April 2019

Uterine prolapse is the leading cause of ill health that exists throughout the entire nation especially in rural regions. While studying the situation globally, World Health Organization estimates that the reproductive ill health accounts for 33% of the total disease burden in women globally. The main aim of the present study was to assess the Effectiveness of Structured teaching programme on Prevention of Uterine prolapse among Multiparous women residing in selected villages at Kirumambakkam Primary Health Centre, Puducherry. The study samples were 100 multiparous women selected from two different villages for experimental and control group. Comparing the pre-test & post-test scores of knowledge, attitude and practice between experimental and control group, the structured teaching programme on prevention of uterine prolapse provided by the investigator proved to be highly effective in the improvement of knowledge, attitude and practice among multiparous women in experimental group. The STP was effective and it is also suggested that the programme should be continued in order to uplift the overall health and practices of mothers. Hence, it will help to reduce the incidence of Uterine prolapse and enhance the quality of life in future.

The main objective of this work was to study experimentally the isotopic fractionation of mercury Hg, in derivatization processes i.e. Ethylation and Propylation. The multi-collector inductively coupled plasma mass spectrometry (MC-ICPMS) technique makes it possible to measure isotopic signatures of mercury stable elements efficiently in extremely compact i.e. 1ppb and 10ppb concentration systems. This device made it possible to study the evolution of mass independent fractionation (MIF) and mass dependent fractionation (MDF) under different conditions. According to our results, the MIF or the so-called anomalies are observed only for the odd isotopic mercury (199Hg and 201Hg). The study conducted from the samples, reveals the presence of a maximum anomaly for hydrochloric acid (HCl) 3% in concentration equal to +1.2 ‰ for Δ201Hg, but also the presence of a negative anomaly, equal to -0.43 ‰ for Δ201Hg at 10% concentration of HCl. As derivatization procedure, direct aqueous phase methylations and propylation were tested on the sample. The different methods of derivatization are compared.

In an effort to safeguard the Lebanese genetic resources of olives (Olea Europea L.), this study was intended to set up an in vitro culture from axillary buds of Bshaaleh millennium trees. A series of treatments preceded the multiplication phase to limit infections in the introduced explants. Best survival rate (56.7%) was recorded when the treatment was based on a mix of fungicides (fosethyl-aluminium (6g/l) and carbendazim (2g/l)), chloroxylenol (2.5%) and NaOCl (15%) as detergents, and oxytetracycline (1mg/l) as antibiotic. Young shoots were used to induce explants in vitro on OM, WPM and MS supplemented with BAP (2, 3 and 4mg/l respectively). Autumn season gave the best multiplication rate (1.08), newly developed explants (1.35) and proliferation rate (47%) on MS medium followed respectively by OM and WPM. The longest explants (1.78cm) and the highest number of newly developed leaves (3.58) were obtained during the first subculture on the MS medium added with BAP (3mg/l).All the examined parameters decreased during subcultures. Following the elongation phase, NAA added at a rate of 2mg/l to MS medium produced 22% of rooted explants. During the autumn season, explants where callus developed on the base, were transferred to fresh media that enabled the rooting of 23% where no subculture was needed.

In this survey, we proposed computer aided with open source platform detection system for the leaf spot detection on cotton crop. This system plays very important role to improve outcomes in farming because it is important sector in India. Lot of peoples are depends on the cotton crop. There are many diseases on cotton crop. Due to this disease there is chance of the decrease productivity of the crop. Soour aim is to develop leaf spot detection system by using artificial neural network. Early detection of this disease can helpful for the farmer to take preventive action.

Alcoholism is a chronic illness with an insidious onset which may occur at any age and adolescent’s drinking behaviour has been the vital social issues in several countries. A pre experimental one group pre-test post-test design was undertaken to evaluate the effectiveness of planned teaching program on knowledge regarding alcohol use and refusal skills among adolescents. Total 98 adolescents from selected schools of Delhi were enrolled. Planned teaching program (PTP) on knowledge regarding alcohol use and refusal skills was developed by focused group discussion. PTP was administered during pre-test and knowledge and refusal skills were assessed after one month of intervention. Data was collected from adolescents by using knowledge questionnaire and standardized drug refusal self efficacy-revised adolescent questionnaire. Data analysis was done using STATA 11.1 with the level of significance at p < 0.05. There was significant improvement in mean knowledge score of adolescents before (13.26) and after (20.58) administration of PTP and significant increase in mean refusal skill score was found before (96.83) and after (104.73) administration of PTP. Inverse correlation was found between age and subjects first learnt about alcohol with knowledge score. Knowledge level was significantly high in females, subjects studying in 11th standard, who denied any friend taking alcohol and who reported any neighbor taking alcohol. The refusal skills were significantly high in females, subjects who did not have any friend taking alcohol, who received information about alcohol through newspaper, radio or television. Study concluded that PTP on knowledge regarding alcohol use and refusal skills was very effective and viable method for improving adolescents’ knowledge on alcohol use and refusal skills.

Falls during hospitalization are a major health care concern (Higaonna, 2014; Shmueli et al., 2014) even more so for inpatient psychiatry (Blair and Waszynski, 2013; Irvin, 1999; Vaughn et al., 1993). The purpose of this quality improvement project was to decrease falls and falls with injury on an adult inpatient psychiatric unit. The project had three key aims: 1) decrease falls and fall-related injuries in a cost-effective manner, 2) enhance communication by embedding the Falls Risk Liaison Nurse (FRLN) within a multidisciplinary team, and 3) increase nursing staff engagement and, promote critical thinking and behaviour. A tool was developed and utilized to capture fall risk-related information. It included the amount of psychotropic medication used in the last 24 hours, vital signs, clinical presentation/complaints, and nursing judgment. The medication profile of these patients was evaluated for appropriate adjustment. At the conclusion of a six-month project, the inpatient psychiatric unit fall rate was reduced from 4.22/1000 patient days to 2.24/1000 patient days. The fall rate with injury was reduced from 0.60/1000 patient days to zero. These results confirm that the multidisciplinary approach was effective in reducing the fall rate and falls with injuries.

The paper propose a survey conducted on the various methodologies and electronic system used to guide the blind people. Addressing the issues of People with Visual, Hearing and Vocal Impairment through a single aiding system is a tough job. Many modern day researches focus on addressing the issues of one of the above challenges but not all. The work focuses on finding a unique technique that aids the visually impaired by letting them hear what is represented as text and it is achieved by the technique that captures the image through a camera and converts the text available as voice signals. The paper provides a way for the people with Hearing impairment to visualize / read which is in audio form by speech to text conversion technique and we also provides a way for the vocally impaired to represent their voice by the aid of text to voice conversion technique. All these three solutions were modulated to be in a single unique system.

It is crucial to handle missing or incomplete information obtained from various low level image processing tasks. Completion of such information requires foundation of typical mathematical, geometrical and linear algebra concepts. In this paper, emphasize is on completion of missing information in terms of detected pixels for expression recognition. Amongst seven standard expressions we chose to work with only Happy, Sad and Normal in this paper. Feature extraction, feature completion and trained decision tree model in XML format on novel and extended dataset has been demonstrated though classical edge detection and Bezier curve modeling. Experimental results show that the recognition rate of proposed system is 71% on CK data set, 76% on JAFEE dataset and 78% using PAKFE dataset for chosen principal emotions.

Introduction: Community pharmacies are generally a first point of contact with 1.6 million people visiting a pharmacy in England each day. Pharmacists are defined as experts in medicines. The role of a pharmacist has advanced from ‘product-focused’ through medicine to a ‘caregiver’ where they provide person-centred care to ensure suitable prescribing. As highlighted by Mark Koziol, chair of the Pharmacists’ Defence Association, the profession of pharmacy is not only to handle prescriptions but to take an interventionist approach to move into a population health management role and save the United Kingdom healthcare industry millions of pounds. Aim: The aim of this project was to identify peoples’ perspective, on hypertension and the role of a pharmacist to manage hypertension. Methods: A mixed-methods health promotion study, questionnaire-based, followed by measurement of their BP, the study was conducted at the University of Wolverhampton (UoW), city campus. The sample was achieved through verbally inviting all those passing by the Millenium City Building main entrance (n=50). Results:Of the participants 50% were not aware of the free BP screenings offered in local pharmacies and 90% had never visited their local pharmacy for BP services. Although, the majority of the participants had adequate knowledge about the recommended BP reading and the complications of long-term hypertension, but the utilization of the services community pharmacies offered and their general knowledge about prevalence hypertension were minimal. Conclusion: Blood pressure screening currently occurs in a small number of community pharmacies and the utilization of this service remains low. The public is in favour of receiving health support and services from the pharmacists in the community setting, therefore; pharmacists should take this opportunity and consider increasing their blood pressure measuring services.

Background: Nutritional and epidemiological transition over the past three decades has resulted in weight changes. The dramatic rise in childhood obesity is one of its adverse outcomes. Objectives: To assess the relationship of socio-demographic variables with overweight and obesity among children. Methods: This cross-sectional community-based study was conducted in school going children of both sex aged 6-14 years in rural and urban areas of Jammu region. After explaining the purpose of the study, students were interviewed by the investigator and needful information regarding socio-demographic variables collected. Following the anthropometric assessment, BMI percentiles were obtained from WHO age and gender-specific BMI charts. Among socio-demographic variables age, gender, residential area, type of school, type of family, education of parents, mother's occupation, family size and birth order were analyzed for their relationship with overweight and obesity. Results: Gender, residential area, type of school and mother's occupation were significantly associated with overweight and obesity. Conclusion: Socio-demographic and socioeconomic factors affect the nutritional status of children and adolescents. Overnutrition as one of its adverse outcome needs to be addressed with priority so as to prevent the pandemic of obesity and its metabolic consequences.

Glass ionomers were introduced to the profession 25 years ago and have been shown to be a very useful adjunct to restorative dentistry. Glass ionomer cement composed of a calcium – alumino – silicate glass powder and an aqueous solution of an acrylic acid homo – or copolymer. These cements possess certain unique properties that make them useful as restorative and adhesive materials, including adhesion to tooth structure and base metals, anticariogenic properties due to release of fluoride, thermal compatibility with tooth enamel, and biocompatibility.

Background: Thalassemia is a herieditary anemia resulting from defects in hemoglobin production. -Thalassemia which is caused by a decreas in the production of B-globin chains, affects multiple organs and is associated with considerable morbidity and mortality Aim: 1.To study the radiographic skeletal changes in transfusion dependent thalassemia patients attending thalassemic center in Ibn_Alather Children Teaching hospital in Mosul and to correlate these changes with age. 2.To asses growth retardation in those patients clinically by using normal growth charts comparing them with our records of weights and heights Setting: The study was conducted in Ibn Al-Atheer Children hospital, Thalassemia center. Mosul city,Iraq from August2009_Octobar 2010 as prospective study. Patients and Methods: Five hundred patients whose age ranged between( 6month _32 year) were studied. Two hundered patients were examind by x-ray for forearm, hand, skull X-ray. 300 patients take for them Chest X-ray. Results: The age of the studied sample ranged between 6 month _32 years. The peak incidence of the patients in the age group 6 month _10 years (29.4%), male to female ratio 1:1.2. Fifty three percent from urban areas and 47% from rural areas. Seventy seven percent of patients diagnosed during the first year of their lifes. Sixty five percent of patients non compliant on chelating agent (desferroxamin). ninty percent their hemoglobin before transfusion range between 7-9gm|dl, 31% had hand bone changes: thinning of bone cortex, fusi form shape metacarpal and phalangyal bone with osteoporosis and localized lucency. Twenty nine percent had abnormal long bone changes highest percentage in the age group 11-14 years, no any case of desferroxamin – induced bone dysplstic changes,71% of patients had osteoporosis of ribs, no any case of thoracic extramedullary hematopoiesis. Fourty two percent of patients their weights fall below 5th centil and 56% of their height fall below 5th centil Conclusion: Radiological skeletal changes in our patients is high in comparison to other thalassemic patients in other studies which is due to poor compliance of these patients to both blood transfusion and chelating agents.

