iosr-JDMS   Volume-7 ~ Issue-6

Abstract: Sirenomelia, Mermaid syndrome, is a very rare fatal congenital anomaly of sirenomelia sequence with fusion and atrophy of lower limbs, giving an appearance of human head and upper body with tail of a fish. The spectrum of anomalies affects primarily musculoskeletal system with severe urogenital and gastrointestinal malformations, neural tube and vertebral anomalies. It has a reported incidence of 1 in 60,000 births with unknown etiology. Depending on the degree of fusion of lower limb and development of feet sirenomelia is distinguished in 3 forms- sympus dipus, sympus monopus and sympus apus. Here we present a case of sirenomelia with sympus monopus , severe oligohydramnios and is still born. We examined the foetus in light of data from medical literature and discussed the embryological origin of such severe form of caudal dysgenesis.

Keywords: Caudal dysgenesis , Oligohydramnios, , Sirenomelia, Sympus dipus, Sympus monopus, Sympus apu, .

[1]. Moosa S, Lambie LA, Krause A.Clin Dysmorphol. 2012 Jul;21(3):124-30. doi: 10.1097/MCD.0b013e328354e51b. ; Sirenomelia: four further cases with discussion of associated upper limb defects. [2]. Pillay M, Yesodharan D, Narayanan DL, Jojo A, Luiz N, Nampoothiri S. Pediatr Dev Pathol. 2012 Sep-Oct;15(5):403-6. doi: 10.2350/12-05-1199-CC.1. Epub 2012 Jul 20.; Sirenomelia: case reports and current concepts of pathogenesis.
[3]. Thottungal AD, Charles AK, Dickinson JE, Bower C. Am J Med Genet A. 2010 Oct;152A(10):2578-87.
[4]. doi: 10.1002/ajmg.a.33599.; Caudal dysgenesis and sirenomelia-single centre experience suggests common pathogenic basis.
[5]. Sikandar R, Munim S. ; J Pak Med Assoc. 2009 Oct;59(10):721-3.; Sirenomelia, the Mermaid syndrome: case report and a brief review of literature.
[6]. Rougemont AL, Bouron-Dal Soglio D, Désilets V, Jovanovic M, Perreault G, Laurier Oligny L, Fournet JC. ; Am J Med Genet A. 2008 Jun 1;146A(11):1470-6. doi: 10.1002/ajmg.a.32081.; Caudal dysgenesis, sirenomelia, and situs inversus totalis: a primitive defect in blastogenesis.
[7]. Onyeije CI, Sherer DM, Handwerker S, Shah L ; Am J Perinatol. 1998 Mar;15(3):193-7.; Prenatal diagnosis of sirenomelia with bilateral hydrocephalus: report of a previously undocumented form of VACTERL-H association..

Abstract: Background: Women's health has always remained neglected because of the traditional reductionist approach to women health research. A significant lacuna persists in understanding the factors influencing gynaecological morbidity as well as consequences for women's lives. Gynaecological diseases cover a range of conditions with a wide spectrum of lethality, chronicity and a substantial impact on women's quality of life. Objectives: To study the prevalence of gynaecological morbidities and its association with some socio demographic and reproductive factors among ever married women of reproductive age group Methodology: Study Design: Community based cross sectional descriptive study. Study Period: January 2011 to June 2012. Sampling Procedure: Probability proportionate sampling using 30 stage cluster sampling technique. Sample Size: 750 ever married women from 15 – 49 years age group Results: Prevalence of gynaecological morbidities was 568(75.73%). Mean gynaecological morbidities were 1.22. Majority 281(37.47%) study subjects had one gynaecological morbidity. Menstrual disorders 351(46.8%) was the most common gynaecological morbidity. There was a significant difference between the proportions of study subjects with gynaecological morbidities with respect to their age, educational status, age at menarche and duration marriage.Conclusions: There was high prevalence of gynaecological morbidities among study subjects with about 50% suffering from more than one gynaecological morbidities.

