iosr-JDMS   Volume-7 ~ Issue-4

Abstract: Aims & Objective: To evaluate if the implants can be osseointegrated in regenerated bone of patients who had large bony defects following odontogenic cyst enucleation. Material & Methods: A total of five patients were chosen for the study, implants were placed one year after surgical cyst enucleation The patients were assessed clinically and radiologically periodically i.e. every month , till 6 months after placement of implant . The success criteria included absence of any sign of periimplant inflammation , clinical mobility of the implant and abutment and finally absence of any peri implant radiolucency when seen on the radiograph. Results: A total of 15 implants were placed in five patients having regenerated bone with 93.3 % osseointegration . One patient showed failure i.e. implant mobility fifteen days after placement. The failure was attributed to poor quality of regenerated bone. Conclusion: By the findings of this study, we can safely conclude that implants can be successfully osseointegrated in regenerated bone , however poor quality of regenerated bone is the main cause of failure. However studies with larger sample size and concurrent HBO therapy to accelerate bone healing can be done in future..

Keywords: Odontogenic cyst, Regenerated bone, Dental implants

[1]. Martins WD, Ávila LFC. Partial Spontaneous Bone Regeneration Subsequent to Mandibulectomy. J Contemp Dent Pract 2004 August;(5)3:108-120. [2]. PA Fugazzotto. Success and failure rates of osseointegrated implants in function in regenerated bone for 72 to 133 months.Int J Oral Maxillofac Implants, January 1, 2005; 20(1): 77-83.
[3]. Kova´cs AF. Clinical analysis of implant losses in oral tumor and defect patients. Clin Oral Impl Res 2000: 11: 494–504.
[4]. Kim BO, Hong KS, Kim SG. Finite element analysis of cylinder type implant placed into regenerated bone with type IV bone quality. J Korean Assoc Oral Maxillofac Surg. 2004 Aug;30(4):331-338.
[5]. Matteo Chiapasco ,Alessandro Rossi,Jason Jones Motta ,Michele Crescentini. Spontaneous Bone Regeneration After Enucleation of Large Mandibular Cysts:A Radiographic Computed Analysis of 27 Consecutive Cases. J Oral Maxillofac Surg .2000 ;58:942-948.
[6]. Dr. Philip J. The restoration of resected mandibles in children without the use of bone grafts. ,Head & Neck Surgery 6,( 2) ,626 – 631
[7]. Ahmed M. A. Hyperbaric oxygen results in an increase in rabbit calvarial critical sized defects Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006;101:144-9
[8]. Hammerle CHF ,Jung RE , Feloutzis A :A Systematic review of the survival of implants in bone sites augmented with barrier membranes(guided bone regeneration ) in partially edentulous patients.J Clin Periodontol 2002 : 29(3) : 226-231. [9]. PA Fugazzotto Success and failure rates of osseointegrated implants in function in regenerated bone for 6 to 51 months: a preliminary report. Int J Oral Maxillofac Implants, January 1, 1997; 12(1): 17-24.
[10]. M.E.Fritz ,M.K Jeffcoat,M.Reddy,D.Koth,L.D Braswell J.Malmquist,J.Lemons. Implants in regenerated bone in a primate model. J.Periodontol. 2001 ; 72 : 703-708.

Abstract: Infant feeding practices comprising of both the breastfeeding as well as complementary feeding have major role in determining the nutritional status of the child. Worldwide, it is estimated that only 34.8% of infants are exclusively breastfed for the first 6 months of life, the majority receiving some other food or fluid in the early months.The first two year of life provide a critical window of opportunity for ensuring children's appropriate growth and development through optimal feeding. Optimal breast feeding could prevent 13% of deaths occurring in children less than 5 year of age globally, while appropriate complementary feeding practice would results in an additional 6% reduction in under-five mortality. Objective-To study infant and young child feeding practices with special reference to breast feeding in children between 6- 36 month of age. Materials And Methods- This cross sectional study was carried out in an urban population of Meerut city, in children between 6 to 36 months of age. Assuming the prevalence of breast feeding to be 50% the sample size was taken as 400 children. Information regarding child rearing practices was collected by interviewing mother by house to house visit on predesigned and pretested Performa. Data was analysed and statistically evaluated. Results-The study showed that 15.0% mothers started breastfeeding within 1 hr of birth, 29.8% started complementary feeding at 6 month, while 5.3% exclusively breastfed for six month duration . 79.6% were given food from four or more group. Minimum meal frequency was adequate in 43.4% while minimum acceptable diet was 37.7%. Conclusion- Present study revealed very poor infant and young child feeding practices in urban area of Meerut.

Key Words: IYCF, Breast feeding

[1]. Govt. of India (2006); National guidelines on Infant and Young Child Feeding (Ministry of Human Resource development, New Delhi; Department of Women and Child development); 9-10.
[2]. WHO (2009): Session-1; Infant and young child feeding model chapter for text books.
[3]. WHO (2003); Implementing the global strategy for infant & young child feeding. Geneva, 3-5 Feb.
[4]. Sinhababu A, Mukhopadhyay D K, Panja T K, Saren A B, Mandal N K and Biswas A B: Infant-and Young Child-feeding Practices in Bankura District, West Bengal, Ind. Jour Health Pop. Nut. 28(3), 2010:294–299.
[5]. IIPS (2007):NFHS-3 (2005-2006); Vol. 1 Chapter 10 nutrition and anaemia Govt. of India.

[6]. Concurrent assessment of health and family welfare programs and technical support to districts of Uttar Pradesh, Meerut, table 4B.4,2006-2007;117,187,189,138,144.

[7]. Dongre A R, Deshmukh P R, Rawool A P and Garg B S; where and how breastfeeding promotion initiatives should focus its attention? A study from rural Wardha; Ind. Jour Comm. Med. 35(2), 2010:226-229.

[8]. Gupta P, Srivastava V K, Kumar V, Jain S, Masood J, Ahmad N and Srivastava J P; Newborn care practices in urban slums of Lucknow city, UP; Ind. Jour Comm. Med. 35(1),2010:82-85. (http://www.ijcm.org.in/ article.asp?issn=09700218;year=2010;volume=35;issue=1;spage=82;epage=85;aulast=Gupta) Accessed on 05/07/2012

[9]. Ravall D, Jankar D V and Singh M P: A study of breast feeding practices among infants living in slums of Bhavnagar city, Gujarat, India; health line, 2 (2), 2011:78-83.