Objective: The purpose of this study was to investigate the difference of outcome of non-surgical root surface debridement done along with adjective use of systemic antibiotics i.e. Azithromycin 500mg once a day for three days. Material and Methods: A retrospective cohort study of adult patients diagnosed with chronic periodontitis. Twenty- nine patients were selected based on inclusion/ exclusion criteria, who were treated at the hospital and medicated with azithromycin from January 2014 to May 2015. Data was collected from their notes for base-line and after three months (3/12) reassessment. The patients were categorized according to depth of the pockets and behavioral factors like smoking and the differences between the baseline 3/12 reassessment were determined. Results: Good response of treatment was seen in the reassessment for the nonsmokers group (median of 39), whereas the smoker group showed a satisfactory difference between base-line and reassessment, showing a median of 24 that may correspond to the less number of subjects in this group. While a good difference was seen in the former smoker group showing a median of 35. Conclusions: Good response was seen in terms of pocket depth reduction, gingival health and patient compliance, with the adjunctive use of azithromycin with non-surgical periodontal therapy in patients treated for moderate to severe periodontitis.

The main target of this ethnographic study was to explore jaarsummaa conflict resolution mechanism in Ilu and Bunno Oromos. In the study, interview and focus group discussion were used for data collection in the informants’ natural setting. The collected data were analyzed from the folklore bearers and from observers’ perspectives. The finding revealed the following. First of all, the informants asserted that jaarsummaa conflict resolution practice is a component of Oromo Gada system. Secondly, kinds of conflicts should be treated by jaarsummaa system are small scales disputes like: farmland, husband and wife, use of resources and other social issues which does not include death issue which would be treated by abba gada of the area. Similarly, the elders agree that jaarsummaa resolve conflicts from ground than modern law court system. However, jaarsummaa has been in challenges since the introduction of Minilik II to the area which sanctioned no to exercise as before. Gradually, the practice lacks its originality. However, it could not disappear completely since it had basic foundation. Currently, the application of jaarsummaa conflict resolution is better than after Oromo Gada system was registered to UNESCO. Lastly, we suggest that Gumii Abbootii Gadaa of salgan Iluu Oromo have to teach the people gada values for good governance and development.

This study made use of the descriptive type of research to ascertain the effect of integrated students’ clubbing towards school performance and membership in Greek clubs among the Junior and Senior students. The researchers employed the short survey that requested specific information from the participants. The survey questionnaire supplied a list of the acceptable clubs for the participants to mark. It was found out that at the start of the implementation, the clubbing did not have any direction for if did not speculate its vision and mission nor projects and calendar of activities that would guide the officers and members of the things to do for the good of the club. The researchers also found out that there were existing clubs in the school that were created for the sake of clubbing only. Academic clubs had the highest pre-test mean and the lowest was the students involved in Greek group or fraternity. The difference was even more impressive because of the improvement of the students’ grade and the results of the non-involvement of students in fraternity after the implementation of students’ clubbing in school. This indicated that the integration of students’ clubbing was effective in helping the students to master and develop their skills and talents and the same time perform better in the activities and test. The 21st century learners are motivated to learn with the clubbing activities which provided them the opportunities to develop their talents, skills, leadership, creativity, and responsibility that led them to improve their academic performance and equipped them holistically to develop the 21st century skills.

Background: Old age is increasing; more population in future would be in old age. India being the one having more young population may in future have more old population. With aging, there occurs deterioration of physical health, cerebral pathology, changes in cardiopulmonary and autonomous nervous system. It also affects the cognitive ability of an individual, which causes changes to occur all over the body. Thus, affecting their activity of daily living , hampering their daily functions, self-care activities, getting dependent on others, lowering their self-esteem, staying more indoors away from society, recumbent to one position, and lots of overthinking and forgetting Important work. All this leads to development of psychological co-morbidity as in depression and/or anxiety and also affecting their functional capacity. As above 60 is rising rapidly and elderly population is facing majority of health problems due to aging with changes in the body, mind and thought process. So there arises a urge to find whether presence of one affects the other. Is there a relation between presence of psychological co morbidity and functional capacity in elderly? Objectives: Primary Objectives: 1. To find out presence of depression and anxiety in elderly by using Geriatric depression scale (GDS) and Generalized anxiety disorder 7 scale (GAD-7). 2. To find out functional capacity by using Six Minute Walk Distance Test. 3. To find out correlation of depression and anxiety on functional capacity Secondary Objectives: Comparison of functional capacity on depression, anxiety, mixed group and no psychological co-morbidity. Methodology: Study design was observational, correlational study, 60 participants were assessed in the study. The participants included had MMSE score above 24 and meeting the inclusion criteria. After the consent and MMSE score, the participants were given the scales Geriatric Depression Scale and Generalised Anxiety Disorder-7 scale and later their 6 minute walk distance test was taken. Data was test for normality using the Shapiro-wilk test. As the data did not pass normality, the correlation was done using spearmen’s correlation test and coefficient of variance was used to compare the functional capacity between the groups. Results: The participants were distributed in group as follows Depressed 8(13%), anxious 6(10%), mixed 9(15%) and no psychological comorbidity 37(61.1 %). The functional capacity among groups were found to be highest in anxious (mean 84.9) and least to be in the mixed group (mean 69.7). The predominance in psychological co morbidity among genders was found to be in females 12(52%). The functional capacity among genders was found to be more in males (83.1%). There is a very weak correlation (r = -0.18) between GDS and Functional capacity and is statistically not significant (p=0.16). There is a very weak correlation (r= -0.14) between GAD and functional capacity and is not statistically significant (p=0.27). Discussion and Conclusion: In the study of 60 participants there were 30 males and 30 females of which 13% had depression, 10 % had anxiety, 13% had mixed and 61.1% had no psychological comorbidity. So there was a very weak negative correlation of functional capacity with depression and anxiety which was not statistically significant. Among gender female had more predominance to psychological comorbidity than male. And males had more functional capacity than females. As the participants belonged to good financial status, had retired from work and were involved in activity and were interested in taking care of one’s health. They had access to regular medication and health check-ups, and involved in social gatherings or meets and did not stay much indoors. They were joyful and satisfied with their lives. And so they did not present any psychological comorbidity and preserved their functional capacity. Though they had comorbidity like hypertension and diabetes mellitus, they took care for it and are not obsessed and dealing the situation, so showing no symptoms of depression. They might have got depression and/or anxiety in some earlier stage or might develop later, but at present they are not showing any symptoms.

The complications of chronic diabetes affect many systems including the nervous system wherein the peripheral neuropathy is the most common presenting feature and which if not controlled may necessitate limb amputation. Since the exact mechanism of hyperglycemia-induced peripheral neuropathy and its treatment are not completely known, the present study was aimed at an effort to further the information in this regard. After ethical clearance, 36 animals were divided into six groups having six rats each. The groups consisted of age-matched controls and experimental groups of two weeks, one month, two months, four months and six months duration of diabetes. Diabetes was induced by a single dose of streptozotocin (60 mg/kg, intraperitoneal). At the end of each experimental period, animals were euthanized and perfusion fixed with Karnovsky’s fixative. The blood serum was subjected to biochemical analysis and the sciatic nerve tissue blocks were processed for paraffin sectioning, routine and special staining for light microscopy. Biochemical, histomorphological findings and histopathological features revealed that the prolonged duration of hyperglycemia resulted in the raised serum creatinine, lowered serum total protein, reduction of myelinated fibers and remarkable thickening of endoneurial, perineurial and epineurial collagen. It is concluded that the biochemical alterations, change in the ratio of myelinated fibers and heaping up of collagen fibers at every level of organization appear to be important contributing factors for the deterioration of peripheral nerve functions in chronic diabetes.

Background: In revolution of functional endoscopic sinus surgery we need to found out new approaches to reduce recurrence after operation, and middle turbinate medialization is important step in this purpose. So we focus on some types of medialization like nothing or conchopexy and bolgraization. Objectives: To find out the effects of different types of middle turbinate medicalization in fess. Patients and methods: Comparative cross sectional study focus on middle turbinate medicalization in patients underwent fess operation in Al-Yarmook teaching hospital in a period between March 2017 to June 2018 in determined days in a week. Thirty six patients included in our study . after taking history and routine otolaryngological examinations were done and sent for imaging if needed . and when fess operation needed the patient included in the study. We collect the data in three categories , patients without middle turbinate medicalization, and patient with cocopexy i.e suturing of middle turbinate to septum ,and patient with bolgeraization which mean cross hatch of both septum and middle turbinate, and made the categories as time of operation , patient nasal patency , infection , adhesion in day one and after 1week and after 2weeks and after 1month and 3months and 6months. Results: In medialization by freer elevator male percentage is 58.33% to female 41.66%, and, 50% recurrence of sinusitis but no time spend. In medialization by conchopexy 25% are males and 75% females. and 16.6% sinusitis recurrence .and the extra time to operation is about 13 min. In medialization by bolgraization 66.66% were males and 33.33% females, and the sinusitis recurrence is 8.3%, the additional time is about 4 min. Conclusion • Females prefer less intervention technique in medicalization of middle turbinate • Boligraztion is the best result of medialzation type of middle turbinate. by less time consuming in comparison with cochopexy , and less recurrence Recommendations • Its better to do medicalization of middle turbinate in FESS surgery. • Bolgiraization is the best type of middle turbinate medialization. • The subject need further researches and studies about another types of medialization like by laser and harmonic and bipolar and others.

Restoration of missing anterior teeth has wide range of treatment options. Fixed economic esthetic restorations are challenging. With the advancements in the dental material science and major improvements in adhesive dentistry, gave clinicians with an option of fiber reinforced composite-fixed partial dentures. They are economical, esthetically pleasing and metal free restorations. This study was carried out to evaluate the clinical performance of anterior fiber reinforced composite-fixed partial dentures using USPHS criteria.

Background: Flexible gastrointestinal Parotid fistulae is although infrequent, rare, uncommon post operative complication of surgical intervention in the temporomandibular or parotid region. Any injury to the gland results in development of fistula or sialocele management of which becomes challenging owing to difficulties with healing, tissue injuries, swelling and distress to patient. We present a case of post operative parotid fistula complication following surgical intervention treatment of subcondylar fracture. This paper presents a simple but effective and conservative method of treating this complication with the use of 9% hot hypertonic saline.

Pathology is a branch of medical science that help in diagnosing the disease by microscopic examination and revealing the information to render correct diagnosis and help in proper treatment planning. Recent advances in technology has put a significant impact in the diagnostic field of pathology. Introduction of slide less pathology also known as Virtual Microscopy or Whole slide imaging (WSI) is not mere an imagination but an upcoming and promising invention. It is highly demanded in everyday pathology as well as in educational, research purpose and bioindustry. Even though these advances are faced with significant challenges such as data storage, image compression, they also provide guidance to newer diagnostic approach. These can also minimize the interobserver variability, diagnostic dilemma, identifies the therapeutic pathways and predicts the patient responses to therapy. Hence the promise of digital pathology is not the simple transfer of an image to monitor, but rather an upgradation with information that cannot be garnered by human examination. This article aims to introduce and discuss the important aspects of this evolving technology.

