Spinal tuberculosis (TB) or Pott's spine is the commonest extrapulmonary manifestation of TB.It spreads through hematogenous route. Clinically, it presents with constitutional symptoms, back pain, tenderness, paraplegia or paraparesis, and kyphotic or scoliotic deformities. Pott's spine accounts for 2% of all cases of TB, 15% of extrapulmonary, and 50% of skeletal TB. The paradiscal, central, anterior subligamentous, and neural arch are the common vertebral lesions. Thoracic vertebrae are commonly affected followed by lumbar and cervical vertebrae. Plain radiographs are usually the initial investigation in spinal TB. For a radiolucent lesion to be apparent on a plain radiograph there should be 30% of bone mineral loss. Computed tomographic scanning provides much better bony detail of irregular lytic lesions, sclerosis, disc collapse, and disruption of bone circumference than plain radiograph. Magnetic resonance imaging (MRI) is the best diagnostic modality for Pott's spine and is more sensitive than other modalities. MRI frequently demonstrates disc collapse/destruction, cold abscess, vertebral wedging/collapse, marrow edema, and spinal deformities. Ultrasound and computed tomographic guided needle aspiration or biopsy is the technique for early histopathological diagnosis. Recently, the coexistence of human immunodeficiency virus infections and TB has been increased globally. In recent years, diffusion-weighted MRI (DW-MRI) and apparent diffusion coefficient values in combination with MRI are used to some extent in the diagnosis of spinal TB. We have reviewed related literature through internet. The terms searched on Google scholar and PubMed are TB, extrapulmonary TB, skeletal TB, spinal TB, Pott's spine, Pott's paraplegia, MRI, and computed tomography (CT).

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Background: Cholecystectomy for symptomatic gallstones is mainly performed after the acute cholecystitis episode settles because of the fear of higher morbidity and conversion from laparoscopic cholecystectomy to open cholecystectomy during acute cholecystitis. Aims: To evaluate the safety and feasibility of laparoscopic cholecystectomy for acute cholecystitis and to compare the results with delayed cholecystectomy. Materials and Methods: This was a prospective and randomized study. For patients assigned to early group, laparoscopic cholecystectomy was performed as soon as possible within 72 hours of admission. Patients in the delayed group were treated conservatively and discharged as soon as the acute attack subsided. They were subsequently readmitted for elective laparoscopic cholecystectomy 6-12 weeks later. Results: There was no significant difference in the conversion rates, postoperative analgesia requirements, or postoperative complications. However, the early group had significantly more blood loss, more operating time, and shorter hospital stay. Conclusion: Early laparoscopic cholecystectomy within 72 hours of onset of symptoms has both medical as well as socioeconomic benefits and should be the preferred approach for patients managed by surgeons with adequate experience in laparoscopic cholecystectomy.

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Influenza virus infection is a common respiratory pathogen. Emerging of new atypical influenza is usually a big public health threat. H7N9 bird flu is the newest atypical influenza virus infection that has just been reported since early 2013. The emerging of this new disease occurred in China and becomes the present focus for possible worldwide pandemic. In this specific article, the author will discus and describe on epidemiology, symptomatology, pathology, diagnosis, treatment, and prevention of this new bird flu. The literature researching by PubMed and Google is used for data gathering in this collective review.

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Background: Several reports have described worse perioperative outcomes of laparoscopic gastric bypass procedure during learning curve, which improved after completion of one-year fellowship training. Aims: The aim of this study was to evaluate the immediate impact of fellowship training on perioperative complications and outcomes of various bariatric procedures. Materials and Methods: One hundred initial patients who underwent laparoscopic gastric banding, laparoscopic Roux-en-Y gastric bypass, laparoscopic vertical sleeve gastrectomy, and robotically-assisted laparoscopic biliopancreatic diversion with duodenal switch by a single fellowship trained surgeon were analyzed. Results: Overall average Body Mass Index (BMI) of the patients was 45.9 kg/m ² , age was 47.5 years, and the American Society of Anesthesiologist Score was 2.89. There were no intraoperative, major 30-day complications, or open conversions. Average operative time was 62 minutes in gastric banding, 160 minutes in gastric bypass, 119 minutes in vertical sleeve gastrectomy, and 320 minutes in biliopancreatic diversion. Length of stay ranged from 0.5 day after gastric banding to 3.9 days after biliopancreatic diversion. The perioperative complications and outcomes are comparable with those reported by experienced surgeons. No mortality occurred in this series. Conclusions: Bariatric fellowship ensured skills acquisition for new surgeons to safely and effectively perform various types of bariatric operations, with minimal perioperative complications and excellent outcomes.

