iosr-JDMS   Volume-6 ~ Issue-3

Abstract: 1.1 IntroductionEpidural anaesthesia is preferred in elderly. Amongst all local anaesthetics Ropivacaine is preferred in elderly due to its low cardiac and central nervous system toxicity. 1.2 Aims and objectivesTo compared efficacy of Ropivacaine 0.5% , 15ml with 0.5% Bupivacaine 15ml givenepidurally for lower limb surgery. We compared onset of sensory block, intensity of motor blockade, maximum level of anaesthesia achieved, time required for two segment regression, pulse rate and systolic blood pressure changes in both groups. 1.3 ObservationTime required to achieve T10 sensory level was earlier Bupivacaine group than Ropivacaine group. Motor blockade inBupivacaine group was grade III ( modified Bromage scale) in 29 patients and grade II in one patient. InRopivacaine group 01 patient had grade III, in 17 grade II, in 10 grade I while in 2 patients grade 0 motor blockade. Maximum sensory blockade achieved was T8 in both groups. In group R cardiovascular stability was better than group B. Time of onset of two segment regression was earlier in group R than in group B. 1.4 ConclusionIt was concluded that sensory blockade is comparable in both Ropivacaine and Bupivacaine group. Ropivacaine provides less potent motor block with better cardiac stability when used in a concentration 0.5% .

Key words: Bupivacaine, Elderly, Epidural anaesthesia, Ropivacaine

[1] Shinichi Sakura; Epidural anesthesia and spinal anesthesia in the elderly; Masui; The Japanese journal of anesthesiology 03/2007; 56(2):130-8.
[2] Bajwa SJ, Bajwa S, JasbirKaur. Comparison of epidural ropivacaine and ropivacaine clonidine combination for elective cesarean sections, Saudi J Anaesth 2010;4:47
[3] Mischa J. G. Simon, Bernadette T. Veering, Rudolf Stienstra, Jack W. van Kleef, and Anton G. L. Burm,; The Effects of Age on Neural Blockade and Hemodynamic Changes After Epidural Anesthesia with Ropivacaine, A & A May 2002 vol. 94 no. 5 1325-1330 [4] M. WILLE; Intrathecal use of ropivacaine : a review , ActaAnaesth. Belg; 2004,55,251-259
[5] Z Kanonidou and G Karystianou Anesthesia for the elderly,Hippokratia. , 2007 Oct-Dec; 11(4): 175–177
[6] Anthony Rodgers, Natalie Walker,SSchug, A McKee, H Kehlet, , A van Zundert, D Sage, M Futter, G Saville,T Clark, and S MacMahon; Reduction of postoperative mortality and morbidity with epidural or spinal anaesthesia: results from overview of randomised trials . BMJ. 2000 December 16; 321(7275): 1493.
[7] C Morton, New_ drugs_ Ropivacaine ;pdfwww.mapar,org

[8] K SAITOH, Y HIRABAYASHI, R. SHIMIZU, H. MITSUHATA & H. FUKUDA Extensive extradural spread in elderly may not relate to decresased leakage through intervertebral foramina Br J Anaesth1995;75:688-691

[9] Bernadette Th. Veering, Anton G. L. Burm, Jack W. van Ueef, rim J. Hennis, and Johan Spierdijk, Epidural Anesthesia with Bupivacaine: Effects of Age on Neural Blockade and Pharmacokinetics ; ANESTH ANALG 1987;66; 589-9

[10] Bernadette T Veering ; The role of ageing in local anaesthesia, Pain Reviews,1996, 6,167-173

Abstract: The placental complex formed by the cooperative effort between the extra embryonic tissue of the embryo and the endometrial tissue of the mother represents symbiosis between the two separate organisms without rejection. The formation of placenta is a biological event which is important both embryologically and immunologically. The growth of the foetus depends upon the functional capacity, location and integrity of the placental attachment. The placenta serves the most basic metabolic needs of fetus including respiration, nourishment and excretion by acting as a temporary lung, liver and kidney. It forms an organ for the interchange of material between fetal and maternal blood streams without mixing or physical contact of two blood streams. Here I am presenting morphological findings of 50 placenta at different gestational ages. present study was conducted in the Department of anatomy Sri venkateswara medical college, Tirupati in collaboration with the department of Obstetrics and Gynecology of maternity hospital Tirupati. It was observed that Out of 50 placentae central attachment is observed in 58% of cases, eccentric attachment in 20%, marginal attachments in 20% and velamentous attachment in 2% of cases. The following data was recorded the study. Consistency,Cord attachment, Thickness of placenta, Weight ,diameter, of the placenta observed The Feto placental weight ratio observed in 50 cases ranged between 3.75-7.7. Number of maternal cotyledons observed ranged between 12 to 20 and foetal cotyledons 36 to 84. The ratio of maternal and foetal cotyledons ranged between 2.22 - 4.6 The placental vascular pattern is disperse in type in all cases.In all 50 cases the umbilical cord contains two arteries and 1 vein.

