Establishing Cephalometric Norms in Primary Dentition Using Comprehensive Craniofacial Growth Analysis - A Digital Cephalometric Study

ABSTRACT Objective: To establish cephalometric norms in primary dentition among males and females using novel customized Comprehensive Cephalometric Growth (CCG) Analysis. Material and Methods: The study was conducted on 67 subjects with a mean age of 5.5 yrs. Digital lateral cephalometric radiographs were obtained using Planmeca Pro One. The digital images were then transferred to Nemoceph software. Craniofacial Growth (CCG) Analysis was configured in the software with five sub-groups. This sub-grouping was done such that related components were grouped together and comprehensively; it would provide an assessment of every component of the craniofacial region that could be affected either by treatment maneuver or growth process. The same was used for the cephalometric analysis and to determine the cephalometric norms in the primary dentition. Results: Certain linear measurements were higher among males when compared to females. However, most measurements remained similar among males and females during this age group. The CCG analysis provided a comprehensive knowledge of the craniofacial parameters during the growth process. Conclusion: The cephalometric norms during primary dentition thus established using Comprehensive Craniofacial Growth analysis would provide the data for early diagnosis and treatment planning in interceptive orthodontic treatment procedures.

Influence of Gestational Age on Eruption of Primary Teeth in Indian Children - A Prospective Longitudinal Study

Context: Eruption of primary teeth is the most anticipated event in a child’s life. Genetics, gender, socio?economic status, gestational age are a few of the determinants of the primary teeth eruption. However, the effect of gestational age on the timing of primary teeth eruption among the Indian population has not been explored to date. Aim: The study was conducted to evaluate the influence of gestational age on time and sequence of eruption of primary teeth among children of Mysore. Settings and Design: A prospective longitudinal cohort study design was conducted at ‘Baby Oral Health Promotion Clinic’ at the Department of Paediatrics, JSS Hospital, Mysore. Methods and Material: 150 newborn babies were recruited by simple random sampling and followed up from birth to 36 months. Teeth present during each visit were recorded. Data were statistically analysed and interpreted. Statistical Analysis Used: Descriptive statistics, t?test for an independent sample, and Pearson’s Chi?squared test were applied. Results: The mandibular central incisor was the first tooth to erupt. Statistically insignificant early eruption in males was noted in both term and preterm children. When the chronological ages were compared, the preterm group showed a statistically significant delay in the eruption of all the teeth. However, when the age was adjusted for prematurity, only the central incisors and second molars showed a statistically significant delay. Conclusions: Gestational age has a strong significant association with the eruption of primary teeth and maybe one of the strong predictors for delayed eruption among children of Mysore.

Comparative assessment of the efficacy of low concentration bleaching agents using quantitative light induced fluorescence in removing stains An In vitro study

Background: Tooth discoloration has become a common esthetic problem in recent years. Removal of stains by bleaching is well-documented. Low concentration home bleaching products are available in market in different forms and concentrations. Aim: The aim of this study is to evaluate and compare the efficacy of low concentration commercially available home bleaching products (whitening strip, gel, and mouthwash) in removing stains and whitening the tooth using clinical and digital methods. Materials and Methods: Sixty permanent enamel samples mounted in an acrylic block were artificially stained and randomly divided into four groups. Negative control, 15 % Carbamide peroxide gel group, 2% Hydrogen 16 peroxide mouthwash group and 6% Hydrogen peroxide strip group respectively. The samples were bleached with respective agents according to the manufacturer's instructions. The efficacy on 7th and 14th day was evaluated clinically (SGU change), photographically (?E), and using quantitative light-induced fluorescence (?F). The data were analyzed using paired t-test and analysis of variance. Results: Postbleaching, 6% hydrogen peroxide strips and 15% carbamide peroxide gel showed maximum improvement (??F – 15.73 and 11.89, ?E – 19.8 and 18.9, respectively) when compared to 2% hydrogen peroxide mouthwash and negative control group (??F – 9.68 and 6.59, ?E – 15.04 and 9.44, respectively). The difference was statistically significant (P = 0.001). Conclusion: 6% hydrogen peroxide strips and 15% carbamide peroxide gel showed maximum improvement in stain removal and tooth whitening however, the strips showed better efficacy than the gel. Strips have the added advantage of lesser contact period, less salivary dilution, and no gingival contact. Therefore, strips can be a better alternative for gels and mouthwashes.

