June 2019

Financial stressors combined with family-farming relationships that blur the line between business and personal lives create unique sources of stress for farmers and farm families. If not addressed, these stressors can lead to physical illness, depression, substance abuse, and suicide. Farmers are more than five times more likely to commit suicide than the general population (McIntosh et al. 2016) and are more likely to report substance abuse (Bush and Lipari, 2015). Stress and depression also increase the already above average probability of accidents and injury (Fetsch, 2012), and stress may affect factors influencing other leading causes of death in rural areas, which include heart disease, chronic lower respiratory disease, and stroke (Moy et al., 2017). Farmers, farm families, and rural communities can help to manage farm-related stress and reduce incidences of Depression, substance abuse, and suicides

Food dietary diversification is a necessary thing to do because the food consumption pattern of our community are not yet diverse, nutritionally balanced and safe, along with the domination by rice and flour. Diversification of food consumption is influenced by many factors and one of them is the agriculture and livestock sector. This study aims to find out the Factors Associated with food dietary diversification in Mataue Village Kulawi Sub-District Sigi District. The type of this research is an analytical survey with a Cross Sectional Study approach. With total sample 61 people and using Simple Random Sampling technique. The results of this study were statistically tested by Chi-square test at a 95%confidence interval. The results showed that there was no relationship between livestock ownership (p=0,929) and food dietary diversification, and there was a relationship between land use (p=0,023), and food crop diversification (p=0,007) with diversification in food consumption. The need for support and encouragement of the village government to expand the scope of land use utilization and increase the type of food crops by all households to increase diversification of food consumption.

Bhagandara (Fistula in ano) is a troublesome surgical disease. Several techniques have been described from ancient age to till date for the management of fistula-in-ano, but every technique has its own limitations. These techniques also carry their own risks of recurrence and incontinence. Conventional fistula surgery techniques have their place, but new technologies such as Ano-rectal Advancement flap Repair, Dermal Island Flap Anoplasty, Fibrin Glue, Fistula Plug, LIFT Procedure, BioLIFT Procedure, Adipose-Derived Stem Cells, VAAFT, PERFACT and OTSC Fistula Closure provide promising alternatives to traditional methods of management, with very good success rates. This review summarizes the revolution in the management of fistula in ano, from ancient to modern age with the recent techniques available currently.

Background: Raw milk (Madara) and its products namely, Kindrimo, Nono and Manshanu sold in Abuja are ready-to-eat meals which do not readily undergo minimal processing. Thus, it could possibly be contaminated with food-borne pathogens. This microbial contamination could pose public health risk. Methods: Three hundred milk samples were microbiologically examined using appropriate culture media for isolation and enumeration of bacteria pathogens associated with milk contamination. Results: The counts of E. coli for Madara, Kindrimo, Nono and Manshanu were 1.75, 1.63, 1.56, and 1.31 x107 cfu/ml, Staphylococcus aureus; 1.7, 1.04, 1.29 and 1.41 x 107cfu/ml, Salmonella sp;1.05, 0.61, 1.15 and 0.50 x 107cfu/ml, Shigellasp;.0.65, 0.68, 0.26 and 0.35 x 107cfu/ml, coliforms; 2.25, 1.92, 2.11 and 1.98 x 107cfu/ml, and 2.59, 2.31, 2.02 and 2.43 x 107cfu/ml for Total Viable Count (TVC). There was no statistically significant difference (p> 0.05) in the counts of E. coli and Total Viable Counts across the six Area Councils and milk types, there was no statistically significant difference (p>0.05) in the counts of Staphylococcus aureus and Salmonella sp across the six Area Councils but there was statistically significant difference of Staphylococcus aureus and Salmonella sp (p< 0.05) in the milk types. There was statistically significant difference (p< 0.05) in the counts of Shigella sp across the six Area Councils and milk types, and in the coliform counts across the six Area Councils but there was no statistically significant difference of coli forms (p> 0.05) in the milk types. Conclusion: The milk products are nutritious dairy meals consumed by the populace but the presence of bacteria pathogens in these milk products is an indication of risk to public health. Standard hygiene practice and processing in all stages is important to improve microbiological quality of these milk products.

Adulteration and contamination are encountered in food consumed at the household level of India, in the food service establishments and business firms, and also when sold as street foods. Non-permitted colors are the most common additives to foods. Contamination of mycotoxins, metals and pesticides in daily foods and milk has been found highly toxic and carcinogenic, and about 70% of deaths are supposed to be of food-borne origin. Food safety measures are emphasized with an objective of prevention of health hazards and strengthening of regulatory system. It is possible to prevent food adulteration and contamination if people are made aware of health hazards. If food inspectors are vigilant and active, the risk of food toxicity can be minimized at all levels of food supply and consumption. Further, simple measures can prevent further complications, particularly those caused by microbiological contaminants. Fatal diseases and health hazards prevalent in India can be minimized and consumers can live happily with good health. The social life in the communities is strengthened resulting in less expense on health related problems. Citizens aware of food adulteration and contamination can arrange camps/campaigns through local bodies and safe food can be the goal for all concerned.

The cabbage aphid is of agricultural concern vectoring at least 20 viral pathogens in crucifers. The aphids have demonstrated tolerance to a number of synthetic pesticides. Botanical pesticides are reasonably sustainable and effective in suppressing cabbage aphid populations in crucifers hence improved crop quality and yield per hectare. An experiment was run to test the efficacy of various concentrations of a botanical pesticide derived from chive (Alliumschoneoprasum) fresh leaf extract in controlling cabbage aphid (Brevicoryne brassicae) in rape. The experiment was laid out in a Complete randomized design (CRD) with four treatments and four replicates as follows; 12g chive extract, 8g chive extract, 4g chive extract and 0g control (water spray). Analysis of variance to separate mean mortality was done using Gens tat version 18 and least significant difference at 0.05 probability level was used to separate means. SPSS version 20 was used in estimating LC50 value and excel was used in calculating the regression equation. Significant differences (p<0.05) were observed throughout the trial, where highest mortality rates were observed in 12g chive extract (94.5%) and lowest mortality in control (12.2%) was observed. Pesticide concentration atLC50for the chive extract was estimated as a concentration of 7g/l. There were no observed signs of phytotoxicity even though other studies have shown that chances are high when the dose is increased. The experiments revealed that chive leaf extracts had pesticidal effects hence can be used to effectively control cabbage aphid in rape by smallholder vegetable producers.

In this present era, the natural science, like physics, soars so high an apex in its studies and researches that it startles us and dazzles our eyes. It has been possible due to a coarse passage of journey from natural phenomena to the apriori laws of thought, or better say, a journey from physics to metaphysics. In this paper I am not going to deal with the success of physics but only to highlight its philosophy of searching.

Environmental factors have been identified as determinants of health-disease process of individuals and include: demographic conditions, leisure economics, use of cigarettes and alcoholic beverages, sedentary lifestyle and even changes in eating habits. The present study aims to evaluate the correlation between imc alterations and depression and the association with environmental factors. This is a cross-sectional and quantitative epidemiological study. Sample was composed of 488 adult individuals of both genders. Being 131 men and 357 women. Sample consisted of 488 individuals of both genders, in whom the socioeconomic profile, the presence of mental disorders (anxiety, stress and depression), body satisfaction and quality of life were verified in individuals with normal weight eutrophism and obese. Most of the sample consisted of women, in social class C and D, for the most part. Schooling was incomplete higher education like most people, followed by full high school and college. In our results, it was possible to perceive the interaction between weight gain and mental illness. The sociodemographic variables create an alert about the influence of social determinants on the emergence of mental disorders, poor quality of life, overweight and also obesity. It serves as an alert for the construction of policies and actions for the prevention of obesity, as well as mental disorders, actions that pass through the social determinants, so that the health indicators are improved, in an epidemiological scope.

High blood pressure (AH) is responsible for a high burden of cardiovascular diseases, as well as for the morbidity, mortality and incapacities of individuals, especially the elderly, and may cause diverse health and public economy impacts in both developed and emerging countries. The present study aims to identify the presence of mental disorders (anxiety, stress and depression) in hypertensive patients who do or do not use the medication to control blood pressure. This is a quantitative, observational study in a municipality in the interior of Bahia. The sample consisted of 87 elderly people, both hypertensive (diagnosed by a specialist physician), who were questioned about the use of the medication to control blood pressure (taking or not taking the medicine). The variables were acquired through the use of globally validated questionnaires, such as BECK anxiety and depression, the LIPP stress questionnaire. Our results show that the majority of the elderly were women, mostly low-middle-class, and who did not work, most likely elderly people who were retired in the majority. Most were widowers, and the other top were married seniors. Most of the elderly were identified as being stressed. Further information can be verified in Table 1, which shows information about the general characteristics of the sample. The use of drugs to control blood pressure is extremely important in that they are responsible for avoiding diseases due to the pathology. Some other chronic problems, such as mental disorders, may influence the use of medications to control blood pressure.

Wayfinding is an essential spatial activity that way finders experience every day in their journeys from their origins to their required destinations. The wayfinder must perceive, explore, solve spatial problems and follow a certain route to reach his/her destination. Golledge has defined the term “wayfinding” as: “The process of determining and following a path or route between an origin and a destination.” Wayfinding process is concentrated on the perception and cognition of the wayfinder within architecture and the built environment and it is based on three processes: processing environmental information, decision-making and decision execution. It is based on the interaction between the way finder and the architectural cues. The way finder is facing two great challenges in the wayfinding process, firstly wayfinding his/her route without any barriers through the journey and secondly perceiving and analyzing the given architectural information within the environment and to choose the route independently and without any barriers to reach the destination in limited time. The barrier free environment has a great impact and direct effect on the wayfinder in the wayfinding process by the given architectural informational cues with the environment. The paper highlights on the design of the architectural in formational cues within the barrier free environment as the main force behind enhancing and facilitating for the wayfinding.

This paper tries to find out the facts and status of women livelihood in India in recent years. Women typically invest in their families and communities significantly to increase the quality of life for themselves and their families. Financial independence enables women to organize themselves increase their self-reliance and it provides greater autonomy. It ensures participation of women in policy and decision-making the process at domestic and public levels. This research paper tries to put forward the current status and contribution of women workers in garment industry as well as importance of skill upgradation and training to improve the living conditions, livelihood status and entrepreneurial opportunities of women, especially in Two district of Madhya Pradesh, i.e. Tikamgarh and Chhatarpur.

Mass moving or capable to move is energy. The very basic fundamental mass is, mass of light photon obtained from Plank's Black Body Radiation Formula E = h.f and the mass energy transformation relation E = mc2. These tiny photonic particles named Dark Photons whirling in space in racing with their anti particles always are in motion. When moving linear at speed c in space, they exhibit as light. They are the building blocks of the universe. They have gravity originally and in motion at speed greater than c in incremental value tending to zero; they exhibit electromagnetic property. When they smash against each other, they glue with each other exhibiting gluonic property. All matter in universe, quark to Black Hole is made up from these basic fundamental particles. The universe itself is born from them. These facts are detailed in this article.

