December 2020

Background: Scale development or tool development is an important area of interest in health research. Psychologically validated tools have made it possible to measure various variables which are not amenable for observation to get evaluated. Development and evaluation of the instrument should be carried out with absolute diligence, as the health measures evaluated through them becomes the basis for many health policies and program delivery. However, the novice researchers find it cumbersome to go through the stringent process in developing a tool which results in less efficient tools which are unable to capture the whole construct. Henceforth the current literature review was undertaken to contribute substantial information on tool development to the scientific world at large. Methods: A comprehensive search was conducted across different databases namely PUBMED, INDMED, Scopus, MEDLINE with the following MESH keywords; test construction, scale development, item analysis and instrument validation. Potential full-text articles were retrieved followed by a narrative synthesis of data from various articles. Results: A wide disparity was observed in the steps observed by different authors in the development of the tool. However, the general steps in the development of tool can be summarized as follows; gap identification, conceptualization, choice of the measurement method, development of measures, scale evaluation and refinement and validation. Conclusion: If a clinical or educational practice is to be enhanced or changed using findings derived from questionnaire/scale-based methods, the questionnaire must be sufficiently developed.

Au Sénégal, la tomate compte parmi les légumes les plus consommés et elle est pratiquée en systèmes irrigués. Cependant, malgré son importance, les rendements sont très faibles. La concurrence exercée par les adventices et la non maitrise des pratiques agricoles sont entre autres l’une des contraintes majeures à la production. Cette étude a été réalisée dans le but d’améliorer les rendements par une amélioration des pratiques agricoles. C’est dans cette optique que cette étude a été entreprise dans la forêt classée de Mbao, dans la zone de Niayes en 2020. Les résultats de cette étude montrent qu’une fertilisation avec une densité de plantation à 9 pieds par m2 peut significativement améliorer la croissance et le développement de tomate. Les rendements de tomate en association avec la laitue peuvent connaitre une baisse de plus de 30%. Sur la diversité floristique, les résultats ont montré que les adventices sont diversement réparties durant le cycle cultural de la tomate. La fertilisation augmente la densité des espèces telles que Boerhavia erecta et Dactyloctenium aegyptium

Multi Drug-Resistant Tuberculosis (MDR-TB) is a type of drug resistant TB. It defined as strains of Mycobacterium tuberculosis resistant to at least isoniazid and rifampicin, i.e., the two first-line anti-TB drugs. MDR-TB poses a major threat to public health worldwide, particularly in low-income countries and it represents a major obstacle towards successful TB control programme. The current long (24 months) and arduous treatment regimen uses powerful drugs with side-effects that include mental ill-health. It has a high loss to- follow-up (25%), higher case fatality and lower cure-rates than those with drug sensitive tuberculosis. Global TB strategy aims to end the global TB epidemic, to reduce TB deaths by 95% and to cut new cases by 90% by 2035, hence the management of MDR-TB is much more difficult than drug-susceptible TB. Aim & Objectives: To understand the psychosocial issues faced by MDR-TB patients and their wellbeing through published articles and conference reports to find out the social work intervention methods to strengthen the Programmatic Management of Drug-Resistant Tuberculosis (PMDT). Methods : Based on the pubMed for studies published from January 1995 to November 2018, with the terms: Tuberculosis, MDR TB, and Psychosocial problems / issues/challenges/ wellbeing. A total of 87 published articles were retrieved, of which 53 articles were chosen for full text review and presented in this review. Findings : This review has captured the psychosocial issues and wellbeing of MDR patients. Number of issues for their psycho social and economic issues due to long duration of treatment, high pill burden, drug adverse effects. Psychological disturbances (worries, fear, tension, denial, depression), social problems (disclosure issues, rejection, enacted stigma, perceived stigma, discrimination by family members, community, lack of social support) and economic problems (inability to go for work, work absenteeism, loss of income, borrowings) In addition, challenges they faced during treatment and further to lead normal life. Conclusion : The social workers strive to eliminate discrimination, to reduced Psycho-Social issues and to promote the drug adherence by using the Social Case Work and Group Work method for intervention among MDR TB patients. Social workers engage in direct practice with patients in such roles as counsellor, enabler, case manager, and advocate. It is recommended that the social worker will work as a bridge between TB patients and Health professionals for psychological intervention.

Background: Perceived Organizational support would be influenced by various aspects of an employee’s treatment by the organization and would in turn, influence the employee’s interpretation of organizational motives underlying that treatment. Job satisfaction may get affected when the organizational climate becomes unhealthy at work place. How nurses perceive their organizational support and its impact on their job satisfaction to be explored as it may affects quality of patient care rendered and work life of nurses. Objectives: To assess the relationship between perceived organizational support and job satisfaction among nurses. Methods: A descriptive cross-sectional study was conducted among 40 nurses to assess the relationship between perceived organizational support and job satisfaction among nurses using perceived organizational support scale (POS) and Job Satisfaction survey in India. Results: The perceived organizational support score was 25.7± 3.8 and job satisfaction score was 136 ± 16.3. There was a significant positive co-relation between perceived organizational support and nurses job satisfaction (r = 0.24, p=0.04). Conclusion: Perceived organizational support is significantly associated with job satisfaction among nurses. Health care organizations should focus on strengthening the organizational support for nurses, henceforth the perception on organization could be positive and enhances nurse’s job satisfaction, reduce the intention to quit.

