The first issue of Chettinad Health City Medical Journal both the online and print version were well received. You will find some e-mails from the readers in the letters to Editor. We are trying to incorporate as many suggestions as possible.

To predict the outcome of surgical retrieval of spermatozoa using serum FSH and testicular volume as markers in men with Azoospermia. Method: It was a cross sectional study from February 2008 to July 2011 done at the Department of Reproductive Medicine at a tertiary care hospital. Forty seven men with Azoospermia who had undergone surgical testicular or epididymal spermatozoa retrieval were included in the study. The data was analyzed in two groups- serum FSH levels: 1–14 and > 14 IU/mL; testicular volumes were analyzed under 2 groups: <8 ml and ≥8 ml.

There is an increasing disagreement and dissatisfaction among common public regarding the current status of health care. With an exponential increase in the number of malpractice lawsuits, the trend is shifting towards the practice of defensive medicine. In an attempt to protect oneself from defamation and harassment, the health care providers anticipate problems and act to prevent them. Amidst the advancements and sophistication of medical practices, at times the very basic component of a physician patient relationship is being overlooked: communication. While effective communication brings down the stress levels of patients and relatives, a healthier and timely discussion might protect a practitioner against malpractice allegations. The present case is an example of how a doctor patient/ relative discussion could have avoided unnecessary legal and emotional hassles for the relatives of the patient and the investigating authority.

Thumb sucking is a common habit among younger children. Usually, the child outgrows this habit by age 2.5-3 years. When a child continues to suck his or her thumb, it can be a cause of potential harm due to peer pressure, ridicule, and shunning. It can also lead to malocclusions. Early detection and appropriate intervention can help in correcting the habit and malocclusion and preventing an orthodontic treatment at a later stage. We are reporting a case of thumb sucking where intervention was done and malocclusion corrected during the growing phase of the child.

Eagle’s syndrome is not an uncommon condition, but less known to Physicians where an elongated styloid process or calcified stylohyoid ligament compresses the adjacent anatomical structures leading to orofacial pain. Pain often gets relieved by amputation of styloid process.

The buccal fat pad is commonly used in oral surgical procedures as it can be harvested easily, is reliable and has minimal complication.The volume of buccal fat pad is important when used for grafting in oral submucous fibrosis to achieve adequate coverage of surgical defect. The fat pad undergoes atrophy as age advances and in severe cases of oral submucous fibrosis, and the availability of normal to good volume of buccal fat is rare in these group of patients.Adequate volume of buccal fat pad is necessary to cover the surgical defect in oral submucous fibrosis.In majority of patients the fat pad undergoes atrophy as the disease progresses. After grafting, the buccal fat is replaced by stratified squamous epithelium over a period of time. We present a peculiar case of oral submucous fibrosis treated surgically with buccal fat pad grafting with special emphasis on the volume of fat obtained.

Bochdalek hernia, a congenital posterolateral hernia of the diaphragm , usually manifests in the neonatal period and occasionally in childhood. Symptomatic Bochdalek hernia is uncommon in adults. Patients are usually investigated and treated for other diseases, therefore diagnosis is purely incidental. Here we report a patient who presented with features of chronic respiratory distress, who on investigation was found to have diaphragmatic hernia which was later operated.

Acetabular fractures are often sustained in four wheeler accidents. Most patients are young. The ideal treatment is internal fixation in displaced fractures. In neglected fractures or following improper fixation, avascular necrosis and secondary osteoarthritis result1 . In such cases total hip replacement is required. These case reports illustrate total and short stem hip replacement for neglected acetabular fracture.

Nitrous oxide or laughing gas as we commonly know was discovered by Joseph Priestly. In the early part of eighteenth century, a lot of work went into the experiment of “airs”and “gases” in the belief that they could provide therapeutic effects. One night in 1772, when Priestly was experimenting with some of the gases he had already discovered, he mixed a few of them and discovered a new gas. He just couldn’t stop laughing after inhaling this new gas, hence called it laughing gas.

All the available drugs in one way or other help the recipient to ward off or cure a disease, but at the same time each drug carries simultaneously an unavoidable risk of causing certain adverse effects which may be tolerable or intolerable. The severity of adverse effect increases when many drugs are prescribed. Whether such combinations, intentional or unintentional, really benefit or harm the recipient, should be known to a prescriber. With this objective the present article reviews in detail the potential outcome of combination of cardiovascular drugs.

The care of the mechanically ventilated patient is a fundamental component of clinical practice in the intensive care unit (ICU). It is important that care of the mechanically ventilated patient in the ICU is well supported by evidence. Published work relating to the numerous issues of safety and care of the mechanically ventilated patient in the ICU is growing significantly, yet is fragmentary by nature. To establish the evidence supporting practice, a full review of current literature was undertaken using the following steps: Electronic search was done on MEDLINE, CINAHL, EMBASE and Psych-Review databases for articles published between 1970 and 2012. The purpose is to provide a single comprehensive examination of the evidence directly related to the safety and care of the mechanically ventilated patient.

Students know him as a flawless and dedicated teacher, colleagues know him as a perfectionist, patients know him as the most trustworthy maxillofacial surgeon, people who have worked under him know him as an able administrator; when we went to meet this interesting person, we saw a carefree, totally unassuming gentleman, completely immersed in his textbooks and study materials. Yes! We are talking about one of the persons who laid the strong foundation for the everdeveloping field of oral and maxillofacial surgery in Chennai- Prof. C.K. Dhanashekaran.