Recent High Court and Supreme Court judgments have awarded large compensations for complications arising out of intravenous treatment. Extravasation of fluids and drugs is the most common complication of any medical procedure worldwide. Extravasation injury leading to gangrene occurs rarely and is due to factors related to patient characteristics, underlying disease, and the type of drug which is being injected. Human error rarely may be contributory to development of the extravasations and injury resultant thereof, but to label all of these complications as negligence by the application of “res ipsa loquitur” has serious consequences. High compensation risk for a complication which is faced universally by all doctors has the potential to raise the cost of this simple procedure.

Osteoporosis is characterized by low bone mineral density (BMD) and deterioration of bone structure resulting in an increased susceptibility to fractures of the hip, spine and wrist. Osteoporosis contributes to a great deal of morbidity and mortality and is a large burden to the health service. In the last four decades, numerous research teams have reported oral radiographic findings associated with osteoporosis. Digital orthopantomographs (OPGs), taken for routine dental evaluations, have a significant role in screening for initial osteoporotic changes. A number of mandibular cortical indices (MCIs) have, also, been developed to allow quantification of mandibular bone mass and identification of osteoporosis. Klemetti Index (KI), mental index (MI), panoramic mandibular index (PMI), antegonial index (AI) and gonial index (GI) are, all, associated with a low bone mineral density (BMD) and of help in the initial screening of osteoporosis.

Background: In 1993, Nigeria enacted a law making it mandatory for all salt both for human and animal consumption to be fortified with iodine in a bid to eliminate iodine deficiency disorders (IDDs). IDD is a silent threat to the growth and development of the child and also to national development. The aim of this study was to assess the status of iodine nutrition in schoolchildren in areas known for the production of local uniodized salt. Materials and Methods: A cross-sectional study was performed in two Local Government Areas of Ebonyi State, Nigeria. Urinary iodine concentration (UIC) was measured in 400 pupils aged 6–12 years old. In addition, the iodine content of kitchen salt samples of the pupils that donated their urine samples were estimated qualitatively using rapid test kit. Salt samples from markets within the localities were also tested to ascertain the level of iodine. Results: Median UIC of the schoolchildren was 145 μg/L and 31.19% of the schoolchildren had sufficient/adequate iodine intake (100–199 μg/L). Household salt iodization testing showed that 90.0% of the total household salt samples collected during the survey proved iodized; however, only 63.5% were adequately iodized (≥15 parts per million [ppm]). Market salt samples tested showed that three brands of salt were adequately iodized (≥15 ppm), whereas two brands of salt were not iodized (0 ppm). Conclusion: Even though the median UIC in the total study population was at the recommended level (100–199 μg/L), indicating optimal iodine nutrition, the proportion of households consuming adequately iodized salt (63.5%) was below the recommended target of >90%.

Introduction: Paroxetine hydrochloride is used as the antidepressant drug of the selective serotonin reuptake inhibitor. It is used to treat depression resistant to other antidepressants, depression complicated by anxiety, panic disorder, obsessive-compulsive disorder (OCD). The objective of the present work is to formulate oral dispersible tablet dosage form using two different superdisintegrants. Materials and Methods: Eight formulations (F1-F8) were prepared using two superdisintegrants in varied concentrations. The optimized formulations (based on %CDR) were further formulated by sublimating agent using camphor as sublimating agent (S1, S2). Results and Discussion: All the formulated tablets were evaluated for physicochemical characteristics, drug content and in vitro drug release, dispersion time, and wetting time and the results were within the permissible limits. Conclusion: Orodispersible tablets of paroxetine HCl were successfully formulated by employing direct compression and sublimation methods. From this investigation, it can be concluded that stable orodispersible tablets gave maximum %CDR with 10% camphor as sublimating agent and 8% crospovidone as super disintegrant.

