iosr-JDMS   Volume-9 ~ Issue-6

Abstract: Exercise is a common physiological stress which has positive chronotropic effect on heart rate and on cessation heart rate returns to pre-exercise level. A delay in heart rate recovery (HRR) (≤12beats in first minute) is considered abnormal and reflects autonomic dysfunction.Pulmonary function tests (PFT) are good indicator of autonomic function.Few studies are available on abnormal HRR (heart rate recovery) in COPDCases. Hence the present study was taken up to find out the presence of abnormal HRR in subjects with normal PFT and to establish HRR as an independent autonomic marker. For the study 150 healthy young adults (both male and female) with normal PFT were subjected to exercise by Bicycle ergometer till targeted Heart Rate (85%Maximum Heart Rate(MHR)) was achieved. HRR at the end of 1 minute followingcessation of exercise were tabulated. In our study 29 subjects (19.33%) with normal PFT show Abnormal HRR indicating HRR could be an independent autonomic marker.

keyword- PFT,HRR,MHR.

[1]. Hurst's The Heart ValentinFuster, Richard A Walshs , Robert ,A.Harrington ,Thirteenth Edition, McGraw Hill Medical, Vol.1, P.371.
[2]. KlussH.A.Wood.R.H. andWelsch.M.A(2000) Vagal modulation of the heart and central hemodynamics during handgrip exercise.American journal of physiology 279,H1648-H1652.
[3]. Arai.Y.Saul.J.P.Albrecht,P.Hartley,L.H,Lilly,L.s,Cohen, R.J. and Colucci,W.S(1989). Modulation of Cardic autonomic activity during and immediately after exercise. American journal of physiology256,H132-H141.
[4]. Cole CR, Blackstone EH, PashkowFJ,et al. Heart-rate recovery immediately after exercise as a predictor of mortality .N Engl J Med 1999,341:1351-1357.
[5]. NiranjanSeshadri,ThomasR,Gildea,Kevin McCarthy, RCPT, Claire Pothier, Mani S .Kavure and Michael S.Lauer.Association of an abnormal exercise Heart Rate Recovery with Pulmonary Function Abnormalites. Chest/125/4/April,2004.
[6]. La RovereMT,BiggerJT,MarcusFI,et al. Baroreflex sensitivity and Heart Rate variability in prediction of total cardiac mortality after myocardial infraction . Laneet 1998;351:478-484.
[7]. Stewart AG,Waterhosue JC, HowordP.TheQTc interval, autonomic neuropathyand mortality in hypoxemic COPD,Respir Med,1995;89:79-84.
[8]. Stewart AG,Marsh F, Waterhosue JC et al. Autonomic nerve dysfunction in COPD as assed by the acetylcholine sweat spot test .EurRespir J ,1994;7:1090-1095.
[9]. Stewart AG,Waterhosue JC, HowordP.Cardiovascular autonomic nerve function in patients with hypoxemic chronic obstructive pulmonary disease. EurRespir J,1991;4:1207-1214.
[10]. SteinPK,NelsonP,Rottman JN et al.Heart rate variability reflects severity of COPD in Piz Alpha-antitryspindeficiency.Chest 1998;113,327-333.

Abstract: Anthropometry of lip-nose complex has been extensively studied for European population.1-6 However, corresponding studies in case of Indian population are very scarce.3-9 Hence anthropometric study of lip-nose complex was undertaken. This study involves comparison with available data from literature. The objective was to study the morphometry of the nasolabial complex in Indian population.

[1]. Farkas LG, Lindsay, Cleft Craft, 1976;1:36-8.
[2]. Farkas LG, Cheung GCK. Nostril asymmetry: Microform of cleft lip palate? An anthropometrical study of healthy North American Caucasians. Cleft Palate J 1979;16 :351.
[3]. Shah M, Verma IC, Mahadevan S, Puri RK. Facial anthropometry in Newborns in Pondicherry. Indian J Paediatrics 1991;25:259-63.
[4]. Farkas LG, Posnick JC, Hreczko, T.M., and Pron, G.E. Growth patterns of the nasolabial region : A morphophetric study. Cleft Palate Craniofac J 1992;29:318.
[5]. Farkas LG, Hajnis K, Posnick JC. Anthropometric and anthroposcopic findings of the nasal and facial region in cleft patients before and after primary lip and palate repair. Cleft Palate Craniofac J 1993;30:1.
[6]. Farkas LG. Anthropometry of the Head and Face, 2nd Ed. New York : Raven Press 1994.
[7]. Farkas LG, Tompson B, Philips J, Katic M, Cornfoot L. Comparison of Anthropometric and Cephalometic Measurements of the adult Face. Cleft Palate Craniofac 1999;5:10-8.
[8]. Mulliken JB, Burvin R, Leslie G, Farkas LG, Repair of bilateral complete cleft lip: Intraoperative Nasolabial Anthropometry, Plastic and Reconstructive Surgery 2001;107:307-14.
[9]. Prasad NN, Reddy D. Anthropometry: Lip-Nose Complex. Indian Journal of Plastic Surgery 2001;34:3-8.