Olfactory Reference Syndrome: a case report

Olfactory reference syndrome (ORS) is a psychiatric condition characterized by the false belief that an individual emits an offensive or foul odour from their body. It causes lot of embarrassment and social impairment to these patients. Treatment options include antidepressants and antipsychotics. Here we present a case of Olfactory Reference Syndrome who responded to combination of antipsychotics and antidepressant.

A cross-sectional study on eruption timing of primary teeth in children of Mysore, Karnataka

Eruption of first primary teeth is the most anxiously awaited developmental milestone in a child. However, primary teeth have shown wide variations in their eruption time among different population, ethnic, and racial groups. Aims: The present study was conducted with the aim to evaluate the time and sequence of eruption of primary teeth of children of Mysore. Settings and Design: A cross-sectional study design included 1392 participants aged 3 months to 36 months recruited by simple random sampling method. The variables such as age, gender, and number of erupted primary teeth were recorded. Subjects and Methods: Clinical examination was done under natural illumination. A tooth was considered erupted when any part of its crown had penetrated the gingiva and was visible in the oral cavity. Statistical Analysis Used: Probit regression analysis was performed to obtain the mean and median age of eruption of teeth. The significance of difference in the mean age of eruption across gender and arch was determined using paired t-test. Results and Conclusion: The first primary tooth to erupt was mandibular central incisor at 10.24 ± 2.47 months followed by maxillary central incisor at 11.06 ± 2.65 months. The duration of primary teeth eruption was 17.89 and 18.32 months in males, 18.54 months and 18.32 months in females for maxilla and mandible, respectively. Eruption of primary tooth is delayed among children of Mysore as compared to standard eruption chart. The results will provide information to health professional about contemporary tooth eruption time derived from an Indian population.

Malodor reductions and improved oral hygiene by toothbrushing and mouthrinsing.

Objective: This clinical study compared the effects of an antibacterial regimen, comprising a triclosan toothpaste and a 0.075% cetylpyridinium chloride (CPC) mouthrinse, on malodor, self‑reported malodor, and oral hygiene measures such as dental plaque, gingivitis, and bleeding relative to brushing with a fluoride toothpaste. Materials and Methods: At baseline, 36 subjects were evaluated for malodor (9‑point organoleptic scale [OLT]), dental plaque (Turesky modification of Quigley‑Hein; PI), gingivitis (Löe‑Silness; GI) and bleeding (Ainamo and Bay; BI) and randomized to (1) tooth brushing with fluoride toothpaste, or (2) a regimen comprising tooth brushing with a triclosan toothpaste and mouth rinsing with CPC mouthrinse. After the first use of assigned treatments, subjects were evaluated for malodor 2 h after breakfast (OLT‑2 h) and used provided treatments for the next 14 days. On the 7th and 14th days, subjects refrained from oral hygiene for 12 h before evaluations (OLT, PI, GI, and BI) and then performed oral hygiene at the dental clinic. Subjects were evaluated for malodor 2 h after breakfast (OLT‑2 h) and self‑assessed their malodor on a 100 mm visual analog scale (VAS). Results: Treatment groups demonstrated no significant differences in OLT, PI, GI, BI at baseline (P > 0.05). OLT‑2 h scores after the first use of regimen and after tooth brushing alone were 5.94 and 6.21, respectively, and were statistically significantly different (P < 0.05). Correspondingly, the regimen demonstrated progressive reductions in OLT and OLT‑2 h on the 7th and 14th day evaluations (5.81, 4.88, and 5.09, 4.20, respectively) and were significantly lower than after tooth brushing alone (6.49, 6.18, and 6.35, 5.99, respectively) (P < 0.05). From the 7th to 14th days, the regimen also demonstrated progressively lower PI, GI, BI, and self‑reported malodor (VAS scores) which were significantly lower than tooth brushing alone (P < 0.05). Conclusions: Results from this study demonstrated that a regimen comprising a triclosan toothpaste and CPC mouthrinse demonstrated significant malodor reductions 2 h after the first use and progressively increasing reductions in malodor, dental plaque, gingivitis, bleeding and self‑reported malodor from the 7th to 14th days than tooth brushing alone.

