iosr-JDMS   Volume-9 ~ Issue-5

Abstract: Technology in health care is increasingly becoming an integral part of the Nigeria health care delivery system and National Universities Commission has made it as part of bench-mark in the training of Nursing Students on Nursing informatics. Nursing and Midwifery Council is equally making efforts to see to the teaching and utilization of Nursing informatics by nursing students and practicing nurses. Therefore, this study was aimed at assessing the knowledge and attitude of nurse-educators and leaders on concept of nursing informatics.

Keywords: Knowledge, Attitude, Informatics, Nurse Educators/leader, Training.

[1]. Anna, D Effihia G, Dimos M, Maria N. Undergraduate Nursing Students' Computers skills assessment: a study in Greece. Health Science Journal 2010; 4(3), 182-188.
[2]. Myers MR. Telemedicine an emerging health care technology. Health Care Mang. 2003, 22(3): 219-233.
[3]. Edworthy sm. Telemedicine in developing countries. BMJ 2001 Sep 8; 323 (7312): 524-525.
[4]. Ogunyade T.O, Oyibo WA. Use of CD or CD-ROM MEDLINE by medical students of the College of Medicine, University of Lagos, Nigeria. Med Internet Ros Mar 31;5(1).
[5]. Aarons, G.A. Mental health provider attitudes toward adoption of evidence-based practice: the evidence-based attitude scale (EBPAS). Mental Health Service Research 6(2), 61-74.
[6]. Marita, K., Maritta V., Heli, H. Nurses' Information retrieval skills in psychiatric hospitals – Are the requirements – for evidence-based practiced fulfilled, Nurse Education in Practice 10(2010), 27-31. www.elsevier.com/nepr assessed 14-08-13.
[7]. Griffiths P, Riddingfon L. Nurses use of Computer databases to identify evidence for practice a cross-sectional questionnaire Survey in a UK hospital. Health info Libr J. 2001; 19(1): 2-9.
[8]. Austin SI. Baccalaureate nursing fealty performance of nursing computer literacy skills curriculum integration of these through teaching practice. J. Nursing Educ 1999; 38(6): 260-6.
[9]. Alexander B. Going Normadic: Mobile learning in Higher Education EDUCAUSE Review 2004; 39(5), 28-35.
[10]. Retsas, A. Barriers to using research evidence in nursing practice. Journal of Advanced Nursing, 2000 31(3), 599-605.

Abstract: Removing the uvula is called uvulectomy, the procedure can be viewed from two ways. As part of the western medicine to address condition like snoring, when it is medically acceptable treatment, but as part of traditional medicine to cure illnesses such as sore throat where it is considered dangerous.

Keywords: Traditional uvulectomy, under-five children, Jigawa, Effects.

[1] Ado Sheu perceived Effects Traditional uvulectomy in Gujungu community of Taura local government Area of Jigawa state, Nigeria unpublished BNSC Thesis, A.B.U. facility of medicine, June, 2013, 6-26.
[2] UCL Current legal Issues colloquium 2012 - Law and Global Health.
[3] NCTEB Baseline survey on harmful traditional practices in Ethiopia, NCPTE, Addis-Ababa, Ethiopia Sept. 1998.
[4] NCTPE/EC Resume material in harmful traditional practices for policy makers, National Committee on traditional practices of Ethiopia, Addis Ababa Ethiopia Dec 1999.
[5] NCTPE/EC Uvulectomy National Committee on traditional practices of Ethiopia, Addis Ababa Ethiopia Dec 1999.
[6] NCTPE/EC children's teeth and their care. National committee on traditional practices of Ethiopia, Addis Ababa Ethiopia Dec. 1999.
[7] NCTPE/EC Major harmful traditional practices in Ethopia: Resource material for higher training institutes, National Committee on traditional practices of Ethopia, (NCTPE) Addis Ababa, Ethopia, Dec. 1999.
[8] Cheees brough Monica. District Laboratory Practices in Tropical Countries 2000 Cambridge University Press, UK.
[9] NCTPE/EC. Early Marriage by Abduction: National Committee on Traditional Practics of Ethopia, Addis Araba, Ethopia, Dec. 1999.
[10] Tobih, JE. Obstetric Complications following traditional uvulectomy: A case report. www.ajolinfo/indesc.php/njorl/aricle/view/32457 assesed August 9, 2013.

Abstract: Technology in health care is increasingly becoming an integral part of the Nigeria health care delivery system and National Universities Commission has made it as part of bench-mark in the training of Nursing Students on Nursing informatics. Nursing and Midwifery Council is equally making efforts to see to the teaching and utilization of Nursing informatics by nursing students and practicing nurses. Therefore, this study was aimed at assessing the knowledge and attitude of nurse-educators and leaders on concept of nursing informatics.

