iosr-JDMS   Volume-16 ~ Issue-10 ~ October-2017

Abstract: Introduction: Anal fissures are considered one of the commonest causes of severe anal pain. An anal Fissure (synonym: fissure-in-ano) is a longitudinal split in the anoderm of the distal anal canal which extends from the anal verge proximally towards, but not beyond, the dentate line. Materials and methods Prospective Longitudinal Comparative Study including Patients with anal fissure coming to the outpatient department in Tertiary Care Teaching Hospital during the period of september 2014 to November 2016. Sample size: 80 patients( 40 each group)...........

Keywords –Anal Fissure, Diltiazem, Sphicterotomy, Sentinel Pile

[1]. Bailey And Love's Short Practice Of Surgery 26th Ed- 72: 1248-1249
[2]. Farquharson's Textbook Of Operative General Surgery, 10E – 24:442
[3]. Ganongs Review of Medical Physiology, 24E (2012)
[4]. Scouten WR, Et Al. Ischemic Nature Of Anal Fissure. British Journal Of Surgery. 1996;83:63–65.
[5]. Tocchi Adriano, Mazzonigianluca, Miccini Michelangelo, Cassini Diletta, BettelliElia, BrozzettiStefania. Total Lateral Sphincterotomy For Anal Fissure. International Journal Of Colorectal Disease.2004;19(3):245–49.

Abstract: Introduction: Carcinoma of the penis is an uncommon tumor that is often devastating for the patient. Though it is of very low incidence in some western countries; it is not uncommon in India. Wide variation in frequency of carcinoma of penis was observed.The disease appears more common in south Indian subcontinent. Smegma that collects in prepucial sac is deemed the important causative factor and penile cancer is rare among neonatally circumcised individuals. Human papilloma virus infections,multiple sexual partners, venereal diseases, smoking, premalignant cutaneous lesions, penile trauma, and ultraviolet radiation are considered as etiological factors............

Key words:Carcinoma, Inguinal Node, Penis, Smegma

[1]. Shammas FV, Ous S, Fossa SD. Cisplatin and 5-fluorouracil in advanced cancer of the penis.
[2]. J Urol 1992 Mar;147(3):630-32.
[3]. Sarada Budamala, P. Venkataramana, N. V. Ramanaiah, B. Anuradha, B. Srihari Rao, C. Srikanth Reddy. "Clinico-Pathological Study of Carcinoma of Penis". Journal of Evidence based Medicine and Healthcare; Volume 2, Issue 19, May11, 2015; Page: 2897-2905
[4]. Althaf S, Narayanakar RP, Gangaiah DM, Dev K, Kurpad VP, Gurawalia J. Inguinal Lymph Nodes in Carcinoma Penis-Observation or Surgery? Journal of Clinical and Diagnostic Research : JCDR. 2016;10(1):XC01-XC04. doi:10.7860/JCDR/2016/15064.7040.
[5]. J C Soria et a1. Squamous cell carcinoma of the penis: Multivariate analysis of prognostic factors and natural history in a mono centric study with a conservative policy. Annals of Oncology 8: 1089-1098, 1997.

Abstract: Worldwide, hypertension (HTN) is estimated to cause 7.5 million deaths, about12.8% of total of all annual deaths. It is one of the most important risk factors for cardiovascular diseases and other clinical outcomes. In India prevalence of HTN varies from 17% to 20 %, in all the states with marginal rural-urban difference. Essential hypertension accounts for more than 90% of cases of hypertension. Aim & objective: The present study was carried out with the objective to find out correlation between inflammatory marker like fibrinogen and paraoxonase 1 in hypertension . Methods: The study was carried out on 90 hypertensive patients and 90 normotensive controls. Cases with diabetes mellitus, thyroid disease, chronic kidney disease, smoking, autoimmune diseases and any other chronic diseases are excluded. The study was approved by Institutional ethical committee. Informed consent was obtained from all cases. Serum PON 1 was estimated by ELISA method............

Key words:Primary hypertension, serum paraoxonase 1, plasma fibrinogen.