For a conventional caries treatment generally a high speed hand-piece is used to access the lesion and a low-speed hand-piece for the caries removal, this method is considered predominantly an invasive approach. Through this approach, along with the carious tooth structure there is unintentional removal of non-carious tooth structure. Approaches for the management of dental caries have changed dramatically in recent years, evolving from the traditional, largely restorative treatment approach to a preventive approach, non-invasion or minimal invasion1. In order to diminish the amount of destruction of the tooth substance, minimally invasive cavity designs and techniques like air abrasion, atraumatic restorative therapy, chemomechanical caries removal, and lasers have been tried. For a better comprehension on the caries process, the contemporary methods of management must be aimed towards prevention of the disease, managing the caries risk and detecting the carious lesions as early as possible in order to steer clear from invasive treatment, but, when indicated, use the least invasive methods1. Various approaches have been suggested for the non-invasive management of non-cavitated caries lesions, which are also known as initial or early caries lesions. These include the remineralisation of the lesion with fluoride2 and casein phosphopeptide amorphous calcium phosphate3, or the use of therapeutic sealants for occlusal lesions4. Additional to these, a non-invasive alternative treatment was proposed that was based on the experiments conducted by Robinson et al.5 on caries infiltration with resorcinol-formaldehyde resin. The aim of this review was to present the scientific basis, the principles of resin infiltration, resin infiltration technique and to discuss its inherent clinical applications in primary and permanent dentition.

Introduction: Road accidents are one of the major causes of death, injury and disability in all over the world both in developed and developing countries. With a broad estimate, in every 1 min, 2 people are killed and 95 people are severely injured or permanently disabled in traffic accidents worldwide. Traffic accident related deaths and injuries result in not only substantial economic losses but also serious physical and mental sufferings. Developing countries are much more affected from traffic accidents than developed countries. According to the world health organization (WHO) statistics, 75% of deaths resulted from traffic accidents occurring in developing countries. Methodology: Quantative research approach was adopted to achieve the objectives of the study. Which was felt to be most appropriate for its practicability in real life situation. it has the advantages of practicability, feasibility and to a certain extent of for generalization. Research design was one group pre test post-test design. The study was conducted in selected villages of bangarupalem (m) Chittoor (dt). Population includes male and female students studying 9th and 10th class selected villages in bangarupalem (m) Chittoor(dt). Sample size consists of 60 school children 9male and female) under inclusion criteria. Non probability convenient sampling technique was adopted for the present study based on inclusion criteria. Results: • In pre-test knowledge levels regarding road traffic accidents 40(66.70%) school children have inadequate knowledge12 (20 %) of school children have moderately adequate knowledge only 8(13.30%) of school children have adequate knowledge. • In post- test knowledge levels regarding road traffic accidents43 (68.30%) school children have adequate knowledge o17 (28.30%) of school children have moderately adequate knowledge. • In pre -test there was significant association between knowledge on prevention of road traffic accidents age, occupation of mother occupation of father monthly family income educational status of mother and father gender area of residence family income per month <0.01 Level and how many times seen the accidents at p< 0.05evel • there was no significant association found between knowledge on prevention of road traffic accidents with the religion, source of information how many times seen the road traffic accidents. • In post-test here was significant association between knowledge on prevention of road traffic accidents with age of the school children educational status of mother, and gender at p< 0.01 and how many times seen the road traffic accidents family income per month at p<0.05 • In post -test there was no significant association was found between knowledge on prevention of road traffic accidents age of the school children religion educational status of father occupation of mother and father, family income per month place of residence how many times seen the road traffic accidents and source of information Conclusion; The study findings revealed that among 60 school children age group of 14-15 years majority of 40(66.70%) school children have inadequate knowledge12 (20 %) of school children have moderately adequate knowledge only 8(13.30%) of school children have adequate knowledge in pre-test. Based on this structure teaching programme was given on prevention of road traffic accidents which helped the school children to improve level of knowledge regarding road traffic accidents. After health education majority of school children 43 (68.30%) were had adequate knowledge o17 (28.30%) of school children have moderately adequate knowledge. It is responsibility of nursing professionals to educate the school children’s regarding prevention of road traffic accidents they can assist themselves and others.

Comparative Literature emphases on the study of literature from different cultures, nations and genres and explores relationship between literature and other forms of cultural expressions. African American Literature is the body of literature produced in the Unites States by the writers of African descent. Dalit literature is the form of literature written by Dalits about their life struggles and experiences. Dalit literature is often compared to African American literature relating to the issues such as racial segregation and injustice. The paper compares these literatures through the novels of Ntozake shange and Ifa Bayeza’s Some Sing, Some Sing and Bama’s Sangati. Some Sing, Some Cry leads to the epic saga, covering almost two hundred years and seven generations of Mayfield family, dealing with the struggles and troubles of black women in contemporary America. Sangati deals with dalit women’s lives and their hard work, where the women of dalit community have to do great labour in the field as well as home, she also portrays the real picture of dalit paraiyar women. The paper discusses in detail about the similarities from novels such as the struggle and hardship of African American women and Dalit women to survive among their society, taking up each tussle as an experience to succeed in their life. Women from both of these novels have learned to accept life wholeheartedly even in the midst of desperation and horror.

