iosr-JDMS   Volume-13 ~ Issue-10 ~ October-2014

Abstract: Background and Objectives: To determine sex from unknown skeletal remains is vital. Various methods to do this on different bones of human skeleton have been extensively studied. In general male bones are heavier, larger and muscular markings are more prominently seen as compared to female bones. The objective of this study was to find out comparative differences between the right and left clavicles from certain metrical parameters and to enable assessment of sex from unknown clavicles. Materials & Method: Study was conducted with 40 clavicles (right 17 and left 23) of unknown sex from the Department of Anatomy, Kamineni Institute of Medical Sciences, Narketpally. The study was an observational, cross-sectional and descriptive in nature. The maximum length of the clavicle (in mm) was taken. Results: The length of the left clavicles varies from123 mm to164 mm with an average of 137.83 mm ±7.99mmS.D.The length of the right clavicles varies from126 mm to162 mm with an average 138.71 mm±8.66m S.D. It has been observed that the right clavicle was longer than the left clavicle by 0.88 mm. There was no such single character which can determine the sex of all clavicles. Depending on the length alone, the sex can be decided in 0% male and 0% female right clavicles and 4.35% male and 0% female bones if the left clavicle is considered. Conclusion: The right clavicle was longer than the left clavicle. The determination of sex from the clavicle has a great medico legal significance to the toxicologists. It also helps the anthropologists in their study of evolution of mankind and migration of races. This study is also useful for medico legal and anthropological examination of bones and for academic studies in anatomy.

Key Words: Clavicle, Demarking points, Sex determination, Vernier calliper

[1]. Krogman, W. M. and Iscan, M. Y. Human Skeleton in Forensic Medicine. 2nd Edition, Charles C. Thomas, Springfield, 1986.
[2]. Asala . S.A. et al 2004 Discriminant function sexing of fragmentary femur of South African blacks, vol 145, issue 1. p. 25-29
[3]. Standring Susan. Gray's anatomy, the anatomical basis of clinical practice, 40th edi. Churchill Livingstone,Elsevier, 2008, p. 791-792
[4]. Haque MK et al. Morphometric analysis of clavicle in Nepalese population. Kathmandu univ Med J. 2011; 35(3):193-197
[5]. Jit I, Singh S. The sexing of adult clavicles, Indian journal of medical research. 1966; 54:551-571

Abstract: Introduction: Several materials and methods have been used for ceramometal crown fabrication. Marginal fit and surface roughness are two important elements in the accuracy of casting. Conventional Technique requires 2-4 hours for completion of casting. Accelerated Technique has been attempted in an effort to achieve similar quality results in 30 – 40 minutes which is significantly time – saving. The purpose of the present study was to evaluate the marginal fit and surface roughness by comparing above two techniques. Methodology: Part I of the study determined marginal fit of base ceramometal crowns with the use of phosphate bonded investment. In the conventional technique, the temperature was raised at a rate of 8°C per minute up to 427°C where it was held for 11/2 hour. A rate of 14°C per minute was used for the second cycle up to 815°C whereas; the invested ring for the accelerated technique was placed in an 815°C preheated furnace immediately after setting of investment, for 15 minutes . Part II evaluated surface roughness of casting made with same techniques as Part I. Results And Conclusion: No statistically significant variation in the marginal discrepancy and surface roughness was observed in all the four quadrants between accelerated and conventional casting techniques. Accelerated technique was found to be definitely a time saving procedure for the dentist and the lab technician as compared to conventional technique.

Keywords: Accelerated casting technique, Base ceramometal alloy, Conventional casting technique, Marginal fit, Surface Roughness.

[1]. Marzouk M.A., Kerby J.: The exothermic casting procedure: a comparative study of four thermal treatments. Chicago: Quintessence Yearbook; 177-85. 1988.
[2]. Konstantoulakis E., Nakajima H., Woody R.D., Miller A.W.: Marginal fit and surface roughness of crowns made with an accelerated casting technique. J Prosthet Dent; 80:337-45. 1998.

[3]. Krishna Mohana T., Krishna Kishore K., Veena K., Rao S.: A comparative study of Marginal Fit and Surface roughness of Nickel- Chrome Complete Cast Crown Fabrication of Accelerated Casting Technique. Jr.of Orofac. Scie. 1(1).22-26. 2009.
[4]. Taggart WH: A new and accurate method of making gold inlays. Dental Cosmos; 11:1117-21. 1907.
[5]. Craig R.G.: Restorative dental materials. 9th ed. St Louis: Mosby; 6-7.1993.

Abstract: Pleomormpic lipoma of the anterior neck is a rare entity. Although pleomorphic lipomas a benign tumour it may contain atypical cells. Histologically pleomorphic lipoma is composed of mature fat, bland spindle shaped mesenchymal cells and coarse "rope like" collagen bands In addition pleomorphic lopoma contains multi-neucleated florat like giant cells. It Enzinger & Harvey [1] in their original series of pleomorphic lipoma \ spindle cell lipoma where there is little fat or no fat is a diagnostic challange.Immunohostochemical analysis by CD 34 positivity and desmin negativity is a diagnostic criteria. Here with we presenting a huge pleomorphic lipoma in the retropharyngeal space presenting as anterior neck swelling and sleep apnoea.

