June 2020

Background: During initial months of 2015 an epidemic of novel Influenza A (H1N1) virus emerged in the western part of India especially in Ahmedabad, Gujarat and parts of Rajasthan. A similar surge in influenza cases were again noticed during the initial months of 2019. We are describing the clinical characteristics and mortality indicators of hospitalised cancer patients in our institute. Methods: We reviewed the case records retrospectively, of our patients who were hospitalized during the 2015 epidemic period and during the initial months of 2019. Patients with cancer and a microbiologically confirmed diagnosis of Seasonal Influenza A (H1N1) were evaluated. The demography, clinical parameters, laboratory reports and outcome data were collected, analyzed and presented here. A total of 24 and 22 hospitalized cancer patients, during 2015 and 2019 respectively, with confirmed H1N1 Influenza infection were studied. One patient was infected twice during the 2019 season. None of our patients were previously immunised with influenza vaccine. In the year 2015 out of the 24 patients 17(70.8%) were male and 7 (29.2%) were females, and that in 2019 12 (54.5%) were male and 10 (45.5%) were female. Haematological malignancies were present in 19 (79.2%) during 2015 epidemic, and in 19 (86.4%) patients in 2019. Number of patients with solid malignancies were 5 (20.8%) and 3 (13.6%) in 2015 and 2019 respectively. During both the episodes pneumonia was the most common manifestation in the hospitalized patients, bilateral being more common than a unilateral presentation. Oseltamavir was started within 48 hours of suspicion of influenza in 17 (58.3%) patients in the previous epidemic of 2015, and in 9 (39.2%) patients in the current year of 2019. Co-morbidities were present in 6(25%) and 6 (27.3%) patients in the two episodes respectively. Associated infections were present in 8 (33.33%) and 5 (21.7%) patients. Absolute lymphocyte count of less than or equal to 1000/microL was observed in 14 (58.3%) and 15 (65.2%) patients in 2015 and 2019 respectively. Altered biochemical parameters in the form of deranged LFT was found in 9 (37.5%) and altered RFT in 5 (20.8%) in the cohort of 2015, and the same were found in 5 (21.8%) and 4 (17.4%) patients observed during the 2019 study period. During the 2015 study, 13 (54.2%) and during 2019, 17 (74%) patients required intensive care. The overall hospital mortality in our cohort was 8 (33%) patients in 2015 and it increased to 15 (65.2%) patients in 2019. Adverse outcome in the patients was closely related to factors like presentation in the form of bilateral pneumonia, development of ARDS, time of commencement of oseltamavir (neuraminidase inhibitor), associated co-morbidities and infections, underlying malignancy and ongoing chemotherapy, absolute lymphocyte count of less than 1000 and multi organ failure. Presence of hypoxemia, bilateral pneumonia, and CURB 65 score more than equal to 3, timing of starting Neuraminidase inhibitors beyond 48 hours of presentation and lymphopenia were predictors of requirement of mechanical ventilation and death. Conclusion: Seasonal Influenza A infection in patients with cancer can cause severe illness, resulting in bilateral pneumonia, ARDS and death. Hypoxemia, bilateral pneumonia, CURB 65 score of more than equal to 3, timing of starting Neuraminidase inhibitors following symptoms, and lymphopenia were predictors of adverse outcome. Cancer patients are prone to develop more severe disease and require longer course of therapy with Neuraminidase inhibitors than the general population. Therefore, a larger study is needed to identify predictors for early suspicion and unfavourable evolution of influenza infection in these patients.

Acute appendicitis is the common cause of surgery for acute abdominal pain in children. The diagnosis of acute appendicitis in pediatric patients remains a challenge internationally. This disease is most common among patients between the age of 10 and 19 years old. The aim of the study was to evaluate whether neutrophil-lymphocyte ratio (NLR) and ultrasound (US) results on admission could aid the diagnostic accuracy of the Pediatric Appendicitis Score (PAS) in pediatric patients with suspected acute appendicitis. Our study was performed on 480 children admitted for suspected acute appendicitis and underwent appendectomy at the MCHHC, Ulaanbaatar Mongolia, between May 2019 and December 2019. Patients were categorized into three groups based on the value of their PAS. The diagnosis of appendicitis was confirmed postoperatively with a histological study. Negative (NPV) and positive predictive values (PPV) of PAS, NLR and ultrasound were calculated. In the diagnosis of acute appendicitis in pediatric patients, the NLR and ultrasound methods are equivalent in terms of diagnostic accuracy. In children with a PAS value of 4 and 5, it more effective to use a combination of ultrasound and NLR to diagnose accurately.

