002468   Deepa M K;Desna D S;Karthikeyan M;Mallikarjun V (Pharmaceutical Chemistry Dep, JDT Islam College of Pharmacy, Marikkunnu, P.B. No. 1702, Jamiath hill, Malabar, Calicut-673 012) : Cefpodoxime proxitil. Antiseptic 2008, 105(2), 81.

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002467   Datta P K;Gharami R;Das N K;Vishwanath B K; Anand N;Kulkarni K R;Bhatavadekar P D;Gupta P G;Nagabhushan K H (Medico Marketing Services, Cosme Farma Laboratories Ltd, , 401, "Sigma", Technology Street, Hiranandani Gardens, Powai, Mumbai-400 076, Email: kh.nagabhushan@cosmefarma.com) : Evaluation of efficacy and tolerability of azithromycin 2% gel in patients with acne vulgaris. Indian Practnr 2007, 60(10), 21-8.

Acne is a multifactorial disorder. Suppression of P. acnes with antibiotic therapy correlates with clinical improvement. Topical antibiotics used in acne vulgaris act against Propionibacte-rium acnes. Azithromycin 2% gel is a novel topical preparation for the treatment of acne vulgaris. This multi-centric study was aimed to evaluate the efficacy and tolerability of azithromycin 2% gel in patients with acne vulgaris. 81 patients completed the treatment as per the protocol. Patients applied azithromycin 2% gel once daily for eight weeks on the affected sites. Clinical evaluations were performed by the investigators at outpatient visits at the base-line, at the end of 1st week, at the end of 3nd week, at the end of 6th week and at the end of 8th week. Patients were evaluated for the reduction in the number of open and closed comedones, papules, pustules, nodules and cysts after the application of the gel. Adverse events were recorded by the investigators at each study visit. Global assessment of the efficacy and tolerability was assessed by the physicians at the end of eight weeks. Patients also assessed the efficacy of the formulation. Azithromycin 2 % gel significantly reduced comedones and also significantly reduced inflammatory lesions like papules, pustules, nodules and cysts. It also significantly reduced other symptoms of acne like erythema and facial oiliness. 56.8% of total study cases showed good to excellent effect of treatment according to the physician followed by 43.2% which had a satisfactory effect to the treatment. Azithromyein 2% gel was safe and well tolerated. There were no reports of hypersensitivity to the formulation. The present study documents that azithromycin 2% gel applied once daily is an effective and safe new alternative for the symptomatic management of acne vulgaris in Indian patients.

7 illus, 9 tables, 10 ref

002466   Dastur A E;Tank P D (NO, Nowrosjee Wadia Maternity Hospital, Mumbai) : Birth of tubal sterilization. J Obstet Gynec India 2008, 58(2), 119-20.

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002465   Dasari P;Phani J G;Badhe B A (Obstetrics & Gynaecology Dep, JIPMER, Pondicherry-605 006) : Cord blood nucleated red blood cell count - a marker of fetal asphyxia. J Obstet Gynec India 2008, 58(1), 45-8.

Studis the cord blood nucleated RBC count (NRBC) in asphyxiated and nonasphyxiated fetuses at birth and to find out the correlation between NRBC count, fetal acidosis and the clinical markers of asphyxia. This is a prospective comparative study conducted between 2002 and 2004. Parturient women who were in labor between 37 and 42 weeks of gestation were selected after satisfying inclusion and exclusion criteria and divided in 2 groups. The control group consisted 51 cases with nonasphyxiated fetuses and study group 52 asphyxiated fetuses. The cord blood was collected soon after birth, one sample for pH determination and the other sample for making smears that were stained with Leishman's stain. NRBCs were counted against 100 WBCs. The statistical analysis was done using SSPS and Chi-square test to find out the relationship between pH and NRBC count and the correlation between NRBC count, and meconium stained amniotic fluid (MSAF), nonreassuring fetal heart rate pattern and low apgar scores. The mean NRBC count in the study group was 25.65 ± 10.14 as compared to 12.33 ± 5.51 in the control group (p=0.003). The NRBC count was significantly higher in MSAF and in neonates with low apgar scores of < 6 at 5 minutes (P=0.02). Acidotic neonates (cord blood pH ≤ 7.1) at birth had higher mean NRBC count compared to nonacidotic neonates and hence NRBC count of cord blood smear serves as a good indicator of fetal asphyxia.

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002464   Dasari P (Obs & Gynaecology Dep, JIPMER, Pondichery-605 006) : Retrospective analysis of fetal neural tube defects: maternal and fetal outcome. Antiseptic 2008, 105(4), 172-75.

A retrospective analysis among 4,166 deliveries revealed 70 major malformations, the incidence of which is 1.68%. Neural tube defects constituted 80%. The mean age of the patients with neural tube defects did not differ from that of all other major malformations. Hydrocephalus was the commonest anomaly. The associated anomalies were again neural tube defects in the majority. USG was performed only in 72% of the cases and the missed anomalies were 22.5%, meningomyelocele being the commonest missed anomaly followed by spinabifida. The cesaerean section rate was 20% for the missed anomaly. The maternal morbidity was 16%, atonic postpartum haemorrhage being more common followed by trauma in the form of rupture uterus. One maternal death occurred due to rupture uterus and septic and haemorrhagic shock in the case of undiagnosed hydrocephalus during labour. Though 41% were live births, the perinatal mortality was 77% with 59% stillbirths and 18% neonatal deaths. Emergency USG screening for fetal malformations for unbooked cases in labour can reduce the maternal morbidity associated with gross fetal malformation and helps in deciding the mode of delivery, the treatment for the neonate in cases where good perinatal outcomel is expected.

