Journal of clinical and diagnostic research https://www.jcdr.net/back_issues.asp JCDR Neonatal Database – An Open Source Data Framework Callander I*, Jain H**, NICUS*** https://jcdr.net/article_fulltext.asp?issn=0973-709x&year=2009&month=February&volume=3&issue=1&page=1248-1254&id=453 https://doi.org/10.7860/JCDR/2009/.453 Performance Of The Medication Counseling Center In Manipal Teaching Hospital: A Follow Up Study ALAM K *, PALAIAN S **,MISHRA P ***,SAH AK****,UPADHYAY DK**,BHANDARI RB ******, <b>Objective:</b> Non-compliance to drug therapy is a common problem worldwide. Providing counseling to the patients regarding their medication is a better means to improve patient compliance. The present study evaluated the performance of the Medication counseling center in Manipal Teaching Hospital, Pokhara, Nepal. <b>Methods:</b> The filled medication counseling documentation forms during the period of three years (September 2004 to September 2007) were analyzed. The data obtained were entered in a Microsoft Excel spread sheet and were analyzed. <b>Results:</b> Altogether, 1105 patients were counseled (as per the Omnibus Budget Reconciliation Act -1990 guidelines) by the center from September 2004 till August 2007. Females comprised 51% of the patients who received counseling. Nearly half of the counseled patients were from the Department of Otorhinolaryngology. Nasal spray was the most commonly used counseling aid (44.48 %). A majority of patients were counseled regarding the dosage form of the medication (97.29%), the dosage regimen (96.38%), the description of the medicine (96.02%), the route of administration (95.84%), duration of therapy (90.41%) and storage conditions (80.45%). Nearly 6-10 minutes were spent while counseling one third of the patients. In general, patients with modified drug delivery system, such as the metered dose inhaler and dry powder inhalers, were counseled more frequently. <b>Conclusion:</b> It can be concluded that the Medication counseling center in the Manipal Teaching Hospital plays an important role in educating the patients regarding safe and effective use of their medications. <b>Practice Implications:</b> In resource limited countries like Nepal, pharmacists can provide counseling to the patients through medication counseling centers. This may in turn improve patient adherence, which is one of the common causes for therapeutic failures in countries like Nepal. https://jcdr.net/article_fulltext.asp?issn=0973-709x&year=2009&month=February&volume=3&issue=1&page=1319-1325&id=450 https://doi.org/10.7860/JCDR/2009/.450 Childhood Blindness In India – Regional Variations MADGULA I <b>Background:</b> Childhood blindness (CB) has far reaching implications for the affected child in educational, employment, personal and social aspects. In India, the overall prevalence is estimated to be a dismal 0.8/1000 children, ranging from 0.3% in well-developed states (like Kerela) to 1.5% in the poorer states. <b>Aim:</b> To identify and compare the aetiology of blindness in children in two geographically different areas of India and to assess the impact of the social and rehabilitative measures available to them. <b>Materials and Methods:</b> A total of 254 students in three blind schools, each in Delhi and Madurai were examined and the data was analysed. <b>Results:</b> No difference was noticed in age, gender and in the rehabilitative and social support system, but for increased consanguinity in the south (47%). Causes of blindness were anomalies of the globe (32.8% vs. 30.8%), Retina (20% vs. 24%), lens and cornea (15% each vs. 10% each), optic nerve (7% vs. 15%) and others (10.2%), with significant regional variation among children of similar visual status. The social acceptance of the blind was gratifying. More than 80% of the students were fluent in Braille, extracurricular activities and vocational skills training in both parts of the country. <b>Conclusion:</b> This study showed significant regional variations in the patterns of childhood blindness in India that may require different strategies to tackle the problems in these areas. https://jcdr.net/article_fulltext.asp?issn=0973-709x&year=2009&month=February&volume=3&issue=1&page=1255-1260&id=430 