[10]. Kumar D, Agarwal N and Swami H M; Socio-demographic correlates of Breast-feeding in urban slums of Chandigarh; Ind. Jour Med. Sci. 60, 2006:461-6.

Abstract: Introduction: To report a case of torsion of gravid uterus by 7200 at 28 weeks: Case Report: A 20 years primigravida presented with complaints of pain in abdomen, vomiting and loss of fetal movement after a fall 3 days back. USG revealed intrauterine fetus and intestinal obstruction but didn't explain the cause of high up and left deviation of cervix which failed to dilate on induction with prostaglandin so MRI was done which revealed a concentric mural thickening of Cervix representing stenosis/ mass. On laparotomy it was diagnosed that there was a uterine torsion of 7200 with dead fetus. Uterus was uniconuate with rudimentary right horn and adnexa. As uterus was devitalized and could not be salvaged so subtotal hysterectomy done. Conclusion:Uterine torsion is a rare complication of pregnancy and obstetricians should have this complication in differential diagnosis.

Keywords: pregnancy, intestinal obstruction, subtotal hysterectomy, uterine anomaly, uterine torsion.

[1]. Corr JE. Axial torsion of the gravid uterus in two successive pregnancies.Am J Obstet Gynecol. 1943; 46: 749-751.
[2]. Jenson JG. Uterine torsion in pregnancy.ActaObstetGynecol Scand.1992; 71: 260-265.
[3]. Barber HRK, Graber EA. Uterine Torsion during pregnancy. In: Surgical disease in pregnancy. Philadelphia: WB Saunders Co Ltd, 1974: 387-388.
[4]. BAROZZI J: Manuel de Gynecology Pratique. Paris, 1907
[5]. ROBINSON AL, DUVALL HM: Torsion of the pregnant uterus. J ObstetGynaecol Br Commonw 38: 55, 1931
[6]. SIEGLER SL, SILVERSTEIN KM: Torsion of a pregnant uterus with rupture. Am J ObstetGynecol 55: 1053, 1948
[7]. Nicholson WK, Coulson CC, McCoy CM, Semelka RC. Pelvic magnetic resonance imaging in the evaluation of uterine torsion.Obstet& Gynecol. 1995; 85: 888-890
[8]. Nesbitt REL, Corner GW.Torsion of the human pregnant uterus.ObstetGynecolSurv. 1956; 11: 311-332.
[9]. RABBINER B: Torsion of the pregnant uterus in patients with kyphotic pelvis. Am J ObstetGynecol 30: 136, 1935
[10]. WRUBEL NN, GREENBERG MV, BEILLY JS: Interstitial pregnancy with torsion of pregnant uterus and spontaneous amputation of adnexa and round ligament. NY State J Med 51: 2533, 1951.

Abstract: In the last decade, knowledge of α-adrenoceptors has expanded enormously. It is the purpose of this review to present the current status of our knowledge of alpha adrenergic receptor subtypes. The goal is to provide a brief perspective as a context for our current understanding and to highlight the gaps in our current understanding. From a pharmacological perspective, it should permit the development of very selective drugs with relatively few side effects.

Key Words: α-adrenergic receptors, subtypes, locations, functions, agonists, antagonists.

[1]. 'From a Nervous System Function and Disorders Thematic Symposium entitled Subtypes of a1 and ct Adrenergic Recep- tors presented at the 74th Annual Meeting of the Federation of American Societies for Experimental Biology, Washington, D. C., April 4, 1990.
[2]. A STUDY OF THE ADRENOTROPIC RECEPTORS RAYMOND P. AHLQUIST, From the Department of Pharmacology, Uniwvsity of Georgia School of Medicine AUGUSTA, GEORGIA, June 1948,volume 153, pages 586-600
[3]. LANGLEY, J. N. J. Physiol. 33: 374, 1905.
[4]. LANGLEY, J. N. Proc. Roy. Sot. 78B : 170, 1906.
[5]. DALE, H. H. J. Plzysiol. 34: 163, 1906.
[6]. McGrath, J. C., Brown, C. M., and Wilson, V. G. (1989) Alpha-adrenoceptors: a critical review. Med. Res. Rev. 9, 407-533
[7]. Minneman, K. P. (1988) ai-Adrenergic recetor subtypes, inositol phosphates, and sources of cell Ca .Pharmacol. Rev. 40, 87-119
[8]. Harrison, J. K., Pearson, W. R., and Lynch, K. R. (1991) Molecular characterization of ai- and ct2-adrenoceptors. TIPS 12, 62-67
[9]. Simonneauz, V., Ebadi, M., and Bylund, D. B. (1991) Iden- tification and characterization of alpha-2D adrenergic receptors in bovine pineal gland. Mol. Pharmacol. 40, 235- 241
[10]. Michel, A. D., Loury, D. N., and Whiting, R. L. (1989) Dif- ferences between the a2-adrenoceptor in rat submaxillary gland and the Uta- and a25-adrenoceptor subtypes. Br. j Phannacol. 98, 890-897

