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Original research article:-Orthodontics
Prabhuraj Kambalyal1 , Promod Shetty2 , Ronak Maniar3* & Sudhanshu Sanadhya4
1Professor,2Professor and Head, 3Postgraduate student, Department of Orthodontics, 4 Postgraduate student, Department of Community dentistry , Pacific Dental College and Hospital, Airport Road, Debari, Udaipur – 313024, Rajasthan, India.
Abstract:- Aims: To correlate and evaluate the changes in the shape and size of the cervical vertebrae with the obese patients and normal patients. Settings and design: A cross sectional radiographic study was carried out among 240 subjects , 8-14 years further divided into 120 normal BMI( body mass index) and 120 obese(increased BMI) visiting Department of Orthodontics, Pacific Dental College and Hospital, Udaipur, India. Methods and Material: The lateral cephalogram were taken and traced for all subjects The system developed by Farman and Hassel modification of Lamparski’s criteria was used to determine skeletal maturation using cervical vertebrae. Results: The obese subjects (3.23±1.2) exhibited a significantly higher mean cervical vertebral maturation score than did the normal subjects (2.6±1.4). Conclusion: Obese subjects showed a higher mean discrepancy between skeletal and chronologic ages compared with normal-weight subjects. Furthermore, obese subjects had a significantly higher cervical vertebral maturation score than did normal-weight subjects. Thus, to account for the earlier growth in obese patients with skeletal discrepancies, it might be necessary to perform earlier examinations and treatments than in normal-weight subjects.
Key words:- Skeletal maturation, cervical vertebrae, obesity.
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:-
Leila Ksiaa Cheikhrouhou (MD), Yousr Lakhoua Gorgi (phD), Salwa Jendoubi Ayed (MD), Houda Aouadi (MD) , Imen Sfar (MD), Mouna Makhlouf (MD), Taieb Ben Abdallah (phD), Khaled Ayed (phD).
Immunology Research Laboratory of Kidney Transplantation and Immunopathology (Laboratoire de Recherche: LR03SP01). University Tunis El Manar; Charles Nicolle Hospital. Tunisia.
Abstract:-
The aim of this study was to investigate the possibility of a significant relationship between the spontaneous clearance or the persistence of HCV infection and chemokines , chemokine receptors, cytokines and apoptosis genes polymorphisms in Tunisian hemodialysed patients. The polymorphisms of genes: CCR5 Δ32, CCR5 (-59029) A/G, CCR2 (64Ile), and MCP-1(-2518) A/G, (-889) IL-1α, (-511) and (+3954) IL-1β, IL-1-Ra, IL-18 (-137) and (-607), IL-12p40 (-1188) and Apo1/Fas (-670) were determined by PCR-RFLP, PCR-SSP and PCR-VNTR, at healthy blood donors (100 for cytokines and apo/fas gene polymorphisms and 170 for chemokine gene polymorphisms) and 100 hemodialysed patients infected by the HCV. Patients were classified in two groups: G1 included 76 active chronic hepatitis patients (positive RNA-HCV) and G2 included 24 having eliminated spontaneously virus (negative RNA-HCV). The univariate analyze of the genotypes and alleles frequencies of the cytokines polymorphisms studied does not reveal any positive or negative association statistically significant with the outcome of the HCV infection. Nevertheless, the frequency of genotype association [-37GC/-607CA] IL-18 is statistically higher among G2 patients (41,7%) compared to that at G1 hemodialysed (15,8%) (p=0,008, OR: 0.26, 95%CI: [0.10-0.73]). We found also, a significant increased frequency of AA genotype of Apo1/Fas gene in G2 patients (41,6%) than in G1 (17,5%) (p=0,026, OR=3,49, 95% CI [1,13-10,69]). Adjustment for known covariates factors (age, gender and genotypes) confirmed these univariate findings and revealed that the genotype association GC-CA of (-137and-607) IL-18 gene and AA genotype of Apo1/Fas gene were associated to the clearance of HCV (p=0.041 and p=0.017 respectively). Our results showed also a statistically increased frequencies of the CCR2 (64Ile) and the (-59029) CCR5 A alleles in total patients HCV infected (22,1% and 35,9%) and in G1 (24,3% and 40,6%) compared to controls (14,4% and 20%)[p=0.0086, p=0.03 and p=0.04, p=0.017 respectively]. Also, we observe a lower frequency of the MCP-1 G allele and a greater frequency of the CCR5 Δ32 variant in G2 (15,2% and 6,5%) compared to G1(22,6% and 1,4%)[p>0.05], but adjustment for known covariates factors didn’t confirmed these univariate findings. In conclusion, our study suggests a possible role of some of the chemokine and cytokine and apo/fas polymorphisms studied in the outcome of HCV infection in Tunisian population. These results should be further investigated by large population-based studies.
Key words:- Hepatitis C virus, Spontaneous clearance, Chemokines, Chemokines Receptors genes polymorphisms, cytokines, apo/fas polymorphisms.
Copyright © 2013 Leila K Cheikhrouho 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.