Lasers were introduced into the field of dentistry as they are a precise and effective way to perform many dental procedures. Treatment with lasers provides a hope of overcoming the disadvantages of conventional dental procedure, the purpose of this article is to describe three cases illustrating the application of Diode laser on soft tissue as gingival recontouring, lingual frenectomy and disengagement of healing abutment.

Introduction: A balanced or equilibrium condition of Dosha, Dhatu , Mala, agniandhappy state of Atma, indrya, and Mana constitutes Swastha purusha . In this context Dhatu is an essential constituent of the body. In the course of Saptadhatus, Meda dhatu is the fourth dahtu of the body which is in semisolid form and lies in the free space of the muscle tissue, below the skin or a subcutaneous fat. As the saar is used to evaluate the status of the dhatu and satva in the body, the vishuddhameda dhatu expresses itself with certain characters in an individual. On the other side Sthaulya is the disorder of improper Meda dhatu metabolism. Objectives: This research is an attempt to assess the Medasaar purusha along with the Sthaulys purusha by the cardinal symptoms given in Samhita. Objective parameters and Anthropometric measurements to clear the doubts and confusion regarding the two states of Meda dhatu is done to form a standard criteria to establish the two healthy and diseased conditions of Meda dhatu. Method: The study was conducted on a sample of 60 individuals divided inti two groups on the basis of BMI. For this purpose, the study was conducted after careful clinical history, examination and laboratory investigations as per proforma, volunteers were selected and screened for their suitability of getting enrolled as per specific inclusion and exclusion criteria. Results: In between Medasaar and Sthaulya purusha study various differences were found in the normal and diseased condition. There is significant difference in Anthropometric measurements, body fat percentage, visceral fat as well as muscle fat percentage. Conclusion: The results found were highly significant and further studies can be performed taking a large sample size so that more accurate results can be seen to prove the hypothesis and giving a standard criterion in understanding of Medasaarnd Sthaulya.

The term Pandemic has been used to describe the global spread of an infectious disease across multiple countries and involving multiple continents. Such an international health crisis may prove catastrophic for nations worldwide in terms of overburdening the healthcare system as well as causing economic stagnation. Halting & controlling the spread of a worldwide disease outbreak requires time bound strategic interventions from the authorities at National, sub national and international levels along with joint cooperative efforts from private and public sectors. Majority of pandemics arise from cross species transmission of pathogens, wherein the microorganism mutates or transforms itself to jump from animals to humans and then disease spreads via human to human transmission at an accelerated rate. The current paper outlines the history of major pandemic outbreaks starting from the Antonine Plague of 165 – 180 AD to the current COVID – 19 pandemic.

The Corona Virus Disease 2019 (COVID-19) is a disease caused by a previously unidentified strain of corona virus family which emerged in Wuhan, Hubei, China in December 2019. Since then the outbreak has transformed rapidly into an extensive global crisis, overburdening the healthcare systems worldwide as well as creating economic instability. Prime mode of transmission in humans include droplet or contact transmission. Healthcare professionals are the frontline warriors who are working tirelessly in order to manage the ever increasing number of patients with each passing day. Such a pandemic is bound to have a lasting impact on the mental and physical health of Doctors and paramedical staff for a long time. This paper is an attempt by the authors to examine and understand the perspective of Medical Professionals related to the obstacles they may be facing in these challenging times from the government and the public in general patients

Dental fluorosis is one of the most common colour disorders which results in discoloured teeth, with white or brown spots. The aspect may be different depending on the severity of the fluorosis and the degree of the damage of the enamel and dentine. This article describes different approaches to treat a dental fluorosis. It is suggested that mild-to-moderate fluorosis be treated by microabrasion and bleaching, while severe fluorosis, with loss of some surface enamel, is managed by veneering and crowning. This option allows us to totally remake the patient’sunpleasant smile.