Abstract: Postoperative nausea and vomiting (PONV) not only increases patient discomfort as for some of the patients, PONV is even more distressing than post operative pain, but also adds to hospital expenditure (increased hospital stay, antiemetics) and complications related to vomiting (dehydration, electrolyte disturbances, pulmonary aspiration and rarely esophageal rupture). AIM: This study is to compare the efficacy of ondansetron hydrochloride (80μg/kg) versus granisetron hydrochloride (20μg/kg) for the control of postoperative nausea and vomiting in patients undergoing laparoscopic cholecystectomy. METHODS: One hundred and forty consecutive adult patients scheduled for elective laparoscopic cholecystectomy were randomized into two groups: group O ondansetron group (n = 70) and group G Granisetron (n =70).Randomization was done using sealed envelope technique. A standard protocol was used in all the patients. The postoperative nausea and vomiting scoring was started immediate post-extubation. The patients were monitored in the recovery unit for the initial two hours. During that period the incidence of nausea and vomiting were recorded every 15 minutes. The nausea and vomiting scoring was continued eighth hourly for the next 24 hours. RESULTS: It was observed that 6 patients from group O and 3 patients from group G had nausea at extubation. The incidence of nausea gradually decreased over the next 24 hours, in both the groups. With regard to the incidence of vomiting, there was a gradual decrease in the incidence with time, in both our study groups. At extubation, 2 patients from group O and 1 patient from group G had one bout of vomiting. But 2 hours post extubation, none of the patients from both the groups had vomiting. On overall comparison, 37% of ondansetron hydrochloride group had nausea compared to 23% in the granisetron hydrochloride group. And 16% from the ondansetron hydrochloride group had vomiting in compasison to 3% in the granisetron hydrochloride group. Thus, based on our study we conclude that, Ondansetron (80μg/kg) is as efficacious as Granisetron (20μg/kg) for the control of postoperative nausea and vomiting in patients coming for laparoscopic cholecystectomy.

Keywords: Postoperative nausea and vomiting, cholecystectomy, ondansetron, granisetron

[1]. Andrew PL, Physiology of nausea and vomiting; Br J Anaesth1992; 69: 2-19.
[2]. McKay WP, Yip RW. Distribution of randomised controlled trials of drugs for postoperative nausea and vomiting. Can J Anaesth 2000; 47(5): 421-26.
[3]. Watcha MF. Postoperative nausea and emesis : Anesth Clin North America 2002; 20(3): 471-84.
[4]. Kazemi-Kjellberg F, Henzi I, Tramer MR. Treatment of established postoperative nausea and vomiting. A quantitative systemic review. BMC Anaesthesiol 2001; 1(1): 2.
[5]. Gold BS, Kitz DS, Lecky JH, Neuhans JM. Unanticipated admission to hospital following ambulatory surgery. JSMA1989; 262: 3008-10.
[6]. Saeeda Islam P. N. Jain postoperative nausea and vomiting, a review article: Indian journal of anaesthesia2004;48(4):253-258
[7]. Sarkar M, Sarkar A, Dewoolkar L, Charan S. Comparative Study of single dose intravenous ondansetron and metoclopramide as a premedication for prevention of post operative nausea and vomiting in obstetrical laparoscopic surgery under general anaesthesia. Internet J Anesthesiology 2007; 13: 2.
[8]. Sneader W. Drug Discovery: A History ( John Wiley and Sons, Ltd.: West Sussex, England, 2005. pp. 217 -19).
[9]. Gan TJ, Coop A, Philip BK. A randomized, double-blind study of granisetron plus dexamethasone versus ondansetron plus dexamethasone to prevent postoperative nausea and vomiting in patients undergoing abdominal hysterectomy.Anesth Analg. 2006 Aug;103(2):510-1; author reply 511.

Abstract: Background: Many studies have estimated the prevalence of Metabolic Syndrome [MS] and also its association with type II Diabetes and cardiovascular disease. But its prevalence and association with acute cardiovascular events like Acute Myocardial Infarction [AMI] remained largely unexplored. Objectives: (1) To determine the prevalence of the metabolic syndrome in patients with AMI; (2) To find out the association of the individual component of the metabolic syndrome with AMI. (3) To study the association of obesity markers like waist circumference [WC], Body Mass Index [BMI] and Waist Hip Ratio [WHR] with AMI. Study Design: Hospital based cross-sectional case control study. Methods: The study was conducted in a Medical College of Kolkata, West Bengal. Applying National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) criteria and evaluated subjects for the 5 component conditions of the metabolic syndrome: insulin resistance, abdominal obesity based on waist circumference, hypertriglyceridemia, low HDL cholesterol (HDL-C), and hypertension, as well as the full syndrome, defined by the presence of at least 3 of the 5 conditions. Statistical Analysis: Student's t test and Chi-square test. Results: Among the 76 AMI patients, 47.36% male AMI cases and 46.87% of female AMI cases had MS and both are statistically significant when compared with controls. Among the 5 component conditions of MS, 4 components like insulin resistance, hypertension, hypertriglyceridemia and low HDL cholesterol were more prevalent in cases in both the sex groups compared with controls and the results were statistically significant. Only one exception obesity measured by high WC [p>0.05] which was not independently related to MS. Among the component conditions insulin resistance had the highest OR in men and low HDL had the highest OR in women. Among other obesity markers the association of BMI with MI was not statistically significant whereas central obesity measured by WHR of >0.09 were significantly related to MI in both male and female group. Conclusion: The study indicates that prevalence of MS and its individual component conditions are significantly related to AMI. Considering the marker of obesity waist circumference and BMI were not significantly related to AMI whereas WHR is significantly related to AMI. Maybe this is the time when we should look upon to derive the cut off points for obesity with consideration specifically related to Asian Indians.

Keywords: Metabolic syndrome, acute myocardial infarction

[1] Rudolph H., Forschung und Praxis, 174 (1994) 3.

[2] Reaven GM. Role of insulin resistance in human disease. Diabetes. 1988;37:1595– 607..

[3] Alberi KGMM, Zimmet PZ, for the WHO Consultation. Definition, diagnosis and classification of diabetes mellitus and its complications, part 1: diagnosis and classification of diabetes mellitus, provisional report of a WHO consultation. Diabet Med. 1998;15:539–553.

[4] Piatti P., G. Fragasso, L. D. Monti, A. Caumo, C. Van Phan, G. Valsecchi, S. Costa, E. Focheasto, G. Pozza, A. E. Pontiroli, S. Chierchia, J. Am. Coll. Cardiol., 34 (1999) 1452.

[5] Deedwania PC. The deadly quartet revisited. Am J Med. 1998;105(suppl 1A):1S–3S.

[6] Fagan TC, Deedwania PC. The cardiovascular dysmetabolic syndrome. Am J Med. 1998;105(suppl 1A):77S–82S.

[7] Stern MP. Diabetes and cardiovascular disease. The "common soil" hypothesis. Diabetes 1995;44:369–74.