[1]. WHO 2011 global statistical report on non-communicable diseases 2010.
[2]. Jena D, Devi N, Jena I,Mishra P.K,Padhy R.K.Study of oxidative stress and serum paraoxonase 1 in essential hypertension International journal of current research. 2017;9(3):48004-48007.

[3]. Ridker PM, Buring JE, Shih J, Matias M, Hennekens CH. Prospective study of C-reactive protein and the risk of future cardiovascular events in apparently healthy women. Circulation 1998; 98:731–733.

[4]. Blake JH, Rifai N, Buring JE, Ridker PM. Blood pressure, C-reactive protein, and risk of future cardiovascular events. Circulation 2003; 108:2993–2999.
[5]. McMillan DE. The microcirculation: Changes in diabetes mellitus (Editorial). Mayo Clinic Proct 1988;63:517-20.

Abstract: To assess the psychosocial stress in medical students (cadre-based) through interview based assessment. Methods: This prospective cross-sectional pilot study was conducted in Jawaharlal Nehru Medical College of Datta Meghe Institute of Medical Sciences (DMIMS) (Grade "A" Accredited by NAAC), Sawangi (Meghe), Wardha. Undergraduate and Postgraduate students of various departments of JNMC were assessed. The subjects were interviewed via a questionnaire, i.e. the Perceived Stress Scale questionnaire (PSS), on the basis of which their stress levels were evaluated. Malondialdehyde (MDA) and Superoxide dismutase (SOD) levels will be assessed in the samples which will indicate the level of oxidative damage. The MDA and SOD levels were compared with the results of the psychosocial stress evaluation test............

Key words: Malondialdehyde, MDA, Superoxide dismutase, SOD, PSS

[1]. Bierhaus A, Humpert PM, Nawroth PP. NF-kappaB as a molecular link between psychosocial stress and organ dysfunction. Pediatr Nephrol 2004; 19: 1189-91.
[2]. Tyagi N, Sedoris KC, Steed M, Ovechkin AV, Moshal KS, Tyagi SC. Mechanisms of homocysteine-induced oxidative stress. Am J Physiol Heart Circ Physiol 2005; 289: H2649-56.
[3]. Hapuarachchi JR, Chalmers AH, Winefield AH, Blake-Mortimer JS.Changes in clinically relevant metabolites with psychological stress parameters.Behav Med 2003; 29: 52-9.
[4]. Familoni OB. "An overview of stress in medical practice". Afr Health Sci. March 2008; 8(1): 6-7
[5]. Firth-Cozens J. "Doctors, their wellbeing, and their stress". BMJ March 2003; 326:670.

Abstract: Health care workers (HCWs) have been known to be an important source for nosocomial transmission of Methicillin Resistant Staphylococcus aureus (MRSA) to hospitalised patients. Screening for MRSA among the HCWs is therefore an essential element of hospital infection control policy. With this aim, the following study was undertaken. A total of 100 health care workers (HCW's) were included in the study.The HCW's comprised of Doctors, Nurses, Nursing students, Ward boy/girl/Cleaner and Laboratory Technicians from various Intensive care units and clinical wards of GMCH.100 nasal and hand swabs each were collected from the 100 HCWs. Following the identification of S.aureus, methcillin resistance was detected by cefoxitin disc diffusion method as per current CLSI Guidelines...........

Key words: Nasal carriage, Hand carriage, Health care workers, MRSA

[1]. Sharon J.Peacock et al. Staphylococcus. Topley and Wilson's Microbiology and Microbial infections. 2nd edition, Wilsey Blackwel:1-62
[2]. Williams, R. E. O. 1963. Healthy carriage of Staphylococcus aureus: its prevalence and importance. Bacteriol. Rev. 27:56–71.

[3]. Moellering RC JR. Problems with antimicrobial resistance in gram-positive cocci. Clin Infect Dis. 1998; 26 :1177–8. [PubMed]

[4]. Taiwo SS. Methicillin resistance in Staphylococcus aureus: a review of the molecular epidemiology, clinical significance and laboratory detection methods. West Afr J Med. 2009; 28: 281–90. [PubMed]

[5]. Philippe Berthelot, Florence; Pascal F, ChristineF, Martine Moulin, Marie Pierre Lt, Georges T, Frédéric L, Bruno P (2003). Implication of a Healthcare Worker with Chronic Skin Disease in the Transmission of an Epidemic Strain of Methicillin-Resistant Staphylococcus aureus in a Pediatric Intensive Care Unit. Infection Cont Hosp Epidemiol; 24(4) 199-303.

