This study is analyzing about the issue of blood to various department and find out the major cause for need of blood. For that the issue of blood to various departments in Govt Sivagangai medical college in the year 2018 was collected and analysed. We found that more than 50% of our issue was to CEmON Centre (Comprehensive Emergency Obstetrics and Neonatal care). Among that the blood was mainly used for the correction of anaemia in antenatal and post-natal mothers. So correction of anaemia in early antenatal period by proper protocols will decrease the burden

Background: Patients with acute bronchiolitis are more prone to develop heart failure even in those without underlying cardiac diseases. Clinical assessment of heart failure in such subjects is a challenge. Our objective was to evaluate the diagnostic utility of myocardial performance index and B-type natriuretic peptide (BNP) as predictors of Heart failure during acute bronchiolitis and correlate them to clinical manifestation. Method: 50 subjects with acute bronchiolitis were enrolled in the study over one year duration; 30 healthy subjects of matched age and gender as control group. Heart failure was identified according to clinical, cardiomegaly in X ray and modified ROS classification. We assess the association between clinical manifestations, echocardiographic findings and serum BNP in subjects with bronchiolitis with and without heart failure. Results: 30% of subjects with bronchiolitis developed heart failure. There is significant decreased tricuspid and mitral annular plane systolic excursion and significant increase in pulmonary artery systolic pressure, myocardial performance index (MPI) and BNP during acute bronchiolitis especially among those who developed heart failure. Regression analysis revealed that MPI and BNP are independent predictors of heart failure during acute bronchiolitis. Conclusion: MPI is a valuable echocardiographic marker for early detection of heart failure while BNP is a useful circulating biomarker that can be used to differentiate respiratory distress due to heart failure from pulmonary diseases. It can also be used to estimate the prognosis, as well as to predict cardiac complication in infants presented with acute bronchiolitis

Introduction: Alcoholic cirrhosis is the end spectrum of alcoholic liver disease (ALD), which includes fatty liver or simple steatosis, alcoholic hepatitis, fibrosis, cirrhosis and super-imposed hepatocellular carcinoma. Although several studies have been conducted on dyslipidemia in cirrhotics in developed countries, there is a paucity of data in this regard in India. As there is a high prevalence of chronic liver disease in our country, we conducted this study to determine lipid levels in patients with cirrhosis and to assess if it relates to the severity of cirrhosis according to pughcriteria. Materials and methods: This is a cross sectional case-control study conducted on alcoholic cirrhotic patients and 50 healthy individuals (controls) without history of alcohol consumption. All the cases were investigated for fasting lipid profile and ultrasonographic evidence of cirrhosis. Biochemical tests including liver function tests were performed, which assisted in the diagnosis of alcoholic cirrhosis. These include serum bilirubin, total serum protein, serum albumin, serum globulin, aspartateaminotranferase (AST), alanineaminotransferase (ALT) and alkaline phosphatase (ALP). The data was collected systematically and analysed statistically according to the standard statistical methods. Results: Serum total, LDL, HDL, VLDL, cholesterol and trigylceride level in patients with cirrhosis is inversely correlate with severity of cirrhosis

Proliferative verrucous leukoplakia (PVL) is a rare form of oral leukoplakia, which was first described in 1985 by Hansen et al. Since then, various published case series have presented PVL as a disease with aggressive biological behavior due to its high probability of recurrence and a high rate of malignant transformation, usually higher than 70%. PVL is a long-term progressive condition, which is observed more frequently in elderly women, over 60 years at the time of diagnosis. We here by present a case of oral proliferative verrucous leukoplakia of retromolar triangle including gingivobuccal sulcus where nasolabial flap was used for reconstruction of the defect

