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March 2019

  1. Dr. Murukan. P.A., Dr. Byju Paul Kurian, Dr. Hridhya K Raj, Dr. Merlyn George, Dr. Jacob George and Dr. Vysakh G. Das

    Background: The maximum tensile bond strength between acrylic special tray and silicone impressions is achieved when adhesive is allowed to dry for a longer period of time, usually 15 minutes. This delays the impression making procedure. Aims and Objectives: This study tested the tensile bond strength of tray adhesive on special trays using warm air to dry and hence decrease its drying time. Materials and Methods: 48 test specimens were prepared with autopolymerizing acrylic resin. The study groups considered in this study were - Group 1: 15 min (control) (normal drying), Group 2: 1 minute (with warm air drying), Group 3: 2 minutes (with warm air drying) and Group 4: 3 minutes (with warm air drying). Statistical Analysis: The one-way ANOVA was used to test the null hypothesis that there is no significant difference in mean tensile bond strength among the four study groups. Results and Conclusion: It was found that there was no change in tensile bond strength between adhesive and impression when air at 35 degree Celsius was blown from a distance of 10 cms for 2minutes: This study suggests a new technique to reduce drying time of tray adhesive considerably without compromising tray- impression bond strength.

  2. Dr. Yasir Hakim and Dr. Albadawi Talha

    Background: Diabetes Mellitus is a major leading health problem worldwide. DM type 2 is the most predominant type. High fibrinogen level in type 2 diabetes mellitus has been suggested to play a role in the occurrence of cardiovascular diseases in patients with type2 diabetes. Objective: The study aimed to determine the fibrinogen level in patients with type 2 diabetes mellitus. Methods: The study included fifty patients (cases) with type 2 diabetes mellitus and twenty are none diabetic (control group). The fibrinogen was compared in both group cases and control correlated by HbA1c and diabetes duration. Blood sample were collected into trisodium citrate container (2.5 ml) for fibrinogen estimation and EDITA container (2.5 ml)for HbA1c estimation. All sample investigated for fibrinogen using semi-automated technique. Data was analyzed using program SPSS. Result: The study revealed that plasma fibrinogen was significantly higher in type2 diabetic patients (cases) when compared to control group that showed statistically significance (P value .000) with significant correlation was found between plasma fibrinogen and HbA1c(P value .000) and none significant correlation was found between plasma fibrinogen and duration of diabetes (P value .411).

  3. Dr. Yasir Hakim

    Objectives: The study was conducted in Dar Al Uloom University during the period (June - August 2017 ) to assess the implementation of cell block technique in the diagnosis of liver disease based on specimen adequacy and diagnostic accuracy, to evaluate the level of background staining, cellularity, nuclear, cytoplasmic preservation in cell block section, to compare the differences between the diagnostic results of cell block slides, conventional smears and to explore the feasibility of the use of cell block preparation in routine cytology. Methods: Eighty study subject were selected for the study, ultrasound guided fine needle aspiration was obtained from liver, then aspirate cells fixed in 40% formalin overnight, the supernatant fluid was decanted and settle cells warped in filter paper and then placed in a tissue cassette. All tissue cassette processed in an automatic tissue processor, the cell block were embedded in paraffin wax, and 4-6 micron were cut using standard rotary microtome. The sections were stained with Haematoxylin and Eosin (H&E) stain and cover with cover slip using DPX mounting media, and cytological smears was also stained with Haematoxylin and Eosin stain. Results: The result obtained that the high score (+3) in smear 41(51.3%) while in cell block 27(33.8%). Moreover when compared the final architecture preservation which include nuclear and cytoplasmic preservation, the nuclear preservation were the best by cytological smears than cell blocks, score (+3) in smears 43(53.8%) while in cell block 37(46.3%). In the comparison of cytoplasmic preservation between the two methods found that the cytological smears was the best, the high score (+3)42 (52.5%) while in cell block 35(43.8%) comparing to the background staining found that the cell block has mild background staining 55(68.8%) while smears 7(8.8%) Conclusion: In this study smear preparation was the best in comparison with cell block technique in preservation of cells, nucleus and cytoplasm of liver disease.

  4. Dr. Shehzad Sheikh, Dr. Nilesh Patil, Dr. Arora, R.S., Dr. Harshad Bhagwat, Dr. Zubair Ahmed and Dr. Palak Umadiya

    Obstructive Sleep apnea is the most common type of sleep apnea caused by complete or partial obstructions in the upper airway. It is characterized by repeated episodes of shallow or slow breathing during sleep, despite the effort to breathe, and is generally associated with a reduction in blood oxygen saturation. These episodes of reduced breathing, called "apneas" (literally, "without breathing"), usually last between 20 and 40 seconds. Obstructive sleep apnea (OSA) is a common medical condition associated with considerable morbidity and is recognized and diagnosed more frequently. Patients with OSA are generally overweight and, in general, have a long history of excessive Russians and daytime sleepiness and associated obesity. The diagnosis is established with polysomnography (PSG), although the decision about who should be sent to a sleep laboratory must be individualized, especially for those patients whose main complaint is snoring. The most important factor in the pathogenesis of OSA is a narrow and flexible pharyngeal airway. Among the various treatment modalities available today, the most successful is the application of continuous positive airway pressure (CPAP) during sleep

  5. Italo Giuffre

    Purpose: To compare the impact on the ocular surface of glaucomatous patients under monotherapy by latanoprost, tafluprost, bimatoprost and bimatoprost/timolol 0.50% fixed combination. Patients and Methods: This is a single center, clinical and epidemiological study. Fourty glaucomatous patients (20 males; 20 females), age and sex-matched were divided in four groups according to monotherapy (latanoprost 0.005%, tafluprost 0.0015%, bimatoprost 0.03% and bimatoprost 0.03%/timolol 0.50% fixed combination). All of these patients had at least three months follow-up and were under tonometric control. All of these patients were categorized according to a new algorithm to classify the clinical and familiar risk factors. All of them received OSDI and NEI-VFQ-25 questionnaires to evaluate their quality of life under monotherapy. The statistical analysis was performed by Student’s t-test as for demographical data and one-way ANOVA as for the questionnaires results. P<0.05 was considered statistically significant. Results: All the glaucomatous patients answered their questionnaires. According to the different groups, latanoprost group had a p=0.302, tafluprost group p=0.381, bimatoprost/timolol 0.50% fixed combination p=0.141 and bimatoprost group p=0.000. Conclusions: All the glaucomatous patients completed this study. The Author hypothesizes that the bimatoprost group is the only statistical significant because bimatoprost is a drug usually prescribed in advanced glaucomatous patients, where the clinical picture and the ocular surface are usually more damaged than in the early stage of glaucoma disease.

  6. Dr. Tejal Kansara, Dr. Tushar Shah and Dr. Faraz Vali

    Introduction: Fetal growth restriction is the second most common cause of perinatal death and the most important cause for it is utero-placental insufficiency. Utero-placental insufficiency is a process leading to progressive deterioration of placental function and a decrease in trans-placental transfer of oxygen and nutrients to fetus. Therefore early detection and treatment of utero-placental insufficiency is required. In this study we have tried to find out the effects of utero-placental insufficiency on fetus. Aims and objectives: 1. To study the risk factors and etiology of utero-placental insufficiency 2. To predict utero-placental insufficiency in high risk pregnancies 3. To study effects of utero-placental insufficiency on perinatal morbidity and mortality. Material and Method: It was an observational study, conducted at Department of Obstetrics and Gynaecology, Civil Hospital Ahmedabad from June to December, 2018. History taking, examination and Doppler study was done for each patient and patients with utero-placental insufficiency were selected. Their pregnancy outcomes, for example still births and birth weight, were noted. Results: In this study 48% of patients with utero-placental insufficiency had PIH and 10% had severe anemia. 40% patients were primi gravida. 66% patients had abnormal Doppler findings. 68% had preterm deliveries and 6% had still births or IUD.

  7. Mabel Duarte Alves Gomides, Astrídia Marília de Souza Fontes, Amanda Oliveira Soares Monteiro Silveira and Geraldo Sadoyama

    Introduction: Patient safety culture is of concern to the scientific community because failures in health care, even today, are causes of many damages to the patient. This study aimed to analyse the perception of safety attitudes of professionals in the intensive care unit with respect to time experience and gender. Methodology: A cross-sectional study to assess patient safety culture among professionals in the intensive care unit of a teaching hospital in Brazil, using the Safety Attitudes Questionnaire. The descriptive and variance analysis presented significance level (α) of 5%. A total of 138 professionals in the adult intensive care unit of the following areas: medical, nursing, physical therapy, psychology, nutrition, and management Data were collected from 1 to 15 July. Results: There was a predominance of women in most positions and in professionals with more than five (5) years of experience 87 (63.0%). In the analysis of the safety culture among professionals, there was an average score of 60.72 in men and 56.76 in women, and scores were 57.77 and 57.67 for those with less than and greater than or equal to five (5) years of experience, respectively. There was strong agreement among males for Climate Working Team (74.28) and in the group with low experience for Job Satisfaction (75.05). Conclusions: The safety attitude of both genders professionals proved not strengthened. The men presented themselves strengthened to the Working Climate Team domain, which measures the quality of collaboration and communication. There was satisfaction in the work of young workers and high perceived stress in those with more time in the job.

  8. Dr. Jamwal, V.S., 2Dr. Konika Razdan and 3Pathania, S.S.

    Blood transfusion is an important mode of transmission of infections to recipients. The aim of the study was to assess the prevalence of transfusion-transmissible infections among blood donors. Donors and recipients were screened for seroprevalence of HIV, HBV and HCV. A total of 5938 persons were tested for HIV, The seroprevalence of HIV was 0.43% in the donors. The seroprevalence of HBV and HCV was 0.27% and 0.17% 1.7% respectively.

  9. Dr. Uma Sudhakar M.D.S Phd., Arun, T B.D.S. and Ashika Yesudhas B.D.S.

    The customer’s choice of toothpaste may seem a light topic to be discussed. This survey discusses the factors that influence the customer’s choice as well as the most common brand preferred among various age groups. This information can help understand the type of oral hygiene methods that patients feel comfortable to approach and use. It can also help to understand the knowledge level of patients regarding dental hygiene.

  10. Ali İhsan Tekin and Rifat Özmen

    Background: Lymphedema is a chronic, progressive disease that affects the quality of life of the patient and is difficult to treat. If untreated, it may diminish the quality of life by affecting the patient's home, work and social life. Therefore, its treatment is of great significance. In our study, we evaluated the results of complex decongestive treatment in patients with lower extremity secondary lymphedema. Methods: 23 patients with secondary lymphedema in their lower extremity in the Cardiovascular Surgery Clinic of Kayseri City Hospital were included in the study. Phase-1 complex decongestive treatment was applied for 4 weeks and subsequently, phase-2 complex decongestive treatment was applied for 2 months. Pre-and post-treatment total circumference difference (TCD), body mass index, lower extremity function scale (LEFS), short form-36 results were compared. Results: 23 patients who were admitted to our clinic were included in the study retrospectively. 17 (73%) of the patients were female and 6 (27%) were male. The mean age was 49 (36-67). The BMI of the patients decreased from 30.78 +/- 2.54 to 28.54 +/- 1.94. TCD (Total Circumference Difference) decreased from 41.84 +/- 7.93 to 22.75 +/- 5.65. The SF-36 quality of life assessment scale increased from 35.56 +/- 4.38 to 45.47 +/- 4.53. LEFS increased from 24.34 +/- 3.47 to 47.08 +/- 5.47. The differences between the values were statistically significant. (p<0.01). Conclusion: Complex decongestive therapy is a highly effective and reliable treatment modality for lower extremity secondary lymphedema patients.

  11. Devdatta Wankhade

    The management of traumatic injuries to patient’s dentition is an integral part of the general dental practice. One of the most important challenges for dentists is the recovery of extensive destroyed teeth. A multi-disciplinary approach is required in Treatment of crown fractures. However, crown-root fractures with fracture line below the gingival attachment or alveolar bone crest present restorative difficulties. In this case report we have presented a 22-year-old male who reported with fractured upper right central incisor following trauma. On clinical examination, it was observed that the upper right lateral incisor had a horizontal fracture at the junction of middle and cervical one-third level. The traumatized teeth treated endodontically, and then referred to our department to increase the crown height by orthodontic extrusion before permanent restoration. A long term follow up revealed that a multidisciplinary approach including: endodontic therapy, surgical crown lengthening or/and orthodontic extrusion followed by rehabilitation prosthesis could lead to long survival rate even for "hopeless" teeth. These procedures have the aim to expose a good amount of healthy tooth tissues that is fundamental to obtain a ferrule effect for the subsequent prosthetic restoration. Forced orthodontic extrusion is a technique in which difficult endodontic cases can be handled by the clinicians. In order to achieve desired results patients cooperation is necessary in spite of this being an easy technique.

  12. Kalaiselvi, G., Tirumurugaan, K.G., Vijayarani, K., Dhinakar Raj, G., Baranidharan, G.R. and Sumedha Bobade

    Metabolomics is the study of small, low molecular weight cellular metabolites that are the end products of metabolism. Metabolomics reflects the downstream of gene expression and very closer to the phenotype of animals than proteomics or genomics. In addition to gene expression, post- transcriptional and posttranslational modification regulate metabolic activities of living creatures. The potential advantage of metabolomic information add metabolomic data to SNP-based genomic prediction approaches integrated with conventional phenotypic data in genomic selection programs. This integration would be useful if the prediction accuracy was limited by the small number of phenotyped animals in the training populations. Metabolome include metabolite profiling, metabolic fingerprinting and metabonomics are the principle approaches for analyzing metabololites of biological system. The traits like disease resistance are unmeasurable require challenge study. The advancements in metabolomics research producing potential biomarkers but most of the identified biomarkers have failed to replace existing clinical tests. Potential biomarker should be confirmed and validated using hundreds of specimens and should be reproducible with high specificity and sensitivity. The metabolomics has contributed substantially to our understanding of different diseases and the development of metabolome analysis will helpful for the discovery of novel biomarkers for early detection of various diseases and improving production and reproduction traits of livestock and poultry.

  13. Anuja Choudhary and Dr. Ajeet kumar Saharan

    Aim: The aim of this study is to investigate the effect of constraint induced movement therapy in improving upper limb function of children with hemiplegic cerebral palsy. Methodology: After satisfying inclusion and exclusion criteria the subjects were randomly selected and assigned in two group: group1 (Experimental Group) and group 2 (Controlled Group). Each group consists of 15 samples on which after applying QUEST, T- test also applying to analysed difference between two groups which is further sub- divided between Pre- Treatment and Post Treatment. Results: QUEST and Parametric Test were the statistical tools evaluating the result at the end of 6 Weeks intervention in which both the group shows significant improvement. Group 1 t- test value (2.03) is better than the group 2 t value (0.164). Conclusion: Both the treatment techniques are effective to gain success on the recovery of C.P children. Group 1 shows higher score than group 2. Similarly post treatment in both the groups shows higher response than the pre treatment stage in both the groups.

  14. Dr. Devdatta Wankhade, Dr. Shubhangi Mani, Dr. N. G. Toshniwal, Dr. Nilesh Mote, Dr. Komal Thange, Dr. Jyoti Rajbhar and Dr. Angaj Malankar.

    The basic prerequisites for successful endodontic treatment are firstly a comprehensive knowledge on the root canal anatomy and proper identification of all the canals, meticulous chemo-mechanical preparation followed by three dimensional obturation with hermetic seal. Failure of any of these steps may occur due to unusual tooth morphology. Usually mandibular first molars have two roots with three canals (mesiobuccal, mesiolingual & distal) but in few cases, the number of roots and canals vary. The variation of mandibular permanent 1st molar with additional distolingual root is called Radix Entomolaris (RE). This article presents seven such case reports. Also mentioned are the modifications in the access opening, canal preparation, problems encountered during the treatment, common iatrogenic errors which occur during the treatment and factors which affect the prognosis.

  15. Dr. Harry Santhaseelan, W. and Dr. Venkata Bhargava Boppana

    Purpose: To study clinical presentation, laboratory results, imaging findings and treatment options and outcomes of retroperitoneal fibrosis (RPF). To determine whether it follows the same natural course and response to treatment in the Asian population as in the Western world. Materials and Methods: Medical records of patients diagnosed with RPF on imaging and histopathology between February 2012 and April 2018 were reviewed. Results: Of the 21 patients analyzed, mean age at presentation was 50.81 years. The male to female ratio was 0.9:1. Pain was most common presenting complaint (95.23% cases), almost 85% cases were idiopathic and rests were postradiation induced. The median creatinine level was 1.8 mg/dL. The mean erythrocyte sedimentation rate (ESR) was 53.2 mm/h. Hydronephrosis was present in all patients and 47.6% had atrophic kidneys. Diffuse retroperitoneal mass was present in 61.1%. Ureterolysis with lateralization, omental wrapping or gonadal pedicle wrap was done in 17 cases. Two patients underwent uretero-ureterostomy. One patient underwent ileal replacement of ureter, and one ileal conduit. Eighteen patients received concurrent medical treatment, 11 were given tamoxifen, 2 steroids (Prednisolone), and five were given both. Of the 20 patients with follow-up, 70% had complete symptomatic relief; ESR improvement was seen in 77.8%. Follow-up ultrasound showed resolved and decreased hydronephrosis in 20% and 55% respectively. One patient had treatment failure and 17.65% had disease recurrence. Conclusions: RPF is a rare disease with varied presentation and outcomes. The male to female ratio may be equal in Asians and smoking could be lesser contributing factor. More Asian cohort studies are required to support same.

  16. Dr. Anuradha Khakre, Dr. Monica Mahajani, Dr. Chandrahas, B., Dr. Anup Shelke, Dr. Subodh Gaikwad, Dr. Anup Gore, Dr. Kuldeep Patil, Dr.Manisha Rathod and Dr. Sumedh Lone

    Periodontally accelerated osteogenic orthodontics (PAOO) or Wilckodontics is a clinical procedure that combines selective alveolar corticotomy, particulate bone grafting and the application of orthodontic forces. Wilckodontics has solved the dilemma of rapid orthodontic movement by exploiting the dynamics of bone physiology and redirecting the emphasis in tooth movement to the manner in which the supporting bone responds to accelerate the tooth movement the orthodontists and the periodontists together have worked out a success formula which is termed Periodontally Accelerated Osteogenic Orthodontics (PAOO) or wilckodontics. Theoretically this procedure is based on the healing property of bone known as (RAP) regional acceleratory phenomenon. This procedure involves the surgical demineralization of the cortical bone (corticotomy) thereby decreasing the resistance offered by the cortical bone of the teeth to the orthodontic force applied and use of particulate bone grafting. This method not only enhances the width of the alveolar bone but also decreases the duration of the treatment and chances of apical root resoption. It also increases the stability of the treatment by reducing the chances of relapse. A proper case selection, careful surgical procedure and accurate orthodontic movements are important for the success of wilckodontics orthodontic forces.

  17. Sidhesh Somne, Dr. Bindu Sarfare, PT. and Dr. Snehal Ghodey, PT.

    Abridged elasticity in Hamstrings and Back leads to Back Pain, Muscle strains, etc. This aims, outcome of Supervised Self Myofascial Release over plantar fascia increasing Hamstring in addition to Lumbar Flexibility. Inclusion -exclusion criteria subjects were selected, informed consent taken. Screening done by Active knee extension. Subjects being randomly divided into 2 groups: Group A (experimental) treated under supervision, B (control) not given the intervention for time being. Pre and post Treatment were stastically analysed. Group B subjects treated post assessment Hence, it concluded Self Myofascial technique signifcantly improved Lumbar with Hamstring Flexibility.

  18. Amar Saharan

    Background: Open fractures are a difficult entity, often complicated by infection and nonunion. Bone loss in such fractures adds to the complexity. Conventional techniques of bone defect management are mainly directed toward fracture union but not against preventing infection or joint stiffness. In this case series, we evaluated Masquelet’s technique for management of open fractures with bone loss. Materials and Methods: Twenty seven open fractures with bone defect, which presented within 3 days of trauma were planned for treatment by Masquelet’s technique. Follow up ranged from 21 to 60 months. Results: Average length of bone defect was 6 cm. Radiological union was obtained at a mean of 280 days since first stage of surgery. Time for union was not related to the size of defect. Union was faster in metaphyseal region (265.6 ± 38.8 days) as compared to diaphysis (300.9 ± 58.6 days). No patient had residual infection after stage 1. All the patients were able to mobilize with full weight bearing after radiological union with a satisfactory range of motion of adjacent joints. Conclusion: This technique can be routinely applied in compound fractures with bone loss with good results. Chances of infection are reduced using antibiotic cement spacer as an adjunct to thorough debridement. Induced biomembrane revascularizes the graft. Union can be expected in most of the cases, however, long time to union is a limitation. Technique is cost-effective and does not require special training or instrumentation. Although it is a two-stage surgery, requirement of multiple surgeries, as may be needed in conventional methods is avoided.

  19. Aourarh, S., Ait Said, L. and Zahlane, K.

    Aim: The aim of our study is to define the epidemiological profile and antibiotic sensitivity of isolated bacteria from blood cultures, in order to enhance the probabilistic antibiotherapy of bacteremia. Material and method: This is a retrospective study, conducted in the laboratory of bacteriology at IBN TOFAIL hospital in Marrakesh over a period of one year (January 2016-January 2018), covering all the bacteria isolated in blood cultures collected from inpatients. The bacterial identification was made by biochemical gallery "Api" and the sensitivity to antibiotics was tested by antibiogram on agar medium according to the recommendations of the EUCAST 2017. Results: During the study period, 460 Blood culture were performed from which 124 bacterial strains were isolated. Enterobacteriaceae dominated the epidemiological profile and accounted for 39% of isolates followed by coagulase-negative Staphylococcus (35%), Enterococcus spp (10%), taphylococcus aureus (6.5%), Acinetobacter boumania (6.5%) and Streptococcus spp (3%). 71% of isolates were from ICU departments. Antibiotic resistance showed that 50% of S.aureus were resistant to oxacillin (Methicillin-resistant Staphylococcus aureus MRSA), 46% of Enterobacteriaceae were resistant to third generation cephalosporins, 21% of which were Extended-spectrum beta-lactamase (ESBL) producers. Conclusion: For a better guidance toward the choice of antibiotics in bacteremia, regular epidemiological studies of blood cultures isolates, and antibiotic sensitivities are necessary and recommended.

  20. Ms. Rinal W. Jadav, and Dr. Anil Sharma

    Background: Anesthesia is defined as a health practice that makes the patient unaware of their surroundings during a surgical procedure. The thought of undergoing general anesthesia frightens many people worldwide. There are some different types of therapies used for reducing the effect of anxiety before administration of the general anesthesia. Music is a non-pharmacological, inexpensive, and safe technique to reduce the anxiety before general anesthesia. Objectives: 1)To assess the effectiveness of non-pharmacological management of anxiety for patients going for general anaesthesia. 2) To determine the association between anxiety level and demographic variables of selected patients going for general anaesthesia. Methods: A quantitative research approach, pre-experimental research design was used to assess the effectiveness of non-pharmacological management of anxiety on 76 patients who were undergoing general anesthesia at selected hospitals of center part of Gujarat with non-probability convenient sampling technique using Pre Intrusive Thoughts Inventory (“The PITI”) scale. Results: In pre- test majority of the participants 38 (50%) were having moderate anxiety, 37(48.68%) were having mild anxiety and 1(1.32%) was having severe anxiety. The mean anxiety level of patients going for general anesthesia is 30.27 with mean percentage 37.37%, median 27, mode 21, range 42 and standard deviation was 11. In post-test majority of the participants 41 (53.9%) were having mild anxiety, 35(46.1%) were having moderate anxiety and no one was having severe anxiety. The mean anxiety level of patients going for general anesthesia is 28.47 with mean percentage 35.14%, median 24, mode 21, range 37 and standard deviation was 9.50. The mean anxiety score in post test (28.47) was lesser than the mean anxiety score in pre-test (30.27) with the mean difference of (1.8). And paired t calculated value is 4.547 *p<0.05 is significant at 0.05% level. Conclusion: It can be concluded that the non-pharmacological management is effective in reducing anxiety for patients going for general anesthesia.

  21. Dr. Eman Abdulla Marie

    Background: Thalassemia is the name of a group of genetic blood disorders. To understand how thalassemia affects the human body, you must first understand a little about how blood is made. Hemoglobin is the oxygen-carrying component of the red blood cells. It consists of two different proteins, an alpha and a beta. If the body doesn’t produce enough of either of these two proteins, the red blood cells do not form properly and cannot carry sufficient oxygen. The result is anemia that begins in early childhood and lasts throughout life. Since thalassemia is not a single disorder but a group of related disorders that affect the human body in similar ways, it is important to understand the differences between the various types of thalassemia. Aim: The aim of the research was to determine the prevalence of thalassemia and its characteristics among patients of a thalassemia center at Ibn-Alatheer hospital, Mosul /Iraq. Methods: This study was conducted on 86 cases over a period of one month from November 10,2017 until December 10, 2017.A specially designed questionnaire form has been prepared; this questionnaire was filled by direct interviews with thalassemic patients taking clinical and familial history then comparing them with their clinical profiles. Results: During the study period of 1 month, about 86 cases were studied. All patients were thalassemia beta major .The first degree consanguinity were 47(55%) from 86 patients. While second degree 31 (36%) from 86 patients. The last percentage were non consanguinity 8(9%) from 86 patients. The age of the patients ranged between 1 – 29 years old. The mean age was found to be 10 years old. All cases displayed abnormal Hb variability. Thalassemic females were 48(56%) while males were 38(44%). Conclusion: In view of the high prevalence of hemoglobinopathy of thalassemia in this region, a routine premarital screening program is needed for the identification and prevention of high-risk marriages and thus, prevention of the psychosocial trauma of bearing a transfusion-dependent child for life.

  22. Kaur Shaminder, Sharma Preksha and Jaura Manjit

    Background: Nausea and vomiting are among the most prevalent and disturbing side effects of chemotherapy. Therefore, there is a need for additional antiemetic agents that could effectively reduce chemotherapy-induced nausea and vomiting (CINV), whether alone or in combination with current standard therapies. Since clinical data on the effectiveness of ginger in patients with breast cancer is lacking, the present study aimed to evaluate the effects of ginger against both acute and delayed forms of CINV in a population with breast cancer as the main malignancy. Methods: In this double blind randomized clinical trial, 60 women with breast cancer who were initially assigned to standard Anthracycline based chemotherapy protocol with the C.A.F regimen were randomly assigned to receive ginger extract (1.0 gm/day in 2 divided doses every 12 hours) plus standard antiemetic regimen or placebo containing glucose with standard antiemetic regimen to control group. The duration of treatment with ginger was specified to 4 days from the initiation of chemotherapy. Chemotherapy induced nausea & vomiting were assessed using MASCC Antiemesis Tool. Result: Significantly low number of subjects had chemotherapy induced nausea and vomiting in the experimental group during acute and delayed period after chemotherapy. In cycle 2 and 3 of chemotherapy significantly less number of subjects suffered from nausea and vomiting in experimental group as compare to control group in acute and delayed period. Conclusion:-Addition of ginger (1 gm/day) to standard antiemetic therapy in patients with breast cancer effectively reduces the chemotherapy induced nausea and vomiting. However, there is no side effects observed with use of ginger. Recommendations: Ginger should be given to breast cancer patients receiving Anthracycline based chemotherapy to decrease CINV.

