iosr-JDMS   Volume-14 ~ Issue-3 ~ March-2015

Abstract: Klippel-Feil syndrome (KFS) is characterized by a short neck with decreased movements and low posterior hairline. It occurs due to the failure of segmentation of cervical vertebrae during development. Deafness is a well known associated feature and may be of sensorineural, conductive or mixed type. Several otological abnormalities have been noted with these patients for e.g. external ear anomalies, cochlear anomalies and ossicular chain deformities. We hereby present a case report on Klippel-Feil Syndrome; a 25 year old female with restricted neck movements, LMN Facial palsy, absent pinna & chronic ear discharge with radiological findings such as Cholesteatoma, absent bony vestibule, semicircular canals, and cochlea and with Partial Atlanto-Occipital fusion & Hemivertebra at various levels (D3-D6) Canal-Wall down mastoidectomy procedure was undertaken with intraoperative Cholesteatoma debris & destruction of ossicles seen.
Keywords: Cholesteatoma, Klippel-Feil Syndrome.

[1]. J M McGaughran, P Kuna, V Das. Audiological Abnormalities in Klippel-Feil Syndrome. Arch Dis Child; 79:352-355
[2]. Robert N Hensinger, John E Lang, Dean Macewan.Klippel-Feil Syndrome, A Constellation of Associated Anomalies. J Bone Joint Surg Am; 56:1246-1253
[3]. Yildrim N, Arslanoglu A, Sahan M. Klippel-Feil Syndrome and Associated Ear Anomalies. Am J Otolaryngol; 29:319-25
[4]. R T Miyamoto, H Y Yune. Klippel-Feil Syndrome and Associated Ear Deformities. The American Journal of Otology; 5(2):113-9.

Abstract: Objective: This study was conducted in the Neonatal Intensive Care Unit (NICU) of a teaching hospital situated in a rural area of Bihar to ascertain the impact of postnatal magnesium sulfate (MgSO4) infusion on moderately to severely asphyxiated neonates. Methods: This single-blind, parallel-group, prospective, longitudinal, randomized controlled trial (RCT) was carried out to study the effect of postnatal magnesium sulfate (MgSO4) infusion on the mortality and neurological morbidity of term (born at 37-42 weeks of gestation) and post-term (>42 weeks of gestation) neonates with severe perinatal asphyxia and hypoxic-ischemic encephalopathy (HIE) stage II (moderate) or III (severe) (Sarnat & Sarnat staging) at 24 hours,at 7 days andat discharge. Fifty (50) patients of severe perinatal asphyxia with HIE stage II or above admitted over a period of 6 months were included in the study. The patients were assigned randomly in two groups- one group of 25 neonates received 3 doses of intravenous MgSO4 infusion at 250 mg/kg/dose (0.5 mL/Kg/dose of inj. MgSO4 (50% w/v) 24 hours apart, and the other 25 neonates did not receive this treatment. Other supportive care as per protocol for perinatal asphyxia was given to the patients in both the groups equally.

[1]. Gathwala G, Khera A, Singh J, Balhara B. Magnesium for neuroprotection in birth asphyxia. J. Pediatr. Neurosci. 2010 Jul-Dec; 5 (2): 102-4.
[2]. Bassant DG, Kumar R, Awasthi S, Morris SK, Paul VK, et al. Causes of neonatal and child mortality in India: nationally representative mortality survey. Lancet. 2010 Nov 27; 376 (9755): 1853-60.
[3]. McDonald JW, Roeser NF, Silverstein FS, Johnston MV. Quantitative assessment of neuroprotection against NMDA-induced brain injury. Exp. Neurol. 1989; 106: 289-96
[4]. Nowak L, Bregestovski P, Ascher P, Herbet A, Prochiantz A. Magnesium gates glutamate-activated channels in mouse central neurones. Nature. 1984; 307: 462-5.
[5]. Djabir Y, Letson HL, Dobson GP. Adenosine, lidocaine and Mg2+ (ALMTM) increases survival and corrects coagulopathy after eight-minute asphyxia cardiac arrest in the rat. Shock.2013 Sep; 40 (3): 222-32.