Fractures have been described as the most common orthopedic problem in goats. Fractures in goats are commonly immobilized by using non-invasive external immobilization techniques such as splints, plaster of paris, fibre glass cast and various external fixation devices due to their economic and conservative nature. However, these methods have various demerits like mal-union, delayed union and non union, large callus formation, weakening of tendons, muscle atrophy and pressure sores, delayed weight bearing, interference with radiographic evaluation, slippage of plasters, softening of plaster cast and wetting of cast due to faulty management which ultimately leads to increase in expenses because of reapplication. The continually-evolving understanding of bone biology and the analysis of clinical complications have led to a modified approach to internal fixation. Biological osteosynthesis with bone plates is one of the most stable fixation techniques for neutralizing all the forces that commonly act on the fracture like compression, tension, shear, torsion and rotation. Bone plating improves the function of surrounding joints, decreases muscle atrophy by allowing early activity and provides an avenue for anatomic reduction of fracture, thus preventing "fracture disease". Evaluation of different implant materials has thrown some light on the development of different bone plates for fracture repair in goats. Various studies have been carried out in goats for fracture repair of long bones using different bone plates prepared from bovine horn, nylon, teflon, stainless steel, horn, xenogenous bone, polypropylene mesh impregnated poly methyl methacrylate plate, dynamic compression plate, veterinary cuttable plate, LC- DCP and locking plates. Further research studies may improve the techniques of application and development of newer biomaterials will help to adopt the most appropriate treatment, thus maximizing benefits and minimizing complications.

Aim: To compare the efficacy of letrozole with clomiphene citrate for ovulation induction in infertile patients with polycystic ovarian syndrome (PCOS). Methods: This clinical trial study was carried out at Gynae unit 2 Lady C.U. Shah medical college and hospital, Surendranagr from 1stJanuary 2018- 31thDecember 2018. Total 100 patients of PCO were included in the study. Diagnosis of PCO was made on Rotterdam criteria. In this clinical trial, 100 infertile patients with PCOS received either 100 mg clomiphene citrate (n=50) or 2.5mg letrozole (n=50) daily since day 2-6 of their menstrual cycle. Human chorionic gonadotropin (hCG) was administered at a dose of 10,000IU when at least 1 mature follicle (17-25mm) was detected. Timed intercourse was advised to the patients after 24-36 hrs of HCG injection. Then the number of follicles, endometrial thickness, P4 on day 21, ovulation rate, and pregnancy rate were measured in both groups. Results: Monofollicular development was statistically significantly, greater in the Let group (CC. 55.76%, Let 78.32%). There was no statistically significant difference between the two groups in endometrial thickness on the day of HCG injection (CC 7.62±1.95mm, Let 7.65±1.98mm P=0.91). Similarly, there was no statistically significant difference between the two groups in days to ovulation, and serum P4on D21. The ovulation rate was 60.02% in CC group and 72.28% in Let group. The pregnancy rate was in 7.42% CC group and 20.55% in Let group. There was one multiple pregnancy in cc group. Conclusion: Letrozole might be an acceptable alternative to clomiphene citrate to induce ovulation and pregnancy in PCOS patients.

Aging is a normal, universal and in evitable change which takes place even with the best of nutrition and health care. It is a time related change that occurs throughout life. The aging process occurs in every living species, as also in human beings by graying of hair, wrinkling of skin, hardening of articles, aches & pains in joints and weakening of eye sight, The way the older adults against to the changes of ageing depends on the individual. For some individuals adaption & adjustment are selectively easy, Where as for other individuals coping with aging changes may requires the assistance of family, friends & health care professionals. Objectives:1.To assess the level of depression among the elderly residing at old age home and within family.2.To compare the level of depression among elderly residing at old age home and within family.3.To associate the level of depression among the elderly residing at old age home and within family with their selected demographic variables. Methodology of the study: A Comparative design was used to assess the level of depression among old age home and within family. A total of 60(30 elderly residing in old age home and 30 family) were selected by Non probability sampling technique. Tool used for conducting study was yesavage Geriatric depression scale (1983) to assess the level of depression data were analyzed with the help of descriptive &inferential statistics. Result: The major findings of the study revealed 73.3% elderly living with old age home having mild depression 3.3% were having severe depression 23.3%were having normal depression where as in living within family 50% were having mild depression 26.6% were having normal depression 23.3& were having severe depression. The association of socio-demographic variables with level of depression among elderly living with old age home and family were determined by using chi square test which revealed that among revealed that among elderly living with old age home was a statistically significant association exists between are you getting old age pension at 0.01 level and hobbies at 0.05 level. Among elderly living within family was a statistically significant association exits between age are you getting old age pension at 0.05 level. H1 is rejected and h2 is partially accepted. Conclusion: Evidence from this investigations revealed that, a majority of elderly were having mild depression both in elderly residing at old age home and within family.

Mandibular fractures associated with dentoalveolar fractures presents as a management delima for achieving proper reduction and fixation. Occlusion serves as the key guide for proper reduction of mandibular fracture. When associated with dentoalveolar fracture three dimensional spatial alligment to achieve proper reduction is tiersome. Various treatment modalities are available for proper reduction and fixation of mandibular fractures, but among them the methods that minimises the need for periosteal stripping and reduces the period of IMF is the most acceptable treatment modality. Here we are discussing a case of symphysis fracture along with dentoalveolar fracture, manged with lagscrew fixation and circum mandibular wiring using acrylic splints.

Objective: Describe the epidemiological aspects and analyze the management of adenoids in Niamey. Materials and methods: This was a retrospective study, on adenoids in children aged 0 to 15 years, managed in the ENT and Cervico-Facial Surgery department of the Niamey Reference General Hospital ( Niger) from November 1, 2016 to November 31, 2018 The studied parameters are: frequency, age, sex, factors favoring adenoids, type and results of treatment. Results: In 02 years, we received 128 cases of adenoids, an overall frequency of 9.85%. The average age was 3.12 years old. Men predominated (58.6%). Children aged 0 to 5 years accounted for 75.78%. The reasons for consultation were night-time snoring (49%), mouth breathing (62%), sleep apnea (36%), recurrent rhinopharyngitis (43%), recurrent otitis media (55%) and irritative cough (45%). Allergy to house dust mites was noted in 52% of cases, indoor and outdoor pollution in 30%. The treatment was pure medical in (35.6%) and surgical (adenoidectomy) in 64.4%. The evolution under treatment was generally satisfactory. Conclusion: Adenoids are common in children, ENT, Niamey (Niger). Children from 0 to 5 years are the most affected. The hot and dry climate, made of dust, is the most favorable factor. The treatment is pure medical or supervises the surgical procedure ('adenoidectomy). Keywords: Adenoids, epidemiology, adénoïdectomy, Niger.

The main purpose of the study is An Exploration of Teachers Perceptions in Teaching Vocabulary via Communicative Language Teaching Approach: Focus on Hobicha Bada Secondary and Preparatory School. The researcher employed descriptive research design in order to gather the needed data. All of eight teachers were selected for this study through convenience sampling technique. To collect valuable and relevant data, interview and focus group discussions used to collect data. The semi-structured and focus group discussions data transcribed and transformed into textual data form. The study divulged that majority of English language teachers’ had a negative perception towards teaching vocabulary using CLT. Finlay, bearing in mind that divulged in the findings, the respondents listed different factors that affect teaching vocabulary through the CLT. Hence, the concerned bodies should capacitate the teachers’ create awareness through different workshops in order to secure a positive attitude towards the importance of vocabulary in the communicative approach. In connection to this, all participants of the study should be given attention and should take care of the importance of the vocabulary for communication purpose.

Background: The maxillofacial trauma is a more tedious and esthetically challenging surgeries till date.Microplates are materials which help us to achieve this both technically and esthetically with less obstacles.They take the maxillofacial trauma to the next level. Objectives: To evaluate the efficacy of Micro plates in fixation of Zygomatico- Complex fractures (Fronto Zygomatico Suture, Zygomatico Maxillary Buttress and Infra Orbital Rim). Materials and Methods: Study sample consists of 14 subjects with Zygomatico- Complex fractures, above 18 years of age. Microplates were used for fracture fixation. Intraoperatively - operating time, Hardware failure (screw breakage) was noted. Postoperatively - Stability of fracture fragments, Infection, Pain & Need for plate removal was noted. All cases have been evaluated clinically for various parameters for minimum of 3 months to assess any postoperative complications. Results: Total number of microplates used in the study is 29. Among them 14 were fixed in Fronto Zygomatic Suture area, 12 were fixed in Zygomatico Maxillary Buttress area and 3 were fixed in Infraorbital Rim area. The mean operation time per patient was 46.19 minutes. The time taken for placement of one screw was highest in the zygomatico maxillary buttress region (80.00 secs.).One screw fractured in Fronto Zygomatic Suture region & two screws in Zygomatico Maxillary Buttress. There was no screw breakage in Infra Orbital Rim region. One screw loosened while placement in Zygomatico Maxillary Buttress region. Post-operative pain present during first week reduced to 0% within one month. One patient needed for plate removal. Conclusion: The overall results demostrated a success rate of zygomatico complex fractures. Infra Orbital Rim had the highest success rate of 100.00%. This study using microplates had given promising results, hence may be considered as a valid tool in the management of zygomatico complex fractures.

The authors are commenting on the article entitled “Focal and diffuse chronic central serous chorioretinopathy treated with half-dose photodynamic therapy or subthreshold micropulse laser” published by van Rijssen et al. in Am J Ophthalmology. DOI: http/dx.doi.org/10.1016/j. ajo.2019.03.025. Published online: April 2, 2019. The authors concluded that half-dose photodynamic therapy is the preferred treatment over high-density subthreashold micropulse laser treatment for chronic central serous chorioretinopathy patients, both with focal and diffuse leakage on fluoresce in angiography. However, the validation, extrapolation, and generalizability of these outcomes can be made only after inclusion in the stepwise multivariate logistic regression analysis of all the missing data mentioned by us in addition to the baseline characteristics already assessed in this study.

Background: Wheezing is considered as an important sign for bronchial hyper-responsiveness in children and adults, and it is considered one of the most common causes for visiting the emergency room. Objective: to describe the prevalence of wheezing and its associated factors in four to six-year-old children living in Jeddah city. Methods: A cross sectional study was conducted in Jeddah city among four to six-year-old children who attend preschool between November to December 2018. We used an adapted and modified questionnaire filled by the parents; It was tested in a pilot study. Results: Out of 400 questionnaires sent to the parent n = 300 (75%) were retained to the researcher. Meanwhile, a highly significant result was observed (p <0.05) between wheezing and smoking in the family, home incense and coal use and low socioeconomic class. Conclusion: There is a significant association between presence of smoker at home, lower Family income and using of incense fragrant and coal inside the house and the appearance of wheezing in children born to atopic parents.

Background: Urolithiasis is the third most common urological disease affecting both males and females. In the latter part of the 20th century the prevalence of upper urinary tract stones was increasing worldwide. Young population visiting uro and nephro OPDs and undergoing dialysis which sensitizes to study this problem to identify the riskfactors and the types of urolithiasis. Methods:Cross sectional descriptive design was used. All male and female patients attended nephrology and urology OPD and diagnosed as nephro and uro lithiasis at Sri Ramachandra Hospital, Sri Ramachandra University, Porur, at Chennai were considered as the population of the study. Purposive sampling was used and 50 participants were participated. Self-structured questionnaire was used to collect the data. Results: The present study concluded that out of 50 patients 12% had family history of renal calculi, 26% were alcoholic, 46% were having the history of recurrent UTI, 34%were on calcium supplement, 54% were drinking fluoridated tap water, 30% consumed aerated beverages, 10% of them were on AYUSH treatment, 40% had previous history of calculi, 42% were on antihypertensive- Trimeterene, 14% were on corticosteroid. It is noted that 20% were known case of diabetic and 42% were hypertensive,40% had sedentary activity, 60% had moderate activity .Regarding water consumption 68% of them had<2 litres per day and 36% had the habit of passing urine with the interval of >8 hours. Conclusion: The study concluded that the urinary catheterization, drinking of fluoridated water, hypertension, obesity, red meat,8th hourly urination and medical conditions such as hypertension, diabetes are risk factors for urolithiasis. There was a statistically significant association between gender and painscore, occupation and BMI.

