iosr-JDMS   Volume-15 ~ Issue-1 ~ January-2016

Abstract: Opioids are well studied adjuncts although the evidence regarding the analgesic benefit of opioid adjuncts remains equivocal. The effectiveness of 0.5%Bupivacine and 0.5% Bupivacaine plus Buprenorphine into brachial plexus sheath was evaluated. Materials and methods: The study was a comparative study carried out at GGH, Guntur. 60 ASA I and II patients undergoing elective upper limb surgeries, aged between16-70 years were randomly allocated into two groups of 30 each. All patients received 0.5% of Bupivacaine at 2mg/kg bodyweight. In addition, 30 patients in group B received Buprenorphine hydrochloride (2μg/kg) .Using VAS score the analgesia was evaluated every hourly for six hours, every two hours for next twelve hours and then ever y sixth hourly till 48 hours.

[1]. DB Murphy, CJ McCartney, VW Chan. Novel analgesic adjuncts for brachial plexus block; a systemic review. Anesth Analg 2000; 90: 1122-8.
[2]. Viel EJ, Eledjam JJ, Coussaye JE, D' Athis F. Brachial plexus block with opioids for post operative pain relief: Comparison between buprenorphine and morphine. Reg Anesth 1989; 14: 274-8.
[3]. Fletcher D, Kuhlman G, Samii K. Addition of fentanyl to 1.5% lidocaine does not increase the success of axillary block.Reg Anesth 1994; 19: 183-8
[4]. Bazin JE,Massoni C,Groslier D.The addition of opioids to local anesthetics in brachial plexus block .Anaesthesia 1997;52:858-62.
[5]. Wajima Z, Shitara T,Nakajima C, Kim NK.Comparison of continuous brachial plexus infusion of butorphanol,mepivacaine and mepivacaine-butorphanol mixtures for postoperative analgesia. Br J Anesth 1995; 75: 548-551.

Abstract: This study is conducted to determine the influence of epilepsy and its treatment on pregnancy and its outcome 1) To study the maternal complications 2) To study the perinatal outcome

[1]. Carhuapoma RF, Mark W, Steven R Levine, Neurological diseases, in James DK, Steer PJ, Weiner CP, Gonik B, High Risk Pregnancy – Management Options, 3rd edition. (Philadelphia : Saunders Elesevier, 2006) 1064-1066.

[2]. Quality Standards Subcommittee of the American Academy of Neurology,Practice parameter: management issues for women with epilepsy (summary statement). Report of the Quality Standards Subcommittee of the American Academy of Neurology,51(4),1998,944–8.

[3]. Kaplan, Peter W et al., Obstetric risks for women with epilepsy during pregnancy, Epilepsy & Behavior, 11(3),2007,283-291.

[4]. Sillanpää, M,Long-term outcome of epilepsy, Epileptic Disord, 2(2),2000,79- 88.

Abstract: Usually two papillary muscles are described in the left ventricle, anterior (superior) and posterior (inferior); either may be multiple. Many authors mentioned presence of accessory papillary muscles and various patterns of the base and apex of papillary muscle. This study was carried out on 25 formalin-fixed human foetal hearts of gestational age ranging from 14 to 40 weeks in the department of Anatomy, RIMS, Imphal. Left ventricles were cut opened and the number, position, pattern of papillary muscle heads at the base and apex, and distribution of chordae tendineae to mitral valvular cusps were observed and recorded. The number of papillary muscles were found to be highly variable in both anterior as well as posterior group of papillary muscle.

[1]. Gatzoulis MA. Thorax. In: Standring S, Borley NR, Collins P, Crossman AR, Gatzoulis MA, Healy JC, editors. Gray's anatomy the anatomoical basis of clinical practice. 40th ed. London: Elsevier Churchill Livingstone; 2008. p. 907-1038.
[2]. Gunnal SA, Wabale RN, Farooqui MS. Morphological variations of papillary muscles in the mitral valve complex in human cadaveric hearts. Singapore Med J. 2013;54(1):44-8.
[3]. Hollinshead WH. Anatomy for surgeons: the thorax, abdomen, and pelvis. 2nd ed. New York: Harper & Row; 1971.
[4]. Uhn JS, Youn JC, Lee HJ, Park J, Park JK, Shim CY, et al. Accessory papillary muscles and papillary muscle hypertrophy are associated with sudden cardiac arrest of unknown cause. Int J Cardiol. 2015;15(197):285-91.
[5]. Hosapatna M, D Souza A, Das AM, Supriya, Ankolekar VH, D Souza AS. Morphology of papillary muscles in human adults: a cadaveric study. Ibnosina J Med BS. 2014;6(4):168-72.
[6]. Skwarek M, Hreczecha J, Grzybiak M, Kosiński A. Remarks on the morphology of the papillary muscles of the right ventricle. Folia Morphol. 2005;64(3):176–82.

