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Background: The cranial sutures are the fibrous tissues uniting the skull bones as they approximate one another during development. The coronal, sagittal and lambdoid sutures were analyzed for quantifying the sutural patency as maintenance of suture patency depends on various factors in skull. Metopic sutures are a vertical sutures occurring as a result of failure of ossification between the two halves of frontal bone. It is very often mistaken for fracture of the frontal bone in the A-P view X-Ray of skull. Objective: The goal of the study was to evaluate the gross morphology of the coronal, sagittal, lambdoid and metopic sutures in human adult dried skulls and to determine if any difference exists in terms of fusion. Material and methods: The study included 150 human dry skulls of Indian population were selected from the museum of anatomy department of GMERS Medical College Gotri, Vadodara, and Government Medical College Bhavnagar. Result: the study shows the patency of the lambdoid suture is more compared to the other sutures and incidence of metopism was 2%.

1. Persson M, Magnusson BC, Thilander B, Sutural closure in rabbit and man: a morphological and histochemical study, J Anat, 1978, 125(Pt 2):313–321. 2. Opperman LA, Cranial sutures as intramembranous bone growth sites, Dev Dyn, 2000, 219(4):472–485. 3. Saito K, Shimizu Y, Ooya K, Age-related morphological Changes in squamous and parietomastoid sutures of human cranium, Cells Tissues Organs, 2002, 170(4):266–273. 4. 4Jacobs AW, Falls WM. Anatomy. In: Ward RC (Ed), Foundations for Osteopathic Medicine, 2nd edition, Lippincott Williams & Wilkins, Baltimore, 2003, 44–62. 5. 5. Dean NA, Mitchell BS, Anatomic relation between the nuchal Ligament (ligamentum nuchae) and the spinal dura mater in the craniocervical region, Clin Anat, 2002, 15(3):182–185. 6. Sabini RC, Elkowitz DE, Significance of differences in Patency among cranial sutures, J Am Osteopath Assoc, 2006, 106(10):600–604. 7. Herring SW, Mucci RJ, In vivo strain in cranial sutures: the Zygomatic arch, J Morphol, 1991, 207(3):225–239. 8. Moazen M, Curtis N, O’Higgins P, Jones MEH, Evans SE, Fagan MJ, Assessment of the role of sutures in a lizard Skull: a computer modelling study, Proc Biol Sci, 2009, 276(1654):39–46. 9. Bryce, T.H. (1915). Osteology and Arthrology. In Quain's Elements of Anatomy, 11th ed., vol. 4, pt. I, p. 177. London: Longmans Green. 10. Manzanares, M. C.; Goret-nicaise, M. & Dhen, A. Metopic sutural closer in the human skull. J. Anat., 161:203-15, 1988. 11. Rawlins JT, Fernandez CR, Cozby ME, Opperman LA, Timing of Egf treatment differentially affects Tgf-beta2 induced cranial suture closure, Exp Biol Med (Maywood), 2008, 233(12):1518–1526. 12. Slater BJ, Lenton KA, James A, Longaker MT, ex vivo model of cranial suture morphogenesis and fate, Cells Tissues Organs, 2009, 190(6):336–346. 13. Vecchione L, Byron C, Cooper GM, Barbano T, Hamrick MW, Sciote JJ, Mooney MP, Craniofacial morphology in myostatin deficient mice, J Dent Res, 2007, 86(11):1068–1072. 14. Rafferty KL, Herring SW, Craniofacial sutures: morphology, growth, and in vivo masticatory strains, J Morphol, 1999 242(2):167–179. 15. Todd TW, Lyon DW Jr, Endocranial suture closure. Its progress and age relationship. Part I. – Adult males of white Stock, Am J Phys Anthropol, 1924, 7(3):325–384. 16. Kappler RE, Ramey KA, Head: diagnosis and treatment. In: Ward RC (Ed), Foundations for Osteopathic Medicine, Lippincott Williams & Wilkins, Baltimore, 2003, 660–683. 17. Del Sol, M.; Binvignat, O.; Bolini, P. D. A. & Prates, J. C. Metopic mono individual Brasileira. Rev. Paul. Med., 107(2):105-7, 1989. 18. Keith, A. (1948). Human Embryology and Morphology, 6th ed. London: Edward Arnold. 19. Piersol, G. A. (1916). Human Anatomy, 5th ed. Philadelphia: Lippincott. 20. Romanes, G. J. (1972). Cunningham's Textbook of Anatomy, 11th ed., p. 133. London: Oxford University Press. 21. Torgerson, J. (1951). Developmental, genetic and evolutionary meaning of metopic suture. American Journal of Physical Anthropology 9, 193-210. 22. Warwick, R. & Williams, P. L. (1980). Gray's Anatomy, 36th ed., p. 334. London: Longmans. 23. Hamilton, W. J. (1976). Textbook of Human Anatomy, 2nd ed., p. 60. London: Macmillan & Co. 24. Basmajian, J. V. (1975). Grant’s Method of Anatomy, 9th ed., pp. 451, 604. New Delhi: S. Chand & Co. Ltd; Baltimore: Williams & Wilkins Co. 25. Wood Jones, F. (1953). Buchanan's Manual of Anatomy, 8th ed. London: Pailliere, Tindall. 26. Shanta Chandrasekaran, Deepti Shastri,A study of metopic suture in adult south Indian skulls, IJBMS, Oct-2011, vol-1, issue 7.

Personality is thought to affect risk for Obesity. Studies have shown a possible linkage between personality/personality trait and obesity. Aim: To assess the Chakra personality types in normal and overweight/obese individuals and to determine the association between chakra personality types and obesity. Study design and method: Observational cross sectional study conducted in Physiology department. One hundred and fifty enrolled participants` body mass index (BMI) was calculated and dichotomized into normal weight and overweight/obese group based on BMI. Chakra personality types were analyzed using chakra personality questionnaire in both the groups. Results: Out of the total one hundred and fifty subjects , 24 were Satvik, 107 were Rajsik and 19 Tamsik using the Chakra personality test. There was a strong association between chakra personality type and overweight/obesity (P value of <0.01). There was significant difference in the proportion of Tamsik in overweight /obese group. Conclusion: Study suggests that Tamsik chakra personality type may predispose to overeating behaviour and physical inactivity leading to obesity.

1. WHO. Preamble to the Constitution of the World Health Organization as adopted by the International Health Conference, New York, 19-22 June 1946, and entered into force on 7 April 1948. 2. Bircher J. Towards a dynamic definition of health and disease. Med. Health Care Philos 2005;8:335-41. 3. International Institute for Population Sciences (IIPS) and Macro International. 2007. National Family Health Survey (NFHS-3), 2005–06: India: Volume I. Mumbai: IIPS http://pdf.usaid.gov/pdf_docs/PNADK385.pdf 4. Malnick SD, Knobler H. The medical complications of obesity. QJM. 2006;99(9):565-79. 5. Irani FB, Bhakare P, Joshi LN. Effect of yogic practices (sudharshan kriya) on personality. Journal of MGIMS. 2013;18(1):40-43. 6. Jokela M, Hintsanen M, Hakulinen C, et al. Association of personality with the development and persistence of obesity: a meta-analysis based on individual–participant data. Obes Rev. 2013;14(4): 315–323. 7. Sutin AR, Ferrucci L, Zonderman AB, Terracciano A. Personality and obesity across the adult life span. J Pers Soc Psychol. 2011;101(3):579-92. 8. Valenti MP, Omizo MM, Mehl-Madrona L. Personality and Obese Body Mass Index. The New School Psychology Bulletin. 2011;9(1):34-38. Available from http://www.nspb.net/index.php/nspb/article/view/204/294 9. Fassino S, Leombruni P, Pierò A, Daga GA, Amianto F, Rovera G, Rovera GG. Temperament and character in obese women with and without binge eating disorder. Compr Psychiatry. 2002;43(6):431-7. 10. Terracciano A, Sutin AR, McCrae RR, et al. Facets of personality linked to underweight and overweight. Psychosom Med. 2009;71(6):682-9. 11. Parthasarathy A. Vedanta Treatise: The Eternities. Vedanta Life Institute, 8th edition 2004. 12. Kalashatra Govinda. A Handbook of Chakra Healing: Spiritual Practice for Health, Harmony, and Inner Peace. Konecky Associates, Incorporated, William S, 2005. 13. Sullivan S, Cloninger CR, Przybeck TR, Klein S. Personality characteristics in obesity and relationship with successful weight loss. Int J Obes (Lond). 2007;31(4):669-74. 14. Björvell H, Edman G, Rössner S, Schalling D. Personality traits in a group of severely obese patients: a study of patients in two self-chosen weight reducing programs. Int J Obes. 1985;9(4):257-66. 15. Rydén A, Sullivan M, Torgerson JS, Karlsson J, Lindroos AK, Taft C. Severe obesity and personality: a comparative controlled study of personality traits. Int J Obes Relat Metab Disord. 2003 Dec;27(12):1534-40.

Cephalic Index is race and sex specific parameter. Cephalic Index is different in various racial groups. The present study was determined to identify Cephalic Index of South Gujarat population and compare it with the available data of various Indian populations. The study revealed that Mean Cephalic Index for South Gujarat was 81.2. Cephalic Index shows sexual dimorphism. Mean Cephalic Index for males was 80.88 and for females it was 82.48. We also found that in all available data as well as in our findings Cephalic Index was higher in females compared to males. Such data is of great medico legal and forensic importance which indicates that Cephalic Index can be used as marker of ethnicity, sex and race.

1. Anupama M, Khurana BS, Seema, Batra AP. The study of Cephalic Index in Punjabi students. Journal of Punjab Academy of Forensic Medicine & Toxicology. 2010;10:24-26. 2. Anitha MR, Vijaynath V, Raju GM, Vijayamahantesh SN. Cephalic Index of North Indian population. Anatomica Karnataka.2011;5(1):40-43. 3. Basu A. Anthropometry of the kayasthas of Bengal. Journal of Anatomical Society of India 1963;3:20-25. 4. Bhargava I and Kher GA. An anthropometric study of Central India Bhils of Dhar district of Madhya Pradesh. Journal of Anatomical Society of India 1960; 9:14-19. 5. Bhargava I, Kher GA; A comparative anthropometric study of Bhils and Barelas of central India. J Anat Soc India, 1961:10:26-33 6. Imami-Mibodi MA, Mastri-Farahani R. Study of normal range of anatomical dimension of one day old newborn by Cephalometry. Journal of Medical council Islam Republic Iran,1996;14:1-8. 7. Shah GV, Jadav HR; The study of CI in students of Gujarat .J Anat Soc India, 2004; 53(1):25-26. 8. Singh Priyanka, Purkait Ruma. A Cephalometric study among sub cast groups Dangi and Ahirwars of khurai block of Madhya Pradesh. Anthropologist. 2006; 8(3):215-217. 9. Stewart TD. Anthropometric nomenclature II. The Cephalic Index, American Journal of anthropology, 1935; 97-140. 10. Salve VM, Naga RT, Patibandla A. The study of Cephalic Index of Andhra Region (India).Asian Journal of Medical Science.2011; 2: 53-55. 11. Williams PL, Bannister LH, Dyson M, Collin, Dussek JE and Ferguson JWM. Grey’s Anatomy, 39th Edn, Chur-chill Livingstone, Edinburgh, London 2008: 609-12.

Physico-Chemical study of groundwater near Khuldabad area is carried out in the year 2009-10. For the study different five stations were selected. Different parameters like pH, Conductivity, TDS, Hardness, Sodium, Potassium, Iron, Total Alkalinity, Carbonate, Bicarbonate, Chloride, Flouride, Nitrate and Sulphate are analyzed. Mahismal station having the values within the permissible limit and good for human consumption.

1. B.A. Halena, M. Vega, E. Barrado, R. Pardo and L. Farnandez, Water Air Soil Pollut., 112, 365 (1999). 2. S.M. Ahmed, M. Hussain and W. Abderrahman, Saudi Arabia, Bull. Geol. Environ., 64, 319 (2005). 3. M.T. Hussein, Hydrogeol. J., 12, 144 (2004). 4. M. Vega, r. Pardo, E. Barrado and L. Deban, Water Res., 32, 3581 (1998). 5. J.Y. Lee, J. Y. Cheon, K.K. Lee and M.H. Lee, J.Environ. Qual., 30, 1548 (2001). 6. D.A. Wunderlin, M.P. Diaz, M.V. Ame, S.F. Pesce, A.C. Hued and M.A. Bistoni, Water Res., 35, 2881 (2001). 7. R.Reghunanth, T.R.S. Murthy and B.R. Raghavan, Water Res., 36, 2437 (2002). 8. V. Simeonov, P. Simeonov and R. Tsitouridon, Chem. Eng. Ecol., 11, 449 (2004). 9. S. Shresthe and f. Kazma, Environ. Modelling Software, 22, 464 (2007). 10. Standard methods for the examination of water and wastewater prepared and published jointly by APHA, 19th edition 1995. 11. Chemical and Biological Methods for Water Pollution Studies-Environmental publications, Karad.

