December 2022

Background: The contribution of adverse consequences of preterm birth to gestational age related risk of cerebral palsy (CP) has rarely been studied. Objectives: To determine the relationship of Mother's Age at conception, Birth Environment and Gestational age at birth with the Type and distribution of Cerebral Palsy. Methods: Study design: Correlation Study, Total number 50 CP children were selected for study, diagnosed by pediatrician. The reported data was converted to the terminology suggested by the SCPE 2000 for convenience. CP children were divided into a preterm and term group, spastic (unilateral, bilateral) and non spastic group (athetoid, ataxic). The age of mother at the time of conception in years was categorized as in travels of five year between 16-40 year age groups. Birth environments divided in to Supervised and unsupervised delivery. Result: The demographic profile of 50 respondents( mother’s age at conception) showed that 10 (20 %), 20 (40.0%), 13 (26 %), 5(10%), 2 (4 %) were in the age group of 16-20 yesrs 21-25 years, 26–30 years, 31–35 years, and 36-40 years respectively. Conclusion: In preterm infants spastic CP is predominant. In term infants the non- spastic form of CP is more prevalent than in preterm infants. And doctor reduces the risk of prevalence of cerebral palsy in most common type of CP in diplegic group.

Physicians are trained and keen to treat their patient efficiently and effectively, and one of the important aspects of the consultation is communication skills especially breaking bad news. There is a limited number of studies done about the knowledge and practice of breaking bad news. The main objective of this study is to explore the knowledge and practice of breaking bad news among physicians in King Fahad Hospital Madinah 2018. This research is a Cross-Sectional descriptive study, sample size was 208 physicians working in king Fahad Hospital Madinah. About half of the participants are facing difficulties in breaking bad news, despite more than half of them have received training in Breaking Bad News (BBN). Although a good number of physicians showed acceptable knowledge in breaking bad news but their practice not as expected based on their knowledge. Effective training in breaking bad news will influence the patient-doctor relationship which will rise the quality of health service.

Background: To investigate the effects of water pollution on the diversity of zooplankton, a study was conducted in the Gagribal Basin of Dal Lake for a period of six months on a monthly basis from mid-March to mid-September (2021) in three different seasons. Methods: Water samples were collected for physico-chemical examination from the lake's surface in 1 L polyethylene bottles at inlet and outlet locations of Basin, and they underwent APHA analysis (1998). Using a Sedgwick-Rafter (S-R) counting cell, the zooplankton was quantitatively counted. Results: During the study period, there were 40 taxa of Rotifers, 26 taxa of Cladocerans, and 11 taxa of Copepods in the zooplankton population. At Inlet of Basin among the Copepoda Eucyclops agilis, Cyclops albidus, was found in all the three seasons but in decreasing order, Alona rectangulata was found in all the three seasons in an increasing order, Bosmina longirostris showing abundance in Grishum season. Camptocercus sp was found uniformly in all the three seasons. Among the Rotifers Brachionus angularis, Asplanchna pridonta was found in all the three seasons showing dominance in Grishum season, and also Ascomorpha sp was found in all the three seasons. While at outlet among the Crustaceans Graptoleberis testudinaria , Eucyclops speratus was found in all the three seasons in an increasing order while as Bosmina coregoni was found in decreasing order. Among the rotifers Brachionus calciflorus was found in all the three seasons in decreasing order. The overall alkalinity suggests that the water was relatively hard in both places. The high chloride content of the lake's water was a sign that organic contamination existed. Overall, the Gagribal Basin of Dal Lake has alkaline, somewhat hard, and nutrient-rich NO3-N water. Conclusion: It was concluded that the zooplankton performs a crucial role, serves as bioindicators, and is an excellent instrument for assessing the level of water pollution.