Abstract: Study of foramen transversarium was made with respect to its shape, diameter, presence of accessory foramen and osteophytic encroachment. The data provided by the present study on morphology will be helpful to solve puzzles about foramen transversarium. Material and Methods: 100 foramen transversarium were studied in fifty dry cervical vertebrae which were randomly selected irrespective of age and sex for the study from the Department of Anatomy, Madurai medical college, Madurai. Digital Vernier caliper was used to measure the diameter.

[1]. Robert E Windsor, Gerard A Malanga, Jasvinder chawla, Cervical Spine Anatomy, 2013,194-196.
[2]. Romanov V A, Miller L. G, Gaevyi M D (1973), Effect of vertebral nerve on internal ear cochlear circulation. Bulletin of Experimental Biology and Medicine, 75 ,10 -1.
[3]. Taitz C , Nathan N H, B.Arensberg (1978) ,some observations on the posterior bridge of atlas, Acta Anat [Basel] 127;212 – 217.
[4]. Cavder S ,Dalcik H ,Erean F , Morpho study on the V2 segment of the vertebral artery, Okajimas – Folia. Anat .Jpn 1996 ;73;133- 7.
[5]. Cagnie B ,Barbaixe E ,Vinck E ,Herde K, Cambier D. Extrinsic risk factors for compromised blood flow in the vertebral artery :Anatomical observations of the transverse foramina from C3 to C7 . Surg Radiol Anat 2005; 27 (4) : 312 – 6.

Abstract: Burning mouth syndrome (BMS) is characterized by oral burning or painful sensations without pathological changes; its real cause is unknown. We previously reported that autonomic lability was probably associated with the pathogenesis of BMS based on the results of frequency analysis of heart rate variability (HRV). HRV is composed of time and frequency domains, although the significance of the time-domain measurements of HRV in BMS has not been discussed. In this study we assessed the significance of the time-domain measurements, particularly in relation to autonomic lability. Twenty-two patients received stellate ganglion near-infrared irradiation (SGR), and the response to SGR was examined by time-domain measurements. No significant difference in the time domain was found between patients in whom SGR was effective and those in whom SGR was ineffective for BMS.

[1] Cekić-Arambasin A, Vidas I, Stipetić-Mravak M (1990) Clinical oral test for the assessment of oral symptoms of glossodynia and glossopyrosis. J Oral Rehabil 17: 495-502.

[2] Femiano F, Lanza A, Buonaiuto C, Gombos F, Nunziata M, et al (2008) Burning mouth syndrome and burning mouth in hypothyroidism: proposal for a diagnostic and therapeutic protocol. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 105: e22-e27.

[3] Huang W, Rothe MJ, Grant-Kels JM (1996) The burning mouth syndrome. J Am Acad Dermatol 34: 91-98.

[4] Tourne LP, Fricton JR (1992) Burning mouth syndrome. Critical review and proposed clinical management. Oral Surg Oral Med Oral Pathol 74: 158-167.

[5] Nakase M, Okumura K, Tamura T, Kamei T, Kada K, et al (2004) Effects of near-infrared irradiation to stellate ganglion in glossodynia. Oral Dis 10: 217-220.

[6] Akselrod S, Gordon D, Ubel FA, Shannon DC, Berger AC, et al (1981) Power spectrum analysis of heart rate fluctuation: a quantitative probe of beat-to-beat cardiovascular control. Science 213: 220-222.

Abstract: Standard procedure for Inguinal hernia repair remains controversial, despite advances in technique and materials. Conventional implants are typically static (passive) and do not move in concert with the groin's motility. Inguinal hernia repair with mesh fixation on dynamic groin structures are not tension free, and are associated with tissue tearing, bleeding, hematoma, and nerve entrapment–all of which might contribute to post operative complications. The poor quality of tissue ingrowth within static meshes/plugs embodies another crucial issue in prosthetic hernia repair. The regressive tissue leads to shrinkage and reduction of the mesh surface area which is a significant cause of recurrence and discomfort.