[1]. The use of complementary therapies and medicines. Birth Issues 2004; 13 (2): 43-50.
[2]. Drug use during pregnancy. Available from: http://www.merck.com/mmhe/sec22/ch259/ch259a.html#
[3]. Royal Pharmaceutical Society of Great Britain, British Medical Association. British National Formulary. 56th edition London: Pharmaceutical Press; 2008.
[4]. Tiran D. The use of complementary therapies in midwifery practice: a focus on reflexology. Complement Ther.Nurs.Midwifery 1996; 2 (2): 32-7.
[5]. Marcus DM, Snodgrass WR. Do no harm: avoidance of herbal medicines during pregnancy. ObstetGynecol 2005; 105 (5): 1119-22.
[6]. Mitchell M,Williams J, Hobbs E, et al. The use of complementary therapies in maternity services: a survey. British Journal of Midwifery 2006; 14 (10): 576-82.
[7]. Gibson PS, Powrie R, Star J. Herbal and alternative medicineuse during pregnancy: a cross sectional survey. ObstetGynecol 2001; 97: S44-S45.
[8]. Hepner DL, Harnett M, Segal S, et al. Herbal medicine use in parturients. Anesthesia and Analgesia 2002; 94 (3): 690-3.
[9]. Ernst E. Pastore L. Home remedies used in pregnancy. The Cochrane Library 2000;3:529 In: Herbal medicinal products during pregnancy: are they safe? Br J ObstetGynaecol 2002; 109 (3): 227-35.
[10]. Pinn G, Pallett L. Herbal medicine in pregnancy. Complement Ther.Nurs.Midwifery 2002; 8 (2): 77-80.

Abstract: In this article we have presented three cases of congenital head & neck anomalies and discussed the possible embryological etiology. These cases include a unilateral right sided isolated anotia in a male baby aged 4 months nasal dermoid sinus cyst in an adult female, adolescent female with high arched palate, stenosis of nares, presenting with stridor. Study involved cases presenting with congenital anomalies surviving into adulthood with attendant implications over the quality of life of these subjects.

Key words: Isolated anotia, High arched palate, Laryngeal web, Nasal dermoid sinus cyst, Congenital head and neck anomalies.

[1]. Chitose S, Umeno H, Nakashima TEndoscopic surgical treatment of posterior glottic stenosis. J Laryngol Otol. 2009 May;123 Suppl 31:68-71. doi: 10.1017/S002221510900512X. PMID: 19460208

[2]. Canfield MA, Langlois PH, Nguyen LM, Scheuerle AE Epidemiologic features and clinical subgroups of anotia/microtia in Texas. Birth Defects Res A Clin Mol Teratol. 2009 Nov;85(11):905-13. doi: 10.1002/bdra.20626. PMID: 19760683

[3]. Charrier JB, Delattre J, Denoyelle F, Garabédian EN. [Clinical and embryological approaches to nasal dermoid sinus cysts]. Ann Otolaryngol Chir Cervicofac. 2003 Dec;120(6):315-29PMID14730276 [4]. Forrester MB, Merz RDDescriptive epidemiology of anotia and microtia, Hawaii, 1986-2002. Congenit Anom (Kyoto). 2005 Dec;45(4):119-24PMID: 16359491

[5]. Gallivan GJ. Bilateral vocal fold posterior glottic/subglottic stenotic web resected with contact tip Nd-YAG laser.J Voice. 2002 Sep;16(3):415-21PMID: 12395994

[6]. Garstecka A, Betlejewski S, Skonieczka KMicrotia: isolated defect of hearing organ, or syndrome forming collection of abnormalitiesOtolaryngol Pol. 2008;62(5):639-42. doi: 10.1016/S0030-6657(08)70332-9. PMID: 19004275

[7]. Holzmann D, Huisman TA, Holzmann P, Stoeckli SJ. Surgical approaches for nasal dermal sinus cysts. Rhinology. 2007 Mar;45(1):31-5 PMID;17432066

[8]. Hacker DC, Freeman JL. Intracranial extension of a nasal dermoid sinus cyst in a 56-year-old man. Head Neck. 1994 Jul-Aug;16(4):366-71. PMID: 8056582

[9]. Harris J, Källén B, Robert E. The epidemiology of anotia and microtia. J Med Genet. 1996 Oct;33(10):809-13 PMID:8933331

[10]. P Mastroiacovo, C Corchia, L D Botto, R Lanni, G Zampino, and D Fusco Epidemiology and genetics of microtia-anotia: a registry based study on over one million births. J Med Genet. 1995 June; 32(6): 453–457. PMCID: PMC1050485

Abstract: Migraine is a neurological syndrome characterized by altered bodily perceptions, severe headaches, and nausea. Migraine headache is a neurological condition more common to women than to men. The typical migraine headache is unilateral (affecting one half of the head) and pulsating, lasting from 4 to 72 hours; symptoms include nausea, vomiting, photophobia (increased sensitivity to light), and phonophobia (increased sensitivity to sound).