Background: Mentoring is vital to the maturation of individuals, especially early in their careers and aids professional growth. This study was conducted to find out the views of final year students of Bayero University Medical School on mentoring. Materials and Methods: This was a cross-sectional observational study. The students were given a self-administered questionnaire after a careful explanation and consent obtained. Data were analyzed by SPSS version 16 using Chi-square (χ²) and Fischer exact test (F) with a P< 0.05 considered to be significant. Results: There were a total of 84 students with a male:female ratio of 3.4:1. The age range was between 22 and 42 years with a mean age of 26.4 ± 2.99 years. All the students had formal mentors assigned to them, but none had mentors in the 1^st year of school, and only two (2.3%) were assigned mentors in the 2^nd year of study. Religion, ethnicity, gender, or specialties of the mentors were not considered important characteristics of mentors by majority of the students, and there was no gender difference in these views. Developing career goals and time management were the priority mentor topics. During the initiation of formal mentoring, only 7 (8.3%) of the students were asked for their goals before being assigned to mentors. Conclusion: Mentoring should be commenced in the 1^st year of study, and mentoring goals should be clearly defined for a successful mentee – mentor relationship.

Background: Family burden affects the health of both patient and caregivers. Identifying determinants of family care burden in patients with schizophrenia has significant psychosocial implications. Aim: To investigate the sociodemographic factors associated with caregiver burden in patients with schizophrenia. Materials and Methods: A series of one hundred schizophrenia within the age group of 18–47 and above and having more than 2 year's history of illness and 100 caregivers of such a patient have been taken up for the study, within the age group of 18–63 and above. To identify the primary care givers of the above patients, Pollack and Perlick scale was used. The International Classification of Disease-10 – Diagnostic Criteria for Research were used for psychiatric diagnosis. Patient and caregivers of the patients were assessed on self-developed sociodemographic pro forma. Pearson correlation coefficient test was used to study the correlation between patient, caregivers, and family burden. Results: Family care burden has statistically significant correlation with patients advanced age (r = 0.239, P< 0.017), duration of illness (r = 0.210, P< 0.036), and patient income (r = 0.202, P< 0.044). The correlation analysis also correlated positively with family care burden and caregivers advanced age (r = 0.226, P< 0.034), low education level (r = −0.215, P< 0.032), poor family income (r = 0.205, P< 0.043), and length of contact with patients (r = 0.242, P< 0.021). Conclusion: Patient advanced ages, duration of illness, poor patient income, caregivers' advanced ages, low education level, poor family income, and length of contact with patients were the factors most likely associated with family care burden in schizophrenia.

Introduction: Eustachian tube (ET) dysfunction has been attributed to many diseases of middle ear cleft ranging from as benign as serous otitis media to squamosal (unsafe) chronic otitis media (COM). Many factors have been attributed for the success of tympanoplasty, out of which ET function (ETF) is considered one of the most important. ETF can be evaluated by various tests and assessment of the same can predict the outcome of tympanoplasty. Objective: The objective of this study was to evaluate the effect of ETF on tympanoplasty outcome in COM patients. Materials and Methods: This observational study was conducted in the department of Otorhinolaryngology and Head and Neck Surgery of KLE University's Jawaharlal Nehru Medical College and KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belagavi, Karnataka, from January 2014 to December 2014. Results: Out of 37 patients who had normal ETF, 33 (90.2%) had successful while four (9.8%) had unsuccessful outcome. Out of 11 patients who had partial dysfunction of ET, seven (63.6%) had successful while four (36.4%) had unsuccessful outcome. On the other hand, all the patients who had gross dysfunction of ET had an unsuccessful outcome. Conclusion: The saccharin test is an easy, simple, and cost-effective method because it does not require any sophisticated equipment. It promises to be a useful diagnostic tool to assess the mucociliary function of the ET. Methylene blue dye test can also be used as an adjunct to know the anatomical patency. Therefore, saccharin test and methylene blue test are recommended as a part of routine preoperative workup for all patients planned for tympanoplasty, which supplementing other existing tests for tubal function.

