iosr-JDMS   Volume-7 ~ Issue-5

Abstract: Introduction: Septicemia is a major cause of mortality in neonates. One of the major problems is non-availability of any sensitive and specific test for early diagnosis. So a number of adjunctive tests including serum fibrinogen level were evaluated. Objective: 1) to note the alteration of serum fibrinogen level in neonatal septicemia. 2) To Study its diagnostic and prognostic implication. Materials & Methods: 60 cases of neonatal septicemia diagnosed by "sepsis screen" were compared with 60 matched controls with respect to their serum fibrinogen level on two occasions: one on admission and other after attaining age of 6th day whenever applicable. The titre taken in first 5 days of life was termed as Day "0‟ value and titre taken 6th day onward was termed as ≥6th day PNA value. The sensitivity of serum fibrinogen as diagnostic test was evaluated compared to "sepsis screen" It‟s value as a prognostic marker was also estimated. Results: The serum fibrinogen level in septicemic neonates was significantly higher than controls both in term and pre-term neonates and the elevation was consistent in both occasions. The hypofibnogenemic (<200mg/ dL) septicemic neonates showed significantly higher mortality and higher bleeding manifestations than non-hypofibrinogenemic (≥ 200mg/ dL) septicemic neonates. The serum fibrinogen level showed a sensitivity to diagnose neonatal septicemia in a range of 66.7% to 83%. Conclusion: Serum fibrinogen level could act as diagnostic and prognostic markers of neonatal septicemia along with other clinical and laboratory parameters.

Key Words: Neonatal septicemia, fibrinogen, sepsis screen.

[1]. Forfar and Arneil‟s Texbook of Pediatrics. 7th edition. 2010. pp 275 282
[2]. Nelson Texbook of Pediatrics. 19th edition. 2011. pp 538 – 552
[3]. Cloherty J.P. Stark A R. Manual of Neonatology. 7th edition. 2012. pp 271 291
[4]. Dutta A K. Newer concepts in the diagnosis and management of neonatal sepsis. In the commemorative volume published on the occasion of MILLENNIUM PEDICON CALCUTTA – 2000. pp 1-8.
[5]. Sharma A, Krishna Kutty CV, Sabharwal U et al. Evaluation of Sepsis Screen for diagnosis of neonatal septicemia. Indian Peditr. 1993; 60: 559 – 563.
[6]. Nathan and Oski. Hematology of Infancy and Childhood. 4th edition. 1993. pp 118 – 119.
[7]. Ries M, Klings J, Rauch R, Zenker M. Changes in the activation markers of blood coagulation and fibrinolysis in the neonatal period. Klin Pediatr. 1996; 208 (6): 350-354.
[8]. The Development of Human Coagulation System in fullterm neonates. Blood. 1987; 70: 165
[9]. Zipursky A, Jabar HM. The Hematology of bacterial infections in neonatal period. Clinical Hematology. 1978; 7: 175.
[10]. Jeffrey GS. Clinico-pathologic approach to the diagnosis of Neonatal Sepsis. Clin Perinatol. 1991; 18(2): 361-381.

Abstract: Background: This was a study to determine hepatitis C sero-prevalence rate and create awareness on hepatitis C. Methods: The study was a descriptive cross-sectional survey of attendees at the 2012, World Hepatitis Day ceremony at the Benue State University Teaching Hospital in Makurdi, Nigeria. Interviewer-administered questionnaires were used to obtain information from consenting participants. All respondents were screened for hepatitis C using the Hepatitis C antibody (Anti HCV) test. Results: Hepatitis C sero-prevalence rate was 2.8%. Most of the respondents were: aged 40 years or less (85%), males (51.5%), had 6-10 persons in their household (51.7%). Only 6.4% had ever been transfused with blood, 4.3% had a history of jaundice, and 15.2% had a family member with hepatitis. Majority (85.1%) had poor knowledge regarding hepatitis C and only 27.4% had previously screened for it. There was no significant association between hepatitis C sero-positive status with demographic, risk factors for hepatitis C or knowledge about hepatitis C Conclusions: Hepatitis C infection is a health challenge in Nigeria in the setting of poor knowledge and inadequate screening facilities. All stakeholders should work towards improved awareness and testing for hepatitis C.