https://doi.org/10.7860/JCDR/2009/.430 Acute Coronary Syndrome In Elderly – The Difference Compared With Young In Intensive Care Unit Of A Tertiary Hospital In Western Nepal Paudel R*, Panta O B**, Paudel B***,Paudel K****, Pathak O K*****, Alurkar V M ******. <b>Introduction:</b> Acute coronary syndrome (ACS), one of the commonest causes of intensive care unit (ICU) admission, casts a large burden of cost on the health care system, along with a huge mortality in the elderly population. <b>Objectives:</b> This study determined the difference in presentation, complication, management and outcome in elderly patients with acute coronary syndrome, as compared to the young patients. <b>Material And Methods:</b> Records of all patients who were diagnosed to have acute coronary syndrome, admitted to the ICU in the Manipal Teaching Hospital in the month of March 2006 to June 2007, was entered in a designated Proforma. Demographic details, clinical findings, treatment and complications were recorded. A total of 153 patients were analyzed and elderly patients (&#8805; 65 yrs) were compared with young patients (< 65yrs) using SPSS-10.0 software. <b>Results:</b> Elderly patients constituted 51% (78) of the study population, among which 46.2% (36) were females. 7.7% (6) elderly patients presented with atypical symptoms, among which syncope was the commonest. Young patients were more likely to be hypertensive as compared to the elderly patients (70.7% vs. 39.7%; p<0.001). The median time of presentation to the hospital after chest pain was comparable in the two groups: 16 hours overall, but in cases of STEMI, elderly patients were brought to the hospital comparatively late, with a median time of 15 hours (IQ 5.5 – 72 as compared to young individuals in which median time was 7.25 hours (IQ 2.87 – 39 hours), which was statistically significant (p=0.000). Non ST elevated myocardial infarction (NSTEMI) and ST elevated myocardial infarction (STEMI) were similar in distribution among the elderly and young patients. Complication was seen predominantly among the elderly, with 62.8 %( 49) Vs38.7% (29); p =0.03. Overall, heart failure was the commonest complication (28.2%), followed closely by arrhythmias (26.9%). Cardiogenic shock complicating STEMI resulted in high patient mortality in both the age groups. Thrombolysed patients were similar in distribution in both groups. But the success rate of thrombolysis was lower in elderly patients (50%) as compared to young patients (76.9%). Beta blockers were less commonly used in the elderly- 47.4% (34) than in young patients- 61.3% (46). A combination of aspirin and clopidogrel was also less commonly used in the elderly patients {60.3% (47) Vs 76% (57); p=0.03}. Mortality was higher in the elderly patients (24.4% Vs 10.7%; p =0.03) <b>Conclusion:</b> Elderly patients are more prone to complications, have less success rate for thrombolysis and have a higher mortality rate as compared to young patients of ACS. https://jcdr.net/article_fulltext.asp?issn=0973-709x&year=2009&month=February&volume=3&issue=1&page=1289-1296&id=435 https://doi.org/10.7860/JCDR/2009/.435 Extended Spectrum Beta-Lactamases (ESBL) In Gram Negative Bacilli At A Tertiary Care Hospital SHOBHA K.L*,RAMACHANDRA L**,RAO G*** ,MAJUMDER S****, RAO S P*****. Extended spectrum beta lactamases (ESBL) hydrolyse expanded spectrum cephalosporins like ceftazidime and cephotaxime ,which are used in the treatment of Pseudomonas and other gram negative bacteria. ESBL producing bacteria may not be detectable by the routine disk diffusion susceptibility test, which leads to inappropriate use of antibiotics and treatment failure. Not much information on ESBL producing organisms causing infection is available from the south west coastal region. An effort was therefore made to study the ESBL producing gram negative organisms by the phenotypic confirmatory test and the novel fashion method. Antibiotic susceptibility pattern of ESBL organisms were also analysed. <b>Methods</b>:160 clinical strains were included in the study. Strains were obtained from adult patients who were either admitted to or attended the outpatient departments of medicine, surgery, obstetrics and