Keywords: Pleomorphic, retropharyngeal space, lipoma , benign neck swelling

[1]. Enzinger F.M, Harvey D A, Spindle cell lipoma description. Cancer. 1975 Nov;36(5):1852-9
[2]. Smookler B M ,Enzinger FM, Pleomorphic lipoma : A benign tumour simulating liposarcoma. Cancer.1981, 47,126 – 133.
[3]. Taylor F. Fatty tumour behind the pharynx, Trans Pathol Soc.london 1877;28:216-218
[4]. Hadad FS, Hadad FF, Zaytoun G, Retropharyngeal lipoma a benign yet potentially lethal condition. Case presentation and review of literature. Neurosurgery . 2005: 15: 145-154.
[5]. Rosai & Ackermans, Surgical pathology. 2: 2275 -2277.
[6]. Sternbergs diagnostic surgical pathology, 4th edition. 2004; 1: 155-157.

Abstract: Congenital hamartomas in infancy embrace cutaneous, Vascular and Lymphatic malformations. Nevus sebaceus of Jadassohn is a rare cutaneous lesion over face in infancy but it is a common epidermal hamartoma of scalp in pre pubertal and adult age groups. The lesions have a potential for benign and malignant transformation under hormonal influence particularly at puberty. Surgical excision is indicated primarily for cosmetic reasons and secondly if there is any suspicion of neoplastic changes.

Keywords: Hamartoma, Nevus sebaceus, Secondary tumors

[1]. Mehregan AH, Pinkus H. Life history of organoid nevi.Special reference to nevus sebaceous of Jadassohn. ArchDermatol 1965; 91:574-588
[2]. Etienne Wang, Joyce Siong. Carcinomatous changes like Sebaceous carcinoma, Trichoblastoma, and Poroma arising from a nevus Journal of Cutaneous Pathology, Volume 40, Issue 7, July 2013, Pages: 676- 682.
[3]. Cribier B, Scrivener Y, Grosshans E. Tumors arising in nevus sebaceus: a study of 596 cases. J Am Acad Dermatol 2000; 42:263-268.
[4]. Munir H. Idriss, Dirk M. Elston, Secondary neoplasms associated with nevus sebaceus of Jadassohn: A study of 707 cases, Journal of the American Academy of Dermatology, 2014, 70, 2, 332
[5]. Margulis A, Bauer BS, Corcoran JF.Surgical management in cutaneous manifestations of linear nevus sebaceus syndrome. Plast Reconstr Surg 2003; 111:1043–1050.

Abstract: Total knee Repalcement is a wellaccepted and routine surgeryperformed for patients with severe osteoarthritis of knee who doesnot show any improvement with analgesics,physiotherapy and intra-articular steroid injections and visco-supplements.Though surgical techniques of Total Knee Replacement have evolved over the years, total knee arthroplasty in a patient with medial tibial defect remains challenging. We came across a patient with severe varusknee with medial tibial defect. He underwent medial tibial reconstruction and Total Knee Replacement.Post operatively patient attained full range of movements and started full weight bearing at the end of 2 months.We recommend that Sculco's Technique of reconstruction is appropriate treatment for these type of cases

[1]. Engh G.A classification of bone defects in revision total knee arthroplasty.Presented at the Knee Soceity Interim Meeting,Philadelphia,Pennsylvania 1992
[2]. AltchekD,SculcoTP,RawlinsB.Autogenous bone grafting for severe angular deformity in total knee arthroplasty. J Arthroplasty 1989: 4(2):151-55
[3]. Dorr LD, Ranawat CS, Sculco TP, McKaskillB,Oriesek BS. Bone grafting for tibial defects in total knee arthroplasty.ClinOrthop 1986;205:153-65
[4]. WindsorRE,Insall JN, SculcoTP.Bone grafting of the tibial defects in primary and revision total knee arthroplasty. ClinOrthop 1986;205:132-7

Abstract: Oral piercing is a popular trend, but this fashion statement comes with some serious health risks. The oral and perioral piercing has a long history as part of religious, tribal, cultural or sexual symbolism. Nowadays there is a high incidence of oral and perioral piercing in the adolescent population. Oral and perioral piercing involve the insertion of jewellery into the tongue, lip, cheek, frenum, uvula or other parts of the mouth. This paper covers some of the commonly and uncommonly encountered complications related to oral piercing.

