Vol 3, Issue 3, Jul-Sep, 2013

Aim: This paper aims to determine the difference between the health and social conditions of women who had their first pregnancy as teenagers (13-19 years old) and those who had their first pregnancy during post-adolescence (20-41 years old). Materials and Methods: The results were based on a structured, 60-item interview schedule with 132 cases (71 teenagers and 61 women ≥ 20 year old) in Trinidad and Tobago. These cases comprised Afro-Trinidadians, Indo-Trinidadians, and Trinidadians of “Mixed” ancestry, who were all recruited by nurses in three health centers in Northern Trinidad, during the period October 2004 to October 2005. The main issues of concern regarding the respondents were history of stillbirths, abortion, contraceptive use, intended family size, marital status, and employment status. Data were analyzed, using Statistical Package for the Social Sciences (SPSS) 12.0. Results: While the study shows similarity between the two groups of respondents, in terms of their breast-feeding practices, there were differences regarding teenage mothers who experienced a higher level of unemployment (35%), single and common law relationships (81%), and lower contraceptive use (11.8%). The older mothers were more likely to be classified as unskilled (34.4%) compared to 22.5% for the teen group. Conclusions: The findings reveal that teenage pregnancy is considered a risk factor and has socio-economic implications regarding the lives of the mother and child in terms health, income, employment, and marital status. Key words: Adults, social, teenage, pregnancy, Trinidad

Background: The rate of decline in maternal and infant mortality in India is not fast enough to achieve Millennium Development Goals. Poor nutrition, during pregnancy is associated with adverse maternal and fetal outcomes. However, due to various factors, pregnant women do not enhance the quality or quantity of diet during pregnancy. Aims: This study was conducted to fi nd whether increase in dietary intake occurs in pregnancy and to understand the factors influencing the dietary intake during pregnancy in an urban resettlement colony in Delhi. Materials and Methods: Community based case control was conducted among 50 pregnant women and 50 matched controls to study the change in dietary intake during pregnancy and its determinants. In-depth interview were conducted among pregnant women to understand the factors influencing the dietary intake. Results: No significant difference in the intake of energy, protein, iron, calcium, protein, folic acid and Vitamin C between pregnant and non pregnant women. The factors like age, family type, history of previous pregnancy and socio economic status were not associated with increase in dietary intake in pregnancy. In-depth interview shows that even though pregnant women knew that dietary intake should increase in pregnancy, they fail to put this into practice. Conclusions: The pregnant women in the urban resettlement colony do not eat differently from their non pregnant counterpart. Key words: Dietary intake, India, pregnant women, urban

Objectives: To analyze the pharmacological management of respiratory tract infections in hospitalized pediatric patients. The economic burden of the disease and the adverse drug reactions occurring during the course of treatment have also been studied. Materials and Methods: It was a prospective, longitudinal, and observational study, carried out over a period of one-and-a-half years. The patients, aged one month to twelve years, diagnosed with respiratory tract infections (RTI), as confirmed by a pediatrician, were enrolled. Modified Kunin’s criteria along with the guidelines set by the Indian Academy of Pediatrics (IAP) were followed for assessing the appropriateness of the antibacterials prescribed. The adverse drug reactions occurring during the course of the treatment were noted and the economic burden of the disease was calculated as direct and indirect costs. Results: A total of 201 patients were enrolled, of whom 46% were in the age group of one month to one year. The most common diagnosis was pneumonia (76%). The number of drugs and antibacterials prescribed per patient were 4.88 ± 1.57 and 1.85 ± 0.86, respectively. Antibacterials (37.7%), intravenous fluids (17.2%), respiratory medicines (16.6%), and analgesic/antipyretics (16.5%) were the common drug groups prescribed. Among the antibacterials, amoxicillin with clavulanic acid (47%) and cefotaxime (22%) were frequently prescribed. Appropriate antibacterial therapy was given in 42% of the cases. Salbutamol and a combination of Levosalbutamol and Ipratropium Bromide were the commonly prescribed respiratory medicines. Three adverse drug reactions (ADRs) were observed in indoor patients, all due to antibacterials. The economic burden of the disease was calculated to be Rs. 4925.14 or US$ 109.9 per patient. Conclusion: An overuse of antibacterials and respiratory medicines was seen in the study. Emphasis on proper diagnosis and treatment, education and availability of locally effective guidelines may help in a better and judicious use of drugs in children. Key words: Adverse drug reactions, antibacterials, drug utilization, modified Kunin’s criteria, respiratory medicines

