iosr-JDMS Volume-12 ~ Issue-5

Abstract:Periodontal medicine defines a rapidly emerging branch of Periodontology focusing on establishing a strong relationship between periodontal health and systemic health. Periodontitis and rheumatoid arthritis are widely prevalent diseases and are characterized by tissue destruction due to chronic inflammation. Several prospective clinical trials have shown that individuals with rheumatoid arthritis are more likely to experience moderate to severe periodontal disease compared to their healthy counterparts. There are growing evidences that the two diseases share many pathological features. This review elaborates the common pathologic mechanisms of these two chronic conditions.Keywords:Bacteria, cytokines, inflammation, periodontitis, rheumatoid arthritis.

[1]. Papapanau PN. Periodontal disease: Epidemiology. Ann Periodontal 1996;1:1-36.
[2]. Alamanos Y, Drosos AA. Epidemiology of adult rheumatoid arthritis. Autoinnun Rev 2005;4:130-6.
[3]. Ciancio S, Ashley R. Safety and efficacy of sub-antimicrobial dose of doxycycline therapy in patients with adult periodontitis. Adv Dent Res 1998;12:27-31.
[4]. Cochran D. Inflammation and bone loss in periodontal disease. Journal of Periodontology. 2008;79:1569-76.
[5]。Hirschfeld L, Wasserman B. A long-term survey of tooth loss in 600 treated periodontal patients. J Periodontol 1978;49:225-237.
[6]。O'Sullivan JB, Cathcart ES. The prevalence of rheumatoid arthritis. Follow up evaluation of the effect of criteria on rates in Sudbury, Massachusetts. Ann Intern Med 1972;76:573-577.
[7]. Pincus T, Marcum SB, Callahan LF. Long term drug therapy for rheumatoid arthritis in seven rheumatology private practices: II. Second line drugs and prednisone. J Rheumatol 1992;19:1885-1894.
[8]。平卡斯T, Marcum某人,卡拉汉低频,等。长term drug therapy for rheumatoid arthritis in seven rheumalology private practices: I. Non-steroidal anti-inflammatory drugs. J Rheumatol 1992;19:1874-1884.
[9]. Wolfe F, Hawley DJ, Cathey MA. Termination of slow acting antirheumatic therapy in rheumatoid arthritis: A 14-year prospective evaluation of 1017 consecutive starts. J Rheumatol 1990;17:994-1002.
[10]. Page RC, Offenbacher S, Schroeder HE, Seymour GJ, Kornman KS. Advances in the pathogenesis of periodontitis: Summary of developments, clinical implications and future directions. Periodontol 2000 1997;14:216-248.

Abstract:脊髓麻醉是最普遍的过程之一dure used in clinical anaesthesia practice. It has the advantage that profound nerve block can be produced in a large part of the body by the relatively simple injection of a small amount of local anaesthetic.Hypotension is one of the most common event encountered with the procedure Hypotension and bradycardia during spinal anesthesia are common and may relate to severe adverse events such as cardiac arrest or death. Preventive measures include fluid preload, lateral tilt, and use of vasopressors. Search is still on for the pharmacological agents that can provide hemodynamic stability with neuraxial blockade.

[1]. Hala E A Eid MD, Mohamed A Shafie MD, Hend Youssef MD. Dose-Related Prolongation of Hyperbaric Bupivacaine Spinal Anesthesia by Dexmedetomidine Ain Shams Journal of Anaesthesiology, Cairo, Egypt
[2]. Liu S, McDonald S. Current issues in spinal anesthesia. Anesthesiology 2001; 94: 888-906.
[3]. Al- Ghanem S M., Massad IM., AlMustafa M M. , Al- Zaben K R., Qudaisat I Y, Qatawneh A M, AbuAli H M. Effect of Adding Dexmedetomidine versus Fentanyl to Intrathecal Bupivacaine on Spinal Block Characteristics in Gynecological Procedures: A Double Blind Controlled Study American Journal of Applied Sciences, 2009 6 (5): 882-887