  23. Ekine A.A., Ibrahim I.A, Unachukwu, C.E, Jeremiah, I., West .O. and Akanate I.D.

    Background: High level of suspicion of heterotrophic pregnancy (HP) is necessary, when women within their reproductive ages present with symptoms of acute abdomen. Although regarded as a rare phenomenon, increased incidence of heterotrophic pregnancy from spontaneous and ART (assisted reproductive technology) have been observed. It could lead to life-threatening condition, if diagnosis is delayed. Spontaneous heterotrophic pregnancy is the presence of two gestations simultaneously, with an estimated prevalence of 0.08% in normal conception. Case Presentation: A 33-year-old nulliparous university student, with previous history of 4 terminations of pregnancy, and a three-year history of secondary infertility from a broken marriage was presented to our accident and emergency department as a result of acute abdomen. Urgent urine pregnancy test with a careful ultrasound assessment led to the diagnosis of a HP. Emergency surgical intervention with supportive measures resulted in a successful feto-maternal outcome as the patient had a normal delivery of a male infant at term. Conclusion: We reported a case of heterotrophic pregnancy of a patient with issues of secondary infertility for a period close to three years, who presented with acute abdomen. Considering the presentation and the increase of this phenomenon from literatures, it is therefore imperative for an adequate advocacy about this possibility during pregnancy.

  24. Abeysundera Hesitha, Lam Anthea Ki Kwan and Nicoll Mandie

    Objective: The Royal Australian and New Zealand College of Psychiatrist (RANZCP) Clinical Practice Guideline for Schizophrenia and Related Disorders highlights the importance of regular monitoring of physical health in those with psychotic illnesses. This audit is a retrospective review of current practice at a regional community mental health team* with regards to identifying patients on anti-psychotic medications and monitoring those at risk of metabolic syndrome in comparison to the standards set by the RANZCP Guidelines for metabolic monitoring. It considers whether implementation of a dedicated metabolic monitoring clinic could improve monitoring in a regional psychiatric outpatient clinic. Settings: This audit was based on data collected from a single community mental health team which covers low socioeconomic suburban areas as well as a small aboriginal community. Patients seen in the outpatient clinic on anti-psychotic medications had a range of diagnoses including psychotic depression, chronic schizophrenia, and schizoaffective disorder. Subjects and Methods: Patients from a single regional adult community mental health clinic ranging in age from 18-70 years old and on anti-psychotic medications were included in the study. A pre-intervention audit of monitoring of metabolic syndrome was performed on all such patients. A dedicated metabolic monitoring clinic was set up, including targeted improvement strategies to make monitoring more accessible in a clinic-based setting and post-intervention audit was then undertaken at 6-monthly intervals. Results: Implementing a metabolic monitoring clinic 3 days a week was associated with a significant improvement of 33% in rates of metabolic monitoring. Conclusion: The metabolic monitoring clinic led to improved screening and monitoring of metabolic syndrome in patients on psychotropic medications but standards remained lower than recommended. Ongoing psycho-education and incorporation throughout the service would likely facilitate extrapolation of these results over time. Further research into focussed strategies is required to improving monitoring to guideline concordant rates.

  25. Dr. Malleswari Devi, A. and Mrs. A. Devaki

    Electronic banking is generally an extension of traditional banking, using the internet as an electric delivery channel for banking products and services. The banking today is redefined and re-engineered with the use of IT and it is sure that the future of banking will offer more sophisticated services to customers with the continuous product and process innovations. Thus there is a paradigm shift from seller’s market to buyer’s market. So banks also change their approach from “Conventional Banking to Convenience Banking” and “Mass banking to Class Banking”. The study examines various relevant issues relating to role of IT in banking and recommends to ensure privacy and confidentiality of data. Implemening IT and other Cyber laws properly. This will ensure the developmental role of IT in the banking industry. The technology needs to be integrated in an organization, with the change management issues linked to people resisting new concepts and ideas. It also needs to support a clearly defined and well communicated business strategy.

  26. Rowena A. Catuday, Ed. D.

    This study aimed to develop and validate the Laboratory Workbook in Plant Biology. It was conducted at Eastern Samar State University during the second semester of school year 2016-2017 with 34 2nd year BSED Biological Science major students and 5 plant biology professors/instructors as respondents. The study used the descriptive-experimental method to describe and evaluate the developed laboratory workbook in Plant Biology using the questionnaire checklist and test results in gathering data. A pretest and posttest was administered to the student users to determine the performance in Plant Biology of the two groups of respondents. They were asked to evaluate the laboratory workbook through the following: format, language, content and evaluation. As to the level of acceptability, science experts rated the laboratory workbook in terms of learning competencies, appropriateness, presentation and organization, accuracy and up-datedness of information. Responses were tallied, tabulated and interpreted with the used of appropriate statistical treatment. Findings of the study showed that the laboratory workbook had a very nice format, very understandable and very appropriate to the target user since it very satisfactorily met the criteria and standard set for its evaluation and assessment. The students exposed to the developed laboratory workbook attained better performance than students taught without the use of the workbook in Plant Biology. The developed workbook contributed to the improvement of students accomplishments in plant biology. It is therefore recommended by the author that the developed laboratory workbook is effective and acceptable for use as instructional material in teaching Plant Biology.

  27. Melisew Tibebu, Yohannis Joressa and Seifu Zinab

    The main purpose of this study is to assess EFL teachers’ practice of using authentic materials in improving students’ communicative competence. The researchers selected five woredas out of 14 woredas using simple random sampling technique. Thus, 15 English language teachers who were teaching English language in the year 2017/18 G.C.in the schools were selected for interviews, questionnaires, document analysis, and classroom observation by using simple random sampling technique. Mixed research design which involves both quantitative and qualitative techniques of data collection and analysis were employed. The data gathered through open ended questionnaire, interview and document analysis were transcribed and thematically organized and then qualitatively analyzed. Then, the researchers tried to triangulate the data obtained through these methods by observing what actually happened in the actual classroom. The overall findings of this study indicate that in spite of the fact that authentic materials are crucial to develop students’ communicative competence, less attention is given to incorporate the materials.

  28. Mazhul, L.A. and Tyutyunnik, V.M.

    A particular solar cooker namely the Binary oppositions are necessary attributes of the Universe. One important manifestation of bipolarity is duality of mental processes, defined by brain lateralization on left and right hemisphere, what determines the creative activity in a particular area: art or science, poetry or painting, physics or lyrics. It is known to divide people into two opposite class: the romantics (right-brain) and pragmatics (left-brain). A highly talented creative personality also falls into two main classes: born in the winter are romantics, born in the summer are pragmatists. Born in winter, typically, are outstanding poets, painters, composers; born in summer are prominent physicists, bankers, administrators, as well as brilliant surgeons and pianists.

  29. Ubah Chukwudi Nelson, Onyebueke Mary Chiamaka and Omodu Collins, O.

    Background: The study focused on discipline and organizational performance in Nigeria. The study was carried out because of the high level of indiscipline amongst some workers which always affects the level of organizational performance. Ethical theory was employed to analyze the subject matter. Methods: The study used only secondary sources of data through literature review approach. The data collected from literature sources were discussed qualitatively. Results: The study discovered that the effect of discipline on organizational performance include industrial peace and harmony, organizational high productivity, increased revenue, employee career development and environmental friendliness. Also, economic, socio-cultural, political and managerial factors are basically responsible for workers indiscipline in Nigeria organizations. Conclusion: The study concludes that the achievement of organizational high performance among other factors is dependent on the level of employee commitment and dedication to duty in the system which is controlled by the level of employee discipline in the system. The study therefore recommends that Nigeria organizations should develop ethical code of conduct and follow it in their management process so as to maintain discipline; there should be constant training and retraining of organizational staff so as to make them adhere to disciplinary behaviour and organizational employees should always be motivated so as they will not have excuse to exhibit an act of indiscipline as that will have positive effects on organizational performance and growth.

  30. Basavanagouda and Dr. Basavaraj, C.S

    In the contemporary global economic scenario international trade and business transactions are highly influenced by the tax agreements between the tax jurisdictions, India is a signatory for about 100 double taxation avoidance agreements. The paper brings out the important features of Indian double taxation avoidance agreements, Indian network of tax agreements, Comprehensive and limited agreements, Relief mechanism, Structure of tax agreements, Taxing rights of the countries and Withholding tax rates applicable. The paper indicates the increasing trend in the signing of tax agreements by India. The paper concludes that the tax agreements being very significant to promote trade and commerce and increase exports from India there must be a sound policy in renegotiating the very old agreements with certain countries.

  31. Saprudin and Ahmad Syukron

    The purpose of this study was to find out: (1) Quality of work productivity of employees in the Solar Water Drinking Water Company Bogor, and (2) Improve the quality of work productivity of employees in the Bogor Water Drinking Water Company Bogor. Limitation of the problem in this study includes improving the quality of work productivity of employees. Besides that, this research focuses on the main problems. Other restrictions are time and cost constraints. The results of the study indicate that: (1) Planning (Plan) has been made but there are still problems concerning: (a) Funding, (b) Special training, and (c) Low quality of work productivity of employees, especially timeliness and achievement of targets, (2 ) Implementation (Do) is still a problem, there is no way to solve the problem of improving the quality of work productivity of employees that have been planned, (3) Check (Check) there are still problems, namely the quality of employee productivity is not in accordance with what is desired, the resources needed are less available, and the quality of employee work productivity that is being carried out requires continuous improvement, and (4) Improvement (Action) there are still problems namely Service Standards (SP): not yet in the Surya Water Drinking Water Company Bogor, and complete facilities, infrastructure, knowledge, technical competence, public perception, etc. inadequate, still lacking.

  32. Ni Wayan Umi Martina and I Made Arjaya

    The purpose of this research is to get answers to two legal issues, namely first, why is it carried out sealing of bankrupt assets, second, what are the benefits of sealing bankrupt assets for Curators and for Creditors. Legal material collection techniques with structured interviews with parties related to existing legal issues. From the results of the research and discussion it was concluded that the bankrupt assets were sealed because the Debtor was not cooperative and if the bankrupt assets were not sealed, the curator would not be able to exercise the authority given to him to sell bankrupt assets and the debtor could harm the creditors because they still controlled and benefited from the bankrupt assets without carrying out its obligations to pay its debts to its creditors.

  33. Giri Babu, B. and Dr. I. Nageswara Rao

    This paper unleashes the idea that financial ratio analysis is the one of the powerful tool to analysis the financial Statements. It provides meaningful understanding and interpretation which absolute accounting data cannot provide. Financial ratio analysis is important to the management, owners, customers, suppliers, competitors, regulatory agencies, tax payers and lenders each having their views in applying financial statement analysis in their evaluations and making judgments about the financial health of organization, while some authors found that financial ratios analysis is an adequate method by which to evaluate the overall performance of an organization.

  34. Alejandra Martinez and Tonya Huber

    In this review of the professional literature, we analyzeattributional feedback and its effect on self-beliefs and academic achievement. As defined by various researchers, attributional feedback refers to feedback that focuses on the students’ abilities and efforts. Studies on the effects of these two types of praise in combination and isolation show a positive correlation between attributional feedback, self-beliefs, and academic achievement. Despite these findings, effort feedback is preferred by many theorists and researchers as it is said that ability feedback can have negative effects on students following failure. Nevertheless, studies which compared the effects of self-efficacy demonstrate that compared to no attributional feedback at all, those receiving this type of feedback showed improved self-efficacy and academic achievement. These findings have important implications for educators who wish to increase student motivation and consequently, academic achievement.

  35. Jeevitha, K. M. and Veena S. Jadhav

    Background: Rain water harvesting (RWH) is a technology that can be used for collecting and storing rainwater from rooftops, open land surfaces using simple storage utensils such as tanks, pits and cistern. Harvested rainwater is a renewable source of clean water that is ideal for multiple uses. Objectives: The present research was conducted with the objective of exploring the purpose for adoption of rain water harvesting system, to assess the physical and chemical characteristics of harvested rainwater samples and assess the impact of usage of harvested rainwater for drinking and cooking purpose. Methods: The study was conducted in urban areas of Dharwad and Hubballi cities, in Dharwad district of Karnataka state. Purposive Random Sampling technique was adopted to choose 60 adopters of rainwater harvesting system, 30 each from Dharwad and Hubballi cities. The harvested rainwater samples were collected during the January month of 2017 so that all seasonal and non-seasonal rains of the year 2016.The rainwater samples were subjected to analysis and checked against drinking water standards prescribed by Bureau of Indian Standards (BIS 10500/1991). Results: The results of the study revealed that majority of the rain water harvesting systems were constructed during 2010-12, costed less than Rs. 20,000/- for construction. It was found that only 5 residents adopted rooftop rainwater harvesting system and use harvested rainwater for domestic purposes. Majority of the residents had borewell recharge system. The adopter cleaned the rain water harvesting system whenever it was dirty and had no filtration system. Conclusion: The physical and chemical parameters of harvested rainwater qualified to the BIS drinking water criterions. The regular maintenance of rain water harvesting system was found to be necessary for ensuring quality of harvested rainwater and life span of the system.

  36. Mutinda Celestine Mutheu, Gatotoh Augustine Mwangi, Keiyoro Peter Njenga

    Revenue authorities are continually implementing strategies to enhance quality of taxpayer services as well as optimize revenue collection within set timelines and budgets. In this regard, Kenya Revenue Authority introduced the iTax system, to enable taxpayers declare tax payable by themselves at the comfort of their homes and offices. This paper is premised on the Technology Acceptance Model). It designed to establish the factors that influence acceptance of the iTax system in Kenya. The variables examined and presented in this paper included the taxpayers’ attitude towards technology and iTtax system. The descriptive research design was used with the target population comprising of 5330 taxpayer property owners in eastern side of Nairobi city. A randomly selected sample of 98 respondents was identified and primary data gathered using a questionnaire. The results showed a positive correlation between user attitude and acceptance of the iTax system (r=.888**p < 0.01). An analysis on technological determinants of iTax acceptance showed a positive \ technology suitability (r=.871**p < 0.01). It was concluded that the positive attitude of taxpayers towards the iTax has greatly contributed to the acceptance of the system. In addition to the attitudes taxpayers are also variously influenced by the suitability, coverage and security of the iTax technology. The study recommends the need for continuous awareness creation, training on the system usage and consideration of user friendliness in systems upgrades.

  37. Dr. Julius Otieno Gogo

    Education policies in Kenya are based on the philosophy spelt out in Sessional Paper No. 10 of 1964 on African Socialism and its Application to Planning in Kenya. The thrust of the Jomtien Conference of 1990 was that all children, young people and adults have the fundamental right to benefit from an education that would meet their basic learning needs. The Dakar Conference in Senegal in 2000 obliged all countries of Africa to achieve education for all by the year 2015. One of its principal goals aimed at improving all aspects of quality of education so that recognized and measurable learning outcomes are achieved by all. To respond to this urge, the growth in the number of schools, colleges and universities, both public and private, has been on the increase to absorb the growing number of learners. In universities evening classes have become a beehive activity similar to tuition in primary and secondary schools. However, many students continue to miss form one and university places in Kenya due to lack of fees and adequate classrooms. Quality education is the degree of achievement in education as evidenced by performance in national examinations, transition from one level of education to the next and retention in the education system. It is influenced by factors such as the quality of student intake, physical facilities, teachers, the curriculum, availability of textbooks, good discipline and the financing of education. Poor performance is a result of low quality of education and has been blamed on poor teaching methods, absenteeism among students and teachers, irrelevance of the curriculum and the inadequacy of the examination system itself. The questions that arise include: What is the optimum level of the quality-quantity trade off? Is it achievable in Kenya?

  38. Jamilah M. Hashemi

    Indomethacin (IND) is an extensively used drug. However, it provokes aggressive ulcerogenic potential. Chamomile is a widely used as natural herb with a powerful antioxidant activity. This study aims to assess the effects of chamomile flowers extract (CFE) in IND induced peptic ulcer (PU). Fifty rats classified to five groups; control, ulcer, and pretreated groups with CFE (200 mg/kg), pretreated with ranitidine RAN (50 mg/kg), and pretreated with CFE+RAN for 14 days pre-ulcer induction. Pretreatment with CFE and/or RAN significantly decreased ulcer index, gastric acidity, pepsin activity, gastric oxidative stress biomarkers, serum anti-inflammatory cytokines, and histopathological changes induced by IND. The pretreated groups significantly elevated gastric enzyme antioxidant activity, mucin content and gastric mucosal prostaglandin E2 with comparison to IND group. Pretreatment with CFE+RAN displayed the most gastroprotective effects compared with pretreated with either CFE or RAN alone. Collectively, the antisecretory and cytoprotective effects of antioxidant and anti-inflammatory activities demonstrated by the CFE's gastroprotective action.

  39. Efuet Simon Akem

    Diverse cultures have elaborated outstanding variety of ways of relating with nature. Many of these are ecologically adaptive, but this is not to say that all of them make ecological sense. Ethnoecology of bushfire among the rural Bakweri people indicates that bushfire is an ancient practice though local practices altered slightly over time in response to larger political and environmental events. The effects of bushfire on the livelihoods and on the ecosystem in Cameroon have more and more become damaging over the years. The increasing frequencies of bushfires in the face of forest conservation and climate change require that researchers focus attention on such anthropogenic activity over which man has control. Current understanding of the fire practices in and around the Mount Cameroon National Park remains rudimentary. The study uses some ethnographic techniques such as in-depth interviewing and Participant observation to establish local practices, perception and behaviour of bushfires in the area. To rural Bakweri people, the forest seems to be all-encompassing and an indispensable link in the circle of growth and death. The study concludes that local cultural knowledge and perception of the forest substantially influence bushfires practice among farmers in the area.

  40. Dr. Emilda Josephine, H.

    India is a country which reveres the country as ‘Motherland’ and ‘Bharatha Matha’. It names its rivers with women names: ‘Ganga’, ‘Cauvery’, ‘Godavari’ ‘Narmadha’ and ‘Tungabadra’. There are many Goddesses who are worshipped for their valour, courage and strength. The culture, though seemingly patriarchal is bound to be maternal in all aspects. It pays the highest regard to the mother in the family. Gender sensitivity is the awareness and acceptance of the ‘ignored sex’ – the female gender. It lies in the affirmation of any role and responsibility to the female gender without rejecting them on the basis of their sexuality. Pro-gender sensitivity deals with the acceptance of all people about their identity in society. It initiates a dynamic change in the perception of the people. They should be taught to perceive ‘the ignored sex’ – women equally as counterparts of the society. This paper tries to discuss some strategies to initiate Pro-Gender sensitivity among students.

  41. Zionvarzing Thiek, Tulika Borah and Arifa Momtaz Begum

    Emotional Maturity refers to one’s own ability to control emotions and how well an individual is able to respond to situations when dealing with others and faced with difficulties. The purpose of this study was to find the level of emotional maturity of 20–24 years students and to find out if there is significant difference between male and female in emotional maturity. A total number of 100 Post Graduate students of age 20-24 years old were selected randomly as sample for the present study from the hostels of Assam Agricultural University, Jorhat. Out of which 50 were males and 50 were females. The “Emotional Maturity Scale” standardized by Singh and Bhargava was utilized to assess the emotional maturity level of 20 – 24 years students. Frequency and percentage was calculated to find out the level of emotional maturity and mean, S.D., independent sample t-test have been used for data analysis. The findings of the present study revealed that majority of the respondents were emotionally immature and there is no significant difference between males and females in emotional maturity.

  42. Dr. Rajender kumar

    In the changing phase of the business environment of the world, ample of advances and progress have been made in our understanding the relationship between entrepreneurships and innovations. Yet, an adequate understanding concentrating the articulation of entrepreneurship, innovation and growth is lacking in India. The immediate objective of this paper is to shed light on the flourishing start up systems in today’s scenario in India. Also to understand how new entrepreneurs have evolved in the recent past and the role of innovation in the growth process of an enterprise. The main methodology of this paper is based on secondary data researched from various journals, papers and articles. The purpose of this paper is to contribute to future researches on related topics. The overall image that emerges from this research is to emphasize the growth of entrepreneurs through the main engine innovation. The story add nuance to our understanding that innovative opportunities are the outcome of systematic and purposeful efforts of investing in new ideas in business.

  43. Dr. Nandhakumar, Dr. AR. Balaji, Dr. JVS. Prakash, Dr. K.V. Arasi and Dr. Vetrichandar

    Introduction: Stone disease is a world wide health problem. We evaluated the efficacy of nifedipine and alfuzosin in the medical management of symptomatic, uncomplicated lower ureteral stones. Materials & methods: This was a randomized controlled prospective study to determine the efficacy of alfuzosin and nidedipine as medical expulsive therapy, to increase the stone-expulsion rates in distal ureteric calculus of size less than 10 mm. Patients were randomly divided into three equal groups of 70 patients each. Patients in group I received nifedipine 30 mg/day, group II received alfuzosin 10 mg/day and group III received a placebo in same dose frequency. Patients were followed up weekly until the patient was stone free or upto 28 days. Statistical analysis was performed and P<0.05 was considered to be significant. Results: Stone expulsion was observed in 60%, 85.7%, and 20% patients in group I,II,III respectively. A statistically significant difference was noted in between groups I vs III, groups II vs III and groups I and II (P<0001, P<0.0001 and P<0.0315 respectively). The mean pain attack episodes were 5.91+-1.01 for group I, 3.8+- 0.83 for group II, and 5.82+-1.12 for group III, which is statistically significant in group II versus III, and groups I versus II(P<0.001 and P<0.001). Conclusions: The use of alfuzosin and nifedipine as a medical expulsive therapy for distal ureteric stones is safe and effective in term of increased stone expulsion rate, reduced pain attacks and decreased hospital re-admissions.

  44. Mohammad-Ayman A. Safi

    Objectives: Although only three studies are available in Saudi Arabia concerning celiac disease (CD) in Down Syndrome (DS), they showed considerable variation in the serological prevalence (4-15.5 %) and in the prevalence of biopsy-proven CD (2-10.7%). Thus, we aim to use meta-analysis to examine the prevalence of celiac disease (CD) in patients with down syndrome (DS) in Saudi Arabia (SA) using meta-analysis for these three studies. Methods: We used the comprehensive systematic search through database and journals followed by selection processes. For data analysis we used two programs: 1-The statistical package for social science (IBM SPSS Inc). 2- The Comprehensive Meta-analysis program (CMA). Results: The three related articles involved 226 (51-91) DS patients with age range (0.5-18 years) covering children and adolescents. The CD positive patients showed considerable variation (4-15.5%) for the serological prevalence and (2-10.7%) for the prevalence of biopsy-proven CD. By Meta analysis the seroprevalence of CD (one serology at least) was 13.4% with moderate heterogeneity (I2=46.519), while the prevalence of biopsy-proven CD 9.4% with moderate heterogeneity (I2=29.229). Anti-tTG was used in all studies; as single in one study; with EMA and AGA in one studies; with EMA and AGA and ARA in one study. Conclusion: People who have DS in SA tend to develop CD at rates (9.4%) higher than the global prevalence (5.8%) and far above those in the Saudi general population (1.4%). The prevalence is high enough to motivate screening CD in DS children. There is a significant difference between the reported serologically- proven rates and the reported biopsy- proven rates (p = 0.002).

  45. Dr. Dipankar Pal, Dr. Mitali Majumder and Dr. Tapas Paul

    Ectodermal dysplasia relates to a group of inherited disorders where the ectodermal derivatives such as skin, sebaceous glands, hair, enamel and nails are malformed. Oligodontia or hypodontia along with abnormal shape of crown is a common dental feature of ectodermal dysplasia. There may be reduction in vertical dimension as alveolar process does not develop in absence of teeth along with varying degrees of xerostomia due to hypoplasia of salivary glands. Those cases of ectodermal dysplasia where oligodontia, abnormal shape of crown, reduced vertical height are the clinical challenges, neither removable nor fixed prosthesis is possible nor is conventional complete denture suitable. Telescopic crown with over denture can be a predictable treatment option in these cases.

  46. Dr. Sowmya, B., Dr. Srujani, J., Dr. Shantha Bai, K., Dr. Srinivasa Rao, R., Dr. A. Anitha and Dr. Mahendranath, Y.

    Introduction: Hypertension is one of the leading cause of global burden of disease and as it is a chronic condition with significant detrimental effects on the wide range of health outcomes, cost effective management of hypertension a appears to be a great challenge for both developed as well as developing countries eventhough recently there have been lot of studies on pharmaco- economics and out come research in the field of hypertension globally, but the results cannot be exactly extrapolated to Indian scenario as the economic status and socio economics factors are different in India as compared to the countries. Hence a study was undertaken to evaluate the cost effectiveness of antihypertensive drugs in our hospital. Objectives: To evaluate the prescription pattern, cost effective antihypertensive therapy and quality of (QoL) of the patients. Materials and Methods: An observational comparative study is planned on 100 patients Attending the outpatient Department of General medicine at GGH, Ananthapuramu from JUNE 2018 to DECEMBER 2018 with a follow up period of 6 months. Written informed consent is obtained from all the patients satisfying the inclusion criteria. In first visit, a detailed history is taken regarding the disease (hypertension) duration, co morbid condition, socio economic status, duration of antihypertensive therapy. Blood pressure and pulse is recorded, drug therapy details noted like pattern (monotherapy or multi drug therapy), costs of the drugs, dosage of the drug and changes in the drug therapy. After 6 months, again same details are collected. The details so obtained regarding the different patterns of drug therapy are analysed for the cost effectiveness. Statistical tests used for analysis are Chi square Test and “T” test. The QoL is evaluated with SF – 30 questionnaire. Results: Multitherapy was frequently prescribed (74%), out of that Atenolol with amlodipine. combination was most common (54%) , Diabetes was the most common co- morbid condition (24%). In mono therapy Amlodipine proved to be more cost effective (CER of 8.93) then Atenolol (CER 18.15) (p-0.0059) and in multitherapy Amlodipine with Enalapril combination was more cost effective *CER 18.24) then Amlodipine with Atenolol (CER 27.73) with (p-0.057). Conclusion: Multitherapy was most frequently prescribed, and Amlodipine with Enalapril combination proved to be most cost effective therapy. HRQoL was not much different in all the treatment groups.

  47. Shujie Tang

    Purpose: To determine the favorable therapeutic position for Chinese manipulation in treating lumbar disc herniation. Methods: We developed a three-dimensional finite element model of L3-5 for the normal spine, along with a mild degeneration and a moderate degeneration model, and carried out a comparative study between the manipulation with lateral position and that with sitting position. The displacement and stress distribution in the intervertebral disc of L4 were investigated. Results: A displacement and stress directing forwards concentrated on the left rear of L4 disc were found in the three models under the two manipulations. The values of displacement and stress under the manipulations with lateral position are larger than those with sitting position in the three models. Conclusion: Lateral position has a better biomechanical effect than sitting position in treating lumbar disc herniation.

  48. Dr. Nidhi Khajuria

    Background: Oral cancer refers to cancers affecting the mouth, lip and oral cavity. The two major known risk factors for oral cancer are alcohol and tobacco. These factors have a synergistic effect so people who both drink and use tobacco have a much higher risk of oral cancer than those using only al- cohol or tobacco. Other factors that have been impli- cated in the development of oral cancer include poor diet and nutrition, sun exposure and the human papil loma virus. In India, oral cavity cancer is among the top five most common cancers in both sexes. This study intends to find out the knowledge, awareness and practice of risk factors of oral cancer among population of Jammu & Kashmir and to provide them health education about the prevention and early diagnosis. Methods: The cross sectional descriptive study was conducted in the Government Dental College & Hospital, Jammu, among 400 adults. Results: Majority, 265 (66.2%) of the population did not know the site of oral cancer, 325 (81.2%) did not know any clinical features of the oral cancer and 180 (45.0%) did not know about any risk factors of oral cancer. About 199 (49.75%) people agreed that there is a need for screening and regular oral examination to detect the lesions early. Conclusion: There is a need to generate awareness regarding the risk factors and about the good and harmful practices in the community.