[1] Gaus W, Walach H, Haag G. Die Wirksamkeit der klassischenhomoÈopathischenTherapiebeichronischenKopfschmerzen. Plan einerplazebokontrolliertenStudie. Der Schmerz 1992; 6:134-40.
[2] Walach H, Gaus W, Haeusler W, Lowes T, Mussbach D, Schamell U et al. Classical homoeopathic treatment of chronic headaches. A double-blind, randomized, placebo-controlled study. Cephalalgia 1997; 17:119-26.
[3] Walach H. Verblindung in klinischenHomoÈopathie-Studien? In: Hornung J, ed. Forschungsmethoden in der KomplementaÈrmedizin UÈ berdieNotwendigkeitEinerMethodologischenErneuerung. Stuttgart: Schattauer, 1996:1-16.
[4] International Headache Society, Committee on Clinical Trials in Migraine. Guidelines for controlled trials of drugs in migraine, 1st edn. Cephalalgia 1991; 11:1-12.
[5] Lowes T, Springer W. NachlesezurMuÈnchenerhomoÈopathischenKopfschmerzstudie. AllgemeineHomoÈopathischeZeitung 1997; 242:22-30.
[6] Whitmarsh TE, Coleston-Shields DM, Steiner TJ. Double-blind randomized placebo controlled study of homoeopathic prophylaxis of migraine. Cephalalgia 1997; 17:600-4.
[7] Straumsheim PA, Borchgrevink CF, Mowinkel P, Kierulf H, Hafslund O. Homeopatiskbehandlingavmigrene. En dobbeltblind, placebonkontrollertstudieav 68 pasienter. Dynamis 1997; 2:18-22.
[8] Mathie RT. Clinical outcomes research: contributions to the evidence base for homeopathy. Homeopathy 2003; 92: 56–57.
[9] Paterson J. Report on the mustard gas experiments (Glasgow and London). Br Hom J 1943; 33: 1–12.
[10] Ritter H. Einhom. ootherapeutischerdoppelterBlindversuch und seine Problematik. Hippokrates 1966; 12: 472–476.

Abstract: This study was conducted with a purpose to assess the perception of Cross infection in Dental practice at 3 institutes and some private clinics. Total of 150 dentists were questioned/interviewed and data recorded on a Questionnaire consisting of 15 questions. 69% of dental practitioners were immunized & 62% routinely screen their patients for the Hepatitis B. Verbal history taking method is predominantly adopted by most of the dentists and this accounts to76.5 %, rest document it in writing. 93 % were of the opinion that autoclaving is the best method of sterilization but only 47.5 % run autoclave every day, 76.1 %dentist routinely uses gloves and among them 92 % dentist handles one patient with a single and new pair of gloves. 65 % dentists neglected use o protective eye wear at the time of procedure and mask wearing was noted only in 40.3 % dentists. Resource deficiency and Cost factor was considered to be the primary reason by 64 % of the dentists for not following the standard Cross infection control precautions.

Key words: Do no harm, Cross infection, Control, Sterilization.

[1]. Smith, C. M. (2005). "Origin and Uses of Primum Non Nocere — Above All, Do No Harm!". The Journal of Clinical Pharmacology 45 (4): 371–377.
[2]. Neguþ EA, Bãlteanu M, Ionescu G, Bãncescu A, Iliescu A and Skaug N. Control of blood-transmitted infections in dentistry. Roumanian archives of microbiology and immunology. 2007; 66: 26-36..
[3]. Adel A, Mousa, Nadia M, Mahmoud, Azza M, Tag El Din, Knowledge and attitudes of dental patients towards cross infection control measures in dental practice. Eastern Mediterranean health j .1997; 3(2): 263-73.
[4]. Verrusio AC et al. The dentist and infectious diseases, a national survey of attitudes and behaviour.JADA<1989:l 18: 553 62.
[5]. Waikinson AC. Primary Herpes Simplex in a dentist. BDJ,1982,153:190-9l.
[6]. Tullman AB et al. The threat of hepatitis B from dental school patients, 0ral surg, oral med and oral path,1980,44:214-16.
[7]. Girdier NM. Mathews RW, Scully C. Use and acceptability of rubber gloves for OP dental treatment. Journal of dent, 1987,15:209-12.
[8]. Zaaijjer HL, transmission of hep. B virus by aurgeons. Ned Tijdschr Genesk 1999;143(47);p2348-50.
[9]. DePaola LG. Infection control and dental practice: frequently asked questions. Compendium of continuing education in dentistry (Jamesburg, NJ: 1995). 2004; 25: 38-42.
[10]. Sultan Mehmood et al,Scrum hepatitis and liver cirrhosispractical guideline for prevent; on. J MS; 1997;(7): l-2.