Key words: prevalence, hepatitis C Virus, Makurdi

[1]. Gravitz L. "A smouldering public-health crisis". Nature 2001; 474 (7350): S2-4.
[2]. World Health Organization (WHO). "Hepatitis C". June 2011.
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[4]. Y. Hutin, M. E. Kitler, G. J. Dore et al., "Global burden of disease (GBD) for hepatitis C," Journal of Clinical Pharmacology. 2004; 44(1): 20–29
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[7]. Ejiofor O S, Emechebe G O, Igwe W C, Ifeadike C O, Ubajaka C F. Hepatitis C virus infection in Nigerians. Niger Med J [serial online] 2010 [cited 2013 Apr 14];51:173-6. Available from: http://www.nigeriamedj.com/text.asp?2010/51/4/173/73290
[8]. Alao O, Okwori E, Araoye M: The Sero-Prevalence Of Hepatitis C Virus (HCV) Infection Among Prospective Blood Donors In Makurdi, Nigeria . The Internet Journal of Infectious Diseases. 2010 Volume 8 Number 1. DOI: 10.5580/1d2e
[9]. Ayolabi C. I, Taiwo M. A, Omilabu S. A, Abebisi A. O, Fatoba O. M. Sero-prevalence of hepatitis C virus among blood donors in Lagos, Nigeria. African Journal of Biotechnology Vol. 5 (20), pp. 1944-1946, 16 October 2006. Available online at http://www.academicjournals.org/AJB
[10]. Halim N. K. and Ajayi O. I. Risk Factors and sero- prevalence of Hepatitis C Antibody in Blood donors in Nigeria. East Afr Med J 2000; 77: 410-2.

Abstract: An experimental study was conducted to study the effect of spirulina on anthropometric parameters and the bio-chemical parameters before and after its use as nutritional supplement in school children. The study was conducted in a residential girl's school in the age group between 11 to 13 years. Three capsules of spirulina were given during dinner time for 3 months. At the initial survey and at the end of 6th month the anthropometric and bio-chemical findings were recorded. Blood samples were taken to analyse hemoglobin (Hb), serum ferrtin, serum zinc, serum protein and serum albumin levels at 0, 3 and 6 months. Result: There was a significant increase in anthropometric measurements and Hemoglobin, serum ferrtin, serum zinc, serum protein and serum albumin levels in the study sample after 6 months.

Conclusion: The anthropometric and bio-chemical parameters improved after the use of spirulina.

[1]. IIMSAM – Intergovernmental Institution for the use of Micro-Algae Spirulina against Malnutrition.
[2]. Bioavailability of spirulina carotenes in preschool children. By V.Annapurana, et al.1991. National Institute of Nutrition, Hyderabad, India.J.Clin.Biochem Nutrition. 10 145.1
[3]. Large scale Nutritional supplementation with spirulina alga. By CV.Seshadri. 1993. All India Coordinated Project on Spirulina. Shri Amma Murugappa Chettiar Research Center (MCRC) Madras, India.
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[5]. Effectiveness of spirulina algae as food for children with protein-energy malnutrition in a tropical environment. By P.Bucaille. 1990. University Paul Sabatier, Toulouse, France. Oct.1990. Zaire. (in French.)
[6]. Clinical experiences of administration of spirulina to patients with hypochromic anemia. By T.Takeuchi, et al. 1978. Tokyo Medical and Dental Univ. Japan.
[7]. The study on curative effect of zinc containing spirulina for zinc deficient children. By Wen Yonghuang, et al. 1994. Capital Medical College, Beijing. Presented at 5th Int'l Phycological Congress, Qingdao, June 1994. China.
[8]. 8 Observations on the utilization of spirulina as an adjuvant nutritive factor in treating some diseases accompanied by a nutritional deficiency. By V.Fica, et al. 1984. Clinica II Medicala, Spitalui Clinic, Bucuresti. Med. Interna 36(3). Romania. (in Romanian)
[9]. Spirulina platensis and specialties to support detoxifying pollutants and to strengthen the immune system. By L.P.Loseva. Sep 1999. Research Insitute of Radiation Medicine, Minsk, Belarus. 8th Int'l Congress of Applied Algology, Italy, Belarus.
[10]. Spirulina in Jiangxi China. By Miao Jian Ren. 1987. Academy of Agricultural Science. Presented at Soc. Appl. Algology, Lille France Sep.1987. China.