  49. Yarajarla Ramesh Babu

    Back ground: In most invertebrate systems, dietary restriction is applied somewhat non-traditionally in that food quality, rather than quantity, is manipulated through dilution of the nutritional components in the medium. To clarify how these nutritional factors influence longevity, nutrient consumption and lifespan, we were measured on a series of diets with varying glucose and vitamin C content. Methods: The fly stock is assessed for this experiment is Drosophila melanogaster. The stock is obtained from the Drosophila stock centre, Mysore, India. For the dietary restriction assays, different concentrations of Glucose (3g/100ml, 5g/100ml and 7g/100ml), vitamin C (0.25mg/100ml, 0.5mg/100ml and 0.75mg/100ml) and both Glucose plus vitamin are formulated in the diet. For longevity analyses, we used the modified protocol of Luckinbill and Clare, 1985. Results: The flies fed with combination of Glucose plus Vitamin C resulted in an increased life span followed by Vitamin C and Glucose in both males and females when compared to control. However LD of Glucose fed flies have resulted significantly decreased lifespan. Interestingly female flies have shown significantly increased life span in all the concentrations. Discussion: In several studies has been demonstrated that increased intake of protein may increase protein synthesis, decrease protein breakdown, reduce fat accumulation, and increase fat-free mass. The flies fed with combination of Glucose plus Vitamin C resulted in an increased life span followed by Vitamin C and Glucose in both males and females when compared to control.

  50. Jouhadi, EM., Amzyl, FZ., Mahdoud, FZ., Hamza, M., Bennani, A. and Andoh, A.

    Introduction: Reproducing dental color requires an accurate shade reading, that will thereafter be transferred to the laboratory technician. Aim: The purpose of this study is to assess the validity of the visual dental shade-matching, as a conventional method, compared to the spectrophotometric shade-matching. Materials and Methods: With visual analysis, 16 prosthodontists examined the middle third of the sound maxillary right central incisor of students using VITAPEN® classical and Vita Tooth- guide 3D-MASTER®. One prosthodontist examined the same teeth using a spectrophotometer. The surveys have been performed within students of Dental Medicine Faculty of Casablanca. They have been conducted by practitioners of the medical staff of the Prosthodontic Department. Results: 192 visual shade selection were performed and converted to the Lab* system color. There was no significant difference between the Vita Classic® and Vita 3D Master® shades. However, regarding occupational categories and gender, a significant difference was found. Conclusion: According to our study, the visual shade-matching has a low to moderate reproducibility compared to the spectrophotometric reading. The sensitivity and the specificity of visual shade-matching, as well as the kappa index, indicate that the conventional method cannot be considered as a reliable tool. However, the study shows that the Vita 3D Master® shade guide presents more satisfactory results regarding its intrinsic validity, compared to the Vita Classic® shade guide.

  51. Rehab Omar Taman, M.N.Sc, Amal Elsayed Shehata, Prof. N.Sc, Salwa Abd El Gawad Sallam, D.N. Sc and Maha Mohamed Mady, P.T. PhD

    Background: The rate of anxiety and pain in coronary artery patients before angiography is significantly higher. Aim: This study aimed to examine the effect of foot massage on physiological and psychological parameters among patients undergone cardiac catheterization. Design: A quasi-experimental research design was utilized. Setting: The current study was conducted in cardiac catheterization unit of Menoufia University Hospital. Subjects: 120 patients undergone cardiac catheterization assigned randomly into two equal groups, 60 patients for each group: Studied group (I) received foot massage therapy besides the routine hospital care while control group (II) received routine hospital care only .Three tools were used by the researcher for collecting the necessary data; Structured Interview Questionnaire, State Anxiety Inventory (SAI) and Visual Analogue pain scale (VAS). Results: There was a statistically significant difference related to pain level between study and control groups post-intervention with p-value =0.02, also there was a highly statistically significance difference related to anxiety level between study and control groups post-intervention with p-value ≤ 0.001 and a highly statistically significance difference related to systolic and diastolic blood pressure as well as heart rate between study and control groups post-intervention. Conclusions: Foot massage has a positive effect in reducing anxiety and pain level as well as heart rate and blood pressure among patients undergone cardiac catheterization. Recommendations: Foot massage should be applied for patients before cardiac catheterization.

  52. Dr. Manish Dubey, Dr. Iqbalali, Dr. Namrata P. Awasthi and Dr. Neha Bajpai

    Adenoid Cystic Carcinoma (ACC) is a relatively rare tumor that accounts for 1% of all head and neck malignancies and 10% of all salivary neoplasms, according to the World Health Organization (WHO) classification of head and neck tumors. Most ACCs originate from the major and minor salivary glands, and a minority called salivary gland–type carcinomas, arise from glands in the nasal, paranasal, and external spaces. ACC has classically been described as having an indolent but persistent and recurrent course, with the delayed onset of distant metastases and eventual death of affected patients. Therefore, although uncommon, ACC is one of the most aggressive of the salivary gland tumors.

  53. Dr. Shilpi Sharma and Rakesh Sharma

    A drastic change in mankind has taken place mostly due to urbanization and industrialization. To cope-up with the speed of the modern era, one has to adopt junk food preparations, over-work and stressful duty schedule. Vitiation of Agni due to various causes leads to Amlapitta. Some of the common causes are - fasting, eating between meals, worry, hurry, spicy foods etc. These factors affect the Pachakapitta (digestive enzymes etc.) and as a result Pachakapitta vitiates. Thus the developed condition is called Amlapitta. A comparative clinical study was adopted in the clinical trial. 40 patients fulfilling the diagnostic and inclusion criteria were selected and randomly assigned into two groups i.e. group I and II. Without any dropout, the children in group I was treated with Khandkushmandaka Avleha and the children in group II were treated with Syrup Patoladi for 30 days. Result obtained after the clinical trial was analysed statistically and all the observation were subjected to creative discussion.

  54. Rosero, R.J. and Polanco, J.P.

    Background: The need to diagnose insulin resistance (IR) is increasingly relevant since an early diagnosis may lead to timely interventions that may slow down onset of associated diseases. Currently, the gold standard for assessing insulin sensitivity is the euglycemic clamp, however, its reproducibility at the clinical level is challenging. Hence, the Homeostatic Model Assessment of Insulin Resistance (HOMA-IR), and the oral glucose tolerance test (OGTT) are being used in the clinical setting to identify insulin resistance, prediabetes, and diabetes. Thus, the purpose of this study was to compare HOMA-IR with insulin curves and their association with early insulin resistance in overweight patients in relation to biochemical markers and anthropometric measurements. Methods: This was descriptive cross-sectional study in 199 patients between 18 and 80 years of age for which demographic data, anthropometric measurements including body composition by bioelectrical impedance, and paraclinical tests (blood glucose, insulin, lipid profile) were performed. Measures of central tendency (mean or median) and dispersion (standard deviation or percentiles) were analyzed for quantitative variables according to data distribution. Shapiro-Wilk and Shapiro-Francia tests were performed to determine normality, which showed that none of the variables are normally distributed, and were therefore corrected with the Spearman correlation coefficient (non parametrical test). Results: Correlation analyses between anthropometric and biochemical measurements (body mass index, hip perimeter, waist-to-hip ratio, waist-to-height ratio, glucose curves 0-120 min, and insulin curve 0-30 min) and body composition (body fat percentage, visceral adipose tissue, and HOMA-IR) were performed. This analysis showed a statistically significant association between insulin curve at 0-30 minutes and body fat percentage (rho= 0.3256; p < 0.001); (rho= 0.2383; p= 0.0007); visceral adipose tissue (rho= 0.2900; p < 0.001) and HOMA-IR (rho= 0.9835; p < 0.001); (rho= 0.5301; p < 0.001). No statistically significant association was identified between plasma glucose at 0 and 120 minutes and body fat percentage (p< 0.1226) or visceral fat (p < 0.2471). Conclusion: By approaching the correlation between basal insulin at 0 and 30 minutes post-loading with VAT, BFP, and other anthropometric indices, we obtained results that strongly suggest that HOMA-IR and glucose curves are altered late and without correlation to the amount of adipose tissue.

  55. Dr.Ranjan Kumar Satish, Dr.Mittal Ankur, Dr.Kumar Sunil and Dr.Bhirud Prakash Deepak

    Renal sinus lipomatosisis are condition, seen in the kidneys of elderly patients. Disease is usually unilateral and associated with renal calculi. There is proliferation of excessive lipomatous tissue in renal sinus, renal hilum and peri-renal space. Presentation of disease is varied, ranging from chronic renal pain to features of renal abscesses or pyonephrosis. Here we reporta interesting case of bilateral renal sinus lipomatosis mimicking as emphysematous pyelonephritis.

  56. Fanthome, Bernard

    A 37-year-old lady presented with a recurrent cystic lump in left hypochondrial region. It was initially thought to be of renal origin and marsupialized. Recurrence of the lesion after three years prompted a repeated surgery in the form of a sub-total excision wherein the “renal cyst” was noted to be densely adherent to the tail of the pancreas. The histopathology was reported as a “benign intestinal duplication cyst”. During post-operative period a collection was noted in left hypochondrial region, which was drained under ultrasound guidance. Further serial sonograms revealed progressive increase in its size as well as appearance of cysts in the ovaries; first in the left and then in the right ovary. Follow up CT Scan revealed a cystic lesion in the spleen with extra splenic extension into the tail of the pancreas. Large thin walled cysts were noted in both ovaries. Tumour markers like CA 125, CEA, AFP and BHCG were all within normal limits. The huge cystic masses of both ovaries and the spleen were distending the abdomen. She was taken up for exploratory Laparotomy and a Total Abdominal Hysterectomy with Bilateral Salpingoophorectomy, with Splenectomy and Distal Pancreatectomy was done. Her post-operative recovery was uneventful. Final histopathology examination revealed a Mucinous Cystic Neoplasm Pancreas with a Well Differentiated Adenocarcinoma Pancreas with extra Pancreatic Extension involving Spleen and Bilateral Ovarian Mucinous Cystadenomas. The rare lesion was difficult to label accurately because of its nebulous connection and origin from the tail of the pancreas. Once excised completely and accurately labelled she has been offered adjuvant chemotherapy which she is continuing, despite a stormy first pulse, which was complicated by a recurrence of collection in left hypochondrial region causing features of sub-acute intestinal obstruction, but managed successfully with ultrasound guided pig tail drainage. In view of propensity of metastases from pancreas to simulate primary mucinous tumours of the ovary a close watch is being maintained while continuing adjuvant chemotherapy.

  57. Dr. Titas Bhattacharyya, Dr. Swagata Gayen, Dr. Mahmud, S.K.A., Dr. Mousumi Pal and Dr. Sanjeet Kumar Das

    Ameloblastic fibroma is an uncommon benign odontogenic neoplasm characterized by simultaneous proliferation of both epithelial and mesenchymal component. It is most commonly seen between 1st and 2nd decades of life, the posterior aspect of mandible being the commonest site having slight male predilection. Herein, we report a case of ameloblastic fibroma in a comparatively higher age group of 35 year old female patient involving right mid face region.

  58. Dr. Yogesh Kukreja

    Background and objectives: Enhanced Recovery after Surgery (ERAS) or Fast-track Surgery (FTS) or Multimodal Surgery is a single program incorporating multimodal interventions in the perioperative period to expedite recovery. It involves using various strategies to facilitate better conditions for surgery and faster recovery with rapid resumption of normal activities without an increase in post-op complications or readmissions. Methods: A Prospective Interventional Randomised Controlled study was carried out at a Armed Forces Tertiary Care Hospital by selecting 60 patients undergoing elective gastrointestinal surgery with an Anastomosis anywhere in the Gl tract distal to (and including) the ileum. The patients were divided, after baseline parameters were recorded, by stratified randomization on the basis of the type of surgery required into case and control groups and subjected to 'fast track' and traditional protocols of peri-operative care and their post-operative recovery. Results: The case group had an earlier discharge from hospital with a mean of 4.73 days while the control group had a mean discharge day of 7.27 days. The rate of complications and readmission were not significantly different. Conclusion: Fast Track protocol represent a paradigm shift in perioperative care based on simple and evidence based principles. It has resulted in a significantly increased understanding of perioperative physiology and its modifications to improve outcomes. With simple, cost effective measures, ERAS is a vital and powerful tool in decreasing length of stay, complication and re-admission rates.

  59. Dr. Anand, K., Dr. Prakash, JVS. and Dr. Balaji, A.R.

    Background: Ultrasound measurement of the IPP has been previously described as an effective instrument for the evaluation of benign prostatic obstruction (BPO) and could help in clarifying the role of silodosin in patients with (BPE).Aim of our study was to investigate the efficacy of silodosin in patients with lower urinary tract symptoms (LUTS) and benign prostatic enlargement (BPE) with intravesical prostatic protrusion (IPP). Methods: In this observational study Patients with BPE and LUTS were enrolled. Intravesical prostatic protrusion was graded as grade 1 (< 5 mm), 2 (5 < IPP < 10 mm) and 3 (> 10 mm). Patients were treated with silodosin for twelve weeks. International Prostate Symptom Score (IPSS) and uroflowmetry was performed before and at the end of treatment. Patients were considered responders if a reduction of IPSS > 3 points was noted. Results: Of the sixty eight patients enrolled, two patients were excluded because of incomplete data. 26 patients showed an IPP grade 1 (group A), 27 a grade 2 (group B) and 13 grade 3 (group C). Treatment success was obtained in 80 %, 44 % and 7.5% of patients respectively; these differences (group A vs B-C and group B vs C) were highly significant. The odd ratio to obtain a treatment success was of 52 and 10 in group A and group B respectively, in comparison to group C. After a multivariate regression, the relationship between IPP grade and treatment success remained significant. Improvement of uroflowmetry parameters has been reported in all the groups especially in patients with a low grade IPP .Prostate volume seems not to influence this relationship. Conclusion: Intravesical prostatic protrusion has found to be significantly and inversely correlated with treatment success in patients with LUTS and BPE under silodosin therapy. silodosin odd ratio of success is 52 times higher in patients with a low grade IPP in comparison to patients with a high grade.

  60. Priya Malhotra, Vipin Bharti, Harmesh Sharma, Deepak Kajla, Sumanjit Kaur and Ketoulelhou Vizo

    Shallow vestibule along with inadequate width of attached gingiva is a common cause of gingival recession especially in mandibular anterior region. Vestibular deepening procedures have always been a point of concern for the Periodontist. Multiple techniques have been developed to increase the vestibular depth. This case report presents a vestibular deepening procedure with continuous locking suture.

  61. Dr. Vipin Balachandran, Dr. Takuya Narita and Dr. Allen James

    Mycotic aneurysms of saphenous vein grafts in coronary artery bypass grafts remain a rare entity with the bulk of global literature being case reports and small series. There is high morbidity and mortality associated with this condition in the peri-operative period. We present our experience with the surgical management of a mycotic aneurysm of a saphenous vein graft 14 years after the original operation.

  62. Dr. Surya Kant Kumar, Dr. Prakash, J.V.S. and Dr. Balaji, AR.

    Background: We compared outcome and complications after ureteroscopic treatment of ureteric calculi with short term external ureteric catheterisation vs routine use of double-j ureteral stenting. Methods: Between August 2017 and August 2018, 80 patients were prospectively randomized to double‐J stent insertion for 7 days vs ureteric catheterisation for 24 hours after ureteroscopic stone extraction. Exclusion criteria were active UTI, solitary kidney, stone size more than 20 mm or deranged renal function test. Stone characteristics, operative time, postoperative pain, lower urinary tract symptoms (LUTS), analgesia need, rehospitalisation, stone-free rate, and late postoperative complications were all studied. Results: There was no significant difference between the two groups regarding hematuria, fever, flank pain, urinary tract infection, and rehospitalisation. At 48 hours and 1 week, frequency/urgency and dysuria were significantly less in group who received short term UC. When comparing two groups, patients with double j stents had statistically significantly more bladder pain (P-0.003), frequency/urgency (P-0.002), dysuria (P-0.001). and need of analgesics (P-0.001). Conclusion: Ureteroscopy for ureteral calculi can safely be performed without placement of a double-j ureteral stent. A short‐term ureteric catheter insertion for 24 hours following ureteroscopic retrograde stone removal is a safe procedure and superior to double‐J stent insertion with regard to urinary symptoms, pain, quality of life, and stent related symptoms. Patients treated with a short‐term ureteric catheter recover more quickly, return to work earlier, and need less doctor visit and may prefer this strategy in case of future stone treatment.

  63. Chennanjali, K., Madhu Varma, K., Girija S. Sajjan, Sumana, M., Kolasani Balaji, Madhuri, S.S. and Kranthi Kiran Sahu

    Introduction and Objectives: To evaluate the diversity of root canal morphology in human permanent teeth in a subpopulation of South India by using CBCT images. Materials and methodology: CBCT images of 520 teeth (100 patients, mean age of 42 years) from database were used. All teeth were evaluated by preview of the planes - sagittal, axial, and coronal. Results: Single rooted maxillary central incisors (100%), lateral incisors (98.5%) and canines (94.5%) commonly showed type I configuration. Maxillary first premolars displayed two roots in 78.4% and one root in 21.6% respectively. Maxillary second premolars displayed two roots in 10.8%and one root in 89.2%.Predominately maxillary molars were 3 rooted. Mesiobuccal root (MB) of maxillary first molars showed most common configurations of type I in 64% and type IV in32% of the teeth. Maxillary second molars reported with three roots in 81.2%, two roots in 14.1%and one root in 4.7% of the teeth. Type I (76.5%) was the most common configuration observed followed by type IV of 14% in maxillary second molars. Mandibular incisors and canines presented type I configuration in 84.4%, 93.4% respectively. Mandibular premolars had single root with frequencies of type I in 79.4% and type V in 5.8%. Mandibular first molars possess variations of type IV in 62.43% followed by type II in 33.7% in their mesial roots. The frequency of Radix Endomolaris was of 23.1%. Mandibular second molar mesial roots displayed 55.3% of type IV, 41.3% of type II and 3.4% of type III. The prevalence of C-shaped canals in mandibular second molars was found to be 9%. Conclusion: Prevalence of Radix Endomolaris in mandibular first molars was of 23.1%. Single rooted second mandibular molars showed 9% frequency of having “C” shaped configuration and type III of 6.06% was reported in this study. Such variations should be taken into consideration and knowledge of canal anatomy would eventually help the operator to deliver a better quality of endodontic therapy. CBCT with its high resolution and magnification properties, enables better identification of canal anatomy and its variations.

  64. Tanu Aggarwal, Sachin Dhingra and Harinder Gupta

    Gingival recession is a common finding and many times it is caused by faulty tooth brushing. Frequently encountered sequelae of gingival recession are compromised esthetics and dentinal hypersensitivity. It lays negative impact on the quality of life. One of the most commonly employed procedure for treating exposed roots is the coronally advanced flap. This paper presents a case of Miller’s Class I gingival recession involving multiple teeth, treated with Zucchelli’s modification of conventional coronally advanced flap and its effect on oral health related quality of life as assessed by Oral Health Impact Profile (OHIP)- 14 scores.

  65. Dr. Kalpana Kulkarni

    Thoracic Para Vertebral Block (TPVB) is one of the Regional Anaesthesia (RA) methods indicated for acute and chronic pain management as well as a sole technique for chest wall surgeries like lumpectomy, mastectomy. Being unilateral it has distinct advantage of minimal hemodynamic effects. Patients with cardiopulmonary comprise are reported to tolerate surgical management of chest wall pathologies very well under TPVB.I report a case of atrial septal defect (ASD) with pulmonary hypertension having lipoma over right infra axillary region for excision. Single needle TPVB was given at the level of T4 using 18G Tuohy’s epidural needle and Loss of Resistance (LOR) technique. An 18G catheter was passed 3cm inside the para vertebral space. Excellent anaesthesia was produced over C8 to T7 region and the surgery was uneventful. Thus sole TPVB is a good option for unilateral surgeries of chest wall especially in patients with cardiopulmonary dysfunction.

  66. Dr. Shuchi Pande and Dr. Sunil G. Gupte

    Introduction: Sleep and headache problems are among the significant concern of health sector. But the exact relationship between these two important has been studied less. Therefore this study is designed to determine the relationship between sleep quality and primary headache .Sleep and headache share a well-recognized, bidirectional relationship, with complex and incompletely understood interactions. The physiology of sleep shares many features with the pathophysiology of headache disorders, both in terms of the neuroanatomical pathways and the neurotransmitters that are involved. This may explain features of primary headache disorders like migraine, cluster headache and tension type headache. Moreover, the painful experience of headache itself disrupts sleep, potentially creating a vicious circle of reinforcement. Both sleep disturbance and chronic headache also greatly increase the risk of depression, anxiety and other psychiatry disturbances hence further affecting the complex relationship between sleep and headache. Methods: Present sample consists of 60 patients who presented with the complaints of primary headache to the department of psychiatry and neuropsychiatry clinic in a tertiary care institute from August 2016 to June 2018. This is a cross sectional Observational study. After being evaluated by the neuropsychiatry clinic, the patients along with records of treatment and classification of primary headache will be evaluated for sleep quality. A self-administered questionnaire Pittsburgh Sleep Quality Index (PSQI) that assesses sleep quality over a 1-month time interval was used to collect data. Result: Headache occurance is associated with poor sleep quality .In this study 95% of the patients presenting with headache had association with poor sleep quality. Conclusion: In this study, there is well established relationship between sleep quality and headache has been shown but more and similar evaluation and study are needed to complete and confirm this relationship in future.

  67. Dr. Viney Sambyal and Dr. Vijant Singh Chandail

    Background: A seizure (from the latin word “to take possession of”) is a paroxysmal event due to abnormal, excessive, hypersynchronous discharge from an aggregate of central nervous system neurons. Aims and Objectives: To Study Clinical profile of Seizure disorders at Tertiary health care center. Methodology: This was a cross-sectional study in 1680 patients of seizure disorder in the age group 18 and above years at tertiary health care center of GMC Jammu, General Medicine department during the two years from 2016 to 2018. Result: Out of the 1680 patients, 63.1% were males and 36.9% were females .86.2% (1448 patients) of the study patients ,had generalized tonic clonic seizures, 3.9% (65 patients) had partial seizure with secondary generalization, 4.8% (80 patients) had complex partial seizures and 5.2% (87 patients) had simple partial seizures. 25.5% (428 patients) of the cases, no cause could be found in spite of rigorous investigation and they were termed ‘idiopathic’ or ‘cryptogenic’. 12.3% (206 patients) of the cases were due to space occupying lesions. 7.5% (126 patients) had electrolyte imbalance, 18.8% (316 patients) had metabolic derangements. Cerebrovascular accidents constitute the most common cause as 30.4 % of patients. Conclusion: It can be concluded from our study that most common type was generalized tonic clonic seizures (GT CS) and most common etiology was stroke followed by idiopathic, metabolic, Space occupying lesion, electrolyte imbalance, metabolic derangements and infections.

  68. Prajakta Karambe, Swati Karkare, Bhushan Pustake and Darpan Kothawade

    Background: Tooth brushing is most commonly practiced oral hygiene procedure. The hardness, size of bristles or manner of brushing may affect enamel, dentin and surface properties of restorative materials. Powered and Ultrasonic toothbrushes are new additions to oral hygiene aids and their abrasive potential must be determined before incorporating them into daily use. Aim and Objectives: To evaluate and compare the abrasive effect of Ultrasonic and powered toothbrush on the surface roughness of enamel, Type II and IX GC Fuji cement. Materials and Methods: The study included 36extracted primary teeth divided into three groups based on the surface treated: Enamel, Type II GIC, and Type IX GIC. These were further subdivided into two groups based on the brush used: Powered and Ultrasonic toothbrush, used over period of 7days, after which the analysis was done for surface micro hardness and surface wear. Results: On analysis, the enamel group showed maximum roughness (Enamel=1.3μm; GCII=0.32μm and GC IX=0.19μm) measured at the baseline. Further analysis after 7 days of brushing showed that the use of powered toothbrushes (Type II=0.45μm; Type IX=0.35μm) showed significantly greater surface roughness compared to Ultrasonic toothbrush (Type II=0.26μm; Type IX=0.17μm) in all the three groups, thereby showing a significantly greater change in Ra for powered toothbrushes. Also, the type II GIC had greater surface roughness compared to type IX GIC. Conclusion: The results indicate that the use of powered toothbrushes causes significantly greater wear of the tooth surface than the use of ultrasonic toothbrushes on enamel and GIC.

  69. Dr. Priya Lokanath, Dr. Satheesha Reddy, B.H. and Dr. Shilpa Patil

    Traumatic ulcerative granuloma with stromal eosinophilia (TUGSE) is a benign lesion of the oral mucosa with an unclear pathogenesis. Clinically, this disease is characterized by the presence of chronic ulcerative lesion with elevated and indurated borders in the oral mucosa. It usually develops rapidly and may persist for several weeks or months. It presents mainly on the tongue but other areas of the oral mucosa such as gingiva, cheek and vestibular mucosa may also be involved. We describe here a rare case of Traumatic ulcerative granuloma with stromal eosinophilia of buccal mucosa associated with Oral submucous fibrosis.

  70. Voinov, V.A. and Zumbana Lopez, G.G.

    The article presents analysis of the most frequent diseases, characteristic for the tropical zone. The general factor defining diseases severity and even their outcome is endotoxemia associated with development of multiple organ insufficiency and drug therapy isn't always effective. It defines indications for extracorporeal detoxification and thus membrane plasma exchange is the most effective.

  71. Manju Bala, Meenakshi and Sameer Aggarwal

    Background: Prediabetes is a stage in the natural history of disordered glucose metabolism rather than a distinctive clinical entity representing an interim condition and a risk factor for the development of diabetes along with an increase in cardiovascular and microvascular complications. So, prediabetes is a state of nondiabetic hyperglycemia that does not satisfy the diagnostic criteria for diabetes mellitus. Objectives: To correlate the levels of fasting blood glucose (FBG) and postprandial blood glucose (PPBG) with glycated hemoglobin (HbA1c) in prediabetics. Materials & Methods: The present case control study was performed at Pt. B. D. Sharma PGIMS, Rohtak includes thirty prediabetes patients of age group 20-40 years diagnosed on the basis of HbA1c (5.7-6.4%). Thirty healthy and age matched control were taken. Venous blood samples were obtained for analysis of fasting blood glucose, postprandial blood glucose and HbA1c after obtaining written consent. Samples were processed by centrifugation and analysed on the same day. Results: The correlation coefficient between fasting blood glucose (108.50 ± 10.51 mg/dL) and HbA1c (5.94 ± 0.21%) is r = 0.444 with p value = 0.014 which is lower than the correlation coefficient between postprandial blood glucose (155.33 ± 13.18 mg/dL) and HbA1c i.e r = 0.648 with p value = 0.001. Conclusion: The contribution of postprandial blood glucose towards glycation of hemoglobin is more than the contribution of fasting blood glucose levels.

