iosr-JDMS   Volume-16 ~ Issue-7 ~ July-2017

Abstract: Background and Objectives: Chronic post herniorrhaphy groin pain is defined as pain lasting for more than 3 months after surgery. It is one of the most important complications occurring after inguinal hernia repair and it occurs with greater frequency than previously thought .Majority of chronic pain has been attributed to Ilioinguinal nerve entrapment. Routine excision of the ilioinguinal nerve is an attempt to decrease the incidence of chronic groin pain caused by nerve entrapment, inflammation and fibrotic reactions around the nerve. The purpose of the current study is to evaluate the effect of routine ilioinguinal ne rve excision compared to nerve preservation on chronic groin pain and other sensory symptoms when performing Lichtenstein tension free inguinal he rnia repair..........

Keywords: Inguinal hernia; Groin; Lichtenstein; Polypropylene mesh; Herniorrhaphy; Ilioinguinal; Neurectomy; Mesh repair.

[1]. Normans S . Williams , Bailey &Love`s Short Practice of Surgery 26th Edition. A .S Poobalan, J . Bruce and W .C Smith et al, A Review of Chronic Pain After Inguinal Herniorrhaphy, Clin J Pain 2003 ;19 : 48 -54.
[2]. 3. M . Bay Nelsen ,F.M Perkins et al, Pain Functional Impairment 1 year After Herniorrhaphy, Ann Surg 2001 ;233 : 1-7 .
[3]. W. P Geis K .sing and G. K. Gillion , An Algorithm for the Treatment of Chronic Pain After Inguinal Herniorrhaphy , P A 2002 ; 307 -16.
[4]. R. Frei , Differential Diagnosis and Treatment of Post Herniorrhaphy Groin Pain, Gen Surg News 2004 ;feb.
[5]. T .I Abdullah, J Iddon et al , Prospective Randomized Controlled trial of Preservation of Intercosto-brachial Nerve during Axillary node clearance for Breast cancer, Br J Surg 1998 ;85 :1443 -45 .

Abstract: Aim: To validate preoperative serum albumin and body mass index as predictors of post operative morbidity and mortality in elective major surgeries. Methods : Details of cases will be recorded including history , clinical examination , investigations done and intraoperative findings. Anthropometry – height and weight recorded pre-operatively. BMI – weight [kg] / height [m2] or 703 x weight [lb] / height2 [in]. Serum albumin measured preoperatively. The patients are to be followed up after surgery and watched for complications such as wound gaping , seroma formation , wound infection , flap necrosis , fistula formation etc. During the post operative period...........

Keywords: Serum , albumin , mortality , predictor

[1]. Shabsigh A, Korets R, Vora KC, et al. Defining early morbidity of radical cystectomy for patients with bladder cancer using a standardized reporting methodology. Eur Urol. 2009;55(1):164–74. [PubMed]

[2]. Lai CC, You JF, Yeh CY, et al. Low preoperative serum albumin in colon cancer: a risk factor for poor outcome. Int J Colorectal Dis. 2011;26(4):473–81.[PubMed]

[3]. Bhamidipati CM, LaPar DJ, Mehta GS, et al. Albumin is a better predictor of outcomes than body mass index following coronary artery bypass grafting. Surgery. 2011;150(4):626–34. [PMC free article] [PubMed]

[4]. Gibbs J, Cull W, Henderson W, Daley J, Hur K, Khuri SF. Preoperative serum albumin level as a predictor of operative mortality and morbidity: results from the National VA Surgical Risk Study. Arch Surg. 1999;134(1):36–42. [PubMed]

[5]. Gregg JR, Cookson MS, Phillips S, et al. Effect of preoperative nutritional deficiency on mortality after radical cystectomy for bladder cancer. J Urol. 2011;185(1):90–6. [PMC free article] [PubMed]

Abstract: This study was conducted to assessantimicrobials prescribing pattern in indoor and outdoor patients of medicinedepartment. It was prospective, cross sectional, observational study. Data of first 1000 eligible consecutive case records during 3 months were considered. About24% and 76% prescriptions were from indoor and outdoor patients respectively. Majority of indoor patients were from age group of 46 – 60 years whereas majority of outdoor patients were from age group of 31 -45 years. Most frequently prescribed antimicrobial in indoor and outdoor patients was ceftriaxone injection (20.05%) and amoxicillin + clavulanic acid tablet (32.62%) respectively..............

