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   2015| January-March  | Volume 4 | Issue 1  
    Online since March 16, 2015

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Oral malodor: A review of etiology and pathogenesis
Ajay Benerji Kotti, RV Subramanyam
January-March 2015, 4(1):1-7
Oral malodor or halitosis is a condition characterized by unpleasant odors emanating from the oral cavity. The aim of the present review is to classify and explain the etiology and pathogenesis of oral malodor. Volatile sulfur compounds (VSCs) that result from bacterial breakdown of protein are considered to be the main culprits for this foul odor. The etiology of oral malodor can be attributed to both systemic and oral conditions. However, nearly 85% of the cases originate from mouth due to tongue coating (especially posterior third of the dorsal surface), periodontal disease, poor oral hygiene, infections, ulcerations, food debris, dry mouth and faulty restorations. Bad breath can be caused by systemic disorders such as upper and lower respiratory tract infections; hepatic, pancreatic, and nephritic insufficiencies; trimethylaminuria and some medications. In addition, there are very few instances where patients suffer from pseudohalitosis or halitophobia.
  6,386 878 1
Ectrodactyly: A rare anomaly of limbs
Nirmala SVSG, Sandeep Chilamakuri, Chaitanya Pavuluri, Sivakumar Nuvvula, Sindhuri Veluru
January-March 2015, 4(1):53-55
Ectrodactyly refers to the congenital limb malformation, characterized by a deep median cleft of the hand and/or foot due to the absence of central rays. Affected individuals may be recognized by a lobster-claw deformity of their limb extremities that causes severe functional disorders. A combination of ectrodactyly, ectodermal dysplasia and cleft (EEC) in the lip or palate is called as EEC syndrome. This paper reports a case of the nonsyn dromic form of ectrodactyly in a 9-year-old girl along with etiological factors and its management.
  5,887 246 -
Detection of alcohol in saliva for blood alcohol concentration using alcohol saliva strip test: A forensic aid
Thokala Madhusudhana Rao, Dorankula Shyam Prasad Reddy, Pratibha Ramani, Priya Premkumar, Natesan Anuja, Herald J Sherlin
January-March 2015, 4(1):24-29
Context: Alcohol is a factor in many categories of injury. Alcohol intoxication is frequently associated with injuries from falls, fires, drowning, overdoses, physical and sexual abusements, occupational accidents, traffic accidents and domestic violence. In many instances, for forensic purpose, it may be necessary to establish whether the patients/subjects have consumed alcohol that would have been the reason for the injury/accidents. Combining rapidity and reliability, alcohol saliva strip test (AST) has been put forward for the detection of alcohol in saliva for blood alcohol concentration (BAC). In the present study, we have determined BAC by using AST. Aims and Objectives: The main objective of this study was to detect alcohol in saliva for BAC in alcoholics by using AST. Materials and Methods: Two socio-economic groups were selected for the present study where Group A consisted of 40 subjects from the local bar and Group B consisted of 40 subjects from an organized party. The subjects were selected randomly at the local bar and at the organized party who have consumed different forms of alcohol. ALCO-SCREEN 02 plastic strip with a reactive pad was used for the detection of presence of alcohol in saliva. Results: In the present study, 85% of subjects from Group A, i.e., at the local bar, demonstrated positive results of variable intensity with AST when compared to the subjects from Group B in the organized party which was only about 25%. Conclusion: The present study showed that AST, performed by using ALCO-SCREEN 02 plastic strip with a reactive pad, can detect the presence of 0.02% BAC or more that can be helpful for various purposes such as forensic, workplace, medical and research settings. The study also showed that amount, time period, concentration and quality of the alcohol intake can influence the BAC, which can be a contributory factor for many accidents, injuries and medical conditions.
  5,178 331 -
Fine-needle aspiration cytology diagnosis of paraganglioma (carotid body tumor)
Kalyani Dukkipati, Odapalli Shravan Kumar
January-March 2015, 4(1):42-43
A case of carotid body tumor was diagnosed based on fine-needle aspiration cytology (FNAC) in 22-year-old female who presented with a mass in the right lower cervical region. Provisional diagnosis was made as metastatic deposits. However, this case was diagnosed on FNAC as carotid body tumor due to the presence of definite diagnostic features on cytology like hemorrhagic aspirate, with clusters and as well as discrete cells, which are round to oval with moderate anisokaryosis, indistinct cell outlines, stippled chromatin and fine granular cytoplasm. Focal attempted acinar formation was also seen. Based on these cytologic findings and the location of the swelling, a diagnosis of carotid body tumor was made. The diagnosis was confirmed on histopathological examination. Carotid body tumor is arising from the chief cells of the carotid body, which is situated at the bifurcation of the common carotid artery. Though the fine needle aspiration was seldom suggested for the diagnosis of carotid body tumor due to its location, there were no complications during the procedure in this case. As the role of FNAC in the diagnosis of carotid body, tumor is minimized due to the severe bleeding complications of the procedure and only few cases were reported in the literature until now. However in this case, the main diagnosis was made by FNAC without any complications.