Aim: The aim of this study was to determine the Efficiency and Effectiveness of Oral Health Manual designed for care givers of Special children. Methods: Caregivers at Sathya Special School, Pondicherry were selected. A total of 100 caregivers participated in this study out of which 93 participants took the pre-test and 89 took the post test. A 14 multiple choice question bank was designed to evaluate the knowledge amongst the care gives based on the specially designed copyrighted manual prepared with regards to oral hygiene maintenance. Results: The test reveals there was a significant raise for percentage of correct answer before and after with a increase of 10 percentages which was found to be statistically highly significant with P Value .000 Conclusion: It is evident that the knowledge of the caregivers of special children about the oral health practices and their attitude towards oral hygiene maintenance is better

Loss of natural teeth could compromise the functional, esthetics and phonetics demand by the patients. Advancements in the oral implant procedures has created various treatment options available. Adequate bone support is essential prior to dental implant placement. Bone defect associated with lost teeth in anterior maxilla will affect both surgical placement of implant and subsequent prosthetic rehabilitation. Augmentation of bone defects can be carried out using autografts, particulate grafts or block grafts combined GBR to regenerate lost bone. This case report presents step by step procedure in which missing anterior tooth was restored with dental implant using hard tissue augmentation.

The aim of our research was to find a connection between human-to-human attachment and human-to-animal attachment, to compare groups of animal owners and non-owners in terms of human attachment, the connection of human-to-animal attachment and life satisfaction, and the comparison of animal owners with non-owners in terms of life satisfaction. We used the ECR scale to measure the human-to-human attachment, the PAQ questionnaire for the human-to-animal attachment, and the Fragebogen zur Lebenszufriedenheit (FLZ, Life Satisfaction Questionnaire) to measure life satisfaction. The research sample consisted of 240 participants, of which 130 were animal owners (dog or cat) and 110 participants, who did not own an animal. The results confirmed that there is a connection between human-to-human attachment and human-to-animal attachment, and between human-to-animal attachment and life satisfaction. There is also a difference between the group of animal owners and the group of non-owners in life satisfaction.

This paper intends to show case the results of a survey conducted among the students of architecture in India, to understand their perception of Architectural Pedagogy in Professional Practice. We are trying to understand the Rationale of Application of Theory Inputs in Architectural Practice. This survey shows the aspects that requires attention in the architectural education in student’s opinion.

Education is fundamental for achieving full human potential, developing an equitable and just society, and promoting national development. Providing universal access to quality education is the key to India’s continued ascent, and leadership on the global stage in terms of economic growth, social justice and equality, scientific advancement, national integration, and cultural preservation. Universal high-quality education is the best way forward for developing and maximizing our country's rich talents and resources for the good of the individual, the society, the country, and the world. India will have the highest population of young people in the world over the next decade, and our ability to provide high-quality educational opportunities to them will determine the future of our country.

Subcutaneous emphysema is defined as the presence of free air in the subcutaneous tissues, and has numerous causes including blunt and penetrating trauma, soft tissue infection and surgical instrumentation. This is a forty-five year old house-wife referred for an emergency plain chest radiograph from a rural health care unit on account of chest trauma following a road traffic accident. The plain chest radiograph showed multiple rib fractures bilaterally, fractured right clavicle, lucencies within the mediastinum, lateral chest wall bilaterally, scapula region and neck regions bilaterally. Features of lung contusion more marked on the right upper zone were also demonstrated. We report the radiographic features of subcutaneous emphysema and pneumomediastinum which are often encountered following penetrating and blunt chest trauma most especially following road traffic accident in our environment.

Non-tuberculous mycobacteria (NTM) is a term used for a huge number of potentially pathogenic and non-pathogenic environmental mycobacterial species other than Mycobacterium tuberculosis complex (MTBC) and Mycobacterium leprae. Aims and Objectives: To identify the species on NTM isolated from the sputum samples of the base line surveillance study (BS study) by high performance liquid chromatographic (HPLC) method. Methods: This was a base line surveillance study carried out from model DOTS programme implemented in Thiruvallur. Base line survey has been completed at the Government Hospital Thiruvallur, Chennai, during the period April 2009 to July 2011. The clinical evaluation of 98 sputum samples were collected and processed for culture by modified pertroff method. After culture selection criteria for non-mycobacteria were identified to species level using HPLC analysis were done by standard operating procedure. Results: A total of 795 cultures of NTM were undergone HPLC identification 98 among them M.terrrae was predominant 42 out of 92 followed by M.avium (12) , M.chitae (10), M.fortuitum (7), M.farcinogenes (6), M.simiae (5), M.fortuitum complex (4), M.bovis (3), M.flavescens (3), and the unidentified 6 was noticed. Conclusion: It concludes the rate of NTM from respiratory specimens at our area has been increasing steadily and therefore, early differentiation between pulmonary TB and NTM lung disease in patients with AFB smear-positive specimens is necessary. Additionally our study says patient presenting with features of TB is less likely to have NTM disease, in related settings.