Keywords: placental complex,velamentous attachment,cotylydons,fetoplacentral ratio,vascular pattern

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[6]. Benirschke, and Driscoll, S.G., 1967, The Pathology of the Human placenta. Springer, Berlin..
[7]. Benirschke,K.,Kaufmann,P.1995, Pathology of the Human Placenta 2nd ed, pp 1-79. New York, Springer – Verlag,
[8]. Benirschke, K.. 1962, A Review of pathological anatomy of human placenta Am: J. obstet. Gynaecol 84:1595.
[9]. Benirschke, and Driscoll, S.G. 1967, The Pathology of the Human Placenta. Springer Berlin.
[10]. Benirschke, K., and Brown, W.H., 1955, Vascular anomaly of umbilical cord; absence of one umbilical artery in umbilical cords of normal and abnormal fetuses. Obstet. Gynec., 6, 399-404.

Abstract: This study was undertaken to estimate ultrasound measurement of nuchal translucency (NT) thickness in normal fetuses between 11 and 13.6 weeks of gestation.The aim of this study was to establish normative data of nuchal translucency distribution in singleton pregnancies.600 fetuses with known normal outcome were included in this study. The distribution of median values of NT thickness with crown rump length(CRL) in 10 mm intervals and 95th percentile were calculated with linear regression method .False positive rates with increasing gestational age were studied. This study offers a normative data of fetal NT thickness in normal pregnancy, which can be used as a reference for screening chromosomal aberrations or other congenital abnormalities in the first trimester.

Keywords-anomalies,fetus, nuchal,screening, translucency.

[1]. Nicolaides KH, Brizot ML, Snijders RJ. Fetal nuchal transluscency: Ultrasound sreening for fetal trisomy in the first trimester of pregnancy.Br J Obstet Gynaecol.1994;101:782-786
[2]. Pandya PP, Snijders RJ, Johnson SP,DeLourdesBrizotM,NicolaidesKH.Screening for fetal trisomies by maternal age and fetal nuchal transluscency thickness at 10 to 14 weeks of gestation.Br J Obstet Gynaecol.1995;102:957-962.
[3]. Pandya PP, Kondylios A, Hilbert L, SnijdersRJ,NicolaidesKH.Chromosomal defects and outcome in 1015 fetuses with increased nuchal translucency. Ultrasound Obstet Gynecol. 1995;5:`15-19.
[4]. Hyett J, PerduM,Sharland G, Snijders R, NicolaidesKH.Using fetal nuchal translucency to screen for major congenital cardiac defects at 10-14 weeks of gestation: Population based cohort study. Br Med J.1999;318:81-85
[5]. Hafner E, SchuchterK,Liebert E, Phillip K.Results of routine fetal nuchal translucency measurement at weeks 10-13 in 4233 unselected pregnant women. Prenat Diagn.1998;18:29-34
[6]. Thilaganathan B, Khare m, Williams B, Wathan NC. Influence of ethnic origin on nuchal translucency screening for Down's syndrome. Ultrasound Obstet Gynecol.2000;43:998-1001.
[7]. SnijdersRJ,NobleP,Sebire N, Souka A,, Nicolaides KH. UK muticentre project on assessment of risk of trisomy 21 by maternal age and fetal nuchal translucency thickness at 10-14 weeks of gestation.Lancet 1998; 352:343-346.
[8]. Scott F, Boogert A, Sinosich M, Anderson J. Establishment and application of a normal range for nuchal translucency across the first trimester. Prenat Diagn.1996;16:629-634.
[9]. Taipale P, Hiilesmaa V, Salonen R, Ylostao P. Increasd nuchal translucency as a marker for fetal chromosomal defects. N Enl J Med. 1997;337:1654-1658.
[10]. Schuchter K, Wald N, Hackshaw AK, Hafner E, Leibhart E. The distreibution of nuchal translucency at 10-13 weeks of pregnancy.Prenat Diagn.1998;18:281-286.

Abstract: Intra- articular fractures of the distal radius represent high energy, complex, unstable injuries and the optimal method of treatment remains controversial. Study Design & Settings: Observational Randomized uncontrolled Study at a tertiary care hospital from September 2010 to August 2012.

Keywords: DASH & DEMERIT Score, External fixator, Fracture distal radius, Functional assessment, Volar plate.

