Dolly Sharma, Ajit Saluja, Santosh Gupta, R. Hazari, Yogesh Patle
The diagnostic category of atypical squamous cells of undetermined significance (ASCUS) varies in threshold and significance among individual pathologists and among cytology laboratories. The rate of concurrent and subsequent squamous intraepithelial lesions (SIL) in patients with ASCUS found on Papanicolaou (Pap) smears shows a wide range in the literature.1–8 The significance of this diagnosis in perimenopausal and postmenopausal women is particularly unclear.4, 9, 10 We therefore compared the ASCUS-to-SIL ratio and the rate of subsequent SIL diagnoses in premenopausal, perimenopausal, and postmenopausal women.
1. Abu-Jawdeh GM, Trawinski G, Wang HH. Histocytological study of squamous atypia on Pap smears. Mod Pathol 1994; 7(9):920–4. 2. Pleotis Howell L, Davis RL. Follow-up of Papanicolaousmears diagnosed as atypical squamous cells of undetermined significance. DiagnCytopathol 1996; 14:20–4. 3. Yang M, Zachariah S. ASCUS on cervical cytologic smears. Clinical significance. J Reprod Med 1997; 42(6):329 –31. 4. Sheils LA, Wilbur DC. Atypical squamous cells of undetermined significance. Stratification of the risk of association with, or progression to, squamous intraepithelial lesionsbased on morphologic subcategorization [see comments]. ActaCytol 1997; 41(4):1065–72. 5. Williams GM, Rimm DL,Pedigo MA, Frable WJ. Atypical squamous cells of undetermined significance: correlativehistologic and follow-up studies from an academic medical center. DiagnCytopathol 1997; 16:1–7. 6. Alanen KW, Elit LM, Molinaro PA, McLachlin CM. Assessment of cytologic follow-up as the recommended management for patients with atypical squamous cells of undetermined significance or low grade squamous intraepithelial lesions. Cancer 1998; 84(1):5–10. 7. Raab SS, Bishop NS, Zaleski MS. Long-term outcome and relative risk in women with atypical squamous cells of undetermined significance. Am J ClinPathol 1999; 112(1):57–62. 8. Duggan MA. Cytologic and histologic diagnosis and significance of controversial squamous lesions of the uterine cervix. Mod Pathol 2000; 13(3):252– 60. 9. Saminathan T, Lahoti C, Kannan V, Kline TS. Postmenopausal squamous-cell atypias: a diagnostic challenge. DiagnCytopathol 1994; 11:226–30. 10. Rader AE, Rose PG, Rodriguez M, Mansbacher S, Pitlik D, Abdul-Karim FW. Atypical squamous cells of undetermined significance in women over 55.Comparison with the generalpopulation and implications for management.ActaCytol1999;43(3):357– 62 11. Kurman RJ, Solomon D. The Bethesda System for reporting cervical/vaginal cytologic diagnoses: definitions, criteria,and explanatory notes for terminology and specimen adequacy. New York: Springer-Verlag, 1994. 12. DeMay RM. The art and science of cytopathology: exfoliativeand aspiration cytology. Vol. 1. Chicago: ASCP Press, 1995. 13. Kaminski PF, Stevens CWJ, Wheelock JB. Squamous atypiaon cytology. The influence of age. J Reprod Med 1989; 34:617–20. 14. Jovanovic AS, McLachlin CM, Shen L, Welch WR, Crum CP. Postmenopausal squamous atypia: a spectrum including“pseudo-koilocytosis”. Mod Pathol 1995; 8(4):408 –12. 15. Abati A, Jaffurs W, Wilder AM. Squamous atypia in the atrophic cervical vaginal smear: a new look at an old problem.Cancer 1998; 84(4):218 –25. 16. Park JJ, Genest DR, Sun D, Crum CP. Atypical immature metaplastic-like proliferations of the cervix: diagnostic reproducibilityand viral (HPV) correlates. Hum Pathol 1999; 30(10):1161–5.
U D Kulkarni, R R Sangpal
This study was aimed at evaluating surface water parameters of Ujjani reservoir to identify major pollutant sources using multivariate statistics. Hydrochemistry of surface water in Ujjani reservoir was used to assess the quality of surface water for determining its suitability for drinking purposes. In two consecutive years along 20 stations of Ujjani reservoir, water parameters such as Temperature, pH, Turbidity, Electrical conductivity (EC), Total Dissolved Solids (TDS), Total Hardness (TH), Total Alkalinity (TA), Ca++, Mg++, Na+, K+, Cl-, HCO3-, CO3--, SO4--, NO3-, SAR, PO43-, DO, BOD and COD were determined in two seasons i.e. pre-monsoon and post- monsoon. Based on the Piper trilinear diagram it was confirmed all the water samples are alkali type excepting three samples which are away from the dam wall which are alkaline earth. In both seasons i.e. pre and post-monsoon, there is a good correlation between the electrical conductivity and elements Ca++, Mg++, K+, Cl-, SO4--, HCO3- and BOD. Total Hardness and elements Ca++, Mg++, HCO3- and TA. The range of values for WQI from different sampling stations showed variations from 44.90 to 189.53. It was inferred that the water quality of Ujjani dam varied from moderately to severely polluted (WQI method). Our findings highlighted the deterioration of water quality in the dam due to industrialization, urbanization and modern agricultural practices.
1. Ammar Tiri, Lazhar Belkhiri, Abderrahmane Boudoukha and Noureddine Lahbari (2011) Characterization and evaluation of the factors affecting the geochemistry of surface water of Koudiat Medouar Basin, Algeria. African J. of EnviL Sci. and Tech. Vol. 5(5), pp. 355-362. 2. APHA, AWWA, WPCF, American Water Works Association and Water Pollution Control Federation 1998.Standard methods for the Examination of Water and Waste Water Washington DC 20th edition. 3. Bordalo, A. A., Teixeira, R., and Wiebe, W. J., (2006). A water quality index applied to an international shared river basin: The case of the Douro River, Environmental Management, 38, pp 910–920. 4. Gabriel, I.O. and D.M.Orazulike (2010) Physicochemical characteristics of groundwater quality from Yola Area, Northeastern Nigeria. J. Appl. Sci. Environ. Manage. Vol. 14(1); pp: 5 – 11. 5. Garg, R. K., R. J. Rao, D. Uchchariya, G. Shukla and D. N. Saksena (2010) Seasonal variations in water quality and major threats to Ramsagar reservoir, India. African Jou. of Env. Sci. and Tech. Vol. 4(2); pp: 61-76. 6. Hem,J.D. (1970).Study and Interpretation of the Chemical Characteristics of Natural Water.USGS Wat.Supply pap.1473. 7. Hill, R.A. (1940) Geochemical patterns in Coachella valley, California. Am. Geophy. Union. Trans. 21; pp: 46–53. 8. Karanth, K.R (1995) Impact of human activities on hydrogeological environments. J. Geol soc. India 382; pp: 195-206. 9. Karanth, K.R. (1989) Hydrogeology. Tata McGraw-Hill Pub Co Ltd, New Delhi, India. 10. Karunakaran, K., P. Thamilarasuu and R. Sharmila (2009) Statistical study on physicochemical characteristics of groundwater in and around Namakkal, Tamilnadu, India. E-Jou. of Chem. 6(3); pp: 909-914. 11. Navneet Kumar and D.K. Sinha (2010) Drinking water quality management through correlation studies among various physicochemical parameters: A case study. Inter. Jou. of Envi.Sci.Vol. 1, No 2; pp: 253-259. 12. Patil,V.T. and P.R.Patil (2010) Physicochemical analysis of selected groundwater samples of Amalner town in Jalgaon District, Maharashtra, India. E-Jou. of Chem., 7(1); pp; 111-116. 13. Piper, A.M. (1944) A graphic procedure in the geochemical interpretation of water. Transac of Ame. Geophy. Uni., 25; pp: 914-923. 14. Piper, M. (1953) A graphic procedure in the geochemical investigation of water analysis. US Geol. Surv. Groundwater Note, 12; pp: 50–59. 15. Ramesh, M., M, Saravanan and G. Pradeepa (2007) Studies on the physicochemical characteristics of the Singallunar lake, Coimbatore, South India. In Proceeding National Seminar on Limnol. Maharana Pratap 16. Sajil Kumar, P.J., P. Jegathambal and E.J. James (2011) Multivariate and geostatistical analysis of groundwater quality in Palar river basin. Int. Jou. of Geol., Issue 4, Vol. 5; pp:108-119. 17. Sonawane G. H. and Shrivastava V. S. (2010). Ground Water Quality Assessment Nearer to the Dye user Industry. Scholars Res. Lib., 2 (6): pp: 126-130. 18. Venkatesan J (2007). Protecting Wetlands. Curr. Sci. 93: 288-290.