gynaecology in a tertiary care hospital .The study was conducted from June 2005 to December 2005. Informed consent was taken from the patients for collecting the samples. The samples were processed for the identification of organisms and were screened for ESBLs. The isolates were also tested for antimicrobial susceptibility by the Kirby-Bauer disc diffusion technique, using Muller Hinton agar. Screening for ESBL was done as per the guidelines recommended by CLSI . Organisms were further tested for confirmation of ESBL production by the phenotypic confirmatory test and by the Novel fashion . <b>Results And Conclusion:</b>Out of the total 160 strains, the common organisms isolated were Klebsiella pneumoniae with 73 strains (45.62%), followed by Escherichia coli with 63 strains (39.37%) and Pseudomonas spp with 14 strains (8.75%), respectively. ESBL positive strains detected by the screening test for Klebsiella pneumoniae were 20(27.39%), for Escherichia coli were 16 (25.39%) and for Pseudomonas species were 03(21.42%), respectively. ESBL positive organisms were also found to remain positive by the Phenotypic confirmatory test, when combinations of Cefotaxime against amoxicillin /clavulanic acid and Cefipime against piperacillin/tazobactum were used. The novel fashion method showed that ESBL and de-repressed mutants in E.coli were 29(46.03%), only de-repressed mutants strains were 15 (23.80%) and inducible Amp C gene producers were 03(4.76%) . Among 48(65.75%) strains, Klebsiella pneumoniae showed ESBL and de-repressed mutants , de-repressed mutants alone in 08(10.95%) strains and inducible Amp C mutants in 02(2.73%). The antimicrobial susceptibility test showed that ESBL organisms were resistant to gentamicin and trimethoprim / sulphamethoxazole, but all were susceptible to imipenem, We conclude that clinical laboratories should develop quick screening methods to assess the different mechanisms of ESBL production, so that the patients can be treated with appropriate antibiotics . https://jcdr.net/article_fulltext.asp?issn=0973-709x&year=2009&month=February&volume=3&issue=1&page=1307-1312&id=436 https://doi.org/10.7860/JCDR/2009/.436 Screening For Fragile X Syndrome Among Neurobehavioural Patients From Kolkata, Eastern India. DAS B *, DUTTA S** , CHATTERJEE A***, SINHA S****,CHATTOPADHYAY A*****, MUKHOPADHYAY K****** <b>Background:</b> Fragile X syndrome (FXS), associated with abnormal functioning of the FMR1 gene, is a major cause for inherited mental retardation (MR). The symptoms which are commonly associated with FXS are also observed in patients suffering from various neuropsychiatric disorders like autism, epilepsy, seizure disorder etc. Thus, the diagnosis of FXS that is solely based on a patient’s physical and behavioural characteristics is very difficult. To avoid a false positive diagnosis which is crucial for better management of the disorder, screening for FXS with easy diagnostic tools becomes extremely important. <b>Aims:</b> In this study, screening for FXS was carried out among 157 various neurobehavioural patients attending the out patients department of Manovikas Kendra, Kolkata. <b>Methods and Material:</b> To screen the level of functioning of the FMR1 gene, the percentage of leukocytes expressing the fragile X mental retardation protein (FMRP) was measured by an immunocytochemical method. CGG repeat size was analyzed by PCR amplification and FMR1 promoter methylation status was checked by methylation sensitive-PCR. <b>Results:</b> Out of 157 patients recruited for this study, only four were confirmed as FXS (3.18% prevalence among neurobehavioural outpatients). 