DocumentsDate added
Original research article:-Orthodontics
Prabhuraj Kambalyal 1 , Ronak Maniar 2*, Sudhanshu Sanadhya 3,Ramesh Nagarajappa4 & Prashant Nahar 5, & Mrudula Tak 6
1Professor,2Postgraduate student, Department of orthodontics,3Postgraduate student,4Head,6Senior lecturer, Department of community Dentistry, 5Professor,Department of oral medicine and radiology, Pacific Dental College and Hospital, Airport Road, Debari, Udaipur – 313024, Rajasthan.
Abstract:-
Aims: To assess the skeletal age of an individual by interpretation of the cervical vertebrae as seen in lateral cephalogram obtained as a standard pre-treatment diagnostic record and to correlate and evaluate the changes in the shape and size of the cervical vertebrae with the skeletal maturity index on a hand wrist radiograph. Settings and design: A cross sectional radiographic study was carried out among 120, 8-14 years old children visiting Department of Orthodontics, Pacific Dental College and Hospital, Udaipur, India. Methods and Material: The hand wrist x-ray and lateral cephalogram were taken and traced for all subjects. The system developed by Fishman and Farman and Hassel modification of Lamparski’s criteria was used to determine skeletal maturation by hand wrist evaluation and cervical vertebrae respectively. Statistical analysis used: Descriptive statistics and percentage of similar assessments were calculated. Chi square, One way ANOVA and Spearman’s correlation tests were applied. Statistical significance was set at p≤0.05. Results: Mean age of the study population was 11.5 ± 1.715 years. With increase in age, the proportion of children with higher CVMI and SMI scores also increased significantly. Significantly greater proportion of females had higher CVMI and SMI scores than males. Positive correlation (r=0.935) between CVMI and SMI scores was observed. The overall percentage correlation was found to be 93.3%. Conclusion: The results of the present study validate the use of cervical vertebrae as a growth marker and authenticate its use as a reliable method for skeletal maturation assessment.
Key words:- Cervical Vertebrae Maturation Indicator, Hand wrist radiograph, lateral cephalogram, Skeletal Maturation Indicator.
References:-
1.Hassel B, Farman AG. Skeletal maturation evaluation using cervical vertebrae. Am J Orthod Dentofac Orthop 1995;107:58-66.
2.Hagg U, Taranger J. Maturation indicators and the pubertal growth spurt. Am J Orthod 1982;82:299-309.
3.Fishman LS. Radiographic evaluation of skeletal maturation. A clinically oriented method based on hand-wrist films. Angle Orthod 1982;52:88-112.
4.Kader HMA. The reliability of the dental X-ray film in assessment of the MP3 stages of the pubertal growth spurt. Am J Orthod Dentofacial Orthop 1998;114:427-9.
5.Fishman LS. Maturation patterns and prediction during adolescent. Angle Orthod 1987;57:178-93.
6.Joshi VV, Iyengar AR, Nagesh KS, Gupta J. Comparative study between cervical vertebrae and hand-wrist maturation for the assessment of skeletal age. Rev Clín Pesq Odontol 2010;6:207-13.
7.Fishman LS. Chronological versus skeletal Age, an evaluation of Craniofacial Growth. Angle Orthod 1979;49:181-9.
8.Sierra AM. Assessment of dental and skeletal maturity: A new approach. Angle Orthod 1987;57:194-208.
9.Bjork A, Helm S. Prediction of age of maximum puberty growth in body height. Angle Orthod 1967;37:134-43.
10.Stiehl J, Müller B, Dibbets J. The Development of the Cervical Vertebrae as an Indicator of Skeletal Maturity: Comparison with the Classic Method of Hand-wrist Radiograph. J Orofac Orthop 2009;70:327-35.
11.Hunter CJ. The correlation of facial growth with body height and skeletal maturation at adolescence. Angle Orthod 1966;36:44-54.