Dhuwadhapare Pravinkumar Gangadhar, Choudhary Kashinath G, Khaire Bhaskar Shankar
Introduction: Pterygium is a degenerative condition of sub-conjunctival tissue which proliferates as vascularised granulation tissue to invade cornea, destroying the superficial layers of stroma and Bowman’s membrane; the whole being covered by conjunctival epithelium. The mainstay of treatment is surgical. There are numerous surgical procedures that have been advocated for the surgical management of pterygia and each has advantages and disadvantages. Aims and Objectives: To study the efficacy and safety of Conjunctival auto graft and Amniotic membrane graft after primary pterygium excision. Material and Method: fifty cases of primary pterygium were enrolled in the study and were divided in two groups of 25 patients each. After receiving institutional ethical committee approval and informed consent from patients the study was conducted. Group A patients underwent pterygium excision with conjunctival auto-grafting whereas Group B patients underwent pterygium excision with amniotic membrane grafting. All the patients were observed keenly for any intra operative and post operative complication. Postoperative follow up was done To find any recurrence. Results: Mean age of patients in group A was 43.16±12.60 years whereas in group B mean age was 42.48±12.20 years. Majority of the patients in both groups were having nasal pterygium (96% each). No patient had intra-operative complications in group A. In group B one patient had intra-operative graft tear. In group A, 5 (20%) patients had subconjuctival hemorrhage, 4 (16%) patients had immediate post operative graft edema, 2 (8%) patients had foreign body granuloma, 1 patient (4%) had graft infection and in group B, 1 (4%) patient had intraoperative graft tear at the time of suturing, 3 (12%) patients had subconjuctival hemorrhage, 2 (8%) patients had foreign body granuloma. None of these had any long term effect on outcome of surgeries. there was recurrence of pterygium in 1 (4%) case each in both groups. Conclusion: Both amniotic membrane grafting and conjunctival autografting are equally safe and effective procedures for the management of primary pterygium. And Amniotic membrane grafting is viable alternative to conjunctival autografting.
1. Sihota R, Tandon R. Parson’ Diseases of the Eye, Elsevier Pub. 21st ed.,2011:181-182 2. Dutta L C, Dutta N K. Modern Ophthalmology, Jaypee Brothers Medical Publisher, New Delhi 3rd ed. 2009: vol1:127-128 3. Yanoff and Duker. Ophthalmology, 3rd ed.: 248 4. Sandeep Saxena. Clinical Ophthalmology Medical And surgical Approach. Jaypee highlights 2nd ed 5. Varssano D, Michaeli-Cohen A, Loewenstein A. Excision of Pterygium and Conjunctival Autograft. IMAJ 2002; 4:1097-1100. 6. Rao SK, Lekha T, Mukesh BN, Sitalakshmi G, Padmanabhan P. Conjunctival-Limbal autografts for primary and recurrent Pterygia: Technique and results. Indian J Ophthalmol 1998;46:203-9 7. Shrestha A, Shrestha A, Bhandari S, Maharajan N, Pant S R, Pant B P. Inferior conjunctival autografting for pterygium surgery: an alternative way of preserving the glaucoma filtration site in far western Nepal. Clin Ophthalmol. 2012; 6: 315–319. 8. Cameron. Pterygium throughout world. Brit. J. Ophthalm 1965 9. Ma D H, See L C, Liau S B, Tsai R J. Amniotic membrane ghraft for primary pterygium: comparision with conjunctival autograft and topical mitomycin C treatment. Br J Ophthalmol 2000;84:973–978 10. Lu P, Chen X M. Prevalence and risk factors of pterygium. Int J Ophthalmol, Vol.2, No.1, Mar.18, 2009: 81-85. 11. Luanratanakorn P, Ratanapakorn T, Suwan-apichon O, Chuck R S. Randomised controlled study of conjunctival autograft versus amniotic membrane graft in pterygium excision. Br. J. Ophthalmol. 2006;90;1476- 1480 12. Maheshwari S. Effect of pterygium excision on pterygium induced astigmatism. Indian J Ophthalmol 2003;51:187-8 13. Tananuvat N, Martin T. The results of amniotic membrane transplantation for primary pterygium compared with conjunctival autograft. Cornea. 2004; 23:458–463. 14. Sebban A, Hirst LW. Pterygium recurrence rate at The Princess Alexandra Hospital. Aust N Z J Ophthalmol. 1991; 19:203–206. 15. Sharma A K, Wali V, Pandita A. Corneo- Conjunctival Auto Grafting in Pterygium Surgery. J K science. Vol. 6 No. 3, July-September 2004 16. Katbaab A, Ardekani A, Khoshniyat H, Hosseini H J. Amniotic Membrane Transplantation for Primary Pterygium Surgery. J Ophthalmic Vis Res 2008; 3 (1): 23-27.
S Mangal, M Khatri, M Mangal, A Nagar
Background: Diabetes in adults is now a global health problem, Projections related to diabetes are often based on one or two available studies. To make these figures more robust, it is necessary to have more studies. This paper contributes new data on the prevalence of diabetes and IGT. This was a cross sectional study involving 600 subjects aged 20 years and above (300 males and 300 females) conducted in the rural field practice area of the concerned medical college. To assess the prevalence and the associated risk factors for DM (in the age group 20 and above). Result: The total prevalence of diabetes was 4.67% and was higher among males as compared to females. (4 % females and 5.3 % males). Prevalence of Pre-diabetes in our study is 3%. The prevalence of diabetes increased significantly with advancing age and this difference was found to be statistically highly significant. The prevalence of obesity was highest in diabetics, and further decreased among pre-diabetics and non-diabetics. This difference was found to be statistically highly significant. Similar results were obtained with central obesity also. Family history of diabetes was present in 12% subjects, being more common in patients with diabetes and high risk subjects i.e. pre-diabetic. This difference was found to be statistically highly significant. Diabetes was more prevalent in higher social class, higher percentage of them were addicted to alcohol while tobacco addiction was similar in diabetics and non diabetics. Diabetic subjects were involved less in moderate activity as compared to non diabetics and more of light activity was seen among diabetics as compared to non diabetics. Conclusion: The study suggests that prevalence of diabetes is on an increase even in rural areas with occurrence even in the younger age group. There are associated risk factors as obesity, addiction to alcohol, and physical activity which are modifiable risk factors and if taken care of can help in controlling this epidemic of diabetes. Besides we have certain non modifiable risk factors contributing to this disease as family history of diabetes and social class.