Teaching as a profession is becoming more challenging and demanding each day and has now been identified as one of the most stressful professions (Olivier & Venter, 2003). Teachers under occupational related stress are not able to achieve the expected high levels of performance leading to inefficient delivery of education (Kyriacou & Chien, 2004). This study investigated the influence of stress to teacher performance of the 268 secondary school teachers from Zamboanga del Sur schools’ division, in the school year 2021-2022. This study utilized quantitative design and specifically used the descriptive - correlation with modified and adapted questionnaire to gather the necessary data. The results and findings concluded that the level of occupational stress factors among teachers were found to be moderately stressful along task overload, challenges met with Generation Z and financial security. The findings also indicated that there was a significant association between occupational stress and the distance from home to work profile of teachers. Moreover, teachers were found to be developing along professional growth and development and special assignment tasks. Thus, it can be concluded that Zamboanga del Sur division teachers were not well-trained in action research and workshop facilitation. Based on the examined variables there was a slight positive correlation in the level of teacher’s occupational stress and their performance, as the level of stress increases, the performance level also increases. However, as stress begins to be perceived as excessive and unmanageable the performance level starts to decline. It is recommended that the Department of Education (DepEd) may adapt stress management programs before teachers’ occupational stress level becomes severe or extremely stressful and they can no longer successfully cope. Stress management programs such as stress counseling through telecounseling and engaging in zumba activities may be applied. In addition, there may be trainings on the basics of financial management, continuous peer mentorship and coaching on conducting action research, teachers may be given opportunities to advance professionally and be trained facilitators in any trainings, seminars, or teacher conferences.

Autism is a neuro developmental disorder of clinical and genetic heterogeneity affecting males three times more than female children. Autism is characterized by a deficit in social interaction and communication, restricted repetitive, aggressive, and stereotyped behavior, motor function deficits, disturbed sleep patterns, abnormality in gastrointestinal functions, epilepsy, and intellectual disability. It is also known as an autism spectrum disorder (ASD) due to diverse risk factors that might be inheritable genetic factors (40-80%) or de novo gene mutations causing multiple phenotypic expressions such as neurocognitive impairment and physical abnormalities. The interplay of genetic (monogenic and multiple gene variants), nongenetic and environmental factors contributes to the predisposition of ASD. A clinical genetic investigation is important to rule out the underlying cause and manage the disease accordingly with the best possible clinical interventions. This review is a step toward understanding the orchestra of genomic and epigenomic interactions, their mechanisms, and pathways influencing the phenotypic expressions which are crucial for both diagnosis, as well as the management of ASD and for novel interventions.

Purpose: This study looks at the factors that influence capital structure in Nigeria's manufacturing sector, with the goal of determining how they affect a company's ability to get financial leverage. Design/methodology/approach: The impact of profitability, business size, tangibility, and liquidity on debt is investigated through a survey of 70 companies conducted over a ten-year period, from 2007 to 2016. Long-Term Debt-Equity (LTD-E) and Long-Term Debt-Total Assets (LTD-TA) ratios have been proxied by capital structure. Findings: The findings reveal that ROA has no discernible impact on the LTD-TA ratio. The variable has a considerable and favourable effect when the capital structure is represented by the LTD-E ratio. The LTD-TA ratio was significantly influenced by size and tangibility, while the effect on the alternate measure was statistically negligible. Both measures of debt indicated a negative and substantial influence of liquidity, indicating that firms invest excess liquidity and are apprehensive of tying up capital. Research limitations/implications: It is assumed that Nigerian manufacturing companies gain from the tax break. The firm size coefficients support the Trade-off Theory (TOT), while the liquidity coefficients support the Pecking Order Theory (POT). Overall, the results were influenced by the approximation chosen, and no one hypothesis dominated the others. Thus, management should decide how much external capital it will need to raise and take advantage of their core competencies to minimise cost of capital. Originality/value: To date, no Nigerian study studying the factors of manufacturing enterprises' capital structure is believed to exist. As a result, this research adds to the body of knowledge on industry-specific capital structure.

This study concerns the frequencies of monthly, yearly and seasonal numbers of rainy days in Dschang and surroundings for the period from 1976 to 2015 and their tendencies over this period. This investigation has revealed a slight time deterioration of these numbers accompanied by the reduction of the rainfall and pluviometry, particularly by the end of the considered period. This deterioration has been caused by the large scale destruction of the environment generated by the sudden augmentation of the populations of the city just after the creation of a classic university in Dschang. The proposed solution to this degradation is to give this area the green look she had before.

