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March 2020

  1. Nirmala P. Ratchagar

    In this paper, we have examine the analysis of pulsatile flow in rectangular plate with multi-stenosis artery. The impact of Hall current in external magnetic field and electrically conducting blood fluid. Dispersion of blood vessels from couple stress fluid using method of solution is (i) Taylor dispersion and (ii) Generalized dispersion model. The velocity field, dispersion coefficient and mean concentration are solved analytically. Variation of different dimensionless parameters are graphically through the plots.

  2. Messina Ebogo, SW., Edouma J., Njock R. and Bombah, F.

    Introduction and objectives: Clefts lip and palate are congenital malformations due to a lack of fusion facial bud of the embryo between the 35th to 40thday of the intra uterine life. Cleft affects higher lip, palate and occasionally velum. The aim of our work was to describe the follow up of cleft lip and palate in Central Africa precisely in Cameroon. Methodology: To attain our aim, we have done a prospective descriptive and analytic study over a period of 25 months from October 2013 to November 2015 in Ngaoundere Protestant Hospital. Our sample was done by consecutive recruitment without limitation of the number of patients to include in our study. Results: Our study concerned 145 patients with 60% (n=87) of male and patients of the age of 2 to 9 years old gave 37.8% (n=55) of the total effective. Labio-alveolar cleft were the most frequent and represented 42.2% (n=61) of all clefts. The left part of the mouth was the most affected part registered 46.7% (n=21) and patients presented in majority a complete character of their malformations (62.2%, n= 78).84% (n = 122) of patients received 1 cleft repair while 11% (n = 8) had 2 repairs. Cheiloplastyaccording to Millardwas the mostpopularsurgical technique (95.6%, n = 138). Conclusion : Cleft lip and palate are congenital malformations causing many disorders as functional, esthetical and psychological aspects. So, considering troubles due to this malformation, it urges to include Bucco-dental Doctor and orthodontists in the multidisciplinary team for better follow up of clefts in our milieu. Many factors as genetic and environmental increase the risk to develop this affection.

  3. Mr. Prabhat Kumar and Dr. Abhijit Bora

    Mass Media since its advent has been a catalyst for social change. It has been the voice of the voiceless, marginalised and those at the periphery of developmental process. Women who constitute half the population of the world have been one such group who have been at the receiving end. Traditionally, they didn’t have same level of freedom of choices and access to opportunities as men due to various socio-cultural factors. But with the growth of media a change in the mindset has been observed. The aim of this paper is to try and explore the synergy between cinema and women empowerment. The objective is to understand the evolution in the representation of the issues of women in India through the lens of cinema and how it has acted as a tool of empowerment for women. In terms of methodology the paper uses empirical observation, content analysis method and secondary literature to explore the intended aim.

  4. Aschale Kassie Haile and Aklilu Aderajew Tsegaw

    This study has focused attention on discovering of the social capital of Sebat-bet Gurage people and examining its social and economic implications. The study basically focuses on the Sebat-bet Guraghe area in Guraghe zone, SNNPR, Ethiopia. A descriptive cross-sectional research design and mixed research approach have been used to gather relevant data. In-depth interviews, FGDs and household survey were the main instruments of data collection. A sample of 199 respondents were consulted in a self-administered questionnaire in attempt to collect data related to the social capital basis of Sebat-bet Guraghe people and its socio-economic value to the peoples’ lives. Descriptive methods of data presentation and analysis were utilized in the study. The findings show the existence of strong neighborhood and family ties; strong adherence to cultural institutions, values and norms that support solidarity and mutual help; culturally institutionalized ways of settling/resolving disputes through ‘Yejoka qicha’. In the study, Iqub and Iddir are identified as the most important self-help and mutual support cultural institutions among the people in the study are. The social system among Sebat-bet Guraghe was also found to be compassionate of natural resource preservation and conservation practices since it emphasized The Role of Community Participation and Customary Norms in the process. The role that community elders play in the community is found to have a contribution to maintaining peaceful social order and maintaining conformity of deviating members, particularly the youth. There is also a welcoming and fostering socio-cultural system where strangers could simply get accustomed to. The strong intra-community ties are contributing in many ways to improving the people’s livelihoods business engagements.

  5. Shu-Lung Kuo

    Currently, the types of treatment for oil-contaminated soil include soil vapor extraction (SVE), biological decomposition, solvent extraction, air stripping, activated carbon adsorption, and oxidation. Among these, solvent extraction, air stripping and activated carbon adsorption can only deal with the transfer between phases and must be supported with other types of treatment to complete remediation. Moreover, they are costly and could destroy local ecological systems. The objective of this study is to explore the fastest degradation rate of diesel contaminated soil and conditions needed for it through batch experiments, in which commercially available smectite is used as a catalyst carrier, modified into nano smectite-Fe catalyst using Fe+3, and reacted withH2O2to treat diesel contaminated soil. In terms of the basic properties of the test soil: the Lo series soil, it is characterized by high clay content, microscopic particles, relatively large specific surface area, extremely high cation exchange capacity, high soil density, and high organic matter content, which all contribute to the high diesel adsorption. As for the effects of smectite-Fe catalyst of various wt%and H2O2of different concentrations on the degradation rate of diesel contaminated soil, the result shows that the higher the concentration of H2O2, the higher the degradation rate of diesel, since smectite-Fe catalyst facilitated the formation of •OH at high H2O2 concentration during the beginning of the reaction. However, the degradation rate of diesel declined, and the shielding effect occurred more often when H2O2 of more than 5~10% of the total weight and more smectite-Fe catalyst were added to the catalytic reaction. Hence, it can be inferred that excessive H2O2 and smectite-Fe catalyst will exhaust catalytic sites. Although more electrons and •OH were formed when H2O2 reacted with the smectite-Fe catalyst, the amount of formed •OH decreased when the two reactedin the Lo series soil, signifying a decline in the catalytic activity.

  6. Onichabor P.O.

    Environmental issues disclosure and stock price volatilityhave featured prominently in the global debate on the financial market. Studies have shown that investors are agitated about stock price volatility due to non-disclosure of some vital environmental issues. Studies abound, especially in the created nations, on the impact of environmental issues disclosure onstock price volatility.This study investigated the effect of environmental issues disclosure on stock price volatility in Nigerian financial market. The study adopted survey research design by administering six hundred copies of structured questionnaire to the staff of eleven selected banks out of the twenty-one Money Deposit Banks in Nigeria as at 31/12/17, using event criterion based on those banks with complete information and continually listed during the period of the study 2008-2017. The regression analysis was adopted in testing the hypothesis formulated. The findings revealed that environmental issues disclosure had significant positive effects onStock Price Volatility (SPV) (Adj. R2 = .114,F (4, 476) =16.47,p<0.05)in the Nigerian financial market. The study concluded that disclosure of environmental issues influenced Stock Price Volatility in the Nigerian financial market. The study therefore, recommended that non-financial information should be captured in the financial statements to engender investors’ confidence in the Nigerian financial market.

  7. Kelvin Gatua Karugu

    The appraisal of Jesus by Muslims all around the world has greatly impacted the relations between Muslims and Christians. Githurai is not that big geographically but in recent times it has seen an increase in growth with Muslims and that has attracted to this research. For a long time the understanding of Jesus by both Muslims and the Christians have attracted attention over the centuries since the birth of Islam. The founder of Islam, Muhammad, who received the Quran inform of a revelation from Allah through angel Gabriel, develops the ground breaking understanding of Jesus as how he was viewed and seen during his time and especially around him. This understanding is grown from the Quran and the hadiths which reflects what Muhammad approved and disapproved and has led to the major discussion by Islamic scholars and leaders in all aspects of the Islamic teachings and theology. As a result of the appraisal of Jesus by Muslims in Githurai Christian Muslim relation has been affected. Conflicting and abusive language has been used in discussions involving Jesus thus causing tension. These have been experienced in several debates and open discussions which have been witnessed in Githurai. In the context of this subject Jesus appraisal by Muslims, the research was guided by three objectives, examining classical Islamic teachings on Jesus, assessing the contemporary perception of Jesus in Githurai, and exploring the implication of Jesus appraisal to Christian Muslim relations. The theory of interreligious hermeneutics, where both interpretation of the Quran, hadith and the interpretation from the encounter with Muslims was used, and the research techniques which was used was qualitative technique adopting a descriptive research design. The population targeted was 3000 as from the records of the church and the mosques that are in the area, though not all churches were considered. As a result of the population gathered, getting the whole population was not easy and therefore the researcher opted to use a small number of respondents that were available. Both Christians and Muslims were the respondents to this research. The researcher ventured into the field and come out with concrete findings, observations and conclusion of the subject of Jesus and his view by Muslims in regards to Christian Muslim relations, which was clear that there have been tension between the two faiths thus affecting Christian Muslim relations. The researcher concludes that Githurai is a growing area where the appraisal of Jesus is a threat to Christian Muslim relations. Therefore the researcher recommends that further study should be conducted in the area seeing to it how businesses can be used as agents of boosting Christian Muslim in the area.

  8. Tadesse G/Egziabher, Delelegn Tsegaye, Yemiamrew Getachew and Sisay Gedamu

    Background: Reducing maternal morbidity and mortality is a global priority which is particularly relevant to developing countries like Ethiopia. One of the key strategies for reducing maternal morbidity and mortality is increasing institutional delivery service utilization of mothers under the care of skilled birth attendants. Objective: To assess skilled institutional delivery service utilization and associated factors among mothers who give birth in the last one year in Mahal sayint woreda, South Wollo zone, North East Ethiopia. Method: A community-based cross-sectional survey was conducted among mothers who had delivered in the previous one year. Data were entered in to Epidata 3.1 and analyses were made by using SPSS version 20. Tables and graphs were used to present descriptive analysis. A bivariate logistic regression analysis was done to see the crude association between independent and outcome variables. After that multiple logistic regression model was done and significant statically association were considered based on adjusted odd ratio included in 95% confidence interval at P-value less than 0.05. Result: A total of 298 mothers were interviewed from 301 total sample sizes which gives 99% response rate. Of the total respondents, 251(84.2 %) gave birth at home due different reasons. Among these reasons ninety (30.3%) of the mothers said having closer attention from family members and 23.8% previous home delivery experience. Age, educational status of the mother, income and number of antenatal care visit were found to be significantly associated with the institutional delivery service utilization in multivariable logistic regression analysis. Conclusion: Majority of the respondents had a history of home deliveries due to many reasons so that attention should be given by health professionals and Mahal sayint woreda health office.

  9. Dr. Navneet Joshi, Sanjive Saxena and Rupal Dhyani

    A public sector undertaking may be defined as a business undertaking, which is owned managed and controlled by the State, on behalf of public at large. These undertakings have come to enjoy a unique position in the Indian economy in the post-independence era. They have been responsible for forming a strong industrial base and providing the basic infrastructure for development in the country. From an investment in 5 enterprises of Rs. 29 crores in 1950-51.Public Enterprises Survey 2017-18, 58th in the series, gives a consolidated picture of the Performance of Central Public Sector Enterprises (CPSEs) which are spread over length and breadth of the country. As on 31st March 2018, there were 339 CPSEs with a total investment of Rs. 13, 73, 412 crore. Over the years, Delhi Metro has become a role model for many things. To urban dwellers, it promises “modern” and “high-tech” public transport system. To governments, it is an easy means to earn “development credits” along with “public welfare”. To private sector, it has clearly a lot to offer since a lot of money is at stake. This also gets rewarding media coverage because of strong public relations (PR) management and it is also honored by various national and international agencies for its “achievements”

  10. Kouamé Bi Gooré Roland

    Cet article vise à étudier le lien entre le faible soutien dont bénéficient les filles-épouses âgées de 14 à 17 ans dans le mariage et leur astreinte aux pires formes de travail des enfants dans les quartiers précaires abidjanais. L’hypothèse stipule que peu soutenues par leur mari dans le foyer, nombreux des besoins de ces adolescentes restent faiblement satisfaits. Pour réduire cette insatisfaction, elles monnaient leur main-d’œuvre en pratiquant des pires formes de travail des enfants. Le cadre de référence théorique est constitué de la perspective systémique de la maltraitance infantile et de la théorie intersectionnelle des violences conjugales. Au plan méthodologique, l’étude documentaire, l’observation et les entretiens semi-directifs ont permis de recueillir des données auprès de l’échantillon d’enquête composé de 103 individus. Cette étude a recouru aux analyses qualitatives et quantitatives. En termes de résultats, les données recueillies indiquent que les jeunes mariées dans les quartiers précaires abidjanais sont faiblement assistées par leurs partenaires pour diverses raisons: indigence économique, polygamie, faible pouvoir de décision de la fille-épouse, conflits conjugaux, absence du conjoint. Insuffisamment assistées, ces adolescentes ont pourtant des charges à supporter: satisfaire leurs propres besoins alimentaires, sanitaires, vestimentaires, esthétiques, ludiques et entretenir leurs enfants. Pour faire face à ces charges, elles « vendent » leur force de travail au sein du foyer et en dehors du ménage en exécutant des pires formes de travail interdites aux enfants.

  11. Dr. Vijaykumar Girhe MDS, Dr. Tyagi G. Teltumde BDS and Dr. Prachi Dhananjay Datey

    Background: The most overwhelming area in head and neck area for essential threatening tumors are oral cavity and over 90% malignant growth comprises of squamous cell carcinoma (SCC). It has a high inclination for extensive lymph node metastases. There are different elements anticipating node involvement and among them tumor related factor is progressively dependable. Objectives: Correlation between the depth of invasion, tumor budding, and presence of satellite tumors in node involvement and treatment planning of T1/T2/T3 N0 M0 oral tongue SCC. Methods: Depth of invasion, tumor budding, satellite tumors were studied in 20 cases of T1, T2, T3 and clinically N0 nodes. Results: Tumor budding (5 clusters at the invasive front of the tumor) depths of invasion (2.5cm), presence of satellite tumors were associated with poor prognosis in patients with early oral tongue SCC. Conclusion: Analyzing the depth of invasion, tumor budding, and presence of satellite tumors in node involvement and treatment planning of T1/T2/T3 N0 M0 oral tongue SCC is recommended.

  12. Dr. Abhilash, E. Dr. Pushpa Nagar, Dr. Mahima Sharma and Dr. Surabhi Arora

    Aims and Objective: To evaluate the diagnostic role of vaginal fluid creatinine in PROM (premature rupture of membranes) and find out appropriate cut off value of vaginal fluid creatinine levels to predict PROM. Materials and Methods: It was a cross-sectional study including two groups with 50 women in each group. Group I included confirmed PROM and controls were included in Group II. Vaginal fluid sampling was done and creatinine levels were assessed in both groups. Data analysis was done by Student’s t-test, Receiving operator characteristic curve and chi square test. Results: The mean value of vaginal fluid creatinine (mg/dL) was higher in the PROM group than the control group (0.75±0.16 and 0.19±0.06 respectively). The best cut-off point for vaginal fluid creatinine for diagnosis of PROM was >0.34mg/dL, with 100% sensitivity, 100% specificity, 100% PPV and 96% NPV (P=0.001). Conclusion: Vaginal fluid creatinine is a simple, practical, cost-effective and easily accessible test and its incorporation in the low resource setting will be a game changer in the diagnosis of PROM.

