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   2012| October-December  | Volume 1 | Issue 4  
    Online since December 27, 2012

 
 
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ORIGINAL ARTICLES
A study of the epidemiologic distribution of renal tumors in Tirupati, Andhra Pradesh
N Bayapa Reddy, K Narayana Reddy, Pallavi Madithati, N Nagarjuna Reddy, C Sainarasimha Reddy, RK Singh
October-December 2012, 1(4):217-221
DOI:10.4103/2277-8632.105105  
Background: The introduction of nephrectomy and other subsequent surgical interventions for renal diseases provided the clinical information and histopathological insight that form the basis of current concepts of renal tumors. Materials and Methods: A sixteen years retrospective record analysis study on kidney tumors was conducted during the period of October 2010 to May 2011. Biopsies registered between Jan 1994 to December 2010 in the Department of Pathology, Sri Venkateswara Institute of Medical Sciences, Tirupati were analyzed. A total of 52,339 samples were studied With the Aim to know the epidemiologic distribution of renal tumor cases. The data was statistically analysed by using Microsoft excel. Results: In the present study Out of the 113 renal neoplastic tumors 106 (93.8%) were malignant tumors and 7(6.19%) were benign. Clear cell variant of renal cell carcinoma (RCC) was most common subtype (90.5%) followed by papillary and collecting duct cell variant (4.7%). Conclusions: The renal tumors were distributed more common in the males in the sixth followed by seventh decade of life, and commonly on right kidney. Majority of the malignant renal tumors were primary type, most common presentation was hematuria followed by flank pain.
  2 2,573 317
Changing trend in the clinical distribution of Candida species in a tertiary care hospital
Jayapriya Sukumaran, Jeya Meenakshi Sundaram, Ranjith Raj Sivan
October-December 2012, 1(4):222-226
DOI:10.4103/2277-8632.105106  
Aims: Candida albicans remains the most common species causing human infections but recent epidemiological data reveal shift from C. albicans to non C. albicans species. The aim of our study is to detect the clinical distribution of Candida species in a tertiary hospital. Materials and Methods: Fifty Candida isolates from clinical samples were studied. The samples were inoculated on Sabouraud's Dextrose Agar (SDA) and Hichrom agar and incubated at 37°C. Growth on SDA were identified and speciated by standard methods. Candida species were identified on Hichrom agar by morphology and color of the colony and were compared with conventional methods. Anti-fungal susceptibility was performed by disc diffusion method using commercially available anti-fungal discs (HiMedia). Results: Out of 50 Candida isolates collected 62% were from males and 38% from females. The distribution of the clinical samples was urine 44%, exudate 32%, respiratory 14% and blood 10%. C. albicans (54%) was the most common species isolated from these samples. The distribution of non C. albicans were C. tropicalis (18%), -C. krusei (12%), - C. glabrata (10%),- C. rugosa (6%). Among the non-albicans C. tropicalis was seen predominantly in urine and exudates. The specificity and sensitivity of Hichrom agar was 98%. Antibiotic susceptibility pattern shows that about 38% of C. albicans and 17% C. krusei isolates were resistant to fluconazole. Conclusions: Percentage of non-albicans species (46%) are increased in the prevalence with C. albicans (54%) as the predominant species from clinical samples. Anti-fungal profile shows an increased percentage of resistance to fluconazole.
  2 7,005 521
A comparative evaluation of bioresorbable type I collagen membrane with and without fibrin fibronectin sealing system in the treatment of gingival recession: A clinical study
Aparajitha Sunkavalli, K. Raja V Murthy
October-December 2012, 1(4):239-244
DOI:10.4103/2277-8632.105112  
Background and Objectives: The purpose of the study was to clinically evaluate and compare the efficacy of type I collagen membrane (BIOMEND REGULAR® ) 1 with and without fibrin fibronectin sealing system (TISSEEL® ) 2 in the treatment of localized gingival recession. Materials and Methods: The study population consisted of 14 patients with a total of 28 gingival recession defects. The selected gingival recession sites were randomly assigned as either experimental site A (BioMend Regular® ) or experimental site B (BioMend Regular® + Tisseel® ). The clinical parameters including plaque index, gingival index, recession depth, recession width, width of keratinized gingiva, probing depth and clinical attachment level were recorded at baseline and at six months and twelve months post-operatively. Results: Twelve months follow-up results showed significant improvements in all clinical parameters for both the treatment groups. The recession width and depth were reduced in both the groups - BioMend Regular® and BioMend Regular® + Tisseel® , with mean root coverage of 31.79% and 35.64%, respectively. Furthermore, the width of keratinized gingiva was increased by 2.71 mm and 3.14 mm for experimental site A and experimental site B respectively when baseline values were compared with twelve month post-operative data. On intergroup comparison, the mean difference in different clinical parameters was statistically not significan. Interpretation and Conclusion: Both groups showed the potential of achieving root coverage; however, on comparison between the two groups, the results obtained of BioMend Regular® with Tisseel® group were slightly better, although statistically not significant.