Aims: The main aim is to determine the optimal orientation of retention rates and then determine reinsurance shares for the various insurance branches in the Saudi insurance market by building statistical modelling with model parameters by which risk factors can be monitored according to the insurance branch, as well as forecasting growth or possible contraction in retention rates by Insurance branch in the Saudi insurance market. Place and Duration of Study: Retention rates by insurance activity in the Saudi insurance market for the year 2018 and up. Methodology: Weibull Generalized Exponential distribution parameters based on censored samples have been discussed by using Maximum Likelihood, Bayesian Estimation based on the Markov Chain Monte Carlo method. Results: An increase in the risk factors for instability in the retention rates with the most extreme values, whether the rate is more extreme, increased, or decreased. Represented in branches; Health insurance, Energy insurance, Vehicle insurance, Protection and savings, an increase in the rate of retention for branches; Energy insurance and Aviation insurance, insurance branches whose retention rate is expected to decrease are Health insurance followed by Vehicle insurance, Bayesian Estimation is better and more efficient than the MLE and MPS estimation. Conclusion: In approximately most of the situations, we notice that the measures of Bayesian estimates are preferable than the measures of MLE estimates. As the data of retention limits by activity in the Saudi insurance market are fitting to the model and how the schemes work in practice, effectiveness in determining retention limits “Reinsurance” ensures balanced financial performance and stable profitability level

In India, Ashwagandha (Withania somnifera Dunal) is a popular medicinal plant since time immemorial. Ashwagandha contains various alkaloids, steroidal lactones and saponins, and has been used for its supposed antistress, antitumor, anti-inflammatory and antiarthritic properties. This review reveals the important phyto-chemicals, various health benefits of Ashwagandha and its cultivation practices.

Country of Origin (COO) can be defined as the total of all descriptive, inferential, and informational beliefs buyers shape about a country versus others. In the marketing literature, the COO effect is known to determine the activation of associations (positive or negative) in the consumer’s mind, which then affect the consumer’s propensity to buy (or not buy) products from that specific COO. The COO effect is exercised primarily through the country’s image. Accordingly, this research will examine the COOI impact on the evaluation stage of mature Egyptian buyers for a new car, and how the COVID-19 pandemic will affect this relationship. The research will apply qualitative research through a focus group of 61 Egyptians in Cairo and Alexandria. The results show that there is a strong relationship between the quality of passenger cars and (Stability Economy as well as Governmental Management);moreover, there is aweak relationship with (Social Discipline as well as Political Response.

Sheep and goat are the important component of the changthang nomade in respect to their rural economy and livelihood particularly changthang a semi-arid and mountain area of Himalaya in ladakh territory where climate is too harsh temperature -30 degree in winter and 30 degree in summer. Due to harsh winter season and lack of proper shelter cause death of 1090 kids/adult sheep and goat which is 23.81% of total mortality from different sources, which consist (62.9%) i.e. 2879 Lamb/kids and (37.09%) i.e. 1698 adult sheep and goat. By considering all this figure there is need to be improvement in to the shelter system so that mitigate some sort of economic loss, since sheep/goat do not need much expensive building to house and a very less number of man power is required to handle it. The shelter is not confined to sheep/goat kept but it have some alternative use in the summer season too, almost 100% household respond that yes there is alternative use of lambing shed, (93.3%) i.e. 56 household out of total 60 household use it for green house purpose, (3.3%) i.e. 2 household use it for Kitchen garden and rest (3.3%) used it for storage purpose.

The purpose of the study was to assess the solid waste management practices in Jos Metropolis of Plateau State, Nigeria. To achieve the purpose of this study, five research questions were formulated A Cross-sectional research design was utilized for the study. The population of the study consisted of all households and commercial centres in Jos Metropolis. The sample size population for the study comprised one hundred and fifty (150) respondents gotten through purposive sampling technique. The instrument used for data collection was questionnaire. Descriptive statistic of frequency counts and percentages were used to analyze the data collected for the study. The findings of the study revealed the types of solid waste generated in Jos Metropolis similar to solid waste in any developing nation of the world. The findings also showed solid waste management practices, materials used for solid waste storage, transportation and methods of disposal as well as the Roles Played by Government Agencies in Solid Waste Management and private sectors. The study recommended among others that public private partnership should be encouraged in the management of solid waste in the State

