and preoperative planning in such cases. Definitive diagnosis is established with demostration of acid fast bacilli (AFB), culture and sensitivity, and histopathological examination. Prompt surgery and antitubercular therapy are the treatment of choice .

Keywords: Calvarium , tuberculosis, anti tubercular therapy

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[5] Mohanty S, Rao CJ, Mukherjee KC. Tuberculosis of the skull. International Surgery. 1981; 66:81–83
[6] Batuk Diyora, Rajiv Kumar, Rahul Modgi, Alok Sharma: A report of eleven patients. Neurology India, Sep-Oct 2009,Vol 57, issue
5, 607-612.
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Neurosurgery, 1989; 25:830-3.
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Neurosurgery, 1990; 26:851-5.
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Journal Neurosurgery. 1996; 10:399‑401.

Abstract: Background- Defective sperm function is the most common cause of infertility. There is growing evidence that damage to spermatozoa by Reactive Oxygen Species(ROS) play a key role in male infertility. Oxidative stress is a common pathology seen in approximately half of all infertile men. Mammalian spermatozoa are rich in poly unsaturated fatty acids (PUFA) and are very susceptible to attack by ROS, leading to a chain of chemical reactions called lipid peroxidation (LPO). Malondialdehyde (MDA), an end product of lipid peroxidation represents level of lipid peroxidation.
Keywords: Reactive Oxygen Species (ROS) Malondialdehyde (MDA), male infertility.

[1] Sikka S C. Oxidative stress and role of antioxidants in normal and abnormal sperm function. Front Biosci 1996;1:78-86.
[2] Pasqualotto F F, Sharma R K, Nelson D R, Thomas A J, Agarwal A. Relationship between oxidative stress, semen characteristics,
and clinical diagnosis in men undergoing infertility investigation. Fertil Steril 2000;73:459-464.
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in male infertility. Hum Reprod 1993;9:2044-2050.
[4] Keskes-Ammar L, Feki-Chakroun N, Rebai T, Sahnoun Z, Ghozzi H, Hammami S, et al. Sperm oxidative stress and the effect of an
oral vitamin E and selenium supplement on semen quality in infertile men. Arch Androl 2003;49(2):83-94.
[5] Zarghami N, Khosrowbeygi A. Seminal plasma levels of 15-F2α-isoprostane, malondialdehyde and total homocysteine in
normozoospermic and asthenozoospermic males. Ind J Clin Biochem 2005;20(2):86-91.
[6] Hsieh Y, Chang C, Lin C. Seminal malondialdehyde concentration but not glutathione peroxidase activity is negatively correlated
with seminal concentration and motility. Int J Biol Sci 2006;2(1):23-29.
[7] Nouri M, Gasemzadeh A, Farzadi L, Shehnazi V. Diagnostic value of non-enzymatic antioxidant capacity and rate of lipid
peroxidation in plasma semen and spermatozoa of asthenozoospermic infertile males. Med J Tab Uni Med Sci 2008;29(4):17.
[8] Saraniya A, Koner B C, Doureradjou P, Selvaraj N, Shivagourou V. Altered malondialdehyde, protein carbonyl and sialic acid
levels in seminal plasma of microscopically abnormal semen. Andrologia 2008;40:56-57.
[9] Yadav S B, Suryakar A N, Huddakar A D, Durgawale P P, Shukla P S. Antioxidant treatment a new therapeutic approach to
reversible male infertility. Biomed Resear 2006;17(3):175-178.
[10] Suleiman S A, Ali M E, Zaki Z M S, El-Malik E M A, Nasr M A. Lipid peroxidation and human sperm motility: protective role of
vitamin E. J Androl 1996;17(5):530-537.

Abstract: Contralateral metastasis in head and neck cancer is concern with its dreaded disease. Questions arise frequently of performing contralateral neck dissection simultaneously or allow time to elapse before second neck dissection, in apprehension of safety. The procedure Simultaneous bilateral neck dissection (SNBD) is indicated for patients with bilateral cervical lymph node metastases so situated that a two stage radical neck dissection could not be done without cuffing through cancer tissue.