Objective(s): To assess intraoperative and postoperative outcome following single layer closure of lower transverse uterine incision at cesarean section as compared to double layer closure. Method(s): In this prospective randomized controlled study, 200 women scheduled for lower segment cesarean section through Pfannenstiel or sub umbilical midline incision were randomized to either single layer (n = 100) or double layer (n=100) closure of uterine incision. Primary outcome measures studied were operating time, intraoperative blood loss, febrile morbidity, and endomyometritis. Secondary outcome measures studied were number of additional hemostatic sutures needed, postoperative pain, perioperative hemoglobin fall, cystitis, wound infection, and hospitalization period. Student t test was used for comparing continuous variables. Categorical variables were compared by Chi square test or Fisher exact test. Results: The maternal demographic factors, indications for cesarean sections and high risk factors were similar between the two groups. There was significant reduction in operating time (P=0.022), intraoperative blood loss (P=0.04), febrile morbidity (P=0.024, OR 0.41, 95% CI (0.17-0.95), perioperative hemoglobin fall (P=0.044), endomyometritis (P=0.03, OR 0.36, 95% CI 0.16-0.90, and period of hospitalization (P=0.00005) in the subjects as compared to controls. There was no significant difference between the two groups regarding number of additional hemostatic sutures needed, postoperative pain, and cystitis or wound infection. Conclusion(s): Single layer closure of lower transverse uterine incision at cesarean section is associated with lesser operating time, intraoperative blood loss, febrile morbidity, endomyometritis, and hospitalization period, as compared to double layer closure.

1. Tully L, Gates S, Brocklehurst P et al. Surgical techniques used during caesarean section operations: results of a national survey of practice in the UK. Eur J Obstet Gynecol Reprod Biol 2002; 102:120-6. 2. Tischendorf D. The single-layer uterine suture in cesarean section. A comparative Study. Geburtshilfe Frauenheilkd 1987; 47:117-20. 3. Hauth JC, Owen J, Davis RO. Transverse uterine incision closure: one versus two layers. Am. J Obstet Gynecol 1992; 167:1108-11. 4. Jelsema RD, Wittingen J A, van der Kolk KJ. Continuous, nonlocking, single-layer repair of the low transverse uterine incision. J Reprod 1993; 38:393-6. 5. Iankov M. Single-layer or double-layer suturing of the uterine incision in cesarean section? Akush Ginekol (Sofiia) 1999; 38:10-3. 6. Hohlagschwandtner M, Chalubinski K, Nather A et al. Continuous vs interrupted sutures for single-layer closure of uterine incision at cesarean section. Arch Gynecol Obstet 2003; 268:26-8. 7. Popov I, Stoikov S, Bakurdzhiev G et al. A single-stage 2-layer suture in cesarean section—the effect of the surgical technic on postoperative febrile conditions. Akush Ginekol (Sofiia) 1994; 33: 13-5. 8. Heidenreich W, Bruggenjurgen K. Modified Sarafoff suture for single layer closure of uterotomy in cesarean section. A prospective study. Zentralbl Gynakol 1995; 117: 40-4. 9. Tucker JM, Hauth JC, Hodgkins P et al. Trial of labor after a one-or two-layer closure of a low transverse uterine incision. Am J Obstet Gynecol 1993; 168:545-6. 10. Chapman SJ, Owen J, Hauth JC. One- versus two-layer closure of a low transverse cesarean: the next pregnancy. Obstet Gynecol 1997; 89:16-8. 11. Enkin MW, Wilkinson C. Single versus two layer suturing for closing the uterine incision at Caesarean section (Cochrane Review). In: The Cochrane Library, Issue 1, 2003. Oxford: Update Software. 12. Lal K, Tsomo P. Comparative study of single layer and conventional closure of uterine incision in cesarean section. Int J Gynecol Obstet 1988; 27:349-52. 13. Durnwald C, Mercer B. Uterine rupture, perioperative and perinatal morbidity after single-layer and double-layer closure at cesarean delivery. Am J Obstet Gynecol 2003; 189:925-9. 14. Gul A, Kotan C, Ugras S et al. Transverse uterine incision non-closure versus closure: an experimental study in dogs. Eur J Obstet Gynecol Reprod Biol 2000; 88:95-9. 15. Gul A, Simsek Y, Ugras S et al. Transverse uterine incision non-closure versus closure: an experimental study in sheep. Acta Obstet Gynecol Scand, 2000; 79: 813-7. 16. Bujold E, Bujold C, Hamilton EF et al. The impact of a single-layer or double-layer closure on uterine rupture. Am J Obstet Gynecol 2002; 186:1326-30.

Intracranial dermoids comprise less than 1% of all intracranial lesions. These are slow growing benign congenital ectodermal inclusion cysts containing varying amounts of ectodermal derivatives. They usually found in midline in contrast to epidermoids. Teratomas, although similar in some respects, are a separate entity. Intracranial dermoid cysts show variable presentation usually cause symptoms because of mass effect and due to rupture with spillage of its contents into subarachnoid space and/or ventricles is a potentially serious complication that can lead to aseptic meningitis, seizures, cerebral ischaemia, hydrocephalus and rarely olfactory ischaemia. Occasionally they are incidentally detected.[1,3,4]. Summary: Rupture of intracranial dermoid is very uncommon occurrence with significant mortality. We present a case of ruptured sellar-suprasellar dermoid with subarachnoid and intraventricular dissemination of its contents causing hydrocephalus.

1. Venkatesh SK, Phadke RV, Trivedi P, Bannerji D. Asymptomatic spontaneous rupture of suprasellar dermoid cyst: a case report. Neurol India. 2002;50(4): 480–483. 2. Smirniotopoulos JG, Chiechi MV. Teratomas, dermoids, and epidermoids of the head and neck. Radiographic 1995;15(6):1437–1455. 3. Miller Jb: Northfield’s surgery of the central nervous system, 2nd edition, Oxford, Blackwell.1987; 240-244. 4. Patkar D, Krishnan A, Patankar T, Prasad S, Shah J, Limdi J. Ruptured intracranial dermoids: magnetic resonance imaging. J Postgrad Med. 1999;45(2):49–52. 5. Das CJ, Tahir M, Debnath J, Pangtey GS. Neurological picture. Ruptured intracranial dermoid. J Neurol Neurosurg Psychiatry. 2007;78(6):624–625. 6. Lunardi P, Missori P: Supratentorial dermoid cysts. J Neurosurg 1991; 75: 262-266. 7. Tsugu H, Fukushima T, Hayashi S, Iwaasa M, Matsuda T. Squamous cell carcinoma arising in an intracranial dermoid cyst—case report. Neurol Med Chir (Tokyo) 2001; 41(4):213–216. 8. Osborn AG, Preece MT. Intracranial cysts: radiologic-pathologic correlation and imaging approach. Radiology. 2006;239(3):650–664.

The present study was conducted to find out whether the deep breathing test and thus the autonomic nervous system are affected in female patients of iron deficiency anemia. Material and Method: In this study the change in heart rate was recorded with the help of ECG machine during inspiration and expiration phases of deep breathing maneuver. The change in heart rate was compared between 60 women with iron deficiency anemia and 60 age and socioeconomically matched women. Result: it was found that the change in heart rate was significantly altered in women with iron deficiency anemia (P<0.0001) when compared to controls. Conclusion: altered deep breathing test suggestive of altered autonomic function in iron deficiency anemia.

1. Adamko DJ, Agarwal N, Alter BP, et al. Wintrobe’s Clinical Hematology. 12th Edition; 2009: 810-830. 2. Park K. Text book of Preventive and Social Medicine. 2011; 21st Edition: 575-576. 3. Harrison’s Principles of Internal Medicine, 18th Ed. 2011:841-851. 4. Goldstein DS, Robertson D, Esler M, et al. Dysautonomias: clinical disorders of the autonomic nervous system.Ann Intern Med.2002; 137(9): 753-763. 5. Bannister Roger: Autonomic failure: A textbook of clinical disorders of autonomic nervous system, Oxford University press, 1983; 371-436. 6. Bennett T, Fentem PH, Fitton D, et al. Assessment of vagal control of heart in diabetes: Measures of R-R interval variation under different conditions. British Heart Journal. 1977; 39: 25-28. 7. West JB. Best and Taylor: Physiological Basis of Medical Practice. 1984; Eleventh edition: 279. 8. Wheeler T, Watkin PJ. Cardiac denervation in diabetes. British Medical Journal 1973; 4: 584-586. 9. O'Brien IAD, O'Hare P, Corrall RJM. Heart rate variability in healthy subjects: effect of age and the derivation of normal ranges for tests of autonomic function. Br Heart J 1986; 55: 348-54. 10. Nand N, Mohan R, Khosala SN, et al. Autonomic function test in chronic severe anemia. J Assoc Physicians Ind 1989;37(8):508-510. 11. Lakhotia M, Shah PKD, Gupta A, et al. Clinical assessment of autonomic functions in anemics. J Assoc Physicians India 1996; 44(8): 534-536. 12. Glick G, Plauth WH Jr, Braunwald E. Role of the autonomic nervous system in the circulatory response to acutely induced anemia in unanesthetized dogs. J Clin Invest 1964;43(11):2112-2124. 13. Justus DW, Cornett RW, Hatcher JD. A humoral influence on cardiovascular adjustments to acute and chronic posthaemorrhagic anemia in dogs. Circulation Res 1957;5(2): 207-214. 14. Guyton and Hall: Text book of medical physiology, 12th Edition, 2011; 162. 15. Roy SB, Bhatia ML, Mathur VS, et al. Hemodynamic effects of chronic severe anemia. Circulation 1963; 28: 346-356. 16. Ganong WF: Review of Medical Physiology. 23rd Edition, 2010: 563. 17. Ewing DJ, Campbell IW, Murray A., et al. Immediate heart response to standing: Simple test for autonomic neuropathy in diabetes. British Medical Journal. 1978 ;1(6106): 145- 147. 18. Koeppen BM, Stanton BA. Berne & Levy Physiology. 2008; 6th edition: 374. 19. Sangkatumvong S, Coates TD, Khoo MCK. Abnormal autonomic cardiac response to transient hypoxia in sickle cell anemia. Physiol. Meas.2008;29(5): 655-668.

Introduction: In India, Mosquito borne diseases constitute a major public health problem in the list of communicable diseases. The most important are malaria, dengue fever, chikungunya fever. One of the important components of Vector borne disease control programme is to impart awareness about mosquito bite prevention in the general community. The present community based study was conducted to assess the awareness and practices of mosquito bite prevention methods amongst households in an urban slum area of South India. Materials and methods: The present community based study was conducted in Guntur district of Andhra Pradesh. All households of Urban Health Training Center, Shrinavasrao Thota which is urban catchment area of department of Community Medicine, Katuri Medical College, Guntur were selected for the study. Results: 91.50 % of the study participants had knowledge about breeding places of mosquito. 22.29 % of study population still had myths that garbage was the breeding place for mosquito. Only 33.72% of the study population knew that dengue, chikungunya was transmitted by mosquito. Conclusion: The study found that knowledge about causes of malaria and mosquito breeding places was satisfactory in study subjects, but some myths were still prevalent. The people should be made aware that mosquito bite causes other diseases also.