1. World Health Organization, and World Health Organization. "Definition and diagnosis of diabetes mellitus and intermediate hyperglycemia: report of a WHO/IDF consultation." Geneva: World Health Organization (2006): 1-50. 2. Park K. Park’s Text Book of Preventive and Social Medicine. 20th ed. Jabalpur India: M/s Banarasidas Bhanot; 2009, pp 341-345. 3. Hu FB, Manson, JE, Stampfer MJ, Colditz G, Liu S, Solomon CG et al. Diet, lifestyle, and the risk of type 2 diabetes in women. N Engl J Med 2001; 345: 790-797 4. Knowler -WC, Barret CE, Fowler SE, Hamman RF, Lachin JM, Walker EA et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 2002; 346: 393-403. 5. Tuomilehto J, Lindstrom J, Eriksson JG, Valle TT, Hamalnainen H, Ilane-Parikka P et al. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med 2001; 344: 1343-1350. 6. "About diabetes". World Health Organization. Retrieved 4 April 2014. 7. "Diabetes Fact sheet N°312". WHO. October 2013. Retrieved 25 March 2014. 8. RSSDI textbook of diabetes mellitus. (Rev. 2nd ed.). New Delhi: Jaypee Brothers Medical Publishers. 2012. p. 235. ISBN 9789350254899. 9. Global status report on non-communicable diseases 2010. Geneva, world health organisation, 2011 10. Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Diabetes Care 1997; 20:1183–97 11. "Understanding blood pressure readings". American Heart Association. 11 January 2011.Last retrieved on 14 oct 2014 12. "Low blood pressure (hypotension) — Causes". MayoClinic.com. Mayo Foundation for Medical Education and Research. 2009-05-23. Retrieved 14 oct 2014 13. "BMI classification". World Health Organization. Retrieved 15 February 2014. 14. World Health Organization. Definition, Diagnosis, and Classification of Diabetes Mellitus and its Complications: Report of a WHO Consultation. Part I: Diagnosis and Classification of Diabetes Mellitus. Geneva: World Health Organization. 1999. Assessed on January 26, 2011. 15. Sharma R. Revision of Prasad's social classification and provision of an online tool for real-time updating. South Asian J Cancer. 2013 Jul-Sep; 2(3): 157. doi: 10.4103/2278-330X.114142 16. Jonas JB, et al. Diabetes mellitus in rural India. Epidemiology. 2010; 21:754–755. 17. Ahmad, J., Masoodi, M. A., Ashraf, M., Rashid, V., Ahmad, V., Ahmad, A., and Dawood, S. (2011). Prevalence of Diabetes mellitus and its associated risk factors in age group of 20 years and above in Kashmir, India. Al Ameen J Med Sci, 4, 38-44. 18. Rathod HK, Darade SS, Chitnis UB, Bhawalkar JS, Jadhav SL, Banerjee A. Rural prevalence of type 2 diabetes mellitus: A cross sectional study. J Soc Health Diabetes. 2014; 2:82–6. 19. Chhetri MR and Chapman RS. Prevalence and determinants of diabetes among the elderly population in the Kathmandu valley of Nepal. Nepal Med Col J. 2009; 11:34-8. 20. Gupta A, Gupta R, Sarna M, Rastogi S, Gupta VP, Kothari K. Prevalence of diabetes, impaired fasting glucose and insulin resistance syndrome in an urban Indian population. Diabetes Research and Clinical Practice, 2003, 61: 69–76. 21. Izharul Hasan, Shabnam Khatoon. Prevalence of diabetes mellitus and obesity among population of Sultanpur Kunhari and its surrounding area, Haridwar Uttarakhand. IRJP 2012, 3 (2) 22. V. Mohan. M. Deepa. R. Deepa. C. S. Shanthirani. S. Farooq. A. Ganesan. M. Datta. Secular trends in the prevalence of diabetes and impaired glucose tolerance in urban South India—the Chennai Urban Rural Epidemiology Study (CURES-17). Diabetologia (2006) 49: 1175–1178 23. Ono K, Limbu YR, Rai SK, Kurokawa M, Yanagida J, et al. (2007) The prevalence of type 2 diabetes mellitus and impaired fasting glucose in semiurban population of Nepal. Nepal Med Coll J 9: 154-156. 24. Anjana RM, Pradeepa R, Deepa M, Datta M, Sudha V, Unnikrishnan R, et al. ICMR-INDIAB Collaborative Study Group. Prevalence of diabetes and prediabetes (impaired fasting glucose and/or impaired glucose tolerance) in urban and rural India: Phase I results of the Indian Council of Medical Research-INdia DIABetes (ICMR-INDIAB) study. Diabetologia. 2011; 54:3022–7. 25. Katulanda, P, Constantine, GR, Mahesh, JG et al., (2008). Prevalence and projections of diabetes and pre-diabetes in adults in Sri Lanka--Sri Lanka Diabetes, Cardiovascular Study (SLDCS). Diabetic medicine: a journal of the British Diabetic Association, 25 (9), 1062-1069. 26. Mohan V, Mathur P, Deepa R, Deepa M, Shukla DK, Menon GR, Anand K, Desai NG, Joshi PP, Mahanta J, Thankappan KR, Shah B. 2008a. Urban rural differences in prevalence of selfreported diabetes in India-The WHO-ICMR Indian NCD risk factor surveillance. Diabetes Res ClinPract;80:159-68
Uma Sudhan E, Rajagovindan D, Sumathi S
Background: Hypothyroidism is associated with hypo metabolic state and endothelial dysfunction; it results in the activation of nitric oxide synthase enzyme, which releases nitric oxide. Nitric oxide synthase derived peroxynitrite has a central component of inflammation. Inflammatory and autoimmune conditions cause synthesis of hs-CRP by liver. This study was done to compare and evaluate the correlation between thyroid function, nitric oxide and inflammatory status in hypothyroid subjects. Material and Methods: 50 cases each of Euthyroidism and Hypothyroidism were included in this study. Blood samples were drawn for the estimation of nitric oxide (NO), hs-CRP and thyroid profile in all the study subjects. Results: No values were significantly decreased in hypothyroid patients (n=50) compared to controls. (n=50) (p<.000) hs-CRP values were significantly increased in hypothyroid patients (n=50) compared to euthyroid controls (n=50). (p<.000) hs-CRP had a significant negative correlation with ft3 and ft4 and positive correlation with TSH.NO had a significant positive correlation with ft3andft4and negative correlation with TSH. Conclusion: These findings suggest that raised hs-CRP and reduced NO levels in hypothyroidism could cause subclinical inflammatory state which could be a risk factor for atherosclerosis and CVD.
1. Mathew J. Burden of thyroid disease in India. Need for aggressive diagnosis. Medcine_update 2008; vol8: 43:334-41. 2. Unnikrishnan A G, Sanjay Kalra S, Prevalence of hypothyroidism in adults: An epidemiological study in eight cities of India Indian J EndocrinolMetab. 2013; Jul-Aug; 17(4): 647–652. 3. Mayer O Jr, Šimon J, Filipovský J and Pikner R. Hypothyroidism in coronary heart disease and its relation to selected risk factors. Vasc Health Risk Manag. Dec 2006; 2(4): 499–506. 4. Taddei S, Caraccio N, Virdis A, Dardano A, Versari D, Ghiadoni L, Salvetti A, Ferrannini E, Monzani F. Impaired endothelium-dependent vasodilatation in subclinical hypothyroidism: beneficial effect of levothyroxine therapy.JClinEndocrinolMetab. 2003 Aug; 88(8):3731-7. 5. Hak AE, Pols HA, Visser TJ, Drexhage HA, Hofman A, Witteman JC 2000 Subclinical hypothyroidism is an independent risk factor for atherosclerosis and myocardial infarction in elderly women: the Rotterdam Study. Ann Intern Med 132:270–278. 6. Siekmeier R, Steffen C, Maarz W. Role of oxidants and antioxidants in atherosclerosis: results of in vitro and in vivo investigations. Other markers of inflammation in the prediction of cardiovascular disease in women. New Eng J Med 2000; 342:836-843. CardiovascPharmacolTher 2007; 12:265–82. 7. Gardiner SM, Compton AM, Bennett T, Palmer RMJ andMoncada S. Control of regional blood flow by endothelium-derived nitric oxide. Hypertension 1990 15 486–492. 8. Sarandöl E, Tas S, Dirican M, Serdar Z. Oxidative stress and serum paraoxonase activity in experimental hypothyroidism: effect of vitamin E supplementation. Cell biochemfunct2005; 23: 1-8. 9. Ignarro LJ, Cirino G, Casini A, Napoli C. Nitric oxide as a signalling molecule in the vascular system: an overview. J Cardiovasc Pharmacol 1999; 34:879-886. 10. Jean Davignon, MD; Peter Ganz, MD. Role of Endothelial Dysfunction in Atherosclerosis 2004; 109: III-27-III-32. 11. Ridker PM, Hennekens CH, Buring JE, C-reactive protein and other markers of inflammation in the prediction of cardiovascular disease in women. N Engl J Med 2000; 342:836-43. 