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

Abstract: To calculate the rate of rejected specimens received in hematology laboratory stratified by area of collection and reason of rejection. Design: Retrospective study conducted at Sir T General Hospital and Govt. Medical College, Bhavnagar, for twelve months period; January 1, 2013 to December 31, 2013. Data were retrieved from the laboratory records. Results: The rate of specimen rejection was highest in the medical ward and clotted specimens were the commonest cause for rejection followed by wrong patent identification. Conclusion: A constellation of factors, mainly related to phlebotomy technique and wrong patient identification are the reasons for rejection of specimens in the hematology laboratory. The phlebotomy technique may be wrong, there may be lesser efficiency of the staff in phlebotomy and inability of correct patient identification maybe reasons for this observation. Keywords: Hematology Anticoagulant Rejection Phlebotomy

[1]. Turgeon, Mary Louise, "Clinical Hematology, Theory and Procedures." Boston/Toronto: Little, Brown and Co., 1988.
[2]. Blood Collection, A SHORT COURSEE D I T I O N 2
[3]. Arch Pathol Lab Med. 2007 Apr; 131(4):588-92.
[4]. Dale JC, Novis DA. Outpatient phlebotomy success and reasons for specimen rejection: a Q-Probes study. Arch Pathol Lab Med. 2002; 126:416–419.
[5]. Jones BA, Calam RR, Howanitz PJ. Chemistry specimen acceptability, a College of American Pathologists Q-Probes study of 453 laboratories. Arch Pathol Lab Med. 1997; 121:19–26.

Abstract: The purpose of the study is to assess the effect of exercise on bone turnover by measuring serum osteocalcin level in young trained male and female athletes in Manipur and to assess the relationship between serum osteocalcin concentration with age, sex and types of sports of the participants. 50 young athletes (25 women and 25 men) ages ranging from 18 to 21 years were selected from Sports Authority of India, Manipur; the sedentary age-matched non-athletes(N=10) were selected from the general medical student population. Serum osteocalcin was estimated using EDMTMOsteocalcin(1-43/49) Specific ELISA Kit, Epitope Diagnostics, Inc. USA. Significantly higher mean±SD serum osteocalcin concentration was seen in athletes (22.97±6.36) than non-athletes(11.68±5.60). On comparing the different age groups of athletes ranging from 18yrs to 21 yrs, no significant difference in serum osteocalcin was found. However,male athletes had significantly higher serum osteocalcin (26.07±5.29) then in female athletes(19.88±5.89).In hockey players (N=21) serum osteocalcin level was 26.41±5.40, runners(N=18) was19.94±5.51 and in cyclist (N=11) it was 21.33±6.64.

Index Terms: Bone turnover, osteocalcin, osteoblast, sedentary age-matched

[1]. Calvo MS, Eyre DR, Gundberg CM. Molecular basis and clinical application of biological markers of bone turnover. Endocr Rev 1996;17:333–68.
[2]. Seibel MJ. Biochemical markers of bone turnover: part I: biochemistry and variability. Clin Biochem Rev 2005; 26:97–122.
[3]. Seibel MJ. Clinical use of markers of bone turnover in metastatic bone disease. Nat Clin Pract Oncol 2005; 2:504–17.
[4]. Seibel MJ. Biochemical markers of bone turnover: part II: clinical applications in the management of osteoporosis. Clin Biochem Rev 2006; 27:123–38.
[5]. Glorieux FH, Travers R, Taylor A. Normative data for iliac bone histomorphometry in growing children. Bone 2000; 26:103–09.
[6]. Clarke BL, Ebeling PR, Jones JD. Changes in quantitative bone histomorphometry in aging healthy men. J Clin Endocrinol Metab 1996; 81:2264–70.

Abstract: Patient satisfaction is a multidimensional concept.[1] As teaching institutions dental college clinics must constantly strive to find a balance between meeting the needs of the students and the patients. Patient satisfaction with the treatment done in a dental hospital clinic is very important because it will influence their service utilization pattern.[2][3] Dental schools are teaching facilities and usually the traditional system is only followed with the students rotating through different clinics. The patients in traditional system have to go to different clinics for each treatment. This was very difficult for the patients and also time consuming. So most of the patients prefer the comprehensive system, because of its convenience. The comprehensive system is patient oriented. This study is done to assess the satisfaction of the patient in a comprehensive clinic.

[1]. Davies AR, Ware JE. Measuring patient satisfaction with dental care. Social Science & Medicine Part A: Medical Sociology 1981; 15 (6): 751-60.
[2]. Murray BP, Wiese HJ. Satisfaction with care and utilisation of dental services at neighbourhood health centre. J Pub Health Dent 1975; 35:170-176.
[3]. Firestein SK. Patient anxiety and dental practice. J Am Dent Assoc 1976; 93:1180-1187.
[4]. Mascarenhas A K. Patient satisfaction with the comprehensive care model of dental delivery. J Dent Educ 2001; 65: 1266–1271.
[5]. Carr-Hill R A. The measurement of patient satisfaction. J Public Health Med 1992; 14:236–249.