Keywords: oral piercing, body art, oral jewellery

[1]. Ferguson H. Body piercing. BMJ 1999; 319: 1627-9.
[2]. Boardman R, Smith R A. Dental implications of oral piercing. J Calif Dent Assoc1997; 25: 200-7.
[3]. Scully C, Chen M. Tongue piercing (oral body art). Br J Oral MaxillofacSurg 1994;32 (1):37-8.
[4]. Baum MS. A piercing issue. Health State 1996;14(3):14-9.
[5]. Campbell A, Moore A, Williams E, Stephens J, Tatakis DN. Tongue piercing: impact of time and barbell stem length on lingual gingival recession and tooth chipping. J Periodontol2002; 73(3):289–97
[6]. Marcoux D. Appearence, cosmetics, and body art in adolescents. DermatolClin 2000;18:667-73.
[7]. Shacham R, Zaguri A, Librus HZ, Bar T, Eliav E, Nahlieli O. Tongue piercing and its adverse effects. Oral Surg Oral Med Oral Pathol Oral RadiolEndod 2003; 95(3):274–6

Abstract: Neurofibromas arise from a mixture of cell types including Schwann cells and perineural fibroblasts. They may occur as solitary lesions or in association with neurofibromatosis. Although most commonly reported in soft tissues, neurofibromas do occur in bone. And very few cases have been reported in association with the inferior alveolar nerve. We report a case of neuro-fibroma of spindle cell origin associated with the inferior alveolar nerve in a 22 year old man. Pain or paresthesia may result from lesions of the inferior alveolar nerve. Patients presents with cortical expansion. Intra-osseous lesions may produce a well demarcated or poorly defined unilocular or multilocular radiolucency. Adjacent soft tissue neurofibromas may produce cortical erosion. Solitary neurofibromas and those found in association with neurofibromatosis share the same microscopic features1. The tumor is composed of spindle-shaped cells with fusiform or wavy nuclei in a delicate connective tissue matrix. It is not encapsulated and may blend with the adjacent connective tissues. The normally recommended treatment of solitary lesions following biopsy is localized excision.

Key Words: Neurofibroma, Spindle cell, Tumor

[1]. Zachariades N, Mezitis M, Vairaktaris E, Triantafyllou D, Skoura- Kafoussia C, Konsolaki-Agouridaki E, Hadjiolou E, Papavassiliou D: Benign neurogenic tumors of the oral cavity. Int J Oral Maxillofac Surg 1987, 16:70-76.
[2]. Sharma P, Narwal A, Rana AS, Kumar S. Intraosseous neurofibroma of maxilla in a child. J Indian Soc Pedod Prev Dent. 2009; 27: 62-4.
[3]. HUB E. Amputation neuromas: Their development and prevention. Archives of Surgery 1920; 1(1):85.
[4]. Rajendran R, Sivapada Sundaram B. Benign and malignant tumors of the oral cavity. Shafer, Hine, Lavy, editors Shafer's Text book of Oral Pathology India: Elsevier2009:120-7.
[5]. Ide F, Shimoyama T, Horie N, Kusama K. Comparative ultrastructural and immunohistochemical study of perineurioma and neurofibroma of the oral mucosa. Oral Oncol. 2004; 40: 948-53.

Abstract: Context: Numerous variations in ghrelin gene have been established to be associated with obesity parameters and ghrelin level. Aims: to focus on single nucleotide polymorphism (SNP) 501A>C in ghrelin gene and study the association of its different genotypes with certain obesity parameters and examine the relationship of these genotypes with ghrelin levels. Settings and Design: The study included 88 unrelated obese subjects recruited from the outpatient clinics in king Abdul-Aziz hospital, Taif, KSA. Age and sex matched 56 unrelated healthy subjects serving as healthy controls. Methods and Material: Waist circumferences (WC) were measured and the body mass index (BMI) was calculated. Fasting serum leptin and ghrelin levels were determined using commercially available ELISA kits. SNP 501A>C in ghrelin gene was studied by restriction fragment length polymorphism (RFLP).The DNA fragment containing the SNP was amplified by PCR. Statistical analysis used: One-way analysis of variance (ANOVA) and simple linear regression analysis were analyzed using Package for Social Sciences (SPSS) software for Windows (version 12.0; SPSS Inc., Chicago, IL, USA).

Key-words: Single nucleotide polymorphism - 5- flanke ghrelin gene - obesity -Saudi subjects

[1]. World Health Organization. Obesity: preventing and managing the global epidemic. Report of a WHO consultation: World Health Organization Technical Report series 2000;894.
[2]. Howard AD, Feighner SD, Cully DF, Arena JP, Liberator PA, Rosenblum CI, et al. A receptor in pituitary and hypothalamus that functions in growth hormone release. Science ,273(5277), 1996, 974–977.
[3]. Kojima M, Hosoda H, Date Y, Nakazato M, Matsuo H, Kangawa K. Ghrelin is a growth-hormone-releasing acylated peptide from stomach. Nature ,402, 1999, 656–660.
[4]. Tschop M, Smiley DL , Heiman ML. Ghrelin induces adiposity in rodents. Nature ;407, 2000, 908–913.
[5]. Zhang JV, Ren PG, Avsian-Kretchmer O, Luo CW, Rauch R, Klein C, et al. Obestatin, a peptide encoded by the ghrelin gene, opposes ghrelin's effects on food intake. Science;310, 2005:996–9.

Abstract: A rare case of Fetus in Fetu (FIF), in a 28 years old female presented as retroperitoneal mass abdomen. Computed tomography scan revealed multiple bones, fatty and cystic components. The mass was successfully excised. After removal of the specimen, the macroscopic appearance, X-ray and histopathologic examination confirmed it as fetus in fetu. Fetus in Fetu should be kept as differential diagnosis of retroperitoneal mass lesions.