Abstract: Many organizations across the world have adopted Problem Based learning (PBL) as a small group teaching – learning (T-L) tool. PBL inculcates self directed learning in students. If PBL is included in the curriculum of basic sciences like Physiology, it can help students to apply knowledge of Physiology in clinical practice. So this study is undertaken as a pilot project to introduce PBL as an innovative T-L method in curriculum of Physiology at Dr. Shankarrao Chavan Government Medical College, Nanded. In this study one PBL session was conducted on cardiovascular Physiology in Dept of Physiology at Dr. S.C. Govt. Medical College Nanded, India. An MCQ test was conducted before and after PBL session. Students' perspectives on PBL were studied by taking feedback from the students. Result: Students commented that PBL made the teaching-learning more interesting. Students opined that PBL enabled them for better understanding of the subject and motivated them for self directed learning and to read more. Students also commented that PBL enabled them to remember the subject better and helped to integrate their knowledge. Most of the students expressed a desire and a need to continue PBL sessions in future also.

Keywords: PBL – Problem based learning, Teaching – Learning (T-L) method, Physiology curriculum

[1]. Laeora Berkson. Problem based learning: Have the expectations been met? Academic Medicine, Volume 68, Number 10, October Supplement 1993, 579-588.
[2]. Albanese, M. A., and S. Mitchell. Problem-based learning: a review of literature on its outcomes and mplementation issues. Acad. Med. , 68(1)), January 1993, 52–81,.
[3]. Barrows, H. S. Problem-based learning in medicine and beyond: a brief overview. New Dir. Teach. Learn, 68, 1996, 3–12.
[4]. Medical Council of India: Salient features of Regulations on Graduate Medical Education 1997 [http://www.mciindia.org/know/rules/ rules_mbbs.htm]. accessed Oct 08, 2007
[5]. Schmidt HG. Problem based learning: rationale and description. Med Educ, 17, 1983, 11–16.
[6]. 6. Morrison JM, Murray TS. An experiment in problem based learning. Med Educ, 28, 1994 139–145.

Abstract: 51 patients with unstable intertrochanteric fracture treated with sliding hip screw alone were selected in our retrospective and prospective study for a period of 28 months with an average follow up of minimum 4 months.Lateral femoral wall integrity was assessed in all patients radiologically prior and after surgery and tip apex distance was calculated following DHS fixation as described by Baumgartner et al. 5 out of 51 patients had screw cutout within six months of surgery. In our study, unacceptable TAD combined with loss of lateral femoral wall integrity is a definite indicator of DHS implant cutout. Lateral femoral wall fracture resulted in six times higher risk of a reoperation due to technical failure when gold standard method of sliding hip screw was used. Tip Apex Distance alone was not a reliable indicator for screw cut out.The simple treatment guideline should be if the lateral femoral wall or greater trochanter is fractured, the use of DHS implant must be guarded.

Keywords: Intertrochanteric fracture, lateralfemoralwallintegrity(LFW), zones in femoral head,tipapexdistance(TAD).

