Brown tumor is a giant cell lesion associated with hyperparathyroidism. It is a non-neoplastic condition and represents terminal stage of the remodeling process in hyperparathyroid state. We report a case of brown tumor with multiple lesions in craniofacial region associated with ectopic parathyroid adenoma revealed after acute L-thyroxine poisoning. This case report emphasizes on the need for routine biochemical investigations along with serum calcium, phosphorus and parathyroid hormone levels in patients on thyroxine therapy.

The main aim of the present work is to study the position and variation in nutrient foramen in relation to styloid process and its distance from the the styloid process which is most important in a fibular flap during mandibular reconstruction. Fibula is one of the long bones present on the lateral side of leg. It receives its own neuro‐vascular bundle apart from the muscles attached to it. The upper end of the fibula with its nutrient artery and nerve entering its nutrient foramen along with muscles attached to it is preferred in most of the mandibular reconstruction and is called as fibular flap. While doing the fibular flap, care is being taken to avoid damage to neuro‐vascular bundle to fibula. The aim of the present work is study the position of nutrient foramen and its distance from the styloid process. The nutrient artery to fibula arises from the peroneal artery which winds around the neck of fibula and descends down along the fibula deep Flexor Hallucis Longus. Near the middle of fibula, it gives off nutrient artery which enters the nutrient foramen, and ramify within the fibula. The study has been carried out in 50 dry specimen (fibula) and radiological study has been carried out in 30 normal individuals. Various parameters like position and direction of nutrient foramen, distance from the styloid process were studied in the dry fibula and the same study was carried out in the radiology of fibula of normal individuals. The results have been tabulated and compared between the dry specimen and the normal individuals. These results were later correlated with the clinical application while tracing the nutrient foramen with the artery during mandibular reconstruction.

Introduction: Cervical node metastasis in oral cancer is anindicatorofadvanceddisease.Itisthereforeimportant to evaluate neck node involvement as a predictor of progressionandtreatmentplanning. Materials & Methods: Eleven patients with age range between38to63years(medianage54years)undergoing neck dissection simultaneously with the resection of primaryintraoralsquamouscellcarcinomaformedthebasis of the present study.A pre-operative assessment of neck by clinical examination, ultrasonography and computed tomographyscanwasdone,whichwasthencomparedto the histopathological assessment. The histopathological examinationformedthereference. Results: The percentage of sensitivity by clinical examination was 46%. The percentage of sensitivity by ultrasonogramwas69%.Thepercentageofsensitivityby computed tomography (CT scan) was 85%. These were againstthehistopathologicalexamination. Conclusion: The study reported an error of almost 50%for the clinical examination alone. The margin of error decreases when combining ultrasonography or CT scan in the examination. However, in the existing economic condition in India, even the use of CT scan can be prohibitive. Nevertheless, it is advised to combine other diagnostic modalities during the clinical examination of cervicalmetastasis.

Urinary tract infection (UTI) is an intermittent cause of sickness in the pregnant women. A study was conducted to identify the microbial gamut and antibiotic vulnerability patterns of bacteria isolated from pregnant women with suspected urinary tract infection. In total, 75 urine specimens were screened for bacteriuria over a period of four months. Aseptically collected urine specimens were subjected to standard isolation and characterization procedures. Antibiotic susceptibility test was performed according to CLSI (2007). Five types of bacteria were isolated namely Escherichia coli 32(55%), Staphylococcus aureus 12 (21%), Enterococcus Sp 7 (12%), Klebseilla pneumoniae 4 (7%) and Pseudomonas aeruginosa 3 (5%). All bacterial isolates exhibited efficacy to all the antibiotics namely fosfomycin (50mg), ciprofloxacin (10mg), trimethoprim & sulfamethoxazole (25 mg), ampicillin (10 mg), nitrofurantoin (300 mg) and cefazolin (30mg) except amoxycillin. Ampicillin and ciprofloxacin exhibited illustrious efficacy at low concentration. Regular antimicrobial surveillance and reinforcement of appropriate antibiotic regimen in pregnant women with UTI will restrain the re‐emergence of antibiotic resistant uropathogens.

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