iosr-JDMS   Volume-3 ~ Issue-6

Abstract: The Raynaud syndroma is a frequent reason of consultation in rheumatology. Most often, the Raynaud syndroma is without underlying disease. However, in rare cases, it can be associated to a cancer, so that it is called paraneoplastic Raynaud syndroma. The breast cancer is not knowen as giving paraneoplastic syndroma. We report one case of breast cancer associated to a Raynaud syndroma .
Keywords: Breast cancer - paraneoplastic Raynaud syndroma - mammectomy

[1] Block JA, Sequeira W. Raynaud's phenomenon. Lancet 2001;357:2042–8.
[2] Wigley FM. Raynaud's phenomenon. N Engl J Med 2002;347:1001–8.
[3] O'Keefe ST, Tsapatsaris NP, Beetham WP. Increased prevalence of migraine and chest pain in patients with primary Raynaud's
disease. Ann Intern Med 1992;116:985–9.
[4] Carpentier PH. Définition et épidémiologie des acrosyndromes vasculaires. Rev Prat 1998;46:1641–6.
[5] Planchon B, Pistorius MA, Beurrier P, de Faucal P. Primary's Raynaud's phenomenon. Age of onset and pathogenesis in a
prospective study of 424 patients. Angiology 1994;45:677–86.
[6] Olsen N, Nielsen SL. Prevalence of primary Raynaud phenomena in young females. Scand J Clin Lab Invest 1978;37:761–4.
[7] Furspan PB, Chatterjee S, Mayes MD, Freedman RR. Cooling-induced contraction and protein tyrosine kinase activity of isolated
arterioles in secondary Raynaud's phenomenon. Rheumatology 2005;44:488–94.
[8] Furspan PB, Chatterjee S, Freedman RR. Increased tyrosine phosphorylation mediates the cooling-induced contraction and increased
vascular reactivity of Raynaud's disease. Arthritis Rheum 2004;50:1578–85.

Abstract:Many people in the world are affected by hyperlipidemia, which is a known risk factor for atherosclerotic disease. On the other hand periodontitis, a prevalent oral disease has been connected to several systemic health changes, including an altered lipid metabolism. Obesity is a risk factor for several chronic diseases most notably hypertension, type II diabetes, dyslipidemia and coronary heart disease. Obesity may have a deleterious consequences on the the host response, leading to alternations in T cell and monocyte, macrophages, increased cytokine IL-1 and IL-6 and tumor necrosis factor alpha. These observations suggest a potential interaction among obesity, periodontitis and chronic disease incidence . Thus in addition to being a risk factor for type 2 diabetes and coronary heart disease, obesity related inflammation may also promote periodontitis. Conversely periodontitis, once existing may promote systemic inflammation, thereby increasing the risk of coronary heart disease.
Keywords: Hyperlipidemia , atherosclerotic disease ,Obesity, Periodontitis,

[1] Flemming TF: Periodontitis, Ann Periodontol 4:32,1999.
[2] Mattila KJ, Valtonen VV et al. Role of infection as a risk factors atherosclerosis, myocardial infarction and stroke. Clin Infec Dis.
1998;26:719-734.
[3] Expert Panel on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults. Executive summary of the
clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults. Arch Intern Med
1998;158:1855-67.
[4] Perlstein ResMI,Bissada NF(1977) Influence of obesity and hypertension on the severity of periodontitis in rats.Oral Surg Med
Oral Pathol 43;707-719.
[5] Saito. Shimazaki Y,Koga T,et al (2001).Relationship between upperbody obesity and Periodontitis. J Dent Res 80:1631-1636.
[6] Pouliot MC, Despreés JP, Lemieux S, Moorjani S, Bouchard C, Tremblay A, et al. Waist circumference and abdominal sagittal
diameter: Best simple anthropometric indexes of abdominal visceral adipose tissue accumulation and related cardiovascular risk in
men and women. Am J Cardiol 1994;73:460-8.
[7] Wang Y, Rimm EB, Stampfer MJ, Willett WC, Hu FB. Comparison of abdominal adiposity and overall obesity in predicting risk
of type 2 diabetes among men.AmJClinNutr2005;81:555-63.
[8] Yusuf S, Hawken S, Ounpuu S, Bautista L, Franzosi MG, Commerford P, et al. Obesity and the risk of myocardial infarction in
27,000 participants from 52 countries:Acase-controlstudy.Lancet2005;366:1640-9.
[9] Ritchie CS. Obesity and periodontal disease. Periodontol 2000 2007;44:154-63
[10] Pischon N, Heng N, Bernimoulin JP, Kleber BM, Willich SN, Pischon T. Obesity, inflammation and periodontal disease. J Dent
Res 2007;86:400-9.

Abstract:Aim of the study is to evaluate the efficacy of inter positional dermis-fat graft in the management of Temporo-mandibular joint(TMJ) ankylosis in children by assessing the maximal mouth opening prior and after procedure, complication at both donor and recipient sites, and prevention of re-ankylosis after inter positioning. Both unilateral, bilateral osseous and fibro-osseous ankylosis of both sexes in 5 patients and the age ranging from 5-12 years were included in this study . All the cases were treated with gap arthroplasty and the gap was filled with an autogenous abdominal dermis-fat graft procured from the supra pubic region. The dermis fat graft interpositional arthroplasty is a safe and effective procedure in the management of temporo-mandibular joint ankylosis which prevents re-ankylosis especially in children by minimizing the occurrence of excessive joint fibrosis and heterotopic calcification.
Key words: Abdominal dermis fat graft, Interpositional gap arthroplasty, TMJ gap arthroplasty

