By:-Dr.Yagnesh Bhalodia

       Under guidance of:-Dr. B.D.Parmar,M.D

                  Acknowledgements

     I humbly take this opportunity to bow down, to express my heartfelt devotion and thanks giving to my God who is the author and finisher of my life and faith; who stood by me and who has promised to do so always.

     I can hardly express in words my sincere gratitude, indebtedness and respect for my teacher  and guide Professor Dr. B.D.Parmar, M.D.,Head of Department of Medicine and Additional Superintendent of Guru Gobind Singh Hospital, Jamnagar, under whose able guidance and constant supervision only this work was possible. His whole hearted co-operation and counsel cheered me through and humbled me. Most of all, his knowledge, considerate nature, love, and care for his students as well as patients has made a deep impression on my life, which I believe will linger on throughout my career.

     I also express my respect, appreciation and gratitude to respected Dr.J.J.Oza, M.D., Dean, M.P.Shah Medical College & Superintendent GGH,Jamnagar and my teachers Dr.Y.K.Oza, M.D., Dr.D.R.Gohel, M.D., Dr.H.K.Acharya, M.D. and all other teachers in the faculty.

     My father , my ideal teacher, who has built every part of my life and his constant encouragement only sustained me through this lengthy work.

     My sincere gratitude to Dr.Deepal Gandhi, Dr.Kinjal and Mr.Pragnesh Bhuva for their kind help and co-operation.

      Lastly I offer my sincere regards and respect to my dear patients and their relatives who willingly co-operated with my humble efforts.

                                                                          -Yagnesh.