Keywords: Antimicrobial prescription pattern, Drug utilization studies, Indoor and outdoor patients of medicine department, Rational drug use, WHO drug use indicators.

[1]. Introduction to drug utilization research, WHO, 2013. Available at http://www.whocc.no/filearchive/publications/drug_utilization_research.pdf. Accessed 07 January 2017.
[2]. Tripathi KD. Antimicrobial drugs, Essentials of Medical Pharmacology. 7th Edition, 12. New Delhi JAYPEE Brothers medical publishers, 2013; 688-704.
[3]. Selvaraj R.Prospective assessment of antimicrobial prescribing pattern at a tertiary care hospital. Al Ameen J Med Sc i 2015; 8(4) :276-280
[4]. Woldu MA, Suleman S, Workneh N, Berhane H. Retrospective study of the pattern of antibiotic use in Hawassa University Referral Hospital Pediatric Ward, Southern Ethiopia. J App Pharm Sci. 2013; 3(02):93-8.
[5]. Ernest JS. Resistance to antimicrobials in humans and animals. BMJ 2005, 331:1219-20.

Abstract: Asthma is defined by airway inflammation, completely or partly reversible airway obstruction and bronchial hyper-responsiveness which collectively induce cough, dyspnoea and wheeze in the affected patient. Persistent asthma was considered to be that requiring scheduled daily maintenance treatment with an anti-inflammatory drug (corticosteroid), in addition to a bronchodilator to relieve symptoms. Acute exacerbation is defined as an episode that required emergency visit for symptoms despite on maintenance therapy.The objective of this study was to evaluate the moderate persistent asthma, acute exacerbations and triggering factors causing it. This study concludes that attention should be paid to modifiable risk factors, such as adherence to maintenance phase treatment and avoiding exposure to known triggering factors needs to be focussed so that control of this condition can be improved in the long term.

[1]. Haahtela T, Lindholm H, Bjorksten F, Koskenvuo K, Laitinen LA. Prevalence of asthma in Finnish young men. BMJ. 1990; 301: 266-8.
[2]. Burney PG, Chinn S, Rona RJ. Has the prevalence of asthma increased in children? Evidencefrom the national study of health and growth 1973-86. BMJ. 1990; 300: 1306-10.
[3]. Asher MI, Montefort S, Bjorksten B, et al. Worldwide time trends in the prevalence of symptomsof asthma, allergic rhinoconjunctivitis, and eczema in childhood: ISAAC Phases One and Threerepeat multicountry cross-sectional surveys. Lancet. 2006; 368: 733-43.
[4]. Busse WW. Asthma diagnosis and treatment: filling in the information gaps. J Allergy ClinImmunol. 2011; 128: 740-50.
[5]. Bateman ED, Boushey HA, Bousquet J, et al. Can guideline-defined asthma control be achieved?The Gaining Optimal Asthma ControL study. Am J Respir Crit Care Med. 2004; 170: 836-44.

Abstract: Background:Central venous catheters play a vital role in medical practice enabling clinicians to monitor and support the efforts of the body to stabilize the circulation and provide nutritional supplements. Objectives:This study was conducted to study various indications, sites of insertion and complications of central venous catheterization. Methods:This article reviews our experience with 609 central venous catheters (CVC) inserted in 589 critically ill adult patients of Medical Intensive Care Unit (MICU) or Artificial Kidney Dialysis Unit (AKD) following a standard protocol during study period. Various indications, insertion sites, type, size and material of catheter................

Keywords: Central Venous Catheterization, Indication, Sites, Complications, MICU and AKD

[1]. Eisenberg HD. Culture of intravascular devices. Clinical Microbiology Procedures Handbook, 2004; 2nd edition. Washington DC: ASM Press 13.12.1-6.
[2]. Maki DG, Weise CE, Sarafin HW. A semiquantitative culture method forIdentifyingintravenous-catheter-relatedinfection.NEJM1977; 296:1305-1309.
[3]. Safdar N, Fine JP, Maki DG (2005) Meta-analysis: methods for diagnosingIntravasculardevice-related bloodstream infection. Ann Intern Med 2005; 142:451-466.
[4]. Eisenberg HD. Culture of intravascular devices. Clinical Microbiology ProceduresHandbook, 2004; 2nd edition. Washington DC: ASM Press 13.12.1-6.
[5]. Eisenhauer ED, Derveloy RJ, Hastings PR. Prospective evaluation of centralVenouspressure (CVP) catheters in a large city-county hospital. Ann Surg1982; 196(Nov):560-4.

