iosr-JDMS   Volume-13 ~ Issue-9 ~ September-2014

Abstract: Spleen preserving distal pancreatectomy is a well accepted procedure for benign tumors of distal pancreas due to its safety and feasibility. Currently, there are not many reports in the literature to validate feasibility and safety of the procedure in trauma. Here in we report a case of distal pancreatic trauma where we managed to preserve the spleen during distal pancreatectomy in an emergency procedure

[1]. Holdsworth RJ, Irving AD, Cuscheri A. Post splenectomy sepsis and its mortality rate: actual versus perceived. BrJ Surg. 1991;78:1031-8 (PubMed).
[2]. Krige JEJ, Beningfield SJ, Nicol AJ, Navsaria P. The management of complex pancreatic injuries. SAJS, Vol. 43, No. 3, August 2005.
[3]. Olah A, Isselkutz A, Haulik L, Makey R. Pancreatic transection from blunt abdominal trauma: early versus delayed diagnosis and surgical management. Dig. Surg 2003;408-414.
[4]. Wilson RH, Moorehead RJ. Current management of trauma to the pancreas. BrJ Surg 1991;78:1196-1202

[5]. Frey CF, Wardell JW. Injuries to the pancreas. In Trede M, Carter DC, eds. Surgery of the Pancreas. Edinburgh: Churchill Livingstone, 1993:565-589.

Abstract: Diabetes mellitus is a complex metabolic disorder resulting from either insulin deficiency or insulin dysfunction. Based on the recent advances and involvement of oxidative stress in complicating diabetes mellitus, efforts are on to find suitable antidiabetic and antioxidant therapy. Medicinal plants are being looked upon once again for the treatment of diabetes. Neem, Azadirachta Indica is a widely grown plant in the Indian subcontinent. It has been found to have various medicinal properties, so this study was carried out. Rats were used as animal models to study the antidiabetic effects of neem. Diabetes was induced in rats by alloxan monohydrate. The assessment was done by fasting blood glucose levels and oral glucose tolerance test. The results of the study indicate that neem oil has got the potential to reduce blood glucose levels within a short period of time and also it has potential to improve the glucose tolerance after a treatment period of 4 weeks. Azadirachta Indica may have beneficial effects in diabetes mellitus and holds the scope of new generation of antidiabetic drug.

Key words: Diabetes Mellitus, Neem, Azadirachta Indica, Alloxan, Hypoglycemic, Antidiabetic

[1]. Kasper DL, Braunwald E, Fauci AS, Hauser SL, Longo DL, Jameson JL ,Editors. Harrison Principles Of Internal Medicine Vol 2 16th Edn Newyork Mc Graw Hill 2005 2152-79.
[2]. Park K. Parks Textbook Of Preventive And Social Medicine 17th Ed., Jabalpur Banarasidas Bhanot ,2002 P294-98.
[3]. American Diabetic Association. Diagnosis and classification of diabetes mellitus,Dabetes Care 2005;28 Suppl 1 :S37-S42
[4]. Grollmann A .Pharmacology and therapeutics ,6th ed., Philadelphia, lea and febiger ,1965,p.901-17.
[5]. Evans JL ,Goldfine ID ,Maddux BA Grodsky GM .Are Oxidative Stress Activated Signaling Pathways Mediators Of Insulin Resistance And Beta Cell Dysfunction,Diabetes 2003;52:1-8.
[6]. Elizabeth MW. Major Herbs Of Ayurveda ,1st Edn London Churchill Livingstone 2002 P56-63.
[7]. Yeh GY ,Kaptchuk TJ ,Eisenburg DM ,Philips RS .Systematic review of herbs and dietry supplements for glycemic control in diabetes ,2003;26:1277-94

Abstract: World Health Organisation defines perimenopause or menopausal transition as the period 2-8 years preceding menopause and 1 year after the final menses. It is the interval from the begining of declining ovarian function to the final ovarian failure. The age of onset & duration of this perimenopausal period can vary greatly. It usually starts in a woman's 40s, but can start in the late 30s as well. It lasts up until menopause and also includes the first year after menopause. However, the idea that any type of irregular bleeding during the perimenopausal period probably is due to menopause is a common misconception. Hence any woman complaining of abnormal bleeding must not be left alone.

[1]. Royal College of Obstetricians and Gynaecology. National evidence-based guidelines. The management of menorrhagia in secondary care. London, Engl: Royal College of Obstetricians and Gynaecology; 1999
[2]. Derzko CM. Perimenopausal dysfunctional uterine bleeding: physiology and management. Ottawa, Ont: Society of Obstetricians and Gynaecologists of Canada; 1997.
[3]. Joseph C Gambone, Michael S Broder et al. Abnormal Uterine Bleeding During the Reproductive Years — Terminology and Treatment.
[4]. Steven R Goldstein. Menorrhagia and abnormal bleeding before the menopause. February 2004; 18( 1): 59-69.

Abstract: Background: The elderly are one of the most vulnerable and high risk groups in terms of health and their health seeking behavior is crucial in any society. Objectives: The study aims to assess the morbidity profile among the elderly population aged 60 years and above. Material and Methods: A community based cross-sectional study was done in Visakhapatnam district. Rural & urban areas were selected by means of simple random sampling. 17,415 population was screened from 3,383 households in both rural and urban areas to identify 1200 elderly aged 60 and above were examined clinically with pretested questionnaire. Results: Among the elderly population aged 60 years and above, 64% have morbidity. Diseases of Musculoskeletal System (39%) followed by diseases of Circulatory system (21%) and diseases of Eye and adnexa (20%) were most commonly seen among study population. Joint pains (41%), defective vision (34%), polyuria (12%) and defective hearing (7%) were most common presenting complaints. The most common history of previous illness was hypertension (12%) and diabetes mellitus (6%) in both rural and urban areas. 40% of elderly individuals presented with Anemia. 25% of the study population has more than one disease. Conclusion: The prevalence of morbidity among elderly aged 60 years and above was 64%. 25% of the study population has more than one disease. Hence special clinics for elderly need to be organized and integrated services should be provided. status and their health care-seeking behavior is crucial in any society

