iosr-JDMS   Volume-14 ~ Issue-1 ~ January-2015

Abstract: Introduction: Coronoid fractures of the ulna are relatively uncommon, yet critical injuries to recognize. They often occur in association with elbow dislocations and play an important role in elbow instability. Case Report: we report a case of 16 years old male with history of pain and swelling and restricted movements of left elbow following a road traffic accident. Left elbow X ray and CT scan confirmed an Isolated Type 3 Coronoid Fracture (O'Driscoll et al. and Morrey) .Limb was initially immobilized in an above elbow slab followed by open reduction and internal fixation with cortical screws. Slow mobilization of elbow was started after two weeks and 3 month follow up showed complete recovery of range of movement with fracture union. Conclusion: Coronoid fractures without elbow dislocations are very rare specially type 3 A fracture but good clinical outcome can be achieved by accurate open reduction and stable internal fixation of fracture with early mobilization.

Keywords: Coronoid fracture, Elbow dislocation, terrible triad of the elbow.

[1]. Selesnick FH, Dolitsky B, Haskell SS.(1984) Fracture of the coronoid process requiring open reduction with internal fixation. A case report. J Bone Joint Surg Am;66:1304–1306.
[2]. MorreyBF(2000). The elbow and its disorders. 3rd ed. Philadelphia, PA: W.B. Saunders Company;
[3]. Hotchkiss RN.(1996) Fractures and dislocations of the elbow. In: Rockwood CA, Green DP, eds. Rockwood and Green'sfractures in adults. Vol 1. 4th ed. Philadelphia, PA: Lippincott Williams & Wilkins;:929–1024.
[4]. Ring D, Jupiter JB, Zilberfarb J.(2002) Posterior dislocation of the elbow with fractures of the radial head and coronoid. J Bone Joint Surg Am;84-A:547–551.
[5]. Doornberg JN, van Duijn J, Ring D. (2006) Coronoid fracture height in terrible-triad injuries. J Hand Surg Am;31:794–797.
[6]. Regan W, Morrey B:( 1989) Fractures of the coronoid process of the ulna. (J Bone Joint Surg Am;71(9):1348-1354)
[7]. O'Driscoll SW, Jupiter JB, Cohen MS, Ring D, McKee MD.(2003) Difficult elbow fractures: pearls and pitfalls. Instr Course Lect;52:113–134.

Abstract: Cerebrovascular diseases or stroke broadly can be classified into ischemic (85%) and haemorrhagic (15%) types. The incidence of cerebrovascular diseases increases with age and the number of strokes is projected to increase as the elderly population grows, with a doubling in stroke deaths [1].

1]. Smith WS, English JD, Johnston SC, Cerebrovascular Diseases,in Longo DL, Fauci AS, Kasper DL et al (Ed.), Harrison's Principles of Internal Medicine, 18 (New York: Mc Graw Hill,2012) 3271-3272.
[2]. Pandian JD , Stroke in India, Annuals of Indian Academy of Neurology, 11,2008, 2-3.
[3]. Pandian JD, Srikanth V, Read SJ, Thrift AG, Poverty and stroke in India, Stoke AHA J, 38,2007, 3063-3069.
[4]. Banarjee TK, Das SK, Epidemiology of stroke in India, Neurology Asia ,11, 2006, 1-4. [5]. Douglas AS, Allan TM, Rawles JM, Composition of seasonality of Disease, Scot Med, 36,1991,76-82.
[6]. Stewart S, McIntyre K, Capewell S, McMurray JJ, Heart failure in a cold climate, Seasonal variation in heart failure-related morbidity and mortality, J Am Coll Cardiol 39,2002,760-766.

