Prolactinoma is classified as microprolactinoma when it measures <10 mm and macroprolactinoma when it measures ≥10 mm. Prolactinoma is an important cause of amenorrhea and infertility in premenopausal female. With early diagnosis and treatment with dopamine agonist, many patients have restoration of fertility within few months of treatment. In presence of estrogenic environment of pregnancy there is a tendency for prolactinoma to increase in size during pregnancy. This may be associated with visual field compromise and rarely pituitary apoplexy. This review discusses some key points in management of prolactinoma during pregnancy and postpartum. In case of microprolactinoma, the risk of complications are low hence it is recommended to keep a close follow up of patient without any need for intervention. In case of macroprolactinoma it is recommended to use barrier contraception to prevent pregnancy for at least 6-12 months after detection and starting treatment to allow proper shrinkage of the tumor with dopamine agonist. Once pregnancy is confirmed -In those with low risk features, dopamine agonist is stopped and a close follow up is advised. In those with high risk features, it is recommended to continue the dopamine agonist therapy with a close follow up. Postpartum period generally doesn’t pose much threat to prolactinoma and treatment may be discontinued if patient wishes to breast feed her infant.

TACs are a group of primary headaches with pain and autonomic features in the distribution of trigeminal nerve on one side. They are also associated with marked restlessness/agitation. The TACs include the following 5 entities: cluster headache (CH), paroxysmal hemicranias (PH), short-lasting unilateral neuralgiform headache with conjunctival injection and tearing (SUNCT), Short lasting unilateral neuralgiform headache attacks with cranial autonomic symptoms (SUNA), and hemicranias continua (HC). All TACs are episodic headache disorders except HC. The TACs differ in attack duration and frequency. CH has the longest attack duration (15-180 minutes) and relatively low attack frequency. PH has intermediate duration (2-30 minutes) and intermediate attack frequency. SUNCT and SUNA have the shortest attack (1-600 seconds) duration and the highest attack frequency. Hemicrania continua are characterized by continuous strictly unilateral pain in trigeminal distribution with variable exacerbations. The most specific part of this group is that they all respond to highly ‘selective’ drug. The drugs commonly used for other headache disorders are largely ineffective here. CH responds to lithium and verapamil. SUNCT and SUNA show response to lamotrigine. HC and PH show dramatic response to indomethacin.

Background: During the last century, cardiovascular disease (CVD) has common occurrence in most of the population and the great attendant mortality, loss of independence, impaired quality life and social and economic costs forming a compelling reason for public health concern. C reactive protein (CRP) in particular has been the focuses of attention as a key marker of atherosclerosis and elevated level constitutes a risk predictor for CVD. Aim: The present study focuses the association between periodontal inflammatory status as assessed by clinical periodontal sum score (CPSS) and levels of CRP and to co-relate periodontal destruction levels with levels of hs- CRP. Methodology: Patients with chronic generalized periodontitis were selected. Periodontal destruction of the patient included in the study was recorded by CPSS and blood was tested for hs-CRP levels. Mean, Standard deviation and range of CPSS and hs-CRP were calculated. The correlation between CPSS and hs-CRP that is clinical index and biochemical marker was made by Spearman correlation test for significant. Results: A total of 20 patients had participated in this study. The CPSS ranged from 31 to 205 and the hs-CRP levels ranged from 0.18 to 16.45. 2 tailed Spearman correlation test showed significant p value (0.05). Conclusion: Statistical significant co-relation was found between periodontal disease as assessed by CPSS and hs-CRP level. Results of this study point to the importance of diagnosing cases of severe periodontal destruction, and the need for proper health education and prompt periodontal therapy for the cases identified.