Abstract: Hypertensive disorders are the most common medical complications during pregnancy and are associated with high maternal and fetal mortality and morbidity.One way to reduce the impact of arterial hypertension on maternal mortality is to establish the correct diagnosis of preeclampsia, and to proceed with an early intervention when it is diagnosed. The clinical signs are considered to be a late manifestation of a disease. The utility of two biochemical markers like hyperuricemia and hypocalcemia for the diagnostic purposes and for the prognosis remains largely to be explored.

Key words: preeclampsia, eclampsia, serum uric acid, serum calcium.

[1]. Darnforth editor Obstetrics & Gynecology (1999), Lippincott Williams and Wilkins, New York, 309-327.
[2]. Cunningham FG, MacDonald PC & Gant NF (1989). Hypertensive disorders in pregnancy. In: Cunningham FG, MacDonald PC & Gant NF (Editors), Williams Obstetrics. Prentice-Hall, Norwalk, 653-694.
[3]. Andrea G. Witlin, and Sibai B M. Hypertension in pregnancy: current conceptsof preeclampsia. Ann Rev Med 1997 Feb; 48: 115-127.
[4]. J.G.L. Ramos, S.H. Martins-Costa, J.B. Kessler, C.A. Costa and E. Barros. 1HCalciuria and preeclampsia.Braz J Med Biol Res, 1998, 31(4) 519-522
[5]. Walker JJ.Preeclamsia.Lancet 2000;356:1260-5.
[6]. Ray J, Vasishta K, Kaur S, Majumdar S, SawhneyH. Calcium metabolism in pre-eclampsia.Int J GynaecolObstet 1999; 66: 245-50.
[7]. Kisters K, Korner J, Louwen F, Witteler R, JackischC, Zidek W, et al. Plasma and membrane Ca2+ andMg2+ concentrations in normal pregnancy andin preeclampsia. GynecolObstet Invest 1998; 46:158-63.
[8]. Singh J, O'Donovan M, Coulter-Smith SD, GearyM. An audit of the use of magnesium sulphate in severe pre-eclampsia and eclampsia. J ObstetGynaecol 2005; 25: 15-7

Abstract: Deeper Neck Infections (DNI) of odontogenic origin are more common in adults than in children. The diagnosis of DNI is difficult due to lack of common clinical symptoms and signs. The diagnosis is further difficult due to deep seated infections which are covered by normal tissues of neck. Early treatment and intervention are important to reduce the morbidity and mortality. Proper antibiotic regimen and the duration of the treatment are important. Any impending airway obstruction should be closely monitored. Decision on treating the patient only with antibiotics or requirement of a surgical intervention depends on the progress of the patient and CT scan reports. Early surgical intervention is demanded due to proximity to important structures like Carotid Artery and Jugular Vein. DNI requires prompt treatment to prevent the most dreadful complications like necrotising fascitis, mediastinitis, carotid A erosion and jugular Vein thrombosis. DNI are not common in day-to-day practice, the knowledge of diagnosis, recognition of comorbid illness and treatment protocols are imperative to effectively treat these life threatening infections. Delay in diagnosis of DNI has high morbidity and mortality rates. This article reviews about the common clinical features of DNI and their management protocols summarizing recent clinical studies.

Keywords: Neck and head abscess, Retropharyngeal, Para pharyngeal, peritonsillar..

[1]. Sakagushi M, Sato S, Ishiyama T, Katsuno S, Tagushi K. Characterization and management of deep neck infection.
[2]. J Oral Maxillofac Surg. 1997, 26:131-134.
[3]. Osborn TM, Assael LA, Bell RB. Deep Space Neck Infection: Principles of Surgical Management. Oral Maxillofacial Surg Clin N Am. 2008, 20:353-365.
[4]. Conrad DE, Parikh SR. Deep Neck Infections. Infect Disord Drug Targets. Feb 17 2012; [Medline].
[5]. Chang L, Chi H, Chiu NC, Huang FY, Lee KS. Deep neck infections in different age groups of children. J Microbial Immunol Infect. Feb 2010;43(1):47-52. [Medline].
[6]. Wang LF, Tai CF, Kuo WR, Chien CY. Predisposing factors of complicated deep neck infections: 12-year experience at a single institution. J Otolaryngol Head Neck Surg. Aug 2010;39(4):335-41. [Medline].
[7]. Poeschl PW, Spusta L, Russ Mueller G, Seemann R, Hirschl A, Poeschl E, et al. Antibiotic susceptibility and resistance of the odontogenic microbiological spectrum and its clinical impact on severe deep space head and neck infections. Oral Surge Oral Med