Abstract:Cleft lip and palate can arise with considerable variation in severity and form. Generally, the wider, more extensive clefts are associated with more significant nasolabial deformity. These clefts, deficient in hard and soft tissue elements, present a significant surgical challenge to achieve a functional and cosmetic outcome. A finer scar forms when a surgical incision heals under less rather than more tension. The principal objective of presurgical nasoalveolar molding (NAM) is to reduce the severity of the initial cleft deformity. The nasoalveolar molding appliance is a modern presurgical orthopedic device that allows for a positive growth of the alveolar ridges into an improved arch form as well as reshaping of the flattened nose into a more symmetrical shape. As a result of the presurgical appliance, the nose and lip are allowed to heal under minimal tension, thereby reducing scar formation and improving the esthetic result. This case report describes the management of a bilateral cleft lip and palate case with the use of an active alveolar molding appliance which retracts the forwardly placed premaxilla into a more esthetic position prior to the primary surgical repair.Keywords:Nasoalveolar Molding, Presurgical Infant Orthopedics, Active Alveolar Molding Appliance, Cleft Lip And Cleft Palate

[1]. Ma X, Giacona MB. Nasoalveolar Molding as Treatment for Cleft Lip and Palate: A Case Report Columbia Dental Review. 13:20-24, 2009
[2]. Prasanth et al. Cleft orthopedics using Liou's technique - A Case Report, Journal of Dental Sciences and Research .2(1):122-131,2011
[3]. Yang et al. Use of Nasoalveolar Molding Appliance to Direct Growth in Newborn Patient With Complete Unilateral Cleft Lip and Palate. Pediatric Dentistry. 25(3):253-256, 2003
[4]. Suri S, Tompson BD. A Modified Muscle-Activated Maxillary Orthopedic Appliance For Presurgical Nasoalveolar Molding In Infants With Unilateral Cleft Lip And Palate. Cleft palate-Craniofacial Journal. 4(3):225-229, 2004
[5]。Karimi et al. Presurgical Nasoalveolar Molding in a Neonate With Bilateral Cleft Lip and Palate: Report of a Case. J Comprehensive Pediatrics. 3(2): 86-9, 2012.
[6]。Grayson et al. Nasoalveolar Molding For Infants Born With Clefts Of The Lip, Alveolus, And Palate. Seminars In Plastic Surgery. 19(4):294-301, 2005.
[7]. Splengler et al. Presurgical Nasoalveolar Molding Therapy For The Treatment Of Bilateral Cleft Lip And Palate: A Preliminary Study, Cleft Palate–Craniofacial Journal. 43(3):321-328, 2006.
[8]。Shetty et al. Pre-Surgical Nasoalveolar Molding In Patients With Unilateral Clefts Of Lip, Alveolus And Palate - A Case Report. Annals And Essences Of Dentistry. 3(2):50-52, 2011.
[9]. Abbott et al. Nasoalveolar molding in cleft care: is it efficacious? Plast Reconstr Surg.130(3):659-66, 2012.
[10]. Grayson BH, Shetye PR. Presurgical nasoalveolar moulding treatment in cleft lip and palate patients. Indian Journal of Plastic Surgery .42(3): 56-61, 2009.

Abstract:Gastrointestinal stromal tumors(GIST) have become a well established entity and its taxonomy is no more ambiguous but GIST of duodenum is rarely seen .In this paper , a patient presented with only recurrent pain abdomen and USG/CECT of abdomen revealed gallstone with 8x7x4.7 cm size mass lesion in the right hypochondrium, most likely arising from the second part of duodenum. The patient underwent cholecystectomy and wedge resection of tumor. The histopathology of the mass confirmed the diagnosis of duodenal stromal tumor.

[1]. Roberts PJ, Eisenberg B. Clinical presentation of gastrointestinal stromal tumors and treatment of operable disease. Eur J Cancer 2002;38 suppl 5:37-8.
[2]. Ignjatovic M. Gastrointestinal stromal tumors. Vojnosanit Pregl 2002;59:183-200.
[3]. Sturgeon C, Chejfec G, Espat NJ. Gastrointestinal stromal tumors: a spectrum of disease.Surg Oncol. 2003;12:21–26.
[4]. DeMatteo RP, Lewis JJ, Leung D, Mudan SS, Woodruff JM, Brennan MF. Two hundred gastrointestinal stromal tumors: recurrence patterns and prognostic factors for survival. Ann Surg. 2000;231:51–58.
[5]。DeMatteo RP, Heinrich MC, El-Rifai WM, Demetri G. Clinical management of gastrointestinal stromal tumors: Before and after STI-571. Human Pathol. 2002;33:466–67.
[6]。Winfield , Robert D, Hochwald , Steven N, Vogel , Stephen B, Hemming , Alan W, Liu , Chen , Cance , William G, Grobmyer , Stephen R. American Surgeon. 2006;72:719–23.
[7]. Rudolph P, Chiaravalli AM, Pauser U, et al. Gastrointestinal mesenchymal tumors-immunophenotypic classification and analysis. Wirchows Arch 2002;441:238-48.
[8]。Bergman J, O'Leary TJ. Gastrointestinal stromal tumors workshop. Hum Pathol 2001;23:578-82.
[9]. Mehmet Yildirim, Saras Yakan, et al. A rare cause of intestinal hemorrhage: Stromal tumor of duodenum.Turk J Cancer 2004; 34(4): 163-165.
[10]. Pidhorecly I, Cheney RT, Kraybill WG, et al. Gastrointestinal stromal tumors: Current diagnosis biologic behavior and management. Ann Surg Oncol 2000;7:705-12.