1] Verneuil, A.: Archives de Medecine, 1860, p. 284
[2] John B. Murphy. The Classic: Ankylosis: Arthroplasty—Clinical and Experimental Clin Orthop Relat Res. 2008 November;
466(11): 2573–2578. Published online 2008 August 30. doi: 10.1007/s11999-008-0455-5.PMCID: PMC2565041
[3] Balaji SM. .Modified temporalis anchorage in craniomandibular reankylosis Int J Oral Maxillofac Surg. 2003 Oct;32(5):480-5
[4] Steinberg MJ, Hohn FI. Procurement of dermal graft from the suprapubic or inguinal fold region with primary linear closure J
Oral Maxillofac Surg. 1994 Aug;52(8):813-6
[5] Chossegros C, Guyot L, Cheynet F, Blanc JL, Cannoni P. Full-thickness skin graft interposition after temporomandibular joint
ankylosis surgery: a study of 31 cases. Int J Oral Maxillofac Surg. 1999;28:330–334
[6] G. Dimitroulis. The interpositional dermis-fat graft in the management of temporomandibular joint ankylosis. International Journal
of Oral & Maxillofacial Surgery Volume 33, Issue 8 , Pages 755-760, December 2004
[7] Dimitroulis G, Trost N, Morrison W. The radiological fate of dermis-fat grafts in the human temporomandibular joint using
magnetic resonance imaging. Int J Oral Maxillofac Surg 2008 Mar;37(3):249- 54. doi 10.1016/j.ijom.2007.11.017. Epub 2008
Feb 13 PMID:18276114
[8] Larry M. Wolford, Carlos A. Morales-Ryan, Patricia Garcia Morales, and Daniel Serra Cassano. Autologous fat grafts placed
around temporomandibular joint total joint prostheses to prevent heterotopic bone formation Proc (Bayl Univ Med Cent). 2008
July; 21(3): 248–254. Copyright © 2008, Baylor University Medical Center PMCID: PMC2446413
[9] D. Mehrotra , , R. Pradhan , S. Mohammad , C. Jaiswara. Random control trial of dermis-fat graft and interposition of temporalis
fascia in the management of temporomandibular ankylosis in children . British Journal of Oral and Maxillofacial Surgery Volume
46, Issue 7, October 2008, Pages 521–526
[10] Mohammad Bayat, Amirali Badri,,Nima Moharamnejad. Treatment of temporo mandibular joint ankylosis: gap and
interpositional arthroplasty with temporalis muscle flap. Oral and Maxillofacial Surgery. December 2009, Volume 13, Issue 4, pp
207- 212

Abstract:The aim of the study was to evaluate oxidative stress in uncomplicated pregnancy by determining the serum malondialdehyde (MDA) and ceruloplasmin (Cp) levels. The study was performed on 100 women attending the antenatal outpatient department of Sree Balaji Medical college and Hospital, Chromepet. Serum MDA and Cp levels were measured in the venous blood samples taken in the first and second trimesters of pregnancy. Serum Malondialdehyde was estimated by manual method of Thiobarbituric reactive substances5. Serum Ceruloplasmin level was estimated manually by Paraphenylene diamine method6. The results were compared between the first and second trimester. MDA levels were high in the second trimester compared to the first trimester (with a p value=0.01). Cp levels were high in the second trimester compared to the first trimester (with a p value=0.01).The conclusion of the research were the pregnant women in the second trimester have increased level of oxidative stress.
Key words: pregnancy, Oxidative stress, Malondialdehyde, Ceruloplasmin

[1] Miao L, St Clair DK Regulation of Superoxide dismutase genes; implications in disease. Free Radic Biol
Med.2009,Aug15,47(4),344-56
[2] Mohora Maria, Greabu Maria, Totan Alexandra, Mitrea Niculina, Battino Maurizio Redox-Sensitive Signaling factors and
antioxidants.Farmacia,2009,vol57(4),399-411
[3] Sugino N,S.Takiguchi ,T.Umekawa, A.Heazell, I.Caniggia Oxidative stress and pregnancy outcome: A workshop report, Placenta
28,Supplement A, Trophoblast Research, vol 21,2007,S48eS50,
[4] Fialova L, Malhoban I, Kalousova M, Soukupova J, Krofta L Stipek S, Zima T,Oxidative stress and inflammation in pregnancy.
Scand J Clin Lab Invest 66,121-127,2006
[5] Lalita Chaudary et al. Lipid peroxidation and anti-oxidant enzymes in gestational diabetics .Indian J of Physiol and Pharmacol
2003;47(4):441-446.
[6] Shaikh Shamim M., Vivian D'Souza, Poornima Manjrekar. Acute phae proteins in newly diagnosed diabetes. Biomedical Research
.2008;19(1):49-53
[7] Adiga U, Adiga MNS. Total antioxidant activity in normal pregnancy. On line J Health Allied Scs.2009,8(2).
[8] Sang H Lee 1993,Robert Lancey, Anahita Montaser,Navid Madani, Maria C. Linder. Ceruloplasmin and copper transport during the
latter part of gestation in the rat. Exp Biol Med.1993;203:428-439
[9] Walsh S W. Lipid peroxidation in pregnancy. Hypertensive Preg. 1994; 13:1-25.
[10] Halliwell B Gutteridge JM. The antioxidants of human extra cellular fluids. Arch Biochem Biophys.1990; 280:1-8.