Abstract: Angiokeratoma corporis diffusum, a rare clinical type of angiokeratoma, reported in association with various diseases of which Fabry disease is most common. Fabry disease, an X-linked recessive inborn error of glycosphingolipid metabolism due to deficiency of lysosomal enzyme α- galactosidase A . Clinically the disease is characterized by acroparesthesias, multiple cherry red coloured raised angiomatous hyperkeratotic lesions over trunk, abdomen, sides of buttocks and genitilia. A 27-year-old male born to a consanguineous marriage presents with acroparaesthesias and multiple cherry red and hyperkeratotic lesions over trunk, abdomen, sides of buttocks and genitilia. Histopathological examination is consistent with angiokeratoma and our case was diagnosed as angiokeratoma corporis diffusum. This case is being reported because of its rarity.

Keywords: Angiokeratoma corporis difffusum, fabry disease, X-linked recessive disease, α- galactosidase A, acroparaesthesias

[1]. Panchami Debbarman, Ashim Kumar Mondal, Niharika Ranjan Lal, Piyush Kumar,
[2]. Ramesh Chandra Gharami. cutaneous variant of angiokeratoma corporis diffuum: a case report. Journal of Pakistan Association of Dermatologists 2013;23 (3):331-334.
[3]. F B B Yap, MRCP, M Pubalan, MRCP. Angiokeratoma Corporis Diffusum. Med J Malaysia Vol 63 No 4 October 2008
[4]. J. Kotnik, F. Kotnik and R. J. Desnick. Fabry disease a case report. Acta Dermatoven APA Vol 14, 2005, No 1.
[5]. Syed Suhail Amin, Mohd. Tahseen, Zuber Ahmad, Mohd. Shoaib Zaheer, Naheed Perwin. Angiokeratoma Corporis Diffusum (Fabry's Disease). JIACM 2004; 5(1): 79-82.
[6]. Ji Eun Cho, M.D., Yong Hee Hong, M.D., Yang Gyun Lee, M.D.Han Wook Yoo, M.D. and Dong Hwan Lee, M.D. Two cases of Fabry disease identified in brothers. Korean Journal of Pediatrics Vol. 53, No. 2, 2010.
[7]. Margarita M.Larralde, Paula C.Luna Fabry disease.In: Klaus wolf, Lowell A.Goldsmith, Stephen I.Katz, Barbara A.Gilchrest, Amy S.Paller, David J.Leffel, editors. Fitzpatrick's Dermatology in General Medicine, 7th edition: New York:Mc Graw Hill Medical Publishers;2008. p. 1281-1288.

Abstract: Objective: To evaluate effectiveness of didactic and integrated lecture modules on learning skills of II MBBS students. Materials and Methods: The study was conducted on 146 second MBBS students. They were exposed to didactic lecture module (DLM) and integrated lecture module (ILM). The didactic lecture on chemotherapy of malaria was taken by Pharmacology faculty for 60 minutes, while integrated lectures on same topic were taken by Pharmacology, Microbiology, General Medicine and Community Medicine faculty. 20 minutes were allotted for each faculty. After the lectures, the evaluation of effectiveness of ILM and DLM was done by a feedback questionnaire with10 questions .

1]. Joglekar S, Bhuiyan PS, Kishore S. Integrat-ed teaching--our experience. J Postgrad Med 1994;40:231-2.
[2]. Goudar SS, Kotur PF. Trends in Medical education. Indian J Anesth 2003;47:25-9.
[3]. Kate MS, Kulkarni UJ, Supe A. Introducing integrated teaching in undergraduate medical curriculum. International Journal of Pharma Sciences and Re-search 2010;1:18-22.
[4]. Malik AS, Malik RH. Twelve tips for developing an integrated Curriculum. Med Teach 2011;33:99-104.
[5]. Medical Council of India [Internet]. India: Vision 2015; [cited 2013 28 August ]. Available from: http://www.muhs.ac.in/courses and syllabus/ II MBBS.
[6]. Dandannawar VS. Effect of Integrated Teaching versus conventional lecturing on MBBS phase I students. Recent Research in Science and Technology 2010;2: 40-8.