Keywords: Gynaecological Morbidities, Married women, Menstrual disorders

[1]. United Nations Population Information Network (POPIN). Guidelines on reproductive health. Geneva, Switzerland, United Nations Population Information Network (POPIN), 2002. Available at: www.un.org/popin/unfpa/taskforce/guide/iatfreph.gdl.html Last cited on 23 October 2012. [2]. Akl Ola A., Ibrahim Hala K, Mamdouh Heba M. Perceived Reproductive Morbidity and Treatment Seeking Behavior among Ever Married Women in Siwa Oasis, Egypt. Journal of American Science, 7(6), 2011, 749-756.
[3]. Stones R William, Matthews Zoë. Gynaecological disease in developing countries: Whose burden? Opportunities and Choices Working Paper. 'Opportunities and Choices' Reproductive Health Research Southampton Social Statistics Research Institute University of Southampton. Page 4. http://www.socstats.soton.ac.uk/choices/Burden%20of%20gynae%20disease%20working%20paper%20WP15.pdf Last cited on 25 October 2012
[4]. Rathore M., Vyas L., Bhardwaj A.K. An Analysis of Prevalence of RTI in A Community of Rajasthan. Health and Population-Perspectives and Issues 29(2), 2006, 59-67.
[5]. Singh S.K., Prasad Rajiv, Verma Ravi K., Pandey Arvind. Psychosocial, Cultural and Service Factors Affecting Reproductive Morbidity among Rural Women In Maharashtra (Summary Report), International Institute for Population Sciences, Mumbai.
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[7]. Gulatia S. C., Chaurasia Alok R., Singha Raghubansh M. Women's Reproductive Morbidity and Treatment-Seeking Behavior in India. Asian Population Studies, 5(1), 2009, 61-84.
[8]. Rahman M. Mizanur, Kabir M., Shahidullah M. Adolescent Self-Reported Reproductive Morbidity and Health Care Seeking Behaviour. Journal of Ayub Medical College, 16(2), 2004.
[9]. Riyami Asya Al, Afifi Mustafa, Fathalla Mohamed M F. Gynecological and Related Morbidities among Ever- Married Omani Women. Afr. J. Reprod. Health , 8(3), 2004, 188-197.
[10]. Delimitation commission, Part – I (C) Abstract Data – Administrative unit, of Nanded city, 2001 census.

Abstract:Tuberculosis has emerged as one of the most lethal disease men has faced. Inspite of presence of effective chemotherapy epidemiological data showed world wide rise in incidence especially since AIDS incidence rose steeply. There seems to be a resurgence of both pulmonary and extra pulmonary tuberculosis. The present case study depicted the comparative study of level of ADA activity with several physiological parameters and nutritional status during tuberculosis infection. The data was collected and interpreted at department of Physiology and Department of Medicine Gandhi Medical College, Bhopal.

Keywords: Tuberculosis, chemotherapy, AIDS, ADA, nutritional status

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[5]. Villegas MV Labrada LA, Saravia NG : Evaluation of polymerase chain reaction, adenosine deaminase, and interferon –  in pleural fluid for the differential diagnosis of pleural tuberculosis. Chest 2000; 118 : 1355-1364.
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Abstract: Introduction: The impulse for carrying out this study stemmed from the fact that there was an observational variation in responding to and conducting the management of critical incidents by residents (senior house officers) in different wards of the hospital. Following an incident where intravenous adrenaline was not available in adequate time during sudden cardiac arrest; the present study was done to objectively evaluate the access to the prototype emergency drug,adrenaline injection.Material and Method: Ten teams were sent to five different wards to simultaneously check the response of duty doctors to pick up Adrenaline injection in any form (pre-filled syringes or ampoules) at the nursing station and hand it over to the auditor. Results: The time to access the adrenaline in ampoule form was least in Accident & Emergency (24.33 ± 3.67 sec) unit while highest in Medicine ward (32.17 ± 3.66 sec). The time to access the adrenaline in pre-filled syringes was least in Accident & Emergency (19.00 ± 2.71 sec) unit while highest in Obstetrics ward (23.50 ± 1.00 sec). Conclusion: Time to access adrenaline injection was shorter in the Accident & Emergency unit but was significantly higher(p<.05) in other wards; also the access to pre-filled syringes was quicker than the ampoules.

[1]. Daul A, Hermes U, Schäfers RF, Wenzel R, von Birgelen C, Brodde OE.The beta- adrenoceptor subtype(s) mediating adrenaline- and dobutamine-induced blood pressure and heart rate changes in healthy volunteers.Int J Clin Pharmacol Ther. 1995 Mar;33(3):140-8.
[2]. Adrenaline, cardiac arrest, and evidence based medicine T H Rainer and C E Robertso,J Accid Emerg Med. 1996 July; 13(4): 234–237
[3]. Soar J, Deakin CD, Nolan JP, et al. European Resuscitation Council guidelines for resuscitation 2005. Section 7. Cardiac arrest in special circumstances. Resuscitation 2005;67(Suppl 1):S135–70.
[4]. Kerddonfak S, Manuyakorn W, Kamchaisatian W, Sasisakulporn C, Teawsomboonkit W, Benjaponpitak S., The stability and sterility of epinephrine prefilled syringe,Asian Pac J Allergy Immunol. 2010 Mar;28(1):53-7.