KEY WORDS: Carcinoma, midline, contralateral, simoultanous, neck dissection

[1] Perzik S. L. One-stage bilateral radical neck dissection. California medicine 78(4), 1953, 288-292.
[2] Feind C R, Cole R. M. Contralateral spread of head & neck cancer. Am Jr of Surg. 118, 1969, 660-665.
[3] Razack M. S., Baffi R., Sako K. Bilateral radical neck dissection. Cancer 47(1), 1981, 197–199.
[4] Koo BS, Lim YC, Lee JS, et al: Management of contralateral N0 neck in oral cavity squamous cell carcinoma. Head Neck 28,2006,
896-901.
[5] Capote-Moreno A, Naval L, Muñoz-Guerra MF, et al. Prognostic factors influencing contralateral neck lymph node metastases in
oral and oropharyngeal carcinoma. J Oral Maxillofac Surg. 68(2), 2010, 268-75.
[6] Kurita H, Koike T, Narikawa J, et al: clinical predictor for contralateral lymph node metastasis from unilateral squamous cell
carcinoma in the oral cavity. Oral Oncol 40, 2004, 898-900.
[7] Kowalski LP, Bagietto R, Lara JRL, et al: Factor influencing contralateral lymph node metastasis from oral carcinoma. Head Neck
21, 1999,104-106.
[8] Chow TL, Chow TK, Chan TTF, et al: Contralateral neck recurrence of squamous cell carcinoma of the oral cavity and
oropharynx. J oral Maxillofac Surg 62, 2004, 1225-28.
[9] Martin. H., Del. Valle. B., Ehrlish H., Chan W.G.,Neck dissection, Cancer 4,1951,441-499.
[10] Brown, B., and McDowell, F, Neck dissections for metastatic carcinoma, Surg., Gynec. & Obst. 79,1944,115-124.

Abstract: Background- Hypertension and Diabetes are known to have autonomic dysfunction and indices of heart rate variability provide window to understand the autonomic modulation of cardio respiratory systems. Hypothesis- Co existing morbidity in Hypertensive diabetic group will cause enhancement of autonomic dysfunction.
Keywords: valsalva ratio,HRV,autonomic functions,frequency analysis

[1] M Epstein and JR Sowers. Diabetes mellitus and hypertention. Hypertension. 1992;19:403-418.
[2] Pikkujämsä SM, Huikuri HV, Airaksinen KE, Rantala AO, Kauma H, Lilja M, Savolainen MJ, Kesäniemi YA. Heart rate
variability and baroreflex sensitivity in hypertensive subjects with and without metabolic features of insulin resistance syndrome.
Am J Hypertens. 1998 May;11(5):523-31.
[3] Jeanet Gerritsen, MSC1, Jacqueline M, Dekkar, PHD2, Ben J, TenVoorde, PHD1, Piet J. Kostense, PHD3, Robert J. Heine, MD2, Lex M. Bouter, PHD2, Rob M,PHD1 and Coen D.A. Stehouwer, MD2. Impaired Autonomic Function Is Associated With Increased
Mortality, Hypertension or history of Cardiovascular Disease. Diabetes Care. October 2001 vol. 24 no. 10 1793-1798.
[4] Dr J. M. Karemaker, Heart Rate Variability:why do spectral analysis? 1996.
[5] 5) Singh JP, Larson MG, Tsuji H, Evans JC, O'Donnell CJ, Levy D. Reduced heart rate variability and new-onset hypertension:
insights into pathogenesis of hypertension: the Framinggam Heart Study. Hypertension. 1998;32:293- 297.
[6] KASER, HAUSER, LONGO, JAMESON. Harrison's Principle of Internal Medicine(16th. Edition)- volume 2, BRAUNWALD,
FAUCI: Mc Graw-Hill-Medical Publishing Division,New Delhi, India: 28, 43, 44, 234, 422, 571, 1423, 2074, 2201, 2209, 2294,
2295, 2428-2432.
[7] Ewing DJ, Borsey DQ, Bellavere F and Clarke BF: Cardiac autonomic neuropathy in diabetes comparision of measures of RR
interval; variation, Diabetologia, 1981;21:18-24.
[8] Hutchison's Clinical Method by Michael Swash(25th edition),ELBS-Great Britain:Page no. 326-327.
[9] 9)Ewing DJ; Analysis of heart rate variability and other non invasive tests with special reference to diabetes mellitus, Autonomic
failure A Textbook of Clinical Disorders of the Autonomic Nervous Ststem, Banniste R and Mathias CJ: oxford University Press
inc, New York, 1992; (3rd edition), Page no. 312-333.
[10] Autonomic Function Testing- Clinical and examples by Alejandro Ortiz-Burgos, M.D-University of Miami, Internal Medicine, 27th June 2006.

