iosr-JDMS   Volume-8 ~ Issue-4

Abstract:Introduction –Total hip arthroplasty for Developmental Dysplasia of Hip with secondary arthritis in younger patient is a challenge in itself due to its distorted anatomy. To restore the normal anatomy of hip, achieving length, stability, function and longer survivorship surgical technique and implant plays a major role. One should be careful to complications like sciatic nerve palsy, non-anatomic positioning of implants, shortening etc. Case Presentation – This is a case report and five year follows up of a young female of 34 years age with Neglected Developmental dysplasia of hip confirmed clinically and radiologically. Patient had painful limp, shortening and decrease range of motion resulting into restriction in performance of her daily routine activities. She was treated with Ceramic on Ceramic Modular uncemented total hip replacement and was followed up for 5 years . Conclusion – Restoration of anatomical hip centre with complete containment of acetabular socket, judicious use of cement-less implant and ceramic bearing surface could provide excellent result in a case of secondary arthritis due to congenital dislocation of the hip (Crowe type IV) in a young and active patient. Keywords- Delta, Ceramic on ceramic bearing, Developmental dysplasia of hip, Congenital dislocation of hip.

[1]. Crowe JF, Mani VJ, Ranawat CS: Total hip replacement in congenital dislocation and dysplasia of the hip. J Bone Joint Surg Am ,1979;61:15,
[2]. Harris WH: Etiology of arthritis of the hip. Clin Orthop, 1986;213:20,
[3]. Symeonides PP, Pournaras J, Petsatodes G, et al: Total hip arthroplasty in neglected congenital dislocation of the hip. Clin Orthop ,1997 ;(341): 55-61.
[4]. Sponseller PD, McBeath A: Subtrochanteric osteotomy for arthroplasty of the dysplastic hip. J Arthroplasty 1988;3:151,
[5]. Kelley SS: High hip center in revision arthroplasty. J Arthroplasty 1994;9:503.
[6]. Pagnano MW, Hanssen AD, Lewallen DG, Shaughnessy WJ: The effect of superior placement of the acetabular component on the rate of loosening after total hip arthroplasty: long term results of patients who have Crowe type II congenital dysplasia of the hip. J Bone Joint Surg Am 1996; 78:1004.
[7]. Yoder SA, Brand RA, Pederson DR, O'Gorman TW:Total hip acetabular component position affects acetabular loosening rates. Clin Orthop 1998;228:79.
[8]. Cameron HU, Eren OT, Solomon M: Nerve injury in the prosthetic management of the dysplastic hip.Orthopedics ,1998; 21:881.
[9]. Klisic P, Jankovic L: Combined procedure of open reduction and shortening of the femur in treatment of congenital dislocation of the hips in older children.
[10]. Clin Orthop 1976;119:60.

Abstract: Aim:-Hospital based study from April 2005 to March 2011 conducted among the population to determine the prevalence of cataract in Alappuzha district of Kerala state of India. Methodology:-The data's collected from registers of ophthalmology department of district hospital and two private hospitals in Alappuzha district to access the gender prevalence and prevalence of different age groups. The total number of cataract operation carried in Alappuzha district was collected from Directorate of Health, Thiruvananthapuram to evaluate the prevalence among the total population Significance were analysed using student's t-test (mat lab). Result:- Among the total population cataract prevalence in Alappuzha district was significantly (p=0.0010) increased from 0.26% to 0.37% within six years. Gender prevalence is significantly higher in females (60.6%,p=0.0000344) than in males, suggest that more cataract patients are females. A significantly highest prevalence recorded in the age group of 61-70 years (40.2%,p=0.000044) compared with all other age groups. Conclusion:-The present study of cataract prevalence in Alappuzha district may to some extend throw light on the gravity of cataract incidence in Kerala state. Cataract blindness in Kerala can be effectively controlled only if effective strategies are developed to reduce the incidence of blinding cataract.

Key words: Cataract, Prevalence

[1]. Foster, A., Renikoff, S. (2005). The impact of vision 2020 on global blindness. Eye. 19: 1133-1135.
[2]. Hans Limburg & Allen Foster. (1998). Cataract surgical coverage: An indicator to measure the impact of cataract intervention programme. Community eye. Health. 11(25): 3-6.
[3]. Nirmalan, et al. (2002). A population based eye survey of older adults in Thirunelveli districts of south India: Blindness cataract surgery and visual outcome. Br.J. Opthal. 86: 505-512.
[4]. Jha, K.N. (2008). Spectrum of ocular diseases at a military hospital in Ladakh, North India. Journal of clinical and diagnostic Research. 2(3): 843-846.
[5]. World Health Organization. (2000). Preventing Blindness in Children: report of WHO/IAPB scientific meeting.
Finger RP.(2007) Cataracts in India: current situation, access, and barriers to services over time. Ophthal Epidemiol . 14:112-118.
[6]. Dandona L, Dandona R, Srinivas M, et al. (2001) Blindness in the Indian state of Andhra Pradesh. Invest Ophthalmol Vis Sci.;42: 908–916.
[7]. Venkata G, Murthy S, Gupta SK, et al.(2005). Current estimates of blindness in India. Br J Ophthalmol. 89:257-260.
[8]. Thylefors B, N'egrel A-D, Pararajasegaram R, Dadzie KY.(1995) Global data on blindness. Bull World Health Organ. 73:115-121.
[9]. Dandona L, Dandona R, Srinivas M, et al. (2002). Moderate visual impairment in India: the Andhra Pradesh Eye Disease Study. Br J Ophthalmol; 86: 373-377.
[10]. Brilliant GE, Lepkowski JM, Zurita B, Thulasiraj RD, the Operations Research Group. (1991).Social determinants of cataract surgery utilization in South India. Arch Ophthalmol . 109: 584- 589