Background: Basic Life Support (BLS)/Cardiopulmonary Resuscitation (CPR) is an important part of emergency medical care. This study is done among medical undergraduate students, to know their knowledge and perceptions about BLS, as they are going to face such situations in future, as doctors. Materials and Methods: A questionnaire-based study was conducted among 377 medical undergraduate students. The questionnaire included the following parts: (1) Basic characteristics of the study participants, (2) Knowledge about BLS/CPR, (3) Perceptions about BLS/CPR. The components of knowledge and perception based questions were scored. The data was analyzed using SPSS version 12. Results were expressed as proportions in appropriate tables and graphs. Student’s Independent ‘t’ test was used to compare means between students who had undergone previous training if any and those who had no such training. Results: Out of 377 students, majority (84.6%) had heard of BLS/CPR. Some of them (30.6%) could give the correct order of performing CPR as per the AHA guidelines (Year 2010). Few (18.9%) had undergone prior training in BLS, whereas, only 17.7% had been in a situation that needed BLS/CPR. Nearly half (50.2%) were not confident of performing BLS/CPR. Comparison of the students revealed that students who had training had higher mean scores for ‘response to a situation needing BLS/CPR’ and ‘signs of successful resuscitation’, though there was little difference in their knowledge of ‘indications for BLS/CPR. Overall perception was not favourable and the students were not confident of performing BLS/CPR. Conclusions: The students need to be taught and trained in the CPR/BLS early in the curriculum to improve their knowledge. Repeated training would increase their confidence. Key words: Basic life support/cardiopulmonary resuscitation, Medical student’s, knowledge and perception

Background: This paper investigates a swift gastrointestinal outbreak in central India and further explores environmental, agent, and host interactions culminating into outbreak. Materials and Methods: Epidemic investigation was launched as per the standard protocol laid by Center for Disease Control to capture the clinico-microbiological pattern of disease. Descriptive and observational epidemiological analysis was performed. Results: This cholera like watery diarrheal episode presented along with vomiting and abdominal cramps had an attack rate of 45.11%. The mean duration of illness was 61 h with a predilection to pediatric age group. Clinico-microbiological picture probed the enterotoxicogenic Escherichia coli contaminated well-water as a source for the outbreak initiated by geo-environmental stimulation. Conclusion: The findings endorse the need of serviceable environmental sanitation strategies in order to prevent the disease transmission through water. Key words: Cholera, enterotoxicogenic Escherichia coli, rainfall, watery diarrhea

Introduction: Sepsis is one of the most important causes of mortality in the intensive care setting. An effective predictor of prognosis of sepsis is required to assess morbidity and mortality of this condition. In this study, sepsis in the intensive care unit (ICU) of a tertiary care hospital was evaluated, with specific reference to clinical features and causative organisms. The sequential organ failure assessment (SOFA) score was calculated to assess the severity of sepsis and multi-organ failure at presentation and after 48 h. The correlation of SOFA and mean SOFA scores with outcome was studied. Materials and Methods: This was a prospective, observational, cohort study carried out in a tertiary care teaching hospital. Forty consecutive cases of septicemia were studied. Detailed history, clinical features, and SOFA score was recorded to assess the disease severity at the time of presentation and after 48 h. Inclusion of patients in the study was performed using the American College of Chest Physicians/Society of Critical Care Medicine (ACCP/SCCM) definition of sepsis. Two sample t-test and 95% confidence interval (CI) for difference of mean was applied. Results: When the SOFA score was <7, the mortality was 56%. It increased to 70% when the score was 8-15 (P = 0.0989, t value: 1.69, Mean difference: 2.12, 95% CI: 0.41-4.665). Patients with SOFA score <7 after 48 h had 52% mortality and it increased to 88% when the score was 8-15. The mean SOFA score at 48 h was 6.96 in patients who died and 2.5 in those who improved (P < 0.001, t value: 4.332, mean difference: 4.39, 95% CI: 2.34-6.44). Hence, the predictive value for mortality of SOFA score was better at 48 h than at presentation. Conclusions: Sequential assessment of organ dysfunction in ICU at presentation and at 48 h is a good indicator of prognosis. Both mean and highest SOFA scores are particularly useful predictors of outcome, independent of the initial score. A high SOFA score at 48 h of presentation predicts an increased mortality rate. Key words: Mortality, multi-organ dysfunction, sepsis, sequential organ failure assessment score