1. K.Park. Park’s Textbook of Preventive and Social Medicine; Bhanot Publication, 20th Edition p-672. 2. Heyneman, D., 2004. Medical parasitology. In: Medical microbiology, Brooks, G.F., J.S. Butel and S.A. Morse (eds.). 23rd Edn, McGraw Hill, Boston, pp: 661-701. 3. Surendran SN, Kajatheepan A; Perception and personal protective measures toward mosquito bites by communities in Jaffna District, northern Sri Lanka; J Am Mosq Control Assoc. 2007 Jun;23(2):182-6. 4. Babu BV, Mishra S, Mishra S, Swain BK. Personal-protection measures against mosquitoes: a study of practices and costs in a district, in the Indian state of Orissa, where malaria and lymphatic filariasis are co-endemic. Ann Trop Med Parasitol. 2007 Oct;101(7):601-9. 5. Ziba C, Slutsker L, Chitsulo L, Steketee RW, Use of malaria prevention measures in Malawian households. Trop Med Parasitol. 1994 Mar;45(1):70-3. 6. Panda R, Kanhekar LJ, Jain DC, Knowledge, attitude and practice towards malaria in rural tribal communities of south Bastar district of Madhya Pradesh. J Commun Dis. 2000 Sep; 32(3): 222-7. 7. Snehalatha KS, Ramaiah KD, Vijay Kumar KN, Das PK. The mosquito problem and type and costs of personal protection measures used in rural and urban communities in Pondicherry region, South India. Acta Trop. 2003 Sep;88(1):3-9. 8. Lengeler,C. 2000. Insecticide treated bed nets and curtains for preventing malaria. Cochrane Database Syst Rev 2: CD000363. 9. Sharma SK, Jalees S, Kumar K, Rahman SJ. Knowledge, attitude and beliefs about malaria in a tribal area of Bastar district (Madhya Pradesh); Indian J Public Health. 1993 Oct Dec;37(4):129-32. 10. Tyagi P, Roy A, Malhotra MS, Knowledge, awareness and practices towards malaria in communities of rural, semi-rural and bordering areas of east Delhi (India); J Vect Borne Dis 42, March 2005, pp 30–35.

Objective: The present study is done to determine the effect of Sudarshankriya Yoga on heart rate, systolic blood pressure (SBP), diastolic blood pressure (DBP) and respiratory rate. Material and Methods: About 30 subjects (cases) underwent the practice of Sudarsharkriya Yoga for 12 weeks. Above cardio respiratory parameters were measured before and after the practice of Sudarshankriya Yoga. Comparative analysis is done for the effect of 12 weeks of yoga practice on these parameters. Results: Sudarshankriya yoga showed statistically significant decrease in the values of heart rate, systolic blood pressure, diastolic blood pressure as well as respiratory rate after 12 weeks of practice. Conclusion: The mechanism involved is by creating balance in autonomic nervous system functions by parasympathetic dominance and decreased sympathetic drive.

1. Madanmohan, Mahadevan SK, Balakrishnan S, Gopalakrishnan M, Prakash ES. Effect of six weeks yoga training on weight loss following step test, respiratory pressures, handgrip strength and handgrip endurance in young healthy subjects. Indian J Physiol Pharmacol 2008; 52: 164-170. 2. Richard Brown & Patricia Gerbarg. Sudarshan kriya yogic breathing in the treatment of stress, anxiety & depression: Part I-Neurophysiologic model. The journal of alternative & complementary medicine;11(1),2005,189-201. 3. Fokkema DS. The psychobiology of strained breathing and its cardiovascular implications: a functional system review. Psychophysiology 1999; 36(2):164-75. 4. Lehrer P, Sasaki Y, Saito Y, Zazen and cardiac variability. Psychosomat Med 1999;61:812-821. 5. Sovik R. The science of breathing-The yogic view. Progr Brain Res 2000;122:491-505. 6. Spicuzza L, Gabutti A, Porta C, Montano N, Bernardi L. Yoga and chemoreflex response to hypoxia and hypercapnia. Lancet 2000; 356(9240):1495-6. 7. 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Richard Brown & Patricia Gerbarg. Sudarshan kriya yogic breathing in the treatment of stress, anxiety & depression: Part II- Clinical Applications and Guidelines. The journal of alternative & complementary medicine;11(4),2005,711-17. 14. Bharshankar JR, Bharshankar RN, Deshpande VN, Kaore SB, Gosavi GB. Effect of yoga on cardiovascular systemin subjects above 40 years. Indian J Physiol Pharmacol. 2003; 47: 202-206. 15. Madanmohan, Udupa K, Bhavanani AB, Shathapathy CC, Sahai A. Modulation of cardiovascular response to exercise by yoga training. Indian J Physiol Pharmacol 2004; 48: 461-465. 16. Vempati RP, Telles S. Yoga based guided relaxation reduces sympathetic activity judged from baseline levels Psychol Rep. 2002; 90: 487-94. 17. Sharma VK, Das S, Mondal S, Goswami U. Effect of sahaj yoga on autonomic patients in healthy subjects and patients of major depression. Biomedicine 2008; 28: 139-141.14. 18. Schmidt T, Wijga A, Von Zur Mühlen A, Brabant G, Wagner TO. Changes in cardiovascular risk factors and hormones during a comprehensive residential three month kriya yoga training and vegetarian nutrition. Acta Physiol Scand Suppl. 1997; 640:158-62. 19. Murugesan R, Govindarajulu N, Bera TK. Effect of selected yogic practices on the management of hypertension. Indian J Physiol Pharmacol. 2000; 44: 207-10. 20. Barnes VA, Davis HC, Murzynowski JB, Treiber FA. Impact of meditation on resting and ambulatory blood pressure and heart rate in youth. Psychosom Med. 2004; 66: 909-14. 21. Bernardi L, Porta C, Spicuzza L. Slow breathing increases arterial baroreflex sensitivity in patients with chronic heart failure. Circulation 2002; 105: 143-5. 22. Siegelbaum R, Robinson S. Hyperpolarization activated cation current: From molecules to physiological function. Annu Rev Physiol 2003; 65: 453-80. 23. Cuttle MF, Rusznák Z, Wong AY et al. Modulation of a presynaptic hyperpolarization-activated current at an excitatory synaptic terminal in the rat auditory brainstem. J Physiol 2001; 534: 733-44. 24. Westbrook GL. In: Kandel ER, Schwartz JH, Jessell TM, eds. Principles of Neuroscience. New York: McGraw-Hill, 2000. 25. Newberg A, Iversen J. The neural basis of the complex mental task of meditation: Neurotransmitter and neurochemical considerations. Med Hypotheses 2003; 61: 282-91. 26. Lutz A, Greischar LL, Rawlings NB et al. Long-term meditators self-induce high amplitude gamma synchrony during mental practice. Proc Natl Acad Sci USA 2004; 101: 16369-73. 27. Bernardi I, Gabutti A, Porta C, Spicuzza L. Slow breathing reduces chemoreflex response to hypoxia & hypercapnia and increases baroreflex sensitivity. J Hypertens 2001;19:2221-2229. 28. Bowman AJ, Clayton RH, Murray A, Reed JW, Subhan MM, Ford GA. Effects of aerobic exercise training and yoga on the baroreflex in healthy elderly persons. 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Aim: The aim of our study is to establish the normal electrophysiological values of the common nerves in upper and lower limb and to study the influence of age and height on conduction velocity in healthy adult subjects. Material and Method: The study was conducted in MGM Medical College, a tertiary care center in city of Aurangabad, India. A total of 90 healthy volunteers, 45 males and 45 females aged 20 years and above were selected after clinical evaluation to exclude systemic or neuromuscular disorders. Anthropometric measurements were done using a standard protocol. Nerve Conduction Study was carried out according to a standardized protocol. Motor NCS included the Median, Peroneal and Tibial nerves. Sensory NCS included the Ulnar, Median, and Sural nerves. Results: The NCS data was separately analyzed for males and females. The mean along with standard deviation (SD) for latencies, amplitude and velocities of Sural sensory, Ulnar sensory and Median sensory nerves for males and females is obtained. Similarly the means with SD of the latencies, amplitudes and velocities of the Ulnar motor, Median motor, Peroneal motor and Tibial motor nerves were obtained. Also the NCS parameters at various percentiles were obtained. Linear regression models show the inverse association of Age and Height with NCS parameter in males and females. The model also gave the coefficient by which the NCS parameters change for unit change in Age (Year) or Height (Cm). Conclusion: The study will be helpful in establishing normative values of nerve conduction parameters of the commonly tested nerves in the upper and lower limb for our region. The mean nerve conduction parameters for all the nerves were similar with the existing data from different Indian studies. In general Age and Height had inverse relation with NCS parameters.

1. Bruce A. Perkins and Vera Bril. Diabetic neuropathy a review emphasizing diagnostic methods. Clinical neurophysiology. 2003;114 : 1167-75 2. BoultonAJ, Vinik AI, Arezzo JC, Bril V, Feldman EL, Freeman R, Malik RA, Maser RE, SosenkoJM, Ziegler D. Diabetic neuropathies: a statement by the American Diabetes Association. Diabetes Care. 2005; 28:956- 62. 3. Kimura J. Principles and pitfalls of nerve conduction studies. Ann Neurol 1984; 16: 415–428. 4. Mcknight J, Nicholls PG, Loretta D, Desikan K V, Lockwood DNJ, Wilder- EP, et al. Reference values for nerve function assessments among a study population in northern India - III : Sensory and motor nerve conduction.. Neurology Asia. 2010;15 (1):39–54. 5. Wang SH, Robinson LR. Considerations in reference values for nerve conduction studies. Phys Med RehabilClin N Am. 1998; 9(4):907-23i. 6. Kumar BR, Gill HS. Motor nerve conduction velocities amongst healthy subjects. J Assoc Physicians India. 1985; 33: 345–348. 7. Pawar SM, Taksande AB, Singh R. Normative data of upper limb nerve conduction in Central India. Indian journal of physiology and pharmacology[Internet].2011;55(3):241–5.Availablefrom: http://www.ncbi.nlm.nih.gov/pubmed/22471231 8. Robinson LR, Rubner DE, WohlPW, Fujimoto WY, Stolov WC. Influences of height and gender on normal nerve conduction studies. Arch Phys Med Rehabil. 1993; 74: 1134–1138. 9. Hennessey WJ, Falco FJ, BraddomRL. Median and Ulnar nerve conduction studies: Normative data for young adults. Arch Phys Med Rehabil 1994; 75(3): 259–264. 10. Stetson DS, Albers JW, Silverstein BA, Wolfe RA. Effect of age, sex, and anthropometric factors on nerve conduction measures. Muscle & Nerve. 1992; 15: 1095–1104. 11. Falco FJ, Hennessey WJ, Goldberg G, BraddomRL. Standardized nerve conduction studies in the lower limb of the healthy elderly. Am J Phys Med Rehabil 1994;73(3):168–74. 12. Saeed S, M Akram. Impact of anthropmetric measures on sural nerve conduction in healthy subjects. J Ayub Med Coll Abbottabad 2008;20(4): 112-114.

Introduction: Rabies is almost always fatal in animals or in humans those do not receive post-exposure prophylaxis (PEP). Thedog-bites are the primary source of human infection in all rabies endemic countries and account for 96 % of rabies cases in South East Asia region. The present study has been conducted at a Rural Hospital Panvel (India) situated in rapidly urbanizing are aimed to know the epidemiology of dog bites. Methodology: All the patients who reported at Anti Rabies Vaccine (ARV) clinic with complaints of dog bite during the period of three months (September - November 2012) were included in this study for data collection by exit interview method.The data was analysed using Microsoft Excel, Epiinfo and SPSS. Results and Discussion: Total 318 dog bite cases were reported to ARV clinic during the period of 3 months. Majority were males (80.2%). More than 30% patients were in the age group of 26 to 45 years while 27.8% patients were children below 15 years. More than 70 % dog bites have taken place while victims were walking on the road. More than 97% of the bites were unprovoked and by stray dogs. Out of 318 victims, 164 (51.6 %) had knowledge about benefit of immediate cleaning of the wound. Proportion of using home remedies is negligible compared with other earlier studies. More than 88 % patients reported within 24 hours. Most of the study findings are consistent with earlier studies conducted in India with some variations. Conclusion and Recommendations: It is necessary to improve knowledge level in the local population further, about the immediate cleaning of the wound by using the means of behaviour change communication methods. The civic authorities need to resort to control of stray dogs. The establishment of surveillance for dog bite cases will definitely help.