Abstract: Mullerian anomalies are often asymptomatic and therefore unrecognized. Unicornuate uterus accounts for 5% of all mullerian duct anomalies, incidence being approximately 1:4020 women1. According to American Fertility Society classification of uterovaginal anomalies Class III B, unicornuate uterus can have presence or absence of rudimentary horn (RH) 2. The presence of RH with cavity leads to well characterized gynecological and obstetrical complications. In 80-90% of cases, the RH is non-communicating and mostly asymptomatic3; however, some contain functional endometrium resulting in chronic pelvic pain, haematometra, endometriosis etc. Pregnancy in a RH is an extremely rare entity, the incidence being 1: 76,000 to 1: 150,000 pregnancies4. The natural course of such pregnancy is rupture during first and second trimester, with a potentially life threatening heavy bleeding. Pregnancy in a non-communicating RH with the delivery of a live newborn is even rarer. Ours is a case of RH pregnancy referred to our hospital in the third trimester with successful maternal and fetal survival.

Keywords: Unicornuate uterus, rudimentary horn pregnancy, live birth.

[1]. Reichman D, Laufer MR, Robinson BK, "Pregnancy outcomes in unicornuate uteri: a review," Fertil Steril 2009 May; 91(5): 1886-94.
[2]. American Fertility Society classification of mullerian anomalies. Fertil Steril 1988; 49:952.
[3]. Liu MM. Unicornuate uterus with rudimentary horn. Int J Gynecol Obstet. 1994; 44:149-53 (PubMed).
[4]. Nahum GG. Rudimentary uterine horn pregnancy: a case report on surviving twins delivered eight days apart. J Reprod Med. 1997; 42:525-53 (PubMed).
[5]. Jayasinghe Y et al. The presentation and early diagnosis of the rudimentary uterine horn. Obstet Gynecol. 2005; 105:1456-67 (PubMed).

Abstract: Background: In current era of high costing health care, the saddle block, a segmental block for lower four sacral spinal roots, is an essential method for day care surgery in anorectal surgical procedure. Aims: We designed our study to find out an easy way for specific saddle block through sacral dorsal foramens to make it suitable for day care and ambulatory anesthesia. Methods: We performed sacral saddle block through 2nd dorsal foramen of sacrum injecting intrathecally 0.75 ml of 0.5% injection bupivacaine. Results: Posterior surface of lower limb including perineum, innervated by sacral component of spinal roots became painless. No motor block detected, only dilatation of anal sphincter was present. Conclusion: With limited involvement of sacral component of spinal roots and comfort to patient, sacral saddle block is highly suitable for anorectal surgical procedure without hemodynamic instability.

[1]. Paria R, Surroy S, Majumder M, Paria A, Paria B, Das G. Sacral Spinal Anesthesia. Indian J Anesth. 2014; 58 : 80-2.
[2]. Senoglu N, Senoglu M, Oksus H, Gumusalan Y, Yuksel KZ, Zencirci B et al. Landmarks of the sacral hiatus for caudal epidural block: an anatomical study. Br J Anesth 2005; 95: 692-5.
[3]. Dahl V, Raeder J - Regional anaesthesia in ambulatory surgery. Curr Opin Anaesthesiol, 2003;16:471-476
[4]. Vaghadia Spinalanaesthea for outpatients: controversies and new techniques. Can J Anaesth, 1998;45:R64-R75.

Abstract: Aim: The aim of this study is to introduced the efficacy, longevity and safety of this new 'T'shaped limbal based sclera flap with fornix based conjunctival flap trabeculectomy leading to better result like controlling intra ocular pressure satisfactory ,and no shallow anterior chamber after the surgery. Method: As it is a clinical research which was done on 26 patients and all the patient went under the 'T'shaped limbal based scleral flap with fornix based conjunctival flap for angle closure glaucoma .To check the short and long term efficacy of this incision. Spss.18 paired sample test was done. All the data were analysed, before and after the surgery. And also the follow up of patient after 1.5 year were also analysed to check the outcome and efficacy of this surgical procedure. Result: Under this research anterior chamber depth before surgery and after surgery where compared and found significant change (P < 0.05).And intra ocular pressure before and after surgery were also compared and also found high significant change (P < 0.05).Where as the comparative study was also done to compare the result after 1.5 year of follow up .In which anterior chamber after surgery compared with anterior chamber after 1.5 years of surgery and were found non-significant change (P > 0.05),where as intra ocular pressure after surgery and after 1.5 years were also analysed and found non-significant change (P > 0.05).Non –significant change of anterior chamber depth and intra ocular pressure after 1.5 year of follow up shows the patency and safety of this surgical procedure in long term as well as short term aspects. Conclusion: Our research demonstrate the long and short term effectiveness of our revised T-shaped limbal based scleral flap with fornix based conjunctival flap trabeculectomy.

Key words: Scleral, Fornix Conjunctival Flap, 'T'shaped, IOP, Anterior Chamber depth.