Fertility is defined as the ability to conceive and bear children through normal sexual activity. According to estimates, a fertile woman can bear average 17 pregnancies from menarche to menopause while 10% of cohabiting couples have become sub fertile due to problems like malnutrition or disease, especially sexually transmitted infections. The world reached its one billion population around the year 1800 and 7 billion in 2011 with projections to reach 20 billion by 2100. Due to varying levels of fertility control and increase in death rates, population growth rate in the world has declined in 2-1.5 % per year during the past 30 years. An induced abortion averts about 0.4 births, while about 0.8 births are averted by using moderately effective contraceptives. Although the fertility rates are declining even across the developing world, the world’s population is growing faster due to increased number of sexually active females in the reproductive age, resulted from high fertility rates existed in the past. Almost 97% of this growth was in developing countries due to their high birth rates, high proportion of sexually active population and their less use of modern contraceptives. However, as a result of fast aging, death rate would exceed birth rate resulting negative population growth as seen in many of the developed countries. According to estimates of the World Health Organization in 2003, a woman dies every 8 minutes due to complications arising from unsafe abortions, resulting death in 68,000 women accounting for about 13% of maternal mortalities and 5 million with long-term health complications. Even by 2017, approximately 810 women died from preventable causes related to pregnancy and childbirth every day. Between 2000 and 2017, the Maternal Mortality Ratio (MMR, number of maternal deaths per 100,000 live births) dropped by about 38% worldwide. Out of all maternal deaths, 94% occur in low and middle-income countries. Young adolescents (ages 10-14) face a higher risk of complications and death as a result of pregnancy than other women in the same age category.

Background: Motor Vehicle Crash (MVC) is the second leading cause of morbidity and mortality in children. Therefore, it is essential to keep children protected in the car by practicing child passenger safety arrangements known as Child Restraint System (CRS). Objectives: To assess the level of adherence and determinants of practicing CRS in the vehicle among guardians of children. Subjects and Methods: Analytic cross-sectional study has been conducted among the guardians of children attending Kindergarten (KG) schools in the western sector of Makkah city, Saudi Arabia. A self-administered validated questionnaire was used for data collection. It consists of two sections: socio-demographic data and general information of the participants and apart assessed the practicing and the application of CRS. Results: The study included 342 guardians. The age of more than half of them (57%) ranged between 30 and 50 years and almost three-quarters (75.1%) of them were females. Always using the seat belt was mentioned by slightly more than half of the participants (52.4%). Almost half of the participants (49.4%) reported the current existence of the children's car seats. Adherence to the Child Restraint System in the Vehicle was reported by almost half of the participants (50.9%). The highest rate of adherence to the CRS in the Vehicle was observed among participants aged between 20 and 29 years (63.8%) whereas the lowest rate was observed among those aged over 50 years (39.2%), p=0.011. Regarding the marital status, single participants had the highest rate of adherence to the CRS (60%) whereas divorced participants had the lowest rate (20.8%), p=0.005. Postgraduate participants had a higher rate of adherence to the CRS compared to university or below university graduated (65.6% versus 47.1% and 50%, respectively), p=0.038. Participants whose income exceeded 20000 SR/month were more adherent to the CRS (60%) than those with lower income, p=0.046. Conclusion: Adherence of guardians to CRS in the vehicle was not enough in comparison to the level of adherence in the US which was around 65%, and further reconsideration is needed for the safety of children in vehicles in Makkah city.

Epidermoid cysts represent the most common cutaneous cysts. Epidermoid cysts are developmental, benign, cutaneous cysts which are commonly found on face followed by trunk and neck. They account for approximately 80% of follicular cysts of the skin. They are slow growing lesions and remain asymptomatic until or unless secondarily infected. They occasionally have tendency to develop into a malignancy. This article is to present a rare case of epidermoid cyst of the outer ear in a 30-year-old male patient. During clinical examination, a soft, cystic, globular, and non-tender swelling with restricted motility and well-defned margins was seen in the retroauricular region. Skin over the swelling was normal and not attached to it. The chosen treatment was total surgical removal. The histopathological findings confirmed the diagnosis of epidermoid cyst, characterized by presence of cyst cavity lined by cystic lining comprised of keratinized stratified squamous epithelium. Few sebaceous glands can also be seen. Revealing dense collagen fiber bundles interspersed with fibroblasts dense chronic inflammatory cells chiefly lymphocytes and plasma cells and endothelial lined blood vessels. Cystic lumen was filled with keratin. The proposed treatment was considered successful, as there was no recurrence.

The present study based on the data for 5 years deals with the role of a minor reservoir in fish production and the influence of stocking densities on fish production. Nagulakunta, a minor reservoir with 10 ha of water spread is located in Vinjapally village of Siddipet District. The minor reservoir is treated as stocking and capture system for development of the fisheries. The overall major carp production is 465.88kg/ha/yr, and that of the rest being 56.25kg/ha/yr. The total fish production is 513.13kg/ha/yr. The major carp production increased significantly from 13.43 to 98.02%, and that of others decreased drastically from 86.57 to 1.98%. The major carp seed (20 - 40mm fry) alone was stocked in the reservoir with overall stocking rate of 5892 fry/ ha/ yr. The major carp production considerably increased with stocking and the maximum yield of carps was recorded at a stocking density of 8500 fry/ha/yr. It is concluded that Nagulakunta is productive reservoir in terms of fish production.