Ranula presents clinically as a painless mucus pseudocyst in the floor of the mouth. They typically grow slowly and may be reported as a cycle of rupture and recurrence. Simple ranulas are mucus walled off above the mylohyoid muscle. Complex or plunging ranulas develop when the mucus extravasation extends through or around the mylohyoid muscle and deeper into the neck. Various treatment modalities have been advocated based on the size and location of the ranula. Deep plunging ranulas can be managed by surgical enucleation of the ranula along with the associated salivary gland or marsupialization whereas simple superficial ranulas can be managed by surgical enucleation or less invasive procedures. Ever since the first therapeutic use by Scott for strabismus till today, the spectrum of therapeutic applications of botulinum toxin has widened. Botulinum toxin offers a transient, reversible, relatively safe treatment option to many conditions of interest in the maxillofacial region. It can be used effectively as well as efficiently as a minimally invasive alternative to conditions which are refractory to routine medical management or require extensive surgical intervention. We present a case of a simple ranula in the floor of the mouth treated by Botulinum toxin efficiently in a non-invasive manner.

Organophosphorus compounds are organic compounds containing phosphorus. They are used primarily in pest control as an alternative to chlorinated hydrocarbons that persist in the environment. Some organophosphorus compounds are highly effective insecticides, although some are extremely toxic to man, including sarin and VX nerve agents. To study the myocardial involvement in organophosphorus compound poisoning. Patients got admitted to the department of medicine, Adichunchanagiri institute of medical sciences, with history of organophosphorus compound poisoning during the period of January 2016 to December 2016. In the preset study, the incidence of OP compound poisoning common in males compared to females. Majority of patients were in the age group 31-49 years. The most common clinical finding in patients was tachycardia (36%) followed by bradycardia (32%). Hypertension was seen in 5 (20%) patients and 4 (16%) showed hypotension. Most common ECG finding was ST elevation (48%), Sinus tachycardia (24%) and QT prolongation (16%) and sinus bradycardia (12%). 15 (60%) of the patient had a significant levels of serum Acetylcholinesterase level >2500 IU/L. Cardiovascular effects are quite common following acute OP poisoning. These effects pertain to different muscarinic and nicotinic effects on the heart, electrolyte disturbances, ABG disorders, respiratory failure and over-atropinization.

Uraemia is the clinical syndrome which occurs when there is a marked nitrogen retention due to renal failure. It had been suggested that urea level has an effect on coagulation and haematological profile. The haemostatic status was studied in Thirty known uraemic patients of the University of Nigeria Teaching Hospital Enugu. Fifteen non-uraemic people were used as controls. The mean result obtained are as follows:-Packed cell volume (PCV), 29 ± 5.4%, Platelet count, 238 + 80.4 n 109L, prothrombin time, 14.8 + 1.45 seconds, Bleeding time 5.9 + 1.98 minutes. For control subjects the following result were obtained: Packed cell volume40.8 + 2.4%, Platelet count 267 ±48 x 109L, Prothrombin time 12.9 +_0.93 seconds and Bleeding time 2.43 + 0.52 minutes. A statistical comparison of the above results between uraemic patients and control subjects showed that there were no significant difference in the platelet count (P>0.20) and prothrombin time (P>0.1) but showed significant difference in the packed cell volume and Bleeding time. A weakly positive correlation (r= + 0.11) was found to exit between prolongation of bleeding time and blood urea

The peculiar anatomy, muscular attachment, and thickness of cortical plate which is interposed between the thicker tooth‑bearing mandibular body and the thinner ascending ramus in addition to the presence of the third molar makes the angle region of the mandible irreplaceable. Innumerable treatment modalities have been proposed for mandibular angle fractures; although the ideal modality remains controversial. The choice of fixation in maxillofacial skeleton should be reformed based on the fracture patterns, displacement, stability of segments, and satisfactory postoperative function. However, due to the varied fracture patterns, there arises a need for variation in fixation devices and their localization. We put forth a case of a mandibular angle fracture displaying a unique fracture pattern and its management along with a brief review and update pertaining to the way mandibular angle fractures should be managed