Introduction: The lungs are a pair of vital organs of respiration which are divided into lobes by fissures. The fissures facilitate the movements of lobes and help in uniform expansion of the whole lungs. The fissure may be complete, incomplete, or absent. The knowledge of position and completeness of fissures and lobes is necessary for an appreciation of lobar anatomy and thus locating bronchopulmonary segments. Objectives: The objective of this study was to analyze the morphology of fissures and lobes of lungs. Materials and Methods: Twenty pairs of lungs were taken for the study, obtained from twenty formalin-fixed cadavers. The specimens were thoroughly observed for the pattern of lobes, fissure variations were noted, and the specimens were photographed. Results: Of the twenty right-sided lungs, incomplete oblique fissure was seen in six (30%) lungs. None of the lungs showed the absence of oblique fissure. Incomplete horizontal fissure was seen in ten (50%) lungs, and horizontal fissure was found absent in four (20%) lungs. Among the twenty lungs, four (20%) lungs showed two lobes due to the absence of horizontal fissure and the remaining 16 (80%) lungs showed normal lobar pattern of lungs. On the left side, incomplete oblique fissure was observed in two (25%) lungs, and two (25%) lungs showed the absence of oblique fissure. Due to the absence of oblique fissure, three (15%) specimens showed only one lobe while 17 (85%) lungs showed normal lobar pattern. There was no incidence of the presence of an accessory fissure in either side of the lungs. Conclusion: The present study when compared with a previous work showed a wide range of difference in the lobes and fissures between and among different populations. Knowledge of such variation may be important for performing lobectomies, surgical resections, and correct interpretation of radiological images.

Context: Attention deficit hyperactivity disorder (ADHD) commonly occurs in patients with bipolar affective disorder (BPAD). However, there is a paucity of data concerning the prevalence of adult ADHD in BPAD from India. Aims: Attention deficit hyperactivity disorder (ADHD) commonly occurs in patients with bipolar affective disorder (BPAD). However, there is a paucity of data concerning the prevalence of adult ADHD in BPAD from India. Hence, this study aimed to find out the prevalence of adult ADHD in bipolar disorder for better diagnosis and management and tried to find association with clinical and sociodemographic features. Settings and Design: The present 1 year cross-sectional study was conducted in the Department of Psychiatry, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belagavi from January 1, 2014, to December 31, 2014. Subjects and Methods: A total of 100 patients with diagnosis of BPAD were evaluated for the presence of ADHD. Statistical analysis was done using Epi Info 7 software. Statistical Analysis Used: The data obtained was coded and entered and analyzed using Epi Info 7. Results: Most of the patients were male (64%) and male:female ratio was 1.77:1. The mean age was 37.36 ± 11.02 years and most common age group was 31–40 years (38%). The place of residence was urban area in 53% of the patients, and 72% were Hindus. Education up to secondary schooling was noted in 63% of the patients, and 63% were unemployed. Forty-four percent of the patients belonged Class I socioeconomic status. History of other psychiatric comorbidities was noted in 55% patients, and most of the patients had alcohol dependence syndrome (23%). Conclusions: The frequency of ADHD in patients with BPAD was 15%. The most common clinical presentation was difficulty in memory/concentration and failure to finish the work, difficulty in organization, avoiding tasks requiring sustained mental effort, forgetfulness, and easily distracted were common signs.

Background: In spite of major advances in the knowledge of fetal and perinatal medicine, perinatal asphyxia is one of the significant causes of mortality and long-term morbidity. Outcome of asphyxiated babies depends on the severity of hypoxia which adversely affects the liver, kidney, brain, heart, and other organs leading to leakage of intracellular enzymes. Aims and Objectives: We undertook this study to estimate hepatic enzyme activity in perinatally asphyxiated babies in relation to nonasphyxiated babies and to know whether hepatic enzyme activity correlates with the severity and outcome of asphyxia. Materials and Methods: This cohort study was conducted in the Department of Pediatrics of our hospital from June 2012 to May 2013. The study included 75 asphyxiated neonates as case and 75 healthy neonates as controls. Serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), and lactate dehydrogenase (LDH) levels were estimated by IFCC method. Data gathered from perinatal asphyxia patients and control patients in a preformed pro forma were analyzed by appropriate statistical methods. Results: Serum AST, ALT, LDH, and ALP were found significantly higher in asphyxiated babies compared to the control group (P < 0.05). The rise of AST, ALT, and LDH also showed a significant positive correlation with the severity and outcome of asphyxia. Conclusion: Estimation of hepatic enzymes can be used as a marker to diagnose the presence of perinatal asphyxia and also to assess its severity and outcome.