[1]. Tan, Yar-Li, et al. "Postoperative complications after glaucoma surgery for primary angle-closure glaucoma vs primary open-angle glaucoma." Archives of ophthalmology 129.8 (2011): 987-992.
[2]. EhaJ, Hoffmann EM, PfeifferN et al. Long-term results after transconjunctival resuturing of the scleral flap in hypotony following trabeculectomy. Am J Ophthalmol,(2013), 155(5):864–869
[3]. Jampel HD, Musch DC, Gillespie BW et al. Perioperative complications of trabeculectomy in the collaborative initial glaucoma treatment study (CIGTS). Am J Ophthalmol (2005) , 140 (1):16–22
[4]. Parekh AS, Weinreb RN, Dorairaj SK et al. Delayed-onset symptomatic hyphema after ab interno trabeculotomy surgery.Am J Ophthalmol2013, 155(4):778–779
[5]. Wells AP, Cordeiro MF, Bunce C, Khaw PT et al. Cystic bleb formation and related complications in limbus- versus fornix-based conjunctival flaps in pediatric and young adult trabeculectomy with mitomycin C. Ophthalmology. 2003;110(11):2192–2197.

Abstract: The clinical entity of an anomalous innominate artery constricting the trachea and causing respiratory symptoms stayed first recognized through Gross and Neuhauser in 1948[1]. In clinical its always find this anomaly, as it can be an incidental finding in asymptomatic .Vascular rings be present uncommon congenital anomalies from an embryological disorder of the combined aortic arches or branching pulmonary arteries. Uncommon congenital anomalies that present with upper airway obstruction [2]. The physical findings and symptoms formed by vascular rings are correlated to the structure(s) they circumscribe both trachea, esophagus, for the confirm diagnosis computed tomography (CT), X-ray, angiography or magnetic resonance imaging (MRI) are used and also for surgical planning. The diagnostic modalities, surgical treatment as well as outcome surely discussed. We report a case of a innominate artery extends to the level of the thyroid. This anomaly is relatively rare, understanding of this anomaly can avoid catastrophic bleeding or other complications of potential, is very necessary

[1]. Gross, R.E. and E.B. Neuhauser, Compression of the trachea by an anomalous innominate artery; an operation for its relief. Am J Dis Child, 1948. 75(4): p. 570-4.
[2]. Bai, S., et al., Surgical treatment for vascular anomalies and tracheoesophageal compression. Chin Med J (Engl), 2012. 125(8): p. 1504-7.
[3]. Lukkarinen, M. and H.P. Lukkarinen, Irreversible airway obstruction due to innominate artery compression of the trachea. BMJ Case Rep, 2012. 2012.
[4]. Mok, J.Y. and H. Simpson, Tracheal compression by an anomalous innominate artery. A report of 2 cases in a family. Arch Dis Child, 1981. 56(10): p. 791-3.
[5]. Gil-Carcedo, E., et al., High-riding innominate artery in neck surgery. Acta Otorrinolaringol Esp, 2012. 63(5): p. 396-8.
[6]. Stahl, M., et al., The role of surveillance bronchoscopy and bronchoalveolar lavage prior to heart transplantation. Transplant Proc, 1988. 20(1 Suppl 1): p. 747-50.

Abstract: Slothful life style and lack of regular physical activity are the main causes of obesity, obesity–induced metabolic disorders. The aims of this study were to consolidation the harmony of serum Irisin with rats' fat development. Thinking over the innovation, can Irisin be therapeutic for metabolic disorders without regular exercise. This prospective experimental study was included 120 Western rats. The study had undergo two lines first was the correction of inducible obesity & diabetes; second was the prevention of mentioned inducible conditions, both lines was done by subjecting the rats to subcutaneous injection of prepared Irisin solution (100 ng/ml). Inducible obese type 2 diabetic (T2DM) rats had significantly higher serum Irisin, insulin level & fasting glucose (S.F.G.) in comparison with inducible obese rats & normal weight rats. Obese rats that were injected with 100 ng/ml of recombinant Irisin had highly significant lower weight mean and S.F.G. than obese rats control . Established diabetic rats with Irisin injection was significantly corrected, with their weight , serum glucose , and insulin after 26 days of irisin treatment. Findings showed that Irisin may act as reformation effect on new onset type 2 diabetics' rats; as well as it may have intensive defiance against fatness .

Keywords : Irisin, Obese Rats, Insulin Resistance ,Obesity Treatment Diabetic Rats, Rat Obesity Induction

[1]. Carey,DanielG,:Quantifying Differences in the ̔Fat Burning ᾽Zone and Aerobic Zone:Implication For Training .Journal of Strength &Conditiong Research .2009.23.2090-2095.
[2]. Bagnasco M, Dube, MG, Katz, A, Kalra, S, &Kalra, SP. Models of diet induced obesity (DIO) are commonly used in research of non-leptin deficient obesity. Characterizations such as insulin resistance 1. Leptin expression in hypothalamic PVN reverses dietary obesity and hyperinsulinemia but stimulates ghrelin. Obesity Res 2003;11: 1463-1470.
[3]. Bergland CH. Irisin: The "Exercise Hormone" has Powerful Health Benefits Irisin can help maintain healthy weight, improve cognition, and slow aging. 2014 by in The Athlete's Way
[4]. Wu J, Bostrom, P, Spark LM, Choi LH et al. Beige Adipocytes Are a Distinct Type of Thermogenic Fat cell in mouse and Human. 2012; S0092-8674(12): 00595-8.
[5]. PuigserverP,AdelmantG,WuZ,FanM,Xu J,Ó MalleyB,SpigelmanBM:ActivationofPPAR gamma coactivitor-1 through transcription factor.Science, 1999.286(5443):1368 -71.