30 distinct alleles with 12-49 CGG repeats were detected, with the 27 and 28 repeats being most common. Premutation alleles were observed in 25 subjects. Molecular biology-based analyses confirmed 5 cases as FXS; four patients were detected with promoter methylation mosaicism and one with full methylation. <b>Conclusion:</b> In the present investigation, FXS screening was performed on various neurobehavioural outpatients and four were confirmed with the disorder. The CGG repeat alleles that were most frequently observed in this study were different from those found in other studies, indicating a racial or ethnic variation. https://jcdr.net/article_fulltext.asp?issn=0973-709x&year=2009&month=February&volume=3&issue=1&page=1266-1273&id=437 https://doi.org/10.7860/JCDR/2009/.437 Evaluation Of Poison Information Services Of A Clinical Pharmacy Department In A South Indian Tertiary Care Hospital SAM K G *, RAJAN M S V **, SAGHIR Z ***,KUMAR P****, RAO P ***** <b>Introduction:</b> Good quality poison information services reduce mortality, prevent prolonged hospitalization and are cost effective. Continuous evaluation of the information services is essential to upgrade the quality of the poison information services provided. <b>Methodology:</b>A retrospective study was conducted to evaluate the quality of all the poison information documented over a period of four years. The quality was measured, based on DSE/WHO seminar guidelines. The quality of service provision after evaluation was scored and rated from poor to excellent, based on the scales, with a 100 point rating. The outcome of the service was evaluated by comparing the mortality rate for the cases in which the poison information service was provided, with the cases in which the Poison Information Center was not consulted. <b>Results:</b>A total of 210 poison information queries were answered during the study period. More than 80% of queries were rated as excellent, as per DSE/WHO seminar guidelines. The mortality rate was reduced in cases where the Poison Information Center was consulted (0.9%) and it was lower compared to that of the cases where the Center was not consulted (12%). <b>Conclusion:</b>The evaluation of the services of the Poison Information Center showed that the services provided during the study period were rated as ‘excellent’ and they reduced the mortality rate. https://jcdr.net/article_fulltext.asp?issn=0973-709x&year=2009&month=February&volume=3&issue=1&page=1313-1318&id=438 https://doi.org/10.7860/JCDR/2009/.438 IL-6 And IL-8 Levels İn Patients With Acute Exacerbation Of Chronic Obstructive Pulmonary Disease AKBULUT H.H. *, OZDEN M. **, DEVECİ F.***, MUZ M. H. **** <b>Background:</b> Chronic Obstructive Pulmonary Disease (COPD) is characterized by an abnormal inflammatory response of airways due to inhalation of harmful gases and particles. Frequent exacerbations are associated with increased pulmonary and systemic inflammation. Interleukin-6 (IL-6) and interleukin-8 (IL-8) are systemic inflammation markers. <b>Aim:</b> The relationship of serum IL-6 and IL-8 levels in patients of exacerbated COPD with pulmonary function tests (PFT), forced expiratory volume in one second (FEV1), FEV1/ forced vital capacity (FVC) values, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) were studied. <b>Methods and Materials:</b> Twenty-seven patients with exacerbated COPD and 20 healthy controls were included in the study. In addition to acute exacerbation therapy, antibiotics were used in all patients. <b>Results:</b> The mean duration of antibiotic usage was 14.1±7.3 days and the mean FEV1 value was 34.11±10.43. Pretreatment and post treatment IL-6 and IL-8 levels were measured by the ELISA method. Pretreatment IL-6 and IL-8 levels were found to be significantly higher in acute excacerbation cases, when compared to levels in the healthy control group and post treatment levels. But no correlation was found between IL-6, IL-8 levels and CRP, ESR values and FEV1, FEV1/ FVC values. <b>Conclusion:</b> We conclude that cases of exacerbated COPD with greater degrees of obstruction of the airways have higher levels of cytokines in serum. The serum levels of these cytokines can therefore be utilised as the clinical and prognostic parameters for evaluation of the disease status and the therapy executed for the same. https://jcdr.net/article_fulltext.asp?issn=0973-709x&year=2009&month=February&volume=3&issue=1&page=1285-1288&id=439 https://doi.org/10.7860/JCDR/2009/.439 Hearing Assessment of Kindergarten Children in Mangalore KAVITHA A K*, JOSE A P**, ANURUDHAN A***, BABY J A*** Identification of hearing loss proves vital at any age for health considerations. In school, hearing loss may interfere with learning and if undetected, it can cause poor school performance. This study was