  13. Dr. Aparna S Nirmal, Dr. Vishnu Sharma. M. (M.D; D N B), Dr. Arun Jude Alphonse, Adarsh, N. and Dr. Harshith, N.

    When a patient with COPD is admitted with acute exacerbation of dyspnea and chest x ray shows unilateral hyper translucency, most likely diagnosis is pneumothorax. Rarely other conditions may radiologically mimic pneumothorax. Treatment of pneumothorax in AECOPD is intercostal tube drain. But intercostal tube drain in other conditions which mimic pneumothorax radiologically can lead to complications. We discuss a case of translucent hemithorax in a patient with AECOPD which was mistaken for pneumothorax. Subject Area: Respiratory medicine Keywords: Unilateral hyper translucency; Bulla; Intercostal tube drain; AECOPD

  14. Jadhav Amit, B., Sanyal Pronob, K. and Priyanka Thorat, B.

    Introduction: Eye prosthesis is a kind of craniofacial prosthesis that replaces a missing or lost natural eye following an evisceration, enucleation or exenteration. Evisceration is a process in which just the contents of the eye ball are removed, in enucleation whole eye ball is removed and if there should arise an occurrence of exenteration eye ball along with its neighbouring supporting structures are expelled. Prosthetic rehabilitation of such cases should be possible by utilizing ocular prosthesis, orbital prosthesis and orbital prosthesis replacing the contiguous supporting tissues respectively. Background: A 37-year-old male patient visited the Department of Prosthodontics with a big concern about the difference in colour and size of the present artificial eye. Patient also gave history of trauma to the left eye 6 years back and the usage of the eye prosthesis for the last 3 years. Method: The patient was treated with ocular prosthesis by utilizing advanced impression technique to accurately record tissue surface of the eye socket and modified laboratory technique to help in holding the eye shell immovably in position with the assistance of a stainless-steel orthodontic wire. Conclusion: The current technique used to protect the eye shell during processing, combined with the modified functional impression technique allowed the artificial eye to move in harmony with the natural eye of the patient without being dislodged by movements.

  15. Kerilyn N. Godbe, BS, Alyssa N. Wenzel, BS, Zainab Ibrahim, MD, Airi Katoh, MD, 1Cynthia Morrow, MD and Douglas J. Grider, MD

    Background: There are limited epidemiologic studies characterizing skeletal metastasis, and fewer, if any, that comprehensively compare and contrast patients who are initially diagnosed with skeletal metastases of unknown primary (SMUP) to patients who have a known primary at the time that skeletal metastases are identified. Methods: This single-centered retrospective study provides a descriptive analysis of patient characteristics (demographics including but not limited to sex, age, and history of tobacco use), lesion characteristics (sites of primary lesion as well as number and location of metastatic lesions), and outcomes for patients identified as having SMUP compared to patients with a known primary cancer who have skeletal metastases. Results: In this study, 164 patients were identified as having bone metastases through record review of ICD-9 and ICD-10 codes. Of these patients, 65.9% had a known primary prior to identification of bone metastases while 34.1%were classified as having SMUP. Patients identified with SMUP were disproportionately male while patients with a known primary were disproportionately female. No other significant differences were identified for other patient characteristics. For patients with bone metastases with known primaries, the most common primary sites were lung, breast, and prostate carcinoma, in that order. However, the most common primary sites for patients with SMUP were, in order, lung, prostate, and breast carcinoma. The most common location for metastases, regardless of known or unknown primary was the spine, followed by the pelvis and the ribs. Lastly, with respect to long term prognosis, while there was a significant difference in patients’ survival time based on solely on SMUP status, there was no difference in survival once bone metastases were identified, regardless of whether the primary is known, as all bone metastases carried a poor prognosis. Conclusion: There are significant differences in the male to female ratio with respect to the initial presentation of bone metastases when comparing known primary to unknown primary malignancies. SMUP are more common in males than females, with 61% of males initially presenting with SMUP compared to only 39% of females presenting with SMUP. This finding warrants further evaluation of the etiology of this difference, which may potentially be clinically significant.

  16. Bayanduuren, B., Altankhuyag, B., Enkhbayar, Batbaatar, G., Mishigdorj, L., Bulganch and Gonchigsuren, D.

    Introduction: Worldwide, the highest incidence rates (up to 7.5 per 100,000 in men and 23 per 100,000 in women) occur among populations in the Western part of South America (Chile and Peru), in North American Indians, in Mexican Americans, and in northern India. The best characterized risk factor for the development of gallbladder cancer is chronic inflammation associated with gallstones. Metastatic clear cell carcinoma in the gallbladder is extremely rare, with reported frequencies of less than 0.6% in large autopsy reviews. Case presentation: 54-year-old female, with no prior medical conditions presented with a 10 days history of upper abdominal pain. Last 4 days ago right abdomen upper quadrant pain, vomiting. Routine hematological leukocytosis and biochemical tests were CRP increased. An abdominal ultrasound revealed the gallbladder is enlargement, about 6.0*3.0 cm like the mudstone in the gallbladder. GB wall thickening/double/. Common bile duct is dilated /1.2cm/. Computed tomography imaging: Moderate thickening with surrounding mild edematous changes in wall of the gallbladder. Size of the GB is moderated dilated with diffuse sludges. IHBD is no dilated, CBD is mild dilated 1.2 cm and no sign of biliary tract obstruction. An open cholecystectomy. Upon pathologic investigation, the morphologic and immunophenotypic features supported a diagnosis of clear cell variant of gallbladder carcinoma. Discussion: Gallbladder cancer was first described in 1777. Clear cell gallbladder carcinoma was first reported in 192. Clear cell carcinoma represents on average over 90% of all malignancies of the kidney. Approximately 20%-30% of patients with clear cell carcinoma have metastatic disease at presentation and nearly 50% of patients with advanced disease die within 5 years of diagnosis. Conclusion: Clear cell carcinoma very rare disease. Our team diagnosed during surgery and histological analysis. As a result of the surgery patient was completely healed and discharged from hospital. After from hospital discharged, we sent to national cancer center.

  17. Mohamed Magdy El Nagar and Amr Samir Shaheen

    Background: Despite known complications and a high recurrence rate, the standard treatment of pilonidal disease still consists of surgical excision of the sinusoidal cyst with primary wound closure. We were the first in Middle East to introduce a new treatment technique using SETON with a radial laser probe (Sinus Laser-Assisted Closure, SILACTM, Biolitec, Germany). Aim of the study: To assess the efficacy of laser (diode) SETON_SILAC as a therapy to the pilonidal sinus. Methods: A prospective study conducted in Hemocure Surgery Department, EL-Rahma Hospital and included 100 patient were operated with the SETON_SILAC technique by two surgeons from June 2018 to December 2019. Results: The median follow up duration was 1 year. The initial success rate was 96% (96/100).There were no complications during or after surgery. Mean patient satisfaction was 9.0 (3.0 to 10.0).Thirteen percent of patients did not require any analgesia, 37% used only when needed, of which 32% for less than one week and 10% for one to two weeks. Conclusion: SETON SILAC is a quick, safe and minimally invasive technique for destruction of the pilonidal cyst and sinus. Success rate and patient satisfaction are high, making this new therapy an attractive option for the majority of the patients with pilonidal disease. Long term results have to be awaited.

  18. Asamenew Endaweke Wale, Bedasa Tessema Hatehu, Asrat Demeke. Wendimu, and Dejen Agegnehu. Fente

    Background: Women’s empowerment is a process by which those who have been denied the ability to make a strategic life choices acquire such ability. Women’s empowerment increase with education and economic status and thereby influences fertility and also associated with contraceptive use. The main objective of this study was to investigate the determinants of family planning services focusing on women’s empowerment and gender related factors among married women or living with a partner in Dire Dawa Administration, Eastern Ethiopia. Methods: A community based cross-sectional community study design using cluster random sampling technique was employed. Data collection was done using self-administered questionnaire among 1,190 married women and data was fed and analyzed into SPSS 20. Descriptive analysis, factor analysis and binary logistic regression analysis were applied. Results: The finding revealed that 410 (34.5%) of married women were use contraceptive methods. The finding indicates that the older the women the less contraceptive user (OR=0.958) and Muslim married women were less contraceptive user (OR=0.482) whereas women were more contraceptive user when they made a decision on the use of contraceptive methods by themselves only. Women’s empowerment and many of the socio-economic and gender-related control measures were significantly associated with use of contraceptives. Dimensions of women’s empowerment representing women attitudes towards refusing sex, women’s reading media exposure and ownership of assets had a positive association with contraceptive use. Conclusions: The Ethiopian government has so far improved access to modern contraceptives, but utilization is still lagging, mainly due to lack of women empowerment, due to religious influence and limited contraceptive knowledge. Therefore, the government and concerned bodies should work to increase empowerments of women’s and usage of contraceptive method.

  19. Samiera Hassan, Junaid S Wani, AaliaRasool and Amina Shah

    Introduction: A trichobezoar is a mass of The relationship between preoperative keratometry (K) and visual outcomes in laser-assisted in situ keratomileusis (LASIK) has been studied in high myopia and hyperopia, but not in moderate myopia. Rao SK et al report increased under-correction in eyes with preoperative spherical equivalent (SE) of −10.0 to −11.9 diopters (D), and in eyes with flat corneas compared with steeper corneas. Williams LB et al, conversely, reported under-correction and loss of best spectacle corrected visual acuity (BSCVA) following hyperopic LASIK in eyes with steep corneas, compared with flat corneas.7Some refractive surgeons have expressed concern that a relatively steep postoperative cornea following hyperopic LASIK may reduce the quality of outcomes. However, published studies examining the association between postoperative keratometry and visual outcomes yield conflicting results. One possible reason for these conflicting findings is the covariance of postoperative keratometry with preoperative sphere. Specifically, higher levels of hyperopic correction typically result in steeper postoperative keratometry, but larger corrections (due to high preoperative sphere values) also tend to result in poorer outcomes, irrespective of keratometry. Therefore, to accurately assess how postoperative keratometry affects visual outcomes, an analysis must differentiate the effect of a large sphere correction from the effect of a steep postoperative cornea. However, studies with limited sample sizes may lack the statistical power to discriminate between these two effects, and most of the available published reports include fewer than 150 eyes. Aims and Objectives: To study the effect of flat cornea on the visual outcome following LASIK. Material and Methods: Our study was a Prospective observational study conducted at the LASIK centre at the Postgraduate Department of Ophthalmology, Govt. Medical College Srinagar. The study was conducted over a period of one and a half year on 89 patients (174 myopic eyes. The pre-LASIK examination included; assessment of uncorrected visual acuity (UCVA) and best corrected visual acuity (BCVA), slit lamp examination, biomicroscopy, non-contact tonometry, indirect opthalmoscospy, specular microscopy for measuring central corneal thickness and corneal topography. Inclusion Criteria: 1. Age >18 years. 2. A stable refraction change of less than 0.5 Diopters(D) in the last year 3. Preoperative cycloplegic spherical refraction between -1.00 D and -8.00 D of myopia and up to -3.00 D of astigmatism. 4. Preoperative best corrected visual acuity (BCVA) > 6/9. 5. Estimated residual thickness of the stroma of at least 250 µm after laser ablation with emmetropia being the goal in all cases. EXCLUSION CRITERIA: 1. Keratoconus or forma frustakeratoconus 2. Central corneal thickness < 450 µm. 3. Unstable refraction 4. Prior ocular and/or corneal surgery 5. Connective tissue disorder 6. Pregnancy and breast feeding 7. Severe dry eye disease. LASIK was done using the Moria One Use Plus micro-keratome (MoriaSurgicals, France) that creates a flap of 9mm with an intended thickness of 100 micro meter with a nasal hinge. Subsequent laser ablation was done with the Carl Zeiss Meditec MEL 80 (Germany) Excimer laser. All eyes were treated using an identical method with optical zone diameter ranging from 6.00 mm to 7.00 mm.Corneal topography was performed on ATLAS (ZIESS) machine. Analysis of the topographic maps was done besides measuring the corneal keratometry (K) in the flat and steep axis. Pre and postoperative average K = (K flat + K steep)/ 2 was calculated.Patient were examined post-LASIK at third month and corneal keratometry was done. Results: Table-3: Effect of keratometry on spherical equivalent Group Mean Pre-LASIK Keratometry No. of Eyes Mean Spherical Equivalent Post Lasik Spherical Equivalent A 40.12 35 -4.00 -0.75 B 44.00 118 -4.25 -0.25 C 45.50 21 -3.75 -0.25 Our study showed that Group A with mean pre-LASIK keratometry of 40.12D had mean postlasik spherical equivalent towards higher myopic side ie 0.-75diopter as compared to Group B and C with residual spherical equivalent of 0.-25diopter. Discussion: Our study showed that pre LASIK mean keratometry influences the visual outcome. The factors influencing the final visual outcome was attributed to the fact that eyes with pre LASIK flatter cornea(mean k 40.12 D), showed a tendency towards under correction as depicted in Table 3. We grouped eyes according to pre- LASIK keratometry and found that the post-LASIK spherical equivalent was towards higher myopic side in group A with mean pre LASIK keratometry of 40.12 D as compared to other groups despite mean pre LASIK spherical equivalent being comparable in all the groups. Our results were supported by many studies, Our study concluded flatter corneas have a tendency towards under-correction

  20. Coskuntuna, L. and GÜL, S.

    Narbon vetch (Vicia narbonensis L.) requires lower rainfall than chickpeas, faba beans and lentils and may be proven a better legume alternative in ratio systems. Vetch was used in this trial as the silage material. This study carried out to determine the effects of lactic acid bacteria and inoculants as silage additives, on the fermentation and aerobic stability of vetch silage. Vicia narbonensis was harvested pot setting period and ensiled in silos type of glass containers. Each application consists of 3 parallel. Chemical and microbiological analyses, were conducted on the silage which was opened on the 45th day after it was ensiled. According to the analysis; control, LAB and LAB + enzyme groups of dry matter 23.03, 21.83, 22.52, pH 4.11, 4.00, 4.15, ammonia-nitrogen; 70.19, 129.44, 106.00 found. In conclusion, it was evaluated that chemical, pyhsical, and microbiological qualities increease with the addition of LAB and LAB + enzyme to the narbon vetch silage. Also use to narbon vetch silage material useful for storage conditions.

