January 2018

Introduction: Esophageal carcinoma is an uncommon malignancy acNumbering for approximately 1% of all malignancies, 6% of all GI malignancies (1). Its distribution across the world is variable. Esophageal cancer is the 8th most common cancer worldwide & 6th leading cause of death world-wide. Aim of the study: To determine the outcomes of the definitive management of thoracic esophageal cancer using chemoradiotherapy or radiotherapy, at our institute during the period between 20011 and 2014. Material and Methods: This is a Retrospective study done at our institute from January 2011 and May 2012 patients who received radiotherapy (RT) alone or chemoradiotherapy (CT+RT) for the treatment of carcinoma esophagus. Conclusion: Our study shows that chemoradiotherapy yields significant survival benefit over the radiotherapy alone in the definitive management of patients with T1-3 N0-1 esophageal tumor, who did not undergo surgery. While the overall survival of the entire cohort (N=185) was 13.9 months, chemoradiotherapy offered a survival advantage of 11.6 months over radiotherapy alone (median survival in the CT+RT versus RT alone groups was 19.1 and 7.5 months, respectively). The overall survival rate (OS) at 1 year following treatment was significantly better in the combined chemoradiotherapy group when compared with RT alone group (56% versus 24%).

Objectives: To evaluate and compare the defects produced on root canal walls during the use of H-files, Pro Taper retreatment files and M-two retreatment files in removal of gutta-percha and also to evaluate the time required for complete removal of gutta-percha. Method: Root canals of 60 single-rooted mandibular premolars were cleaned, shaped, and obturated with gutta-percha and AH plus sealer. The teeth were then randomly divided into four main groups. The group where retreatment was not carried out served as the control group. Gutta-percha was removed in the other three groups using either H-files, ProTaper retreatment files or M-two retreatment files. The roots were sectioned horizontally at 3, 6, and 9mm from the apex with a diamond disc. The root slices were viewed under a stereomicroscope for presence of cracks. Total time required for complete removal of gutta-percha was recorded for each sample. Results: Cracks were observed in all the groups. Total number of cracks present in ProTaper retreatment group, M-two retreatment group, H-files and control group was 44.4%, 35.6%, 13.3% and 4.4% respectively. H-files took significantly more time for removal of gutta-percha when compared with rotary files. Conclusion: Use of rotary Ni-Ti retreatment files leads to increased chances for dentinal defects and cracks. ProTaper retreatment files, though faster than M-two retreatment files or H-files, produced the most number of defects and cracks in the canal walls.

Cleidocranial dysplasia is a rare congenital disease. It is characterized by autosomal dominant inheritance pattern with equal sex distribution which is caused due to mutations in the Cbfa1 gene (Runx2) located on chromosome 6p21. It primarily affecting skull, jaws, teeth, clavicle along with other skeletal abnormalities. It presents with skeletal defects of several bones, like partial or complete absence of clavicles, late closure of the fontanels, presence of open skull sutures and multiple wormian bones. This rare syndrome is of utmost importance in dentistry due to presence of multiple supernumerary teeth, facial bones deformities and deranged eruption patterns .We are reporting a classical case of cleidocranial dysplasia in 12 year old patient.

Objective: This research aimed to determine the efficacy of Crown Rump Length (CRL) by ultrasound in estimating the Gestational Age (GA) compared to GA by Naegele’s rule using Last menstrual period (LMP) date. Materials and Methods: This was a prospective observational study of women with a normal spontaneously conceived viable singleton pregnancy, a regular menstrual cycles, andspontaneous onset of labor at term. The LMP was considered certain in all cases. We used ultrasound to scan 2067 fetuses (894 healthy women) and we had 500CRL measurements. Data were collected prospectively and used for statistical analysis. We used Descriptive Statistics to calculate the Mean, Standard Deviation (SD), Median and Percentiles values (3rd, 5th, 10th, 50th, 90th, 95th, and 97th) for CRL measurements on gestational age. We found a regression equation to estimate the GA using CRL measurements. The results of the current study were compared with different studies using the Paired Differences (t-test analysis). The results were represented as tables & diagrams. Results: The best-fit equation for the estimate of GA from CRL (in mm) was: = 6.254 + 0.151 (CRL)i – 9.5*10-4(CRL)i2 + 4.12*10-6(CRL)i3 The Mean Sum of Squares of regression deviations of the GA regression model using (CRL) was 1546.8and this value is significant at P <0.001. The standard error of the Estimate (Std.Error)was 0.67 and the standard deviation (SD)was (0.65, 0.71, 0.69) weeks when the GA were (≤12, 12-18, 18-22), respectively. Conclusion: In this study, we presented diagrams and tables for the estimation of GA using CRL measurements in a group of pregnant Syrian women. These results can be useful in women who cannot recall their last menstrual period (LMP). Our criteria will provide useful references for estimating gestational age and fetal care. A larger study might be needed to include a larger sample of the population.

This classroom action research aims to find out the implementation of Visual, Auditory, Somatics, and Intelectualy Instructional Approcah on improving Elementary school students’ English vocabulary mastery. It using two cycles of Kemmis and McTaggart’s Model. Each consists of planning, acting, observing, and reflecting. The data about Parts of Body of English vocabulary was collected by using observation sheet of teacher acts, transcription and document analysis applied for VASI Instructional Approach.The Elementary school students’ English vocabulary mastery of Parts of Body proved with students’grade of 56% in the first cycle to 87% in the second cycle. The students’ English vocabulary mastery improve 31%. The study implicated that VASI Instructional Approach impacts on Elementary school students’ English vocabulary mastery of Parts of Body, and so it can be one ofEnglish instruction alternative.

Background: The latter part of the twentieth century saw a transformation in both general health and oral health unmatched in history. Yet, despite the remarkable achievements in recent decades, millions of people worldwide have been excluded from the benefits of socioeconomic development and the scientific advances that have improved healthcare and quality of life. Inequalities in oral health persist worldwide, with mainly affected being the deprived population such as the tribals. Assessment of the oral health status and associated behaviours is an essential part of the process of planning appropriate and acceptable health services and dental health education programs in order to improve the dental health status of this population. Hence, an integrated multidisciplinary approach is required to study the tribal health problems. Aim: To provide baseline data about oral health of Yanadi tribe inhabiting Gonepalli village Methodology: This descriptive cross-sectional study was carried out in the month of December 2014. The data of all the tribal people in the village present during the time of examination was collected by a door to door survey. The data was collected using WHO proforma 1997 by Type III clinical examination. Significance between the variables was determined using Fisher’s exact test. P<0.05 was taken as statistically significant. The data was analyzed using The Statistical Package for the Social Sciences, (SPSS) version 20. Results: In a total sample of 233 (100%), males constitute 37.34% (87), females constitute 62.66% (146). Majority of the participants belonged to 35-50 year old age group, 31.3% (73). Decayed teeth (100%) and total DMFT scores (100%) were highest for the 16-24 year age group. Missing teeth were highest in the >50 year age group (56.4%). There were no filled teeth in all the age groups. Calculus was highest in the 25-34 age group (78.2%), shallow (46.2%) and deep pockets (33.3%) were highest in the >50 age group. As the age increased the number of missing teeth and loss of attachment increased. A significant correlation was seen with the method of cleaning i.e., if they use brush, finger or datun, with the material used for cleaning teeth, type of tooth paste used or if they aren’t using tooth paste, with the frequency of changing brush and how often they rinse their mouth after eating (P<0.05). Conclusion: Yanadi tribal population of Gonepalli village, Nellore district are characterized by lack of dental care and poor oral hygiene practices. There was high prevalence of periodontal diseases in adults and old people, decayed component of DMFT is high in children and adults whereas missing component of DMFT is high in older population.

Distal femoral fractures account for about 6-7% of all femoral fracture and often are unstable and comminuted. They have a potential for long term disability. Impaired healing of such fractures further delays the rehabilitation process, thus impacting quality of life. Teriparatide is not an approved drug for treating osteoporosis in India, unlike other countries. Intermittent administration of teriparatide has anabolic effects that stimulate bone formation and activate bone remodeling. The purpose of this case report is to elucidate the Indian experience of 5 cases of use of teriparatide for fracture of distal femur with non-union. In our experience teriparatide therapy was beneficial to bone healing after the fracture of distal end of femur. Further, it may lead to an early return to activity and vocation for patients undergoing fracture distal end femur.

Chronic diseases such as diabetes and eye complications are a public health problem in the world and in developing countries such as Côte d'Ivoire. A study was conducted at the National Institute of Public Health with the aim of measuring the extent of blinding ocular diseases in diabetic patients. This was a cross-sectional study of patients followed at the Abidjan Antidiabetic Center of the National Institute of Public Health from June to December 2015. The data were collected from patients using pre-tested questionnaires and from an interview and acomplet eophtalmological examination. The collected data were entered on the EPI data software and processed on the SPSS 12.0 software. 376 patients were recruited during this period. It was a population with an averageage of 54 years predominantly female (sex ration H / F of 0.67). The average duration of diabetes reported was 10 years and type II diabetes predominated. The prevalence of low vision (28.5%) and blindness (5.3%) were high. The most common blinding ocular conditions in diabetic patients followed in our study were cataract (32.7%) and diabetic retinopathy (15.4%) and glaucoma (14%). Given the socio-economic weight of this public health problem, the consideration and implementation in the health system of mass screening interventions and programs coupledwith the early management of diagnosed cases becomes a priority.

Background of the Study: Acapella an oscillatory positive expiratory pressure device used for the clearance of secretions in the COPD patients. It sends the vibratory signals into the lungs, shaking the mucus plugs that the patient cough and improve cough effectiveness and push out secretion. The diaphragm is the most efficient muscle of breathing and the diaphragmatic breathing helps to strengthen the diaphragm, decrease the work of breathing, useless effort and energy to breathe. Methodology: It is an experimental and comparative study done at ACS MEDICAL HOSPITAL using 20 subjects of age group 40-60years only male sex included for about 8 weeks for those who had RR>30respiratory fatigue or failure. Materials Used couch, chair, foot stool, stopwatch, acapela device. Procedure: 20 subjects were selected randomly by lottery method. Chits odd number in group and even number in group B. Group A- Acapella device Group B-Diaphragmatic breathing. Outcome Measures: Pulmonary function test (PFT) Result: The result was based on the statistical analysis of data collected and it revealed that both the groups showed improvement while group A comparatively better than group B on the basis of PFT.

This paper deals with focussing on multidimensional effect of Cyperus rotundus Linn. in curing no. of ailments. It is found at tropical and temperate climate throughout the country up to an altitude of 800 m. Aim of this study was to review the efficacy of plant in curing various ailments such as Ulcerative colitis, Dental disorders, Vomitting, Uterine contraction, Bad breath, Wound Healing, Diarrhoea, Indigestion, Cholera, Dyspepsia. Ethnomedicinal uses of the plants also helps in curing various health problems in human. In animal studies it shows a number of activities in various disorders or diseases such as Antiarthritic activity, Anticonvulsant activity, Antidiabetic activity, Antifungal activity, Antihistamine activity, Antihypertension activity, Antiinflammatory activity, Analgesic activity, Antimalarial activity, Antimicrobial activity, Antioxidant activity, Antipyretic activity, Hepatoprotective activity, Smooth muscle relaxant activity, Wound healing activity. It may prove to be source of good molecules for new drug design.

The present study was conducted in Department of Anatomy and 64-slice CT center of Department of Radio diagnosis, King George’s Medical University, U.P. Lucknow. Morpho metric data of the aortic arch can be of help for conceiving, designing and optimizing all types of diagnostic and therapeutic interventions involving the aortic arch. We measured aortic arch diameters at following levels: Aorta just proximal to the innominate artery, Proximal transverse aortic arch, Distal transverse aortic arch and Aortic isthmus. Diameter of major branches of arch of aorta at their origin was also measured. All the parameters were corelaed with age and gender. Aortic diameters were 25.02 ± 5.76 mm proximal to the in nominate artery, 22.48 ± 5.14 mm at the proximal transverse arch, 20.60 ±4.81 mm at the distal transverse arch and 18.26 ± 4.49 mm at the isthmus. Mean diameter of brachiocephalic trunk in female subjects was 11.35+2.87 and in male subjects was 12.39+3.02.Left common carotid artery diameter in males had a mean value 7.2±1.3 mm as compared to females who had 7.0±1.7 mm diameter. Left subclavian artery diameter in females was 8.2+2.6 mm and in males was 10.5±3.1 mm We observed that among all these parameters only diameters of arch of aorta at different levels and left subclavian artery diameter were associated with age and gender. Diameters of arch of aorta were significantly higher in male subjects as compared to female subjects. Diameter of arch of aorta at various levels in age group 0-15 years was found to be significantly lower than that of other age groups. It gradually increases with age till 60yrs then it decreases. Significantly higher left subclavian artery diameter was found in male subjects as compared to female subjects.

Pain is a common experience in orthodontic patients,and fear of pain and discomfort is a concernfor many. Orthodontic pain usually beginsat 2 hours after force application and reaches its maximumintensity at bedtime or at 24 hours, and lastsapproximately 5 to 7 days.The aim of this study was to investigate the intensity of pain experienced by orthodontic patients following the insertion of separators and to compare the efficacy of ibuprofen and chewing gum in pain reduction during the placement of initial archwire. A total number of 60 patients seeking orthodontic treatment were included in this study between age group of 12- 24 years. The subjects were divided into three groups: placebo group (G1), ibuprofen group (G2), chewing-gum group (G3). They were asked to answer the questions based on visual analogue scale and to quantify the level of pain.Pain during placement of separator as per VAS scale- Majority of the participants (59.3%) reported mild pain with mode value of 2. Pain after placement of separator as per VAS scale- Overall 50 % of participants reported moderate pain with mode value of 3 and 4. 73% of participants reported pain on chewing food while 82.5% modified their dietary pattern.30% of participants reported intake of analgesics due to pain from elastomeric separator.Ibuprofen is most effective in reducing the pain. Chewing gum can also be recommended for orthodontic patients to reduce pain at chewing function.