Introduction: Asthma being a chronic inflammatory disease needs treatment for prolonged duration. To increase treatment compliance, each patient should know the course of disease, its precipitating factors, and management protocol. Despite the magnitude of the asthma, very little is known about its public perception. Aim: This study was done to know the knowledge, attitude, and practices of patients of bronchial asthma. Materials and Methods: In this prospective study, subjects were asthmatic patients attending the department of pulmonary medicine, KGMU Lucknow, India. A questionnaire including general understanding of asthma, its triggers and management was given to each patient and results were recorded. Results: A total of 140 patients with confirmed diagnosis of asthma were included in this study. On an average, each patient had already visited 3.2 doctors prior to coming to us. Out of 140 patients, 64% patients were ignorant regarding disease etiology, 47.1% patients thought that their disease is fatal, 30% patients were reluctant to accept the diagnosis of asthma. Regarding precipitating factors, 25.71% patients could not relate to any cause with their disease exacerbation. A total of 62.14% patients used alternative system of medicine too in the hope of getting rid of their disease. Oral medications were preferred by 62.1% patients, while 73.6% were using inhalers and out of them 71.8% were using inhalers incorrectly. Conclusion: Patient education program should augment awareness; eliminate social stigma, and misconcepts in the community regarding asthma. Knowledge about the prevailing perception in community would be the first step in achieving this. Key words: Asthma, attitude and practices, knowledge

Context: Maternal death signifies the quality of healthcare provided in the population. It is the young, relatively healthy women who die of various reasons. Audit of such mortality would prevent the recurrence by taking appropriate measures. Aims: To fi nd the causes of maternal mortality. Settings and Design: Retrospective observational study. Materials and Methods: All maternal deaths in a tertiary care referral center from January 2007 to September 2012 were studied for their demographic profile and causes of death. Results: All 62 women were referred from other healthcare units. Twenty-nine patients died within 24 h of admission and 33 women died after 24 h of admission. Death of 34 patients was due to direct obstetric causes and of 26 patients due to indirect obstetric causes. There were 2 maternal deaths due to accidental causes. Conclusions: The corrective action to prevent the recurrence of such deaths should be taken. Sepsis was found to be the commonest cause for maternal mortality followed by hemorrhage. It important to note that, in the present study, all mothers received antenatal care, had hospital delivery (none had home delivery), no teenage pregnancy or grand multigravidas, and no obstructed labor or rupture uterus, and yet they died. There is a change in the trend of causes of maternal mortality. Strengthening of the first referral units with equipment, blood bank, and adequately competent staff should be of prime importance. Continued medical education of the medial personnel at the periphery is required. Maternal deaths occur in inspite of atenatal care and hospital delivery which is alarming. Contributing factors may be delay in referral or the travel which should be looked in to in order to minimize such death of young women. Key words: Direct obstetric cause, indirect obstetric cause, maternal death, maternal mortality rate

Background: Herpes simplex virus type 2 (HSV-2) infection is the primary cause of genital herpes worldwide and also has potential role in facilitating human immunodeficiency virus (HIV) transmission. Materials and Methods: In our analytical cross-sectional study we interviewed and collected serum samples from 91 HIV positive subjects coming to antiretroviral therapy center at a government hospital in Delhi, to determine the seroprevalence and relative prevalence of HSV-2 among subjects with specific risk attributes. The patients were interviewed using a structured questionnaire and their serum samples were tested for HSV-2 specific immunoglobulin G (IgG) antibodies. We compared prevalence of HSV-2 antibodies between exposed and unexposed; to demographic, socioeconomic, and behavioral variables. Results: Fifty-two (57.1%) male and 39 (42.9%) female HIV positive subjects participated in the study. Seroprevalence of HSV-2 was 48.4% (males: 51.9% and females: 43.6%). Only 4.5% had given current history of genital ulcer. Overall increasing number of lifetime sexual partners showed significant association with HSV-2 seropositivity (Chi-square for trend: 19.17; P = 0.00001). Among men sexual contact with commercial sex workers (prevalence ratio (PR) = 6.6; 95% confidence interval (CI) =1.76-24.83; P = 0.0002) and age at first sexual intercourse <19 years (PR = 2.3; 95% CI = 0.98-5.6; P = 0.021) were significantly associated with HSV-2 seropositivity. Use of condom during sexual intercourse among men, showed significant protective effect (PR = 0.57; 95% CI = 0.356-0.902; P = 0.037). Among women history of past genital ulcer was significantly associated (PR = 2.25; 95% CI = 1.14-4.45; P = 0.026) with HSV-2 seroposititvity. Conclusions: The prevalence of HSV-2 is high in the study group with high proportions of undiagnosed HSV-2 infections. HSV type-specific serological testing in the HIV infected subpopulation should be used to diagnose HSV-2 infections and high risk groups should be targeted for interventions like behavioral intervention messages. Consistent condom use should be promoted. Key words: Genital herpes, herpes simplex virus type 2, human immunodeficiency virus

