iosr-JDMS   Volume-5 ~ Issue-3

Abstract: Fournier's gangrene is one of the infectious and gangrenous diseases seen worldwide ,It is commonly reported in Adult males but also in females. Injuries are nidus to its pathogenesis and many-microbes have been cultured from this clinical entity .This reported case was an incidental presentation resulting from obstetric care given by an unskilled personnel to a high risk pregnancy at term in prolonged labor. The case therefore avails clinician and pediatricians with the opportunity of seeing a rare adult tropical disease of the scrotum in a neonate. A fourteen day old term male baby presented with multiple perineal lacerations from delivery by a traditional birth attendant to the Surgery Unit. Perineum with scrotum and penis inclusive were noticed to be gangrenous .He was manage by debriment of necrotic tissue ,wound dressings , antiseptic solutions (gentian violent ,diluted H2O2)as well as intravenous antibiotics (ceftriaxone,ciprofloxacin, metronidazole,cloxacillin) ,syrup paracetamol and syrup camoquine ,however during the course of management ,parent had financial constraints . Fournier's gangrene are rare phenomenon in neonates ,and could be a complication that may arise from poor resource countries or communities where traditional birth attendants and their practices strives.

Keywords: Fournier's gangrene, traditional birth attendant, tropical disease, antibiotics, debriment.

[1]. Corman JM. Classic articles in colonic and rectal surgery. Dis Colon Rectum. 1988;31:984-8. [2]. Atil Ç, Volkan G , Cihangir A, Ayhan K H and Selçuk M. H; Fournier's gangrene: Is it scrotal gangrene? Advances in Therapy, Volume 25, Number 10 (2008), 1065-1074, DOI: 10.1007/s12325-008-0103-1 .
[3]. López PJ C, Sánchez M JM, Piñeiro F MC, Bouso M M, Parra M L, García A J ;Fournier's gangrene secondary to urethral catheterization. Arch Esp Urol. 2005 Mar;58(2):167-70.
[4]. Basoglu M, Ozbey I, Atamanalp SS, Yildirgan MI, Aydinli B, Polat O, Ozturk G, Peker K, Onbas O, Oren D. Management of Fournier's gangrene: review of 45 cases. Surg Today. 2007;37(7):558-63. Epub 2007 Jun 26.
[5]. Lamerton A.J. : Fournier's gangrene: non-clostridial gas gangrene of the perineum and diabetes mellitus.J R Soc Med. 1986 April; 79(4): 212–215. PMCID: PMC1290277
[6]. McKay TC, Waters WB: Fournier's gangrene as the presenting sign of an undiagnosed human immunodeficiency virus infection. J Urol. 1994 Nov;152(5 Pt 1):1552-4. PMID:7933199
[7]. Darke SG, King AM, Slack WK :Gas gangrene and related infection; classification, clinical features and aetiology, management and mortality. A report of 88 cases.Br J Surg. 1977 Feb;64(2):104-12. [8]. Clayton MD, Fowler JE Jr, Sharifi R, Pearl RK. Causes, presentation and survival of fifty-seven patients with [9]. Gamagami RA, Mostafavi M, Gamagami A, Lazorthes F. Fournier's gangrene: an unusual presentation for rectal carcinoma. Am J Gastroenterol. Apr 1998;93(4):657-8. [Medline]. [10]. Vernon M Pais Jr, Bradley F. S., Thomas Santora, Daniel B Rukstalis: Andrew A Aronson,Alex Jacocks, Richard Lavely,Eric L Legome, Michael T Marynowski, David L Morris,Erik D Schraga, Richard H Sinert, Francisco Talavera, Todd Thomsen: Fournier Gangrene ,Medscape reference,Drug ,Disease,Procedure,up-dated,8 Dec 2011.

Abstract: We present a case of dengue febrile illness as expanded dengue spectrum,with symptoms of overt hyperthyroidism without ophthalmopathy & other stigmatas of Graves' disease including antithyroid antibodies. This atypical presentation of non- goitrous, non ophthalmic Graves' disease as an etiology of overt thyrotoxicosis is aided by performing technetium 99 scan study differentiating this atypical Graves disease' from thyroiditis &/or toxic thyroid nodule.