Background: Body mass index (BMI) is a convenient and simple way of assessing obesity as obesity has a very negative impact on human health in the form of physical and mental health issues and mortality risk. Studying obesity among university students is really important as they are newly exposed to open society after passing school and have multiple dietary options. Their dietary habits can be controlled at early stage and thus multiple diseases’ risk can be prevented. Punjab University has multidisciplinary students and purpose of study was to assess their demographics and dietary habits. Objective: To determine association between dietary habits and body mass index among university students. Methodology: A cross sectional study was conducted among students of the University of the Punjab, Pakistan. The study was approved by IRB of Department of Social and Cultural Sciences. After informed consent, a self-structured questionnaire was used to collect demographic data and dietary habits. Body weight and height was recorded and body mass index (BMI) was calculated. BMI 18.5-24.9kg/m2 was defined as normal, <18.5kg/m2 as underweight, and 25-29.9kg/m2 as overweight. Appropriate statistical tests were used for analysis. Results: Among 200 participants 120 students were having normal BMI, 30 under-weight and 50 overweight. Factors such as low income, skipping meals, taking daily tea, less use of milk, eggs and meat were associated with low BMI. On the other hand, using snacks and junk foods, soft drinks, rice, and paratha had significant association with high BMI. When Chi square test was applied, statistical significant results were age(p 0.000), gender(p 0.004), weight(p 0.000), height(p 0.000), monthly family income (p 0.000), drinking milk(p 0.008), skipping lunch(p 0.000), eating fruits(p 0.006), rice(p 0.000), meat(p 0.000), eggs(p 0.002), butter(p 0.019), bread(p 0.000), lassi(p 0.000), vegetables(p 0.000), snacks(p 0.000), milk shake(p 0.000), soft drinks(p 0.000), fries(p 0.000) and type of snack used(p 0.000). Conclusion: More than 1/3rd university students were having abnormal BMI. This study augments the need of creating awareness in this specific group regarding beneficial effects of healthy nutritional values and importance of normal BMI.

Background: Chrons is a relapsing remitting disease that affects children and demands a reliable diagnostic tool to detect active episode with minimum hazards. Objectives: i- to assess the reliability of MR enterography, quantitative and qualitative DWI measurements done by radiologists of different experiences in assessment of disease activity in children, ii to explore if diffusion weighted imaging (DWI) can substitute contrast enhanced images. Methods: Post contrast MR Enterography with DWI of 32 patients suspected to have active chron's disease were retrospectively evaluated by 3 radiologists with different years of experience. Magnetic resonance score ≥7 was used as reference of activity. Results: 21 patients had active lesions. There was almost perfect inter-reader agreement regarding graded DWI hyperintensity (ICC)= 0.93. There was significant moderate correlation between graded DWI hyperintensity and MaRIA (r = 0.64),mMaRIA (r=0.65). DWI hyperintensity had sensitivity of 100%, specificity of 95.5% in detecting active disease. Mean ADC for active lesions was 1.4 ± 0.2 × 10-3 mm2 /s. A proposed cut-off 1.67 x10-3 mm2/sec had sensitivity of 100%, specificity 62.5. There was significant moderate inverse correlation between ADC values and MaRIA, mMaRIA, mural thickness and wall edema, while there was no significant correlation between ADC and ulcers or relative contrast enhancement. The 3 readers did not find significant difference in lesion visibility between (DWI + ADC) and (post contrast images). Conclusions: MRE with DWI is a reliable tool that accurately assessed activity of chron's disease, regardless the experience of readers. DWI is comparable to post contrast images in detection of active disease.

Background of the study: The admission of an infant to the paediatric unit inevitably causes emotional stress for the parents and hence complicates parenting. Parents are partly influenced by hospitalization experience and by their own personal characteristics, past experiences and their relationship to the child. Parents relate their fears and anxieties to their children verbally or nonverbally. They need assurance that their child is receiving adequate medical treatment. They need information, to allow them to understand the child's medical status and treatment the child receives. Communication between parents and health care personnel is an essential part of the support offered to the parents and can reduce their emotional stress, effective communication is paramount between parents of sick neonates and the direct care providers. Parents need to participate in decision making regarding their child’s wellbeing. They value open and honest communication. Effective communication is recognized as a priority in the entire health care continuum especially in the paediatric units, since it directly affects the quality of child care, safety, outcome, parental perception and satisfaction. Methods: This study has assessed the perception of the parents whose child has been admitted in the paediatric units using semi-structured interview schedule Research approach- exploratory, Research design- descriptive, Sample-Primary care givers of the child admitted in the Pediatric unit, Sample technique- convenience sampling, Sample size-100, Tool semi-structured questionnaire to assess the perception. Results: The researcher has identified that majority (97%) of the parents had positive perception on communication on care given by health care personnel, whereas only 3% had partially positive perception and none of the parents had negative perception. Conclusion: The study reveals that there is no statistical association among the other variables, but the variables such as age of the child, occupation, type of family, birth order of the child, number of previous admission has an impact on the levels of perception because hospitalization is a stressor and the caregivers are from different backgrounds and with varied expectations. As health care personnel communication has a lasting impact during the child’s hospitalization. Thus barriers identified (Language used by the health care personnel, poor orientation and poor pre planned discharge) among doctors and nurses should be rectified to ease the stress of parents and thereby improve the quality of care.

Anger need not be a negative expression. Anger is a normal human emotion that, when handled appropriately and expressed assertively can provide an individual with a positive force to solve problems and make decisions concerning life situations. Anger becomes a problem when it is not expressed and when it is expressed aggressively. The aim of the study is to learn to control anger by recognizing what triggers their anger, how behaviour contributes to a volatile situation. The number of and impact of violent incidents in mental healthcare settings can be reduced by the appropriate, therapeutic and effective use of the full range of interventions. This can only occur if adequate number of professionals are properly trained in the different techniques and organizations have robust systems for auditing and monitoring the prevention and management of violence.

Background: Laparoscopic cholecystectomy (LC) is the gold standard treatment for Cholelithiasis and is the most commonly performed operation of the digestive tract. Methods: Data of 860 patients who underwent LC at SMVD Superspeciality Hospital Katra from 1st May 2016 to 30th April 2018wasanalyzedretrospectively for comorbidities, Calots anatomy, conversion to open cholecystectomy, operative time, intra operative and postoperative complications and hospital stay. Results: Out of 860 patients, 697 (81.04%) were females and 163 (18.96%) males. The mean age of the patients was 49.5 years. Mean operative time was 65 min. 18 (2.09%) patients were converted to open surgery, 11 due to difficult dissection in Calot’s triangle (1.27%), one by bleeding from liver bed (0.12%), two patients (0.23%) had biliary leakage, one (0.12%) due to partial tear in common bile duct, one (0.12%) patient had bowel perforation at umbilical port, one patient (0.12%) was converted to open for suspicion of malignancy while one of the patients (0.12%) developed biliary peritonitis due to slippage of clips from cystic duct. Mean hospital stay was 3±1.5 days. Fifteen (1.7%) developed wound infection. There was no mortality recorded in this study. Conclusion: Laparoscopic cholecystectomy is a gold standard for management of gallstone disease that can be performed with acceptable morbidity.

Formulations must be manufactured to the highest quality levels. In the pharmaceutical industry, process validation performs this task, ensuring that the process does what it purports to do. It is an essential regulatory requirement. According to Food and Drug Administration (FDA), the goal of validation is “To Establish documented evidence which provides a high degree of assurance that a specific process will consistently produce a product meeting its predetermined specification and quality attributes.” Process validation is to create robust manufacturing process that consistently produces a drug product with minimum variation that adheres to quality criteria of purity, identity and potency. In the last few decades there has been an exponential growth in the field of herbal medicine. It is getting popularized in developing as well as in developed countries owing to its natural origin and lesser side effects. Herbal medicines are being manufactured on the large scale in Pharmaceutical units, where manufacturers come across many problems such as availability of good quality raw material, authentication of raw material, availability of standards, proper standardization methodology of single drugs and formulation, quality control parameters. Therefore, at present quality assurance is one of the thrust area for the evaluation of traditionally vv used medicinal plants and herbal formulations. Phytochemical constituents present in the polyherbal formulation act as the critical quality attributes and control variables which are essential to carry out the process validation. Development of authentic analytical methods which can reliably profile the phytochemical composition and help in validation of manufacturing process is a major challenge to scientists. Thus control of the process from the beginning to the end and quality assurance along the complete process chain is the key which will ensure the batch to batch consistency of finished polyherbal products. Results proved that manufacturing process stands validated as it met acceptance criteria.

Evaluating the conformational changes of a modified viral protein could be the first step in generating a successful stable recombinant virus. This study demonstrates the effect of a small epitope addition into the haemagglutinin (HA) protein of theH1N1 influenza virus, which was compared with the wild-type protein. A hexahistindine (His6) tag was inserted intoa selected antigenic domain within thehaemagglutininHA1 subunit of the A/Puerto Rico/8/34 influenza virus. To investigate the stability of the recombinant HA protein, a molecular dynamics (MD) simulation was used for the His6-HA protein and for the wild-type HA protein under physiological conditions. Analysis of the MD trajectories showed no significant differencein terms of stability between both systems after 100 nanoseconds of the MD simulation. The His6 tag influenza virus was then successfully generated using the helper virus-based method. The recombinant mRNA was positively detected amongst the wild-type virus population after three passages of the polymerase chain reaction (PCR) detection method. Our findings indicate that addition of a small epitope is less likely to affect virus stability and infectivity for up to several rounds. Finally, an affinity purification trial resulted in an eluted sample with a low virus amount, which most likely represents the isolated His-tagged virus; however, more investigation is required.

Environmental and climate conditions are two very important factors that affect flexible asphalt pavements in roads. Asphalt Pavements (AP) are usually under continuous expansion and contraction effects from the nonstop increases and decreases of temperatures. As a result, AP structures are subjected to critical stresses and strains leading to cracks and defects. The physical and mechanical properties of hot mix asphalt (HMA) must be improved to resist the thermal cracking defects that generally occur in a pavement’s asphalt. Meanwhile, many types and huge quantities of waste plastics and industrial polyethylene are being generated. These wastes are harmful to the environment. This research aims to improve HMA specimen’s properties by adding waste plastic bags and industrial polyethylene to pure asphalt with replacement percentages of 2%, 3%, 4%, 5%, and 6% by total weight of asphalt. The optimal contents of additives to asphalt were found to be 4.6% and 4.1% for waste plastic bags and polyethylene, respectively. The effect of the short term freeze–thaw cycle on asphalt mixtures with and without additives was also studied. Durability curves and indexes were used to find the resistances of mixtures against freeze–thaw stresses. Three types of asphalt mixtures were prepared according to the Marshall method; all were exposed to freeze-thaw cycles according to the following timetable (1, 2, 3, 4, and 5) cycles, where each cycle represent 48 hours (24 hours freezing and 24 hours thawing). The first durability index (FDI) for asphalt mixtures with polyethylene had a lower loss rate in stability in one day, at 30.86 %, followed by asphalt mixtures with waste plastic bags where the value of FDI was 38.59%, while asphalt mixtures without additives gave an FDI value of 55.22%. Adding polyethylene and waste plastic clearly improves the mixtures properties and in turn increases the durability of asphalt pavements.