Key-Words: Elderly, Morbidity profile, Rural areas, Urban areas

[1]. World Population Aging 2007. Online 2007 [Cited 2012 July 15]. Available from URL: http://www.un.org/esa/population/unpop.htm.
[2]. UN Report on Current Status of the Social Situation, Well-Being, Participation in Development and Rights of Older Persons Worldwide, Department of Economic and Social Affairs, United Nations. New York. 2011. Available from: URL: http://www.un.org/esa/socdev/ageing/ documents/publications/current-status-older-persons.pdf.
[3]. United Nations Population Fund (UNFPA) and Help Age International. Ageing in the Twenty-First Century: A Celebration and a Challenge, New York. 2012. Available from: URL: https://www.unfpa.org/public/home/ publications/pid/11584.
[4]. Dr. Indira Jai Prakash "Ageing in India" World health organization 1999.
[5]. World Health Organization. World Health Day – 7 April 2012; Theme: Ageing and health: Good health adds life to years. WHO. Available from: URL:http://www.who.int/world-health-day/en/

Abstract: Hyperhidrosis from cerebral and cerebellar infarction has been reported in stroke literature with paucity. The pathophysiological mechanism of the same has remained obscure. Contralateral excessive sweating was noted in a 70 years old male patient 48 hours after the stroke over forehead, face and upper trunk. Clinical and MRI studies revealed Cerebellar infarct and Ischemia in Vertebrobasilar Artery Territory. No associated hypothalamic dysfunction, Horner's Syndrome or any other autonomic dysfunction were noted in the case. The phenomenon of contralateral hyperhidrosis could be attributed to lesion of the sympathetic pathway that controls sweating. This putative pathway is close to the corticospinal tracts in the brainstem (Vertebrobasilar Artery Territory). Keywords: Hyperhidrosis, Cerebellar Infarct, Vertebrobasilar Artery Territory Ischemia

[1]. Appenzeller O. The autonomic nervous system. Amsterdam: Elsevier, 1982.
[2]. Labar DR, Mohr JP, Nichols FT, Tatemichi TK. Unilateral hyperhidrosis after cerebral infarction. Neurology 1988; 38: 1679-82.
[3]. Rousseaux M, Hurtevent JF, Benaim C, Cassim F. Late contralateral hyperhidrosis in lateral medullary infarct. American Heart Association Journal. Stroke. 1996; 27: 991-95.

[4]. Korpelainen JT, Sotaniemi KA, Myllyla VV. Asymmetric sweating in stroke: a prospective quantitative study of patients with hemispheral brain infarction. Neurology 1993; 43:1211-14.

[5]. Sakashita Y, Kakuta K, Kakuma K, Matsuda H. Unilateral persistent hyperhidrosis after ischemic stroke [in Japanese]. Rinsho Shinkeigaku.1992; 32:454-56.

Abstract: Middle aged old female with swelling in left knee suggestive of giant cell tumor was treated with excisional biopsy with curettage, high speed burr drilling, phenol cauterisation and cementing. Sample sent for histopathology was consistent with diagnosis of giant cell tumour. Patient started weight bearing from second postoperative day. No recurrence has been seen after 1 year of follow up. Keywords: Bone cement ,Giant cell tumour, proximal tibia, Excisional biopsy, phenol

[1]. Chapter 21: Benign/aggressive tumors of bone," in Campbell's Operative Orthopaedics, T. S. Canale, Ed., vol. 1, pp. 883–886, Mosby, New York, NY, USA, 11th edition, 2007.
[2]. Dahlin DC. Caldwell Lecture. Giant cell tumor of bone: Highlights of 407 cases. AJR Am J Roentgenol.1985, 144: 955-60.
[3]. Dahlin DC, Cupps RE, Johnson EWJr. Giant cell tumor: A study of 195 cases. Cancer. 1970, 25: 1061-70.
[4]. Campanacci M, Baldini N, Boriani S, Sudanese A.Giant cell tumor of bone. J Bone Joint Surg Am. 1987,69: 106-14.
[5]. Canale ST, Beaty JH: Benign/Aggressive tumors of bone. In Campbell's Operative Orthopaedics 11th edition. Philadelphia: Mosby;2007:883-886

Abstract: Introduction: Cone-beam computerized tomography (CBCT) is a medical image acquisition technique based on a cone-shaped X-ray beam centered on a two-dimensional (2D) detector. The source-detector system performs one rotation around the object producing a series of 2D images. The images are reconstructed in a three-dimensional (3D) data set using a modification of the original cone-beam algorithm developed by Feldkamp1 et al in 1984. This technique is widely used in different industrial and biomedical applications such as micro- CT. Among the first clinical applications were single photon emission computerized tomography (SPECT), angiography and image-guided radiotherapy. Dedicated cone-beam computerized tomography scanners for the oral and maxillofacial (OMF) region were pioneered in the late 1990s independently by Arai2 et al. in Japan.

[1]. Feldkamp LA, Davis LC, Kress JW. Practical cone-beam algorithm. J Opt Soc Am 1994: 1: 612–619.
[2]. Arai Y, Tammisalo E, Iwai K, Hashimoto K, Shinoda K. Development of a compact computed tomographic apparatus for dental use. Dentomaxillofac Radiol 1999: 28: 245–248.
[3]. Simon JHS. Incidence of periapical cysts in relation to the root canal. J Endod 1980;6:845– 8.
[4]. Kaffe I, Gratt BM. Variations in the radiographic interpretation of the periapical dental region. J Endod 1988;14:330.
[5]. Lofthag-Hansen S, Hummonen S, Gröndahl K, Gröndahl H-G. Limited cone-beam CT and intraoral radiography for the diagnosis of periapical pathology. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007;103:114 –9.