Abstract: Aim of the study: Malaria is major health problem in the tropics with significant high mortality and morbidity.Malaria is usually associated with reduced blood cell counts & mild to moderate thrombocytopenia which is a common association of malaria. The cause of thrombocytopenia is poorly understood, but the immune-mediated lysis, sequestration in the spleen and dyspoietic processes in the marrow with diminished platelet production have all been postulated. This study was conducted to coorrelate thrombocytopenia in the patients suffering from acute malaria. A finding of thrombocytopenia should increase the suspicion of malaria and lead to performance of more specific tests, including multiple peripheral smears and ELISA for parasite-specific antigen.Hence we conducted this study to assess the occurrence of thrombocytopenia in hospitalized patients of malaria and to correlate its severity with the type of malaria. Design : A total of 200 subjects were included in this study group .These patients were having high fever , intermittent in nature associated with chills and rigors,with or without splenomegaly and responded only to antimalarial drugs.Thrombocytopenia count was done by fully automated hematological analyser. Result: Normal platelet count was observed in about 20% of cases who responded only to antimalarials while it reduced in about 80% of cases presented with fever.Thrombocyte count was 77,869 cells/μl (mean).Thrombocytopenia was present in both (P.falciparum > P. vivax) types of malaria.

[1]. Kakar A, Bhoi S, Prakash V, Kakar S. Profound thrombocytopenia in Plasmodium vivax malaria. Diagn Microbiol Infect Dis 1999;35:243-4

[2]. S. S. Jamal Khan, F. R. Khan, M. Usman, and S. Zahid, "Malaria can lead to thrombocytopenia," Rawal Medical Journal, vol. 33, no. 2, pp. 183–185, 2008

[3]. T. S. Faseela, R. A. Roche, K. B. Anita, C. S. Malli, and Y. Rai, "Diagnostic value of platelet count in malaria," Journal of Clinical and Diagnostic Research, vol. 5, no. 3, pp. 464–466, 2011

[4]. V. Bhatia and J. Bhatia, "Severe thrombocytopenia with bleeding manifestations in two children secondary to Plasmodium vivax," Platelets, vol. 21, no. 4, pp. 307–309, 2010

[5]. R. Harish and S. Gupta, "Plasmodium vivax malaria presenting with severe thrombocytopenia, cerebral complications and hydrocephalus," Indian Journal of Pediatrics, vol. 76, no. 5, pp. 551–552, 2009.

Abstract: Fistula-in-ano is one of the common ano-rectal disorder which causes appreciable morbidity and inconvenience to the patient. Fistula is a Latin word which means pipe. Fistula-in-ano is a preventable disease provided the perianal or perirectal suppurations are treated on time and in a correct manner. The common pathogenesis is the bursting open of an acute or inadequately treated ano-rectal abscess. The location of the diseased part makes the patient refrain from early consultation and this is the main cause for the delay in treating the patients with perianal suppurations. The more important second factor is that a significant percentage of these diseases persist or recur when the right modality of treatment is not adopted or when the postoperative care is inadequate.

[1]. Das A C, PrakashAgarwal, A comparative study of surgical techniques for fistula-in-ano, IJS; 1997; Vol 60 (4); 254-255.
[2]. Goligher John, Surgery of the anus, rectum and colon, London, BailliereTindall; 1984; 178.
[3]. Parks A G, The pathogenesis and treatment of fistula-in-ano, British Medical Journal, 1961; Vol 1; 463-469.
[4]. Prakash S, Lakshmi Ratan V, Gajendren V, Fistula-in-ano treatment by fistulectomy and primary closure reconstitution, Aust J Surg; Vol 55; 23-27.
[5]. Schwartz S I, Principles of Surgery, New York, McGraw Hill Inc, 1994; 1232-34.
[6]. Shahbaz C M, Ghazanfar A, Goraya A R, Comparative study of fistulectomy and fistulotomy with primary repair for low fistula-in-ano, Apr-jun 2002; Vol 8 (2); 87-90

Abstract: The passage of flatus or bowel movements after abdominal surgery is traditionally considered as the indication for commencing oral diet. The resolution of post-operative ileus defined by the passage of flatus usually occurs after 24 to 48 hours. Hence, patients were started on oral feeding only after the first post-operative day. If studies can prove the safety of early oral feeding after abdominal surgeries, it will help us to reduce the delay in commencing the oral feeding of these patients. Studies were undertaken to evaluate whether different abdominal surgeries could benefit from early oral feeding. Initially, the early oral feeding concept was well established for colorectal surgery. Recently, it has been applied to other abdominal surgeries such as vascular, fundoplication, nephrectomy, appendicectomy, gastric and gynaecological operations. Though we have evidence of safety and advantage of early oral feeding after abdominal surgeries, many surgeons have reservations about this method of early oral feeding due to the fear of the complications such as vomiting, distension, postoperative ileus and anastomotic leak. Appendicectomy is one of the most common surgeries performed by the surgeons worldwide. But, early feeding regimens are not practiced worldwide due to the fear of above stated. Primarily, we undertook a study to evaluate the safety of early oral feeding after open appendicectomy. The secondary purpose of this study was to study the duration of hospital stay in early feeding group in comparison with the traditional feeding group.