[1]. Integrity of the Lateral Femoral Wall in Intertrochanteric Hip Fractures : An Important Predictor of a Reoperation. Henrik Palm. JBJS Am. 2007; 89 : 470-475.
[2]. The value of the tip-apex distance in predicting failure of fixation of peritrochanteric fractures of the hip. MR Baumgaertner. JBJS Am. 1995; 77 : 1058-1064.
[3]. Prediction of Fixation failure after sliding hip screw fixation. Pervez et al. Vowler S. Injury 2004 Oct.; 35(10) : 994-998.
[4]. Bannister, G.C., Gibson, A.G., Ackroyd C.E., Newman, J.H., The fixation and prognosis of trochanteric fractures. A randomized prospective controlled trial.Clin.Orthop. 254:242-246, 1990.
[5]. Bridle, S.H., Patel, A.D.; Bircher M., and Calvert P.T.: Fixation of intertrochanteric fractures of femur. A randomized prospective comparison of the Gamma nail and dynamic hip screw. J.B.J.S. 73-B(2):330-334,1991.
[6]. Clawson, D.K., Trochanteric fractures treated by sliding screw plate fixation method. J. Trauma, 4:737-752, 1964.
[7]. Davis, T.R.C.; Sher, J.L.,; Horsman, A.; Simpson, M., Porter, B.B.; and Checketts, R.G.: Intertrochanteric femoral fractures. Mechanical failure after internal fixation J.B.J.S., 72-B(1) : 26-31, 1989.
[8]. Doherty, J.H., and Lyden, J.P., Intertrochanteric fractures of hip treated with the hip compression screw. Analysis of problems.ClinOrthop., 141:184-187,1979.
[9]. Kaufer, H. : Mechanics of treatment of hip injuries. Clin.Orthop.146 : 53-61, 1980.
[10]. Kyle R.F.; Gustilo, R.B., and Premer R.F. : Analysis of six hundred and twenty two intertrochanteric fractures. A retrospective and prospective study. J.B.J.S. 61-A:216-221, March 1979.

Abstract: Drug-induced nephrotoxicity is an important cause of renal failure. Aminoglycosides throughout the endocytic pathway are taken up into the epithelial cells of the renal proximal tubules and stay there for a long time, which leads to nephrotoxicity. Wistar‐albino male rats weighing 125–150gms, are utilized for the present study.Blood samples were collected with cardiac puncture for biochemical investigations like blood urea, uric acid, creatinine, serum Na, K, Ca, determination.By using one way ANOVA the results are significant at .001. Hyaline cast formation is observed in PCT with atrophic glomeruli effecting half of the cortical region when rats treated with 80mg/kg b.w. administration of Punarnava 400mg and 800mg/kg.bw rejuvenated necrotic cells of kidney .Gentamicin must be given in the lowest effective therapeutic doses in patients with normal kidney function along with punarnava.

Key words: gentamycin, glomeruli, lymphatic infiltration, proximal convoluted tubules, punarnava

[1] Nephrol Dial Transplant. 1994;9 Suppl 4:135-40 Singh RH, Udupa KN. Studies on the Indianindigenous drug Punarnava (Boerhaavia diffusa L.) Part I, Identification and pharmacological studies. J Res Ind Med 1972; 7: 1-12. 25

[2] Gaitonde BB, H. Kulkarn, Nabar SD. Diuretic activity of punarnava (Boerhaavia diffusa). Bull. Haffkine Inst. 1974; 2: 24-25.

[3] Singh RH, Udupa KN. Studies on the Indianindigenous drug Punarnava (Boerhaavia diffusa L.) Part I, Identification and pharmacological studies. J Res Ind Med 1972; 7: 1-12. 25.

[4] Pareta SK, Patra KC, Mazumder PM, Sasmal D. Boerhaavia diffusa linn aqueous extract as curative agent in ethylene glycol induced urolithiasis. Pharmacologyonline 2011; 3: 112-120.)

[5] Mishra J, Singh R. The effect of indigenous drug Boerhaavia diffusa on kidney regeneration. IndJ Pharmacol 1980; 12: 59-64. 24.

[6] Dvipriya S, Shyamaladevim CS. Protective effect of quercetin in cisplatin induced cell injury in the rat kidney. Indian J. Pharmacol. 1999; 31: 422-423.)

[7] Ali,B.H.; Al-Qarawi, A.A.; Haroun,E.M. and Mousa, H.M.(2003): The effect of treatment with gum arabic on gentamicin nephrotoxicity in rats Ren Fail., 25(1):15-20. [8] Goto, A.M. (2004): "The role of lipid coronary heart disease" Kalamazoo, M. I. Upjhion Company

[9] Heibashy, M.I.A.; El-Nahla, A.M.; Ibrahim, A.I. and Saleh, Sh.Y.A. (2009): Comparative study between dimethyl sulfoxide (DMSO),allopurinol and urate oxidase administration in nephrotoxic rats induced with gentamicin. 43rd Annual Veterinary Medical Symposium, College of Veterinary Medicine Nursing and Allied Health, Tuskegee University, Alabama, USA

[10] Heibashy, M. I. A. and Abdel Moneim, A. E. (1999): Kidney and liver function tests after late Dimethyl sulfoxide (DMSO) administration in rats with gentamicin induced acute renal failure. J. Egypt. Ger. Soc. Zool., 30(A): 35-48.