Abstract: Enuresis is an important problem among secondary school adolescents. It results in psychosocial disturbances. Knowledge ofits prevalence, types and associated factors willguide proper management.The objective of the study was to determine the prevalence, types and associated factors of enuresis among secondary school adolescents in Enugu. This cross sectional study was carried out in six secondary schools in Enugu town. Self-administered pre-tested questionnaire was used to collect information. Data was analyzed using descriptive statistics and chi square tests. 626 adolescents consisting 302 males and 324 females were studied. Overall prevalence of nocturnal enuresis was 15.82%. Of this, 3.7% also had diurnal enuresis. 33.3% had primary enuresis, while 66.7% had secondary enuresis. Gender had no significanteffect on this prevalence. The age range10-13 years had the highest prevalence of 17.6%. Emotional disturbance and family history of enuresis were significant predictors of enuresis.

Key Words: Adolescents, Enugu, Enuresis, Prevalence.

[1]. Samuel T Gontkovsky. Prevalence of enuresis in a community sample of children and adolescents referred for outpatient clinical psychological evaluation: Psychiatric comorbidities and association with intellectual functioning.Journal of child and adolescent mental health23 (1).2011, 53-58.
[2]. AttiaZein AT, Amr AS. Nocturnal enuresis at a Primary Health Care Setting: Analysis of 117 cases. Bahrain Medical Bulletin, 33( 2)June 2011.
[3]. Nappo S, Del Gado R, Chiozza ML, et al. Nocturnal enuresis in the adolescent: a neglected problem. BJU International, 90(9), 2002, 912–917.
[4]. Butler RJ. Annotation: night wetting in children: psychological aspects. J Child Psychol Psychiatry, 39, 1998, 453 – 63
[5]. Mohammad A, Mohsen D. Nocturnal Enuresis among School Children in Menofia Governorate, Egypt: a hidden problem. Journal of American Science, 8(1), 2012

Abstract: Haemostasis is a defence mechanism that protects vascular integrity, avoids blood loss, and maintains blood fluidity throughout the circulatory system. Per oral hematoma secondary to anticoagulation is a rare fatal condition. Haemorrhagic complications of warfarin therapy are well known.In any case, the most important concern is the prevention of bleeding complications by compiling a detailed clinical history, with adequate planning of treatment, and taking special care to avoid soft tissue damage during the dental treatment of such patients. Only occasional reports state sublingual and labial vestibule hematoma formation as a result of deficient coagulation. This particular case is very unique in that the patient was on warfarin for the past 3 years but did not develop any hematoma. However trauma by fall triggered the episode of sublingual and buccal vestibular hematoma in this patient. The patient was managed by temporarily stopping warfarin for 4 days and transfusing 2 units of fresh frozen plasma. Tab. Warfarin was restarted after 4 days on alternate days and INR dropped to 2. The sharp cusp of the mandibular tooth was smoothened to prevent ulcer development. The hematoma resolved and no new hematoma formation was observed for a period of 6 months.

Key Words: blood coagulation/physiology; blood coagulation disorders/complications; dental care, Haemostasis.

[1]. Medyan al-rousan.dental management of patients on warfarin therapy.Oral medicine/oral & maxillofacial surgery.Pakistan Oral & Dental Journal Vol 30, No. 1, (June 2010)

[2]. John E. Murphy. Clinical Pharmacokinetics.Ann K. Wittkowsky.Warfarin. American Society of Health-System Pharmacists, Inc..5th edition. 2012. p 351

[3]. Schulman S, Beyth RJ, Kearon C, et al. Hemorrhagic complications of anticoagulant treatment: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest 2008;133:257S-298S.

[4]. Beyth RJ. Hemorrhagic Complications of oral anticoagulant therapy.ClinGeriatr Med. 2001;17(1): 49-56.

[5]. Dahri K, Loewen P. The risk of bleeding with warfarin: A systematic review and performance analysis of clinical prediction rules. ThrombHaemost. 2007;98:980-987.

Abstract: Introduction: To study the tongue movement during swallowing and assess the relationship between tongue movement and facial morphology in three types of malocclusion. Materials and methods: 30 volunteers with class I, class II and class III skeletal pattern were chosen. The skeletal pattern was assessed from lateral cephalogram. B+M mode ultrasonography with cushion scanning technique was used to study the tongue movement during swallowing. The motion magnitude, duration and speed of tongue movement during each phase of swallowing were obtained from the m-mode graph and the representative values used for statistical analysis. Results: The individuals with class III skeletal pattern (prognathic mandible) had prolonged duration of tongue movement and greater motion magnitude in the early final phase (III A) of swallowing. Though there was a decrease in the motion magnitude and duration of swallowing in the early final phase in the individuals with class II skeletal pattern, the difference between class I and class II skeletal pattern was not found to be statistically significant. There was no significant difference in the speed of swallowing between the three skeletal patterns. Conclusion: More correlation was found to exist between abnormal tongue function during swallowing and class III skeletal pattern than the class I and class II skeletal patterns.

Key words: malocclusion, swallowing, tongue movement, ultrasonography

[1]. Graber TM. Removable orthodontic appliances. 1984; Philadelphia; London; Toronto: W.B. Saunders
[2]. Cheng CF, Peng CL, Chiou HY and Tsai CY. Dentofacial morphology and tongue function during swallowing. Am J OrthodDentofacialOrthop. 2002 Nov; 122(5):491–9.
[3]. Akiyoshi M, Suzuki S, Kawamura M, Terashima T, Noguchi K, Kuroda T. Study on the tongue movement and the tongue palate relation in deglutition J Jpn.Orthod.Soc. 1995:54: 102-11.
[4]. Shawker TH, Sonies B, Hall TE, Baum BF. Ultrasound analysis of tongue, hyoid, and larynx activity during swallowing. Invest Radiol. 1984 Apr;19(2):82–6.
[5]. Peng CL, Jost-Brinkmann PG, Miethke RR. The cushion scanning technique: a method of dynamic tongue sonography and its comparison with the transducer-skin coupling scanning technique during swallowing. AcadRadiol. 1996 Mar;3(3):239–44.