Abstract: Detection of carriers among healthcare workers is an important component of strategies for controlling the spread of Methicillin resistant Staphylococcus aureus (MRSA) in a hospital setting. We conducted a cross sectional study on clinical and non-clinical healthcare workers at Lagos University Hospital, Nigeria. A total of 250 healthcare workers from medical and surgical units, hospital attendants (ward maids), laboratory and laundry departments were randomly sampled and screened for MRSA using nasal swabs. The overall carriage rate of MRSA was 13.6% and the prevalence was seen higher among the clinical healthcare workers than the non-clinical staff (10% vs. 3.6%; P<0.0001). Poor adherence to infection control practices, antibiotic use within the past three months, contact with patients with cutaneous lesions were among factors associated with MRSA in this study. Other risk factors observed included the Length of service of workers as well as use of protective clothing. However, the prevalence of MRSA carriage among healthcare workers is still low in this endemic setting compared to others in same Sub-Saharan African region or developed countries hence screening is however highly useful to identify the imported cases and also to allow prompt isolation precautions.

Keywords: carrier, infection control, prevalence, risk factors, Staphylococcus aureus

[1]. Baldan, R., C. T. Din, G. Semeraro, C. Costa, P. Cichero, P. Scarpellini, M. Moro, and D. M. Cirillo. Severe community-onset infections in healthy individuals caused by community-acquired MRSA in an Italian teaching hospital.J. Hosp. Infect.2009; 72:271-273.
[2]. Cosgrove, S.E., Sakoulas, G. and Perencevich, E.N. Comparison of mortality associated with penicillin-resistant and methicillin- susceptible Staphylococcus bacteremia: A meta-analysis.Clinical Infectious Disease.(2003); 36:53-59.
[3]. National Nosocomial Infections Surveillance (NNIS) System Report, data summary from January 1992 through June 2004, issued October 2004. Am. J. Infect. Control.2004; 32:470–485.
[4]. Kluymans, J., van Belkun, A. and Verburgh, H. Nasal carriage of Staphylococcus aureus. Epidemiology, underlying mechanisms and associated risks.ClinMicrobiol Rev. 1997; 10:505-520.
[5]. Kesah, C., Redjeb, S.B., Odugbemi, T.O., Boye, C. S. B., Dosso, M. and Ndinya-Achela, J.O. Koulla-Shiro, S. Benbachir, M. and Borg, M. Prevalence of Methicillin-resistant Staphylococcus aureusin eight African hospitals and Malta.J. Clin. Microbiol.infection. 2003; 9:153-156.
[6]. Muder, R.R., Brennen, C. and Goetz, A.M. Infection with Methicillin-resistant Staphylococcus aureus among hospital employees. Infect. Control Hosp. Epidemiol. 1993; 14:576-578.
[7]. Lessing, M.P., Jordens, J.Z. and Bowler, I.C. When should the healthcare workers be screened for Methicillin-resistant Staphylococcus aureus? 1996; 34:205-210.
[8]. Nur, Y.A., Vandenbergh, M.F.O., Yusuf, M.A., Van Belkum, A. and Verbrugh, H.A. Nasal carriage of Methicillin-resistant Staphylococcus aureus among healthcare workers and peadiatric patients in two hospitals, 1975-91. Infect. Control Epidermiol.1992;13: 582-6.
[9]. Jernigan, J.A., Pullen, A.M., Flowers, L., Bell, M., and Jarvis, W.R. Prevalence of and risk factors for colonization with Methicillin-resistant Staphylococcus aureusat the time of hospital admission. Infect. Control Hosp. Epidermiol.2003;24:409-414.
[10]. Sandri, A.M., Dalarosa, M.G., Ruschel, de Alcantara L., da Siva Elias, L. and Zavascki, A.P. Reduction in incidence of nosocomial methicillin-resistant Staphylococcus aureus (MRSA) infection in an intensive care unit: role of treatment with mupirocinointment and chlorhexidine baths for nasal carriers of MRSA. Infect. Control Hosp. Epidemol. 2006; 27(2):185 – 187.