[8] Laaksonen DE, Lakka HM, Niskanen LK, Kaplan GA, Salonen JT, Lakka TA. Metabolic syndrome and development of diabetes mellitus: application and validation of recently suggested definitions of the metabolic syndrome in a prospective cohort study. Am J Epidemiol. 2002;156:1070–7.

[9] Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, et al. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation. 2005;112:2735–52.

[10] Lindsay RS, Howard BV. Cardiovascular risk associated with the metabolic syndrome. Curr Diab Rep. 2004;4:63–8.

Abstract: Structural variations of the renal vessels are not uncommon. During the routine dissection of the abdomen for the under graduate teaching, it was found that the kidney on the Right side had an accessory renal artery and also an accessory renal vein. In our study of about 120 specimens observed in Anatomy Department from 2004 to 2012, this type of combination of variations was found only once, hence presented for its clinical importance.

Keywords - Aberrant Renal Vessels, Accessory Renal Artery, Accessory Renal Vein, Variation in Right Kidney

[1] Bayramoglu. A., Demerymek. D., Erbil. K.M. Bilateral additional renal arteries and an additional right renal vein associated with unrotated kidneys. Saudi Med J. 2003 May;24(5):535-7 PMID: 12847633
[2] Brodei P., Sapte E., Iliescu D. Double renal arteries originating from the aorta. Surg Radiol Anat. 2004; 26(6):474-9 (ISSN: 0930-1038)
[3] Dhar P, Lal K.(2005) Main and accessory renal arteries--a morphological study; Ital J Anat Embryol. 2005 Apr-Jun;110(2):101-10; PMID: 16277160.

Abstract: Conservation of tooth structure has always been the prime aim of the restorative procedures. Hemisection is a conservative treatment approach for multirooted teeth affected with caries, bone loss and furcation involvement. Proper case selection is of utmost importance for successful treatment. This case report presents a review on hemisection or premolarization and describes the management of mandibular molar with furcation involvement via hemisection.

Keywords – Furcation, Hemisection, Premolarization.

[1]. DeSanctis M, Murphy KG. The role of resective periodontal surgery in the treatment of furcation defects. Periodontol 2000 2000;22:154-168
[2]. American Academy of Periodontology. Glossary of Periodontal Terms. Chicago: American Academy of Periodontology; 2001:45.
[3]. Farrar JN. Radical and heroic treatment of alveolar abscess by amputation of roots of teeth. Dental Cosmos 1884;26:79.
[4]. Carnevale G, Di Febo G, Tonelli MP, Marin C, Fuzzi M. A retrospective analysis of the periodontal-prosthetic treatment of molars with interradicular lesions. Int J Periodontics Restorative Dent 1991:11:189-205.
[5]. Carnevale G, Pontoriero R, di Febo G. Long-term effects of root-resective therapy in furcation-involved molars. A 10-year longitudinal study. J Clin Periodontol 1998;25:209-214.
[6]. Langer B, Stein SD, Wagenberg B. An evaluation of root resections. A ten-year study. J Periodontol 1981; 52:719-722.
[7]. Buhler H. Evaluation of root-resected teeth. Results after 10 years. J Periodontol 1988;59:805-810.
[8]. Green EN. Hemisection and root amputation. J Am Dent Assoc 1986;112:511-518.
[9]. Blomlof L, Jansson L, Appelgren R, Ehnevid H, Lindskog S. Prognosis and mortality of root-resected molars. Int J Periodontics Restorative Dent 1997; 17: 190-201.
[10]. Kinsel RP, Lamb RE, Ho D. The treatment dilemma of the furcated molar: Root resection versus single-tooth implant restoration. A literature review. Int J Oral Maxillofac Implants 1998;13:322-332.

Abstract: Normal foetal growth and survival depends on proper development and function of the placenta. It serves to maintain a maternal-foetal interference for the exchange of blood gases, nutrients, and waste. The placenta has been described as a "diary of intrauterine life" and it may elucidate many aspects of intra uterine life. The aim of this study is to observe the histological and radiological changes in excessive placental calcification, in pregnancy induced hypertension (PIH) and placental abruption. This retrospective study was conducted at the department of Anatomy of Liaquat University of Medical & Health Sciences Jamshoro. One hundred twenty placentae were collected from labour room and gynaecology operation theatre of Liaquat University Hospital. Forty placentae from parturient suffered from PIH, forty from parturient with placental abruption & forty placentae from parturient of normal pregnancy (Control Group). Age of all parturient is between 17 to 32 years. Radiological study was conducted in the department of radiology of Liaquat University Hospital Jamshoro. Approximately five mm pieces of placenta was taken and processed for histological study. Both radiology and histological studies show highly significant (p=<0.001) difference in calcification in placental abruption and PIH group as compared to control.

Key words: calcification, Placenta, PIH, placental abruption.

[1]. Ragunath G, Lakshmi v, shenoy VS. A study on the Morphology and the Morphometry of the Human Placenta and its Clinical Relevance in a population in Tamilnadu Journal of Clinical and Diagnostic Research. 2011 Apr, Vol-5(2):282-286
[2]. Devi C K, Neelam S, Raghupathy NS The Histological Findings in Human Placenta at Different Gestational Ages IOSR-JDMS 2013 ;6(1):29-31
[3]. Sarkar M, Ingole IV, Ghosh SsK, Bhakta A, Das RS, Tandale S, Tarnekar AM. Calcification in Placenta. J Anat soc India 2007; 56(1):01-06.
[4]. Guo Y, Zhang D, Lu H, Luo S, ShenX. Association between calcifying nano particles and placental calcification Int J Nanomedicine. 2012; 7: 1679–1686.
[5]. Agababov RM, Abshina TN, Suzina NE, Vainshtein MB, Schartburd PM. Link between the early calcium deposition in placenta and nanobacterial like infection. J Biosic 2007; 32(6): 1163-68.
[6]. Elsasser DA, Ananth CV, Prasad V, Vintzileos AM. Diagnosis of Placental Abruption: Relationship between Clinical and Histopathological Findings Eur J Obstet Gynecol Reprod Biol. 2010 February; 148(2): 125.
[7]. Singh S, Gugapriya TS. Micro anatomical analysis of hypertensive placenta A retrospective case control study. National j of clinical anatomy 2013; 2 (1) p 5-10
[8]. Rasmussen S, Irgens LM. Fetal growth and body proportion in Preeclampsia. Obstet Gynaecol 2003; 101(3):575-83.
[9]. Baloch AH, Memon SF, Ansari AK. Comparison of placentae from hypertension associated pregnancies and normal pregnancies. JLUMHS 2012; 11(01):03-06
[10]. Goswami P, Lata H, Memon S, Khaskhelli LB.Excessive Placental Calcification Observed in PIH Patients and its Relation to Fetal Outcome. JLUMHS 2012; 11: (3) p 144-14