Abstract: Patients with bullets in the pericardial sac without myocardial injuries are rare and most commonly are associated with significant trauma. The diagnosis of an intrapericardial foreign body can be difficult. Its removal is always indicated because it prevents pericarditis either sterile or infectious with potential for other significant complications. The syndrome of acute intermittent pericarditis from a foreign body within the pericardium is rarely seen except during time of war. Recently the authors treated a patient with a bullet in the pericardium three month following gunshot injury. During this period the patient developed sterile pericarditis and tamponade which necessitated emergency pericardiectomy and removal of the bullet. This experience and a brief review of the pertinent literature follows.

Keywords: Foreign body, Gunshot, Intrapericardial, Sterile Pericarditis, Pericardium injuries, Temponade..

[1]. Bland, E. F., and Beebe, G. W. Missiles in the heart: A twenty year follow- up of World War I1 cases. N e w Eng. J. M e d . 274:1039, 1966. Friedberg, C. Diseases of the H e a r t (2d ed.). Philadelphia: Saunders, 1956. P. 959.
[2]. Lower, W. E. Removal of bullet from pericardium. Ann. Surg. 63:533, 1916. Nicholson, G. M. Conference of Army Physicians. Central Mediterranean Forces, Rome, 1945
[3]. Valle, A. R. War injuries of heart and mecliastinum. Arch. Surg. 70:398, 1955
[4]. Wood, P. Diseases of the Heart and Circulation (2d ed.). Philadelphia: Lippincott, 1956. P. 927
[5]. Ledgerwood AM. The wandering bullet. Surg Clin North Am1977;57:97-109.
[6]. Szentkereszty Z, Trunqel E, Posan J, Sapy P, Szerafin T, Kiss S. Current issues in the diagnosis and treatment of penetrating chest trauma. Maqy Seb 2007;60:199-204.
[7]. Mattox KL, Limacher MC, Feliciano DV, Colosino L,OMeara ME,Beall AC Jr, DeBakey ME. Cardiac evaluation following heart injury
[8]. Decker HR. Foreign bodies in the heart and pericardium: should they removed? J Thorac Surg. 1939;9(1):62-79
[9]. Burkhart HM, Gomez GA, Jacobson LE, Broadie TA, Tarver RD. Meandering bullet in the pericardial sac: to remove or not remove. Am Surg. 1998;64(4):341-3.
[10]. Watts T, Toone EC. Successful removal of foreign bodies within the pericardium: a report of two cases. Surgery. 1945;17:685-95.

Abstract: Periapical radiography is essential in diagnosis, treatment planning and follow-up in endodontics. However, image interpretation can be confounded by geometric distortion, superimposition of regional anatomy and technique errors. These problems can be overcome by utilizing small or limited-volume cone beam-computed tomography imaging techniques, which produce accurate 3-D images of the teeth and surrounding dentoalveolar structures. The periapical index score (PAI) is commonly used to follow up the lesions in the bone using periapical radiographs. Recently, a new PAI scoring system based on CBCT was introduced (CBCT-PAI). We report a case where CBCT-PAI scoring was achieved using image fusion to assess healing of a large periapical lesion.

Keywords: Apical periodontitis, cone beam computed tomography, healing, periapical index, radiography

[1]. Cotti E, Vargiu P, Dettor C, Mallarini G. Computerized tomography in the management and follow-up of extensive periapical lesion. Endod Dent Traumatol, 15, 186–189.
[2]. Laux M, Abbott PV, Pajarola G, Nair PNR. Apical inflammatory root resorption: a correlative radiographic and histological assessment. Int Endod J, 33, 2000, 483–93.
[3]. Trope M, Pettigrew J, Petras J, Barnett F, Tronstad L. Differentiation of radicular cyst and granulomas using computerized tomography. Endod Dent Traumatol, 5, 1989, 69–72.
[4]. Simon JHS, Enciso R, Malfaz JM, Rogers R, Bailey-Perry M, Patel A. Differential diagnosis of large periapical lesions using cone beam computed tomography measurements and biopsy. J Endod, 32, 2006,833–7.
[5]. Cotti E. Advanced techniques for detecting lesions in bone. Dent Clin North Am, 54, 2010, 215–235.
[6]. Patel S. New dimensions in endodontic imaging: Part 2. Cone beam computed tomography. Int Endod J, 42, 2009, 463–475.
[7]. Lofthag-Hansen S, Hummonen S, Grondahl K. Limited cone beam CT and intraoral radiography for the diagnosis of periapical pathology. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 103, 2007, 114–119.
[8]. Estrela C, Bueno MR, Azevedo BC, Azevedo JR, Pe´cora JD. A new periapical index based on cone beam computed tomography. J Endod 34, 2008, 1325–1331.
[9]. Velvart P, Hecker H, Tillinger G. Detection of the apical lesion and the mandibular canal in conventional radiography and computed tomography. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 92, 2001, 682– 8.
[10]. Nakata K, Naitoh M, Izumi M, Inamoto K, Ariji E, Nakamura H. Effectiveness of dental computed tomography in diagnostic imaging of periradicular lesion of each root of a multirooted tooth: a case report. J Endod, 32, 2006, 583–7.