Keyword: Fetus in Fetu(FIF), Mature Teratoma, Retroperitoneal Mass

[1]. Hoeffel C C , Nguyen KQ, Phan HT, Truong NH, Nguyen TS, Tran TT, Fornes P:Fetus in fetu: a case report and literature review.Pediatrics2000, 105:1335-1344.
[2]. Massed MG, Kory L, Beneditti E, Ghorl RD, Geha AS, Abcarian H. Dysphagia caused by a fetus in fetu in a 29 year old man. Am.Thorac. Surg, 2001; 71(45):1338-1341.
[3]. Grant P, Pearn JH. Foetus in foetu, Med J. Aust1969; 1:1016 -1020.
[4]. Nagar A, Raut AA, Narlawar RS. Foetus in Fetu. J Postgrad Med 2002; 48:133-134.
[5]. Willis RA. The borderland of embryology and pathology 2nd ed. Washington DC: Butterworth, 1962; 442-462.
[6]. Potter EL. Pathology of the fetus and the newborn. In: Potter EL, ed. Pathology of the fetus and the newborn. 2nd ed. Chicago, Ill: Year Book, 1961; 183-187

Abstract: Objective: The objective of the study is to evaluate the effectiveness of rubber band ligation in the treatment of internal hemorrhoids. Methods: This is a prospective study of 120 cases who underwent rubber band ligation as an outpatient procedure for internal haemorrhoids. Binomial probability pre-post test were used for statistical analysis, p-value less than 0.0001 was taken as significant. Results: One hundred twenty patients underwent rubber band ligation as a outpatient procedure for internal haemorrhoids. No major post procedure complications as sepsis, vasovagal reflex were observed. Only 36 patients had moderate discomfort following procedure, which lasted for 3-4 days and none had severe discomfort, and 84 patients did not need pain relief; 84 patients returned to work just after procedure .of symptom improvement post procedure compared to at presentation only 49% patients had bleeding post procedure out of 108 patients who had bleeding at presentation p-value of which was significant as p-value = 0.00055, 6 patients had pain post procedure out of 36 patients who had pain at presentation p-value = 0.00024 was found significant. None patient after procedure had prolapse out of 24 patients who had prolapse on presentation (p-value = 0.0025). No patient had irritation or discharge post procedure (p-value = 0.00036). Ninety-six patients assessed rubber band ligation as excellent and 24 patients as of moderate help. Conclusion: Rubber band ligation for internal haemorrhoids is an effective modality of treatment mainly in 2° grade haemorrhoid which is convenient, simple, high patient acceptance with limitations as post procedure discomfort and pain.

Key Words: Rubber band ligation; Sepsis; Vasovagal reflex; Bleeding, Prolapse; Irritation; Discharge

[1]. Keighley and Williams. Surgery of anus, rectum and colon. 3rd ed. Vol 1. Philadelphia: Saunders Publications; 2008. p.351-422.
[2]. Jeffery PJ, Sheila M Ritchie, Miller W, Haweley PR. The treatment of haemorrhoids by rubber band ligation at St Mark's Hospital. Postgraduate Medical Journal 2002;56:847-9.
[3]. Indru T Khubchandani. A randomized comparison of single and multiple rubber band ligations. Dis Colon Rectum 1983;26:705-8.
[4]. Henry H Lee, Robert J Spencer, Robert W Beart Jr. Multiple Haemorrhoidal bandings in a single session. Dis Colon Rectum 1994;37;37-41.
[5]. Ruffinhood T, Alexander Williams J. Anal dilatation versus rubber band ligation for internal Haemorrhoids. Method of treatment in outpatients. Am J Surg 1971 Oct;122 545-8.
[6]. Warshaw LJ, Turell R. Occupational aspects of proctological disease. New York State Journal of Medicine 1957;57:3006.

Abstract: NF1 is the most frequently-observed phakomatosis, with a frequency of occurrence of approximately 1 in 3300. Half of the cases occur via autosomal dominant inheritance, and the rest occur as a result of spontaneous mutations. The NF1 gene is located on chromosome 17 and encodes a protein called neurofibromin, which functions as a tumor suppressor 7,9,15. Tumoral formations observed in NF1 occur due to mutations in this gene 31. Despite advances in molecular genetics, diagnosis of NF1 still depends on clinical criteria. The diagnostic criteria were established at the National Institutes of Health (NIH) Consensus Development Conference in 1987 17. The present paper examines the diagnosis of Compressive Myelopathy secondary to multiple extramedullary intradural plexiform neurofibromas with basal ganglia glioma in a 6year-old male patient diagnosed with NF1

[1]. Baden E, Fischer RJ: Multiple neurofibromatosis and neurofibroma of the palate: report of a case. Oral Surg Oral Med Oral Pathol 16: 1356-1364, 1963
[2]. Bhatia S, Khosla A, Dhir R, Bhatia R, Banerji AK: Giant lumbosacral nerve sheath tumors. Surg Neurol 37: 118-122, 1992
[3]. Broniscer A, Gajjar A, Bhargava R, Langston JW, Heideman R, Joner D, Kun LE, Taylor J: Brain stem involvement in children
[4]. with neurofibromatosis type 1: Role of magnetic resonance imaging and spectroscopy in the distinction from pontine diffuse glioma; Neurosurgery 40: 331-338, 1997
[5]. Canbaz B, Tanriverdi T: Norofibromatozis. Aksoy K, Palaoglu S, Pamir N and Tuncer R (eds), Temel Norosirurji, Ankara; 2005: 823-829