  72. Dr. Khushbu Naik and Rushita Kakdiya

    Background and Objectives: The world health organization (WHO) has declared overweight as one of the 10 health risk among any individuals. Lower performance level in balance and muscles strength has been observed in children compared to healthy adults. Deficit in lower extremity muscles strength and balance represents major intrinsic fall and injury risk factor. In overweight children skeletal muscles changes and development of muscles function are seen. Child with increased BMI affects the strength, balance, and mobility. The objectives of the study are to compare the strength, balance and mobility among normal and overweight among student of Physiotherapy College. Method: 140 adolescent with age group of 18 to 22 years was selected on basis of inclusion criteria from the college. Anthropometric measurement is taken for calculating body mass index. Body mass index is calculated based on subject height and weight. Height was measured in cm. and body mass in kg. Standing long jump test is used to assess the strength of the lower limb. Balance is assessed by the Y balance test and Mobility is assessed by timed up and go test. Result: Data analyzed by using t-test and Pearson correlation coefficient which showed significantly negative correlation of standing long jump test (r=0.0741,p<0.05) and (r=0.6573,p<0.05) shows negative correlation of Y balance test of right leg, (r=0 3486*p.<0.05)shows negative correlation of y balance test of left leg. (r=0.4928, p<0.05) which shows negative correlation of timed up and go test. Conclusion: Present study conducted between normal and overweight adolescent among age group of 18 to 22 years shows hardly any significant associations between variables of balance, mobility and lower extremity muscles strength. The children with increased BMI affect the balance, strength, speed .i.e.-mobility. There is not much significant correlation between normal and overweight adolescent among student of Physiotherapy College.

  73. Tajamul Hussain Sherazi, Mohd Irshad and Khurshid Ahmad Wani

    Background: Advances in the neonatal management has led to increase in survival of most very low birth weight and extremely low birth babies resulting in surge in number of infants with aberrations in growth and department. Early detection of such aberrations leads to marked improvement in ultimate outcome of such children. Methods: A hospital based case control follow up study was under taken in the department of pediatrics Government medical college Srinagar.72 out of 78 preterm low birth weight and extremely low birth weight who survived to discharge were registered as cases and 64 term babies admitted as suspected sepsis were registered as controls after ruling out sepsis between January 2014 to June 2014 .Gestational age was estimated by recommended methods and serial computation of Z-scores was done from anthropometric measurements at different intervals during first year of life. Neurodevlopmental assessment was done at one year corrected age using Denver Developmental screening test. Hearing assessment was done by transient evoked otoacoustic emissions and auditory brainstem responses. Screening for Retinopathy of prematurity was done per set protocol. Data was analyzed by standard statistical methods. Results: Among VLBW and ELBW infants, there was a significant decline in Z-scores of all three anthropometric parameters from birth to discharge. Thereafter they showed increasing trend throughout infancy. However, all anthropometric Z-scores of these infants continued to be significantly lower than NBW infants (P<0.05).Six infants among cases and none among controls had developmental delay at one year corrected age.18 cases had evidence of retinopathy of prematurity more so in extremely low birth babies .Three infants among cases had significant hearing impairment. Conclusion: Very low birth and extremely low birth babies remain smaller, lighter and have significantly lower neurodevelopmental indices at one year corrected age as compared to normal birth weight counterparts despite advances in neonatal care, a challenge for neonatal care providers.

  74. Dr. Garvita Dubey, Dr. Ashish Gupta, Dr. Gaurav Sharma, Dr. Gaurav Arya and Dr. Suresh Sharma

    Smile is an important constituent of one’s own aesthetics and orthodontist plays a crucial role in enhancing it. Redefining the facial skeleton has been the area of interest among orthodontist from past three decades and achieving an ideal smile is of primary concern in planning any treatment as a beautiful smile not only enhance the beauty of the face but also increase the social acceptance of a well being.

  75. Dr. Suresh Sharma, Dr. Ashish Gupta, Dr. Gaurav Sharma, Dr. Dinesh Choudhary and Dr. Garvita Dubey

    For more than 170 years, silver halide films form the back bone of photography, eventually being replaced by film less photography, pictures on a chip, or call it by any name but this is the new phenomenon of technology. Applications of photography is popularizing in dental practice as it is simple, quick and includes self-checking of one’s own results, illustration of lectures and publications, marketing and accomplishing electronic tele dental systems. Every practicing orthodontist should master the vital skill of clinical orthodontic photography to be successful at clinical diagnosis, treatment planning and case documentation in modern Orthodontics and General Dentistry.

  76. Dr. Robina Rose Mathew and Dr. Manu M Kochupurackal

    To achieve goals of endodontic therapy the clinician must have thorough knowledge about internal and external dental anatomy of the tooth and its variations in presentation. The internal anatomy of the maxillary central incisor is well known and usually presents with one root and one radicular canal system. This case report describes an endodontic treatment of a maxillary central incisor with two roots and two canal systems, demonstrated by radiography. Failure to recognize unusual root canal anatomy may lead to unsuccessful endodontic treatment.

  77. Dr. Rakesh Sharma, Dr. Amar Saharan, Dr. Maninder Singh and Dr. Sahil Mansotra

    Background: Intertrochanteric fragility fracture (IFF) treated with proximal femoral nail anti- rotation (PFNA) is associated with significant hidden blood loss and high blood transfusion rate. The purpose of the present study was to evaluate the efficacy and safety of tranexamic acid (TXA) in reducing blood loss in these patients. Materials and Methods: Consecutive eligible patients were recruited and randomly assigned to a TXA group or a control group. The TXA group received 15 mg/kg body weight of TXA intravenously 15 min before incision and the same dose 3 h later. The control group received 100 mL of saline intravenously 15 min before incision. The efficacy outcomes included the total perioperative blood loss, postoperative transfusion rate, postoperative hemoglobin level, and length of the hospital stay. The safety outcomes were the incidence of thrombotic events and the mortality rate within 6 weeks after surgery. Results: We had 44 patients in the TXA group and 46 patients in the control group for the final analysis. The TXA group had significantly lower total perioperative blood loss than the control group (384.5 ± 366.3 mL vs. 566.2 ± 361.5 mL; P <0.020). Postoperative transfusion rate was 15.9% in the TXA group versus 36.9% in the control group (P = 0.024). Conclusion: Intravenous TXA is effective in reducing total perioperative blood loss and rate in IFF treated with PFNA. No increased risk of thrombotic events was observed with the use of TXA; however, this study was underpowered for detecting this outcome. Further research is necessary before TXA can be recommended for high-risk patients.

  78. Akanksha Sehgal and Dr. Adarsh Garg

    With the advancement in Information and communication Technology Online education systems and Massive open online course (MOOC) are expanding rapidly. Learners form different backgrounds are joining these courses with different motives. Inspite of massive enrollments the platforms offering these courses are facing many challenges. One of the major challenge that needs attention is dropout. There may be different reason for different learner to dropout from a course. These reasons may be independent or dependent on each other. In this paper existing studies are reviewed to find out the reasons of dropout from online courses. Around 40 factors were identified that can facilitate a learners decision to dropout from course. These factors are grouped in to five main categories Social, family, personal, institutional, Technical

  79. Dr. Beanish Bashir, Dr. Rashidat ul khairat, Dr. Suhail Majid Jan and Dr. Roobel Behal

    Aim: The present clinical study was designed to evaluate clinically the effect of platelet rich fibrin (PRF) graft for the treatment of denuded root surfaces. Materials and Methods: 10 isolated Miller’s Class I and II gingival recession of single rooted teeth were selected for the study. Scaling and root planing was done, and oral hygiene instructions were given to the patients. Recession parameters (probing depth, gingival recession height and width of keratinized tissue (WKT)) were assessed at baseline. Following this, LPF with PRF was done at the recession sites, and parameters were again assessed at 6 months. Results: The mean percentage of RC attained was 71.98% at 6 months. The WKT shows a mean gain of 1.2 mm at 6 months. Conclusion: LPF with PRF produced statistically significant reduction in recession depth and gain in WKT by the end of 6 months.

  80. Ummy Sahara Matondang, Zulfendri, Heldy BZ

    Background: A doctor in conducting medical examinations and treatment must respect the rights of patients and work according to the standards of the medical profession. This can be done by implementing the provisions according to the procedure in giving informed consent, so that doctors are deemed to have carried out their obligations to provide information to patients or families of patients and get their approval. Aims: to explore informants about the application of informed consent in the surgical and womb room in Sibuhuan General Hospital. Methods: A qualitative study with analytic description was used. Four informants were selected using purposive sampling in this study. The data were gathered in-depth interview. Analysis and interpretation used verbatim descriptions in Bahasa Indonesia and subsequently translated into English language. Results: 1) Explanation of Diagnosis of Diseases of Patients, 2) Giving Informed Consent in Detailed, 3) Executors Explained Informed Consent and Signed Informed Consent, 4) Explanation of Disease and the Need for Medical Action, 5) Explanation of the steps when the risk arises, 6) Explanation of Risks and Possible Effects of Not Performing Medical Measures, and 7) Explanation of Informed Consents Done Honestly. Conclusion: As health provider must be attention with informed consent to avoid the negligence.

  81. Dr. Abhijeet Kore, Dr. Malvika Suresh Roy, Dr. Aaditee Vande, Dr. Sushma R., Dr. Pronob Sanyal and Dr. Rakshith Guru

    Aim: To evaluate awareness among maxillofacial defect patients about different. Prosthodontic treatment modalities. Materials and Methods: A self-administered structured questionnaire was used for the survey and a survey sheet was prepared based on these questionnaire and circulated personally. The feedback was gathered individually from each patient which would be then statistically analyzed to achieve the objectives of the study. Results: Based on the statistical analyses, it was found that majority of participants (61%) were not willing for taking the treatment and the reasons being economic problems, multiple visits, difficulty in wearing. Conclusion: Maxillofacial rehabilitation plays a very important where enhanced expectation about esthetics and need to restore function to best possible extent is required. Though the participants in the present study had the knowledge about the replacement of missing part, majority of them were not willing for replacement of defect.

  82. Dr. Hrishikesh Karpe, Dr. Sneha Sadhwani, Dr. Gaurav Shinde, Dr. Balaji Kapse and Dr. Harshal Najan

    Dentigerous cysts are generally associated with the crowns of impacted or unerupted permanent teeth and are more common in the third and fourth decades of life. Most dentigerous cysts are mainly developmental in origin but may not be similar for all cases. The purpose of this paper is to present a case of lateral dentigerous cyst with unusual presentation in a 14 year old boy and discuss the variation in etiology, presentation of such a cyst and in its management.

  83. Francesco Asprea, Barbara Gaudio, Francesco Carfì, Gregorio Micali and Annunziata Maceri

    The purpose of this study is to recognize with nasal endoscopy the presence of vomeronasalorgan before any surgical procedure of septoplasty Ludvig Jacobson published a scientific work in Danish in 1813, entitled "Anatomical description of a new organ in the nose of domesticated animals" but Kolliker can be considered the discoverer of the vomeronasal organ in humans. Potiquet described in 1891 the possibility of locating and identifying the Jacobson channel in the living man and hypothesized its possible role in the pathogenesis of some nasal septum lesions. The importance of this anatomical structure in nasal pathology and nasal surgery justifies its preoperative systematic research in order to carry out a conservative and respectful surgery.

  84. Bhat A Tanveer, Wani Y Nahida, Shah OJ, Chu A Naseer, Bhat A Younis and Rabbani Irfan

    Background: Choledochal Cysts are congenital anomalies which present as either isolated or combined dilatations of the extra and intra-hepatic biliary tree. The condition typically presents in infancy and childhood. The different radiological investigations used to diagnose choledochal cyst have different diagnostic accuracies. Methods: It is a prospective study carried out in the Department of Surgical Gastroenterology, and Department of Radiodiagnosis and Imaging Sheri-Kashmir Institute of Medical Sciences, Srinagar from October 2011 to October 2014. A total of 40 patients were taken for the study. Clinical profile, different radiological imaging details and intra operative findings were collected for each patient and the radiological reports were compared with intra operative findings. Results: Out of 40 patients 10(25%) were children upto 18 years of age and 30(75%) were adults with a male female ratio of 1:3. 29(73%) patients had type 1, 11(27%) patients had type 4 choledochalcyst. All type 1 choledocal cysts were type 1A. Hepatobiliary calculi was the most common associated feature found in around 18(45%) patients. The diagnostic accuracy for USG, CECT,MRCP,ERCP was 87%,74%,97%,93% with a sensitivity of 88%,75%,97%,91% respectively. Conclusion: Of all the investigations used in the diagnosis of choledochal cyst MRCP is the diagnostic tool of choice.

  85. Sarath, K., Sathyanarayanan, R. and Nithin Joseph Jude, B.

    Purpose: To compare the efficacy of drill free screws and self tapping screws in the fixation of zygomatico maxillary complex fractures. Materials and Methods: A prospective randomized comparative study was planned comprising of 18subjects, underwent fixation of zygomatico maxillary complex fracture. The subjects were block randomized into two groups—group a fixation using miniplates and self tapping screws and group B fixation using miniplates and self drilling screws. Intra operatively operating time, screw fixation time, fixation at operation, state of reduction at operation were evaluated. Postoperatively occlusal discrepancy, segmental mobility, anatomic reduction and signs of infection were evaluated. Chi square test and independent t test was used for Statistical analysis. Results: The mean operation time for fixing mini plates using self-tapping screws was 130(SD=15.61) seconds whereas for drill free screws was 108(SD=23) seconds. The mean screw fixation time for fixing mini plates using self-tapping screws was 337.2(SD=39.37) seconds whereas for drill free screws was 284.3(SD=104.94) seconds. The differences in measurements of fixation at operation, state of reduction at operation occlusal discrepancy, segmental mobility, anatomic reduction between 2 groups were not statistically significant. Post operative signs of infection was also not statistically significant among the 2 groups. Conclusion: On analysing the results of our study, apart from the operating and fixation time, the drill free and the self tapping screws are equally effective in terms of stabilization of fractures clinically and radiologically, intra-operative ease of handling and recording, intraoperative technical challenges and post operative complications. To conclude, drill free screws can be used as an alternative to self tapping screws in fixation of zygomatico maxillary complex fractures as the efficacy of both the screws was found to be equally effective. In our study, the sample size was limited and thus further studies are to be done in future to evaluate the efficacy of drill free screws.

  86. Dr. Manish Kumar, Dr. M. Srinivasa Raju, Dr. Soni Kumari, Dr. Shiwangi and Dr. Nikita Pradhan

    Desquamative gingivitis is a clinical term associated with a variety of clinical conditions and is characterized by the erythematous gingiva, desquamation, ulceration and erosion of gingival epithelium. It may be a manifestation of a variety of dermato - mucous disorders and conditions such as dermatitis, bullous pemphigoid, pemphigus, psoriasis, cicatricial, herpetiformis, lichen planus, erythema mulitiformae. of all the diseases entitled, Lichen Planus is a relatively most common disorder affecting the skin as well as the mucous membrane. The lesions of oral lichen planus have myriad but distinct morphology and as they mimic many other mucocutaneous disorders, many lesions of oral lichen planus are diagnosed wrongly. This case report describes a case of desquamative gingivitis which was diagnosed with erosive lichen planus based on symptoms, clinical findings and histological examination.

  87. Charusuri, Mallipudi Bhavana, Syed Afroz Ahmed, Satish Brahme, K Shraddha and Shahela Tanveer

    A female patient named Suguna of 68 years presented with a benign fibro-osseous lesion that was located apically in the mandibular anterior teeth region which was provisionally thought to be an odontoma. The pathogenesis and its origin is discussed in detail in this case report.

  88. Anurag Shukla, Pathak, R. K. and Divya Singh

    The aim of this experiment is Evaluation of various fungicides and their effectiveness at different doses against Phytophthorainfestans, the causal pathogen of late blight disease of potato. For the study of design Descriptive statistics was used and each treatment was replicated thrice by using complete randomize design. The experiment was conducted in Department of Plant Pathology, CSA University of Agriculture &Technology, Kanpur, Uttar Pradesh, India in November 2016. In this we use “Food Poison Technique” (1) to find out the relative efficacy of various fungicides in inhibiting the growth of pathogen. A small piece of infected leaf from border of sporulating lesion along with some healthy green tissue was cut and Sterilized. These small pieces were then placed on Pimaricin, Ampicillin and Rifampicin media (PAR media) which was previously poured in sterilized Petri plates. As soon as the mycelia growth is noticedaround the bits, the pathogen was purified by hyphal tip culture method. Mycelial bits of 5 mm from the pure culture were placed on the tomato extract media which was incorporated with various fungicides at different doses. In this we use five different fungicides among these Acrobat inhibited the mycelial growth upto 99.2% over the control at 300 ppm concentration followed by 98.44% inhibition at 300 ppm concentration mancozeb at 3500 ppm concentration inhibited the radial growth upto75.48% followed by 71.15% inhibition at 3000 ppm concentration. By this we concluded that this method can be used for analysing the efficacy of various fungicides against different pathogens within a very short period of time.

  89. Celsia and Janarthanan

    The ITK is an explicit or “Codified” knowledge that is transmittable in formal, systematic language. On the other hand, ITK is a tacit knowledge of the local or indigenous people, which is personal, content-specific, and therefore hard to formalize and communicate. Rice is an important crop in India occupying 43 million hectares of land representing various ecosystems. The crop is cultivated 2 meters below the sea level in Kuttanadu region of Kerala and 2500 meter above sea level in Jammu Kashmir. The list of indigenous technical knowledge followed by the rice farmers are listed below under various headings viz., seed treatment, growth management, weed management, pest and disease management and storage pest management.

  90. Muhammad Haneef Mugheri, Mushtaque A.Pathan, Mushtaque A. Sayed, Maryam Maira, Dhani Bakhsh Soomro, Safdar Ali amur and Najaf Ali Soomro

    Drinking water is important element for the continuance of human beings. An exclusive present study was carried out for the determination of five parameter of arsenic (As), pH, electrical conductance (EC), total dissolved salts (TDS) and turbidity in drinking water of Jamshoro city that purpose, total of 147drinking water samples were collected from 09Villages and three UC, Taluka Manjh and of the city Jamshoro method. Results revealed that maximum concentration of pH was found in sample no: 25, 27, electrical conductance was found in sample no: 73, total dissolved salts was found in sample no: 72, turbidity was found in sample no: 27, arsenic was found in sample no: 53, 100.While in minimum and maximum mean concentration of pH was 7.4 and 8.4 unit, EC was 497 (µg/L) and 11580(µg/L), TDS was 743 (mg/L) and 4560 (mg/L), turbidity was 1.6 (mg/L) and 34 (mg/L), arsenic was 01 (µg/L) and 250 (µg/L), respectively. The pH is moderate correlated with EC, TDS, Turbidity but negative correlate to arsenic. EC are good correlate with TDS but moderate correlate to turbidity. Total no of 147drinking water samples of Jamshoro. The pH, electrical conductance, total dissolved salts, turbidity, arsenic were within WHO limits.

  91. Jamilah M. Hashemi and Samaa M. A. Al-Zaeem

    Background: Hyperkalemia and Hyperphosphatemia are common among Hemodialysis (HD) patients. It is caused by the excessive ingestion of potassium and phosphate-rich foods. Dieting helps reduce this increase in blood serum also they use an oral phosphate binder medication can to help lower phosphate absorption. However, some characteristics of using phosphate binders are associated with poor adherence. Additionally, the hemodialysis patients mentioned some side effects of the medication. Monitoring nutritional parameters is an important factor for treating hemodialysis patients. Nutritional intervention by a dieticianis key when managing hyperkalemia and hypophosphatemia. The aim of this study was to evaluate the effect of the dietician educational program to control hyperkalemia, hypophosphatemia and phosphate binder among HD patients in the hemodialysis charity center (Hisham Attar Dialysis Center), Jeddah, Kingdom of Saudi Arabia. Methods: a comparison was made between HD patients before and after a nutritional educational program. A group of 190 patients was assessed using medical history, hemodialysis status, An thropometric measurements including [height, weight after a dialysis session and body mass index (BMI, kg/m2)]. Plus, biochemical measurements including (Potassium and Phosphate) levels were examined. Furthermore, groups of HD patients received teaching sessions by a dietician. An individual meeting with each one of the HD patients or with his/her family was held in a dietician clinic room. Next, data were collected before and after the nutritional educational program. Results: a significant decrease has been found in the average levels of potassium from before the program as compared to 1to 3 months following the program. The laboratory results for phosphorus levels showed a significant increase in Phosphorus after 1to 3 months from the nutritional educational program. A significant decrease of Phosphorus binder was observed after the nutritional educational programat (P ˂ 0.05). Interventions involving the nutritional educational program supported the adherence of dietary recommendations additionally, positive changes and improvements to HD patient health status were found. This study suggested that repeated, personalized nutritional educational program is an effective way to improve patient care as well as to prevent abnormal potassium and phosphate parameters and reduce the use of phosphorus binder medicine.

  92. Njipouakouyou Samuel

    This investigation on the time distribution of the rainfall in Bissau from 1971 to 2015 has shown that within this period a slowly decrement of the rainfall regime is going. This phenomenon is clearly visible by the end of the period where intensive rainfall with pluviometry greater or equal to 600 mm/month was becoming rare and rare. This situation calls the authorities of the country to take very important and urgent measures to reduce or even to stop its evolution as it seems to be the beginning.

  93. Sridevi, V., Naveen, P. and Ramachandra Reddy, P

    Excessive baicalein (BC; a flavonoid) intake during pregnancy period has been demonstrated to provoke oxidative stress an associated factor of male infertility in offspring. The role of testosterone depot in the recovery of damaged antioxidative system in prenatal BC exposed male mice was tested. For this female Wistar mice were administrated IP with 30, 60 and 90 mg/kg BW of BC on gestation days 11, 13, 15 and 17. F1 BC exposed males were sacrificed on post natal day (PND) 60 to assess the oxidative stress. The results showed a significant increase (P<0.0001) in testicular, liver and kidney malondialdehyde (MDA) levels in prenatal BC exposed males. In contrast to increased lipid peroxidation observed decrease in (P<0.001) levels of antioxidant enzymes such as superoxide dismutase (SOD) and catalase (CAT) in prenatal BC exposed adult males in a dose dependent manner than controls. Administration of testosterone (4.16 mg/kg body weight) to BC exposed adult mice were normalized the levels of MDA, SOD and catalase in testis, liver and kidney and are comparable to controls. The administration of testosterone refused the antioxidant defence system and is proved in the present study.

  94. Wan Roswita, Zulfan Saam, Yusni Ikhwan Siregar, Sukendi and Mubarak Mubarak

    Environmental education has recommended by UNESCO four decades ago. Indonesian Government through Ministry for Environment Affairs and Ministry of National Education initiated an environmental education program as co-work program, called as Adiwiyata, for elementary and second education level school. Although, this program has ran for more ten years, it was found that many school facing problem in adopting curriculum and program. In Dumai city-Indonesia, State Senior High School (SMAN) 2 Dumai is projected to reach Adiwiyata School in national level, now the school remaining as Adiwiyata School in city level. As upgrading efforts to higher level, an assessment of the school preparation, program and progress to achieve national level is needed. This research give an evaluation of Adiwiyata program progress which adopted by SMAN 2 Dumai. We use qualitative and quantitative approachment in collecting all data through interviewing stakeholders, questionnaire, focus discussion group (FDG) and direct observation to evaluate environment-friendly behavior and program inside the school. Over all, the school has been conducted many efforts to fully adopt Adiwiyata program.

  95. Alemayehu Hailemariam and Mesfin Bibiso

    The purpose of the current study was to determine the concentration of selected essential and nonessential metals; Na, Ca, Cu, Fe, Zn, Mn, Cr, Ni, Cd, and Pb in traditional medicinal plants; Artemisia afra (ariti), Hagenia abyssinica (kosso enchet), Foeniculum vulgare (Ensilal), Echinops kebericho (qeberecho) grown in Wolaita Zone, southern Ethiopia. A wet digestion procedure involving the use of mixtures of (69-72%) HNO3 and (70%) HClO4 at an optimum temperature and time duration were used to isolate metals from the medicinal plants by using FAAS. Based on the results, the concentration of Ca ranged from 1.75 mg/kg to 4.98 mg/kg, the concentration of Mg ranged from 1.35 mg/kg to 2.22 mg/kg, the concentration of Na ranged from 1.29 mg/kg to1.80mg/kg, Mn ranged from 0.09 mg/kg to 1.21 mg/kg and that of Fe lied in range of 0.23 mg/kg to 0.78 mg/kg in the plants studied. Among the toxic heavy metals, the concentration of Pb was in the least range (0.08 mg/kg to 0.11 mg/kg) and the levels of remaining trace metals were in the ranges of 0.54-0.97 mg/kg, 0.25-0.29 mg/kg and 0.20-0.33 in Zn, Cd and Cu respectively. Further studies will be continued on the screening of phytochemical activities of the plants under study

  96. Yamini Tiwari and Krishan Kumar

    A protocol has been developed to facilitate regeneration and Agrobacterium mediated genetic transformation using antibiotics in regeneration of cotyledonary petiole and hypocotyls explants of Brassica juncea cv. NRCHB-101. Three antibiotics viz. Kanamycin (kan), Cefatoxime (Cef) and Hygromycin (hygro) have been used in this study during shoot regeneration along with the growth regulators. The antibiotic Cefatoxime overpowered the growth of Agrobacterium tumefaciens at minimum concentration (250 mg/l) whereas kanamycin and hygromycin not only eliminates the traces of excess Agrobacterium but also prevents the occurrence of false-positive shoots at the concentration of 20 mg/L. The present inquisition gives an account on the effectiveness of Kan, Cef and Hygro for regeneration and Agrobacterium tumefaciens-mediated genetic transformation in Brassica juncea cv. NRCHB-101.

  97. Saurav Dwari, Sanjukta Mondal (Parui), Amal Kumar Mondal and Rasidul Islam, SK

    Indian Moon Moth (Actias selene Hubner, 1806) is widespread moth species of India. It is cosmopolitan in India. Previously it had recorded from four districts of West Bengal including Kolkata. Present paper deals with the three new records from West Bengal. During the biodiversity survey of different regions of South West Bengal this species photographed and identified from three new districts of Southern part of West Bengal. With these three new records update the present distribution of Indian Moon Moth in West Bengal. Beautifully coloured pale green with tailed hindwing, large sized moth Actias selene Hubner, 1806 recorded in October 22, 2012, 4.05 PM from Santipur (Nadia), September 23, 2017 6.30 PM from Belpahari (Jhargram), Sunday, September 30, 2018, 8:05:24 AM from Ajodhya hill (Purulia).

  98. Ammar M. S. Abdalla, Nabil H. H. Bashir, Azhari O. Abdelbagi and Yousif O. H. Assad

    The contamination of metals is a major environmental problem and, especially in the aquatic environment. This study aims to identify and determine the levels the heavy metals (HMs) in the tilapia fish tissue in two localities in the Northern State, Sudan. The tilapia fish tissue was analyzed in the Central Petroleum Laboratories, Khartoum, Sudan, using Inductively Coupled Plasma– Optical Emission Spectrometer ICP-OES 725 E) instrument to determine Zn, Pb, Cu, Co, Ni, Cd, Mo, Cr, Fe, Li, and Hg levels and compare their concentrations with the permissible levels (PLs), using the Complete Randomized Design (CRD) with three replications. The results from two localities reflects the presence of high amounts of HMs, the two types of tissue (muscular & liver) from Tilapia fish demonstrated the presence of high quantities of Lead and Nickel in muscle tissue more than the permissible limits (0.214 and 0.5 -0.6 ppm) according to FAO/WHO1999 EPA2003. Similar in the Liver tissue also demonstrated high quantities of Lead more than the permissible limits according to FAO/WHO (1999) EPA (2003). It is concluded that the accumulation of Heavy metals in the aquatic environment in the northern state requires more attention from the authorities.

  99. Varsha Sharma, Priyanka Srivastava, Shakshi Shrivastava, Pooja Prajapati and D.D. Agrawal

    This communication report knoevenagel cyclo-condensationusing hydrotalcites prepared using various methods. Further, the hydrotalcite providing maximum yields was used for the synthesis of 3 acetyl coumarin. In this multi-component reaction the yields obtained with Mg-Al-CO3 LDH was 94% and with the unreported Ca-Al-CO3 LDH was 93% respectively. The reaction conditions being 2 wt% catalysts at 800C for only 90 minutes. The main benefit of the present work is reduction of time along with the catalyst used is environmentally benign, recyclable and easy to work up procedure using water as green solvent. The catalysts as well the products were subjected to various characterization being X-RD, TGA, FT-IR, SEM, NMR, Mass, and basicity respectively.