Key words : Dengue fever , Overt thyrotoxicosis, Graves'disease , expanded dengue syndrome.

[1]. WHO: Comprehensive guidelines for prevention and control of dengue and dengue hemorrhagic fever. World Health Organization, Regional Office for South-East Asia; 2011.
[2]. Brent GA. Clinical practice Graves' disease. NEJM.2008; 358 :2594–05.
[3]. Hegazi M O and Ahmed S. Atypical Clinical Manifestations of Graves' Disease:An Analysis in Depth. Journal of Thyroid Research. 2012; Article ID 768019.
[4]. Gianoukakis A G, Leigh M J, Richards P et al. Characterization of the anaemia associated with Graves' disease.Clinical Endocrinology. 2009;70 ( 5 ): 781–87.
[5]. Hegazi M O and El-sonbaty M R. Unusual presentations of hyperthyroidism. Handbook of Hyperthyroidism: Etiology,Diagnosis and Treatment.2011;265–70.
[6]. Maheshwari A and Thuluvath P J. Endocrine diseases and the liver. Clinics in Liver Disease.2011;15: 55–67.
Expanded Dengue Syndrome : Presenting as Overt Thyrotoxicosis without stigmata of Graves'
www.iosrjournals.org 6 | Page
[7]. Malik R and Hodgson H. The relationship between the thyroid gland and the liver.QJM.2002;95:559–69.
[8]. Owen P J, Baghomian A, Lazarus J H, and Godkin A J. An unusual cause of jaundice. BMJ.2007;335: 773–74.
[9]. Dengue cases double, deaths rise four times.Published: Sunday, Mar 25 , 8:00 IST.By Rito Paul /Place:Mumbai/Agency:DNA http://www.dnaindia.com/mumbai/report_dengue-cases-double-deaths-rise-four-times_1667057
[10]. Pearce EN. Clinical Review.Diagnosis and management of thyrotoxicosis.BMJ.2006;332:1369-73.

Abstract: It is the norm/belief that being in the upper socio-economic class parallels a higher quality of life. In 2008, during the Medical outreach of the annual Health week held by the Igbinedion University medical students' Association, this hypothesis was tested.

Key words: Quality of Life(QOL), Igbinedion University, SF-12, students, Association

[1]. Mainous.A.G. 3rd, Kohrs.F.P ; A comparison of Health status between rural and urban adults. J comm. Health;1995;20(5); 423-431
[2]. Suni Lee;Marital Status,Gender and Subjective Quality of life in Korea;Development and Society;1998;27(2);35
[3]. Oninla S, Owa J, Onayade A, Taiwo O: Comparative study of Nutritional status of urban and rural Nigerian School children. J Trop pediatr;2007;53(1);39-43
[4]. World Health Organisation ;WHOQOL study protocol; 1993;WHO (MNH 7PSF/93.9)
[5]. World Health Organisation;WHOQOL-BREF; Introduction, Administration, Scoring and Generic version of the assessment (Field Trial version);1996;1-18
[6]. Gregory.D.,Johnston.R.,Pratt.G. et al;eds;"Quality of Life"; Dictionary of Human Geography (5th ed); Oxford: Wiley-Blackwell;2009;ISBN 978-1-4051-3287-9.
[7]. University of Toronto Quality of Life Research Unit:"Quality of Life: How Good is Life for You?";Retrieved October 14,2009.
[8]. The World Bank;"The World Bank";2009;Retrieved 2010-11-02
[9]. The World Bank;Poverty-Overview;Retrieved October 20,2009
[10]. Mehrdad.M.;Subjective well being,Depression,Anxiety and Stress Ratings;A comparison of Healthy and Unhealthy Students;WHOQOL-BREF and DASS-42

Abstract: Periodontal attachment loss in the maxillary anterior region can often lead to esthetic and functional clinical problems including disproportional and elongated clinical crowns and visible interdental embrasures. Gingival replacement prosthesis have historically been used to replace lost tissue. An acrylic resin gingival veneer is an easily constructed, inexpensive, and practical device to optimize the esthetic and functional outcome in these special situations while permitting cleansibility of the prosthesis and supporting tissues. This is a case report of a young female patient treated using an acrylic gingival veneer with a two-year follow-up. The acrylic gingival mask, has enabled the patient to regain her lost smile and face people with newly found confidence also enhancing the esthetic appearance. Virtually no problem was encountered during the two years of usage of the veneer and the patient continues to use it comfortably.