Background: The entire world is struggling with a pandemic caused due to novel corona virus (Covid-19) and this pandemic is still not under control. The present study was aimed to know various demographic factors, clinical features, co-morbidities and complication of COVID-19 deaths as well to determine case fatality rate of our institute. Methodology: We analyzed, Demographic, clinical, co-morbidities, complication and case fatality rate of all 22 RT-PCR confirmed COVID-19 deaths that occurred at Dedicated COVID Hospital, a tertiary care centre, attached to RNT Medical college Udaipur Rajasthan, over a period of four month from 15th March 2020 to 22th July 2020.Result: We found that the maximum patients were from age group ≥ 60 years (68.2%) followed by 40 to 59 years (27.3%) and predominantly seen in male sex (77.3%). The major clinical feature was shortness of breath (100%), fever (86.4%) and cough (81.8%) The most common co-morbidities was diabetes (54.5 %) and hypertension (50%).The major cause of death was bilateral pneumonia with ARDS (100%), septicaemia (27.3%), and MODS (18.2%) and case fatality rate was 2.1%. Conclusion: At present case fatality rate of our institute was 2.10%. We recommend early active intervention and various newer modalities of treatment such as anti viral therapy, convalescent plasma therapy will be further reduced case fatality rate and hopefully we will be able to control and manage this present pandemic.

Background: Diabetes Mellitus and obesity are increasing in the population undergoing Coronary Artery Bypass Graft, and these conditions are major factors in the development of Metabolic Syndrome. Metabolic syndrome is a group of factors that associated with an increased cardiovascular risk. The purpose of this study was to determine postoperative morbidity and mortality in patients with metabolic syndrome compared to patients with metabolic syndrome who undrewent Coronary Artery Bypass Grafting (CABG) surgery at H. Adam Malik General Hospital Medan. Patients and Methods: This study is an analytical study with a cross-sectional design, by taking secondary data from the medical records of patients who underwent CABG at H. Adam Malik General Hospital Medan, with total of 74 patients. Analysis of the data was using the Chi-Square test, which must be obtained p <0.05, the difference is statistically significant. Results: From 74 patients, we found statistically significant difference (p <0.05) on duration of intubation, and post-CABG surgery wound infection, there were longer postoperative CABG stay and intubation in the patient groupwith the metabolic syndrome and higher number of patient with post surgery wound infection in the group of patients with the metabolic syndrome compared to the group without the metabolic syndrome. Conclusion: Duration of stay, duration of intubation, and minimalizing of surgical wound infection, especially in patients with metabolic syndrome contributed in postoperative morbidity of CABGsurgery.

The development and experience in the world so far have shown that small private agricultural cooperatives are economical only to a certain extent at the expense of high labor intensity. Practice shows that the small commodity-based economy cannot be competitive in the market and cannotappropriatelyapply the scientific - technical achievements in agriculture. The experience of developed countries shows that in all cases with such an agricultural system, consolidation of holdings begins, with disintegration and disappearance of a large number of small agricultural holdings and creation of holdings - cooperatives of rational size. However, it is also known that this path is long and difficult, and it usually takes place by buying the land from the owners of small and non-competitive holdings. The primary disadvantage of this path of consolidation is the time it takes to achieve and accomplish this long-lasting process, as well as the need to invest substantial funds that will limit the development opportunity and will not contribute to improving profitability in the short run. There is another way to form optimally large economies by means of lease, as the experience of some countries shows (Netherlands, Germany, France), and it is used in our conditions, however some experts assess this system as unfavorable, due to the termination of the connection between the land owner and its management. However, despite the previously elaborated problems, it is necessary to point out that there is clear unsustainability of holdings with a small property in Macedonia, and the only rational way to effectuate land property is through cooperatives created as a real opportunity to unite into a powerful force of a large economy with collective management.

The expression “dental caries” is utilized to represent the outcomes, signs, symptoms, and side effects of a localized chemical disintegration of the tooth surface (enamel and dentin) caused by dental plaque and mediated by saliva1. Caries is considered as disease with high incidence among childhood chronic conditions, where it is also well-thought-out to cause harm on both population and individual well- being2,3. When comparing it with other common diseases, dental caries is five times as frequent as asthma and seven times as common as hay fever4. The American Academy of Pediatrics demonstrates that dental and oral infections keep on infecting children and, specifically, very young children. In primary teeth, dental caries is a preventable and reversible disease if treated in early stages, but when left untreated it will lead to pain, bacteremia, alteration in growth and development, premature tooth loss, speech disorder, increase in treatment costs, loss of confidence, and negatively affect successor permanent teeth. The definitions used previously to describe this bacterial disease were related to cause and the improper utilization of nursing bottle. These terms are used interchangeably: “Early childhood tooth decay”, “early childhood caries (ECC)”, “bottle caries”, “nursing caries”, “baby bottle tooth decay”, or “night bottle mouth”5,6. The expression “ECC” was proposed more than 20 years ago during a workshop supported by the Centers for Disease Control and Prevention (CDC) trying to scope the consideration upon the various issues, such as financial, sociopsychological, and behavioral, which contributes to the formation of caries at such initial years, instead of attributing its manifestation solely on feeding bottles7. This article explores the various means of preventive strategies, including anticipatory guidance and future approaches to prevent ECC, interprofessional education and practise also explores the implications of ECC epidemiology for evolving health service delivery and financing approaches

Introduction: Appendicectomy is one of the commonly performed surgeries in the emergency setup in our medical college (THANJAVUR MEDICAL COLLEGE). Aim of the Study: The study was conducted to know the effect of antibiotics in reducing surgical site infection and abscess formation after open appendicectomy.(1) Materials and Methods: A randomised controlled study was done in our medical college (THANJAVUR MEDICAL COLLEGE) between April 2019 and April 2020 in two groups. Group A received a single dose of postoperative antibiotic and group B received antibiotics for 3 days. Both groups received single dose preoperative antibiotic.(2) Results: Both groups were compared and there was no significant difference in rates of Surgical site infections between both groups. None of the patients developed intra-abdominal collection.(3) Conclusion: Single dose of postoperative antibiotic was sufficient in reducing surgical site infection after appendicectomy (5).