Background: Preeclampsia is associated with higher prevalence of abnormal global left ventricular function. So present study was designed to compare these changes in normal and preeclamptic pregnancies using echocardiography. Methods: In present study, 96 patients with pre-eclampsia with singleton pregnancy between 20-30 years (study group) were compared with 96 age matched healthy pregnant women (control group). They were non-invasively analysed for cardiovascular hemodynamics using echocardiography. The data was analysedusing student’s t- test. p value <0.05 was considered to be significant. Results: Mean stroke volume in pre-eclampsia group was 72.4±5.1 ml v/s 67.7±5.6 ml in control group and the difference was statistically significant. Mean Cardiac output inpre-eclampsia group was64.2±3.4 lt/min v/s 5.69±0.47 lt/min in control group which is statistically significant.Mean Systemic vascular resistance (dyne.sec cm-5) in pre-eclampsia group was 1468.22±5.7 v/s 957.7±131 in control group which is statistically significant. Mean Ejection fraction (%) in pre-eclampsia group was 68.31±5.1 v/s 66.54±4.7 in control group which is statistically significant. Conclusions: Doppler echocardiography provides an excellent non-invasive method for evaluation of hemodynamic changes during pregnancy. Therefore if it is introducedinto antenatal protocol, could help to identify subset of preeclamptic women who are at high risk to developing complications and thereby can do early intervention.

India has a vast variety of medicinal plants. Medicinal plants synthesize variety of phytochemicals that help to defend against wide variety of microorganisms including bacteria, fungi, helminthes, and viruses. Use of plants as a source of medicine has been an ancient practice and is important component of health system in India. General public, academic and government interest in traditional medicine is growing rapidly due to increase side effects of the adverse drug reactions and cost factor of modern system of medicine. The present study focuses on comparison of nine Indian medicinal plants extracts for their Antibacterial, Anti-fungal, and Antioxidant activities.

Introduction: There is a high degree of similarity between Human Immunodeficiency Virus (HIV) and Hepatitis C Virus (HCV) in terms of routes of transmission, associated risk factors and their presence in the body fluids. Thus the co-infection of these two viruses is a common phenomenon. HIV accelerates the natural course of HCV infection and facilitates faster progression of liver disease to cirrhosis and heap tocellular carcinoma. Co-infection of HCV with HIV infection results into substantial impairment of cell mediated responses, faster progression of HIV to AIDS-defining illness. Progression of liver related pathogenicity in HIV-HCV co-infection leads to increased risk of drug related hepatotoxicity when Anti-retroviral Therapy (ART) is initiated in these patients. Material and Methods: A study was carried out in a tertiary care Hospital to determine the sero-prevalence of HIV-HCV co-infection. 200 randomly selected newly diagnosed HIV patients were enrolled. From each of the patient, 3-5 cc venous blood was collected and Anti-HCV by ELISA was performed on obtained serum samples. Recent CD4 T cell count, Liver function Tests and WHO staging of the co-infected patients was noted. Results: A single HIV-HCV co-infected case was found with its sero-prevalence of 0.5%. The co-infected case had lower CD4 T-cell count, deranged ALT level and presented with WHO clinical stage-II. Summary and Conclusions: We recommend screening of all HIV positive patients for Anti-HCV to know HIV-HCV co-infection. In HIV-HCV co-infected cases, liver function tests, CD4 T-cell count and WHO clinical staging should be regularly monitored.

The teaching and use of formative research within academic programs are greater than at any time in educational history. The formative research process of construction of knowledge, associated with learning and teaching. Objective: to analyze formative research as a learning strategy in leveling nurses, the theorists were developed: Demo with Research in learning, and Freire with problematizing and liberating education Díaz tummy with meaningful learning; Methodological design. Qualitative study, descriptive method carried out in 8 Leveling students, in-depth interviews were used. The thematic analysis was carried out using the Minayo technique. Results and discussion: 3 categories were selected 1. Generation of knowledge 2.- Research through problems 3. Linking practical theory Final considerations: they use strategies for formative research.

Objective: To study the maternal and neonatal outcome in multifetal gestation in a tertiary care centre Method: A retrospective observational analysis of 152 twin pregnancies admitted and managed at Govt. Rajaji Hospital, Madurai from May 2016 to april 2017 was done. Patients were studied for any adverse antenatal complications, mode of delivery and pregnancy outcome both maternal and perinatal. Results: Most common indication for admission was threatened preterm labour, Anaemia, Non severe preeclampsia. Out of the 152 patients 77 delivered at GRH(50%), others delivered at their native places, out of which 44 delivered by vaginal route (57%) whereas 33(42%) had to undergo caesarean section. Malpresentation of the first twin was the commonest indication (42%) for caesarean section. Out of the 77 women of twin pregnancy giving birth to 142 live-born babies, out of which 3(2%) were single fetal demises, and 9(6%) died due to complications related to prematurity: hyaline membrane disease, hyperbilirubinemia. Conclusion: The risk of pregnancy related complications in twin gestation are definitely more than a singleton pregnancy. Early detection and proper management of twin pregnancies can reduce the complication rates thereby improving maternal and neonatal outcome

Von Hippel-Lindau (VHL) syndrome is a multisystem disease caused by mutations of the VHL gene. In patients with family history of this syndrome, the diagnosis is usually easy to establish and these patients require screening for various lesions. However, diagnosis of this syndrome, in the absence of family history, is challenging. We present a case of VHL syndrome in a young female, with no family history. The case highlights the significance of high degree of clinical suspicion and close follow up, for lesions of VHL syndrome, in patients with cerebellar hemangioblastoma.

Background and objectives: The pain of childbirth is the most severe pain, most women will endure in their lifetimes. Women in pain don’t need an “indication” for pain relief in labour. According to the American Society of Anesthesiology (ASA) “in the absence of a medical contraindication, maternal request is a sufficient medical indication for pain relief during labour” A prospective study was conducted with the approval of the hospital Ethics Committee. 60 parturient in labor were enrolled in the study after signing written informed consent. This study is descriptive case series study which was conducted in department of obstetrics and gynecology, from January 2017 to July 2017. Methodology: The inclusion criteria were • Nulliparity • Age 18-35 years • Gestational age >37 weeks • Single foetus with vertex presentation. Exclusion criteria included • Multigravida • Abnormal presentations :Breech,Transverse • Infection at the site of epidural • Coagulopathies • Any spinal deformities • History of allergy to local anesthetics, fentanyl or tramadol. All parturients were counseled on admission to the labor ward and those who were desirous of epidural analgesia were allocated to the epidural group (study group). Visual Analogue Pain Scale (VAPS) was used for quantification of pain at the peak of uterine contractions (0mm = no pain and 100mm = worst pain). Results: Parturient recruitment and data collection occurred over a period of two consecutive years. Out of the 60 parturients who participated, 50 completed the study. 10 patients from the epidural group were excluded as epidural analgesia was ineffective in 3 cases, data was incomplete in 4cases and in 3 cases caesarean was done before full cervical dilatation. Conclusion: Epidural analgesia, prolongs the first stage of labor, but is not associated with adverse maternal or neonatal outcome.

Introduction: - It has been reported that the over-prescription of antibiotics in children is leading to increased fatal diarrheal cases and a drastic change in the sensitiveness of gut flora. The American Academy of Pediatric Dentistry (AAPD) has published guidelines for antibiotic use, recognizing the increasing prevalence of antibiotic resistant microorganisms. Objective: The objective of this survey is to compare the antibiotic prescription pattern and the awareness of antibiotic resistance among Bachelor of Dental Surgery (BDS) practitioners and Pediatric Dentists. Materials and methods: 100 BDS practitioners and 100 Pediatric Dentists were included in the study and a questionnaire were given to each practitioner which is comprised of information regarding antibiotic prescription for most common oral conditions, their dosage, etc. Results: The majority of the practitioners prescribed antibiotics for managing oral diseases. On comparing the prescription patterns between the BDS practitioners and Pediatric Dentists, it has been found that an over prescription in the BDS group for many conditions, which was statistically significant. Amoxicillin was the most commonly prescribed drug in both the groups. In the presence of an anaerobic infection, the most preferred drug was a combination of metronidazole. With regard to the duration of antibiotic prescription, 74% BDS practitioners prescribed antibiotics for 3-day course and 36% Pediatric Dentists has given it for 5 day or 1 week course which was statistically significant. The awareness regarding antibiotic prophylaxis and antibiotic resistance was found to be adequate in the pediatric practitioner groups. However, there was a general lack of awareness with regard to the guidelines for antibiotic prescribing in BDS practitioner groups. Conclusion: Practitioners should prescribe antibiotics in accordance with the guidelines to curb antibiotic resistance, for an emerging health problem.

Ocular trauma resulting eye injuries are a frequent threat to vision worldwide. The causes of eye injury are diverse, but the risk and type of injury is often correlated with age, gender, and race. While a focused history and prompt ocular examination are essential to immediate management, patient education regarding safety precautions and risk reduction help to prevent future recurrences. This article describes a case of penetrating eye injury in a 25-year-old male. The case discussion will review the initial examination and management decision. A suggested approach to the management of patients with ocular trauma will be discussed.

Introduction: Ultrasonography has proved its accuracy in orbital imaging by virtue of its high frequency probes and b mode imaging. The CT extends privilege of perfect anatomical images and better delineation using intravenous contrast. The current study evaluated clinical and radiological presentation of various orbital lesions; and compared diagnostic accuracy of USG and CT. Material and methods: A prospective observational study was planned at a tertiary teaching institute on 100 patients referred to radiology department for ultrasonography and computed tomography of orbit. Patients with lesions arising primarily from orbit or spread from adjacent structures were included in the study. Observations: Majority of patients were pediatric; common etiology being retinoblastoma and infection. The central orbital space was most predisposed in inflammatory and vascular lesions: and, peripheral orbital space in neoplastic, trauma, congenital, lacrimal gland and fossa lesions. The diagnostic sensitivity of USG in evaluation of orbital lesions was found to be 93.6 % as against 100% with CT. Diagnostic specificity of CT was higher than USG when single specific diagnosis was given (93% vs 68% respectively), as well as when final diagnosis was given as second differential (96% vs 78.7% respectively). Conclusion: Orbital vascular lesions and Retinoblastoma can be diagnosed easily on both USG and CT. Both USG and CT failed to differentiate between aspergillosis, mucormycosis and sino-nasal malignancies extending to orbit. CT is more sensitive and specific than USG and should be the preferred modality for suspected orbital lesions.

Dental problems being the most common health problem that affects children. Most traumatic injuries to the teeth and their supporting structures constitute a true dental emergency and because teeth have the lowest potential of any tissue for returning to a normal healthy state following injury, most injuries require urgent evaluation and treatment. Due to lack of awareness and knowledge among parents/mothers most of children with dental trauma present late for treatment that result in unfavorable long-term prognosis. Aim: The aim of the study was to assess the knowledge and attitude of parents regarding dental avulsion and its emergency management using a questionnaire. Materials and Methods: The study included 500parents who accompaniedtheir children, aged between 5 years and 14 years, to the Dental Section Sub District Hospital Damhal,Kulgam, J&K. Chi-square test was done to evaluate the association between the results and the genders, educational level, and geographical status of the respondents. Statistical analysis was performed using Statistical Package for Social Sciences (SPSS) version 17.0 Results: This study showed 90% of parents knew that saving an avulsed permanent tooth is important but majority of parents thought ice water was the best media to transport avulsed teeth. The data showed that there was lack of knowledge regarding the preservation and management of avulsed tooth amongst parents. Conclusion: This study showed lack of lack of awareness among the parents regarding the emergency management of dental trauma, This warrants the need of an effective communication between dental professionals and parents for better handling of dental traumas and thus preventing the physical, psychosocial, and economic consequences of trauma by appropriate assessment, education, and referral of children to the dentist.

Background: The term “aphthous” is derived from a Greek word “aphtha” which means ulceration. Recurrent aphthous stomatitis (RAS) is one of the most common painful oral mucosal conditions seen among patients. These present as recurrent, multiple, small, round, or ovoid ulcers, with circumscribed margins, having yellow or gray floors and are surrounded by erythematous haloes, present first in childhood or adolescence. Many studies have reported that stress and anxiety have a role in the onset and recurrence of aphthous ulcers. We aimed to do a study on association between apthous ulcer and stress.s Material and Methods: A cross sectional study was done on 100 medical students in Hamdard Institue of Medical sciences, New Delhi. Questionnaire contained questions about aphthous ulcers and questions on perceived stress by modified perceived stress scale. Statistical analysis was done using SPSS 20. Student t test and chi square test were used and a p value of <0.05 was taken as significant. Result: The prevalence of aphthous ulcers among medical students was high (60%). Majority participants (81.6%) showed high level of stress due to exams or some other reasons. Only 26.6% of participants showed positive history. Conclusion: The study revealed that there was a significant association between stress and apthous ulcer as was observed in medical students who are under constant pressure as compared to other professional students.