Objective: To describe the epidemiological, clinical, diagnostic and therapeutic aspects of esophageal foreign bodies in the ENT department and head and neck surgery of the Niamey National Hospital in Niger. Material and Method: From January 2013 to December 31, 2018, we analyzed the epidemiological, clinical, diagnostic and therapeutic aspects of esophageal foreign bodies through a retrospective and descriptive study. Results: In 6 years, 247 cases of esophageal foreign bodies have been recorded. Non-food foreign bodies accounted for 84% of cases (with 71.2% of coins) and 16% of foreign food bodies (7.8% of meat). Rigid esophagoscopy under general anesthesia was performed in all patients and allowed the extraction of all foreign bodies. At oesophagoscopy, the esophageal mucosa was normal in 72.8% (n = 214) of cases, inflammatory in 24.1% (n = 71) and infected in 1.7% (n = 5). The foreign body was blocked in the esophageal mouth in 69.97% (n = 206), in the aortobronchial narrowing of the esophagus in 6.14% (n = 18), and in the lower sphincter of the esophagus. the esophagus in 3.41% (n = 10). The follow-up was simple in 267 patients (90.82%) and complicated in the other 27 (9.18%). 9.18% of cases of complications were found. Operative mortality was zero. Conclusion: Esophageal foreign bodies are common in ENT. The diagnosis is clinical but especially paraclinical based on endoscopy which is also the main treatment.

Pharmaceutical Care is defined as a model of pharmaceutical practice, developed in the context of Pharmaceutical Assistance. It includes attitudes, care, ethical values, behaviors, skills, commitments and co-responsibilities of diseases, promotion and recovery of health in an integrated way to the health team. In this study, we will focus on the perception of users of pharmaceutical establishments in relation to the quality of care and Pharmaceutical Care performed at these sites. Thus, the present study aimed to measure the perception of customers regarding the quality of care and Pharmaceutical Care provided. The present study demonstrates that although pharmacies have differentiated and qualified professionals to provide care, most of the users of the service can not identify these professionals. But at the same time they report that they prefer to be taken care of by pharmacists, as well as, they observe in their speeches the importance of receiving care guided by pharmaceutical care.

Students' participation in decision making on disciplinary matters plays an important role in influencing discipline in secondary school. However, students' perception determines the level of participation. The purpose of the study was to investigate the perception of secondary school students in Eldoret East, Uasin-Gishu County, on their participation in decision making, and its influence on discipline. The study was guided by the following objectives; to determine the perception of secondary school students on their participation in decision making and discipline, to investigate students' involvement in decision making in secondary schools, to establish the constraints to students’ participation in decision making in secondary schools, and to establish strategies used to enhance students' participation in decision making in secondary schools. This study used a mixed approach, using both qualitative and quantitative methods. The research instruments were questionnaires and interview schedules. The study sample comprised 369 form two students. The study used stratified and simple random sampling to obtain the sample. The sample also comprised 3 deputy principals and 3 teacher counselors who were purposively selected. The research findings showed that the students are involved in academic and co-curricular activities. The study established that perception and discipline are related. It was concluded that there is need to enhance students' involvement in school activities as this has a great influence on students' behavior.

Gender equality is a fundamental human right and a powerful driver for accelerating economic growth by unlocking the potential of women and men not only in Kenya but also at international level. Gender wage gap is a manifestation of gender wage discrimination against women or men at workplace. This discrimination is mostly demonstrated where qualified women are offered lower pay as compared to their men counterparts at the same level of work. The same situation is experienced at glass ceiling with larger gender wage gaps at the upper levels. Therefore, once the government has put in place its development policy framework, it is imperative to ensure execution of gender equality in order to address the problems of gender wage gap. However, despite great awareness and existence of gender equity in the policy documents and blue prints for National development agenda, particularly of the Kenya Vision 2030, the Big four agenda and the Global agenda on Sustainable Development Goal 5 on achieving gender equality and empowerment of all women and girls and legal provisions in Kenya Employment Act 2007, gender wage gap has remained high at the work place in Kenya. Drawing on secondary data, this paper examines the root causes of gender wage gap and investigate gender wage gap and its implications on shared prosperity for sustainable development by exploring what can inform institutional policy decisions in order to narrow the wage differentials. The article argues that reducing gender wage gap has great positive implications on shared prosperity including access to new economic opportunities, opening spaces for decision-making and expanding human capital in education sector. To effectively achieve this reduction, enforcement mechanism is necessary by government and institutional managers on effective implementation of policy on gender equality if narrowing the gender wage gap is going to be achieved for sustainable development in Kenya.

This article assessed the impact of head teachers’ instructional supervision practices on teachers’ performances in selected studies. The researcher used a random design to choose related variables on the impact of school head supervision to teacher’s performance. This includes, using of incentives and rewards to encourage teacher’s input, checking of teacher’s record and visiting classes during class period. The findings of this literature review revealed that school head’s practices vary from one country to another in terms of perspectives and application. This implies that one school head supervision might effective to one county but not to other countries.

In the present study, an attempt has been made to find out that whether the adjustment capacity of school going girls in different socio-economic status influenced by their health related physical fitness or not. Total95girls were selected for the study. Two higher secondary schools of South 24 Paraganas district in West Bengal were selected for the study. In this study the present researchers considered adjustment level as dependent variable and Health Related Physical Fitness as independent variable. The data was collected by use adjustment level questionnaires by Sinha and Singh and Socio economic were measured through the kuppuswamy questionnaire of latest version. Health related physical fitness components were BMI was measured by Weight (kg.)/Height2 (mtr.), Upper Body Strength Endurance measured by maximum duration of flex arm hang, Abdominal Strength Endurance measured by no. of curl ups in one minute, Flexibility (FLX) measured by v-sit and reach test and Cardio Respiratory Endurance (CRE) measured by 1500 meter run/walk test. The data were analyzed with the help of statistical procedures. Mean, standard deviation (S.D), and correlation coefficient were employed. Adjustment level of lower middle class has a very weak negative correlation with Cardio Respiratory Endurance (r = -0.055), significantly negative correlation found with flexibility (r =-0.776). But in case of other health related fitness variables i.e. Upper Body Strength Endurance (r = 0.209), Abdominal Strength Endurance(r = 0.325), Body Mass Index(r = 0.023) positive but not significant correlations were found respectively. The Adjustment level of upper lower class with Cardio Respiratory Endurance (r = -0.046), Flexibility (r = -0.165), Upper Body Strength Endurance (r = -0.165) and Abdominal Strength Endurance (r = -0.038)of girls students negative correlation were found respectively. But in case of BMI it has significant positive relation (r = 0.318) was found. In this study we concluded that adjustment level significantly influenced by flexibility and BMI.

Vermiform appendix is considered to be a vestigial organ its importance in surgery results inflammation known as acute appendicitis. If appendix mass is present, standard treatment is the conservative Oschner Sherren regime. However it is based on the inflammatory process already formed and difficult to find the appendix and faecal fistula may form. But some cases may require surgical management if the clinical condition of the patient detoriates. This study is used to compare the conservative management versus early surgical management of appendiceal mass. The study was a prospective study conducted among 50 patients of appendiceal mass admitted in Department of General Surgery, RIMS during the period of September 2008 to March 2010 approval from institutional ethical committee and informed consent was taken. Data were entered in IBM SPSS and check for correlation before analysis. Analysis was done using Chi square test and ANOVAs. This study shows that higher hospital stay was noted in conservative group but the cost of treatment was same in both groups. Paralytic ileus and wound infection were common in early appendicectomy group. Thus, conservative management is a better management for a presenting with appendiceal mass.

Involvement of the community in school management may not necessarily improve education service delivery in schools. The purpose of this study was to conduct an empirical study on the challenges School Management Committees (SMCs) experience in monitoring the implementation of Universal Primary Education (UPE) in Uganda. SMCs are mandated to participate and monitor all the activities that make a school operational. The research objective that guided this study was: to assess the challenges SMCs experience in their monitoring roles and how these challenges affect the implementation of UPE in Uganda. The questionnaire and interview guide were usedas instruments to collect data. The results of the study seem to suggest that SMCs experience a number of challenges in their monitoring roles in schools of their jurisdictions that include the following :lack of knowledge and skills to do their monitoring work in schools, they lack expertise in financial management yet they are involved in financial budgeting that involves revenue mobilization and expenditures as well as financial controls. The study further found out that decision making seem to be dominated by influential members of the committee that most of the time biased decisions that are not crucial to the management of schools are taken due to lack of teamwork. The study also seem to suggest that SMCs have limited power and authority to take action regarding the way schools are run since the management and control of teachers remains in the hands of the central government with less inputs from the SMCs. The study recommends a need for policy makers to put in place the minimum requirements for one to be elected a member of SMC in terms of knowledge and skills especially in financial management. This creates a sense of efficient utilization of school funds and thus promoting teaching and learning in schools. The study further recommends that SMCs should be empowered to take corrective actions on issues concerning with the management of schools including the management and control of teachers. This empowerment creates a sense of ownership of schools that is likely to guarantee transparency and accountability in the way school resources are managed.

Background: A meticulous knowledge of the anatomy of sphenoid sinus and its related adjacent structures preoperatively is crucial in order to prevent unintentional damage to the vital structures like optic nerve which can result in blindness and injury to internal carotid artery which can result in fatal haemorrhage. Material and Method: Our CT scan based study was conducted by Postgraduate Department of Anatomy in collaboration with Department of Radiodiagnosis and Imaging, Government Medical College, Srinagar for a period of 1 year. Since the aim of our study was to evaluate normal variations, cases found to harbor pathology or disease enough to distort or obscure the regional anatomy were excluded from the study. Relationship of optic nerve with sphenoid sinus was studied using De Lano’s classification. Result: In our study of 200 cases (400 sides), in majority of sides i.e. 286 (71.50%) optic nerves of type1 were found, type 2 optic nerves were found in 88(22%) sides, type 3 in 19 (4.75%) sides and least 7(1.75%)optic nerves were of type 4. Protrusion of optic nerve into sphenoid sinus was seen in 20 (10%) cases, bony wall dehiscence of optic nerve was seen in 8 (4.00%) cases, protrusion of internal carotid artery (ICA) into sphenoid sinus was seen in 25 (12.50%) cases, bony wall dehiscence of internal carotid artery was seen in 4 (2.00%) cases and pneumatization of anterior clinoid process was seen in 50 (25%) cases. Conclusion: Detailed preoperative analysis of anatomy and knowledge of individual variations of the sphenoid sinus and its boundaries is essential to prevent serious complications in surgical area.

The paper intends to present a case study report on how the ideas of Education for Sustainable Development were mainstreamed and integrated into national standards and curricula of basic and complete secondary education in Mongolia. First, we tried to give a proper definition of the terms such as ‘Sustainable Development’, ‘Education for Sustainable Development’ from Mongolian nomadic perspectives. The term ‘Sustainable Development’ in Mongolian context is, on the one hand, the integration of nature and quality of a matter (content and form), and on the other hand, it is the integration of ‘arga’ and ‘bilig’ (intelligence and practice). To live in one world, it is absolutely essential to stabilize the socio-ecological inequality for dealing with the urgent ecological crisis (Jadamba and Tungalag, 2015). Secondly, based on the Mongolian context, the studydefined the most important elements covering the three pillars of sustainable development that were to be used as the main indicators for the assessment of ESD mainstreaming into standards and curricula of basic and complete secondary education in Mongolia. With the help of clearly defined elements, we revisedthe education policy documents, the existing standards and curricula for basic and secondary education in Mongolia; carried out an assessment of ESD mainstreaming into standards, and curricula of basic and complete secondary education of Mongolia; prepared recommendations on how to improve the mainstreaming of ESD in standards and curricula.