12.Gabriel DB, Southard KA, Qian F, Marshall SD, Franciscus RG, Southard TE. Cervical vertebrae maturation method: Poor Reproducibility. Am J Orthod Dentofacial Orthop 2009;136:478-80.
13.Garcia FP, Torre H, Flores LI, Rea. The cervical vertebrae as maturational indicators. J Clin orthod 1998;32:221-5.
14.Kucukkelea N, Acer A, Biren S, Arun T. Comparison between cervical vertebrae and hand-wrist maturation for the assessment of skeletal maturity. J Pediatr 1999;24:47-52.
15.Baccetti T, Lorenzo F, McNamara JA. An improved version of cervical vertebral maturation (CVM) method for the assessment of mandibular growth. Angle Orthod 2002;72:316-23.
16.Santiago RC, de Miranda Costa LF, Vitral RW, Fraga MR, Bolognese AM, Maia LC. Cervical vertebral maturation as a biologic indicator of skeletal maturity. Angle Orthod 2012;82:1123-31.
17.Lai EH, Liu JP, Chang JZ, Tsai SJ, Yao CC, Chen MH, et al. Radiographic assessment of skeletal maturation stages for orthodontic patients: hand-wrist bones or cervical vertebrae? J Formos Med Assoc 2008;107:316-25.
18.Mahajan S. Evaluation of skeletal maturation by comparing the hand wrist radiograph and cervical vertebrae as seen in lateral cephalogram. Indian J Dent Res 2011;22:309-16.
19.Chang HP, Liao CH, Yang YH, Chang HF, Chen KC. Correlation of cervical vertebra maturation with hand-wrist maturation in children. Kaohsiung J Med Sci 2001;17:29-35.
20.Roman PS, Palma JC, Oteo D, Nevado E. Skeletal maturation determined by cervical vertebrae development. Eur J Orthod 2002;24:303-11.
21.Caltabiano M, Leonardi R, Zaborra G. Valutazione delle vertebre cervicali per la determinazione dell’eta scheletrica. Rivista Italiana di Odontoiatria Infantile 1990;1:15-20.
Copyright © 2013 Maniar Ronak et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Original research article:-
Porwal Sanjay K1*,Gupta Ritu 2,Swarnkar Madhusudan3,Baig Vaseem N.4,Deewan Rishi5 & Jain Chetna6.
1Associate Professor, Department of Surgery, 2Associate Professor, Department of Obstetrics and Gynecology, 3Assistant Professor, 4Associate Professor, Department of P.S.M., 5Professor, 6Assistant Professor, Department of Pathology, Jhalawar Medical College, Jhalawar, Rajasthan- 326001,India.
Abstract:- Background: The Fine needle aspiration cytology is now an investigation of choice in evaluating thyroid swellings. It is simple, safe, cost effective and easy to do as out patient procedure. It is accurate, specific and sensitive. The objective of this study was to determine the reliability of FNAC in detecting various benign and malignant lesions of thyroid and correlate the results with histopathological examination report. Materials and Methods: This study was carried out at the Department of Surgery, S.M S. Medical College Hospital, Jaipur, Rajasthan (India). FNAC was performed on 100 patients of all age group and both sexes who presented with thyroid swellings. Results: Out of 100 patients, 87 were females and 13 were males. Majority of patients came with swelling of duration of less than a year. Majority cases came without any predominant symptoms. All cases underwent surgery and finally histopathological report collected. The goiter seen in 47, adenoma in 33, cancer in 13 and 7 histopathological reports were miscellaneous like lymphoid hyperplasia, hashimotos disease. Majority of population was iodine salt user (75%). Key words:- Fine Needle Aspiration Cytology, Thyroid swelling, Sensitivity, Specificity, Accuracy, Histopathology.
References:-
1.http://www.nobelprize.org/nobel_prizes/medicine/laureates/1909/kocher-bio.html.
2.Vander JB, Gaston EA Dawber TR. The significance of nontoxic thyroid nodule: final report of a 15 year study of the incidence of thyroid malignancy. Ann Int Med 1968; 69:537-40.
