iosr-JDMS   Volume-4 ~ Issue-1

Abstract: A smile is one of the most effective means by which people convey their emotions. When an excess of gingiva superior to the maxillary anterior teeth is displayed upon full smile, it is termed a gingival smile or Gummy smile. Treatment modalities for gummy smile change according to its etiology. One cause of excessive gingival display is the muscular capacity to raise the upper lip higher than average. Several surgical procedures have been reported to improve the condition, but surgery always involves risk and is costly. Botulinum toxin type A (BTX-A) (Botox; Allergan, Irvine, Calif) has been studied since the late 1970s for the treatment of several conditions associated with excessive muscle contraction. Injection with BTX-A at preselected sites is a novel, cosmetically effective, minimally invasive alternative for the temporary improvement of gummy smiles caused by hyperfunctional upper lip elevator muscles.
Keywords: NEUROMUSCULAR CORRECTION, GUMMY SMILE, BOTOX

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(2):132-144.
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[3] E. van Ergmengem. 1897. Über einen neuen anaeroben Bacillus und seine Beziehungen Zum Botulismus. Zentralbl. Hyg. Infektionskr. 26:1–8.
[4] Frank J. Erbguth. From poison to remedy: the chequered history of botulinum toxin Journal of neural transmission (2008) 115:
559–565
[5] Kane MA. The effect of botulinum toxin injections on the nasolabial fold. Plast Reconstr Surg 2003;112:66S-72S.
[6] Mario Polo, Botulinum toxin type A in the treatment of excessive gingival display, Am J Orthod Dentofacial Orthop, 2005;
127:214-8.
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butyricum type E. Clin Infect Dis. 1999; 29:1381–7. DOI: 10.1086/313497.
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DOI:10.1128/JCM.40.6.2260-2262.2002Centers for Disease Control and Prevention. Botulism in the UnitedStates, 1899–1996.
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Abstract: "Oral health is a mirror of general health". Certain signs manifested in head and neck region including oral cavity serve as an imperative clue in diagnosing systemic disorders. These manifestations serve as clinical pearls in leading the clinician towards appropriate management of the disorder. The present review discusses some of the significant signs which act as clinical guide.
Keywords: Oral manifestations, systemic disorders, clinical guide.

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J Am Acad Dermatol, 48, 2003, 263–4.
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Abstract:Most prominent feature in osteoarthritis is the progressive destruction of articular cartilage which results in impaired joint motion, severe pain, structural and functional failure of synovial joints. A hospital based cross sectional study was conducted in Burdwan Medical College, West Bengal, India on 76 postmenopausal women aged 45–70 years suffering from Osteoarthritis (OA) of the knee joint, which was diagnosed from symptoms, clinical examinations and radiographic findings. 150 subjects undergoing knee joint arthroscopy for chronic knee pain, meniscal tears or anterior cruciate ligament reconstruction were taken as control .plasma vitamin C was measured. The width of knee joint space was measured from the radiographic plates to assess the disease severity. Knee joint radiographs were evaluated with the Kellgren–Lawrence grading scale .Furthermore both were correlated with plasma vitamin C levels to find out possible association between the vitamin C and the disease progression. Results showed that there was a significant decrease in vitamin C levels in patients with knee joint osteoarthritis as compared to the controls. Plasma vitamin C showed negative correlation with Kellgren–Lawrence grading and positive correlation with knee joint space width. Knee joint space width and vitamin C decreased with increasing Kellgren–Lawrence grade.
Key words: vitamin C .Knee Osteoarthritis, Kellgren–Lawrence grading scale,

[1] Yelin E. The economics of osteoarthritis. In Osteoarthritis. Oxford University Press; Oxford: 2003:17-21.
[2] Kenneth D. Brandt., osteoarthritis, Harrison principle of medicine 17 edition ;pages 2032-2045
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Res.1988; 17(1):11-22.
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antioxidants. Free Radic Res.1999 May; 30(5):395-405.
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[8] Shikhman AR, Brinson DC, Valbracht J, etal. Cytokine regulation of facilitated glucose transport in human articular chondrocytes.
JImmunol. 2001
[9] Cartilage: a possible mechanism throughwhich age is a risk factor for osteoarthritis.Arthritis Rheum. 2002 Jan; 46(1):14-23.
[10] Richardson S, Neama G, Phillips T, et al.Molecular characterization and partial cDNA cloning of facilitative glucosetransport ers
expressed in human articularchondrocytes; stimulation of 2-deoxyglucose uptake by IGF-1 and elevatedMMP-2 secretion by
glucose deprivation.Osteoarthritis Cartilage. 2003Feb; 11(2):92–101