Abstract:Objective: To study the antioxidant status and the extent of oxidative stress in patients with organophosphate poisoning before and after specific treatment. Material and methods : The study was conducted in 50 OP poisoned patients. Superoxide dimutase (SOD), catalase (CAT) and malonalaldehyde levels were estimated as an index of antioxidant status and oxidative stress respectively and comparisons were made(a) healthy control subjects& sprayer poisoned patients(b) between pretreated &post treated patients, after specific treatment . Results : There were significantly increase in superoxide dismutase(SOD)& catalase in the exposed sprayer groups, comparative to normal healthy control subjects .The increase in lipid peroxidation as reflected by elevated levels of malonalaldehyde (MDA) in the pesticide exposed group, indicates oxidative stress. There were progressive improvement observed in the both SOD&CAT levels after specific therapy in post treated patients, comparative to pretreated patients. Significant compensatory level of malonalaldehyde(MDA)were observed in post treated patients in comparison to pretreated patients. The level of improvement in post treated patients also depends on the severity grade of poisoning. . Conclusion: The increased level of MDA in OPP patients who failed to survive was probably reflective of accelerated lipid peroxidation, cell damage &death(oxidative stress).significant improvement was noticed in the SOD&CAT levels with specific treatment (atropine plus pralidoxime (PAM) therapy).

Key Words : Antioxidant status ,free radicals ,malonalaldehyde (MDA) ,pesticide poisoning ,superoxide dismutase(SOD) ,catalase(CAT) .

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Abstract: Objective: To find a cut off level of mid abdominal circumference in North Indian subjects to use as a predictive tool for diagnosing individuals with raised serum triglyceride levels. Methods: This was a cross-sectional hospital based study conducted over a period of three years at Vivekananda Polyclinic and Institute of Medical Sciences, Lucknow, India. Not known cases of dyslipedimia were included in this study attending in the out-patient clinic of the hospital. The subjects were screened for overnight fasting (for 8 to 12 hrs) levels of triglycerides after asking them to be on a normal diet for three days. A total of 857 subjects were included in the study. Results: One forth (25%) of the subjects were in the age group 40-49 years. The mean age was 54.57 years. More than half (53.3%) of the subjects were males and were vegetarian (63%). Less than one third (28.6%) of the subjects were alcoholic and 39% were smokers. The mean abdominal girth was 106.25 (±11.07) cms and height was 161.46 (±6.68). However, average weight was 69.38 (±9.66) kg and TG level was 205.08 (±55.80). Linear regression analysis showed that the cut off of 92 cms was obtained for male and 93 cms for females. Above this abdominal girth, an increased TG levels will be with a high rate of sensitivity and specificity for both the sexes

Key words: Mid abdominal circumference/girth, Hypertriglycedemia, Biometric tool

[1]. Seales CE, Ooi TC. Underrecognition of chylomicronemia as a cause of acute pancreatitis. CMAJ. 1992;147:1806–8
[2]. Kanjilal S, Shankar j et al. association of Metabolic syndrome with atherothrombotic blood phenotypes in Asian Indian families with premature Coronary Artery disease. Archives of Medical Science 2/2008.
[3]. Perez, Maritza et al. Using Waist Circumference as a screening tool to identify Colombian subjects at CV risk. European J of Cardiovascular prevention and rehabilitation 2003; 10;5; p 328-335
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Abstract: Introduction: The health hazard of glass factory has been enlisted in ILO encyclopedia. Morbid conditions in glass factory workers are injuries, heat exhaustion, respiratory morbidity, ophthalmic morbidity, nephrolithiasis etc. Objective: To estimate the prevalence of morbidity in the glass factory workers and compare it with comparison group. Materials and methods: Cross-sectional study with comparison group, which was matched for age, sex and socio-economic status, unexposed to similar working environment from adjacent area. The Glass Factory is situated at Kamptee Road, Nagpur. 263 workers were studied along with 263 comparison group. Interview technique, general observation was used for data collection by using Pre-designed Proforma. Sampling design was Convenience sampling Technique. Statistical analysis was done with Epi Info 2002. Results: Total morbidities were 442 and 153 in the workers and in the comparison group respectively. Mean no. of morbidity in the worker was 1.7 with SD 0.94 and in the comparison group it was 0.6 with SD 0.83. The difference was statistically significant [Z=13.76, p<0.01, highly significant]. Of the total morbidities i.e. 442 in workers, injury constituted 251 (56.9%). Incised injury 156 (59.3%) in the workers and 32 (12.2%) in the comparison group. Conclusion: Prevalence of injury and effect of environment in the workers of Glass Factory was more than subjects in comparison group.

Key Words: Glass factory, Injuries, Morbidity, workers.

