Chronic obstructive pulmonary disease is a leading cause of morbidity and mortality in adults all over the world. While other major causes of non-cancer mortality such as coronary artery disease and stroke have shown a consistent downward trend, COPD is the only one that continues to increase [1]. In the present study, Majority of patients were in the age group 61-70years. Out of 50 patients studied, 34 patients were male and 16 patients were females. Most of the patients are farmers by occupation followed by beedi worker and factory worker. Cough was present in 92% of patients, sputum production in 96% of patients, breathlessness in 88% of patients, weakness and fatigue was present in 54 % of patients and swelling of lower limbs in 30% of patients. Among 50 patients, 64% of patients were smokers and 36% were non-smokers. 82% of patients had use of accessory muscles of respiration, 52% patients had barrel shaped chest, chest movements were found to be minimal in 64% patients, rhonchi was present in 62% patients, crepitations were heard in 90% patients and clinical signs of pulmonary hypertension were present only in 36% patients.70% patients were found to have severe pulmonary hypertension, 28% had moderate pulmonary hypertension and mild pulmonary hypertension was present in 2%patients. Diagnosis of pulmonary hypertension in patients with COPD is difficult because patients diagnosed with COPD, and are stable, do not routinely undergo right heart catheterization – which makes PH more difficult to detect. In addition, the symptoms of both diseases are easily mistaken as the. While it is difficult to determine the prevalence of COPD with pulmonary hypertension, early detection can improve treatment and quality of life

During 5th & 6th century BC, sweet taste of urine in polyuric patient was described in Sanskrit (Indian) literature by Susruta, charaka, Vagbhata and the disease was named “Madhumeha”. They described that the urine of these patients tasted like honey (madhu), sticky to touch and Ants were strongly attracted to it. To correlate the blood sugar level with clinical manifestation of diabetic peripheral neuropathy in type 2 diabetes mellitus. The study includes all type 2 diabetic patients who attended the department of medicine, ADICHUNCHANAGIRI INSTITUTE OF MEDICAL SCIENCES. This study period was from JANUARY 2016 to DECEMBER 2016 with 100 sample size. Majority of patients were in the age group > 70years. Out of 100 patients studied, 50 patients were male and 50 patients were females. Peripheral neuropathy was more commonly seen in male (42 cases) compared to female (37 cases). Increased duration of diabetes had significant relation to Neuropathy. Out of the 100 diabetic neuropathy patients 18 patients had good control (18%) and 28 patients had fair control (28%) and 54 patient had poor control of blood sugars (54%). Symptoms pertaining to the involvement of the nervous system due to diabetes mellitus were further analyzed in all 100 cases. Sensory involvements were seen in 72 cases and motor involvement in 31 cases. Diabetic neuropathy is common complication of Diabetes mellitus. It is generally considered to be related to duration and severity of hyperglycemia, usually more than 50% of patients with the duration of diabetes of 25yrs or more are affected, making it as the most common disease of Nervous system. It is well known that Diabetes mellitus is rising in an epidemic proportion in Indian subcontinent, prevalence of Diabetic Neuropathy in type -2DM of this country was reported to be 17 to 19% and that of Automatic Neuropathy of 35% of peripheral neuropathy cases.

Mandibular high condylar fracture is still challenging task for oral maxillofacial surgeon to go for open reduction and internal fixation. Due to the complex anatomy of temporomandibular joint. Most surgeon prefer closed reduction for such fractures. However, some prefer opening and fixing it in correct form and position to achieve appropriate function. Some cases require fixation of the fracture segment outside the socket and refixation with the rest segment which is termed as extracorporeal fixation. Hereby we present a similar case report of 21-year-old male with difficulty in opening and closing mouth and DE arranged occlusion following road traffic accident. On radiographic investigation medially displaced right high condyle and left sub condylar fracture was detected and open reduction and internal fixation was done by extracorporeal fixation of right segment and normal fixation of left segment. extracorporeal fixation is an effective method for management of displaced and dislocated condylar fracture to achieve proper form and function

Diabetes Mellitus is a metabolic disorder char¬acterized by the presence of chronic hyperglycemia ac¬companied by alterations in the carbohydrate, protein, and lipid metabolisms. It has become a global epidemic, the complications of which have a significant bearing on the quality of life and longevity of an individual. Long standing hyperglycemia which is unattended can results in widespread multisystem damage in the form of retinopathy, neuropathy, nephropathy, macrovasular disease, and delayed wound healing. This article intends to put forth a complete review on the oral manifestations as a sequle of diabetes mellitus