Abstract:Obesity and hypertension are non-communicable diseases of public interests. There is a strong interplay among the risk factors implicated in both Obesity and Hypertension. The alarming rate at which these diseases increase worldwide, calls for serious concern amongst the scientific community. The continuous presence of the risk factors associated with these diseases, eventually leads to dreadful complications that may ultimately results in morbidities affecting the quality of life.

[1]. Flegal KM, Carroll MD, Kuczermarski RJ, Johnson CL. Overweight in the US. Int J Obes Relat Metab Disord. 1988;22:39–4.
[2]. Delpeuch F, Maire B. Obesity and developing countries of the south. Med Trop. 1997;57:380–388.

[3]. Sobal J, Stunkard AJ. Socioeconomic status and obesity: a review of the literature. Psycho Bull. 1989;105:260–275.
[4]. Gortmaker SL, Must A, Perrin JM, Sobal AM, Dietz WH. Social and economic consequences of overweight in adolescence and young adulthood. N Engl J Med.

[5]。斋月J, Barac-Nieto m .报道的频率of physical activity, fitness, and fatness in Kuwait. Am J Hum Bio. 2003;15(4):514–521.

[6]。Al Muhailan ARS, Ramadan J, Gjorgov AN, Moussa M. Assessment of selected coronary risk factors in adult Kuwaiti males. Med Princip Pract. 1990;2:199–203.

[7]. Cooper R, Rotimi C. Hypertension in blacks. Am J Hypertens. 1997;10:804–812.

[8]。Cooper R, Rotimi C, Ataman S, et al. The prevalence of hypertension in seven populations of West African origin. Am J Publ Health. 1997;87:160–168.

[9]. Gwatkin D, Guillot M, Heuveline P. The burden of disease among the global poor. Lancet. 1999;354:586–589.

[10]. Cappuccio FP, Cook DG, Atkinson RW, Strazzullo P. Prevalence, detection, and management of cardiovascular risk factors in different ethnic groups in south London. Heart. 1997;78:555–563.

Abstract:Circumcision is an operation practiced in various parts of the world for different reasons. In Nigeria today, circumcision is a customary rite for males and occasionally done in females in some parts of the country. The process of circumcision which appear simple to the untrained hands could be associated with severe complications and may even result in mortality.

[1]. Okeke LI, Asinobi AA, Ikuerowo OS, Epidemiology of complication of male circumcision in Ibadan, Nigeria. BMC urol. 2006;6:21. PubMed
[2]. Agugua N.E.N, Egwuatu V.E. Female Circumcision: Management of Urinary Complications.
[3]. J Trop Pediatr 1982;28:248-252. PubMed
[4]. Myers RA, Omorodion FI, Isenalumhe AE, Akenzua GI.
[5]。Circumcision: its nature and practice among some ethnic groups in southern Nigeria.
[6]。Soc Sci Med. 1985;21:581-8. PubMed
[7]. ORTUN M, David LB. Traditional male circumcision in the Eastern cape-scourge or blessing? SAMJ 2007;97:371-373. PubMed
[8]。Magoha GA. Circumcision in various Nigeria and Kenya hospitals.
[9]. East Afr med J. 1999, 76:583-586. PubMed
[10]. Ben Chaim J, Levin PM, Binyamin J, Hardak B, Ben-Meir D, Mor Y: Complications of circumcision in Israel: a one year multi-center survey. Isr Med Assoc J 2005, 7:368-70. PubMed

Abstract:冻结了n section is a highly accurate and useful procedure wherein knowledge of the clinical presentation, good rapport with the operating surgeon, pathologist's experience and in depth knowledge of the subject, awareness of the limitations of the procedure, ability to provide a rapid and reliable diagnosis under pressure are of great importance. The correlation between intra operative frozen section diagnoses with final histopathological diagnosis is an integral part of quality assurance in surgical pathology. The indication, methodology, discordance of result, causes for the discordance and deferrals were analysed to improve the accuracy of frozen section diagnosis and to minimise the avoidable errors.