5 tables, 13 ref

002463   Das S K;Mukherjee R S;Ghosh I N;Halder A K; Saha S K (Tuberculosis and Respiratory Medicine Dep, National Medical College and Hospital, Kolkata-700 014) : Pulmonary tuberculosis in the elderly. J Indian Med Ass 2007, 105(8), 432-9.

The incidence of tuberculosis (TB) is increasing globally. The diagnosis of TB in elderly is often delayed due to the atypical presentation. There is also therapeutic problems because of presence of comorbidity, nutritional and socio-economic factors and increased incidence of adverse drug reactions and mortality. A prospective study was conducted among patients presenting with pulmonary tuberculosis at the department of TB and respiratory medicine in a tertiary care hospital between January, 2006 to July, 2006. Thirty patients aged more than 65 years were studied for their clinical characteristics, comorbid illnesses, sputum status, radiological features and adverse drug reactions. They were contrasted against the same parameters in 40 patients aged 65 years or less. The study showed that pulmonary TB in the elderly is characterised by (a) atypical symptoms, (b) more extensive radiological lesion with lower zone preponderance, (c) higher sputum positivity, (d) more frequent comorbidity, (e) more frequent side-effects and (f) higher mortality.

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002462   Das L;Mishra P;Khuntia P;Satapathy U;Panda N (NO, , Gamandia Canal Road, Buxibazar, Cuttack-753 001, Email: uksatapathy@yahoo.co.uk) : Pregnancy with meningioma. J Obstet Gynec India 2008, 58(2), 156-8.

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002461   Das H K;Borkakoty B J;Mahanta J;Medhi G K; Chelleng P K (Regional Medical Research Centre, NE Region (Indian Council of Medical Research), PB No.105, Dibrugarh, Assam, Email: icmrrcdi@hub.nic.in) : Hepatitis C virus infection and risk behaviors among injection drug users of Nagaland. Indian J Gastroenterol 2007, 26(5), 253-4.

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002460   Das C J;Srivastava D N;Debnath J;Ramchandran V;Pal S;Sahni P (Radiodiagnosis and Gastrointestinal Surgery, All India Institute of Medical Sciences, New Delhi, Email: drdeepsrivastava@rediffmail.com) : Endovascular management of hepatic hemorrhage and subcapsular hematoma in HELLP syndrome. Indian J Gastroenterol 2007, 26(5), 244-5.

Spontaneous intrahepatic hemorrhage with or without subcapsular extension is a rare and grave complication of pregnancy. A 22-year-old lady in whom liver rupture was noted on emergency Caesarian section and later confirmed on contrast-enhanced CT scan. She gradually recovered following selective hepatic angiography and embolization.

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002459   Darwazah A K;Hasan R A R;Sham A;Aloul J;Kamal N S;Sharabati B (Cardiac Surgery Dep, Makassed Hospital, Jerusalom 22110, P.O.Box 19482, Israel, Email: darwaz30@hotmail.com) : Combined surgical management of tuberculous constrictive pericarditis and coronary artery disease. Indian J Thoracic Cardiovascular Surg 2007, 23(4), 263-6.

The combination of constrictive pericarditis and coronary artery disease is rarely reported in medical literature. Constrictive pericarditis occurs after cardiac operations in 0.2 - 0.3 % of cases. Normal coronary vessels can be involved in the inflammatory process of constrictive pericarditis by scar tissue. The association between tuberculosis and coronary artery disease is rare. Obliteration of coronary vessels may occur in rare cases of tuberculous aortitis. Presents a case of coronary artery disease associated with tuberculous constrictive pericarditis. Combined treatment by total pericardiectomy and coronary artery bypass surgery was successful.

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002458   Dandavatimath U S;Dastikop V;Yakkundi A; RamaKrishna K;Hiremath S G (Ophtholmology Dep, J.N. Medical College, Belgaum-590 010) : Malignant melanoma of choroid. J Scient Soc 2008, 35(4), 140-1.

Malignant melanoma of the choroid is a malignant neoplasm that arises from neuro ectodermal melanocytes within the choroid. This has a well documented capacity to metastasize haematogenously. It is a rare disease in our country. Usually it presents in the 4th-6th decades of life. The incidence of this tumour is 0.02-0.06%. In this scenario, reports a case of malignant melanoma of the choroid with typical clinical, investigate and histopathological features.

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002457   Dabholkar J P;Vora K;Sikdar A (NO, , 10, SUDHA, 3rd Floor, 20, Nepean Sea Road, Mumbai-400 036, Email: tucson@vsnl.com) : Comparative study of underlay tympanoplasty with temporalis fascia and tragal perichondrium. Indian J Otolar Head Neck Surg 2007, 59(2), 116-19.