  100. Alaa' Turki Monawer

    Background: Root canal treatment has been the main form of treatment for endodontic infections, and it comprises, chiefly, of physical instrumentation coupled with chemical irrigation. Objective: To compare the antibacterial effect of a diode laser and a Miswak (Salvadora persica) on Enterococcus faecalis in deep root canal dentin. Materials and Methods: A total of 500 extracted teeth with single rooted canal were collected randomly from different private dental clinics in Duhok city. The samples were collected using sterile red stopper plain plastic tubes. The samples were grouped in to two groups, 250 for the diode laser treatment and 250 for a miswak treatment, and inoculated into (Brain Heart Infusion agar and Blood agar) for the isolation and identification of Enterococcus faecalis. Results: Thirty (12%) isolates of E. faecalis were isolated from 250 single rooted canals, after treatment with diode laser 29 (96.7%) isolates were eliminated, whereas only 1 (3.3%) isolate was resistant to treatment with diode laser, while twenty eight (11.2%) isolates of E. faecalis were isolated from 250 single rooted canals, after injection with Miswak 27 (96.4%) isolates were eliminated, whereas only 1 (3.6%) isolate was resistant to Miswak activation. Conclusion: Both Diode laser and Miswak methods were very active in the elimination of E. faecalis isolated from infected single rooted canals.

  101. Sanjay V. Satpute

    Animal bites and stings are common throughout the World. After snake bite, scorpion stings and mad-dog bites are major problems of public health. These are causing heavy loss of human and livestock population in Africa and Asia. The anti-venoms require time, money and labour for their development. Also, they have some limitations. Therefore, traditional medicinal plant or herbal treatment is the only alternative available for the treatment of scorpion stings and mad-dog bites. In this attempt, total 07 medicinal plant species belonging to 07 families have been mentioned for scorpion stings treatment; while 09 plant species belonging to 07 families for mad-dog bites treatment, as herbal medicine. Mode of treatment is also given in some detail.

  102. Boureima DIANDA, Thierry Sikoudouin Maurice, KY., Issaka OUEDRAOGO, Mibienpan KI., Abdoulaye COMPAORE, Roger Charles Mathurin COMPAORE and Dieudonné Joseph BATHIEBO

    A particular solar cooker namely the parabolic trough solar cooker (low concentration) called "blazing tube" is studied in the present work. It is about determining experimentally its performances. Several tests were conducted, tests while empty, water heating, frying tests and rice cooking. In these tests, temperature readings of the various components were also carried out. The cooking time of certain dishes has also been determined. It emerges from these experiments that the outlet temperature of the fluid depends on the sun and is close to 200 ° C in good weather conditions. The device can be used all day as needed, even in slightly unfavorable times.

  103. Palwe, S. D.

    An ethnobotanical survey was conducted to document the ethnomedicinal plants which are used by tribals such as Konkani, Mahadeo Koli, Charans and Vanjaris in Dang-Surgana forest ranges, which forms a part of the northern tip of Western Ghats region of Ahwa and Nashik District, Gujrat and Maharashtra, India. In the present study, 52 species of plants included in 48 genera and 36 families which are being potentially used by the tribals for treating various diseases are documented. The collection and documentation of their experimental learning and conventional strategies dependent on the customary utilization of plants is no uncertainty a surprising advance keeping in view the blurring society and ethnic customs. More endeavors ought to be made to verify and assess the efficacy of these restorative plants and formulations utilized by these tribals.

  104. Davasuba, S. and Nagarajan, A.

    In this paper we discuss about Near product cordial labeling graphs like (C4 ⊗ C4) n,Qn, Parachute P2,n-2,Total graph. If the labeling in the graph satisfies the condition of Near product cordial then it is called Near product cordial graphs.In this paper we have proved that the above mentioned graphs except Total graph are Near product cordial graphs.

     

  105. Azmeraw Misganaw Getahun, Wolde Mariam Erkalo Gobena and Dereje Gebeyehu Ababu

    Introduction: The household saving rate is calculated by dividing household savings by household disposable income. A negative savings rate indicates that a household spends more than it receives as regular income and finances some of the expenditure either by incurring debt or through gains arising from the sale of assets. From the classical times, saving has been considered as one of the determinants of growth. Objectives: The aim of this study is determining factor that affect saving behavior of households in Metu town. Methods: In this study the researcher uses cross-sectional study design and applied self-administered questionnaires to collects data to make inferences about a population of interest at one point in time. The source of data is primary source and the target population of this study was covers list of households of Metu town which contains 3 kebeles and random sampling method were applied to select representative sample form for the total population of household. The researcher is primarily used based on quantitative research, which constructed regression model to identify and measure the predictors of saving households behavior in the study area. Results: From descriptive analysis the average amount of household saving monthly is 852.97 birr per month and almost 49.3 percent of households were involved in saving. According to descriptive statistics of the sample households, the highest percentage of income of households was observed greater than 6,000ETB (27.9 percent) followed by in between 4,801 to 6,000ETB (20.5 percent) and 3601 to 4800ETB (20.2 percent). On the other hand, the lowest percentage of income of households was recorded in between 2,401 to 3,600ETB (13.9 percent), 1201-2400ETB (12.5 percent) and followed by households income which is less than 1,200birr (5.0 percent). Hence, there appears to be some variation in proportion of income of household’s heads in Metu town during the study period. Concussion: Income of the household head, working status of household heads, housing status of household heads, household size, and encouragements to save their income were found the major predictors that affects saving behavior households during the study period. It is also recommended to conduct a study that compares status of saving behavior in rural households with urban households.

  106. Trisha Kundu

    A truth table is a logical method by which we can test the validity of a deductive argument and so mechanically whether a statement is a tautology, contradictory or contingent. In this paper my objective is not to explain truth table proper but to highlight its efficacy in different field of studies like Mathematics, Physics etc besides its own field (Logic).

  107. Afzal Ahmed

    In many engineering institutions design projects are assigned to groups of students. The evaluation of these projects may be extremely tedious and time consuming due to very high intake of students: say 250 students in a branch of engineering. A project takes about 2 ½ hours in evaluation. Hence proper evaluation is impossible if examiners are short in number having limited time to spare. This problem was solved by making evaluation committees and distributing the evaluation work in committees. To make the work of committees uniform or homogeneous a check list for project evaluation was developed. The work of evaluation committees was to a great extent uniform as evident from statistical analysis. This method enabled thorough evaluation of large number of projects in comparatively short time. The combined results of the committees fitted the normal curve with 5% level of significance. Hence the committees can be considered as substitute of single evaluation committee.

  108. Vishal Kushwaha, Archit Maniyath and Himatkumar Purohit

    Most dominant password storage method, store passwords directly in the databases and are mainly prone to brute force attack. Similar to password, storing data directly in the database on the server is another common thing to do. We have proposed the use of honey encryption as an algorithm to limit the possibilities of a password to get hacked. We have considered generating password based on password and other data. We then encrypt the generated password before storing them in the database. Further we have considered applying steganography techniques to hide the data behind multimedia content before storing them directly into the database on the server. We will define certain functions that will allow any user to generate passwords and consequently hide them behind some multimedia content. We will also compress the data before storing it on the server to make storage efficient system.

  109. Saqib-Ur-Rehman, Bilal Ahmed Usmani and Abdul Jamil Khan, Kamran Khan, Syeda Sadia Zia and Syed Adnan Hussain

    Present study uses the nonparametric Mann Kendall trend test to analyse the temporal variations in anticyclones over the Indian Ocean. The increasing trend in the anticyclones over 1020 hPa intensity starts to organize over the Indian Ocean during summer months. The area as well as the intensity of the high pressure system further increases during autumn months and it covers the entire southern part of the domain. During winter time further intensification and expansion covers the entire band with more anticyclones. During spring the center moves to the westwards over the Indian Ocean due to this the anticyclones started to decrease over the continent and then it attains the summer positions again

  110. Vinila, V. S., Satheesh, D.J., Reenu Jacob, Sam Rajan, Anitha S. Nair, Sheeja, P. and Jayakumari Isac

    The nano crystalline ferroelectric perovskite ceramic Lead Barium Titanate (PbBaTiO3) is designed and synthesised by high temperature solid state reaction method (weighing, mixing, milling and calcination of raw materials). This perovskite is made in a specially designed furnace which allows oxygen flow during cooling process after calcination. Final calcination temperature is optimised by trial and error method at 900 degree Celsius to obtain desired crystal structure, crystal system and phase formation. This paper discusses the thermal properties of PbBaTiO3 using TGA, DTG and DSC and IR spectroscopy methods of thermal characterization.

  111. Njipouakouyou Samuel

    Monthly averages of the air temperature in Bissau have been grouped into classes of equal length, 1.0°C. The 45 years period of investigation has been divided into equal sub periods of 5 years each. The number of temperature in each class was counted and the results of this treatment presented in tabular forms. The analysis of these tables has shown that the air temperature in Bissau is slowly increasing, particularly by the end of the period of investigation.

  112. Jaffar S. Pandu, Dedong Ma, Mwanaidi Ali, Salma J. Ali and He Kaixin

    Hypertension is a widespread global health problem. It has been the main cause of morbidity and mortality. With the concept of disease transition in Africa, we are moving from an era of communicable diseases to an era of non-communicable diseases such as Hypertension. In sub-Saharan Africa (SSA), patients with hypertension frequently present late to health facility often with complications. Moreover, the fact that hypertension is asymptomatic, patients tend to have poor adherence to medications which results to uncontrolled hypertension. Uncontrolled hypertension will eventually result into progressive damage to target organs such has the heart and kidneys. Chronic elevation of blood pressure (BP) leads to progressive development of left ventricular hypertrophy (LVH) with consequent cardiac remodelling, heart failure (HF) and increased risk of cardiovascular events. The burden of LVH together with the factors associated with its progression has not been well studied. This study aimed to investigate the prevalence, pattern and associated factors for LVH among patients attending MMH Zanzibar. In this current study we found among 389 hypertensive patients 241 (62%) patients had abnormal LV geometry, 55% had concentric hypertrophy. We also found sex, employment, domicile, duration of hypertension, BMI, and urea levels were having the positive value predictors of LVH.

  113. Lalrammuana, R., Vignesh, V., Lalthatluanga, S.R., Nejoobala Chanu, A., Vikramaditya, Lalruatliana Pachuau, Gojen Singh Kh and Lekhachandra Sharma, K.

    Background: The aim of the study was to establish the association between serum bilirubin levels and acute inflammation of appendix. Methods: A Cross sectional study was conducted among 215 patients of acute appendicitis with or without complication in the Department of General Surgery, Regional Institute of Medical Sciences, Imphal. These were subjected to investigations to support the diagnosis. These cases were also subjected to liver function tests and clinical diagnosis was confirmed perioperatively and post-operatively by histopathological examination. Their clinical and investigative data were compiled and analyzed. Statistical analysis was performed using chi square test and t test. The level of significance was set at P< 0.05. Results: Total serum bilirubin was high in 74% of cases and so the remaining 26% was normal. There was a good positive correlation (rs = 0.606) between duration of appendicitis and serum bilirubin levels and this finding was statistically significant (p-0.000). Mean serum bilirubin level in appendicular perforation was more than acute appendicitis but the finding was statistically insignificant (p>0.05). Conclusion: With increase in the duration of appendicitis there was rise in the level of bilirubin in this study.

  114. Dr. Asha Jha and Dr. Mayank Ravindra Dhore

    Hyperlipidemia can be inherited and increases the risk of disease of the blood vessels leading cardiovascular events and requiring lifelong therapy. Hence the cost of medication plays an important in patient care arising the need for all physicians to keep oneself updated regarding latest prices and price variation of various brands of hypolipidemic drugs. Objective: To analyze the cost variation of hypolipidemic drugs in Indian market. Materials and Methods: The Prices of different Hypolipidemic drugs manufactured by different Pharmaceutical companies were taken form IRD tripeli (Indian Drug Review) drug compendium 2017. The difference in the minimum and maximum price of the same drug manufactured by different pharmaceutical companies and percentage variation in cost per 10 tablets was calculated. Results: A total of 21 drugs (11 single 10 combination preparation) which were manufactured by different companies were analyzed .In single drug therapy atorvastatin 20 mg has maximum percentage (1017.78%) variation while pravastatin 10 mg has minimum percentage variation (1.01%). Among lipoprotein lipase activators Finofibrate 200mg showed maximum variation (549.43%) and Bezafibrate 200 mg has least percentage variation (10%). Conclusion: In the Indian market, there is a wide cost variation among different brands of oral hypolipidemic drugs of same strength and dosage forms. Therefore, physicians should be encouraged to prescribe the drugs by generic names as they are cheaper and in no way inferior to costlier branded counterpart. This would alsoreduce the economic burden on the patients.

  115. Dr. Shivani Bhatia, Dr. Anupam Sharma, Dr. Anirudha Sharma, DR. Esha Kedia, Dr. Sonali Bansod and Dr. Kanchan Hegde

    An emergency is a medical condition that demands immediate attention and successful management. These are the life-threatening situations of which every practitioner must be aware of so that needless morbidity can be avoided. Medical emergencies in dental practice are those adverse medical events that may present in the course of dental treatment. The three vital parameters which constitute the criteria on which emergency medicine is based are consciousness, respiration and circulation. One must be familiar with the treatable medical problems that are likely to occur, know how to recognize them and be able to provide treatment. A decision must be made for every patient about activating the emergency medical services system and whether the patient should be transferred to the emergency department. This review article deals with management of commonly occurring cardiovascular emergencies in dental clinic.

  116. Ravi V, Balaji A.R. and Prakash J.V.S.

    Background: The Prostate-specific antigen level is used to diagnose prostate cancer in last decades. However, its specificity is low in patients with a PSA level ranging from 4 to 10 ng/ml. This study aims to investigate the value of the length of intravesical prostatic protrusion (IPP) combined with serum prostate specific antigen on diagnosis of prostatic cancer (PCa). Methods: Data of 51 patients with prostate biopsy indications who came to the urology OPD at Stanley Medical College from October 2016 to July 2018 were collected. Clinical data include prostatic volume and IPP measured by TRUS and Serum PSA. Patients were divided into BPH group or PCa group based on the results of TRUS guided biopsy results. IPP, PSA Density(PSAD) in the two groups were analyzed. Their Sensitivity and specificity rate at different levels were respectively calculated to make sure the bestcut–off point in the diagnosis of PCa. Results: Among 51 cases, 15 patients had PCa and 36 patients had BPH. The PCa positive rate was 30.99%. Between PCa and BPH groups, there was statistical difference in IPP, PV and PSAD (P< 0.05). If taking IPP 7.5mm as the cut-off point, PCa can be diagnosed with highest specificity and sensitivity. Conclusion: The diagnosis of PCa in patients with tPSA ranging from 4.0 to 10.0 ng/ml, is a diagnostic ‘grey zone’. IPP and PSAD will help deciding which group of patients in the grey zone need to be investigated with prostatic biopsy. Further studies are needed for a better conclusion.

  117. Wirianti Absari, Dyah Aryani Perwitasari, Wahyu Widyaningsih, Ayudia Paramitha Zulkhainen, and Nurkhasanah Nurkhasanah

    Background: All institution must have both vision and mission, the two aspects that constitutes their educational goals. Therefore, to achieve this objectives, the key stakeholders must be well acquainted with the two aspects. Purposed: This study was intended to determine the level of knowledge, understanding, and behavior, as well as the influence of characteristics such as age, gender, organization, years of service, and the level of education of the community towards the vision and mission of the Faculty of Pharmacy Ahmad Dahlan University of Yogyakarta. Methods: The study used a cross-sectional design Data was presented in tables and images to describe data, and chi square test for analysis. Results: Out of the 316 respondents in the research, 195 (61.70%) had a high knowledge, 145 (47.15%) with understanding, and 162 (51.26%) with high behavior agreement. There is a significant relationship between the characteristics of the level of knowledge of employees on the basis of age (p = 0.008), work period (p = 0.008) and education level (p = 0.048). Contrastingly, there is no significant relationship between the characteristics of the level of understanding and behavior towards the faculty's vision and mission (p> 0.05). Conclusion: The majority of academics have a high level of knowledge and suitability for behavior. There are relationship between age, years of service and education and the level of knowledge of employees, on the contrary, there are no relationship between the level of knowledge, understanding and behavior of lecturers, employees, students and the pharmacist profession on the vision and mission

  118. Ali Mahmood Saleem, Ashraf Kamel Abdul- Rahman Al-Nuaimee, Salim Jasim Al-Mola

    Background: The World Health Organization (WHO) and the United Nations have declared the decade of 2000-2010 the “Bone and Joint Decade”. As life expectancy has increased throughout the world, musculoskeletal system disorders as osteoarthritis (OA) have emerged as important health care concerns for the elderly with considerable social and economic burden on all society, including developing countries. Materials and Methods: In order to achieve the aim of the present study, a case-control study design was adopted, and conducted in the Rheumatology Consultation Unit in Ibn-Sena Teaching Hospital in right sector of Mosul city. 200 as cases and 200 as controls were collected consecutively. Study period was from the 1st of November, 2007 to the 30th June, 2008. Data collection tool was a questionnaires used to measure general information as age in years, sex, residence, marital status and occupation. The specific information consist of history of OA, the presence of family history, history of joint trauma, stressful life events, seasonal history, the current smoking status, history of pre-existing medical disease, history of congenital anomalies and history of prolonged occupational or sport stress. Chi-square test with Odd ratio (OR) was used to the association. P-value ≤ 0.05 was considered significant. The 95% confidence interval (95% CI) were also computed. Results: The highest age-specific groups of cases was (55-64) years which constituted about 44%. The result of the present study indicated a highly positive significant association (p=0.000) between knee OA and female gender, manual working, being ever married (OR=3.94), and congenital anomalies (p=0.004). Females aged ˃45 years were prone to develop knee OA (p=0.000). A highly significant relationship was spotted regarding the history of prolonged unhealthy posture or sport stress (OR=8.27, p=0.000). Overweight and obesity are seen to duplicated the probability for knee OA. Persons with positive history of trauma were 10 times more prone to have OA. A positive association between unhealthy dietary behavior and knee OA was observed (OR=3.09). Conclusions: The OA increased steadily with age, and more in females; congenital anomalies, ever married, overweight, obesity, manual workers, history of prolong unhealthy posture or sport stress, family history, history of trauma, and unhealthy dietary behavior, all appear to play a role as risk factors in the development of knee OA.

  119. Yarajarla Ramesh Babu

    Fruit flies react to taste molecules in a way which is quite similar to humans and within the detection range of mammals. They are attracted to sugars, avoid bitter and toxic molecules, and adapt their consumption of acids and salts to their internal needs. In Drosophila adults, contact chemoreception is mediated through hair-like structures, called sensilla, located on the mouthparts, the legs, the wings margin, and the ovipositor. The behavior paradigms are relatively complicated, it is necessary to understand how the fundamental behavior is organized at neural level, before a full understanding of the complex behavior. In the present study Drosophila melanogaster has shows biased preference when facing sensory stimulations towards varied concentrations of tobacco.

  120. Sharath Kumar Shetty, Jobin Benny, Mahesh Kumar, Y., Vijayananda K. Madhur, Brigit Alphonsa Gervasis and Myna Pare

    Background: Interarch tooth size relationships differ between populations because differences in tooth sizes are not systematic. Population and gender differences in maxillary tooth size may not be the same as the differences in mandibular tooth size; hence, different interarch relations might be expected. Objective: The objective was to compare anterior tooth size discrepancies in Angles Class I and Class II malocclusions with Bolton standards and evaluate its effect on gender in a sample of Dakshina Kannada population who underwent orthodontic treatment. Methods: The study sample consisted of 203 pretreatment study casts, which were selected from records of orthodontic patients, who were residents of Dakshina Kannada, Karnataka. Subjects were divided into two groups: Group I (Angle's Class I, n = 108), Group II (Angle's Class II, n = 95) according to Angle's classification of malocclusion. The mesiodistal widths of all maxillary and mandibular teeth from right canine to left canine were measured with a digital caliper to calculate the Bolton ratio. The readings were then used to compute the anterior Bolton ratios. Chi square test was used for the statistical analysis. Results: A mean anterior Bolton ratio of 77.78± 4.31 for class I malocclusion group and a mean anterior Bolton ratio of 78.3± 4.52 for class II malocclusion group were found for the sample, The anterior ratio was found to be statistically insignificant when compared to the Bolton’s norm of 77.2 ± 1.65 (P>0.1724). Comparison between gender and the different malocclusion groups for the anterior ratio revealed no statistically significant difference. Conclusion: From analyzing the data, it was found that there was no significance between Bolton’s norms and type of malocclusion in Dakshina Kannada population. No significant relationship between gender and type of malocclusion was observed.

  121. Azwanis Binti Abdul Hadi, Nur Syuhada Binti Mohd Mustapha, Nur Farhana Binti Ahmad Hafidzi, Nur Sahira Binti Shaari, Hafizah Binti Pasi, Iskandar Firzada Osman, Mohd Daud Bin Che Yusof

    Introduction: HIV infection is a chronic disease with multiple challenges that could affect the psychological well-being of patients. Objective: The objective of this research was to determine the prevalence of depression, anxiety and stress among HIV patients and its significant associated factors. Methodology: This is a cross-sectional study which was carried out in two health centers in a town in the East Coast of peninsular Malaysia. A total of 42 patients with HIV were recruited via convenience sampling. Those who fulfilled the inclusion and exclusion criteria completed a validated set of Malay version of DASS-21 questionnaire. Data was analyzed using IBM SPSS Statistics. Results: The prevalence of depression, anxiety and stress among adult HIV patients in community follow-up were 33.3%, 28.6% and 21.4% respectively. Marital status was significantly associated with both depression and stress. While CD4 count was found to be significantly associated with anxiety.

  122. Manikandan, V. and Dr. Jasmine, J.

    Background: Osteoarthritis is the most common form of arthritis. Osteoarthritis mostly affects cartilage, the hard but slippery tissue that covers the ends of bones where they meet to form a joint Reflexology is an alternative treatment for osteoarthritis..Objectives: To assess the level of symptoms among patient with osteoarthritis in control group and experimental before and afterreflexology. Design: Quasi-experimental design, where Pretest Posttest Nonequivalent Group designs, Setting: Government head quartershospital, Erode, Tamilnadu and Erode Trust Hospital, Erode, Tamilnadu. Participants: 30 patients with osteoarthritis, out of which 15 were experimental group and 15 were controlgroup. Selection criteria: Patients with osteoarthritis with the age group of 35-55 years and both gender were included. Patients with moderate Pain and those who were willing to participate. Methods: Out of 30 patients, 15 patients were selected as experimental group and 15 patients were selected as control group by convenient sampling technique. Experimental group were done with reflexology. Level of symptoms were measured by Osteoarthritis symptomsScalebefore and after the procedure. Results: Reflexology is an intervention in reducing the osteoarthritis symptoms, control group mean score was (36.48 ± 1.62), which is 61%, whereas in experimental group the mean score was (21.48 ± 1.62), which is 36%, showing a difference of 25% on the level of the osteoarthritis symptoms. It seems that reflexology was effective in reducing the dysmenorrheal pain and symptoms among adolescentgirls. Reflexology is an intervention in reducing the osteoarthritis symptoms, control group mean score was (36.48 ± 1.62), which is 61%, whereas in experimental group the mean score was (21.48 ± 1.62), which is 36%, showing a difference of 25% on the level of the osteoarthritis symptoms. It seems that reflexology was effective in reducing the dysmenorrheal pain and symptoms among adolescentgirls. The calculated paired ‘t’ value (t= 6.22, t= 13.65) was higher than the table value (t 14 = 2.15,p<0.05). There was a significant reduction in post test the osteoarthritis symptoms score of patients in control group than the post test the osteoarthritis symptoms score of experimental group. The computed ‘t’value (t= 9.56) was greater than the table value (t 28 = 2. 05p<0.05) There is no significant association between post test the osteoarthritis symptoms score with demographic variables of adolescent girls in control group and experimentalgroup. Conclusion: Reflexology is an effective intervention to reduce the symptoms of patients with osteoarthritis. Clinical applications: Reflexology can be employed all kind of painful medical and surgical procedures as alternative therapy, instead of using pharmacological interventions.

  123. Yaavar shafi, Danish Rafiq, Baba Iqbal Khaliq, Wajahat-un-Nazir and Naheena Bashir

    Introduction: Urinary bladder cancer ranks 9th in worldwide cancer incidence. It is the 7th most common malignancy in men and the 17th most common in women. (1) Urinary bladder carcinoma accounts for 5.6% of cancer in males and 1.8% of cancer in females in India. Aims and objectives: To study the histopathological pattern of urinary bladder tumors and to compare the histopathological spectrum of urinary bladder tumors in various age groups and genders at a tertiary care hospital in Kashmir valley (SKIMS). Materials and Methods: The study was conducted in the Department of Pathology at the Sher-i-Kashmir Institute of Medical sciences (SKIMS), Kashmir and included retrospective data analysis for 4 years and a prospective study over a period of 1 year. The specimens/biopsies for urinary bladder tumors received in the Department of Pathology were properly labeled, numbered and then subjected to gross and detailed histopathological examination. The specimens/ biopsies were fixed in 10% buffered formalin. Biopsies were measured. The specimens (partial cystectomy/ cystectomy) were measured and a detailed gross examination was carried out. Gross photographs of the specimens were taken. The tissue was processed as per standard procedure 4-5 micron sections were cut on microtome and stained by haematoxylin and eosin stain and special stains like PAS was done when required. The findings were then analyzed. Microphotographs of tumors were to represent various histological types. Results: A total of 433 cases were received. Out of those 413 cases (95.7%) were TUR biopsies followed by cystectomy specimens i.e. 13 cases (3%). Cases received for review were 4 (0.9%). Partial cystectomy specimens were least common specimens received i.e. 3 cases (0.7%). Of the total of 433 urinary bladder specimens/ biopsies studied, 411 (94.92%) were found to be neoplastic and 22 (5.08%) were non -neoplastic. Thus majority of urinary bladder lesions comprised of neoplastic lesions. Out of 379 cases of TCC, 315 cases (83.11%) were primary and 64 cases (16.89%) were recurrent. Of the 353 urinary bladder lesions in males, non- neoplastic lesions seen were 18, benign were 16 and 319 were found to be malignant, including 310 TCC cases. Conclusion: Higher number of Bladder tumors are found in males as compared to females. The most common clinical presentation was hematuria followed by lower urinary tract symptoms, pain abdomen and retention of urine. Right posterolateral wall was the most common site of tumor in Radical cystectomy specimen. Transitional cell carcinoma was the most common tumor type. Muscle invasion was seen in 22.89% of malignant cases and there was increasing trend of cases annually.

  124. Dr. Rashmi Prakash, Dr. Ankita Prakash, Dr. Mohd Nawaj and Dr. Nitin Ashok John

    Maturity Onset Diabetes of Young (MODY) is ahereditary form of diabetes mellitus and is caused due to mutations in autosomal dominant gene and isreferred to as Monogenic diabetes. It may be confuses to be a disease Latent Autoimmune Diabetes of Adult (LADA). But LADA has a slower progression to insulin dependence as age progresses while MODY has childhood onset and occurs later in life. MODY variant forms include MODY 2 and 3 which are most common forms. Children and adolescents with MODY may have fasting hyperglycemia at diagnosis and these patient presents with typical microangiopathic and macroangiopathic complications with similar degree of hyperglycemia In retrospect we can now recognize that this category covered a heterogeneous collection of disorders which included cases of dominantly inherited diabetes, still call MODY today. As in 20th century the concept and understanding of MODY has become refined and debatable, hence the pathophysiology and management has been explored through literature in this review.

