Background The vertebrae undergo continuous remodeling throughout life, primarily in response to the changing needs of the body. 1 Evolution of human erect posture and bipedal gait coupled with lifestyle changes is often reflected as stress on the vertebral column. 2 The lumbar region of vertebral column being the most common site of expression of this stress in the form of low backache. 2 The five lumbar vertebrae are distinguished by their large size, wider body in transverse plane, strong and short paired pedicles, shallow superior vertebral notches, spinal canal etc. The dimensions of these vertebral segments provide key relevance in clinical diagnosis of lower backache as well as other pathological lumbar diseases Lumbar morphometry is intended at its stabilization and correction of deformities. 3 Accurate anatomical description of the shape and orientation of lumbar vertebrae are necessary for the development and use of implantable devices and spinal instrumentation in spinal disorders including fractures. 4 It is also imperative to assess the differences in morphometry of vertebrae  Material And Method The anteroposterior body diameter (APD) was measured as the anteroposterior distance of each vertebral body, while the interpedicular distance (IPD) was measured as the minimal distance between the medial surfaces of the pedicles on either side. The midsagittal diameter (MSD) was measured as the maximum anteroposterior distance of the spinal canal of each vertebra while the pedicle length (PL) were measured starting from the origin of the pedicle from the body to the superior articular facet on either side using the average. Results The vertebral body anteroposterior dimension was more at its lower border than at the upper (p<0.01). The length of lamina was higher over the right side (p < 0.001). The height of lamina, width of inferior articular facet, diameter of lateral recess and thickness of pars inter-articularis were greater for the left side (p<0.01). The remaining parameters, which were compared on the right and left sides did not reveal the difference with respect to the statistical significance (p>0.05). Conclusion This anatomical study offered several dimensions of lumbar vertebrae, which are essential in the surgical practice. The implants at the lumbar vertebrae need to be manufactured based on the anatomical dimensions of that particular sample population.

Background: Mandible also known as the largest and inferior, primary facial bone of the face giving a curved shape to it. It changes its shape and gives variations to the bony structure of the face from birth till older age. Mental foramen is known as the ventage of the mandible and is an important mark of the face for carrying out many diagnostics and surgical processes along with anesthetic procedures of the face. Thus, the present study is designed with an aim to get insight knowledge of position and shape of mental foramen in dry adult human mandible. Materials and methods: A total of 50 mandibles were measured bilaterally with a pachymeter for various dimensions, and a proportional calculation of each parameter was obtained, based on the size of the length of each mandibular base. In addition to the general descriptive morphology of the mandibles, considering that six mandibles presented duplicated foramina, they were divided into two groups, and the mandibles with no anatomical variation (normal group, N = 57) were compared to those with duplicated foramina (N = 6). Data Results: The present study showed that the position of mental foramen from symphysis menti and posterior border of ramus of mandible was more from right side than left side and found to be insignificant while position of mental foramen from inferior border of body of mandible was more from left side than right side and found to be insignificant for right side while significant for left side. The shape of mental foramen from right side was found to be (Oval shape- 68.33% and round shape – 31.66%) while for left side was found to be (Oval shape- 71.66% and round shape – 28.33%). Conclusion: The knowledge of the distances from surgically encountered anatomical landmarks in the   present study provide valuable information to dental surgeons that will facilitate effective localization of the neurovascular bundle passing through mental foramen, thus avoiding complications from local anaesthetic, surgical and other invasive procedures. The study is also of forensic significance as the position of mental foramen also helps in determination of sex of an individual.

Introduction Recurrent abdominal pain is one of the commonest gastrointestinal complaints in children, affecting approximately 10% of school-aged children and adolescents. There is no consensus with regards to etiology, investigation, and management of this common problem. This article addresses some of the issues related to epidemiology, etiology, management, and prognosis of recurrent abdominal pain. Material and Methods: This is prospective, descriptive and observational study conducted at Tertiary Care Teaching Hospital over a period of 1 year among 90 children with RAP. Patients of age group of 4 to 14 years attending the paediatric OPD of tertiary care teaching hospital was included in the study. Children with age less than 4 years and more than 14 years not meeting the criteria of RAP were excluded from the study. Children with organic causes of RAP have been treated according to corresponding reason. Results: Out of 120 patients of RAP, male predominance (64.1%) was seen and forty-four (40.8%) of the patient population belonged to age group of 4 to 6 years. Organic RAP was found in 88% of patients and RAP due to non- organic causes was found in 10.8% of patients. Conclusion: Recurrent abdominal pain (RAP) in children with careful history and examination, clear explanation and follow-up and a commitment from parent and child to stop the condition limiting normal activities, good results are obtained for children without referral, drugs or extensive testing