Abstract: Thalassemia describes a group of inherited disorders characterized by reduced amount of hemoglobin, the oxygen-carrying protein inside the red blood cells. Various haematological and serological parameters were studied in a cohort of thalasaemic patients coming for routine blood transfusion regime in a government run children hospital of Rajkot. Due to poor socio-economic condition, none of the patients were taking chelation therapy needed for better management of thalassaemia. To get insight into effect of multiple blood transfusions on these patients, age, spleen status, distribution of blood group, hemoglobin level and other hematological indices and serolological parameter like SGPT related to iron overburden was studied. A very low hemoglobin level with very high SGPT level along with sleenomegaly is suggestive of poor prognosis in these patients.

Key Words: Thalassemia, Hematology, Serology, Spleenomegaly.

[1]. Hall GW, Thein SL, Newland AC, Chisholm M, Traeger-Synodinos J, Kanavakis E, et al. A base substitution T-G in codon 29 of the α2- globin gene causes α thalassaemia. Br.J. Haematol 1993; 85:546-52.
[2]. El-Hazmi MA. Genetic red cell disorders in Saudi Arabia: A multifactorial problem. Hemoglobin 1994; 18:257-72.
[3]. Marouf R, D'Souza TM, Adekile AD. Hemoglobin electrophoresis and hemoglobinopathies in Kuwait. Med Princ Pract 2002;11:38-41
[4]. Denic S, Souid AK, Nagelkerke N, Showqi S, Balhaj G . Erythrocyte reference values in Emirati people with and without α+ thalassemia. BMC Blood Disord 2011; 11:1.
[5]. Balgir RS. Hematological profile of twenty nine tribal compound cases of hemoglobinopathies and G-6-PD deficiency in rural Orissa. Indian J Med Sci 2008; 62:364-73.
[6]. Rathod DA, Kaur A, Patel V, Patel K, Kabrawala R, Patel V, et al. Usefulness of cell counter-based parameters and formulas in detection of β thalassemia trait in areas of high prevalence. Am J Clin Pathol 2007; 128:585-9
[7]. Tritipsombut J, Sanchaisuria K, Fucharoen S, Fucharoen G, Siriratmanawong N, Pinmuangngam C, et al. Hemoglobin profiles and hematologic features of thalassemic newborns. Arch Pathol Lab Med 2008; 132:1739-45.
[8]. Tongnoi P. Hematologic parameters and level of HbE for predicting Alpha-thalassemia 1 gene in pregnant women. Khon K Med J 2008;32:2
[9]. Xi Q, Jie W, YanNi H. Study on α-thalassemia and hematological parameter in Li nationality pregnant women in Hainan province. Mat Chil Heal Care China 2009; 32:4590-2.

Abstract: Brachial artery is the main artery supplying the upper limb. Variations in brachial artery are so many that it becomes a rule rather than an exception. A study was done to note the variations in the relation of median nerve to brachial artery. A total of 95 upper limbs (51 Right, 44 Left), with a mean arm length of 30.82 cms, were studied. In 11 of the limbs (11.57%) median nerve was noted to course posterior (deep) to brachial artery (Superficial Brachial Artery, SBA). Out of these 11 limbs, 6 (54.54%) belonged to right side and 5 (45.45%) belonged to left side. In 9 of these limbs (81.81%), median nerve coursed posterior to brachial artery in the middle 1/3rd of the arm, whereas in 2 of the limbs (18.18%), crossing took place at the junction of middle and lower 1/3rd of the arm. In 5 (45.45%) of these limbs brachial artery terminated normally, whereas in the remaining 6 (54.54%) trifurcation of brachial artery was noted. A significant association (χ2=29.971, P=0.003) was found between the type of terminal branches of brachial artery and level of crossing of median nerve in relation to arm segment. This anatomical knowledge of variations in the relation of median nerve to brachial artery is of great clinical significance to general surgeons, vascular surgeons and orthopaedicians and helps in preventing iatrogenic injuries. Keywords: Brachial artery, level of crossing, median nerve, superficial brachial artery, variations.