Abstract:The hand is the most used and versatile part of body is of great scientific importance to investigators in the field of anthropometry, forensic pathology, orthopedic surgery and ergonomics. The aim of the present study is to provide an authentic database on right and left hand length, hand breadth and hand shape indices of males and females of Kashmiri Pandits community of a particular age and sex. And study its correlation with handedness and sexual dimorphism. The study was conducted on 300 Kashmiri Pandits (150 each of either sex) of age group 18 year and above. The values for hand-length, hand breadth and hand shape indices were calculated for both the hands. Hand preference was constituted after calculation of laterality score established according to Edinburg inventory and five hand-preference determination groups were The results were tabulated and subjected to statistical analyses. Mean values for hand-length handbreadth and hand shape indices in males are more in when assessed by sex. These values were found statistically significant (p≤00.1). when relationship between laterality score(indicator of hand preference) and hand-length, handbreadth, and shape indices were examined, the values were found to be positively correlated for right hand-length, left hand-length, left shape index but the correlation was no statistically significant. Laterality score was positively correlated in Kashmiri Pandits it was with right hand length, left hand length and left hand shape index. But the correlation was statistically significant in case of right hand breadth (p≤0.01) and right shape index (p≤0.01).
Keywords: Hand length—hand breadth—hand index-- sexual dimorphism—hand preference.

[1]. Choudhary S, Singh H and Gupta N. Estimation of stature from combined length of forearm and hand in jammu region of india. Internet journal of basic and applied sciences, 2014;3(1):8-10.
[2]. Dyal MR, Steyn M and Kuykendell KL. Stature Estimation from bones of South African Whites. South Afri Jr Sci;2008,104(3&4):124-8.
[3]. Krishan K. Determination of stature from foot and its segments in north Indian population. Am JR Forensic Med and Path;2008:29(4):296-303.
[4]. Barnabas D and Elukpo A. Sexual dimorphism in hand and foot length, indices, stature-ratio and relationship to height in Nigerians. Internet Jr Forensic Sci ;2008,3(1):1-10.
[5]. Jasuja OP & Singh G. Estimation of stature from and Phallenge length. J ind a\Asso Forensic Med. 2004;26(3):100-6.

Abstract: Objective:-To study the socioeconomic , demographic characteristics and complications in acceptors of double puncture laparoscopy and conventional tubal ligation procedure. Study Design: It is a prospective study. Study Area:-Department of family planning. Government General hospital, GUNTUR,A.P, INDIA. Materials And Methods:-Study was conducted in Family planning unit, GGH, GUNTUR from Jan 2014-dec 2014. 200 cases of women undergoing DPL, 200 women undergoing CTL were personally interviewed before surgery and the data regarding age, literacy, last child birth were taken. Complications that occurred during procedure and after the procedure were noted and analyzed. Results:-Most of the women acceptors of DPL and CTL fall in same age group i.e21-30yrs. As the level of education increased, there was clear correlation in DPL acceptance.77% of CTL acceptors were of low socioeconomic group compared to 62.5% in DPL acceptors.DPL acceptance was more in women with previous caesarean section (63.5%) than women who underwent normal delivery(36.5%).Risk of Major intra operative complications in DPL was more than CTL. Minor postoperative complications are more with CTL than with DPL which were managed conservatively. Conclusion:-Acceptance of method of tubectomy is greatly influenced by age, mode of delivery, socioeconomic status and literacy.
Keywords: DPL, CTL, Acceptance, Complications.