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[3]. Gordon SB, Curran AD, Fishwick D, Morice AH, Howard P. Respiratory symptoms among glass bottle workers – cough and airways irritancy syndrome? Occup Med (Lond) 1998 ; 48 (7) : 455 – 59. [Abstract from Medline]
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[5]. Lydhal E. Infrared radiation and cataract. Acta Ophthalmol 1984 ; 16 : 61 – 63 [Abstract from Medline].
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[7]. Patel HarshadC, Rao NelloreMohan, Saha Asim. Indian Journal of Occupational and Environmental Medicine, Vol. 10, No. 3, September-December, 2006, pp. 121-123
[8]. Vulnerability to Heat Stress: Scenario in Western India WHO APW No. SO AMS 6157206 .2009. [Cited 2011 August 29] Availablefrom:URL:http://www.whoindia.org/.../Climate_Change_Vulnerability_to_Heat_Stress_Scenario_in_Western_India.pdf-Ado

Abstract:Non Compliance in patients with Chronic Obstructive Pulmonary Disease (COPD) to the medication can result in worsening of the disease and increases the hospital admissions. This study aimed at examining the dimensions of compliance to the medication, life style modification and smoking cessation in 60 COPD patients. A pre validated questionnaire was administered at 0 week, 2 weeks and at 6 weeks. Ninety percent of the patients took the prescribed oral drugs in correct dose, correct timings and 77% complied to hospital visits. In contrast to oral drugs only 36% of the patients were compliant to the use of inhaler at the first visit which improved to 59%. Life style changes related to diet and exercise were followed by 32% patients. Only 19% of patients quit smoking. In order to improve compliance levels repeated counseling or stressing the importance of use of inhalers and quitting smoking was found an effective method. Key Words: Chronic Obstructive Pulmonary Disease (COPD), Compliance, Smoking cessation, Inhalers.

[1]. Trappenburg J CA, Touwen I, Bourbeau J, Monninkhof EM, Verheij T JM, Lammers J W J et al. Detecting exacerbations using the Clinical COPD QuestionnaireHealth and quality of life outcomes 2010; 8: 102. [2]. Vander Wall MHL, Jaarsmal T, Veeger JGM N, Gilst WHV, Veldhuisen DJV. Compliance in heart failure patients: the importance of knowledge and beliefs. Eur heart J 2005; 27: 434-40.
[3]. Rabe KF, Timmer W, Sagkriotis A, Viel K. Comparison of a Combination of Tiotropium Plus Formetrol to Salmetrol Plus Fluticasone in Moderate COPD. Chest 2008; 134: 255-63. [4]. Jin J, Sklar GE, Oh VMS, Li Shu Chuen. Factors affecting therapeutic compliance: A review from the patient's perspective. Ther Clin Risk Manag 2008 ; 4: 269–86.
[5]. . Beauchamp MK, Nonoyama M, Goldstein RS, Hill K, Dolmage TE, Mathur S,Brooks D. Interval versus continuous training in individuals with chronic obstructive pulmonary disease- a systematic review. Thorax 2010; 65: 157-64.
[6]. Rand CS. Patient adherence with COPD therapy. Eur Respir Rev 2005; 96: 97-101.
[7]. Vestbo J, Anderson JA, Calverley PMA, Celli B, Ferguson GT, Jenkins C et al. Adherence to inhaled therapy, mortality and hospital admission in COPD. Thorax 2009;64: 939-43.
[8]. Bourbeau J, Bartlett SJ. Patient adherence in COPD. Thorax 2008; 63: 831-8.
[9]. Bischoff EWMA, Hamd DH, Sedeno M, Benedetti A, Schermer TRJ, Bernard S et al. Effects of a written action plan adherance on COPD exacerbation recovery. Thorax 2011; 66: 26-31.

Abstract: Osteoid osteoma accounts for 10% of all benign bone tumours affecting young adults of age group 10-30 years. Intra articular osteiod osteoma accounts for approximately 13% of all osteoid osteoma cases and present as monoarthropathy. Clinical and radiological features of osteiod osteoma are atypical when located intra articularly and differ significantly from extra articular lesions. Intraarticular osteoid osteoma presents a diagnostic challenge and can cause a delay in diagnosis for years. We present a case of 39 year old female with a rare Intraarticular osteoid osteoma of hip involving femoral head diagnosed early with CT imaging and bone scintigraphy. Complete excision of the tumour with femoral head and hemiarthroplasty with modular bipolar prosthesis was done and diagnosis was confirmed by histopathological examination. Hence a high index of suspicion with correlation between clinical and appropriate radiological imaging is necessary for early diagnosis and effective management of the tumour.

Key Words: Osteoid osteoma, Intra articular, hip.

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Abstract: Abdominal pregnancy is an extremely rare form of extra uterine gestation. They may be primary or secondary with USG and MRI aiding in the diagnosis. Here we report a case of abdominal pregnancy in a 24 year woman with 12 wks amenorrhoea.

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[3]. Amy J. Voedisch, Carrie E. Frederick, Antonia F. Nicosia, Thomas G. Stovall: Early pregnancy loss and Ectopic pregnancy in wolters kluwer/lippincott williams & wilkins, Berek & Novak's Gynaecology 15th ed ; p644
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Abstract: Variations in the branching pattern of abdominal aorta are quite common, knowledge of which is required to avoid complications during surgical interventions involving the posterior abdominal wall. Inferior Phrenic Arteries, the lateral aortic branches usually arise from Abdominal Aorta ,just above the level of celiac trunk. Occasionally they arise from a common aortic origin with celiac trunk, or from the celiac trunk itself or from the renal artery. This study describes the anomalous origin of this lateral or para aortic branches in the light of embryological and surgical basis. Knowledge of such variations has important clinical significance in abdominal operations like renal transplantation, laparoscopic surgery, and radiological procedures in the upper abdomen or invasive arterial procedures .