Abstract: Background and Objectives: Maternal and fetal morbidity and mortality was largely preventable in a vast number of obstetric emergencies. In our study analysis of critically ill obstetric patients admitted in ICU was done in order to characterize the cause of admission, intervention required and observed the maternal and fetal outcome. Utilization of APACHE II score to predict maternal mortality was also assessed. Methods: This is a prospective study conducted in Rajiv Gandhi Medical Sciences (RIMS), Kadapa during the period April 2015-March 2016. A total of 75 obstetric emergencies admitted in ICU (intensive care unit) was enrolled in this study based upon the inclusion and exclusion criteria..................

Keywords: Obstetric emergencies , Booked cases, Intensive care unit, Critical care.

[2]. LapinskySE ,Kruezynski K AS. Critical CareinThe Pregnant Patient. Am J Respir CritCareMedicine1995;152;427- 455.
[3]. RizkNW,KalassianK,CilliganT,etal.Obstetric complications in pulmonary and critical care medicine,chest1996;110:791 – 809.
[4]. Soubra SH, Guntupalli KK. Critical illness in pregnancy: An overview. Crit Care Med. 2005;33(10 Suppl):248–55. [PubMed: 16215344]
[5]. Karnad DR, Guntupalli KK. Critical illness and pregnancy: Review of a global problem.(vii).CritCareClin. 2004;20:555–76. [PubMed: 15388189]
[6]. Gatt S. Pregnancy, delivery and the intensive care unit: need, outcome and management. CurrOpinAnaesthesiol 2003;16:263-7.
[7]. WHO. Maternal mortality in 1995, estimates developed by WHO, unicef and UNFPA 2001; 56.

Abstract: Background: Thoracolumbar junction spine i.e. T11-L1 is a transition zone between the more stable T1-T10 spine which is connected by rib cage to the sternum & the more mobile L2-L5 spine. There are several factors that affect the outcome; but which are these factors are determining the outcomes are still unknown. Objective: To study and evaluate the factors influencing the outcome following acute thoraco lumbar junction spine injury. Materials and Methods: A prospective observational study at a single centre with all patients with thoracolumbar junction(TLJ) spine injury, attending our hospital within a week of injury during a period of November 2014 to August 2016 were included for analysis..................

Keywords: Thoracolumbar junction(TLJ), Magnetic resonance imaging, Outcome.

[1]. Spinal cord injury facts and figures at a glance. National Spinal Cord Injury Statistical Center. J Spinal Cord Med. 2013;36:1-2.
[2]. Coleman WP, Geisler FH. Injury severity as primary predictor of outcome in acute spinal cord injury: retro- spective results from a large multicenter clinical trial. Spine 2004;4:373-8.
[3]. Burns SP, Golding DG, Rolle WA Jr., Graziani V, Ditunno JFJr. Recovery of ambulation in motor-Incomplete tetraplegia: Archives of Physical Medicine Rehabilitation 1997;78:1169-72.
[4]. Kulkarni MV, McArdle CB, Kopanicky D. Acute spinal cord injury: MR imaging at 1.5T. Radiology 1988;164:837-43.
[5]. Morry Silberstein, Brian M, Tress, Oliver Hennessy. Prediction of Neurologic Outcome in Acute Spinal cord Injury: The role of CT and MR. AJNR 1992;13:1597-1608.

Abstract: Purpose: To evaluate the safety and efficacy of subconjunctival and/or intrastromal bevacizumab preoperatively in preventing corneal graft rejection in corneal scars with vascularization more than 2 quadrants. Methods: This randomized, placebo controlled clinical trial was conducted on 20 eyes of 20 patients attending the ophthalmology OPD, Rajindra Hospital Patiala, randomized to Group 1 (bevacizumab) 10 patients and Group 2(Balanced salt solution), 10 patients. Group 1 received a cycle of three subconjunctival and/or intrastromal injections of 5mg/0.2ml Bevacizumab. After last injection, all patients underwent keratoplasty. An adjunctive injection was performed on half of the patients intraoperatively................