Abstract: Orthodontic appliances has always been a factor impeding oral hygiene maintenance, resulting in plaque accumulation and enamel demineralization. But method of ligation as an additional factor has been evaluated by very few. New non-conventional ligation methods are available, which reduces the friction(eg.Slide modules),but the amount of plaque accumulation with them is a concern. So,the aim of this study was to determine changes in microbial flora and periodontal status with two different archwire ligation techniques-ie conventional elastomeric modules and SlideTM.(Leone Orthodontic Product)

[1] Batoni G, Pardini M, Giannotti A, Ota F, Giuca MR, Gabriele M,Campa M, Senesi S. Effect of removable orthodontic appliances on oral colonization by mutans streptococci in children. Eur J Oral Sci. 2001;109:388–392.
[2] Jordan C, LeBlanc DJ. Influences of orthodontic appliances on oral populations of mutans streptococci. Oral Microbiol Immunol.
2002;17:65–71.
[3] Hakan Tu¨rkkahraman,M. O¨ zgu¨ r Sayın; F. Yes¸ im Bozkurt; Zuhal Yetkin; Selc¸uk Kaya, Su¨leyman O` nal..Archwire Ligation
Techniques, Microbial Colonization, and Periodontal Status in Orthodontically Treated Patients. (Angle Orthod 2005;75:231–236.)
[4] Kloehn JS, Pfeifer JS. The effect of orthodontic treatment on the periodontium. Angle Orthod 1974;44:127-34.
[5] Forsberg CM, Brattstrom V, Malmberg E, Nord CE. Ligature wires and elastomeric rings:two methods of ligation, and their
association with microbial colonization of Streptococcus mutans and lactobacilli. Eur J Orthod 1991;13:416-20.
[6] Huser MC, Baehni PC, Lang R. Effects of orthodontic bands on microbiologic and clinical parameters. Am J Orthod Dentofacial
Orthop 1990;97:213-8.
[7] Arends J, Christofferson I. The nature of early caries lesions in enamel. J Dent Res. 1986;65:2–11.
[8] O'Reilly MM, Featherstone JD. Demineralization and remineralization around orthodontic appliances: an in vivo study. Am J
Orthod Dentofacial Orthop. 1987;92:33–40.
[9] Ricardo Alves de Souza,a Maria Beatriz Borges de Araújo Magnani.;Periodontal and microbiologic evaluation of 2 methods of
archwire ligation: Ligature wires and elastomeric rings; Am J Orthod Dentofacial Orthop 2008;134:506-12
[10] Arturo Fortini,Massimo Lupoli ;Vittorio Cacciafesta .-A New Low-Friction Ligation System; JCO/AUGUST 2005.

Abstract:The morbidity and mortality from biliary atresia cannot be overemphasized. Therefore, its early detection especially using a non invasive means will go a long way in preventing liver cirrhosis, liver failure and even death from this disease entity. This study was done to highlight the abdominal scan findings in infants suspected to have biliary atresia, demonstrate the Triangular Cord sign (TC) and to assess how many of these were confirmed at surgery. It is a prospective study of 25 consecutive jaundiced infants sent to the Radiology department of a Teaching Hospital for abdominal ultrasound scan, on account of persistent elevated conjugated bilirubin and thus the suspicion of biliary atresia. The Triangular cord sign, liver size and echotexture, gallbadder longitudinal diameter, pre and postprandial were assessed. Infants that were highly suspected for biliary atresia were operated and findings were correlated with ultrasound findings. About a third of the infants scanned had a positive Triangular cord sign, only three of whom were found to be positive at surgery. The Triangular cord width ranged from 0.07 - 4.7mm, with a mean of 2.62 +1.23 mm.This study confirmed that TC measuring 3.5 - 4mm or more on ultrasound is diagnostic of biliary atresia.
Key words: Biliary Atresia, Hepatitis, Congugated Hyperbilirubinaemia, Triangular Cord Sign.

[1] AO Johnson, VA Nottidge, CO Ojo, TA Junaid , NA Akingbehin , EB Attah Conjugated hyperbilirubinaemia in Nigerian infants,
Afr J Med Med Sci. 9(3-4), 1980, 117-127.
[2] Shi-Xing Li, Yao Zhang, Mei Sun, Bo Shi, Zhong-Yi Xu, Ying Huang, and Zhi-Qin Mao Ultrasonic diagnosis of biliary atresia: a
retrospective analysis of 20 Patients. World J Gastroenterol.14 (22),2008, 3579-3582.
[3] K . Zukotynski, EC Lin. Biliary Atresia. Medscape reference, retreived from http://emedicine.medscape.com/article/406335-
overview.
[4] SO Choi , WH Park , HJ Lee , SK Woo. 'Triangular cord': a sonographic finding applicable in the diagnosis of biliary atresia. J
Pediatr Surg. 31(3), 1996, 363-366.
[5] Y Weerakkody and G Singh et al. Biliary atresia. Retrieved from Radiopedia.org http://radiopaedia.org/articles/biliary-atresia.
[6] MH Imanieh , SM Dehghani , MH Bagheri , V Emad , M Haghighat , M M Zahmatkeshan , HR Forutan , AR Rasekhi , F Gheisari
.Triangular cord sign in detection of biliary atresia: is it a valuable sign? Dig Dis Sci. 55(1),2010,172-175. doi:
10.1259/bjr/34728497.
[7] Hee-Jung Lee, Sung-Moon Lee, Woo-Hyun Park, Soon-Ok Choi. Objective Criteria of Triangular Cord Sign in Biliary Atresia on US
Scans. doi: 10.1148/radiol.292020472 Radiology. 229. 2003, 395-400.
[8] A. K Magd , K Ahmed , F. S Maha , M. E Nehal , M. E Hanaa , K. A Mohamed , A Ahmed , EE Mohammed , W Rady , M Hosam , K Manoochehr , H. A Hassan . Evaluation of the Triangular Cord Sign in the Diagnosis of Biliary Atresia Pediatrics.108 (2), 2001,
416 -420.
[9] HA Shah , W Spivak . Neonatal cholestasis. New approaches to diagnostic evaluation and therapy. Pediatr Clin North Am. 41(5),
1994, 943-966.
[10] AP Tan Kendrick , KB Phua , BC Ooi , R Subramaniam , CE Tan , AS Goh . Making the diagnosis of biliary atresia using the
triangular cord sign and gallbladder length. Pediatr Radiol. 30(2), 2000, 69-73.