[1]. Anderson AD, McNaught CE, MacFrie J, Tring I, Barker p, Mitchell CJ. Randomized clinical trial of multimodal optimization and standard perioperative surgical care. Br J Surg 2003; 90:1497e504.
[2]. Basse L, HjortJakobsen D, Billesbolle P, Kehlet H. A clinical pathway to accelerate recovery after colonic resection. Ann Surg 2000; 232(1):51e7.
[3]. Bisgaard T, Kehlet H. Early oral feeding after elective abdominal surgery-what are the issues? Nutrition 2002;18: 944-8.
[4]. Bohm B, Haase O, Hofmann H, Heine G, Junghans T, Muller JM. Tolerance of early
[5]. oral feeding after operation of the lower gastrointestinal tract Chirurg 2000;71:955-62
[6]. Bufo AJ, Feldman S, Daniels GA, Lieberman RC. Early postoperative feeding. Dis Colon Rectum 1994;37:1260-5
[7]. Burrows WR, Gingo AJ Jr, Rose SM, Dierker LJ, et al. Safety and efficacy of early postoperative solid food consumption after cesarian section. J Reported Med 1995;40:463-7.

Abstract: Background: A huge number of children in their millions get debilitated and pass on consistently from water borne diseases and absence of essential sanitation and hygiene.Objectives: To assess the source, functionality and availability of water in primary schools in Obio-Akpor Local Government area.Methodology: This was a descriptive cross sectional study that involved the use of an observational checklist to get information from 25 primary schools and the administration of 480 self-administered structured questionnaires to pupils in the primary schools. A multistage sampling was employed in choosing the pupils that were studied.Results: 22 (88.00%) of the primary schools had borehole with electric pump and 2 (8.00%) of the primary schools had no water supply, 1 (4%) of the primary schools had piped water to the school premises and 2 (8.00%) of the primary schools had no water supply. The study also revealed that; of the 23 primary schools that had a source of water, 18 (78.26%) had constant water supply and 5 (21.74%) occasionally had water supply, pupils in 20 (86.96%) schools had to walk a distance of < 5 minutes from the source to the common point of use, and pupils in 3 (13.04%) schools had to walk > 5 minutes. Conclusion: The water facilities as observed from this study, met with internationally acceptable standards. However, development of maintenance plan and strict compliance with admission proceedings such that the number of pupil admitted into both private and public primary schools do not exceed the capacity provided for by the existing water facilities is inimical to communicable disease prevention.

Keywords: Water Sanitation and Hygiene, Water access, Water supply, Water quality, Water source, Primary schools.

[1]. Goodman D L, Worden H V, Shordt K, Snell M. Water, Sanitation and Hygiene education for Schools. Oxford Roundtable. UK; Oxford University Press; 2005: 24.28
[2]. WHO. Cause specific mortality: regional estimates for 2008. Geneva, World Health Organization. 2011a, (http://www.who.int/healthinfo/global burden disease/estimates regional/en/index.html).
[3]. Liu et al. Global, regional and national causes of child mortality: an updated systematic analysis for 2010 with time trends since 2000. Lancet, 2012, 379: 2151-61.
[4]. WHO. Cholera, 2011. Weekly Epidermiological Report.
[5]. United Nations Children's Fund. Development of a Framework and an Action Plan for School Sanitation and Hygiene Education in Punjab. Innovative Consultant Limited. Dec 2007

Abstract: Background: A biofilm is group of bacteria embedded in a self-produced matrix made of polysaccharide and protein. Bacterial biofilms cause chronic infections because they show increased tolerance to antibiotics and disinfectant chemicals as well as resisting phagocytosis. Biofilm bacteria show much greater resistance to antibiotics than their free-living counterparts. Essential oils are a cheap and effective alternative to antibiotics that could be used to combat antibiotics resistant microorganisms. The aim of the present study was to determine the effects of essential oil of wild Thymus vulgaris grown in Jordan on biofilm-forming clinical bacterial isolates. Results: All of the isolates included in this study were able to produce a stable biofilm that adhered to polystyrene microwells. Thymus vulgaris essential oil produced inhibitory effects against all isolates with considerable variation in susceptibility. The MIC values varied between 0.0625 to 2% v/v. Isolate 6 (Pseudomonas aeruginosa) was the most resistant for both planktonic and biofilm growth while isolate 4 Escherichia coli was the most sensitive. Isolate 6 was the only isolate to exhibit a specific biofilm-related response to Thymus vulgaris essential oil i.e. the minimum Thymus vulgaris essential oil concentration needed to inhibit biofilm adherence was much lower than that required to inhibit planktonic growth. For the remaining isolates, MIC for the biofilm did not differ from the MIC for planktonic. Thymus vulgaris essential oil was able to inhibit Pseudomonas aeruginosa adherence to polystyrene. Conclusions The MIC values of Thymus vulgaris essential oil show that the essential oil has strong antibacterial and antibiofilm activity. Thymus vulgaris was able to inhibit biofilm formation in the most tolerant isolate at sub-inhibitory concentrations.