Abstract: To compare the incidence of feto-maternal complications of pregnancy and labor between grandmultiparas and multiparous women. Material and Methods: This prospective study was carried out in the Departments of Obstetrics and Gynaecology in two hospitals in Khartoum state (Omdurman Maternity Hospital, and Khartoum North Teaching Hospital), in the period from January 2010 to June 2010. A total of 450 deliveries in the two hospital were divided in two groups (150 grandmultiparas and 300 multiparas) in whom the maternal and fetal outcomes were analyzed and compared.

Keyword: grandmultipara, multiparous, maternal outcome, fetal outcome, placenta previa, abrubtio placentae,caesarean section.

[1]. B Solomons, the dangerous multgipara. Lancet 2 (1934), pp 8-11.
[2]. PA King, SJ Duthie and HK Ma, Grandmultiparity: a reappraisal of risks. Int. J Gynaecol Obstet 36 (1994), pp 13-16.
[3]. DS Seidman, Y Armor, D Roff, DK Stevenson and R Gale , Grand multiparity: an obstetric or neonatal risk factor?. Am J Obstet Gynecol 158 (1988), pp. 1034–1039. View Record in Scopus | Cited By in Scopus (25).
[4]. A Eidelman, R Kamar, MS Schimmel and B Eichanan , The grandmultipara: is she still at risk?. Am J Obstet Gynecol 158 (1988), pp. 389–392. View Record in Scopus | Cited By in Scopus (29).
[5]. K Fuchs, BA Peretz, R Marcovic and I Timor-Tritsch , The grandmultipara: is it a problem? A review of 5,785 cases. Int J Gynaecol Obstet 23 (1985), pp. 321–325. View Record in Scopus | Cited By in Scopus (40).
[6]. A Samueloff, S Mor-Yosef, D Seidman, R Rabinowitz, A Simon and J Schenker , Grand multiparity: a nationwide survey. Isr J Med Sci 25 (1989), pp. 625–629. View Record in Scopus | Cited By in Scopus (18).
[7]. Toohey JS, Keegan KA, Morgan MA, Francis J, Task S, deVeciana M. The ―dangerous multipara‖: fact or fiction? Am J Obstet Gynecol 1995;172:683–6. Buy Now [Context Link].
[8]. Babinszki A, Kerenyi T, Torok O, Grazi V, Lapinski RH, Berkowitz RL. Perinatal outcome in grand and great-grand multiparity: effects of parity on obstetric risk factors. Am J Obstet Gynecol 1999;181:669–74. Buy Now [Context Link].
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Abstract: Honey is a natural product of bees containing numerous nutrients that have significant benefits to human race. These benefits stretch across from its antiseptic, antibacterial, and wound healing properties to its possible sex boosting properties. Due to environmental, nutritional, behavioral and physiological factors, male infertility has become an ubiquitous issue over the world. This study therefore investigates the effect of honey on some sperm parameters in rats. Eighteen adult male rats weighing 130g-165g were used for this study. They were randomly divided into three groups with group A serving as the control; group B served as the standard group treated with a standard drug (622mg/kg); and group C was treated with honey (1ml of honey per 100g of body weight). They were treated for 65 days thereafter, the sperm count, motility, and morphology were evaluated. The mean value of the sperm count of group C rats (130.5±7.50 x106/ml) was significantly higher than the group B rats (104.3±3.48 x106/ml) and the group A rats (93.5± x106/ml) at p<0.05. The sperm motility of group C animals, 85 ± 5.0%, was significantly higher (p<0.05) when compared to group B animals, 33.3 ± 3.33%, and group A animals, 75 ± 5.0%. The percentage of abnormal sperm was reduced in group C rats (5%) as compared to group B (8.3%) and group A rats (10%). This study showed that honey increases the sperm count, the sperm motility and improves the sperm morphology. Thus it serves as a potential fertility booster in experimental animals.