The study aimed to investigate the perception of teachers and education experts towards the implementation of inclusive education in primary schools of south nations, nationalities peoples region: its practices, challenges and opportunities. To meet the objectives of the study, descriptive survey method was used. This method is concerned with surveying existing current status of inclusive education practices, opportunities and challenge. Participants of the study were 317 regular and special needs teachers, 33 school principals, woreda, zone and region education bureau experts included in the study. For data collection, Likert Scale, questionnaire, interview, document consultation and check lists were used. The finding revealed that there are environmental and schools challenges for the implementation of inclusive education such as lack of infrastructure, sanitation facilities, ramps, acoustically treated classrooms for hearing impairments, educational materials and services. Moreover, negative attitudes of school administration and teachers, limited utilization of professionals, lack of budget, lack of skillful professionals to screen and identify learners with special needs according to their interest of learning. The finding displayed that, only11.3 % of the children with disabilities got a chance of education, 88.7 % of children with disabilities are still out of the school. Furthermore, finding revealed that grade one students are the highest repeaters of all grades when compared to other grades. The reason is poor treatment and poor early intervention problems of diversity of learning. The study suggested that high attention is needed from the concerned parties for the implementation of the inclusive education.

Conduct Disorder (CD) is a behavioral emotional mental disorder associated with a host of negative health, academic and social outcomes among adolescents. They include among others, unwanted pregnancies, bullying, threatening other students, poor school attendance and truancy. Several studies have found other behaviors exhibited by students such as inability or unwillingness to do assigned class work or homework, disrespect for teachers and other learners and poor academic performance suggestive of CD. The serious disruption of school programs, students’ poor academic performance and the emotional agony of the affected parents warrants effective assessment and treatment. The purpose of the study was to determine the effect of conduct disorder on students’ academic performance and their correlation. The study adopted a cross sectional study design. A multistage sampling technique was used to select the study participants. A total of 611 respondents were sampled from a total population of 840 from the two study sites. Data was collected through administration of a Social Demographic Questionnaire (SDQ) and a standardized conduct disorder scale (CDS) while academic performance was measured using end-of-term one, two and term three examination results. Data was analyzed using SPSS version 21 and presented in tables, figures and descriptive statistics. The key findings of the study ware; there was no statistical significant association between CD and academic achievement (p=0.397). The statistical association between CD and level of academic performance had a marginal satisfactory academic performance (10.4%) as compared to students with no CD (10.0%). This difference was statistically significant (p=0.022). The association of the severity of CD and academic performance did not have any statistical significance (p=0.615). Based on the findings, the study recommends further investigation to better understand the link between intelligence and the occurrence of externalizing disorders (CD) and future achievements. Capacity building of principals and teachers to be able to identify CD tendencies among the students. The study further prescribes effective treatment for CD in order to help curb the emergence of CD among the students so as to improve their academic performance while easing the burden of disease to the parents of the affected adolescents, the school and the community.

The authors are commenting on the article entitled “A two-year study of diffused retinal pigment epitheliopathy treated with half-dose photodynamic therapy guided by simultaneous angiography and optical coherence tomography”published by Liu et al. in Eye 2019;33(5):737-745. The authors concluded that the best-corrected visual acuity was inversely significantly correlated with the ellipsoid and interdigitation zone and vision improvement may be attributed to the restoration of the outer retinal microstructures. However, the validation, extrapolation, and generalizability of the excellent outcomes of this study can be made only by regression analyses including all the missing baseline potential predictive factors mentioned by us in addition to the baseline characteristics already assessed.

Background: In 1891, William B. Coley injected streptococcal organisms into a patient with inoperable cancer. He thought that the infection he produced would have the side effect of shrinking the malignant tumor. Hypothesis: Surgical infection may improve host response. Methods: 55 urinary bladder cancer patients, with radical cystectomy and lymphadenectomy were studied. Blood samples were taken on day 0 and day 1, 3, 6, 9 and 14 after operation and at 5-year follow up. TNFα, soluble TNFα receptor I and IL-6 levels in sera were determined by HS ELISA and/or ELISA kits. Plasma cortisol values were measured by RIA kits. Results: From 55 patients.27 infected (wound and urine infections) in 30 days after surgery, 5 patients suffered peritonitis 2 died following leakage of small intestine suture.23 uneventfuly healed.All patients were bacterially contaminated, as wound samples taken at the end of operation demonstrated. 21 died due to the metastatic cancer during follow up.On day 0 the circulating values of TNFα were lower in infected patients. TNFα started to increase from day 3 till day 9 never reaching values of uneventful healing group.Soluble TNFα receptor I was elevated in septic group while, IL-6 elevated on day 1 than decreased for 14 days. Cortisol concentrations were elevated on day 0 and a correlation was found between cortisol and TNFα. Number of serum lymphocyte reduced by half one day after operation. Recovery in 5 days resulted in uneventful healing in 10 days septic consequences. If no recovery death occurs. Conclusions: Measuring serum TNFα levels before and after operations can predict the outcome. The infection may improve host response. However, the postoperative infection is a double edge sword can result in a severe sepsis and/or can elevate immune response improving the outcome from operation and/or from tumor disease.

There are many ways in which migration has been characterized. Cycles of migration may be permanent or longer term, they may be circular, following a particular pattern of movement to and from the home of origin, practiced over a number of years by the same individual or household, it may be seasonal with the movements following seasonal trends in resources and potential activities, and may be managed on long cycles or short cycles. The reasons for migrating and the relative benefits of this kind of life-style have been debated by academics. Some see migration as a way of managing livelihood risk and vulnerability, by diversifying the various income streams coming into the household and moving individuals into less risky income-generating activities at certain times of the year or according to changing economic circumstances

Background: Which mobilization has better results in patients with frozen shoulder? What is Angular joint mobilization? Can we go beyond the conventional margins of concave-convex rule for deciding a glide during mobilizing a joint? Objective: H0: Angular joint mobilization and Maitland Mobilization will have equal effects on pain, range of motion and function in patients suffering from periarthritis of shoulder. H1: Angular joint mobilization will be more effective in reducing pain, increasing range of motion and improving function than Maitland Mobilization in patients suffering from periarthritis of shoulder. H2: Maitland Mobilization will be more effective in reducing pain, increasing range of motion and improving function than Angular joint mobilization in patients suffering from periarthritis of shoulder. Method: It was a comparative pilot study.30 out of which 45 patients with PA fell into the inclusion criteria. 20 patients followed up for the entire duration of 2 weeks (3 sessions/week) and were included in the study. Hence there were 10 in each group.Both the groups received conventional treatment but one group received AJM and the other group received Maitland mobilization. The outcome measures were taken using Goniometer and SPADI. Results: The result of paired t-test between ROM and SPADI within the AJM group and Maitland group was significant. Hence proving that both have a significant effect in improving ROM and reducing pain and disability. The result of unpaired t-test between the differences of outcomes was not significant except for improving internal rotation. Hence proving there is no significant difference in improving ROM and reducing pain and disability between the both groups. Except for improving internal rotation, AJM is better than Maitland. But if we see clinically, patients in the AJM group were reported to have 36.10% improvement as compared to 25.80% in the Maitland group, i.e. 10.30% more than the other group. Similarly for abduction, there was 23.30% improvement due to AJM than 14.40% due to Maitland, i.e. 8.90% more. And clinically 2.40% for improving flexion, 4.60% for external rotation, 6.20% for reducing pain and 6.40% for reducing disability. Conclusion: Angular joint mobilization and Maitland Mobilization are equally effective in reducing pain, improving range of motion and improving function.

Background: Oral health is an important factor in maintaining sound psychological and physical health. According to World Oral Health report 2003, the prevalence of periodontitis is 86% in India. Dental care can sometimes be a forgotten part of a healthy life style. Oral health has been neglected for long in India. Objective: The aim of the study is to assess the oral hygiene awareness and practice among the patients attending OPD at HSRSM’s dental college in Hingoli and encourage them about the benefits of a healthy oral cavity. Methodology: A total of 300 patients (150male and 150females) participated in the study through a questionnaire that consisted of closed ended questions. The data was analyzed using statistical package for social sciences (SPSS) version 15 and results were accumulated by percentage distribution. Results: Awareness among patients about oral hygiene was good. 95% patients in our study were brushing the teeth at least daily but with different oral hygiene measures. It was observed that 86.67% patients didn’t know the relationship between oral and general health. Patients only visited the dental clinic during the problem. Conclusion: The need for continuing dental education through promotion programs is emphasized with justification.

Today, many people receive orthodontic treatment for better occlusion, improved oral function and harmonized facial appearance. However, two perplexing challenges have not been solved in clinical orthodontics, i.e. long treatment time (on average 2-3 years) and iatrogenic root resorption. Figuring out these challenges will dramatically improve the quality of orthodontic care. The following article deals with the first challenge i.e Long treatment time and the most reliable and effective way to enhance the tooth movement.

Doctor patient relationship is a contract-based relationship and it is considered as elementary to healing art of medicine. This is not a new concept in medical field, but it has a profound influence on the treatment outcome. Over the years many literatures have been published in this area; however, there is a paucity of information especially focusing on doctors in India. Considering this a literature review was performed using Medline, Pub Med, Wiley, Science Direct, Scopus, and Grey literature using Me SH terms like doctor; doctor-patient relation; India. Using the results of this review, a conceptual portrait of doctor patient relationship in India was constructed which mainly focused on the basic elements of this relationship and also the current scenario of this relationship in India especially on corruption, nepotism, quackery, health care inequality, violence etc. Apart from these, certain recommendations were also incorporated for strengthening this relationship in India.

Aim: Effective pain control during dental treatment of a pediatric patient is the cornerstone for successful behavior guidance. The aim of the present study was to evaluate the effectiveness of active and passive distraction techniques on children’s behavior during dental treatment. Material and methods: Atotal number of 150 children between of 4-10 years of age group were selected and randomly divided into 3 equal groups. Group I comprised of the control group on whom the treatment was performed under normal dental setup, group II was the active distraction group, who were instructed for repeated deep breathing and blowing out air throughout the treatment and the group III, the passive distraction group were shown audiovisual presentation through Visual Reality Glasses 3D Box during the entire treatment. Each patient was scheduled for 3 dental visits. Pre and post-operative response to dental stress was assessed using the Facial Image Scale for dental anxiety. Statistical analysis was done using SPSS 18 (Chicago, USA) and p<0.05 was considered to be statistically significant. Result: The maximum number of children (24%) belonged to the 6-7 years of age group. The mean values for SBP obtained during the prophylaxis visit in group II and group III was higher as compared to the control group. The SBP during the application of local anesthetic in group II and III group was significantly higher than the control group children (p<0.05). There were differences in the SBP, DBP and PR in all the groups but they were not statistically significant. The correlation of clinical anxiety and co-operative behavior showed that children were more relaxed in the group II and group III during dental procedures. Conclusion: The results of the study suggested that active and passive distraction made children not only less anxious as compared to the control group but they also showed more cooperative response during the invasive dental procedures.