[1] Jerome BT. Frozen section and surgical pathologist. Arch Pathol Lab Med 2009; 133:1135-1138.
[2] Hwang TS, Ham EK, Kim CW. et al. An evaluation of frozen section biopsy in 4434 cases. Journal of Korean Medical Science 1987; 2:239-245.
[3] Rebecca D. Folkerth. Smears and Frozen sections in the intra operative diagnosis of central nervous system lesions. Neuropathol 1994:5; 1-18.
[4] Silva EG, Kraemer BB. Intra operative Pathologic Diagnosis. Frozen section and Other techniques.1987
[5] Hull ME, Hunphrey PA, Pfeifer JD. Washington manual of surgical pathology. Elsevier 2006; First Edition: Chapter 51.
[6] Susan CL .Manual of Surgical Pathology. Elsevier 2006; Second Edition: 49-69.
[7] Gephardt GN, Zarbo RJ. International comparison of frozen section consultation. A college of American Pathologists Q-probe study of 90,538 cases in 461 institutions.
[8] Aijaz F,Muzaffar S, Hussainy AS,Pervez S. et al. Intra operative frozen section consultation: an analysis of accuracy in a teaching hospital. J Pak Med Assoc 1993;43(12):253-255.
[9] Novis DA, Gephardt GN, Zarbo RJ. Inter institutional comparison of frozen section consultation in small hospitals: a college of American Pathologists QProbes study of 18,532 frozen section consultation diagnoses in 233 small hospital.Arch Pathol Lab Med 1996;120(12):1087-1093.
[10] Ahmad Z, Barakzai MA Idrees R.et。Correlation of intra operative frozen section consultation with the final diagnosis at a referral center in Karachi, Pakisthan. Am J Surg 1993:166(4):424 – 427Dankwa EK, Davies JD. Frozen section diagnosis: an audit. J Clin Pathol 1985; 38:1235-1240

Abstract:Adult Sacrococcygeal teratomas are very rare with female preponderance.
The manuscript is a review of this rare tumor presenting in adulthood and review of literature. We report a case of sacrococcygeal teratoma in an adult female complicated by acute urinary retention and intestine obstruction. She had a 26 year old mass at the same site excised 10 year before the current presentation. In conclusion sacrococcygeal teratomas are rare especially in adults and usually present in complicated state and with high incidence of recurrence.

[1]. Abubakar Am,Nggada HA,Chinda JY. Sacrococcygeal tetratoma in Northeastern Nigeria:18 year experience .Pediatr Surg Int 2005, 21;645-648 (pubmed Abstract).
[2]. M. Monteiro, TM Cunha, A Catarino, V Tome : Sacrococcygeal teratoma with malignanttransformation in an adult female :CT and MRI findings.
[3]. Valdiserri RO, Younis EJ. Sacrococcygeal teratoma: a review of 68 cases cancer 1981; 48:217-221.
[4]. Ajuwape O.O., Ogundoyin O.O., Ogulana D I, Adeleye A.O.;Adult Sacrococcygeal teratoma: A case report Ghana Med J. 2009 March; 43(1); 40 -42.
[5]。Harbon S,Pheline y.Grant sacrococcygeal teratoma in adult.Ann Chir Esthet:1989,34:153-159.
[6]。Ghosh J, Eglinton T, Frizelle FA,沃森AJ: Presacral tumour in adults.Surrgeon.2007;5(1):31-38
[7]. Ng EW, Porcu P, Loehrer PJ Sr, Sacrococcygeal teratoma in adults; case reports and a review of the Literature. Cancer 1999, 86:1199-1202.
[8]。Juan Rosai: Sacrococcygeal region; germ cell tumors .in Rasai and Ackerman's Surgical Pathology. 9th Ed ,2:2401-2.
[9]. Audet IM, Goldhahn RT, Dent TL,Adult sacrococcygeal teratomas.Am surg. 2000;66(1):61-65.
[10]. Mahour GH,Sacrococcygeal teratomas. CA Cancer J Clin .1988;38(6):362-367.