Abstract: Background: Ascending infections of the upper genital tract are associated with morbidities such as infertility, chronic pelvic abscess, chronic pelvic pain, and ectopic pregnancy, if not treated properly. The treatment of pelvic inflammatory disease requires accurate diagnosis which largely is dependent on laid out clinical criteria that had been noted to lack specificity. Laparoscopy has been used as a gold standard over time but is not used routinely in the diagnosis of this disease entity. Objective: The objective was to determine the correlation between use of clinical diagnostic criteria and laparoscopy in the diagnosis of pelvic inflammatory disease. Design/Method: An electronic literature search of articles published on the subject from 1969 to 2012, using search engines: Highwire, Springerlink, Hinari, Pubmed, and Google were analyzed. Outcome: There is poor correlation between clinically diagnosed pelvic inflammatory disease and laparoscopic confirmations resulting in over diagnosis of the disease. Conclusion: Clinical criteria for the diagnosis of pelvic inflammatory disease have a low predictive value. The routine use of laparoscopy appears to be a better option to reduce over diagnosis of this condition, missed diagnosis of other pelvic pathology, and ultimately to reduce expenditure incurred in overtreatment.

Key words: Clinical criteria, laparoscopy, pelvic inflammatory disease

[1]. Nazar NA, Anthony G. Pelvic inflammatory disease. In: Robert Davids, Ash L, edited. Gynaecology. 4th ed. Church Livingstone, Elsevier Publishers; 943-954.
[2]. Wiesenfiled HS, Sweet RL, Ness RB, Krohn MA, Amotegni AJ, Hiller SL. Comparison of acute and subclinical Pelvic inflammatory disease. Sex Transm Dis 2005;32:400-5.
[3]. Alison SB. Pelvic Inflammatory disease. ObstetGynaecol 2004; 6:138-44.
[4]. Frei BJ. Acute Pelvic inflammatory disease. Semin Adolesc Med 1986;2:143-53.
[5]. Gogate A, Rabin S, Nicholas S, Gogate S, Gaonkar T, Naidu A, et al. Risk factors for laparoscopically confirmed pelvic inflammatory disease: Findings from Mumbai(Bombay ) India. Sex Transm Inf 1998;74:426-32.
[6]. Grosestein F, Rothman KJ. Epidemiology of Pelvic inflammatory disease. Epidemiology 1994;5:234-42.
[7]. Simms I, Rogers P, Charlett A. The rate of diagnosis and demographics of Pelvic inflammatory disease in general practice England and Wales. Int J STD AIDS 1999;10:448-51.
[8]. Washington AE, Goves S, Schachter J, Sweet RL. Oral contraception, Chlamydia trachomatis infection and Pelvic inflammatory disease: A word of caution about protection. JAMA 1985;253:2246-50.
[9]. Rein DB, Kassler WJ, Irwin KL, Rabiee L. Direct medical cost of pelvic inflammatory disease and its sequelae: Decreasing but still substantial. Obstet Gynecol 2000;95:397-402.
[10]. Washington AE, Katz P. Cost of and payment source for Pelvic inflammatory disease, trends and projections 1993 through 200. JAMA 1991;266:2565-9.