Objective: The aim of this study was to evaluate the relationship between chronic nasal obstruction caused by nasal septal deviation and Eustachian tube dysfunction–related symptoms using the Eustachian Tube Dysfunction Questionnaire (ETDQ-7) as an assessment in compared study with Tympanometry Eustachian tube function tests result. Methods: This study was carried out at a private clinic in BAGHDAD from May 2018 to February 2019A total of 80 adults were enrolled and divided into 2 groups matched by age and sex. Group 1 (cases) 40 patient (24 male 16 female) age from (18 to 60), with complaint of unilateral or bilateral chronic nasal obstruction due to septal deviation. Group 2 (controls) were healthy adults without any clinical signs or history of persistent nasal obstruction or others nasal problems. The ETDQ-7 scores, ETF tests and Tympanometry results of both groups were compared. Results: In group 1 the median total score of the ETDQ-7was ((2.8) which are Significant higher than in group 2 (1.0)in group 1 (80 ears) 60 had type A, 20 had Type C in Tympanometry results and 30 had Poor ETF test, 10 had Good EDF Test results. In group 2 (80 ears) 72 had type A, 8 had type C tympanogram results and 22 had Poor ETF test, 18 had Good ETF. Conclusion: Patients with nasal obstruction due to DNS had significantly more symptoms related to ETD compared to the healthy controls as subjective data which shown a great association with the results of objective data (Tympanometry and ETF tests). Recommendations 1. We prefer to increase the awareness of otolaryngologist doctor to relationship between septal deviation and Eustachian tube dysfunction. 2. We recommend to do further studies on this subject by make relationship of types of Septal deviation and Eustachian tube dysfunction, as there's new septal deviation Classifications and match every type of septal deviation with Eustachian tube dysfunction

Blowout fracture of orbital floor is a common presentation in maxillofacial trauma triage, usually blunt trauma with an object slightly larger than orbital rim is the classic mechanism. In this manuscript a new presentation is described where spontaneous peri-orbital edema and pain observed after aggressive nasal blowing. Computerized tomography reveals defect in the orbital floor with herniation of soft tissue to the sinus. Ipsilateral sinus is clear with thin uniform lining; however the enlarged inferior turbinate obstruct sinus osteoum where, nasal blowing creates sinus negative pressure that could explain fracture mechanism.

Pneumocystis carinii pneumonia (PCP) is the most common opportunistic infection in AIDS patients. To find out the prevalence of PCP among HIV infected patients, to elicit its association with pulmonary tuberculosis and gender, and to find out the superiority of the commonly used stains to detect pneumocystis. After getting approval from Institutional Ethical Committee, this study was carried out among 144 newly detected HIV infected patients who satisfied a presumptive diagnosis of PCP as per CDC/CDSC, attending Thoracic medicine department, Govt hospital. HIV infection was established by two different ELISA tests. Induced sputum was collected from each patient and processed for PCP by Giemsa and Toluidine blue staining, and for acid fast bacilli by Ziehl Neelsen method. The data were analyzed statistically. Among 144, PCP was identified both by Giemsa and Toluidine blue staining in 77. In addition, Giemsa helped to identify two 2 more cases of PCP. However, there was no statistical difference (P < 0.53), among the two stains used. Prevalence of PCP in HIV positive TB negative, HIV and TB co-infected group was 61%, and 54% respectively. The PCP among symptomatic HIV infected patients was 54.8%. The results of the study suggest that Giemsa staining is user-friendly.

Perforated duodenal ulcer is one of the common surgical emergency and it is considered the most common cause of peritonitis. Inspite of antiulcer medication and Helicobacter eradication, Perforated peptic ulcer (PPU), is still the most common indication for emergency gastric surgery and is associated with high morbidity and mortality. Perforations of the peptic ulcers (PPUs) are the most common cause of emergency surgery among the complications of the gastroduodenal ulcers and the leading cause for morbidity and mortality due to secondary peritonitis and sepsis. PPU is a condition in which laparoscopic perforation repair (LPR) is an optimal solution. It makes possible the identification of the perforation's site and allows closure of the perforation and the subsequent peritoneal lavage, as in an open repair (OR) but without the large uppermid-abdominal incision. The outcome might be improved by performing this procedure laparoscopicallywithomental patch repair of perforated peptic ulcer carries lessmorbidity and mortality and early return of patients to their normal daily routine.

Background: Nasal obstruction after adenoidectomy and the need for second adenoidectomy operation i.e (Revision), put as under focus on nasal obstruction types after adenoidectomy. We should search and report the causes of nasal obstruction to improve outcomes of adenoidectomy. Objectives: To find out the causes of nasal obstruction after adenoidectomy. Patients and Methods: Comparative cross sectional study focus on causes of nasal obstruction after adenoidectomy operations which done in Al-FURATE general hospital, in a period between February 2015 to November 2017 to patients visit our outpatient clinic in determined days in a week. Eighty six paitents included in our study who complain from nasal obstruction and or decrease hearing and diagnosed clinically and by nasal endoscopy and imaging if needed to have adenoid enlargement, and planned for adenoidectomy. We entered data of each patient on questionnaire and follow up them in periods 1 week, 2 weeks, 1 month, 3months, 6months, 1year, to evaluate their nose, ear problems if founded. Results: Number of normal cases after adenoidectomy is 66 out of 86 i.e 76.74%, Nasal obstruction by adenoid regrowth is 8 out of 86 cases I,e 9.3% ,. while Nasal obstruction by inferior turbinate hypertrophy is 11 out of 86 i.e 12.79%, Males has the higher number of nasal obstruction by adenoid regrowth 62.5% of cases, while females has the higher number of nasal obstruction by inf. Turbinate hypertrophy 72.72%of cases. Nasal obstruction by adenoid regrowth is more common in (2-3 years) age group. Nasal obstruction by inferior turbinate hypertrophy is more common in age group (6-7 years). Conclusion 1- Most common cause of nasal obstruction after adenoidectomy is inferior turbinate hypertrophy. 2-Second most common cause of nasal obstruction after adenoidectomy is adenoid recurrence. 3- Males has the higher number of nasal obstruction by adenoid regrowth. 4- Nasal obstruction by adenoid regrowth is more common in (2-3 years) age group. 5- Nasal obstruction by inferior turbinate hypertrophy is more common in age group (6-7 years). Recommendations 1- We should try to decrease adenoidectomy operation as condition permits at least to after 4 years age. 2- Cases of adenoidectomy should follow up after operation as no any nasal obstruction mean adenoid recurrence. 3- Using endoscope during adenoidectomy may decrease recurrence. 4- We recommend more studies about nasal obstruction after adenoidectomy with more facilities

Background: Brachial plexus block has now evolved into a valuable and safe alternative to general anaesthesia for upper limb surgeries. Various approaches like interscalene, supraclavicular, infraclavicular and axillary have been used for blocking the brachial plexus. Supraclavicular approach gives the most effective block for upper extremity and is carried out at level of trunks of brachial plexus. Objectives: To determine and compare the efficacy of supraclavicular block of brachial plexus with bupivacaine (0.5%) with dexmedetomidine (30 µg) and levobupivacaine (0.5%) with dexmedetomidine (30 µg) for brachial plexus blockade. Material & Method: This prospective, randomized, double blinded, controlled trial was conducted on patients of either sex, aged between 18 to 60 years with ASA class I and II posted for upper limb surgeries. Two groups comprising of 30 patient in each group, who received bupivacaine + dexmedetomidine, or levobupivacaine + dexmedetomidine, were selected to compare their effects on onset, duration and quality of BPB. Results: Onset of sensory block was early in Group B (6.45+0.91 minutes) as compared to that in Group A (8.02+0.82 minutes). Onset of motor block too was early in Group B (9.02+0.90 min) as compared to Group A (10.01+0.88 min.) Duration of sensory block was statistically significantly longer in Group B (891.50+68.38 min) as compared to Group A (756.67+64.68 min). Duration of motor block was statistically significantly longer in Group B (788.83+62.97 min) as compared to Group A (700.67+64.67 min). Duration of total block was statistically significantly longer in Group B (1002.67+43.54 min) as compared to Group A (787.07+61.62 min). Conclusion: Our study revealed that 30μg dexmedetomidine as adjuvant to levobupivacaine in supraclavicular brachial plexus block improves sensory, motor block characteristics, hemodynamics, and VAS pain scores without clinically relevant adverse effects.

Listening is an essential component of effective communication. Listening requires attention and practice to analyze and organize sounds into recognizable patterns, interpret the patterns and infer meaning to messages communicated. This descriptive study determined the relationship between listening knowledge and academic performance among nursing students of the University of Calabar. Simple random sampling technique was used to select one hundred and twenty (120) participants from 200 level class with a population of 220 students. Self-reporting questionnaire was used to collect listening knowledge information while academic performance information was retrieved from participants’ academic records. Listening knowledge and barrier checklists used confirmed participants’ knowledge. Socio-demographic data were analyzed using SPSS version 22 and reported in frequencies and percentages while Pearson Moment Product Coefficient determined the relationship between listening knowledge and academic performance. Socio-demographic characteristics findings showed participants to be within the age ranges of 25-31years (30.00%) and 32-38years (29.17%), 90 (75.0%) were females, 88 (73.33%) were generic students with 32 (26.67%) direct entry. Participants had high listening Knowledge with a mean and SD of20.45±5.24 but failed to identify 4 key listening barrier issues. Listening knowledge and Academic performance findings revealed a negative correlation, indicating, a weak relationship since value is nearer to zero (calr-value = -0.0204, crir-value = 0.178, df = 118, P>0.05) thus accepted the null hypothesis. It was concluded that Listening is essential for successful academic performance that must be emphasized during nurse education training.

Aims: The study was aimed to check the correlation of Yen angle with other sagittal discrepancy parameters and to obtain a more reliable and least variable parameter for antero-posterior cephalometric analysis. Methods and Material: The lateral cephalograms of 450 North Indian subjects were obtained and traced for five different sagittal discrepancy parameters. The age of subjects ranged from 18-30 years. Statistical analysis: ANOVA analysis, t-test and correlation coefficient analysis were done. Results: Mean values of YEN angle, W angle, BETA angle, ANB angle and WITS appraisal were found to be 120.63±5.55, 53.13±4.21, 27.83±4.97 and 3.07±2.79 respectively. The ANOVA analysis revealed highly significant differences among the means of all the three groups (Group I, II & III). Pearson’s correlation coefficient test revealed that YEN angle was correlated with W and BETA angles. Conclusions: Study revealed that, YEN angle was highly reliable (CV= 4.6) and most homogenously distributed parameter to assess antero-posterior sagittal discrepancy among North Indian population. In addition it could significantly differentiate among the three groups and was highly correlated to W and BETA angle.

During active phase of tuberculosis, antibodies especially IgM and IgG are developed against different mycobacterial antigens and these can be detected in patients’ sera. Patients with confirmed tuberculosis reporting to the Department of Thoracic Medicine and General Medicine of Govt Rajaji Hospital, Madurai were taken up for the present study. Of the 80 patients, 50 were (M=38, F=12) in PTB group and 30 (M=19, F=11) in EPTB group. Their age ranged from 19 to 45 years. Blood samples from 21, age and sex matched healthy control were included. IgG test was positive in 20 (8 PTB & 12 EPTB) of the 80. In the present study, IgG positive status was more among EPTB and it was significant (P<0.001).

Background: Acute Renal Failure (ARF) is a common complication observed in critically ill newborns and neonates admitted in NICU. Methods and Subjects: This prospective case control study was carried out in the Neonatal Intensive Care Unit of a tertiary level hospital for a period of one year with an objective of determining the incidence of ARF in neonatal sepsis. 113 neonates, who had a positive sepsis screen and/ or a positive blood culture were evaluated for the presence or absence of ARF. Sepsis was identified on the basis of either a positive blood culture or a positive sepsis screen. ARF was defined as Blood Urea Nitrogen (BUN) > 20 mg/dl on two separate occasions at least 24 hrs apart. Oliguria was defined as urine output <1 ml/kg/hr for more than 24 hours. Data was analysed using Student’s t test. Results: The sepsis screen positivity rate was 89.4% whereas the culture positivity rate was 44.2%. ARF developed in 32 out of 113 neonates giving an incidence of 28.3%. The ARF in neonates was predominantly non oliguric (59%) and it was significantly associated with gestational age (p value 0.001), birth weight (p value 0.013), weight on admission (p value 0.001) and the place of dwelling (p value 0.034). There was high incidence of volume responsive ARF in those neonates with presumptive ARF on day 1 of admission. The overall mortality of the study group was 25.7%; it was 50% in the neonates with ARF and in neonates with sepsis alone it was only 16% (p value <0.001) showing the significant increase in mortality in neonates with sepsis who develop ARF as a complication. Conclusion: There is a high prevalence of volume sensitive ARF in neonatal sepsis that can be corrected by proper fluid and electrolyte management.