Aims: To assess hearing in patients undergoing tympanoplasty with and without cortical mastoidectomy for chronic otitis media. Settings and Design: A hospital-based, randomized controlled study. Subjects and Methods: The study included sixty patients. Patients were randomly allocated into two groups of thirty each. In Group 1, patients underwent tympanoplasty alone. In Group 2, patients underwent tympanoplasty with cortical mastoidectomy. Hearing assessment was done by pure tone audiometry. Follow-up period was 3 months. Statistical Analysis Used: Paired and unpaired t-tests were used for quantitative variables and Chi-square test was used for qualitative ones. P< 0.05 was considered statistically significant. Results: The mean pre- and post-operative pure-tone average was 42.4 ± 10.53 dB and 32.8 ± 13.02 dB in Group 1, with a mean hearing gain of 9.5 ± 11.33 dB. The mean pre- and post-operative pure-tone average was 42 ± 10.43 dB and 34.9 ± 9.94 dB in Group 2, with a mean hearing gain of 7.1 ± 8.85 dB. The mean pre- and post-operative air-bone gap was 37.27 ± 9.51 dB and 24.21 ± 11.64 dB in Group 1, with improvement in air-bone gap of 13.07 ± 12.93 dB. The mean pre- and post-operative air-bone gap was 32.27 ± 11.53 dB and 23.75 ± 9.91 dB in Group 2, with improvement in air-bone gap of 8.52 ± 9.13 dB. No statistically significant difference was seen between the two groups. Conclusions: Combining cortical mastoidectomy with tympanoplasty in the patients of chronic otitis media, mucosal disease, offers no additional benefit in terms of hearing improvement compared to tympanoplasty alone.

Objectives: To assess the antidiabetic potential of Shilajatvadi Lauha (SL) processed with Daruharidra (modified SL [MSL]) in streptozotocin (STZ)-nicotinamide (NA)-induced diabetic rats. Materials and Methods: Animals were divided into diabetic and nondiabetic groups. Type 2 diabetes in rats was induced with a single dose of STZ (65 mg/kg) NA (110 mg/kg) intraperitoneal diabetic rats were treated with formulation MSL (10, 30, and 100 mg/kg) and glibenclamide (10 mg/kg) once daily for 14 days orally. After 14 days treatment, fasting blood glucose and plasma insulin were assayed. Different biochemical parameters such as total cholesterol (TC), triglycerides (TGs), low-density lipoprotein-cholesterol (LDL-C), high-density lipoprotein-cholesterol (HDL-C), and very LDL-C (VLDL-C) were also examined. Results: MSL significantly lowered the blood glucose and increases insulin level, which was comparable to the standard antidiabetic drug, glibenclamide. Treatment with MSL showed a significantly reduction in the levels of TC, TG, LDL-C, and VLDL-C and increases the level of HDL-C. Conclusion: MSL possess significant antidiabetic and antihyperlipidemic activity in Type 2 diabetes mellitus rats. The results are encouraging and further studies can be used to evaluate the exact mechanism of action to develop a novel molecule that will benefit the ailing.

Background: A proton pump inhibitor is an acid labile drug which degrades at stomach pH 1.2. Delayed release pellets were prepared to stabilize the formulation applying an enteric coat. Objective: the objective of the study was to design, formulation and evaluation of delayed release oral dosage form of proton pump inhibitor. Materials and Methods: Twelve different formulations of pellets were prepared by fluid bed technology (bottom spray technique) using different polymers for different coating processes namely seal coat (HPMC); drug coat (HPMC); barrier coat (Ethyl cellulose) and enteric coat (HPMC Phthalate). The formulated pellets were evaluated. Results: FTIR studies revealed that there was no physic-chemical interaction between drug and excipients. Micromeritic property study for pellets revealed that the values were within the permissible limits. The pellets were filled into the capsules and evaluated for drug content, %loss on drying, weight variation and in vitro dissolution. Conclusion: The filled weight of the capsule was in the pharmacopeail limits, the 5 drug content of all the formulation was fund to be in the range of 97-99 % and the % LOD was less that 35. F1-F12 formulations exhibited a release in a range of 60-90.37% in 45 min at PH 6.8.Optimized Formulation F10 Exhibited maximum release of 90.37% in 45 min . The barrier coat of the all the formulations effectively prevented the release of the drug in the stomach. The stability study revealed that the formulation F10 was stable when stored at 30°C±2°C/65±5% RH for one month.

