Oral Submucous Fibrosis (OSMF) is a disease of unknown etiology. A total of 96 patients with Oral Submucous Fibrosis have received four regimens of treatmentlocal dexamethasone, local hyaluronidase. local combination of dexamethasone and hyaluronidase, and local placental extract. The patients were followed up for a period varying from 3 months to 2 years. The group of patients receiving hyaluronidase alone showed quicker improvement in symptoms although its combination with dexamethasone gave somewhat better longer-term results. A new regimen for the treatment of submucous fibrosis is recommended.

The pathogenesis of slipped upper femoral epiphysis is unknown but the condition has been linked with various endocrine disorders. Nine patients with slipped epiphyses in association with primary juvenile hypothyroidism are presented. In all patients, slipping occurred or symptoms developed in the affected hip before the hypothyroidism was diagnosed. A generalised pathology was suggested by the absence of trauma (8 patients), by bilateral slipping (6 patients), and by obesity and short stature in all patients. All cases had delayed skeletal maturation and characteristic metaphysial changes were seen on their radiographs. The clinical diagnosis of juvenile hypothyroidism can be difficult but it merits consideration in patients who have a slipped upper femoral epiphysis in association with short stature, obesity, delay in skeletal maturity, or any one of these.

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realms of a person's life (5). It is conceived as a lack of health, which generates feelings of anger and sadness, as well as embarrassment. There is also the stigma associated with urinary/stool incontinence. Due to the smell of urine, patients avoid social gatherings and lose self-confidence, which has a proportional impact on their social interactions, their sexual life and emotional health (5;6). Obstetric fistula survivors who have been shunned and isolated typically experience intense feelings of shame, self-loathing and depression (8). Obstetric fistula survivors often avoid social contact because of feelings of shame, which negatively influences their quality of life (QoL) (3;9;10). Up to the present, only a few studies have investigated QoL after fistula surgery so there is paucity of information. Overall, the existing studies show that the symptoms in most patients are reduced after treatment, which leads to an increase of