Keywords: Fertility, Honey, Sperm morphology, Sperm motility, Sperm count,

[1] Johansson M, Hellström A, Berg M :Severe male infertility after failed ICSI Treatment-a phenomenological study of men's experiences Reproductive Health, :2011., vol 8 iss 4 pg 1

[2] Nygren K G and Zegers-Huchschud F : Documentation of infertility prevalence, treatment access and treatment outcomes in developing countries. Oxford Journals: ESHRE monographs. 2008, issue 1, pg 5-7.

[3] Boivin J, Bunting L, Collins J A. and Nygren K G.: International estimates of infertility prevalence and treatment-seeking: potential need and demand for infertility medical care. Human Reproduction 2007;Vol.22, No.6 pp. 1506– 1512

[4] Rubeinstein J; Brannigan R.E Male infertility. Medscape reference copyright 1994-2012. All rights reserved.

[5] Mahaneem M, Sulaiman S A, Jaafar H 3, Sirajudeen K N S, Ismail Z I M and Islam N M Effect of Honey on Testicular Functions in Rats Exposed to Cigarette Smoke. Journal of ApiProduct and ApiMedical Science 2010;vol 3 iss 1: pg 12 - 17

[6] Carangelo L, . Infertility cures (instead of adoption). Americans for open records. ©2001, 2002 ISBN# 0-942605-23-3. All rights reserved

[7] Bradley R. Raw Honey and Cinnamon, 2010. © One 80 Turn LLC.

[8] National Honey Board (2002) Honey-health and therapeutic qualities. Copyright © 2009 National Honey Board, All Rights Reserved

[9] Estevinho, L.; Pereira, A.; Moreira, L.; Dias, L.; Pereira, E Antioxidant and antimicrobial effects of phenolic compounds extracts of Northeast Portugalhoney. Food and Chemical Toxicology ; . 2008:.46: 3774-3779

[10] Syazana N.S., Hashida N.H. , Majid A.M., Durriyyah H.A. Sharifah , Kamaruddin M.Y Effects of Gelam Honey on Sperm Quality and Testis of Rat Sains Malaysiana. ;2011: vol 40 iss 11 pg 1243–1246

Abstract: Class III malocclusions are usually growth-related discrepancies & are associated with deviation in the sagittal relationship of the maxilla and the mandible, characterized by a deficiency and/or a backward position of the maxilla, or by prognathism and/or forward position of the mandible or both1,2,3. A class III malocclusion is defined by the presence of a class III molar and incisor relationship, which may range from a reduced overjet or edge-to-edge incisor relationship to a frank reversed overjet, the severity typically reflecting the underlying skeletal pattern1,4. Treatment planning in class III cases is notoriously difficult and primarily influenced by the likelihood of future growth , skeletal discrepancy, size of the reverse overjet, extent of crowding, and degree of existing dento-alveolar compensation.

[1]. Proffit WR. Contemporary Orthodontics. 4th ed. St Louis, Mo: Mosby; 2007:689–707.
[2]. Guyer EC, Ellis EE, McNamara JA Jr, Behrents RG. Components of Class III malocclusion in juveniles and adolescents. Angle Orthod
1986; 56: 7–30.[Medline]
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Orthop 1986; 89: 302–11.
[4]. Moyers, R.E. Handbook of Orthodontics, 3rd Ed. Year Book Medical Publishers, Inc; Chicago, 1983, 574-77.
[5]. Bhalajhi S.I, Orthodontics- The Art and Science. 3rd Ed., Anja (Med) Publishing House , chap20 , pg. 233 .
[6]. Pinkham J.R , Pediatric Dentistry- Infancy through Adolescence , 4th Edition, Elseveir , a division of Reed Elsevier India Pvt. Ltd.
2005 , chapter 35, pg. 642-644.
[7]. Baccetti T, McGill JS, Franchi L, McNamara JA Jr, Tollaro I. Skeletal effects of early treatment of Class III malocclusion
with maxillary expansion and face-mask therapy. Am J Orthod Dentofacial Orthop. 1998;113:333–343.
[8]. Kajiyama K, Murakami T, Suzuki A. Evaluation of the modified maxillary protractor applied to Class III malocclusion with
retruded maxilla in early mixed dentition. Am J Orthod Dentofac Orthop. 2000;118:549–559.
[9]. Yuksel S, Ucem TT, Keykubat A. Early and late facemasktherapy. Eur J Orthod. 2001;23:559–568.
[10]. Popp TW, Gooris CGM, Schur AJ. Nonsurgical treatment for a Class III dental relationship: a case report Am J Orthod Dentofac
Orthop 1993; 103: 203–11.[Medline]