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[4]. Hudak PL, Amadio PC, Bombardier C. Development of an Upper Extremity Outcome measure: The DASH (Disabilities of Arm, Shoulder and hand). http://www.orthopaedicscore.com/scorepages/disabilities_of_arm_shoulder_hand_score_dash.html. Published Jun 1996.
[5]. Nijs S, O‟Broos PL. Fractures of the Distal Radius: A Contemporary Approach. Acta Chir Belg. 2004; 104: 401-12.
[6]. Lafontaine M, Hardy D, Delince P. Stability Assessment of Distal Radius Fractures. Injury. 1989; 20:208-10.
[7]. Wong KK, Chan KW, Kwok TK, Mak KH. Volar Fixation of Dorsally Displaced Distal Radial Fractures Using LCP. J Orthop Surg. 2005; 13(2):153-7.
[8]. Egol K, Walsh M, Tejwani N, McLaurin T, Wynn C, Pakisma N. Bridging External Fixation and Supplementary Kirschner-wire Fixation versus Volar Locked Plating for Unstable Factures of the Distal Radius. J Bone Joint Surg Br. 2008; 90-B: 1214-21.
[9]. Mehta JA, Bain GI, Heptinstall RJ. Anatomical Reduction of Intra-articular Fractures of the Distal Radius: An Arthroscopically-Assisted Approach. J Bone Joint Surg Br. 2000; 82-B: 79-86.
[10]. Komurcu M, Kamaci L, Ozdemir MT, Atesalp AS, Basbozkurt M. Treatment of AO type C2-C3 Fractures

Abstract: Whipple's operation can be carried out either under general anaesthesia or continuous epidural anaesthesia with sedation. We report three cases that were managed successfully and we found that the combination of lumbar epidural analgesia with sedation is safer and beneficial as compared to those who undergo Whipple's operation under general anaesthesia. For the last three decades epidural analgesia has been the part of anaesthesia practice. Epidural analgesia can be a useful method of pain management various situations. It facilitates early mobilization and also avoids perioperative pulmonary complications especially after major thoracic or upper abdominal surgeries. The combination of continuous epidural analgesia with sedation has many advantages in prolonged major upper abdominal surgeries.

Keywords- Whipple's operation, general anaesthesia, continuous epidural anaesthesia, sedation, upper abdominal surgery.

[1]. Fingerhut, A; Vassiliu, P; Dervenis, C; Alexakis, N; Leandros, E (2007). "What is in a word: Pancreatoduodenectomy or pancreaticoduodenectomy?". Surgery 142 (3): 428–9.
[2]. Lim Y, Sia AT, Ocampo C (2005). "Automated regular boluses for epidural analgesia: a comparison with continuous infusion". Int J Obstet Anesth 14 (4): 305–9.
[3]. Wong CA, Ratliff JT, Sullivan JT, Scavone BM, Toledo P, McCarthy RJ (2006). "A randomized comparison of programmed intermittent epidural bolus with continuous epidural infusion for labor analgesia". Anesth Analg 102 (3): 904–9.
[4]. Sia AT, Lim Y, Ocampo C (2007). "A comparison of a basal infusion with automated mandatory boluses in parturient-controlled epidural analgesia during labor". Anesth Analg 104 (3): 673–8.
[5]. Burgess Fw, Anderson DM, Colonna D, Cavnaugh DG. Thoracic epidural analgesia with bupivacaine and fentanyl for postoperative thoracotomy pain. J Cardio Vasc Anesth 1994; 8: 420-424.
[6]. David AS, David SNB, Caleem McC. Postoperative analgesia using epidural infusion of fentanyl with bupivacaine. Anesthesiology 1995; 83: 727-737.

Abstract: Estimation of amniotic fluid volume is an integral part of the routine obstetric ultrasound scan and the amniotic fluid index (AFI) is one of the methods for doing this. Reduction or excessive production of amniotic fluid during pregnancy is also a strong predictor of possible associated congenital fetal anomaly. This study was to assess the AFI in Nigerian women and correlate same with their gestational age. It is a prospective cross sectional study of 300 scanned singleton pregnancies between 15-42 gestational ages. Their amniotic fluid indices were determined and correlated with their gestational age. A statistical analysis of data was done using the SPSS version 16, Chicago, Illinois. The study population mean AFI was 12.91±4.82cm, ranging from 4.17 – 22.05cm and a median of 12.56; the 5th and 95th percentile being 5.81 and 21.95 respectively. The mean AFI for preterm and term gestations were 12.70±5.02cm and 14.07±3.34cm respectively. There was no statistically significant difference between the mean AFI of the total study population and that of preterm and term gestations. The peak mean AFI value occurred at 28 weeks gestational age, with no bias in the distribution of amniotic fluid in the four quadrants of the uterus. Apart from establishing the normal AFI values in this environment, this study also showed that there was a weak positive correlation between gestational age and AFI, with no statistically significant difference in AFI of preterm and term gestations.

Key Words: Amniotic fluid index, Nigeria, Singleton pregnancies, Ultrasound.