  21. Ms. Senthamizhselvi, V. and Dr. Jayasankari, S.

    Introduction: Culture includes customs, beliefs, laws, religious practices etc acquired through generation, which impacts prosperity and sickness.1 Breastfeeding is influenced by economy, religion, kinship system and the growing sophistication of communications and medical technology. Though there are many advantages in feeding breast milk, there are many cultural practices regarding breastfeeding are still present. Breastfeeding is culturally well accepted but inadequately practiced. Statement of the problem: A Study to Explore the Cultural Practices Regarding Breastfeeding among Postnatal Mothers in PIMS, Pondicherry. Objectives: To explore the cultural practices regarding breastfeeding among postnatal mothers. To associate the cultural practices with selected socio demographic variables among postnatal mothers. Methodology: Quantitative approach with Non Experimental Descriptive Research Design was adopted for the study. Formal permission was obtained from HOD, Dept of Obstetrics and Gynaecology for conducting the main study. 60 postnatal mothers who attended OBG units of Pondicherry Institute of Medical Sciences were selected using purposive sampling technique. Data collection was done using a Semi Structured Interview Questionnaire on cultural practices regarding breast feeding among postnatal mothers. The collected data was compiled for data analysis. Result: In the present study, Antenatal preparation for breastfeeding reveals that most of the mothers practiced cleaning the breast with soap and water while bathing 17 (28.3%), mothers had a practice of intake of more fish and garlic to increase the breast milk secretion 51 (85%), foods recommended culturally during breastfeeding period was egg and meat 34 (56.7%) , most mothers avoided the intake of mango 25 (41.7%) and cold beverages 23 (38.3%), still mothers had a practice of giving water 7 (11.5%), and sugar water 2 (3.3%) as first feed to the baby, still some mothers think that colostrums is a infectious milk and milk which has to be discarded. Mothers had a practice of temporary stoppage of breastfeeding if she was suffering from breast problem or any other ailments (fever) 25 (41.7%). Some mother had a practice of giving cow’s milk / formula feed when she is suffering from fever 50 (80.3%). Mothers had a practice of giving artificial feed during night time if she is suffering from breast problem and breast milk is not sufficient 44 (40%). Most of the mothers were not had a practice of breast milk storage 40 (66.7%). Conclusion: The findings of the study revealed that most of the postnatal mothers were still practicing the cultural practices regarding breastfeeding. There was a significant association between some of the demographic variables with cultural practices regarding breastfeeding. Elderly in the family place an important role in determining the cultural practice to be followed regarding breast feeding. Hence there is a necessity for providing information and education on myths and facts of breastfeeding for protecting and promoting healthy practices on breastfeeding.

  22. Mrs. Eswari, S. and Dr. Saravanabavan, V.

    Medical Geography is a multi-dimensional structure of knowledge and understanding the spatial aspects of human health problems and issues. Diarrhoeal disease claims almost two million children’s lives worldwide every year because their bodies are weak from lack of fluids and undernourishment. Africa and India alone lose 1.4 million lives to diarrhoeal diseases. UNICEF and WHO report that around four billion cases of diarrhoea are recorded each year, mostly among children under the age of five. The present study attempt to describe the diarrhoeal diseases among children and its association with environmental factor. The study area Madurai is located in the Southern part of Tamil Nadu, India. This analysis helps to understand which region has highly prone to diarrhoeal diseases and the causes of the diarrhoeal occurrence among children at Madurai city. This study analyzed the precipitating factors for the occurrence of diarrhoeal disease among children with reference to drinking water supply, personal hygiene and nutritional factors. The main aim of this study is to conceptualize the facts and bring out in a conceptual framework by applying Geographical Information System (GIS) and statistical analyses.

  23. Dr. Khaled Hashim Sultan and Dr. Ruthwan Suhaib Saeed

    Background: Rickets is a common condition characterized by growth slowness and bone age retardation due to mineral deficiency that occurs at the growth plate. Nutritional rickets in children is mainly due to vitamin D deficiency or due to dietary calcium deficiency which is very rare. Rickets has been known since Roman times, it derived its name from an old English word, WRECKTEN, meaning *to twist, the original account of the disease was by Glisson &Whistler in 1650, but not until the late 1880 was its recognized as a dietary deficiency disease and it was first successfully treated with cod liver oil in 1807 and by ultraviolet irradiation in 1919. Rickets is unlike most nutritional disorders in that it is more determined by cultural factors than social& economics. Objective: To find out the cause of nutritional rickets and to detect the main presenting symptoms and the distribution of rachitic signs. I also tried our best to reach the best recommendations that may decrease the incidence of nutritional rickets. Methods: This study was carried out on 100 patients with diagnosed rickets who were either seen at the outpatient dept or admitted in Bin –Sina teaching hospital in Mosul city (iraq) from September 2018 –Jun 2019.The criteria for diagnosis were physical findings, radiological studies and biological investigations full detailed history was taken from each case focusing on age group, type of feeding, economic state type of housing, season of birth and sun exposure strategy. The presenting symptoms at time of diagnosis were organized also. Results: (62%)of cases borne during winter, almost half of them were exclusively breast fed, the vast majority(89%) came from urban areas, all of them had history of a good sun exposure, the commonest presenting feature was a respiratory problem(42%), (97%) were proved to have wide wrist,(91%) had an excessive sweating, (62%) had a persistent open anterior fontanel and (81%) of them showed their first tooth between the age of 5_9 months. Conclusion: Nutritional rickets is still an increasing medical problem in Iraq specially in Mosul after a 3 years of a very horrible war which caused a significant nutritional deficiency among pregnant and lactating women and among the children themselves. Still I noticed the ignorance mothers about the importance of sun exposure.

  24. Mallick Yasmin, Shastry, V. G. R. and Das, I.

    A trichobezoar is a mass of undigested hair within the gastrointestinal tract. Trichobezoars are often associated with trichotillomania (hair pulling), and trichophagia (hair swallowing). Trichotillomania may be unconsciously or unintentionally done and is part of the DSM IV psychiatric classification of impulse control disorders ( Gastrointestinal Bezoars, 1991; Trichobezoar, 1972). In up to 18% of patients with trichotillomania, trichophagia occurs; one third of patients with trichophagia develop trichobezoars (Sood, 2000). Trichobezoars most commonly occur in adolescent females ( Lamerton, 1984). The site of hair pulling is most commonly from the scalp, but can occur from the eyelashes, eyebrows, and pubic area ( Taylor, 1975). Trichobezoars commonly occur in adolescent females, often with an underlying psychiatric or social problem. Clinical presentation of these patients may be confusing as often they are not forthcoming with a history of trichophagia either due to embarrassment or the unintentional nature of the problem. Although this is a rare condition, numerous case reports and series have been reported as high mortality may follow complications associated with this condition. Trichobezoars in humans were first described from a post mortem by Swain in 1854 (Ratcliffe, 1982). The postulated reason for formation in the stomach is that hair is undigestable and due to its smooth nature cannot be propulsed with peristalsis and over time forms a bezoar within the stomach. Presentation ranges from nonspecific abdominal or epigastric pain, to a range of complications as mentioned. In 5% patients diagnosed with Trichobezoars , attempted endoscopic removals were successful and in 75% of patients attempted laparoscopies were successful. However, laparotomy was 100% successful and thus favoured as their management of choice.

  25. De Maynard, V. A.

    Introduction: Within context societal moral indignation and panic expressed in response to recent increases in urban violence and death amongst young adults in the UK, some researchers are asking whether exposure to video game violence (EVGV) might be a contributing factor. Methods: Using a correlational design, and web-based survey methods to collect data, the author examined the relationship between violent video games, moral disengagement, competitiveness, and trait aggression. Results: Commensurate with other studies, a small significant positive correlation was found between exposure to video game violence (EVGV) and reported trait aggression. Multiple regression revealed that EVGV explained an additional 4.5% of the reported trait aggression after controlling for age, sex, average violent video game difficulty, average violent video game pace of action, moral disengagement, and trait competitiveness. Conclusion: Moral disengagement might better explain trait aggression in young people exposed to video game violence in the UK, but violent video games along with other risk factors can act as potential primers for aggressive behaviours and cognition. Implications for public and mental health are discussed.

  26. Dr. Zahra Adnan Ahmed, Dr. Shatha Adnan Ahmed and Dr. Atika Waddah Mahmood Thabit

    Purpose of the study: is to review the ultrasound appearances of different clinical types of abortion . Since its, introduction in late 1950 ultrasound become very useful diagnostic tool in obstetric practice. Each abortion type has its own ultrasound appearances.

  27. Priya Mehta and Akshita Maheshwari

    Background: Upper crossed syndrome (UCS) also referred as Forward Head Posture (FHP) is a condition characterized by muscular imbalance where muscles of the neck and the shoulder girdle experience with weakness and tightness that affects head position, spine, and shoulder girdle. Literature reviewed that FHP has negative impact on respiratory functions. Objective: To study the effects of posture correcting exercises on respiratory parameters in individuals with upper crossed syndrome. Methods: 15 participants with defined upper crossed syndrome fulfilling the inclusion and exclusion criteria were selected who performed pectoralis major and minor, levator scapulae and upper trapezius muscles stretching exercise, middle and lower trapezius strengthening exercise and McKenzie exercise respectively. The aforementioned interventions were provided for 30 minutes per session, five times a week, for 3 weeks. Chest expansion, Peak Expiratory flow rate (PEF) and Acromian-Tragus (A-T) length were assessed using an inch tape, peak flow meter and a steel ruler respectively on the first visit and after completion of 3 weeks exercise protocol. Results: Statistical analysis was done by SPSS version 20 and Mann Whitney U Test was used. The results showed statistically significant improvement in Chest expansion (p<0.05) and Peak expiratory flow (p<0.05) post Intervention. Conclusion: There is significant effect of posture correcting exercises on respiratory parameters in individuals with upper crossed syndrome and they may be recommended as effective exercises to improve neck posture as well as respiratory functions in adults with UCS.

  28. Niladri Sekhar Bhunia

    A 6 months old male infant came with lethargy and poor feeding. On evaluation there was bradycardia. Positive family history of sibling death and hearing loss in another sibling were present. ECG shows long QT interval and B/L sensori-neural hearing loss. On the basis of long QT and hearing defect a diagnosis of Jervell- Lang - Nielsen syndrome was suspected and child was started on beta blocker therapy. epicardial pacemaker insertion was done and child was given discharge.

  29. Dr. Umesh Chandra Nayak

    Balasore district was part of the ancient Kalinga which later became a territory of Toshala or Utkal, till the death of Mukunda Dev. It was annexed by Moghuls in 1568 and remained as a part of their suzerainty up to the middle of eighteenth century, to be précised up to 1750-51.Then the Marahattas occupied this part of Odisha and it became a part of the dominion of the Marahatta Rajas of Nagpur. The East India Company ceded this part through a treaty called treaty of Deogaon in 1803 and it became a part of Bengal Presidency up to 1912.But the first English Settlement came into existence in Balasore region in 1634 while Sahajahan was the emperor at Delhi. The first of English factories was established in this region in 1640.During this period Dutch and Danish settlements were also founded in this region. Balasore as a separate district was created in October, 1828 while it was in the Bengal Presidency. With the creation of Bihar province, Odisha was diverted along with Balasore district from Bengal to Bihar But with the creation of Odisha as a separate State on 1st April, 1936Balasore became an integral part of Odisha State. The national movement of independence surged ahead with the visit of Mahatma Gandhi in 1921. Similarly PrajaAndolan was initiated against the ruler of Nilagiri State. The state of Nilagiri merged with state of Odisha in January, 1948 and became a part of Balasore district. In 3rd April, 1993Bhadrak Sub-division became a separate district and from this day Balasore remains a district of Odisha with two Sub-divisions namely Balasore and Nilagiri having 7 Tahasils namely Balasore, Soro, Simulia, Nilagiri, Jaleswar, Basta&Baliapal and 12 Blocks namely Bhograi, Jaleswar, Baliapal, Basta, Balasore, Remuna, Nilagiri, Oupada, Khaira, Soro & Bahanaga. The name of the district is being derived from the name of the town, which is old and important. The name Balasore is recognised from the Persian word BALA-E-SHORE which means “TOWN IN THE SEA”. The historical legend ascribes that the district has been named as per the LORD BANESHWAR (LORD SHIVA) of the town, which subsequently changed to Balasore during Mughal Rules. The History of Balasore District is the amalgamation of several cultures and civilizations colonized the region for a couple of years. The history of Balasore witnessed a quick succession of several dynasties in its bosom. As far as the history of Balasore District is concerned; there was a constant strife among the different rulers over the entire tract of the District. When the power of the indigenous Hindu kings falls short to retain their kingdom with a strong foundation, the Mughals and the realm of Balasore District was passed in the hands of Marhatta Rajas of Nagpur. Finally during the British expedition in India, the absolute political power came in the hands of the British Raj. The East India Company ceded Balasore District in 1803, through a treaty called as The Treaty of Deogaon and then it became a part of Bengal Presidency up to the year 1912. However, the first English settlement came into existence in Balasore region in 1634, while Sahajahan was the emperor at Delhi and the first of the English factories was established in this region in 1640. During this period, Dutch and Danish settlements were also founded in this region. Balasore, as a separate District was created in October 1828, while it was under Bengal Presidency. With the creation of Odisha as a separate state on 1st April 1936, Balasore became an integral part of Odisha State. The state of Nilagiri merged with the state of Odisha in January 1948 and then it became a part of Balasore District. On 3 April 1993, Bhadrak sub-division became a separate District and from this day onwards, Balasore remains a district of Odisha with two sub-divisions namely Balasore and Nilagiri. There are many historical monuments in the Balasore District. Some of the major monuments in Balasore District include the rich sculptural remains found in Ayodhya. The ruin of the old Buddhist monastery and temple is there in Kupali in Balasore District. Some of the ruined forts at the Jayachandi forests in Raibania are also there in the District. The major religious monument found in the District is the Lord Chandaneswar Shrine.

  30. Dr. Kabilan Saminathan, MS, MCh

    The usual procedure of choice in a staghorn calculus will be Percutaneous nephrolithotomy. In selected patients Anatropic nephrolithotomy or nephrectomy. In surgically high-risk patients we usually try multiple sessions of Extracorporeal shock wave lithotripsy combined with double J stent or percutaneous nephrostomy. We are reporting this unusual neurological patient who had a huge load of stones in both kidneys and ureters who responded well with complete stone clearance after just drainage of the system, with bilateral ureteric stents and continuous bladder drainage and antibiotics.

  31. Pathmavathy, R. and Ebanasar, J.

    The present study emphasizes on the prey composition of the communal spider Stegodyphus sarasinorum Karsch in four different stations of Sigur Plateau. Hence the biological pest control potency of S. sarasinorum was remarkable in the study area. Spiders are the best predators to regulate pest population in a sustainable manner. The investigation reveals that the spider species captured six different order of the prey from the roadsides and fencings of different study sites. Mostly the Hemiptera and Hymenoptera prey species were subsequently fed by the spider S. sarasinorum, while the Diptera species was found as least group.