The article is devoted to the problem of formation of geographical and cartographic traditions of Central Asia in Russia, especially in the XVII – XVIII centuries. This period was one of the fundamental researching of the Central Asian territories by Russian specialists. Given detail information about the cartographic and geographic sources, its contents and influence for the future researching of the region.

The purpose of this study is to examine socialization via Social Network Site (SNS) use in university undergraduate students as they approach graduation. It provides a description of undergraduate students’ SNS socialization from a mixed-methods approach. The main research questions include: (1) Is there a significant relationship between percent of undergraduate program completed and minutes of SNS use? and (2) What are the differences in the uses and perceptions of SNSs as students approach the end of their undergraduate programs? Student academic information (i.e., years of undergraduate program completed) was used to determine how progress across undergraduate years is linked to SNS use (i.e., minutes/day on SNSs) in a cross-sectional design. Data (n = 356) have been collected online from a survey-hosting website from multiple universities in Africa. The results show that as a student’s undergraduate program nears completion, SNS use increases as well, controlling for other variables.

Propagation of a plant in efficient way is the prime act of any farming and plays vital role in its existence, survival and continuity in future course of action. Mulberry (Morus alba L.) being perennial in nature cultivated as seasonal crop for its foliage to feed silkworm (Bombyx mori L.) is mainly propagated through vegetatively and plays major role on the upliftment and socio economic conditions of the sericulturists. Therefore, proficient method of propagation not only saves farmers economy but also plays pivotal role on the future of sericulture. Keeping the above aspects two popular mulberry varieties such as V1 and G4 mulberry varieties were planted in winter i.e. during December, 2018 considering as one of the favourable season to raise mulberry nurseries at Regional Sericultural Research Station, Central Silk Board, Ananthapuram, Andhra Pradesh. Each variety was planted @ 2500 cuttings and maintained properly for their survival. It was noticed that after 30 to 45 days of plantation G4 mulberry variety has recorded increased levels of sprouting (6.36%), survival (10.90%) compared to V1 mulberry var. Similarly 60 and 90 day after plantation the saplings growth of G4 was luxuriant and healthy recording an increased plant height (66.67%), sapling biomass (66.67%), sapling shoot weight (46.51%) and root biomass (128.57%) compared to V1. Further, G4 saplings have also exhibited their superiority in resisting various pest incidences such as millibug, thrips and leaf hoffers compared to V1 mulberry saplings indicating its susceptibility in resisting the seasonal pests incidents by recording 64.50%. The above results not only encourages the farming community for opting G4 mulberry variety as the best plantation of choice to raise nurseries but also opens avenues to adopt as standing crop as alternate to V1 mulberry as because G4 is not only a high yielding variety but also suitable for late age rearing as because the farmers are rearing chawki worm only. Hence, G4 can be considered as strong in nurseries, healthy against pests and most suitable for bivoltine silkworm rearing thereby encouraging the farming community for adoption and silkworm rearing for enhanced quality cocoon production.

The research handles the training of workers and its types. Training is one of the most important strategic functions of human resource management, as it is one of the important reasons for the sustainability and success of organizations in the modern era, as well as its relation to the human resource, which is the basis of the work of any organization. The research is based on two aspects: the theoretical one, using the various researches and studies related to the subject of research, and the practical one, which is conducted by distributing the questionnaire to managers at all levels of management in the organization as a sample for research. The research aims to demonstrate the importance of training employees as an administrative science mission in improving the performance of the organization.In general, the study tries to answer the following questions. • Is there a clear vision of the management of the organization for the importance of training workers. • Is there a difference in the attitudes of respondents about the types of training prepared by the management of organizations. • Does the management of the organization in question depend on the criteria for evaluating its trainees.

Background: Type 2 Diabetes Mellitus is characterized by peripheral insulin resistance and inadequate insulin secretion by pancreatic β-cells. When there is a build-up of glucose in the blood it may lead to acute and serious, long-term complications. Walking has been shown to reduce blood glucose levels and improve the Quality of life in subjects having Type 2 Diabetes Mellitus. Effects of Zumba have been studied and shown improvement in Quality of life in several neuro-musculoskeletal disorders. However as per our knowledge no study has been done till date to compare the effects of Zumba aerobic technique and Walking on blood glucose level and Quality of life in subjects having type 2 Diabetes Mellitus. Objectives • To study and compare the effects of Zumba aerobic technique and Walkingon Fasting blood glucose levels and Quality of life in subjects with type 2 diabetes mellitus. • To compare the effects of Zumba aerobic technique and Walking with age-matched controls on Fasting blood glucose levels and Quality of life in subjects with type 2 diabetes mellitus. Methods: A convenience sample of 45 type 2 Diabetes Mellitus subjects participated in a prospective randomized control trial. Fasting blood glucose levels and Quality of life score was measured on day 1 and day 30 in group A which performed Zumba aerobic technique under supervision 3 times a week for 4 weeks. The scores were compared with group B which performed walking for 3 days a week for 4 weeks and group C which was the control group. Results: A statistically significant reduction in Fasting blood glucose levels as well as significant improvement in the Quality of life score was observed after 4 weeks of training in both groups A (FBS,QOL p - < 0.0001) and B (FBS,QOL p - < 0.0001) whereas in Group C is was statistically non-significant (FBS p - 0.2115,QOL p - 0.1689). Also, a statistically significant change was seen in both FBS and QOL score on comparison between groups A, B and C. (FBS p - < 0.0001, QOL p - 0.0419) Conclusion: Zumba aerobic technique and Walking are both effective in reducing the Fasting blood glucose levels and improving the Quality of life in subjects with Type 2 Diabetes Mellitus where Zumba shows better results as compared to Walking and age matched controls.

Many surveys are conducted by many people for Passengers and Drivers. Feedback is available on various web sites. But very less data is available on the most important link in the chain is bus owner who take the decision on bus purchase and invest his hard earned money. Bus owners are primary owners but passengers and drivers are influencers. PCMC is a newly developing smart city, it is also called as Detroit of India or Auto hub of India. Thousands of small scale, medium scale and large scale companies are located here. Millions of employees live here and infrastructure is developed for them-like hospitals schools and Government offices. Naturally lot of staff, school buses are required for public and private transportation. Manufacturers need to study the purchase motivators, customer experience, and usage pattern.

This article is focused on understanding how the potato crop behaves and captures the solar energy to be reflected, through the use of CANON SX260HS camera with sensor that capture the electromagnetic spectrum of the near infrared. This is captured during the phenological process of the potato crop Solanum spp. in its four stages of growth as: Vegetative Growth, Start of tuber production, Growth of Tubers and Maturation or Senescence, with a drip irrigationsystem. In each phenological stage we observe different behavior in the Reflectance of solar energy that is measured through the Normalized Vegetation Differential Index that ranges from 0.2 to 0.9. These results are obtained since irrigation sheets were applied according to the information on: three drainage lysimeters, evaporimeter tank and empirical formulas. In the field research, completely randomized blocks were designed with three treatments T1 = application of the irrigation sheet measured by lysimeter, T2 = application of the irrigation sheet measured with tank type A, T3 = application of the irrigation sheet calculated with formula with three repetitions of each.

In the present study anchoring of hemin a protoporphyrin IX Fe (III) molecule on the surface of SrTiO3/SnO2 composite (H-(STO / SnO2)) is attempted. STO / SnO2 composite show activity under visible light due to the staggering band edge positions. However the activity under solar light is very poor. When hemin is anchored on the STO/SnO2 composite the activity increases by 22 folds. The activity can be further improved by the addition of H2O2 as an oxidant by 70 folds. This higher activity in presence of H2O2 can be due to the synergistic effect of photocatalysis, photosensitization and photo-Fenton process. The higher efficiency of H-(STO / SnO2) composite sample along with H2O2 can also be accounted to the efficiency of non-radiative electron-transfer through Inter System Crossing (ISC) from the excited singlet to triplet state which increases the life time of the charge carriers. Triplet state is more favorable than the excited singlet state for the transfer of electrons from the hemin molecule to the conduction band of H-(STO / SnO2) composite and in turn to the adsorbed oxygen molecule. The actual life time of singlet state is ̴ 10-9 s and the triplet state is ̴ 10-5 s. The process of electron trapping either by oxygen triplet or by Fe3+ ion in the hemin molecule (in the presence of H2O2) reduces the rate of recombination of photo generated charge carriers.

Intravitreal administration of adenosine triphosphate (ATP) has been found to be effective for inducing photoreceptor death and loss of retinal function. Due to lack of studies that investigate the changes consumed the lens during early steps of retinal degeneration, the aim of the present search is to give an approach for lens molecular structure changes in ATP rats model of retinal degeneration by using fourior transformer infrared technique. Fifty healthy albino Wistar rats were divided into 4 groups: Group I served as the control group and received intravitrial injection of saline. All other groups were received a single intravitreal injection of 2µL of 1 M ATP and decapitated after 1, 3 and 6 days, respectively. The results indicated that NHOH region was found to be dramatically affected in particular after one day of ATP injection where more vibrational mode was observed relative to control. These reflex more conformational changes which involve moiety of lens fiber. The detection of asymNH after 3 and 6 days of ATP injection indicated the increase of disorder of lens fiber. CH region shows that the symmetric vibration mode (symCH3) is sensitive to ATP injection as indicated by the fluctuation change in its band frequency and this band is associated with lens lipid molecule. The phosphate lipids were found to be sensitive by the ATP injection and this represented by the detection of symPO2vibrational mode in all ATP injected groups relative to control group. We concluded that ATP injection dramatically affect both protein and lipid moieties of lens fiber. Recommendation of a regular examination for whole eye especially lens in case of retinal degeneration not retina only.

The current study included investigated pollen grains morphology (mainlyexine sculpture) of seven species of the A steraceae family from the northern and eastern parts of the Kingdom of Saudi Arabia. These plant species included Artemisia sieberi L, Achillea fragrantissima (Forssk.) Sch. Bip, Calendula officinalis L., Matricaria aurea Loefl, Picris abyssinca L., Rhanterium epapposum Oliv.and Tanacetum santolinoides D.C. The pollen morphology of seven Asteraceae plant species was investigated with light microscopy. Pollen slides were prepared using Wodehouse technique. Measurements were based on 25 -30 pollen grains per specimen. The pollen grains of the studied plant species are radially symmetric and is opolar. The pollen grains are oblate-spheroidal with the polar axes 18.5–23.4 µm and the equatorial axes 19.8–26.7 µm. The pollen grains of the plant species aretricolporate. The pollen grain of all species has echinate ornamentation. The spines have conical shape with a wide base tapering towards an apical section. The spine length ranges between2.1–3.5 µm and its width ranges between 2.6–3.8 µm. The overall exine thickness ranges from 3.7 - 5.1 µm, while intine thickness ranges from 0.37-0.81µm.It is clear that the external surface characteristics of the pollen and the presence of spines are important traits and can be used successfully for species taxonomic classification.