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[3]. W.P. Callen, Amniotic Fluid Volume: Its Role, in Fetal Health and Disease, in W.P. Callen, Ultrasonography in Obstetrics and Gynaecology. 5th ed. (Philadelphia: Saunders, 2008) 758-779.
[4]. R.A. Brace, E.J. Wolf, Normal amniotic fluid volume changes throughout pregnancy, American Journal of Obstetrics and Gynaecology, 161(2), 1989, 382-388.
[5]. D. Laughlin, A.R..Knuppel, Maternal-Placental-Fetal Unit; Fetal and Early Neonatal Physiolog, in HA Decherney & L. Nathan, Current Obstetrics and Gynaecologic Diagnosis & Treatment. 9th ed. on CD-ROM (The Mc Graw Hill Companies Inc, 2003).
[6]. A.A. Umar, A.O. Akano, G.O.G Awosanya, S.B. Lagundoye, Maximum Vertical Pocket measurement of Amniotic fluid volum,. Archives of Nigerian Medicine and Medical Sciences, 1(2), 2004, 1-4.
[7]. A.F. Chervenak, G.S. Gabbe, Obstetric Ultrasound: Assessment of Fetal Growth and Anatom, in G.S .Gabbe , J.R. Niebyl, J.L. Simpson, G.S. Gabbe, Normal and Problem Pregnancies. 4th ed. (New York: Churchill Livingstone Inc, 2002) 251 -296.
[8]. O.B. Alao, O.O. Ayoola, V.A. Adetiloye, A.A. Aremu, The Amniotic Fluid Index in Normal Human Pregnancies in Southwestern Nigeria, The Internet Journal of Radiology, 5( 2), 2007
[9]. J.P. Phelan, M.O. Ahn, C.V. Smith, S.E. Rutherford, E. Anderson, Amniotic Fluid Index measurements during pregnancy, J Reprod Med, 32(8) 1987, 601- 604.
[10]. T.R. Moore, J.E. Cayle, The amniotic fluid index in normal human pregnancy, Am J Obstet Gynecol, 162(5) 1990, 1168-1173.

Abstract: Peripheral cemento-ossifying fibroma is a gingival lesion of reactive nature and is believed to arise from the periodontal ligament. It comprises about 9% of all gingival overgrowths. Its incidence is around the second and third decade of life. It has a predilection for females and about 60%of the lesions are seen most often in the maxillary arch. Trauma, local irritation such as calculus,ill-fitting dentures or faulty restorations are known to precipitate the development of these lesions. This report describes a case of Peripheral cemento-ossifying fibroma in a 45 year old male involving the maxillary anterior region. An excisional biopsy was carried out for the lesion and was diagnosed with peripheral cemento- ossifying fibroma after histological analysis.

Key Words: Peripheral cement-ossifying fibroma, Gingival overgrowth, Excisional biopsy

[1]. Eversole LR, Rovin S. Reactive lesions of the gingival. J Oral Pathol 1972;1:30-8.
[2]. Orkin DA, Amaidas VD. Ossifying fibrous epulis—an abbreviated case report. Oral Surg Oral Med Oral Pathol 1984;57:147-148.
[3]. Kenney JN, Kaugars GE, Abbey LM. Comparison between the peripheral ossifying fibroma and peripheral odontogenic fibroma. J Oral Maxillofac Surg 1989;47:378-382.
[4]. Gardner DG. The peripheral odontogenic fibroma: an attempt at clarification. Oral Surg Oral Med Oral Pathol 1982:54:40-48.
[5]. Neville BW, Damm DD, Allen CM, Bouquot JE. Oral and Maxillofacial Pathology. 3rd ed. St. Louis, MO: Elsevier; 2009;pp451-452.
[6]. Bhaskar SN, Jacoway JR. Peripheral fibroma and peripheral fibroma with calcification: report of 376 cases. J Am Dent Assoc1966;73:1312-1320.
[7]. Sanchis JM, Peñarrocha M, Balaguer JM, Camacho F. Fibroma cemento-osificante mandibular:Presentación de dos casos y revisiónde la literatura. Med Oral 2004; 9:69-73.
[8]. Buduneli E, Buduneli N, Unal T. Long-term follow-up of peripheral ossifying fibroma: report of three cases. Periodontol Clin Investig 2001;23:11-14.
[9]. Walters JD, Will JK, Cacchilo DA, Raabe DA. Excision and repair of the peripheral ossifying fibroma: a report of 3 cases. J Periodontol 2001;72:939-944.

Abstract: Inflammatory fibroid polyps are rare benign lesions that occur throughout the gastrointestinal tract.We present a case of inflammatory fibroid poly occurring in caecum. A 26 year old female presented with intestinal obstruction. Caecum showed a polypoidal growth.External surface of polyp was smooth with focal areas of ulceration. Histologically,inflammatory fibroid polyp was the diagnosis.Conclusion:Inflammatory fibroid polyp should be considered as one of the differential diagnosis of pedunculated polyps in proximal colon and caecum.

