Paper Type	::	Research Paper
Title	::	FIBROLIPOMATOUS HAMARTOMA OF ULNAR NERVE: A RARE CASE REPORT
Country	::	India
Authors	::	Durgaprasad Agrwal || Sudhamani S || Manthan Patel || Lavina Loungani
Page No.	::	01-03
Paper Index	::	DOI :10.9790/XXXXXXXXX
ANED	::	DDL : 05.3013/05110103

Nervous fibrolipomatous hamartoma is said to be a rare tumor-like condition involving the peripheral nerves,in which the epineurium and perineurium are enlarged and distorted by excess of fatty and fibrous tissues that infiltrate between and around nerve boundaries. The median nerve is more likely to develop a hamartoma than other nerves with a predilection for the carpal tunnel. A fibrolipomatous hamartoma – is a rare, benign, congenital lesion most commonly found in the median nerve, usually at the level of the wrist or hand.
KEYWORDS: We report a case of this rare condition in ulnar nerve.

[1] Jamal Louaste, Hassan Zejjari, Mohamed Chkoura et al. Carpal tunnel syndrome due to fibrolipomatous hamartoma of the median nerve. American association for hand surgery, 676-79; 2011.
[2] Asmita Parihar, Sarika Verma, Mamta Senger et al. Fibrolipomatous hamartoma of sural nerve: a new sie of an unusual lesion. Malaysian J Pathol, 59-62; 2014.
[3] Taketo Okubo, Tsuyoshi Saito. Intraneural lipomatous tumor of the median nerve. International journal of surgery case report. 407-11, 2012.

Paper Type	::	Research Paper
Title	::	Evaluation the efficacy of IVIgG in treatment of Hemolytic Disease of Newborn
Country	::	Iran
Authors	::	Minoo fallahi || Seyed Hossein Fakhraee || Mohammad Kazemian || Farid Aleali
Page No.	::	04-08
Paper Index	::	DOI :10.9790/XXXXXXXXX
ANED	::	DDL : 05.3013/05110408

Background: Hemolytic disease of newborn (HDN) is an important cause of hyperbilirubinemia in the neonatal period,and delayed diagnosis and treatment may lead to permanent brain damage. Traditional neonatal treatment of HDN is intensive phototherapy and exchange transfusion.Intravenous immunoglobulin(IVIgG) has been introduced as an alternative therapy to exchange transfusion. This study was conducted to assess the effect of IVIG in HDN . Material and method: we performed a cohort study in 2011,in 56 healthy newborn with jaundice and hemolysis due to ABO and RH incompatibility that admitted in neonatal ward of Mahdieh hospital with gestational age of 35 weeks and more . Infants with jaundice due to other causes ,sick and preterm infants with gestational age less than 35 weeks were excluded. In our study we use 500mg/kg IVIgG for treatments of HDN in addition of phototherapy, and in cases with continued hemolysis , second or third same dose of drug was used .In cases with high bilirubin levels in accordance with AAP guideline for treatment of hyperbilirubinemia, without appropriate response to those modalities of treatment exchange transfusion was done. To evaluate the effect of treatment with IVIgG ,we compared results of therapy with results of traditional therapy (exchange& phototherapy) in newborns with the same condition without use of IVIgG . Total duration of phototherapy and hospital stay,need for exchange transfusion and simple transfusion of packed red blood cell was compared in two groups ,and probable side effect of was evaluated .
KEYWORDS:IVIgG, hyperbilirubinemia ,neonates ,Hemolytic Disease of Newborn

[1] Neil A Murray, Irene A G RobertsHaemolytic disease of the newbornArch Dis Child Fetal Neonatal Ed. Mar 2007; 92(2): F83–F88
[2] Roberts IA1.The changing face of haemolytic disease of the newborn.Early Hum Dev. 2008 Aug;84(8):515-23. doi: 10.1016/j.earlhumdev.2008.06.005. Epub 2008 Jul 14.
[3] Vivianne EHJ Smits-WintjensFrans J Walther Enrico Lopriore Rhesus hemolytic disease of the newborn: postnatal management, associated morbidity and long-term outcomeSemin Fetal Neonatal Med 2008; 13:265-271
[4] Enrico Lopriore, Mirjam E.A. Rath, Helen Liley, and Vivianne E.H.J. Smits-Wintjens1Improving the management and outcome in haemolytic disease of the foetus and newbornBoodTransfus. Oct 2013; 11(4): 484–486.