Orofacial and dental trauma continues to be a common problem for sports medicine teams. All sports have a risk of dental injury, but "contact sports" are thought to be associated with higher risk. Prompt assessment and appropriate treatment of the most common dental injuries can Tooth structure can be preserved or restored. Despite mounting evidence, mouth guards and mouth guard use have not kept up with increased participation in sports. Sports dentistry is one of the newest and most promising fields in dentistry. It mainly covers the prevention and management of sports-related dental injuries and related dental diseases. Sports dentists or teams assist athletes in the prevention, treatment, and diagnosis of dental injuries. The most important aspect of preventing sports-related facial injuries is wearing basic protective equipment such as helmets, masks and/or properly fitted mouth guards. Tooth trauma is the most common type of dental injury during sports. Many athletes are not aware of the health effects of mouth injuries or the risk of serious head and face injuries during competition. Dentists can play an important role in educating athletes, coaches and patients about the importance of preventing oral injuries in sports. The purpose of this article is to raise professional awareness and interest in referrals to sports dentistry.

Purpose: The goal of this study was to assess how competitive advantage can be achieved through supply chain performance measures. Methodology: A quantitative descriptive research approach was used in the study. The procurement specialists from Airtel Zambia, MTN, and Zamtel mobile communications businesses were chosen using the purposive sampling technique. Version 26 of the Statistical Package for Social Science (SPSS) was used to analyze the data. Results/Conclusion: The study found that that Price/cost enhances competitive advantage as demonstrated by mean value of 4.28 and a standard deviation of 1.180. Further, the research found that Quality enhances competitive advantage of an organization as shown by an average value of 4.72 and a standard deviation of 1.203. Similarly, it was discovered that delivery dependability enhances competitive advantage as shown by mean value of 4.05 and standard deviation of 0.918. Additionally, the study found that Product Innovation enhances competitive advantage. This was shown by an average value of 4.31 and a standard deviation of 1.740. Lastly, the research established Time to Market enhances competitive advantage as indicated by an average value of 4.49 and a standard deviation of 0.815.

Introduction: Gastrointestinal stromal tumors (GIST) represent 3% of all GIT tumors (Lech, Korcz et al., 2015) and 85% of all mesenchymal tumors of the gastrointestinal tract (GIT), their biological behavior ranges from borderline to malignant depending on the size and the mitotic activity, tumor site, tumor vascularization and infiltration (Lech, Korcz et al. 2015). Patients and methods: This is a retrospective observational study comprising 90 cases of Giant GIST in the National Cancer Institute during the period from 2010 to 2020. Results: All the giant GIST patients underwent surgical resection, including 77 cases (91.7%) of R0 resection, 5 cases (5.9%) of R1 resection and 2 cases (2.4%) of R2 resection, besides, 16 cases (19.2%) underwent multiorgan resection and 24 cases (28.6) underwent lymphadenectomy. Discussion: To our knowledge this is one of the largest series of published Giant GIST. Many case reports of giant rare subtypes of GISTS were published. The incidence of the large size of the tumors in this study is 40.4% which is high compared to the published data estimating that only 20% of GIST tumors present as giant GIST., this is because most of the GIST are diagnosed after reaching very large sizes causing symptoms(Kimura, Togawa et al. 2020). Conclusion: Complete surgical excision combined with targeted therapy imatinib can improve the prognosis significantly whether used in the neoadjuvant setting to downsize the tumor or in the adjuvant setting to decrease recurrences. Overall survival and DFS in this study are excellent and comparable to the literature

The purpose of the study was to design and develop norms for Gymnastics of 4- 5 years children of West Bengal. There were 264 subjects who were beginners in Gymnastics already introduced to basic skills. No gender-wise grouping was done. The subjects were trained for 5 days a week, for 2 hours and for 36 weeks. After 9 months of training period, competition was conducted with an aim to collect data for the study. To test the reliability, a retest was conducted after 1 week of 15 subjects from the same group who were selected randomly. The descriptive statistics of the different parameters was found out by calculating mean and the variability was expressed by standard deviation. Correlation was analysed to test the reliability through the test-retest method. Finally, z-score of the data was calculated to develop the norms in Gymnastics for 4 to 5 years children of West Bengal by using the Z-scale.The norms for Floor Exercise of 4 to 5 years children, out of 20points designed from the z-scores of final scores as Very Good > 14.65, Good: 10.94 – 14.64, Average: 7.24 – 10.93, Below Average: 3.53 – 7.23 and Poor<3.53. The wide diversity of movements and positions makes it viable for children to develop a fund of quality sensory and motor pathways and make a positive stimulant on their psychosomatic status.