  125. Jamilah M. Hashemi

    Indomethacin (IND) is an extensively used drug. However, it provokes aggressive ulcerogenic potential. Chamomile is a widely used as natural herb with a powerful antioxidant activity. This study aims to assess the effects of chamomile flowers extract (CFE) in IND induced peptic ulcer (PU). Fifty rats classified to five groups; control, ulcer, and pretreated groups with CFE (200 mg/kg), pretreated with ranitidine RAN (50 mg/kg), and pretreated with CFE+RAN for 14 days pre-ulcer induction. Pretreatment with CFE and/or RAN significantly decreased ulcer index, gastric acidity, pepsin activity, gastric oxidative stress biomarkers, serum anti-inflammatory cytokines, and histopathological changes induced by IND. The pretreated groups significantly elevated gastric enzyme antioxidant activity, mucin content and gastric mucosal prostaglandin E2 with comparison to IND group. Pretreatment with CFE+RAN displayed the most gastroprotective effects compared with pretreated with either CFE or RAN alone. Collectively, the antisecretory and cytoprotective effects of antioxidant and anti-inflammatory activities demonstrated by the CFE's gastroprotective action.

  126. Ubah Chukwudi Nelson, Onyebueke Mary Chiamaka and Omodu Collins, O.

    Background: The study focused on discipline and organizational performance in Nigeria. The study was carried out because of the high level of indiscipline amongst some workers which always affects the level of organizational performance. Ethical theory was employed to analyze the subject matter. Methods: The study used only secondary sources of data through literature review approach. The data collected from literature sources were discussed qualitatively. Results: The study discovered that the effect of discipline on organizational performance include industrial peace and harmony, organizational high productivity, increased revenue, employee career development and environmental friendliness. Also, economic, socio-cultural, political and managerial factors are basically responsible for workers indiscipline in Nigeria organizations. Conclusion: The study concludes that the achievement of organizational high performance among other factors is dependent on the level of employee commitment and dedication to duty in the system which is controlled by the level of employee discipline in the system. The study therefore recommends that Nigeria organizations should develop ethical code of conduct and follow it in their management process so as to maintain discipline; there should be constant training and retraining of organizational staff so as to make them adhere to disciplinary behaviour and organizational employees should always be motivated so as they will not have excuse to exhibit an act of indiscipline as that will have positive effects on organizational performance and growth.

  127. Ali OLLIEK and Georges ABI RIZK

    The current research was conducted to study the effect of diets supplemented with chelated oligo-elements (Manganese (Mn), Zinc (Zn), and Fe (Iron)) on growth performance, carcass traits and meat quality in Japanese quails (Coturnix japonica). A total of 160 Japanese quails were randomly segregated into 4 equal groups: Manganese group “Mn” (Commercial feed + 0.4 g/kg Mn Availa®), Zinc group “Zn” (Commercial feed + 0.3 g/kg Zn Availa®), Iron group “Fe” (Commercial feed + 0.3 g/kg Fe Availa®) and Control group “Control” (Commercial feed only). Birds were raised in collective cages for 52 days of age, where they have been supplemented with ad libitum feed and water. In order to assess the live performance and meat quality, the following traits were measured: Live body weight (LBW), feed conversion ratio (FCR), carcass weight and drip loss (%), carcass yield (%), breast and thigh’s weight and yield (%), pH, meat color (L* a* b*), water holding capacity, thawing and cooking losses, and tenderness. Our results had shown that despite the live body weight of any of the groups not being significantly affected (P>0.05) by the diets, but at the 35th day and afterwards, the Fe group showed the highest live body weight among the groups. In addition, the feed conversion ratio at 29 days showed that group Fe had a significant difference with respect to the control group (3.1±0.06 in comparison with 0.35±0.05: P<0.05). The carcass weight of the Fe group (109.9±16.78g) had shown highly significant difference with all of the other groups (90.68±21.59g, 83.33±18.95g, and 90.58±24.92g for Mn, Zn, and control group respectively; P<0.05). The breast weight of the Fe group (27.3±7g) had also shown highly significant difference with respect to the other groups (20.3±5.48g, 18.6±4.67g, and 21.9±4.62g, for Mn, Zn, and control respectively; P<0.05) whereas for the thigh weight, the Fe group (26.7±4.15g) presented a significant difference only with groups Mn and Zn (22.1±5.16g, and 19.2±4.15g for Mn and Zn respectively; P<0.05). As for the meat color, the Lightness (L*) was not affected by the diets (P>0.05), whereas for the redness (a* value), the Mn group had shown a higher (P<0.05) value than all the other groups at both 24 and 48 hours post mortem. As for the yellowness (b*-value), Mn group had a significantly (P<0.05) higher b* value than Fe at 48 hours p.m. only, with no regards to the control or the Zn groups. Regarding the data presented, the Fe group had shown superiority over the majority of factors; including growth performance and carcass traits.

  128. Georges Abi Rizk, Saleh Fares and Jad Rizkallah

    An experiment was conducted to investigate the effect of supplementation of organic chelated trace mineral Zinc-Methionine ZM complex (ZINPRO®, Zinpro Corporation, Eden Prairie, MN, USA) on extensive Awassi sheep herd submitted to subclinicalmastitis SCM in Bekaa valley of Lebanon. The effects of ZM complex on milk quality (fat, protein and somatic cell count SCC) were examined. 32 Awassi ewes were randomly assigned after separating them into two groups: ZM- group of 16 ewes affected to a control group that were fed on basic ration with no mineral premix (barley, wheat bran, soybean meal, salt, vitamins and hay) and ZM+ group of 16 ewes affected to an experimental group that received a supplement of ZM in their basic ration with an average of 600 mg/head/day for the first month then 1200 mg/head/day for the next month of the trial. Moreover, each group was separated into 2 sub-groups: CMT+ group (n=8) positive to California mastitis test (CMT) and CMT- group (n=8) negative to CMT. In total, 4 groups of 8 ewes each were assigned: ZM+CMT+, ZM+CMT-, ZM-CMT+ and ZM-CMT-. Treatment affected significantly milk protein percent (3.72 ± 0.03 vs 3.63 ± 0.03 % for ZM+ vsZM-,p<0.05), fat percent (5.60 ± 0.07 vs 5.35 ± 0.07 % for ZM+ vs ZM-, p<0.05), and SCC count (339.82 ± 4.48 vs 324.63 ± 4.48 x103 cells/ml for ZM+ vs ZM-, p<0.05). However, milk protein, fat percent and SCC count were significantly different in the infected halves (CMT+) comparing to the non-infected halves (CMT-) in both groups (milk protein and fat percent was lower in CMT+ comparing to CMT-; 3.55 ± 0.03 vs 3.80 ± 0.03, p<0.001 and 4.99 ± 0.07 vs 5.95 ± 0.07, p<0.001 respectively), while SCC count was higher in CMT+ comparing to CMT-; 377.70 ± 4.48 vs 286.76 ± 4.48 x103 cells/ml, p<0.001). Interestingly, the effect of ZM on the experimental affected group was significant (p<0.05) over time especially in the second month of the trial (increase of 1.83%, 4.55% and a decrease of 12.6% in milk protein, fat percent and SCC count in ZM+CMT+). Finally, supplementation of ZM improved dairy performance and udder health by reducing somatic cell count and increasing protein and fat contents in affected ewes.

  129. Samoon Nuzhat, Lone mohd Iqbal, Sumat ul Khursheed, Irfan hussain, Bhat Nazia, Huzaifa Nazier, Aijaz muzamil, Maniza ayoub and Sabreen

    Ewing sarcoma (ES)/primitive neuroectodermal tumours (PNET, together defined as Ewing sarcoma [ES]) is a primary neoplasm of the skeletal system, first described by James Ewing in 1921 (Gupta et al., 2009). ES is the second most common bone cancer, most often occurring in Caucasian children, adolescents and young adults. we are presenting two cases of ewings sarcoma maxilla and one case of ewings sarcoma scapula. Ewing's sarcoma is a radiosensitive tumour (Infante-Cossio et al., 2005). Multimodality therapy consisting of an initial biopsy, aggressive combination of surgery, chemotherapy and localized radiotherapy is the treatment of choice for Ewing's sarcoma of the head and neck region and may result in long-term survival (Vikas Prasad et al., 2008). The prognosis of ES is poor because hematogenous spread and lung metastases occur within a few months after diagnosis, although the tumor burden is considered today as an important factor of prognosis (Ross et al., 2013; Regezi et al.; Davido et al., 2011; Brazão-Silva et al., 2010). Systemic disease is the most important predictive factor towards disease-free survival followed by the clinical response to chemotherapy (Zheng et al., 1998).

  130. Mensah P.J., Marake, M.V., Mugabe, F.T., Mapeshoane, B.E., Nkheloane, T. and Molete, S.F.

    Land degradation in Lesotho is destroying the limited natural resources on which the Basothos’ depend for survival. Soil chemical property assessment was conducted at the Bolahla-Mphosong Catchemnt using LADA Mehtodologies to estimate the extent of soil nutrients depletion and the level of degradation in the catchment. The study indicated that the level of degradation in the catchment was from slightly to very highly degraded soils and there was severe Phosphorus with Nitrogen depletion whiles organic carbon and organic matter content were poor in the soil due to low pH. Sustainable management practise such as Conservation Agriculture (CA), organic mulching, liming, contour ridging and stripe cropping, avoid overgrazing and avoid farming on marginal lands should be encouraged among the land user to help mitigate land degradation in the catchment. Also, the study should be repeated to ascertain concrete evidence on the soil properties to help undertake decision support projects.

  131. Yussif Dokurugu and Chika A Elechi-Onicha

    Zika virus (ZIKV) infection is one of the re-emerging infectious diseases that are of public health important considering its short-term and long-term effects. Aedes mosquitoes are widely distributed globally, and native habitats of most species are warm tropical and subtropical regions. Zika virus, a mosquito-borne disease that belonged to the genus flavivirus and flaviviriae family was discovered during a study of yellow fever in Uganda in Zika Forest (Ioos et al., 2014). The Zika Virus has been described as having two lineages, the African and Asian lineages. Human illness caused by Zika virus was first recognized in Nigeria in 1953, when viral infection was confirmed in three ill persons (Hamel, Liégeois, et al., 2016). Despite recognition that Zika virus infection could produce a mild, febrile illness, only 13 naturally acquired cases were reported during the next 57 years. Zika virus was first identified in the Americas in March 2015, when an outbreak of an exanthematous illness occurred in Bahia, Brazil (Musso, 2015). Epidemiologic data indicate that in Salvador, the capital of Bahia, the outbreak had begun in February and extended to June 2015. No Zika virus vaccine exists; thus, prevention and control measures center on avoiding mosquito bites, reducing sexual transmission, and controlling the mosquito vector (Baden et al., 2016). The rapid spread of Zika infection raises new challenges for the health authorities and researchers about the magnitude and possible complications in future outbreaks (Plourde & Bloch, 2016).

  132. Arvind Varchaswi, Dr. Ravi Kumar Reddy, M. and Ramakanth Reddy, K.

    Now a day’s many dietary supplements are available in the present market. Source Natural Foods and Herbal Supplements limited, Hyderabad also came up with a dietary supplementOjasvita Chocolate which is charged with the addition of seven herbs extracts namely With aniasomnifera, Bacopamonniera, Ecliptaalba, Curculigoorchioides, Celastruspaniculatus, Asparagus racemosus and Convolvulus pluricaulis. The present study evaluates brain function activity of the dietary supplement since the herbs used have rich neuropharmacological significance. Effect of our supplement on Neuro pharmacological conditions like Stress, Anxiety and Memory are evaluated by conducting locomotor and open field testfor antianxiety and in case of antistress swimming test was performed and finally memory enhancer activity was evaluated by using Light & dark explorations, Object recognition test and Elevated plus maze test. Ojasvita Chocolate (OC) at 0.54 gm/kg has enhanced antianxiety activity, moderate anti-stress activity and exhibited moderate memory enhancement in light & dark, elevated plus test. Where, object recognition test shows significant activity when compared with standard on experimental animals.

  133. Yamini Tiwari, Krishan Kumar and Sonam Sneha

    Establishment of a competent protocol for high frequency plant regeneration is done by analyzing a range of factors such as genotypes, combinations of plant growth regulator, types of explants, age of explants etc. in present study maximum shoot regeneration frequency observed was 56.5% for cotyledonary petiole on Murashige and Skoog (MS) medium supplemented with 2 mg/L BA (6-benzyladenine) and 0.2 mg/L NAA (1-naphthalene acetic acid). Out of all the explants reported from Brassica species cotyledonary explants generated the highest frequency in regeneration of shoots. The regenerated plantlets were acclimatized, hardened and transferred to field and grown to maturity in the greenhouse. All the regenerated plants obtained were fertile and morphologically indistinguishable with the source plants.

  134. Elie Bou Yazbeck, Georges Abi Rizk, Alfredo Battistini, Georges Hassoun, Leila Geagea, Rony El-Khoury and Franco Famiani

    Since Lebanon does not have a comprehensive reference on national olive (Oleaeuropaea L.) germplasm, concerning especially the oldest olive trees growing the Bshaaleh area, in northern Lebanon, this study was conducted to characterize these trees using a morphological and biochemical approach and to evaluate the level of their similarity. Samples were taken from leaves, flowers, fruits and stones from the 15 olives accessions and oil was extracted from fruits. Notable all morphological characteristics considered were similar to many different cultivars identified in the Mediterranean area including: tree canopy, leaves, inflorescence and fruit characteristics. According to the PCA and the cluster analysis, morphological characterization of the ancient olive trees of Bshaaleh showed that the olive trees were clustered into three groups, with difference in morphology between B1, B2, B3 and B5 (group 1), B4, B7, B8, B9, B10, B12, B13 and B15 (group 2) and B6, B11 and B14 (group 3).Concerning the biochemical characteristics of the 15 accessions oils, the acidity, peroxide number and the spectrophotometer absorbencies in ultra-violet were low and iodine value high. All of the biochemical values (acidity, peroxide number, absorbencies in ultra-violet, refractive index, iodine value and saponification values) used to evaluate oil quality were within the IOC trade standards for extra virgin olive oil.

  135. Dr. Saba Hashim Mahmood and Dr. Enas Sami AL-Modaris

    Background: Breast self examination (BSE) is non invasive technique that women are able to practice to monitor any changes in their breasts. Breast cancer is one of the leading cause of cancer deaths in women worldwide so the early diagnosis & management of breast lesions is therefore important to reduce mortality .Objective of the study to assess the validity of breast self examination in detection of breast disease. Patients and method: The study was conducted in Breast Center, Radiology Department and Pathology Department in AL-Zahrawi Teaching Hospital over period between October 2005 to August 2006 in Mosul City. 113 selective patients presented with breast mass by self examination referred to combined examination (mammogram and sonogram) and the finding were compared with fine needle aspiration cytology. Result: 113 patients were examined by combined examination and histopathology biopsy showed 32 patients (28.31%)from total were normal, 68 patients (60.17%) were benign masses, the commonest benign tumor 26 patients (23.00%) were fibro adenomas, 5 patients (4.42%) were fibro/adenosis, 14 patients (12.38%) were breast abscess, 7 patients (6.19%) were breast cyst, 1 patient (0.88%) was lipoma, 15 patients (13.27%) were duct actasia and 13 patients (11.50%) were ductal carcinoma. Conclusion: Breast self examination is valuable in early detection of breast masses in addition to combined examination and fine needle aspiration and 66 patients (58.40%)of self examination was positive in triple test, periodic breast self examination is advisable to improve the mortality rate from breast cancer.

  136. Sudhakar, P., Sobhana, V., Sibayan Sen, Sneha, M.V., Swamy Gowda, M.R., Jalaja S. Kumar and Sivaprasad, V.

    The fertility of soil plays key role for the development of any farming crops and mulberry is no exception for it. Demand for essential nutrient supply to the soils ever growing due to intensive cropping systems. Therefore, additional supplementation of required organic and inorganic nutrients to retain the desired levels of soil nutrient status in mulberry is imperative for sustainable leaf production. In the present study a total of 1118 composite soil samples were collected from the traditional sericultural areas of 14 clusters under Cluster Promotion Programme (CPP) to assess the prevailing nutrient status spread over in 13 districts of Karnataka. The soils were subjected for the categorization of their soil types and chemical analysis to determine their soil reaction, salinity and nutrient status viz. pH, EC, OC, available macro (N, P & K) and micro (S, B, Zn, Fe, Mn & Cu) nutrients respectively. The perusal of the results indicated that out of the soils received, loamy soils recorded high (52%) followed by red (28%), black (12%) where as lateritic type in low (8%) among the soils categorised, indicating maximum soils are mulberry friendly. In regard to the soil reaction (pH) 59% soils recorded in desired level (6.5-75), 20% with low (<6.5) where as 21% soils in high pH (>7.5). Most of the cluster soils (97%) showed ideal range of soluble salts (<1.0 dS/m). Organic carbon (OC) was low in 80% soils (<0.65%) whereas 19% medium (0.65-1.0%) and only 1% soils recorded higher OC content (>1.0%). In case of macronutrients, available Nitrogen (N) recorded low in 70% soils (<250kg/ha) whereas Phosphorous (P) and Potassium (K) recorded high (>25kg/ha & >224kg/ha) in 44% and 62% soils, respectively. Micronutrients such as available S, B, Zn, Fe, Mn and Cu, sulphur (S: >15ppm) prevailed high in 71% soils, Boron (B) medium level (0.5-1.0 ppm) in 48%; 49% soils recorded low (<0.6ppm) in Zinc (Zn); Ferrous (Fe) was recorded high in (<4.5ppm) 67% soils; Manganese (Mn) high (>4.0) in 79% soils where as 86% soils recorded with high Copper content (Cu: >0.4%), respectively.

  137. Dr. Aditi Khot and Dr. Deepali Hande

    Urinary Incontinence is an unpleasant and most common crisis for adult, mainly for majority of the women in today’s fast life; stress incontinence is the most common problem. Weak pelvic floor muscles are primarily responsible for urinary incontinence. It is a distressing and disabling condition mainly affecting the social and psychological well being of an individual. Different forms of pelvic floor muscle exercises are used to lessen the severity of stress urinary incontinence by improving the strength of the pelvic floor muscles. Thus, this study was done to check the effectiveness of the Pilates Training and Conventional Therapy Exercises in women with urinary incontinence and their impact on the quality of life of the women.

  138. Chaudhary Veena,

    In this study, the aim was to find out the prevalence of Glucose-6-Phosphate Dehydrogenase (G6PD) deficiency in a group of neonates admitted in Rockland Hospital, Delhi. In this study, the blood samples of 300 neonates were evaluated respectively. In this study, the results showed that the prevalence of Glucose-6-Phosphate Dehydrogenase (G6PD) deficiency in a group of 300 neonates admitted in Rockland Hospital, Delhi was nil (0%).

  139. Sutar Kanchan

    Indian agriculture economy is most widely recognized alternative farming system. Modern organic farming evolved as an alternative to chemical agriculture in the 1940s (P. K. Gupta 2004). The organic fertilizers are derived from plants, animals or mineral sources which help in reducing the use of chemical fertilizers for suitable agriculture. The use of organic fertilizers to meet the nutrient rich requirements would be an inevitable practice in the years to come for suitable agriculture since, organic manures do not improve the physical, chemical and biological properties of soil (V. D. Kapse) This study was designed to observe the effects of different organic fertilizers on growth and yield.

  140. Karma Bako Rimamcwe, Chavan, U. D, Lande, S. B. and Kotecha, P. M.

    The present study was undertaken with the objectives to study the Rheological properties of Roselle seed flour with wheat flour. For this study the Roselle seed were procured from the local market and decortications treatments were given to the seeds. All experiments were laid in completely randomized design with suitable replications for statistical analysis. The pre-treatments decortications and whole seed were adopted in this investigation to ascertain the best treatment for onward inclusion in cookie products. Amylograph, farinograph and extensograph properties of the pre-treatments were also studied. The preliminary investigations adjudged decorticated Roselle seed flour (DRSF) have superior nutritional and functional qualities. The decorticated Roselle seed flour had higher nutrient contents than the whole seeds. Therefore, this treatment was used to study the amylograph, farinograph and extensograph properties. These properties showed good characters for using this flour in bakery products.

  141. Samoon Nuzhat, Syed Besina Yasin, Bhat Nazia, Bhat Irfan Hussain, Huzaifa Nazier, Umara Jan, Hilal, Sabiya Hafiz and Saba Gul

    Back ground: Salivary gland lesions form about 2-6.5% of all head and neck neoplasms in adults. They are easily accessible for FNAC with lower risk factors compared to surgical biopsy. Methods: FNAC was done using 20 cc syringes and reporting was done according to Milan’s system for reporting salivary gland cytology. Cases from the year 2016 and 2017 were retrieved and recategorised according to Milan’s system for reporting salivary gland cytology. Histopathological examination was done on routine H & E (Haematoxylin and eosin) stained paraffin sections. Special stains and IHC was done where ever needed. Results: In the present study we had 47 cases of salivary gland lesions and histopathogical correlation was done in 43 cases as two were non diagnostic , two cases of metastatic melanoma and a single case of metastaic squamous cell carcinoma were not included. Male to female ratio was 1:1.7. Pleomorphic adenoma was the most frequent benign neoplasm while mucoepidermoid carcinoma was the most frequent malignant lesion. A statistical analysis was performed for the 43 cases histopathology of which was available. Sensitivity of 90% was observed, whereas the specificity was 95.65%. The positive and negative predictive values were 94.7% and 92%, respectively. Conclusions: FNAC being a simple, rapid, high patient compliance and cost effective, continues to have high diagnostic accuracy and is thus helpful for guiding management. Neoplasms with classic cytomorphology are easily diagnosed; however, in difficult cases showing overlapping features, the use of the Milan system could be beneficial.

  142. Hebzibha Isravel

    In an extended phase-space where the cosmological constant is treated as pressure, the qualitative behavior of the dyonic charged spinning four dimensional Ads black hole is investigated. The system holds a similarity to the Vander Waals liquid-gas. The curves at T

  143. William Brown

    The concept of a luminiferous, meaning light bearing, ether has been a persistent idea throughout time. Einstein delivered an address in 1920 and revealed some relevant and prescient thoughts. The Special Theory of Relativity is based on two postulates. The second has come to be interpreted that the speed of light is always C in every inertial reference frame. This second postulate is one that was never been based on any empirical evidence. The general acceptance of this assumption has been perpetuated by the difficulty in measuring the one-way speed of light. Many experiments have been proposed to measure the constancy of the one-way speed of light but, so far, all have failed. What is significantly important is that there is now no experimental evidence to fully substantiate Einstein’s second postulate by which the one-way speed of light is constant in all inertial reference frames. If there is an ether, the postulate may prove to be invalid. It might be assumed that the null result of the Michelson Morley Experiment has already determined the nonexistence of any ether, but that would be wrong. There is a need for an experiment to determine whether relative motion is always the key to known kinematic phenomena. The purpose of this paper is to suggest a new way to make one-way speed of light tests and to confirm or reject the assumed relativistic idea that all inertial reference frames are equal.

  144. Afandiyev, O.Z, Allahverdiyeva, A.Т. and Shikhiyev, A.S.

    At this time in the field of instrumentation technology, the creation of advanced instruments is very important. On this basis, the article considers the necessary determination of the values of the main parameter of the power characteristics of the interaction between a solenoid and a magnetic core of magnetic levitation systems - magnetic induction of the core. The ability to measure the level and density of a buoy magnetolovitsionnym level sensor in ship tanks gives this device a huge number of positive features due to a levitating body, which is a sensitive element that can be placed on various measuring chambers. The method of calculation is based on using the demagnetization curve of the hysteresis loop of the magnet material.

  145. Prof. Dr. Iwasan D. Kejawa, Ed. D.

    It is discovered that we learn by quantum thinking, which means by looking at the world in a new way; and learning in a safe environment. It may also be inferred that adults, not the educators, determine what they want to learn (Knowles,1980). Education creates a foundation for the success of professionals. The education of the adults may be formal or informal. The combinations of formal and informal education are the major fundamental of adult professionalism. The education obtained through informal education is the day to day observations or scanning of the environment or societal activities of the population. Informal education may be classified as knowledge or education obtained out of the classroom or out of the congregation of people. It is the education acquired through exploration of various paraphernalia of possible educational documentations or situations. The formal education obtained by many professional adults are classrooms-based, these may be through seminars or conferences. The basis for educating the professional adults is to update their skills because of changes in the society: Thus, this justified the purpose and the need for strategic adult educational planning (Knowles, 1980).

  146. Sheladia Siddharth Kantilal, Savalia Vraj Dharmendra and Patel Kathan Prakashbhai

    Electromagnetic field is an important, crucial and one of the four fundamental forces available in nature. The behaviour of all ferrous and charged objects is affected when they are in vicinity of the field. EMF is objectively made out of two fields i.e. Electric and magnetic field. The force created by magnetic field is much lower than the force created by EMF. Stationary charges produce the electric field where as the moving charges or the currents produce the magnetic field. Maxwell’s equations with Lorentz force law explain the interaction of charges and current with the electromagnetic field. According to the classical theory EMF is considered to be the smooth and continuous field which propagates in the wavelike manner. In quantum field theory EMF is regarded as quantized and composed of individual particles. In electromagnetic forming device a plunger of ferrous material is used so that it can either attract or repel according to its own charge when it comes in contact with the electromagnetic field. This movement of plunger possesses extremely high velocity which makes plethora of operations possible.

  147. Sandip Mandal and Abhijit Guha

    Women plays a vital role in inclusive growth of a nation or a society through sustainable development. A girl child may blossom into an ever fragrant flower with the proper nourishment of her mother. Education is a vital issue to be an ideal mother in future. Few measures were taken for empowerment of women in the course of providing incentives or providing different scopes to access education since early age. The present study is conducted with the main objectives to know the attitude towards education of adolescent girl students in the light of Kanyashree Prakalpa with respect to the variation of class (across age), locality and caste category. The data are collected from randomly selected 926 unmarried adolescent girl students from the secondary and higher secondary schools of Medinipur division (administrative division), West Bengal through using self developed tool, Adolescent Girls’ Attitude towards Education Scale (AGATES). Data consists of 85.9 % beneficiary of Kanyashree Prakalpa and 14.1% non-beneficiary of Kanyashree Prakalpa, 50.1 % urban area student and 49.9% rural area student, 38.3% general category student, 29.6 % OBC category student, 22.8 % scheduled caste category student and 9.3 % scheduled tribe category student and the girl students belonging to class VIII (13 plus years) to class XII (17 plus years). The raw data are tabulated in MS-Excel 2007 and t-test, ANOVA are done by SPSS 22.00 version. Result of investigation indicates that there are significant changes in attitude towards education of Kanyasree Prakalpa beneficiaries among the class groups VIII (13 plus years) – IX (14 plus years) (p= 0.00),VIII (13 plus years) – X (15 plus years) (p= 0.001),VIII(13 plus years) – XI (16 plus years) (p= 0.02),VIII (13 plus years) – XII (17 plus years) (p= 0.006), XI (16 plus years) – IX (14 plus years) (p= 0.045)and the attitude towards education of beneficiaries are in better position than non-beneficiaries. Local variation plays significant role for beneficiaries but it does not play any role for non-beneficiaries. Mean score of Scheduled tribe category students’ attitude towards education are low for both beneficiaries and non-beneficiaries. Finally the investigator concluded that Kanyashree Prakalpa is not just a social welfare scheme, it is future.