Keywords:Caecum, Eosinophils, Fibroblast, Polyp

[1]. Abraham SC, Burgart LJ, Odze RD. Polyps of the large intestine. Chapter 15 In: Odze RD, Goldblum JR, Crawford JM. Editors. Surgical pathology of the GI tract, liver, biliary tree and pancreas. Saunders, 2004;p.327-379
[2]. Ng C, Lam KY, Gupta TS, Ho YH. Inflamamtory fibroid polyp of the caecum in a patient with neurofibromatosis. Ann Acad Med Singapore 2004;33:797-9
[3]. De la Plaza R, Picardo AL, Cuberes R, Jara A, Martinez-Penalver I, Villanueva MC, Medina M, Alias D, Osorio S,Pacheco E, Suarez A. Infl ammatory fi broid polyps of the large intestine. Dig Dis Sci 1999; 44: 1810-1816
[4]. Konjetzny GE. Uber Magenfi brome. Beitr Klin Chir 1920; 119: 53-61
[5]. Hirasaki S, Matsubara M, Ikeda F, Taniguchi H, Suzuki S. Inflammatory fibroid polyp occurring in the transverse colon diagnosed by endoscopic biopsy. World J Gastroenterol 2007 July;21:13(27).3675-3676
[6]. Blackshaw AJ, Levison DA. Eosinophilic infiltrates of the gastrointestinal tract. J Clin Pathol 1986; 39: 1-7
[7]. Nakase H, Mimura J, Kawasaki T, Itani T, Komori H, Hashimoto K, Okazaki K, Chiba T. Endoscopic resection of small inflammatory fibroid polyp of the colon. Intern Med 2000; 39: 25-27
[8]. Gupta RS. Inflammatory fibroid polyps of the gastrointestinal tract. Pathologe 2001;22:333-8.
[9]. Kuestermann SA, Saleeb SF, Teplick SK. General case of the day. Jejunal intussusception caused by an inflammatory fibroid polyp (IFP). Radiographics 1999;19:539-41

Abstract: Semantic verbal fluency tests are used as a measure of cognitive function to assess language and executive function. Secondary to increasing life spans, there are increasing numbers of older individuals at work places. Our study was done to assess the effect of aging on verbal fluency in South Indians. 50 controls aged 20-50 years (Group I) , 50 subjects aged 60-75 years (Group II) and 50 subjects aged above 75 years (Group III) of both sexes who were cognitively unimpaired with a minimum 6th standard education took part in the study. The semantic category verbal fluency test and verbal mental tracking test were administered. Comparison of the verbal fluency scores between Group I versus Group II (p=0.00) and Group I versus Group III (p=0.00) was significant. Comparison of the verbal mental tracking scores between Group I versus Group II (p=0.002) and between Group I versus Group III (p=0.00) was also significant. However there were no significant differences in the number of perseverative errors (repetitions) between controls and subjects. Our study therefore showed that while verbal fluency declined significantly with aging, there was no evidence of cognitive inflexibility and executive dysfunction with aging.

Keywords–Aging, Cognition, Cognitive inflexibility, Executive dysfunction, semantic verbal fluency test.

[1]. Glisky EL, Changes in Cognitive Function in Human Aging, in Riddle DR (Ed), Brain Aging: Models, Methods, and Mechanisms (Boca Raton, FL: CRC Press, 2007)
[2]. Salthouse TA, What and when of cognitive aging. Curr Dir Psychol Sci 13, 2004,140 –144,
[3]. Ardila A, Ostrosky-Solís F: Cognitive testing towards the future: The example of Semantic Verbal Fluency (ANIMALS).Int J Psychol 2006, 41(5):324-332
[4]. Benito-Cuadrado MM, Esteba-Castillo S, Bohm P, Cejudo-Bolivar J, Pena-Casanova J. Semantic verbal fluency of animals: a normative and predictive study in a Spanish population. J Clin Exp Neuropsychol. 2002;24:1117–1122.
[5]. Bolla KI, Gray S, Resnick SM, Galante R & Kawas C (1998). Category and letter fluency in highly educated older adults. Clinical Neuropsychology, 12: 330-338
[6]. Yassuda, M. S., Diniz, B. S., Flaks, M. K., Viola, L. F., Pereira, F. S., Nunes, P. V., & Forlenza, O. V. (2009). Neuropsychological profile of Brazilian older adults with heterogeneous educational backgrounds. Archives of Clinical Neuropsychology, 24(1), 71-79.
[7]. Lee, T. M., Yuen, K. S., & Chan, C. C. (2002). Normative data for neuropsychological measures of fluency, attention, and memory measures for Hong Kong Chinese. Journal of Clinical and Experimental Neuropsychology, 24(5), 615-632.
[8]. van Hooren SAH, Valentijn AM, Bosma H, Ponds RWHM, van Boxtel MPJ, Jolles J: Cognitive functioning in healthy older adults
aged 64–81: a cohort study into the effects of age, sex, and education. Neuropsychol Dev Cogn B Aging Neuropsychol Cogn 2007, 14:40-54
[9]. Mathuranath, P. S., George, A., Cherian, P. J., Alexander, A., Sarma, S. G., & Sarma, P. S. (2003). Effects of age, education and gender on verbal fluency. Journal of Clinical and Experimental Neuropsychology, 25(8), 1057-1064.
[10]. Llewellyn, D. J., Matthews, F. E., & The Medical Research Council Cognitive Function and Ageing Study (MRC CFAS). (2009). Increasing levels of semantic verbal fluency in elderly English adults. Aging, Neuropsychology, and Cognition, 16(4), 433-445.