In this paper, we reveal a (3+1)-dimensional nonlinear evolution equation to determine interaction between lump waves and kink soliton. In this regard, we cast the model into it Hirota bilinear form firstly. We offer periodic lump wave through a test function in-terms of exponential and periodic cosine functions. We also consider test function as a combination of a general quadratic polynomial with exponential function to reveal interaction of lump wave and kink soliton. Finally, the interactions of solitary waves and lump waves are presented with an entire analytic derivation. Some graphs are incorporated to visualize the dynamics of the obtained wave solutions.

Cleome viscosa L. is a plant widely used to treat various diseases and grows on degraded or marginal agricultural lands. This study is aimed to investigate the phytochemical screening and anti-radical activity of Cleome viscosa.An ethnobotanical survey was conducted. Alkaloids were checked using BOUCHARDAT reagent and flavonoids were detected using SHINODA reagent. The 1,1-Diphenyl-2-Pycril Hydrazil (DPPH) free radical scavenging and the Ferric-Reducing Antioxidant Power (FRAP) assays were used to highlight the antioxidant activities. The ethnobotanical investigations conducted show that women (57%) uses more Cleome viscosa than men (47%) to fight diseases. Phytochemical screening revealed that Cleome viscosa contains alkaloids, flavonoids, saponins and tannins.The DPPH free radical value is 16.18± 0.024 mg of quercetin per gram of plant material and the FRAP value is 986.88± 0.012 μmol/L equivalent in Fe2+ per gram of plant material. Our result shows that Cleome viscosa possesses phytochemical compounds and anti-radical activity.

Background: Preeclampsia is a multisystem disorder of pregnancy hypothesized to be due to endothelial cell dysfunction that increases the maternal and fetal morbidity and mortality. Although intensive research has been done, the etiopathogenesis of preeclampsia (PE) remains uncertain. Inflammatory cytokines are thought to be involved in the pathogenesis of preeclampsia.Preeclampsia occurs in two stages. In the first stage there is reduced placental perfusion because of abnormal implantation and development of the placental vasculature. In the second stage there is widespread inflammation resulting in maternal endothelial cell dysfunction. TNF alpha is an inflammatory cytokine expressed by neutrophils, monocytes and macrophages. Material and methods: The present study isa non-randomized prospective case control study comparing the serum levels of TNF alpha in thirty preeclamptic and thirty normotensive pregnant women during third trimester of pregnancy. Preeclamptic women were divided according to severity (BP and level of proteinuria) into mild (n=15) and severe (n=15). TNF alpha estimation was done by ELISA. Results: TNF alpha levels were significantly higher in preeclamptic women compared to normotensive pregnant women (p=0.001). Serum TNF alpha levels were higher in severe preeclampsia than mild preeclampsia (p=0.043). These results suggest that normal pregnancy is a state of mild inflammation which becomes exaggerated in preeclampsia. Conclusion: The levels of TNF alpha are related with severity of preeclampsia. TNF alpha can be used as a predictive marker for preeclampsia.

Globally, stakeholders in learning institutions have strived to improve schools’ physical environments in an attempt to enhance learning outcomes. It is not known whether the physical environment in public secondary schools in Nairobi County have been mainstreamed to positively influence learning outcomes. The objective of the study was to explore the quality of the physical environment in public secondary schools in Nairobi City County, Kenya The study applied a case study design. A sample size of 39 was proportionally allocated by gender and geopolitical location resulting in 9 boys’, 12 girls’ and 18 mixed schools. A revised Commonwealth Association of Physical Environment questionnaire was used to collect data. The overall average quality of mixed schools’ index (126) was lower than that of boys’ and girls’ schools (134 for both). A framework of funding improvement of school facilities including the building stock and associated infrastructure is proposed.