3.Gharib H. fine needle aspiration biopsy of thyroid: An appraisal. Ann Int Med 1993; 118: 282-9.
4.Rojeski MT, Gharib H. Nodular thyroid disease: evaluation and management. N Eng J Med 1985; 313: 428-36.
5.Guido M. Sclabas, Gregg A. Staerkel, Suzanne E.Shapiro, et al Fine Needle aspiration of thyroid & correlation with histopathology in a contemporary series of 240 patients. Am J Surgery 2003; 186-702-10.
6.Martin HE, Ellis EB. Biopsy by needle puncture and aspiration. Ann Surg 1930;92:169-81.
7.Mahar SA, Husain A, Islam N. Fine needle aspiration cytology of thyroid nodule: diagnostic accuracy and pitfalls. J Ayub Med Coll Abbottabad 2006;18(4):26–9.
8.Gharib H. Diffuse nontoxic and multinodular goiter. Curr Ther Endocrinal Metab 1994; 5:99–101.
9.Bugis SP, Young JKE, Archibald SD, Chen VS. Diagnostic accuracy of fine needle aspiration cytology verses frozen section in solitary thyroid nodules. Am J Surg 1986;152(4):411–6.
10.Boyd LA, Earnardt RC, Dunn JT, Frierson HF, Hanks JB. Preoperative evaluation and predictive value of fine needle aspiration and frozen section of thyroid nodules. J Am Coll Surg 1998;187(5):494–502.
11.Baloch ZW, Sack MJ, yu GH, Livolsi VA, gupta PK. Fine needle aspiration of thyroid an institutional experience. Thyroid 1998; 8: 565-69.
12.Ghariab H. Fine needle aspiration of thyroid nodules advantages limitations and effects. Mayo clin proc 1994; 69:44-9.
13.Caraway NP Sniege N, Samaan. Diagnosyic pitfalls in thyroid fine needle aspiration: a review of 394 cases. Diagn cytopathol. 1993; 9: 345-50.
14.Giuffrida D, Gharib H. Controversies in the management of cold, hot and occult thyroid nodules. Am J Med 1995;99:642-50.
15.DeMicco, Zoro P, Garcia S, Skoog L, Tani EM, Carayon P, et al. Thyroid peroxidase immunodetection as a tool to assist diagnosis of thyroid nodules on fine needle aspiration biopsy. Eur J Endocrinol 1994;131:474-9.
16.Handa U, Garg S, Mohan H, Nagarkar N. Role of fine needle aspiration cytology in diagnosis and management of thyroid lesions: A study on 434 patients. J Cytol 2008;25:13–7.
17.Caraway NP, Sneige N, Samaan N. Diagnostic pitfalls in thyroid fine needle aspiration: a review of 394 cases. Diagn Cytopatho 1993; 9: 345-50.
18.Cruso D, Muzzaferri EL. Fine needle aspiration biopsy in the management of thyroid nodules. Endocrinologist 1991; 1: 1194-202.
19.Muzzaferri EL. Management of a Solitary thyroid nodule. N Eng J Med 1993: 328: 553– 9.
20.Ridgway CE. Clinical review 30: Clinicians evaluation of a solitary thyroid nodule. J clin Endocrinol metab 1992; 74: 231-5.
21.Bista M, KC Toran, Regmi D, Maharjan M, Kafle P, Shrestha S. Diagnostic accuracy of fine needle aspiration cytology in thyroid swellings. J Nepal Health Res Counc 2011;9:14-6.
22.Agarwal A, Mishra SK. Completion total thyroidectomy in the management of differentiated thyroid carcinoma. Aust N Z J Surg 1996;66:358-60.
23.Ikram M, Hyder J, Muzaffar S, Hasan SH. Fine Needle Aspiration cytology (FNAC) in the management of thyroid pathology – the Aga Khan University Hospital experience. J Pak Med Assoc 1999;49(6):133-5.