Abstract:Temporomandibular joint (TMJ) ankylosis is defined as osseous or fibrous fusion of the condyle of the mandible and the mandibular fossa of temporal bone (Nitzan et. al. 1998).It is a debilitating disease that renders the afflicted person unable to use their oral cavity well. Clinical presentation depends on the age at which ankylosis occurs and whether ankylosis is unilateral or bilateral. Surgery and postoperative physiotherapy are regarded as the mainstay treatment for TMJ ankylosis. The study reviews surgical outcomes of 13 children treated for temporomandibular joint (TMJ) ankylosis in the maxillofacial and oral surgery unit at Red Cross Children' s Hospital. Nine patients were treated by gap arthroplasty, while four patients had previous reconstruction with costochondral graft. One patient treated by gap arthroplastyreankylosed.The study showed a positive correlation between intraoperative MIO and the outcome, and between age and the outcome. Mouth opening was improved by With postoperative change of -4mm.

[1]. Nitzan D.W.; Bar-Ziv B; Shteyer A 1998Surgical management of temporomandibular joint Ankylosis Type III by relating the displaced condyle and discJ. Oral Maxillofac. Surg. 56: 1133-1138
[2]. Elgazzar RF; AbdelhadyAI, SaadKA et al 2010Treatment modalities of TMJ ankylosis: experience in Delta Nile, EgyptInt. J Oral Maxillofac.Surg 39:333 – 342
[3]. Danda AK, Ramkumar S and Chinnaswami 2009Comparison of Gap Arthroplasty With and without a temporalis Muscle Flap for the Treatment of Ankylosis J Oral MaxillofacSurg 2009; 67:1425-1431
[4]. El-Mofty S 1974 Surgical treatment of ankylosis of the temporomandibular joint.J. Oral Surg. 32:202-206
[5]。Andrade NN, RaikwarKanchan R 2009 Management of Patients with Obstructive SleepApnoea Induced by Temporomandibular Joint Ankylosis: a novel 2-Stage Surgical Protocol and Report o 5 Cases. Asian J Oral Maxillofac Surg. 2009;21:27-32
[6]。Jain G, Kumar S, Rana Samar et al 2008 Temporomandibular joint ankylosis: a review of 44 cases Oral MaxillofacSurg 2008;12:61-66
[7]. El-Mofty S. 1972 Ankylosis of the temporomandibular joint Oral Surg. 33:650-660
[8]。El-Sheikh Mohammad M.1999 Temporomandibular joint ankylosis: the Egyptian experience. Ann. R. Coll. Surg. Engl. 81:12-18
[9]. SarmaU.C.and Dave P.K. 1991 Temporomandibular joint Ankylosis : An Indian experience Oral Surgery Oral Medicine Oral Pathology 72:660-664
[10]. Kazanjian, V.H.1938 Ankylosis of the temporomandibular joint Am. J. Orthodontia 24:1181-1206Topazian R.G.1966.

Abstract:An Enterocutaneous fistulae (ECF) also known Gastro-intestinal fistulae, communicates between stomach, small or large bowel and skin, allowing gastrointestinal contents to flow on to the skin. The majority of ECF (75% - 90%) are the result of previous surgeries but it is estimated that 10% - 25% of the patients may develop an ECF without having had a surgical procedure. Negative pressure wound therapy (NPWT) is used extensively in the acute and chronic wound care arena of health care. It has become a standard of care for many types of wound from non-healing diabetic foot ulcer and burns to traumatic and surgical wounds. Recently attention has been paid using this system for the treatment of catastrophic abdominal wounds and open abdomen with ECF. We present 3 cases of ECF arising within open abdomen managed successfully by Vacuum assisted Negative pressure wound therapy.