The value of infinity multiply by zero is one of the most mysterious calculation. Here we will find the standard value of infinity multiply by zero.

Numerical modeling of communicable disease is a device to appreciate the instrumentin what waysyndrome pushovers and in what waystately. we have studied numerically the dynamics of HBV. We frame an entirelyconstant Non-Standard Finite Difference (NSFD) structurefor a mathematical model of HBV. The introduce numerical array is bounded, dynamically designate and contain the positivity of the solution, which is one of the important requirements when modeling a prevalent contagious. The comparison between the innovative Non-Standard Finite Alteration structure, Euler method and Runge-Kutta scheme of order four (RK-4) displays the usefulness of the suggested Non-Standard Finite Alteration scheme. NSFD scheme shows convergence to the exact equilibrium facts of the model for any time steps used but Euler and RK-4 fail for large time steps.

“Lakshmanrekha” also known as an insecticide is a combination of Cypermethrin and Deltamethrin. Both are pyrethroid compound and is widely used due to its high insecticidal potential and slow resistance in pest. It is considered less toxic for human use, because of poor dermal absorption, rapid metabolism, less tissue accumulation, and environmental persistence. Cases of accidental pyrethroid poisoning at work places have been reported, but poisoning with suicidal intention is extremely rare. We report a case of 33-year old female who presented to our emergency department with complaints of recurrent vomiting, epigastric and throat pain, increased salivation, drooling, lacrimation, anxiety after ingestion of Lakshmanrekha. There was no history of convulsion, diarrhea, frequent urination, chest pain, or fever.

The effectiveness of Nigeria Cybersecurity strategy can have serious effect on the Cybersecurity stance of the country and significantly impact how well the country financial critical IT infrastructures are protected. The problem is that, different organizations use different tools to evaluate their Cybersecurity strength against any cyber attack. This Model is developed to provide a measure which the Nigeria financial organizations can apply to determine their level of vigilance on preventing and responding to a cyber attack.

Engineering is the creative application of scientific principles that are put in practice to invent, design, build, maintain and improve structures, machines, devices, systems, materials and processes. This means that engineering requires infrastructure or institutional facilities in addition to other key variables. This includes human resource and materials. They are all key to successful engineering education. Infrastructure for Engineering courses offered at Diploma level in polytechnics play a critical role in acquisition of practical skills and knowledge relating to industrial development worldwide. In Kenya there were two National polytechnics; Kisumu National Polytechnic and The Eldoret National Polytechnic at per the time of the study. Through engineering education, countries build competence based workforce for key industries. However, performance of students in engineering courses in National Polytechnics was unsatisfactory. For instance A sample of 645 candidates who sat diploma examination in engineering courses between 2010 and 2014 in National Polytechnics, only 40 (6.2%) earned credits, 143(22.2%) passes, 247(38.3%) were referred and 215(33.3%) failed compared to their counterparts in non-engineering courses in which 22(1%) attained distinctions, 963(44%) credits 720 (33%) passes, 400(18.3%) were referred and 106(4.8%) failed. In another sample from another national polytechnic, 831 candidates during the same period for diploma examination in engineering courses, 110 (13.3%) attained credits, 283(34.1%) pass, 309(37.2%) were referred and 129 (15.5%) failed; compared to their counterparts in non-engineering courses in which 31(1.59%) earned distinctions, 672(34.62%) credits, 744(38.33%) passes, 393(20.3%) were referred and 101(5.2%) failed. The purpose of this study therefore was to determine the influence of institutional facilities on students’ academic achievement in engineering courses in National Polytechnics. The study established that institutional facilities accounted for 4.2% of the variation in students’ academic achievement in engineering courses. This means that the influence was low. The reason for being low was that from descriptive statistics, it was clear that the students hardly utilized the institutional facilities to the optimum. Engineering courses are competence based and highly practical in nature, which means that achievement in these courses can only be guaranteed by optimum frequent use of institutional facilities besides other factors. The study concluded that institutional facilities had low but significant influence on students’ academic achievement. These findings are significant to the management of National Polytechnics in engineering courses that needs to be improved to enhance students’ academic achievement. Institutional facilities should be provided and adequately used to enhance performance.

The loss of dental elements is one of the main factors for the pneumatization of the maxillary sinus. The lack of bone crest dimensions in both height and width is an important indication for maxillary sinus lift surgery that aims at future oral rehabilitation. Case Report: A female patient, leucoderma, 41 years old, sought care at a postgraduate center and complained that she had no dental elements on the right side, claiming that she would like oral rehabilitation. After anamnesis, an accurate clinical examination and volumetric tomographic of the conical bundle, the pneumatization of the maxillary sinus was diagnosed and surgical intervention was required to lift it. Final Considerations: Maxillary sinus lift surgery using the lateral window technique with the use of L-PRF aides with the bovine matrix xenografts used has an easy surgical feasibility of material handling as well as allows better results for oral rehabilitation, besides allow a quick post surgical.

Fibrolamellar hepatocellular carcinoma (FLHCC) is a rare variant of primary hepatocellular malignancy. It mainly affects younger adults and adolescents between 10 and 30 years of age. FL HCC differs from HCC in many ways such as patient demographics, presence and absence of common risk factors, tumor markers and prognosis. These tumors have typical radiographic findings which are confirmed by histopathology. We describe three cases of fibro lamellar carcinoma that were received in our department over a period of two years.

The Purpose of the study was to examine the relationship between teacher quality and a pupil’s achievement in Mathematics on the Primary Leaving Examinations (i.e., 7th grade) in Uganda. The study employed a cross- sectional survey design. Data were from the Uganda National Examinations Board (UNEB) Primary Leaving Examinations (PLE) Mathematics results, 2018 (N = 952). Mathematics teachers who taught the seventh grade were also part of the study participants (n = 18). A Two-Level Hierarchical Linear Model (HLM) was used to investigate the question “What is relationship between teacher quality and pupils’ achievement on (PLE) achievement in mathematics controlling for prior achievement/knowledge. The result show that the effect of the Teacher Quality Measure (TQM) on mathematics PLE scores controlling for the pretest was statistically significant (γ11= -.01, t = -2.17, df = 16, p = .045). That is, for every one-point increase in teacher TQM scores, the effect of the pretest on mathematics PLE scores decreases by .01 point. Additionally, statistically significant variability in the mathematics PLE means exists (τ00 = 1.72, Χ2= 336, df = 16, p = .000), as well as statistically significant variability in the effect of the pretest (τ11 = .02, Χ2= 40.85, df = 16, p = .000).

We studied the development and reproductive behavior of two sympatric New Zealand spiders, Badumna longinqua and Badumna insignis (Araneae: Desidae), in the laboratory. Both species have intersexual size dimorphism and, within each species, males vary up to 35-fold in size. Females of B. longinqua produce up to 12 egg sacs, and those of B. insignis produce up to 18 sacs. Clutch size and number of egg sacs is positively correlated with adult female longevity, but not female weight, in both species. Courtship in B. longinqua is longer and entails more acts than in B. insignis. Both species exhibit prolonged copulation. The number of palpal insertions during copulation is not correlated with clutch size, length of sperm storage, female longevity, male weight, or female weight in either species, but number of insertions is positively correlated with relative male weight in B. longinqua and time until first oviposition in B. insignis. The two species do not interbreed in the laboratory. Although theyare similar morphologically, they are reproductively isolated via reproductive behavior; similarities in courtship suggest that the female might use vibratory or chemical cues to assess conspecificity of males.

The goal of this work is to develop, carpentry residues which are sawdust of teak, and agricultural, the African locust bean pod (Parkia biglobosa), for the manufacture of particleboards. So we research a palliative to environmental problems caused by sawdust and the use of conventional binders. Teak sawdust particleboards were manufactured by varying the content of tannin powder of African locust bean pod. The mechanical, thermal and physical properties of these panels were determined using three-point bending test, tensile test, internal bond, swelling in water and thermal conductivity measurement. The bending test was used to determine the modulus of elasticity (MOE) and the modulus of rupture (MOR). The tensile test leads to the determination of the Young modulus (E) and the modulus of rupture (MOT). The immersion in water allows determining the rate of thickness swelling and water absorption after two and twenty-four hours. The thermal property evaluated is the thermal conductivity coefficient. This shows that the tannic powders can validly replace the conventional binders in the manufacture of particle board.

Personality enables us to predict what a person will do in a given situation; more so, personality is the governing trait of an individual that has been associated with performance at work. A descriptive-correlational study was employed to examine the relationship between personality and employee performance in XYZ Company. The participants of the study were the 138 rank-and-file employees of the three (3) business entities in Bacolod City. The SFPQ (Six Factor Personality Questionnaire) was utilized to measure employees’ personality. Personality dimensions assessed in this study were the factor scales namely: Extraversion, Agreeableness, Openness to Experience, Independence, Methodicalness, Industriousness, and Conscientiousness. The Performance Appraisal Rating Report as of December 2015 was used in determining employees’ performance. Results revealed that rank-and-file employees had Openness to Experience and average performance level. In addition, there were no significant differences between employees’ personality and performance as to sex, chronological age, and length of service. The findings revealed no significant relationship between personality and job performance. The not significant results put forward that when personality tests are used for recruitment, selection, promotion, and placement purposes are perhaps not the appropriate tool to calculate performances. Motivation and human ability (e.g. technical skills, conceptual skills) may be the other factors that mediate employee performance. Personality alone cannot envisage performance at work. Having the right competences is vital in job performance. The placement of right people to the right designation is central to an organization.

Diagnostic methods with high sensitivity and specificity are highly essential for effective tuberculosis management. Endemic nature of the pathogen, cross-reaction in vaccinated individuals and poor growth rate makes it’s diagnosis more complicated and urges the need for improved diagnostic methods to limit progression and the spread. Advancements in technology in combination with conventional knowledge on TB and molecular genetics approaches have helped to achieve considerable progress in TB diagnostics. This review highlights different methods of TB diagnosis ranging from phenotypic methods to genetic approaches, which are approved by WHO and are in the pipeline for commercialization.

The optimal spore concentration of F. verticillioides that will be just high enough to cause moderate rotting (infective dosage) in the tissues of maize (Zea mays) stem was investigated. Two inoculation methods viz., toothpick and injection methods were used for the inoculation. Four spore concentration levels of F. verticillioides were employed viz., 1 x 106; 5 x 105; 3 x 105 and 1 x 105 spore/ml. Maize seeds (DMR-LSRW) were planted in several pots in the screenhouse. Four weeks after planting, 5 sets each, of the potted plants were injected on the stems at the second internodes with the different concentration levels of F. verticillioides using both inoculation methods. Inoculation of sterile distilled water served as control. Experiment was conducted in three replications and experimental design was completely randomized design. The stems were later observed and rated for rot severity within the internodes using modified form of Hooker’s scale. Results showed varying extent of rot formation within internodes of stems that received different treatment concentrations of F. verticillioides. Concentration levels of 1 x 106 and 5 x 105 spore/ml of F. verticillioides, for both injection and toothpick methods caused total rotting of inoculated internodes in most plants. Rotting was moderate at 3 x105 spore/ml concentration for both injection and toothpick methods in most plant stands. Concentration level of 1 x105spore/ml had a slightly higher rot formation using toothpick method than using injection method. Rot formation was better with toothpick method than with injection method. 3 x 105 spore/ml inoculum concentration of F. verticillioides could thus be suggested as the appropriate infective but non-lethal dosage that is just high enough to cause infection in tissues of maize stem without killing the entire stem. Toothpick method could also be said to be better than injection method in the inoculation of maize (Zea mays) stem with F. verticillioides.

