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June 2019

  1. Esha Kedia, Jyoti Mandlik, Anupam Sharma, Shivani Bhatia, Anirudha Sharma, Sonali Bansod and Vasudha Sharma

    Over the past few years, immense importance has been given to free radicals and anti-oxidants in the field of dentistry. Depending on the balance between their destruction and formation, free radicals can either be beneficial or deleterious to health. Stabilization of free radicals is done by anti-oxidants, thus preserving the cells from destruction. Hence, antioxidants that are prolific in our diet holds the interest of today’s dental community as an armoury to positively impact oral environment. One such anti-oxidant is lycopene. Lycopene, the red pigment of ripe tomatoes, watermelons, red chillies and guavas, is a tetraterpene with eight isoprene units composed entirely of carbon and hydrogen. This highly unsaturated hydrocarbon contains 11 conjugated and two nonconjugated carbon–carbon double bonds. It is a strong antioxidant and free radical-scavenger because it possesses the property of quenching singlet oxygen. This review article is an overview of various anti-oxidants in general and lycopene in particular.

  2. Randhir Yadav and Dr. Rai, J.

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

  3. Rosmala Nur, Nikmah Utami Dewi, Rosita and Nurul Fitriah Aras

    A simple, sensitive, linear, precise and accurate RP-HPLC method for simultaneous estimation of Zaltoprofen and Paracetamol in bulk and tablet formulation as developed and validated. Chromatographic conditions used are stationary phase Grace C18 column (250mm × 4.6mm, 5µ particle size. The mobile phase Methanol: Phosphate buffer (PH 3.0) in the ratio 75:25 v/v and flow rate was maintained 0.8ml/min, detection wavelength was 241nm. The retention times were 3.101min and 5.838min for Zaltoprofen and Paracetamol respectively. Calibration plot were linear R2 =0.9994 over the concentration range 10-18µg/ml for Zaltoprofen, R2 = 0.9994 for the Paracetamol 40-72µg/ml. No interference from any component of pharmaceutical dosage form was observed. The proposed method has been validated as per ICH guidelines, validation studies revealed that method id specific, rapid, reliable and reproducible. The developed method successfully employed for routine quality control analysis in the combined pharmaceutical dosage form.

  4. Rosmala Nur, Nikmah Utami Dewi, Fadlun, Diah Ayu Hartini and Vidyanto

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

  5. Suresh Chander, V.C. and Kavin Kumar, A.

    Introduction: The CA MRSA gained much attention during mid 1990, after death of four children in Minnesota and North Dakota. The first reports in India on CA MRSA were reported during mid-2000s, whereas the present study reports MRSA among Community acquired pyoderma cases during mid-1990s. Methods: A total of 100 coagulase positive Staphylococcus aureus isolates, obtained from 185 pyoderma cases. Retrospectively, it is understood that the studied cases fulfilled the criteria for community acquired MRSA including no history of hospitalization, contact with hospitalized patients and previous antibiotic treatment. Results: Of 100 S. aureus isolates tested for methicillin resistance, 42% were found to be MRSA and 58% were MSSA. MRSA skin infections (89%) were found predominantly among children and young youths. The demographic details of the pyoderma cases show that, 67% of cases had contact with the crowded community setups (school going children). Impetigo (46%), folliculitis (32%) and furunculosis (20%) were found to be the commonest infections in this study. Phage typing of S. aureus showed all four phage groups and mixed groups. Conclusion: Retrospectively, it is evident from the existing demographic data and scientific data of the study, that in India the MRSA were circulating in community settings during 1990s, its first reports in USA.

  6. Dr. Jyoti Shinde and Dr. Subhash Raut

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

  7. Jefirstson Richset Riwukore and Fellyanus Habaora

    Research on the productivity display of the Konetuef pasture of Timor Tengah Utara Regency, East Nusa Tenggara Province, Indonesia was carried out using a qualitative descriptive method with primary and secondary data. The results of the study explain that Konetuef pasture is a beef cattle breeding area with a grassland base belonging to Timor Tengah Utara Regency Government, East Nusa Tenggara Province Indonesia with limited quantity feed and poor maintenance management. To increase the universal base of livestock productivity, it is necessary to integrate mixed farming. The limiting factors at this ranch are climate, land, plants, livestock production and reproduction, livestock marketing, including ecology and policy.

  8. Okechukwu, E. C., Amuta, E. U., Gberikon, G. M., Ikpa, F.T. and Njoku, M.

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

  9. Syndoux Dembélé, Koffi N’dri Emmanuel, Goze Nomane Bernard and Anin Atchibri Anin Louise

    Objective: The aim of this study was to quantify some compounds of the aqueous extracts of two tomato varieties grown in Cote d'Ivoire and assess their anti-hypertensive activity on arterial blood pressure in rabbit. Material: Two ripe tomato varieties were collected from different tomato fields in Yamoussoukro district (Cote d'Ivoire) during season of June to July 2018. These samples were dried and crushed. The powder obtained was used for different extract preparations. Duration : This study was carried out from june 2018 to february 2019. The determination of polyphénol and lycopene contents was carried out at the National Laboratory of Public Health. Then, antihypertensive activity was evaluated at Animal Physiology Laboratory of Felix Houphouët Boigny University. Methodology: Lycopene and polyphenol contents were determined by high performance liquid chromatography (HPLC) method. The antihypertensive activity was performed on rabbits by manometric method using Ludwig's manometer. Results : Lycopene content of tomato aqueous extracts was ranging from 0.01 to 89.9 mg/100g of extract. The most abundants polyphenolic compounds identified were caffeic acid (1.37 to 2.14 mg/100 g) and quercetin (1.10 to 2.19 mg/100 g) of extract. Other phenolic compounds like, catechin, flavanone, cinnamate, coumarine and tanninol were identified. Efficacy dose (ED50) of aqueous extracts varies between 26.25 mg/kg bw for the macerated of Local cotelette variety and 31.62 mg/kg bw for the macerated of Cobra F1 variety. Conclusion : Tomato aqueous extracts reduced rabbit arterial blood pressure. This decrease will be due to compounds with antihypertensive activity contain in extracts such as lycopene and quercetin. As a result, tomato in take would be beneficial for hypertensives.

  10. Hiralal Jana and Debabrata Basu

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

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

    The present study was undertaken with the objectives to study the effect of sprouting whole seed flour on rheological properties. For this study the Roselle seed were procured from the local market and then soaking and germination treatments were given to the seeds. All experiments were laid in completely randomized design with suitable replications for statistical analysis. The pre-treatments soaking and sprouting of whole seed were adopted in this investigation to ascertain the best treatment for onward inclusion in bakery products. Amylograph, farinograph and extensograph properties of the pre-treatments were studied. The preliminary investigations adjudged sprouted whole Roselle seed flour (SWRSF) have superior nutritional and functional qualities. The sprouted 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.

  12. Shadreck Katuruza, Nyembezi Mgocheki and Wisdom Kurangwa

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

  13. Zaheer Yousaf

    The present study of confined to the taxonomic revision of family salicaceae of Pakistan. In this family considerable hybridization between different taxa is involved and there is considerable morphological variation within each species. The extensive availability of frequently misidentified plant specimens. In different herbaria of Pakistan suggest that it is taxonomically a difficult family. Some species of the genus Salix Linn show nomenclatural problems. The present study was therefore under taken to clear up the taxonomic position of a number of taxa. Minute character have been considered for the delimitation of various taxa, e.g. pubescence, the length and position of the pedicle and peduncles, the length of catkin, the size and shape of leaves, the size and shape of capsule, etc.. Numerical analysis was carried out using following computer packages: SPSS &statistical cluster analysis was used and delineate and defined taxa. Result are presented in the form of keys and dendrogram

  14. Tanima Kundu

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

  15. Dubey, R. S. and Yaman Shandilya

    Corrosion is one of the major issues these days in various sectors of the industries related to construction, sewage disposal, food and manufacturing. Microbiologically induced corrosion (MIC) is a key factor for infrastructure degradation worldwide, which is actually a result of wastewater collection. It is the most common form of corrosion, which is aided by the presence, and activity of microorganisms on the surface of the materials. MIC has hiked demands for sustainable and cost effective construction material on a global level. This review focuses on the reasons and effects of MIC in the environment specifically highlighting the adversity of MIC on cement based structures. Various research works have been discussed for reducing the effect of MIC and thereby increasing the durability of structures.

  16. Karinne Silva Meira, Beatriz Rocha Sousa, Larissa Alves Guimarães, Ramon Alves Pires, Vinícius Narciso Santos, Ísis Silveira Dias, Felipe Oliveira Bittencourt, Iaggo Raphael David and Stenio Fernando Pimentel Duarte

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

  17. Andrew Koch and Dr. Daniel Flippo

    Planetary gear systems are a useful and ubiquitous means for power transfer. Ap- plications range from agricultural equipment drive lines to wind power generator gear- trains. In many applications torque spikes or reversals are an issue that shorten bearing and component life. In many applications a clutch design is used to soak up torque spikes (Hogan, 1996) or de coupling the drive during the event (Packer, 2015). This work documents and tests a design that potentially reduces torque spikes that may occur during drive line operation. It was discovered that the springs reduce both the torque spikes and the vibration amplitudes. This reduction of amplitudes in torque reversals will increase the life of the mechanical drive train.

  18. Thalles Argôlo Correira, Larissa Alves Guimarães, Beatriz Rocha Sousa, Danielle Soares Silva, Ísis Silveira Dias, Iaggo Raphael David and Stenio Fernando Pimentel Duarte and Tayanne Andrade dos Santos

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

  19. Fernanda Teresa Moro and Débora Valim Sinay Neves

    This work is result of a final work proposal of the discipline Strategies of Teaching I, in PhD in Teaching at University of Vale do Taquari - Univates. The strategies discussed here are Conceptual Maps and Problem Based Learning (PBL), which will be described throughout the paper. The Conceptual Maps strategy has been developed with a second-year high school class from a private school in the municipality of Erechim, Rio Grande do Sul. On the other hand, the proposal named Problem Based Learning was developed with students of Chemical Engineering, 3rd semester, of a private university, also in the municipality of Erechim. Those two proposals contemplate contents studied by those students in disciplines of Physics and General Physics C, respectively.

  20. Iman Salah- El-Din Hamza and Amr El-Gohary

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

  21. Sakthivadivel Rajendran, Xavier Arulantham, Pandi Pitchai and Siva Sundarajan

    Visible light active TiO2 nanoparticles modified with Chloro flavonol base - copper complex (Cu-CLF-TiO2) has been prepared by chemical impregnation route. The optical properties, phase structures and morphologies of the as-prepared nanoparticles were characterized using Fourier transform infrared spectroscopy (FT-IR), X-ray diffraction(XRD). Compared to bare TiO2, surface modified photocatalysts (Cu-CLF-TiO2) showed are shifted in the visible region. The photocatalytic activity was monitored in the degradation of Methylene Blue (MB) dye and the results revealed that Cu-CLF-TiO2 showed best photocatalytic activity than TiO2. The superior photocatalytic activity of Cu-CLF-TiO2 could be attributed to the effective electron-hole separation by the surface modifiers. The effect of photocatalyst amount, initial dye concentration and Kinetic studies on the photocatalytic activity was explained in detail. Furthermore, the antifungal activity and their usability of Cu-CLF-TiO2 were tested.

  22. Dr. Anupam Saxena and Shalini Pandey

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

  23. Dr. Kyaw Zan Aung and Dr. Mi Mi Yee

    In the present investigation the antimicrobial activities of some traditional medicinal plants which were selected based on medicinal reports practiced by native people of Myeik Township, Tanintharyi region in Myanmar. Antimicrobial activities of aqueous extract of Lawsonia inermis L.(Henna), Oroxylum indium (L.)Vent (midnight horror) and Melastoma melabathricum L.(Malabar ) tested against the following microorganism like Staphylococcus aureus, Bacillus pumilus ,Bacillus subtilis , Pseudomonas aeruginosa ,Escherichia coli and Candida albicans by Agar-well diffusion method. The Lawsonia inermis L. showed maximum zone of inhibition against Staphylococcus aureus, (15 mm) and minimum (13 mm) of Candida albicans. The Oroxylum indium (L.)Vent showed maximum zone of inhibition against Staphylococcus aureus, (13 mm) and minimum (11 mm )of Pseudomonas aeruginosa. Melastoma melabathricum L. showed maximum zone of inhibition against Bacillus subtilis (13 mm) and the minimum (12 mm) of Candida albicans. The results revealed the presence of important medicinal phytochemicals constituents, such as alkaloids, flavonoids, phenols, saponins, α-amino acids, reducing sugar, phlobatannins and tannins. were present in the Lawsonia inermis L. and Melastoma melabathricum L.For Oroxylum indium (L.)Vent, presence of alkaloids, glycosides, phlobatannins, phenolic compounds, α-amino acids, saponins and tannins which interpret its medicinal values. Among the three samples, coumarins was found to be presence in Lawsonia inermis L.

  24. Dadarao Dhone

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

  25. Dr. Reyaz Ahmed Tasleem, Dr. Manzoor Ahmed Sofi, Dr. Farhat ABA's and Dr. Summiya Farooq

    Background: A appendix removed for acute appendicitis has been sent for histopathological examination, but this practice has been the subject of controversy. This study was conducted to assess the feasibility or otherwise of performing histopathological examination in every specimen of appendix. Methods: we analyzed, retrospectivelyhisto pathological reports of all appendix specimens after appendectomy in last one year. Results: - A total of 952 appendix specimens were sent for HPE, out of which347(36.5%) showed evidence of acute suppurative appendicitis, 219(23%) showed evidence of acute appendicitis,,174(18%) showed evidence of acute transmural appendicitis,168(17.6%) showed evidence of lymphoid follicular hyperplasia,3(0.3%) showed evidence of chronic appendicitis,4(0.4%) showed evidence of benign mucinous cyst adenoma,3(0.3%) showed evidence of carcinoid tumour,32(3.3%) were unremarkable,1(0.1%) case of xanthogranolomatous appendicitis and one poorly preserved specimen. Conclusion: Incidental diagnosis of carcinoma appendix is not rare,if the protocol of routine histopathology of appendix specimen is not followed, subclinical malignancies would fail to be identified with disastrous results. we strongly recommend routine histopathology of all appendix specimens.

