iosr-JDMS   Volume-14 ~ Issue-4 ~ April-2015

Abstract: Background and Aims: Middle ear surgery requires bloodless surgical field for better operatingconditions, deep level of anaesthesia and rapid emergence. Recent studies suggest that α2agonists could provide desired surgical field, sedation and analgesia. The present study was aimed to evaluate the clinical effects of dexmedetomidine infusion as anaesthetic adjuvant during middle ear microsurgery.

[1]. Jellish WS, Owen K, Edelstein S, Fluder E, Leonetti JP. Standardanesthetic technique for middle ear surgical procedures:A comparison of desflurane and sevoflurane. OtolaryngolHead Neck Surg 2005;133:269-74.
[2]. Marchal JM, Gómez-Luque A, Martos-Crespo F, SánchezDe La Cuesta F, Martínez-López MC, Delgado-Martinez AD.Clonidine decreases intraoperative bleeding in middle earmicrosurgery. ActaAnaesthesiolScand 2001;45:627-33.
[3]. Firat Y, Kizilay A, Akarcay M, Yucel A, But K, Yologlu S. Theeffect of dexmedetomidine on middle ear pressure. OtolaryngolHead Neck Surg 2007;137:218-23.
[4]. Liang S, Irwin MG. Review of anesthesia for middle earsurgery. AnesthesiolClin 2010;28:519-28.
[5]. Nasreen F, Bano S, Khan RM, Hasan SA. Dexmedetomidineused to provide hypotensive anesthesia during middle earsurgery. Indian J Otolaryngol Head Neck Surg 2009;61:205-7.

Abstract: Objective: To determine why women would register for antenatal care in more than one centre in the same pregnancy. Methodology: This was a descriptive cross sectional study conducted at the University of Port-Harcourt Teaching Hospital, Port- Harcourt (UPTH), South-South Nigeria, between June and September, 2014. It consisted of a set of structured, pretested questionnaires that were administered to consecutive antenatal attendees at the centre.

[1]. Garroli G, Rooney C, Villar J. How Effective Is Antenatal Care In Preventing Maternal Mortality? An Overview of Evidence. Paediatric and Perinatal Epidemiology, 2001; 15 (Supplement 1): 1-42.
[2]. "Reproductive Health and Research Publications: Making Pregnancy Safer". World Health Organization Regional Office for South-East Asia. 2009.
[3]. Alvarez JL, Gil R, Hernández V, Gil A. Factors associated with maternal mortality in Sub-Saharan Africa: an ecological study BMC Public Health 2009, 9:462.
[4]. Maternal and Child Health. Population Institute, August, 2005.
[5]. 'Women on the Front Lines of Health Care' Save the Children, 2010.
[6]. Child Survival Partnership' (New York, United Nations, 2004, http/wwww.unicef.org/publications/files/child survival update¬_march05.pdf).

Abstract: The aetiology of anal fissure is not fully understood—why some heal spontaneously and others become chronic remains a mystery. In this study we compared use of sitz bath to medical therapy in the treatment of acute anal fissure on OPD basis.Seventy five patients with an acute first episode of anal fissure were randomised to receive a three weektreatment of Sitz bath with psyllium husk vs 5% lignocaine ointment vs 2% Glyceryl trinitrate ointment. After one, two and three weeks of treatment, symptomatic relief and healing rates were comparable among patients treated with sitz baths with psyllium husk and GTN ointment than those treated with lignocaine ointment. Therefore, a cheap and effective treatment of sitz bath can be used as first line instead of GTN ointment which has potential side effects.

Keywords: Fissure, sitz bath, medical therapy.

[1]. Schouten WR, Briel JW, Auwerda JJ. Relationship between anal pressure and anodermal blood flow. The vascular pathogenesis of anal fissure. Dis Colon Rectum 1994;37:664-9.
[2]. Klosterhalfen B, Vogen P, Rixen H, Mittermayer C. Topography of the inferior rectal artery: a possible cause of chronic, primary anal fissure. Dis Colon Rectum 1989;32:43-52.
[3]. Goligher JC. Surgery ofanus, rectum, and colon. 4th ed. London: Balliere, Tindall, 1980.
[4]. Jensen SL. Treatment of first episode of acute anal fissure - a prospective, randomized study of lignocaine ointment vs. hydrocortisone ointment vs. warm Sitz bath plus bran. BMJ 1986; 292(6529): 1167-69.
[5]. Lund-JN, Scholefield-JH, Aetiology, and treatment of anal fissures. B JSurg. 1996, Oct; 83[10]: 1335-44.

Abstract: Malaria is a public health problem in several parts of the country. About 95% population in the country resides in Malaria endemic areas and 80% of malaria reported in the country is confined to areas consisting 20% of population residing in tribal, hilly, difficult and inaccessible areas. India contributes about 70% of malaria in South East region of W.H.O. Although annually India reports about 2 million cases and 1000 deaths attributable to malaria, there is increasing trend in the proportion of Plasmodium Falciparum as the agent. This study aimed to note the presentations and complications of Plasmodium Falciparum in Government General Hospital, ,Anantapuramu district of Andhra Pradesh.