Dengue fever is a mosquito-borne tropical disease caused by the dengue virus. Symptoms typically begin three to fourteen days after infection. This may include a high fever, headache, vomiting, muscle and joint pains, and a characteristic skin rash. Recovery generally takes two to seven days. The present study was conducted in Department of Medicine, Adichunchanagiri Institute of Medical Sciences, from the period of January 2017 to December 2018 to Study of Clinical and Haematological profile of patients with dengue fever. In our study, the incidence of dengue fever common in males compared to females. Majority of patients were in the age group 31-40 years. Out of 100 patients 69(69%) patients were diagnosed to have DF, 24(24%) patients were diagnosed to have DHF and 7(7%) patients were diagnosed to have DSS based on WHO criteria. Fever was present in100 cases, myalgia in 94 cases, headache was present in 81 cases, joint pains in 90cases, vomiting in 74 cases, pain abdomen in 69 cases, rash in 52 cases, hepatomegaly in 21 cases, bleeding in 34 cases and shock in9 cases. As per WHO criteria 71(71%) patients had low platelet counts. Apart from attempts to control the spread of the Aedes mosquito there are ongoing efforts to develop antiviral drugs that would be used to treat attacks of dengue fever and prevent severe complications. Discovery of the structure of the viral proteins may aid the development of effective drugs

Background: Approximately 1–2% of the adult population in developed countries has Heart Failure, with the prevalence rising to ≥10% among persons 70 years or more. Most of the molecular and cellular mechanisms responsible for the cardiovascular effects of thyroid hormone have been clarified. Thyroid hormones produce changes in cardiac inotropism and chronotropism more rapidly than would be expected from regulation of gene expression. Hypothyroidism causes cardiac atrophy, due to decreased αMHC expression and increased β MHC expression. Moreover, hypothyroidism also leads to chamber dilatation and impaired myocardial blood flow [1]. Material and Methods: 200 patients between age group of 45 to 75 yrs, presented in medical emergency and medical outdoor of the institution with heart failure were studied. Comparison of Thyroid Profile and LVIDd (Left Ventricular Internal Diameter at Diastole) was done at Baseline, 3 months and 6 months. Results: After comparing the thyroid profile and 2DEchocardiography findings in subclinical hypothyroidism of treated group after 6 months, there was increase in TSH and fall in FT4 (p 0.001) with a significant improvement in LVIDd. Conclusion: There was improvement in EF, a decrease in LVIDd, increase in Mitral E velocity, decrease in Mitral A velocity and increase in E/A ratio in cases as compared to controls with treatment

Background: Background: Vitamin B12 (B12) deficiency leads to a wide spectrum of disorders affecting all age groups. However, reports on B12 status in vegetarian adults in India are limited. Hence, we determined the prevalence of B12 in the northern Indian vegetarian population. Methods: A cross sectional study was conducted in an urban north Indian population amongst 200 apparently adults distributed into 3 age groups: <20, 21-40 and >40 years. Plasma concentrations of B12 were analyzed. Results: The overall prevalence of B12 deficiency was 45%. B12 deficiency was higher in vegetarians (35.5%) compared to those consuming non vegetarian diet (9.5%). Conclusions: These results indicate a higher prevalence of B12 deficiency in apparently healthy vegetarian adults in a north Indian population

A Pandemic of Influenza A (H1N1), caused by a new strain of the Virus started in Mexico in 2009. The first case in India was seen at Hyderabad in June 2009. Influenza A H1N1 2009 is transmitted by airborne droplet infection. The disease was initially known as Swine Flu, but now called as Seasonal Flu. The study has been carried out at M. P. Shah Government Medical College and Guru Gobind Singh Hospital, Jamnagar Gujarat. As per Ministry of Health and Family Welfare (MOHFW), Government of India guidelines, Category C Seasonal Flu patients were admitted in the Hospital. Out of 178 samples sent, 99 samples tested positive. 26 patients succumbed to the illness. Retrospective analysis of the Fatal cases were done with respect to various parameters. Maximum number of patients were in the age group above 60years. More number of fatal cases were in the age group of 40 to 49 years. Mortality was more in males although incidence was almost same in both sex. Presence of Co-Morbid illness was high amongst fatal cases. All fatal cases had low Oxygen saturation on presentation and were late in starting Oseltamivir after onset of symptoms. Even after 10 years Seasonal Influenza caused by H1N1 Virus carries significant mortality