  26. Jahangirbasha, D., Shivaprakash, B.V., Dilipkumar, D., Patil, N. A., Tikare, V.P. and Usturge, S. M.

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

  27. Dr. Kishore Kumar Aindala and Dr. Indranil Das

    The B-adrenergic receptor antagonists, or B-blockers, are common medications used in the treatment of various cardiovascular, neurologic, endocrine, ophthalmologic, and psychiatric disorders. Because of their widespread availability, accidental and intentional toxicity is common. Also SSRI are present in the prescriptions of Neurologists and psychiatrists. The Emergency physicians also encounter many of the overdose of these drugs in patients who are on poly-pharmacy along with accidental and intentional ingestion. In our present case we will be describing a case of this mixed toxicity/overdose in a 30year old male patient who presented to the Emergency.

  28. Dr. Bhavesh B. Airao, Dr. Vimal Vasava and Dr Dipal Patel

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

  29. Savitha, A.

    There are more than 100 different types of arthritis. It is common chronic, progressive musculoskeletal disorder characterized by gradual loss of articular cartilage. The disease most commonly affects the middle-aged and elderly, although it may begin earlier as a result of injury or overuse. It is often more painful in weight bearing joints such as the knee, hip, and spine than in the wrist, elbow, and shoulder joints. All joints may be affected if they are used extensively in work or sports, or if they have been damaged from fractures or other injuries. Methodology: A pre experimental research design was adopted for this study.. The main study was conducted in selected rural areas of Puducherry like Kalitheerthalkuppam and Thirubuvanai. The period of data collection was six weeks. Totally 88 arthritis adult were selected by using the Systematic random technique and it was divided into two groups,44 in experimental group and 44 in control group. The pre-test was done among 88 adult by using Pain scale (Modified western ontrio and master universities osteoarthritis index) intervention was given to experimental group and routine measures was given for control group. And on sixth the post-level of pain was assessed for both groups. Results: The result of the study in experimental group mean effectiveness is 24.11. when compared with control group mean difference is 4.29. Concluded that rendering apitherapy to arthritis adult was more effective one in reduction of pain. Therefore the investigator suggests to use apitherapy for pain reduction and there is no side effects and resulting with good prognosis. Conclusion: The result of the study concluded that rendering apitherapy to arthritis adult was more effective one in reduction of pain. Therefore the investigator suggests to use apitherapy for pain reduction and there is no side effects and resulting with good prognosis.

  30. Naga Malli Ravupalli, Dr. Indirani Dasarathan, Dr. Ramesh Shanmugam and Dr. Ramarao, P.S.V.

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

  31. Dr. P. Genesta Mary Gysel, Uma, R. and Santhi, R.

    The main aim of the present study was to assess the effectiveness of amla on increasing the hemoglobin level among anaemic adolescent gilrs in selected college, at Kirumambakkam, Puducherry. The study samples were 50 anaemic adolescent girls selected from Sabari College of Nursing, Kirumambakkam by using convenient sampling technique non randomnly. The knowledge level was assessed regarding anaemia to anaemic adolescent girls. In pre-test, blood samples were taken and the adolescent girls were classified based on the hemoglobin level.100gm of amla was provided by the investigator for one month after breakfast and lunch. In post-test, blood samples were taken. Comparing the pre-test and post-test values of hemoglobin, the pre test mean value of hemoglobin is 9.97 and the post test mean value of hemoglobin is 10.71and the difference is 0.74 and the p value is < 0.001 and so it is highly significant. By providing amla the investigator proved the study is highly effective in the improvement of hemoglobin level among anaemic adolescent girls. Since the amla was effective in improving hemoglobin, it was also suggested to be continued in order to uplift the overall health of adolescent girls. Hence, it will help to reduce the incidence of anaemia and enhance the quality of life in future.

  32. Dr. Muhammad Ali, T., Dr. Naveen Nandagopal and Dr. Sobitha, G.

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

  33. Dr. Munish Chopra, Dr. Sudhir Munjal, Dr. Satnam Singh, Dr. Amanpreet S. Natt, Dr. Harmeet Singh, Dr. Akshita Mahajan, Dr. Shivangi Duggal and Dr. Chandni

    Elastics in orthodontics have been used effectively both intra-orally and extra-orally. Their use combined with good patient co-operation provides the clinician with the ability to correct both anteroposterior and vertical discrepancies. It’s the intent of the clinician to maintain optimal force values over desired period of time. Force degradation over a period of time is a major problem in the clinical usage of these elastics. Loss of force makes it difficult for the clinician to determine the actual force transmitted to the dentition. Comparative knowledge of this parameter in various latex & non latex elastics could help the clinician in proper selection of elastic for an efficient treatment of the orthodontic discrepancy. This study will be an attempt to compare in vitro performance of the various latex and non-latex elastics by measuring force degradation for the different types of elastics in varying pH.

  34. Illé S,, Djafarou Abarchi, B., Inoussa Daouada B and Timi N.

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

  35. Dr. Naveed Anjum Qureshi and2Dr. Viney Sambyal

    Background: Fistula-in-ano is an abnormal communication between the anal canal or rectum and the perianal skin. Most commonly caused by an anorectal abscess resulting from cryptoglandular infection. Patient usually presents with intermittent or constant purulent perianal discharge. There is usually a history of anorectal abscess that ruptured spontaneously or was surgically drained. Digital rectal examination remains the main stay of diagnosis in anorectal fistula cases. Methods: Data of 69 patients who were admitted at SMVD Superspeciality Hospital Katra from 1st May 2016 to 30th April 2018 was analyzed retrospectively. In addition to clinical examination, routine investigations and Digital Rectal Examination, MRI fistulography was done in all cases and appropriate surgical management was done. Data was analyzed retrospectively for intraoperative findings, nature of surgery, intra and postoperative complications and recurrence. Results: Most common mode of presentation in our study was perianal discharge and discomfort (98%). 66 (95.6%) patients were males with a male to female ratio of 13.2:1. Young adults (40-50 years) were most commonly involved comprising 28 patients (40.5%). 55 Patients (79.7%) had single opening. 27 patients (40%) had previous history of surgical drainage of perianal abscess. 55 Patients (80%) had posterior opening while 14 patients (20%) had anterior opening. Fistulectomy and fistulotomy were performed in 55 patients (80%) and 4 patients (20 %) respectively. Conclusion: Anal fistula is a common disease which results from cryptoglandular infection. The complexity of the disease poses challenges to the surgeon. Early diagnosis and appropriate management are the key to success.

  36. Amare Teshome Derso

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

  37. Dr. Rohan Gupta, Dr. Shobhana Nayak Rao and Dr. Pradeep Shenoy, M.

    Paraquat(1, 1’-dimethyl-4,4’-bipyridium dichloride)is a commonly used contact herbicide in India. Chronic toxicities are not known since it inactivates on coming in contact with soil. The notoriety associated with paraquat is because it came to be used as a commonly used and cheap modality for intentional suicidal use. When ingested, paraquat is quickly but incompletely absorbed and the rest is largely excreted by the kidneys, unchanged, in about 12-24 hours from ingestion. But within the first few hours of ingestion paraquat is actively taken up against a marked concentration gradient into the type II pneumocyte from where the elimination is much slower. Due to its pharmacokinetics, the first two target organs are lungs and kidneys. Suicidal poisoning with paraquat has a very high fatality since there is no known antidote. We present a young lady who presented with a delayed presentation of intentional paraquat poisoning with good renal recovery. The patient however succumbed due to respiratory failure.

  38. Dr. Thamizhp Pozhil Guna and Dr. Sathyanarayanan, R.

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

  39. Dr. Varsha Kolhe, Dr. Jyoti Tembhurne, Dr. Devesh Tiwari and Dr. Akul Agarwal

    Eyes are important part of the facial expression to be noticed. Loss or absence of a part of the eye can cause severe psychological and emotional problems to the patient. To prevent this, prosthetic rehabilitation should be done as soon as possible. Ready-made (stock) or custom made ocular prosthesis can be given to the patient. When time limitation exists, a stock ocular prosthesis can be given. Custom made ocular prosthesis is preferred over stock ocular prosthesis as it helps to improve aesthetics and gives comfort to the patient. So a less complex technique for the fabrication of custom-made ocular prosthesis is described in this case series.

  40. Dan Călugăru and Mihai Călugăru

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

  41. Bayan Hashim Al Sharif, Iman Mohmad Wahby Salem and Sulafa Tarek Alqutub

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

  42. Bayan Hashim Al Sharif, Iman Mohmad Wahby Salem and Sulafa Tarek Alqutub

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

  43. Balasubramanian Samivel, Lakshmi Narasimhan Ranganathan, Kaushik Mani Gowthaman and Guhan Ramamurthy

    Background: Malignant Middle cerebral artery territory (MCA) infarction constitutes about 10% of ischemic strokes. Though Decompressive Hemicraniectomy (DHC) has shown decreased mortality, the functional outcome and prognostic markers are still inconclusive. Objective: To determine the prognostic markers and functional outcome of Decompressive Hemicraniectomy in a series of patients with Malignant MCA Infarction. Methods: This was a prospective study from November 2015 to December 2017 at tertiary care hospital. Totally, 52 patients with massive MCA infarct were included in this study. All the patients were analysed elaborately both in pre-operative and post-operative period. The functional outcome was assessed with Barthel index (BI) during the follow up period of 6 months. Results: Out of 52 patients, 23 patients (44.2%) had favourable outcome (BI > 60). The good prognostic factors noted were age less than 45 years (60.9%), surgery done within 24 hours (73.3%), right sided infarction (60.9%). Early return of consciousness within 5 days in post-operative period and absence of clinical signs of herniation pre-operatively had statistically significant functional outcome based on BI>60 over 6 months follow up. Mortality was noted in 23.1% of patients. Conclusion: Decompressive hemicraniectomy is a favourable surgical treatment in patients with massive middle cerebral artery infarction. Age less than 45 years, right sided infarction, surgery done within 24 hours from ictus especially before clinical signs of herniation and postoperative regaining of consciousness within 5 days after surgery are good prognostic markers.

  44. Shanmugapriya Kannan, Batti Vijaya Kumar, E., Dhivya, S. Saisruthi, Sharmila, P. and Dr. Sreelekha, B.

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

  45. Dr. Cherian Mathew, Dr. Sooraj K, Dr. Binoj Kumar, Dr. Sai Kiran Reddy, Dr. Manohar Babu, Dr. Mary Treasa Pouline and Dr. Sahira

    Adoloscent t and adult intussusception (AI) is a rare cause of bowel obstruction and is often associated with a pathologic lead point located in a single region of bowel. The mechanism of intussusception is not fully understood, but it is believed to result from a lesion in the bowel wall that alters the peristaltic pattern of the bowel causing invagination. In cases where no lead point is identified, intussusception may be due to submucosal bowel edema, fibrous adhesions or dysrhythmic contractions. We report a case of multiple simultaneous jejuno-jejunal intussusceptions in a 16 year-old boy who presented with a 1 month history of intermittent, crampy epigastric abdominal pain and nausea. All investigations were normal and Computed tomography imaging was inconclusive. The patient underwent Diagnostic laparoscopy, and five separate regions of intussusception were discovered in the jejunum, which was resected through a mini-laparotomy.

  46. Illé, S., Djafarou Abarchi, B., Timi, N., Ganda Aissa, M. and Dan Sono, A.

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

  47. Prof. Mayur Phatak, Nanu Suyal, Shruti Tiwari, Shubham Shende, Shumham Khattar, Sanchit Soni, Aditi Tandon, Ankush Goyal, Bhavya Agnihotri, Sarvesh Shrivastava, Zia Shaikh, Rashmi Keshari, Kashish Anand, Ashnav. Alexander, Menka Rana and Meenal Asnani

    There is a growing movement towards creating the desire for zero waste societies. This movement aims at reducing the amount of vegetable wastage. This will not only reduce environmental impacts, but also build upon a more sustainable future. Composting is one strategy to achieve these goals. The purpose of this report is to outline the findings of a composting pilot project at Universal Business School (India-Karjat, Dist-Maharashtra). This project was implemented to quantify the amount of organic waste produced in UBS canteen and assess the impact of separating and treating this waste. The project also incorporated investigation of behavioural barriers to implementing organic waste recycling, analysis of the impact of treating commercial and college waste streams and comparison of treatment technologies. The study was conducted in 1 phases: to study the leachate characteristics of vegetable waste. The results showed that around 55-58% of volatile solids reductions was possible within four months of composting of vegetable waste. Odor is the one of the major problems during the initial stage of composting of vegetable waste.

  48. Karolina Melo and Alexandra Crispim Boing

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

  49. Marinho Soares Guterres Lay and Jose Cornelio Guterres

    The Democratic Republic of Timor-Leste will establish bonds of friendship and cooperation especially with neighboring countries in their respective regions” and viewed from history and geographically. Lack of support of the government to improve agricultural productivity and industries and human resources a capacity to compete in any market employment and business activity in the region. These indicator became the opposite idea for Timor-Leste to join as an ASEAN member, in terms of economic aspects, especially agriculture and industry. This research aimed to analyze and find out the opportunity and challenges in preparing Timor-Leste to join ASEAN in agriculture and industry sector. The method in this study is a qualitative method with a descriptive approach, the type data and data collection techniques namely observation, interviews and documentation, and data analysis techniques using the model Milles and Humberman. Base on the statistical analysis shows the gross domestic product (GDP) of the ASEAN countries from 2008 to 2016, with projections up until 2018. The estimated GDP of all ASEAN states amounted to approximately 2.57 Trillion American Dollars and it can be argued that Timor-Leste economic contribution has declined compared to ASEAN member countries.