Key Words: Periodontal attachment, gingival replacement, esthetic, gingival veneer

[1]. Studer S, Naef R, Scharer P. Adjustment of localized alveolar ridge defects by soft tissue transplantation to improve
muco-gingival aesthetics: A proposal for clinical classification and an evaluation of procedures. Quintessence Int 1997;28:785-805
[2]. Greene PR.: The flexible gingival mask: an esthetic solution in periodontal practice. Brit Dent Jour. 1998; 11(184): 536-
40.
[3]. Ellis SGS., Sharma P. and Harris IR.: Case report: Aesthetic management of localized periodontal defect with a gingival
veneer prosthesis. Eur J Prosthodont Rest Dent. 2000; 8(1): 23-26.
[4]. Nair C. and Dange SP.: Aesthetic management of gingival recession – A flexible gingival mask. Jour of Indian Prosth
Society. 2003; 3(1):34-35.
[5]. Wray D. & McCord J F.: Labial veneers in the management of Desquamative gingivitis. Oral Surg. Oral Med. Oral Pathol.
1987; 64: 41-42.
[6]. Materdomini D. and Friedman MJ.: The contact lens effect: Enhancing porcelain veneer esthetics. Journal of Esthetic
Dent. 1995; 7(3): 99-103.
[7]. Friedman MJ.: Augmenting restorative dentistry with porcelain veneer. JADA. 1991; 122: 29-34.
[8]. Chalian NA, Philips RW. Materials in maxillofacial prosthodontics. J Biomed Mat Res 2004;8:349-63.
[9]. Hummert TW, Kaiser DA. Block out technique for impression of teeth with increased open gingival embrasures. J Prosthet
Dent 1999;82:100-2. 5.

Abstract: The present paper aimed to overcome the Viral Pathology in the emerging Dengue Virus Epidemic. Since 2010 it is a second epidemic of dengue Fever (DF) and dengue Hemorrhagic fever (DHF) that has claimed over 300 lives in the Punjab area. There has been no set treatment protocol other than the World Health Organization (WHO) guidelines to treat this viral infection. Many physicians tried to follow the same and achieved some degree of success but unfortunately mismanagement of Dengue inflicted patients led to a high mortality. Malaysian physicians reported to have modified the WHO protocol to fit the needs of the local epidemic in 2009. However; the mainstay of the treatment was the balance of fluid dynamics of the patient's body. Unfortunately, the depleting platelets counts have been a media promoted scare of the dengue fever and dengue hemorrhage fever. The depleting Platelets count is not the only indication of the DF and DHF. However, its drastic reduction below 150,000 is the leading cause of bleeding (Internal & External) and eventual death. To date, the Pathophysiology that causes the symptoms of DF & DHF and the neurological deficits have been very poorly understood. Therefore, the treatment protocol presented by the WHO and the local medical practioners has been deemed partial or insufficient. Great number of patients has been seen with the recurrence of the dengue fever or incomplete treatment or the extensive dengue infection leading to bleeding, neurological deficit or directly comatose and death. Ever changing patient admission guidelines also led to the high risk of patient mortality. Therefore, the treatment protocol designed by us has successfully addressed the DF & DHF challenged patient population most effectively, resulting into no platelets transfusion and zero patient mortality. This unique project entertained 1298 patients from the greater community of city of Lahore. Majority of patients were seen as a direct visit to the UCH Dengue clinic, and many were received as a referral from other hospitals.

Keywords: Dengue Virus, Dengue Fever.

