Chronic diseases are significantly increasing globally and increasing premature deaths among population. CDC has defined chronic diseases are the conditions that last 1 year or more and require ongoing medical support or limit the daily activities or both. Diabetes and hypertension are popular chronic diseases. But there are many others are also now increasing. The current study was conducted to find out the prevalence of noncompliance among chronic diseases like thyroid diseases, Asthma, COPD, Orthopedic problems and epilepsy. Also to understand the determinants factors among them. It was a hospital based cross sectional study. The sample size was calculated and it was 36 for each disease. Total 40 study participants of each disease were included. It was randomly selected the individuals diagnosed with the mentioned chronic diseases who have been diagnosed and on treatment for more than 3 years from hospital.
Result: A total of 200 patients participated in the study. The study included 40 patients from each chronic disease that is thyroid disorders, COPD, Orthopedic problems, Asthma and Epilepsy. The rural population comprised 69% of the total study group. The prevalence of medical noncompliance was found in 56.5% of all the patients. People having the disease for longer period of time were more non-compliant. The study revealed that family support and regular follow up with doctor are two important determinates factors which has positive impact on compliance.
Conclusion: Noncompliance to medication regimen among chronic disease patients is an important issue for public health consideration. This current study recorded an overall noncompliance level of 57.5%. The factors identified as contributing to medication noncompliance in this study were regular follow ups, family support, adequate knowledge regarding their disease and importance of taking medication with or without symptoms.

Oral carcinoma is quite common and increasing trend in India and worldwide. Smoking and smokeless tobacco both are increasing worldwide. The common oral precancerous lesions are oral leukoplakia, erythroplakia, nicotina palati and oral sub mucous fibrosis (OSMF). Screening is best tool to find out such lesions. The current study is conducted to know the prevalence of tobacco consumption and also to examine oral cavity of tobacco consumer to detect precancerous lesions among the staff.
Method: The present study was cross sectional study carried out tertiary care hospital staff. The study was conducted over a period of 6 month from May 2017 to October 2017. Ethical clearance for study was obtained from Institutional Ethical Committee. The staff members of class 3 and class 4 of hospital were taken as a study participants involving both of sex and who provided written informed consent. Sample of 120 staff members were enrolled for the study from provided sampling frame with the use of random sampling method. Study participants with previous history of hospital admission for any systemic illness, immunodeficiency or immunosuppressive patients, and participants who already diagnosed to have malignant cancer lesions in any part of body were excluded.
Result: Of 120 study participants, 40% were belongs to 31 – 40 years of age group and majority were male (80%) and belonged to Hindu (90.83%) religion. The prevalence of tobacco consumption in any of form is 85%; of them 43.33% used smokeless tobacco and 10.83% used to with smoking and 30.83% had both forms of tobacco. Oral Sub Mucosal Fibrosis (OSMF) was the most common (70.58%) precancerous lesion found in the present study, followed by leukoplakia (16.67%).
Conclusion: Current study revealed the high prevalence. There is urgent need to plan de-addiction at various level. Also those having the precancerous lesion need to warn and treat accordingly.

Following thyroidectomy, the preservation of the recurrent laryngeal nerve is the gold standard. Visual identification of the recurrent laryngeal nerve is mandatory during thyroidectomy. That technique has decreased the rate of permanent palsy during thyroid or parathyroid surgery (1). However, the palsy can occur when using only the visualization of the nerve, even in experienced hands (2).
Intraoperative nerve monitoring is a common technique in ear surgery, used to permanently monitor the facial nerve. This technique can be used in the thyroid surgery as well. Intraoperative neuromonitoring of the recurrent laryngeal nerve represents an adjuvant technique, until the visual identification and functional confirmation of the nerve.