Energy is a limited resource that is used in reproduction, growth, and maintenance. For organisms to reproduce, energy may be transferred from maintenance to reproduction. We studied the effect of a single mating period on adult lifespan in Drosophila melanogaster to examine whether exposing female D. melanogaster to 0, 1, 2, or 6 male(s) for a 48-hour time interval would impact female lifespan while also examining how male competition during these intervals would impact male lifespan. We assigned females (n=20) to one of the four above treatments and exposed them to the designated number of males for a 48-hr time period, and we then isolated both males and females and monitored them daily for survival. There were no significant differences in the number of days survived between treatments for either males or females when comparing 0 versus 1 male or when comparing 2 versus 6 males. All four treatments could not be statistically compared because they were not conducted at the same time due to the number of virgins required for trials These results suggest that lifespan is not affected by the number of mates a female is exposed to or the number of competitors a male is exposed to. Further research could investigate whether 1 versus 6 males results in statistical significance.

Introduction: The increasing opportunities for medical students to participate in international, supervised and structured electives have been evidenced to enhance medical students’ professionalism, cultural competence and clinical reasoning (CR) skills in preclinical years. Evidence is scant in achieving the specific learning objectives and improving CR during senior-years. This study evaluates how supervised elective can improve medical students’ CR skills through bedside demonstration, case presentation and reporting. Methods: This qualitative pilot study recorded daily bedside discussions and cases collections with six students during international elective in a focus-group style. The recorded CR discussions and case collections form the students’ reflective themes including CR learning, journal case report writing and impact on ongoing learning. The individual interview design is based on SNAPPS feedback tool and PICO framework. We also collected 6-months/18-months/30-months post-elective reflections for evaluating longer-term academic impact of the elective. Results: The five domains of CR learning identified in daily students-supervisors discussions were reflected in-depth by students, and pedagogically evaluated by supervisors in a focus-group style and individual interview. The SNAPPS feedback tool and PICO framework enabled students’ completion of case reports for successful journal publication. Students’ reflections on their learning at the time of the exchange, 6-months, 18-months and 30-months post-exchange have demonstrated that the elective can improve CR skill learning, case report writing skill, clinical competency. Conclusions: This study demonstrated through students’ reflections that SNAPPS feedback tool and PICO framework are most valuable for CR learning, case presentation and reporting. The students’ reflections have provided insight into how this elective can improve students’ CR learning, enhance academic writing skills and facilitate competent clinical practice as junior doctors.

Morphometric properties represent a measurement of earth’s surface and processed according to the principles of quantitative analysis through the application of mathematics equation and statical methods to data from topographic maps and satellite. Morphometric analysis of watershed is an important aspect of watershed characterization. It usually consists of dimensional, aerial and relief aspects. Watershed development and management plans are very important for surface and ground water conservation. To prepare a watershed development plan, it becomes important to know the topography, lithology, erosional status and drainage pattern of the area. This study attempts to study the morphometric characteristics of Jatayu Ganga Watershed by using Geographical information system (GIS). The ArcGIS 10.4.1 has been accustomed to extrapolating various necessary parameters. The watershed delineated using SRTM data and on 1:50000 scale and Survey of India Toposheet as reference. In the present investigation various morphometric parameters of the Jatayu ganga watershed are outlined. Various morphometric characteristics of the Jatayu Ganga watershed have been assessed by applying GIS techniques and using SRTM data. Strahler’s, Horton’s and Schumm’s methods have been employed to assess the fluvial characteristics of the study area. Jatayu Ganga one of the major tributaries of Saryu River flows on eastern part of Almora district, Uttarakhand that occupies an area of 78.64Km2. The river amasses the water all over from 545 Perennial and non-perennial Streams which together forms the Jatayu Ganga watershed. Total length of all tributaries is 311.26 km. This analysis has shown that the relation of stream order (U) and stream number (Nu)which gives negative linear pattern that order increases with a decreasing number of stream segment of a particular order. Different morphometric parameters such as stream length (Lu), bifurcation ratio (Rb), drainage density (D), stream frequency (Fs), texture ratio (Rt), elongation ratio (Re), circularity ratio (Rc) and form factor ratio (Rf), relief ratio (Rh) have revealed the basin has dendritic pattern of drainage, indicating high relief and steep ground slope with less elongated young and mature landforms in which geological structures don’t have a dominant influence on watershed. Dendritic drainage pattern in the area shows that the area consists of homogeneous rock material, which is structurally undisturbed. The elongation and circulatory ratio reveal that the Jatayu Ganga watershed is highly elongated and flood flows are easier to manage than that of circulatory basins. The results clearly indicate relations among various morphometric attributes of the basin and help to understand their role in sculpturing the surface of the region.