Frequency of left main artery/three vessel disease predicted through ECG changes in patients presenting with non-ST segment acute coronary syndrome

Background: Electrocardiography [ECG] is simple, quick and economic investigation for diagnosis of acute coronary syndrome. Its applicability in prediction of left main coronary artery/ 3 vessel coronary disease can be of very useful in saving precious time in the critical care of coronary patients

Objective: Electrocardiography changes as a predictor of left main coronary artery / 3 vesselcoronary disease in patients presenting with Non-ST segment elevation acute coronary syndrome

Methodology: This cross sectional study was executed from July 2014 to June 2015 at Isra University hospital Hyderabad taking 114 consecutive patients of age >/=20, of either gender, presenting with symptoms of Non-ST segment elevation MI or that showed ECG changes in lead aVR. Informed written consent for the study was taken from the immediate family members of patients. Approval from ethics review committee of Isra University was taken. Data analysis was done through SPSS. Descriptive statistics [Mean +/-standard deviation for continuous and frequencies and percentages for categorical variables] were expressed

Results: Patients' mean +/-SD age was 56.65 +/-15.44 years [Range: 20-89 years]. Male to female ratio was 3.4:1. More than a half [52%] of these patients had Left main [LM] / 3 vessels disease. About a quarter other [25%] had 2 vessels while [22%] had single vessel disease [P value <0.0001]. Patients having ST elevation in lead aVR, were associated with increased risk of developing LM / three vessels disease [P value <0.0001]

Conclusion: ST elevation in lead aVR and ST depression in leads II, III, and aVF can be practically used for evaluation left main / 3 vessel disease among NSTE-ACS patients

Comparative evaluation of shear bond strength of nano‑hydroxyapatite incorporated glass ionomer cement and conventional glass ionomer cement on dense synthetic hydroxyapatite disk: An in vitro study.

Aim: The aim was to evaluate and compare the shear bond strength of nano‑hydroxyapatite (Nano‑HAp) incorporated and conventional glass ionomer cement (GIC). Materials and Methods: Nano‑HAp GIC was prepared by replacing 8 wt% of GIC powder with nano‑HAp powder. Twenty‑six HAp disks were used as substrate for bonding and divided into two equal groups. Before bonding the HAp disk was prepared by silicon carbide (no. 2500) followed by 10% polyacrylic acid conditioning. The standardized samples were prepared using split teflon mold on customized bonding jig so as to adhere testing materials to pretreated HAp disk. These samples were stored in distilled water for 24 h at 37°C before bond strength testing. Results: The descriptive statistical analysis and independent samples t‑test were used. The nano‑HAp incorporated and conventional GIC had the mean shear bond strength of 3.28 ± 0.89 MPa and 5.25 ± 0.88 MPa, respectively. Nano‑HAp incorporated GIC had lower shear bond strength with very high level of significance (P < 0.001). The nano‑HAp incorporated GIC showed mainly mixed type of failure whereas conventional GIC showed mainly a cohesive failure. Conclusion: The lower shear bond strength of nano‑HAp incorporate GIC revealed that the addition of nano‑HAp interfered with the bonding ability of GIC to the substrate interface, but the mixed type of failure in nano‑HAp incorporated GIC suggests that it increases the strength of the matrix. However, the role of nano‑size particles on the micro‑size particles of GIC for the bonding mechanism and the ratio and proportions of nano‑HAp to the GIC needs further elucidation.

