iosr-JDMS   Volume-9 ~ Issue-1

Abstract: A case control study was done to find out the effects of simple yogic exercise programs (asanas and pranayamas) on selected pulmonary function tests of forty elderly individuals of both sexes, between 50 and 70 years of age, with no active medical disorders. The study was conducted at a selected yoga centre in Siliguri town of Darjeeling district of West Bengal. Forced Vital Capacity (FVC), Forced Expiratory Volume in one second (FEV1) and Peak Expiratory Flow Rate (PEFR) were measured, once initially and again after six weeks of yoga training under supervision of a certified yoga instructor. Two instruments were used: a) A Vitalograpgh Gold Standard Spirometer; b) A Wright's Peak Flow meter. There was definite improvement of ventilatory functions as revealed by significant increase in FVC, FEV1 and PEFR that was measured after 6 weeks. (P<0.05)

Keywords: Forced Expiratory Volume in one second (FEV1), Forced Vital Capacity (FVC), Peak expiratory flow rate (PEFR), yogic exercises, elderly people.

[1]. Bijlani RL. Physiological effects of yogic practices. In: Understanding Medical Physiology; 4th Edition. Jaypee Brothers Medical Publishers, Ch 17.5, pg 765.
[2]. Belman MJ, Gaesser GA. Ventilatory muscles training in the elderly. J Appl Physiol 1983; 64: 899-905.
[3]. Ahmed QR, Sau SK, Kar SK. An evaluation of pulmonary parameters in two groups of subjects during yoga practice. Nepal Med Coll J 2010; 12(3): 180-182.
[4]. Joshi LN, Joshi VD, Gokhale LV. Effect of short term "Pranayam" practice on breathing rate and ventilatory functions of lungs. Indian J Physiol Pharmacol 1992; 36: 105-108.
[5]. Leelver BH, Butter J. Alteration in pulmonary function: In Principles of geriatric medicine 1985; 26: 280-57.
[6]. Birkel DA, Edgren L. Hatha Yoga: Improved vital capacity of college students. Altern Ther Health Med 2000; 6:55-63.
[7]. Nayar HS, Mathur RM, Kumar RS. Effects of yogic exercises on human physical efficiency. Indian J Med Res 1975; 63: 1369-1376.
[8]. Jain SK, Kumar R, Sharma DA. Factors influencing peak expiratory flow rate in normal subjects. Lung India 1983; 3:92-97.
[9]. User Manual: Vitalograph Gold Standard with 12 seconds chart. [Online]. 2004 [cited 2004 Aug 22]; Available from: URL: http://www.vitalograph.com/products/vitalograph _gold_standard.php
[10]. Peak Flow Measurement [Online]. 2011 [cited 2011 Sep 10]; Available from: URL:http://www.muschealth.com/gs/TandPcontent.aspx/pageid=P07755

Abstract: Background: Therapeutic endoscopy in Nigeria is still in its infancy despite its obvious advantages of minimal access trauma, less post operative pain and shorter hospital stay. Although many gastrointestinal procedures are now being performed endoscopically, there are very few reports of experience with therapeutic endoscopy in Nigeria and the range of procedures are limited most times to upper gastrointestinal interventions. This study was aimed at auditing our experience with therapeutic endoscopy in a developing country. Patients and methods: This was a prospective analysis of all consecutive patients with endoscopic diagnoses of oesophageal varices, benign oesophageal strictures and colorectal polyps that had injection sclerotherapy and rubber band ligation for the varices, oesophageal dilatation for strictures and snare polypectomy for the colorectal polyps. Results: A total of 87 patients had therapeutic endoscopic interventions. Their ages ranged from 11 to 53yrs with a mean age of 37.4 +/- 9.3yrs. There were 63 males and 24 females (M: F = 2.7: 1). Seventy patients (80.5%) had rubber band ligation, while 8 (9.2%) had injection sclerotherapy of oesophageal varices. Six patients (6.9%) had rectal and colonic polypectomies while three patients (3.4%) had dilatation of benign distal oesophageal strictures. Massive upper gastrointestinal bleeding was recorded in one patient complicating injection sclerotherapy. There was no mortality in this study. Conclusion: Therapeutic endoscopy is a safe and worthwhile method of treating gastrointestinal diseases in our environment and the types of pathologies treatable this way is bound to increase as the expertise and equipment become more widely available.

Keywords: Audit, endoscopy, Nigeria, Therapeutic.

[1]. Wright G, Lewis H, Hogan B, Burroughs A, Patch D, O'Beirne J. A self-expanding metal stent for complicated variceal hemorrhage: experience at a single center. Gastrointest Endosc. 2010 Jan;71(1):71-8.
[2]. Zubritskii VF, Zabelin MV, Sal'nikov AA, Konenkova MA, Davydov DO. [Minimal invasive treatment of bleeding of esophagus and stomach varices in patients with portal hypertension]. Eksp Klin Gastroenterol. 2010(5):48-51.
[3]. Schembre DB. Endoscopic therapeutic esophageal interventions: old, new, borrowed and . . . methylene blue? Curr Opin

Abstract: Iron deficiency is the most common cause of anemia in pregnancy. The conventional iron preparations with ferrous salts showed noncompliance due to various side effects when compared to iron polymaltose complex. But the efficacy of iron polymaltose complex (IPC) in the treatment of iron deficiency anaemia (IDA) during pregnancy has not been established, and the evidence is inconclusive. The aim of this study was to compare efficacy, safety, compliance and cost-effectiveness of ferrous sulphate (FS) with IPC in antenatal women. 100 antenatal women with 14 to 20 weeks of gestation were recruited in the study, one group of 50 women were given FS and the other group of 50 women were given IPC for 6 weeks. Haemoglobin concentration (Hb), Packed cell volume(PCV),Mean Corposcular Haemoglobin concentration and serum iron were estimated before and after treatment with the above iron formulations. Compliance with pill count and safety with adverse effects monitoring in followup were noted. Statistical analysis was done with student's T test and chi square test. The improvement of haematological parameters was comparable in both groups statistically but compliance and safety were better with the IPC group when compared to FS group. IPC is a better alternative to FS as it is safe and showed more compliance.

Key words: Iron deficiency anemia, Iron polymaltose complex, haemoglobin, Serum iron, compliance.