The perforations of the tympanic membrane maybe of traumatic origin or due to chronic suppurative otitis media. If the perforations fail to heal conservatively, they require surgical closure. Autologous graft materials have stood the test of time in repairing tympanic membrane perforations. In our tertiary care institution we conducted a prospective randomized control trial on 50 subjects to evaluate the comparative efficacy of temporalis fascia and tragal perichondrium as grafting material in underlay tympanoplasty. In this study surgical success was evaluated in terms of intact drum membrane during the follow up period and closure of A-B gap within 10 dB. Temporalis fascia achieved a graft uptake of 84% and a satisfactory hearing improvement in 76% of the patients. Tragal perichondrium achieved a success rate of 80% graft uptake and 75% hearing gain. The rates are comparable with no statistical significance of the difference between them.

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002456   Dabholkar J P;More M;Avanindra K;Sharma A (Otorhinoalaryngology & Head & Neck Surgery Dep, King Edward VII Memorial Hospital & Seth G.S. Medical College, Mumbai, Email: tucson@vsnl.com) : Primary exophytic laryngeal amyloidosis presenting as sudden airway obstruction. Indian J Otolar Head Neck Surg 2007, 59(4), 357-9.

Primary amyloidosis of larynx is an uncommon phenomenon, the precise etiopathogenesis of which is not yet clear. It can present with slowly increasing hoarseness or difficulty in breathing. It presents more commonly as infiltrative lesion, exophytic presentation is a rare occurrence.

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002455   Chhajed M R;Khedekar P B;Mundhey A S;Galghate S S (NO, Shri Gujarat Samaj College of Pharmacy, AB Road Scheme No. 54, Near Bombay Hospital, Indore-452 010) : Resurgence of chickungunya virus in India : an emerging threat. Antiseptic 2008, 105(4), 182-84.

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002454   Chhabra S;Datta N (Obstetrics and gynaecology, MGIMS, Sevagram-442 001) : Comparative study of hypertensive and nonhypertensive pregnancies. Indian Practnr 2007, 60(10), 9-12.

Study was done to compare the demographic profile and perinatal outcome of women suffering from hypertensive disorders with normotensive controls. Majority of the study subjects, (56.8%) were between 20-24 years so also controls (57.5%). 356(67.8%) controls had received antenatal care and 330 (62.9%) study subjects also. 62.1% study subjects and 72% controls had height more than 150 cms and 1.7% study subjects and 0.8% controls were short statured (<140 cm). 144(27.4%) controls weighed more than 50 kg but 219 (41.7%) study subjects. 56 (10.7%) study subjects weighed ≤ 39 kg and 117 (22.3%) controls (statistically significant difference P < 0.05 in height and weight both). Placental abruption occurred in 10.1%, oliguria in 8%, haematuria in 3%, pulmonary oedema in 2.3%, laryngeal oedema in 4%, severe hypoglycaemia with coma 0.19% and postpartum haemorrhage in 4.8% study cases and in controls postpartum haemorrhage occurred in 2.3%. 410 (78.1%) study subjects and 477 (90.9%) controls had full term births. Out of 532 births (in 525 cases with 7 sets of twins) in study subjects, perinatal loss was 14.1% and 1.2% in controls. Many problems do arise in women with hypertensive disorder during pregnancy. Routine antenatal care does not prevent the disorder. Research needs to be continued for prediction of the disorder. Till that time early detection is essential for critical careful management because life threatening morbidities and even mortality can occur. It is essential to monitor high risk like thick short statured critically.

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002453   Chaturvedi M;Nandan D;Gupta S C (Social and Preventive Medicine Dep, S.N. Medical College, Agra) : Rapid assessment of nutritional status of children in Agra district. Indian J Prev Soc Med 2006, 37(3-4), 165-9.

A rapid assessment of malnutrition was done in 80 clusters of district Agra utilizing Shakir strip for the measurement of mid upper arm circumference. A total of 516 children of 12-23 month age were screened in both urban and rural settings. The current study showed that about half of children (53.2%) were malnourished having mid upper arm circumference less than 13.5 cm. The percentage of undernourished (<12.5 cm) children in the urban and rural area was 8.4 and 17.6 percent respectively.

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002452   Chandra Shekhar;Kranti Bhavana (E.N.T. Dep, Patna Medical College, Patna) : Aesthetics in ear surgery: a comparative study of different post auricular incisions and their cosmetic relevance. Indian J Otolar Head Neck Surg 2007, 59(2), 187-90.

Post auricular incisions play a very important role in the final post operative position of pinna and hence keeps a cosmetic bearing. study shows that "behind the groove" incision gives a better post operative result in terms of minimal deviation of pinna and thus is cosmetically a better incision. study also includes a new method to measure the concho-mastoid or the post auricular angle.

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002451   Budhiraja S (NO, , 157-h, Bhai Randhir Singh Nagar, Ludhiana-141 001, Email: sheelbudhiraja@rediffmail.com ) : Cecal web causing neonatal intestinal obstruction. Indian J Gastroenterol 2007, 26(5), 256.

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002450   Braham Prakash;Dhawan A;Sethi H (NO, MSSO, National Drug Dependence Treatment Centre (NDDTC), AIIMS, New Delhi-110 029) : Profile of treatment non-seeker heroin addicts and their reasons for not seeking treatment. Indian J Prev Soc Med 2006, 37(3-4), 158-64 .