Abstract: Birth weight is the single most important criteria for determining the neonatal and infant survival. Low Birth Weight is the result of complex interplay of various social and reproductive health factors. A cross-sectional community based retrospective study was carried out in rural West Bengal among 540 birth episodes. Proportion of low birth weight infants were found significantly more among mothers elderly & teenaged, less educated, addicted to tobacco, Multipara and primipara, received less antenatal care, female infants, delivered at home, short stature, anaemic and had obstetric complications. Focused attention to reduce low birth weight babies, community specific strategies such as improving awareness of the community and utilization of existing maternal health services is essential.

Keywords: Biological factors, Low Birth Weight, Rural Community, Social factors.

[1] H.Phung ,A. Bauman,T.V..Nguyen, L.Young, M. Tran ,K. Hillman. Risk factors for low birth weight in a socio-economically
disadvantaged population: Parity, marital status, ethnicity and cigarette smoking. European Journal of Epidemiology 18(3):235-43.
[2] Park K. Maternal and child health in "Text book of Preventive and Social Medicine‟. Jabalpur, India, 20 th edition Banarasidas
Bhanot 2009: 460.
[3] R. Biswas, A. Dasgupta, R.N.Sinha, R.N.Chaudhury. An Epidemiological study of Low Birth Weight Newborns in the district of
Puruliya, West Benngal. Indian J Public Health Apr-Jun 2008;52(2):65-71.
[4] UNICEF (2009), State of world‟s children, 2009.
[5] Wardlaw T, Blane A, Ahman E. Country regional and global estimate. New York; United Nations' Children Emergency Fund and
WHO;2004.
[6] K. P.Stillerman, D.R.Mattison, L.C.Giudice, T.J.Woodruff. "Environmental exposures and adverse pregnancy outcomes: a review
of the science." Reproductive Sciences 2008, 15(7):631-50.
[7] V. S. Dogra, S Bhatt. "Intrauterine growth retardation".2005.[accessed online on http:// emedicine.medscape.com\article\404098].
[8] Roudbari M, Yaghmaei M, Soheili M. Prevalence and risk factors of low birth weight infants in Zahedan, Islamic Republic of Iran.
East Mediterr Health J 2007, 13:838-45.
[9] Watson Jone D, Weiss H A, Changalucha J M, Todd J, Gumoduka B, Bulmer J et al. Adverse birth outcomes in United Republic of
Tanjania-impact and prevention of maternal risk factors. Bull World Health Organ 2007;85:9-18..
[10] Redek B, Gordan C S Smith, Fergal D M, Robert H B, David A N, Christine H C et all. Fetal growth in early pregnancy and risk of
delivery of low birth weight infant: Prospective cohort Study. B M J 2007 April 21;334(7598):836.