Keywords: Bevacizumab, Corneal graft rejection, Corneal scars, Vascularization, Keratoplasty

[1]. Eye Bank Association of America 2014 Eye Banking Stastical Report. Available at http://www.restoresight.org/wp-content/uploads/2015/03/2014_Stastical_FINAL.pdf. Accessed: June 16, 2015
[2]. Banerjee S, Dick AD: Recent developments in the pharmacological treatment and prevention of corneal graft rejection. Expert Opin Investig Drugs 12:29-37, 2003
[3]. Shapiro MB, Mandel Mr., Krachmer H: Rejection, in Bright B (ed): Corneal Surgery, Theory, Technique and Tissues. St LOUIS, cv Mosby Company, ed 2 1997, pp. 254-68
[4]. Maumenee AE: Clinical aspects of the corneal homograft reaction. Invest Ophthalmol 1:244-52, 1962
[5]. Khodadoust AA, Silverstein AM: Transplantation and rejection of individual cell layers of cornea. Invest Ophthalmol 8:180-95, 1969

Abstract: Laparoscopic cholecystectomy is probably the most frequently done procedure. Being done in significant numbers all over the globe it is important and pertinent that the complications associated with the procedure will be encountered by all surgeons. It is important to realize that some of them are seen more frequently and some are seen rarely. This work is concentrating on the incident of stone spill, bile leak, and clip spill which are common events. Complications associated with them seem to be rare. Over the last 5 years study of LC 's our experience has been different and we have not seen any complication both immediate and remote as reported in all most all the literature reported so far.

Keywords: Gallbladder perforation,Laparoscopic cholecystectomy Spilled gallstones, Spilled Surgical clips

[1]. Complications of laparoscopic cholecystectomy: A national survey of 4,292 hospitals and an analysis of 77,604 cases .Article in The American Journal of Surgery 165(1):9-14 · February 1993
[2]. 2Spilled gall stones during laparoscopic cholecystectomy: a review of the literature. T Sathesh-Kumar, A P Saklani, R Vinayagam, R L Blackett . Postgrad Med J 2004;80:77–79. doi: 10.1136/pmj.2003.006023
[3]. Rosen M, Fred B, Jeffery P. Predictive factors for conversion of laparoscopic cholecystectomy. Am J Surg 2002;184:254-8.
[4]. 4 Management of Spilled Stones during Laparoscopic Cholecystectomy, T Florin ,World Journal of Laproscopic Surgery, May-August 2010; 3 (2): 103-107
[5]. Hui TT, Giurgiu DI, Margulies DR, Takagi S, Iida A, Phillips EH.Iatrogenic gallbladder perforation during laparoscopic cholecystectomy:etiology and sequelae.Am Surg.1999;65:944-8

Abstract: Introduction: India's geriatric population will increase dramatically over the next four decades. Skin diseases are a major health problem in the geriatric age group. Aim: To describe the cutaneous lesions in geriatric population in a tertiary care centre in Jharkhand Materials and Methods: 500 geriatric patients, aged 60 and above, with clinical evidence of cutaneous disorders were studied at Rajendra Institute of Medical Sciences, Ranchi. Results: Geriatric patients accounted for 4.2% of Dermatology, Venereology and Leprosy OPD attendance with a male preponderance (M:F::2.2:1). Majority (52%) of the patients were literate, 67% belonged to low socio-economic group. 36% were farmers and 22% labourer...............

Keywords: Geriatric dermatoses, superficial fungal infections, xerosis, acrochordons

[1]. United Nations Population Division (UN), World Population Prospects: The 2010 Revision (New York: United Nations, 2011), accessed at http://esa.un.org/unpd/wpp/index.htm, on Jan. 12, 2012
[2]. K Park. Preventive medicine in obstetrics, paediatrics and geriatrics. In: Park's Textbook of Preventive and Social Medicine. 24th ed. Jabalpur: M/s Banarsidas Bhanot Publishers 2017: 631
[3]. Droller H. Dermatologic findings in a random sample of old persons. Geriatrics 1995; 10: 421-4

[4]. Weismann K, Krakauer R, Wanscher B. Prevalence of skin diseases in old age. Acta Derm Venereol (Stockh) 1980;60:352-3.