Abstract: Epilepsy is one of the most common disorders of the brain.1 One of every ten people will have at least one epileptic seizure during a normal lifespan, and a third of these will develop epilepsy. Worldwide, epilepsy affects 50 million people. According to a World Health Organization (WHO) survey, epilepsy accounts for 1% of the global burden of disease, a figure equivalent to breast cancer in women and lung cancer in men.2 Epilepsy has been known since antiquity. An Assyrian-Babylonian textbook written over three millennia ago provides an accurate clinical description of the condition, 3 and Indian and Chinese physicians of that time were also familiar with it. The word epilepsy is derived from the Greek verb epilamvanein (‗to be seized', ‗to be taken hold of', or ‗to be attacked').

[1]. World Health Organization. Atlas: Epilepsy Care in the World. Geneva: World Health Organization; 2005:91.
[2]. Johnston MV. Seizure in childhood: febrile seizure. 17th ed. In: Nelson's text book of pediatrics, Behrman RE, Kliegman RM, Jenson HB, eds. Pennsylvania: Saunders; 2004. pp. 1994-5.
[3]. Murray CJL, Lopez AD. Global Comparative Assessment in the Health Sector; Disease Burden, Expenditures, and Intervention Packages. Geneva: World Health Organization; 1994.
[4]. Kinnier Wilson JV, Reynolds EH. Translation and analysis of a cuniform text forming part of a Babylonian treatise on epilepsy. Med Hist 1990;34:185-98.
[5]. Temkin O. The Falling Sickness. Baltimore: Johns Hopkins Press; 1945:380. 6. Hippocrates. The sacred disease. In: Hippocrates, Page TE, Capps E, Rouse WHD, eds. Cambridge, MA: Harvard University Press; 1967. 2:127-84.
[6]. Jackson JH. On epilepsy and epileptiform convulsions. In: Selected Writings of John Hughlings Jackson, Taylor J, ed. London: Hodder and Stoughton; 1931. 1. 8. Senanayake N, Roman GC. Epidemiology of epilepsy in developing countries. Bull WHO 1993;71(2):247-58.

Abstract: The life time prevalence of disc herniation has been estimated at 1%-3% 1,2, although anatomic evidence of disc herniation is said to be present in 20% to 40% imaging tests among asymptomatic persons3,4 Most clinically relevant herniation occurs between the ages of 30years and 50years but can also occur in adolescent and older people 5. Two to 5% of patients seeking help are thought to suffer disc herniation 6 while in about 40% of patient with low back pain seeking help, the cause is disc herniation 7. Conservative care is beneficial in more than 50% of low back pain patients with disc herniation and sciatica and it is associated with low complication rate 7. Surgery has not been proven to be more effective than conservative care6 and there is now broad agreement in medical practice that surgery should not generally be considered for these patients until there has been a trial of conservative non-surgical care 8,9. This could be attributed to the facts that the majority of patients recover adequately and at least as well as after surgery, under conservative care. Also, current surgical techniques, even though less invasive than in the past, have significant problems in terms of effectiveness, safety and cost 9,. Similarly studies have also reported complication rate of 24% associated with surgical interventions with almost half of these complications being serious and approximately 8% of patients required re-operation 9,. This emphasizes the importance of a trial of conservative care, which is beneficial to most patients and has very low complication rates, 7, however, on the basis of current evidence, One option, with at least as much research evidence of safety, effectiveness and patient satisfaction as any other, is skilled manipulation, 6,.7. Manipulation is one of the physiotherapy treatment options for disc herniation. Manipulation has been reported to be useful for the Syndrome of Prolapsed lumbar intervertebral disc via causing relieve of pain, relaxation of the muscles and recover the nerve function

[1] Anderson G, The epidemiology of spinal disorders In: The adult spine: principals and practice 2nd edition . Philadephia Lippincott-Raven 1997.
[2] Crawford CM, Hannon RF, Management of acute lumbar disc herniation initially presenting as mechanical low back pain J. Manipulative Physiol Ther 1999; 22:235 44
[3] Deyo RA, Rainville J, Kent DL, What can history and physical examination tells us about low back pain JAMA 1992: 268: 760-765
[4] Frymoyer JW, Back pain and sciatica N. Engl J. Med 1988; 318:291-300
[5] Weber H, The natural history of disc herniation and the influence of intervention Spine1994; 19:234-238
[6] Stern P.J, Cote P, Cassidy JD, A series of consecutives cases of low back pain with radiating pain treated by chiropractors. J. Manipulative Physiol Ther 1995; 18: 335-41
[7] Cassidy JD,. Thiel HW,. Kirkaldy-Willis WH,.. Side posture manipulation for lumbar intervertebral disc herniation J. Manipulative Physiol Ther 1993; 16: 96-103