Abstract: There are multiple variations of recurrent laryngeal nerve in relation to inferior thyroid artery and ligament of Berry which are important from a surgeon's point of view during thyroid surgeries Aim: The study aims to describe the clinically relevant variations of recurrent laryngeal nerve with respect to inferior thyroid artery and ligament of Berry in the cadavers. Material and Methods: 108 preserved cadavers (216 sides) were dissected within a span of 5 years i.e from 2008 to 2013. The position of recurrent laryngeal nerve in relation to inferior thyroid artery and ligament of Berry was noted and tabulated. Results: Our study revealed that in 59% of cadavers, the recurrent laryngeal nerve passed dorsal to inferior thyroid artery, 30% of cadavers, it coursed ventral to the artery, followed by 11% of cadavers where the nerve traversed through a loop formed by the branches of inferior thyroid artery. In 63.8% of cadavers, the nerve passed superficial to ligament of Berry, in 25% of cadavers the nerve passed through the ligament, followed by 11.1% of cadavers where the recurrent laryngeal nerve coursed deep to the ligament. Conclusion: A thorough knowledge of the laryngeal nerves and their anatomical variations is necessary for safe thyroid surgery.

Key Words: Recurrent laryngeal nerve, inferior thyroid artery, anatomical variations, ligament of Berry.

[1]. Walsh J. Galens discovery. Ann Med History 1926;8:176-184.
[2]. Gray SW, Skandalakis JE, Akin JT- Embryological consideretions of thyroid surgery: developmental anatomy of the thyroid, parathyroid and the recurrent laryngeal nerve. Am surg. 1976;42:621-628.
[3]. Skandalakis JE, DrouLiasc, Harlaftis N et al. The recurrent laryngeal nerve. Am Surg 1976; 42: 629-634.
[4]. SiMON MM- Recurrent laryngeal nerve in thyroid surgery- triangle for its recognition and protection. Amer J Surg 1943; 60(2):212-220.
[5]. LAHEY FH and Hoover WB – Injuries to the recurrent laryngeal nerve in thyroid operations. Ann surg 1938;108: 545-562.
[6]. Lekacos NL, Tzardis PJ, Sfikakis PJ, Patoulis SD, Restos SD. Course of recurrent laryngeal nerve to the inferior thyroid artery and the Suspensory ligament of berry.Int. Surg. 1992;77(4):287-8 Dec.

Abstract: Background: The management of earlobe keloids need to be well highlighted especially among young ladies of African descent as cosmesis is almost always an issue. More so, that there is no clearly defined universally accepted management protocol among medical practitioners. Recurrence is high even after an arduous treatment, follow up visits are mandatory and so patience is required. Choice of treatment depends on the site, size, duration and depth of the lesion. Surgical excision, low-tension wound closure, intra operative corticosteroid injections and pressure wound dressing will give a good cosmetic outcome. Despite all of these, the patient needed to be adequately counseled about recurrence and follow up visits. Materials and Method: Seven patients with earlobe keloids, 2 unilateral and 5 bilaterally involvement, making a total of twelve earlobe keloids. They were one male and six females, that were treated with surgical excision, low-tension wound closure, intra-operative corticosteroid injections, pressure wound dressing and six weeks of post operative corticosteroids injections. In all patients, a follow-up period of 6 months was the minimum duration. Results: Male to female ratio was 1: 6, mean age was 28.1years. Ten of the earlobe keloids (83.3%) resulted from ear piercing and with recurrence in one of the ears (8.3%). Conclusion Although the sample size is small, follow up period short, surgical excision with adjuvant corticosteroids offers a good outcome. I recommend that Surgeons should stick to treatment that give them best results in their areas of practice with the hope that continued research may one day lead to a better standard of managing these lesions.

Key words: Management, Earlobe, Keloids, Lokoja, Nigeria

[1]. Kelly PA. Medical and Surgical Therapies for keloids. Dermatologic Therapy. 2004; 17:212-218.
[2]. Alibert JLM. Quelques recherches sur la cheloide. Mem Soc Med d'Emul. 1817; 744.
[3]. [Leventhal D, Furr M, Reiter D. Treatment of keloids and hypertrophic scars. Arch Facial Plast Surg. 2006; 8(6):362–368.
[4]. Butler PD, Longaker MT, Yang GP. Current progress in keloid research and treatment. J Am Coll Surg. 2008; 206 (4):731–741.
[5]. Berman B, Perez OA, Konda S, et al. A review of the biologic effects, clinical efficacy, and safety of silicone elastomer sheeting for hypertrophic and keloid scar treatment and management. Dermatol Surg. 2007; 33 (11):1291–1303.
[6]. Bock O, Schmid-Ott G, Malewski P, Mrowietz U.Quality of life of patients with keloid and hypertrophic scarring. Arch Dermatol Res.2006, 297:433-8

Abstract: Background: The process of aging is associated with degenerative changes in all parts of the human body including the neural and sensory aspect of the ear. Hearing loss is one of the disabling diseases found common in elderly patients due to these degenerative changes. Objective: To determine the prevalence and common causes of sensorineural hearing loss in the elderly. Materials and Method: All patients aged 65 years and above with sensorineural (SNHL) hearing loss diagnosed by Pure Tone Audiometric (PTA) test were included in the study. A total of 9,712 patients were seen and 564 (5.8%) of them had hearing loss. From those who had hearing loss, 336(60%) of them had diagnostic PTA test done of which 62 (18.5%) were elderly that had SNHL. They include 34males and 28 females. Their case files were retrieved from the Health Record Unit and information about their age, sex, PTA test, etiology of hearing loss were extracted, studied, analyzed, with results presented in tabular and text format. Results: The female to male ratio was 1:1.2, prevalence of 18.5% and 67.7% of them had severe SNHL of which presbyacusis was the most common cause. Conclusion: The prevalence of SNHL among the elderly is high and age related degenerative changes in the organ of Corti were found to be the most common cause.