Abstract: Saliva is a fluid that can be easily collected, contains locally-derived and systemically-derived markers of periodontal disease, and hence may offer the basis for a patient specific diagnostic test for periodontitis. The present study evaluates the salivary levels of aspartate aminotransferase in periodontal disease conditions like gingivitis, periodontitis and their comparison with the healthy, based on their largest Community periodontal index of treatment needs code. Total of 100 participants were included. Twenty five patients in each group, assigned to four groups C0, C1, C3 and C4. Mean levels of aspartate aminotransferase (U/ml) for groups C0 - 25.75, C1 - 30.59, C3 - 46.90 and C4 -100.28 and there were statistically significant differences (p< 0.05) between levels from group C0 to C1, C3 and C4. Higher salivary aspartate aminotransferase levels seem to be related to periodontal destruction that includes periodontal pockets and gingival bleeding.

Key Words: Aspartate aminotransferase, Community periodontal index of treatment needs code, gingivitis, periodontitis, saliva.

[1] Agnihotram G, Singh TR, Pamidimarri G, Jacob L, Rani S, Sravanthi. Study of clinical parameters in chronic periodontitis. Int.J.Appl.Biol.Pharm.Technol 2010; 1(3):1202-1208.

[2]. Totan A, Greabu M, Totan C, Spinu T. Salivary aspartate aminotransferase, alanine aminotransferase, & alkanine phosphatase. Possible markers in periodontal diseases? Clin Chem Lab Med 2006; 44:612-615.

[3]. Ladue.JS, Wroblewski F, Karmen. A. Serum glutamate oxaloacetate transaminase in human acute transmural myocardial infarction. Sci 1954; 120: 497-499.

[4]. Persson GR, Page RC. Diagnostic characteristics of crevicular fluid aspartate aminotransferase (AST) levels associated with periodontal disease activity. J Clin Periodontol 1992; 19: 43-48.

[5]. Deshpande BM, Kohad RM. Comparative study of alkaline phosphatase, aspartate transaminase and alanine transaminase in serum and gingival creivicular fluid in gingivitis and periodontitis. J Indian Soc Periodontol 1997; 21(3):71-73.

[6]. Smith AJ, Alexander M, Mackernzie D, Lennon A, Riggio MP, MacFarlane TW. Microbial factors and gingival crevicular fluid aspartate aminotransferase levels. A cross-sectional study. J Clin Periodontol 1998; 25: 334-339.

[7]. Todorovic T, Dozic I, Vicente-Barrero M, Ljuskovic B, Pejovic J, Marjanovic M et al. Salivary enzymes & periodontal disease. Med Oral Patol Oral Cir Bucal 2006; Mar 1: 11(2): E115-9.

[8]. Shimada K, Mizuno T, Ohshio K, Kamaga M, Murai S, Ito K. Analysis of aspartate aminotransferase in gingival crevicular fluid assessed by using PocketWatchTM: a longitudinal study with initial therapy. J Clin Periodontol 2000; 27: 819–823.

[9]. Cesco R de T, Ito IY, Albuquerque RF Jr. Levels of aspartate aminotransferase (AST) in saliva of patients with different periodontal conditions. J Clin Periodontol 2003; 30: 752–755.

[10]. Richard JO, Howard HT, Marc LN, David SR, Gordon HD, Julio S et al. Relationship between crevicular aspartate aminotransferase levels and periodontal disease progression. J Periodontol 2001; 72:17-24.

Abstract:During the routine undergraduate dissection of the Thyroid Gland of a sixty year old male cadaver in the department of Anatomy, Gandhi Medical College, it was observed that the presence of Levator Glandulae Thyroidae on both sides of isthmus of Thyroid Gland. This type of variation is observed only once in our study of about 150 specimens observed in Anatomy Department from 2004 to 2013, hence presented for its clinical importance.