Abstract: Objectives: The purpose of this study is to investigate the effects of frequency of application of spinal stabilization exercises on plasma levels of serotonin in participants with chronic low back disorders. Methods: Eighty four participants (34 males, 50 females) volunteered to take part in this study. Plasma level of serotonin was measured with Enzyme linked Immuno absorbent assasy (ELISA) technique. Participants were randomly assigned to one of the exercise groups where they carried out exercise training at different frequencies i.e. once weekly (1wkly), twice weekly (2wkly)and three times a week (3wkly) or the control (no exercise group). Data were collected at baseline, after six weeks of exercise treatment and at 18 week follow up after exercise treatment. Results: The result showed that plasma levels of serotonin increases significantly in all the exercises groups after 6 weeks of treatment with the highest increase in the three times a week (P<0.05). Surprisingly, only the three times a week (3wkl) showed significant increase in plasma serotonin level at three months follow up (P<0.05) which was not present in all other exercise groups. Conclusion: The result of this study suggested that stabilization exercises carried out three times a week could be associated perhaps be associated with an optimal biochemical and long term therapeutic effects of spinal stabilization exercise via increase in production of plasma serotonin levels.

Key words: Chronic back pain, stabilization exercises, serotonin, RCT

[1] Kidd, BL., Richardson, PM., ''How does neurophysiology affect the signs and symptoms of spinal disorders''? Best Practice Research Clinical Rheumatology 2002, 16:1

[2] Goldby L., Moore, AP., Doust, J., Trew, M., ''A randomized controlled clinical trial investigating the efficacy of musculoskeletal therapy on chronic low back disorders'' Spine 2006. 31 (10)1083-1093

[3] Sokunbi O., Moore A., Watt, P., ''Plasma levels of beta endorphin and serotonin in response to specific spinal based exercises''. South African Journal of physiotherapy 2008 ,64:1 31-37

[4] Kema IP., deVries EG., Musket FA., ''Clinical Chemistry of serotonin and metabolites''. Journal of Chromatography 2000; 747(1-2)33-48

[5] Sokunbi O., Watt, P., Moore A. ''Changes in plasma level of serotonin in response to spinal stabilization exercises in chronic low back pain patients''. Nig. Qt. J., Hosp. Med 2007,17(3):108-111

Abstract: Harlequin syndrome is caused by autonomic dysfunction, affecting sweating and flushing of the face and less commonly, the upper limb and upper chest. It results from compromise of vasomotor and pseudomotor sympathetic nerve supply to one side of face with over-reaction, presumably compensatory, of the corresponding fibres on the intact side. This syndrome is a rare phenomenon, and is even rare following thyroidectomy, but is a worrying symptom for both the patient and the surgeon. Till now only a single case of Harlequin syndrome has been reported following thyroidectomy, we hereby present the second case of Harlequin syndrome following thyroidectomy, in a 40 year old female.

Keywords: Autonomic dysfunction, Harlequin sign, Harlequin syndrome, Sympathectomy, Thyroidectomy.

[1] Shin RK, Galetta SL, Ting TY et al. Ross syndrome plus: beyond Horner, Holmes – Adie and harlequin. Neurology 2000; 55: 1841-6.

[2] E.M. Duddy and M.R. Baker, "Harlequin's darker side," The New England Journal of Medicine, Vol. 357, no. 20, p. e22, 2007.

[3] Van Slycke S, Stockman A, Dionigi G, Carette R, Gillardin JP, Brusselaers N. Harlequin syndrome after thyroidectomy for compressive retrosternal goiter. Case report and review of literature. Acta Chir Belg. 2014; 114(3): 212-4.

[4] Lance JW, Drummond PD, Gandevia SC, Morris JG. Harlequin syndrome: the sudden onset of unilateral flushing and sweating. J Neurol Neurosurg Psychiatry. 1988; 51: 635- 42.

[5] W.I.M. Willaert, M.R.M. Scheltinga, S.F. Steenhuisen and J.A.P. Hiel. Harlequin syndrome: two new cases and a management proposal. Acta Neurol. Belg. 2009; 109: 214-20.

Abstract: Juvenile nasopharyngeal angiofibroma (JNA) constitutes less than 0.5% of all head and neck neoplasm. It is a histopathologically benign, yet locally aggressive, vascular tumor that occurs most frequently in males from 5 to 25 years. However, it could mimic the clinical course of antrochoanal polyp. The clinical and radiological evaluated with computer tomography and with endoscopic resection of the tumor (an antrochoanal polyp), a histopathological report was angiofibroma.