Abstract: Background: Occurrence of diseases in children varies every month, so does their OPD attendance. This can be attributed to the seasonal variation of certain diseases. Time series analysis can identify the correlation among the numbers of OPD attendance over a period and can also forecast OPD attendance month wise. Objectives:i To builf a time series model of OPD attendance by under 5 children at the Urban Health Training Centre (UTC) of R. G. Kar Medical College and Hospital, Kolkata. ii) To forecast the OPD attendance at the UTC.

[1]. Das N G. Statistical Methods. 3rd ed. Delhi: Tata McGraw Hill; 2010.Chapter 6, Time Series; p. 290-343.
[2]. Time-Series Analysis.[Internet] [cited 2014 July 8]. Available from: https://datajobs.com/data-science-repo/Time-Series-Analysis-Guide.pdf
[3]. Chowdhury R, Mukherjee A, Naska S, Adhikary M, Lahiri SK. Seasonality of tuberculosis in rural West Bengal: A time series analysis. Int J Health Allied Sci 2013; 2: 95-8.
[4]. Time Series Analysis: The basics. [Internet] [cited 2014 July 22]. Available from: http://www.abs.gov.au/websitedbs/D3310114.nsf/home/Time+Series+Analysis:+The+Basics
[5]. Ljung-Box Statistics for ARIMA Residuald in R. [Internet] [cited on 2014 June 17]. Available from: http://stats.stackexchange.com/questions/64711/ljung-box-statistics-for-arima-residuals-in-r-confusing-test-results
[6]. Limitations of Time Series Analysis. [Internet] [cited on 2014 July 8]. Available from: http://node101.psych.cornell.edu/Darlington/series/series1.htm.

Abstract: Leprosy is a chronic granulomatous disease caused by mycobacterium leprae with wide spectrum of clinical, histopathological and immunological characteristics. Leprosy reactions mainly encountered are type 1 and type 2 lepra reactions .In type 1 leprosy reaction, the pre existing lesions become erythematous,oedematous and rarely ulcerate.Ulcerating type 1 reaction is called lazarine leprosy.Ulcerations may occur in borderline tuberculoid pole or borderline lepromatous pole but more common in borderline tuberculoid pole.In this post elimination era of leprosy ,we are reporting two interesting case reports of type 1 lepra reaction with ulceration ,one is borderline lepromatous leprosy and another is borderline tuberculoid leprosy.

Keywords: borderline leprosy, lazarine leprosy, type 1 leprosy reaction.

[1]. Lucio R., Alvarado I. Opusculo sobre el mal de San Lazaro o elephantiasis de los Griegos. México: Murguía e Cia; 1852.
[2]. PARDO-CASTELLO, V. and CABALLERO, G. M. Lazarine leprosy, a peculiar monosymptomatic form of leprosy. Arch. Derm. Syph. 23 (1931) 1 (Jan.).
[3]. RYRIE, GORDON A. Acute ulcerative or sloughing tuberculoid leprosy. Internat. J . Leprosy 6 (1938) 153 (April-June).
[4]. LATAPI, FERNANDO and CHEVEZ ZAMORA, AGUSTIN. La lepra manchada de Lucio. Read at the V International Leprosy Congress, Havana, April 1948 (in press, Congress Memoires). [Also: Internat. J. Leprosy 16 (1949) 421 (Oct.-Dec.) J.
[5]. Nanda s,bansal s ,grover c,garg v,reddy b s n,Lazarine leprosy revisited?indian J lepr 2004;76;351-354
[6]. Salafia A.Lazarine leprosy-revisited.Indian J lepr.2005;77182-183.

Abstract: Background: There is a dearth of studies which are related to consultation-liaison psychiatry in India. The psychiatric referral rates in India are very low, considering the higher rates of psychiatric morbidity in patients who attend various departments of a hospital. Studying the pattern of psychiatric referrals may pave the way for interventions to improve the current scenario.