[1]. International Institute of Population Sciences and ORC Macro. National Family Health Survey - 3. International Institute of Population Sciences, Mumbai. [Last accessed on 2010, Nov 05]..Available www.nfhsindia.org/pdf/India.pdf.
[2]. National Family Health Survey - 3. International Institute of Population Sciences, Mumbai. [Last accessed on 2011 Sep 27]. Available: www.nfhsindia.org/NFHS-3%20Data/VOL- 1/India_volume_I_corrected_17oct08.pdf .
[3]. Jayakrishnan K, Sumeet NB. Laparoscopic tubal sterilization reversal and fertility outcomes. J Hum Reprod Sci. 2011; 4(3): 125–129.
[4]. Engender Health; Contraceptive Sterilization Global Issues and Trends. Sterilization Incidence and Prevalence. Engender Health; 2002:139-58.
[5]. Pati S, Cullins V. Female sterilization. Evidence. Obstet Gynecol Clin North Am 2000;27:859-99.

Abstract: Eye is the most important sensory organ and it is prone to many diseases. Development of opacity of lens is called as cataract .Cataract accounts for 81% among all causes of blindness in India. Cataract can be treated by surgery. Post- operative inflammation of eye (aseptic uveitis) is one of the most common complication .It can be controlled by steroid drugs, but they have got other ocular and systemic complications. To avoid this non-steroidal anti- inflammatory drugs are been tried. Based on the literature and clinical study reports we wish to substantiate these findings, we undertook this study to compare Predinisolone acetate 1% eye drops and Diclofenac sodium 0.1% eye drops in the treatment of post- operative uveitis after uncomplicated cataract surgery. Total 150 patients were taken into the study .They were divided randomly in two groups 75 patients in each group. The study was conducted up to 42nd day of post -operative period. Patients were observed up to 6 weeks. During 1st week , Predinosolone patients responded well than the patients kept on Diclofenac but in later weeks Diclofenac patients yielded better results. No adverse effects were seen in Diclofenac group but in prednisolone group raised intraocular pressure. Cost of prednisolone was more than Diclofenac. So in conclusion Diclofenac 1% eye drops were effective and safer than prednisolone 0.1% eye drops in aseptic uveitis .It could also tried in patents in whom corticosteroids were contraindicated.
Keywords: Aseptic uveitis, Diclofenac sodium.Intra ocular pressure, Predinisolone acetate,Uncomplicated cataract surgery.

[1]. Park's Text Book of Preventive and social Medicine 18th Edition Page:320.
[2]. Brennan KM, Brown RM, Roberts CW. A comparison of non steroidal anti inflammatory 1993 Apr 18(1) 8-11.
[3]. Stelow S.A., Sherwood MD, Bron Cato LJ, Napier A. The effect of diclofenac sodium ophthalmic solution on intra ocular pressure following cataract extractius. Opthalmi surg 1992 March, 23(3) : 170-175
[4]. Onakoya A.O., Majekonduu AA, Adecate. Clinical trial of Diclofenac Sodium eye drops on Nigerions. Niger post graduate medical journal 2004 December, 11(4): 265 – 268.
[5]. Matsuo K, Hojou H, Honbou M, Clinical efficacy of Diclofenac sodium on post surgical inflammation after intra ocular lens implantation. Journal of cataract refract surgery 1995 May, 21(3) : 309-12.

Abstract: Surgical margin as read in a pathology report define the histological measurement of normal or unaffected tissue surrounding the visible tumor under a microscopeon a glass mounted histology section. A surgeon often performs a second surgery if a narrow or involved surgical margin is noted on a pathology report. The tumor with surrounding tissue is painted with a special ink so that the outer edges, or margins, are clearly visible under a microscope. If the margins are positive, more surgery is needed. In this study 25 cases of breast cancer were considered. After surgery (lumpectomy/ mastectomy) the surgical margins of specimen were marked with paint and sent for histopathological examination to observe the involvement of margins.Margins positive histopathologically were reoperated.