Abstract: Rehabilitation of post maxillectomy is the challenge to clinician. The size of these defects can vary from small to large, and they may include portions of the hard and soft palate, alveolar ridges, and floor of the nasal cavity. The size and location of the defect usually influences the extent of impairment and difficulty in prosthetic rehabilitation. The increased weight of the prosthesis when closing large defects is often a concern to its retention. Lightweight obturators are thus warranted in such clinical situations. Conventional clasp design may not provide adequate retention, stability and support in cases of large defects............

Keywords: Maxillectomy, defect, rehabilitation, obturator, extracoronal resilient attachment, esthetics, retention

[1]. Okay DJ, Genden E, Buchbinder D, Urken M. Prosthodontic guidelines for surgical reconstruction of the maxilla: A classification system of defects. J Prosthet Dent 2001;86:352-363.
[2]. Etienne OM, Taddei CA. Use of bar-clip attachments to enhance the retention of a maxillofacial prosthetic obturator: a clinical report. J Oral Rehabil2004;31:618-622.
[3]. Nekora- Azak A, Evlıoglu G, Ozdemir-Karatas M ，Keskin H. Use of biofunctional prosthetic system following partial maxillary resection: a clinical report. J Oral Rehabil2005;32:693-695.
[4]. Curtis TA, Beumer J. Restoration of acquired hard palate defects: etiology, disability, and rehabilitation. In: Beumer J, Curtis TA, Marunick MT, editors. Maxillofacial rehabilitation: prosthodontic and surgical considerations. 1st ed. St Louis: Ishiyaku Euro-America; 1996. p. 225-284.
[5]. Devlin H, Barker GR. Prosthetic rehabilitation of the edentulous patient requiring a partial maxillectomy. J ProsthetDent 1992;67:223-227.

Abstract: Background:Cervical tuberculosis resulting in massive retropharyngeal abscess formation, leading to dysphagia and airway obstruction is a rare and potentially life-threatening complication. Management options include urgent anterior cervical decompression, immediate endotracheal intubation, emergency tracheostomy to secure airway. We are here presenting a case of cervical tubercular spondylo-discitis with giant retropharyngeal abscess causing dysphagia and airway obstruction treated with USG guided aspiration resulting in prompt relief of symptoms and rapid neurological recovery..................

Keywords: Retropharyngeal abscess; Dysphagia; Airway obstruction; Needle aspiration;Spondylodiscs

[1]. Pollard BA, El-Beheiry H. Pott's disease with unstable cervical spine, retropharyngeal cold abscess and progressive airway obstruction. Can J Anaesth 1999; 46:772-5.
[2]. Bhargava SK, Gupta S. Large retropharyngeal cold abscess in an adult with respiratory distress. J LaryngolOtol 1990; 104:157-8.
[3]. Nagy M, Pizzuto M, Backstrom J, Brodsky L. Deep neck infections in children: a new approach to diagnosis and treatment. Laryngoscope 1997: 107(12 pt 1):1627-34.
[4]. Weir M, Thosnton G. Extrapulmonary tuberculosis. Am J Med. 1985; 79: 467-76
[5]. Gorse GJ, Pais MJ, Kusske JA, et al. Tuberculousspondilitis. A report of six cases and review of literature.Medicine 1983; 62; 178-93.

Abstract: We report a case of young male who presented with neurotoxic snakebite, right sided hemiparesis and altered sensorium 5 hours after the bite. Neurotoxicity with snake bite is well known with varied presentatation. Toxic effect of venom can be a possible cause for this rare presentation

Keywords: Encephalopathy, neurotoxicity, snakebite Snake bite is one of the common life threatening medical emergencies encountered in Indian population particularly in rural and farming areas. South Asia is world's most affected region by snake bite due to its high population density, widespread agricultural activities, numerous various venomous snake species and lack of appropriate information regarding primary treatment [first Aid] in general population.1

[1]. Warell DA. The clinical management of snakebites in the Southeast Asian region. Southeast Asian J Trop Med Public Health 1999;30:1-84.
[2]. Bawaskar HS, Bawaskar PH, Punde DP, Inamdar MK, Dongare RB, Bhoite RR. Profile of snakebite envenoming in rural Maharashtra, India. J Assoc Physicians India 2008;56:88-95
[3]. Dhaliwal U. Cortical blindness : an unusual sequalae of snake bite. Indian J Opthalmol 1999;47(3):191-2
[4]. Murthy JM, Kishore LT, Naidu KS. Cerebral infarction after envenomation by viper. J Comput Assist Tomogr 1997;21(1):35-7.