Integrated functional adult literacy provides learners to acquire knowledge and skills useful to their daily live. Now a day, the focus has been shifted to illiterate adult who due to a number of reasons is out of formal education. Our country has been aggressively doing in functional adult education since 2006. In light of this, this research was aimed at assessing the effectiveness of integrated functional adult literacy in Wolaita and Dawuro Zones. It was also intended to identify how effectively the program coordinated, how relevant to and benefit adult learners, and the challenges that hamper the implementation of the program. Consequently, it also suggests a way out of the problems evidenced in the study. To conduct the study a descriptive survey method was used. Samples of 2 woredas, 24 adult learners, 24 facilitators 8 school leaders, 4 supervisors, 6 department /sector heads, 2 woreda adult education unit were selected by simple random and purposive sampling techniques as data sources. To answer the basic questions, data were collected from groups of sample respondents through questionnaires, interview and document analysis. The data were analyzed using descriptive statistical technique such as percentages. The results of the study revealed that the program was relevant, practical and beneficial to the adult learners. However, almost all adult education facilitators were poorly qualified in terms of schooling and received inadequate training on andragogy. Thus, the training for facilitators and the preparation of more literacy materials in addition to current materials in locale language are among recommendations.

Critical film review of the American television series When We Rise. From the methodology of Cinematherapy, important and historical points are listed and analyzed in the light of the theories of sexuality and gender. Launched in January 2017, it runs through landmark events for the LGBT movement in the United States and shows how prejudice and homophobia have been institutionalized in the actions of culture, institutions and politics. In view of the current times in Brazil, the series comes together with the pertinence of discussing the presence of the theme in schools, as well as alerting to the fact that society has boycotted, through ignorance and fear, the presentation to be made in a systematized way, frank and unprejudiced in classrooms in elementary schools.

Background: drug dependence can be a result of or can cause a number of socio-cultural issues. Our study aims to find socio-cultural issues of heroin addiction in a city in northern India. Objective: 1) To discuss socio-cultural issues associated with heroin dependence. 2) To study the socio-demographic variables associated with Heroin dependence. Methods: 244 patients visiting an outpatient psychiatric clinic for heroin detoxification were assessed for their socio-cultural and socio-demographic profile using a semi-structured questionnaire. Percentages were calculated and results analysed. Results: More males visited the treatment facility. A majority of patients were of the age group 18-30 years (158 patients, 64.75%). About half of the patients were those who are either doing or dropped out from graduation (127 patients, 52.05%). A very high number of patients were from nuclear family (203 patients, 83.2%). Peer pressure and experimentation were major reasons for initiating heroin dependence. A large majority of patients had family disharmony and financial troubles due to heroin dependence. Conclusions: This study has hence bought forward important socio-cultural anomalies associated with drug abuse in a small city and its periphery.

Deep bite is one of the most common malocclusions seen in children as well as adults that can occur along with other associated malocclusions. It is said to be one of the most deleterious malocclusion when considered from the viewpoint of the future health of the masticatory apparatus and the dental units. The correction of the deep bite is one of the primary objectives of orthodontic treatment. Deep bite has been considered one of the most common malocclusions and the most difficult to treat successfully. Thus an optimal treatment of deep bite requires a proper diagnosis, a careful treatment plan, and an efficient appliance design.

Background & objective: CONS species have been recognized as etiological agents in wide variety of infections especially in immunocompromised patients, patients with indwelling or implanted foreign bodies. Furthermore, there is increasing rates of antibiotic resistance which varies within species of CONS and limits therapeutic options .Hence the present study was undertaken to determine common CONS species isolated from clinically significant specimens and to evaluate antimicrobial susceptibility pattern of these species. Methods: This cross sectional study was carried out from September, 2016 to September, 2018in which 200 CONS isolates from clinically significant samples were identified upto species level by conventional phenotypic methods. Antibiotic Susceptibility profile was studied by Kirby Bauer Disk Diffusion method with special emphasis on methicillin & clindamycin resistance. Result: Total 9 species were isolated, the most common being S. epidermidis(40%) followed by S. haemolyticus (25%) , S. schleiferi (11%) and most commonly from blood ,pus,urine.Overall there was high rate of resistance to penicillin & erythromycin(60%)and all were sensitive to vancomycin & linezolid.66% isolates were methicillin resistant CONS of which 18.18% showed iMLSB phenotype. Conclusion: Species identification of CONS is important because of rising clinical importance and variation in antibiotic resistance pattern within species. Accuracy and promptness in the detection of species wise antibiotic resistance pattern will help in understanding definitive therapy for CONS.

The river long profile analysis has been studied over the past several decades to decode the nature of river. The morphology of a river channel is the resultant effect of the interactions among a number of factors. Mainly lithology, slope, hydraulic characteristics like width, depth, velocity, sediment present in the fluid, etc. control the morphology of a river channel which in turn effect the mechanics of flow. Erosion, transportation and deposition shape the long profile as well as the cross profile. Meandering river in flood plain oscillates due to alternate erosion and deposition. Thalweg points shift over time and space. River energy gradient varies thought out the channel and finally the river tends to erosion or deposition prone or stable or unstable. The migration of meander is a common phenomenon of alluvial river and is capable to affect the long profile and hydraulic geometry which in turn controls the fold plain evolution. This paper presents a detail account of long profiles and hydraulic geometry to evaluate the present scenario of the Kulik River.

The use of denture base resin has revolutionized the dental material sciences ever since their discovery. Many prostheses and implants made from polymers have been in use for the last three decades and there is a continuous search for more biocompatible and stronger polymer prosthetic materials. Resins have been reinforced using different materials to improve strength. This paper reviews acrylic denture base resin enhancement during the past few decades. Specific attention is given to the effect of fiber, filler, and nanofiller addition on poly (methyl methacrylate) (PMMA) properties.

This study was carried out to investigate the causes of convulsions With in age group 6 M-7 years & to estimate the characters of patients with febrile convulsion. The study was done in AL-khansa – Teaching Hospital, pediatrics department in Mosul during the period 1/2/2018-1/6/2018. Data on age, sex convulsion & its duration, character, clinical presentation & family history of F.C., examination of children for any neurological abnormality, delayed developmental milestones & family history for epilepsy. Also the education of the mother in considered because has important role to prevent recurrence of convulsion. The study was showed that the F.C formed abut (60) (77.9%), epilepsy & C.P (7.8%), uremia (2.6%), hypocalcaemia (2.6%). The F.C was most common among the age group l >11-23 months, the males slightly predominant than females with 1.5:1 ratio. Most of the convulsion were of simple types. All cases have generalized tonic clonic mode of convulsions except 3 (5%) who presented with focal type. Positive family history of convulsions was found in (15) (25%) of cases. Positive family history of epilepsy was seen in (4)(3.3%) of F.C., delayed developmental milestone was seen in (2)(3.3%) of cases. The comparison between the complex and simple F.C there was significant difference (P-value< 0.05) in the age group 6-35 month, while there were no significant difference according to EEG finding, family history, and delayed development of milestones. According we recommend early intervention by the family to avoid the occurrence of F.C as well as improve the educational level of the mothers

The research paper aims to explore the impact of globalization upon education sector. The research paper specifically focuses upon Pakistan to find out the changes brought by globalization on its education system. The paper adopts a qualitative approach to attain the set objectives and mainly relies upon the analysis of secondary sources for the collection of information. The relevant literature existed around the topic has been accessed and reviewed to have deep insight over the issue under consideration. The study reveals that the process of globalization has resulted in easy and swift transfer of knowledge and skill from one place to another due to which the education systems have also refined. Easy mobility of people from one place to another has also allowed transmission of ideas and knowledge. it is found that In Pakistan globalization has increased the popularity of English language whereas the trend of commercialization and international collaboration through affiliated programs and study tours have also increased. These changes have allowed the Pakistani students and teachers to get hold of the ideas and patterns that are followed in the western educational sphere.

Madhumeha has been described as maharoga in ayurvedic classics. It is one of the most alarming disease and possesses a special place in medical science due to its high prevalence in the society and increased incidence. In Ayurveda, Madhumeha has been described as one among one of the 20 types of Prameha and is a sub-type of VatikaPrameha. The factors which provoke Vata directly cause Apatarpanajanya Madhumeha and the factors which provoke Kapha and Pitta cause Santarpanajanya Madhumeha. In the former type the patients are usually asthenic can be correlated with Type I DM and in the latter type patients are obese and can be equated with Type II DM. Shodhana is the preferred choice for the elimination of Doshas, thus Virechana karma was selected as Shodhana procedure, which is specific for the elimination of vitiated Pitta Dosha1 as well as Kapha Dosha2. Even for VatavyadhiVirechana is a good treatment.3 The present study was an open trial, which was carried out at R. G. G. P. G. Ayurvedic Hospital, Paprola. The study was conducted in two groups on 10 patients in each group and results were compared. Patients who fulfilled the criteria of assessment of the trial were selected.In group1 patients were given Triphala Ghrita for snehpana as a purvakarma followed by Virechana karma as shodhana chikitsa and Trayushnadi gutika as a shaman yog for 30 days after Virechana. In group2 only Trayushnadi gutika was given as shamana yoga for 45 days. 10 Patients in age group between 25-70 years having clinical features of Diabetes Mellitus were taken in each group. After evaluating the total effect of therapies comparative result of Virechana and Trayushnadi gutika (combined therapy) and Trayushnadi gutika (shamana therapy) was seen on Madhumeha.

Engineering education is not attracting enough secondary school leavers and often it is not attracting the diversity of backgrounds needed, namely; persons with mild disabilities, girls and the talented among others. The main obstacle is the way engineering is perceived by prospective students, teachers, counselors and parents. In fact engineers are perceived as “nerds” without interpersonal skills, doing narrowly focused jobs that are prone to being outsourced. Most high school girls believe engineering is for boys who love mathematics and science. At diploma level the admission criteria is low compared to degree level, where engineering education is highly competitive. Notwithstanding this scenario quite a number of students pursue engineering education in National Polytechnics at diploma level. Engineering courses offered at Diploma level in the polytechnics play a critical role in acquisition of practical skills and knowledge relating to industrial development worldwide. Through engineering education, countries build competence based workforce for key industries. Performance of students in engineering courses in national polytechnics was unsatisfactory and a serious concern. The unsatisfactory performance could have been due to a myriad of factors such as students’ attitude, students entry behaviour, teaching learning resources, infrastructure, lecturer characteristics, location of the polytechnics and the nature of curricula as suggested by the literature review. The objective of this study was to determine the influence of students’ entry behavior on students’ academic achievement in engineering courses in National Polytechnics in Kenya. The study established that students’ entry behavior accounted for 6.3% of the variation in students’ academic achievement in engineering courses. This means that statistically for every one unit improvement in performance in Kenya Certificate of Secondary Education mean scores the respective students’ academic achievement improved by about. 01 units. The practical significance is that entry behaviour is a significant predictor of students’ academic achievement in engineering courses. The study concluded that students’ entry behavior influences students’ academic achievement in polytechnics in Kenya. Going forward, the entry behaviour of students joining engineering course should be revised upward to reduce wastage in engineering courses.

Our study revealed a significantly high expression of Ki67 in neoplastic epithelial glands of gall bladder, oesophageal, small intestinal and colorectal adenocarcinomas as compared to the non neoplastic areas. The Ki67 labelling index was higher in moderately and poorly differentiated areas as well as mucopapillary and signet ring type adenocarcinomas. There was no particular relation with stage of tumor spread/depth of tumor invasion. CerbB-2 was significantly overexpressed in gall bladder and colorectal adenocarcinomas. Expression was higher in tumors of advanced stage and greater depth of invasion. There was no significant association with tumor grade or type. In esophageal and small intestine adenocarcinomas, expression was not related to either tumor stage or grade.