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[3]. Tampi C. In search of the rainbow: Coloured inks in surgical pathology. Indian Journal of Pathol Microbiol.2012;55:154-7
[4]. Kakarala M, Rozek L, Cote M, Liyanage S, Brenner DE. Breast cancer histology and receptor status characterization in Asian Indian and Pakistani women in the U.S.--a SEER analysis. BMC Cancer; 10:191.
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Abstract:Background: Tobacco use is the single most preventable cause of adult death and disease in the world today this fact has been accepted and is being emphasized by the world health organization and all other agencies concerned with human health in the world. The total number of tobacco users in the world has been estimated at 1.2 billion, which is expected to rise to 1.6 billion during 2020s.There are 100 million deaths had occurred due to smoking in 20th century, with the same trends there will be 1 billion deaths in 21st century. Tobacco use alone accounts for about 40 per cent of all cancers in India. "About 275 million Indians (35 per cent of adult population and 14.1 per cent of children aged 13-15 years) are tobacco users, mainly smokeless tobacco. (1) Worldwide, the number of deaths caused by tobacco is expected to rise from around 6 million a year now to more than 8 million by 2030, according to the World Health Organisation. According to the Global Adult Tobacco Survey, 26 percent of adults in India consume smokeless tobacco - 33 percent of men and 18.4 percent of women. Smokeless tobacco can cause oral and other cancers, as well as other mouth diseases and heart disease. Objectives:
i) To study patients suffering from tobacco & non-tobacco related cancers in relation to Demographic attributes.
ii) To study tobacco& non-tobacco related cancer patients in relation to selected Environmental attributes.
iii) To study tobacco& non-tobacco related cancer patients in relation to life style factors.
Materials and Methods: Study design: Cross-sectional hospital based study. Sample size: About 750 male subjects aged between 1-85 years, who were non-institutionalized were included in the study. The sample was taken according to the prevalence (35%) of tobacco-related cancers in India. Setting: The study was conducted at 1) Government Guntur General Hospital, Guntur 2) Cancer Research centre, Chinakakani 3) Bommidala Cancer Care Centre, Pedakakani of Guntur district. Period of study: The study was conducted over period of one year from October 2013 –September 2014. Method of data collection: The data was collected by using a semistrutured, pretested questionnaire, from patients attending radiotherapy departments of above study setting after taking their informed oral consent.
Keywords: Tobacco related cancers, Non-Tobacco related cancers, male cancers, Tertiary care hospitals, Guntur.

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Abstract: Burn injuries are a global public health problem, accounting for an estimated 265000 deaths annually. The majority of these occur in low- and middle-income countries and almost half occur in the WHO South-East Asia Region. The rate of child deaths from burns is currently over 7 times higher in low- and middle-income countries than in high-income countries. In India, over 100000 people are moderately or severely burnt every year. In many high-income countries,burn death rates have been decreasing due to improvements in treatment of burns, control of infection and advances in nutritional support. Non-fatal burn injuries are a leading cause of morbidity. Burns occur mainly in the home and workplace. Burns are preventable. Burns are among the leading causes of disability-adjusted life-years (DALYs) lost in low- and middle-income countries. Nutrition therapy is a cornerstone of burn care from the early resuscitation phase until the end of rehabilitation. While several aspects of nutrition therapy are similar in major burns and other critical care conditions,the patho-physiology of burn injury with its major endocrine, inflammatory, a metabolic and immune alteration requires some specific nutritional interventions.

Keywords: Burn injury, Thermal Burns, Nutritional support, Proteins, Carbohydrates, Substrate, critical care, Hypermetabolism, Hypercatabolism,

[1]. National Collaborating Center for Acute Care. Nutrition support in adults: Oral nutrition support, enteral tube feeding and parenteral nutrition. Methods, evidence & guidance. National Collaborating Center for Acute Care, London 2006.
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[3]. Jeschke MG, Chinkes DL, Finnerty CC, et al. Pathophysiologic response to severe burn injury. Ann Surg. 2008;248:387-401.
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[7]. McDonald WS, Sharp CW, Jr., Deitch EA. Immediate enteral feeding in burn patients is safe and effective. Ann Surg. 1991;213:177-183.
[8]. Tinckler LF. Surgery and intestinal motility. Br J Surg. 1965;52:140-150