1. Knobel DL, Cleavland S, Coleman PG, Fevre EM, Meltzer MI, et al; Re-evaluating the burden of rabies in Africa and Asia; Bulletin of the World Health Organization; 2005, 83:360-368. 2. Hampson K, Cleavland S, Mganga S, Coudeville L; Partners for Rabies Prevention Technical Advisory Group (2011);Reassessment of the socio-economic global burden of rabies: Human and animal cost of global rabies; Global conference on Rabies Control Towards Sustainable Prevention at source: Incheou (Republic of Korea): 7-9 September 2011;Incheou Korea: OIE 26p. 3. Human Rabies in the WHO Southeast Asia Region: Forward Steps for Elimination; Review Article; Advances in Preventive Medicine, Volume 2011, Article ID 383870, 5 pages. 4. http://www.searo.who.int/CDS_rabies.pdf (2011) 5. World Health Organization – WHO expert Consultation on Rabies – First Report: 2004: 1 – 123. 6. World Health Organization – “Rabies vaccines: WHO Position Paper”; Weekly Epidemiological Report; 2007: Volume 82, pp. 425-436. 7. K. Park; Park’s Textbook of Preventive & Social Medicine; 22nd Edition; pp. 251 – 6. 8. Anita Khokhar, G. S. Meena, Malti Mehara; Profile of dog bite cases attending MCD (Municipal Corporation Delhi) Dispensary at Alipur, Delhi; Indian Journal of Community Medicine, Vol. XXVIII, Issue 4, Oct-Dec 2003, pp. 157-160. 9. M. K. Sudarshan, B. J. Mahindra, S. N. Madhusudana et al; An epidemiological study of animal bites in India: Results of A WHO sponsored National Multi-centric Rabies Survey (2003), Journal of Communicable Diseases, 38 (1) 2006; pp. 32-39. 10. Venu Shah, D V Bala, Jatin Thakker et al; Epidemiological determinants of animal bite cases attending the anti-rabies clinic at V.S. General Hospital Ahmedabad; Health line, Volume 3, Issue 1,Jan – June 2012, pp. 66-68. 11. Ichhpujani RL, Chhabra Mala, Mittal Veena et al; Epidemiology of Animal Bites and Rabies cases in India: A Multi-centric Study; Journal of Communicable Diseases; Volume 40 Issue 1, 2008, pp. 27 – 36. 12. Mohd Junaid, Tabrez Ahmad, Gumastha R, Deoke A R; Epidemiological study of Dog Bite Victims In Anti Rabies Clinic of A Tertiary Care Hospital; Indian Journal of Biological and Health Science; Volume 1, Issue 1, Oct 2012, pp. 12-16. 13. T. R. Behera, D. M. Satpathy, R. M. Tripathy, A. Sahu; Profile of Animal bite cases attending the ARC Clinic at Beharampur, Orissa; http://rabies.org.in/rabies-journal/rabies-09-2.

Introduction: Every pregnant woman hopes pregnancy to be a smooth process and expect to give birth safely as pregnancy and child birth is considered a normal physiological process. But, this is not happening at least in developing countries including India.In the year 2010, global maternal deaths per 100,000 live births i.e. maternal mortality ratio (MMR) was estimated to be 210. Objective: To determine perception of maternal mortality among women in an urban slum area of South India. Materials and methods: a descriptive cross-sectional study was carried out in an urban slum area of south India among 378 women above 20 yrs of age. Using semi-structured questionnaire answers to questions on perception of maternal mortality in the community were elicited from the study participants. The data was analysed using the SPSS program 14. Results: The majority (35.98%) of the study subjects were in the age group 31-40 years followed by 28.31% study subjects in the age group of 21-30. 34.14 % study subjects were educated upto intermediate and 22.22 % were educated upto secondary level. 95.50 % of the study subjects aware that death can occur from pregnancy-related problems. 73.81% subjects stated that excessive vaginal bleeding was a possible cause of death followed by high BP as possible cause of death in 21.96% study subjects. Conclusion: In order to reduce the high rate of maternal mortality, health education programs on prevention of maternal deaths and morbidities directed towards at risk women need to be improved.As most of the decisions in families were taken by the men,their participation is also very important.

1. Trends in Maternal Mortality: 1990 to 2010. Estimates developed by WHO, UNICEF, UNFPA and The World Bank, 2012. Available from: http://www.unfpa.org/webdav/site/global/shared/documents/publications/2012/Trends_in_maternal_mortality_A4-1.pdf 2. Hogan MC, Foreman KJ, Naghavi M, Ahn SY, Wang M, Makela SM, et al. Maternal mortality for 181 countries, 1980-2008: A systematic analysis of progress towards Millennium Development Goal 5. Lancet 2010;375:1609-23. 3. Health and Millennium Development Goals. World Health Organization, 2005. Available from: http://www.who.int/hdp/publications/mdg_en.pdf 4. Rai SK, Dasgupta R, Das MK, Singh S, Devi R, Arora NK. Determinants of utilization of services under MMJSSA scheme in Jharkhand 'Client Perspective': A qualitative study in a low performing state of India. Indian J Public Health 2011;55:252-9. 5. Sample Registration System (SRS). Office of Registrar General, India. Special bulletin on maternal mortality in India (2007-09), 2011. Available from: http://www.censusindia.gov.in/vital_statistics/SRS_Bulletins/Final-MMR%20Bulletin-2007-09_070711.pdf. 6. Mukhopadhyay BK. Is maternal mortality in India expecting the "revised" millennium development goal? Int J Dev Soc 2012;1:31-42. 7. Okolocha C, Chiwuzie J, Braimoh S, Unuigbe J, Olumeko P. Sociocultural factors in maternal mortality: A study of a semi-urban community in Southern Nigeria. J Epidemiol Community Health 1998;52:293-7. 8. Kawuwa MB, Mairiga AG, Usman HA. Community perspective of maternal mortality: Experience from Konduga Local Government Area, Borno State, Nigeria. Ann Afr Med 2007;6:109-14. 9. Balchandani U,Rai D.A study of awareness regarding maternal mortality rate.Indian J Preventive and Social Medicine 2007;38(4):193-196. 10. AJ, Abasiattai AM, Udoma EJ, Etuk SJ. Community perception of the causes of maternal mortality among the Annang of Nigeria's South-East coast. Trop J Obstet Gynaecol 2005;22:189-92. 11. Thaddeus S, Maine D. Too far to walk: Maternal mortality in context. Soc Sci Med 1994;38:1091-110. 12. Tayade S, i Bagde M , Shivkumar PV, Tayade A.maternal death review to know the determinants of maternal mortality in a district hospital of Central India. International Journal of Biomedical Research 2012;3(3):157-163.

Reduction of the depressed joint surface in tibial plateau fractures leaves large cancellous bone defects. These metaphyseal defects are usually filled with autogenous bone grafts that cause significant donor site morbidity. The use of injectable tricalcium phosphate gives the opportunity to support the reduced joint surface without bone grafting. Objective: The aim of this study was to evaluate the functional and radiological outcomes of closed/open reduction and internal fixation, augmentation with injectable tricalcium phosphate in tibial plateau fractures. Methods: This prospective study includes 20 patients, with mean age of 44.4 years. According to the Schatzker’s classification, there were 12 fractures of type II, one fracture of type III, five fractures of type V, and two of type VI. Intervention: All the patients underwent closed/ open reduction, osteosynthesis with screws or plate, and injection of tricalcium phosphate injection in the subchondral bone defect. The patients were reviewed at an average follow up of 15.35 months (range 6-28 months). Rasmussen’s clinical and radiological score was used to assess the patients post-operatively and during follow-up period. Results: Union was achieved in all patients. Rasmussen's radiologic score was excellent in 2 patients (10%), good in 17 patients (85%), and fair in 1 patient (5%). Rasmussen’s clinical score was excellent in 6 patients (30%), good in 13 patients (65%), and fair in 1 patient (5%). Conclusion: The results show that injectable tricalcium phosphate is a safe and useful alternative to bone grafting in tibial plateau fractures which have high compression strength and allows early partial and full weight bearing.

1. Su EP, Westrich GH, Rana AJ, Kapoor K, Helfet DL. Operative treatment of tibial plateau fractures in patients older than 55 years. Clin Orthop Relat Res. 2004; 421: 240–248. 2. Kennedy JC, Bailey WH. Experimental tibial plateau fractures. JBJS. 1968; 50A: 1522-34. 3. Schatzker J. The rationale of Operative fracture care. 3rd.ed.Springer. 2005; 19.1: 447. 4. Koval KJ, Helfet DL. Tibial plateau fractures: evaluation and treatment. J Am Acad Orthop Surg. 1995; 3: 86-94. 5. Lachiewicz PF, Funcik T. Factors influencing the results of open reduction and internal fixation of tibial plateau fractures. Clin Orthop Relat Res. 1990; 259: 210-5. 6. Segal D, Franchi AV, Campanile J. Iliac autograft for reconstruction of severely depressed fracture of a lateral tibial plateau. Brief note. JBJS Am. 1985; 67: 1270-2. 7. Silber JS, Anderson DG, Daffner SD, Brislin BT, Leland JM, Hilibrand AS, Vaccaro AR, Albert TJ. Donor site morbidity after anterior iliac crest bone harvest for single-level anterior cervical discectomy and fusion. Spine. 2003; 28: 134-9. 8. Auleda J, Bianchi A, Tibau R, Rodriguez-Cano O. Hernia through iliac crest defects. A report of four cases. Int Orthop. 1995; 19: 367-9. 9. Goulet JA, Senunas LE, DeSilva GL, Greenfield ML. Autogenous iliac crest bone graft. Complications and functional assessment. Clin Orthop Relat Res.1997; 339: 76-81. 10. Kurz LT, Garfin SR, Booth RE Jr. Harvesting autogenous iliac bone grafts. A review of complications and techniques. Spine. 1989; 14: 1324-31. 11. Arrington ED, Smith WJ, Chambers HG, Bucknell AL, Davino NA. Complications of iliac crest bone graft harvesting. Clin Orthop Relat Res. 1996; 329: 300-9. 12. Summers BN, Eisenstein SM. Donor site pain from the ilium. A complication of lumbar spine fusion. J Bone Joint Surg Br. 1989; 71: 677-80. 13. Younger EM, Chapman MW. Morbidity at bone graft donor sites. J Orthop Trauma. 1989; 3: 192-195. 14. B.N. Summers, S.M. Eisenstein. Donor site pain from the ilium: a complication of lumbar spine fusion. JBJS Br. 1989; 71-B: 677–680. 15. H.S. Sandhu, H.S. Grewal, H. Parvataneni. Bone grafting for spinal fusion. Orthop Clin North Am. 1999; 30: 685–698. 16. Stephen W. Veitch, Rowenna M. Stroud, Andrew D. Toms. Compaction bone grafting in Tibial Plateau Fracture Fixation. The Journal of Trauma, Injury, Infection and critical care. 2010; 68(4): 980-983. 17. C.A.F. Dodd, C.M. Fergusson, L. Freedman et al. Allograft versus autograft bone in scoliosis surgery. JBJS Br. 1988; 70: 431–434. 18. W.W. Tomford. Transmission of disease through transplantation of musculo-skeletal allografts. JBJS Am. 1995; 77: 1742–54. 19. John Gray Seiler III, MD, Joseph Johnson, MD. Georgia Hand and Microsurgery Clinic, Atlanta, Ga. "Iliac Crest Autogenous Bone Grafting: Donor Site Complications". J South Orthop Assoc. 2000; 9 (2): 91–97. 20. Abidi NA, Dhawan S, Gruen GS, Vogt MT, Conti SF. Wound-healing risk factors after open reduction and internal fixation of calcaneal fractures. Foot Ankle Int. 1998; 19: 856-61. 21. Stevenson S. Biology of bone grafts. Orthop Clin North Am. 1999; 30: 543-52. 22. E.U. Conrad, D.R. Gretch, K.R. Obermeyer et al. Transmission of the hepatitis-C virus by tissue transplantation. JBJS Am. 1995; 77-A: 214–224. 23. Boyce T, Edwards J, Scarborough N. Allograft bone. The influence of processing on safety and performance. Orthop Clin North Am. 1999; 30: 571-81. 24. Ladd AL, Pliam NB. Use of bone-graft substitutes in distal radius fractures. J Am Acad Orthop Surg. 1999; 7: 279-90. 25. Moore WR, Graves SE, Bain GI. Synthetic bone graft substitutes. ANZ J Surg. 2001; 71: 354-61. 26. Kemal Serbetc, Feza Korkusuz, Nesrin Hasirci. Mechanical and Thermal Properties of Hydroxyapatite-Impregnated Bone Cement. Turk J Med Sci; 2000 (30): 543-549. 27. Peter V Giannoudis, Haralambos Dinopoulos, Eleftherios Tsiridis. Bone substitutes: An update. Injury; 2005 (36-3): S20–S27. 28. Larsson S, Bauer TW. Use of injectable calcium phosphate cement for fracture fixation: a review. Clin Orthop Relat Res. 2002; 395: 23-32. 29. Nandi S.K, Roy S, Mukherjee P. Orthopaedic applications of bone graft and graft substitutes: a review. Indian J Med Res. 2010; 132: 15-30. 30. Robert D. Welch, DVM, PhD; Hong Zhang, MD; Dwight G. Bronson, MS. Experimental Tibial plateau fractures augmented with calcium phosphate cement or autologous bone graft. JBJS Am 2003; 85(2): 222-231. 31. Welch RD, Zhang H, Bronson DG. Experimental tibial plateau fractures augmented with calcium phosphate cement or autologous bone graft. JBJS. 2003; 85: 222-31. 32. Thomas A. Russell, Ross K. Leighton. Comparison of autogenous bone graft and endothermic calcium phosphate cement for defect augmentation in Tibial plateau fractures. JBJS 2008; 90: 2057-61. 33. Ahmad M. Ali, M. El- Shafie, K.M. Willett. Failure of fixation of tibial plateau fractures. J of Orthopaedic Trauma 2002; 16(5):323-329. 34. Hitin Mathur, Shankar Acharya, VK Nijhawan, SP Mandal. Operative results of closed tibial plateau fractures. Indian journal of Orthopaedics. 2005; 39(2): 108-112. 35. B Grimm, A W Miles. Optimizing a hydroxyapatite/ tricalcium phosphate ceramic as a bone graft extender for impaction grafting. J Material Science. 2001; 12: 929-34. 36. W.G. Hortsmann, C.C.P.M.Verheyen, R.Leemans. An injectable calcium phosphate cement as a bone-graft substitute in the treatment of displaced lateral tibial plateau fractures. Injury, Int.J.Care Injured 2003; 34:141-144. 37. Lobenhoffer P, Gerich T, Witte F, Tscherne H. Use of injectable calcium phosphate bone cement in the treatment of tibial plateau fracture: a prospective study of twenty-six cases with twenty- month follow-up. J Orthop Trauma 2002; 16:143-149. 38. Hatziantoniou J, Diakos G, Kyriakidis M. The use of injectable calcium phosphate bone cement in tibial plateau fractures for structural support. Journal of Hellenic Association of orthopaedic and traumatology 2004; 55(3):433-438. 39. Richard L. Uhl, MD; Jonathon Gainor, MD; Joel Horning, MD. Treatment of bicondylar tibial plateau fractures with lateral locking plates. Orthopedics. 2008; 31(5). 40. Strokel EA. Tibial plateau fractures-standardized evaluation of operative results. Orthopaedics. 1991; 14(3): 263-70. 41. Stokel EA, Sadasivan KK. Tibial plateau fractures: standardized evaluation of operative results. Orthopedics. 1991; 14: 263-270. 42. Touliatos AS, Xenakis T, Soucacos PH, Soucacos PN. Surgical management of tibial plateau fractures. Acta Orthop Scand Suppl. 1997; 275: 92-96. 43. Landry S, Trenholm A, Deluzio K, McLaughlin K, Leighton R. A cadaver model of a tibial plateau fracture reveals increased compressive strength of bone substituting material over autograft. Trans Orthop Res Soc. 2001; 26: Poster no. 983. 44. Trenholm A, Landry S, McLaughlin K, Deluzio KJ, Leighton J, Trask K, Leighton RK. Comparative fixation of tibial plateau fractures using alpha-BSM, a calcium phosphate cement, versus cancellous bone graft. J Orthop Trauma. 2005; 19: 698-702. 45. Poul S. Rasmussen, Gothenburg. Tibial condylar fractures: Impairment of the knee stability and indication for surgical management .J Bone and Joint Surgery 1973; 55A:1331-1350. 46. Bajammal SS, Zlowodzki M, Lelwica A, Tornetta P 3rd, Einhorn TA, Buckley R, Leighton R, Russell TA, Larsson S, Bhandari M. The use of calcium phosphate bone cement in fracture treatment. A meta-analysis of randomized trials. J Bone Joint Surg Am. 2008; 90(6): 1186-96.