Abstract: Post operative nausea and vomiting (PONV) continue to be frequent occurrences, even when conventional antiemetics are prophylactically used. In a randomized double blind study, 100 female patients scheduled for elective laparoscopic cholecystectomy under general anaesthesia were divided into 2 groups of 50 patients each and received 0.1mg/Kg of Ondansetron (Group X) or 0.04mg/Kg of Granisetron (Group Y) preoperatively. Patients were observed for 24 hours post operatively and interpretation of symptoms of nausea and vomiting was done according to Gan and Alexander scale (0-2). 80% of patients in Group Y and 48 % patients
in Group X did not experience PONV; the difference was statistically significant (p<0.001). 2 patients (4%) in Group Y and 15patients (30%) in Group X required rescue antiemetic medication during the 24 hour study period. The difference was found to be highly significant (p<0.001) The difference in the incidence of PONV between the two groups after 6 hours to 24 hours was highly significant (p<0.001). It was concluded that prophylactic administration of Granisetron is more effective than Ondansetron, in reducing in incidence of PONV with prolonged effects.
Key words: Granisetron, laparoscopic cholecystectomy, Ondansetron,

[1] Watcha MF, White PF: post operative nausea and vomiting. Anesthesiology 1992; 77(1): 162 – 84
[2] Fuji Y, Tanaka H, Toyooka H: The effect of Dexamethasone on antiemetics in female patients underling gynaecological surgery.
Anesthesia Analgesia 1997; 85: 913 – 917.
[3] Diemunsch P, Schoeffler P, Bryssine B: Antiemetic activity of the NK1 Receptor antagonist in the treatment of established post
operative nausea and vomiting after major gynecological surgery. British Journal of Anaesthesia 1999; 82:274 – 276.
[4] Yogendran S, Sunthera LY: A prospective randomized double blinded study of the effect of intravenous fluid therapy on adverse
outcomes in outpatient surfer. Anesthesia Analgesia 1995; 80:682 – 686
[5] Trammer R: A rational approach to control of post operative nausea and vomiting; evidence for prevention and treatment and
research agenda. Acta Anesthesiologica Scand 2001; 45: 14.
[6] Willium M, Splinter MD: Prevention of vomiting after strabismus surgery in children; Dexamethasone alone v/s Dexamethasone plus
low dose Ondansetron. Pediatric Anesthesia 2001:11(5):591
[7] Bune KT, Tyres MB. The role of 5-HT in postoperative nausea and vomiting. British Journal of Anaesthesiology 1992; 69:245-325.
[8] Linbald T, Bucklers DN, Forrest JB: The incidence of post operative nausea and vomiting in women undergoing laparoscopy is
influenced by the day of menstrual cycle. Canadian Journal of Anesthesia 1991; 38:298.
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ondansetron in the prevention of nausea and vomiting induced by moderately emetogenic chemotherapy: A multicentric double blind
randomized parallel study. J Clin Oncol 1998; 16(2): 754-760.
[10] Rajeeva V, Bhardwaj N, Batra YK, Dhaliwal LK: Comparison of Ondansetron with Ondansetron and dexamethasone in
prevention of post operative nausea and vomiting in diagnostic laparoscopy Canadian Journal of Anesthesia 1999; 46: 40 – 44.