Chloroquine and Hydroxychloroquine have been in use for more than 75 years with a satisfactory safety profile, for malaria and autoimmune disorders. They have been repositioned for the prophylaxis or treatment of emerging viral disorders like SARS Co-V, MERS and now in SARS-CoV2, which ,in a few months, has caused havoc globally. Drugs used in earlier epidemics are being tried again and HCQ is in the forefront for its anti-viral and immune modulatory properties. It has shown good results in vitro and few observational studies, but there are objections that it has not been proved in randomised control trials, which was difficult in the initial pandemonium .However, more than 150 trials have now been registered and the picture will be clearer. HCQ has stood the test of the controversies and must be the most trending molecule currently-whether the fanfare from the President of America or it’s temporary suspension and re-inclusion in the WHO Solidarity trial! The apex body of India, ICMR, has stood by it through thick and thin and has expanded its advisory for the prophylactic use of HCQ in SARS-CoV2.It has also started a trial for evaluating its use in prophylaxis. Most of the reports so far are related to its therapeutic utility, but the doses used globally are variable. This article reviews the profile of HCQ and its status in preventing infection or severity of SARS-CoV2 and focuses on its prophylactic role.

Introduction: The precise identification of skeletal maturity with regard to the onset of the pubertal growth spurt has major clinical implications in treatment efficacy and efficiency. Different methods in an attempt to determine the best indicator of maturity have been evaluated. But still researches are being done to assess the maturity of an individual in relation to chronological age. Aims and objectives: To evaluate the correlation of maxillary sinus area and frontal sinus area as growth indicator with chronological age to assess the maturity of an individual in Himachali Population. Material and Methods: 150 lateral cephalograms of subjects were divided into three groups of 50 each based on chronological age and each group was further subdivided into 2 subgroups of 25 males and 25 females: group I (8-10) years of age), group II(10-12)years of age and group III( 12-14)years of age and measurements were recorded ; the chronological age was correlated with the area of maxillary sinus and frontal sinus using SPSS software. Conclusion: maxillary sinus was found to be highly correlated with the chronological age.

Probiotics are a valuable adjunct for the prevention of oral diseases. These are dietary supplements containing potentially beneficial bacteria or yeast. Probiotics have come to play a vital role in the shift of paradigm of treatment from the age old practice of specific bacteria elimination, to alteration of bacterial ecology. Aim: The aim of the study is to assess the awareness, knowledge and attitude about probiotics among pediatric dentists in Chennai. Material and Methods: This study recruited pediatric dentists (n=51) in Chennai city. The subjects completed a questionnaire that aimed to assess the awareness, knowledge and attitude about probiotics through online survey. The collected data were summarized in the MS Excel and subjected to statistical evaluation using SPSS. Results: 88.2% of the pediatric dentists were aware of the use of probiotic in dentistry while 58.8% willing to prescribe it to their patients in that 20.8% will do to reduce the incidence of dental caries. Commonly prescribed probiotics formulation was 41.2% milk products and least was 3.9% drops. 80.4% were not aware about probiotic side effects. Conclusion: Therefore, this study revealed awareness about probiotics among pediatric dentists was moderate. Though beneficial, lack of adequate knowledge regarding probiotics limited its usage among pediatric dentists in Chennai.

The most prevalent impacted teeth are the mandibular third molars, maxillary canines, mandibular second premolars, and maxillary central incisors. Maxillary canines are the 2nd most commonly impacted teeth encountered during orthodontic treatment. Studies by Johnston WD have shown that about two-thirds of maxillary canines are impacted on palatal side, one third are impacted labial side.(1) during the ages of 11 and 12 years permanent maxillary canine usually erupts into the oral cavity; but approximately 1-3% of the population has missing one or both the cuspids.(2) The incidence of impacted canine has been reported between 0.92% to 1.7% in the literature review .Dachi and Howell reported an incidence of 0.92%, Ericson and Kurol also reported an incidence of 1.7%,commonly seen in females (1.17%) than in men (0.51%) with a ratio of 2:1.4 .Bilateral impaction is rare seen in approx 8% of people with maxillary impacted cuspids.(3,4,5) Yamaoka et al, suggested that there was no difference in the incidence of completely impacted canines in the edentulous as compared with the maxillary arch having teeth.(6) Dewel concluded that the maxillary canines have not only the longest duration of evolution, but also the longest and perhaps most tortuous route to migrate from their point of origin, lateral to the piriform fossa, before they reach the point in full-occlusion .developmental point of view the crowns of the permanent canines is in close contact with the roots of the lateral incisors.(7) The management of a impacted cuspid commonly comprises of a surgical procedure to enable the tooth to be aligned via orthodontics. Two techniques of surgical exposure are given: An ‘Open’ exposure, which involves raising a mucoperiosteal flap, followed by removal of bone and mucosa overlying the tooth and placement of a surgical pack. The cuspid is subsequently aligned above the mucosa by orthodontics. shorter treatment time, and improved hygiene during treatment ,minimal effects on the periodontium are one of the advantages of open exposure. A ‘Closed’ exposure, comprises of raising a mucoperiosteal flap, limited removal of bone and instead of excision of the overlying mucosa, an attachment is bonded to the crown of the exposed cuspid, enabling proper alignment of the tooth from below the mucosa (2,8)