  148. Ranjith Kumar Gunaseelan, Dinesh Sellakutty and Ganesh Kumar

    Iron oxide is one of the oxides of iron, which is present in the sand. The content of iron oxide present in river sand is generally up to 6%. The objective of this project is to check the tensile strength of concrete with increase in iron oxide. The Compressive strength, Split tensile test, Modulus of Elasticity, Impact test and Flexural strength test were also found using destructive testing techniques.

  149. Abdulfetah Nesha and Seifu Zinab

    This paper attempts to describe how the nouns of Kafi Noonoo formed. To do so the intended data was collected from the native speaker of the language and analyzed. Since the language is tonal Praat Software was used to identify the high and low tone of the syllable in the word. The result obtained showed that noun is the main of speech that is formed from different types of words such as noun, verb, and adjective. Different types of nouns such as abstract, agentive, instrumental, action, gerundive (infinitival), and manner are mainly derived from nouns, adjectives and verbs suffixation.

  150. Abdulghani Al-Hattami and Dr. Fatima Mohamed Al-Malki

    One of the significant issues in organizations and working environments is useful human resource. The purpose of this cross-sectional research is to investigate the relationship between faculty member’s job satisfaction and work innovation at Bahrain Teachers College (BTC). Faculty members were asked to identify what they like about being employed at BTC and what factors affect their levels of job satisfaction. The sample consisted of 55 faculty members from BTC with a response rate of 89%. A questionnaire was developed and validated used to collect the data. The results showed that there are many things that faculty members like for being working at BTC, the most of which is teaching itself, followed by the working environment. They do not like bureaucracy of rules, policies and dealing with a lot of paper works. Some rrecommendations are presented in light of the findings with the hope that this research can help the university administrators to increase the satisfaction level.

  151. Dr NGUESSAN Kouamé, O.

    Considered as a social tool designed to fulfill the needs of this society, teacher training aims at allowing individuals to be equipped with teaching competences. This paper puts to examine the new Ivorian teachers training policy with a specific focus on junior high physics-chimestry/biology teachers training at the teachers training college of Abidjan. The latter recruited among students and teachers at the level of License 2 in the subjects taught at the college, join the Ecole Normale Supérieure (ENS) of Abidjan for a training of three semesters of theoretical courses and a semester of practice in secondary schools. . They come out with the title of bivalent profile high school teachers. The present study intends to contribute to evaluate not only the quality of this training policy, especially the professional performances of bivalent high school teachers. To achieve this goal, we applied two methodological approaches. The first is qualitative and based on documents analysis. The second is qualitative and. It was based on classroom observations. The results show a good integration educationnal sciences in the training policy of the latter and a weak vocational training in the second subject associated with the basic subject of the bivalent teacher. This study argues accordingly for a reinforcement of these dimensions in the pre-service and in-service training of the bivalent high school teacher for a better performance in classrooms.

  152. Tony Okwach Omusonga

    Effective curriculum supervision by head teachers is necessary for schools to offer quality education to learners. Learners’ assessment is one of the key areas of curriculum supervision. Thus head teachers should possess requisite knowledge, skills and attitude in supervision of learners’ assessment. In Bungoma West Sub-County low academic achievement was an issue in most public primary schools. In Kenya Certificate of Primary Education (KCPE) examination, the Sub-County’s mean scores for the year 2012 to 2014 were below average with performance indices of 237.22, 239.63 and 232.30 respectively out of possible 500 marks. This was attributed to various factors, with inefficiency in learners’ assessment often mentioned by stakeholders in the Sub-County as one of the factors. In-Service Education and Training (INSET) courses for primary school head teachers had previously been organized based on the whims of course organizers and not actual curriculum supervision needs of head teachers. The purpose of the study was to assess learners’ assessment supervision training needs of public primary school head teachers in Bungoma West Sub-County. Specific objectives were to determine the discrepancies between the ideal and actual learners’ assessment supervision knowledge, skills and attitudes of the head teachers. The study used descriptive survey research design. A conceptual framework comparing the ideal and actual outcome was used to guide the study. The study population was 81 primary school head teachers, 1 Sub-County Director of Education (SCDE) and 1 Teachers Service Commission Sub-County Director (TSC SCD). The research instruments comprised of head teachers questionnaire, interview schedule and document analysis guide. To ascertain reliability of the instruments, a pilot study was carried out involving 10% of the study population. Curriculum studies experts at Bomet University College were consulted to ascertain content validity. Test re-test method was used to determine an acceptable reliability Pearson coefficient of 0.9. Quantitative data was analyzed by descriptive statistics of frequencies, percentages and means. Qualitative data was grouped based on objectives and analyzed based on emerging themes. The study found very low discrepancy between ideal and actual learners’ assessment supervision knowledge and skills of head teachers (m=4.02). The study equally observed very low discrepancy in the attitude of head teachers towards learner’s assessment supervision (m=3.75). The study concluded that head teachers had training needs with regard to learners’ assessment. Based on the findings of the study, it was recommended that INSET courses for primary school head teachers should focus on participants’ knowledge, skills and attitudes in learners’ assessment supervision with specific emphasis on construction of various types of test items and mechanisms for monitoring quality of both internally and externally designed evaluation tests. The study is significant to the Ministry of Education and Teachers Service Commission Sub-County officials in the organization of INSET courses for head teachers. The study findings further contribute significantly to the knowledge in the field of teacher education and training.

  153. Memory Queensoap and Goodness W. Orluwene

    This study used mantel haenszel Differential Item Functioning (DIF) approach to detect item bias in a Chemistry Achievement Test (CAT) in four ethnic groups in Nigeria. The CAT was administered to 400 chemistry students of senior secondary III in Niger State, Kwara State, Anambra State and Bayelsa State representing Hausa, Yoruba, Igbo and Ijaw respectively. A descriptive-comparative research design was used to describe and compare examinees of the four ethnic groups. A statistical and content analysis was done with Mantel Haenzel’s adjusted – DIF.The Mantel-Haenszel adjusted-DIF statistics flagged all items as showing significant differential item functioning between the focal group (Ijaw) and reference group (Yoruba, Hausa & Igbo). It was also observed that item 20 and 36 showed NO DIF for Ijaw/Yoruba and Ijaw/Hausa respectively. Based on the analysis, the study established that the CAT has some items that showed biases and not all items that exhibited differential functioning were flagged biased because some items fall within category A, (small effect) following the Educational Test Services (ETS) scale. Therefore, the study concludes that there was an ethnic bias in the CAT. The study recommends, among others, that Item Response Theory based DIF approaches should be used in educational testing.

  154. Supriya Yadav and Dr. Manju Mahanada

    Reproductive health of adolescent girls is crucial in determining the health of future generations. For ensuring informed decisions by adolescents regarding their sexuality and reproductive health, National AIDS Control Organization has introduced life skills education in school curriculum. However, there exist many roadblocks in implementation from theory to practice. Hence, the present study was conducted to assess the reproductive health awareness and most preferred source of information.

  155. Sayan Banerjee

    The Article highlights the consequence of entry of Multi-National Corporations on the host nation. It hlights how the consequences on development condition of the economy is essentially determined by the type of FDI that multinational corporations bring into the host nation rather than a generic description of it.

  156. I Wayan Subawa and I Gede Agus Kurniawan

    Trademark has so called economic right which is right toreceiveeconomic benefits of the trademark owned by the owner of trademark. With such economic right; therefore, ideally, trademark should be able to provide financial benefits and should also be used as the object of bank guaranty. However, trademark still does not have an adequate arrangement as a guaranty in Indonesia. Hence this article discusses more deeply on the existence of Indonesian Law No. 20 of 2016 on Trademark and Geographical Indication (Trademark and GI Law) which does not seem to accommodate trademark as fiduciary guaranty from the perspective of the value of justice. This is a normative legal research which uses statute, conceptual and analytical approaches. The results show that the implications of the existence of Trademark and GI Law which does not seem to accommodate trademark as fiduciary guaranty from the perspective of the value of justice in the perspective of the justice and utility values are: (1) absence of justice for entrepreneurs as the owners of trademark because their rights as trademark owners are not fully recognized; (2)stakeholders cannot enjoy the benefits of trademark rights as bank guaranty; and (3) trademark has not received adequate protection due to the absence of comprehensive juridical support and has no clear legal certainty in terms of the legality of trademark as guaranty in bank or other financial institutions.

  157. Yerima B.D. Aboubacar, ILLA Salifou, Guero Yadji and Ado M. Nasser

    In arid and semi-arid areas, where water is a imitating factor, the agriculturals use other system of irrigation especially the drip to drip one for the agricultural production. The ground water particularly the pool waters employed are generally trouble and limit the working device of drip to drip irrigation due to clogging of the drippers. The aim of this study is to test the kernel powder of Oleifera Moringa for the pool water clarification in order to improve the durability of drip to drip system of irrigation. The pool waters of Kongou Gorou Zarmadandey is located in North-East at 7km of Niamey in Niger has been taken away for the treatment. The latter found on coagulation-flocculation with a recipient -test consists in applying the kernel powder of Oleifera Moringa respectively dried at three temperatures ( 25, 40 and 50° C) and applied by three doses ( 50, 100 and 150 mg, l-1). ). The parameter sized up is essentially the turbidity of water. The results has showed that the application of kernel powder of Oleifera Moringa clarified significantly the pool water especially from 30 minutes of decantation. In fact, the initial turbidity of the unrefined water (638 NTU) lowered significantly by 74, 99 and 99% respectively with the dose of 50, 100 and 150 mg / l of oleifera M. after 24 hours of decantation. The diminution of turbidity by oleifera M. is significantly higher with the doses of 100 and 150 mg / l than with the dose of 50 ml / l. The dose of 100 mg / l oleifera M. seems to be the optimal dose for the clarification of Kongou Gorou Zarmagandey pool waters. However, an additional works can be consider for studying the impact of oleifera M. kernel powder on the chemical and bacteriological quality of pool waters.

  158. I Wayan Gede Rumega

    Administrative law cannot be separated from the use of state finance; therefore, it is possible for state administrators and the government to take actions that may violate legal norms and cause deviation in the use of state finances. In Indonesia, if the state and government officials violate administrative legal norms and cause state financial losses, they will be categorized as committing criminal acts of corruption. The occurrence of corruption is not only contrary to the criminal law norms, but it is also possible that it is contrary to the administrative law norms. This article discussed the legal issue on the parameters of criminal acts of corruption under the Administrative Law from Indonesian law perspective. This is a normative legal research which employs statute and conceptual approaches. It is noted that there are connections between the administrative law regime and the corruption criminal law regime in: (a) the use of the term “abuse of authority”; (b) the scoop of the concept of “abuse of authority”; (c) the address addressed by a norm or norm subject (normadressat) in “abuse of authority”; and (d) the use of authority for purposes other than the initial purposes.

  159. Deepa Patil and Tejashri Ligade

    Breast milk is not only the best but is also a must for the babies. Especially exclusive breast feeding during first few months of life is important as it reduces the risk factors for the infant mortality and the morbidity rate. WHO estimates that 1.5 million of infant’s life can be saved each year through increased breast feeding. Although the health benefits of breastfeeding are well established, early introduction of formula remains a common practice. Cultural beliefs and practices can have a important impact on breastfeeding. Scientific research studies conducted during the last three decades have clearly proved that breastfeeding provides the most suitable nutrition for an infant. However in India, breastfeeding is inadequately practiced due to prevailing misconceptions and cultural taboos. This study assesses the socio-cultural beliefs influencing breastfeeding practices among 100 primi postnatal mothers in selected UPHC of selected area. In this study, convenient sampling was adopted. A Likert type belief scale were used level.

  160. Nur Shahida Nasha Mohd Nashir and Mohd Hafizal Ismail

    The Royal Mausoleum of Sultan Mahmud Shah is a small and mundane heritage landmark in the Historical Tourism District in Johor. The Royal Mausoleum represents the history of Sultan Mahmud Shah II, which his decease remarked the end of the glorious dynasty of Melaka Sultanate in Johor ruling system. It is realized through the inheritance of history of the deceased Sultan Mahmud Shah and the symbolic of the Royal Mausoleum as a heritage asset in Kota Tinggi creates an identity among the local community towards the place. This research aimed to identify the identity and value of cultural heritage among community in relation to the existence of Royal Mausoleum at Kota Tinggi, Johor using an adopted model by Breakwell’s Theory on Identity which emphasized on continuity, distinctiveness, and self-esteem. Quantitative method is used based on questionnaire survey conducted to 300 respondents in order to measure the dependency of the place and local identity of the community. Analysed using t-test and ANOVA analysis, the results showed that there was an emotion bonding and memory attachment to the Royal Mausoleum among the local community in the village. The Royal Mausoleum seems to bring back the nostalgia in terms of old memories especially among the veteran group of local community. The results confirmed that the socio-demographic background such as education, occupation, and age group mostly influenced the significance of items for place identity, which were ‘distinctiveness’ and ‘self-esteem’. This research contributed in identifying the place identity of the Royal Mausoleum. Hence, it helped in strengthen the criteria of the Royal Mausoleum to be more presentable as tourist attraction.

  161. Ms. Priyanka Shukla and Dr. Adarsh Garg

    Online learning platforms are being tremendously used by the researcher, educators or learners now days. As e-learning is not interactive so the communication is required in different way using asynchronous communication with discussion forum or through e-mail. Purpose of this paper is to explore various e-learning platforms and to categorize them, which are using the asynchronous communication to analyze the behavior of learner, improvement of course content, improvement of instructor and so on.

  162. Ni Wayan Sorinasih

    Tourism, including in Indonesia, is one of the sectors that can greatly contribute to the country’s foreign exchange earnings and employment. However, there is no technical norms available in the legislations on the absorption of local workers originating from indigenous people of the area which resulted in very little absorption of these type of local workers compared to workers originating from other regions. Thus, this article aims to analyze the legal basison the utilization of local residents as workers in the tourism service field in Indonesia and to analyze standard benchmarkof such utilization. This study uses normative legal research with statute, conceptual and historical approaches. The results show thatthe current legal basis on the utilization of local local residents asworkers in the field of tourism service in Indonesialay in the 1945 Indonesian Constitution, Indonesian Human Rights Law, Indonesian Investment Law, Indonesian Manpower Law and Indonesian Tourism Law. As for standard benchmarks of such utilization in Indonesia are the existence of competence in accordance with Government Regulation Number 52 of 2012 on Competency Certification and Business Certification in the Field of Tourism and human resources development related to the development of attitudes, behavior, manners and so on. Meanwhile the percentage of the utilization of local local residents as workers needs to be further examined in terms of its fairness and appropriateness.

  163. Cynthia Mafra Fonseca de Lima, MD, MsC, Beatriz Mangueira Saraiva-Romanholo, PhD, Elayne de FatimaMaçaira, MsC, Elizabete Medina Coeli Mendonça, MD, PhD, Kalil, Jorge, Fabio Fernandes Morato MD, PhD and Clovis Eduardo Santos Galvao, MD, PhD

    Background: There is consistent evidence that cleaning workers are at high risk of developing asthma. Predisposing factors are not fully understood and it is important to produce evidence that this risk is work-related. Objective: To assess whether the work environment induces pulmonary inflammation in asymptomatic cleaning workers and to determine the efficacy of noninvasive methods to detect early pulmonary inflammation. Methods: Sixty-seven workers were evaluated by comparing sputum cytology, fractional exhaled nitric oxide (FeNO) values and spirometry tests, performed during the work period and after vacations. Results: We observed a significant increase in FEV1 values after the vacation period (pre 2.90L ± 0.57L and post 2.94L ± 0.61L, p <0.05), even though those values were within normal limits, in both periods. There was a reduction in the values of the FeNO measurements after vacations (pre 16.3 ± 9.7 and post 13.8 ± 7.8, p <0.05) and a reduction of inflammatory cells count in the induced sputum (Eosinophils: pre 0.019 ± 0.05 and post 0.003 ± 0.01, p <0.05 Lymphocytes: pre 0.16 ± 0.35 and post 0.01 ± 0.09, p <0.05 Macrophages: pre 0.421 ± 0, 47 and post 0.235 ± 0.30, p <0.05. Conclusion: We observed that the occupational environment to which the studied population was exposed caused inflammation in the airways without functional abnormalities. Noninvasive methods such as counting of cells after induced sputum and FeNO measures showed to be promising tools for the detection of pulmonary inflammation, although they still require standardization.

  164. Shalan Joodah Rhemah Al-Abbudi

    Background: Depression is most frequent among physical illness. Diffuse Idiopathic Skeletal Hyperostosis is a condition in which several ligaments and entheses become ossified. Objectives: Assessment of depression and the severity of depression among patients with diffuse idiopathic skeletal hyperostosis, and detection of risk factors. Methods: patients with diffusive idiopathic skeletal hyperostosis, both genders who have consulted during the study period and given their consent were assessed through sociodemographic and clinical data collection, and PHQ-9 questionnaire for depressive disorders evaluation. Results: The study investigates 43 patients with diffuse idiopathic skeletal hyperostosis. Prevalence of depression was 62%. Almost 88.88% of them were moderate to severe depression. Depression significantly associated with age, gender, occupation, life events, and duration of illness. Conclusion: depression is high in patients with diffuse idiopathic skeletal hyperostosis. Age, gender, occupation, life events, and duration of illness consider as the significant risk factors.

  165. Osama Abdullah Abdul Raheem, Mohamed Mahmoud and Ibrahim Zidan

    Objective: This study aims to evaluate the outcome of ligasure hemorrhoidectomy versus conventional (Milligan Morgan) hemorrhoidectomy regarding blood loss, lenghth of the procedure, postoperative pain and wound healing. Method: This prospective study was included 40 patients with grade III, or IV hemorrhoid. Patients divided into 2 groups Conventional (Milligan- Morgan) hemorrhoidectomy for 20 patients and Ligasure hemorrhoidectomy for 20 patients. Result: This study defined that the application of Ligasure hemorrhoidectomy was associated with shorter operative time, almost bloodless operative field, smooth postoperative period with lower pain score, analgesic requirement and lower incidence of postoperative complications. In addition, it found that patient satisfaction significantly more superior after Ligasure hemorrhoidectomy. Conclusion: Ligasure hemorrhoidectomy is safe, effective, associated with lower pain and fewer postoperative complications than conventional hemorrhoidectomy.

  166. Gustavo Henrique Belarmino Góes, Lívio Amaro Pereira, Thiago Cesar Araujo, Raul Emidio de Lima, Raimundo Hugo Matias Furtado, Patrícia Muniz Mendes Freire de Moura, Luydson Richardson Silva Vasconcelos and Leila Maria Moreira Beltrão Pereira

    Background: Non-alcoholic fatty liver disease is characterized by excessive accumulation of fat in the form of triglycerides in the liver. A subgroup of these patients presents, in addition to excess fat, cell damage and inflammation, a condition called non-alcoholic steatohepatitis. Objective: Evaluating the clinical and epidemiological aspects of patients with non non-alcoholic fatty liver disease, allowing a better screening of patients who will require liver biopsy. Methods: We analyzed the medical records of 73 patients with non-alcoholic steatohepatitis, all diagnosed histopathologically after performing liver biopsy. Patients were grouped according to the degree of hepatic steatosis, being classified as mild, moderate, or severe. The normality test was performed for all cases. The mean values of the clinical epidemiological parameters were used for statistical analysis with ANOVA. The median value of the laboratory parameters was used for statistical analysis with the Kruskal-Wallis test. Results: In our study on non-alcoholic steatohepatitis patients, 53.44% (39) showed mild disease, 34.24% (25) showed moderate disease and 12.32% (9) showed severe disease. Among the epidemiological, clinical and laboratory parameters evaluated, a statistically significant difference was observed among the three groups for low density lipoprotein (p = 0.02), systemic arterial hypertension (p = 0.03), metabolic syndrome (p = 0.02), and female sex (p = 0.03). Conclusions: Most patients of non-alcoholic steatohepatitis are females and present with mild hepatic steatosis, which is associated with raised low density lipoprotein values, in addition to the presence of other risk factors, such as hypertension and metabolic syndrome.

  167. Dr. Debasish Kar, Dr. Swagata Gayen, Dr. Sajeet Kumar Das, Dr. Sk. A. Mahamud and Dr. Mousumi Pal

    The Odontogenic keratocyst (OKC) is a benign lesion of the Oro-facial region having distinct clinicopathological features, high propensity for recurrence and characteristic aggressive behaviour. It commonly involves the mandible while maxilla is relatively unusual location. The clinico-histo-pathological characteristics and subsequent of OKC in a 30 years old male patient with maxillary involvement has been discussed herewith.

  168. Erick Magdiel Ramírez Rayón, Jorge Luis Rivera Rodriguez, Diana Fabiola López Velazquez, , Francisco Javier García Jiménez, Dulce María Astudillo de la Vega, José Francisco Guadarrama Quintana, Juan Alberto Suategui Guinto Karina Almazan Valenzo and José

    Objective: Report of a series of cases of tetanus and learned experience in the diagnosis and treatment of this disease, which continues to prevail in developing countries such as ours. Methods: This is a descriptive and retrospective study of a series of cases of tetanus diagnosed in Acapulco General Hospital from January 2015 to January 2019. Results: A total of 6 cases of tetanus were reported in adults who had not been vaccinated or had not received an adequate tetanus vaccination. All patients were isolated in a silent, dark room in Intensive Care Unit (ICU). Five patients needed a tracheotomy and respiratory support. 4 of them underwent early tracheotomy as a management protocol of the hospital. All patients received tetanus toxoid and immunoglobulin on admission. Two deaths occurred throughout the period of the study. Conclusions: These cases highlight the difficulties of early diagnosing and adequately managing rare diseases such as tetanus in health care systems of developing countries such as Mexico, being this a highly preventable infectious disease by vaccination. Our hospital is characterized by a low mortality rate in patients with tetanus due to our systematized and multidisciplinary clinical experience.

  169. Dr. Uğur YARADILMIŞ, Dr. Mehmet ÖZER, Dr. Mustafa Caner OKKAOĞLU, Dr. Ahmet ATEŞ, Dr. İsmail DEMİRKALE and Dr. Murat ALTAY

    Background: In pediatric forearm fractures casting and conservative treatment follow-up, a relationship has been found between re-displacement and malalignment with complete fracture, quality of the first reduction, and proximal 1/3 fracture. For similar reasons, we believe that instability in the operating room also continues and some fractures require open reduction. Objective: The aim of this study is, to predict the fractures that require mini-open intervention and to evaluate the functional results of these unstable fractures. Methods: 69 patients treated with intramedullary kischner wire [Open reduction (n:45), closedreduction (n:24)] for a pediatric forearm fracture in our clinic were reviewed retrospectively. Information regarding the age, gender, left/right side were obtained from the patients' files, and data regarding preoperative fracture displacement, angulation, localization of radius and ulna fracture, type of injury of the radius fracture, and the level of fracture. The patients were evaluated radiologically with radial inclination index and functionally with the Price criteria regarding location. Results: Open reduction and fixation were applied to 45 patients (65%). Open reduction was required when the radius fracture was non-transverse, and the fracture localization progressed proximally (p=0.039, 0.049, 0.039). No relationship was found between open reduction with age, side, gender, angled fracture, and displacement. According to the Price criteria, an excellent result in the ratio of 94% was obtained. There was no difference in mini-open fixation regarding union duration and complications. Although the radial inclination index increased in proximal and non-transverse fractures (7.8% ± 1.9), this was not reflected in functional scores. Conclusion: In pediatric forearm fractures, if the fracture is proximal or not transverse, open reduction is needed mostly and open reduction intramedullary fixation is performed successfully in these fractures.

  170. Parvaze Sheikh

    Dental caries is the leading dental problem of children, 90% of all children have some tooth decay by 12 years of age, and 95% of all cavities are caused by specific eating habits like candies, ice cream, canned juices which usually develop during early childhood as a result of changing life style. The ages of greatest vulnerability are 4-8 years for the primary dentition and 12-15 years for the secondary (or) permanent dentition. Dental caries if untreated result in destruction of involved teeth. The goal of WHO, “Health for all by the year 2025”, includes oral health as one among the healthy life. So WHO has selected the theme “Oral health for healthy life” in 1994. The purpose behind this was to make the people aware about various diseases of oral cavity and to educate them in relation to prevention of these diseases. The aim of the study was to evaluate the effectiveness of structured teaching programme on knowledge regarding Dental Hygiene among school children in Govt. Middle schools of District Budgam Kashmir. Objectives 1) To assess the pre-existing knowledge score of middle school children regarding dental hygiene before implementation of structured teaching programme (pre-test). 2) To assess the knowledge score of middle school children, after implementation of structured teaching programme. (Post-test). 3) To determine the effectiveness of structured teaching programme regarding dental hygiene among middle school children by comparing pre-test and post-test knowledge scores of middle school children. 4) To determine association of pre-test knowledge score of middle school children regarding dental hygiene with their selected demographic variables (Gender, Type of family, Educational status of parents, Monthly family income). Methods: Quantitative research approach & pre-experimental one group pre test post test design was used. Purposive sampling technique was used to select the samples that were 50 middle school children studying at Govt. Middle school Razwan, Zone Narbal Dist .Budgam Kashmir. Data was collected using self structured knowledge questionnaire. Results: The result of the study showed that the mean knowledge score in pre test was 22.58 and S.D was 3.78 and in post test mean was 31.14 and S.D was 3.81. By the evidence of results mean post test knowledge score of school children regarding dental hygiene were significantly greater than their mean pre test knowledge score at p≤0.05 level of significance. Hence structured teaching programme regarding dental hygiene among school children was effective. There was significant association of pre test knowledge score and selected demographic variables like educational status of parents (0.000) and Monthly family income (0.000) of the school children. The other demographic variables like Gender (0.220), and Type of family (0.128) were found to be insignificant. Interpretation and conclusion: The findings of the study revealed that the knowledge score of middle school children was very low before the implementation of structured teaching programme. The structured teaching programme facilitated them to improve their knowledge about dental hygiene which was evident from the post test knowledge score. Hence structured teaching programme was an effective method for providing information and to improve knowledge of school children which was well appreciated and accepted by school children.

  171. Arezou Bikdeli and Naser Golsanami

    Body fat is one of the most important parameters in determining one’s health condition. The current study focuses on estimating body fat values from routine characteristics of adults with the use of artificial intelligent systems. The methodology applied here combines the results of the individual models in a committee machine with intelligent systems (CMIS) for estimating body fat percentage. The artificial neural networks (ANNs), fuzzy logic (FL), and adaptive neuro-fuzzy inference system (ANFIS) were utilized as intelligent experts of the CMIS. The NN models were developed with four different training algorithms (Levenberg–Marquardt (LM), scaled conjugate gradient (SCG), one step secant (OSS) and resilient back-propagation (RP)) and the best one was chosen as the optimal NN expert of the CMIS. The CMIS assigns a weight factor to each individual expert by the simple averaging and weighted averaging methods. A genetic algorithm (GA) optimization technique was used to derive the weighted averaging coefficients. The results indicated that the GA-optimized CMIS performed better than the individual experts acting alone for estimating the body fat percentage from one specific set of input characteristics.

  172. Dr. Shete S.S., Dr. Pandit G.A., Dr. Agrawal S., Dr. Sagar S., Dr. Kesale M.B.

    Chronic non healing ulcers are common in developing countries including India, keeping rural, poor living conditions and lack of health education in view. The vast majority of cases includes chronic diabetes, tuberculosis, leprosy, vascular insufficiency and other immunosuppressive states which adds further confusion to the pool, especially for patients receiving treatment in nearby local/peripheral centre. A non-healing post burn scar should be addressed promptly because it may transform into cutaneous malignancies like squamous cell carcinoma, basal cell carcinoma and malignant melanoma. Such patients should be treated meticulously and followed up.