[1]. Dengue Report, World Health Organization, 2010.
[2]. Garg RK, V Atam , R V erma , P S harma, MK Singh and HS Mehrotra , 2011.Neurological complications of dengue fever: Experience from a tertiary center of north India. Ann Indian Acad Neurol. 2011 Oct;14(4):272-8
http://www.ncbi.nlm.nih.gov/pubmed/22346016/
[3]. Gov't of Punjab, Department of Health, Dengue Viral Epidemic 2011.
[4]. Plomp M, A McPherson and A. Malkin, 2002. Atomic Force Microscopy. AJP June 2002, Vol. 160, No. 6
[5]. Sheikh S. , 2012.Breakthrough Treatment of Hypertension, IOSR-JDMS: 2012 Sep-Oct, Vol 1, No. 5:33-38

Abstract: Lumbricals are very small muscles in the hand but their role is much more important for the fine movements of fingers. So any variation in the lumbrical muscles has great clinical significance. During routine dissection of the right hand of a 55 year old male Indian cadaver, an accessory belly to second lumbrical was observed while in the left hand no variation observed. This accessory belly united with the second lumbrical. This variation might be useful during the routine clinical practices and hand surgeries.

Keywords - Lumbrical, accessory belly, origin, flexor digitorum profundus, carpal tunnel syndrome.

[1] S. Standring, Gray's Anatomy: The anatomical basis of clinical practices, 40th Ed. Edinburgh: Churchill Livingstone Elsevier, 2008: 886. [2] H.J. Mehta and W.U. Gardner, A study of lumbrical muscles in the human hand, American Journal of Anatomy, 109, 1961, 227–238.
[3] R.A. Bergman, S.A. Thompson, A.K. Afifi, and F.A. Saadeh, Compendium of human anatomic variation, Munich, Urban and Schwarzenberg, 17, 1988, 13–14. [4] M.L. Ajmani, Morphological variations of lumbrical muscles in the human hand with some observations on its nerve supply, Iranian Red Crescent Medical Journal, 3, 2001, 20–25.
[5] P.R. Lipscomb, Duplication of hypothenar muscles simulating soft-tissue tumor of the hand - Report of a case, Journal of Bone and Joint Surgery (American Volume), 42, 1960, 1058-1061.

[6] A.W. Dunn, Anomalous muscles simulating soft-tissue tumors in the lower extremities - Report of three cases, Journal of Bone and Joint Surgery (American Volume), 47, 1965, 1379-1400.
[7] F. Braithwaite, G.D. Channel, F.T. Moore, and J. Whillis, The applied anatomy of the lumbrical and interosseous muscles of the hand, Guy's Hospital Reports, 97, 1948, 185–195.
[8] S.D. Joshi, S.S. Joshi, and S.A. Athavale, Lumbrical muscles and carpal tunnel, Journal of Anatomical Society of India, 54, 2005, 12-15.

[9] M.A. Entin, Carpal tunnel syndrome and its variants, Surgical Clinics of North America, 48, 1968, 1097-1112.

[10] T.K. Cobb, K.N. An, W.P. Cooney, and R.A. Berger, Lumbrical muscles incursion into the carpal tunnel during finger flexion, Journal of hand Surgery (British Volume), 19, 1994, 434-438.

Abstract: Amniotic band syndrome (ABS), also known as Streeter's dysplasia refers to a continuous spectrum of manifestations due to intra-uterine rupture of amnion.1 The manifestations range from simple soft tissue constrictive bands to amputation of digits or more severely the whole limb due to dysplastic vasculature.1The prevalence is estimated to be about 7.7/10,000 live births2 and as high as 178/10,000 among abortuses.3We herein present two cases of amniotic band syndrome seen at theNiger Delta University Teaching Hospital(NDUTH) with the aim of highlighting its existence in the State as well as throwing light on the prenatal diagnostic challenges and the socio-economic problems faced by families living with physical disabilities.