Abstract: Verruca vulgaris also known as common warts is a benign lesion of skin and mucous membrane caused by human papilloma virus. Intraoral warts can occur at any age but are most commonly seen in age group of 30-50 years with equal incidence in both genders. It is found commonly on the palate followed by lip, tongue, buccal mucosa and rarely on gingiva. Conservative surgical excision with safe margins is the treatment of choice. The purpose of this paper is to present a rare clinical presentation of oral verruca vulgaris on buccal mucosa occurring in a 40-year-old male. Verruca vulgaris must be considered in the differential diagnosis of papillary lesions.

Keywords: Common warts, human papilloma virus, papillary lesions, verruca vulgaris.

[1]. Swetha P, Supriya NA, Kumar GR. Characterization of different verrucous mucosal lesions. Indian Journal of Dental Research. 2013 Sep 1; 24(5):642. [2]. Joshi M, Shah A, Vishnoi S. Oral verruca vulgaris: report of two rare cases and review. National Journal of Integrated Research in Medicine. 2013 Jul-Aug; 4(4): 145-148. [3]. Atullah JK, Murad N, Khitab U. Oral verruca vulgaris: A rare case with transformation of papilloma to Well Differentiated Oral Squamous Cell Carcinoma. Pakistan Oral & Dental Journal. 2010 Dec 1;30 (2). [4]. Sarabadani J, Ghanbariha M, Khajehahmadi S, Nehighalehno M. Consistency rates of clinical and histopathologic diagnoses of oral soft tissue exophytic lesions. Journal of dental research, dental clinics, dental prospects. 2009; 3(3):86. [5]. Desai VD, Sharma R, Bailoor DN. Extensive Mucocutaneous Verruca Vulgaris in a Nonimmunocompromised Patient. International journal of clinical pediatric dentistry. 2011 Jan; 4 (1):65

Abstract: Stroke is the third leading cause of death and the most prevalent disabling neurologic disease. Urinary albumin creatinine ratio (UACR) ratio in spot urine sample can be assessed as an early predictive factor for stroke risk determination. A cross sectional study was performed on 117 patients with stroke as case at Chittagong Medical College Hospital, Bangladesh and 117 individuals of their relatives and/or accompanying family members without history of cardiovascular disease as healthy control. Spot urine samples were obtained from both groups and urinary creatinine and albumin.............

Keywords: Albumin creatinine ratio, Stroke, Microalbuminuria.

[1]. WHO MONICA Project Investigators. The World Health Organization MONICA Project (Monitoring trends and determinants in cardiovascular disease). J Clin Epidemiol 1988;41:105-114.
[2]. Mackay J and Mensah G. The Atlas of Heart Disease and Stroke. Geneva, Switzerland, World Health Organization 2004.
[3]. Roger et al. AHA Heart Disease and Stroke Statistics 2011 update: a report from the American Heart Association 2011; 123:e18-e209.
[4]. Kim AS & Johnston SC. Global variation in the relative burden of stroke and ischaemic heart disease 2011;124:314-323.
[5]. Islam MN, Moniruzzaman M, Khalil MI, et al. Burden of stroke in Bangladesh 2013;8(3):211-3.

Abstract: Complex anatomy of the root canal system creates difficulties in its cleaning, shaping and 3D obturation, which is a prerequisite for a number of failures of the endodontic treatment.This survey is aimed at identifying the methods and tools used for obturation of the root canal system, as well as the problems associated with their application in dental practice.An anonymous survey was conducted among 157 dental practitioners of different ages, length of service and practice location. The questionnaire includes 15 questions, the respondents are expressing their opinion on the frequency of endodontic...............