[1] O'Dwyer PJ, Kingsnorth AN, Mohillo RG, et al. Randomized clinical trial assessing impact of a lightweight or heavyweight on chronic pain after inguinal hernia repair. Br J Surg, 92(2),2005,166-70.
[2] Kim-Fuch C, Angst E, Vorburger S, et al. Prospective randomized trial comparing sutured with sutureless mesh fixation forLichtenstein hernia repair: long-term results.Hernia,16(1), 2012, 21-7.
[3] Amato G, Marasa L, Sciacchitano T, et al. Histological findings of the internal inguinal ring in patients having indirect inguinal hernia. Hernia 13(3), 2009, 259-62.
[4] Amato G, Ober E, Romano G, et a. Nerve degeneration in inguinal hernia specimens.Hernia, 15(1), 2011, 53-8.
[5] Amato G, Romano G, Salamone G, et al. Damage to the vascular structures in inguinal hernia specimens. Hernia, 16(1), 2012, 63-7.

Abstract: SPlatelets play a key role in initiation of atherosclerosis and formation of coronary thrombus in
coronary artery diseases (CAD). Active platelets are large in size and have a higher potential thrombotic
ability, evaluation of their volume indices as indicator of their activity could be useful in prediction and
differentiation of coronary events. This study evaluated the platelets volume indices in a group of Sudanese
patients with CAD and compared with normal populations. Among the total included 103 patients with CAD;
there were 53 patients with acute coronary syndrome (ACS), 50 patients with chronic stable angina. Age and
sex matched; 100 subjects with non-cardiac chest pain were also included as normal controls. K3-EDTA
anticoagulated venous blood of each subject was collected, platelets count and indices were measured using
Sysmex KX-21 analyzer.

[1]. Lippi G, Montagnana M, Salvagno GL, Guidi GC. Potential value for new diagnostic markers in the early recognition of acute
coronary syndromes, CJEM,8, 2006, 27–31.
[2]. Trip MD, Cats VK, van Capelle FJL, et al. Platelet hyperreactivity and prognosis in survivors of myocardial infarction, New Engl J
Med, 322, 1990, 1549–1554.

Abstract:To Renaissance(meaning "rebirth") the art of Non Descent Vaginal Hysterectomy as a primary
approach for benign pathology.
Methods: A comparitive study of 50 patients who were admitted for hysterectomy with a wide range of
indications and who underwent Non Descent Vaginal Hysterectomy orTotal Abdominal Hysterectomy or Total
Laparoscopic Hysterectomywere studied. The outcomes were compared in terms of age group,indications,
parity, surgery duration, post op complications, post op hospital stay, need for blood transfusion etc.
Results: Majority of the patients were in age group of 40-49(46%)with a median of 44 years.

[1]. (wilcese, peterunte. Hysterectomy in U.S 1988-1990)
[2]. Meikle SF ,Nugent SW ,Oleans M.Complications and recovery from laparoscopy –assisted vaginal hysterectomy compared with
abdominal and vaginal hysterectomy Obstet Gynecol 1997;89:304-11.
[3]. Davies A , Wizza E , Bournas N et al . How to increase the proportion of hysterectomies performed vaginally .Am J Obstet Gynecol
1998;179:1008-12.
[4]. Mazdisnian F,Kurzel RB,Coe S et al . Vaginal Hysterectomy by uterine morcellation: efficient non morbid procedure. Obstet
Gynecol 1995;86:60-4.
[5]. Unger JB . Vaginal Hysterectomy for the woman with moderately enlarged uterus weighing 200 to 700 grams. Am J Obstet
Gynecol 1999;180:1337-44.
[6]. Dewan rupali. Non Descent Vaginal Hysterectomy-An Experience. J Obstet Gynecol 2004;376-378..

Abstract:This study aims at unravelling the characteristics of SNHL in DM and its relation to age, sex, duration ,family history, type of anti diabetic medication and control of DM.A total of 200 cases, 150 type 2 diabetic patients and 50 non diabetic(controls) cases between the age group of 20-55years were enrolled in the study. FBS and PPBS and HbA1c of all the subjects were done and later subjected to PTA. Bilaterally symmetrical graph were observed for both cases andcontrols. 81.3%diabetics showed significant high frequency SNHL and only 58% of non diabetic individuals showed high frequency SNHL, in an age group of 50-55years, suggesting age related changes. Low and midfrequencies also showed increased incidence of SNHL among diabetics when compared to control group.