Key words: amniotic band syndrome, case, constriction band, ultra sound scan

[1]. Verma A, Mohan S, Kumar S. Late presentation of amniotic band syndrome. A case report. J Clin Diagnos Res 2007; 1(2): 65 – 68.
[2]. Buyse ML. Birth defects encyclopedia. Cambridge (MA): Black Well scientific publications: 1990.
[3]. Seeds JW, Cefalo RC, Herbert WNP. Amniotic band syndrome. Am J Obstet Gynecol 1982; 144: 243.
[4]. Editorial: Amniotic bands. Brit Med J. 1973; 3: 651 – 652.
[5]. Ambika H, Sinjatha C, Santhosh S. Amniotic bands with infantile digital fibromatosis. N Dermatol Online 2011; 2(4): 232 – 233.
[6]. Hata T, Tanaka H, Noguchi. 3D/4D sonographic evaluation of amniotic band syndrome in early pregnancy: a supplement to 2D ultrasound. J Obstet Gynaecol Res 2011; 37: 656 – 660.
[7]. Allington NJ, Kumar SJ, Guille JT. Clubfeet associated with congenital constriction bands of the ipsilateral loer extremity. J Pediatr Orthop 1995; 15(5): 599 – 603.
[8]. Nyberg DA, Mahony BS, Pretorius DH. Diagnostic ultrasound of fetal anomalies. Littleton (MA): Year book Medical publishers; 1990.
[9]. Oyinbo CA, Dare NW, Amain ED. Prevalence of polydactyly, syndactyly, amniotic band syndrome, cleft lip, cleft palate and talipes equinovarus in Bayelsa State, Nigeria. J Med Inf Biomet Epidemiol 2009; 5(2): 1 – 5.
[10]. Bakare TIB, Sowande OA, Adejuyigbe OO, Chinda Y, Usang UE. Epidemiology of external birth defects in neonates in Southwestern Nigeria. Afr J Paediatr Surg 2009; 6(1): 28 – 30.

Abstract: Root resorption is a dental complication caused by dental trauma, surgical procedures, excessive pressure or irritation from bleaching agents that can lead to loss of tooth. This paper presents a case of internal resorption in maxillary central incisor and demonstrates the use of MTA as filling material

[1]. Wedenberg C, Lindskog S. Experimental internal resorption in monkey teeth. Endod Dent Traumatol 1985;1:221–7.

[2]. Tronstad L. Root resorption--etiology, terminology and clinical manifestations.Endod Dent Traumatol 1988;4:241–52.

[3]. Ingle JI, Bakland LK. Endodontics. 5th ed. Hamilton: BC Decker; 2002:138 –9.

[4]. Gartner AH, Mack T, Somerlott RG, Walsh LC. Differential diagnosis of internal and external root resorption. J Endod 1976;2:329 –34.

[5]. Andreasen JO. Traumatic injuries of the teeth 2nd ed. Copernhagen, Denmark: Munksgaard International Publisheers; 1981:193.

[6]. Torabinejad M, Hong CU&Pitt Ford TR. Physical properties of a new root end filling material. J Endod 1995; 21: 349–53.

[7]. . Al- KahtaniA, ShostadS, SchifferleR, BhambhaniS. In- vitro evaluation of microleakage of an orthograde apical plug of mineral trioxide aggregate in permanent teeth with simulated immature apices. J Endod 2005; 31:117– 9.

[8]. Mitchell PJ, PittFord TR, Torabinejad M, McDonald F.Osteoblast biocompatibility of minera ltrioxide aggregate. Biomaterials 1999; 20: 167– 73.

[9]. TorabinejadM, HigaRK, McKendryDJ, PittFordTR. Dye leakage of four root end filling materials: effects of blood contamination. J Endod 1994; 20:159– 63.

[10]. Culbreath TE, Davis GM, West NM, Jackson A. Treating internal resorption using a syringeable composite resin. J Am Dent Assoc 2000; 131, 493–5.

Abstract: ERM (ezrin/radixin/moesin) proteins, concentrated in actin rich cell-surface structures, cross-link actin filaments with the plasma membrane. Recent work using genetic approaches has revealed a surprising wealth of phenotypes and functions for ERMs in the context of both normal tissues and disease states. Such a wide array of phenotypes, from loss of epithelial integrity to disruption of embryonic anterior–posterior polarity, seems to suggest a wide range of molecular functions. They are involved in the formation of microvilli, cell-cell adhesion, maintenance of cell shape, cell motility, membrane trafficking and metastasis. The functions of ERM proteins are regulated by their conformational changes: the intramolecular interaction between the N- and C-terminal domains of ERM proteins masks several binding sites, leading to a dormant protein. Different activation signals regulate ERM proteins functions by modulating these intramolecular interactions.