Keywords: adherence, antibiotic resistance, biofilm, essential oil, MIC, Thymus vulgaris

[1]. A. Stewart, Biofilm bacteria in chronic middle ear infection. Molecular Medicine Today, 141, 1998, 1357-4310.
[2]. R. Van Houdt, and C.W. Michiels, Biofilm formation and the food industry, a focus on the bacterial outer surface. Journal of Applied Microbiology, 109, 2010, 1117–1131
[3]. G. Reid, J. Howard, and B.S. Gan, Can bacteria interference prevent infection. Trends in Microbiology, 9(9), 2001, 424-428.
[4]. T. F. Mah, and G. A. O'Toole, Mechanisms of biofilm resistance to antimicrobial agents. Trends in Microbiology, 9(l1), 2001, 34-9.
[5]. C. Fuente-Nunez, J. Mertens, J. Smit, and R. E. W Hancock, The bacterial surface layer provides protection against antimicrobial peptides. Applied and Environmental Microbiology, 78(15), 2012, 5452–5456.
[6]. K. Lewis, Riddle of Biofilm Resistance. Antimicrobial Agents and Chemotherapy, 45(4), 2001, 999-1007.
[7]. C. Stephens, Microbiology: Breaking down biofilms. Current Biology, 12, 2002, R132-R134

Abstract: Knowledge of the shape and dimensions of the glenoid cavity are important in the design and proper fitting of glenoid component for total shoulder arthroplasty. One hundred and forty two dry scapulae (62 right and 80 left) of unknown sex and age, belonging to Indian population, were examined using digital vernier caliper. The height and anteroposterior width of the glenoid cavity was measured at three different levels. Shape of the glenoid cavity, based on the presence of a notch on the anterior glenoid rim, was noted as pear, oval or inverted comma shape. The mean height of the glenoid cavity was observed as 35.03 ± 5.25 mm on the right side and 35.3 ± 3.41mm on the left side. The Anteroposterior diameter was 24.17 ± 2.57 mm on the right and 23.9 ± 2.66 mm on the left side. 49.9% glenoid cavities were pear shape, 38% were oval and 12.05% were of inverted comma shape. Size of the glenoid cavity is variable. Hence while designing the glenoid component of the prosthesis; the smaller dimensions of the glenoid cavities in Indian population should be considered.

Key words: Glenoid cavity, Shoulder prosthesis, Morphometry

[1] Mamatha T, Pai SR, Murlimanju BV, Kalthur SG, Pai MM, Kumar B. Morphology of glenoid cavity. Online J health Allied Scs. 10(3), 2011, 7.
[2] Strauss EJ, Roche C, Flurin PH, Wright T, Zuckerman JD. The glenoid in shoulder arthroplasty. J shoulder Elbow Surg , 18, 2009, 819-833.
[3] Fick R Anatomie der Gelenke. Handbuch der Anatomie des Menschen. (ed. Von Bardelben K) 1904 Bd II, Abt 1, TI 1. Jena: G Fischer.
[4] Prescher A, Klumpen T. The glenoid notch and its relation to the shape of the glenoid cavity. J. Anat 190, 1997, 457-460.
[5] Wild LFDe, Berghs BM, Audenaert E, Sys G, Van Maele GO, Barbaix E. About the variability of the shape of the glenoid cavity. Surg Radiol Anat 26, 2004, 54-59.

Abstract: This study was carried out to determine the ferritin level and total iron binding capacity in pregnancy and postpartum. The study was carried out at federal medical center Owerri (FMC). Sixty (60) samples were used for the study, thirty (30) pregnant women and (30) thirty postpartum women were studied. Serum iron and TIBC were determined using standard haematological method. The results obtained were 115.6±41.3 for pregnant women and 121.3±44.85 for postpartum. When the two results were analyzed statistically, there is a statistical significant difference between the two p<0.05. The results obtained in TIBC were 265.3±79.1 for pregnant women and 473.5±82.6 for postpartum women. When the two results were analyzed statistically there is a statistical significant difference between the two P<0.05. From this study, there is a statistical significant decrease in serum iron for pregnant women (115.6±41.3) than in postpartum women (121.3±44.85) P < 0.05. And also a statistical significant decrease in TIBC for pregnant women (265.3±79.1) than in postpartum women (473.5±82.6) P < 0.05.

Keywords: Pregnancy, haematological, Serum iron, ferritin level and TIBC.

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[2]. Berymann, C., (2005). Iron Defiency and anaemia in pregnancy: Modern aspects of diagnosis and therapy. Fur. J. Obstet Gynecol Reprod. Biol. 123(2):3-13.
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[5]. Fernandez- Ballart, J. (2000). Iron metabols during pregnancy. Clin. Drud Invest. 19 (1): 9-19.
[6]. Gambling L., Czopek, A., Anderson HS, et al.,(2009). Fetal iron status regulates maternal iron metabolism during pregnancy in the rat. Am. Journal Physiol. 296: 1063-70.

