At present, the Food and Drug Administration (FDA) and the European Medicines Agency (EMA) have approved drugs for Relapsing Remitting Multiple Sclerosis (RRMS) and Secondary Progressive MS (SPMS). In this paper, modern therapeutic strategies for MS are reviewed. A comprehensive research in MEDLINE, PUBMED, and SCIENCEDIRECT databases using two Boolean phrases {i.e. 1. [(Multiple Sclerosis) and (Disease Modifying Therapies)] and 2. [(Multiple Sclerosis) and (Neuroprotective Therapies)]} yielded more than 1,5000 articles in total. Therefore, for the purposes of this paper, articles written within the last decade were considered for review.

Background: H1N1 infection tends to be more severe in pregnant than nonpregnant women. It is not known whether this is due to hormonal changes during pregnancy and/or immune responses to hormones. Aims: Whether the effect of pregnancy on responses to the H1N1 pandemic is mediated by the effects of immune responses to hormones resulting in anti-hormone antibody production requires investigation. Settings and Design: A prospective study was designed, and H1N1-infected pregnant women were recruited from the Intensive Care Unit of a hospital during the period 2009-2010. Materials and Methods: Differences in the levels of anti-estrogen and anti-progesterone antibodies were determined in H1N1-infected pregnant patients and healthy pregnant and healthy non-pregnant women, using the Enzyme-Linked Immunosorbent Assay technique. Statistical Analysis: Statistical Package for the Social Sciences 16.0 (SPSS inc, Chicago, USA) software was used for all statistical procedures. Results: Pregnant women showed nonsignificant trends for higher immunoglobulin G (IgG) and IgM anti-estrogen-antibodies as compared to the healthy non-pregnant women. IgG, IgM, and IgE anti-progesterone-antibodies were also higher in pregnant women than in nonpregnant women, with marginally significant effects for IgG and IgE. H1N1 infection was associated with increased anti-estrogen IgG and IgA relative to healthy pregnant females. Conclusion: Findings about elevated anti-estrogen and anti-progesterone antibodies might improve our understanding of higher susceptibility of pregnant females to swine flu, and thereby lead to better management of this disease.

Background and Aim: Oral submucous fibrosis (OSMF) is a high-risk premalignant condition largely seen in the Indian subcontinent. A number of studies have proven the use of antioxidants in the management of OSMF. Therefore, the aim of the present study was to compare the efficacy of two antioxidants, lycopene and aloe vera in the management of OSMF. Material and Methods: One hundred and twenty clinicopathologically diagnosed OSMF patients, were included in the study. They were divided equally into, Group A (lycopene group) and Group B (aloe vera group). Group A was administered 8mg lycopene in two divided doses of 4mg daily and Group B was given5mg aloe vera gel to be applied topically thrice daily for 3 months. Different clinical parameters were evaluated at regular intervals and data was analyzed using the Student's paired t-test and Chi-square test. P < 0.001 was considered to be statistically significant. Results: Clinical improvements in mouth opening and tongue protrusion were significant in Group A (P < 0.001). Subjective symptoms of burning sensation (P = 0.007), pain associated with the lesion (P = 0.005), and difficulty in swallowing and speech (P = 0.003) improved in both the groups, but were insignificant. There was a mild to moderate decrease in the size of the lesion. Conclusion: The present study concludes that though, there is no definitive treatment for the condition; however, lycopene can bring about significant clinical improvements in the symptoms like mouth opening and tongue protrusion when compared to aloe vera. Both the drugs appear to be promising in the treatment of OSMF.

Introduction: Facebook was founded in 2004 and is one of the most popular social networking sites. Although Facebook is used to connect and stay in touch with friends and also to maintain relationships, there may be situations where an individual uses the site way too much. Relatively little research has been carried out to explain effects of usage to Facebook in terms of addiction in India. Objectives: The aim was to find out the burden of Facebook addiction among college students of health university. Subjects and Methods: This exploratory qualitative study was conducted in Bengaluru City covering six colleges attached to a health university using convenient sampling from May 2013 to July 2013. About 400 students had enrolled for the study. Results : It was observed that the burden of addiction was 7.25% and high risk was 24.75% in the study subjects. 61 (31.12%) males and 38 (18.62%) females were categorized as high-risk behavior subjects. 12 (6.12%) males and 17 (8.33%) females were categorized as having Facebook addiction. 64% of study subjects used Facebook daily. 32% of the subjects felt strain in the eye, 11% watering of the eye, 20% felt frustrated and 17% were anxious when they did not have access to Facebook. Conclusion: The burden of Facebook addiction and high-risk behavior was observed in one-third of the subjects.

Background: Assessment and management of abnormal lumbar spine mobility are essential in the clinical setting. There are limited studies carried out to obtain lumbar range of motion values in children of the Indian population and to explore the anthropometric measurements on it. Purpose: The purpose was to find any association of anthropometric measurements, hamstring muscle length with lumbar range of motion in school age children from South India. Methodology: Active flexion, extension, and right- and left-side bending, and rotation of the lumbar spine were measured using modified Schober's test for 294 normally developing school going children 6-12 years (147 girls, 147 boys) from Mangalore, Karnataka, India. Means were determined for each motion by age and sex. Further, the correlation between spinal mobility and individual factors such as body mass index and hamstring flexibility was explored. Results: Females were identified as have a significantly higher forward flexion, lateral flexion, and rotation range of motion than males. Age, anthropometric parameters, and hamstring length were significant correlates of lumbar spinal mobility. Conclusion: This study provides the reference values for lumbar spinal flexibility in healthful school going children (6-12 years) from India. Females were found to have a considerably higher forward flexion, lateral flexion, and rotation range of motion than males. Age, anthropometric parameters, and hamstring length were significant correlates of lumbar spinal flexibility.