Objective is to examine the reasons given for not receiving treatment by regular heroin users who live close to community outreach clinic (AIIMS); study the profile of heroin users in Trilokpuri; and to suggest intervention for treatment non-seekers. Study design: cross sectional. Setting: Trilokpuri (Resettlement Colony), Delhi. Participants: 85 heroin users who have not received treatment for heroin addiction. Tools: DSM IV- criteria for drug dependence and semi - structured interview schedule. Statistical analysis: Percentage, mean, standard deviation. Results: Profile - chasing was the most common route of intake of heroin. Majority of heroin users were between the age group 21-40years. Mean duration of heroin dependence was 4.11 years. Nuclear type of family was more common. Various occupational group were represented however, transport operator (Drivers) and small businessman were the two largest group. Majority took 1 to 2 gm of street level heroin. Peer group influence was the main source of introduction of heroin in 48.62% addicts. Majority of them (42.35%) were illiterate. Lack of awareness about the treatment facilities, need for treatment not felt, not possible to give up heroin (afraid of heroin withdrawals), treatment does not help; concern about child care; can leave on one's own & ashamed to admit problem were found to be the common reasons for not seeking treatment. Barriers to treatment must be addressed if we want to encourage the greater population of untreated heroin user to enter in treatment.

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002449   Borkakoty B J;Biswas D;Mahanta J (Regional Medical Research Center, Northeast Region (India Council of Medical Research), P.O. Box. 105, Dibrugarh-786 001, Email: icmrrcdi@hub.nic.in) : Delta hepatitis infection in Northeast India. Indian J Gastroenterol 2007, 26(5), 251.

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002448   Bora D P;Barman N N;Bhattacharyya D K (Microbiology Dep, College of Veterinary Science and Livestock Research Station, Mondira, Assam) : Isolation of rotavirus in MA 104 cell line from diarrhoeic piglets of Assam. Indian J Virol 2007, 18(1), 40-3.

Rotaviras (RV) has emerged as one of the important causes of piglet diarrhoea. In the present study, rotavirus was detected in faeces of infected pigs by ELISA and PAGE. Rotavirus was isolated from faecal samples using MA 104 cell culture. ELISA could detect the RV antigen in slightly higher numbers (29.35%) than that of PAGE (24.84%). A total of 18 samples were passaged in MA 104 cell culture up to the 8th passage. Out of which in 16 samples RV could be detected after completion of 8th passage. Interestingly virus isolated from two samples showed CPE characterized by elongation and rounding of cells. But remaining isolates were non-CPE producing. The propagated virus was detected by FAT, ELISA and PAGE.

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002447   Bist S S;Varshney S;Bisht M;Pathak V P; Anuradha Kusum;Gupta N (NO, Himalayan Institute of Medical Sciences, Jolly Grant, Dehradun, Email: Sampanbist@yahoo.com) : Rosai dorfman syndrome - a rare clinical entity. Indian J Otolar Head Neck Surg 2007, 59(2), 184-6.

Sinus histiocytosis with massive lymphadenopathy (also known as Rosai Dorfman syndrome) is a unique disease of unknown etiology with a childhood predilection. It is an uncommon benign condition, often confused with lymphoma. Patients usually present with massive, painless, bilateral cervical lymphadenopathy and clinical course is variable. This condition has been sporadically reported in Indian literature¹. Here we report a 26-year-old women presenting with a painless bilateral cervical lymphadenopathy. A FNAC from cervical lymph node was compatible with Rosai Dorfman syndrome and confirmed histopathologically.

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002446   Bist S S;Varshney S (E.N.T. and Head-Neck Surgery Dep, Himalayan Institute of Medical Sciences, Dehradun-248 140, Email: varshneyhm@sancharnet.in) : Pediatric cervical lymphadenopathy : is it nasopharyngeal carcinoma. Indian med Gaz 2008, 162(10), 401-4.

Cervical lymphadenopathy is a common clinical finding in pediatrics practice. The aetiological profile varies from country to country and region to region. In developing countries like India, acute upper respiratory tract infections, suppurative skin infections and tuberculosis are the major cause for cervical lymphadenopathy¹. However, it may be also due to the serious conditions like malignancies^2,3. Nasopharyngeal carcinoma in children may present as cervical lymphadenopathy. Pediatrician should keep this aspect in mind while working up a patient of cervical lymphadenopathy. Here we report an 11-year old boy diagnosed as a case of nasopharyngeal carcinoma who presented as cervical lymphadenopathy.

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002445   Bist S S;Bist M;Varshney S;Gupta N;Bhatia R (E.N.T. & Head-Neck Surgery Dep, Himalayan Institute of Medical Sciences, Jolly-Grant, Dehradun-248 140, Email: Sampanbist@Yahoo.com) : Thyroglossal duct cyst in hyoid bone: unusual location. Indian J Otolar Head Neck Surg 2007, 59(4), 366-8.

A 10-year-old female presenting with a discharging sinus in the midline of the neck of one month duration was diagnosed to have a thyroglossal sinus. She underwent sistrunk's operation, intra-operatively a thyroglossal duct cyst was atypically sited in the intrahyoid region. The cyst may be located in the intralingual, suprahyoid, thyrohyoid or suprasternal region. A literature search revealed that this intrahyoid location of a thyroglossal duct cyst is extremely rare and so far only three cases have been reported. A case and review of literature regarding this unusual entity are presented.