[1]. Parkar SR, Dawani VS, Apte JS. History of Psychiatry in India.J Postgrad Med. 2001; 47:73-76.
[2]. Sarada MM. Mental Health in Independent India: The Early Years. In: Agarwal SP, editor. Mental Health and Indian Prospective. New Delhi: Directorate General of Health Sciences Ministry of Health and Family Welfare; 2005;30-36.
[3]. Grover S. State of consultation-liaison psychiatry in India: Current status and vision for future. Indian J Psychiatry.2011; 53:202-13.
[4]. Parekh HC, Deshmukh DK, Bagadia VN, Vahia NS.Analysis of indoor psychiatric referrals in a general hospital.Indian J Psychiatry.1968; 10:81-83.
[5]. Malhotra S. Liaison Psychiatry in General Hospitals.Indian J Psychiatry.1984; 26(3):264-73.
[6]. Grover S, Subodh BN, Avasthi A, Chakrabarti S, Kumar S, et al. Prevalence and clinical profile of Delirium: A study from a tertiary care hospital in north India. Gen Hosp Psychiatry. 2009; 31:25-9.
[7]. Bhogale GS, Katte RM, Heble SP, Sinha UK, Patil PA. Psychiatric referrals in multi-speciality hospital.Indian J Psychiatry.2000; 42: 188-94.

Abstract: Objective: To assess the risk factors causing nutritional rickets among children in our part of world. Subjects And Methods: 47 children with rickets and 47 control children matched for age and sex were recruited over a 18 month period in a tertiary care hospital in northern kerala.Diagnosis was based on clinical, radiological, biochemical parameters and response to treatment. Children who presented in our OPD with non nutritional illness were used as control. A specially designed questionnaire was administered by one of the investigators to both mothers of patients and control subjects to assess the role of social, nutritional and other related factors in the pathogenesis of nutritional rickets.

1]. Curran JS, Barness LA. Nutrition. In: Behrman RE, Kleigman Rm, Jenson HB, editors. Nelson textbook of Paediatrics. Sixteenth edition. Philadelphia. W. B. Saunders Company. 2000.p. 184-187.
[2]. Leanne M.Ward MD,Isabelle Gaboury MSc,et al.Vitamin D-deficiency rickets among children in Canada.CMAJ 2007;177(2):161-6
[3]. Narendra Rathi and Akanksha Rathi.Vitamin D and child health in the 21st century.Indian Pediatr.2011; 48:619-625.
[4]. Holick MF. The vitamin D deficiency pandemic and consequences for nonskeletal health : mechanisms of action. Mol Aspects Med. 2008; 29:361-8.
[5]. Huh SY, Gordon CM. Vitamin D deficiency in children and adolescents: Epidemiology , impact and treatment. Rev Endocr Metab Disord. 2008; 9:161-70.
[6]. Sedrani SH, Al-Arabik Abanmy A, Elidrissy A. Vitamin D status of Saudis: Seasonal variations. Are Saudi children at risk of developing vitamin D deficiency rickets. Saudi Med.J. 1992;13: 430–3.

Abstract: Background: Most of the medical colleges still follow age old techniques in teaching. There is a need to improve the teaching methods for the medical students, taking into consideration the perception of the students. Aim and Objective: This study was done to evaluate the teaching and learning methods of third semester medical students in a Government Medical College. Materials and Methods: The study was done on 140 medical students of third semester, of age 18-20 years. The study subjects were given a common questionnaire to fill, about various teaching and learning methods in Pharmacology and the results were analyzed using Likert Scale.

[1]. Vallance P, Smart TG (January 2006). "The future of pharmacology". British Journal of Pharmacology.147.Suppl.1(S1):S304

[2]. Gatto, John Taylor. A Different Kind of Teacher: Solving the Crisis of American Schooling. Berkeley Hills Books. ISBN 1-893163-21-0.

[3]. Brown, Peter C.; Roediger, Henry L.; McDaniel, Mark A. (2014). Make It Stick: The Science of Successful Learning. Cambridge, MA: Belknap Press. ISBN 978-0-674-72901-8.