Aim: This study was aimed to investigate the effect of simvastatin (SIM) and rosuvastatin (ROS) on the extent of tissue damage in cisplatin (CIS) induced hepatotoxicity. Methodology: Hepatotoxicity was induced in rats with single intraperitoneal injection of 7 mg/kg cisplatin. Group 1 received 0.5% sodium carboxy methyl cellulose, group 2 and 3 received SIM and ROS, respectively, and group 4 was injected single dose of CIS (7 mg/kg, i.p.).Group 5 and 6 were treated with SIM (10 mg/kg, p.o.) and ROS (10 mg/kg, p.o.) daily from 5 days before to 5 day after intraperitoneal administration of CIS, respectively. Liver function tests like AST, ALT and Total bilirubin, and markers of oxidative stress such as liver malondialdehyde (MDA) level, superoxide dismutase (SOD), catalase (CAT) activities and reduced glutathione (GSH) were measured. All tissues were investigated for histopathological changes. Results: CIS treated rats showed a significant increase in AST, ALT and total bilirubin. Moreover, cisplatin caused liver damage with a higher MDA level, depletion of SOD, CAT activity and GSH. SIM and ROS ameliorate CIS induced liver damage due to improvement in liver function, oxidative stress, and histological alteration. Conclusions: These finding suggests that simvastatin and rosuvastatin may have a protective effect against cisplatin-induced liver damage via amelioration of lipid peroxidation as well as due to improvement of liver function.

Aim: Comparison of the effect of QMix, 7% maleic acid and 2.5% sodium hypochlorite on the accuracy of Root ZX II and Root ZX Mini apex locator. Methodology: 45 single rooted teeth were decoronated. Patency was checked and coronal flaring was done. They were then divided into 3 groups: i) QMix, ii) 7% Maleic acid and iii) 2.5% Sodium hypochlorite. The actual length of each tooth was determined before embedding them in an alginate model. 5ml of the respective irrigant was introduced into the canal. Working length was measured with Root ZX and Root ZX Mini apex locators. For each sample, an average of a total of three readings was considered. Statistical analysis was performed using Anova, Two Way, Post hoc, Paired t-tests. Results: Group I (QMix) showed no statistically significant results. Group II (7% Maleic acid), showed statistically significant difference from the actual length with Root ZX Mini (p=0.002). Group III (2.5% sodium hypochlorite) showed statistically significant difference from the actual length with Root ZX II (p=0.04) and Root ZX Mini (p=0.0002). A statistically significant difference was seen in the readings by both the apex locators (p=0.005). Conclusion: QMix does not affect the accuracy of apex locators. Root ZX II is more accurate than Root ZX Mini in the presence of 7% maleic acid and 2.5% sodium hypochlorite.

Cryptococcosis is a chronic, subacute or acute systemic infection caused by Cryptococcus neoformans. We present a case of cryptococcosis in an immunocompromised person, having meningitis with characteristic skin lesions. Apart from signs and symptoms of meningitis, he had giant molluscum contagiosum like lesions suggestive of cryptococcal infection. CSF examination by India ink preparation and cryptoccal antigen test confirmed the diagnosis. This case highlights the importance of meticulous cutaneus examination in all HIV and other immunodeficient patients as cutaneous lesions can appear prior to systemic involvement and thus can indicate a full blown systemic disease.

External ophthalmomyiasis is a relatively rare condition caused by infestation of ocular tissue by the larva of oestrus ovis (a fly) which is a parasite of sheep and goats. Ophthalmomyiasis has been reported from all over the world, mostly from rural population. It generally presents as catarrhal symptoms in one eye and may be easily mistaken for viral conjunctivitis, foreign body in eye and chemical injury. A careful examination and physical removal of the larva offers complete relief. We present one such case of external ophthalmomyiasis.

Angiolymphoid hyperplasia with eosinophilia consists of erythematous papules and nodules involving the head and neck, though the other sites may also be involved. Here we present a case of 50 year old female patient who presented with pruritic papules on the pinna since 6-7 months, which on histopathology revealed features of angiolymphoid hyperplasia. Her lesions were ablated with Carbon dioxide laser in 2 sittings, with no recurrence of lesions over a 1 year follow up period.