12. Christ-Crain M, Meier C, Guglielmetti M, Huber PR, Riesen W, Staub JJ, Müller B. Elevated C-reactive protein and homocysteine values: cardiovascular risk factors in hypothyroidism? A cross-sectional and a double-blind, placebo-controlled trial. Atherosclerosis. 2003; 166:379–86. 13. Nagasaki T, Inaba M, Shirakawa K, Hiura Y, Tahara H, Kumeda Y, Ishikawa T, Ishimura E, Nishizawa Y. Increased levels of C-reactive protein in hypothyroid patients and its correlation with arterial stiffness in the common carotid artery. Biomed Pharmacother. 2007; 61:167–72. 14. Jublanc C, Bruckert E, Giral P, Chapman MJ, Leenhardt L, Carreau V, Turpin G. Relationship of circulating C-reactive protein levels to thyroid status and cardiovascular risk in hyperlipidemic euthyroid subjects: low free thyroxine is associated with elevated hsCRP. Atherosclerosis. 2004 Jan; 172:7-11. 15. Hueston WJ, King DE, Geesey ME Serum biomarkers for cardiovascular inflammation in subclinical hypothyroidism. Clin Endocrinol (Oxf) 2005; 63:582-7. 16. Verma S, Wang CH, Li SH, Dumont AS, Fedak PW, Badiwala MV. A self-fulfilling prophecy: C-reactive protein attenues nitric oxide production and inhibits angiogenesis. Circulation 2002; 106:913-919. 17. Kochupillai N. Clinical Endocrinology in India. Current Science 2000; 1061-67. 18. American Association of Clinical Endocrinologists medical guidelines for clinical practice for the evaluation and treatment of hyperthyroidism and hypothyroidism. Endocr Pract. 2002; 8:457–469. 19. Dillmann WH. Mechanism of action of thyroid hormones. Med Clin North Am. 1985; 69:849. 20. Ueta Y., Levy A., Chowdreys H.S, And Lightman S.L., Hypothalamic Nitric Oxide Synthases Gene Expression Is Regulated by Thyroid Hormones, Endocrinology 1995; 136 : 4182-4187. 21. Cabral MD, Teixeira PFS, Silva NAO, Morais FFC, Soares DV, Salles E, et al. Normal flow-mediated vasodilatation of the brachial artery and carotid artery intima-media thickness in subclinical hypothyroidism. Braz J Med Biol Res 2009; 42:426–32. 22. Siekmeier R, Steffen C, Ma¨ rz W. Role of oxidants and antioxidants in atherosclerosis: results of in vitro and in vivo investigations. J Cardiovasc Pharmacol Ther 2007; 12(4):265–82. 23. OzcanO, CakirE, Yaman H et al. The effects of thyroxine replacement on the levels of serum asymmetric dimethylarginine and other biochemical cardiovascular risk markers in patients with subclinical hypothyroidism. ClinEndocrinol 2005;63:203-6. 24. Abhinav Kumar, Suresh DR, Annam V, Srikrishna R. Significance of early biochemical markers of atherosclerosis in subclinical hypothyroidism patients with normal lipid profile. Int J Biol Med Res. 2012; 3(4): 2483-2486. 25. Kleinbongard P, Dejam A, Lauer T, Rassaf T, Schindler A, Picker O. Plasma nitrite reflects constitutive nitric oxide synthase activity in mammals. Free RadicBiol Med 2003; 35:1551-1559. 26. Pepys MB, Hirschfield GM, Tennent GA, Gallimore JR, Kahan MC, Bellotti V, Hawkins PN, Myers RM, Smith MD. "Targeting C-reactive protein for the treatment of cardiovascular disease". 2006; Nature 440 (7088): 1217–21. 27. Jager A, van Hinsberg VW, Kostense PJ, Emeis JJ, Yudkin JS, Nijpels G, Dekker JM, Heine RJ, Bouter LM, von Willebrand factor, C-reactive protein, and 5-year mortality in diabetic and nondiabetic subjects. Arterioscler Thromb Vas Biol 1999; 19: 3071-3078. 28. Sharma R, Sharma TK, Kaushik GG, Sharma S, Vardey SK, Sinha M. Subclinical hypothyroidism and its association with cardiovascular risk factors. [Journal Article]Clin Lab 2011; 57(9-10):719-24.
V Pradhan, S Javadekar, V Pawar, D K Sindal, V Karambelkar
Anophthalmia is a very rare condition. Clinical anophthalmia is a term to describe cases of severe microphthlmia when the eyeball is severely hypoplastic or absent. Anophthalmos is complete absence of ocular tissue and is a histopathological diagnosis. The preciseaetiology of anophthalmos unknownbut is considered to be multifactorial. They include genetic mutations and environmental factors like viruses including the TORCH group of viruses. It may also occur as a part of a syndrome.This case report discusses a 2 days old child with clinical anophthalmia. It delves into the possible causes of this condition.
1. Albert and Jakobiec’s Principles and Practice of Ophthalmology, Congenital Anomalies of the Whole Eye Formation, pg. 4179, Edition 3. 2. Morrison D, FitzPatrick D, Hanson I, Williamson K, van Heyningen V, Fleck B, Jones I, Chalmers J, Campbell H: National study of microphthalmia, anophthalmia, and coloboma (MAC) in Scotland: investigation of genetic aetiology. J Med Genet 2002, 39:16-22. 3. Mann I: The Developmental Basis of Eye Malformations. Philadelphia: JB Lippincott; 1953 4. Verma AS, FitzPatrick DR. Anophthalmia and microphthalmia. Orphanet Journal of Rare Diseases 2007; 2: 47. 5. Yomai AA, Pavlin BI. Microphthalmia and Anophthalmia in Chuuk state, Federeated States of Micronesia 6. Silva F, et al. Anophthalmia and microphthalmia: A clinical case with a prenatal diagnosis. DiagnPrenat. 2013. http://dx.doi.org/10.1016/j.diapre.2013.07.005 7. Chen D, Heher K. “Management of the anophthalmic socket in pediatric patients.”CurrOpinOphthalmol. 2004 Oct; 15(5):449-53. Review. 8. Dunaway DJ, David DJ. “Intraorbital tissue expansion in the management of congenital anophthalmos.” Br J Plast Surg. 1996 Dec; 49(8):529-35. 9. Mazzoli, Robert A; Raymond, William R IV; Ainbinder, Darryl J; Hansen, Elizabeth A. “Use of self-expanding, hydrophilic osmotic expanders (hydrogel) in the reconstruction of congenital clinical anophthalmos,” Current Opinion in Ophthalmology. 15(5):426-431, October 2004.
Bindu C B, Srinivasa B S, Bhagawan
A boy aged 2 years 6 months was reported to our district hospital with a rare syndrome of goldenhar having multiple symptoms. He had facial asymmetry, scoliosis, eye problems like limbaldermoid, hypoplastic mandible with bilateral preauricular skin tag and there is history of delayed dentition and the baby was operated during neonatal period for tracheoesaphagialfistulla. Child also had absent Right Kidney.
1. Altamar Rios J. Síndrome de Goldenhar – A propósito de umcaso. An OtorrinolaringolIber Am 1998; XXV: 491-497. 2. Oski FA, de Angelis CA, Feigin RD, Warshaw JB. Síndromescomuns com anormalidadesmorfológicas.Princípios e Prática de Pediatria. Rio de Janeiro: Guanabara Koogan; 1990. p 482. 3. Kokavec R (2006) Goldenharsyndrome with various clinical manifestations. Cleft Palate Craniofac J 43,628-634. 4. Garcia de Paula e Silva FW, de Carvalho FK, Diaz-Serrano KV, de Freitas AC, Borsatto MC, de QueirozAM (2007) Solitary median maxillary central incisor in association with Goldenhar’s syndrome: a case report. Spec Care Dentist 27, 105-107. 5. Vinay C, Reddy RS, Uloopi KS, Madhuri V, Sekhar RC (2009) Craniofacial features in Goldenhar syndrome. J Indian SocPedodPrev Dent 27, 121-124. 6. Bielicka B, Necka A, Andrych M (2006) Interdisciplinary treatment of patients with Goldenhar syndrome – clinical reports. Dent Med Probl 43, 458-462. 7. Pinheiro AL, Araújo LC, Oliveira SB, Sampaio MC, Freitas AC (2003) Goldenhar’s syndrome – case report. Braz Dent J 14, 67-70. 8. Rodríguez JI, Palacios J, Lapunzina P. Severe axial anomalies in the oculo-auriculo-vertebral (Goldenhar) complex. Am J Med Gen 1993; 47:69-74. 9. Schaffer AJ, Avery ME. Doenças do Recém-Nascido. 4th ed. São Paulo: Interamericana; 1979. p 803. 10. Carvalho GJ, Song CS, Vargervik K, Lalwani AK. Auditory and facial nerve dysfunction in patients with hemifacialmicrosomia.ArchOtolaryngol Head Neck Surg 1999; 125:209-212. 11. Nakajima H, Goto G, Nakata N. Goldenhar syndrome associated with various cardiovascular malformations. JnpCirc J 1998; 62:617-620. 12. Ritchey ML, Norbeck J, Huang C, Keating MA, Bloom DA. Urologic manifestations of Goldenhar syndrome. Urology 1994; 43:88-91. 13. Kumar R, Balani B, Patwari AK, Anand VK, Ahuja B. Goldenhar syndrome with rare association. Indian J Pediatr 2000; 67:231-233.