  1 3,243 317
Evaluation of the shear bond strength of fiber-reinforced composite using different adhesive systems
PS Raju, Ankur Gupta, Jaishree Garg, Preeti Bhattacharya, Deepak K Agarwal, Abhishek Agarwal
October-December 2012, 1(4):249-252
DOI:10.4103/2277-8632.105117  
Introduction: The purpose of the study was to evaluate the effect of 3 adhesive systems on the shear bond strength of a fiber-reinforced composite (FRC). Materials and Method: Sixty extracted premolars were randomly divided into 3 groups (each containing 20 specimens). The FRCs (Splint - it, Jeneric/Pentron) were bonded to the teeth with 3 adhesive systems Transbond XT (Unitek/3M), Tetric Flow (Ivoclar-Vivadent), and Filtek Supreme (3M ESPE). All the samples were stored in distilled water at room temperature for 24 hours and subsequently tested for shear bond strength (SBS). Analysis of variance and the Sheffe post-hoc tests were used at a significant level of P < .05. Results: Analysis of variance indicated significant differences among the various groups. Fibers bonded with Transbond XT demonstrated significantly higher shear bond strength than the other 2 groups. Filtek Flow showed significantly higher shear bond strength values than Tetric Flow and lower than Transbond XT. No significant differences in debonded locations (ARI scores) were found among the groups. Conclusion: Transbond XT can successfully be used for direct bonding of FRC, thus improving their shear bond strength.
  1 2,476 350
CASE REPORTS
Perivascular epitheliod cell tumors (PEComas): Presentation of two cases with unusual morphological features
Kristina A Matkowskyj, Zong-Ming E Chen, Sambasiva Rao, Guang-Yu Yang
October-December 2012, 1(4):257-261
DOI:10.4103/2277-8632.105108  
A distinctive group of mesenchymal tumors coexpressing markers of melanocytic and smooth muscle differentiation and presumably derived from perivascular epithelioid cells (PECs) are colligated under the rubric of PEComas. This group of tumors with classical and distinctive histological features is increasingly recognized at various sites. PEComas can occur sporadically or in association with tuberous sclerosis complex. In this report, we present two sporadic cases of PEComa, one sclerosing type arising in an unusual site, the kidney, and the other is an unusual inflammatory variant occurring in the liver. The defining histological features of the sclerosing PEComa in the kidney are bland epithelioid and spindle cells arranged in nests or fascicles surrounded by dense sclerotic stroma with calcifications. In contrast, the inflammatory PEComa in the liver showed a dense inflammatory background with scattered epithelioid cells and adipocytes. Both these tumors were positive for melanocytic markers. These isolated observations will further expand the morphological spectrum of PEComa occurring at unusual sites.
  - 2,148 304
Penile fracture with bilateral rupture in tunica albuginea and complete urethral disruption: A case report with review of literature
K Sugunakara Rao, M Prasada Rao
October-December 2012, 1(4):262-264
DOI:10.4103/2277-8632.105110  
Penile fracture is a rare emergent condition, which includes rupture of the tunica albuginea of corpus cavernosum that occurs after trauma to the erect penis. The true incidence of penile fracture is not known as it is rare and under reported entity. Bilateral rupture of tunica albuginea with complete urethral disruption is very rare and very few cases were reported. We report a case of a 46-year-old man who presented with acute pain and swelling of penis and hematuria and severe burning pain during micturition, after a blunt trauma during sexual intercourse. Magnetic resonance imaging (MRI) revealed bilateral rupture in tunica albuginea and complete urethral disruption. We have done emergency repair of tunica and urethra suturing over a catheter. Postoperatively, patient regained normal erectile and voiding functions.
  - 10,243 287
Thymic cyst in the differential diagnosis of pediatric lateral cervical masses
Raghu S Ramareddy, Anand Alladi
October-December 2012, 1(4):265-267
DOI:10.4103/2277-8632.105111  
Thymic cyst is a very rare differential diagnosis of pediatric neck swellings and often misdiagnosed as either branchial cleft cyst or cystic hygromas. An eleven year old boy presented a painless left lateral cervical swelling with initial diagnosis of branchial cyst. He underwent complete excision of the lesion and histological examination confirmed a thymic cyst. The embryological development, clinical presentation, differential diagnosis, pathology and management of ectopic thymic lesions are discussed together with a brief review of the literature.