[1]. Andrade BB,Reis-Filho A,Souza-Neto SM,Clarencio J,Camargo LM,Barral-Netto M (2010) Severe Plasmodium Vivax Malaria exhibits marked inflammatory imbalance.Malar J9:13.
[2]. Anstey NM,Russll B,Yeo TW,Price RN (2009) The pathophysiology of vivax malaria.Trends parasitol 25:220-227.
[3]. Beg MA,Khan R,Baig SM,Gulzar Z,Hussain R,Smego RA,Jr (2002) Cerebral involvement in benign tertian malaria AmJ Trop Med Hyg 67:230-232
[4]. Kaur D,Wsir V,Gulati S,Bagga A (2007) Unusual presentation of plasmodium vivax malaria with severe thrombocytopenia and acute renal failure.J Trop Pediatr 53:210-212
[5]. Kochar DK,Das A, Kochar SK,Saxena V,Sirohi P,Garg S,Kochar A,Khatri MP,Gupta V(2009) Severe Plasmodium Vivax Malaria: a report on serial cases from Bikaner in northwestern India.Am J Trop Med Hyg 80:194.

Abstract: Medical studies press unprecedented demands on the young students. Unlike the school curriculum, medical curriculum requires greater involvement of students in organized learning activities. Instead of traditional ways of teaching, new methods of teaching, learning and evaluation may inspire the students desire for learning and once the students mind is set on fire, it will find its way to provide its own fuel. Thus, the ultimate goal of self teaching and learning could be achieved. With this view in mind, we thought of conducting quiz competitions as Quiz [1] [2] is one of the various methods [3] [4] described in the literature. Studies have shown that quiz games promote active learning and provide motivational impetus. They also enhance meaningful knowledge retention by igniting interest and placing theoretical subjects in a real-world perspective. Thus, game styled quiz competitions based on curricular subjects can be an effective tool to increase interest and motivation and enhance learning is established beyond doubt.

[1]. Rotti SB, Dutta S, Danabalan M Narayan KA, Soudarssanane MB, Roy G. use of a quiz as a method to teach nutrition and health, Med teach.,23(5),2001,519.
[2]. SB Rotti, B sudhir M Danabalan, Quiz as a Method to teach family welfare and Demography to Medical Undergraduate Students, Indian Journal of community Medicine; 29(3), 2004,
[3]. 121-22.
[4]. Dongre AR, Deshmukh PR, Garg BS. Transect walk as a public health teaching learning tool, Medical education, 43,2009,1081-117.
[5]. Dongre AR, Deshmukh PR, Garg BS Portfolio based approach for teaching community Medicine among medical undergraduates and assessment of their learning in a Medical college of rural India. south East Asian J of Medical Education,4 (1) 2010,17-24.
[6]. Barthakur R, Srivastava R, Thourani S, Thourani MK, Dawka S. Quiz gaming competitions for undergraduate medical students: Questioning the MediQuiz. Arch Med Biomed Res.1(3),2014,103-112

Abstract: Emphysematous prostatitis (EMP) is a very rare inflammatory condition, characterized by localized collection of gas and purulent exudates in the prostate and carries a high mortality rate. We present a case of 62 year old man admitted with fever and chills , without any urinary complaints or co-morbidities and had none of the usual risk factors for EMP.Imaging revealed a collection within the prostatic parenchyma with air shadowsextending into right pararectal area.Patient was successfully treated with guided aspirationand broad spectrum antibiotics without any complications.

Keywords : ANTIBIOTICS , DRAINAGE , EMP , NCCT, TRUS

[1]. Mariani AJ, Jacobs LD, Clapp PR, Hariharan A, Stams UK, Hodges CV. Emphysematous prostatic abscess: diagnosis and treatment. J Urol 1983; 129: 385-6.
[2]. Lu DC, Lei MH, Chang SC. Emphysematous prostatic abscess due to Klebsiella pneumoniae. Diagn Microbiol Infect Dis 1998; 31: 559-61.
[3]. Rifkin MD. Ultrasonography of the lower genitourinary tract. Urol Clin North Am 1985; 12: 645 - 656.
[4]. Arger PH. Computed tomography of the lower urinary tract. Urol Clin North Am 1985; 12: 677 - 686.
[5]. Tai HC. Emphysematous prostatic abscess: a case report and review of literature. J Infect 2007; 54: e51-54.

Abstract: Oligodendrogliomas are extremely rare intramedullary spinal cord tumours and only a few cases were reported in the literature. The most common site is thoracic cord. We report a case of oligodendroglioma in a middle aged male patient presenting as a rapidly growing intramedullary spinal cord tumour, which was surgically excised.