Objective: To highlight the profile of five patients diagnosed as having idiopathic granulomatous mastitis by histopathological examination. Materials and Methods: This presentation is a case series of patients, diagnosed as idiopathic granulomatous mastitis by histopathological examination of excised specimens. The total number of cases included in the report was five females over a 4-year period from 2005 to 2009. Results: The mean age of the patients was 29.6 years and the duration of symptoms varied from 3 weeks to 4 months. All the patients presented with a palpable mass in the breast, and two patients had associated pain and one had a bloody nipple discharge. The average size of the excised mass was 3.8 × 3.1 cm. Four out of the fi ve patients diagnosed to have breast abscess or segmental mastitis had taken a course of antibiotics. One patient had a persistent wound sinus which subsided with ATT and the rest of the patients had no post-operative complications. Conclusion: Idiopathic granulomatous mastitis is a relatively rare disease which mimics the common breast disorders in the reproductive age group including malignancy. Key words: Abscess, idiopathic, mastitis

Objective: To study the utilization of health services by mothers during antenatal, natal and post-natal period under Janani Suraksha Yojna (JSY). Materials and Methods: This cross-sectional study was conducted in rural areas of two districts of Haryana as per the rate of institutional deliveries. A total of 48 sub-centers were selected by multistage random sampling. 1386 JSY beneficiary mothers were interviewed by house-to-house visits, after obtaining informed consent. Results: Majority 1216 (87.5%) of the study subjects were registered between 12-26 weeks of pregnancy whereas only 170 (12.3%) of them were registered within first 12 weeks. Around one-fourth of the mothers did not receive the recommended minimum three antenatal check-ups. The coverage of TT immunization was 92.1%. Majority 1253 (90.4%) of the deliveries were institutional. More than three-fourth of the home deliveries were conducted by trained dais and 15% of the home deliveries were conducted by untrained persons. Out of the 1253 institutional deliveries, 84.6% were conducted in Government institutions while 15.4% deliveries were conducted in Private hospitals. About two-third mothers received at least three post-natal care visits by the health functionaries. Discussion: Janani Suraksha Yojna is an ambitious scheme serving as a safe motherhood intervention under NRHM. It has been fairly successful in promoting institutional deliveries but the key components of Essential Obstetric Care i.e., early antenatal registration, minimum three antenatal care visits, three post-natal care visits still need strengthening. Key words: Antenatal check-up, institutional delivery, Janani Suraksha Yojna, post-natal care

Introduction: Medication errors are currently a worldwide public health issue. Since errors of prescribing are the commonest form of avoidable medication errors, it is the most important target for improvement. The purpose of study was to screen drug prescriptions dispensed in a tertiary care hospital for completeness of information. Materials and Methods: A retrospective cross-sectional study was conducted including 400 prescriptions. All prescriptions were evaluated for presence of (a) Prescriber information (hospital details, department, name, designation and signature of physician) (b) Patient information: Name, age, sex, weight, address, and date of issue (c) Details of each medication prescribed: Strength, frequency, route, dosage form, quantity to be dispensed, and instructions for use. Subjective assessment of legibility of handwriting was done. Results: Hospital identification details were present on all prescriptions. Prescriber details like name, designation, and signature were present in 46.25%, 21.75%, and 73.25%, respectively. The patient’s name, age, and gender were on 94.75%, 77.25% and 69.50%, respectively. Weight was mentioned on 10% and address on none. Details of medication like strength of medication and the frequency of administration were included in 70.33% and 93.77%, respectively. Route and dosage form were on 26.92 and 77.93%, respectively. 88.09% had quantity to be dispensed and 17.76% had instructions for use mentioned. Conclusions: The results demonstrate that prescription error frequently occur and may contribute to medical error. There is a need to critically address the legibility of prescription, correct spelling with the correct strength and frequency and all other information on a prescription concerned with patient, prescriber and drugs to minimize the occurrence of medication errors. Key words: Prescription analysis, prescription errors, prescription pattern