Key words: Nasopharyngeal mass, Nasopharynx angiofibroma, antrochoanal polyp,

[1]. Liu L, Wang R, Huang D, et al. Analysis of intra-operative bleeding and recurrence of juvenile nasopharyngeal angiofibromas. Clin Otolaryngol Allied Sci. 2002; 27:536-40.
[2]. Lloyd G, Howard D, Phelps P, et al. Juvenile angiofibroma: The lessons of 20 years of modern imaging. J Laryngol Otol. 1999; 113: 127–34.
[3]. Mafee M: Imaging of the Nasal Cavities, Paranasal Sinuses, Nasopharynx, Orbits, Infratemporal Fossa, Pterygomaxillary Fissure, Parapharyngeal Space, and Base of the Skull, Snow Jr J.& Ballenger J. editors: Ballenger's Otorhinolaryngology ,Head and Neck Surgery, 16'th ed., 2003,BC Decker Inc, chapter 31, p 654-707

[4]. Topi MJ, Siniluoto MD, Jukka PL, Leinonen MD and Kalevi EJ. Value of pre-operative embolization in surgery for nasopharyngeal angiofibroma. J Laryngol Otol. 1993; 107: 514–21.
[5]. Nongrum HB, Thakar A, Gupta G, et al. Current Concepts in Juvenile Nasopharyngeal Angiofibroma. Journal of ENT Master class. 2009; 2: 88–95

Abstract: While there is increased maternal and perinatal morbidity associated with the failure of trial of vaginal birth after cesarean section (VBAC), a successful trial of VBAC reduces the risk of complications in future pregnancies, associated with a repeat cesarean section. Studies in patients attempting VBAC have shown that the highest rate of maternal complications occur in patients who have a failed attempt at VBAC, intermediate in those who have an elective repeat cesarean section and lowest in those who have a successful VBAC[1]. There is evidence to suggest that overall success of a VBAC ranges from 72-76 % [2], with factors that can increase or decrease the chances of success. Assessment of individual risks and the likelihood of VBAC can help determine appropriate candidates for trial of labor. Screening tools consider the relative effect of multiple factors to predict an individual's likelihood of vaginal delivery [3]. Majority of the scoring systems have used indication of previous cesarean, Bishops score and history of VBAC in their screening tools. Some have used other factors like maternal age,

[1]. Landon MB,Hauth JC,Leveno KJ,Spong CY,Leindecker S ,et al. (2004) Maternal and perinatal outcomes associated with a trial of labor among women with prior cesarean delivery.N Engl J Med 345:3-8
[2]. Birth after previous cesarean section.Green top guideline No. 45,RCOG press. Feb 2007.(www.rcog.org.uk)
[3]. Hashima JN,Eden KB,Osterweil P,nygren P,Guise JM.Predicting vaginal birth after cesarean delivery: A review of prognostic factors and screening tools.American Journal of Obstetrics and Gynecology 2004:190:547-55.
[4]. Guise JM et al .vaginal birth after cesarean :new insights evidence report/ technoloigy assessment no 191 AHRQ publication no 10-E003. March 2010
[5]. Guise JM,McDonagh MS,Hashima J ,et al.Vaginal Birth after cesarean (VBAC).Evidence report:Technology assessment.2003(71):1-8.
[6]. Grobman WA,Lai Y,Landon MB,et al.Development of a normogram for prediction of vaginal birth after cesarean delivery.Obstet Gynecol.2007;109(4):806-12

Abstract: Interimplant distance is one of the factors influencing crestal bone resorption. In addition , Several studies have shown the ability of microthreads and platform switching to minimize crestal bone resorption around implants. This report shows microthreaded and platform switched implants separated by less than 2mm in the posterior mandible.

Keywords: Microthreads , Platform switching

[1]. DE OLIVEIRA, R. R., NOVAES, A. B., JR., PAPALEXIOU, V., MUGLIA, V. A. & TABA, M., JR. 2006. Influence of interimplant distance on papilla formation and bone resorption: a clinical-radiographic study in dogs. J Oral Implantol, 32, 218-27.
[2]. ELIAN, N., BLOOM, M., DARD, M., CHO, S. C., TRUSHKOWSKY, R. D. & TARNOW, D. 2011. Effect of interimplant distance (2 and 3 mm) on the height of interimplant bone crest: a histomorphometric evaluation. J Periodontol, 82, 1749-56.
[3]. HUDIEB, M. I., WAKABAYASHI, N. & KASUGAI, S. 2011. Magnitude and direction of mechanical stress at the osseointegrated interface of the microthread implant. J Periodontol, 82, 1061-70.
[4]. JUNG, R. E., JONES, A. A., HIGGINBOTTOM, F. L., WILSON, T. G., SCHOOLFIELD, J., BUSER, D., HAMMERLE, C. H. & COCHRAN, D. L. 2008. The influence of non-matching implant and abutment diameters on radiographic crestal bone levels in dogs. J Periodontol, 79, 260-70.
[5]. MOMBELLI, A. & LANG, N. P. 1994. Clinical parameters for the evaluation of dental implants. Periodontol 2000, 4, 81-6.

Abstract: Physical inactivity has been associated with increasing prevalence and mortality of cardiovascular and other diseases. The purpose of this study is to identify if there is an association between, self–efficacy, mental health, and physical inactivity among university students. The study comprises of 202 males and 692 females age group 18-25 years drawn from seven faculties selected using a table of random numbers. Questionnaires were used for the data collection. The findings revealed that the prevalence of physical inactivity among the respondents was 41.4%. Using a univariate analysis, the study showed that there was an association between gender (female), low family income, low self-efficacy, respondents with mental health probable cases and physical inactivity (p<0.05).Using a multivariate analysis, physical inactivity was higher among females(OR = 3.72, 95% CI = 2.399-5.788), low family income (OR = 4.51, 95% CI = 3.266 – 6.241), respondents with mental health probable cases (OR = 1.58, 95% CI = 1.136- 2.206) and low self-efficacy for pysical activity(OR = 1.86, 95% CI = 1.350 - 2.578).Conclusively there is no significant decrease in physical inactivity among university students when compared with previous studies in this population, it is therefore recommended that counselling on mental health, physical activity awareness among new university students should be encouraged.