[1] Susan Standring. Gray's Anatomy ( London, Elsevier Churchill Livingstone Publishers, 2008) 856.

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

[3] Shubha R, Sudarshan Babu K G, Mekala D, Jeyanthi k, Lalitha C. An Anatomical study of variations in termination of brachial artery:embryological basis and clinical application. IOSR Journal of Dental and Medical Sciences. Vol 9 Issue 1 (Jul-Aug 2013). 68-75.

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

[5] Chandrika Teli, Nilesh N Kate, Paarthipan N. High division and variation in brachial artery branching pattern. IOSR Journal of Dental and Medical Sciences. 2013. 3(6). 68-70.
[6] A Rodriguez-Baeza, J Nebot, B Ferreira, F Reina, J Perez, J R Sanudo, M Roig. An anatomical study and ontogenic explanation of

Abstract: Schwannomas are painless, benign, and slow-growing solitary tumors. It involves the cranial nerves such as V, VII, IV, X, XI, and XII or the sympathetic and peripheral nerves and most commonly occur in the neck[1]. These tumors are well encapsulated, and nerve fibers often splay out on the surface but never penetrate the capsule. They have a rare malignant degeneration.Cervicalschwannomas are uncommon, those arising from the cervical Vagal nerve [fig 1,2,3] are extremely rare. We are describing a rare neoplasm cervical vagal schwanoma with a rare presentation of neckmass with chronic cough with newer surgical management technique of nerve preservation which is enucleation and excision.

Key Words: Cervical Vagal Nerve, Schwanoma, Neck Mass,Enucleation, Excision.

[1]. Colreavy MP, Lacy PD, Hughes J, Bouchier-Hayes D, BrennanP, O'Dwyer AJ, et al. Head and Neck schwannomas – a10-year review.JLaryngolOtol 2000;114:119-24.2
[2]. Ford LC, Cruz RM, Rumore GJ, Klein J. Cervical cystic schwannoma of the vagusnerve:Diagnostic and surgicalchallenge. J Otolaryngol 2003;32:61-3. 3
[3]. Green JD, Olsen KD, DeSanto LW, Scheithauer BW (1988)Neoplasms of the vagus nerve. Laryngoscope 98:648–654
[4]. Som P, Sacher M, Stollman A, Biller H, Lawson W (1988)Common tumors of theParapharyngeal space: refined imagingdiagnosis. Radiology 169:81–855.
[5]. Al-Ghamdi S, Black MJ, Lafond G. Extracranial head and neck schwannomas. J Otolaryngol 1992 Jun; 21(3)
[6]. 6.Park CS, Suh KW, Kim CK. Neurilemmomas of the cervical vagus nerve. Head Neck1991;15:439-4111
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[8]. Furukawa M, Furukawa MK, Katoh K, Tsukuda M. Differentiation between schwannoma ofthevagus nerve and schwannoma of the cervical sympathetic chain by imaging diagnosis.Laryngoscope 1996;106:1548-52.

Abstract: Objective: The aim of the present study was to evaluate the serum homocysteine level as a biological marker in Oral sub mucous fibrosis patients. Methods: This was a cross-sectional study conducted in a tertiary care hospital. A total of 50 patients diagnosed with oral sub mucous fibrosis not taking treatment clinically and histologically diagnosed were included in the study. Patients suffering from cardiovascular diseases, osteoporosis, dementia, alzheimer's disease, diabetes, Oral cancer, blood cancer, lung cancer, breast cancer and other malignancies were excluded from the study. Results: The average age of the patients was 34.9 (±9.00) years. Majority were males (94%). More than half (54%) of the patients were in stage II followed by III (36%) and IV (10%). The overall homocysteine level was 24.1 (± 3.3) μmol/lit (Table not shown). The level of homocysteine was similar male and female patients. No females were in stage III. The homocysteine level was higher among the patients of stage IV (31.02±6.33) than stage III (26.98±8.67) and II (25.47±7.72). However, the difference was statistically insignificant (p>0.05). There was no significant difference in the level of homocysteine by gender and clinical staging.

Conclusion: A longitudinal study of larger groups of patients with OSMF is necessary, as are lengthier follow-ups, to define the real role of serum homocysteine..