Abstract:Background : The burden of Acute Kidney injury in developing countries especially in Sub- Saharan Africa is enormous. The morbidity and mortality appears to be rising despite the availability of dialysis therapy in some parts of Africa. Objective: To determine the causes and the factors that influence outcome of acute kidney injury in hospitalized patients at the University of Calabar Teaching Hospital (UCTH), Calabar, Nigeria. Design : This was a prospective study of patients with acute kidney injury admitted in UCTH, Calabar over a 12 month period from January 2014 to December 2014. Data was analysed using SPSS version 18. Results : A total of 1138 patients were admitted with 42 of them developing AKI giving an incidence rate of 3.6%. Eighteen (42.9%) of the participants were males while 24 (57.1%) were females. Age ranged from 11 to 81 years with a mean age of 44.2±17.32 years. The common causes of AKI were septicaemia 20 (47.6%), malignant phase hypertension 7 (16.7%) and hypovolaemia 4 (9.5%).Other causes accounted for the remaining 11 (26.1%). Thirty one (73.8%) had co-morbidities and hypertension 12 (38.7%) was the commonest co-morbid condition. For outcome, 29 (69.0%) of the patients were discharged home while 13 (31.0%) of them died in the hospital. Survivors had more dialysis sessions than those that died (P < 0.05).

[1]. S.P. Andreoli, Acute kidney injury in children, Pediatric Nephrology, 24(2), 2009, 253 – 263.
[2]. R.W. Schrier, W.Wang, B.Pole and A.Mitra, Acute renal failure: definitions, diagnosis, pathogenesis and therapy, Journal of Clinical Investigations, 114(1), 2004, 5 -14.
[3]. F.Liano and J.Pascual, Epidemiology of acute renal failure: a prospective, multicenter, community-based study, Kidney International, 50(3), 1996, 811 – 818.
[4]. O.C.Okoye, E.I.Unuigbe and L.I.Ojogwu, Acute kidney injury in adult Nigerians: a single center experience: An abstract, Proc.22nd AGM and Scientific conf. of the The Nigerian Association of Nephrology, Zaira, Nigeria, 2010, 4 - 5.
[5]. A.Chijioke, A.Aderibigbe, T.O.Olarenwaju and A.M.Makusidi, Pattern of acute renal failure in Ilorin: A report, Proc.22nd AGM and Scientific conf. of the The Nigerian Association of Nephrology, Zaira, Nigeria, 2010, 6 - 7.
[6]. A.I.Udo, F.A.Arogundade, and A.A.Sanusi, Acute kidney injury, a review of the causes, severity and outcome in Ile – Ife, Nigeria: An abstract, Proc.22nd AGM and Scientific conf. of the The Nigerian Association of Nephrology, Zaira, Nigeria, 2010, 7 – 8.
[7]. R.Vanholder, W.Van Biesen, and N.Lameire, What is the renal replacement method of first choice for intensive care patients, Journal of American Society of Nephrology, 12(17), 2001, 540.

Abstract: Syphilis is a great old venereal disease with broad range of manifestations and variable course which may be altered in HIV positive patients that will make the diagnosis more difficult. Syphilis and other STI`s that produce genital lesions or evoke an inflammatory response are important risk factors for the acquisition and transmission of HIV. The present retrospective study includes a total of 506 new male and female patients who attended STI clinic at Govt. General Hospital, Vijayawada from January to December 2014 for a period of one year. Patients were diagnosed on the basis of history, clinical examination, Serum RPR test confirmed by TPHA. CSF –RPR and TPHA were done in all syphilis patients. Diagnosed cases were screened for HIV test and CD4 count was done subsequently. Serum TPHA was positive in all 12 patients and RPR in 11 patients. CSF RPR and TPHA was positive in 8 patients, indicating asymptomatic neurosyphilis. 11 out of 12 had concurrent HIV infection with CD4 counts ranging from 190-500.

Key words: Syphilis with HIV, CSF RPR & TPHA, Asymptomatic neurosyphilis in HIV.

