iosr-JDMS   Volume-8 ~ Issue-6

Abstract: In children pneumonia is a leading cause of death which is characterized by inflammation of the parenchyma of the lung tissue due to infection. Additional risk factors being continuous exposure of lung epithelium to environmental pollutants, microorganisms, resulting into inflammation and increased oxidative stress .Lung tissue are protected from environmental oxidants by the endogenous antioxidants. A disruption in the fine balance between the antioxidants and oxidants leads to oxidative stress. The present study was conducted to study the oxidative stress in pneumonia by measuring the levels of lipid peroxidation in terms of malondialdehyde, enzymatic and non-enzymatic antioxidants as compared to control group. The study observed significantly lowered levels of antioxidant enzymes glutathione peroxidase, glutathione reductase and paraoxonase 1 along with lowered levels of non enzymatic antioxidants Vitamin C, vitamin E, and β carotene (p< 0.001) and an increased malondialdehyde levels among patients diagnosed with pneumonia when compared with the control group(p <0.001). Our observations are suggestive of an increased oxidative stress in cases of pneumonia in the pediatric age group.

Key words: Antioxidants, Nrf2, Oxidative stress, Pneumonia ,Reactive oxygen species.

[1] Pneumonia WHO Fact sheet N°331 November 2012.

[2] Wilson JN, Pierce JD, Clancy RL, Reactive oxygen species in acute respiratory distress syndrome, Heart Lung Sep-Oct (5)2001:370-375.

[3] Jacob N Finkelstein and Carl J. Johnston, Enhanced sensitivity of the postnatal lung to environmental insults and oxidative stress Paediatrica 2004 113:1092-1096.
[4] Katsoulis K, Kontakiotis T, Baltopoulos G et al: Total antioxidant status and severity of community acquired pneumonia: Are they correlated? Respiration, 2005; 72:381-87.

[5] Kelly FJ, Mudway I, Blomberg A, Frew A, Sandström T, Altered lung antioxidant status in patients with mild asthma. Lancet 1999,354:482–483

[6] Al-Abdulla NO, Al Naama LM, Hassan MK Antioxidant status in acute asthmatic attack in children. J Pak Med Assoc2010 Dec;60(12):1023-7.
[7] Young EJ Brucella species In: Mandell GL, Bennett JE, Dolin R, editors. Principles and practice of infectious diseases. 6th ed, Philadelphia: Churchill Livingstone; 2005 p. 2669–2672

[8] Cemek M , Cakson H, Bayiroglu F. Oxidative stress and enzymatic-non enzymatic antioxidant responses in children with pneumonia. Cell Biochem Function, 2006, 24 (3): 269-273.

[9] Shamir R, Hartman C, Karry R, Pavlotzky E, Eliakim R, Lachter J, Suissa A, Aviram M Paraoxonases (PONs) 1, 2 and 3 are expressed in human and mouse gastrointestinal tract and in Caco-2 cell line: selective secretion of PON1 and PON2. Free Radic. Biol.Med., 2005 39: 336–344.

[10] Aviram M, Rosenblat MParaoxonases 1,2, and 3, oxidative stress and macrophage foam cell formation during atherosclerosis development. Free. Radic. Biol. Med.,2004 37: 1304–1316.

Abstract: Aim: To determine the prevalence of human immunodeficiency virus (HIV) among patients who underwent eye surgery in a tertiary facility. Materials and methods: This was a retrospective study using health records of patients who underwent eye surgery over a 21/2 year period. Demographic information including age, sex, occupation, diagnosis, type of surgery and HIV status were extracted and analyzed with SPSS 17.0. Results: A total of 99 patients were screened, made up of 60 males and 39 females. The age range was between 5 and 83 years with mean age of 49.9 years. Seven patients (7.1%) were sero-positive for human immunodeficiency virus. Of these, five were between 3rd and 5th decade of life while 2 were more than sixty years old. Conclusion: The sero-prevalence of HIV is high in our series. Patients undergoing ophthalmic surgery should be counseled to accept pre-operative HIV screening and ophthalmic surgeons should take precautions to minimize the risks of transmission to self, other health workers and uninfected patients. Keywords: Sero-prevalence, HIV, ophthalmic, surgical, patients.

[1]. Peter M. Nthumba and Paul I. Juma Kijabe. HIV Infection: Implications on Surgical Practice. in Eugenia Barros (ed). HIV Infection- Impact, Awareness and Social Implications of living with HIV/AIDS., (Nairob: Kenya, 2011), 271-284.
[2]. Nwosu SNN, Anyiwo CE, OnochieAU. The Seroprevalenve of Human Immunodeficiency in Nigerians with Ophthalmic Disorders. Nig J Ophthalmo 1996, 4, 9-11.
[3]. Kehinde AV, Samaila E, Eni RN. Ocular aids: experience at the Guinness Ophthalmic unit,Kaduna , Nigeria. Niger J Surg Res 2005; (7)3: 305-308.
[4]. Mann J. Control Strategies: AIDS a Global problem. AIDS action, 1986, 1,4-5
[5]. Lewallen S. HIV/AIDS: What is the impact on prevention of blindness programmes? Community Eye Health, 2003, 16, 33- 34
[6]. Olapade-Olaopa EO, Salami MA, Afolabi AO. HIV/AIDS and the surgeon. Afr J Med Sci, 2006, 35, 77–83.
[7]. WHO report. Guidelines on sterilization and high – level disinfections methods effective against human immunodeficiency virus (HIV). AIDS Action 1988, 3 (suppl), 2 – 4
[8]. Marasco S, Woods S. The risk of eye splash injuries in surgery. Aust N Z J Surg, 1995, 65, 627-629
[9]. Veeken H, Verbeek J, Houweling H, Cobelens F. Occupational HIV infection and Health care workers in the tropics. Trop Doc, 1991, 21, 28–31.
[10]. UNAIDS Reports on the Global AIDS 2006: HIV/AIDS estimates and data. 2005.