Key words: Ezrin, Radixin, Moesin, Cytoskeleton, Membrane Dynamics, Metastas

[1] Funayama, N., Nagafuchi, A., Sato, N., Tsukita, S., (1991). Radixin is a novel member of the band 4.1 family. J. Cell Biol. 115, 1039–1048.
[2] Sato, N., Funayama, N., Nagafuchi, A., Yonemura, S., Tsukita, S., (1992). A gene family consisting of ezrin, radixin and moesin. Its specific localization at actin filament/plasma membrane association sites. J. Cell Sci. 103, 131–143.
[3] Turunen, O., Wahlstrom, T. & Vaheri, A. (1994) Ezrin has a COOH-terminal actin-binding site that is conserved in the ezrin protein family. J. Cell Biol. 126, 1445–1453.
[4] Gary, R. & Bretscher, A. (1995) Ezrin self-association involves binding of an N-terminal domain to a normally masked C-terminal domain that includes the F-actin binding site. Mol. Biol. Cell 6, 1061–1075.
[5] McCartney, B. M. & Fehon, R. G. (1996) Distinct cellular and subcellular patterns of expression imply distinct functions for the Drosophila homologues of Moesin and the neurofibromatosis 2 tumor suppressor, Merlin. J. Cell Biol. 133, 843–852.
[6] Yang, H. S. & Hinds, P. W. (2003) Increased Ezrin expression and activation by CDK5 coincident with acquisition of the senescent phenotype. Mol. Cell 11, 1163–1176.
[7] Pearson, M., Reczek, D., Bretscher, A. & Karplus, P. (2000) Structure of the ERM protein moesin reveals the FERM domain fold masked by an extended actin binding tail domain. Cell 101, 259–270.
[8] Krieg, J. & Hunter, T. (1992) Identification of the two major epidermal growth factor-induced tyrosine phosphorylation sites in the microvillar core protein ezrin. J. Biol. Chem. 267, 19258–19265.
[9] Yonemura, S. et al. (1998) Ezrin/radixin/moesin (ERM) proteins bind to a positively charged amino acid cluster in the juxta-membrane cytoplasmic domain of CD44, CD43, and ICAM-2. J. Cell Biol. 140, 885–895.
[10] Weinman, E. J., Hall, R. A., Friedman, P. A., Liu-Chen, L. Y. & Shenolikar, S. (2006) The association of NHERF adaptor proteins with G protein-coupled receptors and receptor tyrosine kinases. Annu. Rev. Physiol. 68, 491–505.

Abstract: BACKGROUND & OBJECTIVES: Abnormal uterine bleeding is the most common complaint in gynaecology and an important source of morbidity. This study evaluates the role of hysteroscopy in the diagnosis of Abnormal Uterine Bleeding and its correlation with histopathological findings. METHODS: 50 patients with AUB who got admitted at Dr. PSIMS & RF in the Department of Obstetrics and Gynaecology were subjected to panoramic hysteroscopy and subsequent Dilatation and Curettage. Data was collected and analysed. RESULTS: AUB was more common in 30-39 yrs. The most common presenting complaint was Menorrhagia. Negative hysteroscopic view was seen in 54% cases. Abnormalities seen were: endometrial hyperplasia, polyps, submucous myoma and endometrial atrophy. Both hysteroscopy and curettage were accurate when an abnormality was diagnosed, giving a specificity of 96.15% and positive predictive value of 96.65%. But the ability to diagnose a lesion (sensitivity) was more with hysteroscopy in comparison to curettage. Hysteroscopy revealed more information than curettage 12% and curettage had more in 6% cases. INTERPRETATION & CONCLUSION: This study confirms the conclusion of many others that hysteroscopy is superior to Dilatation and Curettage in evaluating patients with Abnormal Uterine Bleeding.

Keywords: Hysteroscopy, D&C, Abnormal Uterine Bleeding, Histopathology.