[1]. World Health Organization. The prevalence of anaemia in women: a tabulation of available information. Geneva, Switzerland: WHO; 1992.
[2]. Sharma JB. Nutritional anaemia during pregnancy in non-industrialised countries. In: Studd J, editor. Progress in Obstetrics and Gynaecology. New Delhi: Churchill Livingstone; 2003. pp. 103–122.
[3]. Robbins and Cotran, Pathologic basis of disease 8th edition,(saunders Elsevier,2009) chapter-14, pg.no. 639-645.
[4]. Jacobs P, Johnson G, Wood L. Oral iron therapy in human subjects, comparative absorption between ferrous salts and iron polymaltose. J Med. 1984;15:367–377. [PubMed]
[5]. Tietz NW. In: Textbook of Clinical Chemistry. Tietz NW, editor. Philadelphia, Pa: WB Saunders Co.; 1986. pp. 1578–1583.
[6]. Jacobs P, Wormald LA, Gregory MC. Absorption of iron polymaltose and ferrous sulphate in rats and humans – a comparative study. S Afr Med J. 1979;26:1065–1072. [PubMed]
[7]. Reddy PSN, Adsul BB, Gandewar K, Korde KM, Desai A. Evaluation of efficacy and safety of iron polymaltose complex and folic acid (Mumfer) vs iron formulation (ferrous fumarate) in female patients with anemia. J Indian Med Assoc. 2001;99:154–155. [PubMed]
[8]. Badhwar VR, Rao S, Fonseca MM. Comparative efficacy and safety of iron polymaltose+folic acid and oral ferrous fumarate in the treatment of adult patients with iron deficiency anemia. Indian Med Gazette. 2003;136:296–301.
[9]. Mehta BC. Ineffectiveness of ironpolymaltose treatment of iron deficiency anaemia. Journal of the Association of Physicians of India. 2003;51:419–421. [PubMed]
[10]. Mehta BC. Iron hydroxide polymaltose complex –cause of persistent anemia at delivery. Indian J Med Sci. 2001;55:616–620. [PubMed]

Abstract: Objective: To estimate the level of umbilical cord TSH in term Neonates in Manipur Study design and setting: Cross-sectional study conducted in the Dept. of Biochemistry in collaboration with Dept. of Pediatrics and Dept. of Obstetrics &Gynaecology, Regional Institute of Medical Sciences (RIMS), Imphal (Manipur). Materials and Methods: Blood samples were collected from the umbilical cord of 500 term newborn infants at the time of birth of the baby. Thus a mixed cord blood sample including both from the umbilical artery and vein was obtained and Thyroid stimulating hormone level (TSH) was estimated within 24 hrs by enzyme immunoassay. Results: The birth weights ranged between 2.5 to 4.0 kg. The male: female ratio was 205:295. TSH values ranged from 2.8-52.3mlU/L. The mean value was 13.264mlU/L. A cut –off value of 20 mlU/L was used for recall testing of complete thyroid profile (T3, T4 and TSH). Forty seven infants were recalled for repeating complete thyroid profile

Key words: Hypothyroidism, TSH, cord blood

[1]. Kleigman RM, Behrman RE, Stanton BF, editors. Nelson Textbook of Pediatrics. 19th ed. Philadelphia: Saunders;2012: 1895-1903.
[2]. Newborn screening for congenital hypothyroidism: recommended guidelines,AAP policy statement.Paediatrics 1993:91;1203-1209
[3]. Arun Kumar Manglik ,Nandita Chatterjee and Gautam Ghosh .Umbilical Cord Blood TSH Levels in Term Neonates: A screening tool for congenital hypothyroism,Indian Pediatrics 2005;42:1029-1032
[4]. Fuse Y, Wakae E, Nemoto Y, Uga N, Tanaka M, Maeda M, Tada H, Miyachi Y, Irie M. Inflence of perinatal factors and sampling methods on TSH and thyroid hormone levels in cord blood. Endocrinol Jpn.1991 Jun; 38(3): 297-302.S
[5]. Walfish PG.Evaluation of three thyroid-function screening tests for detecting neonatal hypothyroidism. Lancet.1976 Jun 5; 1(1971): 1208-10.
[6]. Vulsma T, GonsMH,de Vijlder JJ. Maternal-fetal transfer of thyroxine in congenital hypothyroidism due to a total organification defect or thyroid agenesis. N Engl J Med.1989;321: 13-16
[7]. Kester MH.Martinez de MenaR ,ObgeronMJ et al.Iodothyronine levels in human developing brain: major regulatory roles of iododothyronine deiodenases in different areas.J Clin Endocrinol Metab 2004; 24:3117-3128
[8]. Glinoer D. Potential consequences of maternal hypothyroidism on the offspring : evidence and implications. Horm Res 2001:55: 109-114
[9]. Haddow JE , Palomaki GE, Allan WC et al . Maternal thyroid during pregnancy and consequent neuropsycological development of the child .n Engl J Med . 1999; 341: 549-555
[10]. Morreale de Escober G, Obregon MJ, Escobar del Rey F.Is neuropsychological development related to maternal hypothyroidism or to maternal hypothyroxinemia ? J Clin Endocrinol Metab.2000; 85: 3975-3987

Abstract:Artificial apical barrier technique for the management of blunder buss canals is being widely used in modern endodontics as compared to the conventional apexification using calcium hydroxide, which inturn is m
uch time consuming. In addition to the current gold standard, MTA, a large number of novel materials are bein g studied and marketed world wide as pretty promising , effective , and less expensive alternatives for the sam
e. This article describes the successful management of a traumatized and necrotic permanent maxillary central I. 1Assistant professor, 2Assistant professor 3Post Graduate Student, 4Professor And Head
1,3,4Department Of Conservative Dentistry & Endodontics, 2.Department of Oral medicine Government Dental CollegeMedical College Calicut-673008 incisor with an open apex using artificial apical barrier technique with a novel endodontic material, Calcium Enriched Mixture ( CEM cement) in which remarkable healing of the periapical lesion could be achieved withi.