Abstract: Five hundred thousand patients of tuberculosis die every year in India. Delay in diagnosis and in initiating treatment results in poor prognosis. This disease is affecting the children more and more. Meningeal tuberculosis has acquired an endemic shape with about 12% incidence. The aim of the present study is to evaluate Cerebrospinal fluid Adenosine deaminase: as a marker for diagnosing tuberculous meningitis Eighty paediatric patients of age group 6-24 months having symptoms and signs of meningitis were divided into two groups; tuberculous and non-tuberculous, as per the accepted criteria. The CSF was drawn and ADA levels estimated in all patients. Out of 38 tuberculous patients, 36 had CSF ADA at or above the cutoff value, while 02 had below. Out of 42 non-tuberculous patients, 04 patients had at or above while 38 were below the cutoff value. Results of our study indicate that ADA levels in CSF are not only of considerable value in the diagnosis of TBM; CSF ADA level 10 IU/L as a cutoff value exhibited 94.73% sensitivity;90.47% specificity; 90.00% positive predictive value and 95.00% negative predictive value. Cerebrospinal fluid Adenosine deaminase estimation is less expensive, rapid and fairly specific method for the diagnosis of tuberculous etiology in TBM; it may prove to be diagnostic marker for diagnosing tuberculous meningitis in paediatric patients.
KeyWords: Adenosine deaminase (ADA), Cell-mediated immunity (CMI), Cerebrospinal fluid (CSF),
Tuberculous meningitis (TBM),

[1] Garcia-Monco, J.C. (1999) CNS Tuberculosis. In: Neurologic Clinics. Marra, C.M. (ed.). 17(4), 737-760.
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tuberculous meningitis. J. Trop. Med. Hy. 87. 33-40.
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deaminase in cerebrospinal fluid for the diagnosis and follow-up of tuberculous meningitis in adults. J. Inf. Dis. 155, 603-607.
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Abstract: Background: The benefits of breastfeeding for the health and wellbeing of the mother and baby are well documented. WHO recommends early (i.e. within one hour of giving birth) initiation of breastfeeding. Objectives: To assess the knowledge of breast-feeding and the practices regarding initiation of breast feeding among postnatal mothers as well as to find their association with various factors if any.Settings: Postnatal ward of Calcutta National Medical College & Hospital, Kolkata.Study design: Hospital based descriptive study.Participants: Postnatal mothers.Methodology: Systematic random sampling was done for interview of 620 mothers.Various data were recorded and analyzed. Results: Around 51% mothers were in the age group of 20-25, 15% were illiterate and about 75%were of the socio=economic class III and IV and 70% came from joint family. About 88% mothers had good knowledge score which was used here as the yardstick of knowledge measurement. Variables like increasing age, education, better socioeconomic status, joint family affected knowledge favorably, whereas age of mother below 20, first childbirth adversely affected the score . Also knowledge regarding initiation of breast feeding and duration of continuation of it was poor. Knowledge score did not influence the practice of timely initiation of breastfeeding, but the prelacteal feeding was favorably affected by it.
Key words: breastfeeding knowledge, hospital practices, initiation of breastfeeding, socio- demography

[1] Edmond KM, Zandoh C, Quigley MA, Amenga-Etego S, Owusu-Agyei S, Kirkwood BR. Delayed breastfeeding initiation increases
risk of neonatal mortality. Pediatrics 2006;117:380-386
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[4] Leon-Cava N, Lutter S, Ross J, Martin L. Quantifying the benefits of breastfeeding: A summary of the evidence. Pan American
Health Organization, Washington DC, 2002
[5] Gupta A, Arora V, Bhatt B. The State of World's Breastfeeding: India Report card 2006 . International Baby Food Action Network
(IBFAN), Asia Pacific. India. 2006
[6] Dadhich JP, Gupta A. Assessment of Status of Infant and Young Child Feeding (IYCF) practice, policy and program-Achievements
and Gaps. Breast feeding pro-motion network of India. 2005
[7] (http://fex.ennonline.net/28/neonatal.aspx )
[8] Kishore M. Sal Sunil, Kumar Praveen and Aggarwal Arun K. Breastfeeding Knowledge and Practices amongst Mothers in a Rural
Population of North India: A Community- based study. Journal of Tropical Pediatrics. Vol 55 Issue3 :183-188
[9] Chaudhury RN, Shah T, Raja S. Knowledge and practice of mothers regarding breastfeeding: a hospital based study. Health
Renaissance.Vol9,No3(2011).
[10] Oqunlin TA. Maternal socio-demographic factors influencing initiation and exclusivity of breastfeeding in a Nigerian semi-urban
setting. Child Health J 2010 May, 14(3) 459-65.