Abstract: Since its introduction, medical abortion has rapidly gained popularity. The ease of administration ,the convenience ,wider availability of drugs –sometimes over the counter – low complication rates, and the affordable cost has led to the of abuse medical abortion [M.A.]. Objective of the study was to see why women resort to abortion without hesitation, what is their knowledge, attitude and mindset about medical abortion .We subjected 124 women seeking medical abortion to a questionnaire comprising their educational social ,religious background ,reasons for seeking abortion, contraceptive usage, acceptability of post- abortion contraception. Observations; .Most of women were married. Common cause pregnancy was non use of contraceptive, followed by failed contraception. Reasons for wanting abortion was too soon after LCB, having completed family, too early in the married life, economic conditions and wanting to postpone pregnancy for education and career. Conclusion; Medical abortions is being looked as an easy way to get rid of an unintended pregnancy. More women are taking pro-choice rather than pro-life approach. The guilt of abortion and moral liability is reducing, because of easy availability. Women opt for medical abortion instead of using regular contraception, as a means of post conception method of limiting and spacing families

Keywords – Abuse, Alternative to contraception, medical abortion, Psycho-social aspects

[1]. N .Sheriar, Accessing safe abortion, Journal of Family Welfare ,vol 50,special issue,2007
[2]. Etul Bataya,Sheriar Nozer,Anand Abhijeet, Philip Neena,Are obstetrician and gynecologists awarwe of Medical abortion in India?Journal of Obstetrics and Gynecology Of India, vol.,56,no.4,August 2006,349-345
[3]. Anke Hemmerling, Freiederike Siedentopf, &Heribert Kentenich Emotional impact and acceptability of medical abortion with mifepristone: A German experience, Journal of Psychosomatic Obstetrics & Gynecology, March 2005; 26(1): 23–31ISSN 0167-482X print/ISSN 1743-8942 online # 2005 Taylor & Francis Group Ltd
[4]. Saseendran Pallikadavath and R. William Stones ,Maternal and Social Factors Associated with Abortion in India: A Population-Based Study, International Family Planning PerspectivesVolume 32, Number 3, September 2006
[5]. Ravindran TK and Balasubramanian P, "Yes" to abortion but "no" to sexual rights: the paradoxical reality of married women in rural Tamil Nadu, India, Reproductive Health Matters, 2004, 12(23):88–99.
[6]. Ulmann, A., Silvestre, L., Chemama, L., Rezvani, Y., Renault, M., Aguillaume, C. J. and Baulieu, E.-E. (1992), Medical termination of early pregnancy with mifepristone (RU 486) followed by a prostaglandin analogue: Study in 16, 369 women. Acta Obstetricia et Gynecologica Scandinavica, 71: 278–283. doi: 10.3109/00016349209021052, Available at website http://www.ncbi.nlm.nih.gov/pubmed/1322621

Abstract: Violence against women could be physical, mental or sexual. It reflects inequities between men and women and compromises health, dignity, security & autonomy of the victims. The present study was carried out at the Urban Health Centre & included all married women in the reproductive age, to study various factors associated with violence, and the decision making power of the women.

Keywords – Domestic Violence, Decision making power, Urban Health Centre, Women, Risk factors

[1] National family health survey-3, 2005-06: Domestic Violence, pg. 503.

[2] Khosla A. H, Deepti Dua, Lajya Devi, Shyam Sunder Sud; Domestic violence in pregnancy in North Indian women. Indian J of Med Sci 2005; 59(5):195-199.

[3] Mitra S.; Domestic Violence along with its Socio cultural Determinants among Pregnant Women attending MCH Clinic of a Sub Divisional Hospital West Bengal. Indian Journal of Community Medicine,2006, 31(4), 267 - 269.

[4] Ghosh D.; Predicting Vulnerability of Indian Women to Domestic Violence Incidents; Research and Practice in Social Sciences, Vol.3, No.1 (Aug. 2007) 48-72.
[5] Domestic Violence in India and repercussion on Women's Health. Ajay Kumar, Rabindra kumar Sinha. Available at http://paa2004.princeton.edu/papers/41350. Accessed on 13th August 2008.
[6] Women's autonomy in household decision making: a demographic study in Nepal. Acharya D.R., Jacquelline S. Bell, Padam Simbhada, Edwin Rvan Teijlenjer, Pramod R. Ragmi. Available at http://www.ncbi.nlm.nih.gov/pubmed/20630107. Accessed on 15th September 2011.