Keywords: Sensorineural, Hearing loss, Elderly, Five-year, Review.

[1] Walling AD, Dickson GM. Hearing loss in older adults. Am Fam Physician. 2012 Jun 15; 85(12):1150-6

[2]. Lee FS, Matthews LJ, Dubno JR, Mills JH. Longitudinal study of pure-tone thresholds in older persons. Ear Hear. 2005;26(1):1–11 [3] Aremu SK, Alabi BS, Segun-Busari S, Ogah SA. Audit of otological diseases amongst elderly in Nigeria. Intl. Arch.Otorhinolaryngol.2010; 14(.2):212-216

[4]. Ogah SA, Okomanyi A. Pattern of Hearing Loss as seen at the Federal Medical Centre Lokoja, Nigeria: A Five Year Retrospective Study. Asian Journal of Pharmacy, Nursing and Medical Sciences. August 2014; 2(4):87-9

[5] Kakehata SK, Futai A, Sasaki. "Endoscopic transtympanic tympanoplasty in the treatment of conductive hearing loss: early results." Otol Neurotol 2006; 27(1): 14-9

[6]. Gates GA, Cooper JC Jr, Kannel WB, Miller NJ. Hearing in the elderly: the Framinghan cohort, 1983–1985. Part 1. Basic audiometric tests results. Ear Hear. 1990;11(4):257–256

Abstract: This review considered inequalities affecting oral health. Oral health inequity- inequitable access to oral health services contributes to the health inequity of the population and further exasperates the socio- economic inequity. This paper attempts to elaborate the nature of oral health inequity in India, by exploring the process and trajectories of oral health inequity. Despite vast improvement in global oral health, problems still persist in many communities and population around the world, particularly among the under privileged in both developed and developing countries. Poor oral health has a substantial impact on quality of life, with poor oral health-related quality of life, in turn, having a substantial impact on daily performance and general life satisfaction. Barriers to oral health care include illiteracy, financial constraints, cultural perceptions, lack of awareness, inequitable distribution of dental manpower and inaccessibility to services as seen in most parts of our country. Systematic differences in the dental practices attended were evident, as a function of the person's race and income, differences that are associated with social disparities in oral health. So these factors must be addressed to improve the oral health, and overall the general wellbeing, it gives a clear focus to health policy and promotes the monitoring of quantitative changes over time in inequalities in oral health, which is essential to assess the effects of health policy interventions.

Keywords: dental caries, India, inequity, oral health, public health.

[1]. Parkash H Shah N. National Oral Health Care Programme: Implementation Strategies. Directorate General of Health Services, Ministry of Health and Family Welfare, Govt. of India, New Delhi. 2000.
[2]. Pan American Health Organization. Principles and basic concepts of equity and health. Washington: Pan American Health Organization, HDP Health Equity Interprogrammatic Group, Division of Health and Human Development; 1999.
[3]. MilindDeogaonkar Socio-economic inequality and its effect on healthcare delivery in India: Inequality and healthcare, Electronic Journal of Sociology (2004).
[4]. Ahluwalia MS. Economic performance of states in post-reforms period. Economic and Political weekly, May 6 2000, 1648.
[5]. Parkash H, Duggal R, Mathur V P.Final report and recommendations "Formulation of Guidelines for Meaningful and Effective Utilization of Available Manpower at Dental Colleges for Primary Prevention of Oro-dental Problems in the Country". A GOI- WHO Collaborative Programme.2007.New Delhi

Abstract: A total of 340 specimens from 192 (56.5%) male and 148 (43.5%) females attending tuberculosis clinics in Abuja metropolis were analysed by five different laboratory techniques (ZN Direct, ZN Bleach, LJ slants, BACTEC and Serology TB) for the diagnosis of Mycobacterium tuberculosis. Comparative analysis of results at P=0.05, revealed that there was a statistical significant (X2=127.1, P<0.001) difference between the diagnosistic performance of the five laboratory techniques. A follow-up analysis based on the 95% confidence interval of pair differences in proportion between the five techniques indicated that the BACTEC assay was the major source of the difference(P<0.001) in pair methods. Comparism of the 95% confidence limit of pair differences in diagnostic specificity of Mycobacterium tuberculosis between ZN-BACTEC and other methods confirmed (P<0.001) the high detection rate of BACTEC. It was observed that BACTEC had the highest detection rate (61.2%), followed by LJ (31.2%), then ZN Bleach (30.3%) and ZN Direct (28.8%), while Serology had only 25.3% ZN BACTEC appeared to the most reliable, and time effective combination. ZN Bleach should be encouraged in poor resource settings in lieu of the conventional three standard smears for ZN Direct. The use of Serologic TB kit alone for the diagnosis of tuberculosis should be discouraged.

Keywords: Mycobacterium tuberculosis, BACTEC, Laboratory and Serology

[1]. Baker F. J. and Breach M. R. ;(1980) Mycobacteria: In medical microbiological techniques. Butterwort and co.ltd. 183-195.
[2]. Centre for Disease Control and Prevention, (1992). National action plan to combact multidrug- resistant tuberculosis. MMWR; 41 (NO. RR-11).
[3]. Centre for Disease Control and Prevention, (1995). Laboratory Practices for Diagnosis of Tuberculosis-United State in 1994; MMWR 44 (31); 587-589.
[4]. David N. Memurray, (1996). Mycobacteria and Norcardia: In Medical Microbioligy. 4th Edition. Samuel Brown (ed). The University of Texas Medical Branch Publishers, Galverston USA; 423-439.
[5]. Doern G.V. (1996) Diagnosis Mycobacteriology where are we today? J. Clin Microbiol; 34 : 1873 -1876.