  - 2,203 207
Complete oral rehabilitation in a child with classical cornelia de lange syndrome: A rare case report
Radhika Muppa, Narendra Varma Penumatsa, Mahesh Kumar Duddu, Dhanalakshmi Karre
October-December 2012, 1(4):268-271
DOI:10.4103/2277-8632.105113  
Cornelia de Lange syndrome (CdLS) is a rare multiple congenital anomaly often termed as Amsterdam dwarfism. Exact incidence is unknown, but is estimated at 1 in 30,000 to 50,000. This syndrome is characterized by distinctive facial features, growth retardation, and limb anomalies with learning difficulties. Diagnosis of these children can be difficult and is mainly based on clinical findings. This paper discusses the full mouth rehabilitation of a 7-year-old child with classic CdLS under general anesthesia.
  - 2,386 265
FOCUS
State medicine at cross roads
Murali M Patnaik, Vaddi Narayana Rao, Mude Jagadeesh Naik
October-December 2012, 1(4):253-256
DOI:10.4103/2277-8632.105116  
In these days of rapid advancement of medical science, there is need for reforms in its teaching. The educationists in India are trying their best to do so in the rigid framework of four and half years of under graduate curriculum in the vision document 2015. Working like a censor the educationists are trying to cut short certain subjects, which are, felt can be coped up by the students themselves. Even before vision document 2015 the axe has already fallen on the departments of Anatomy, Physiology and Bio-chemistry departments. With greater emphasis on public health and some emphasis on basic and foundation courses, some further reductions have to occur in other subjects. The focus of attention now is on forensic medicine. Three issues have arisen in the vision document 2015. (1) Whether the subject of forensic medicine can be reduced to a one-year teaching program? (2) Is there a need to vertically integrate the teaching of forensic medicine in the last two semesters of under graduate teaching? (3) Should clinicians teach the subject of forensic medicine by splitting? These issues have been adequately dealt with in this article. Also, discussed is the state of affairs of the practice forensic medicine in India today for which certain remedies are suggested to lessen the inadequacies, deficiencies and the delinquencies noted in the teaching and practice of forensic medicine.
  - 1,501 251
GUEST EDITORIAL
Perivascular epithelioid cell tumors: Recent advances
William B Laskin
October-December 2012, 1(4):207-209
DOI:10.4103/2277-8632.105103  
  - 1,781 1,102
INDEX
Author Index 2012

October-December 2012, 1(4):274-276
Full text not available  [PDF]
  - 164 99
Title Index 2012

October-December 2012, 1(4):277-277
Full text not available  [PDF]
  - 181 93
NEWS
University News

October-December 2012, 1(4):272-272
  - 964 139
ORIGINAL ARTICLES
Dental prosthetic status and needs of adult rural population living in and around Nalgonda: A survey
Chittaranjan Bhogisetty, Narayana Rao, Sudheer Narayanaraopeta, Suresh Sanikommu, Taruna Marri, Rami Reddy
October-December 2012, 1(4):245-248
DOI:10.4103/2277-8632.105115  
Aim and Objective: The aim of the study was to assess the dental prosthetic status and needs of adult population in Nalgonda district, Andhra Pradesh. In order to promote the health of adult population, it is necessary to assess their prosthetic needs that would aid in planning oral health service programs. Materials and Methods: The study population comprised of 625 patients who were divided into two age groups; 35-44 and 65-74 years. Prosthetic status and prosthetic needs were recorded using WHO oral health assessment form. The examination was carried out by two examiners, and inter examiner calibration was done with kappa statistics 88%. Chi-square test was used to compare proportions, and significance level was set at α = 0.05. Results: Among 35-44 years age group, only 11.7% and 5.6% were having some kind of prosthesis in upper and lower arches and among 65-74 years age group; 12.7% and 15.9% were having some kind of prosthesis in upper and lower arches. Among 35-44 years age group, 35.1% and 30.4% require one unit prosthesis in upper and lower arches. Among 65-74 years age group, 25.1% and 24.7% require full prosthesis in upper and lower arches. Conclusion: Most of the prosthetic need was unmet in the study population. In order to improve the oral health status, it is important to educate and motivate the patients regarding oral health care and provide free dental treatment camps in rural areas.