Renal vein thrombosis (RVT) affects 1.3-2.2/100,000 newborns. The classical presenting triad includes gross haematuria, thrombocytopenia and palpable abdominal mass. RVT can appear due to low-flow intrarenal circulation or umbilical vein catheterization. Perinatal factors like asphyxia, hypovolemia or shock and prothrombotic disorders have also been described as predisposing factors for spontaneous RVT. Although treatment is controversial, thrombolysis has been suggested for extensive cases with bilateral involvement. We present a case of a neonate with extensive bilateral renal vein and inferior cava vein thrombosis who was managed with heparin therapy.

Nutritional psychiatry is a new area of research that seeks the relationship of nutrients in the brain axis and associated comorbidities. At the moment, there is an increasing discussion on the brain and heart axis seeking the understanding of the activity in reducing oxidative stress and mitochondrial respiratory chain, among the nutrients investigated is coenzyme Q10 (CoQ10). This important nutrient, which has a number of already established functions, has benefits in the treatment of psychiatric and heart disorders, it is believed to be the result of its antioxidant property and production of mitochondrial energy. However, there is a scarcity of studies on CoQ10 in the line of nutritional psychiatry, including there is still no consensus on the appropriate dosage or therapeutic plasmatic level of this nutrient. And this information is necessary both for the treatment of mitochondrial diseases and psychiatric and heart disorders. Therefore, this study seeks to describe the current knowledge about CoQ10 in the axis of nutritional psychiatry in the disordens brain and heart.

Purpose: Age related macular degeneration (AMD) is the leading cause of blindness in the developed world. Its incidence is on the rise in developing nations as well. Formation of choroidal neovascular membrane(CNVM) is the major cause of vision loss in AMD. Purpose of this study is to study the progression of AMD and risk factors associated with development of CNVM in Indian population. Methods: 200 eyes of 100 patients of more than 55 years of age presenting to our out patient department with AMD were selected and were followed for a period of 2 years. Progression of disease into active CNVM and conditions predisposing to its formation were analysed. Results: Progression of AMD into neovascular form (CNVM) is faster in the elderly population. Approximately 13% of patients developed CNVM within 1 year of presentation. Patients with large drusens, RPE abnormalities, serous PED have an increased risk of developing CNVM. Our study showed that, serous PED was the strongest risk factor in development of CNVM. Conclusion: Incidence of CNVM in AMD patients is more as compared to that of western population. Serous PED followed by a presence of both large drusens and RPE (Retinal Pigment Epithelium) abnormalities combined, are the major risk factors for Indian population. Early identification of risk factors and determining the major risk factors for development of CNVM in Indian population can help in early diagnosis and early treatment resulting in a better visual outcome.

Kenya Sugar sub-sector accounts for 7.5% of the National GDP and 15% of the Agricultural GDP. These firms have been experiencing poor financial performance with an average after tax profit of -24% for the period 2010-2018. Some of these firms have faced frequent closures with a case of Miwani sugar firm being put under receivership back in the year 2000. However, a section of these firms have been thriving. The inconsistency in these sugar firm’s financial performance points out to the contribution of financial leverage as presumed by the trade-off and the theories of ROA and ROE. The purpose of this study was to determine financial leverage and financial performance relationship in sugar firms in Western Kenya. The study was anchored on the trade-off theory and the theories of ROA and ROE. The study used correlation research design. The target population was 8 sugar firms found in Western Kenya that were in operation during the study period. The firms were pooled for10 years resulting to 80 data points. The result show that financial leverage is a significant negative predictor of financial performance with (R2 =.1290, p=.0001) (coeff= -.0765) implying that12.9% of the variance in financial performance of sugar firms in Western Kenya was explained by financial leverage. The negative coefficient revealed that for every one unit increase in financial leverage, there was an ensuing drop in financial performance of these firms by 0.0765, an implication that most of the Kenyan sugar firm had incorporated borrowed funds in their financial structure beyond the optimal levels. The study concludes that financial leverage had a statistically significant negative effect on financial performance. The study recommends that sugar firms should reduce their leverage levels to optimal levels to enhance their financial performance. The findings are deemed to be of use to academia as a basis for further research in finance.

Biological waste water treatment is a decades-old biochemical technique. The treatment of waste water using a natural process has always been desirable. photoextractionis a green remediation technology used to treat polluted soils. This paper discusses the potential for copper photoextraction to use vetiver, a hyperaccumulator plant, on a river barge. Experimental data were obtained in a research experiment in which many vetiver-filled styrofoam boxes were put in buckets filled with copper sulphate. The results of the experiment-which took place over a duration of 2 weeks-demonstrate that the vetiver set-up is more effective than the hydrophytes in copper absorption. The set-up is applicable to clean up metal contaminated lakes and rivers - for this example it will be applied to a copper contaminated pond near a mining site.