In this paper, we deal the control problem for marine turbine systems in multimachine configuration. For this, we are modelling four interconnected marine turbine system and connected to an infinite bus by taking into account the multimachine interactions and the marine current dynamics. This multimachine system modelling is made through a transmittance matrix which uses the voltages and currents at each nodes of interconnection network. A decentralized sliding mode control is designed by using this multimachine model with taking into account the marine current constraints and multimachine interactions. Our proposed control law is applied on our multimachine marine turbine system in simulation under Matlab/Simulink environment with mechanical and electrical perturbations. The electrical perturbation is a short circuit of 200ms duration and the mechanical perturbation is the mechanical power drop of 50% of its value. The obtained simulation results prove that the proposed decentralized sliding mode control is able to well regulate our multimachine marine turbine system and preserves its performances despite the hydrodynamic perturbations and multimachine interactions. These results are compared to obtained results by the classical AVR-PSS (Automatic Voltage Regulator, Power Systems Stabilizer). The robustness test reveals that the proposed control law is better than AVR-PSS in precision terms and oscillation damping after perturbations.

Metoclopramide hydrochloride, a neuroleptic dopamine receptor antagonist used to treat gastric ailments, is reported to cause extrapyramidal movement disorder. Our case in rural district in Jazan, Southern area in Saudi Arabia the medical service provided by general practitioner, deal with simple cases only and refer the complicated one. A 44 years old Saudi male, came to primary health care center complain of epigastric pain after eating spicy meal he has epigastric pain localize not radiating and vomiting of whatever he drinks or eat he was assessed by general practitioner and diagnosed as acute gastritis, 10 mg metoclopramide, After he received the injection; the patient developed a spasticity and rigors over all his limps, difficulty of speaking and a noisy breathing was heard but not strider, his tongue was contracted and retracted. He remained fully conscious during this episode. The patient connected to monitor, Oxygen mask, and placed on lateral position, His SPO2 dropped to 81%, Metoclopramide was discontinued, A Promethazine was given, diagnosed as adverse effect of metoclopramide, After 10 minutes the breathing return to normal and SPO2 98% maintained in room air while the spasticity of the limps stopped after 2 hours.no further dystonic reaction were observed. Conclusion: Metoclopramide has rare adverse effects, but itsquite serious central nervus system disorders: Tardive dyskinesia, acute dystonic reactions, drug-induced parkinsonism, akathisia, other extrapyramidal symptoms, convulsive seizure, hallucinations, neuroleptic which need to be treated with well-trained health care providers and well equipped health facilities.

Aim: This study will be done to evaluate and determine the cause of ascites using USG meanwhile using laboratory paracentesis as a reference. Materials and methods: The study will be conducted in the department of Radio-Diagnosis and Imaging in co-ordination with the department of Medicine and department of Pathology at Acharya Shri Chander College of Medical Sciences and Hospital, Sidhra, Jammu. A total of 50 patients will be included in this study irrespective of the gender. Scanning technique of abdominal and pelvic ultrasound: All the US examinations will be performed using LOGIC C5 PREMIUM following a fasting period of atleast 4 hours. The results of the evaluation will be recorded on standardized proforma. Existence of septa-debris, accompanying organ pathology, omental involvement, intestinal wall thickening, peritoneal implants, lymph node, diameter of portal vein, thickening of gall bladder wall, pleural effusion, collateral vascular structure and cavernous transformation will be investigated on USG. Result of biopsy or surgical intervention will be regarded as the gold standard for the pathological diagnosis in all cases. Informed consent will be obtained from each patient. Immediately after the ultrasound examination within an average of 14 minutes interval), US guided paracentesis will be done under sterile conditions. Blood sample will also be drawn immediately after the paracentesis. The ascitic fluid and blood samples will be sent to the laboratory to determine ascitic albumin, cell count and differential as well as serum albumin and total protein. A portion of ascitic fluid sample will also be sent to the pathology unit for cytology. The serum and ascitic albumin values will be used to determine the serum ascites albumin gradient (SAAG). Results: In this study, a total of 50 patients with ascites will be included. In the present study, the age of the patients ranged from 05 years to 67 years. The mean age will be 48 years. The maximum number of patients 37 (74%) will be in the age group of 31-60 years. Out of 50 cases 39 (78%) will be supposedly having benign ascites and 11 (22%) malignant ascites.