Keywords: Intramedullary, Oligodendroglioma, spinalcord

[1]. Edelman, Spinalcord and intradural disease,Clinical magnetic resonance imaging 3rd ed, 2006, 2163-64.
[2]. Kelly K. Koeller, CDR, MC, USN , R. Scott Rosenblum, DO , Alan L. Morrison, CDR, MC and USN, Neoplasms of the Spinal Cord and Filum Terminale, Radiologic-Pathologic Correlation, Radiographiocs 2000, 20, 1721-1749.
[3]. Wober G, Jellinger K, Intramedullary oligodendroglioma with meningocerebral dissemination, Acta Neurochirurgica, 35;4, 1976, p.261-9.
[4]. Vera Van Velthoven, Luc Calliauw and Jacques Caemaert Ugent,Intramedullary spread of a cerebral oligodendroglioma, surgical neurology(1988),30(6). P.476-481 [5]. Oshiro S1, Komatsu F, Tsugu H, Nabeshima K, Abe H, Ohkawa M, Inoue T; A case of intramedullary cervical metastasis from cerebellar anaplastic oligodendroglioma without typical MR appearance for CSF dissemination; 2010 Mar;38(3):279-85.
[6]. C. Ramirez1, O. Delrieu2, J.-F. Mineo1, G. Paradot1, M. Allaoui1, F. Dubois1 and S. 11,Intracranial dissemination of primary spinal cord anaplastic oligodendroglioma, APR 2007

Abstract: Anatomical variations of Renal arteries are common, usually kidney is supplied by the renal artery which is the anterolateral branch of the abdominal aorta. During the regular dissection of cadavers in the Department of Anatomy, we observed no.of variations in the pattern of renal artery instead of single renal artery to the kidney. Some renal arteries showing early ramification before entering into the hilum of kidney. For some other kidneys along with main renal artery extra renal arteries going to the kidney through its hilum are accessory renal arteries and some extra renal arteries are directly going to the upper or lower pole of the kidney without entering into the hilum are aberrant arteries. As per our study 32% of the specimens showing variations. 68% are the single renal arteries irrigating the kidneys. Morphological variations of the renal arteries are common. It is better to have awareness to prevent the surgical hazards because of anatomical consideration.

Keywords: Variations, renal artery

[1]. Bayramoglu A, Demiryurek D, Erbil KM. Bilateral additional renal arteries and an additional vein associated with unrotated kidneys. Saudi Med J. 2003;24:535-7.
[2]. Bordei P, Sapte E, Iliescu D. Double renal arteries originating from the aorta. Surg Radiol Anat 2004;26:474-9.
[3]. Dhar P, Lal K. Main and accessory renal arteries – A morphological study. Ital J Anat Embryol.2005;110:101-10.
[4]. Gray's- Textbook of Anatomy –Rare origin of accessory Renal arteries. 35th edition, p:13-25.
[5]. Khamanarong K, Prachaney P, Utraravichien A, Tong-Un T, Sripaoraya K. Anatomy of renal arteries supply. Clin Anat 2004;17:334-336.

Abstract: The Interstitial Lung Diseases Are A Clinically Challenging And Diverse Groups Of Over A 150 Disorders Characterized By Varying Degrees Of Fibrosis And Inflammation Of The Lung Parenchyma Of Interstitium. The Interstitial Lung Diseases Represent Many Features In Common Such As Similarities Of Symptoms, Comparable Appearance Of Chest Imaging Studies, Consistent Alteratios In Pulmonary Physiology And Typical Histological Features. One Useful Approach Is To Separate Ilds Into Two Groups, Those With Known And Those With Unknown Causes. For Each Ild There May Be An Acute Phase Followed By A Phase Of Chronicity With Acute Exacerbation.

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Abstract: Comparison of maternal fetal outcome with active versus expectant management in PROM Material and Methods: From March 2007 to July 2008 a total of 103 pregnant women with PROM allocated randomly to expectant group A (53) and active group B (50) and fetal and maternal morbidity were compared at Government Maternity Hospital, Tirupati. Results: PROM to delivery interval in expectant group was 30.49  16.07 hours, in active group it was 17.46  6.0 hours. Caesarean delivery rate in expectant group is 5.7% and 12% in active group. In group (A) 32 % of the patients had spontaneous labour but in group (B) it is 67%.Incidence of caesarean delivery and operative delivery was 12% and 18% in active group compared to 5.7% and 5.7% in expectant group. 81.1% and 96 % of babies in both groups at birth had APGAR  7 respectively. Neonatal mortality is 1.9% in expectant group and 2% in active group. Maternal morbidity in expectant cases was 3.81% and in active cases 4%. Neonatal morbidity in expectant group was 20.6% and in active cases was 18%.

[1]. F. Gary Cunnigham, Kenneth J.Leveno, L.Bloom, John C. Hauth, Larry C. Gilstrap III, Katharine D, Wenstrom. Normal labor, chapter 17.Williams Obstetrics 22nd edn,New York; Mc Graw-Hill; 2005:433-52.
[2]. Parry jones E, Priya S: A study of elasticity and tension of fetal membranes and of the relation of the area of the gestational sac to the area of the uterine cavity.Br.J Obstet and Gynecol 1976; 83: 205.