The objective of this contribution is to update the debate on the informal economy by highlighting the important investment of women in this sector. Context: Urbanisation in Burkina Faso has not been accompanied by the development of the employment sector to meet the needs of urban dwellers. In order to cope with the imperatives of urban life, many urban dwellers have been forced to develop initiatives outside the norms of the formal economy. Among the actors investing in the informal economy, there are more women due to their low level of education and lack of training. Method: Based on a survey using a qualitative approach, interviews were conducted with 29 women entrepreneurs in the informal economy. The study reveals that women entrepreneurs are generally between 25 and 51 years old, often have a low level of education and the activities they carry out are small in scale. Eleven of them are heads of households, four of whom are widows. Two thirds of them have a very low level of education, limited to primary school without the primary school certificate. Results: The data significantly illustrate the place they occupy in this sector, in various activities. The survey also reveals the contribution of women's incomes to the survival of many urban households. It also revealed that the informal sector, beyond the traps it contains, is appreciated by some women because of its openness and above all its flexibility, which allows them to articulate their professional constraints with their domestic tasks and social obligations.

This paper seeks to examine metaphorical references of disability in Kuria language, spoken in Kenya. Particularly to explore how language usage in relation to disability creates hierarchies in the society by positioning the disabled below the ‘normal’ non-disabled language users. The paper will make use of Critical Discourse Analysis (CDA) as its theoretical framework. Critical discourse analysis (CDA) is a form of analysis that seeks to explain how unequal power relationships can be established, reproduced and maintained in social and political contexts. It also clarifies elements of the marginalisation, exclusion and domination of some people by others through ideological processes, and the effect this can have on social relationships. CDA uncovers visible as well as hidden inequalities in social relationships by examining ways in which language works in specific discourses to perpetuate these inequalities. The paper makes use of primary data in form of metaphors and reference words. These were collected ethnographically through day to day interaction with the disabled and their families. Six families with members who are categorised as physically challenged were involved in the study. Interviewing and note taking were used as data collection instruments. Data was analysed thematically basing on CDA principles. The findings revealed that both male and female disabled persons are labelled negatively and referred to using demeaning metaphors. Physically challenged people are placed lowly as opposed to those who are viewed to be normal people in Kuria. The paper suggests that this view be challenged and demystified and disabled people be placed on the same lane as ‘normal’ ones. It further suggests that ways of challenging such discursive inequalities and ultimately realising a just and equitable society be sought for. This paper will be of importance to physical education teachers, human rights activists and organisations dealing with the physically challenged members of the society

Background: The association of endometriosis with hyperprolactinemia is controversial. Objective: The present study aimed to determine the association of endometriosis with hyperprolactinemia in infertile women. Method: Women between age group 19-38 years who presented with chief complaint of infertility in the outpatient Department of Obstetric and Gynaecology at Sawai Maan Singh (SMS) Medical College and simultaneously underwent diagnostic laparoscopy were included in a cross sectional study. The presence of endometriosis was evaluated. To investigate the association of endometriosis with hyperprolactinemia, the patients whose infertility was not caused by endometriosis were included in the control group. Serum prolactin levels were measured in follicular phase in all females undergoing diagnostic laparoscopy for evaluation of infertility. The comparison of serum prolactin levels between the two groups was performed using unpaired t-test. Results: Prolactin levels were found to be significantly higher in the endometriosis group as compared to the control group (34.30±13.81 vs. 12.30±4.95 respectively). The results were statistically significant (p< 0.001). Conclusion: In the present study, hyperprolactinemia i.e. serum prolactin >20ng/ml was found to be associated with endometriosis. Hence, serum prolactin levels should be estimated in all patients who are suspected of endometriosis.

Krebs cycle andthe membrane redoxy potential three state dependent 9 stepped full cycle of proton conductance, described by usare more similar each other in a closed loop figures, unlike glycolysis, the citric acid cycle is a closed loop: last step in the citric acid cycle regenerates oxaloacetate by oxidizing malate, meanwhile first step of Krebs cycle is a condensation step, combining the two - carbon acetyl group (from acetyl CoA) with a four - carbon oxaloacetate molecule forms a six - carbon molecule of citrate, which is used in the first step as proton, electron donators. Similar to Krebs cycle, the membrane redoxy potential three state dependent 9 stepped full cycle of proton conductance, described by us also have a closed loop figure. In the last ninth stage of the membrane redoxy potential three state dependent 9 stepped full cycle of proton conductance, proton combine with hemoglobin (generation of HbH), which promotes the release of oxygen from hemoglobin, oxygen diffusion to all cells conditioning the release of proton, electron from food substrates as proton, electron donators in the 1-stage of closed cycle, described by us, also proton released from hemoglobin promotes uptake of oxygen by hemoglobin, CO2 promotes the generation of free proton by mecchanism as H2CO3- = H+HCO3, carbonic anhydrase catalyzes the formation of CO2 from H2CO3 and CO2 diffuse out in the alveoli in the last stage of closed loop figured cycle of proton conductance.

Research culture can be ascribed as values and ideas that researchers use to handle research related problems. It is the combination of all the activities, all the thinking, all the collaboration and cooperation carried out to promote the research in faculty members. Higher Education Commission is providing research funding for research projects and publications in renowned research journals. Higher Education Commission provides teachers with training courses on research and research incentives to those who attend these courses. These efforts are made for developing research culture in universities and teacher education institutions. This research paper deals with III criterion of NAAC out of the seven criteria. It is a research study of colleges of education teaching department in which the researcher studied all the six key aspects under the III criterion -research, consultancy and extension. This criterion seeks information on the policies, practices and outcomes of the institutions with reference to research, consultancy and extension. The reason to choose this criterion is that NAAC provides 35% of weightage to it, for colleges of education. It throws light on the efforts and strengths of colleges of education to promote a research culture. Its quality of research and extension work is known all over the nation which distinguishes it from the other institutions in the country and makes it an ideal symbol for the other teacher education institutions. The present research article falls under the purview of quantitative research and hence quantitative methods, such as data collection, analysis, comparison, tabulation and illustration, are used. Among 48 randomly selected colleges of education, I received replies from 19 colleges of education only, and the same data are taken for granted for analysis.