The research on synthesis of hollow silica structures in the nanoscale has flourished in recent years because of their importance in the development of catalysis1 and biomedical applications2. In this work, a novel “worm-like” silica nanostructure holding Ag particle and nanocavities in the same shell was first reported. Studies on this interesting structure discovered a facile one-pot method to construct cavities-containing silica nanostructure using Ag+ salt and ligand 11-MUA. Variation of the key reaction factors such as metal salt, thiol ligand, water concentration and TEOS hydrolysis rate, along with the characterization experiments on the initial Ag+/11-MUA composite implied that a metal ion/thiol ligand coordination polymer had formed under the experimental condition. Furthermore, the unstable coordination polymer could possibly act as the template for silica coating/growth. This new method is significant as it does not require any complicated pre-synthesis or post-treatment procedures. Beside the potential applications of the cavity structure, combination with Ag NP in the “worm-like” nanocomposite may provide new opportunity for hybrid nanostructure development.

On-farm verification trial was conducted with lime and soil test based fertilizer application for improving the yield of potato in acidic soils under the Surma‐Kushiyara Floodplain soil of Bangladesh. The trials were laid out in a factorial randomized complete block design with six dispersed replications. The treatments were, M1: soil test based (STB) recommended fertilizer and M2: farmers practice (FP) and dolomite levels (L0: 0 t ha-1, L1: 1 t ha-1 and L2: 2 t ha-1). The result showed that average yield of tuber (24.04t ha-1) was higher in STB fertilizer (M1). Lime application gave significantly superior tuber yields of potato in all three years. The average tuber yield of potato increased in treatments L1 and L2 by 6.73 and 19.75%, respectively over non- lime control. The STB fertilizer dose (N151 P29 K116 S14 Zn1 kg ha-1) along with 2 t ha-1 of dolomite (M1L2) performed better and produced the highest average tuber yield (25.46 t ha-1) of potato. Economic analysis revealed that maximum gross return (Tk. 305520 ha-1) and gross margin (Tk.170852 ha-1) was obtained from treatment combination M1L2 followed by M2L1 (N160 P50 K130 S0 Zn0 kg ha-1 and 1 t ha-1 of dolomite lime). The maximum marginal benefit cost ratio (MBCR) 9.06 over non-lime control was also observed in treatment combination M2L1. Considering the results, the fertilizer nutrients practice by farmers (N160 P50 K130 S0 Zn0 Kg ha-1) with 1 t ha-1 of dolomite lime was found more profitable and viable among the treatments for cultivating potato under strongly acidic soil of Sylhet in Bangladesh.

A system of ferrites with formula Ni0.5+xZnxCu0.5Fe2-2xO4 (x=0.0,0.1,0.2,0.3,0.4,0.5) synthesized through ceramic route. As a special consideration for optimisation the material is quenched from 1137 K to 77 K by dropping it in liquid nitrogen bath in the final stage. XRD patterns present that the crystals formed are in the polycrystalline nature. The structure of ferrite is confirmed as Face Centred Cubic (FCC) phase. The particle size of the ferrite system varies from 20 nm to 40 nm and they are nano particles. Thermal study helps to infer completion of reaction of formation of ferrite. FTIR and Raman Spectroscopy measurements confirm the presence of tetrahedral and octahedral coordination of atoms in spinel structure of ferrite. However a dominating impact of defect states intruded in the structure of ferrite is visualized through FTIR and Raman Spectra. The presence of defect states is attributed to mainly to the quenching of the ferrite by a large range of fall of temperature. The existence of defect states is expected to contribute a big variation in electrical and the magnetic properties.

A system of Ferrites with formula Ni0.5-x Znx Cu0.5 Fe2O4 (x=0.0,0.1,0.2,0.3,0.4,0.5) synthesized through solid state route. During the second sintering the material is quenched from 1137 K to 77 K by dropping it in liquid nitrogen bath. The solid material is ground in agate pestle, mortar and made as powder. The powder form of ferrite is subjected to structural studies using XRD, thermal, FTIR and Raman measurements.XRD patterns present that the crystals formed are in the polycrystalline nature. The structure of ferrite is confirmed as Face Centred Cubic (FCC) phase. The particle size of the ferrite system varies from 262 to 427 Å and they are bulk particles. Thermal study helps to infer completion of reaction of formation of ferrite. FTIR and Raman spectroscopy measurements confirm the presence of tetrahedral and octahedral coordination of atoms in spinel structure of ferrite. However a dominating impact of defect states intruded in the structure of ferrite is visualized through FTIR and Raman spectra. The presence of defect states is attributed to mainly to the quenching of the ferrite by a large range of temperature. The existence of defect states will contribute a big variation in electrical and the magnetic properties.

Post copulatory mate guarding in insects is a major means of securing paternity. It is explained as a male adaptation to avoid sperm competition by excluding rivals from mating with the guarded female. The present experiments were designed to investigate the effect of single mating and subsequent or interval based second mating with same or different male on mate guarding duration, fecundity and percent egg viability of a ladybird, Menochilus sexmaculatus (Fabricius). For this study second mating was given with same or different male. Statistical analysis revealed significant difference between mate guarding duration of first and second matings. Maximum mate guarding duration was recorded for interval based double mating treatment with different male and same was recorded for the fecundity and percent egg viability. Present results clearly indicate that in interval based second mating is sufficient duration to the female for the preparation of second mating and female trying to diversify own offspring by the high mating duration with the different male. This may occurs due to highly diversify population of any species have high survival rate by the natural selection. Such condition may be very use full for the improving the biocontrol activity of this ladybird against to aphid pest population.

In order to improve the quality of CCN-51 cocoa beans, this study was developed in which 5 concentrations of total sugars, defined by the Brix degrees (° Bx) and adjusted by pre-drying, were evaluated prior to the process of fermentation. A completely random distribution was used in the allocation of the treatments, which were defined by 1 ° Bx (T1), 1 - 5 ° Bx (T2), 5 - 10 ° Bx (T3), 10 - 15 ° Bx ( T4) and more than 15 ° Bx (T5). The selected grains came from healthy cobs of the same farm, which after the pre-drying were subjected to the fermentation process in jute bags for three days; exposing them later to natural drying, until leaving them with 7% humidity. The proportion of fermented, violet and slate grains was evaluated, making the longitudinal cut of the grains and comparing them with a visual scale. Likewise, sensory acceptance was valued through a paste, using 5 trained judges and a hedonic scale of 6 points, in categories ranging from undesirable (0) to excellent (5). In addition, the temperature was evaluated in the 3 days of fermentation and the initial and final pH of this process. Properly fermented grains were obtained in more than 80% in the first 4 treatments; reducing the violet and slate grains below 10 and 5%, respectively. The highest acceptance was established for the T2 treatment, defining it between very good and excellent. In conclusion, the pre-drying favors the quality of cocoa beans CCN-51.

Background: Incidence rate of intra-operative hypothermia during surgeries is estimated to be around 40% in China, causing damages as cardiovascular complications and also increase costs due to treatment for adverse reactions and prolonged hospital stay. However in current stage, hypothermia and effective warming measurements are attached with relatively low importance in aesthesia procedures. This study aims to compare the potential economic benefits for patients using active warming system during major surgeries. Methods: A randomized controlled open-label trial was design in Beijing, China. Target population were patients undergoing surgeries. A total of 240 patients receiving Pancreatectomy and Esophagectomy were randomized into active warming group (using forced air warming system) and passive warming group (using cotton blanket). Health outcomes as incidence of intra-operative hypothermia and adverse clinical events including surgical site infection would be observed, and costs following these events would be measured. Economic benefit would be analyzed using cost-consequence analysis and cost-utility analysis between two groups. Incremental cost-utility ratio would be used for decision-making. Discussion: Economical evaluation evidence application in insurance entry for pharmaceuticals and medical devices is in its early stage in China. This study may help to provide as a template for trial-based economical evaluation for medical devices. We also hope to promote discussion on proper use of cost-consequences analysis which is less often applied but with high appropriateness in economical evaluation studies for medical devices. Trial registration: Trial registration: This trial was registered on the Chinese Clinical Trial Registry (ChiCTR) on 2017/4/9. ChiCTR is one of the primary registries in the WHO Registry Network. Trial registry number: ChiCTR-IPR-17011099. http://www.chictr.org.c n/edit.aspx?pid=18892&htm=4

Geographically, Bacan Island is truly strategic due to its position that situated at the center of skipjack fishing ground. The fishermen who are based in coastal fishing port (PPP) Panamboang using pole and line to catch this economist pelagic species in this site assisted by Fish Aggregate Devices (FADs). This fishing operation particularly requires live baits. However, the problems that are being faced by the fishermen are not having their own FADs. Additionally, live baits depend on the coastal dynamic such as tides and current. To solve these problems, this work prioritized on the strategy of pole and line development with FAD-basis. The objectives of this work are to evaluate the performance of pole and line and to formulate the priority and strategy of pole and line FAD-based in Bacan Island. This research was conductedin Bacan Island Waters during 30 days. Data collection was carried out using survey method to the object of the fishermen as the subject. Fishing gear used to catch skipjack was pole and line and the fishing ground was at the FAD area. The production trend during 10 years (2007 – 2016) had been increasing. Whereas, the productivity trend of caught tripe underwent a decreasing in 2014. This fishery business is profitable and feasible to continue. One of the strategy to save pole and line that has been operating in Bacan Island and based in coastal fishing port (PPP) Panamboang. South Halmahera has established a cooperation which has been coordinating the fishermen needs such as facilitating FAD, the small fleet units to obtain live bait and license arrangement.

The low level of common beans production in Tanzania has been attributed partly to low levels of soil plant-available phosphorus. In view of that, a screen house experiment was conducted to recover phosphorus from treated wastewater and to assess its effects on growth parameters of common beans. Three irrigation treatments (T0: freshwater, T1: freshwater and fertiliser, T2: treated wastewater) were used. The experiment was laid out in a Completely Randomized Design with 20 replications. Results showed that Treated wastewater significantly (P < 0.05) improved days to 50% flowering and maturity compared to other treatments. Beans irrigated with treated wastewater also had significantly higher (P < 0.05) height, number of branches, number of pods and number of leaves than in T0 and T1. Maximum dry weight was also obtained from treated wastewater treatment compared to the other treatments. The study indicated that treated wastewater could be used in common beans production.

On the basis of published data and results of our own research, we are discussing classification, properties, side effects, indications, contraindications, principles of administration of antmetabolites, cytostatics, antlymphocytic serum and immunoglobulins, antibiotics, enzymes, corticosteroids and other hormones, salicylates, other pharmaceuticals, surgical methods, radiation in autoimmune treatment, malignant and other diseases.

In Ancient Greece numerous mathematicians managed to gain global fame. Figures such as Archimedes and Euclid presented new thoughts to the scientific society and contributed to growth of mathematics. Sometime later, the Roman Empire defeated the Greek empire and replaced it in the world. Despite all the attempts that the Roman Empire made to develop science, it failed to progress as much as the ancient Greek empire did in mathematics. One reason was the fact that the Roman Empire was deprived of famous talented mathematicians that boosted the scientific capabilities of the Greek empire. For instance, the numerical system in Roman Empire was so primitive that it failed to define numbers, equations and many other simple relations. This weakness and complexity in the numerical system prevented them from doing advanced mathematical operations and, eventually, making progress in the field. Roman society and mathematicians were so submerged in their numerical system that they did not even feel the complexities. As an example, since they could not work well with their accounting and banking systems, they attributed this weakness to the accounting system itself not to the numerical system or mathematics. Today's world is much different from the age of Roman and Greek Empires. However, we are still entangled in our own systems such as measurement, balance, accounting, banking, logistics, traffic management and the like. We are much similar to ancient Roman scholars in this respect. As we are submerged in these systems, we refuse to acknowledge their basic shortcomings. At the same time, we are stubborn enough to refrain from reviewing processes, presuppositions, structures and hypotheses.

In the recent past, there has been many research works going on to examine performance of airfoils, on their aerodynamic characteristics. There is no definite airfoil, which can define aerodynamic characteristics more precisely. This paper is an attempt made to fabricate, define and compare aerodynamic characteristics by MH and KFm airfoils. Fabrication of said airfoils MH and KFm airfoils as per requirements and specifications airfoil’s can be manufactured using composite material in two halves and providing tapings on it for pressure measurement over airfoil surface with the help from multi-tube manometer. This experiment was conducted in open circuit, low speed wind tunnel for velocity up to 25.3m/s and Reynolds number of 3.56*10^5. Corresponding manometric head readings noted and graphs Cp vs X/C plottedlift and drag coefficient, calculated along with graphs as CL and CD vs AOA.

Sustainable development is a difficult concept to define, because it is a continually evolving, which makes it difficult to define. Sustainable development is development that meets the needs of the present without compromising the ability of future generation to meet their own needs (World Commission on Environment and Development, 1987, pg.43). Sustainable development has three major components: environment, society and economy. The wellbeing of these three areas is intentioned, but not separate e.g. a healthy, prosperous society relies on a healthy environment to provide food, and resources, safe drinking water, and clean air for its citizens. The sustainability paradigm rejects the contention that casualties in the environmental and social realms are inevitable and acceptable consequences of economic development. Thus, this paper considers: economic growth, social equity and environmental protection.

Childhood is the most critical and important phase of human development. Children learn to move, communicate, and interact with the world, and develop a sense of personal and cultural identity. Early childhood offers the greatest opportunities for positive human development, but is also the period when children are most at risk. Nearly half of all deaths in children under 5 are attributable to under nutrition. The study analyzed the beneficiary of ICDS according to different social dimensions of India. The prime objective of the present study was to find out the determinants of child beneficiary under ICDS scheme. To explain the indicators of the child to participate (or not participate) in the benefit of taking supplementary food from ICDS by fitting a logistic regression, with consideration of a number of independent socio-economic variables. The study reveals that social category, years of schooling of the mother, mother engagement, decision making power of the mother, locality of the household as well as asset holding of the household have significant influence on children participation in ICDS programme.