[1] Kurien M., Thomas K, Bhanu T.S. "Hearing threshold in patients with diabetes mellitus", Journal of Laryngology and Otology,
1989 Feb; 103(2) : 164-168.
[2] Cullen R, Cinnamond N.J. "Hearing loss in diabetes", Journal of laryngology and otology, 1993 ; 107 : 179-182.
[3] Virteniemi J et al, "Hearing thresholds in Insulin dependent diabetes mellitus", Journal of laryngology and Otology, 1994 ; 108 :
837-841.
[4] Tay HL, Ray N, Ohri R, "Diabetes mellitus and hearing loss", Clinical otolaryngology, 1995 ; 20 : 130-134.
[5] Ravi KV, Henderson A, "Sudden deafness as a sole presenting symptom of diabetes mellitus". Journal of laryngology and otology,
1996, Vol.110 ; 59-61.
[6] Anthony Wright, "Anatomy and Ultrastructure of human ear", in Scott-Brown‟s Otolaryngology, 1997, 6th edition, Vol. 1, 1/1-49.
[7] James O. Pickles, "Physiology of Hearing", in Scott-Brown‟s Otolaryngology, 1997, 6th edition, Vol.1, 2/1-31.

Abstract: This study was conducted to assess the effect of hemodialysis (HD) on prolactin and testosterone level and their relations with study variables in chronic kidney disease (CKD) male patients. In a cross-sectional study carried out in 80 males aged range from (22 to 80 years old), timed pre and post-HD samples were collected. Serum prolactin, testosterone, urea and creatinine were measured by using TOSOH® Bioscience full automated immunoassay analyzer AIA-360 and Mindary BS-200. Paired t-test found that mean testosterone, urea and creatinine level obtained after HD significantly lower p-value (0.000, 0.000 and 0.000) respectively, while insignificant difference was observed in mean prolactin concentration p-value 0.408. Interestingly change in prolactin after HD had a significant correlation with testosterone level (r = -0.280, p-value 0.042).

[1]. Robert Thomas, Abbas Kanso, and John R. Sedor, Chronic Kidney Disease and Its complications Prim Care. (2008); 329-335.
[2]. Kunal Chaudhary, Peritoneal Dialysis Drop-out: Causes and Prevention Strategies, International Journal of Nephrology Volume (2011).
[3]. Unruh A, Kurella M, Brett T, Larive C, Rastogi A and James S. Impact of Sleep Quality on Cardiovascular Outcomes in Hemodialysis Patients: Results from the Frequent Hemodialysis Network Study. American Journal of Nephrology (2011);33:398-406.
[4]. Finkelstein SH, Finkelstein FO. Evaluation of sexual dysfunction in dialysis patients. In: Nissenson AR, Fine RN, editors. Dialysis Therapy. 3rd ed. Philadelphia: Hanley and Belfus; (2002) 368–373.
[5]. Schaefer F, Mehls O, Ritz E.New insights into endocrine disturbances of chronic renal failure. Miner Electrolyte Metab(1992) ; 18: 169–173.

Abstract:The objective of this study was to assess lipid profile among restricted diet control autistic patients in Khartoum Autism spectrum disorders (ASDs) Centers. This was cross-sectional study carried out in 80 control diet autistic patients (4 to 16 years old) compared with 80 controls matched healthy non-autistic subjects. Lipids profile (Cholesterol, triglycerides, LDL-C, HDL-C and LDL/HDL ratio) were measured after overnight fasting blood samples collection. Independent t-test analyses showed cholesterol, HDL and LDL were lower in autistic patients compared to controls with (p-value 0.004, 0.000, 0.009) respectively. In addition triglycerides was higher in autistic patients compared to controls (p-value 0.025), while LDL/HDL ratio was insignificantly difference (p-value 0.516).