Objective: The aim of this study is to measure and compare the compressive strength and micro hardness of Bulk-fill composite-light cure (Ivoclar vivadent)) with Cention-N-dual cure (Ivoclar vivadent) Material and methods: In this in vitro study, two different types of bulk-fill composites are used: Group 1: Bulk-fill composite (Ivoclar vivadent)-light activated (blue phase). Group 2-Cention-N (Ivoclar vivadent)-light activated (blue phase). Group 3-Cention-N (Ivoclar vivadent)-self cured. Ten samples of 4 mm height and 6 mm diameter in each group were made using a mold. The composites filled in the mold were photo polymerized using light-emitting diode (LED) light-curing unit for 20 seconds from top for group1 and group2.Specimens in Group 3 were kept for 4 minute for self curing. The compressive strength of the samples were tested on top surface using universal testing machine (Instron 3366, UK) at a cross-head speed of 1.0 mm/minute. The micro hardness value of each sample will be evaluated using Vicker’s micro hardness tester on top .Micro indentation was carried out using a 100 mN load with a 15 seconds dwell time. Then the data will be collected, tabulated and subjected to statistical analysis. Result: In this study we found that compressive strength of the Cention-N (270) (Light-cure) > Cention-N (215) (Self-cure) > Bulk-fill (129). Microhardness values of Cention-N (147) (Light-cure) > Bulk-fill (112) > Cention-N (82) (Self-cure). CONCLUSION: In this study Cention-N (Light-cure) had the highest compressive strength and microhardness. Cention-N (Self-cure) had more compressive strength than Bulk-Fill ,but had lowest microhardness. Bulk-Fill composite had the lowest compressive strength, they had micro hardness more than Cention-N (Self-cure). Cention-N also has anticariogenic activity, it prevents the secondary caries formation of the restored tooth. The future of restorative dentistry appears to be smarter and faster in the coming years with the advent of Cention-N.

An antiregular deformation is considered for an in-equal elastic material consisting of an infinite system of parallel identical circular fiber cylinders covered with a homogeneous cylindrical film uniformly covering the surface of each fiber and a binding medium weakened by a doubly periodic system of rectilinear cracks. The boundaries of the destruction of the composite are determined, which occur by the detachment of the fiber from the matrix, at the fiber-matrix interface. By varying the rigidity of the fiber with respect to the stiffness of the binder medium, the degree of viscosity of the composite as a whole can be controlled. The viscosity fracture equations for the stress intensity factor of a fibrous composite are obtained as a function of the nature of internal structural defects. A mathematical description is given of the strength of the composite both in detachment and in share. As a result, the stress-strain state of the fiber composite weakened by periodic linear cracks is determined.

The objective of this study is to examine the effects of mobile phone use on the study habits of University of Karachi students. The research was carried out using questionnaires distributed to 1200 students who own mobile phones .The questionnaires collected demographic information about the respondents, mobile phone type preferences, uses of mobile phones during study, predominant usage during study and information about challenges facing students in using mobile phones for study purposes. The results showed significant gender differences in several aspects of mobile phone use. The results also revealed that mobile phone use has negative and positive effects on the study habits of university students depending on usage patterns.

Cloud computing is a new computing model which enables individuals and organizations to attain access to huge computing resources without capital investment. It does mean that users can utilize computing resources in pay per use fashion. Transmissible cyber threats nowadays have been considered one among the major serious security problems in cyberspace. Several techniques were proposed to model, simulate and identify threats' sources and their propagation in large-scale distributed networks. Most techniques are based on the analysis of real networks dataset that contains sensitive information. Traditional in-memory analysis of these dataset always leads to data leakage because of system vulnerabilities. If the dataset itself is compromised by adversaries, this threat cost would be even higher than the threat being analyzed. To overcome this problem, in this paper, a new Distributed Security Shielded Execution (DSSE) for communicable cyber threats analysis using the Secure Identity Based Encryption (SIBE) technique is proposed. The purpose of the proposed work is to provide security sensitive operations then implemented properly in the Disef enclave. And to minimize potential Iago attacks in Disef system. To introduce a Novel SIBE unbreakable new key-value encrypted format integrated with the version number and update counter to prevent possible rollback and replay attacks. Also to secure a Disef system in high availability with multi-cloud support. The experimental outcomes showed that the proposed framework supports secure cost analysis and response time analysis of large network dataset and has comparable performance with systems that have no confidentiality and integrity guarantees.

Usually, Users are not aware of all the details about the hospitals, doctors, treatment or symptoms regarding the particular disease. For the small problems, users have to go personally to the hospital for a check-up which is time consuming and expensive. Also handling the telephonic calls for the complaints is quite hectic. Such problems can be solved by using medical Chabot which provides proper guidance for healthy living. The proposed medical chatbot functioning based on Natural language processing, topic modeling, aspect mapping and SVM which helps users to submit their queries about health problems, concerned specialists and get the suggestion about treatment and related services. The User can ask any personal query related to health care through medical chatbot without accessing the hospital in person. The proposed approach for medical chatbot has three phase processing. The first phase is the preprocessing stage which includes Natural language processing methods like word splitting, filter out punctuations, stop word removal and finally porter stemming is done to identify the root word. The second phase includes topic modeling, Aspect extraction and topic aspect mapping. Here the identified topics and aspects are mapped together and assigned to each categorized dataset and trained a machine with SVM. The third phase of the proposed approach is the trained system identifies the aspect from the human typed sentences in medical chatbot and these identified aspects matched with the database sets. And the chatbot redirected to matched dataset and retrieved the corresponding information and displayed in chatbot. Finally, check the efficiency of proposed work with different size of the medical conversation dataset and also the efficiency of the machine learning approach.

Intelligent decision is the key technology of smart systems. Data mining technology has been very important in decision-making activities. A Frequent item set mining (FIM), as an important step of association rule analysis is becoming one of the most important research fields in data mining. Weighted FIM in uncertain databases should take both existential probability and importance of items into account in order to find frequent itemsets of great importance to users. This system is intended to show the things occurred in between the searches happened in the place of client and server. The users can able to know about the process of sending ahttp request for the particular thing and getting a http response for that request. But no one can able find out the internal process of searching thousands of records from a large database. This system openlyvisible the internal process of the searching. The WD-FIM is failed to deliver the document based on their preference because the preference should be of any type like pdf, ppt, word document, text document, image and video To overcome the problem of WD-FIM it should be combined with User preference tree. This is a web based online project. The main aim of the project is a providing Learning Course to the user based on their preference. The algorithm should learn the user behavior and provide the preference type in ascending order. Many learning resource management system can offer basic course administration features, but their functionality isn't as robust. It also typically use users behavior to track learners competencies and recommend materials, but most systems lack the capability to deliver personalized materials to the user. Ex: Learning Resource Management should provide authoring, sequencing, and aggregation tools that structure content to facilitate the learning process.

The dynamic and complex affiliation among price of Gold, Oil and inflation has attracted to the market practitioner and policy makers, from the last few decades. In order to gain the profit, investors consider as a secure form of investment against the unforeseen disasters. This study investigates the relationship between prices of gold, oil and inflation. We use secondary data of gold prices, oil prices and inflation covering the period from August, 2004 to January, 2017 of Pakistan. In order to examine the impact of oil prices and gold prices on inflation we use Vector Error Correction model. It is found that there is long term relation between the oil, gold and inflation via cointegration process. Moreover, empirical analysis shows that fitted VEC model is adequate based on portmanteau autocorrelation and Lagrange Multiplier test. Forecast of gold prices, oil prices and inflation for the next 12 months are computed through VEC model, FMAE is minimum as compared to FRMSE.

The more we are able to peer into the future, the better equipped we will be to prepare ourselves to do well in the environment ahead. It may therefore be interesting to look at trends we can expect in veterinary medicine in the upcoming years. Medical diagnostic technology has made rapid strides after the advent of computer. Many of the advances in human diagnostic medicines are translated into veterinary medicine in the developed countries. In brief, newer branches like Imaging, Radiodiagnosis, Telemedicine, Telesonography and Teleradiology have emerged.

Background and Objective: Surgical care has a role in treating a broad spectrum of diseases in the alleviation of human suffering. Upper abdominal surgery included gastrectomy, pancreatectomy, hepatic resection, cholecystectomy and splenectomy. Maximal inspiratory pressure (Pimax) is an important indicator for assessing the strength of inspiratory muscles. Respiratory muscle training devices enhance respiratory muscle strength, endurance and exercise capacity. Pressure Threshold IMT devices are usually handheld devices with a spring load that is impeded with different intensities. Incentive Spiro meter is a form of ventilatory training that emphasis sustained maximum inspiration. Therefore, the present study aims to assess the effect of Threshold Inspiratory Muscle Training versus Incentive spirometry in participants with upper abdominal surgeries. Materials and Methods: A prospective cross-sectional comparative study was done with 30 participants with upper abdominal surgeries in the age group of 20 to 65.On Day 1 and after 2 weeks the maximal inspiratory pressure was measured using Hand Held Pressure Manometer Device (Pimax). Group Aparticipants received Threshold Inspiratory Muscle Training (IMT) and Group B participants received Incentive spirometry. The intervention was given for 5 days in a week for 2 weeks. The duration for each session was of 15-30 minutes which also includes rest periods. Data was analyzed using student Paired ‘t’ testand Unpaired‘t’ test. Result: There was extremely significant difference (p<0.0001) in Maximal Inspiratory Pressure (Pimax) in both the groups but Group A showed slightly more improvement were Threshold Inspiratory Muscle Training (IMT) was given as an intervention after 2 weeks. Conclusion: The study shows extremely significant improvement in Maximal Inspiratory Pressure (PImax) in both the groups. This study concluded that Threshold IMT has more effect than Incentive Spirometry in participants with upper abdominal surgeries.

Background: Healing followed by the surgical removal of third molar is known to cause increased discomfort to the patients. Many theories and ideas have been idealized to reduce this discomfort. Traditionally, systemic antibiotics were used. But due to the phenomena of antibiotic resistance to multiple microorganisms we are constantly on the process of discovering new methods and modifying age-old methods for the better usage of antibiotics in future by either finding a supplement or an alternative. Ozone is one of such old methods which is found to be effective. It meets all the expectations as an alternative for antibiotics and also ful fills the application of it in the needed area alone thereby, restricting the systemic use of antibiotics. Platelet rich fibrin (PRF) is well known as the gold standard material for promoting healing.In this study, topical ozone gel and platelet-rich fibrin(PRF) are compared with the conventional method to evaluate their effectiveness in the healing of surgical extraction of impacted mandibular third molars. Materials and Methods: A double-blinded randomized controlled clinical trial was designed involving the patients who required removal of impacted mandibular third molars. The sample size was estimated as 60 individuals with 20 in each group. Of the study groups, one received topical ozone without post-operative systemic antibiotics, another received metronidazole with PRF while the control group received systemic antibiotics. All the groups were prescribed standard analgesics for 3 days. Postoperatively, the patients were reviewed at 24 hours, 3rd day and 7th day. Results: Data were collected and analysis involved independent sample ‘t’ test. The study groups, ozone gel application and metronidazole with PRF demonstrated statistically significant (p<0.05) reduction in post-operative pain, swelling, and incidence of alveolar osteitis with increased mouth opening. No adverse effects of ozone gel were observed in any of the patients. Conclusion: In this study, it is concluded, that ozone can be considered as a potent topical antibiotic with healing property and also as an adjunct analgesic.

Low back pain is a common, disabling musculoskeletal disorder in both developing and developed countries. Foot reflexology is referred as “medicine of the soul” as it is able to reach the root of physical or emotional problems. Aim: To assess the effectiveness of foot reflexology technique on reducing lower back pain among adults. Methodology: Study was conducted using True experimental pre-test and post-test control group research design among 50 adults (25 in control group and 25 in experimental group) who were selected using purposive sampling technique at selected villages under Kirumampakkam PHC, Puducherry. Data was collected by interview method using the pre-determined tool-Oswestry low back pain disability questionnaire. Results: Through Mann-Whitney test, It revealed that the difference in median level oflower back pain of adults in experimental group (M=5) was lower in the post-test than in the pre-test (M=18) which is statistically significant (p<0.05). In control group, median level of lower back pain of adults between the pre-test and post-test (M=18, 20) was not statistically significant (p>0.05). Conclusion: The study findings revealed that foot reflexology technique is effective in reducing lower back pain among adults. Hence we recommended that foot reflexology technique can be used as an alternative non-pharmacological therapy for lower back pain.