Keywords - Levator Glandulae Thyroidae, Thyroid Gland, Isthmus

[1] Lee McGregor's Synopsis of Surgical Anatomy 12th Edition 1995 Verghese Publishing House, Bombay
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[3] Gregory JK, Guse DM. Unique variant of levator glandulae thyroideae muscle. Clin Anat 2007; 20:966-7. Cited by Ranade AV, Rai R, Pai MM, Nayak SR, Prakash, Krishnamurthy A, Narayana S. Anatomical variation of the thyroid gland: possible surgical implications. Singapore Med J 2008;49:831–4.
[4] Bourgery JM. Traite complet d'anatomie de l'homme, comprenant la medecine operatoire, avec planches lithographiees d'apres nature par NH Jacob. Atlas. Paris. C. [-A.] Delaunay 1831; Tome II: 90, 1836; Tome IV: 91. French. Cited by Ranade AV, Rai R, Pai MM, Nayak SR, Prakash, Krishnamurthy A, Narayana S. Anatomical variation of the thyroid gland: possible surgical implications. Singapore Med J 2008;49:831-34.
[5] Godart J. Muscle de la glande thyroide, muscle de Duvernoi, musculus levator glandulae thyreoideae. (Exemple du Soemmerring.) [Abstr.] Bull Soc Anat Paris 1847; 22:202-5. French. Cited by Ranade AV, Rai R, Pai MM, Nayak SR, Prakash, Krishnamurthy A, Narayana S. Anatomical variation of the thyroid gland: possible surgical implications. Singapore Med J 2008;49:831-34.
[6] Huschke E. Traité de splanchnologie et des organes des sens. In: Encyclopedie Anatomique. Vol V. Paris: JB Bailliere, 1845: 274. Cited by Ranade AV, Rai R, Pai MM, Nayak SR, Prakash, Krishnamurthy A, Narayana S. Anatomical variation of the thyroid gland: possible surgical implications. Singapore Med J 2008;49:831-34

Abstract: This study aimed to evaluate effectiveness of the chick cardiomyocyte micromass (MM) system for prediction of teratogenecity of common environmental factors and prevention of such effects by addition of multivitamins. White Leghorn 5-day-old embryo hearts were dissected and disassociate to produce a cardiomyocyte cell suspension in Dulbecco's Modified Eagle's Medium. The cultures were incubated at 370C in 5% CO2 in air. Microscopic observations regarding cell beating and contractility were made at 24, 48 and 144 hours post culture. Cellular viability/metabolic activity was assessed by using the resazurin reduction assay and cell total protein content was assessed by the kenacid blue assay. It was observed that cadmium chloride induced toxicity was not reversed by addition of folic acid and vitamin C, however the nicotine induced teratogenic effects were reversed by addition of folic acid and vitamin C. The results demonstrate the potential of the chick cardiomyocyte MM culture assay to identify teratogens/embryotoxins that alter morphology and function, which may result in either teratogenic outcome or causing cytotoxicity and also protection brought about by addition of multivitamins. This could form part of a screen for developmental toxicity related to cardiac function. The effects of nicotine were compared to in ovo culture also showed protective effects of multivitamins in nicotine induced teratogenecity.

Key Words: Chick cardiomyocyte, Micromass culture, environmental teratogens, multivitamins.