24.Ashcraft MW, Van Herle AJ. Management of thyroid nodules II: scanning techniques, thyroid suppressive therapy and fine needle aspiration. Head Neck Surg 1981;3:297–322.
25.Hall TL, Layfield LJ, Philippe A, Rosenthal DL. Source of diagnostic error in the fine needle aspiration of the thyroid. Cancer 1989; 63:718-25.
26.Guidelines of the Papnicoloau Society of Cytopathology for the examination of fine needle aspiration specimens from thyroid nodules. Mod Pathol 1996;9(6):710–5.
27.Morgan JL, Serpell Jhq, Cheng MS. Fine Needle Aspiration Cytology of thyroid nodules, how useful is it. ANZ- J Surg 2003, Jul, 73(7); 480-3.
Copyright © 2013 Sanjay K Porwal. et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Research article:-Anaesthesia
R.Uma1, Meera Rani Nayak2 & Hansa Jayakumar3
1,2Assisstant professor, 3Professor, Department of anaesthesia, Sree Balaji Medical College and Hospital, Chennai, India.
Abstract:-
Clonidine is an alpha2 adrenorecptor agonist which has become a popular adjuvant in anaesthesia. Its effectiveness in providing better intraoperative hemodynamics has been well proven. In our study we show the effectiveness of bolus doses of iv clonidine without a follow up infusion in providing better hemodynamic stability in laparoscopic cholecystectomy. METHODS: We did a randomised placebo controlled study to assess the effect of intravenous clonidine on intraoperative hemodynamics in 40patients who underwent elective laparoscopic cholecystectomy. Patients were randomised into 2 groups. Group C received iv clonidine at a dose of 3micrograms/kg over 15mts prior to induction and Group P recieved same volume of NS(normal saline).Anaesthesia was induced and maintained with propofol, fentanyl and vecuronium bromide, isoflurane and nitrous and oxygen 2:1. Pulse rate(PR) and mean arterial pressure(MAP) were recorded prior to induction, 2mts after intubation, before pneumoperitoneum, 10 and 20mts after pneumoperitoneum and 10mts after extubation. Post operative recovery was assessed using the ramsay sedation score at 30mins, 60mins and 120mins. The occurrence of adverse effects such as nausea, vomiting, hypotension, bradycardia and respiratory depression where also noted. RESULTS AND DISCUSSION: Patients in group C maintained greater intraoperative hemodynamic stability. There was significant decrease in PR and MAP in the Group-C during pneumoperitoneum and after extubation.
Key words:- Clonidine, laparoscopic cholecystectomy, hemodynamic stability.
References:
1. Ghignone M, Calvillo O, Quintin L. Anesthesia and hypertension : the effect of clonidine on perioperative hemodynamics and isoflurane requirements. Anesthesiology 1987; 67:3-10.
2. Ghignone M, Quintin L, Duke PC, Kehler CH, Calvillo O. Effects of clonidine on narcotic requirements and hemodynamics response during induction of fentanyl anesthesia and endotracheal intubation. Anesthesiology 1986;64:36-42.
3. Brest AN. Haemodynamic and cardiac effect of clonidine. J Cardiovasc Pharmacol 1980; 2:S39-46.
4. Parlow JL, Bégou G, Sagnard P, Cottet-Emard JM, Levron JC, Annat G, Bonnet F, Ghignone M, Hughson R, Viale JP, Quintin L. Cardiac baroreflex during the postoperative period in patients with hypertension. Effect of clonidine. Anesthesiology 1999;90:681-92.
5. Flacke JW, Bloor BC, Flacke WE, Wong D, Dazza S, Stead SW, Laks H. Reduced narcotic requirements by clonidine with improved hemodynamic and adrenergic stability in patients undergoing coronary bypass surgery. Anesthesiology, 1987; 67:11-9.
6. Quintin L, Bonnet F, Macquin I, Szekely B, Becquemin JP, Ghignone M. Aortic surgery : effect of clonidine on intraoperative catecholaminergic and circulatory stability. Acta Anaesthesiol Scand, 1990; 34:132-13.