conducted to assess the hearing status of 339 preschool children attending 6 kindergarten schools in Mangalore. Each child underwent an otoscopic examination, followed by tuning fork tests and pure tone audiometry. Otoscopic findings were found to be significant in 217(64.01%) children. After the audiological examination, 37 (10.91%) children were found to have conductive hearing loss and none had sensorineural hearing loss. Out of the 31 children with middle ear disease, only 11 (35.48%) were detected to have hearing impairment. Prevalence of hearing impairment and otitis media was higher in rural school children than in urban schools. https://jcdr.net/article_fulltext.asp?issn=0973-709x&year=2009&month=February&volume=3&issue=1&page=1261-1265&id=440 https://doi.org/10.7860/JCDR/2009/.440 Significance Of Prostate Specific Antigen And Prostate Volume In The Diagnosis Of Prostatic Diseases TAURO LF #, RAO K **, SHETTY M **** , RAO BSS *, SHENOY DH.*** <b>Background and Objectives:</b> Prostate Specific Antigen (PSA) has been used as a screening tool for prostate cancer. Controversies exist with studies showing significant prostate cancer in men with normal PSA. The objective is to study the role of PSA in differentiating benign and malignant diseases of prostate and Prostate Specific Antigen Density (PSA-D) in prostate diseases. <b>Methods:</b>This is a prospective study of data from 100 patients in our Medical College Hospital from July 2005-May 2007. All patients with lower urinary tract symptoms (LUTS), suggestive of prostate enlargement, were included. Patients with urethral strictures, calculi or with a previous history of surgeries and procedures on the prostate were excluded. All patients underwent digital rectal examination, serum PSA measurement and transrectal ultrasonography to measure prostate volume. Prostatic pathology was confirmed by biopsy in all patients after obtaining informed written consent. <b>Results:</b>The mean age was 68.05 ± 8.27 (SD) years. 40% of the patients had PSA values between 4-10ng/ml. There was no statistical correlation between age and PSA. Digital rectal examination had a sensitivity of 65.5% for detection of prostate cancer. Prostatic volume, as an independent variable, was not significant in predicting malignancy. Total PSA done in all cases was significant for the detection of cancer at levels >10ng/ml. PSA-D improved the sensitivity to detect malignancy. <b>Conclusion:</b> PSA is significant in detecting prostate cancer at values >10ngm/ml. Prostate volume is not significant for diagnosis of prostatic diseases but PSA-D has a high sensitivity (96.55%) in detecting prostate cancer. https://jcdr.net/article_fulltext.asp?issn=0973-709x&year=2009&month=February&volume=3&issue=1&page=1274-1284&id=442 https://doi.org/10.7860/JCDR/2009/.442 Pulmonary Tuberculosis And Some Underlying Conditions In Golestan Province Of Iran, During 2001-2005 GOLSHA R*, REZAEI SHIRAZI R**, SHAFIEE A*, NAJAFI L*, DASHTI M*, ROSHANDEL G*** <b>Context:</b> Pulmonary tuberculosis has been a major health problem in Golestan province of Iran. <b>Aims:</b> This descriptive cross-sectional study was performed to evaluate the frequency of coexisting medical conditions and their effects on some epidemiologic factors in patients with pulmonary tuberculosis. <b>Setting and Design:</b> This was a descriptive cross-sectional study. <b>Methods and Material:</b> Demographic information, time of admission in the hospital and coexisting medical conditions (diabetes, chronic renal failure/hemodyalysis, corticosteroids consumption and malignancies) were extracted from the patient's file. <b>Statistical analysis used:</b> Chi-square test was used to assess the relationship between variables. <b>Results:</b> Two hundred forty three patients with pulmonary tuberculosis during 5 years were studied. Out of all, 162 cases (66.7%) did not have any co-morbidities. Diabetes mellitus was found to be the most prevalent condition (23.05%) followed by chronic renal failure, corticosteroid consumption and malignancy ranking second, third and forth in the list (5.8%, 2.5% and 2 respectively). The mean age of the patients was 50.15±19 years old. In the group without co