Abstract: A 15 year old boy presented with à painful non mobile, bony hard swelling of lower end of left femur of 4 years duration. The swelling was present since 4 years with progressive increase in size of the swelling and pain on knee movements since last 1 year.
Clinical examination revealed a bony hard swelling arising from medial aspect of lower end of femur away from the knee joint. The swelling was painful on knee flexion of more than 90 degrees . XRays revealed a giant pedunculated exostosis arising from lower end of femur with a fungating mass at the cartilaginous cap abutting the skin. A diagnosis of giant exostoses lower end femur with possible malignant transformation was made. In view of sudden increase in size of the lesion and associated pain on knee movements, and mechanical obstruction Patient underwent surgical excision of the exostoses .Histopathology revealed no malignant transformation.
Keywords: exostoses, cartilage cap, malignant transformation, excision

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DIAGNOSTIC PATHOLOGY, copyright 2010 by saunders an imprint of Elsevier,inc
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follow-up study. J Bone Joint Surg (br) 2003; 85B:1161
[8] Variants of exostosis of the bone in children. -Randy Ray Richardson, MD-Seminars inRoentgenology-Volume 40, Issue 4 , Pages
380-390, October 2005
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thickness by ultrasound. Skeletal Radiol 21:33-37, 1992
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Abstract: Orthodontists have used a variety of hand-held dental instruments to position the brackets for direct bonding. A number of instruments, including the Boone and Dougherty gauges, have been used but the bracket can easily slip when the instrument is removed. Other gauges like MBT, ABJ , require multiple instruments for the same. Indirect bonding may be a solution, but it is time- consuming and does not provide for precise repositioning of bracket that fall off. We have developed a multipurpose gauge that allow accurate, reproducible bracket placement with a sensitivity of 0.5mm.
Keywords: Bracket Positioning Gauge,Caliper, Metallic or Wooden jigs.

[1] Roth R H, Five year clinical evaluation of the Andrews Straight-Wire Appliance, 2nd International Conference for Orthodontists,
Munich, West Germany, 1975.
[2] Carlson S K , Johnson E : Bracket positioning and resets: Five steps to align crowns and roots consistently, Am. J. Orthod. 119,
2001,76-80.
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[4] Droschl H, Bantleon H P : Bracket positioning gauge, J. Clin. Orthod. 20, 1986,266-268.
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[7] Fowler P V : Variations in the perception of ideal bracket location and its implications for the preadjusted edgewise appl iance, Br. J.
Orthod. 17, 1990,305-310.
[8] McLaughlin R.P, Bennett J C : Bracket placement with the preadjusted appliance, J. Clin. Orthod. 29, 1995,302-311.
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Abstract: Adenomyosis of uterus is a relatively à common condition and is usually divided into two main types, the diffuse adenomyosis and focal adenomyosis. However, there is third rare variant called as cystic adenomyosis which is due to repeated focal haemorrhages and results in cystic spaces filled with altered blood. Here, we are presenting a unique case of 25 years old girl who presented with severe dysmenorrhoea with 26 weeks abdominal lump. USG showed uterine fibroid with right ovarian chocolate cyst. Patient was planned for myomectomy with cystectomy. Intraoperatively large, irregular solid cystic mass (25x15x10 cm3) was removed
which appeared malignant and total hysterectomy with bilateral salpingectomy was done. But mass was identified as cystic adenomyosis associated with diffuse adenomyosis of uterus on histopathology. Thus, although rare, but adenomyosis may be abnormally enlarged, solid, irregular, malignant in appearance and MRI may be required preoperatively for correct diagnosis and plan of management.
Keywords: Cystic adenomyosis, diffuse adenomyosis, Focal adenomyosis, Juvenile adenomyosis, Solid cystic mass.