Abstract: Recent therapeutic strategies in acute lymphoblastic leukemia (ALL) have been developed for the prognostic and hematological response or remission. Most chemotherapeutic agents induce tumor cell death by apoptosis. Therefore, regulation of the apoptotic and anti-apoptotic proteins influence treatment outcome. The mechanisms of caspase-3 and survivin have not been well investigated in childhood ALL. The aim of this study was to compare the active caspase-3 and survivin before and after receiving induction chemotherapy in ALL and to determine caspase-3/survivin ratio. The peripheral blood mononuclear cell was collected from ALL children before treatment and 6 weeks after starting induction therapy. Caspase-3 and survivin was measured by flow cytometry using monoclonal antibodies. Data were analysed by Kruskal-Wallis and Mann Whitney for comparison between groups, Spearman's test and linier regression to find out correlation between variables with significant value p<0.05. A total of 36 children were evaluated. The intensity of caspase-3 expression and ratio of caspase-3/survivin were significantly elevated in the after treatment group compared with the levels prior to chemotherapy, but no significant difference of caspase-3 compared with its expression in control group. Survivin was significantly decreased after induction chemotherapy compared to that at diagnosis (p=0.000). There was strong inverse correlation between survivin and caspase-3/survivin ratio before chemotherapy (r=−0.769, p=0.003), but no correlation between caspase-3 and survivin within group. It was concluded that the higher survivin expression, the lower caspase-3/survivin ratio. Caspase-3 expression and caspase-3/survivin ratio were increased, whereas survivin expression was decreased after induction chemotherapy.

Keywords: caspase-3, survivin, acute lymphoblastic leukemia.

[1] Gaynon P.S. Childhood acute lymphoblastic leukemia and relaps. British J Haematol, 13, 2005, 579-87.

[2] Spector L.G., Ross J.A., Robison L.L. Epidemiology and etiology in childhood leukemias (New York: Cambridge University Press, 2006) 48-61.

[3] Pui C.H., Robinson L.L., Look A.T. Acute lymphoblastic leukemia. Lancet. 371, 2008,1030-43.

[4] Ribera J.M.and Oriol A. Acute lymphoblastic leukemia in adolescents and young adults. Hematol Oncol Clin North Am, 23(5), 2009, 1033- 42.

[5] Ross D.D. Novel mechanisms of drug resistance in leukemia. Leukemia, 14, 2000, 467-473.

[6] MacKenzie S.H.and Clark A.C. Targeting cell death in tumors by activating caspases. Current cancer drug targets, 8, 2008,98-109. [7] Altieri D.C. Survivin and IAP proteins in cell death mechanisms. Biochem J. 430, 2010, 199-205.

[8] Schimmer A.D., Pedersen I.M., Kitada S., et al. Functional blocks in caspase activation pathways are common in leukemia and predict patient response to induction chemotherapy. Cancer Res. 63, 2003, 1242-48.

[9] Fulda S. And Debatin K.M. Extrinsic versus intrinsic apoptosis pathways in anticancer chemotherapy. Oncogene, 25, 2006, 4798-811.

[10] Dohi T., Okada K., Xia F., et al. An IAP-IAP complex inhibits apoptosis. J Biol Chem, 279 (33), 2004, 34087-34090.

Abstract: Oral hygiene is the practice of keeping the mouth clean to prevent dental decay. Cleaning the teeth is the process of removing dental plaque, which mainly consist of streptococcus mutans bacteria. Streptococcus mutans contribute towards tooth decay. Prolonged plaque presence increases the likelihood of cavities, gum diseases and gingivitis. The need for good oral hygiene is obvious and is achieved mostly through brushing the teeth with a fluoride treated toothpaste and toothbrush. The SoladeyTM toothbrush differs from conventional toothbrush by utilizing a TiO2 semiconductor to accomplish the plaque removal assistance of toothpaste. The following article focuses on the function of SoladeyTM toothbrush as additional plaque removal force.

Keywords: - dental plaque, SoladeyTM, semiconductor

[1]. Weiger. R (1987), Clinical experimental investigation in regard to the effectiveness of the 'Denta-Solar' with integrated semiconductor of TiO2. Dissertation: Doctor of Dentistry.
[2]. Hoover JN, Singer DL, Pahwa P, Komwama K. Clinical evaluation of a light energy conversion toothbrush. J. Clin Periodontol: 1992, 19; 434-436.
[3]. Niwa. M, Fakuda. M (1989), Clinical study on the control of dental plaque using solar energy conversion toothbrush equipped with a TiO2 semiconductor. Odontology, 77; 598-606.
[4]. Kusunoki. K, Oku. T, Koni. H (1986) A study on the effect of the solar energy conversion toothbrush on the control of dental plaque. Journal of the Osaka Odontological Society, 49; 550-559.
[5]. Morioka.T, Saito. T, Nara. K, Onoda. K (1988) Antibacterial action of powdered semiconductor on a serotype g Streptococcus mutans. Caries Research, 22; 230-231

Abstract: Objectives: To study the role of low-dose aspirin in prevention of pre-eclampsia .and its effect on maternal & neonatal outcome. DESIGN: A prospective randomized double-blind placebo controlled study. METHODS: All the high risk antenatal women presenting between 12–24 weeks of gestation were randomized to receive either aspirin 75 mg/day or matching placebo. Both the groups were compared for pre-eclampsia, pregnancy duration, birthweight, adverse maternal or neonatal outcome. RESULTS: A total of 120 women were followed up. The incidence of pre-eclampsia in aspirin group was 0.83% ,whereas none of the patients developed preeclampsia in placebo group. There were no significant differences between both the groups in. number of preterm delivery 11.47% in aspirin group vs 22% in placebo group, of SGA babies 16.9% vs 17.2% in placebo group. Aspirin was also not associated with increased risk of maternal or fetal complications. CONCLUSIONS: : The results of present study do not support the use of low dose aspirin for prevention of pre-eclampsia or its complications in any category of high risk women as proven by results of previous large scale trials and further multicentric large trials are still required to assess the role.