[1]. Spielmann, H., et al., Preliminary results of the ECVAM validation study on three in vitro embryotoxicity tests. Altern. Lab. Anim, 2001. 29: p. 301-303.
[2]. Flint, O.P. and T.C. Orton, An invitro assay for teratogens with cultures of rat embryo midbrain and limb bud cells. Toxicology and Applied Pharmacology, 1984. 76: p. 383-395.
[3]. Parsons, J.F., J. Rockley, and M. Richold, In vitro micromass teratogen test: Interpretation of results from a blind trial of 25 compounds using three separate criteria. Toxicology in Vitro, 1990. 4(4-5): p. 609-611.
[4]. Tsuchiya, T., et al., Embryolethality of new herbicides is not detected by the micromass teratogen tests 1991. 65(2): p. 145-149.
[5]. Wiger, R., A. Strottum, and G. Brunborg, Estimating chemical developmental hazard in chicken embryo limb bud micromass system. Pharmacol Toxicol., 1988. 62(1): p. 32-37.
[6]. L'Huillier, N., M.K. Pratten, and R.H. Clothier, The relative embryotoxicity of 1,3-dichloro-2-propanol on primary chick embryonic cells. Toxicology in Vitro, 2002. 16(4): p. 433-442.
[7]. Meyer, M.P., et al., The Extracellular ATP Receptor, cP2Y1, Inhibits Cartilage Formation in Micromass Cultures of Chick Limb Mesenchyme. Developmental Dynamics, 2001. 222: p. 494-505.
[8]. Hurst, H.S., R.H. Clothier, and M. Pratten, An evaluation of a novel chick cardiomyocyte micromass culture assay with two teratogens/embryotoxins associated with heart defects. ATLA, 2007. 35(5): p. 505-511.
[9]. Ahir, B. and M.K. Pratten, Association of anxiolytic drugs diazepam and lorazepam, and the antiepileptic valproate, with heart defects--effects on cardiomyocytes in micromass (MM) and embryonic stem cell culture. Reprod Toxicol., 2011. 31(1): p. 66-74.
[10]. Memon, S. and M.K. Pratten, Developmental toxicity of ethanol in chick heart in ovo and in micromass culture can be prevented by addition of vitamin C and folic acid. . Reprod Toxicol, 2009. 28(2): p. 262-269.

Abstract: Fatherhood is the act of being a father, as opposed to merely "fathering" a child. The father has an important potential role at each developmental stage that his children pass through. During pregnancy and birth, the father-to-be plays crucial roles in the transition of the family. Fathers discipline with respect and with love, the goal being to help socialize their children in positive ways. Good fathers set limits and are firmThe present study was undertaken to assess the Impact of father's involvement in child care and development . The study was based upon the sample 120 respondents in South City, RajniKhand, RuchiKhand and Banglabajar were selected purposively from semi urban area in Lucknow city in U.P Interview schedule as used for data collection and Purposive sampling method was used for sample selection. F test and Chi square analysis was used for data analysis. . The result revealed that father's education and occupation had highly significant impact on father's involvement in child care and development.

Keywords:- fathers involvement, child care and development

[1]. Russel (1983).Responsibility is the most important for a child's developmental wellbeing
[2]. Mishra.S, and Dayal.O (2012). "Impact of father's education on personality development of school going children". International Research Journal Lab to Land,4: 182-186
[3]. Mishra.S and Dayal O (2012). Impact of family size and gender on personality of school going children among low income group families. Asian journal Home Science: An International Referred Journal, , 7 (2): 544-547
[4]. Mishra.S and Prabha S (2012).The parent involvement in their children activities. Asian journal Home Science: An International Referred Journal, 70 (2):551-553
[5]. http://msuextension.org/publications/HomeHealthandFamily/MT200008HR.pdf
[6]. http://www.civitas.org.uk/hwu/fathers.php

Abstract: Introduction: The Nigerian Federal Ministry of health reports indicate that Lassa fever outbreaks occur very frequently in different parts of Nigeria. Most of the cases pass unnoticed because the index of suspicion has remained low. The recent Makurdi outbreak was unnoticed for several weeks and killed several people including a Physician before detection. This review aims to remind health workers and enlighten the general public on the danger of Lassa fever. Methods: The Makurdi epidemic was used as a case study to review Lassa fever in Nigeria. Data from the Federal Ministry of Health, the World Health Organisation and published articles on Lassa fever were reviewed.We acknowledge the Federal Ministry of Health Outbreak Investigation and Control Team that worked with us in Benue during the outbreak for sharing the Nigerian Lassa fever data with us. We equally are grateful to the Disease Prevention and Control (DPC) Unit, World Health Organization Country Office, Abuja, Nigeria for providing resource materials on prevention of Lassa fever. Conclusion: A high index of suspicion is crucial to early detection and treatment of Lassa fever and strict adherence to universal precautions would prevent nosocomial transmission.