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002444   Bisht M;Bist S S (E.N.T Dep, Himalayan Institute of Medical Sciences, Jolly Grant, Dehradun, Uttaranchal-248 140) : Update on new classes of anti-HIV drugs. Indian Practnr 2007, 60(12), 774-8.

The incidence of human immunodeficiency virus (HIV) infections has increased significantly world wide and especially in developing country like India; it has evolved as a major health problem in past few years. Combination antiretroviral therapy or highly active antiretroviral therapy (HAART) is the cornerstone of management of patients with HIV infection. A significant number of HIV infections have become resistant to antiretroviral treatment; hence the need for developing novel drug targets to defeat HIV is paramount. Until recently all the anti-HIV drugs inhibited the viral replication by mechanisms operating inside the infected cells. In contrast, newer antiretroviral drugs are capable of inhibiting the viral entry into the cells, there by halting the very first step of HIV replication. These newer class of drugs include entry inhibitors, coreceptor antagonists and fusion inhibitors. In addition to their novel mechanism of action, this new class of drugs also has potential action against resistant HIV strain, cause fewer adverse effects and may have simplified dosing regimen. Newer developments in this area represent hope for people infected with HIV, especially those who have exhausted current therapies.

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002443   Bhuyian P;Tripathy K L;Pujari S;Mahapatra S; Mishra R K;Rath J (Pathology Dep, S.C.B. Medical College, Cuttack-753 007) : Cytodiagnosis of glial heterotopia in scalp. Antiseptic 2008, 105(4), 166-67.

Glial heterotopia in scalp is very rare. Reported a case of glial heterotopia in a 18 years old male who presented with a cystic swelling in the scalp. Fine needle aspiration cytology (FNAC) revealed glial cells in a neurofibrillary background. The Computerized Tomography (CT) Scan and X-Ray of the skull did not reveal any intracranial connection. A diagnosis of glial heterotopia was given which was confirmed by histopathological study.

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002442   Bhuyan P;Tripathy K;Mishra A;Mahapatra S;Rath J;Satpathy S (Pathology Dep, S.C.B. Medical College, Cuttack-753 007) : Gastric adenocarcinoma metastatic to myometrium. Antiseptic 2008, 105(2), 61-2.

Extragenital tumors directly metastasizing to the uterine corpus is very rare. In the case, a 55 years old female presented with a myometrial nodule, which on histopathological examination was diagnosed as metastatic adenocarcinoma. The primary was searched for and was detected in the stomach.

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002441   Bhushan T V;Traffi F;Shetgaonkar B (Huraymala General Hospital, , Saudi Arabia) : Pilonidal sinus disease excision & primary closure. Antiseptic 2008, 105(2), 78-80.

Pilonidal Sinus disease needs definitive surgical treatment. There are many surgical procedures ranging from simple shaving to excision and complex flap repairs. Bascom's repair is popular in the West (Great Britain) but takes longer time to heal and recurrence rate is around 10%. Reports the series of 56 patients who underwent excision and primary closure with good results. Prospective study conducted to assess, excision of the pilonidal sinus and primary closure from December 96- December 1999. (3 years) All patients coming to Huraymala General Hospital with Pilonidal Sinus of the natal cleft, after routine pre op. workup and underwent complete excision and primary closure of the pilonidal sinus. All patients having pilonidal sinus disease were included in the study. All patients of pilonidal sinus having either abscess or active infection were excluded till local complications were treated, usually taken up for surgery after 4-6 weeks. All the patients were followed up to a minimum period of 12 months. A total of 56 patients underwent pilonidal excision in this period. 30 of these patients were operated by the author. Wound infection was 2.8% (5 pts.) Recurrence was 1.2% (2 pts.). Our study clearly shows that excision and primary closure of pilonidal sinus offers better results compared to other surgical techniques, therefore we reconimand this procedure as a definitive treatment.

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002440   Bhushan T V;Mastolimath R D (Grace Ville 4824, C/6 Kolhapur Cross, Belgaum-590 016, Email: theobhushan@rediffmail.com) : Leiomyoma of the breast. Indian Practnr 2007, 60(10), 649-50.

Intra parenchymal leiomyomas of the breast are quite rare. Areolar lesions are distin-guished easily from intra parenchymal lesions.

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002439   Bhattacharya S S;Patki P S;Mitra S K (R&D Center, The Himalaya Drug Company, Bangalore-562 123) : Clinical evaluation and safety of liv.52 drops in the management of loss of appetite in children: a subset analysis. Antiseptic 2008, 105(3), 139-41.

Loss of appetite is a common complaint of mothers who bring their children for pediatric consultation. A number of pharmacological agents like cyproheptadine are used to correct this problem, but a number of adverse effects are known to occur with this medication. Liv.52 is a novel herbal formulation recommended for hepatic diseases and anorexia. Present study was carried out to evaluate the safety and efficacy of Liv.52 drops in the management of loss of appetite in children. Results indicated that Liv.52 drops improved appetite significantly in the children. It also led to general well being of the children. There were no adverse effects attributed to Liv.52 drops.

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002438   Bhat M G;Somasundaram S K (NO, , Unit 102, I floor, Prestige Towers, 99/100 Residency Road, Bangalore-560 025, Email: drmgbhat@gmail.com) : Preperitoneal mesh repair of incisional hernias: a seven-year retrospective study. Indian J Surg 2007, 69(3), 95-8.