Shanmugasamy K, Anandraj Vaithy K2, Vaishali Dhananjay Kotasthane, Dhananjay S Kotasthane4
Background: Transfusion of blood and blood components remains the main stay of treatment for hematological and co-morbid conditions. They also serve the purpose of saving life during accidental blood loss and also during elective and emergency circumstances. Aims and Objectives: The main objective of the present study was to find the prevalence of HIV and HbsAg among the voluntary blood donors in a tertiary care hospital [SBV UNIVERSITY] and to find its association with age, gender, and alcohol consumption. Materials and Methodology: The prospective study (prevalence study) included 100 voluntary blood donors with inclusion and exclusion criteria with a standard protocol. Blood grouping was performed in the blood samples obtained through this voluntary blood donation and were screened for HbsAg and HIV serology using ELISA. Data analysis was done by SPSS software. Results and Observations: Among 100 voluntary blood donor studied, 92 were male donors and 8 were female donors. Out of the 100 voluntary blood donors, 65 were in the age group of 16-25 while 25 were in the age group of 26-35 years of age.78 donors were found to be non alcoholics. Only 22 of the voluntary blood donors gave history of alcohol consumption. Out of the 100 voluntary blood donors, 31 had O +ve blood group and 29 had B +ve blood group. 81 of the voluntary blood donors had Rh +ve blood group while only 19 had Rh-ve blood group. Of the 100 voluntary blood donors, only 4 were found to be sero-positive for HbsAg while there were no donors who were found to be sero-positive for HIV. All 4 HbsAg positive cases were found to be male with age group of 16-25 years. Of the 4 HbsAg positive donors, 3 were non alcoholics and only one was an alcoholic. During the course of the present study, HbsAg positive donors were found to be distributed among different blood groups. Hence an analysis was done. It was found that of the 4 HbsAg positive donors, 2 belonged to ‘B’ blood group, 1 belonged to ‘O’ blood group and 1 had ‘A’ blood group. All 4 HbsAg positive donors had Rh +ve blood group. Conclusion: This study emphasizes the importance of donor screening among voluntary donors in all blood banks of hospitals. Significant association was found between HbsAg positivity and Rh blood grouping. HbsAg positivity was significantly high in Rh +ve blood groups. The study also show alcohol consumption has no impact on HbsAg positivity.
1. P. Pallavi C, K. Ganesh, K. Jayashree et al. Seroprevalence and trends in transfusion transmitted infections amomg blood donors in a university hospital blood bank: 5 year study. Indian J Hematol Blood Transfus. 2011 March; 27(1): 1–6. 2. Dhaval Mehta, J.H.Vachhani, N...J.Desai. Seroprevalence of Hiv, Hbv, Hcv and Syphilis in Donors: INDIAN JOURNAL OF RESEARCH. Volume: 2 | Issue: 2 | february 2013. 3. Bharat Singh, Monika Verma, Mrinalini Kotru et al. Prevalence of HIV and VDRL seropositivity in blood donors of Delhi. Indian J Med Res 122, September 2005, pp 234-236 4. Nanu A, Sharma SP, Chatterjee K et al. Markers for transfusion-transmissible infections in north Indian voluntary and replacement blood donors: prevalence and trends 1989-1996: Vox Sang. 1997; 73(2):70-3. 5. Soldan K,Davison K, Dow B (2005) Estimates of the frequency of HBV, HCV and HIV infectious donations entering the blood supply in the United Kingdom, 1996 to 2003. Eurosurveillance 10:9–10. 6. Piyush A.Patel, Sangeeta P.Patel, H.V.Oza. Seroprevalence of Transfusion Transmitted Infections (TTIs) in Blood Donors at Western Ahmedabad – A Secondary Care Hospital Based Study: Int J Biol Med Res. 2012; 3(2):1806-1810 7. Rose D, Sudarsanam A, Padankatti T et al. Increasing prevalence of HIV antibody among blood donors monitored over 9 years in one blood bank. Indian J Med Res. 1998 Aug; 108:42-4. 8. Deshpande R H and Kolhe Shirish M. Distribution of Blood Groups in Blood Donors at Smt. Saraswati Karad Blood Bank, Latur. Journal of Medical Education and Research, Vol. 2, No.2, July-Dec 2012. 9. Dongdem JT, Kampo S, Soyiri IN et all Prevalence of hepatitis B virus infection among blood donors at the Tamale Teaching Hospital, Ghana (2009). [PubMed - indexed for MEDLINE, BMC Res Notes. 2012 Feb 22;5:115 10. Neeraj Shah, Anupa Mishra, Dhaval Chauhan, et all. Study on effectiveness of transfusion program in thalassemia major patients receiving multiple blood transfusions at a transfusion centre in Western India, Asian J Transfus Sci. Jul 2010; 4(2): 94–98. 11. Sonia Garg, Dr Mathur, DK Garg at jodhpur 5 year study, Comparsion of HIV,HBV,HCV,SYPHILIS In replacement and voluntary donor in western India. Year: 2001| Volume: 44 | Issue: 4|Page: 409-12. 12. Singh B, Kataria SP, Gupta R, Infectious markers in blood donors of East Delhi. Prevalence and trends, Indian Journal of Pathology and Microbiology [2004, 47(4):477-479]. 13. Abel Girma Ayele and Solomon Gebre-Selassie. Prevalence and Risk Factors of Hepatitis B and Hepatitis C Virus Infections among Patients with Chronic Liver Diseases in Public Hospitals in Addis Ababa, Ethiopia; ISRN Tropical MedicineVolume 2013 (2013), Article ID 563821, 7 pages. Chandrasekaran S, Palaniappan N, Krishnan V, et al. Relative prevalence of hepatitis B viral markers and hepatitis C virus antibodies (anti HCV) in Madurai, south India; Indian J Med Sci. 2000 Jul;54(7):270-3. 14. Emanuele Calabrese, Eleonora Gonnelli, Silvia Ambu et al. Role of hepatitis B virus infection in Alcoholic patients : La Ricerca clin. Lab.16, 543, 1986. 15. Le Viet, Nguyen Thi Ngoc Lan, Phung Xuan et al ; Prevalence of hepatitis B and hepatitis C virus infections in potential blood donors in rural Vietnam: Indian J Med Res 136, July 2012, pp 74-81. 16. Omar, Noor, Mohamood et al: The infection with HBV and HCV and their relationship to ABO blood group among blood donors: J Fac Med Baghdad 2012 Vol.54, No.1. 17. M. Saeed Anwar, G. Mujtaba Siddiqi, Salma Haq et al: Association of blood group types to hepatitis b and hepatitis c virus infection: D:/Biomedica Vol.27, Jan. – Jun. 2011/Bio-12.Doc P. 57 – 61 (KC) IV.
S M Chavan Swati, S R Tankhiwale Suresh, S G Damke Sachin
Aim and Objectives: To assess learning gain and learning preference of students based on PowerPoint versus chalkboard for department of Microbiology. Material and Methods: Students were divided into two groups of 80 each. Two didatic lectures were delivered. In lecture 1, Group A was taught on PowerPoint, while the group B on chalkboard on the same topic. In lecture 2, Groups were interchanged. Learning gain of the student was assessed from the pre test and post test. Result: In lecture 1, mean absolute learning gain score for group A was 42.1 and group B 45.7. Average normalized gain (g) for group A was 49.6% and group B 54.88%. Impact of students pass in group A was 73.77% versus 66.19% for group B. In lecture 2, mean absolute learning gain score for group A was 57.8 and group B 26.4. Average normalized gain (g) for group A was 64.10% and group B 27.56% .Impact of students pass in group A was significantly higher than group B, 79.63% versus 15.07 %. Students’ preference for PowerPoint was 70% and 78% versus 23% and 14% for chalkboard, in lecture 1and2 respectively. Conclusion: Difference in learning gain of student for simple topic was of no significance for PowerPoint and chalkboard. Learning gain of student for complex topic was significantly more for chalkboard than PowerPoint. Student’s preference for learning is by PowerPoint.