Tympanic membrane perforations are encountered by Otologists in clinical practice. It is the most common cause of hearing loss. We in the present study tried to evaluate the size and location of perforation to the degree of hearing loss and the outcome of treatment of these patients in our hospital. Methods: This prospective observational study was conducted in the Department of ENT, Rajiv Gandhi Institute of Medical Sciences [RIMS], Adilabad. A detailed clinical history including the name, age, sex, address, occupation, presenting complains, past history and physical examination and ENT examinations under microscopy was done to assess the size, site, and shape of perforation including Pure Tone Audiometry. All the patients underwent Myringoplasty through postaural approach using underlay technique taking temporalis fascia as graft material. Results: A total of n= 40 patients were included in the study male patients were n=24(60%) and n=16 (40%) were female patients and the male to female ratio was 6:4 with the predominance of male patients common cause of the injuries was related to RTA 18(45%). The right ear was involved in n=18(45%) of cases left ear was involved in n=21 (52.5%) and bilateral involvement was seen in n=1(2.5%) of cases. n=40 patients underwent myringoplasty in the Grade I perforations the preoperative hearing loss was 29.59 ± 6.65 and in the postoperative, after 12 weeks 17.05 ± 4.4 dB and the audiometric gain was 12.54 dB. In Grade II it was 35.40 ± 5.44 dB and postoperative 12 weeks were 18.51 ± 3.5 dB audiometric gains was 16.89 dB. The Grade III had pre-operative levels 37.95 ± 6.10 dB and the audiometric gain 19.84 dB and similarly in Grade IV 37.95 ± 6.10 dB and the audiometric gain was 25.95 dB. Conclusion: It can be concluded the tympanic membrane perforations are very common in men with the frequency of posterior perforations are greater and the hearing loss does not vary substantially with the location of the perforation. Surgical intervention of perforations is required when they fail to heal spontaneously and the audiometric gain following myringoplasty was more where the size of perforations was large

Myeoloproliferative syndrome can cause portal hypertension by inducing the formation of portal thrombosis. In this rectrospective study, we report all cases of portal hypertension caused by myeoloproliferative syndrome and the steps of the final diagnosis

Background and Aim: Anemia is a common and serious complication of chronic kidney disease (CKD). Despite the use of erythropoietin, anemia of CKD can be resistant to therapy. Hepcidin is the main iron regulatory hormone; increased hepcidin production during chronic inflammation interferes with iron absorption, prevents iron recycling leading to hypoferremia and iron-restricted erythropoiesis. Our study aims to evaluate the role of serum hepcidin in predicting the response to erythropoietin (EPO) therapy in children with CKD on regular hemodialysis. Subjects and methods: a cross sectional comparative study included 40 children with CKD on regular hemodialysis who received EPO therapy for at least 3 months and 40 age and sex matched healthy children. Assessment of anemia and iron profile before and after 3 months of EPO therapy and was correlated to the serum level of hepcidin. Results: in comparison to healthy controls, CKD children have significant anemia and high hepcidin level. CKD children have CKD children with high hepcidin level have significant lower hemoglobin and impaired response to EPO therapy in comparison to those with normal hepcidin level (P-value <0.005). There was significant negative correlation between serum hepcidin level and HB, HCT and iron level in children with CKD. Conclusion: children with CKD on regular dialysis have higher hepcidin level that interferes with the response of anemia to EPO therapy suggesting functional defect in iron utilization among those children

Odontogenic anomalies may sometimes be encountered in our routine dental practice. These anomalies may pose a challenge to the dentist, considering the magnitude of condition. Hyperdontia in the mandibular premolar region is a rare occurrence. We describe a case report of a 35-year-old male patient, presenting with concurrent occurrence of chronic periodontitis and supernumerary premolar, and a possible correlation between the two entities

Cutaneous metastasis is a condition where cancers originating from various parts of the body spread to the skin. There are rare but not unusual. The objective of our study is to study the epidemiological, clinical and evolutionary profiles of cutaneous metastases. Throw this retrospective study rendered over 6 years period from 2011 to 2016. 10 patients were selected from the dermatology department of Moulay Ismail’s Hospital in Meknes. We deduced the following: The sex- ratio M/F is 2.3, the average age is 60.9 years. Skin metastases appeared mostly during the evolution of the primary tumor. The preferred seat of the MCs in study was the trunk. The clinical appearance was mostly nodular. Adenocarcinoma (60%) was the most frequent histological form followed by squamous cell carcinoma (40%). Evolution was unfavorable, as 40% of the 60% of patients followed died at about 3 months after diagnosis of MCs. Skin metastases are a sign of poor prognosis, and occur most often at a late stage during the development of tumor pathology, but on the other hand, MCs may reveal underlying neoplasia. Its asymptomatic character makes early screening difficult