Root canal anatomy is highly complex and unpredictable. An awareness and thorough knowledge of internal and external root canal morphology contribute to the successful root canal treatment. Usually mandibular molars have two roots with three canals (Mesiobucccal, Mesiolingual & Distal). But in few teeth, the number of roots and canals vary. Mandibular molars can have an additional root located lingually (Radix Entomolaris) Or buccally (Radix Paramolaris). Clinicians should be aware of these unusual root morphologies in the mandibular first molar which needs strategic treatment as unfilled canals remain a nidus for infection and can compromise treatment outcome. This case series discusses endodontic treatment of Mandibular First Molar with Radix Entomolaris, which is a rare entity and poses as an endodontic dilemma for the clinician with respect to diagnosis and subsequent treatment.

The present study was conducted to evaluate the effectiveness of Interventional Module to enhance self-esteem among adolescents in selected Government schools, Puducherry. Objectives : to assess the pre-test and post-test level of self-esteem among adolescents in experimental and control group, to evaluate the effectiveness of Interventional Module on the level of self-esteem among the adolescents within the experimental group, to compare the effectiveness of Interventional Module on the level of self-esteem among the adolescents between experimental and control group, to associate the post- test level of self-esteem among adolescents with the selected demographic variables in experimental group. Methods: The research approach used for this study was quantitative approach and the design selected was quasi experimental design pre-test and post-test with control group. The researchers assessed the level of self-esteem among the adolescents studying in 8th and 9th standard by using a Rosenberg self-esteem scale. By using purposive sampling technique 130 adolescent’s whose self-esteem score was less than 50 percentile. 65 subjects were allotted to experimental group and 65 subjects were allotted to the control group. Interventional Module to enhance the self-esteem was imparted to experimental group for 8days for the duration of 1hour and no intervention was given to control group. Results: it was statistically significant at the level of p<0.001 and the post-test self-esteem score was associated with age, mother’s educational level, mother’s occupational, average travelling time, and leisure time activities and it was found significant at the level of p<0.001 . Conclusion: The study concluded that Interventional Module was effective in enhancing the self-esteem among adolescents in experimental group when compared to the control group.

Background: Depressive symptoms are common mental disorders around worldwide. The prevalence of depression is much higher irrespective than in general population.Prison is a place where criminal persons are residing for many years which makes them to have severe depression,. Around 49% of women and 23% of male prisoners having Low Self- esteem and depression. Thus selected limbs of Ashtanga Yoga (Asanas and Pranayama) will provide a positive effect on enhancing self esteem and decrease the level of depression among prisoners. Aim: To evaluate the effectiveness of selected limbs of Ashtanga Yoga on Self-esteem and Depression among Male Inmates in Central prison. Materials and Methods: Pre Experimental Research Design (One group Pre- test Post-test). 42 Male Inmates were selected by Purposive Random Sampling Technique. The data was collected and pre test was done by Rosenberg Self- Esteem Scale and Beck Depression Inventory. Selected limbs of Ashtanga Yoga, namely Asanas and Pranayama techniques were administered for 30 minutes daily for 21 days and post- test was done. The data was analyzed by descriptive and inferential statistics. Result: The obtained paired t- test was -11.76 and 13.18 which is significant at p < 0.001. Conclusion: Selected limbs of Ashtanga Yoga (Asanas and Pranayama) were effective to bring about positive changes in the level of Self Esteem and Depression among Male Inmates in Central Prison.

Introduction: Kamala is one of the important common clinical entity in Ayurveda whose description appears to be most comprehensive and incorporates the disorders of hepatobiliary system of modern medicine. In Ayurvedic literature Kamala has been mentioned as a sequel of Pandu roga. It occurs when Pandu rogi takes more Paittikaharavihara1. Jaundice, a yellowish discoloration of tissue resulting from the deposition of bilirubin is the common presentation of patients with liver and biliary diseases. The liver diseases have remained a challenge to medical profession since many of the liver disorders may ultimately lead to irreversible changes. Liver function tests along with liver enzymes constitutes group of tests used to determine the state of liver function in a patient. Materials and methods: Literary material from Ayurvedic and Modern texts was compiled and assessment criteria was formulated.15 patients of age 10-70yrs were registered from OPD/IPD of R.G.G.P.G.A.C Paprola fulfilling the inclusion criteria. Drug, Dosage and Duration: One group of minimum 15 patients were treated with both the trial drugs i.e. Trivritchuran with Sharkara 4gm orally twice a day for 7 days and Kamalaharyoga- Liver tone syrup 10 ml TID for 30 days and Liver tone capsule 1 BD for next 30 days . Duration of trial was 60 days with follow up after every 15 days. Observations Effect of therapy on Subjective and Objective Parameters: Out of those 13 patients who completed the study;38.46% patients were completely relieved, 3 patients each with the percentage of 23.07% reported mild and moderate improvement, marked improvement in patients symptoms and biochemical improvement was found in 7.70% of patient and 7.70% reported no relief in symptoms and signs of disease Results and conclusion: Therapy has significant role in relieving symptoms and signs of the disease. It showed better efficacy on subjective criteria than biochemical criteria. No adverse effects were observed during the course of trial.

Purpose: The palatal rugae are a prominent stable landmark in the maxillary arch and its position lies constant throughout the life. Therefore it can be used as a guideline for the placement of artificial teeth in the maxillary arch. Materials and Methods: 150 subjects were randomly selected, 50 subjects of age group 20-40 years were taken for each arch form i.e. U shaped, V shaped and ovoid arch were selected and impressions were made. Materials used were maxillary dentulous casts, graphite pencil, metal scale, brass wire and divider. The length of palatal rugae, distance from palatal rugae to tip of canine, perpendicular distance from incisive papilla and midpoint of incisal surface to a line connecting 1st premolar and the distance from central incisor to incisive papilla were compared in all the 3 arch forms. Results: The length of 1st, 2nd and 3rd palatal rugae were statistically significant in ovoid, U and V shaped arches. The distance from end of first palatal rugae to tip of canine was more in ovoid arch when compared to U shaped arches and V shaped arches. The distance from incisive papilla to midpoint of central incisors in ovoid arch, U shaped arch, V shaped arch was not so significant. The Distance from posterior point of incisive papilla to perpendicular line connecting from premolars in ovoid, U shaped arch, V shaped arch was not so significant. Conclusion: In U shaped arches which appear broad mesio distally, square incisor teeth can be used. In ovoid arch, medium sized teeth were ovoid incisor teeth can be used. In V shaped arch as it is narrow and tapering mesio distally, tapering incisor teeth can be used. This study was therefore done to find out the position of teeth in relation to palatal rugae which in turn determines the selection of teeth accordingly.

This study was performed from November 2018 to the end of December 2018 to assess knowledge and awareness among a sample of paramedical staff regarding seasonal influenza vaccine in Mosul health workers .The results of demographic data of the studied sample showed that ( male : female ratio was (1:1.1 ) , more than half of the sample selected were females (52.8%), while males were (47.2%). The age of the studied sample at the time of study was between (20-57) years. The peoples of the sample were working in different health centers. The study revealed that there is significant association between paramedical staff education and their knowledge level for using the vaccine in preventive programs. No significant association has been found between (age groups, Gender, residence and working centers ) of paramedical staff and their knowledge. Results revealed that 16% of medical staff studied in Mosul received influenza vaccine, and 35.2% of sample who did not receive vaccine had a doubt about effectiveness of vaccine which is manly in medical staff 42% rather than 29% of sub staff, influenza vaccines are valid for one year only. The study recommendation is to intensify the general programs for health educations towards the importance of influenza vaccine for all paramedical staff(staff and sub staff).

Background: Forensic Odontology is a vital component of forensic science and one branch involves the application of dental science to the identification of unknown human remains. The aim of this study was to investigate whether endodontic obturation radiographs have a potential aid for forensic identification. Methods: Thirty periapical radiographs of patients having endodontic treatment of mandibular left first molars with three canals were selected randomly from the data bank of the digital X- ray system. The post-operative radiographs were considered as an ante-mortem data “Set 1”. Ten radiographs from the thirty were reprinted, labelled from (A-J) and considered as a post-mortem data “Set 2”. This post-mortem group of 10 radiographs “Set 2” would be compared with the ante-mortem group of 30 radiographs comprising “Set 1”. These two sets of radiographs would be examined by 80 dentally trained personnel. The thirty radiographs comprising “Set 1” and the 10 radiographs comprising “Set 2” were provided to each of the examiners who were asked to match the individual post-mortem radiographs (“Set 2”) with the ante-mortem radiographs (“Set1”). Results: The result demonstrated that 73 examiners achieved a success rate of 100%. Conclusion: If post-mortem radiographs are accurate duplicates of endodontic obturated radiographs then the unique shape of obturation can be used for forensic identification.

Introduction: The significance of smoking in the hypertensive patient may be unappreciated. The risk of hypertension may be tripled in such patients. Tobacco addiction may also compromise the treatment of hypertensives. The contribution of nicotine to adverse cardiovascular events has been a concern, both among physicians and patients. Nicotine has also been reported to have adverse effects on endothelial function and may impair insulin tolerance, although the biologic relevance of these effects in individuals remains unclear. Materials and methods: the study was conducted in SVS Medical college, Mahboobnagar, for a period of 4 months. Study sample consisted of 100 chronic hypertensive patients diagnosed by general physician and nicotine dependence was assessed using a questionnaire and diagnosed according to ICD-10 RDiC criteria. Later, severity of nicotine dependence in these patients is assessed using Fagerstrom scale. Results: Nicotine dependence was more common in older group when compared to younger individuals with chronic hypertension. Male individuals were more affected with nicotine dependence when compared to female population which was statistically significant. Conclusion: In conclusion this survey demonstrates the increased incidence and prevalence of nicotine dependence in chronic hypertensive patients in North Telangana population. The severity of nicotine dependence is more affected by the socioeconomic status and urbanization. As the age of individuals increased, severity of nicotine dependence increased which was statistically significant.

Background and objective: Diabetes is an increasing epidemic in India, and associated diabetic peripheral neuropathy (DPN) is its most common and disabling complication. As DPN has an insidious onset and heterogeneous clinical manifestations it is difficult to detect high-risk patients of DPN. Early diagnosis is recommended and is the key factor for a better prognosis and preventing diabetic foot ulcers, amputation, or disability. We conducted this study to study the scope of Semmes Weinstein Monofilament (SWMF) as a screening tool to identify these patients during the early course of the disease to provide a targeted therapy to modify the course of DPN. Methods and Materials: This was a case control study, comprised of 80 subjects.40 type 2 diabetic patients with clinical features of diabetic peripheral neuropathy (DPN) and abnormal nerve conduction studies (NCS) were selected as cases and 40 age, sex and height matched healthy adults were included as controls. All were subjected to NCS and SWMF tests. Diagnostic values were calculated for SWMF test taking NCS as gold standard for diagnosis of DPN. Results: The SWMF had sensitivity and specificity of 85% and 75% respectively with a accuracy of 84% for diagnosis of DPN. Conclusions: SWMF is a good screening tool for detecting the presence of DPN in diabetes mellitus patients because of its high diagnostic value besides being noninvasive, low cost, rapid and easy to apply test. There is a significant correlation between the NCS and SWMF in the diagnosis of DPN.