Paper Type	::	Research Paper
Title	::	Sulphasalazine Induced Toxic Epidermal Necrolysis A Case Report
Country	::	India
Authors	::	Dr. N. Asvini || Dr. K.Vasanthira
Page No.	::	09-11
Paper Index	::	DOI :10.9790/XXXXXXXXX
ANED	::	DDL : 05.3013/051109011

Toxic Epidermal Necrolysis (TEN) is a rare and life threatening mucocutaneous reaction characterized by extensive necrosis and detachment of epidermis. The Worldwide incidence of TEN is 0.9 to 1.4 per million populations per year [1]. Here we have discussed a case of Toxic Epidermal Necrolysis secondary to Sulfasalazine managed with fluid replacement, analgesics, anti-infective therapy aggressive nutritional support and intravenous high dose steroid therapy. Keywords- Toxic Epidermal Necrolysis, Sulfasalazine

[1]. R.G.Valia, Ameet R.Valia. IADVL textbook of dermatology 3rd edition: Bhalani publishing home; Chapter 4.

[2]. Tony burns, Stephen Breath nach, Neil Cox, Christopher Griffiths. Rook's Textbook of dermatology 8th ed. Wiley-Blackwell; Volume 4 Chapter 76; p.76.22.

[3]. Lyell A. Toxic epidermal necrolysis: an eruption resembling scalding of the skin. Br. J. Dermatology. 1956; 68:355-361

[4]. Achten G, Ledux-Corbusier M. Lyel's toxic epidermal necrolysis: histological aspects. Arch. Belg. Dermatol. Syphiigr 1970; 26:97-114.

[5]. Klaus Wolff, Lowell A, Goldsmith, Stephen I Katz, Barbara A, Gilchrest Amy S, Paller, David J Leffell.Fitzpatrick's Dermatology in General Medicine. 7th ed. United States of America: McGraw –Hill Edition 2008: Chapter 39, p.349.

[6]. Nguyen DV, Chu HC, Phan MH, Craig T,Baumgart K et al. HLA-B*1502 and carbamazepine – induced severe cutaneous reactions in Vietnamese. Asia Pac Allergy 2015 Apr 5(2):68-77

[7]. Kongpan T, Mahasirimongkol S, Konyoung P, Kanjana wart S, Chumworathayi P, Wichukchinda N et al. Candidate HLA genes for prediction of cotrimoxazole induced severe cutaneous reactions. 2015 Aug 25(8): 402-11

[8]. Longo, Fauci, Kasper, Hauser, Jameson. Loscalzo. Harrison's principles of internal medicine. 18th ed. United States of America: McGraw –Hill Edition; Chapter 55, .p436

Paper Type	::	Research Paper
Title	::	The Comprehensive Review on Fat Soluble Vitamins
Country	::	India
Authors	::	Panchumarthy Ravisankar || A. Abhishekar Reddy || B. Nagalakshmi || O. Sai Koushik || B. Vijaya Kumar || Panchumarthy Sai Anvith
Page No.	::	12-28
Paper Index	::	DOI :10.9790/XXXXXXXXX
ANED	::	DDL : 05.3013/0511012028