Abstract: Differential white blood count in children between the age of 5-10 years in Owerri was investigated in 50 malaria positive children and 20 age matched children who were negative for malaria. Their differential count where estimated in addition with their PCV and platelet. The mean total white blood cell count was also estimated the result obtained shows that The mean total white blood cell count was significantly lower in malaria subjects than in non infected subjects (5.1±0.98), (7.9 ± 1.2), (p<0.05) the results obtained also shows that neutrophil count of infected subjects (42.7± 7.90) was significantly lower (P<0.05) when compared with that of non infected subjects (49.0±8.60). The mean value of lymphocyte count of malaria subjects was significantly increased (p<0.05)(52.5±9.35) when compared with non infected subjects (48.9±8.80). The mean value of eosinophil count of malaria subjects was significantly increased (2.2±0.49) when compared with non infected subjects (1.1±0.27). The mean value of monocyte was significantly increased in malaria infected subjects (3.3±0.66) when compared with non infected subjects (1.0±0.25), (p<0.05). The PCV and platelet of infected subjects respectively were significantly decreased when compared with that of non infected subjects (p<0.05). Conclusively, malaria parasite infection affects almost all the blood cells.

Keywords: Malaria, Parasitamia, monocyte, differential count, PCV and platelet

[1]. Snow, R.W., Guera, C.A., Noov, A.M., Myint, H.Y.,and Hays, (2005): The Global Distribution Of Clinical Episodes Of Plasmodium Falciparium Malaria. Nature 434: 214-217.
[2]. Snow, R.N., Trapeyf, and Marsh, K., (2001): The Past Present And Future Of Childhood Malaria Mortality In Africa Treads .Parasitol. 17 (12): 593
[3]. Chenl, Zhang,and Sendo, F. (2005): Function Of Neutrophil In Experimental Cerebral Malaria. Clin. Exp. Immunal. 120: 12-33
[4]. Muller, Immerman, PA., Reader, J.C., (2007). Plasmodium Malaria And Plasmodium Oral. The Bashful Malaria Parasite.Tread in parasitology 23(6): 278-83.

Abstract: Background: Human Immunodeficiency Virus (HIV) is a global phenomenon with an estimated population of 7.7% infected people in Plateau state, Nigeria. Aim: This study was aimed at monitoring the effectiveness of Anti-retroviral Therapy (ART) on HIV-1 infected patients. Procedure: A total number of 109 experimental volunteers' from Our Lady of Apostle (OLA) hospital, Jos, Nigeria were screened and detailed records were collected using a semi structured questionnaire for a period of 24 months at six months intervals. The effectiveness of ART was monitored using CD4 count and viral loads of the volunteers. Samples were collected in EDTA containers and the baseline CD4 and viral load were estimated. With high viral load (≥400 copies/ml) and low CD4 count (≤200 cells/mm3), the volunteers were made to commence ART treatments based on their low immunity. The CD4 count and the viral load values of the volunteers were then assessed at 6th, 12th, 18th and 24th month intervals. Result: Significant improvement was recorded in CD4 and viral load values of the volunteers; thus leading to an overall improvement in their physical health status and productivity. The active age groups (20 – 49 years) had a collective prevalence rate of 92.66% of the total study population. The highest percentage adherence of 84% was recorded in 40 – 49 years old volunteers. The patients between 50 – 59 years had a 4.59 % prevalence, while those at the two extremities of life had a combined prevalence of 2.75%. The positive response to ART improved steadily throughout the period of the study with an overall adherence rate of 84%. Conclusion: The use of Anti-retroviral Therapy (ART) in the treatment of patients with HIV-1 infection proved to be effective among patients attending OLA hospital, Jos. It should be further encouraged and well advocated in the treatment and management of patient's with HIV-1 infection.

Keywords: Anti-retroviral Therapy, Viral load, CD4, HIV-1, Adherence rate

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[3]. S. Migueles and M. Connors. Long-term Non- Progressive Disease among Untreated HIV – Infected Individuals: Clinical implications of understanding Immune control of HIV. Journal of American Medical Association, 304 (2), 2010, 194-201.
[4]. R.S. Hogg, B. Yip, and K.J. Chan. Rates of Disease Progression by Baseline CD4 Cell Count and Viral load after Initiating Triple-Drug Therapy, JAMA. 2001 Nov 28; 286 (20), 2001, 2568-77.
[5]. W.W. Daniel, Biostatistics: A foundation for Analysis in the Health Science. 7 th edition. New York, John Wiley & Sons, 1999

Abstract: Bone grafts are invaluable players in the arena of regenerative dentistry. Reconstitution of the lost bone was the objective behind the introduction of these bone grafts based on the properties of osteoconduction, osteoinduction and osteogenesis. Although autogenous bone grafts still uphold their reputation as gold standard, certain issues like the unpredictable quantity and the donor site morbidity limited its usage. Allografts too have their own shortcomings. Subsequently, significant efforts are in progress in the development of ideal bone graft substitutes. A range of alloplasts starting from hydroxyapatite and tricalcium phosphate to the currently available nanoparticles, titanium granules are available in the market. Some of these are resorbable while others are not. The point of issue at this juncture is how far are these materials effective in promoting regeneration. In the course of finding a solution, researchers ended up with varied sources for procuring suitable bone grafts. One such resource is Titanium and its availability in the form of porous granules popularly known as porous titanium granules represents a new possibility in augmenting osseous regeneration. The aim of the present review paper is to discuss the characteristics, added benefits as well as different applications of this material with a varied range of success in the field of clinical practice.