Abstract:Background: As the pelvic motion comes from trunk muscles, a specific use of pelvic pattern not only exercises the pelvis for mobility and stability but also facilitate trunk motion and stability.Objective: To determine the effect of Pelvic Proprioceptive Neuromuscular Facilitation(PNF) technique on facilitation of trunk movement in hemiparetic stroke patients.Interventions: Thirty hemiparetic stroke patients were randomly divided into two groups. The experimental group received pelvic PNF while the control group received conventional physiotherapy in the form of truncal exercises for 30 minutes. Along with these both group received regular physiotherapy in the form of tonal management and range of motion exercises for the affected limbs for 30 minutes. Intervention was given once in a day for five days/week for four weeks.Outcome Measures: Trunk Impairment Scale (TIS), Trunk Lateral Flexion Range of Motion (TLF ROM), and Tinetti Test (TT). Results: Post-intervention, both the groups shows improvement on trunk performance, range of motion, balance and gait but the experimental group shows more improvement than control group [changes in mean score between group comparison for TIS 3.4 (1.8); TLF ROM for affected and non-affected side 0.734 & 3.666 (0.267 & 2.533); Balance 3.534 (2.266) and Gait 2.2 (1)]. The level of significance was set at p < 0.05 and highly significance at p < 0.01.
Key words: Inclinometer, Pelvic Proprioceptive Neuromuscular Facilitation, Stroke, Tinetti Test, Trunk Impairment Scale, Trunk Lateral Flexion Range of Motion

[1] Dally S, and Ruff RL, Electrically induced recovery of gait components for older patients with chronic stroke, Am J Phys Med
Rehabil. 79, 2000, 349- 60.
[2] Thompson JE, The evolution of surgery for the treatment and prevention of stroke. The Willis Lecture, Stroke 27(8), 1996, 1427- 34.
[3] Kopito, and Jeff, A Stroke in Time. 6(9), 2001, MERGINET.Com.
Available from http://www.webasx.com/articles/strokeintime.html
[4] World Health Organization, Cerebrovascular Disorders Geneva: World Health Organization. 1978.
Available from whqlibdoc.who.int/offset/WHO_OFFSET_43.pdf
[5] Susan B O Sullivan and Thomas J Schmitz, Physical Rehabilitation (Fifth edition. New Delhi: Jaypee Brothers Publication; 2007).
[6] Brain stroke third biggest killer in India, health.indiatimes.com/articleshow /1148565.cms
[7] D. Nagaraja, G. Gururaj, N. Girish, Samhita Panda, A.K. Roy, G.R.K. Sarma, R. Srinivasa, Feasibility study of stroke surveillance:
Data from Bangalore, India, Indian J Med Res130, 2009, 396-403.
[8] Indian Council for Medical Research,Stroke: Assessment of the burden of Non-communicable diseases: Final project report, New
Delhi. Indian Council of Medical Research 2004; 18-22.
[9] Bohannon RW, Lateral trunk flexion strength: impairment, measurement reliability and implications following unilateral brain
lesion, Int J Rehabil Res.15, 1992, 249-251.
[10] Tanaka S, Hachisuka K, Ogata H, Trunk rotatory muscle performance in post-stroke hemiplegic patients, Am J Phys Med
Rehabil.76, 1997, 366-369.

Abstract:Fractures involving the bones of forearm present unique problem not encountered with fractures of other long bones . The aim of this prospective study was to evaluate and compare the outcomes of locking compression plate (LCP) with limited contact dynamic compression plate(LC-DCP ) for the treatment of adult diaphyseal both bone forearm fractures.
Key words:diaphyseal, forearm, limited contact dynamic compression plate , locking compression plate , radius and ulna,

[1] Moore KL, Dalley AF, Agur AMR. Clinically oriented Anatomy. 6th Ed. Philadelphia: Lippincott William and Wilkins; 2010.
Crenshaw AH, Perez FA, Fractures of the shoulder, arm and forearm. In:
[2] Crenshaw AH , Canale ST, Beaty JH, Editors. Campbell's operative orthopaedics Vol III. 11th Ed. Philadelphia: Mosby Elseviar;
2008. p . 3425-27.
[3] Kotwal PP. Fractures of the Radius and Ulna. In: Kulkarni GS (Ed.); Textbook of orthopaedics and Trauma, 2nd Ed.New delhi :
Jaypee; 2008.p.1967.
[4] Muller ME. The comprehensive classification of fractures of long bone. In: Muller ME, Allgower M, Schneider R, Willenegeer H,
editors. Manual of internal fixation (3rd Ed.),Berlin: Springer ; 1999.p.132.
[5] Chapman MW, Gordon JE, Zissimos AG. Compression plate fixation of acute fracture of the diaphysis of the radius and ulna. J.
Bone Joint Surg. Am. 1989;71: 159-169.
[6] Gustilo RB, Mendoza RM, Williams DN. Problems in the management of type (III) (Severe) open fractures: a new classification of
type (III) open fracture. J Trauma 1984; 24: 742.
[7] Perreo SM. The concept of biological plating using the Limited contact dynamic compression plate (LC-DCP). Scientific
background, design and application: Injury 1991; 22 (1): 1-41
[8] Charnley J. Closed treatment of common fractures. 3rd ed. Edinburgh: Livingstone; 1961.
[9] Hughston JD. Fractures of the distal radial shaft, mistakes in management. J Bone Joint surg Am 1957; 39:249-264.
[10] Sommer C. Gautier E, Muller M, Helfet DL, Wagner M. First Clinical results of the locking compression plate (LCP). Injury 2003;
34(2): 31-42.