Incisional hernia is a common surgical condition with a reported incidence of 2-11% following all laparotomies. Results of repair have been disappointing. Evaluates technique of preperitoneal mesh repair of incisional hernias. A seven-year retrospective study was done from January 1994 to December 2000 using a computerized database. Follow-up was initiated by a postal questionnaire on a response card. The repair was evaluated by clinical examination, response card and telephone. Results were documented and statistically analyzed. Results: In the series of 105 patients, clinical details of 95 (90.5%) patients were available. Females (90.5%, n = 90) outnumbered males (9.5%, n = 10) and the highest incidence was in the 5th decade of life in females and the 6th decade of life in males (P = 0.028). Gynecological operations accounted for 68.4% (n = 65) of the index operations, with lower midline incisions resulting in 63% (n = 60) of the incisional hernias. The polypropylene mesh placed preperitoneally varied from 15 x 7.5 cm to 30 x 20 cm. Sixty-five patients (62%) attended our follow-up, ranging from 14 months to eight years. Method of follow-up in outpatients department (OPD): 44.6% (n = 29), postal: 40% (n = 26), telephone: 15.3% (n = 10). No recurrence was noted in the follow-up group. Based on analyses, believes that preperitoneal mesh repair is the ideal operation for incisional hernias. There are however, very few publications covering this technique of repair.

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002437   Bhaskar J;Sharma A K (NO, , Consultant Cardiothoracic Surgeon Wellington Public Hospital, Private Bag 7902, Wellington South, New Zealand) : Off pump coronary artery revascularization via left thoracotomy -early results. Indian J Thoracic Cardiovascular Surg 2007, 23(4), 236-9.

There are very few studies in literature, which have reported primary revascularization of the coronaries via a thoracotomy incision. Presents initial experiences using this approach to off pump coronary revascularization. 27 patients with coronary artery disease were selected for surgical revascularization via the thoracotomy approach. The left chest is entered through the 5th intercostal space, and the left internal mammary artery (LIMA) pedicle is harvested under direct vision. The radial artery or saphenous vein is harvested simultaneously depending on the availability and suitability of the conduits. Using standard off pump techniques, the LIMA is anastomosed to the Left Anterior Descending Artery (LAD) followed by other distal anastomoses. Complete revascularization was achieved in all patients. The average number of grafts were 2.40. I The mean blood loss during the first 6 hours was 380 ± 169 ml. None of the patients needed emergency conversion to cardiopulmonary bypass/sternotomy. Post operatively 4 patients had on table extubation. One patient was re-explored due to bleeding from the thoracotomy. There was no peri-operative Myocardial infarction and the mortality was nil. The average hospital stay was 6.4 ±1 days. Based on our initial experience, this approach appears to be safe and practical in selected cases. It is well tolerated hemodynamically, with minimal postoperative morbidity.

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002436   Bhanot A;Patel G R;Bachani M;Gohil V D (NO, , No.295, Tilak Nagar, Amritsar, Punjab-143 001, Email: bhanotashish@rediffmail.com) : Isolated phlebectasia of the forearm. Indian J Surg 0000, 69(3), 115-16.

Isolated forearm phlebectasia is noted for its extreme rarity. It may present as a painless cosmetic deformity or may cause pain, decreased range of movement, compression on adjacent structures, bleeding, thrombosis and consumptive coagulopathy. Surgery is indicated to prevent thrombosis, bleeding, coagulation disorder and to correct cosmetic deformities.

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002435   Bhandari B;Pal A (Medicine Dep, Bankura Sammilani Medical College and Hospital, Bankura-722 102) : Hepatitis C - Clinical Profile. J Indian Med Ass 2007, 105(8), 453-6,465.

Hepatitis C virus is a small enveloped RNA virus of the flaviviridae family of genus hepacivirus. Hepatitis C is one of the five viruses that account for majority of cases of viral hepatitis. Hepatitis C has a variable course that can lead to chronic hepatitis, cirrhosis and hepatocellular carcinoma. Course of the disease can be adversely altered by various factors including alcohol. Presently various tests are available for diagnosing hepatitis C virus infection but polymerase chain reaction assay detects the hepatitis C virus RNA with a greater suitability though significant variability exists among different laboratories. Exact pathogenesis is not clear but infiltration of lymphocytes are typically observed in hepatic parenchyma along with cytotoxic T lymphocytes and a CD4+ proliferative response. Hepatitis C has a variable clinical course, only 15% develop acute viral hepatitis and rest will eventually develop chronic infection and hepatocellular carcinoma. Extra-intestinal manifestation of immunological origin has been observed. Two forms of therapy viz, α-interferon and α-interferon with ribavirin are usually used but combination therapy with ribavirin and α-interferon has shown promise in the treatment of patient with relapse. Interruption of the transmission routes of HCV remains the main-stay of treatment.

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002434   Bhagyalaxmi A (NO, , B/403, Spectrum Tower, Opp. Police Stadium, Shahibaug, Ahmedabad-380 004, Email: bhagya_mardi@yahoo.com) : Role of insecticide treated bed nets (ITNs) in control of Malaria. Indian Practnr 2007, 60(10), 39-41.