Till date there is no definite basis of burn out syndrome. There is vast difference in the bookish knowledge and practicability of this particular so called syndrome or disease. It’s the aftermath of over work, loss of self confidence and reduction in satisfaction. But till now it’s counted as a result of inadequate treatment of chronic stress. In this publication I have tried my level best to explore the current concept of this syndrome which could affect the future and contemporary generations. A variety of factors play into burnout among healthcare professionals, many of which are non-modifiable such as gender, socio-demographic variables, personality, and age [1]; however, the top cited reason for burnout is work overload [2]. When a person works in a high stress field such as healthcare they are exposed to emotionally draining experiences all the time so the added pressure of working while the hospital is understaffed only piles on to that stress. Many studies within hospitals have found a direct link between reducing workload and reduced burnout among healthcare professionals [3] which led to a significant drop in patient deaths [4]. It is impossible to expect for us as healthcare professionals to do the work of two or three people and still give the same quality care to a patient as usual. Burnout only leads to mediocre patient care and a poor work environment, which continue the vicious circle to only cause more burnout. and Medical institutions across the world have attempted to provide both preventive and curative care for healthcare workers who are at risk for experiencing burnout; however, many of these attempts were unsuccessful and do not address the underlying problem: overworked staff. Goal: The goals of this study were: to identify the specific stressors of high intensity in the hospital physicians work environment, to discover whether and how certain stressors can affect the appearance of burnout syndrome at work in a hospital physician, to determine whether certain individual factors influence the occurrence of burnout syndrome at work. Methods and subjects: Study was conducted on medical professionals working at Govt. Medical College, Amritsar. Results: The study comprised 64.8% hospital doctors (specialists and doctors on specialization) of a total 321 employees in various departments. High level of emotional exhaustion was recorded in 45.9% a high level of depersonalization in 54.8 %, and a low level in perceptions of personal accomplishments in 45.2% of respondents. Conclusions: Continuous exposure to stressors at the workplace, such as work at shifts, excessive workload, poor communication with superiors, and lack of continuous education of hospital physicians can lead to mental and physical exhaustion, professional burnout. Socially there was no source to make amendments in the working conditions of the professionals. High-quality controlled studies on burnout syndrome are lacking. A standardized and internationally accepted diagnostic instrument with a validated rating scale should be developed. The etiology and pathogenesis of burnout should be studied with special regard to the possible role of neurobiological factors. Treatments for it should be studied systematically so that their effects can be judged at a high level of evidence. In view of the current lack of knowledge about what is called “burnout,” the term should not be used as a medical diagnosis or as a basis for decisions regarding disability or other socioeconomic matters.

Introduction: The surgical outcome is always influenced by postoperative respiratory complications. In few cases post-operative mechanical ventilation is needed while undergoing surgeries with general anaesthesia. There are many postoperative and intraoperative parameters are responsible for this. This study was designed to assess the association of pre and intra operative parameters with post-operative mechanical ventilation in cases subjected to elective abdominal surgery. Materials and methods: A total 100 cases scheduled to undergo elective major or minor abdominal surgeries between age group 21-70 years were recruited. Cases were administered with general anesthesia and cases were scheduled for extubation at the end of surgery, but complicated cases were shifted to ICU for post-operative mechanical ventilator support. Peak expiratory flow rates were measured in those extubated within 24 hrs after surgery. Results: Low albumin levels, alcohol consumption, preoperative hospital stay, preoperative respiratory tract infection, COPD, bronchial asthma, obstructive sleep apnea, Sputum production, smoking were not statistically significant and pre-operative hospitalization time, Smoking, >10% weight loss, Hypertension, ischemic heart diseases, cerebrovascular complication were significantly correlating with postoperative mechanical ventilation. Conclusion: Significant parameters such as <10% weight loss, pre-operative hospitalization and smoking found to be significant parameters of requirement of post-operative mechanical ventilation by multiple logistic regressions