Medico Legal Awareness:Where are we? – A Survey among Health Professionals in Maharashtra and Haryana

Medicine is a noble profession but there is also growing anxiety both within the medical profession and in the community regarding increasing trends of complaints and lawsuits against doctors. Knowledge about medical ethics is as fundamental to the practice of medicine as clinical skills. To assess the knowledge of health care professionals regarding medico-legal issues. The questionnaire study consisted of questions pertaining to basic knowledge of COPRA (Consumer Protection Act 1984), informed consent and Medico-legal courses. A total of 325 health care professionals enrolled for the study. Most of the health care professionals were able to answer questions about informed consent. Almost 80% of health professionals were aware about informed consent, 41.84% of health professionals were not aware about consumer protection act 92%of health professionals don’t know about the courses regarding Medico-legal issues. The participants were knowledgeable about medical ethics and informed consent but when it came to Consumer Protection act, professional indemnity claim and medico- legal courses their information was basic, they lacked knowledge about finer details hence showed an immediate need to update the understanding of these issues to be on legally safer side.​

Acute myocardial infarction; a comparative study to assess the angiographic changes in diabetic and non diabetic patients

To compare the angiographic findings in patients with acute myocardial infarction [AMI] and compare it with diabetic and non-diabetic patients admitted in the cardiology department of LUHMS. Descriptive analytical study. Department of cardiology at Liaquat University of Medical and Health Sciences [LUMHS] Hospital, Hyderabad. Periods of 1[st] June 2012 to 31[st] July 2013. All patients with AMI and had diabetes mellitus and age eighteen or more than eighteen years both male and female were included after taking informed consent. Out of 297 patients diagnosed as AMI, 195 [65.65%] patients had acute ST elevation Myocardial Infarction and 102 [34.35%] patients had acute non ST elevation myocardial infarction. Among 297 patients, 190 [64%] patients were non-diabetic and 107 [36%] patients were diabetic. Diabetic patients were older, more often males, but prevalence of smoking was less marked. Coronary angiographic findings among patients with AMI and diabetics revealed three vessels disease. Older patients with male predominance presented with AMI and had diabetes mellitus were found to have three vessels disease in coronary angiography

Comparative evaluation of remineralization potential of casein phosphopeptide-amorphous calcium phosphate and casein phosphopeptide-amorphous calcium phosphate fluoride on artificial enamel white spot lesion: An in vitro light fluorescence study.

Background: World-wide, the contribution of dental caries to the burden of oral diseases is about 10 times higher than that of periodontal disease, the other common oral condition. Owing to its globally high prevalence, dental caries is a "pandemic" disease characterized by a high percentage of untreated carious cavities causing pain, discomfort and functional limitations. Untreated carious cavities; furthermore, have a significant impact on the general health of children and on the social and economic well-being of communities. A surgical approach to the elimination of carious lesion was developed a century ago; this approach was necessary at that time, because there was no valid alternative. The focus in caries has recently shifted to the development of methodologies for the detection of the early stages of caries lesions and the non-invasive treatment of these lesions. The non-invasive treatment of early lesions by remineralization has the potential to be a major advance in the clinical management of the disease. Remineralization of white-spot lesions may be possible with a variety of currently available agents containing fluoride, bioavailable calcium and phosphate and phosphate. This concept bridges the traditional gap between prevention and surgical procedures, which is just what dentistry needs today. Aims and Objectives: The aim of this in vitro study was to evaluate and to compare the remineralization potential of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) and casein phosphopeptide-amorphous calcium fluoride phosphate (CPP-ACFP) on artificial white spot enamel lesions using the quantitative light fluorescence (QLF). Materials and Methods: A total of 45 caries-free extracted maxillary first premolars were embedded in acrylic resin. The samples were randomly divided into three groups namely control group, CPP-ACP group and CPP-ACFP group with 15 samples in each group. The samples of each group were subjected to demineralization process for a period of 96 h. The samples were then mounted in the artificial mouth model and subjected to remineralization and pH cycling for a period of 21 days. QLF readings were recorded at the end of demineralization (1 st , 7 th , 14 th and 21 st day) and were statistically analyzed. Results: As compared with artificial saliva both CPP-ACP and CPP-ACFP produced significant amount of remineralization of the artificial enamel white spot lesion (P < 0.001), however when the remineralizing effect of CPP-ACP was compared with the remineralizing effect of CPP-ACFP there was no significant difference. Significant amount of remineralization was produced by CPP-ACP and CPP-ACFP only after the 7 th day. After the 14 th day, the remineralization produced by both CPP-ACP and CPP-ACFP as compared to artificial saliva was non-significant.