Aim: The aim of the study is to compare and assess the knowledge, attitudes and practices of government and private primary school teachers towards oral hygiene and preventive dental health care, in Mogappair, Chennai. Materials and Methods: Government primary school teachers (n=21) and private primary school teachers (n=31) were recruited in this study. The subjects completed a questionnaire that aimed to evaluate teacher’s knowledge, attitudes and practices on oral hygiene and preventive dental health care. Results: The overall awareness among teachers regarding oral hygiene and preventive oral healthcare was less, and has to be increased. Private primary school teachers were better informed and correctly answered most of the questions in the questionnaire, when compared to government primary school teachers, thus proving that they have comparatively more awareness regarding oral hygiene and preventive oral healthcare than government school teachers in Mogappair, Chennai.

Fixation is the critical step in the preparation of tissues for routine histopathology in which Formalin is the universal fixative. The fundamental advantage stems from its continuous and almost universal use for over 100 years and all the accumulated scientific knowledge on it. Also, formalin is readily available, economical, fairly convenient to store, allows long-term storage, preserves lipids well, and has been accepted the perfect fixative, with no clear “all purpose” alternative found to date. However, formalin has well known disadvantages like high toxicity and classified as a human carcinogen. It binds severely to DNA, RNA and proteins, which makes them difficult or impossible to extract in a useful form for molecular tests. However we explored more economical, eco-friendly and readily available substances like sugar, honey and jaggery which have shown to have the potential to preserve compounds without any harmful effects. They are advantageous in that they are non- hazardous, compatible with routine processing, staining, do not require additional equipments and are easily available at any place. Hence the present study is undertaken with an aim to compare the tissue fixation abilities of honey, sugar syrup and jaggery syrup with that of formalin followed by H & E staining in order to determine the best fixative.

Recently, the research focus is shifting towards replacing classic surfactants with colloidal particles in stabilizing emulsions. This review gives an overview of utility of metallic nanoparticles as emulsion stabilizers. The emphasis is on the use of metallic nanoparticle stabilized Pickering emulsions as carriers for antibiotics. It’s an established fact that metallic nanoparticles possess antimicrobial properties themselves and can be a good choice for formulating drug delivery systems. Additionally, they have a capability to evade drug resistance mechanisms in bacteria. Metals like gold, silver, copper, iron, manganese etc are used extensively. So, combining plant based antimicrobials and a metallic nanoparticle into one drug delivery system, with an add-on of the recommended antibiotic seems a promising possibility.

COVID-19 has affected human life completely and obviously the education sector is also not untouched from it, in this situation this article is bringing the picture of present days’ classrooms which are running on a virtual mode i.e. as online mode and how this online mode of education has changed the practices of teaching, learning and evaluation. The review of situations is describing and presenting the scenario of today’s classrooms, which has come into practice after the lockdown implemented for maintaining social distance as a prevention measure from corona affect. The present situation has emerged up as a challenge in education sector not only for the students but for teachers also, that how to continue teaching as well as learning in realistic and fruitful manner. Where teachers are dealing with the good teaching-learning and evaluation practices for the students, simultaneously students are also facing challenges with their real learning situation. Because the traditional mode has been completely closed during and after the lockdown, in this mode students were habitual to direct interaction with their teachers regarding educational matters and whereas nowadays students' community is completely dependent on the online mode. The study has concluded with the drawbacks as well as some positive sides of this online education mode during lockdown period especially in respect to the education and teaching-learning process.