1. PowerPoint or chalk and talk: Perceptions of medical students versus dental students in a medical college in India, Vikas Seth, Prerna Upadhyaya, Mushtaq Ahmad, Vijat Moghe, Advances in Medical Education and Practice 2010:1 Page 11-16. 2. Comparison of the impact of PowerPoint and chalkboard in undergraduate medical teaching: An evidence based study: Sultan Ayoub Meo, Shaikh Shahabuddin, Abeer A. Al Masri, Shaikh Mujeeb Ahmed, Mansoor Aqil, Muhammad Akmal Anwer and Abdul Majeed Al-Drees, Journal of the College of Physicians and Surgeons Pakistan 2013, Vol. 23 (1): Page 47-50 3. Comparison of the Efficacy of Different Teaching Tools in First Year Medical Students: Dr. Ravi B. Thaker, Dr. Kapil J. Govani, Dr. Rajesh M. Desai ,International Journal of Scientific Research, Volume : 2 , Issue : 7 , July 2013, Page 366-367. 4. Impact comparison of Chalkboard and Powerpoint Teaching in Medical Education; Dr. Kusum Lata Gaur, Dr. Afifa Zafer, Dr. Dilip Raj, International Journal of Information Technology and Computer Science ( IJITCS ) Volume No : 12 Issue No : 3, Page 81-86. 5. To Slideware Or Not To Slideware: Students’ Experiences With Powerpoint Vs. Lecture Nicole Amare, J. Technical Writing And Communication, 2006, Vol. 36(3) Page 297-308. 6. Nitin Gaikwad ,Suresh Tankhiwale, Crossword puzzle-A self learning tool in pharmacology, Perspective Medicine Education, 2012 (1), Page 237-248 7. Hake RR, Interactive-engagement vs traditional methods: A six thousand student’s survey of mechanics test data for introductory physics course, American Journal of Physics, 1998, 66: Page 64-74. 8. Perception of post graduate students on teaching aids, Florence Lalvarmawi, Sarada Ningthoujam, Uttam, Naithok, Manoj Mishra; Journal of Medical Society, Jan-April 2013, Volume 27, Issue 1, Page 36-38. 9. Shall We Teach Anatomy with Chalk and Board or PowerPoint Presentations? - An Analysis of Indian Students’ Perspectives and Performance, Rokade S A, Bahetee B H, Scholars Journal of Applied Medical Sciences (SJAMS), 2013; 1(6), Page 837-842 10. Students’ Preferred Teaching Techniques for Biochemistry in Biomedicine and Medicine Courses, Ethel L. B. Novelli and Ana Ange´ lica H. Fernandes, Biochemistry and molecular biology education 2007,volume 35, no. 4, Page 263–266.
Pervez Ahmed, Apurva Arora, Narayanan Cunnigaiper Dhanasekhar
Introduction: Non hodgkins lymphoma (NHL) of soft tissue and particularly the lower trunk are rare. We report a 67 year old female with a mass and pain in the left buttock. Computerized tomography (CT) and Magnetic resonance imaging (MRI) revealed it as a soft tissue mass infiltrating left gluteus minimus and involving the left iliac bone. Fine needle aspiration cytology (FNAC) was inconclusive. Incision biopsy revealed small cell non hodgkins lymphoma of B variety with CD45+ and high Ki67 activity. It is a systemic disease which is chemotherapy and radiotherapy sensitive.
1. Travis WD, Banks PM and Reiman HM: Primary extranodal soft tissue lymphoma of the extremities. Am J Surg Pathol 11: 359-366, 1987. 2. Komaki R, Cox J, Hansen R, Gunn W and Greenberg M: Malignant lymphoma of the uterus and cervix. Cancer 54: 1699 1704, 1984. 3. Hariprasad R, Kumar L, Bhatla DM, Kukreja M and Papaiah S: Primary uterine lymphoma: Report of 2 cases and review of literature. Am J Obstet Gynecol 195: 308-313, 2006. 4. Kolve ME, Fischbach W and Wilhelm M: Primary gastric non-Hodgkin's lymphoma: requirements for diagnosis and staging. Recent Results Cancer Res 156: 63-68, 2000. 5. Laskar S, Mohindra P, Gupta S, Shet T and Muckaden MA: Non-Hodgkin lymphoma of the Waldeyer's ring: clinicopath¬ologic and therapeutic issues. Leuk Lymphoma 49: 2263-2271, 2008. 6. King AD, Lei KI and Ahuja AT: MRI of neck nodes in non-Hodgkin's lymphoma of the head and neck. Br J Radiol 77: 111-115, 2004 7. Sasai K, Yamabe H, Tsutsui K, Dodo Y, Ishigaki T, Shibamoto Y and Hiraoka M: Primary testicular non-Hodgkin's lymphoma: a clinical study and review of the literature. Am J Clin Oncol 20: 59-62, 1997. 8. Ray S, Mallick MG, Pal PB, Choudhury MK, Bandopadhyay A and Guha D: Extranodal non-Hodgkin's lymphoma presenting as an ovarian mass. Indian J Pathol Microbiol 51: 528-530, 2008. 9. Camilleri-Broët S, Martin A, Moreau A, Angonin R, Hénin D, Gontier M Rousselet MC, Caulet-Maugendre S, Cuillière P, Lefrancq T, et al: Primary central nervous system lymphomas in 72 immunocompetent patients: pathologic findings and clinical correlations. Am J Clin Pathol 110: 607-612, 1998. 10. Colović M, Matić S, Kryeziu E, Tomin D, Colović N and Atkinson HD: Outcomes of primary thyroid non-Hodgkin's lymphoma: a series of nine consecutive cases. Med Oncol 24: 203-208, 2007. 11. Hinoshita E, Tashiro H, Takahashi I I, Onohara T, Nishizaki T, Matsusaka T, Wakasugi K, Ishikawa T, Kume K, Yamamoto I and Hirota Y: Primary non-Hodgkin's lymphoma of the breast: a report of two cases. Breast Cancer 5: 309-312, 1998. 12. Pant V, Jambhekar NA, Madur B, Shet TM, Agarwal M, Puri A, Gujral S, Banavali M and Arora B: Anaplastic large cell lymphoma (ALCL) presenting as primary bone and soft tissue sarcoma - a study of 12 cases. Indian J Pathol Microbiol 50: 303-307, 2007. 13. Theander E, Henriksson G, Ljungberg O, Mandl T, Manthorpe R and Jacobsson LT: Lymphoma and other malignancies in primary Sjögren's syndrome: a cohort study on cancer incidence and lymphoma predictors. Ann Rheum Dis 65: 796-803, 2006. 14. Lai YC, Chiou HJ, Wu HT, Chou YH, Wang HK and Chen PC: Ultrasonographic and MR findings of alveolar soft part sarcoma. J Chin Med Assoc 72: 336-339, 2009. 15. Kransdorf MJ, Jelinek JS and Moser RP Jr: Imaging of soft tissue tumors. Radiol Clin North Am 31: 359-372, 1993.
Vitus D’silva, K Shreedhara Avabratha
Introduction: Febrile seizureis the leading cause of convulsive disorder in paediatric age group with incidence varying from 2-14 %.Iron deficiency anaemia is one of the risk factors known to be associated with febrile seizures. The incidence of iron deficiency anemia among children 6 to 59 months in India is79% and the age for peak incidence of febrile seizure is 14 to18 months, which overlaps with that of iron deficiency anemia which is 6 to 24 months. Iron deficiency is the commonest micronutrient deficiency causing anemia and is a preventable and treatable condition. Objectives: To find the prevalence of low hemoglobin in children presenting with febrile seizures and its correlation with the type of febrile seizures. Results: Sixty four children diagnosed with febrile seizures over a period of 1 yearin a tertiary care hospital were included, out of which 39 were males and 25 females. The prevalence of Simple febrile seizures was 43 (67.2%) and Complex febrile seizures 21 (32.8%).Complex febrile seizure was significantly higher in males compared to females. The prevalence of anemia was 42 % and among the total 27 children with anemia 19 (70.4%) had simple febrile seizures and 8 (29.6%) had complex febrile seizures. However these findings were not statistically significant, probably because the study involved small sample size and was conducted in a tertiary care hospital. Conclusion: This study concludes that there is no statistically significant relation between low hemoglobin, febrile seizures and type of febrile seizures. Further studies are needed to correlate anemia, febrile seizures and type of febrile seizures and establish possible role of anemia as a risk factor.