[1]. Stamm LV Biology of Treponema pallidum,In: Holmes KK, Sparling PF, Mardh PA, Lemon SM, Stamm WE, Piot P, Wasserneit JN, editors Sexually transmitted diseases, 3rd ed, New York: McGraw-Hill; 1999. P. 467-72.
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Abstract: Takayasu's arteritis (TA) is a rare, chronic progressive pan-endarteritis involving the aorta and its main branches. Anaesthesia for patients with TA is complicated by their severe uncontrolled hypertension, end-organ dysfunction. We had a 26 year-old, 94 kg woman married since 6 years with G2 P1IUFD1, with 36.5 weeks of amenorrhoea (by date) and known case of Takayasu's Arteritis with non-functioning left kidney and chronic hypertension admitted for safe confinement. Patient was having pain in abdomen when presented to operation theatre for emergency lower segment caesarean section in view of non-progression of labour. A spinal anaesthesia was given to this patient with 23G Quincke's spinal needle. A spinal level of T6 was achieved and patient got delivered successfully. She was hemodynamically stable throughout the procedure.

Keywords: Takayasu's arteritis, spinal anaesthesia

[1]. Dutta B, Pandey R, Darlong V, Garg R. Low-dose spinal anaesthesia for a parturient with Takayasu's arteritis undergoing emergency caesarean section. Singapore Med J. 2010 Jun;51(6):e111-3. PubMed PMID: 20658099.
[2]. Gautam S1, Srivastava VK, Kumar S, Wahal R Successful low-dose spinal anaesthesia for lower segment caesarean section in a patient with Takayasu arteritis BMJ Case Rep. 2013 May 23;2013. pii: bcr2013010107. doi: 10.1136/bcr-2013-010107.

Abstract: Background: Anesthesiologists play a significant role in perioperative medical care of the patients. In Anesthesia OPD, preanesthesia evaluation is done to assess patient's medical condition before surgery and formulate anesthetic plan based on risk assessment and streamline the preoperative experience of patients. But the patient experience and satisfaction with such clinics has not been adequately studied in India. Patient satisfaction is a unique clinical endpoint and is an indicator of the quality of healthcare provided. The main objective of this study is to assess the satisfaction of patients who have availed services of preanesthesia evaluation, identify problems, and suggest measures to improve the services.

[1] Lew E, Pavlin DJ, 2004, Outpatient preanaesthesia evaluation clinics, Singapore Med J ;45:509–16
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[3] Orkin FK, 1996, Ambulatory anesthesia. Anesthesiol Clin North Am ; 14:595-608.
[4] Anju Gupta, 2011 Oct-Dec, Patient's experiences and satisfaction with preanesthesia services: A prospective audit, J Anaesthesiol Clin Pharmacol. ; 27(4): 511–515.
[5] Caljouw MA, 2008, Patient's satisfaction with perioperative care: Development, validation, and application of a questionnaire, Br J Anaesth. ;100:637–44.
[6] Fung D, Cohen M. 1998, Measuring patient satisfaction with anesthesia care: A review of current methodology. Anesth Analg. ;87:1089–98.
[7] Fischer SP,2000, Organizational infrastructure of a preoperative evaluation center. In: Sweitzer BJ, ed. Handbook of Preoperative Assessment and Management. Philadelphia: Lippincott Williams & Wilkins, 378-87.
[8] American Society of Anesthesiologists Task Force on Preanesthesia Evaluation , 2002, Practice advisory for preanesthesia evaluation, Anesthesiology;96:485–96.