Abstract: Overall 5.1% of the global burden of the disease and injury is attributed to alcohol as measured by DALY1. As well as in India, according to national mental health survey (2014) 2 there is a high prevalence of substance use disorders (SUDs) which account for 22.4 % and the prevalence of alcohol use disorder (dependence and harmful use/alcohol abuse) was 4.6%. According to the ICD-10, the alcohol dependence is a cluster of physiological, behavioral, and cognitive phenomena in which the use of a substance takes on a much higher priority for a given individual than other behaviors that once had greater value. Variety of factors both at individual and society level affect the initiation, pattern of drinking and continuation of its use.Genetic (biological vulnerability), psychological and environmental factors influence use of psychoactive substances in wide range of population. The personality factors may influence use of drugs at several levels which might affect the chances of relapse and subsequent outcome in alcohol............

[1]. Global Status Report on Alcohol and Health, 2014. Geneva: World Health Organization, 2014.

[2]. Murthy, Rsrinivasa. "National Mental Health Survey of India 2015–2016." Indian Journal of Psychiatry 59.1 (2017): 21.

[3]. Malouff, John M., Einar B. Thorsteinsson, Sally E. Rooke, and Nicola S. Schutte. "Alcohol Involvement and the Five-Factor Model of Personality: A Meta-Analysis." Journal of Drug Education 37.3 (2007): 277-94.

4]. Mccrae, Robert R., and Paul T. Costa. "A Contemplated Revision of the NEO Five-Factor Inventory." Personality and Individual Differences 36.3 (2004): 587-96.

[5]. Dubey, Charu, et al. "Five factor correlates: A comparison of substance abusers and non-substance abusers." Journal of the Indian Academy of Applied Psychology 36.1 (2010): 107-114..

Abstract: Aim of the study: The study was done to know the spectrum of cases presenting with hematological and non hematological disorders which are diagnosed by bone marrow aspiration. Materials and Methods: This was a 2 1/2 years retrospective study of bone marrow aspiration done on patients with hematological disorders in department of pathology Rangaraya medical college kakinada from January 2015to june 2017.All details of patients were obtained from the record file in the department of pathology. Results:Bone marrow aspiration from 344 patients were analyzed. Nutritional anemia contributed highest number of cases among hematologic non malignant cases. Acute myeloid leukemia was the commonest malignant hematological disorder in present study. Among 344 cases 174 cases were males and 170 cases were female patients with highest number of cases in the age group of 0-10years. Conclusion: Although bone marrow examination is an invasive procedure this is well tolerated by patients. The examination helps in many cases to arrive at a final diagnosis within a short span of time.

Key words: Bone marrow aspiration, hematological disorders

[1]. Rahim F, Ahmad I, Islam S, Hussain M, Khattak TA, Bano Q. Spectrum of hematological disorders in children observed in 424 consecutive bone marrow aspirations/biopsies. Pak J Med Sci 2005;21:433-6.
[2]. Shastry SM, Kolte SS. Spectrum of hematological disorders observed in one hundred and ten consecutive bone marrow aspirations and biopsie. Med. J. Dr. D.Y. Patil Univ. 2012; 5(2):118-121.
[3]. Bates I. Dacie and Lewis Practical Haematology. In: Mitchell Lewis, Barbara Bain, Imelda Bates, editors. Bone marrowbiopsy. 10th ed. Philadelphia: Churchill Livingstone; 2011. p. 115-30.
[4]. Young NS, Abkowitz JL, Luzzatto L. New Insights into the Pathophysiology of Acquired Cytopenias. Hematology Am SocHematol Educ Program 2000:18-38.
[5]. Niazi M, Raziq FI. The incidence of underlying pathology in pancytopenia- an experience of 89 cases. JPMI 2004;18:76-9.