1. Verity CM, Butler NR, Golding J. Febrile convulsions in a national cohort followed up from birth. Prevalence and recurrence in the first five years of life. Br Med J (Clin Res Ed). 1985; 290(6478):1307–1310. 2. Johnston MV. Seizures in childhood: Febrile seizures. In: Behrman RE, Kliegman RM, Jenson HB, eds. Nelson’s Textbook of Pediatrics. Pennsylvania: Saunders; 2004. p. 1994-1995. 3. Commission on Epidemiology and Prognosis, International League against Epilepsy. Guidelines for epidemiologic studies on epilepsy. Epilepsia. 1993; 34:592–596. 4. AzharDaoud. Febrile convulsion: Review and update. Jou of Ped Neurology. 2004; 2(1):9-14. 5. John P Greer,John Foerster, John N Lukens. In: Wintrobe`s clinical hematology.11thed: Lipincott Williamsand Wilkins publisher; 2003. 6. U.S. Preventive Services Task Force. Screening for iron deficiency anemia – including iron prophylaxis. In: Guide to Clinical Preventive Services. Baltimore: Williams and Wilkins; 1996.p. 231–46. 7. Paradeeauvichayapat et al. J Med AssocaThai. 2004;87(8):970-31. 8. Mahoney DH. Iron-Deficiency Anaemia in children. [Cited 2009 May]. Available from: http://www.UptoDate.com. 9. Pisacane A, Sansone R, Impagliazzo N, Coppola A, Rolando P, D'Apuzzo A, et al. Iron deficiency anaemia and febrile convulsions: case-control study in children under 2 years. BMJ.1996; 313(7053):343. 10. Ohls RK, Christensen RD. Iron-Deficiency Anaemia. In: Nelson Text book of Pediatrics. Philadelphia: Saunders; 2008. p. 2014–7. 11. Ambruso DR, Hays T, Goldenberg NA. Iron Deficiency Anaemia. In: Current Diagnosis and Treatment.Paediatrics. Denver USA: McGraw Hill; 2009. P.810–11. 12. Bidabadi E, Mashouf M. Association between iron deficiency anemia and first febrile convulsion: A casecontrol study. Seizure.2009; 18(5):347–51. 13. Naveed-ur-Rehman, Billoo AG. Association between iron deficiency anemia and febrile seizures. J Coll Physicians Surg Pak. 2005; 15(6):338–40. 14. Kobrinsky NL, Yager JY, Cheang MS, Yatscoff RW, Tenenbein M. Does iron deficiency raise the seizure threshold. J Child Neurol. 1995; 10(2):105–9. 15. Abbaskhanian A, Vahidshahi k, Parvinnejad N. The association between iron deficiency and the first episode of febrile seizure. J BabolUni Med Sci. 2009; 11(3):32–6. 16. Derakhshanfar H, Abaskhanian A, Alimohammadi H, ModanlooKordi M. Association between iron deficiency anemiaand febrile seizure in children. Med GlasLjekkomoreZenicko-dobojkantona. 2012; 9(2):239-242. 17. Kumari PL, Nair MK, Nair SM, Kailas L, Geetha S. Iron deficiency as a risk factor for simple febrile seizures-a case control study. Indian Pediatr. 2012; 49(1):17–9.
Sahadev C K, M J Bharath, Praveen Kumar M R, Sandeep R, Rosamma George
The indications for surgical Endodontics have become fewer with the advancements in non surgical endodontic techniques and material. However, there are some cases, which definitely required an apical surgery. The success of apical surgery depends on regeneration of the periapical tissues and filling of the osseous defects. For this purpose, different grafts are used. One such allogenous bone graft is the bioresorbable, bioactive hydroxyapatite: Biograft-HA. The effects of this graft on bone regeneration are evaluated in this study. This graft was used in three cases with osseous defects by a simple procedure. The cases with three months, six months follow up are presented here.
1. Tobon SI, Arismendi JA, Marin ML, Mesa AL, Valencia JA. Comparison between a conventional technique and two bone regeneration techniques in periradicular surgery. Int Endod J 2002; 35:635–41. 2. Kim S, Kratchman S. Modern endodontic surgery concepts and practice: a review. J Endod 2006; 32:601-623. 3. Bernard GN Healing and repair of osseous defects. Dent Clin of North Amer1991;35 4. Derine OR, Curtis et al. Mandibular augmentation with Hydroxyapatite. J. Prosth Dent 1986; 55:383-367. 5. Dennison H and Mangano C. et al. Hydroxy implants. Pican Nuova.1985;17 6. Kandaswamy D, Ramchandran G. Bone regeneration using hydroxyapatite crystals for periapical lesions. J Endod 2000; 12:51-54. 7. Kenny EG,et al. The use of porus hydroxyapatite implant in periodontal defects. J.Periodontal 1985;50:82-88 8. Tobon SI, Arismendi JA, Marin ML, Mesa AL, Valencia JA. Comparison between a conventional technique and two bone regeneration techniques in periradicular surgery. Int Endod J 2002; 35:635–41. 9. Pecora G, Baek SH, Rethnam S, Kim S. Barrier membrane techniques in endodontic surgery. Dent Clin North Am 1997; 41:1–16. 10. European Society of Endodontology. Quality guidelines for endodontic treatment: consensus report of the European Society of Endodontology. Int Endod J 2006; 39:921-930. 11. Rud J, Andreasen JO, Moller-Jensen JE. A multivariate analysis of the influence of various factors upon healing after endodontic surgery. Int J Oral Surg 1972;1:258–71.
Aim: Estimation of the age in living individual by using the third molar space as a criteria was attempted and also the female preponderance in the development of third molar space was verified. Materials and Methods: 151 school students between the age group of 14 and 17 years were selected based on the availability of their birth certificates. Their oral cavity was examined for the development of third molar space behind second permanent molar. Observations and Results: It has been observed that third molar space developed in the students between the age group of 14 and 17 years in various percentages and female preponderance is present in 14 and15 year group and male preponderance is Present In 16 and17 Year Age Group of Students.
1. Ajay kumar, personal identity, Text book of Forensic Medicine, 1st edition, Delhi, Avichal publishing company, 2011 ; 60. 2. VV Pillay, Identification, Text book of Forensic Medicine and Toxicology, 16 th edition, Hyderabad /New Delhi, Paras Medical Publisher, 2011 ;61 3. Sushil B Naik, Reliability of Third Molar Development for Age Estimation by Radiographic Examination ( Demirjian’s Method), Journal of Clinical and Diagnostic Research, May 2014 ; 8 (5) 4. Dr K.S. Narayan Reddy and O.P. Murty, Identification, The Essentials of Forensic Medicine and Toxicology, 33rd edition, New Delhi / London / Philadelphia / Panama, The Health Sciences Publishers, 2014 ; 71. 5. Rajesh Bardale, Identification, Principles of Forensic Medicine and Toxicology, 1st edition, New Delhi /London / Panama city, Jaypee Brothers Medical Publishers (P) L td, 2011, 56 6. Apurba Nandy, Identification of an individual, Principles of Forensic Medicine, 2nd edition, Kolkata, New Central Book Agency (P) Ltd, 2000 ;61. 7. P V Guharaj, M R Chandran, Personal Identity, Forensic Medicine, 2nd edition, Chennai, Orient Longman Pvt Ltd, 2003, 35.
Suneeth P Lazarus
Hyperglycaemic response in diabetic patients can be well controlled with adequate depth in general anaesthesia and it can be totally eliminated in the regional anaesthesia. In group I [general anaesthesia] the hyperglycaemic response was not clinically significant. The haemodynamic response measured as rise in heart rate and blood pressure were also not clinically significant. Where as in group II [Regional Anaesthesia] the differentiation of sympathetic nervous system eliminates hyperglycemic response.
1. Chernow B, Higgins T, The endocrine and metabolic responses to the stress of anaesthesia and surgery – Scientific foundations of Anaesthesia: Pg -354 2. Medical clinics North America1988;Vol 72:No:6 ;P1535-36 3. Walsh E S, Paterson J L, O’RiodanJ B et al. Effect of high dose fentanyl anaesthesia on the metabolic and endocrine response tocardiac surgery.BJA1981;53:155-164 4. Houghton A, Hyckey J B Ross S A, Dupre J. Glucose tolerance during anaesthesia and surgery. Comparison of general and extradural anaesthesia BJA1978;50:495 5. Bromage P R ,Shibata H R, Willoughby H W. Influence of prolonged epidural blockage of bloodsugar and cortisol responses to operations upon the upper part of abdomen and thorax1971; 132: 1051 6. Brandt M R, Kehlet H, Blinder C, Hagen C, Mc Neilly A S, Effect of epidural analgesia on the glycoregulatory endocrine response to surgery. Clin Endocrinol1976;(Oxf)5:107 7. Shende D, Suman Sharma, Soma Kaushik. Effects of spinalanaesthesia on metabolic process Ind J of Med .Sc 1997; 197-200.
Ajay K Boralkar, Ansari Mohammed Abdul Muqtadir, Pankaj S Vairagad
Present study describes the various types of reconstructive procedures undertaken and its outcome in the Orofacial cancer patients at the tertiary care hospital in Aurangabad district of Maharashtra during the study period. Total of 40 cases with squamous cell carcinoma were studied. The procedures done were Split Thickness Skin Graft in 2 cases, Naso-labial flaps in 12 cases, Myocutaneous flaps in 23 cases and free flaps in 3 cases. Pectoralis Major Myocutaneous (PMMC) Flap repair was the most common type of reconstructive procedure employed and it was done in 17 cases. On analysis of complications in PMMC Flap repair, we found partial Flap necrosis in one case, Flap Dehiscence in 2 cases, Infection in 3 cases, Seroma in one case, orocutaneous fistula in 2 cases, restricted jaw movement in 3 cases and Donor site morbidity in one case. Overall outcome analysis in PMMC repair showed good functional outcome in the form of oral diet in 85.5% cases, good speech intelligibility as well as mouth opening in 82.6% patients and good aesthetic outcome in 86.95% patients. Overall functional and aesthetic outcome was found to be best in patients with Free Flap reconstruction and Split Thickness Skin Graft.