[1]. Satwicki SP, Braslow BM. Gastrointestinal fistulae. OPUS 12 Scientist 2008; 2(1): 13-16.
[2]. Denham DW, Fabri PJ. Enterocutaneous fistula. In: Cameron JL, Ed. Current Surgical Therapy, 7th ed. St Louis: Mosby. 2001.
[3]. J. Cipolla et al. Negative pressure wound therapy: Unusual and Innovative applications. OPUS 12 Scientist. 2008; 2 (3); 15-29.
[4]. Berry SM & Fischer JE. Classification and pathophysiology of enterocutaneous fistulas. Surg Clin North Am 1996; 76: 1009-1018.
[5]。Cameron J. Current Surgical Therapy. 7th ed. St. Louis, MO: Mosby; 2001. Pp. 156-161.
[6]。Haffejee A A. Surgical management of high output enterocutaneous fistulae: a 24-year experience. Curr Opin Clin Nutr Metab Care. 2004; 7: 309-316.
[7]. Makhdoom Z A, Komar M J, Still C D. Nutrition and enterocutaneous fistulas. J Clin Gastroenterol. 2000; 31: 195-204.
[8]。Sinha S K, Sethy P K, Kaman L, et al. Multiple spontaneous enterocutaneous fistulae in malakoplakia. Indian J Gastroenterol. 2003; 22: 234-235.
[9]. Schein M, Decker G A. Postoperative external alimentary tract fistulas. In Bryant R (ed.), Acute and Chronic Wounds. St. Louis: Mosby. 1991: 74.
[10]. D'Harcour J B, Boverie J H, Dondelinger R F. Percutaneous management of enterocutaneous fistulas. AJR Am J Roentgenol. 1996; 167: 33-38.

Abstract:This review is aimed at studying the initial alignment efficiency and pain experience of Self ligating brackets and comparing them with conventionally ligated brackets. Materials and Methodology: Electronic databases were searched without limits for this review (Pubmed, Google, Medline). Studies that addressed initial alignment and pain experience of self ligating brackets were analysed and reviewed. In addition, a manual search was done to search the missed articles during electronic search. Results: 5 studies were included out of which three were randomised control trials and two were clinical control trials. Three review articles on Self ligating brackets were obtained. Subjective pain experience and initial alignment of Self ligating brackets were analysed.

[1]. Schwartz's Principles of Surgery. (2010), McGraw Hill.
[2]. Sabiston Textbook of Surgery. (2008), Saunders.
[3]. Mastery of Surgery. (2007), LWW.
[4]. Adams D B, Ford M C, Anderson M C. Outcome after lateral pancreaticojejunostomy for chronic pancreatitis. Department of
Surgery, Medical University of South Carolina, Charleston, South Carolina
[5]。Mannell A, Adson MA, Mcllrath DC, Ilstrup DM. Surgical Management of Chronic Pancreatitis: long-term results in 141
patients. BrJSurg 1988 75:467-472.
[6]。Greenlee HB, Prinz RA, Aranha GV. Long-term results of side-to side pancreaticojejunostomy. World J Surg 1990; 14:70-76.
[7]. Leger, L. and Lenriot, J. P.: Five to Twenty Year Follow-up After Surgery for Chronic Pancreatitis in 148 Patients. Ann. Surg.,
184:185, 1974.
[8]。Way LW, Gadacz T, Goldman L. Surgical treatment of chronic pancreatitis. Am J Surg 1974; 127: 202-209.
[9]. Jordan GL, Strug BS, Crowder WE. Current status of pancreatojejunostomy in the management of chronic pancreatitis. Am J
Surg 1977; 133:46-5 1.
[10]. Bradley EL III. Long-term results of side-to side pancreaticojejunostomy. World J Surg 1990; 14:70-76

Abstract:AIM- To assess the benefit of Lateral Pancreaticojejunostomy (LPJ) in patients with chronic pancreatitis. MATERIALS AND METHODS-45 patients of chronic pancreatitis at Civil hospital of Ahmedabad, with Major pancreatic duct of 6 mm or more and not responding to analgesics, were treated by Lateral Pancreaticojejunostomy. Follow up of the operated patients was done over three years either in person or by telephonic interview. Data was analysed using chi-square test. RESULTS- Immediate Post-op morbidity rate was 13.3%; mortality rate was 7.14%. 1 patient died later secondary to chronic pancreatitis. Rehospitalization for recurrent attacks of pancreatitis and pain was necessary in 16.7% of patients. 7% patients required revision surgery for chronic pancreatitis. Overall Health status was characterized as good in 16, fair in 20 and poor in 6 patients. Insulin/oral hypoglycemics use continued in 11.9% patients; however the daily dose was decreased following surgery. One patient was diagnosed as having Diabetes Mellitus 3 months after surgery. Pancreatic enzyme supplementation was required in 31%.