By Far the most defining feature of the 21st century, the Internet, has become an integral part of our daily lives. So much so, that many of us have become pathologically addicted to its use. This cross sectional study attempts to examine the existence and possible effects of Internet addiction among medical trainees in the Kingdom of Bahrain. A total of 291 medical doctors were asked to fill the “Internet Addiction Diagnostic Questionnaire” developed by Dr. Kimberly Young. The prevalence of Internet addiction was found to be quite significant, proving that medical trainees are among high-risk pathological Internet use groups because they use the Internet for both educational purposes and non-educational purposes as found in the results. The Majority of the participants frequently stayed online longer than they intended. It was also found that many of the participants frequently neglected their household chores to spend more time online, blocked out disturbing thoughts about life with soothing thoughts of the Internet, found themselves anticipating when they would go online again, feared that life without Internet would be boring, empty and joyless and tried to cut down the amount of time they spent online but failed

Background: Midline line incisions are known for its versality of rapid and wide access to the peritoneal cavity with least damage to abdominal wall musculature, vessels and nerves. The closure technique varies from operating surgeon to institutions. The aim of this study was to see the postoperative results in reference to small tissue bites in the closure of abdominal wall. Materials and methods: The study was conducted in the department of general Surgery SKIMS, MCH Bemina Srinagar. A total of 50 cases were managed with small bites technique that underwent midline laparotomy in both elective and emergencies from 2016 to 2018. Patients were operated with small tissue bite sutures placed 5 - 7 mm from the wound edge and 5 - 7 mm apart and included only the aponeurosis in the stitches without peritoneum. Results: Maximum number of patients were males, maximum number of patients were in age group of 20-30 years (56%), serum albumin was ≥3 in36 (72%) of patients. Surgical site infection was seen in 12 (24%) of patients. Conclusion: Our study showed that small stitch length between 5 to 7 mm with SL: WL ratio: greater than or equivalent to 6:1 to achieve safe closure of midline laparotomy incision

It has been reported that there are effects of deep breathing and breath holding on the cardiovascular and blood pressure parameters. It is generally seen that BP tends to decrease during inhalation and increase during exhalation these changes may alter blood pressure measurements resulting in measured blood pressures being different. This study aims to find the effects of slow deep breathing practice on the blood pressure and Heart rate of young healthy adult male and female medical students. Methods: This study was conducted in the Department of Physiology, RVM Institute of Medical Sciences, Laxmakapally, Telangana. A total of n=50 subjects were selected randomly; the subjects were the medical students of RVM institute. Out of which (n=25) Group (M) males and (n=25) Group (F) were females. The baseline parameters of the subjects were recorded at the beginning of the study and the subjects were then trained for slow deep breathing @ 6 breaths per minute for a period of 3 months under the supervision of the investigator. Subjects are asked to take slow and maximal inspiration lasting for five seconds, followed by maximal expiration which also lasts for five seconds at a rate of 6 breaths per minute during each practice. A standard BP measurement was performed using a pneumatic cuff while listening to "Korotkoff sounds". All cardiovascular functional parameters were recorded before the trial, during breath-holding, and during recovery. Results: The values of SBP parameters in Group (M) Male before and after training were found to be significant. The DBP change in initial and final values in this group was not significant. The respiratory rates changes were also found to be significant in the Group (M). In the Group (F) no parameter was found to be changed significantly between the initial and final readings. The intergroup comparison of the parameters in the final readings shows a significant change in both SBP and DBP. Conclusion: it can be concluded that slow deep breathing for a period of 3 months decreases the blood pressure and heart rates and improves the autonomic functions. The effects are more marked in the male participants as compared to females of the same age group. The effect of slow deep breathing for long durations tends to improve the parasympathetic tone