1. Liaqat B, Ehsan A, Baig AM, Bukhari SG. Orofacial reconstruction with local flaps at AFID. J Ayub Med Coll Abbottabad. 2010 Oct-Dec; 22(4):131-4. 2. George RK, Krishnamurthy A. Microsurgical free flaps: Controversies in maxillofacial reconstruction. Ann Maxillofac Surg 2013;3:72-9 3. Beausang ES, Ang EE, Lipa JE, Irish JC, Brown DH, Gullane PJ, Neligan PC (2003) Microvascular free tissue transfer in elderly patients: the Toronto experience. Head Neck 25:549–553 4. Haughey BH, Wilson E, Kluwe L, Piccirillo J, Fredrickson J, Sessions D, Spector G (2001) Free flap reconstruction of the head and neck: analysis of 241 cases. Otolaryngol Head Neck Surg 125:10–17
Sivakkumar Shanmugasundaram, Premamalini Thayanidhi
Introduction: HIV counselling and disclosure of status play a vital role in care, treatment and support of retropositive patients. This ensures that people have the right to know their HIV status with confidentiality, and benefit from increased access to antiretroviral treatment. The study was conducted in a Non Government Organization among 61 retropositive patients. It was observed that for majority of the patients (52.5%) pre and post test counselling was not done, and also written consent was not obtained from them (55.7%) before HIV testing, at both government hosiptals, private hospitals and laboratories. This kind of practice should be curtailed. Qualified medical practitioners should be trained in this regard which will motivate people to come forward for testing voluntarily.
1. Jorjoran Shushtari Z, Sajjadi H, Forouzan AS, Salimi Y, Dejman M. Disclosure of HIV Status and Social Support Among People Living With HIV. Iran Red Crescent Med J. 2014 Aug; 16(8):e11856. 2. Chen Z, Branson B, Ballenger A, Peterman TA. Risk assessment to improve targeting of HIV counseling and testing services for STD clinic patients. Sex Transm Dis. 1998;25(10):539–43 3. Dr K.S. Narayan Reddy and O.P. Murty, Death and its cause, The Essentials of Forensic Medicine and Toxicology, 33rd edition, New Delhi / London / Philadelphia / Panama, The Health Sciences Publishers, 2014 ; 149 4. Communicable disease control manual. BC centre for disease control. Chapter 5- Sexually transmitted infections.HIV Pre and Post test Guidelines. September 2011 5. Khalsa AM. Preventive counseling, screening, and therapy for the patient with newly diagnosed HIV infection. Am Fam Physician. 2006; 73(2):271–80. 6. Margolis AD, Wolitski RJ, Parsons JT, Gomez CA. Are healthcare providers talking to HIV-seropositive patients about safer sex? AIDS. 2001;15(17):2335–7 7. Golin CE, Smith SR, Reif S. Adherence counseling practices of generalist and specialist physicians caring for people living with HIV/AIDS in North Carolina. J Gen Intern Med. 2004; 19(1):16–27. 8. Obermeyer CM, Osborn M. The utilization of testing and counseling for HIV: a review of the social and behavioral evidence. Am J Public Health. 2007; 97(10):1762–74. 9. Metsch LR, Pereyra M, del Rio C, Gardner L, Duffus WA, Dickinson G, et al. Delivery of HIV prevention counseling by physicians at HIV medical care settings in 4 US cities. Am J Public Health.2004;94(7):1186–92 10. Kohler HP, Behrman JR, Watkins SC. Social networks and HIV/AIDs risk perceptions. Demography.2007;44(1):1–33. 11. Thato S, Charron-Prochownik D, Dorn LD, Albrecht SA, Stone CA. Predictors of condom use among adolescent Thai vocational students. J Nurs Scholarsh. 2003; 35(2):157–63. 12. Amar Shireesh Kanekar. HIV/AIDS Counseling Skills and Strategies: Can Testing and Counseling Curb the Epidemic. Int J Prev Med. 2011 Jan-Mar; 2(1): 10–14. 13. Technical guidance on HIV counseling. Center for Disease Control and Prevention. MMWR Recomm Rep. 1993; 42(RR-2):11–7.
S T Balamurali, S Sivakkumar
Background: Raised Blood pressure is an important modifiable risk factor for cardiovascular diseases, cerebrovascular diseases, Pheripheral vascular diseases etc. The prescribing pattern of drugs used for treating hypertension changes from time to time in response to changes in recommended guidelines and innovations of new drugs. Therefore it is necessary to find out the prescribing pattern of anti-hypertensive drugs by medical practitioners in current medical practice. Aims and Objectives: To evaluate the recent trends in prescribing pattern of anti-hypertensive drugs, the different combinations being prescribed and the commonly prescribed dosage of individual drugs. Methodology: This study was carried out for a 3 months’ time period. The patients selected were in the age group of 25 to 70 years, diagnosed to have mild to severe systemic hypertension and on treatment, who were attending the OPD of General Medicine, without any other complications or co-morbid diseases. Result and Conclusion: The most common anti-hypertensive agents used were CA channel blockers 75 % (n=90) followed by β blockers (BBS) 30% (n=36), Angiotensin receptor blockers 25% (n=30), Angiotensin converting enzyme inhibitors 15 % (n=18) and Diuretics 15 % (n=18). Among those, most commonly prescribed drug for Monotherapy was calcium channel blockers (55%).Of the respondents 52.5 % were receiving at least 2 anti-hypertensive agents. Among them the most common agents used in combination were CA channel blockers + β blockers (40%) followed by AR blockers + CA channel blockers (20 %) and Diuretics + AR blockers (17.5 %). CA channel blockers were the most commonly used drug for combination therapy.
1. Campbell NR, Brant R, Johansen H, Walker RL, Wielgosz A, Onysko J et al. Increases in antihypertensive prescriptions and reductions in cardiovascular events in Canada. Hypertension. 2009 Feb; 53(2):128-34. 2. World Health Organization - The world health report 2002 –reducing risks, promoting healthy life. Geneva, Switzerland. 3. Turnbull F. Effects of different blood-pressure-lowering regimens on major cardiovascular events: results of prospectively-designed overviews of randomized trials. Lancet. 2003 Nov 8; 362(9395):1527-35. 4. Collins R, Peto R, MacMahon S, Hebert P, Fiebach NH, Eberlein KA et al. Blood pressure, stroke and coronary heart disease. Part 2, Short-term reductions in blood pressure: overview of randomized drug trials n their epidemiological context. Lancet. 1990 Apr 7;335(8693):827-38. 5. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr et al. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure. Hypertension. 2003 Dec; 42(6):1206-52. 6. Lewington S, Clarke R, Qizibash N, Peto R, Collins R. Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet. 2002 Dec 14; 360(9349):1903-13. 7. Levy D, Larson MG, Vasan RS, Kannel WB, Ho KK. The progression from hypertension to congestive heart failure. JAMA. 1996 May 22-29;275(20):1557-62. 8. Sipahi I, Tuzcu EM, Schoenhagen P, Wolski KE, Nicholls SJ, Balog C et al. Effects of normal, pre-hypertensive and hypertensive blood pressure levels on progression of coronary atherosclerosis. J Am CollCardiol. 2006 Aug 15; 48(4):833-8. 9. Daniel AC, Veiga EV. Factors that interfere the medication compliance in hypertensive patients. Einstein (Sao Paulo). 2013 Sep; 11(3):331-7. 10. Chan WK, Chung TS, Lau BS, Law HT, Yeung AK, Wong Ch. Hongkong Primary Care Foundation. Management of hypertension by private doctors in Hong Kong. Hong Kong Med J. 2006 Apr; 12(2):115-8. 11. WHO Collaborating Centre for Drug Statistics Methodology. Complete ATC index 2012. Oslo, NO. Norwegian Instituite of Public Health. 2012. 12. Abaci A, Kozan O, Oguz A, Sahin M, Deger N, Senocak H et al. Prescribing pattern of antihypertensive drugs in primary care units in Turkey: results from the TURKSAHA study. Eur J ClinPharmacol. 2007 Apr; 63(4):397-402. 13. Mohan V, Shanthirani S, Deepa R, Premalatha G, Sastry NG, Saroja R. Chennai Urban Population Study (CUPS No. 4). Intra-urban differences in the prevalence of the metabolic syndrome in southern India. Diabet Med. 2001 Apr;18(4):280-7. 14. Tiwari H, Kumar A, Kulkarni SK. Prescription monitoring of anti-hypertensive drug utilization at the Punjab University Health Centre in India. Singapore Med J. 2004 Mar; 45(3):117-20.