The present study aims to determine the food security status of marine fisheries households in Batticaloa district of Sri Lanka and to analyse the impact of socioeconomic and demographic variables on the food security status of households in the district. This study was entirely depended on the primary data which was collected from a sampled questionnaire survey. The questionnaire survey was administered in the form of face-to-face interviews. Batticaloa district was selected and the sample was selected from seven fisheries inspectors division in the district. Marine fishing households were randomly selected as sample for the study. Five points Likert scale method was used in the study to calculate the index. The study confirmed that around half of the sampled marine fisheries households were in a moderate level of food security status in the study area. Using the logistic regression model, the study analyzed gender, age, marital status and education of household head, family size, fishing experience, household income and the household population in employment influencing the probability of household food security. The implication of the results highlights that the probability of a food security of the marine fisheries household in Batticaloa district of Sri Lanka depends on various factors such as Gender, Age and Level of Education, Fishing Experience of head of the households, Household Income and the Household Population in Employment. Introducing of alternative livelihood options has been the standard policy to uplift the income and food security conditions of the fishers.

This study examined the perception and involvement of major forest stakeholders in the protection of forest reserves in Ondo state, Nigeria. The forest estate in the country has continued to diminish very fast through deforestation and over exploitation of forest resources. There is however the need to stop this ugly trend through proper protection of the forest by involving other forest stakeholders in forest protection. To achieve this objective four forest reserves were randomly selected Three communities close to each forest reserve were randomly selected to make a total of 12 communities. 20 household heads were randomly selected in each of the selected communities to make a total of 240 respondents. 20 forestry personnel working in each of the selected forest reserves were randomly selected. In addition seven timber contractors in each of the selected forest reserve were purposively selected. The results of the study showed that 52.3% and 71.3% of local community dwellers and timber contractors respectively perceived that the forests are not well protected. 63.5% of the forestry personnel perceived that the forest is partially protected. The results further showed that forestry personnel are involved in the protection of the forest by being involved in forestry extension, monitoring of timber contractors and through constant patrol of the forest reserves. Chi-square test (p>0.05) shows that economic status of forest community dwellers and timber contractors do not have any significant association with their involvement in the protection of the forest in the study area. The State forestry Department will do well by organizing training programmes for forest guards and workshops for forest community dwellers and timber contractors in order to improve their involvement in forest protection in the study area.

Agile software design and development methodologies have been gaining heavy-handed attention in the field of the software engineering in the research community and additional to being highly adopted by the software development industry. Basically, Innovative industry needs an agile concept to rapidly respond and changing conditions until encourages customer satisfaction by early incremental delivery of software. A great number of notable methods have been proposed and various surveys have been presented by many researchers. People and interactions are emphasized rather than process and tools. Customers, developers and testers constantly interact with each other.

One of the human attributes is the production of the images, in fact, they are the earliest human art evidence, The types of animal and human specimens expressing thoughts, beliefs and knowledge of human life in ancient times, Among which, women's bodies were worshiped as a symbol of blessings and goddesses, and in every civilization a woman has a special place of social value. In the history of Iran, we have also witnessed the brilliance of women in different parts of the country, so many women's specimen in many civilizations have been discovered in ancient Iran. One of these civilizations is the ancient hill of Shahr-i sokhta inSistan (Iran), with the age of 2500 years, in which a large number of figures and goddesses were gained during its exploration and showed the high status of women in different editions of Iranian history. Therefore, in the present research, we study the social status of women in ancient history in order to express the value and importance of the role of women in the society of that time and To prove this, we examined samples of women's bodies in the Shahr-i sokhta (Iran), comparing it with comparable examples of women's sample in northern India (Mohenjo-Daro and Harappa civilizations) to express the connection between civilizations of Iran with other civilizations. The main goal is to express the high value of women in the community throughout history in order to maintain its place in the new era.

Savings and Credit Co-operative is a financial institution that is owned and controlled by its members and operated for the purposes of promoting thrift, providing credit at low interest rates and providing other financial services to its members. Over the years the SACCOs expanded financially and even started banking like services which were called FOSA in attempt to increase efficiency in services delivery but instead led to illiquidity, capital inadequacy, poor credit management and low confidence among members. The rapid growth and such failures in the SACCO Sub-sector created the need for SACCO Specific legislation hence the enactment of the SACCO Societies Act (2008) to specifically regulate and supervise their operations. The purpose of this study is to establish the effects of Prudential Regulatory Standards on Financial Performance of Deposit taking SACCOs in Kenya. More in detail the study ought to establish the effect of liquidity management regulatory standards; loan provisioning requirements and core capital regulatory standards on Financial Performance of DTS. The relevant literature was reviewed to ascertain the knowledge gap left by earlier scholars. The target population of the study will be all 175 DTS registered and operate in Kenya which will be obtained through random sampling using Comparative research design. Secondary source of data will be used and data analysis will be done using both descriptive and inferential statistics with the aid of SPSS. The study findings indicated that Liquidity ratio as recommended by SASRA had the highest effect on financial performance of DTS in Kenya in Pre PRS era. Liquidity ratio and Loan allowance both had a high effect on financial performance of DTS in Kenya in Post PRS era. Further research should be conducted in the areas relating to risk management framework because DTS like any other financial institution are affected by risk factors and expound on other measures of performance.

The study examined the effect of working capital management on profitability of small and medium sized hardware stores in Mavoko Municipality, Machakos County. Working capital management components used were:-inventory management; payables management; receivables management and cash management which were measured using inventory conversion period; average payment period; average collection period and Cash Conversion Cycle respectively. Profitability was measured using return on assets. Data collected for measuring both dependent and independent variable included total assets, net profit, net sales, accounts receivables, cost of sales, accounts payables and inventory outstanding for each store. Analysis was done using descriptive and inferential statistics. The analysis found that working capital management had significant impact on profitability since all independent variables had significant relationship with profitability except receivable management. A conclusion was made that working capital management affects profitability of small and medium sized hardware stores in Mavoko Municipality.

Dental implants have become a mainstay for restoring teeth that have been lost over the last few decades. Eventhough suc¬cess rates in implant dentistry are well above 90 percent, complications do occur. Most complications are preventable with proper diagnosis, treatment planning and execu¬tion. Other complications are inherent to the risks of surgery and may require intervention. The purpose of this paper is to classify the possible complications that may occur and to discuss their prevention and management.

Nomads are the a group of communities who travel from place to place for their livelihood. They do not have a fix settlement. Socio-demographic profile of the nomadic tribes who migrated from different states to Karnataka. Sample size of 30 families from 6 districts of North Karnataka have been taken. General information regarding socio-demographic was collected by pretested structured questionnaire. Majority of them were migrants from Rajasthan. Excreta disposal was open. They resided in tents. Overall socio-demographic characteristics of these tribes were found to be very poor.

Ready-to-serve beverage of grapes are a product with severe shelf life problems. Alcoholic fermentation, Quality loss, color changes and mould contamination are greatly influenced the quality of grape beverage. Limiting or preventing the growth of undesirable microbial flora in grape juice for the inhibition of alcoholic fermentation is one of the main goal of preservation. The present work was to investigate the effects of preservatives such as sodium benzoate, potassium meta bisulphite and combination of both (potassium meta bisulphite + sodium benzoate) in grape juice preservation. Initially various pulp concentration (8%, 10%, 12%, 14%,16%) of grape juice was taken and preserved with sodium benzoate of 140mg/l. Then sugar content was optimized to 15ºBrix and preservatives of sodium benzoate (140mg/L), potassium metabisulphite (120mg/L) and combination of both 60mg/L + 60mg/L) were used for preservation and storage studies were conducted. The Organoleptic studies of preserved grape juice such as alcohol estimation indicates that sodium benzoate alone and combination of sodium benzoate and potassium meta bisulphte showed significant preservation effect in grape juice. This study nuances the application of the above mentioned.

Chennai floods 2015 show the vulnerabilities that arise from the neglect of urban planning. The sights have taken residents of the city to devastating times when boats plied on the roads. It may have evoked memories of the river’s channels-and other water bodies. Ironically, Chennai has lost most – if not all of the water bodies of old. Media reports quoting the National Institute of Disaster management pointed out that Chennai had about 650 water bodies, including lakes, ponds and storage tanks till about two decades ago; today it has less than 30. In the recent floods, the city paid a heavy price for the loss. Mudichur in Chennai and the surrounding areas of Kanchipuram district of Tamil Nadu was badly hit during Chennai Floods, 2015. Many areas like GST Road, CTO colony were badly affected It was mainly due to uncontrolled developments of concrete spaces, shrinking of marshland, improper housing, subsequent embankment breaches and water overflowing from the Chembarambakkam lake which flooded Mudichur main road. The present research study was undertaken to find out the policies which were formulated and implemented by the State Disaster Management during Chennai Floods, 2015 and its impact.

Parental conflict distracts the task of parenting. Tribal family system involves with biological parents in parenting. The study is conducted in Quetta, Balochistan in order to find out the behavior of parents, the role of family and the behavior of female child influenced by parental conflict. Total hundred girls from twelve to eighteen years old are taken to find the response or data from two towns. The data reveals that traditional system of paternal in-laws involved in the mother’s role of familial taskscauses parental conflict. Female child is ignored as well as scolded by their parents therefore feels sadness and develops ignoring attitude towards her parents that leads to less parent child attachment.

The present work describes the chemical and nutraceutical study of Ramaria flava, a wild and edible mushroom collected inHidalgo state, Mexico. Reductive power, antioxidant activity, total phenolic compounds content, ß-glucans, phenolic acids (cinnamic, gallic and chlorogenic) in microwave-assisted methanol-water extracts as well as in acidic and alkaline extracts are described. Isolation and identification of sterol as a secondary metabolite of R. flavais reported, not previously described for this species in Mexico. The Al, Cd, Cr, Cu, Fe, K, Mg, Mn, Pb concentrations were determinedin extracts as well as the soils of the study area in which the mushroom was collected.The highestvalueswere found for Cu and Fe, in agreement with the literature reporting levels of these metals in the region.An inverse relationship was foundbetween the antioxidant power of the mushroom extracts with the Fe, Cu, Mn and K concentration. The R. flava metabolite extraction and chromatographic separation were notreported before on this species in Mexicoand showed up the presence of ergosterol, demonstrated by spectroscopic characterized.

Nickel deposition has been widely studied and much work has been devoted to the mechanism of the deposition process.In the present paper, we review studies of the electrode position of nickel and nickel based alloys in aqueous solution over the last two decades, which have built on the extensive pioneering work of DiBari, Evans, Bockris, Matulis, Heusler, Weil, and Ives and many others. The aim is to highlight new, and interesting, developments in nickel electrode position.

To assess the level of mental toughness and to compare the factors of mental toughness among the athletes of different sports like, water polo, swimming and diving. Methodology: For the purpose of the study 33 swimmers (both and male and female), 31 water polo players (male) and 22 divers (both male and female) from All India Inter-University held at Amritsar, Punjab, 2013 were selected. The age of the athletes were ranging from 17 to 25 year of age. For the assessment of the data on mental toughness of the selected athletes the questionnaire “Mental Toughness Questionnaire” developed by Dr. Alan Goldberg was used to assess the mental toughness level of the athletes. Descriptive statistics was used to find out the mental toughness level of the selected athletes and to examine the significance differences among the athletes of different sports on mental toughness One Way ANOVA was used and the hypothesis was tested at .05 levels of significance. Results: The mean and standard deviation of the factors of mental toughness for shooters and archers are Rebound Ability (4.52 ± .85), (3.88 ± .93) and (3.77 ± 1.45), Handle Pressure (4.65 ± 1.05), (4.18 ± 1.24) and (4.45 ± .80), Concentration Ability (4.13 ± 1.06), (3.91 ± 1.23) and (4.77 ± .61), Level of Confidence (4.13 ± 1.45), (4.45 ± 1.12) and (4.45 ± 1.53) Motivation (4.32 ± .94), (4.12 ± 1.17) and (4.27 ± 1.32) and Total Mental Toughness Scores (21.74 ± 3.32), (20.55 ± 3.82) and (21.73 ± 3.63) respectively. To compare the mental toughness of the selected sports athletes, the one way analysis of variance was applied. The ANOVA result shows that the p-value of the factors of the sports motivation of the selected athletes is less than 0.05 and hence the F - value is significant at 5 % level. In order to determine which groups differs significantly, the post hoc mean comparison was obtained by applying LSD Test. The Post hoc Comparison of Means results shows that there exists a significant difference in the different factors in between Water Polo and Swimming (p = .018), Water Polo and Diving (p = .014) on Rebound Ability and Water Polo and Diving (p = .029), Swimming and Diving (p = .003) on Concentration Ability as their obtained p–values were less than 0.05 (p ˂ .05). This implies that in spite of similarities in nature of events there exist differences, or there are special requirements for participation in these sports. The existence of similarities in between these groups is prevalent in Swimming and Diving (p = .717) on Rebound Ability, Water Polo and Swimming (p = .088), Water Polo and Diving (p = .525) and Swimming and Diving (p = .358) on Handle Pressure, Water Polo and Swimming (p = .401) on Concentration Ability, Water Polo and Swimming (p = .341), Water Polo and Diving (p = .392) and Swimming and Diving (p = 1.00) on Level of Confidence, Water Polo and Swimming (p = .480), Water Polo and Diving (p = .875) and Swimming and Diving (p = .629) on Motivation, and Water Polo and Swimming (p = .187), Water Polo and Diving (p = .988) and Swimming and Diving (p = .236) on Total Mental Toughness Scores as their obtained p-values were greater than .05 (p ˃ .05). Conclusion: The present study shows that the significant differences in between athletes of Water Polo and Swimming, Water Polo and Diving. The Additional research is needed to find out the real reason of similarities and difference exists in the present study. The efficacy of proposed methods of enhancing mental toughness such as environmental manipulations, and mental skills training approaches need to be evaluated if the gap between theoretical research and practice is to be bridged.