Background: In Dermatology, corticosteroids (CSs) are widely prescribed in either topical or systemic formulations in various potencies to tailor therapy according to severity of the underlying condition, area of involvement, and patient’s age. CSs, however, are associated with a number of serious adverse effects, particularly with long-term usage. Aims: To study the relationship of adverse drug reactions (ADR) of long-term glucocorticoids (GC) with age, sex, smoking, alcoholism, underlying dermatologic conditions and co-existing medical disorders. To study CSs in relation to musculoskeletal system, metabolic & blood sugar levels and eye complications. To compare the ADR in cases on Oral mini pulse therapy (OMP) and Daily glucocorticoid (DGC) therapy groups. Methods: This was a hospital based prospective study done on 130 patients on OMP or Daily glucocorticoid therapy for more than 1 month duration, over a period of 2 years. Results: Cushingoid features and weight gain were observed in both groups. Bone changes, diabetes mellitus and hypertension were seen in patients on DGC therapy. Bone changes were seen in 17 (18.88%), Steroid induced Diabetes Mellitus (SDM) in 27(30%), Hypertension in 12(13.3%), Lipid abnormalities (in the form of raised cholesterol and triglyceride levels) in 7 (7.77%), Cataract in 12(13.33%) and glaucoma was seen in 1(1.11%) out of 90 patients on Daily glucocorticoid therapy.1 patient each out of 40 in the OMP group developed cataract and hypertension. Conclusion: In conditions like vitiligo, alopecia areata and lichen planus particularly in children, it is preferable to give OMP. In pemphigus group of disorders while using daily GC therapy, continuous monitoring and ADR prevention measures should be considered for patient's benefit.

In April 2009, World Health Organization declared the first ever public health emergency affecting overseas countries, territories and communities of the world with a new strain of the influenza A virus causing a global pandemic. This novel strain (H1N1) of the virus appears to be of swine origin and contains a unique combination of gene segments that have not been previously identified in swine or human influenza viruses. The symptoms of the 2009 H1N1 flu virus are clinically similar to those of seasonal influenza and have ranged from mild to severe. The neuraminidase inhibitors provide valuable defences against the virus, but their massive use has lead to the development of resistance to these antiviral agents. Vaccination is the only effective way to protect people from contracting illness during epidemics and pandemics of influenza.

Female sexual dysfunction (FSD) is a serious morbidity which could occur postnatally. It is important for different members of staff (GP, midwife, obstetrician, nurse, psychosexual therapist) to be aware of this problem and its various implementations. Objectives of the review: The main scope of writing this review is to try to categorise the different forms of postpartum sexual dysfunction, and to assess the risk factors involved, with a focus on the different opinions in literature regarding the role of mode of delivery (vaginal or by caesarean section) in alleviating or aggravating the problem. Search strategy: the National Health Library electronic database was searched, including all resources. Only studies discussing the risk factors of PPFSD after vaginal birth were included. Perineal pain as a complication after episiotomy or tears was differentiated from dyspareunia, and studies on perineal pain after delivery were excluded from the review if they did not discuss the effect of the pain on sexual activity. A meta-analysis was performed to summarise the outcome of the different studies comparing the effect of modes of delivery on PPFSD. Author’s conclusion: episiotomy is an important risk factor for short term PPFSD. However, there is little evidence to support a possible long term effect. Breastfeeding, use of progestogen-only pill and the lack of postpartum sexual health counselling and treatment are other significant risk factors for PPFSD. There is insufficient evidence to advocate a decision of performing a caesarean section on basis of alleviating PPFSD.