Abstract: The inferior alveolar nerve (IAN) block is the most frequently used mandibular injection technique for achieving local anesthesia for dental treatment. However, the IAN block does not always result in successful anesthesia. Various other nerve blocks were introduced over the period of time to improve the success rate of anesthesia. The objective of this systematic review was to compare and evaluate the anesthetic efficacy of Inferior alveolar nerve block with various mandibular nerve blocks in dental patients. Electronicdatabases were systematically searched for randomized controlled clinical studies and Clinical trials studies. Studies were selected by predefined inclusion criteria. Methodological quality was appraised and strength of evidence was determined. Seven studies from seven countries were included based on inclusion criteria. Although there is difference in the values comparing the different techniques the data is not significantly different in the anesthetic efficacy of various mandibular nerve block in dental patients. Based on this review, most of the articles included, point towards a better anesthetic efficacy of the classic inferior alveolar nerve block compared to the other inferior alveolar anesthesia techniques. However due to various variables like type of local anesthesia, experience of the operator and familiarity with the individual techniques it is not possible to conclude that classic inferior alveolar nerve block is relatively superior. Hence further research should be aimed at better matching of groups and variables like operator experience and familiarity to validate the findings.

Keywords: anesthetic efficacy,local anesthesia, local anesthetic technique,mandibular anesthesia,pulpal anesthesia

[1]. Gow-Gates, G. A., and J. E. Watson. "The Gow-Gates mandibular block: further understanding." Anesthesia Progress 24.6 (1977): 183.
[2]. Todorović L, Stajcić Z, Petrović V. Mandibular versus inferior dental anaesthesia: clinical assessment of 3 different techniques.Int J Oral Maxillofac Surg. 1986 Dec; 15(6): 733-8.
[3]. Agren, E., and K. Danielsson. "Conduction block analgesia in the mandible. A comparative investigation of the techniques of Fischer and Gow-Gates." Swedish dental journal 5.3 (1981): 81.
[4]. Montagnese, Thomas A., Al Reader, and Rudy Melfi. "A comparative study of the Gow-Gates technique and a standard technique for mandibular anesthesia."Journal of endodontics 10.4 (1984): 158-163.
[5]. Hung PC, Chang HH, Yang PJ, Kuo YS, Lan WH, Lin CP. Comparison of the Gow-Gates mandibular block and inferior alveolar nerve block using a standardized protocol.JFormos Med Assoc. 2006 Feb; 105(2): 139-46.
[6]. Akinosi, J. O. "A new approach to the mandibular nerve block."British Journal of Oral Surgery 15.1 (1977): 83-87.
[7]. Sisk, Allen L. "Evaluation of the Akinosi mandibular block technique in oral surgery."Journal of Oral and Maxillofacial Surgery 44.2 (1986): 113-115.
[8]. Donkor P, Wong J, Punnia-Moorthy A. An evaluation of the closed mouth mandibular block technique. Int J Oral Maxillofac Surg. 1990 Aug; 19(4): 216-9.
[9]. Yücel E, Hutchison IL. A comparative evaluation of the conventional and closed-mouth technique for inferior alveolar nerve block.Aust Dent J. 1995Feb; 40(1): 15-6.
[10]. Martínez González JM, Benito Peña B, FernándezCáliz F, San HipólitoMarín L, PeñarrochaDiago M. A comparative study of direct mandibular nerve block and the Akinosi technique. Med Oral. 2003 Mar-Apr;8(2): 143-9. English, Spanish.

Abstract: Health workforce includes clinically trained health professionals, health management and support workers. Imbalance in health workforce is a major challenge, as its size and quality positively determine country's ability to meet its goals of organizing and delivering health services, like immunization coverage, outreach of primary care etc. Unfortunately, India has uneven, inequitable and mal-distributed health workforce regarding number, skill, gender mix and type. The perceived gap being more in rural hilly areas, this study in a rural primary health centre (PHC) in Ghayabari, approximately 45 kilometres from Darjeeling was envisaged. The objectives of the study was to assess the status of health workforce in Ghayabari PHC in the hilly terrain of Darjeeling district and find out the associated reasons of any existing imbalance.A cross-sectional study was conducted in Ghayabari PHC, from August to October 2011. Focus–Group-Discussion (FGD) with staff, local leaders, In-Depth- Interview (IDI) of medical officers, nurses and record review was done. There are two doctors, three nurses, ten beds for approx.16,800 population with 8.4 turnover rates. Indian Public Health Standard criteria are incompletely met regarding adequacy and health workforce distribution. 27.27% posts are vacant, 13% left jobs in last 3 yrs. Though emergency and referral services are present, outreach and home visits are irregular, increasing load on the PHC. FGD, IDI identify reasons as staff –shortages, absenteeism, attrition, less capacity building efforts, unskilled staff, intense communication problems in adverse terrain, harsh living and working conditions, absent job satisfaction, irregular supervision and no untied funds. Issues pertaining to staff shortage, skill imbalance and job satisfaction need to be addressed with concern and care to ensure primary health care at doorstep of community.