  5,187 256 1
A case report of scrub typhus
Pothukuchi Venkata Krishna, Shaik Ahmed, Katreddy Venkata Narasimha Reddy
January-March 2015, 4(1):47-49
Although scrub typhus is endemic in our country, it is grossly under diagnosed owing to the nonspecific clinical presentation, lack of access to specific diagnostic facilities in most areas, and low index of suspicion by the clinicians. It presents as either a nonspecific febrile illness with constitutional symptoms such as fever, rash, myalgias and headache or with organ dysfunctions involving organs such as kidney (acute renal failure), liver (hepatitis), lungs (acute respiratory distress syndrome), central nervous system (meningitis), or with circulatory collapse with hemorrhagic features. We are reporting a case report of scrub typhus presenting as fever with bilateral bronchopneumonia.
  5,005 373 1
Prehypertension among Medical Students and its Association with Cardiovascular Risk Factors
Ravi Venkatachelam Chitrapu, Zeeshan Muzahid Thakkallapalli
January-March 2015, 4(1):8-12
Aims and Objectives: To assess the prevalence of prehypertension among medical students and its association with cardiovascular risk factors. Materials and Methods: Blood pressure and anthropometric data were measured in 275 medical students. An oral glucose tolerance test and lipid profile results were compared in 30 prehypertensives and 30 normotensives. Results: The overall prevalence of prehypertension in the study sample was 37.45% (103/275) while, 3.63% (10/275) were hypertensive. Prevalence was similar in boys and girls and was associated with a greater mean weight, body mass index and waist circumference, when compared to normotensives. Glucose tolerance and lipid profile levels were similar in both groups. Conclusion: Prehypertension is prevalent in more than a third of medical students and is associated with body weight, calling for adoption of healthy lifestyle measures to control weight and thus prevent hypertension. (ClinicalTrials.gov Identifier: NCT01776294)
  4,618 493 -
Nutritional status assessment of school children in Bellary district, Karnataka
Ramachandra Kamath, Ravi Prasad Jakkula, Saurabh Kumar
January-March 2015, 4(1):13-16
Background: Malnutrition continues to be a primary cause of ill-health and morality among children in developing countries. It is a major public health problem and accounts about half of the deaths worldwide. About 150 million children in developing countries are still malnourished and more than half of underweight children live in South East Asia region. The high levels of under-nutrition in south Asia pose major challenge for child development. There are other factors that affect the nutritional status of children. Aims and Objectives: To assess the Nutritional Status of School Children in Bellary district. Materials and Methods: A total 27,544 students from 169 schools were enrolled for the study. Sample size was calculated by taking 20% of total enrolled school children in Bellary district. Statistical Analysis: The body mass index, Z score and World Health Organization Multicenter Growth Reference Study growth charts was used for analysis. Results: The study population of 27,544 students comprised of which 13,519 (49.1%) male and 14,025 (50.9%) female. On the analysis, 4447 (16.1%) found to be undernourished. More male students were found to be undernourished 2237 (16.9%), but obesity was common in females 1723 (12.3%). Conclusions: The nutritional status of the students in our study has been found better than other studies, but there are cases of undernourished that need attention and there is a need to deal with obesity and overweight in the school in order to prevent the epidemic of noncommunicable diseases.
  4,613 452 1
Spinoglenoid notch syndrome
Vemuri Rama Tharaknath, Surath Amarnath, Sushil Kumar Kamaraju, Raja Challapalli
January-March 2015, 4(1):44-46
Spinoglenoid notch syndrome is due compression of suprascapular nerve, due to a cyst, at the spinoglenoid notch causing pain, which is often mistaken for rotator cuff injury or cervical spondylosis. This patient presented with pain on the back of the right shoulder with weakness of external rotation and abduction. On examination, he had wasting, and weakness of the infraspinatus muscle and rest of the neurological examination was normal. His right shoulder magnetic resonance imaging scan revealed a cystic lesion at the spinoglenoid notch. An ultrasound guided aspiration of the cyst was done. He improved well with physiotherapy. One year later, the bulk and power of his infraspinatus muscle was normal.