Abstract: This study was done on the prevalence of Trichomonas vaginalis among pregant women attending Irrua Specialist Teaching Hospital, Edo. The study was done to ascertain the prevalence level among those women. T. vaginalis is a common sexually transmitted infection among sexually active women with its attendant complications especially to these women whose immune systems are not too robust.The study was done among pregant women attending the above hospital.The study showed that the pregnant women in that hospital were not infected with T.vaginalis which could be traceable to improved healthy living.

Keywords: Trichomonas vaginalis,Pregnant women,Complication of Trichomonas vaginalis, Epidemiology of Trichomonas vaginalis.

[1]. Adu-Sarkodie, Y., Opoku, B.K., Crucitti, T., Weiss, H.A. and Mabey, D. (2007): Lack of evidence for the involvement of rectal and oral trichomonads in the aestiology of vaginal trichomoniasis in Ghana. Sex Transm Infect. 83(2):130-132.
[2]. Alcamo, I.E. (2000): Trichomonas vaginalis. In: Fundamentals of microbiology. Jones and Bartlett Publishers, Boston. Pp. 486-487.
[3]. Ashwood, E.R. (1992): Evaluating Health Maturation of Unborn: the role of the clinical laboratory. Journal of Clinical Chemistry. 38: 883-887.
[4]. Benchimol, M. (2004): Trichomonads under microscopy. Microsc Microanal. 10(5):528-550.
[5]. Burtis, C.A., Ashwood, E.R. and Bruns, D.E. (2OO6): Trace elements. In: Tietz Textbook of clinical Chemistry and Molecular Diagnostics. Saunders. Elsevier Inc., Pp 496-507.
[6]. Carlton, J.M. (2007): Draft genome sequence of the sexually transmitted pathogen Trichomonas vaginalis. Science. 315 (5):207-212.

Abstract: Formaldehyde is an organic compound with the formula CH2O and it is the simplest aldehyde, with systematic name methanol. The aim of this investigation was to sensitize embalming laboratory users of the impending danger associated with overexposure to forty percent (40%) formaldehyde vapour (the active component of embalming fluid) on the lungs. Twenty adult male albino rats were used for this investigation. The animals were divided into five (A, B, C, D, and E) groups. Animals in group B, C, D and E were respectively exposed to forty percent( 40%) formaldehyde for ten(10), fifteen(15), twenty(20) and twenty five(25) days while animals in group A which serve as control group were not exposed to forty percent (40%) formaldehyde at all. At different stages of the experiment, the animals in each of the group were decapacitated and the thoracic cage cut open to expose the lungs. The lung tissue was processed for light microscopic investigation adopting the Haematoxylin and Eosin (H and E) staining procedure. The histopathological observation in this study showed that exposure to forty percent (40%) formaldehyde induced changes in the histology of the lungs. The observed changes were duration dependent. So forty percent (40%) formaldehyde may be able to have greater marked effect at a prolonged exposure. These findings suggests that forty percent (40%) formaldehyde vapour may be remarkably toxic on the rat lung tissue and advocate for precautionary measure for human handlers while handling this chemical especially in the histopathology unit for fixation and embalming purposes.
Keywords: Embalming, Histopathological, Haematoxylin and Eosin.

[1]. Alexandersson, R., Hedenstierna, G. and Kolmodin-Hedman B., (1982): Exposure to formaldehyde:effects on pulmonary function. Arch Environ Health. 37(5): 279-84.
[2]. American Conference of Governmental Industrial Hygienists (1992): Formaldehyde Application Occupation Environmental Hygene, ISSN: 10960929, 7: 852-874.
[3]. Australian National Industrial Chemicals Notification and Assessment Scheme,2007Formaldehyde in Clothing and Other Textiles, Existing C h e m i c a l s I n f o r m a t i o n S h e e t ,
[4]. http://www.nicnas.gov.au/Publications/Information_Sheets/Existin hemical_Information_Sheets/EC_I S_Formaldehyde_1 02007_P DF.pdf, retrieved 2009-09-01
[5]. ATSD R. (1999): Toxicological profile for formaldehyde. Atlanta, GA: Agency forToxic Substances and Disease Registry http://www.atsdr.cdc.gov/ toxprofiles/tp111.pdf.

Abstract: The correlation of values of CD4 Count, platelet, PT, APTT, fibrinogen and factor viii was carried out. One hundred and sixty four subjects were sampled, comprising one hundred and fourteen HIV positive subjects and fifty HIV negative subjects which served as the control. PT, APTT, Fibrinogen, Factor VIII, Platelet and CD4 count were analyzed using standard techniques. The results showed that HIV positive subjects had a significantly lower CD4 count (360.00±107.09) and Platelet count (157 ± 98.40) when compared with the HIV negative subjects (940 ± 220.05) and (228 ± 62.04) respectively. Also PT and APTT were significantly higher (P<0.05) in HIV positive subjects (19.56 ± 3.14) and (42.86 ± 7.10) respectively when compared with the HIV negative subjects (14.90 ± 1.91) and (37.90 ± 3.98) respectively. Whereas, there were no significant changes (P> 0.05) in fibrinogen and factor viii concentration between the HIV Positive subjects and the HIV negative subjects. Among the HIV positive subjects, platelet count did not differ significantly (p> 0.05) between those with CD4 count < 200 cells/μl and those with CD4 count ≥ 200 cells/ μl. However, PT and APTT showed significant changes (22.40 ± 2.96) and (48.20 ± 8.01) respectively, in HIV Positive subjects with CD4 count <200 cells/μl. Furthermore, there were positive correlation between PT and APTT, PT and CD4 count, APTT and CD4 count, Platelet and CD4 count (P<0.01) respectively while there were no correlation between other coagulation parameters tested(P > 0.01).