  - 1,573 279
To assess the efficacy of hydroxyurea, in children with homozygous sickle cell disease, in the age group of 1 year to 18 years, at tertiary care hospital
Sunil K Pondugala, Pundari K Varanasi, K Madhusudhana Rao, Sunitha Vegesna
October-December 2012, 1(4):227-232
DOI:10.4103/2277-8632.105107  
Aims: To evaluate the increase in fetal hemoglobin percentage and MCV in children of sickle cell disease treated with hydroxyurea. To observe the safety of hydroxyurea in treated children. To arrive at the therapeutic dose of the drug to produce the beneficial effects. Settings and Design: A single blind randomized controlled trial of 12 months duration was designed to study the effect of hydroxyurea on sickle cell patients which aims to study the clinical and laboratory effects, in tertiary care hospital. Materials and Methods: Sixty children with severe sickle cell disease in the age group of 1-18 years were studied. Outcomes were measured in terms of decrease in number of vaso-occlusive crises, necessity of blood transfusions, laboratory parameters for different organ functions, blood cell counts and toxicity of hydroxyurea. Results: In patients of sickle, cell disease treated with hydroxyurea there was significant reduction in number and severity of vaso- occlusive crises and necessity of blood transfusions. Total hemoglobin, MCV and fetal hemoglobin percentage were raised significantly. Bone marrow suppression as reflected by the decrease in white blood cell and reticulocyte counts occurred but it was not below the defined toxicity levels. Serum bilirubin was decreased significantly. Conclusions: In the present study, we concluded that, hydroxyurea decreases number of vaso-occlusive crises and need for blood transfusions in children with severe sickle cell disease. It increases total, fetal hemoglobin concentration and MCV. It causes bone marrow suppression thereby decreasing white blood cell and reticulocyte count. However, this fall was never below defined toxicity levels. It causes no hematological, hepatic, renal or general toxicities when given on short-term basis. Overall, hydroxyurea has proved to be safe and efficacious in children between the age groups of 1-18 years.
  - 1,544 222
Morbidity pattern in tribals and non tribals above the age of 5 years of Gundlupet forest area, Mysore district, India
Sarjapura V Divakar, PA Balaji, Syed Sadat Ali
October-December 2012, 1(4):233-238
DOI:10.4103/2277-8632.105109  
Background and Objectives: According to 2001 census conducted by Government of India, more than 8.2% of the total Indian population constitutes of tribals. Reliable and comprehensive data on disease level, patterns and trends in tribal areas are required to monitor local epidemics and to assess the effectiveness of public health programs to prevent and control diseases. There are very few studies done to assess the health status and morbidity pattern among the tribal and non tribal population and it prompted us to undertake this study. Materials and Methods: A cross-sectional study was carried out between March 2010 - January 2012 in the forest areas of Gundlupettaluk, Mysore, India. Of the 33 tribal hamlets present, 18 hamlets were selected at random and the villages adjacent to these hamlets were included in non tribal population constituting intended homogenous population without mix up. Data were statistically analyzed using SPSS-I. The standard normal test (Z) was used to compare the equality of proportions having specific type of diseases among tribal and non tribal population. P value of < 0.05 was considered to be statistically significant. Results: Observations from our study revealed statistically significant proportion of Skin disorders and Dental disorders (P < 0.05) among tribal population compared to non tribal population. Nutritional deficiency, Respiratory infections, Intestinal disorders, Ophthalmic disorders and ENT disorders were also prevalent among both the tribal, as well as non tribal population, however, the difference in proportions between tribal and non tribals were not statistically significant. Conclusion: There was increased prevalence of morbid conditions like skin disorders and dental disorders among tribal population compared to non tribal population. Further research surveys among tribal population, elucidating the health status and insighting the probable reasons behind morbidty and mortality thus highlighting a need for an integrated approach towards reducing the morbidity rates and improving the health, as well as nutritional status in tribal population would be invaluable.
  - 1,994 299
REVIEW ARTICLE
Sunscreens
Aruna Chintaginjala, Lakshmi Kamcharla, Seetharam Kolalapudi
October-December 2012, 1(4):210-216
DOI:10.4103/2277-8632.105104  
Photoprotection is an essential component of many dermatologic therapeutic programs, which includes effective sunscreens. An ideal effective sunscreen should provide broad spectrum photoprotection (290-760), photostable, non-toxic, aesthetically acceptable and affordable. Sunscreens are broadly grouped as organic and inorganic. They protect against UV-A and UV-B rays preventing photodamage. The efficacy against UV-B rays is measured by sun protection factor and there is no universal consensus against UV-A protection. Various formulations are available improving the efficacy and aesthetics. Adverse effects are noted in 15-19% of the users. Desired protection is achieved with proper selection, application and compliance to the sunscreens. In addition to effective sunscreens, alternative protection measures like protective clothing and shade are necessary to obtain the maximum benefit.
  - 3,820 1,291
REVIEWERS
Reviewers 2012

October-December 2012, 1(4):273-273
Full text not available  [PDF]
  - 176 118
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