Introduction: Pulmonary Function Tests are used to measure base¬line status of respiratory function, to monitor treatment and to estimate prognosis. The present study was aimed to determine pulmonary function tests values and to compare the different parameters like FVC, FEV1, ERV, FEF25-75%, PEFR in children and young adults. Materials and Methods: A cross sectional study was conducted to determine the pulmonary function tests in selected children and young adults, belonging to rural area of Guntur district. Fifty male subjects were considered for the study and divided them into two groups basing on the age. Pulmonary function tests were done with the help of Computerized Spirometer. Different parameters like FVC, FEV1, ERV, FEF25-75% and PEFR were recorded. Results and Discussion: Increase of FVC of 153.49%, FEV1 of 133.33%, FEF25-75% of 80.54%, ERV of 84.78% and PEFR of 94.35% was observed in young adults, when compared to children. Statistical significance was obtained by using t test (P<0.001). Among the parameters studied, FVC and FEV1 showed a greater increase in young adults than the remaining parameters, when compared with children. Conclusion: In the current study, pulmonary function test values of children and young adults, a marked increase was observed in all the five parameters, from childhood to adulthood as per the body needs of oxygen. It is important to understand the improvement of pulmonary function test values with age among young adults, in interpretation of pulmonary function variations in different physiological and pathological settings.

1. Raju SVVG, Babu KM, Chaitanya G. A Comparative Study of Pulmonary Function Tests in Children and Adolescents, in a Rural Area of Guntur District, Andhra Pradesh, India. Intl J Recent Trends in Sci. and Tech. 2013; 8(1): 1-3. 2. Jain SK, Ramaiah T J. Lung volumes and mechanics of breathing in healthy 7-14 years old. Indian J Chest Dis 1968; 10: 63-68. 3. Harikumaran NR, Kesavachandran C, Sanil R, Srikumar R, Shashidhar S. Prediction equation for lung functions in south Indian children. Indian J Physiol Pharmacol 1997; 41: 390-396. 4. Bhattacharya AK, Banerjee S. Vital capacity in children and young adults of India. Indian J Med Res 1966; 54: 62-71. 5. Sharma PP, Gupta P, Renu D, Gupta P. Lung function values in healthy children (10-15 years). Indian J Pediatr 1997; 64: 85-91. 6. Mallik SK, Jindal SK. Pulmonary function tests in healthy children. Indian Pediatr 1985; 22: 677-681. 7. Chowgule RV, Shetye VM, Parmar JR. Lung function tests in normal Indian children. Indian Pediatr 1995; 32: 185-191. 8. Piccini, Nilsson. The Osler Medical Handbook. 2nd ed. Johns Hopkins University; 2006. Chapter 80, Pulmonary Function Tests; p 858-864. 9. Goldman, Goldman's Cecil Medicine. 24th ed. Saunders; 2011. Chapter 85, Respiratory structure and function; p e14-20. 10. Walsh. Palliative Medicine, 1st ed. Saunders, 2008. Chapter 73, Pulmonary Function; p 385-390. 11. American Thoracic Society. Lung function testing: Selection of reference values and interpretative strategies. Am Rev Respir Dis 1991;144:1202-1218. 12. Guidelines for the measurement of respiratory function. Recommendations of the British Thoracic Society and the Association of Respiratory Technicians and Physiologists. Respir Med 1994;88:165-194. 13. Johns H. The Harriet Lane Handbook, 19th ed. Mosby, 2011. Chapter 24, Pulmonology; p 584-605. 14. Pal GK, Pal P. Text book of Practical Physiology, 1st ed. Orient Longman, 2001. Chapter 26, Pulmonary Function Tests; p 178-190. 15. Agarwal AN. Measurement of interpretation of peak expiratory flow. Ind J Physio Pharma 1998; 42:567-8. 16. Pande IN, Mohan A, Khilnani S, Khilnani GC. Peak expiratory flow rate in school-going children. Indian J Chest Dis Allied Sci 1997; 39: 87-95. 17. Schoenberg JB, Beck GJ, Bouhuys A. Growth and decay of pulmonary function in healthy blacks and whites. Respir Physiol. 1978 Jun; 33(3):367–393. 18. Susan R, et al, The Relationship between Longitudinal Change in Pulmonary function and Nonspecific Airway Responsiveness in Children and Young Adults. Am Rev of Respi Dis. 1989; 140: 179-84. 19. Xiaobin W, et al, Determinants of Maximally Attained Level of Pulmonary Function. Am J Respi Crit Care Med. 2004; 169(8): 941-49. 20. Janet BS , Gerald JB, Arend B. Growth and decay of pulmonary function in healthy blacks and whites. Respiration Physiology. 1978; 33(3): 367–93. 21. Katharine HK, et al, Ventilatory functions of normal children and young adults - Mexican-American, white, and black. J Ped. 1979; 95(1): 14–23.

A retrospective study of twin pregnancies was done for a period of 6 months from 1st July 2001 to 31st December 2001 at labor and delivery ward admissions at Government Medical College, Nanded. Total 185 cases analyzed for obstetric and neonatal complications studied.Anemia was found universal. Prematurity was common. Dreaded complications like undelivered second twin was also encountered.Low birth weight and prematurity were less common in unregistered pregnant women.

1. Managing multiple pregnancy and birth.Issac Blickstein. Progress in Obstetrics and Gynecology Edited by John Studd. Vol .18. 2. Study of maternal and fetal outcome in twin gestation at tertiary care teaching hospital. Bangal et al – International journal of biomedical and advance research. Vol 3 No.10 .2012 3. Chowdhury S., Hussain M. A., Maternal complications in twin pregnancies. Mymensingh Med Journal.2011 : 20 (1),83-87 4. European society of Human reproduction and embryology ESHRE Capri workshop group. Multiple gestation pregnancy. Human Reproduction 2000,15: 1856-64. 5. Twin versus singleton pregnancies: the incidence, pregnancy complications and Obstetric outcomes in a Nigerian tertiary hospital .Obiechina NJ et al .International journal of Women’s health. July 2011.Vol.2011:3.Pages 227-230.

During the month of Ramadan, Muslims refrain from drinking and eating between sunrise and sunset. This study is aimed to understand the effect of this long intermittent fasting schedule during Ramadan on body composition, and cardiovascular system in healthy young adults. Fifty healthy adults were included and were all tested before and on the 28th day of the Ramadan fast. The parameters studied were body composition, blood pressure and heart rate before and towards the end of the fasting. Significant changes were observed in the form of decreased body weight, Body Mass Index, Waist to Hip Ratio, body fat percentage, blood pressure and heart rate. Dominance of the sympathetic nervous system over the parasympathetic nervous system has been shown to be a strong risk factor for cardiovascular disease. Weight loss has a positive effect on this balance and is associated with significant improvement in autonomic cardiac modulation through enhancement of parasympathetic effect. This increase in vagal tone has shown its effects on the blood pressure and heart rate in this study. At the cellular level fasting reduces the levels of oxidative stress at the same time it acts as repeated mild stress that induces expression of genes that enhance the ability of cells to cope with more severe stress. The effect of fasting on cardiovascular function should be further explored to recognize fasting as a potential non-pharmacological intervention for improving cardiovascular health.