Introduction: Cardiovascular diseases are a group of disorders of the heart and blood vessels. Cardiovascular diseases are the leading cause of death in India, and its contribution to mortality is rising. According to WHO, most cardiovascular diseases can be prevented by addressing behavioral risk factors such as tobacco use, unhealthy diet, obesity, physical inactivity and harmful use of alcohol using population wide strategies and for successful prevention of cardiovascular diseases, knowledge is an important pre requisite. Hence this study aimed to assess knowledge and perception on risk for cardiovascular diseases among the ministerial staffs. Materials and Methods: A cross sectional study was conducted among ministerial staffs working in various departments (Administrative section, academic section and clinical departments) of JIPMER, Puducherry. 263 ministerial staffs were selected by non-probability convenience sampling technique. The data was collected by using modified structured questionnaire. Results: The study showed that majority 53.6% had moderate level of knowledge and most of them 87.5% had increased perception on risk for cardiovascular disease. There was no correlation between knowledge and perception. There was an association between levels of knowledge with family history of cardiovascular diseases and between level of perception with smoking status & family history of cardiovascular disease at p<0.05. Conclusion: The above findings reveal the importance of the need for implementation of awareness on cardio vascular risk factors and disease.

Background: Early diagnosis is the best way to reduce mortality and to improve the survival of women with breast cancer. In Brazil, there are few studies that provide detailed data on inequalities in the access of mammography. Objective: Investigate the inequalities associated with mammography in Brazil among women between 50 and 69 years of age. Methods: A cross-sectional study was carried out in Brazil. The outcome was access to mammography. The independent variables were: age, race/skin color, census region (urban/rural), macroregion, educational level, per capita income, coverage by health insurance and use of medical service in the last 12 months. Poisson regression was performed to test the association and calculate crude and adjusted models. Results: The prevalence of mammography was 54.2% (95%CI 53.1-55.3).The prevalence of non-mammographywas higher among women from the Northeast, living in a rural region, aged 60-69 years, with lower income and educational level and who did not have a health insurance. Conclusions: There are important inequalities in the access to mommagraphy in Brazil that need to be addressed by effective public policies.

To know yourself, your strengths, weaknesses, do’s and don’ts is the most challenging task everyone has to face. To accomplish that task several psychometric tests are available but after finding the answer, “who are you?” the next step is finding the compatible career that can only be achieved by career counseling. Career counseling is required in order to build a pathway for students towards a career that not only provides a foundation to a successful profession but also compliment their interest, skills and talents. This research presents the findings of a study conducted to explore the significant need of career counseling among the students of different departments in University of Karachi in year 2019. The research method used includes data analysis, in depth interview and the survey through Judgmental sampling technique. Career counseling provides students the answer to explore and find the domain in which their expertise should be placed. The research aims to highlight the confusion and uncertainty students face while deciding for their career, when they have to choose their respective field without consultation and guidance. This research is used as a tool to identify that majority of the students is not aware with their life goals and objectives. Students are not properly educated about outcomes of the specific programs they are enrolled in, the scope and career opportunities in these fields, merely because of proper career counseling which is missing both at school and college level in Pakistan. In the absence of career counseling the students have no choice but to choose their field either under influence of others or simply based on availability. Thus, the research emphasizes the importance of career counseling among students.

The main objective of the study was to analyze how print media represented HIV positive persons. To do that, the researcher purposively selected Life 101 comic book which was prepared and distributed to almost all Ethiopian universities to create awareness and to educate universities’ students about HIV/AIDS. All episodes, 31, of the comic book were considered for the analysis. Besides, qualitative content analysis was employed to analyze the data gathered from the comic book. The analysis of comic book divulged that HIV positive persons were represented as persons who were sick, dependable, hopeless, loneliness, and worthless. In addition, they were represented as persons who were in crisis and who are dead or lifeless. Such negative representations of HIV positive persons in print media could adversely affect those who are already positive of HIV. Thus, it is recommended that print media’s messages should be well -designed to avoid unnecessary stigma and discrimination.

Globalization as an ongoing process allows and promotes the development of economy of big countries as well as developing countries that are seeking their place in the global market. Interactive communication has been enabled between people, companies, civil society organizations and other institutions, whose needs can be met over the internet anywhere in the world and at any time. Also, professional and competent human resources are needed and therefore it is necessary to invest in new knowledge, innovation, new technologies and lifelong learning. In this environment, management sets its strategic goals through which it will be able to carry out the plans for the sale of products or services. Nowadays, a manager has to have interdisciplinary skills and lifelong education because only in this way it is possible to respond to the constant and rapid changes in the world. Global environment requires the continuous research, monitoring competition, innovation and the ability to change rapidly.

The present study is explored that invidious discriminations on the ground of the untouchables caste is being considered while handing out tickets. The Dalits in Karnataka comprise 23 per cent of the population. The Lingayats and the Vokkaligas have been dominant in Karnataka since time immemorial and the tussle for power between these two communities is no secret. Objectives are To analyze the symbiotic framework of dalith politics in Karnataka; and To study the Economic Inequalities of Scheduled cast in Kolar means for achieving their rights and privileges. Dalits also learned the art of direct action i.e., agitation, sit-ups, strikes, etc., which were very scantly used by them in the early part of their organizing.

Students’ academic performance is measured by use of national examinations and these examinations are recognized as an important backbone of the education system. Examination outcome is used as the major basis for deciding a student’s ability and is used as a means for acquiring employment and academic advancement. The importance of education to both national and individual development is indisputable. Many students do not excel in national examinations in many countries around the world, Kenya included. The underperformance has raised alarm and efforts have been made to identify the factors that lead to this but the problem still persists. The Objective of the study was to determine the influence of principal’s leadership skills on students’ academic performance in Kenya. It was established that principals’ leadership skills highly influence students’ academic performance with overall mean rating of mean = 4.07, SD =0.55. The principals’ leadership skills accounted for 23.0% of the variation of the students’ academic performance in secondary schools as signified by the adjusted R square. 230. This implies that 77% of the variation in students’ academic performance was due to other factors which were not subject of this study. Since the influence was significant (P<.05) it means that students academic performance can be predicted by principals leadership skills. This data is significant to stakeholders in education and particularly the Directorate of Quality Assurance and principals of secondary schools.

Background: Philadelphia chromosome positive acute lymphoblastic leukemia (Ph+ALL) is an aggressive disease, which differs from chronic myeloid leukemia in lymphoid blast crisis at both chromosomal and molecular level. The current study aims to study additional chromosomal abnormalities (ACAs) in Ph+ALL, with review on its prognostic implications. Materials and Methods: This is retrospective single group exploratory study, from 2014 to 2019. Cytogenetic information of 74 cases of Ph+ALL and their clinical information were obtained from the departmental records and case files. Cytogenetic analysis of samples was done in accordance with standard laboratory protocol. Results: Thirty out of 74 patients showed ACAs (40.5%). The median age of patients was 21years. ACAs were more frequent in females than in males up to 40years of age and reverse was true in older patients. Most frequent abnormalities observed were extra Ph, del(9p), add(19p), del(6q) and dic(9;12). Limited follow-up data for patients with extra Ph showed complete remission at median survival of 15 months and poor prognosis in an elderly patient with dic(9;12) as additional abnormality. Conclusion: The frequency and pattern of ACAs in our cohort of Ph+ALL patients were similar to standard available literature, with few exceptions. Long-term follow-up studies are recommended to analyze the prognostic significance of these ACAs in Ph+ALL.

Introduction: Esophageal cancer is a serious malignancy with regards to mortality and prognosis. The incidence of esophageal adenocarcinoma is increasing in trends. In India, the extremely high incidence rates of esophageal cancer have been reported from the state of Jammu and Kashmir which seems to fall in the Asian esophageal-cancer belt particularly from Kashmir. The unique personal and dietary habits and environmental factors in Kashmir have been related to this high risk. Immunohistochemistry is nowadays a simple, reproducible way to assess the expression of oncogenic factors in paraffin embedded samples from cancer tissues. It is therefore more and more used customarily to study the expression of new potential therapeutic targets and to determine which patients are the most liable to answer to these specific therapies. Aiims and objectives: To study the expression of.ER/PR, EGFR and HER-2 in esophageal carcinoma.and to study the correlation of above mentioned markers with pathological characteristics such as tumor type, grade and lymph node status. Materials and Methods: It was a prospective study for a period of one and half years from June 2016 to December 2017 and retrospective study for three and half years from January 2013 to May 2016.The study was carried on resected specimens of esophagus over the period mentioned above. All esophageal carcinomas with or without nodal metastasis and other primary tumors of esophagus, tumors metastasized to esophagus and those who have received neoadjuvant therapy were taken. For the retrospective study, cases were taken from the records maintained in the Department of Pathology at SKIMS. Histopathological data was collected and relevant details were noted. Corresponding slides were collected and photographed wherever available. Prospective study comprised of fresh cases of esophageal carcinomas. In each case a brief clinical history was taken, along with other relevant investigations. The clinical data of the patient was recorded as per proforma. Samples were collected in 10% formalin for routine histopathological examination. After overnight fixation, the specimens were grossed with 3-4 sections taken from the tumor. Gross photographs of the specimen were taken. Sections from all resection margins were taken. The tissue was processed as per standard procedure for histological examination and 4-5 micron thick sections were cut on microtome and stained by routine haematoxylin and eosin stain. Immunohistochemistry was done in 30 Squamous cell carcinoma cases (out of a total of 86 cases) and all (12) Adenocarcinoma cases. After final microscopic diagnosis was made, the slides were photographed. Results: The study included a total of 98 cases received in our department and with the final diagnosis of esophageal carcinoma (SCC and AC). Out of 98 cases, 57 (58.2%) were males and 41 (41.8%) were females with a male to female ratio of 1.39:1. Age range was 35-75 years. The maximum number of cases was in the age group of 45-54 and 55-64 years and the least number of cases was seen in the age group of 35-44 years. Mean age was 55.9+8.92 years. Dysphagia was the main presenting complaint in majority of patients (69.4%). Most of the tumors presented as ulceroin filtrative lesions (25.5%). Most of the tumors were in the size range of 3-5 cm (49%). Middle 1/3rd of the esophagus was the most common site (48%) followed by lower 1/3rd (37.6%). Among the 98 esophagectomy cases, 83 (84.7%) were diagnosed as SCC, 12 as AC (12.2) and 3 (3.1%) as squamous cell carcinoma in situ. Most of the tumors were well and moderately differentiated. Regional lymph node involvement was present in 25% cases. Distant metastasis was not seen in any case.11 (11.2%) cases had CRM involved by the tumor. Out of the 83 cases of squamous cell carcinoma, 42 (50.6%) were T2, 39 (47.0%) were T3, 2 cases were in T1. Out of 12 AC cases, 11 (91.7%) were T3 and 1 (8.3%) was T2. Majority of the cases i.e.; 72 (73.5%) were in N0, 19 (19.4%) were in N1, 6 (6.1%) were in N2, 1 (1%) was in N3. Out of 86 SCC cases, 25 (29.1%) were in Stage IB, 24 (27.9%) were in stage IIA, 21 (24.4%) were in Stage IIB, 9 (10.5%) were in Stage IIIA, 3 (3.5%) were in Stage IIIB and 3 (3.5%) were in Stage 0. None of the cases was in Stage IV. One patient was in stage IA. Out of 12 AC cases, 7 (58.3%) cases were in Stage IIB, 3 (25%) cases were in Stage IIIB and 2 (16.7%) cases were in Stage IIIC. None of the cases was in Stage IV or Stage 0. Out of 98 esophagectomy cases, 32 (32.7%) had LVI and 29 (29.6%) had PNI. On immunohistochemistry; (IHC was done on 30 SCC and 12 AC cases), none of the 42 cases was positive for ERα or PR. For ERβ, among 12 adenocarcinoma cases, 9 cases were positive and among 30 SCC cases, 7 were positive. For EFGR, among 12 AC cases, 3 were positive and among 30 SCC cases, 17 were positive. For HER2, among 12 AC cases, 1 was positive and among 30 SCC cases, 2 were positive. Among 16 ERβ positive cases, 2 were in Grade 1, 7 in Grade 2 and 7 in Grade 3. None of the cases was of Grade 4. Among 20 EGFR positive cases, 3 were in Grade 1, 9 in Grade 2 and 8 in Grade 3. Among 3 HER2 positive cases, 1 was in Grade 1and 2 were in Grade 3. None of the cases was of Grade 2. ERβ positive cases were predominantly in N0 (8/16), followed by N2 (5/16). 2 cases were in N1 and 1 in N3. Among 20 EGFR positive cases, 7 were in N1, 6 in N2 and 7 in N0. Among 3 HER2 positive cases, 2 were in N0 and 1 was in N1. . Among the 16 ERβ positive cases, majority (7/16) were in Stage IIB. 3 were in Stage IIIB, 2 were in IIIC, 2 in IIIA and 2 in IB. None of the cases was in Stage IA or in Stage IV. Among the 20 EGFR positive cases, 7 cases were in Stage IIIA, 5 in Stage IIB, 3 in Stage IB, 3 in Stage IIIB, 1 in Stage IIA and 1 in Stage IIIC. . Among 3 HER2 positive cases, 2 were in Stage IIB and 1 in Stage IIA. ERβ expression had a significant correlation with tumor type. AC showed higher expression than SCC. EGFR had a significant correlation with tumor type, tumor grade and lymph node status. Summary and conclusion: The present study suggests that EGFR is a candidate for targeted therapy using anti-EGFR antibodies. Evaluation of EGFR overexpression detected by IHC may aid the selection of patients and prediction of sensitivity to adjuvant EGFR -targeted therapy for esophageal carcinoma. HER2 overexpression may also play a crucial role in the therapeutic management of both esophageal squamous cell carcinoma and esophageal adenocarcinoma. In present study, HER2 was positive in both ESCC and EAC. The sample size may have undermined statistical significance between HER2 and histopathological characteristics of esophageal carcinoma. Further studies may augment the understanding in this area.