Abstract:Diabetogenic potential of chikungunya fever was suspected during routine management of cases attending my hospital during the 2009 chikungunya epidemic in Kerala, south India. The suspicion was given due attention because doctors were treating chikungunya with steroids like methyl prednisolone,a known diabetogenic drug and many patients had one ... or more components of metabolic syndrome..I made an attempt to evaluate the interaction between chikungunya and diabetes using the patient and laboratory data that was naturally available to me till cases ceased to report.
Key words: Chikungunya 2.Diabetogenesis.

[1] Effect of environmental factors on the development of IDDM Yoon JW, Kim CJ, Pak CY, Mc Arthur RG. Department of
microbiology and Infectious Diseases. Julia McFarlane Diabetes Research Unit University of Calgury ,Alberta, Canada.
[2] Possible mechanism in the pathogenesis of virus induced diabetes by the same workers above.
[3] Chikungunya ;Wikipedia.
[4] Chikungunya in India; Information sheet W.H.O;S.E.A.R.O ,New Delhi.
[5] A study on Chikungunya outbreak during during 2007 in Kerala, South India; Kannan et al,I.C.M.R. Madurai,India. Indian journal of
Med Res.129, March2009. Pp311 to 315.
[6] Diabetes and myasthenia gravis- Article in internet by Dr.Robert. M. Cohen M.D, Associate professor of medicine Univercity of
Cincinati.
[7] Myasthenia gravis and Diabetes mellitus.Internet- Researchers ; Toho University .Tokyo.
[8] Diabetes mellitus and Frozen shoulder or Capsular fibroplasias-The mystery unfolding.Int.J. Diab. Devoloping Countries (1999)
Vol.19.
[9] A.G. Archer et al. The natural history of acute painful neuropathy in diabetes mellitus. Topic Abstract; Internet.

Abstract:A retrospective microbiological review of pleural fluid samples was conducted to investigate the various bacteria associated with empyema thoracis and to monitor their antibiogram pattern in the 2 year study period. A total of 2219 pleural fluid samples were included in the study yielding 393 positive cultures, 302 pyogenic isolates and 107 tubercular isolates. An obvious stronghold of Gram negative bacteria in the pleural space was clearly demonstrated. A massive amount of antimicrobial resistance was noted among the pyogenic isolates increasing over time. A need for an appropriate antibiotic policy to herald judicious antibiotic use was strongly felt for.
Key words: Antimicrobial resistance ,empyema, Gram negative bacteria, MBL, pleural fluid.

[1] J.M. Porcel, P. Vázquez, M. Vives, A. Nogués, M. Falguera, A. Manonelles: Pleural Space Infections: Microbiologic and Fluid
Characteristics in 84 Patients. The Internet Journal of Pulmonary Medicine. 2003 Volume 3 Number 1.
[2] Chen KY, Hsueh PR, Liaw YS, Yang PC, Luh KT.A 10-year experience with bacteriology of acute thoracic empyema: emphasis on
Klebsiella pneumoniae in patients with diabetes mellitus. Chest. 2000 Jun;117(6):1685-9.
[3] D Raghunath.Emerging antibiotic resistance in bacteria with special reference to India: J.Biosc.33(4),November 2008,593-603
[4] Peter M. Hawkey, Annie M Jones, The changing epidemiology of resistance. Journal of antimicrobial chemotherapy (2009) 64,
suppl 1, i3-i10
[5] Robert E Siegel, Emerging Gram-Negative Antibiotic Resistance: Daunting Challenges, Declining Sensitivities, and Dire
Consequences; Respiratory Care, April 2008 VOL 53 NO 4;471-9
[6] Betty A Forbes, Daniel F.Sahm, Alice S Weissfeld, bailey & scott's diagnostic microbiology, 12 e (Mosby,2007)
[7] M100-S23, Performance Standards for Antimicrobial Susceptibility Testing; Twenty-Third Informational Supplement, CLSI
[8] Fiebelkorn KR, Crawford SA, McElmeel ML, Jorgensen JH. Practical disk diffusion method for detection of inducible clindamycin
resistance in Staphylococcus aureus and coagulase-negative staphylococci. J Clin Microbiol. 2003;41:4740–4
[9] Ami Varaiya, Nikhil Kulkarni, Manasi Kulkarni, Pallavi Bhalekar & Jyotsana Dogra , Incidence of metallo beta lactamase
producing Pseudomonas aeruginosa in ICU patients: Indian J Med Res 127, April 2008, pp 398-402
[10] Loveena Oberoi, Nachhatarjit singh, PoonamSharma, Aruna Aggarwal, ESBL ,MBL and Ampc β Lactamases Producing Superbugs
– Havoc in the Intensive Care Units of Punjab India: JCDR/2012/5016:2497

Abstract:Tuberculosis is a chronic communicable bacterial disease of ancient origin. It is caused by Mycobacterium tuberculosis, primarily infects the lungs causing pulmonary tuberculosis. TB continues to be a major public health problem worldwide. World Bank has estimated the global burden of TB in terms of DALYs loss and stated that tuberculosis stands 7th in the ten leading causes of global DALYs loss and expected to maintain its position even in 2010 AD. Because of its severity and consequences, in 1993, WHO has declared TB as a "global emergency".
Key words: prevalence of suspected tuberculosis patient was high in the community. Key words:- Tuberculosis, prevalence, rural area,