Abstract:Disulfiram is a deterrent agent used in the treatment of alcohol dependence syndrome. Though it is regarded as one of the most efficacious drugs, it is associated with various side effects. On the other hand catatonia is a clinical syndrome characterized by varieties of psychomotor abnormalities of retardation and excitement often seen in schizophrenia, mood disorder and other medical conditions. Here we are presenting a case report of catatonia associated with Disulfiram therapy following Disulfiram Ethanol Reaction

Key words: Disulfiram, Alcohol Dependence, Catatonia, Antabuse therapy, Disulfiram Ethanol Reaction

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[6]. Yeh AW, Lee JW, Cheng TC, Wen JK, Chen WH. Clozapine withdrawal catatonia associated with cholinergic and serotonergic rebound hyperactivity: a case report. Clin Neuropharmacol 2004; 27:216-218.
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Abstract: Early detection of any disease plays an important role in successful treatment. Early diagnosis and treatment reduces the severity and possible complications of disease activity. Human saliva is not just a fluid in our mouth, but it mirrors our body's health and well-being. Biomolecules that are circulating in the blood are also found in human saliva. It consists of approximately about 2,000 proteins, and 26% of these proteins are also found in blood, therefore it emphasizes saliva's importance as an added biological resource for disease diagnosis and monitoring, as well as an ultimate diagnostic medium to establish a person's response to treatment. It has been a great challenge in periodontologyto determine biomarkers for screening and predicting the early onset of disease (prognostic tests) or evaluating the disease activity and the efficacy of therapy (diagnostic tests).

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[7]. Priyanka N, NitishKalra, et all. RECENT APPROACHES IN SALIVA AS A CREDIBLE PERIODONTAL DIAGNOSTIC AND PROGNOSTIC MARKER. Archives of Oral Sciences & Research 2012;2(1):40-46.

Abstract: This study aimed to explore the risk factors of rugby-related dental injuries and factors associated with the restorations received. Questionnaire survey and dental examination were carried out on 456 rugby players in a cross-sectional study. Experience of trauma was examined against the playing position and total playing time. To determine the factors associated with the restoration and replacement of the injured tooth, logistic regression was performed using the backward stepwise (conditional) method. Prevalence of self-reported rugby-related dental injuries was 26.5% (n=121). The injuries were associated with the total playing time (r=0.247, p<0.001), but not with the playing position (chi-square=3.246, p=0.197). A total of 172 injured teeth were found during clinical examination. The most common injury was fracture of enamel (31.4%), followed by luxation (26.2%) and tooth loss (16.9%). Most of the injured teeth (84.3%) were unrestored. Anterior teeth were found to have greater odds of being restored than posterior teeth (OR=10.0, 95% CI=2.3–42.6). Injuries involving the dentine (OR=7.8, 95% CI=1.8–32.9), pulp (p=0.009, OR=10.4, 95% CI=1.8–60.3), and tooth loss (OR=21.5, 95% CI=4.5–103) had greater odds of being restored. In conclusion, injury prevalence is positively correlated with increased playing time. Restorative decision depends on antero-posterior position of the tooth and the extent of tooth injury.

Keywords: athletic injuries, epidemiology, tooth injuries, tooth fracture, avulsion, rugby

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Abstract:Segmental resection of the mandible commonly results in the deviation of mandible towards the defective side. The amount of deviation depends on the amount of hard and soft tissue involvement, method of surgical site closure, degree of impaired tongue function, number of remaining teeth and the extent of loss of sensory and motor innervations. Prosthodontic treatment along with physical therapy may be useful in reducing mandibular deviation and improving masticatory efficiency. This clinical report describes the use of a cue-sill prosthesis to rehabilitate a hemimandibulectomy case for improved masticatory efficiency and esthetics.

Keywords: Cue-sil,Hemimandibulectomy, Rehabilitation.

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Abstract: Aim: Our objective is to present how to accomplish an optimal desired esthetic outcome in a specific clinical situation including a previously disappointing result. Only a multi-disciplinary approach allows overcoming the difficulties related to gingival smile and discolored abutments complicated by very natural bright teeth.