Keyword: Exercise,Mental Health, Self-Efficacy,Physical Inactivity, University students

[1] World Health Organisation (WHO, 2014). Physical Activity, WHO website, retrieved fromhttp://www.who.int/topics/physical_activity/en/

[2] World Health Organisation. World Health Report. Geneva: WHO 2002

[3] Vuori, I. (2004). Physical inactivity as a disease risk and health benefits of increased physical activity.

[4] US DHHS, 2006; Physical Activity and Health, A report of the Surgeons General Executive Summary. US DHHS CDC national Center for Chronic disease Prevention and Health Promotion The President Council on Physical Fitness and Sports. Retrieved from http://www.cdc.gov/nccdphp/sgr/pdf/execsumm.pdf

[5] Wannamethee, S. G., & Shaper, A. G. (2001). Physical activity in the prevention of cardiovascular disease: an epidemiological perspective. Sports Medicine, 31(2), 101–114.

Abstract: The present study was aim to evaluate the relationship between TC and BMI with BP of 500 male students of the University of Rajshahi, Bangladesh, ageing from 18 to 27 years, having different family size and income. The samples were classified into three groups which are age, family size and income. The samples were issued randomly and calculated mean, standard deviation and coefficient correlation. It was found that mean value systolic and diastolic (BP), TC, height, weight and BMI is positively correlated with increasing age and family income whereas decreased values were found in family sizes but BMI remain unchanged in all groups. Age is strongly correlated with systolic BP (r= 0.668, p<0.05) while TC is significantly correlated with systolic blood pressure in age group (r= 656, p< 0.05) but height, weight and BMI are not significantly correlated with blood pressure in age group. Weight and BMI are significantly correlated with both of systolic and diastolic BP in family income groups (r= 0.795 and 0.780, p< 0.01 and r= 0.780 and 0.781, p< 0.01) whereas TC is significantly correlated with only systolic blood pressure (r= 0.805, p< 0.01) in this groups. TC and BMI are also positively and significantly correlated with diastolic BP (r= 0.644, 0.729, p< 0.05, 0.01) in family size group however. This study assumed that total circumference (TC) may be used for the prediction of hypertension along with height-weight and BMI in young male aged between 18 – 27 years belonging to different socio-economic group.

Keywords: Blood Pressure, Body Mass Index Hypertension & Total circumference

[1] Zhu SK, Wang ZM, Heshka S, Heo M., Faith MS. and Heymsfield SB. Waist circumference and obesity-associated risk factors among whites in the third National Health and Nutrition Examination Survey: clinical action thresholds. Amer. J. Clin. Nut, 2002, 76(4): 743.
[2] Ahrens EH. The evidence relating six dietary factors to the Nation's health. Amer. J. Clin. Nut, 1979, 32(12), 2627-2631.
[3] Harlan WR, Hull AL. and Schmodder RL. Blood pressure and nutrition in adults. The National Health and Nutrition Examination Survey Amer. J. Epidemiol, 1984, 120(1), 17-28.
[4] Treuth MS, Butte NF and Wong WW. Effects of familial predisposition to obesity on energy expenditure in multiethnic prepubertal girls. Amer. J. Clin. Nut, 2000, 71(4): 893-900
[5] Moore VM, Cockington RA, Ryan P and Robinson JS. The relationship between birth weight and blood pressure amplifies from childhood to adulthood. J. Hyperten, 1999, 17: 883-888.

Abstract: Cardiac tumours are rare in neonates, most are benign hamartomas (rhabdomyomas) of the muscle cells. Due to large size, they may cause homodynamic instability and even death in neonatal period. They are rarely diagnosed prenatally and are found in multiple forms. We report a neonate 1st of the twin, who was found to have a rhabdomyoma attached to right ventricle free valve measuring 3x2.6 cms seen compressing right ventricle, with significant pericardial effusion soon after birth with poor perfusion requiring inotropic support and emergency pericardiocentisis, following which child's condition stabilised

[1] Nadas AS, Ellison RC. Cardiac tumours in infancy. Am J Cardiol 1968; 21: 363-6
[2] 2. Beghetti M, Gow RM, Haney l, Mawson J, Williams WG, Freedom RM: Pediatric primary benign cardiac tumours: a 15 year review. Am Heart J 1997, 134: 1107 – 1114
[3] Daniel Bernstein. Tumors of the heart. In: Kliegman, Stanton B.F, St Geme J.W, SchorN.F,Behrman R.E, Nelson textbook of pediatrics, 19e: Saunders, 2008; page 1975
[4] Butany et al., 2005. Butany J, Nair V, Naseemuddin A, et al: Cardiac tumours: Diagnosis and anagement. Lancet 2005; 6:219-228