[1]. Tahir MM, Biqriqq MA, Browning JJ, et al. A randomized controlled trial comparing transvaginal ultrasound, outpatient hysteroscopy and endometrial biopsy with inpatient hysteroscopy and curettage. Br J Obstet Gynaecol. 1999;106:1259–64.
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[4]. Hamou JE. Microhysteroscopy: a new procedure and its original applications in gynecology. J Reprod Med. 1981; 26:375–82.
[5]. Pasqualotto EB, Margossian H, Price LL, et al. Accuracy of preoperative diagnostic tools and outcome of hysteroscopic management of menstrual dysfunction. J Am Assoc Gynecol Laparosc. 2000;7:201–9.
[6]. Baggish MS, Barbot J. Contact hysteroscopy. Clin Obstet Gynecol. 1983;26:219–41.
[7]. Bhattacharya BK. Hysteroscopy for gynaecologic diagnosis J Obstet Gynecol India. 1992;42:373–5.
[8]. Valle RF, Illinois C. Hysteroscopic evaluation of patients with abnormal uterine bleeding. Surg Gynecol Obstet. 1981;153:521–6.
[9]. Cicinelli E, Romano F, Anastasio PS, et al. Sonohysterography versus hysteroscopy in the diagnosis of endouterine polyps. Gynecol Obstet Invest. 1994;38:266–71

Abstract: Introduction: Historically, countless compounds in aqueous solution have been suggested as root canal irrigants. MTAD shows promise as an endodontic irrigant but there are very few studies comparing its antimicrobial effectiveness with NaOCl and Chlorhexidine. Objectives: To compare the antibacterial efficiency of MTAD, 2.5% Sodium Hypochlorite and 2% Chlorhexidine root canal irrigants against Enterococcus faecalis in root canals of single rooted mandibular premolars.

Keywords: Chlorhexidine; Enterococcus faecalis; Irrigants; MTAD; Sodium Hypochlorite

[2]. Siqueira JF Jr, Lima KC, Magalhaes FA , Lopes HP D. Mechanical reduction of the bacterial population in the root canal by three instrumentation techniques. Journal of Endodontics, 25(5), 1999, 332-5.
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[4]. Kuruvilla JR, Kamath MP. Antimicrobial activity of 2.5% sodium hypochlorite and 0.2% chlorhexidine gluconate separately and combined, as endodontic irrigants. Journal of Endodontics, 24(7), 1998, 472-6.
[5]. Svec TA, Harrison JW. Chemo-mechanical removal of pulpal and dentinal debris with sodium hypochlorite and hydrogen peroxide vs normal saline solution. Journal of Endodontics, 3(2), 1977, 49–53.
[6]. Gulabivala K, Patel B, Evans G, Ng YL. Effects of mechanical and chemical procedures on root canal surfaces. Endodontic Topics, 10, 2005, 103–22.
[7]. Zehnder M. Root Canal Irrigants. Journal of Endodontics, 32(5), 2006, 389–398.
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Abstract: The act of concealing illicit packets of drugs in body cavities for trafficking purposes is not only criminal but could prove to be a fatal venture. The most frequent cause of death among drug couriers is acute drug intoxication due to rupture of the packages inside the body. These illicit substances are often ingested with aids of balloons, condoms or plastic bags and in some cases packets are inserted into the rectum or vagina. In this report, we present a seven year study, from 402 autopsied victims spanning from 1999 – 2005 which included male and female cocaine couriers from Lagos Nigeria. A detailed autopsy was carried out on each body brought to the Pathology department. The different tissues and organs involved were studied and all pathological changes noted. In all the law enforcement agencies responsible for narcotics and other drugs were available before autopsy was carried out. The ratio of incidence of male to female was approximately 4:1. Results showed overwhelmed cerebral haemorrhage with massive oedema in the CNS. This trend was observed mostly among male couriers. Also the gastrointestinal tract revealed massive erosion of underlying mucosa with torrential haemorrhage. We also observed gross heart enlargement, severe pulmonary oedema and gross anthracotic patches in the lungs. Bitten tongues and multiple haemorrhages on serial cutting of the tongue were also observed. It should be noted therefore that materials used for concealment of these illicit drugs are not full proof. These can undergo damage while inside the body as we have seen, leading to acute intoxication due to mucosal absorption and death. Law enforcement agents should be suspicious seizures and sudden deaths of would be travellers at airports. Massive campaign is need by government to educate intending drug couriers on the dangers of this venture and the fatal consequences they might face in the process.