Abstract: Background: Disability associated with psychiatric illness is a major contributory factor to the global burden of the disease. Among other mental illnesses, Major Depressive Disorder and Alcohol Use Disorder emerge a great challenge with their extensive disabilities in various aspects of life. Henceforth assessment of nature and level of disability of this two disease groups stands for prime importance. Materials and Method: It is a hospital based , cross – sectional study conducted in Psychiatry Department , Assam Medical College And Hospital ,Dibrugarh . Samples were Major Depressive Disorder ( n= 30) and Alcohol Use Disorder (n = 30).The various tools used were ICD-10 Classification of Mental and Behavioural Disorders Clinical Descriptions and Diagnostic Guidelines to diagnose......

Key words:Major Depressive Disorder , Alcohol Use Disorder, Disbility , Severity of Illness

[1]. Murray C, Lopez AD (1996): The global burden of disease, A comprehensive assessment of mortality and disability from diseases, injuries and risk factors in 1990 and projected to 2020: Cambridge M A, Harvard School of Public Health on behalf of the World Health Organization and the World Bank (Global Burden of Disease and Injury Series)
[2]. Benegal V, Murthy P, Shantala A, Janakiramiah N (2001): Alcohol related problems. A manual for medical officers: NIMHANS Publication No. 41, ISBN 81-900 992-4-8.
[3]. Brennan P L, Moos R H, Kelly K M (1994): Spouses of late life problem drinkers: Functioning, coping responses, and family cotexts; Journal of Family Psychology 8: 447 – 457
[4]. Chaturvedi S K, Rajashekhar K, Desai M, Murthy P (2000): Quality of life in alcoholism. Chaturvedi S K, Chandra P S (Eds) NIMHANS. Bangalore. ISBN 81-900992–2-1.
[5]. World Health Organization (1992): ICD – 10 Classification of mental and behavioural disorders - clinical descriptions and diagnostic guidelines: world health organization, Geneva.

Abstract: Context and background: Cytological grading of thyroid swelling, which is a simple, feasible and reproducible method, can be used as tool for selection of treatment modality. The National Cancer Institute, Bethesda introduced one guideline for reporting of thyroid cytology and thus helps in individualised treatment. Aims & Objectives: 1) To establish the validity and reliability of The Bethesda System of cytological grading in diagnosis of thyroid swelling, 2) To calculate malignancy risk.........

Key words:Fine needle aspiration, thyroid, Bethesda

[1]. Baloch ZW, LiVolsi VA, Asa SL, Rosai J, Merino MJ, Randolph G et al. Diagnostic terminology and morphologic criteria for cytologic diagnosis of thyroid lesions: a synopsis of the National Cancer Institute Thyroid Fine-Needle Aspiration State of the Science Conference. Diagn Cytopathol. 2008;6:425–37.
[2]. Soderstrom NJ, Berman LH, Grant JW. US guided core needle biopsy of the thyroid gland. Radiology 2003; 226: 827-32.
[3]. Lowhagen T, Willems J, Lundell G, Sundblad R, Granberg P. Aspiration biopsy cytology in diagnosis of thyroid cancer. World J Surg .1981; 5: 61-73.
[4]. Al-Sayer HM, Krukowski ZH, Williams VMM, Matheson NA. Fine needle aspiration cytology in isolated thyroid swellings: a prospective two year evaluation. BMJ 1985; 290: 1490-2.
[5]. Verma AK, Kohli S, Mehra P, Singhal A, Narang S, Kumar V. Correlation of sonographic criteria with Bethesda system of thyroid cytopathology reporting in thyroid nodules. Indian Journal of Basic and Applied Medical Research. 2014; 3:582-92..

Abstract: Varicose veins of lower limbs instead of conducting blood upwards, back to heart, conduct blood downward in reversed fashion, back to foot. The management depends on the severity and whether the deep system is involved or superficial system is involved. The authors have treated 100 patients of varicose veins using foam sclerotherapy with good results and without any significant complications.