Key words: Aspirin, Preeclampsia, Gestational hypertension, Pregnancy

[1]. Poston L, Briley A, Seed P, Kelly F, Shennan A. Vitamin C and vitamin E in pregnant women at risk for pre-eclampsia (VIP trial):Randomised placebo-controlled trial. The Lancet 2006;367(9517):1145-54.
[2]. Robert JM, Cooper DW. Pathogenesis and genetics of preeclampsia. Lancet 2001;357:53-56.
[3]. De Wolf F, Robertson WB, Brosens I. The ultrastructure of acute atherosis in hypertensive pregnancy. Am J Obstet Gynecol 1975;123: 164-74.
[4]. Khong TY, De Wolf F, Robertson WB, et al. Inadequate maternal vascular response to placentation in pregnancies complicated by pre-eclampsia and by small–for– gestational age infants. Br J Obstet Gynaecol 1986;93:1049-59.
[5]. Walsh SW: Preeclampsia – An imbalance of placental prostacyclin and thromboxane production. Am J Obstet Gynecol 1985;152:335-40.
[6]. Redman CWG. Platelets and the beginnings of pre-eclampsia. N Engl J Med 1990;323:478-80.
[7]. CLASP: A randomized trial of low dose aspirin for the prevention and treatment of preeclampsia among 9364 pregnant women (collaborative low dose aspirin study in pregnancy).The Lancet 1994;343:619-29
[8]. Caritis S, Sibai B, Hauth J, et al and NICHD (National Institute Child Health and Human Development Network)Low dose aspirin to prevent preeclampsia in women at high risk. N Engl J Med 1998;338(11):701-05.
[9]. Sibai BM, Gariti SN, Thom E, et al. Prevention of preeclampsia with low dose aspirin in healthy nulliparous pregnant women. N Engl Med J 1993;329:1213-18.
[10]. Royal College of Obstetricians and Gynaecologists. Preeclampsia–study group recommendations. Sept 3;page 2.

Abstract: Background: Adherence to antihypertensive is crucial to treatment success in subjects with hypertension. This study is aimed at assessing antihypertensive drug adherence using validated tool and its relationship with some demographic and clinical parameters in outpatient hypertensive subjects. Methods:The Morisky Medication Adherence Scale (MMAS-4) was used to assess drug adherence status in 150 hypertensive patients who were consecutively recruited in a Medical Outpatient Department of a Tertiary Health Centre. All the patients had resting 12- lead electrocardiogram (ECG) done to determine left ventricular hypertrophy (LVH). Data were analyzed with SPSS 13 and statistical significance of p< 0.05 was used. Results: One hundred and fifty hypertensive patients with a mean age of 61.53± 9.72years were recruited over a period of 6 months. Sixty seven (44.7%) were good drug adherers while 55.3% were not. Patients with poor antihypertensive adherence had higher Sokolow- Lyon ECG score (34.46 ± 7.87 vs. 22.96 ± 7.07; p= 0.07) as well as longer P wave duration on ECG (0.15 ± 0.03 vs. 0.12± 0.04; p= 0.03). There was higher rate of ECG LVH among patients with poor drug adherence (47.0%) compared to patients with good drug adherence (4.5%). Significant correlates of poor drug adherence were age (r= - 0.221; p=0.022) and BMI (r= 0.431; P<0.001). Conclusion:The rate of poor drug compliance was high with preponderance of LVH in poor adherer. Physicians will do well to engage their hypertensive patients on hypertension and its treatment with a view to improving drug adherence in them.

Keywords: Medication, adherence, hypertension, electrocardiogram

[1]. World Health Organization (WHO). The world health report 2002—reducing risks, promoting healthy life. 2011. www.who.int/whr/2002/en/.
[2]. Salako LA: Hypertension in Africa and Effectiveness of Its Management with Various Classes of Antihypertensive Drugs and in Different Socio- Economic and Cultural Environments. Clin Exp Hypertens 1993, 15(6):997–1004.
[3]. Ekwunife OI and Aguwa CN. A meta analysis of prevalence rate of hypertension in Nigerian populations. J. Public Health Epidemiol. 2011, 3(13): 604-607.
[4]. World Health Organization. Chapter III Hypertension in Adherence to Long- Term Therapies-Evidence for Action. 2003. p. 27. Available: http:// www.who.int/chronic_conditions/adherencereport/en/print.html.
[5]. Berenson GS, et al. Association between multiple cardiovascular risk factors and atherosclerosis in children and young adults. The Bogalusa Heart Study. N Engl J Med. 1998, 338: 1650–1656.
[6]. Thompson DW and Furlan AJ. Clinical epidemiology of stroke. Neurol Clin. 1996, 14: 309–315.10.
[7]. Baune BT, Aljeesh YI, Bender R. The impact of non-compliance with the therapeutic regimen on the development of stroke among hypertensive men and women in Gaza, Palestine. Saudi Med J. 2004, 25(11): 1683–8.
[8]. Morisky DE, Green LW, Levine DM: Concurrent and predictive validity of a self-reported measure of medication adherence. Med Care 1986, 24(1):67–74.
[9]. Cockcroft DW, Gault MH. Prediction of creatinine clearance from serum creatinine. Nephron. 1976; 16(1): 31-41.
[10]. Sokolow M, Lyon TP. The ventricular complex in left ventricular hypertrophy as obtained by unipolar precordial and limb leads. Am Heart J. 1949; 37:161-186.