Abstract:Introduction: The study highlights and ascertains the utility of cytology in picking up early cervical cancer and associated causative pathogens in patients with leucorrhoea. Material And Methods: Cytopathological changes observed in the cervical squames were graded according to the Bethesda system for reporting cervical cytology. Results: The cytological patterns were found to be 1)Normal-2(1.7%) 2)Inflammatory-107(93%) 3)LSIL-5(4.3%) 4)HSIL-3(2.6%) 5)ASCUS-3(2.6%).

[1]. Misra J.S.Das zk and Harish A cytological studies in women complaining of leucorrhoea. Journal of cytology. 14(1):11,1997.
[2]. http://www.ons.gov.uk/ons/index.html.
[3]. National institutes of health. Cervical Cancer .NIH Consensus satetment.1996;14(1):1-38. U.S Cancer statistics working group. United States Cancer Statistics: 1999-2011. Incidence and Mortality Web;based report.
[4]. http://www.medindia.net/patients/patientinfo/cervicalcancer-incidence.
[5]. Bray F, Ren JS, Masuyer,Ferlay J(2013). Global estimates of cancer prevalence for 27sites in the adult population in 2008. Int I Cancer,132(5): 1133-1145. http://dx.doi.org/10.1002/ijc.27711
[6]. The 1998 Bethesda system for reporting cervical/vaginal cytologic diagnosis. Developed and approved at the national cancer institute workshop in Bethesda, Maryland, Dec. 12-13,1988: HUMAN PATHOLOGY, Vol. 21, No. 7,(July 1990); 704-708.
[7]. Harvey M. Cramer, and Suzanne: Cytomorphologic correlates of Human Papiloma Virus infection in the Normal cervico vaginal smear: Acta Cytologica Vol.41,No.2/Mar 1997;261-268.

Abstract:Renal cell carcinoma of any type exhibiting atleast focal sarcomatoid / spindle cell differentiation is called as Sarcomatoid renal cell carcinoma / Carcinosarcoma / Spindled carcinoma. It is a rare change in renal cell carcinoma, mostly seen in older age group having an incidence of 1%. Sarcomatoid differentiation in renal cell carcinoma is considered to have poor prognosis. It is composed of spindle shaped cells with marked nuclear pleomorphisim and tumor giant cells. The nuclear grade is high. We present here a case of sarcomatoid renal cell carcinoma, due to its rare incidence. Keywords: Sarcomatoid change, renal cell carcinoma

[1]. A min MB Tamboli P.et all, Prognostic impact of histologic sub typing of adult renal epithelial neoplasm .AN experience of 405 cas
[2]. Cheville JC, Lohse CM, Zincke H, et al. Sarcomatoid renal cell carcinoma: An examination of underlying histologic subtype and an analysis of associations with patient outcome. Am J Surg Pathol. 2004;28:435–441anamaru H, Sasaki M, Miwa Y, Akino H, Okada K. Prognostic value of sarcomatoid histology and volume-weighted mean nuclear volume in renal cell carcinoma. BJU Int. Feb 1999;83(3):222-6. [Medline].
[3]. Kuroiwa K, Konomoto T, Kumazawa J, Naito S, Tsuneyoshi M. Cell proliferative activity and expression of cell-cell adhesion factors (E-cadherin, alpha-, beta-, and gamma-catenin, and p120) in sarcomatoid renal cell carcinoma. J Surg Oncol. Jun 2001;77(2):123-31. [Medline].
[4]. Tickoo SK, Alden D, Olgac S, Fine SW, Russo P, Kondagunta GV, et al. Immunohistochemical expression of hypoxia inducible factor-1alpha and its downstream molecules in sarcomatoid renal cell carcinoma. J Urol. Apr 2007;177(4):1258-63. [Medline].
[5]. Lopez-Beltran A, Scarpelli M, Montironi R, Kirkali Z. 2004 WHO classification of the renal tumors of the adults. Eur Urol. May 2006;49(5):798-805. [Medline].
[6]. Mian BM, Bhadkamkar N, Slaton JW, Pisters PW, Daliani D, Swanson DA, et al. Prognostic factors and survival of patients with sarcomatoid renal cell carcinoma. J Urol. Jan 2002;167(1):65-70. [Medline].