Chassis and other body parts of sports cars must be rigid, strong but made of light-weight materials. Chassis in modern sports cars are designed with Computer Aided Design (CAD) Technology which aids in the creation, modification, analysis, or optimization of a design to obtain highly specialized curvatures capable of running stress simulations. Frameworks of the modern sports cars utilize monocoque structural skin which is a structural system in which loads are supported by the external skin. Use of stainless steel in constructing car frameworks makes the vehicle heavier and hence search for light-weight but strong and corrosion- resistant materials are desirable for constructing frameworks or chassis of sports cars. Use of aluminium alloys in place of stainless began to reduce weight and magnesium alloys were found to be even better in terms of weight reduction. One such material is the new steel made of Fe-Al-Ni which is much cheaper than other light-weight materials such as titanium alloys used in constructing airplane bodies and comparable in price to conventional steel. As opposed to metal alloys, other viable alternatives are carbon fibers and polymer-mineral nanocomposites. Then came the carbon fiber era where very strong carbon fibers are used in many parts of automobiles. Inorganic particle-polymer composites present the latest developments where nanoparticles of inorganic materials. In this review, we discuss clay-polymer nanocomposites which we developed using montmorillonite clay and poly (vinyl alcohol) polymer. These novels, low-cost and light-weight yet very strong materials can replace stainless steel in constructing body parts of sports cars.

The study focused on the town where the traffic congestion occur due to the railway crossing and other alternative to minimised problem. Chhapi is a main town surrounding area so the approach road which connect the SH 41 is only the way where railway crossing is there. So, the many people have problem occur due to crossing likewise traffic congestion, pollution, delay, fuel consumption etc. For this research will carry out the survey likewise Delay survey, traffic volume count, accident survey so that will be done for mitigate present scenario of the condition and to find other alternative to suggestion. In the town all types of vehicles likewise two-wheelers, three-wheelers, four-wheelers, loaded- unloaded vehicle, trucks, buses etc. are travelled in the day or night time so congestion of the traffic. People are used public and private vehicle also to connect with different areas of the town also the state highway. Chhapi is the main business district centre of around all town so the all localities are coming to town for some work and the chhapi is connected only state highway 41 so the around area no connectivity of them and only connectivity and in that one big problem of railway crossing in the 24 hours railway crossing more than 50 times closed so that big problem of traffic congestion, delays, fuel consumption and also the bad pavement condition so that will be direct effect to the vehicle maintenance and operation cost.

Climate change is a serious environmental concern not only at global level but regional and local level too. It is primarily caused by the increasing up of Greenhouse Gases (GHGs) in the atmosphere due to increase negative human interference to the environment which cause impact on the changes in temperature, precipitation, increase the rate of melting glaciers, increase in sea level is an emerging issue. Water is an essential resource to maintain ecological balance, sustain livelihood and economy. It serves as the fundamental link between the climate system, human society and the environment. Depleting prime recourses, frequently drying up natural spring, lakes and ponds are the serious concern of local communities. Climate change has substantial impact on both water resources demand and availability. Adaptation is an adjustment in human and natural systems in response to actual or expected climate stimuli or their impacts that moderate harm or exploit beneficial opportunities (IPCC 2007). Sustainable Adaptation techniques are the only weapons to cope up potential impact of dynamic behavioural challenges caused by the climatic elements.

Introduction: Thalassemia is one of the heterogenic groups of inherited anemia which occurs mainly dueto mutation in the gene related to the synthesis of hemoglobin beta- chains. Objectives: The aim of our study was to evaluateserumlipid profile andferritin levels in β- thalassemia trait (BTT) and compare them with that ofage and sex matched controls. Methodology: Totally 120 young adults were selected for the study, in which 60 wereBTT and other 60 were healthy controls. Serum lipid profile was analyzed using ERBA kit and serum ferritin was estimated withMeril Diagnostic kit. Results: Total cholesterol and LDL values were lower in BTT when compared to controls and TG and HDL values were higherin BTT with that of controls.Serum ferritin values were found to be higher in BTT than that ofcontrols. Conclusion: The presentstudy revealed that there were significant changes in serum lipid profile and ferritin levels in BTT when compared to controlswhich should be a cause for anxiety of better assessment of cardiovascular risk factors in the patients.

Framing Human Resource policies based on the career stage of an employee is one of the challenges for the policy makers. This study intends to understand the career stage of an employee along with understanding impact of career stage of an employee with respect to the sectors in which they are working.Do employees aspire differently depending on the sectors they are working? For this propose two mutually exclusive and different sectors were selected to carry out the study. The study shows the perceived career stage of an employee differs significantly in Mid carrier stage which is the most productive age of an employee across two different sectors.

Background: Fasciola hepatica is a parasite of herbivorous animals (sheep, goat, and cattle), living in the biliary passages of the liver and it also infects humans. Fasciola gigantica is the largest of human liver and lung flukes. Both of these parasitic flat worms cause the disease termed fasciolosis or fascioliasis in herbivorous animals as well as in humans. The prevalence of Fasciola gigantica does overlap with that of Fasciola hepatica. The key objectives of this study were to assess the prevalence rate of bovine fasciolosis and dealing with the consequences & the associated issues of interest. Method: Information from the sample animals was collected by observation and palpation during antemortem examination of each slaughtered animal. Date that the cattle entered the Debre Birhan municipal abattoir, age, sex, breed, and body condition of each individual cattle was recorded. Postmortem examination of liver and associated bile ducts were carefully accomplished by visualization and palpation of the entire organ followed by transverse opening of the organ across thin sections. The livers of 400 randomly selected cattle were examined. Result: Out of 400 cattle examined 261 (65.25%) cattle were confirmed positive for Fasciola species. Conclusion: Fasciola hepatica and Fasciola gigantica were the causative agents of bovine fasciolosis in and around Debre Birhan. Poor nutrition & resistance of the livestock, types of nonproductive breed and seasonal occurrence of these infectious parasites together with nonproductive husbandry practices worsen the effects of fasciolosis. Assessment of human fasciolosis must be executed in & around Debre Birhan.

Situated on the south-eastern coast of Indian subcontinent the district of Kendrapara occupies a prominent place in the history of folk dances of India. It is the cradle of many folk-dances of Odisha. Folk dances were generally patronised by the rulers, Zamindars as well as by the affluent sections of the society. Even today most of the villages in the district have Akhada Ghars which maintain the musical instruments and equipments and serve as the place of rehearsal organised by the locally recruited Gurus (teachers).

Two artificial methods, which affect the ionosphere, including physical and chemical, are studied in this paper. In this paper, we summarize the physical methods and the chemical methods of chemical ionization, such as the influence of different nuclear explosion types on the ionosphere, the ionospheric thermal effect of rocket launching, the influence of high-power radio heating on the ionosphere. World scholars’ researches on the human impact ionosphere research process and progress is systematically summarized too.

This paper synthesizes the data gathered by the IDRC- funded Agri-Food Systems Project; and the McKnight Foundation-funded Scaling Up Project implemented by Bunda College of Agriculture to examine leading ideas underlying efforts to improve productivity of the agro-ecosystems in Malawi. The political ecology framework has been used to locate the actors, their power and interests that underlie resource allocation, extension and research on agricultural productivity. The results have revealed that farmers and all actors agree that agro-ecological systems in Malawi are degraded and productivity is declining. There are two leading ideas informing the strategies to deal with declining agricultural productivity. These are what we call “modernizing smallholder farmers” and “making smallholder farmers go local”. These ideas are two extremes and powerful. They are ‘boxing’ smallholder farmers into either modern technologies such as chemical fertilizer and hybrid seeds or local technologies such as compost manure. By being so powerful the farmers believe that the only solution to declining agricultural productivity is modern or traditional technology. The actors have vested economic and intellectual interests in boxing smallholder farmers. Approaching agricultural productivity this way has created a dilemma, whereby, on the one hand few farmers can afford modern technologies and on the other hand adoption of local technologies is low. Amidst the dilemmas farmers are combining local and modern technologies to improve productivity of their agro-ecosystems. We call this idea a ‘combined technology’. With this third idea farmers look for principles with which they can generate technologies to be used to reverse the decline in agricultural productivity. However, the ‘combined technology’ lacks support and investment from extension and research. It is our critical and professional extension argument that unless extension, research and investment supports the combined technology idea, efforts to build agricultural productivity and make agro-ecosystems work will make less impact.

Ganjam is the largest district of Odisha. According to the British administrators it was the most beautiful district of Madras Presidency. Being the meeting place of Aryan and Dravidian cultures, with delightful assimilations from the fascinating life style of the tribals, the district serves as the cultural bridge between the Dravidian culture of South and Aryan culture of North. The tourist spots of district are full of scenic beauties. But many of them have not yet received the publicity they deserve. An humble attempt has been made in this paper to highlight the tourist potentiality of the district.

Carbon nano materials are superb materials for photovoltaic solar cells: they are Earth-abundant, possess high optical absorption, and better-quality thermal and photostability. Carbon, one of the few elements recognized since antiquity, holds outstanding potential as a material for solar cells. It’s abundant in the Earth’s crust (~0.2 wt. %), it can be found in Nature in its fundamental form as graphite, diamond and coal, and it is extensively used technologically with a production on documentation among other elements of 9 Gt/year. Nanostructured carbon allotropes have been intensively investigate in the history, including single–walled carbon nanotubes (SWCNT), fullerenes, grapheneand their chemical derivative. These materials grasp record values for physical properties essential for PV such as carrier mobility, mechanical strength, thermal conductivity and optical absorption, and are attractive for PV as they can be dissolve in organic solvents to deposit thin solar cell active layers from solution. Extra carbon allotropes such as amorphous carbon, nanodiamonds and graphene can be deposit in thin film form on flexible substrates using chemical vapor deposition.

In terms Indexing refractionis an important parameter in studying the characteristics of liquids. In this study the characteristic variation in the indexing of refraction of homemade pure virgin coconut Oil is done with a spectrometer and a hollow liquid prism, when locally available palm oil is added to it as an adulterant. Expected value is calculated at an interval of 5% and Graph is drawn giving regression to the mean value R² = 1. Different samples of coconut oil are collected from the local market. The refraction of these sample is indexed, and Graph is drawn which gives a regression to the mean value R² = 0.9643. This Graph is compared with the graph drawn with the standard calculated value. Comparison Graph shows considerable adulteration as reported in the local news during festive season in September 2015 in state Kerala, India, when coconut oil was in high demand. Low cost palm oil was widely available, and the state produces no other cheaper oil other than palm oil to be used as an adulterant. Nonetheless, Simple laboratory experiments still plays an important role in bringing equally important outcomes as that of more expensive and sophisticated instruments in the expensive laboratory settings.

Intestinal parasitic diseases have remained endemic in rural communities of developing countries with significant economic and public health consequences. The study determined the prevalence of intestinal protozoan parasites infestation of fruits, in Jalingo markets of Taraba State, Nigeria. Five (5) different types of fruits from five markets were sampled. A total of four hundred and fifty samples (450) were examined using sedimentation method. The results showed 19.8% prevalence of intestinal protozoan parasites in fruits with Ananas comosus (44.0%) the most infested among fruits while Psidium guajava (2.0%) had the least infestation of protozoan parasites. Entamoeba histolytica (36.0%) was the most common protozoan parasite implicated on fruits from the various markets; Bera-Koffai market (24.7%) had highest infestation of intestinal protozoan parasites on fruits while Sabon-gari (16.9%) market had the lowest infestation, with no significant difference between the infestation of protozoan parasites on fruits among the markets (χ²=7.848, p>0.05). The results showed that fruits sold in Jalingo markets harbor intestinal protozoan parasites and there is the need for proper cleaning and handling of fruits by growers, sellers and buyers.

Actually, how long have people been active in science? The answer is the same for both women and men as long as we have been human. One of the defining marks of humanity is our ability to affect and predict our environment. Science, technology, and mathematics all have been part of our human progress, through every step of our path to the present. Women and men together have researched and solved each emerging need. Women Symbolize 'Prakriti' means 'Nature' in Indian Philosophy. She creates and nurtures the creation to bloom. She signifies 'sakti' - the power that drives the system. True, that the status of Indian women has eroded significantly since the vedic times. Nevertheless, 20th century saw reawakening and a steady upswing, which is largely attributable to spread of Education and social reforms. In this paper I covered few latest developments in Science and Technology by women.

Giant cell tumor (GCT) of the bone is an uncommon neoplasm that accounts for about 4% of all primary bone tumors. GCT most frequently occurs at the end of long bones. GCT in spine (above sacrum) is a rare presentation. We present here a case of 30 years old female who presented with complaints of progressive weakness in bilateral lower limbs with the involvement of bladder and bowel. MRI showed collapse of D4 vertebral body. Biopsy was taken from thoracic vertebra. Histopathological examination revealed the presence of Giant Cell tumor in thoracic spine, which is a rare presentation.

Impatiens are commonly known as ‘Balsams’ (Jewel weeds). Impatiens L. is one of the largest genera of flowering plants. Among 850 species found in the tropics and north temperate regions. 86 species reported from the Western Ghats, 76 are found to be endemic. Bryophyte, wild Impatiens and some Pteridophytes are more sensitive environmental indicators. They survive well in adjoining fresh water seeping habitat. Endemic plants association depend one another to maintain their micro climate and ecosystem. So neighborhood population study helps to conserve endemic plants. This study shows Bryophyte population also helps to impatiens levingei succession in untainted environment. 13 endemic species placed in the study area.