This review article deals with brief description of fat soluble vitamins with figures and tables showing statistical analytical data duly quoting the references wherever necessary. The word "soluble" actually means "able to be dissolved." Whether a vitamin is classified as 'fat-soluble' or 'water-soluble' has to do with how the vitamin is absorbed, stored and removed from the body. Vitamins are tiny organic compounds with a huge impact on the health and well-being of the body. The body needs a small amount of fat soluble vitamins in order to stay in optimal health. Fat soluble vitamins play an important role in keeping the body healthy and functioning from immune system and muscle and heart function, easy flow and clotting of blood as well as eye health. They are critical to health and wellness–particularly reproductive health and wellness. Low-fat, no-fat and vegan diets are woefully lacking in fat soluble vitamins. However a diet based on traditional foods can naturally provide these vitamins. Science is still learning about many of the functions of vitamins. "Too much vitamin A, D, or K can lead to increased levels that are unhealthy and can cause serious health consequences. Diseased conditions leading to decreased fat absorption leads to decreased absorption of vitamins. The fat-soluble vitamins work most safely and effectively when obtained them from natural foods within the context of a diet rich in all their synergistic partners. If fat soluble vitamins are stored for lengthy time they generate threat for toxicity than water soluble vitamins and such situation even aggravated, provided they are consumed in excess. Vitamin products, above the legal limits are not considered food supplements and must be registered as prescription or non-prescription (over-the-counter drugs) due to their potential side effects. Vitamin A and E supplements do not provide health benefits for healthy individuals, instead they may enhance mortality, and it is held proved that beta-carotene supplements can be harmful to smokers.

Keywords- Vitamin A, Vitamin D, Vitamin E, Vitamin K.

[1] CM. Rohde, H. DeLuca, Bone resorption activity of all-trans retinoic acid is independent of vitamin D in rats, J Nutr, 133(3), 2003, 777–783.

[2] MF. Sowers, RB. Wallace, Retinol, supplemental vitamin A and bone status, J Clin Epidemiol, 43(7), 1990, 693–699.

[3] GS. Omenn, GE. Goodman and MD. Thornquist et al, Effects of a combination of beta-carotene and vitamin A on lung cancer and cardiovascular disease, N Engl J Med, 334(18),1996, 1150–1155. [4] MP. Longnecker, PA. Newcomb, R. Mittendorf, ER. Greenberg and WC. Willett, Intake of carrots, spinach, and supplements containing vitamin A in relation to risk of breast cancer, Cancer Epidemiology Biomarkers Prev, 6(11), 1997, 887–892.

[5] K. Hulten, AL. Van Kappel, A. Winkvist, et al, Carotenoids, alpha-tocopherols, and retinol in plasma and breast cancer risk in northern Sweden, Cancer Causes Control, 12(6), 2001, 529–537. [6] RD. Semba, The role of vitamin A and related retinoids in immune function, Nutr Rev, 56(1 Pt. 2), 1998, 38–48.

[7] EL. Berson, B. Rosner, MA. Sandberg, et al, A randomized trial of vitamin A and vitamin E supplementation for retinitis pigmentosa, Arch Ophthalmol, 111(6), 1993, 761–772.

Paper Type	::	Research Paper
Title	::	Chest sonography images in neonatal r.d.s. And proposed grading
Country	::	India
Authors	::	PRADEEP KULKARNI || NIKIT MEHTA || VASUDHA JADHAV
Page No.	::	29-31
Paper Index	::	DOI :10.9790/XXXXXXXXX
ANED	::	DDL : 05.3013/0511029031

BACKGROUND : Lung sonography has been used to monitor the patients of R.D.S. in N.I.C.U. in recent times.

AIMS : To Describe and Grade the changes of R.D.S. by lung sonography. SETTING & DESIGN : Tertiary care institutional set up in a rural medical college.

STUDY DURATION : September 2014 to May 2015. Follow-up variable, upto 2 weeks. PROSPECTIVE, ANALYTICAL STUDY.

MATERIALS AND METHODS -This was a single institute study approved by the institutional ethics committee. Prior informed consent was obtained from the parents. 100 consecutive patients admitted in N.I.C.U. WITH gestational age < 36 weeks with respiratory complaints were enrolled. Chest x-ray was obtained within few hours of admission and lung sonography was performed within 24 hours. Follow – up sonography was performed as and when necessary. Sonography image was graded and correlated with chest xray and clinical picture

Keywords- B lines (ultrasound lung comets),1. neonate, respiratiory distress syndrome, segmental white lung, transabdominal ultrasound, white lungs.