morbidities, male/female ratio was 1.41/1, but co morbidity with diabetes was significantly more prevalent in females (p<0.05). <b>Conclusions:</b> We suggest screening of tuberculosis in patients with chronic renal failure and diabetes mellitus in our area. Also for patients with pulmonary tuberculosis, diabetes screening should be considered essential. https://jcdr.net/article_fulltext.asp?issn=0973-709x&year=2009&month=February&volume=3&issue=1&page=1302-1306&id=443 https://doi.org/10.7860/JCDR/2009/.443 The State Of Birth Weight in the North of Iran Veghari G *,Marjani A **, Rahmati R ***,Hosseini *** <b>Introduction and object:</b> This study was designed for determining the birth weight and some other factors affecting rural newborn children in the north of Iran (south east of Caspian sea). <b>Material and Method:</b> A sample size of 695 cases was chosen by cluster and random sampling from 20 villages. The birth weight of the newborn and the mother’s socio-economic status were recorded by a questionnaire. The data was analyzed by SPSS windows software. <b>Results:</b> The prevalence of LBW, NBW and HBW was observed to be 11.1%, 84.1% and 4.8%, respectively. The birth weight among children whose mothers had iron supplements was lower than that of children whose mothers did not take iron supplement (3173gr vs 3246gr) and statistical differences between the two groups were not significant. Birth weight have a positive correlation and significant statistical differences with both maternal age (r=0.2 , p=0.01) and maternal BMI(r=0.24 , p=0.01).The birth weight in the 5th birth order was more than that in the1st birth order and statistical differences were significant (P=0.01). Birth weight had a positive correlation with familial income (P<0.05). <b>Discussion:</b> Our study showed that maternal BMI, birth order and socioeconomic factors were associated with intrauterine weight gain, but iron supplements didn’t have a positive outcome. https://jcdr.net/article_fulltext.asp?issn=0973-709x&year=2009&month=February&volume=3&issue=1&page=1297-1301&id=445 https://doi.org/10.7860/JCDR/2009/.445 Molar Pregnancy And Co-Existent Foetus: A Report Of Two Cases KASHANI E *, BOUSTANI P **, ROSHANDEL G***, ROSHANDEL D ***** Molar pregnancy with a co-existent foetus will lead to preterm labour, severe preeclampsia or bleeding in most of the cases and may need urgent intervention. However, if it does not become complicated with preeclampsia or preterm labour, the outcome is usually good, with minimal post partum complications and so such pregnancies can be managed with watchful waiting and close observation. The first case was a 29 year-old at 19 weeks of gestation, with hypertension, oedema and severe epigastric pain. Karyotypic assessment of the contents of the uterus revealed a 46-XX foetus with no chromosomal abnormality, as well as the molar placenta also suggesting a complete mole with 46-XX. The second case was a 19 year old woman in labour. A pathological study of the delivered contents of the uterus revealed a complete hydatidiform mole and a normal placenta. https://jcdr.net/article_fulltext.asp?issn=0973-709x&year=2009&month=February&volume=3&issue=1&page=1334-1337&id=434 https://doi.org/10.7860/JCDR/2009/.434 An Unusual Presentation Of Aortic Dissection ABBAS M T *, , KHAN F Y **, JASSEM Z M ***, ,SHAWKY A H ****, AL- BAIDAA D ***** We report a case of painless dissecting aneurysm, mainly involving the descending aorta in a 46-year old Philippine patient, who was admitted to our hospital, presenting with cerebrovascular accident. His medical history was remarkable for hypertension for 9 years. The patient did not have chest or back pain. On clinical examination, it was observed that he had left sided hemiplegia. Computed tomography (CT) of the head showed multiple infarctions. Trans oesophageal echocardiography and Magnetic Resonance Imaging of the chest and abdomen showed dissecting aneurysm in the descending thoracic aorta with big thrombus. The patient was treated conservatively and was discharged in good condition. https://jcdr.net/article_fulltext.asp?issn=0973-709x&year=2009&month=February&volume=3&issue=1&page=1338-1340&id=441 https://doi.org/10.7860/JCDR/2009/.441 