Abstract: The defect which is associated with loss of eye can lead to major physical, mental and emotional disturbance. Treatment of facial deformity is a difficult task in which procedure for each patient is very skilled and précised. Visual judgment alone will not be perfect. Here we report a case of 45-year-old female patient with meningiosarcoma of the right eye, undergone surgical enucleation and was rehabilitated by spectacle with magnet retained silicon orbital prosthesis in order to accomplish perfect fit and aesthetics. Keywords: artificial eye, magnet, orbital prosthesis.

1]. PERMAN KI, BAYLIS HI. EVISCERATION, ENUCLEATION, AND EXEN-TERATION. OTOLARYNGOL CLIN NORTH AM 1988; 21:171-82.
[2]. Artopoulou LL, Montgomery PC, Wesley PJ,. Digital imaging in the fabrication of ocular prostheses. J Prosthet Dent 2006; 95:327-30.
[3]. Parajuli PK et al A spectacle retained acrylic orbital prosthesis for rehabilitation of an exenterated eye Acrylic orbital prosthesis 2012; Vol 10 (No.2);144-146
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Abstract: Breast cancer is a disease condition that is associated with alterations in the body's physiological homeostasis. Bone metastases are common in advanced cancer and cause considerable morbidity and mortality. The study aimed to assess the serum levels of alkaline phosphatase activity and the bone minerals in breast cancer. A total of 80 subjects within the ages of 20-65 years were investigated (40 breast cancer subjects and 40 age-matched apparently healthy female subjects as controls). Serum calcium was estimated using calcium kit from Randox Laboratories, inorganic phosphate and magnesium were estimated using kits from Biosystems while the estimation of serum alkaline phosphatase activity was done using King Armstrong's method.

[1]. Jemal A., Bray A., Ferlay J., Ward E., Foreman D. (2011). Global cancer statistics. CA: Cancer Journal for Clinicians; 61: 69-90
[2]. Okorie N. (2012). Mass media strategies for creating awareness of breast cancer. Public Knowledge Journal; vol.3, issue 1,3S
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[4]. Solomayer E. F., Diel I. J., Meyberg G. C., Gollan C., Bastert G. (2000). Metastatic breast cancer: clinical course, prognosis and therapy related to first site of metastasis. Breast Cancer Research and Treatment; 59: 271-278
[5]. Mundy G. R. (2002). Metastasis to bone: causes, consequences and therapeutic opportunities. Nature Reviews Cancer; 2: 584-593
[6]. Bundred N. J. (2007). Optimising bone health in survivors of breast cancer. Lancet Oncology; 8:89-91
[7]. Gaillard S and Stearns V.,(2011) . Aromatase inhibitor-associated bone and musculoskeletal effects: new evidence defining etiology and strategies for management. Breast Cancer Research, 13:205 doi:10.1186/bcr2818

Abstract: Antimicrobial agent has been effectively used systemically and locally in management of periodontal disease. Local drug has an advantage of higher antimicrobial concentration in subgingival site. Presently large number of herbal product researches in oral use in various from. The study researches neem extract when incorporated in LLD system used as adjunct to scaling and root planing.

[1]. Michael G. Newman, Henry H. Takei, Fermin A. Carranza, Carranza's, Clinical Periodontology, 9th Edition, W.B. Saunders Company.
[2]. THOMAES. RAMS& JBRGEN SLOTS, Local delivery of antimicrobial agents in the periodontal pocket, Periodontology 2000, Vol. 10, 1996, 139-159.
[3]. Moore, W. E. C. (1987), Microbiology of periodontal disease. Journal of Periodontal Research, 22: 335–341 [4]. Sanz M, van Winkelhoff AJ, Herrera D, et al.. Differences in the composition of the subgingival microbiota of two periodontitis populations of different geographical origin. A comparison between Spain and The Netherlands. Eur J Oral Sci 2000 Oct; 108(5) :383-92. [5]. M.Raveendra Pai, Leelavathi D Acharya, N Udupa, Evaluation of antiplaque activity of Azadirachta indica leaf extract gel—a 6-week clinical study , Journal of Ethnopharmacology, Volume 90, Issue 1, January 2004, Pages 99-103

Abstract: Menopause leads to changes in lipid profile due to hormonal changes related to menopause and may lead to significant increase in the development of coronary heart disease (CHD).The present study was prospective study aimed to study and compare the levels of lipid profile between pre and post-menopausal women and to correlate the results with that of other studies..