The issue regarding a composite of accurate data for Recipients of Aid of National Health Insurance often gets the spotlight. The process of implementing data collection of these beneficiaries is still considered to be lacking maximum, that many citizens in Indonesia still have not received their social security rights fairly and transparently. In this study the juridical basis used were Law Number 40 of 2014 concerning to SJSN, Government Regulation Number 101 of 2012 concerning to Contribution Beneficiary (PBI), Presidential Regulation Number 12 of 2013 concerning to Health Insurance and JKN Roadmap and Decree of the Minister of Social Affairs Number 146/HUK/2013 concerning to the determination of criteria for the poor. This research aimed to describe and analyze the implementation of PBI-JKN data verification and validation. And to identify the cause of low accuracy of the data generated in the implementation of PBI-JKN data verification and validation. The research method used qualitative methods with descriptive data, and the data collection techniques were in-depth interviews, observations and documents. The technique of determining informants used a purposive method and in its development the snowball method was used to get more information accurate. Data analysis methods include data reduction, data presentation and conclusion/verification. The conclusion of this study showed as follows; First, the implementation of PBI-JKN data verification and validation were not running optimally. Second, the issue of the availability of Human Resources, verification and socialization data validation was still lacking, and budget support was not proportional. Third, there were elements of political or sector ego among executors. Fourth, there was still a lacking timeliness of implementers in giving the latest data with various kinds of problems in the field.

The aim of this study is to analyze the child social welfare program in Bondowoso with the highest number of beneficiary children in East Java, Indonesia in 2017. The informants of this study were the implementers of the child social welfare program in Bondowoso. The results of the study are some of the goals of the child social welfare program that can be achieved. Sources for the implementation of the child welfare program in Bondowoso are still fully utilized from the Ministry of Social Affairs through the East Java Provincial Social Office. Communication established between program implementers is running well and effectively. Characteristics of implementing agency which include the Social Office, Social worker from the Ministry of Social Affairs and child social welfare institutions in Bondowoso are still not qualified in quantity and quality. The economic, social and political conditions in Bondowoso have had an impact on child neglect.The tendency of the implementing agent to accept the program goals. Further studies are needed with a longer time span and wider location to test the findings in this study.

The objective of this study was to explore the relationship between vocabulary learning strategies and academic achievement. To this end, fifteen fast and fifteen slow learners were selected purposively based on their performance in exams. A close-ended questionnaire was designed to gather data on their vocabulary learning strategies. Interviews were also conducted for triangulation. T-test and frequency statistics were used to analyze the data. Based on the data, it was found out that there was no significant difference between fast and slow learners in their vocabulary learning strategies. Only slight differences were observed in frequency use of the strategies; fast learners tend to use vocabulary learning strategies than slow learners. In planning and memory strategies both groups used the strategies similarly. Based on these findings, it was concluded that even though the difference between the two groups was statistically non-significant, there existed slight changes in adopting some vocabulary learning strategies. Thus, the slow learners are recommended to practices strategies used by fast learners and consider themselves as a student who can successfully learn new words.

Buccal exostosis is Begin, smooth, broad-based bony growth on the facial aspect of maxilla or mandible. The etiology has been studied but no consensus has been reached so far. A 55-year-old female reported with the complaint of swelling in the lower anterior region. Patients prime concern was esthetics and the eitology was unclear, the bony enlargement was treated with resective osseous surgery. This article presents a case report of mandibular buccal exostosis and its management. Subject Area: Periodontology

In this essay we will present the ethnomathematics of the Bedouin society in the south of Israel, and in particular the ethnomathematics manifested in the folkloric embroidery of Bedouin women. The purpose of this essay is to show how Bedouin women knew mathematics intuitively and used unique cultural values and elements in their daily lives, which contain and reflect a variety of didactical mathematical aspects, concepts, and attributes. In this essay we will show how Bedouin women knew mathematics through their embroidery work. The data presented in this essay is based on research we conducted among the Bedouin population and particularly with Bedouin women, with the aim of searching for and collecting ethnomathematics knowledge in Bedouin society. This goal was derived from our need to experiment with the ethnomathematical approach in math instruction in order to make the subject easier and more accessible to our students, and to increase their desire to study it. In the future, at a more advanced stage, we intend to integrate it in the curriculum.

Introduction: Life style diseases have been recognized as a clear threat not only to human health, but also to the development and economic growth in many countries. The number of individuals suffering from these diseases has been a steady rise. Chronic diseases of lifestyle are a group of diseases that share risk factors such as unhealthy dietary choices, smoking, lack of physical exercise, sedentary behavior and life-stress. Background of the study: The impact of non communicable diseases on the lives of the people is serious in terms of economic loss of country, loss of life and loss of potentially productive years of life, disability, family hardship and poverty. Objectives: The main objective of the study was to assess the prevalence and influencing factors of lifestyle diseases among middle aged(30-55yrs) among patients in General Ward. Hypothesis: 1,There is no significant relationship between gender and lifestyle diseases.2,Stress in lifestyle diseases.3,Family history and lifestyle diseases. Materials and methods: A cross sectional study was conducted on 87 patients in District Hospital, Thodupuzha. Census method was adopted for selection of sample. Chi-square test and frequency distribution tables were used for the analysis and interpretation. Results and discussion: Males are more victims for the lifestyle diseases than the females in the sample study. Among the sample ,76 patients is having Lifestyle diseases , from the study it is clear that 47.61% of sample population is having the habit of alcoholism and smoking ,majority of patients in the sample population is having hyperlipidemia ,hypertension ,diabetics, joint pains etc . Statistical analysis shows that there is a significant relationship between gender and Lifestyle diseases, stress and lifestyle diseases and family history and lifestyle diseases. Conclusion: The study were conducted to assess the Lifestyle diseases among all patients in a district hospital .Modern life style patterns affects our health in different aspects like physically ,psychologically ,and socially. A healthy lifestyle must be adopted to combat these diseases with proper balanced diet, physical activity, and giving due with respect to a biological clock. Healthy diet, regular sleep, daily activity, and a moderate approach to life’s stressful moments will all lead in the right direction to a healthy lifestyle.

The objective of this study The main objective of this study was assessing teachers’ and students’ attitudes towards pronunciation teaching and learning strategies and their implementation in Halale Secondary and Preparatory School focusing on grade ten. To this end, descriptive research design was used. To collect data, questionnaire, interview, classroom observations and textbook analysis were utilized .The data were collected from 243 participants (240 students and 3 teachers). The students were selected using simple random sampling technique while their teachers were selected using available sampling technique. The data collected from the participants using the aforementioned instruments were analyzed quantitatively and qualitatively. The analysis revealed that both teachers and students have positive attitude towards pronunciation teaching and learning. Regarding the implementation, the majority of the teachers did not focus on supra-segmental aspects of pronunciation teaching. The textbook also does not give emphasize to the supra-segmental aspects of pronunciation. Thus, it was concluded that teachers and students have positive attitude for the structural oriented of teaching and learning and the approach of grade 10 English textbook is structural or bottom up and less communicative to help students and teachers who have limited knowledge of the communicative approach of teaching and learning pronunciation. Consequently, it was recommended that the English language textbook of grade ten should address the needs of students on intelligible pronunciation by providing the necessary support on how pronunciation functions in language use through a greater focus on supra-segmental aspects of connected speech that have greater communicative function. This can gear teachers to focus on supra-segmental aspects of pronunciation teaching.

Background: As a matter of public health importance, food safety and hygienic practices employed in this food marketing sector, restaurants and hotels would play an important function in ensuring that safe food is available for consumption. Safe foods ensure minimal risks and hazards to human health through protecting and preventing edible substances from becoming hazardous in the presence of chemical, physical and biological contaminants that deteriorate or spoil the food. Contaminated food represents one of the greatest health risks in a population and a leading cause of disease outbreaks and transmission. Materials and Method: Census method was used for the study. The sample population study of the hygienic practice among the workers in restaurants in municipal area Guruvayoor. One hundred samples were taken from the selected population in the 43 restaurants Results: From the population it is clear that majority of workers are doing regular health check up. From the sample population it is clear that all of restaurant workers ware in the clean cloth. From the sample population it is clear that majority of workers regular cutting the nails. From the sample population it is clear that majority of workers are washing the hands before and after going toilets. From the sample population it is clear that majority of workers carrying non communicable diseases in the restaurant. Conclusion: Health education plays an important role in the community hygiene. To prevent illness and have positive health attitude, correct and complete knowledge of health is necessary. Health is cleanliness and cleanliness is one of the main defences against diseases, whether contagious or self-generated.

Background: Tuberculosis cases are increasing day by day. National TB treatment guidelines strongly recommend using a patient-centred case management approach - including directly observed therapy (“DOT”) - when treating persons with active TB disease. The study conducted at Taluk hospital Perumbavoor. The study will add knowledge on understanding the knowledge level of patients regarding DOTs therapy. Need and significance of Study: The study helps to understand tuberculosis patients regarding importance of treatment and follow up. Materials and Method: Cross- sectional study was conducted. Census method was used for the study. Population of the study is the patients coming under TB unit of hospital. Sample - The sample of the study is the 58 patients came for treatment in government Taluk hospital Perumbavoor, Ernakulam District. 16 questions have been used for the study. For those questions, scoring was done. Patients who answered YES, 3 score was given. For the question patients who answered NO, 1 score was given. Hypotheses- There is no significant relation between patients’ education and knowledge about DOTs therapy. Result: Majority of the people have poor knowledge regarding DOTs therapy. Males are more affected with tuberculosis. Patients with above sslc qualification have more knowledge regarding tuberculosis and its treatment strategy and have good knowledge regarding DOTs therapy. Most of them know that treatment is free of cost. Therefore, there is a significant relationship between patients’ education and knowledge level. Conclusion: The authorities should have to give more importance for patient education regarding DOTs therapy and its important.

Marine actinomycetes are known to be rich sources of new bio active compounds. However, only a very small proportion of microbial organisms living in this environment have been isolated and even fewer successfully grown in the laboratory. To facilitate this avenue of research, there is a need for new methods to collect, isolate and identify marine microorganisms as well as new source for the isolation. The demand for new antibiotics continues to grow due to the rapid emerging of multiple antibiotic resistant pathogens causing life threatening disease cancer. Marine soil sample from different depths at two different sites were collected and all the samples were subjected for the analysis of the actinomycetes diversity. Actinomycetes were counted in five different soil depths, at two different sites of east cost. The actinomycetes counts were found maximum in the soil sample of luxuriant site than that in degrading site. The reason can be attributed to the level of nutrients available in the different marine ecosytem. Marine region is goldmine of biodiversity has been amply justified by richness of floral and faunal diversity and now also microbial diversity. This project investigation has established the rich antifungal actinomycetes diversity and promising bioactive potential of the actinomycetes isolate MNG3 of Rameswaram costal region. This study revealed that costal region of Rameswaram is a potential source for wide spectrum of antimicrobial and anticancer metabolite producing actinomycetes. Findings of the present study conclude that marine environment actinobacteria are the potential ecosystem for antagonistic actinobacteria which deserves for bioprospecting. Isolation of actinomycetes from marine sediment of Rameswaram is successfully achived. In vitro screening of the actinomycete strains for antimicrobial activity with special emphasis on anticancer activity shows positive results .and one of the most promising potential isolate was selected and with anticancer activity is completed and Characterization of the isolate by physico chmical property is also completed followed by International streptomyces project