[1] Kriplani A, Mahey R, Agarwal N, Bhatla N, Yadav R, Singh MK. Laparoscopic management of juvenile cystic adenomyoma: four
cases. J Minim Invasive Gynecol. 2011 May-Jun;18(3):343-8.
[2] Kamio M, Taguchi S, Oki T, Tsuji T, Iwamoto I, Yoshinaga M, Douchi T. - J Obstet Gynaecol Res. Isolated adenomyotic cyst
associated with severe dysmenorrhea 2007 Jun;33(3):388-91.
[3] Ho ML, Ratts V, Merritt D. Adenomyotic cyst in an adolescent girl. Journal of Pediatric and Adolescent Gynecology 22(3): e33- e38, 2009.
[4] English DP, Verma U, Pearson JM.Uterine cyst as a cause of chronic pelvic pain: a case report. J Reprod Med. 2012 Sep-Oct;57(9-
10):446-8.
[5] Kataoka ML, Togashi K, Konishi I, Hatabu H, Morikawa K, Kojima N, et al. MRI of adenomyotic cyst of the uterus. J Comput Assist. Tomogr 1998; 22:555–9. [PubMed] J Comput Assist Tomogr. 1998 Jul-Aug; 22(4):555-9.

Abstract: This case report describes the autotransplantation of a third molar with developing roots in a young female patient. Following transplantation into the socket of mandibular first molar, the tooth was stabilized with sutures and a custom made semi rigid splint. On recall examination one year after completion of the surgical technique, the transplant responded positively to electric pulp testing and showed absence of infection, ankylosis or progressive resorption. The transplantation of a third molar can be seen as a promising method to replace a lost permanent tooth. Clinical relevance :The permanent first molar is the most caries prone permanent tooth, probably because of its early exposure to the oral environment. Unrestorable teeth need to be extracted. Its extraction leads to unfavorable occlusal changes . Fixed prosthesis and implants are not feasible in growing patients because they may impede the normal growth of facial bones, in particular, of the alveolar process. This case report describes autotransplantation of third molar with incompletely formed roots as a viable treatment option when permanent first molar needs to be extracted. The use of semirigid splint has been demonstrated and follow up showed good prognosis.
Keywords: third molar, autotransplantation, semi rigid splint

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Orthop 2008; 134:270-5.
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126:481–5.
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24:137–41.
[6] Kvint S, Lindsten R, Magnusson A, Nilsson P, Bjerklin K.Autotransplantation of Teeth in 215 Patients. A follow-up study. Angle
Orthod 2010; 80:446-51.
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2004; 70:761–6.
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Company 1992 ; 111–34.
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Abstract: Background: Urban poor in India are highly vulnerable to malaria due to poor sanitary conditions, awareness and climate change. Methodology: an observational, descriptive study was carried out at ward 37 under Borough V of K.M.C. for one year. Records regarding malariometric indices in last 4 years were collected. Study population (n=342) were slide positive cases of malaria reporting in the malaria clinic. Data on socio demographic profile, environment , housing status, knowledge and practice regarding different aspects
of malaria were collected. Quantitative assessment of knowledge and practice was done. Chi-square test and Pearson's correlation coefficient was computed. Results: All the malariometric indices increased gradually over the years (2006-09). There existed a seasonal trend in transmission of malaria . Male gender, nuclear family, higher education and higher socio-economic status were statistically significantly associated with both the higher knowledge and practice score. Conclusions and recommendations: socio-demographic factors are associated with knowledge and practice of malaria prevention. Malaria control must be based on disease epidemiology with emphasis on improvement of knowledge and practice of appropriate preventive measures.
Key Words: Malaria, malaria epidemiology, malariometric indices, practice

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Abstract:Cleft lip (Cheiloschisis) is a most common congenital facial anomaly. It is due to non fusion of maxillary process with medial nasal processes (Globular process). A cleft lip can be either unilateral (or) bilateral. The oral clefts are congenital anomalies caused by the interaction between genetic and environmental factors. The abnormal craniofacial morphogenesis leads to various types of oral clefts. The oral clefts result from failure of migration of neural crest cells (or) non fusion of the facial prominences between 4th and 8th weeks after conception. During the germinal stage the embryo is most susceptible to environmental factors predisposing to clefts.
Keywords: Cleft lip, Globular process, Maxillary process, Neural crest cells.

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