Key Word: Artificial Apical Barrier, Blunder Buss Canal, Calcium Enriched Mixture, CEM Cement

[1]. American Association of Endodontists. Glossary of endodontic terms, 7th edn. Chicago: American Association of Endodontists; 2003.
[2]. Camp. J, Fuks A Pediatric Endodontics: Endodontic Treatment For The Primary And Young Permanent Dentition.In: CohenS, Hargreaves K, Keiser K editors, Pathways of the Pulp 9Th Edition. St Louis Mosby Elsevier; 2006.p 822-82
[3]. Parirokh M, Torabinejad M,. Mineral Trioxide Aggregate: A Comprehensive Literature Review- Part I: Chemical physical and Anti bacterial properties, J Endod 2010;36:16-27
[4]. Fridland M & Rosado R (2003) Mineral Trioxide aggregate (MTA) solubility and porosity with different water-to-powder ratios. Journal of Endodontics 29(12) 814-817.
[5]. Torabinejad M, Hong C, McDonald F & Pitt Ford T (1995) Physical and chemical properties of a new root-end filling material .Journal of Endodontics 21(7) 349-35.

Abstract: Assessment of Risk perception regarding HIV AIDS of wives whose husbands are staying away from them OBJECTIVES: 1. To assess the risk perceptions of wives regarding their husbands' extramarital affairs while staying away from them, with regards to HIV/AIDS 2. To find out effect of various socio-economic factors on their perceptions. METHODS: Cross-sectional study of Sample of around 60 married females, whose husbands are staying away from them, selected by Snow ball sampling technique and using Central limit theorem in the reproductive age group of 18 to 45 years, were included. RESULTS: 88% of wives felt that due to their absence and separation there is a possibility of their husbands' involvement in extramarital affairs. Also 82% of the wives even were ready to accept if and when such affair comes to light. 80% of the females were aware of HIV/AIDS and only 47% out of them knew about the risk of getting infection from their husbands. CONCLUSIONS: Most of the females are ready to accept the chances of development of husband's extramarital affair due to separation but still are willing to continue with the relation inspite and despite of the knowledge about HIV/AIDS. And factors such as - Future of children, financial security, she not earning are forcing her to continue with the relationship.

Keywords: Extra marital affairs, risk perception regarding HIV/AIDS

[1]. Population reference Bureau (2003) '2003 Data Sheet Highlights: Using Global Population Projections', Data Sheet
[2]. Text book of Survey Methods in Community Medicine by J H Abramson, Fifth Edition, 2002 , Churchill Livingstone Publications
[3]. APN Nurses' Manual of research methodology, Third Edition, 1996, Century Publications
[4]. Umesh Sharma, Study of HIV/AIDS preventive behavior of women attending antenatal clinic in Ratchvithi hospital, Bangkok Metropolitan, Thailand, 1999.
[5]. UNAIDS (2001) 'Population Mobility and AIDS', Technical Update, February, p.5

Abstract: Testicular abscess is a rare surgical entity of Zone III of inguinoscrotal region. C Trachomatis and E Coli are the two commonest causative organism worldwide. A total number of eleven cases of testicular abscesses had been reviewed for a period of one and half years. It was seen that, the cases mainly present with complaint of acute scrotum with discharging pus and acute abdomen. Mean age of the patients under study is around 53 yrs. Ultrasonography used for diagnosis. In two third cases epididymoorchitis history was obtained. Regarding growth pattern of pus, it was found that identifying bacterial pathogens are found in seven case where as no growth was found in rest. E coli was found to be the commonest pathogen in culture isolate. One patient of chronic testicular abscess, who was on treatment for pulmonary tuberculosis; pus culture revealed AFB to be causative bacteria. Only a single case of acute testicular abscess was found to have seropositivity for HIV virus, his pus culture was notably negative for any other bacterial pathogen. One out of the 7 cases of acute testicular abscess and 2 of the 4 cases of chronic testicular abscess were found to have type II DM. Orchiectomy and broad spectrum antibiotics were used as mainstay of treatment.

Keywords: AFB, acute abdomen, epididymoorchitis, inguinoscrotal region, orchiectomy, testicular abscess, type II DM, ultrasonography.

[1]. S. Khan, J. Rehman, B. Chughtai, D. Sciullo, E. Mohan & H. Rehman : Anatomical Approach to Scrotal Emergencies: A New Paradigm for the Diagnosis and Treatment of the Acute Scrotum. The Internet Journal of Urology. 2010 Volume 6 Number 2
[2]. Dogra, V.S., et al., Sonography of the scrotum. Radiology, 2003. 227(1): p. 18.36.
[3]. Thakur, A., et al., Scrotal abscess following appendectomy. PediatrSurgInt, 2001. 17(7): p. 569.71.
[4]. Granados Loarca, E.A., [Testicular abscess: a manifestation of tuberculosis]. ActasUrolEsp, 1998. 22(4): p. 381.3.
[5]. Farriol, V.G., et al., Gray.scale and power dopplersonographic appearances of acute inflammatory diseases of the scrotum. J Clin Ultrasound, 2000. 28(2): p. 67.72.
[6]. Granados Loarca, E.A. et al. Epididymo.testicular abscess. Arch EspUrol, 1994. 47(6): p. 553.6.
[7]. Slavis, S.A., J. Kollin, and J.B. Miller, Pyocele of scrotum: consequence of spontaneous rupture of testicular abscess. Urology, 1989. 33(4): p. 313.6.
[8]. Trojian TH, Lishnak TS, Heiman D (April 2009). "Epididymitis and orchitis: an overview". Am Fam Physician79 (7): 583–7.
[9]. Schlossberg D. Clinical Infectious Disease. Cambridge Univ Pr. (2008)

Abstract: The effects of oral administration of Hibiscus sabdariffa aqueous extract on some haematological parameters of wistar albino rats were studied. A total of twenty five (25) male albino rats were grouped randomly into groups. Group A (control), Group B (0.6g/100ml of water of HS extract) Group C (1.2g/100ml HS extract), Group D (1.8g/100ml HS extract) and Group E (1.8g/100ml + vitamin C) and treatment period was 28 days. A decrease in body weight of the rats was observed except in Group A (control) and Group E. Haematological parameters; (Haemoglobin (Hb), packed cell volume (PCV), total white blood cells (WBC) and differentials) increased significantly (p<0.05) in all the groups when compared with Group A (control) in a dose dependent manner. The study suggests that administration of aqueous extract of Hibiscus sabdariffa might be beneficial to the haematopoietic system.

Key Words: Body weight, Haemoglobin, Hibiscus sabdariffa, packed cell volume, and White blood cell

[1] J.A. Duke, and A.A Atchley, B.R Christie, The Handbook of Plant Science in Agriculture (Ed), (CRC Press Inc., Boca Raton. 1984). Page 120-122.

[2] J.M Dalziel, The Useful Plants of West Tropical Africa (The crown Agents, London, 1973), 314-315.