Background: This study explores the effectiveness of Navjaat shishu surakasha karyakram (NSSK) training using mannequin for imparting neonatal resuscitation skills to health professionals. Materials and Methods: NSSK training was conducted at district hospitals for the three districts of western Uttar Pradesh (India) by Dept. of Community Medicine, L.L.R.M. Medical College Meerut (U. P.). Total number of participants included was 312. Methodology included lectures, audio-visuals, and individual practice on mannequins followed by performance evaluation and posttest (written) based on format given in NSSK module. Results: A total of 92-95% participants expressed that their confidence in handling newborns and conducting deliveries improved after training on mannequins and will be useful where only few resources and facilities are available. The best part of the training was bag and mask resuscitation and Kangaroo mother care. Conclusion: Although Mannequin-based trainings will be difficult and costly, they may be justified to determine how this technology can best be applied. Key words: Kangaroo mother care, mannequins, Navjaat Shishu Surakasha Karyakram training program

Introduction: The role of magnesium in treating arrhythmias due to acute myocardial infarction (AMI) has been controversial. Most of the studies have reported a significant reduction in the mortality and frequency of arrhythmias in patients with AMI, who received magnesium therapy, in comparison with control with AMI, who did not receive magnesium treatment. We, therefore, decided that we would evaluate the effect of intravenous magnesium supplement therapy in patients admitted for acute myocardial infarction and if this would be helpful in reducing the morbidity and mortality in patients. Materials and Methods: The study was carried out as a prospective randomized controlled trial of magnesium therapy in acute myocardial infarction. Hundred patients with acute myocardial infarction were randomly divided into two groups of 50 patients each, one for trial and other for placebo therapy. Control group consisted of 20 healthy volunteers of the same age group. All of the 100 patients included in the study had reported within 12 hours of the onset of chest pain. Blood samples for estimation of serum magnesium were taken on admission and on days 2 and 5. Results: The mean age in the Group I and II were 59.52 years ± 15.03 and 59.14 years ± 13.41, respectively. Serum magnesium level on admission was higher in the healthy controls than in the patients of acute myocardial infarction (P < 0.0001). Fourteen percent patients of Group I had conduction disturbance, whereas 4% patients of Group II had conduction disturbances. Fifty percent patients of Group I developed heart failure, whereas only 30% patients of Group II developed this complication (P < 0.005). Incidence of cardiac arrhythmias, heart failure, and hospital mortality were significantly lower in magnesium treated group. Mortality as well as morbidity was very less in the magnesium treated group of patients as compared to placebo treated patients. Conclusions: Intravenous magnesium is a safe and effective method of reducing the frequency of arrhythmias and mortality following the acute myocardial infarction. Magnesium therapy reduces the incidence of arrhythmias and mortality even in the absence of demonstrable magnesium deficiency. Key words: Cardiac arrhythmias, intravenous magnesium, myocardial infarction, serum magnesium

Introduction: Chronic exposure to Portland cement dust has been reported to lead to greater prevalence of various clinical conditions (includes both respiratory and non-respiratory). These conditions are consistently associated with the degree and duration of exposure. Regular use of appropriate personal protective equipment if made available at the work site could protect the cement factory workers from adverse health effects. Objective: To study the morbidity profile of the cement factory workers.Type of Study: Retrospective cohort study. Material and Methods: This study was conducted in the Portland Cement Factory in North Karnataka. Data was collected using predesigned questionnaire by personal interview method and clinical examination. A total of 64 male workers are randomly selected who are working in various departments like crushing, raw/cement mill, rotary kiln and packing department. Equal number of unexposed controls was selected from the area atleast 5 kms from the factory and those who are not exposed to cement dust in the past, who are matched for age, Socio economic status and smoking with the exposed population. Statistical Analysis: Chisquare test for qualitative data and unpaired t test for quantitative data using Epi info. Results: A total of 64 male workers and equal number of matched controls who are not exposed to the cement dust were included in the study. Among exposed maximum of 36% were employed in Crushing department, 25% each in Packing and cement/raw mill. Systolic and Diastolic blood pressure was found to be higher among the exposed, which is statistically highly significant (p<0.001). There is significant increase in weight among exposed (p<0.001). Maximum 29(45.3%) of the workers had stuffy nose and epistaxis when compared to unexposed with Relative risk(RR) of 2.6, followed by Dermatological complaints and lower respiratory complaints with RR of 2.18 and 2.3 respectively. Conclusion: Personal protective equipment should be made available at the workplace and educate the personnel to use them. Extensive research is necessary to improve the technical preventive measures that will reduce the risk of occupational health hazards. Key Words: Portland cement dust, occupational health hazard, COPD.