Abstract: Objectives: The aim and objectives of intervention with Team Based Learning (TBL) was to foster active learning environment in large group teaching and to obtain their perception on team work. Methods: It was single blind controlled interventional study conducted at Jawaharlal Nehru Medical College Sawangi (Meghe), Wardha, India. First MBBS students of second semester were enrolled for the study. Thirty five students (n=35) were randomly divided in 5 teams of 7 members each. The TBL program was introduced as supplement to the traditional instructional methodology in Physiology by taking 2 modules. Perception of students on TBL, teamwork and preference to TBL was obtained. Quantitative analysis was done by comparing the scores in preliminary examination between study and control group. The Students "t" test was applied to find out significance. Results: Results showed that most of the students were agreed for this type of instructional strategy as it enriched their knowledge and find relevant for the subject Physiology. While comparing these sessions with classroom lecture method, students were of opinion that TBL was better than lecture. There was overall increase in marks obtained in examination. Conclusion: TBL was successfully introduced and well accepted with 2 modules in Physiology promoting self-directed learning.

Keywords - Active learning, Large group teaching, Self directed learning, Team based learning.

[1]. Miller SA, Perotti W, Silverthorn DU. From college to clinic: reasoning over memorization is key for understanding anatomy. Anat Rec. 2002; 269:69–80.

[2]. Boyer Commission on Educating Undergraduates in the Research University, 1998. Boyer Commission on Educating Undergraduates in the Research University. Reinventing Undergraduate Education: A Blueprint for American Research Universities. 1998. http://naples.cc.sunysb.edu/Pres/boyer.nsf. (accessed on May 2012).

[3]. Seidel, C., & Richards, B. Application of team learning in a medical physiology course. Academic Medicine. 2001; 76:533-534.

[4]. Haidet, P., O‟Malley, K., & Richards, B. An initial experience with "team learning" in medical education. Academic Medicine. 2002; 77: 40-44.
[5]. Medical Council of India. List of Colleges Teaching MBBS. http://www.mciindia.org/InformationDesk/MedicalCollegeHospitals/ListofCollegesTeachingMBBS. (cited on 2.9.2012).

[6]. National Center for Education Statistics (NCES), Postsecondary Education Quick Information Survey on Higher Education Finances and Services. Washington, D.C.: 1995. http://nces.ed.gov/pubs95/95393.pdf.(accessed 14 March 2012).

[7]. Lord T. "Darn it, professor. Just tell us what we need to know to pass your course." J. Coll. Sci. Teach. 2008; 37:71–73.
[8]. Julio Frenk, Lincoln Chen, Zulfiqar A Bhutta, Jordan Cohen, Nigel Crisp, Timothy Evans et al. Health professionals for a new century: transforming education to strengthen health systems in an interdependent world: The Lancet Commissions Report. 2010; 376; 1943-44. Available on www.thelancet.com. (Cited on 31.5.2012).

[9]. Nagaswami S. Vasan, David O. DeFouw, Bart K. Holland. Modified Use of Team-Based Learning for Effective Delivery of Medical Gross Anatomy and Embryolog.y Anat Sci Ed. 2008;1:3–9.
[10]. Harden, R.M. & Davis, M.H. The continuum of problem-based learning. Medical Teacher, 1998; 20: 317 – 322.

Abstract: hyperglycemic emergencies and to ascertain the factors associated with outcome with emphasis on the determinants of outcome. Method: A total of 105 patients admitted to the Accident and Emergency unit who fulfilled the criteria for hyperglycaemic emergencies were selected using a non-probability sampling technique. The information extracted included socio-demographic, clinical and laboratory data and hospitalization outcome. Statistical comparison of proportions was done with chi-squared test, while the students t -test was used for comparison of means. A p-value of less than or equal to 0.05 was accepted as the level of statistical significance. Results: Hyperosmolar hyperglycaemic non ketotic state (HHNK) was seen in 50% (53) of the subjects, while diabetic ketoacidosis (DKA) was seen in 31% (29), Normo osmolar non-ketotic hyperglycaemic state (NNHS) in 12% (13) and MIXED hyperglycaemic emergency in 7% (10) of the subjects. There was a statistically significant difference in the mean RBS (p=0.01), anion gap (p=0.01), and in the mean serum osmolality (p=0.01) however there was no statistically significant difference in the FBS on discharge (p=0.14). Patients with Mixed hyperglycaemic emergency had the highest mean HbA1c (9.0±0.47%) while patients with NNHS had the lowest mean HbA1c (7.9±0.44%). Patients with HHNK had the highest mean admitting RBS (611.4±68.11mg/dl) while patients with DKA had the lowest mean admitting RBS (439.8±98.29mg/dl). The mean (SD) serum potassium at presentation was 3.95mmol/L (0.64) with a range of 2.2mmol/L to 5.7mmol/L: The mean (SD) serum bicarbonate in this study was 19.3mmol/L (2.87) with a range of 10 to 30mmol/L. Conclusion:In view of the morbidity and mortality associated with hyperglycemic emergencies, there is need for prompt recognition and diagnosis and this highlights the need for provision of adequate diagnostic facilities in healthcare centers. Concerted efforts should be made by attending physicians in using biochemical parameters to make diagnosis of these hyperglycemic emergencies with a view to instituting prompt and adequate treatment.

Keywords: Diabetes mellitus, electrolytes, hyperglycemic emergencies, Insulin, ketones.