Abstract: The essence of orthodontic treatment is the movement of teeth throughbone to obtain a more perfect dental occlusion. Mechanical forces exerted ontooth and transmitted to the surrounding tissues of periodontal ligament initiates the remodeling activity and facilitates the movement of teeth through bone. Cells of the nervous , immune and endocrine systems become involved in the activation and response of periodontal ligament and alveolar bone cells during tooth movement.Orthodontic tooth movement has an inflammatory response and so evokes painwhich is the most unpleasant symptom which drives the patient to seek medicaments. Analgesic drugs are commonly prescribed in day to day orthodontic practice to control pain evoked by orthodontic forces. These drugs are also available as OTC ( over-the –counter) drugs and can be bought from medical shops without prescription.

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[9]. Davidovitch & Shanfeld : Cyclic AMP level in alveolar bone of orthodontically treated cats.
[10]. Feldman R. S. et al : Inhibition of alveolarbone loss in humans by aspirin . J. Dent. Resc.59 ; Special issue A; 1980.

Abstract: The study aimed to ascertain the efficacy of oropharyngeal topical 10% lignocaine spray applied prior to induction of anaesthesia and also to determine the optimal time for spraying to attenuate pressor response to laryngoscopy and endotracheal intubation. 80 patients of either sex, in the age group of 20-60 years (ASA I & II) undergoing different elective surgical procedures under general anaesthesia were taken up for the study. 10 puffs of Lignocaine 10% sprayed 1 min before induction in Group I, 3 min before induction in Group 2, 5 min before induction in Group 3 and normal Saline in Group 4 as control. Heart rate(HR), systolic (SBP), diastolic (DBP) and mean arterial pressure (MAP) were measured at baseline, after intubation, after 1min, 3 min and 5 min following intubation. There was statistically significant increase in HR, systolic, diastolic and MAP in control group when compared to baseline as well as to study groups. Following laryngoscopy and intubation attenuation of pressor response did not show a significant difference at 1min, 3min and 5min of 10% lignocaine spray within study groups. Lignocaine 10% when sprayed to the oropharynx prior to induction of anaesthesia attenuated the pressor response to laryngoscopy and intubation irrespective of timing of the spray.

Keywords: Endotracheal Intubation, Lignocaine spray (10%), Laryngoscopy, Pressor response, Systolic Blood pressure (SBP), Diastolic blood pressure (DBP), Mean arterial pressure (MAP).

[1]. Hassan, H. G., El-Sharkawy, T. Y., Renck, H., Mansour, G. and Fouda, A. (1991), Hemodynamic and catecholamine responses to laryngoscopy with vs. without endotracheal intubation. Acta Anaesthesiologica Scandinavica, 35: 442–447. doi: 10.1111/j.1399-6576.1991.tb03325.x.
[2]. Mi WD, Sakai T, Takahashi S, Matsuki A,Haemodynamic and electroencephalograph responses to intubation during induction with propofol or propofol/fentanyl. Can J Anaesth 1998; 45:19.
[3]. Wilson IG, Meiklejohn BH, Smith G: Intravenous lignocaine and sympathoadrenal responses to laryngoscopy and intubation. The effect of varying time of injection. Anaesthesia. 1991 Mar;46(3):177-180.
[4]. Shribman AJ, Smith G, Achola KJ: Cardiovascular and catecholamine responses to laryngoscopy with and without tracheal intubation. Br J Anaesth 1987; 59:295.

[5]. King BD, Harris LC, Greifenstein FE, Elder JD, Dripps RD. Reflex circulatory responses to direct laryngoscopy and tracheal intubation performed during general anesthesia. Anesthesiology 1951; 12:556-566.

[6]. Stoelting RK. Circulatory changes during direct laryngosocpy and tracheal intubation - influence of duration of laryngoscopy with or without prior lidocaine. Anesthesiology 1977; 47(4): 381-384.

[7]. RavalDipak L., Mehta Malini K. Oral clonidine pre medication for attenuation of haemodynamic response to laryngoscopy and intubation.Indian J. Anaesth. 2002; 46 (2) : 124-124.

[8]. Carabine UA, Allen RW, Moore J. Partial attenuation of the pressor response to endotracheal intubation. A comparison of the effects of intravenous clonidine and fentanyl. Eur J Anaesthesiol. 1992 Jul;9(4):325-329.