[3] C.J. Wang, J.W. Wang, and H. Tseng, Protective effect of Hibiscus anthocyanins against tert- butyl hydro peroxide induced hepatic toxicity in rats. Food Chem.Toxicol., 38(5), 2000:411-416

[4] L. S. Wang, and G. D. Stoner, Anthocyanins and Their Role in Cancer Prevention," Cancer Letters, Vol. 269, 2008, No. 2, pp. 281-290.

[5] I.P. Odigie, R.P Ettarh, and S.A Adigun, Chronic administration of aqueous extract of Hibiscus sabdariffa attenuates hypertension and reverses cardiac hypertrophy in 2K-1 hypertensive rats. J Ethnopharmacol, 86: 2003, 181-185.

[6] E. E. Iyare, and O.A., (Adegoke, Maternal consumption of an aqueous extract of Hibiscus sabdariffa during lactation accelerates postnatal weight and delays onset of puberty in female offspring. Niger .J Physiol. Sci., 23, 2008, 89-94.

[7] M.J. Lynch, and S.S. Raphael, Lynch Med. Laboratory Technology (W.B. Saunders company, 4th Ed., 1983) 681-685

[8] E.J. Baker, and R.E Silverton, Introduction to Medical Laboratory Technology (W.B. Saunders company, 6th edition, 1985), page 316-324.

[9] O.J Afonne, C. U. Orisakwe, O. E. Ndubuka, G. I. Akuumfa, and N. A. Ilon-Ilondu, Bio. Pharm Bull 2002, 235-8.

[10] I.P. Odigie, R.P. Ettarh and S.A.Adigun, Chronic administration of aqueous extract of Hibiscus sabdariffa attenuates hypertension and reverses cardiac hypertrophy in 2K-1 hypertensive rats. J Ethnopharmacol, 86, 2003, 181-185.

Abstract: Hibiscus sabdariffa had been reported to have a broad range of therapeutic effects. The effects of oral administration of Hibiscus sabdariffa aqueous extract on some biochemical parameters were studied in wistar albino rats. A total of twenty five (25) male albino rats were grouped randomly into groups. Group A (control), Group B (0.6g/100ml of water of HS extract) Group C (1.2g/100ml HS extract), Group D (1.8g/100ml HS extract) and Group E (1.8g/100ml + vitamin C) and treatment period was 28 days. The results indicate an increase activity of liver function enzymes; alkaline phosphatase (ALP), alanine transaminase (ALT), aspartate transaminase (AST). This increase was statistically significant (p<0.05) when compared with Group A (control) in a dose dependent manner.No significant difference was observed in total and direct bilirubin in all the groups. Similarly for renal indices, bicarbonate (Hco3), urea and creatinine in all the groups, but a significant increase (p<0.05) in sodium (Na+) and potassium (K+) and chloride were noted in comparison to the control.It is of note that there was no significant difference between results of Group E and the control (Group A). However, this study suggests that long term administration of the extract may indeed be toxic to liver and kidney especially at high doses.

Key Words: Bilirubin, Hibiscus sabdariffa, liver enzymes (ASP, ALT, ALP), and renal indices

[1] J.M Dalziel, The Useful Plants of West TropicalAfrica (The crown Agents, London, 1973), 314-315.

[2] M. H. Faraji, and T. A. Haji, The effect of sour tea (Hibisussabdariffa) on essential hypertension, J Ethnopharmaco; 65(3), 1999, 231-236.

[3] J.A. Duke, and A.A Atchley, B.R Christie, The Handbook of Plant Science in Agriculture (Ed), (CRC Press Inc., Boca Raton. 1984). Page 120-122.

[4] C. J. Wang, J. W. Wang, and H. Tseng, Protective effect of Hibiscus anthocyanins against tert- butyl hydro peroxide induced hepatic toxicity in rats. Food Chem.Toxicol.,31(5), 2004, 241-246

[5] I.P. Odigie, R.P. Ettarh and S.A.Adigun, Chronic administration of aqueous extract of Hibiscus sabdariffa attenuates hypertension and reverses cardiac hypertrophy in 2K-1 hypertensive rats. J Ethnopharmacol, 86, 2003, 181-185.

[6] E. E. Iyare, and O.A., (Adegoke, Maternal consumption of an aqueous extract of Hibiscus sabdariffa during lactation accelerates postnatal weight and delays onset of puberty in female offspring. Niger .J Physiol. Sci., 23, 2008, 89-94.

[7] S. Reitman, and S. Frankel, Colorimetric method for the determination of serum oxaloacetic and glutamicpyruvictransaminases.Am. J. Clin. Pathol.28, 1957, 53-56.

[8] L. Jendrassik, And P. Grof, Biochem. Z.297, 1938, 81

[9] P. J. Wright, and D. Plummer, The use of urinary enzyme measurement to detect renal damages caused by nephrotoxic compounds. Biochem.Pharmacol. 12, 1974, 65

[10] M. A. Akanji, O.A. Olagoke and O.R. Oloyede, Effect of chronic consumption of metabisulphite on the integrity of the kidney cellular system. Toxicol.81,1993, 173-179

Abstract: This study was carried out to investigate non-compliance with medicaments prescriptions among tuberculosis patients on self-administration of multi-drug regimen in a local government of Oyo State, Nigeria. The isonicotinic acid method used is based on detecting the isoniazid metabolites-isonicotinic acid and isonicotinylglycine. The sensitivity of the method is high that reliably positive result is obtainable up to more than 24 hours after the ingestion of 100mg isoniazid. Three hundred (300) urine samples were collected from non-smoking tuberculosis (TB) patients on medicaments that included isoniazid: Fifty (50) samples from patients who took their drugs under supervision daily at the clinic; Two hundred and fifty (250) samples from patients who were given drugs away home for self-administration daily. One hundred percent (100%) and Eighty two percent (82%) showed isoniazid metabolites in their urines for supervised and self-administration respectively. Eighteen percent (18%) on self-administration showed no isoniazid metabolites in their urines, indicating that they had not taken drugs in about 48 hours or more.

Keywords: Isoniazid, isonicotinic acid, isonicotinylglycine, Non-compliance, self- administration.