Abstract: Worldwide there are approximately 385 million geriatric populations, India being the second largest among them. 45% have chronic diseases and disabilities. The challenge of the 21stcentury is to improve the quality of life in elderly. The objectives were to study the distribution of activities of daily living (ADL) and physical morbidities and to explore the association of selected socio-demographic and lifestyle variables with the quality of life. This hospital based, cross-sectional study was performed on 153 patients aged 60 years & above selected by systematic consecutive sampling from Geriatric O.P.D and I.P.D of Medical College, Kolkata. They were interviewed by a pre-designed, pre-tested schedule and assessed for physical activity by using ADL (Activity of daily living) scores. Hypertension (65.3%), diabetes (47.7%), osteoarthritis (62.7%), visual impairment (55.5%) and hearing impairment (7.8%) were the commonest physical morbidities among study population. 21.7% needed support for walking, 43.8% were economically independent. The ADL score was significantly associated with age and social problem was significantly associated with economic dependency and living with family members. Family counseling for old age care, creation of a viable family and social environment with competent geriatric services will go a long way to improve the quality of life of elderly.

Key Words: geriatric, morbidity, ADL, family

[1] http://www.who.int/healthinfo/survey/ageingdefnolder/en/index.html Health statistics and health information systems (accessed on 20.3.2013)
[2] B R Dharamvir, P Ranabir, R Rekha, TV Yamuna, K Sumit, RN Angeline. Ageing in Puducherry, South India: An overview of morbidity profile. Journal of Pharmacy and BioAllied Sciences 2011;3(4):537-42

[3] http://www.dementia-assessment.com.au/symptoms/OARS_adl_iadl.pdf. OARS multi- dimensional functional assessment questionnaire.

[4]. Lawrence A. Adebusoye, Modupe M. Ladipo, Eme T. Owoaje, Adetola M. Ogunbode. Morbidity patterns amongst geriatric patients. Af J of Primary health care and family medicine.2011;3(1):211-16

[5]. Clausen F, Sandberg E, Ingstaad B, Hjortdan P. Morbidity and healthcare utilization among the elderly people in Mmankgodi village. J Epidemiol Community Health. 2000; 54:58−63.

[6]. Kamlesh J, Rajesh K, Ajit A. Morbidity profile and its relationship with disability and psychological distress among elderly people in Northern India. Int J Epidemiol. 2004;10:978–87.

[7]. M Anitha Rani, Palani G, Sathiyasekaran BWC on Morbidity profile of elders in old age homes in Chennai. njcmindia (2012);3(3):458-64.

[8]. MK Sharma, HM Swami, V Bhatia, A Verma, SPS Bhatia, G Kaur. An Epidemiological Study of Correlates of Osteoarthritis in Geriatric Population of UT Chandigarh. IJCM (2007);32(1):77-8

[9]. Ashok Kumar T, Sowmiya KR, Radhika G Morbidity Pattern among the Elderly People Living in a Southern Rural India - A Cross Sectional Study Nat.J.Res.Com.Med (2012);1(1):01-60.

[10]. J.Yeo, G. Karimova, S Bansal.Co-morbidity in older patients with COPD—its impact on health service utilization and quality of life, a community study.Age Ageing (2006); 35 (1): 33-7

Abstract: This is a case report of a woman in her 60s who presented with neurological symptoms of ataxic gait, slurred speech and difficulty in swallowing since last 5-6 months. She turned out to be a case of primary fallopian tube cancer presenting as paraneoplastic neurological syndrome. Primary Fallopian tube cancer is a rare malignancy. Moreover, FTC presenting as paraneoplastic neurological disorder is an extremely rare presentation. "Fallopian tube cancer presenting as paraneoplastic syndrome can be misdiagnosed. Don't let it happen to you"

Key Words: 1. FTC: Fallopian Tube Cancer 2. PNS: Paraneoplastic Syndrome 3. PNDs: Paraneoplastic Neurological Disorders

[1]. Aziz S, Kupersteom G. Rosen B, Cole D, Nedelcu R,. Mclaughlin J, Narod SA. A genetic Epidemiological study of carcinoma of the
fallopian tube. GynecolOncol 2001; 80:341-345
[2]. Stewart, SL, Wike, JM, Foster, SL, Michaud, F. The incidence of primary fallopian tube cancer in the United States. GynecolOncol
2007; 107:392
[3]. J. Neurology, Neurosurgery 3.2.rees JH (2004) "paraneoplastic syndromes: when to suspect, how to confirm, and how to Manage"
(http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmecentrez &artid=1765657).