  50. Susan Wambui Nyamu, Dr. Wilson Kiptala and Dr. Francisca Mbutitia

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

  51. Dr. Munaif, V., Dr. Jyothikiran H., Dr. Raghunath N. and Dr. Sanjeed Kabeer

    Anchorage in orthodontics has been defined as the nature and degree of resistance to displacement offered by an anatomic unit when used for the purpose of performing tooth movement. A temporary anchorage device (TAD) is a device that is temporarily fixed to bone for the purpose of enhancing orthodontic anchorage either by supporting the teeth of the reactive unit or by obviating the need for the reactive unit altogether, and which is subsequently removed after use. They can be located transosteally, subperiosteally, or endosteally; and they can be fixed to bone either mechanically (cortically stabilized) or biochemically (osseointegrated). It should also be pointed out that dental implants placed for the ultimate purpose of supporting prosthesis, regardless of the fact that they may be used for orthodontic anchorage, are not considered temporary anchorage devices since they are not removed and discarded after orthodontic treatment. Importantly, the incorporation of dental implants and TADs into orthodontic treatment made possible infinite anchorage or absolute anchorage

  52. Josephine Thua – Oredi and Dr. Samuel K. Mutukaa

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

  53. Dr. Anupam Deka and Dr. Swarga Jyoti Das

    Background: Inadequate zone of attached gingiva is not sufficient to protect the periodontium from injury occurring due to frictional forces encountered during mastication and dissipate the pull on the gingival margin created by the muscles of the adjacent alveolar mucosa. It also facilitates subgingival plaque formation and results in loss of attachment and soft tissue recession and a shallow vestibular fornix that in turn favours food accumulation. Thus, an adequate zone of attached gingiva is essential for maintenance of periodontal health. The Apically Repositioned Flap is a predictable method of increasing the zone of attached gingiva. This Conventional Apically Repositioned Flap method has been modified by Carnio in 1996, where the existing keratinized tissue is retained as a marginal collar, referred to as Modified Apically Repositioned Flap. Objective: The present study was conducted to compare the results of Conventional Apically Repositioned Flap and Modified Apically Repositioned Flap in terms of changes in width of attached gingiva, apparent gingival recession, sulcus depth and clinical attachment level. Methods: The study comprised of 28 sites in 14 subjects, in a split mouth design. The sites were referred to as Experimental Site ‘A’ and ‘B’, referring to as the Conventional Apically Repositioned Flap and Modified Apically Repositioned Flap, respectively. The clinical parameters were recorded preoperatively on day 0 and again postoperatively on day 90 and 150.The data obtained was analyzed statistically. Results: The results showed that both Conventional and Modified Apically Repositioned Flapsare equally effective and efficient methods for widening the attached gingiva. Conclusion: Both the procedures are equally effective in increasing the zone of attached gingiva, though Modified Apically Repositioned Flaps may be preferred due to its advantages.

  54. Roberto Suson, Regina Galigao, Marievel Velasquez, Christna Baratbate and Sheila Pearl Igot Mejica

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

  55. Bijukrishnan, R., Vijayan P. and Sreenath, K.

    Background: To study the clinical and radiological features of symptomatic Chiari I malformations. Materials and methods: This study was a retrospective study conducted in Government medical college, Thrissur, which is a tertiary care government medical college in Kerala, India. The patients admitted with diagnosis of symptomatic Chiari I malformations during the period of 2015 to 2019 were selected for the study. Results: The mean age was 23.3 years. Females were 66.7% and males were 33.3%. Mean duration of symptoms (onset of first symptom to the time of presentation) was 16.75 months. Occurrence of symptoms include - sensory symptoms 14(58.3%), walking difficulty 10(41.7%), headache 8(33.3%), neck pain 6(25%), vertigo 5(20.8%), weakness of limbs 4(16.7%), spine deformity 2(8.3%), seizures 2(8.3%) diplopia 1(4.2%) , hoarseness of voice 1(4.2%), swallowing difficulty 1(4.2%) and signs (table3&figur3) include gait disturbance 12(50%), hyperreflexia 8(33.3%), nystagmus 4(16.7%), hypertension 4(16.7%), cape sensory loss 4(16.7%), hand atrophy 3(12.5%), scoliosis 2(8.3%). Mean tonsillar descend from the level of foramen magnum was 11.5 mms. Syringomyelia was present in 14(58.3%) cases. Discussion: Patients with Chiari I malformation usually do not become symptomatic until adulthood hence it is also known as adult Chiari malformation. In our study, mean age is 23.5 years. The anomaly is more common among females and our study also females are affected more(66.7%).The most common presenting symptom is usually occipital and upper cervical pain(60% to 70%), often induced by sneezing or coughing according to most of the studies.5,6,7 Sensory symptoms 14(58.3%) are the commonst symptoms in our study. Magnetic resonance imaging is the imaging modality of choice and it is helpful in differentiating intramedullary spinal cord tumours from syrinx.13,14,15,16 The radiological definition of Chiari I malformation has been reported as tonsillar herniation of at least 3 mm17 or at least 5 mm18 below the foramen magnum. We considered tonsillar herniation 5mm as the cut off for the diagnosis of Chiari I malformation. Mean tonsillar descend from the level of foramen magnum was 11.5 mm as per our study. Syringomyelia was present in 58.3% of cases in our study. Conclusions: Chiari I Malformations are more common in adults and incidence is slightly higher in females. Various symptoms include sensory symptoms,walking difficulty, headache , neck pain, vertigo, weakness of limbs, spine deformity, seizures, diplopia, hoarseness of voice, swallowing difficulty and signs include include gait disturbance, hyperreflexia, nystagmus, hypertension, cape sensory loss, hand atrophy, scoliosis in their order of frequency occurrence. Syringomyelia is commonly associated with Chiari I Malformations.

  56. Ali Hosen Molla, Arumay Jana and Dr. Asish Paul

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

  57. Dr. Nidhi Ved and Dr. Nikhil Aggarwal

    Background: Menstrual cycle is defined as cyclic events that take place in a rhythmic fashion during the reproductive period of a woman’s life. Changes in the ovary during each menstrual cycle occur in two phases: A. Follicular phase B. Luteal phase. During the Luteal Phase Progesterone hormone level decreases which causes difficulty in breathing. Respiratory muscle stretch gymnastics which is designed to stretch inspiratory chest wall muscle during inspiration and expiratory chest wall muscle during expiration. Peak expiratory flow measurements are the most widely used tests to assess airflow limitation. Objectives: To find out immediate effect of respiratory muscle strength gymnastic on peak expiratory flow rate among young girls during their menstruation phase. Method: This study was carried out in and around Rajkot city. Subjects who fulfil exclusion and inclusion criteria were selected by purposive sampling. They were explained about the study, its usefulness and written consent were taken.30 subjects who were selected Respiratory Muscle Stretch Gymnastic Exercise was given and Pre &Post Peak expiratory flow rate was measured. Result: Pre-treatment and post-treatment Peak expiratory flow rate was analysed by Paired t-test, it was statistically significant (P value < 0.05). Conclusion: Respiratory muscle stretch gymnastic is effective in improving peak expiratory flow rate among young girls during their menstrual phase.

  58. Angkhong Rongmei, P., *Gojen Singh, Kh., Lokesh, S., Nityanand Verma, Lalruatliana Pachuau, Ashwin, M., Teiboklang Wann and Lekhachandra Sharma, K.

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

  59. Dr. Ankita Chauhan and Dr. Arjun Patel

    Background: Kathak is the typical form of Indian classical dancing originated in northen India. The normal stance position of kathak dancers during the performance consists of overly turning out the foot. This results in the typical, functional hyper pronated foot. So, the purpose of the study was to find of the effects of intrinsic foot muscles strengthening exercises on foot postural deviations in the Kathak dancers. Objective: To evaluate the effect of intrinsic foot muscle strengthening exercises on foot postural deviation in Kathak dancers. Methodology: 40 asymptomatic femalebetween age of 8-23 years were randomly divided into two groups. Group-A performed intrinsic foot muscle strengthening exercises performed intrinsic foot muscle strengthening exercises and Group-B was the control group, not participating in any intervention. The duration of treatment was 4 weeks. The outcome measures were measured at 0 day and 4th week. Outcome Measure– Navicular Drop Test (NDT), Foot Posture Index-6 (FPI-6). Data Analysis: Data were analysed using SPPS statistical software version 20.0 for windows. Results: Group-A showed significant reduction in NDT and FPI-6(p<0.05) in a subjects treated with intrinsic foot muscle strengthening exercises. Conclusion: It is concluded that intrinsic foot muscle strengthening exercises are effective in reducing navicular drop test and foot posture index in female Kathak dancers.

  60. Dr. Robert Mugabe

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

  61. Claudia Nicole Kilian Lourenco, Marcos Bueno de Souza, Jonathan Henrique Magalhães Sangiacomo and Carlos Alberto Kelencz

    Aging refers to a natural process inherent in every Human Being. Important advances in the area of health, the awareness of this population to lead a life with more quality and thinking of incorporating a healthier style based on the practice of physical activity, makes life expectancy increase symbolically. In this aspect, the practice of physical exercise plays a very important role, causing the elderly to develop through resistance training the different physical capacities, each of which will provide several functional, neural and strength gains. This study aimed to investigate in the literature through the research in scientific articles, the benefits of resistance training of power over the functional capacities of the elderly. These abilities refer to the basic skills that demand the day to day of the elderly, such as getting up from a chair, getting around and climbing stairs. The practice of physical exercise with focus on physical capacity muscular power evidences a gain of functional capacity and thus it offers the quality of life and the autonomy of the elderly.

  62. Dr. Samreen Siraj Bala, Dr. Omar Sharief Kirmani and Dr. Shaheen Shahdad

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

  63. Kitty Kuruvilla and Dr. Shashikanth Hegde

    Aim: comparative evaluation of alloplastic bone graft alone and combination of autologous platelet rich fibrin with alloplastic bone graft in the treatment of vertical intrabony defects by selecting patients with chronic periodontitis. Methodology: A total 28 sites with vertical intrabony defects in chronic periodontitis patients of age range 25-54 years were included in the study. They were divided into group A-14 sites underwent open flap debridement with placement of bone graft alone and group B -14 sites underwent open flap debridement with placement of bone graft and PRF after a thorough phase1 therapy. Clinical evaluation of surgical sites were carried out using PPD, MGI, RAL, Mobility at baseline, 3 months and 6 months interval. Radiographic assessment of the defect was done at baseline 3 months and at 6 month interval. Results: The mean probing depth was 7.43 ± 0.852 in group A and 7.86 ± 0.770 in group B. At the end of 3rd month it was 5.43 ± 0.646 in group A and 4.43 ± 0.514 in group B. At the end of 6 months it was 4.14 ± 0.663 in group A and 3.36 ± 0.497 in group B. Relative attachment level was 11.36 ± 0.842 in group A and 11.07 ± 0.730 in group B. At the end of 3rd month it was 9.36 ± 0.842 in group A and 8.00 ± 0.877 in group B. At the end of 6 months it was 7.50 ± 0.650 in group A and 5.21 ± 1.051 in group B. In modified gingival index there is no significant difference at the end of 6 months between group A and group B. The mean mobility score in group A as well as in group B 78.6% had score 1, 21.4% had score 2 in baseline. In the 3rd month too, both the groups had 78.6%- score 1 and 21.4%- score 2. At the end of 6 months, in all the 14 sites mobility score was 1 in group A as well as in group B. In baseline radiographic evaluation mean value was 13.00 ± 1.75 in group A and 14.79 ± 2.72 in group B. At the end of 3rd month it was 7.00 ± 1.03 in group A and 6.36 ± 1.08 in group B. At the end of 6 months it was 6.05 ± 0.855 in group A and 5.57 ± 0.852 in group B. This shows that group B is better than group A. Conclusion: In comparative evaluation of open flap debridement with bone graft and open flap debridement in combination with bone graft and PRF in the treatment of intrabony defects there was significant improvement in clinical parameters like probing pocket depth and gain in clinical attachment level in test sites at 6 month interval. Radiographic evaluation showed some evidence of bone fill in both the groups, however significantly higher percentage of bone fill was observed in test sites.

  64. Tungalag Baljir, Jadamba Badrakh, Bolortuya Baljir and Ganzorig Banzragch

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

  65. Dr. Neha Singh, Dr. Chandra Lekha Pande, Dr. Anjali Sharma and Dr. Niharika Pattnaik

    Background: The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) has attempted to standardize reporting and cytological criteria in aspiration smears. Aim: The objective of this study was to analyze the thyroid cytology smears by TBSRTC, to determine the distribution of diagnostic categories and subcategories, to analyze cytological features, and to correlate the cytopathology with histopathology, wherever surgery was done. Materials and Methods: This was a prospective study of 100 fine needle aspirations (FNA) of thyroid nodules. All fine needle aspiration cytology (FNAC) diagnoses were classified according to the features given in the monograph of TBSRTC into nondiagnostic/ un satisfactory (ND/UNS), benign, atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS), follicular neoplasm/suspicious of a follicular neoplasm(FN/SFN), suspicious for malignancy (SFM), and malignant. Cytohistological correlation was done, when surgical material was available. Results: The distribution of various categories from 100 evaluated thyroid nodules was as follows: 7% ND/UNS, 20% benign, 3% AUS/FLUS, 23% FN, 3% SFM, and 44% malignant. Sensitivity, specificity, positive predictive value, and negative predictive value were calculated. Conclusion.: TBSRTC is an excellent reporting system for thyroid FNA. It also provides clear management guidelines to clinicians to go for follow-up FNA or surgery and also the extent of surgery. Use of TBSRTC for thyroid FNAC reporting helps to highlight increased malignancy risk associated with FN, SM and malignant categories as well as provide data in a standardize pattern to ompare between different studies related to cytology of thyroid lesions.