Abstract: Oxidative stress which influences the glucose profile & lipid profile in diabetic patients. Patient with diabetes may also prominent to the symptoms that are repercussion upon the altered glucose & lipid profile levels. The study shows that, comparision of glucose & lipid profiles variations in oxidative stress contain diabetic patients.
Keywords: Fbs, PPbs, lipid profiles (total cholesterol, HDL, LDL, VLDL, TGL).

REFERENCE FOR ESTIMATION OF GLUCOSE
[1] Estimation of glucose by the method of GOD-POD. [Trinder, P. (1969, Annals. Clin. Bio Chem, 6, 24].
REFERENCE FOR ESTIAMTION OF CHOLESTEROL
[2] Schettler, G. and Nussel, E., Arb. Med, soz. Med. 10, 25 (1975).
[3] Richmond, W., Clin. Chem. Clin. Biochem. 12, 403 (1973).
[4] Rochalu, p. et al, J. Clin. Chem. Clin. Biochem. 12, 403 (1974).
REFERENCE FOR ESTIMATION REDUCED GLUTATHIONE
[5] Estimation of erythrocyte glutathione. [Teitz, Biochemical aspects of Haematology, 1652-1653].

Abstract: Cornual ectopic pregnancy remains a rarity among ectopic pregnancies with higher mortality rates due to rupture & late diagnosis. We are reporting a case of rupture cornual ectopic pregnancy, with no risk factors identified & a delayed presentation. Patient presented with complaints of pain abdomen and vomiting & syncopal attacks of 4 days duration. Case was diagnosed using bedside USG. Emergency laparotomy was done & left ruptured cornual ectopic pregnancy was seen with hemoperitoneum. Left salpingectomy was done. Case was revived with 4 units of intra & post op transfusions. This is to emphasize that all women in reproductive age group with symptoms least suggestive of ectopic pregnancies should be evaluated until proved otherwise & the suspicion for ectopic pregnancy be continued.

Key words: Cornual ectopic pregnancy, low risk group, institutional care, mortality.

[1] Williams Text book of Obstetrics 23rd edition pg no: 239.
[2] Takei T, Matsuoka S, Ashitani N, Makihara N, Morizane M, Ohara N, PMID:
[3] 19688960, [PubMed - indexed for MEDLINE]
[4] Tulandi T. Incidence, risk factors, and pathology of ectopic pregnancy. http://www.uptodate.com/index. Accessed Nov. 14, 2011.
[5] Faraj R, Steel M. Management of cornual (interstitial) pregnancy. The Obstetrician & Gynaecologist 2007: 9 :249-255.
[6] Brewer H, Gefroh S, Munkarah A, Hawkins R, Redman ME, J Reprod Med. 2005 Sep;50(9):715-8.

Abstract: Tuberous sclerosis is a neurocutaneous autosomal-dominant disorder, presents with highly variable clinical manifestation and affects multiple organ system. Its manifestation in neonate is poorly described. We report a case of intractable neonatal seizure with multiple hypopigmented patch. Neuroimaging of brain shows classical cortical tubers and subependymal nodule suggestive of tuberous sclerosis in newborn. Hence tuberous sclerosis should be considered as an etiology of neonatal seizure and neuroimaging should be performed when other common causes of neonatal seizure have been excluded.

Keywords: Neonatal seizure, Neuroimaging,Tuberous sclerosis

[1] John H. Menkes, Harvey B. Sarnat, Bernard L. Maria Neurocutaneous syndrome, Child neurology 7th edition,(California, Williams
and willkins 2006),
[2] Miller SP, Tasch T, Sylvian M, Farmer JP, O'Gorman AM, Shevell MI. Tuberous sclerosis complex and neonatal seizures. J Child
Neurol,13(12), 1998 Dec,619-23
[3] Mustafa Sahin,Tuberous Sclerosis,Nelson Textbook of Pediatrics,19th edition (India:Elsevier, 2012)2049-2051
[4] Isaacs H, Perintal (fetal and neonatal) tuberous sclerosis: a review, Am J Pernatol.26(10), 2009 Nov,755-60