Purpose: More men with genital piercings (GP) are presenting to health care facilities, yet a paucity of medical literature exists about their body modifications, health issues, and medical needs. Historically, they have turned to a piercer or the internet for medical advice which may put their health at risk by receiving inappropriate guidance or delayed treatment by an experienced, well-informed clinician. Methods: A comparative, descriptive cross-sectional study was conducted using an 83-item web-based survey. Demographics, risk behaviours, procedural motives, and post-piercing experiences about men with GP were examined, as well as depression, abuse, self-esteem, and need for uniqueness. Similarly published studies were also compared. Results: 445 men from 42 states and 26 international sites reported 656 genital piercings. The average participant was 36 years of age, Caucasian, possessing some college education, married or in a monogamous, heterosexual relationships, and in excellent health. Deliberate decision-making was present: 36% chose a Frenum/Frenum Ladder GP and 56% chose a Prince Albert GP, with 25% experiencing urinary flow changes. Outcomes were related to their motives: sexual expression, uniqueness, and aesthetics, with improvement of personal and partner’s sexual pleasure. Conclusions: Several unsubstantiated assumptions about men with GP were challenged regarding the number of STDs, GP complications, and overall demographics. Currently their GP care information is still obtained from a piercer or the internet. Clinician awareness of GP is important to educate and inform adequately, give professional advice, and provide a realistic picture of structural complications.

The aim of the present study was to evaluate the self-medication of self-prescribed antibiotics among government doctors in the Hassan district. A close and open-ended questionnaire was used to collect data from a sample of 160 Government doctors, randomly chosen from Hassan district. Data was collected using a self-assessing questionnaire. Data was entered and analyzed using SPSS 14 and the results were presented as a percentage. Out of 160 doctors only 97.5% filled and returned the questionnaires. Self-medication with antibiotics was reported by 53% of doctors during the cross-sectional study at a CME programme in Hassan Institute Medical Sciences, Hassan within 6 months prior to the study. The main indication for self-medication with antibiotics was respiratory problems (73.3%) such as the common cold and sore throats. Amoxicillin was the most commonly used antibiotic (40%). The main source of medicines was drugs from medical representatives (47.8%, samples), drug stores (44.8%, self-prescribed) and the government hospital pharmacy (7.4%). Only 26.8% of antibiotic users completed the course. The prevalence of self-medication with antibiotics among doctors is high. Proper prescription writing is an essential skill for doctors in medical profession, as it is the primary intervention that doctors offer to the suffering humanity. Medical students learn the science of prescription from the medical faculty. Hence educational programs are needed to improve potential problems of self-medication with antibiotics and to minimize the different forms of prescribing errors, by vigorous training programs.

According to estimates of the World Health Organization (WHO), in 2005, out of 58 million total deaths in the world due to different causes 30 percent (17.4 million) were due to cardio vascular diseases, mainly heart disease and stroke. 53 percent of global deaths due to coronary heart disease occurred in males and 47 percent in women. The common modifiable risk factors identified were unhealthy diet, physical inactivity and tobacco use, leading to raised blood pressure and blood glucose, abnormal blood lipids and becoming overweight.1 The WHO MONICA Project - an international collaboration of researchers from 21 countries, studied more than 30 populations, mainly from Europe, over a period of ten years, from the mid-1980s to the mid-1990s. More than seven million men and women aged between 35 and 64 years of age were monitored to examine if and how certain coronary risk factors and new treatments for heart disease contribute to the decline or increase of heart disease rates in these communities. 2 Hence it has been observed that there have been number of studies on risk factors in patients of coronary artery disease (CAD) but comparatively few studies are available on risk factors in healthy community members in Africa and still fewer on comparison of risk factors for CAD in the patients and community members from the same population. The present study was conducted on 528 community members in Tripoli the capital of Libya including 70 individuals having a history of suffering from Myocardial infarction (MI). The comparison of both the groups of same community revealed that hypertension followed by smoking, diabetes and increased body mass index were more prevalent in the community members with history of MI. It was alarming to note that these risk factors earlier thought to be more frequent after the age of 50 years are now present in higher numbers in the younger age groups of 35 to 54 and 15 to 34 years as well. As most of the risk factors stated above are modifiable there seems to be urgent need of initiating a National Health Programme on prevention and control of these risk factors. The priorities and strategy of such a National Programme has also been suggested in brief for consideration of the national decision makers.

Whilst transient rectifiable nocturnal hypercapnia is common in patients with OSA, awake hypercapnia in OHS appears to be a final expression of multiple factors. There has been a debate about BMI and AHI not being the most important independent predictors of hypercapnia in obese patients with OSA. More definitive evidence for the role of OSA, however, is suggested by resolution of hypercapnia in the majority of patients with hypercapnic OSA or OHS with treatment, with either PAP or tracheostomy, without any significant changes in body weight or respiratory system mechanics. Yet some recent studies have shown that nocturnal hypoxaemia and diurnal hypercapnia, persist in about 50% of such individuals even after complete resolution of OSA with CPAP or tracheostomy. This raises questions such as how good is AHI as a measure of severity of OSA?