[9]. Vucevic M, Purdy GM, Ellis FR. Esmolol hydrochloride for management of the cardiovascular stress responses to laryngoscopy and tracheal intubation. Br J Anaesth1992; 68: 529-530.

[10]. Braude N, Clements EAF, Hodges UM, Andrews BP. The pressor response and laryngeal mask insertion - a comparison with tracheal intubation Anaesthesia, 1989; 44: 551-554.

Abstract: Preterm birth represents a major problem in the world because of its increasing frequency and accompanying socioeconomic impact. Globally prematurity is the leading cause of newborn deaths and now the second leading cause of death after pneumonia under age of five. Periodontitis and adverse pregnancy outcomes may be linked through a chronic, systemic inflammatory challenge to the mother and fetus in response to pathogens. Several studies in the past have demonstrated an association between infection and preterm birth. However several other risk factors need to be considered. The principle reasons cited for the continued high rate of preterm and low birth weight is poor understanding of the risk factors associated. This article explains the association between preterm birth and periodontitis by stating various complications of preterm birth, pathophisiology of the associated risk factors like bacterial infection, viral infection, gene polymorphism, adaptive immune responses, preeclampsia. The early diagnostic predictors in the form of biomarkers and the effect of periodontal therapy in preventing the preterm birth are discussed. As Peridontitis is an important risk factor for preterm birth there is a need to expand preventive measures during pregnancy to avoid this adverse effect.

Keywords: adversepregnancyoutcome, lowbirthweight, periodontitis, pretermbirth.

[1] WHO-International statistical of diseases and related health problems.Tenth vision. Geneva: WHO 1992.
[2] Bryan S.Michalowtz and Robert Dwand,Maternal periodontal disease and spontaneous preterm birth, Periodontology 2000,44, 2007,103-112.
[3] W.Kim Seow MDSc, DDSc, Phd, FRACDS, Effect of preterm birth on oral growth and development, Australian dental journal, 42(2) ,1997,85-91.
[4] AN Guimaraes, AS Mato, LO Miranda Cota, FM Siqueira and FO corta, Maternal periodontal disease and preterm or extreme preterm birth: An ordinal logistic regression analysis, Journal of Periodontology, 81(3), 2010, 350-358.
[5] LA.Schieve, A.Handler, R.Hershow, V.Persky, F.Davis, Urinary tract infection during pregnancy, its association with maternal morbidity and perinatal outcome, American journal of publichealth, 84(3), 1994, 405-410.
[6] J.K.Baskaradoss, A.Geevarghese, V.R.Kutty,Maternal Periodontal status and preterm delivery a hospital based case control study, Journal of periodontal research, 46(5), 2011, 542-549.
[7] Lorief. Cram, Maria-Isabel Zapata, Eugene C. Toy, and Benton Baker Am Fam Physician. 2002 Jan 15;65(2):241-249.,.
[8] Auro Heimonen, Sok-ja-Janket, Risto Kajaa, Leland K Ackerson, Preetika Muthukrishnan, Jukka H.mausman, Oral inflammatory burden and preterm birth, Journal of Periodontology, 80(6),2009, 884-891.
[9] Hui-chen chan, Chen-trai Wu, Kathleen B.Welch, and Watter J.Loeshe, Periodontal disease activity measured by the Benzoyl-DL-Arginine Naphthilamide test is associated with preterm births, Journal of Periodontology, 81(7), 2010, 982-991.
[10] SA.Santos Pareira, Gealdo.PC, Eduardo Saba, RLG Amaral, SS Morais, AM Gonlalalics, Chronic Periodontitis and preterm labour on Brazilian pregnant women : an association to be analyzed. Journal of clinical Periodontology, 34(3), 2007, 208-213.

Abstract: Obstructive Sleep Apnea is caused by an interplay between a variety of factors, including sleep related loss of muscle tone in the tissues supplied by the glossopharyngeal nerve,, anatomical obstruction of the nasal passages, large tonsils, large tongue, a retrognathic Mandible, obesity, alcohol, sedative medication, allergies. The orthodontic approach is intended to provide patients with immediate relief from OSA, as well as changes to the airway that may address an underlying cause. It can be treated using surgery, continuous positive airway pressure and oral appliances therapy. This article review some of the basic aspects of this sleep-related disorder, its diagnosis and treatment modalities.

Keywords: Orthodontics, Obstructive Sleep Apnea, mandibular advancement, Oral appliance, CPAP

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