  66. Tesfaye Basha and Tsehaynew Getaneh

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

  67. Prof. Mrs. R. Uma and Dr. A. Kalaimathi

    Background: Prevalence of alcoholism among men is so high in puducherry (66.2/1000males) compared to neighboring states Tamilnadu and Karnataka. The effects of alcohol dependency can cause more damage and pain than any other internal or external influence on the family unit,. wives feel difficult to manage their marital life and feel stress, as a result they are depressed and likely to affect their marital quality and puts strain on marriage. Aim: To explore and compare the marital quality and level of depression among wives of alcoholics and non alcoholics. Materials and Methods: A Community based cross sectional study was carried out at Moorthikuppam and Mathikrinapuram villages in Pondicherry. Study samples consisted of 50 married women; Out of them 26 were wives of alcoholics and 24 were wives of non alcoholics. A purposive sampling technique was used to select the samples. Data were collected by house to house survey through individual interviews. Anisha shah ‘Marital qualityscale and Beck’s Depression scale were used. Results: The Marital quality among wives of alcohol dependents was poor than wives of non alcoholdependents. The level of depression is not statistically significant between two groups; if the sample size is more and randomization is used it may be significant.

  68. Gitonga, M.K., Muriungi, S.K. and Omondi, M.P.

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

  69. Damindra Ranjan Dissabandara

    Have you heard about the alpha wolf? they are not "leaders" in the human sense of the term. The alphas do not give the other wolves orders; rather, they simply have the most freedom in choosing where to go, what to do, and when to do it. The rest of the pack usually follows. Unlike many other animals’ wolves only kill for hunger and they have they adapted a unique way of hunting, different from the rest of the animals. With over 25 years of experience, as a Cooperate Executive, I have gained knowledge working in diverse industries as well as in different business sectors ranging from NGOs, Banking, Housing, Leisure and Construction. Today I’m happy to say that the time spent with each organization has resulted in molding them to their success. As in humans, no two organizations are alike; each one has its own organizational culture and most of the time indefinite. This is the reason I quest beyond conventional theories and strategies thus introduced the 5 factor model, I call it the WOLFS Theory which is a mirror reflection of my personal life.

  70. Dan Călugăru and Mihai Călugăru

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

  71. Ramija, B.

    Women entrepreneurship has been recognized as an important source of economic growth. Women entrepreneurs create new jobs for themselves and others and also provide society with different solutions to management, organization and business problems. However, they still represent a minority of all entrepreneurs. Women entrepreneurs often face gender-based barriers to starting and growing their businesses, like discriminatory property, matrimonial and inheritance laws and/or cultural practices; lack of access to formal finance mechanisms; limited mobility and access to information and networks, etc. Women’s entrepreneurship can make a particularly strong contribution to the economic well-being of the family and communities, poverty reduction and women’s empowerment, thus contributing to the Millennium development goals. Thus, governments across the world as well as various developmental organizations are actively undertaking promotion of women entrepreneurs through various schemes, incentives and promotional measures.

  72. Mózes, T., Gornicsar, K., Grosz, A., Ta. Mózes, Bíró, E., Kovács, L., Ta. Beöthe, Zs. Domján and I. Buzogány

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

  73. Dr. Navjot Singh Mann, Dr. Ashu Jhamb, Dr. Mohit Sachdeva, Dr. Manu Rana, Dr. Divya Batra and Dr. Garima Goel

    Attractive smiles not only influence other people’s perceptions but also affect the psychosocial well-being of the individual. Aesthetic dentistry enables the dentist to change the appearance, size, color, shape, spacing and positioning of the teeth. This article comes from Punjab in India where its surrounding towns are fluorosis-prone zones. The treatment options for fluorosis are varied depending upon individual cases. The purpose of this article is to report various treatment modalities available for dental fluorosis.

  74. Dr. Chinnadurai, R.

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

  75. Vibha Verma, Anshu and Anjali Mathur

    Adolescence is viewed as a period of transformation and reorganization in family relationships (Steinberg 1991). In the adolescents year adolescents’ faced many challenges, like physical, psychological, social etc. parents- adolescents conflict is one of them. Conflict between parent and adolescent is an opportunity to communicate. Parent-child conflict during adolescence is characterized as a dyadic, interpersonal event involving overt behavioral opposition including quarrels, disagreements, and arguments (Shantz, 1987). The present study aims at assessing the gander difference on communication related parents- adolescents conflict in upper socio- economic group. The study was conducted in Allahabad city. Total sample of 300 adolescents comprising of 100 adolescents each (50 boys and 50 girls) from lower, middle and upper socio economic groups. Sample was selected using stratified random sampling technique for the study. Socio- economic status scale by Kuppuswamy (1962) revised by Kumar and Tiwari (2014) was used to ascertain the socio economic status of the selected respondents. To find out the gender based comparison of adolescents in reference to communication related conflict between parents and adolescents. Self made questionnaire was administered on the selected adolescents in the age group of 13- 19 years. The study revealed that the mean score of boys were higher than girls thus boys were found to have significantly more conflict with their parents on issues related to communication than the girls counterparts of upper, middle and lower socio- economic groups.

  76. Disha Purohit and Dr. Snehal Ghodey

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

  77. Dr. Osama Abdullah Abdul Raheem

    Laparoscopic inguinal hernia repair began in the early 1990s as laparoscopy gained a foothold in general surgery. Inguinal hernias account for about 75% of all abdominal wall hernias, and with a lifetime risk of 27% in men and 3% in women. Repair of inguinal hernias is considered one of the most commonly performed surgical procedures allover world. Inguinal hernia repairs are also of the most common operations done in general surgery. In addition to the conventional open repairs, minimally invasive approaches are becoming increasingly preferred in the management of groin hernia repair. Although open, mesh-based, tension-free is still the standard, laparoscopic herniorrhaphy, when performed by adequately trained surgeons, produces very good results comparable to those of open repair.

  78. Dr. Manisha Rathod, Dr. Amit Saragade, Dr. Vipul Pawar, Dr. Monica Mahajani, Dr. Sumedh Lone, Dr. Anuradha Khakre and Dr. Avadhesh Tiwari

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

  79. Dr. Abhimanyu Vikram Singh, Dr. Ragni Tandon, Dr. Pratik Chandra, Dr. Ashish chauhan, Dr. Sharlin, A. and Dr. Stuti Raj

    Class II Malocclusion has been called the most frequent treatment problem in the orthodontic literature. Among the various jaw based discrepancies that exist, a Class II Skeletal pattern is probably the most prevalent one. The best timing for treatment of Class II malocclusion has been controversial. The question is whether early treatment, which is initiated during the mixed dentition, is more effective and efficient than treatment started in the permanent dentition. Patients can experience “burn out” with this potential prolonged treatment time. Lastly treatment could begin in the permanent dentition, which could shorten the treatment time and lessen the costs to the patient. Orthodontics today has a variety of treatment protocols and tools that may be used. Many of these include: fixed appliances, functional appliances, extra- oral headgear, Inter maxillary elastics, distalizing appliances, selective extraction patterns, and surgical correction. In this article various factors are outlined which shows a distinctive differentiation and relation between the early and late treatment timing in Class II malocclusions.

  80. Dr. Tanushree Sharma, Dr. Kamlesh Singh, Dr. Ragni Tandon, Dr. Pratik Chandra Dr. Aftab Azam and Dr. Abhi, A.

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

  81. Ritu Bhagat and Roopali Jandial

    Introduction: The cytological analysis of serous effusions helps in diagnostic, therapeutic and prognostic implications. The cytological interpretation of individual cells that are exfoliated into these fluids is of paramount importance since they provide an insight into the diagnostic, prognostic and therapeutic aspect of various pathological processes in the body. Cytological evaluation of fluids is a relatively simple, rapid, inexpensive and less invasive tool having a high accuracy with low incidence of false positive diagnosis. Method and Material: The study was conducted over a period of one year in the Department of Pathology. A total of 156 fluid cytology samples obtained from patients of various departments were analyzed. Results: A total of 156 cases were studied over a period of one year. Majority of the patients were in the 41 to 50 years of age group . Eighty-six cases were male which formed the majority. Among all fluids, peritoneal fluid comprised of maximum number of cases. On evaluation, a total of 12 cases were found to be malignant, of which 10 were encountered in peritoneal fluid whereas 02 were found in pleural fluids. Conclusion: Evaluation of body fluid is simple, safe and cost effective technique which helps the treating physician to reach a diagnosis and to understand the disease progression.

  82. Dr. Umesh R Bilagi and Dr. Ramya Kalyanpur

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

  83. Tomoyuki Nishizaki, Miyuki Mabuchi and Akito Tanaka

    The linoleic acid derivative 8-[2-(2-pentyl-cyclopropylmethyl)-cyclopropyl]-octanoicacid (DCP-LA) has been developed as a promising and novel anti-dementia drug. The present study probed the binding partners of DCP-LA. In the DCP-LA binding assay using rat hippocampal lysates, fluorescein-conjugated DCP-LA produced a fluorescent signal band at 75 kDa. In the matrix-assisted laser desorption ionization time of flight mass spectrometry (MALDI-TOFMS) analysis, the signal band corresponded to N-ethylmaleimide-sensitive factor (NSF). In the immunofluorescent cytochemistry using acutely dissociated rat hippocampal neurons, intracellular localization of NSF was well consistent with DCP-LA distribution. The Biacore assay equipped with a sensor chip immobilizing DCP-LA was carried out and the equilibrium dissociation constant (Kd) value between DCP-LA and NSF was measured by applying a variety of concentrations of recombinant NSF. The results of the present study show that DCP-LA binds to NSF specifically, with the Kd value of 3.3x10-7 M.

  84. Siraj DAA Khan, Dinesh Rao B., Sakshi Malik, Anshul Sharma, Muqrin Hobidan Hamad Al-Shermah and Yosef Hassan Hamad Al-Mordef

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

  85. Flávia L.P.G. Tuyama, Carmelia M.S. Reis and Maria Rita C.G. Novaes

    Background: To evaluate the use of potentially inappropriate drugs and propose pharmacotherapeutic interventions for older adults cared for by a specialist service in Recanto das Emas, Federal District, Brazil. Methods: Analytical, cross-sectional research with a quantitative approach, conducted in the city of Recanto das Emas, Federal District, Brazil, with a sample of 191 older adults, of both sexes, during routine clinic visits in a specialized geriatric outpatient service. The variables analyzed were sex, age, educational level, origin, functional capacity, illnesses diagnosed and history of medications used. The data were investigated using bivariate analyses and multiple analysis through logistic regression. Results: A high prevalence of drugs used by the sample was observed (n=191, 1.111 medications, median of 06 drugs/patient). A total of 150 drugs (13.5%) was classified as potentially inappropriate according to the Beers criteria (2015), and 135 drugs (12.16%) were classified as potentially inappropriate according to the STOPP/START criteria (2014). According to the ATC/WHO classification (2017), a wide variety was presented in terms of both quantity and pharmacological classes. Orthostatic hypotension and hypoglycemia were the unwanted outcomes caused by the use of inappropriate drugs, confirmed in this study. Conclusion: Greater commitment is required from the multi-professional team to improve the prescribing of drugs for, and use of drugs by, the elderly.

  86. Jalel Fakri Salama AL-Shujairi

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

  87. Padma, M., Pooja Gujjal Chebbi, Jyothi, M., Nuthan Kumar, M.K., Arunkumar, A.R., Arunakumari, B.S. and Appaji, L.

    Background: Treatment adherence is a complex phenomenon, which has a significant impact on therapeutic success especially with respect to pediatric oncology patients in developing countries like ours where socioeconomic factors have an important bearing on treatment. To gain an insight into the factors that affect adherence in pediatric oncology we conducted this study in a tertiary care center. Methods: Retrospective analysis of case records of children <15 years of age who visited the pediatric Oncology out-patient department at Kidwai Cancer Institute between June -2018 and Jan-2019 was carried out to assess their adherence to treatment and in case of non-adherence to treatment the factors responsible were identified. Results: Of the 600 case records that were screened 115 of them had poor adherence to treatment. These patients were then studied in detail with respect to their demographic details and the factors responsible for poor adherence. The commonest causes for poor adherence that emerged from the study were those pertaining to socio-economic factors and caregiver issues. Conclusions: Socioeconomic factors and caregiver issues are important barriers to treatment adherence. Targeted interventions in the form of social support systems and shared care models have the potential to improve treatment adherence and consequently overall survival in developing countries

  88. Hebasleem and Sleem Heba Abdulwahed

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

  89. Ankwasiize Evarist

    The study dealt with the Identification, analysis and a discussion of findings of the non African based family systems therapies on African family recovery. The major objective of this study was to identify and analyse the Family systems therapies used in Entebbe-Uganda and the method of achieving this was done by carrying out in-depth interviews with the sample counsellors, nominal group discussions and by analysing their written cases. This study was a case study because the researcher intended to intensively assess the effectiveness of family systems therapies in a limited environment to generalise the findings to the entire population Mbabazi (2008). The research tools used were based on one hour interview with each of the respondent (counsellors) and the analysis of their written cases of practicing counsellors. This study adds to the reading community family therapeutic approaches in use in Uganda which are still rare fields for dilettantes, within significant academic engagement and contribution to Af ican scholarship and world view. This study also has given to readers a contextualised and an application of elements on the voluminous corpus of family approaches and many other cardinal principles of family management which have evolved considerably through institutional and substantive growth over the years but especially with non African perspective. This study explored and documented non African family therapeutic applications and enforceability in the specific context of the African family healing in the context of Entebbe – Wakiso - Uganda. The 68 counsellors who were interviewed were as follows: 3 PhD candidates, 10 Masters Holders, 12 bachelor’s holders and 43 diploma holders. These were sampled using snow ball sampling technique and purposive sampling technique. Findings revealed that no family approach is used 100%, and that family therapies are not sufficiently employed by family therapists. Therapists agreed that even though they use all family therapies eclectically they do not use them at the same level and those other therapeutic models especially social cultural traditional approaches to family healing are also used. The study recommended that therapists come up with an approach that incorporates the dynamics of the indigenous African world view and western based family therapies.