[1] World Health Organization. Anti-tuberculosis resistance in the World. Report No. 4. (Geneva: The organization, 2008).
[2] C. Monica, Medical Laboratory Manual for tropical countries Vol.II. (England: Stephen Austin and Sons Ltd. Hertford 1981).
[3] M. F Sydney and J. B . Ellen, Bailey & Scott's Diagnostic Microbiology. (New York, USA: The CV Mosby co. 1986)
[4] N.R. Gandhi, A. Moll, A.W. Sturm, R. Pawinski , T. Govender , U. Lalloo , K. Zeller , J. Andrews and G. Friendland . Extensively drug-resistant tuberculosis as a cause of death in patients co-infected with tuberculosis and HIV in a rural area of South Africa, Lancet, 368(9547), 2006, 1575-1580.
[5] S.B. Abram, Control of Communicable Diseases in Man (USA: American Public Health Association 1990)
[6] L. Eyitayo., National Tuberculosis and Leprosy control programme. Workers' Manual 4th ed 2004.
[7] B. Eker, J. Ortmann , G.B. Migliori, G. Sotgiu , R. Muetterlein, R. Centis , H. Hoffmann , D. Kirsten , T. Schaberg , S. Ruesch-Gerdes , C. Lange C and German TBNET Group, Multidrug- and extensively drug-resistant tuberculosis, Germany. Emerging Infectious Diseases, 14(11), 2008, 1700-1706.
[8] World Health Organization. Anti-tuberculosis drug resistance in the World. (Geneva: The Organization, 1997).
[9] World Health Organization. Global tuberculosis Control: Surveillance planning, financing (Geneva: The organization, 2007).

[10] W. Burman, D. Benator D, A. Vernon, A. Khan, B. Jones, C. Silva , C. Lahart, S. Weis, B. King, B. Mangura, M. Weiner and W. El-Sadr, Tuberculosis Trials Consortium. Acquired rifamycin resistance with twice-weekly treatment of HIV-related tuberculosis, American Journal of Respiratory and Critical Care Medicine, 173(3), 2006, 350-356.

Abstract: Peritoneal loose bodies or peritoneal mice are asymptomatic incidentalomas predominantly found at abdominal surgery orat autopsy.Peritoneal loose bodies evolve from torsion and separation of appendices epiploicae. Peritoneal loose body is a histopathological diagnosis and most other differential diagnosis for calcified intra peritoneal masses can be ruled out during the histological examination.

Key Words: Calcified mass, Peritoneal loose body, Mice, Acute abdomen.

[1]. Ghanremani GG, White EM, Hoff FL, Gore RM, and Matter, Christ ML- Appendices epiploicae of the colon: Radiologic and pathologic features, 1992:12:59-77.
[2]. RossJA,McQueenA, Peritoneal loose bodies. Br J surg, 1947/48:35:313 -7.
[3]. Ross JA: Vascular loops in appendices epiploicae: their anatomy and surgical significance with a surgical pathology of appendices epipolicae. Br.J Surgery 1950{148}: 464-4.
[4]. Borg SA, Whitehouse, Griffiths: A mobile calcified amputated appendix epiploica: AM J Rentogenol, 1976:127:349-506.
[5]. Patterson DC, Appendices epiploicae and their surgical significance with report of 3 cases, N Eng. J med, 1933: 209; 1255-95.
[6]. Tareq M, AL-jabber: Torsion of abdominal appendages presenting with acute abdominal pain, Annals of Saudi medicine, Vol 20.2010.
[7]. Ghost P, Strong C, Naugher W, Haghighi P: Peritoneal mice implicated in intestinal obstruction: report of a case and review of literature. Journal clinical gastroenterology, 2006 40 (5);427-430.
[8]. BhendwarAH,DesaiVV,GajbhijyeRN,DeshrajBP: Acute retention of urine due to loose peritoneal body, British journal of urology 1996; 78; (6) 951-952.
[9]. Short practice of surgery, Bailey and Love26th edition, p.no:981.
[10]. G. Gayer MD & Petrovith MD: CT diagnosis of large peritoneal loose bodies; A case report and review of literature. British Journal of Radiology, 84(2011)e83-e8f

Abstract: Tendon transfer of flexor digitorum longus tendon(FDLT) or flexor hallucis longus tendon(FHLT) into the tibialis posterior tendon is carried out in patients with tibialis posterior dysfunction. FDLT and FHLT are connected in the region of the Knot of Henry. The present study has investigated the anatomical variations of this tendinous interconnection. The results could be used to determine which of two tendons should be transected proximal to the region of knot of henry in surgical treatment of tibialis posterior dysfunction. The transaction of FDLT /FHLT proximal to region of Knot of Henry for repair of tibialis posterior dysfunction would result in retention of function of the hallux and lesser digits in majority of cases.

Key words: FDLT- flexor digitorum longus tendon,FHLT- flexor hallucis longus tendon,Knot of henry

[1]. Henry AK. 1995 Extensile exposure. 3rd Ed. Edinburgh: Churchill Livingstone. p. 300-308.
[2]. Coughlin MJ, Mann RA 1999. Surgery of the foot and ankle, 7th Ed. Vol. 1. St. Louis: Mosby. p. 745-758.
[3]. Basmajian VJ, Stecko G, 1963. The role of the muscle in arch support of the foot: an electromyographic study. J Bone Joint Surg 45A: 1184-1190.
[4]. Goldner JL. 1985. Letter to the editor. J Bone Joint Surg 67A: 1448.
[5]. Mann RA, Thompson FM. 1985. Rupture of the posterior tibial tendon causing flat foot, J Bone Joint Surg 67 A: 556-561.
[6]. Richardson EG. 1998. Disorders of the hallux. In: Canale ST, editor. Campbell's operative orthopaedics. 9th Ed. St. Louis: Mosby – Year Book. P 1712-1745.
[7]. Cobb N. 1996. Tibialis posterior tendon disorders. In Helal B. editor. Surgery of disorders of the foot and ankle. London: Lippincott- Raven. P 291-302.

Abstract: The finger ridge configurations do not change throughout life of individuals by environment or age factors except in events such as bruises and cuts on the finger tips (Henneberg et al, 1997). A sample size of 396 Nigerians residing in Lagos was obtain, 327 were males and 75 were females. The ink procedure was used to obtain samples and analyzed. The result obtained showed that the ulnar loop had the highest percentage frequency in both thumbs of both hands (79.5%), followed by the whorls (42.4%), Arch (12.6%) and radial loop (9.3%) respectively. The mean percentage of patterns frequencies in all the ten digit of the hand was in this order; ulnar loop = 58.93%, whorls = 29.63%, Arch = 8.86% and radial loop = 2.5%. This result tallies with data obtain from the ikwerres and okrika of river state and berber population, in morocco. It agrees partially with Danberno et al on the hause ethnic group of Nigeria in terms of percentage frequencies distribution pattern of ulnar loop > whorls.