The issues of economic integration and poverty are at the heart of concerns in the cities of Burkina Faso in particular and those of sub-Saharan Africa in general. For example, in 2019, the ILO unemployment rate in the cities of Burkina Faso was 10% compared to 7.1% nationally (1). Urban centers that were once an "El Dorado" for people looking for work have become places of growing poverty and misery. It is in this context that the informal sector has grown and constitutes a godsend for young people, educated or not. The objective of this article is to analyze the contribution of the informal sector to the socio-economic integration of the population in Po.The methodology adopted is based on documentary research, field observation, data collection through surveys and interviews with 245 people. The data collected was processed and analyzed. The results of these analyses showed that three categories of actors contribute to the distribution of products in Po. In addition, 100% of the respondents stated that the sale of various products is their main means of survival. The income obtained from the sale of products is used by 82% for current household expenses, 15% for projects and 3% for social events. In sum, the informal sector in Po has contributed to the creation of employment and the improvement of the socio-economic conditions of the population.

Introduction: Organophosphate intoxication can cause serious life threatening acute neurological complications such as seizures, paralysis, neuromuscular and cardiac conduction disorders. Less often, a predominantly motor and delayed axonal neuropathy can occur. This syndrome is due to inhibition of neuropathic target esterase. Case report: Herein we describe a 20-year-old-male patient who after ingestion of large amount of (200 ml) Chlorpyriphos based insecticide had an acute cholinergic crisis followed by development of lower limb weakness 8 weeks after initial exposure to organophosphorous. Pyramidal tract involvement was also observed as the patient developed spastic paraparesis in lower limbs. Electrophysiological study was characterized by motor axonal polyneuropathy. Conclusion: This was a case of organophosphate induced delayed neuropathy with myelopathy leading to spastic paraparesis. Hence all patients with organophosphorous poisoning should be under regular follow up and examined for neurological involvement.

Introduction: World health organization stated in 2109 report that 35 million people worldwide suffer from drug use disorders while only 1 in 7 people receive treatment. Further than the destructive effects for the person with drug addiction its negative effects can harm further people, pregnant mother affects her pregnancy. Materials and Methods: This is cross sectional study conducted between August to November 2022 in Jazan, it included all psychological and social workers in Iraha hospital for mental health, aiming to assess the perception of psychological and social workers about the of prevention services provided by Iradah hospital and the associated factors, data was collected with pre-structured and pretested questionnaire, and analyzed with Statistical backage of social science version 25. Results: (82.6%) were male, more than 80% fromage group 25 to 45, education levels varied from university level (78.9%) and post graduate (21.1%) , 81% were married and 66% lived in urban areas, only 35% of them think the addict have the knowledge about the addiction prevention services and 26.8% think the addict is willing to seek care those facilities. 87% of them agree about the role of family in prevention addiction as well as 87% agree that family breakdown leads to clutches of addiction, there is statistical significance between the sex of psychological and social workers (P-value 0.007) and their perception about the knowledge of addict in importance of addiction prevention services, 60% from both male and female agree about the role of different societies in addiction prevention with no statistical association (Pvalue 0.122) we found that female and age group (25-35) is an associated factors with a statistical significance (Pvalue.000) and (Pvalue.02) consecutively Conclusion: Psychological and social workers are a corner stone in addiction prevention and treatment services, they have a good perception about the role of family, community, education, sport and social support , they participate actively in health education and awareness raising activities, more effort is needed to be involving in research and be up to date countries experience in addiction prevention and treatment.