Keywords- primary health workforce imbalance, hilly terrains

[1]. WHO. Not Enough Here… Too Many There…Health Workforce in India.World Health Organization .Country Office for India 2007. pp. 1. Available at: http://www.whoindia.org/LinkFiles/Human Resources Health Workforce in India-Apr07.pdf
[2]. National Rural Health Mission (2005-2012). Mission Document. Available at: http://mohfw.nic.in/NRHM/Documents/MissionDocument.pdf.
[3]. Zurn P, Poz M D, Stilwell B ,Adams O. Imbalances in the health workforce. Briefing paper. World Health Organization. Evidence and Information for Policy. Health Service Provision 2002. pp. 7-42. Available at: http://www.who.int/hrh/documents/en/imbalancesbriefing.pdf.
[4]. Cohen M. Labor shortages as America approaches the twenty-first century. The University of Michigan Press. Ann Arbour 1998.

Abstract: Prosthetic management of surgical defects has always been a big challenge for a prosthodontist. The sudden change in patient's perspective towards life affects the future outcome of any prosthetic rehabilitation. A good prosthesis can bring back the lost pride and smile on the patients face. A thorough understanding of post surgical anatomy and physiology is a prerequisite for the development of successful prosthesis. This case report describes prosthodontic management of a patient who has undergone hemi-mandibulectomy with a provisional prosthesis ; modified mandibular guide flange prosthesis . The prosthesis helps patient moving the mandible normally, without deviation during functions like speech and mastication.

Key Words: Squamous cell carcinoma; Dental prosthesis design; Mandibular prosthesis; maxillofacial prosthesis; Segmental mandibulectomy, GFP. Guiding Flange Prosthesis.

[1]. Beumer J, Curtis TA, Mark T. Marunick: MaxillofacialmRehabilitation – Prosthodontic and Surgical Considerations.
[2]. Desjardins RP. Relating examination findings to treatment procedures. In: Laney WR. Maxillofacial prosthetics. Littleton; PSG Publishing; 1979. p. 69-114.
[3]. Taylor TD. Diagnostic considerations for prosthodontic rehabilitation of the mandibulectomy patient. In: Taylor TD, editor. Clinical maxillofacial prosthetics. Chicago; Quintessence Publishing; 2000. p. 155-70.
[4]. McGarry TJ, Nimmo A, Skiba JF, Ahlstrom RH, Smith CR, Koumjian JH, Arbree NS. Classification system for partial edentulism. J Prosthodont 2002;11:181-93.
[5]. Cantor R, Curtis TA. Prosthetic management of edentulous mandibulectomy patients -Part II, Clinical Procedures J Prosthet Dent 1971; 25; 546-55
[6]. Pravinkumar Gajanan Patil Guide flange prosthesis for early management of reconstructed hemimandibulectomy: a case report J Adv Prosthodont 2011;3:172-6
[7]. M Satish , Nirmala Pasam Training flange appliance after hemimandibulectomy – A case report. SRM University journal of dental sciences.Vol 2, Issue4 . October- December 2011

Abstract: Background: Oral health is essential to quality of life as it ensures social and physical well-being and it acts as the mirror which reflects general health. Oral diseases are topping the list of some common diseases in the world. Poor oral hygiene is a known important predisposing factor of some oral diseases like cancrum oris, periodontitis, acute necrotizing ulcerative gingivitis etc. Research question: What is the oral health status among adolescents age group? Aim & objectives: To find out factors affecting oral health status among adolescents. Study design: Cross-sectional study in urban slum areas, house to house survey was carried out to study epidemiological profile of oral health among adolescents. Oral cavity examination of study population was done with the help of torch or natural light. Setting: Field practice area of urban health training centre, Shivaji Nagar, Nanded. Participants: - 718 Study subjects from urban health centre field practice area. Results: - Prevalence of dental caries was found 33% among adolescents and 27% adolescents were having more than one oral morbidity. The other dental conditions like plaque, tartar, oral ulcer, candidacies, bleeding gums, injuries, calculus and fibrosis were also seen among adolescents. Statistically significant difference was noted with dental caries and type of cleaning aids (χ2 = 18.39 d.f.=2 p<0.001), cleaning material aids and prevalence of dental caries (χ2 = 30.69 d.f.= 4 p<0.01), Frequency of tooth cleaning and dental caries (χ2 = 6.07 d.f. = 1 p<0.05), Rinsing of mouth after meals and prevalence of dental caries (χ2 = 9.06 d.f.= 2 p<0.05) Conclusion: - Oral health (diseases) strongly related with frequency of mouth washing, type of cleaning aids, rinsing of mouth. There is need for accessible and affordable oral health services. Awareness among adolescents about oral health should be encouraged

Key-Words: - Oral health, adolescents, teeth decay, addiction and literacy status.

[1] Charlotte Fatty Ndiaye Oral Health :A key to general health and well-being African Health Monitor January-June 2008.