7.Guglieminotti J,Descraques C, Petitmaire S, Almenza L, Grenapin O, Mantz J, Effects of premdication on dose requirements for propofol; comparison of clonidine and hydroxyzine. Br J Anaesth 1998; 80:733-6.
8.Kulka PJ, Tryba M, Sczepanski U, Zenz M. Does clonidine modify the hypnotic effect of propofol? Anaesthetist 1993; 42:630-7.
9.Fehr SB, Zalunardo MP, Seifert B, Rentsch KM, Rohling RG, Pasch T, et al.Clonidine decreases propofol requirements during anaesthesia: effect of bispectral index. Br J Anaesth 2001:86:627-32.
10.Taittonen M, Kirvela O, Aantaa R. Kanto J. Cardiovascular and metabolic responses to clonidine and midazolam premedication. Eur J Anaesthesiol 1997:14:190-6.
11.De Deyne C, Struys M, Heylen R, De Jough R, Vander Laenen M, Buyse L, Dedhislage J, Rolly G. Influence of intravenous clonidine pretreatment on anaesthetic requirements during BIS EEG guided sevoflurane anaesthesia. J Clin Anesth 2000 Feb;12(1):52-7.
12.Altan A, Turgut N, Yildiz F, Turkmen A, Ustun H. Effect of magnesium sulphate and clonidine on propofol consumption, haemodynamics and post operative recovery. Br J Anaesth2006;94:438-41.
13. Manjushree Ray, Dhurjoti Prosad Bhattacharjee, Bimal Hajra, Rita Pal, and Nilay Chatterjee. Effect of clonidine and magnesium sulphate on anaesthetic consumption, haemodynamics and postoperative recerovy: A comparative study: Indian J Anaesth. 2010 Mar-Apr; 54(2): 137–41.
14.Shivinder Singh, Kapil Arora. Effect of clonidine premedication on perioperative hemodynamic response and post operative analgesic requirements for patients undergoing laparoscopic cholecystectomy. Indian J Anaesth. 2011,Vol 55,Issue 1;26-30.
15.Mrinmoy Das, Manjushree Ray, Gauri Mukherjee. Hemodynamic changes during laparoscopic cholecystectomy: Effect of clonidine premedication. Indian J Anesth. 2007,Vol 51, Issue 3;205.
16.Naude GP,Ryan MK, Pianim NA,Klein SR, Lippmann M, Bongard FS. Comparative stress hormone changes during helium versus carbon di oxide laparoscopic cholecystectomy. J Laparoendosc Surg 1996;6:93-8.
17. Harron DW,Ridell JG, Shanks RG. Effects of azepexole and clonidine on baroreceptor mediated reflex bradycardia and physiological tremor in man. Br J Clin Pharmacol 1985;20:431-6.
Copyright © 2013 R.Uma, Meera Rani Nayak & Hansa Jayakumar. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Review article:-Pedodontics
Prashant Babaji1*, Nitin Sharma2, Rohit Sharma6,Subhash Chander4, Shivaprakash S3 & Jagadeesh G5.
1Associate Professor,2Senior Lecturer, Department of Pedodontics,4Senior Lecturer, Department of Conservative & Endodontics, Senior Lecturer, Department of Oral Pathology, Vyas Dental College, Jodhpur, India. 3Senior Lecturer, Department of Orthodontics, Malbar Dental College, Manoor, Kerala, India. 5Senior Lecturer, Department of Orthodontics, VPDC Dental College, Sangli, Maharastra, India.
Abstract:- Teeth present at the time of birth are called Natal teeth. Teeth which erupt in the neonatal period that is within thirty days of birth are Neonatal teeth. Presence of natal tooth may results into several complications like difficulty in breast feeding, sublingual ulceration or risk of aspiration of mobile tooth. Hence the purpose of the present paper is to report an unusual case of natal tooth and to discuss its clinical features, complications and management.
Key words:- Clinical features, complications, natal tooth, Riga Fédé syndrome, syndromes, talon like structure.