Management and outcome of bracka's procedure on penile shaft hypospadias

OBJECTIVES: To evaluate the outcome of Bracka's procedure in patients with penile hypospadias

MATERIAL AND METHODS: All the patients from urology, plastic surgery and Pediatric Surgery Departments at LUHMS Jamshoro from October 2007 to September 2008 having penile shaft hypospadias were included in this study. Patients who were above age 15 years, other congenital and already circumscribed penis were excluded from this study. Detailed examination of the patients such as position and size of abnormal meatus, the presence of chordee, the quality and width of urethral plate and the configuration of glans penis were noted. All the patients were operated under general anesthesia. The surgical technique applied on the basis of stage 1 and 2. The data were entered and analyzed in Statistical Program SPSS version 16.0

Results: Total number of 30 cases was included in this study. Twenty one [70%] patients had the Distal Penile Hypospadias, 6 [20%] had the Proximal penile and 3 [10%] patients had mid penile Hypospadias. Various post-operative Complications were noted, chordee 2 [6.7%], lnfection 1[ 3.3%], and loss of split thickness skin graft 1[3.3%], while after stage II, 2[6.7%] developed fistula formation and in 2 [6.7%] developed edema. In this study the outcomes of Bracka's procedure include Voiding direction and meatal opening, 29 out of 30 patients had straight voiding direction and one patient had deviated voiding direction, similarly 29 out of 30 patients had near normal meatal opening and one had abnormal meatal opening

CONCLUSIONS: From our results we concluded that on the whole Bracka's two stage technique is simple, safe and versatile adjuvant to all types of hypospadias with minimal risk of complications and better out come

Role of laparoscopy in peritonitis

Laparoscopy has gained clinical acceptance in many subspecialties in the last decade. The conventional open surgery for peritonitis carries significant morbidity and mortality. The present study was done to extend and evaluate benefits of minimally invasive surgery in this subset of patients. This was a prospective study spanning over a period of four years. All those patients diagnosed as having peritonitis on clinical assessment and preoperative investigations and those who were stable enough haemodynamically were included in this study. After initial resuscitation for few hours, they underwent diagnostic and therapeutic laparoscopy to identify the cause of peritonitis and to confirm the pathology. All cases were done under general anesthesia, using three standard ports at appropriate sites according to pathology. Patients were treated by different procedures either laparoscopically or with laparoscopic assistance after diagnosis. Operative and post operative data was collected and analyzed. Ninety two cases of peritonitis underwent diagnostic and therapeutic laparoscopy. Mean age of patient was 46.5 years. 24 patients were diagnosed as perforated duodenal, in 14 [58.3%] patients laparoscopic suture repair was done and in 8 [33.3%] small upper midline incision was given and perforation was repaired. Out of 32 patients having perforated appendix, 25 [78.1%] patients laparoscopic appendectomy was done while in 7 [21.8%] perforation was dealt by laparoscopic assistance. Out of 14 patients of ileal perforation 6 [42.8%] with minimal contamination laparoscopic suture was applied, while in 8 [57.1%], perforated loop was brought out by making small window and perforation was closed. All 22 patients with pelvic sepsis needed only aspiration of pus and peritoneal lavage. Only one patient died post operatively and 2 [2.1%] patients developed fistula. 6 [6.5%] patients developed port site infection. Laparoscopic management is feasible, safe and effective surgical option for patients with peritonitis due to different abdominal emergencies in properly selected cases with higher diagnostic yield and a faster postoperative recovery

Plastinated fetus: 3D CT scan (VRT) evaluation.