  90. Kuppamuthu Ramakrishnan, Subramanian, Rajesh Mondal, Uma A., Senathipathy, R., Ponniah Thirumalaikolundu Vijayaraj and Rathinasabapathy

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

  91. Ravneet Kaur, Sidaveerappa Tuppad and Simarjeet Kaur

    Background: Stress is any situation in which a non-specific demand requires an individual to respond or take action. Stress can lead to negative or counterproductive feelings or threaten emotional well being. Objectives of the study were • To assess the level of stress among G.N.M 1st year students. • To administer laughing among G.N.M 1st year students. • To assess the level of stress after the administration of laughing among G.N.M 1st year students. • To find out association between effectiveness of laughing on stress reduction among G.N.M 1st year students with their selected socio-demographic variables. Methods: Quasi-experimental (Non-randomized pre test-post test control group) design was selected for the study; the study was conducted in selected nursing institutes of district Sangrur, Punjab. Sixty G.N.M 1st year students through convenient sampling technique who met the inclusion criteria were included in the study. Data was collected by using Stress Scale. Data was analyzed using descriptive statistics and inferential statistics. Results: In experimental group post test mean score of stress was 57.37 that was less than the pre test mean score of stress that was 74.23 so it was concluded from study results that laughing was effective to reduce stress among G.N.M 1st year students. There was no significant association between effects of laughing on stress among G.N.M 1st year students with their selected socio-demographic variables. Interpretation: The result shows that there was significant difference between the pre test mean score of stress and post test mean score of stress in experimental among G.N.M 1st year students after the administration of laughing. Conclusion: The study shows that there was significant decrease in the level of stress among G.N.M 1st year students after the administration of laughing; hence laughing is effective in the reduction of stress.

  92. Dr. Osama Abdullah Abdul Raheem

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

  93. Padma Maneya, Nuthan Kumar, Arun Kumar, Pooja Gujjal Chebbi, Jyothi M., Aarthi Viswanathan, Prerana Nesargi, Akkineni Veena, Saksham Singh and Appaji Lingappa

    Background: Pediatric intensive care unit(PICU) is an important component of the supportive care for the children being treated for cancer. The aim of this study was to review the commoner malignancies requiring PICU admissions at our centre, the reason for PICU admission, their microbiological data and to have a brief idea of outcomes of each individual malignant case admitted to PICU. Methods: A retrospective review of the cases who were admitted in PICU at Kidwai memorial institute of oncology, Bangalore from July 2017 to December 2017 was done. Data was collected from the patients case files and the PICU registry. Results: There were a total of 127 cases admitted to our PICU. The mean age of the children admitted was 8.3 years ranging from 8 months to 14 years. There were 79 boys and 48 girls with male: female sex ratio of 1.6:1. The duration of stay in PICU of the children ranged from 1 day to 30 days. Acute lymphoblastic leukemia was the most common malignancy requiring PICU admission and febrile neutropenia with sepsis being the most common cause. Totally there were 39 deaths in our PICU during the study period and approximately 50% of the deaths were due to sepsis. Conclusions: Children with hematologic malignancies formed a major part of our PICU admissions. Sepsis has still been the most common cause warranting intensive unit care in our setting like any other developing country and also of the mortality.

  94. Dr. Jalel Fakri Salama Al shujairi

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

  95. Sachin Dhingra and Shelly Sharma

    Drug-induced gingival enlargement is mainly caused by three classes of drugs (1) Anticonvulsants; (2) calcium channel blockers and (3) immunosuppressants. Amlodipine is a calcium channel blocker which is used in the management of hypertension and angina.This case report presents a case of non-surgical management of a patient with amlodipine induced gingival enlargement with six months follow up.

  96. Himanshu Prince, Vaibhav Tewari, Premraj Singh, Dinesh Singh, Vinita Singh

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

  97. Dr. Padma M., Dr. Jyothi M., Dr. Pooja Gujjal Chebbi, Dr. Nuthan Kumar, Dr. Appaji L. and Dr. Aruna Kumari B.S.

    Background: Improvements in supportive care strategies has contributed to improved survival of children with malignancies. PICU support is one of the pillars of such a supportive care system. Data from developing nations on the outcome estimates of critically ill pediatric oncology patients in the PICU is sparce. Methods: A retrospective review of case records of all PICU admissions from the Kidwai Cancer Institute pediatric oncology unit between May 2017 and April 2018 was undertaken. The aim of the study is to analyse outcome of pediatric oncology patients admitted to PICU and also determine factors predicting poor prognosis. Results: A total of 274 admissions were made in the PICU of the Institute during the study period. 80% of admissions were those with hemato-lymphoid malignancies while the remainder had solid tumours. Chidlren in remission status/newly diagnosed cases contributed to 86.5% of total admissions. The most common indication for ICU admission was sepsis followed by respiratory distress. Children admitted to the PICU in view of neurological deterioration had the highest mortality followed by those admitted for respiratory distress and cardiac complications. 26.3% and 21.5% required inotropic support and ventilation (Invasive/Non invasive) respectively with proportion of survivors being 58.3% and 51.8% in the respective groups. The median PRISM III score at admission in the survivor group was 9 (Range: 1-25 ) while that in the non-survivor group was 17 (Range: 3-35). Multiorgan dysfunction was present in 23.7% (n=65). Survival in those children with MODS was 29.2% (n=19). Conclusion: Risk factors such as disease status, presence of MODS, need for mechanical ventilation and inotropic support were found to be associated with poor prognosis in children with malignancies requiring PICU care.

  98. Mary A Mgbekem, Ndukaku Nwakwue, Victoria Kalu Uka and Margaret A Armon

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

  99. Dr. Mahesh Dave, Dr. Aniruddha Burli and Dr. Mukesh Jiterwal

    Introduction: Stroke is an emergency requiring urgent investigation and treatment. It remains a major cause of mortality and disability worldwide. The association between lipid profile and stroke remains uncertain. This study therefore investigated whether changes in lipid profile might contribute to the risk of ICH. Materials and Methods: This is a case control which included 50 patients of ICH as cases and 50 persons of same age and sex as controls. Serum lipid profile was done which consisted of Total Cholesterol, High density lipoprotein cholesterol, Low density lipoprotein cholesterol and Triglycerides. The diagnosis was ascertained based on Non-Contrast Computed Tomography of Head, done at the time of admission. The correlation of lipid profile and clinical outcome was studied. Result: In our study, 68% were males and 32% were females in case and in control group 58% were males and 42% females. All the levels of different lipid components were significantly different except HDL. The mean LDL for death patients was 109.62±38.17 and for discharged patients was 89.23±28.01. The mean level of triglycerides for discharged group was 110±45.76 and for death group was 85.14±37.20. Conclusion: Our study concluded that there is significant correlation between lipid profile, specifically LDL-C and Triglycerides and clinical outcome of ICH patients in terms of death or discharge. Low levels of LDL-C and Triglycerides are associated with poor outcome in patients with ICH.

  100. Dr. Abhi A., Dr. Pratik Chandra, Dr. Ragni Tandon, Dr. Kamlesh Singh, Dr. Aftab Azam and Dr. Hisana Hameed

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

  101. Dona Das and R. V. Sridhar

    Introduction: The World Health Organization estimates that more than 180 million people worldwide have diabetes, and by 2030 it is expected that this number will have doubled.[1] There is an alarming increase in the incidence and prevalence of diabetes mellitus (DM) in Asian Indians. Epidemiology of Diabetes in India: The prevalence of diabetes is rapidly rising all over the globe at an alarming rate13. Over the past 30 years, the status of diabetes has changed from being considered as a mild disorder of the elderly to one of the major causes of morbidity and mortality affecting the youth and middle aged people. Pulmonary function test (PFT) is a complete evaluation of the respiratory system including patient history, physical examinations, and tests of pulmonary function. with insulin-dependent diabetes compared with age-matched control subjects, all lifelong nonsmokers. Lung CO transfer capacity is significantly affected by the integrity of lung capillary endothelium and, therefore, the findings of Sandler et al. focused attention on pulmonary vascular changes. The concept of the lung as a target organ for diabetic microangiopathy received continuing attention. Reports of lung function tests in patients with diabetes over the next 15 years have focused largely on pulmonary microangiopathy with relatively few studies of pulmonary mechanical function Diabetes and Lung Function Test : Some studies showed that all the pulmonary parameters, that is, FVC, FEV1, FEF25, FEF50, FEF75, FEF25–75, FEF0.2–1.2, and PEFR were significantly reduced except FEV1/FVC in patients of type 2 DM as compared with the healthy controls. Conclusion : It can be concluded from our narrative review that the Type II or Type I diabetes is definitely having decreased lung functions assessed by spirometry not only because of diabetic complications like pneumonia or other but also due to long term effect of diabetes may be because of micro-angiopathy or decreased elastic recoil capacity of lungs.

  102. Kuppamuthu Ramakrishnan, Uma, A., Rathinasabapati, R., Thiyagarajan, V., Vijayaraj, S., Thirumalaikolundu Subramanian, P., Senathipathy R. and Rajesh Mondal

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

  103. Mrs. Sunita Rani and Dr. Dimple Madaan

    Elders are the pillars of the family, need support and care from the family to strengthen their autonomy and self esteem. As physical deterioration progresses with age, elders encounter more loss of function and greater inability to cope with stressful events. In this stage of life family support can help to establish a good coping environment. A non experimental correlational research design was used to achieve the stated objectives. Sample comprised of 100 subjects. The study was conducted in OPD of civil hospital, Hoshiarpur. Target population comprises of elderly patients more than 65 years of age attending OPD in civil hospital. Purposive sampling technique was used to select adequate size of the sample. Assessment of the functional autonomy was done with the help of standardized rating scale-SMAF and assessment of perceived family support was done with the help of standardized rating scale- TFSS-EP. Analysis was done using descriptive and inferential statistics. Findings shows that 69 % of the elderly are having level 1 functional autonomy means they need only supervision or stimulation. Similarly as per perceived family support 53% are having good family support. So, nearly half of the elderly reported good perceived family support. Functional autonomy and perceived family support have been found positively correlated. Majority of the elderly patients had level 1 functional autonomy. Nearly half of the sample is only getting good perceived family support and both functional autonomy and perceived family support are positively correlated.

  104. Waseem Iqbal, Muzaffar Jan and Mohd Irshad

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

  105. Vinod Kumar, Ritu Bhagat and Shahbaz Khan

    Introduction: Peripheral artery disease in chronic kidney disease patients is commonly reported in Jammu region, especially in patients with concomitant coronary artery disease, attributable to accelerated atherosclerosis. The present study establishes wide prevalence of peripheral artery disease in chronic kidney disease stage III-V. Material and Methods: This study is a cross sectional study which was carried out in Department of Nephrology, GMC Jammu during the year 2013-2014. 130 patients were included in the study period and after taking their proper history and medical records, all patients of Chronic kidney disease(stage III-V) were subjected to baseline investigations and their Ankle Branchial index(ABI) was calculated. The GFR was calculated by Cockcroft –Gault equation. Results: The mean age of the patients was 52.34±14.42years, 84(64.6%) being male and 46(35.3%) being females. All the patients were known case of CKD (diagnosed or first time evaluated) following Nephrology OPD at Government Medical College, Jammu with mean eGFR of 15.69±9.8 ml/min−1. 12 patients (9.23%) were CKD stage III, (K/DOQI classification), 55(42.3%) were CKD stage IV and 63(48.46%) were CKD stage V. The lower eGFR was independently associated with PAD. Conclusion: Our study showed that the PAD is associated with thrice higher mortality than that of the general population and its prevalence is much higher among end-stage renal disease patients i.e. CKD stage III-V.

  106. Sanjeev Khuraijam

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

  107. Akul Agarwal, Jyoti Tembhurne, Ruchz Agarawal, Varsha Kolhe and Abhishek Meena

    The fabrication of a full-arch implant supported maxillary and mandibular prosthesis has been associated with several prosthetic complications and difficulties. Even though it has been reported that phonetics, esthetics, and proper lip support are difficult to achieve with fixed full arch implant supported, there is a scarcity in the literature regarding the clinical and laboratory procedures necessary to minimize these complications. This article provides clinical and laboratory steps that may enable the clinician to achieve more predictable restorative results when using computer-aided design/computer-assisted manufacture (CAD/CAM). The technique presented here describes the fabrication of a wax pattern of the metal framework using CAD/CAM followed by casting to fabricate a maxillary and mandibular implant supported porcelain fused to metal restoration in a more predictable manner.

  108. Anmole Razzaq

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

  109. PhyuPhyu Mar and Aye Thida Aung

    The simplest form of a metal detector was included an oscillator which produced an alternating current and magnetic field that passes through a coil. When a piece of electrically conductive metal is closed to the coil, eddy currents will be induced in the metal, to form create its own magnetic field as a metal detector. It is used to detect the metallic object and used for Mine finding Mechanism in war. It is short range device and between 9 inch and below, it can detect any metal between this range such as gold, tin, steel and any electropositive elements.

  110. Jeevana Kurugodu, Dr. Dolly C. Yadav and Dr. Indranil Das

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

  111. Harpreet Singh, Gaikwad Mahesh, Ashish Mittal, Manoj Kumar Mangla, Kusum Yadav and Somdatta Giri

    Background: Patient reported Outcome - Clinical Arthritis Activity Index (PRO-CLARA) is a new, continuous and feasible index to assess the impact on activity of daily living (which is the patient’s prime concern) so it could be useful in regular clinical practice for monitoring Rheumatoid Arthritis (RA) patients. Objective: Assessment of disease activity in Rheumatoid Arthritis using Patient reported Outcome - Clinical Arthritis Activity Index (PRO-CLARA). Material and method: The present study was a cross sectional study done on hundred RA patients as per American College of Rheumatology criteria (ACR criteria) who presented in Rheumatology clinic at PGIMS, Rohtak (Haryana). Patients were assessed for disease activity using Disease activity score-28 (DAS28), Clinical disease activity index (CDAI) and PRO-CLARA at baseline thereafter two months and at four months on therapy. Results: The mean age was 44.4±11.8 yrs with 84 females and 16 males. At baseline the mean DAS28, CDAI and PRO-CLARA score was 6.65±0.68, 36.5±9.7 and 8.78±0.64 respectively, at two months 4.58±0.81, 18.36±6.58 and 6.62±1.31 respectively while at four months was 3.33±0.96, 9.69±6.69, and 4.21±1.59, respectively. At baseline, 2 months and 4 months Pearson’s Correlation Coefficient of PRO-CLARA with DAS28 was 0.931, 0.889 and 0.893 respectively, and with CDAI was 0.517, 0.674 and 0.682 respectively (all P value <0.001). Reliability index (as assessed by Cronbach’s alfa) at baseline, 2 months and 4 months for DAS28 was 0.662, 0.569 and 0.685; for CDAI was 0.574, 0.586 and 0.767 for PROCLARA was 0.862, 0.980 and 0.987 respectively. Conclusion: PRO-CLARA was found to be significantly correlated with DAS28 and CDAI. The components of PRO-CLARA include all important measures of disease activity, so it could be useful in regular clinical practice for monitoring RA patients.