[1]. Zafarhussain, Muhammed Akram, Sharoona M. Muhammed Akram et al. Postenopausal women: Atherosclerotic risk factors. Professional med J 2007 Sep; 14(3) : 484-90
[2]. Lgweh JC,Nwagha IU, Okaro JM. The effects of menopause on the serum lipidf profile of normal females of south east Nigeria. Nigerian journal of physiological sciences 2005; 20(1-2): 48-53.
[3]. Chee JK, Tae HK,Wang SR, Un HR. Infouence of menopause on HDL-C and lipids. J Korean Med Sci 2000; 15:380-86.
[4]. C.A.O. Usoro, C.C. Adikwuru, I.N. Usoro, A.C.sonwu.Lipid profle of postmenopausal women in calaar, Nigeria. Pakistan journal of nutrition 2006; 5(1): 79-82.
[5]. Srinivas Reddy Kilim and Srinivasa Rao Chandala; "A Comparative study of Lipid profile and oestradiol in pre-and post menopausal Women". Journal of Clinical and Diagnostic Research: JCDR. J Clin Diagn Res. 2013 Aug; 7(8)" 1596-1598.

Abstract: During the past decades many industrialized countries have experienced a dramatic decline in dental caries prevalence among children. The reasons behind the improved oral conditions include but not limited to improved oral hygiene practices, fluoridated toothpastes, and effective oral health programs beside establishment of school-based health education programs. Consequently the oral and dental health knowledge increased and the attitude of children and their parent was changed. Health education is defined as the principles that people follow and behave in a manner that promotes, maintains and/or restores health.

[[1]. Ajith krishnan CG, Thanveer K, Sudheer H, Abhishek S. Impact of oral health education on oral health of 12 and 15 years old school children of Vadodara city, Gujarat state. Journal of International Oral Health.2010; (2): 15–21.
[2]. Amin TT, Al-Abad BM. Oral hygiene practices, dental knowledge, dietary habits and their relation to caries among male primary school children in Al Hassa, Saudi Arabia ; Int J Dent Hygiene 2008; (6): P. 361–370 [3]. Biesbrock, A.R., Walters, P.A. and Bartizek, R.D Short-term impact of a national dental education program on children's oral health knowledge. Journal of Clinical Dentistry . 2004; 15 (4): P. 93-97. [4]. Booth ML, Samdal O. Health-promoting schools in Australia: models and measurement. Aust N Z J Public Health 1997; 21 (4): 365-70. [5]. Borges HC, Garbin CA, Saliba O, Saliba NA, Moimaz SA. Socio-behavioral factors influence prevalence and severity of dental caries in children with primary dentition. Braz Oral Res. 2012 Nov-Dec;26(6):564-70.

Abstract: Toxic epidermal necrolysis is a common life threatening dermatological emergency. It occurs most often as an adverse drug reaction due to drugs like NSAIDS, antibiotics, anticonvulsants, quinolones. It is acute in onset and involves integumentary system and other systems having high mortality. This condition necessitates intense management because of acute skin failure characterised by confluent purpuric and erythematous macules evolving in to flaccid blisters and epidermal detachment predominantly on the trunk and upper limbs and associated with mucous membrane involvement. Awareness regarding drugs causing TEN is known but Quinine as an etiological factor is never reported as cause for TEN in existing literature. Here we are reporting three cases which developed signs and symptoms of TEN shortly after initiating Quinine therapy. The cause in this cases was found to be Quinine which was given to patients undergoing treatment for Malaria. Usage of Quinine in cases with Falciparum Malaria is still being practised by many physicians and awareness of this dreaded complication is important.

Keywords: Toxic epidermal necrolysis, Integumentary system, Quinine, TEN.

[1]. Breathnach SM, Hintner H. Adverse Drug Reactions and the Skin. Oxford: Blackwell Scientific, 1992.
[2]. Crowson AN, Brown TJ, Magro CM. Progress in the understanding of the pathology and pathogenesis of cutaneous drug eruptions. Am J Clin Dermatol 2003; 4: 407–428.
[3]. Wolkenstein P, Revuz J. Drug-induced severe skin reactions. Drug Safety 1995; 13: 56–68.
[4]. Bigby M. Rates of cutaneous reactions to drugs. Arch Dermatol 2001; 137: 765–770.
[5]. McKenna JK, Leiferman KM. Dermatologic drug reactions. Immunol Allergy Clin North Am 2004; 24: 399–423.
[6]. Pichler WJ. Immune mechanism of drug hypersensitivity. Immunol Allergy Clin North Am 2004; 24: 373–397.

Abstract: Total hip replacement arthroplasty is a surgical procedure, which has relieved millions of people from incapacitating pain arising from the hip joint. At present it is the most commonly performed adult re-constructive hip procedure[1]. The success of Total Hip Replacement arthroplasty is its ability to relieve the pain associated with hip joint pathology, while maintaining the mobility and stability of the hip joint. The incidence of chronic disabling conditions of the hip such as osteoarthritis, inflammatory arthritis and osteonecrosis is on the rise.