[2] Brennan DS, Spencer AJ (2004) Oral health trends among adult public dental patients. AIHW cat. no.DEN 127. Canberra : AIHW (Dental Statistics and Reasearch Series No. 30). Australia's National Health plan 2004-2013.

[3] Britt H, Sayer GP, Miller GC, Charles J, Scahill S, Horn F, Bhasale A, McGeechan K(1999) General Practice activity in Australia 1998-1999. Canberra: Australian Institute of Health and Welfare.

[4] Jayashree D. Chatufale, R.C. Goyal A Cross-Sectional Study of Factors Related to Oral Health in Rural Area of Loni, Western Maharashtra Indian journal of Community Medicine Vol. 27, No.2 (2002-04-2002-06)

[5] Bhowate RR, Borle SR. Dental health amongst 11-15 year old children in Sewagram, Maharashtra. Indian Journal of Dental Research. Apr-June 1994:5-6. [6] Goyal Rc, Sachdeva NL, Somsundaram Kv. Oral Health Status of rural community in Western Maharashtra. Indian Journal of PSM. July-Dec1994;25(3):138-45.

[7] Chalmers JM (1999) Oral diseases in older adults In: Chalmers JM Ageing and Dental Health. AIHW Dental Statistics and Research Series No.19. Adelaide: The University of Adelaide.

[8] Chalmers JM(2003) Oral health promotion for our ageing Australian population. Australian Dental Journal 48(1): 2-9.

[9] Halmers JM, Hodge CP, Fuss JM, Spencer AJ, Carter KD (2000) The Adelaide Dental Study of Nursing Homes 1998 AIHW cat. No. DEN 83. Adelaide: AIHW Dental Statistics and Research Unit (Dental Statistics and Research Series No.22).

[10] Chalmers JM, Hodge CP, Fuss JM, Spencer AJ, Carter KD (2001) The Adelaide Dental Study of Nursing Homes One-Year follow-up-1999. AIHW cat. No. DEN 84 Adelaide: AIHW Dental Statistics and Research Unit (Dental Statistics and Research Series No.23).

Abstract:Background: Wounds which results from an injury or trauma to any tissue of the body, has been claimed to be managed by traditional healers, with over fifty plants reported to have shown wound healing effect or properties. A good example is the Napoleona Vagelii commonly called Mkpodu in Igbo language. Extract from this plant is sometimes prepared as polyherbal medicine. The use of plant extract in the external management of wound is becoming widely acceptable because there is a growing interest in the clinical practice of wound management with the use of chemical component impregnated dressing.

Key Words: Wound healing, effect, Napoleona Vogelii extract.

[1]. Rajadurai M; Vidhya V. Ramya M., Annusha B. Ethnomedicinal Plants used by traditional healers. 2009; 3:39-41.
[2]. Gary Null. Complete Encyclopaedia of Natural Healing 1998; 5:220-222.
[3]. Iwu Maurine M. Handbook of African Medicinal Plants, CKC press 1993; 2:3-4.
[4]. Valiathan M.S. Healing Plants. Current Science 1998; 75:1122-1126.
[5]. Evans W.C. Treas and Evans Pharmacology 15th Edition 2001; 26:328-330.
[6]. Rate S.M. Plants as source of Drugs. Toxican 2001; 39:603-613.
[7]. Ibadan P.P. Complete Encyclopaedia of National Healing. 1999; 5:220-222.
[8]. Doughty O.B. Wound care strategies by the Homeopath Nurse 2004; 22(6) 364-366.
[9]. Bhora F.Y. Donkin B.J. Sidaway A.N. Effect of Growth Factors and epitheliaziation in Human skin. Journal of Surgical Research 1995; 59:236-244.
[10]. Fish F. Dawson J.I. Surgical Dressing, Ligatures and sutures. Heinemann Medical London 1969; 12:62-64.

Abstract: The plant Newbouldia laevis, commonly known as boundary tree, is a medium sized angiosperm which belongs to the family of Bignoniaceae. It is a native of trospical Africa. Extracts of all parts of Newbouldia laevis have been shown to exhibit antihypertensive property. Blood pressure is the optimal force needed to move blood through the body at rest and during physical activity while not exposing the arterial system to excessive force. An increase in blood pressure above the optimal level for an individual indicates that the cardiovascular system is abnormal in some way, and if this persists, damage to the heart and other vital organs will occur. Hypertension is not a threshold disease even though the current definition is commonly equated with blood pressure level above 140/90 mmHg.

Key Words: Antihypertensive, Newbouldia laevis cats.

[1]. Arbonnier M. Trees and Shrubs of West Africa Dry Zones. 5th Edition 2004 page 194.
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[3]. Akunyili D.N. Anticonvulsant activity of the Ethanolic Extract of Newbouldia laevis. 2nd NAAP conference 2000, page 155-158 Kannel W.B.
[4]. Blood pressure as a cardio vascular risk factor: Prevention and Treatment. 1996; 275, 1571-1576.
[5]. Bost L. Primatesta P; Dong W. Blood pressure Evidence from Health survey for England 1999; 13 (2): 123-128.
[6]. Swarles J.D. Essential Hypertension. Oxford Medical Publications 3rd Edition 1992; 2527-2543.
[7]. Oparil S. Arterial Hypertension Cecil Textbook of Medicine 19th Edition 1992: 253-269.
[8]. Mulatero P: Bertello C. Verhovez A. Current Hypertension Reports 2009; U (3): 217-223.
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[10]. Nelson Mark. Drug Treatment of Elevated Blood pressure 2010, (11) 33:

Abstract: Peptic ulcer results from an imbalance between ulcer promoting factors (gastric acid, pepsin secretion) and ulcer preventing factors (gastric mucosa, prostaglandins). Unripe plantain and cabbage when used individually were effective in the treatment of peptic ulcer in folkloric medium. This hereby paved way for this research that involved the co-administration of aqueous extracts of Musa paradisiaca (plantain) and Brassica oleracea (cabbage) in the treatment of peptic ulcer.