Introduction: Long suffering from diabetes is often associated with complications such as neuropathy. Complications usually begin to arise after the client has suffered from DM for more than 10 years.Diabetes mellitus clients who have long been diagnosed with diabetes have a higher risk of developing diabetic ulcers.Blood sugar levels that are not controlled from time to time can lead to hyperglycemia, which can lead to complications associated with diabetic neuropathy in which diabetes mellitus patients will lose their sense of taste and are not aware of the appearance of injury.Foot exercise is an exercise for diabetics or non-sufferers to prevent injuries and help blood circulation in the legs. Foot exercises can help improve blood circulation and strengthen the small muscles of the legs and prevent foot deformities. Effective treatment will reduce the complication rate so that there are no further complications that can harm people with mellitus. The aim of this study was to identify the effect of diabetic foot exercise on neuropathy scores based on the length of time a client suffered from type 2 diabetes mellitus. Method: The research design used was a quasy experiment to identify the effect of diabetic foot exercise on neuropathy scores based on the length of time a client suffered from type 2 diabetes mellitus. This research was conducted at the Padangsidimpuan City Hospital. Population in this study was all of the type 2 diabetes mellitus clients in Padangsidimpuan City Hospital. The sampling technique used was consecutive sampling with a sample size of 16 people based on power analysis tables. The measuring instrument used is Diabetic Neuropaty Symptom (DNS), and data analysis was carried out using the Wilcoxon test. Results: Data analysis was carried that after a significant test using the Wilcoxon test on the comparison of neuropathy scores before and after diabetic foot exercise in the group with DM <6 years duration, there was a significant change with p value = 0.038 (p <0, 05) which means that there is an effect of diabetic foot exercise on the reduction of neuropathy in type 2 diabetes patients. Likewise with the neuropathy score before and after diabetic foot exercise in the group with a duration of DM> 6 years, there was a significant change with p value = 0.011 (p <0.05) which means that there is an effect of diabetic foot exercise on decreasing neuropathy in people with type 2 diabetes. Conclusions: Neuropathy scores in respondents decreased when compared between before and after diabetic foot exercises in both groups.This shows that there is an effect of diabetic foot exercise on reducing neuropathy in people with type 2 diabetes mellitus. In accordance with the results of the research obtained, it is hoped that all people with type 2 diabetes mellitus will always try to do physical exercise in the form of diabetic foot exercises to reduce the risk of neuropathy in people with type 2 diabetes mellitus.

Background and Purpose: Participation restriction means lack of capability to participate in any activity or perform any activity. Participation restriction in older adults indicates lack of any older adult to perform any activity due to one or other problems whether physical or mental or social. This study enlists different reasons that influence participation restriction. Method: 27 different articles were searched about participation restrictions among elder adults and the factors that influenced the restriction. Out of these, 18 articles have been selected on basis of inclusion and exclusion criteria. All the articles showed different factors that affected the participation in elders. Stroke, impairment and many other factors that influence participation restriction and how the factors that correlate with each other in participation restriction. Result and Conclusion: Different studies have included different number of adults using different types of scales to assess the factors. The study’s result says that the factors assessed, affected the AL and PR of the adults.

Background: Impaction of tooth is a retardation or halt in the normal process of eruption. After the third molar, maxillary canine is the most frequently impacted tooth in the dental arch. The treatment of impacted teeth has caught the imagination of many in dental profession. However, the orthodontic / surgical modality has achieved the most satisfactory result in long-term. Aims and objectives: This study was aimed to measure and compare the linear and angular measurements and to perform maxillomandibular asymmetry comparison in transverse dimensions on impaction side with contralateral non impacted side. Materials and Methods: A total sample of 30 subjects in different malocclusion groups with unilateral palatally impacted canines were included. The age groups 13–30 years were included with male and female subjects. The linear and angular parameters were measured and variation was studied and maxillomandibular asymmetry comparison was done on impaction side with contralateral non impacted side, mean values, SDs, and P values were calculated by applying descriptive statistics along with student’s independent t-test by using statistical software SPSS (version 20.0) and Microsoft Excel. The level of significance was set at p value < 0.05. Results: Descriptive statistical analysis was first done to find out the mean of each linear and angular parameter along with standard deviation. Then comparison was made between the impaction side with contralateral non impacted side by using student’s independent t-test. Statistically significant difference was found in nasal cavity width between two sides. The distance from the centre of the canine crowns to median sagittal plane and angulation of long axis of canine to Za-Za plane was also found statistically significant between two sides, and on doing the maxillomandibular comparison of asymmetry, no statistically significant difference was found. Conclusions: This study concluded that the distance of canines on the impaction side from mid sagittal plane are decreased and long axis of canines showed more obtuse angulation with respect to the selected plane and there was decreased nasal cavity width on impaction side when compared with contralateral non impacted side. No maxillomandibular asymmetry was present in subjects with unilateral palatal canine impaction.