Keywords: Obturation, root canal system, survey

[1]. Unal GC, Kaya BU, Tac AG, Kececi AD. Survey of attitudes, materials and methods preferred in root canal therapy by general dental practice in Turkey: Part 1. Eur J Dent. 2012;6(4):376.
[2]. Schilder H.: Filling root canals in three dimensions. Dent. Clin. North Am. 1974, 11, 723–744.
[3]. Al-Omari WM. Survey of attitudes, materials and methods employed in endodontic treatment by general dental practitioners in North Jordan. BMC oral health. 2004;4(1):1
[4]. Bjørndal L, Reit C.The adoption of new endodontic technology amongst Danish general dental practitioners.IntEndod J. 2005;38(1):52–8
[5]. Bishop K, Dummer P. A comparison of stainless steel Flexofiles and nickel‐titanium NiTiFlex files during the shaping of simulated canals. IntEndod J. 1997;30(1):25–34

Abstract: Context: The clinical signs of alcohol abuse are rather minimal in the early phase while most of the signs arise later after several years of excessive drinking. Among the laboratory markers hematological abnormalities, appear earlier than other biochemical abnormalities and also reversible with abstinence,Alcohol effect on hematopoeitic system are both direct & indirect, its also dose dependent, The direct consequences of excessive alcohol consumption include toxic effects on the bone marrow; suppress the production of all blood cell precursors. Alcohol's indirect effects include nutritional deficiencies that impair the production and function of various blood cells.................

Keywords: Pancytopenia, spur cells, alcohol , serum B12

[1]. BALLARD, H.S. Hematological Complications Of Alcoholism. Alcoholism: Clinical And ExperimentalResearch 13(5):706–720, 1989.
[2]. BALLARD, H.S. Alcohol, Bone Marrow, And Blood. Alcohol Health & Research World 17(4):310–315, 1993. DEITRICH, R.A., AND ERWIN, V.G., EDS. PharmacologicalEffects Of Ethanol On The Nervous System.
[3]. Boca Raton, FL: CRC Press, 1996. Pp. 383–408. DOUGLAS, C.C., AND TWOMEY, J.J. Transient StomatocytosisWithHemolysis: A Previously Unrecognized Complication Of Alcoholism. Annals Of InternalMedicine 72:159–164, 1970.
[4]. DUARTE, A.P.T.; DONG, Q.S.; YOUNG, J.; ABI-YOUNES, J.; AND MYERS, A.K. Inhibition Of Platelet Aggregation In Whole Blood By Alcohol. Thrombosis Research 78(2):107–115, 1995.
[5]. HOMAIDAN, F.R.; KRICKA, L.J.; AND WHITEHEAD, T.P. Morphology Of Red Blood Cells In Alcoholics. Lancet 1(8382):913–914, 1984.

Abstract: Lumbosacral radiculopathy has been treated using steroid injections by various approaches for symptomatic pain relief. This study was conducted to identify the efficacy of fluoroscopy guided depot methylprednisolone: lignocaine transforaminal injection for patients with chronic lumbosarcal radiculopathy. Methodology: After clearance from the institutional ethics committee, 20 patients diagnosed with lumbosacral radiculopathy were identified and included in the study with their written informed consent. Detailed history and clinical examination was done and patients were injected with 40mg/ml of depot-methylprednisolone with lignocaine via transforaminal approach. Patients were assessed for pain relief with the Numeric Pain Rating Scale (NPRS-11) on the day of procedure and 1 month , 3 months and 6 months post procedure.................

Keywords: fluoroscopy , lumbosaral radiculopathy,sciatica, steroid, transforaminal

[1]. Vialle LR, Vialle EM, Henao JES, Giraldo G. Hérniadiscallombar. Rev Bras Ortop. 2010;45(1):17–22
[2]. Tachihara H, Sekiguchi M, Kikuchi S, Konno S. Docorticosteroids produce additional benefit in nerve rootinfiltration for lumbar disc herniation? Spine (Phila PA 1976).2008;33(7):743–7.
[3]. Depalma MJ, Bhargava A, Slipman CW. A critical appraisal ofthe evidence for selective nerve root injection in thetreatment of lumbosacral radiculopathy. Arch PhysMedRehabil. 2005;86(7):1477–83.
[4]. Fish DE, Lee PC, Marcus DB. The S1 "Scotty Dog": report of atechnique for S1 transforaminal epidural steroid injection.ArchPhys Med Rehabil. 2007;88(12):1730–3.

[5]. Karppinen J, Malmivaara A, Kurunlahti M, KyllönenE,Pienimäki T, Nieminen P, et al. Periradicular infiltration forsciatica: a randomized controlled trial. Spine (Phila PA 1976).2001;26(9):1059–67