Abstract: The study assessed the knowledge and practices for domestic accident among 756 mothers of pre-school children in Ibadan Southwest Local Government Area, Nigeria. Pretested questionnaire with a 15-point knowledge scale relating to domestic accident prevention was used for data collection. Descriptive statistics and ANOVA were used for data analysis. Mean age of respondents was 28.7±5.8 years and 97.8% had at least primary school education. About 30.3% of mothers place cooking utensils on the floor and 46.0% reported domestic accidents [falls (47.0%), burns (23.5%) and ingestion of kerosene (8.4%)] in their preschool children. Domestic accidents were perceived as not totally preventable (85.3%) and part of children's development (50.8%). Preventive practices employed included consistent monitoring of preschool children (58.5) and keeping drugs in secured boxes (55.5%). Self responsibility (58.1%), perceived danger (37.0%) and fear of husband's reaction (32.7%) were main influences for adoption of the preventive behaviour. Although knowledge on the causes and prevention of domestic accidents was high among the respondents, preventive practices need to be strengthened. Educational interventions such as training and public enlightenment aimed at empowering mothers and significant others to be more involved in the prevention of domestic accidents among their pre- school children are recommended.

Keywords - Domestic accident, Preschool children, Mothers, Knowledge, Prevention

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[5] A.A. Hyder, K.S. Kashyap, S. Fishman & S.A Wali.. Literature Review: Review of childhood burn injuries in sub-Saharan Africa: a forgotten public health challenge. African Safety Promotion, 2(2):43-58.
[6] B.A. Morongiello & M. Corbett. The Parent Supervision tributes Profile Questionnaire (PSAPQ): A measure of supervision that is relevant for understanding children's risk of unintentional injury. Injury Prevention 2006, 12: 19-23
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[8] S. Sharma. Prevalence of "At Risk" Under-Five children in a rural area. Indian Journal of Community Medicine 2005, 30(1): 30-32.
[9] T.M. Beirens, E.F. van Beeck, R. Dekker, J. Brug & H. Raat. Unsafe storage of poisons in homes with toddlers. Accident Analysis & Prevention, 2006, 38 (4): 772-6.
[10] N. Saad, F.M. Moftah, H.D.F. Ibrahim & R. H.Hassanen. Mothers knowledge and practice towards home accidents among children under six years. Assuit Univerity Bulletin. Environmental Research, 2005, 8(2): 11-27.

Abstract: Acute necrotizing encephalopathy (ANEC) is a rare disease well recognized in Japan but few cases have been reported from Indian subcontinent. Many cases of ANEC have been reported in the pediatric literature, but very few cases have been described in adults. We describe here a case of adult onset ANEC with the neuro-imaging findings.

Key Words: Bilateral Symmetric Brain Involvement, Post-Viral

[1]. Mizuguchi M, Abe J, Mikkaichi K et al. Acute necrotising encephalopathy of childhood; A new syndrome presenting with multifocal symmetric brain lesions. J Neurol Neurosurg Psychiatry 1995; 58: 555-561.
[2]. Mizuguchi M. Acute necrotising encephalopathy of childhood; A novel form of acute encephalopathy prevalent in Japan and Taiwan. Brain Dev 1997; 19: 81-92.
[3]. Wang HS, Huang SC. Acute necrotizing encephalopathy of childhood. Chang Gung Med J 2001; 24: 1-10
[4]. Barkovich AJ. Toxic and metabolic brain disorders. In : editors Pediatric Neuroimaging, 4th ed Philadelphia: Lippincott Williams and Wilkins; 2005: 76-189.
[5]. Sugaya N. Influenza associated encephalopathy in Japan: pathogenesis and treatment. Pediatr Intl 2000; 42: 215-218.
[6]. Yoshikawa H, Yamazaki S, Watanabe T, Abe T. Study of influenza associated encephalopathy in children during the 1997 to 2001 influenza season. J Child Neurol 2001; 16: 885- 890.
[7]. Morishima T, Togashi T, Yokota S et al. Encephalitis and encephalopathy associated with an influenza epidemic in Japan. Clin Inf Dis 2002; 35: 512-517.
[8]. Mizuguchi M, Hayashi M, Nakano I et al. Concentric structure of thalamic lesion in acute necrotizing encephalopathy. Neuroradiology 2002; 44: 489-493.
[9]. Kim JH, Kim IO, Lim MK et al. Acute necrotizing encephalopathy in Korean infants and children: imaging findings and diverse clinical outcome. Korean J Radiol 2004; 5: 171-77.
[10]. Okumura A, Mizuguchi M, Kidokoro H et al. Outcome of acute necrotizing encephalopathy in relation to treatment with corticosteroids and gammaglobulin. Brain Dev 2008; May 2. [Epub ahead of print]