Key words: Musa paradisiaca, Brassica oleracea, peptic ulcer.

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[9]. Rosemary G. Family herbal guides to living life with energy, health and vitality 2001; 6(1):19.
[10]. Richo. C. Making plant medicine 2000; 2(1): 62-70

Abstract: Gingival recession results in a cosmetic deficit and may also affect function.The main indications for root coverage procedures are progressive gingival recession,esthetic demands and root sensitivity. Coverage of denuded roots is one of the most challenging procedures in periodontal mucogingival surgery. Various surgical options have been developed to achieve the root coverage and include the use of free gingival autograft (FGG), subepithelial connective tissue graft, laterally sliding flap, coronally advanced flap, double papilla flap, guided tissue regeneration etc. FGG is a procedure of high degree of predictability when used alone or combined with other technique. However it is technically demanding, time consuming, and the color match of the tissue is often less than ideal. A 25 year old male patient reported with the chief compliant of receding gum and root sensitivity in a lower front tooth (Miller's Class II gingival recession with 41). Free gingival autograft was carried out with 41 and complete recession coverage was achieved. Despite the fact that other effective root coverage techniques have been developed, the free gingival graft may still be the best treatment option when recession coverage with an increase in the apicocoronal dimension of the keratinized gingival tissues is the desired treatment outcome. Key words: Gingival recession, root sensitivity, root coverage, mucogingival surgery, free gingival autograft (FGG )

[1] Glossary of Periodontal Terms.

[2] Nabers C L. Free gingival grafts Periodontics 1966, 4, 244–245. [3] Pennel B M, Tabor J C, King K O et al. Free masticatory mucosa graft J Periodontol 1969, 40,16c2

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[5] Miller PD. Root coverage using a free soft tissue autograft following citric acid application. I. Technique. International Journal of Periodontics & Restorative Dentistry 1982, 2, 65–70.

[6] Paulo M. Camargo, philip R. Melnick &e. Barrie Kenney. The use of free gingival grafts for aesthetic purposes. Periodontology 2000, 2001, Vol. 27, 72–96.

[7] Miller PD A classification of marginal tissue recession. International Journal of Periodontics & Restorative Dentistry 1985, 5, 9–13.

[8] Sullivan H, Atkins J. Free autogenous gingival grafts. Utilization of grafts in the treatment of gingival recession. Periodontics1968; 6(4):152.

[9] Holbrook T, Ochsenbein C Complete coverage of the denuded root surface with a one stage gingival graft International Journal of Periodontics & Restorative Dentistry 1983,3, 8-27
[10] Matter J, Cimasoni G Creeping attachment after free gingival grafts J Periodontol 1976, 47, 574-579

Abstract: Cavernous haemangioma of uterine cervix is very rare benign vascular tumor. Less than 50 cases have been reported till date, amongst them only few cases are associated with pregnancy.Although it is rare but may cause gynaecological and obstetrical complications.Cavernous haemangioma of cervix mainly managed by surgical excision.A multiparous lady at 37weeks pregnancy presented with complaints of something coming out through introitus and bleeding per vaginum following trauma.On examination a mass of 8x4x4cm in size, reddish blue in color arising from anterior lip of cervix having laceration on its surface which was bleeding.Caesarian section has been done in view of excessive bleeding per vaginum followed by removal of cervical mass done vaginaly. Histopathological report shows cavernous haemangioma of cervix. Antepartum hemorrhage is very unusual presentation of cervical haemangioma, never reported in literature till now. Although cavernous haemangioma of the uterine cervix in pregnancy is very rare,it should be kept in mind as a differential diagnosis by clinicians as it may cause severe fetomaternal complications.

Keywords: Cavernous haemangioma,uterine cervix, pregnancy,antepartum haemorrhage caesarian section

[1] Gupta R, Singh S, Nigam S and Khurana N., Benign vascular tumors of the female genital tract,International Journal of Gynecology Cancer, 16, 2006, 1195-1200

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[10] Jackson J, Natural history of a cervical cavernous hemangioma through two pregnancies, 6, Journal of the American Board of Family Practice, 6,1993, 283-287.