Abstract:Today's medical educators are facing different challenges than their predecessors in teaching tomorrow's physicians. An Innovative teaching and learning method, Blended learning (Mixed methods learning) transforms the role of teachers and learners, where educators will become more involved as facilitators of learning and assessors of competency. The aim of this study was to evaluate the effectiveness of blended-learning approach in teaching. A study was conducted on 81 medical under-graduate students with the help of Bloom's taxonomy as a measuring tool for evaluating various levels of cognitive knowledge skills of learning. Initially a Pre-test comprising 15 multiple choice and one word answer questions, was conducted, followed by self learning, group discussions, peer group presentations and an interactive session, facilitated by a faculty member.

[1]. Ozuah PO. Undergraduate medical education: thoughts on future challenges. BMC Med Educ. 2002;2:8–10. Cited Here... | PubMed | CrossRef
[2]. Leung WC. Competency based medical training: review. BMJ. 2002;325:693–96. Cited Here... | View Full Text | PubMed | CrossRef
[3]. Constructing Knowledge Together (21-45). Extract from Tele-collaborative Language Learning. A guidebook to moderating intercultural collaboration online. M. Dooly (ed.). (2008) Bern: Peter Lang
[4]. Buckwalter JA, Schumacher R, Albright JP. Use of an educational taxonomy for evaluation of cognitive performance. J Med Educ. 1981;56:115-121.
[5]. Bloom B, Englehart M, Furst E. Taxonomy of educational objectives: The classification of educational goals. Handbook I: Cognitive domain. New York, Toronto: Longmans. 1956.

Abstract:Rape is an oral, anal or vaginal penetration that involves threat or force against an unwilling person younger than the age of consent. It is a traumatic and life threatening experience, one that cannot be forgotten easily. It may leave survivor full of fear, doubt and anger. Not only does it affect the survivor, .the pains and ripples through the family, friend and other significant others. Rape is an example of violence against the girl-child. Reducing the rate of this crime in our society must begin from a change in the way girls are perceived. There are different types of rape such as statutory rape, date rape, war rape, stranger rape and child rape. Parents should educate the girl child on sexuality education, decent dressing and good moral upbringing in a Godly way and teach them to avoid peers with negative influence. The law enforcement agents should investigate and bring the offenders to book to serve as a deterrent to others. This paper discussed the types of rape, predisposing factors to rape, effects on the girl child and care of rape victim. Adequate suggestions were made for the prevention of the girl child from rape.

Keywords: child, consent, girl, Rape, victim,

[1]. M..C .Townsend (2006): Psychiatric mental Health Nursing (5ed). Concept of care in Evidence Based Practice. Philadelphia: F.A
Dawis Company Publishers.
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Abstract:The study was undertaken to compare the effects of Dexmedetomidine and Clonidine in attenuating hemodynamic response to laryngoscopy and intubation. This study was done in 90 patients divided into 3 groups
 To observe the variations in sympathetic response to laryngoscopy and intubation.
 To study effectiveness of
a) Dexmedetomidine 1mcg /kg bolus administration 10 minutes before laryngoscopy and intubation and
b) Clonidine 0.5mcg/kg administered 10 minutes before laryngoscopy and intubation in attenuating the sympathetic response.