Key words:Varicose veins, Foam sclerotherapy, OPD treatment

[1]. Scurr JH, Coleridge-Smith PD. Venous disorders. In: Russel RCG, Williams NS, Bulstrode CJK editors. Bailey and love,s Short Practice of Surgery.23rd ed.London:Arnold;2000.p.235-55.
[2]. Burkitt DP, Liem TK, Monete GL. Venous and lymphatic diseases. In: Brunicardi FC, Anderson DK, Billair TR, Dunn DL, Hunter JG, Pollock RE, editors. Schwartz's principles of surgery.9th ed. USA. McGraw-Hill Companies;2009.p.821-7.
[3]. Leach BC, Gold MP. Venous digest. Dermatol Surg 2003;29:612-5.
[4]. Everett YL, Mary EG, Gregory LM. Venous and lymphatic diseases. In: Brunicardi FC, Anderson DK, Billair TR, Dunn DL, Hunter JG, Pollock RE, editors. Schwartz,s principles of surgery 8th ed. Philadelphia: McGraw-Hill;2009.p.821.
[5]. Zimmet SE. Sclerotherapy treatment of telangiectasias and varicose veins. Tech Vase Internet Radio 2003; 6(3):116-20..

Abstract: 29 year old female presented with history of missed copper-T. On evaluation with ultrasound, it was found in intrabdominal cavity. Successful laparoscopic retrieval of copper-T was done under general anesthesia.

Key words:Copper-T, Ultrasound, Laparoscopy

[1]. Hatcher RA, Trussell J, Stewart F, et al: Contraceptive Technology, 16th revised ed.New York, Irvington Publishers, 1994, p 371.
[2]. Treiman K, Liskin L: IUDs - A New Look. Population reports series B no. 5. Baltimore, Population Information Program, Center for Communication Programs, Johns Hopkins University, 1988 (reprinted April 1989)
[3]. Ohana E, Sheiner E, Leron E, et al: Appendix perforation by an intrauterine contraceptive device. Eur J Obstet Gynecol Reprod Biol 88(2):129 - 131, 2000.
[4]. Sarkar P: Translocation of a copper 7 intra-uterine contraceptive device with subsequent penetration of the caecum: Case report and review. Br J Fam Plan 26(3):161, 2000.

Abstract: Background: Palmaris longus (PL) has received a growing interest because of its role in constructive surgery. As the agenesis of PL shows a strong racial variation, its prevalence in Eastern India will further confirm this phenomenon. Methods: A total of 600 subjects comprising 335 males and 265 females aged 8 - 60years were studied to assess the prevalence of agenesis of the PL in the population of Eastern India. Results: The overall prevalence of absence both unilaterally and bilaterally in the two sexes was 2% which includes 0.5% in males & 1.5% in females. In males, unilateral absence was 0.33% & bilateral absence was 0.16%. In females, unilateral absence was 1% & bilateral absence was 0.5..........

Key words: Palmaris longus, constructive surgery, agenesis, prevalence.

[1]. McMinn RMH. Last's Anatomy Regional and Applied. 9th ed. Edinburgh: Churchill Livingstone; 1994
[2]. Williams PL. Warwick R, Dyson M, Bannister LH. Gray's Anatomy. 37th ed. Edinburgh: Churchill Livingstone; 1993.
[3]. Palastanga N, Field D, Soames R. Anatomy and human movement: structure and function. 3rd ed. Edinburgh: Butterworth-Heinemann Elsevier; 1998.
[4]. Koo CC, Roberts AH. The palmaris longus tendon. Another variation in its anatomy. J Hand Surg (Br) 1997;22(1): 138-9.
[5]. Chauhan R. Atypical innervation of palmaris longus - A case report. J Anat Soc India 2003;52(2):171-3..

Abstract: Background: Hemodynamic responses associated with laryngoscopy and intubation can be deleterious in patients with underlying cardiovascular compromise. We compared the efficacy of drugs, namely, Nalbuphine and Fenatnyl in attenuating the reflex pressor response of the above mentioned manoeuvres. Materials and Methods: Sixty patients in the age group of 18-60 years and belonging to ASA physical staus, either I or II, were randomized into two groups. Group F received fentanyl 1μg/kg and group N received nalbuphine 0.1mg/kg. Heart rate, blood pressure, oxygen saturation were recorded before administration of study drug, after administration of study drugs and then at 1, 3, 5 and 10 minutes of endotracheal intubation. Aims and Objectives............