  4,654 198 -
Synovial chondromatosis in a young child: A rare presentation
Kuppa Srinivas, Dema Rajaiah, Yerukala Ramana, Puppula Kiran Kumar
January-March 2015, 4(1):36-38
Synovial chondromatosis is a benign cartilaginous metaplasia of the synovium, which may affect any synovial joint. Knee joint is the most commonly involved joint presenting with pain swelling and restricted movements. It usually occurs aged 30 to 50 years and is extremely rare in children. Diagnosis is made by radiographs, computed tomography, magnetic resonance imaging and on surgery.
  4,290 245 -
Arachnoid cyst presenting with endocrine manifestations: Tale of two patients
Babulreddy Hanmayyagari, Mounika Guntaka, Sridevi Patnala, Prasun Deb
January-March 2015, 4(1):32-35
Arachnoid cysts are benign cysts that occur in the cerebrospinal axis in relation to the arachnoid membrane. These are usually congenital and asymptomatic. We herein report endocrine manifestations associated with large intracranial arachnoid cyst in two of our patients, the first case presented with the combination of precocious puberty and growth hormone deficiency and the second case with precocious puberty; subsequently, we discuss the relevant literature on this association.
  4,082 237 -
Esthetic rehabilitation of prosthodontically compromised orthodontic patient: An interdisciplinary approach
Dodda Kiran Kumar, Eswar Prasad Singamsetty, Bhanu Prasad Meka, Sreevalli Suryadevara
January-March 2015, 4(1):56-59
A 28-year-old male patient came with the chief complaint of missing front teeth. On examination, the anterior bite is collapsed with no space for the replacement of fixed prosthesis. The patient was started by means of a conventional fixed orthodontic therapy, in which bite opening mechanics were used like the leveling of curve of spee in the lower arch and removable prosthesis with anterior bite plate incorporated, in the upper arch. After 15 months of orthodontic treatment, adequate bite opening was achieved for the replacement of the prosthesis. The interdisciplinary approach gave the patient not only the best possible esthetics but also functional outcome.
  3,234 291 -
Baseline characteristics of patients on growth hormone therapy: Experience of two centers from South India
Babulreddy Hanmayyagari, Mounika Guntaka, Sunitha Chadalavada, Voleti Sri Nagesh, Sudhakar Reddy Pendyala, Sridevi Patnala
January-March 2015, 4(1):17-20
Objective: The objective of this study is to determine the age at presentation, etiology and other characteristics of short children who are on growth hormone therapy (GHT) at a tertiary care hospital. Materials and Methods: This cross-sectional study analyzed 96 children on GHT. All the children were assessed clinically, hormonally, radiologically, and genetic analysis were done wherever needed. GH deficiency (GHD) was diagnosed in the presence of short stature (height standard deviation score <2) and peak GH levels <10 ng/ml. Bone age (BA) was estimated by using Greulich-Pyle Atlas. Results: Of 96 patients on GHT for short stature, 49 (51%) were male and 47 (49%) were female. Primary GHD (42.7%) was the most common diagnosis, followed by idiopathic short stature (ISS) and the rest were small-for-gestational age, multiple pituitary hormone deficiency, organic pituitary lesions and genetic syndromes. Mean chronological age at presentation was 9.5 ± 2.3 years (median: 10 years, range: 3-16 years), mean height age was 6.4 ± 1.8 years (median: 6.5 years, range: 1-14 years), mean BA was 6.8 ± 2.1 years (median: 7.4 years, range: 1.3-15 years) and mean height at presentation was 110 ± 18.2 cm (median: 120 cm, range: 74-142 cm). Two girls entered puberty during the study period and were managed with simultaneous GH and gonadotropin-releasing hormone analog treatment. Conclusion: We conclude idiopathic GHD is the most common etiology in our patients on GHT followed by idiopathic short stature (ISS). In order to improve outcomes, short children need to be evaluated at the earliest.