Craniofacial fibrous dysplasia is a non-malignant disease. It appears due to the mutations of the GNAS gene that results in inhibition of the differentiation and proliferation of bone-forming stromal cells and leads to the replacement of normal bone and marrow by fibrous tissue and woven bone. Sometimes it is isolated to a single or multiple skeletal sites and / or endocrine organ (1, 2, 3, 4). The disease commonly progress as a slow developing mass. Distortion of optic nerve, eye ball, nasal airway, facial nerve, teeth and middle year ossicles can occur. In young patients, at prepubertal age, the growth is rapid and can cause aneurismal bone cysts or mucoceles (1, 3, 5). The malignant change to osteosarcoma or other form of sarcoma can appear in less than 1% of cases (1, 2).

Coblation is a surgical technology which consists in delivering radiofrequency energy to soft tissue. This technology uses radiofrequency in a bipolar mode with a conductive solution, such as saline (1). It energizes the ions in the saline to form localized plasma near the tissue placed in the area of surgical interest. Plasma’s energy dissociates water molecules from saline solution thus providing the optimal chemical conditions for breaking the tissue’s molecular bonds (2). The application of this technology has three effects: tissue ablation, localized removal and tissue volumetric reduction (2). The dissipated heat by using this type of radiosurgery is significantly lower than common radiofrequency techniques. This is due to intrinsic of the chemical process and the continuous cooling of the tissue from the surrounding saline solution at the level of the instrument’s tip (3). In this way the temperature rises to 45-85°C (1, 2). The decreased thermal effect of coblation, better than classic radiosurgery, induces a gentle but efficient surgical effect in the target area. Thus the surgeon can gently remove tumors, small organs (tonsils) and can melt some anatomical structures (turbinate, palate, base of tongue). There is a large field of surgical applications in the pathology of the upper aero digestive tract.

The original vascularised nasoseptal mucoperichondrial flap was described and used, in the endoscopic reconstructive surgery of the skull base tumors, for the first time in 2006, by two surgeons, Hadad and Bassagasteguy [1]. This kind of vascularised flap provides the surgeons the ability to close large skull base deffects after removing sinonasal tumors. The vascularisation is provided by the posterior septal branch of the spheno-palatine artery [1]. The flap is well vascularised and the surgeon is able to harvest a large surface flap using almost all septal mucosa from one nostril. Sometimes, if the defect that had to be reconstructed was very large, some authors reported that they harvested the nasal mucosa from the nasal floor too. Some modifications were reported on patients where the flap was created by using bilateral nasal mucosa, but no advantage was gained by sub-maximal, bilateral septal flap harvesting as compared to a single, large, long, unilateral flap, taken to the vestibular skin anteriorly and to the inferior meatus laterally including the palatal floor [2,3]. Bilateral mucosal elevation leaves denuded septal cartilage and bone on both sides of the septum which prolongs the return of nasal mucosal function unless a formal posterior septectomy is also performed. The large surface area of the nasoseptal flap allows great versatility of movement [4]. It is capable of reaching any single segment of the ventral skull base, including the sella turcica, planum sphenoidale, clivus or the cribriform plate [4,5]. At its largest dimension, the nasoseptal flap is able to cover an entire anterior craniofacial defect from the frontal sinus to the planum sphenoidale and from orbit to orbit. The good vascularisation of the flap and the origin of the vascular source provide the surgeon with the ability to rotate the flap almost all directions [5].

Fibrous dysplasia is a benign condition consisting in replacement of normal bone with fibrous tissue and unorganized bone woven (1). The malignant change to osteosarcoma can appear in less than 1% of cases (2). Osteosarcoma is found most often, but other lesions as fibrosarcoma, chondrosarcoma, and malignant fibrohistiocytoma are reported (3,4). Fibrous dysplasia appears due to somatic activation of mutation in the G protein encoded by the gene GNAS. GNAS gene mutations cause McCune-Albright syndrome defined by the triad of PFD, café-au-lait skin macules and endocrinopathies, including amongothers, precocious puberty (5). It is caused by a random mutation in the GNAS gene that occurs very early in development.