[1] World Health Organization. Global Tuberculosis Control 2009: Epidemiology, Strategy, Financing. [Online] 2009 [cited on 2010
Feb]; Available from: URL:whqlibdoc.who.int/publications/2009/9789241563802_eng.pdf
[2] Government of India. TB India 2010 RNTCP status report. New Delhi (India), Central TB division MOHFW; 2010. p 1
[3] Government of India. TB India 2010 RNTCP status report. New Delhi (India), Central TB division MOHFW; 2010. p 2
[4] Tuberculosis key facts. [Online] [cited 2012 Feb] ;Available from: URL:http://www.tbcindia.org/key.asp
[5] Yadav SP, Mathur ML, Dixit AK, Knowledge attitude practises towards TB among sandstone quarry workers in desert parts of
Rajasthan, Indian Journal Tubercle 2006; 53:187-195
[6] Kishore J. National health programs of India national policies and legislations related to health. 9th ed. New Delhi (India), Century
Publications; 2011.
[7] Sreeparna ghosh, Apurba S,Taraphdar P,Mukhopadhyay DK,Mahapatra, Biwas AB.A study on care seeking behaviour of chest
symptamatics in a slum of Bankura,WB.ijph,2010;54:1
[8] Niruparani Charles1*, Beena Thomas1, Basilea Watson1, Raja Sakthivel M.1, Chandrasekeran V.1, Fraser Wares2. Care Seeking
Behavior of Chest Symptomatics: A Community Based Study Done in South India after the Implementation of the RNTCP. PLoS
ONE | www.plosone.org 2 September 2010 | Volume 5 | Issue 9 | e12379
[9] Thorson A, Hoa N, long N. Health seeking behaviour of individuals with cough of more than three weeks.lancet,2000;356:1823-24.
[10] "Global Tuberculosis Control 2011, WHO, Geneva, 2011, 9 www.who.int/tb/publications/global_report/

Abstract:Transmigration of mandibular canines is a rare phenomenom. Bilateral transmigration of mandibular canine is even much rarer. Treatment can be orthodontic or surgical. Orthodontic treatment is very cumbersome. Here we are reporting a case of a bilateral transmigration of canines which was treated surgically, with great results. Also we are giving a brief review of literature.
Key words: abgel, bilateral, canine ,management, transmigration,

[1] Javid B.R.Transmigration of impacted mandibular cuspids. International journal of oral surgery.volume 14,issue
6,dec1985,pages547-549
[2] Ando S.AizaeaK.Nakashima T.Sanka Y.Shimbo K.Kiyikawa k.Transmigration Process of impacted mandibular cuspid.J Nihon
univ sch Dent1964;6;66-71.
[3] Tarsitano JJ,wooten J W,Burditt J T.Transmigration of nonerupted mandibular canines.report of cases.J Am Dent association
1971;82;1395-97
[4] Howard RD.The anomalous mandibular canine.Br.J Orthod.1976;3;117-21
[5] Bruszt P.neurological anomaly associated with extreme malposition of mandibular canine.J oral surg [chic][1958;11;89-90].
[6] Mitchell L. Displacement of a mandibular canine following fracture of the mandible,br dent j.1993;174;417-8
[7] Shapira Y,Mischler W A,kuflinac MM. The displaced mandibular canine.ASDC J Dent child 1982;49;362-364.
[8] Camilleri S,Scerri E;transmigration of mandibular canines and review of literature and report of five cases. Angle orthod
2003;73;753-762
[9] Aydin U,Yilmaz H.H..Transmigration of Impacted Dento maxilofac Radiol;2003;32;198-200
[10] Mupparapa M.Patterns of intra osseous transmigration and ectopic eruption of mndibular canines; review of literature and report of nine additional cases. Dentomaxillofac Radiol 2002;31:355-60.).

Abstract:Osteoarthritis is the most common cause of pain due to arthritis in women. Its high prevalence especially in the postmenopausal women, and the high rate of disability associated with the disease makes it a diagnostic and therapeutic priority. A hospital based cross sectional study was conducted in Burdwan Medical College, West Bengal, India on 76 postmenopausal women aged 45–70 years suffering from Osteoarthritis (OA) of the knee joint, which was diagnosed from symptoms, clinical examinations and radiographic findings. 150 subjects undergoing knee joint arthroscopy for chronic knee pain, meniscal tears or anterior cruciate ligament reconstruction were taken as control .Synovial fluid malondialdehyde (MDA) was measured as an index of synovial fluid lipid peroxidation. The width of knee joint space was measured from the radiographic plates to assess the disease severity. Knee joint radiographs were evaluated with the Kellgren–Lawrence grading scale .Furthermore both were correlated with oxidative stress parameters ,synovial fluid MDA levels to find out possible association between the oxidative stress induced damage and the disease progression. Results showed that there was a significant increase in MDA levels in patients with knee joint osteoarthritis as compared to the controls. Synovial MDA showed positive correlation with Kellgren–Lawrence grading and negative correlation with knee joint space width. The joint space width decreased and synovial MDA increase with increasing Kellgren–Lawrence grad.
Key words: Knee Osteoarthritis, Kellgren–Lawrence grading scale, lipid peroxidation marker, malondialdehyde,.

[1] Chopra A, Patil J, Bilampelly V, Relwane J, Tandle HS. Prevalence of rheumatic disease in rural population in Western
India: a who- ilar-copcord study. J Assoc Physicians India 2001; 49:240-46.
[2] Poole AR. An introduction to the pathophysiology of osteoarthritis. Front Biosci. 1999 Oct 15; 4:D662-70.
[3] The burden of musculoskeletal conditions at the start of the new millenium, who technical report series: 919.
[4] Hamerman D. The biology of osteoarthritis. New Engl J Med 1989;320:1322–30
[5] Del Carlo M Jr, Loeser RF. Increased oxidative stress with aging reduces chondrocytes survival: correlation with intracellular
glutathione levels. Arthritis Rheum 2003;48:3419–30
[6] Spector TD, Cooper C. Radiographic assessment of osteoarthritis in population studies: whither Kellgren and
Lawrence? Osteoarthritis Cartilage. 1993 Oct;1(4):203–206
[7] Tiku ML, Allison GT, Naik K, Karry SK. Malondialdehyde oxidation of cartilage collagen by chondrocytes. Osteoarthritis
Cartilage 2003; 11:159–66.
[8] Altman R, Asch E, Bloch D, Bole G, Borenstein D, Brandt K, et al. Development of criteria for the classification and reporting of
osteoarthritis: classification of osteoarthritis of the knee. Arthritis Rheum 1986;29:1039-49.
[9] Masaaki Takahashi, Kenichi Naito, Masashi Abe, Tomokazu Sawada and Akira Nagano. Relationship between radiographic
grading of osteoarthritis and the biochemical markers for arthritis in knee osteoarthritis; 2004, 6:R208-R212
[10] Dahle LK, Hill EG, Holman RT. The thiobarbituric acid reaction and the autoxidations of polyunsaturated fatty acid methyl
esters. Arch Biochem Biophys. 1962 Aug; 98:253–261.