Keywords: Abdominal Aorta, Celiac Trunk(Ct), Diaphragm, Inferior Phrenic Artery (Ipa), Retro Peritoneal, Renal Artery(Ra).

[1]. Gray's Anatomy.Susan Standring et al.40th ed.Elsivier.2008;p.1198.

[2]. Ronald A Bergman.et ai.Illustrated encyclopedia of anatomical variations:Opus11:Cardio vascular system:Arteries:Abdomen:p.76 [3]. Soni s Wadhwa A. Multiple variations in the paired arteries of Abdominal Aorta – Clinical Implications JCDR 2010 June ;(4):2622-25

[4]. Origin of a common trunk for the Inferior phrenic arteries from the right renal artery:a new anatomic vascular variant with clinical implications.On Topaz Allyne Topaz Pritam R et al Cardiovascular Revascularization Medicine.11. 2010, 57-62.

[5]. Multiple aberrant coeliac trunk ramifications .Paraskevas G K ,Raikos .Singapore Med J 2011;52(7):e 147.

[6]. Felix. The development of urogenital organs. Mannual of human embryology.V.II .London.

[7]. Thejodhara Pulakunta , Bhagath Kumar Potu, Vasavi Rakesh Gorantla et al .J Vas Bras 2007 sept : 6(3)
[8]. Inferior Phrenic Artery: Anatomy, Variations, Pathologic Conditions, and Interventional ManagementDong Il Gwon, MD, Gi-Young Ko, MD, Hyun-Ki Yoon, MD, Kyu-Bo Sung, MD, May 2007 RadioGraphics, 27, 687-705
[9]. Inferior phrenic arteries: angiographic anatomy, variations, and catheterization techniques for transcatheter arterial chemoembolization . Miyayama, Shiro; Yamashiro, Masashi; Yoshie, Yuichi. Japanese Journal of Radiology, Volume 28, Number 7

Abstract: Liliequist's membrane is an important surgical landmark in various neurosurgical operations. The structure of the Liliequist's membrane, as reported in the literature, varies considerably. Most of the anatomic studies of Liliequest's membrane have been reported following removal of both the frontal lobes. This report presents the image of Liliequist's membrane as viewed endoscopically from a retrosigmiod, posterior cranial fossa approach, in a formalin fixed cadaver. The images provided, define its anatomic features and boundaries, as well as its relationship with surrounding neurovascular structures.

Key words – Liliequist membrane, endoscope, retrosigmoid, posterior cranial fossa

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Abstract:The cervical part of the sympathetic trunk contains three interconnected ganglia - superior, middle and cervicothoracic. They send grey rami communicantes to all the cervical spinal nerves. The study was conducted on 157 cadavers (99 Male & 58 Female) bilaterally. Superior cervical ganglion was observed in all the cases. Middle cervical ganglion was found in 58.5% of the cases which lies between the common carotid artery in front and loop of inferior thyroid artery behind. Ansasubclavia extends from middle cervical ganglion to inferior cervical ganglion in 12.5% of the cases. Inferior cervical ganglion was observed in the 45% of the cases. The stellate ganglion was observed in 55% of the cases. The variations of the cervical sympathetic trunk were noted and photographed. Stimulated by the need of surgery, anatomy of the cervical sympathetic chain has acquired increasing importance. To diminish the potential risk of injury during surgery better surgical methods are to be developed.

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[8]. Hyun Min Cho et al. Anatomical variations of rami communicantes in the upper thoracic sympathetic trunk.Eur spine J. 2004. 9:256-259.
[9]. Kanagasuntheram R, Dharshini. The cervical sympathetic trunk; a new hypothesis.Ann Acad med Singapore. 1994. 23:923-928.
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Abstract: Amniotic Band Sequence (ABS) also known as Amniotic Deformity, adhesion, and Mutilation (ADAM) complex or Congenital Constriction Band Syndrome (CCBS) had variety of presentation and is cause of disfigurement and disability in the newborn. This retrospective study was conducted in department of Plastic and Reconstructive Surgery, Liaquat University Hospital Jamshoro, Sindh Pakistan to determine presentation of constriction band syndrome and its association with other congenital anomalies seen at our institution. Ten patients with constriction band syndrome were included in the study. All were admitted through the outpatient department. The site and extent of each constricting ring and related anomalies were recorded. Surgery was performed. The most common associated anomalies were syndactyly, acrosyndactyly, hypo plastic phalanges, lymph edema and Talipes Equino Varus. Such type of study in our population is conducted for the first time which shows that constriction band syndrome is also not uncommon in our setup and successful surgical repair is also possible. Further research is also required in order to diagnose this in uterus, intra uterine lysis/ surgical intervention and possible causative factors needs elaboration.