Thrombocytopenia After Ibuprofen: A Case Report JAUHARI AC*,BISTA D**,JOHOREY AC***,SAHA S****,SAHA A***** Ibuprofen, a propionic acid derivative, is an important non steroidal anti-inflammatory drug (NSAIDs) used freely for the treatment of various arthritic diseases, and as analgesic and antipyretic drug available over the counter (OTC) in Nepal. Thrombocytopenia (TPA) is one of the rare haematopoitic adverse drug reactions (ADRs, <1%) of ibuprofen. This is a fatal case of ibuprofen induced TPA, reported from the Nepalese population. Ibuprofen is documented to be one of the safest anti-inflammatory, analgesic and antipyretic drugs used frequently. https://jcdr.net/article_fulltext.asp?issn=0973-709x&year=2009&month=February&volume=3&issue=1&page=1329-1333&id=451 https://doi.org/10.7860/JCDR/2009/.451 A Neonate With Multiple Fractures RAMESH BHAT. Y*, K. PRAKASHINI** Fractures in a neonate commonly result from a genetic predisposition and birth trauma. Osteogenesis imperfecta, a rare heterogeneous group of disorders, mainly affecting the bones, remains the commonest cause of genetic osteoporosis. Osteogenesis imperfecta congenita (OIC) is the most severe form among them, with an incidence of 1 in 60000 live births. Presented here, is a neonate with OIC, having multiple bone fractures and deformities. https://jcdr.net/article_fulltext.asp?issn=0973-709x&year=2009&month=February&volume=3&issue=1&page=1326-1328&id=448 https://doi.org/10.7860/JCDR/2009/.448 Digital Camera – A Review Of Its Applications In Urology And Genitourinary Surgery SINGH IQBAL <b>Aims:</b> To choose the right digital imaging device and to report and review on the various applications of a digital camera in our urological setting. Advances and newer emerging tools in the field of digital imaging makes it mandatory for a urologist to acquaint oneself with the basics of digital imaging, so as to enable oneself to choose the appropriate system compatible with one’s requirement and work setting. Methods: We have reviewed the basic technical literature on digital photography and the factors to be considered while choosing the right digital camera. We have described the usage and testing of three such camera devices (Sony Mavica FD73™, Sony Cybershot™ (DSC-T10) and the Nokia™ 6270 mobile phone in built camera device) in our hospital urological setting over the last three years. <b>Results:</b> The right digital camera must have at least 2-4 mega-pixel resolution with a macro mode; CCD sensor, adequate compression, high memory and at least 4x optical zoom with white balance. <b>Conclusion:</b> The digital camera is like a hand held mobile scanner that allows instant digital data acquisition. It is a portable, extremely versatile, reliable and efficient device to capture, store and reproduce digital images throughout the urological setting in any compatible format. It should be considered as a standard accessory by all practicing urologists and surgeons, so as to maintain a reliable documentation of all their records and investigations in a readily reproducible format. https://jcdr.net/article_fulltext.asp?issn=0973-709x&year=2009&month=February&volume=3&issue=1&page=1341-1347&id=447 https://doi.org/10.7860/JCDR/2009/.447 Prosthodontic Rehabilitation of Weakened Root Canals: A Case Report DESHPANDE S S*, SARIN S P**, PARKHEDKAR R D*** This paper highlights the fact that many anterior teeth requiring restoration are severely weakened, having wide flared canal spaces and thin dentinal walls, and are at a high risk of getting fractured. Traditionally, such teeth would be restored using metal posts, but this procedure has often been unsuccessful, because of lack of retention or root fracture. The canal can be reinforced using a new post system involving intraradicular composite resin polymerization with light transmitting posts, rendering the defective endodontically treated root capable of supporting a post and core, and thereby ensuring continued function of the badly damaged tooth. https://jcdr.net/article_fulltext.asp?issn=0973-709x&year=2009&month=February&volume=3&issue=1&page=1353-1356&id=428 https://doi.org/10.7860/JCDR/2009/.428 A Preliminary Study Of The Guided Tissue