1]. Nassim Zecavati, Sarah J .Spence, Neurometabolic disorders and Dysfunction in Autism Spectrum Disorders, Current medicine group LLC, 2009, (9): 129-136
[2]. Christine carson , Caroline Keir , Margret Ghlaimi , Nichole Taske , Jasdeep Hayre , Anna poppa, Autism, The Management And Support Of Children And Young People One The Autistic Spectrum Introduction, National Institute for Health and Car Excellence, 2013, 1-42
[3]. Paoli A, Rubini A, Volek J S and Grimaldi K A, Beyond weight loss: a review of the therapeutic uses of very-low-carbohydrate (ketogenic) diets, European Journal of Clinical Nutrition (2013) (67): 789–796
[4]. James B. Adams, Stephen M. Edelson, Temple Grandin, Bernard Rimland, Advice For Parents of Young Autistic Children, Autistic Research Institute, 2014, 1-13
[5]. Anna jarvinen Pasley, Gregory L. Wallace, Franck Ramus, Francesca Happe, Pamela Lteaton, Enhanced Perceptual Processing Of Speech In autism, Dveleopmental Science 2008, 11(1): 109-121

Abstract: Immediate implant placement has been the acceptable procedure for the past two decades. Perhaps the most important aspect of any implant surgery in accordance with the successful procedure is implant surgery and bone to implant contact.The aim of this article is to describe a clinical case in which a fractured maxillary canine was replaced by an immediately loaded postextraction implant using a simplified technique, which permits a reduction of the number of implant components and consequently a lower cost of treatment, while at the same time maintaining acceptable aesthetic and functional outcomes. Key words: Immediate implant placement, Immediate loading, Immediate provisionalisation, Esthetics

[1]. Wang TM, Leu LJ, Wang J, Lin LD. Effects of prosthesis materials and prosthesis
[2]. splinting on peri-implant bone stress around implants in poor-quality bone: a numeric analysis. International Journal of Oral and Maxillofacial Implants. 2002;17(2): 231-7.
[3]. Misch CE. Bone Density: A Key Determinant for Treatment Planning. In: Contemporary Implant Dentistry, (Misch CE) 3rd ed. Mosby Elsevier, St. Louis, Missouri;2008. pp. 130-146.
[4]. Wohrle PS. Single tooth replacement in esthetic zone with immediate provisionalization: 14 consecutive case reports. Practical periodontics and Aesthetic Dentistry 1998; 10:1107-1114.
[5]. Alphonse Gargilo etal. Immediate molar implant placement: A clinical investigation. The journal of implant and advancedclinical dentistry 2011; 3(6):37-44.
[6]. Turkyilmaz I, Suarez JC, Company AM. Immediate implant placement and provisional crown fabrication after a minimally invasive extraction of a peg-shaped maxillary lateral incisor: a clinical report. The Journal of Contemporary Dental Practice. 2009;10(5):e73-80.

Abstract: Urinary stone is the third most common urological disease. Urinary stones are mineral deposition within the urinary tract. Renal stones are common, being present at some time in one in ten of the population. Bladder stones (calculi) account for around 5% of urinary tract stones and usually occur because of foreign bodies and obstruction or infection. Many literatures are available for the formation of urinary tract stones and revealed different reasons are involved in the formation of these stones.

[1]. Ben Halim M, Bash-Agha I, Elfituri O, Turki M and Hawas A (2012) Child hood Urolithiasis in North-western Libya. Saudi J Kidney Dis Transpl 23(1):162-170.
[2]. Evan A, Lingeman J and Coe FL (2006) Randall's plaque: pathogenesis and role in calcium oxalate nephrolithiasis. Kidney Int. 69(8):1313-1318.
[3]. Guidelines on Urolithiasis (2015) European Association of Urology.
[4]. Schwartz BF and Stoller ML (2000) The vesical calculus. Urol Clin North Am. 27(2):333-346.
[5]. Shiekh FA , Khullar M and Singh SK (2006) Lithogenesis: induction of renal calcifications by nanobacteria. Urol Res. 34(1):53-57.
[6]. Sial JS, Khan J, Iqbal S, Akbar A and Khan F (1995) Chemical analysis of renal calculi from D.G. Khan. Professional Med J.2:89-93.