Dengue is an arthropod-borne viral infection of humans with potential fatal complications. Dengue virus infection can clinically manifest as dengue fever, dengue shock syndrome, and dengue hemorrhagic fever. Usual symptoms during the early febrile stage include fever, malaise, headache, body pains and rash. Atypical manifestations of dengue can be diverse and multisystemic. We describe a case of dengue presenting with epididymo-orchitis which to our knowledge is the first such report.

Maxillofacial trauma is often associated with avulsion of teeth. Occasionally, there may be tooth aspiration either spontaneously or following intubation. We report a case of tooth aspiration in a patient of head injury and maxillofacial soft tissue injury following motor vehicle accident and have discussed regarding its incidence, sequelae, and management.

Haberland syndrome, also known as encephalocraniocutaneous lipomatosis, is a rare, congenital neurocutaneous disorder. It is characterized by unilateral central nervous system, cutaneous, and ocular anomalies. We report here a case of 28-year-old female presented with history of intermittent episodes of generalized tonic–clonic type convulsions for 3 years, soft lipomatous swelling over the right temporal area with nonscarring alopecia of the part of frontal and parietal region, and ipsilateral scleral dermoid. Computed tomography findings were lipomas and calcification of falx. Magnetic resonance imaging showed right-sided hemiatrophy, two intracranial cysts, and enlargement of the right lateral ventricle. We report this case because of its rarity.

Hashimoto's encephalopathy is a controversial and underrecognized condition, associated with autoimmune thyroiditis. Presentation may be an insidious development of cognitive impairment or recurrent acute episodes of focal neurological deficit with confusion. Here, we present a case of middle-aged female that presented with headache, vomiting with alteration of sensorium, and left side weakness and responded well to steroids. A negative microbiological screen of the cerebrospinal fluid (CSF) and serum along with raised CSF protein, elevated serum antithyroid antibodies, and characteristic electroencephalogram and neuroimaging findings yielded the diagnosis.

Nasal polyp is a chronic inflammatory disease affecting the nasal cavity and the paranasal sinuses. It is a relatively common disease occurring in 1%–4% of the general population, but it is also seen in the pediatric population. Children present with nasal polyps are also known to have other underlying systemic diseases, mainly cystic fibrosis and bronchial asthma. Nasal polyp is common in the pediatric population especially in teenage, and is found usually bilateral. It is also commonly associated with bronchial asthma and many other systemic diseases. Beginning in preschool age, up to 50% of patients experience obstructing nasal polyp. In contemporary science, nasal polyp is not curable but can be clinically stabilized. When conservative measures are exhausted, surgical intervention combining endoscopic sinus surgery and supportive conservative treatment is performed. In the present paper, we aimed to present a treated patient of nasal polyp by the ayurvedic modalities such as Snehana, Swedana, Nasya, Gandusha, and Dhoompana with a positive change in the clinical picture.

A 32-year-old female was admitted with Organophosphorus (OP) poisoning and was managed with gastric lavage, intravenous pralidoxime, and atropine. On the 3^rd day, she developed swelling and pain in the right upper extremity. Color Doppler confirmed upper extremity deep venous thrombosis (DVT). In addition to the neurologic manifestations patients of OP poisoning patients should also be monitored carefully for the development of DVT as these agents can lead to persistent inflammatory response which increases the risk of DVT. Upper limb DVT is rare and generally secondary to cancer, strenuous exercise, and insertion of central venous catheters. We hereby report a rare case of the upper limb DVT following OP poisoning.

Presences of normal genes on the Y chromosome are essential for normal sex determination and sex differentiation of male genitalia. Several genes on the X chromosome and other autosomes have been shown to be anti-testes and have a detrimental effect on the development process of normal male genital system. The addition of X chromosomes to the 46, XY karyotype results in seminiferous tubules dysgenesis, hypogonadism, and malformed genitalia. We report an infant male with 49, XXXXY syndrome presenting with ambiguous genitalia and multiple extra-gonadal anomalies.