Abstract: Candida species are present in the flora of the skin and mucosa of man, and are of common occurrence in the oral cavity of healthy individuals, Candida albicans being the predominant species in the oral microbiota. Therefore, this study was to verify in vitro the effectiveness of oral antiseptics such as chlorhexidine digluconate 0.12%, Cepacol ®, Flogoral ® and Melaleuca 0.2% in the control of Candida albicans. We selected 30 strains of Candida albicans stored in specific culture medium. To the Müeller Hinton Agar - Biobrás ® was added sterile paper disks impregnated with the antiseptics studied, and then the samples were incubated at 37 ° C for 24 - 48 hours. Evidence of antifungal activity was the formation of inhibition zone around the paper disk, and evaluated by measuring the halos with a millimeter ruler. According to the results, it is clear that Chlorhexidine was startled on the other oral antiseptics because it has a broad spectrum of activity against various microorganisms. The Cepacol ® also stands out from others because it has a certain efficacy against the some microrganisms. The Flogoral ® and Melaleuca is not observed as effective in the treatment of C. albicans.

Key-Words: Candida albicans; antiseptics; effectiveness; treatment.

[1]. BEVILACQUA, I. M.; HABITANTE, S. M.; CRUZ, C. W. (2004). A Clorexidina como Alternativa no Tratamento de Infecções Endodônticas. Rev. biociên. 10 (3), 139-145.
[2]. BUENO, M. E.; FEIJO, A. M.; COIMBRA, H. S.; NASCENTE, P. S. (2005). Pesquisa de Candida spp na microbiota oral de crianças. Congresso de Iniciação Cientifica UFPel, Pelotas, RS.
[3]. CANDIDO, R. C.; AZEVEDO, R. V.; ITO, I. Y. (1996). Determinação da Concentração Inibitória Mínima de Cepacol, Malvona e Periogard, Ante a Cândida albicans Isoladas da Cavidade Bucal. Ver. Odontol. UNESP. 25 (1), 79-84.
[4]. DRUMOND, M. R. S.; CASTRO, R. D.; ALMEIDA, R. V. D.; PEREIRA, M. S. V.; PADILHA, W. W. N. (2004). Estudo Comparativo in vitro da Atividade Antibacteriana de Produtos Fitoterápicos Sobre Bactérias Cariogênicas. Pesq. Bras. Odontoped. Clin. Integr. 4 (1), 33-38.
[5]. FARIAS, N. C.; BUFFON, M. M.; CINI, R. (2003). Avaliação in vitro da Ação Antifúngica do Digluconato de Clorhexidina e Nistatina no Controle do Crescimento de Candida albicans. Visão Acadêmica. 4 (2), 83-88.

Abstract: PURPOSE: The main objectives of our study are to assess the QOL depression and the level of physical activity in hemodialysis patients. METHOD: The self reported measures WHO BREF Questionnaire, Beck depression inventory scale and Global physical activity questionnaire were given to the participants who were receiving hemodialysis and age matched normal individuals at the time of study and consented. And the data was collected with the necessary personal and demographical data. In data Analysis descriptive statistics and non parametric man Whitney and spearman's correlation were done using SPSS v. 15. RESULT: The non parametric man Whitney u test was done to compare the means of total QOL score, physical health, psychological health, social relationship, environment and depression score. The groups compared show a significant difference and are not equal. The physical activity hypothesis testing showed significance with chi-square value 15.306, p<.05 which indicate there is difference between the patient group and normal in terms of physical activity. The non parametric correlation analysis was done between the QOL and depression scores. There was positive relationship between total raw QOL score and physical health, psychological health. The physical health was positively related to psychological health, environment score and negatively related to depression score. The psychological health was positively related to environment and negatively related to depression score. CONCLUSION: The present study showed compromised health related quality of life, low level physical activity and moderate level of depression among hemodialysis patients. The relationship between physical and psychological dimensions and low level of physical activity pronounces the importance of regular exercises or supervised physiotherapy training to improve the compromised health related quality of life. Keywords: health related quality of life, depression, physical activity, dialysis patients

1]. Dirks JH, de Zeeuw D, Agarwal SK et al. Prevention of chronic kidney and vascular disease: toward global health equity—the Bella- gio 2004 Declaration. Kidney Int Suppl 2005: S1–S6

[2]. Edgell ET, Coons SJ, Carter WB, Kallich JD, Mapes D, Damush TM, et al. A review of Health-Related quality-of-life measures used in end stage renal disease. Clin Ther 1996;18:887-938.