Objective: The intent of this study was to evaluate the effect of plastination on the morphology and structure of stored organs, to find out how much accuracy a plastinated specimen has, and to look into the changes that occurred because of plastination. Materials and Methods: A human fetus of gestational age 24 weeks was plastinated, and 3D CT scan evaluation of the fetus was done. Results: The results showed normal, well-defined, clearly identifiable organs, with no alteration in morphology and structure of organs. Conclusion: In our opinion, plastinated specimens are better way of visualization of morphology and structure of stored organs, which is a useful tool for teaching as well as for research purposes.

Congenital soft tissue Ewing's sarcoma

A 15 days old female baby presented with a 6 x 7 cm reddish lump with irregular margins on her right scapular region, since birth. Histopathology and immunohistochemistry of excised tissue revealed it to be soft tissue Ewing's sarcoma. Postoperatively, she received only one dose of chemotherapy but could not survive and expired at the age of one month

Our experience of bleomycin sclerotherapy for peripheral lymphangioma in children and review of the literature

To assess the efficacy of intralesional bleomycin in peripheral lymphangioma in children. This prospective study was conducted at the Department of Pediatric Surgery at Liaquat University of Medical and Health Sciences Jamshoro/Hyderabad from January 2005 to December 2009 .Patients included in this study were only with peripheral lymphngioma, while those with visceral lesions or previously operated for lymphangiomas were excluded. Diagnostic tools for lymphangioma were physical examination and ultrasound. All patients had aspiration of lesion with 20-24 gauge needle and intralesional injection therapy with bleomycin with dosage of 0.5mg/kg body weight diluted in normal saline. The procedure was performed as out patients. Patients were followed up at four weeks interval for up to six months. Personal data, procedure, complications and follow up were recorded on pre-designed proforma. Total number of patients included in this study was 20, with13 males and 7 females. Reduction in size was noted in 75%. Excellent response was seen in 9 [45%] patients who had cystic lymphangioma, while 6[30%] patients showed good response and 5[25%] had poor response. Common site was neck [65%].Transient increase in size of lesion and cellulitis were observed in three patients and treated conservatively. Intralesional bleomycin is excellent in cystic lymphangioma, while it had good response in mixed lymphangioma. We suggest bleomycin as a primary therapy in all varieties of lymphangiomas

Laparoscopic cholecystectomy without the use of drain in selected cases

Objective: To observe the effects of omitting the routine drainage after laparoscopic cholecystectomy, with respect to hospital stay, morbidity, and mortality

Methodology:This comparative observational study was carried out in the Department of Surgery, Liaquat University of Medical and Health Sciences, Jamshoro, from January 2009 to December 2009. During study period 100 consecutive cases of cholelithiasis, underwent laparoscopic cholecystectomy. The patients were divided in two groups; group A without drain and group B with drain. The effects of omitting the drain, regarding hospital stay, morbidity, and mortality were observed

Results: This study consists of 100 patients [male 22 and females78] with male female ratio of 1:3.54 and mean age of 37.86 years. Post operative hospital stay in patients without drain was 2.1 days as compared to 3.58 days for those with drain [p-value 0.000]. Moreover the use of drain has also been found to be associated with significant drain site pain / discomfort. There was no mortality in any group

Conclusion: We have observed that routine placement of drain after laparoscopic cholecystectomy, not only prolongs the post-operative hospital stay; it also leads to drain site pain / discomfort