  32. Anindita Mandal and Priyanka Malhotra

    Background: Health system for patients with Mental illness is a low public health importance at majority of developing or less developed nations. Those who are in need of treatment don’t receive required mental health services at a level of large public health facilities. They favour to seek care from easy-going community resources like traditional faith-based healers or quacks. Therefore, inadequate community-based formal mental health services leave native healers as ultimate and viable avenue for mental health treatment. Limited accessibility to mental health care facility affects the pathways to seeking care, makes it lengthy and lengthy pathway increase suffering period of clients and make their recovery difficult. Methodology: PubMed, Embess, Google Scholars and other electronic search engines were used to get high standard evidence regarding factors which cause delay in proper care or provide early engagement with quality health services to minimize expenditure and maximize prognosis. Results: The evidence of different sources indicate lack of literateness, superstition, cultural myth and lack of understanding about mental illness make patients available to faith- healers but general practitioners, community nurses, school teachers and social workers can work as door keepers to move patients to adequate level of mental health care. Conclusion: There is a need to focus and identify the factors of pathways to care that influence or act as barriers in public mental health service delivery in developing or less developed country. Because well regulated mental health practices both in public and private treatment centres can help to combat against discrimination of people with mental disorders and try to make them productive for themselves as well as for community.

  33. Mr. Lenin, R. M.Sc and Dr. Sujatha, S. M.Sc (N), Ph.D(N)

    Purpose of the study: Adolescent is a period of biological, psychological and economic transition. This period bridges childhood to adulthood. Adolescence faces many challenges in the development in today’s world. Risk taking is a common characteristic among adolescents and is initiated in early adolescents to late adolescents. Risk taking behaviour shapes future adults of the nation. 50% of school students itself engage in risk taking behaviour. Negative risk behaviour of adolescents brings challenges to legislative and policy responses. Statement of the Problem: A study to assess the risk taking behaviour and perceived health status among adolescent boys in Tagore arts college at Puducherry. Objectives 1. To assess the risk taking behaviour of the adolescents 2. To determine perceived health status among adolescents 3. To associate the perceived health status and risk taking behaviour among adolescents Method: An Quantitative approach with Non Experimental Descriptive Research Design was used and the study was conducted in Tagore arts college, Puducherry. The sampling technique used was Simple Random Technique. Data collection was done using a Self administered questionnaire with 5point likert scale for assessing risk taking behaviour and perceived health status. Pilot study was conducted with 20 samples of adolescents, at vivekanandha community college, puducherry to assess the feasibility for conducting the study. Prior to data collection permission was obtained from Principal, Tagore arts college for conducting the main study. The main study data collection was conducted among 110 adolescents by using Self administered questionnaire with 5point likert scale for assessing risk taking behaviour and perceived health status. The data collected was compiled for data analysis. Results: Frequency and percentage distribution risk taking behaviour among adolescent reveals that 36(32.7%)of participants were not having risk taking behaviour, 70(63.6%) of participants were having mild risk taking behaviour and 4(3.6%) of participants were having high risk taking behaviour. Frequency and percentage distribution of participants according to perceived health status reveals that 1(0.9%) of participant had fair level of perceived health status, 37(33.6%) of participants had good level of perceived health status, 65(59.1%) of participants had very good level of perceived health status and 7(6.4%) of participants had excellent level of perceived health status. Conclusion: The finding of the study reveals that there is no relationship between risk taking behaviour and perceived health status of the adolescents. There was no significant association between risk taking behaviour and perceived health status of the adolescents.

  34. Esmail, N.R., Darwish, A.M., ElShanshory, M.R. and Morsy, M.A.,

    Hospitalization and invasive procedures impose a significant anxiety in the young children. Children's anxiety of the invasive procedures represented in behavioral and physiological changes , which are upsetting them and their parents. In addition, it makes it more difficult to complete the needed procedure. One of the suggested methods to prepare children for invasive nursing procedures is to familiarize children with invasive procedures through therapeutic play. This study aimed to determine the effect of therapeutic play on the anxiety level as a preparation technique of children undergoing invasive nursing procedures. The study sample comprised 100 children of age 2-7 years, undergoing invasive nursing procedures. First admitted to Pediatric Department, Hematology/Oncology Unit at Tanta University Hospitals was included in the study. They were randomized into two equal groups: study group received therapeutic play before the invasive procedure and control group received routine hospital care. Two tools were used to collect the necessary data: the questionnaire sheet and the observation check list sheet. The main results yielded by the study proved that, significantly lower in anxiety level and physiological reactions to invasive nursing procedures in children underwent therapeutic play.

  35. Darrell Robinson

    Sickle Cell Anemia Disease is an autosomal recessive heredity disorder and it is a growing global health concern. It mainly affects people of African & African American descent, but it does affect people from the Mediterranean, the Middle East, the Caribbean, and Central and South America. Sickle cell anemia transforms healthy red blood cells into deformed sickle cells that restrict or completely obstruct the blood vessel causing weakness, susceptibility to infection, stroke, acute chest syndrome, and death. The highest mortality rates are in young children and infants. There are pain-suppression treatments for sickle cell anemia with the most prominent treatment being a bone marrow transplant from a matched donor, but there is yet to be a permanent cure. Mitigating drugs for sickle cell anemia include hydroxyurea and penicillin prophylaxis, but the drugs are not in commercial use and can sometimes not work due to mutagenicity of the disease. There are various levels of prevention such as genetic counseling and education, and newborn diagnostic screening. Due to various factors such as age, heredity, vitamin D levels, and even air pollution the clinical care knowledge and resources to handle sickle cell admissions is severely deficient. This makes sickle cell anemia remains one of the most misunderstood, silent killers on the planet.

  36. Dr. Mohit Biswas, Dr. Arjun Agarwal, Dr. Sharad Seth, Dr. Cheena Garg and Shubham Biswas

    Background: Soft-tissue sarcomas are a varied group of rare mesenchymal malignancies that can arise at any location in the body and affect all age groups. oft-tissue sarcomas arising from the abdominal wall mostly appear as palpable mass, abdominal wall deformity, or pain that is more clinically apparent. Case report: This case corresponds to a 44 years old female patient with ulcer over anterior abdominal wall extending up to the perineum since 1 year which gradually increased in size since 6 months. CT scan of the pelvis showed a large ulcerated soft density mass lesion in the abdomino-pelvic-perineal and inguinal region on right side measuring 23cm x 17cm x 15cm in size. The microscopic features from the biopsy showed epitheloid tumor cells with high N: C ratio, myxoid changes and final impression of Undifferentiated tumor. Outcome: The patient was initially kept on conservative treatment for pain and was advised for IHC markers to plan for further management but the patient refused for the same and did not follow up lately after discharge. Discussion: Abdomen and pelvis soft tissue sarcomas constitute 25-30% of all soft tissue sarcomas, with equal incidence in men and women. Although surgery remains the principal therapy for soft-tissue sarcomas, some tumors are not amenable to surgical resection because of the location and extent of the tumor or the presence of distant metastatic disease, or due to comorbid condition. Prognosis depends on location, on malignancy grade, histological subtype, size and quality of the operative resection.

  37. Mintah Clement, Blessing Dwumah Manu, Mohammed Sulamana, Bright Archer and Ernest Amoako Atta

    There is a broad and ongoing confab in our academic institutions about the effects of urbanization on livelihood of people living in the peri-urban fringes. Rapid urbanization, population burden and the government decisions, shelter, infrastructural, industrial and commercial needs of a fast-growing city have stretched the land delivery system in Wa Municipality to flouting point. Agricultural lands, which serves as the main source of livelihood, has been encroached by the process of urbanization in peri-urban zones. This study seeks to assess how rapid urbanization is impacting on farmers’ livelihood in developing cities, drawing empirical evidence from Wa, Ghana. The focus was mainly to describe the conditions and current Situation on urbanization and livelihood sustainability in the peri-urban zones in the Wa Municipality. Findings about causes, effects, alternatives livelihoods and remedial measures on rapid urbanization in the peri-urban zones in the Wa Municipality has been presented in the form of narratives. A descrptive research design was adopted and data of 145 respondents or stakeholders were collected through a questionnaire survey and interview for analysis. The results of the survey revealed that 93 respondents constituting about 64.14% of the sample population were males while 52 representing 35.86% were females. Contrary to the mainstream view that, the polygamous nature of Upper west region is the main source of increment in the population and thus urbanization in the peri-urban zones, stakeholders’ perception was different as responses indicated that, the rapid urbanization of WA is as a result of increased commercial activities, presence of tertiary institutions and its strategic location. The rapid urbanization of WA has sparked up a succession syndrome where prime agricultural lands have been converted to other land uses believed to be the highest and best use. The pressures of urbanization have negative implications on predominantly poor farming communities in the WA region. Policy focus should be geared towards the protection of prime agricultural lands that serves as main sources of livelihood. Urbanization is necessary but not to the extent of denying peri-urban zones of their main source of livelihood.

  38. Dr. Mahesh Dave and Dr. Akhil Vignesh

    Introduction: Stroke is a worldwide health problem. It makes an important contribution to morbidity, mortality and disability in developed and developing countries. Stroke is one of the leading causes of death after ischemic heart disease and malignancy. White blood cells are the cells of the immune system which protect the body against both infections and foreign invaders. An elevated white blood cell count may be caused either due to an infectious , inflammatory process .Present work was conducted to address the role of TLC in acute stroke patient and its correlation with severity and outcome. Materials and methods: It was Hospital based randomized case control observational study in which 50 Patients of acute ischemic stroke were enrolled as cases and 50 healthy age and sex matched individuals were enrolled as controls. The study was carried out between June 2019 and November 2019. Observation and Results: All these 50 patients of ischemic stroke confirmed by CT and MRI were classified on the basis of severity according to NIHSS stroke classification in mild (1-4), moderate (5-15), severe (16-20) and very severe (21-42) type of stroke. TLC level of all these patients were sent at the time of admission and mean TLC levels were calculated and it was compared with both the groups and correlated with severity and outcome. Conclusion: From our study it can be reasonably concluded that higher the levels of TLC, the greater will be the severity of stroke and poorer will be the outcome.

  39. Dr. Prabu, D., Dr. Saskala, M. Dr. Sunayana Manipal and Dr.Rajmohan, M.

    Aim: To analyze the changing trends in dental public health in India and to asses job prospectus and provide solutions. Materials and Method: The databases accessed were those provided by the Central Bureau of Health Intelligence, Dental Council of India, Indian Association of Public Health Dentistry and Ministry of Health and Family Welfare and further this data was statistically analyzed. Statistical analysis used: Descriptive statistics. Results: At present there are about 1600 public health dentists in India, out of which 678 (42.3%) were working in dental academic institutions. According to time trend analysis the future projectile growth of public health dentists for the year 2045, will be 5,825. The job positions for public health dentists that rightfully to be placed in government sector are the Directorate of Medical Services (DMS) and Directorate of Public Health (DPH) which numbers around 6,716. Hence, according to the time trend analysis, when rightfully the positions are created the job demand for public health dentists in India would be on rise till the year 2045. Conclusions: currently, significant proportion of public health dentists to outlive joblessness they seek other jobs irrelevant to their scope. The growth trend projection of public health dentists makes no scope in academics for their future. Hence government positions pertinent to treatment aspects and administrative aspects under Directorate of Medical Services (DMS) and Directorate of Public Health (DPH) will create more job opportunities that will seek to provide satisfaction and career development for future public health dentists and mandatorily serve the needy population, which is alarmingly need of the hour.

  40. Graziano Giorgio Maria, Paolo Antonino Buffone and Antonino Graziano

    Introduction: The incidence of lymphomas is around 20 cases per 100,000 inhabitants. is largely influenced by geographic, racial and age factors, resulting higher in industrialized countries A complication that frequently arises in these patients is the acute abdomen of unclear etiology The purpose of this study is to evaluate the causes that determined the increase in spontaneous ileocolic perforation events after chemotherapy treatment Materials and methods: From January 2015 to December 2018 consulted the database of the specialist department II AOU Policlinico University of Catania 52 cases of neoplastic pathology associated with perforation events after chemotherapy of which: n 20 (38.5%) patients diagnosed with intestinal obstruction, n 25 (48.5%) cases with acute colon diverticulitis (sigmoid colon), and 7 cases (13%) of intestinal ischemia. 61% of the cases were female and 49% of the male cases were of average age 75 (range 58-92 y.). The history of symptoms to locate the perforation site. Results: In the first approach to the patient with an acute abdomen as a complication of chemotherapy, it was necessary to evaluate whether the pathology is of surgical relevance, and whether the surgery had to be performed in an emergency or in an emergency or could be delayed. Treatment algorithms have been particularly helpful in this decision. In the unstable patient all the principles of "resuscitation therapy" with fluids were applied, and a slight delay was useful in surgical treatment with a correction of electrolyte imbalances. immediate surgery was required in the following phase in patients suffering from: (peritonitis, pneumoperitoneum, intestinal ischemia and hemodynamic instability). The specific surgical treatment strategies depended largely on a certain diagnosis. Discussion: The severity of the toxic side effect to chemo depends on the extent of the clinical manifestation and its duration which can increase the risk and complications that have been in the observed cases: a) Immediate: those that appear immediately or within a few hours from the therapy, b) sub Acute: those that appear within a few weeks c) Late: those that appear months or years after the therapies. The most fearsome complication was organ toxicity leading to a paralytic ileus [vinca alkaloids] (abdominal distension, marked constipation, abdominal pain) up to ischemia or perforation. Conclusions: Post chemotherapy intestinal perforation is not a well-defined pathology but a set of morbid conditions that require a "tailor-made" approach.

  41. Dr. Anil Humane and Dr. Nikita Agrawal

    Mullerian duct anomalies represent a group of congenital anomalies that result from arrested development, or incomplete fusion of the mesonephric ducts. The incidence of congenital mullerian anomalies is 1/200 to 1/600. The incidence of rudimentary horn is very rare (1:100,000). Approximately 75% of such horns do not communicate with the normal hemiuterus. These uterine anomalies are either diagnosed incidentally or the patient may present with obstetrical or gynecological problems. Vaginal obstruction is associated with perivaginal mass, pain, and endometriosis, but cyclic menstrual flow may be present because of the normally functioning opposite side. This anomaly is usually associated with ipsilateral renal agenesis (67%) or ipsilateral pelvic kidney. Laparotomy has been the standard approach for such cases. We report this case in hope of expanding the knowledge of a rare occurrence.