[3]. Fox E, Peace K, Neale TJ, Morrison RB, HatÞ eld PJ, Mellsop G. ―Quality of Life‖ for patients with end stage renal failure. Ren Fail 1991;13:31-5.

[4]. Hudson JQ, Johnson CA. Chronic kidney disease. In: Koda Kimble MA, et al, editors. Applied therapeutics. 8th ed. Philadelphia: Lippincott Williams and Wilkins; 2004. p. 32-1

[5]. Testa MA, Simonson DC. Assessment of quality-of-life outcomes. N Engl J Med 1996;334:835-9. [6]. Kaufman SE. The increasing importance of quality of life research. Clin Res 2001;1:18-22.

[7]. Lopes AA, Bragg J & Young A et al. Depression as a predictor of mortality and hospitalization among hemodialysis patients in the United States and Europe in the Dialysis Outcomes and Practice Patterns Study (DOPPS). Kidney Int 2002; 62: 199−207

[8]. DeOreo PB. Hemodialysis patient-assessed functional health status predicts continued survival, hospitalization, and dialysis-attendance compliance. Am J Kidney Dis 1997; 30: 204−212

[9]. Mapes DL, Lopes AA & Satayathum S et al. Health-related quality of life as a predictor of mortality and hospitalization: The Dialysis Outcomes and Practice Patterns Study (DOPPS). Kidney Int 2003; 64: 339−349.

[10]. Indian journal of nephrology, An assessment of the quality of life in hemodialysis patients using the WHOQOL-BREF questionnaire. B. S. Sathvik, G. Parthasarathi, M. G. Narahari, and K. C. Gurudev, 2008.

Abstract: Research Question: Dental Fluorosis Status in School Children of Jaipur (Raj) India Objectives: To find out the Dental Fluorosis and its associating factors among students. Methodology: A cross-sectional observational study was carried out on 3200 children of 5-16 years of age of 20 elementary schools of urban and rural area of Jaipur in year 2011. Socio-demographic data were collected from parents of children and thorough dental check-up was arranged by a dentist for these children. Children with fluorosis were identified. Data in details were collected as per pre-designed proforma. Data collected were analysed and inferred with chi-square test. Result: 34.5% of children were diagnosed as having dental fluorosis. Dental fluorosis was significantly (P<0.05) more in rural areas (43.94%) than in the urban areas (25.06%). Variation in proportion of cases as per the age was also found to be highly significant (P< 0.001) with M:F ratio 1.18(P>0.05).Conclusion: More than one third students were having dental fluorosis. It was found associated with rural areas and age but sex was not associated

Keywords - Dental fluorosis, Socio-demographic factors, chi-square Test

[1]. Fluoride and Fluorosis A review report on Fluorosis http://www. krassindia.org/downloads/ebook1.pdf.
[2]. Indo-Asian News Service. Fluorosis on the rise in Rajasthan Jaipur. January 31, 2004.
[3]. World Health Organization. Oral Health Surveys - Basic Methods; WHO 2004.
[4]. Singhal J.P. An Epidemiological Study of Dental and Periodontal diseases among school children in Ajmer City. Thesis submitted for the degree of MD. (P.S.M.), University of Rajasthan 1981.
[5]. S Saravanan. Prevalence of Dental Flurosis Among Primary School Children in Rural Areas of Chidambaram Taluk, Cuddalore District, Tamil Nadu, India Indian Journal of Community Medicine, Vol. 33, Issue 3, July 2008.
[6]. National Oral Health Survey and Fluoride Mapping. An Epidemiological Study of Oral Health Problems and Estimation of Fluoride Levels in Drinking Water. Dental Council of India, New Delhi, 2004; 32 : 67-78
[7]. Baskaradoss, JK. Prevalence of dental fluorosis and associated risk factors in 11-15 year old school children of Kanyakumari District, Tamilnadu, India : A cross sectional survey. Indian J Dent Res. 2008 Oct-Dec; 19 (4) : 297-303.
[8]. Dhar V et al. Prevalence of gingival diseases, malocclusion and fl uorosis in school-going children of rural areas in Udaipur district. J Indian Soc Pedod Prev Dent - June 2007.
[9]. Poornima Tiwari et al. Dental fluorosis and its association with the use of fluoridated toothpaste among middle school students of Delhi, 2010; Volume: 64, Issue: 1 : 1-6.
[10]. Rajesh Kr. Yadav et al. Endemic Dental Fluorosis and Associated Risk Factors in Dausa District, Rajasthan, World Applied Sciences Journal, 2012; 16 (1) : 30-33, IDOSI Publications.
[11]. Suma G, Crowding, Spacing And Closed Dentition And Its Relationship With Malocclusion In Primary Dentition. International Journal of Clinical Dental Science 2010; 1 (1)
[12]. Ana Karina Mascarenhas. Risk factors for dental fluorosis : A review of the recent literature. American Academy of Pediatric Dentistry (Pediatr Dent, 2000; 22 : 269-277.