Abstract: When inflammation is initiated, goal of host response is to quickly return to homeostasis through rapid elimination of invading leucocytes. Resolution of inflammation is an active process. Cells and events are stimulated to respond, which is quite different from blocking pro-inflammatory pathways.
Key words: LIPOXIN, RESOLUTION, RESOLVINS

[1] Cotren RS, Kumar V, Collins T. Cellular Pathology I: Cell injury and cell death. Philadelphia: Saunders 1999; 1-29.
[2] Sehran CN, Brain SD, Gilroy DW, Haslett C, O'Neill LA, Perritti M, Rossi AG, Wallace JL. Resolution of inflammation: state of art, definitions and terms. FASEB 2007; 21:325-332.
[3] Sehran CN. A search of endogenous mechanisms of anti inflammation uncovers novel chemical mediators: missing links to
resolution. Histochem Cell Biology, 122, 2004, 305-321.
[4] Sehran CN. Lipoxin biosynthesis and its impact in inflammatory and vascular events. Biochim Biophys Acta, 1212, 1994, 1212:1-25.
[5] Serhan CN, Hong S, Gronert K, Colgan SP, Devchand PR, Mirick G, Moussignac RL. Resolvins: a family of bioactive products of
omega-3 fatty acid transformation circuits initiated by Aspirin treatment that counter proinflammation signal. J. Exp Me, 196, 2002
:1025-1037.
[6] Bannerberg GL, Chiang N, Ariel M, Tjonahen E, Gotlinger KH, Hongs, Sehran CN. Molecular circuits of resolution: formation and
actions of resolvins and protectins. J Immunology ,174, 2005,4345-4355.
[7] Pouliot M, Clish CB, Petasis NA, Van Dyke TE, Sehran CN. Lipoxin A4 analogues inhibit leukocyte recruitment to Porphyromonas
gingivalis. A role for cyclooxygenase-2 and lipoxins in periodontal disease. Biochemistry, 39, 2000,4761-4768.
[8] Sehran CN, Clish CB, Brannan J, Colgan SP, Chiang N, Grovert K. Novel functional sets of lipid derived mediators with anti
inflammatory actions generated from omega-3 fatty acids via cyclooxygenase 2- nonsteroidal anti inflammatory drugs and
transcellular processing. J. Exp. Med., 192, 2000, 1197-1204.
[9] Rosenstein Elliot D., Kushner Laura J., Kraner Neil, Kazandjian Gregory. Pilot study of dietary fatty acid supplementation in
treatment of adult periodontitis. Prostaglandins, leukotrienes and essential fatty acids (march), 68:3, 2003 213-218.
[10] Saynur Vardar et al. Therapeutic versus prophylactic plus therapeutic administration of omega-3 fatty acids on endotoxin induced
periodontitis in rats. J Periodontol 75(12), 2004; 1640-1646.

Abstract: In a 45 year male cadaver unusual variation of right brachial artery branching was observed. Brachial artery also showed high division in to radial and ulnar artery in upper third of arm. The posterior circumflex humeral artery, profunda brachii artery and superior ulnar collateral artery all arose from one common trunk in proximal part of brachial artery before its termination. In this report we endeavor to discuss the relevance of embryogenesis and clinical importance.
Key words: Brachial artery, Posterior circumflex humeral artery, Profunda brachii artery, superior ulnar collateral artery, high division of brachial artery

[1] Williams PL, Bannister LH, Berry MM, Collins P, Dyson M, Dussek JE, Ferguson MW, eds. Gray's Anatomy. 38th Ed., London,
Churchill Livingstone. 1999; 319, 1539.
[2] Bergman RA, Thompson SA, Afifi AK, Saadeh FA. Compendium of human anatomic variation. Baltimore: Urban &
Schwarzenberg; 1988.
[3] Anson,B.J:morris.Human Anatomy in;the cardiovascular system-Arteries and veins. Thoms,M.Edr.Mc Grow Hill Book c. new
York.pp708-724[1966].
[4] De Garis CF, Swartley WB. The axillary artery in white and Negro stocks. Am J Anat. 1928:41; 353-97.
[5] Muller E (1903) Beitra$ge zur Morphologie des Gefa$sssystems.I. Die Armarterien des Menschen. Anatomische Hefte 22,377-575.
[6] Karlsson S, Niechajev I A (1982) Arterial anatomy of the upper extremity. Acta Radiologica 23, 115-121
[7] M. Rodriguez-Niedenfu HR, T. Vazquez, L. Nearn, B. Ferreira, I. Parkin, J. R. Sannudo Variations of the arterial pattern in the
upper limb revisited: a morphological and statistical study, with a review of the literature J. Anat. (2001) 199, pp. 547-566,
[8] Keen JA. A study of the arterial variations in the limbs, with special reference to symmetry of vascular patterns. Am J Anat. 1961;
108: 245–261. T. Ramesh Rao; Prakashchandra Shetty , R. Suresh: Abnormal Branching Pattern of the Axillary Artery and its
Clinical SignificanceInt. J. Morphol. v.26 n.2 Temuco jun. 2008
[9] Sampath Madhyastha, Soubhagya R. Nayak,Ashwin Krishnamurthy, Sujatha D'Costa, Asha Anu Jose, Kumar M.R. Bhat : Case
report of high origin of radial, ulnar, and profunda brachii arteries, its clinical implications and review of the literature J Vasc Bras
[10] Vijaya Paul Samuel ,Venkata Raman Vollala, Satheesha Nayak, Mohandas Rao,Shreenivasa Rao Bolla, Narendra Pammidi: A rare
variation in branching pattern of axillary artery, letter to editor, Indian journal of plastic surgery July- Dec2006, vol 39 (2)