[1] Gino Soldati. Et al. Sonographic Interstitial Syndrome. J Ultrasound Med 2009; 28:163–174.
[2] Raimondi F. Et al. Use of neonatal chest ultrasound to predict noninvasive ventilation failure. Pediatrics October 2014. 134(4):e1089-94.
[3] Ok Hwa kim et al. US in the diagnosis of pediatric chest diseases. Radiographics May 2000. Volume 20, Issue 3.

[4] Bober K. Et al. Diagnostic utility of ultrasonography for respiratory distress syndrome in neonates. Medical science monitor : international medical journal of experimental and clinical research 12:10 2006 Oct pg CR440-6
[5] Chirag kumar Ahuja et al.Role of transabdominal ultrasound of lung bases and follow-up in premature neonates with respiratory distress soon after birth. Indian journal of Radiology and Imaging. 2012 volume 22 Issue 4.
[6] Liu, Jing et al.Diagnosis of neonatal Transient Tachypnoea and its Differentiation From Respiratory Distress Syndrome Using Lunf Ultrasound. Medicine December 2014. Volume 93 Issue 27.
[7] Andrea Smarglassi et al. The role of chest sonography in the management of respiratory diseases : document II. Multidisciplinary Respiratory Medicine 2013, 8:55

Paper Type	::	Research Paper
Title	::	Analytical Study of Urine Samples for Epidemiology of Urinary Tract Infections by using Urine R/E in Local Population of Abbottabad, Pakistan
Country	::	Pakistan
Authors	::	Ehsan Humayun || Aqsa Bibi || Adil Khan || Maleeha Asif || Nodia Shujaat || Atif ur Rehman
Page No.	::	32-38
Paper Index	::	DOI :10.9790/XXXXXXXXX
ANED	::	DDL : 05.3013/0511032038

The current study was carried out in District Abbottabad aimed to determine the common urinary tract infections in local community to determine the epidemiology of significant diseases in asymptomatic patients of renal disorder. In this study a total of 1000 urine samples were examined during 3rd February to 1st April 2015 from patients attending Ayub Teaching Hospital Abbottabad by using dipstick and microscopic analysis of urine. There were 638 females and 362 males patients examined during this period. The range of age groups is between 1.5 years to 80 years. Results of this study was reported as Pyuria 11%, Proteinuria 21.1%, Hematuria 10.4%, Epithelial Cells 8.2%, pH 7.8 %, Granular casts 7.3%, Triple phosphate 6.6%, Calcium oxalate 6.4%, Glycosuria 6.3%, Bacteria 6.2% and mucous 4.1%. This study concludes that routing urinalysis should be performed for all individuals to diagnose the asymptomatic diseases that will help in simple therapeutic measurements as urinalysis is a simple step to determine the root of Urinary tract disorders

Keywords- Proteinuria, Glycosuria, Hematuria, Pyuria, Epithelial Cells

[1] A.H. Nagi, Urine Examination, Clinical pathology interpretations second edition, National Book Foundation Lahore Pakistan, 2004, 149-153.
[2] J.A. Somerville, W.C. Maxted, J.J Pahira, Urinalysis a comprehensive review, American Family Physician, 71, 2005, 53-62. Retrived June 27, 2008, Pubmed database.
[3] H.P. Patel, The abnormal urinalysis, Pediatr Clinc N Am, 53(3), 2006, 25 37.
[4] P.S. Topham, A. Jethwa, M. Watkins, Y. Rees, J. Feehally, The value of urine screening in young adult population, Fam Pract, 18(1), 2004, 8-21.
[5] B.S. Cho, S.D. Kim, Y.M. Choi, H.H. Kang, School urinalysis screening in korea: Prevalence of chronic renal diseases, Pediatr Nephrol, 16(11), 2001, 26-28

Paper Type	::	Research Paper
Title	::	Correlation of Estrogen and Progesterone Receptor expression in Breast Cancer
Country	::	India
Authors	::	Vinita Trivedi ||, Ranjit Kumar ||, Rita Rani ||, Anita Kumari ||, Richa Chauhan ||, Arun Kumar ||, and Md Ali
Page No.	::	39-42
Paper Index	::	DOI :10.9790/XXXXXXXXX
ANED	::	DDL : 05.3013/05113942