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Abstract: Human Immunodeficiency Virus (HIV), Hepatitis B Virus (HBV), and Hepatitis C Virus (HCV) are devastating disease agents that share common modes of transmission. This study was aimed at determining the prevalence of hepatitis B and C co-infection rates among HIV patients accessing healthcare at Federal Medical Center Keffi, Nasarawa State, Nigeria. This study lasted between June - December, 2012. A total of 200 sero-positive HIV patients participated in the study at the ART clinic. Blood samples collected routinely were screened for the presence of HBV and HCV. Socio-demographic information was collected by the use of a questionnaire. The study population comprised of 54(27%) males and 146 (73%) females. 11% (22/200) were positive for HBV, 13.5% (27/200) were positive for HCV and 5% (10/200) were positive for both HBV and HCV. The prevalence rates of hepatitis B and C co-infection among the HIV patients was insignificantly different (P>0.05) statistically for sex (P=0.37) and ART status (P=0.57) different for Educational status (P=0.57), Marital status (P=0.09), Age (P=0.99), Occupation (P=0.79), CD4 Count (P=0.96) and socio-demographic factors (P=0.88). The prevalence rates of HBV and HCV co-infection are increasing in patients with HI. Having acquired the knowledge about the importance of such a co-infection, it is essential that all the patients with HIV be screened for HBV and HCV co-infection. Keywords: Serosurvey – Hepatitis/HIV – Co-Infection – Keffi - Nigeria.

[1]. Akwa, V.L., Binbol, N.L., Samaila, K.L., and Marcus, N.D., (2007). Geographical Perspective of Nasarawa State. Onaiv Printing and Publishing Company, Keffi. pp 3

[2]. Alavi S.M, Etemadi A, (2007).HIV/HBV, HIV/HCV and HIV/HLTV Co-infections among injection drug–users patients hospitalized at the infectious disease ward of training hospital in Iran. Park J. Med. Sci: 23: 510-13
[3]. Ameh James, Joseph Okwori, Humphrey Musuluma, Henry Mbah (2012) Hepatitis B and C co-infection among HIV-1 positive individuals in the North-East of Nigeria: prevalence and implication of high risk sexual behaviour in the transmission of hepatitis C virus. Journal of Medicine and Medical Science Vol. 3(12) pp. 784-788. Available online http://www.interesjournals.org/JMMS

[4]. Baba M.M, Gashau W, Hassan A.W (1998). Detection of HBsAg in patient's mirth and `without the manifestations of AIDS in Maiduguri; Nigeria, Niger postgrad. Med. J., 5: 125-8 Disease. Official Journal of the Italian Society of Gastroenterology and the Italian Association for the study of the Liver. 43(1): S57-63

[5]. Chang, M.H. (2008): Hepatitis B Virus Infection; Neonatal Medicine. 12: 160-167.

[6]. Chen, L., Lin, F., Fan, X., Gao, J., Chen, N., Wong, T., Wu, J., Wenz, S.W., (2009): Detection of Hepatitis B Surface Antigen, Hepatitis C Cure Antigen and Hepatitis B Virus DNA in Paratoid Tissues. International Journal of Infectious Diseases.13: 20-23.

[7]. Diop-Ndiaye H, Toure-Kane C, Etard J.F, Lo G, Diaw p, Ngom-Gueye N.F, Gueye P.M, (2008). Hepatitis B, C seroprevalence and delta viruses in HIV -1 Senegalese patients at Haart initiation. J. Med Virology: 80:1332-1336

[9]. Dodig, M., Tarill, A.S. (2001): Hepatitis and HIV Infections. Journal of Gastroenterol. 33: 367-374.

[10]. Ejele, O.A., Erhabor, O., and Nwauche, C.A. (2005): The Risk of Transfusion- Transmission Infection in the Niger-Delta Area of Nigeria. Sahel Medical Journal. 8: 16-19.

Abstract: Day by day there is a definite increase in the number of woman bearing children in their older age. So, elder maternal age has become an important topic in the world wide. But yet it has not received adequate attention in our country. This study has done with an objective to find out problems associated with pregnancy and perinatal outcome in woman 35 years of age and above. It is a comparative study. This study was done in BSMMU from August 2008 to January 2009. A total 1130 obstetric patient were admitted during this study period. From this admitted patient consecutive 35 patients were selected for this study, whose ages were above 35 years. At the same time 35 patients were selected as a control, whose age was below 35 years. Among 35 elderly patients caesarian section was significantly high both in elderly patients (Group A)88.5% & control group(Group B) 63%, followed by vaginal delivery(11.5% Vs 37%). Pregnancy complications were found significantly high in A group (57%) compared to B group(20%). Most common complications observed in group A were APH 14.2%, preeclampsia 11.4%, malpresentation 11.4%, obstructed labour 8.5% oigohydramnions 5.7%.

Keywords: Advanced maternal age, Feto-maternal outcome, High risk pregnancy, Perinatal motility, and post delivery complication.

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