Background: Colorectal cancer (CRC) is the third most common epithelial malignancy in the world. Colorectal cancer develops slowly from removable precancerous lesions, detection of lesion can reduce the incidence and mortality of this malignancy. Hence the present study was under taken to relate the TIMP-1 and MIF protein analysis that are non- invasive, which may enable us to detect colorectal cancer quite early. Study design: Case control study. Aims and objectives: The present study included total 120 patients diagnosed with colorectal cancer. They categorized as- Group I – included 10 patients with disease dissemination (stage I-IV with recurrences); Group II – 110 patients with non dissemination (stage I-IV without recurrences) and Group III – 120 age and sex matched healthy controls. To rule out the risk of colorectal cancer CEA, Ca 19-9 and fecal hemoglobin were analyzed. Genetic and prognostic markers like, TIMP-1 and MIF protein were analyzed. All statistical analysis was performed by using SPSS software and expressed as mean ± standard deviation, p˂0.005 was considered as statistically significant. Correlations between the parameters were analyzed. Results: The concentration of CEA, Ca19-9, TIMP-1, MIF protein, level were significantly higher in patient group then in controls group (p˂0.005). A significant correlation between CEA and CA19-9, TIMP-1 and MIF were observed. Conclusions: In this study the level of TIMP-1 and MIF expression exhibits an upper moderate diagnostic value in CRC, and this result could offer new approaches in the diagnosis, prognosis and monitoring risk factors in colorectal cancer.

One of the keys to successful root canal therapy is adequate obturation of the prepared root canal space. Three dimensional obturation provides hermetic seal to prevent ingress of bacteria and their toxins into the periapical tissues and when this is not achieved by an orthograde approach, then a root end filling technique is used. The purpose of a root-end filling is to establish a seal between the root canal space and the periapical tissues. A number of materials have been suggested for use as root-end fillings, including gutta-percha, amalgam, Cavit, intermediate restorative material (IRM), super EBA, glass ionomers, composite resins, carboxylate cements, zinc phosphate cements, zinc oxide-eugenol cements and mineral trioxide aggregate (MTA). This article reviews different root end filling materials and compare their biocompatibility, sealing ability and microleakage.

The fast changing financial environment exposes the banks to various types of risk. Effective risk management is critical to any bank for achieving financial soundness. In view of this, aligning risk management to bank’s organisational structure and business awareness has become integral in banking business. Strategic plans and different financial techniques must have implement by the banks to avoid the financial uncertainty. Collecting up to date market information and providing sufficient training to the employees as well as management became a strategic part to every bank. In that process, this study was done in Wolkite towns, in Gurage Region, with the main objective of assessing the risk and implementing training methods for effective risk management practices of Commercial Banks. Accordingly, qualitative and quantitative study methods were employed and a total of seventy two respondents representing different sections of the banks were purposively selected and contacted. In doing so, great efforts were made to applying the bank exposure, financial and managerial skills and knowledge compositions of these respondents. The tools for data gathering were structured open and close ended questions.

India the ambient atmospheric conditions have progressively deteriorated due to urbanization, industrial development, lack of awareness, poor maintenance of motor vehicles, and poor road conditions. Transport vehicles and industrial emissions are the major sources of pollutants in the earth’s atmosphere. Among the various air pollutants from various sources particulate matter, sulfur dioxide, oxides of nitrogen, carbon monoxide are having a significant role in affecting the air quality and thereby causing harm to human health. Hence, these parameters were considered to determine the air quality of India. The objective of this paper is to provide insight details about the current situation of air quality across various cities present in India, along with countless origins and effects of air pollution. An attempt is made to make people aware about various types of gases and particulate matter present in air highlighting their effects on the environment along with the various ways of overcoming this situation during the lockdown COVID19 period, which was started on 22March2020, using the Air Quality Indexis proposed for the seven major cities of India, for simplified public information and data interpretation. The 24-hourly average concentrations of six major criteria pollutants, viz. Particulate matter PM10, PM2.5, Sulfur Dioxide (SO2), and Nitrogen Dioxide (NO2) carbon monoxide and two meteorological parameters, e.g., Humidity and Temperature for the year 2018, 2019, 2010 (January, February, March and April). During the study of the meteorological parameter we observed that, there are no changes in temperature, the humidity level is also not getting any significant changes in the overall cities. Particular Matter (PM10 and PM2.5) both parameters are decreasing overall selected cities, especially in March and April month. Ozone activities are also decreasing as compared with 2018 and 2019 data, during the study of all cities. Nitrogen dioxide levels is decreasing for all cities during these periods. The sulfur dioxide level is decreasing for all cities exceptional Bengaluru city their sulfur dioxide level is very low. The carbon monoxide level is decreasing overall cities during the March and April month.