Introduction: The internal thoracic artery is known for its anatomical variations and their clinical implications. It has important anatomical characteristics that make it an excellent arterial graft for myocardial vascularization. However, data from the literature report variations regarding the origin, course, and termination of the internal thoracic artery. Through this dissection work we wanted to report a rare origin of the left internal thoracic artery directly from the thyrocervical trunk, instead of its usual subclavian origin. Material and methods: The dissected patient was a 64-year-old subject with no history of cervical region surgery or previous deformity. The cadaver showed no asymmetry about the shoulders or the lateral cervical regions, it had been preserved in a non-formaldehyde solution. Initially, on the subject in supine position, the lateral triangle of the neck was approached and a cleidectomy was performed. The subclavian artery and its collaterals were dissected, identified, and marked. The collateral branches of the subclavian artery were injected with a solution made from a mixture of gelatin, methylene blue and iron powder. Dissection of the subclavian artery and its collateral branches was then continued until their course was fully exposed. Results: On the course of the left subclavian artery and after the left vertebral artery, we found a thyrocervical trunk giving rise to 4 classic terminal branches, among which an oblique left internal thoracic artery due to its more lateral birth than d 'habit. Discussion and Conclusion: The left internal thoracic artery is the first choice in coronary bypass surgery because of the permeability of the graft. However, an abnormal origin of the internal thoracic artery on the thyrocervical trunk and a modification of its proximal course, can firstly increase the risk of vascular lesions during different invasive procedures of the lateral triangle of the neck. secondly, they can have circulatory consequences in the vertebrobasilar arterial system. It is important for the practitioner to resort to a morphological study of this region to expose and prevent this anatomical variation.

Lung isolation techniques and maintenance of one lung ventilation (OLV) with stable hemodynamics has always been a challenge to the anaesthesiologists. A detailed preoperative evaluation of the patient along with knowledge about the surgical plans and requirements is essential for proper planning of lung isolation strategies as different modalities are available for OLV currently. We are reporting the case of a young female, already operated for primary mid rectal carcinoma, now posted for bilateral pulmonary metastasectomy. OLV was achieved using an EZ bronchial blocker considering the surgical requirements of bilateral lung isolation. With a team of expert anaesthesiologist’s proper planning and good intraoperative management, patient was extubated on table post procedure with stable hemodynamics inspite of a prolonged surgery with bilateral lung isolation.

Marker assisted backcross breeding (MABB) is a promising strategy for improvement of elite crop varieties for one or more agronomical traits with minimal linkage drag. Akshayadhan is a high-yielding medium duration variety (135 days), whose yield is significantly limited by brown plant hopper (BPH) and gall midge (GM) insects. In the present study, we attempted to improve Akshayadhan for resistance against BPH and GM through marker-assisted backcross breeding (MABB). A rice line in the Abhaya, possessing the gall midge (GM) resistance gene, Gm4 and a rice line RP 2068 18-3-5 possessing the brown planthopper (BPH) resistance gene, Bph33 served as donors and two sets of backcrosses were carried out to combine Gm4 and Bph33 into Akshayadhan separately. Backcrossing was continued till BC2 generation, and gene-specific markers for the two resistance genes were used for marker-assisted selection at each stage of backcrossing in addition to phenotype-based selection for identification of plants closely resembling Akshayadhan. A single BC2F2 plant from each backcross possessing either Bph33 or Gm4 in homozygous condition and closely resembling Akshayadhan were intercrossed to generate inter-cross F1s (ICF1s) to combine the two traits. ‘True’ICF1s were identified using the gene-specific marker(s) and selfed to generate ICF2s, which were then subjected for marker-assisted selection to identify plants which are homozygous for both Bph33 and Gm4.. At ICF2 selected lines were subjected for screening against BPH and GM, all of them were observed to be resistant against the two insects and were advanced further by pedigree method for further evaluation. Further, the selected lines also were observed to closely resemble Akshayadhan with respect to agromorphological traits and possessed long-slender grains.

The advancement of technology allows for the adoption of smart systems operations exemplified by using autonomous vehicles in the logistics industry. Companies have embraced innovative technologies through the improvisation of truck platooning using autonomous networking. Approximately smart logistics using autonomous truck monitoring has attracted various benefits, such as reduced accidents and timely delivery of products to customers. However, it has drawbacks to high implementation costs and risk of data protection. Amazon has acquired the patent right for autonomous lane switching alongside testing various fully autonomous trucks in delivery through a partnership with independent manufacturing companies such as Embark.

Oil pulling is a traditional folk remedy practiced in ancient India. It is believed to cure more number of systemic diseases when practiced regularly and as directed. Due to occurrence of side effects to modern medicines and oral hygiene products, people are increasingly attracted towards complementary and traditional practices. Oil pulling is claimed to improve oral hygiene by killing number of microorganisms.