Keywords: Dermatoglyphics, digit,Lagos,loops,whorls

[1] Angrosino, M. V. (2004). Projects in ethnographic research. Long grove, IL: Waveland press.
[2] Bhasin M. K., 2007. Genetics of castes and tribes of india: Dermatoglyphics. Int. J. hum. Genet. 72: 175-215.
[3] Blabber W J (1991). Embryologic development of epidermal ridge and their configuration. Birth defects original articles series. 27(2) 95-112.
[4] Chaabani H. and cox D. W., 1988. Genetic characterization and origin of Tunisian Berbers. Hum. Hered. 38: 308-316.
[5] Crawford M.H., Duggirala A.R., 1992. Digital dermatoglyphics pattern s of Eskimo and Amerindian populations: relationships between geographic, dermatoglyphic, genetic and linguistic distances. Human biology, 64:683-704.
[6] Cummins, H. & C. midlo. 1961. Fingerprints, palms and soles. An Introduction to Dermatoglyphics. Dover publications, New York, USA.
[7] Gupta uk and Prakash S. Dermatoglyphics: a study of finger tips pattern in bronchial asthma and its genetic disposition.kathmandu University medical journal (2003) Vol. 1, No. 4, Issue 4, 267-271.
[8] Igbigbi PS, Didia BC. Plantar dermatoglyphic features of the Urhobos of southern Nigeria. E Afr Med J 1999; 77: 12-15.
[9] Igbigbi PS, Didia BC, Emenike UJC. Plantar dermatoglyphics in ibosof Nigeria. W Afr J Anat 1996, 4: 44-49.
[10] Igbigbi, P. S., Msamati, B. c. and Ngambi, T. M. (2001). Plantar anddigitaldermatoglyphic patterns in malawian patients with diabetes, hypertension and diabetes with hypertension. International journal of diabetes and Metabolism. 9: 24-31.

Abstract: The haematological and biochemical response of albino rats to their administration with the aqueous extracts of Gmelina arborea was studied. Fifty-six (56) female albino rats within the weight range of 140-160g were used. They were placed into 3 groups (A, B, C). They were fed with high dose (Group A), low dose (Group B) and extract free (Group C) for 28 days. Haematological tests were performed with blood samples collected from the animals. Result showed that Gmelina aborea increases Haemoglobin concentration, Packed Cell Volume, platelet count while the white blood cell count, and white blood cell differential count were unaffected compared with their corresponding control. There was no marked difference in the liver function test of the test and control rats. It could be deduced from this study that the extract of Gmelina aborea encourages haemopoiesis in rats.

Key Words: Gmelina aborea, albino rats white blood cells, platelets.

[1]. ALEXANDAR R.R and GRIFITHS J.M (1993). Haematocrit in: Basic Biochemical methods 2nd Ed. John Willey and Sons. Inc. Publications New York pp 186-187.
[2]. Available from http://bioethics od.nih gov/animals html (Last accessed on 2010 Dec 30).
[3]. BARKER F.J (1985). Liver Function tests Introduction to Medical laboratory Technology. Butterworths Publications Woburn London p 134-139.
[4]. DACIE J.K and LEWIS S.M (1991). Practical Haematological in: Biochemical methods 2nd Ed. John Willey and Sons. Inc. Publications New York pp 186-187.
[5]. IWU M, (1983). I.A.P University of Nigeria Nsukka Project Report. Traditional Igbo Medicine, 30.
[6]. JENSEN M, (1995). Trees commonly cultivated in South East Asia; illustrated field guide. Publication: 1995/38, FAO, Bangkok, Thailand.
[7]. KIRTIKAR K.R, BASU B.D (1999). Indian Medicinal Plants. Dehradun; International Book Distributor, p1932-3.
[8]. PENNIGTON D (1978). Pathological Variation in White Cell Count Values. Clinical Haematology in Medical practice. Blackwell Scientific Publication Osney Mend Oxford 0X20EI. 8 Johnson Street London Pp 396.
[9]. UREME A (1996). The relationship of clot retraction platelet count and serum calcium concentration in apparently healthy adolescent in Enugu. Journal of Environmental Health Vol 6. Pp 22.
[10]. Veeranjanevulu a (2010). "Evaluation of acute and reported dose toxicity of the methanol extract (ME) of the Gmelina arborea stem bark/. School of Pharmacy and Technology Management SVKM's NMIMS University, V.L. Mehta Read, Vile Parle (W), Mumbai =400056 Maharashtra India.

Abstract: Cherubism is a rare, benign, non-neoplastic fibro-osseous hereditary condition related to genetic mutations, characterised by symmetrical expansion of the mandible and/or maxilla, usually found in children between 2-5 years of age giving characteristic cherubic appearance and an upward turning of the eyes. These lesions gradually increase for next few years, stay inactive and start regressing after puberty. On radiography, the lesions exhibit bilateral multilocular radiolucent areas. Histopathology reveals multinucleated giant cells in the background of proliferating fibrous connective tissue. These self-limiting, spontaneously regressing lesions do not require any surgical intervention, except for significant functional and/or esthetic impairment. The present case describes Cherubism in a young child who is far from reaching puberty, with a brief review of literature on cherubism.

Keywords: cherubism, childhood disease, fibro-osseous lesion, hereditary, self-limiting.