Key Words: Lassa fever, outbreak, Makurdi

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Abstract: Sex determination is not only a useful tool but of extreme necessity in forensic investigations specifically in cases of sexual assault, aged blood stains and human skeletal remains whereby rapid, sensitive, accurate and reliable methods of investigation are of the utmost importance. A forensic study for genetic sex determination of burnt powdered skeletal fragments from Sokoto, Northwestern Nigeria, using amelogenin gene and alphoid repeats primers was undertaken. With amelogenin gene primers, a success rate of 33.3% was recorded for correct genetic sex identification. PCR Sensitivity = 100%, Specificity = 25%, Predictive value of positive test = 40%, Predictive value of negative test = 100%, False positive rate = 300%, False negative rate = 0%, Efficiency of test = 50%. Fisher's exact probability test P = 1. Z-test: z-value = 0.7746, p>0.05; not statistically significant. Alphoid repeats primers, yielded a success rate of 50% for correct genetic sex identification. PCR Sensitivity = 100%, Specificity = 33%, Predictive value of positive test = 60%, Predictive value of negative test = 100%, False positive rate = 200%, False negative rate = 0%, Efficiency of test = 83%. Fisher's exact probability test P = 1. Z-test: z-value = -2.02837, p<0.05; statistically significant. This study has demonstrated the use of amelogenin gene and alphoid repeats in forensic study for genetic sex determination of burnt powdered skeletal fragments from Sokoto, Northwestern Nigeria, and that alphoid repeats yielded better results than amelogenin gene. This is the first known study determining the sex of burnt cadaveric skeletal fragments by means of PCR in Nigeria. There is need for further studies in Nigeria to complement the findings of this study.

Key Words: Bone, Fire, Identification, Sex, Sokoto.

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Abstract: Polycythemia rubra vera (PRV) commonly presents with non specific symptoms and in due course can develop Stroke. But ischemic stroke as the initial presentation of PRV is rare. A 36 yr male presented to us with right sided hemiparesis and imaging revealed one recent infarct over left thalamo-ganglionic area. Evaluation for underlying cause proved him as a case of polcythemia rubra vera. The case is reported here in view of rarity.

Key Words: Hypercoagulable state, Ischaemic stroke, Polycythemia rubra vera,

[1] Smith Wade S, English Joey D, Johnston S Claiborne. Cerebrovascular Diseases. Harrison's principles of internal medicine.18th Edn. (Mc Graw Hill Companies. 2012) 3270-3299.

[2] Hugh SM. Stroke-causes and clinical features. Medicine international 2005; 32:9, 05(1):36-40.

[3] Frizzell JP. Acute stroke –pathophysiology, diagnosis and treatment. AACN clinical issues 2005; 16(4):421-40.

[4] Matijevic N, Wu KK. Hypercoagulable states and strokes. Curr Atheroscler Rep 2006; 8(4): 324-29.

[5] Spivak Jerry L . Polycythemia vera and other myeloproliferative diseases. Harrison's principles of internal medicine.18th Edn. (Mc Graw Hill Companies. 2012) 898-904.

[6] Pearce JMS, Chandrasekera CP, Ladusans EJ. Lacunar infarcts in polycythemia with raised packed cell volume . BMJ 1983; 287:935-36.

[7] Meng R, Zhou J,J i XM et al. The diagnosis and treatment of polycythemia rubra vera manifesting as acute cerebral stroke. Zhonghua Nei Ke Za Zhi 2006; 45(5): 366-8.

[8] Spivak JL. Polycythemiavera. myths, mechanisms and management. Blood.2002; 100:4272-90.

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[10] Finazzi G. Risk stratification , staging and treatment of patients with Polycythemia Vera: Italian and Europian Collaberation on low dose aspirin in Polycythemia Vera.Semin Thromb Hemost. 2006;32:276-82.