References:-
1.Alexander K.C. Leung, William Lane M. Robson. Natal Teeth: A Review. Journal of the national medical association 2006; 98 (2):226-8.
2.Kumar A, Grewal H, Verma M. Posterior neonatl teeth. J Indian Soc Ped Prev Dent. 2011;1(29):68-70.
3.Massler M, Savara BS. Natal and neonatal teeth; a review of 24 cases reported in the literature. J Pediatr. 1950; 36(3):349-59.
4.Kates GA, Needleman HL, Holmes LB. Natal and neonatal teeth: a clinical study. JADA 1984, 109: 441–3.
5.Anegundi RT, Sudha P, Kaveri H, Sadanand K. Natal and neonatal teeth: a report of 4 cases. J Indian Soc Pedo Prev Dent 2002;20(3): 86–92.
6.Rao RS, Mathad SV. Natal teeth: Case report and review of literature. J Oral Maxillofac Pathol 2009; 13:41-6.
7.Portela MB, Damasceno L, Primo LG. Unusual case of multiple natal teeth. J o Clin Pediatr Dent 2004; 29(1): 37-40.
8.Kamboj M, Cougule R. Neonatal Tooth—How Dangerous Can it Be? The J Clin Pediatr Dent 2009; 34(1): 59-60.
9.Sogi S, Hugar SM, Patil S, Kumar S. Multiple natal teeth: A rare case report. IJDR. 2011;22(1):169-71. 10.Bodenoff J, Gorlin RJ. Natal and neonatal teeth. Folklore and fact. Pediatrics 1963, 1087–93.
11.Spouge JD, Feasby WH. Erupted teeth in new born. Oral Surg Oral Med Oral Pathol 1966, 22: 198–208.
12.Rao BB, Mamatha GR, Jameera KM, Hegde RB. Natal and neonatal teeth: A case report. J Indian Soc Pedo Prev Dent 2001; 19:110-2.
13.Limos LV and Shintome LK. Natal and Neonatal teeth. Einstein. 2009; 7(1):112-3.
14.Singh S, Subbba Reddy VV, Dhananjaya G, Patil R. Reactive fibrous hyperplasia associated with a natal tooth: A case report. J Indian Soc Pedo Prev Dent 2004; 22:183-6.
15.McDonald RD, Avery DR, Dean JA. Dentistry for the Child and Adolescent. In: Eruption of the teeth. 8th edition. Mosby publications.2005 pp183-84.
16.Alvarez MP, Crespi PV, Shanske AL. Natal molars in Pfeiffer syndrome type 3: A case report. J Clin Pediatr Dent 1993; 18:21-4.
17.Darwish S, Sastry RH, Ruprecht A. Natal teeth, bifid tongue and deaf mutism. J Oral Med 1987; 42:49-53.
18.Uzamis M, Olmez S, Ozturk H, Celik H. Clinical and ultrastructural study of natal and neonatal teeth. J Clin Pediatr Dent 1999; 23:173-7.
19.Masatomi Y, Abe K, Ooshima T. Unusual multiple natal teeth: case report. Pediatr Dent 1991; 13: 170-2.
0.Goho C. Neonatal sublingual traumatic ulceration (Riga-Fede disease): reports of cases. J Dent Child 1996; 63: 362–4.
21.Groeneveld X, Damme VP. Natal teeth inperspective: Literature review and report of two cases. Ned Tijdschr Tandheelkd 1993; 100(2): 49-51.
Copyright © 2013 Prashant Babaji et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Original article:-Nursing
Radhamaniamma Jayasree(M Phil(N),MSN,RN/RM)
Senior Teacher, Salalah Nursing Institute, Sultanate of Oman.
Abstract:- Within nursing, the development and utilization of nursing model is an area of constant growth. The purpose of this article is to describe a detailed case application of Roy’s adaptation model (RAM) in the nursing care of patients with Rheumatoid arthritis (RA). The assessment and interventions are guided by RAM. An assessment tool for RA patient was prepared by the author and administered it to patients. A case study is presented to demonstrate how RAM can be used to guide nursing care of RA patients.