[1] Khalifa MC, Ibrahim RA. Cherubism. J Laryngol Otol. 1988;102:568-570.
[2] Beaman FD, Bancroft LW, Peterson JJ, Kransdorf MJ, Murphey MD, Menke DM. Imaging characteristics of cherubism. AJR Am J Roentgenol. 2004;182:1051-1054.
[3] Yamaguchi T, Dorfman HD, Eisig S. Cherubism: clinicopathologic features. Skelet Radiol. 1999;28:350-353.
[4] Carvalho Silva E, Carvalho Silva GC, Vieira TC. Cherubism: clinicoradiographic features, treatment and long-term follow-up of 8 cases. J Oral Maxillofac Surg. 2007;65:517-522.
[5] Gomes MF, de Souza Setubal Destro MF, de Freitas Banzi EC, et al. Aggressive behaviour of cherubism in a teenager: 4-years of clinical follow-up associated with radiographic and histological features. Dentomaxillofac Radiol. 2005;34:313-318.
[6] Atalar MH, Albayrak E, Erdinc P, et al. Cherubism as a rare cause of bilateral expansion of the mandible: radiological manifestations. J HK Coll Radiol 2008;11:76-80.
[7] Regezi JA, Sciubba J. Oral pathology: clinical-pathologic correlations. 2nd ed. Philadelphia: Saunder;1993.p345-354.
[8] Ozkan Y, Varol A, Turker N, et al. Clinical and radiological evaluation of cherubism: a sporadic case report and review of the literature. Int J Pediatr Otorhinolaryngol. 2003;67:1005-1012.
[9] Lo B, Faiyaz-Ul-Haque M, Kennedy S, et al. Novel mutation in the gene encoding c-Abl-binding protein SH3BP2 causes cherubism. Am J Med Genet A 2003;121A:37-40
[10] Ongole R, Pillai RS, Pai KM. Cherubism in siblings: a case report. J Can Dent Assoc. 2003;69:150-154.

Abstract: Candidosis is said to be the most opportunistic infection in the world.This can result from many different conditions like irrelevant antibiotic treatment, dentures, corticosteroid therapy, cancer chemotherapy, diabetes mellitus, HIV infection, hypoparathyroidism, infancy, multiple myeloma, primary T-lymphocyte deficiency, xerostomia. This review attempt at spreading awareness among clinicians regarding isolation & accurate diagnosis of yeast in their practice to save & serve mankind in a better way. Keywords: Oral Candidosis, Candida albicans ,Laboratory Diagnosis

[1] Rajendran R., Shivapathasundharam B. Shafer‟s text book of oral pathology, 5th ed. India: elsevier; 2005.
[2] Parihar.S,Oral Candidiasis- A Review,WebmedCentral
[3] Jagadish Chander. Textbook of Medical Mycology 2nd edition Mehta Publishers 2002; 40-53.
[4] Epstein J B, Pearsall N N, Trulove E L.Oralcandidosis: effects of antifungal therapy upon clinical signs and symptoms, salivary antibody and mucosal adherence of C.albicans. Oral Surg Oral Med Oral Pathol 1981; 51:32-38.
[5] Samaranayake LP, Yaacob H. Classification of oral Candidoses: In Oralcandidoses. London:Butterworth 1990. Pg No 124-132
[6] Olsen I and Stenderup A. Clinical – mycologic diagnosis of oral yeast infections. Acta Odontol Scand.1990; 48:18
[7] ten Cate JM, Klis FM, Pereira-Cenci T, Crielaard W, de Groot PWJ. Molecular and cellular mechanisms that lead to Candida biofilm formation. J Dent Res 2009; 88: 105-15.
[8] Hornby JM, Jensen EC, Lisec AD, et al. Quorum sensing in the dimorphic fungus Candida albicans is mediated by farnesol. Appl Environ Microbiol 2001; 67(7): 2982-92.
[9] Neppelenbroek KH, Campanha NH, Spolidorio DM, Spolidorio LC, Seo RS, Pavarina AC. Molecular fingerprinting methods for the discrimination between Candida Albicans and Candida dubliensis. Oral Dis 2006; 12(3): 242-53
[10] Liquori G, Di Onofrio V, Luvariello A, et al. Oral Candidiasis: a comparison between conventional methods and multiplex polymerase chain reaction for species identification. Oral Microbiol Immunol 2009; 24(1): 76-8.

Abstract: A study was done to note the variations in the termination of brachial artery in relation to the level of termination and the terminal branches. A total of 95 upper limbs (51 Right, 44 Left) were studied. The level of termination of brachial artery was classified into five groups based on the distance between the intercondylar line and the point of termination. There was a significant positive correlation (P=0.031) between the arm length and level of termination. Statistically significant association (P=0.022) was observed between the type of terminal branch and different groups of level of termination. Difference in the mean level of termination between brachial artery bifurcation and trifurcation was found to be statistically significant (P < 0.001). Bifurcation of brachial artery occurred at a proximal level when compared to trifurcation which occurred more distally. Due to higher incidence of anatomical variations of arteries of the upper limb, prior anatomical knowledge of anomalies is of great clinical significance to vascular surgeons, orthopaedicians and radiologists performing angiographic studies.

Keywords: Arm length, brachial artery, level of termination, terminal branches, variations.

[1] Ahmet Uzun, Leonard L Seelig Jr. The anastomotic artery connecting the axillary or brachial artery to one of the forearm arteries. Folia Morphol. 59( 3). 2000. 217-220.

[2] Konstantinos Natsis, Anastásia L. Papadopoulou, Efthymia Papathanasiou, George Noussios, George Paraskevas, Nikolaos Lazaridis. Study of two cases of high-origin radial artery in humans. Eur J Anat. 13 (2). 2009. 97-103. [3] Susan Standring. Gray's Anatomy ( London, Elsevier Churchill Livingstone Publishers, 2008) 856.

[4] Suganthy J., Koshy S., Indrasingh I., and Vettivel S. A Very Rare Absence of Radial Artery : A Case Report. J Anat. Soc. India. 51(1). 2002. 61-64.

[5] Jasna Malcic-Gu¨rbu¨Z, Raffi Gu¨ru¨Nlu¨Ogˆlu, O¨mer O¨zdogˆMus , and Aymelek Yalin. Unique Case of Trifurcation of the Brachial Artery: Its Clinical Significance. Clinical Anatomy. 15. 2002. 224–227

[6] G J Romanes. Cunningham's manual of practical Anatomy ( New York, Oxford University Press, 2005) 67-71

[7] M. Rodríguez-Niedenführ, T. Vázquez, I.G. Parkin and J.R. Sañudo. Arterial patterns of the human upper limb: update of anatomical variations and embryological development. Eur J Anat. 7(1). 2003. 21-28.

[8] M. Rodriguez-Niedenfuhr, T. Vazquez, L. Nearn B. Ferreira, I. Parkin and J. R. Sanudo. Variations in the arterial pattern in the upper limb revisited- a morphological and statistical study, with a review of the literature. J. Anat. 199. 2001. 547-566.

[9] Konstantinos Natsis, Anastásia L. Papadopoulou, Efthymia Papathanasiou, George Noussios, George Paraskevas, Nikolaos Lazaridis. Study of two cases of high-origin radial artery in humans. Eur J Anat. 13 (2). 2009. 97-103.