Key words: amputation, constriction band syndrome, hypo plastic fingers, lymph edema, radial nerve palsy

[1]. Pedersen TK, Thomsen SG. Spontaneous resolution of amniotic bands. Ultrasound Obstet Gynecol 2001;18:673-4
[2]. Kawamura K, Chung KC. Constriction band syndrome. Hand Clin. 2009 ;25(2):257-64
[3]. Walter JH Jr, Goss LR, Lazzara AT. Amniotic band syndrome. J Foot Ankle Surg. 1998 Jul-Aug; 37(4):325-33.
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[6]. Kino Y. Clinical and experimental studies of the congenital constriction band syndrome, with an emphasis on its etiology. J Bone Joint Surg Am 1995; 57: 636-43.
[7]. Patterson TJ. Congenital ring constrictions. Brit J Plast Surg 1961; 14:1-31.

[8]. Adu AJ, Annaw C. Congenital constriction ring syndrome of the limbs: a prospective study of 16 cases. Afr J Paed Surg 2008;5:79-83

[9]. Moran SL, Jensen M, Bravo C.Amniotic Band Syndrome of the Upper Extremity: Diagnosis and Management. J Am Acad Orthop Surg 2007;15: (7) 397-407

[10]. Khan F, Shah SA, Naji Ullah Khan, Faheem Ullah. Pattern of constriction band syndrome · R M J 2010; 35(2):184-7.

Abstract: This study was carried out to determine relationship of palmar dermatoglyphics with the incidence of Hypertension, especially the essential variety. Digital & palmar dermatoglyphic analysis of 145 normotensive subjects & 131hypertensive subjects was performed. The parameters used were digital ridge pattern, total ridge count & atd angle. The result showed that the double loop whorl patterns are present with higher frequency in hypertensives. Total ridge count is significantly higher in hypertensive population (p<0.05). The palm angle (atd angle) has increased value in hypertensive individuals (p<0.05). By this study association of specific dermatoglyphic parameters with the disease mentioned can be established.

Keywords – atd angle, Dermatoglyphics, Hypertension, TRC

[1] Deepa.G., Khan A.A.,Study of Palmar Dermatoglyphics in Essential Hypertension among people living in catchment area of NMCH, Raichur.2009. www.rguhs.ac.in/cdc/onlinecdc/uploads/01_M031_10410.doc cited on 12-05-13

[2] Mendenhall G, Mertens T, Hendrix J. Fingerprint Ridge Count- A polygenic trait useful in classroom instruction. The American Biology Teacher, Volume 51, No.4, April 1989, pg 203-207.

[3] David, T.J.(1971). The palmat axial triradius t- a new method of location, Hum.Hered.21:624-627
[4] Palyzová D, Kuklík M, Beránková M, Schaumann B Dermatoglyphics in juvenile hypertension. Department of Pediatrics, School of Medicine, Charles University, Prague, CSFR. 1991

[5] Pursnani ML, Elthence GP, Tiberwala L. Palmar dermatoglyphics in essential hypertension. Indian Heart Journal. 1989; 41(2): 119-122.

[6] Kulkarni DU, Herekan NG. Dermatoglyphics in essential hypertension in Western Maharashtra Population. Journal of natomical Society of India. 2005-06; 54(2):1.
[7] http://www.nist.gov/itl/iad/ig/nbis.cfm

[8] Iqbal P et al. Dermatoglyphics Pattern in Hypertensive Patients,
http://pjmhsonline.com/OctDec2012/dermatoglyphics_pattern_in_hypertensive%20pts.htm

[9] Oladipo, G.S, Osogba, I.G, Bobmanuel, I, Ugboma, H.A.A, Sapira, M.K, Ekeke, O.N. Palmer Dermatoglyphics in essential hypertension among Rivers Indigenes. Australian Journal of Basic & Applied Sciences, 4(12):6300-6305, 2010.