[1]. Harkess, J. W. "Arthoplasty of the hip".Campbell's Operative Orthopaedics Mosby, 1998.
[2]. Petty W, P., WB Saunders, Total Joint Replacement-VI, Lower Extremity Replacement. The Hip. Philadelphia, 1991: p. pp 189-465.
[3]. McKee GK, W.-F.J., Replacement of arthritic hips by the McKee-Farrar prosthesis. J Bone Joint Surg [Br], 1966. 48: p. 245-259.
[4]. J, C., Total hip replacement. JAMA, 1974. 230: p. 1025-1028.
[5]. J, C., Low Friction Arthroplasty of the Hip – Theory and Practice.Berlin. Springer-Verlag. 1979.: p. 332-345.
[6]. Russotti GM, C.M., Stauffer RN, Cemented total hip arthroplasty with contemporary techniques. ClinOrthop, 1988. 235: p. 141-145.
[7]. Cook SD, M.L., Martir PC, Inflammatory response in retrieved noncemented porous-coated materials. ClinOrthop, 1991. 264: p. 209-222.

Abstract: Introduction:Incidence of intertrochanteric fractures has increased significantly during recent decades and this tendency will probably continue to rise in near future due to increased span of life. Closed methods of treatment for intertrochanteric fractures have shown higher mortality rates & have largely been abandoned. Rigid internal fixation and early mobilization has been the standard protocol of treatment now a days.This study is intended to compare the results of Intertrochanteric fractures by DHS over PROXIMAL FEMORAL NAILING..

[1]. Gulberg B, Jhonell O, Kanis J. Worldwide projection for hip fractures Osteoporosis Int. 1997; 7:407-413
[2]. Hagino H, Furukawa K, Fujiwara S, et al.Recenttrands in incidents and lifetime risk of hip fracture in Tottori, Japan Osteoporos Int. 2009;20(4):543-548
[3]. Jarnlo GB, Thorngren KG, Background factors to hip fractures. Clinorthop 1993; 287:41-49
[4]. Kyle RF, CabanelaME,RusellTA,et al. Fractures of the proximal part of the femur. Instr Course Lect 1995; 44:227-253.
[5]. Zuckerman JD, Comprehensive care of orthopaedic injuries in the elderly, Baltimore : Urban and Schwarzenberg, 1990
[6]. Schumpelick W, Jantzen PM: A new principle in the operative treatment of trochanteric fracture of the hip, J.Bone Joint Surg 1988, 70-A:1297-303.

Abstract: Chylothorax is a rare clinical entity characterised by a milky white fluid with increased triglyceride levels and chylomicrons in the pleural cavity. The commonest aetiology is malignancy and trauma. Persistent leak leads to significant loss of essential proteins, immunoglobulins, fat, vitamins, electrolytes and water and needs a prompt treatment. Bilateral idiopathic Chylothorax as observed in the present case is a rare entity.

Keywords: Chyle, Thoracic duct, Chylothorax, Triglyceride, Chylomicrons.

[1]. De Meester TR. The pleura. In: Sabiston DC, Spencer E, editors. Surgery of the chest. 4th ed. Philadelphia: WB Saunders; 1983.
[2]. Chan EH, Russel JL, Williams WG. Post operative chylothorax after cardiovascular surgery in children. Ann Thorac Surg. 2005;80:1864–70.
[3]. McWilliams A, Gabbay E. Chylothorax ocurring 23 years post-irradiation: literature review and management strategies. Respirology 2000;5:301-3.
[4]. Jindal SK, Malik SK, Malik AK, Sinoh K, Gujral JS, Sodhi JS. Bronchogenic carcinoma a review of 150 cases. Indian J Chest Dis Allied Sci. 1979;21:59–64.
[5]. Malthaner RA, Inculet RI, et al. The thoracic duct and chylothorax. In: Pearson FG, Deslauries J, Ginsberg RJ, editors. Thoracic surgery. 2nd ed. Churchill Livingstone; 2005. p. 1128-240.
[6]. Chauvin O, Dore P, Meurice JC, Boita F, Patte F. Bilateral chylothorax after mild trauma: Apropos of a case. Rev Pneumol Clin. 1992;48:71–3.

Abstract: Periapical lesions of endodontic origin may develop asymptomatically and become extensive. Treatment options to manage such lesions range from non-surgical root canal treatment and/or apical surgery to extraction. A high percentage of complete and partial healing of extensive perapical lesions following conventional endodontic therapy has been reported. The case reports in this article describe the management of such lesions by conventional endodontic therapy. Triple antibiotic paste and calcium hydroxide were used as intra canal medicaments. The two and three year follow up radiographs of the cases showed progressive healing of periapical lesions. Keywords: Calcium Hydroxide, Conventional Endodontic treatment, Intracanal medicament, Periapical lesions, Triple antibiotic paste,.

[1]. Nair P.N.R., Apical periodontitis: a dynamic encounter between root canal infection and host response, Periodontology 2000, 13(1), 1997, 121-148.
[2]. Nair P.N.R., Pathogenesis of apical periodontitis and the cause of endodontic failures, Critical Reviews in Oral Biology & Medicine, 15(6), 2004, 348-381.
[3]. Bhaskar SN, Nonsurgical resolution of radicular cysts, Oral Surgery, Oral Medicine, Oral Pathology, 34(3), 1972, 458-68.
[4]. Murphy WK, Kaugars GE, Collet WK and Dodds RN, Healing of periapical radiolucencies after nonsurgical endodontic therapy, Oral Surgery, Oral Medicine, Oral Pathology, 71(5), 1991, 620–4.
[5]. Asunción Mendoza-Mendoza, Carolina Caleza-Jiménez, Alejandro Iglesias-Linares, Beatriz Solano-Mendoza and Yañez-Vico RM, Endodontic treatment of large periapical lesions: An alternative to surgery, Edorium Journal of Dentistry, Vol. 2, 2015, 1-6.