The teaching of medicine in Portugal began in Monastery of Santa Cruz in Coimbra, in the 12th century, through the teaching of members of religious orders. In the 13th century, the medical education started to be carried out in Lisbon, in EstudoGeral, until the construction of the Hospital of Todos-os-Santos in the 15th century. Almost at the same time, it was created the brotherhood of NossaSenhora da Mesericórdia. In the 16th century, the theoretical teaching(medicine) was carried out at the University of Coimbra, while practical teaching (surgery) was carried out at the Hospital of Todos-os-Santos, in Lisbon.

The paper intends to throw light on critical analysis in detail and its effect on slavery, racism and feminism. The paper will also examine the contribution of the novelist, Alice Walker in her works "The Color Purple" and "Meridian." This paper is a brief survey of the selected texts of Alice Walker from the entire canon of Afro-American. The objective of this survey is to bring to light the psychological aspects which explore the real agony in the minds of the people under slavery, racism and women’s struggle. The sufferings they undergo each and every minute of their life which makes them feel unfit to live in the world. They don't have the chance of being loved by someone and so they hate themselves and are being disturbed psychologically. They are always subjugated by upper class people or men in all aspects. They feel traumatic which is an emotional wound that leads to psychological injury. The novels, "The Color Purple" and "Meridian" by Alice Walker pictures the issues of slavery, racism and women's struggle which involves the readers in, while reading it.

In the context of a study on multiaxial criteria for aluminum alloy welded structures 6000, biaxial tests are carried out on equivalent structures (simulated ZAT) in the field of fatigue with a large number of cycles. Critical plan criteria and global criteria are verified using the Castem 2000 code. The predictions compared with the experimental results show that some criteria work better for certain types of loading. Global criteria seem to give better predictions than critical plan criteria.

Construction is a complex industry and its performance determines profitability. Performance of any construction project refers to attainments of its construction within specified time and cost with maintaining safety and quality. The objective of this research is to assess the impact of performance on profitability of small hydropower projects in Nepal. Two projects namely, Upper Hugdi Khola Hydropower Project and Bijaypur Khola Hydropower Project were considered for detail cost performance, schedule performance and profitability analysis. Time management, cost and safety in construction enhance the performance of the construction and increase the profitability of the project. It is clear that the performance management enhances the profitability of project; however other factor such as social issues as well as internal management plays the vital role in overall profitability of the company. Even though, Upper Hugdi Hydropower Project had completed on time and less than estimated cost but the financial indicators of the projects has been decreasing because of other external factors. The IRR of the project had decreased from 15.18 percent to 13.42 percent. The construction organization should incorporate the identified factors in practice for enhancing the performance to increase the profitability.

This study is aiming to find the assessment process implemented by Islamic Education Teacher in Islamic Junior High School Darussalam Bermi Babussalam, Gerung, West Lombok. The study concentrates on; How do Islamic education teachers develop and implement assessment instrument on cognitive, psychomotor, and authentic aspect? The qualitative approach in this study covers some of data collection method; (1) pre-fieldwork, (2) fieldwork, and (3) intensive analysis. Includes: observation, questionnaire, interview, and documentation. All data were analyzed by data reduction, data presentation and data verification. The findings indicated that (1) Islamic education teachers have not implemented assessment instrument on affective, cognitive and psychomotor aspect, only12.5% teachers implemented it while 87.5% did not. (2) The Islamic education teachers have not applied authentic assessment aspects comprehensively.

The best type of salt are manufactured in Odisha. It has a flourishing tradition of salt manufacture during the British period. Its soil, impregnated with the saline particles as far as the spring tides reach during the dry seasons was singularly well fitted for the manufacture of salt. The salt lands in the calciferous tract of Odisha possessed unique natural qualities for salt production. The methods of salt manufacture prevalent in Odisha can be classified under two main processes viz. panga and karkatch. In the panga process salt was obtained by boiling concentrated sea water. The karkatch process meant the solar evaporation of sea water. As Odisha is proned to frequent rains and thunderstorms during the manufacturing season. Salt manufactured in the karkatch had to be abandoned panga process is only suitable for Odisha.

Organizations exist on the basis of continuing businesses and they do so because of their ability to serve customers and find solutions to their problems. This is a dynamic situation because the organizations go through the vicissitudes of the changing business environment making them more and more demanding. The organizations cannot remain static and so they continuously evolve to face the realities of the environment. This depends on the organizational resources and their approach to problem solving. Organizational posture and behavior will determine how successful they are on this effort. Present research paper will attempt to examine how organizations approach such problems and their effectiveness on solving them. Organizations need to reorganize, reinvent and streamline the operations so that business is as usual and continues to make an impact in the market. Present focus of research through this paper will be to find out the key result areas and how various companies succeed in their efforts. This process will involve the changes in strategy, structure and business plans. May be the organizations need to reinvent themselves to be more relevant and successful.

Child labour has become a big problem in India. It is no doubt a socio-economic problem. A national survey had shown that more than 16 million children between eight to fourteen are largely appointed in the informal sector, like restaurants, tea stall, motor garages etc. The main objective of the paper are: 1. To find out the factor of motivation for being engaged in such occupation, their prior status. 2. To explain the co-relation between their Socio-economic characteristics and their nature of the job and their working and living conditions. 3. To make an indepth study of their work situation income potential, employer-employee relationship, job satisfaction and exploitative tendencies. The study purpose 100 case sample has been selected purposive randomly of the different restaurants, tea stalls, tailoring, motor garages and scissor work in Meerut city which is scattered in entire city. The Guardian/Parents and employers also too were covered of the selective sample. The primary data of the study was collected through observation and interview schedule. The main finding of the study are: • The poverty was the most important reason for non-schooling of the child labour. • The main reason behind the employers preference for children were suitability for odds job and create less trouble. • The tea stalls, tailoring, motor garages and Scissors work relatively, serve and entry jobs for the child labour in those occupations. • More educated child labour were doing odds jobs and working in tea stalls, in comparison to other occupation. Here is negative co-relationship. • The majority of working children were employed before the got into their present job. • The educated child get employed much later than the illiterate child who gets employed earlier. • The general observation is that the children are put to long hours of work more than adults. • The majority of children work more than 8 hours a day. The decreasing the working hours with increasing of literacy. • The working children do not have fixed time of recess and relaxation it depend Marcy of employer. • The ill-treatment by the employer of the children are decreases with increasing age. It show positive co relation between the employers relation and age. • The majority of the child labour are maximum paid up to 2000/- per month and other are nominal allowances unpaid learner. • The wages of child labour and their educational background do not have positive relationship between the variables. • No discrimatory reason in tailoring, motor garages and scissors work against the low wages. • The mode of payment of wages varies according to the nature of activity. • The shop & commercial establishment act do not follow by the employers. • The majority of the child laborer were dissatisfied with their jobs. • The majority of the child labour have the health problem due to heavy work. • Most of the child labourers were have faced several problem like ill treatment by the employers as well as customers. The greedy employer do not care the existing law like employment act 1973 and the child labour (Prohibition and regulation)8 act 1986. etc.

The Small and Medium sized enterprises are considered as the power driving many countries’ economies. It has been argued that SMEs are the lifeblood of most economies around the world and any government cannot afford to ignore the sector. Access to financial capital can be a critical factor for the success of SMEs, particularly in their early years. A recent Central bank of Kenya (CBK) survey shows these SMEs topped the list of biggest loan defaulters in the first quarter of 2015. The objective of this study is to assess financial factors influencing loan defaulting by the SMEs operating in Kitui central Sub-county. It is an extension of empirical work on the loan default. The target population in this study was all the registered SMEs operating in Kitui central Sub-county. This study adopted simple random sampling method to select reasonable number of firms to represent the target population. Data for this study constituted the primary data. Primary data was obtained by use of a structured questionnaire which was administered to the chief executive officers of each specific enterprise. The data was edited, coded and analyzed using statistical package for social sciences (SPSS). Descriptive analysis was also done and the respective statistics computed. The study employed multiple correlation and regression analysis. Correlation was used to investigate the association between the variables under study. Multiple regression analysis was used to measure the effect of financial factors on loan default by SMEs. The findings of this study revealed that there was a medium positive correlation and a significant relationship between the mode of loan payment and loan default. There was also a strong positive correlation and a significant relationship between the structure of interest rate and loan default. The research findings also revealed that there was also a weak positive correlation and a significant relationship between the size of loan and loan default. There was also a weak correlation between the loan repayment interval and loan default. There was a significant relationship between the type of financial institution and loan default. The study concluded that the mode of loan repayment, the structure of interest rate and the type of financial institution were highly associated with loan default. The study therefore recommends that the non bank commercial banks should revise their lending policies so that they can reduce loan repayment problems arising from lender, loan, and institutional characteristics.

Aim: The purpose of this randomized spilt mouth clinical trial was designed to compare the effectiveness of non-surgical periodontal therapy through plaque control, scaling and root planing with the surgical one using Modified Widman’s flap, in reduction of periodontal pockets 5 - 8 mm in depth. Material and Methods: Seventeen patients males and females with advanced periodontal diseases who were recruited. Full mouth scaling, polishing and root planning applied to all patients followed by oral hygiene instructions. One month later, Modified Widman’s flap procedure applied to one sextant which was randomly selected. Periodontal parameters measurements were taken again at days 1 month, 3 month and 6 months. Results: For both surgical and non-surgical treated sites, the Mean and Standard deviations of periodontal Parameters, Plaque index (PI), Gingival index (GI), Probable pocket Depth (PPD) and Gingival recession showed significant reduction. Conclusion: Both Surgical therapy using Modified Widman’s Flap and Non-surgical treatment by scaling and root planing are equally effective in the reduction of periodontal pockets (5 - 8 mm) depth.

Aim: The aims of the study are to compare two graft procedures for the amount of root coverage. Material and Method: Thirty patients with Miller’s class I or II gingival recession were treated with either lateral pedicle flap or subcutaneous connective tissue graft. The percentage of root coverage and the esthetic appearance of the flap post operatively were checked after 1 & 6 months. Result: Statistical analysis of the data (students t-test) shows that the difference in root coverage between the two methods is not significant (p>0.05). For esthetics, though the relation is statistically non-significant, patient treated with SCTG showed better esthetics than patients treated with LPG. Conclusion: The post-treatment assessment showed complete root coverage and an excellent aesthetic outcome of lateral pedicle graft and sub-epithelial connective tissue graft root coverage procedures of an isolated gingival recession.

DC-DC converter is used to stabilize or control the DC output voltage. Many optimization techniques have been developed to turn the PID parameters. In this paper, deals with the Genetic Algorithm based Optimization technique for DC–DC Buck converter. Genetic algorithm is proposed latest method for PID controller optimization to develop the dynamic performance of the voltage regulator. The result of simulation show GA- PID controller provide better performance of the Buck converter than the conventional PID controller.

The aim of the present study was to assess the knowledge regarding first aid management among 30 Zilla Parishad High school teachers. In pre-test knowledge scores of teachers is Mean, 18.27 and Standard deviation 4.544037397. in post-test knowledge score of teachers is Mean 28.67 and Standard Deviation was 3.744728.. The comparison of pre-test and post- test parameters showed significant improvement of knowledge regarding first aid management Paired t value in pre-test and post-teat knowledge of teachers is 1.01836, which is significant at 0.05 levels. Thus it can be concluded that Planned Teaching is effective in increasing knowledge of teachers. There was no significant association of knowledge with demographic variables.

Ayurveda is one of the most ancient medical science among the world. It describes the conceptual study of different disease with reference to its own principles and approaches. According, to the Ayurveda ‘sthoulya’ is described by different acharya’s in their own way and charakacharya has described sthoulya among the ‘ashtaninditiyapurusha’, ‘santarpanjanyarogas’. Obesity is the most common metabolic disorder found in the recent years.Commonly the obesity due to lack of exercise and excessive intake of fatty foods. Madhavnidankar, charakacarya and other samhitakaras comment on sthoulya that this disorder is caused due to ‘medodhatavagnimandya’.So depending upon the told factors therapy and treatments should be carried out. So looking upon the importance of this disorder the selected articleis presented.

Background: Serum albumin is negative acute phase protein and might be the practical marker of general health status of patient. Albumin concentration is associated with nutritional and inflammatory status of individual. Periodontitis is a chronic inflammatory disease caused by bacterial infection of periodontium. Aims: The aim of this study was to evaluate the relationship between periodontal health status and serum albumin levels. Material and Methods: Total 100 subjects irrespective of gender, with age range of 40–70 years were included in the study. Patients were divided into two groups. Group I: clinically healthy Subjects and Group II: patients with chronic periodontitis and loss of attachment ≥5 mm. Serum albumin concentration was estimated by bromocresol green albumin method. Results: Mean value of serum albumin level for Group I was 4.710g/dL with standard deviation (SD) of 0.127 and for Group II, the mean value of serum albumin level was 4.125g/dL (SD 0.128). The difference between serum albumin level in Group I and Group II were found to be statistically significant (P ≤ 0.001). Conclusions: The findings of this clinical study suggest an inverse relationship and statistically significant correlation between the serum albumin concentration and chronic periodontal disease.