[10] M. Vashist, R. Yadav, . Neelkamal, A. kumar: Axial triradius as a preliminary diagnostic tool in patients of mental retardation. The Internet Journal of Biological Anthropology. 2010 Volume 4 Number 1. DOI: 10.5580/5f8 - See more at: http://archive.ispub.com/journal/the-internet-journal-of-biological-anthropology/volume-4-number-1/axial-triradius-as-a-preliminary-diagnostic-tool-in-patients-of-mental-retardation.html#sthash.khdgkfI1.dpuf

Abstract: The Aim of this study was to investigate the correlation of oral lesions in HIV positive patients with their CD4, CD8 cell count and CD4/CD8 ratio. 150 HIV seropositive patients of any age and sex were evaluated. Then analyses of data obtained were revealed Pseudo membranous candidiasis (P-0.0043) was the most common variant, mostly seen when CD8 count was increased (>500 cells/mm3, P-0.05) and CD4/CD8 ratio was > 0.31(P-0.0034). Periodontal diseases (29%) mostly were seen in patients with CD4 count >400 cell/ mm3 (P-0.045), CD8 count >500 CD8 cell/mm3 (P-0.55) and CD4/CD8 ratio < 0.3(P-0.28). Oral lesions were seen when CD8 count is increased >500 cells/mm3 and CD4/CD8 ratio is in between 0.31 - 0.6. Oral lesions especially oral candidiasis can be useful as a diagnostic marker for immunosuppression in HIV positive patients, particularly where laboratory assessment cannot be done routinely.

Keywords: AIDS, CD4+ cell, CD8+cell counts, CD4+/CD8+ ratio, HIV positive Indians

[1] Bravo IM, Correnti M, Escalona L, Perrone M, Brito A, Tovar V, Rivera H (2006) Prevalence of oral lesions in HIV patients related to CD4 cell count and viral load in a Venezuelan population. Med Oral Patol Oral Cir Bucal. 1;11(1):E33-9.
[2] Pantaleo G, Demarest JF, Schacker T, Vaccarezza M, Cohen OJ, Daucher M, Graziosi C, Schnittman SS, Quinn TC, Shaw GM, Perrin L, Tambussi G, Lazzarin A, Sekaly RP, Soudeyns H, Corey L, Fauci AS. (1997). "The qualitative nature of the primary immune response to HIV infection is a prognosticator of disease progression independent of the initial level of plasma viremia". Proc Natl Acad Sci U S A. 94 (1): 254–258.
[3] Anil S, Beena VT, Nair RG. (1996) Squamous cell carcinoma of the gingiva in an HIV-positive patient: a case report. Dent Update. Dec; 23(10):424-5.
[4] Scully C, Laskaris G, Pindborg J, Porter SR, Reichart P. (1991) Oral manifestations of HIV infection and their management. I. More common lesions. Oral Surg Oral Med Oral Pathol. 71:158–166
[5] Ramirez-Amador VA, Esquivel-Pedraza L, Ponce de Leon S, Ponce de Leon S. (1996) Prognostic value of oral candidiasis and hairy leukoplakia in 111 Mexican HIV-infected patients. J Oral Pathol Med.; 25(5):206-11.
[6] World food programme (2005) Literature review of impact of education level on HIV/AIDS prevalence rate.
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[8] Nittayananta W, Chanowanna N, Sripatanakul S, Winn T. (2001) Risk factors associated with oral lesions in HIV-infected heterosexual people and intravenous drug users in Thailand. J Oral Pathol Med.;30(4):224-30.
[9] Gazzard B, (1990) HIV infection. Clinical picture and management. Baillieres Clin Haematol. 3(1):1-35.
[10] Ghesquiere WG, Marrie T. (1989) Update: AIDS and the nervous system. Med North Am; 35:6353-61.

Abstract: AV (arteriovenous) fistulas are recognized as the preferred access method for haemodialysis over cental venous catheter .Bracheocephalic fistula and radiocephalic fistula are the types of fistula done.AVF also have complications like aneurysm .A case of 71 yr old female of ckd on haemodialysis with a side-to-end Cimino–Brescia AVF presented with aneurysm of A V FISTULA.

Key Words: Aneurysm,Arterio Venous Fistula, Ckd, Dialysis, Law Of Laplace

[1]. Brescia MJ, Cimino JE, Appel K, Hurwich BJ (1966). "Chronic hemodialysis using venipuncture and a surgically created arteriovenous fistula". N. Engl. J. Med. 275 (20): 1089–92.doi:10.1056/NEJM196611172752002. PMID 5923023.
[2]. National Kidney Foundation-Kidney Disease Outcomes Quality Initiative (NFK-DOQI) Clinical Practice Guidelines for Vascular Access 2000. Am J Kidney Dis2001;37:S163.

Abstract:Gorlin-Goltz syndrome is a rare autosomal dominant disorder that involves multiple organ systems, including the skin, skeleton and jaws. We report a case of young female with multiple odontogenic keratocysts, high arched palate, euryopia, palmer pits, solitary, pigmented nevus , areas of hyper-pigmentation in the upper eyelid of left eye, dorsal surface of hands, calcified diaphragma sellae, right 5th bifid rib & extensive bilamellar calcifications of the falx cerebri. Based on the combination of imaging and clinical findings the diagnosis of Gorlin-Goltz syndrome was made.

Keywords – bifid rib, calcification, Gorlin-Goltz syndrome, OKC, palmer pits.