Key words:Fentanyl,Nalbuphine.

[1]. Derbyshire DR, Chimielewski DF and Vater M. Plasma catecholamine responses to tracheal intubation.Br J Anaesth 1983;55:855-60.
[2]. Forbes AM and Dally FG. Acute hypertension during induction of anaesthesia and endotracheal intubation in normotensive man. Br J Anaesth 1970;42:618-24.
[3]. Safavi M, Honammand A. Attenuation of cardiovascular responses to laryngoscopy and intubation: intravenous sufenatnilvspethidine. M. E. J Anaesth 2008; 19(6): 1349-59.
[4]. Magulre AM, Kumar N, Parker JL et al. Comparison of effects of remifenanil and alfenanil on cardiovascular response to tracheal inubation in hypertensive patients. Br J Anaesth 2001; 86: 90-3.
[5]. Casati A, Fanelli A, Albertin A, et al. Small doses of remifentanil or sufentanil for blunting cardiovascular changes induced by tracheal intubation: a double blind comparison. Eur J. Anaesthesiol 2001; 18: 102-12.

Abstract: Background: This study aimed to determine the facial divergence and facial profile and their relation with the facial thirds in a sample of Iraqi adults with normal dental and skeletal relations. Materials and methods: Fifty dental students (22 males and 28 females) agreed to participate in this study. Standardized profile photograph was taken for each student and analyzed using AutoCAD program (2016). Results: The mean values of facial divergence and profile angle were the same in both genders with a non-significant gender difference. Upper and lower facial thirds were significantly larger in males. No significant relations were present among variables........

Key words: Facial divergence, facial profile, facial thirds

[1]. Proffit WR, Ackerman JL. Diagnosis and treatment planning in orthodontics. In Graber TM, Swain BF (eds.). Orthodontics: Current principle and technique. 1st ed. St. Louis: The C.V. Mosby Company; 1985.
[2]. Proffit WR, Fields HW, Sarver DM, Ackerman JL. Contemporary orthodontics. 5th ed. St. Louis: Elsevier Mosby; 2013.
[3]. Singh G. Textbook of orthodontics. 3rd ed. New Delhi: Jaypee; 2015.
[4]. Al-Ramahi SCA. Evaluation of buccal corridor in posed smile for Iraqi adults sample with Class I normal occlusion. A master thesis, Department of Orthodontics, College of Dentistry, University of Baghdad, 2009.
[5]. Al-Maliki HMAA. Dental arches dimensions, forms and the relation to facial types in a sample of Iraqi adults with skeletal and dental class I normal occlusion (A cross sectional study). A master thesis, Department of Orthodontics, College of Dentistry, University of Baghdad, 2011..

Abstract: The success of endodontic therapy is based on correct diagnosis and treatment planning, proper knowledge of anatomy and morphology of root canal system and thorough debridement and obturation. Variations in the root canal anatomy are a commonly occurring phenomenon. Mandibular first and second premolars are commonly single rooted teeth with a complicated endodontic anatomy, variations have to be considered every time endodontic therapy is performed .This case report describes the non-surgical endodontic retreatment performed on a mandibular first and second premolar with two roots.

Key words: Retreatment, Root canal anatomy.

[1]. Mohamed Idris, Nasil Sakkir, Nandakishore kj, Annapurna kini Endodontic Retreatment of a Mandibular Second Molar with four Separate Roots: A Case Report Journal of Clinical and Diagnostic Research. 2014 Mar, Vol-8(3): 280-282
[2]. Pratima Shenoi, Wanmala Mute, Archana Kandhari, Rahul Atara Endodontic Treatment of Mandibular Second Premolars with occult canals Using CBVT International Journal Of Dental Clinics,2011: 3 ( 4);68-69.
[3]. S Nandini, Suma Ballal, Sowmya N Kumar, D Kandaswamy Two-rooted mandibular second premolars: Case report and surveyCase. Indian J Dent Res 2008;19:70-73
[4]. Sadia Tabassm and Farhan Raza Khan ,failure of endodntiv treatment the usual suspects,European Journa l of Dentitry 2016,10(1);144-147.
[5]. Vertucci FJ. Root canal morphology and its relationship to endodontic procedures. Endodontic Topics. 2005;10:3–29