Keywords: CD4 Count, PT, APTT, fibrinogen and factor viii.

[1]. Acharga, S., Dimichele, D., M., (2008)."Rare inherited disorders of fibrinogen". Haemophilia: the Official Journal of the World Federation of Haemophilia; 14 (6):1151-1158.
[2]. Ascher, M., S., Sheppard, H., W., (1990). AIDS as immune system activation. J. Acquired Immune Deficiency Syndromes; 3: 177.
[3]. Baker, F., J, Silverton, R., E., Pallister, C., J., (2007). Haemaostasis in Introduction to Medical Laboratory Technology. 7th ed, Honeyland Resources limited. PP 387.
[4]. Centres for Disease Control and Prevention (2009). Guidelines for prevention and treastment of opportunistic infections in HIV-1 infected adults and adolescents: Recommendations from CDC, the national institutes of Health and the HIV medicine association of the infectious diseases society of America.
[5]. Clauss A, (1957). Rapid physiological coagulation method in determination of fibrinogen. Acta haematologia. 17: 237-246.
[6]. Cohan AJ, Philips TM, K essler CM, (1986). Circulating coagulation inhibitors And AIDs. Ann. Intern. Med, 104: 175-180

Abstract: This study was carried out to determine the comparative study of cd8+ cell count and leukopoietin levels in human immunodeficiency virus infection in Umuahia, Nigeria. A total number of ninety (90) subjects within the age of 18-60 years were used for the study. The subjects were divided into three (3) groups of thirty (30) subjects in each group. Group I comprised of control subjects. Group II were HIV- subjects not on therapy, and group III were AIDS- subjects not on therapy. Blood samples were collected into commercially prepared dipotassium EDTA vacutainer for both test and control subjects after informed consent. These were used in determining their CD8+cells counts and Leukopoietin levels. After the analyses of the blood samples, the following results were observed. The CD8+cells count of group II (967 +198 cells/ml) was significantly higher than that of group I (586+81 cells/ml) while the CD8+cells count of group III CD8+ (1086+228 cells/ml) showed a statistically higher level when compared with those of groups I & II at p<0.05. The level of leukopoietin of group II (1.9+0.9) was slightly higher than that of group I (1.2+0.9) but not statistically significant at P<0.05. The Leukopoietin of group III (5.4 + 1.5) was statistically higher when compared with those of groups I (1.2 +0.9) and II (1.9 + 0.9) respectively there was a strong positive correlation between CD8+ cell counts and leukopoietin levels as observed from analysis. The results therefore showed that following HIV infection there is expansion of CD8+ cells with increased production of leukopoietin.

[1]. Araoye, M. O. (2004). Research Methodology with Statistic for Health and Social Science. 1st Edition. Nathodex Publisher, Ilorin. Pp 115 – 120.
[2]. Bierman, H. R. (2006). Characteristics of Leukopoietin G. in animal and man. Annals of the New York Academy of Science. 113: 753 – 765.
[3]. Boasso, A. and Shearer, G. M. (2008). Chronic Innate Immune Activation as a Cause of HIV Immunopathogenesis. Clinical Immunology 126: 235 – 245.
[4]. Darius, M. and Mark, S. F. (2003). Immune System Overview. Encyclopedia of the Neurological Sciences. 633 -639.
[5]. Douek, D.C., Roederer, M. and Koup, R. A. (2009).Emerging Concepts in the Immunopathogenesis of AIDS. Annu. Rev. Med. 60: 471–84.

Abstract: A study of fungal contaminants of non-cellulosic instruments in Umuahia. Abia State was carried out. The instruments involved were microscopes, cameras, clocks and wristwatches.Four species of fungi were isolated namely: Aspergillus niger, Aspergillus fumigates, Rhizopus species and Penicillum species.The ability of these isolates to produce four enzymes namely cellulose, amylase, caseinase and gelatinase were tested. Among the isolates Aspergillus fumigates produced the highest amount of amylase and cellulose. All the isolates tested positive for caseinase and gelatinase production tests. Carbon sources such as glucose, sucrose, fructose, lactose, mannose and maltose were all utilized by the isolates as carbon sources, but Aspergillus niger utilized them faster than others. No gas was produced of these isolates ranged between 300C and 370C. Aspergillus niger grew best at 320C, Aspergillus fumigates grew best at 320C, Aspergillus and penicillium species grew best at 300C.The determinantion of moisture contents at the isolates revealed that moisture (% wet weight) of Aspergillus niger was 51.85%, Aspergillus fumigates was 59.26%, Rhizopus species was 72.59% while Penicillium species was 54.82%. optimal pH determination indicated that A. niger and A. fumigates grew best at pH 4, Rhizopus species grew best at pH 6 while Penicillum species grew best at pH 5. These results obtained can provide a starting point for preventing biodegradation of these expensive non-cellulosic instruments.

Keywords: Fungal Contamination,Fungi and Non-cellulosic instruments.

[1]. Alexopoulos, C. J. (1962): Introduction to Mycology. Pp. 3 – 44. John Wiley and sons Inc., New York.
[2]. Ayerst, G. (1969): The effects of moisture and temperature on growth and spore germination in some fungi. Journal of Stored Products Research 5 (2), 127 – 141.
[3]. Beuchat, L. R. (1978): Food and beverage mycology. Pp 378 – 388. Avi Publishing Company Inc. Connecticut.
[4]. Eggins, H. O. W. and Allsopp, D. (1975): Biodeterioration and biodegradation by fungi. In smith, E. J. and Berry, D. R. The filamentous fungi I: 301 – 324.
[5]. Ingold, C. T. (1962): The biology of fungi, pp 35 – 42. Hutchinson Educational, London.