Background: Anaemia is reduced oxygen carrying capacity of blood, due to reduced RBC mass and/or haemoglobin concentration [1]. Causes of anaemia include nutritional deficiencies, inherited genetic defects, medication-related side effects and chronic diseases. We had studied patients attending our tertiary care centre to determine aetiology of anaemia and its different clinical aspects during period of July 2012 to March 2014. Methods: A total 100 patients having anaemia were enrolled in the study and detailed clinical examination and relevant laboratory investigations were performed. Results: Out of 100 patients 55 were females and 45 were males. In present study 45 females fall in age between 12-40 years and 29 males were in the similar age group. Most common presenting symptoms were generalised weakness and easy fatigability. Pallor was noted in 94 patients. Severe anaemia (Hb <7 g/dl) were seen in 89% of the cases. 34% of the patients had subnormal serum iron levels and 45 patients were having low serum vit. B12 level (<187 pg/dl). Among other causes, 7 patients had anaemia of chronic disease, 4 had malabsorption and 2 had drug toxicity. Conclusion: Vitamin B12 deficiency in association with iron deficiency was found to be the commonest cause for anaemia in the study group. Haemolytic anaemia was more common in males in thid study

The primary function of a temporary filling material is to prevent the contamination of the root canal system by fluids, organic debris, and bacteria from the oral cavity in multiple-appointment root canal treatment. The aim of this study was to evaluate the sealing ability of a new temporary filling material Orafil LC compared with Cavit G and IRM using a dye penetration test. Standard endodontic access cavities were prepared in 24 human premolars. The teeth were divided into three groups (n = 8 for each group). Samples are de-coronated at the level of CEJ, 4mm of obturated material was removed from the coronal portion and were sealed with one of the three temporary restorative material. Samples were immersed in 2% methylene blue dye solution for 3 days. The teeth were then rinsed, dried, sectioned in bucco‑lingual direction and evaluated under a stereomicroscope for dye penetration. Data were analysed. The dye penetration was observed in all experimental groups. The lowest mean leakage was in Cavit G followed by (in ascending order of dye penetration) IRM, Orafil LC. Dye penetration was observed in all the samples. Cavit G exhibited minimal dye penetration when compared to IRM and Orafil LC. Within the limitation of the present study Cavit G is considered to be a promising option for the provisional restoration of endodontically treated teeth

Background: Dermatoglyphics is referred to as study of the friction ridge formation that appears on the palms of the hands and soles of the feet. There have been works done by different researchers on dermatoglyphics in the field of medicine which has helped in the detection of diseases like breast cancer, anemia. Objective: This study was aimed at determining the Palmar Ridge Counts of the Igbos’ and Okirikas’ in Southern Nigeria. Materials and Methods: The study was non-experimental and analytical. Two hundred subjects selected by simple random sampling. One-way Anova was done using SPSS twenty version. Results and Discussion: The Igbo males with AB ridge count 38.3±4.9156 on the left hand while 37.3± 5.5698 for Okrika males. The Igbo males had BC ridge count 27.4± 5.3560 on the left hand while Okrika males had BC ridge count of 25.0±6.0527. The Igbo males had CD ridge count of 36.0 ±9.1109 on the right hand while Okrika males had CD ridge count of 33.5± 7.3289. Test of significance showed significant difference between the Right CD, Left AB and Left BC Ridge count of Igbo and Okrika subjects (P<0.05). Conclusion: The study has shown the palmar ridge counts of the Igbos and Okrikas. It also showed traces of sexual dimorphism in both populations and explicitly revealed that both populations have nothing to show common ancestry, the similarity seen may have occurred by chance which further implies that both populations could be regarded distinct and unrelated entities

Acute appendicitis is one of the most common surgical emergencies. It involves 10 to 20% patients in causality. The aim of the study is to predict the credibility of clinical, radiological and laboratory findings in acute appendicitis with normal leukocyte counts. Material & Methods: This study was carried in our tertiary care hospital over a period of one year by retrieving the data from hospital records to access the diagnostic factors in acute appendicitis with normal leukocyte counts. Results: The median age was 16 years. 228 were males and 149 females. Alvarado scores ranged from 5 to 10, with a median score of 8. Temperature at time of presentation ranged from 36.8°C to 38.33 °C. The duration of symptoms was less than 24 hours in 134 patients and more than 24 hours in 243 patients. Total WBC count was found to be normal in 55 patients (14.58%) as compared to elevated total WBC counts found in 322 patients (85.41%). Polymorph nuclear leucocytes were more than 75% in 52 of the Group B patients (94.54 %). The same was found in 306 (95.03 %) patients of Group A