  3,082 259 -
The effect of aluminum oxide addition on the flexural strength of heat activated acrylic resin: An in vitro study
Gopinadh Anne, Swetha Hima Bindu Oliganti, Jyothi Atla, Sreedevi Budati, Prakash Manne, Sandeep Chiramana
January-March 2015, 4(1):21-23
Aim: This study was done to investigate the effect of adding 5-20% aluminum oxide (Al 2 O 3 ) powder by weight on the flexural strength of heat-polymerized acrylic resin. Materials and Methods: A total of 50 specimens of heat-polymerized acrylic resin were fabricated and were divided into five groups (n = 10). Group A was the control group (unmodified acrylic resin specimens). The specimens of the remaining four groups i.e., Groups B, C, D and E were reinforced with Al 2 O 3 powder to achieve loadings of 5%, 10%, 15% and 20% by weight. Specimens were stored in distilled water for 1 week and the flexural strength of the specimens was tested in a universal testing machine (5 mm/min crosshead speed). Results were analyzed by one-way analysis of variance. Weibull analysis was used to calculate the Weibull modulus, characteristic strength and the required stress for 1% and 5% probabilities of failure. Results: The mean flexural strength values of the heat-polymerized acrylic resin were (in MPa) 92.01, 114.46, 116.77, 123.11 and 129.72, for Groups A, B, C, D and E, respectively. The flexural strength increased significantly with the incorporation of Al 2 O 3 . Conclusion: Al 2 O 3 fillers are potential components to be added in denture bases to provide increased flexural strength. Adequate flexural strength of denture base is quite essential for the longevity of the prosthesis.
  3,009 297 1
Scope of ergonomics in ensuring improvement of the health sector
Saurabh RamBihariLal Shrivastava, Prateek Saurabh Shrivastava, Jegadeesh Ramasamy
January-March 2015, 4(1):62-63
  3,008 179 -
Anorexia nervosa in the male with co-morbid adjustment disorder and body dysmorphic disorder
AK Koushik, PV Bhaskar Reddy, N Senthil
January-March 2015, 4(1):39-41
Anorexia nervosa is a rare psychological disorder. Epidemiological studies have shown a female to male ratio of 10:1, suggesting, it is predominately seen among females. Anorexia nervosa and related eating disorders are rare in non-Western countries. The association of anorexia nervosa with body dysmorphic disorder and Adjustment disorder indicate a more severe form of illness. This case is rare because here in we present a male anorexic with adjustment disorder and body dysmorphic disorder. To the best of our knowledge, there is no case report in the literature describing a male anorexic patient with co-morbid adjustment disorder and body dysmorphic disorder.
  2,754 176 -
Torsion omentum mimicking appendicitis: A rare cause of pain abdomen
Janardhana Rao Konkena, Santa Rao Gunta, Srinubabu Kollu, Prasad Neelam
January-March 2015, 4(1):50-52
Omental torsion is a rare cause of acute abdomen. It usually presents with acute onset right-sided abdominal pain. The most common risk factors are adult male between 40 and 50 years of age and obesity. Clinical diagnosis is challenging and difficult to differentiate from more common clinical pathologies such as acute appendicitis and acute cholecystitis. Transabdominal imaging such as ultrasonography and computed tomography are useful showing typical whirl pattern. Advocated management is surgical excision of torted omentum. Herein, we report a case of primary omental torsion in an adult and a review of current literature. The diagnosis was incidental when patient was undertaken for laparoscopic appendectomy. This case not only highlights the importance of considering omental torsion in the differential diagnosis of right-sided acute abdominal pain but also endorses the changing practice to the laparoscopic approach for management of right-sided abdominal pain.
  2,646 172 -
Dieulafoy lesion: A rare cause of gastrointestinal bleeding
Aswini Kumar Sahoo, Sudhasmita Rauta, Mohapatra Subash Chandra, Md Akbar, Prasnna Kumar Padhy
January-March 2015, 4(1):30-31
Dieulafoy lesion is characterized by exteriorization of a large pulsatile arterial vessel through a minimal mucosal tear surrounded by normal mucosa, causing massive and recurrent upper digestive bleeding in previously healthy patients. More frequently presented than diagnosed, with the increase of its knowledge among endoscopists, a large number of cases are expected in the literature. Dieulafoy lesion is a distinct nosologic entity that must be suspected in patients with massive digestive bleeding. Endoscopy became the procedure of choice for diagnosis and treatment of this disease.
  2,572 158 -
Spontaneous pneumoperitoneum: A surgical dilemma
Muthya Subramanyam, Yerrarapu Srimanarayana, Thogari Kiran Kumar, Muddaboina Hari Krishna, Venkat Krishna
January-March 2015, 4(1):60-61
  2,242 152 -