Regeneration Procedures For Adjacent Buccal Root Coverage Using Single Gtam-Tr6t Membrane VANDANA K L*, REDDY V R **,JOSHI V M** The purpose of this study was to assess the reliability of the GTR procedure in terms of root coverage, using material (GTAM-TR6T) in single and adjacent buccal recessions. One of the major therapeutic goals of periodontal treatment is to obtain root coverage in areas of localized or generalized gingival recession associated with aesthetic problems, dentinal hypersensitivity and root caries lesions. This study showed enhanced root coverage and attachment gain with a Titanium reinforced GTR (GTAM-TR6T) membrane in both single and adjacent buccal recessions. Therefore, a preliminary attempt to cover adjacent buccal recessions with single GTAM-TR6T (Augmentation material) has proved clinically successful. https://jcdr.net/article_fulltext.asp?issn=0973-709x&year=2009&month=February&volume=3&issue=1&page=1365-1369&id=429 https://doi.org/10.7860/JCDR/2009/.429 A Rare Radiopaque Parotid Duct Calculus. A Case Report Bhat M*, Rai R**, Vaidyanathan V*** Salivary duct lithiasis is a condition characterized by the obstruction of a salivary gland or its excretory duct due to the formation of calcareous concretions or sialoliths, resulting in salivary ectasia, and even provoking the subsequent dilation of the salivary gland. Sialolithiasis accounts for 30% of salivary diseases, and most commonly involves the submaxillary gland (83 to 94%), and less frequently, the parotid (4 to 10%) and sublingual glands (1 to 7%). The present study reports the case of a 50-year-old female patient who attended our clinic, complaining of a painful swelling over the cheek which aggravated with chewing movements, bad breath and foul-tasting mouth at meal times and presenting with a salivary calculus in the right Stensen´s duct. Once the patient was diagnosed with a radiopaque stone, the sialolith was surgically removed using general anaesthesia. In this paper, we have also updated a series of concepts related to the aetiology, diagnosis and treatment of sialolithiasis. https://jcdr.net/article_fulltext.asp?issn=0973-709x&year=2009&month=February&volume=3&issue=1&page=1357-1364&id=431 https://doi.org/10.7860/JCDR/2009/.431 Platform Switching of Dental Implants: Panacea For Crestal Bone Loss? DESHPANDE SAEE S*, SARIN SOUMIL P**, PARKHEDKAR R D *** Crestal bone loss has been documented as one of the important factors that affect the long term prognosis of a dental implant. Various factors responsible for crestal bone loss have been reviewed. The concept of platform switching has been described on a histological basis. Its clinical benefits are discussed. A finite element analysis was performed to assess the mechanical behaviour of platform switched implants, which shows reduced crestal stress values under occlusal loads. https://jcdr.net/article_fulltext.asp?issn=0973-709x&year=2009&month=February&volume=3&issue=1&page=1348-1352&id=432 https://doi.org/10.7860/JCDR/2009/.432 ‘Letter to Editor’ SHANKAR PR*, SUBISH P**, SHRESTHA R***, ALAM K**** https://jcdr.net/article_fulltext.asp?issn=0973-709x&year=2009&month=February&volume=3&issue=1&page=1370-1371&id=433 https://doi.org/10.7860/JCDR/2009/.433 Nanotechnology, (Nanomedicine)- A Function Based Technology In Cancer Diagnosis PATRA S https://jcdr.net/article_fulltext.asp?issn=0973-709x&year=2009&month=February&volume=3&issue=1&page=1372-1373&id=446 https://doi.org/10.7860/JCDR/2009/.446 A Comparative Study On The Antimicrobial Activity Of Meropenem And Other Anti-infective Agents RAJESH P K* https://jcdr.net/article_fulltext.asp?issn=0973-709x&year=2009&month=February&volume=3&issue=1&page=1374-1375&id=452 https://doi.org/10.7860/JCDR/2009/.452 Community Pharmacovigilance In Nepal - A Guide For Community Pharmacists SHANKAR PR*, JHA N** https://jcdr.net/article_fulltext.asp?issn=0973-709x&year=2009&month=February&volume=3&issue=1&page=1379-1380&id=449 https://doi.org/10.7860/JCDR/2009/.449 Blurring the Boundaries - New Trends in Drug Promotion SHANKAR PR*, JHA N** https://jcdr.net/article_fulltext.asp?issn=0973-709x&year=2009&month=February&volume=3&issue=1&page=1376-1378&id=444 https://doi.org/10.7860/JCDR/2009/.444