Abstract: Supernumerary roots are uncommon in primary teeth. Primary mandibular second molars normally have two roots, one mesial and one distal. Rarely an additional third root is seen and when this extra root is situated distolingual to the main distal root it is referred as Radix Entomolaris and when it is present mesiobuccal to mesial root it is called Radix Paramolaris. The knowledge of the presence of additional roots and root canals is very essential for the successful endodontic treatment. This report presents an unusual case of bilateral Radix Entomolaris in primary mandibular second molars in a 5-year-old male patient. Key Words: Primary mandibular second molar, Radix Entomolaris, Radix Paramolaris, supernumerary root.

[1]. Barker BC. Dental anthropology: Some variations and anomalies in human tooth form. Aust Dent J 1973;18:132-140.
[2]. Curzon MEJ, Curzon JA. Three-rooted mandibular molars in the Keewatin Eskimo: Its relationship to the prevention and treatment of caries. J Can Dent Assoc 1972;38:152-154.
[3]. Nagaveni NB, Umashankara KV. Radix entomolaris and paramolaris in children: A review of literature. J Indian Soc Pedod Prev Dent 2012;30:94-102.
[4]. Tratman EK. Three-rooted lower molars in man and their racial distribution. Br Dent J 1938;64:264-274.
[5]. Srivathsa SH. Prevalence of three rooted deciduous mandibular molars in Indian children. Int J Dent Sci Res 2014.[in press].
[6]. Nagaveni NB, Bajaj M, Shruthi AS, Poornima P. Radix paramolaris (supernumerary third root) in primary mandibular second molar: Report of two cases. Niger J Exp Clin Biosci 2014;2:134-137.

Abstract: Head injury is a recognized as a major public health problem that is a frequent cause of death and disability in young people and makes considerable demands on health services. Alteration of the trace elements such as Zinc and copper has great importance in head injury patients. Objective: To Study the serum level of Copper, Magnesium, Zinc and Chromium in trauma patients and its association between these trace elements and severity of head injury in terms of GCS. Methods: Special designed performa was used to collect data of Trauma patients. The data were expressed in percentage.

[1]. Becker D et al. Trauma and adolescence I: The nature and scope of trauma. Adolescent Psychiatry,2003.
[2]. Jennett B Epidemiology of head injury. J Newrol Neurosurg Psychiatry 1996;60:362-369.
[3]. Mass AIR, Stocchetti N, Bullock R. Moderate and severe traumatic brain injury in adults. Lancet Neurol 2008;7:728-41.
[4]. Fraga CG. Relevance, essentiality and toxicity of trace elements in human health. Molecular aspects of medicine 2005;26:235-244.
[5]. Saraymen R, Kilic E, Yazar S.Sweat Copper, Zinc, Iron, Magnesium and Chromium levels in National Wrestler. Inonu University Tip Fakultesi Dergisi 2004;11(1):7-10.

Abstract: Medullary thyroid carcinoma (MTC) originates from the thyroid parafollicular cells and accounts for 3% to 10% of all thyroid malignancies. Approximately 84% of cases are sporadic. A case of 45 yrs male patient presented with thyroid nodule and difficulty in swallowing.Fine-needle aspiration biopsy (FNAB)had been performed preoperatively subsequently it was reported as follicular neoplasm .In histopathology it is reported as medullary carcinoma of thyroid. IHC on sections show Thyroglobulin is negative , Calcitonin is positive and it is confirmed as medullary carcinoma of thyroid. Since it is a rare case ,we present this case.

Keywords: Thyroid nodule , Medullary carcinoma of thyroid , Calcitonin..

[1]. Clayman GL, el-Baradie TS. Medullary thyroid cancer. Otolaryngol Clin North Am 2003;36:91–105.
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[3]. Hundahl SA, Fleming ID, Fremgen AM, et al. A National Data Base report on 53,856 cases of thyroid carcinoma treated in the U.S., 1985–1995. Cancer 1998;83:2638– 2648.
[4]. Block MA, Jackson CE, Greenwald KA, et al. Clinical characteristics distinguishing hereditary from sporadic medullary thyroid carcinoma: treatment implications. Arch Surg 1980;115:142–148.
[5]. Duh QY, Sancho JJ, Greenspan FS, et al. Medullary thyroid carcinoma: the need for early diagnosis and total thyroidectomy. Arch Surg 1989;124:1206–1210.