Background: The gold standard method considered to assess the severity of portal hypertension is the hepatic venous pressure gradient (HVPG). Patients with severe portal hypertension (HVPG ≥ 12 mm Hg) are at risk for variceal bleeding, with mortality rates ranging from 20% to 35%. However, due to its invasiveness, it is gradually getting replaced by Doppler ultrasound where, Damping index (DI) reflects portal pressure and liver dysfunction. Spleen stiffness measurements by acoustic radiation force impulse (ARFI) elastography have been proposed as a new, non-invasive parameter for assessment of portal hypertension. Objectives: To assess value of spleen stiffness measurements by acoustic radiation force impulse (ARFI) elastography in predicting the severity of portal hypertension. Materials and Methods: 130 clinically diagnosed cases of portal hypertension were included in the study. Spleen Elastography was performed by ARFI method to calculate the median shear wave velocity of the spleen. Results: In our series of 130 cases, the Spleen stiffness (SS) as measured by ARFI shear wave velocity ranged between 2.54 – 4.1 m/s with mean SSM of 3.14 ± 0.28 m/s. In our study, the Spleen stiffness cut-off value of 3.11 m/sec was considered as the better indicator to rule out the presence of severe portal hypertension with a sensitivity of 93.3% and specificity of 80% (p<0.05). Conclusion: Increased value of Spleen stiffness measurement by ARFI elastography has shown a strong association with the severity of portal hypertension.

Ameloblastoma is a benign, true neoplasm of odontogenic epithelial origin It is usually asymptomatic and manifest clinically when lesion enlarges in size. It mostly occurs in mandible, maxillary involvement is quite uncommon. We are presenting a case of Cystic Ameloblastoma in a 45 year old female patient.

Background: Dentists, dental materials, and dental laboratories are exposed to different types of pathogenic microorganisms. Impression materials, impression trays, and poured stone cast have been said to be the main source of cross infection between patients and dentists. The aim of the present study consisted in evaluating the effectiveness of water washing and sodium hypochlorite disinfection in reducing the microbial load of alginate after mouth contact. Materials and Methods: In this in vitro experimental study twenty students voluntarily participated. The inclusion criteria were age between 21 and 24 years, and inexistence of systemic and salivary gland pathologies. For each participant, one impression was taken in alginate from the mandibular arch. These samples were submitted to water wash and sodium hypochlorite disinfection and to subsequent microbiological analysis. Statistical analysis included the analysis of variance for multiple comparisons (one-way ANOVA) followed by Student’s t-test. Results: After mouth contact, alginate microbial count increased from 1.72 ± 2.92 to 2.81 × 103 ± 5.36 × 102 CFU/mm2. It was seen that after water wash the microbial count decreased to 48.5% while after sodium hypochlorite disinfection the microbial count decreased to 99.99%. Conclusion: This study revealed that alginate impression can be effectively disinfected by sodium hypochlorite. Tap water rinsing reduces microbial load but does not eliminate the cross-infection potential of alginate impressions.

Aim: Aim of the study is to evaluate the role of Laparoscopy with hysterosalpingography in evaluation of patients with infertility. Materials and Methods: This prospective clinical study is conducted Maharashtra Institute of Medical Education and Research (MIMER) medical college from Jan 2013 – Dec 2013. Results: Out of 50 cases of primary infertility, 38 (76%) were primary infertility and 12 (24%) were secondary infertility. The most common age group of primary infertility is 21-25 years and secondary is 26-30 years, With mean duration of 4.6 years for primary and 4.9 years for secondary infertility. Laparoscopic findings of ovary showed 7 cases (58.33%) of PCOD, 3 cases (25%) of simple ovarian cyst and 2 cases (16.67%) of chocolate cyst in primary infertility, while in secondary infertility PCOD was 1 case (33.34%), Simple ovarian cyst 1 case (33.33%) and chocolate cyst 1 case (33.33%). Laparoscopic examination of tubes in primary infertility showed 5 cases (13.15%) with unilateral block and 1 case (2.63%) with bilateral block, while in secondary infertility 2 cases (16.66%) had unilateral block and 2 cases (16.66%) had bilateral tubal block. On peritoneal examination in primary infertility, 7 cases (18.42%) had endometriosis and 2 cases (5.26%) had peritoneal adhesions, while in secondary infertility 1 case (8.33%) had endometriosis and 4 cases (33.33%) had pelvic adhesions. Laparoscopic examination of uterus in primary infertility showed 2 cases (5.26%) of myoma and 2 cases (5.26%) of uterine anomalies, While in secondary infertility 3 cases (25%) had myomas and 1 case (8.53%) had uterine anomaly. Conclusion: Laparoscopy is useful in the diagnosis of pelvic adhesions, endometriosis and external part of tube, fimbriae, Relations of tubes and ovaries. Hysterosalpingography is useful in the evaluation of endometrial and tubal pathology.

Background: Denture fractures are common, reflecting the fact that both impact strength and flexural strength of the material are barely adequate. Objective: The purpose of the study was to evaluate the effect of aramid and carbon fiber reinforcement in autopolymerizing resin used to repair heat polymerized polymethyl methacrylate at 1mm and 3mm thickness respectively. Materials and methods: A total of 180, resin specimens using conventional heat polymerized PMMA resin and measuring (64mm×10mm×3.3mm) were fabricated in a preformed machined mold. A cantilever type bending forces was applied to each specimen till it fractured. The resin was relieved from bonding area to create 1mm and 3mm space. These fragments were realigned and repaired using conventional autopolymerizing resin and reinforced with carbon or aramid fibers. The specimens after repair were tested for impact strength using Izod type impact tester and for flexural strength using Universal testing machine. The data obtained was subjected to statistical analysis. Results: The results demonstrated that the mean impact strength values was significantly higher in polyaramid fiber reinforced PMMA repair group at 3mm thickness and the mean flexural strength values was significantly higher in polyaramid fiber reinforced PMMA repair group at 1mm thickness. Conclusion: Within the limitation of this study, it can be concluded that fiber reinforcement improved the strength of repair of the fractured heat-polymerized denture base. The strength after repair may be influenced by the gap at the repair region.

Congenital cystic adenomatoid malformation of the lung is a rare lesion which manifests as neonatal respiratory distress secondary to progressive expansion of the affected lung. Three distinct types have been described based on the size of the cysts and the microscopic appearance. The treatment of choice is excision of the affected lobe. The prognosis is favourable in the absence of pulmonary hypoplasia, foetal hydrops, or associated congenital anomalies.

Periodontal regenerative surgery aims at the recovery of lost tissues which further might lead to compromised esthetics, disturbed phonetics, and unpleasant appearance especially where aesthetic zone is the area of interest. Papilla preservation flap (Takei 1985) allows maintenance of intact interdental papilla in contrast to papilla splitting techniques. This case report aims towards assessment of papilla preservation flap in the treatment of a 27 year old female with generalized chronic moderate periodontitis leading to pathological migration in anterior esthetic zone, with 9 months follow-up.

Surgical site infection is the greatest enemy to success of a surgeon eroding his pride and glory which is a dreaded complication and hence resulting in poor outcomes, increased morbidity, prolonged hospital stay, escalation of hospital expenditure and constrained relationship between the patient and the surgeon, placing an immense economic burden on the patient and the healthcare infrastructure. SSI is of multifactorial origin where Bacteria may access the surgical site through both endogenous and exogenous routes which is predominantly exogenous contacting during the initial operative exposure. Staphylococcus aureus is the leading cause. Implants provide a niche for such organisms where biofilms provide a safe environment for microbial replication. Various modifiable risk factors are there such as DM, Obesity, Malnutrition etc. Imaging not only confirms the diagnosis but also provides details about the extent, severity and any associated complications providing an objective and longitudinal method of monitoring treatment

Rabies is a viral zoonotic disease responsible for an estimated 59,000 human deaths and over 3.7 million disability-adjusted life years lost every year. Our country is endemic for the disease and every animal bite is suspected to be by a potentially rabid animal. The rate of rabies related death rate is 100% in unvaccinated patients and bites by dogs and cats must be considered as a “medical emergency” and the “life-saving” post exposure prophylaxis must be provided immediately. In the present case report we present a 2.5 yrs old male child with history of dog bite on face and in spite of being given rabies immunoglobulin and post exposure prophylaxis developed Rabies 15 days after the bite and succumbed to his disease.

Amelogenesis imperfect (AI) is an inheritable disease manifest as enamel defect. It affects both primary and permanent dentition. It seldom affects the dentin and pulp.Amelogenesis imperfecta shows wide range of variation starting from mild discolouration to complete abrasion as soon as the teeth erupt into the oral cavity. Enamel may show quantitative as well as qualitative defect in mineral and protein content. In this article we present a special case of amelogenesis imperfecta which shows a rare hypomaturative type with sporadic inheritance and we discuss about its mode of inheritance, types, clinical presentation, histopathological features and management.