Abstract: Aims and Objectives: This is to determine the age range of the lesion within our study;as a way to suggest possible recommendation(s). Materials/Methods: A sectional study of results of 463 patients within the study year(Jan 2005-Dec 2012) was obtained from the Dept. of Pathology register of the university of calabar Teaching hospital Calabar. These were analyzed using SPSS version 16 per each year. The result was represented in bar chats and pie chats respectively. Results: It showed that the ages of 50-60 years and 60-70 years are the worst vulnerable in the lesion(enlargement of prostrate) with its consequences of obstruction during micturition. Above the age of 70 years;only showed a significant rise in 2012 with 22% of patients indicated. Conclusion/recommendation: A better understanding of all risk factors (increasing age as per negroid race) and rates of clinical progression of benign prostatic hyperplasia (BPH) should be advocated – in terms of medical education of the citizenry. Since urinary retention is one of the most usual and important complications of long term BPH as this calls for both conservative and surgical therapy. Keywords: Male, benign prostatic hyperplasia,histology

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Abstract: The coeliac trunk is a surgically significant artery of the abdomen which supplies the supracolic organs. Variations of these arteries are important from a surgical perspective. In the present study, the length of coeliac trunk and its branching pattern was noted in 50 embalmed human cadavers. The length of coeliac trunk was correlated with its branching pattern. The specimens were studied by dissection method at the Department of Anatomy, KIMS and other medical colleges in and around Bangalore. The maximum number of specimens of coeliac trunk had a length ranging from 1.3-1.8 cm which was observed in 20 (40%) specimens. 84% of the specimens studied showed trifurcation. Quadrifurcation was seen in 8%, pentafurcation in 6% and bifurcation in 2% specimens. A smaller length of coeliac trunk was associated with varying branching pattern. This knowledge of the varied branching patterns forms the basis for surgical and radiological procedures in the upper abdomen.

Keywords: Branching pattern, common hepatic artery, left gastric artery, splenic artery, variations of coeliac trunk.

[1] WilliamsPL.,Bannister.L.H.,Berry.M.M.,Collins.P.,Dyson.M.,Dussek.J.E.et.al. Gray's anatomy 38th.ed.churchill Livingstone, 2000, 1548-1552.

[2] Gielecki J., Zurada A., Sonpal N., Jabtonska B., "The clinical relevance of coeliac trunk variations." Folia Morphol. 2005; 64(3):123-129.

[3] Iezzi.R.,Cotroneo.A.R.,Giancristofaro.D.,Santoro.M.,Storto.M.L.,"Multidetector-row CT angiographic imaging of the coeliac trunk :anatomy and normal variants." 2008; 30(4):303-310 [4] Petrella S, Rodriguez CFS, Sgrott EA, Fernandes GJM, Marques SR, Prates JC. Anatomy and variations of coeliac trunk. Int J. Morphology, 2007; 25(2): 249-257.

[5] Mburu KS, Alexander OJ, Hassan S, Bernard N. Variations in the branching pattern of the coeliac trunk in Kenyan population. Int. J. Morphol., 2010; 28(1):199-204.

[6] Saeed M, Rufal AA. Duplication of hepatic artery. Saudi J Gastroenterology 2001; 7(3):103-108

[7] Urugel MS, Battal B, Bozlar U, Nural MS, Tasar M,ORS F et al. Anatomical variations of hepatic arterial system, coeliac trunk and renal arteries: an analysis with multidetector CT angiography. British journal of radiology June 15 2010

[8] Yildirim M., Ozan H., Kutoglu T., Anatomic variations "Left gastric artery originating directly from the aorta." Journal of surgical and radiological anatomy, 2005; 20(4):303-305.

[9] Pulakunta T, Potu BK, Gorantla VR, Rao MS, Madhyastha S, Vollala VR. The origin of the inferior phrenic artery: a study in 32 South Indian cadavers with a review of literature. J Vasc Bras 2007; 6(3):225-230.

[10] Petrella S, Rodrigues CFS, Sgrott EA, Fernandez GJM, Marques SR, Prates JC. "Origin of inferior phrenic arteries in the coeliac trunk." Int. J. Morphology., 2006; 24(2):275-278.

Abstract: Objective: To assess appropriateness of prescription of acid suppressive therapy (AST) in Internal Medicine ward in a tertiarycare hospital. Methods: In this prospective observational study , weincluded all those patientswho were started on AST after admission in the internal medicine ward in a tertiary care hospital in Hyderabad ,Sindh ,Pakistan from May 1 to July 31, 2013 . All those patientswere excluded from the study who were alreadyon the AST therapy. Details were taken regarding age, sex, primary diagnosis, other morbidity, drug used for AST and indication for AST on a specifically designed proforma. The appropriatenessof AST was determined by widely accepted Food and drug authority (FDA) indications and American society of health system pharmacist (ASHP) guidelines. Results: We included300 Patients in our study. All patients, in our study, were given AST at the time of admission tothe medicine ward. 133 (44.33%) Patients were male and 167 (55.66%) were female, their mean age was 43.91±18.58 (mean ± SD). 53 (17.6%) Patients had a FDA approved indication.51 (17%) Patients received AST therapy for SUP (stress ulcer prophylaxis) Out of that 7 (2.3%) had an absolute indication for SUP, 44(14.8%) had 2 or more relative indications for SUP . 196 (65.3%)received AST without any appropriate indication. Omeparzolewas themost frequently used AST (55%), followed byranitidine (45%) Conclusion:Use of AST is mostly inappropriate inInternal medicinewards.Implementation of institutional protocols, evidence based medicine teaching during residency training, and frequent review of therapy by the attending consultant during ward rounds may be helpfulto promote appropriate use of AST in medicine wards.