Abstract: Objectives: To determine and compare Total Antioxidant Capacity (TAC)of saliva in children undergoing active orthodontic treatment with removable and fixed orthodontic appliances before and after treatment. Methods: Total antioxidant capacity of saliva was investigated in 46 healthy children aged 8-14 years. The children divided into three groups. Group A treated with fixed orthodontic appliance , group B treated with removable orthodontic appliance and group C receive no treatment. Saliva samples(2mm) were collected. in different time intervals: before the orthodontic treatment, three months and six months after treatment. Salivary total antioxidant capacity was measured by spectrophotometric method.

[1]. Prithviraj C, Suresh K, Debarupa D, Vikas G. Role of Antioxidants in Common Health Diseases. Research J. Pharm. and Tech. 2009; 2 (2): 238–244.
[2]. Srikrishna R, Suresh DR. Variation of Total antioxidant Status after Ischemic stroke, British J Med Practision. 2009; 2(1): 35-37.
[3]. Dilip Daniel Quadras, U. S. Krishna Nayak, Suchetha Kumarin, Prashant Pujari, Vijay R. and Ajay Dethose.In vivo analysis of Lipid Peroxidation and Total Antioxidant status in subjects treated with stainless steel orthdontic appliances.Niti University Journalof Health Science. 2013; 3(3): 83-86.
[4]. Bast, Haenen CD. Reactive oxygen species and airway inflammation. Free Radio Bio Med. 2003; 91(3):2-13.
[5]. Bouayed J and Bohn T. Exogenous antioxidants - Double-edged swords in cellular redox state: Health beneficial effects at physiologic doses versus deleterious effects at high doses. Oxid Med Cell Longev. 2010; 3(4): 228–237.

Abstract: Prostate cancer causes significant morbidity and mortality among African men. Anaemia is a known association of cancer patients. Aim: To determine the prevalence and risk factors for anaemia in prostate cancer (CaP) patients in Nigeria. Method: A prospective study of prostate cancer patients and matched healthy controls, clinical data were obtained and samples were taken for Haemoglobin estimation. Data analysed using EPI Info, version 6.0 ..

[1]. Nalesnik JG, Mysliwiec AG, Canby-Hagino E. Anemia in Men With Advanced Prostate Cancer: Incidence, Etiology, and Treatment Rev Urol. 2004;6(1):1-4.
[2]. Shahani S, Braga-Basaria M, Maggio M, Basaria S. Androgens and erythropoiesis: past and present, J of Endocrinol Invest. 2009 ;32(8): 704–716.
[3]. Caro JJ, Salas M, Ward A, Goss G. Anaemia as an independent prognostic factor for survival in patients with cancer: a systemic quantitative review. Cancer 2001; 91: 2214-2221.
[4]. Badmaus TA, Adesunkanmi AR, Yusuf BM, Oseni GO, et al. Burden of prostate cancer in southwestern Nigeria. Urology, 2010 Aug;76(2):412-6
[5]. Ekwere PD, Egbe SN. The changing pattern of prostate cancer in Nigerians: current status in the southeastern states. J Natl Med Assoc 2002;94:619-27
[6]. Sapira KM, Onwuchekwa AC, Onwuchekwa CR. Co-morbid Medical Conditions and Medical Complications of Prostate Cancer in Southern Nigeria. Med J Malaysia. 2012; 67(4): 412-416.

Abstract: Aim: To compare the efficacy of various instrumentation techniques for removing obturating material from root canals using Cone Bean Computed Tomography (CBCT). Materials and Methods: Thirty extracted human premolar teeth, each with a single canal were selected. The root canals were prepared upto F4 ProTaper file and obturated with corresponding gutta percha cone. Teeth were divided into three groups according to the technique used for removing the obturating material: group I – Reciproc R50 instrument; group II – Gates–Glidden burs and hand files up to size 50; group III – Mtwo files upto size 50, 0.04 taper. The amount of remaining filling materials after the retreatment procedures was assessed by CBCT. The data was statistically analysed by One way Anova test..

[1]. Betti LV, Bramante CM. Quantec SC rotary instruments versus hand files for gutta-percha removal in root canal retreatment. Int Endod J 2001;34:514-9.
[2]. Giuliani V, Cocchetti C, Pagavino G. Efficacy of ProTaper Universal retreatment files in removing filling materials during root canal retreatment. J Endod 2008;34:1381-4.
[3]. Bonaccorso A, Cantatore G, Condorelli GG, Schäfer E, Tripi TR. Shaping ability of four nickel-titanium rotary instruments in simulated S-shaped canals. J Endod 2009;35:883-6.
[4]. Rödig T, Reicherts P, Konietschke F, Dullin C, Hahn W, Hülsmann M. Efficacy of reciprocating and rotary NiTi instruments for retreatment of curved root canals assessed by micro-CT. Int Endod J 2014;47:
[5]. Saad AY, Al-Hadlaq SM, Al-Katheeri NH. Efficacy of two rotary NiTi instruments in the removal of guttapercha during root canal retreatment. J Endod 2007;33:38–41.