  42. Hassan S Alamri, Beshair Alahamri, Fai Altayar, Shahad Alquraini, Marwh G Aldriwesh, Tarig Karar, Mohamed Abdul Fattah, Naif M. Alhawiti, Maaged A. Akiel, Jawaher M. Alsughayyir and Mohammad A. Alfhili

    Background: Thyroid cancer (TC) is the most common endocrine malignancy in the world. Previous studies that link the levels of thyroid-stimulating hormone (TSH) and 25-hydroxyvitamin D (25(OH) D) to TC have been relatively inconsistent. Our goal is to assess alterations in serum levels of TSH and 25(OH)D between TC patients and non-toxic goiter patients and to examine the association between TSH and 25(OH) D levels in Saudi patients. Methods: A retrospective analysis of serum hormone fluctuations in primary TC (n= 162) and non-toxic goiter (n=98) cases. Results: TSH was significantly higher in TC patients than in non-toxic goiter patients (P<0.05). When gender was taken into consideration, the difference in females remained significant but was eliminated in males. Conversely, there was an insignificant difference in 25(OH) D between the two groups (P>0.05). Spearman rank correlation analysis demonstrated a statistically insignificant association between TSH and 25(OH) D (r=0.011), TSH and (r=0.005), or 25 (OH)D and body mass index BMI (r=0.159) in TC patients. Conclusion: TSH level is associated with TC in female Saudi patients, independent of 25(OH) D or obesity.

  43. Dr. Anil Pathak, Dr. Veer Davinder Singh, Dr. Gursatinder Singh and Dr. Reagan Madan

    A study was done to compare the efficacy of dorzolamide 2% timolol 0.5%fixed combination versus brinzolamide 1% brimonidine 0.2% fixed combination therapy in patients of primary open angle glaucoma. A randomized, open label, comparative, parallel group study was conducted on 40 patients of POAG attending the Outpatient Department of Ophthalmology, Government Medical College, Patiala. Patients selected were then randomised into two groups of 20 each. Baseline IOP was recorded at 9 am and 11 am on day 0 of the study.Group A: Fixed drug combination of Dorzolamide2%/ Timolol 0.5% (DTFC) dosed twice daily at 9 am and 9 pm .This group instilled 1 drop of DTFC ophthalmic solution into study eye twice daily at 9.00 a.m. and 9.00 p.m. for 6 weeks. Group B: Fixed drug combination of Brinzolamide 1%/ Brimonidine 0.2% (BBFC) dosed twice daily at 9 am and 9 pm. This group instilled 1 drop of BBFC ophthalmic solution into study eye twice daily at 9.00 a.m. and 9.00 p.m. for 6 weeks. Patients were then called for follow up at 2nd week, 4th week and 6th week during the study period and IOP recorded at 9 am and 11 am in the OPD. In Group A (DTFC), mean IOP at visit 1 ( baseline) at 9:00 AM was 27.00 ± 1.78 mm Hg, at 11:00 AM was 27.50 ± 1.91 mm Hg and mean IOP at all time points was 27.25 ± 1.81 mm Hg. There was no statistically significant variation in the mean IOP at any of the follow up visit in group A (p > 0.05). In Group B (BBFC), mean IOP at visit 1 ( baseline) at 9:00 AM was 26.85 ± 1.98 mm Hg, at 11:00 AM was 27.10 ± 2.17 mm Hg and mean IOP at all time points was 26.98 ± 2.04 mm Hg.There was no statistically significant variation in the mean IOP at any of the follow up visit in group A (p > 0.05).The reduction in mean IOP at visit 6 weeks in group A (DTFC) was 10.32 mm Hg (37.87%) and in group B (BBFC) was 9.50 mm Hg (35.21%). The reduction in mean IOP was comparable between the two groups. The difference was statistically non significant (p > 0.05).

  44. Priya Mehta and Akshita Maheshwari

    Background: Upper crossed syndrome (UCS) also referred as Forward Head Posture (FHP) is a condition characterized by muscular imbalance where muscles of the neck and the shoulder girdle experience with weakness and tightness that affects head position, spine, and shoulder girdle. Literature reviewed that FHP has negative impact on respiratory functions. Objective: To study the effects of posture correcting exercises on respiratory parameters in individuals with upper crossed syndrome. Methods: 15 participants with defined upper crossed syndrome fulfilling the inclusion and exclusion criteria were selected who performed pectoralis major and minor, levator scapulae and upper trapezius muscles stretching exercise, middle and lower trapezius strengthening exercise and McKenzie exercise respectively. The aforementioned interventions were provided for 30 minutes per session, five times a week, for 3 weeks. Chest expansion, Peak Expiratory flow rate (PEF) and Acromian-Tragus (A-T) length were assessed using an inch tape, peak flow meter and a steel ruler respectively on the first visit and after completion of 3 weeks exercise protocol. Results: Statistical analysis was done by SPSS version 20 and Mann Whitney U Test was used. The results showed statistically significant improvement in Chest expansion (p<0.05) and Peak expiratory flow (p<0.05) post Intervention. Conclusion: There is significant effect of posture correcting exercises on respiratory parameters in individuals with upper crossed syndrome and they may be recommended as effective exercises to improve neck posture as well as respiratory functions in adults with UCS.

  45. Vincent Antony, Premalatha and Josephine Abarna Vincent

    A community based cross sectional study was carried out among 222 women during the month of January 2017 in Chunampet, a rural area in Kanchipuram District, Tamil Nadu, South India, also the field practice area of Rural Health Training Centre, Pondicherry Institute of Medical Sciences. Based on previous studies, prevalence of Gender inequality among the families in rural regions in India was presumed to be 60%, and the minimum required sample size was calculated to be 222. Data was collected using a predesigned and pretested questionnaire, which included Socio-Demographic profile of the Family, Education details of children aged 5 to 17 years (Only if there is a female child in the family) and Nutritional status of the child (Up to 15 years) were studied. All married women in the study area, who gave consent to participate are included in the study.

  46. Eliza E. Bayang and Ariane Lou R. Rodriguiz

    This paper is purposive, has emphasized the significance of the Filipino language to the Philippines which being used as a medium during classes or lectures, subsequently exclusive for Filipinos yet inclusive for those interested foreign-neighboring citizens, humbly this needs everyone’s apathy onward to anyone’s natural rights. Layunin ng pag-aaral na tasain Kaalaman at kasanayan sa pananaliksik ng mga senior high sa Filipino at ang implikasyon sa nito sa pagtanggal ng asignaturang Filipino sa Kolehiyo. Ginamit ng mananaliksik ang disenyong deskriptive o paglalarawan sa tunay na kalagayan at correlational -differential sarvey upang malaman ang layo ng kaalaman at kakayahan ng mga mag-aaral tungkol sa pananaliksik sa mga kaalamang itinuro sa kanila ng asignaturang Filipino antas senior hayskul. Tasain din ang kaugnayan ng profayl at pagkakaiba sa pagi-pagitan ng kaalaman at kakayahan ng 301 na mga tagatugong mag-aaral.Ang instrumremtong ginamit ay talatanungan (Apendiks A). Nagkakaroon ng 301 tagatugong mag-aaral sa aktwal na sarbey. Frequency and percent, Mean, Standard Deiviation And Quartile, Multi-Variate ANOVA at Repeated measures ANOVA ang ginamit na istadistikang kagamitan. Napag-alaman namula sa greyd 12 ang karamihang mag-aaral, inilarawang kulang ang kasanayan sa pananaliksik sa Filipino ng mga tagatugong mag-aaral sa senior hayskul. Mas magaling ang GAS sa kakayahang pagpili ng paksa sa pananaliksik; ang Humms strand mahusaya kaysa TechVoch sa pangangalap ng tala para sa pananaliksik. Mas ma katamtaman lamang ang kakayahan sa Filipino ngunit may karanasan naman sa gawaing pananaliksik dahil nirekwayr ng kanilang guro ang pagbuo nito bilang panapos na gawain sa Filipino. Nalalaman na hindi gaanong naipaliwanag nang maayos sa mga tagatugon ang mga bahagi ng pananaliksik paano pasukin at kung ano ang isusulat sa bawat bahagi ng saliksik at lalo na rin ang pagsulat ng talasanggunian. Inirekomenda na bigyan ng pansin ng Kagawaran ng CHED itong munting ideya bilang batayan nila sa pagpapatanggal ng asignaturang Filipino sa kolehiyo.

  47. Annie P. Gravoso

    The main purpose of this study was to gather and classify some coined words and expressions in informal oral communication. The study was basically oral since the study was limited only to uttered rather than written expressions. Uttered coined words and expressions become different when written. It is in oral communication where one can emphasize pitch, stress, and juncture. Aside from the context, the meanings attached to these words depend a lot on these supra-segmental phonemes. The research was conducted among 100 college and high school students selected at random. All of these Cebuano-speaking respondents also used and understood Tagalog or Filipino words. Moreover, English words have become part of their language repertoire because they also practice code switching. The study employed a descriptive method in the interpretation of data based on the questionnaires, interviews, and researcher’s observations. Results showed that coined words and expressions have distinct characteristics and can be classified according to form, meaning, and expression. Furthermore, their effectiveness depends on many factors. Their meaning and correctness are under some circumstances and nature of the speakers in a given context. However, the active usage of these coined words and expressions in oral communication rests on the persons who have been fond of using them. The study recommends that it is of outmost importance to conduct a similar study based on the currency of coined words and expressions since language is considered dynamic, and that it changes through time and culture.

  48. Dr. Neethu Elizabeth Antony, Dr. Padmaja, S., Dr. Malathi Dayalan and Dr. Savitha, P.N.

    Nanotechnology is extremely diverse and multidisciplinary field, ranging from novel extensions of conventional physics to completely new approaches based upon molecular self-assembly to developing new materials and machines with nanoscale dimensions. Nanotechnology is based on the perception of generating functional structures by monitoring atoms and molecules on a one-by-one basis. It deals with all physical, chemical, and biological properties of structures with their components at nanoscale magnitudes. It has been shown that the performances of many biomaterials used in prosthodontics have been significantly enhanced after their scales were reduced by nanotechnology, from micron-size into nanosize. Properties such as modulus elasticity, surface hardness, polymerization shrinkage and filler loading, were significantly increased after the addition of the nanomaterial.

  49. Nawal G. H. Almalki, Rukaia Gashgari, Mohamed Abu-Zeid, Mohamed Ali A. Almatary, Khalid M.S. Al-Ghamdi and Prof. Salah Abo Aba (PhD)

    Fungi play an important role in the soil ecosystem, it decompose nutrients and elements to simple compounds for plants growth, also play a rolein biological control for suppression of plant pathogens. Isolation, purification of soil fungi using conventional microbiological techniques is hard but it needed for study the distribution of fungal community in soil rhizosphere. Molecular techniques using 18s rDNA based sequences analysis provide the taxonomic resolution for identification of fungal species and strains, also provide information on the diversity and dynamics of fungus in environmental samples. In the present study, isolation and purification of fungi near some medicinal plants soil rhizospher from Saudi Arabia regions, extraction of DNA from isolated fungal strains, 18S-ribosomal-DNA using universal primer sequences were used for amplification of 18S rDNA gene from each isolated fungus. Clear banding patterns were obtained with each isolated fungi by using primer sets. Sequencing of isolated 18S-ribosomal-DNA done by Macrogen Company in Korea and compared to known rDNA sequences using NCBI taxonomy were also done. Phylogenetic tree construction of each isolated fungus obtained and results confirmed that the 18S-rDNA PCR amplification are reproducible and confirming the fingerprints which indicate differences of the fungal community in used soil rhizosphere.

  50. Dr. Sumanjit Kaur, Dr. Harinder Gupta, Dr. Harmesh Sharma, Dr. Priya Malhotra and Dr. Megha Sharma

    An epulis is any localised swelling of gingiva usually results from local irritants such as calculus formation, poorly adapted margin of dental restorations. Mostly it does not involve underlying bone but occasionally it may invade underlying bone which results in displacement and mobility of the affected tooth. In advanced cases along with surgical excision of an epulis, removal of involved teeth and alveolar bone is required.

  51. Abdulelah Aziz E Alenzi, Osama Assalloum Alanazi, Fahad Ali A Alsahli, Amjednaeem M Alruwaili, Wael Sughayyir G Alanazi, Tariq Hulayyil M Alanazi, Ahmed Saad N Alanazi, Anwar Mohammed O Alhadhari, Razan Mahmoud A Alshaheen, Abdulhamid Mahmoud A. Alshaheen

    Background: Cardiovascular disease is increased in type 2 diabetes mellitus subjects due to a complex combination of various traditional and non-traditional risk factors. Objectives: To illustrate the association between Type II DM and cardiovascular comorbidities in Riyadh, Saudi Arabia. Methods: A cross-sectional study carried out among type II diabetic patients in Riyadh city during the period from 1 May to 31 August, 2019.Data was collected using a self-administered questionnaire after taking the acceptance from the administration to distribute the questioner to all eligible participants. The questionnaire was analyzed to evaluate prevalence of CVD among diabetic patients. Results: 290 (17.3%) of the respondents had Type II diabetes mellitus. As regards the association between Type II DM and cardiovascular comorbidities, according to our findings 31% of diabetic patients were hypertensive, 41.4% had hypercholesterolemia and 6.9% had atherosclerosis, 27.6% were obese and the association between these conditions and type II DM was significant (P<0.05). Conclusion: among the general population of Riyadh, KSA, there was significant association between type II DM and hypertensive, hypercholesterolemia atherosclerosis, and obesity (P<0.05).

  52. Dr. Jai Prakash Singh and Dr. Singh, O.P.

    Neurocysticercosis is the commonest parasitic central nervous infection world-wide.(1,2,3,4) It is a public health problem in India . It has a wide population distribution in the world and affects children as well as adults. (1,2,3,4,5). It is the most common helminthic infection of the nervous system and is endemic in most underdeveloped countries as well as in industrialized nations. It is estimated that approximately 50,000 people die every year from neurocysticercosis (NCC) worldwide.

  53. Sridhar Lakshmana Sastry, Gaurav Bharadwaj, Cholenahally Nanjappa Manjunath, Satvic C. Manjunath, Balaraju Doddaiah, Vikram S. Patil, Lachikrathman Devegowda, Prabhavathi Bhat and Shanmugam Krishnan

    Objective: This study was devised in view of the real life application of FFR in catheterisation laboratory from a developing world country and to evaluate the cost effectiveness of the same. Background: FFR has been proved to be superior to angiographic ally driven PCI in various studies also it has been proven to be economically beneficial. However there is difference between trials and real life situation. Considering this we conducted this study and evaluated clinical outcome and cost effectiveness associated with use of FFR. Methods: We conducted a retrospective study which included all patients who underwent FFR in our hospital. Coronary angiograms of these patients were retrospectively analysed by two interventional cardiologists and decision regarding the lesion were made. The proposed decisions and their associated costs were compared with the actual procedure and costs incurred with the use of FFR. Also patients were evaluated for any adverse outcome after the procedure to the time of analysis. Results: 38 patients underwent FFR in our hospital. 12 patients had SVD, 13 patients had DVD, 3 patients had TVD and 2 patients had LMCA disease. Mean FFR value in our study was 0.84±0.09 and 36.8% of all lesions had FFR≤0.80 and 16.2% had FFR 0.75-0.80. LAD was the most common vessel interrogated (27 patients). Total 42 lesions were analysed in 38 patients. Concordance between cardiologist opinion and FFR results were seen in 47.6% lesions. On basis of angiography alone intervention cardiologists decided 22 lesions to be stented but after estimation of FFR, 16 lesions were stented. Overall in 22 lesions decision was changed of which 14 lesions were deferred and 8 lesions were those which underwent PCI. On evaluation total cost of procedures as per decision of intervention cardiologist was found to be Rs 2603254 and actual total cost was Rs 2887954 with a difference of Rs 284700, which was not significant statistically. If further it was considered that FFR wire was used as guide wire for the patients who later underwent PCI after FFR, and cost of guide wire was reduced from the actual cost then Rs 207900 was the difference. Out of 38 patients we were able to contact 32 patients only. Mean duration of follow up was 12.7±7.14 mths. Amongst the 32 patients only 2 patients complained of class II angina. One patient later underwent CABG and was asymptomatic on follow up. Conclusion: Despite few number of patients this study reinforces that clinical trials don’t represent real life scenario and cost effective analysis may not be achieved in each set of situations. However, despite the increased cost we support the use of FFR for guiding revascularisation in intermediate severity lesions as it helps to classify these lesions correctly into significant or non significant. More so deferring of insignificant lesions and attending to significant lesions both are important to improve outcome.