  112. Aliyu Musa Bade and Idi Mohammed

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

  113. Reem Mohammed Bushra Mohammed, Nuha Eljaili Abubaker Mohammed and Mariam Abbas Ibrahim Abdelghafour

    Background: The uses of saliva markers have clear benefits than serum , the reason of this benefits saliva collection is a noninvasive, easy, and cheap. Objectives: The aim of this study was to compare the levels of urea and creatinine in plasma and saliva of Sudanese patients with renal failure under hemodialysis, and to investigate the potentiality of determination of saliva urea and creatinine levels instead of using plasma. Participants and Methods: A case-control study was conducted from May to Jun2018, involving fifty Sudanese Patients who had been diagnosed ofrenal failure, and had been admitted to Omer Alhag Musa Hospital, in GazeraState as cases(17 of them were females and 33 were males); and fifty healthy individuals were recruited as controls (16 of them were females and 34 of them were males), age ranged from 20 to 70 years in both groups, blood samples and saliva were collected and the levels of urea and creatinine were measured, using BioSystem (Apel/AP-101). Data analysis was carried out, using SPSS version, 21. Mean values werecalculated and independent t-test was used to compare mean values in case versus control group and Pearson’s correlation was used to find the relationship between urea and creatinine levels in serum and saliva. Results: There were significant increase in the mean levels of plasma urea (mean ± SD: 179.9 ± 51.4 vs. 37.00 ± 253 mg/dL; p = 0.001) and creatinine (9.40 ± 2.38 versus 0.97 ± 0.6 mg/dL; p = 0.001) in patients with renal failure when compared to control group. Also there were a significant increase in the mean levels of saliva urea(214.1 ± 64.1 vs. 27.2 ± 27.5 mg/dL; p = 0.001) and creatinine (12.00 ± 3.89 vs. 1.01 ± 0.7 mg/dL; p = 0.001) in patients with renal failure when compared to control group.The result shows a significant positive correlation between plasma urea and saliva urea in patients with renal failure (r = 0.529; p = 0.001), also there wasa significant positive correlation between plasma urea and saliva urea in patients with renal failure (r=0.579; p =0.001).The plasma urea showed sensitivity of 99.9%, and specificity of 99.8% while the salivary urea showed sensitivity of 98% and specificity of 98%, but the plasma and saliva creatinine showed same sensitivity of 97% and same specificity of 97%. Conclusion: Sudanesepatients with renal failure under hemodialysis had increased levels of urea and creatinine in saliva and plasma. Sensitivity and specificity of saliva urea and creatinine levels are comparable to those of plasma.

  114. Enose M.W. Simatwa and Khajeha Hariet

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

  115. Caíque Edgar Spínola Lima, Anderson Matheus Ferreira Rodrigues, Amanda de Oliveira Barbosa, Grazielli Queiroz Andrade, Alan Alves de Sousa, Ruth Caracas Rocha, Regiane Lima Vieira, Vinicius de Moraes and Danilo Rocha Santos Caracas

    The method of training with partial blood flow occlusion has been one of the great research targets of health professionals in recent years for having significant results in high performance athletes. At the same time, Inspiratory Muscle Training (IMT) provides an improvement in the functionality of inspiratory muscles, including the diaphragm, generating morphological changes. The objective of the present study was to evaluate the influence of the KAATSU (KT) method on Inspiratory Muscle Training. This is a randomized clinical trial consisting of 22 untrained, healthy patients divided into two groups (IMTG + KT: 13, IMTG: 9). Both groups performed spirometry before and after the protocol. The groups were submitted to a protocol of 8 sessions, in which the Inspiratory Muscle Training + KAATSU Group (IMTG + KT) was performed with an initial load of 40% of the Maximum Inspiratory Pressure (MIP) associated to the vascular occlusion training in the proximal third of the humerus, inflating to 220mmHg. The IMT Group (IMTG) training was carried out with 70% of Maximum Inspiratory Pressure (MIP). It was observed that both protocols obtained significant results in the spirometric variables of Forced Expiratory volume (FEV 1) and Forced Vital Capacity (FVC) pre and post intervention. However, IMTG + KT was significantly higher when compared to IMTG at all evaluated points.

  116. Jaqueline Alves do Nascimento, Severino Alexandre Barbosa da Silva, Samia Aguiar Dantas, Hiochabel Duarte Rodrigues, Cássio Rocha Medeiros, Antônio Jackson Andrade Gonzaga de Oliveira and Tiago França Araripe Cariri

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

  117. Ochwo Pius

    The purpose of the study was to examine relationship between school type and a pupil’s achievement on the Mathematics Primary Leaving Examinations (PLE) (i.e., 7th grade) in Uganda). The study employed a cross- sectional survey design. Data were from the Uganda National Examinations Board (UNEB) Primary Leaving Examinations results for the year 2018 (N = 903). Date analysis was done using a One-Factor Analysis of Covariance (ANCOVA). This was conducted to determine the relationship between a pupil’s school type (i.e., urban or rural, essentially school Social Economic Status [SES]) on the PLEs in Uganda, while controlling for pupils’ prior mathematics achievement/knowledge. The results indicate that there are significant differences between urban and rural schools on student Mathematics achievement controlling for prior mathematics ability. Specifically, the adjusted means indicate that urban schools have higher mathematics achievement on average (M = 4.68, SE = 1.9) compared to rural schools (M = 4.76, SE = .2.5). Note that the lower mean indicates better performance, and a higher mean indicates poorer performance on the PLE exams. (i.e., 1 is the highest score and 9 is the lowest score).

  118. Zubaida Rasool, Naheena Bashir and Imza Feroz

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

  119. Eze-Michael, Ezedikachi N., Dr. Adewumi, Eyitayo F. and Oni, Michael Abiodun

    The United States and Russia have a long history in the involvement in the affairs of the Middle East while China has not reallybeen an active actor in Middle East politics.Maintaining a balance between China’s relations with Israel and the Arab States as well as between the Sunni Arab States and Iran has been a guiding principle of China’s Middle East policy. China has cordial relations with Israel but at the same time it supports a Palestinian state with East Jerusalem as its capital and supports a Weapon of Mass Destruction (WMD)-Free Zone in the Middle East.This study discussed the interests and roles of the United States, Russia and China in the Middle East, emphasizing more on the historical context. The study adopted qualitative method. The population for the study was the Middle East, particularly the Arab states and Syria and Iran. Data were collected through documentary review of publications as well as journals and materials from the internet. Data were descriptively analyzed in the historical context. The study found that the Middle East is arena for foreign interests’ competition amongst the superpowers of United States, Russia and China. In addition, the Gulf States’ disillusionment with the US, along with their economic pragmatism in light of the global power transition to the East, motivated them to diversify their political and security relations. Furthermore, Russia whose interest was to engage the Middle Eastern states economically, played a marginal role in the economies of the Gulf States. The study concluded that Middle East is volatile region that has faced immense challenges. The strategic location and the energy richness of the region is a contributing factor that has attracted outside powers to expand their influence in the region. The regional rivalries have been harnessed by the outside powers by directly supporting the states and their proxies. In this regard, the Syrian case was the best example to illustrate the involvement of regional as well as extra-regional states and the drastic consequences of such involvement for regional peace and stability. The inherent instability which is caused by ethnic, tribal and sectarian conflicts and strategic competition between regional as well as extra-regional powers Russia and the US make the Middle East a crisis ridden region.

  120. Ochwo Pius

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

  121. Dr. Reyas Y Rasool, Dr. Shally Mahajan, Dr. Aftab Azam, Dr. Ashish Chauhan and Dr. Ragni Tandon

    Evaluating age and gender related change is important to determine the abnormality happening to the soft tissues, incisors display with increasing age and in different gender. When we are aware of the normal profile, soft tissue, and incisor display during smile then only we will be able to treat abnormal changes in smile and incisor display and bring back to its normal condition. The sample sizes of 90 subjects were selected from the Uttar Pradesh population between the age group of 15 and 45 years. They were divided into three age groups. Esthetics in orthodontics has been defined mainly in terms of profile enhancement, but if we ask a lay person or a patient, their answer will usually include something about creating beautiful smiles. The study concluded that the lip commissure height, both left and right followed the same pattern of the lip length where-in, they show an increase in length as the age increases. This was markedly seen in males than in their female counterparts and aging leads to a significant decrease in the maxillary central incisor display at smile.

  122. Marianne W. Robertson and Dr. Peter H. Adler

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

  123. Dan Călugăru and Mihai Călugăru

    The authors are commenting on the article entitled “Randomized trial of wide-field guided PRP for diabetic macular oedema treated with ranibizumab” published by Talks et al. in Eye 2019; 33(6):930-937. After thorough analysis of the issues related to the addition of targeted panretinal photocoagulation to areas of nonperfusion in patients with macular diabetic oedema the authors concluded that the specific anti-vascular endothelial growth factor drugs (e.g., bevacizumab/ ranibizumab/aflibercept) represent the front-line therapy for the treatment of diabetic macular oedema but only the vascular endothelial growth factor inhibition may not be sufficient to decrease inflammatory response. Therefore, addition of a non-specific anti-vascular endothelial growth factor substance, (e.g., corticosteroid implant) is mandatory. As for the role of targeted panretinal photocoagulation to areas of nonperfusion, the retinal lesions that develop after panretinal photocoagulation increase vascular endothelial growth factor expression and induce breakdown of blood-retina barrier dysfunction and hard exudates formation. The pre-existing diabetic macular oedema prior to panretinal photocoagulation results in overburdened retinal pigment epithelium, so that panretinal photocoagulation could aggravate diabetic macular oedema.

  124. Soviwadan DROVOU, Komlan A. KASSEGNE, Komi KADJA, Demagna KOFFI, Yao KOUTSAWA and Komla SANDA

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

  125. Dr. Avanee Vajar, Dr. Shweta Rakholiya, Dr. Hitiksha Dedania and Dr. Ami Vyas

    Background: Major concern facing individual with upper extremity paresis after stroke is recovery of upper extremity movement and function. Hemi paresis leads to compromise normal biomechanics and stability of shoulder complex by loss of motor control and development of abnormal pattern. There are many therapeutic approach used to restore motion and maintain scapular stability. Objective: To compare the effect of scapular stability exercise versus scapular PNF on function of paretic upper extremity in stroke patients. Method: 30 patients who fulfilled the criteria were selected and divided into two groups of 15 each. Group A Scapular PNF and Group B Blackburn exercise. Intervention given for 4 weeks and pre and post scoring done by Fugl Meyer Assessment and Manual Function Test. Result: Wilcoxon Signed Rank Test and Mann Whitney U Test were used to analyze data for statistical significant among groups. Result shows a statistically significant difference in both groups and group B is more significant than group A. Conclusion: This study concluded that scapular stability exercises are more effective in improving paretic upper extremity function in stroke patients.

  126. Beverly E. Resuelo

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

  127. Dr. Vinod Kumar, Dr. Ritu Bhagat and Dr. Shahbaz Khan

    Acute glomerulonephritis is defined as the sudden onset of hematuria, proteinuria and red blood cell casts. This clinical picture is often accompanied by hypertension, edema and impaired renal function. Acute glomerulonephritis can be due to a primary renal disease or secondary to systemic diseases. Aim: To study the clinical and histopathological correaltion of acute glomerulonephritis in hospitalized patients. Materials and Methods:This is a prospective study for a period of two years from Jan.2011 to Jan. 2013 performed in GMC Jammu. Results: A total of 80 patients were included in this study. Out of 80 patients admitted as clinically suspected cases of acute glomerulonephritis (AGN). 9 patients responded to medical treatment.56 patients underwent renal biopsy. 10 patients diagnosed on renal biopsies as chronic glomerulonephritis and excluded on further analysis.46 patients diagnosed on renal biopsies as acute glomerulonephritis. Conclusion: PSAGN is the most common entity.

  128. Azger Dusthackeer, Silambuchelvi Kannayan, Sam Ebenezer Rajadas and Rajesh Mondal

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

  129. Dr. Elesia B. Buenaflor and Dr. Roberto C. Buenaflor

    The study investigated the essentials of building a peace culture among State Universities and Colleges (SUCs) in the Philippines. It determined the extent of importance of each identified essential factor, namely: adhering to constitutional and human rights; fostering democratic participation; respecting academic freedom; advancing understanding, tolerance, and solidarity; supporting participatory communication and free flow of information; promoting safe and healthy working environment; and equal access to opportunities in public service. It examined the presence of significant difference among these essential factors and the existence of significant relationships among the ratings of the respondents on the same. The researcher-made instrument adopting the 4-point scale rating, where138 faculty federated officials of SUCs were respondents. It employed mean, one-way repeated measure ANOVA, correlation coefficient, t-test, and tested the hypotheses at 5% error margin. The results disclosed these seven indicators being “very much important” essentials for building peace culture, with “equal access to opportunities in public service” as the highest and “promoting safe and healthy working environment”, the lowest. These essentials were significantly different among each other, though the ratings of faculty underscored the remarkable relationships among these essentials for setting peace culture among SUCs. Peace education efforts is pivotal among SUCs.