[1]. Abubakar Am,Nggada HA,Chinda JY. Sacrococcygeal tetratoma in Northeastern Nigeria:18 year experience .Pediatr Surg Int 2005, 21;645-648 (pubmed Abstract).
[2]. M. Monteiro, TM Cunha, A Catarino, V Tome : Sacrococcygeal teratoma with malignanttransformation in an adult female :CT and MRI findings.
[3]. Valdiserri RO, Younis EJ. Sacrococcygeal teratoma: a review of 68 cases cancer 1981; 48:217-221.
[4]. Ajuwape O.O., Ogundoyin O.O., Ogulana D I, Adeleye A.O.;Adult Sacrococcygeal teratoma: A case report Ghana Med J. 2009 March; 43(1); 40 -42.
[5]。Harbon S,Pheline y.Grant sacrococcygeal teratoma in adult.Ann Chir Esthet:1989,34:153-159.
[6]。Ghosh J, Eglinton T, Frizelle FA,沃森AJ: Presacral tumour in adults.Surrgeon.2007;5(1):31-38
[7]. Ng EW, Porcu P, Loehrer PJ Sr, Sacrococcygeal teratoma in adults; case reports and a review of the Literature. Cancer 1999, 86:1199-1202.
[8]。Juan Rosai: Sacrococcygeal region; germ cell tumors .in Rasai and Ackerman's Surgical Pathology. 9th Ed ,2:2401-2.
[9]. Audet IM, Goldhahn RT, Dent TL,Adult sacrococcygeal teratomas.Am surg. 2000;66(1):61-65.
[10]. Mahour GH,Sacrococcygeal teratomas. CA Cancer J Clin .1988;38(6):362-367.

Abstract:Low level laser therapy is defined to supply direct biostimulative light energy to the cells .It has been reported that low-level semiconductor diode lasers could enhance the wound healing process. The periodontal ligament is crucial for maintaining the tooth and surrounding tissues in periodontal wound healing. Low-level semiconductor diode lasers have been used in low-level laser therapy ,there have been few reports on their effects on periodontal ligament fibroblasts(PDLFs).Low intensity laser therapy also has stimulating effects on bone cells and can accelerate the repair process of the bone .However still further research needs to be done in laser efficacy for periodontal treatment.

[1]. Mester E, Mester AF, Mester A. The biomedical effects of laser application. Lasers Surg Med. 1985; 5(1):31-9. y of semiconductor laser application as an adjunct to conventional scaling and root planing. Lasers Surg Med 2005; 37:350-5.
[2]. Moritz A, Schoop U, Goharkhay K, Schauer P, Doertbudak O, Wernisch J, et al. Treatment of periodontal pockets with a diode laser. Lasers Surg Med 1998; 22:302-11. 8
[3]. Kreisler M, Al Haj H, d'Hoedt B. Clinical efficacy of semiconductor laser application as an adjunct to conventional scaling and root planning. Lasers Surg Med 2005; 37:350-5.
[4]. Karu TI. Photobiology of low-power laser effects. Hlth Phys 1989:56:691-704.
[5]。Karu TI. Photobiology of low-power laser therapy. London: Harwood Academic Publishers. 1989
[6]。Qadri T, Miranda L, Tuner J, Gustafsson A (2005) The short term effects of low-level lasers as adjunct therapy in the treatment of periodontal inflammation. J Clin Periodontol 32 (7):714–719.
[7]. Qadri T, Bohdanecka P, Tuner J, Miranda L, Altamash M, Gustafsson A (2007) The importance of coherence length in laser phototherapy of gingival inflammation: a pilot study. Lasers Med Sci 22(4):245–251.
[8]。Ribeiro IW, Sbrana MC, Esper LA, Almeida AL (2008) Evaluation of the effect of the GaAlAs laser on subgingival scaling and root planing. Photomed Laser Surg 26(4):387–391.
[9]. Ozawa Y, Shimizu N, Abiko Y (1997) Low-energy diode laser irradiation reduced plasminogen activator activity in human periodontal ligament cells. Lasers Surg Med 21(5):456–463.
[10]. Pejcic A, Zivkvic V (2007) Histological examination of gingival treated with low-level laser in periodontal therapy. J Oral Laser Appl 71(1):37–43.