1]. Reid& Brace: Irritation of respiratory tract and its reflex effect on heart-Surgery gynaecology Obstetrics. 1940; 70:157.
[2]. Derbyshire DR, Chmielewski A, Fell D, Vaters M, AcholaK, Smith G. Plasma Catecholamine response to tracheal intubation. Bsr J Anaesth 1983; 55:855-9.
[3]. Fox EJ, Sklar GS, Hill CH, VillanueVar, King BD. Complications related to thepressor response to endotracheal intubation. Anaesthesiology. 1977; 47:524-5.
[4]. Karl et al- Insertion of LMA in place of endotracheal intubation to attenuate thecardiovascular response. IJA, 1999; 43:30-35.
[5]. Kumar et al- Blocking Glossopharyngeal & superior laryngeal nerves to attenuatethe cardiovascular response to laryngoscopy & endotracheal intubation.IJA,1993; 41:20-25

Abstract:Dextrocardia with situs inversus (situs inversus totalis) is rare congenital anomaly which can be asymptomatic and compatible with normal life. Incidence is 1 in 10000. But in cases of situs inversus with levocardia association of congenital heart disease is high. We are presenting a pair of twins, born out of nonconsangunious marriage, from a primigravida mother, with an uneventful antenatal period, at 34 weeks 5 days of gestation. Both the twins did not required active resuscitation. On routine examination it was found that, both the twins had situs inverus and chest x ray, echocardiography and abdominal ultrasound was done, which confirmed the same. Our 1st twin was a case of situs inversus totalis (cardiac apex on right side) without any congenital heart disease and 2nd twin was a case of situs inversus with levocardia (cardiac apex on left side) with complex congenital cyanotic heart disease. To conclude newborn babies should have a thorough physical examination after delivery before discharge to enable early diagnosis of congenital anomalies for appropriate referral. Though situs inversus in single neonate is well described, but we have not come across any case report in which both twins have situs inversus with or without dextrocardia, so we think the case is worth reporting.

Keywords: neonate, twins, dextrocardia, situs inversus.

[1]. Applegate KE, Goske MJ, Pierce G, Murphy D. Situs revisited: Imaging of heterotaxy Syndrome. Radiographics 1999; 19 (4): 837-52.
[2]. Chib P, Grover DN, Shahi BN. Unusual occurrence of dextrocardia with situs inversus in succeeding generations of a family. J Med Genetics 1977;14:30-2.
[3]. Nawaz A, Matta H, Hamchou M, Jacobez A, Trad O, Al Salem AH. Situs inversus abdominus in association with congenital duodenal obstruction: a report of two cases and review of literature. Pediatr SurgInt 2005; 21: 589–92.
[4]. Radhika D, Rekha NS, Mohan KVM. Dextrocardia with Situs inversus – a case report. Int Jour Anat Variat. 2011; 4:88-89.
[5]. Uchenna DI, Jesuoribo DE, Anyalechi JI. Dextrocardia with Situs Inversus Totalis in an Adult Nigerian: a case report. American Journal of Medicine and Medical Sciences 2012, 2(3): 59-61.
[6]. Agirbashi M, Hamid R, Jennings HS, Tiller GE. Situs inversus and hypertrophic cardiomyopathy in identical twins. Am J Genetics 2000;91:327-30.

Abstract: HIV infection of the oesophagus is one of the cause of oesophageal ulcer in HIV positive patient with odynophagia and retro- sternal chest pain. We report a case of idiopathic oesophageal ulcer in a HIV positive individual with immunological and virological failure on first line HAART who responded symptomatically and endoscopically to oral steroid, adequate nutrition and second line HAART. Recurrence of ulcer was not seen on six month follow up due to adequate immunological recovery and virological suppression on second line HAART.

Keywords: HAART, HIV, Idiopathic Oesophageal Ulcer, Immunological Failure, Virological Failure

[1]. D P Epstein, M Locketz, Oesophageal ulceration in HIV infected patients, South Asian Medical Journal, Feb 2009, Vol. 99, No.2
[2]. Wilcox CM, Esophageal disease in the acquired immunodeficiency syndrome: etiology, diagnosis, and management, American Journal of Medicine, 1992; 92: 412-421.
[3]. Kotler DP, Reka S, Orenstein JM, et al, Chronic idiopathic ulceration in the acquired immunodeficiency syndrome. Journal of Clinical Gastroenterology 1992; 15(4): 284-290.