Keywords: Acid suppressive therapy, Liquate UniversityHospital, lUMHSJamshoro,Sindh, Pakistan

[1] Aciphex [package insert]. Eisai Inc. and Janssen Pharmaceuticals Inc., Titusville, NJ, USA, 2008
[2] Kapidex [package insert]. Takeda Pharmaceuticals America, Inc., Osaka, Japan, 2009
[3] ASHP therapeutic guidelines on stress ulcer prophylaxis: ASHP commission on therapeutics and approved by the ASHP Board of Directors on November 14, 1998. American Journal of Health-System Pharmacy. 1999;56:347–379
[4] Nardino RJ, Vender RJ, Herbert PN. Overuse of acid-suppressive therapyin hospitalized patients.Am J Gastroenterol. 2000; 95:31 1 8 –31 22.
[5] Gullotta R, Ferraris L, Cortelezzi C, Minoli G , Prada A, Comin U, Rocca F, Ferrara A, Curzio M. Are we correctlyusing the inhibitors of gastric acid secretion and cytoprotective drugs? Results of amulticentre study. Ital J GastroenterolHepatol. 1997;29:325–329.
[6] Pham CQ, Regal RE, Bostwick TR, Knauf KS. Acid suppressive therapyuse on an inpatient internal medicine service. Ann Pharmacother.2006;40:1 261–1 266.
[7] Parente F, Cucino C, G allus S, Bargiggia S, Greco S, Pastore L, Bianchi Porro G . Hospital use of acid-suppressive medications and its fall-out on prescribing in general practice: a 1 -month survey Aliment PharmacolTher. 2003; 1 7:1 503–1 506.
[8] Heidelbaugh JJ, Inadomi JM. Magnitude and economic impact of inappropriate use of stress ulcer prophylaxis in non-I CU hospitalized patients. Am JGastroenterol. 2006; 101:2200–2205.
[9] Martín-Echevarría E, Pereira Juliá A, Torralba M, ArriolaPereda G , Martín Dávi la P, Mateos J, Rodríguez Zapata M. [Assessing the use of proton pump inhibitors in an internal medicine department] Rev EspEnferm Dig. 2008 ;100:76–8 1
[10] Hwang KO, Kolarov S, Cheng L, G riffith RA. Stress ulcer prophylaxis for non-critically ill patients on a teaching service. J EvalClin Pract.2007; 1 3:71 6–721.

Abstract: Monophase elastomeric impression materials are commonly used with acrylic custom trays. Every effort is made to maximize bonding between the two. Lot of studies have focused on variables like adhesive drying time, tray material and type of elastomer but very few have solely concentrated on efficacy of surface treatment and effect of salivary contamination of the custom tray. The objective of this study was to find out the most effective surface treatment for the custom tray and also find out the extent to which salivary contamination could affect bond strengths. This invitro study was carried out in two parts using 40 samples. The materials used were Reprosil monophase impression materials and autoploymerizing acrylic blocks. The samples were divided into four groups of five samples each. The first part of the study concentrated on finding out the effect of surface treatment of the tray and the second part focused on the effect of salivary contamination. The specimens were tested in an Instron testing machine and the results of the study were interpreted by statistical analysis to arrive at the conclusions. The results showed statistically significant increase in tensile strengths for surfaces subjected to grit blasting and roughening with bur and decrease for specimens cured against wax. Salivary contamination of the tray prior to adhesive application decreased bond strengths significantly. It was concluded from the study that mechanical treatment of the tray prior to adhesive application maximizes adhesion of the impression material and that salivary contamination of the custom tray prior to adhesive application reduces adhesion between tray and elastomer regardless of the surface treatment carried out

Keywords: Acrylic custom tray, Monophase elastomer, salivary contamination, Surface treatment, Tensile bond strength..

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[3] Chai J.Y, Jameson L.M, Moser J.B: Adhesive properties of several impression material systems: Part- I. J Prosthet Dent, 66, 1991, 201-209. [4 ] Phillips R.W, Science of dental materials 9th ed,( Philadelphia. WB Saunders Co, 1991)

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Abstract: Periodontitis is a group of inflammatory diseases that affect the connective tissue attachment and supporting bone around the teeth. Early diagnosis and treatment of progressive periodontitis is important because of the irreversible nature of this disease. Biochemical mediators in oral fluids like saliva and gingival crevicular fluid (GCF) are highly beneficial in the determination of current periodontal status. This article highlights recent advances in the use of biomarker-based disease diagnostics that focus on the identification of active periodontal disease from GCF, and saliva.

Key Words: Biomarkers, Gingival crevicular fluid, Diagnosis, saliva, Periodontal disease

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[2] Offenbacher S, Barros S, Mendoza L, et al. Changes in gingival crevicular fluid inflammatory mediator levels during the induction and resolution of experimental gingivitis in humans. J Clin Periodontol 2010;37:324-33.

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[6] Colburn WA . Biomarkers in drug discovery and development: from target identification through drug marketing. Journal of Clinical Pharmacology,2003, 43(4):329–41.

[7] Frodge BD, Ebersole JL, Kryscio RJ, et al. Bone Remodeling Biomarkers of Periodontal Disease in Saliva. J Periodontol. 2008;79:1913–19.

[8] Zhang L et al. The clinical value of salivary biomarkers for periodontal disease. Periodontology 2000; 2009: 51:25-37.

[9] Reddy S, Kaul S, Prasad M.G.S. Biomarkers in Periodontal Diagnosis: "What The Future Holds..."int. journal of clinical dental science • february, 2011 • 2(1).

[10] Li Y, Zhou X, John MA, et al. RNA profiling of cell-free saliva using microarray technology. J Dent Res. 2004;83(3):199–203.

