Surgical resection of mandible has to be done to treat various odontogenic epithelial tumours. Prosthodontic rehabilitation of the hemimandibulectomy patients with functional & aesthetic acceptance by the patient is the most difficult task. Guide flange appliance is given to correct deviation as well as permitting function of mastication & speech. Thus here two different case reports are discussed with removable & fixed guide flange appliances.

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Background: Effective keloid management is still a distant dream in spite of many recent modalities being tried for the same. Objective: To compare the efficacy of intralesional 5-Fluorouracil, intralesional triamcinolone acetonide and CO₂ laser in the treatment of keloids. Materials and Methods: This randomized controlled trial was conducted on 45 patients with keloids, randomly divided into three groups, treated with intralesional 5-fluorouracil (Group A), CO₂ laser (Group B) and triamcinolone acetonide (Group C). The groups were compared for reduction in the size of keloid, symptoms (pain and itching) and the incidence of adverse effects. Results: The reduction in the size of the keloid was found to be significantly better in Group A (86.33%) than in Group B (80%) and in Group C (66.66%). Conclusion: Reduction in the size of the keloid was significantly better in those treated with 5-fluorouracil than those treated with triamcinolone acetonide and CO₂ laser. The incidence of adverse effects like immediate burning sensation, ulceration are more with intralesional 5-fluorouracil. The incidence of recurrence was higher with CO laser than the other modalities.

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Introduction: Cold chain is important elements of immunization programme. Aims & objectives: 1) To evaluated the status of Non electrical equipments. 2) To take necessary corrective measures whenever required and give relevant advices to handlers for improving the system. Methodology: A cross sectional study was conducted at all the 56 UHCs of AMC area during May 2012 to January 2013. Pretested check list was used having details of various cold chain elements. Results & discussion: Majority (55.4%) of the UHCs had no cold boxes. Majority (92.9%) of the UHC had adequate stock of vaccine carriers. Mean of broken vaccine carriers was 5.9 ± 8.2. Vaccine carrier were properly closed at 47 (83.9%) & secured with belt at 14 (25%) sites. Only 10(18.5%) DFs showed criss-cross icepacks arrangement. Significantly higher number of icepacks had leakage at the session site (38.1%) than at UHCs (14.6%) Conclusion: The practice of using thermocol box instead of cold box needs to be stopped. Effective monitoring & logistic management for all non electrical cold chain equipments are required.

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Introduction: Journal clubs (JC) are an integral part of medical curriculum. Evidence based journal clubs (EBJC) are now being preferred by some over traditional JCs claiming that EBJC answers questions regarding validity, reliability and applicability specifically. However, there is lack of studies addressing effect of EBJC on participants' understanding of results and critical appraisal capability. Methodology: This was a pilot study. To test effect of EBJC on understanding of the specific topic and improvement in decision making ability, pre and post tests were conducted before and after each assessed EBJC presentation. Results: Total 36 residents were included. 53% could not make up their mind about the acceptability of the results in the pretest. However, almost all could make a specific decision regarding reliability of results and applicability of the authors' conclusion at the end of the assessed EBJC presentation. Conclusion: We concluded that exposure to EBJC resulted in significant improvement in the participants' understanding of the article and specific decision making capacity.

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Mycetoma or Madura Foot is a chronic localized granulomatous disease characterized by exuberant granulomatous tissue formation involving the subcutaneous plane. It is most common in tropical countries. Diagnosis has been traditionally done by microbiological culture and histopathological tissue diagnosis but these are often difficult to obtain and frequently inconclusive. MRI has recently emerged as a promising technique for early and prompt diagnosis of Mycetoma with the description of a highly specific sign called as “Dot in Circle” sign. We hereby present 2 cases showing this characteristic “Dot in circle” sign on MRI and thereby establishing the diagnosis of Madura Foot.

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Sickle cell disease affects 10% of tribal population of India. These patients have multiple orthopaedic complications like AVN (avascular necrosis) of femoral and humeral head, osteomyelitis, etc. One such patient having an atypical bilateral hip ankylosis has been reported. A 17 year female, known case of sickle cell disease, came to our hospital with complains of pain in bilateral hip since five years, both hips showed ankylosis and both knees showed flexion deformities. Ideal treatment for ankylosed hip in modern era is total hip replacement. However in sickle cell disease patients belonging to tribal population requiring squatting ability and having financial constraints, alternatives like RAO (resection angulation osteotomy) and arthrodesis for mobility as well as stability respectively should be considered inspite of inferior outcomes.

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Background The aim of the study was to find the endocrinal profile of patients with hirsutism presenting to dermatology OPD. Hirsutism is defined objectively by Modified Ferriman-Gallwey score ≥ 8 (mFG). Methods The study included 44 premenopausal women in whom after history and clinical examination, endocrine tests were done which included Diabetes profile, TSH, FSH, LH, Free and Total Testosterone, DHEAS, Fasting insulin,17-hydroxyprogesterone and Prolactin. Results Mean age of the patients was 20-29 years while duration of symptoms was of 3 years. Upper lip was the most common site for hair growth while upper arm was the least common. Hair loss and menstrual irregularity were common associated findings. Obesity had a significant correlation with severity of hirsutism. Mean total testosterone in study patients was 64.31 ng/dl. There was no correlation between severity of hirsutism and any of the endocrinal tests. Idiopathic hirsutism (IH) was the most common diagnosis, closely followed by PCOS. We detected 1 case of Non classical Congenital Adrenal Hyperplasia and no cases of Ovarian or Adrenal tumors. Serum testosterone and LH/FSH ratio were significantly elevated in PCOS group as compared to IH group. Conclusion Obesity had a strong relation with severity of Hirsutism independent of other parameters. Fasting blood sugar, serum testosterone, TSH and Fasting insulin levels had no correlation with severity of Hirsutism.

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Background - Even after more than 60 years of independence, access to safe water and sanitation facilities remains a formidable challenge in developing countries including India. Objectives - To assess the drinking water management practices among residents of urban field practice area of a tertiary care teaching centre in northern India. Methods - The present cross sectional survey was conducted among 405 residents of the urban field practice area of a tertiary care teaching centre located in district Farrukhabad of Uttar Pradesh. After filling the questionnaire, the free chlorine in the drinking water of the households was determined by using O-Toluidine test. Results - Majority (85%) of the households were depending on the municipality water supply. 72.1% of the population does not use any method to treat water in their households. 6.9% of the respondents strained the water through the cloth whereas 2.7% of the houses boiled water before consumption. 43.95% of study subjects dipped a glass into the storage vessel using their hands to take water from storage vessel for drinking purpose whereas only 17.78% of the people used a tap to collect water for drinking. The OT test did not yield any positive result in surveyed households. Conclusion - Safe sources alone do not guarantee of providing safe and healthy water supply to the houses, this should be supported by the safe treatment and storage practices of drinking water at household level. Therefore it is need of the hour to launch IEC activities so as to improve the storage and handling practices of drinking water.

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