Breast cancer is the most common malignant tumor among women. It accounts for 22% of all male cancers; more than twice the prevalence of cancer in women at any other site. Immunohisto chemistry (IHC) is now the globally accepted methodology for detection of estrogen (ER) and progesterone (PR) receptors in breast carcinomas. The present study is designed for further insight into age and biology of ER and PR expression pattern in breast cancer patient of Bihar, India. Samples were obtained from biopsy and analyzed for ER/PR expression through Immunohistochemistry (IHC). Data were collected and statistically analyzed. It was observed that mean age of ER+ positive breast cancer patients were 47 years, while mean age of PR positive patient were 44 years. Two third patients had either ER or PR is positive while one third had both negative. In our study we observed 6.4 % patients with ER negative and PR positive. Thus it is concluded that two third of breast cancer patients was positive for hormone receptor. ER/PR positive indicates over-expression of estrogen and progesterone in carcinoma breast. ER negative and PR positive group was also observed in significant number of breast cancer patients. ER negative were observed in early age group of breast cancer while PR negative were observed in higher age group patients.

 

Key Words: Immunohistochemistry, Carcinoma, ER, PR.

[1]. Lal P, Chen B. Correlation of HER-2 status with estrogen and progesterone receptors and histological features in 3,655 invasive breast cancers. American Journal of Clinical Pathology, 2005, 123 (4): 541-6,
[2]. Carey L A, Perou C M, Livasy C A,et al. Race breast cancer subtypes and survival in the Carolina breast cancer study. JAMA, 2006, 295: 2492- 502,
[3]. Parkin DM, Bray F, Ferlay J, Pisani P. Global cancer statistics-2002. CA Cancer J Clin 2005; 55: 74-108.

[4]. Allred DC, Wu Y, Mao S, et al. Ductal carcinoma in situ and the emergence of diversity during breast cancer evolution. Clin Cancer Res 2008; 14: 370-8.
[5]. Mario CS, Jose´ LP, Ricardo FS, Cla´udio GZ. Are the pure in situ breast ductal carcinomas and those associated with invasive carcinoma the same?. Appl Immunohistochem Mol Morphol 2010; 18:51-4.

Paper Type	::	Research Paper
Title	::	Hemodynamic and recovery profile with Dexmedetomidine and Fentanyl in intracranial supratentorial surgeries: A comparative study
Country	::	India
Authors	::	Dr.Manoj Tripathi ||, Dr.Virendra Kumar ||, Dr.Deepak Malviya ||, Dr.Mahendra Singh ||, Dr.Manoj Kumar ||, Dr.Amit Tyagi
Page No.	::	43-48
Paper Index	::	DOI :10.9790/XXXXXXXXX
ANED	::	DDL : 05.3013/05114348

Background: Dexmedetomidine (DEX) has shown analgesic effects without significant respiratory depression. As Dexmedetomidine (DEX) provides good perioperative hemodynamic stability with decreased intraoperative opioid requirements, and neural protection, it might be a suitable anaesthetic adjuvant to neurosurgical anaesthesia. Fentanyl is a synthetic opioid with analgesic potency 50-100 times more than that of morphine and can be a valuable component of neuroanesthesia but can cause respiratory depression. Aims and objectives: The aim of this study is to compare hemodynamics and recovery profile with dexmedetomidine and fentanyl in supratentorial intracranial surgeries at a tertiary care hospital in central India. Patients and methods: In this randomized, prospective and comparative group study, the recruited patients were randomly allocated in two groups, Fentanyl group received an intravenous bolus of 2 μg/ kg fentanyl with maintenance of 1g/kg/hour of fentanyl and Dexmedetomidine group received a loading dose of 1 μg/kg of dexmedetomidine followed by maintenance of 0.4-0.6 μg/kg//hour till completion of surgery. Hemodynamic parameters, recovery profile and postoperative complications are monitored and assessed in both the groups. Results: Patients receiving Dexmedetomidine (group D) showed not only significantly a longer time to regain spontaneous ventilation (5 ± 1 vs. 4 ± 1, P = 0.001) but also of extubation (11 ± 2 vs. 8 ± 2, P = 0.001) than patients receiving Fentanyl group F. Better Post operative analgesia was observed in the patients receiving Dexmedetomidine (group D) than as compared with the patients receiving Fentanyl (group F). Conclusion: In the present study, the hemodynamic control was better reported with the Dexmedetomidine group as compared to Fentanyl. In our study, the patients in the DEX group higher number of patients (37/50) reported a good quality extubation than patients in the Fentanyl group (26/50).