Abstract: The effect of physical exercise on serum electrolyte was estimated in this work with interest on the effect of short duration exercise(45 minutes) on serum sodium,potassium,chloride and bicarbonate.The samples for analysis were collected randomly from athletes,football players,volley ball players and handball players at two instatnts,pre-exercise and post-exrecise.Samples were also collected from individuals not active in these physical exercises as control.The mean values and standard error mean for pre and post-exercise samples were respectively 139.26± 0.18 and 137.36± 0.16,for Na+,4.33± 0.003 and 4.04± 0.02,for K+,101.25± 0.15 and 98.32± 0.14 for Cl- and 27.94± 0.19 and 25.60± 0.23 for HCO3-.The values for the control correlated well with pre-exrecise values.The findings of this work showed that in short duration exercise,accompanied with sweating,the serum electrolytes are usually decreased but at variable rate.

Keywords: Physical exercise,Serum Electrolytes,Short duration exercises,

[1]. Armstrong,L.E.,Hubbard,R.W.Szlyk,P.C.,Matthew,W.T., and Silas(1985).Volutary Dehydration and Electrolyt Losses During Prolonged Exercise in the Heat.Aviation,Space and Environmental Medicine 56(8):765-770.
[2]. Armstrong,L.E. and Epstein,Y.(1999).Fluid-electrolyte Balance During Labour and Exercise:Concepts and Misconceptions.International Journal of Sports and Nutrition 9(1):1-12.
[3]. Brouns,F.(1992). Rationale for Upper Limits of Electrolyte Replacement During Exercise.International Journal of Spotrs and Nutrition 2:229-38.
[4]. Convertino,V.A.,Armstrong,L.E. and Coyle,E.F.(1996).American College of Sports Medicine Position Stand Exercise and Fluid Replacement.Medicine and Science in Sports and Exercise28:i-vii.
[5]. Irving,R.A.,Noakes,T.D and Buck,R.(1991).Evaluation of Renal Function and Fluid Homeostasis During Recovery from Exercise-induced Hyponatraemia.Journal of Applied Physiology 70:342-348.

Abstract: This research evaluated the haematological parameters of pregnant women in college of health demonstration clinic, Port Harcourt, Nigeria. The results indicated an elevation in WBC concentration of pregnant women when compared with that of apparently non pregnant women while PCV concentration of pregnant women decreased significantly when compared with that of apparently non pregnant women. This result also indicated that some of the pregnant women were anemic.

Keywords: Anaemia, pregnant women, PCV and WBC.

[1]. Cheesbrough, M. (2006): District Laboratory Practice in Tropical Countries Part 2. Cambridge University Press, UK. Pp 300.
[2]. Chekwuebelu & Obi; (2005): Prevalence of Anaemia in Pregnant Women at Enugu (Unpublished).
[3]. Dacie, J. V. & Lewis, S. M (2005): Packed cell volume and total white blood cell count. In: Practical Haematology. Edinburgh; Church hill Living Stone Publishing Oxford Pp. 01-623.
[4]. Harrison, K. A. (2009): Blood volume changes in Normal Pregnant Nigeria Women. British Journal of Obstetric and Gynaecology. 147:576 – 583.
[5]. Huisman, A; Aaronondse, J. G; Krans M., Huisjes, H. J; Fidler, V; Zijlstra, W.G (2008): Red Cell During Normal Pregnancy. British Journal of Haematology. 147:576 – 587.

Abstract: The effect of storage on full blood count in different anticoagulant was determined in view of it's importance on the reliability and validity of test results. The study was designed to know the effect of storage on full blood count in different anticoagulant which is Ethylendiamine tetra acetic acid and citrate phosphate dextrose Adenine. A total of 50 samples of apparently healthy individuals were analyzed for their packed cell volume, Haemoglobin concentration, Red blood cell, Platelet, white blood cell and differential Neutrophils, Lymphocytes and monocytes, by storing 2mls each of their blood sample in Ethylendiamine tetra acetic acid and Citrate phosphate dextrose adenine (CPDA) anticoagulant for a period of 24hrs and 168hours at 40C. Changes were observed in some but not all haematological parameters measured on LDW-3600 Auto haematological analyzer, specifically the HB, PCV, Lymphocytes and Monocytes showed a drastic increase on day seven compared to day one and more decreased on platelet and WBC on seven day compared to day one. For this study no statistical change was observed for Rbc. Based on these findings, samples stored for 24hours at 40C would not result in significant changes in blood parameters, therefore haematological laboratories are advised not to keep samples beyond 24hours at 40C for reliability of test result.

Keywords: Anticoagulant, Full blood count, HB, PCV and Leucocytes

[1]. Baker, J.K. and Silvertone R.E (2002); Introduction to Medical Laboratory Technology. Blood Count Butterworth London. 6th Edition, Pp. 556-583.
[2]. Beutler, E., Lichtman; Collar B.S; and Kippst. (2005); Williams Hematology. Mccraw Hill. New York. 5th Edition, Pp 119-127.
[3]. Cohle, S.D., Abduss, Mmakkaowis D.E (1981); Effects of the storage Of Blood on the stability of haematological Parameters. American journal of clinical pathology 76:67-69.
[4]. Cohles, EH (1986) Verterinary clinical pathology, 4th Edition., W.B. Saunders Co; philadephia.
[5]. Cohle, S.D., Abdus S. And Mmakkaowis D.E. (1981); Effects of the storage of Blood on the stability of haematologic parameters. American Journal of Clinical pathology. 76:67-69.
[6]. Dacie, J.V. and Lewis S.M (2001); Differential Leucocytes count blood cells, De Grouchy's Clinical hematology. 6th Edition. Pp. 4-8.