[1]. Alvin CP. Diabetes Mellitus: Aetiological classification In: Kasper DL, Braunwald E, Fauci AS, Hauser SL, Longo DL, Jameson JL (eds). Harrison's principles of Internal Medicine. 16th edition. Mc Graw Hill (Medical Publishing division) 2005: 323: 2153-2179.
[2]. Eregie A, Unadike BC. Common causes of morbidity and mortality amongst diabetic admissions at the University of Benin Teaching Hospital, Benin City, Nigeria. Pak J Med Res 2010; 49: 89-93.
[3]. Umpierrez GE, Murphy MB, Kitabchi AE. Diabetic Ketoacidosis and Hyperglycaemic Hyperosmolar Syndrome. Diabetes Spectrum 2002; 15: 28-36.
[4]. Mac Isaac RJ, Lee LY, Mc Neil KJ, Tsalamandris C, Jerums G. Influence of age on the presentation and outcome of acidotic and hyperosmolar diabetic emergencies. Internal Medicine Journal. 2002; 32: 379-385.
[5]. Kitabchi AE, Umpierrez GE, Murphy MB, Barret EJ, Kreisberg RA, Malone JI, Wall BM. Management of Hyperglycaemic crises in patients with diabetes. Diabetes Care. 2001; 24: 131-153.
[6]. Wachtel TJ, Tchi-Mouradjan LM, Goldman DL, Ellis SA, O'Sullivan PS. Hyperosmolarity and acidosis in diabetes morbidity. J Gen Int Met. 1991; 6: 495-502.
[7]. Lorber D. Non Ketotic hypertonicity in diabetes mellitus. Med Clin North Am.1995; 79: 39-52.
[8]. Winter SD, Pearson JR, Gabow PA, Schultz AL, Lepoff RB. The fall of the serum anion gap. Arch Intern Med .1990; 150: 311-313.
[9]. Kitabchi AE, Guillermo E, Umpierre MD, Mary BM, Robert A, et al. Hyperglycaemic crises in Adult patients with Diabetes. Diabetes Care 2006; 29: 2739-2748.
[10]. Slovis CM, Mask VG, Slovis RJ, Bain RP. Diabetic Ketoacidosis and infection, leukocyte count and differential as early predictors of infection. Am J Emerg Med. 1987; 5: 1-5.

Abstract: Acute bacterial meningitis continues to be a major public health problem. Pretreatment with antibacterial agents in patients of purulent meningitis may modify the clinical picture and CSF findings. Culture of CSF takes 24-48 hours for isolating the causative organism. Latex Particle Agglutination Test (LAT) since antigen may persist in the CSF even after lysis of bacteria. These immunological test could prove useful in partially treated patients. The present study was therefore designed to evaluate the utility of Latex Agglutination Test (LAT).

Keywords - etiology, LAT, Newborn, meningitis, sepsis,

[1]. J.S. Yu and A.Gravaog. Purulent meningitis in the neonatal period. Arch. Dis. Childhealth. 1963, 38:391.
[2]. James C.Overall Jr.M.D. Neonatal bacterial meningitis. Journal of Paediatrics. April 1970: 76 : 499 – 511.
[3]. H.C Whittle P.Tugwell, L.J Egler, B.M Greenwood. Rapid bacteriological diagnosis of pyogenic meningitis by latex agglutination test. The lancet Sep.14: 1974: 619-621.
[4]. Joel I, Ward, M.D., George, R.Siber, M.D. Rapid diagnosis of Haemophilus influenza type b infections by latex particle agglutination and counter immune electrophoresis. The Journal of Pediatrics 1978: 93: 37-42.
[5]. Harcharan Singh R.Sarkar. Immunological test in acute bacterial meningitis. Indian pediatrics Vol.25: 188.
[6]. Bijay R. Mirdha, U.Gupta and R.A. Bhujwala Latex agglutination test. An adjunct to the laboratory diagnosis of pyogenic bacterial meningitis. Indian Journal of Paediatrics. 199 : 58 : 521 – 524.
[7]. N.Deivanayagam, T.P Ashok, K.Nedunchelian, S.Shaffi Ahamad. N.Mala. Bacterial meningitis diagnosis by latex agglutination test Indian Pediatrics. Vol.30 : 1993: 495-499.
[8]. B.K das Rajesh Lal Gurubhacharya, I.M Mohapatra and O.P Mishra Bacterial antigen detection test in meningitis. Indian Journal of Pediatrics. 2003: 70 (10) : 799-801.
[9]. McCarthy A.E Victor G. Ramotar K. Toye B 1994 Risk factor for Acquiring ampicillin resistant enterococci and clinical outcomes at candian tertiary care hospital. Journal of clinical microbiology 32: 2671 – 2676.
[10]. Nulder C.J.J Van Alphen L. Zanon H.C 1984 neonatal meningitis caused by E.coli in Netherlands. Journal of infections diseases, 935 – 940.

Abstract: Objective: This is a report of 5 cases of complete second branchial fistula which were diagnosed and treated in a span of 2 years in the Department of ENT , head & neck surgery, Rural Medical College, Loni. The main objective of this report is to highlight the use of fistulogram for the diagnosis. Case report: 5 cases were reported of the age group between 11 to 22 years who presented with an intermittent mucoid discharge from an external opening in the neck since birth with right to left ratio being 4:1 and male: female ratio being 1.5:1 & were diagnosed to have a second branchial cleft fistula. A preoperative fistulogram revealed the tracts up to the tonsillar fossa . Complete excision of the tracts were done by a two step neck incision. Conclusion: Though second branchial fistulae are common, complete fistulae are rare and this merits the publication of this report. The report also stresses on the need to perform a preoperative fistulogram for the diagnosis.

Keywords: Branchial cleft, Branchial fistula, Complete second Branchial fistula, Management .