Achyranthes aspera & Calotropis gigantean plant are used in folklore medicines for a number of ailments. The freshly collected leaves of above plants were screened. Shade dried & firstly defatted with petroleum ether & then ethanol respectively and the leaf extracts were subjected to various physicochemical studies. The percentage yield of both plant of extract was (5.1%) for Calotropis gigantean & (5.25%) for Achyranthes aspera obtained with ethanol. The obtained extracts separately & in combination were used to carry out anti-inflammatory action. Achyranthes aspera leaf extract also exhibited anti-inflammatory activity. The obtained result showed that the EE at dose of 300 mg/kg showed 28.74% inhibition in carrageenan induced paw oedema, 14.64% inhibition of granuloma dry weight & 11.11% inhibition against formalin induced paw edema. Calotropis gigantean leaf extract also exhibited anti-inflammatory activity. The obtained result showed that the EE at dose of 300 mg/kg showed 34.97% inhibition in carrageenan induced paw edema, 18.82% inhibition of granuloma dry weight & 15.77% inhibition against formalin induced paw oedema. Calotropis gigantean & Achyranthes aspera leaf extract in combination also exhibited anti-inflammatory activity. The obtained result showed that the EE at dose (300+100) mg/kg showed 43.62% inhibition in carrageenan induced paw oedema, 25.81% inhibition of granuloma dry weight & 20.77% inhibition in formalin induced paw oedema.

Tuberculosis continues to be an important public health problem in India and globally. Drug resistance, especially multi-drug resistance to antituberculous drugs and co-infection of human immunodeficiency virus with mycobacteria are the two most important hurdles in the management of tuberculosis. In this study, we isolated and identified mycobacteria from clinical specimens of patients with tuberculosis using conventional methods and tested their drug susceptibility using the proportion method on Lowenstein-Jensen (LJ) medium. Of the 100 mycobacterial isolates from newly diagnosed cases, 3% were non tuberculous mycobacteria (NTM). Among the isolates of Mycobacterium tuberculosis, primary drug resistance to isoniazid and rifampicin were 5.2% and 2.1% respectively. The initial anti tuberculosis drug resistance in this study is low and more studies with larger sample size are needed in future to ascertain the true prevalence of drug resistance.

Ibopamine is currently used in Ophthalmology. Its action is on both adrenergic and dopaminergic receptors. The adrenergic receptors cause a marked mydriasis without accommodative paralysis, while the dopaminergic receptors increase the production of aqueous humor. Ibopamine may be useful for diagnostic purposes in Ophthalmology. This review article focuses on presenting the most intriguing evidence on ibopamine.

Introduction: Cataract surgery incisions have been known to influence astigmatism. It has been found by keratometric measurement, the degree of induced astigmatism was significantly less in superolateral compared to superior incision and the variability of astigmatism was also less. In view of this, we have made an effort to compare the astigmatism following conventional superior scleral incision and superotemporal scleral incision with posterior chamber intraocular lens implantation. Objectives: Of the study were to compare and analyse the astigmatic profile produced by superior scleral incision v/s superotemporal scleral incision and its decay over a period of 6 weeks and the post- operative astigmatic profile in patients having pre- operative against the rule astigmatism Materials and Methods: It was a prospective cross-sectional study done on 96 patients who underwent suture less small incision cataract surgery during the period of 2 years (2014-2016) All patients with cataract were included. All the surgeries were performed by a single surgeon. Results: Most of the patients were in the age group of 50-60 years. Follow-up showed that 18.8% patients undergoing superior scleral incision had >2.5 D astigmatism at any given time, whereas none of the patients in superotemporal group showed such high induced astigmatism. On the contrary <1D astigmatism was seen in 37.5% patients undergoing superior scleral incision and in 85 % patients in Superotemporal group.6 weeks follow up of these patients showed significant difference in astigmatism. Conclusion: Surgically induced astigmatism in superotemporal incision is significantly less compared to superior incision in SICS. Superotemporal incision did not show significant post op against the rule drift. It has the added advantage of being the incision of choice in deep set eyes and in situations where filtration surgery may be required at a future date.

Angelman syndrome (AS) is a neurodevelopmental disorder characterised by severe learning difficulties,ataxia, a seizure disorder with a characteristic EEG, subtle dysmorphic facial features, and a happy,sociable disposition and a behavioral uniqueness. Children with AS shows oral manifestations like tongue thrusting, diastema, mandibular prognathism, frequent drooling and excessive chewing behavior.This case report elaborates a child patient of 5 yrs old suffering from AS who reported to the clinics with a chief complain of pain and decayed teeth. The child was treated comprehensively with pulp therapy, Stainless steel crown, extraction and apt space management.

This paper describes and demonstrates pharmaceutical quality dashboard, is a visual display of the pharmaceutical industry critical quality metrics information to steer industry to meet quality vision and overall performance of your firm, set objectives, consolidated and arranged in a single frame so that the quality metrics can be monitored effectively by senior management at a glance and promoting transparence throughout the organization. Despite the availability of robust quality systems in-place and in-use, it does not mitigate quality risk and non-compliances. Therefore, this study proposes a research model that support management monitor and steer their quality metrics throughout the continuous improvement cycles. The exploratory method has been used for study through data available on regulatory websites, interview with pharma industrial personnel and secondary data in articles of other researchers for developing quality dashboard to be included in a measurement framework for systems strengthening. More than 83 participants, who represented 05 different organizations working to design and roll-out of quality dashboard. The quality dashboard framework and indicators will help guide pharmaceutical industry in ways that will have lasting results. Objective: The purpose of this study is to identify the pharmaceutical quality dashboard which will give new level of comfort with their visualization of overall quality risk of firm and analytic abilities. The dynamic, interactive pharmaceutical quality dashboard have helped keep management and internal/external stakeholders about the time-to-time quality performance indicators. Methods: Interview with pharmaceutical industry employees has been used for primary source of data. And the exploratory method has been used for study through data available on regulatory websites and secondary data in articles of other researchers. Results: After several data pharmaceutical quality dashboards evaluation, finally prototype pharmaceutical quality dashboards designed and developed which is cost effective, feasible, no special training required for roll-out, customizable, easy to use, eye-catching and drive management to meet quality mission for pharmaceutical industry. Conclusion: Through pharmaceutical quality dashboards, overall quality risk shall be visualized, quantified and do qualitative analysis pertaining to all departments effectively & take necessary actions if needed and mitigate the quality risk with connect-communicate-collaborate with all stakeholders of organization.

Objectives: To evaluate Clinical profile in H1N1 positive patients and effectiveness of Oseltamivir started within 48 hours and after 48 hours of onset of symptoms in H1N1 positive patients. Materials and methods: A retrospective study from Indoor cases of H1N1 positive patients (Total 141), were collected from the medical record section of Sir Takhatsinhji general hospital, Bhavnagar and scrutinized. H1N1 positive (category C; RT-PCR confirmed) patients admitted from June 2014 to April 2015 were included in the study. Data were collected in standard case record form like Demographic details, Duration of symptoms, Laboratory and X-ray findings, Treatment given, Various Complications after admission and Clinical outcome. Results: In this study total 141 patients were evaluated retrospectively among whom most of the patients were young adults like age group of 21 to 40 yrs, more residing in Urban area and gender affected was relatively equal, Total 23 patients died due to further complications and this study shows that 18 patients were with co-morbidities. Only 5 patients who died had no pre-existing history of co-morbidities. Most common symptoms were cough followed by fever, difficulties in breathing, sore throat and nasal catarrh. Other less dominant symptoms include Headache, Hemoptysis, Bodyache, Abdominal pain, Diarrheoa and Vomiting. There is significant association found between treatment (oseltamivir) given within 48 hours of symptoms onset and outcome among the swine flue patients. ( p value is less than 0.05 at 1 DF and chi square value is 108.10 at 95 % CI). There is significant association found between co morbidity and death among the swine flue patients. ( p value is less than 0.05 at 1 DF and chi square value is 12.064 at 95 % CI). Conclusion: In this study 141 patients were evaluated retrospectively among whom most of the patients, Most common symptoms were cough followed by fever, difficulties in breathing, sore throat and nasal catarrh. Death is more prevalent in those patients who have pre existing co-morbid conditions. Patients involved in this study have been treated with Oseltamivir and other supportive management, but patients who admitted within 48 hours of symptoms onset had better outcome and who were late after 48 hours of symptoms onset had developed complications more. And some patients died due to life threatening complications.

Objective: This research aimed to determine the efficacy of Bi-Parietal Diameter (BPD) by ultrasound in estimating the Gestational Age (GA) compared to GA by Naegele’s rule using Last menstrual period (LMP) date. Materials and Methods: This was a prospective observational study of women with a normal spontaneously conceived viable singleton pregnancy, a regular menstrual cycles, and spontaneous onset of labor at term. The LMP was considered certain in all cases. We used ultrasound to scan 2067 fetuses (894 healthy women) and we had 1586Bi-Parietal Diameter (BPD) measurements. Data were collected prospectively and used for statistical analysis. We used Descriptive Statistics to calculate the Mean, Standard Deviation (SD), Median and Percentiles values (3rd, 5th, 10th, 50th, 90th, 95th, and 97th) for BPD measurements on gestational age. We found a regression equation to estimate the GA using BPD measurements. The results of the current study were compared with different studies using the Paired Differences (t-test analysis). The results were represented as tables & diagrams. Results: The best-fit equation for the estimate of GA from BPD (in mm) was: = 7.567 + 0.236 (BPD)i – 1.02*10-4(BPD)i2 + 1.08*10-5 (BPD)i3 The Mean Sum of Squares of regression deviations of the GA regression model using (BPD) was 36939.5 and this value is significant at P <0.001. The standard error of the Estimate (Std.Error) and the standard deviation (SD) for the GA regression model (using BPD measurements) was 1.38 and (0.8, 1.1, 1.4, 1.6, 1.7) weeks when the GA were (12-18, 18-24, 24-30, 30-36, 36-42), respectively. Conclusion: In this study, we presented diagrams and tables for the estimation of GA using BPD measurements in a group of pregnant Syrian women. These results can be useful in women who cannot recall their last menstrual period (LMP). Our criteria will provide useful references for estimating gestational age and fetal care. A larger study might be needed to include a larger sample of the population.

Background and Objective: The objective of the study was to identify the predominant oral microbes associated with oral squamous cell carcinoma in their pre and post radiotherapeutic status. Materials and Methods: A total no of 40 patients were selected, having squamous cell carcinoma and not receiving any treatment. Swabs are collected from the ulcerated area and microbiological evaluation was performed. Swabs were again collected from the same patient receiving radiotherapy as treatment modality just one month ago. The microbes were identified by gram stain and biochemical test. Results: The results suggested both aerobic and anaerobic bacteria were colonized over the surface of the ulcer, but the distinguishing feature between these two groups that after radiotherapy the % of bacterial count (especially the anaerobes) markedly diminished. Conclusion: It was concluded from the results that, the diseased individuals suffering from Oral Squamous Cell Carcinoma in their pre-radiotherapeutic status showed the presence of Streptococcus, Staphylococcus, Pseudomonas, Proteus, Klebsiella and Bacillus subtilis, Actinomycetes, Fusobacterium in higher concentration, whereas in post radiotherapy phase more or less the same group of microbes were found, but in a significantly reduced amount. This was because of the fact- the removal of the tumour mass as well as effect of radiotherapy.

ZadiZaourou and Jean-Marie Adiaffi are part of the new generation of Negro-African writers who use the subversion of the French language to found their existence. This generation proceeds by morphosyntactic distortion and lexical "hybridization" to convey their ideology. The study shows that the deconstruction of linguistic norms is characterized by a constancy, by a morphological and structural heterogeneity in the works. By voluntarily transgressing the rules of good usage and by "coloring" works with African terms, the two authors project the foundations of a new African identity, which must henceforth be characterized by the refusal of servile assimilation and to undo the inferiority complex.

Background: Some viruses, such as rubella and human cytomegalovirus, are known to cross the placental barrier and infect the fetus. In other cases of maternal viral infections, such as herpes simplex, evidence for transplacental passage is less convincing and fetal damage or neonatal disease may be coincidental or associated with prenatal infection. Certain cases of fetal or neonatal disease following maternal viral infections may be associated with disease in the mother which affects her metabolic processes or the placenta in such a way as to interfere with development of the fetus and infant (Neighbors and Tannehill-Jones, 2010). The possible effects of transplacental viral infections are several. Fetal loss may occur by means of abortion or stillbirth. There may be infection of the fetus, with clinical manifestations such as rash, or without clinical manifestations. The infant may be born with congenital defects, including such deformities as cataracts, cardiac anomalies, mental retardation or cerebral palsy. ( Huong Mc Lean, 2014) Objectives: the aim of this study was to assess the common viral infection as a causative agent in congenital babies in Khartoum state- Sudan. Results: The results of the study revealed presence of Rubella IgM in (10) cases and IgG in (90) cases, Cytomegallo virus IgM in (10%) of cases. HSV-1 IgM was detected in (20%) of cases. HSV-2 IgM is not detected in all cases while HSV-2 IgG is positive in 10 cases. All viruses in study Assimilation 40% of Congenital babies causative Agents. In 80% of positive cases related to Rubella (IgM) there were maternal Antibodies (IgG). In Cytomegallo virus IgM; (7) of (10) cases there were maternal Antibodies (IgG). In HSV-1 IgM all (20) cases there were maternal Antibodies (IgG); 100% of cases has maternal Abs). Conclusions: There were presumptive evidences that the maternal viral infection is considered as a common causative agent for congenital anomalies in Sudan.