Abstract: Achondroplasia is the most common cause of congenital dwarfism. It is autosomal dominant disturbance in epiphyseal chondroblastic growth and maturation(1). Patients are of normal intelligence. Usually they have normal motor function. However a few present with mild to moderate motor symptoms. . Not all patients presents with neurological findings and hence MRI is usully not done. As skull base forms by enchondral ossification, its growth can be effected with increasing age, leading to stenosis of the foramen magnum, that can cause compression over medulla/cervical cord.We present a case of 12 month old girl child who presented to the pediatric OPD with chief complains

[1]. Yochum and Rowe's essentials of skeletal radiology; third edition; Terry R. Yochum, Lindsay J. Rowe; Lippincott Williams & Wilkins;Chapter8:SkeletalDysplasias(Pg722).
[2]. 1. Kao SC, Waziri MH, Smith WL et-al. MR imaging of the craniovertebral junction, cranium, and brain in children with achondroplasia. AJR Am J Roentgenol. 1989;153 (3): 565-9. AJR Am J Roentgenol (abstract) - Pubmed citation.
[3]. Wang H, Rosenbaum AE, Reid CS et-al. Pediatric patients with achondroplasia: CT evaluation of the craniocervical junction. Radiology. 1987;164 (2): 515-9. Radiology (abstract) - Pubmed citation
[4]. Hirabuki N, Watanabe Y, Mano T et-al. Quantitation of flow in the superior sagittal sinus performed with cine phase-contrast MR imaging of healthy and achondroplastic children. AJNR Am J Neuroradiol. 2000;21 (8): 1497-501. AJNR Am J Neuroradiol (full text) - Pubmed citation..

Abstract: Schizencephaly is a rare brain malformation disease with either congenital or aquired cause (neonatal stress). It may either be closed lip(Type 1) or open lip(Type 2)(1). Patients present usually with the first decade with Either or combination of symptoms of mental retardation , delayed milestones or seizures. We present a case of Type 1 schizencephaly with temporal lobe heterotopia who presented to us with a chief complain of intractable seizures(2).

Keywords: Schizencephaly,nipple sign, heterotropias , septum pellucidum agenesis, mental retardation , delayed milestones ,seizures.

[1]. A.A.K. Abdel Razek A.Y. Kandell L.G. Elsorogy. Disorders of Cortical Formation: MR Imaging Features by. 10.3174/ajnr.A1223
[2]. O.A. Glenn J. Barkovich et al.Magnetic Resonance Imaging of the Fetal Brain and Spine: An Increasingly Important Tool in Prenatal Diagnosis: Part 2 . AJNR Am J Neuroradiol 27:1807–14.
[3]. Neuroradiology By Osborne
[4]. Stafford Johnson DB1, Brennan P, Dwyer AJ et al. Grey matter heterotopia: an unusual association of intractable epilepsy. .Ir J Med Sci. 1997 Jul-Sep;166(3):135-8.
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Abstract: The present paper reports the treatment of a young adult woman with congenitally missing maxillary lateral incisors who underwent orthodontic treatment for improvement of teeth alignment and occlusal balance previous to dental implant surgery. This treatment also allowed appropriate space for the future lateral incisors crowns. Then, Implants were positioned and prosthetic abutments installed. Ceramic laminates were planned on central incisors in order to improve anterior aesthetics. All-ceramic crowns and laminates were made using lithium dissilicate-based ceramic The multidisciplinary association of orthodontic, implant and prosthetic techniques resulted in successful functional and aesthetic rehabilitation of the case, which was maintained after 1 year follow up. Keywords: Dental agenesis. Dental implants. Ceramic laminates. Esthetic.

[1]. Abu-Hussein M., Watted N., Abdulgani N. , Alterman M.; Non-Syndromic Oligodontia: A Rare Case Report, jmscr2015,3(5),
[2]. 5649-5655
[3]. Abu-Hussein M., Abdulgani A., Watted N .Zahalka M.; Congenitally Missing Lateral Incisor with Orthodontics, Bone Grafting and Single-Tooth Implant: A Case Report. Journal of Dental and Medical Sciences2015, 14(4),124-130
[4]. Abu-Hussein M., Watted N., Abdulgani A., Bajali M.;Treatment of Patients With Congenitally Missing Lateral Incisors: Is an
[5]. Interdisciplinary Task. RRJDS 2014,2(4),53-68

Abstract: A one and half year female child by name aishwarya came to the bapuji hospital with chief complaints of spasticity of the limbs,loss of attained milestones,difficulty in standing ,swallowing difficulties and excessive crying MRI of brain was done in the bapuji hospital radiodiagnosis department using 1.5 tesla Philips machine.mri was done with contrast study and spectros

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