Abstract: Background; Non albican candidas had for a long time been neglected because of the assumption that candida albican causes all or almost all case of Vulvovaginal candidiasis. Aim; To determine the proportion of non albican Candida (NAC) causing Vulvovaginitis in Port Harcourt using mycology culture and germ tube test. Material and Method; High vaginal swab (HVS), demographic data and epidemiological risk factors were collected from 247 respondents with symptomatic vulvovaginal candidiasis. While germ tube test was used to differentiate between albican and non albican candida. The data was analyzed using the SPSS version 20. Association between variables was compared by using the Chi‑square (χ2) test and level of significant was set at P < 0.05...........

[1]. S. Onuorah, I. Obika,U Okafor, Prevalence of Candida Species among Vaginitis Symptomatic Pregnant Women Attending Ante-natal Clinic of Anambra State University Teaching Hospital, Awka, Nigeria, Bioengineering and Bioscience 3(2).2015, 23-27.
[2]. AM.Geider, B.Foxrnan, WB.Gillespie. The epidemiology of vulvovaginal candidasis among University students, Arnerican journal of public Health.85, 1995, NO.8.
[3]. JA.Lennox, SD. Abbey, D. Udiba, CI. Mboto, IS. Ikpohl, FC. Akubuenyi. Prevalence of vaginitis and vaginosis among University of Calabar female students, acadamicjournals,vol.5(4),2013,167-172.
[4]. SC Deorukhkar, S. Saini, S Mathew, Non-albicans candida Infection: An Emerging Threat,Interdiscip perspectinfect Dis 2014.Article ID 615958,7pages.doi.org/10.1l55/20I4/6l5958.
[5]. M Richardson C Lass-Flörl, Changing epidemiology of systemic fungal infections. ClinMicrobiol Infect. 2008; 14 (4), 2008, 5-24.

Abstract: Low back pain is a discomfort in the world where 80-85% of people live in at least one period of their lives, and they have great economic burden on the countries as well as on the individual during diagnosis and treatment. If most of the low back pain (90%) is caused by mechanical low back pain, fractures, cancer, infection, ankylosing spondylitis, nephrolithiasis, pancreatitis, aortic aneurysm, endocarditis, viral syndromes, metabolic causes, congenital and developmental problems should be exacerbated. The goal in the treatment of low back pain is to relieve pain, to provide adequate level of spinal motion, to reduce the most if there is functional impairment, and to return to the patient's daily activities and work. Patients who are referred to the hospital with low back pain should listen to family physicians fully and completely. Before the medicine is prescribed to the patient, the reason for the low..........

Key words: Exercises, Family medicine, Low back pain, Obesity

[[1]. Hoy D, Brooks P, Blyth F, Buchbinder R. The epidemiology of low back pain. Best practice & research Clinical rheumatology 2010;24(6):769-781.
[2]. Özdağ NH, Mollahaliloğlu S, Öztaş D, Güzeldemirci G. Acupuncture in the treatment of pain. Ankara Medical Journal 2015;15(4):249-253.
[3]. Kermond W, Gatchel RJ, Mayer TG. Functional restoration treatment for chronic spinal disorder or failed back surgery. In Contemporary and Conservative Care for Painful Spinal Disorders. Eds. Mayer TG, Mooney V, Gatchel RG. Philadelphia, Lea-Febiger. 1991; 473-481.
[4]. Atkinson JH, Slater MA. Behavioral medicine approaches to chronic low back pain. ın: the spine. Eds. Rotman RH, Simeone FA. vol. II. Philadelphia. 1992: 1961-1981.
[5]. Deyo RA. Practice variations, treatment fads, rising disability. Do we need a new clinical research paradigm? Spine 1993;18:2153-2162.