[10] Ahmet Uzun, Leonard L Seelig Jr. The anastomotic artery connecting the axillary or brachial artery to one of the forearm arteries. Folia Morphol. 59 (3). 2000. 217-220.

Abstract: There is increasing evidence of high BP among asymptomatic children. This has been associated with life style influenced co-morbid conditions like obesity. This cross sectional non interventional observational study was designed to determine the prevalence of pre-hypertension and hypertension in school going children aged 13-17 years in an urban city. Anthropometric & BP measurements were taken as per standard methods. Agarwal charts were used to estimate BMI for age and sex. The average of 3 BP measurements were compared to age, sex and height percentile standards given by the report of Fourth task force on hypertension control in children. Spearman correlation was applied for independent variable (BMI) with dependent variables. Non parametric tests Mann-Whitney and Kruskal-Wallis tests were used to determine the association of gender and BMI with outcomes like average DBP, average SBP, pre-hypertension and hypertension. Prevalence of hypertension was 6.75% and 8.4% for pre-hypertension among the 785 studied, 10.5% boys and 8.5% girls were overweight and 5.8% boys and 5.1% girls were obese. In girls, increasing BMI was associated significantly (p<0.0001) with average SBP and average DBP in both pre-hypertension and hypertension groups but in boys only DBP was found to be significantly (p<0.0001) associated with BMI. A higher prevalence of pre hypertension and hypertension seen in our study group compared to similar studies in the state. Children with higher BMI were associated with pre-hypertension or hypertension.

Key Words: adolescents; obese; overweight; target organ damage (TOD)

[1] World Health Organization. The World Health Report 2002. Geneva, Switzerland: WHO, 2002
[2] Shyamal KD, Kalyan S, Arindam B. Study of urban community survey in India: growing trend of high prevalence of hypertension in a developing country. Int. J. Med. Sci, 2(2),2005 , 70-78
[3] Yadav S, Boddula R, Genitta G, Bhatia V, Bansal B, Kongara S et al. Prevalence & risk factors of pre-hypertension & hypertension in an affluent north Indian population. Indian J Med Res,128, 2008,712–720
[4] Sougat R, Bharati K,. Sreenivas A. Prevalence of prehypertension in young military adults & its association with overweight & dyslipidaemia. Indian J Med Res,134(2), 2011,162-167

Abstract: "Few people crave for popularity, few for power and few for money, but there is very very small category of people who simply focus on their work and rest everything follows them in abundance" The aim of this review is to emphasize on Anxiety which is one of the common mental state in day to day to life due to traumatic events and stressful lifestyle, influence of others in our lives and absence of relaxation in schedule. Anxiety has been neglected both by the operators and patients. However, many studies have proved association of Anxiety with increased pain during dental treatment, muscle contractions and altered state of concentration in everyday activities. This review includes aspect of anxiety, its causes, recognition, prevention and management.

Keywords: Anxiety, Dental treatment, Pain, Phobias, Relaxation.

[1]. (Effectiveness of various medications on postoperative pain following complete instrumentation. J Endod 1994: 20: 345–354.)
[2]. Sokol D, Sokol S, Sokol C. A Review of non-intrusive therapies used to deal with anxiety and pain in the dental office. J Am Dent Assoc 1985: 110: 217–222.)
[3]. Gatchel RJ. Managing Anxiety and Pain during dental treatment. J Am Dent Assoc 1992: 123: 37–41.)
[4]. Nakai Y, Milgram P, Mancl L, Coldwell SE, Domoto PK, Ramsay DS. Effectiveness of local anesthesia in pediatric dental practice. J Am Dent Assoc 2000: 131: 1699– 1705.)
[5]. A brief literature review about relaxation therapy and anxiety, : Body, Movement and Dance in Psychotherapy: An International Journal for Theory, Research and Practice
[6]. Progressive Muscle Relaxation, Journal of Human Behavior in the Social Environment Volume 13, Issue 3, 2006.

Abstract: A Univentricular Heart (UVH) is a rare congenital heart malformation. Prognosis without surgical intervention is considered to be poor and survival into the adulthood is unusual (1, 2). Its incidence being 1% to 4.3% of all congenital heart defects. Here we reported this rare congenital heart defect; hence it was worth reporting this interesting case.

Key Words: Univentricular Heart, Double Inlet Ventricle, Single Ventricle, TGA.

[1]. Anderson RH, Becker AE, Tynan M, Macartney FJ, Rigbu MZ,Wilkinson JL. The Univentricular atrioventricular correction: getting to the root of a thorny problem. Am J Cardiol 1984; 54:822-828.
[2]. Ho SY, Luberbuhler JR, Anderson RH. Pathology of heart with a univentricular atriovenrticular connection. In: Rosenberg HS, Bernstein J, eds. cardiovascular diseases .Perspectives in pediatric pathology, Volume 12, Basal: karger, 1988:66-69.
[3]. Hubta JC, Seward JB, Tajik AJ, Hoglet DJ, Edwards WD. Two Dimensional echocardiographic spectrum of univentricular atrio-ventricular connection. J Am Coll Cardiol 1985; 5:149-157.
[4]. Anderson RH, Tynan M, Freedom RM et.al. Ventricular morphology in the univentricular heart. Herz 1979; 4:107-112.
[5]. Samanek M. Children with congenital heart disease: Probability of natural survival .Pediatr Cardiol.1992;13:152-158.
[6]. Moodie DS, Ritter DG, Tajik AJ, O‟Fallon WM. Long term follow-up in the unoperated univentricular heart. Am J Cardiol. 1984; 53:1124-1128.
[7]. Samanek M, Voriskova M. Congenital heart diseases among 815,569 children born between 1980-1990 and their 15-year survival :a prospective Bohemia survival study. Pediatr Cardiol .1999; 20:411-417.
[8]. Perloff JK. The clinical recognition of congenital heart disease. Fourth edition .Philadelphia:WB.Saunders; 1994.
[9]. Van Praagh R, Ongley P, Swan H. Anatomic types of single or common ventricle in man: Morphological and geometric aspects of 60 necropsied cases. Am J Cardiol.1964:13:367-368.
[10]. Moodie D.S., Ritter D.G., Tajik A.J., and O‟Fallon W.M. Long term follow-up in the unoperated univentricular heart. Am. J. Cardiol.53:1124, 1984.