[1] Gailani MR, Bale SJ, Leffell DJ, et al. Developmental defects in Gorlin syndrome related to a putative tumor suppressor gene on chromosome. Cell 1992;69(1):111-117.
[2] Lindeboom JA, Kroon FH, de Vires J, van den Akker HP. Multiple recurrent and de novo odontogenic keratocysts associated with oral-facial-digital syndrome. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2003;95(4):458–462.
[3] Kolm I, Puig S, Iranzo P, Malvehy J. Dermoscopy in Gorlin-Goltz syndrome. Dermatol Surg. 2006;32(6):847-851.
[4] Rozylo-Kalinowska I, Rozylo TK. Odontogenic keratocyst in Gorlin-Goltz syndrome. Ann Univ Mariae Curie Sklodowska. 2002;57(2):79-85.
[5] Lo ML. Nevoid basal cell carcinoma syndrome (Gorlin syndrome). Orphanet J Rare Dis 2008; 3:32.
[6] Kimonis VE, Goldstein AM, Pastakia B, Yang ML, Kase R, DiGiovanna JJ, et al. Clinical manifestations in 105 persons with nevoid basal cell carcinoma syndrome. Am J Med Genet 1997;69(3):299-308.
[7] Kalogeropoulou C, Zampakis P, Kazantzi S, Kraniotis P, Mastronikolis NS. Gorlin-Goltz syndrome: Incidental finding on routine CT scan following car accident. Cases J 2009;2:9087.
[8] Evans DG, Ladusans EJ, Rimmer S, Burnell LD, Thakker N, Farndon PA: Complications of the nevoid basal cell carcinoma syndrome: results of a population based study. J Med Genet 1993;30:460-464.
[9] Kimonis VE, Mehta SG, Digiovanna JJ, Bale SJ, Pastakia B: Radiological features in 82 patients with nevoid basal cell carcinoma (NBCC or Gorlin) syndrome. Genet Med 2004;6(6):495-502.
[10] Manfredi M., Vescovi P., Bonanini M., Porter S.: Nevoid basal cell carcinoma syndrome : A review of the literature. Int J. Oral Maxillofac. Surg, 2004;33:117-124.

Abstract: The placenta is a distinctive organ, which facilitates the supply of oxygen and nutrients to the fetus through placental microcirculation. Placenta potentially plays a key role in the etiology of developmental programming through its impact on nutrient transfer. Placental transport efficiency depends on a variety of parameters, including surface area for exchange, thickness of the placental membrane. The aim of this study is to see the morphological, histological and radiological changes in excessive placental calcification and its relation with fetal outcome. 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 labor room and gynecology operation theatre of Liaquat University Hospital. Forty placentae from parturient that PIH, forty from parturient having placental abruption & forty placentae from parturient belonged to normal pregnancy (Control Group). Age of all parturient is between 17 to 32 years. The study of gross morphology of placenta was done in the department of anatomy. Approximately five mm piece of placenta was taken and processed for histological study. Radiological study was done in the department of radiology of LUH Jamshoro. Highly significant (p=<0.001) difference seen in placental abruption and PIH group than normal.

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

[1]. Udainia, A, Jain M.L. Morphological study of Placenta in pregnancy induced hypertension with its clinical relevance. J Anat Soc India 2001; 50(01):01 –06.
[2]. Lúcio H. Oliveira LH, Xavie CC, Lana AM.J Pediatr (Rio J) 2002;78(5):397-402
[3]. Anca M. Pasca and Anna A. Penn The Placenta: The Lost Neuroendocrine Organ Neoreviews 2010;11;e64-77
[4]. 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.
[5]. Avery CR, Aterman K. Calcification of the basement membrane of placental villi J Path 2005; 103(3):199-200.
[6]. Wentworth P. Macroscopic Placental Calcification and Its Clinical Significance. Bjog 2005; 72 (2): 215 – 222.
[7]. Kumar V, Abbas AK, Fausto N. Robbins & Cotran pathological basis of disease. 7th ed. Phildilphia: Elesevier ; 2004 pp 41-42.
[8]. 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.
[9]. 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.
[10]. 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

Abstract: The disease spectrum of primary hyperparathyroidism varies from asymptomatic hypercalcemia to severe metabolic bone disease, pathological fractures and renal stones. Lack of universal screening for hypercalcemia and lack of awareness about prevalence and presentation of PHPT among general practitioners led to delayed diagnosis. With this study we emphasise on how improving early detection of PHPT the dreadly complications of this curable disease can be avoided.

Key Words: Asymptomatic hypercalcemia,early detection, screening

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[7]. P.Prasarttong-Osoth, P.Wathanaoran, W.Imruetaicharoenchoke, and S. Rojananin" Primary Hyperparathyroidism: 11-Year Experience in a Single Institute in Thailand" International Journal of Endocrinology Volume 2012, Article ID 952426, 4 pages doi:10.1155/2012/952426