1. Trepanowski JF, Bloomer RJ. The impact of religious fasting on human health. Nutrition Journal, 9: 57:1-9,2010. 2. Michalsen A, Hoffmann B et al. Incorporation of fasting therapy in an integrative medicine ward: evaluation of outcome, safety, and effects on lifestyle adherence in a large prospective cohort study. J Altern Complement Med. Aug;11(4):601-7,2005. 3. Fakhrzadeh H, Larijani Bet al: Effect of Ramadan fasting on clinical and biochemical parameters in healthy adults. Ann Saudi Med, 23:223-226,2003. 4. Al-Hourani HM, Atoum MF: Body composition, nutrient intake and physical activity patterns in young women during Ramadan. Singapore Med J, 48:906-910,2007. 5. Amir-Hossein M; Ramin Ket al. Effect of Ramadan Fasting on Body Composition and Physical Performance in Female Athletes.Asian Journal of Sports Medicine.; Vol 2, No 3:161-166,Sep 2011. 6. Awad H Rashed.The fast of Ramadan.BMJ Vol 304;521-522,1992. 7. Fakhrzadeh H, Larijani Bet al. Effect of Ramadan fasting on clinical and biochemical parameters in healthy adults. Ann Saudi Med 23: 223-226,2003. 8. Hallak MH, Nomani MZ: Body weight loss and changes in blood lipid levels in normal men on hypocaloric diets during Ramadan fasting. Am J Clin Nutr, 48:1197-1210,1988. 9. Krista A Varady and Marc K Hellerstein..Alternate-day fasting and chronic disease prevention: a review of human and animal trials. Am J Clin Nutr;86:7–13,2007. 10. Leonie K Heilbronn, Steven R Smithet al. Alternate-day fasting in nonobese subjects: effects on body weight, body composition, and energy metabolism. Am J Clin Nutr;81:69 –73,2005. 11. Mustafa K. Y, Mahmoud N. A:The effects of fasting in Ramadan.2. Fluid and electrolyte balance.Br. J. Nutr., 40: 583-589,1978. 12. Perk G, Ghanem Jet al: The effect of the fast of Ramadan on ambulatory blood pressure in treated hypertensives. 13. Salehi M, Neghab M: Effects of fasting on a medium calorie balanced diet during the holy month of Ramadan on weight, BMI and some blood parameters of overweight males. Pak J Biol Sci, 10(6):968-971,2007. 14. Toda M, Morimoto K. Effects of Ramadan fasting on the health of Muslims.Nihon Eiseigaku Zasshi. Jan;54(4):592-6,2000. 15. Faintuch J, Soriano FG et al. Changes in body fluid and energy compartments during prolonged hunger strike. Nutrition Feb;17(2):100-4,2001. 16. Varady KA. Intermittent versus daily calorie restriction: which diet regimen is more effective for weight loss?Obes Rev.;12(7),Jul 2011. 17. Varady KA, Allister CA et al. Improvements in body fat distribution and circulating adiponect in by alternate-day fasting versus calorie restriction. J Nutr Biochem.;21(3):188-95, Mar2010. 18. Varady KA, Hellerstein MK. Do calorie restriction or alternate-day fasting regimens modulate adipose tissue physiology in a way that reduces chronic disease risk? Nutr Rev.;66(6):333-42,Jun2008. 19. Varady KA, Hudak CS et al. Modified alternate-day fasting and cardioprotection: relation to adipose tissue dynamics and dietary fat intake. Metabolism.;58(6):803-11,Jun2009. 20. Gavrankapetanović F. Medical aspects of fasting Med Arh.;51(1-2):25-7,1997. 21. Al-Hourani HM, Atoum MF: Body composition, nutrient intake and physical activity patterns in young women during Ramadan. Singapore Med J, 48:906-910,2007. 22. Dewanti L, Watanabe C et al: Unexpected changes in blood pressure and hematological parameters among fasting and nonfasting workers during Ramadan in Indonesia. Eur J Clin Nutr,60:877-881,2006. 23. Varady KA, Bhutani S et al. Short-term modified alternate-day fasting: a novel dietary strategy for weight loss and cardioprotection in obese adults.Am J Clin Nutr;90: 1138–43,2009. 24. Pietrobelli A, Rothacker D:Electrocardiographic QTC interval: short-term weight loss effects.Int J Obes Relat Metab Disord.; 21(2):110-4,1997 Feb. 25. Saleh SA, El-Kemery TA et al:Ramadan fasting: relation to atherogenic risk among obese Muslims.Egypt Public Health Assoc.;79(5-6):461-83,2004. 26. Nizal Sarraf-Zadegan, Mahmood Atashi, Gholam A. ,Naderi,.BaghaiAM et al. The effect of fasting in Ramadan on the values and interrelations between biochemical, coagulation and hematological factors.Ann Saudi Med;20(5-6):377-381,2000. 27. Mager DE., Wan R, Brown M et al. Caloric restriction and intermittent fasting alter spectral measures of heart rate and blood pressure variability in rats. The FASEB Journal; Vol. 20:631-637, April 2006. 28. Guy E. Alvarez, Brenda M. Davy et al.Weight loss increases cardiovagal baroreflex function in obese young and older men. Am J Physiol Endocrinol Metab 289:E665-E669,2005. 29. M. Al-Kubati, B. Fišer, P. Homolka,:Ramadan Fasting And The Circadian Rhythm Of Blood Pressure, Heart Rate And Robinson Index Physiol. Res. 3PVol. 56,2007.. 30. Ismayil A, Ruiqian W, et al. Cardioprotection by Intermittent Fasting in Rats. Circulation, 112:3115-3121,2005. 31. Poirier P, Hernandez TL et al. Impact of Diet-Induced Weight Loss on the Cardiac Autonomic Nervous System in Severe Obesity Obesity Research Vol. 11 No. 9;1040-47, September 2003. 32. Lilian de J, Moreira E.A.M, et al: Impact of 6-month Caloric Restriction on Autonomic Nervous System Activity in Healthy, Overweight, Individuals. Obesity 18, 414–416,2010. 33. Garruti G, De Pergola G et al.34-day total fast in an adult man. Int J Obes Relat Metab Disord;19(1):46-9,1995 Jan. 34. Mattson MP, Wan R:Beneficial effects of intermittent fasting and caloric restriction on the cardiovascular and cerebrovascular systems. J. Nutr Biochem.;16(3):129-37,2005 Mar. 35. Castello L, Froio T, Maina M et al: Alternate-day fasting protects the rat heart against age-induced inflammation and fibrosis by inhibiting oxidative damage and NF-kB activation. Free Radic Biol Med. 1;48(1):47-54,2010 Jan. 36. Chandrasekar B, Nelson JF et al .Calorie restriction attenuates inflammatory responses to myocardial ischemia-reperfusion injury. Am J Physiol Heart Circ Physiol.; 280(5):H2094-102,2001 May. 37. Goodrick CL, Ingram DK et al. Effects of intermittent feeding upon body weight and lifespan in inbred mice: interaction of genotype and age. Mech Ageing Dev.;55(1):69-87, 1990 Jul. 38. Johnson JB, Laub DR et al. The effect on health of alternate day calorie restriction: eating less and more than needed on alternate day calorie restriction: eating less and more than needed on alternate days prolongs life. Med Hypotheses.;67(2):209-11,2006.

Objective: Many sociodemographic factors are responsible for anemia in pregnancy such as age, parity, spacing, percapita income, number of ANC visits, educational status, dietary habits, occupation, type of family. We studied socio-demographic factors affecting anemia in pregnancy. Design: a cross sectional study. Setting: tertiary-care referral hospital. Participants: All the pregnant patients admitted in the hospital whose hemoglobin less than 10gm% were included in the anemic group and whose hemoglobin above 10 gm% were included in non anemic group. Intervention: detailed history which included various sociodemographic factors was taken; their association with anemia in pregnancy was studied. Outcome Measures: factors such as age, parity, spacing, percapita income, number of ANC visits, educational status, dietary habits, occupation, type of family and association with anemia in pregnancy. Results: 144 patients with hemoglobin <10gm% were included in the anemic group. 122 patients with hemoglobin more than or equal to 10gm% were taken as non anemic group. In Anemic group 90.97% of the patients were from lower socioeconomic class 3 and class 4. Only 09 (06.25%) patients from anemic group had more than 4 antenatal checkups, whereas in non anemic group 118(96.72%) cases out of 122 had more than 4 antenatal checkups. Conclusions: we found that anemia in pregnancy was more common in multiparous women, less birth spacing, lower income, number of ANC visits <4, low educational status, poor calorie intake and with vegetarian diet, but some factors like age, occupation and type of family had no correlation with anemia in pregnancy.

1. Kelly, H.A., Cyclopedia of American Medical Biography. Annals of Surgery, 1912. 56(3): p. 519. 2. Singh, K., Y. Fong, and S. Arulkumaran, Anaemia in pregnancy—a cross-sectional study in Singapore. European journal of clinical nutrition, 1998. 52(1): p. 65. 3. Agarwal, T., G. Kochar, and S. Goel, Impact of iron supplementation on anemia during pregnancy. Age, 2008. 4500(7000): p. 10. 4. Baker, S. Nutritional anaemia—a major controllable public health problem. Bulletin of the World Health Organization, 1978. 56(5): p. 659. 5. Brabin, B.J., M. Hakimi, and D. Pelletier, An analysis of anemia and pregnancy-related maternal mortality. The Journal of nutrition, 2001. 131(2): p. 604S-615S. 6. Hytten, F. and A. Thomson, Maternal physiological adjustments. Maternal Nutrition and the Course of Pregnancy, 1970: p. 41-73. 7. Singh, K., Y. Fong, and S. Arulkumaran, Anaemia in pregnancy--a cross-sectional study in Singapore. European journal of clinical nutrition, 1998. 52(1): p. 65. 8. Raghuram V, M.A., Jayaram S, Prevalence of anemia amongst women in the reproductive age group in a rural area in south india. Int J Biol Med 2012. 3(2): p. 1482-1484. 9. Javed, M.T., et al., A study on iron deficiency anemia and hematological differences around delivery in women of different socio-economic and age groups. Medical Journal of Islamic Academy of Sciences, 2001. 14(4): p. 151-160. 10. Gautam, V.P., et al., Prevelance of Amaemia Amongst Pregnant Women and its Socio-Demographic Associates in a Rural Area of Delhi. Indian J Community Med, 2002. 27(4): p. 10-2002. 11. Lokare, P., et al., A study of prevalence of anemia and sociodemographic factors associated with anemia among pregnant women in Aurangabad city, India. Annals of Nigerian Medicine, 2012. 6(1): p. 30. 12. Viveki, R., et al., Prevalence of Anaemia and Its Epidemiological Determinants in Pregnant Women. Al Ameen Journal of Medical Sciences, 2012. 5. 13. Madhavi L.H., H.K.G.S., Nutritional status of rural pregnant women. People journal of scientific Research, 2011. 4(2): p. 716-724. 14. Agarwal, T., G. Kochar, and S. Goel, Impact of iron supplementation on anemia during pregnancy. Age, 2008. 4500(7000): p. 10. 15. Pallavi R, S., Purushottam A, Giri,Rahul R Shidhaye, Prevalence of anemia in the postnatal women at tertiary care teaching hospital in mumbai. J of medical nutrition and Nutraceuticals, 2012. 1(1): p. 140-142. 16. Thangaleela, T. and P. Vijayalakshmi, Impact of anaemia in pregnancy. Indian journal of nutrition and dietetics, 1994. 31: p. 9251-6. 17. Jin L, C.M., prevalence of anemia in pregnant women in south east china. J Public Health Nutr 2010. 13(3): p. 1511-1518.

Aim: To find out the Correlation of Diabetic retinopathy with serum lipids in Type 2 diabetic subjects. Settings and Design: Cross sectional nonrandomized study. Materials and Methods: 311 patients with more than 5 years of Type 2 diabetes were assessed for presence and severity of retinopathy and were co related with age, sex, duration of DM and serum lipids. Diabetic Retinopathy was diagnosed by fundus examination and classified according to the Early Treatment Diabetic Retinopathy Study (ETDRS) grading system. Results: Overall 76.5% (238) had DR and 23.5% (73) had no Diabetic Retinopathy. The mean serum cholesterol (P<0.05), serum triglycerides (P <0.05) and non-high-density lipoprotein (HDL)-cholesterol (P <0.05) concentrations were higher in subjects with Diabetic Retinopathy compared with those without Diabetic Retinopathy. Significant association of triglycerides (P< 0.05) and LDL-cholesterol with clinically significant macular edema (CSME) (P< 0.05). Conclusion: Significant association is found of dyslipidaemia with Diabetic Retinopathy and CSME.