Abstract: Objectives: Acne vulgaris is a chronic disease affecting the face in adolescents and adults. It has considerable psycho-social impact on Health Related Quality of Life (HRQOL).The aim of our study is to assess the impact of acne on Quality of Life. Material and Methods: The study sample consisted of 483 consecutive patients with facial acne vulgaris. Patients who had attended the Dermatology OPD of Dr.Pinnamaneni Siddhartha Institute of Medical Sciences between November 2012 to March 2013 were included in the study. After obtaining the history, the acne was graded into mild, moderate and severe based on the type and number of lesions. Dermatology Life Quality Index(DLQI) and Cardiff Acne Disability Index(CADI) were administered on the patients to measure the Quality of Life. Results: Majority (53.2%) of the study population were betweeen16-20 years and the number of males was more than the number of females. Most of the patients were educated and unmarried.61.4% of patients belonged to the urban areas & (60.04%) had an acne duration of >1 year. Severe acne was seen in 30.64% of patients and 50.35% had a moderate grade of acne. In 333 patients (68.94%) the CADI scores were >8 showing a clear impact on QOL. Based on the DLQI scores 75.1% of the patients had a moderate to extremely large impairment of QOL. Conclusion: Acne has an impact on Quality of Life (QOL) and evaluation of Quality of Life helps in the better management of patients with acne.

Keywords - Acne vulgaris, Quality of Life, DLQI, CADI

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[5]. Tallab TM. Beliefs, perceptions and psychological impact of acne vulgaris among patients in the Assir region of Saudi Arabia. West Afr J Med 2004;23:85-7.
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Abstract: Background: Revised National Tuberculosis Control Programme (RNTCP) was introduced in India in 1993, as a pilot project but the full-fledged programme was started in 1997. Very few long-term follow-up studies of patients at one year after completing treatment under DOTS are available. Methodology: A cross sectional observational study was done to assess the performance and treatment outcome of patients under RNTCP and to determine the status of the tuberculosis (TB) patients after one year of completion of treatment under RNTCP. Data were collected by review of records from TB patients registered at the DOTS centre of TB Unit, Urban Health Centre, Chetla, Kolkata and subsequently followed up at their home. Statistical Analysis was done by proportions and Chi-square test. Results: Outcome of 82 registered patients during the study period at the end of completion of their treatment was: treatment success (cured plus treatment completed)- 90.2%, default- 6.1%, death- 2.4% and treatment failture-1.2%. On follow-up at one year, only 60 (73.2%) patients were traced. The follow-up status of 60 patients revealed that all patients were asymptomatic and had no history of relapsed/death. Conclusion: Treatment under RNTCP was effective as revealed by the results at one year follow-up. Key Words: Assessment of performance, DOTS, RNTCP, relapse, treatment outcome.

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[4]. Yatin D, Danani U, Desai C. Relapse following directly observed therapy short course (DOTS): a follow-up study. Indian J Tub 2000; 47: 233-6.

[5]. Prasad R, Srivastawa SK, Ratan RK, Srivastawa P. Report on Revised National Tuberculosis Control Programme Urban Project in Lucknow. Indian J Tub 2000; 47: 159.

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[7]. Gaur SN, Dhingra VK. Tuberculosis in the elderly and their outcome under DOTS. Indian J Tub 2004; 51: 83-7.

[8]. Jagota P, Chandrasekaran S, Sumathi G. Follow-up of pulmonary tuberculosis patients treated with short course chemotherapy through traditional birth attendants. Indian J Tub 1998; 45: 89-93.

Abstract: Cancer is an increasingly important public health problem in developing countries including Africa. The burden of cancer in Nigeria is unknown, mainly because of lack of statistics or under reporting. The aim of this study is to determine the incidence and pattern of cancer distribution among patients attending the hospital and comparing with existing data. This is a descriptive cross sectional study conducted among Cancer patients who attended the Oncology clinic of Lagos State University Teaching Hospital over the period between 2005 and 2011 and incidence rates were calculated. Ethical approval was obtained from the Ethics Committee of the institution. From the cancer registry of the institution, it was reported that 1315 cancer cases was recorded between 2005 and 2011; Male cancers accounted for 14.1% while female cancers was 85.9%. Following the statistical analysis, it was found that Breast cancer topped the incidence chart with 974 patients (74.75%). This was followed by colorectal Cancer and Prostate; Then, Ovarian, Bone, Occular, Endometrial, Lung, Nasopharyngeal, Gastric, bladder, parotid, oral and maxillary cancers in that order. The broader outlook of this global burden ignites a drive towards intensive research aimed at reducing the current morbidity & mortality statistic from this debilitating disease.

Keywords: Burden, Cancer, Incidence , Nigeria, ,Pattern

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