Abstract: Background: The high burden of disease due to breast cancer has continued to have its toll on global health, without exception to Nigeria. The menace of late presentation, with resultant poor survival rates, may be better contained, with improved understanding of the disease characterization in our local settings. Objective: to determine the distribution of tumor grades and histologic types of breast cancer, in Calabar Methodology: retrospective study of eighty-one (81) cases, with use of hospital records Results: Most of the patients were young, with a mean age of 45.06 years, and 30-39 years being the commonest age group (38.3%). They were mostly non-menopausal (72.6%) urban residents (72.2%). As in similar local and international studies, invasive ductal carcinoma was the most prevalent histologic type (85.2%). Grade 3 tumors were most prevalent (66.7%), while grade 1 tumors were least commonly seen (9.9%), with no significant difference in tumor grades across the various socio-demographic and notable risk factors. Recommendations And Conclusion: high prevalence of late stage presentation in our young women is a cause of public health concern, with urgent need for early detection, especially through wide coverage of breast cancer education and screening programs. In-depth interviews, with further case-control studies using larger samples, is required for better understanding of the determinants of tumor grades and histologic types, towards disease prevention and effective health service delivery.

Keywords: Histological Type, Grade, Breast Cancer.

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Abstract: Objectives: The aim of the study was to determine the frequency and nature of oral manifestations secondary to use of cardiovascular drugs. Methods: Six hundred and three patients attending the general medicine departments of Bapuji hospital and Chigeteri Government hospital, Davangere, were evaluated for oral signs and symptoms like oral dryness, alteration in the taste or burning sensation and they were clinically examined for the presence of any oral mucosal lesions such as lichenoid reactions, xerostomia, gingival enlargements, aphthous ulcers, angioedema etc. Data were statistically analyzed with chi-square tests. Results: Oral symptoms were recorded in 382 [67.4%] patients with xerostomia being the most common [25.5%], followed by dysgeusia [17.7%], combination of xerostomia with dysgeusia [12.4%] and burning sensation [6%]. Oral signs were noticed in 181 [39.7%] patients with clinically detectable xerostomia [15.3%] being the common, followed by gingival enlargement [9%] and lichenoid reaction [4.5%]. There were no statistically significant differences [p>0.05] was noticed between age, gender, cardiovascular risk factors and cardiac disease, whereas association between cardiovascular drugs and oral symptoms were statistically highly significant [p<0.01] and with the signs it was statistically significant [p=0.01]. Conclusions: The frequencies of oral manifestations in patients receiving cardiovascular drugs were 67.4% [symptoms] and 39.7% [signs] respectively. There was a significant correlation of oral manifestations with group of cardiovascular drugs and also with the increasing number of drugs.

Key Words: Adverse drug reactions, cardiovascular drugs, dysgeusia, oral drug reactions, xerostomia.

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Abstract: Hepatic injury is associated with distortion of the metabolic function. Hepatic disease/Cirrhosis of liver can be evaluated by biochemical analysis of serum tests, includes levels of serum Alanine and Aspartate amino transferases, Alkaline Phosphatase, and also by Uric Acid estimation. The present study was continued to assay liver associated enzymes on patients with cirrhosis of liver, Amoebic liver abscess and hepatitis and to find out the comparative levels of enzymes and uric acid among the groups. In this study total 80 male subjects ( 25 healthy controls and 55 patients as case groups) aged between 20 to 60. yrs. Was enrolled. One case group consists 25 male patients(cirrhosis of liver) and second case group consists of 15 male patients (Amoebic liver abscess disease) and third case group consists of 15 male patients ( Hepatitis ) suffering from corresponding diseases ad controls group subjects are 25 in number. ALT, AST, ALP,GGT and uric acid levels are estimated in the above groups by standard methods. Several folds of variations in the analysed enzymes were found between healthy controls and case groups. There is a significant elevation in the Uric acid levels comparatively with controls group. Comparitive elevation of serum associated enzymes were observed to indicate the degree of hepatic damage in cirrhosis, amoebic abscess of liver diseases and hepatitis. Data analysed using SPSS software.

Key Words: Cirrhosis of liver, Amoebic abscess of liver disease, hepatitis, Uric acid , and hepatic damage.

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