The Epstein-Barr virus (EBV), also called human herpes virus 4, is a virus of the herpes family, having linear double-stranded DNA as its genome. It is best known as the cause of infectious mononucleosis. Besides this, EBV is also associated with particular forms of malignancy, particularly Hodgkin's lymphoma, Burkitt's lymphoma, and nasopharyngeal carcinoma, all of which may show their prime manifestations in head and neck area, for which patient may seek a dentist referral initially. In addition, EBV is linked with oral hairy leukoplakia, which may be an earliest oral manifestation of HIV infection. This review article primarily deals with clinical manifestations of diseases associated with EBV infection particularly in head and neck area.

The identification of nitric oxide in exhaled breath and its role as a surrogate marker of eosinophilic inflammation of the airways led to rapid development in the area of its measurement. Standardized measurement techniques have been developed as well as simple, cheap, and reliable equipments. Although a number of factors have been identified as affecting its assay, fractional exhaled nitric oxide (FENO) can reliably be used to distinguish eosinophilic from non-eosinophilic airway inflammation. Unlike the other indirect measures of airway inflammation such as FEV1 reversibility and bronchoprovocative tests, FENO is noninvasive and gives a direct measure of inflammation. There are sufficient data supporting its role in the diagnosis of asthma, monitoring of disease, prediction of relapse, and level of compliance. Measurement of FENO has therefore made the transition from the bench to the bedside. Of recent, there are attempts at devising interpretative strategies for its use in day to day clinical practice.

Background: Birth weight is an important determinant of child survival and development. It is also a subject of clinical and epidemiological investigations. This study was planned to find out the epidemiological factors associated with low birth weight (LBW) among institutional deliveries so that suitable recommendation can be made to prevent LBW. Objectives: The present study was therefore undertaken to find out some maternal factors that may have their association, if any with LBW. Materials and Methods: This cross-sectional study was carried out at tertiary care hospital among 350 mothers delivering live born neonate in study place. All babies were weighed within 24 hours after the birth. The babies were weighed on beam type weighing machine up to 20 g accuracy. LBW was defined as a birth weight of <2500 gram. All mothers were examined and interviewed within 24 hours after delivery and findings were recorded. The analysis was done using Epi Info package. Results : In this study, 40.0% mothers delivered LBW babies. Findings indicate that gestational age less than 37 weeks (76.5%), maternal age less than 20 years (58.5%), irregular antenatal checkup (70.5%), mother's height less than 150 cm (68.5%), mother's weight less than 50 kg (76.1%), hemoglobin less than 10 gm/dl (60.5%), severe physical work (78%), and tobacco chewing (58.5%) are significant determinants of LBW. Conclusion: Our study indicates that gestational age, maternal age, regular antenatal checkup, mother's height, mother's weight, anemia, physical work, and tobacco chewing are significant determinants of LBW. Prevalence of LBW can be reduced by increasing the gestational age, regular antenatal checkup, balanced diet during antenatal period, adequate rest during antenatal period, and avoiding the tobacco chewing.

Background and Objectives: Neonatal hypoglycemia, a common metabolic problem, often goes unnoticed owing to lack of specific symptoms. We designed this study to assess the incidence of hypoglycemia in healthy normal birth weight and low birth weight babies, including both preterm and small for gestational age (SGA) newborns, to evaluate the impact of early breastfeeding on hypoglycemia and to assess the impact of exclusive breast feeding on glucose values up to 48 h of age. Design and Settings: A hospital-based prospective longitudinal study. Materials and Methods: The study was conducted over six months involving one hundred fifty healthy (both term and preterm) appropriate for gestational age (AGA) or SGA babies with birth weight between 1.5 kg and 3.99 kg. Blood glucose values were measured at the age of 1 h, 6 h, 12 h, 24 h and 48 h after delivery which was independent of feeding time. Blood glucose value less than 40 mg/dl (2.2 mmol/l) was defined as hypoglycemia. Sick newborns, those less than 34 weeks of gestation or less than 1500 g, infant of diabetic mother, those with birth asphyxia, congenital malformations and endocrine deficiencies were excluded. Results: Overall incidence of hypoglycemia was 32%. Hypoglycemia was significantly greater in SGA and preterm as compared to AGA and term newborns respectively (P<0.001). Incidence of hypoglycemia was significantly more in newborns with delayed breast feeding than early breast feeding (64% vs 17%; P<0.001). Conclusion: Low birth weight babies (both preterm and small-for-date) are prone to develop hypoglycemia especially in first 24 h of life with delayed introduction of breast feeding being an additional risk.

We report an uncommon case of tuberculosis involving left second toe associated with left inguinal lymphadenopathy and an ulcer in a 30-year-old male with no other pulmonary or extra pulmonary tubercular infection. Diagnosis was made by biopsy. He responded very well to anti tubercular treatment.

Claudius Amyand, Surgeon to King George II, was the first to describe the presence of a perforated appendix within the hernial sac (in 1735) of an 11-year-old boy who had undergone successful appendicectomy. Amyand's hernia is an inguinal hernia with an appendix involved. It is a rare condition. The chance finding of the vermiform appendix lying within an inguinal hernia occurs in approximately one percent of cases of inguinal hernia. Preoperative diagnosis is difficult. If additional pathologies exist, the diagnosis is more troublesome. We aimed to present a patient with Amyand's hernia which is rare in the literature