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002433   Betigeri V;Niwariya Y;Modi P;Srivastava A R; Sahi S;Banerjee A (Cardiovascular and Thoracic Surgery Dep, G B Pant Hospital, New Delhi-110 002, Email: amit_banerjee@india.com) : Congenitally unguarded tricuspid valve orifice with a hypoplastic right ventricle and free thrombus in a giant right atrium. Indian J Thoracic Cardiovascular Surg 2007, 23(4), 272-4.

Patients with congenitally unguarded tricuspid valve orifice, along with associated abnormalities, rarely survive till adulthood. Reports such a case, with a hypoplastic right ventricle and a floating thrombus in a giant right atrium, with intact interatrial and interventricular septa. The patient was managed surgically with satisfactory outcome.

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002432   Bedi H S;Sohal C S;Sengar B S (NO, , Ludhiana MediCiti, Ferozpur Road Ludhiana, Punjab-160 055, Email: drhsbedi@hotmail.com) : Elective preoperative use of intra aortic balloon counterpulsation in high risk group of coronary artery disease patients to facilitate off pump surgery. Indian J Thoracic Cardiovascular Surg 2007, 23(2), 128-34.

To avoid the deleterious effects of cardio-pulmonary bypass, off pump coronary artery bypass graft surgery (OPCABG) is increasingly the procedure of choice in the majority of patients needing myocardial revascularization. However patients at high operative risk are sometimes not given the advantage of off pump surgery because of haemodynamic deterioration during displacement of the heart to access the target vessels, or deterioration per se due to the factor causing the high risk (eg unstable hemodynamics) leading to institution of cardio-pulmonary bypass (CPB). Preoperative intraaortic balloon counterpulsation (IABC) therapy improves cardiac performance and facilitates the access to the anastomotic site during off pump coronary artery bypass grafting while maintaining haemodynamic stability. Two hundred and twelve patients for isolated coronary artery bypass grafting (CABG) between June 2000 and June 2006 were studied in whom preoperative IABC was instituted. Initially, the trial was started in two groups and patients were computer randomized to 'IABC' and 'No IABC' groups. The trial was abandoned after 15 cases in each group, because of the adverse outcomes in 'No IABC' group. Left main stenosis was present in 31.1%, triple vessel disease in 87.7%, recent myocardial infarction in 21.2%, 35.8% were hypertensive, and 32% were diabetic. Out of 212 cases in whom preoperative IABC was instituted OPCABG was possible in the majority (88.2%), while of 15 cases in 'No IABP' group all CABG were done on CPB. Mortality and average stay in ICU was markedly lower in patients where IABC was instituted preoperatively. Elective preoperative IABC in patients with high-risk coronary artery disease permits OPCABG in the majority, reduces the ICU stay, leads to earlier weaning from intra aortic balloon pump (IABP), reduces the morbidity and mortality, and is more economical.

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002431   Barik B K;Ravi Kumar L (General Medicine Dep, V.S.S. Medical College, Burla) : Pseudoxanthoma elasticum presenting as haematuria. Antiseptic 2008, 105(3), 118-20.

Pseudoxanthoma elasticum is a rare inherited disorder of connective tissue, characterized by general elastorrhexis of the elastic tissue in the dermis, the blood vessels and Bruch membranes of the eye.

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002430   Barik B K;Pradhan B;Panigrahi A K (General Medicine Dep, V.S.S. Medical College, Burla-768 017) : Uncommon presentation of hypogonadism and hypertension in a case of sickle cell disease. Antiseptic 2008, 105(2), 63-4.

Sickle cell haemoglobinopathy, a common haemolytic disease predominant in Western part of Orissa is a multisystemic disease, with varied manifestation. Though some cases of nephropathy has been reported earlier, reports a case of Sickle Cell Disease (SCD) who had Primary hypogonadism, Hypertension and Sickle Cell Nephropathy. The pathogenesis and management are reviewed.

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002429   Bansal R K;Kumar P (Community Medicine Dep, Surat Municipal Instt. of Medical Education and Research Umarwada, Surat-395 010, Email: drrkbansal@gmail.com) : Informed patient care: the edifice of modern medicine. Indian Practnr 2007, 60(10), 641-4.

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002428   Bansal P;Sannd R;Kumar S;Bansal R;Sharma S; Mishra D K (NO, CCRAS, Janakpuri, New Delhi) : Medicated thread kshara sutra-an example of novel drug delivery system in ancient parasurgical measures. Antiseptic 2008, 105(2), 90-3.

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002427   Banerjee P;Ray L;Ray S;Das S;Sinha R (NO, Calcutta National Medical College, 32, Gorachand Road, Calcutta-14, Email: drpranab_2005@rediffmail.com) : Papillary carcinoma of thyroglossal cyst. Indian J Otolar Head Neck Surg 2007, 59(4), 377-9.

Malignancy of thyroglossal cyst is a rare entity. Medical literature has reported only a very few cases till date. His-topathologically papillary carcinoma of thyroglossal cyst is the most common variety encountered in clinical practice. Surgical excision by Sistrunk operation is the standard treatment of choice followed by subtotal or total thyroidectomy whenever indicated. We report here two cases of thyroglossal cyst carcinomas and their respective management.

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002426   Balchandani U;Rai D (NO, Home Science Shri Agrsen Kanya P.G. College, Varanasi) : Awareness regarding maternal mortality rate (MMR) (between urban & rural area in Varanasi). Indian J Prev Soc Med 2007, 38(3-4), 193-6.