Shared decision-making (SDM) is a process where clinicians and patients communicate and share evidence, giving patients an informed, active role in healthcare decisions.1 This paper addresses SDM in a local setting in the kingdom of Bahrain. Participants filled a questionnaire with two decisional-role outcome measures. Dependent variables were patient role preference pre- and post-consultation. McNamar-Bowker’s test was used to assess deviations in patient preferences pre- and post-consultation. A total (n=566) filled the questionnaire; 2.3% (95% CI; 1.2 - 3.9) preferred an active role while the majority preferred a collaborative role (43%, 95% CI; 39.0- 47.2) before their encounter with the doctor. Post-consultation, 7% of the participants had a less active role, and 31% a less collaborative role in comparison with their preference, whereas the passive role increased from 49% to 62.0% in relation to expressed preferences. It is apparent that the results lack symmetry (McNemar-Bowker S=38.5; DF=3; P= 0.001). Patients aged 36-49 years are less “collaborative” (33.1%) and more “passive” (57.5%) than younger and older age groups (p < 0.028). Higher educational meant more preference for the collaborative or active role (p < 0.01). Primary healthcare attendees prefer a passive role in SDM. Nevertheless, healthcare providers should not assume patient passivity in SDM, but must assess and treat each patient individually

Dentinogenesis imperfecta is an autosomal dominant disorder of tooth development charecterized by the presence of opalescent dentin, resulting in a dusky blue to brownish discoloration of the teeth. This condition is genetically and clinically heterogeneous. Both deciduous and permanent dentitions are affected. This report describes a case of 19 year old female patient with characteristic dental features of dentinogenesis imperfecta type II

Background: Histoid leprosy (HL) cases are a reservoir of disease as it is a rare variant of lepromatous leprosy lead to further spread of leprosy. Therefore, early diagnosis and management of these cases needed to edadicate leprosy. The main objective of our present case series is to show different clinical features, histology findings and bacteriological findings in patients who attended tertiary care hospital outpatient department over last 6 years. Methods: It is a retrospective 6 year study (January 2014-January 2019). Particular of patients were obtained and clinical findings are noted in histoid leprosy patients in Mahatma Gandhi Medical College and Hospital, Jaipur, Rajasthan (India). Results: In this study, there were 7 cases of HL. All cases were males in the age group ranging from 30 to 65 years with shorter duration of illness. 3 patients (42.80%) were de novo cases of HL. Nodule (71.5%) were the commonest skin lesions while arm (78%) were the most common sites involved.Earlobe infiltration was seen in 2 cases (28.5%). Lepra reactions were seen in one (14.2%) cases. No Deformity/disability were noted. Most common nerve involved was ulnar nerve. The bacteriological index (B.I) of Histoid leprosy, +3/ +4 were mainly seen in borderline leprosy (BB, BL), B.I +1/ +2 mainly in borderline tuberculoid (BT) leprosy. Conclusion: In this study majority of cases were de novo three out of seven.It also develop in patient who took inadequate or irregular treatment. So, early detection of Histoid Hansen is needed for awareness and to eradicate leprosy

Background: The coexistence of primary hyperparathyroidism (PHPT) and thyroid disease (TD) is a well-known entity. The aim of our study is to report our experience, to evaluate the prevalence of this association with review of the literature. Methods: We retrospectively examined the operative database over the past 03 years. We looked for patients who underwent parathyroid surgery. All patients underwent preoperative neck US and Tc99m sestamibi scintigraphy and /or CT scan or MRI. Results: Among the 43 patients who underwent a parathyroidectomy. Preoperative thyroid US revealed that 62, 79 % of patients with PHPT had thyroid abnormalities. 58, 14 % patients underwent parathyroidectomy, whereas 41, 86 % patients underwent both parathyroidectomy and thyroidectomy. Postoperative histopathology results showed that 62.96% of patients had benign thyroid disease and 3.70 % of patients had malignant thyroid disease. Conclusion: In our study, we found a high prevalence of concomitant thyroid disease and PHP T. however, one patient had a micro papillary carcinoma and that emphasize the importance of careful judgment to avoid over-treatment