  130. Sobowale, A. A.

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

  131. Dr. Raad Al- Timimi, Dr. Abdulbasit Fathi Mossa, and Dr. Najim Abid Issa

    Cryptorchidism is the most common genital problem encountered in pediatrics, it carries the risk of testicular cancer, infertility and psychological upset. In Iraq the screening of undescended testes (UDT) after child birth is not routinely done that will cause a lot of cases remain undiagnosed till after child and adulthood. 319 primary school randomly selected all over Baghdad city including urban and rural regions for screening males with undescended testes among children aged 6-14 years. Exclusion criteria include those who are treated previously from this anomaly, and those who refused examination to inter the study. A total of 184,852 pupils aged 6-14 years were examined During year 2015(from 15 November 30 April), 3910 pupils (2.11%) were found to have undescended testes. The prevalence of cryptorchidism among our primary school children in Baghdad city is nearly 2 % in urban area and 2.4% in rural area and the result of this mass screening aware us to go forward in order to engage this problem in our early detection program for cancer prevention.

  132. Deribe Debella, Endale Berhanu and Tafano Ouke

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

  133. Roberto De Vivo and Luigi Zicarelli

    The purpose of this processing is to compare the emissions of greenhouse gases produced by farmed animals and the carbon dioxide fixed by the crops of the various plants used for their feeding. Starting from the collection of FAO data, the CO2 fixed by the main crops of zootechnical interest was calculated. The biomass produced and the CO2 set by them were calculated using the "Calvin-Benson cycle" and then subtracted from the atmosphere. All the emissions related to ruminal fermentations and the management of the dejections in the various types of farms were also calculated. A balance has been made and the ratio between the emissions due to the animals and their dejections and the CO2 set by the crops destined for their feeding has been calculated. The relationship and the incidence of the various species bred on the emissions related to the dejections have been calculated. The results obtained showed that the contribution of the atmospheric emissions of the farms is compensated by the vegetation used by the animals themselves.

  134. Eduardo Jorge Sant’Ana Honorato, Sônia Maria Lemos, Tirza Almeida da Silva, Daniel Cerdeira de Sousa, Amanda Caroline de Almeida Amazonas and Hulda Bruno Barbosa Senna

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

  135. Dr. Senthilmurugan, T. K. and Dr. Gowthaman, R.

    Introduction: Mosquitoes are generally considered an annoyance but some species act as vectors of diseases such as malaria, lymphatic filariasis, dengue, chikungunya and Japanese encephalitis. Knowledge of the bionomics of mosquitoes, especially of disease vectors, is essential to plan appropriate vector control strategies and diseases prevention. Objectives: To Find out the Man landing densityand periodicity of Different species of Mosquitoes prevalence in Nagai district. Methodology: Two houses located close to each other in the same street have been selected for the present study with natural setup. House 1and where a human volunteer, who acted as bait, was made to lie on the floor with his usual clothing. He had been exposed to mosquito landing for five minutes of each hour of the night that is 6 pm to 6 am and the mosquitoes were collected by an electronic aspirator. House 2 also followed the same, for subsequent five minutes of the same hour. Results: Throughout the study period Culexquinquefasciatus, was found to be the predominant mosquito species in Nagapattinam area. Culexquinquefasciatus was found to have maximum man landing Density (MLD) 9 – 10 p.m. and 11pm to 12 mid night. However the Culexquinquefasciatus density ranged between 3.5 to 5 MLD throughout the night.

  136. Dr. Abhishek Chowhan and Dr. Arti Sakral

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

  137. Luis Núñez Oreza, Betty Sarabia Alcocer, Zelyna Kassandra Cárdenas García, Giezi Espadas Granados, Paulino Tamay Segovia, Selene Blum Domínguez, Baldemar Aké Canche, 4Francisco Aguirre Crespo, Javier Maldonado Rivas and Rafael Mex Álvarez

    In Mexico, the main causal agents of hospital infections are the species of Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli and Klebsiella pneumoniae; whose strains are usually multiresistant to antibiotics. In view of this situation, new antimicrobials are required, with structures and mechanisms of action different from current commercial antibiotics and, in the future, new drugs to counteract the infections caused by these microorganisms. The foregoing has led to the investigation of new antimicrobial substances from plants considered popular medicinal. These plants have a wide range of chemicals, whose active ingredients can be useful as a medicine and can be found in their entire structure or only in some sections. Therefore, this work evaluated in vitro the bactericidal activity of ethanolic extracts from red mangle bark, garlic clove, onion and lemon peel in multi-resistant gram-negative bacteria.

  138. Dr. Amit Bhardawaj, Dr. Shalini Patel and Dr. Kratika Mishra

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

  139. Thilakavathi Arunagiri, Arjun Pandian and Samiraj Ramesh

    The present study was undertaken to evaluate the differences in the fatty acid composition between the species of finfishes of Nagapattinam coast, Tamil Nadu, India. The values of 20:0 and 20:2n-6 fatty acids did not significantly differ (P > 0.05) between S. fimbriata and E. malabaricus. The levels of saturated (SFA), monounsaturated (MUFA) polyunsaturated (PUFA) fatty acids varied between two fishes. The fatty acid composition showed quantitative differences in the percentages of individual acids between the species. Total fatty acids included 43.23% of SFA, followed by 37.29% of PUFA and 24.48% MUFA in S. fimbriata. In E. malabaricus total SFA content was 49.02%, MUFA 32.51% and PUFA 23.47% of the total fatty acid composition.

  140. Dr. Suvarna Sande Tathe and Dr. Abhishek Devnath

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

  141. Bulusu Radhika, Yadav C Dolly, Das Indranil and Shastry VGR

    Anaphylaxis is a serious life- threatening allergic reaction and requires emergent diagnosis and treatment. The first – line pharmacological treatment in anaphylaxis is intramuscular adrenaline. Concurrent occurrence of acute coronary syndromes with hypersensitivity reactions is a rare but possible occurrence known as ‘Kounis Syndrome’. We report a case of a young healthy male with no significant risk factors for coronary artery disease developed ventricular tachycardia and myocardial infarction following therapeutic dose of intramuscular administration of adrenaline for an anaphylactic reaction to the ED.

  142. Dr. Rumki Sarkar, Biswajit Das and Ganesh Biswas

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

  143. Sumit Debnath and Dr. Anurag

    Introduction: The jugular foramen lies at the posterior end of the petro-occipital suture between the jugular process of the occipital bone and jugular fossa of the petrous part of the temporal bone which allows the passage of important nervous and vascular elements, such as the glossopharyngeal nerve, vagus nerve, accessory nerves and the internal jugular vein. Glomic tumors, schwannomas, metastatic lesions and infiltrating inflammatory processes are associated with this foramen, which can account for injuries of related structures. The increasing use of modern diagnostic procedures and new surgical approaches has created a need for much more detailed anatomical studies and explanations. Methods and materials: 44 jugular foramina of unknown age and gender were examined from the Department of Anatomy at SGRR Institute of Medical and Health Sciences, Dehradun, Uttarakhand. The morphological characteristic of all the foramina were studied, described and compared. Result: the mean anteroposterior, mediolateral diameter, area and depth of the jugular foramen was found to be greater on the right side than the left. Conclusion: The involvement of IX, X and XI cranial nerves at jugular foramen is known as Vernet’s Syndrome, which might occur in this case due to narrowing of the jugular foramen. The need for familiarity with detailed anatomy of this region becomes greater importance for a neuro surgeon to approach this region.

  144. Dr. Neha Prakash, Dr. Rajeev Srivastava and Dr. Vivek Choukse

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

  145. Dr. Safia Urooj, Tabassum Kausar, Saba Naz and Dr. Wahaj Muhammad Khan

    The research paper strives to have an insight over the core issues and challenges surrounding the Science subjects teacher education provided at the teacher education institutes. It has been observed that there is an overall discomfort among the students and teachers regarding the curriculum introduced by HEC for the teachers education in General Science subject. The paper adopts a qualitative strategy to explore the issue. Ten in-depth interviews of teachers practicing at the teacher education institutes have been conducted coupled with ten interviews of the students of same colleges so that the perspectives could be collected both from the teachers and students side. The interviews are conducted face to face with the help of structured questionnaires. It has been unveiled from the study that the topics included in the course are largely mismatched with the syllabus being taught at the schools. Moreover, the students not having the science background are unable to understand the concepts included in the courses. The lab facilities are also not provided at the education colleges due to which the experiments could not be conducted. Consequently, both the students and teachers are viewing the curriculum inappropriate and ineffective. It has been recommended that General science education curriculum must be revised and restructured to meet the concerns of the teachers as well as students.

  146. Dr. Abdulla Halbos Mohammed, Dr.Suhair Mohammed Abd-Alsalam and Dr. Aterah Salim Abdulla

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

  147. Dr. Safia Urooj, Tabassum Kausar, Saba Naz and Dr. Wahaj Muhammad Khan

    The research paper intends to investigate the core reasons behind the implementation gaps that exist within the educational policies of Pakistan. The research paper takes a qualitative research approach and presents a concise overview of the related literature to provide an insight over the issues that have been creating footraces in the way of educational policy implementation. The research finds that there are some critical obstructive areas like mismanagement of financial resources, ideological differences among various ruling elite, lack of political will, low quality level of teachers training, corrupt system, minimum follow ups, weak monitoring system, deprived policy evaluations and absence of visionary leadership that have jointly worked to create flaws within the education system that in turn has created several gaps in the implementation of the educational policies. The research also finds that there has been no systematic continuality in the formulation of educational policies that has drawn obvious impacts upon the implementation process as well. The research concludes that the Pakistani sector is not facing the real problem in the policy formulation areas because on paper the educational sector has ideal policies documented from time to time but the actual problem exists in form of gaps that are found in the implementation of these policies created by the above mentioned factors.

  148. Dr. Safia Urooj, Saba Naz, Dr. Wahaj Muhammad Khan and Tabassum Kausar

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

  149. Tushar Rai, Arushi Gupta, Nidhi Shukla, Vinita Singh and Anita Malik, Monica Kohli and G.P. Singh

    Background: Isoflurane had always been known to have neuroprotective properties. Sevoflurane by virtue of its low solubility provides rapid onset and offset of an aesthesia, thus facilitating early postoperative evaluation of the patients especially in the neurosurgical procedures. However superior role of sevoflurane to isoflurane in pediatric patients requiring intermediate lasting anaesthesia remains controversial. Therefore the aim of this prospective comparative randomized study was to compare inhaled anesthetics sevoflurane and isoflurane in paediatric patients undergoing surgery for spinal dysraphism on the basis of early post recovery outcomes, pain, intraoperative and postoperative hemodynamics, and postoperative side effects of both the agents. Materials and Methods: 60 patients scheduled for spinal dysraphism surgery of ASA physical status I & II, of either sexes, aged between 6 months - 6 years, were divided into two groups. After I.V. induction maintenance anesthesia was given on low-flow with inhalational agent as isoflurane for Group I (n=30), and sevoflurane for Group II (n=30). The primary end points being post-anaestheisa recovery, extubation time, discharge readiness in PACU and emergence agitation, While the secondary end points included intraoperative and postoperative Heat Rate, noninvasive blood pressure and SpO2 and postoperative complications such as nausea, vomiting, shivering, and desaturation episodes (SpO2<95%). Results: While faster times to awakening and extubation were observed with sevoflurane compared with isoflurane (p< 0.001), no difference in discharge readiness in recovery room was seen. Moreover, emergence agitation was almost absent in both the groups and no complications were observed in PACU during our observation period. Conclusion: Both isoflurane and sevoflurane can be used safely in maintenance of anaesthesia in pediatric patients undergoing spinal dysraphism surgery. Since isoflurane is a cheaper alternative, so in developing countries it could be preferred over sevoflurane on the basis of risk benefit ratio.

  150. Dr. Anchal Lalhal and Dr. Pushpinder Singh

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

  151. Prof. Arumugam Thiruvalluvan and Dr. Nihal Ahemad

    Background: The Arcuate fasciculus (AF) is an important neural tract for language function. Various language deficits including conduction aphasia can be caused by injury of the AF. Little is known about injury of the arcuate fasciculus (AF) in patients with mild traumatic brain injury (TBI). Objective: To investigate the injury of the AF in the dominant hemisphere in patients with mild TBI presenting with aphasia, using diffusion tensor tractography (DTT) and to find a correlation between them. Materials and Methods: Study design was observational retrospective cross sectional study. We recruited 20 patients with injury of the left AF with mild TBI and evaluated the DTTs of the left AF ; decline in FA values of left AF compared to right AF using age matched controls using previous study data was used as an index of dominant AF injury. On WAB evaluation, aphasia quotient was calculated and correlated with the degree of aphasia and the severity of AF injury. Results: Based on the aphasia quotient patients were classified into mild, moderate and severe and this was correlated well with the level of arcuate fasciculus injury. A positive linear correlation between the decline of FA values in the language dominant hemisphere to the degree of aphasia in that patient was established. Hence it can be postulated that severity of injury to arcuate fasciculus is directly proportional to the degree of severity of aphasia. However, no such correlation could be established between the FA values to the specific type of aphasia. Conclusion: DTT could provide useful information in detecting injury of the AF and evaluation of the AF using DTT would be necessary even in the case of a patient with mild TBI who complains of mild language deficit.

  152. Enose M.W. Simatwa, Khajeha Hariet and Olive T. Baraza

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

  153. Khajeha Hariet, Enose M.W. Simatwa and Olive T. Baraza

    Engineering covers many different types of activities. Engineers make things, make things work and make things work better. They also use their creativity and innovativeness to provide solutions to the world’s problems and help transform the future. Lecturers who teach Engineering courses offered at Diploma level in polytechnics play a critical role in students’ acquisition of practical skills and knowledge relating to industrial development worldwide. There is no doubt that the country’s economy, national security and everyday lives increasingly depend on scientific and technical innovation. Engineering is a key component of innovation and technological society. Changes on global scene are commonplace challenges and the national leadership is responding quickly by expanding Technical and Vocational Educational Training Institutes (TVET). In fact it is the government policy that every constituency should have a technical training institute. The government has doubled its efforts by extending Higher Education Loan Boards’ (HELB) loans to trainees in the technical training institutes. The government is seriously concerned about the declining interest on the part of Kenyan citizens in engineering studies and careers; and the poor performance in national examinations. The trainers who are lecturers, are considered key players in moving forward to improve engineering education. Through engineering education lecturers build competence based workforce for key industries. The performance of students in engineering courses in national polytechnics was unsatisfactory and a serious concern. The unsatisfactory performance could have been due to many factors such as students’ attitude, students’ entry behaviour, teaching learning resources, infrastructure, lecturer characteristics, location of the polytechnics and the nature of curricula as suggested by the literature review. The objective of this study was therefore to determine the influence of lecturer characteristics on academic achievement of trainees in engineering courses in national polytechnics in Kenya. This study established that lecturers’ age and experience significantly influenced academic achievement of engineering students while lecturers’ qualification did not statistically influence students academic achievement significantly.