[4]. Levine MS, Loercher G, Katzka DA, Herlinger H, Rubesin SE, Laufer I, Giant human immunodeficiency virus-related ulcers in the esophagu, Radiology, 1991 Aug;180(2):323-6

Abstract:Aim: Angiogenesis is an essential prerequisite for endometrial development and differentiation. Absence of optimum endometrial perfusion can be one of the important reasons behind the patients with unexplained infertility. The present study was undertaken to identify the endometrial vascularity by Doppler and find its relation with serum VEGF in infertile women. Materials And Methods: 60 Patients who qualified the exclusion and inclusion criteria were enrolled in the study. Patient's blood was obtained by venepuncture on the day of Doppler examination to be evaluated for serum VEGF. Results: Doppler vascular penetration zones were identified as zone 1, zone 2 and zone 3 i.e. poor, intermediate and good vascularity respectively. A rise in the mean serum VEGF level was observed with the increase in the endometrial vascular penetration zones on Doppler i.e. from 37.67±10.53 pg/ml in Zone 1 to 83.69 ±19.86 pg/ml in Zone 2 to 215.07±25.60pg/ml in Zone3(p<0.05). The Doppler vascular penetration zones were taken as gold standard and cut-off value of serum VEGF was determined that could predict good endometrial receptivity.

[1]. Hull MG, Glazener CM, Kelly NJ, Conway DI, Foster PA, Hinton RA et al. Population study of causes, treatment and outcome of infertility. Br Med J (Clin Res Ed). 1985; 291(6510): 1693–1697.
[2]. Raine-Fenning NJ, Campbell BK, Kendall NR, Clewes JS and Johnson IR. Endometrial and subendometrial perfusions are impaired in women with unexplained subfertility. Hum Reprod. 2004; 19(11): 2605–2614.
[3]. Goswamy RK, Williams G and Steptoe PC. Decreased uterine perfusion—a cause of infertility. Hum Reprod. 1988; 3(8):955–959.
[4]. Kurjak A, Kupesic-Urek S, Schulman H and Zalud I. Transvaginal color flow Doppler in the assessment of ovarian and uterine blood flow in infertile women. Fertil Steril. 1991; 56(5):870–873.
[5]. Raine-Fenning NJ, Campbell BK, Kendall NR, Clewes JS and Johnson IS. Quantifying the changes in endometrial vascularity throughout the normal menstrual cycle with three-dimensional power Doppler angiography. Hum Reprod. 2004; 19(2): 330-338.
[6]. Ahmadi F, Vosough A, Irani S and Zafarani F. Correlation between Endometrial Parameters in Doppler Sonography and Success Rate of Implantation in Assisted Reproductive Program. Iran J Fertil Steril. 2007; 1(2): 63-68.

Abstract:This study was done to determine the prevalence of visual impairment due to refractive errors and ocular diseases in lower middle class school children of Imphal, India. A total of 842 children, which included 481 males and 361 females, in the age range of 4 to 17 years from 5 schools were screened with a detailed ocular examination protocol. Among 842 children in whom 20 students (2.37%) had visual acuity < 6/18 in the better eye (equivalent to visual impairment), while 2 (0.2%) had visual acuity < 6/60 in the better eye (equivalent to economic blindness). data support the assumption that vision screening of school children in developing countries could be useful in detecting correctable causes of decreased vision, especially refractive errors, and in minimizing long term permanent visual disability. A total approach in a school eye health programme must include teacher orientation and health education of children in addition to screening for eye diseases. Considering the fact that one-third of India's blind lose their eyesight before the age of 20 years and many of them are under five when they become blind, early detection and treatment of ocular morbidity among children is important.

Keywords: Ocular disorders, ocular morbidity, refractive errors, school children, vision screening

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