Gastric perforation in newborns: analysis of 14 cases

Objective: Neonatal gastric perforation is a rare entity with poor prognosis. Etiology of this anomaly is unknown but prematurity, low birth weight and hypoxia is considered as contributing factors. The purpose of this study is to share our experience regarding the etiology, clinical features and surgical outcome of neonatal gastric perforation

Methodology:We reviewed the data of all newborn with gastric perforation in Liaquat University Hospital as well as in private practice, from July 2003 to June 2010 with respect to age , sex, weight, parity, mode of delivery, clinical presentations, investigations, associated anomalies and surgical outcome

Results: There were 14 patients, 9 males and 5 females. Birth weight ranged from 1.6 kg to 3 kg with mean of 2.3 kg. Out of 14 babies 11[87.57%] were full term and 3[21.42%] preterm. Clinical features observed were abdominal distension, respiratory distress, vomiting and hematemesis. Associated anomalies were found in three patients, which were Down's syndrome, talipes equinovarus and bilateral inguinal herniae with hypospadias. Most of the patients had spontaneous gastric perforation and few might had ischemic cause. Nine had perforation on posterior wall of body of stomach and three on posterior wall of greater curvature of stomach while two had on anterior wall of body of stomach and anterior wall of greater curvature of stomach respectively. All the patients had primary closure of perforation along withintraperitoneal placement of drain. Complications observed in 4 [28.57%] cases, three term low birth weight and one preterm baby; wound dehiscence in two patients, who were re-operated, wound infection in one and pneumonia in one which were treated conservatively. Three patients 21.4% [two term low birth weight and one preterm] expired in this series due to septicemia

Conclusion: Prominent features in this study were low birth weight and perforation on the posterior surface of stomach. There is need to evaluate the correlation of these findings

Effect of prone versus supine position on oxygen saturation in patients with respiratory distress in neonates

To analyze the effect of prone versus supine position on oxygen saturation in neonates with respiratory distress. This comparative study was conducted in the department of paediatric medicine at Liaquat University Hospital Hyderabad during the period of six months. Total numbers of the patients enrolled were one hundred with age ranging three hours to 28 days. All the newborns with respiratory distress [RD] were kept in supine position for three hours after all necessary resuscitation measures and oxygen saturation was recorded with pulse oximeter. Then they were kept in prone position for six hours and oxygen saturation and respiratory rate was measured with two hour interval respectively for six hours. One hundred patients were enrolled in the study with age range 3 hours - 28 days, out of them 87 [87%] term, 9 [9%] preterm and 4 [4%] were post term respectively, male to female ratio was 1.2:1. The oxygen saturation in supine position was 84.84 +/- 4.20. After 2 hour in prone position saturation was 91.05 +/- 3.29, after 4 hour 91.62 +/- 3.89 and after 6 hours it was 92.63 +/- 3.02 respectively with P value of < 0.001 which is statistically highly significant. It shows that Oxygen saturation is increased by about 7%, and maximum oxygen saturation increases in first 2 hours. Similar trend was seen in respiratory rate with reduction of respiratory rate by 6 breaths / min in first two hours. Prone position improves oxygenation saturation and decreases respiratory distress as compared to supine position in neonates with respiratory distress

Radiographic and CT (VRT) Scan evaluation of incisive fissure in a plastinated fetus.

Incisive fissure is a well known anatomical structure in human palate. The term incisive fissure, given by Wood et al, was previously regarded as incisive suture. Incisive fissure on a radiograph is seen as bilateral radiolucent line on the palate during early fetal life. It disappears with age and generally cannot be seen on the palatal and nasal aspect of the adult skull. Plastination is a technic of preparing a dry, colored, nontoxic, durable, odorless, natural looking specimen. A human fetus of gestational age 24 weeks was plastinated, radiographs and 3D CT (VRT) Scan of the fetus was taken. The obtained images were studied and results were drawn.