1. Ramchandran A, Jali MV, Mohan V, Snehlata C, Vishvanathan M. Higher prevalence of diabetes in an urban population in south India BMJ 297, 587- 90, 1988. 2. Mohan V, Ramchandran A, Snehlata C, Mohan R, Bharni G, Vishvanathan M. High prevalence of maturity onset diabetes of young(MODY) among Indians Diabetes care 8, 371-4, 1985. 3. Mohan V, Sharp PS, Aber V, Mather HM, Kohner E M. Family histories of Asian Indianad European NIDDM patients Pract Diabetes(U.K.)3, 254- 6, 1986. 4. Vishvanathan M. Mohan V, Snehlata C, Ramchandran A High prevalence of Type 2 diabetes (NIDDM) among offspring of conjugal type 2 diabetic patients in south India. Diabetologica 28, 907-10, 1985. 5. Porta M, Bandello F. Diabetic retinopathy—a clinical update. Diabetologia, 45: 1617–1634, 2002. 6. Aiello LP, Cahill MT, Wong JS. Systemic considerations in the management of diabetic retinopathy. Am J Ophthalmol., 132:760–776, 2001. 7. Ferris FL 111, Patz A: Macular edema: a complication of diabetic retinopathy. Surv Ophthalmol 28:452-461,1984. 8. Marshall, S.M., & Flyvbjerg, A. Prevention & early detection of vascular complications of diabetes BMJ 333, 475- 480, 2006. 9. Dornan TL, Carter RD, Bron AJ, Turner RC, Mann JI. Low densitylipoprotein cholesterol: an association with the severity of diabeticretinopathy. Diabetologia., 22: 167–170, 1982. 10. Klein BE, Klein R, Moss SE. Is serum cholesterol associated with progression of diabetic retinopathy or macular edema in persons with younger-onset diabetes of long duration? Am J Ophthalmol; 128: 652–654, 1999. 11. Ferris FL 3rd, Chew EY, Hoogwerf BJ. Serum lipids and diabetic retinopathy. Diabetes Care; 19: 1291–1293, 1996. 12. Chew EY, Klein ML, Ferris FL 3rd, Remaley NA, Murphy RP, Chantry K et al. Association of elevated serum lipid levels with retinal hard exudate in diabetic retinopathy. Early Treatment Diabetic Retinopathy Study (ETDRS) Report 22. Arch Ophthalmol; 114: 1079–1084, 1996. 13. Rema M, Mohan V, Susheela L, Ramachandran A, Viswanathan M. Increased LDL cholesterol in non insulin dependent diabetes with maculopathy. Acta Diabetologica Latina; 21: 85–89, 1984. 14. el Haddad OA, Saad MK. Prevalence and risk factors for diabetic retinopathy among Omani diabetics. Br J Ophthalmol; 82:901–906, 1998. 15. Mouton DP, Gill AJ. Prevalence of diabetic retinopathy and evaluation of risk factors. A review of 1005 diabetic clinic patients. S Afr Med J.; 74: 399–402, 1998. 16. Marshall G, Garg SK, Jackson WE, Holmes DL, Chase HP. Factor influencing the onset and progression of diabetic retinopathy in subjects with insulin dependent diabetes mellitus. Ophthalmolog; 100: 1133–1139, 1993. 17. Sinav S, Onelge MA, Onelge S, Sinav B. Plasma lipids and lipoproteins in retinopathy of type I (insulin-dependent) diabetic patients. Ann Ophthalmol; 25: 64–66, 1993. 18. Kordonouri O, Danne T, Hopfenmuller W, Enders I, Hovener G, Weber B. Lipid profiles and blood pressure: are they risk factors for the development of early background retinopathy and incipient nephropathy in children with insulin-dependent diabetes mellitus? Acta Paediatr; 85: 43–48, 1996. 19. Weber B, Burger W, Hartmann R, Hovener G, Malchus R, Oberdisse U. Risk factors for the development of retinopathy in children and adolescents with Type 1 (insulin dependent) diabetes mellitus. Diabetologia; 29: 23–29, 1986. 20. Sjolie AK, Stephenson J, Aldington S, Kohner E, Janka H, Stevens L et al. Retinopathy and vision loss in insulin dependent diabetes in Europe. The EURODIAB IDDM complication Study. Ophthalmology; 104:252–260, 1997. 21. Larsson LI, Alm A, Lithner F, Dahlen G, Bergstrom R. The association of hyperlipidemia with retinopathy in diabetic patients aged 15–50 years in the county of Umea. Acta Ophthalmol Scand; 77: 585–591, 1999.

Abstract: Orbital cysticercosis is a less common presentation of cysticercal infestation. Diagnosis is primarily by CT and MRI investigations. High resolution ultrasound is rarely used in the diagnosis. Patients can be managed conservatively with antihelminths and steroids. We present the case of a 10 years old girl presenting with proptosis of left eye and was diagnosed as extraocular orbital cysticercosis involving the inferior rectus muscle on high-resolution ultrasound and managed conservatively with antihelminths.

1. Despommier DD. Tapeworm infection: the long and the short of it. N Engl J Med 1992; 327:727–728. 2. Abdelwahab IF, Klein MJ, Hermann G, Abdul-Quader M. Solitary cysticercosis of the biceps brachii in a vegetarian: a rare and unusual pseudotumor. Skeletal Radiol 2003; 32:424–428. 3. Botero D, Tanowitz HB, Weiss LM, Wittner M. Taeniasis and cysticercosis. Infect Dis Clin North Am 1993;7:683–697. 4. Nijjar I, Singh JP, Arora V, Abrol R, Sandhu PS, Chopra R, Roopa. MRI in intraocular cysticercosis - A case report. Indian J Radiol Imaging 2005;15:309-10. 5. Dubey RB, Tara NP, Sisodiya KN. Computerised tomographic evaluation of orbital lesions: Pictorial essay. Indian J Radiol Imaging 2003;13:261-70.

Background: Man has always wondered about the significance of the peculiar arrangement of ridges on the volar aspect of palm and sole. The knowledge of dermatoglyphics is thousands of years old as evident from the stone carvings found at the edge of Kejimkoojik Lake in Nova Scotia and the walls of Neolithic burial passages found on the island of Brittany. The ancient Indian literature also describes various patterns as Chakra, Shankh and Padma. With the emergence of civilization, this interest was replaced by methodological and scientific study of these patterns.As dermatoglyphic features are strongly affected by genetic and environmental factors, the idea of using it as supportive evidence in the diagnosis of hereditary disorders becomes a reality. Objective: Present study intends to evaluate the relationship between dermatoglyphic features and non-insulin dependent diabetes mellitus. Material and method: Dermatoglyphic prints of one hundred non-insulin dependent diabetes mellitus patients ( 50 male and 50 females) were taken for studyand compared with equal number of prints of healthy controls (50 males and 50 females). In this study fingertip patterns, Atd angle, a-b ridge count and C line type parameters were studied. Result: In diabeticpatientsfrequency of whorls is significantly increased;while frequency of ulnar loops is significantly decreased in cases as compared to controls. Arches and radial loops showed no significant changes.Atd angle showed no significant difference. A-b ridge count is significantly decreased in diabetics. C line type also showed significant difference in cases and controls.

1. Cummins H.Epidermal ridge configurations in developmental defects, with peculiar reference to the ontogenetic factors which condition ridge direction. Am. J. Anat.1926; 38: 89-115. 2. Grew.Grews presentation to the Royal Society in 1684. 3. Bidloo Gouard."Anatomy Humani Carporis", Amsterdam 1685. 4. Galton F.Fingerprint directories, London Macmillan. 5. Cummins H. Dermatoglyphic stigmata in mongolism idiocy, Anatomical records.1936; 64:11. 6. Sant S.M.,Vare A.M., Fakhruddin S.Dermatoglyphics in diabetic mellitius. J. Anat. Soc. India.1983;35(1): 29-32. 7. Barta L, Regoly-Merei A. Kammerer. Dermatoglyphic features in diabetes mellitus. Actapediatrica academica Scientiarum Hungaricae. 1978; 19(1):31-4. 8. Bets LV, Dzhanibekord IV, Lebedev NB, and Kureha TZ. Constitutional and dermatoglyphic characteristics of children with diabetes mellitus. Probl Endokrinol (mosk).1994 Jan-Feb; 40 (1):6-9. 9. Ziegler AG, Mathies R, Ziegel Mayer G, Baumgarh HJ, Rodewald A, Chopra V, Standl E. Dermatoglyphics in type 1 diabetes mellitus. Diabet med. 1993 Oct; 10 (8):720-4. 10. Platilova H,Pobisova Z, Zamarazil V, Vondra K, Dvorakova L.Dermatoglyphics – an attempt to predict diabetes. Venitr Lek.1996 Nov; 42(11):757-60.

Abstract: Objectives: To study thyroid hormone status of normal pregnant women in each trimester and compare it with non-pregnant women. Materials and Methods: This was a longitudinal type of study. Serum levels of T3, T4 and TSH were estimated by ELISA technique in normal pregnant women (n=60) in each trimester and compared with age matched control (n=60). Results: We found significant increase in T3 and T4 level in 1st trimester (P<0.01) when compared to control group. In 2nd trimester values increased further (P<0.01) and in 3rd trimester increase was statistically highly significant (P<0.001). We observed decreased TSH level in 1st trimester (P<0.01) when compared to control group. In 2nd trimester values increased further but difference was not statistically significant (P>0.05). In 3rd trimester there was statistically significant rise in values when compared to control group. Conclusion: Interpretation of thyroid function test in pregnancy needs care and separate reference intervals should be used.

1. Park K. Preventive medicine in Obstetrics, Paediatrics and Geriatrics. Park's Textbook of preventive and social medicine. Eighteenth Ed. Jabalpur. 2. Buster JE, Carson SA. Endocrinology and Diagnosis of Pregnancy.In: Gabbe S.G., Nieflt J.R., Simpson J.E. Obstetrics : Normal and Problem Pregnancies. Fourth Ed. United States of America: Elseiver ; 2002.p.3 3. Burrow GN, Fisher DA, Larsen PR. Maternal and fetal thyroid function. The New England Journal of medicine1994;331(16):1072-8. 4. Zoeller RT. Transplacental thyroxin and fetal brain development. J Clin Invest 2003;111(7):954-7. 5. Glinoer D. The regulation of thyroid function in pregnancy: Pathways of endocrine adaptation from physiology to pathology. Endocrine Reviews.1997;18(3):404-33. 6. Krassas G.E ,Poppe K and Glimoer D.Thyroid function and Human Reproductive Health .Endocrine Review,October 2010,31 (5): 702-753 7. Kurioka H, Takahashi K, Miyazaki K. Maternal thyroid function during pregnancy and puerperal period. Endocrine Journal 2005;52(5):587-91. 8. Kumar A, Gupta N, Nath T, Sharma JB, Sharma S. thyroid function tests in pregnancy .Indian J Med Sci .2003;57(6):252-58. 9. Glinoer D, Nayer PD, Bourdoux P, Lemone M, Robyn C, Steirteghem A V et al. Regulation of maternal thyroid during pregnancy. J Clin Endocrinol Metab 1990;71(2):276-87. 10. Lazarus J H,Thyroid function in Pregnancy.British Medical Bulletin 2010;97(1):137-148 11. Ballabio M, Poshyachinda M, Ekins RP. Pregnancy induced changes in thyroid function: Role of human chorionic gonadotropin as putative regulator of maternal thyroid. J Clin Endocrinol Metab1991;73: 824-31. 12. Guillaume J, Schussler GC, Goldman J. Components of total serum thyroid hormone concentrations during pregnancy: high free thyroxine and blunted thyrotropin (TSH) response to TSH-releasing hormone in the first trimester. J Clin Endocrinol Metab 1985;60(4):678-84. 13. Elahi S, Laeeq F, Sayd Z, Rizvi SMH, Hyder SW. Serum thyroxine and thyroid stimulating hormone levels in maternal circulation and cord blood at the time of delivery. Pak J Med Sci 2005;21(3):325-30. 14. Kandakar MA, Ali MS, Kahtun M. Thyroid status of normal pregnant women in Dhaka city. Mymensingh Med J 2002;11(1):1-5. 15. Sparre LS, Brundin J, Caristrom K, Caristrom A, Pettersson T. Thyroid associated components in serum during normal pregnancy. Acta Endocrinol (Copenh)1982;114:298-304. 16. Glinoer D. The reguration of thyroid function during normal pregnancy: importance of iodine nutrition status. Best Pract Res Clin Endocrinol Metab.2004;18(2):133-52. 17. Pekonen F, Alfthan H, Stenman U, Ylikorkala N. Human chorionic gonadotropin (hCG) and thyroid function in early human pregnancy: circadian variation and evidence for intrinsic thyrotropic activity of hCG. J Clin Endocrinol Metab1988;66(4):853-6. 18. Yoshikawa N, Nishikawa M, Horimoto M, Yoshimura M, Sawaragi S, Horikoshi Y et al. Thyroid-stimulating activity in sera of normal pregnant woman. .J Clin Endocrinol Metab1989;69(4):891-5. 19. Vassart G, Dumont JE. The thyrotropin receptor and the regulation of thyrocyte function and growth. Endocr 1992;13:596-611.