[1]. Anil K. Lalwani Current Diagnosis and Treatment Otolaryngology Head and neck surgery chapter 27 page 418-419 .
[2]. Nicolas R, Ducroz V , Garabedian EN, Triglia JM, Fourth Branchial pouch anomalies : a study of six cases and review of literature . International Journal of Paediatric Otorhinolaryngology . 1998 ;44 :5-10 .
[3]. Wg C dr Samaresh Sahu , Wg Cdr Ameet Kumar , gp Capt TS Ramakrishnan Branchial fistula : an imaging perspective , MJAFI 2011 :67 : 262-264 .
[4]. C . Shekhar ,R. Kumar ,R. Kumar, S.K. Mishra ,M. roy ,K. Bhavana The complete branchial fistula : A case report , Indian journal of otolaryngology and Head and neck Surgery Vol . 57 , No. 4 October- December 2005.
[5]. Chava Anjaneyulu , Chakkyath Jayaram Sharan , Complete branchial fistula , Bahrain Medical Bulletin , Vol .25 ,No. 4, December 2003 .

Abstract: Background: oral complications may be leukemia's first presentation. Aim: to present a case of a young girl with gingival enlargement that led to the diagnosis of acute lymphoblastic leukemia is reported. Conclusion: dentists must be able to clearly recognize oral physiological characteristics, and, when identifying changes of normalcy, to fully investigate it requesting additional tests or referring the patient to specialized professionals.

Keywords: gingival enlargement, diagnosis, acute lymphoblastic leukemia

[1]. Vernon P. Burke, James M. Startzell. The Leukemias. Oral Maxillofacial Surg Clin N Am 2008; 20: 597–608
[2]. Cotran RS, Kumar V, Collins T. Robbin's Pathologic Basis of Disease. 6th edn. Philadelphia: WB Saunders Company 1999: 675- 678.
[3]. Serhat Demirer, Hakan Özdemir. Gingival Hyperplasia as an Early Diagnostic Oral Manifestation in Acute Monocytic Leukemia: A Case Report. European Journal of Dentistry 2007; 1
[4]. Santosh Patil, Nitin Kalla. Leukemic gingival enlargement: a report of two Cases. Archives of Orofacial Sciences 2010; 5: 69-72
[5]. Dreizen S, McCredie KB, Keating MJ and Luna MA. Malignant gingival and skin "infiltrates" in adult leukemia. Oral Surg Oral Med Oral Pathol 1983; 55: 572-579
[6]. Curtis L. Cooper, Ruth Loewen. Gingival Hyperplasia Complicating Acute Myelomonocytic Leukemia. J Can Dent Assoc 2000; 66:78-9
[7]. Mahesh Chavan, Arun Subramaniam. Acute myeloid leukemia: a case report with palatal and lingual gingival alterations. Braz J Oral Sci January/March 2010; 9: 1

Abstract: AIM: The aim of this study was to assess the extent of backpack load on postural changes in school children who were carrying school bags. Materials And Methods: 87 normal healthy school children out of these 40 girls and 47 boys from CBSE school were tested in upright erect posture. Depending on % of schoolbag weight of their total body weight, they were divided into three groups - Group I-(<10%), Group II (10-20%) and Group III (20-30%) Postural angles such as Craniohorizontal(CHA),Craniovertebral angle (CVA) and shoulder saggital posture were measured in three groups. Results: With increasing schoolbag load from less than10% to 30% BW, CVA progressively increased significantly while CHA and shoulder saggital angle was decreased significantly as magnitude of backpack load increases. These results indicate a limitation on the ventilatory pump caused by load carriage which is directly related to the load carried and characteristic of restrictive disease of the respiratory system. Conclusion: The present study demonstrates the increased forward head posture observed in children while carrying loaded backpacks are associated with backpack weight. The greatest differences were noted as the magnitude of backpack loads goes on increasing. Further analyses of the changes in forward head posture suggest that the condition as well as the weight of backpack loads markedly affect forward head posture and present a risk for neck pain in children.

Keywords: school children, backpack load, CVA, CHA, shouldser saggital posture.

[1]. Heather M. Brackley, Joan MS and Jessica CS (2009). Effect of backpack load placement on posture and spinal curvature in prepubescent children. Work. 32:351-360.
[2]. Frances E.Kistner , Postural Compensations and Subjective Complaints Due to Backpack Loads and Wear Time in Schoolchildren Aged 8 to 11,Abstract of a dissertation at the University ofMiami.August-2011, page no 25-107.
[3]. Haselgrove C, Straker L, Smith A.(2008) Perceived school bag load, duration of carriage, and method of transport to school are associated with spinal pain in adolescents: an observational study.Australian Journal of Physiotherapy. 54:193-200.
[4]. Voll HJ, Klimt F 1977. On strain in children caused by carrying schoolbags. (From Die beanspruchung des kindes durch die schultasche). Offentliche Gesundheitswesen,39: 369-378.
[5]. Grimmer KA, Williams MT, Gill TK 1999. The association between adolescent head-neck posture,backpach weight and anthropometric features. Spine,24: 2262-2267.
[6]. Mohan M, Singh U, Quddus N 2007. Effect of Backpack loading in Indian school children. Ind J Physiotherap & Occup Therap, 1: 1-9.
[7]. Brackley HM, Stevenson JM. Are children's backpack weight limits enough? A critical review of the relevant literature. Spine 2004; 29:2184–2190
[8]. Mackie HW, Legg SJ. Postural and subjective responses to realistic schoolbag carriage. Ergonomics 2008; 51:217–231.
[9]. Devroey C, Jonkers I, Becker AD,Lenaerts G, Spaepen A. Evaluation of the effect of backpack load and position during standing and walking using biomechanical, physiological and subjective measures. Ergonomics 2007; 50:728–742.
[10]. McKvoy MP, Grimmer K. Reliability of upright posture measurements in primary school children.BMC Musculoskeletal Disorders 2005; 6: 35.

Abstract: Background: Neisseria gonorrhoeae infection can occur asymptomatically and due to the growth requirements in the laboratory, it can be easily missed even if it is symptomatic. Isolating the organism using conventional laboratory procedures has yielded varying degrees of sensitivity and specificity. Since there is paucity of information on the prevalence rate of the organism using nucleic acid amplification technique as the detection tool, this study became pertinent. Also, the associated risk factors to the infection on female undergraduate students were highlighted. Methodology: Two hundred undergraduate, non-pregnant, asymptomatic female students who were above the age of 16 years but not above the age of 30 years were randomly selected and given questionnaires with self administrable vaginal swab sticks. The participants completed the questionnaires and provided the vaginal swab specimens which were analyzed using Strand Displacement and Amplification Technique. Results: Out of the 200 sexually active participants, 10 tested positive, giving a prevalence of 5% for Neisseria gonorrhoeae. Some of the associated risk factors elicited were; having multiple sexual partners, irregular use of condom and past history of sexually transmitted infections Conclusion: There is a need for a policy on routine screening for Neisseria gonorrhoeae since the treatment is available but the complications are danderous to reproductive health.