Abstract: Successful root canal treatment requires the complete elimination of microbial flora from root canal system. Irrigating solutions play vital role in destruction of microbes. However, interaction of various irrigating solution can be proved to be detrimental to the outcome of root canal therapy. The Purpose of this study were : (1) to evaluate the interaction between 7% maleic acid (MA) and 2% chlorhexidine gluconate solution (CHX) and to find out the availability of individual irrigant and (2) to determine the free available chlorine content when 7% MA was mixed with 5% sodium hypochlorite (NaOCl) solution. Results: It was observed that more than 90% free MA and CHX were available when MA was combined with CHX. It was also observed that there was no precipitate formation when 7% MA was mixed with 2% CHX. Available chlorine content decreased significantly in the MA/NaOCl mixture.

Key Words: Irrigation, Maleic acid, Chlorhexidine gluconate, Sodium hypochlorite..

[1]. Peters OA, Laib A, Gohring TN, Barbakow F. Changes in root canal geometry after preparation assessed by high resolution computed tomography. J Endod 2001;27: 1–6.
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[4]. Wieczowski G, Davis EL, Joynt RB. Microleakage in various bonding agent composite resin systems. Oper Dent 1992;(Supplement):62–7.
[5]. Ballal NV, Kandian S, Mala K, Seetharama K, Acharya S. Comparison of the efficacy of maleic acid and ethylenediaminetetraacetic acid in smear layer removal from instrumented human root canal: a scanning electron microscopic study. J Endod 2009;35:1573–6.
[6]. Ballal NV, Kundabala M, Bhat S, Rao N, Rao BS. A comparative in vitro evaluation of cytotoxic effects of EDTA and maleic acid: root canal irrigants. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009;108:633–8.
[7]. Rasimick BJ, Nekich M, Hladek MM, Musikant BL, Deutsch AS. Interaction between chlorhexidine digluconate and EDTA. J Endod 2008;34:1521–3.
[8]. Grawehr M, Sener B, Waltimo T, Zehnder M. Interactions of ethylenediaminetetraacetic acid with sodium hypochlorite in aqueous solutions. Int Endod J 2003;36:411–5.
[9]. Basrani BR, Manek S, Sodhi RNS, Fillery E, Manzur A. Interaction between sodium hypochlorite and chlorhexidine gluconate. J Endod 2007;33:966–9.
[10]. Bui TB, Baumgartner JC, Mitchell JC. Evaluation of the interaction between sodium hypochlorite and chlorhexidine gluconate and its effect on root dentin. J Endod 2008;34:181–5.

Abstract: Abdominal pregnancy is historically been defined as an implantation in the peritoneal cavity; exclusive of tubal, ovarian or intra ligamentary implantation. It is a rare form of ectopic pregnancy with an incidence of 1:8099 hospital deliveries and accounts for 1-4% of all ectopic pregnancies. The diagnosis of such a condition is missed during antenatal period despite the use of prenatal ultrasound. Newer advances, like use of MRI complement ultrasound in the diagnosis of abdominal pregnancy. We present an advanced case of secondary abdominal pregnancy which presented as placenta previa with fibroid uterus. The diagnosis was established after MRI scan. A live term baby was extracted after laparatomy and placenta was partially removed after ligating its blood supply. Mother and baby were healthy after such a catastrophic event. A review of the topic and management is also presented.

Keywords: Ectopic pregnancy, secondary abdominal pregnancy.

[1] Nkusu Nunyalulendho D, Einterz EM. Advanced abdominal pregnancy: case report and review of 163 cases reported since 1946. Rural and Remote Health8: 1087. (Online) 2008.

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[3] Desai BR, Patted Shobhana S, Pujar Yeshita V, Ruge J: Advanced secondary abdominal pregnancy following rupture of rudimentary horn. J Obstet Gynecol India 2005, 55(2):180.

[4] Bhandary Amritha, Thirunavukkarasu Sumangali, Ballal Priya, Shedde Deepak and Rai Sharadha: A rare case of term viable secondary abdominal pregnancy following rupture of a rudimentary horn: a case report. Journal of Medical Case Reports 2009, 3:38 doi:10.1186/1752-1947-3-38

[5] Sh. Motazedian .Term asymptomatic abdominal pregnancy with good maternal and perinatal outcome: a case report: Irn J Med Sci 2000; 25(1&2):76-80 [6] Wondwossen Belete. Advanced abdominal pregnancy managed at Ambo hospital: a case report: Ethiopian journal of reproductive health May 2007, 1 (1): 44-51

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[8] J.M. Hall, N. Manning, N.R. Moore, W.R. Tingey, P. Chamberlain. Antenatal diagnosis of late abdominal pregnancy using ultrasound and magnetic resonance imaging: a case report of successful outcome. Ultrasound Obstet & Gynecol 7, (1996) 289-292.

[9] Martin JNJr, Sessums JK, Martin RW, et al:Abdominal pregnancy: Current concepts of management. ObstetGynecol 1988;71(4):549-57.

[10] L. Badria · Z. Amarin · A. Jaradat · H. Zahawi A. Gharaibeh · A. Zobi. Full-term viable abdominal pregnancy: a case report and review. Arch GynecolObstet (2003) 268:340–342 DOI 10.1007/s00404-002-0363-y