Maternal mortality in India is very high. Health action can reduce maternal mortality by half over five to ten years period. Other factors such as income, nutrition, education, woman's status and equity are important though improvement can be seen in long term. Major causes of maternal death are hemorrhage, anemia, toxemia, illegal abortion, sepsis and abstracted labour. This study has shown that in 50% of maternal death, there were one or more risk, factors and in the rest 50% there was none. A comparative study was carried out in 300 women's of urban and rural area in Varanasi. Out of 300 target women, 150 from urban and 150 from rural are of Varanasi. From them, some respondents have knowledge about MMR & some doesn't. Finds that there are many causes of M.M.R. some respondent are known about that and some not & some strainged to know about MMR causes.

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002425   Baig M S;Samir M A;Gade P R;Khandelwal P N (Pharmacology Dep, GMC, Aurangabad, Maharashtra-431 001) : Therapeutic uses of enzymes as drugs. Antiseptic 2008, 105(3), 123-29.

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002424   Arunkumar J S;Prasad K C;Shanthi N (NO, SDM College of Medical Sciences, Sattur, Dharwar, Karnataka) : Nasal teeth. Indian J Otolar Head Neck Surg 2007, 59(2), 197-8.

The ectopic eruption of the teeth into the nasal cavity is a rare phenomenon. We report a case of nasal tooth in the left nasal cavity in a 64-year-male. We describe the clinical and radiological findings of the case and discuss their etiology, diagnosis, complications and treatment.

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002423   Arcot R;Thanka J;Rajendiran S;Ravi A (NO, , 1/756, Sabari Nagar Extension, Mugallivakkam, Porur, Chennai-600 116, Email: rekha_a@yahoo.com) : Signet ring cell carcinoma of the appendix presenting with intestinal obstruction. Indian J Surg 2007, 69(1), 22-4.

Appendicular carcinomas are rare tumors. They are more likely to be carcinoids, mucocoeles and adenomas. Signet ring cell carcinoma is uncommon in the appendix. Reports the patient who presented with intestinal obstruction due to a signet ring cell carcinoma of the appendix, (studies proved that it was not a primary colonic lesion invading the appendix) and review literature of this very uncommon lesion.

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002422   Anand N;Rai A K (NO, , F-6/17, Krishan Nagar, Delhi-110 051, Email: doc_nitin77@rediffmail.com) : Nasopharyngeal glioma: a unique presentation in infants. Indian J Otolar Head Neck Surg 2007, 59(2), 151-3.

Despite the complex embryological development of the nose and surrounding structures, significant developmental nasal anomalies are rare. Of the various anomalies like-nasopharyngeal cysts, hairy polyps, dermoids, haemangiomata, fibromas, mucocoeles, lipoma, aplasias. We are presenting a rare case of Heterotopic Brain Tissue in the nasopharynx. This 1.5-month-old patient was operated through transpalatal route and mass excised. Histopathologicaly it consisted of various central nervous tissue elements. Seven months post surgery patient is thriving well.

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002421   Anand N;Chaudhary N;Dravid C (Registrar-ENT Safdarjung Hospital, , New Delhi-110 029, Email: doc.nitinanand@gmail.com) : Lupus vulgaris of pinna. Indian J Otolar Head Neck Surg 2007, 59(4), 390-2.

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002420   Aloorkar N H;Bhise S B (Satara College of Pharmacy, , Satara-415 004) : Drug induced pulmonary diseases. Antiseptic 2008, 105(4), 176-81.

Deals with the clinical presentation of the respiratory illness, the pathophysiologic mechanism and usual clinical presentation of the most important agents in each disease group. A table listing all the agents that have been associated with each disease complments the discussion.

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002419   Alfaresi M S;Abdulsalam A I;Elkoush A A (Pathology & Laboratory Medicine Dep, Zayed Military Hospital, Abu Dhabi, UAE, Email: uaenow@emirates.net.ae) : Analysis of Helicobacter pylori antimicrobial susceptibility and virulence genes in gastric mucosal biopsies in the United Arab Emirates. Indian J Gastroenterol 2007, 26(5), 221-4.

Objective is to determine the virulence attributes (presence of cagA and vacA genes) of Helicobacter pylori, and presence of clarithromycin resistance genes in gastric mucosal biopsy samples obtained in the United Arab Emirates. DNA was extracted from antral gastric biopsy samples from 91 dyspeptic patients. Real-time PCR and melting curve analysis were used to identify patients infected with H. pylori and to further identify strains containing the A(2142/ 43)G or the A(2142)C mutations that are associated with clarithromycin resistance. PCR was also used to identify cagA- and vacA-positive strains. Real-time PCR analysis detected the presence of H. pylori in 55 (60%) samples. Thirty-six pathogen-positive samples contained at least one of three point mutations associated with clarithromycin resistance. The vacA gene was present in 40 (72.7%) and cagA was present in 41 (74.5%) of the positive samples. Both genes were present in 36 (65%) of the positive samples. The presence of each clarithromycin-inducing mutation was largely independent of the others. Mutation at one position, A(2142/43)G, was strongly associated with the presence of both the vacA gene and the cagA gene. A high proportion of gastric mucosal biopsies obtained in the UAE is positive for genes associated with clarithromycin resistance. This may have implications for treatment of the infection.

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