Key Words: PTGs, bone graft, osteoconduction, regeneration, thrombogenicity

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[2]. Klokkevold, PR, Jovanovic, SA (2002). "Advanced Implant Surgery and Bone Grafting Techniques". In Newman, Takei, Carranza. Carranza's Clinical Periodontology (9th ed.). Philadelphia: W.B. Saunders. pp. 907–8.
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[4]. Biomedical Applications of Titaniumand its Alloys .C.N. Elias, J.H.C. Lima, R. Valiev, and M.A. Meyers. Biological Materials Science. JOM • March 2008
[5]. M. B. GorbetandM. V. Sefton, "Biomaterial-associated thrombosis: roles of coagulation factors, complement, platelets and leukocytes," Biomaterials, vol. 25, no. 26, pp. 5681–5703, 2004.

Abstract: The first stage of orthodontic treatment entails leveling and aligning the teeth. These orthodontic applications are served by an arch wire that delivers a force that is low and decrease moderately between the appointments.1 The wires used for this first stage should have low modulus of elasticity, high resistance to deformation and wide clinical range. Since the mid 1960s, the availability of materials used for orthodontic arch wires have markedly increased. Today, not only stainless steel but also chrome cobalt, Nickel-Titanium and B-Titanium wires are used in the field of orthodontics. Stainless steel wire has higher modulus of elasticity and yield strength and hence requires loops, multiple strands and other modifications to achieve the mechanical objectives of the first stage

[1]. Waters NE. Superelastic nickel-titanium wires. Br J Orthod 1992; T9: 319-322.
[2]. Kapila S and Sachdeva R. Mechanical properties and clinical applications of orthodontic wires. Am J OrthodDentofacOrthop 1989; 96: 100-109
[3]. Meling TR, Odegaard J and Meling EO. On mechanical properties of square and rectangular stainless steel wires tested in torsion. Am J OrthodDentofacOrthop 1997; 111: 310-320.
[4]. Meling TR and Odegaard J. The effect of short term temperature changes on the mechanical properties of rectangular nickel titanium archwires tested in torsion. Angle Orthod 1998; 68: 369-376.
[5]. Meling TR and Odegaard J. On the variability of cross sectional dimensions and torsional properties of rectangular nickel-titanium arch wires. Am J OrthodDentofacOrthop 1998; 113: 546-557

Abstract: Background: 75% of calcaneal fractures are intra articular. Treating calcaneal fractures is a challenge for orthopaedic surgeon due to the complex fracture pathology. A wide range of treatment options varying from non operative to operative methods are available. The purpose of this study is to assess the functional outcome of conservatively treated and operatively managed intra articular calcaneal fractures. Methods: 25 intra articular fractures have been classified as per Computerized Tomography based Sanders system.11 fractures were treated conservatively.11 fractures were treated with open reduction and internal fixation with bone grafting and plating. 3 fractures were treated with percutaneous screw fixation. Functional outcome was assessed using Modified Rowe score after following the cases over mean period of 24 months. Results: In conservatively managed 11 fractures, average functional outcome score was good in 6 Sanders Type-I fractures, average functional outcome score was satisfactory in 3 Sanders Type –II fractures and was poor in 2 Type-III Sanders fractures. In percutaneously fixed 3 cases of Sanders Type –II intra articular fractures by screws, average functional outcome score was good. In fractures fixed with open reduction and internal fixation with bone grafting and plating, average functional outcome score was excellent in 6 Sanders Type-II fractures and good in 5 Sanders Type-III fractures. Conclusion: Sanders Type-I fractures can be treated conservatively with good functional outcome. Managing Sanders Type II and III conservatively results in satisfactory to poor outcome. Hence for Sanders Type-II and Type-III, Open reduction and internal fixation with plating and bone grafting has to be considered for achieving excellent functional outcome. Percutaneous screw fixation can also be considered which yields good functional outcome and less post operative complications.

Key words: Calcaneum, conservative, plating, screws, Sanders classification, Modified Rowe scale

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Abstract: During the past three decades, there has been an exponential increase in the number of physiological function tests designed to evaluate pulmonary function.These tests have made it possible to assess the functional abnormalities in persons with restrictive and obstructive airway disorders , with the availability of nomograms based on studies in normal healthy persons it is now possible to predict the range of normal lung function values in a given individual.The dominant functional abnormality in patients disabled by asthma,bronchitis,emphysema and other COPDs ( Chronic Obtructive Pulmonary Disorders ) is the difficulty in expiration.Hence the measurement of Peak Expiratory Flow Rate (PEFR) has gained world wide acceptability as a method for identification,assessment,rational therapy and followup of such patients.

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