  173. Dr. Yogesh Kukreja

    Background and Objectives: Acute appendicitis is most common surgical emergency and Appendicectomy for same is a common procedure. The rate of negative appendicectomies remains high despite several technical advancements. The study aims to compare few investigations like Total leucocyte count (TLC), C-reactive protien (CRP), Lactate dehydrogenase (LDH) and Ultrasonographic (USG) with per-op findings. Histopathologic examination (HPE) report will be taken as confirmatory test. The need to study is to find out which is the most sensitive and specific investigation that can help us improve our diagnosis of acute appendicitis. Methods: The study was conducted in 100 consecutive patients of Acute Appendicitis at an Armed Forces Tertiary Care Hospital. Total leucocyte count (TLC), C-reactive protien (CRP), Lactate dehydrogenase (LDH) and Ultrasonographic (USG) findings were noted preoperatively. Per-operative findings were noted in all the patients. Histopathologic examination (HPE) of appendicectomy specimen was done in all cases. All investigations and USG findings were compared with per-operative findings and with HPE findings. Results: CRP has highest sensitivity and specificity (90%, 80%) followed by, USG (87.5%. 90%), WBC count (78.75%, 80%) and LDH (77.5%, 80%). When all the four tests are combined the sensitivity, specificity, positive predictive value and predictive value of negative test increased significantly (100%. 80%, 95.23%, 100% respectively). When all the four tests were negative, appendicitis could be safely ruled out and surgery could be avoided. Conclusion: With all the four tests were negative, appendicitis was ruled out and surgery was avoided thereby decreasing the rate of negative appendicectomy to 09%. TLC, CRP, LDH, USG should be used as aids in diagnosis of appendicitis. However no investigation can undermine the importance of clinical judgment. Good history and examination still remains the most valued tools in cases of acute appendicitis.

  174. Dr. Zeanath, C.J.

    The unprecedented economic development and rapid urbanization in Asian countries, particularly in India has led to a shift in health problems from Communicable to Non-communicable diseases1. Coronary Artery Disease (CAD) has been often considered as “affluent person’s disease”, that is a disease caused by easy and sedentary life style, high calorie and high fat diet2. The CAD not only brings mortality but also results in increased morbidity resulting from the complications due to the disease2. The nurses have a significant role in making a difference in people’s attitude regarding health care and life style modifications for CAD3. The purpose of the present study is to assess the Knowledge and Practices of CAD patients regarding management of CAD and to develop an information booklet so as to enable them to cope with the lifestyle modifications. Objectives: Assess the level of Knowledge on Practices regarding Management of Coronary Artery Disease among patients diagnosed and admitted with Coronary Artery Disease. Determine the relationship between Knowledge and Practices regarding Management of Coronary Artery Disease among patients diagnosed and admitted with Coronary Artery Disease. Methods: The descriptive survey approach was used for the present study. The study was conducted in R.L Jalappa Hospital and Research center and R.L.Jalappa Narayana Hrudayalaya Hospital, Tamaka, Kolar in the OPDs and Medical Wards. The formal permission along with patient consent was taken before collecting the data. The study participants were selected by using purposive sampling technique, which fulfilled the inclusion criteria. The data was collected by structured interview schedule by using Structured Knowledge and Knowledge on Practice Questionnaire from 80 CAD patients. Major findings of the study showed that, the overall mean Knowledge score of CAD patients regarding Management of CAD was found to be inadequate (39.60%). the overall mean Knowledge on Practice score of CAD patients regarding Management of CAD was found to be inadequate (37.52%). there was a positive correlation between Knowledge and Knowledge on Practice of CAD patients regarding Management of CAD (r(79) =+ 0.97, t(cal)= 35.69) at 0.05 level and was significant. Conclusion: Health maintenance is the self- responsibility of each individual patient. The study highlights the vital role of nurses in making the CAD patients aware about the prevention and control of the modifiable risk factors of CAD thus reinforcing the statement, “Prevention is better than Cure.”

  175. Dr. Debajyoti Pathak, Dr. Kaushik Roy, Dr. Suniti Kumar Saha, Dr. Partha Ghosh and Dr. Abhishek Nadkarni

    Neurenteric cysts are congenital lesions of the spinal cord which usually communicate to other endodermally derived structures of the body, the embryological theory of which is yet not properly established. They are usually located in the cervico-dorsal region of the spinal cord with an associated vertebral anomaly like spina bifida, butterfly vertebra, lack of segmentation, partial fusion, scoliosis together with the cyst. However, only few cases have been reported in literature where the cysts have not been associated with any vertebral anomalies.

  176. Salma J. Ali, Sang Xi Guang, Li Pengyu , Zhao Xin, Emmanuel H. Suluba, Hussein Haji, Jaffar S. Pandu and Emmerenceana Mahulu

    Background: Despite the diagnostic and therapeutic advancement in medicine, appendicitis remains a clinical emergency and is one of the common causes for acute abdominal pain. Having chronic illness in patients with acute appendicitis may have direct or indirect effect on the outcomes. This is because hypertension and other cardiovascular disease such as CHF have known effects on cardiopulmonary physiology. For that reason we decided to evaluate the surgical outcomes in patients with hypertension in comparison to those without hypertension undergoing appendectomy. Objective: comparison of the outcomes of LA and OA in hypertensive and non-hypertensive patients. Methodology: A hospital-based retrospective study involving adult patients above 18 years who underwent appendectomy 2º appendicitis at Emergency Surgery Department at Qilu Hospital of Shandong University 2014 – 2018. Patient’s data obtained were; age, sex, previous history of abdominal surgery, ASA risk score, pre-operative WBC and neutrophil count, radiological diagnosis, type of appendectomy, intra-operative diagnosis, use of post-operative analgesia, post-operative initiation of oral feeding, LOS, post-operative complication and mortality. Inclusion criteria were adult population above 18 years with a history of peri-umbilical abdominal pain, fever; Pre-operative diagnosis of appendicitis by Ultra-sound or CT scan (inflammatory phlegmon, gangrenous appendicitis, perforated appendicitis and appendiceal abscess) and history of hypertension. Exclusion criteria were patients below 18 years of age, patients who had appendix removed due to other causes and negative appendectomy, appendicitis history for > 7 days, pregnancy of > 3 months, presence of other chronic illness such as DM, IHD and/or CBD. Statistical Package for Social Science (SPSS) version 16 was used to analyse the data. Descriptive data was expressed as mean ±SD. Independent t-test and chi-square test were used to analyse the association of continuous and categorical variables, respectively. Univariate analysis was used to compare the outcomes of LA and OA in hypertensive and non-hypertensive patients. P-value <0.05 was considered statistical significant. Results: The study involved 139 randomly selected patients who underwent appendectomy at Qilu Hospital between 2014 and 2018. The mean age was 42.2±15.657 years with a range of 18-82 years. Majority of the patients 62.6% were between 18-45 years, while only 11.5% aged 65 years and above. 54% were male. 27.3% (n=38) had history of hypertension. 84.2% underwent LA (n=117) whereas, 15.8% underwent OA (n=22). Regarding on the intra-operative diagnosis, 42.4% had acute phlegmon appendicitis (n=59), 15.1% had acute gangrenous appendicitis (n=21), 7.9% had perforated appendicitis (n=11) and 34.5% had appendiceal abscess (n=48). Post-operative complications occurred in 1.4% patients (n=2). One patient had IAA and the other patient had fat liquefaction. Non-hypertensive patients on OA group had the longest duration of operation 117.5±56.679 min. Among hypertensive patients, the duration of operation was longer in LA group 88.92±38.525 min than in OA group 82.08±33.538 min. This was statistically significant with p-value <0.05.The mean duration for analgesia use was 0.48±0.774 days. Hypertensive patients on OA group had longer mean duration of analgesia use 0.75±1.357 days than those who underwent LA 0.5±0.99 days. In non-hypertensive patients, LA group had the shortest duration of analgesia use 0.44±0.618 days than OA group 0.5±0.527 days, with p-value <0.05. Mean LOS was 8.09±4.051 days (4-28) days. Mean LOS was significantly longer in non-hypertensive OA patients 10.4±4.502 days and was found to be shorter in non-hypertensive LA patients 7.26±3.235 days. Among hypertensive patients, the mean LOS was longer in OA group 10.08±4.944 days than in LA group 9.15±5.213 days. P -value < 0.05. Apart from type of appendectomy and hypertensive status, we also found other factors associated with poor surgical outcomes. These include higher ASA risk score (ASA III), higher pre-operative WBC and having gangrenous appendicitis. Conclusion: Despite the fact that pneumo-peritoneum is known to have effects on cardiopulmonary physiology our study showed that LA has protective effect in-terms of post-operative outcomes especially with duration of operation, and LOS in non-hypertensive on OA group whereas, longer duration of analgesia use was seen in hypertensive OA group. This indicates that laparoscopic appendectomy can be safely performed in hypertensive patients as it has better outcomes than OA. A part from hypertension and type of appendectomy we have also seen other factors associated with poor surgical outcomes in appendicitis patients; including higher ASA score, higher WBC and an intra-operative diagnosis of gangrenous appendicitis.

  177. Dr. Gazanfer Ali Shah, Dr. Syed Saima and Dr. Reyaz Ahmad Mir

    Background: The objective of this study was to compare the effectiveness of Periosteal pedicle membrane with DFDBA versus open flap debridement with PRF in Grade II/III furcations defects Methods: The study population included 10 subjects, who visited the out-patient department of periodontics, Govt Dental College and Hospital Srinagar with complaint of bleeding and sensitivity, diagnosed as chronic periodontitis. After conducting routine examinations, Relative attachment and probing depth and Horizontal defect fill was measured were measured. The measurement of Relative attachment was made with ocllusal stent as guiding value. Test side operated (Periosteal pedicle membrane with DFDBA)), on contralateral control side Open flap debridement with PRF was done. Results: Results showed that Patients treated with periosteal pedicle membrane in combination with DFDBA graft in Grade II/ III showed favourable results in test group than control (open flap debridement with PRF) as per Relative attachment level and furctaion defect fill is concerned. Conclusion: within the limitations of this study, it can be concluded that space provision by an alloplastic graft material increases the regenerative potential of periosteal pedicle graft.

  178. Hoon Hur, Duck Taik Shim, Min Seok Cheon, Pyoung Su Kim, Dong Nyeok Hyun and Yu Ri Kim

    Prurigo pigmentosa is a rare cutaneous inflammatory disorder characterized by a sudden onset of pruritic, erythematous papules and plaques that leave a reticulated postinflammatory hyperpig mentation (PIH) when they heal. The PIH due to Prurigo pigmentosa is not successfully treated with antibiotics such as doxycycline and minocycline, and by resolution of ketosis. Generally, treating PIH due to Prurigo pigmentosa with traditional laser therapies including 532nm Nd:YAG laser, 694nm ruby laser and 755nm alexandrite laser can provoke side effects such as purpurae, crusts, PIH, mottled hypopigmentation and scarring. Unfortunately, there is no golden standard for the laser treatment of PIH due to Prurigo pigmentosa yet. Therefore, this study was performed to investigate the efficacy and safety of Dr. Hoon Hur’s Golden Parameter Therapy (GPT) using a high fluence 1064nm Q-switched Nd: YAG laser (QSNL) for treating PIH due to Prurigo pigmentosa. Eleven Korean patients with PIH due to Prurigo pigmentosa were treated with a 1064nm QSNL at a one-week interval for 30 treatment sessions of Dr. Hoon Hur’s GPT. The parameters were a spot size of 7 mm, a fluence of 2.4 J/cm2 and a pulse rate of 10Hz with a slow single pass by a sliding-stacking technique over the PIH due to Prurigo pigmentosa. At the week of the final treatment, all of the 11 patient with PIH due to Prurigo pigmentosa were achieved the complete clearance of pigmented lesions without any side effects such as purpurae, crusts, PIH, mottled hypopigmentation and scarring. There were no recurrences after a follow- up of 6-12 months. We suggest that Dr. Hoon Hur’s GPT using a high fluence 1064nm QSNL is a safe and effective method without side effects and recurrences for treating PIH due to Prurigo pigmentosa.

  179. Tittu Thomas James, Dr. Selva Ganapathy, Dr. Pradnya Dhargave and Jarapla Srinivas Nayak

    Background: Psychogenic gait disorders are a challenge for the medical professionals both in diagnosis and management because the signs and symptoms demonstrated by the patients are medically unexplainable. Objective: The objective of this case report is to introduce the scope of treadmill ambulation as a diagnosis in cases of psychogenic gait disorders. Methods: A patient was referred to physiotherapy OPD for gait training for her bizarre gait pattern. Quantitative and qualitative analysis of gait was done using GaitRite system as well as on treadmill. Results: We observed that when the patient was made to walk on the treadmill which was a novel task for the individual, there was a major change in the quality of gait to a normal alternate leg pattern. Conclusion: Treadmill ambulation for patients with gait deviations, for whom the disorders are medically unexplainable, will help in early diagnosis of psychogenic gait disorders.

  180. Tushar Rothe, Prachur Kumar, Neel Shah, Siddhant Jain, Shubham Dubey, Pooja Patel

    Aim: Evaluation of efficacy of Conventional Erich arch bar Vs Intermaxillary Fixation screws. Material and methods: This study we compared the efficacy of Conventional Erich arch bar and intermaxillary fixation screws with respect to plaque accumulation, time required for procedure, postoperative stability after achieving the intermaxillary fixation, mucosal growth and complications encountered for intermaxillary fixation. The participants were divided into two groups of 10 in each and designated as Group A and Group B. In Group A, Intermaxillary fixation was achieved by the conventional method using Erich arch bar, fastened with 26 gauge stainless steel wires. In Group B, Intermaxillary fixation was achieved by prefabricated intermaxillary fixation screws. Results: In present study total of 20 patients were analysed, The average working time for Group A and Group B were 96 minutes and 16 minutes respectively. Oral hygiene scores through modified Turskey Gilmore plaque index which was taken at immediate post operative, after 15 days, 30 days and 45 days. Maximum hygiene was maintained in intermaxillary fixation screws than conventional arch bar group but maximum stability was seen in the conventional arch bar group. In respect to mucosal coverage, mucosal growth was seen over intermaxillary fixation screws. Conclusion: This study emphasizes, the use of intermaxillary fixation screws is quick method than conventional arch bar. Conventional arch bar was significantly stable when compared with intermaxillary fixation screws therefore the patients who require long-term intermaxillary fixation, conventional arch bars would be a better option but it requires longer duration for the placement and had complications like needle sticks injury.

  181. Krishna Prasad Subedi, Bijaya Chandra Acharya, Chin Bahadur Pun, Pradhananga, K.K., Soma Kanta Baral and Khem Bahadur Karki

    In recent years, due to the application of modern technology for the diagnosis of cancer, numbers of cancer cases are found to be increasing day by day in Nepal. But it is hard to assess the burden of cancer in national context based on available data. The available hospital based information neither shows the magnitude of the problem nor there has been any community-based study in the past. First time in Nepal, population based Cancer registry (PBCR) was started in 15 districts of three ecological regions; Mountain, Hills and plan land, which covered the 25.8% of total population of the nation. This study includes data from fifteen districts of the country located in Terai, Hills and Himalaya. Therefore, upshot of this study can be used to deduce an overall situation of cancer in Nepal. For the process of population based cancer registration, cancer cases were reported from various data source institutions in the year 2015. Among them, the cases were verified by name, age, sex and topography/morphology of diseases. Out of projected areas and multiple entries were excluded from data base and total 2950 cases were analyzed for the purpose. The mean age at diagnosis was found to be 52.8 years. The most frequent form of cancer for both sexes was bronchus & lung (12.9%), followed by cervix uteri (10.9%), and breast (9.1%). Among the female cases, cervix uteri cancer (19.2%) was the most common followed by breast (15.7%) and bronchus & lung cancer (10.9%). Similarly, bronchus & lung cancer (15.6%) was the most common cancer among males, followed by stomach (6.6%) and larynx cancer (4.9%). The most prevalent age group (60-64 years) in male was found to be 12.8%, while in female of same age group was 13.4%.

  182. Dr. Prabhati Gupta, Dr. Suhail Majid Jan and Dr. Roobal Behal

    Background: Dentin hypersensitivity is a common occurrence and is often a chief concern among patients. The aim of this study was to evaluate the dentinal tubule occluding ability of Proargin (arginine bicarbonate) containing desensitizing dentifrices using scanning electron microscope. Methods: Forty-five 1mm thick dentine discs were obtained from orthodontically extracted human premolar teeth. Each disc was then split into two halves. One half was allotted to Group-1 (Control group) and the other half was allotted to Group-2 (Test group). GROUP 1: brushed without dentifrices. GROUP 2: brushed with dentifrices containing Proargin (arginine bicarbonate). After brushing for 2 minutes twice a day, the specimens were stored in artificial saliva. Specimens were analyzed after 7 days under SEM. Results: The proargin containing desensitizing agent significantly resulted in effective dentinal tubule occlusion. 84.36% of the dentinal tubules showed complete dentinal tubule occlusion, 10.24% showed partial occlusion and 5.40% remained unoccluded. Conclusion: The inclusion of proargin into a toothpaste formulation may be an effective approach to treat dentinal hypersensitivity as it showed high percentage of dentinal tubule occlusion.

  183. Ramya, H. and Neeta Pattan

    Coconut flour is a by – product prepared from coconut residue obtained after the extraction of coconut milk. Utilization of food by – products and wastes receive more attention in the food industry. Coconut flour is believed as a "functional food" because it provides many health benefits beyond its nutritional content. Hence a study has been undertaken to develop standardized procedure for the extraction of coconut flour from fresh coconuts and to analyze the nutritional composition of coconut flour. Nutritional composition of standardized coconut flour was determined by conducting proximate chemical analysis using standard methods (IS 7874, IS 1656 and Physio chemical method). The physical characteristics of coconut flour were observed for colour, odour, taste, particle size and high water absorption capacity. The physical characteristics of coconut flour were found as off-white colour, nutty odour, bland taste, fine to medium particle size with high water absorption capacity. Proximate composition of coconut flour revealed that 32.13 per cent of carbohydrates, 3.88 per cent of protein, 25.41 per cent of fibre, 33.56 per cent of fat content and 411.3 kcal content per 100 grams.

  184. Anabtawi, R.N. and Qtait, F.A. and Hammad, B.M.

    Risk factors for infection include improper care for patients, and incorrect practice of infection control strategies, for that there is a need to increase the level of awareness toward infection control strategies, and to improve the practice techniques in using such strategies. In addition there is a great concern in improving the awareness of nursing students as they are trained in hospitals and they are in direct contact with patients. The purpose of this study is to assess the level of knowledge, attitude, and practice of nursing students’ toward using infection control strategies in hospitals. Descriptive design was used to conduct this study, 95 nurses’ students were randomly selected and included from different academic year at AAUP. The results of the study revealed that there were no significance relationship between nursing students knowledge towards infection control strategies used in hospital according to gender, academic year, and wards that have been trained in. Also there were no significance relationship between their awareness and attitude according to gender, educational level, and while in wards being trained in the result showed a significant relationship. In addition to a significance relationship between students awareness and practice according to gender, and there is no significance relationship between awareness and practice according to level of education and wards being trained in. In conclusion there must be more focus on infection control in the university lectures. In addition to initiate workshops to enhance knowledge, attitude and practice towards infection control among nursing students.

  185. Dr. Kuntal Nayak, Dr. Shruti Shah, Dr. Biswaroop Chandra and Dr. Gautam Kumar Kundu

    Acute Early childhood caries is a public health problem which has biological, social, and behavioural determinants. Aim of This study: The aim of this research is to evaluate the different socio-economical determinants of early childhood caries in north Kolkata. Materials and Methods: The questionnaire-based study was conducted on a sample of 902 children between 2 to 5 years age and their respective parents (either mother or father or both), in north Kolkata in a span of 1 and half years. Either of the parent with higher income was considered as the head of the family. The decayed-missing-filled teeth (dmft) indices (dmft, Greubbell,1994) was recorded for each child in the study population and socio-economical status of the children was determined by their parental education, occupation, monthly family income according to modified Kuppuswamy scale (2017). Statistical Analysis: All the data collected were subjected to statistical analysis using ANOVA test, Tukey post hoc analysis and unpaired t test. Result: Caries status or prevalence was inversely proportional with parental education, occupation, monthly family income, socio-economic classes. Conclusion: Oral health assessment and dental health education of children at an early stage helps in improving dental behaviour and attitudes, which is beneficial for life time. This can be achieved by educating the parents and mainly reaching out to that class of society who is deprived of education thereby with lower occupational levels and lower socioeconomic status and educating them about oral health through different oral health education programmes.

  186. Ashish Vora, Ekta Yadav, Himanshu Agrawal, Siddharth Desai and Mayank Mathur

    Infestation of Maggot’s around colostomy is an uncommon finding. Common sites include nose, ear, orbit, tracheostomy wound, face, gums and serous cavities. We report a case of myiasis in post-operative patient of adenocarcinoma ano-rectum with abdomino-perineal resection (APR) and end colostomy.

  187. Dr. Rajiv, B., Jadhav, Dr. Vijay, N., Dr. Mohit Relekar and Dr. Sharik, M.D.

    Background: Hemorrhoid is a common disease treated by various modalities of treatment and sclerotherapy is one of the hemorrhoidal treatment. Here we are presenting our experience of sclerotherapy in hemorrhoids. Aims: To see the effictiveness of sclerotherapy. Material and methods: This prospective study of 50 cases attending surgery opd in department of surgery at Institute of Medical Sciences and Research, Mayani, Satara, Maharashtra, India from Jan 13- Sep 2014. Results: Majority of the patients were male with 56% and most of the patients were in age group between the 31 to 40 years i.e. 32%. The most of the patients were garde 1 hemorrhoids i.e. 68% followed by grade 2 i.e. 32%. 72% of the patients were discharged on the day of procedure only. 43% of the patients return to the normal activity with in a week after procedure. Most of the patients has first normal bowel movement i.e. 88%. Following the procedure 82% of the patients had experienced mild pain. Conclusion: It is a safe procedure and more effective with less pain and least complications.

  188. Dr. Rashidat ul khairat MDS., Dr. Beanish Bashir, MDS, Dr. Suhail Majid Jan, MDS and Dr. Roobal Behal, MDS

    Background: Gingival recession in maxillary molars can be treated by buccal pad of fat due to its easy assessibility, less donor site mobidity, excellent blood supply, minimal patient discomfort and better clinical outcome. Thus in this study we tried to treat miller class II and classIII gingival recession in maxillary 1st and 2nd molars using buccal pad of fat. Materials and Methods: 10 systemically healthy patients with age ranging from 34 to 55 years with Class II and Class III gingival recession in the maxillary molars were selected. Before the surgical phase, all the patients received oral hygiene instructions and scaling and root planning. A horizontal incision of 1–1.5 cm was made in the buccal sulcus of the maxillary molar region; buccinator muscle was separated bluntly to expose the BFP. The fat was then teased out from its bed and spread to cover defects adequately. It was then secured and sutured without tension. Clinical parameters such as probing depth, recession length (RL), and width of keratinized gingiva were recorded at baseline and at 6 months postoperatively, and weekly assessment for postoperative healing was done at 1 week, 2 weeks, 3 weeks, and 4 weeks Results: Treated recession defects healed successfully without any significant postoperative complications. RL from 5.6±1.26 to 1.5±1.702 were observed postoperatively (P < 0.05). Percentage of root coverage average was 80.8%. Conclusion: Pedicled buccal fat showed promising results as the treatment modality in the management of Class II and Class III gingival recession of maxillary posterior teeth.

  189. Ufaque Muzaffar and Farhat Jabeen

    Objective: To study the levels of lipid profile during second and third trimester pregnancy. Introduction: Currently, maternal prepregnancy body mass index (BMI) has increased and reflecting the overall increase in the prevalence of obesity (1). Higher BMI during pregnancy have negative implications on pregnancy outcomes, results affect the burden on health of both mother and the infant at risk. Material and methods: This case control study was conducted at the department of gynecology & obstetrics, Lalla Ded Hospital a tertiary care hospital, by enrolling antenatal cases for the the study. The study was conducted on 25 obese women (BMI>30Kg/ m2). Results: In obese second and third trimester, the mean cholesterol levels were 215.35±15.8 229.82±16.2 mg/dl respectively. The mean HDL levels were 43.5±5.8 and 40.6±5.2 mg/dl. The mean TGL levels were 179.23±36.5 and 190.58±39.4 mg/dl. Whereas, non-obese second and third trimester had decreased total cholesterol levels. Conclusion: Overweight/obese women have more atherogenic lipid profile than normal weight women during second and third trimester pregnancy, which may help to predict the pregnancy outcomes.

  190. Peer review process

    All papers received will be submitted to a peer review process. The Editors may discard some manuscripts from the outright due to notorious low quality or disadjustment with the journal’s scope.

    Taking in consideration its subjects, the papers passing this preliminary screening will be remitted to a panel of referees involved in those research areas. They can be either external or members of the Advisory Board, though always chosen by their recognized expertise. Each paper will be reviewed by two referees.

    After evaluation, the referees will produce reports about the works reviewed, by which the papers can be a) accepted with modifications or corrections; b) approved as they are or c) rejected from the start. In case that the papers proposed are accepted but in need of modifications or corrections, the Editors will return the manuscripts to the authors, together with the referee’s reports and all the suggestions, recommendations and comments therein.

    To secure impartiality during the review process, all papers, as remitted to the referees, will be anonymous. Moreover, the referees’ identities will not be known, neither by the rest of the evaluation panel, nor by the authors.

    The final decision concerning the publication of papers belongs to the Editorial Board, having the referees a consultative role.

  191. Final Proof Corrections and Submission

    The next step in the publication process involves reviewing the galley proofs for your article. Please return the checked galley proofs via e-mail journalcra@gmail.com or via online submission system within 72 hours of receipt. Late return of galley proofs may mean postponement to a later issue. Please make a copy of the corrected proofs before returning them; keep the copy for your records.

    This step is entirely the responsibility of the corresponding author. The galley proofs will not be read by editorial staff. Errors that you fail to mark will be published.

    The corresponding author of an accepted manuscript will receive e-mail notification and complete instructions when page proofs are available for review via a secure Web site. Final proof will be provided in Portable document format (PDF) files of the typeset pages. The attention of the authors is directed to the instructions which accompany the proof, especially the requirement that all corrections, revisions, and additions be entered on the proof and not on the manuscript.

    Note that you are being asked to correct errors, not to revise the paper. You will not be charged for our editing mistakes or typographical errors, but you will be charged for any alterations from the original text that you make on the galley proofs. Extensive alteration may require Editorial Board approval, possibly delaying publication.

    Please follow these guidelines when reviewing the galley proofs:

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    Note: If you are completely SATISFIEID from the final proof, just inform to the Editorial Office about your satisfaction via e-mail or via online submission system. Only on the receipt of your final satisfaction opinion, Editorial Office will send your article for final publication.

  192. Aina Matthew Adebayo

    The study investigated educational resources and students’ acquisition of vocational skills in business studies among Junior Secondary Schools (JSS) students in Ekiti State. Descriptive survey design was adopted. The population comprised all the 477 business studies teachers in the 187 JSS during the 2017/2018. academic session. The sample comprised of 179 business studies’ teachers. The study employed a stratified random sampling technique. Instruments used for data collection was self-developed questionears. Data collected were analyzed, the results revealed that business studies teachers are not evenly spread, most of the infrastructural and instructional facilities are not adequately provided also, not all the five components of business studies are effectively taught in most of these schools. Based on the findings it is concluded that most of the JSS leavers in public schools do not possess employable vocational skills in business studies. It is therefore recommended that the state government should recognize business studies as a subject that requires instructional facilities/equipment and be proactive in funding it.

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