Background: Oral hygiene status can be seen from the plaque index contained in the mouth. Children aged 6-12 years are school age, they can be taught about oral health care independently. The research objective was to obtain data about description of the differences in plaque index between normal and autistic children aged 6-12 years in Yayasan Autisme Ourdream, Lembaga Pendidikan Autisme Prananda, and SDN Banjarsari in the Bandung city. Materials and Methods: This study was a descriptive analytic. The population was all the students at SDN Banjarsari and autistic children aged 6-12 years in both the foundation. Samplings were collected by simple random sampling, the number of samples obtained normal and autistic children each were 21 persons. Clinical examinations for plaque index using Patient Hygiene Performance (PHP) index of Podshadley and Halley. The data were analyzed with independent t-test. Results: The results showed an average of plaque index normal and autistic children aged 6-12 years was 2.06 with a standard deviation of 0.573 and 3.23 with a standard deviation of 0.473. Conclusion: The conclusions showed that there were significant differences in plaque index between normal and autistic children, these values are equally moderate category by Patient Hygiene Performance (PHP) index of Podshadley and Halley. Key words: 6-12 years, normal and autistic children, patient hygiene perfirmance index, plaque index

Context: Laryngoscopy and endotracheal intubation is associated detrimental hemodynamic changes like rise in blood pressure (BP), heart rate (HR) leading to adverse cardiological outcome specially in susceptible individuals. Aims: To compare the blood pressure (BP) and heart rate (HR) changes during laryngoscopy and endotracheal intubation as well as to evaluate the preoperative sedation status between oral clonidine and oral midazolam as premedication for the patients undergoing general anesthesia (GA). Settings and Design: Fifty patients between 18 and 60 years of age of either sex of American Society of Anesthesiologists (ASA) Grade I and II undergoing GA were randomly divided into two equal groups of 25 patients each. Group-C patients received clonidine 4 mcg/kg orally and Group-M patients received 0.5 mg/kg midazolam orally as premedication. Materials and Methods: After measuring baseline hemodynamic parameters patients of both groups received premedication. Preoperative sedation was assessed 2 hr after premedication administration. Standard anesthetic technique was followed. Hemodynamic (HR, BP) parameters were noted baseline, immediately after laryngoscopy and intubation and 5 min after intubation to observe the stress response. Results and Statistical Analysis: A significant difference in pre-operative sedation between two groups (P < 0.05) and midazolam (group M) produced significantly better sedation than clonidine (group C). Laryngoscopic stress response in group C was still at a lower level than baseline values and significantly (P < 0.005) less than group M. Conclusions: Oral midazolam is more effective in producing preoperative sedation than oral clonidine while on the contrary oral clonidine is more efficacious in reducing laryngoscopic stress response than oral midazolam. Laryngoscopy and intubation was better controlled by oral clonidine than midazolam. Key words: Clonidine, endotracheal intubation, general anesthesia, laryngoscopy, midazolam

Background and Objectives: Identification of the sex of an individual is important in determining, the identity from the available parts of skeleton. Aims: To derive a logistical regression formula for sex determination of Indian population, using dimensions of scapula. Materials and Methods: Thirty one adult scapulae (20 males and 11 females) were used in the study. Scapulae were measured in millimetre for MSH, MSB, GCH and GCB with the help of the sliding calliper. The logistical regression equation was derived from these measurements. Results: Among all parameters, MSB found to be most significant (P ≤ 0.001). For the regression equation incorporating all for Scapular dimensions, the logistic regression score (Y) is calculated as follow: Y = (–0.246*MSH) + (0.122*MSB) + (–0.486*GCH) + (–0.034*GCB) +35.356. Conclusion: The results of this study are very useful for sex determination in medicolegal cases where the skulls and pelvic bones are damaged or not available. In this study, population specific logistic regression formula is derived by combination of parameters, which can be helpful for sex determination in Indian populations. Key words: Glenoid cavity, scapula, Sex determination

Cysticercosis is a grave helminth infection caused by the larval stage of a Taenia solium, it is commonly seen as cysts in various body tissues. Usually the patients with cysticercosis are asymptomatic, but in symptomatic patients the clinical findings depend on the number and location of cysticerci as well as the extent of surrounding inflammation. In the present case, we discuss an unusual presentation of the muscular cysticercosis as the cause of low back pain. The typical cysticercal cyst could be demonstrated on ultrasonography in the paraspinal muscles that responded well to conservative management. Key words: Cysticercosis, diagnosis, high resolution sonography, intramuscular, medical management, noninvasive