[1] Manappallil JJ. Classification system for conventional crown and fixed partial denture failures. The Journal of prosthetic dentistry. 2008;99:293-8.
[2] Spear FM, Kokich VG. A multidisciplinary approach to esthetic dentistry. Dental Clinics of North America. 2007;51:487-505.
[3] Burke F, Lucarotti P. Re-intervention on crowns: What comes next? Journal of dentistry. 2009;37:25-30.
[4] Walton JN, Gardner FM, Agar JR. A survey of crown and fixed partial denture failures: length of service and reasons for replacement. The Journal of prosthetic dentistry. 1986;56:416-21.
[5] Deliperi S. Direct fiber-reinforced composite restoration in an endodontically-treated molar: a three-year case report. Operative dentistry. 2008;33:209-14.
[6] Mosharraf R, Baghaei Yazdi N. Comparative evaluation of effects of different surface treatment methods on bond strength between fiber post and composite core. The journal of advanced prosthodontics. 2012;4:103-8.
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[8] Conrad HJ, Seong W-J, Pesun IJ. Current ceramic materials and systems with clinical recommendations: a systematic review. The Journal of prosthetic dentistry. 2007;98:389-404.

Abstract:Background: Perforation peritonitis is the most common surgical emergency encountered by surgeons all over the world. The aim of this study is to provide an overview of the spectrum of perforation peritonitis managed in People's hospital of PCMS &RC, Bhopal along with NSAD induced GI perforations. Method: This retrospective study conducted at People's hospital of People's college of medical sciences & Research centre, Bhopal between July 2010 and January 29, 2015 .It included 300 patients of perforation peritonitis who underwent exploratory laparotomy were studied in terms of clinical presentations, causes, site of perforation, surgical treatment, postoperative complications, outcome, history of addiction, income group, co morbid condition, history of NSAID intake.

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Abstract: Objectives: To study the diverse clinical features, laboratory manifestations, complications and outcome in children with scrub typhus. Materials and Methods: Children below 15 yrs of age, presenting with fever, during June'13 to-Dec'14. Scrub typhus was suspected when fever continued for more than 5 days, with 1) an eschar and 2) one or more of the following clinical features - rash, edema, hepato-splenomegaly, lymphadenopathy, capillary leak, tick bite or 3) positive IgM antibodies (rapid test immuno-chromatography).

[1]. Clinical Profile of Scrub Typhus in children and its association with Haemophagocytic lymphocytosis. Indian Pediatrics, vol 51, Aug 15,2014,651-653. Naveen Sankhyan, LG Saptharishi, Kandasamy Saridaran.
[2]. Scrub Typhus in children at a tertiary hospital in Southern India- Clinical profile and complications. Manish Kumar. Sriram Krishna Murthy, C.G.Delhikumar, Parameswaran Narayanan. Journal of infection and Public Heaflth, 2012, 82-88.
[3]. Scrub Typhus in patients reporting with acute febrile illness at a tertiary health care institution in Goa. Indian J Med Res 136, Dec 2012, pp 1020-1024. Kedareshvafr P.S, Sario Rodrigura, Ramnath, Lydia Dias, Amit Dias, Marina Vaz and E.Gomes.
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Abstract: In adult patients venous cannulation, though painful, is often performed without analgesia. Numerous strategies are available to minimize the pain including local skin infiltration, ethyl chloride spray, inhalation of nitrous oxide, topical application of eutectic mixture of local anesthetics (EMLA) or application of non-steroidal anti-inflammatory drugs. In this study we compare the efficacy of diclofenac and ketoprofen transdermal patch with placebo in attenuating intravenous cannulation pain in patients posted for elective surgeries. 150 patients aged 18- 55yrs of ASA I and II were selected and divide into groups of 50 each. In Group I (control) PTP-Placebo control patch, Group II KTP- ketoprofen transdermal patch and Group III DTP-diclofenac transdermal patch was applied 4 hrs before venous cannulation and VAS score was observed. Transdermal diclofenac and ketoprofen patch significantly decreased both the incidence and severity of pain associated with cannulation without any adverse effects. However ketoprofen patch fared better in reducing the severity of pain.

Keywords: Intravenous cannulation, Pain, Transdermal patch

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