  154. Cheena Garg, Arjun Agarwal, Ranjan Agrawal and Parbodh Kumar

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

  155. Solomon Tadesse and Tekalign Assefa

    The government of Ethiopia has been implemented participatory forest management (PFM) program since 1990s, with twin policy goals of promoting sustainable forest management and improving livelihoods. However, the benefits of this program intervention for forest conservation and livelihoods are not systematically studied and well documented. This study assessed the contribution of PFM program to forest conservation and the livelihoods in Nono sele woreda, southwest of Ethiopia. Data were collected from 241 randomly selected households. A mixed research approach, which integrates household survey, focus group discussions, key informant interviews and field observations were used for this study. Quantitative data were analysed using the Statistical Package for Social Science (SPSS version 23).The findings revealed that improved forest conservation and socio-economic conditions of the local communities were observed after the implementation of PFM in the study area. Expansion of agriculture into forest areas and settlement in the forest has been reduced as reported by vast majority of the respondents 83.4% and 87.1% respectively, while secured right of access to non-timber forest products and household incomes were enhanced as reported by 84.2% and 63.1% of the respondents, respectively. In order to sustain the PFM program, there is a need to provide more tangible economic benefits and alternative income-generating activities to the local communities. Thus, we recommend that Oromia Forest and Wildlife Enterprise and other non-governmental organizations should work on forest and non-forest based livelihood activities.

  156. Akbar Maulana, Sasongko and Bagus Sigit Sunarko

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

  157. Dr. Arti Sakral, Dr. Abhishek Chowhan, Dr. Nidhi Sharma, Dr. Naina Dogra and Dr. DevRaj Dogra

    Background: Dermatology and psychiatry have an embryonic connection. Dermatological disorders are said to be associated with significant psychological distress and poor quality of life. Our study aims to find out psychiatric morbidity in a treatment seeking population in dermatology outpatient clinic. In addition, quality of life of these patients will be assessed. Methods: 300 outpatients with various dermatological disorders were assessed for their psychiatric morbidity and quality of life. Hindi version of the 12-item General Health Questionnaire (GHQ) and Hindi version of the Dermatology Life Quality Index (DLQI) were used. Percentages were calculated and results analysed. Results: More females visited the treatment facility. Acne, contact dermatitis and tinea were the commonest diagnosis in the sample. More psychiatric distress and poor quality of life was observed in chronic dermatological conditions like systemic sclerosis, psoriasis, pemphigus and vitiligo. Conclusions: This study has brought forward important connections between dermatological illnesses and psychiatric disorders. A holistic approach in management of dermatological illnesses including psychiatry and dermatology and is therefore warranted.

  158. Imam Sunarto, Akhmad Toha and Selfi Budi Helpiastuti

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

  159. Plora Novita Febrina Sinaga, Sri Rahayu Sanusi and Etti Sudaryati

    Background: pregnant woman must have adequate and nutritious nutrition during pregnancy for the process of growth and development of the fetus. Pregnant women who experience malnutrition during pregnancy such as lack of iron intake, it will cause adverse effects on the mother and fetal growth and development. Lack of iron intake in pregnant women can cause anemia. Aims: to analyze the influences of age, antenatal care visit and adherence with Fe tablet consumption toward the incidence of anemia in pregnant women. Methods: This study was observational analytic with case control research design. Respondents were 88 using by purposive sampling. Collecting data were questionnaires guideline. Analysis data were Chi-square and Manova. Results: there was a significant influence between age on the incidence of anemia in pregnant women p=<0.001, there was a significant influence between ANC visits to the incidence of anemia in pregnant women in the Medan Johor Health Center Working Area in 2019, p=<0.001, and there was a significant influence between adherence to consumption of Fe tablets to the incidence of anemia in pregnant women in the Medan Johor Health Center Working Area in 2019 p=<0.001. Conclusion: to overcome the problem of anemia in pregnancy is by early detection of complications and complications in pregnancy through the ANC service program, in the form of a pregnancy check-up of at least four visits namely at least once in the first trimester, once second trimester and two in the third trimester. Pregnant women who do not routinely make ANC visits are at risk of developing complications in pregnancy, one of which is the incidence of anemia.

  160. Dinku Gebeyehu and Solomon Mekonnen

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

  161. Dr. Prathusha Subramanian, Dr. Darimeka Kharbuli and Dr. Swarga Jyoti Das

    Peripheral giant cell granuloma appears as a solitary purplish-red nodule, having vascular or hemorrhagic appearance, with or without surface ulceration. It may be a sessile or pedunculated lesion on the gingiva or the alveolar crest, common in relation to incisors and first molars. It occurs in response to local irritation from the connective tissue of the gingiva, periodontal ligament or periosteum of the alveolar ridge and may occur in periimplant tissues and edentulous arches. They are more common in females than males, more frequently seen in mandible than maxilla. Their growth potential is very high,and may penetrate interdentally to involve the adjacent cortical bone. An accurate diagnosis based on the histological observation is vital for its management. Considering its rapid and penetrating nature of its growth, surgical excision including its base is recommended to prevent the recurrence.

  162. Dr. Shashikanth Hegde, Dr. Jyosthna G Madhurkar, Dr. Rajesh Kashyap, Dr. Arun Kumar Maiya and Dr. Vijay Desai

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

  163. Dr. Pawan k Sharma and Dr. Pity Koul

    Background: Adolescents are the future of the nation, forming a major demographic and economic force. One of every six person is an adolescent. There are about 1.2 billion adolescents with the age group of 10-19 years, which comprises sixteen percent of world’s population. Studies have shown that relaxation training has tremendous effect in decreasing anxiety. In present study a combination of Deep Breathing, Progressive Muscle Relaxation and Laughter Therapy was included. Objectives • To assess and analyze the level of anxiety among adolescents, • To prepare a multi component intervention programme for adolescents with anxiety, • To evaluate the effect of multi component intervention programme (MCIP) on anxiety level of Adolescents. Methods: Descriptive approach with Quasi experimental Pre-test Post-test Control Group design was used to conduct the study. The study was conducted in two phases. In phase I total enumeration sampling was used to assess the prevalence and level of anxiety among 1447 study subjects using standardized tool i.e. State Trait Anxiety Inventory (STAI). In phase II, study subjects who were having high to extremely high state anxiety scores were selected and Multi Component Intervention Programme (MCIP) was implemented once in a day for 15 days. Anxiety in study subjects was re-assessed with State Trait Anxiety Inventory (STAI) after 15 days. Results: Finding revealed that in phase I majority 51.14% study subjects had average state anxiety followed by 20.73% with high state anxiety as measured by STAI. In phase II MCIP was implemented and findings revealed that MCIP was effective in reducing the anxiety of adolescents. Association of anxiety with Gender, Family income and Class was found to be statistically significant among study subjects. Conclusion: The present study confirms the prevalence of anxiety among adolescents and highlights the need for immediate attention towards strategies in reducing the magnitude of the problem. Teachers can play a vital role in early identification of anxious adolescents and helping them in promotion of their psychological functioning thereby improving their self confidence, social integrity and social interaction.

  164. Abu Qouder Fouze and Prof. Miriam Amit

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

  165. Pratiwi Lumbantobing, Erna Mutiara and Tukiman

    Background: Data from the Medan District Health Office in 2015, that the coverage of assistance during delivery by medical staff was 82.38%, postpartum health services was 80.80%, a woman postnatal received vitamin A was 80.80%. Objective: to find out the determinants of utilization of postpartum health services. Methods: The research was an quantitative research with explanatory survey design with cross sectional approach. It was conducted in the working area of Medan Belawan Public Health Center, Medan Belawan Subdistrict. The study population was all mothers who passed the postpartum period and had biological children aged 6-9 years who resided in the working area of Medan Belawan Public Health Center in 2015 as many as 1,385 people. The study sample was a portion of a population as many as 102 people. Sampling using purposive sampling technique. Data analysis used univariate analysis, and bivariate analysis with chi-square test. Results: the determinants of utilization of postpartum health services in the working area of Medan Belawan Public Health Center, Medan Belawan Subdistrict, were knowledge (p=0.032), ownership of Mother and Child Health Books (p=0.026), information source (p=0.003), and maternal conditions (p=0.001). The variable maternal condition is the most contributing and most dominant variable in determining the utilization of postpartum health services which has an Exp (B) value of 26.89. Conclusion: It is recommended to the Medan City Health Office and medical workers to improve socialization about the use of postpartum health services, train and guide cadres in the utilization of postpartum health services for postpartum mothers, fill out and check and inform about maternal and child health books, and provide information about everything regarding utilization of postpartum health services and reminding mothers of the time of their next visit.

  166. Dr. Shibu Puthenparambil

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

  167. Tomoyuki Nishizaki and Akito Tanaka

    The linoleic acid derivative DCP-LA serves as a selective activator of PKCε. The present study aimed at understanding the mechanism underlying PKCε-regulated α7 nicotinic acetylcholine (ACh) receptor trafficking. DCP-LA specifically bound to N-ethylmaleimide-sensitive factor (NSF) in lysates from the rat brain. PKCε, activated by DCP-LA, phosphorylated NSF at the serine residues, but not the threonine residues, in differentiated PC-12 cells. DCP-LA enhanced an association of NSF/α7 nicotinic ACh receptor in PC-12 cells, and the effect was cancelled by the PKC inhibitor GF109203X. DCP-LA increased cell surface localization of α7 nicotinic ACh receptor in PC-12 cells, which was abolished by GF1090203X or knocking-down NSF. DCP-LA also increased cell surface localization of α7 nicotinic ACh receptor in rat hippocampal slices, and the effect was suppressed by GF109203X, the vesicular transport inhibitor latrunculin B, or the vesicular exocytosis inhibitor botulinum toxin A. Collectively, the results of the present study show that PKCε, activated by DCP-LA directly binding to NSF, phosphorylates NSF at the serine residues, facilitates an association of NSF/α7 nicotinic ACh receptor, and stimulates NSF-dependent vesicular exocytosis of α7 nicotinic ACh receptor.

  168. Dinku Gebeyehu, Solomon Mekonnen and Fisum Alemayehu

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

  169. Husamath Parayi and Dr. Shobhana Nayak –Rao

    Non –traumatic subarachnoid hemorrhage (SAH) is an uncommon occurrence in hemodialysis patients and has been infrequently reported in medical literature so far. We report a case of spontaneous, non-aneurysmal SAH in a young maintenance hemodialysis patient with a poor outcome. The dialysis prescription following bleeding needs to be modified in these patients in order to prevent further worsening of cerebral oedema and progression of hemorrhage. Switch over to peritoneal dialysis or continuous forms of renal replacement therapies with regional anti-coagulation is the best option for such patients till neurologic stabilization is achieved.

  170. Dr. Shibu Puthenparambil

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

  171. Venkatesan Manickam, Chandramouleeswaran Venkatraman, Lakshminarasimhan Ranganathan and Kannan Vellaichamy

    Objective: This study aimed to compare the cephalometric and anthropometric characteristics of obstructive sleep apnea (OSA) patients with those of healthy subjects and to determine possible relationships between cephalometric and anthropometric measurements of OSA patients and control subjects. Methods: Standardized lateral cephalograms of 10 OSA patients and 10 healthy controls were obtained. Airway dimensions and dentofacial parameters were measured using a cephalometric analysis program .Anthropometric assessment was done in all of them. All statistical analyses were conducted using SPSS version 17.0.0. Descriptive statistics were calculated for all measurements, and the Mann–Whitney U test was used to evaluate intergroup differences. Results: Midface length was shorter in the OSA group than in the controls (P<.05). SNA, SNB angles were similar in both groups. The axial inclination of the lower incisor to its respective plane was normal, and the upper incisor was not significantly protrusive in the OSA group. Distance between the hyoid and mandible was significantly greater in the OSA group than in the controls, indicating that the hyoid bone was positioned more downward in the OSA group (P<.05).soft palate length was significantly longer and posterior airway space was significantly reduced in OSA group. Anthropometric analysis revealed significantly high mallampatti score>3, high waist hip ratio, neck circumference, reduced lateral neck length and high BMI in OSA group. Conclusions: In this study, the patients with OSA demonstrated significant differences in several craniofacial measurements and anthropometric analysis. OSA patients showed reduced posterior airway space, increased soft palate length and inferiorly placed hyoid bone and Mallampatti score>3,increased waist hip ratio, neck circumference, neck to height ratio, reduced lateral neck length and high BMI.

  172. Dr. Shibu Puthenparambil

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

  173. Obenebob Ayukosok

    There is obvious need to have the safest working environments and the best quality of health care delivery for patients by nursing students on clinical practice/learning. Effective social support is one of the very important steps in achieving his goal. This paper identifies the majorsocial support required for managing stress in nursing students during clinical learning and the most effective management and coping strategies as contained in literature. The paper employed a qualitative method involving a review of secondary data and the application of content analysis. The Transactional Model of Stress and Coping by Lazarus and Folkman formed the theoretical framework for this study. Findings from this study indicated that a combination of physical factors, administrative and organisational malfunction, psychological factors and interpersonal conflict are the major sources of stress for nursing students during clinical practice. On the other hand, the best management and coping strategies for nursing students involves combination of personal coping skills, effective organisational plans and social support.

  174. Nirmalkumar, K. and Ganesan, T.

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

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