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Prion diseases are a group of neurodegenerative disorders characterized by accumulation of abnormal prion proteins in the central nervous system. The prions resist conventional sterilization procedures especially when infected tissue becomes dried onto metal or glass surfaces. This article, a review of literature collected using Pubmed as search engine, describes the oral manifestations of prion diseases in addition to studying the possibility of cross contamination in the dental office. The article emphasizes the importance for dentists to be aware of these diseases, to identify the high-risk patients by obtaining adequate medical history and to know the appropriate deactivation procedures to be followed.

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Background: Anthropometric and socioeconomic factors are known to influence peak expiratory flow rate, but the effect of altitude has not been established decisively, due to conflicting results of various studies. Aim: This study was conducted to evaluate the effect of altitude on peak expiratory flow rate of healthy school children. Materials and Methods: A cross-sectional study was conducted in which the peak expiratory flow rate of a group of 290 school children (140 male and 150 female), aged 7-14 years, residing in Shimla (altitude 2150 meters), were compared with the results obtained in an age- and sex-matched control group, consisting of 280 school children (138 male and 142 female), residing in Patiala (altitude 278 meters). Mini Wright Peak Flow Meter was used for the study. Results: The mean peak expiratory flow rate value of boys at high altitude (265 ± 92.6 L/min) was significantly higher than those in plain areas (245 ± 82.1 L/min). Similarly, the mean peak expiratory flow rate of highlander girls (250.4 ± 70.2 L/min) was significantly higher than girls of plains (232.6 ± 65 L/min). Conclusion: The study suggests that besides anthropometric and socioeconomic factors, altitude is an important determinant of lung function.

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Background: In forensics, the mouth allows for a myriad of possibilities. Lip print on glass or cigarette butt found at crime scenes may link to a suspect. Hence, a dentist has to actively play his role in personal identification and criminal investigation. Aims: To investigate the uniqueness of the lip print patterns in relation to gender, ABO blood groups and intercommissural distance (ICD). Materials and Methods: The study was conducted on 208 randomly selected students. The lip print of each subject was obtained and pattern was analyzed according to Tsuchihashi classification. The blood group and ICD at rest position was recorded for each. Results: The study showed that Type II (branched) lip pattern to be most prominent. The B+ blood group was the most common in both genders and the ICD is higher in males. The lip print pattern does not show any correlation between ABO blood groups, gender, and ICD. Conclusions: The lip print pattern shows no correlation with gender, ABO blood groups, or ICD. Further studies with larger samples are required to obtain statistical significance of this correlation.

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Background: Human immunodeficiency virus (HIV) associated lymphoma is an important public health concern; however, the epidemiological data available from India is sparse. Aims: The present study was carried out at a tertiary cancer care center in South India to analyze the scenario of HIV-associated lymphoma. Materials and Methods: This was a retrospective observational study conducted at our center, on consecutive patients diagnosed with HIV-associated lymphoma, from January 2008 to December 2012. Results: A total of 44 patients were diagnosed with HIV-associated lymphoma, of which 18 opted for treatment. There were 11 males and 7 females in the study population. Median interval from the diagnosis of HIV infection to diagnosis of lymphoma was 18 months. Median CD4 count at the time of lymphoma diagnosis was 218/mm ³ . Five patients had Hodgkin's lymphoma, and the rest had non-Hodgkin's lymphoma. Five out of 18 (28%) patients in the present study expired during treatment. Ten (55.5%) patients are alive and lymphoma free, with a median follow up of 18 months. Conclusions: More than half of our treated patients are lymphoma free with a median follow up of 18 months; hence treatment of patients with HIV-associated lymphoma should be encouraged.

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Background: We are introducing a novel in vivo technique to document cellular calcium deposits, which reflect a snapshot of the effect of calcium wave propagation. This technique however is not advocated enough to replace the accuracy and resolution of the confocal laser technique. Light microscopy equipment, calcium chelators and a histological calcium staining kit are essential. Aims: The purpose of this study is to introduce the use of standard light microscopy to display in vivo ionic cellular calcium deposits. Materials and Methods: Oxalic Acid (OA) (100 millimol) was the calcium chelator used in the study. This substance was injected into the dog right atrial tissue in vivo in an area of 1 cm ² . Samples were fixed and stained by the calcium specific von Kossa protocol. Results and Conclusions: Histological slides demarcated the intracellular calcium as black dots. Heterogeneity of calcium deposits mimicked images of both, the calcium sparks and calcium waves theories. This light microscopy technique could expand the number of experimental studies in the function of cellular calcium physiology.

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