 

Keywords: Dexmedetomidine, Fentanyl, Neuroanesthesia, Hemodynamics

[1]. Basali A, Mascha EJ, Kalfas I, Schubert A. Relation between perioperative hypertension and intracranial hemorrhage after craniotomy.Anesthesiology2000;93: 48–54.
[2]. Maze M, Tranquilli W. Alpha-2 adrenergic agonists: defining the role in clinical anesthesia. Anesthesiology 1991;74: 581–605

[3]. Ebert TJ, Hall JE, Barney JA, Uhrich TD, Colinco MD. The effectsof increasing plasma concentrations of dexmedetomidine inhumans.Anesthesiology2000;93: 382–94
[4]. Hall JE, Uhrich TD, Barney JA, Shahbaz RA, Ebert TJ. Sedative,amnestic, and analgesic properties of small-dose dexmedetomidine infusions.AnesthAnalg2000;90: 699–705
[5]. Scheinin B, Lindgren L, Randell T, Scheinin H, Scheinin M. Dexmedetomidine attenuates sympathoadrenal responses to trachealintubation and reduces the need for thiopentone and peroperative fentanyl.Br J Anaesth1992;68: 126–31

Paper Type	::	Research Paper
Title	::	Congenital Agenesis Of The Corpus Callosum With Intracerebral Lipoma And Frontal Encephalocele Presenting As A Case Of Unresolved Anterior Fontannel Swelling: A Case Report
Country	::	Nigeria
Authors	::	Kiridi EK || Dambo ND
Page No.	::	49-52
Paper Index	::	DOI :10.9790/XXXXXXXXX
ANED	::	DDL : 05.3013/05114952

Integration between the right and left cerebral hemispheres of the brain is important for proper function of the sensory, motor and higher cognitive activities. The corpus callosum which is the largest commissure in the brain is responsible for this integration1. Its absence is associated with both clinical and social problems2. The corpus callosum begins to form as early as the sixth week of gestation and by birth, the number is callosal fibres is already fixed with structural changes occurring in the post natal period2, 3 and growth occurring in puberty4.

[1]. Derbali F, Ben Fradj F, Rezgui A, Karmani M et al. The Corpus Callosum Agenesis. American Journal of Medical Case Reports. 2015; 3(2):27-29.
[2]. Luders E, Thompson PM, Toga AW. The Development of the Corpus Callosum in the Healthy Human Brain. The Journal of neuroscience : the official journal of the Society for Neuroscience. 2010; 30(33):10985-10990. doi:10.1523/JNEUROSCI.5122-09.2010.
[3]. Schell-Apacik CC, Wagner K, Bihler M, et al. Agenesis and Dysgenesis of the Corpus Callosum: Clinical, Genetic and Neuroimaging Findings in a Series of 41 Patients. American journal of medical genetics Part A. 2008; 146A(19):2501-2511. doi:10.1002/ajmg.a.32476.
[4]. Chavarria MC, Sánchez FJ, Chou Y-Y, Thompson PM, Luders E. Puberty in the Corpus Callosum. Neuroscience. 2014;265:1-8. doi:10.1016/j.neuroscience.2014.01.030.
[5]. Chiappedi M, Bejor M. Corpus callosum agenesis and rehabilitative treatment. Italian Journal of Pediatrics. 2010;36:64. doi:10.1186/1824-7288-36-64.