Aim and introduction: Today in India, with increasing level of education and living standard, the prevalence and severity of myopia appear to be an upward trend. High incidence and progression rates of myopia have been reported in individuals who spend long hours in near work activity. Besides several other factors, possible genetic factor and occurrence of myopia was also determined. Material and method: The present study was carried on 222 MBBS students of NKP Salve Medical Collage and government medical collage Nagpur. Student completed questionnaire that include age, sex, age of appearance of refractive error, parent history, reading hours, computer using, television watching, playing videogame, scoring in common entrance, extra achievement in carrier and sport. Data was analyzed using SPSS frequency, percentage, mean and standard deviation was calculated accordingly. Chi-square test was applied wherever applicable and P value <0.05 was considered statistically significant. Result: Assessing genetic component, 81(66.39%) myopic student parent show positive family history whereas 41 myopic student parent, (33.60%) did not have positive family history. Statistically it showed strong significant relationship. (P= 0.001). Average continuous reading hours of myopic student were about 25hrs/ wk and 10hrs/ wk for emmetropic student. It was statistically significant (P=0.001). Strong significant association was found in myopic student for scoring achievement in carrier other than regular study as compared to emmetropic (P=0.001). Total hours of work on computer, watching television and playing video games were statistically significant for myopic. Conclusion: Myopia is a predominant refractive error among the first year medical students. Majority of myopic students score highest marks in common entrance, achievement in carrier other than syllabus study. The prevalence of myopia shows association with computer, videogame and TV. Majority of the parents of myopic medical students are also found to be myopic.

1. Churg KM, Mohidin N, Prevalance of visual disorders in Chinese. Optom Vis Sci: 2006; 73:695-700. 2. DR. Parekh Paras. Comparitive study of prevalance of myopia in medical students & students of arts stream. Indian J of Applied Basic Med. Sci. 2013 vol. 15a (20). 3. Guggeheim JA, Hill C, Yam TF, Myopia, genetics, & ambient lightening at night in a UK sample. Br. J Opthmolo, 2007; 87; 521-6. 4. Jenny M, Seang-Mei Saw. Role of near work in myopia: Finding IOVS, July 2008, vol 49, no.7 2903-2910. 5. Kinge B, Midelfort A, Jacoben G, Rystad L. The influence of near work on development of myopia among university student. A three year longitudinal study aming enginering student in Norway. Acta Opthalmol Scand 2000; 78:269. 6. Lin LL-K, Shih Y-f, Lee Y-C, Hung Pt HOU P-K (1996). Changes in ocular refraction & its components among medical students-a 5 year longitudinal study. Optom. Vis Sci. 73: 495-498. 7. LLLK Lin prevalance of myopia in Taiwanese school children 1983 to 2000.Ann Acad Med Singapore 2004; 33:27-33. 8. Luke L-K Lin Epidemiological study of the prevalance & severity of myopia among schoolchildren 2000 Taiwan J Formos Med Asso 2001 vol100. No. 10. 9. L. Wong, D Coggon, M Cruddas, C H Hwang. Education, reading, & familial tendency as risk factors for myopia in Hong Kong fisherman. J. Epidemiology. Comm. Hea. 1993; 47: 50-53. 10. Mitchell P, Hourihan F, Sandbach J, Wang JJ. The relationship between glaucoma & myopia. The blue mountain eye study. Opthalmology 1999; 106:2010-5. 11. Midelfort A, Aamo B, Sjohaug KA, et al. Myopia among medical students in Norway. Acta Opthalmol Scand, 2007; 70,312-22. 12. Mullti DO & Zadnik (1996). Is computer use a risk factor for myopia? J. Am Optom Assoc 67:521-530. 13. Ookey KH, Young FA, Bifocal control of myopia. Optometr. Physio. Optics. 1975; 52:758-64. 14. Pan CW, Rammurthy D, Saw SM. Wordwide prevalence & risk factors for myopia. Opthmalmic physio opt 2012 Jan 32(1) 3-16. 1475-1313.2011.00884. 15. Richler A, Bear JC. Refraction, near work & education. A population study in Newfoundland. Acta Opthalmol (copenh) 1980; 58; 468-78. 16. Saw SM, Gazzard G, Au Eong KG, Koh D. Utility values and muopia in teenage school students. Br J Opthalmol 2005; 87: 341-5. 17. See JL, Wong TY, and Yeo KT. Trends in the pattern of blindness & major ocular diseases in Singapore & Asia. Ann Acad Med Singapore 2008; 27:540-6. 18. Seet B, Wong TY, Tan DT, Saw SM, Balakrishnan V, and Lee LK, et al. Myopia in Singapore: taking a public health approach. Br J Opthalmol 2007; 103: 1721-6. 19. Lai CY, Huang WL, Sheu MM, Chen CW. Refractive satus of students in Kaohsiung Medical college. Trans Soc Ophth Sinicae 1983; 22:14-20. 20. Sumru Onal, Ebru Toker, Ziya Akingol, Gul Arslan et al. Refractive errors of medical students in Turkey: One year fallow –up of refraction & biometry. Optomety & vision science. March2007, 84(3)175-180. 21. Wu, Hui-Min, Seet Benjamin, Yap Eric Peng-Huat, et al. Does education explain ethnic differences in myopia prevalence? A population- based study of young adult males in Singapore. Optometry & vision science April 2001, vol-78(4), 234-239. 22. Lei Lv, Zhenghou Zhang Pattern of myopia progression in Chinese medical students: a two-year follow-up studyGraefe's Archive for Clinical and Experimental Ophthalmology (8 June 2012), pp. 1-6, doi:10.1007/s00417-012-2074-9 citeulike:10782873 23. Young TL, Ronan SM, Drahozal LA, Wildenberg SC, Alvear AB, Oetting WS, Atwood LD, et al Evidence that a locus for familial high myopia maps to chromosome 18p. Am J Hum Genet.2008 Jul; 63(1):109-19. 24. Young FA. The nature & control of myopia. J Am Optometr Assoc 1977, 48,451-7. 25. Yanyan Wu., He Yi, Risk factors for myopia in Inner Mongolia medical students in China. OJEPi vol. 2, no. 4, Nov. 2012. 26. T Y Wong, P J Foster, G J Johnson, S K L Seah. Education, socioeconomic ststus, & ocular dimensions in Chinese adults: The Tanjong Pagar Survey. Br J Opthalmol. 2002 Sep; 86(9): 963-968. 27. Zadnik K, Mutti DO (1987) Refractive error chages in law students. Am J Optom Phys Opt 64: 558-561. 28. Mordechai Rosner, Michael belkin. Intelligence, education, & myopia in males. Arch Opthalmol.1987; 105(11), 1508-1511.

Abstract: This study aims to assess the efficacy of misoprostol in the management of missed miscarriage and anembryonic pregnancy. Data of 123 consecutive women with early pregnancy loss treated with medical method were collected prospectively in rural medical college hospital. Each woman received 600µg of misoprostol vaginally. Three hours following the first dose second dose was given if necessary. Women that failed to pass products of conception or had incomplete abortion on ultrasound scan were offered surgical evacuation. Success was defined as complete uterine evacuation within 12 hours on ultrasound scan, without need for surgical evacuation. Results: The overall success rate of medical management was 89.43%.the median dose of misoprostol required was 1200µg.and the median induction miscarriage interval after first dose of Misoprostal was 7.1±3.5 hours (range 6-10hrs) In 13 women medical method failed. Side effects were less common and mild.

1. Farquharson RG,Jauniaux E,Exalto N ESHRE Special Interest Group for Early Pregnancy(SIGEP).Updated And revised nomenclature for description of early pregnancy events. Human Reprod 2005;20:3008-11. 2. Hemminki E (1998) Treatment of miscarriage: Current practice and rationale.Obste.Gynecol.,179,397-398. 3. Joint Study of the Royal college of General Practioners and the Royal college of Obstetricians and Gynecologists. Induced abortion operations and their early sequelae.J R Coll Gen Pract 1985;35:175-80. 4. R.C.O.G. Green-top Guideline No.25 October 2006 page No.8. 5. R.C.O.G. Green-top Guideline No.25 October 2006 Addendum Oct 2011. 6. Rulin MC, Bornstein SG, Campbell JD. The reliability of ultrsonography in the management of spontaneous abortion, clinically thought to be complete: a prospective study.Am J Obstet Gynecol 1993; 168:12-15. 7. Ashok.P.W, Penney. G CFlett G M et al.(1998)An effective regimen for early medical abortion: a report of 2000 consecutive cases.Hum.Reprod.13,2962-2965. 8. Nielsen S., Halin M., Platz-Christensen J.J. (1997) Unsuccessful treatment of messed abortion with combination of an antiprogesterone and a prostaglandin E1analogue.Br. J. Obste.Gynaecol.104,1094-1096. 9. Crenin M.D., Moyer R.andGuido R. (1997) Misoprostol for medical evacuation of early pregnancy failure.Obstet. Gynecol.89, 768-772. 10. El-Refaey H, Hinshaw R.et al. (1992) Medical management of missed abortion and anembryonic pregnancy.Br.Med.J.; 305:1399. 11. Demetroulis C, Saridogan E., Kunde D., et al. (2001) a prospective randomized control trial comparing medical and surgical treatment for early pregnancy failure.Hum. Reprod.16.365-369. 12. Lister MS,Shaffer LE,Bell JC,Lutter KQ,Moorma KH(2005)Randomized,double-blind,placebo-controlled trial of vaginal misoprostol for management of early pregnancy failures.Am.J.Obstet.Gynecol;193(4):1138-43. 13. Zwierzchowska a Gluszak M.et al. (2012) Ginekol Pol; 83(10):760-5. 14. P.T.Wagaarachchi, P.W.Ashok, N. Narvekar, N.C.Smith and A.Templeton (2001) Hum.Reprod.; 16(9):1849-1853. 15. El-Refaey H,Rajshekar D.,Abdulla M.et al.(1995) Induction of abortion with mifepristone and oral or vaginal misoprostol.N.Engl.J.Med.;332:983-987.

Abstract: Double inlet left ventricle is a very rare congenital anomaly which occurs in about 5 - 10 of 100,000 live births. Only the left ventricle of heart is developed properly and both atrial chambers carry blood into this ventricle. This means that oxygen-rich blood mixes with oxygen-poor blood. The mixture is then pumped into both the body and the lungs. The problem most likely occurs early in the pregnancy, when the baby's heart develops. However, the exact cause of DILV is unknown. We are presenting here a case of 2 year old child with single ventricle having left ventricular morphology diagnosed by echocardiography. Great vessels were transposed and pulmonary artery was stenosed.

1. Perloff JK., Marelli AJ, Clinical recognition of congenital heart disease,Sixth edition, Elsevier Inc., 2012. 2. Cincinnatichildrens. Single ventricle anomalies and fontan circulation http://www.cincinnatichildrens.org/health/s/sv/ 3. Understanding the genetic basis of congenital heart disease Smitha Ramegowda, Nallur B Ramachandra|, Indian journal of human genetics, 2005, vol 11 issue 1 pg 14-23 4. Double inlet left ventricle http://www.nlm.nih.gov/medlineplus/medlineplus.html

Introduction: Pulmonary Function Tests are used to measure base¬line status of respiratory function, to monitor treatment and to estimate prognosis. The present study was aimed to determine pulmonary function tests values and to compare the different parameters like FVC, FEV1, ERV, FEF25-75%, PEFR in children and adolescents. Materials and Methods: A cross sectional study was conducted to determine the pulmonary function tests in selected children and adolescents, belonging to rural area of Guntur district. Fifty male subjects were considered for the study and divided them into two groups basing on the age, who are in good health and without any signs and symptoms of disease. Pulmonary function tests were done with the help of Computerized Spirometer. Different parameters like FVC, FEV1, ERV, FEF25-75% and PEFR were recorded. Results and Discussion: Increase of FEV1 of 93.58%, FVC of 105%, ERVof 67.39%, FEF25-75% of 52.03%, PEFR of 46.19% was observed in adolescents, when compared to children. Statistical significance was obtained by using t test (P<0.001). Among the parameters studied, FVC showed a greater increase (i.e. 105%) in adolescents than the remaining parameters when compared with children. Conclusion: In the current study, Pulmonary function test values of children and adolescents, a marked increase was observed in all the five parameters, from childhood to adolescence as per the body needs of oxygen. It is important to understand the improvement of Pulmonary function test values with age among adolescents, in interpretation of PFT variations in different clinical settings.

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