Keywords: Cocaine, autopsy, intoxication, illicit drug, haemorrhage, courier.

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Abstract: This is a presentation of comparative study of autopsy findings in sickle cell patients. A total of 403 cases were seen in Abia state, Nigeria in which autopsies were performed on 142 (35.2 %) of them. This study spanned from January 1995 –December 2000. Sickle cell disease (SCD) as is well known and is the commonest hereditary haematological disorder which is associated with increased mortality and morbidity. Many characteristic autopsy findings have been documented, some of which, though consistent, are not related to death like cardiomegaly, hepatomegaly, splenic atrophy and cholesthiasis. Common causes of death in this study include anaemic heart failure, pulmonary embolism, septicaemia, cerebrovascular accident (CVA) and meningitis. These were compared with other studies in other parts of the world. A good number of cases show no anatomical basis of death at autopsy. These then, calls for thorough autopsies to been performed and subtle causes of death for example septicaemia or biochemical abnormalities excluded appropriately. The goal is to draw awareness on the physicians on the need to do basic haematological profile of any patient that is on their care, as to exclude misdiagnosis, rate of morbidity and mortality. Also to create awareness among physicians and relatives on need of autopsy as to minimize future unexpected death from complication/crisis and enhance knowledge on both parties. From our study, anaemic heart failure was seen as the commonest cause of death which is a result of plasmodiasis. In most of the cases during emergency situations, genotypes were not known and were hence misdiagnosed. The condition of SCD was only revealed at autopsy after blood sample was analysed which showed positive for Hbss.

Keywords: Sickle cell disease, autopsy anaemia, death.

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Abstract: Aims and Objectives: To evaluate incidence of deaths following gunshot injuries with the resultant lesions.Materials and Method: A cross-sectional study of all incidence of gunshot injuries spanning from 2008-2012 were extracted from the coroner forms of all autopsy carried out during these period. A total of 30 cases of various age were obtained and by a statistical assessment placed according to age range. The sex ratio was evaluated and various injury/lesions also noted after a detailed forensic autopsy. A pre-designed program was used to record data. Data collected were organized, tabulated and statistically analyzed on Spss version 16. Results: It was observed that age range of 21-30 years (33%) are more affected followed by 31-40 years (26.7%). The gender more affected are males accounting for 82.8%. Also the extent of injuries /lesions of more are multiple soft tissue and skeletal injuries which is 33%; closely followed by massive exsanguinations (25%). Conclusion: Gunshot injuries is more common form of trauma leading death in our environment with very young, productive age of the society affected hence there is a greater need for effective law guiding acquisition and a good disaster victim team investigation; with forensic pathologist heading it.

Keywords: Gunshot, Medico-legal Autopsy, Death

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Abstract: Many studies have examined the pattern of various analgesics and antibiotics prescribed by primary care dental practitioners to treat irreversible pulpitis. To determine the pattern of medicines for irreversible pulpitis among undergraduate dental students, a cross sectional survey seeking mock medications based on dental scenarios of irreversible pulpitis for child, pregnant woman and apical periodontitis for man was carried out on final year dental students. Responses (n=111) were collected and analysed by frequency for drug prescribed. Data included the name of medicines, dose and presentation of the drugs. Majority of mock prescriptions (97.4%) had a combination of antibiotics and analgesics to male patients having apical periodontitis. Almost 25% prescribed antibiotics to the pregnant women of 1st trimester, while 81.9% suggested antibiotic and analgesic in tablet form to a child patient. In analgesic and antibiotics groups, acetaminophen (75.5%) and amoxicillin (56.7%) were highest respectively. Abbreviated drug name (11.7% analgesic and 0.9% antibiotic), and incorrect strengths (7.3% antibiotics and 14 % analgesics) were found. Amoxicillin and acetaminophen were primary medication for irreversible pulpitis. More clinical training especially on prescribing medication was suggested.

Key words: Analgesics, Antibiotics, Dental students, Irreversible pulpitis, Medication.

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