Abstract:Background: India is contributing to around 20% of world total under five children deaths. Major cause of under five children deaths is malnutrition and multiple factors are involved in determining the nutritional status of the children. Therefore the objective of the study is to measure the prevalence of underweight and to study the selected factors associated with underweight among children under five years of age residing in a rural area.
Key words: Children, Prevalence, Risk factors, Underweight

[1] Levels & Trends in Child Mortality Report 2011. Estimates Developed by the UN Inter -agency Group for Child Mortality
Estimation. Available at
[2] http://www.who.int/maternal_child_adolescent/documents/childmortality_booklet_2011.pdf Accessed on 17 June 2012.
[3] International Institute for Population Sciences (IIPS) and Macro International. 2007. National Family Health Survey (NFHS-3),
2005–06: India: Volume I. Mumbai: IIPS.
[4] Afshan Sharghi, Aziz Kamran, Mohammad Faridan. Evaluating risk factors for protein-energy malnutrition in children under the
age of six years: a case-control study from Iran. International Journal of General Medicine. 2011;4:607–611
[5] Teresa Janevic, Oliver Petrovic, Ivana Bjelic, Amber Kubera. Risk factors for childhood malnutrition in Roma settlements in Serbia.
BMC Public Health 2010;10: 509 – 516
[6] A Basit, S Nair, KB Chakraborthy, BB Darshan, A Kamath. Risk factors for under-nutrition among children aged one to five years
in Udupi taluk of Karnataka, India: A case control study. Australasian Medical Journal 2012; 5(3): 163-167
[7] The HUNGaMA survey report 2011. HUNGaMA Fighting Hunger and Malnutrition. Available at
http://www.naandi.org/CP/HungamaBKDec11LR.pdf Accessed on 17 June 2012.
[8] Ehtisham Ahmad, Salman Khalil, Zulfia khan. Nutritional Status in Children (1 – 5 Yrs) – A Rural Study. Indian Journal of
Community Health. 2011; 23(2): 84 – 86.
[9] Sutanu Dutta Chowdhury, Tarun Chakraborty and Tusharkanti Ghosh. Prevalence of Undernutrition in Santal children of Puruliya
District, West Bengal. Indian Pediatrics. 2008; 45(1):43-6
[10] Mohsena M, Mascie-Taylor CG, Goto R. Association between socio-economic status and childhood undernutrition in Bangladesh; a comparison of possession score and poverty index. Public Health Nutr. 2010;13(10):1498-504. Epub 2010 Jun 25.

Abstract: Traumatic brain injuries (TBI) are increasing cause of functional disability which requires aggressive researches on neuroprotective agents to prevent or rectify the consequences of organic brain damage and to enhance rehabilitation. Many of the drugs which proves beneficial in preclinical studies failed to translate into clinical practice, hence the search for the ideal neuroprotective drug continues. Since the pathophysiology of TBI is highly complex and variable with multiple factors playing their roles simultaneously, it's a very tiring job to find out a novel agent. When we try to alter one of the patho-physiological aspect of TBI, it affects many targets at a time, in the same manner as the waves affect the multiple points when we throw an object into pond. As the many aspects of the TBI are still obscured, it will be of great difficulty to search a suitable target which has got pronounced effect on TBI. The failure of newer molecules to fulfill its promise can also be attributed to the flaw in preclinical and clinical studies. Eventually the journey to have an ideal neuroprotective agent still continues.
Key words: Traumatic Brain Injury, Neuro-Protection.

[1] World Health Organization. Projections of Mortality and Burden of Disease to 2030: Deaths by Income Group. Geneva; 2002 12/01/06.
[2] Gururaj G. An Epidemiological Approach To Prevention – Prehospital Care And Rehabilitation In Neurotrauma. Neurology India 1995;43(3):95-105
[3] Gururaj G. Epidemiology of traumatic brain injuries: Indian scenario. Neurological Research 2002;24:24- 8.
[4] Murray CJ, Lopez AD. Global Health Statistics: A Compendium of Incidence, Prevalence and
Mortality Estimates for Over 200 Conditions Cambridge: Harvard University Press; 1996.
[5] Dirnagl, U.; Iadecola, C.; Moskowitz, M.A. Pathobiology of ischaemic stroke: An integrated view. Trends Neurosci. 1999, 22, 391–397.
[6] Werner, C. and Engelhard, K. (2007) Pathophysiology of traumatic brain injury. Br.J. Anaesth. 99, 4–9
[7] Amaro, S.; Chamorro, A. Translational stroke research of the combination of thrombolysis and antioxidant therapy. Stroke 2011, 42, 1495–1499.
[8] Allen, E., 1912. The cessation of mitosis in the central nervous system of the albino rat.J. Comp. Neurol. 22, 547–568.
[9] Eriksson, P.S., et al., 1998a. Neurogenesis in the adult human hippocampus. Nat.Med. 4,1313–1317.
[10] Curtis, M.A., et al., 2007. Human neuroblasts migrate to the olfactory bulb via a lateral ventricular extension. Science 315,
1243–1249.