Cerebral venous thrombosis is an uncommon disorder in the general population. Venous and arterial thrombosis is a rare but well-recognized extraintestinal complication of ulcerative colitis. Venous thromboembolic events commonly involve deep peripheral veins, and cerebral venous thrombosis is less common. We report a case of cerebral vein thrombosis associated with ulcerative colitis managed successfully with anticoagulant therapy.

Orodental rehabilitation through the use of implants offers very high success rates. Peri-implantitis is a site specific disease characterized by bone destruction around dental implants due to the host immune-inflammatory response induced by biofilm accumulation. Several approaches have been proposed to treat peri-implantitis, including mechanical debridement, antimicrobial therapy, and respective or regenerative surgical therapy. Calcium sulfate has multifaceted properties and has versatile use in the field of orthopedics. The present case report describes a peri-implantitis case treated by calcium sulphate which is a simple and easily available alloplastic material.

Although genitourinary tuberculosis (TB) is common, reports of isolated ovarian TB are rare. However, its presentation can mimic that of an ovarian tumor, leading to diagnostic difficulties. A 25-year-old woman presented with chronic pelvic pain, weight loss, a right ovarian mass on ultrasound, and a significantly elevated cancer antigen 125 (CA-125) level. Laparotomy was performed with resection of the right ovary. Postoperative histological examination, however, revealed evidence of TB, with no signs of malignancy. Anti-TB treatment was commenced, with full resolution of her symptoms and a decrease in CA-125 level. Isolated ovarian TB is most common in young women living in endemic zones. CA-125 can be raised in many conditions, and imaging is rarely conclusive. Intraoperative frozen section of tissue specimens can be helpful if available. Early diagnosis of ovarian TB is vital as untreated disease can lead to infertility.

Unusual communications between the branches of brachial plexus is not uncommon phenomenon. But among these, aberrant interconnection between radial and ulnar nerve is seldom reported. We present a case of persistence of well established abnormal communication between radial and ulnar nerves and its distribution to medial head of the triceps brachii muscle. Due to this, the triceps brachii which is normally innervated by radial nerve received additional innervations from the twigs of ulnar nerve through this communication. Aberrant communicating nervous channels when persist are vulnerable to iatrogenic injuries during surgical procedures as well as might results in entrapment neuropathic syndromes.

A 45-year-old immunocompetent man, tailor by occupation, presented with pyrexia of unknown origin since last 6 months. He was diagnosed to be a case of cerebral pheohyphomycosis caused by dematiceous fungi, Cladophylophora bantiana. Unfortunately, the patient succumbed to death before the confirmation of diagnosis. To conclude, apart from tubercular meningitis, cerebral pheohyphomycosis should be considered in differential diagnosis while examining the immunocompetent patients exhibiting chronic features of pyrexia of unknown origin.

Tuberculosis is an inflammatory granulomatous systemic disease that rarely presents as primary lesions in gingiva. Gingival involvement has been reported in only a very limited number of cases. A case of primary tuberculosis affecting gingiva and alveolar mucosa is presented. A 20-year-old female patient presented with multiple gingival ulcers, necrotic slough over the gingiva in maxillary arch facially and palatally, and bone destruction. The patient had no evidence of tuberculosis elsewhere. The diagnosis was made following a gingival biopsy. An incisional biopsy with polymerase chain reaction (PCR) and Ziehl Nielsen (ZN) staining was consistent with the diagnosis of gingival tuberculosis. The patient was subsequently referred to the physician for clinical management and the condition resolved with active antitubercular treatment. It is concluded that tuberculosis is a systemic disease that rarely affects the gingiva. The possibility of gingival involvement as sole manifestation of the disease should be considered in the differential diagnosis of gingival lesions

A 52-year-old male presented with complaints of pain abdomen, vomiting, and distention of abdomen since 3 months. He had similar complaints 1 year back and was treated conservatively. He was a known case of pulmonary tuberculosis and completed Category I treatment 3 years back. Abdomen was distended with stepladder pattern of visible peristalsis. Erect X-ray of the abdomen was suggestive of intestinal obstruction. Utrasonography (USG) and computed tomography (CT) scan suggested distal ileocecal thickening-probably ileocecal tuberculosis. A provisional diagnosis of ileocecal tuberculosis causing intestinal obstruction was made and patient was taken up for laparotomy. Laparotomy revealed dilated small bowel loops with distended cecum. Right hemicolectomy was performed. Histopathological Examination (HPE) sent showed features of eosinophilic enteritis a rare cause of intestinal obstruction.

Introduction: Globally, about 16,000 people die of injuries every day. It is estimated that 5.8 million people die each year as a result of some form of injury corresponding to an annual mortality rate of 97.9/100,000 populations. The study aimed to arrive at sociodemography of traumatic musculoskeletal injuries. Materials and Methods: A prospective, descriptive hospital-based study was conducted on 1272 patients presenting with musculoskeletal injuries to the Department of Orthopedics in a tertiary care hospital in rural North-west India, for a period of 1 year from January 1, 2012 to December 31, 2012. Results: Age group 16-30 was the most common (25.2%) age to suffer from injuries with a male preponderance. Students and farmers suffered more commonly. The most common place for the occurrence of injury was outside home (69.9%). Fall was the most common cause of injury (74.6%), followed by road traffic crash (14.6%). Discussion and Conclusion: The study defines the profile of traumatic musculoskeletal injuries and demonstrates the utility of development of a trauma registry.