Key Words: Prevalence, Neisseria gonorrhoeae, Strand Displacement and Amplification (SDA) Technique.

[1]. Velicko Iand Unemo M: Increase in reported gonorrhoea cases in Sweden, 2. Euro Surveill 2009; 14: 1-5.
[2]. ESSTI. sexually transmitted infections in Europe. Health Protection Agency, 2008; 3: p.27-54.
[3]. Janier M, Lassau F, Casin Iand Morel P. Pharyngeal gonorrhoea: The forgotten reservoir, Sex Transm Ifect 2003; 79;345.
[4]. Hook EWI and Handsfield HH. Gonococcal infections in adults. In: Holmes KK, Sparling PF and Mardh PA, et al, eds. Sexually Transmitted Diseases 3rd ed. San Francisco, CA: Macgraw-Hill. 1999 : 451-466.
[5]. Fleming DT and Wasserheit JN. From epidemiological synergy to public health practice: the contribution of sexually transmitted disease to sexual transmission of HIV infection. Sex Transm Infect 1999; 75: 3-17.
[6]. Chem A, Boulton IC, Pongoski J, Conchrane A and Gray-Owen SD. Induction of HIV-1 long terminal repeat mediated transcription by Neisseria gonorrhoeae. AIDS 2003; 17: 625-628.
[7]. Schieh ISD. National Public Health Service for Wales. Renewing the focus, HIV and other sexually transmitted infections in the United Kingdom in 2002. London: Health Protection Agency, 20002.
[8]. World Health Organization Task force on Prevention and Management of Tubal Infertility: Serological relationship to Post Chlamydia and Gonococcal infections. Sex Transm Dis. 1995; 22: 71-77.
[9]. Killick V, Kell P, Plumb H, Hurd N and Turner P. Screening for Neisseria gonorrhoeae using the BD Probe Tec Nucleic acid amplification test in a low prevalence genitourinary medicine clinic. Int. J.STD AIDS. June 2002; vol 23 no. 6 e1-e3.
[10]. Clinic- based testing for rectal and pharyngeal Neisseria gonorrhoeae and Chlamydia trachomatis infect ions by community-based organizations-five cities, United States, 2007. MMWR Morb. Mortal Wkly Rep 2009; 58: 716-719.

Abstract: The aim of the study was to investigate the periodontal and microbiological status of patient undergoing fixed orthodontic treatment. Methods: In this study, plaque samples were collected from 12 patients at baseline, four monthly visits during orthodontic treatment and at 30 days after removal of the appliance. A benzoyl-DL-arginine-naphthylamide (BANA) test was performed to identify the periodontal pathogens. Dark field microscopy was used to recognize the morphotypes. The Plaque Index and probing depths were assessed at each test interval to determine the hygiene and periodontal status of the patients. Data were analyzed using analysis of variance and Tukey's test. Results: Significant increase in plaque score, probing depths, and BANA scores were found at each interval after placement of orthodontic appliances. The levels, however returned to baseline after removal of the appliances. Dark field microscopy confirmed increases in small spirochetes (8.5%), large spirochetes (2%), non-motile rods (8.5%), fusiforms (5.5%), and filaments (1%) with orthodontic treatment. Conclusions: Patients undergoing orthodontic therapy have an increase in plaque accumulation, probing depth, and microbial activity that may be associated with periodontal destruction. Thirty days after removal of the orthodontic appliance, the plaque score, probing depth, and BANA test score returned to almost baseline level.

Key words: orthodontic appliance, plaque index, probing depth.

[1]. Naranjo AA, Trivino ML, Jaramillo A, Betancourth M, Botero JE. Changes in the subgingival microbiota and periodontal parameters before and 3 months after bracket placement. Am J Orthod Dentofacial Orthop 2006;130:275.17-22.
[2]. Ai H, Lu HF, Liang HY, Wu J, Li RL, Liu GP, Xi Y. Influences of bracket bonding on mutans streptococcus in plaque detected by real time fluorescence-quantitative polymerase chain reaction. Chin Med J (Engl) 2005;118:2005-10.
[3]. Hirsch DI, Kulbersh R, Kaczynski R. Assessment of pretreatment orthodontic patients using the BANA test. N-benzoyl-DLarginine- naphthylamide. Am J Orthod Dentofacial Orthop 1997;112:154-8.
[4]. Atack NE, Sandy JR, Addy M. Periodontal and microbiological changes associated with the placement of orthodontic appliances. A review. J Periodontol 1996;67:78-85.
[5]. Socransky SS, Haffajee AD, Cugini MA, Smith C, Kent RL Jr. Microbial complexes in subgingival plaque. J Clin Periodontol 1998;25:134-44.
[6]. Loesche WJ, Lopatin DE, Giordano J, Alcoforado G, Hujoel P. Comparison of the benzoyl-DL-arginine-naphthylamide (BANA) test, DNA probes, and immunological reagents for ability to detect anaerobic periodontal infections due to Porphyromonas gingivalis, Treponema denticola, and Bacteroides forsythus. J Clin Microbiol 1992;30:427-33.
[7]. Loesche WJ, Giordano J, Hujoel PP. The utility of the BANA test for monitoring anaerobic infections due to spirochetes (Treponema denticola) in periodontal disease. J Dent Res 1990;69:1696-702.
[8]. O‟Leary TJ, Drake RB, Naylor JE. The plaque control record. J. Periodontol 1972;43:38.
[9]. Sadowsky C, BeGole EA. Long-term effects of orthodontic treatment on periodontal health. Am J Orthod 1981;80:156-72.
[10]. Polson AM, Subtelny JD, Meitner SW, et al. Long-term periodontal status after orthodontic treatment. Am J Orthod Dentofacial Orthop 1988;93:51-8