In India most of the people almost 70% of the total population inhabits in rural villages. Rural development depends on rural infrastructural facilities. Poverty can be elevated from society by improving rural basic infrastructural facilities. Despite several Government initiatives, the development in rural villages in terms of rural basic infrastructure facilities shows unsatisfactory results. The article evaluates rural infrastructure facilities in 125 villages of Tufanganj C.D Blocks of Coochbehar District. The village development index has been prepared on the basis of six basic indicators education, health, transport, communication, access to drinking water and electricity. The result suggests that Government should give more priority for the investments in the rural infrastructure development in terms of health, transport, educational institute, communication and drinking water facility.

Background: Cesarean section is a major abdominal surgery and may entail more discomfort, longer recovery and difficulty returning to normal activity than vaginal delivery. Early mobilization was the most significant nursing intervention for improving post-operative outcomes including enhancing pain relief, promoting wound healing, prevention of deep vein thrombosis, reducing hospital stay, and expediting recovery and return to normal activity. Objective: The current study was undertaken to assess the effectiveness of early ambulation on post-operative recovery among caesarean mothers. Materials and Methods: The research design was quasi-experimental post-test only control group design. Total 80 caesarean mothers were enrolled by simple random sampling technique, 40 in each study and control group. The intervention early ambulation at 6 hours after caesarean section was given for 3 consecutive days to study group whereas control group was ambulated as per routine care. Data were collected one time everyday for 4 consecutive days after given intervention. Post-operative recovery was assessed in both groups by using observation Schedule including wound healing, fundal height and activity of daily living. Pain score was assessed with numeric pain rating scale. Results: The results revealed that there was significant difference between the mean post-operative pain score from POD 0 to POD 3 after ambulation among study and control group as shown by p-value (p=0.001 to p<0.001). On wound healing parameter there was significant difference seen in discharge, redness, swelling at p-value 0.002, 0.029,0.017 respectively except separation as p-value was 0.317. Similarly fundal height had been significantly decreased from POD 1 to POD 3 at p-value (p=0.010 to p=0.001). In activity of daily living highly significant difference were seen from POD 0 to POD 3 at p-value (p<0.001). Statistically no significant association was found of post-operative recovery among caesarean mothers with selected demographic variables and obstetrics characteristics at (p>0.05) level. Conclusions: Therefore the study concluded that early ambulation was effective in postoperative recovery among caesarean mothers.

Knowing about anatomical variations in the terminal branching pattern of popliteal artery is of great clinical importance for the endovascular surgeons while planning for the endovascular interventions and also to minimize the post operative complications as hemorrhage. For the same reason author has notified a case of bilateral presence of trifurcation of popliteal artery in a adult male cadaver and explained embryological basis of the same.

The word 'LASERS' is an acronym for " Light Amplification by stimulated emission of radiation." Since the advent of lasers in the 1960's by Theodore Maiman, lasers have been an important treatment modality in the field of dentistry. It has revolutionized treatments in all fields of dentistry, such as periodontal treatments, dental implants, oral and maxillofacial surgery etc. Several new technologies have been innovated in the field of lasers. The objective of this article is to emphasise the applications of lasers in oral and maxillofacial surgery.

Current situation of Corona Virus in the United State has been proven to be the biggest failure in American history. Past & recent briefings of President Trump on combating corona virus shows the incompetence of the federal government as well as state government. Anyone can see that this COVID-19 is something which cannot be taken lightly as there are no vaccines or immunization present in the laboratory which will lower the number of the spread, but social distancing is just a huge step trying to be enforced around the world to give some time to the health sector, researchers, scientists etc to come up with vaccines and immunizations"