Key Words:- Adaptation, Assessment, Nursing Interventions, Rheumatoid arthritis, Roy’s adaptation model (RAM).
References:-
1.Smith M C. The distinctiveness of nursing knowledge. Nurs Sci Quart 1992; 5:148-9.
2.Kim HS. The nature of theoretical thinking in nursing. Norwalk, Connecticut: Appleton-Century Croft; 1983.
3.Phillip K. Sister Callista Roy adaptation model, In A. Tomey and M. Alligood (Eds). Nursing theorists and their work. 6th ed. St. Louis: Mosby; 2006.
4.Hanna D, Roy C. Roy adaptation model and perspectives on family. Nurs Sci Quart. 2001; 14: 9-13.
5.Fawcett J. The nurse theorists: 21st century updates-Callista Roy. Nurs Sci Quart. 2002; 15: 308-10.
6.Cobb S., Warren JE, Merchant WR, Thompson DJ. An estimate of the prevalence of rheumatoid arthritis. J Chron Dis 1957; 5: 636-43.
7.Laine VAI. Rheumatic complaints in an urban population in Finland. Acta Rheum Scand 1962; 8: 81-8.
8.Wood PHN, Badley EM. Epidemiology of individual rheumatic disorders. In Scott JT, editor. Copeman’s Textbook of rheumatic diseases. 6th ed. Edinburgh: Churchil- Livingstone; 1986.
9.Heiberg T, Uhlig T, Kvin TK. Seven year changes in health status and priorities for improvement of health in patients with rheumatoid arthritis. Ann Rheu Dis 2005; 64(2): 191-5.
10.Riehl J, Roy C. Conceptual models for nursing practice. New York: Appleton- Century – Crofts; 1980.
11.Roy C. Adaptation: implication for curriculum change. Nursing outlook. 1973; 21(3): 163-8.
12.Roy C. The Roy adaptation model, 3rd ed. Upper Saddle River, NJ: Prentice Hall Health; 2009.
13.Roy C, Corliss. The Roy adaptation model: Theoretical update and knowledge for practice, New York: National League for Nursing; 1993.
14.Andrews HA, Roy C. Essentials of the Roy adaptation model. Norwalk, CT: Appleton-Century- Crofts; 1986.
15.Fawcett J. Analysis and evaluation of conceptual model of nursing. 3rd ed, Philadelphia: F.A Davis company; 1995.FraiserM. Conceptual nursing in practice (Lippincott nursing series). London: Harper & Row; 1990.
16.Keen M, Breckenridge D, Frauman AC, Hartigan MF, Smith L, Butera E. Nursing assessment and intervention for adult hemodialysis patients: Application of Roy’s adaptation model. ANNA Journal 1998; 25(3), 311- 9.
17.Andrews H A, Roy C. The nursing process according to the Roy adaptation model. Norwalk, CT: Appleton-Century- Crofts; 1991b. 18.George JB. Nursing theories: The base for professional nursing practice, 3rd ed. Connecticut: Appleton &Lange; 1995.
19.Giger JA, Bower CA,Miller SW. Roy adaptation model: ICU application. Dimensions of critical care nursing. 1987; 6(4), 215-24.
20.Carpenito L. Nursing diagnosis: Application to clinical practice, Philadelphia: J B Lippincott; 1983.
21.Smettzer S C, Bare BG, Hinkle JL, Cheever KH. Brunner and Suddarth’s text book of medical surgical nursing, Philadelphia: Wolters Kluwer/ Lippincott Williams & Wilkins; 2010.
22.Akinsanya J, Cox G, Crouch C, Fletcher L. The Roy adaptation model in action, London; The Macmillan press Ltd; 1994.
23.Fraser M. Using conceptual nursing in practice (Lippincott nursing series, London: Harper & Row;1990.
Copyright © 2013 Radhamaniamma Jayasree et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.