  54. Sridhar Lakshmana Sastry, Gaurav Bharadwaj, CholenahallyNanjappa Manjunath, Satvic C. Manjunath, Balaraju Doddaiah, Vikram S. Patil, Lachikrathman Devegowda, Prabhavathi Bhat and Shanmugam Krishnan

    Objective: This study was designed to evaluate the risk factors and angiographic profile of coronary artery disease in premenopausal females. Traditionally premenopausal females are thought to be at low risk for coronary artery disease but only few studies have been done to exactly look for the risk factors and angiographic picture in this subset of patients. Background: Coronary artery disease in premenopausal females appears to have particularly poor prognosis. Evaluation of risk factors associated and relative importance of risk factors in this subset of population needs more studies. Methods: We evaluated 100 premenopausal patients who presented with acute coronary syndrome or chest pain considered to be anginal in origin. Traditional risk factors were reviewed in all patients and association with angiographically detectable corornary artery disease was made. Also,cases were compared with age and sex matched controls who had normal coronaries. Results: Out of 100 patients 33 patients presented with Effort Angina (EA), 15 with Unstable Angina (UA) ,4 with NSTEMI and 48 with STEMI. The mean age was 45.67±6.28 years. Only 2 patients had no risk factors and 17 patients had all the 4 risk factors evaluated. Out of all cases 17 patients had normal coronaries, 16 had non-obstructive disease and 65 had significant disease. Amongst patients with obstructive disease 37 had SVD, 17 had DVD, 8 had TVD and 5 had significant LMCA disease. Among the traditional risk factors analyzed no significant difference amongst the three angiographic groups were seen. On comparative analysis between cases and controls significant difference was present with reference to diabetes, hypertension, total cholesterol, LDL,TG and BMI. After multivariate analysis DM (p=0.016), HTN (p=0.000) and BMI (p=0.002) were found to be significantly associated with the patient group. Conclusion: Premenopausal females with coronary artery disease are not so uncommon entity as initially thought. These patients have high prevalence of conventional risk factors as compared to normal population. Majority of these patients had significant disease in our study. However conventional risk factors failed to predict the presence of angiographically significant disease in this group of patients.

  55. Wobo Tefera, Sisay Gedamu, Dr. Muluken Fentaw and Dr. Caridad Sanchez Olis

    Introduction: Cataract is the leading cause of blindness globally, particularly in developing countries. Cataract surgery with implantation of an intraocular lens is a sophisticated technological procedure. Despite improvements in cataract surgical services in many parts of the world, cataract remains responsible for half of the global blindness burden. Objective: The aim of this study was to determine the visual outcomes and complications of patients who had cataract surgery at Borumeda hospital, Northeast Ethiopia. Method: A facility-based retrospective cross-sectional study was employed. The data was collected from 306 cataract operated patient cards and systematic random sampling technique was used to select the patient cards. The data collection tool was adopted from WHO guidelines for monitoring the outcome of cataract surgery. The data was entered and analyzed by using SPSS version 20. Descriptive statistics were used to describe socio-demographic characteristics, postoperative cataract surgery visual outcomes, intra and postoperative complications. The result was displayed in text, table and different form of graphs. Result: The findings of this study had shown that out of the study participants examined after one day, five weeks and six weeks of surgery 19.3%, 43.6% and 49.3% of patients had good visual acuity and had successful surgical outcome respectively. From all study participants undergoing cataract surgery 2.9% had developed complications. Conclusion: The result of this study had shown that from all study participants after 6 weeks of cataract surgery, half of them had no good visual acuity. Out of all 306 study participants 2.9% of them had complication of cataract surgery. Therefore recommendations forwarded for health care personnel’s, academic higher education s’, researchers, family members and friends to improve outcome of cataract surgery and to prevent post operative complications.

  56. Randah Ashour and Robert Chen

    Background: Rowshan (pl. Rawāshīn) is the projected latticework window, commonly found in façades of traditional dwellings in Madinah. Due to functions that Rowshan provides, such as overlooking the surroundings with complete privacy and controlling natural ventilation and lighting in the dwelling, it achieved a widespread popularity in the traditional architecture of Madinah, which gave the city its unique architectural identity. Aim: We attempt to explore that the Madinah's Rawāshīn carving units are not only esthetic, but also functional for daylight filtering. Our goal is to perform a computer simulation experiment using Velux Daylight Visualizer software and analyze the daylight performance filtered through the front (top) carving units of the Rawāshīn of Madinah. Method: Thirty carving panels of Madinah's Rawāshīn were studied to calculate the solid: void ratios using Image J software. A total of 12 carving units was selected with different solid to void ratios ranged from 0.8:1 to 11.5:1. Our experiment identified the background data such as material specifications, climate input and lighting conditions before the simulation process sets about. The experiment applied a basic geometry model of the standard living room found in Madinah's traditional houses, measuring 4 m (Length) x 3 m (Width) x 3 m (Height) with Rowshan window's (Forehead part of Rowshan) dimensions of 3 m (Width) x 1 m (Height) and window projection of 50 cm out of the wall. The Rowshan window is located 2 m from the floor. The daylight level of 100-300 lux was selected as a target lux level for these experiments. The lux levels were measured three times a day, three seasons a year and over four directions. Results: The average illuminance levels decreased dramatically with the use of Rowshan screens with all ratios compared with base cases with no screen in all orientations and seasons and at three different times of the day. The Rowshan screens with the ratios of (S:V 3.8:1) and (S:V 4.3:1) can provide the recommended levels of daylight (100-300 lux) in the studied room in all orientations and seasons and at three different times of the day. Conclusion: The findings of the present study alter the perception that the interior of the traditional house of Madinah has always been dark and subdued and suggest that the Rawāshīn of Madinah can be presented as potential daylight filters.

  57. Yashaswini, S. and Shylaja, S.S.

    Part of speech (POS) tagger assigns a lexical tag to each word in given sentence. Part of Speech Tagging is a subtask Natural Language Processing Systems, identifies the correct tag according to syntax for each word in corpus (6). Part of speech can be used in many scenarios like information extraction, parsing, word semantic disambiguation, question answering, named entities recognition, virtual chats, scene generation etc. While POS tagging works great for commonly used simple English sentences, but it has not yet achieved good accuracy in the field of interior designing due to its morphological characteristics. This paper compares various POS techniques.

  58. Dr. Neera Ohri, Dr. Sukhvinder Singh Rana and Dr. AmanAbrol

    Haemangioma is the most common benign tumour of vascular origin of the head and neck region. The possible sites of occurrence in oral cavity are lips, tongue, buccal mucosa, and palate. Despite its benign origin and behaviour, it is always of clinical importance to the dental profession and requires appropriate management. Phleboliths are calcified thrombi found in veins, venulae and sinusoidal vessels of hemangiomas formed due to Changes in blood flow dynamics in the head and neck. Phleboliths nearly always signal the presence of a hemangioma. This article presents a relatively rare and unusual case of multiple hemangiomas of oral soft tissue and one intraossous hemangioma with phleboliths in mandible in a 45-year-old male.

  59. Naga Vaishnavi, C. and Sruthi Reddy, C.

    There has been a drastic transition in Architectural education and design pedagogy, from 17th century till current scenario. This paper examines the changes and different models of pedagogy used world over. This is a review paper that analysis and presents the design education in the light of traditional studio approach and Beyond while modelling the new studio typologies. This paper is the part of research on “Rationale of Application of Theory Inputs in Architectural Practice”. While the first Paper was “Importance of theory In Architecture”.

  60. Maqsood Rezayee, Sayed Adnan Mosawi, and Raihana Attaee

    Rapid urbanization is accentuating urban challenges, mostly leading to urban sprawl and development of informal settlements in the cities, as result affecting the reduction of agricultural land, natural and rural areas surrounding the cities. Increasing level of improper consumption of land, threat sustainable development, destroy the earth’s regenerative capability. The most important is the worsening state of climate change. In fact, the cities and urban areas are more responsible for climate change. Therefore, the rapid urbanization is not without negative impacts on residents of urban areas such as demographic and migration patterns, change in the production and consumption pattern, as well as threatening of climate changes toward basic services and infrastructure. Cities are then called to find the urgent and proper solution for, not only for decreasing the missions affecting climate change, but also to adapt to challenges posed by climate changes to decrease the disaster in the metropolitan areas. Apart from climate change the lack of basic services, infrastructure, shelter, public amenities and development of slums, informal settlement, are prioritized issues to be addressed by using integrated approaches to tackle urbanization problems. In addition, these approaches must ensure design, management, and development of sustainable cities. Therefore, this paper aims to evaluate the Land Readjustment Scheme as policy option in addressing the urban issue to contribute in achieving vision of SDGs, New Urban Agenda and Paris Agreement.

  61. Marcelo Albuquerque de Oliveira, Fabiane Patrícia Marques de Azevedo, António Cardoso, Gabriela de Mattos Veroneze and Laura Lima da Rocha

    This paper aims to present a study carried out in a municipal school in the city of Manaus, in the state of Amazonas (Brazil). The purpose of the proposal was to assess students' perception of the concepts advocated by the circular economy and how environmental education contributes to circular actions in order to boost the local economy. Since environmental education is a political and pedagogical process, it was intended to assess the lifestyle, consumption habits and values of the students involved and their relationship with their environment. The methodology consisted of the application of a questionnaire to students of a public school, in order to assess their perception about the environmental theme and the promotion of circular actions, followed by an exploratory analysis of the information obtained. As a conclusion of the study, from the premise that the Amazon region is extremely vulnerable to human actions, it was realized that the lack of understanding about the environmental issue is strongly linked to the lack of actions focused on Environmental Management and Education, such as a bridge for clarification, awareness and training of those involved.

  62. Agu, Peter Ashlame and Samuel, Iwanger Ruth

    This study compared the Effects of Scaffolding and Collaborative Instructional Strategies on Science and Technical Students’ Achievement in Basic Electronics in Nasarawa State, Nigeria. Two research questions and three hypotheses were formulated for the study. The study adopted a quasi-experimental research design; specifically, the pre-test post-test non-equivalent control-group experimental design was used. A sample of 63 (35 males and 27 females) from two schools were drawn using purposive sampling technique from all the 157 senior secondary school year two (SS II) students of Basic Electronics in the three science and technical colleges offering Basic Electronics in Nasarawa State, Nigeria. Basic Electronics Achievement Test (BEAT) was used as instrument for data collection. Reliability testing of BEAT was carried out with the use of Kuder-Richardson 20 (K-R 20) and a reliability coefficient of 0.82 was obtained. Data collected were analyzed using mean and ANCOVA at 0.05 level of significance. Findings of this study revealed that; students taught Basic Electronics using the scaffolding instructional strategy achieved better than those taught with the collaborative instructional strategy. It also revealed that; gender had no significant effect on students’ achievement in Basic Electronics. Based on the findings of this study, it was recommended that collaborative and scaffolding instructional strategies should be utilized by teachers to teach basic electronics in Science and Technical Colleges.

  63. Mohammed Nizam Uddin, A.N.M. Rezaul Karim, and Taslima Akter

    The unsteady flow phenomena dominate the blood stream in arteries. The cardiovascular system in the human body can be defined as an inner loop with a complex liquid flowing in multiple branches. Further, the relationship between viscous and unsteady forces is governed primarily, by the Womersley number, a non-dimensional frequency parameter. By the Finite Element method, the researcher is able to resolve the resultant nonlinear implicit system related to partial differential equation. By generating secondary flow in branches and curves, the normal arterial flow remains laminar. The arteries in the human body remain the living organs, capable of changing and adapt to varying hemodynamic conditions, however, in some particular situations, an abnormal biological response is created by unusual hemodynamic conditions. Due to the skewing of the velocity profile, the creation of pockets, takes place in the cardiovascular system, with which the oscillation of the direction of wall shear stress takes place. These sites remain the core of Atherosclerotic disease and that further, results in stenosis or the narrowing of the artery lumen. Due to stenosis, the human body suffers from turbulence and a reduction of flower due to flow choking and viscous head losses. Further, due to extremely high shear stresses near stenosis throat, the platelets are activated, that, further, leads to thrombosis, that, again, retains the capability of blocking the complete blood flow both to the brain and the heart. For surgical intervention, the detection, as well as quantification of stenosis remains the basis. In future studies, the research related to of arterial blood flow would definitely lead to the accurate hemodynamic flow in any particular patient, the development of the accurate diagnostic tools for quantifying the level of the disease, as well as the design various devices required to mimic as well as alter the flow of the blood. When compared to other research, the field of fluid mechanics offers considerable challenges that involve three-dimensional, pulsatile flows at the edge of turbulence.

  64. Rakhi Sood and Gaurav Gaur

    All Kushthas are having Tridoshaja origin; hence Vicharchika can be explained in similar manner. Dermititis is being used as synonym of eczema by most of the dematologist. These are the kind of non contagious inflammation of the skin characterized by erythema, Scaling, edema, vesiculation and oozing the disease Vicharchika to a greater extent ressembles eczema/dermatitis. Therefore the eczematous dermatitis can be included in study of Vicharchika.Vicharchika can be correlated with eczema in the sequence. The involvement of Vata results in dry, blackish lesion of eczema, itching in those affected areas is due to Kapha and Pitta responsible for Strava. Thought, the disease Vicharchika is not life threatening, it makes worried the patient due to its appearance, severe itching, disturbing routine and its nature susceptible to be chronic. In classical texts of Ayurveda, Acharyas emphasizes Shodhana and Shamana therapy as the line of treatment at various places. Among the Shodhana Karmas, Virechana is chiefly advocated, purificatory measures in Vicharchika. Virechana is not only a mere bowel cleaning procedure but also has systemic effects. Acharya Charaka has advocated Virechana for the Pitta Dosha and Rakta Dushti (Ch.Chi.7/39). Purpose of study aimed to evaluate efficacy of Virechana and Khadiradi Kwatha on Vicharchika and thus forming key of successful remedy in Vicharchika for focusing its trial on large populations. Dermatitis, commonly known as eczema, is a common chronic, relapsing skin disease characterized by pruritus, disrupted epidermal barrier function, and immunoglobulin E-mediated sensitization to food and environmental allergens. Atopic dermatitis is a complex disease that arises from interactions between genes and the environment. Eczema can be co-related with Vicharchika. Vicharchika can be treated with Shodhana Chikitsa and Shamana Chikitsa. Here, a female subject, aged 18 years, Student, living presently in Chandigarh, with the chief complains of kandu (itching) on affected sites.