Abstract: Background: Breast cancer is one of the most important tumours affecting women in Nigeria and all over the world, with high morbidity and mortality if detection is delayed. Objectives: This study was carried out to review the histology of all breast biopsies sent to Histopathology Laboratory in UDUTH. Method: Using haematoxylin and eosin staining method, breast biopsies received from January 2002 to December 2011 were analyzed. Demographic data such as age, sex, site of the biopsy of all the patients were obtained through histology request card and biopsy registers. Result: A total of 788 breast samples were received during the period under review, 403 samples (51.1%) were benign lesions, 256 samples (32.5%) malignant lesions and 61 samples (7.7%) are inflammatory lesions. The age group with the highest occurrence of breast pathology is 20-29 years which are mostly benign lesions, with 50-59 years age group having the highest occurrence of malignant lesions. Conclusion: The study indicated that most breast lesions occurring in the first three decades of life are benign, while those in the elderly are mostly malignant. We recommend strong awareness among the populace to encourage early detection of these lesions.

[1]. Bentley, G. R. (2001). The evolution of the breast. American Journal of Physical Anthropology 32 (38).
[2]. Robinson, R.B. (1971). Current trends in Management of Breast Cancer. Maryland (USA): Johns Hopkins University Press.
[3]. Wohlfart, J. (1999). Reproductive risk factors for Breast cancer receptor status, Histology and Location. International Journal of Cancer 81 (1).
[4]. Nagata, C., Kawakami, N. and Shimizu, H. (1997). Trends in the incidence rate and risk factors of Breast Cancer in Japan: Breast Cancer Retreat 44(1), p.75-85.
[5]. Muhammad, M. (2001). Short Textbook of Pathology. 3rd edition. Karachi (Pakistan): Journal Publishers.
[6]. Kumar, V., Abbas A.K., Fausto, N. (2004). Robbins and Cotran Pathologic basis of disease. 7th edition. India: Elsevier, a division of Reed Elsevier India Private Ltd.
[7]. Bodian, C.A. (1993). Prognostic significance of Proliferative Breast Diseases, 71-3896.
[8]. Michael, R. (2007). Breast Cancer Information (online): http//www.google.com/search.
[9]. Olusola, D. (2011). Lecture notes on tumours of the Breast and Cervix.
[10]. Goodman, M.T. (2006). Comparative Epidemiology of Breast Cancer among men and women in USA, 17(2).

Abstract: Schwannoma arising within breast parenchyma is very rare. This report describes such a case in a 52year old woman. This tumor which measured 3.5cmx2.5cm was painless mobile,smooth and elastic. At ultrasonography it appeared as a hypoechoic solid mass.Fine needle cytology revealed several clusters of spindle cels indicative of a neoplasm of mesenchymal origin. Histological examination evidenced the characteristic morphological appearance of a schwannoma with Antoni A and Antoni B areas.

Key words: breast ,schwannoma.

1]. Soft tissue. In:JaunRosai(ed).Rosai and Akerman`s Surgical Pathology,vol.2. 9thedn.Mosby,2004;2237-2372.
[2]. Uchida N,Yokoo H, and Kuwano H, Schwannoma of the breast: report of a case.Surgery Today 2005;35 no.3: 238-242.
[3]. BellezzaG,LombardiT,Panzarola P, SidoniA,Cavaliere A, and Giansanti M, Schwannoma of the breast: a case report and review of literature. Tumori 2007; 93 no.3:308-311.
[4]. YeganeR,MousavianSA,BashashatiM,Rare Peripheral Nerve Schwannoma. IJCP 2009;2:107-110.
[5]. Dialani V, Hines N, Wang Y et al, Breast Schwannoma: a case report.Case Reports in Medicine.vol 2011.
[6]. Cho KS,Choi HY, Lee SW, and Sung SH, Sonographic findings in solitary schwannoma of the Breast. Journal of Clinical Ultrasound 2001;29 no. 2: 99-101.
[7]. Fletcher C. Diagnostic Histopathology of Tumors, 3rd Edn,: Churchill Livingstone, New York, NY, USA, 2007.
[8]. Gupta RK, Naran S, Lallu S, and Fauck R, Fine-needle aspiration cytology in neurilemoma (Schwannoma) of the breast: report of two cases in a man and a woman. Diagnostic Cytopathology 2001;24.no.1:76-77.
[9]. Lee EK, Kook SH, Kwag HJ, Park YL, and Bae WG, Schwannoma of the breast showing massive exophytic growth: a case report. Breast 2006; 15 no. 4: 562-566.
[10]. Shishiba T, Niimura M, Ohtsuka F, Tsuru N. Multiple cutaneous neurilemmomas as a skin manifestation of neurilemmomatosis. J Am A cad Dermatol. 1984; 10:744-54.