The availability of potent combination of antiretroviral regimens has resulted in a dramatic reduction in HIV-1 associated morbidity and mortality in the developed world. However, HIV infection and treatment has been associated with the development of insulin resistance, glucose intolerance and diabetes. The aim of the present study was to evaluate the effect of raltegravir (antiHIV drug) on pharmacodynamic activity of sitagliptin (antidiabetic drug) in normal and diabetic rats with respect to insulin levels. Alloxan-induced diabetic model in rats has been used in this study. In normal rats and diabetic rats the levels of insulin were calculated at 3 hr and 8 hr. The insulin levels were found to be similar in the groups of sitagliptin control and after single dose and multiple dose treatment of raltegravir in normal rats. The insulin levels of diabetic rats did not reduce significantly in single and multiple dose treatment of raltegravir when compared to sitagliptin control. The results confirm the absence of pharmacodynamic interaction of sitagliptin with acute and chronic administration of raltegravir.

This study aimed atpreparation of an experimental mouthwash from Siwak sticks, and compare it with the gold standard mouthwash; chlorohexidine (CHX), regarding the effectiveness on some bacteria responsible for dental plaque formation qualitatively and quantitatively. Materials and Methods: This study was conducted in Makkah, Faculty of dentistry, Umm Al-Qura University. Twenty female patients with gingivitis and/or periodontitis, aged 20-40 years, systemically free were selected. An aqueous extract of Miswak was prepared by grinding Siwak sticks. The ground powder was soaked in distilled water for 48 hrs, filtered and dried. The filtrate was added in concentration of 10% to preservative, sweetener, freshness, surfactant, Co-surfactant and purified water. CHX was used as control. Plaque index (PI) was determined using modified Quigley-Hein plaque index and plaque samples were collected using sterile wooden toothpicks for microbiologic analysis using Caries Risk Test (CRT) for counting Streptococcus mutans and Lactobacilli. Then, the investigated mouthwashes were used twice daily for two weeks during which patients were instructed to perform regular oral hygiene measures. At the end of investigation period, PI was redetermined and bacterial plaque samples were collected again. For qualitative assessment of the mouthwashes, a subjective questionnaire was answered by the selected patients. Results: There is always substantial improvement of PI and significant reduction in bacterial counts after the use of both mouthwashes. Conclusion: An experimental Siwak mouthwash proved comparable effect in diminishing (PI) and reduction in counts of bacteria aid in dental plaque formation. The experimental mouthwash; Siwak, proved better patient's tolerance than CHX.

Aims and Objectives: To study the effects of Inj. LMWH and Progesteron given to improve the outcome in women with unexplained pregnancy loss irrespective of its etiology (luteal phase defect, endocrinopathy, immunological disorders) Material and Method: In this prospective observational study 60 pregnant women of reproductive age group with a history of two or more previous unexplained pregnancy loss before 20 weeks of gestation with live birth or no live births prior to reccurent losses coming at civil hospital Ahmedabad during study period of Jun 2016 to November 2017 who received LMWH; enoxaparin (n=30) and progesterone or nothing (n=30) were followed for the pregnancy outcome measures. 30 patients out of 60 were given inj.LMWH 60mg sc. Every alternate day till delivery and Tab. Micronised progrsterone in first trimester. Another 30 patients were given nothing except conservative routine antenatal treatment. Conclusion: Thromboprophylaxis with LMWH resulted in a improved live-birth rate in patient with 2 or more consecutive unexplained recurrent pregnancy loss irrespective of mode of delivery whether vaginal delivery or Cesarean delivery. Nevertheless these findings need to be confirmed in larger randomized trials.

Introduction: Congenital TalipesEquino Varus (CTEV) is a commonly seen complex congenital deformity of the foot, with an incidence of approximately 1 in 1000 live births. Over the past two decades, Ponseti management has become accepted throughout the world as the most effective and least expensive treatment of clubfoot. About 85% of the cases treated with the Ponseti technique require percutaneous sectioning of the tendoachilles for correction of residual equinus deformity. The sectioning of the tendoachilles is simple, effective and involves low risks. Originally, as described by Ponseti, tenotomy is performed using a tenotomy blade, such as a #11 or #15, or any other small blade, such as an ophthalmic knife. However, complications related to the procedure, such as excessive bleeding, formation of a pseudoaneurysm and neurovascular injuries, were described. To avoid these rare but serious complications, many modifications such as mini-open tenotomy and needle tenotomy, have been developed. Materials and Methods: The study was performed in the Department of Orthopaedics, Govt Medical College Jammu from November 2015 to October 2016. All the children with CTEV presenting during this period were treated by the Ponseti casting technique. Only the cases with idiopathic CTEV were included in the present study. Results: Between November 2015 and October 2016, twenty five patients with idiopathic clubfoot presented to department. Out of them, fourteen (56%) were male and eleven (44%) were females, sixteen (64%) have unilateral and nine(36%) had bilateral club foot. Out of these twenty five, twenty one (84%) were managed successfully. In case of two (8%) patients percutaneous needle tenotomy failed. Due to poor and faulty application of D-B splint and irregular follow up, (8%) patients developed relapse of the deformity. There were no cases of blister formation, excessive bleeding, psuedoaneurysm formation or neurovascular compromise. Conclusion: In this study we performed the modified technique of tenotomy with a wide bore needle, as described by Minkowitz et al, as we consider this technique easy, simple, cost effective, and with fewer complication rates.

Background: Bilateral posteriorfracture dislocation is a rare injury when compared to unilateral anterior dislocation. It was first described in 1971 by Shaw and most of the reported cases are secondary to seizures. Case presentation: We present a rare case of a 72 years old man who presented to the emergency department with bilateral posterior fracture dislocation of proximal humerus following a simple fall with no previous history of any seizures, CVA, previous falls or trauma to the shoulder, his ECG holter monitor showed intermittent profound sinus bradycardia that was thought to be the cause of his syncope prior the incidence. Patient was treated with bilateral shoulder hemi arthroplasty , a pacemaker was inserted andthe patients was discharged in a stable condition.Follow up after 4 weeks post operatively revealed gradual improvement in range of motion with no complications. Conclusion: Bilateral posterior dislocation of the proximal humerus complicating syncope are rare. Profound sinus bradycardia is the likely cause for the fracture dislocations in our patient and this had not been reported before.

In spite of rapid advances in the development of pharmaceutical medicines, the targeting of drugs to host macrophage, the key cell responsible for body’s defense as well as immune response against invading Leishmania parasite, the causative agent for kala-azar or leishmaniasis, still remains unexplored. Perturbation of macrophage surface by parasites leads to activate oxidative burst and signal transduction for the interaction of host-parasite i.e. macrophage with Leishmania parasite. Amastigotes residing within macrophage phagolysomal compartment are the pivotal target for anti-leishmanial treatment. In general, free drugs cannot overpower main configurational barriers. Moreover, restrictions on ongoing therapy regarding toxicity, efficiency, cost, and duration of treatment may influence in enhanced parasitic resistance. Therefore, vesicular (liposomal and nanoparticulated) drug deliveries have emerged as alternative conventional approach for having not only their improved bioavailability, non-immunogenecity, reduced toxicity and higher carrier capacity but also for promoting encapsulated drug release in parasite-loaded intracellular macrophage cell in a sustained manner.

This paper is discussed about the consortia and how it is providing a great effect on the libraries and its particular users. Journals and other E journals are though producing at high speed still for the insufficient budget a library cannot be able to procure their demanded resources. With the help of consortia it is able to disseminate the maximum information to the library users. The consortium has grown up due to budget insufficiency, demanding variety of information needs, better and effective utilization of resources. Consortia are all about sharing resources and improving access to information. We are sharing own library resources through inter library loan, but in this Information communication technology (ICT) age it has gained momentum even in the developing countries. When library consortiums are formed, the existing environment about users’ preferences and difficulties need to be studied. This Paper Describe the Library Consortia in India

Despite rapid development in most medical branches, Psychiatry has been slow in adapting to changes and is gradually losing its footing. The areas which were previously considered under the domains of psychiatry are slowly been taken over by other branches of medical Science. This article tries to express the need of mental health professionals to be vigilant and adapting to periodic changes in medical science.

An Andrews bridge takes the benefits of fixed and removable prostheses while doing away with their shortcomings. A reduced denture bulk and mucosal coverage with good retention ensures patient comfort. An Andrews bridge is also physiologically viable since it acts as a stress breaker and reduces harmful leverage forces on the abutments.The aim of the present article is to describe a case having multiple missing mandibular anterior teeth compounded by advanced horizontal and vertical bone loss, restored successfully by using fixed-removable Andrews's bridge system.

Laryngoscopy and endotracheal intubation is integral part of anaesthesia, which is associated with sudden rise in heart rate, blood pressure, intracranial tension which is harmful in patients with poor cardiac reserve. We conducted study in 150 normotensive patients of ASA 1, 2 who are divided in three equal group of 50 each.Group C, Group E, Group D received normal saline, inj esmolol 2mg/kg, and inj diltiazem. 2mg/kg respectively 3 minutes before laryngoscopy. We measured heart rate, systolic blood pressure, diastolic blood pressure, and mean blood pressure as baseline before induction of anaesthesia,then after induction and 1,3,5, and 10 minutes after laryngoscopy and intubation. We observed for rise or fall in all parameters. Our results are calculated by paired, unpaired ‘t’ test and ‘chi square’ test. Result showed that there is maximum attenuation of all parameters in esmolol group followed by diltiazem group, control group demonstrated maximum rise in all parameters. Thus we can conclude that esmolol offers better attenuation of haemodynamic response to laryngoscopy and intubation than diltiazem without any side effect

The Lyell Syndrome is a severe toxicodermy, rare, characterized by fever, cutaneous necrosis, and epidermal desquamation in over 30% of the body, including mucositis. It is a late anaphylactic reaction caused mainly by pharmacies. The authors present a case of a woman, aged 22, VIH positive at A1 stage, medicated during 5 days, the 15 days before admission, with carbamazepine (CMZ) for a trigeminal neuralgia, admitted to the emergency room (ER) with fever (40ºc) and a generalized cutaneous rash including hand palm, oral, genital and eye mucous membranes. Blood cultures and serology were negative. The rash kept evaluating despite the beginning of corticotherapy, with the appearance of skin detachment, Nikolsky sign and uncontrolled pain. At the 5th day of admission, the patient entered in Toxic Shock, with multiorgan dysfunction, and was transferred to a Burn Unit (IBU), where she died with a septic shock caused by Acinetobacter baumanni bactaeriemia.

Background: The Mental foramen is an important landmark to facilitate local block, surgical and other dental procedures. The present study is aimed at the morphometric analysis of the mental foramen in dry adult human mandibles. Materials and Methods: Fifty dry adult human mandibles of undetermined age and sex, from the Department of Anatomy, JKKN Dental College were used for the present study. The location, shape and presence of accessory foramen were noted by visual examination. The measurements were taken using a Vernier caliper, ruler, thread and a marker. The SPSS 16 software was used for statistical analysis,to calculate mean, Standard deviation, minimum, maximum and incidence. Results: From the observation most of the mandibles showed the location of Mental foramen, opposite 2nd molar tooth, midway between upper and lower borders, with predominant oval shape on both right and left sides and accessory mental foramina were seen in five mandibles. Conclusion: The knowledge of Mental foramen’s position and variation is important for the dental surgeons especially in placing the dental implants.

Background: Functional Endoscopic Sinus Surgery (FESS) is a minimally invasive procedure for diseases of the nose and paranasal sinuses like chronic sinusitis and polypus rhinosinusitis. Intraoperative bleeding causing poor visibility of surgical field is a major concern during FESS and this may result in many complications. Controlled hypotension is a technique wherein arterial blood pressure is lowered in a deliberate but controlled manner to minimise blood loss and enhance operative field visibility. Aim: To compare the hypotensive efficacies of Nitroglycerin (NTG) and Esmolol (ESM) in terms of changes in heart rate (HR), systolic blood pressure, diastolic blood pressure, mean arterial pressure (MAP), duration of surgery and operative field visibilty assessment by surgeon using Average category scale (ACS) or Fromme scale, in patients undergoing FESS under General Anesthesia (GA). Methods: 80 ASA grade I and II patients aged between 18-60 years undergoing FESS under GA were divided into 2 groups of 40 each to receive either Inj. Esmolol 500 µg/kg over 30 seconds followed by infusion at 100-300 µg/kg/min or Inj. NTG at 5-10 µg/kg/min. All patients were premedicated with oral Alprazolam and Ranitidine on the previous night. In the operation theatre, all patients were premedicated with i.v. Glycopyrrolate, i.v. Midazolam and i.v. Fentanyl, and then induced with i.v. Propofol. Laryngoscopy and intubation was facilitated by i.v. Succinyl choline. Anaesthesia was maintained with Isoflurane vapour in balanced nitrous oxide/oxygen mixture and i.v Vecuronium for muscle relaxation. Heart rate, Systolic, Diastolic and Mean arterial blood pressure were assessed at 5, 10, 15 minutes and every 15 minutes from the start of infusion till completion of surgery. Visibility of the surgical field was rated by the surgeon using ACS with 0 being the driest and 5 making surgery impossible. Results: Intraoperative Heart rate was less in Esmolol group compared to NTG group. Both drugs produced desired hypotension but ideal operative conditions were achieved at a higher MAP of 80.5 ± 2.5 mm Hg in ESM group, while same operating conditions were achieved at lower MAP of 70.8 ± 1.2 mm Hg in NTG group. ACS scores were significantly low in ESM group compared to NTG group (p < 0.001). Mean duration of surgery was less in ESM group than NTG group (p < 0.001). Conclusion: Both drugs are safe and effective in providing optimal operating conditions but Esmolol is a superior agent to NTG for controlled hypotension in FESS under GA, as it minimizes surgical blood loss, enhances operative field visibility and reduces duration of surgery with minimal reduction in MAP. Absence of reflex tachycardia was the added advantage of ESM over NTG.