  65. C (Linda) MC van Campen and Frans C Visser

    Introduction: Among the main characteristics of patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) are effort intolerance along with a prolonged recovery from exercise and post-exertional exacerbation of ME/CFS symptoms. The gold standard for measuring the severity of physical activity intolerance is cardiopulmonary exercise testing (CPET). Multiple studies have shown that peak oxygen consumption is reduced in the majority of ME/CFS patients. A consecutive day CPET protocol has shown a difference on day 2 in ME/CFS patients in contrast to sedentary controls. Because the studied numbers of female ME/CFS patients in the published literature, are not very extensive, the aim of this study was to examine whether the response to a 2-day CPET protocol in a larger sample of female ME/CFS patients was similar to that studied in other research teams. Methods: From 102 female patients, 70 female ME/CFS patients fulfilled the criteria of a 2-day CPET protocol for analysis. Measures of oxygenconsumption (VO2), heart rate (HR), systolic and diastolic blood pressure, workload (Work), and respiratory exchange ratio (RER)were made at maximal (peak) and ventilatory threshold (VT) intensities. Data were analysed using a paired t-test. Results: Baseline characteristics of the group were as follows. Mean age was 44 (12) years, median BMI was 27.1(4.4)kg/m2. Median disease duration was 10 years (IQR 7-13). Heart rate, systolic and diastolic blood pressure at rest and the RER did not differ significantly between CPET 1 and CPET 2. All other CPET parameters at the ventilatory threshold and maximum exercise differed significantly (p-value between <0.005 and <0.0001). All patients experienced a deterioration of performance on CPET2 as measured by the predicted and actual VO2 and workload at peak exercise and ventilatory threshold. Conclusion: This study confirms that female ME/CFS patients have a reduction in exercise capacity in response to a consecutive day CPET. These results are similar to published results in female ME/CFS populations.

  66. Animesh Karmakar, Nirupama Goswami Bhattacharyya and Jagatpati Tah

    The white sandalwood plant Santalum album L. is a tree species has been proved its ability to adopt various ecological conditions since ancient time. Like other terrestrial tree species Santalum album L. can grow in various soil conditions also though it requires hosts at least two years for up-taking nutrition for its proper establishment on soil. Santalum album L. has a special nutrient up-taking haustorial mechanism. It forms small campanulate haustoria on the roots of host plant to make parasitic relationship. The haustorial structures are not only found on the tap roots and rootlets of the host but also found on the tubers of the host. The haustorium is consists of a peripheral hyaline body and a central penetration peg like structure. This peg gives sufficient pressure and secrete cell wall degrading bio-chemical fluid to make a proper and sure relation with the host. The entire host parasite interface is made up of parenchymatous tissue (K.U.Tennakoon and D.D. Cameron, 2006). We could trace out a little bit relationship of Santalum album L. with different host plants. We could find three different host plants in this phase of work which were not recorded previously elsewhere. The aims and objects of this investigation were to prove the hidden relationship between Santalum album L. with different host plants for which the possible morpho-physiological and anatomical evidences have been illustrated in this context.

  67. Dr. Asha Gupta

    The continuation of archaic Science Syllabi in State universities and collegiate system in India has become a matter of deep concern. Graduates and Post graduates are without technical skills, creativity, comprehension and futuristic vision. They are not only unemployable, but untrainable. Interdisciplinary programs of teaching and training can reverse this malaise. Initially, Nanotechnology and Biotechnology were treated as separate emerging frontiers of science and technology. However, with increasing volume of information, the two are wedded to become the holistic pivot of channelising new knowledge. Nanobiotechnology has numerous, albeit ever expanding components. They relate to issues of development of strategic defense equipment; agriculture, veterinary and biomedical sciences, atomic and sub- atomic sciences, engineering (all sections) etc. There is the need to develop coherent and linked curricula from 10+2 to P.G. level that entails foundation aspects of Nano-biotechnology; and incorporates basic instrumentation training. The areas need to be identified for the purpose of streamlining the curricula, for imparting practical training. This will enable the youth of country to find employment in defense industry, biomedical science, agriculture, engineering etc. New areas of entrepreneurship will also open. This would be globally competitive.

  68. Apeyuan, Alice Mamlu, Prof. Mu’azu M. Sani, Dr Blaise G. Gbaden and Prof. Philip O. Gushem

    Artists react and re-present the existential realities that surround them in different ways. While some creatively and realistically present these realities as they are, others conceptualise these realities, in diverse artistic styles and orientations. In deviation from the prescriptions of authors such as Lamb (1976) who wrote an extensive exposition on the use of conventional materials in creating art works, unconventionality has, for a while now, permeated the world of art such that, virtually any solid entity can be used in creating artworks. It is on such basis that I chose to explore the possibilities of creating abstract paintings, using unconventional media, specifically mirrors and fabrics. In the paper’s capacity to advance the exploratory possibilities in painting, Candy’s (2006) opinion on the practice-based research methodology, was adopted as the paper’s conceptual framework. The paper concludes by recommending that other artists should endeavour to explore and exploit other possibilities of creating paintings, through the adaptation of similarly unconventional media and procedure.

  69. Krishna kumar, S., Parkavi, C., Navaneethan. R., Vikash, J. and Dr. Kalai Kumaran

    Environmental issues This invention relate to a cleaning drone based on a multi-copter flying platform comprising a plurality of sustentation rotors, a cleaning device protruding from the main body of the drone and a plurality of pusher propellers protruding from the main body of the done in a position being opposite to the protruding cleaning device, these pusher propellers being aligned at a substantially orthogonal angle in respect to the sustentation rotors in order to provide a pushing force for the cleaning device to act upon the surface to be cleaned, the cleaning drone further comprising a communications system, allowing it to receive commands and to send back responses to a remote controller, a geographical positioning system, allowing it to execute translation operations based on a known position, and a visual recognition system, allowing it to recognize visual features on the surface to be cleaned or on its immediate surroundings, wherein the sustentation rotors and pusher propellers are driven by electric motors which are fed by at least one power source selected from the group consisting of electric batteries, a fuel cell, a generator driven by a small piston engine, a thermo-photovoltaic fuel based generator, or any other electric energy storage or conversion mean. In a preferred aspect, the cleaning device is protruding from the front side of the drone's main body and comprises at least two straight flexible blades being hold in place by an enclosure defining a cavity which progressively.

  70. Shelke G. B.

    Thick films of bulk SnO2 and ZrO2 powders were observed as less sensitive to polluting, hazardous and inflammable gases. Hence, nanostructured SnO2 and ZrO2 powders were synthesized by disc type ultrasonicated microwave assisted centrifuge technique. Nanocomposite material, Zr(0.50)Sn(0.50)O4 was prepared using synthesized ZrO2 and SnO2 powders by taking their 1:1 proportion. Thick films of nanostructured pure Zr(0.50)Sn(0.50)O4 powder were fabricated by screen printing technique. These films were surface functionalized by Bi2O3 for different intervals of time followed by firing at 450oC for 30 min. The surface morphology, chemical composition, crystal structure of the unmodified and surface activated nanostructured Zr(0.50)Sn(0.50)O4 powder by Bi2O3 have been investigated by XRD, FESEM and E-DAX. Electrical and oxygen gas sensing performance of the thick films were also studied.

  71. Loumingou, R., Gandzali-Ngabe P.E. and Mahoungou, G.H.

    Black subjects' hypertension (hypertension) is characterized by high blood pressure, more frequent heart and kidney complications, and ineffective system inhibitors (ACE inhibitors or ARAIIs) as monotherapy. The objective of this work was to evaluate the profile, characteristics of black hypertensive subjects balanced by monotherapy with ACE or ARB II 18 patients with hypertension out of 258 or 8% were balanced by monotherapy with ACE or ARB II. The average age was 38.5 years. The profiles found were; hypertension associated with obesity, sickle cell disease, keloids, polycystosis, and hydronephrosis. Black hypertensive subjects balanced by ACE or ARB II monotherapy are young subjects who often have secondary hypertension.

  72. ALY K, Diallo, A.O.S., Mohamed K,. Naydenova E, V., Soumahl, II., Kabal,, Konatey, Sidime Y, and Boiro M,Y.

    Rickettsial and related infections are infectious, re-emerging, polymorphic, life-threatening and globally prevalent diseases. These pathologies prevail in Guinea in several forms with a variation of the etiological agents. The objective of this study was to identify the infectious agents responsible for rickettsial diseases and related diseases in the regions of Kindia and Mamou. The investigation work was carried out from January 6, 2016 to February 6, 2017. A total of 6 types of infectious agents were found by PCR, 2 at Mamou Coxiella burnetti and Bartonella spp. and 4 to Kindia Coxiella burnetti, Borellia burgdorferi, Borellia burgdorferi. The frequency of Coxiella burnetti rickettsiosis was 84.22% in the 2 target regions. For related infections the overall prevalence was 5.26% for rickettsial disease with Bartonella spp. 5.26% with Q Fever and 5.26% with Lyme Borellia burgdorferi disease. The vectors were overall Ripicephalus decoloratus (Coxiella burnetti and Bartonella spp. Rickettsiosis), Amblyomma variegatum (Crimean-Congo hemorrhagic fever). The presence of ticks on livestock is a factor in the spread of rickettsial diseases in regions in Guinea. Particular attention should be paid to these pathologies by the public and veterinary health services.

  73. Mhetre, R.M.

    The HR function holds a Providing high-quality, safe medical care is the primary goal of health systems. When the public is alerted to quality failures, such as preventable medication errors resulting in patient harm or death, concerns about the quality of healthcare arise. As experts in medication delivery, pharmacists play an integral role in preventing and managing medication errors; however, ensuring safety in the health system is a team effort. Pharmacists need to broaden their responsibilities by taking on roles in quality and performance improvement projects. Pharmacists are well positioned to assist the healthcare system in improving quality of care, and they are already established as experts in medication management processes. As pharmacists branch out into the quality arena, they will need to expand their knowledge base with respect to quality. This discussion guide is intended to provide health-system pharmacists with the basic tools they need to lead and participate in quality improvement and medication safety initiatives.

  74. Dr. Richa Tiwari and Dr. Rashmi, S.

    Cervical cancer is the most common cancer among females in India. Cervical cancer usually spreads by local extension and through the lymphatic drainage to the lymph nodes. Choroidal metastasis is a very rare kind of hematogenous metastasis seen in cervical cancer. We report a case of a 50-year-old woman who presented with unilateral right sided progressive visual impairment since 40 days. Fundoscopic examination revealed presence of multiple choroidal masses and posterior exudative retinal detachment, suspicious of choroidal metastasis. Metastatic work up with CT scan of brain, thorax and abdominopelvic region was unremarkable. Unilateral choroidal metastasis arising from a squamous cell carcinoma of the cervix is extremely rare. Although uncommon, choroidal metastases may be the presenting feature of primary cervical malignancy. Furthermore, cervical malignancy must be ruled out in women who present with orbital or choroidal metastasis arising from unknown primary.

  75. Abada, Ifeanyichukwu Michael, Omeh, Paul Hezekiah, Okafor, Nneka Ifeoma and Adewale, Dorcas

    The quantum of xenophobism have been a major source of concern for the globalizing and liberal world at large. This is as a result of its recurring nature and complexities as it creates economic nationalism against preaches for opening of different nations' economies. In Africa, the reverse has been the case as lives and property of Africans had been lost, and tensions created between South Africa and other Africans, including Nigerians. Scholars who have done research on this area have not sufficiently criticized the status of imports and exports, and impacts the attacks may have had on trade agreements between both countries. However, it is against this backdrop that the paper examined xenophobic attacks in relations to importation and exportation that take place between Nigeria and South Africa, and the trade agreements between both countries, involving progressive steps to further improve trade. Methodologically, the paper utilized documentary method and data were generated through the secondary sources and analyzed in content. The framework of analysis for the study was anchored on the Complex Interdependence Model(CIM), developed by Robert O Keohane and Joseph S. Nye. The theory highlighted that Nigeria and South Africa will be willing to enter into cooperative alliances even in the times of anarchy and conflict. The finding of the study has adequately revealed that xenophobic attacks have not affected rate of importation-exportation activities, and has not undermined ongoing trade deliberations between both countries. The paper recommended amongst others, that the governments of both countries should ensure adequate opening and distribution of national economies to the contents and benefits of their citizens. Also, there should be provisions in immigration laws of both countries to enable for the foreigners.

  76. Assouman Ahou Estelle Mélissa and Gacha Franck-Gautier

    The HR function holds a primordial place today in private organizations. In fact, any organization brings together actors who have personal needs, specific aspirations and who lead a life outside the organization. However, some private companies attach little importance to the establishment of a social policy and the HR department exists only by name. Social policy is nonexistent and employees work under pressure. This article builds on previous work, and semi-structured interviews with managers at this company. The results indicate that the development of this enterprise results from the change in its human capital management policy. Given the objectives to be achieved and its aspiration to be a leader in its field, Universelle Industrie has decided to rely on a social policy that listens to its staff.

  77. Febria Yolanda and Ira Purwitasari

    The growth of electronic money transactions in Indonesia at 2019 increased by 230.25% and making any financial enterprise technology (fintech) more competing. Digital Payment OVO Instagram used social media to expand their marketing activities, thus forming a digital communication between companies and customers. Communication is a form of Electronic Word Of Mouth Activity (EWOM)in social media. The purpose of this study to determined how big electronic word of mouth on social media Instagram influence brand loyalty OVO. This study was conducted using a quantitative approach through surveys. The survey was conducted using questionnaires distributed online to the respondents through social media. The measurement clarified by eight dimensions: quality EWOM, quantity EWOM, Sender expertise, Measures behavior, switch cost, satisfaction, linking Brand, And commitment. The population of OVO users by 2019, amounting to 115 million people and 100 people into the sample by using the formula Taro Yamanewith a confidence interval of 90%. The sampling technique used purposive sampling. Based on the results of research and data analysis has been done, the obtained results that electronic word of mouth has a contribution of 32.8% in an effort to influence the Brand Loyalty OVO. The rest 67.2% is made up of the effects and influence of other factors outside of this study.

  78. Abdullahi, Y. Abbas, Abdulkarim, Y. Saidu, Y. Anas, A. Sabir, Bena, K. and Lawal, S. Bilbis

    Background: Diabetic retinopathy (DR) is a complication of diabetes mellitus resulting from increased oxidative stress which affects the retina. Uncontrolled hyperglycemia leads to increase oxidative stress that is associated with development of DR. The study evaluated the oxidative stress status of diabetic retinopathy subjects. Methods: Serum fasting blood glucose (FBS), glycated hemoglobin (HbA1C), antioxidants vitamins (A, C, E,), minerals (Manganese, Copper, Zinc and Selenium) and enzymes (superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (Gpx) of nine (9) subjects that consist of three (3) apparently healthy individuals serving as control, three(3) newly diagnosed DM and three (3) DR subjects attending Usmanu Danfodiyo University Teaching Hospital Sokoto, Nigeria were evaluated using standard laboratory methods. The DR subjects were recruited based on the result from visual acuity test and funduscopy examination. Results: The results of FBS and HbA1C levels revealed significant (P<0.05) increase in DM and DR subjects compared with control subjects. Serum vitamin A, C, E, Zinc and Selenium and the activities of GPx, SOD and CAT showed significant (P<0.05) decrease among DM and DR subjects compared with the control. Gene expression analysis of supreoxide dismutase 1 (SOD1), catalase 1 (CAT1) and glutathione peroxidase 1 (GPx1) revealed up regulation in DM and down regulation in the DR subjects. Conclusion: The results indicated that DM and DR subjects are associated with increased oxidative stress that is associated with decrease activities of antioxidant enzymes and low levels of antioxidants vitamins and minerals.

  79. Dr. Alex Yaw Adom, Christina Ayitey and Lydia Boateng

    The purpose of the study was to explore the effects of non-monetary incentives on employee performance. The specific objectives of the study were to:identify the various types of non-monetary incentives; find the determinants of employee performance; identify the challenges of non-monetary incentives; and find the effects of non-monetary incentives on employee performance. This was a case study approach was adopted in which purposive and simple random sampling technique was used to select 63 respondents from Zenith bank and Agricultural Development Bank (ADB) in Sunyani municipality. Questionnaire was the instrument for data collection. Data analysis was done using Statistical Package for Social Sciences (SPSS).The results showed that non-monetary incentives have a strong significant positive relationship on employee performance at Zenith bank while the relationship is moderate positive at ADB. The total variation in employee performance at Zenith bank explained by the linear relationship between non-monetary incentives and employee performance was 35.64% while it was 14.3% at ADB. What determined these performances were ability and motivation, declarative knowledge, procedural knowledge, motivation to work, achievement of set goals, staff competence, and set standards. The types of non-monetary incentives discovered were job security, good working condition, participation in goal setting, achievement, staff recognition, job enlargement, incentives that address social needs, improved working conditions, and fringe benefits. However, training and career path-related incentives as well as drive to exercise power is peculiar to Zenith bank and not ADB. This could explain why the employees at Zenith bank perform better than ADB since there is room for initiative and development. Nonetheless, short-term impact, entitlements, wrong things for rewards, delay which discounts any reward, inflexibility of reward systems and demotivators were the identified challenges. Based on the findings of the study, the researcher recommends among things that: rewards should be given to deserved staff as soon as possible since delay discount the reward in both banks. Management of both banks should engage employees in the kind of reward to be given. This will eliminate wrong things for reward. For future research, the study should cover the effects of monetary and non-monetary reward on employee performance in more than two organisations. Again, further studies should look at employee’s perception of monetary and non-monetary reward on their job satisfaction.

  80. Tsedale Tessema

    The aim of this article is to analyze the findings of the major factors that lead college students to ineffective academic writing skills based on reports of research journals from local and international universities.

  81. Dr. Santosh Kumar Sahu, Dr. Nilesh V. Chougule, Dr. Umakant N. Rabb and Dr. Abhishek Jain

    Shalakya Tantra is one of the Eight specialties of Astang Ayurveda which deals with diseases occur above the clavicle specially related to the sensory organs. In this the eye is an important sense organ for vision and it is responsible for social and intellectual development of human being. In Ayurvedic classical texts various types of eye diseases are described. Ex: Sandhigata Rogas, Varthamagata Rogas, Shuktagata Rogas, Krishnagata Rogas, Sarvagata Rogas, and Bhaya Netra Rogas. Among them Shuklagata Rogas are the diseases which occur in conjunctiva. Ayurveda classics prescribed several preventive and curative measures for the management of ophthalmic diseases called “Netra Kriya Kalpa”. Netra Kriya Kalpa is unique, effective and topical application to the eye diseases. Anjana is a one them. According to its form the Anjana is of three type i.e. Gutika, Rasakriya and Churn Anjana. These three types of Anjana can be co related with ophthalmic suspensions and eye drops.

  82. Nath Ranjit Kumar, Kamal Athar and Pandit Neeraj

    Cardiac resynchronization therapy (CRT) is one of the established treatment modalities for systolic heart failure with wide QRS morphology on electrocardiogram (ECG). It acts by synchronized pacing of left and right ventricles in order to coordinate systolic contraction of the left ventricular septum and the free wall. Predicting proper responders to the CRT still remains elusive. Post-implantation 12-lead ECG showing a tall R wave in lead V1 of ≥4 mm and predominant negative deflection (S wave) in lead I (RV1SI pattern) has been postulated as a marker of optimal resynchronization after CRT. We investigated whether presence of this ECG pattern predicts better response and improvement in heart failure outcomes at 6 months after CRT device implantation and found to be very much helpful. Method: Post-implant 12-lead ECG of 75 patients were reviewed and divided into two groups based on the positive RV1SI (Group I) or negative RV1SI (Group II) pattern on ECG. At six months, follow-up response rate was assessed on the basis of echocardiographic parameters of Left Ventricular End Systolic Volume (LVESV) & Left Ventricular Ejection Fraction (LVEF), and functional assessments {(Packer’s Clinical Composite Score, 6-minutes walk test (6MWT) and Minnesota living with heart failure questionnaire (MLWHF)} compared to baseline (pre-implant) values. Result: Evaluation of the post-CRT ECG of 75 patients revealed 29 (38.66%) in Group I and 46 (61.33%) in Group II. It was found that patients in Group I showed better response to CRT in comparison to Group II with respect to improvement in echocardiographic parameters (LVESV reduction of 25.69% vs. 21.81% and EF improvement of 40.29% vs. 33.44%) and functional assessment parameters (6MWT improvement 374.6 meters vs. 218.06 meters, MLWHF improvement 3.85 vs. 1.22 and clinical composite score (New York Heart Association functional class improvement from class IV to II 75% vs. 50% and heart failure related hospitalization after CRT implantation of 3.45% vs. 21.74%). Conclusion: Patients with a positive RV1SI pattern in post-implant 12-lead ECG showed better response with CRT at six months. This simple tool can be used to predict clinical improvement after therapy and accordingly proper positioning of the LV lead or programming the lead-vectors to get such ECG pattern may yield proper CRT response.

  83. Rania Reda Afifi and Moustafa Nabil Aboushelib

    Objectives: Resin adhesives could be used as a carrier of nano-hyrdoxy apatite particles added to treat early enamel caries. The aim of this study was to evaluate micro tensile bond strength of a remineralizing enamel infiltrant to early carious enamel lesion. Methods: An artificial caries model was used to induce early partially-cavitated enamel caries-like lesion in maxillay centrals. Nano hydroxyapatite particles (nHA) were applied in two forms to a low shrinkage low viscosity resin adhesive (TTEMA/TEGDMA): particles were directly added to resin adhesive or silanated before addition. Unmodified adhesive was used as control. Micro-tensile bond strength (MTBS) was performed to evaluate bond strength to demineralized enamel after application of the remineralizing resin adhesive (n=20, α=0.05). Scanning electron microscopy (SEM) was performed to assess mode of failure and to study infiltrant-enamel interface. Results: Direct addition of nano-particles resulted in significant reduction (F=32, P<0.001) in MTBS (19 MPa ± 3.8) compared to addition of silanated particles (24 MPa ± 3.2) which presented comparable values to the unmodified enamel infiltrant (26 MPa ± 4.1). SEM image analysis revealed adhesive failure observed for directly added particles while the other two groups demonstrated cohesive failure observed in the resin adhesive. On the other hand, direct addition of nHA resulted in partial remineralization of enamel (42% recovery in calcium content). Conclusion: TTEMA/TEGDMA enamel infiltrant could be used as a carrier for nano hydroxyapatite particles without compromising bond strength to early carious enamel lesions.

  84. Dr. Darsana Krishnan, Dr. K. Korath Abraham, Dr. Ektah Khosla, Dr. Arun Roy James and Dr. Elza Thenumkal

    Background: Resin based composite materials are widely used for aesthetically restoring primary teeth. Fundamental mechanism for resin - enamel adhesion relies on resin - micro tag formation. This is achieved by acid etching, where the smooth enamel surface is transformed into an irregular surface with increased surface energy. Primary enamel has increased organic content than permanent teeth which stand as a barrier in the way for achieving generalised retentive surface over the entire acid treated surface. Deproteinization of enamel is proposed as a non- invasive way by which organic protein content of enamel can be removed. 5.25 % sodium hypochlorite has been used as an endodontic irrigant due to excellent protein denaturing action, which might also be effective in removing organic content of primary enamel structure. Objectives: To evaluate and compare the effect of sodium hypochlorite conditioning on the surface micro morphological features of acid etched primary enamel. Methods: Buccal enamel surface of 10 extracted human primary molars were cut and into trimmed to forty 2 mm2 blocks. Each group comprises of 10 enamel blocks (1mm2 size). Group 1: No treatment group Group 2: Enamel surface etched with 37 % H3PO4 for 15 sec, washed and dried for 10sec Group 3: Enamel surface pre-treated with 5.25% NaOCl solution for 120 seconds, washed, dried and etched as for Group1. Group 4: Enamel surface pre-treated with 5.25% NaOCl gel for 120 seconds, washed, dried and etched as for Group1. Samples subjected to SEM analysis and 5 microphotograhs of each sample were obtained at 500x magnification and evaluated for quality of etching pattern of enamel in percentage using Auto –CAD 2014 software. Statistical analysis used: Anova Result: The mean value of acid etching pattern was similar between Group 2 and Group 3( p = 0.78), but the mean value of acid etching was significantly lower in the Group 4 (p=0.04) than in the control group. Conclusion: Acid etching with 37% phosphoric acid for 15 seconds still remains the best method of pretreatment in primary enamel. There is no significant effect of deproteinization with 5.25% NaOCl on acid etched enamel surface.

  85. Sharmada B.K., Amtul Salma, Hemanth, M., Karthik Kabbur, Goutham, K., Darsan J.P., Fatima Khalidij and Suchitra, M.P.

    Objective: The aim is to determine the perception of pain and discomfort by the patient during the placement of orthodontic separators. Methods: Elastomeric separators were placed mesially and distally to the first molars in 200 orthodontic patients, and the participants were given self administrated questionnaires to document perceived pain, type of pain felt, pain upon chewing, and the severity of pain's affecting daily life, using a visual analog scale for three days. Results: The mean perceived pain scores out of 100 on the first 3 days were:49.00±27.7 88.00±30.7 and 25.12±14.3 respectively; chewing pain scores were: 49.25± 33.49 ,78.80 ± 44.2, 31.21± 20.01,respectively; the pain's affecting daily life scores were16.7 ± 26.7,28.1± 38.7, 14.6±12.1, respectively. A Kruskal–Wallis test showed a statistically significant difference in the reported pain between the studied parameters. Conclusion: 51.7% of population reported pain after separator placement.88% of patients reported the maximum intensity of pain one day after separator placement. Intensity of pain reduced two days after separator placement.56.12% of patients had to change their food consistency.

  86. Sumit Rajewar, Arunkumar Sajjanar, Sadanand Kulkarni and Milind Wasnik

    Aim: This study was conducted to assess and compare the oral health status and treatment need of hearing and speech impaired children and normal children. Materials and Methods: A cross-sectional descriptive survey was conducted among 250 children with ages ranging from 6 to 13 years. Out of that 125 children’s had hearing and speech impairment and 125 children were normal with no disabilities. Data were collected using a standard method recommended by WHO for the oral health survey in 1977. Oral health status was assessed using OHI-S, Loe and Sinless Gingival index, Silness and Loe plaque index, DMFT and def Index for dental caries and dental malocclusion using Dental aesthetic index(DAI). Statistical analysis was performed with chisquare test and student’s unpaired t test using the SPSS software package (version 22.2). Results: The mean Plaque Index was found to be 0.85 for normal children and 1.53 for Deaf and Dumb Children. Mean Oral Hygiene Index was found to be 1.39 for normal children and 2.36 for Deaf and Dumb Children. Mean Gingival Index was found to be 0.85 for normal children and 1.52 for Deaf and Dumb Children. p-value for Dental Caries Index was found to be p=0.0004. Mean Dental Aesthetic Index score was found to be 22.92 for normal children and 28.24 for Deaf and Dumb Children. Conclusion: These findings suggest that children with hearing disabilities can also have good oral hygiene comparable to normal individuals of the same age group. These results may be attributed to the fact that the study sample was taken from a single school of a private organization with a well-equipped dental setup.

  87. Lehulu Tilahun and Habtamu kassa

    Objective: To assess Burden of road traffic accident among victims admitted to Dessie Referral hospita at Dessie town, South Wollo Zone, Ethiopia 2018 G.C. Results: A total of 306 injury victim medical records were considered and of which 270 were actually included in this study. Of which 51(18.9%) were due to road traffic accidents. The male to female ratio was 2:1. The highest number 177(66%) of victims who came to facilities were between 25-40 years of age. Concerning the place where the accidents happened, major accidents 258(95.6%) was occurred on the streets. Out of the total road traffic injury, most of them were passengers 190(70.4%).

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Dr. Mustafa Y. G. Younis
Libiya
Dr. Muhammad shoaib Ahmedani
Saudi Arabia
DR. MUHAMMAD ISMAIL MOHMAND
United State
DR. MAHESH SHIVAJI CHAVAN
India
DR. M. ARUNA
India
Dr. Lim Gee Nee
Malaysia
Dr. Jatinder Pal Singh Chawla
India
DR. IRAM BOKHARI
Pakistan
Dr. FARHAT NAZ RAHMAN
Pakistan
Dr. Devendra kumar Gupta
India
Dr. ASHWANI KUMAR DUBEY
India
Dr. Ali Seidi
Iran
Dr. Achmad Choerudin
Indonesia
Dr Ashok Kumar Verma
India
Thi Mong Diep NGUYEN
France
Dr. Muhammad Akram
Pakistan
Dr. Imran Azad
Oman
Dr. Meenakshi Malik
India
Aseel Hadi Hamzah
Iraq
Anam Bhatti
Malaysia
Md. Amir Hossain
Bangladesh
Ahmet İPEKÇİ
Turkey
Mirzadi Gohari
Iran